ST. MARY'S HOSPITAL DECATUR - 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 HSHS , AETNA MEDICARE , AMISH COMMUNITY DISCOUNT , BC EXCHANGE , BC MEDICARE , BCBS OF ILLINOIS PPO , BLUE CROSS BLUE SHEILD OF ILLINOIS DUAL , BLUE CROSS BLUE SHIELD  IL HMO , BLUE CROSS BLUE SHIELD IPA IL , BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV , BLUE CROSS SIHCA , CELTIC INSURANCE COMPANY , CHOICE CARE , CIGNA , CIGNA BEHAVIORAL HEALTH , CLAIM DOC , CLEAR SPRING HEALTH MEDICARE ADV , CONSOCIATE GROUP , COVENTRY MEDICARE ADVENTRA , CURRENT HEALTH SOLUTIONS ," ESSENCE, L.L.P. ", FIRST HEALTH NETWORK , HEALTH ALLIANCE KINGERY , HEALTH ALLIANCE MEDICAL PLAN EXCHANGE ," HEALTH ALLIANCE MEDICAL PLANS, INC. ", HEALTH ALLIANCE MEDICARE , HEALTH ALLIANCE PPO , HEALTHLINK , HEALTHLINK PPO , HFN , HOPETRUST , HUMANA , HUMANA MEDICARE , ILLINOIS BREAST AND CERVICAL CANCER PROGRAM , LIVE360 HSHS HEALTHY PLAN , LIVE360 MEDICARE COST PLAN , LIVE360 NON HSHS HEALTHY PLAN , MAGELLAN BEHAVIORAL HEALTH , MERIDIAN HMO MCD , MOLINA MEDICAID , MOLINA MEDICARE , MULTIPLAN , PHYSICIANS HEALTH ASSOCIATION OF IL BCBS HMO , PLAIN CHURCH MEDICAL GROUP , PROVIDER NETWORK OF AMERICA , UHC CATERPILLAR , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , WELLFIRST 
ST. MARY'S HOSPITAL - DECATUR,N/A,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,120,1 ,"$60,517.70 ","$39,336.51 ","$2,402.55 ","$156,898.30 ","$156,898.30 ","$60,517.70 ","$33,284.74 ","$61,504.13 ","$16,944.96 ","$60,517.70 ","$61,504.13 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$60,517.70 ","$59,307.35 ","$60,517.70 ","$59,307.35 ","$30,258.85 ","$60,517.70 ","$13,125.00 ","$60,517.70 ","$62,119.17 ","$42,362.39 ","$61,504.13 ","$30,258.85 ","$61,504.13 ","$45,388.28 ","$60,517.70 ","$60,517.70 ","$60,517.70 ","$61,504.13 ","$60,517.70 ","$60,517.70 ","$60,517.70 ","$51,440.05 ","$60,517.70 ","$41,938.77 ","$61,504.13 ", N/A ,"$33,284.74 ","$61,504.13 ","$15,916.16 ","$11,925.00 ","$2,516.95 ","$2,402.55 ","$64,579.34 ","$39,336.51 ","$60,517.70 ","$16,944.96 ","$54,465.93 ","$60,517.70 ","$60,517.70 ","$61,504.13 ","$29,048.50 "
ST. MARY'S HOSPITAL - DECATUR,N/A,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,120,1 ,"$15,305.70 ","$9,948.71 ","$1,590.00 ","$40,205.10 ","$40,205.10 ","$15,305.70 ","$8,418.14 ","$16,082.04 ","$4,285.60 ","$15,305.70 ","$16,082.04 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$10,713.99 ","$15,305.70 ","$1,750.00 ","$15,305.70 ","$16,242.86 ","$2,034.00 ","$16,082.04 ","$7,652.85 ","$16,082.04 ","$11,479.28 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$16,082.04 ","$15,305.70 ","$15,305.70 ","$15,305.70 ","$13,009.85 ","$15,305.70 ","$10,606.85 ","$16,082.04 ", N/A ,"$8,418.14 ","$16,082.04 ","$4,025.40 ","$1,590.00 ","$2,516.95 ","$2,402.55 ","$16,886.14 ","$9,948.71 ","$15,305.70 ","$4,285.60 ","$13,775.13 ","$15,305.70 ","$15,305.70 ","$16,082.04 ","$7,346.74 "
ST. MARY'S HOSPITAL - DECATUR,N/A,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,120,1 ,"$11,455.16 ","$7,445.85 ","$1,590.00 ","$30,267.90 ","$30,267.90 ","$11,455.16 ","$6,300.34 ","$12,107.16 ","$3,207.44 ","$11,455.16 ","$12,107.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$8,018.61 ","$11,455.16 ","$1,750.00 ","$11,455.16 ","$12,228.23 ","$8,018.61 ","$12,107.16 ","$5,727.58 ","$12,107.16 ","$8,591.37 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$12,107.16 ","$11,455.16 ","$11,455.16 ","$11,455.16 ","$9,736.89 ","$11,455.16 ","$7,938.43 ","$12,107.16 ", N/A ,"$6,300.34 ","$12,107.16 ","$3,012.71 ","$1,590.00 ","$2,516.95 ","$2,402.55 ","$12,712.52 ","$7,445.85 ","$11,455.16 ","$3,207.44 ","$10,309.64 ","$11,455.16 ","$11,455.16 ","$12,107.16 ","$5,498.48 "
ST. MARY'S HOSPITAL - DECATUR,N/A,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,120,1 ,"$23,694.57 ","$15,401.47 ","$2,385.00 ","$61,857.80 ","$61,857.80 ","$23,694.57 ","$13,032.01 ","$24,248.26 ","$6,634.48 ","$23,694.57 ","$24,248.26 ","$23,694.57 ","$23,220.68 ","$23,694.57 ","$23,694.57 ","$23,220.68 ","$23,694.57 ","$23,220.68 ","$16,586.20 ","$23,694.57 ","$2,625.00 ","$23,694.57 ","$24,490.74 ","$3,051.00 ","$24,248.26 ","$11,847.29 ","$24,248.26 ","$17,770.93 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$24,248.26 ","$23,694.57 ","$23,694.57 ","$23,694.57 ","$20,140.38 ","$23,694.57 ","$16,420.34 ","$24,248.26 ", N/A ,"$13,032.01 ","$24,248.26 ","$6,231.67 ","$2,385.00 ","$2,516.95 ","$2,402.55 ","$25,460.67 ","$15,401.47 ","$23,694.57 ","$6,634.48 ","$21,325.11 ","$23,694.57 ","$23,694.57 ","$24,248.26 ","$11,373.39 "
ST. MARY'S HOSPITAL - DECATUR,N/A,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,120,1 ,"$6,828.61 ","$4,438.60 ","$1,590.00 ","$18,326.70 ","$18,326.70 ","$6,828.61 ","$3,755.74 ","$7,330.68 ","$1,912.01 ","$6,828.61 ","$7,330.68 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$4,780.03 ","$6,828.61 ","$1,750.00 ","$6,828.61 ","$7,403.99 ","$2,034.00 ","$7,330.68 ","$3,414.31 ","$7,330.68 ","$5,121.46 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$7,330.68 ","$6,828.61 ","$6,828.61 ","$6,828.61 ","$5,804.32 ","$6,828.61 ","$4,732.23 ","$7,330.68 ", N/A ,"$3,755.74 ","$7,330.68 ","$1,795.92 ","$1,590.00 ","$2,516.95 ","$2,402.55 ","$7,697.21 ","$4,438.60 ","$6,828.61 ","$1,912.01 ","$6,145.75 ","$6,828.61 ","$6,828.61 ","$7,330.68 ","$3,277.73 "
ST. MARY'S HOSPITAL - DECATUR,12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,$844.00 ,$548.60 ,$221.97 ,$844.00 , Inpatient Medicare +150% ,"$1,320.00 ",$464.20 , Inpatient Medicare ,$236.32 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$590.80 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,017.00 ", Inpatient Medicare ,$422.00 , Inpatient Medicare ,$633.00 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ",$717.40 , Inpatient Medicare +150% ,$584.89 , Inpatient Medicare , N/A ,$464.20 , Inpatient Medicare ,$221.97 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$548.60 ,"$10,935.25 ",$236.32 ,$759.60 ,"$8,081.00 ","$6,700.00 ", Inpatient Medicare ,$405.12 
ST. MARY'S HOSPITAL - DECATUR,12000004,N/A,HC DAILY ORGAN DONOR,120,1 ,$844.00 ,$548.60 ,$221.97 ,$844.00 , Inpatient Medicare +150% ,"$1,320.00 ",$464.20 , Inpatient Medicare ,$236.32 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$590.80 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,017.00 ", Inpatient Medicare ,$422.00 , Inpatient Medicare ,$633.00 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ",$717.40 , Inpatient Medicare +150% ,$584.89 , Inpatient Medicare , N/A ,$464.20 , Inpatient Medicare ,$221.97 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$584.60 ,"$10,935.25 ",$236.32 ,$759.60 ,"$8,081.00 ","$6,700.00 ", Inpatient Medicare ,$405.12 
ST. MARY'S HOSPITAL - DECATUR,12200001,N/A,HC DAILY SERVICE OBSTETRICS,122,1 ,$844.00 ,$548.60 ,$221.97 ,$844.00 , Inpatient Medicare +150% ,"$1,320.00 ",$464.20 , Inpatient Medicare ,$236.32 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$590.80 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,017.00 ", Inpatient Medicare ,$422.00 , Inpatient Medicare ,$633.00 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ",$717.40 , Inpatient Medicare +150% ,$584.89 , Inpatient Medicare , N/A ,$464.20 , Inpatient Medicare ,$221.97 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$584.60 ,"$10,935.25 ",$236.32 ,$759.60 ,"$8,081.00 ","$6,700.00 ", Inpatient Medicare ,$405.12 
ST. MARY'S HOSPITAL - DECATUR,12300001,N/A,HC DAILY PEDIATRIC,123,1 ,$844.00 ,$548.60 ,$221.97 ,$844.00 , Inpatient Medicare +150% ,"$1,320.00 ",$464.20 , Inpatient Medicare ,$236.32 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$590.80 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,017.00 ", Inpatient Medicare ,$422.00 , Inpatient Medicare ,$633.00 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ",$717.40 , Inpatient Medicare +150% ,$584.89 , Inpatient Medicare , N/A ,$464.20 , Inpatient Medicare ,$221.97 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$584.60 ,"$10,935.25 ",$236.32 ,$759.60 ,"$8,081.00 ","$6,700.00 ", Inpatient Medicare ,$405.12 
ST. MARY'S HOSPITAL - DECATUR,12400001,N/A,HC DAILY SERVICE PSYCH,124,1 ,"$1,228.00 ",$798.20 ,$322.96 ,"$1,228.00 ", Inpatient Medicare +150% ,"$1,320.00 ",$675.40 , Inpatient Medicare ,$343.84 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$798.20 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,105.20 ", Inpatient Medicare ,$614.00 , Inpatient Medicare ,$921.00 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ","$1,043.80 ", Inpatient Medicare +150% ,$798.20 , Inpatient Medicare , N/A ,$675.40 , Inpatient Medicare ,$322.96 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$798.20 ,"$10,935.25 ",$343.84 ,"$1,105.20 ","$1,110.00 ","$6,700.00 ", Inpatient Medicare ,$589.44 
ST. MARY'S HOSPITAL - DECATUR,12400004,N/A,HC DAILY PSYCH GERIATRIC,124,1 ,"$1,142.00 ",$742.30 ,$300.35 ,"$1,142.00 ", Inpatient Medicare +150% ,"$1,320.00 ",$628.10 , Inpatient Medicare ,$319.76 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$742.30 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,027.80 ", Inpatient Medicare ,$571.00 , Inpatient Medicare ,$856.50 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ",$970.70 , Inpatient Medicare +150% ,$742.30 , Inpatient Medicare , N/A ,$628.10 , Inpatient Medicare ,$300.35 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$742.30 ,"$10,935.25 ",$319.76 ,"$1,027.80 ","$1,110.00 ","$6,700.00 ", Inpatient Medicare ,$548.16 
,12500001,N/A,HC DAILY HOSPICE ACUTE CARE,125,1 ,$622.00 ,$404.30 ,$163.59 ,$622.00 , Inpatient Medicare +150% ,"$1,320.00 ",$342.10 , Inpatient Medicare ,$174.16 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$435.40 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,017.00 ", Inpatient Medicare ,$311.00 , Inpatient Medicare ,$466.50 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ",$801.00 ,$801.00 ,$528.70 , Inpatient Medicare +150% ,$431.05 , Inpatient Medicare , N/A ,$342.10 , Inpatient Medicare ,$163.59 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$404.30 ,"$10,935.25 ",$174.16 ,$559.80 ,"$8,081.00 ","$1,000.00 ", Inpatient Medicare ,$298.56 
ST. MARY'S HOSPITAL - DECATUR,12800001,N/A,HC DAILY REHAB SERVICE,128,1 ,"$1,863.00 ","$1,210.95 ",$489.97 ,"$1,863.00 ", Inpatient Medicare +150% ,"$1,950.00 ","$1,024.65 ", Inpatient Medicare ,$521.64 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,"$1,304.10 ","$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,017.00 ", Inpatient Medicare ,$931.50 , Inpatient Medicare ,"$1,397.25 ","$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ","$1,583.55 ", Inpatient Medicare +150% ,"$1,291.06 ", Inpatient Medicare , N/A ,"$1,024.65 ", Inpatient Medicare ,$489.97 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,210.95 ","$10,935.25 ",$521.64 ,"$1,676.70 ","$1,142.00 ","$1,150.00 ", Inpatient Medicare ,$894.24 
ST. MARY'S HOSPITAL - DECATUR,17100001,N/A,HC DAILY INFANT SERVICE LEV 1,171,1 ,$713.00 ,$463.45 ,$187.52 ,$713.00 , Inpatient Medicare +150% ,"$1,320.00 ",$392.15 , Inpatient Medicare ,$199.64 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$499.10 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$448.00 , Inpatient Medicare ,$356.50 , Inpatient Medicare ,$534.75 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ",$777.00 ,$777.00 ,$606.05 , Inpatient Medicare +150% ,$494.11 , Inpatient Medicare , N/A ,$392.15 , Inpatient Medicare ,$187.52 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$463.45 ,"$10,935.25 ",$199.64 ,$641.70 ,"$8,081.00 ",$600.00 , Inpatient Medicare ,$342.24 
ST. MARY'S HOSPITAL - DECATUR,17200002,N/A,HC DAILY INFANT SERVICE LEV 2,172,1 ,$838.00 ,$544.70 ,$220.39 ,$838.00 , Inpatient Medicare +150% ,"$1,320.00 ",$460.90 , Inpatient Medicare ,$234.64 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,$586.60 ,"$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,$966.00 , Inpatient Medicare ,$419.00 , Inpatient Medicare ,$628.50 ,"$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ",$777.00 ,$777.00 ,$712.30 , Inpatient Medicare +150% ,$580.73 , Inpatient Medicare , N/A ,$460.90 , Inpatient Medicare ,$220.39 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,$544.70 ,"$10,935.25 ",$234.64 ,$754.20 ,"$8,081.00 ",$850.00 , Inpatient Medicare ,$402.24 
ST. MARY'S HOSPITAL - DECATUR,20000001,N/A,HC DAILY SERVICE ICU,200,1 ,"$2,339.00 ","$1,520.35 ",$615.16 ,"$2,339.00 ", Inpatient Medicare +150% ,"$1,320.00 ","$1,286.45 ", Inpatient Medicare ,$654.92 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,"$1,637.30 ","$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,867.00 ", Inpatient Medicare ,"$1,169.50 ", Inpatient Medicare ,"$1,754.25 ","$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ","$1,988.15 ", Inpatient Medicare +150% ,"$1,620.93 ", Inpatient Medicare , N/A ,"$1,286.45 ", Inpatient Medicare ,$615.16 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,520.35 ","$10,935.25 ",$654.92 ,"$2,105.10 ","$8,081.00 ","$6,700.00 ", Inpatient Medicare ,"$1,122.72 "
ST. MARY'S HOSPITAL - DECATUR,20300001,N/A,HC DAILY PEDIATRIC IMC,203,1 ,"$1,757.00 ","$1,142.05 ",$462.09 ,"$1,757.00 ", Inpatient Medicare +150% ,"$1,320.00 ",$966.35 , Inpatient Medicare ,$491.96 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,"$1,229.90 ","$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,867.00 ", Inpatient Medicare ,$878.50 , Inpatient Medicare ,"$1,317.75 ","$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ","$1,493.45 ", Inpatient Medicare +150% ,"$1,217.60 ", Inpatient Medicare , N/A ,$966.35 , Inpatient Medicare ,$462.09 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,142.05 ","$10,935.25 ",$491.96 ,"$1,581.30 ","$8,081.00 ","$6,700.00 ", Inpatient Medicare ,$843.36 
ST. MARY'S HOSPITAL - DECATUR,20600002,N/A,HC DAILY SERVICE IMCU,206,1 ,"$1,757.00 ","$1,142.05 ",$462.09 ,"$1,757.00 ", Inpatient Medicare +150% ,"$1,320.00 ",$966.35 , Inpatient Medicare ,$491.96 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,"$1,229.90 ","$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,867.00 ", Inpatient Medicare ,$878.50 , Inpatient Medicare ,"$1,317.75 ","$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ","$1,493.45 ", Inpatient Medicare +150% ,"$1,217.60 ", Inpatient Medicare , N/A ,$966.35 , Inpatient Medicare ,$462.09 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,142.05 ","$10,935.25 ",$491.96 ,"$1,581.30 ","$8,081.00 ","$6,700.00 ", Inpatient Medicare ,$843.36 
ST. MARY'S HOSPITAL - DECATUR,21000002,N/A,HC DAILY CARDIAC CARE,210,1 ,"$1,757.00 ","$1,142.05 ",$462.09 ,"$1,757.00 ", Inpatient Medicare +150% ,"$1,320.00 ",$966.35 , Inpatient Medicare ,$491.96 ,"$9,846.99 ", Inpatient Medicare ,"$11,317.73 ", Inpatient Medicare ,"$10,935.25 ","$10,935.25 ", Inpatient Medicare ,"$10,935.25 ", Inpatient Medicare +90% ,"$1,229.90 ","$10,845.00 ",$875.00 , Inpatient Medicare +150% , Inpatient Medicare +1% ,"$1,867.00 ", Inpatient Medicare ,$878.50 , Inpatient Medicare ,"$1,317.75 ","$8,514.00 ","$7,661.00 ","$8,514.00 ", Inpatient Medicare ,"$8,514.00 ","$11,152.00 ","$11,152.00 ","$1,493.45 ", Inpatient Medicare +150% ,"$1,217.60 ", Inpatient Medicare , N/A ,$966.35 , Inpatient Medicare ,$462.09 ,$795.00 , Inpatient Medicaid +10% , Inpatient Medicaid +5% , Inpatient Medicare +5% ,"$1,142.05 ","$10,935.25 ",$491.96 ,"$1,581.30 ","$8,081.00 ","$6,700.00 ", Inpatient Medicare ,$843.36 
ST. MARY'S HOSPITAL - DECATUR,23100003,N/A,HC ADVANCED NURSING CARE,231,1 ,$232.00 ,$150.80 ,$61.02 ,$232.00 , N/A ,$118.32 ,$127.60 , N/A ,$64.96 ,$109.04 , N/A ,$125.28 , N/A ,$125.98 ,$125.98 , N/A ,$125.98 , N/A ,$162.40 ,$116.00 ,$185.60 , N/A , N/A ,$162.40 , N/A ,$139.20 , N/A ,$174.00 ,$128.06 ,$115.54 ,$128.06 , N/A ,$128.06 ,$180.96 ,$180.96 ,$197.20 , N/A ,$160.78 , N/A ,$232.00 ,$127.60 , N/A ,$61.02 ,$232.00 , N/A , N/A , N/A ,$185.60 ,$125.98 ,$64.96 ,$208.80 ,$88.16 ,$150.80 , N/A ,$111.36 
ST. MARY'S HOSPITAL - DECATUR,23100004,N/A,HC CARDIAC/RESPIRATORY MONITOR,231,1 ,$46.00 ,$29.90 ,$12.10 ,$46.00 , N/A ,$23.46 ,$25.30 , N/A ,$12.88 ,$21.62 , N/A ,$24.84 , N/A ,$24.98 ,$24.98 , N/A ,$24.98 , N/A ,$32.20 ,$23.00 ,$36.80 , N/A , N/A ,$32.20 , N/A ,$27.60 , N/A ,$34.50 ,$25.39 ,$22.91 ,$25.39 , N/A ,$25.39 ,$35.88 ,$35.88 ,$39.10 , N/A ,$31.88 , N/A ,$46.00 ,$25.30 , N/A ,$12.10 ,$46.00 , N/A , N/A , N/A ,$36.80 ,$24.98 ,$12.88 ,$41.40 ,$17.48 ,$29.90 , N/A ,$22.08 
ST. MARY'S HOSPITAL - DECATUR,26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$526.00 ,$341.90 ,$65.19 ,$526.00 ,$484.13 ,$268.26 ,$289.30 ,$193.65 ,$147.28 ,$257.74 ,$193.65 ,$307.71 ,$193.65 ,$285.62 ,$65.19 ,$193.65 ,$285.62 ,$367.93 ,$368.20 ,$263.00 ,$420.80 ,$484.12 ,$193.65 ,$368.20 ,$193.65 ,$315.60 ,$193.65 ,$394.50 ,$290.35 ,$261.95 ,$290.35 ,$193.65 ,$290.35 ,$410.28 ,$410.28 ,$447.10 ,$484.12 ,$364.52 ,$193.65 ,$526.00 ,$289.30 ,$193.65 ,$138.34 ,$526.00 ,$218.85 ,$208.90 ,$203.33 ,$420.80 ,$285.62 ,$147.28 ,$473.40 ,$199.88 ,$286.14 ,$193.65 ,$252.48 
ST. MARY'S HOSPITAL - DECATUR,26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$265.00 ,$172.25 ,$23.36 ,$326.57 ,$94.70 ,$135.15 ,$145.75 ,$37.88 ,$74.20 ,$129.85 ,$37.88 ,$155.03 ,$37.88 ,$143.90 ,$23.36 ,$37.88 ,$143.90 ,$71.97 ,$185.50 ,$132.50 ,$212.00 ,$94.70 ,$37.88 ,$185.50 ,$37.88 ,$159.00 ,$37.88 ,$198.75 ,$146.28 ,$131.97 ,$146.28 ,$37.88 ,$146.28 ,$206.70 ,$206.70 ,$225.25 ,$94.70 ,$183.65 ,$37.88 ,$265.00 ,$145.75 ,$37.88 ,$69.70 ,$265.00 ,$265.00 ,$326.57 ,$39.77 ,$212.00 ,$143.90 ,$74.20 ,$238.50 ,$100.70 ,$144.16 ,$37.88 ,$127.20 
ST. MARY'S HOSPITAL - DECATUR,26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$794.00 ,$516.10 ,$100.13 ,$794.00 ,$484.13 ,$404.94 ,$436.70 ,$193.65 ,$222.32 ,$389.06 ,$193.65 ,$464.49 ,$193.65 ,$431.14 ,$100.13 ,$193.65 ,$431.14 ,$367.93 ,$555.80 ,$397.00 ,$635.20 ,$484.12 ,$193.65 ,$555.80 ,$193.65 ,$476.40 ,$193.65 ,$595.50 ,$438.29 ,$395.41 ,$438.29 ,$193.65 ,$438.29 ,$619.32 ,$619.32 ,$674.90 ,$484.12 ,$550.24 ,$193.65 ,$794.00 ,$436.70 ,$193.65 ,$208.82 ,$794.00 ,$218.85 ,$208.90 ,$203.33 ,$635.20 ,$431.14 ,$222.32 ,$714.60 ,$301.72 ,$431.94 ,$193.65 ,$381.12 
ST. MARY'S HOSPITAL - DECATUR,26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$510.00 ,$331.50 ,$30.71 ,$510.00 ,$94.70 ,$260.10 ,$280.50 ,$37.88 ,$142.80 ,$249.90 ,$37.88 ,$298.35 ,$37.88 ,$276.93 ,$30.71 ,$37.88 ,$276.93 ,$71.97 ,$357.00 ,$255.00 ,$408.00 ,$94.70 ,$37.88 ,$357.00 ,$37.88 ,$306.00 ,$37.88 ,$382.50 ,$281.52 ,$253.98 ,$281.52 ,$37.88 ,$281.52 ,$397.80 ,$397.80 ,$433.50 ,$94.70 ,$353.43 ,$37.88 ,$510.00 ,$280.50 ,$37.88 ,$134.13 ,$510.00 ,$342.12 ,$326.57 ,$39.77 ,$408.00 ,$276.93 ,$142.80 ,$459.00 ,$193.80 ,$277.44 ,$37.88 ,$244.80 
ST. MARY'S HOSPITAL - DECATUR,26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$107.00 ,$69.55 ,$28.14 ,$208.90 ,$146.73 ,$54.57 ,$58.85 ,$58.69 ,$29.96 ,$52.43 ,$58.69 ,$62.60 ,$58.69 ,$58.10 ,$44.08 ,$58.69 ,$58.10 ,$107.00 ,$74.90 ,$53.50 ,$85.60 ,$146.72 ,$58.69 ,$74.90 ,$58.69 ,$64.20 ,$58.69 ,$80.25 ,$59.06 ,$53.29 ,$59.06 ,$58.69 ,$59.06 ,$83.46 ,$83.46 ,$90.95 ,$107.00 ,$74.15 ,$58.69 ,$107.00 ,$58.85 ,$58.69 ,$28.14 ,$107.00 ,$107.00 ,$208.90 ,$61.62 ,$85.60 ,$58.10 ,$29.96 ,$96.30 ,$40.66 ,$58.21 ,$58.69 ,$51.36 
ST. MARY'S HOSPITAL - DECATUR,26000005,96368,HC INFUS CONCURRENT,260,1 ,$115.00 ,$74.75 ,$29.69 ,$208.90 , N/A ,$58.65 ,$63.25 , N/A ,$32.20 ,$56.35 , N/A ,$67.28 , N/A ,$62.45 ,$29.69 , N/A ,$62.45 , N/A ,$80.50 ,$57.50 ,$92.00 , N/A , N/A ,$80.50 , N/A ,$69.00 , N/A ,$86.25 ,$63.48 ,$57.27 ,$63.48 , N/A ,$63.48 ,$89.70 ,$89.70 ,$97.75 , N/A ,$79.70 , N/A ,$115.00 ,$63.25 , N/A ,$30.25 ,$115.00 ,$115.00 ,$208.90 , N/A ,$92.00 ,$62.45 ,$32.20 ,$103.50 ,$43.70 ,$62.56 , N/A ,$55.20 
ST. MARY'S HOSPITAL - DECATUR,26000006,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$526.00 ,$341.90 ,$65.19 ,$526.00 ,$484.13 ,$268.26 ,$289.30 ,$193.65 ,$147.28 ,$257.74 ,$193.65 ,$307.71 ,$193.65 ,$285.62 ,$65.19 ,$193.65 ,$285.62 ,$367.93 ,$368.20 ,$263.00 ,$420.80 ,$484.12 ,$193.65 ,$368.20 ,$193.65 ,$315.60 ,$193.65 ,$394.50 ,$290.35 ,$261.95 ,$290.35 ,$193.65 ,$290.35 ,$410.28 ,$410.28 ,$447.10 ,$484.12 ,$364.52 ,$193.65 ,$526.00 ,$289.30 ,$193.65 ,$138.34 ,$526.00 ,$218.85 ,$208.90 ,$203.33 ,$420.80 ,$285.62 ,$147.28 ,$473.40 ,$199.88 ,$286.14 ,$193.65 ,$252.48 
ST. MARY'S HOSPITAL - DECATUR,26000007,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$794.00 ,$516.10 ,$100.13 ,$794.00 ,$484.13 ,$404.94 ,$436.70 ,$193.65 ,$222.32 ,$389.06 ,$193.65 ,$464.49 ,$193.65 ,$431.14 ,$100.13 ,$193.65 ,$431.14 ,$367.93 ,$555.80 ,$397.00 ,$635.20 ,$484.12 ,$193.65 ,$555.80 ,$193.65 ,$476.40 ,$193.65 ,$595.50 ,$438.29 ,$395.41 ,$438.29 ,$193.65 ,$438.29 ,$619.32 ,$619.32 ,$674.90 ,$484.12 ,$550.24 ,$193.65 ,$794.00 ,$436.70 ,$193.65 ,$208.82 ,$794.00 ,$218.85 ,$208.90 ,$203.33 ,$635.20 ,$431.14 ,$222.32 ,$714.60 ,$301.72 ,$431.94 ,$193.65 ,$381.12 
ST. MARY'S HOSPITAL - DECATUR,26000008,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$418.00 ,$271.70 ,$23.53 ,$418.00 ,$94.70 ,$213.18 ,$229.90 ,$37.88 ,$117.04 ,$204.82 ,$37.88 ,$244.53 ,$37.88 ,$226.97 ,$23.53 ,$37.88 ,$226.97 ,$71.97 ,$292.60 ,$209.00 ,$334.40 ,$94.70 ,$37.88 ,$292.60 ,$37.88 ,$250.80 ,$37.88 ,$313.50 ,$230.74 ,$208.16 ,$230.74 ,$37.88 ,$230.74 ,$326.04 ,$326.04 ,$355.30 ,$94.70 ,$289.67 ,$37.88 ,$418.00 ,$229.90 ,$37.88 ,$109.93 ,$418.00 , N/A , N/A ,$39.77 ,$334.40 ,$226.97 ,$117.04 ,$376.20 ,$158.84 ,$227.39 ,$37.88 ,$200.64 
ST. MARY'S HOSPITAL - DECATUR,26000009,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$300.00 ,$195.00 ,$14.70 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$147.00 , N/A ,$175.50 , N/A ,$162.90 ,$14.70 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$163.20 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,26000014,M0239,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB",260,1 ,$867.00 ,$563.55 ,$228.02 ,$867.00 , N/A ,$442.17 ,$476.85 , N/A ,$242.76 ,$407.49 , N/A ,$468.18 , N/A ,$470.78 ,$346.80 , N/A ,$470.78 , N/A ,$606.90 ,$433.50 ,$693.60 , N/A , N/A ,$606.90 , N/A ,$520.20 , N/A ,$650.25 ,$478.58 ,$431.77 ,$478.58 , N/A ,$478.58 ,$676.26 ,$676.26 ,$736.95 , N/A ,$600.83 , N/A ,$867.00 ,$476.85 , N/A ,$228.02 ,$867.00 , N/A , N/A , N/A ,$693.60 ,$470.78 ,$242.76 ,$780.30 ,$329.46 ,$471.65 , N/A ,$416.16 
ST. MARY'S HOSPITAL - DECATUR,26000015,M0243,"HC INTRAVENOUS INFUSION, CASIRIVIMAB AND IMDEVIMAB ADMINISTRATION",260,1 ,$930.00 ,$604.50 ,$208.90 ,"$1,043.88 ","$1,043.88 ",$474.30 ,$511.50 ,$417.55 ,$260.40 ,$437.10 ,$417.55 ,$502.20 ,$417.55 ,$504.99 ,$372.00 ,$417.55 ,$504.99 ,$793.35 ,$651.00 ,$465.00 ,$744.00 ,"$1,043.88 ",$417.55 ,$651.00 ,$417.55 ,$558.00 ,$417.55 ,$697.50 ,$513.36 ,$463.14 ,$513.36 ,$417.55 ,$513.36 ,$725.40 ,$725.40 ,$790.50 ,$930.00 ,$644.49 ,$417.55 ,$930.00 ,$511.50 ,$417.55 ,$244.59 ,$930.00 ,$218.85 ,$208.90 ,$438.43 ,$744.00 ,$504.99 ,$260.40 ,$837.00 ,$353.40 ,$505.92 ,$417.55 ,$446.40 
ST. MARY'S HOSPITAL - DECATUR,26000016,M0245,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB AND ETESEVIMAB ADMINISTRATION",260,1 ,$933.00 ,$606.45 ,$208.90 ,"$1,043.88 ","$1,043.88 ",$475.83 ,$513.15 ,$417.55 ,$261.24 ,$438.51 ,$417.55 ,$503.82 ,$417.55 ,$506.62 ,$373.20 ,$417.55 ,$506.62 ,$793.35 ,$653.10 ,$466.50 ,$746.40 ,"$1,043.88 ",$417.55 ,$653.10 ,$417.55 ,$559.80 ,$417.55 ,$699.75 ,$515.02 ,$464.63 ,$515.02 ,$417.55 ,$515.02 ,$727.74 ,$727.74 ,$793.05 ,$933.00 ,$646.57 ,$417.55 ,$933.00 ,$513.15 ,$417.55 ,$245.38 ,$933.00 ,$218.85 ,$208.90 ,$438.43 ,$746.40 ,$506.62 ,$261.24 ,$839.70 ,$354.54 ,$507.55 ,$417.55 ,$447.84 
ST. MARY'S HOSPITAL - DECATUR,27000024,N/A,HC TRAY SPINAL ANESTHESIA,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27000045,N/A,HC BED SPECIALTY,270,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27000046,N/A,HC BRACE WRIST ARTERIAL,270,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27000050,N/A,HC DEVICE THERAPEP,270,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27000051,N/A,HC DIALYSATE BAG 5 LITERS,270,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27000052,N/A,HC KIT CPM MACHINE,270,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27000053,N/A,HC KIT ISOLATION SUPPLIES,270,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27000055,N/A,HC MASK ANESTHESIA,270,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27000056,N/A,HC MDI CHAMBER,270,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27000057,N/A,HC REHAB TREATMENT JOURNAL,270,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27000059,N/A,HC STRAP FETAL MONITOR,270,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27000060,N/A,HC WRAP GEL COLD PAK,270,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27000090,N/A,HC KIT REFILL PUMP SYNCHROMED,270,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27100080,N/A,HC LARYNGEAL MASK AIRWAY,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27100096,N/A,HC NASAL PHANYNGEAL AIRWAY,271,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27100105,N/A,HC OXYGEN CANNULA,271,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27100107,N/A,HC OXYGEN HOURLY,271,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27100114,N/A,HC PEAK FLOWMETER,271,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27100163,N/A,HC VENTILATOR CIRCUIT,271,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27100167,N/A,HC WARMING BLANKET DISPOSABLE,271,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27100188,N/A,HC SLING ARM,271,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27100193,L3260,HC SHOE POST OP,274,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A , N/A ,$11.00 , N/A ,$5.60 ,$9.80 , N/A ,$10.80 , N/A ,$10.86 ,$10.86 , N/A ,$10.86 , N/A ,$10.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$10.00 ,$10.00 ,$17.00 , N/A ,$9.90 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$9.92 , N/A , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27100204,N/A,HC CIRCUIT BREATHING,271,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27100215,N/A,HC RESTRAINT ANY TYPE,271,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27100219,N/A,HC SET IV MICRO PRIMARY,271,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27100223,N/A,HC SHELL/SHIELD BREAST,271,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27100235,N/A,HC MASK OXYGEN,271,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27100250,N/A,HC ADAPTER NASAL CO2,271,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27100251,N/A,HC BAG URINARY DRAIN,271,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27100253,N/A,HC BLOOD WARMER PRESSURIZED,271,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27100254,N/A,HC CUFF BLOOD PRESSURE,271,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27100256,N/A,HC ELECTRODE FETAL SCALP,271,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27100257,N/A,HC KIT INFANT RESUSCITATOR,271,1 ,$50.00 ,$32.50 ,$13.15 ,$50.00 , N/A ,$25.50 ,$27.50 , N/A ,$14.00 ,$23.50 , N/A ,$27.00 , N/A ,$27.15 ,$20.00 , N/A ,$27.15 , N/A ,$35.00 ,$25.00 ,$40.00 , N/A , N/A ,$35.00 , N/A ,$30.00 , N/A ,$37.50 ,$27.60 ,$24.90 ,$27.60 , N/A ,$27.60 ,$39.00 ,$39.00 ,$42.50 , N/A ,$34.65 , N/A ,$50.00 ,$27.50 , N/A ,$13.15 ,$50.00 , N/A , N/A , N/A ,$40.00 ,$27.15 ,$14.00 ,$45.00 ,$19.00 ,$32.50 , N/A ,$24.00 
ST. MARY'S HOSPITAL - DECATUR,27100258,N/A,HC KIT RT OXYGEN SUPPLY,271,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27100259,N/A,HC LINER SUCTION CANISTER,271,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27100262,N/A,HC PAD EGG CRATE,271,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27100263,N/A,HC POSITIONER HEAD,271,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27100264,N/A,HC PILLOW POSITIONING PRONE,271,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27100266,N/A,HC SLEEVE SCD THIGH,271,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27100267,N/A,HC SLEEVE SCD FOOT,271,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27100269,N/A,HC SUSPENSORY/SUPPORT SCROTAL,271,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27100519,N/A,HC SYSTEM MONITR NOVII PTCH,271,1 ,$87.00 ,$56.55 ,$22.88 ,$87.00 , N/A ,$44.37 ,$47.85 , N/A ,$24.36 ,$40.89 , N/A ,$46.98 , N/A ,$47.24 ,$34.80 , N/A ,$47.24 , N/A ,$60.90 ,$43.50 ,$69.60 , N/A , N/A ,$60.90 , N/A ,$52.20 , N/A ,$65.25 ,$48.02 ,$43.33 ,$48.02 , N/A ,$48.02 ,$67.86 ,$67.86 ,$73.95 , N/A ,$60.29 , N/A ,$87.00 ,$47.85 , N/A ,$22.88 ,$87.00 , N/A , N/A , N/A ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$56.55 , N/A ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,27200054,C1751,HC KIT CATHETER,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27200226,N/A,HC ADHESIVE DERMABOND,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27200297,N/A,HC BAG RESUSCITATION DISP,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27200357,N/A,HC BIS MONITOR STRIP,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27200543,N/A,HC BLOOD FILTER,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27200544,N/A,HC BLOOD TUBING,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27200546,N/A,HC BLOOD WARMER UNIT AND TUBING,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27200571,N/A,HC BREAST PUMP KIT,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27200798,N/A,HC CATH INTRODUCER,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27200832,N/A,HC CATH TRAY WITH FOLEY,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27200848,N/A,HC CATHETER - ARTERIAL SET,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27200849,N/A,HC CATHETER - FOLEY,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27200885,N/A,HC CELL SAVER RESERVOIR,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27201077,N/A,HC DIS INCENTIVE SPIROMETER,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27201148,N/A,HC DRESSING AQUACELL W/HYDROFIBER,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27201221,N/A,HC ENDO BRONCHIAL TUBE,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27201252,N/A,HC EPIDURAL TRAY,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27201271,N/A,HC EYE GUARDS POST-OP,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27201413,N/A,HC HI-LO EVAC ENDOTRACH TUBE,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27201596,N/A,HC LASER-FLEX ENDOTRACH TUB,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27201613,N/A,HC LINER DISP SUCTION,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27201713,N/A,HC NEEDLE SPINAL,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27201890,N/A,HC PREP CHLORAPREP 26ML,272,1 ,$50.00 ,$32.50 ,$13.15 ,$50.00 , N/A ,$25.50 ,$27.50 , N/A ,$14.00 ,$23.50 , N/A ,$27.00 , N/A ,$27.15 ,$20.00 , N/A ,$27.15 , N/A ,$35.00 ,$25.00 ,$40.00 , N/A , N/A ,$35.00 , N/A ,$30.00 , N/A ,$37.50 ,$27.60 ,$24.90 ,$27.60 , N/A ,$27.60 ,$39.00 ,$39.00 ,$42.50 , N/A ,$34.65 , N/A ,$50.00 ,$27.50 , N/A ,$13.15 ,$50.00 , N/A , N/A , N/A ,$40.00 ,$27.15 ,$14.00 ,$45.00 ,$19.00 ,$32.50 , N/A ,$24.00 
ST. MARY'S HOSPITAL - DECATUR,27201938,N/A,HC PULSE OXIMETER PROBE DISP,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27201950,N/A,HC RAE TUBE,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27201973,N/A,HC RETR ALEXIS LG,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27201974,N/A,HC RETR ALEXIS XL,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27202002,N/A,HC SCD SLEEVE KNEE,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27202033,N/A,HC SET IV SECONDARY,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27202120,N/A,HC STAPLER SKIN,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27202151,N/A,HC STOCKING TED KNEE HIGH,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27202152,N/A,HC STOCKING TED THIGH HIGH,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27202729,N/A,HC TRANSDUCER COVER,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27202885,N/A,HC TUBE NIM EMG ENDOTRACHEAL,272,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A ,$267.75 ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$210.00 , N/A ,$285.08 , N/A ,$367.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$409.50 ,$409.50 ,$446.25 , N/A ,$363.83 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$341.25 , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27203101,N/A,HC STOPCOCK,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203265,N/A,HC ELECTRODES,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203298,N/A,HC HEMOSTATIC PARTICLES,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27203511,N/A,HC BAG LEG URINARY,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203519,A6223,HC DRESSING XEROFORM,272,1 ,$10.00 ,$6.50 ,$2.23 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.90 , N/A ,$5.85 , N/A ,$5.43 ,$2.23 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203526,A6266,HC PACKING GAUZE IODOFORM,272,1 ,$10.00 ,$6.50 ,$1.77 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.90 , N/A ,$5.85 , N/A ,$5.43 ,$1.77 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203528,A6403,HC DRESSING KERLIX SPONGE >16  AND  <48 SQ CM,272,1 ,$20.00 ,$13.00 ,$0.50 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$4.92 , N/A ,$4.92 , N/A ,$10.86 ,$0.50 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27203538,N/A,HC KIT ARTERIAL LINE,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27203557,N/A,HC CATHETER INTRAUTERINE,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27203560,N/A,HC CATHETER IV,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203562,N/A,HC CATHETER SUCTION,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203575,N/A,HC DRESSING TELFA,272,1 ,$25.00 ,$16.25 ,$6.58 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$6.58 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 ,$16.25 , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,27203589,N/A,HC STYLET INTUBATING,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203590,N/A,HC SYRINGE PUMP SYRINGE,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27203605,N/A,HC CIRCUIT ANESTHESIA,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203617,N/A,HC SET IV PRIMARY,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27203626,N/A,HC TUBE ENDOTRACH,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27203632,N/A,HC SET IV PRIMARY PUMP,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27203841,N/A,HC BALLOON DILATOR CERVICAL,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27203846,N/A,HC SYSTEM VACUUM ASSIST MUSHROOM CAP,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27203849,N/A,HC DRESSING WOUND PICO,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27203923,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T13,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27203941,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T31,272,1 ,"$9,900.00 ","$6,435.00 ","$2,603.70 ","$9,900.00 ", N/A ,"$5,049.00 ","$5,445.00 ", N/A ,"$2,772.00 ","$4,653.00 ", N/A ,"$5,346.00 ", N/A ,"$5,375.70 ","$3,960.00 ", N/A ,"$5,375.70 ", N/A ,"$6,930.00 ","$4,950.00 ","$7,920.00 ", N/A , N/A ,"$6,930.00 ", N/A ,"$5,940.00 ", N/A ,"$7,425.00 ","$5,464.80 ","$4,930.20 ","$5,464.80 ", N/A ,"$5,464.80 ","$7,722.00 ","$7,722.00 ","$8,415.00 ", N/A ,"$6,860.70 ", N/A ,"$9,900.00 ","$5,445.00 ", N/A ,"$2,603.70 ","$9,900.00 ", N/A , N/A , N/A ,"$7,920.00 ","$5,375.70 ","$2,772.00 ","$8,910.00 ","$3,762.00 ","$6,435.00 ", N/A ,"$4,752.00 "
ST. MARY'S HOSPITAL - DECATUR,27203942,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T32,272,1 ,"$10,500.00 ","$6,825.00 ","$2,761.50 ","$10,500.00 ", N/A ,"$5,355.00 ","$5,775.00 ", N/A ,"$2,940.00 ","$4,935.00 ", N/A ,"$5,670.00 ", N/A ,"$5,701.50 ","$4,200.00 ", N/A ,"$5,701.50 ", N/A ,"$7,350.00 ","$5,250.00 ","$8,400.00 ", N/A , N/A ,"$7,350.00 ", N/A ,"$6,300.00 ", N/A ,"$7,875.00 ","$5,796.00 ","$5,229.00 ","$5,796.00 ", N/A ,"$5,796.00 ","$8,190.00 ","$8,190.00 ","$8,925.00 ", N/A ,"$7,276.50 ", N/A ,"$10,500.00 ","$5,775.00 ", N/A ,"$2,761.50 ","$10,500.00 ", N/A , N/A , N/A ,"$8,400.00 ","$5,701.50 ","$2,940.00 ","$9,450.00 ","$3,990.00 ","$6,825.00 ", N/A ,"$5,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27203949,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27203950,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T8,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27203951,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T9,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27203952,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T10,272,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A ,$267.75 ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$210.00 , N/A ,$285.08 , N/A ,$367.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$409.50 ,$409.50 ,$446.25 , N/A ,$363.83 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$341.25 , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27203953,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27203954,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T12,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27203955,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T13,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27203956,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T14,272,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ", N/A ,$535.50 ,$577.50 , N/A ,$294.00 ,$493.50 , N/A ,$567.00 , N/A ,$570.15 ,$420.00 , N/A ,$570.15 , N/A ,$735.00 ,$525.00 ,$840.00 , N/A , N/A ,$735.00 , N/A ,$630.00 , N/A ,$787.50 ,$579.60 ,$522.90 ,$579.60 , N/A ,$579.60 ,$819.00 ,$819.00 ,$892.50 , N/A ,$727.65 , N/A ,"$1,050.00 ",$577.50 , N/A ,$276.15 ,"$1,050.00 ", N/A , N/A , N/A ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$399.00 ,$682.50 , N/A ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,27203957,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T15,272,1 ,"$1,200.00 ",$780.00 ,$315.60 ,"$1,200.00 ", N/A ,$612.00 ,$660.00 , N/A ,$336.00 ,$564.00 , N/A ,$648.00 , N/A ,$651.60 ,$480.00 , N/A ,$651.60 , N/A ,$840.00 ,$600.00 ,$960.00 , N/A , N/A ,$840.00 , N/A ,$720.00 , N/A ,$900.00 ,$662.40 ,$597.60 ,$662.40 , N/A ,$662.40 ,$936.00 ,$936.00 ,"$1,020.00 ", N/A ,$831.60 , N/A ,"$1,200.00 ",$660.00 , N/A ,$315.60 ,"$1,200.00 ", N/A , N/A , N/A ,$960.00 ,$651.60 ,$336.00 ,"$1,080.00 ",$456.00 ,$780.00 , N/A ,$576.00 
ST. MARY'S HOSPITAL - DECATUR,27203958,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T16,272,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$540.00 , N/A ,$733.05 , N/A ,$945.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,"$1,053.00 ","$1,053.00 ","$1,147.50 ", N/A ,$935.55 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$513.00 ,$877.50 , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27203959,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T17,272,1 ,"$1,500.00 ",$975.00 ,$394.50 ,"$1,500.00 ", N/A ,$765.00 ,$825.00 , N/A ,$420.00 ,$705.00 , N/A ,$810.00 , N/A ,$814.50 ,$600.00 , N/A ,$814.50 , N/A ,"$1,050.00 ",$750.00 ,"$1,200.00 ", N/A , N/A ,"$1,050.00 ", N/A ,$900.00 , N/A ,"$1,125.00 ",$828.00 ,$747.00 ,$828.00 , N/A ,$828.00 ,"$1,170.00 ","$1,170.00 ","$1,275.00 ", N/A ,"$1,039.50 ", N/A ,"$1,500.00 ",$825.00 , N/A ,$394.50 ,"$1,500.00 ", N/A , N/A , N/A ,"$1,200.00 ",$814.50 ,$420.00 ,"$1,350.00 ",$570.00 ,$975.00 , N/A ,$720.00 
ST. MARY'S HOSPITAL - DECATUR,27203960,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T18,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27203961,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T19,272,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,080.00 ", N/A ,"$1,466.10 ", N/A ,"$1,890.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$2,106.00 ","$2,106.00 ","$2,295.00 ", N/A ,"$1,871.10 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,026.00 ","$1,755.00 ", N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27203962,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T20,272,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,320.00 ", N/A ,"$1,791.90 ", N/A ,"$2,310.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,574.00 ","$2,574.00 ","$2,805.00 ", N/A ,"$2,286.90 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,254.00 ","$2,145.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27203963,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$1,560.00 ", N/A ,"$2,117.70 ", N/A ,"$2,730.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$3,042.00 ","$3,042.00 ","$3,315.00 ", N/A ,"$2,702.70 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,482.00 ","$2,535.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27203966,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T24,272,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$2,280.00 ", N/A ,"$3,095.10 ", N/A ,"$3,990.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$4,446.00 ","$4,446.00 ","$4,845.00 ", N/A ,"$3,950.10 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,166.00 ","$3,705.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27204073,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T1,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204074,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T2,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204075,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T3,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27204084,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T12,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204090,C1753,HC CATHETER US IMAGING/IVUS T5,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204091,C1753,HC CATHETER US IMAGING/IVUS T6,272,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,080.00 ", N/A ,"$1,466.10 ", N/A ,"$1,890.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$2,106.00 ","$2,106.00 ","$2,295.00 ", N/A ,"$1,871.10 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,026.00 ","$1,755.00 ", N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27204092,C1753,HC CATHETER US IMAGING/IVUS T7,272,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,320.00 ", N/A ,"$1,791.90 ", N/A ,"$2,310.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,574.00 ","$2,574.00 ","$2,805.00 ", N/A ,"$2,286.90 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,254.00 ","$2,145.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27204099,C1753,HC CATHETER US IMAGING/IVUS T14,272,1 ,"$7,500.00 ","$4,875.00 ","$1,972.50 ","$7,500.00 ", N/A ,"$3,825.00 ","$4,125.00 ", N/A ,"$2,100.00 ","$3,525.00 ", N/A ,"$4,050.00 ", N/A ,"$4,072.50 ","$3,000.00 ", N/A ,"$4,072.50 ", N/A ,"$5,250.00 ","$3,750.00 ","$6,000.00 ", N/A , N/A ,"$5,250.00 ", N/A ,"$4,500.00 ", N/A ,"$5,625.00 ","$4,140.00 ","$3,735.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,850.00 ","$5,850.00 ","$6,375.00 ", N/A ,"$5,197.50 ", N/A ,"$7,500.00 ","$4,125.00 ", N/A ,"$1,972.50 ","$7,500.00 ", N/A , N/A , N/A ,"$6,000.00 ","$4,072.50 ","$2,100.00 ","$6,750.00 ","$2,850.00 ","$4,875.00 ", N/A ,"$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,27204100,C1753,HC CATHETER US IMAGING/IVUS T15,272,1 ,"$8,100.00 ","$5,265.00 ","$2,130.30 ","$8,100.00 ", N/A ,"$4,131.00 ","$4,455.00 ", N/A ,"$2,268.00 ","$3,807.00 ", N/A ,"$4,374.00 ", N/A ,"$4,398.30 ","$3,240.00 ", N/A ,"$4,398.30 ", N/A ,"$5,670.00 ","$4,050.00 ","$6,480.00 ", N/A , N/A ,"$5,670.00 ", N/A ,"$4,860.00 ", N/A ,"$6,075.00 ","$4,471.20 ","$4,033.80 ","$4,471.20 ", N/A ,"$4,471.20 ","$6,318.00 ","$6,318.00 ","$6,885.00 ", N/A ,"$5,613.30 ", N/A ,"$8,100.00 ","$4,455.00 ", N/A ,"$2,130.30 ","$8,100.00 ", N/A , N/A , N/A ,"$6,480.00 ","$4,398.30 ","$2,268.00 ","$7,290.00 ","$3,078.00 ","$5,265.00 ", N/A ,"$3,888.00 "
ST. MARY'S HOSPITAL - DECATUR,27204106,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204107,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204108,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T8,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204109,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T9,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27204110,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T10,272,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A ,$267.75 ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$210.00 , N/A ,$285.08 , N/A ,$367.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$409.50 ,$409.50 ,$446.25 , N/A ,$363.83 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$341.25 , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27204113,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T13,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27204114,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T14,272,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ", N/A ,$535.50 ,$577.50 , N/A ,$294.00 ,$493.50 , N/A ,$567.00 , N/A ,$570.15 ,$420.00 , N/A ,$570.15 , N/A ,$735.00 ,$525.00 ,$840.00 , N/A , N/A ,$735.00 , N/A ,$630.00 , N/A ,$787.50 ,$579.60 ,$522.90 ,$579.60 , N/A ,$579.60 ,$819.00 ,$819.00 ,$892.50 , N/A ,$727.65 , N/A ,"$1,050.00 ",$577.50 , N/A ,$276.15 ,"$1,050.00 ", N/A , N/A , N/A ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$399.00 ,$682.50 , N/A ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,27204116,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T16,272,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$540.00 , N/A ,$733.05 , N/A ,$945.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,"$1,053.00 ","$1,053.00 ","$1,147.50 ", N/A ,$935.55 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$513.00 ,$877.50 , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27204118,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T18,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204123,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T23,272,1 ,"$5,100.00 ","$3,315.00 ","$1,341.30 ","$5,100.00 ", N/A ,"$2,601.00 ","$2,805.00 ", N/A ,"$1,428.00 ","$2,397.00 ", N/A ,"$2,754.00 ", N/A ,"$2,769.30 ","$2,040.00 ", N/A ,"$2,769.30 ", N/A ,"$3,570.00 ","$2,550.00 ","$4,080.00 ", N/A , N/A ,"$3,570.00 ", N/A ,"$3,060.00 ", N/A ,"$3,825.00 ","$2,815.20 ","$2,539.80 ","$2,815.20 ", N/A ,"$2,815.20 ","$3,978.00 ","$3,978.00 ","$4,335.00 ", N/A ,"$3,534.30 ", N/A ,"$5,100.00 ","$2,805.00 ", N/A ,"$1,341.30 ","$5,100.00 ", N/A , N/A , N/A ,"$4,080.00 ","$2,769.30 ","$1,428.00 ","$4,590.00 ","$1,938.00 ","$3,315.00 ", N/A ,"$2,448.00 "
ST. MARY'S HOSPITAL - DECATUR,27204124,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T24,272,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$2,280.00 ", N/A ,"$3,095.10 ", N/A ,"$3,990.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$4,446.00 ","$4,446.00 ","$4,845.00 ", N/A ,"$3,950.10 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,166.00 ","$3,705.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27204129,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T29,272,1 ,"$8,700.00 ","$5,655.00 ","$2,288.10 ","$8,700.00 ", N/A ,"$4,437.00 ","$4,785.00 ", N/A ,"$2,436.00 ","$4,089.00 ", N/A ,"$4,698.00 ", N/A ,"$4,724.10 ","$3,480.00 ", N/A ,"$4,724.10 ", N/A ,"$6,090.00 ","$4,350.00 ","$6,960.00 ", N/A , N/A ,"$6,090.00 ", N/A ,"$5,220.00 ", N/A ,"$6,525.00 ","$4,802.40 ","$4,332.60 ","$4,802.40 ", N/A ,"$4,802.40 ","$6,786.00 ","$6,786.00 ","$7,395.00 ", N/A ,"$6,029.10 ", N/A ,"$8,700.00 ","$4,785.00 ", N/A ,"$2,288.10 ","$8,700.00 ", N/A , N/A , N/A ,"$6,960.00 ","$4,724.10 ","$2,436.00 ","$7,830.00 ","$3,306.00 ","$5,655.00 ", N/A ,"$4,176.00 "
ST. MARY'S HOSPITAL - DECATUR,27204174,C1760,HC DEVICE VASCULAR CLOSURE T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27204175,C1760,HC DEVICE VASCULAR CLOSURE T12,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27204203,C1769,HC GUIDEWIRE GLIDEWIRE T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204204,C1769,HC GUIDEWIRE GLIDEWIRE T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204206,C1769,HC GUIDEWIRE GLIDEWIRE T9,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27204208,C1769,HC GUIDEWIRE GLIDEWIRE T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27204217,C1769,HC GUIDEWIRE GLIDEWIRE T20,272,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,320.00 ", N/A ,"$1,791.90 ", N/A ,"$2,310.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,574.00 ","$2,574.00 ","$2,805.00 ", N/A ,"$2,286.90 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,254.00 ","$2,145.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27204219,C1769,HC GUIDEWIRE T2,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204220,C1769,HC GUIDEWIRE T3,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204221,C1769,HC GUIDEWIRE T4,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204222,C1769,HC GUIDEWIRE T5,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204223,C1769,HC GUIDEWIRE T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204224,C1769,HC GUIDEWIRE T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204225,C1769,HC GUIDEWIRE T8,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204226,C1769,HC GUIDEWIRE T9,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27204227,C1769,HC GUIDEWIRE T10,272,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A ,$267.75 ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$210.00 , N/A ,$285.08 , N/A ,$367.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$409.50 ,$409.50 ,$446.25 , N/A ,$363.83 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$341.25 , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27204228,C1769,HC GUIDEWIRE T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27204229,C1769,HC GUIDEWIRE T12,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27204235,C1769,HC GUIDEWIRE T18,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204257,C1773,HC DEVICE RETRIEVAL INSERTABLE T12,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27204258,C1773,HC DEVICE RETRIEVAL INSERTABLE T13,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27204259,C1773,HC DEVICE RETRIEVAL INSERTABLE T14,272,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ", N/A ,$535.50 ,$577.50 , N/A ,$294.00 ,$493.50 , N/A ,$567.00 , N/A ,$570.15 ,$420.00 , N/A ,$570.15 , N/A ,$735.00 ,$525.00 ,$840.00 , N/A , N/A ,$735.00 , N/A ,$630.00 , N/A ,$787.50 ,$579.60 ,$522.90 ,$579.60 , N/A ,$579.60 ,$819.00 ,$819.00 ,$892.50 , N/A ,$727.65 , N/A ,"$1,050.00 ",$577.50 , N/A ,$276.15 ,"$1,050.00 ", N/A , N/A , N/A ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$399.00 ,$682.50 , N/A ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,27204260,C1773,HC DEVICE RETRIEVAL INSERTABLE T15,272,1 ,"$1,200.00 ",$780.00 ,$315.60 ,"$1,200.00 ", N/A ,$612.00 ,$660.00 , N/A ,$336.00 ,$564.00 , N/A ,$648.00 , N/A ,$651.60 ,$480.00 , N/A ,$651.60 , N/A ,$840.00 ,$600.00 ,$960.00 , N/A , N/A ,$840.00 , N/A ,$720.00 , N/A ,$900.00 ,$662.40 ,$597.60 ,$662.40 , N/A ,$662.40 ,$936.00 ,$936.00 ,"$1,020.00 ", N/A ,$831.60 , N/A ,"$1,200.00 ",$660.00 , N/A ,$315.60 ,"$1,200.00 ", N/A , N/A , N/A ,$960.00 ,$651.60 ,$336.00 ,"$1,080.00 ",$456.00 ,$780.00 , N/A ,$576.00 
ST. MARY'S HOSPITAL - DECATUR,27204261,C1773,HC DEVICE RETRIEVAL INSERTABLE T16,272,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$540.00 , N/A ,$733.05 , N/A ,$945.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,"$1,053.00 ","$1,053.00 ","$1,147.50 ", N/A ,$935.55 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$513.00 ,$877.50 , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27204263,C1773,HC DEVICE RETRIEVAL INSERTABLE T18,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204296,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T19,272,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,320.00 ", N/A ,"$1,791.90 ", N/A ,"$2,310.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,574.00 ","$2,574.00 ","$2,805.00 ", N/A ,"$2,286.90 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,254.00 ","$2,145.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27204297,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T20,272,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,320.00 ", N/A ,"$1,791.90 ", N/A ,"$2,310.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,574.00 ","$2,574.00 ","$2,805.00 ", N/A ,"$2,286.90 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,254.00 ","$2,145.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27204298,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$1,560.00 ", N/A ,"$2,117.70 ", N/A ,"$2,730.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$3,042.00 ","$3,042.00 ","$3,315.00 ", N/A ,"$2,702.70 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,482.00 ","$2,535.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27204299,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T22,272,1 ,"$4,500.00 ","$2,925.00 ","$1,183.50 ","$4,500.00 ", N/A ,"$2,295.00 ","$2,475.00 ", N/A ,"$1,260.00 ","$2,115.00 ", N/A ,"$2,430.00 ", N/A ,"$2,443.50 ","$1,800.00 ", N/A ,"$2,443.50 ", N/A ,"$3,150.00 ","$2,250.00 ","$3,600.00 ", N/A , N/A ,"$3,150.00 ", N/A ,"$2,700.00 ", N/A ,"$3,375.00 ","$2,484.00 ","$2,241.00 ","$2,484.00 ", N/A ,"$2,484.00 ","$3,510.00 ","$3,510.00 ","$3,825.00 ", N/A ,"$3,118.50 ", N/A ,"$4,500.00 ","$2,475.00 ", N/A ,"$1,183.50 ","$4,500.00 ", N/A , N/A , N/A ,"$3,600.00 ","$2,443.50 ","$1,260.00 ","$4,050.00 ","$1,710.00 ","$2,925.00 ", N/A ,"$2,160.00 "
ST. MARY'S HOSPITAL - DECATUR,27204300,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T23,272,1 ,"$5,100.00 ","$3,315.00 ","$1,341.30 ","$5,100.00 ", N/A ,"$2,601.00 ","$2,805.00 ", N/A ,"$1,428.00 ","$2,397.00 ", N/A ,"$2,754.00 ", N/A ,"$2,769.30 ","$2,040.00 ", N/A ,"$2,769.30 ", N/A ,"$3,570.00 ","$2,550.00 ","$4,080.00 ", N/A , N/A ,"$3,570.00 ", N/A ,"$3,060.00 ", N/A ,"$3,825.00 ","$2,815.20 ","$2,539.80 ","$2,815.20 ", N/A ,"$2,815.20 ","$3,978.00 ","$3,978.00 ","$4,335.00 ", N/A ,"$3,534.30 ", N/A ,"$5,100.00 ","$2,805.00 ", N/A ,"$1,341.30 ","$5,100.00 ", N/A , N/A , N/A ,"$4,080.00 ","$2,769.30 ","$1,428.00 ","$4,590.00 ","$1,938.00 ","$3,315.00 ", N/A ,"$2,448.00 "
ST. MARY'S HOSPITAL - DECATUR,27204301,C1884,HC SYSTEM EMBOLIZATION PROTECTIVE T24,272,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$2,280.00 ", N/A ,"$3,095.10 ", N/A ,"$3,990.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$4,446.00 ","$4,446.00 ","$4,845.00 ", N/A ,"$3,950.10 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,166.00 ","$3,705.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27204326,C1887,HC CATHETER GUIDING T2,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204327,C1887,HC CATHETER GUIDING T3,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204328,C1887,HC CATHETER GUIDING T4,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204329,C1887,HC CATHETER GUIDING T5,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204330,C1887,HC CATHETER GUIDING T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204331,C1887,HC CATHETER GUIDING T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204332,C1887,HC CATHETER GUIDING T8,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204333,C1887,HC CATHETER GUIDING T9,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27204334,C1887,HC CATHETER GUIDING T10,272,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A ,$267.75 ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$210.00 , N/A ,$285.08 , N/A ,$367.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$409.50 ,$409.50 ,$446.25 , N/A ,$363.83 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$341.25 , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27204335,C1887,HC CATHETER GUIDING T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27204336,C1887,HC CATHETER GUIDING T12,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27204337,C1887,HC CATHETER GUIDING T13,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27204338,C1887,HC CATHETER GUIDING T14,272,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ", N/A ,$535.50 ,$577.50 , N/A ,$294.00 ,$493.50 , N/A ,$567.00 , N/A ,$570.15 ,$420.00 , N/A ,$570.15 , N/A ,$735.00 ,$525.00 ,$840.00 , N/A , N/A ,$735.00 , N/A ,$630.00 , N/A ,$787.50 ,$579.60 ,$522.90 ,$579.60 , N/A ,$579.60 ,$819.00 ,$819.00 ,$892.50 , N/A ,$727.65 , N/A ,"$1,050.00 ",$577.50 , N/A ,$276.15 ,"$1,050.00 ", N/A , N/A , N/A ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$399.00 ,$682.50 , N/A ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,27204339,C1887,HC CATHETER GUIDING T15,272,1 ,"$1,200.00 ",$780.00 ,$315.60 ,"$1,200.00 ", N/A ,$612.00 ,$660.00 , N/A ,$336.00 ,$564.00 , N/A ,$648.00 , N/A ,$651.60 ,$480.00 , N/A ,$651.60 , N/A ,$840.00 ,$600.00 ,$960.00 , N/A , N/A ,$840.00 , N/A ,$720.00 , N/A ,$900.00 ,$662.40 ,$597.60 ,$662.40 , N/A ,$662.40 ,$936.00 ,$936.00 ,"$1,020.00 ", N/A ,$831.60 , N/A ,"$1,200.00 ",$660.00 , N/A ,$315.60 ,"$1,200.00 ", N/A , N/A , N/A ,$960.00 ,$651.60 ,$336.00 ,"$1,080.00 ",$456.00 ,$780.00 , N/A ,$576.00 
ST. MARY'S HOSPITAL - DECATUR,27204340,C1887,HC CATHETER GUIDING T16,272,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$540.00 , N/A ,$733.05 , N/A ,$945.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,"$1,053.00 ","$1,053.00 ","$1,147.50 ", N/A ,$935.55 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$513.00 ,$877.50 , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27204341,C1887,HC CATHETER GUIDING T17,272,1 ,"$1,500.00 ",$975.00 ,$394.50 ,"$1,500.00 ", N/A ,$765.00 ,$825.00 , N/A ,$420.00 ,$705.00 , N/A ,$810.00 , N/A ,$814.50 ,$600.00 , N/A ,$814.50 , N/A ,"$1,050.00 ",$750.00 ,"$1,200.00 ", N/A , N/A ,"$1,050.00 ", N/A ,$900.00 , N/A ,"$1,125.00 ",$828.00 ,$747.00 ,$828.00 , N/A ,$828.00 ,"$1,170.00 ","$1,170.00 ","$1,275.00 ", N/A ,"$1,039.50 ", N/A ,"$1,500.00 ",$825.00 , N/A ,$394.50 ,"$1,500.00 ", N/A , N/A , N/A ,"$1,200.00 ",$814.50 ,$420.00 ,"$1,350.00 ",$570.00 ,$975.00 , N/A ,$720.00 
ST. MARY'S HOSPITAL - DECATUR,27204342,C1887,HC CATHETER GUIDING T18,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204343,C1887,HC CATHETER GUIDING T19,272,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,080.00 ", N/A ,"$1,466.10 ", N/A ,"$1,890.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$2,106.00 ","$2,106.00 ","$2,295.00 ", N/A ,"$1,871.10 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,026.00 ","$1,755.00 ", N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27204344,C1887,HC CATHETER GUIDING T20,272,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,320.00 ", N/A ,"$1,791.90 ", N/A ,"$2,310.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,574.00 ","$2,574.00 ","$2,805.00 ", N/A ,"$2,286.90 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,254.00 ","$2,145.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27204345,C1887,HC CATHETER GUIDING T21,272,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$1,560.00 ", N/A ,"$2,117.70 ", N/A ,"$2,730.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$3,042.00 ","$3,042.00 ","$3,315.00 ", N/A ,"$2,702.70 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,482.00 ","$2,535.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27204346,C1887,HC CATHETER GUIDING T22,272,1 ,"$4,500.00 ","$2,925.00 ","$1,183.50 ","$4,500.00 ", N/A ,"$2,295.00 ","$2,475.00 ", N/A ,"$1,260.00 ","$2,115.00 ", N/A ,"$2,430.00 ", N/A ,"$2,443.50 ","$1,800.00 ", N/A ,"$2,443.50 ", N/A ,"$3,150.00 ","$2,250.00 ","$3,600.00 ", N/A , N/A ,"$3,150.00 ", N/A ,"$2,700.00 ", N/A ,"$3,375.00 ","$2,484.00 ","$2,241.00 ","$2,484.00 ", N/A ,"$2,484.00 ","$3,510.00 ","$3,510.00 ","$3,825.00 ", N/A ,"$3,118.50 ", N/A ,"$4,500.00 ","$2,475.00 ", N/A ,"$1,183.50 ","$4,500.00 ", N/A , N/A , N/A ,"$3,600.00 ","$2,443.50 ","$1,260.00 ","$4,050.00 ","$1,710.00 ","$2,925.00 ", N/A ,"$2,160.00 "
ST. MARY'S HOSPITAL - DECATUR,27204351,C1887,HC CATHETER GUIDING T27,272,1 ,"$7,500.00 ","$4,875.00 ","$1,972.50 ","$7,500.00 ", N/A ,"$3,825.00 ","$4,125.00 ", N/A ,"$2,100.00 ","$3,525.00 ", N/A ,"$4,050.00 ", N/A ,"$4,072.50 ","$3,000.00 ", N/A ,"$4,072.50 ", N/A ,"$5,250.00 ","$3,750.00 ","$6,000.00 ", N/A , N/A ,"$5,250.00 ", N/A ,"$4,500.00 ", N/A ,"$5,625.00 ","$4,140.00 ","$3,735.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$5,850.00 ","$5,850.00 ","$6,375.00 ", N/A ,"$5,197.50 ", N/A ,"$7,500.00 ","$4,125.00 ", N/A ,"$1,972.50 ","$7,500.00 ", N/A , N/A , N/A ,"$6,000.00 ","$4,072.50 ","$2,100.00 ","$6,750.00 ","$2,850.00 ","$4,875.00 ", N/A ,"$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,27204370,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T5,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204371,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204376,C1892,HC INTRODUCER/SHEATH FIXED PEEL-AWAY T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27204408,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T3,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204409,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T4,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204410,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T5,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204411,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204412,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204413,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T8,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204416,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27204417,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T12,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27204418,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T13,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27204419,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T14,272,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ", N/A ,$535.50 ,$577.50 , N/A ,$294.00 ,$493.50 , N/A ,$567.00 , N/A ,$570.15 ,$420.00 , N/A ,$570.15 , N/A ,$735.00 ,$525.00 ,$840.00 , N/A , N/A ,$735.00 , N/A ,$630.00 , N/A ,$787.50 ,$579.60 ,$522.90 ,$579.60 , N/A ,$579.60 ,$819.00 ,$819.00 ,$892.50 , N/A ,$727.65 , N/A ,"$1,050.00 ",$577.50 , N/A ,$276.15 ,"$1,050.00 ", N/A , N/A , N/A ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$399.00 ,$682.50 , N/A ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,27204423,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T18,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204431,C1894,HC INTRODUCER/SHEATH NON-GUIDING NON-LASER T26,272,1 ,"$6,900.00 ","$4,485.00 ","$1,814.70 ","$6,900.00 ", N/A ,"$3,519.00 ","$3,795.00 ", N/A ,"$1,932.00 ","$3,243.00 ", N/A ,"$3,726.00 ", N/A ,"$3,746.70 ","$2,760.00 ", N/A ,"$3,746.70 ", N/A ,"$4,830.00 ","$3,450.00 ","$5,520.00 ", N/A , N/A ,"$4,830.00 ", N/A ,"$4,140.00 ", N/A ,"$5,175.00 ","$3,808.80 ","$3,436.20 ","$3,808.80 ", N/A ,"$3,808.80 ","$5,382.00 ","$5,382.00 ","$5,865.00 ", N/A ,"$4,781.70 ", N/A ,"$6,900.00 ","$3,795.00 ", N/A ,"$1,814.70 ","$6,900.00 ", N/A , N/A , N/A ,"$5,520.00 ","$3,746.70 ","$1,932.00 ","$6,210.00 ","$2,622.00 ","$4,485.00 ", N/A ,"$3,312.00 "
ST. MARY'S HOSPITAL - DECATUR,27204443,C2628,HC CATHETER OCCLUSION T9,272,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$1,560.00 ", N/A ,"$2,117.70 ", N/A ,"$2,730.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$3,042.00 ","$3,042.00 ","$3,315.00 ", N/A ,"$2,702.70 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,482.00 ","$2,535.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27204446,C2628,HC CATHETER OCCLUSION T12,272,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$2,280.00 ", N/A ,"$3,095.10 ", N/A ,"$3,990.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$4,446.00 ","$4,446.00 ","$4,845.00 ", N/A ,"$3,950.10 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,166.00 ","$3,705.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27204447,N/A,HC SUTURE T1,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204448,N/A,HC SUTURE T2,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204449,N/A,HC SUTURE T3,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204450,N/A,HC SUTURE T4,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204451,N/A,HC SURGICAL STERILE SUPPLY T1,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204452,N/A,HC SURGICAL STERILE SUPPLY T2,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204453,N/A,HC SURGICAL STERILE SUPPLY T3,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204454,N/A,HC SURGICAL STERILE SUPPLY T4,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204455,N/A,HC SURGICAL STERILE SUPPLY T5,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204456,N/A,HC SURGICAL STERILE SUPPLY T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204457,N/A,HC SURGICAL STERILE SUPPLY T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204458,N/A,HC SURGICAL STERILE SUPPLY T8,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204459,N/A,HC SURGICAL STERILE SUPPLY T9,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27204460,N/A,HC SURGICAL STERILE SUPPLY T10,272,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A ,$267.75 ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$210.00 , N/A ,$285.08 , N/A ,$367.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$409.50 ,$409.50 ,$446.25 , N/A ,$363.83 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$341.25 , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27204461,N/A,HC SURGICAL STERILE SUPPLY T11,272,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A ,$306.00 ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$240.00 , N/A ,$325.80 , N/A ,$420.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$468.00 ,$468.00 ,$510.00 , N/A ,$415.80 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$390.00 , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27204462,N/A,HC SURGICAL STERILE SUPPLY T12,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27204463,N/A,HC SURGICAL STERILE SUPPLY T13,272,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A ,$459.00 ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$360.00 , N/A ,$488.70 , N/A ,$630.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$702.00 ,$702.00 ,$765.00 , N/A ,$623.70 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$342.00 ,$585.00 , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27204465,N/A,HC SURGICAL STERILE SUPPLY T15,272,1 ,"$1,200.00 ",$780.00 ,$315.60 ,"$1,200.00 ", N/A ,$612.00 ,$660.00 , N/A ,$336.00 ,$564.00 , N/A ,$648.00 , N/A ,$651.60 ,$480.00 , N/A ,$651.60 , N/A ,$840.00 ,$600.00 ,$960.00 , N/A , N/A ,$840.00 , N/A ,$720.00 , N/A ,$900.00 ,$662.40 ,$597.60 ,$662.40 , N/A ,$662.40 ,$936.00 ,$936.00 ,"$1,020.00 ", N/A ,$831.60 , N/A ,"$1,200.00 ",$660.00 , N/A ,$315.60 ,"$1,200.00 ", N/A , N/A , N/A ,$960.00 ,$651.60 ,$336.00 ,"$1,080.00 ",$456.00 ,$780.00 , N/A ,$576.00 
ST. MARY'S HOSPITAL - DECATUR,27204466,N/A,HC SURGICAL STERILE SUPPLY T16,272,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$540.00 , N/A ,$733.05 , N/A ,$945.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,"$1,053.00 ","$1,053.00 ","$1,147.50 ", N/A ,$935.55 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$513.00 ,$877.50 , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27204468,N/A,HC SURGICAL STERILE SUPPLY T18,272,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ",$840.00 , N/A ,"$1,140.30 ", N/A ,"$1,470.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,638.00 ","$1,638.00 ","$1,785.00 ", N/A ,"$1,455.30 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ",$798.00 ,"$1,365.00 ", N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27204469,N/A,HC SURGICAL STERILE SUPPLY T19,272,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,080.00 ", N/A ,"$1,466.10 ", N/A ,"$1,890.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$2,106.00 ","$2,106.00 ","$2,295.00 ", N/A ,"$1,871.10 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,026.00 ","$1,755.00 ", N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27204470,N/A,HC SURGICAL STERILE SUPPLY T20,272,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,320.00 ", N/A ,"$1,791.90 ", N/A ,"$2,310.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$2,574.00 ","$2,574.00 ","$2,805.00 ", N/A ,"$2,286.90 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,254.00 ","$2,145.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27204475,N/A,HC SURGICAL STERILE SUPPLY T25,272,1 ,"$6,300.00 ","$4,095.00 ","$1,656.90 ","$6,300.00 ", N/A ,"$3,213.00 ","$3,465.00 ", N/A ,"$1,764.00 ","$2,961.00 ", N/A ,"$3,402.00 ", N/A ,"$3,420.90 ","$2,520.00 ", N/A ,"$3,420.90 ", N/A ,"$4,410.00 ","$3,150.00 ","$5,040.00 ", N/A , N/A ,"$4,410.00 ", N/A ,"$3,780.00 ", N/A ,"$4,725.00 ","$3,477.60 ","$3,137.40 ","$3,477.60 ", N/A ,"$3,477.60 ","$4,914.00 ","$4,914.00 ","$5,355.00 ", N/A ,"$4,365.90 ", N/A ,"$6,300.00 ","$3,465.00 ", N/A ,"$1,656.90 ","$6,300.00 ", N/A , N/A , N/A ,"$5,040.00 ","$3,420.90 ","$1,764.00 ","$5,670.00 ","$2,394.00 ","$4,095.00 ", N/A ,"$3,024.00 "
ST. MARY'S HOSPITAL - DECATUR,27204525,C1752,HC CATHETER HEMODIALYSIS/PERITONEAL SHORT TERM T1,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204560,C1729,HC CATHETER DRAINAGE T4,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204562,C1729,HC CATHETER DRAINAGE T6,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204563,C1729,HC CATHETER DRAINAGE T7,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204564,C1729,HC CATHETER DRAINAGE T8,272,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A ,$191.25 ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$150.00 , N/A ,$203.63 , N/A ,$262.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$292.50 ,$292.50 ,$318.75 , N/A ,$259.88 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$142.50 ,$243.75 , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27204573,C1729,HC CATHETER DRAINAGE T17,272,1 ,"$1,500.00 ",$975.00 ,$394.50 ,"$1,500.00 ", N/A ,$765.00 ,$825.00 , N/A ,$420.00 ,$705.00 , N/A ,$810.00 , N/A ,$814.50 ,$600.00 , N/A ,$814.50 , N/A ,"$1,050.00 ",$750.00 ,"$1,200.00 ", N/A , N/A ,"$1,050.00 ", N/A ,$900.00 , N/A ,"$1,125.00 ",$828.00 ,$747.00 ,$828.00 , N/A ,$828.00 ,"$1,170.00 ","$1,170.00 ","$1,275.00 ", N/A ,"$1,039.50 ", N/A ,"$1,500.00 ",$825.00 , N/A ,$394.50 ,"$1,500.00 ", N/A , N/A , N/A ,"$1,200.00 ",$814.50 ,$420.00 ,"$1,350.00 ",$570.00 ,$975.00 , N/A ,$720.00 
ST. MARY'S HOSPITAL - DECATUR,27204574,N/A,HC ORAL AIRWAY,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204575,N/A,HC LARYNGEAL MASK AIRWAY SUPREME,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204579,N/A,HC DIALYZER,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204581,N/A,HC FILTER CIRCUIT,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204582,N/A,HC FILTER IV,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204584,N/A,HC KIT OXYGEN THERAPY,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204585,N/A,HC KIT MULTILUMEN CATHETER,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27204586,N/A,HC KIT TRANSDUCER,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204587,N/A,HC KIT TRANSDUCER TRIPLE,272,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$195.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27204588,N/A,HC NEEDLE PACK,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204589,N/A,HC NEEDLE REGIONAL,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204590,N/A,HC PACK C-SECTION,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204591,N/A,HC PROBE,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204593,N/A,HC SET BLOOD WASH,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204594,N/A,HC SPONGE GELFOAM,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204595,N/A,HC SYRINGE PACK,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204596,N/A,HC SUCTION TIP,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204597,N/A,HC SUTURE CHROMIC,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204598,N/A,HC SUTURE MONOCRYL,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204599,N/A,HC SUTURE PLAIN,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204600,N/A,HC SUTURE VICRYL,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204601,N/A,HC TAPE ELASTIKON,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204606,N/A,HC TUBE JET VENTILATION,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204607,N/A,HC TUBE NASOGASTRIC,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204609,N/A,HC TUBE PRESSURE,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204610,N/A,HC TUBING CELL SAVER,272,1 ,$150.00 ,$97.50 ,$39.45 ,$150.00 , N/A ,$76.50 ,$82.50 , N/A ,$42.00 ,$70.50 , N/A ,$81.00 , N/A ,$81.45 ,$60.00 , N/A ,$81.45 , N/A ,$105.00 ,$75.00 ,$120.00 , N/A , N/A ,$105.00 , N/A ,$90.00 , N/A ,$112.50 ,$82.80 ,$74.70 ,$82.80 , N/A ,$82.80 ,$117.00 ,$117.00 ,$127.50 , N/A ,$103.95 , N/A ,$150.00 ,$82.50 , N/A ,$39.45 ,$150.00 , N/A , N/A , N/A ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$97.50 , N/A ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27204611,N/A,HC TUBING EPIDURAL,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204612,N/A,HC TUBING EXTENSION,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27204613,N/A,HC TUBING HIGH PRESSURE,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204614,N/A,HC TUBING IV,272,1 ,$75.00 ,$48.75 ,$19.73 ,$75.00 , N/A ,$38.25 ,$41.25 , N/A ,$21.00 ,$35.25 , N/A ,$40.50 , N/A ,$40.73 ,$30.00 , N/A ,$40.73 , N/A ,$52.50 ,$37.50 ,$60.00 , N/A , N/A ,$52.50 , N/A ,$45.00 , N/A ,$56.25 ,$41.40 ,$37.35 ,$41.40 , N/A ,$41.40 ,$58.50 ,$58.50 ,$63.75 , N/A ,$51.98 , N/A ,$75.00 ,$41.25 , N/A ,$19.73 ,$75.00 , N/A , N/A , N/A ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$48.75 , N/A ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,27204615,N/A,HC TUBING Y,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27204616,N/A,HC TUBING SUCTION,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27204769,N/A,HC BALLOON UTERINE TAMPON,272,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A ,$382.50 ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$300.00 , N/A ,$407.25 , N/A ,$525.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$585.00 ,$585.00 ,$637.50 , N/A ,$519.75 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$487.50 , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27204771,N/A,HC BLADE LARYNGOSCOPE,272,1 ,$20.00 ,$13.00 ,$5.26 ,$20.00 , N/A ,$10.20 ,$11.00 , N/A ,$5.60 ,$9.40 , N/A ,$10.80 , N/A ,$10.86 ,$8.00 , N/A ,$10.86 , N/A ,$14.00 ,$10.00 ,$16.00 , N/A , N/A ,$14.00 , N/A ,$12.00 , N/A ,$15.00 ,$11.04 ,$9.96 ,$11.04 , N/A ,$11.04 ,$15.60 ,$15.60 ,$17.00 , N/A ,$13.86 , N/A ,$20.00 ,$11.00 , N/A ,$5.26 ,$20.00 , N/A , N/A , N/A ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$13.00 , N/A ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,27205006,N/A,HC RETRACTOR ABDOMINAL T2,272,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A ,$114.75 ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$90.00 , N/A ,$122.18 , N/A ,$157.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$175.50 ,$175.50 ,$191.25 , N/A ,$155.93 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$146.25 , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27205258,N/A,HC RETRACTOR ADBOMINAL ADHESIVE,272,1 ,$138.00 ,$89.70 ,$36.29 ,$138.00 , N/A ,$70.38 ,$75.90 , N/A ,$38.64 ,$64.86 , N/A ,$74.52 , N/A ,$74.93 ,$55.20 , N/A ,$74.93 , N/A ,$96.60 ,$69.00 ,$110.40 , N/A , N/A ,$96.60 , N/A ,$82.80 , N/A ,$103.50 ,$76.18 ,$68.72 ,$76.18 , N/A ,$76.18 ,$107.64 ,$107.64 ,$117.30 , N/A ,$95.63 , N/A ,$138.00 ,$75.90 , N/A ,$36.29 ,$138.00 , N/A , N/A , N/A ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$89.70 , N/A ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,27205329,N/A,HC SUTURE SPECIALTY,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27205381,N/A,HC SURGICEL HEMOSTAT 4X4,272,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A ,$229.50 ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$180.00 , N/A ,$244.35 , N/A ,$315.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$351.00 ,$351.00 ,$382.50 , N/A ,$311.85 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$171.00 ,$292.50 , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27205386,N/A,HC HANDLE LARYNGEAL BLADE,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27205434,N/A,HC DISPOSABLE FIBEROPTIC SCOPE,272,1 ,$550.00 ,$357.50 ,$144.65 ,$550.00 , N/A ,$280.50 ,$302.50 , N/A ,$154.00 ,$258.50 , N/A ,$297.00 , N/A ,$298.65 ,$220.00 , N/A ,$298.65 , N/A ,$385.00 ,$275.00 ,$440.00 , N/A , N/A ,$385.00 , N/A ,$330.00 , N/A ,$412.50 ,$303.60 ,$273.90 ,$303.60 , N/A ,$303.60 ,$429.00 ,$429.00 ,$467.50 , N/A ,$381.15 , N/A ,$550.00 ,$302.50 , N/A ,$144.65 ,$550.00 , N/A , N/A , N/A ,$440.00 ,$298.65 ,$154.00 ,$495.00 ,$209.00 ,$357.50 , N/A ,$264.00 
ST. MARY'S HOSPITAL - DECATUR,27272900,S2900,HC SURGERY ROBOTIC TECHNICAL SYSTEM,272,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,27280032,N/A,HC DRSG NASAL HOLDER,272,1 ,$10.00 ,$6.50 ,$2.63 ,$10.00 , N/A ,$5.10 ,$5.50 , N/A ,$2.80 ,$4.70 , N/A ,$5.40 , N/A ,$5.43 ,$4.00 , N/A ,$5.43 , N/A ,$7.00 ,$5.00 ,$8.00 , N/A , N/A ,$7.00 , N/A ,$6.00 , N/A ,$7.50 ,$5.52 ,$4.98 ,$5.52 , N/A ,$5.52 ,$7.80 ,$7.80 ,$8.50 , N/A ,$6.93 , N/A ,$10.00 ,$5.50 , N/A ,$2.63 ,$10.00 , N/A , N/A , N/A ,$8.00 ,$5.43 ,$2.80 ,$9.00 ,$3.80 ,$6.50 , N/A ,$4.80 
ST. MARY'S HOSPITAL - DECATUR,27280160,N/A,HC DETECTOR CO2,272,1 ,$30.00 ,$19.50 ,$7.89 ,$30.00 , N/A ,$15.30 ,$16.50 , N/A ,$8.40 ,$14.10 , N/A ,$16.20 , N/A ,$16.29 ,$12.00 , N/A ,$16.29 , N/A ,$21.00 ,$15.00 ,$24.00 , N/A , N/A ,$21.00 , N/A ,$18.00 , N/A ,$22.50 ,$16.56 ,$14.94 ,$16.56 , N/A ,$16.56 ,$23.40 ,$23.40 ,$25.50 , N/A ,$20.79 , N/A ,$30.00 ,$16.50 , N/A ,$7.89 ,$30.00 , N/A , N/A , N/A ,$24.00 ,$16.29 ,$8.40 ,$27.00 ,$11.40 ,$19.50 , N/A ,$14.40 
ST. MARY'S HOSPITAL - DECATUR,27282051,N/A,HC FETAL PILLOW,272,1 ,"$2,985.00 ","$1,940.25 ",$785.06 ,"$2,985.00 ", N/A ,"$1,522.35 ","$1,641.75 ", N/A ,$835.80 ,"$1,402.95 ", N/A ,"$1,611.90 ", N/A ,"$1,620.86 ","$1,194.00 ", N/A ,"$1,620.86 ", N/A ,"$2,089.50 ","$1,492.50 ","$2,388.00 ", N/A , N/A ,"$2,089.50 ", N/A ,"$1,791.00 ", N/A ,"$2,238.75 ","$1,647.72 ","$1,486.53 ","$1,647.72 ", N/A ,"$1,647.72 ","$2,328.30 ","$2,328.30 ","$2,537.25 ", N/A ,"$2,068.61 ", N/A ,"$2,985.00 ","$1,641.75 ", N/A ,$785.06 ,"$2,985.00 ", N/A , N/A , N/A ,"$2,388.00 ","$1,620.86 ",$835.80 ,"$2,686.50 ","$1,134.30 ","$1,940.25 ", N/A ,"$1,432.80 "
ST. MARY'S HOSPITAL - DECATUR,27400044,L3908,HC COCK UP WRIST SPLINT/FIT  AND  ADJ,274,1 ,$150.00 ,$97.50 ,$39.45 ,$215.80 ,$215.80 , N/A ,$82.50 ,$86.32 ,$42.00 ,$73.50 ,$86.32 ,$81.00 ,$86.32 ,$81.45 ,$81.45 ,$86.32 ,$81.45 ,$150.00 ,$75.00 ,$75.00 ,$120.00 ,$215.80 ,$86.32 ,$105.00 ,$86.32 ,$90.00 ,$86.32 ,$112.50 ,$82.80 ,$74.70 ,$82.80 ,$86.32 ,$82.80 ,$75.00 ,$75.00 ,$127.50 ,$150.00 ,$74.25 ,$86.32 ,$150.00 ,$82.50 ,$86.32 ,$39.45 ,$150.00 , N/A , N/A ,$90.64 ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$74.40 , N/A ,$86.32 ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,27400069,L8501,HC PASSEY MUIR VALVE,274,1 ,$300.00 ,$195.00 ,$78.90 ,$403.93 ,$403.93 , N/A ,$165.00 ,$161.57 ,$84.00 ,$147.00 ,$161.57 ,$162.00 ,$161.57 ,$162.90 ,$162.90 ,$161.57 ,$162.90 ,$300.00 ,$150.00 ,$150.00 ,$240.00 ,$403.92 ,$161.57 ,$210.00 ,$161.57 ,$180.00 ,$161.57 ,$225.00 ,$165.60 ,$149.40 ,$165.60 ,$161.57 ,$165.60 ,$150.00 ,$150.00 ,$255.00 ,$300.00 ,$148.50 ,$161.57 ,$300.00 ,$165.00 ,$161.57 ,$78.90 ,$300.00 , N/A , N/A ,$169.65 ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$148.80 , N/A ,$161.57 ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27500049,C1721,HC ICD DEFIB DUAL CHAMBER T7,275,1 ,"$34,500.00 ","$22,425.00 ","$9,073.50 ","$34,500.00 ", N/A ,"$17,595.00 ","$18,975.00 ", N/A ,"$9,660.00 ","$16,215.00 ", N/A ,"$18,630.00 ", N/A ,"$18,733.50 ","$18,733.50 ", N/A ,"$18,733.50 ", N/A ,"$17,250.00 ","$17,250.00 ","$27,600.00 ", N/A , N/A ,"$24,150.00 ", N/A ,"$20,700.00 ", N/A ,"$25,875.00 ","$19,044.00 ","$17,181.00 ","$19,044.00 ", N/A ,"$19,044.00 ","$17,250.00 ","$17,250.00 ","$29,325.00 ", N/A ,"$17,077.50 ", N/A ,"$34,500.00 ","$18,975.00 ", N/A ,"$9,073.50 ","$34,500.00 ", N/A , N/A , N/A ,"$27,600.00 ","$18,733.50 ","$9,660.00 ","$31,050.00 ","$17,112.00 ","$12,075.00 ", N/A ,"$16,560.00 "
ST. MARY'S HOSPITAL - DECATUR,27500051,C1721,HC ICD DEFIB DUAL CHAMBER T9,275,1 ,"$36,000.00 ","$23,400.00 ","$9,468.00 ","$36,000.00 ", N/A ,"$18,360.00 ","$19,800.00 ", N/A ,"$10,080.00 ","$16,920.00 ", N/A ,"$19,440.00 ", N/A ,"$19,548.00 ","$19,548.00 ", N/A ,"$19,548.00 ", N/A ,"$18,000.00 ","$18,000.00 ","$28,800.00 ", N/A , N/A ,"$25,200.00 ", N/A ,"$21,600.00 ", N/A ,"$27,000.00 ","$19,872.00 ","$17,928.00 ","$19,872.00 ", N/A ,"$19,872.00 ","$18,000.00 ","$18,000.00 ","$30,600.00 ", N/A ,"$17,820.00 ", N/A ,"$36,000.00 ","$19,800.00 ", N/A ,"$9,468.00 ","$36,000.00 ", N/A , N/A , N/A ,"$28,800.00 ","$19,548.00 ","$10,080.00 ","$32,400.00 ","$17,856.00 ","$12,600.00 ", N/A ,"$17,280.00 "
ST. MARY'S HOSPITAL - DECATUR,27500052,C1721,HC ICD DEFIB DUAL CHAMBER T10,275,1 ,"$39,000.00 ","$25,350.00 ","$10,257.00 ","$39,000.00 ", N/A ,"$19,890.00 ","$21,450.00 ", N/A ,"$10,920.00 ","$18,330.00 ", N/A ,"$21,060.00 ", N/A ,"$21,177.00 ","$21,177.00 ", N/A ,"$21,177.00 ", N/A ,"$19,500.00 ","$19,500.00 ","$31,200.00 ", N/A , N/A ,"$27,300.00 ", N/A ,"$23,400.00 ", N/A ,"$29,250.00 ","$21,528.00 ","$19,422.00 ","$21,528.00 ", N/A ,"$21,528.00 ","$19,500.00 ","$19,500.00 ","$33,150.00 ", N/A ,"$19,305.00 ", N/A ,"$39,000.00 ","$21,450.00 ", N/A ,"$10,257.00 ","$39,000.00 ", N/A , N/A , N/A ,"$31,200.00 ","$21,177.00 ","$10,920.00 ","$35,100.00 ","$19,344.00 ","$13,650.00 ", N/A ,"$18,720.00 "
ST. MARY'S HOSPITAL - DECATUR,27500053,C1721,HC ICD DEFIB DUAL CHAMBER T11,275,1 ,"$40,500.00 ","$26,325.00 ","$10,651.50 ","$40,500.00 ", N/A ,"$20,655.00 ","$22,275.00 ", N/A ,"$11,340.00 ","$19,035.00 ", N/A ,"$21,870.00 ", N/A ,"$21,991.50 ","$21,991.50 ", N/A ,"$21,991.50 ", N/A ,"$20,250.00 ","$20,250.00 ","$32,400.00 ", N/A , N/A ,"$28,350.00 ", N/A ,"$24,300.00 ", N/A ,"$30,375.00 ","$22,356.00 ","$20,169.00 ","$22,356.00 ", N/A ,"$22,356.00 ","$20,250.00 ","$20,250.00 ","$34,425.00 ", N/A ,"$20,047.50 ", N/A ,"$40,500.00 ","$22,275.00 ", N/A ,"$10,651.50 ","$40,500.00 ", N/A , N/A , N/A ,"$32,400.00 ","$21,991.50 ","$11,340.00 ","$36,450.00 ","$20,088.00 ","$14,175.00 ", N/A ,"$19,440.00 "
ST. MARY'S HOSPITAL - DECATUR,27500055,C1721,HC ICD DEFIB DUAL CHAMBER T13,275,1 ,"$41,000.00 ","$26,650.00 ","$10,783.00 ","$41,000.00 ", N/A ,"$20,910.00 ","$22,550.00 ", N/A ,"$11,480.00 ","$19,270.00 ", N/A ,"$22,140.00 ", N/A ,"$22,263.00 ","$22,263.00 ", N/A ,"$22,263.00 ", N/A ,"$20,500.00 ","$20,500.00 ","$32,800.00 ", N/A , N/A ,"$28,700.00 ", N/A ,"$24,600.00 ", N/A ,"$30,750.00 ","$22,632.00 ","$20,418.00 ","$22,632.00 ", N/A ,"$22,632.00 ","$20,500.00 ","$20,500.00 ","$34,850.00 ", N/A ,"$20,295.00 ", N/A ,"$41,000.00 ","$22,550.00 ", N/A ,"$10,783.00 ","$41,000.00 ", N/A , N/A , N/A ,"$32,800.00 ","$22,263.00 ","$11,480.00 ","$36,900.00 ","$20,336.00 ","$14,350.00 ", N/A ,"$19,680.00 "
ST. MARY'S HOSPITAL - DECATUR,27500056,C1721,HC ICD DEFIB DUAL CHAMBER T14,275,1 ,"$45,000.00 ","$29,250.00 ","$11,835.00 ","$45,000.00 ", N/A ,"$22,950.00 ","$24,750.00 ", N/A ,"$12,600.00 ","$21,150.00 ", N/A ,"$24,300.00 ", N/A ,"$24,435.00 ","$24,435.00 ", N/A ,"$24,435.00 ", N/A ,"$22,500.00 ","$22,500.00 ","$36,000.00 ", N/A , N/A ,"$31,500.00 ", N/A ,"$27,000.00 ", N/A ,"$33,750.00 ","$24,840.00 ","$22,410.00 ","$24,840.00 ", N/A ,"$24,840.00 ","$22,500.00 ","$22,500.00 ","$38,250.00 ", N/A ,"$22,275.00 ", N/A ,"$45,000.00 ","$24,750.00 ", N/A ,"$11,835.00 ","$45,000.00 ", N/A , N/A , N/A ,"$36,000.00 ","$24,435.00 ","$12,600.00 ","$40,500.00 ","$22,320.00 ","$15,750.00 ", N/A ,"$21,600.00 "
ST. MARY'S HOSPITAL - DECATUR,27500058,C1721,HC ICD DEFIB DUAL CHAMBER T16,275,1 ,"$48,000.00 ","$31,200.00 ","$12,624.00 ","$48,000.00 ", N/A ,"$24,480.00 ","$26,400.00 ", N/A ,"$13,440.00 ","$22,560.00 ", N/A ,"$25,920.00 ", N/A ,"$26,064.00 ","$26,064.00 ", N/A ,"$26,064.00 ", N/A ,"$24,000.00 ","$24,000.00 ","$38,400.00 ", N/A , N/A ,"$33,600.00 ", N/A ,"$28,800.00 ", N/A ,"$36,000.00 ","$26,496.00 ","$23,904.00 ","$26,496.00 ", N/A ,"$26,496.00 ","$24,000.00 ","$24,000.00 ","$40,800.00 ", N/A ,"$23,760.00 ", N/A ,"$48,000.00 ","$26,400.00 ", N/A ,"$12,624.00 ","$48,000.00 ", N/A , N/A , N/A ,"$38,400.00 ","$26,064.00 ","$13,440.00 ","$43,200.00 ","$23,808.00 ","$16,800.00 ", N/A ,"$23,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27500066,C1722,HC ICD DEFIB SINGLE CHAMBER T2,275,1 ,"$27,250.00 ","$17,712.50 ","$7,166.75 ","$27,250.00 ", N/A ,"$13,897.50 ","$14,987.50 ", N/A ,"$7,630.00 ","$12,807.50 ", N/A ,"$14,715.00 ", N/A ,"$14,796.75 ","$14,796.75 ", N/A ,"$14,796.75 ", N/A ,"$13,625.00 ","$13,625.00 ","$21,800.00 ", N/A , N/A ,"$19,075.00 ", N/A ,"$16,350.00 ", N/A ,"$20,437.50 ","$15,042.00 ","$13,570.50 ","$15,042.00 ", N/A ,"$15,042.00 ","$13,625.00 ","$13,625.00 ","$23,162.50 ", N/A ,"$13,488.75 ", N/A ,"$27,250.00 ","$14,987.50 ", N/A ,"$7,166.75 ","$27,250.00 ", N/A , N/A , N/A ,"$21,800.00 ","$14,796.75 ","$7,630.00 ","$24,525.00 ","$13,516.00 ","$9,537.50 ", N/A ,"$13,080.00 "
ST. MARY'S HOSPITAL - DECATUR,27500069,C1722,HC ICD DEFIB SINGLE CHAMBER T5,275,1 ,"$31,500.00 ","$20,475.00 ","$8,284.50 ","$31,500.00 ", N/A ,"$16,065.00 ","$17,325.00 ", N/A ,"$8,820.00 ","$14,805.00 ", N/A ,"$17,010.00 ", N/A ,"$17,104.50 ","$17,104.50 ", N/A ,"$17,104.50 ", N/A ,"$15,750.00 ","$15,750.00 ","$25,200.00 ", N/A , N/A ,"$22,050.00 ", N/A ,"$18,900.00 ", N/A ,"$23,625.00 ","$17,388.00 ","$15,687.00 ","$17,388.00 ", N/A ,"$17,388.00 ","$15,750.00 ","$15,750.00 ","$26,775.00 ", N/A ,"$15,592.50 ", N/A ,"$31,500.00 ","$17,325.00 ", N/A ,"$8,284.50 ","$31,500.00 ", N/A , N/A , N/A ,"$25,200.00 ","$17,104.50 ","$8,820.00 ","$28,350.00 ","$15,624.00 ","$11,025.00 ", N/A ,"$15,120.00 "
ST. MARY'S HOSPITAL - DECATUR,27500071,C1722,HC ICD DEFIB SINGLE CHAMBER T7,275,1 ,"$34,500.00 ","$22,425.00 ","$9,073.50 ","$34,500.00 ", N/A ,"$17,595.00 ","$18,975.00 ", N/A ,"$9,660.00 ","$16,215.00 ", N/A ,"$18,630.00 ", N/A ,"$18,733.50 ","$18,733.50 ", N/A ,"$18,733.50 ", N/A ,"$17,250.00 ","$17,250.00 ","$27,600.00 ", N/A , N/A ,"$24,150.00 ", N/A ,"$20,700.00 ", N/A ,"$25,875.00 ","$19,044.00 ","$17,181.00 ","$19,044.00 ", N/A ,"$19,044.00 ","$17,250.00 ","$17,250.00 ","$29,325.00 ", N/A ,"$17,077.50 ", N/A ,"$34,500.00 ","$18,975.00 ", N/A ,"$9,073.50 ","$34,500.00 ", N/A , N/A , N/A ,"$27,600.00 ","$18,733.50 ","$9,660.00 ","$31,050.00 ","$17,112.00 ","$12,075.00 ", N/A ,"$16,560.00 "
ST. MARY'S HOSPITAL - DECATUR,27500072,C1722,HC ICD DEFIB SINGLE CHAMBER T8,275,1 ,"$36,000.00 ","$23,400.00 ","$9,468.00 ","$36,000.00 ", N/A ,"$18,360.00 ","$19,800.00 ", N/A ,"$10,080.00 ","$16,920.00 ", N/A ,"$19,440.00 ", N/A ,"$19,548.00 ","$19,548.00 ", N/A ,"$19,548.00 ", N/A ,"$18,000.00 ","$18,000.00 ","$28,800.00 ", N/A , N/A ,"$25,200.00 ", N/A ,"$21,600.00 ", N/A ,"$27,000.00 ","$19,872.00 ","$17,928.00 ","$19,872.00 ", N/A ,"$19,872.00 ","$18,000.00 ","$18,000.00 ","$30,600.00 ", N/A ,"$17,820.00 ", N/A ,"$36,000.00 ","$19,800.00 ", N/A ,"$9,468.00 ","$36,000.00 ", N/A , N/A , N/A ,"$28,800.00 ","$19,548.00 ","$10,080.00 ","$32,400.00 ","$17,856.00 ","$12,600.00 ", N/A ,"$17,280.00 "
ST. MARY'S HOSPITAL - DECATUR,27500073,C1722,HC ICD DEFIB SINGLE CHAMBER T9,275,1 ,"$37,500.00 ","$24,375.00 ","$9,862.50 ","$37,500.00 ", N/A ,"$19,125.00 ","$20,625.00 ", N/A ,"$10,500.00 ","$17,625.00 ", N/A ,"$20,250.00 ", N/A ,"$20,362.50 ","$20,362.50 ", N/A ,"$20,362.50 ", N/A ,"$18,750.00 ","$18,750.00 ","$30,000.00 ", N/A , N/A ,"$26,250.00 ", N/A ,"$22,500.00 ", N/A ,"$28,125.00 ","$20,700.00 ","$18,675.00 ","$20,700.00 ", N/A ,"$20,700.00 ","$18,750.00 ","$18,750.00 ","$31,875.00 ", N/A ,"$18,562.50 ", N/A ,"$37,500.00 ","$20,625.00 ", N/A ,"$9,862.50 ","$37,500.00 ", N/A , N/A , N/A ,"$30,000.00 ","$20,362.50 ","$10,500.00 ","$33,750.00 ","$18,600.00 ","$13,125.00 ", N/A ,"$18,000.00 "
ST. MARY'S HOSPITAL - DECATUR,27500077,C1722,HC ICD DEFIB SINGLE CHAMBER T13,275,1 ,"$43,500.00 ","$28,275.00 ","$11,440.50 ","$43,500.00 ", N/A ,"$22,185.00 ","$23,925.00 ", N/A ,"$12,180.00 ","$20,445.00 ", N/A ,"$23,490.00 ", N/A ,"$23,620.50 ","$23,620.50 ", N/A ,"$23,620.50 ", N/A ,"$21,750.00 ","$21,750.00 ","$34,800.00 ", N/A , N/A ,"$30,450.00 ", N/A ,"$26,100.00 ", N/A ,"$32,625.00 ","$24,012.00 ","$21,663.00 ","$24,012.00 ", N/A ,"$24,012.00 ","$21,750.00 ","$21,750.00 ","$36,975.00 ", N/A ,"$21,532.50 ", N/A ,"$43,500.00 ","$23,925.00 ", N/A ,"$11,440.50 ","$43,500.00 ", N/A , N/A , N/A ,"$34,800.00 ","$23,620.50 ","$12,180.00 ","$39,150.00 ","$21,576.00 ","$15,225.00 ", N/A ,"$20,880.00 "
ST. MARY'S HOSPITAL - DECATUR,27500080,C1722,HC ICD DEFIB SINGLE CHAMBER T16,275,1 ,"$48,000.00 ","$31,200.00 ","$12,624.00 ","$48,000.00 ", N/A ,"$24,480.00 ","$26,400.00 ", N/A ,"$13,440.00 ","$22,560.00 ", N/A ,"$25,920.00 ", N/A ,"$26,064.00 ","$26,064.00 ", N/A ,"$26,064.00 ", N/A ,"$24,000.00 ","$24,000.00 ","$38,400.00 ", N/A , N/A ,"$33,600.00 ", N/A ,"$28,800.00 ", N/A ,"$36,000.00 ","$26,496.00 ","$23,904.00 ","$26,496.00 ", N/A ,"$26,496.00 ","$24,000.00 ","$24,000.00 ","$40,800.00 ", N/A ,"$23,760.00 ", N/A ,"$48,000.00 ","$26,400.00 ", N/A ,"$12,624.00 ","$48,000.00 ", N/A , N/A , N/A ,"$38,400.00 ","$26,064.00 ","$13,440.00 ","$43,200.00 ","$23,808.00 ","$16,800.00 ", N/A ,"$23,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27500094,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T8,275,1 ,"$9,900.00 ","$6,435.00 ","$2,603.70 ","$9,900.00 ", N/A ,"$5,049.00 ","$5,445.00 ", N/A ,"$2,772.00 ","$4,653.00 ", N/A ,"$5,346.00 ", N/A ,"$5,375.70 ","$5,375.70 ", N/A ,"$5,375.70 ", N/A ,"$4,950.00 ","$4,950.00 ","$7,920.00 ", N/A , N/A ,"$6,930.00 ", N/A ,"$5,940.00 ", N/A ,"$7,425.00 ","$5,464.80 ","$4,930.20 ","$5,464.80 ", N/A ,"$5,464.80 ","$4,950.00 ","$4,950.00 ","$8,415.00 ", N/A ,"$4,900.50 ", N/A ,"$9,900.00 ","$5,445.00 ", N/A ,"$2,603.70 ","$9,900.00 ", N/A , N/A , N/A ,"$7,920.00 ","$5,375.70 ","$2,772.00 ","$8,910.00 ","$4,910.40 ","$3,465.00 ", N/A ,"$4,752.00 "
ST. MARY'S HOSPITAL - DECATUR,27500095,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T9,275,1 ,"$10,500.00 ","$6,825.00 ","$2,761.50 ","$10,500.00 ", N/A ,"$5,355.00 ","$5,775.00 ", N/A ,"$2,940.00 ","$4,935.00 ", N/A ,"$5,670.00 ", N/A ,"$5,701.50 ","$5,701.50 ", N/A ,"$5,701.50 ", N/A ,"$5,250.00 ","$5,250.00 ","$8,400.00 ", N/A , N/A ,"$7,350.00 ", N/A ,"$6,300.00 ", N/A ,"$7,875.00 ","$5,796.00 ","$5,229.00 ","$5,796.00 ", N/A ,"$5,796.00 ","$5,250.00 ","$5,250.00 ","$8,925.00 ", N/A ,"$5,197.50 ", N/A ,"$10,500.00 ","$5,775.00 ", N/A ,"$2,761.50 ","$10,500.00 ", N/A , N/A , N/A ,"$8,400.00 ","$5,701.50 ","$2,940.00 ","$9,450.00 ","$5,208.00 ","$3,675.00 ", N/A ,"$5,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27500098,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T12,275,1 ,"$12,300.00 ","$7,995.00 ","$3,234.90 ","$12,300.00 ", N/A ,"$6,273.00 ","$6,765.00 ", N/A ,"$3,444.00 ","$5,781.00 ", N/A ,"$6,642.00 ", N/A ,"$6,678.90 ","$6,678.90 ", N/A ,"$6,678.90 ", N/A ,"$6,150.00 ","$6,150.00 ","$9,840.00 ", N/A , N/A ,"$8,610.00 ", N/A ,"$7,380.00 ", N/A ,"$9,225.00 ","$6,789.60 ","$6,125.40 ","$6,789.60 ", N/A ,"$6,789.60 ","$6,150.00 ","$6,150.00 ","$10,455.00 ", N/A ,"$6,088.50 ", N/A ,"$12,300.00 ","$6,765.00 ", N/A ,"$3,234.90 ","$12,300.00 ", N/A , N/A , N/A ,"$9,840.00 ","$6,678.90 ","$3,444.00 ","$11,070.00 ","$6,100.80 ","$4,305.00 ", N/A ,"$5,904.00 "
ST. MARY'S HOSPITAL - DECATUR,27500099,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T13,275,1 ,"$12,900.00 ","$8,385.00 ","$3,392.70 ","$12,900.00 ", N/A ,"$6,579.00 ","$7,095.00 ", N/A ,"$3,612.00 ","$6,063.00 ", N/A ,"$6,966.00 ", N/A ,"$7,004.70 ","$7,004.70 ", N/A ,"$7,004.70 ", N/A ,"$6,450.00 ","$6,450.00 ","$10,320.00 ", N/A , N/A ,"$9,030.00 ", N/A ,"$7,740.00 ", N/A ,"$9,675.00 ","$7,120.80 ","$6,424.20 ","$7,120.80 ", N/A ,"$7,120.80 ","$6,450.00 ","$6,450.00 ","$10,965.00 ", N/A ,"$6,385.50 ", N/A ,"$12,900.00 ","$7,095.00 ", N/A ,"$3,392.70 ","$12,900.00 ", N/A , N/A , N/A ,"$10,320.00 ","$7,004.70 ","$3,612.00 ","$11,610.00 ","$6,398.40 ","$4,515.00 ", N/A ,"$6,192.00 "
ST. MARY'S HOSPITAL - DECATUR,27500100,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T14,275,1 ,"$13,500.00 ","$8,775.00 ","$3,550.50 ","$13,500.00 ", N/A ,"$6,885.00 ","$7,425.00 ", N/A ,"$3,780.00 ","$6,345.00 ", N/A ,"$7,290.00 ", N/A ,"$7,330.50 ","$7,330.50 ", N/A ,"$7,330.50 ", N/A ,"$6,750.00 ","$6,750.00 ","$10,800.00 ", N/A , N/A ,"$9,450.00 ", N/A ,"$8,100.00 ", N/A ,"$10,125.00 ","$7,452.00 ","$6,723.00 ","$7,452.00 ", N/A ,"$7,452.00 ","$6,750.00 ","$6,750.00 ","$11,475.00 ", N/A ,"$6,682.50 ", N/A ,"$13,500.00 ","$7,425.00 ", N/A ,"$3,550.50 ","$13,500.00 ", N/A , N/A , N/A ,"$10,800.00 ","$7,330.50 ","$3,780.00 ","$12,150.00 ","$6,696.00 ","$4,725.00 ", N/A ,"$6,480.00 "
ST. MARY'S HOSPITAL - DECATUR,27500103,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T17,275,1 ,"$8,700.00 ","$5,655.00 ","$2,288.10 ","$8,700.00 ", N/A ,"$4,437.00 ","$4,785.00 ", N/A ,"$2,436.00 ","$4,089.00 ", N/A ,"$4,698.00 ", N/A ,"$4,724.10 ","$4,724.10 ", N/A ,"$4,724.10 ", N/A ,"$4,350.00 ","$4,350.00 ","$6,960.00 ", N/A , N/A ,"$6,090.00 ", N/A ,"$5,220.00 ", N/A ,"$6,525.00 ","$4,802.40 ","$4,332.60 ","$4,802.40 ", N/A ,"$4,802.40 ","$4,350.00 ","$4,350.00 ","$7,395.00 ", N/A ,"$4,306.50 ", N/A ,"$8,700.00 ","$4,785.00 ", N/A ,"$2,288.10 ","$8,700.00 ", N/A , N/A , N/A ,"$6,960.00 ","$4,724.10 ","$2,436.00 ","$7,830.00 ","$4,315.20 ","$3,045.00 ", N/A ,"$4,176.00 "
ST. MARY'S HOSPITAL - DECATUR,27500104,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T18,275,1 ,"$16,500.00 ","$10,725.00 ","$4,339.50 ","$16,500.00 ", N/A ,"$8,415.00 ","$9,075.00 ", N/A ,"$4,620.00 ","$7,755.00 ", N/A ,"$8,910.00 ", N/A ,"$8,959.50 ","$8,959.50 ", N/A ,"$8,959.50 ", N/A ,"$8,250.00 ","$8,250.00 ","$13,200.00 ", N/A , N/A ,"$11,550.00 ", N/A ,"$9,900.00 ", N/A ,"$12,375.00 ","$9,108.00 ","$8,217.00 ","$9,108.00 ", N/A ,"$9,108.00 ","$8,250.00 ","$8,250.00 ","$14,025.00 ", N/A ,"$8,167.50 ", N/A ,"$16,500.00 ","$9,075.00 ", N/A ,"$4,339.50 ","$16,500.00 ", N/A , N/A , N/A ,"$13,200.00 ","$8,959.50 ","$4,620.00 ","$14,850.00 ","$8,184.00 ","$5,775.00 ", N/A ,"$7,920.00 "
ST. MARY'S HOSPITAL - DECATUR,27500108,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T22,275,1 ,"$19,500.00 ","$12,675.00 ","$5,128.50 ","$19,500.00 ", N/A ,"$9,945.00 ","$10,725.00 ", N/A ,"$5,460.00 ","$9,165.00 ", N/A ,"$10,530.00 ", N/A ,"$10,588.50 ","$10,588.50 ", N/A ,"$10,588.50 ", N/A ,"$9,750.00 ","$9,750.00 ","$15,600.00 ", N/A , N/A ,"$13,650.00 ", N/A ,"$11,700.00 ", N/A ,"$14,625.00 ","$10,764.00 ","$9,711.00 ","$10,764.00 ", N/A ,"$10,764.00 ","$9,750.00 ","$9,750.00 ","$16,575.00 ", N/A ,"$9,652.50 ", N/A ,"$19,500.00 ","$10,725.00 ", N/A ,"$5,128.50 ","$19,500.00 ", N/A , N/A , N/A ,"$15,600.00 ","$10,588.50 ","$5,460.00 ","$17,550.00 ","$9,672.00 ","$6,825.00 ", N/A ,"$9,360.00 "
ST. MARY'S HOSPITAL - DECATUR,27500110,C1785,HC PACEMAKER DUAL CHAMBER RATE-RESP T24,275,1 ,"$21,000.00 ","$13,650.00 ","$5,523.00 ","$21,000.00 ", N/A ,"$10,710.00 ","$11,550.00 ", N/A ,"$5,880.00 ","$9,870.00 ", N/A ,"$11,340.00 ", N/A ,"$11,403.00 ","$11,403.00 ", N/A ,"$11,403.00 ", N/A ,"$10,500.00 ","$10,500.00 ","$16,800.00 ", N/A , N/A ,"$14,700.00 ", N/A ,"$12,600.00 ", N/A ,"$15,750.00 ","$11,592.00 ","$10,458.00 ","$11,592.00 ", N/A ,"$11,592.00 ","$10,500.00 ","$10,500.00 ","$17,850.00 ", N/A ,"$10,395.00 ", N/A ,"$21,000.00 ","$11,550.00 ", N/A ,"$5,523.00 ","$21,000.00 ", N/A , N/A , N/A ,"$16,800.00 ","$11,403.00 ","$5,880.00 ","$18,900.00 ","$10,416.00 ","$7,350.00 ", N/A ,"$10,080.00 "
ST. MARY'S HOSPITAL - DECATUR,27500120,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T10,275,1 ,"$7,500.00 ","$4,875.00 ","$1,972.50 ","$7,500.00 ", N/A ,"$3,825.00 ","$4,125.00 ", N/A ,"$2,100.00 ","$3,525.00 ", N/A ,"$4,050.00 ", N/A ,"$4,072.50 ","$4,072.50 ", N/A ,"$4,072.50 ", N/A ,"$3,750.00 ","$3,750.00 ","$6,000.00 ", N/A , N/A ,"$5,250.00 ", N/A ,"$4,500.00 ", N/A ,"$5,625.00 ","$4,140.00 ","$3,735.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,750.00 ","$3,750.00 ","$6,375.00 ", N/A ,"$3,712.50 ", N/A ,"$7,500.00 ","$4,125.00 ", N/A ,"$1,972.50 ","$7,500.00 ", N/A , N/A , N/A ,"$6,000.00 ","$4,072.50 ","$2,100.00 ","$6,750.00 ","$3,720.00 ","$2,625.00 ", N/A ,"$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,27500121,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T11,275,1 ,"$8,100.00 ","$5,265.00 ","$2,130.30 ","$8,100.00 ", N/A ,"$4,131.00 ","$4,455.00 ", N/A ,"$2,268.00 ","$3,807.00 ", N/A ,"$4,374.00 ", N/A ,"$4,398.30 ","$4,398.30 ", N/A ,"$4,398.30 ", N/A ,"$4,050.00 ","$4,050.00 ","$6,480.00 ", N/A , N/A ,"$5,670.00 ", N/A ,"$4,860.00 ", N/A ,"$6,075.00 ","$4,471.20 ","$4,033.80 ","$4,471.20 ", N/A ,"$4,471.20 ","$4,050.00 ","$4,050.00 ","$6,885.00 ", N/A ,"$4,009.50 ", N/A ,"$8,100.00 ","$4,455.00 ", N/A ,"$2,130.30 ","$8,100.00 ", N/A , N/A , N/A ,"$6,480.00 ","$4,398.30 ","$2,268.00 ","$7,290.00 ","$4,017.60 ","$2,835.00 ", N/A ,"$3,888.00 "
ST. MARY'S HOSPITAL - DECATUR,27500125,C1786,HC PACEMAKER SINGLE CHAMBER RATE-RESP T15,275,1 ,"$10,500.00 ","$6,825.00 ","$2,761.50 ","$10,500.00 ", N/A ,"$5,355.00 ","$5,775.00 ", N/A ,"$2,940.00 ","$4,935.00 ", N/A ,"$5,670.00 ", N/A ,"$5,701.50 ","$5,701.50 ", N/A ,"$5,701.50 ", N/A ,"$5,250.00 ","$5,250.00 ","$8,400.00 ", N/A , N/A ,"$7,350.00 ", N/A ,"$6,300.00 ", N/A ,"$7,875.00 ","$5,796.00 ","$5,229.00 ","$5,796.00 ", N/A ,"$5,796.00 ","$5,250.00 ","$5,250.00 ","$8,925.00 ", N/A ,"$5,197.50 ", N/A ,"$10,500.00 ","$5,775.00 ", N/A ,"$2,761.50 ","$10,500.00 ", N/A , N/A , N/A ,"$8,400.00 ","$5,701.50 ","$2,940.00 ","$9,450.00 ","$5,208.00 ","$3,675.00 ", N/A ,"$5,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27500156,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T17,275,1 ,"$46,500.00 ","$30,225.00 ","$12,229.50 ","$46,500.00 ", N/A ,"$23,715.00 ","$25,575.00 ", N/A ,"$13,020.00 ","$21,855.00 ", N/A ,"$25,110.00 ", N/A ,"$25,249.50 ","$25,249.50 ", N/A ,"$25,249.50 ", N/A ,"$23,250.00 ","$23,250.00 ","$37,200.00 ", N/A , N/A ,"$32,550.00 ", N/A ,"$27,900.00 ", N/A ,"$34,875.00 ","$25,668.00 ","$23,157.00 ","$25,668.00 ", N/A ,"$25,668.00 ","$23,250.00 ","$23,250.00 ","$39,525.00 ", N/A ,"$23,017.50 ", N/A ,"$46,500.00 ","$25,575.00 ", N/A ,"$12,229.50 ","$46,500.00 ", N/A , N/A , N/A ,"$37,200.00 ","$25,249.50 ","$13,020.00 ","$41,850.00 ","$23,064.00 ","$16,275.00 ", N/A ,"$22,320.00 "
ST. MARY'S HOSPITAL - DECATUR,27500157,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T18,275,1 ,"$48,000.00 ","$31,200.00 ","$12,624.00 ","$48,000.00 ", N/A ,"$24,480.00 ","$26,400.00 ", N/A ,"$13,440.00 ","$22,560.00 ", N/A ,"$25,920.00 ", N/A ,"$26,064.00 ","$26,064.00 ", N/A ,"$26,064.00 ", N/A ,"$24,000.00 ","$24,000.00 ","$38,400.00 ", N/A , N/A ,"$33,600.00 ", N/A ,"$28,800.00 ", N/A ,"$36,000.00 ","$26,496.00 ","$23,904.00 ","$26,496.00 ", N/A ,"$26,496.00 ","$24,000.00 ","$24,000.00 ","$40,800.00 ", N/A ,"$23,760.00 ", N/A ,"$48,000.00 ","$26,400.00 ", N/A ,"$12,624.00 ","$48,000.00 ", N/A , N/A , N/A ,"$38,400.00 ","$26,064.00 ","$13,440.00 ","$43,200.00 ","$23,808.00 ","$16,800.00 ", N/A ,"$23,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27500159,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T20,275,1 ,"$51,000.00 ","$33,150.00 ","$13,413.00 ","$51,000.00 ", N/A ,"$26,010.00 ","$28,050.00 ", N/A ,"$14,280.00 ","$23,970.00 ", N/A ,"$27,540.00 ", N/A ,"$27,693.00 ","$27,693.00 ", N/A ,"$27,693.00 ", N/A ,"$25,500.00 ","$25,500.00 ","$40,800.00 ", N/A , N/A ,"$35,700.00 ", N/A ,"$30,600.00 ", N/A ,"$38,250.00 ","$28,152.00 ","$25,398.00 ","$28,152.00 ", N/A ,"$28,152.00 ","$25,500.00 ","$25,500.00 ","$43,350.00 ", N/A ,"$25,245.00 ", N/A ,"$51,000.00 ","$28,050.00 ", N/A ,"$13,413.00 ","$51,000.00 ", N/A , N/A , N/A ,"$40,800.00 ","$27,693.00 ","$14,280.00 ","$45,900.00 ","$25,296.00 ","$17,850.00 ", N/A ,"$24,480.00 "
ST. MARY'S HOSPITAL - DECATUR,27500161,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T22,275,1 ,"$54,000.00 ","$35,100.00 ","$14,202.00 ","$54,000.00 ", N/A ,"$27,540.00 ","$29,700.00 ", N/A ,"$15,120.00 ","$25,380.00 ", N/A ,"$29,160.00 ", N/A ,"$29,322.00 ","$29,322.00 ", N/A ,"$29,322.00 ", N/A ,"$27,000.00 ","$27,000.00 ","$43,200.00 ", N/A , N/A ,"$37,800.00 ", N/A ,"$32,400.00 ", N/A ,"$40,500.00 ","$29,808.00 ","$26,892.00 ","$29,808.00 ", N/A ,"$29,808.00 ","$27,000.00 ","$27,000.00 ","$45,900.00 ", N/A ,"$26,730.00 ", N/A ,"$54,000.00 ","$29,700.00 ", N/A ,"$14,202.00 ","$54,000.00 ", N/A , N/A , N/A ,"$43,200.00 ","$29,322.00 ","$15,120.00 ","$48,600.00 ","$26,784.00 ","$18,900.00 ", N/A ,"$25,920.00 "
ST. MARY'S HOSPITAL - DECATUR,27500162,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T23,275,1 ,"$55,500.00 ","$36,075.00 ","$14,596.50 ","$55,500.00 ", N/A ,"$28,305.00 ","$30,525.00 ", N/A ,"$15,540.00 ","$26,085.00 ", N/A ,"$29,970.00 ", N/A ,"$30,136.50 ","$30,136.50 ", N/A ,"$30,136.50 ", N/A ,"$27,750.00 ","$27,750.00 ","$44,400.00 ", N/A , N/A ,"$38,850.00 ", N/A ,"$33,300.00 ", N/A ,"$41,625.00 ","$30,636.00 ","$27,639.00 ","$30,636.00 ", N/A ,"$30,636.00 ","$27,750.00 ","$27,750.00 ","$47,175.00 ", N/A ,"$27,472.50 ", N/A ,"$55,500.00 ","$30,525.00 ", N/A ,"$14,596.50 ","$55,500.00 ", N/A , N/A , N/A ,"$44,400.00 ","$30,136.50 ","$15,540.00 ","$49,950.00 ","$27,528.00 ","$19,425.00 ", N/A ,"$26,640.00 "
ST. MARY'S HOSPITAL - DECATUR,27500166,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T27,275,1 ,"$61,500.00 ","$39,975.00 ","$16,174.50 ","$61,500.00 ", N/A ,"$31,365.00 ","$33,825.00 ", N/A ,"$17,220.00 ","$28,905.00 ", N/A ,"$33,210.00 ", N/A ,"$33,394.50 ","$33,394.50 ", N/A ,"$33,394.50 ", N/A ,"$30,750.00 ","$30,750.00 ","$49,200.00 ", N/A , N/A ,"$43,050.00 ", N/A ,"$36,900.00 ", N/A ,"$46,125.00 ","$33,948.00 ","$30,627.00 ","$33,948.00 ", N/A ,"$33,948.00 ","$30,750.00 ","$30,750.00 ","$52,275.00 ", N/A ,"$30,442.50 ", N/A ,"$61,500.00 ","$33,825.00 ", N/A ,"$16,174.50 ","$61,500.00 ", N/A , N/A , N/A ,"$49,200.00 ","$33,394.50 ","$17,220.00 ","$55,350.00 ","$30,504.00 ","$21,525.00 ", N/A ,"$29,520.00 "
ST. MARY'S HOSPITAL - DECATUR,27500169,C1882,HC ICD DEFIB OTHR SINGLE/DUAL CHAMBER T30,275,1 ,"$66,000.00 ","$42,900.00 ","$17,358.00 ","$66,000.00 ", N/A ,"$33,660.00 ","$36,300.00 ", N/A ,"$18,480.00 ","$31,020.00 ", N/A ,"$35,640.00 ", N/A ,"$35,838.00 ","$35,838.00 ", N/A ,"$35,838.00 ", N/A ,"$33,000.00 ","$33,000.00 ","$52,800.00 ", N/A , N/A ,"$46,200.00 ", N/A ,"$39,600.00 ", N/A ,"$49,500.00 ","$36,432.00 ","$32,868.00 ","$36,432.00 ", N/A ,"$36,432.00 ","$33,000.00 ","$33,000.00 ","$56,100.00 ", N/A ,"$32,670.00 ", N/A ,"$66,000.00 ","$36,300.00 ", N/A ,"$17,358.00 ","$66,000.00 ", N/A , N/A , N/A ,"$52,800.00 ","$35,838.00 ","$18,480.00 ","$59,400.00 ","$32,736.00 ","$23,100.00 ", N/A ,"$31,680.00 "
ST. MARY'S HOSPITAL - DECATUR,27500188,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T18,275,1 ,"$16,500.00 ","$10,725.00 ","$4,339.50 ","$16,500.00 ", N/A ,"$8,415.00 ","$9,075.00 ", N/A ,"$4,620.00 ","$7,755.00 ", N/A ,"$8,910.00 ", N/A ,"$8,959.50 ","$8,959.50 ", N/A ,"$8,959.50 ", N/A ,"$8,250.00 ","$8,250.00 ","$13,200.00 ", N/A , N/A ,"$11,550.00 ", N/A ,"$9,900.00 ", N/A ,"$12,375.00 ","$9,108.00 ","$8,217.00 ","$9,108.00 ", N/A ,"$9,108.00 ","$8,250.00 ","$8,250.00 ","$14,025.00 ", N/A ,"$8,167.50 ", N/A ,"$16,500.00 ","$9,075.00 ", N/A ,"$4,339.50 ","$16,500.00 ", N/A , N/A , N/A ,"$13,200.00 ","$8,959.50 ","$4,620.00 ","$14,850.00 ","$8,184.00 ","$5,775.00 ", N/A ,"$7,920.00 "
ST. MARY'S HOSPITAL - DECATUR,27500192,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T22,275,1 ,"$19,500.00 ","$12,675.00 ","$5,128.50 ","$19,500.00 ", N/A ,"$9,945.00 ","$10,725.00 ", N/A ,"$5,460.00 ","$9,165.00 ", N/A ,"$10,530.00 ", N/A ,"$10,588.50 ","$10,588.50 ", N/A ,"$10,588.50 ", N/A ,"$9,750.00 ","$9,750.00 ","$15,600.00 ", N/A , N/A ,"$13,650.00 ", N/A ,"$11,700.00 ", N/A ,"$14,625.00 ","$10,764.00 ","$9,711.00 ","$10,764.00 ", N/A ,"$10,764.00 ","$9,750.00 ","$9,750.00 ","$16,575.00 ", N/A ,"$9,652.50 ", N/A ,"$19,500.00 ","$10,725.00 ", N/A ,"$5,128.50 ","$19,500.00 ", N/A , N/A , N/A ,"$15,600.00 ","$10,588.50 ","$5,460.00 ","$17,550.00 ","$9,672.00 ","$6,825.00 ", N/A ,"$9,360.00 "
ST. MARY'S HOSPITAL - DECATUR,27500193,C2621,HC PACEMAKER OTHER THAN SINGLE/DUAL T23,275,1 ,"$18,500.00 ","$12,025.00 ","$4,865.50 ","$18,500.00 ", N/A ,"$9,435.00 ","$10,175.00 ", N/A ,"$5,180.00 ","$8,695.00 ", N/A ,"$9,990.00 ", N/A ,"$10,045.50 ","$10,045.50 ", N/A ,"$10,045.50 ", N/A ,"$9,250.00 ","$9,250.00 ","$14,800.00 ", N/A , N/A ,"$12,950.00 ", N/A ,"$11,100.00 ", N/A ,"$13,875.00 ","$10,212.00 ","$9,213.00 ","$10,212.00 ", N/A ,"$10,212.00 ","$9,250.00 ","$9,250.00 ","$15,725.00 ", N/A ,"$9,157.50 ", N/A ,"$18,500.00 ","$10,175.00 ", N/A ,"$4,865.50 ","$18,500.00 ", N/A , N/A , N/A ,"$14,800.00 ","$10,045.50 ","$5,180.00 ","$16,650.00 ","$9,176.00 ","$6,475.00 ", N/A ,"$8,880.00 "
ST. MARY'S HOSPITAL - DECATUR,27801599,C1764,HC RECORDER CARDIAC EVENT IMPLANT T17,278,1 ,"$15,000.00 ","$9,750.00 ","$3,945.00 ","$15,000.00 ", N/A ,"$7,650.00 ","$8,250.00 ", N/A ,"$4,200.00 ","$7,050.00 ", N/A ,"$8,100.00 ", N/A ,"$8,145.00 ","$8,145.00 ", N/A ,"$8,145.00 ", N/A ,"$7,500.00 ","$7,500.00 ","$12,000.00 ", N/A , N/A ,"$10,500.00 ", N/A ,"$9,000.00 ", N/A ,"$11,250.00 ","$8,280.00 ","$7,470.00 ","$8,280.00 ", N/A ,"$8,280.00 ","$7,500.00 ","$7,500.00 ","$12,750.00 ", N/A ,"$7,425.00 ", N/A ,"$15,000.00 ","$8,250.00 ", N/A ,"$3,945.00 ","$15,000.00 ", N/A , N/A , N/A ,"$12,000.00 ","$8,145.00 ","$4,200.00 ","$13,500.00 ","$7,440.00 ","$5,250.00 ", N/A ,"$7,200.00 "
ST. MARY'S HOSPITAL - DECATUR,27801601,C1764,HC RECORDER CARDIAC EVENT IMPLANT T19,278,1 ,"$15,600.00 ","$10,140.00 ","$4,102.80 ","$15,600.00 ", N/A ,"$7,956.00 ","$8,580.00 ", N/A ,"$4,368.00 ","$7,332.00 ", N/A ,"$8,424.00 ", N/A ,"$8,470.80 ","$8,470.80 ", N/A ,"$8,470.80 ", N/A ,"$7,800.00 ","$7,800.00 ","$12,480.00 ", N/A , N/A ,"$10,920.00 ", N/A ,"$9,360.00 ", N/A ,"$11,700.00 ","$8,611.20 ","$7,768.80 ","$8,611.20 ", N/A ,"$8,611.20 ","$7,800.00 ","$7,800.00 ","$13,260.00 ", N/A ,"$7,722.00 ", N/A ,"$15,600.00 ","$8,580.00 ", N/A ,"$4,102.80 ","$15,600.00 ", N/A , N/A , N/A ,"$12,480.00 ","$8,470.80 ","$4,368.00 ","$14,040.00 ","$7,737.60 ","$5,460.00 ", N/A ,"$7,488.00 "
ST. MARY'S HOSPITAL - DECATUR,27801621,C1779,HC LEAD PACEMAKER TRANSVENOUS VDD T1,278,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A , N/A ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$285.08 , N/A ,$285.08 , N/A ,$262.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$262.50 ,$262.50 ,$446.25 , N/A ,$259.88 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$260.40 , N/A , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27801669,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T5,278,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ","$1,140.30 ", N/A ,"$1,140.30 ", N/A ,"$1,050.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,050.00 ","$1,050.00 ","$1,785.00 ", N/A ,"$1,039.50 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ","$1,041.60 ",$735.00 , N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27801670,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T6,278,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,466.10 ", N/A ,"$1,466.10 ", N/A ,"$1,350.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$1,350.00 ","$1,350.00 ","$2,295.00 ", N/A ,"$1,336.50 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,339.20 ",$945.00 , N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27801671,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T7,278,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,791.90 ", N/A ,"$1,791.90 ", N/A ,"$1,650.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$1,650.00 ","$1,650.00 ","$2,805.00 ", N/A ,"$1,633.50 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,636.80 ","$1,155.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27801672,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T8,278,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$2,117.70 ", N/A ,"$2,117.70 ", N/A ,"$1,950.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$1,950.00 ","$1,950.00 ","$3,315.00 ", N/A ,"$1,930.50 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,934.40 ","$1,365.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27801673,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T9,278,1 ,"$4,500.00 ","$2,925.00 ","$1,183.50 ","$4,500.00 ", N/A ,"$2,295.00 ","$2,475.00 ", N/A ,"$1,260.00 ","$2,115.00 ", N/A ,"$2,430.00 ", N/A ,"$2,443.50 ","$2,443.50 ", N/A ,"$2,443.50 ", N/A ,"$2,250.00 ","$2,250.00 ","$3,600.00 ", N/A , N/A ,"$3,150.00 ", N/A ,"$2,700.00 ", N/A ,"$3,375.00 ","$2,484.00 ","$2,241.00 ","$2,484.00 ", N/A ,"$2,484.00 ","$2,250.00 ","$2,250.00 ","$3,825.00 ", N/A ,"$2,227.50 ", N/A ,"$4,500.00 ","$2,475.00 ", N/A ,"$1,183.50 ","$4,500.00 ", N/A , N/A , N/A ,"$3,600.00 ","$2,443.50 ","$1,260.00 ","$4,050.00 ","$2,232.00 ","$1,575.00 ", N/A ,"$2,160.00 "
ST. MARY'S HOSPITAL - DECATUR,27801674,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T10,278,1 ,"$5,100.00 ","$3,315.00 ","$1,341.30 ","$5,100.00 ", N/A ,"$2,601.00 ","$2,805.00 ", N/A ,"$1,428.00 ","$2,397.00 ", N/A ,"$2,754.00 ", N/A ,"$2,769.30 ","$2,769.30 ", N/A ,"$2,769.30 ", N/A ,"$2,550.00 ","$2,550.00 ","$4,080.00 ", N/A , N/A ,"$3,570.00 ", N/A ,"$3,060.00 ", N/A ,"$3,825.00 ","$2,815.20 ","$2,539.80 ","$2,815.20 ", N/A ,"$2,815.20 ","$2,550.00 ","$2,550.00 ","$4,335.00 ", N/A ,"$2,524.50 ", N/A ,"$5,100.00 ","$2,805.00 ", N/A ,"$1,341.30 ","$5,100.00 ", N/A , N/A , N/A ,"$4,080.00 ","$2,769.30 ","$1,428.00 ","$4,590.00 ","$2,529.60 ","$1,785.00 ", N/A ,"$2,448.00 "
ST. MARY'S HOSPITAL - DECATUR,27801676,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T12,278,1 ,"$6,300.00 ","$4,095.00 ","$1,656.90 ","$6,300.00 ", N/A ,"$3,213.00 ","$3,465.00 ", N/A ,"$1,764.00 ","$2,961.00 ", N/A ,"$3,402.00 ", N/A ,"$3,420.90 ","$3,420.90 ", N/A ,"$3,420.90 ", N/A ,"$3,150.00 ","$3,150.00 ","$5,040.00 ", N/A , N/A ,"$4,410.00 ", N/A ,"$3,780.00 ", N/A ,"$4,725.00 ","$3,477.60 ","$3,137.40 ","$3,477.60 ", N/A ,"$3,477.60 ","$3,150.00 ","$3,150.00 ","$5,355.00 ", N/A ,"$3,118.50 ", N/A ,"$6,300.00 ","$3,465.00 ", N/A ,"$1,656.90 ","$6,300.00 ", N/A , N/A , N/A ,"$5,040.00 ","$3,420.90 ","$1,764.00 ","$5,670.00 ","$3,124.80 ","$2,205.00 ", N/A ,"$3,024.00 "
ST. MARY'S HOSPITAL - DECATUR,27801677,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T13,278,1 ,"$6,900.00 ","$4,485.00 ","$1,814.70 ","$6,900.00 ", N/A ,"$3,519.00 ","$3,795.00 ", N/A ,"$1,932.00 ","$3,243.00 ", N/A ,"$3,726.00 ", N/A ,"$3,746.70 ","$3,746.70 ", N/A ,"$3,746.70 ", N/A ,"$3,450.00 ","$3,450.00 ","$5,520.00 ", N/A , N/A ,"$4,830.00 ", N/A ,"$4,140.00 ", N/A ,"$5,175.00 ","$3,808.80 ","$3,436.20 ","$3,808.80 ", N/A ,"$3,808.80 ","$3,450.00 ","$3,450.00 ","$5,865.00 ", N/A ,"$3,415.50 ", N/A ,"$6,900.00 ","$3,795.00 ", N/A ,"$1,814.70 ","$6,900.00 ", N/A , N/A , N/A ,"$5,520.00 ","$3,746.70 ","$1,932.00 ","$6,210.00 ","$3,422.40 ","$2,415.00 ", N/A ,"$3,312.00 "
ST. MARY'S HOSPITAL - DECATUR,27801678,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T14,278,1 ,"$7,500.00 ","$4,875.00 ","$1,972.50 ","$7,500.00 ", N/A ,"$3,825.00 ","$4,125.00 ", N/A ,"$2,100.00 ","$3,525.00 ", N/A ,"$4,050.00 ", N/A ,"$4,072.50 ","$4,072.50 ", N/A ,"$4,072.50 ", N/A ,"$3,750.00 ","$3,750.00 ","$6,000.00 ", N/A , N/A ,"$5,250.00 ", N/A ,"$4,500.00 ", N/A ,"$5,625.00 ","$4,140.00 ","$3,735.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,750.00 ","$3,750.00 ","$6,375.00 ", N/A ,"$3,712.50 ", N/A ,"$7,500.00 ","$4,125.00 ", N/A ,"$1,972.50 ","$7,500.00 ", N/A , N/A , N/A ,"$6,000.00 ","$4,072.50 ","$2,100.00 ","$6,750.00 ","$3,720.00 ","$2,625.00 ", N/A ,"$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,27801679,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T15,278,1 ,"$8,100.00 ","$5,265.00 ","$2,130.30 ","$8,100.00 ", N/A ,"$4,131.00 ","$4,455.00 ", N/A ,"$2,268.00 ","$3,807.00 ", N/A ,"$4,374.00 ", N/A ,"$4,398.30 ","$4,398.30 ", N/A ,"$4,398.30 ", N/A ,"$4,050.00 ","$4,050.00 ","$6,480.00 ", N/A , N/A ,"$5,670.00 ", N/A ,"$4,860.00 ", N/A ,"$6,075.00 ","$4,471.20 ","$4,033.80 ","$4,471.20 ", N/A ,"$4,471.20 ","$4,050.00 ","$4,050.00 ","$6,885.00 ", N/A ,"$4,009.50 ", N/A ,"$8,100.00 ","$4,455.00 ", N/A ,"$2,130.30 ","$8,100.00 ", N/A , N/A , N/A ,"$6,480.00 ","$4,398.30 ","$2,268.00 ","$7,290.00 ","$4,017.60 ","$2,835.00 ", N/A ,"$3,888.00 "
ST. MARY'S HOSPITAL - DECATUR,27801680,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T16,278,1 ,"$8,700.00 ","$5,655.00 ","$2,288.10 ","$8,700.00 ", N/A ,"$4,437.00 ","$4,785.00 ", N/A ,"$2,436.00 ","$4,089.00 ", N/A ,"$4,698.00 ", N/A ,"$4,724.10 ","$4,724.10 ", N/A ,"$4,724.10 ", N/A ,"$4,350.00 ","$4,350.00 ","$6,960.00 ", N/A , N/A ,"$6,090.00 ", N/A ,"$5,220.00 ", N/A ,"$6,525.00 ","$4,802.40 ","$4,332.60 ","$4,802.40 ", N/A ,"$4,802.40 ","$4,350.00 ","$4,350.00 ","$7,395.00 ", N/A ,"$4,306.50 ", N/A ,"$8,700.00 ","$4,785.00 ", N/A ,"$2,288.10 ","$8,700.00 ", N/A , N/A , N/A ,"$6,960.00 ","$4,724.10 ","$2,436.00 ","$7,830.00 ","$4,315.20 ","$3,045.00 ", N/A ,"$4,176.00 "
ST. MARY'S HOSPITAL - DECATUR,27801681,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T17,278,1 ,"$9,300.00 ","$6,045.00 ","$2,445.90 ","$9,300.00 ", N/A ,"$4,743.00 ","$5,115.00 ", N/A ,"$2,604.00 ","$4,371.00 ", N/A ,"$5,022.00 ", N/A ,"$5,049.90 ","$5,049.90 ", N/A ,"$5,049.90 ", N/A ,"$4,650.00 ","$4,650.00 ","$7,440.00 ", N/A , N/A ,"$6,510.00 ", N/A ,"$5,580.00 ", N/A ,"$6,975.00 ","$5,133.60 ","$4,631.40 ","$5,133.60 ", N/A ,"$5,133.60 ","$4,650.00 ","$4,650.00 ","$7,905.00 ", N/A ,"$4,603.50 ", N/A ,"$9,300.00 ","$5,115.00 ", N/A ,"$2,445.90 ","$9,300.00 ", N/A , N/A , N/A ,"$7,440.00 ","$5,049.90 ","$2,604.00 ","$8,370.00 ","$4,612.80 ","$3,255.00 ", N/A ,"$4,464.00 "
ST. MARY'S HOSPITAL - DECATUR,27801682,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T18,278,1 ,"$9,900.00 ","$6,435.00 ","$2,603.70 ","$9,900.00 ", N/A ,"$5,049.00 ","$5,445.00 ", N/A ,"$2,772.00 ","$4,653.00 ", N/A ,"$5,346.00 ", N/A ,"$5,375.70 ","$5,375.70 ", N/A ,"$5,375.70 ", N/A ,"$4,950.00 ","$4,950.00 ","$7,920.00 ", N/A , N/A ,"$6,930.00 ", N/A ,"$5,940.00 ", N/A ,"$7,425.00 ","$5,464.80 ","$4,930.20 ","$5,464.80 ", N/A ,"$5,464.80 ","$4,950.00 ","$4,950.00 ","$8,415.00 ", N/A ,"$4,900.50 ", N/A ,"$9,900.00 ","$5,445.00 ", N/A ,"$2,603.70 ","$9,900.00 ", N/A , N/A , N/A ,"$7,920.00 ","$5,375.70 ","$2,772.00 ","$8,910.00 ","$4,910.40 ","$3,465.00 ", N/A ,"$4,752.00 "
ST. MARY'S HOSPITAL - DECATUR,27801683,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T19,278,1 ,"$10,500.00 ","$6,825.00 ","$2,761.50 ","$10,500.00 ", N/A ,"$5,355.00 ","$5,775.00 ", N/A ,"$2,940.00 ","$4,935.00 ", N/A ,"$5,670.00 ", N/A ,"$5,701.50 ","$5,701.50 ", N/A ,"$5,701.50 ", N/A ,"$5,250.00 ","$5,250.00 ","$8,400.00 ", N/A , N/A ,"$7,350.00 ", N/A ,"$6,300.00 ", N/A ,"$7,875.00 ","$5,796.00 ","$5,229.00 ","$5,796.00 ", N/A ,"$5,796.00 ","$5,250.00 ","$5,250.00 ","$8,925.00 ", N/A ,"$5,197.50 ", N/A ,"$10,500.00 ","$5,775.00 ", N/A ,"$2,761.50 ","$10,500.00 ", N/A , N/A , N/A ,"$8,400.00 ","$5,701.50 ","$2,940.00 ","$9,450.00 ","$5,208.00 ","$3,675.00 ", N/A ,"$5,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27801684,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T20,278,1 ,"$11,100.00 ","$7,215.00 ","$2,919.30 ","$11,100.00 ", N/A ,"$5,661.00 ","$6,105.00 ", N/A ,"$3,108.00 ","$5,217.00 ", N/A ,"$5,994.00 ", N/A ,"$6,027.30 ","$6,027.30 ", N/A ,"$6,027.30 ", N/A ,"$5,550.00 ","$5,550.00 ","$8,880.00 ", N/A , N/A ,"$7,770.00 ", N/A ,"$6,660.00 ", N/A ,"$8,325.00 ","$6,127.20 ","$5,527.80 ","$6,127.20 ", N/A ,"$6,127.20 ","$5,550.00 ","$5,550.00 ","$9,435.00 ", N/A ,"$5,494.50 ", N/A ,"$11,100.00 ","$6,105.00 ", N/A ,"$2,919.30 ","$11,100.00 ", N/A , N/A , N/A ,"$8,880.00 ","$6,027.30 ","$3,108.00 ","$9,990.00 ","$5,505.60 ","$3,885.00 ", N/A ,"$5,328.00 "
ST. MARY'S HOSPITAL - DECATUR,27801685,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T21,278,1 ,"$11,700.00 ","$7,605.00 ","$3,077.10 ","$11,700.00 ", N/A ,"$5,967.00 ","$6,435.00 ", N/A ,"$3,276.00 ","$5,499.00 ", N/A ,"$6,318.00 ", N/A ,"$6,353.10 ","$6,353.10 ", N/A ,"$6,353.10 ", N/A ,"$5,850.00 ","$5,850.00 ","$9,360.00 ", N/A , N/A ,"$8,190.00 ", N/A ,"$7,020.00 ", N/A ,"$8,775.00 ","$6,458.40 ","$5,826.60 ","$6,458.40 ", N/A ,"$6,458.40 ","$5,850.00 ","$5,850.00 ","$9,945.00 ", N/A ,"$5,791.50 ", N/A ,"$11,700.00 ","$6,435.00 ", N/A ,"$3,077.10 ","$11,700.00 ", N/A , N/A , N/A ,"$9,360.00 ","$6,353.10 ","$3,276.00 ","$10,530.00 ","$5,803.20 ","$4,095.00 ", N/A ,"$5,616.00 "
ST. MARY'S HOSPITAL - DECATUR,27801686,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T22,278,1 ,"$12,300.00 ","$7,995.00 ","$3,234.90 ","$12,300.00 ", N/A ,"$6,273.00 ","$6,765.00 ", N/A ,"$3,444.00 ","$5,781.00 ", N/A ,"$6,642.00 ", N/A ,"$6,678.90 ","$6,678.90 ", N/A ,"$6,678.90 ", N/A ,"$6,150.00 ","$6,150.00 ","$9,840.00 ", N/A , N/A ,"$8,610.00 ", N/A ,"$7,380.00 ", N/A ,"$9,225.00 ","$6,789.60 ","$6,125.40 ","$6,789.60 ", N/A ,"$6,789.60 ","$6,150.00 ","$6,150.00 ","$10,455.00 ", N/A ,"$6,088.50 ", N/A ,"$12,300.00 ","$6,765.00 ", N/A ,"$3,234.90 ","$12,300.00 ", N/A , N/A , N/A ,"$9,840.00 ","$6,678.90 ","$3,444.00 ","$11,070.00 ","$6,100.80 ","$4,305.00 ", N/A ,"$5,904.00 "
ST. MARY'S HOSPITAL - DECATUR,27801687,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T23,278,1 ,"$12,900.00 ","$8,385.00 ","$3,392.70 ","$12,900.00 ", N/A ,"$6,579.00 ","$7,095.00 ", N/A ,"$3,612.00 ","$6,063.00 ", N/A ,"$6,966.00 ", N/A ,"$7,004.70 ","$7,004.70 ", N/A ,"$7,004.70 ", N/A ,"$6,450.00 ","$6,450.00 ","$10,320.00 ", N/A , N/A ,"$9,030.00 ", N/A ,"$7,740.00 ", N/A ,"$9,675.00 ","$7,120.80 ","$6,424.20 ","$7,120.80 ", N/A ,"$7,120.80 ","$6,450.00 ","$6,450.00 ","$10,965.00 ", N/A ,"$6,385.50 ", N/A ,"$12,900.00 ","$7,095.00 ", N/A ,"$3,392.70 ","$12,900.00 ", N/A , N/A , N/A ,"$10,320.00 ","$7,004.70 ","$3,612.00 ","$11,610.00 ","$6,398.40 ","$4,515.00 ", N/A ,"$6,192.00 "
ST. MARY'S HOSPITAL - DECATUR,27801688,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T24,278,1 ,"$13,500.00 ","$8,775.00 ","$3,550.50 ","$13,500.00 ", N/A ,"$6,885.00 ","$7,425.00 ", N/A ,"$3,780.00 ","$6,345.00 ", N/A ,"$7,290.00 ", N/A ,"$7,330.50 ","$7,330.50 ", N/A ,"$7,330.50 ", N/A ,"$6,750.00 ","$6,750.00 ","$10,800.00 ", N/A , N/A ,"$9,450.00 ", N/A ,"$8,100.00 ", N/A ,"$10,125.00 ","$7,452.00 ","$6,723.00 ","$7,452.00 ", N/A ,"$7,452.00 ","$6,750.00 ","$6,750.00 ","$11,475.00 ", N/A ,"$6,682.50 ", N/A ,"$13,500.00 ","$7,425.00 ", N/A ,"$3,550.50 ","$13,500.00 ", N/A , N/A , N/A ,"$10,800.00 ","$7,330.50 ","$3,780.00 ","$12,150.00 ","$6,696.00 ","$4,725.00 ", N/A ,"$6,480.00 "
ST. MARY'S HOSPITAL - DECATUR,27801689,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T25,278,1 ,"$14,250.00 ","$9,262.50 ","$3,747.75 ","$14,250.00 ", N/A ,"$7,267.50 ","$7,837.50 ", N/A ,"$3,990.00 ","$6,697.50 ", N/A ,"$7,695.00 ", N/A ,"$7,737.75 ","$7,737.75 ", N/A ,"$7,737.75 ", N/A ,"$7,125.00 ","$7,125.00 ","$11,400.00 ", N/A , N/A ,"$9,975.00 ", N/A ,"$8,550.00 ", N/A ,"$10,687.50 ","$7,866.00 ","$7,096.50 ","$7,866.00 ", N/A ,"$7,866.00 ","$7,125.00 ","$7,125.00 ","$12,112.50 ", N/A ,"$7,053.75 ", N/A ,"$14,250.00 ","$7,837.50 ", N/A ,"$3,747.75 ","$14,250.00 ", N/A , N/A , N/A ,"$11,400.00 ","$7,737.75 ","$3,990.00 ","$12,825.00 ","$7,068.00 ","$4,987.50 ", N/A ,"$6,840.00 "
ST. MARY'S HOSPITAL - DECATUR,27801690,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T26,278,1 ,"$15,000.00 ","$9,750.00 ","$3,945.00 ","$15,000.00 ", N/A ,"$7,650.00 ","$8,250.00 ", N/A ,"$4,200.00 ","$7,050.00 ", N/A ,"$8,100.00 ", N/A ,"$8,145.00 ","$8,145.00 ", N/A ,"$8,145.00 ", N/A ,"$7,500.00 ","$7,500.00 ","$12,000.00 ", N/A , N/A ,"$10,500.00 ", N/A ,"$9,000.00 ", N/A ,"$11,250.00 ","$8,280.00 ","$7,470.00 ","$8,280.00 ", N/A ,"$8,280.00 ","$7,500.00 ","$7,500.00 ","$12,750.00 ", N/A ,"$7,425.00 ", N/A ,"$15,000.00 ","$8,250.00 ", N/A ,"$3,945.00 ","$15,000.00 ", N/A , N/A , N/A ,"$12,000.00 ","$8,145.00 ","$4,200.00 ","$13,500.00 ","$7,440.00 ","$5,250.00 ", N/A ,"$7,200.00 "
ST. MARY'S HOSPITAL - DECATUR,27801696,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T32,278,1 ,"$17,400.00 ","$11,310.00 ","$4,576.20 ","$17,400.00 ", N/A ,"$8,874.00 ","$9,570.00 ", N/A ,"$4,872.00 ","$8,178.00 ", N/A ,"$9,396.00 ", N/A ,"$9,448.20 ","$9,448.20 ", N/A ,"$9,448.20 ", N/A ,"$8,700.00 ","$8,700.00 ","$13,920.00 ", N/A , N/A ,"$12,180.00 ", N/A ,"$10,440.00 ", N/A ,"$13,050.00 ","$9,604.80 ","$8,665.20 ","$9,604.80 ", N/A ,"$9,604.80 ","$8,700.00 ","$8,700.00 ","$14,790.00 ", N/A ,"$8,613.00 ", N/A ,"$17,400.00 ","$9,570.00 ", N/A ,"$4,576.20 ","$17,400.00 ", N/A , N/A , N/A ,"$13,920.00 ","$9,448.20 ","$4,872.00 ","$15,660.00 ","$8,630.40 ","$6,090.00 ", N/A ,"$8,352.00 "
ST. MARY'S HOSPITAL - DECATUR,27801699,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T35,278,1 ,"$19,500.00 ","$12,675.00 ","$5,128.50 ","$19,500.00 ", N/A ,"$9,945.00 ","$10,725.00 ", N/A ,"$5,460.00 ","$9,165.00 ", N/A ,"$10,530.00 ", N/A ,"$10,588.50 ","$10,588.50 ", N/A ,"$10,588.50 ", N/A ,"$9,750.00 ","$9,750.00 ","$15,600.00 ", N/A , N/A ,"$13,650.00 ", N/A ,"$11,700.00 ", N/A ,"$14,625.00 ","$10,764.00 ","$9,711.00 ","$10,764.00 ", N/A ,"$10,764.00 ","$9,750.00 ","$9,750.00 ","$16,575.00 ", N/A ,"$9,652.50 ", N/A ,"$19,500.00 ","$10,725.00 ", N/A ,"$5,128.50 ","$19,500.00 ", N/A , N/A , N/A ,"$15,600.00 ","$10,588.50 ","$5,460.00 ","$17,550.00 ","$9,672.00 ","$6,825.00 ", N/A ,"$9,360.00 "
ST. MARY'S HOSPITAL - DECATUR,27801700,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T36,278,1 ,"$20,250.00 ","$13,162.50 ","$5,325.75 ","$20,250.00 ", N/A ,"$10,327.50 ","$11,137.50 ", N/A ,"$5,670.00 ","$9,517.50 ", N/A ,"$10,935.00 ", N/A ,"$10,995.75 ","$10,995.75 ", N/A ,"$10,995.75 ", N/A ,"$10,125.00 ","$10,125.00 ","$16,200.00 ", N/A , N/A ,"$14,175.00 ", N/A ,"$12,150.00 ", N/A ,"$15,187.50 ","$11,178.00 ","$10,084.50 ","$11,178.00 ", N/A ,"$11,178.00 ","$10,125.00 ","$10,125.00 ","$17,212.50 ", N/A ,"$10,023.75 ", N/A ,"$20,250.00 ","$11,137.50 ", N/A ,"$5,325.75 ","$20,250.00 ", N/A , N/A , N/A ,"$16,200.00 ","$10,995.75 ","$5,670.00 ","$18,225.00 ","$10,044.00 ","$7,087.50 ", N/A ,"$9,720.00 "
ST. MARY'S HOSPITAL - DECATUR,27801713,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T10,278,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A , N/A ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$285.08 , N/A ,$285.08 , N/A ,$262.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$262.50 ,$262.50 ,$446.25 , N/A ,$259.88 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$260.40 , N/A , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27801720,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T17,278,1 ,"$1,500.00 ",$975.00 ,$394.50 ,"$1,500.00 ", N/A ,$765.00 ,$825.00 , N/A ,$420.00 ,$705.00 , N/A ,$810.00 , N/A ,$814.50 ,$814.50 , N/A ,$814.50 , N/A ,$750.00 ,$750.00 ,"$1,200.00 ", N/A , N/A ,"$1,050.00 ", N/A ,$900.00 , N/A ,"$1,125.00 ",$828.00 ,$747.00 ,$828.00 , N/A ,$828.00 ,$750.00 ,$750.00 ,"$1,275.00 ", N/A ,$742.50 , N/A ,"$1,500.00 ",$825.00 , N/A ,$394.50 ,"$1,500.00 ", N/A , N/A , N/A ,"$1,200.00 ",$814.50 ,$420.00 ,"$1,350.00 ",$744.00 , N/A , N/A ,$720.00 
ST. MARY'S HOSPITAL - DECATUR,27801721,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T18,278,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ","$1,140.30 ", N/A ,"$1,140.30 ", N/A ,"$1,050.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,050.00 ","$1,050.00 ","$1,785.00 ", N/A ,"$1,039.50 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ","$1,041.60 ",$735.00 , N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27801722,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T19,278,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,466.10 ", N/A ,"$1,466.10 ", N/A ,"$1,350.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$1,350.00 ","$1,350.00 ","$2,295.00 ", N/A ,"$1,336.50 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,339.20 ",$945.00 , N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27801723,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T20,278,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,791.90 ", N/A ,"$1,791.90 ", N/A ,"$1,650.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$1,650.00 ","$1,650.00 ","$2,805.00 ", N/A ,"$1,633.50 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,636.80 ","$1,155.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27801724,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T21,278,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$2,117.70 ", N/A ,"$2,117.70 ", N/A ,"$1,950.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$1,950.00 ","$1,950.00 ","$3,315.00 ", N/A ,"$1,930.50 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,934.40 ","$1,365.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27801725,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T22,278,1 ,"$4,500.00 ","$2,925.00 ","$1,183.50 ","$4,500.00 ", N/A ,"$2,295.00 ","$2,475.00 ", N/A ,"$1,260.00 ","$2,115.00 ", N/A ,"$2,430.00 ", N/A ,"$2,443.50 ","$2,443.50 ", N/A ,"$2,443.50 ", N/A ,"$2,250.00 ","$2,250.00 ","$3,600.00 ", N/A , N/A ,"$3,150.00 ", N/A ,"$2,700.00 ", N/A ,"$3,375.00 ","$2,484.00 ","$2,241.00 ","$2,484.00 ", N/A ,"$2,484.00 ","$2,250.00 ","$2,250.00 ","$3,825.00 ", N/A ,"$2,227.50 ", N/A ,"$4,500.00 ","$2,475.00 ", N/A ,"$1,183.50 ","$4,500.00 ", N/A , N/A , N/A ,"$3,600.00 ","$2,443.50 ","$1,260.00 ","$4,050.00 ","$2,232.00 ","$1,575.00 ", N/A ,"$2,160.00 "
ST. MARY'S HOSPITAL - DECATUR,27801726,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T23,278,1 ,"$5,100.00 ","$3,315.00 ","$1,341.30 ","$5,100.00 ", N/A ,"$2,601.00 ","$2,805.00 ", N/A ,"$1,428.00 ","$2,397.00 ", N/A ,"$2,754.00 ", N/A ,"$2,769.30 ","$2,769.30 ", N/A ,"$2,769.30 ", N/A ,"$2,550.00 ","$2,550.00 ","$4,080.00 ", N/A , N/A ,"$3,570.00 ", N/A ,"$3,060.00 ", N/A ,"$3,825.00 ","$2,815.20 ","$2,539.80 ","$2,815.20 ", N/A ,"$2,815.20 ","$2,550.00 ","$2,550.00 ","$4,335.00 ", N/A ,"$2,524.50 ", N/A ,"$5,100.00 ","$2,805.00 ", N/A ,"$1,341.30 ","$5,100.00 ", N/A , N/A , N/A ,"$4,080.00 ","$2,769.30 ","$1,428.00 ","$4,590.00 ","$2,529.60 ","$1,785.00 ", N/A ,"$2,448.00 "
ST. MARY'S HOSPITAL - DECATUR,27801727,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T24,278,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$3,095.10 ", N/A ,"$3,095.10 ", N/A ,"$2,850.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$2,850.00 ","$2,850.00 ","$4,845.00 ", N/A ,"$2,821.50 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,827.20 ","$1,995.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27801728,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T25,278,1 ,"$6,300.00 ","$4,095.00 ","$1,656.90 ","$6,300.00 ", N/A ,"$3,213.00 ","$3,465.00 ", N/A ,"$1,764.00 ","$2,961.00 ", N/A ,"$3,402.00 ", N/A ,"$3,420.90 ","$3,420.90 ", N/A ,"$3,420.90 ", N/A ,"$3,150.00 ","$3,150.00 ","$5,040.00 ", N/A , N/A ,"$4,410.00 ", N/A ,"$3,780.00 ", N/A ,"$4,725.00 ","$3,477.60 ","$3,137.40 ","$3,477.60 ", N/A ,"$3,477.60 ","$3,150.00 ","$3,150.00 ","$5,355.00 ", N/A ,"$3,118.50 ", N/A ,"$6,300.00 ","$3,465.00 ", N/A ,"$1,656.90 ","$6,300.00 ", N/A , N/A , N/A ,"$5,040.00 ","$3,420.90 ","$1,764.00 ","$5,670.00 ","$3,124.80 ","$2,205.00 ", N/A ,"$3,024.00 "
ST. MARY'S HOSPITAL - DECATUR,27801729,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T26,278,1 ,"$6,900.00 ","$4,485.00 ","$1,814.70 ","$6,900.00 ", N/A ,"$3,519.00 ","$3,795.00 ", N/A ,"$1,932.00 ","$3,243.00 ", N/A ,"$3,726.00 ", N/A ,"$3,746.70 ","$3,746.70 ", N/A ,"$3,746.70 ", N/A ,"$3,450.00 ","$3,450.00 ","$5,520.00 ", N/A , N/A ,"$4,830.00 ", N/A ,"$4,140.00 ", N/A ,"$5,175.00 ","$3,808.80 ","$3,436.20 ","$3,808.80 ", N/A ,"$3,808.80 ","$3,450.00 ","$3,450.00 ","$5,865.00 ", N/A ,"$3,415.50 ", N/A ,"$6,900.00 ","$3,795.00 ", N/A ,"$1,814.70 ","$6,900.00 ", N/A , N/A , N/A ,"$5,520.00 ","$3,746.70 ","$1,932.00 ","$6,210.00 ","$3,422.40 ","$2,415.00 ", N/A ,"$3,312.00 "
ST. MARY'S HOSPITAL - DECATUR,27801730,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T27,278,1 ,"$7,500.00 ","$4,875.00 ","$1,972.50 ","$7,500.00 ", N/A ,"$3,825.00 ","$4,125.00 ", N/A ,"$2,100.00 ","$3,525.00 ", N/A ,"$4,050.00 ", N/A ,"$4,072.50 ","$4,072.50 ", N/A ,"$4,072.50 ", N/A ,"$3,750.00 ","$3,750.00 ","$6,000.00 ", N/A , N/A ,"$5,250.00 ", N/A ,"$4,500.00 ", N/A ,"$5,625.00 ","$4,140.00 ","$3,735.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,750.00 ","$3,750.00 ","$6,375.00 ", N/A ,"$3,712.50 ", N/A ,"$7,500.00 ","$4,125.00 ", N/A ,"$1,972.50 ","$7,500.00 ", N/A , N/A , N/A ,"$6,000.00 ","$4,072.50 ","$2,100.00 ","$6,750.00 ","$3,720.00 ","$2,625.00 ", N/A ,"$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,27801731,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T28,278,1 ,"$8,100.00 ","$5,265.00 ","$2,130.30 ","$8,100.00 ", N/A ,"$4,131.00 ","$4,455.00 ", N/A ,"$2,268.00 ","$3,807.00 ", N/A ,"$4,374.00 ", N/A ,"$4,398.30 ","$4,398.30 ", N/A ,"$4,398.30 ", N/A ,"$4,050.00 ","$4,050.00 ","$6,480.00 ", N/A , N/A ,"$5,670.00 ", N/A ,"$4,860.00 ", N/A ,"$6,075.00 ","$4,471.20 ","$4,033.80 ","$4,471.20 ", N/A ,"$4,471.20 ","$4,050.00 ","$4,050.00 ","$6,885.00 ", N/A ,"$4,009.50 ", N/A ,"$8,100.00 ","$4,455.00 ", N/A ,"$2,130.30 ","$8,100.00 ", N/A , N/A , N/A ,"$6,480.00 ","$4,398.30 ","$2,268.00 ","$7,290.00 ","$4,017.60 ","$2,835.00 ", N/A ,"$3,888.00 "
ST. MARY'S HOSPITAL - DECATUR,27801732,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T29,278,1 ,"$8,700.00 ","$5,655.00 ","$2,288.10 ","$8,700.00 ", N/A ,"$4,437.00 ","$4,785.00 ", N/A ,"$2,436.00 ","$4,089.00 ", N/A ,"$4,698.00 ", N/A ,"$4,724.10 ","$4,724.10 ", N/A ,"$4,724.10 ", N/A ,"$4,350.00 ","$4,350.00 ","$6,960.00 ", N/A , N/A ,"$6,090.00 ", N/A ,"$5,220.00 ", N/A ,"$6,525.00 ","$4,802.40 ","$4,332.60 ","$4,802.40 ", N/A ,"$4,802.40 ","$4,350.00 ","$4,350.00 ","$7,395.00 ", N/A ,"$4,306.50 ", N/A ,"$8,700.00 ","$4,785.00 ", N/A ,"$2,288.10 ","$8,700.00 ", N/A , N/A , N/A ,"$6,960.00 ","$4,724.10 ","$2,436.00 ","$7,830.00 ","$4,315.20 ","$3,045.00 ", N/A ,"$4,176.00 "
ST. MARY'S HOSPITAL - DECATUR,27801767,C1880,HC FILTER VENA CAVA T5,278,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ","$1,140.30 ", N/A ,"$1,140.30 ", N/A ,"$1,050.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,050.00 ","$1,050.00 ","$1,785.00 ", N/A ,"$1,039.50 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ","$1,041.60 ",$735.00 , N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27801768,C1880,HC FILTER VENA CAVA T6,278,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,466.10 ", N/A ,"$1,466.10 ", N/A ,"$1,350.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$1,350.00 ","$1,350.00 ","$2,295.00 ", N/A ,"$1,336.50 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,339.20 ",$945.00 , N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27801769,C1880,HC FILTER VENA CAVA T7,278,1 ,"$3,276.92 ","$2,130.00 ",$861.83 ,"$3,276.92 ", N/A ,"$1,671.23 ","$1,802.31 ", N/A ,$917.54 ,"$1,540.15 ", N/A ,"$1,769.54 ", N/A ,"$1,779.37 ","$1,779.37 ", N/A ,"$1,779.37 ", N/A ,"$1,638.46 ","$1,638.46 ","$2,621.54 ", N/A , N/A ,"$2,293.84 ", N/A ,"$1,966.15 ", N/A ,"$2,457.69 ","$1,808.86 ","$1,631.91 ","$1,808.86 ", N/A ,"$1,808.86 ","$1,638.46 ","$1,638.46 ","$2,785.38 ", N/A ,"$1,622.08 ", N/A ,"$3,276.92 ","$1,802.31 ", N/A ,$861.83 ,"$3,276.92 ", N/A , N/A , N/A ,"$2,621.54 ","$1,779.37 ",$917.54 ,"$2,949.23 ","$1,625.35 ","$1,146.92 ", N/A ,"$1,572.92 "
ST. MARY'S HOSPITAL - DECATUR,27801770,C1880,HC FILTER VENA CAVA T8,278,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$2,117.70 ", N/A ,"$2,117.70 ", N/A ,"$1,950.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$1,950.00 ","$1,950.00 ","$3,315.00 ", N/A ,"$1,930.50 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,934.40 ","$1,365.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27801771,C1880,HC FILTER VENA CAVA T9,278,1 ,"$4,500.00 ","$2,925.00 ","$1,183.50 ","$4,500.00 ", N/A ,"$2,295.00 ","$2,475.00 ", N/A ,"$1,260.00 ","$2,115.00 ", N/A ,"$2,430.00 ", N/A ,"$2,443.50 ","$2,443.50 ", N/A ,"$2,443.50 ", N/A ,"$2,250.00 ","$2,250.00 ","$3,600.00 ", N/A , N/A ,"$3,150.00 ", N/A ,"$2,700.00 ", N/A ,"$3,375.00 ","$2,484.00 ","$2,241.00 ","$2,484.00 ", N/A ,"$2,484.00 ","$2,250.00 ","$2,250.00 ","$3,825.00 ", N/A ,"$2,227.50 ", N/A ,"$4,500.00 ","$2,475.00 ", N/A ,"$1,183.50 ","$4,500.00 ", N/A , N/A , N/A ,"$3,600.00 ","$2,443.50 ","$1,260.00 ","$4,050.00 ","$2,232.00 ","$1,575.00 ", N/A ,"$2,160.00 "
ST. MARY'S HOSPITAL - DECATUR,27801794,C1889,HC COIL EMBOLIZATION T1,278,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A , N/A ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$122.18 , N/A ,$122.18 , N/A ,$112.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$112.50 ,$112.50 ,$191.25 , N/A ,$111.38 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$111.60 , N/A , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27801795,C1889,HC COIL EMBOLIZATION T2,278,1 ,$300.00 ,$195.00 ,$78.90 ,$300.00 , N/A , N/A ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$162.90 , N/A ,$162.90 , N/A ,$150.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$150.00 ,$150.00 ,$255.00 , N/A ,$148.50 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$148.80 , N/A , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,27801796,C1889,HC COIL EMBOLIZATION T3,278,1 ,$375.00 ,$243.75 ,$98.63 ,$375.00 , N/A , N/A ,$206.25 , N/A ,$105.00 ,$176.25 , N/A ,$202.50 , N/A ,$203.63 ,$203.63 , N/A ,$203.63 , N/A ,$187.50 ,$187.50 ,$300.00 , N/A , N/A ,$262.50 , N/A ,$225.00 , N/A ,$281.25 ,$207.00 ,$186.75 ,$207.00 , N/A ,$207.00 ,$187.50 ,$187.50 ,$318.75 , N/A ,$185.63 , N/A ,$375.00 ,$206.25 , N/A ,$98.63 ,$375.00 , N/A , N/A , N/A ,$300.00 ,$203.63 ,$105.00 ,$337.50 ,$186.00 , N/A , N/A ,$180.00 
ST. MARY'S HOSPITAL - DECATUR,27801797,C1889,HC COIL EMBOLIZATION T4,278,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A , N/A ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$244.35 , N/A ,$244.35 , N/A ,$225.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$225.00 ,$225.00 ,$382.50 , N/A ,$222.75 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$223.20 , N/A , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27801798,C1889,HC COIL EMBOLIZATION T5,278,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A , N/A ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$285.08 , N/A ,$285.08 , N/A ,$262.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$262.50 ,$262.50 ,$446.25 , N/A ,$259.88 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$260.40 , N/A , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27801799,C1889,HC COIL EMBOLIZATION T6,278,1 ,$600.00 ,$390.00 ,$157.80 ,$600.00 , N/A , N/A ,$330.00 , N/A ,$168.00 ,$282.00 , N/A ,$324.00 , N/A ,$325.80 ,$325.80 , N/A ,$325.80 , N/A ,$300.00 ,$300.00 ,$480.00 , N/A , N/A ,$420.00 , N/A ,$360.00 , N/A ,$450.00 ,$331.20 ,$298.80 ,$331.20 , N/A ,$331.20 ,$300.00 ,$300.00 ,$510.00 , N/A ,$297.00 , N/A ,$600.00 ,$330.00 , N/A ,$157.80 ,$600.00 , N/A , N/A , N/A ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$297.60 , N/A , N/A ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,27801800,C1889,HC COIL EMBOLIZATION T7,278,1 ,$750.00 ,$487.50 ,$197.25 ,$750.00 , N/A , N/A ,$412.50 , N/A ,$210.00 ,$352.50 , N/A ,$405.00 , N/A ,$407.25 ,$407.25 , N/A ,$407.25 , N/A ,$375.00 ,$375.00 ,$600.00 , N/A , N/A ,$525.00 , N/A ,$450.00 , N/A ,$562.50 ,$414.00 ,$373.50 ,$414.00 , N/A ,$414.00 ,$375.00 ,$375.00 ,$637.50 , N/A ,$371.25 , N/A ,$750.00 ,$412.50 , N/A ,$197.25 ,$750.00 , N/A , N/A , N/A ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$372.00 , N/A , N/A ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,27801801,C1889,HC COIL EMBOLIZATION T8,278,1 ,$900.00 ,$585.00 ,$236.70 ,$900.00 , N/A , N/A ,$495.00 , N/A ,$252.00 ,$423.00 , N/A ,$486.00 , N/A ,$488.70 ,$488.70 , N/A ,$488.70 , N/A ,$450.00 ,$450.00 ,$720.00 , N/A , N/A ,$630.00 , N/A ,$540.00 , N/A ,$675.00 ,$496.80 ,$448.20 ,$496.80 , N/A ,$496.80 ,$450.00 ,$450.00 ,$765.00 , N/A ,$445.50 , N/A ,$900.00 ,$495.00 , N/A ,$236.70 ,$900.00 , N/A , N/A , N/A ,$720.00 ,$488.70 ,$252.00 ,$810.00 ,$446.40 , N/A , N/A ,$432.00 
ST. MARY'S HOSPITAL - DECATUR,27801802,C1889,HC COIL EMBOLIZATION T9,278,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ", N/A ,$535.50 ,$577.50 , N/A ,$294.00 ,$493.50 , N/A ,$567.00 , N/A ,$570.15 ,$570.15 , N/A ,$570.15 , N/A ,$525.00 ,$525.00 ,$840.00 , N/A , N/A ,$735.00 , N/A ,$630.00 , N/A ,$787.50 ,$579.60 ,$522.90 ,$579.60 , N/A ,$579.60 ,$525.00 ,$525.00 ,$892.50 , N/A ,$519.75 , N/A ,"$1,050.00 ",$577.50 , N/A ,$276.15 ,"$1,050.00 ", N/A , N/A , N/A ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$520.80 , N/A , N/A ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,27801803,C1889,HC COIL EMBOLIZATION T10,278,1 ,"$1,200.00 ",$780.00 ,$315.60 ,"$1,200.00 ", N/A ,$612.00 ,$660.00 , N/A ,$336.00 ,$564.00 , N/A ,$648.00 , N/A ,$651.60 ,$651.60 , N/A ,$651.60 , N/A ,$600.00 ,$600.00 ,$960.00 , N/A , N/A ,$840.00 , N/A ,$720.00 , N/A ,$900.00 ,$662.40 ,$597.60 ,$662.40 , N/A ,$662.40 ,$600.00 ,$600.00 ,"$1,020.00 ", N/A ,$594.00 , N/A ,"$1,200.00 ",$660.00 , N/A ,$315.60 ,"$1,200.00 ", N/A , N/A , N/A ,$960.00 ,$651.60 ,$336.00 ,"$1,080.00 ",$595.20 , N/A , N/A ,$576.00 
ST. MARY'S HOSPITAL - DECATUR,27801804,C1889,HC COIL EMBOLIZATION T11,278,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$733.05 , N/A ,$733.05 , N/A ,$675.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,$675.00 ,$675.00 ,"$1,147.50 ", N/A ,$668.25 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$669.60 , N/A , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27801805,C1889,HC COIL EMBOLIZATION T12,278,1 ,"$1,500.00 ",$975.00 ,$394.50 ,"$1,500.00 ", N/A ,$765.00 ,$825.00 , N/A ,$420.00 ,$705.00 , N/A ,$810.00 , N/A ,$814.50 ,$814.50 , N/A ,$814.50 , N/A ,$750.00 ,$750.00 ,"$1,200.00 ", N/A , N/A ,"$1,050.00 ", N/A ,$900.00 , N/A ,"$1,125.00 ",$828.00 ,$747.00 ,$828.00 , N/A ,$828.00 ,$750.00 ,$750.00 ,"$1,275.00 ", N/A ,$742.50 , N/A ,"$1,500.00 ",$825.00 , N/A ,$394.50 ,"$1,500.00 ", N/A , N/A , N/A ,"$1,200.00 ",$814.50 ,$420.00 ,"$1,350.00 ",$744.00 , N/A , N/A ,$720.00 
ST. MARY'S HOSPITAL - DECATUR,27801806,C1889,HC COIL EMBOLIZATION T13,278,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ","$1,140.30 ", N/A ,"$1,140.30 ", N/A ,"$1,050.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,050.00 ","$1,050.00 ","$1,785.00 ", N/A ,"$1,039.50 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ","$1,041.60 ",$735.00 , N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27801807,C1889,HC COIL EMBOLIZATION T14,278,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,466.10 ", N/A ,"$1,466.10 ", N/A ,"$1,350.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$1,350.00 ","$1,350.00 ","$2,295.00 ", N/A ,"$1,336.50 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,339.20 ",$945.00 , N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27801808,C1889,HC COIL EMBOLIZATION T15,278,1 ,"$3,300.00 ","$2,145.00 ",$867.90 ,"$3,300.00 ", N/A ,"$1,683.00 ","$1,815.00 ", N/A ,$924.00 ,"$1,551.00 ", N/A ,"$1,782.00 ", N/A ,"$1,791.90 ","$1,791.90 ", N/A ,"$1,791.90 ", N/A ,"$1,650.00 ","$1,650.00 ","$2,640.00 ", N/A , N/A ,"$2,310.00 ", N/A ,"$1,980.00 ", N/A ,"$2,475.00 ","$1,821.60 ","$1,643.40 ","$1,821.60 ", N/A ,"$1,821.60 ","$1,650.00 ","$1,650.00 ","$2,805.00 ", N/A ,"$1,633.50 ", N/A ,"$3,300.00 ","$1,815.00 ", N/A ,$867.90 ,"$3,300.00 ", N/A , N/A , N/A ,"$2,640.00 ","$1,791.90 ",$924.00 ,"$2,970.00 ","$1,636.80 ","$1,155.00 ", N/A ,"$1,584.00 "
ST. MARY'S HOSPITAL - DECATUR,27801809,C1889,HC COIL EMBOLIZATION T16,278,1 ,"$3,900.00 ","$2,535.00 ","$1,025.70 ","$3,900.00 ", N/A ,"$1,989.00 ","$2,145.00 ", N/A ,"$1,092.00 ","$1,833.00 ", N/A ,"$2,106.00 ", N/A ,"$2,117.70 ","$2,117.70 ", N/A ,"$2,117.70 ", N/A ,"$1,950.00 ","$1,950.00 ","$3,120.00 ", N/A , N/A ,"$2,730.00 ", N/A ,"$2,340.00 ", N/A ,"$2,925.00 ","$2,152.80 ","$1,942.20 ","$2,152.80 ", N/A ,"$2,152.80 ","$1,950.00 ","$1,950.00 ","$3,315.00 ", N/A ,"$1,930.50 ", N/A ,"$3,900.00 ","$2,145.00 ", N/A ,"$1,025.70 ","$3,900.00 ", N/A , N/A , N/A ,"$3,120.00 ","$2,117.70 ","$1,092.00 ","$3,510.00 ","$1,934.40 ","$1,365.00 ", N/A ,"$1,872.00 "
ST. MARY'S HOSPITAL - DECATUR,27801810,C1889,HC COIL EMBOLIZATION T17,278,1 ,"$4,500.00 ","$2,925.00 ","$1,183.50 ","$4,500.00 ", N/A ,"$2,295.00 ","$2,475.00 ", N/A ,"$1,260.00 ","$2,115.00 ", N/A ,"$2,430.00 ", N/A ,"$2,443.50 ","$2,443.50 ", N/A ,"$2,443.50 ", N/A ,"$2,250.00 ","$2,250.00 ","$3,600.00 ", N/A , N/A ,"$3,150.00 ", N/A ,"$2,700.00 ", N/A ,"$3,375.00 ","$2,484.00 ","$2,241.00 ","$2,484.00 ", N/A ,"$2,484.00 ","$2,250.00 ","$2,250.00 ","$3,825.00 ", N/A ,"$2,227.50 ", N/A ,"$4,500.00 ","$2,475.00 ", N/A ,"$1,183.50 ","$4,500.00 ", N/A , N/A , N/A ,"$3,600.00 ","$2,443.50 ","$1,260.00 ","$4,050.00 ","$2,232.00 ","$1,575.00 ", N/A ,"$2,160.00 "
ST. MARY'S HOSPITAL - DECATUR,27801811,C1889,HC COIL EMBOLIZATION T18,278,1 ,"$5,100.00 ","$3,315.00 ","$1,341.30 ","$5,100.00 ", N/A ,"$2,601.00 ","$2,805.00 ", N/A ,"$1,428.00 ","$2,397.00 ", N/A ,"$2,754.00 ", N/A ,"$2,769.30 ","$2,769.30 ", N/A ,"$2,769.30 ", N/A ,"$2,550.00 ","$2,550.00 ","$4,080.00 ", N/A , N/A ,"$3,570.00 ", N/A ,"$3,060.00 ", N/A ,"$3,825.00 ","$2,815.20 ","$2,539.80 ","$2,815.20 ", N/A ,"$2,815.20 ","$2,550.00 ","$2,550.00 ","$4,335.00 ", N/A ,"$2,524.50 ", N/A ,"$5,100.00 ","$2,805.00 ", N/A ,"$1,341.30 ","$5,100.00 ", N/A , N/A , N/A ,"$4,080.00 ","$2,769.30 ","$1,428.00 ","$4,590.00 ","$2,529.60 ","$1,785.00 ", N/A ,"$2,448.00 "
ST. MARY'S HOSPITAL - DECATUR,27801812,C1889,HC COIL EMBOLIZATION T19,278,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$3,095.10 ", N/A ,"$3,095.10 ", N/A ,"$2,850.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$2,850.00 ","$2,850.00 ","$4,845.00 ", N/A ,"$2,821.50 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,827.20 ","$1,995.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27801920,C1895,HC LEAD ICD ENDOCARDIAL DUAL COIL T8,278,1 ,"$9,300.00 ","$6,045.00 ","$2,445.90 ","$9,300.00 ", N/A ,"$4,743.00 ","$5,115.00 ", N/A ,"$2,604.00 ","$4,371.00 ", N/A ,"$5,022.00 ", N/A ,"$5,049.90 ","$5,049.90 ", N/A ,"$5,049.90 ", N/A ,"$4,650.00 ","$4,650.00 ","$7,440.00 ", N/A , N/A ,"$6,510.00 ", N/A ,"$5,580.00 ", N/A ,"$6,975.00 ","$5,133.60 ","$4,631.40 ","$5,133.60 ", N/A ,"$5,133.60 ","$4,650.00 ","$4,650.00 ","$7,905.00 ", N/A ,"$4,603.50 ", N/A ,"$9,300.00 ","$5,115.00 ", N/A ,"$2,445.90 ","$9,300.00 ", N/A , N/A , N/A ,"$7,440.00 ","$5,049.90 ","$2,604.00 ","$8,370.00 ","$4,612.80 ","$3,255.00 ", N/A ,"$4,464.00 "
ST. MARY'S HOSPITAL - DECATUR,27801922,C1895,HC LEAD ICD ENDOCARDIAL DUAL COIL T10,278,1 ,"$10,500.00 ","$6,825.00 ","$2,761.50 ","$10,500.00 ", N/A ,"$5,355.00 ","$5,775.00 ", N/A ,"$2,940.00 ","$4,935.00 ", N/A ,"$5,670.00 ", N/A ,"$5,701.50 ","$5,701.50 ", N/A ,"$5,701.50 ", N/A ,"$5,250.00 ","$5,250.00 ","$8,400.00 ", N/A , N/A ,"$7,350.00 ", N/A ,"$6,300.00 ", N/A ,"$7,875.00 ","$5,796.00 ","$5,229.00 ","$5,796.00 ", N/A ,"$5,796.00 ","$5,250.00 ","$5,250.00 ","$8,925.00 ", N/A ,"$5,197.50 ", N/A ,"$10,500.00 ","$5,775.00 ", N/A ,"$2,761.50 ","$10,500.00 ", N/A , N/A , N/A ,"$8,400.00 ","$5,701.50 ","$2,940.00 ","$9,450.00 ","$5,208.00 ","$3,675.00 ", N/A ,"$5,040.00 "
ST. MARY'S HOSPITAL - DECATUR,27801971,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T5,278,1 ,"$1,200.00 ",$780.00 ,$315.60 ,"$1,200.00 ", N/A ,$612.00 ,$660.00 , N/A ,$336.00 ,$564.00 , N/A ,$648.00 , N/A ,$651.60 ,$651.60 , N/A ,$651.60 , N/A ,$600.00 ,$600.00 ,$960.00 , N/A , N/A ,$840.00 , N/A ,$720.00 , N/A ,$900.00 ,$662.40 ,$597.60 ,$662.40 , N/A ,$662.40 ,$600.00 ,$600.00 ,"$1,020.00 ", N/A ,$594.00 , N/A ,"$1,200.00 ",$660.00 , N/A ,$315.60 ,"$1,200.00 ", N/A , N/A , N/A ,$960.00 ,$651.60 ,$336.00 ,"$1,080.00 ",$595.20 , N/A , N/A ,$576.00 
ST. MARY'S HOSPITAL - DECATUR,27801972,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T6,278,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$733.05 , N/A ,$733.05 , N/A ,$675.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,$675.00 ,$675.00 ,"$1,147.50 ", N/A ,$668.25 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$669.60 , N/A , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27801973,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T7,278,1 ,"$1,350.00 ",$877.50 ,$355.05 ,"$1,350.00 ", N/A ,$688.50 ,$742.50 , N/A ,$378.00 ,$634.50 , N/A ,$729.00 , N/A ,$733.05 ,$733.05 , N/A ,$733.05 , N/A ,$675.00 ,$675.00 ,"$1,080.00 ", N/A , N/A ,$945.00 , N/A ,$810.00 , N/A ,"$1,012.50 ",$745.20 ,$672.30 ,$745.20 , N/A ,$745.20 ,$675.00 ,$675.00 ,"$1,147.50 ", N/A ,$668.25 , N/A ,"$1,350.00 ",$742.50 , N/A ,$355.05 ,"$1,350.00 ", N/A , N/A , N/A ,"$1,080.00 ",$733.05 ,$378.00 ,"$1,215.00 ",$669.60 , N/A , N/A ,$648.00 
ST. MARY'S HOSPITAL - DECATUR,27801975,C1898,HC LEAD PACEMAKER NON TRANSVENOUS SINGLE PASS T9,278,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,466.10 ", N/A ,"$1,466.10 ", N/A ,"$1,350.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$1,350.00 ","$1,350.00 ","$2,295.00 ", N/A ,"$1,336.50 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,339.20 ",$945.00 , N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27801991,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T5,278,1 ,"$5,100.00 ","$3,315.00 ","$1,341.30 ","$5,100.00 ", N/A ,"$2,601.00 ","$2,805.00 ", N/A ,"$1,428.00 ","$2,397.00 ", N/A ,"$2,754.00 ", N/A ,"$2,769.30 ","$2,769.30 ", N/A ,"$2,769.30 ", N/A ,"$2,550.00 ","$2,550.00 ","$4,080.00 ", N/A , N/A ,"$3,570.00 ", N/A ,"$3,060.00 ", N/A ,"$3,825.00 ","$2,815.20 ","$2,539.80 ","$2,815.20 ", N/A ,"$2,815.20 ","$2,550.00 ","$2,550.00 ","$4,335.00 ", N/A ,"$2,524.50 ", N/A ,"$5,100.00 ","$2,805.00 ", N/A ,"$1,341.30 ","$5,100.00 ", N/A , N/A , N/A ,"$4,080.00 ","$2,769.30 ","$1,428.00 ","$4,590.00 ","$2,529.60 ","$1,785.00 ", N/A ,"$2,448.00 "
ST. MARY'S HOSPITAL - DECATUR,27801992,C1900,HC LEAD VENTRICULAR CORONARY VENOUS T6,278,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$3,095.10 ", N/A ,"$3,095.10 ", N/A ,"$2,850.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$2,850.00 ","$2,850.00 ","$4,845.00 ", N/A ,"$2,821.50 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,827.20 ","$1,995.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27802021,N/A,HC IMPLANT SURGICAL T6,278,1 ,$225.00 ,$146.25 ,$59.18 ,$225.00 , N/A , N/A ,$123.75 , N/A ,$63.00 ,$105.75 , N/A ,$121.50 , N/A ,$122.18 ,$122.18 , N/A ,$122.18 , N/A ,$112.50 ,$112.50 ,$180.00 , N/A , N/A ,$157.50 , N/A ,$135.00 , N/A ,$168.75 ,$124.20 ,$112.05 ,$124.20 , N/A ,$124.20 ,$112.50 ,$112.50 ,$191.25 , N/A ,$111.38 , N/A ,$225.00 ,$123.75 , N/A ,$59.18 ,$225.00 , N/A , N/A , N/A ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$111.60 , N/A , N/A ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,27802033,N/A,HC IMPLANT SURGICAL T18,278,1 ,"$2,100.00 ","$1,365.00 ",$552.30 ,"$2,100.00 ", N/A ,"$1,071.00 ","$1,155.00 ", N/A ,$588.00 ,$987.00 , N/A ,"$1,134.00 ", N/A ,"$1,140.30 ","$1,140.30 ", N/A ,"$1,140.30 ", N/A ,"$1,050.00 ","$1,050.00 ","$1,680.00 ", N/A , N/A ,"$1,470.00 ", N/A ,"$1,260.00 ", N/A ,"$1,575.00 ","$1,159.20 ","$1,045.80 ","$1,159.20 ", N/A ,"$1,159.20 ","$1,050.00 ","$1,050.00 ","$1,785.00 ", N/A ,"$1,039.50 ", N/A ,"$2,100.00 ","$1,155.00 ", N/A ,$552.30 ,"$2,100.00 ", N/A , N/A , N/A ,"$1,680.00 ","$1,140.30 ",$588.00 ,"$1,890.00 ","$1,041.60 ",$735.00 , N/A ,"$1,008.00 "
ST. MARY'S HOSPITAL - DECATUR,27802098,C1750,HC CATHETER HEMODIALYSIS/PERITONEAL LONG TERM T9,278,1 ,$450.00 ,$292.50 ,$118.35 ,$450.00 , N/A , N/A ,$247.50 , N/A ,$126.00 ,$211.50 , N/A ,$243.00 , N/A ,$244.35 ,$244.35 , N/A ,$244.35 , N/A ,$225.00 ,$225.00 ,$360.00 , N/A , N/A ,$315.00 , N/A ,$270.00 , N/A ,$337.50 ,$248.40 ,$224.10 ,$248.40 , N/A ,$248.40 ,$225.00 ,$225.00 ,$382.50 , N/A ,$222.75 , N/A ,$450.00 ,$247.50 , N/A ,$118.35 ,$450.00 , N/A , N/A , N/A ,$360.00 ,$244.35 ,$126.00 ,$405.00 ,$223.20 , N/A , N/A ,$216.00 
ST. MARY'S HOSPITAL - DECATUR,27802099,C1750,HC CATHETER HEMODIALYSIS/PERITONEAL LONG TERM T10,278,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A , N/A ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$285.08 , N/A ,$285.08 , N/A ,$262.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$262.50 ,$262.50 ,$446.25 , N/A ,$259.88 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$260.40 , N/A , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,27802103,C1750,HC CATHETER HEMODIALYSIS/PERITONEAL LONG TERM T14,278,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ", N/A ,$535.50 ,$577.50 , N/A ,$294.00 ,$493.50 , N/A ,$567.00 , N/A ,$570.15 ,$570.15 , N/A ,$570.15 , N/A ,$525.00 ,$525.00 ,$840.00 , N/A , N/A ,$735.00 , N/A ,$630.00 , N/A ,$787.50 ,$579.60 ,$522.90 ,$579.60 , N/A ,$579.60 ,$525.00 ,$525.00 ,$892.50 , N/A ,$519.75 , N/A ,"$1,050.00 ",$577.50 , N/A ,$276.15 ,"$1,050.00 ", N/A , N/A , N/A ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$520.80 , N/A , N/A ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,27802104,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T1,278,1 ,"$5,100.00 ","$3,315.00 ","$1,341.30 ","$5,100.00 ", N/A ,"$2,601.00 ","$2,805.00 ", N/A ,"$1,428.00 ","$2,397.00 ", N/A ,"$2,754.00 ", N/A ,"$2,769.30 ","$2,769.30 ", N/A ,"$2,769.30 ", N/A ,"$2,550.00 ","$2,550.00 ","$4,080.00 ", N/A , N/A ,"$3,570.00 ", N/A ,"$3,060.00 ", N/A ,"$3,825.00 ","$2,815.20 ","$2,539.80 ","$2,815.20 ", N/A ,"$2,815.20 ","$2,550.00 ","$2,550.00 ","$4,335.00 ", N/A ,"$2,524.50 ", N/A ,"$5,100.00 ","$2,805.00 ", N/A ,"$1,341.30 ","$5,100.00 ", N/A , N/A , N/A ,"$4,080.00 ","$2,769.30 ","$1,428.00 ","$4,590.00 ","$2,529.60 ","$1,785.00 ", N/A ,"$2,448.00 "
ST. MARY'S HOSPITAL - DECATUR,27802105,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T2,278,1 ,"$5,700.00 ","$3,705.00 ","$1,499.10 ","$5,700.00 ", N/A ,"$2,907.00 ","$3,135.00 ", N/A ,"$1,596.00 ","$2,679.00 ", N/A ,"$3,078.00 ", N/A ,"$3,095.10 ","$3,095.10 ", N/A ,"$3,095.10 ", N/A ,"$2,850.00 ","$2,850.00 ","$4,560.00 ", N/A , N/A ,"$3,990.00 ", N/A ,"$3,420.00 ", N/A ,"$4,275.00 ","$3,146.40 ","$2,838.60 ","$3,146.40 ", N/A ,"$3,146.40 ","$2,850.00 ","$2,850.00 ","$4,845.00 ", N/A ,"$2,821.50 ", N/A ,"$5,700.00 ","$3,135.00 ", N/A ,"$1,499.10 ","$5,700.00 ", N/A , N/A , N/A ,"$4,560.00 ","$3,095.10 ","$1,596.00 ","$5,130.00 ","$2,827.20 ","$1,995.00 ", N/A ,"$2,736.00 "
ST. MARY'S HOSPITAL - DECATUR,27802106,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T3,278,1 ,"$6,300.00 ","$4,095.00 ","$1,656.90 ","$6,300.00 ", N/A ,"$3,213.00 ","$3,465.00 ", N/A ,"$1,764.00 ","$2,961.00 ", N/A ,"$3,402.00 ", N/A ,"$3,420.90 ","$3,420.90 ", N/A ,"$3,420.90 ", N/A ,"$3,150.00 ","$3,150.00 ","$5,040.00 ", N/A , N/A ,"$4,410.00 ", N/A ,"$3,780.00 ", N/A ,"$4,725.00 ","$3,477.60 ","$3,137.40 ","$3,477.60 ", N/A ,"$3,477.60 ","$3,150.00 ","$3,150.00 ","$5,355.00 ", N/A ,"$3,118.50 ", N/A ,"$6,300.00 ","$3,465.00 ", N/A ,"$1,656.90 ","$6,300.00 ", N/A , N/A , N/A ,"$5,040.00 ","$3,420.90 ","$1,764.00 ","$5,670.00 ","$3,124.80 ","$2,205.00 ", N/A ,"$3,024.00 "
ST. MARY'S HOSPITAL - DECATUR,27802107,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T4,278,1 ,"$6,900.00 ","$4,485.00 ","$1,814.70 ","$6,900.00 ", N/A ,"$3,519.00 ","$3,795.00 ", N/A ,"$1,932.00 ","$3,243.00 ", N/A ,"$3,726.00 ", N/A ,"$3,746.70 ","$3,746.70 ", N/A ,"$3,746.70 ", N/A ,"$3,450.00 ","$3,450.00 ","$5,520.00 ", N/A , N/A ,"$4,830.00 ", N/A ,"$4,140.00 ", N/A ,"$5,175.00 ","$3,808.80 ","$3,436.20 ","$3,808.80 ", N/A ,"$3,808.80 ","$3,450.00 ","$3,450.00 ","$5,865.00 ", N/A ,"$3,415.50 ", N/A ,"$6,900.00 ","$3,795.00 ", N/A ,"$1,814.70 ","$6,900.00 ", N/A , N/A , N/A ,"$5,520.00 ","$3,746.70 ","$1,932.00 ","$6,210.00 ","$3,422.40 ","$2,415.00 ", N/A ,"$3,312.00 "
ST. MARY'S HOSPITAL - DECATUR,27802109,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T6,278,1 ,"$7,500.00 ","$4,875.00 ","$1,972.50 ","$7,500.00 ", N/A ,"$3,825.00 ","$4,125.00 ", N/A ,"$2,100.00 ","$3,525.00 ", N/A ,"$4,050.00 ", N/A ,"$4,072.50 ","$4,072.50 ", N/A ,"$4,072.50 ", N/A ,"$3,750.00 ","$3,750.00 ","$6,000.00 ", N/A , N/A ,"$5,250.00 ", N/A ,"$4,500.00 ", N/A ,"$5,625.00 ","$4,140.00 ","$3,735.00 ","$4,140.00 ", N/A ,"$4,140.00 ","$3,750.00 ","$3,750.00 ","$6,375.00 ", N/A ,"$3,712.50 ", N/A ,"$7,500.00 ","$4,125.00 ", N/A ,"$1,972.50 ","$7,500.00 ", N/A , N/A , N/A ,"$6,000.00 ","$4,072.50 ","$2,100.00 ","$6,750.00 ","$3,720.00 ","$2,625.00 ", N/A ,"$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,27802111,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T8,278,1 ,"$8,100.00 ","$5,265.00 ","$2,130.30 ","$8,100.00 ", N/A ,"$4,131.00 ","$4,455.00 ", N/A ,"$2,268.00 ","$3,807.00 ", N/A ,"$4,374.00 ", N/A ,"$4,398.30 ","$4,398.30 ", N/A ,"$4,398.30 ", N/A ,"$4,050.00 ","$4,050.00 ","$6,480.00 ", N/A , N/A ,"$5,670.00 ", N/A ,"$4,860.00 ", N/A ,"$6,075.00 ","$4,471.20 ","$4,033.80 ","$4,471.20 ", N/A ,"$4,471.20 ","$4,050.00 ","$4,050.00 ","$6,885.00 ", N/A ,"$4,009.50 ", N/A ,"$8,100.00 ","$4,455.00 ", N/A ,"$2,130.30 ","$8,100.00 ", N/A , N/A , N/A ,"$6,480.00 ","$4,398.30 ","$2,268.00 ","$7,290.00 ","$4,017.60 ","$2,835.00 ", N/A ,"$3,888.00 "
ST. MARY'S HOSPITAL - DECATUR,27802112,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T9,278,1 ,"$8,700.00 ","$5,655.00 ","$2,288.10 ","$8,700.00 ", N/A ,"$4,437.00 ","$4,785.00 ", N/A ,"$2,436.00 ","$4,089.00 ", N/A ,"$4,698.00 ", N/A ,"$4,724.10 ","$4,724.10 ", N/A ,"$4,724.10 ", N/A ,"$4,350.00 ","$4,350.00 ","$6,960.00 ", N/A , N/A ,"$6,090.00 ", N/A ,"$5,220.00 ", N/A ,"$6,525.00 ","$4,802.40 ","$4,332.60 ","$4,802.40 ", N/A ,"$4,802.40 ","$4,350.00 ","$4,350.00 ","$7,395.00 ", N/A ,"$4,306.50 ", N/A ,"$8,700.00 ","$4,785.00 ", N/A ,"$2,288.10 ","$8,700.00 ", N/A , N/A , N/A ,"$6,960.00 ","$4,724.10 ","$2,436.00 ","$7,830.00 ","$4,315.20 ","$3,045.00 ", N/A ,"$4,176.00 "
ST. MARY'S HOSPITAL - DECATUR,27802113,C2623,HC CATHETER TRANS ANGIO DRUG COATED NON-LASER T10,278,1 ,"$9,300.00 ","$6,045.00 ","$2,445.90 ","$9,300.00 ", N/A ,"$4,743.00 ","$5,115.00 ", N/A ,"$2,604.00 ","$4,371.00 ", N/A ,"$5,022.00 ", N/A ,"$5,049.90 ","$5,049.90 ", N/A ,"$5,049.90 ", N/A ,"$4,650.00 ","$4,650.00 ","$7,440.00 ", N/A , N/A ,"$6,510.00 ", N/A ,"$5,580.00 ", N/A ,"$6,975.00 ","$5,133.60 ","$4,631.40 ","$5,133.60 ", N/A ,"$5,133.60 ","$4,650.00 ","$4,650.00 ","$7,905.00 ", N/A ,"$4,603.50 ", N/A ,"$9,300.00 ","$5,115.00 ", N/A ,"$2,445.90 ","$9,300.00 ", N/A , N/A , N/A ,"$7,440.00 ","$5,049.90 ","$2,604.00 ","$8,370.00 ","$4,612.80 ","$3,255.00 ", N/A ,"$4,464.00 "
ST. MARY'S HOSPITAL - DECATUR,27802115,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T41,278,1 ,"$25,500.00 ","$16,575.00 ","$6,706.50 ","$25,500.00 ", N/A ,"$13,005.00 ","$14,025.00 ", N/A ,"$7,140.00 ","$11,985.00 ", N/A ,"$13,770.00 ", N/A ,"$13,846.50 ","$13,846.50 ", N/A ,"$13,846.50 ", N/A ,"$12,750.00 ","$12,750.00 ","$20,400.00 ", N/A , N/A ,"$17,850.00 ", N/A ,"$15,300.00 ", N/A ,"$19,125.00 ","$14,076.00 ","$12,699.00 ","$14,076.00 ", N/A ,"$14,076.00 ","$12,750.00 ","$12,750.00 ","$21,675.00 ", N/A ,"$12,622.50 ", N/A ,"$25,500.00 ","$14,025.00 ", N/A ,"$6,706.50 ","$25,500.00 ", N/A , N/A , N/A ,"$20,400.00 ","$13,846.50 ","$7,140.00 ","$22,950.00 ","$12,648.00 ","$8,925.00 ", N/A ,"$12,240.00 "
ST. MARY'S HOSPITAL - DECATUR,27802116,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T42,278,1 ,"$27,000.00 ","$17,550.00 ","$7,101.00 ","$27,000.00 ", N/A ,"$13,770.00 ","$14,850.00 ", N/A ,"$7,560.00 ","$12,690.00 ", N/A ,"$14,580.00 ", N/A ,"$14,661.00 ","$14,661.00 ", N/A ,"$14,661.00 ", N/A ,"$13,500.00 ","$13,500.00 ","$21,600.00 ", N/A , N/A ,"$18,900.00 ", N/A ,"$16,200.00 ", N/A ,"$20,250.00 ","$14,904.00 ","$13,446.00 ","$14,904.00 ", N/A ,"$14,904.00 ","$13,500.00 ","$13,500.00 ","$22,950.00 ", N/A ,"$13,365.00 ", N/A ,"$27,000.00 ","$14,850.00 ", N/A ,"$7,101.00 ","$27,000.00 ", N/A , N/A , N/A ,"$21,600.00 ","$14,661.00 ","$7,560.00 ","$24,300.00 ","$13,392.00 ","$9,450.00 ", N/A ,"$12,960.00 "
ST. MARY'S HOSPITAL - DECATUR,27802118,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T44,278,1 ,"$30,000.00 ","$19,500.00 ","$7,890.00 ","$30,000.00 ", N/A ,"$15,300.00 ","$16,500.00 ", N/A ,"$8,400.00 ","$14,100.00 ", N/A ,"$16,200.00 ", N/A ,"$16,290.00 ","$16,290.00 ", N/A ,"$16,290.00 ", N/A ,"$15,000.00 ","$15,000.00 ","$24,000.00 ", N/A , N/A ,"$21,000.00 ", N/A ,"$18,000.00 ", N/A ,"$22,500.00 ","$16,560.00 ","$14,940.00 ","$16,560.00 ", N/A ,"$16,560.00 ","$15,000.00 ","$15,000.00 ","$25,500.00 ", N/A ,"$14,850.00 ", N/A ,"$30,000.00 ","$16,500.00 ", N/A ,"$7,890.00 ","$30,000.00 ", N/A , N/A , N/A ,"$24,000.00 ","$16,290.00 ","$8,400.00 ","$27,000.00 ","$14,880.00 ","$10,500.00 ", N/A ,"$14,400.00 "
ST. MARY'S HOSPITAL - DECATUR,27802119,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T45,278,1 ,"$31,500.00 ","$20,475.00 ","$8,284.50 ","$31,500.00 ", N/A ,"$16,065.00 ","$17,325.00 ", N/A ,"$8,820.00 ","$14,805.00 ", N/A ,"$17,010.00 ", N/A ,"$17,104.50 ","$17,104.50 ", N/A ,"$17,104.50 ", N/A ,"$15,750.00 ","$15,750.00 ","$25,200.00 ", N/A , N/A ,"$22,050.00 ", N/A ,"$18,900.00 ", N/A ,"$23,625.00 ","$17,388.00 ","$15,687.00 ","$17,388.00 ", N/A ,"$17,388.00 ","$15,750.00 ","$15,750.00 ","$26,775.00 ", N/A ,"$15,592.50 ", N/A ,"$31,500.00 ","$17,325.00 ", N/A ,"$8,284.50 ","$31,500.00 ", N/A , N/A , N/A ,"$25,200.00 ","$17,104.50 ","$8,820.00 ","$28,350.00 ","$15,624.00 ","$11,025.00 ", N/A ,"$15,120.00 "
ST. MARY'S HOSPITAL - DECATUR,27802121,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T47,278,1 ,"$34,500.00 ","$22,425.00 ","$9,073.50 ","$34,500.00 ", N/A ,"$17,595.00 ","$18,975.00 ", N/A ,"$9,660.00 ","$16,215.00 ", N/A ,"$18,630.00 ", N/A ,"$18,733.50 ","$18,733.50 ", N/A ,"$18,733.50 ", N/A ,"$17,250.00 ","$17,250.00 ","$27,600.00 ", N/A , N/A ,"$24,150.00 ", N/A ,"$20,700.00 ", N/A ,"$25,875.00 ","$19,044.00 ","$17,181.00 ","$19,044.00 ", N/A ,"$19,044.00 ","$17,250.00 ","$17,250.00 ","$29,325.00 ", N/A ,"$17,077.50 ", N/A ,"$34,500.00 ","$18,975.00 ", N/A ,"$9,073.50 ","$34,500.00 ", N/A , N/A , N/A ,"$27,600.00 ","$18,733.50 ","$9,660.00 ","$31,050.00 ","$17,112.00 ","$12,075.00 ", N/A ,"$16,560.00 "
ST. MARY'S HOSPITAL - DECATUR,27802124,C1788,HC PORT VASCULAR ACCESS,278,1 ,"$1,500.00 ",$975.00 ,$394.50 ,"$1,500.00 ", N/A ,$765.00 ,$825.00 , N/A ,$420.00 ,$705.00 , N/A ,$810.00 , N/A ,$814.50 ,$814.50 , N/A ,$814.50 , N/A ,$750.00 ,$750.00 ,"$1,200.00 ", N/A , N/A ,"$1,050.00 ", N/A ,$900.00 , N/A ,"$1,125.00 ",$828.00 ,$747.00 ,$828.00 , N/A ,$828.00 ,$750.00 ,$750.00 ,"$1,275.00 ", N/A ,$742.50 , N/A ,"$1,500.00 ",$825.00 , N/A ,$394.50 ,"$1,500.00 ", N/A , N/A , N/A ,"$1,200.00 ",$814.50 ,$420.00 ,"$1,350.00 ",$744.00 , N/A , N/A ,$720.00 
ST. MARY'S HOSPITAL - DECATUR,27802170,C1755,HC CATHETER INTRASPINAL,278,1 ,"$1,200.00 ",$780.00 ,$315.60 ,"$1,200.00 ", N/A ,$612.00 ,$660.00 , N/A ,$336.00 ,$564.00 , N/A ,$648.00 , N/A ,$651.60 ,$651.60 , N/A ,$651.60 , N/A ,$600.00 ,$600.00 ,$960.00 , N/A , N/A ,$840.00 , N/A ,$720.00 , N/A ,$900.00 ,$662.40 ,$597.60 ,$662.40 , N/A ,$662.40 ,$600.00 ,$600.00 ,"$1,020.00 ", N/A ,$594.00 , N/A ,"$1,200.00 ",$660.00 , N/A ,$315.60 ,"$1,200.00 ", N/A , N/A , N/A ,$960.00 ,$651.60 ,$336.00 ,"$1,080.00 ",$595.20 , N/A , N/A ,$576.00 
ST. MARY'S HOSPITAL - DECATUR,27802171,C1778,HC LEAD NEUROSTIMULATOR,278,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,466.10 ", N/A ,"$1,466.10 ", N/A ,"$1,350.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$1,350.00 ","$1,350.00 ","$2,295.00 ", N/A ,"$1,336.50 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,339.20 ",$945.00 , N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27871751,C1751,"HC CATHETER, INFUSION, PERIPH, CENTRALLY OR MIDLINE (OTHER THAN HEMO)",278,1 ,"$2,700.00 ","$1,755.00 ",$710.10 ,"$2,700.00 ", N/A ,"$1,377.00 ","$1,485.00 ", N/A ,$756.00 ,"$1,269.00 ", N/A ,"$1,458.00 ", N/A ,"$1,466.10 ","$1,466.10 ", N/A ,"$1,466.10 ", N/A ,"$1,350.00 ","$1,350.00 ","$2,160.00 ", N/A , N/A ,"$1,890.00 ", N/A ,"$1,620.00 ", N/A ,"$2,025.00 ","$1,490.40 ","$1,344.60 ","$1,490.40 ", N/A ,"$1,490.40 ","$1,350.00 ","$1,350.00 ","$2,295.00 ", N/A ,"$1,336.50 ", N/A ,"$2,700.00 ","$1,485.00 ", N/A ,$710.10 ,"$2,700.00 ", N/A , N/A , N/A ,"$2,160.00 ","$1,466.10 ",$756.00 ,"$2,430.00 ","$1,339.20 ",$945.00 , N/A ,"$1,296.00 "
ST. MARY'S HOSPITAL - DECATUR,27879354,C9354,HC PERICARDIAL TISSUE MATRIX NON-HUMAN PER SQ CM,278,1 ,$525.00 ,$341.25 ,$138.08 ,$525.00 , N/A , N/A ,$288.75 , N/A ,$147.00 ,$246.75 , N/A ,$283.50 , N/A ,$285.08 ,$285.08 , N/A ,$285.08 , N/A ,$262.50 ,$262.50 ,$420.00 , N/A , N/A ,$367.50 , N/A ,$315.00 , N/A ,$393.75 ,$289.80 ,$261.45 ,$289.80 , N/A ,$289.80 ,$262.50 ,$262.50 ,$446.25 , N/A ,$259.88 , N/A ,$525.00 ,$288.75 , N/A ,$138.08 ,$525.00 , N/A , N/A , N/A ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$260.40 , N/A , N/A ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$31.00 ,$20.15 ,$6.28 ,$31.00 , N/A ,$15.81 ,$17.05 , N/A ,$8.68 ,$14.57 , N/A ,$16.74 , N/A ,$16.83 ,$10.00 , N/A ,$16.83 , N/A ,$21.70 ,$15.50 ,$24.80 , N/A , N/A ,$21.70 , N/A ,$18.60 , N/A ,$23.25 ,$17.11 ,$15.44 ,$17.11 , N/A ,$17.11 ,$21.70 ,$21.70 ,$26.35 , N/A ,$21.48 , N/A ,$31.00 ,$17.05 , N/A ,$8.15 , N/A , N/A , N/A , N/A ,$24.80 ,$16.83 ,$8.68 ,$27.90 ,$11.78 ,$6.28 , N/A ,$14.88 
ST. MARY'S HOSPITAL - DECATUR,30000010,36415,HC VENIPUNCTURE,300,1 ,$31.00 ,$20.15 ,$1.58 ,$31.00 ,$7.50 ,$15.81 ,$17.05 ,$3.00 ,$8.68 ,$14.57 ,$3.00 ,$16.74 ,$3.00 ,$16.83 ,$10.00 ,$3.00 ,$16.83 ,$5.70 ,$21.70 ,$15.50 ,$24.80 ,$7.50 ,$3.00 ,$21.70 ,$3.00 ,$18.60 ,$3.00 ,$23.25 , N/A , N/A , N/A ,$3.00 , N/A ,$3.90 ,$3.90 ,$26.35 ,$7.50 ,$21.48 ,$3.00 ,$3.00 ,$17.05 ,$3.00 ,$8.15 , N/A ,$1.65 ,$1.58 ,$3.15 ,$24.80 ,$16.83 ,$8.68 ,$27.90 ,$11.78 ,$6.00 ,$3.00 ,$14.88 
ST. MARY'S HOSPITAL - DECATUR,30000015,36600,HC ARTERIAL PUNCTURE,300,1 ,$233.00 ,$151.45 ,$32.36 ,$266.85 ,$266.85 ,$118.83 ,$128.15 ,$106.74 ,$65.24 ,$109.51 ,$106.74 ,$125.82 ,$106.74 ,$126.52 ,$34.62 ,$106.74 ,$126.52 ,$202.80 ,$163.10 ,$116.50 ,$186.40 ,$266.84 ,$106.74 ,$163.10 ,$106.74 ,$139.80 ,$106.74 ,$174.75 ,$128.62 ,$116.03 ,$128.62 ,$106.74 ,$128.62 ,$163.10 ,$163.10 ,$198.05 ,$233.00 ,$161.47 ,$106.74 ,$233.00 ,$128.15 ,$106.74 ,$61.28 , N/A ,$33.90 ,$32.36 ,$112.08 ,$186.40 ,$126.52 ,$65.24 ,$209.70 ,$88.54 , N/A ,$106.74 ,$111.84 
ST. MARY'S HOSPITAL - DECATUR,30000016,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$282.00 ,$183.30 ,$32.36 ,$282.00 ,$266.85 ,$143.82 ,$155.10 ,$106.74 ,$78.96 ,$132.54 ,$106.74 ,$152.28 ,$106.74 ,$153.13 ,$54.89 ,$106.74 ,$153.13 ,$202.80 ,$197.40 ,$141.00 ,$225.60 ,$266.84 ,$106.74 ,$197.40 ,$106.74 ,$169.20 ,$106.74 ,$211.50 ,$155.66 ,$140.44 ,$155.66 ,$106.74 ,$155.66 ,$197.40 ,$197.40 ,$239.70 ,$266.84 ,$195.43 ,$106.74 ,$282.00 ,$155.10 ,$106.74 ,$74.17 , N/A ,$33.90 ,$32.36 ,$112.08 ,$225.60 ,$153.13 ,$78.96 ,$253.80 ,$107.16 , N/A ,$106.74 ,$135.36 
ST. MARY'S HOSPITAL - DECATUR,30000213,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$120.00 ,$78.00 ,$31.56 ,$266.85 ,$266.85 ,$61.20 ,$66.00 ,$106.74 ,$33.60 ,$56.40 ,$106.74 ,$64.80 ,$106.74 ,$65.16 ,$49.05 ,$106.74 ,$65.16 ,$120.00 ,$84.00 ,$60.00 ,$96.00 ,$266.84 ,$106.74 ,$84.00 ,$106.74 ,$72.00 ,$106.74 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$106.74 ,$66.24 ,$84.00 ,$84.00 ,$102.00 ,$120.00 ,$83.16 ,$106.74 ,$120.00 ,$66.00 ,$106.74 ,$31.56 , N/A ,$33.90 ,$32.36 ,$112.08 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 , N/A ,$106.74 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30000218,86927,HC FFP THAWING EACH UNIT,300,1 ,$124.00 ,$80.60 ,$21.04 ,$352.95 ,$352.95 ,$21.04 ,$68.20 ,$141.18 ,$34.72 ,$60.76 ,$141.18 ,$72.54 ,$124.00 ,$67.33 ,$29.49 ,$124.00 ,$67.33 ,$124.00 ,$86.80 ,$62.00 ,$99.20 ,$352.95 ,$141.18 ,$86.80 ,$141.18 ,$74.40 ,$141.18 ,$93.00 ,$68.45 ,$61.75 ,$68.45 ,$141.18 ,$68.45 ,$86.80 ,$86.80 ,$105.40 ,$124.00 ,$85.93 ,$141.18 ,$124.00 ,$68.20 ,$141.18 ,$32.61 , N/A ,$28.49 ,$27.20 ,$148.24 ,$99.20 ,$67.33 ,$34.72 ,$111.60 ,$47.12 ,$124.00 ,$141.18 ,$59.52 
ST. MARY'S HOSPITAL - DECATUR,30000219,86970,HC RBC PRETREAT CHEM,300,1 ,$210.00 ,$136.50 ,$27.20 ,$210.00 ,$80.10 ,$31.54 ,$115.50 ,$32.04 ,$58.80 ,$102.90 ,$32.04 ,$122.85 ,$32.04 ,$114.03 ,$43.98 ,$32.04 ,$114.03 ,$60.88 ,$147.00 ,$105.00 ,$168.00 ,$80.10 ,$32.04 ,$147.00 ,$32.04 ,$126.00 ,$32.04 ,$157.50 ,$115.92 ,$104.58 ,$115.92 ,$32.04 ,$115.92 ,$147.00 ,$147.00 ,$178.50 ,$80.10 ,$145.53 ,$32.04 ,$210.00 ,$115.50 ,$32.04 ,$55.23 , N/A ,$28.49 ,$27.20 ,$33.64 ,$168.00 ,$114.03 ,$58.80 ,$189.00 ,$79.80 ,$67.68 ,$32.04 ,$100.80 
ST. MARY'S HOSPITAL - DECATUR,30000220,86971,HC RBC PRETREAT ENZYME,300,1 ,$153.00 ,$99.45 ,$25.24 ,$689.24 ,$689.23 ,$25.24 ,$84.15 ,$275.69 ,$42.84 ,$74.97 ,$275.69 ,$89.51 ,$153.00 ,$83.08 ,$35.18 ,$153.00 ,$83.08 ,$153.00 ,$107.10 ,$76.50 ,$122.40 ,$689.24 ,$275.69 ,$107.10 ,$275.69 ,$91.80 ,$275.69 ,$114.75 ,$84.46 ,$76.19 ,$84.46 ,$275.69 ,$84.46 ,$107.10 ,$107.10 ,$130.05 ,$153.00 ,$106.03 ,$275.69 ,$153.00 ,$84.15 ,$275.69 ,$40.24 , N/A ,$28.49 ,$27.20 ,$289.47 ,$122.40 ,$83.08 ,$42.84 ,$137.70 ,$58.14 ,$153.00 ,$275.69 ,$73.44 
ST. MARY'S HOSPITAL - DECATUR,30000221,86999,HC TRANSFUSION UNLISTED PROCEDURE,300,1 ,$327.00 ,$212.55 ,$23.38 ,$327.00 ,$58.45 ,$166.77 ,$179.85 ,$23.38 ,$91.56 ,$153.69 ,$23.38 ,$176.58 ,$23.38 ,$177.56 ,$130.80 ,$23.38 ,$177.56 ,$44.43 ,$228.90 ,$163.50 ,$261.60 ,$58.46 ,$23.38 ,$228.90 ,$23.38 ,$196.20 ,$23.38 ,$245.25 ,$180.50 ,$162.85 ,$180.50 ,$23.38 ,$180.50 ,$228.90 ,$228.90 ,$277.95 ,$58.46 ,$226.61 ,$23.38 ,$327.00 ,$179.85 ,$23.38 ,$86.00 , N/A ,$28.49 ,$27.20 ,$24.55 ,$261.60 ,$177.56 ,$91.56 ,$294.30 ,$124.26 ,$49.34 ,$23.38 ,$156.96 
ST. MARY'S HOSPITAL - DECATUR,30000223,89051,HC CELL CT BODY FLUID W/DIFF,300,1 ,$217.00 ,$141.05 ,$3.50 ,$217.00 ,$14.00 ,$12.86 ,$119.35 ,$5.60 ,$60.76 ,$58.78 ,$5.60 ,$58.78 ,$5.60 ,$117.83 ,$3.50 ,$5.60 ,$117.83 ,$10.64 ,$151.90 ,$108.50 ,$173.60 ,$14.00 ,$5.60 ,$151.90 ,$5.60 ,$130.20 ,$5.60 ,$162.75 ,$119.78 ,$108.07 ,$119.78 ,$5.60 ,$119.78 ,$7.96 ,$7.96 ,$184.45 ,$14.00 ,$150.38 ,$5.60 ,$217.00 ,$119.35 ,$5.60 ,$57.07 , N/A ,$22.52 ,$21.49 ,$5.88 ,$173.60 ,$117.83 ,$60.76 ,$195.30 ,$82.46 ,$11.20 ,$5.60 ,$104.16 
ST. MARY'S HOSPITAL - DECATUR,30000225,89190,HC SMEAR NASAL EOSINOPHILS,300,1 ,$153.00 ,$99.45 ,$3.50 ,$153.00 ,$14.48 ,$11.10 ,$84.15 ,$5.79 ,$42.84 ,$50.72 ,$5.79 ,$50.72 ,$5.79 ,$83.08 ,$3.50 ,$5.79 ,$83.08 ,$11.00 ,$107.10 ,$76.50 ,$122.40 ,$14.48 ,$5.79 ,$107.10 ,$5.79 ,$91.80 ,$5.79 ,$114.75 ,$84.46 ,$76.19 ,$84.46 ,$5.79 ,$84.46 ,$7.53 ,$7.53 ,$130.05 ,$14.48 ,$106.03 ,$5.79 ,$153.00 ,$84.15 ,$5.79 ,$40.24 , N/A ,$22.52 ,$21.49 ,$6.08 ,$122.40 ,$83.08 ,$42.84 ,$137.70 ,$58.14 ,$11.58 ,$5.79 ,$73.44 
ST. MARY'S HOSPITAL - DECATUR,30000242,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$120.00 ,$78.00 ,$31.56 ,$266.85 ,$266.85 ,$61.20 ,$66.00 ,$106.74 ,$33.60 ,$56.40 ,$106.74 ,$64.80 ,$106.74 ,$65.16 ,$49.05 ,$106.74 ,$65.16 ,$120.00 ,$84.00 ,$60.00 ,$96.00 ,$266.84 ,$106.74 ,$84.00 ,$106.74 ,$72.00 ,$106.74 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$106.74 ,$66.24 ,$84.00 ,$84.00 ,$102.00 ,$120.00 ,$83.16 ,$106.74 ,$120.00 ,$66.00 ,$106.74 ,$31.56 , N/A ,$33.90 ,$32.36 ,$112.08 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 , N/A ,$106.74 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30000245,89055,HC LEUKO ASSESS STOOL QN/SEMI,300,1 ,$157.00 ,$102.05 ,$3.50 ,$157.00 ,$10.68 ,$9.98 ,$86.35 ,$4.27 ,$43.96 ,$45.61 ,$4.27 ,$45.61 ,$4.27 ,$85.25 ,$3.50 ,$4.27 ,$85.25 ,$8.11 ,$109.90 ,$78.50 ,$125.60 ,$10.68 ,$4.27 ,$109.90 ,$4.27 ,$94.20 ,$4.27 ,$117.75 ,$86.66 ,$78.19 ,$86.66 ,$4.27 ,$86.66 ,$6.18 ,$6.18 ,$133.45 ,$10.68 ,$108.80 ,$4.27 ,$157.00 ,$86.35 ,$4.27 ,$41.29 , N/A ,$4.90 ,$4.67 ,$4.48 ,$125.60 ,$85.25 ,$43.96 ,$141.30 ,$59.66 ,$8.54 ,$4.27 ,$75.36 
ST. MARY'S HOSPITAL - DECATUR,30000247,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$274.00 ,$178.10 ,$5.64 ,$274.00 ,$18.33 ,$16.72 ,$150.70 ,$7.33 ,$76.72 ,$56.42 ,$7.33 ,$56.42 ,$7.33 ,$148.78 ,$5.64 ,$7.33 ,$148.78 ,$13.93 ,$191.80 ,$137.00 ,$219.20 ,$18.33 ,$7.33 ,$191.80 ,$7.33 ,$164.40 ,$7.33 ,$205.50 ,$151.25 ,$136.45 ,$151.25 ,$7.33 ,$151.25 ,$10.34 ,$10.34 ,$232.90 ,$18.33 ,$189.88 ,$7.33 ,$274.00 ,$150.70 ,$7.33 ,$72.06 , N/A ,$22.52 ,$21.49 ,$7.70 ,$219.20 ,$148.78 ,$76.72 ,$246.60 ,$104.12 ,$14.66 ,$7.33 ,$131.52 
ST. MARY'S HOSPITAL - DECATUR,30000249,89320,HC SEMEN ANALYSIS COMPLETE,300,1 ,$573.00 ,$372.45 ,$3.50 ,$573.00 ,$30.78 ,$23.50 ,$315.15 ,$12.31 ,$160.44 ,$128.67 ,$12.31 ,$128.67 ,$12.31 ,$311.14 ,$3.50 ,$12.31 ,$311.14 ,$23.39 ,$401.10 ,$286.50 ,$458.40 ,$30.78 ,$12.31 ,$401.10 ,$12.31 ,$343.80 ,$12.31 ,$429.75 ,$316.30 ,$285.35 ,$316.30 ,$12.31 ,$316.30 ,$17.41 ,$17.41 ,$487.05 ,$30.78 ,$397.09 ,$12.31 ,$573.00 ,$315.15 ,$12.31 ,$150.70 , N/A ,$22.52 ,$21.49 ,$12.93 ,$458.40 ,$311.14 ,$160.44 ,$515.70 ,$217.74 ,$24.62 ,$12.31 ,$275.04 
ST. MARY'S HOSPITAL - DECATUR,30000250,89321,HC SEMEN PRESENCE/MOTILITY,300,1 ,$147.00 ,$95.55 ,$3.50 ,$147.00 ,$30.13 ,$23.50 ,$80.85 ,$12.05 ,$41.16 ,$72.03 ,$12.05 ,$86.00 ,$12.05 ,$79.82 ,$3.50 ,$12.05 ,$79.82 ,$22.90 ,$102.90 ,$73.50 ,$117.60 ,$30.13 ,$12.05 ,$102.90 ,$12.05 ,$88.20 ,$12.05 ,$110.25 ,$81.14 ,$73.21 ,$81.14 ,$12.05 ,$81.14 ,$17.41 ,$17.41 ,$124.95 ,$30.13 ,$101.87 ,$12.05 ,$147.00 ,$80.85 ,$12.05 ,$38.66 , N/A ,$22.52 ,$21.49 ,$12.65 ,$117.60 ,$79.82 ,$41.16 ,$132.30 ,$55.86 ,$24.10 ,$12.05 ,$70.56 
ST. MARY'S HOSPITAL - DECATUR,30000254,S3620,HC NEWBORN METABOLIC SCREEN-90,300,1 ,$337.00 ,$219.05 ,$7.52 ,$337.00 , N/A ,$9.90 ,$185.35 , N/A ,$94.36 ,$165.13 , N/A ,$197.15 , N/A ,$182.99 ,$159.00 , N/A ,$182.99 , N/A ,$235.90 ,$168.50 ,$269.60 , N/A , N/A ,$235.90 , N/A ,$202.20 , N/A ,$252.75 ,$186.02 ,$167.83 ,$186.02 , N/A ,$186.02 ,$235.90 ,$235.90 ,$286.45 , N/A ,$233.54 , N/A ,$337.00 ,$185.35 , N/A ,$88.63 , N/A ,$7.88 ,$7.52 , N/A ,$269.60 ,$182.99 ,$94.36 ,$303.30 ,$128.06 , N/A , N/A ,$161.76 
ST. MARY'S HOSPITAL - DECATUR,30002036,N/A,HC LAB HANDLING/TRANSPORT FEE,300,1 ,$23.00 ,$14.95 ,$6.05 ,$23.00 , N/A ,$11.73 ,$12.65 , N/A ,$6.44 ,$10.81 , N/A ,$12.42 , N/A ,$12.49 ,$9.20 , N/A ,$12.49 , N/A ,$16.10 ,$11.50 ,$18.40 , N/A , N/A ,$16.10 , N/A ,$13.80 , N/A ,$17.25 ,$12.70 ,$11.45 ,$12.70 , N/A ,$12.70 ,$16.10 ,$16.10 ,$19.55 , N/A ,$15.94 , N/A ,$23.00 ,$12.65 , N/A ,$6.05 , N/A , N/A , N/A , N/A ,$18.40 ,$12.49 ,$6.44 ,$20.70 ,$8.74 ,$11.50 , N/A ,$11.04 
ST. MARY'S HOSPITAL - DECATUR,30100101,80048,HC BASIC METABOLIC PANEL,301,1 ,$250.00 ,$162.50 ,$3.50 ,$250.00 ,$21.15 ,$19.78 ,$137.50 ,$8.46 ,$70.00 ,$90.34 ,$8.46 ,$90.34 ,$8.46 ,$135.75 ,$3.50 ,$8.46 ,$135.75 ,$16.07 ,$175.00 ,$125.00 ,$200.00 ,$21.15 ,$8.46 ,$175.00 ,$8.46 ,$150.00 ,$8.46 ,$187.50 ,$138.00 ,$124.50 ,$138.00 ,$8.46 ,$138.00 ,$12.22 ,$12.22 ,$212.50 ,$21.15 ,$173.25 ,$8.46 ,$8.46 ,$137.50 ,$8.46 ,$65.75 , N/A ,$7.18 ,$6.86 ,$8.88 ,$200.00 ,$135.75 ,$70.00 ,$225.00 ,$95.00 ,$16.92 ,$8.46 ,$120.00 
ST. MARY'S HOSPITAL - DECATUR,30100103,80051,HC ELECTROLYTE PANEL,301,1 ,$234.00 ,$152.10 ,$3.50 ,$234.00 ,$17.53 ,$16.38 ,$128.70 ,$7.01 ,$65.52 ,$74.90 ,$7.01 ,$74.90 ,$7.01 ,$127.06 ,$3.50 ,$7.01 ,$127.06 ,$13.32 ,$163.80 ,$117.00 ,$187.20 ,$17.53 ,$7.01 ,$163.80 ,$7.01 ,$140.40 ,$7.01 ,$175.50 ,$129.17 ,$116.53 ,$129.17 ,$7.01 ,$129.17 ,$10.13 ,$10.13 ,$198.90 ,$17.53 ,$162.16 ,$7.01 ,$234.00 ,$128.70 ,$7.01 ,$61.54 , N/A ,$7.18 ,$6.86 ,$7.36 ,$187.20 ,$127.06 ,$65.52 ,$210.60 ,$88.92 ,$14.02 ,$7.01 ,$112.32 
ST. MARY'S HOSPITAL - DECATUR,30100104,80053,HC COMPREHENSIVE METABOL PANEL,301,1 ,$211.00 ,$137.15 ,$3.50 ,$211.00 ,$26.40 ,$24.70 ,$116.05 ,$10.56 ,$59.08 ,$103.39 ,$10.56 ,$112.85 ,$10.56 ,$114.57 ,$3.50 ,$10.56 ,$114.57 ,$20.06 ,$147.70 ,$105.50 ,$168.80 ,$26.40 ,$10.56 ,$147.70 ,$10.56 ,$126.60 ,$10.56 ,$158.25 ,$116.47 ,$105.08 ,$116.47 ,$10.56 ,$116.47 ,$15.26 ,$15.26 ,$179.35 ,$26.40 ,$146.22 ,$10.56 ,$10.56 ,$116.05 ,$10.56 ,$55.49 , N/A ,$7.18 ,$6.86 ,$11.09 ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 ,$21.12 ,$10.56 ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,30100107,80061,HC LIPID PANEL,301,1 ,$313.00 ,$203.45 ,$3.50 ,$313.00 ,$33.48 ,$31.32 ,$172.15 ,$13.39 ,$87.64 ,$143.03 ,$13.39 ,$143.03 ,$13.39 ,$169.96 ,$3.50 ,$13.39 ,$169.96 ,$25.44 ,$219.10 ,$156.50 ,$250.40 ,$33.48 ,$13.39 ,$219.10 ,$13.39 ,$187.80 ,$13.39 ,$234.75 ,$172.78 ,$155.87 ,$172.78 ,$13.39 ,$172.78 ,$19.34 ,$19.34 ,$266.05 ,$33.48 ,$216.91 ,$13.39 ,$313.00 ,$172.15 ,$13.39 ,$82.32 , N/A ,$7.18 ,$6.86 ,$14.06 ,$250.40 ,$169.96 ,$87.64 ,$281.70 ,$118.94 ,$26.78 ,$13.39 ,$150.24 
ST. MARY'S HOSPITAL - DECATUR,30100108,80069,HC RENAL PANEL,301,1 ,$280.00 ,$182.00 ,$3.50 ,$280.00 ,$21.70 ,$20.30 ,$154.00 ,$8.68 ,$78.40 ,$92.70 ,$8.68 ,$92.70 ,$8.68 ,$152.04 ,$3.50 ,$8.68 ,$152.04 ,$16.49 ,$196.00 ,$140.00 ,$224.00 ,$21.70 ,$8.68 ,$196.00 ,$8.68 ,$168.00 ,$8.68 ,$210.00 ,$154.56 ,$139.44 ,$154.56 ,$8.68 ,$154.56 ,$12.55 ,$12.55 ,$238.00 ,$21.70 ,$194.04 ,$8.68 ,$280.00 ,$154.00 ,$8.68 ,$73.64 , N/A ,$7.18 ,$6.86 ,$9.11 ,$224.00 ,$152.04 ,$78.40 ,$252.00 ,$106.40 ,$17.36 ,$8.68 ,$134.40 
ST. MARY'S HOSPITAL - DECATUR,30100109,80074,HC HEPATITIS PANEL ACUTE,301,1 ,$976.00 ,$634.40 ,$3.50 ,$976.00 ,$119.08 ,$111.30 ,$536.80 ,$47.63 ,$273.28 ,$375.80 ,$47.63 ,$375.80 ,$47.63 ,$529.97 ,$3.50 ,$47.63 ,$529.97 ,$90.50 ,$683.20 ,$488.00 ,$780.80 ,$119.08 ,$47.63 ,$683.20 ,$47.63 ,$585.60 ,$47.63 ,$732.00 ,$538.75 ,$486.05 ,$538.75 ,$47.63 ,$538.75 ,$68.81 ,$68.81 ,$829.60 ,$119.08 ,$676.37 ,$47.63 ,$976.00 ,$536.80 ,$47.63 ,$256.69 , N/A ,$7.18 ,$6.86 ,$50.01 ,$780.80 ,$529.97 ,$273.28 ,$878.40 ,$370.88 ,$95.26 ,$47.63 ,$468.48 
ST. MARY'S HOSPITAL - DECATUR,30100110,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$304.00 ,$197.60 ,$3.50 ,$304.00 ,$20.43 ,$19.10 ,$167.20 ,$8.17 ,$85.12 ,$64.48 ,$8.17 ,$64.48 ,$8.17 ,$165.07 ,$3.50 ,$8.17 ,$165.07 ,$15.52 ,$212.80 ,$152.00 ,$243.20 ,$20.43 ,$8.17 ,$212.80 ,$8.17 ,$182.40 ,$8.17 ,$228.00 ,$167.81 ,$151.39 ,$167.81 ,$8.17 ,$167.81 ,$11.80 ,$11.80 ,$258.40 ,$20.43 ,$210.67 ,$8.17 ,$304.00 ,$167.20 ,$8.17 ,$79.95 , N/A ,$7.18 ,$6.86 ,$8.58 ,$243.20 ,$165.07 ,$85.12 ,$273.60 ,$115.52 ,$16.34 ,$8.17 ,$145.92 
ST. MARY'S HOSPITAL - DECATUR,30100116,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$321.00 ,$208.65 ,$3.50 ,$321.00 ,$36.43 ,$34.04 ,$176.55 ,$14.57 ,$89.88 ,$114.91 ,$14.57 ,$114.91 ,$14.57 ,$174.30 ,$3.50 ,$14.57 ,$174.30 ,$27.68 ,$224.70 ,$160.50 ,$256.80 ,$36.43 ,$14.57 ,$224.70 ,$14.57 ,$192.60 ,$14.57 ,$240.75 ,$177.19 ,$159.86 ,$177.19 ,$14.57 ,$177.19 ,$21.03 ,$21.03 ,$272.85 ,$36.43 ,$222.45 ,$14.57 ,$321.00 ,$176.55 ,$14.57 ,$84.42 , N/A ,$9.05 ,$8.64 ,$15.30 ,$256.80 ,$174.30 ,$89.88 ,$288.90 ,$121.98 ,$29.14 ,$14.57 ,$154.08 
ST. MARY'S HOSPITAL - DECATUR,30100120,80162,HC DIGOXIN LEVELS,301,1 ,$296.00 ,$192.40 ,$3.50 ,$296.00 ,$33.20 ,$31.02 ,$162.80 ,$13.28 ,$82.88 ,$104.69 ,$13.28 ,$104.69 ,$13.28 ,$160.73 ,$3.50 ,$13.28 ,$160.73 ,$25.23 ,$207.20 ,$148.00 ,$236.80 ,$33.20 ,$13.28 ,$207.20 ,$13.28 ,$177.60 ,$13.28 ,$222.00 ,$163.39 ,$147.41 ,$163.39 ,$13.28 ,$163.39 ,$19.18 ,$19.18 ,$251.60 ,$33.20 ,$205.13 ,$13.28 ,$296.00 ,$162.80 ,$13.28 ,$77.85 , N/A ,$9.05 ,$8.64 ,$13.94 ,$236.80 ,$160.73 ,$82.88 ,$266.40 ,$112.48 ,$26.56 ,$13.28 ,$142.08 
ST. MARY'S HOSPITAL - DECATUR,30100121,80164,HC VALPROIC ACID,301,1 ,$520.00 ,$338.00 ,$3.50 ,$520.00 ,$33.85 ,$31.68 ,$286.00 ,$13.54 ,$145.60 ,$106.85 ,$13.54 ,$106.85 ,$13.54 ,$282.36 ,$3.50 ,$13.54 ,$282.36 ,$25.73 ,$364.00 ,$260.00 ,$416.00 ,$33.85 ,$13.54 ,$364.00 ,$13.54 ,$312.00 ,$13.54 ,$390.00 ,$287.04 ,$258.96 ,$287.04 ,$13.54 ,$287.04 ,$19.57 ,$19.57 ,$442.00 ,$33.85 ,$360.36 ,$13.54 ,$520.00 ,$286.00 ,$13.54 ,$136.76 , N/A ,$9.05 ,$8.64 ,$14.22 ,$416.00 ,$282.36 ,$145.60 ,$468.00 ,$197.60 ,$27.08 ,$13.54 ,$249.60 
ST. MARY'S HOSPITAL - DECATUR,30100124,80170,HC GENTAMICIN,301,1 ,$430.00 ,$279.50 ,$3.50 ,$430.00 ,$40.95 ,$38.30 ,$236.50 ,$16.38 ,$120.40 ,$129.17 ,$16.38 ,$129.17 ,$16.38 ,$233.49 ,$3.50 ,$16.38 ,$233.49 ,$31.12 ,$301.00 ,$215.00 ,$344.00 ,$40.95 ,$16.38 ,$301.00 ,$16.38 ,$258.00 ,$16.38 ,$322.50 ,$237.36 ,$214.14 ,$237.36 ,$16.38 ,$237.36 ,$23.66 ,$23.66 ,$365.50 ,$40.95 ,$297.99 ,$16.38 ,$430.00 ,$236.50 ,$16.38 ,$113.09 , N/A ,$9.05 ,$8.64 ,$17.20 ,$344.00 ,$233.49 ,$120.40 ,$387.00 ,$163.40 ,$32.76 ,$16.38 ,$206.40 
ST. MARY'S HOSPITAL - DECATUR,30100127,80178,HC LITHIUM,301,1 ,$341.00 ,$221.65 ,$3.50 ,$341.00 ,$16.53 ,$15.46 ,$187.55 ,$6.61 ,$95.48 ,$70.58 ,$6.61 ,$70.58 ,$6.61 ,$185.16 ,$3.50 ,$6.61 ,$185.16 ,$12.56 ,$238.70 ,$170.50 ,$272.80 ,$16.53 ,$6.61 ,$238.70 ,$6.61 ,$204.60 ,$6.61 ,$255.75 ,$188.23 ,$169.82 ,$188.23 ,$6.61 ,$188.23 ,$9.56 ,$9.56 ,$289.85 ,$16.53 ,$236.31 ,$6.61 ,$341.00 ,$187.55 ,$6.61 ,$89.68 , N/A ,$9.05 ,$8.64 ,$6.94 ,$272.80 ,$185.16 ,$95.48 ,$306.90 ,$129.58 ,$13.22 ,$6.61 ,$163.68 
ST. MARY'S HOSPITAL - DECATUR,30100129,80184,HC PHENOBARBITAL,301,1 ,$211.00 ,$137.15 ,$3.50 ,$211.00 ,$38.25 ,$26.02 ,$116.05 ,$15.30 ,$59.08 ,$97.81 ,$15.30 ,$97.81 ,$15.30 ,$114.57 ,$3.50 ,$15.30 ,$114.57 ,$29.07 ,$147.70 ,$105.50 ,$168.80 ,$38.25 ,$15.30 ,$147.70 ,$15.30 ,$126.60 ,$15.30 ,$158.25 ,$116.47 ,$105.08 ,$116.47 ,$15.30 ,$116.47 ,$19.89 ,$19.89 ,$179.35 ,$38.25 ,$146.22 ,$15.30 ,$211.00 ,$116.05 ,$15.30 ,$55.49 , N/A ,$9.05 ,$8.64 ,$16.07 ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 ,$30.60 ,$15.30 ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,30100130,80185,HC PHENYTOIN TOTAL,301,1 ,$276.00 ,$179.40 ,$3.50 ,$276.00 ,$33.13 ,$30.98 ,$151.80 ,$13.25 ,$77.28 ,$104.49 ,$13.25 ,$104.49 ,$13.25 ,$149.87 ,$3.50 ,$13.25 ,$149.87 ,$25.18 ,$193.20 ,$138.00 ,$220.80 ,$33.13 ,$13.25 ,$193.20 ,$13.25 ,$165.60 ,$13.25 ,$207.00 ,$152.35 ,$137.45 ,$152.35 ,$13.25 ,$152.35 ,$19.15 ,$19.15 ,$234.60 ,$33.13 ,$191.27 ,$13.25 ,$276.00 ,$151.80 ,$13.25 ,$72.59 , N/A ,$9.05 ,$8.64 ,$13.91 ,$220.80 ,$149.87 ,$77.28 ,$248.40 ,$104.88 ,$26.50 ,$13.25 ,$132.48 
ST. MARY'S HOSPITAL - DECATUR,30100138,80198,HC THEOPHYLLINE,301,1 ,$296.00 ,$192.40 ,$3.50 ,$296.00 ,$35.35 ,$33.06 ,$162.80 ,$14.14 ,$82.88 ,$111.57 ,$14.14 ,$111.57 ,$14.14 ,$160.73 ,$3.50 ,$14.14 ,$160.73 ,$26.87 ,$207.20 ,$148.00 ,$236.80 ,$35.35 ,$14.14 ,$207.20 ,$14.14 ,$177.60 ,$14.14 ,$222.00 ,$163.39 ,$147.41 ,$163.39 ,$14.14 ,$163.39 ,$20.42 ,$20.42 ,$251.60 ,$35.35 ,$205.13 ,$14.14 ,$296.00 ,$162.80 ,$14.14 ,$77.85 , N/A ,$9.05 ,$8.64 ,$14.85 ,$236.80 ,$160.73 ,$82.88 ,$266.40 ,$112.48 ,$28.28 ,$14.14 ,$142.08 
ST. MARY'S HOSPITAL - DECATUR,30100139,80200,HC TOBRAMYCIN,301,1 ,$362.00 ,$235.30 ,$3.50 ,$362.00 ,$40.33 ,$26.50 ,$199.10 ,$16.13 ,$101.36 ,$127.20 ,$16.13 ,$127.20 ,$16.13 ,$196.57 ,$3.50 ,$16.13 ,$196.57 ,$30.65 ,$253.40 ,$181.00 ,$289.60 ,$40.33 ,$16.13 ,$253.40 ,$16.13 ,$217.20 ,$16.13 ,$271.50 ,$199.82 ,$180.28 ,$199.82 ,$16.13 ,$199.82 ,$23.30 ,$23.30 ,$307.70 ,$40.33 ,$250.87 ,$16.13 ,$362.00 ,$199.10 ,$16.13 ,$95.21 , N/A ,$9.05 ,$8.64 ,$16.94 ,$289.60 ,$196.57 ,$101.36 ,$325.80 ,$137.56 ,$32.26 ,$16.13 ,$173.76 
ST. MARY'S HOSPITAL - DECATUR,30100141,80202,HC VANCOMYCIN,301,1 ,$322.00 ,$209.30 ,$3.50 ,$322.00 ,$33.85 ,$31.68 ,$177.10 ,$13.54 ,$90.16 ,$106.85 ,$13.54 ,$106.85 ,$13.54 ,$174.85 ,$3.50 ,$13.54 ,$174.85 ,$25.73 ,$225.40 ,$161.00 ,$257.60 ,$33.85 ,$13.54 ,$225.40 ,$13.54 ,$193.20 ,$13.54 ,$241.50 ,$177.74 ,$160.36 ,$177.74 ,$13.54 ,$177.74 ,$19.57 ,$19.57 ,$273.70 ,$33.85 ,$223.15 ,$13.54 ,$322.00 ,$177.10 ,$13.54 ,$84.69 , N/A ,$9.05 ,$8.64 ,$14.22 ,$257.60 ,$174.85 ,$90.16 ,$289.80 ,$122.36 ,$27.08 ,$13.54 ,$154.56 
ST. MARY'S HOSPITAL - DECATUR,30100158,82010,HC ACETONE KETONES SERUM QN,301,1 ,$201.00 ,$130.65 ,$3.50 ,$201.00 ,$20.43 ,$19.10 ,$110.55 ,$8.17 ,$56.28 ,$87.29 ,$8.17 ,$87.29 ,$8.17 ,$109.14 ,$3.50 ,$8.17 ,$109.14 ,$15.52 ,$140.70 ,$100.50 ,$160.80 ,$20.43 ,$8.17 ,$140.70 ,$8.17 ,$120.60 ,$8.17 ,$150.75 ,$110.95 ,$100.10 ,$110.95 ,$8.17 ,$110.95 ,$11.80 ,$11.80 ,$170.85 ,$20.43 ,$139.29 ,$8.17 ,$201.00 ,$110.55 ,$8.17 ,$52.86 , N/A ,$7.88 ,$7.52 ,$8.58 ,$160.80 ,$109.14 ,$56.28 ,$180.90 ,$76.38 ,$16.34 ,$8.17 ,$96.48 
ST. MARY'S HOSPITAL - DECATUR,30100165,82040,HC ALBUMIN SERUM,301,1 ,$82.00 ,$53.30 ,$3.35 ,$82.00 ,$12.38 ,$11.56 ,$45.10 ,$4.95 ,$22.96 ,$40.18 ,$4.95 ,$47.97 ,$4.95 ,$44.53 ,$3.50 ,$4.95 ,$44.53 ,$9.41 ,$57.40 ,$41.00 ,$65.60 ,$12.38 ,$4.95 ,$57.40 ,$4.95 ,$49.20 ,$4.95 ,$61.50 ,$45.26 ,$40.84 ,$45.26 ,$4.95 ,$45.26 ,$7.15 ,$7.15 ,$69.70 ,$12.38 ,$56.83 ,$4.95 ,$82.00 ,$45.10 ,$4.95 ,$21.57 , N/A ,$3.51 ,$3.35 ,$5.20 ,$65.60 ,$44.53 ,$22.96 ,$73.80 ,$31.16 ,$9.90 ,$4.95 ,$39.36 
ST. MARY'S HOSPITAL - DECATUR,30100166,82042,HC ALBUMIN BODY FLUID,301,1 ,$100.00 ,$65.00 ,$3.35 ,$100.00 ,$19.45 ,$12.08 ,$55.00 ,$7.78 ,$28.00 ,$49.00 ,$7.78 ,$58.50 ,$7.78 ,$54.30 ,$3.50 ,$7.78 ,$54.30 ,$14.78 ,$70.00 ,$50.00 ,$80.00 ,$19.45 ,$7.78 ,$70.00 ,$7.78 ,$60.00 ,$7.78 ,$75.00 ,$55.20 ,$49.80 ,$55.20 ,$7.78 ,$55.20 ,$10.11 ,$10.11 ,$85.00 ,$19.45 ,$69.30 ,$7.78 ,$100.00 ,$55.00 ,$7.78 ,$26.30 , N/A ,$3.51 ,$3.35 ,$8.17 ,$80.00 ,$54.30 ,$28.00 ,$90.00 ,$38.00 ,$15.56 ,$7.78 ,$48.00 
ST. MARY'S HOSPITAL - DECATUR,30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$173.00 ,$112.45 ,$2.69 ,$173.00 ,$14.45 ,$13.52 ,$95.15 ,$5.78 ,$48.44 ,$61.73 ,$5.78 ,$61.73 ,$5.78 ,$93.94 ,$3.50 ,$5.78 ,$93.94 ,$10.98 ,$121.10 ,$86.50 ,$138.40 ,$14.45 ,$5.78 ,$121.10 ,$5.78 ,$103.80 ,$5.78 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$5.78 ,$95.50 ,$8.35 ,$8.35 ,$147.05 ,$14.45 ,$119.89 ,$5.78 ,$173.00 ,$95.15 ,$5.78 ,$45.50 , N/A ,$2.82 ,$2.69 ,$6.07 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 ,$11.56 ,$5.78 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,30100186,82140,HC AMMONIA,301,1 ,$220.00 ,$143.00 ,$3.50 ,$220.00 ,$36.43 ,$34.06 ,$121.00 ,$14.57 ,$61.60 ,$107.80 ,$14.57 ,$114.91 ,$14.57 ,$119.46 ,$3.50 ,$14.57 ,$119.46 ,$27.68 ,$154.00 ,$110.00 ,$176.00 ,$36.43 ,$14.57 ,$154.00 ,$14.57 ,$132.00 ,$14.57 ,$165.00 ,$121.44 ,$109.56 ,$121.44 ,$14.57 ,$121.44 ,$21.05 ,$21.05 ,$187.00 ,$36.43 ,$152.46 ,$14.57 ,$220.00 ,$121.00 ,$14.57 ,$57.86 , N/A ,$7.88 ,$7.52 ,$15.30 ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 ,$29.14 ,$14.57 ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,30100188,82150,HC AMYLASE,301,1 ,$264.00 ,$171.60 ,$3.50 ,$264.00 ,$16.20 ,$15.14 ,$145.20 ,$6.48 ,$73.92 ,$69.20 ,$6.48 ,$69.20 ,$6.48 ,$143.35 ,$3.50 ,$6.48 ,$143.35 ,$12.31 ,$184.80 ,$132.00 ,$211.20 ,$16.20 ,$6.48 ,$184.80 ,$6.48 ,$158.40 ,$6.48 ,$198.00 ,$145.73 ,$131.47 ,$145.73 ,$6.48 ,$145.73 ,$9.36 ,$9.36 ,$224.40 ,$16.20 ,$182.95 ,$6.48 ,$264.00 ,$145.20 ,$6.48 ,$69.43 , N/A ,$7.88 ,$7.52 ,$6.80 ,$211.20 ,$143.35 ,$73.92 ,$237.60 ,$100.32 ,$12.96 ,$6.48 ,$126.72 
ST. MARY'S HOSPITAL - DECATUR,30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$134.00 ,$87.10 ,$3.35 ,$134.00 ,$12.55 ,$11.74 ,$73.70 ,$5.02 ,$37.52 ,$53.57 ,$5.02 ,$53.57 ,$5.02 ,$72.76 ,$3.50 ,$5.02 ,$72.76 ,$9.54 ,$93.80 ,$67.00 ,$107.20 ,$12.55 ,$5.02 ,$93.80 ,$5.02 ,$80.40 ,$5.02 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$5.02 ,$73.97 ,$7.24 ,$7.24 ,$113.90 ,$12.55 ,$92.86 ,$5.02 ,$134.00 ,$73.70 ,$5.02 ,$35.24 , N/A ,$3.51 ,$3.35 ,$5.27 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$10.04 ,$5.02 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$120.00 ,$78.00 ,$3.35 ,$120.00 ,$12.55 ,$11.74 ,$66.00 ,$5.02 ,$33.60 ,$53.57 ,$5.02 ,$53.57 ,$5.02 ,$65.16 ,$3.50 ,$5.02 ,$65.16 ,$9.54 ,$84.00 ,$60.00 ,$96.00 ,$12.55 ,$5.02 ,$84.00 ,$5.02 ,$72.00 ,$5.02 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$5.02 ,$66.24 ,$7.24 ,$7.24 ,$102.00 ,$12.55 ,$83.16 ,$5.02 ,$120.00 ,$66.00 ,$5.02 ,$31.56 , N/A ,$3.51 ,$3.35 ,$5.27 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$10.04 ,$5.02 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30100207,82272,HC OCCULT BLOOD FECAL DIAG,301,1 ,$80.00 ,$52.00 ,$3.35 ,$80.00 ,$10.58 ,$7.62 ,$44.00 ,$4.23 ,$22.40 ,$36.57 ,$4.23 ,$36.57 ,$4.23 ,$43.44 ,$3.50 ,$4.23 ,$43.44 ,$8.04 ,$56.00 ,$40.00 ,$64.00 ,$10.58 ,$4.23 ,$56.00 ,$4.23 ,$48.00 ,$4.23 ,$60.00 ,$44.16 ,$39.84 ,$44.16 ,$4.23 ,$44.16 ,$5.50 ,$5.50 ,$68.00 ,$10.58 ,$55.44 ,$4.23 ,$80.00 ,$44.00 ,$4.23 ,$21.04 , N/A ,$3.51 ,$3.35 ,$4.44 ,$64.00 ,$43.44 ,$22.40 ,$72.00 ,$30.40 ,$8.46 ,$4.23 ,$38.40 
ST. MARY'S HOSPITAL - DECATUR,30100212,82306,HC VITAMIN D 25 OH,301,1 ,$110.00 ,$71.50 ,$3.50 ,$110.00 ,$74.00 ,$69.20 ,$60.50 ,$29.60 ,$30.80 ,$53.90 ,$29.60 ,$64.35 ,$29.60 ,$59.73 ,$3.50 ,$29.60 ,$59.73 ,$56.24 ,$77.00 ,$55.00 ,$88.00 ,$74.00 ,$29.60 ,$77.00 ,$29.60 ,$66.00 ,$29.60 ,$82.50 ,$60.72 ,$54.78 ,$60.72 ,$29.60 ,$60.72 ,$42.76 ,$42.76 ,$93.50 ,$74.00 ,$76.23 ,$29.60 ,$110.00 ,$60.50 ,$29.60 ,$28.93 , N/A ,$21.22 ,$20.25 ,$31.08 ,$88.00 ,$59.73 ,$30.80 ,$99.00 ,$41.80 ,$59.20 ,$29.60 ,$52.80 
ST. MARY'S HOSPITAL - DECATUR,30100214,82310,HC CALCIUM,301,1 ,$168.00 ,$109.20 ,$3.35 ,$168.00 ,$12.90 ,$12.06 ,$92.40 ,$5.16 ,$47.04 ,$55.15 ,$5.16 ,$55.15 ,$5.16 ,$91.22 ,$3.50 ,$5.16 ,$91.22 ,$9.80 ,$117.60 ,$84.00 ,$134.40 ,$12.90 ,$5.16 ,$117.60 ,$5.16 ,$100.80 ,$5.16 ,$126.00 ,$92.74 ,$83.66 ,$92.74 ,$5.16 ,$92.74 ,$7.45 ,$7.45 ,$142.80 ,$12.90 ,$116.42 ,$5.16 ,$168.00 ,$92.40 ,$5.16 ,$44.18 , N/A ,$3.51 ,$3.35 ,$5.42 ,$134.40 ,$91.22 ,$47.04 ,$151.20 ,$63.84 ,$10.32 ,$5.16 ,$80.64 
ST. MARY'S HOSPITAL - DECATUR,30100215,82330,HC CALCIUM IONIZED,301,1 ,$204.00 ,$132.60 ,$3.50 ,$204.00 ,$34.20 ,$31.94 ,$112.20 ,$13.68 ,$57.12 ,$99.96 ,$13.68 ,$119.34 ,$13.68 ,$110.77 ,$3.50 ,$13.68 ,$110.77 ,$25.99 ,$142.80 ,$102.00 ,$163.20 ,$34.20 ,$13.68 ,$142.80 ,$13.68 ,$122.40 ,$13.68 ,$153.00 ,$112.61 ,$101.59 ,$112.61 ,$13.68 ,$112.61 ,$19.76 ,$19.76 ,$173.40 ,$34.20 ,$141.37 ,$13.68 ,$204.00 ,$112.20 ,$13.68 ,$53.65 , N/A ,$7.88 ,$7.52 ,$14.36 ,$163.20 ,$110.77 ,$57.12 ,$183.60 ,$77.52 ,$27.36 ,$13.68 ,$97.92 
ST. MARY'S HOSPITAL - DECATUR,30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$245.00 ,$159.25 ,$3.50 ,$245.00 ,$15.08 ,$14.10 ,$134.75 ,$6.03 ,$68.60 ,$47.58 ,$6.03 ,$47.58 ,$6.03 ,$133.04 ,$3.50 ,$6.03 ,$133.04 ,$11.46 ,$171.50 ,$122.50 ,$196.00 ,$15.08 ,$6.03 ,$171.50 ,$6.03 ,$147.00 ,$6.03 ,$183.75 ,$135.24 ,$122.01 ,$135.24 ,$6.03 ,$135.24 ,$8.71 ,$8.71 ,$208.25 ,$15.08 ,$169.79 ,$6.03 ,$245.00 ,$134.75 ,$6.03 ,$64.44 , N/A ,$7.88 ,$7.52 ,$6.33 ,$196.00 ,$133.04 ,$68.60 ,$220.50 ,$93.10 ,$12.06 ,$6.03 ,$117.60 
ST. MARY'S HOSPITAL - DECATUR,30100222,82374,HC BICARBONATE,301,1 ,$127.00 ,$82.55 ,$3.35 ,$127.00 ,$12.20 ,$11.42 ,$69.85 ,$4.88 ,$35.56 ,$52.20 ,$4.88 ,$52.20 ,$4.88 ,$68.96 ,$3.50 ,$4.88 ,$68.96 ,$9.27 ,$88.90 ,$63.50 ,$101.60 ,$12.20 ,$4.88 ,$88.90 ,$4.88 ,$76.20 ,$4.88 ,$95.25 ,$70.10 ,$63.25 ,$70.10 ,$4.88 ,$70.10 ,$7.06 ,$7.06 ,$107.95 ,$12.20 ,$88.01 ,$4.88 ,$127.00 ,$69.85 ,$4.88 ,$33.40 , N/A ,$3.51 ,$3.35 ,$5.12 ,$101.60 ,$68.96 ,$35.56 ,$114.30 ,$48.26 ,$9.76 ,$4.88 ,$60.96 
ST. MARY'S HOSPITAL - DECATUR,30100224,82375,HC CARBON MONOXIDE,301,1 ,$45.00 ,$29.25 ,$3.50 ,$45.00 ,$30.80 ,$13.54 ,$24.75 ,$12.32 ,$12.60 ,$22.05 ,$12.32 ,$26.33 ,$12.32 ,$24.44 ,$3.50 ,$12.32 ,$24.44 ,$23.41 ,$31.50 ,$22.50 ,$36.00 ,$30.80 ,$12.32 ,$31.50 ,$12.32 ,$27.00 ,$12.32 ,$33.75 ,$24.84 ,$22.41 ,$24.84 ,$12.32 ,$24.84 ,$17.80 ,$17.80 ,$38.25 ,$30.80 ,$31.19 ,$12.32 ,$45.00 ,$24.75 ,$12.32 ,$11.84 , N/A ,$7.88 ,$7.52 ,$12.94 ,$36.00 ,$24.44 ,$12.60 ,$40.50 ,$17.10 ,$24.64 ,$12.32 ,$21.60 
ST. MARY'S HOSPITAL - DECATUR,30100226,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$333.00 ,$216.45 ,$3.50 ,$333.00 ,$47.40 ,$44.34 ,$183.15 ,$18.96 ,$93.24 ,$149.61 ,$18.96 ,$149.61 ,$18.96 ,$180.82 ,$3.50 ,$18.96 ,$180.82 ,$36.02 ,$233.10 ,$166.50 ,$266.40 ,$47.40 ,$18.96 ,$233.10 ,$18.96 ,$199.80 ,$18.96 ,$249.75 ,$183.82 ,$165.83 ,$183.82 ,$18.96 ,$183.82 ,$27.39 ,$27.39 ,$283.05 ,$47.40 ,$230.77 ,$18.96 ,$333.00 ,$183.15 ,$18.96 ,$87.58 , N/A ,$7.88 ,$7.52 ,$19.91 ,$266.40 ,$180.82 ,$93.24 ,$299.70 ,$126.54 ,$37.92 ,$18.96 ,$159.84 
ST. MARY'S HOSPITAL - DECATUR,30100237,82435,HC CHLORIDE,301,1 ,$98.00 ,$63.70 ,$3.35 ,$98.00 ,$11.50 ,$10.74 ,$53.90 ,$4.60 ,$27.44 ,$48.02 ,$4.60 ,$49.15 ,$4.60 ,$53.21 ,$3.50 ,$4.60 ,$53.21 ,$8.74 ,$68.60 ,$49.00 ,$78.40 ,$11.50 ,$4.60 ,$68.60 ,$4.60 ,$58.80 ,$4.60 ,$73.50 ,$54.10 ,$48.80 ,$54.10 ,$4.60 ,$54.10 ,$6.64 ,$6.64 ,$83.30 ,$11.50 ,$67.91 ,$4.60 ,$98.00 ,$53.90 ,$4.60 ,$25.77 , N/A ,$3.51 ,$3.35 ,$4.83 ,$78.40 ,$53.21 ,$27.44 ,$88.20 ,$37.24 ,$9.20 ,$4.60 ,$47.04 
ST. MARY'S HOSPITAL - DECATUR,30100238,82436,HC CHLORIDE URINE,301,1 ,$228.00 ,$148.20 ,$3.35 ,$228.00 ,$14.38 ,$11.74 ,$125.40 ,$5.75 ,$63.84 ,$39.71 ,$5.75 ,$39.71 ,$5.75 ,$123.80 ,$3.50 ,$5.75 ,$123.80 ,$10.93 ,$159.60 ,$114.00 ,$182.40 ,$14.38 ,$5.75 ,$159.60 ,$5.75 ,$136.80 ,$5.75 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$5.75 ,$125.86 ,$7.48 ,$7.48 ,$193.80 ,$14.38 ,$158.00 ,$5.75 ,$228.00 ,$125.40 ,$5.75 ,$59.96 , N/A ,$3.51 ,$3.35 ,$6.04 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$11.50 ,$5.75 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,30100240,82438,HC CHLORIDE OTHER SOURCE,301,1 ,$203.00 ,$131.95 ,$3.35 ,$203.00 ,$12.50 ,$11.42 ,$111.65 ,$5.00 ,$56.84 ,$38.53 ,$5.00 ,$38.53 ,$5.00 ,$110.23 ,$3.50 ,$5.00 ,$110.23 ,$9.50 ,$142.10 ,$101.50 ,$162.40 ,$12.50 ,$5.00 ,$142.10 ,$5.00 ,$121.80 ,$5.00 ,$152.25 ,$112.06 ,$101.09 ,$112.06 ,$5.00 ,$112.06 ,$7.06 ,$7.06 ,$172.55 ,$12.50 ,$140.68 ,$5.00 ,$203.00 ,$111.65 ,$5.00 ,$53.39 , N/A ,$3.51 ,$3.35 ,$5.25 ,$162.40 ,$110.23 ,$56.84 ,$182.70 ,$77.14 ,$10.00 ,$5.00 ,$97.44 
ST. MARY'S HOSPITAL - DECATUR,30100241,82465,HC CHOLESTEROL,301,1 ,$179.00 ,$116.35 ,$3.35 ,$179.00 ,$10.88 ,$10.16 ,$98.45 ,$4.35 ,$50.12 ,$46.50 ,$4.35 ,$46.50 ,$4.35 ,$97.20 ,$3.50 ,$4.35 ,$97.20 ,$8.27 ,$125.30 ,$89.50 ,$143.20 ,$10.88 ,$4.35 ,$125.30 ,$4.35 ,$107.40 ,$4.35 ,$134.25 ,$98.81 ,$89.14 ,$98.81 ,$4.35 ,$98.81 ,$6.29 ,$6.29 ,$152.15 ,$10.88 ,$124.05 ,$4.35 ,$179.00 ,$98.45 ,$4.35 ,$47.08 , N/A ,$3.51 ,$3.35 ,$4.57 ,$143.20 ,$97.20 ,$50.12 ,$161.10 ,$68.02 ,$8.70 ,$4.35 ,$85.92 
ST. MARY'S HOSPITAL - DECATUR,30100254,82533,HC CORTISOL TOTAL,301,1 ,$271.00 ,$176.15 ,$3.50 ,$271.00 ,$40.75 ,$38.10 ,$149.05 ,$16.30 ,$75.88 ,$128.58 ,$16.30 ,$128.58 ,$16.30 ,$147.15 ,$3.50 ,$16.30 ,$147.15 ,$30.97 ,$189.70 ,$135.50 ,$216.80 ,$40.75 ,$16.30 ,$189.70 ,$16.30 ,$162.60 ,$16.30 ,$203.25 ,$149.59 ,$134.96 ,$149.59 ,$16.30 ,$149.59 ,$23.54 ,$23.54 ,$230.35 ,$40.75 ,$187.80 ,$16.30 ,$271.00 ,$149.05 ,$16.30 ,$71.27 , N/A ,$18.45 ,$17.61 ,$17.12 ,$216.80 ,$147.15 ,$75.88 ,$243.90 ,$102.98 ,$32.60 ,$16.30 ,$130.08 
ST. MARY'S HOSPITAL - DECATUR,30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$163.00 ,$105.95 ,$3.35 ,$163.00 ,$16.28 ,$15.22 ,$89.65 ,$6.51 ,$45.64 ,$69.60 ,$6.51 ,$69.60 ,$6.51 ,$88.51 ,$3.50 ,$6.51 ,$88.51 ,$12.37 ,$114.10 ,$81.50 ,$130.40 ,$16.28 ,$6.51 ,$114.10 ,$6.51 ,$97.80 ,$6.51 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$6.51 ,$89.98 ,$9.40 ,$9.40 ,$138.55 ,$16.28 ,$112.96 ,$6.51 ,$163.00 ,$89.65 ,$6.51 ,$42.87 , N/A ,$3.51 ,$3.35 ,$6.84 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$13.02 ,$6.51 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$28.88 ,$26.98 ,$116.60 ,$11.55 ,$59.36 ,$91.12 ,$11.55 ,$91.12 ,$11.55 ,$115.12 ,$3.50 ,$11.55 ,$115.12 ,$21.95 ,$148.40 ,$106.00 ,$169.60 ,$28.88 ,$11.55 ,$148.40 ,$11.55 ,$127.20 ,$11.55 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$11.55 ,$117.02 ,$16.68 ,$16.68 ,$180.20 ,$28.88 ,$146.92 ,$11.55 ,$212.00 ,$116.60 ,$11.55 ,$55.76 , N/A ,$7.88 ,$7.52 ,$12.13 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$23.10 ,$11.55 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30100262,82565,HC CREATININE,301,1 ,$167.00 ,$108.55 ,$3.35 ,$167.00 ,$12.80 ,$11.96 ,$91.85 ,$5.12 ,$46.76 ,$54.75 ,$5.12 ,$54.75 ,$5.12 ,$90.68 ,$3.50 ,$5.12 ,$90.68 ,$9.73 ,$116.90 ,$83.50 ,$133.60 ,$12.80 ,$5.12 ,$116.90 ,$5.12 ,$100.20 ,$5.12 ,$125.25 ,$92.18 ,$83.17 ,$92.18 ,$5.12 ,$92.18 ,$7.40 ,$7.40 ,$141.95 ,$12.80 ,$115.73 ,$5.12 ,$5.12 ,$91.85 ,$5.12 ,$43.92 , N/A ,$3.51 ,$3.35 ,$5.38 ,$133.60 ,$90.68 ,$46.76 ,$150.30 ,$63.46 ,$10.24 ,$5.12 ,$80.16 
ST. MARY'S HOSPITAL - DECATUR,30100264,82570,HC CREATININE OTH SOURCE,301,1 ,$170.00 ,$110.50 ,$3.35 ,$170.00 ,$12.95 ,$12.08 ,$93.50 ,$5.18 ,$47.60 ,$55.24 ,$5.18 ,$55.24 ,$5.18 ,$92.31 ,$3.50 ,$5.18 ,$92.31 ,$9.84 ,$119.00 ,$85.00 ,$136.00 ,$12.95 ,$5.18 ,$119.00 ,$5.18 ,$102.00 ,$5.18 ,$127.50 ,$93.84 ,$84.66 ,$93.84 ,$5.18 ,$93.84 ,$7.48 ,$7.48 ,$144.50 ,$12.95 ,$117.81 ,$5.18 ,$170.00 ,$93.50 ,$5.18 ,$44.71 , N/A ,$3.51 ,$3.35 ,$5.44 ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$10.36 ,$5.18 ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,30100266,82575,HC CREATININE CLEARANCE,301,1 ,$268.00 ,$174.20 ,$3.50 ,$268.00 ,$23.65 ,$22.08 ,$147.40 ,$9.46 ,$75.04 ,$74.61 ,$9.46 ,$74.61 ,$9.46 ,$145.52 ,$3.50 ,$9.46 ,$145.52 ,$17.97 ,$187.60 ,$134.00 ,$214.40 ,$23.65 ,$9.46 ,$187.60 ,$9.46 ,$160.80 ,$9.46 ,$201.00 ,$147.94 ,$133.46 ,$147.94 ,$9.46 ,$147.94 ,$13.66 ,$13.66 ,$227.80 ,$23.65 ,$185.72 ,$9.46 ,$268.00 ,$147.40 ,$9.46 ,$70.48 , N/A ,$7.88 ,$7.52 ,$9.93 ,$214.40 ,$145.52 ,$75.04 ,$241.20 ,$101.84 ,$18.92 ,$9.46 ,$128.64 
ST. MARY'S HOSPITAL - DECATUR,30100269,82607,HC VITAMIN B12,301,1 ,$232.00 ,$150.80 ,$3.50 ,$232.00 ,$37.70 ,$35.22 ,$127.60 ,$15.08 ,$64.96 ,$113.68 ,$15.08 ,$118.94 ,$15.08 ,$125.98 ,$3.50 ,$15.08 ,$125.98 ,$28.65 ,$162.40 ,$116.00 ,$185.60 ,$37.70 ,$15.08 ,$162.40 ,$15.08 ,$139.20 ,$15.08 ,$174.00 ,$128.06 ,$115.54 ,$128.06 ,$15.08 ,$128.06 ,$21.78 ,$21.78 ,$197.20 ,$37.70 ,$160.78 ,$15.08 ,$232.00 ,$127.60 ,$15.08 ,$61.02 , N/A ,$10.60 ,$10.12 ,$15.83 ,$185.60 ,$125.98 ,$64.96 ,$208.80 ,$88.16 ,$30.16 ,$15.08 ,$111.36 
ST. MARY'S HOSPITAL - DECATUR,30100290,82728,HC FERRITIN,301,1 ,$230.00 ,$149.50 ,$3.50 ,$230.00 ,$34.08 ,$31.84 ,$126.50 ,$13.63 ,$64.40 ,$107.54 ,$13.63 ,$107.54 ,$13.63 ,$124.89 ,$3.50 ,$13.63 ,$124.89 ,$25.90 ,$161.00 ,$115.00 ,$184.00 ,$34.08 ,$13.63 ,$161.00 ,$13.63 ,$138.00 ,$13.63 ,$172.50 ,$126.96 ,$114.54 ,$126.96 ,$13.63 ,$126.96 ,$19.70 ,$19.70 ,$195.50 ,$34.08 ,$159.39 ,$13.63 ,$230.00 ,$126.50 ,$13.63 ,$60.49 , N/A ,$7.88 ,$7.52 ,$14.31 ,$184.00 ,$124.89 ,$64.40 ,$207.00 ,$87.40 ,$27.26 ,$13.63 ,$110.40 
ST. MARY'S HOSPITAL - DECATUR,30100291,82731,HC FETAL FIBRONECTIN,301,1 ,$850.00 ,$552.50 ,$3.50 ,$850.00 ,$161.03 ,$109.38 ,$467.50 ,$64.41 ,$238.00 ,$416.50 ,$64.41 ,$497.25 ,$64.41 ,$461.55 ,$3.50 ,$64.41 ,$461.55 ,$122.38 ,$595.00 ,$425.00 ,$680.00 ,$161.03 ,$64.41 ,$595.00 ,$64.41 ,$510.00 ,$64.41 ,$637.50 ,$469.20 ,$423.30 ,$469.20 ,$64.41 ,$469.20 ,$93.04 ,$93.04 ,$722.50 ,$161.03 ,$589.05 ,$64.41 ,$850.00 ,$467.50 ,$64.41 ,$223.55 , N/A ,$21.22 ,$20.25 ,$67.63 ,$680.00 ,$461.55 ,$238.00 ,$765.00 ,$323.00 ,$128.82 ,$64.41 ,$408.00 
ST. MARY'S HOSPITAL - DECATUR,30100292,82746,HC FOLIC ACID SERUM,301,1 ,$204.00 ,$132.60 ,$3.50 ,$204.00 ,$36.75 ,$34.36 ,$112.20 ,$14.70 ,$57.12 ,$99.96 ,$14.70 ,$115.99 ,$14.70 ,$110.77 ,$3.50 ,$14.70 ,$110.77 ,$27.93 ,$142.80 ,$102.00 ,$163.20 ,$36.75 ,$14.70 ,$142.80 ,$14.70 ,$122.40 ,$14.70 ,$153.00 ,$112.61 ,$101.59 ,$112.61 ,$14.70 ,$112.61 ,$21.24 ,$21.24 ,$173.40 ,$36.75 ,$141.37 ,$14.70 ,$204.00 ,$112.20 ,$14.70 ,$53.65 , N/A ,$7.88 ,$7.52 ,$15.44 ,$163.20 ,$110.77 ,$57.12 ,$183.60 ,$77.52 ,$29.40 ,$14.70 ,$97.92 
ST. MARY'S HOSPITAL - DECATUR,30100308,82810,HC BLOOD GAS O2 SAT ONLY,301,1 ,$102.00 ,$66.30 ,$3.50 ,$102.00 ,$24.43 ,$20.40 ,$56.10 ,$9.77 ,$28.56 ,$49.98 ,$9.77 ,$59.67 ,$9.77 ,$55.39 ,$3.50 ,$9.77 ,$55.39 ,$18.56 ,$71.40 ,$51.00 ,$81.60 ,$24.43 ,$9.77 ,$71.40 ,$9.77 ,$61.20 ,$9.77 ,$76.50 ,$56.30 ,$50.80 ,$56.30 ,$9.77 ,$56.30 ,$12.70 ,$12.70 ,$86.70 ,$24.43 ,$70.69 ,$9.77 ,$102.00 ,$56.10 ,$9.77 ,$26.83 , N/A ,$7.88 ,$7.52 ,$10.26 ,$81.60 ,$55.39 ,$28.56 ,$91.80 ,$38.76 ,$19.54 ,$9.77 ,$48.96 
ST. MARY'S HOSPITAL - DECATUR,30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$137.00 ,$89.05 ,$3.35 ,$137.00 ,$9.83 ,$9.16 ,$75.35 ,$3.93 ,$38.36 ,$41.97 ,$3.93 ,$41.97 ,$3.93 ,$74.39 ,$3.50 ,$3.93 ,$74.39 ,$7.47 ,$95.90 ,$68.50 ,$109.60 ,$9.83 ,$3.93 ,$95.90 ,$3.93 ,$82.20 ,$3.93 ,$102.75 ,$75.62 ,$68.23 ,$75.62 ,$3.93 ,$75.62 ,$5.68 ,$5.68 ,$116.45 ,$9.83 ,$94.94 ,$3.93 ,$137.00 ,$75.35 ,$3.93 ,$36.03 , N/A ,$3.51 ,$3.35 ,$4.13 ,$109.60 ,$74.39 ,$38.36 ,$123.30 ,$52.06 ,$7.86 ,$3.93 ,$65.76 
ST. MARY'S HOSPITAL - DECATUR,30100312,82947,HC GLUCOSE,301,1 ,$96.00 ,$62.40 ,$3.35 ,$96.00 ,$9.83 ,$9.16 ,$52.80 ,$3.93 ,$26.88 ,$41.97 ,$3.93 ,$41.97 ,$3.93 ,$52.13 ,$3.50 ,$3.93 ,$52.13 ,$7.47 ,$67.20 ,$48.00 ,$76.80 ,$9.83 ,$3.93 ,$67.20 ,$3.93 ,$57.60 ,$3.93 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$3.93 ,$52.99 ,$5.68 ,$5.68 ,$81.60 ,$9.83 ,$66.53 ,$3.93 ,$96.00 ,$52.80 ,$3.93 ,$25.25 , N/A ,$3.51 ,$3.35 ,$4.13 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$7.86 ,$3.93 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30100313,82950,HC GLUCOSE SCREEN,301,1 ,$173.00 ,$112.45 ,$3.35 ,$173.00 ,$11.88 ,$11.10 ,$95.15 ,$4.75 ,$48.44 ,$50.72 ,$4.75 ,$50.72 ,$4.75 ,$93.94 ,$3.50 ,$4.75 ,$93.94 ,$9.03 ,$121.10 ,$86.50 ,$138.40 ,$11.88 ,$4.75 ,$121.10 ,$4.75 ,$103.80 ,$4.75 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$4.75 ,$95.50 ,$6.85 ,$6.85 ,$147.05 ,$11.88 ,$119.89 ,$4.75 ,$173.00 ,$95.15 ,$4.75 ,$45.50 , N/A ,$3.51 ,$3.35 ,$4.99 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 ,$9.50 ,$4.75 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$390.00 ,$253.50 ,$3.50 ,$390.00 ,$32.18 ,$30.08 ,$214.50 ,$12.87 ,$109.20 ,$137.42 ,$12.87 ,$137.42 ,$12.87 ,$211.77 ,$3.50 ,$12.87 ,$211.77 ,$24.45 ,$273.00 ,$195.00 ,$312.00 ,$32.18 ,$12.87 ,$273.00 ,$12.87 ,$234.00 ,$12.87 ,$292.50 ,$215.28 ,$194.22 ,$215.28 ,$12.87 ,$215.28 ,$18.59 ,$18.59 ,$331.50 ,$32.18 ,$270.27 ,$12.87 ,$390.00 ,$214.50 ,$12.87 ,$102.57 , N/A ,$7.88 ,$7.52 ,$13.51 ,$312.00 ,$211.77 ,$109.20 ,$351.00 ,$148.20 ,$25.74 ,$12.87 ,$187.20 
ST. MARY'S HOSPITAL - DECATUR,30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$116.00 ,$75.40 ,$3.50 ,$116.00 ,$9.80 ,$9.16 ,$63.80 ,$3.92 ,$32.48 ,$41.88 ,$3.92 ,$41.88 ,$3.92 ,$62.99 ,$3.50 ,$3.92 ,$62.99 ,$7.45 ,$81.20 ,$58.00 ,$92.80 ,$9.80 ,$3.92 ,$81.20 ,$3.92 ,$69.60 ,$3.92 ,$87.00 ,$64.03 ,$57.77 ,$64.03 ,$3.92 ,$64.03 ,$5.67 ,$5.67 ,$98.60 ,$9.80 ,$80.39 ,$3.92 ,$116.00 ,$63.80 ,$3.92 ,$30.51 , N/A ,$7.88 ,$7.52 ,$4.12 ,$92.80 ,$62.99 ,$32.48 ,$104.40 ,$44.08 ,$7.84 ,$3.92 ,$55.68 
ST. MARY'S HOSPITAL - DECATUR,30100318,82962,HC GLUCOSE BY DEVICE,301,1 ,$48.00 ,$31.20 ,$3.28 ,$48.00 ,$8.20 ,$5.48 ,$26.40 ,$3.28 ,$13.44 ,$23.52 ,$3.28 ,$28.08 ,$3.28 ,$26.06 ,$3.50 ,$3.28 ,$26.06 ,$6.23 ,$33.60 ,$24.00 ,$38.40 ,$8.20 ,$3.28 ,$33.60 ,$3.28 ,$28.80 ,$3.28 ,$36.00 ,$26.50 ,$23.90 ,$26.50 ,$3.28 ,$26.50 ,$4.26 ,$4.26 ,$40.80 ,$8.20 ,$33.26 ,$3.28 ,$48.00 ,$26.40 ,$3.28 ,$12.62 , N/A ,$3.51 ,$3.35 ,$3.44 ,$38.40 ,$26.06 ,$13.44 ,$43.20 ,$18.24 ,$6.56 ,$3.28 ,$23.04 
ST. MARY'S HOSPITAL - DECATUR,30100319,82977,HC GGT/GGTP,301,1 ,$152.00 ,$98.80 ,$3.35 ,$152.00 ,$18.00 ,$16.84 ,$83.60 ,$7.20 ,$42.56 ,$74.48 ,$7.20 ,$76.87 ,$7.20 ,$82.54 ,$3.50 ,$7.20 ,$82.54 ,$13.68 ,$106.40 ,$76.00 ,$121.60 ,$18.00 ,$7.20 ,$106.40 ,$7.20 ,$91.20 ,$7.20 ,$114.00 ,$83.90 ,$75.70 ,$83.90 ,$7.20 ,$83.90 ,$10.40 ,$10.40 ,$129.20 ,$18.00 ,$105.34 ,$7.20 ,$152.00 ,$83.60 ,$7.20 ,$39.98 , N/A ,$3.51 ,$3.35 ,$7.56 ,$121.60 ,$82.54 ,$42.56 ,$136.80 ,$57.76 ,$14.40 ,$7.20 ,$72.96 
ST. MARY'S HOSPITAL - DECATUR,30100322,83001,HC FSH,301,1 ,$277.00 ,$180.05 ,$3.50 ,$277.00 ,$46.45 ,$43.42 ,$152.35 ,$18.58 ,$77.56 ,$135.73 ,$18.58 ,$162.05 ,$18.58 ,$150.41 ,$3.50 ,$18.58 ,$150.41 ,$35.30 ,$193.90 ,$138.50 ,$221.60 ,$46.45 ,$18.58 ,$193.90 ,$18.58 ,$166.20 ,$18.58 ,$207.75 ,$152.90 ,$137.95 ,$152.90 ,$18.58 ,$152.90 ,$26.85 ,$26.85 ,$235.45 ,$46.45 ,$191.96 ,$18.58 ,$277.00 ,$152.35 ,$18.58 ,$72.85 , N/A ,$18.45 ,$17.61 ,$19.51 ,$221.60 ,$150.41 ,$77.56 ,$249.30 ,$105.26 ,$37.16 ,$18.58 ,$132.96 
ST. MARY'S HOSPITAL - DECATUR,30100325,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$277.00 ,$180.05 ,$3.50 ,$277.00 ,$46.30 ,$43.28 ,$152.35 ,$18.52 ,$77.56 ,$135.73 ,$18.52 ,$162.05 ,$18.52 ,$150.41 ,$3.50 ,$18.52 ,$150.41 ,$35.19 ,$193.90 ,$138.50 ,$221.60 ,$46.30 ,$18.52 ,$193.90 ,$18.52 ,$166.20 ,$18.52 ,$207.75 ,$152.90 ,$137.95 ,$152.90 ,$18.52 ,$152.90 ,$26.74 ,$26.74 ,$235.45 ,$46.30 ,$191.96 ,$18.52 ,$277.00 ,$152.35 ,$18.52 ,$72.85 , N/A ,$18.45 ,$17.61 ,$19.45 ,$221.60 ,$150.41 ,$77.56 ,$249.30 ,$105.26 ,$37.04 ,$18.52 ,$132.96 
ST. MARY'S HOSPITAL - DECATUR,30100327,83010,HC HAPTOGLOBIN,301,1 ,$126.00 ,$81.90 ,$3.50 ,$126.00 ,$31.45 ,$29.40 ,$69.30 ,$12.58 ,$35.28 ,$61.74 ,$12.58 ,$73.71 ,$12.58 ,$68.42 ,$3.50 ,$12.58 ,$68.42 ,$23.90 ,$88.20 ,$63.00 ,$100.80 ,$31.45 ,$12.58 ,$88.20 ,$12.58 ,$75.60 ,$12.58 ,$94.50 ,$69.55 ,$62.75 ,$69.55 ,$12.58 ,$69.55 ,$18.16 ,$18.16 ,$107.10 ,$31.45 ,$87.32 ,$12.58 ,$126.00 ,$69.30 ,$12.58 ,$33.14 , N/A ,$7.88 ,$7.52 ,$13.21 ,$100.80 ,$68.42 ,$35.28 ,$113.40 ,$47.88 ,$25.16 ,$12.58 ,$60.48 
ST. MARY'S HOSPITAL - DECATUR,30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$155.00 ,$100.75 ,$3.50 ,$155.00 ,$24.28 ,$22.68 ,$85.25 ,$9.71 ,$43.40 ,$75.95 ,$9.71 ,$90.68 ,$9.71 ,$84.17 ,$3.50 ,$9.71 ,$84.17 ,$18.45 ,$108.50 ,$77.50 ,$124.00 ,$24.28 ,$9.71 ,$108.50 ,$9.71 ,$93.00 ,$9.71 ,$116.25 ,$85.56 ,$77.19 ,$85.56 ,$9.71 ,$85.56 ,$14.03 ,$14.03 ,$131.75 ,$24.28 ,$107.42 ,$9.71 ,$155.00 ,$85.25 ,$9.71 ,$40.77 , N/A ,$7.88 ,$7.52 ,$10.20 ,$124.00 ,$84.17 ,$43.40 ,$139.50 ,$58.90 ,$19.42 ,$9.71 ,$74.40 
ST. MARY'S HOSPITAL - DECATUR,30100393,83540,HC IRON TOTAL,301,1 ,$145.00 ,$94.25 ,$3.35 ,$145.00 ,$16.18 ,$15.14 ,$79.75 ,$6.47 ,$40.60 ,$51.02 ,$6.47 ,$51.02 ,$6.47 ,$78.74 ,$3.50 ,$6.47 ,$78.74 ,$12.29 ,$101.50 ,$72.50 ,$116.00 ,$16.18 ,$6.47 ,$101.50 ,$6.47 ,$87.00 ,$6.47 ,$108.75 ,$80.04 ,$72.21 ,$80.04 ,$6.47 ,$80.04 ,$9.35 ,$9.35 ,$123.25 ,$16.18 ,$100.49 ,$6.47 ,$145.00 ,$79.75 ,$6.47 ,$38.14 , N/A ,$3.51 ,$3.35 ,$6.79 ,$116.00 ,$78.74 ,$40.60 ,$130.50 ,$55.10 ,$12.94 ,$6.47 ,$69.60 
ST. MARY'S HOSPITAL - DECATUR,30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$170.00 ,$110.50 ,$3.50 ,$170.00 ,$21.85 ,$20.44 ,$93.50 ,$8.74 ,$47.60 ,$68.91 ,$8.74 ,$68.91 ,$8.74 ,$92.31 ,$3.50 ,$8.74 ,$92.31 ,$16.61 ,$119.00 ,$85.00 ,$136.00 ,$21.85 ,$8.74 ,$119.00 ,$8.74 ,$102.00 ,$8.74 ,$127.50 ,$93.84 ,$84.66 ,$93.84 ,$8.74 ,$93.84 ,$12.62 ,$12.62 ,$144.50 ,$21.85 ,$117.81 ,$8.74 ,$170.00 ,$93.50 ,$8.74 ,$44.71 , N/A ,$7.88 ,$7.52 ,$9.18 ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$17.48 ,$8.74 ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$210.00 ,$136.50 ,$3.50 ,$210.00 ,$28.93 ,$24.96 ,$115.50 ,$11.57 ,$58.80 ,$102.90 ,$11.57 ,$114.13 ,$11.57 ,$114.03 ,$3.50 ,$11.57 ,$114.03 ,$21.98 ,$147.00 ,$105.00 ,$168.00 ,$28.93 ,$11.57 ,$147.00 ,$11.57 ,$126.00 ,$11.57 ,$157.50 ,$115.92 ,$104.58 ,$115.92 ,$11.57 ,$115.92 ,$15.43 ,$15.43 ,$178.50 ,$28.93 ,$145.53 ,$11.57 ,$210.00 ,$115.50 ,$11.57 ,$55.23 , N/A ,$7.88 ,$7.52 ,$12.15 ,$168.00 ,$114.03 ,$58.80 ,$189.00 ,$79.80 ,$23.14 ,$11.57 ,$100.80 
ST. MARY'S HOSPITAL - DECATUR,30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$178.00 ,$115.70 ,$3.35 ,$178.00 ,$15.10 ,$14.12 ,$97.90 ,$6.04 ,$49.84 ,$47.58 ,$6.04 ,$47.58 ,$6.04 ,$96.65 ,$3.50 ,$6.04 ,$96.65 ,$11.48 ,$124.60 ,$89.00 ,$142.40 ,$15.10 ,$6.04 ,$124.60 ,$6.04 ,$106.80 ,$6.04 ,$133.50 ,$98.26 ,$88.64 ,$98.26 ,$6.04 ,$98.26 ,$8.72 ,$8.72 ,$151.30 ,$15.10 ,$123.35 ,$6.04 ,$178.00 ,$97.90 ,$6.04 ,$46.81 , N/A ,$3.51 ,$3.35 ,$6.34 ,$142.40 ,$96.65 ,$49.84 ,$160.20 ,$67.64 ,$12.08 ,$6.04 ,$85.44 
ST. MARY'S HOSPITAL - DECATUR,30100409,83690,HC LIPASE,301,1 ,$223.00 ,$144.95 ,$3.35 ,$223.00 ,$17.23 ,$16.10 ,$122.65 ,$6.89 ,$62.44 ,$54.36 ,$6.89 ,$54.36 ,$6.89 ,$121.09 ,$3.50 ,$6.89 ,$121.09 ,$13.09 ,$156.10 ,$111.50 ,$178.40 ,$17.23 ,$6.89 ,$156.10 ,$6.89 ,$133.80 ,$6.89 ,$167.25 ,$123.10 ,$111.05 ,$123.10 ,$6.89 ,$123.10 ,$9.95 ,$9.95 ,$189.55 ,$17.23 ,$154.54 ,$6.89 ,$223.00 ,$122.65 ,$6.89 ,$58.65 , N/A ,$3.51 ,$3.35 ,$7.23 ,$178.40 ,$121.09 ,$62.44 ,$200.70 ,$84.74 ,$13.78 ,$6.89 ,$107.04 
ST. MARY'S HOSPITAL - DECATUR,30100415,83718,HC CHOLESTEROL HDL,301,1 ,$210.00 ,$136.50 ,$3.50 ,$210.00 ,$20.48 ,$19.14 ,$115.50 ,$8.19 ,$58.80 ,$87.59 ,$8.19 ,$87.59 ,$8.19 ,$114.03 ,$3.50 ,$8.19 ,$114.03 ,$15.56 ,$147.00 ,$105.00 ,$168.00 ,$20.48 ,$8.19 ,$147.00 ,$8.19 ,$126.00 ,$8.19 ,$157.50 ,$115.92 ,$104.58 ,$115.92 ,$8.19 ,$115.92 ,$11.83 ,$11.83 ,$178.50 ,$20.48 ,$145.53 ,$8.19 ,$210.00 ,$115.50 ,$8.19 ,$55.23 , N/A ,$7.88 ,$7.52 ,$8.60 ,$168.00 ,$114.03 ,$58.80 ,$189.00 ,$79.80 ,$16.38 ,$8.19 ,$100.80 
ST. MARY'S HOSPITAL - DECATUR,30100416,83721,HC CHOLESTEROL LDL,301,1 ,$115.00 ,$74.75 ,$3.50 ,$115.00 ,$26.25 ,$22.28 ,$63.25 ,$10.50 ,$32.20 ,$56.35 ,$10.50 ,$67.28 ,$10.50 ,$62.45 ,$3.50 ,$10.50 ,$62.45 ,$19.95 ,$80.50 ,$57.50 ,$92.00 ,$26.25 ,$10.50 ,$80.50 ,$10.50 ,$69.00 ,$10.50 ,$86.25 ,$63.48 ,$57.27 ,$63.48 ,$10.50 ,$63.48 ,$13.78 ,$13.78 ,$97.75 ,$26.25 ,$79.70 ,$10.50 ,$115.00 ,$63.25 ,$10.50 ,$30.25 , N/A ,$7.88 ,$7.52 ,$11.03 ,$92.00 ,$62.45 ,$32.20 ,$103.50 ,$43.70 ,$21.00 ,$10.50 ,$55.20 
ST. MARY'S HOSPITAL - DECATUR,30100417,83735,HC MAGNESIUM,301,1 ,$171.00 ,$111.15 ,$3.35 ,$171.00 ,$16.75 ,$15.66 ,$94.05 ,$6.70 ,$47.88 ,$71.56 ,$6.70 ,$71.56 ,$6.70 ,$92.85 ,$3.50 ,$6.70 ,$92.85 ,$12.73 ,$119.70 ,$85.50 ,$136.80 ,$16.75 ,$6.70 ,$119.70 ,$6.70 ,$102.60 ,$6.70 ,$128.25 ,$94.39 ,$85.16 ,$94.39 ,$6.70 ,$94.39 ,$9.67 ,$9.67 ,$145.35 ,$16.75 ,$118.50 ,$6.70 ,$171.00 ,$94.05 ,$6.70 ,$44.97 , N/A ,$3.51 ,$3.35 ,$7.04 ,$136.80 ,$92.85 ,$47.88 ,$153.90 ,$64.98 ,$13.40 ,$6.70 ,$82.08 
ST. MARY'S HOSPITAL - DECATUR,30100435,83874,HC MYOGLOBIN,301,1 ,$196.00 ,$127.40 ,$3.50 ,$196.00 ,$32.30 ,$30.18 ,$107.80 ,$12.92 ,$54.88 ,$96.04 ,$12.92 ,$101.94 ,$12.92 ,$106.43 ,$3.50 ,$12.92 ,$106.43 ,$24.55 ,$137.20 ,$98.00 ,$156.80 ,$32.30 ,$12.92 ,$137.20 ,$12.92 ,$117.60 ,$12.92 ,$147.00 ,$108.19 ,$97.61 ,$108.19 ,$12.92 ,$108.19 ,$18.66 ,$18.66 ,$166.60 ,$32.30 ,$135.83 ,$12.92 ,$196.00 ,$107.80 ,$12.92 ,$51.55 , N/A ,$7.88 ,$7.52 ,$13.57 ,$156.80 ,$106.43 ,$54.88 ,$176.40 ,$74.48 ,$25.84 ,$12.92 ,$94.08 
ST. MARY'S HOSPITAL - DECATUR,30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$354.00 ,$230.10 ,$3.50 ,$354.00 ,$98.15 ,$66.26 ,$194.70 ,$39.26 ,$99.12 ,$173.46 ,$39.26 ,$207.09 ,$39.26 ,$192.22 ,$3.50 ,$39.26 ,$192.22 ,$74.59 ,$247.80 ,$177.00 ,$283.20 ,$98.15 ,$39.26 ,$247.80 ,$39.26 ,$212.40 ,$39.26 ,$265.50 ,$195.41 ,$176.29 ,$195.41 ,$39.26 ,$195.41 ,$51.04 ,$51.04 ,$300.90 ,$98.15 ,$245.32 ,$39.26 ,$354.00 ,$194.70 ,$39.26 ,$93.10 , N/A ,$21.22 ,$20.25 ,$41.22 ,$283.20 ,$192.22 ,$99.12 ,$318.60 ,$134.52 ,$78.52 ,$39.26 ,$169.92 
ST. MARY'S HOSPITAL - DECATUR,30100668,83930,HC OSMOLALITY BLOOD,301,1 ,$133.00 ,$86.45 ,$3.35 ,$133.00 ,$16.53 ,$15.00 ,$73.15 ,$6.61 ,$37.24 ,$52.10 ,$6.61 ,$52.10 ,$6.61 ,$72.22 ,$3.50 ,$6.61 ,$72.22 ,$12.56 ,$93.10 ,$66.50 ,$106.40 ,$16.53 ,$6.61 ,$93.10 ,$6.61 ,$79.80 ,$6.61 ,$99.75 ,$73.42 ,$66.23 ,$73.42 ,$6.61 ,$73.42 ,$9.56 ,$9.56 ,$113.05 ,$16.53 ,$92.17 ,$6.61 ,$133.00 ,$73.15 ,$6.61 ,$34.98 , N/A ,$3.51 ,$3.35 ,$6.94 ,$106.40 ,$72.22 ,$37.24 ,$119.70 ,$50.54 ,$13.22 ,$6.61 ,$63.84 
ST. MARY'S HOSPITAL - DECATUR,30100669,83935,HC OSMOLALITY URINE,301,1 ,$126.00 ,$81.90 ,$3.35 ,$126.00 ,$17.05 ,$15.92 ,$69.30 ,$6.82 ,$35.28 ,$53.77 ,$6.82 ,$53.77 ,$6.82 ,$68.42 ,$3.50 ,$6.82 ,$68.42 ,$12.96 ,$88.20 ,$63.00 ,$100.80 ,$17.05 ,$6.82 ,$88.20 ,$6.82 ,$75.60 ,$6.82 ,$94.50 ,$69.55 ,$62.75 ,$69.55 ,$6.82 ,$69.55 ,$9.84 ,$9.84 ,$107.10 ,$17.05 ,$87.32 ,$6.82 ,$126.00 ,$69.30 ,$6.82 ,$33.14 , N/A ,$3.51 ,$3.35 ,$7.16 ,$100.80 ,$68.42 ,$35.28 ,$113.40 ,$47.88 ,$13.64 ,$6.82 ,$60.48 
ST. MARY'S HOSPITAL - DECATUR,30100672,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$353.00 ,$229.45 ,$3.50 ,$353.00 ,$103.20 ,$96.46 ,$194.15 ,$41.28 ,$98.84 ,$172.97 ,$41.28 ,$206.51 ,$41.28 ,$191.68 ,$3.50 ,$41.28 ,$191.68 ,$78.43 ,$247.10 ,$176.50 ,$282.40 ,$103.20 ,$41.28 ,$247.10 ,$41.28 ,$211.80 ,$41.28 ,$264.75 ,$194.86 ,$175.79 ,$194.86 ,$41.28 ,$194.86 ,$59.62 ,$59.62 ,$300.05 ,$103.20 ,$244.63 ,$41.28 ,$353.00 ,$194.15 ,$41.28 ,$92.84 , N/A ,$18.45 ,$17.61 ,$43.34 ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$82.56 ,$41.28 ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$120.00 ,$78.00 ,$3.35 ,$120.00 ,$12.95 ,$12.08 ,$66.00 ,$5.18 ,$33.60 ,$55.24 ,$5.18 ,$55.24 ,$5.18 ,$65.16 ,$3.50 ,$5.18 ,$65.16 ,$9.84 ,$84.00 ,$60.00 ,$96.00 ,$12.95 ,$5.18 ,$84.00 ,$5.18 ,$72.00 ,$5.18 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$5.18 ,$66.24 ,$7.48 ,$7.48 ,$102.00 ,$12.95 ,$83.16 ,$5.18 ,$120.00 ,$66.00 ,$5.18 ,$31.56 , N/A ,$3.51 ,$3.35 ,$5.44 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$10.36 ,$5.18 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30100684,84100,HC PHOSPHORUS,301,1 ,$156.00 ,$101.40 ,$3.35 ,$156.00 ,$11.85 ,$11.08 ,$85.80 ,$4.74 ,$43.68 ,$37.35 ,$4.74 ,$37.35 ,$4.74 ,$84.71 ,$3.50 ,$4.74 ,$84.71 ,$9.01 ,$109.20 ,$78.00 ,$124.80 ,$11.85 ,$4.74 ,$109.20 ,$4.74 ,$93.60 ,$4.74 ,$117.00 ,$86.11 ,$77.69 ,$86.11 ,$4.74 ,$86.11 ,$6.85 ,$6.85 ,$132.60 ,$11.85 ,$108.11 ,$4.74 ,$156.00 ,$85.80 ,$4.74 ,$41.03 , N/A ,$3.51 ,$3.35 ,$4.98 ,$124.80 ,$84.71 ,$43.68 ,$140.40 ,$59.28 ,$9.48 ,$4.74 ,$74.88 
ST. MARY'S HOSPITAL - DECATUR,30100685,84105,HC PHOSPHORUS URINE,301,1 ,$63.00 ,$40.95 ,$3.35 ,$63.00 ,$14.45 ,$12.08 ,$34.65 ,$5.78 ,$17.64 ,$30.87 ,$5.78 ,$36.86 ,$5.78 ,$34.21 ,$3.50 ,$5.78 ,$34.21 ,$10.98 ,$44.10 ,$31.50 ,$50.40 ,$14.45 ,$5.78 ,$44.10 ,$5.78 ,$37.80 ,$5.78 ,$47.25 ,$34.78 ,$31.37 ,$34.78 ,$5.78 ,$34.78 ,$7.51 ,$7.51 ,$53.55 ,$14.45 ,$43.66 ,$5.78 ,$63.00 ,$34.65 ,$5.78 ,$16.57 , N/A ,$3.51 ,$3.35 ,$6.07 ,$50.40 ,$34.21 ,$17.64 ,$56.70 ,$23.94 ,$11.56 ,$5.78 ,$30.24 
ST. MARY'S HOSPITAL - DECATUR,30100691,84132,HC POTASSIUM,301,1 ,$106.00 ,$68.90 ,$3.35 ,$106.00 ,$11.90 ,$10.74 ,$58.30 ,$4.76 ,$29.68 ,$49.15 ,$4.76 ,$49.15 ,$4.76 ,$57.56 ,$3.50 ,$4.76 ,$57.56 ,$9.04 ,$74.20 ,$53.00 ,$84.80 ,$11.90 ,$4.76 ,$74.20 ,$4.76 ,$63.60 ,$4.76 ,$79.50 ,$58.51 ,$52.79 ,$58.51 ,$4.76 ,$58.51 ,$6.64 ,$6.64 ,$90.10 ,$11.90 ,$73.46 ,$4.76 ,$106.00 ,$58.30 ,$4.76 ,$27.88 , N/A ,$3.51 ,$3.35 ,$5.00 ,$84.80 ,$57.56 ,$29.68 ,$95.40 ,$40.28 ,$9.52 ,$4.76 ,$50.88 
ST. MARY'S HOSPITAL - DECATUR,30100694,84133,HC POTASSIUM URINE,301,1 ,$96.00 ,$62.40 ,$3.35 ,$96.00 ,$11.83 ,$10.04 ,$52.80 ,$4.73 ,$26.88 ,$34.01 ,$4.73 ,$34.01 ,$4.73 ,$52.13 ,$3.50 ,$4.73 ,$52.13 ,$8.99 ,$67.20 ,$48.00 ,$76.80 ,$11.83 ,$4.73 ,$67.20 ,$4.73 ,$57.60 ,$4.73 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$4.73 ,$52.99 ,$6.23 ,$6.23 ,$81.60 ,$11.83 ,$66.53 ,$4.73 ,$96.00 ,$52.80 ,$4.73 ,$25.25 , N/A ,$3.51 ,$3.35 ,$4.97 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$9.46 ,$4.73 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30100696,84144,HC PROGESTERONE,301,1 ,$184.00 ,$119.60 ,$3.50 ,$184.00 ,$52.15 ,$48.76 ,$101.20 ,$20.86 ,$51.52 ,$90.16 ,$20.86 ,$107.64 ,$20.86 ,$99.91 ,$3.50 ,$20.86 ,$99.91 ,$39.63 ,$128.80 ,$92.00 ,$147.20 ,$52.15 ,$20.86 ,$128.80 ,$20.86 ,$110.40 ,$20.86 ,$138.00 ,$101.57 ,$91.63 ,$101.57 ,$20.86 ,$101.57 ,$30.13 ,$30.13 ,$156.40 ,$52.15 ,$127.51 ,$20.86 ,$184.00 ,$101.20 ,$20.86 ,$48.39 , N/A ,$10.60 ,$10.12 ,$21.90 ,$147.20 ,$99.91 ,$51.52 ,$165.60 ,$69.92 ,$41.72 ,$20.86 ,$88.32 
ST. MARY'S HOSPITAL - DECATUR,30100697,84146,HC PROLACTIN,301,1 ,$292.00 ,$189.80 ,$3.50 ,$292.00 ,$48.45 ,$45.28 ,$160.60 ,$19.38 ,$81.76 ,$143.08 ,$19.38 ,$152.86 ,$19.38 ,$158.56 ,$3.50 ,$19.38 ,$158.56 ,$36.82 ,$204.40 ,$146.00 ,$233.60 ,$48.45 ,$19.38 ,$204.40 ,$19.38 ,$175.20 ,$19.38 ,$219.00 ,$161.18 ,$145.42 ,$161.18 ,$19.38 ,$161.18 ,$27.99 ,$27.99 ,$248.20 ,$48.45 ,$202.36 ,$19.38 ,$292.00 ,$160.60 ,$19.38 ,$76.80 , N/A ,$18.45 ,$17.61 ,$20.35 ,$233.60 ,$158.56 ,$81.76 ,$262.80 ,$110.96 ,$38.76 ,$19.38 ,$140.16 
ST. MARY'S HOSPITAL - DECATUR,30100698,84153,HC PSA TOTAL,301,1 ,$192.00 ,$124.80 ,$3.50 ,$192.00 ,$45.98 ,$43.00 ,$105.60 ,$18.39 ,$53.76 ,$94.08 ,$18.39 ,$112.32 ,$18.39 ,$104.26 ,$3.50 ,$18.39 ,$104.26 ,$34.94 ,$134.40 ,$96.00 ,$153.60 ,$45.98 ,$18.39 ,$134.40 ,$18.39 ,$115.20 ,$18.39 ,$144.00 ,$105.98 ,$95.62 ,$105.98 ,$18.39 ,$105.98 ,$26.57 ,$26.57 ,$163.20 ,$45.98 ,$133.06 ,$18.39 ,$192.00 ,$105.60 ,$18.39 ,$50.50 , N/A ,$7.88 ,$7.52 ,$19.31 ,$153.60 ,$104.26 ,$53.76 ,$172.80 ,$72.96 ,$36.78 ,$18.39 ,$92.16 
ST. MARY'S HOSPITAL - DECATUR,30100699,84154,HC PSA FREE,301,1 ,$151.00 ,$98.15 ,$3.50 ,$151.00 ,$45.98 ,$43.00 ,$83.05 ,$18.39 ,$42.28 ,$73.99 ,$18.39 ,$88.34 ,$18.39 ,$81.99 ,$3.50 ,$18.39 ,$81.99 ,$34.94 ,$105.70 ,$75.50 ,$120.80 ,$45.98 ,$18.39 ,$105.70 ,$18.39 ,$90.60 ,$18.39 ,$113.25 ,$83.35 ,$75.20 ,$83.35 ,$18.39 ,$83.35 ,$26.57 ,$26.57 ,$128.35 ,$45.98 ,$104.64 ,$18.39 ,$151.00 ,$83.05 ,$18.39 ,$39.71 , N/A ,$7.88 ,$7.52 ,$19.31 ,$120.80 ,$81.99 ,$42.28 ,$135.90 ,$57.38 ,$36.78 ,$18.39 ,$72.48 
ST. MARY'S HOSPITAL - DECATUR,30100700,84155,HC PROTEIN TOTAL,301,1 ,$93.00 ,$60.45 ,$3.35 ,$93.00 ,$9.18 ,$8.56 ,$51.15 ,$3.67 ,$26.04 ,$39.22 ,$3.67 ,$39.22 ,$3.67 ,$50.50 ,$3.50 ,$3.67 ,$50.50 ,$6.97 ,$65.10 ,$46.50 ,$74.40 ,$9.18 ,$3.67 ,$65.10 ,$3.67 ,$55.80 ,$3.67 ,$69.75 ,$51.34 ,$46.31 ,$51.34 ,$3.67 ,$51.34 ,$5.29 ,$5.29 ,$79.05 ,$9.18 ,$64.45 ,$3.67 ,$93.00 ,$51.15 ,$3.67 ,$24.46 , N/A ,$3.51 ,$3.35 ,$3.85 ,$74.40 ,$50.50 ,$26.04 ,$83.70 ,$35.34 ,$7.34 ,$3.67 ,$44.64 
ST. MARY'S HOSPITAL - DECATUR,30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$182.00 ,$118.30 ,$3.35 ,$182.00 ,$9.18 ,$8.56 ,$100.10 ,$3.67 ,$50.96 ,$28.90 ,$3.67 ,$28.90 ,$3.67 ,$98.83 ,$3.50 ,$3.67 ,$98.83 ,$6.97 ,$127.40 ,$91.00 ,$145.60 ,$9.18 ,$3.67 ,$127.40 ,$3.67 ,$109.20 ,$3.67 ,$136.50 ,$100.46 ,$90.64 ,$100.46 ,$3.67 ,$100.46 ,$5.29 ,$5.29 ,$154.70 ,$9.18 ,$126.13 ,$3.67 ,$182.00 ,$100.10 ,$3.67 ,$47.87 , N/A ,$3.51 ,$3.35 ,$3.85 ,$145.60 ,$98.83 ,$50.96 ,$163.80 ,$69.16 ,$7.34 ,$3.67 ,$87.36 
ST. MARY'S HOSPITAL - DECATUR,30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$111.00 ,$72.15 ,$3.35 ,$111.00 ,$10.00 ,$8.56 ,$61.05 ,$4.00 ,$31.08 ,$39.22 ,$4.00 ,$39.22 ,$4.00 ,$60.27 ,$3.50 ,$4.00 ,$60.27 ,$7.60 ,$77.70 ,$55.50 ,$88.80 ,$10.00 ,$4.00 ,$77.70 ,$4.00 ,$66.60 ,$4.00 ,$83.25 ,$61.27 ,$55.28 ,$61.27 ,$4.00 ,$61.27 ,$5.29 ,$5.29 ,$94.35 ,$10.00 ,$76.92 ,$4.00 ,$111.00 ,$61.05 ,$4.00 ,$29.19 , N/A ,$3.51 ,$3.35 ,$4.20 ,$88.80 ,$60.27 ,$31.08 ,$99.90 ,$42.18 ,$8.00 ,$4.00 ,$53.28 
ST. MARY'S HOSPITAL - DECATUR,30100721,84295,HC SODIUM,301,1 ,$67.00 ,$43.55 ,$3.35 ,$67.00 ,$12.03 ,$11.26 ,$36.85 ,$4.81 ,$18.76 ,$32.83 ,$4.81 ,$39.20 ,$4.81 ,$36.38 ,$3.50 ,$4.81 ,$36.38 ,$9.14 ,$46.90 ,$33.50 ,$53.60 ,$12.03 ,$4.81 ,$46.90 ,$4.81 ,$40.20 ,$4.81 ,$50.25 ,$36.98 ,$33.37 ,$36.98 ,$4.81 ,$36.98 ,$6.96 ,$6.96 ,$56.95 ,$12.03 ,$46.43 ,$4.81 ,$67.00 ,$36.85 ,$4.81 ,$17.62 , N/A ,$3.51 ,$3.35 ,$5.05 ,$53.60 ,$36.38 ,$18.76 ,$60.30 ,$25.46 ,$9.62 ,$4.81 ,$32.16 
ST. MARY'S HOSPITAL - DECATUR,30100724,84300,HC SODIUM URINE,301,1 ,$167.00 ,$108.55 ,$3.35 ,$167.00 ,$12.65 ,$11.38 ,$91.85 ,$5.06 ,$46.76 ,$38.34 ,$5.06 ,$38.34 ,$5.06 ,$90.68 ,$3.50 ,$5.06 ,$90.68 ,$9.61 ,$116.90 ,$83.50 ,$133.60 ,$12.65 ,$5.06 ,$116.90 ,$5.06 ,$100.20 ,$5.06 ,$125.25 ,$92.18 ,$83.17 ,$92.18 ,$5.06 ,$92.18 ,$7.02 ,$7.02 ,$141.95 ,$12.65 ,$115.73 ,$5.06 ,$167.00 ,$91.85 ,$5.06 ,$43.92 , N/A ,$3.51 ,$3.35 ,$5.31 ,$133.60 ,$90.68 ,$46.76 ,$150.30 ,$63.46 ,$10.12 ,$5.06 ,$80.16 
ST. MARY'S HOSPITAL - DECATUR,30100725,84302,HC SODIUM OTHER FLUID,301,1 ,$99.00 ,$64.35 ,$3.35 ,$99.00 ,$12.15 ,$11.38 ,$54.45 ,$4.86 ,$27.72 ,$38.34 ,$4.86 ,$38.34 ,$4.86 ,$53.76 ,$3.50 ,$4.86 ,$53.76 ,$9.23 ,$69.30 ,$49.50 ,$79.20 ,$12.15 ,$4.86 ,$69.30 ,$4.86 ,$59.40 ,$4.86 ,$74.25 ,$54.65 ,$49.30 ,$54.65 ,$4.86 ,$54.65 ,$7.02 ,$7.02 ,$84.15 ,$12.15 ,$68.61 ,$4.86 ,$99.00 ,$54.45 ,$4.86 ,$26.04 , N/A ,$3.51 ,$3.35 ,$5.10 ,$79.20 ,$53.76 ,$27.72 ,$89.10 ,$37.62 ,$9.72 ,$4.86 ,$47.52 
ST. MARY'S HOSPITAL - DECATUR,30100733,84403,HC TESTOSTERONE TOTAL,301,1 ,$190.00 ,$123.50 ,$3.50 ,$190.00 ,$64.53 ,$60.34 ,$104.50 ,$25.81 ,$53.20 ,$93.10 ,$25.81 ,$111.15 ,$25.81 ,$103.17 ,$3.50 ,$25.81 ,$103.17 ,$49.04 ,$133.00 ,$95.00 ,$152.00 ,$64.53 ,$25.81 ,$133.00 ,$25.81 ,$114.00 ,$25.81 ,$142.50 ,$104.88 ,$94.62 ,$104.88 ,$25.81 ,$104.88 ,$37.28 ,$37.28 ,$161.50 ,$64.53 ,$131.67 ,$25.81 ,$190.00 ,$104.50 ,$25.81 ,$49.97 , N/A ,$18.45 ,$17.61 ,$27.10 ,$152.00 ,$103.17 ,$53.20 ,$171.00 ,$72.20 ,$51.62 ,$25.81 ,$91.20 
ST. MARY'S HOSPITAL - DECATUR,30100740,84439,HC T4 FREE,301,1 ,$167.00 ,$108.55 ,$3.50 ,$167.00 ,$22.55 ,$21.08 ,$91.85 ,$9.02 ,$46.76 ,$71.07 ,$9.02 ,$71.07 ,$9.02 ,$90.68 ,$3.50 ,$9.02 ,$90.68 ,$17.14 ,$116.90 ,$83.50 ,$133.60 ,$22.55 ,$9.02 ,$116.90 ,$9.02 ,$100.20 ,$9.02 ,$125.25 ,$92.18 ,$83.17 ,$92.18 ,$9.02 ,$92.18 ,$13.03 ,$13.03 ,$141.95 ,$22.55 ,$115.73 ,$9.02 ,$167.00 ,$91.85 ,$9.02 ,$43.92 , N/A ,$10.60 ,$10.12 ,$9.47 ,$133.60 ,$90.68 ,$46.76 ,$150.30 ,$63.46 ,$18.04 ,$9.02 ,$80.16 
ST. MARY'S HOSPITAL - DECATUR,30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$255.00 ,$165.75 ,$3.50 ,$255.00 ,$42.00 ,$39.28 ,$140.25 ,$16.80 ,$71.40 ,$124.95 ,$16.80 ,$149.18 ,$16.80 ,$138.47 ,$3.50 ,$16.80 ,$138.47 ,$31.92 ,$178.50 ,$127.50 ,$204.00 ,$42.00 ,$16.80 ,$178.50 ,$16.80 ,$153.00 ,$16.80 ,$191.25 ,$140.76 ,$126.99 ,$140.76 ,$16.80 ,$140.76 ,$24.27 ,$24.27 ,$216.75 ,$42.00 ,$176.72 ,$16.80 ,$255.00 ,$140.25 ,$16.80 ,$67.07 , N/A ,$10.60 ,$10.12 ,$17.64 ,$204.00 ,$138.47 ,$71.40 ,$229.50 ,$96.90 ,$33.60 ,$16.80 ,$122.40 
ST. MARY'S HOSPITAL - DECATUR,30100746,84450,HC AST,301,1 ,$204.00 ,$132.60 ,$3.35 ,$204.00 ,$12.95 ,$12.08 ,$112.20 ,$5.18 ,$57.12 ,$55.24 ,$5.18 ,$55.24 ,$5.18 ,$110.77 ,$3.50 ,$5.18 ,$110.77 ,$9.84 ,$142.80 ,$102.00 ,$163.20 ,$12.95 ,$5.18 ,$142.80 ,$5.18 ,$122.40 ,$5.18 ,$153.00 ,$112.61 ,$101.59 ,$112.61 ,$5.18 ,$112.61 ,$7.48 ,$7.48 ,$173.40 ,$12.95 ,$141.37 ,$5.18 ,$204.00 ,$112.20 ,$5.18 ,$53.65 , N/A ,$3.51 ,$3.35 ,$5.44 ,$163.20 ,$110.77 ,$57.12 ,$183.60 ,$77.52 ,$10.36 ,$5.18 ,$97.92 
ST. MARY'S HOSPITAL - DECATUR,30100747,84460,HC ALT,301,1 ,$190.00 ,$123.50 ,$3.35 ,$190.00 ,$13.25 ,$12.36 ,$104.50 ,$5.30 ,$53.20 ,$56.62 ,$5.30 ,$56.62 ,$5.30 ,$103.17 ,$3.50 ,$5.30 ,$103.17 ,$10.07 ,$133.00 ,$95.00 ,$152.00 ,$13.25 ,$5.30 ,$133.00 ,$5.30 ,$114.00 ,$5.30 ,$142.50 ,$104.88 ,$94.62 ,$104.88 ,$5.30 ,$104.88 ,$7.66 ,$7.66 ,$161.50 ,$13.25 ,$131.67 ,$5.30 ,$190.00 ,$104.50 ,$5.30 ,$49.97 , N/A ,$3.51 ,$3.35 ,$5.57 ,$152.00 ,$103.17 ,$53.20 ,$171.00 ,$72.20 ,$10.60 ,$5.30 ,$91.20 
ST. MARY'S HOSPITAL - DECATUR,30100748,84466,HC TRANSFERRIN,301,1 ,$106.00 ,$68.90 ,$3.50 ,$106.00 ,$31.90 ,$29.84 ,$58.30 ,$12.76 ,$29.68 ,$51.94 ,$12.76 ,$62.01 ,$12.76 ,$57.56 ,$3.50 ,$12.76 ,$57.56 ,$24.24 ,$74.20 ,$53.00 ,$84.80 ,$31.90 ,$12.76 ,$74.20 ,$12.76 ,$63.60 ,$12.76 ,$79.50 ,$58.51 ,$52.79 ,$58.51 ,$12.76 ,$58.51 ,$18.43 ,$18.43 ,$90.10 ,$31.90 ,$73.46 ,$12.76 ,$106.00 ,$58.30 ,$12.76 ,$27.88 , N/A ,$7.88 ,$7.52 ,$13.40 ,$84.80 ,$57.56 ,$29.68 ,$95.40 ,$40.28 ,$25.52 ,$12.76 ,$50.88 
ST. MARY'S HOSPITAL - DECATUR,30100750,84478,HC TRIGLYCERIDES,301,1 ,$240.00 ,$156.00 ,$3.35 ,$240.00 ,$14.35 ,$13.44 ,$132.00 ,$5.74 ,$67.20 ,$61.34 ,$5.74 ,$61.34 ,$5.74 ,$130.32 ,$3.50 ,$5.74 ,$130.32 ,$10.91 ,$168.00 ,$120.00 ,$192.00 ,$14.35 ,$5.74 ,$168.00 ,$5.74 ,$144.00 ,$5.74 ,$180.00 ,$132.48 ,$119.52 ,$132.48 ,$5.74 ,$132.48 ,$8.29 ,$8.29 ,$204.00 ,$14.35 ,$166.32 ,$5.74 ,$240.00 ,$132.00 ,$5.74 ,$63.12 , N/A ,$3.51 ,$3.35 ,$6.03 ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 ,$11.48 ,$5.74 ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,30100754,84480,HC T3 TOTAL,301,1 ,$180.00 ,$117.00 ,$3.50 ,$180.00 ,$35.45 ,$25.78 ,$99.00 ,$14.18 ,$50.40 ,$88.20 ,$14.18 ,$105.30 ,$14.18 ,$97.74 ,$3.50 ,$14.18 ,$97.74 ,$26.94 ,$126.00 ,$90.00 ,$144.00 ,$35.45 ,$14.18 ,$126.00 ,$14.18 ,$108.00 ,$14.18 ,$135.00 ,$99.36 ,$89.64 ,$99.36 ,$14.18 ,$99.36 ,$20.48 ,$20.48 ,$153.00 ,$35.45 ,$124.74 ,$14.18 ,$180.00 ,$99.00 ,$14.18 ,$47.34 , N/A ,$10.60 ,$10.12 ,$14.89 ,$144.00 ,$97.74 ,$50.40 ,$162.00 ,$68.40 ,$28.36 ,$14.18 ,$86.40 
ST. MARY'S HOSPITAL - DECATUR,30100755,84481,HC T3 FREE,301,1 ,$317.00 ,$206.05 ,$3.50 ,$317.00 ,$42.35 ,$26.50 ,$174.35 ,$16.94 ,$88.76 ,$133.69 ,$16.94 ,$133.69 ,$16.94 ,$172.13 ,$3.50 ,$16.94 ,$172.13 ,$32.19 ,$221.90 ,$158.50 ,$253.60 ,$42.35 ,$16.94 ,$221.90 ,$16.94 ,$190.20 ,$16.94 ,$237.75 ,$174.98 ,$157.87 ,$174.98 ,$16.94 ,$174.98 ,$24.47 ,$24.47 ,$269.45 ,$42.35 ,$219.68 ,$16.94 ,$317.00 ,$174.35 ,$16.94 ,$83.37 , N/A ,$10.60 ,$10.12 ,$17.79 ,$253.60 ,$172.13 ,$88.76 ,$285.30 ,$120.46 ,$33.88 ,$16.94 ,$152.16 
ST. MARY'S HOSPITAL - DECATUR,30100758,84484,HC TROPONIN QN,301,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$31.18 ,$23.00 ,$106.15 ,$12.47 ,$54.04 ,$79.72 ,$12.47 ,$79.72 ,$12.47 ,$104.80 ,$3.50 ,$12.47 ,$104.80 ,$23.69 ,$135.10 ,$96.50 ,$154.40 ,$31.18 ,$12.47 ,$135.10 ,$12.47 ,$115.80 ,$12.47 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$12.47 ,$106.54 ,$16.21 ,$16.21 ,$164.05 ,$31.18 ,$133.75 ,$12.47 ,$193.00 ,$106.15 ,$12.47 ,$50.76 , N/A ,$7.88 ,$7.52 ,$13.09 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$24.94 ,$12.47 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30100761,84520,HC BUN,301,1 ,$84.00 ,$54.60 ,$3.35 ,$84.00 ,$9.88 ,$9.24 ,$46.20 ,$3.95 ,$23.52 ,$41.16 ,$3.95 ,$42.17 ,$3.95 ,$45.61 ,$3.50 ,$3.95 ,$45.61 ,$7.51 ,$58.80 ,$42.00 ,$67.20 ,$9.88 ,$3.95 ,$58.80 ,$3.95 ,$50.40 ,$3.95 ,$63.00 ,$46.37 ,$41.83 ,$46.37 ,$3.95 ,$46.37 ,$5.71 ,$5.71 ,$71.40 ,$9.88 ,$58.21 ,$3.95 ,$3.95 ,$46.20 ,$3.95 ,$22.09 , N/A ,$3.51 ,$3.35 ,$4.15 ,$67.20 ,$45.61 ,$23.52 ,$75.60 ,$31.92 ,$7.90 ,$3.95 ,$40.32 
ST. MARY'S HOSPITAL - DECATUR,30100764,84540,HC UREA URINE,301,1 ,$80.00 ,$52.00 ,$3.35 ,$80.00 ,$13.90 ,$11.10 ,$44.00 ,$5.56 ,$22.40 ,$37.45 ,$5.56 ,$37.45 ,$5.56 ,$43.44 ,$3.50 ,$5.56 ,$43.44 ,$10.56 ,$56.00 ,$40.00 ,$64.00 ,$13.90 ,$5.56 ,$56.00 ,$5.56 ,$48.00 ,$5.56 ,$60.00 ,$44.16 ,$39.84 ,$44.16 ,$5.56 ,$44.16 ,$7.23 ,$7.23 ,$68.00 ,$13.90 ,$55.44 ,$5.56 ,$80.00 ,$44.00 ,$5.56 ,$21.04 , N/A ,$3.51 ,$3.35 ,$5.84 ,$64.00 ,$43.44 ,$22.40 ,$72.00 ,$30.40 ,$11.12 ,$5.56 ,$38.40 
ST. MARY'S HOSPITAL - DECATUR,30100765,84550,HC URIC ACID,301,1 ,$122.00 ,$79.30 ,$3.35 ,$122.00 ,$11.30 ,$10.56 ,$67.10 ,$4.52 ,$34.16 ,$48.27 ,$4.52 ,$48.27 ,$4.52 ,$66.25 ,$3.50 ,$4.52 ,$66.25 ,$8.59 ,$85.40 ,$61.00 ,$97.60 ,$11.30 ,$4.52 ,$85.40 ,$4.52 ,$73.20 ,$4.52 ,$91.50 ,$67.34 ,$60.76 ,$67.34 ,$4.52 ,$67.34 ,$6.53 ,$6.53 ,$103.70 ,$11.30 ,$84.55 ,$4.52 ,$122.00 ,$67.10 ,$4.52 ,$32.09 , N/A ,$3.51 ,$3.35 ,$4.75 ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$9.04 ,$4.52 ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,30100766,84560,HC URIC ACID OTH SRC,301,1 ,$120.00 ,$78.00 ,$3.35 ,$120.00 ,$12.70 ,$11.10 ,$66.00 ,$5.08 ,$33.60 ,$37.45 ,$5.08 ,$37.45 ,$5.08 ,$65.16 ,$3.50 ,$5.08 ,$65.16 ,$9.65 ,$84.00 ,$60.00 ,$96.00 ,$12.70 ,$5.08 ,$84.00 ,$5.08 ,$72.00 ,$5.08 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$5.08 ,$66.24 ,$6.85 ,$6.85 ,$102.00 ,$12.70 ,$83.16 ,$5.08 ,$120.00 ,$66.00 ,$5.08 ,$31.56 , N/A ,$3.51 ,$3.35 ,$5.33 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$10.16 ,$5.08 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30100802,84702,HC HCG QN,301,1 ,$238.00 ,$154.70 ,$3.50 ,$238.00 ,$37.63 ,$35.20 ,$130.90 ,$15.05 ,$66.64 ,$116.62 ,$15.05 ,$139.23 ,$15.05 ,$129.23 ,$3.50 ,$15.05 ,$129.23 ,$28.60 ,$166.60 ,$119.00 ,$190.40 ,$37.63 ,$15.05 ,$166.60 ,$15.05 ,$142.80 ,$15.05 ,$178.50 ,$131.38 ,$118.52 ,$131.38 ,$15.05 ,$131.38 ,$21.75 ,$21.75 ,$202.30 ,$37.63 ,$164.93 ,$15.05 ,$238.00 ,$130.90 ,$15.05 ,$62.59 , N/A ,$10.60 ,$10.12 ,$15.80 ,$190.40 ,$129.23 ,$66.64 ,$214.20 ,$90.44 ,$30.10 ,$15.05 ,$114.24 
ST. MARY'S HOSPITAL - DECATUR,30100808,84703,HC HCG QL,301,1 ,$204.00 ,$132.60 ,$3.50 ,$204.00 ,$18.80 ,$17.56 ,$112.20 ,$7.52 ,$57.12 ,$80.41 ,$7.52 ,$80.41 ,$7.52 ,$110.77 ,$3.50 ,$7.52 ,$110.77 ,$14.29 ,$142.80 ,$102.00 ,$163.20 ,$18.80 ,$7.52 ,$142.80 ,$7.52 ,$122.40 ,$7.52 ,$153.00 ,$112.61 ,$101.59 ,$112.61 ,$7.52 ,$112.61 ,$10.87 ,$10.87 ,$173.40 ,$18.80 ,$141.37 ,$7.52 ,$204.00 ,$112.20 ,$7.52 ,$53.65 , N/A ,$7.88 ,$7.52 ,$7.90 ,$163.20 ,$110.77 ,$57.12 ,$183.60 ,$77.52 ,$15.04 ,$7.52 ,$97.92 
ST. MARY'S HOSPITAL - DECATUR,30100810,88720,HC BILICHECK TEST,301,1 ,$25.00 ,$16.25 ,$3.35 ,$25.00 ,$12.55 ,$11.74 ,$13.75 ,$5.02 ,$7.00 ,$12.25 ,$5.02 ,$14.63 ,$5.02 ,$13.58 ,$3.50 ,$5.02 ,$13.58 ,$9.54 ,$17.50 ,$12.50 ,$20.00 ,$12.55 ,$5.02 ,$17.50 ,$5.02 ,$15.00 ,$5.02 ,$18.75 ,$13.80 ,$12.45 ,$13.80 ,$5.02 ,$13.80 ,$7.24 ,$7.24 ,$21.25 ,$12.55 ,$17.33 ,$5.02 ,$25.00 ,$13.75 ,$5.02 ,$6.58 , N/A ,$3.51 ,$3.35 ,$5.27 ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 ,$10.04 ,$5.02 ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,30100845,82948,HC GLUCOSE BLOOD REAGENT STRIP,301,1 ,$29.00 ,$18.85 ,$1.69 ,$29.00 ,$12.60 ,$7.40 ,$15.95 ,$5.04 ,$8.12 ,$14.21 ,$5.04 ,$16.97 ,$5.04 ,$15.75 ,$3.50 ,$5.04 ,$15.75 ,$9.58 ,$20.30 ,$14.50 ,$23.20 ,$12.60 ,$5.04 ,$20.30 ,$5.04 ,$17.40 ,$5.04 ,$21.75 ,$16.01 ,$14.44 ,$16.01 ,$5.04 ,$16.01 ,$6.55 ,$6.55 ,$24.65 ,$12.60 ,$20.10 ,$5.04 ,$29.00 ,$15.95 ,$5.04 ,$7.63 , N/A ,$1.77 ,$1.69 ,$5.29 ,$23.20 ,$15.75 ,$8.12 ,$26.10 ,$11.02 ,$10.08 ,$5.04 ,$13.92 
ST. MARY'S HOSPITAL - DECATUR,30100860,84145,HC PROCALCITONIN,301,1 ,$277.00 ,$180.05 ,$3.50 ,$277.00 ,$68.05 ,$62.60 ,$152.35 ,$27.22 ,$77.56 ,$135.73 ,$27.22 ,$162.05 ,$27.22 ,$150.41 ,$3.50 ,$27.22 ,$150.41 ,$51.72 ,$193.90 ,$138.50 ,$221.60 ,$68.05 ,$27.22 ,$193.90 ,$27.22 ,$166.20 ,$27.22 ,$207.75 ,$152.90 ,$137.95 ,$152.90 ,$27.22 ,$152.90 ,$38.70 ,$38.70 ,$235.45 ,$68.05 ,$191.96 ,$27.22 ,$277.00 ,$152.35 ,$27.22 ,$72.85 , N/A ,$18.45 ,$17.61 ,$28.58 ,$221.60 ,$150.41 ,$77.56 ,$249.30 ,$105.26 ,$54.44 ,$27.22 ,$132.96 
ST. MARY'S HOSPITAL - DECATUR,30100996,82075,HC ALCOHOL BREATH,301,1 ,$103.00 ,$66.95 ,$0.02 ,$103.00 ,$75.00 ,$0.02 ,$56.65 ,$30.00 ,$28.84 ,$50.47 ,$30.00 ,$60.26 ,$30.00 ,$55.93 ,$3.50 ,$30.00 ,$55.93 ,$57.00 ,$72.10 ,$51.50 ,$82.40 ,$75.00 ,$30.00 ,$72.10 ,$30.00 ,$61.80 ,$30.00 ,$77.25 ,$56.86 ,$51.29 ,$56.86 ,$30.00 ,$56.86 ,$39.00 ,$39.00 ,$87.55 ,$75.00 ,$71.38 ,$30.00 ,$103.00 ,$56.65 ,$30.00 ,$27.09 , N/A ,$7.88 ,$7.52 ,$31.50 ,$82.40 ,$55.93 ,$28.84 ,$92.70 ,$39.14 ,$60.00 ,$30.00 ,$49.44 
ST. MARY'S HOSPITAL - DECATUR,30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$180.00 ,$117.00 ,$7.52 ,$180.00 ,$48.28 ,$43.00 ,$99.00 ,$19.31 ,$50.40 ,$88.20 ,$19.31 ,$105.30 ,$19.31 ,$97.74 ,$14.51 ,$19.31 ,$97.74 ,$36.69 ,$126.00 ,$90.00 ,$144.00 ,$48.28 ,$19.31 ,$126.00 ,$19.31 ,$108.00 ,$19.31 ,$135.00 ,$99.36 ,$89.64 ,$99.36 ,$19.31 ,$99.36 ,$26.57 ,$26.57 ,$153.00 ,$48.28 ,$124.74 ,$19.31 ,$180.00 ,$99.00 ,$19.31 ,$47.34 , N/A ,$7.88 ,$7.52 ,$20.28 ,$144.00 ,$97.74 ,$50.40 ,$162.00 ,$68.40 ,$38.62 ,$19.31 ,$86.40 
ST. MARY'S HOSPITAL - DECATUR,30101076,80050,HC GENERAL HEALTH PANEL,301,1 ,$946.00 ,$614.90 ,$3.50 ,$946.00 , N/A ,$63.10 ,$520.30 , N/A ,$264.88 ,$344.05 , N/A ,$344.05 , N/A ,$513.68 ,$3.50 , N/A ,$513.68 , N/A ,$662.20 ,$473.00 ,$756.80 , N/A , N/A ,$662.20 , N/A ,$567.60 , N/A ,$709.50 ,$522.19 ,$471.11 ,$522.19 , N/A ,$522.19 ,$662.20 ,$662.20 ,$804.10 , N/A ,$655.58 , N/A ,$946.00 ,$520.30 , N/A ,$248.80 , N/A ,$7.18 ,$6.86 , N/A ,$756.80 ,$513.68 ,$264.88 ,$851.40 ,$359.48 ,$90.72 , N/A ,$454.08 
ST. MARY'S HOSPITAL - DECATUR,30101083,80061,HC LIPID PANEL - 90,301,1 ,$313.00 ,$203.45 ,$3.50 ,$313.00 ,$33.48 ,$31.32 ,$172.15 ,$13.39 ,$87.64 ,$143.03 ,$13.39 ,$143.03 ,$13.39 ,$169.96 ,$3.50 ,$13.39 ,$169.96 ,$25.44 ,$219.10 ,$156.50 ,$250.40 ,$33.48 ,$13.39 ,$219.10 ,$13.39 ,$187.80 ,$13.39 ,$234.75 ,$172.78 ,$155.87 ,$172.78 ,$13.39 ,$172.78 ,$19.34 ,$19.34 ,$266.05 ,$33.48 ,$216.91 ,$13.39 ,$313.00 ,$172.15 ,$13.39 ,$82.32 , N/A ,$7.18 ,$6.86 ,$14.06 ,$250.40 ,$169.96 ,$87.64 ,$281.70 ,$118.94 ,$26.78 ,$13.39 ,$150.24 
ST. MARY'S HOSPITAL - DECATUR,30101089,80150,HC AMIKACIN - 90,301,1 ,$170.00 ,$110.50 ,$3.50 ,$170.00 ,$37.70 ,$26.50 ,$93.50 ,$15.08 ,$47.60 ,$83.30 ,$15.08 ,$99.45 ,$15.08 ,$92.31 ,$3.50 ,$15.08 ,$92.31 ,$28.65 ,$119.00 ,$85.00 ,$136.00 ,$37.70 ,$15.08 ,$119.00 ,$15.08 ,$102.00 ,$15.08 ,$127.50 ,$93.84 ,$84.66 ,$93.84 ,$15.08 ,$93.84 ,$21.78 ,$21.78 ,$144.50 ,$37.70 ,$117.81 ,$15.08 ,$170.00 ,$93.50 ,$15.08 ,$44.71 , N/A ,$9.05 ,$8.64 ,$15.83 ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$30.16 ,$15.08 ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,30101094,80158,HC CYCLOSPORINE - 90,301,1 ,$246.00 ,$159.90 ,$3.50 ,$246.00 ,$45.13 ,$42.18 ,$135.30 ,$18.05 ,$68.88 ,$120.54 ,$18.05 ,$142.34 ,$18.05 ,$133.58 ,$3.50 ,$18.05 ,$133.58 ,$34.30 ,$172.20 ,$123.00 ,$196.80 ,$45.13 ,$18.05 ,$172.20 ,$18.05 ,$147.60 ,$18.05 ,$184.50 ,$135.79 ,$122.51 ,$135.79 ,$18.05 ,$135.79 ,$26.08 ,$26.08 ,$209.10 ,$45.13 ,$170.48 ,$18.05 ,$246.00 ,$135.30 ,$18.05 ,$64.70 , N/A ,$9.05 ,$8.64 ,$18.95 ,$196.80 ,$133.58 ,$68.88 ,$221.40 ,$93.48 ,$36.10 ,$18.05 ,$118.08 
ST. MARY'S HOSPITAL - DECATUR,30101095,80159,HC CLOZAPINE - 90,301,1 ,$151.00 ,$98.15 ,$3.50 ,$151.00 ,$50.38 ,$27.80 ,$83.05 ,$20.15 ,$42.28 ,$73.99 ,$20.15 ,$88.34 ,$20.15 ,$81.99 ,$3.50 ,$20.15 ,$81.99 ,$38.29 ,$105.70 ,$75.50 ,$120.80 ,$50.38 ,$20.15 ,$105.70 ,$20.15 ,$90.60 ,$20.15 ,$113.25 ,$83.35 ,$75.20 ,$83.35 ,$20.15 ,$83.35 ,$26.72 ,$26.72 ,$128.35 ,$50.38 ,$104.64 ,$20.15 ,$151.00 ,$83.05 ,$20.15 ,$39.71 , N/A ,$9.05 ,$8.64 ,$21.16 ,$120.80 ,$81.99 ,$42.28 ,$135.90 ,$57.38 ,$40.30 ,$20.15 ,$72.48 
ST. MARY'S HOSPITAL - DECATUR,30101099,80168,HC ETHOSUXIMIDE - 90,301,1 ,$217.00 ,$141.05 ,$3.50 ,$217.00 ,$40.85 ,$38.20 ,$119.35 ,$16.34 ,$60.76 ,$106.33 ,$16.34 ,$126.95 ,$16.34 ,$117.83 ,$3.50 ,$16.34 ,$117.83 ,$31.05 ,$151.90 ,$108.50 ,$173.60 ,$40.85 ,$16.34 ,$151.90 ,$16.34 ,$130.20 ,$16.34 ,$162.75 ,$119.78 ,$108.07 ,$119.78 ,$16.34 ,$119.78 ,$23.60 ,$23.60 ,$184.45 ,$40.85 ,$150.38 ,$16.34 ,$217.00 ,$119.35 ,$16.34 ,$57.07 , N/A ,$9.05 ,$8.64 ,$17.16 ,$173.60 ,$117.83 ,$60.76 ,$195.30 ,$82.46 ,$32.68 ,$16.34 ,$104.16 
ST. MARY'S HOSPITAL - DECATUR,30101100,80169,HC EVEROLIMUS - 90,301,1 ,$237.00 ,$154.05 ,$3.50 ,$237.00 ,$34.33 ,$31.84 ,$130.35 ,$13.73 ,$66.36 ,$108.33 ,$13.73 ,$108.33 ,$13.73 ,$128.69 ,$3.50 ,$13.73 ,$128.69 ,$26.09 ,$165.90 ,$118.50 ,$189.60 ,$34.33 ,$13.73 ,$165.90 ,$13.73 ,$142.20 ,$13.73 ,$177.75 ,$130.82 ,$118.03 ,$130.82 ,$13.73 ,$130.82 ,$19.84 ,$19.84 ,$201.45 ,$34.33 ,$164.24 ,$13.73 ,$237.00 ,$130.35 ,$13.73 ,$62.33 , N/A ,$9.05 ,$8.64 ,$14.42 ,$189.60 ,$128.69 ,$66.36 ,$213.30 ,$90.06 ,$27.46 ,$13.73 ,$113.76 
ST. MARY'S HOSPITAL - DECATUR,30101102,80171,HC GABAPENTIN PLASMA - 90,301,1 ,$222.00 ,$144.30 ,$3.50 ,$222.00 ,$54.18 ,$30.76 ,$122.10 ,$21.67 ,$62.16 ,$108.78 ,$21.67 ,$129.87 ,$21.67 ,$120.55 ,$3.50 ,$21.67 ,$120.55 ,$41.17 ,$155.40 ,$111.00 ,$177.60 ,$54.18 ,$21.67 ,$155.40 ,$21.67 ,$133.20 ,$21.67 ,$166.50 ,$122.54 ,$110.56 ,$122.54 ,$21.67 ,$122.54 ,$28.17 ,$28.17 ,$188.70 ,$54.18 ,$153.85 ,$21.67 ,$222.00 ,$122.10 ,$21.67 ,$58.39 , N/A ,$9.05 ,$8.64 ,$22.75 ,$177.60 ,$120.55 ,$62.16 ,$199.80 ,$84.36 ,$43.34 ,$21.67 ,$106.56 
ST. MARY'S HOSPITAL - DECATUR,30101104,80175,HC LAMOTRIGINE - 90,301,1 ,$222.00 ,$144.30 ,$3.50 ,$222.00 ,$33.13 ,$30.76 ,$122.10 ,$13.25 ,$62.16 ,$104.49 ,$13.25 ,$104.49 ,$13.25 ,$120.55 ,$3.50 ,$13.25 ,$120.55 ,$25.18 ,$155.40 ,$111.00 ,$177.60 ,$33.13 ,$13.25 ,$155.40 ,$13.25 ,$133.20 ,$13.25 ,$166.50 ,$122.54 ,$110.56 ,$122.54 ,$13.25 ,$122.54 ,$19.15 ,$19.15 ,$188.70 ,$33.13 ,$153.85 ,$13.25 ,$222.00 ,$122.10 ,$13.25 ,$58.39 , N/A ,$9.05 ,$8.64 ,$13.91 ,$177.60 ,$120.55 ,$62.16 ,$199.80 ,$84.36 ,$26.50 ,$13.25 ,$106.56 
ST. MARY'S HOSPITAL - DECATUR,30101106,80177,HC LEVETIRACETAM - 90,301,1 ,$92.00 ,$59.80 ,$3.50 ,$92.00 ,$33.13 ,$30.76 ,$50.60 ,$13.25 ,$25.76 ,$45.08 ,$13.25 ,$53.82 ,$13.25 ,$49.96 ,$3.50 ,$13.25 ,$49.96 ,$25.18 ,$64.40 ,$46.00 ,$73.60 ,$33.13 ,$13.25 ,$64.40 ,$13.25 ,$55.20 ,$13.25 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$13.25 ,$50.78 ,$19.15 ,$19.15 ,$78.20 ,$33.13 ,$63.76 ,$13.25 ,$92.00 ,$50.60 ,$13.25 ,$24.20 , N/A ,$9.05 ,$8.64 ,$13.91 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$26.50 ,$13.25 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,30101108,80180,HC MYCOPHENOLATE/MYCOPHENOLIC ACID - 90,301,1 ,$68.00 ,$44.20 ,$3.50 ,$68.00 ,$45.13 ,$41.88 ,$37.40 ,$18.05 ,$19.04 ,$33.32 ,$18.05 ,$39.78 ,$18.05 ,$36.92 ,$3.50 ,$18.05 ,$36.92 ,$34.30 ,$47.60 ,$34.00 ,$54.40 ,$45.13 ,$18.05 ,$47.60 ,$18.05 ,$40.80 ,$18.05 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$18.05 ,$37.54 ,$26.08 ,$26.08 ,$57.80 ,$45.13 ,$47.12 ,$18.05 ,$68.00 ,$37.40 ,$18.05 ,$17.88 , N/A ,$9.05 ,$8.64 ,$18.95 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$36.10 ,$18.05 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30101109,80183,HC OXCARBAZEPINE - 90,301,1 ,$100.00 ,$65.00 ,$3.50 ,$100.00 ,$33.13 ,$30.76 ,$55.00 ,$13.25 ,$28.00 ,$49.00 ,$13.25 ,$58.50 ,$13.25 ,$54.30 ,$3.50 ,$13.25 ,$54.30 ,$25.18 ,$70.00 ,$50.00 ,$80.00 ,$33.13 ,$13.25 ,$70.00 ,$13.25 ,$60.00 ,$13.25 ,$75.00 ,$55.20 ,$49.80 ,$55.20 ,$13.25 ,$55.20 ,$19.15 ,$19.15 ,$85.00 ,$33.13 ,$69.30 ,$13.25 ,$100.00 ,$55.00 ,$13.25 ,$26.30 , N/A ,$9.05 ,$8.64 ,$13.91 ,$80.00 ,$54.30 ,$28.00 ,$90.00 ,$38.00 ,$26.50 ,$13.25 ,$48.00 
ST. MARY'S HOSPITAL - DECATUR,30101110,80184,HC PHENOBARBITAL - 90,301,1 ,$211.00 ,$137.15 ,$3.50 ,$211.00 ,$38.25 ,$26.02 ,$116.05 ,$15.30 ,$59.08 ,$97.81 ,$15.30 ,$97.81 ,$15.30 ,$114.57 ,$3.50 ,$15.30 ,$114.57 ,$29.07 ,$147.70 ,$105.50 ,$168.80 ,$38.25 ,$15.30 ,$147.70 ,$15.30 ,$126.60 ,$15.30 ,$158.25 ,$116.47 ,$105.08 ,$116.47 ,$15.30 ,$116.47 ,$19.89 ,$19.89 ,$179.35 ,$38.25 ,$146.22 ,$15.30 ,$211.00 ,$116.05 ,$15.30 ,$55.49 , N/A ,$9.05 ,$8.64 ,$16.07 ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 ,$30.60 ,$15.30 ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,30101113,80185,HC PHENYTOIN TOTAL - 90,301,1 ,$276.00 ,$179.40 ,$3.50 ,$276.00 ,$33.13 ,$30.98 ,$151.80 ,$13.25 ,$77.28 ,$104.49 ,$13.25 ,$104.49 ,$13.25 ,$149.87 ,$3.50 ,$13.25 ,$149.87 ,$25.18 ,$193.20 ,$138.00 ,$220.80 ,$33.13 ,$13.25 ,$193.20 ,$13.25 ,$165.60 ,$13.25 ,$207.00 ,$152.35 ,$137.45 ,$152.35 ,$13.25 ,$152.35 ,$19.15 ,$19.15 ,$234.60 ,$33.13 ,$191.27 ,$13.25 ,$276.00 ,$151.80 ,$13.25 ,$72.59 , N/A ,$9.05 ,$8.64 ,$13.91 ,$220.80 ,$149.87 ,$77.28 ,$248.40 ,$104.88 ,$26.50 ,$13.25 ,$132.48 
ST. MARY'S HOSPITAL - DECATUR,30101114,80186,HC PHENYTOIN FREE - 90,301,1 ,$142.00 ,$92.30 ,$3.50 ,$142.00 ,$34.40 ,$32.16 ,$78.10 ,$13.76 ,$39.76 ,$69.58 ,$13.76 ,$83.07 ,$13.76 ,$77.11 ,$3.50 ,$13.76 ,$77.11 ,$26.14 ,$99.40 ,$71.00 ,$113.60 ,$34.40 ,$13.76 ,$99.40 ,$13.76 ,$85.20 ,$13.76 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$13.76 ,$78.38 ,$19.88 ,$19.88 ,$120.70 ,$34.40 ,$98.41 ,$13.76 ,$142.00 ,$78.10 ,$13.76 ,$37.35 , N/A ,$9.05 ,$8.64 ,$14.45 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$27.52 ,$13.76 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30101115,80188,HC PRIMIDONE - 90,301,1 ,$114.00 ,$74.10 ,$3.50 ,$114.00 ,$41.48 ,$34.82 ,$62.70 ,$16.59 ,$31.92 ,$55.86 ,$16.59 ,$66.69 ,$16.59 ,$61.90 ,$3.50 ,$16.59 ,$61.90 ,$31.52 ,$79.80 ,$57.00 ,$91.20 ,$41.48 ,$16.59 ,$79.80 ,$16.59 ,$68.40 ,$16.59 ,$85.50 ,$62.93 ,$56.77 ,$62.93 ,$16.59 ,$62.93 ,$23.97 ,$23.97 ,$96.90 ,$41.48 ,$79.00 ,$16.59 ,$114.00 ,$62.70 ,$16.59 ,$29.98 , N/A ,$9.05 ,$8.64 ,$17.42 ,$91.20 ,$61.90 ,$31.92 ,$102.60 ,$43.32 ,$33.18 ,$16.59 ,$54.72 
ST. MARY'S HOSPITAL - DECATUR,30101116,80192,HC PROCAINEAMIDE - 90,301,1 ,$202.00 ,$131.30 ,$3.50 ,$202.00 ,$41.88 ,$39.16 ,$111.10 ,$16.75 ,$56.56 ,$98.98 ,$16.75 ,$118.17 ,$16.75 ,$109.69 ,$3.50 ,$16.75 ,$109.69 ,$31.83 ,$141.40 ,$101.00 ,$161.60 ,$41.88 ,$16.75 ,$141.40 ,$16.75 ,$121.20 ,$16.75 ,$151.50 ,$111.50 ,$100.60 ,$111.50 ,$16.75 ,$111.50 ,$24.19 ,$24.19 ,$171.70 ,$41.88 ,$139.99 ,$16.75 ,$202.00 ,$111.10 ,$16.75 ,$53.13 , N/A ,$9.05 ,$8.64 ,$17.59 ,$161.60 ,$109.69 ,$56.56 ,$181.80 ,$76.76 ,$33.50 ,$16.75 ,$96.96 
ST. MARY'S HOSPITAL - DECATUR,30101117,80194,HC QUINIDINE - 90,301,1 ,$148.00 ,$96.20 ,$3.50 ,$148.00 ,$36.50 ,$34.12 ,$81.40 ,$14.60 ,$41.44 ,$72.52 ,$14.60 ,$86.58 ,$14.60 ,$80.36 ,$3.50 ,$14.60 ,$80.36 ,$27.74 ,$103.60 ,$74.00 ,$118.40 ,$36.50 ,$14.60 ,$103.60 ,$14.60 ,$88.80 ,$14.60 ,$111.00 ,$81.70 ,$73.70 ,$81.70 ,$14.60 ,$81.70 ,$21.09 ,$21.09 ,$125.80 ,$36.50 ,$102.56 ,$14.60 ,$148.00 ,$81.40 ,$14.60 ,$38.92 , N/A ,$9.05 ,$8.64 ,$15.33 ,$118.40 ,$80.36 ,$41.44 ,$133.20 ,$56.24 ,$29.20 ,$14.60 ,$71.04 
ST. MARY'S HOSPITAL - DECATUR,30101118,80195,HC RAPAMYCIN (SIROLIMUS) - 90,301,1 ,$244.00 ,$158.60 ,$3.50 ,$244.00 ,$34.33 ,$32.08 ,$134.20 ,$13.73 ,$68.32 ,$108.33 ,$13.73 ,$108.33 ,$13.73 ,$132.49 ,$3.50 ,$13.73 ,$132.49 ,$26.09 ,$170.80 ,$122.00 ,$195.20 ,$34.33 ,$13.73 ,$170.80 ,$13.73 ,$146.40 ,$13.73 ,$183.00 ,$134.69 ,$121.51 ,$134.69 ,$13.73 ,$134.69 ,$19.84 ,$19.84 ,$207.40 ,$34.33 ,$169.09 ,$13.73 ,$244.00 ,$134.20 ,$13.73 ,$64.17 , N/A ,$9.05 ,$8.64 ,$14.42 ,$195.20 ,$132.49 ,$68.32 ,$219.60 ,$92.72 ,$27.46 ,$13.73 ,$117.12 
ST. MARY'S HOSPITAL - DECATUR,30101119,80197,HC TACROLIMUS - 90,301,1 ,$331.00 ,$215.15 ,$3.50 ,$331.00 ,$34.33 ,$32.08 ,$182.05 ,$13.73 ,$92.68 ,$108.33 ,$13.73 ,$108.33 ,$13.73 ,$179.73 ,$3.50 ,$13.73 ,$179.73 ,$26.09 ,$231.70 ,$165.50 ,$264.80 ,$34.33 ,$13.73 ,$231.70 ,$13.73 ,$198.60 ,$13.73 ,$248.25 ,$182.71 ,$164.84 ,$182.71 ,$13.73 ,$182.71 ,$19.84 ,$19.84 ,$281.35 ,$34.33 ,$229.38 ,$13.73 ,$331.00 ,$182.05 ,$13.73 ,$87.05 , N/A ,$9.05 ,$8.64 ,$14.42 ,$264.80 ,$179.73 ,$92.68 ,$297.90 ,$125.78 ,$27.46 ,$13.73 ,$158.88 
ST. MARY'S HOSPITAL - DECATUR,30101122,80200,HC TOBRAMYCIN - 90,301,1 ,$362.00 ,$235.30 ,$3.50 ,$362.00 ,$40.33 ,$26.50 ,$199.10 ,$16.13 ,$101.36 ,$127.20 ,$16.13 ,$127.20 ,$16.13 ,$196.57 ,$3.50 ,$16.13 ,$196.57 ,$30.65 ,$253.40 ,$181.00 ,$289.60 ,$40.33 ,$16.13 ,$253.40 ,$16.13 ,$217.20 ,$16.13 ,$271.50 ,$199.82 ,$180.28 ,$199.82 ,$16.13 ,$199.82 ,$23.30 ,$23.30 ,$307.70 ,$40.33 ,$250.87 ,$16.13 ,$362.00 ,$199.10 ,$16.13 ,$95.21 , N/A ,$9.05 ,$8.64 ,$16.94 ,$289.60 ,$196.57 ,$101.36 ,$325.80 ,$137.56 ,$32.26 ,$16.13 ,$173.76 
ST. MARY'S HOSPITAL - DECATUR,30101124,80201,HC TOPIRAMATE - 90,301,1 ,$202.00 ,$131.30 ,$3.50 ,$202.00 ,$29.80 ,$27.86 ,$111.10 ,$11.92 ,$56.56 ,$94.07 ,$11.92 ,$94.07 ,$11.92 ,$109.69 ,$3.50 ,$11.92 ,$109.69 ,$22.65 ,$141.40 ,$101.00 ,$161.60 ,$29.80 ,$11.92 ,$141.40 ,$11.92 ,$121.20 ,$11.92 ,$151.50 ,$111.50 ,$100.60 ,$111.50 ,$11.92 ,$111.50 ,$17.21 ,$17.21 ,$171.70 ,$29.80 ,$139.99 ,$11.92 ,$202.00 ,$111.10 ,$11.92 ,$53.13 , N/A ,$9.05 ,$8.64 ,$12.52 ,$161.60 ,$109.69 ,$56.56 ,$181.80 ,$76.76 ,$23.84 ,$11.92 ,$96.96 
ST. MARY'S HOSPITAL - DECATUR,30101126,80203,HC ZONISAMIDE - 90,301,1 ,$177.00 ,$115.05 ,$3.50 ,$177.00 ,$33.13 ,$30.76 ,$97.35 ,$13.25 ,$49.56 ,$86.73 ,$13.25 ,$103.55 ,$13.25 ,$96.11 ,$3.50 ,$13.25 ,$96.11 ,$25.18 ,$123.90 ,$88.50 ,$141.60 ,$33.13 ,$13.25 ,$123.90 ,$13.25 ,$106.20 ,$13.25 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$13.25 ,$97.70 ,$19.15 ,$19.15 ,$150.45 ,$33.13 ,$122.66 ,$13.25 ,$177.00 ,$97.35 ,$13.25 ,$46.55 , N/A ,$9.05 ,$8.64 ,$13.91 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$26.50 ,$13.25 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30101131,80299,HC THERAPEUTIC DRUG OTHER - 90,301,1 ,$272.00 ,$176.80 ,$3.50 ,$272.00 ,$46.60 ,$31.68 ,$149.60 ,$18.64 ,$76.16 ,$119.14 ,$18.64 ,$119.14 ,$18.64 ,$147.70 ,$3.50 ,$18.64 ,$147.70 ,$35.42 ,$190.40 ,$136.00 ,$217.60 ,$46.60 ,$18.64 ,$190.40 ,$18.64 ,$163.20 ,$18.64 ,$204.00 ,$150.14 ,$135.46 ,$150.14 ,$18.64 ,$150.14 ,$24.23 ,$24.23 ,$231.20 ,$46.60 ,$188.50 ,$18.64 ,$272.00 ,$149.60 ,$18.64 ,$71.54 , N/A ,$9.05 ,$8.64 ,$19.57 ,$217.60 ,$147.70 ,$76.16 ,$244.80 ,$103.36 ,$37.28 ,$18.64 ,$130.56 
ST. MARY'S HOSPITAL - DECATUR,30101134,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1,301,1 ,$443.00 ,$287.95 ,$3.50 ,$443.00 ,$155.35 ,$135.68 ,$243.65 ,$62.14 ,$124.04 ,$217.07 ,$62.14 ,$259.16 ,$62.14 ,$240.55 ,$3.50 ,$62.14 ,$240.55 ,$118.07 ,$310.10 ,$221.50 ,$354.40 ,$155.35 ,$62.14 ,$310.10 ,$62.14 ,$265.80 ,$62.14 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$62.14 ,$244.54 ,$84.05 ,$84.05 ,$376.55 ,$155.35 ,$307.00 ,$62.14 ,$443.00 ,$243.65 ,$62.14 ,$116.51 , N/A ,$21.22 ,$20.25 ,$65.25 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$124.28 ,$62.14 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,30101135,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T2,301,1 ,$509.00 ,$330.85 ,$3.50 ,$509.00 ,$155.35 ,$135.68 ,$279.95 ,$62.14 ,$142.52 ,$249.41 ,$62.14 ,$297.77 ,$62.14 ,$276.39 ,$3.50 ,$62.14 ,$276.39 ,$118.07 ,$356.30 ,$254.50 ,$407.20 ,$155.35 ,$62.14 ,$356.30 ,$62.14 ,$305.40 ,$62.14 ,$381.75 ,$280.97 ,$253.48 ,$280.97 ,$62.14 ,$280.97 ,$84.05 ,$84.05 ,$432.65 ,$155.35 ,$352.74 ,$62.14 ,$509.00 ,$279.95 ,$62.14 ,$133.87 , N/A ,$21.22 ,$20.25 ,$65.25 ,$407.20 ,$276.39 ,$142.52 ,$458.10 ,$193.42 ,$124.28 ,$62.14 ,$244.32 
ST. MARY'S HOSPITAL - DECATUR,30101139,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT,301,1 ,$114.00 ,$74.10 ,$3.50 ,$155.35 ,$155.35 ,$114.00 ,$62.70 ,$62.14 ,$31.92 ,$55.86 ,$62.14 ,$66.69 ,$62.14 ,$61.90 ,$3.50 ,$62.14 ,$61.90 ,$114.00 ,$79.80 ,$57.00 ,$91.20 ,$155.35 ,$62.14 ,$79.80 ,$62.14 ,$68.40 ,$62.14 ,$85.50 ,$62.93 ,$56.77 ,$62.93 ,$62.14 ,$62.93 ,$84.05 ,$84.05 ,$96.90 ,$114.00 ,$79.00 ,$62.14 ,$114.00 ,$62.70 ,$62.14 ,$29.98 , N/A ,$21.22 ,$20.25 ,$65.25 ,$91.20 ,$61.90 ,$31.92 ,$102.60 ,$43.32 ,$114.00 ,$62.14 ,$54.72 
ST. MARY'S HOSPITAL - DECATUR,30101140,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T1-90,301,1 ,$443.00 ,$287.95 ,$3.50 ,$443.00 ,$155.35 ,$135.68 ,$243.65 ,$62.14 ,$124.04 ,$217.07 ,$62.14 ,$259.16 ,$62.14 ,$240.55 ,$3.50 ,$62.14 ,$240.55 ,$118.07 ,$310.10 ,$221.50 ,$354.40 ,$155.35 ,$62.14 ,$310.10 ,$62.14 ,$265.80 ,$62.14 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$62.14 ,$244.54 ,$84.05 ,$84.05 ,$376.55 ,$155.35 ,$307.00 ,$62.14 ,$443.00 ,$243.65 ,$62.14 ,$116.51 , N/A ,$21.22 ,$20.25 ,$65.25 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$124.28 ,$62.14 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,30101141,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T2-90,301,1 ,$177.00 ,$115.05 ,$3.50 ,$177.00 ,$155.35 ,$135.68 ,$97.35 ,$62.14 ,$49.56 ,$86.73 ,$62.14 ,$103.55 ,$62.14 ,$96.11 ,$3.50 ,$62.14 ,$96.11 ,$118.07 ,$123.90 ,$88.50 ,$141.60 ,$155.35 ,$62.14 ,$123.90 ,$62.14 ,$106.20 ,$62.14 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$62.14 ,$97.70 ,$84.05 ,$84.05 ,$150.45 ,$155.35 ,$122.66 ,$62.14 ,$177.00 ,$97.35 ,$62.14 ,$46.55 , N/A ,$21.22 ,$20.25 ,$65.25 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$124.28 ,$62.14 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30101142,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT T3-90,301,1 ,$664.00 ,$431.60 ,$3.50 ,$664.00 ,$155.35 ,$135.68 ,$365.20 ,$62.14 ,$185.92 ,$325.36 ,$62.14 ,$388.44 ,$62.14 ,$360.55 ,$3.50 ,$62.14 ,$360.55 ,$118.07 ,$464.80 ,$332.00 ,$531.20 ,$155.35 ,$62.14 ,$464.80 ,$62.14 ,$398.40 ,$62.14 ,$498.00 ,$366.53 ,$330.67 ,$366.53 ,$62.14 ,$366.53 ,$84.05 ,$84.05 ,$564.40 ,$155.35 ,$460.15 ,$62.14 ,$664.00 ,$365.20 ,$62.14 ,$174.63 , N/A ,$21.22 ,$20.25 ,$65.25 ,$531.20 ,$360.55 ,$185.92 ,$597.60 ,$252.32 ,$124.28 ,$62.14 ,$318.72 
ST. MARY'S HOSPITAL - DECATUR,30101145,80320,HC ALCOHOLS - 90,301,1 ,$555.00 ,$360.75 ,$0.02 ,$555.00 , N/A ,$0.02 ,$305.25 , N/A ,$155.40 , N/A , N/A , N/A , N/A ,$301.37 , N/A , N/A ,$301.37 , N/A ,$388.50 ,$277.50 ,$444.00 , N/A , N/A ,$388.50 , N/A ,$333.00 , N/A ,$416.25 ,$306.36 ,$276.39 ,$306.36 , N/A ,$306.36 ,$14.57 ,$14.57 ,$471.75 , N/A ,$384.62 , N/A ,$555.00 ,$305.25 , N/A ,$145.97 , N/A ,$7.88 ,$7.52 , N/A ,$444.00 ,$301.37 ,$155.40 ,$499.50 ,$210.90 , N/A , N/A ,$266.40 
ST. MARY'S HOSPITAL - DECATUR,30101146,80323,HC NICOTINE - 90,301,1 ,$144.00 ,$93.60 ,$0.02 ,$144.00 , N/A ,$0.02 ,$79.20 , N/A ,$40.32 , N/A , N/A , N/A , N/A ,$78.19 , N/A , N/A ,$78.19 , N/A ,$100.80 ,$72.00 ,$115.20 , N/A , N/A ,$100.80 , N/A ,$86.40 , N/A ,$108.00 ,$79.49 ,$71.71 ,$79.49 , N/A ,$79.49 ,$26.46 ,$26.46 ,$122.40 , N/A ,$99.79 , N/A ,$144.00 ,$79.20 , N/A ,$37.87 , N/A ,$21.22 ,$20.25 , N/A ,$115.20 ,$78.19 ,$40.32 ,$129.60 ,$54.72 , N/A , N/A ,$69.12 
ST. MARY'S HOSPITAL - DECATUR,30101147,80323,HC NICOTINE URINE - 90,301,1 ,$149.00 ,$96.85 ,$0.02 ,$149.00 , N/A ,$0.02 ,$81.95 , N/A ,$41.72 , N/A , N/A , N/A , N/A ,$80.91 , N/A , N/A ,$80.91 , N/A ,$104.30 ,$74.50 ,$119.20 , N/A , N/A ,$104.30 , N/A ,$89.40 , N/A ,$111.75 ,$82.25 ,$74.20 ,$82.25 , N/A ,$82.25 ,$26.46 ,$26.46 ,$126.65 , N/A ,$103.26 , N/A ,$149.00 ,$81.95 , N/A ,$39.19 , N/A ,$21.22 ,$20.25 , N/A ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 , N/A , N/A ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30101148,80327,HC ANABOLIC STERIODS 1-2  - 90,301,1 ,$223.00 ,$144.95 ,$0.02 ,$223.00 , N/A ,$0.02 ,$122.65 , N/A ,$62.44 , N/A , N/A , N/A , N/A ,$121.09 , N/A , N/A ,$121.09 , N/A ,$156.10 ,$111.50 ,$178.40 , N/A , N/A ,$156.10 , N/A ,$133.80 , N/A ,$167.25 ,$123.10 ,$111.05 ,$123.10 , N/A ,$123.10 ,$28.83 ,$28.83 ,$189.55 , N/A ,$154.54 , N/A ,$223.00 ,$122.65 , N/A ,$58.65 , N/A ,$21.22 ,$20.25 , N/A ,$178.40 ,$121.09 ,$62.44 ,$200.70 ,$84.74 , N/A , N/A ,$107.04 
ST. MARY'S HOSPITAL - DECATUR,30101149,80342,HC ANTIPSYCHOTICS NOT 1-3  -90,301,1 ,$220.00 ,$143.00 ,$0.02 ,$220.00 , N/A ,$0.02 ,$121.00 , N/A ,$61.60 , N/A , N/A , N/A , N/A ,$119.46 , N/A , N/A ,$119.46 , N/A ,$154.00 ,$110.00 ,$176.00 , N/A , N/A ,$154.00 , N/A ,$132.00 , N/A ,$165.00 ,$121.44 ,$109.56 ,$121.44 , N/A ,$121.44 ,$18.20 ,$18.20 ,$187.00 , N/A ,$152.46 , N/A ,$220.00 ,$121.00 , N/A ,$57.86 , N/A ,$21.22 ,$20.25 , N/A ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 , N/A , N/A ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,30101150,80346,HC BENZODIAZEPINES 1-12  -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$20.94 ,$20.94 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$21.22 ,$20.25 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101151,80349,HC CANNABINOIDS NATURAL -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$17.45 ,$17.45 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$7.88 ,$7.52 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101152,80353,HC COCAINE QN -90,301,1 ,$240.00 ,$156.00 ,$0.02 ,$240.00 , N/A ,$0.02 ,$132.00 , N/A ,$67.20 , N/A , N/A , N/A , N/A ,$130.32 , N/A , N/A ,$130.32 , N/A ,$168.00 ,$120.00 ,$192.00 , N/A , N/A ,$168.00 , N/A ,$144.00 , N/A ,$180.00 ,$132.48 ,$119.52 ,$132.48 , N/A ,$132.48 ,$15.86 ,$15.86 ,$204.00 , N/A ,$166.32 , N/A ,$240.00 ,$132.00 , N/A ,$63.12 , N/A ,$7.88 ,$7.52 , N/A ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 , N/A , N/A ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,30101153,80359,HC METHYLENEDIOXYAMPHETAMINES MDA MDEA MDMA -90,301,1 ,$214.00 ,$139.10 ,$0.02 ,$214.00 , N/A ,$0.02 ,$117.70 , N/A ,$59.92 , N/A , N/A , N/A , N/A ,$116.20 , N/A , N/A ,$116.20 , N/A ,$149.80 ,$107.00 ,$171.20 , N/A , N/A ,$149.80 , N/A ,$128.40 , N/A ,$160.50 ,$118.13 ,$106.57 ,$118.13 , N/A ,$118.13 ,$13.16 ,$13.16 ,$181.90 , N/A ,$148.30 , N/A ,$214.00 ,$117.70 , N/A ,$56.28 , N/A ,$7.88 ,$7.52 , N/A ,$171.20 ,$116.20 ,$59.92 ,$192.60 ,$81.32 , N/A , N/A ,$102.72 
ST. MARY'S HOSPITAL - DECATUR,30101154,80361,HC OPIATES 1 OR MORE -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$22.10 ,$22.10 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$21.22 ,$20.25 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101155,82010,HC ACETONE KETONES SERUM QN-90,301,1 ,$201.00 ,$130.65 ,$3.50 ,$201.00 ,$20.43 ,$19.10 ,$110.55 ,$8.17 ,$56.28 ,$87.29 ,$8.17 ,$87.29 ,$8.17 ,$109.14 ,$3.50 ,$8.17 ,$109.14 ,$15.52 ,$140.70 ,$100.50 ,$160.80 ,$20.43 ,$8.17 ,$140.70 ,$8.17 ,$120.60 ,$8.17 ,$150.75 ,$110.95 ,$100.10 ,$110.95 ,$8.17 ,$110.95 ,$11.80 ,$11.80 ,$170.85 ,$20.43 ,$139.29 ,$8.17 ,$201.00 ,$110.55 ,$8.17 ,$52.86 , N/A ,$7.88 ,$7.52 ,$8.58 ,$160.80 ,$109.14 ,$56.28 ,$180.90 ,$76.38 ,$16.34 ,$8.17 ,$96.48 
ST. MARY'S HOSPITAL - DECATUR,30101157,82017,HC ACYLCARNITINES QN EA SPEC-90,301,1 ,$283.00 ,$183.95 ,$3.50 ,$283.00 ,$42.18 ,$39.40 ,$155.65 ,$16.87 ,$79.24 ,$133.10 ,$16.87 ,$133.10 ,$16.87 ,$153.67 ,$3.50 ,$16.87 ,$153.67 ,$32.05 ,$198.10 ,$141.50 ,$226.40 ,$42.18 ,$16.87 ,$198.10 ,$16.87 ,$169.80 ,$16.87 ,$212.25 ,$156.22 ,$140.93 ,$156.22 ,$16.87 ,$156.22 ,$24.36 ,$24.36 ,$240.55 ,$42.18 ,$196.12 ,$16.87 ,$283.00 ,$155.65 ,$16.87 ,$74.43 , N/A ,$7.88 ,$7.52 ,$17.71 ,$226.40 ,$153.67 ,$79.24 ,$254.70 ,$107.54 ,$33.74 ,$16.87 ,$135.84 
ST. MARY'S HOSPITAL - DECATUR,30101158,82024,HC ACTH -90,301,1 ,$163.00 ,$105.95 ,$3.50 ,$163.00 ,$96.55 ,$90.28 ,$89.65 ,$38.62 ,$45.64 ,$79.87 ,$38.62 ,$95.36 ,$38.62 ,$88.51 ,$3.50 ,$38.62 ,$88.51 ,$73.38 ,$114.10 ,$81.50 ,$130.40 ,$96.55 ,$38.62 ,$114.10 ,$38.62 ,$97.80 ,$38.62 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$38.62 ,$89.98 ,$55.78 ,$55.78 ,$138.55 ,$96.55 ,$112.96 ,$38.62 ,$163.00 ,$89.65 ,$38.62 ,$42.87 , N/A ,$18.45 ,$17.61 ,$40.55 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$77.24 ,$38.62 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30101159,82040,HC ALBUMIN-90,301,1 ,$82.00 ,$53.30 ,$3.35 ,$82.00 ,$12.38 ,$11.56 ,$45.10 ,$4.95 ,$22.96 ,$40.18 ,$4.95 ,$47.97 ,$4.95 ,$44.53 ,$3.50 ,$4.95 ,$44.53 ,$9.41 ,$57.40 ,$41.00 ,$65.60 ,$12.38 ,$4.95 ,$57.40 ,$4.95 ,$49.20 ,$4.95 ,$61.50 ,$45.26 ,$40.84 ,$45.26 ,$4.95 ,$45.26 ,$7.15 ,$7.15 ,$69.70 ,$12.38 ,$56.83 ,$4.95 ,$82.00 ,$45.10 ,$4.95 ,$21.57 , N/A ,$3.51 ,$3.35 ,$5.20 ,$65.60 ,$44.53 ,$22.96 ,$73.80 ,$31.16 ,$9.90 ,$4.95 ,$39.36 
ST. MARY'S HOSPITAL - DECATUR,30101160,82042,HC ALBUMIN OTHER SOURCE-90,301,1 ,$100.00 ,$65.00 ,$3.35 ,$100.00 ,$19.45 ,$12.08 ,$55.00 ,$7.78 ,$28.00 ,$49.00 ,$7.78 ,$58.50 ,$7.78 ,$54.30 ,$3.50 ,$7.78 ,$54.30 ,$14.78 ,$70.00 ,$50.00 ,$80.00 ,$19.45 ,$7.78 ,$70.00 ,$7.78 ,$60.00 ,$7.78 ,$75.00 ,$55.20 ,$49.80 ,$55.20 ,$7.78 ,$55.20 ,$10.11 ,$10.11 ,$85.00 ,$19.45 ,$69.30 ,$7.78 ,$100.00 ,$55.00 ,$7.78 ,$26.30 , N/A ,$3.51 ,$3.35 ,$8.17 ,$80.00 ,$54.30 ,$28.00 ,$90.00 ,$38.00 ,$15.56 ,$7.78 ,$48.00 
ST. MARY'S HOSPITAL - DECATUR,30101162,82085,HC ALDOLASE-90,301,1 ,$77.00 ,$50.05 ,$3.50 ,$77.00 ,$24.28 ,$22.68 ,$42.35 ,$9.71 ,$21.56 ,$37.73 ,$9.71 ,$45.05 ,$9.71 ,$41.81 ,$3.50 ,$9.71 ,$41.81 ,$18.45 ,$53.90 ,$38.50 ,$61.60 ,$24.28 ,$9.71 ,$53.90 ,$9.71 ,$46.20 ,$9.71 ,$57.75 ,$42.50 ,$38.35 ,$42.50 ,$9.71 ,$42.50 ,$14.03 ,$14.03 ,$65.45 ,$24.28 ,$53.36 ,$9.71 ,$77.00 ,$42.35 ,$9.71 ,$20.25 , N/A ,$7.88 ,$7.52 ,$10.20 ,$61.60 ,$41.81 ,$21.56 ,$69.30 ,$29.26 ,$19.42 ,$9.71 ,$36.96 
ST. MARY'S HOSPITAL - DECATUR,30101163,82088,HC ALDOSTERONE-90,301,1 ,$315.00 ,$204.75 ,$3.50 ,$315.00 ,$101.88 ,$95.24 ,$173.25 ,$40.75 ,$88.20 ,$154.35 ,$40.75 ,$184.28 ,$40.75 ,$171.05 ,$3.50 ,$40.75 ,$171.05 ,$77.43 ,$220.50 ,$157.50 ,$252.00 ,$101.88 ,$40.75 ,$220.50 ,$40.75 ,$189.00 ,$40.75 ,$236.25 ,$173.88 ,$156.87 ,$173.88 ,$40.75 ,$173.88 ,$58.86 ,$58.86 ,$267.75 ,$101.88 ,$218.30 ,$40.75 ,$315.00 ,$173.25 ,$40.75 ,$82.85 , N/A ,$18.45 ,$17.61 ,$42.79 ,$252.00 ,$171.05 ,$88.20 ,$283.50 ,$119.70 ,$81.50 ,$40.75 ,$151.20 
ST. MARY'S HOSPITAL - DECATUR,30101164,82103,HC ALPHA-1 ANTITRYPSIN TOTAL-90,301,1 ,$122.00 ,$79.30 ,$3.50 ,$122.00 ,$33.60 ,$31.40 ,$67.10 ,$13.44 ,$34.16 ,$59.78 ,$13.44 ,$71.37 ,$13.44 ,$66.25 ,$3.50 ,$13.44 ,$66.25 ,$25.54 ,$85.40 ,$61.00 ,$97.60 ,$33.60 ,$13.44 ,$85.40 ,$13.44 ,$73.20 ,$13.44 ,$91.50 ,$67.34 ,$60.76 ,$67.34 ,$13.44 ,$67.34 ,$19.41 ,$19.41 ,$103.70 ,$33.60 ,$84.55 ,$13.44 ,$122.00 ,$67.10 ,$13.44 ,$32.09 , N/A ,$7.88 ,$7.52 ,$14.11 ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$26.88 ,$13.44 ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,30101165,82104,HC ALPHA-1 ANTITRYPSIN PHENO-90,301,1 ,$122.00 ,$79.30 ,$3.50 ,$122.00 ,$36.15 ,$33.80 ,$67.10 ,$14.46 ,$34.16 ,$59.78 ,$14.46 ,$71.37 ,$14.46 ,$66.25 ,$3.50 ,$14.46 ,$66.25 ,$27.47 ,$85.40 ,$61.00 ,$97.60 ,$36.15 ,$14.46 ,$85.40 ,$14.46 ,$73.20 ,$14.46 ,$91.50 ,$67.34 ,$60.76 ,$67.34 ,$14.46 ,$67.34 ,$20.89 ,$20.89 ,$103.70 ,$36.15 ,$84.55 ,$14.46 ,$122.00 ,$67.10 ,$14.46 ,$32.09 , N/A ,$7.88 ,$7.52 ,$15.18 ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$28.92 ,$14.46 ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,30101166,82105,HC ALPHA FETOPROTEIN SERUM-90,301,1 ,$163.00 ,$105.95 ,$3.50 ,$163.00 ,$41.93 ,$39.20 ,$89.65 ,$16.77 ,$45.64 ,$79.87 ,$16.77 ,$95.36 ,$16.77 ,$88.51 ,$3.50 ,$16.77 ,$88.51 ,$31.86 ,$114.10 ,$81.50 ,$130.40 ,$41.93 ,$16.77 ,$114.10 ,$16.77 ,$97.80 ,$16.77 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$16.77 ,$89.98 ,$24.23 ,$24.23 ,$138.55 ,$41.93 ,$112.96 ,$16.77 ,$163.00 ,$89.65 ,$16.77 ,$42.87 , N/A ,$7.88 ,$7.52 ,$17.61 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$33.54 ,$16.77 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30101168,82106,HC ALPHA FETOPROTEIN AMNIOTIC FLUID-90,301,1 ,$143.00 ,$92.95 ,$3.50 ,$143.00 ,$42.50 ,$39.20 ,$78.65 ,$17.00 ,$40.04 ,$70.07 ,$17.00 ,$83.66 ,$17.00 ,$77.65 ,$3.50 ,$17.00 ,$77.65 ,$32.30 ,$100.10 ,$71.50 ,$114.40 ,$42.50 ,$17.00 ,$100.10 ,$17.00 ,$85.80 ,$17.00 ,$107.25 ,$78.94 ,$71.21 ,$78.94 ,$17.00 ,$78.94 ,$24.23 ,$24.23 ,$121.55 ,$42.50 ,$99.10 ,$17.00 ,$143.00 ,$78.65 ,$17.00 ,$37.61 , N/A ,$7.88 ,$7.52 ,$17.85 ,$114.40 ,$77.65 ,$40.04 ,$128.70 ,$54.34 ,$34.00 ,$17.00 ,$68.64 
ST. MARY'S HOSPITAL - DECATUR,30101169,82108,HC ALUMINUM-90,301,1 ,$189.00 ,$122.85 ,$3.50 ,$189.00 ,$63.70 ,$59.54 ,$103.95 ,$25.48 ,$52.92 ,$92.61 ,$25.48 ,$110.57 ,$25.48 ,$102.63 ,$3.50 ,$25.48 ,$102.63 ,$48.41 ,$132.30 ,$94.50 ,$151.20 ,$63.70 ,$25.48 ,$132.30 ,$25.48 ,$113.40 ,$25.48 ,$141.75 ,$104.33 ,$94.12 ,$104.33 ,$25.48 ,$104.33 ,$36.80 ,$36.80 ,$160.65 ,$63.70 ,$130.98 ,$25.48 ,$189.00 ,$103.95 ,$25.48 ,$49.71 , N/A ,$9.61 ,$9.18 ,$26.75 ,$151.20 ,$102.63 ,$52.92 ,$170.10 ,$71.82 ,$50.96 ,$25.48 ,$90.72 
ST. MARY'S HOSPITAL - DECATUR,30101171,82128,HC AMINO ACIDS MULT QL EA SPECIMEN-90,301,1 ,$147.00 ,$95.55 ,$3.50 ,$147.00 ,$34.68 ,$32.40 ,$80.85 ,$13.87 ,$41.16 ,$72.03 ,$13.87 ,$86.00 ,$13.87 ,$79.82 ,$3.50 ,$13.87 ,$79.82 ,$26.35 ,$102.90 ,$73.50 ,$117.60 ,$34.68 ,$13.87 ,$102.90 ,$13.87 ,$88.20 ,$13.87 ,$110.25 ,$81.14 ,$73.21 ,$81.14 ,$13.87 ,$81.14 ,$20.03 ,$20.03 ,$124.95 ,$34.68 ,$101.87 ,$13.87 ,$147.00 ,$80.85 ,$13.87 ,$38.66 , N/A ,$7.88 ,$7.52 ,$14.56 ,$117.60 ,$79.82 ,$41.16 ,$132.30 ,$55.86 ,$27.74 ,$13.87 ,$70.56 
ST. MARY'S HOSPITAL - DECATUR,30101172,82131,HC AMINO ACID QN SINGLE-90,301,1 ,$265.00 ,$172.25 ,$3.50 ,$265.00 ,$57.45 ,$39.40 ,$145.75 ,$22.98 ,$74.20 ,$129.85 ,$22.98 ,$146.86 ,$22.98 ,$143.90 ,$3.50 ,$22.98 ,$143.90 ,$43.66 ,$185.50 ,$132.50 ,$212.00 ,$57.45 ,$22.98 ,$185.50 ,$22.98 ,$159.00 ,$22.98 ,$198.75 ,$146.28 ,$131.97 ,$146.28 ,$22.98 ,$146.28 ,$29.87 ,$29.87 ,$225.25 ,$57.45 ,$183.65 ,$22.98 ,$265.00 ,$145.75 ,$22.98 ,$69.70 , N/A ,$7.88 ,$7.52 ,$24.13 ,$212.00 ,$143.90 ,$74.20 ,$238.50 ,$100.70 ,$45.96 ,$22.98 ,$127.20 
ST. MARY'S HOSPITAL - DECATUR,30101173,82135,HC AMINOLEVULINIC ACID 24 HR UR-90,301,1 ,$219.00 ,$142.35 ,$3.50 ,$219.00 ,$41.13 ,$33.92 ,$120.45 ,$16.45 ,$61.32 ,$107.31 ,$16.45 ,$128.12 ,$16.45 ,$118.92 ,$3.50 ,$16.45 ,$118.92 ,$31.26 ,$153.30 ,$109.50 ,$175.20 ,$41.13 ,$16.45 ,$153.30 ,$16.45 ,$131.40 ,$16.45 ,$164.25 ,$120.89 ,$109.06 ,$120.89 ,$16.45 ,$120.89 ,$23.76 ,$23.76 ,$186.15 ,$41.13 ,$151.77 ,$16.45 ,$219.00 ,$120.45 ,$16.45 ,$57.60 , N/A ,$7.88 ,$7.52 ,$17.27 ,$175.20 ,$118.92 ,$61.32 ,$197.10 ,$83.22 ,$32.90 ,$16.45 ,$105.12 
ST. MARY'S HOSPITAL - DECATUR,30101174,82136,HC AMINO ACIDS 2-5 ACIDS QN-90,301,1 ,$103.00 ,$66.95 ,$3.50 ,$103.00 ,$49.03 ,$39.40 ,$56.65 ,$19.61 ,$28.84 ,$50.47 ,$19.61 ,$60.26 ,$19.61 ,$55.93 ,$3.50 ,$19.61 ,$55.93 ,$37.26 ,$72.10 ,$51.50 ,$82.40 ,$49.03 ,$19.61 ,$72.10 ,$19.61 ,$61.80 ,$19.61 ,$77.25 ,$56.86 ,$51.29 ,$56.86 ,$19.61 ,$56.86 ,$25.49 ,$25.49 ,$87.55 ,$49.03 ,$71.38 ,$19.61 ,$103.00 ,$56.65 ,$19.61 ,$27.09 , N/A ,$7.88 ,$7.52 ,$20.59 ,$82.40 ,$55.93 ,$28.84 ,$92.70 ,$39.14 ,$39.22 ,$19.61 ,$49.44 
ST. MARY'S HOSPITAL - DECATUR,30101175,82139,HC AMINO ACIDS 6+ QN CSF-90,301,1 ,$721.00 ,$468.65 ,$3.50 ,$721.00 ,$42.18 ,$39.40 ,$396.55 ,$16.87 ,$201.88 ,$133.10 ,$16.87 ,$133.10 ,$16.87 ,$391.50 ,$3.50 ,$16.87 ,$391.50 ,$32.05 ,$504.70 ,$360.50 ,$576.80 ,$42.18 ,$16.87 ,$504.70 ,$16.87 ,$432.60 ,$16.87 ,$540.75 ,$397.99 ,$359.06 ,$397.99 ,$16.87 ,$397.99 ,$24.36 ,$24.36 ,$612.85 ,$42.18 ,$499.65 ,$16.87 ,$721.00 ,$396.55 ,$16.87 ,$189.62 , N/A ,$7.88 ,$7.52 ,$17.71 ,$576.80 ,$391.50 ,$201.88 ,$648.90 ,$273.98 ,$33.74 ,$16.87 ,$346.08 
ST. MARY'S HOSPITAL - DECATUR,30101176,82140,HC AMMONIA-90,301,1 ,$220.00 ,$143.00 ,$3.50 ,$220.00 ,$36.43 ,$34.06 ,$121.00 ,$14.57 ,$61.60 ,$107.80 ,$14.57 ,$114.91 ,$14.57 ,$119.46 ,$3.50 ,$14.57 ,$119.46 ,$27.68 ,$154.00 ,$110.00 ,$176.00 ,$36.43 ,$14.57 ,$154.00 ,$14.57 ,$132.00 ,$14.57 ,$165.00 ,$121.44 ,$109.56 ,$121.44 ,$14.57 ,$121.44 ,$21.05 ,$21.05 ,$187.00 ,$36.43 ,$152.46 ,$14.57 ,$220.00 ,$121.00 ,$14.57 ,$57.86 , N/A ,$7.88 ,$7.52 ,$15.30 ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 ,$29.14 ,$14.57 ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,30101177,82150,HC AMYLASE-90,301,1 ,$154.00 ,$100.10 ,$3.50 ,$154.00 ,$16.20 ,$15.14 ,$84.70 ,$6.48 ,$43.12 ,$69.20 ,$6.48 ,$69.20 ,$6.48 ,$83.62 ,$3.50 ,$6.48 ,$83.62 ,$12.31 ,$107.80 ,$77.00 ,$123.20 ,$16.20 ,$6.48 ,$107.80 ,$6.48 ,$92.40 ,$6.48 ,$115.50 ,$85.01 ,$76.69 ,$85.01 ,$6.48 ,$85.01 ,$9.36 ,$9.36 ,$130.90 ,$16.20 ,$106.72 ,$6.48 ,$154.00 ,$84.70 ,$6.48 ,$40.50 , N/A ,$7.88 ,$7.52 ,$6.80 ,$123.20 ,$83.62 ,$43.12 ,$138.60 ,$58.52 ,$12.96 ,$6.48 ,$73.92 
ST. MARY'S HOSPITAL - DECATUR,30101178,82157,HC ANDROSTENEDIONE-90,301,1 ,$274.00 ,$178.10 ,$3.50 ,$274.00 ,$73.20 ,$68.40 ,$150.70 ,$29.28 ,$76.72 ,$134.26 ,$29.28 ,$160.29 ,$29.28 ,$148.78 ,$3.50 ,$29.28 ,$148.78 ,$55.63 ,$191.80 ,$137.00 ,$219.20 ,$73.20 ,$29.28 ,$191.80 ,$29.28 ,$164.40 ,$29.28 ,$205.50 ,$151.25 ,$136.45 ,$151.25 ,$29.28 ,$151.25 ,$42.29 ,$42.29 ,$232.90 ,$73.20 ,$189.88 ,$29.28 ,$274.00 ,$150.70 ,$29.28 ,$72.06 , N/A ,$18.45 ,$17.61 ,$30.74 ,$219.20 ,$148.78 ,$76.72 ,$246.60 ,$104.12 ,$58.56 ,$29.28 ,$131.52 
ST. MARY'S HOSPITAL - DECATUR,30101179,82164,HC ANGIOTENSIN 1 ENZYME (ACE)-90,301,1 ,$142.00 ,$92.30 ,$3.50 ,$142.00 ,$36.50 ,$34.12 ,$78.10 ,$14.60 ,$39.76 ,$69.58 ,$14.60 ,$83.07 ,$14.60 ,$77.11 ,$3.50 ,$14.60 ,$77.11 ,$27.74 ,$99.40 ,$71.00 ,$113.60 ,$36.50 ,$14.60 ,$99.40 ,$14.60 ,$85.20 ,$14.60 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$14.60 ,$78.38 ,$21.09 ,$21.09 ,$120.70 ,$36.50 ,$98.41 ,$14.60 ,$142.00 ,$78.10 ,$14.60 ,$37.35 , N/A ,$7.88 ,$7.52 ,$15.33 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$29.20 ,$14.60 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30101180,82172,HC APOLIPOPROTEIN SERUM-90,301,1 ,$111.00 ,$72.15 ,$3.50 ,$111.00 ,$52.73 ,$36.22 ,$61.05 ,$21.09 ,$31.08 ,$54.39 ,$21.09 ,$64.94 ,$21.09 ,$60.27 ,$3.50 ,$21.09 ,$60.27 ,$40.07 ,$77.70 ,$55.50 ,$88.80 ,$52.73 ,$21.09 ,$77.70 ,$21.09 ,$66.60 ,$21.09 ,$83.25 ,$61.27 ,$55.28 ,$61.27 ,$21.09 ,$61.27 ,$27.42 ,$27.42 ,$94.35 ,$52.73 ,$76.92 ,$21.09 ,$111.00 ,$61.05 ,$21.09 ,$29.19 , N/A ,$7.88 ,$7.52 ,$22.14 ,$88.80 ,$60.27 ,$31.08 ,$99.90 ,$42.18 ,$42.18 ,$21.09 ,$53.28 
ST. MARY'S HOSPITAL - DECATUR,30101181,82175,HC ARSENIC-90,301,1 ,$92.00 ,$59.80 ,$3.50 ,$92.00 ,$47.43 ,$44.34 ,$50.60 ,$18.97 ,$25.76 ,$45.08 ,$18.97 ,$53.82 ,$18.97 ,$49.96 ,$3.50 ,$18.97 ,$49.96 ,$36.04 ,$64.40 ,$46.00 ,$73.60 ,$47.43 ,$18.97 ,$64.40 ,$18.97 ,$55.20 ,$18.97 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$18.97 ,$50.78 ,$27.40 ,$27.40 ,$78.20 ,$47.43 ,$63.76 ,$18.97 ,$92.00 ,$50.60 ,$18.97 ,$24.20 , N/A ,$9.61 ,$9.18 ,$19.92 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$37.94 ,$18.97 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,30101182,82180,HC VITAMIN C (ASCORBIC ACID)-90,301,1 ,$213.00 ,$138.45 ,$3.50 ,$213.00 ,$24.73 ,$13.54 ,$117.15 ,$9.89 ,$59.64 ,$77.95 ,$9.89 ,$77.95 ,$9.89 ,$115.66 ,$3.50 ,$9.89 ,$115.66 ,$18.79 ,$149.10 ,$106.50 ,$170.40 ,$24.73 ,$9.89 ,$149.10 ,$9.89 ,$127.80 ,$9.89 ,$159.75 ,$117.58 ,$106.07 ,$117.58 ,$9.89 ,$117.58 ,$14.27 ,$14.27 ,$181.05 ,$24.73 ,$147.61 ,$9.89 ,$213.00 ,$117.15 ,$9.89 ,$56.02 , N/A ,$7.88 ,$7.52 ,$10.38 ,$170.40 ,$115.66 ,$59.64 ,$191.70 ,$80.94 ,$19.78 ,$9.89 ,$102.24 
ST. MARY'S HOSPITAL - DECATUR,30101183,82190,HC ATOMIC ABSORPTION SPEC EA ANALYTE-90,301,1 ,$126.00 ,$81.90 ,$3.50 ,$126.00 ,$39.75 ,$34.84 ,$69.30 ,$15.90 ,$35.28 ,$61.74 ,$15.90 ,$73.71 ,$15.90 ,$68.42 ,$3.50 ,$15.90 ,$68.42 ,$30.21 ,$88.20 ,$63.00 ,$100.80 ,$39.75 ,$15.90 ,$88.20 ,$15.90 ,$75.60 ,$15.90 ,$94.50 ,$69.55 ,$62.75 ,$69.55 ,$15.90 ,$69.55 ,$21.53 ,$21.53 ,$107.10 ,$39.75 ,$87.32 ,$15.90 ,$126.00 ,$69.30 ,$15.90 ,$33.14 , N/A ,$7.88 ,$7.52 ,$16.70 ,$100.80 ,$68.42 ,$35.28 ,$113.40 ,$47.88 ,$31.80 ,$15.90 ,$60.48 
ST. MARY'S HOSPITAL - DECATUR,30101184,82232,HC BETA 2 MICROGLOBULIN-90,301,1 ,$140.00 ,$91.00 ,$3.50 ,$140.00 ,$40.45 ,$37.80 ,$77.00 ,$16.18 ,$39.20 ,$68.60 ,$16.18 ,$81.90 ,$16.18 ,$76.02 ,$3.50 ,$16.18 ,$76.02 ,$30.74 ,$98.00 ,$70.00 ,$112.00 ,$40.45 ,$16.18 ,$98.00 ,$16.18 ,$84.00 ,$16.18 ,$105.00 ,$77.28 ,$69.72 ,$77.28 ,$16.18 ,$77.28 ,$23.36 ,$23.36 ,$119.00 ,$40.45 ,$97.02 ,$16.18 ,$140.00 ,$77.00 ,$16.18 ,$36.82 , N/A ,$18.45 ,$17.61 ,$16.99 ,$112.00 ,$76.02 ,$39.20 ,$126.00 ,$53.20 ,$32.36 ,$16.18 ,$67.20 
ST. MARY'S HOSPITAL - DECATUR,30101185,82239,HC BILE ACID TOTAL-90,301,1 ,$116.00 ,$75.40 ,$3.50 ,$116.00 ,$42.80 ,$40.04 ,$63.80 ,$17.12 ,$32.48 ,$56.84 ,$17.12 ,$67.86 ,$17.12 ,$62.99 ,$3.50 ,$17.12 ,$62.99 ,$32.53 ,$81.20 ,$58.00 ,$92.80 ,$42.80 ,$17.12 ,$81.20 ,$17.12 ,$69.60 ,$17.12 ,$87.00 ,$64.03 ,$57.77 ,$64.03 ,$17.12 ,$64.03 ,$24.74 ,$24.74 ,$98.60 ,$42.80 ,$80.39 ,$17.12 ,$116.00 ,$63.80 ,$17.12 ,$30.51 , N/A ,$7.88 ,$7.52 ,$17.98 ,$92.80 ,$62.99 ,$32.48 ,$104.40 ,$44.08 ,$34.24 ,$17.12 ,$55.68 
ST. MARY'S HOSPITAL - DECATUR,30101186,82247,HC BILIRUBIN TOTAL-90,301,1 ,$134.00 ,$87.10 ,$3.35 ,$134.00 ,$12.55 ,$11.74 ,$73.70 ,$5.02 ,$37.52 ,$53.57 ,$5.02 ,$53.57 ,$5.02 ,$72.76 ,$3.50 ,$5.02 ,$72.76 ,$9.54 ,$93.80 ,$67.00 ,$107.20 ,$12.55 ,$5.02 ,$93.80 ,$5.02 ,$80.40 ,$5.02 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$5.02 ,$73.97 ,$7.24 ,$7.24 ,$113.90 ,$12.55 ,$92.86 ,$5.02 ,$134.00 ,$73.70 ,$5.02 ,$35.24 , N/A ,$3.51 ,$3.35 ,$5.27 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$10.04 ,$5.02 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,30101189,82270,HC OCCULT BLOOD FECAL SCRN,301,1 ,$75.00 ,$48.75 ,$3.35 ,$75.00 ,$10.95 ,$7.62 ,$41.25 ,$4.38 ,$21.00 ,$36.75 ,$4.38 ,$37.85 ,$4.38 ,$40.73 ,$3.50 ,$4.38 ,$40.73 ,$8.32 ,$52.50 ,$37.50 ,$60.00 ,$10.95 ,$4.38 ,$52.50 ,$4.38 ,$45.00 ,$4.38 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$4.38 ,$41.40 ,$5.69 ,$5.69 ,$63.75 ,$10.95 ,$51.98 ,$4.38 ,$75.00 ,$41.25 ,$4.38 ,$19.73 , N/A ,$3.51 ,$3.35 ,$4.60 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$8.76 ,$4.38 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,30101192,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$75.00 ,$48.75 ,$3.35 ,$75.00 ,$13.30 ,$7.62 ,$41.25 ,$5.32 ,$21.00 ,$36.75 ,$5.32 ,$43.88 ,$5.32 ,$40.73 ,$3.50 ,$5.32 ,$40.73 ,$10.11 ,$52.50 ,$37.50 ,$60.00 ,$13.30 ,$5.32 ,$52.50 ,$5.32 ,$45.00 ,$5.32 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$5.32 ,$41.40 ,$6.92 ,$6.92 ,$63.75 ,$13.30 ,$51.98 ,$5.32 ,$75.00 ,$41.25 ,$5.32 ,$19.73 , N/A ,$3.51 ,$3.35 ,$5.59 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$10.64 ,$5.32 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,30101196,82300,HC CADMIUM-90,301,1 ,$87.00 ,$56.55 ,$3.50 ,$87.00 ,$59.10 ,$54.08 ,$47.85 ,$23.64 ,$24.36 ,$42.63 ,$23.64 ,$50.90 ,$23.64 ,$47.24 ,$3.50 ,$23.64 ,$47.24 ,$44.92 ,$60.90 ,$43.50 ,$69.60 ,$59.10 ,$23.64 ,$60.90 ,$23.64 ,$52.20 ,$23.64 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$23.64 ,$48.02 ,$33.44 ,$33.44 ,$73.95 ,$59.10 ,$60.29 ,$23.64 ,$87.00 ,$47.85 ,$23.64 ,$22.88 , N/A ,$9.61 ,$9.18 ,$24.82 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$47.28 ,$23.64 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30101197,82306,HC VITAMIN D 25 OH-90,301,1 ,$110.00 ,$71.50 ,$3.50 ,$110.00 ,$74.00 ,$69.20 ,$60.50 ,$29.60 ,$30.80 ,$53.90 ,$29.60 ,$64.35 ,$29.60 ,$59.73 ,$3.50 ,$29.60 ,$59.73 ,$56.24 ,$77.00 ,$55.00 ,$88.00 ,$74.00 ,$29.60 ,$77.00 ,$29.60 ,$66.00 ,$29.60 ,$82.50 ,$60.72 ,$54.78 ,$60.72 ,$29.60 ,$60.72 ,$42.76 ,$42.76 ,$93.50 ,$74.00 ,$76.23 ,$29.60 ,$110.00 ,$60.50 ,$29.60 ,$28.93 , N/A ,$21.22 ,$20.25 ,$31.08 ,$88.00 ,$59.73 ,$30.80 ,$99.00 ,$41.80 ,$59.20 ,$29.60 ,$52.80 
ST. MARY'S HOSPITAL - DECATUR,30101199,82308,HC CALCITONIN-90,301,1 ,$209.00 ,$135.85 ,$3.50 ,$209.00 ,$66.98 ,$62.60 ,$114.95 ,$26.79 ,$58.52 ,$102.41 ,$26.79 ,$122.27 ,$26.79 ,$113.49 ,$3.50 ,$26.79 ,$113.49 ,$50.90 ,$146.30 ,$104.50 ,$167.20 ,$66.98 ,$26.79 ,$146.30 ,$26.79 ,$125.40 ,$26.79 ,$156.75 ,$115.37 ,$104.08 ,$115.37 ,$26.79 ,$115.37 ,$38.70 ,$38.70 ,$177.65 ,$66.98 ,$144.84 ,$26.79 ,$209.00 ,$114.95 ,$26.79 ,$54.97 , N/A ,$18.45 ,$17.61 ,$28.13 ,$167.20 ,$113.49 ,$58.52 ,$188.10 ,$79.42 ,$53.58 ,$26.79 ,$100.32 
ST. MARY'S HOSPITAL - DECATUR,30101200,82310,HC CALCIUM-90,301,1 ,$168.00 ,$109.20 ,$3.35 ,$168.00 ,$12.90 ,$12.06 ,$92.40 ,$5.16 ,$47.04 ,$55.15 ,$5.16 ,$55.15 ,$5.16 ,$91.22 ,$3.50 ,$5.16 ,$91.22 ,$9.80 ,$117.60 ,$84.00 ,$134.40 ,$12.90 ,$5.16 ,$117.60 ,$5.16 ,$100.80 ,$5.16 ,$126.00 ,$92.74 ,$83.66 ,$92.74 ,$5.16 ,$92.74 ,$7.45 ,$7.45 ,$142.80 ,$12.90 ,$116.42 ,$5.16 ,$168.00 ,$92.40 ,$5.16 ,$44.18 , N/A ,$3.51 ,$3.35 ,$5.42 ,$134.40 ,$91.22 ,$47.04 ,$151.20 ,$63.84 ,$10.32 ,$5.16 ,$80.64 
ST. MARY'S HOSPITAL - DECATUR,30101203,82340,HC CALCIUM URINE QN TIMED-90,301,1 ,$245.00 ,$159.25 ,$3.50 ,$245.00 ,$15.08 ,$14.10 ,$134.75 ,$6.03 ,$68.60 ,$47.58 ,$6.03 ,$47.58 ,$6.03 ,$133.04 ,$3.50 ,$6.03 ,$133.04 ,$11.46 ,$171.50 ,$122.50 ,$196.00 ,$15.08 ,$6.03 ,$171.50 ,$6.03 ,$147.00 ,$6.03 ,$183.75 ,$135.24 ,$122.01 ,$135.24 ,$6.03 ,$135.24 ,$8.71 ,$8.71 ,$208.25 ,$15.08 ,$169.79 ,$6.03 ,$245.00 ,$134.75 ,$6.03 ,$64.44 , N/A ,$7.88 ,$7.52 ,$6.33 ,$196.00 ,$133.04 ,$68.60 ,$220.50 ,$93.10 ,$12.06 ,$6.03 ,$117.60 
ST. MARY'S HOSPITAL - DECATUR,30101205,82365,HC CALCULUS ANLYS INFRARED-90,301,1 ,$105.00 ,$68.25 ,$3.50 ,$105.00 ,$32.25 ,$24.88 ,$57.75 ,$12.90 ,$29.40 ,$51.45 ,$12.90 ,$61.43 ,$12.90 ,$57.02 ,$3.50 ,$12.90 ,$57.02 ,$24.51 ,$73.50 ,$52.50 ,$84.00 ,$32.25 ,$12.90 ,$73.50 ,$12.90 ,$63.00 ,$12.90 ,$78.75 ,$57.96 ,$52.29 ,$57.96 ,$12.90 ,$57.96 ,$18.63 ,$18.63 ,$89.25 ,$32.25 ,$72.77 ,$12.90 ,$105.00 ,$57.75 ,$12.90 ,$27.62 , N/A ,$7.88 ,$7.52 ,$13.55 ,$84.00 ,$57.02 ,$29.40 ,$94.50 ,$39.90 ,$25.80 ,$12.90 ,$50.40 
ST. MARY'S HOSPITAL - DECATUR,30101206,82373,HC CARBOHY DEFICIENT TRANSFER-90,301,1 ,$290.00 ,$188.50 ,$3.50 ,$290.00 ,$45.15 ,$42.20 ,$159.50 ,$18.06 ,$81.20 ,$142.10 ,$18.06 ,$142.44 ,$18.06 ,$157.47 ,$3.50 ,$18.06 ,$157.47 ,$34.31 ,$203.00 ,$145.00 ,$232.00 ,$45.15 ,$18.06 ,$203.00 ,$18.06 ,$174.00 ,$18.06 ,$217.50 ,$160.08 ,$144.42 ,$160.08 ,$18.06 ,$160.08 ,$26.08 ,$26.08 ,$246.50 ,$45.15 ,$200.97 ,$18.06 ,$290.00 ,$159.50 ,$18.06 ,$76.27 , N/A ,$7.88 ,$7.52 ,$18.96 ,$232.00 ,$157.47 ,$81.20 ,$261.00 ,$110.20 ,$36.12 ,$18.06 ,$139.20 
ST. MARY'S HOSPITAL - DECATUR,30101208,82378,HC CARBINOEMBRYONIC AG (CEA)-90,301,1 ,$333.00 ,$216.45 ,$3.50 ,$333.00 ,$47.40 ,$44.34 ,$183.15 ,$18.96 ,$93.24 ,$149.61 ,$18.96 ,$149.61 ,$18.96 ,$180.82 ,$3.50 ,$18.96 ,$180.82 ,$36.02 ,$233.10 ,$166.50 ,$266.40 ,$47.40 ,$18.96 ,$233.10 ,$18.96 ,$199.80 ,$18.96 ,$249.75 ,$183.82 ,$165.83 ,$183.82 ,$18.96 ,$183.82 ,$27.39 ,$27.39 ,$283.05 ,$47.40 ,$230.77 ,$18.96 ,$333.00 ,$183.15 ,$18.96 ,$87.58 , N/A ,$7.88 ,$7.52 ,$19.91 ,$266.40 ,$180.82 ,$93.24 ,$299.70 ,$126.54 ,$37.92 ,$18.96 ,$159.84 
ST. MARY'S HOSPITAL - DECATUR,30101209,82379,HC CARNITINE TOTAL AND FREE QN-90,301,1 ,$281.00 ,$182.65 ,$3.50 ,$281.00 ,$42.18 ,$39.40 ,$154.55 ,$16.87 ,$78.68 ,$133.10 ,$16.87 ,$133.10 ,$16.87 ,$152.58 ,$3.50 ,$16.87 ,$152.58 ,$32.05 ,$196.70 ,$140.50 ,$224.80 ,$42.18 ,$16.87 ,$196.70 ,$16.87 ,$168.60 ,$16.87 ,$210.75 ,$155.11 ,$139.94 ,$155.11 ,$16.87 ,$155.11 ,$24.36 ,$24.36 ,$238.85 ,$42.18 ,$194.73 ,$16.87 ,$281.00 ,$154.55 ,$16.87 ,$73.90 , N/A ,$7.88 ,$7.52 ,$17.71 ,$224.80 ,$152.58 ,$78.68 ,$252.90 ,$106.78 ,$33.74 ,$16.87 ,$134.88 
ST. MARY'S HOSPITAL - DECATUR,30101210,82380,HC CAROTENE-90,301,1 ,$114.00 ,$74.10 ,$3.50 ,$114.00 ,$23.05 ,$21.56 ,$62.70 ,$9.22 ,$31.92 ,$55.86 ,$9.22 ,$66.69 ,$9.22 ,$61.90 ,$3.50 ,$9.22 ,$61.90 ,$17.52 ,$79.80 ,$57.00 ,$91.20 ,$23.05 ,$9.22 ,$79.80 ,$9.22 ,$68.40 ,$9.22 ,$85.50 ,$62.93 ,$56.77 ,$62.93 ,$9.22 ,$62.93 ,$13.33 ,$13.33 ,$96.90 ,$23.05 ,$79.00 ,$9.22 ,$114.00 ,$62.70 ,$9.22 ,$29.98 , N/A ,$7.88 ,$7.52 ,$9.68 ,$91.20 ,$61.90 ,$31.92 ,$102.60 ,$43.32 ,$18.44 ,$9.22 ,$54.72 
ST. MARY'S HOSPITAL - DECATUR,30101211,82384,HC CATECHOLAMINE FRACTION-90,301,1 ,$234.00 ,$152.10 ,$3.50 ,$234.00 ,$63.13 ,$59.00 ,$128.70 ,$25.25 ,$65.52 ,$114.66 ,$25.25 ,$136.89 ,$25.25 ,$127.06 ,$3.50 ,$25.25 ,$127.06 ,$47.98 ,$163.80 ,$117.00 ,$187.20 ,$63.13 ,$25.25 ,$163.80 ,$25.25 ,$140.40 ,$25.25 ,$175.50 ,$129.17 ,$116.53 ,$129.17 ,$25.25 ,$129.17 ,$36.48 ,$36.48 ,$198.90 ,$63.13 ,$162.16 ,$25.25 ,$234.00 ,$128.70 ,$25.25 ,$61.54 , N/A ,$18.45 ,$17.61 ,$26.51 ,$187.20 ,$127.06 ,$65.52 ,$210.60 ,$88.92 ,$50.50 ,$25.25 ,$112.32 
ST. MARY'S HOSPITAL - DECATUR,30101212,82390,HC CERULOPLASMIN-90,301,1 ,$86.00 ,$55.90 ,$3.50 ,$86.00 ,$26.85 ,$25.10 ,$47.30 ,$10.74 ,$24.08 ,$42.14 ,$10.74 ,$50.31 ,$10.74 ,$46.70 ,$3.50 ,$10.74 ,$46.70 ,$20.41 ,$60.20 ,$43.00 ,$68.80 ,$26.85 ,$10.74 ,$60.20 ,$10.74 ,$51.60 ,$10.74 ,$64.50 ,$47.47 ,$42.83 ,$47.47 ,$10.74 ,$47.47 ,$15.51 ,$15.51 ,$73.10 ,$26.85 ,$59.60 ,$10.74 ,$86.00 ,$47.30 ,$10.74 ,$22.62 , N/A ,$7.88 ,$7.52 ,$11.28 ,$68.80 ,$46.70 ,$24.08 ,$77.40 ,$32.68 ,$21.48 ,$10.74 ,$41.28 
ST. MARY'S HOSPITAL - DECATUR,30101213,82397,HC CHEMILUMINESCENT ASSAY-90,301,1 ,$289.00 ,$187.85 ,$3.50 ,$289.00 ,$35.30 ,$33.02 ,$158.95 ,$14.12 ,$80.92 ,$111.37 ,$14.12 ,$111.37 ,$14.12 ,$156.93 ,$3.50 ,$14.12 ,$156.93 ,$26.83 ,$202.30 ,$144.50 ,$231.20 ,$35.30 ,$14.12 ,$202.30 ,$14.12 ,$173.40 ,$14.12 ,$216.75 ,$159.53 ,$143.92 ,$159.53 ,$14.12 ,$159.53 ,$20.40 ,$20.40 ,$245.65 ,$35.30 ,$200.28 ,$14.12 ,$289.00 ,$158.95 ,$14.12 ,$76.01 , N/A ,$7.88 ,$7.52 ,$14.83 ,$231.20 ,$156.93 ,$80.92 ,$260.10 ,$109.82 ,$28.24 ,$14.12 ,$138.72 
ST. MARY'S HOSPITAL - DECATUR,30101214,82436,HC CHLORIDE URINE -90,301,1 ,$228.00 ,$148.20 ,$3.35 ,$228.00 ,$14.38 ,$11.74 ,$125.40 ,$5.75 ,$63.84 ,$39.71 ,$5.75 ,$39.71 ,$5.75 ,$123.80 ,$3.50 ,$5.75 ,$123.80 ,$10.93 ,$159.60 ,$114.00 ,$182.40 ,$14.38 ,$5.75 ,$159.60 ,$5.75 ,$136.80 ,$5.75 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$5.75 ,$125.86 ,$7.48 ,$7.48 ,$193.80 ,$14.38 ,$158.00 ,$5.75 ,$228.00 ,$125.40 ,$5.75 ,$59.96 , N/A ,$3.51 ,$3.35 ,$6.04 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$11.50 ,$5.75 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,30101215,82438,HC CHLORIDE OTHER SOURCE-90,301,1 ,$203.00 ,$131.95 ,$3.35 ,$203.00 ,$12.50 ,$11.42 ,$111.65 ,$5.00 ,$56.84 ,$38.53 ,$5.00 ,$38.53 ,$5.00 ,$110.23 ,$3.50 ,$5.00 ,$110.23 ,$9.50 ,$142.10 ,$101.50 ,$162.40 ,$12.50 ,$5.00 ,$142.10 ,$5.00 ,$121.80 ,$5.00 ,$152.25 ,$112.06 ,$101.09 ,$112.06 ,$5.00 ,$112.06 ,$7.06 ,$7.06 ,$172.55 ,$12.50 ,$140.68 ,$5.00 ,$203.00 ,$111.65 ,$5.00 ,$53.39 , N/A ,$3.51 ,$3.35 ,$5.25 ,$162.40 ,$110.23 ,$56.84 ,$182.70 ,$77.14 ,$10.00 ,$5.00 ,$97.44 
ST. MARY'S HOSPITAL - DECATUR,30101216,82480,HC CHOLINESTERASE PSEUDO-90,301,1 ,$67.00 ,$43.55 ,$3.50 ,$67.00 ,$19.68 ,$18.42 ,$36.85 ,$7.87 ,$18.76 ,$32.83 ,$7.87 ,$39.20 ,$7.87 ,$36.38 ,$3.50 ,$7.87 ,$36.38 ,$14.95 ,$46.90 ,$33.50 ,$53.60 ,$19.68 ,$7.87 ,$46.90 ,$7.87 ,$40.20 ,$7.87 ,$50.25 ,$36.98 ,$33.37 ,$36.98 ,$7.87 ,$36.98 ,$11.38 ,$11.38 ,$56.95 ,$19.68 ,$46.43 ,$7.87 ,$67.00 ,$36.85 ,$7.87 ,$17.62 , N/A ,$7.88 ,$7.52 ,$8.26 ,$53.60 ,$36.38 ,$18.76 ,$60.30 ,$25.46 ,$15.74 ,$7.87 ,$32.16 
ST. MARY'S HOSPITAL - DECATUR,30101217,82482,HC CHOLINESTERASE RBC-90,301,1 ,$67.00 ,$43.55 ,$3.50 ,$67.00 ,$24.53 ,$17.96 ,$36.85 ,$9.81 ,$18.76 ,$32.83 ,$9.81 ,$39.20 ,$9.81 ,$36.38 ,$3.50 ,$9.81 ,$36.38 ,$18.64 ,$46.90 ,$33.50 ,$53.60 ,$24.53 ,$9.81 ,$46.90 ,$9.81 ,$40.20 ,$9.81 ,$50.25 ,$36.98 ,$33.37 ,$36.98 ,$9.81 ,$36.98 ,$12.75 ,$12.75 ,$56.95 ,$24.53 ,$46.43 ,$9.81 ,$67.00 ,$36.85 ,$9.81 ,$17.62 , N/A ,$7.88 ,$7.52 ,$10.30 ,$53.60 ,$36.38 ,$18.76 ,$60.30 ,$25.46 ,$19.62 ,$9.81 ,$32.16 
ST. MARY'S HOSPITAL - DECATUR,30101218,82495,HC CHROMIUM SERUM-90,301,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$50.70 ,$47.40 ,$89.10 ,$20.28 ,$45.36 ,$79.38 ,$20.28 ,$94.77 ,$20.28 ,$87.97 ,$3.50 ,$20.28 ,$87.97 ,$38.53 ,$113.40 ,$81.00 ,$129.60 ,$50.70 ,$20.28 ,$113.40 ,$20.28 ,$97.20 ,$20.28 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$20.28 ,$89.42 ,$29.29 ,$29.29 ,$137.70 ,$50.70 ,$112.27 ,$20.28 ,$162.00 ,$89.10 ,$20.28 ,$42.61 , N/A ,$9.61 ,$9.18 ,$21.29 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$40.56 ,$20.28 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30101219,82507,HC CITRATE-90,301,1 ,$46.00 ,$29.90 ,$3.50 ,$69.50 ,$69.50 ,$29.88 ,$25.30 ,$27.80 ,$12.88 ,$22.54 ,$27.80 ,$26.91 ,$27.80 ,$24.98 ,$3.50 ,$27.80 ,$24.98 ,$46.00 ,$32.20 ,$23.00 ,$36.80 ,$69.50 ,$27.80 ,$32.20 ,$27.80 ,$27.60 ,$27.80 ,$34.50 ,$25.39 ,$22.91 ,$25.39 ,$27.80 ,$25.39 ,$40.16 ,$40.16 ,$39.10 ,$46.00 ,$31.88 ,$27.80 ,$46.00 ,$25.30 ,$27.80 ,$12.10 , N/A ,$7.88 ,$7.52 ,$29.19 ,$36.80 ,$24.98 ,$12.88 ,$41.40 ,$17.48 ,$46.00 ,$27.80 ,$22.08 
ST. MARY'S HOSPITAL - DECATUR,30101220,82523,HC COLLAGEN CROSS LINKS ANY METHOD-90,301,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$46.70 ,$43.68 ,$106.15 ,$18.68 ,$54.04 ,$94.57 ,$18.68 ,$112.91 ,$18.68 ,$104.80 ,$3.50 ,$18.68 ,$104.80 ,$35.49 ,$135.10 ,$96.50 ,$154.40 ,$46.70 ,$18.68 ,$135.10 ,$18.68 ,$115.80 ,$18.68 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$18.68 ,$106.54 ,$26.99 ,$26.99 ,$164.05 ,$46.70 ,$133.75 ,$18.68 ,$193.00 ,$106.15 ,$18.68 ,$50.76 , N/A ,$12.17 ,$11.61 ,$19.61 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$37.36 ,$18.68 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30101221,82525,HC COPPER-90,301,1 ,$99.00 ,$64.35 ,$3.50 ,$99.00 ,$31.03 ,$28.14 ,$54.45 ,$12.41 ,$27.72 ,$48.51 ,$12.41 ,$57.92 ,$12.41 ,$53.76 ,$3.50 ,$12.41 ,$53.76 ,$23.58 ,$69.30 ,$49.50 ,$79.20 ,$31.03 ,$12.41 ,$69.30 ,$12.41 ,$59.40 ,$12.41 ,$74.25 ,$54.65 ,$49.30 ,$54.65 ,$12.41 ,$54.65 ,$17.93 ,$17.93 ,$84.15 ,$31.03 ,$68.61 ,$12.41 ,$99.00 ,$54.45 ,$12.41 ,$26.04 , N/A ,$9.61 ,$9.18 ,$13.03 ,$79.20 ,$53.76 ,$27.72 ,$89.10 ,$37.62 ,$24.82 ,$12.41 ,$47.52 
ST. MARY'S HOSPITAL - DECATUR,30101222,82530,HC CORTISOL FREE-90,301,1 ,$100.00 ,$65.00 ,$3.50 ,$100.00 ,$41.78 ,$39.04 ,$55.00 ,$16.71 ,$28.00 ,$49.00 ,$16.71 ,$58.50 ,$16.71 ,$54.30 ,$3.50 ,$16.71 ,$54.30 ,$31.75 ,$70.00 ,$50.00 ,$80.00 ,$41.78 ,$16.71 ,$70.00 ,$16.71 ,$60.00 ,$16.71 ,$75.00 ,$55.20 ,$49.80 ,$55.20 ,$16.71 ,$55.20 ,$24.14 ,$24.14 ,$85.00 ,$41.78 ,$69.30 ,$16.71 ,$100.00 ,$55.00 ,$16.71 ,$26.30 , N/A ,$7.88 ,$7.52 ,$17.55 ,$80.00 ,$54.30 ,$28.00 ,$90.00 ,$38.00 ,$33.42 ,$16.71 ,$48.00 
ST. MARY'S HOSPITAL - DECATUR,30101223,82533,HC CORTISOL TOTAL-90,301,1 ,$271.00 ,$176.15 ,$3.50 ,$271.00 ,$40.75 ,$38.10 ,$149.05 ,$16.30 ,$75.88 ,$128.58 ,$16.30 ,$128.58 ,$16.30 ,$147.15 ,$3.50 ,$16.30 ,$147.15 ,$30.97 ,$189.70 ,$135.50 ,$216.80 ,$40.75 ,$16.30 ,$189.70 ,$16.30 ,$162.60 ,$16.30 ,$203.25 ,$149.59 ,$134.96 ,$149.59 ,$16.30 ,$149.59 ,$23.54 ,$23.54 ,$230.35 ,$40.75 ,$187.80 ,$16.30 ,$271.00 ,$149.05 ,$16.30 ,$71.27 , N/A ,$18.45 ,$17.61 ,$17.12 ,$216.80 ,$147.15 ,$75.88 ,$243.90 ,$102.98 ,$32.60 ,$16.30 ,$130.08 
ST. MARY'S HOSPITAL - DECATUR,30101224,82542,HC CHROMO SPECTROMETRY -90,301,1 ,$285.00 ,$185.25 ,$3.50 ,$285.00 ,$60.23 ,$42.20 ,$156.75 ,$24.09 ,$79.80 ,$139.65 ,$24.09 ,$153.94 ,$24.09 ,$154.76 ,$3.50 ,$24.09 ,$154.76 ,$45.77 ,$199.50 ,$142.50 ,$228.00 ,$60.23 ,$24.09 ,$199.50 ,$24.09 ,$171.00 ,$24.09 ,$213.75 ,$157.32 ,$141.93 ,$157.32 ,$24.09 ,$157.32 ,$31.32 ,$31.32 ,$242.25 ,$60.23 ,$197.51 ,$24.09 ,$285.00 ,$156.75 ,$24.09 ,$74.96 , N/A ,$7.88 ,$7.52 ,$25.29 ,$228.00 ,$154.76 ,$79.80 ,$256.50 ,$108.30 ,$48.18 ,$24.09 ,$136.80 
ST. MARY'S HOSPITAL - DECATUR,30101225,82550,HC CREATINE KINASE (CPK) TOTAL-90,301,1 ,$163.00 ,$105.95 ,$3.35 ,$163.00 ,$16.28 ,$15.22 ,$89.65 ,$6.51 ,$45.64 ,$69.60 ,$6.51 ,$69.60 ,$6.51 ,$88.51 ,$3.50 ,$6.51 ,$88.51 ,$12.37 ,$114.10 ,$81.50 ,$130.40 ,$16.28 ,$6.51 ,$114.10 ,$6.51 ,$97.80 ,$6.51 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$6.51 ,$89.98 ,$9.40 ,$9.40 ,$138.55 ,$16.28 ,$112.96 ,$6.51 ,$163.00 ,$89.65 ,$6.51 ,$42.87 , N/A ,$3.51 ,$3.35 ,$6.84 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$13.02 ,$6.51 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30101226,82552,HC CREATINE KINASE (CPK) ISO-90,301,1 ,$128.00 ,$83.20 ,$3.50 ,$128.00 ,$33.48 ,$31.32 ,$70.40 ,$13.39 ,$35.84 ,$62.72 ,$13.39 ,$74.88 ,$13.39 ,$69.50 ,$3.50 ,$13.39 ,$69.50 ,$25.44 ,$89.60 ,$64.00 ,$102.40 ,$33.48 ,$13.39 ,$89.60 ,$13.39 ,$76.80 ,$13.39 ,$96.00 ,$70.66 ,$63.74 ,$70.66 ,$13.39 ,$70.66 ,$19.34 ,$19.34 ,$108.80 ,$33.48 ,$88.70 ,$13.39 ,$128.00 ,$70.40 ,$13.39 ,$33.66 , N/A ,$7.88 ,$7.52 ,$14.06 ,$102.40 ,$69.50 ,$35.84 ,$115.20 ,$48.64 ,$26.78 ,$13.39 ,$61.44 
ST. MARY'S HOSPITAL - DECATUR,30101227,82565,HC CREATININE-QW,301,1 ,$167.00 ,$108.55 ,$3.35 ,$167.00 ,$12.80 ,$11.96 ,$91.85 ,$5.12 ,$46.76 ,$54.75 ,$5.12 ,$54.75 ,$5.12 ,$90.68 ,$3.50 ,$5.12 ,$90.68 ,$9.73 ,$116.90 ,$83.50 ,$133.60 ,$12.80 ,$5.12 ,$116.90 ,$5.12 ,$100.20 ,$5.12 ,$125.25 ,$92.18 ,$83.17 ,$92.18 ,$5.12 ,$92.18 ,$7.40 ,$7.40 ,$141.95 ,$12.80 ,$115.73 ,$5.12 ,$5.12 ,$91.85 ,$5.12 ,$43.92 , N/A ,$3.51 ,$3.35 ,$5.38 ,$133.60 ,$90.68 ,$46.76 ,$150.30 ,$63.46 ,$10.24 ,$5.12 ,$80.16 
ST. MARY'S HOSPITAL - DECATUR,30101231,82570,HC CREATININE OTH SOURCE-90,301,1 ,$170.00 ,$110.50 ,$3.35 ,$170.00 ,$12.95 ,$12.08 ,$93.50 ,$5.18 ,$47.60 ,$55.24 ,$5.18 ,$55.24 ,$5.18 ,$92.31 ,$3.50 ,$5.18 ,$92.31 ,$9.84 ,$119.00 ,$85.00 ,$136.00 ,$12.95 ,$5.18 ,$119.00 ,$5.18 ,$102.00 ,$5.18 ,$127.50 ,$93.84 ,$84.66 ,$93.84 ,$5.18 ,$93.84 ,$7.48 ,$7.48 ,$144.50 ,$12.95 ,$117.81 ,$5.18 ,$170.00 ,$93.50 ,$5.18 ,$44.71 , N/A ,$3.51 ,$3.35 ,$5.44 ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$10.36 ,$5.18 ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,30101232,82585,HC CRYOFIBRINOGEN-90,301,1 ,$80.00 ,$52.00 ,$3.50 ,$80.00 ,$35.35 ,$20.06 ,$44.00 ,$14.14 ,$22.40 ,$39.20 ,$14.14 ,$46.80 ,$14.14 ,$43.44 ,$3.50 ,$14.14 ,$43.44 ,$26.87 ,$56.00 ,$40.00 ,$64.00 ,$35.35 ,$14.14 ,$56.00 ,$14.14 ,$48.00 ,$14.14 ,$60.00 ,$44.16 ,$39.84 ,$44.16 ,$14.14 ,$44.16 ,$18.38 ,$18.38 ,$68.00 ,$35.35 ,$55.44 ,$14.14 ,$80.00 ,$44.00 ,$14.14 ,$21.04 , N/A ,$7.88 ,$7.52 ,$14.85 ,$64.00 ,$43.44 ,$22.40 ,$72.00 ,$30.40 ,$28.28 ,$14.14 ,$38.40 
ST. MARY'S HOSPITAL - DECATUR,30101233,82595,HC CRYOGLOBULIN QL OR SQN-90,301,1 ,$80.00 ,$52.00 ,$3.50 ,$80.00 ,$16.18 ,$15.12 ,$44.00 ,$6.47 ,$22.40 ,$39.20 ,$6.47 ,$46.80 ,$6.47 ,$43.44 ,$3.50 ,$6.47 ,$43.44 ,$12.29 ,$56.00 ,$40.00 ,$64.00 ,$16.18 ,$6.47 ,$56.00 ,$6.47 ,$48.00 ,$6.47 ,$60.00 ,$44.16 ,$39.84 ,$44.16 ,$6.47 ,$44.16 ,$9.33 ,$9.33 ,$68.00 ,$16.18 ,$55.44 ,$6.47 ,$80.00 ,$44.00 ,$6.47 ,$21.04 , N/A ,$7.88 ,$7.52 ,$6.79 ,$64.00 ,$43.44 ,$22.40 ,$72.00 ,$30.40 ,$12.94 ,$6.47 ,$38.40 
ST. MARY'S HOSPITAL - DECATUR,30101234,82600,HC CYANIDE-90,301,1 ,$208.00 ,$135.20 ,$3.50 ,$208.00 ,$48.50 ,$45.32 ,$114.40 ,$19.40 ,$58.24 ,$101.92 ,$19.40 ,$121.68 ,$19.40 ,$112.94 ,$3.50 ,$19.40 ,$112.94 ,$36.86 ,$145.60 ,$104.00 ,$166.40 ,$48.50 ,$19.40 ,$145.60 ,$19.40 ,$124.80 ,$19.40 ,$156.00 ,$114.82 ,$103.58 ,$114.82 ,$19.40 ,$114.82 ,$28.02 ,$28.02 ,$176.80 ,$48.50 ,$144.14 ,$19.40 ,$208.00 ,$114.40 ,$19.40 ,$54.70 , N/A ,$9.61 ,$9.18 ,$20.37 ,$166.40 ,$112.94 ,$58.24 ,$187.20 ,$79.04 ,$38.80 ,$19.40 ,$99.84 
ST. MARY'S HOSPITAL - DECATUR,30101236,82608,HC VITAMIN B-12 BINDING CAPACITY-90,301,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$35.80 ,$33.46 ,$80.30 ,$14.32 ,$40.88 ,$71.54 ,$14.32 ,$85.41 ,$14.32 ,$79.28 ,$3.50 ,$14.32 ,$79.28 ,$27.21 ,$102.20 ,$73.00 ,$116.80 ,$35.80 ,$14.32 ,$102.20 ,$14.32 ,$87.60 ,$14.32 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$14.32 ,$80.59 ,$20.68 ,$20.68 ,$124.10 ,$35.80 ,$101.18 ,$14.32 ,$146.00 ,$80.30 ,$14.32 ,$38.40 , N/A ,$7.88 ,$7.52 ,$15.04 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$28.64 ,$14.32 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30101237,82626,HC DHEA-90,301,1 ,$215.00 ,$139.75 ,$3.50 ,$215.00 ,$63.18 ,$59.06 ,$118.25 ,$25.27 ,$60.20 ,$105.35 ,$25.27 ,$125.78 ,$25.27 ,$116.75 ,$3.50 ,$25.27 ,$116.75 ,$48.01 ,$150.50 ,$107.50 ,$172.00 ,$63.18 ,$25.27 ,$150.50 ,$25.27 ,$129.00 ,$25.27 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$25.27 ,$118.68 ,$36.50 ,$36.50 ,$182.75 ,$63.18 ,$149.00 ,$25.27 ,$215.00 ,$118.25 ,$25.27 ,$56.55 , N/A ,$7.88 ,$7.52 ,$26.53 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$50.54 ,$25.27 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,30101238,82627,HC DHEA SULFATE-90,301,1 ,$178.00 ,$115.70 ,$3.50 ,$178.00 ,$55.58 ,$51.96 ,$97.90 ,$22.23 ,$49.84 ,$87.22 ,$22.23 ,$104.13 ,$22.23 ,$96.65 ,$3.50 ,$22.23 ,$96.65 ,$42.24 ,$124.60 ,$89.00 ,$142.40 ,$55.58 ,$22.23 ,$124.60 ,$22.23 ,$106.80 ,$22.23 ,$133.50 ,$98.26 ,$88.64 ,$98.26 ,$22.23 ,$98.26 ,$32.12 ,$32.12 ,$151.30 ,$55.58 ,$123.35 ,$22.23 ,$178.00 ,$97.90 ,$22.23 ,$46.81 , N/A ,$18.45 ,$17.61 ,$23.34 ,$142.40 ,$96.65 ,$49.84 ,$160.20 ,$67.64 ,$44.46 ,$22.23 ,$85.44 
ST. MARY'S HOSPITAL - DECATUR,30101240,82652,HC VITAMIN D (1 25 DIHYDROXY)-90,301,1 ,$315.00 ,$204.75 ,$3.50 ,$315.00 ,$96.25 ,$89.96 ,$173.25 ,$38.50 ,$88.20 ,$154.35 ,$38.50 ,$184.28 ,$38.50 ,$171.05 ,$3.50 ,$38.50 ,$171.05 ,$73.15 ,$220.50 ,$157.50 ,$252.00 ,$96.25 ,$38.50 ,$220.50 ,$38.50 ,$189.00 ,$38.50 ,$236.25 ,$173.88 ,$156.87 ,$173.88 ,$38.50 ,$173.88 ,$55.61 ,$55.61 ,$267.75 ,$96.25 ,$218.30 ,$38.50 ,$315.00 ,$173.25 ,$38.50 ,$82.85 , N/A ,$21.22 ,$20.25 ,$40.43 ,$252.00 ,$171.05 ,$88.20 ,$283.50 ,$119.70 ,$77.00 ,$38.50 ,$151.20 
ST. MARY'S HOSPITAL - DECATUR,30101241,82656,HC ELASTASE PANCREATIC EL1 FECAL QL OR SQN-90,301,1 ,$433.00 ,$281.45 ,$3.50 ,$433.00 ,$28.83 ,$26.96 ,$238.15 ,$11.53 ,$121.24 ,$91.03 ,$11.53 ,$91.03 ,$11.53 ,$235.12 ,$3.50 ,$11.53 ,$235.12 ,$21.91 ,$303.10 ,$216.50 ,$346.40 ,$28.83 ,$11.53 ,$303.10 ,$11.53 ,$259.80 ,$11.53 ,$324.75 ,$239.02 ,$215.63 ,$239.02 ,$11.53 ,$239.02 ,$16.65 ,$16.65 ,$368.05 ,$28.83 ,$300.07 ,$11.53 ,$433.00 ,$238.15 ,$11.53 ,$113.88 , N/A ,$7.88 ,$7.52 ,$12.11 ,$346.40 ,$235.12 ,$121.24 ,$389.70 ,$164.54 ,$23.06 ,$11.53 ,$207.84 
ST. MARY'S HOSPITAL - DECATUR,30101242,82657,HC ENZYME ACT NONRAD SUBS-90,301,1 ,$296.00 ,$192.40 ,$3.50 ,$296.00 ,$55.43 ,$42.20 ,$162.80 ,$22.17 ,$82.88 ,$142.44 ,$22.17 ,$142.44 ,$22.17 ,$160.73 ,$3.50 ,$22.17 ,$160.73 ,$42.12 ,$207.20 ,$148.00 ,$236.80 ,$55.43 ,$22.17 ,$207.20 ,$22.17 ,$177.60 ,$22.17 ,$222.00 ,$163.39 ,$147.41 ,$163.39 ,$22.17 ,$163.39 ,$28.82 ,$28.82 ,$251.60 ,$55.43 ,$205.13 ,$22.17 ,$296.00 ,$162.80 ,$22.17 ,$77.85 , N/A ,$7.88 ,$7.52 ,$23.28 ,$236.80 ,$160.73 ,$82.88 ,$266.40 ,$112.48 ,$44.34 ,$22.17 ,$142.08 
ST. MARY'S HOSPITAL - DECATUR,30101244,82664,HC ELECTROPHORETIC TEST-90,301,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$153.75 ,$64.56 ,$106.15 ,$61.50 ,$54.04 ,$94.57 ,$61.50 ,$112.91 ,$61.50 ,$104.80 ,$3.50 ,$61.50 ,$104.80 ,$116.85 ,$135.10 ,$96.50 ,$154.40 ,$153.75 ,$61.50 ,$135.10 ,$61.50 ,$115.80 ,$61.50 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$61.50 ,$106.54 ,$79.95 ,$79.95 ,$164.05 ,$153.75 ,$133.75 ,$61.50 ,$193.00 ,$106.15 ,$61.50 ,$50.76 , N/A ,$21.22 ,$20.25 ,$64.58 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$123.00 ,$61.50 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30101245,82668,HC ERYTHROPOIETIN-90,301,1 ,$189.00 ,$122.85 ,$3.50 ,$189.00 ,$46.98 ,$43.92 ,$103.95 ,$18.79 ,$52.92 ,$92.61 ,$18.79 ,$110.57 ,$18.79 ,$102.63 ,$3.50 ,$18.79 ,$102.63 ,$35.70 ,$132.30 ,$94.50 ,$151.20 ,$46.98 ,$18.79 ,$132.30 ,$18.79 ,$113.40 ,$18.79 ,$141.75 ,$104.33 ,$94.12 ,$104.33 ,$18.79 ,$104.33 ,$27.14 ,$27.14 ,$160.65 ,$46.98 ,$130.98 ,$18.79 ,$189.00 ,$103.95 ,$18.79 ,$49.71 , N/A ,$7.88 ,$7.52 ,$19.73 ,$151.20 ,$102.63 ,$52.92 ,$170.10 ,$71.82 ,$37.58 ,$18.79 ,$90.72 
ST. MARY'S HOSPITAL - DECATUR,30101246,82670,HC ESTRADIOL-90,301,1 ,$204.00 ,$132.60 ,$3.50 ,$204.00 ,$69.85 ,$26.50 ,$112.20 ,$27.94 ,$57.12 ,$99.96 ,$27.94 ,$119.34 ,$27.94 ,$110.77 ,$3.50 ,$27.94 ,$110.77 ,$53.09 ,$142.80 ,$102.00 ,$163.20 ,$69.85 ,$27.94 ,$142.80 ,$27.94 ,$122.40 ,$27.94 ,$153.00 ,$112.61 ,$101.59 ,$112.61 ,$27.94 ,$112.61 ,$40.35 ,$40.35 ,$173.40 ,$69.85 ,$141.37 ,$27.94 ,$204.00 ,$112.20 ,$27.94 ,$53.65 , N/A ,$18.45 ,$17.61 ,$29.34 ,$163.20 ,$110.77 ,$57.12 ,$183.60 ,$77.52 ,$55.88 ,$27.94 ,$97.92 
ST. MARY'S HOSPITAL - DECATUR,30101248,82671,HC ESTROGEN FRACTIONATED-90,301,1 ,$233.00 ,$151.45 ,$3.50 ,$233.00 ,$80.75 ,$59.76 ,$128.15 ,$32.30 ,$65.24 ,$114.17 ,$32.30 ,$136.31 ,$32.30 ,$126.52 ,$3.50 ,$32.30 ,$126.52 ,$61.37 ,$163.10 ,$116.50 ,$186.40 ,$80.75 ,$32.30 ,$163.10 ,$32.30 ,$139.80 ,$32.30 ,$174.75 ,$128.62 ,$116.03 ,$128.62 ,$32.30 ,$128.62 ,$46.66 ,$46.66 ,$198.05 ,$80.75 ,$161.47 ,$32.30 ,$233.00 ,$128.15 ,$32.30 ,$61.28 , N/A ,$18.45 ,$17.61 ,$33.92 ,$186.40 ,$126.52 ,$65.24 ,$209.70 ,$88.54 ,$64.60 ,$32.30 ,$111.84 
ST. MARY'S HOSPITAL - DECATUR,30101249,82672,HC ESTROGEN TOTAL-90,301,1 ,$226.00 ,$146.90 ,$3.50 ,$226.00 ,$54.25 ,$50.70 ,$124.30 ,$21.70 ,$63.28 ,$110.74 ,$21.70 ,$132.21 ,$21.70 ,$122.72 ,$3.50 ,$21.70 ,$122.72 ,$41.23 ,$158.20 ,$113.00 ,$180.80 ,$54.25 ,$21.70 ,$158.20 ,$21.70 ,$135.60 ,$21.70 ,$169.50 ,$124.75 ,$112.55 ,$124.75 ,$21.70 ,$124.75 ,$31.34 ,$31.34 ,$192.10 ,$54.25 ,$156.62 ,$21.70 ,$226.00 ,$124.30 ,$21.70 ,$59.44 , N/A ,$18.45 ,$17.61 ,$22.79 ,$180.80 ,$122.72 ,$63.28 ,$203.40 ,$85.88 ,$43.40 ,$21.70 ,$108.48 
ST. MARY'S HOSPITAL - DECATUR,30101250,82677,HC ESTRIOL-90,301,1 ,$83.00 ,$53.95 ,$3.50 ,$83.00 ,$60.45 ,$26.02 ,$45.65 ,$24.18 ,$23.24 ,$40.67 ,$24.18 ,$48.56 ,$24.18 ,$45.07 ,$3.50 ,$24.18 ,$45.07 ,$45.94 ,$58.10 ,$41.50 ,$66.40 ,$60.45 ,$24.18 ,$58.10 ,$24.18 ,$49.80 ,$24.18 ,$62.25 ,$45.82 ,$41.33 ,$45.82 ,$24.18 ,$45.82 ,$34.93 ,$34.93 ,$70.55 ,$60.45 ,$57.52 ,$24.18 ,$83.00 ,$45.65 ,$24.18 ,$21.83 , N/A ,$18.45 ,$17.61 ,$25.39 ,$66.40 ,$45.07 ,$23.24 ,$74.70 ,$31.54 ,$48.36 ,$24.18 ,$39.84 
ST. MARY'S HOSPITAL - DECATUR,30101251,82679,HC ESTRONE-90,301,1 ,$123.00 ,$79.95 ,$3.50 ,$123.00 ,$62.38 ,$26.12 ,$67.65 ,$24.95 ,$34.44 ,$60.27 ,$24.95 ,$71.96 ,$24.95 ,$66.79 ,$3.50 ,$24.95 ,$66.79 ,$47.41 ,$86.10 ,$61.50 ,$98.40 ,$62.38 ,$24.95 ,$86.10 ,$24.95 ,$73.80 ,$24.95 ,$92.25 ,$67.90 ,$61.25 ,$67.90 ,$24.95 ,$67.90 ,$36.05 ,$36.05 ,$104.55 ,$62.38 ,$85.24 ,$24.95 ,$123.00 ,$67.65 ,$24.95 ,$32.35 , N/A ,$18.45 ,$17.61 ,$26.20 ,$98.40 ,$66.79 ,$34.44 ,$110.70 ,$46.74 ,$49.90 ,$24.95 ,$59.04 
ST. MARY'S HOSPITAL - DECATUR,30101252,82693,HC ETHYLENE GLYCOL-90,301,1 ,$262.00 ,$170.30 ,$3.50 ,$262.00 ,$37.25 ,$34.82 ,$144.10 ,$14.90 ,$73.36 ,$117.57 ,$14.90 ,$117.57 ,$14.90 ,$142.27 ,$3.50 ,$14.90 ,$142.27 ,$28.31 ,$183.40 ,$131.00 ,$209.60 ,$37.25 ,$14.90 ,$183.40 ,$14.90 ,$157.20 ,$14.90 ,$196.50 ,$144.62 ,$130.48 ,$144.62 ,$14.90 ,$144.62 ,$21.53 ,$21.53 ,$222.70 ,$37.25 ,$181.57 ,$14.90 ,$262.00 ,$144.10 ,$14.90 ,$68.91 , N/A ,$9.61 ,$9.18 ,$15.65 ,$209.60 ,$142.27 ,$73.36 ,$235.80 ,$99.56 ,$29.80 ,$14.90 ,$125.76 
ST. MARY'S HOSPITAL - DECATUR,30101253,82705,HC FECAL FAT QUALITATIVE-90,301,1 ,$7.00 ,$4.55 ,$1.84 ,$12.75 ,$12.75 ,$6.64 ,$3.85 ,$5.10 ,$1.96 ,$3.43 ,$5.10 ,$4.10 ,$5.10 ,$3.80 ,$3.50 ,$5.10 ,$3.80 ,$7.00 ,$4.90 ,$3.50 ,$5.60 ,$12.75 ,$5.10 ,$4.90 ,$5.10 ,$4.20 ,$5.10 ,$5.25 ,$3.86 ,$3.49 ,$3.86 ,$5.10 ,$3.86 ,$7.00 ,$7.00 ,$5.95 ,$7.00 ,$4.85 ,$5.10 ,$7.00 ,$3.85 ,$5.10 ,$1.84 , N/A ,$3.51 ,$3.35 ,$5.36 ,$5.60 ,$3.80 ,$1.96 ,$6.30 ,$2.66 ,$7.00 ,$5.10 ,$3.36 
ST. MARY'S HOSPITAL - DECATUR,30101254,82710,HC FECAL FAT QN-90,301,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$42.00 ,$8.14 ,$106.15 ,$16.80 ,$54.04 ,$94.57 ,$16.80 ,$112.91 ,$16.80 ,$104.80 ,$3.50 ,$16.80 ,$104.80 ,$31.92 ,$135.10 ,$96.50 ,$154.40 ,$42.00 ,$16.80 ,$135.10 ,$16.80 ,$115.80 ,$16.80 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$16.80 ,$106.54 ,$24.27 ,$24.27 ,$164.05 ,$42.00 ,$133.75 ,$16.80 ,$193.00 ,$106.15 ,$16.80 ,$50.76 , N/A ,$7.88 ,$7.52 ,$17.64 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$33.60 ,$16.80 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30101255,82726,HC FATTY ACIDS VERY LONG CHAIN-90,301,1 ,$383.00 ,$248.95 ,$3.50 ,$383.00 ,$49.38 ,$42.20 ,$210.65 ,$19.75 ,$107.24 ,$142.44 ,$19.75 ,$142.44 ,$19.75 ,$207.97 ,$3.50 ,$19.75 ,$207.97 ,$37.53 ,$268.10 ,$191.50 ,$306.40 ,$49.38 ,$19.75 ,$268.10 ,$19.75 ,$229.80 ,$19.75 ,$287.25 ,$211.42 ,$190.73 ,$211.42 ,$19.75 ,$211.42 ,$26.08 ,$26.08 ,$325.55 ,$49.38 ,$265.42 ,$19.75 ,$383.00 ,$210.65 ,$19.75 ,$100.73 , N/A ,$7.88 ,$7.52 ,$20.74 ,$306.40 ,$207.97 ,$107.24 ,$344.70 ,$145.54 ,$39.50 ,$19.75 ,$183.84 
ST. MARY'S HOSPITAL - DECATUR,30101256,82728,HC FERRITIN-90,301,1 ,$230.00 ,$149.50 ,$3.50 ,$230.00 ,$34.08 ,$31.84 ,$126.50 ,$13.63 ,$64.40 ,$107.54 ,$13.63 ,$107.54 ,$13.63 ,$124.89 ,$3.50 ,$13.63 ,$124.89 ,$25.90 ,$161.00 ,$115.00 ,$184.00 ,$34.08 ,$13.63 ,$161.00 ,$13.63 ,$138.00 ,$13.63 ,$172.50 ,$126.96 ,$114.54 ,$126.96 ,$13.63 ,$126.96 ,$19.70 ,$19.70 ,$195.50 ,$34.08 ,$159.39 ,$13.63 ,$230.00 ,$126.50 ,$13.63 ,$60.49 , N/A ,$7.88 ,$7.52 ,$14.31 ,$184.00 ,$124.89 ,$64.40 ,$207.00 ,$87.40 ,$27.26 ,$13.63 ,$110.40 
ST. MARY'S HOSPITAL - DECATUR,30101257,82731,HC FETAL FIBRONECTIN-90,301,1 ,$363.00 ,$235.95 ,$3.50 ,$363.00 ,$161.03 ,$109.38 ,$199.65 ,$64.41 ,$101.64 ,$177.87 ,$64.41 ,$212.36 ,$64.41 ,$197.11 ,$3.50 ,$64.41 ,$197.11 ,$122.38 ,$254.10 ,$181.50 ,$290.40 ,$161.03 ,$64.41 ,$254.10 ,$64.41 ,$217.80 ,$64.41 ,$272.25 ,$200.38 ,$180.77 ,$200.38 ,$64.41 ,$200.38 ,$93.04 ,$93.04 ,$308.55 ,$161.03 ,$251.56 ,$64.41 ,$363.00 ,$199.65 ,$64.41 ,$95.47 , N/A ,$21.22 ,$20.25 ,$67.63 ,$290.40 ,$197.11 ,$101.64 ,$326.70 ,$137.94 ,$128.82 ,$64.41 ,$174.24 
ST. MARY'S HOSPITAL - DECATUR,30101258,82731,HC FETAL FIBRONECTIN,301,1 ,$330.00 ,$214.50 ,$3.50 ,$330.00 ,$161.03 ,$109.38 ,$181.50 ,$64.41 ,$92.40 ,$161.70 ,$64.41 ,$193.05 ,$64.41 ,$179.19 ,$3.50 ,$64.41 ,$179.19 ,$122.38 ,$231.00 ,$165.00 ,$264.00 ,$161.03 ,$64.41 ,$231.00 ,$64.41 ,$198.00 ,$64.41 ,$247.50 ,$182.16 ,$164.34 ,$182.16 ,$64.41 ,$182.16 ,$93.04 ,$93.04 ,$280.50 ,$161.03 ,$228.69 ,$64.41 ,$330.00 ,$181.50 ,$64.41 ,$86.79 , N/A ,$21.22 ,$20.25 ,$67.63 ,$264.00 ,$179.19 ,$92.40 ,$297.00 ,$125.40 ,$128.82 ,$64.41 ,$158.40 
ST. MARY'S HOSPITAL - DECATUR,30101259,82747,HC FOLIC ACID RBC-90,301,1 ,$224.00 ,$145.60 ,$3.50 ,$224.00 ,$44.13 ,$40.48 ,$123.20 ,$17.65 ,$62.72 ,$109.76 ,$17.65 ,$131.04 ,$17.65 ,$121.63 ,$3.50 ,$17.65 ,$121.63 ,$33.54 ,$156.80 ,$112.00 ,$179.20 ,$44.13 ,$17.65 ,$156.80 ,$17.65 ,$134.40 ,$17.65 ,$168.00 ,$123.65 ,$111.55 ,$123.65 ,$17.65 ,$123.65 ,$25.03 ,$25.03 ,$190.40 ,$44.13 ,$155.23 ,$17.65 ,$224.00 ,$123.20 ,$17.65 ,$58.91 , N/A ,$4.90 ,$4.67 ,$18.53 ,$179.20 ,$121.63 ,$62.72 ,$201.60 ,$85.12 ,$35.30 ,$17.65 ,$107.52 
ST. MARY'S HOSPITAL - DECATUR,30101260,82757,HC SEMEN ANALYSIS FRUCTOSE-90,301,1 ,$261.00 ,$169.65 ,$3.50 ,$261.00 ,$43.35 ,$40.52 ,$143.55 ,$17.34 ,$73.08 ,$127.89 ,$17.34 ,$136.74 ,$17.34 ,$141.72 ,$3.50 ,$17.34 ,$141.72 ,$32.95 ,$182.70 ,$130.50 ,$208.80 ,$43.35 ,$17.34 ,$182.70 ,$17.34 ,$156.60 ,$17.34 ,$195.75 ,$144.07 ,$129.98 ,$144.07 ,$17.34 ,$144.07 ,$25.04 ,$25.04 ,$221.85 ,$43.35 ,$180.87 ,$17.34 ,$261.00 ,$143.55 ,$17.34 ,$68.64 , N/A ,$7.88 ,$7.52 ,$18.21 ,$208.80 ,$141.72 ,$73.08 ,$234.90 ,$99.18 ,$34.68 ,$17.34 ,$125.28 
ST. MARY'S HOSPITAL - DECATUR,30101261,82775,HC GALACTOSE TRANSFERASE QN-90,301,1 ,$207.00 ,$134.55 ,$3.50 ,$207.00 ,$52.68 ,$41.42 ,$113.85 ,$21.07 ,$57.96 ,$101.43 ,$21.07 ,$121.10 ,$21.07 ,$112.40 ,$3.50 ,$21.07 ,$112.40 ,$40.03 ,$144.90 ,$103.50 ,$165.60 ,$52.68 ,$21.07 ,$144.90 ,$21.07 ,$124.20 ,$21.07 ,$155.25 ,$114.26 ,$103.09 ,$114.26 ,$21.07 ,$114.26 ,$30.43 ,$30.43 ,$175.95 ,$52.68 ,$143.45 ,$21.07 ,$207.00 ,$113.85 ,$21.07 ,$54.44 , N/A ,$7.88 ,$7.52 ,$22.12 ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$42.14 ,$21.07 ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,30101262,82784,HC GAMMAGLOBULIN-90,301,1 ,$87.00 ,$56.55 ,$3.50 ,$87.00 ,$23.25 ,$21.72 ,$47.85 ,$9.30 ,$24.36 ,$42.63 ,$9.30 ,$50.90 ,$9.30 ,$47.24 ,$3.50 ,$9.30 ,$47.24 ,$17.67 ,$60.90 ,$43.50 ,$69.60 ,$23.25 ,$9.30 ,$60.90 ,$9.30 ,$52.20 ,$9.30 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$9.30 ,$48.02 ,$13.44 ,$13.44 ,$73.95 ,$23.25 ,$60.29 ,$9.30 ,$87.00 ,$47.85 ,$9.30 ,$22.88 , N/A ,$7.88 ,$7.52 ,$9.77 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$18.60 ,$9.30 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30101263,82785,HC GAMMAGLOBULIN IGE-90,301,1 ,$119.00 ,$77.35 ,$3.50 ,$119.00 ,$41.15 ,$38.48 ,$65.45 ,$16.46 ,$33.32 ,$58.31 ,$16.46 ,$69.62 ,$16.46 ,$64.62 ,$3.50 ,$16.46 ,$64.62 ,$31.27 ,$83.30 ,$59.50 ,$95.20 ,$41.15 ,$16.46 ,$83.30 ,$16.46 ,$71.40 ,$16.46 ,$89.25 ,$65.69 ,$59.26 ,$65.69 ,$16.46 ,$65.69 ,$23.78 ,$23.78 ,$101.15 ,$41.15 ,$82.47 ,$16.46 ,$119.00 ,$65.45 ,$16.46 ,$31.30 , N/A ,$7.88 ,$7.52 ,$17.28 ,$95.20 ,$64.62 ,$33.32 ,$107.10 ,$45.22 ,$32.92 ,$16.46 ,$57.12 
ST. MARY'S HOSPITAL - DECATUR,30101265,82787,HC IMMUNOGLOBULIN SUBCLASSES-90,301,1 ,$87.00 ,$56.55 ,$3.50 ,$87.00 ,$20.05 ,$18.76 ,$47.85 ,$8.02 ,$24.36 ,$42.63 ,$8.02 ,$50.90 ,$8.02 ,$47.24 ,$3.50 ,$8.02 ,$47.24 ,$15.24 ,$60.90 ,$43.50 ,$69.60 ,$20.05 ,$8.02 ,$60.90 ,$8.02 ,$52.20 ,$8.02 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$8.02 ,$48.02 ,$11.58 ,$11.58 ,$73.95 ,$20.05 ,$60.29 ,$8.02 ,$87.00 ,$47.85 ,$8.02 ,$22.88 , N/A ,$12.17 ,$11.61 ,$8.42 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$16.04 ,$8.02 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30101268,82941,HC GASTRIN-90,301,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$44.08 ,$41.20 ,$89.10 ,$17.63 ,$45.36 ,$79.38 ,$17.63 ,$94.77 ,$17.63 ,$87.97 ,$3.50 ,$17.63 ,$87.97 ,$33.50 ,$113.40 ,$81.00 ,$129.60 ,$44.08 ,$17.63 ,$113.40 ,$17.63 ,$97.20 ,$17.63 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$17.63 ,$89.42 ,$25.47 ,$25.47 ,$137.70 ,$44.08 ,$112.27 ,$17.63 ,$162.00 ,$89.10 ,$17.63 ,$42.61 , N/A ,$18.45 ,$17.61 ,$18.51 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$35.26 ,$17.63 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30101269,82945,HC GLUCOSE BODY FLUID-90,301,1 ,$137.00 ,$89.05 ,$3.35 ,$137.00 ,$9.83 ,$9.16 ,$75.35 ,$3.93 ,$38.36 ,$41.97 ,$3.93 ,$41.97 ,$3.93 ,$74.39 ,$3.50 ,$3.93 ,$74.39 ,$7.47 ,$95.90 ,$68.50 ,$109.60 ,$9.83 ,$3.93 ,$95.90 ,$3.93 ,$82.20 ,$3.93 ,$102.75 ,$75.62 ,$68.23 ,$75.62 ,$3.93 ,$75.62 ,$5.68 ,$5.68 ,$116.45 ,$9.83 ,$94.94 ,$3.93 ,$137.00 ,$75.35 ,$3.93 ,$36.03 , N/A ,$3.51 ,$3.35 ,$4.13 ,$109.60 ,$74.39 ,$38.36 ,$123.30 ,$52.06 ,$7.86 ,$3.93 ,$65.76 
ST. MARY'S HOSPITAL - DECATUR,30101274,82955,HC G6PD ENZYME QN-90,301,1 ,$119.00 ,$77.35 ,$3.50 ,$119.00 ,$24.25 ,$22.66 ,$65.45 ,$9.70 ,$33.32 ,$58.31 ,$9.70 ,$69.62 ,$9.70 ,$64.62 ,$3.50 ,$9.70 ,$64.62 ,$18.43 ,$83.30 ,$59.50 ,$95.20 ,$24.25 ,$9.70 ,$83.30 ,$9.70 ,$71.40 ,$9.70 ,$89.25 ,$65.69 ,$59.26 ,$65.69 ,$9.70 ,$65.69 ,$14.00 ,$14.00 ,$101.15 ,$24.25 ,$82.47 ,$9.70 ,$119.00 ,$65.45 ,$9.70 ,$31.30 , N/A ,$7.88 ,$7.52 ,$10.19 ,$95.20 ,$64.62 ,$33.32 ,$107.10 ,$45.22 ,$19.40 ,$9.70 ,$57.12 
ST. MARY'S HOSPITAL - DECATUR,30101275,82977,HC GGT/GGTP-90,301,1 ,$152.00 ,$98.80 ,$3.35 ,$152.00 ,$18.00 ,$16.84 ,$83.60 ,$7.20 ,$42.56 ,$74.48 ,$7.20 ,$76.87 ,$7.20 ,$82.54 ,$3.50 ,$7.20 ,$82.54 ,$13.68 ,$106.40 ,$76.00 ,$121.60 ,$18.00 ,$7.20 ,$106.40 ,$7.20 ,$91.20 ,$7.20 ,$114.00 ,$83.90 ,$75.70 ,$83.90 ,$7.20 ,$83.90 ,$10.40 ,$10.40 ,$129.20 ,$18.00 ,$105.34 ,$7.20 ,$152.00 ,$83.60 ,$7.20 ,$39.98 , N/A ,$3.51 ,$3.35 ,$7.56 ,$121.60 ,$82.54 ,$42.56 ,$136.80 ,$57.76 ,$14.40 ,$7.20 ,$72.96 
ST. MARY'S HOSPITAL - DECATUR,30101276,82985,HC FRUCTOSAMINE-90,301,1 ,$86.00 ,$55.90 ,$3.50 ,$86.00 ,$41.90 ,$35.22 ,$47.30 ,$16.76 ,$24.08 ,$42.14 ,$16.76 ,$50.31 ,$16.76 ,$46.70 ,$3.50 ,$16.76 ,$46.70 ,$31.84 ,$60.20 ,$43.00 ,$68.80 ,$41.90 ,$16.76 ,$60.20 ,$16.76 ,$51.60 ,$16.76 ,$64.50 ,$47.47 ,$42.83 ,$47.47 ,$16.76 ,$47.47 ,$21.79 ,$21.79 ,$73.10 ,$41.90 ,$59.60 ,$16.76 ,$86.00 ,$47.30 ,$16.76 ,$22.62 , N/A ,$7.88 ,$7.52 ,$17.60 ,$68.80 ,$46.70 ,$24.08 ,$77.40 ,$32.68 ,$33.52 ,$16.76 ,$41.28 
ST. MARY'S HOSPITAL - DECATUR,30101279,83003,HC GROWTH HORMONE (HGH)-90,301,1 ,$135.00 ,$87.75 ,$3.50 ,$135.00 ,$41.68 ,$38.12 ,$74.25 ,$16.67 ,$37.80 ,$66.15 ,$16.67 ,$78.98 ,$16.67 ,$73.31 ,$3.50 ,$16.67 ,$73.31 ,$31.67 ,$94.50 ,$67.50 ,$108.00 ,$41.68 ,$16.67 ,$94.50 ,$16.67 ,$81.00 ,$16.67 ,$101.25 ,$74.52 ,$67.23 ,$74.52 ,$16.67 ,$74.52 ,$24.08 ,$24.08 ,$114.75 ,$41.68 ,$93.56 ,$16.67 ,$135.00 ,$74.25 ,$16.67 ,$35.51 , N/A ,$18.45 ,$17.61 ,$17.50 ,$108.00 ,$73.31 ,$37.80 ,$121.50 ,$51.30 ,$33.34 ,$16.67 ,$64.80 
ST. MARY'S HOSPITAL - DECATUR,30101281,83010,HC HAPTOGLOBIN-90,301,1 ,$126.00 ,$81.90 ,$3.50 ,$126.00 ,$31.45 ,$29.40 ,$69.30 ,$12.58 ,$35.28 ,$61.74 ,$12.58 ,$73.71 ,$12.58 ,$68.42 ,$3.50 ,$12.58 ,$68.42 ,$23.90 ,$88.20 ,$63.00 ,$100.80 ,$31.45 ,$12.58 ,$88.20 ,$12.58 ,$75.60 ,$12.58 ,$94.50 ,$69.55 ,$62.75 ,$69.55 ,$12.58 ,$69.55 ,$18.16 ,$18.16 ,$107.10 ,$31.45 ,$87.32 ,$12.58 ,$126.00 ,$69.30 ,$12.58 ,$33.14 , N/A ,$7.88 ,$7.52 ,$13.21 ,$100.80 ,$68.42 ,$35.28 ,$113.40 ,$47.88 ,$25.16 ,$12.58 ,$60.48 
ST. MARY'S HOSPITAL - DECATUR,30101282,83013,HC H PYLORI BREATH TEST-90,301,1 ,$209.00 ,$135.85 ,$3.50 ,$209.00 ,$168.40 ,$157.40 ,$114.95 ,$67.36 ,$58.52 ,$102.41 ,$67.36 ,$122.27 ,$67.36 ,$113.49 ,$3.50 ,$67.36 ,$113.49 ,$127.98 ,$146.30 ,$104.50 ,$167.20 ,$168.40 ,$67.36 ,$146.30 ,$67.36 ,$125.40 ,$67.36 ,$156.75 ,$115.37 ,$104.08 ,$115.37 ,$67.36 ,$115.37 ,$97.29 ,$97.29 ,$177.65 ,$168.40 ,$144.84 ,$67.36 ,$209.00 ,$114.95 ,$67.36 ,$54.97 , N/A ,$21.22 ,$20.25 ,$70.73 ,$167.20 ,$113.49 ,$58.52 ,$188.10 ,$79.42 ,$134.72 ,$67.36 ,$100.32 
ST. MARY'S HOSPITAL - DECATUR,30101283,83018,HC HEAVY METAL QN EACH-90,301,1 ,$206.00 ,$133.90 ,$3.50 ,$206.00 ,$54.90 ,$51.32 ,$113.30 ,$21.96 ,$57.68 ,$100.94 ,$21.96 ,$120.51 ,$21.96 ,$111.86 ,$3.50 ,$21.96 ,$111.86 ,$41.72 ,$144.20 ,$103.00 ,$164.80 ,$54.90 ,$21.96 ,$144.20 ,$21.96 ,$123.60 ,$21.96 ,$154.50 ,$113.71 ,$102.59 ,$113.71 ,$21.96 ,$113.71 ,$31.73 ,$31.73 ,$175.10 ,$54.90 ,$142.76 ,$21.96 ,$206.00 ,$113.30 ,$21.96 ,$54.18 , N/A ,$9.61 ,$9.18 ,$23.06 ,$164.80 ,$111.86 ,$57.68 ,$185.40 ,$78.28 ,$43.92 ,$21.96 ,$98.88 
ST. MARY'S HOSPITAL - DECATUR,30101284,83020,HC HGB ELECTROPHORESIS-90,301,1 ,$79.00 ,$51.35 ,$7.52 ,$79.00 ,$32.18 ,$23.08 ,$43.45 ,$12.87 ,$22.12 ,$38.71 ,$12.87 ,$46.22 ,$12.87 ,$42.90 ,$10.15 ,$12.87 ,$42.90 ,$24.45 ,$55.30 ,$39.50 ,$63.20 ,$32.18 ,$12.87 ,$55.30 ,$12.87 ,$47.40 ,$12.87 ,$59.25 ,$43.61 ,$39.34 ,$43.61 ,$12.87 ,$43.61 ,$18.59 ,$18.59 ,$67.15 ,$32.18 ,$54.75 ,$12.87 ,$79.00 ,$43.45 ,$12.87 ,$20.78 , N/A ,$7.88 ,$7.52 ,$13.51 ,$63.20 ,$42.90 ,$22.12 ,$71.10 ,$30.02 ,$25.74 ,$12.87 ,$37.92 
ST. MARY'S HOSPITAL - DECATUR,30101285,83021,HC HEMOGLOBIN FRACT QN-90,301,1 ,$75.00 ,$48.75 ,$3.50 ,$75.00 ,$45.15 ,$42.20 ,$41.25 ,$18.06 ,$21.00 ,$36.75 ,$18.06 ,$43.88 ,$18.06 ,$40.73 ,$3.50 ,$18.06 ,$40.73 ,$34.31 ,$52.50 ,$37.50 ,$60.00 ,$45.15 ,$18.06 ,$52.50 ,$18.06 ,$45.00 ,$18.06 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$18.06 ,$41.40 ,$26.08 ,$26.08 ,$63.75 ,$45.15 ,$51.98 ,$18.06 ,$75.00 ,$41.25 ,$18.06 ,$19.73 , N/A ,$7.45 ,$7.11 ,$18.96 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$36.12 ,$18.06 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,30101289,83051,HC HEMOGLOBIN PLASMA-90,301,1 ,$69.00 ,$44.85 ,$3.50 ,$69.00 ,$18.28 ,$8.34 ,$37.95 ,$7.31 ,$19.32 ,$33.81 ,$7.31 ,$40.37 ,$7.31 ,$37.47 ,$3.50 ,$7.31 ,$37.47 ,$13.89 ,$48.30 ,$34.50 ,$55.20 ,$18.28 ,$7.31 ,$48.30 ,$7.31 ,$41.40 ,$7.31 ,$51.75 ,$38.09 ,$34.36 ,$38.09 ,$7.31 ,$38.09 ,$10.56 ,$10.56 ,$58.65 ,$18.28 ,$47.82 ,$7.31 ,$69.00 ,$37.95 ,$7.31 ,$18.15 , N/A ,$7.88 ,$7.52 ,$7.68 ,$55.20 ,$37.47 ,$19.32 ,$62.10 ,$26.22 ,$14.62 ,$7.31 ,$33.12 
ST. MARY'S HOSPITAL - DECATUR,30101291,83088,HC HISTAMINE-90,301,1 ,$264.00 ,$171.60 ,$3.50 ,$264.00 ,$73.83 ,$69.02 ,$145.20 ,$29.53 ,$73.92 ,$129.36 ,$29.53 ,$154.44 ,$29.53 ,$143.35 ,$3.50 ,$29.53 ,$143.35 ,$56.11 ,$184.80 ,$132.00 ,$211.20 ,$73.83 ,$29.53 ,$184.80 ,$29.53 ,$158.40 ,$29.53 ,$198.00 ,$145.73 ,$131.47 ,$145.73 ,$29.53 ,$145.73 ,$42.65 ,$42.65 ,$224.40 ,$73.83 ,$182.95 ,$29.53 ,$264.00 ,$145.20 ,$29.53 ,$69.43 , N/A ,$21.22 ,$20.25 ,$31.01 ,$211.20 ,$143.35 ,$73.92 ,$237.60 ,$100.32 ,$59.06 ,$29.53 ,$126.72 
ST. MARY'S HOSPITAL - DECATUR,30101292,83090,HC HOMOCYSTEINE-90,301,1 ,$207.00 ,$134.55 ,$3.50 ,$207.00 ,$44.80 ,$39.42 ,$113.85 ,$17.92 ,$57.96 ,$101.43 ,$17.92 ,$121.10 ,$17.92 ,$112.40 ,$3.50 ,$17.92 ,$112.40 ,$34.05 ,$144.90 ,$103.50 ,$165.60 ,$44.80 ,$17.92 ,$144.90 ,$17.92 ,$124.20 ,$17.92 ,$155.25 ,$114.26 ,$103.09 ,$114.26 ,$17.92 ,$114.26 ,$24.36 ,$24.36 ,$175.95 ,$44.80 ,$143.45 ,$17.92 ,$207.00 ,$113.85 ,$17.92 ,$54.44 , N/A ,$18.45 ,$17.61 ,$18.82 ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$35.84 ,$17.92 ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,30101293,83150,HC HOMOVANILLIC ACID (HVA)-90,301,1 ,$188.00 ,$122.20 ,$3.50 ,$188.00 ,$56.03 ,$45.22 ,$103.40 ,$22.41 ,$52.64 ,$92.12 ,$22.41 ,$109.98 ,$22.41 ,$102.08 ,$3.50 ,$22.41 ,$102.08 ,$42.58 ,$131.60 ,$94.00 ,$150.40 ,$56.03 ,$22.41 ,$131.60 ,$22.41 ,$112.80 ,$22.41 ,$141.00 ,$103.78 ,$93.62 ,$103.78 ,$22.41 ,$103.78 ,$29.13 ,$29.13 ,$159.80 ,$56.03 ,$130.28 ,$22.41 ,$188.00 ,$103.40 ,$22.41 ,$49.44 , N/A ,$18.45 ,$17.61 ,$23.53 ,$150.40 ,$102.08 ,$52.64 ,$169.20 ,$71.44 ,$44.82 ,$22.41 ,$90.24 
ST. MARY'S HOSPITAL - DECATUR,30101294,83497,HC HYDROXYINDOLACET 5 (HIAA)-90,301,1 ,$129.00 ,$83.85 ,$3.50 ,$129.00 ,$32.25 ,$30.12 ,$70.95 ,$12.90 ,$36.12 ,$63.21 ,$12.90 ,$75.47 ,$12.90 ,$70.05 ,$3.50 ,$12.90 ,$70.05 ,$24.51 ,$90.30 ,$64.50 ,$103.20 ,$32.25 ,$12.90 ,$90.30 ,$12.90 ,$77.40 ,$12.90 ,$96.75 ,$71.21 ,$64.24 ,$71.21 ,$12.90 ,$71.21 ,$18.63 ,$18.63 ,$109.65 ,$32.25 ,$89.40 ,$12.90 ,$129.00 ,$70.95 ,$12.90 ,$33.93 , N/A ,$10.60 ,$10.12 ,$13.55 ,$103.20 ,$70.05 ,$36.12 ,$116.10 ,$49.02 ,$25.80 ,$12.90 ,$61.92 
ST. MARY'S HOSPITAL - DECATUR,30101295,83498,HC HYDROXYPROGESTERONE 17D-90,301,1 ,$204.00 ,$132.60 ,$3.50 ,$204.00 ,$67.93 ,$63.50 ,$112.20 ,$27.17 ,$57.12 ,$99.96 ,$27.17 ,$119.34 ,$27.17 ,$110.77 ,$3.50 ,$27.17 ,$110.77 ,$51.62 ,$142.80 ,$102.00 ,$163.20 ,$67.93 ,$27.17 ,$142.80 ,$27.17 ,$122.40 ,$27.17 ,$153.00 ,$112.61 ,$101.59 ,$112.61 ,$27.17 ,$112.61 ,$39.25 ,$39.25 ,$173.40 ,$67.93 ,$141.37 ,$27.17 ,$204.00 ,$112.20 ,$27.17 ,$53.65 , N/A ,$18.45 ,$17.61 ,$28.53 ,$163.20 ,$110.77 ,$57.12 ,$183.60 ,$77.52 ,$54.34 ,$27.17 ,$97.92 
ST. MARY'S HOSPITAL - DECATUR,30101297,83516,HC MLT NON INFECT QL/SQ-90,301,1 ,$138.00 ,$89.70 ,$3.50 ,$138.00 ,$28.83 ,$26.96 ,$75.90 ,$11.53 ,$38.64 ,$67.62 ,$11.53 ,$80.73 ,$11.53 ,$74.93 ,$3.50 ,$11.53 ,$74.93 ,$21.91 ,$96.60 ,$69.00 ,$110.40 ,$28.83 ,$11.53 ,$96.60 ,$11.53 ,$82.80 ,$11.53 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$11.53 ,$76.18 ,$16.65 ,$16.65 ,$117.30 ,$28.83 ,$95.63 ,$11.53 ,$138.00 ,$75.90 ,$11.53 ,$36.29 , N/A ,$7.06 ,$6.74 ,$12.11 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$23.06 ,$11.53 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30101298,82960,HC G6PD SCREEN,301,1 ,$58.00 ,$37.70 ,$3.50 ,$58.00 ,$15.13 ,$14.14 ,$31.90 ,$6.05 ,$16.24 ,$28.42 ,$6.05 ,$33.93 ,$6.05 ,$31.49 ,$3.50 ,$6.05 ,$31.49 ,$11.50 ,$40.60 ,$29.00 ,$46.40 ,$15.13 ,$6.05 ,$40.60 ,$6.05 ,$34.80 ,$6.05 ,$43.50 ,$32.02 ,$28.88 ,$32.02 ,$6.05 ,$32.02 ,$8.74 ,$8.74 ,$49.30 ,$15.13 ,$40.19 ,$6.05 ,$58.00 ,$31.90 ,$6.05 ,$15.25 , N/A ,$7.88 ,$7.52 ,$6.35 ,$46.40 ,$31.49 ,$16.24 ,$52.20 ,$22.04 ,$12.10 ,$6.05 ,$27.84 
ST. MARY'S HOSPITAL - DECATUR,30101299,83516,HC MLT NON INFECT QL/SQ TTG,301,1 ,$163.00 ,$105.95 ,$3.50 ,$163.00 ,$28.83 ,$26.96 ,$89.65 ,$11.53 ,$45.64 ,$79.87 ,$11.53 ,$95.36 ,$11.53 ,$88.51 ,$3.50 ,$11.53 ,$88.51 ,$21.91 ,$114.10 ,$81.50 ,$130.40 ,$28.83 ,$11.53 ,$114.10 ,$11.53 ,$97.80 ,$11.53 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$11.53 ,$89.98 ,$16.65 ,$16.65 ,$138.55 ,$28.83 ,$112.96 ,$11.53 ,$163.00 ,$89.65 ,$11.53 ,$42.87 , N/A ,$7.06 ,$6.74 ,$12.11 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$23.06 ,$11.53 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30101300,83516,HC MLT NON INFECT QL/SQ TTG-90,301,1 ,$160.00 ,$104.00 ,$3.50 ,$160.00 ,$28.83 ,$26.96 ,$88.00 ,$11.53 ,$44.80 ,$78.40 ,$11.53 ,$93.60 ,$11.53 ,$86.88 ,$3.50 ,$11.53 ,$86.88 ,$21.91 ,$112.00 ,$80.00 ,$128.00 ,$28.83 ,$11.53 ,$112.00 ,$11.53 ,$96.00 ,$11.53 ,$120.00 ,$88.32 ,$79.68 ,$88.32 ,$11.53 ,$88.32 ,$16.65 ,$16.65 ,$136.00 ,$28.83 ,$110.88 ,$11.53 ,$160.00 ,$88.00 ,$11.53 ,$42.08 , N/A ,$7.06 ,$6.74 ,$12.11 ,$128.00 ,$86.88 ,$44.80 ,$144.00 ,$60.80 ,$23.06 ,$11.53 ,$76.80 
ST. MARY'S HOSPITAL - DECATUR,30101301,83516,HC MLT NON INFECT QL/SQ,301,1 ,$163.00 ,$105.95 ,$3.50 ,$163.00 ,$28.83 ,$26.96 ,$89.65 ,$11.53 ,$45.64 ,$79.87 ,$11.53 ,$95.36 ,$11.53 ,$88.51 ,$3.50 ,$11.53 ,$88.51 ,$21.91 ,$114.10 ,$81.50 ,$130.40 ,$28.83 ,$11.53 ,$114.10 ,$11.53 ,$97.80 ,$11.53 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$11.53 ,$89.98 ,$16.65 ,$16.65 ,$138.55 ,$28.83 ,$112.96 ,$11.53 ,$163.00 ,$89.65 ,$11.53 ,$42.87 , N/A ,$7.06 ,$6.74 ,$12.11 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$23.06 ,$11.53 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30101302,83519,HC QN RIA-90,301,1 ,$221.00 ,$143.65 ,$3.50 ,$221.00 ,$46.00 ,$31.56 ,$121.55 ,$18.40 ,$61.88 ,$108.29 ,$18.40 ,$117.57 ,$18.40 ,$120.00 ,$3.50 ,$18.40 ,$120.00 ,$34.96 ,$154.70 ,$110.50 ,$176.80 ,$46.00 ,$18.40 ,$154.70 ,$18.40 ,$132.60 ,$18.40 ,$165.75 ,$121.99 ,$110.06 ,$121.99 ,$18.40 ,$121.99 ,$23.92 ,$23.92 ,$187.85 ,$46.00 ,$153.15 ,$18.40 ,$221.00 ,$121.55 ,$18.40 ,$58.12 , N/A ,$7.06 ,$6.74 ,$19.32 ,$176.80 ,$120.00 ,$61.88 ,$198.90 ,$83.98 ,$36.80 ,$18.40 ,$106.08 
ST. MARY'S HOSPITAL - DECATUR,30101303,83520,HC IMMUNOASSAY QN OTHER-90,301,1 ,$203.00 ,$131.95 ,$3.50 ,$203.00 ,$43.18 ,$30.26 ,$111.65 ,$17.27 ,$56.84 ,$99.47 ,$17.27 ,$118.76 ,$17.27 ,$110.23 ,$3.50 ,$17.27 ,$110.23 ,$32.81 ,$142.10 ,$101.50 ,$162.40 ,$43.18 ,$17.27 ,$142.10 ,$17.27 ,$121.80 ,$17.27 ,$152.25 ,$112.06 ,$101.09 ,$112.06 ,$17.27 ,$112.06 ,$22.45 ,$22.45 ,$172.55 ,$43.18 ,$140.68 ,$17.27 ,$203.00 ,$111.65 ,$17.27 ,$53.39 , N/A ,$7.06 ,$6.74 ,$18.13 ,$162.40 ,$110.23 ,$56.84 ,$182.70 ,$77.14 ,$34.54 ,$17.27 ,$97.44 
ST. MARY'S HOSPITAL - DECATUR,30101307,83525,HC INSULIN TOTAL-90,301,1 ,$120.00 ,$78.00 ,$3.50 ,$120.00 ,$28.58 ,$26.70 ,$66.00 ,$11.43 ,$33.60 ,$58.80 ,$11.43 ,$70.20 ,$11.43 ,$65.16 ,$3.50 ,$11.43 ,$65.16 ,$21.72 ,$84.00 ,$60.00 ,$96.00 ,$28.58 ,$11.43 ,$84.00 ,$11.43 ,$72.00 ,$11.43 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$11.43 ,$66.24 ,$16.51 ,$16.51 ,$102.00 ,$28.58 ,$83.16 ,$11.43 ,$120.00 ,$66.00 ,$11.43 ,$31.56 , N/A ,$10.60 ,$10.12 ,$12.00 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$22.86 ,$11.43 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30101308,83527,HC INSULIN FREE-90,301,1 ,$140.00 ,$91.00 ,$3.50 ,$140.00 ,$32.38 ,$30.26 ,$77.00 ,$12.95 ,$39.20 ,$68.60 ,$12.95 ,$81.90 ,$12.95 ,$76.02 ,$3.50 ,$12.95 ,$76.02 ,$24.61 ,$98.00 ,$70.00 ,$112.00 ,$32.38 ,$12.95 ,$98.00 ,$12.95 ,$84.00 ,$12.95 ,$105.00 ,$77.28 ,$69.72 ,$77.28 ,$12.95 ,$77.28 ,$18.71 ,$18.71 ,$119.00 ,$32.38 ,$97.02 ,$12.95 ,$140.00 ,$77.00 ,$12.95 ,$36.82 , N/A ,$18.45 ,$17.61 ,$13.60 ,$112.00 ,$76.02 ,$39.20 ,$126.00 ,$53.20 ,$25.90 ,$12.95 ,$67.20 
ST. MARY'S HOSPITAL - DECATUR,30101309,83540,HC IRON TOTAL-90,301,1 ,$145.00 ,$94.25 ,$3.35 ,$145.00 ,$16.18 ,$15.14 ,$79.75 ,$6.47 ,$40.60 ,$51.02 ,$6.47 ,$51.02 ,$6.47 ,$78.74 ,$3.50 ,$6.47 ,$78.74 ,$12.29 ,$101.50 ,$72.50 ,$116.00 ,$16.18 ,$6.47 ,$101.50 ,$6.47 ,$87.00 ,$6.47 ,$108.75 ,$80.04 ,$72.21 ,$80.04 ,$6.47 ,$80.04 ,$9.35 ,$9.35 ,$123.25 ,$16.18 ,$100.49 ,$6.47 ,$145.00 ,$79.75 ,$6.47 ,$38.14 , N/A ,$3.51 ,$3.35 ,$6.79 ,$116.00 ,$78.74 ,$40.60 ,$130.50 ,$55.10 ,$12.94 ,$6.47 ,$69.60 
ST. MARY'S HOSPITAL - DECATUR,30101311,83605,HC LACTATE/LACTIC ACID-90,301,1 ,$210.00 ,$136.50 ,$3.50 ,$210.00 ,$28.93 ,$24.96 ,$115.50 ,$11.57 ,$58.80 ,$102.90 ,$11.57 ,$114.13 ,$11.57 ,$114.03 ,$3.50 ,$11.57 ,$114.03 ,$21.98 ,$147.00 ,$105.00 ,$168.00 ,$28.93 ,$11.57 ,$147.00 ,$11.57 ,$126.00 ,$11.57 ,$157.50 ,$115.92 ,$104.58 ,$115.92 ,$11.57 ,$115.92 ,$15.43 ,$15.43 ,$178.50 ,$28.93 ,$145.53 ,$11.57 ,$210.00 ,$115.50 ,$11.57 ,$55.23 , N/A ,$7.88 ,$7.52 ,$12.15 ,$168.00 ,$114.03 ,$58.80 ,$189.00 ,$79.80 ,$23.14 ,$11.57 ,$100.80 
ST. MARY'S HOSPITAL - DECATUR,30101312,83615,HC LACTATE DEHYDRO (LDH)-90,301,1 ,$178.00 ,$115.70 ,$3.35 ,$178.00 ,$15.10 ,$14.12 ,$97.90 ,$6.04 ,$49.84 ,$47.58 ,$6.04 ,$47.58 ,$6.04 ,$96.65 ,$3.50 ,$6.04 ,$96.65 ,$11.48 ,$124.60 ,$89.00 ,$142.40 ,$15.10 ,$6.04 ,$124.60 ,$6.04 ,$106.80 ,$6.04 ,$133.50 ,$98.26 ,$88.64 ,$98.26 ,$6.04 ,$98.26 ,$8.72 ,$8.72 ,$151.30 ,$15.10 ,$123.35 ,$6.04 ,$178.00 ,$97.90 ,$6.04 ,$46.81 , N/A ,$3.51 ,$3.35 ,$6.34 ,$142.40 ,$96.65 ,$49.84 ,$160.20 ,$67.64 ,$12.08 ,$6.04 ,$85.44 
ST. MARY'S HOSPITAL - DECATUR,30101313,83625,HC LDH ISOENZYMES-90,301,1 ,$89.00 ,$57.85 ,$3.50 ,$89.00 ,$31.98 ,$26.86 ,$48.95 ,$12.79 ,$24.92 ,$43.61 ,$12.79 ,$52.07 ,$12.79 ,$48.33 ,$3.50 ,$12.79 ,$48.33 ,$24.30 ,$62.30 ,$44.50 ,$71.20 ,$31.98 ,$12.79 ,$62.30 ,$12.79 ,$53.40 ,$12.79 ,$66.75 ,$49.13 ,$44.32 ,$49.13 ,$12.79 ,$49.13 ,$18.49 ,$18.49 ,$75.65 ,$31.98 ,$61.68 ,$12.79 ,$89.00 ,$48.95 ,$12.79 ,$23.41 , N/A ,$7.88 ,$7.52 ,$13.43 ,$71.20 ,$48.33 ,$24.92 ,$80.10 ,$33.82 ,$25.58 ,$12.79 ,$42.72 
ST. MARY'S HOSPITAL - DECATUR,30101314,83630,HC LACTOGEN FECAL QL-90,301,1 ,$138.00 ,$89.70 ,$3.50 ,$138.00 ,$49.25 ,$45.86 ,$75.90 ,$19.70 ,$38.64 ,$67.62 ,$19.70 ,$80.73 ,$19.70 ,$74.93 ,$3.50 ,$19.70 ,$74.93 ,$37.43 ,$96.60 ,$69.00 ,$110.40 ,$49.25 ,$19.70 ,$96.60 ,$19.70 ,$82.80 ,$19.70 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$19.70 ,$76.18 ,$28.35 ,$28.35 ,$117.30 ,$49.25 ,$95.63 ,$19.70 ,$138.00 ,$75.90 ,$19.70 ,$36.29 , N/A ,$7.88 ,$7.52 ,$20.69 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$39.40 ,$19.70 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30101315,83632,HC LACTOGEN PLACENTAL-90,301,1 ,$143.00 ,$92.95 ,$3.50 ,$143.00 ,$50.55 ,$47.24 ,$78.65 ,$20.22 ,$40.04 ,$70.07 ,$20.22 ,$83.66 ,$20.22 ,$77.65 ,$3.50 ,$20.22 ,$77.65 ,$38.42 ,$100.10 ,$71.50 ,$114.40 ,$50.55 ,$20.22 ,$100.10 ,$20.22 ,$85.80 ,$20.22 ,$107.25 ,$78.94 ,$71.21 ,$78.94 ,$20.22 ,$78.94 ,$29.21 ,$29.21 ,$121.55 ,$50.55 ,$99.10 ,$20.22 ,$143.00 ,$78.65 ,$20.22 ,$37.61 , N/A ,$7.88 ,$7.52 ,$21.23 ,$114.40 ,$77.65 ,$40.04 ,$128.70 ,$54.34 ,$40.44 ,$20.22 ,$68.64 
ST. MARY'S HOSPITAL - DECATUR,30101316,83655,HC LEAD-90,301,1 ,$105.00 ,$68.25 ,$3.50 ,$105.00 ,$30.28 ,$28.28 ,$57.75 ,$12.11 ,$29.40 ,$51.45 ,$12.11 ,$61.43 ,$12.11 ,$57.02 ,$3.50 ,$12.11 ,$57.02 ,$23.01 ,$73.50 ,$52.50 ,$84.00 ,$30.28 ,$12.11 ,$73.50 ,$12.11 ,$63.00 ,$12.11 ,$78.75 ,$57.96 ,$52.29 ,$57.96 ,$12.11 ,$57.96 ,$17.49 ,$17.49 ,$89.25 ,$30.28 ,$72.77 ,$12.11 ,$105.00 ,$57.75 ,$12.11 ,$27.62 , N/A ,$9.61 ,$9.18 ,$12.72 ,$84.00 ,$57.02 ,$29.40 ,$94.50 ,$39.90 ,$24.22 ,$12.11 ,$50.40 
ST. MARY'S HOSPITAL - DECATUR,30101317,83661,HC FETAL LUNG MATURITY L/S RATIO-90,301,1 ,$332.00 ,$215.80 ,$3.50 ,$332.00 ,$54.98 ,$51.38 ,$182.60 ,$21.99 ,$92.96 ,$162.68 ,$21.99 ,$173.40 ,$21.99 ,$180.28 ,$3.50 ,$21.99 ,$180.28 ,$41.78 ,$232.40 ,$166.00 ,$265.60 ,$54.98 ,$21.99 ,$232.40 ,$21.99 ,$199.20 ,$21.99 ,$249.00 ,$183.26 ,$165.34 ,$183.26 ,$21.99 ,$183.26 ,$31.76 ,$31.76 ,$282.20 ,$54.98 ,$230.08 ,$21.99 ,$332.00 ,$182.60 ,$21.99 ,$87.32 , N/A ,$7.88 ,$7.52 ,$23.09 ,$265.60 ,$180.28 ,$92.96 ,$298.80 ,$126.16 ,$43.98 ,$21.99 ,$159.36 
ST. MARY'S HOSPITAL - DECATUR,30101318,83690,HC LIPASE-90,301,1 ,$223.00 ,$144.95 ,$3.35 ,$223.00 ,$17.23 ,$16.10 ,$122.65 ,$6.89 ,$62.44 ,$54.36 ,$6.89 ,$54.36 ,$6.89 ,$121.09 ,$3.50 ,$6.89 ,$121.09 ,$13.09 ,$156.10 ,$111.50 ,$178.40 ,$17.23 ,$6.89 ,$156.10 ,$6.89 ,$133.80 ,$6.89 ,$167.25 ,$123.10 ,$111.05 ,$123.10 ,$6.89 ,$123.10 ,$9.95 ,$9.95 ,$189.55 ,$17.23 ,$154.54 ,$6.89 ,$223.00 ,$122.65 ,$6.89 ,$58.65 , N/A ,$3.51 ,$3.35 ,$7.23 ,$178.40 ,$121.09 ,$62.44 ,$200.70 ,$84.74 ,$13.78 ,$6.89 ,$107.04 
ST. MARY'S HOSPITAL - DECATUR,30101319,83695,HC LIPOPROTEIN-90,301,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$35.80 ,$30.26 ,$80.30 ,$14.32 ,$40.88 ,$71.54 ,$14.32 ,$85.41 ,$14.32 ,$79.28 ,$3.50 ,$14.32 ,$79.28 ,$27.21 ,$102.20 ,$73.00 ,$116.80 ,$35.80 ,$14.32 ,$102.20 ,$14.32 ,$87.60 ,$14.32 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$14.32 ,$80.59 ,$18.71 ,$18.71 ,$124.10 ,$35.80 ,$101.18 ,$14.32 ,$146.00 ,$80.30 ,$14.32 ,$38.40 , N/A ,$7.88 ,$7.52 ,$15.04 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$28.64 ,$14.32 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30101321,83701,HC VAP CHOLESTEROL SERUM-90,301,1 ,$34.00 ,$22.10 ,$3.50 ,$84.65 ,$84.65 ,$34.00 ,$18.70 ,$33.86 ,$9.52 ,$16.66 ,$33.86 ,$19.89 ,$33.86 ,$18.46 ,$3.50 ,$33.86 ,$18.46 ,$34.00 ,$23.80 ,$17.00 ,$27.20 ,$84.65 ,$33.86 ,$23.80 ,$33.86 ,$20.40 ,$33.86 ,$25.50 ,$18.77 ,$16.93 ,$18.77 ,$33.86 ,$18.77 ,$34.00 ,$34.00 ,$28.90 ,$34.00 ,$23.56 ,$33.86 ,$34.00 ,$18.70 ,$33.86 ,$8.94 , N/A ,$7.88 ,$7.52 ,$35.55 ,$27.20 ,$18.46 ,$9.52 ,$30.60 ,$12.92 ,$34.00 ,$33.86 ,$16.32 
ST. MARY'S HOSPITAL - DECATUR,30101322,83704,HC NMR LIPOPROFILE LIP-90,301,1 ,$126.00 ,$81.90 ,$3.50 ,$126.00 ,$85.48 ,$73.72 ,$69.30 ,$34.19 ,$35.28 ,$61.74 ,$34.19 ,$73.71 ,$34.19 ,$68.42 ,$3.50 ,$34.19 ,$68.42 ,$64.96 ,$88.20 ,$63.00 ,$100.80 ,$85.48 ,$34.19 ,$88.20 ,$34.19 ,$75.60 ,$34.19 ,$94.50 ,$69.55 ,$62.75 ,$69.55 ,$34.19 ,$69.55 ,$45.58 ,$45.58 ,$107.10 ,$85.48 ,$87.32 ,$34.19 ,$126.00 ,$69.30 ,$34.19 ,$33.14 , N/A ,$21.22 ,$20.25 ,$35.90 ,$100.80 ,$68.42 ,$35.28 ,$113.40 ,$47.88 ,$68.38 ,$34.19 ,$60.48 
ST. MARY'S HOSPITAL - DECATUR,30101323,83721,HC CHOLESTEROL LDL,301,1 ,$115.00 ,$74.75 ,$3.50 ,$115.00 ,$26.25 ,$22.28 ,$63.25 ,$10.50 ,$32.20 ,$56.35 ,$10.50 ,$67.28 ,$10.50 ,$62.45 ,$3.50 ,$10.50 ,$62.45 ,$19.95 ,$80.50 ,$57.50 ,$92.00 ,$26.25 ,$10.50 ,$80.50 ,$10.50 ,$69.00 ,$10.50 ,$86.25 ,$63.48 ,$57.27 ,$63.48 ,$10.50 ,$63.48 ,$13.78 ,$13.78 ,$97.75 ,$26.25 ,$79.70 ,$10.50 ,$115.00 ,$63.25 ,$10.50 ,$30.25 , N/A ,$7.88 ,$7.52 ,$11.03 ,$92.00 ,$62.45 ,$32.20 ,$103.50 ,$43.70 ,$21.00 ,$10.50 ,$55.20 
ST. MARY'S HOSPITAL - DECATUR,30101324,83727,HC GONADOTROPIN RELEASING HORM-90,301,1 ,$465.00 ,$302.25 ,$3.50 ,$465.00 ,$42.98 ,$40.18 ,$255.75 ,$17.19 ,$130.20 ,$135.56 ,$17.19 ,$135.56 ,$17.19 ,$252.50 ,$3.50 ,$17.19 ,$252.50 ,$32.66 ,$325.50 ,$232.50 ,$372.00 ,$42.98 ,$17.19 ,$325.50 ,$17.19 ,$279.00 ,$17.19 ,$348.75 ,$256.68 ,$231.57 ,$256.68 ,$17.19 ,$256.68 ,$24.83 ,$24.83 ,$395.25 ,$42.98 ,$322.25 ,$17.19 ,$465.00 ,$255.75 ,$17.19 ,$122.30 , N/A ,$18.45 ,$17.61 ,$18.05 ,$372.00 ,$252.50 ,$130.20 ,$418.50 ,$176.70 ,$34.38 ,$17.19 ,$223.20 
ST. MARY'S HOSPITAL - DECATUR,30101325,80335,HC ANTIDEPRESSANTS TRYCLIC 1-2  -90,301,1 ,$211.00 ,$137.15 ,$0.02 ,$211.00 , N/A ,$0.02 ,$116.05 , N/A ,$59.08 , N/A , N/A , N/A , N/A ,$114.57 , N/A , N/A ,$114.57 , N/A ,$147.70 ,$105.50 ,$168.80 , N/A , N/A ,$147.70 , N/A ,$126.60 , N/A ,$158.25 ,$116.47 ,$105.08 ,$116.47 , N/A ,$116.47 ,$6.50 ,$6.50 ,$179.35 , N/A ,$146.22 , N/A ,$211.00 ,$116.05 , N/A ,$55.49 , N/A ,$21.22 ,$20.25 , N/A ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 , N/A , N/A ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,30101326,83735,HC MAGNESIUM-90,301,1 ,$171.00 ,$111.15 ,$3.35 ,$171.00 ,$16.75 ,$15.66 ,$94.05 ,$6.70 ,$47.88 ,$71.56 ,$6.70 ,$71.56 ,$6.70 ,$92.85 ,$3.50 ,$6.70 ,$92.85 ,$12.73 ,$119.70 ,$85.50 ,$136.80 ,$16.75 ,$6.70 ,$119.70 ,$6.70 ,$102.60 ,$6.70 ,$128.25 ,$94.39 ,$85.16 ,$94.39 ,$6.70 ,$94.39 ,$9.67 ,$9.67 ,$145.35 ,$16.75 ,$118.50 ,$6.70 ,$171.00 ,$94.05 ,$6.70 ,$44.97 , N/A ,$3.51 ,$3.35 ,$7.04 ,$136.80 ,$92.85 ,$47.88 ,$153.90 ,$64.98 ,$13.40 ,$6.70 ,$82.08 
ST. MARY'S HOSPITAL - DECATUR,30101327,83785,HC MANGANESE-90,301,1 ,$137.00 ,$89.05 ,$3.50 ,$137.00 ,$66.63 ,$57.46 ,$75.35 ,$26.65 ,$38.36 ,$67.13 ,$26.65 ,$80.15 ,$26.65 ,$74.39 ,$3.50 ,$26.65 ,$74.39 ,$50.64 ,$95.90 ,$68.50 ,$109.60 ,$66.63 ,$26.65 ,$95.90 ,$26.65 ,$82.20 ,$26.65 ,$102.75 ,$75.62 ,$68.23 ,$75.62 ,$26.65 ,$75.62 ,$35.53 ,$35.53 ,$116.45 ,$66.63 ,$94.94 ,$26.65 ,$137.00 ,$75.35 ,$26.65 ,$36.03 , N/A ,$9.61 ,$9.18 ,$27.98 ,$109.60 ,$74.39 ,$38.36 ,$123.30 ,$52.06 ,$53.30 ,$26.65 ,$65.76 
ST. MARY'S HOSPITAL - DECATUR,30101328,83789,HC MASS SPEC QN EACH-90,301,1 ,$263.00 ,$170.95 ,$3.50 ,$263.00 ,$60.28 ,$42.20 ,$144.65 ,$24.11 ,$73.64 ,$128.87 ,$24.11 ,$153.86 ,$24.11 ,$142.81 ,$3.50 ,$24.11 ,$142.81 ,$45.81 ,$184.10 ,$131.50 ,$210.40 ,$60.28 ,$24.11 ,$184.10 ,$24.11 ,$157.80 ,$24.11 ,$197.25 ,$145.18 ,$130.97 ,$145.18 ,$24.11 ,$145.18 ,$31.34 ,$31.34 ,$223.55 ,$60.28 ,$182.26 ,$24.11 ,$263.00 ,$144.65 ,$24.11 ,$69.17 , N/A ,$7.88 ,$7.52 ,$25.32 ,$210.40 ,$142.81 ,$73.64 ,$236.70 ,$99.94 ,$48.22 ,$24.11 ,$126.24 
ST. MARY'S HOSPITAL - DECATUR,30101329,83825,HC MERCURY-90,301,1 ,$92.00 ,$59.80 ,$3.50 ,$92.00 ,$40.65 ,$38.00 ,$50.60 ,$16.26 ,$25.76 ,$45.08 ,$16.26 ,$53.82 ,$16.26 ,$49.96 ,$3.50 ,$16.26 ,$49.96 ,$30.89 ,$64.40 ,$46.00 ,$73.60 ,$40.65 ,$16.26 ,$64.40 ,$16.26 ,$55.20 ,$16.26 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$16.26 ,$50.78 ,$23.48 ,$23.48 ,$78.20 ,$40.65 ,$63.76 ,$16.26 ,$92.00 ,$50.60 ,$16.26 ,$24.20 , N/A ,$9.61 ,$9.18 ,$17.07 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$32.52 ,$16.26 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,30101330,83835,HC METANEPHRINES-90,301,1 ,$270.00 ,$175.50 ,$3.50 ,$270.00 ,$42.35 ,$39.60 ,$148.50 ,$16.94 ,$75.60 ,$132.30 ,$16.94 ,$133.69 ,$16.94 ,$146.61 ,$3.50 ,$16.94 ,$146.61 ,$32.19 ,$189.00 ,$135.00 ,$216.00 ,$42.35 ,$16.94 ,$189.00 ,$16.94 ,$162.00 ,$16.94 ,$202.50 ,$149.04 ,$134.46 ,$149.04 ,$16.94 ,$149.04 ,$24.47 ,$24.47 ,$229.50 ,$42.35 ,$187.11 ,$16.94 ,$270.00 ,$148.50 ,$16.94 ,$71.01 , N/A ,$18.45 ,$17.61 ,$17.79 ,$216.00 ,$146.61 ,$75.60 ,$243.00 ,$102.60 ,$33.88 ,$16.94 ,$129.60 
ST. MARY'S HOSPITAL - DECATUR,30101332,83864,HC MUCOPOLYSACCHARIDES ACID QN-90,301,1 ,$173.00 ,$112.45 ,$3.50 ,$173.00 ,$71.25 ,$46.52 ,$95.15 ,$28.50 ,$48.44 ,$84.77 ,$28.50 ,$101.21 ,$28.50 ,$93.94 ,$3.50 ,$28.50 ,$93.94 ,$54.15 ,$121.10 ,$86.50 ,$138.40 ,$71.25 ,$28.50 ,$121.10 ,$28.50 ,$103.80 ,$28.50 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$28.50 ,$95.50 ,$37.05 ,$37.05 ,$147.05 ,$71.25 ,$119.89 ,$28.50 ,$173.00 ,$95.15 ,$28.50 ,$45.50 , N/A ,$7.88 ,$7.52 ,$29.93 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 ,$57.00 ,$28.50 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,30101333,83873,HC MYELIN BASIC PROTEIN (CSF)-90,301,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$43.00 ,$38.12 ,$80.30 ,$17.20 ,$40.88 ,$71.54 ,$17.20 ,$85.41 ,$17.20 ,$79.28 ,$3.50 ,$17.20 ,$79.28 ,$32.68 ,$102.20 ,$73.00 ,$116.80 ,$43.00 ,$17.20 ,$102.20 ,$17.20 ,$87.60 ,$17.20 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$17.20 ,$80.59 ,$24.86 ,$24.86 ,$124.10 ,$43.00 ,$101.18 ,$17.20 ,$146.00 ,$80.30 ,$17.20 ,$38.40 , N/A ,$7.88 ,$7.52 ,$18.06 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$34.40 ,$17.20 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30101334,83874,HC MYOGLOBIN-90,301,1 ,$196.00 ,$127.40 ,$3.50 ,$196.00 ,$32.30 ,$30.18 ,$107.80 ,$12.92 ,$54.88 ,$96.04 ,$12.92 ,$101.94 ,$12.92 ,$106.43 ,$3.50 ,$12.92 ,$106.43 ,$24.55 ,$137.20 ,$98.00 ,$156.80 ,$32.30 ,$12.92 ,$137.20 ,$12.92 ,$117.60 ,$12.92 ,$147.00 ,$108.19 ,$97.61 ,$108.19 ,$12.92 ,$108.19 ,$18.66 ,$18.66 ,$166.60 ,$32.30 ,$135.83 ,$12.92 ,$196.00 ,$107.80 ,$12.92 ,$51.55 , N/A ,$7.88 ,$7.52 ,$13.57 ,$156.80 ,$106.43 ,$54.88 ,$176.40 ,$74.48 ,$25.84 ,$12.92 ,$94.08 
ST. MARY'S HOSPITAL - DECATUR,30101335,83874,HC MYOGLOBIN,301,1 ,$196.00 ,$127.40 ,$3.50 ,$196.00 ,$32.30 ,$30.18 ,$107.80 ,$12.92 ,$54.88 ,$96.04 ,$12.92 ,$101.94 ,$12.92 ,$106.43 ,$3.50 ,$12.92 ,$106.43 ,$24.55 ,$137.20 ,$98.00 ,$156.80 ,$32.30 ,$12.92 ,$137.20 ,$12.92 ,$117.60 ,$12.92 ,$147.00 ,$108.19 ,$97.61 ,$108.19 ,$12.92 ,$108.19 ,$18.66 ,$18.66 ,$166.60 ,$32.30 ,$135.83 ,$12.92 ,$196.00 ,$107.80 ,$12.92 ,$51.55 , N/A ,$7.88 ,$7.52 ,$13.57 ,$156.80 ,$106.43 ,$54.88 ,$176.40 ,$74.48 ,$25.84 ,$12.92 ,$94.08 
ST. MARY'S HOSPITAL - DECATUR,30101336,83880,HC BNP NATRIURETIC PEPTIDE-90,301,1 ,$354.00 ,$230.10 ,$3.50 ,$354.00 ,$98.15 ,$66.26 ,$194.70 ,$39.26 ,$99.12 ,$173.46 ,$39.26 ,$207.09 ,$39.26 ,$192.22 ,$3.50 ,$39.26 ,$192.22 ,$74.59 ,$247.80 ,$177.00 ,$283.20 ,$98.15 ,$39.26 ,$247.80 ,$39.26 ,$212.40 ,$39.26 ,$265.50 ,$195.41 ,$176.29 ,$195.41 ,$39.26 ,$195.41 ,$51.04 ,$51.04 ,$300.90 ,$98.15 ,$245.32 ,$39.26 ,$354.00 ,$194.70 ,$39.26 ,$93.10 , N/A ,$21.22 ,$20.25 ,$41.22 ,$283.20 ,$192.22 ,$99.12 ,$318.60 ,$134.52 ,$78.52 ,$39.26 ,$169.92 
ST. MARY'S HOSPITAL - DECATUR,30101337,83883,HC NEPHELOMETRY EA ANALYTE-90,301,1 ,$186.00 ,$120.90 ,$3.50 ,$186.00 ,$34.00 ,$31.78 ,$102.30 ,$13.60 ,$52.08 ,$91.14 ,$13.60 ,$107.25 ,$13.60 ,$101.00 ,$3.50 ,$13.60 ,$101.00 ,$25.84 ,$130.20 ,$93.00 ,$148.80 ,$34.00 ,$13.60 ,$130.20 ,$13.60 ,$111.60 ,$13.60 ,$139.50 ,$102.67 ,$92.63 ,$102.67 ,$13.60 ,$102.67 ,$19.64 ,$19.64 ,$158.10 ,$34.00 ,$128.90 ,$13.60 ,$186.00 ,$102.30 ,$13.60 ,$48.92 , N/A ,$12.17 ,$11.61 ,$14.28 ,$148.80 ,$101.00 ,$52.08 ,$167.40 ,$70.68 ,$27.20 ,$13.60 ,$89.28 
ST. MARY'S HOSPITAL - DECATUR,30101338,83885,HC NICKEL-90,301,1 ,$228.00 ,$148.20 ,$3.50 ,$228.00 ,$61.28 ,$24.88 ,$125.40 ,$24.51 ,$63.84 ,$111.72 ,$24.51 ,$133.38 ,$24.51 ,$123.80 ,$3.50 ,$24.51 ,$123.80 ,$46.57 ,$159.60 ,$114.00 ,$182.40 ,$61.28 ,$24.51 ,$159.60 ,$24.51 ,$136.80 ,$24.51 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$24.51 ,$125.86 ,$35.40 ,$35.40 ,$193.80 ,$61.28 ,$158.00 ,$24.51 ,$228.00 ,$125.40 ,$24.51 ,$59.96 , N/A ,$9.61 ,$9.18 ,$25.74 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$49.02 ,$24.51 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,30101339,83915,HC NUCLEOTIDASE 5 -90,301,1 ,$107.00 ,$69.55 ,$3.50 ,$107.00 ,$27.88 ,$26.06 ,$58.85 ,$11.15 ,$29.96 ,$52.43 ,$11.15 ,$62.60 ,$11.15 ,$58.10 ,$3.50 ,$11.15 ,$58.10 ,$21.19 ,$74.90 ,$53.50 ,$85.60 ,$27.88 ,$11.15 ,$74.90 ,$11.15 ,$64.20 ,$11.15 ,$80.25 ,$59.06 ,$53.29 ,$59.06 ,$11.15 ,$59.06 ,$16.11 ,$16.11 ,$90.95 ,$27.88 ,$74.15 ,$11.15 ,$107.00 ,$58.85 ,$11.15 ,$28.14 , N/A ,$7.88 ,$7.52 ,$11.71 ,$85.60 ,$58.10 ,$29.96 ,$96.30 ,$40.66 ,$22.30 ,$11.15 ,$51.36 
ST. MARY'S HOSPITAL - DECATUR,30101340,83916,HC OLIGOCLONAL BANDS-90,301,1 ,$145.00 ,$94.25 ,$3.50 ,$145.00 ,$68.48 ,$46.98 ,$79.75 ,$27.39 ,$40.60 ,$71.05 ,$27.39 ,$84.83 ,$27.39 ,$78.74 ,$3.50 ,$27.39 ,$78.74 ,$52.04 ,$101.50 ,$72.50 ,$116.00 ,$68.48 ,$27.39 ,$101.50 ,$27.39 ,$87.00 ,$27.39 ,$108.75 ,$80.04 ,$72.21 ,$80.04 ,$27.39 ,$80.04 ,$35.61 ,$35.61 ,$123.25 ,$68.48 ,$100.49 ,$27.39 ,$145.00 ,$79.75 ,$27.39 ,$38.14 , N/A ,$7.88 ,$7.52 ,$28.76 ,$116.00 ,$78.74 ,$40.60 ,$130.50 ,$55.10 ,$54.78 ,$27.39 ,$69.60 
ST. MARY'S HOSPITAL - DECATUR,30101341,83918,HC ORGANIC ACIDS QN-90,301,1 ,$468.00 ,$304.20 ,$3.50 ,$468.00 ,$59.00 ,$38.46 ,$257.40 ,$23.60 ,$131.04 ,$150.79 ,$23.60 ,$150.79 ,$23.60 ,$254.12 ,$3.50 ,$23.60 ,$254.12 ,$44.84 ,$327.60 ,$234.00 ,$374.40 ,$59.00 ,$23.60 ,$327.60 ,$23.60 ,$280.80 ,$23.60 ,$351.00 ,$258.34 ,$233.06 ,$258.34 ,$23.60 ,$258.34 ,$30.68 ,$30.68 ,$397.80 ,$59.00 ,$324.32 ,$23.60 ,$468.00 ,$257.40 ,$23.60 ,$123.08 , N/A ,$9.61 ,$9.18 ,$24.78 ,$374.40 ,$254.12 ,$131.04 ,$421.20 ,$177.84 ,$47.20 ,$23.60 ,$224.64 
ST. MARY'S HOSPITAL - DECATUR,30101342,83919,HC ORGANIC ACIDS QL-90,301,1 ,$280.00 ,$182.00 ,$3.50 ,$280.00 ,$41.13 ,$38.46 ,$154.00 ,$16.45 ,$78.40 ,$129.76 ,$16.45 ,$129.76 ,$16.45 ,$152.04 ,$3.50 ,$16.45 ,$152.04 ,$31.26 ,$196.00 ,$140.00 ,$224.00 ,$41.13 ,$16.45 ,$196.00 ,$16.45 ,$168.00 ,$16.45 ,$210.00 ,$154.56 ,$139.44 ,$154.56 ,$16.45 ,$154.56 ,$23.76 ,$23.76 ,$238.00 ,$41.13 ,$194.04 ,$16.45 ,$280.00 ,$154.00 ,$16.45 ,$73.64 , N/A ,$7.88 ,$7.52 ,$17.27 ,$224.00 ,$152.04 ,$78.40 ,$252.00 ,$106.40 ,$32.90 ,$16.45 ,$134.40 
ST. MARY'S HOSPITAL - DECATUR,30101343,83935,HC OSMOLALITY URINE-90,301,1 ,$126.00 ,$81.90 ,$3.35 ,$126.00 ,$17.05 ,$15.92 ,$69.30 ,$6.82 ,$35.28 ,$53.77 ,$6.82 ,$53.77 ,$6.82 ,$68.42 ,$3.50 ,$6.82 ,$68.42 ,$12.96 ,$88.20 ,$63.00 ,$100.80 ,$17.05 ,$6.82 ,$88.20 ,$6.82 ,$75.60 ,$6.82 ,$94.50 ,$69.55 ,$62.75 ,$69.55 ,$6.82 ,$69.55 ,$9.84 ,$9.84 ,$107.10 ,$17.05 ,$87.32 ,$6.82 ,$126.00 ,$69.30 ,$6.82 ,$33.14 , N/A ,$3.51 ,$3.35 ,$7.16 ,$100.80 ,$68.42 ,$35.28 ,$113.40 ,$47.88 ,$13.64 ,$6.82 ,$60.48 
ST. MARY'S HOSPITAL - DECATUR,30101344,83937,HC OSTEOCALCIN-90,301,1 ,$181.00 ,$117.65 ,$3.50 ,$181.00 ,$74.63 ,$69.76 ,$99.55 ,$29.85 ,$50.68 ,$88.69 ,$29.85 ,$105.89 ,$29.85 ,$98.28 ,$3.50 ,$29.85 ,$98.28 ,$56.72 ,$126.70 ,$90.50 ,$144.80 ,$74.63 ,$29.85 ,$126.70 ,$29.85 ,$108.60 ,$29.85 ,$135.75 ,$99.91 ,$90.14 ,$99.91 ,$29.85 ,$99.91 ,$43.11 ,$43.11 ,$153.85 ,$74.63 ,$125.43 ,$29.85 ,$181.00 ,$99.55 ,$29.85 ,$47.60 , N/A ,$18.45 ,$17.61 ,$31.34 ,$144.80 ,$98.28 ,$50.68 ,$162.90 ,$68.78 ,$59.70 ,$29.85 ,$86.88 
ST. MARY'S HOSPITAL - DECATUR,30101345,83945,HC OXALATE-90,301,1 ,$143.00 ,$92.95 ,$3.50 ,$143.00 ,$36.13 ,$30.08 ,$78.65 ,$14.45 ,$40.04 ,$70.07 ,$14.45 ,$83.66 ,$14.45 ,$77.65 ,$3.50 ,$14.45 ,$77.65 ,$27.46 ,$100.10 ,$71.50 ,$114.40 ,$36.13 ,$14.45 ,$100.10 ,$14.45 ,$85.80 ,$14.45 ,$107.25 ,$78.94 ,$71.21 ,$78.94 ,$14.45 ,$78.94 ,$18.79 ,$18.79 ,$121.55 ,$36.13 ,$99.10 ,$14.45 ,$143.00 ,$78.65 ,$14.45 ,$37.61 , N/A ,$7.88 ,$7.52 ,$15.17 ,$114.40 ,$77.65 ,$40.04 ,$128.70 ,$54.34 ,$28.90 ,$14.45 ,$68.64 
ST. MARY'S HOSPITAL - DECATUR,30101346,83950,HC ONCOPROTEIN HER-2/NEU-90,301,1 ,"$2,004.00 ","$1,302.60 ",$3.50 ,"$2,004.00 ",$161.03 ,$109.38 ,"$1,102.20 ",$64.41 ,$561.12 ,$508.11 ,$64.41 ,$508.11 ,$64.41 ,"$1,088.17 ",$3.50 ,$64.41 ,"$1,088.17 ",$122.38 ,"$1,402.80 ","$1,002.00 ","$1,603.20 ",$161.03 ,$64.41 ,"$1,402.80 ",$64.41 ,"$1,202.40 ",$64.41 ,"$1,503.00 ","$1,106.21 ",$997.99 ,"$1,106.21 ",$64.41 ,"$1,106.21 ",$93.04 ,$93.04 ,"$1,703.40 ",$161.03 ,"$1,388.77 ",$64.41 ,"$2,004.00 ","$1,102.20 ",$64.41 ,$527.05 , N/A ,$24.77 ,$23.65 ,$67.63 ,"$1,603.20 ","$1,088.17 ",$561.12 ,"$1,803.60 ",$761.52 ,$128.82 ,$64.41 ,$961.92 
ST. MARY'S HOSPITAL - DECATUR,30101347,83970,HC PARATHYROID HORMONE (PTH)-90,301,1 ,$353.00 ,$229.45 ,$3.50 ,$353.00 ,$103.20 ,$96.46 ,$194.15 ,$41.28 ,$98.84 ,$172.97 ,$41.28 ,$206.51 ,$41.28 ,$191.68 ,$3.50 ,$41.28 ,$191.68 ,$78.43 ,$247.10 ,$176.50 ,$282.40 ,$103.20 ,$41.28 ,$247.10 ,$41.28 ,$211.80 ,$41.28 ,$264.75 ,$194.86 ,$175.79 ,$194.86 ,$41.28 ,$194.86 ,$59.62 ,$59.62 ,$300.05 ,$103.20 ,$244.63 ,$41.28 ,$353.00 ,$194.15 ,$41.28 ,$92.84 , N/A ,$18.45 ,$17.61 ,$43.34 ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$82.56 ,$41.28 ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,30101348,83986,HC PH BODY FLUID NOT BLOOD-90,301,1 ,$63.00 ,$40.95 ,$3.35 ,$63.00 ,$8.95 ,$8.36 ,$34.65 ,$3.58 ,$17.64 ,$30.87 ,$3.58 ,$36.86 ,$3.58 ,$34.21 ,$3.50 ,$3.58 ,$34.21 ,$6.80 ,$44.10 ,$31.50 ,$50.40 ,$8.95 ,$3.58 ,$44.10 ,$3.58 ,$37.80 ,$3.58 ,$47.25 ,$34.78 ,$31.37 ,$34.78 ,$3.58 ,$34.78 ,$5.17 ,$5.17 ,$53.55 ,$8.95 ,$43.66 ,$3.58 ,$63.00 ,$34.65 ,$3.58 ,$16.57 , N/A ,$3.51 ,$3.35 ,$3.76 ,$50.40 ,$34.21 ,$17.64 ,$56.70 ,$23.94 ,$7.16 ,$3.58 ,$30.24 
ST. MARY'S HOSPITAL - DECATUR,30101349,83992,HC PHENCYCLIDINE (PCP)-90,301,1 ,$163.00 ,$105.95 ,$0.02 ,$163.00 , N/A ,$0.02 ,$89.65 , N/A ,$45.64 ,$79.87 , N/A ,$95.36 , N/A ,$88.51 ,$3.50 , N/A ,$88.51 , N/A ,$114.10 ,$81.50 ,$130.40 , N/A , N/A ,$114.10 , N/A ,$97.80 , N/A ,$122.25 ,$89.98 ,$81.17 ,$89.98 , N/A ,$89.98 ,$21.84 ,$21.84 ,$138.55 , N/A ,$112.96 , N/A ,$163.00 ,$89.65 , N/A ,$42.87 , N/A ,$9.61 ,$9.18 , N/A ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$83.04 , N/A ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30101350,83992,HC PHENCYCLIDINE UMB CORD-90,301,1 ,$55.00 ,$35.75 ,$0.02 ,$55.00 , N/A ,$0.02 ,$30.25 , N/A ,$15.40 ,$26.95 , N/A ,$32.18 , N/A ,$29.87 ,$3.50 , N/A ,$29.87 , N/A ,$38.50 ,$27.50 ,$44.00 , N/A , N/A ,$38.50 , N/A ,$33.00 , N/A ,$41.25 ,$30.36 ,$27.39 ,$30.36 , N/A ,$30.36 ,$21.84 ,$21.84 ,$46.75 , N/A ,$38.12 , N/A ,$55.00 ,$30.25 , N/A ,$14.47 , N/A ,$9.61 ,$9.18 , N/A ,$44.00 ,$29.87 ,$15.40 ,$49.50 ,$20.90 ,$55.00 , N/A ,$26.40 
ST. MARY'S HOSPITAL - DECATUR,30101351,83993,HC CALPROTECTIN STOOL-90,301,1 ,$230.00 ,$149.50 ,$3.50 ,$230.00 ,$49.08 ,$45.86 ,$126.50 ,$19.63 ,$64.40 ,$112.70 ,$19.63 ,$134.55 ,$19.63 ,$124.89 ,$3.50 ,$19.63 ,$124.89 ,$37.30 ,$161.00 ,$115.00 ,$184.00 ,$49.08 ,$19.63 ,$161.00 ,$19.63 ,$138.00 ,$19.63 ,$172.50 ,$126.96 ,$114.54 ,$126.96 ,$19.63 ,$126.96 ,$28.35 ,$28.35 ,$195.50 ,$49.08 ,$159.39 ,$19.63 ,$230.00 ,$126.50 ,$19.63 ,$60.49 , N/A ,$7.88 ,$7.52 ,$20.61 ,$184.00 ,$124.89 ,$64.40 ,$207.00 ,$87.40 ,$39.26 ,$19.63 ,$110.40 
ST. MARY'S HOSPITAL - DECATUR,30101352,84030,HC NEWBORN SCREEN PKU-90,301,1 ,$177.00 ,$115.05 ,$3.35 ,$177.00 ,$13.75 ,$12.86 ,$97.35 ,$5.50 ,$49.56 ,$58.78 ,$5.50 ,$58.78 ,$5.50 ,$96.11 ,$3.50 ,$5.50 ,$96.11 ,$10.45 ,$123.90 ,$88.50 ,$141.60 ,$13.75 ,$5.50 ,$123.90 ,$5.50 ,$106.20 ,$5.50 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$5.50 ,$97.70 ,$7.94 ,$7.94 ,$150.45 ,$13.75 ,$122.66 ,$5.50 ,$177.00 ,$97.35 ,$5.50 ,$46.55 , N/A ,$3.51 ,$3.35 ,$5.78 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$11.00 ,$5.50 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30101353,84066,HC PHOSPHATASE ACID PROSTATIC-90,301,1 ,$108.00 ,$70.20 ,$3.50 ,$108.00 ,$24.15 ,$22.58 ,$59.40 ,$9.66 ,$30.24 ,$52.92 ,$9.66 ,$63.18 ,$9.66 ,$58.64 ,$3.50 ,$9.66 ,$58.64 ,$18.35 ,$75.60 ,$54.00 ,$86.40 ,$24.15 ,$9.66 ,$75.60 ,$9.66 ,$64.80 ,$9.66 ,$81.00 ,$59.62 ,$53.78 ,$59.62 ,$9.66 ,$59.62 ,$13.95 ,$13.95 ,$91.80 ,$24.15 ,$74.84 ,$9.66 ,$108.00 ,$59.40 ,$9.66 ,$28.40 , N/A ,$7.88 ,$7.52 ,$10.14 ,$86.40 ,$58.64 ,$30.24 ,$97.20 ,$41.04 ,$19.32 ,$9.66 ,$51.84 
ST. MARY'S HOSPITAL - DECATUR,30101354,84075,HC ALKALINE PHOSPHATASE-90,301,1 ,$120.00 ,$78.00 ,$3.35 ,$120.00 ,$12.95 ,$12.08 ,$66.00 ,$5.18 ,$33.60 ,$55.24 ,$5.18 ,$55.24 ,$5.18 ,$65.16 ,$3.50 ,$5.18 ,$65.16 ,$9.84 ,$84.00 ,$60.00 ,$96.00 ,$12.95 ,$5.18 ,$84.00 ,$5.18 ,$72.00 ,$5.18 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$5.18 ,$66.24 ,$7.48 ,$7.48 ,$102.00 ,$12.95 ,$83.16 ,$5.18 ,$120.00 ,$66.00 ,$5.18 ,$31.56 , N/A ,$3.51 ,$3.35 ,$5.44 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$10.36 ,$5.18 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30101355,84078,HC ALKALINE PHOSPHATASE HEAT-90,301,1 ,$103.00 ,$66.95 ,$3.35 ,$103.00 ,$20.65 ,$17.06 ,$56.65 ,$8.26 ,$28.84 ,$50.47 ,$8.26 ,$57.60 ,$8.26 ,$55.93 ,$3.50 ,$8.26 ,$55.93 ,$15.69 ,$72.10 ,$51.50 ,$82.40 ,$20.65 ,$8.26 ,$72.10 ,$8.26 ,$61.80 ,$8.26 ,$77.25 ,$56.86 ,$51.29 ,$56.86 ,$8.26 ,$56.86 ,$10.74 ,$10.74 ,$87.55 ,$20.65 ,$71.38 ,$8.26 ,$103.00 ,$56.65 ,$8.26 ,$27.09 , N/A ,$3.51 ,$3.35 ,$8.67 ,$82.40 ,$55.93 ,$28.84 ,$92.70 ,$39.14 ,$16.52 ,$8.26 ,$49.44 
ST. MARY'S HOSPITAL - DECATUR,30101356,84080,HC ALK PHOS ISOENZ-90,301,1 ,$80.00 ,$52.00 ,$3.50 ,$80.00 ,$36.95 ,$34.56 ,$44.00 ,$14.78 ,$22.40 ,$39.20 ,$14.78 ,$46.80 ,$14.78 ,$43.44 ,$3.50 ,$14.78 ,$43.44 ,$28.08 ,$56.00 ,$40.00 ,$64.00 ,$36.95 ,$14.78 ,$56.00 ,$14.78 ,$48.00 ,$14.78 ,$60.00 ,$44.16 ,$39.84 ,$44.16 ,$14.78 ,$44.16 ,$21.36 ,$21.36 ,$68.00 ,$36.95 ,$55.44 ,$14.78 ,$80.00 ,$44.00 ,$14.78 ,$21.04 , N/A ,$7.88 ,$7.52 ,$15.52 ,$64.00 ,$43.44 ,$22.40 ,$72.00 ,$30.40 ,$29.56 ,$14.78 ,$38.40 
ST. MARY'S HOSPITAL - DECATUR,30101357,84081,HC PHOSPHATIDYLGLYCEROL (PG)-90,301,1 ,$202.00 ,$131.30 ,$3.50 ,$202.00 ,$41.30 ,$38.60 ,$111.10 ,$16.52 ,$56.56 ,$98.98 ,$16.52 ,$118.17 ,$16.52 ,$109.69 ,$3.50 ,$16.52 ,$109.69 ,$31.39 ,$141.40 ,$101.00 ,$161.60 ,$41.30 ,$16.52 ,$141.40 ,$16.52 ,$121.20 ,$16.52 ,$151.50 ,$111.50 ,$100.60 ,$111.50 ,$16.52 ,$111.50 ,$23.86 ,$23.86 ,$171.70 ,$41.30 ,$139.99 ,$16.52 ,$202.00 ,$111.10 ,$16.52 ,$53.13 , N/A ,$7.88 ,$7.52 ,$17.35 ,$161.60 ,$109.69 ,$56.56 ,$181.80 ,$76.76 ,$33.04 ,$16.52 ,$96.96 
ST. MARY'S HOSPITAL - DECATUR,30101358,84105,HC PHOSPHORUS URINE-90,301,1 ,$63.00 ,$40.95 ,$3.35 ,$63.00 ,$14.45 ,$12.08 ,$34.65 ,$5.78 ,$17.64 ,$30.87 ,$5.78 ,$36.86 ,$5.78 ,$34.21 ,$3.50 ,$5.78 ,$34.21 ,$10.98 ,$44.10 ,$31.50 ,$50.40 ,$14.45 ,$5.78 ,$44.10 ,$5.78 ,$37.80 ,$5.78 ,$47.25 ,$34.78 ,$31.37 ,$34.78 ,$5.78 ,$34.78 ,$7.51 ,$7.51 ,$53.55 ,$14.45 ,$43.66 ,$5.78 ,$63.00 ,$34.65 ,$5.78 ,$16.57 , N/A ,$3.51 ,$3.35 ,$6.07 ,$50.40 ,$34.21 ,$17.64 ,$56.70 ,$23.94 ,$11.56 ,$5.78 ,$30.24 
ST. MARY'S HOSPITAL - DECATUR,30101359,84110,HC PORPHOBILINOGEN QN-90,301,1 ,$130.00 ,$84.50 ,$3.50 ,$130.00 ,$21.10 ,$19.72 ,$71.50 ,$8.44 ,$36.40 ,$63.70 ,$8.44 ,$66.55 ,$8.44 ,$70.59 ,$3.50 ,$8.44 ,$70.59 ,$16.04 ,$91.00 ,$65.00 ,$104.00 ,$21.10 ,$8.44 ,$91.00 ,$8.44 ,$78.00 ,$8.44 ,$97.50 ,$71.76 ,$64.74 ,$71.76 ,$8.44 ,$71.76 ,$12.19 ,$12.19 ,$110.50 ,$21.10 ,$90.09 ,$8.44 ,$130.00 ,$71.50 ,$8.44 ,$34.19 , N/A ,$7.88 ,$7.52 ,$8.86 ,$104.00 ,$70.59 ,$36.40 ,$117.00 ,$49.40 ,$16.88 ,$8.44 ,$62.40 
ST. MARY'S HOSPITAL - DECATUR,30101360,84112,HC EVAL C/V AMNIOTIC FLD QL EA,301,1 ,$228.00 ,$148.20 ,$3.50 ,$245.28 ,$245.28 ,$109.38 ,$125.40 ,$98.11 ,$63.84 ,$111.72 ,$98.11 ,$133.38 ,$98.11 ,$123.80 ,$3.50 ,$98.11 ,$123.80 ,$186.41 ,$159.60 ,$114.00 ,$182.40 ,$245.28 ,$98.11 ,$159.60 ,$98.11 ,$136.80 ,$98.11 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$98.11 ,$125.86 ,$127.54 ,$127.54 ,$193.80 ,$228.00 ,$158.00 ,$98.11 ,$228.00 ,$125.40 ,$98.11 ,$59.96 , N/A ,$21.22 ,$20.25 ,$103.02 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$196.22 ,$98.11 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,30101361,84120,HC PORPHYRINS QN FRACT-90,301,1 ,$189.00 ,$122.85 ,$3.50 ,$189.00 ,$36.78 ,$34.38 ,$103.95 ,$14.71 ,$52.92 ,$92.61 ,$14.71 ,$110.57 ,$14.71 ,$102.63 ,$3.50 ,$14.71 ,$102.63 ,$27.95 ,$132.30 ,$94.50 ,$151.20 ,$36.78 ,$14.71 ,$132.30 ,$14.71 ,$113.40 ,$14.71 ,$141.75 ,$104.33 ,$94.12 ,$104.33 ,$14.71 ,$104.33 ,$21.26 ,$21.26 ,$160.65 ,$36.78 ,$130.98 ,$14.71 ,$189.00 ,$103.95 ,$14.71 ,$49.71 , N/A ,$7.88 ,$7.52 ,$15.45 ,$151.20 ,$102.63 ,$52.92 ,$170.10 ,$71.82 ,$29.42 ,$14.71 ,$90.72 
ST. MARY'S HOSPITAL - DECATUR,30101362,84126,HC PORPHYRINS FECES QN-90,301,1 ,$520.00 ,$338.00 ,$3.50 ,$520.00 ,$97.78 ,$59.52 ,$286.00 ,$39.11 ,$145.60 ,$249.88 ,$39.11 ,$249.88 ,$39.11 ,$282.36 ,$3.50 ,$39.11 ,$282.36 ,$74.31 ,$364.00 ,$260.00 ,$416.00 ,$97.78 ,$39.11 ,$364.00 ,$39.11 ,$312.00 ,$39.11 ,$390.00 ,$287.04 ,$258.96 ,$287.04 ,$39.11 ,$287.04 ,$50.84 ,$50.84 ,$442.00 ,$97.78 ,$360.36 ,$39.11 ,$520.00 ,$286.00 ,$39.11 ,$136.76 , N/A ,$7.88 ,$7.52 ,$41.07 ,$416.00 ,$282.36 ,$145.60 ,$468.00 ,$197.60 ,$78.22 ,$39.11 ,$249.60 
ST. MARY'S HOSPITAL - DECATUR,30101364,84133,HC POTASSIUM URINE-90,301,1 ,$96.00 ,$62.40 ,$3.35 ,$96.00 ,$11.83 ,$10.04 ,$52.80 ,$4.73 ,$26.88 ,$34.01 ,$4.73 ,$34.01 ,$4.73 ,$52.13 ,$3.50 ,$4.73 ,$52.13 ,$8.99 ,$67.20 ,$48.00 ,$76.80 ,$11.83 ,$4.73 ,$67.20 ,$4.73 ,$57.60 ,$4.73 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$4.73 ,$52.99 ,$6.23 ,$6.23 ,$81.60 ,$11.83 ,$66.53 ,$4.73 ,$96.00 ,$52.80 ,$4.73 ,$25.25 , N/A ,$3.51 ,$3.35 ,$4.97 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$9.46 ,$4.73 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30101365,84134,HC PREALBUMIN-90,301,1 ,$137.00 ,$89.05 ,$3.50 ,$137.00 ,$36.48 ,$34.08 ,$75.35 ,$14.59 ,$38.36 ,$67.13 ,$14.59 ,$80.15 ,$14.59 ,$74.39 ,$3.50 ,$14.59 ,$74.39 ,$27.72 ,$95.90 ,$68.50 ,$109.60 ,$36.48 ,$14.59 ,$95.90 ,$14.59 ,$82.20 ,$14.59 ,$102.75 ,$75.62 ,$68.23 ,$75.62 ,$14.59 ,$75.62 ,$21.07 ,$21.07 ,$116.45 ,$36.48 ,$94.94 ,$14.59 ,$137.00 ,$75.35 ,$14.59 ,$36.03 , N/A ,$7.88 ,$7.52 ,$15.32 ,$109.60 ,$74.39 ,$38.36 ,$123.30 ,$52.06 ,$29.18 ,$14.59 ,$65.76 
ST. MARY'S HOSPITAL - DECATUR,30101366,84140,HC PREGNENOLONE-90,301,1 ,$134.00 ,$87.10 ,$3.50 ,$134.00 ,$51.68 ,$48.32 ,$73.70 ,$20.67 ,$37.52 ,$65.66 ,$20.67 ,$78.39 ,$20.67 ,$72.76 ,$3.50 ,$20.67 ,$72.76 ,$39.27 ,$93.80 ,$67.00 ,$107.20 ,$51.68 ,$20.67 ,$93.80 ,$20.67 ,$80.40 ,$20.67 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$20.67 ,$73.97 ,$29.86 ,$29.86 ,$113.90 ,$51.68 ,$92.86 ,$20.67 ,$134.00 ,$73.70 ,$20.67 ,$35.24 , N/A ,$18.45 ,$17.61 ,$21.70 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$41.34 ,$20.67 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,30101368,84144,HC PROGESTERONE-90,301,1 ,$184.00 ,$119.60 ,$3.50 ,$184.00 ,$52.15 ,$48.76 ,$101.20 ,$20.86 ,$51.52 ,$90.16 ,$20.86 ,$107.64 ,$20.86 ,$99.91 ,$3.50 ,$20.86 ,$99.91 ,$39.63 ,$128.80 ,$92.00 ,$147.20 ,$52.15 ,$20.86 ,$128.80 ,$20.86 ,$110.40 ,$20.86 ,$138.00 ,$101.57 ,$91.63 ,$101.57 ,$20.86 ,$101.57 ,$30.13 ,$30.13 ,$156.40 ,$52.15 ,$127.51 ,$20.86 ,$184.00 ,$101.20 ,$20.86 ,$48.39 , N/A ,$10.60 ,$10.12 ,$21.90 ,$147.20 ,$99.91 ,$51.52 ,$165.60 ,$69.92 ,$41.72 ,$20.86 ,$88.32 
ST. MARY'S HOSPITAL - DECATUR,30101369,84145,HC PROCALCITONIN (PCT)-90,301,1 ,$277.00 ,$180.05 ,$3.50 ,$277.00 ,$68.05 ,$62.60 ,$152.35 ,$27.22 ,$77.56 ,$135.73 ,$27.22 ,$162.05 ,$27.22 ,$150.41 ,$3.50 ,$27.22 ,$150.41 ,$51.72 ,$193.90 ,$138.50 ,$221.60 ,$68.05 ,$27.22 ,$193.90 ,$27.22 ,$166.20 ,$27.22 ,$207.75 ,$152.90 ,$137.95 ,$152.90 ,$27.22 ,$152.90 ,$38.70 ,$38.70 ,$235.45 ,$68.05 ,$191.96 ,$27.22 ,$277.00 ,$152.35 ,$27.22 ,$72.85 , N/A ,$18.45 ,$17.61 ,$28.58 ,$221.60 ,$150.41 ,$77.56 ,$249.30 ,$105.26 ,$54.44 ,$27.22 ,$132.96 
ST. MARY'S HOSPITAL - DECATUR,30101372,84155,HC PROTEIN TOTAL-90,301,1 ,$88.00 ,$57.20 ,$3.35 ,$88.00 ,$9.18 ,$8.56 ,$48.40 ,$3.67 ,$24.64 ,$39.22 ,$3.67 ,$39.22 ,$3.67 ,$47.78 ,$3.50 ,$3.67 ,$47.78 ,$6.97 ,$61.60 ,$44.00 ,$70.40 ,$9.18 ,$3.67 ,$61.60 ,$3.67 ,$52.80 ,$3.67 ,$66.00 ,$48.58 ,$43.82 ,$48.58 ,$3.67 ,$48.58 ,$5.29 ,$5.29 ,$74.80 ,$9.18 ,$60.98 ,$3.67 ,$88.00 ,$48.40 ,$3.67 ,$23.14 , N/A ,$3.51 ,$3.35 ,$3.85 ,$70.40 ,$47.78 ,$24.64 ,$79.20 ,$33.44 ,$7.34 ,$3.67 ,$42.24 
ST. MARY'S HOSPITAL - DECATUR,30101373,84156,HC PROTEIN TOTAL URINE-90,301,1 ,$182.00 ,$118.30 ,$3.35 ,$182.00 ,$9.18 ,$8.56 ,$100.10 ,$3.67 ,$50.96 ,$28.90 ,$3.67 ,$28.90 ,$3.67 ,$98.83 ,$3.50 ,$3.67 ,$98.83 ,$6.97 ,$127.40 ,$91.00 ,$145.60 ,$9.18 ,$3.67 ,$127.40 ,$3.67 ,$109.20 ,$3.67 ,$136.50 ,$100.46 ,$90.64 ,$100.46 ,$3.67 ,$100.46 ,$5.29 ,$5.29 ,$154.70 ,$9.18 ,$126.13 ,$3.67 ,$182.00 ,$100.10 ,$3.67 ,$47.87 , N/A ,$3.51 ,$3.35 ,$3.85 ,$145.60 ,$98.83 ,$50.96 ,$163.80 ,$69.16 ,$7.34 ,$3.67 ,$87.36 
ST. MARY'S HOSPITAL - DECATUR,30101374,84157,HC PROTEIN TOTAL OTH SRC-90,301,1 ,$111.00 ,$72.15 ,$3.35 ,$111.00 ,$10.00 ,$8.56 ,$61.05 ,$4.00 ,$31.08 ,$39.22 ,$4.00 ,$39.22 ,$4.00 ,$60.27 ,$3.50 ,$4.00 ,$60.27 ,$7.60 ,$77.70 ,$55.50 ,$88.80 ,$10.00 ,$4.00 ,$77.70 ,$4.00 ,$66.60 ,$4.00 ,$83.25 ,$61.27 ,$55.28 ,$61.27 ,$4.00 ,$61.27 ,$5.29 ,$5.29 ,$94.35 ,$10.00 ,$76.92 ,$4.00 ,$111.00 ,$61.05 ,$4.00 ,$29.19 , N/A ,$3.51 ,$3.35 ,$4.20 ,$88.80 ,$60.27 ,$31.08 ,$99.90 ,$42.18 ,$8.00 ,$4.00 ,$53.28 
ST. MARY'S HOSPITAL - DECATUR,30101375,84165,HC PROTEIN ELECTROPHORESIS-90,301,1 ,$46.00 ,$29.90 ,$7.52 ,$46.00 ,$26.85 ,$25.10 ,$25.30 ,$10.74 ,$12.88 ,$22.54 ,$10.74 ,$26.91 ,$10.74 ,$24.98 ,$8.47 ,$10.74 ,$24.98 ,$20.41 ,$32.20 ,$23.00 ,$36.80 ,$26.85 ,$10.74 ,$32.20 ,$10.74 ,$27.60 ,$10.74 ,$34.50 ,$25.39 ,$22.91 ,$25.39 ,$10.74 ,$25.39 ,$15.51 ,$15.51 ,$39.10 ,$26.85 ,$31.88 ,$10.74 ,$46.00 ,$25.30 ,$10.74 ,$12.10 , N/A ,$7.88 ,$7.52 ,$11.28 ,$36.80 ,$24.98 ,$12.88 ,$41.40 ,$17.48 ,$21.48 ,$10.74 ,$22.08 
ST. MARY'S HOSPITAL - DECATUR,30101377,84166,HC PROTEIN EP OTH FLUID-90,301,1 ,$46.00 ,$29.90 ,$7.52 ,$46.00 ,$44.58 ,$41.68 ,$25.30 ,$17.83 ,$12.88 ,$22.54 ,$17.83 ,$26.91 ,$17.83 ,$24.98 ,$14.07 ,$17.83 ,$24.98 ,$33.88 ,$32.20 ,$23.00 ,$36.80 ,$44.58 ,$17.83 ,$32.20 ,$17.83 ,$27.60 ,$17.83 ,$34.50 ,$25.39 ,$22.91 ,$25.39 ,$17.83 ,$25.39 ,$25.75 ,$25.75 ,$39.10 ,$44.58 ,$31.88 ,$17.83 ,$46.00 ,$25.30 ,$17.83 ,$12.10 , N/A ,$7.88 ,$7.52 ,$18.72 ,$36.80 ,$24.98 ,$12.88 ,$41.40 ,$17.48 ,$35.66 ,$17.83 ,$22.08 
ST. MARY'S HOSPITAL - DECATUR,30101379,84181,HC PROTEIN WESTERN BLOT-90,301,1 ,$346.00 ,$224.90 ,$6.74 ,$346.00 ,$42.58 ,$39.80 ,$190.30 ,$17.03 ,$96.88 ,$134.28 ,$17.03 ,$134.28 ,$17.03 ,$187.88 ,$13.43 ,$17.03 ,$187.88 ,$32.36 ,$242.20 ,$173.00 ,$276.80 ,$42.58 ,$17.03 ,$242.20 ,$17.03 ,$207.60 ,$17.03 ,$259.50 ,$190.99 ,$172.31 ,$190.99 ,$17.03 ,$190.99 ,$24.60 ,$24.60 ,$294.10 ,$42.58 ,$239.78 ,$17.03 ,$346.00 ,$190.30 ,$17.03 ,$91.00 , N/A ,$7.06 ,$6.74 ,$17.88 ,$276.80 ,$187.88 ,$96.88 ,$311.40 ,$131.48 ,$34.06 ,$17.03 ,$166.08 
ST. MARY'S HOSPITAL - DECATUR,30101380,84182,HC PROTEIN WEST BLOT BAND ID-90,301,1 ,$291.00 ,$189.15 ,$11.61 ,$291.00 ,$73.03 ,$42.06 ,$160.05 ,$29.21 ,$81.48 ,$142.59 ,$29.21 ,$170.24 ,$29.21 ,$158.01 ,$20.74 ,$29.21 ,$158.01 ,$55.50 ,$203.70 ,$145.50 ,$232.80 ,$73.03 ,$29.21 ,$203.70 ,$29.21 ,$174.60 ,$29.21 ,$218.25 ,$160.63 ,$144.92 ,$160.63 ,$29.21 ,$160.63 ,$37.97 ,$37.97 ,$247.35 ,$73.03 ,$201.66 ,$29.21 ,$291.00 ,$160.05 ,$29.21 ,$76.53 , N/A ,$12.17 ,$11.61 ,$30.67 ,$232.80 ,$158.01 ,$81.48 ,$261.90 ,$110.58 ,$58.42 ,$29.21 ,$139.68 
ST. MARY'S HOSPITAL - DECATUR,30101381,84202,HC PROTOPORPHYRIN-90,301,1 ,$58.00 ,$37.70 ,$3.50 ,$58.00 ,$35.88 ,$33.52 ,$31.90 ,$14.35 ,$16.24 ,$28.42 ,$14.35 ,$33.93 ,$14.35 ,$31.49 ,$3.50 ,$14.35 ,$31.49 ,$27.27 ,$40.60 ,$29.00 ,$46.40 ,$35.88 ,$14.35 ,$40.60 ,$14.35 ,$34.80 ,$14.35 ,$43.50 ,$32.02 ,$28.88 ,$32.02 ,$14.35 ,$32.02 ,$20.72 ,$20.72 ,$49.30 ,$35.88 ,$40.19 ,$14.35 ,$58.00 ,$31.90 ,$14.35 ,$15.25 , N/A ,$7.88 ,$7.52 ,$15.07 ,$46.40 ,$31.49 ,$16.24 ,$52.20 ,$22.04 ,$28.70 ,$14.35 ,$27.84 
ST. MARY'S HOSPITAL - DECATUR,30101382,84206,HC PROINSULIN-90,301,1 ,$222.00 ,$144.30 ,$3.50 ,$222.00 ,$66.73 ,$41.64 ,$122.10 ,$26.69 ,$62.16 ,$108.78 ,$26.69 ,$129.87 ,$26.69 ,$120.55 ,$3.50 ,$26.69 ,$120.55 ,$50.71 ,$155.40 ,$111.00 ,$177.60 ,$66.73 ,$26.69 ,$155.40 ,$26.69 ,$133.20 ,$26.69 ,$166.50 ,$122.54 ,$110.56 ,$122.54 ,$26.69 ,$122.54 ,$34.70 ,$34.70 ,$188.70 ,$66.73 ,$153.85 ,$26.69 ,$222.00 ,$122.10 ,$26.69 ,$58.39 , N/A ,$18.45 ,$17.61 ,$28.02 ,$177.60 ,$120.55 ,$62.16 ,$199.80 ,$84.36 ,$53.38 ,$26.69 ,$106.56 
ST. MARY'S HOSPITAL - DECATUR,30101383,84207,HC VITAMIN B6-90,301,1 ,$293.00 ,$190.45 ,$3.50 ,$293.00 ,$70.25 ,$65.66 ,$161.15 ,$28.10 ,$82.04 ,$143.57 ,$28.10 ,$171.41 ,$28.10 ,$159.10 ,$3.50 ,$28.10 ,$159.10 ,$53.39 ,$205.10 ,$146.50 ,$234.40 ,$70.25 ,$28.10 ,$205.10 ,$28.10 ,$175.80 ,$28.10 ,$219.75 ,$161.74 ,$145.91 ,$161.74 ,$28.10 ,$161.74 ,$40.59 ,$40.59 ,$249.05 ,$70.25 ,$203.05 ,$28.10 ,$293.00 ,$161.15 ,$28.10 ,$77.06 , N/A ,$7.88 ,$7.52 ,$29.51 ,$234.40 ,$159.10 ,$82.04 ,$263.70 ,$111.34 ,$56.20 ,$28.10 ,$140.64 
ST. MARY'S HOSPITAL - DECATUR,30101384,84210,HC PYRUVATE-90,301,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$36.20 ,$25.36 ,$89.10 ,$14.48 ,$45.36 ,$79.38 ,$14.48 ,$92.50 ,$14.48 ,$87.97 ,$3.50 ,$14.48 ,$87.97 ,$27.51 ,$113.40 ,$81.00 ,$129.60 ,$36.20 ,$14.48 ,$113.40 ,$14.48 ,$97.20 ,$14.48 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$14.48 ,$89.42 ,$18.82 ,$18.82 ,$137.70 ,$36.20 ,$112.27 ,$14.48 ,$162.00 ,$89.10 ,$14.48 ,$42.61 , N/A ,$7.88 ,$7.52 ,$15.20 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$28.96 ,$14.48 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30101386,84238,HC RECEPTOR ASSAY NON ENDO-90,301,1 ,$130.00 ,$84.50 ,$3.50 ,$130.00 ,$91.43 ,$85.46 ,$71.50 ,$36.57 ,$36.40 ,$63.70 ,$36.57 ,$76.05 ,$36.57 ,$70.59 ,$3.50 ,$36.57 ,$70.59 ,$69.48 ,$91.00 ,$65.00 ,$104.00 ,$91.43 ,$36.57 ,$91.00 ,$36.57 ,$78.00 ,$36.57 ,$97.50 ,$71.76 ,$64.74 ,$71.76 ,$36.57 ,$71.76 ,$52.82 ,$52.82 ,$110.50 ,$91.43 ,$90.09 ,$36.57 ,$130.00 ,$71.50 ,$36.57 ,$34.19 , N/A ,$21.22 ,$20.25 ,$38.40 ,$104.00 ,$70.59 ,$36.40 ,$117.00 ,$49.40 ,$73.14 ,$36.57 ,$62.40 
ST. MARY'S HOSPITAL - DECATUR,30101387,84244,HC RENIN-90,301,1 ,$184.00 ,$119.60 ,$3.50 ,$184.00 ,$54.98 ,$51.40 ,$101.20 ,$21.99 ,$51.52 ,$90.16 ,$21.99 ,$107.64 ,$21.99 ,$99.91 ,$3.50 ,$21.99 ,$99.91 ,$41.78 ,$128.80 ,$92.00 ,$147.20 ,$54.98 ,$21.99 ,$128.80 ,$21.99 ,$110.40 ,$21.99 ,$138.00 ,$101.57 ,$91.63 ,$101.57 ,$21.99 ,$101.57 ,$31.77 ,$31.77 ,$156.40 ,$54.98 ,$127.51 ,$21.99 ,$184.00 ,$101.20 ,$21.99 ,$48.39 , N/A ,$18.45 ,$17.61 ,$23.09 ,$147.20 ,$99.91 ,$51.52 ,$165.60 ,$69.92 ,$43.98 ,$21.99 ,$88.32 
ST. MARY'S HOSPITAL - DECATUR,30101388,84255,HC SELENIUM-90,301,1 ,$202.00 ,$131.30 ,$3.50 ,$202.00 ,$63.83 ,$59.68 ,$111.10 ,$25.53 ,$56.56 ,$98.98 ,$25.53 ,$118.17 ,$25.53 ,$109.69 ,$3.50 ,$25.53 ,$109.69 ,$48.51 ,$141.40 ,$101.00 ,$161.60 ,$63.83 ,$25.53 ,$141.40 ,$25.53 ,$121.20 ,$25.53 ,$151.50 ,$111.50 ,$100.60 ,$111.50 ,$25.53 ,$111.50 ,$36.88 ,$36.88 ,$171.70 ,$63.83 ,$139.99 ,$25.53 ,$202.00 ,$111.10 ,$25.53 ,$53.13 , N/A ,$7.88 ,$7.52 ,$26.81 ,$161.60 ,$109.69 ,$56.56 ,$181.80 ,$76.76 ,$51.06 ,$25.53 ,$96.96 
ST. MARY'S HOSPITAL - DECATUR,30101389,84252,HC VITAMIN B-2 (RIBOFLAVIN)-90,301,1 ,$286.00 ,$185.90 ,$3.50 ,$286.00 ,$50.60 ,$47.30 ,$157.30 ,$20.24 ,$80.08 ,$140.14 ,$20.24 ,$159.64 ,$20.24 ,$155.30 ,$3.50 ,$20.24 ,$155.30 ,$38.46 ,$200.20 ,$143.00 ,$228.80 ,$50.60 ,$20.24 ,$200.20 ,$20.24 ,$171.60 ,$20.24 ,$214.50 ,$157.87 ,$142.43 ,$157.87 ,$20.24 ,$157.87 ,$29.24 ,$29.24 ,$243.10 ,$50.60 ,$198.20 ,$20.24 ,$286.00 ,$157.30 ,$20.24 ,$75.22 , N/A ,$7.88 ,$7.52 ,$21.25 ,$228.80 ,$155.30 ,$80.08 ,$257.40 ,$108.68 ,$40.48 ,$20.24 ,$137.28 
ST. MARY'S HOSPITAL - DECATUR,30101390,84270,HC SEX HORMONE BIND GLOB-90,301,1 ,$131.00 ,$85.15 ,$3.50 ,$131.00 ,$54.33 ,$50.78 ,$72.05 ,$21.73 ,$36.68 ,$64.19 ,$21.73 ,$76.64 ,$21.73 ,$71.13 ,$3.50 ,$21.73 ,$71.13 ,$41.29 ,$91.70 ,$65.50 ,$104.80 ,$54.33 ,$21.73 ,$91.70 ,$21.73 ,$78.60 ,$21.73 ,$98.25 ,$72.31 ,$65.24 ,$72.31 ,$21.73 ,$72.31 ,$31.40 ,$31.40 ,$111.35 ,$54.33 ,$90.78 ,$21.73 ,$131.00 ,$72.05 ,$21.73 ,$34.45 , N/A ,$7.88 ,$7.52 ,$22.82 ,$104.80 ,$71.13 ,$36.68 ,$117.90 ,$49.78 ,$43.46 ,$21.73 ,$62.88 
ST. MARY'S HOSPITAL - DECATUR,30101391,84270,HC SEX HORMONE BIND GLOB,301,1 ,$131.00 ,$85.15 ,$3.50 ,$131.00 ,$54.33 ,$50.78 ,$72.05 ,$21.73 ,$36.68 ,$64.19 ,$21.73 ,$76.64 ,$21.73 ,$71.13 ,$3.50 ,$21.73 ,$71.13 ,$41.29 ,$91.70 ,$65.50 ,$104.80 ,$54.33 ,$21.73 ,$91.70 ,$21.73 ,$78.60 ,$21.73 ,$98.25 ,$72.31 ,$65.24 ,$72.31 ,$21.73 ,$72.31 ,$31.40 ,$31.40 ,$111.35 ,$54.33 ,$90.78 ,$21.73 ,$131.00 ,$72.05 ,$21.73 ,$34.45 , N/A ,$7.88 ,$7.52 ,$22.82 ,$104.80 ,$71.13 ,$36.68 ,$117.90 ,$49.78 ,$43.46 ,$21.73 ,$62.88 
ST. MARY'S HOSPITAL - DECATUR,30101392,84260,HC SEROTONIN-90,301,1 ,$131.00 ,$85.15 ,$3.50 ,$131.00 ,$77.45 ,$13.54 ,$72.05 ,$30.98 ,$36.68 ,$64.19 ,$30.98 ,$76.64 ,$30.98 ,$71.13 ,$3.50 ,$30.98 ,$71.13 ,$58.86 ,$91.70 ,$65.50 ,$104.80 ,$77.45 ,$30.98 ,$91.70 ,$30.98 ,$78.60 ,$30.98 ,$98.25 ,$72.31 ,$65.24 ,$72.31 ,$30.98 ,$72.31 ,$44.76 ,$44.76 ,$111.35 ,$77.45 ,$90.78 ,$30.98 ,$131.00 ,$72.05 ,$30.98 ,$34.45 , N/A ,$18.45 ,$17.61 ,$32.53 ,$104.80 ,$71.13 ,$36.68 ,$117.90 ,$49.78 ,$61.96 ,$30.98 ,$62.88 
ST. MARY'S HOSPITAL - DECATUR,30101394,84300,HC SODIUM URINE-90,301,1 ,$167.00 ,$108.55 ,$3.35 ,$167.00 ,$12.65 ,$11.38 ,$91.85 ,$5.06 ,$46.76 ,$38.34 ,$5.06 ,$38.34 ,$5.06 ,$90.68 ,$3.50 ,$5.06 ,$90.68 ,$9.61 ,$116.90 ,$83.50 ,$133.60 ,$12.65 ,$5.06 ,$116.90 ,$5.06 ,$100.20 ,$5.06 ,$125.25 ,$92.18 ,$83.17 ,$92.18 ,$5.06 ,$92.18 ,$7.02 ,$7.02 ,$141.95 ,$12.65 ,$115.73 ,$5.06 ,$167.00 ,$91.85 ,$5.06 ,$43.92 , N/A ,$3.51 ,$3.35 ,$5.31 ,$133.60 ,$90.68 ,$46.76 ,$150.30 ,$63.46 ,$10.12 ,$5.06 ,$80.16 
ST. MARY'S HOSPITAL - DECATUR,30101395,84302,HC SODIUM OTHER FLUID-90,301,1 ,$99.00 ,$64.35 ,$3.35 ,$99.00 ,$12.15 ,$11.38 ,$54.45 ,$4.86 ,$27.72 ,$38.34 ,$4.86 ,$38.34 ,$4.86 ,$53.76 ,$3.50 ,$4.86 ,$53.76 ,$9.23 ,$69.30 ,$49.50 ,$79.20 ,$12.15 ,$4.86 ,$69.30 ,$4.86 ,$59.40 ,$4.86 ,$74.25 ,$54.65 ,$49.30 ,$54.65 ,$4.86 ,$54.65 ,$7.02 ,$7.02 ,$84.15 ,$12.15 ,$68.61 ,$4.86 ,$99.00 ,$54.45 ,$4.86 ,$26.04 , N/A ,$3.51 ,$3.35 ,$5.10 ,$79.20 ,$53.76 ,$27.72 ,$89.10 ,$37.62 ,$9.72 ,$4.86 ,$47.52 
ST. MARY'S HOSPITAL - DECATUR,30101396,84305,HC SOMATOMEDIN-90,301,1 ,$225.00 ,$146.25 ,$3.50 ,$225.00 ,$53.15 ,$49.68 ,$123.75 ,$21.26 ,$63.00 ,$110.25 ,$21.26 ,$131.63 ,$21.26 ,$122.18 ,$3.50 ,$21.26 ,$122.18 ,$40.39 ,$157.50 ,$112.50 ,$180.00 ,$53.15 ,$21.26 ,$157.50 ,$21.26 ,$135.00 ,$21.26 ,$168.75 ,$124.20 ,$112.05 ,$124.20 ,$21.26 ,$124.20 ,$30.72 ,$30.72 ,$191.25 ,$53.15 ,$155.93 ,$21.26 ,$225.00 ,$123.75 ,$21.26 ,$59.18 , N/A ,$18.45 ,$17.61 ,$22.32 ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$42.52 ,$21.26 ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,30101397,84307,HC SOMATOSTATIN-90,301,1 ,$260.00 ,$169.00 ,$3.50 ,$260.00 ,$45.70 ,$42.72 ,$143.00 ,$18.28 ,$72.80 ,$127.40 ,$18.28 ,$144.11 ,$18.28 ,$141.18 ,$3.50 ,$18.28 ,$141.18 ,$34.73 ,$182.00 ,$130.00 ,$208.00 ,$45.70 ,$18.28 ,$182.00 ,$18.28 ,$156.00 ,$18.28 ,$195.00 ,$143.52 ,$129.48 ,$143.52 ,$18.28 ,$143.52 ,$26.40 ,$26.40 ,$221.00 ,$45.70 ,$180.18 ,$18.28 ,$260.00 ,$143.00 ,$18.28 ,$68.38 , N/A ,$18.45 ,$17.61 ,$19.19 ,$208.00 ,$141.18 ,$72.80 ,$234.00 ,$98.80 ,$36.56 ,$18.28 ,$124.80 
ST. MARY'S HOSPITAL - DECATUR,30101398,84311,HC SPECTROPHOTOMETRY-90,301,1 ,$302.00 ,$196.30 ,$3.50 ,$302.00 ,$20.25 ,$16.34 ,$166.10 ,$8.10 ,$84.56 ,$55.15 ,$8.10 ,$55.15 ,$8.10 ,$163.99 ,$3.50 ,$8.10 ,$163.99 ,$15.39 ,$211.40 ,$151.00 ,$241.60 ,$20.25 ,$8.10 ,$211.40 ,$8.10 ,$181.20 ,$8.10 ,$226.50 ,$166.70 ,$150.40 ,$166.70 ,$8.10 ,$166.70 ,$10.53 ,$10.53 ,$256.70 ,$20.25 ,$209.29 ,$8.10 ,$302.00 ,$166.10 ,$8.10 ,$79.43 , N/A ,$7.88 ,$7.52 ,$8.51 ,$241.60 ,$163.99 ,$84.56 ,$271.80 ,$114.76 ,$16.20 ,$8.10 ,$144.96 
ST. MARY'S HOSPITAL - DECATUR,30101400,84315,HC SPEC GRAVITY NON UR-90,301,1 ,$72.00 ,$46.80 ,$3.28 ,$72.00 ,$8.20 ,$5.86 ,$39.60 ,$3.28 ,$20.16 ,$20.94 ,$3.28 ,$20.94 ,$3.28 ,$39.10 ,$3.50 ,$3.28 ,$39.10 ,$6.23 ,$50.40 ,$36.00 ,$57.60 ,$8.20 ,$3.28 ,$50.40 ,$3.28 ,$43.20 ,$3.28 ,$54.00 ,$39.74 ,$35.86 ,$39.74 ,$3.28 ,$39.74 ,$4.26 ,$4.26 ,$61.20 ,$8.20 ,$49.90 ,$3.28 ,$72.00 ,$39.60 ,$3.28 ,$18.94 , N/A ,$3.51 ,$3.35 ,$3.44 ,$57.60 ,$39.10 ,$20.16 ,$64.80 ,$27.36 ,$6.56 ,$3.28 ,$34.56 
ST. MARY'S HOSPITAL - DECATUR,30101401,84315,HC SPEC GRAVITY NON UR,301,1 ,$72.00 ,$46.80 ,$3.28 ,$72.00 ,$8.20 ,$5.86 ,$39.60 ,$3.28 ,$20.16 ,$20.94 ,$3.28 ,$20.94 ,$3.28 ,$39.10 ,$3.50 ,$3.28 ,$39.10 ,$6.23 ,$50.40 ,$36.00 ,$57.60 ,$8.20 ,$3.28 ,$50.40 ,$3.28 ,$43.20 ,$3.28 ,$54.00 ,$39.74 ,$35.86 ,$39.74 ,$3.28 ,$39.74 ,$4.26 ,$4.26 ,$61.20 ,$8.20 ,$49.90 ,$3.28 ,$72.00 ,$39.60 ,$3.28 ,$18.94 , N/A ,$3.51 ,$3.35 ,$3.44 ,$57.60 ,$39.10 ,$20.16 ,$64.80 ,$27.36 ,$6.56 ,$3.28 ,$34.56 
ST. MARY'S HOSPITAL - DECATUR,30101402,84376,HC SUGARS SINGLE QL-90,301,1 ,$122.00 ,$79.30 ,$3.35 ,$122.00 ,$13.75 ,$12.86 ,$67.10 ,$5.50 ,$34.16 ,$43.35 ,$5.50 ,$43.35 ,$5.50 ,$66.25 ,$3.50 ,$5.50 ,$66.25 ,$10.45 ,$85.40 ,$61.00 ,$97.60 ,$13.75 ,$5.50 ,$85.40 ,$5.50 ,$73.20 ,$5.50 ,$91.50 ,$67.34 ,$60.76 ,$67.34 ,$5.50 ,$67.34 ,$7.94 ,$7.94 ,$103.70 ,$13.75 ,$84.55 ,$5.50 ,$122.00 ,$67.10 ,$5.50 ,$32.09 , N/A ,$3.51 ,$3.35 ,$5.78 ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$11.00 ,$5.50 ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,30101403,84378,HC SUGARS SINGLE QN-90,301,1 ,$413.00 ,$268.45 ,$3.50 ,$413.00 ,$28.83 ,$26.92 ,$227.15 ,$11.53 ,$115.64 ,$90.93 ,$11.53 ,$90.93 ,$11.53 ,$224.26 ,$3.50 ,$11.53 ,$224.26 ,$21.91 ,$289.10 ,$206.50 ,$330.40 ,$28.83 ,$11.53 ,$289.10 ,$11.53 ,$247.80 ,$11.53 ,$309.75 ,$227.98 ,$205.67 ,$227.98 ,$11.53 ,$227.98 ,$16.65 ,$16.65 ,$351.05 ,$28.83 ,$286.21 ,$11.53 ,$413.00 ,$227.15 ,$11.53 ,$108.62 , N/A ,$7.88 ,$7.52 ,$12.11 ,$330.40 ,$224.26 ,$115.64 ,$371.70 ,$156.94 ,$23.06 ,$11.53 ,$198.24 
ST. MARY'S HOSPITAL - DECATUR,30101405,84392,HC SULFATE URINE-90,301,1 ,$46.00 ,$29.90 ,$2.69 ,$46.00 ,$13.73 ,$11.10 ,$25.30 ,$5.49 ,$12.88 ,$22.54 ,$5.49 ,$26.91 ,$5.49 ,$24.98 ,$3.50 ,$5.49 ,$24.98 ,$10.43 ,$32.20 ,$23.00 ,$36.80 ,$13.73 ,$5.49 ,$32.20 ,$5.49 ,$27.60 ,$5.49 ,$34.50 ,$25.39 ,$22.91 ,$25.39 ,$5.49 ,$25.39 ,$7.14 ,$7.14 ,$39.10 ,$13.73 ,$31.88 ,$5.49 ,$46.00 ,$25.30 ,$5.49 ,$12.10 , N/A ,$2.82 ,$2.69 ,$5.76 ,$36.80 ,$24.98 ,$12.88 ,$41.40 ,$17.48 ,$10.98 ,$5.49 ,$22.08 
ST. MARY'S HOSPITAL - DECATUR,30101406,84402,HC TESTOSTERONE FREE-90,301,1 ,$94.00 ,$61.10 ,$3.50 ,$94.00 ,$63.68 ,$59.50 ,$51.70 ,$25.47 ,$26.32 ,$46.06 ,$25.47 ,$54.99 ,$25.47 ,$51.04 ,$3.50 ,$25.47 ,$51.04 ,$48.39 ,$65.80 ,$47.00 ,$75.20 ,$63.68 ,$25.47 ,$65.80 ,$25.47 ,$56.40 ,$25.47 ,$70.50 ,$51.89 ,$46.81 ,$51.89 ,$25.47 ,$51.89 ,$36.79 ,$36.79 ,$79.90 ,$63.68 ,$65.14 ,$25.47 ,$94.00 ,$51.70 ,$25.47 ,$24.72 , N/A ,$18.45 ,$17.61 ,$26.74 ,$75.20 ,$51.04 ,$26.32 ,$84.60 ,$35.72 ,$50.94 ,$25.47 ,$45.12 
ST. MARY'S HOSPITAL - DECATUR,30101407,84403,HC TESTOSTERONE TOTAL-90,301,1 ,$190.00 ,$123.50 ,$3.50 ,$190.00 ,$64.53 ,$60.34 ,$104.50 ,$25.81 ,$53.20 ,$93.10 ,$25.81 ,$111.15 ,$25.81 ,$103.17 ,$3.50 ,$25.81 ,$103.17 ,$49.04 ,$133.00 ,$95.00 ,$152.00 ,$64.53 ,$25.81 ,$133.00 ,$25.81 ,$114.00 ,$25.81 ,$142.50 ,$104.88 ,$94.62 ,$104.88 ,$25.81 ,$104.88 ,$37.28 ,$37.28 ,$161.50 ,$64.53 ,$131.67 ,$25.81 ,$190.00 ,$104.50 ,$25.81 ,$49.97 , N/A ,$18.45 ,$17.61 ,$27.10 ,$152.00 ,$103.17 ,$53.20 ,$171.00 ,$72.20 ,$51.62 ,$25.81 ,$91.20 
ST. MARY'S HOSPITAL - DECATUR,30101408,84425,HC VITAMIN B1-90,301,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$53.08 ,$49.62 ,$80.30 ,$21.23 ,$40.88 ,$71.54 ,$21.23 ,$85.41 ,$21.23 ,$79.28 ,$3.50 ,$21.23 ,$79.28 ,$40.34 ,$102.20 ,$73.00 ,$116.80 ,$53.08 ,$21.23 ,$102.20 ,$21.23 ,$87.60 ,$21.23 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$21.23 ,$80.59 ,$30.67 ,$30.67 ,$124.10 ,$53.08 ,$101.18 ,$21.23 ,$146.00 ,$80.30 ,$21.23 ,$38.40 , N/A ,$7.88 ,$7.52 ,$22.29 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$42.46 ,$21.23 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30101410,84432,HC THYROGLOBULIN-90,301,1 ,$158.00 ,$102.70 ,$3.50 ,$158.00 ,$40.15 ,$37.54 ,$86.90 ,$16.06 ,$44.24 ,$77.42 ,$16.06 ,$92.43 ,$16.06 ,$85.79 ,$3.50 ,$16.06 ,$85.79 ,$30.51 ,$110.60 ,$79.00 ,$126.40 ,$40.15 ,$16.06 ,$110.60 ,$16.06 ,$94.80 ,$16.06 ,$118.50 ,$87.22 ,$78.68 ,$87.22 ,$16.06 ,$87.22 ,$23.19 ,$23.19 ,$134.30 ,$40.15 ,$109.49 ,$16.06 ,$158.00 ,$86.90 ,$16.06 ,$41.55 , N/A ,$18.45 ,$17.61 ,$16.86 ,$126.40 ,$85.79 ,$44.24 ,$142.20 ,$60.04 ,$32.12 ,$16.06 ,$75.84 
ST. MARY'S HOSPITAL - DECATUR,30101412,84436,HC THYROXINE (T-4) TOTAL-90,301,1 ,$68.00 ,$44.20 ,$3.50 ,$68.00 ,$17.18 ,$16.04 ,$37.40 ,$6.87 ,$19.04 ,$33.32 ,$6.87 ,$39.78 ,$6.87 ,$36.92 ,$3.50 ,$6.87 ,$36.92 ,$13.05 ,$47.60 ,$34.00 ,$54.40 ,$17.18 ,$6.87 ,$47.60 ,$6.87 ,$40.80 ,$6.87 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$6.87 ,$37.54 ,$9.92 ,$9.92 ,$57.80 ,$17.18 ,$47.12 ,$6.87 ,$68.00 ,$37.40 ,$6.87 ,$17.88 , N/A ,$10.60 ,$10.12 ,$7.21 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$13.74 ,$6.87 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30101413,84439,HC T4 FREE-90,301,1 ,$158.00 ,$102.70 ,$3.50 ,$158.00 ,$22.55 ,$21.08 ,$86.90 ,$9.02 ,$44.24 ,$71.07 ,$9.02 ,$71.07 ,$9.02 ,$85.79 ,$3.50 ,$9.02 ,$85.79 ,$17.14 ,$110.60 ,$79.00 ,$126.40 ,$22.55 ,$9.02 ,$110.60 ,$9.02 ,$94.80 ,$9.02 ,$118.50 ,$87.22 ,$78.68 ,$87.22 ,$9.02 ,$87.22 ,$13.03 ,$13.03 ,$134.30 ,$22.55 ,$109.49 ,$9.02 ,$158.00 ,$86.90 ,$9.02 ,$41.55 , N/A ,$10.60 ,$10.12 ,$9.47 ,$126.40 ,$85.79 ,$44.24 ,$142.20 ,$60.04 ,$18.04 ,$9.02 ,$75.84 
ST. MARY'S HOSPITAL - DECATUR,30101415,84442,HC THYROXINE BIND GLOB-90,301,1 ,$170.00 ,$110.50 ,$3.50 ,$170.00 ,$36.95 ,$34.56 ,$93.50 ,$14.78 ,$47.60 ,$83.30 ,$14.78 ,$99.45 ,$14.78 ,$92.31 ,$3.50 ,$14.78 ,$92.31 ,$28.08 ,$119.00 ,$85.00 ,$136.00 ,$36.95 ,$14.78 ,$119.00 ,$14.78 ,$102.00 ,$14.78 ,$127.50 ,$93.84 ,$84.66 ,$93.84 ,$14.78 ,$93.84 ,$21.36 ,$21.36 ,$144.50 ,$36.95 ,$117.81 ,$14.78 ,$170.00 ,$93.50 ,$14.78 ,$44.71 , N/A ,$10.60 ,$10.12 ,$15.52 ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$29.56 ,$14.78 ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,30101417,84445,HC THYROID STIM IMMUNO GLOB-90,301,1 ,$461.00 ,$299.65 ,$3.50 ,$461.00 ,$127.15 ,$118.84 ,$253.55 ,$50.86 ,$129.08 ,$225.89 ,$50.86 ,$269.69 ,$50.86 ,$250.32 ,$3.50 ,$50.86 ,$250.32 ,$96.63 ,$322.70 ,$230.50 ,$368.80 ,$127.15 ,$50.86 ,$322.70 ,$50.86 ,$276.60 ,$50.86 ,$345.75 ,$254.47 ,$229.58 ,$254.47 ,$50.86 ,$254.47 ,$73.46 ,$73.46 ,$391.85 ,$127.15 ,$319.47 ,$50.86 ,$461.00 ,$253.55 ,$50.86 ,$121.24 , N/A ,$18.45 ,$17.61 ,$53.40 ,$368.80 ,$250.32 ,$129.08 ,$414.90 ,$175.18 ,$101.72 ,$50.86 ,$221.28 
ST. MARY'S HOSPITAL - DECATUR,30101418,84446,HC VITAMIN E-90,301,1 ,$132.00 ,$85.80 ,$3.50 ,$132.00 ,$35.45 ,$33.14 ,$72.60 ,$14.18 ,$36.96 ,$64.68 ,$14.18 ,$77.22 ,$14.18 ,$71.68 ,$3.50 ,$14.18 ,$71.68 ,$26.94 ,$92.40 ,$66.00 ,$105.60 ,$35.45 ,$14.18 ,$92.40 ,$14.18 ,$79.20 ,$14.18 ,$99.00 ,$72.86 ,$65.74 ,$72.86 ,$14.18 ,$72.86 ,$20.48 ,$20.48 ,$112.20 ,$35.45 ,$91.48 ,$14.18 ,$132.00 ,$72.60 ,$14.18 ,$34.72 , N/A ,$7.88 ,$7.52 ,$14.89 ,$105.60 ,$71.68 ,$36.96 ,$118.80 ,$50.16 ,$28.36 ,$14.18 ,$63.36 
ST. MARY'S HOSPITAL - DECATUR,30101419,84460,HC ALT-90,301,1 ,$190.00 ,$123.50 ,$3.35 ,$190.00 ,$13.25 ,$12.36 ,$104.50 ,$5.30 ,$53.20 ,$56.62 ,$5.30 ,$56.62 ,$5.30 ,$103.17 ,$3.50 ,$5.30 ,$103.17 ,$10.07 ,$133.00 ,$95.00 ,$152.00 ,$13.25 ,$5.30 ,$133.00 ,$5.30 ,$114.00 ,$5.30 ,$142.50 ,$104.88 ,$94.62 ,$104.88 ,$5.30 ,$104.88 ,$7.66 ,$7.66 ,$161.50 ,$13.25 ,$131.67 ,$5.30 ,$190.00 ,$104.50 ,$5.30 ,$49.97 , N/A ,$3.51 ,$3.35 ,$5.57 ,$152.00 ,$103.17 ,$53.20 ,$171.00 ,$72.20 ,$10.60 ,$5.30 ,$91.20 
ST. MARY'S HOSPITAL - DECATUR,30101420,84466,HC TRANSFERRIN-90,301,1 ,$106.00 ,$68.90 ,$3.50 ,$106.00 ,$31.90 ,$29.84 ,$58.30 ,$12.76 ,$29.68 ,$51.94 ,$12.76 ,$62.01 ,$12.76 ,$57.56 ,$3.50 ,$12.76 ,$57.56 ,$24.24 ,$74.20 ,$53.00 ,$84.80 ,$31.90 ,$12.76 ,$74.20 ,$12.76 ,$63.60 ,$12.76 ,$79.50 ,$58.51 ,$52.79 ,$58.51 ,$12.76 ,$58.51 ,$18.43 ,$18.43 ,$90.10 ,$31.90 ,$73.46 ,$12.76 ,$106.00 ,$58.30 ,$12.76 ,$27.88 , N/A ,$7.88 ,$7.52 ,$13.40 ,$84.80 ,$57.56 ,$29.68 ,$95.40 ,$40.28 ,$25.52 ,$12.76 ,$50.88 
ST. MARY'S HOSPITAL - DECATUR,30101421,84478,HC TRIGLYCERIDES-90,301,1 ,$240.00 ,$156.00 ,$3.35 ,$240.00 ,$14.35 ,$13.44 ,$132.00 ,$5.74 ,$67.20 ,$61.34 ,$5.74 ,$61.34 ,$5.74 ,$130.32 ,$3.50 ,$5.74 ,$130.32 ,$10.91 ,$168.00 ,$120.00 ,$192.00 ,$14.35 ,$5.74 ,$168.00 ,$5.74 ,$144.00 ,$5.74 ,$180.00 ,$132.48 ,$119.52 ,$132.48 ,$5.74 ,$132.48 ,$8.29 ,$8.29 ,$204.00 ,$14.35 ,$166.32 ,$5.74 ,$240.00 ,$132.00 ,$5.74 ,$63.12 , N/A ,$3.51 ,$3.35 ,$6.03 ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 ,$11.48 ,$5.74 ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,30101422,84479,HC T3 UPTAKE-90,301,1 ,$138.00 ,$89.70 ,$3.50 ,$138.00 ,$16.18 ,$15.12 ,$75.90 ,$6.47 ,$38.64 ,$51.02 ,$6.47 ,$51.02 ,$6.47 ,$74.93 ,$3.50 ,$6.47 ,$74.93 ,$12.29 ,$96.60 ,$69.00 ,$110.40 ,$16.18 ,$6.47 ,$96.60 ,$6.47 ,$82.80 ,$6.47 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$6.47 ,$76.18 ,$9.33 ,$9.33 ,$117.30 ,$16.18 ,$95.63 ,$6.47 ,$138.00 ,$75.90 ,$6.47 ,$36.29 , N/A ,$10.60 ,$10.12 ,$6.79 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$12.94 ,$6.47 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30101425,84482,HC T3 REVERSE-90,301,1 ,$245.00 ,$159.25 ,$3.50 ,$245.00 ,$39.40 ,$36.84 ,$134.75 ,$15.76 ,$68.60 ,$120.05 ,$15.76 ,$124.35 ,$15.76 ,$133.04 ,$3.50 ,$15.76 ,$133.04 ,$29.94 ,$171.50 ,$122.50 ,$196.00 ,$39.40 ,$15.76 ,$171.50 ,$15.76 ,$147.00 ,$15.76 ,$183.75 ,$135.24 ,$122.01 ,$135.24 ,$15.76 ,$135.24 ,$22.76 ,$22.76 ,$208.25 ,$39.40 ,$169.79 ,$15.76 ,$245.00 ,$134.75 ,$15.76 ,$64.44 , N/A ,$10.60 ,$10.12 ,$16.55 ,$196.00 ,$133.04 ,$68.60 ,$220.50 ,$93.10 ,$31.52 ,$15.76 ,$117.60 
ST. MARY'S HOSPITAL - DECATUR,30101426,84484,HC TROPONIN QN-90,301,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$31.18 ,$23.00 ,$106.15 ,$12.47 ,$54.04 ,$79.72 ,$12.47 ,$79.72 ,$12.47 ,$104.80 ,$3.50 ,$12.47 ,$104.80 ,$23.69 ,$135.10 ,$96.50 ,$154.40 ,$31.18 ,$12.47 ,$135.10 ,$12.47 ,$115.80 ,$12.47 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$12.47 ,$106.54 ,$16.21 ,$16.21 ,$164.05 ,$31.18 ,$133.75 ,$12.47 ,$193.00 ,$106.15 ,$12.47 ,$50.76 , N/A ,$7.88 ,$7.52 ,$13.09 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$24.94 ,$12.47 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30101429,84510,HC TYROSINE-90,301,1 ,$141.00 ,$91.65 ,$3.50 ,$141.00 ,$26.58 ,$24.32 ,$77.55 ,$10.63 ,$39.48 ,$69.09 ,$10.63 ,$82.08 ,$10.63 ,$76.56 ,$3.50 ,$10.63 ,$76.56 ,$20.20 ,$98.70 ,$70.50 ,$112.80 ,$26.58 ,$10.63 ,$98.70 ,$10.63 ,$84.60 ,$10.63 ,$105.75 ,$77.83 ,$70.22 ,$77.83 ,$10.63 ,$77.83 ,$15.03 ,$15.03 ,$119.85 ,$26.58 ,$97.71 ,$10.63 ,$141.00 ,$77.55 ,$10.63 ,$37.08 , N/A ,$7.88 ,$7.52 ,$11.16 ,$112.80 ,$76.56 ,$39.48 ,$126.90 ,$53.58 ,$21.26 ,$10.63 ,$67.68 
ST. MARY'S HOSPITAL - DECATUR,30101430,84520,HC UREA NITROGEN QUANTITATIVE-QW,301,1 ,$84.00 ,$54.60 ,$3.35 ,$84.00 ,$9.88 ,$9.24 ,$46.20 ,$3.95 ,$23.52 ,$41.16 ,$3.95 ,$42.17 ,$3.95 ,$45.61 ,$3.50 ,$3.95 ,$45.61 ,$7.51 ,$58.80 ,$42.00 ,$67.20 ,$9.88 ,$3.95 ,$58.80 ,$3.95 ,$50.40 ,$3.95 ,$63.00 ,$46.37 ,$41.83 ,$46.37 ,$3.95 ,$46.37 ,$5.71 ,$5.71 ,$71.40 ,$9.88 ,$58.21 ,$3.95 ,$3.95 ,$46.20 ,$3.95 ,$22.09 , N/A ,$3.51 ,$3.35 ,$4.15 ,$67.20 ,$45.61 ,$23.52 ,$75.60 ,$31.92 ,$7.90 ,$3.95 ,$40.32 
ST. MARY'S HOSPITAL - DECATUR,30101433,84540,HC UREA URINE-90,301,1 ,$80.00 ,$52.00 ,$3.35 ,$80.00 ,$13.90 ,$11.10 ,$44.00 ,$5.56 ,$22.40 ,$37.45 ,$5.56 ,$37.45 ,$5.56 ,$43.44 ,$3.50 ,$5.56 ,$43.44 ,$10.56 ,$56.00 ,$40.00 ,$64.00 ,$13.90 ,$5.56 ,$56.00 ,$5.56 ,$48.00 ,$5.56 ,$60.00 ,$44.16 ,$39.84 ,$44.16 ,$5.56 ,$44.16 ,$7.23 ,$7.23 ,$68.00 ,$13.90 ,$55.44 ,$5.56 ,$80.00 ,$44.00 ,$5.56 ,$21.04 , N/A ,$3.51 ,$3.35 ,$5.84 ,$64.00 ,$43.44 ,$22.40 ,$72.00 ,$30.40 ,$11.12 ,$5.56 ,$38.40 
ST. MARY'S HOSPITAL - DECATUR,30101434,84560,HC URIC ACID OTH SRC-90,301,1 ,$120.00 ,$78.00 ,$3.35 ,$120.00 ,$12.70 ,$11.10 ,$66.00 ,$5.08 ,$33.60 ,$37.45 ,$5.08 ,$37.45 ,$5.08 ,$65.16 ,$3.50 ,$5.08 ,$65.16 ,$9.65 ,$84.00 ,$60.00 ,$96.00 ,$12.70 ,$5.08 ,$84.00 ,$5.08 ,$72.00 ,$5.08 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$5.08 ,$66.24 ,$6.85 ,$6.85 ,$102.00 ,$12.70 ,$83.16 ,$5.08 ,$120.00 ,$66.00 ,$5.08 ,$31.56 , N/A ,$3.51 ,$3.35 ,$5.33 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$10.16 ,$5.08 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30101435,84585,HC VANILLYLMAND AC (VMA)-90,301,1 ,$171.00 ,$111.15 ,$3.50 ,$171.00 ,$38.75 ,$36.22 ,$94.05 ,$15.50 ,$47.88 ,$83.79 ,$15.50 ,$100.04 ,$15.50 ,$92.85 ,$3.50 ,$15.50 ,$92.85 ,$29.45 ,$119.70 ,$85.50 ,$136.80 ,$38.75 ,$15.50 ,$119.70 ,$15.50 ,$102.60 ,$15.50 ,$128.25 ,$94.39 ,$85.16 ,$94.39 ,$15.50 ,$94.39 ,$22.39 ,$22.39 ,$145.35 ,$38.75 ,$118.50 ,$15.50 ,$171.00 ,$94.05 ,$15.50 ,$44.97 , N/A ,$18.45 ,$17.61 ,$16.28 ,$136.80 ,$92.85 ,$47.88 ,$153.90 ,$64.98 ,$31.00 ,$15.50 ,$82.08 
ST. MARY'S HOSPITAL - DECATUR,30101436,84586,HC VASOACTIVE INTEST PEPTIDE-90,301,1 ,$342.00 ,$222.30 ,$3.50 ,$342.00 ,$88.33 ,$82.56 ,$188.10 ,$35.33 ,$95.76 ,$167.58 ,$35.33 ,$200.07 ,$35.33 ,$185.71 ,$3.50 ,$35.33 ,$185.71 ,$67.13 ,$239.40 ,$171.00 ,$273.60 ,$88.33 ,$35.33 ,$239.40 ,$35.33 ,$205.20 ,$35.33 ,$256.50 ,$188.78 ,$170.32 ,$188.78 ,$35.33 ,$188.78 ,$51.04 ,$51.04 ,$290.70 ,$88.33 ,$237.01 ,$35.33 ,$342.00 ,$188.10 ,$35.33 ,$89.95 , N/A ,$18.45 ,$17.61 ,$37.10 ,$273.60 ,$185.71 ,$95.76 ,$307.80 ,$129.96 ,$70.66 ,$35.33 ,$164.16 
ST. MARY'S HOSPITAL - DECATUR,30101437,84588,HC VASOPRESSIN (ADH)-90,301,1 ,$140.00 ,$91.00 ,$3.50 ,$140.00 ,$84.85 ,$66.26 ,$77.00 ,$33.94 ,$39.20 ,$68.60 ,$33.94 ,$81.90 ,$33.94 ,$76.02 ,$3.50 ,$33.94 ,$76.02 ,$64.49 ,$98.00 ,$70.00 ,$112.00 ,$84.85 ,$33.94 ,$98.00 ,$33.94 ,$84.00 ,$33.94 ,$105.00 ,$77.28 ,$69.72 ,$77.28 ,$33.94 ,$77.28 ,$49.02 ,$49.02 ,$119.00 ,$84.85 ,$97.02 ,$33.94 ,$140.00 ,$77.00 ,$33.94 ,$36.82 , N/A ,$18.45 ,$17.61 ,$35.64 ,$112.00 ,$76.02 ,$39.20 ,$126.00 ,$53.20 ,$67.88 ,$33.94 ,$67.20 
ST. MARY'S HOSPITAL - DECATUR,30101438,84590,HC VITAMIN A-90,301,1 ,$135.00 ,$87.75 ,$3.50 ,$135.00 ,$29.03 ,$27.12 ,$74.25 ,$11.61 ,$37.80 ,$66.15 ,$11.61 ,$78.98 ,$11.61 ,$73.31 ,$3.50 ,$11.61 ,$73.31 ,$22.06 ,$94.50 ,$67.50 ,$108.00 ,$29.03 ,$11.61 ,$94.50 ,$11.61 ,$81.00 ,$11.61 ,$101.25 ,$74.52 ,$67.23 ,$74.52 ,$11.61 ,$74.52 ,$16.77 ,$16.77 ,$114.75 ,$29.03 ,$93.56 ,$11.61 ,$135.00 ,$74.25 ,$11.61 ,$35.51 , N/A ,$7.88 ,$7.52 ,$12.19 ,$108.00 ,$73.31 ,$37.80 ,$121.50 ,$51.30 ,$23.22 ,$11.61 ,$64.80 
ST. MARY'S HOSPITAL - DECATUR,30101439,84591,HC VITAMIN A OTHER-90,301,1 ,$200.00 ,$130.00 ,$3.50 ,$200.00 ,$42.65 ,$27.12 ,$110.00 ,$17.06 ,$56.00 ,$98.00 ,$17.06 ,$109.01 ,$17.06 ,$108.60 ,$3.50 ,$17.06 ,$108.60 ,$32.41 ,$140.00 ,$100.00 ,$160.00 ,$42.65 ,$17.06 ,$140.00 ,$17.06 ,$120.00 ,$17.06 ,$150.00 ,$110.40 ,$99.60 ,$110.40 ,$17.06 ,$110.40 ,$22.18 ,$22.18 ,$170.00 ,$42.65 ,$138.60 ,$17.06 ,$200.00 ,$110.00 ,$17.06 ,$52.60 , N/A ,$9.05 ,$8.64 ,$17.91 ,$160.00 ,$108.60 ,$56.00 ,$180.00 ,$76.00 ,$34.12 ,$17.06 ,$96.00 
ST. MARY'S HOSPITAL - DECATUR,30101440,84597,HC VITAMIN K-90,301,1 ,$101.00 ,$65.65 ,$3.50 ,$101.00 ,$34.30 ,$26.50 ,$55.55 ,$13.72 ,$28.28 ,$49.49 ,$13.72 ,$59.09 ,$13.72 ,$54.84 ,$3.50 ,$13.72 ,$54.84 ,$26.07 ,$70.70 ,$50.50 ,$80.80 ,$34.30 ,$13.72 ,$70.70 ,$13.72 ,$60.60 ,$13.72 ,$75.75 ,$55.75 ,$50.30 ,$55.75 ,$13.72 ,$55.75 ,$19.81 ,$19.81 ,$85.85 ,$34.30 ,$69.99 ,$13.72 ,$101.00 ,$55.55 ,$13.72 ,$26.56 , N/A ,$7.88 ,$7.52 ,$14.41 ,$80.80 ,$54.84 ,$28.28 ,$90.90 ,$38.38 ,$27.44 ,$13.72 ,$48.48 
ST. MARY'S HOSPITAL - DECATUR,30101441,84600,HC VOLATILES-90,301,1 ,$149.00 ,$96.85 ,$3.50 ,$149.00 ,$42.78 ,$37.18 ,$81.95 ,$17.11 ,$41.72 ,$73.01 ,$17.11 ,$87.17 ,$17.11 ,$80.91 ,$3.50 ,$17.11 ,$80.91 ,$32.51 ,$104.30 ,$74.50 ,$119.20 ,$42.78 ,$17.11 ,$104.30 ,$17.11 ,$89.40 ,$17.11 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$17.11 ,$82.25 ,$23.23 ,$23.23 ,$126.65 ,$42.78 ,$103.26 ,$17.11 ,$149.00 ,$81.95 ,$17.11 ,$39.19 , N/A ,$7.88 ,$7.52 ,$17.97 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$34.22 ,$17.11 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30101442,84630,HC ZINC-90,301,1 ,$108.00 ,$70.20 ,$3.50 ,$108.00 ,$28.48 ,$26.44 ,$59.40 ,$11.39 ,$30.24 ,$52.92 ,$11.39 ,$63.18 ,$11.39 ,$58.64 ,$3.50 ,$11.39 ,$58.64 ,$21.64 ,$75.60 ,$54.00 ,$86.40 ,$28.48 ,$11.39 ,$75.60 ,$11.39 ,$64.80 ,$11.39 ,$81.00 ,$59.62 ,$53.78 ,$59.62 ,$11.39 ,$59.62 ,$16.45 ,$16.45 ,$91.80 ,$28.48 ,$74.84 ,$11.39 ,$108.00 ,$59.40 ,$11.39 ,$28.40 , N/A ,$9.61 ,$9.18 ,$11.96 ,$86.40 ,$58.64 ,$30.24 ,$97.20 ,$41.04 ,$22.78 ,$11.39 ,$51.84 
ST. MARY'S HOSPITAL - DECATUR,30101443,84681,HC C PEPTIDE-90,301,1 ,$169.00 ,$109.85 ,$3.50 ,$169.00 ,$52.03 ,$48.64 ,$92.95 ,$20.81 ,$47.32 ,$82.81 ,$20.81 ,$98.87 ,$20.81 ,$91.77 ,$3.50 ,$20.81 ,$91.77 ,$39.54 ,$118.30 ,$84.50 ,$135.20 ,$52.03 ,$20.81 ,$118.30 ,$20.81 ,$101.40 ,$20.81 ,$126.75 ,$93.29 ,$84.16 ,$93.29 ,$20.81 ,$93.29 ,$30.07 ,$30.07 ,$143.65 ,$52.03 ,$117.12 ,$20.81 ,$169.00 ,$92.95 ,$20.81 ,$44.45 , N/A ,$7.88 ,$7.52 ,$21.85 ,$135.20 ,$91.77 ,$47.32 ,$152.10 ,$64.22 ,$41.62 ,$20.81 ,$81.12 
ST. MARY'S HOSPITAL - DECATUR,30101444,84702,HC HCG QN-90,301,1 ,$238.00 ,$154.70 ,$3.50 ,$238.00 ,$37.63 ,$35.20 ,$130.90 ,$15.05 ,$66.64 ,$116.62 ,$15.05 ,$139.23 ,$15.05 ,$129.23 ,$3.50 ,$15.05 ,$129.23 ,$28.60 ,$166.60 ,$119.00 ,$190.40 ,$37.63 ,$15.05 ,$166.60 ,$15.05 ,$142.80 ,$15.05 ,$178.50 ,$131.38 ,$118.52 ,$131.38 ,$15.05 ,$131.38 ,$21.75 ,$21.75 ,$202.30 ,$37.63 ,$164.93 ,$15.05 ,$238.00 ,$130.90 ,$15.05 ,$62.59 , N/A ,$10.60 ,$10.12 ,$15.80 ,$190.40 ,$129.23 ,$66.64 ,$214.20 ,$90.44 ,$30.10 ,$15.05 ,$114.24 
ST. MARY'S HOSPITAL - DECATUR,30101447,84830,HC OVULATION TEST VISUAL,301,1 ,$114.00 ,$74.10 ,$3.50 ,$114.00 ,$31.75 ,$23.44 ,$62.70 ,$12.70 ,$31.92 ,$55.86 ,$12.70 ,$66.69 ,$12.70 ,$61.90 ,$3.50 ,$12.70 ,$61.90 ,$24.13 ,$79.80 ,$57.00 ,$91.20 ,$31.75 ,$12.70 ,$79.80 ,$12.70 ,$68.40 ,$12.70 ,$85.50 ,$62.93 ,$56.77 ,$62.93 ,$12.70 ,$62.93 ,$16.51 ,$16.51 ,$96.90 ,$31.75 ,$79.00 ,$12.70 ,$114.00 ,$62.70 ,$12.70 ,$29.98 , N/A ,$18.45 ,$17.61 ,$13.34 ,$91.20 ,$61.90 ,$31.92 ,$102.60 ,$43.32 ,$25.40 ,$12.70 ,$54.72 
ST. MARY'S HOSPITAL - DECATUR,30101450,G0480,HC DRUG SCRN DEFINT 1-7 CLASS T1,301,1 ,$201.00 ,$130.65 ,$3.50 ,$286.08 ,$286.08 ,$135.90 ,$110.55 ,$114.43 ,$56.28 ,$34.41 ,$114.43 ,$34.41 ,$114.43 ,$109.14 ,$3.50 ,$114.43 ,$109.14 ,$201.00 ,$140.70 ,$100.50 ,$160.80 ,$286.08 ,$114.43 ,$140.70 ,$114.43 ,$120.60 ,$114.43 ,$150.75 ,$110.95 ,$100.10 ,$110.95 ,$114.43 ,$110.95 ,$148.76 ,$148.76 ,$170.85 ,$201.00 ,$139.29 ,$114.43 ,$201.00 ,$110.55 ,$114.43 ,$52.86 , N/A ,$21.22 ,$20.25 ,$120.15 ,$160.80 ,$109.14 ,$56.28 ,$180.90 ,$76.38 ,$201.00 ,$114.43 ,$96.48 
ST. MARY'S HOSPITAL - DECATUR,30101451,G0480,HC DRUG SCRN DEFINT 1-7 CLASS T2,301,1 ,$477.00 ,$310.05 ,$3.50 ,$477.00 ,$286.08 ,$135.90 ,$262.35 ,$114.43 ,$133.56 ,$34.41 ,$114.43 ,$34.41 ,$114.43 ,$259.01 ,$3.50 ,$114.43 ,$259.01 ,$217.42 ,$333.90 ,$238.50 ,$381.60 ,$286.08 ,$114.43 ,$333.90 ,$114.43 ,$286.20 ,$114.43 ,$357.75 ,$263.30 ,$237.55 ,$263.30 ,$114.43 ,$263.30 ,$148.76 ,$148.76 ,$405.45 ,$286.08 ,$330.56 ,$114.43 ,$477.00 ,$262.35 ,$114.43 ,$125.45 , N/A ,$21.22 ,$20.25 ,$120.15 ,$381.60 ,$259.01 ,$133.56 ,$429.30 ,$181.26 ,$228.86 ,$114.43 ,$228.96 
ST. MARY'S HOSPITAL - DECATUR,30101452,G0480,HC DRUG SCRN DEFINT 1-7 CLASS T3,301,1 ,$509.00 ,$330.85 ,$3.50 ,$509.00 ,$286.08 ,$135.90 ,$279.95 ,$114.43 ,$142.52 ,$34.41 ,$114.43 ,$34.41 ,$114.43 ,$276.39 ,$3.50 ,$114.43 ,$276.39 ,$217.42 ,$356.30 ,$254.50 ,$407.20 ,$286.08 ,$114.43 ,$356.30 ,$114.43 ,$305.40 ,$114.43 ,$381.75 ,$280.97 ,$253.48 ,$280.97 ,$114.43 ,$280.97 ,$148.76 ,$148.76 ,$432.65 ,$286.08 ,$352.74 ,$114.43 ,$509.00 ,$279.95 ,$114.43 ,$133.87 , N/A ,$21.22 ,$20.25 ,$120.15 ,$407.20 ,$276.39 ,$142.52 ,$458.10 ,$193.42 ,$228.86 ,$114.43 ,$244.32 
ST. MARY'S HOSPITAL - DECATUR,30101455,G0480,HC DRUG SCRN DEFNT 1-7 CLS T1-90,301,1 ,$295.00 ,$191.75 ,$3.50 ,$295.00 ,$286.08 ,$135.90 ,$162.25 ,$114.43 ,$82.60 ,$34.41 ,$114.43 ,$34.41 ,$114.43 ,$160.19 ,$3.50 ,$114.43 ,$160.19 ,$217.42 ,$206.50 ,$147.50 ,$236.00 ,$286.08 ,$114.43 ,$206.50 ,$114.43 ,$177.00 ,$114.43 ,$221.25 ,$162.84 ,$146.91 ,$162.84 ,$114.43 ,$162.84 ,$148.76 ,$148.76 ,$250.75 ,$286.08 ,$204.44 ,$114.43 ,$295.00 ,$162.25 ,$114.43 ,$77.59 , N/A ,$21.22 ,$20.25 ,$120.15 ,$236.00 ,$160.19 ,$82.60 ,$265.50 ,$112.10 ,$228.86 ,$114.43 ,$141.60 
ST. MARY'S HOSPITAL - DECATUR,30101456,G0480,HC DRUG SCRN DEFNT 1-7 CLS T2-90,301,1 ,$443.00 ,$287.95 ,$3.50 ,$443.00 ,$286.08 ,$135.90 ,$243.65 ,$114.43 ,$124.04 ,$34.41 ,$114.43 ,$34.41 ,$114.43 ,$240.55 ,$3.50 ,$114.43 ,$240.55 ,$217.42 ,$310.10 ,$221.50 ,$354.40 ,$286.08 ,$114.43 ,$310.10 ,$114.43 ,$265.80 ,$114.43 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$114.43 ,$244.54 ,$148.76 ,$148.76 ,$376.55 ,$286.08 ,$307.00 ,$114.43 ,$443.00 ,$243.65 ,$114.43 ,$116.51 , N/A ,$21.22 ,$20.25 ,$120.15 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$228.86 ,$114.43 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,30101461,G0481,HC DRUG SCRN DEFINT 8-14 CLASS-90,301,1 ,$885.00 ,$575.25 ,$3.50 ,$885.00 ,$391.48 ,$209.08 ,$486.75 ,$156.59 ,$247.80 ,$34.41 ,$156.59 ,$34.41 ,$156.59 ,$480.56 ,$3.50 ,$156.59 ,$480.56 ,$297.52 ,$619.50 ,$442.50 ,$708.00 ,$391.48 ,$156.59 ,$619.50 ,$156.59 ,$531.00 ,$156.59 ,$663.75 ,$488.52 ,$440.73 ,$488.52 ,$156.59 ,$488.52 ,$203.57 ,$203.57 ,$752.25 ,$391.48 ,$613.31 ,$156.59 ,$885.00 ,$486.75 ,$156.59 ,$232.76 , N/A ,$21.22 ,$20.25 ,$164.42 ,$708.00 ,$480.56 ,$247.80 ,$796.50 ,$336.30 ,$313.18 ,$156.59 ,$424.80 
ST. MARY'S HOSPITAL - DECATUR,30101462,G0482,HC DRUG SCRN DEFINT 15-21 CLS-90,301,1 ,"$1,328.00 ",$863.20 ,$3.50 ,"$1,328.00 ",$496.85 ,$282.26 ,$730.40 ,$198.74 ,$371.84 ,$34.41 ,$198.74 ,$34.41 ,$198.74 ,$721.10 ,$3.50 ,$198.74 ,$721.10 ,$377.61 ,$929.60 ,$664.00 ,"$1,062.40 ",$496.85 ,$198.74 ,$929.60 ,$198.74 ,$796.80 ,$198.74 ,$996.00 ,$733.06 ,$661.34 ,$733.06 ,$198.74 ,$733.06 ,$258.36 ,$258.36 ,"$1,128.80 ",$496.85 ,$920.30 ,$198.74 ,"$1,328.00 ",$730.40 ,$198.74 ,$349.26 , N/A ,$21.22 ,$20.25 ,$208.68 ,"$1,062.40 ",$721.10 ,$371.84 ,"$1,195.20 ",$504.64 ,$397.48 ,$198.74 ,$637.44 
ST. MARY'S HOSPITAL - DECATUR,30101463,G0483,HC DRUG SCRN DEFINT 22+ CLASS-90,301,1 ,"$1,770.00 ","$1,150.50 ",$3.50 ,"$1,770.00 ",$617.30 ,$365.90 ,$973.50 ,$246.92 ,$495.60 ,$34.41 ,$246.92 ,$34.41 ,$246.92 ,$961.11 ,$3.50 ,$246.92 ,$961.11 ,$469.15 ,"$1,239.00 ",$885.00 ,"$1,416.00 ",$617.30 ,$246.92 ,"$1,239.00 ",$246.92 ,"$1,062.00 ",$246.92 ,"$1,327.50 ",$977.04 ,$881.46 ,$977.04 ,$246.92 ,$977.04 ,$321.00 ,$321.00 ,"$1,504.50 ",$617.30 ,"$1,226.61 ",$246.92 ,"$1,770.00 ",$973.50 ,$246.92 ,$465.51 , N/A ,$21.22 ,$20.25 ,$259.27 ,"$1,416.00 ",$961.11 ,$495.60 ,"$1,593.00 ",$672.60 ,$493.84 ,$246.92 ,$849.60 
ST. MARY'S HOSPITAL - DECATUR,30101465,83921,HC ORGANIC ACIDS QN SINGLE-90,301,1 ,$270.00 ,$175.50 ,$3.50 ,$270.00 ,$53.03 ,$38.46 ,$148.50 ,$21.21 ,$75.60 ,$132.30 ,$21.21 ,$135.56 ,$21.21 ,$146.61 ,$3.50 ,$21.21 ,$146.61 ,$40.30 ,$189.00 ,$135.00 ,$216.00 ,$53.03 ,$21.21 ,$189.00 ,$21.21 ,$162.00 ,$21.21 ,$202.50 ,$149.04 ,$134.46 ,$149.04 ,$21.21 ,$149.04 ,$27.57 ,$27.57 ,$229.50 ,$53.03 ,$187.11 ,$21.21 ,$270.00 ,$148.50 ,$21.21 ,$71.01 , N/A ,$7.88 ,$7.52 ,$22.27 ,$216.00 ,$146.61 ,$75.60 ,$243.00 ,$102.60 ,$42.42 ,$21.21 ,$129.60 
ST. MARY'S HOSPITAL - DECATUR,30101472,82376,HC CARBOXYHEMOGLOBIN QL,301,1 ,$302.00 ,$196.30 ,$3.50 ,$302.00 ,$35.18 ,$13.32 ,$166.10 ,$14.07 ,$84.56 ,$89.94 ,$14.07 ,$89.94 ,$14.07 ,$163.99 ,$3.50 ,$14.07 ,$163.99 ,$26.73 ,$211.40 ,$151.00 ,$241.60 ,$35.18 ,$14.07 ,$211.40 ,$14.07 ,$181.20 ,$14.07 ,$226.50 ,$166.70 ,$150.40 ,$166.70 ,$14.07 ,$166.70 ,$18.29 ,$18.29 ,$256.70 ,$35.18 ,$209.29 ,$14.07 ,$302.00 ,$166.10 ,$14.07 ,$79.43 , N/A ,$7.88 ,$7.52 ,$14.77 ,$241.60 ,$163.99 ,$84.56 ,$271.80 ,$114.76 ,$28.14 ,$14.07 ,$144.96 
ST. MARY'S HOSPITAL - DECATUR,30101473,80339,HC ANTIEPILIPTICS NOS 1-3 -90,301,1 ,$236.00 ,$153.40 ,$0.02 ,$236.00 , N/A ,$0.02 ,$129.80 , N/A ,$66.08 , N/A , N/A , N/A , N/A ,$128.15 , N/A , N/A ,$128.15 , N/A ,$165.20 ,$118.00 ,$188.80 , N/A , N/A ,$165.20 , N/A ,$141.60 , N/A ,$177.00 ,$130.27 ,$117.53 ,$130.27 , N/A ,$130.27 ,$6.50 ,$6.50 ,$200.60 , N/A ,$163.55 , N/A ,$236.00 ,$129.80 , N/A ,$62.07 , N/A ,$21.22 ,$20.25 , N/A ,$188.80 ,$128.15 ,$66.08 ,$212.40 ,$89.68 , N/A , N/A ,$113.28 
ST. MARY'S HOSPITAL - DECATUR,30101474,80360,HC METHYLPHENIDATE -90,301,1 ,$97.00 ,$63.05 ,$0.02 ,$97.00 , N/A ,$0.02 ,$53.35 , N/A ,$27.16 , N/A , N/A , N/A , N/A ,$52.67 , N/A , N/A ,$52.67 , N/A ,$67.90 ,$48.50 ,$77.60 , N/A , N/A ,$67.90 , N/A ,$58.20 , N/A ,$72.75 ,$53.54 ,$48.31 ,$53.54 , N/A ,$53.54 ,$14.09 ,$14.09 ,$82.45 , N/A ,$67.22 , N/A ,$97.00 ,$53.35 , N/A ,$25.51 , N/A ,$7.88 ,$7.52 , N/A ,$77.60 ,$52.67 ,$27.16 ,$87.30 ,$36.86 , N/A , N/A ,$46.56 
ST. MARY'S HOSPITAL - DECATUR,30101475,80375,HC DRUG THIOPURINE METAOLITES-90,301,1 ,$274.00 ,$178.10 ,$0.02 ,$274.00 , N/A ,$0.02 ,$150.70 , N/A ,$76.72 , N/A , N/A , N/A , N/A ,$148.78 , N/A , N/A ,$148.78 , N/A ,$191.80 ,$137.00 ,$219.20 , N/A , N/A ,$191.80 , N/A ,$164.40 , N/A ,$205.50 ,$151.25 ,$136.45 ,$151.25 , N/A ,$151.25 ,$27.99 ,$27.99 ,$232.90 , N/A ,$189.88 , N/A ,$274.00 ,$150.70 , N/A ,$72.06 , N/A ,$21.22 ,$20.25 , N/A ,$219.20 ,$148.78 ,$76.72 ,$246.60 ,$104.12 , N/A , N/A ,$131.52 
ST. MARY'S HOSPITAL - DECATUR,30101476,82610,HC CYSTATIN C -90,301,1 ,$166.00 ,$107.90 ,$3.50 ,$166.00 ,$46.30 ,$31.78 ,$91.30 ,$18.52 ,$46.48 ,$81.34 ,$18.52 ,$97.11 ,$18.52 ,$90.14 ,$3.50 ,$18.52 ,$90.14 ,$35.19 ,$116.20 ,$83.00 ,$132.80 ,$46.30 ,$18.52 ,$116.20 ,$18.52 ,$99.60 ,$18.52 ,$124.50 ,$91.63 ,$82.67 ,$91.63 ,$18.52 ,$91.63 ,$24.08 ,$24.08 ,$141.10 ,$46.30 ,$115.04 ,$18.52 ,$166.00 ,$91.30 ,$18.52 ,$43.66 , N/A ,$7.88 ,$7.52 ,$19.45 ,$132.80 ,$90.14 ,$46.48 ,$149.40 ,$63.08 ,$37.04 ,$18.52 ,$79.68 
ST. MARY'S HOSPITAL - DECATUR,30101477,83519,HC QN RIA MUSK-90,301,1 ,"$1,124.00 ",$730.60 ,$3.50 ,"$1,124.00 ",$46.00 ,$31.56 ,$618.20 ,$18.40 ,$314.72 ,$117.57 ,$18.40 ,$117.57 ,$18.40 ,$610.33 ,$3.50 ,$18.40 ,$610.33 ,$34.96 ,$786.80 ,$562.00 ,$899.20 ,$46.00 ,$18.40 ,$786.80 ,$18.40 ,$674.40 ,$18.40 ,$843.00 ,$620.45 ,$559.75 ,$620.45 ,$18.40 ,$620.45 ,$23.92 ,$23.92 ,$955.40 ,$46.00 ,$778.93 ,$18.40 ,"$1,124.00 ",$618.20 ,$18.40 ,$295.61 , N/A ,$7.06 ,$6.74 ,$19.32 ,$899.20 ,$610.33 ,$314.72 ,"$1,011.60 ",$427.12 ,$36.80 ,$18.40 ,$539.52 
ST. MARY'S HOSPITAL - DECATUR,30101478,82800,HC BLOOD GAS PH,301,1 ,$156.00 ,$101.40 ,$3.50 ,$156.00 ,$27.50 ,$14.22 ,$85.80 ,$11.00 ,$43.68 ,$76.44 ,$11.00 ,$91.26 ,$11.00 ,$84.71 ,$3.50 ,$11.00 ,$84.71 ,$20.90 ,$109.20 ,$78.00 ,$124.80 ,$27.50 ,$11.00 ,$109.20 ,$11.00 ,$93.60 ,$11.00 ,$117.00 ,$86.11 ,$77.69 ,$86.11 ,$11.00 ,$86.11 ,$14.30 ,$14.30 ,$132.60 ,$27.50 ,$108.11 ,$11.00 ,$156.00 ,$85.80 ,$11.00 ,$41.03 , N/A ,$7.88 ,$7.52 ,$11.55 ,$124.80 ,$84.71 ,$43.68 ,$140.40 ,$59.28 ,$22.00 ,$11.00 ,$74.88 
ST. MARY'S HOSPITAL - DECATUR,30101479,82803,HC BLOOD GAS PH PO2  AND /OR PCO2,301,1 ,$297.00 ,$193.05 ,$3.50 ,$297.00 ,$65.18 ,$28.20 ,$163.35 ,$26.07 ,$83.16 ,$145.53 ,$26.07 ,$173.75 ,$26.07 ,$161.27 ,$3.50 ,$26.07 ,$161.27 ,$49.53 ,$207.90 ,$148.50 ,$237.60 ,$65.18 ,$26.07 ,$207.90 ,$26.07 ,$178.20 ,$26.07 ,$222.75 ,$163.94 ,$147.91 ,$163.94 ,$26.07 ,$163.94 ,$33.89 ,$33.89 ,$252.45 ,$65.18 ,$205.82 ,$26.07 ,$297.00 ,$163.35 ,$26.07 ,$78.11 , N/A ,$7.88 ,$7.52 ,$27.37 ,$237.60 ,$161.27 ,$83.16 ,$267.30 ,$112.86 ,$52.14 ,$26.07 ,$142.56 
ST. MARY'S HOSPITAL - DECATUR,30101480,82805,HC BLOOD GASES W/O2 SAT,301,1 ,$294.00 ,$191.10 ,$3.50 ,$294.00 ,$196.93 ,$66.18 ,$161.70 ,$78.77 ,$82.32 ,$144.06 ,$78.77 ,$171.99 ,$78.77 ,$159.64 ,$3.50 ,$78.77 ,$159.64 ,$149.66 ,$205.80 ,$147.00 ,$235.20 ,$196.93 ,$78.77 ,$205.80 ,$78.77 ,$176.40 ,$78.77 ,$220.50 ,$162.29 ,$146.41 ,$162.29 ,$78.77 ,$162.29 ,$102.40 ,$102.40 ,$249.90 ,$196.93 ,$203.74 ,$78.77 ,$294.00 ,$161.70 ,$78.77 ,$77.32 , N/A ,$7.88 ,$7.52 ,$82.71 ,$235.20 ,$159.64 ,$82.32 ,$264.60 ,$111.72 ,$157.54 ,$78.77 ,$141.12 
ST. MARY'S HOSPITAL - DECATUR,30101486,82375,HC CARBON MONOXIDE QN,301,1 ,$45.00 ,$29.25 ,$3.50 ,$45.00 ,$30.80 ,$13.54 ,$24.75 ,$12.32 ,$12.60 ,$22.05 ,$12.32 ,$26.33 ,$12.32 ,$24.44 ,$3.50 ,$12.32 ,$24.44 ,$23.41 ,$31.50 ,$22.50 ,$36.00 ,$30.80 ,$12.32 ,$31.50 ,$12.32 ,$27.00 ,$12.32 ,$33.75 ,$24.84 ,$22.41 ,$24.84 ,$12.32 ,$24.84 ,$17.80 ,$17.80 ,$38.25 ,$30.80 ,$31.19 ,$12.32 ,$45.00 ,$24.75 ,$12.32 ,$11.84 , N/A ,$7.88 ,$7.52 ,$12.94 ,$36.00 ,$24.44 ,$12.60 ,$40.50 ,$17.10 ,$24.64 ,$12.32 ,$21.60 
ST. MARY'S HOSPITAL - DECATUR,30101487,83050,HC METHEMOGLOBIN QN,301,1 ,$38.00 ,$24.70 ,$3.50 ,$38.00 ,$20.50 ,$8.22 ,$20.90 ,$8.20 ,$10.64 ,$18.62 ,$8.20 ,$22.23 ,$8.20 ,$20.63 ,$3.50 ,$8.20 ,$20.63 ,$15.58 ,$26.60 ,$19.00 ,$30.40 ,$20.50 ,$8.20 ,$26.60 ,$8.20 ,$22.80 ,$8.20 ,$28.50 ,$20.98 ,$18.92 ,$20.98 ,$8.20 ,$20.98 ,$10.66 ,$10.66 ,$32.30 ,$20.50 ,$26.33 ,$8.20 ,$38.00 ,$20.90 ,$8.20 ,$9.99 , N/A ,$7.88 ,$7.52 ,$8.61 ,$30.40 ,$20.63 ,$10.64 ,$34.20 ,$14.44 ,$16.40 ,$8.20 ,$18.24 
ST. MARY'S HOSPITAL - DECATUR,30101488,83986,HC PH BODY FLUID,301,1 ,$63.00 ,$40.95 ,$3.35 ,$63.00 ,$8.95 ,$8.36 ,$34.65 ,$3.58 ,$17.64 ,$30.87 ,$3.58 ,$36.86 ,$3.58 ,$34.21 ,$3.50 ,$3.58 ,$34.21 ,$6.80 ,$44.10 ,$31.50 ,$50.40 ,$8.95 ,$3.58 ,$44.10 ,$3.58 ,$37.80 ,$3.58 ,$47.25 ,$34.78 ,$31.37 ,$34.78 ,$3.58 ,$34.78 ,$5.17 ,$5.17 ,$53.55 ,$8.95 ,$43.66 ,$3.58 ,$63.00 ,$34.65 ,$3.58 ,$16.57 , N/A ,$3.51 ,$3.35 ,$3.76 ,$50.40 ,$34.21 ,$17.64 ,$56.70 ,$23.94 ,$7.16 ,$3.58 ,$30.24 
ST. MARY'S HOSPITAL - DECATUR,30101497,80373,HC TRAMADOL-90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$15.99 ,$15.99 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$7.88 ,$7.52 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101498,80354,HC FENTANYL -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$19.83 ,$19.83 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$7.88 ,$7.52 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101499,83664,HC LAMELLAR BODY CT-90,301,1 ,$274.00 ,$178.10 ,$3.50 ,$274.00 ,$48.30 ,$44.20 ,$150.70 ,$19.32 ,$76.72 ,$134.26 ,$19.32 ,$149.22 ,$19.32 ,$148.78 ,$3.50 ,$19.32 ,$148.78 ,$36.71 ,$191.80 ,$137.00 ,$219.20 ,$48.30 ,$19.32 ,$191.80 ,$19.32 ,$164.40 ,$19.32 ,$205.50 ,$151.25 ,$136.45 ,$151.25 ,$19.32 ,$151.25 ,$27.31 ,$27.31 ,$232.90 ,$48.30 ,$189.88 ,$19.32 ,$274.00 ,$150.70 ,$19.32 ,$72.06 , N/A ,$22.52 ,$21.49 ,$20.29 ,$219.20 ,$148.78 ,$76.72 ,$246.60 ,$104.12 ,$38.64 ,$19.32 ,$131.52 
ST. MARY'S HOSPITAL - DECATUR,30101500,82943,HC GLUCAGON-90,301,1 ,$158.00 ,$102.70 ,$3.50 ,$158.00 ,$35.73 ,$18.22 ,$86.90 ,$14.29 ,$44.24 ,$77.42 ,$14.29 ,$92.43 ,$14.29 ,$85.79 ,$3.50 ,$14.29 ,$85.79 ,$27.15 ,$110.60 ,$79.00 ,$126.40 ,$35.73 ,$14.29 ,$110.60 ,$14.29 ,$94.80 ,$14.29 ,$118.50 ,$87.22 ,$78.68 ,$87.22 ,$14.29 ,$87.22 ,$20.64 ,$20.64 ,$134.30 ,$35.73 ,$109.49 ,$14.29 ,$158.00 ,$86.90 ,$14.29 ,$41.55 , N/A ,$18.45 ,$17.61 ,$15.00 ,$126.40 ,$85.79 ,$44.24 ,$142.20 ,$60.04 ,$28.58 ,$14.29 ,$75.84 
ST. MARY'S HOSPITAL - DECATUR,30101511,80345,HC BARBITURATE -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$14.17 ,$14.17 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$7.88 ,$7.52 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101512,80324,HC AMPHETAMINE 1-2 -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$19.71 ,$19.71 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$21.22 ,$20.25 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101513,80365,HC OXYCODONE -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$18.43 ,$18.43 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$7.88 ,$7.52 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101514,80358,HC METHADONE -90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$17.06 ,$17.06 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$7.88 ,$7.52 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101515,80352,HC CANNABINOIDS SYNTHETIC >7 - 90,301,1 ,$354.00 ,$230.10 ,$0.02 ,$354.00 , N/A ,$0.02 ,$194.70 , N/A ,$99.12 , N/A , N/A , N/A , N/A ,$192.22 , N/A , N/A ,$192.22 , N/A ,$247.80 ,$177.00 ,$283.20 , N/A , N/A ,$247.80 , N/A ,$212.40 , N/A ,$265.50 ,$195.41 ,$176.29 ,$195.41 , N/A ,$195.41 ,$20.93 ,$20.93 ,$300.90 , N/A ,$245.32 , N/A ,$354.00 ,$194.70 , N/A ,$93.10 , N/A ,$21.22 ,$20.25 , N/A ,$283.20 ,$192.22 ,$99.12 ,$318.60 ,$134.52 , N/A , N/A ,$169.92 
ST. MARY'S HOSPITAL - DECATUR,30101516,80321,HC ALCOHOL BIOMARKERS 1-2 - 90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$17.51 ,$17.51 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$21.22 ,$20.25 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101517,80371,HC STIMULANTS SYNTHETIC -90,301,1 ,$92.00 ,$59.80 ,$0.02 ,$92.00 , N/A ,$0.02 ,$50.60 , N/A ,$25.76 , N/A , N/A , N/A , N/A ,$49.96 , N/A , N/A ,$49.96 , N/A ,$64.40 ,$46.00 ,$73.60 , N/A , N/A ,$64.40 , N/A ,$55.20 , N/A ,$69.00 ,$50.78 ,$45.82 ,$50.78 , N/A ,$50.78 ,$18.28 ,$18.28 ,$78.20 , N/A ,$63.76 , N/A ,$92.00 ,$50.60 , N/A ,$24.20 , N/A ,$7.88 ,$7.52 , N/A ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 , N/A , N/A ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,30101520,80356,HC HEROIN METABOLITE-90,301,1 ,$59.00 ,$38.35 ,$0.02 ,$59.00 , N/A ,$0.02 ,$32.45 , N/A ,$16.52 , N/A , N/A , N/A , N/A ,$32.04 , N/A , N/A ,$32.04 , N/A ,$41.30 ,$29.50 ,$47.20 , N/A , N/A ,$41.30 , N/A ,$35.40 , N/A ,$44.25 ,$32.57 ,$29.38 ,$32.57 , N/A ,$32.57 ,$20.67 ,$20.67 ,$50.15 , N/A ,$40.89 , N/A ,$59.00 ,$32.45 , N/A ,$15.52 , N/A ,$7.88 ,$7.52 , N/A ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$22.42 , N/A , N/A ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,30101521,84132,HC POTASSIUM -90,301,1 ,$109.00 ,$70.85 ,$3.35 ,$109.00 ,$11.90 ,$10.74 ,$59.95 ,$4.76 ,$30.52 ,$49.15 ,$4.76 ,$49.15 ,$4.76 ,$59.19 ,$3.50 ,$4.76 ,$59.19 ,$9.04 ,$76.30 ,$54.50 ,$87.20 ,$11.90 ,$4.76 ,$76.30 ,$4.76 ,$65.40 ,$4.76 ,$81.75 ,$60.17 ,$54.28 ,$60.17 ,$4.76 ,$60.17 ,$6.64 ,$6.64 ,$92.65 ,$11.90 ,$75.54 ,$4.76 ,$109.00 ,$59.95 ,$4.76 ,$28.67 , N/A ,$3.51 ,$3.35 ,$5.00 ,$87.20 ,$59.19 ,$30.52 ,$98.10 ,$41.42 ,$9.52 ,$4.76 ,$52.32 
ST. MARY'S HOSPITAL - DECATUR,30101525,82465,HC CHOLESTEROL -90,301,1 ,$179.00 ,$116.35 ,$3.35 ,$179.00 ,$10.88 ,$10.16 ,$98.45 ,$4.35 ,$50.12 ,$46.50 ,$4.35 ,$46.50 ,$4.35 ,$97.20 ,$3.50 ,$4.35 ,$97.20 ,$8.27 ,$125.30 ,$89.50 ,$143.20 ,$10.88 ,$4.35 ,$125.30 ,$4.35 ,$107.40 ,$4.35 ,$134.25 ,$98.81 ,$89.14 ,$98.81 ,$4.35 ,$98.81 ,$6.29 ,$6.29 ,$152.15 ,$10.88 ,$124.05 ,$4.35 ,$179.00 ,$98.45 ,$4.35 ,$47.08 , N/A ,$3.51 ,$3.35 ,$4.57 ,$143.20 ,$97.20 ,$50.12 ,$161.10 ,$68.02 ,$8.70 ,$4.35 ,$85.92 
ST. MARY'S HOSPITAL - DECATUR,30101526,82947,HC GLUCOSE -90,301,1 ,$96.00 ,$62.40 ,$3.35 ,$96.00 ,$9.83 ,$9.16 ,$52.80 ,$3.93 ,$26.88 ,$41.97 ,$3.93 ,$41.97 ,$3.93 ,$52.13 ,$3.50 ,$3.93 ,$52.13 ,$7.47 ,$67.20 ,$48.00 ,$76.80 ,$9.83 ,$3.93 ,$67.20 ,$3.93 ,$57.60 ,$3.93 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$3.93 ,$52.99 ,$5.68 ,$5.68 ,$81.60 ,$9.83 ,$66.53 ,$3.93 ,$96.00 ,$52.80 ,$3.93 ,$25.25 , N/A ,$3.51 ,$3.35 ,$4.13 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$7.86 ,$3.93 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30101527,84450,HC AST -90,301,1 ,$204.00 ,$132.60 ,$3.35 ,$204.00 ,$12.95 ,$12.08 ,$112.20 ,$5.18 ,$57.12 ,$55.24 ,$5.18 ,$55.24 ,$5.18 ,$110.77 ,$3.50 ,$5.18 ,$110.77 ,$9.84 ,$142.80 ,$102.00 ,$163.20 ,$12.95 ,$5.18 ,$142.80 ,$5.18 ,$122.40 ,$5.18 ,$153.00 ,$112.61 ,$101.59 ,$112.61 ,$5.18 ,$112.61 ,$7.48 ,$7.48 ,$173.40 ,$12.95 ,$141.37 ,$5.18 ,$204.00 ,$112.20 ,$5.18 ,$53.65 , N/A ,$3.51 ,$3.35 ,$5.44 ,$163.20 ,$110.77 ,$57.12 ,$183.60 ,$77.52 ,$10.36 ,$5.18 ,$97.92 
ST. MARY'S HOSPITAL - DECATUR,30101531,82633,HC DESOXYCORTICOSTERONE 11  -90,301,1 ,$287.00 ,$186.55 ,$3.50 ,$287.00 ,$77.45 ,$64.56 ,$157.85 ,$30.98 ,$80.36 ,$140.63 ,$30.98 ,$167.90 ,$30.98 ,$155.84 ,$3.50 ,$30.98 ,$155.84 ,$58.86 ,$200.90 ,$143.50 ,$229.60 ,$77.45 ,$30.98 ,$200.90 ,$30.98 ,$172.20 ,$30.98 ,$215.25 ,$158.42 ,$142.93 ,$158.42 ,$30.98 ,$158.42 ,$44.76 ,$44.76 ,$243.95 ,$77.45 ,$198.89 ,$30.98 ,$287.00 ,$157.85 ,$30.98 ,$75.48 , N/A ,$18.45 ,$17.61 ,$32.53 ,$229.60 ,$155.84 ,$80.36 ,$258.30 ,$109.06 ,$61.96 ,$30.98 ,$137.76 
ST. MARY'S HOSPITAL - DECATUR,30101534,80377,HC PANEL HYPOGLYCEMIC QL-90,301,1 ,$218.00 ,$141.70 ,$0.02 ,$218.00 , N/A ,$0.02 ,$119.90 , N/A ,$61.04 , N/A , N/A , N/A , N/A ,$118.37 , N/A , N/A ,$118.37 , N/A ,$152.60 ,$109.00 ,$174.40 , N/A , N/A ,$152.60 , N/A ,$130.80 , N/A ,$163.50 ,$120.34 ,$108.56 ,$120.34 , N/A ,$120.34 ,$10.10 ,$10.10 ,$185.30 , N/A ,$151.07 , N/A ,$218.00 ,$119.90 , N/A ,$57.33 , N/A ,$21.22 ,$20.25 , N/A ,$174.40 ,$118.37 ,$61.04 ,$196.20 ,$82.84 , N/A , N/A ,$104.64 
ST. MARY'S HOSPITAL - DECATUR,30101540,84163,HC PLASMA PROTEIN-A PREGNANCY ASSOCIATED-90,301,1 ,$141.00 ,$91.65 ,$3.50 ,$141.00 ,$37.63 ,$35.20 ,$77.55 ,$15.05 ,$39.48 ,$69.09 ,$15.05 ,$82.49 ,$15.05 ,$76.56 ,$3.50 ,$15.05 ,$76.56 ,$28.60 ,$98.70 ,$70.50 ,$112.80 ,$37.63 ,$15.05 ,$98.70 ,$15.05 ,$84.60 ,$15.05 ,$105.75 ,$77.83 ,$70.22 ,$77.83 ,$15.05 ,$77.83 ,$21.75 ,$21.75 ,$119.85 ,$37.63 ,$97.71 ,$15.05 ,$141.00 ,$77.55 ,$15.05 ,$37.08 , N/A ,$7.88 ,$7.52 ,$15.80 ,$112.80 ,$76.56 ,$39.48 ,$126.90 ,$53.58 ,$30.10 ,$15.05 ,$67.68 
ST. MARY'S HOSPITAL - DECATUR,30101566,82340,HC CALCIUM URINE QN TIMED,301,1 ,$240.00 ,$156.00 ,$3.50 ,$240.00 ,$15.08 ,$14.10 ,$132.00 ,$6.03 ,$67.20 ,$47.58 ,$6.03 ,$47.58 ,$6.03 ,$130.32 ,$3.50 ,$6.03 ,$130.32 ,$11.46 ,$168.00 ,$120.00 ,$192.00 ,$15.08 ,$6.03 ,$168.00 ,$6.03 ,$144.00 ,$6.03 ,$180.00 ,$132.48 ,$119.52 ,$132.48 ,$6.03 ,$132.48 ,$8.71 ,$8.71 ,$204.00 ,$15.08 ,$166.32 ,$6.03 ,$240.00 ,$132.00 ,$6.03 ,$63.12 , N/A ,$7.88 ,$7.52 ,$6.33 ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 ,$12.06 ,$6.03 ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,30101574,82670,HC ESTRADIOL,301,1 ,$81.00 ,$52.65 ,$3.50 ,$81.00 ,$69.85 ,$26.50 ,$44.55 ,$27.94 ,$22.68 ,$39.69 ,$27.94 ,$47.39 ,$27.94 ,$43.98 ,$3.50 ,$27.94 ,$43.98 ,$53.09 ,$56.70 ,$40.50 ,$64.80 ,$69.85 ,$27.94 ,$56.70 ,$27.94 ,$48.60 ,$27.94 ,$60.75 ,$44.71 ,$40.34 ,$44.71 ,$27.94 ,$44.71 ,$40.35 ,$40.35 ,$68.85 ,$69.85 ,$56.13 ,$27.94 ,$81.00 ,$44.55 ,$27.94 ,$21.30 , N/A ,$18.45 ,$17.61 ,$29.34 ,$64.80 ,$43.98 ,$22.68 ,$72.90 ,$30.78 ,$55.88 ,$27.94 ,$38.88 
ST. MARY'S HOSPITAL - DECATUR,30101579,82784,HC GAMMAGLOBULIN,301,1 ,$85.00 ,$55.25 ,$3.50 ,$85.00 ,$23.25 ,$21.72 ,$46.75 ,$9.30 ,$23.80 ,$41.65 ,$9.30 ,$49.73 ,$9.30 ,$46.16 ,$3.50 ,$9.30 ,$46.16 ,$17.67 ,$59.50 ,$42.50 ,$68.00 ,$23.25 ,$9.30 ,$59.50 ,$9.30 ,$51.00 ,$9.30 ,$63.75 ,$46.92 ,$42.33 ,$46.92 ,$9.30 ,$46.92 ,$13.44 ,$13.44 ,$72.25 ,$23.25 ,$58.91 ,$9.30 ,$85.00 ,$46.75 ,$9.30 ,$22.36 , N/A ,$7.88 ,$7.52 ,$9.77 ,$68.00 ,$46.16 ,$23.80 ,$76.50 ,$32.30 ,$18.60 ,$9.30 ,$40.80 
ST. MARY'S HOSPITAL - DECATUR,30101580,82785,HC GAMMAGLOBULIN IGE,301,1 ,$116.00 ,$75.40 ,$3.50 ,$116.00 ,$41.15 ,$38.48 ,$63.80 ,$16.46 ,$32.48 ,$56.84 ,$16.46 ,$67.86 ,$16.46 ,$62.99 ,$3.50 ,$16.46 ,$62.99 ,$31.27 ,$81.20 ,$58.00 ,$92.80 ,$41.15 ,$16.46 ,$81.20 ,$16.46 ,$69.60 ,$16.46 ,$87.00 ,$64.03 ,$57.77 ,$64.03 ,$16.46 ,$64.03 ,$23.78 ,$23.78 ,$98.60 ,$41.15 ,$80.39 ,$16.46 ,$116.00 ,$63.80 ,$16.46 ,$30.51 , N/A ,$7.88 ,$7.52 ,$17.28 ,$92.80 ,$62.99 ,$32.48 ,$104.40 ,$44.08 ,$32.92 ,$16.46 ,$55.68 
ST. MARY'S HOSPITAL - DECATUR,30101589,83036,HC GLYCOSYLATED HGB -90,301,1 ,$152.00 ,$98.80 ,$3.50 ,$152.00 ,$24.28 ,$22.68 ,$83.60 ,$9.71 ,$42.56 ,$74.48 ,$9.71 ,$88.92 ,$9.71 ,$82.54 ,$3.50 ,$9.71 ,$82.54 ,$18.45 ,$106.40 ,$76.00 ,$121.60 ,$24.28 ,$9.71 ,$106.40 ,$9.71 ,$91.20 ,$9.71 ,$114.00 ,$83.90 ,$75.70 ,$83.90 ,$9.71 ,$83.90 ,$14.03 ,$14.03 ,$129.20 ,$24.28 ,$105.34 ,$9.71 ,$152.00 ,$83.60 ,$9.71 ,$39.98 , N/A ,$7.88 ,$7.52 ,$10.20 ,$121.60 ,$82.54 ,$42.56 ,$136.80 ,$57.76 ,$19.42 ,$9.71 ,$72.96 
ST. MARY'S HOSPITAL - DECATUR,30101591,83090,HC HOMOCYSTEINE,301,1 ,$203.00 ,$131.95 ,$3.50 ,$203.00 ,$44.80 ,$39.42 ,$111.65 ,$17.92 ,$56.84 ,$99.47 ,$17.92 ,$118.76 ,$17.92 ,$110.23 ,$3.50 ,$17.92 ,$110.23 ,$34.05 ,$142.10 ,$101.50 ,$162.40 ,$44.80 ,$17.92 ,$142.10 ,$17.92 ,$121.80 ,$17.92 ,$152.25 ,$112.06 ,$101.09 ,$112.06 ,$17.92 ,$112.06 ,$24.36 ,$24.36 ,$172.55 ,$44.80 ,$140.68 ,$17.92 ,$203.00 ,$111.65 ,$17.92 ,$53.39 , N/A ,$18.45 ,$17.61 ,$18.82 ,$162.40 ,$110.23 ,$56.84 ,$182.70 ,$77.14 ,$35.84 ,$17.92 ,$97.44 
ST. MARY'S HOSPITAL - DECATUR,30101602,84105,HC PHOSPHORUS UR,301,1 ,$62.00 ,$40.30 ,$3.35 ,$62.00 ,$14.45 ,$12.08 ,$34.10 ,$5.78 ,$17.36 ,$30.38 ,$5.78 ,$36.27 ,$5.78 ,$33.67 ,$3.50 ,$5.78 ,$33.67 ,$10.98 ,$43.40 ,$31.00 ,$49.60 ,$14.45 ,$5.78 ,$43.40 ,$5.78 ,$37.20 ,$5.78 ,$46.50 ,$34.22 ,$30.88 ,$34.22 ,$5.78 ,$34.22 ,$7.51 ,$7.51 ,$52.70 ,$14.45 ,$42.97 ,$5.78 ,$62.00 ,$34.10 ,$5.78 ,$16.31 , N/A ,$3.51 ,$3.35 ,$6.07 ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$11.56 ,$5.78 ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,30101605,84134,HC PREALBUMIN,301,1 ,$134.00 ,$87.10 ,$3.50 ,$134.00 ,$36.48 ,$34.08 ,$73.70 ,$14.59 ,$37.52 ,$65.66 ,$14.59 ,$78.39 ,$14.59 ,$72.76 ,$3.50 ,$14.59 ,$72.76 ,$27.72 ,$93.80 ,$67.00 ,$107.20 ,$36.48 ,$14.59 ,$93.80 ,$14.59 ,$80.40 ,$14.59 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$14.59 ,$73.97 ,$21.07 ,$21.07 ,$113.90 ,$36.48 ,$92.86 ,$14.59 ,$134.00 ,$73.70 ,$14.59 ,$35.24 , N/A ,$7.88 ,$7.52 ,$15.32 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$29.18 ,$14.59 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,30101614,84165,HC PROTEIN ELECTROPHORESIS,301,1 ,$45.00 ,$29.25 ,$7.52 ,$45.00 ,$26.85 ,$25.10 ,$24.75 ,$10.74 ,$12.60 ,$22.05 ,$10.74 ,$26.33 ,$10.74 ,$24.44 ,$8.47 ,$10.74 ,$24.44 ,$20.41 ,$31.50 ,$22.50 ,$36.00 ,$26.85 ,$10.74 ,$31.50 ,$10.74 ,$27.00 ,$10.74 ,$33.75 ,$24.84 ,$22.41 ,$24.84 ,$10.74 ,$24.84 ,$15.51 ,$15.51 ,$38.25 ,$26.85 ,$31.19 ,$10.74 ,$45.00 ,$24.75 ,$10.74 ,$11.84 , N/A ,$7.88 ,$7.52 ,$11.28 ,$36.00 ,$24.44 ,$12.60 ,$40.50 ,$17.10 ,$21.48 ,$10.74 ,$21.60 
ST. MARY'S HOSPITAL - DECATUR,30101615,84166,HC PROTEIN EP OTH FLUID,301,1 ,$45.00 ,$29.25 ,$7.52 ,$45.00 ,$44.58 ,$41.68 ,$24.75 ,$17.83 ,$12.60 ,$22.05 ,$17.83 ,$26.33 ,$17.83 ,$24.44 ,$14.07 ,$17.83 ,$24.44 ,$33.88 ,$31.50 ,$22.50 ,$36.00 ,$44.58 ,$17.83 ,$31.50 ,$17.83 ,$27.00 ,$17.83 ,$33.75 ,$24.84 ,$22.41 ,$24.84 ,$17.83 ,$24.84 ,$25.75 ,$25.75 ,$38.25 ,$44.58 ,$31.19 ,$17.83 ,$45.00 ,$24.75 ,$17.83 ,$11.84 , N/A ,$7.88 ,$7.52 ,$18.72 ,$36.00 ,$24.44 ,$12.60 ,$40.50 ,$17.10 ,$35.66 ,$17.83 ,$21.60 
ST. MARY'S HOSPITAL - DECATUR,30101620,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$67.00 ,$43.55 ,$3.50 ,$67.00 ,$17.18 ,$16.04 ,$36.85 ,$6.87 ,$18.76 ,$32.83 ,$6.87 ,$39.20 ,$6.87 ,$36.38 ,$3.50 ,$6.87 ,$36.38 ,$13.05 ,$46.90 ,$33.50 ,$53.60 ,$17.18 ,$6.87 ,$46.90 ,$6.87 ,$40.20 ,$6.87 ,$50.25 ,$36.98 ,$33.37 ,$36.98 ,$6.87 ,$36.98 ,$9.92 ,$9.92 ,$56.95 ,$17.18 ,$46.43 ,$6.87 ,$67.00 ,$36.85 ,$6.87 ,$17.62 , N/A ,$10.60 ,$10.12 ,$7.21 ,$53.60 ,$36.38 ,$18.76 ,$60.30 ,$25.46 ,$13.74 ,$6.87 ,$32.16 
ST. MARY'S HOSPITAL - DECATUR,30101634,80348,HC BUPRENORPHINE -90,301,1 ,$106.00 ,$68.90 ,$0.02 ,$106.00 , N/A ,$0.02 ,$58.30 , N/A ,$29.68 , N/A , N/A , N/A , N/A ,$57.56 , N/A , N/A ,$57.56 , N/A ,$74.20 ,$53.00 ,$84.80 , N/A , N/A ,$74.20 , N/A ,$63.60 , N/A ,$79.50 ,$58.51 ,$52.79 ,$58.51 , N/A ,$58.51 ,$21.27 ,$21.27 ,$90.10 , N/A ,$73.46 , N/A ,$106.00 ,$58.30 , N/A ,$27.88 , N/A ,$7.88 ,$7.52 , N/A ,$84.80 ,$57.56 ,$29.68 ,$95.40 ,$40.28 , N/A , N/A ,$50.88 
ST. MARY'S HOSPITAL - DECATUR,30101642,84999,HC OSMOLALITY FECAL-90,301,1 ,$300.00 ,$195.00 ,$7.52 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$141.00 , N/A ,$162.00 , N/A ,$162.90 ,$120.00 , N/A ,$162.90 ,$135.00 ,$210.00 ,$150.00 ,$240.00 ,$210.00 , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$210.00 ,$210.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 , N/A ,$7.88 ,$7.52 , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$150.00 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,30101645,83951,HC ONCOPROTEIN DCP-90,301,1 ,$350.00 ,$227.50 ,$3.50 ,$350.00 ,$161.03 ,$109.38 ,$192.50 ,$64.41 ,$98.00 ,$171.50 ,$64.41 ,$204.75 ,$64.41 ,$190.05 ,$3.50 ,$64.41 ,$190.05 ,$122.38 ,$245.00 ,$175.00 ,$280.00 ,$161.03 ,$64.41 ,$245.00 ,$64.41 ,$210.00 ,$64.41 ,$262.50 ,$193.20 ,$174.30 ,$193.20 ,$64.41 ,$193.20 ,$93.04 ,$93.04 ,$297.50 ,$161.03 ,$242.55 ,$64.41 ,$350.00 ,$192.50 ,$64.41 ,$92.05 , N/A ,$24.77 ,$23.65 ,$67.63 ,$280.00 ,$190.05 ,$98.00 ,$315.00 ,$133.00 ,$128.82 ,$64.41 ,$168.00 
ST. MARY'S HOSPITAL - DECATUR,30101649,80368,HC SEDATIVE HYPNOTICS-90,301,1 ,$56.00 ,$36.40 ,$0.02 ,$56.00 , N/A ,$0.02 ,$30.80 , N/A ,$15.68 , N/A , N/A , N/A , N/A ,$30.41 , N/A , N/A ,$30.41 , N/A ,$39.20 ,$28.00 ,$44.80 , N/A , N/A ,$39.20 , N/A ,$33.60 , N/A ,$42.00 ,$30.91 ,$27.89 ,$30.91 , N/A ,$30.91 ,$13.65 ,$13.65 ,$47.60 , N/A ,$38.81 , N/A ,$56.00 ,$30.80 , N/A ,$14.73 , N/A ,$7.88 ,$7.52 , N/A ,$44.80 ,$30.41 ,$15.68 ,$50.40 ,$21.28 , N/A , N/A ,$26.88 
ST. MARY'S HOSPITAL - DECATUR,30101650,83516,HC MLT NON INFECT QL/SQ,301,1 ,$135.00 ,$87.75 ,$3.50 ,$135.00 ,$28.83 ,$26.96 ,$74.25 ,$11.53 ,$37.80 ,$66.15 ,$11.53 ,$78.98 ,$11.53 ,$73.31 ,$3.50 ,$11.53 ,$73.31 ,$21.91 ,$94.50 ,$67.50 ,$108.00 ,$28.83 ,$11.53 ,$94.50 ,$11.53 ,$81.00 ,$11.53 ,$101.25 ,$74.52 ,$67.23 ,$74.52 ,$11.53 ,$74.52 ,$16.65 ,$16.65 ,$114.75 ,$28.83 ,$93.56 ,$11.53 ,$135.00 ,$74.25 ,$11.53 ,$35.51 , N/A ,$7.06 ,$6.74 ,$12.11 ,$108.00 ,$73.31 ,$37.80 ,$121.50 ,$51.30 ,$23.06 ,$11.53 ,$64.80 
ST. MARY'S HOSPITAL - DECATUR,30101651,84150,HC PROSTAGLANDIN-90,301,1 ,$413.00 ,$268.45 ,$3.50 ,$413.00 ,$104.43 ,$24.88 ,$227.15 ,$41.77 ,$115.64 ,$202.37 ,$41.77 ,$241.61 ,$41.77 ,$224.26 ,$3.50 ,$41.77 ,$224.26 ,$79.36 ,$289.10 ,$206.50 ,$330.40 ,$104.43 ,$41.77 ,$289.10 ,$41.77 ,$247.80 ,$41.77 ,$309.75 ,$227.98 ,$205.67 ,$227.98 ,$41.77 ,$227.98 ,$54.30 ,$54.30 ,$351.05 ,$104.43 ,$286.21 ,$41.77 ,$413.00 ,$227.15 ,$41.77 ,$108.62 , N/A ,$18.45 ,$17.61 ,$43.86 ,$330.40 ,$224.26 ,$115.64 ,$371.70 ,$156.94 ,$83.54 ,$41.77 ,$198.24 
ST. MARY'S HOSPITAL - DECATUR,30101652,83698,HC LIPOPROTEIN ASSOC PHOSPHOLIPASE A2-90,301,1 ,$241.00 ,$156.65 ,$3.50 ,$241.00 ,$115.78 ,$66.26 ,$132.55 ,$46.31 ,$67.48 ,$118.09 ,$46.31 ,$140.99 ,$46.31 ,$130.86 ,$3.50 ,$46.31 ,$130.86 ,$87.99 ,$168.70 ,$120.50 ,$192.80 ,$115.78 ,$46.31 ,$168.70 ,$46.31 ,$144.60 ,$46.31 ,$180.75 ,$133.03 ,$120.02 ,$133.03 ,$46.31 ,$133.03 ,$60.20 ,$60.20 ,$204.85 ,$115.78 ,$167.01 ,$46.31 ,$241.00 ,$132.55 ,$46.31 ,$63.38 , N/A ,$21.22 ,$20.25 ,$48.63 ,$192.80 ,$130.86 ,$67.48 ,$216.90 ,$91.58 ,$92.62 ,$46.31 ,$115.68 
ST. MARY'S HOSPITAL - DECATUR,30101653,82642,HC DIHYDROTESTOSTERONE-90,301,1 ,$181.00 ,$117.65 ,$3.50 ,$181.00 ,$73.20 ,$55.30 ,$99.55 ,$29.28 ,$50.68 ,$85.07 ,$29.28 ,$97.74 ,$29.28 ,$98.28 ,$3.50 ,$29.28 ,$98.28 ,$55.63 ,$126.70 ,$90.50 ,$144.80 ,$73.20 ,$29.28 ,$126.70 ,$29.28 ,$108.60 ,$29.28 ,$135.75 ,$99.91 ,$90.14 ,$99.91 ,$29.28 ,$99.91 ,$42.29 ,$42.29 ,$153.85 ,$73.20 ,$125.43 ,$29.28 ,$181.00 ,$99.55 ,$29.28 ,$47.60 , N/A ,$10.60 ,$10.12 ,$30.74 ,$144.80 ,$98.28 ,$50.68 ,$162.90 ,$68.78 ,$58.56 ,$29.28 ,$86.88 
ST. MARY'S HOSPITAL - DECATUR,30101663,83631,HC LACTOFERRIN FECAL QN-90,301,1 ,$250.00 ,$162.50 ,$3.50 ,$250.00 ,$49.08 ,$45.86 ,$137.50 ,$19.63 ,$70.00 ,$122.50 ,$19.63 ,$146.25 ,$19.63 ,$135.75 ,$3.50 ,$19.63 ,$135.75 ,$37.30 ,$175.00 ,$125.00 ,$200.00 ,$49.08 ,$19.63 ,$175.00 ,$19.63 ,$150.00 ,$19.63 ,$187.50 ,$138.00 ,$124.50 ,$138.00 ,$19.63 ,$138.00 ,$28.35 ,$28.35 ,$212.50 ,$49.08 ,$173.25 ,$19.63 ,$250.00 ,$137.50 ,$19.63 ,$65.75 , N/A ,$7.88 ,$7.52 ,$20.61 ,$200.00 ,$135.75 ,$70.00 ,$225.00 ,$95.00 ,$39.26 ,$19.63 ,$120.00 
ST. MARY'S HOSPITAL - DECATUR,30101669,81500,HC ONCOLOGY OVARIAN BIOCHEMICAL ASSAY CA-125/HE4 -90,301,1 ,$959.00 ,$623.35 ,$3.50 ,$959.00 ,$651.25 ,$442.86 ,$527.45 ,$260.50 ,$268.52 ,$469.91 ,$260.50 ,$561.02 ,$260.50 ,$520.74 ,$3.50 ,$260.50 ,$520.74 ,$494.95 ,$671.30 ,$479.50 ,$767.20 ,$651.25 ,$260.50 ,$671.30 ,$260.50 ,$575.40 ,$260.50 ,$719.25 ,$529.37 ,$477.58 ,$529.37 ,$260.50 ,$529.37 ,$338.65 ,$338.65 ,$815.15 ,$651.25 ,$664.59 ,$260.50 ,$959.00 ,$527.45 ,$260.50 ,$252.22 , N/A ,$27.97 ,$26.70 ,$273.53 ,$767.20 ,$520.74 ,$268.52 ,$863.10 ,$364.42 ,$521.00 ,$260.50 ,$460.32 
ST. MARY'S HOSPITAL - DECATUR,30101674,82978,HC GLUTATHIONE-90,301,1 ,$189.00 ,$122.85 ,$3.50 ,$189.00 ,$38.63 ,$33.32 ,$103.95 ,$15.45 ,$52.92 ,$92.61 ,$15.45 ,$110.57 ,$15.45 ,$102.63 ,$3.50 ,$15.45 ,$102.63 ,$29.36 ,$132.30 ,$94.50 ,$151.20 ,$38.63 ,$15.45 ,$132.30 ,$15.45 ,$113.40 ,$15.45 ,$141.75 ,$104.33 ,$94.12 ,$104.33 ,$15.45 ,$104.33 ,$20.59 ,$20.59 ,$160.65 ,$38.63 ,$130.98 ,$15.45 ,$189.00 ,$103.95 ,$15.45 ,$49.71 , N/A ,$7.88 ,$7.52 ,$16.22 ,$151.20 ,$102.63 ,$52.92 ,$170.10 ,$71.82 ,$30.90 ,$15.45 ,$90.72 
ST. MARY'S HOSPITAL - DECATUR,30101675,83050,HC METHEMOGLOBIN-90,301,1 ,$123.00 ,$79.95 ,$3.50 ,$123.00 ,$20.50 ,$8.22 ,$67.65 ,$8.20 ,$34.44 ,$57.80 ,$8.20 ,$57.80 ,$8.20 ,$66.79 ,$3.50 ,$8.20 ,$66.79 ,$15.58 ,$86.10 ,$61.50 ,$98.40 ,$20.50 ,$8.20 ,$86.10 ,$8.20 ,$73.80 ,$8.20 ,$92.25 ,$67.90 ,$61.25 ,$67.90 ,$8.20 ,$67.90 ,$10.66 ,$10.66 ,$104.55 ,$20.50 ,$85.24 ,$8.20 ,$123.00 ,$67.65 ,$8.20 ,$32.35 , N/A ,$7.88 ,$7.52 ,$8.61 ,$98.40 ,$66.79 ,$34.44 ,$110.70 ,$46.74 ,$16.40 ,$8.20 ,$59.04 
ST. MARY'S HOSPITAL - DECATUR,30101676,82375,HC CARBON MONOXIDE-90,301,1 ,$174.00 ,$113.10 ,$3.50 ,$174.00 ,$30.80 ,$13.54 ,$95.70 ,$12.32 ,$48.72 ,$85.26 ,$12.32 ,$97.22 ,$12.32 ,$94.48 ,$3.50 ,$12.32 ,$94.48 ,$23.41 ,$121.80 ,$87.00 ,$139.20 ,$30.80 ,$12.32 ,$121.80 ,$12.32 ,$104.40 ,$12.32 ,$130.50 ,$96.05 ,$86.65 ,$96.05 ,$12.32 ,$96.05 ,$17.80 ,$17.80 ,$147.90 ,$30.80 ,$120.58 ,$12.32 ,$174.00 ,$95.70 ,$12.32 ,$45.76 , N/A ,$7.88 ,$7.52 ,$12.94 ,$139.20 ,$94.48 ,$48.72 ,$156.60 ,$66.12 ,$24.64 ,$12.32 ,$83.52 
ST. MARY'S HOSPITAL - DECATUR,30101682,82963,HC GLUCOSIDASE BETA ASSAY-90,301,1 ,$325.00 ,$211.25 ,$3.50 ,$325.00 ,$53.70 ,$41.42 ,$178.75 ,$21.48 ,$91.00 ,$159.25 ,$21.48 ,$169.47 ,$21.48 ,$176.48 ,$3.50 ,$21.48 ,$176.48 ,$40.81 ,$227.50 ,$162.50 ,$260.00 ,$53.70 ,$21.48 ,$227.50 ,$21.48 ,$195.00 ,$21.48 ,$243.75 ,$179.40 ,$161.85 ,$179.40 ,$21.48 ,$179.40 ,$31.03 ,$31.03 ,$276.25 ,$53.70 ,$225.23 ,$21.48 ,$325.00 ,$178.75 ,$21.48 ,$85.48 , N/A ,$7.88 ,$7.52 ,$22.55 ,$260.00 ,$176.48 ,$91.00 ,$292.50 ,$123.50 ,$42.96 ,$21.48 ,$156.00 
ST. MARY'S HOSPITAL - DECATUR,30101685,80235,HC LACOSAMIDE -90,301,1 ,$256.00 ,$166.40 ,$3.50 ,$256.00 ,$67.78 ,$46.08 ,$140.80 ,$27.11 ,$71.68 ,$120.32 ,$27.11 ,$138.24 ,$27.11 ,$139.01 ,$3.50 ,$27.11 ,$139.01 ,$51.51 ,$179.20 ,$128.00 ,$204.80 ,$67.78 ,$27.11 ,$179.20 ,$27.11 ,$153.60 ,$27.11 ,$192.00 ,$141.31 ,$127.49 ,$141.31 ,$27.11 ,$141.31 ,$35.24 ,$35.24 ,$217.60 ,$67.78 ,$177.41 ,$27.11 ,$256.00 ,$140.80 ,$27.11 ,$67.33 , N/A ,$9.05 ,$8.64 ,$28.47 ,$204.80 ,$139.01 ,$71.68 ,$230.40 ,$97.28 ,$54.22 ,$27.11 ,$122.88 
ST. MARY'S HOSPITAL - DECATUR,30101690,80357,HC DRUG SCREEN KETAMINE AND NORKETAMINE-90,301,1 ,$13.00 ,$8.45 ,$0.02 ,$13.00 , N/A ,$0.02 ,$7.15 , N/A ,$3.64 , N/A , N/A , N/A , N/A ,$7.06 , N/A , N/A ,$7.06 , N/A ,$9.10 ,$6.50 ,$10.40 , N/A , N/A ,$9.10 , N/A ,$7.80 , N/A ,$9.75 ,$7.18 ,$6.47 ,$7.18 , N/A ,$7.18 ,$13.00 ,$13.00 ,$11.05 , N/A ,$9.01 , N/A ,$13.00 ,$7.15 , N/A ,$3.42 , N/A ,$7.88 ,$7.52 , N/A ,$10.40 ,$7.06 ,$3.64 ,$11.70 ,$4.94 , N/A , N/A ,$6.24 
ST. MARY'S HOSPITAL - DECATUR,30101691,80330,HC DRUG SCREEN ANALGESICS NON-OPIOID 3-5-90,301,1 ,$76.00 ,$49.40 ,$0.02 ,$76.00 , N/A ,$0.02 ,$41.80 , N/A ,$21.28 , N/A , N/A , N/A , N/A ,$41.27 , N/A , N/A ,$41.27 , N/A ,$53.20 ,$38.00 ,$60.80 , N/A , N/A ,$53.20 , N/A ,$45.60 , N/A ,$57.00 ,$41.95 ,$37.85 ,$41.95 , N/A ,$41.95 ,$6.63 ,$6.63 ,$64.60 , N/A ,$52.67 , N/A ,$76.00 ,$41.80 , N/A ,$19.99 , N/A ,$21.22 ,$20.25 , N/A ,$60.80 ,$41.27 ,$21.28 ,$68.40 ,$28.88 , N/A , N/A ,$36.48 
ST. MARY'S HOSPITAL - DECATUR,30101692,80366,HC DRUG SCREEN PREGABALIN-90,301,1 ,$133.00 ,$86.45 ,$0.02 ,$133.00 , N/A ,$0.02 ,$73.15 , N/A ,$37.24 , N/A , N/A , N/A , N/A ,$72.22 , N/A , N/A ,$72.22 , N/A ,$93.10 ,$66.50 ,$106.40 , N/A , N/A ,$93.10 , N/A ,$79.80 , N/A ,$99.75 ,$73.42 ,$66.23 ,$73.42 , N/A ,$73.42 ,$10.73 ,$10.73 ,$113.05 , N/A ,$92.17 , N/A ,$133.00 ,$73.15 , N/A ,$34.98 , N/A ,$7.88 ,$7.52 , N/A ,$106.40 ,$72.22 ,$37.24 ,$119.70 ,$50.54 , N/A , N/A ,$63.84 
ST. MARY'S HOSPITAL - DECATUR,30101693,80326,HC DRUG SCREEN QUANT AMPHETAMINES >5-90,301,1 ,$111.00 ,$72.15 ,$0.02 ,$111.00 , N/A ,$0.02 ,$61.05 , N/A ,$31.08 , N/A , N/A , N/A , N/A ,$60.27 , N/A , N/A ,$60.27 , N/A ,$77.70 ,$55.50 ,$88.80 , N/A , N/A ,$77.70 , N/A ,$66.60 , N/A ,$83.25 ,$61.27 ,$55.28 ,$61.27 , N/A ,$61.27 ,$12.00 ,$12.00 ,$94.35 , N/A ,$76.92 , N/A ,$111.00 ,$61.05 , N/A ,$29.19 , N/A ,$21.22 ,$20.25 , N/A ,$88.80 ,$60.27 ,$31.08 ,$99.90 ,$42.18 , N/A , N/A ,$53.28 
ST. MARY'S HOSPITAL - DECATUR,30101694,80370,HC DRUG SCREEN SKEL MUSCLE RELAXANTS >3-90,301,1 ,$13.00 ,$8.45 ,$0.02 ,$20.25 , N/A ,$0.02 ,$7.15 , N/A ,$3.64 , N/A , N/A , N/A , N/A ,$7.06 , N/A , N/A ,$7.06 , N/A ,$9.10 ,$6.50 ,$10.40 , N/A , N/A ,$9.10 , N/A ,$7.80 , N/A ,$9.75 ,$7.18 ,$6.47 ,$7.18 , N/A ,$7.18 ,$13.00 ,$13.00 ,$11.05 , N/A ,$9.01 , N/A ,$13.00 ,$7.15 , N/A ,$3.42 , N/A ,$13.00 ,$20.25 , N/A ,$10.40 ,$7.06 ,$3.64 ,$11.70 ,$4.94 , N/A , N/A ,$6.24 
ST. MARY'S HOSPITAL - DECATUR,30101695,80344,HC ANTIPSYCHOTICS NOS >7-90,301,1 ,$12.00 ,$7.80 ,$0.02 ,$20.25 , N/A ,$0.02 ,$6.60 , N/A ,$3.36 , N/A , N/A , N/A , N/A ,$6.52 , N/A , N/A ,$6.52 , N/A ,$8.40 ,$6.00 ,$9.60 , N/A , N/A ,$8.40 , N/A ,$7.20 , N/A ,$9.00 ,$6.62 ,$5.98 ,$6.62 , N/A ,$6.62 ,$10.73 ,$10.73 ,$10.20 , N/A ,$8.32 , N/A ,$12.00 ,$6.60 , N/A ,$3.16 , N/A ,$12.00 ,$20.25 , N/A ,$9.60 ,$6.52 ,$3.36 ,$10.80 ,$4.56 , N/A , N/A ,$5.76 
ST. MARY'S HOSPITAL - DECATUR,30101696,80338,HC ANTIDEPRESSANT NOS-90,301,1 ,$73.00 ,$47.45 ,$0.02 ,$73.00 , N/A ,$0.02 ,$40.15 , N/A ,$20.44 , N/A , N/A , N/A , N/A ,$39.64 , N/A , N/A ,$39.64 , N/A ,$51.10 ,$36.50 ,$58.40 , N/A , N/A ,$51.10 , N/A ,$43.80 , N/A ,$54.75 ,$40.30 ,$36.35 ,$40.30 , N/A ,$40.30 ,$16.58 ,$16.58 ,$62.05 , N/A ,$50.59 , N/A ,$73.00 ,$40.15 , N/A ,$19.20 , N/A ,$7.88 ,$7.52 , N/A ,$58.40 ,$39.64 ,$20.44 ,$65.70 ,$27.74 , N/A , N/A ,$35.04 
ST. MARY'S HOSPITAL - DECATUR,30101697,80367,HC DRUG SCREEN PROPOXYPHENE-90,301,1 ,$65.00 ,$42.25 ,$0.02 ,$65.00 , N/A ,$0.02 ,$35.75 , N/A ,$18.20 , N/A , N/A , N/A , N/A ,$35.30 , N/A , N/A ,$35.30 , N/A ,$45.50 ,$32.50 ,$52.00 , N/A , N/A ,$45.50 , N/A ,$39.00 , N/A ,$48.75 ,$35.88 ,$32.37 ,$35.88 , N/A ,$35.88 ,$16.26 ,$16.26 ,$55.25 , N/A ,$45.05 , N/A ,$65.00 ,$35.75 , N/A ,$17.10 , N/A ,$7.88 ,$7.52 , N/A ,$52.00 ,$35.30 ,$18.20 ,$58.50 ,$24.70 , N/A , N/A ,$31.20 
ST. MARY'S HOSPITAL - DECATUR,30101698,80372,HC DRUG SCREEN TAPENTADOL-90,301,1 ,$22.00 ,$14.30 ,$0.02 ,$22.00 , N/A ,$0.02 ,$12.10 , N/A ,$6.16 , N/A , N/A , N/A , N/A ,$11.95 , N/A , N/A ,$11.95 , N/A ,$15.40 ,$11.00 ,$17.60 , N/A , N/A ,$15.40 , N/A ,$13.20 , N/A ,$16.50 ,$12.14 ,$10.96 ,$12.14 , N/A ,$12.14 ,$16.43 ,$16.43 ,$18.70 , N/A ,$15.25 , N/A ,$22.00 ,$12.10 , N/A ,$5.79 , N/A ,$7.88 ,$7.52 , N/A ,$17.60 ,$11.95 ,$6.16 ,$19.80 ,$8.36 , N/A , N/A ,$10.56 
ST. MARY'S HOSPITAL - DECATUR,30101699,80355,HC DRUG SCREEN GABAPENTIN NON-BLOOD-90,301,1 ,$96.00 ,$62.40 ,$0.02 ,$96.00 , N/A ,$0.02 ,$52.80 , N/A ,$26.88 , N/A , N/A , N/A , N/A ,$52.13 , N/A , N/A ,$52.13 , N/A ,$67.20 ,$48.00 ,$76.80 , N/A , N/A ,$67.20 , N/A ,$57.60 , N/A ,$72.00 ,$52.99 ,$47.81 ,$52.99 , N/A ,$52.99 ,$11.93 ,$11.93 ,$81.60 , N/A ,$66.53 , N/A ,$96.00 ,$52.80 , N/A ,$25.25 , N/A ,$7.88 ,$7.52 , N/A ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 , N/A , N/A ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30101700,80337,HC ANTIDEPRESSANTS TRICYCLIC OTH CYCLICALS >6-90,301,1 ,$124.00 ,$80.60 ,$0.02 ,$124.00 , N/A ,$0.02 ,$68.20 , N/A ,$34.72 , N/A , N/A , N/A , N/A ,$67.33 , N/A , N/A ,$67.33 , N/A ,$86.80 ,$62.00 ,$99.20 , N/A , N/A ,$86.80 , N/A ,$74.40 , N/A ,$93.00 ,$68.45 ,$61.75 ,$68.45 , N/A ,$68.45 ,$13.46 ,$13.46 ,$105.40 , N/A ,$85.93 , N/A ,$124.00 ,$68.20 , N/A ,$32.61 , N/A ,$21.22 ,$20.25 , N/A ,$99.20 ,$67.33 ,$34.72 ,$111.60 ,$47.12 , N/A , N/A ,$59.52 
ST. MARY'S HOSPITAL - DECATUR,30101701,80333,HC ANTIDEPRESSANTS SEROTONERGIC CLASS 3-5-90,301,1 ,$155.00 ,$100.75 ,$0.02 ,$155.00 , N/A ,$0.02 ,$85.25 , N/A ,$43.40 , N/A , N/A , N/A , N/A ,$84.17 , N/A , N/A ,$84.17 , N/A ,$108.50 ,$77.50 ,$124.00 , N/A , N/A ,$108.50 , N/A ,$93.00 , N/A ,$116.25 ,$85.56 ,$77.19 ,$85.56 , N/A ,$85.56 ,$19.37 ,$19.37 ,$131.75 , N/A ,$107.42 , N/A ,$155.00 ,$85.25 , N/A ,$40.77 , N/A ,$21.22 ,$20.25 , N/A ,$124.00 ,$84.17 ,$43.40 ,$139.50 ,$58.90 , N/A , N/A ,$74.40 
ST. MARY'S HOSPITAL - DECATUR,30101706,80230,HC DRUG ASSAY INFLIXIMAB-90,301,1 ,$412.00 ,$267.80 ,$3.50 ,$412.00 ,$96.43 ,$65.56 ,$226.60 ,$38.57 ,$115.36 ,$193.64 ,$38.57 ,$222.48 ,$38.57 ,$223.72 ,$3.50 ,$38.57 ,$223.72 ,$73.28 ,$288.40 ,$206.00 ,$329.60 ,$96.43 ,$38.57 ,$288.40 ,$38.57 ,$247.20 ,$38.57 ,$309.00 ,$227.42 ,$205.18 ,$227.42 ,$38.57 ,$227.42 ,$50.14 ,$50.14 ,$350.20 ,$96.43 ,$285.52 ,$38.57 ,$412.00 ,$226.60 ,$38.57 ,$108.36 , N/A ,$9.05 ,$8.64 ,$40.50 ,$329.60 ,$223.72 ,$115.36 ,$370.80 ,$156.56 ,$77.14 ,$38.57 ,$197.76 
ST. MARY'S HOSPITAL - DECATUR,30101714,80374,HC METHAMPHETAMINE- 90,301,1 ,$301.00 ,$195.65 ,$0.02 ,$301.00 , N/A ,$0.02 ,$165.55 , N/A ,$84.28 , N/A , N/A , N/A , N/A ,$163.44 , N/A , N/A ,$163.44 , N/A ,$210.70 ,$150.50 ,$240.80 , N/A , N/A ,$210.70 , N/A ,$180.60 , N/A ,$225.75 ,$166.15 ,$149.90 ,$166.15 , N/A ,$166.15 ,$15.34 ,$15.34 ,$255.85 , N/A ,$208.59 , N/A ,$301.00 ,$165.55 , N/A ,$79.16 , N/A ,$7.88 ,$7.52 , N/A ,$240.80 ,$163.44 ,$84.28 ,$270.90 ,$114.38 , N/A , N/A ,$144.48 
ST. MARY'S HOSPITAL - DECATUR,30101745,81277,HC CYTOGENOMIC NEO MICRORA ALYS- 90,301,1 ,"$3,590.00 ","$2,333.50 ",$3.50 ,"$3,590.00 ","$2,900.00 ","$1,972.00 ","$1,974.50 ","$1,160.00 ","$1,005.20 ","$1,687.30 ","$1,160.00 ","$1,938.60 ","$1,160.00 ","$1,949.37 ",$3.50 ,"$1,160.00 ","$1,949.37 ","$2,204.00 ","$2,513.00 ","$1,795.00 ","$2,872.00 ","$2,900.00 ","$1,160.00 ","$2,513.00 ","$1,160.00 ","$2,154.00 ","$1,160.00 ","$2,692.50 ","$1,981.68 ","$1,787.82 ","$1,981.68 ","$1,160.00 ","$1,981.68 ","$1,508.00 ","$1,508.00 ","$3,051.50 ","$2,900.00 ","$2,487.87 ","$1,160.00 ","$3,590.00 ","$1,974.50 ","$1,160.00 ",$944.17 , N/A ,$258.42 ,$246.68 ,"$1,218.00 ","$2,872.00 ","$1,949.37 ","$1,005.20 ","$3,231.00 ","$1,364.20 ","$2,320.00 ","$1,160.00 ","$1,723.20 "
ST. MARY'S HOSPITAL - DECATUR,30101765,83872,HC ASSAY SYNOVIAL FLUID MUCIN- 90,301,1 ,$62.00 ,$40.30 ,$3.35 ,$62.00 ,$14.65 ,$13.70 ,$34.10 ,$5.86 ,$17.36 ,$30.38 ,$5.86 ,$36.27 ,$5.86 ,$33.67 ,$3.50 ,$5.86 ,$33.67 ,$11.13 ,$43.40 ,$31.00 ,$49.60 ,$14.65 ,$5.86 ,$43.40 ,$5.86 ,$37.20 ,$5.86 ,$46.50 ,$34.22 ,$30.88 ,$34.22 ,$5.86 ,$34.22 ,$8.46 ,$8.46 ,$52.70 ,$14.65 ,$42.97 ,$5.86 ,$62.00 ,$34.10 ,$5.86 ,$16.31 , N/A ,$3.51 ,$3.35 ,$6.15 ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$11.72 ,$5.86 ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,30101776,80051,HC ELECTROLYTE PANEL- 90,301,1 ,$167.00 ,$108.55 ,$3.50 ,$167.00 ,$17.53 ,$16.38 ,$91.85 ,$7.01 ,$46.76 ,$74.90 ,$7.01 ,$74.90 ,$7.01 ,$90.68 ,$3.50 ,$7.01 ,$90.68 ,$13.32 ,$116.90 ,$83.50 ,$133.60 ,$17.53 ,$7.01 ,$116.90 ,$7.01 ,$100.20 ,$7.01 ,$125.25 ,$92.18 ,$83.17 ,$92.18 ,$7.01 ,$92.18 ,$10.13 ,$10.13 ,$141.95 ,$17.53 ,$115.73 ,$7.01 ,$167.00 ,$91.85 ,$7.01 ,$43.92 , N/A ,$7.18 ,$6.86 ,$7.36 ,$133.60 ,$90.68 ,$46.76 ,$150.30 ,$63.46 ,$14.02 ,$7.01 ,$80.16 
ST. MARY'S HOSPITAL - DECATUR,30200119,86038,HC ANA SCREEN,302,1 ,$246.00 ,$159.90 ,$3.50 ,$246.00 ,$30.23 ,$28.26 ,$135.30 ,$12.09 ,$68.88 ,$95.35 ,$12.09 ,$95.35 ,$12.09 ,$133.58 ,$3.50 ,$12.09 ,$133.58 ,$22.97 ,$172.20 ,$123.00 ,$196.80 ,$30.23 ,$12.09 ,$172.20 ,$12.09 ,$147.60 ,$12.09 ,$184.50 ,$135.79 ,$122.51 ,$135.79 ,$12.09 ,$135.79 ,$17.46 ,$17.46 ,$209.10 ,$30.23 ,$170.48 ,$12.09 ,$246.00 ,$135.30 ,$12.09 ,$64.70 , N/A ,$7.06 ,$6.74 ,$12.69 ,$196.80 ,$133.58 ,$68.88 ,$221.40 ,$93.48 ,$24.18 ,$12.09 ,$118.08 
ST. MARY'S HOSPITAL - DECATUR,30200137,86225,HC DNA DOUBLE STRAND AB,302,1 ,$142.00 ,$92.30 ,$3.50 ,$142.00 ,$34.35 ,$32.10 ,$78.10 ,$13.74 ,$39.76 ,$69.58 ,$13.74 ,$83.07 ,$13.74 ,$77.11 ,$3.50 ,$13.74 ,$77.11 ,$26.11 ,$99.40 ,$71.00 ,$113.60 ,$34.35 ,$13.74 ,$99.40 ,$13.74 ,$85.20 ,$13.74 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$13.74 ,$78.38 ,$19.85 ,$19.85 ,$120.70 ,$34.35 ,$98.41 ,$13.74 ,$142.00 ,$78.10 ,$13.74 ,$37.35 , N/A ,$7.06 ,$6.74 ,$14.43 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$27.48 ,$13.74 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30200138,86235,HC ENA AB,302,1 ,$168.00 ,$109.20 ,$3.50 ,$168.00 ,$44.83 ,$41.42 ,$92.40 ,$17.93 ,$47.04 ,$82.32 ,$17.93 ,$98.28 ,$17.93 ,$91.22 ,$3.50 ,$17.93 ,$91.22 ,$34.07 ,$117.60 ,$84.00 ,$134.40 ,$44.83 ,$17.93 ,$117.60 ,$17.93 ,$100.80 ,$17.93 ,$126.00 ,$92.74 ,$83.66 ,$92.74 ,$17.93 ,$92.74 ,$25.91 ,$25.91 ,$142.80 ,$44.83 ,$116.42 ,$17.93 ,$168.00 ,$92.40 ,$17.93 ,$44.18 , N/A ,$12.17 ,$11.61 ,$18.83 ,$134.40 ,$91.22 ,$47.04 ,$151.20 ,$63.84 ,$35.86 ,$17.93 ,$80.64 
ST. MARY'S HOSPITAL - DECATUR,30200158,86300,HC TUMOR AG CA 15-3 (27.29),302,1 ,$175.00 ,$113.75 ,$3.50 ,$175.00 ,$52.03 ,$48.64 ,$96.25 ,$20.81 ,$49.00 ,$85.75 ,$20.81 ,$102.38 ,$20.81 ,$95.03 ,$3.50 ,$20.81 ,$95.03 ,$39.54 ,$122.50 ,$87.50 ,$140.00 ,$52.03 ,$20.81 ,$122.50 ,$20.81 ,$105.00 ,$20.81 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$20.81 ,$96.60 ,$30.07 ,$30.07 ,$148.75 ,$52.03 ,$121.28 ,$20.81 ,$175.00 ,$96.25 ,$20.81 ,$46.03 , N/A ,$18.71 ,$17.86 ,$21.85 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$41.62 ,$20.81 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,30200164,86316,HC TUMOR AG OTHER AG QN,302,1 ,$299.00 ,$194.35 ,$3.50 ,$299.00 ,$52.03 ,$48.64 ,$164.45 ,$20.81 ,$83.72 ,$146.51 ,$20.81 ,$164.26 ,$20.81 ,$162.36 ,$3.50 ,$20.81 ,$162.36 ,$39.54 ,$209.30 ,$149.50 ,$239.20 ,$52.03 ,$20.81 ,$209.30 ,$20.81 ,$179.40 ,$20.81 ,$224.25 ,$165.05 ,$148.90 ,$165.05 ,$20.81 ,$165.05 ,$30.07 ,$30.07 ,$254.15 ,$52.03 ,$207.21 ,$20.81 ,$299.00 ,$164.45 ,$20.81 ,$78.64 , N/A ,$7.88 ,$7.52 ,$21.85 ,$239.20 ,$162.36 ,$83.72 ,$269.10 ,$113.62 ,$41.62 ,$20.81 ,$143.52 
ST. MARY'S HOSPITAL - DECATUR,30200197,86430,HC RHEUMATOID FACTOR,302,1 ,$316.00 ,$205.40 ,$3.50 ,$316.00 ,$15.35 ,$13.26 ,$173.80 ,$6.14 ,$88.48 ,$44.73 ,$6.14 ,$44.73 ,$6.14 ,$171.59 ,$3.50 ,$6.14 ,$171.59 ,$11.67 ,$221.20 ,$158.00 ,$252.80 ,$15.35 ,$6.14 ,$221.20 ,$6.14 ,$189.60 ,$6.14 ,$237.00 ,$174.43 ,$157.37 ,$174.43 ,$6.14 ,$174.43 ,$8.19 ,$8.19 ,$268.60 ,$15.35 ,$218.99 ,$6.14 ,$316.00 ,$173.80 ,$6.14 ,$83.11 , N/A ,$7.06 ,$6.74 ,$6.45 ,$252.80 ,$171.59 ,$88.48 ,$284.40 ,$120.08 ,$12.28 ,$6.14 ,$151.68 
ST. MARY'S HOSPITAL - DECATUR,30200198,86431,HC RHEUMATOID FACTOR QN,302,1 ,$138.00 ,$89.70 ,$3.50 ,$138.00 ,$14.18 ,$13.26 ,$75.90 ,$5.67 ,$38.64 ,$44.73 ,$5.67 ,$44.73 ,$5.67 ,$74.93 ,$3.50 ,$5.67 ,$74.93 ,$10.77 ,$96.60 ,$69.00 ,$110.40 ,$14.18 ,$5.67 ,$96.60 ,$5.67 ,$82.80 ,$5.67 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$5.67 ,$76.18 ,$8.19 ,$8.19 ,$117.30 ,$14.18 ,$95.63 ,$5.67 ,$138.00 ,$75.90 ,$5.67 ,$36.29 , N/A ,$7.06 ,$6.74 ,$5.95 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$11.34 ,$5.67 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30200199,86480,HC TB QUANTIFERON GOLD,302,1 ,$317.00 ,$206.05 ,$3.50 ,$317.00 ,$154.95 ,$144.84 ,$174.35 ,$61.98 ,$88.76 ,$155.33 ,$61.98 ,$185.45 ,$61.98 ,$172.13 ,$3.50 ,$61.98 ,$172.13 ,$117.76 ,$221.90 ,$158.50 ,$253.60 ,$154.95 ,$61.98 ,$221.90 ,$61.98 ,$190.20 ,$61.98 ,$237.75 ,$174.98 ,$157.87 ,$174.98 ,$61.98 ,$174.98 ,$89.53 ,$89.53 ,$269.45 ,$154.95 ,$219.68 ,$61.98 ,$317.00 ,$174.35 ,$61.98 ,$83.37 , N/A ,$12.17 ,$11.61 ,$65.08 ,$253.60 ,$172.13 ,$88.76 ,$285.30 ,$120.46 ,$123.96 ,$61.98 ,$152.16 
ST. MARY'S HOSPITAL - DECATUR,30200201,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$134.00 ,$87.10 ,$3.50 ,$134.00 ,$10.68 ,$9.98 ,$73.70 ,$4.27 ,$37.52 ,$33.72 ,$4.27 ,$33.72 ,$4.27 ,$72.76 ,$3.50 ,$4.27 ,$72.76 ,$8.11 ,$93.80 ,$67.00 ,$107.20 ,$10.68 ,$4.27 ,$93.80 ,$4.27 ,$80.40 ,$4.27 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$4.27 ,$73.97 ,$6.18 ,$6.18 ,$113.90 ,$10.68 ,$92.86 ,$4.27 ,$134.00 ,$73.70 ,$4.27 ,$35.24 , N/A ,$7.06 ,$6.74 ,$4.48 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$8.54 ,$4.27 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,30200204,86593,HC SYPHILIS VDRL RPR QN,302,1 ,$95.00 ,$61.75 ,$3.50 ,$95.00 ,$11.00 ,$10.28 ,$52.25 ,$4.40 ,$26.60 ,$34.80 ,$4.40 ,$34.80 ,$4.40 ,$51.59 ,$3.50 ,$4.40 ,$51.59 ,$8.36 ,$66.50 ,$47.50 ,$76.00 ,$11.00 ,$4.40 ,$66.50 ,$4.40 ,$57.00 ,$4.40 ,$71.25 ,$52.44 ,$47.31 ,$52.44 ,$4.40 ,$52.44 ,$6.36 ,$6.36 ,$80.75 ,$11.00 ,$65.84 ,$4.40 ,$95.00 ,$52.25 ,$4.40 ,$24.99 , N/A ,$7.06 ,$6.74 ,$4.62 ,$76.00 ,$51.59 ,$26.60 ,$85.50 ,$36.10 ,$8.80 ,$4.40 ,$45.60 
ST. MARY'S HOSPITAL - DECATUR,30200219,86618,HC LYME AB,302,1 ,$209.00 ,$135.85 ,$3.50 ,$209.00 ,$42.58 ,$39.80 ,$114.95 ,$17.03 ,$58.52 ,$102.41 ,$17.03 ,$122.27 ,$17.03 ,$113.49 ,$3.50 ,$17.03 ,$113.49 ,$32.36 ,$146.30 ,$104.50 ,$167.20 ,$42.58 ,$17.03 ,$146.30 ,$17.03 ,$125.40 ,$17.03 ,$156.75 ,$115.37 ,$104.08 ,$115.37 ,$17.03 ,$115.37 ,$24.60 ,$24.60 ,$177.65 ,$42.58 ,$144.84 ,$17.03 ,$209.00 ,$114.95 ,$17.03 ,$54.97 , N/A ,$12.17 ,$11.61 ,$17.88 ,$167.20 ,$113.49 ,$58.52 ,$188.10 ,$79.42 ,$34.06 ,$17.03 ,$100.32 
ST. MARY'S HOSPITAL - DECATUR,30200270,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$353.00 ,$229.45 ,$3.50 ,$353.00 ,$34.28 ,$32.04 ,$194.15 ,$13.71 ,$98.84 ,$146.37 ,$13.71 ,$146.37 ,$13.71 ,$191.68 ,$3.50 ,$13.71 ,$191.68 ,$26.05 ,$247.10 ,$176.50 ,$282.40 ,$34.28 ,$13.71 ,$247.10 ,$13.71 ,$211.80 ,$13.71 ,$264.75 ,$194.86 ,$175.79 ,$194.86 ,$13.71 ,$194.86 ,$19.80 ,$19.80 ,$300.05 ,$34.28 ,$244.63 ,$13.71 ,$353.00 ,$194.15 ,$13.71 ,$92.84 , N/A ,$7.06 ,$6.74 ,$14.40 ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$27.42 ,$13.71 ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,30200273,86706,HC HEP B SURFACE AB,302,1 ,$331.00 ,$215.15 ,$3.50 ,$331.00 ,$26.85 ,$25.10 ,$182.05 ,$10.74 ,$92.68 ,$84.73 ,$10.74 ,$84.73 ,$10.74 ,$179.73 ,$3.50 ,$10.74 ,$179.73 ,$20.41 ,$231.70 ,$165.50 ,$264.80 ,$26.85 ,$10.74 ,$231.70 ,$10.74 ,$198.60 ,$10.74 ,$248.25 ,$182.71 ,$164.84 ,$182.71 ,$10.74 ,$182.71 ,$15.51 ,$15.51 ,$281.35 ,$26.85 ,$229.38 ,$10.74 ,$331.00 ,$182.05 ,$10.74 ,$87.05 , N/A ,$7.06 ,$6.74 ,$11.28 ,$264.80 ,$179.73 ,$92.68 ,$297.90 ,$125.78 ,$21.48 ,$10.74 ,$158.88 
ST. MARY'S HOSPITAL - DECATUR,30200277,86709,HC HEP A AB IGM,302,1 ,$211.00 ,$137.15 ,$3.50 ,$211.00 ,$28.15 ,$26.30 ,$116.05 ,$11.26 ,$59.08 ,$88.86 ,$11.26 ,$88.86 ,$11.26 ,$114.57 ,$3.50 ,$11.26 ,$114.57 ,$21.39 ,$147.70 ,$105.50 ,$168.80 ,$28.15 ,$11.26 ,$147.70 ,$11.26 ,$126.60 ,$11.26 ,$158.25 ,$116.47 ,$105.08 ,$116.47 ,$11.26 ,$116.47 ,$16.26 ,$16.26 ,$179.35 ,$28.15 ,$146.22 ,$11.26 ,$211.00 ,$116.05 ,$11.26 ,$55.49 , N/A ,$7.06 ,$6.74 ,$11.82 ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 ,$22.52 ,$11.26 ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,30200282,86735,HC MUMPS AB,302,1 ,$199.00 ,$129.35 ,$3.50 ,$199.00 ,$32.63 ,$30.50 ,$109.45 ,$13.05 ,$55.72 ,$97.51 ,$13.05 ,$102.92 ,$13.05 ,$108.06 ,$3.50 ,$13.05 ,$108.06 ,$24.80 ,$139.30 ,$99.50 ,$159.20 ,$32.63 ,$13.05 ,$139.30 ,$13.05 ,$119.40 ,$13.05 ,$149.25 ,$109.85 ,$99.10 ,$109.85 ,$13.05 ,$109.85 ,$18.85 ,$18.85 ,$169.15 ,$32.63 ,$137.91 ,$13.05 ,$199.00 ,$109.45 ,$13.05 ,$52.34 , N/A ,$7.06 ,$6.74 ,$13.70 ,$159.20 ,$108.06 ,$55.72 ,$179.10 ,$75.62 ,$26.10 ,$13.05 ,$95.52 
ST. MARY'S HOSPITAL - DECATUR,30200288,86762,HC RUBELLA AB,302,1 ,$170.00 ,$110.50 ,$3.50 ,$170.00 ,$35.98 ,$33.64 ,$93.50 ,$14.39 ,$47.60 ,$83.30 ,$14.39 ,$99.45 ,$14.39 ,$92.31 ,$3.50 ,$14.39 ,$92.31 ,$27.34 ,$119.00 ,$85.00 ,$136.00 ,$35.98 ,$14.39 ,$119.00 ,$14.39 ,$102.00 ,$14.39 ,$127.50 ,$93.84 ,$84.66 ,$93.84 ,$14.39 ,$93.84 ,$20.79 ,$20.79 ,$144.50 ,$35.98 ,$117.81 ,$14.39 ,$170.00 ,$93.50 ,$14.39 ,$44.71 , N/A ,$7.06 ,$6.74 ,$15.11 ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$28.78 ,$14.39 ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,30200291,86765,HC RUBEOLA AB,302,1 ,$189.00 ,$122.85 ,$3.50 ,$189.00 ,$32.20 ,$30.10 ,$103.95 ,$12.88 ,$52.92 ,$92.61 ,$12.88 ,$101.64 ,$12.88 ,$102.63 ,$3.50 ,$12.88 ,$102.63 ,$24.47 ,$132.30 ,$94.50 ,$151.20 ,$32.20 ,$12.88 ,$132.30 ,$12.88 ,$113.40 ,$12.88 ,$141.75 ,$104.33 ,$94.12 ,$104.33 ,$12.88 ,$104.33 ,$18.60 ,$18.60 ,$160.65 ,$32.20 ,$130.98 ,$12.88 ,$189.00 ,$103.95 ,$12.88 ,$49.71 , N/A ,$7.06 ,$6.74 ,$13.52 ,$151.20 ,$102.63 ,$52.92 ,$170.10 ,$71.82 ,$25.76 ,$12.88 ,$90.72 
ST. MARY'S HOSPITAL - DECATUR,30200298,86780,HC TREPONEMA P AB CONFIRM,302,1 ,$127.00 ,$82.55 ,$3.50 ,$127.00 ,$33.10 ,$30.94 ,$69.85 ,$13.24 ,$35.56 ,$62.23 ,$13.24 ,$74.30 ,$13.24 ,$68.96 ,$3.50 ,$13.24 ,$68.96 ,$25.16 ,$88.90 ,$63.50 ,$101.60 ,$33.10 ,$13.24 ,$88.90 ,$13.24 ,$76.20 ,$13.24 ,$95.25 ,$70.10 ,$63.25 ,$70.10 ,$13.24 ,$70.10 ,$19.12 ,$19.12 ,$107.95 ,$33.10 ,$88.01 ,$13.24 ,$127.00 ,$69.85 ,$13.24 ,$33.40 , N/A ,$12.17 ,$11.61 ,$13.90 ,$101.60 ,$68.96 ,$35.56 ,$114.30 ,$48.26 ,$26.48 ,$13.24 ,$60.96 
ST. MARY'S HOSPITAL - DECATUR,30200314,86803,HC HEP C AB,302,1 ,$452.00 ,$293.80 ,$3.50 ,$452.00 ,$35.68 ,$33.36 ,$248.60 ,$14.27 ,$126.56 ,$152.37 ,$14.27 ,$152.37 ,$14.27 ,$245.44 ,$3.50 ,$14.27 ,$245.44 ,$27.11 ,$316.40 ,$226.00 ,$361.60 ,$35.68 ,$14.27 ,$316.40 ,$14.27 ,$271.20 ,$14.27 ,$339.00 ,$249.50 ,$225.10 ,$249.50 ,$14.27 ,$249.50 ,$20.61 ,$20.61 ,$384.20 ,$35.68 ,$313.24 ,$14.27 ,$452.00 ,$248.60 ,$14.27 ,$118.88 , N/A ,$12.17 ,$11.61 ,$14.98 ,$361.60 ,$245.44 ,$126.56 ,$406.80 ,$171.76 ,$28.54 ,$14.27 ,$216.96 
ST. MARY'S HOSPITAL - DECATUR,30200343,86891,HC BLOOD SALVAGE AUTOLOOUS INTRA,302,1 ,$339.00 ,$220.35 ,$27.20 ,"$1,550.85 ","$1,550.85 ",$150.36 ,$186.45 ,$620.34 ,$94.92 ,$166.11 ,$620.34 ,$198.32 ,$339.00 ,$184.08 ,$210.06 ,$339.00 ,$184.08 ,$339.00 ,$237.30 ,$169.50 ,$271.20 ,"$1,550.85 ",$620.34 ,$237.30 ,$620.34 ,$203.40 ,$620.34 ,$254.25 ,$187.13 ,$168.82 ,$187.13 ,$620.34 ,$187.13 ,$237.30 ,$237.30 ,$288.15 ,$339.00 ,$234.93 ,$620.34 ,$339.00 ,$186.45 ,$620.34 ,$89.16 , N/A ,$28.49 ,$27.20 ,$651.36 ,$271.20 ,$184.08 ,$94.92 ,$305.10 ,$128.82 ,$339.00 ,$620.34 ,$162.72 
ST. MARY'S HOSPITAL - DECATUR,30200507,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$206.00 ,$133.90 ,$3.50 ,$206.00 ,$32.38 ,$30.26 ,$113.30 ,$12.95 ,$57.68 ,$100.94 ,$12.95 ,$102.13 ,$12.95 ,$111.86 ,$3.50 ,$12.95 ,$111.86 ,$24.61 ,$144.20 ,$103.00 ,$164.80 ,$32.38 ,$12.95 ,$144.20 ,$12.95 ,$123.60 ,$12.95 ,$154.50 ,$113.71 ,$102.59 ,$113.71 ,$12.95 ,$113.71 ,$18.71 ,$18.71 ,$175.10 ,$32.38 ,$142.76 ,$12.95 ,$206.00 ,$113.30 ,$12.95 ,$54.18 , N/A ,$7.06 ,$6.74 ,$13.60 ,$164.80 ,$111.86 ,$57.68 ,$185.40 ,$78.28 ,$25.90 ,$12.95 ,$98.88 
ST. MARY'S HOSPITAL - DECATUR,30200515,86304,HC TUMOR AG CA 125,302,1 ,$324.00 ,$210.60 ,$3.50 ,$324.00 ,$52.03 ,$48.64 ,$178.20 ,$20.81 ,$90.72 ,$158.76 ,$20.81 ,$164.26 ,$20.81 ,$175.93 ,$3.50 ,$20.81 ,$175.93 ,$39.54 ,$226.80 ,$162.00 ,$259.20 ,$52.03 ,$20.81 ,$226.80 ,$20.81 ,$194.40 ,$20.81 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$20.81 ,$178.85 ,$30.07 ,$30.07 ,$275.40 ,$52.03 ,$224.53 ,$20.81 ,$324.00 ,$178.20 ,$20.81 ,$85.21 , N/A ,$18.71 ,$17.86 ,$21.85 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$41.62 ,$20.81 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,30200543,86704,HC HEP CORE AB,302,1 ,$144.00 ,$93.60 ,$3.50 ,$144.00 ,$30.13 ,$28.16 ,$79.20 ,$12.05 ,$40.32 ,$70.56 ,$12.05 ,$84.24 ,$12.05 ,$78.19 ,$3.50 ,$12.05 ,$78.19 ,$22.90 ,$100.80 ,$72.00 ,$115.20 ,$30.13 ,$12.05 ,$100.80 ,$12.05 ,$86.40 ,$12.05 ,$108.00 ,$79.49 ,$71.71 ,$79.49 ,$12.05 ,$79.49 ,$17.41 ,$17.41 ,$122.40 ,$30.13 ,$99.79 ,$12.05 ,$144.00 ,$79.20 ,$12.05 ,$37.87 , N/A ,$7.06 ,$6.74 ,$12.65 ,$115.20 ,$78.19 ,$40.32 ,$129.60 ,$54.72 ,$24.10 ,$12.05 ,$69.12 
ST. MARY'S HOSPITAL - DECATUR,30200547,86708,HC HEP A AB TOTAL,302,1 ,$158.00 ,$102.70 ,$3.50 ,$158.00 ,$30.98 ,$28.96 ,$86.90 ,$12.39 ,$44.24 ,$77.42 ,$12.39 ,$92.43 ,$12.39 ,$85.79 ,$3.50 ,$12.39 ,$85.79 ,$23.54 ,$110.60 ,$79.00 ,$126.40 ,$30.98 ,$12.39 ,$110.60 ,$12.39 ,$94.80 ,$12.39 ,$118.50 ,$87.22 ,$78.68 ,$87.22 ,$12.39 ,$87.22 ,$17.89 ,$17.89 ,$134.30 ,$30.98 ,$109.49 ,$12.39 ,$158.00 ,$86.90 ,$12.39 ,$41.55 , N/A ,$7.06 ,$6.74 ,$13.01 ,$126.40 ,$85.79 ,$44.24 ,$142.20 ,$60.04 ,$24.78 ,$12.39 ,$75.84 
ST. MARY'S HOSPITAL - DECATUR,30200559,86850,HC AB SCREEN,302,1 ,$144.00 ,$93.60 ,$6.74 ,$144.00 ,$117.60 ,$26.28 ,$79.20 ,$47.04 ,$40.32 ,$62.42 ,$47.04 ,$62.42 ,$47.04 ,$78.19 ,$6.94 ,$47.04 ,$78.19 ,$89.37 ,$100.80 ,$72.00 ,$115.20 ,$117.60 ,$47.04 ,$100.80 ,$47.04 ,$86.40 ,$47.04 ,$108.00 ,$79.49 ,$71.71 ,$79.49 ,$47.04 ,$79.49 ,$12.70 ,$12.70 ,$122.40 ,$117.60 ,$99.79 ,$47.04 ,$144.00 ,$79.20 ,$47.04 ,$37.87 , N/A ,$7.06 ,$6.74 ,$49.39 ,$115.20 ,$78.19 ,$40.32 ,$129.60 ,$54.72 ,$19.54 ,$47.04 ,$69.12 
ST. MARY'S HOSPITAL - DECATUR,30200560,86860,HC ELUTION,302,1 ,$260.00 ,$169.00 ,$6.74 ,$352.95 ,$352.95 ,$33.64 ,$143.00 ,$141.18 ,$72.80 ,$127.40 ,$141.18 ,$152.10 ,$141.18 ,$141.18 ,$47.08 ,$141.18 ,$141.18 ,$260.00 ,$182.00 ,$130.00 ,$208.00 ,$352.95 ,$141.18 ,$182.00 ,$141.18 ,$156.00 ,$141.18 ,$195.00 ,$143.52 ,$129.48 ,$143.52 ,$141.18 ,$143.52 ,$182.00 ,$182.00 ,$221.00 ,$260.00 ,$180.18 ,$141.18 ,$260.00 ,$143.00 ,$141.18 ,$68.38 , N/A ,$7.06 ,$6.74 ,$148.24 ,$208.00 ,$141.18 ,$72.80 ,$234.00 ,$98.80 ,$260.00 ,$141.18 ,$124.80 
ST. MARY'S HOSPITAL - DECATUR,30200561,86870,HC RBC AB ID PANEL,302,1 ,$281.00 ,$182.65 ,$6.74 ,$689.24 ,$689.23 ,$46.26 ,$154.55 ,$275.69 ,$78.68 ,$137.69 ,$275.69 ,$164.39 ,$275.69 ,$152.58 ,$64.67 ,$275.69 ,$152.58 ,$281.00 ,$196.70 ,$140.50 ,$224.80 ,$689.24 ,$275.69 ,$196.70 ,$275.69 ,$168.60 ,$275.69 ,$210.75 ,$155.11 ,$139.94 ,$155.11 ,$275.69 ,$155.11 ,$196.70 ,$196.70 ,$238.85 ,$281.00 ,$194.73 ,$275.69 ,$281.00 ,$154.55 ,$275.69 ,$73.90 , N/A ,$7.06 ,$6.74 ,$289.47 ,$224.80 ,$152.58 ,$78.68 ,$252.90 ,$106.78 ,$281.00 ,$275.69 ,$134.88 
ST. MARY'S HOSPITAL - DECATUR,30200562,86880,HC COOMBS DIRECT,302,1 ,$141.00 ,$91.65 ,$3.50 ,$141.00 ,$131.73 ,$12.56 ,$77.55 ,$52.69 ,$39.48 ,$42.47 ,$52.69 ,$42.47 ,$52.69 ,$76.56 ,$3.50 ,$52.69 ,$76.56 ,$100.11 ,$98.70 ,$70.50 ,$112.80 ,$131.73 ,$52.69 ,$98.70 ,$52.69 ,$84.60 ,$52.69 ,$105.75 ,$77.83 ,$70.22 ,$77.83 ,$52.69 ,$77.83 ,$7.79 ,$7.79 ,$119.85 ,$131.73 ,$97.71 ,$52.69 ,$141.00 ,$77.55 ,$52.69 ,$37.08 , N/A ,$7.06 ,$6.74 ,$55.32 ,$112.80 ,$76.56 ,$39.48 ,$126.90 ,$53.58 ,$10.78 ,$52.69 ,$67.68 
ST. MARY'S HOSPITAL - DECATUR,30200564,86890,HC AUTOLOGOUS PROCESSING FEE,302,1 ,$444.00 ,$288.60 ,$27.20 ,$444.00 ,$352.95 ,$106.20 ,$244.20 ,$141.18 ,$124.32 ,$217.56 ,$141.18 ,$259.74 ,$141.18 ,$241.09 ,$148.49 ,$141.18 ,$241.09 ,$268.24 ,$310.80 ,$222.00 ,$355.20 ,$352.95 ,$141.18 ,$310.80 ,$141.18 ,$266.40 ,$141.18 ,$333.00 ,$245.09 ,$221.11 ,$245.09 ,$141.18 ,$245.09 ,$310.80 ,$310.80 ,$377.40 ,$352.95 ,$307.69 ,$141.18 ,$444.00 ,$244.20 ,$141.18 ,$116.77 , N/A ,$28.49 ,$27.20 ,$148.24 ,$355.20 ,$241.09 ,$124.32 ,$399.60 ,$168.72 ,$298.32 ,$141.18 ,$213.12 
ST. MARY'S HOSPITAL - DECATUR,30200565,86900,HC BLOOD TYPING ABO,302,1 ,$103.00 ,$66.95 ,$3.50 ,$266.85 ,$266.85 ,$6.98 ,$56.65 ,$106.74 ,$28.84 ,$23.59 ,$106.74 ,$23.59 ,$103.00 ,$55.93 ,$3.50 ,$103.00 ,$55.93 ,$103.00 ,$72.10 ,$51.50 ,$82.40 ,$266.84 ,$106.74 ,$72.10 ,$106.74 ,$61.80 ,$106.74 ,$77.25 ,$56.86 ,$51.29 ,$56.86 ,$106.74 ,$56.86 ,$4.32 ,$4.32 ,$87.55 ,$103.00 ,$71.38 ,$106.74 ,$103.00 ,$56.65 ,$106.74 ,$27.09 , N/A ,$4.38 ,$4.18 ,$112.08 ,$82.40 ,$55.93 ,$28.84 ,$92.70 ,$39.14 ,$5.98 ,$106.74 ,$49.44 
ST. MARY'S HOSPITAL - DECATUR,30200566,86901,HC BLOOD TYPING RH,302,1 ,$91.00 ,$59.15 ,$3.50 ,$91.00 ,$80.10 ,$6.98 ,$50.05 ,$32.04 ,$25.48 ,$23.59 ,$32.04 ,$23.59 ,$32.04 ,$49.41 ,$3.50 ,$32.04 ,$49.41 ,$60.88 ,$63.70 ,$45.50 ,$72.80 ,$80.10 ,$32.04 ,$63.70 ,$32.04 ,$54.60 ,$32.04 ,$68.25 ,$50.23 ,$45.32 ,$50.23 ,$32.04 ,$50.23 ,$4.32 ,$4.32 ,$77.35 ,$80.10 ,$63.06 ,$32.04 ,$91.00 ,$50.05 ,$32.04 ,$23.93 , N/A ,$4.38 ,$4.18 ,$33.64 ,$72.80 ,$49.41 ,$25.48 ,$81.90 ,$34.58 ,$5.98 ,$32.04 ,$43.68 
ST. MARY'S HOSPITAL - DECATUR,30200567,86902,HC RBC AG SCR RGT SERUM,302,1 ,$154.00 ,$100.10 ,$3.50 ,$689.24 ,$689.23 ,$8.92 ,$84.70 ,$275.69 ,$43.12 ,$40.60 ,$275.69 ,$40.60 ,$154.00 ,$83.62 ,$3.50 ,$154.00 ,$83.62 ,$154.00 ,$107.80 ,$77.00 ,$123.20 ,$689.24 ,$275.69 ,$107.80 ,$275.69 ,$92.40 ,$275.69 ,$115.50 ,$85.01 ,$76.69 ,$85.01 ,$275.69 ,$85.01 ,$8.26 ,$8.26 ,$130.90 ,$154.00 ,$106.72 ,$275.69 ,$154.00 ,$84.70 ,$275.69 ,$40.50 , N/A ,$4.38 ,$4.18 ,$289.47 ,$123.20 ,$83.62 ,$43.12 ,$138.60 ,$58.52 ,$12.70 ,$275.69 ,$73.92 
ST. MARY'S HOSPITAL - DECATUR,30200568,86905,HC RBC ANTIGEN OTHER THAN ABO OR RH(D) EACH,302,1 ,$146.00 ,$94.90 ,$3.50 ,$689.24 ,$689.23 ,$8.92 ,$80.30 ,$275.69 ,$40.88 ,$30.18 ,$275.69 ,$30.18 ,$146.00 ,$79.28 ,$3.50 ,$146.00 ,$79.28 ,$146.00 ,$102.20 ,$73.00 ,$116.80 ,$689.24 ,$275.69 ,$102.20 ,$275.69 ,$87.60 ,$275.69 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$275.69 ,$80.59 ,$5.53 ,$5.53 ,$124.10 ,$146.00 ,$101.18 ,$275.69 ,$146.00 ,$80.30 ,$275.69 ,$38.40 , N/A ,$4.38 ,$4.18 ,$289.47 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$7.66 ,$275.69 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30200569,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$263.00 ,$170.95 ,$4.18 ,$352.95 ,$352.95 ,$37.32 ,$144.65 ,$141.18 ,$73.64 ,$128.87 ,$141.18 ,$153.86 ,$141.18 ,$142.81 ,$52.26 ,$141.18 ,$142.81 ,$263.00 ,$184.10 ,$131.50 ,$210.40 ,$352.95 ,$141.18 ,$184.10 ,$141.18 ,$157.80 ,$141.18 ,$197.25 ,$145.18 ,$130.97 ,$145.18 ,$141.18 ,$145.18 ,$184.10 ,$184.10 ,$223.55 ,$263.00 ,$182.26 ,$141.18 ,$263.00 ,$144.65 ,$141.18 ,$69.17 , N/A ,$4.38 ,$4.18 ,$148.24 ,$210.40 ,$142.81 ,$73.64 ,$236.70 ,$99.94 ,$263.00 ,$141.18 ,$126.24 
ST. MARY'S HOSPITAL - DECATUR,30200571,86922,HC CROSSMATCH AHG,302,1 ,$201.00 ,$130.65 ,$27.20 ,$352.95 ,$352.95 ,$39.96 ,$110.55 ,$141.18 ,$56.28 ,$98.49 ,$141.18 ,$117.59 ,$141.18 ,$109.14 ,$55.88 ,$141.18 ,$109.14 ,$201.00 ,$140.70 ,$100.50 ,$160.80 ,$352.95 ,$141.18 ,$140.70 ,$141.18 ,$120.60 ,$141.18 ,$150.75 ,$110.95 ,$100.10 ,$110.95 ,$141.18 ,$110.95 ,$140.70 ,$140.70 ,$170.85 ,$201.00 ,$139.29 ,$141.18 ,$201.00 ,$110.55 ,$141.18 ,$52.86 , N/A ,$28.49 ,$27.20 ,$148.24 ,$160.80 ,$109.14 ,$56.28 ,$180.90 ,$76.38 ,$201.00 ,$141.18 ,$96.48 
ST. MARY'S HOSPITAL - DECATUR,30200572,86923,HC CROSSMATCH ELECTRONIC,302,1 ,$62.00 ,$40.30 ,$16.31 ,$352.95 ,$352.95 ,$29.96 ,$34.10 ,$141.18 ,$17.36 ,$30.38 ,$141.18 ,$36.27 ,$62.00 ,$33.67 ,$41.91 ,$62.00 ,$33.67 ,$62.00 ,$43.40 ,$31.00 ,$49.60 ,$352.95 ,$141.18 ,$43.40 ,$141.18 ,$37.20 ,$141.18 ,$46.50 ,$34.22 ,$30.88 ,$34.22 ,$141.18 ,$34.22 ,$43.40 ,$43.40 ,$52.70 ,$62.00 ,$42.97 ,$141.18 ,$62.00 ,$34.10 ,$141.18 ,$16.31 , N/A ,$28.49 ,$27.20 ,$148.24 ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$62.00 ,$141.18 ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,30200573,86978,HC RBC PRETREAT ABSOR,302,1 ,$291.00 ,$189.15 ,$4.18 ,$291.00 ,$80.10 ,$37.32 ,$160.05 ,$32.04 ,$81.48 ,$142.59 ,$32.04 ,$170.24 ,$32.04 ,$158.01 ,$52.26 ,$32.04 ,$158.01 ,$60.88 ,$203.70 ,$145.50 ,$232.80 ,$80.10 ,$32.04 ,$203.70 ,$32.04 ,$174.60 ,$32.04 ,$218.25 ,$160.63 ,$144.92 ,$160.63 ,$32.04 ,$160.63 ,$203.70 ,$203.70 ,$247.35 ,$80.10 ,$201.66 ,$32.04 ,$291.00 ,$160.05 ,$32.04 ,$76.53 , N/A ,$4.38 ,$4.18 ,$33.64 ,$232.80 ,$158.01 ,$81.48 ,$261.90 ,$110.58 ,$67.68 ,$32.04 ,$139.68 
ST. MARY'S HOSPITAL - DECATUR,30200575,87801,HC INFECT MLT  ORG AMP,302,1 ,$243.00 ,$157.95 ,$3.50 ,$243.00 ,$175.50 ,$164.04 ,$133.65 ,$70.20 ,$68.04 ,$119.07 ,$70.20 ,$142.16 ,$70.20 ,$131.95 ,$3.50 ,$70.20 ,$131.95 ,$133.38 ,$170.10 ,$121.50 ,$194.40 ,$175.50 ,$70.20 ,$170.10 ,$70.20 ,$145.80 ,$70.20 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$70.20 ,$134.14 ,$101.39 ,$101.39 ,$206.55 ,$175.50 ,$168.40 ,$70.20 ,$243.00 ,$133.65 ,$70.20 ,$63.91 , N/A ,$5.63 ,$5.38 ,$73.71 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$140.40 ,$70.20 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30200822,86705,HC HEP B CORE IGM,302,1 ,$372.00 ,$241.80 ,$3.50 ,$372.00 ,$29.43 ,$27.50 ,$204.60 ,$11.77 ,$104.16 ,$92.89 ,$11.77 ,$92.89 ,$11.77 ,$202.00 ,$3.50 ,$11.77 ,$202.00 ,$22.36 ,$260.40 ,$186.00 ,$297.60 ,$29.43 ,$11.77 ,$260.40 ,$11.77 ,$223.20 ,$11.77 ,$279.00 ,$205.34 ,$185.26 ,$205.34 ,$11.77 ,$205.34 ,$17.00 ,$17.00 ,$316.20 ,$29.43 ,$257.80 ,$11.77 ,$372.00 ,$204.60 ,$11.77 ,$97.84 , N/A ,$7.06 ,$6.74 ,$12.36 ,$297.60 ,$202.00 ,$104.16 ,$334.80 ,$141.36 ,$23.54 ,$11.77 ,$178.56 
ST. MARY'S HOSPITAL - DECATUR,30200843,86000,HC AGGLUTININS FEBRILE EA AG-90,302,1 ,$231.00 ,$150.15 ,$3.50 ,$231.00 ,$17.45 ,$16.32 ,$127.05 ,$6.98 ,$64.68 ,$55.05 ,$6.98 ,$55.05 ,$6.98 ,$125.43 ,$3.50 ,$6.98 ,$125.43 ,$13.26 ,$161.70 ,$115.50 ,$184.80 ,$17.45 ,$6.98 ,$161.70 ,$6.98 ,$138.60 ,$6.98 ,$173.25 ,$127.51 ,$115.04 ,$127.51 ,$6.98 ,$127.51 ,$10.09 ,$10.09 ,$196.35 ,$17.45 ,$160.08 ,$6.98 ,$231.00 ,$127.05 ,$6.98 ,$60.75 , N/A ,$7.06 ,$6.74 ,$7.33 ,$184.80 ,$125.43 ,$64.68 ,$207.90 ,$87.78 ,$13.96 ,$6.98 ,$110.88 
ST. MARY'S HOSPITAL - DECATUR,30200844,86001,HC RAST ALLERGEN IGG QN SQ EA-90,302,1 ,$53.00 ,$34.45 ,$3.50 ,$53.00 ,$19.55 ,$12.18 ,$29.15 ,$7.82 ,$14.84 ,$25.97 ,$7.82 ,$31.01 ,$7.82 ,$28.78 ,$3.50 ,$7.82 ,$28.78 ,$14.86 ,$37.10 ,$26.50 ,$42.40 ,$19.55 ,$7.82 ,$37.10 ,$7.82 ,$31.80 ,$7.82 ,$39.75 ,$29.26 ,$26.39 ,$29.26 ,$7.82 ,$29.26 ,$10.17 ,$10.17 ,$45.05 ,$19.55 ,$36.73 ,$7.82 ,$53.00 ,$29.15 ,$7.82 ,$13.94 , N/A ,$7.06 ,$6.74 ,$8.21 ,$42.40 ,$28.78 ,$14.84 ,$47.70 ,$20.14 ,$15.64 ,$7.82 ,$25.44 
ST. MARY'S HOSPITAL - DECATUR,30200845,86003,HC RAST ALLERGEN IGE QN SQ EA-90,302,1 ,$112.00 ,$72.80 ,$3.50 ,$112.00 ,$13.05 ,$12.18 ,$61.60 ,$5.22 ,$31.36 ,$41.19 ,$5.22 ,$41.19 ,$5.22 ,$60.82 ,$3.50 ,$5.22 ,$60.82 ,$9.92 ,$78.40 ,$56.00 ,$89.60 ,$13.05 ,$5.22 ,$78.40 ,$5.22 ,$67.20 ,$5.22 ,$84.00 ,$61.82 ,$55.78 ,$61.82 ,$5.22 ,$61.82 ,$7.54 ,$7.54 ,$95.20 ,$13.05 ,$77.62 ,$5.22 ,$112.00 ,$61.60 ,$5.22 ,$29.46 , N/A ,$7.06 ,$6.74 ,$5.48 ,$89.60 ,$60.82 ,$31.36 ,$100.80 ,$42.56 ,$10.44 ,$5.22 ,$53.76 
ST. MARY'S HOSPITAL - DECATUR,30200847,86021,HC LEUKO AB ID-90,302,1 ,$401.00 ,$260.65 ,$3.50 ,$401.00 ,$37.63 ,$35.20 ,$220.55 ,$15.05 ,$112.28 ,$118.75 ,$15.05 ,$118.75 ,$15.05 ,$217.74 ,$3.50 ,$15.05 ,$217.74 ,$28.60 ,$280.70 ,$200.50 ,$320.80 ,$37.63 ,$15.05 ,$280.70 ,$15.05 ,$240.60 ,$15.05 ,$300.75 ,$221.35 ,$199.70 ,$221.35 ,$15.05 ,$221.35 ,$21.75 ,$21.75 ,$340.85 ,$37.63 ,$277.89 ,$15.05 ,$401.00 ,$220.55 ,$15.05 ,$105.46 , N/A ,$7.06 ,$6.74 ,$15.80 ,$320.80 ,$217.74 ,$112.28 ,$360.90 ,$152.38 ,$30.10 ,$15.05 ,$192.48 
ST. MARY'S HOSPITAL - DECATUR,30200851,86022,HC PLATELET AB ID-90,302,1 ,$507.00 ,$329.55 ,$3.50 ,$507.00 ,$45.93 ,$34.08 ,$278.85 ,$18.37 ,$141.96 ,$144.89 ,$18.37 ,$144.89 ,$18.37 ,$275.30 ,$3.50 ,$18.37 ,$275.30 ,$34.90 ,$354.90 ,$253.50 ,$405.60 ,$45.93 ,$18.37 ,$354.90 ,$18.37 ,$304.20 ,$18.37 ,$380.25 ,$279.86 ,$252.49 ,$279.86 ,$18.37 ,$279.86 ,$26.53 ,$26.53 ,$430.95 ,$45.93 ,$351.35 ,$18.37 ,$507.00 ,$278.85 ,$18.37 ,$133.34 , N/A ,$7.06 ,$6.74 ,$19.29 ,$405.60 ,$275.30 ,$141.96 ,$456.30 ,$192.66 ,$36.74 ,$18.37 ,$243.36 
ST. MARY'S HOSPITAL - DECATUR,30200856,86022,HC PLATELET CROSSMATCH,302,1 ,$507.00 ,$329.55 ,$3.50 ,$507.00 ,$45.93 ,$34.08 ,$278.85 ,$18.37 ,$141.96 ,$144.89 ,$18.37 ,$144.89 ,$18.37 ,$275.30 ,$3.50 ,$18.37 ,$275.30 ,$34.90 ,$354.90 ,$253.50 ,$405.60 ,$45.93 ,$18.37 ,$354.90 ,$18.37 ,$304.20 ,$18.37 ,$380.25 ,$279.86 ,$252.49 ,$279.86 ,$18.37 ,$279.86 ,$26.53 ,$26.53 ,$430.95 ,$45.93 ,$351.35 ,$18.37 ,$507.00 ,$278.85 ,$18.37 ,$133.34 , N/A ,$7.06 ,$6.74 ,$19.29 ,$405.60 ,$275.30 ,$141.96 ,$456.30 ,$192.66 ,$36.74 ,$18.37 ,$243.36 
ST. MARY'S HOSPITAL - DECATUR,30200857,86023,HC PLATELET ASSOC AB ID IGG-90,302,1 ,$341.00 ,$221.65 ,$3.50 ,$341.00 ,$31.15 ,$29.10 ,$187.55 ,$12.46 ,$95.48 ,$98.30 ,$12.46 ,$98.30 ,$12.46 ,$185.16 ,$3.50 ,$12.46 ,$185.16 ,$23.67 ,$238.70 ,$170.50 ,$272.80 ,$31.15 ,$12.46 ,$238.70 ,$12.46 ,$204.60 ,$12.46 ,$255.75 ,$188.23 ,$169.82 ,$188.23 ,$12.46 ,$188.23 ,$17.99 ,$17.99 ,$289.85 ,$31.15 ,$236.31 ,$12.46 ,$341.00 ,$187.55 ,$12.46 ,$89.68 , N/A ,$7.06 ,$6.74 ,$13.08 ,$272.80 ,$185.16 ,$95.48 ,$306.90 ,$129.58 ,$24.92 ,$12.46 ,$163.68 
ST. MARY'S HOSPITAL - DECATUR,30200858,86038,HC ANA SCREEN-90,302,1 ,$246.00 ,$159.90 ,$3.50 ,$246.00 ,$30.23 ,$28.26 ,$135.30 ,$12.09 ,$68.88 ,$95.35 ,$12.09 ,$95.35 ,$12.09 ,$133.58 ,$3.50 ,$12.09 ,$133.58 ,$22.97 ,$172.20 ,$123.00 ,$196.80 ,$30.23 ,$12.09 ,$172.20 ,$12.09 ,$147.60 ,$12.09 ,$184.50 ,$135.79 ,$122.51 ,$135.79 ,$12.09 ,$135.79 ,$17.46 ,$17.46 ,$209.10 ,$30.23 ,$170.48 ,$12.09 ,$246.00 ,$135.30 ,$12.09 ,$64.70 , N/A ,$7.06 ,$6.74 ,$12.69 ,$196.80 ,$133.58 ,$68.88 ,$221.40 ,$93.48 ,$24.18 ,$12.09 ,$118.08 
ST. MARY'S HOSPITAL - DECATUR,30200859,86039,HC ANA TITER-90,302,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$27.90 ,$26.10 ,$89.10 ,$11.16 ,$45.36 ,$79.38 ,$11.16 ,$88.08 ,$11.16 ,$87.97 ,$3.50 ,$11.16 ,$87.97 ,$21.20 ,$113.40 ,$81.00 ,$129.60 ,$27.90 ,$11.16 ,$113.40 ,$11.16 ,$97.20 ,$11.16 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$11.16 ,$89.42 ,$16.12 ,$16.12 ,$137.70 ,$27.90 ,$112.27 ,$11.16 ,$162.00 ,$89.10 ,$11.16 ,$42.61 , N/A ,$7.06 ,$6.74 ,$11.72 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$22.32 ,$11.16 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30200860,86060,HC ASO-90,302,1 ,$94.00 ,$61.10 ,$3.50 ,$94.00 ,$18.25 ,$17.06 ,$51.70 ,$7.30 ,$26.32 ,$46.06 ,$7.30 ,$54.99 ,$7.30 ,$51.04 ,$3.50 ,$7.30 ,$51.04 ,$13.87 ,$65.80 ,$47.00 ,$75.20 ,$18.25 ,$7.30 ,$65.80 ,$7.30 ,$56.40 ,$7.30 ,$70.50 ,$51.89 ,$46.81 ,$51.89 ,$7.30 ,$51.89 ,$10.54 ,$10.54 ,$79.90 ,$18.25 ,$65.14 ,$7.30 ,$94.00 ,$51.70 ,$7.30 ,$24.72 , N/A ,$7.06 ,$6.74 ,$7.67 ,$75.20 ,$51.04 ,$26.32 ,$84.60 ,$35.72 ,$14.60 ,$7.30 ,$45.12 
ST. MARY'S HOSPITAL - DECATUR,30200861,86140,HC C-REACTIVE PROTEIN-90,302,1 ,$119.00 ,$77.35 ,$3.50 ,$119.00 ,$12.95 ,$12.08 ,$65.45 ,$5.18 ,$33.32 ,$40.79 ,$5.18 ,$40.79 ,$5.18 ,$64.62 ,$3.50 ,$5.18 ,$64.62 ,$9.84 ,$83.30 ,$59.50 ,$95.20 ,$12.95 ,$5.18 ,$83.30 ,$5.18 ,$71.40 ,$5.18 ,$89.25 ,$65.69 ,$59.26 ,$65.69 ,$5.18 ,$65.69 ,$7.48 ,$7.48 ,$101.15 ,$12.95 ,$82.47 ,$5.18 ,$119.00 ,$65.45 ,$5.18 ,$31.30 , N/A ,$7.06 ,$6.74 ,$5.44 ,$95.20 ,$64.62 ,$33.32 ,$107.10 ,$45.22 ,$10.36 ,$5.18 ,$57.12 
ST. MARY'S HOSPITAL - DECATUR,30200862,86140,HC C-REACTIVE PROTEIN,302,1 ,$169.00 ,$109.85 ,$3.50 ,$169.00 ,$12.95 ,$12.08 ,$92.95 ,$5.18 ,$47.32 ,$40.79 ,$5.18 ,$40.79 ,$5.18 ,$91.77 ,$3.50 ,$5.18 ,$91.77 ,$9.84 ,$118.30 ,$84.50 ,$135.20 ,$12.95 ,$5.18 ,$118.30 ,$5.18 ,$101.40 ,$5.18 ,$126.75 ,$93.29 ,$84.16 ,$93.29 ,$5.18 ,$93.29 ,$7.48 ,$7.48 ,$143.65 ,$12.95 ,$117.12 ,$5.18 ,$169.00 ,$92.95 ,$5.18 ,$44.45 , N/A ,$7.06 ,$6.74 ,$5.44 ,$135.20 ,$91.77 ,$47.32 ,$152.10 ,$64.22 ,$10.36 ,$5.18 ,$81.12 
ST. MARY'S HOSPITAL - DECATUR,30200864,86146,HC BETA 2 GLYCO AB-90,302,1 ,$141.00 ,$91.65 ,$3.50 ,$141.00 ,$63.63 ,$59.44 ,$77.55 ,$25.45 ,$39.48 ,$69.09 ,$25.45 ,$82.49 ,$25.45 ,$76.56 ,$3.50 ,$25.45 ,$76.56 ,$48.36 ,$98.70 ,$70.50 ,$112.80 ,$63.63 ,$25.45 ,$98.70 ,$25.45 ,$84.60 ,$25.45 ,$105.75 ,$77.83 ,$70.22 ,$77.83 ,$25.45 ,$77.83 ,$36.76 ,$36.76 ,$119.85 ,$63.63 ,$97.71 ,$25.45 ,$141.00 ,$77.55 ,$25.45 ,$37.08 , N/A ,$7.88 ,$7.52 ,$26.72 ,$112.80 ,$76.56 ,$39.48 ,$126.90 ,$53.58 ,$50.90 ,$25.45 ,$67.68 
ST. MARY'S HOSPITAL - DECATUR,30200865,86147,HC CARDIOLIPIN AB EA-90,302,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$63.63 ,$59.44 ,$89.10 ,$25.45 ,$45.36 ,$79.38 ,$25.45 ,$94.77 ,$25.45 ,$87.97 ,$3.50 ,$25.45 ,$87.97 ,$48.36 ,$113.40 ,$81.00 ,$129.60 ,$63.63 ,$25.45 ,$113.40 ,$25.45 ,$97.20 ,$25.45 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$25.45 ,$89.42 ,$36.76 ,$36.76 ,$137.70 ,$63.63 ,$112.27 ,$25.45 ,$162.00 ,$89.10 ,$25.45 ,$42.61 , N/A ,$12.17 ,$11.61 ,$26.72 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$50.90 ,$25.45 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30200866,86148,HC ANTI-PHOSPHATIDYLSERINE AB-90,302,1 ,$79.00 ,$51.35 ,$3.50 ,$79.00 ,$40.18 ,$37.54 ,$43.45 ,$16.07 ,$22.12 ,$38.71 ,$16.07 ,$46.22 ,$16.07 ,$42.90 ,$3.50 ,$16.07 ,$42.90 ,$30.53 ,$55.30 ,$39.50 ,$63.20 ,$40.18 ,$16.07 ,$55.30 ,$16.07 ,$47.40 ,$16.07 ,$59.25 ,$43.61 ,$39.34 ,$43.61 ,$16.07 ,$43.61 ,$23.21 ,$23.21 ,$67.15 ,$40.18 ,$54.75 ,$16.07 ,$79.00 ,$43.45 ,$16.07 ,$20.78 , N/A ,$7.88 ,$7.52 ,$16.87 ,$63.20 ,$42.90 ,$22.12 ,$71.10 ,$30.02 ,$32.14 ,$16.07 ,$37.92 
ST. MARY'S HOSPITAL - DECATUR,30200867,86156,HC COLD AGGLUTININ SCREEN-90,302,1 ,$134.00 ,$87.10 ,$3.50 ,$134.00 ,$20.18 ,$15.66 ,$73.70 ,$8.07 ,$37.52 ,$52.89 ,$8.07 ,$52.89 ,$8.07 ,$72.76 ,$3.50 ,$8.07 ,$72.76 ,$15.33 ,$93.80 ,$67.00 ,$107.20 ,$20.18 ,$8.07 ,$93.80 ,$8.07 ,$80.40 ,$8.07 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$8.07 ,$73.97 ,$10.49 ,$10.49 ,$113.90 ,$20.18 ,$92.86 ,$8.07 ,$134.00 ,$73.70 ,$8.07 ,$35.24 , N/A ,$7.06 ,$6.74 ,$8.47 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$16.14 ,$8.07 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,30200868,86157,HC COLD AGGLUTININ TITER-90,302,1 ,$171.00 ,$111.15 ,$3.50 ,$171.00 ,$20.15 ,$18.86 ,$94.05 ,$8.06 ,$47.88 ,$63.60 ,$8.06 ,$63.60 ,$8.06 ,$92.85 ,$3.50 ,$8.06 ,$92.85 ,$15.31 ,$119.70 ,$85.50 ,$136.80 ,$20.15 ,$8.06 ,$119.70 ,$8.06 ,$102.60 ,$8.06 ,$128.25 ,$94.39 ,$85.16 ,$94.39 ,$8.06 ,$94.39 ,$11.65 ,$11.65 ,$145.35 ,$20.15 ,$118.50 ,$8.06 ,$171.00 ,$94.05 ,$8.06 ,$44.97 , N/A ,$7.06 ,$6.74 ,$8.46 ,$136.80 ,$92.85 ,$47.88 ,$153.90 ,$64.98 ,$16.12 ,$8.06 ,$82.08 
ST. MARY'S HOSPITAL - DECATUR,30200869,86160,HC COMPLEMENT AG EA-90,302,1 ,$138.00 ,$89.70 ,$3.50 ,$138.00 ,$30.00 ,$28.06 ,$75.90 ,$12.00 ,$38.64 ,$67.62 ,$12.00 ,$80.73 ,$12.00 ,$74.93 ,$3.50 ,$12.00 ,$74.93 ,$22.80 ,$96.60 ,$69.00 ,$110.40 ,$30.00 ,$12.00 ,$96.60 ,$12.00 ,$82.80 ,$12.00 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$12.00 ,$76.18 ,$17.33 ,$17.33 ,$117.30 ,$30.00 ,$95.63 ,$12.00 ,$138.00 ,$75.90 ,$12.00 ,$36.29 , N/A ,$7.06 ,$6.74 ,$12.60 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$24.00 ,$12.00 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30200870,86161,HC C1 ESTERASE INHIBITOR-90,302,1 ,$225.00 ,$146.25 ,$3.50 ,$225.00 ,$30.00 ,$28.06 ,$123.75 ,$12.00 ,$63.00 ,$94.66 ,$12.00 ,$94.66 ,$12.00 ,$122.18 ,$3.50 ,$12.00 ,$122.18 ,$22.80 ,$157.50 ,$112.50 ,$180.00 ,$30.00 ,$12.00 ,$157.50 ,$12.00 ,$135.00 ,$12.00 ,$168.75 ,$124.20 ,$112.05 ,$124.20 ,$12.00 ,$124.20 ,$17.33 ,$17.33 ,$191.25 ,$30.00 ,$155.93 ,$12.00 ,$225.00 ,$123.75 ,$12.00 ,$59.18 , N/A ,$7.06 ,$6.74 ,$12.60 ,$180.00 ,$122.18 ,$63.00 ,$202.50 ,$85.50 ,$24.00 ,$12.00 ,$108.00 
ST. MARY'S HOSPITAL - DECATUR,30200871,86162,HC COMPLEMENT TOTAL-90,302,1 ,$259.00 ,$168.35 ,$3.50 ,$259.00 ,$50.80 ,$47.48 ,$142.45 ,$20.32 ,$72.52 ,$126.91 ,$20.32 ,$151.52 ,$20.32 ,$140.64 ,$3.50 ,$20.32 ,$140.64 ,$38.61 ,$181.30 ,$129.50 ,$207.20 ,$50.80 ,$20.32 ,$181.30 ,$20.32 ,$155.40 ,$20.32 ,$194.25 ,$142.97 ,$128.98 ,$142.97 ,$20.32 ,$142.97 ,$29.35 ,$29.35 ,$220.15 ,$50.80 ,$179.49 ,$20.32 ,$259.00 ,$142.45 ,$20.32 ,$68.12 , N/A ,$7.06 ,$6.74 ,$21.34 ,$207.20 ,$140.64 ,$72.52 ,$233.10 ,$98.42 ,$40.64 ,$20.32 ,$124.32 
ST. MARY'S HOSPITAL - DECATUR,30200873,86200,HC CCP AB-90,302,1 ,$207.00 ,$134.55 ,$3.50 ,$207.00 ,$32.38 ,$30.26 ,$113.85 ,$12.95 ,$57.96 ,$101.43 ,$12.95 ,$102.13 ,$12.95 ,$112.40 ,$3.50 ,$12.95 ,$112.40 ,$24.61 ,$144.90 ,$103.50 ,$165.60 ,$32.38 ,$12.95 ,$144.90 ,$12.95 ,$124.20 ,$12.95 ,$155.25 ,$114.26 ,$103.09 ,$114.26 ,$12.95 ,$114.26 ,$18.71 ,$18.71 ,$175.95 ,$32.38 ,$143.45 ,$12.95 ,$207.00 ,$113.85 ,$12.95 ,$54.44 , N/A ,$7.06 ,$6.74 ,$13.60 ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$25.90 ,$12.95 ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,30200874,86215,HC DEOXYRIBONUCLEASE AB-90,302,1 ,$87.00 ,$56.55 ,$3.50 ,$87.00 ,$33.13 ,$30.96 ,$47.85 ,$13.25 ,$24.36 ,$42.63 ,$13.25 ,$50.90 ,$13.25 ,$47.24 ,$3.50 ,$13.25 ,$47.24 ,$25.18 ,$60.90 ,$43.50 ,$69.60 ,$33.13 ,$13.25 ,$60.90 ,$13.25 ,$52.20 ,$13.25 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$13.25 ,$48.02 ,$19.14 ,$19.14 ,$73.95 ,$33.13 ,$60.29 ,$13.25 ,$87.00 ,$47.85 ,$13.25 ,$22.88 , N/A ,$7.06 ,$6.74 ,$13.91 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$26.50 ,$13.25 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30200875,86225,HC DNA DOUBLE STRAND AB-90,302,1 ,$142.00 ,$92.30 ,$3.50 ,$142.00 ,$34.35 ,$32.10 ,$78.10 ,$13.74 ,$39.76 ,$69.58 ,$13.74 ,$83.07 ,$13.74 ,$77.11 ,$3.50 ,$13.74 ,$77.11 ,$26.11 ,$99.40 ,$71.00 ,$113.60 ,$34.35 ,$13.74 ,$99.40 ,$13.74 ,$85.20 ,$13.74 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$13.74 ,$78.38 ,$19.85 ,$19.85 ,$120.70 ,$34.35 ,$98.41 ,$13.74 ,$142.00 ,$78.10 ,$13.74 ,$37.35 , N/A ,$7.06 ,$6.74 ,$14.43 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$27.48 ,$13.74 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30200876,86226,HC DNA SINGLE STRAND AB-90,302,1 ,$95.00 ,$61.75 ,$3.50 ,$95.00 ,$30.28 ,$28.30 ,$52.25 ,$12.11 ,$26.60 ,$46.55 ,$12.11 ,$55.58 ,$12.11 ,$51.59 ,$3.50 ,$12.11 ,$51.59 ,$23.01 ,$66.50 ,$47.50 ,$76.00 ,$30.28 ,$12.11 ,$66.50 ,$12.11 ,$57.00 ,$12.11 ,$71.25 ,$52.44 ,$47.31 ,$52.44 ,$12.11 ,$52.44 ,$17.49 ,$17.49 ,$80.75 ,$30.28 ,$65.84 ,$12.11 ,$95.00 ,$52.25 ,$12.11 ,$24.99 , N/A ,$7.06 ,$6.74 ,$12.72 ,$76.00 ,$51.59 ,$26.60 ,$85.50 ,$36.10 ,$24.22 ,$12.11 ,$45.60 
ST. MARY'S HOSPITAL - DECATUR,30200877,86235,HC ENA AB-90,302,1 ,$161.00 ,$104.65 ,$3.50 ,$161.00 ,$44.83 ,$41.42 ,$88.55 ,$17.93 ,$45.08 ,$78.89 ,$17.93 ,$94.19 ,$17.93 ,$87.42 ,$3.50 ,$17.93 ,$87.42 ,$34.07 ,$112.70 ,$80.50 ,$128.80 ,$44.83 ,$17.93 ,$112.70 ,$17.93 ,$96.60 ,$17.93 ,$120.75 ,$88.87 ,$80.18 ,$88.87 ,$17.93 ,$88.87 ,$25.91 ,$25.91 ,$136.85 ,$44.83 ,$111.57 ,$17.93 ,$161.00 ,$88.55 ,$17.93 ,$42.34 , N/A ,$12.17 ,$11.61 ,$18.83 ,$128.80 ,$87.42 ,$45.08 ,$144.90 ,$61.18 ,$35.86 ,$17.93 ,$77.28 
ST. MARY'S HOSPITAL - DECATUR,30200878,86255,HC FLUOR AB SCR-90,302,1 ,$405.00 ,$263.25 ,$9.51 ,$405.00 ,$30.13 ,$28.16 ,$222.75 ,$12.05 ,$113.40 ,$95.06 ,$12.05 ,$95.06 ,$12.05 ,$219.92 ,$9.51 ,$12.05 ,$219.92 ,$22.90 ,$283.50 ,$202.50 ,$324.00 ,$30.13 ,$12.05 ,$283.50 ,$12.05 ,$243.00 ,$12.05 ,$303.75 ,$223.56 ,$201.69 ,$223.56 ,$12.05 ,$223.56 ,$17.41 ,$17.41 ,$344.25 ,$30.13 ,$280.67 ,$12.05 ,$405.00 ,$222.75 ,$12.05 ,$106.52 , N/A ,$12.17 ,$11.61 ,$12.65 ,$324.00 ,$219.92 ,$113.40 ,$364.50 ,$153.90 ,$24.10 ,$12.05 ,$194.40 
ST. MARY'S HOSPITAL - DECATUR,30200879,86256,HC FLUOR AB TITER-90,302,1 ,$228.00 ,$148.20 ,$9.51 ,$228.00 ,$30.13 ,$28.16 ,$125.40 ,$12.05 ,$63.84 ,$95.06 ,$12.05 ,$95.06 ,$12.05 ,$123.80 ,$9.51 ,$12.05 ,$123.80 ,$22.90 ,$159.60 ,$114.00 ,$182.40 ,$30.13 ,$12.05 ,$159.60 ,$12.05 ,$136.80 ,$12.05 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$12.05 ,$125.86 ,$17.41 ,$17.41 ,$193.80 ,$30.13 ,$158.00 ,$12.05 ,$228.00 ,$125.40 ,$12.05 ,$59.96 , N/A ,$12.17 ,$11.61 ,$12.65 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$24.10 ,$12.05 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,30200880,86300,HC TUMOR AG CA 15-3 (27.29)-90,302,1 ,$175.00 ,$113.75 ,$3.50 ,$175.00 ,$52.03 ,$48.64 ,$96.25 ,$20.81 ,$49.00 ,$85.75 ,$20.81 ,$102.38 ,$20.81 ,$95.03 ,$3.50 ,$20.81 ,$95.03 ,$39.54 ,$122.50 ,$87.50 ,$140.00 ,$52.03 ,$20.81 ,$122.50 ,$20.81 ,$105.00 ,$20.81 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$20.81 ,$96.60 ,$30.07 ,$30.07 ,$148.75 ,$52.03 ,$121.28 ,$20.81 ,$175.00 ,$96.25 ,$20.81 ,$46.03 , N/A ,$18.71 ,$17.86 ,$21.85 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$41.62 ,$20.81 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,30200881,86301,HC TUMOR AG CA 19-9  -90,302,1 ,$202.00 ,$131.30 ,$3.50 ,$202.00 ,$52.03 ,$48.64 ,$111.10 ,$20.81 ,$56.56 ,$98.98 ,$20.81 ,$118.17 ,$20.81 ,$109.69 ,$3.50 ,$20.81 ,$109.69 ,$39.54 ,$141.40 ,$101.00 ,$161.60 ,$52.03 ,$20.81 ,$141.40 ,$20.81 ,$121.20 ,$20.81 ,$151.50 ,$111.50 ,$100.60 ,$111.50 ,$20.81 ,$111.50 ,$30.07 ,$30.07 ,$171.70 ,$52.03 ,$139.99 ,$20.81 ,$202.00 ,$111.10 ,$20.81 ,$53.13 , N/A ,$18.71 ,$17.86 ,$21.85 ,$161.60 ,$109.69 ,$56.56 ,$181.80 ,$76.76 ,$41.62 ,$20.81 ,$96.96 
ST. MARY'S HOSPITAL - DECATUR,30200883,86305,HC HE4 OVARIAN CANCER-90,302,1 ,$251.00 ,$163.15 ,$3.50 ,$251.00 ,$52.03 ,$48.64 ,$138.05 ,$20.81 ,$70.28 ,$122.99 ,$20.81 ,$146.84 ,$20.81 ,$136.29 ,$3.50 ,$20.81 ,$136.29 ,$39.54 ,$175.70 ,$125.50 ,$200.80 ,$52.03 ,$20.81 ,$175.70 ,$20.81 ,$150.60 ,$20.81 ,$188.25 ,$138.55 ,$125.00 ,$138.55 ,$20.81 ,$138.55 ,$30.07 ,$30.07 ,$213.35 ,$52.03 ,$173.94 ,$20.81 ,$251.00 ,$138.05 ,$20.81 ,$66.01 , N/A ,$18.71 ,$17.86 ,$21.85 ,$200.80 ,$136.29 ,$70.28 ,$225.90 ,$95.38 ,$41.62 ,$20.81 ,$120.48 
ST. MARY'S HOSPITAL - DECATUR,30200885,86308,HC HETEROPHILE SCR MONO,302,1 ,$263.00 ,$170.95 ,$3.50 ,$263.00 ,$12.95 ,$12.08 ,$144.65 ,$5.18 ,$73.64 ,$55.24 ,$5.18 ,$55.24 ,$5.18 ,$142.81 ,$3.50 ,$5.18 ,$142.81 ,$9.84 ,$184.10 ,$131.50 ,$210.40 ,$12.95 ,$5.18 ,$184.10 ,$5.18 ,$157.80 ,$5.18 ,$197.25 ,$145.18 ,$130.97 ,$145.18 ,$5.18 ,$145.18 ,$7.48 ,$7.48 ,$223.55 ,$12.95 ,$182.26 ,$5.18 ,$263.00 ,$144.65 ,$5.18 ,$69.17 , N/A ,$7.06 ,$6.74 ,$5.44 ,$210.40 ,$142.81 ,$73.64 ,$236.70 ,$99.94 ,$10.36 ,$5.18 ,$126.24 
ST. MARY'S HOSPITAL - DECATUR,30200886,86632,HC CHLAMYDIA AB IGM-90,302,1 ,$54.00 ,$35.10 ,$3.50 ,$54.00 ,$31.70 ,$29.64 ,$29.70 ,$12.68 ,$15.12 ,$26.46 ,$12.68 ,$31.59 ,$12.68 ,$29.32 ,$3.50 ,$12.68 ,$29.32 ,$24.09 ,$37.80 ,$27.00 ,$43.20 ,$31.70 ,$12.68 ,$37.80 ,$12.68 ,$32.40 ,$12.68 ,$40.50 ,$29.81 ,$26.89 ,$29.81 ,$12.68 ,$29.81 ,$18.32 ,$18.32 ,$45.90 ,$31.70 ,$37.42 ,$12.68 ,$54.00 ,$29.70 ,$12.68 ,$14.20 , N/A ,$5.63 ,$5.38 ,$13.31 ,$43.20 ,$29.32 ,$15.12 ,$48.60 ,$20.52 ,$25.36 ,$12.68 ,$25.92 
ST. MARY'S HOSPITAL - DECATUR,30200887,86635,HC COCCIDIOIDES AB-90,302,1 ,$99.00 ,$64.35 ,$3.50 ,$99.00 ,$28.68 ,$26.80 ,$54.45 ,$11.47 ,$27.72 ,$48.51 ,$11.47 ,$57.92 ,$11.47 ,$53.76 ,$3.50 ,$11.47 ,$53.76 ,$21.79 ,$69.30 ,$49.50 ,$79.20 ,$28.68 ,$11.47 ,$69.30 ,$11.47 ,$59.40 ,$11.47 ,$74.25 ,$54.65 ,$49.30 ,$54.65 ,$11.47 ,$54.65 ,$16.58 ,$16.58 ,$84.15 ,$28.68 ,$68.61 ,$11.47 ,$99.00 ,$54.45 ,$11.47 ,$26.04 , N/A ,$12.17 ,$11.61 ,$12.04 ,$79.20 ,$53.76 ,$27.72 ,$89.10 ,$37.62 ,$22.94 ,$11.47 ,$47.52 
ST. MARY'S HOSPITAL - DECATUR,30200888,86638,HC Q FEVER AB-90,302,1 ,$205.00 ,$133.25 ,$3.50 ,$205.00 ,$30.30 ,$28.32 ,$112.75 ,$12.12 ,$57.40 ,$95.65 ,$12.12 ,$95.65 ,$12.12 ,$111.32 ,$3.50 ,$12.12 ,$111.32 ,$23.03 ,$143.50 ,$102.50 ,$164.00 ,$30.30 ,$12.12 ,$143.50 ,$12.12 ,$123.00 ,$12.12 ,$153.75 ,$113.16 ,$102.09 ,$113.16 ,$12.12 ,$113.16 ,$17.51 ,$17.51 ,$174.25 ,$30.30 ,$142.07 ,$12.12 ,$205.00 ,$112.75 ,$12.12 ,$53.92 , N/A ,$12.17 ,$11.61 ,$12.73 ,$164.00 ,$111.32 ,$57.40 ,$184.50 ,$77.90 ,$24.24 ,$12.12 ,$98.40 
ST. MARY'S HOSPITAL - DECATUR,30200890,86644,HC CMV AB-90,302,1 ,$243.00 ,$157.95 ,$3.50 ,$243.00 ,$35.98 ,$33.64 ,$133.65 ,$14.39 ,$68.04 ,$113.54 ,$14.39 ,$113.54 ,$14.39 ,$131.95 ,$3.50 ,$14.39 ,$131.95 ,$27.34 ,$170.10 ,$121.50 ,$194.40 ,$35.98 ,$14.39 ,$170.10 ,$14.39 ,$145.80 ,$14.39 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$14.39 ,$134.14 ,$20.79 ,$20.79 ,$206.55 ,$35.98 ,$168.40 ,$14.39 ,$243.00 ,$133.65 ,$14.39 ,$63.91 , N/A ,$12.17 ,$11.61 ,$15.11 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$28.78 ,$14.39 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30200891,86645,HC CMV AB IGM-90,302,1 ,$243.00 ,$157.95 ,$3.50 ,$243.00 ,$42.13 ,$39.36 ,$133.65 ,$16.85 ,$68.04 ,$119.07 ,$16.85 ,$132.90 ,$16.85 ,$131.95 ,$3.50 ,$16.85 ,$131.95 ,$32.02 ,$170.10 ,$121.50 ,$194.40 ,$42.13 ,$16.85 ,$170.10 ,$16.85 ,$145.80 ,$16.85 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$16.85 ,$134.14 ,$24.34 ,$24.34 ,$206.55 ,$42.13 ,$168.40 ,$16.85 ,$243.00 ,$133.65 ,$16.85 ,$63.91 , N/A ,$12.17 ,$11.61 ,$17.69 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$33.70 ,$16.85 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30200892,86648,HC DIPTHERIA-90,302,1 ,$188.00 ,$122.20 ,$3.50 ,$188.00 ,$38.03 ,$35.54 ,$103.40 ,$15.21 ,$52.64 ,$92.12 ,$15.21 ,$109.98 ,$15.21 ,$102.08 ,$3.50 ,$15.21 ,$102.08 ,$28.90 ,$131.60 ,$94.00 ,$150.40 ,$38.03 ,$15.21 ,$131.60 ,$15.21 ,$112.80 ,$15.21 ,$141.00 ,$103.78 ,$93.62 ,$103.78 ,$15.21 ,$103.78 ,$21.97 ,$21.97 ,$159.80 ,$38.03 ,$130.28 ,$15.21 ,$188.00 ,$103.40 ,$15.21 ,$49.44 , N/A ,$12.17 ,$11.61 ,$15.97 ,$150.40 ,$102.08 ,$52.64 ,$169.20 ,$71.44 ,$30.42 ,$15.21 ,$90.24 
ST. MARY'S HOSPITAL - DECATUR,30200893,86651,HC ENCEPHALITIS CALIFORNIA AB-90,302,1 ,$68.00 ,$44.20 ,$3.50 ,$68.00 ,$32.98 ,$30.82 ,$37.40 ,$13.19 ,$19.04 ,$33.32 ,$13.19 ,$39.78 ,$13.19 ,$36.92 ,$3.50 ,$13.19 ,$36.92 ,$25.06 ,$47.60 ,$34.00 ,$54.40 ,$32.98 ,$13.19 ,$47.60 ,$13.19 ,$40.80 ,$13.19 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$13.19 ,$37.54 ,$19.05 ,$19.05 ,$57.80 ,$32.98 ,$47.12 ,$13.19 ,$68.00 ,$37.40 ,$13.19 ,$17.88 , N/A ,$12.17 ,$11.61 ,$13.85 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$26.38 ,$13.19 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30200894,86652,HC ENCEPHALITIS EAST EQUINE AB-90,302,1 ,$68.00 ,$44.20 ,$3.50 ,$68.00 ,$32.98 ,$30.82 ,$37.40 ,$13.19 ,$19.04 ,$33.32 ,$13.19 ,$39.78 ,$13.19 ,$36.92 ,$3.50 ,$13.19 ,$36.92 ,$25.06 ,$47.60 ,$34.00 ,$54.40 ,$32.98 ,$13.19 ,$47.60 ,$13.19 ,$40.80 ,$13.19 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$13.19 ,$37.54 ,$19.05 ,$19.05 ,$57.80 ,$32.98 ,$47.12 ,$13.19 ,$68.00 ,$37.40 ,$13.19 ,$17.88 , N/A ,$12.17 ,$11.61 ,$13.85 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$26.38 ,$13.19 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30200895,86653,HC ENCEPHALITIS ST LOUIS AB-90,302,1 ,$68.00 ,$44.20 ,$3.50 ,$68.00 ,$32.98 ,$30.82 ,$37.40 ,$13.19 ,$19.04 ,$33.32 ,$13.19 ,$39.78 ,$13.19 ,$36.92 ,$3.50 ,$13.19 ,$36.92 ,$25.06 ,$47.60 ,$34.00 ,$54.40 ,$32.98 ,$13.19 ,$47.60 ,$13.19 ,$40.80 ,$13.19 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$13.19 ,$37.54 ,$19.05 ,$19.05 ,$57.80 ,$32.98 ,$47.12 ,$13.19 ,$68.00 ,$37.40 ,$13.19 ,$17.88 , N/A ,$12.17 ,$11.61 ,$13.85 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$26.38 ,$13.19 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30200896,86654,HC ENCEPHALITIS WEST EQUINE AB-90,302,1 ,$68.00 ,$44.20 ,$3.50 ,$68.00 ,$32.98 ,$30.82 ,$37.40 ,$13.19 ,$19.04 ,$33.32 ,$13.19 ,$39.78 ,$13.19 ,$36.92 ,$3.50 ,$13.19 ,$36.92 ,$25.06 ,$47.60 ,$34.00 ,$54.40 ,$32.98 ,$13.19 ,$47.60 ,$13.19 ,$40.80 ,$13.19 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$13.19 ,$37.54 ,$19.05 ,$19.05 ,$57.80 ,$32.98 ,$47.12 ,$13.19 ,$68.00 ,$37.40 ,$13.19 ,$17.88 , N/A ,$12.17 ,$11.61 ,$13.85 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$26.38 ,$13.19 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30200897,86658,HC ENTEROVIRUS AB-90,302,1 ,$23.00 ,$14.95 ,$3.50 ,$32.58 ,$32.58 ,$23.00 ,$12.65 ,$13.03 ,$6.44 ,$11.27 ,$13.03 ,$13.46 ,$13.03 ,$12.49 ,$3.50 ,$13.03 ,$12.49 ,$23.00 ,$16.10 ,$11.50 ,$18.40 ,$32.58 ,$13.03 ,$16.10 ,$13.03 ,$13.80 ,$13.03 ,$17.25 ,$12.70 ,$11.45 ,$12.70 ,$13.03 ,$12.70 ,$18.81 ,$18.81 ,$19.55 ,$23.00 ,$15.94 ,$13.03 ,$23.00 ,$12.65 ,$13.03 ,$6.05 , N/A ,$12.17 ,$11.61 ,$13.68 ,$18.40 ,$12.49 ,$6.44 ,$20.70 ,$8.74 ,$23.00 ,$13.03 ,$11.04 
ST. MARY'S HOSPITAL - DECATUR,30200898,86663,HC EBV EARLY AG-90,302,1 ,$106.00 ,$68.90 ,$3.50 ,$106.00 ,$32.80 ,$30.66 ,$58.30 ,$13.12 ,$29.68 ,$51.94 ,$13.12 ,$62.01 ,$13.12 ,$57.56 ,$3.50 ,$13.12 ,$57.56 ,$24.93 ,$74.20 ,$53.00 ,$84.80 ,$32.80 ,$13.12 ,$74.20 ,$13.12 ,$63.60 ,$13.12 ,$79.50 ,$58.51 ,$52.79 ,$58.51 ,$13.12 ,$58.51 ,$18.95 ,$18.95 ,$90.10 ,$32.80 ,$73.46 ,$13.12 ,$106.00 ,$58.30 ,$13.12 ,$27.88 , N/A ,$12.17 ,$11.61 ,$13.78 ,$84.80 ,$57.56 ,$29.68 ,$95.40 ,$40.28 ,$26.24 ,$13.12 ,$50.88 
ST. MARY'S HOSPITAL - DECATUR,30200899,86664,HC EBV NUCLEAR AG-90,302,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$38.23 ,$35.76 ,$89.10 ,$15.29 ,$45.36 ,$79.38 ,$15.29 ,$94.77 ,$15.29 ,$87.97 ,$3.50 ,$15.29 ,$87.97 ,$29.05 ,$113.40 ,$81.00 ,$129.60 ,$38.23 ,$15.29 ,$113.40 ,$15.29 ,$97.20 ,$15.29 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$15.29 ,$89.42 ,$22.09 ,$22.09 ,$137.70 ,$38.23 ,$112.27 ,$15.29 ,$162.00 ,$89.10 ,$15.29 ,$42.61 , N/A ,$12.17 ,$11.61 ,$16.05 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$30.58 ,$15.29 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30200900,86665,HC EBV VIRAL CAP-90,302,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$45.35 ,$42.40 ,$89.10 ,$18.14 ,$45.36 ,$79.38 ,$18.14 ,$94.77 ,$18.14 ,$87.97 ,$3.50 ,$18.14 ,$87.97 ,$34.47 ,$113.40 ,$81.00 ,$129.60 ,$45.35 ,$18.14 ,$113.40 ,$18.14 ,$97.20 ,$18.14 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$18.14 ,$89.42 ,$26.21 ,$26.21 ,$137.70 ,$45.35 ,$112.27 ,$18.14 ,$162.00 ,$89.10 ,$18.14 ,$42.61 , N/A ,$12.17 ,$11.61 ,$19.05 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$36.28 ,$18.14 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30200901,86666,HC EHRLICHIA AB-90,302,1 ,$220.00 ,$143.00 ,$3.50 ,$220.00 ,$25.45 ,$23.78 ,$121.00 ,$10.18 ,$61.60 ,$80.21 ,$10.18 ,$80.21 ,$10.18 ,$119.46 ,$3.50 ,$10.18 ,$119.46 ,$19.34 ,$154.00 ,$110.00 ,$176.00 ,$25.45 ,$10.18 ,$154.00 ,$10.18 ,$132.00 ,$10.18 ,$165.00 ,$121.44 ,$109.56 ,$121.44 ,$10.18 ,$121.44 ,$14.70 ,$14.70 ,$187.00 ,$25.45 ,$152.46 ,$10.18 ,$220.00 ,$121.00 ,$10.18 ,$57.86 , N/A ,$12.17 ,$11.61 ,$10.69 ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 ,$20.36 ,$10.18 ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,30200902,86668,HC FRANCISELLA AB-90,302,1 ,$201.00 ,$130.65 ,$3.50 ,$201.00 ,$35.40 ,$24.32 ,$110.55 ,$14.16 ,$56.28 ,$90.44 ,$14.16 ,$90.44 ,$14.16 ,$109.14 ,$3.50 ,$14.16 ,$109.14 ,$26.90 ,$140.70 ,$100.50 ,$160.80 ,$35.40 ,$14.16 ,$140.70 ,$14.16 ,$120.60 ,$14.16 ,$150.75 ,$110.95 ,$100.10 ,$110.95 ,$14.16 ,$110.95 ,$18.41 ,$18.41 ,$170.85 ,$35.40 ,$139.29 ,$14.16 ,$201.00 ,$110.55 ,$14.16 ,$52.86 , N/A ,$12.17 ,$11.61 ,$14.87 ,$160.80 ,$109.14 ,$56.28 ,$180.90 ,$76.38 ,$28.32 ,$14.16 ,$96.48 
ST. MARY'S HOSPITAL - DECATUR,30200903,86671,HC FUNGUS AB NOS-90,302,1 ,$136.00 ,$88.40 ,$3.50 ,$136.00 ,$30.63 ,$28.64 ,$74.80 ,$12.25 ,$38.08 ,$66.64 ,$12.25 ,$79.56 ,$12.25 ,$73.85 ,$3.50 ,$12.25 ,$73.85 ,$23.28 ,$95.20 ,$68.00 ,$108.80 ,$30.63 ,$12.25 ,$95.20 ,$12.25 ,$81.60 ,$12.25 ,$102.00 ,$75.07 ,$67.73 ,$75.07 ,$12.25 ,$75.07 ,$17.71 ,$17.71 ,$115.60 ,$30.63 ,$94.25 ,$12.25 ,$136.00 ,$74.80 ,$12.25 ,$35.77 , N/A ,$7.06 ,$6.74 ,$12.86 ,$108.80 ,$73.85 ,$38.08 ,$122.40 ,$51.68 ,$24.50 ,$12.25 ,$65.28 
ST. MARY'S HOSPITAL - DECATUR,30200904,86674,HC GIARDIA LAMBLIA AB-90,302,1 ,$184.00 ,$119.60 ,$3.50 ,$184.00 ,$36.80 ,$34.40 ,$101.20 ,$14.72 ,$51.52 ,$90.16 ,$14.72 ,$107.64 ,$14.72 ,$99.91 ,$3.50 ,$14.72 ,$99.91 ,$27.97 ,$128.80 ,$92.00 ,$147.20 ,$36.80 ,$14.72 ,$128.80 ,$14.72 ,$110.40 ,$14.72 ,$138.00 ,$101.57 ,$91.63 ,$101.57 ,$14.72 ,$101.57 ,$21.26 ,$21.26 ,$156.40 ,$36.80 ,$127.51 ,$14.72 ,$184.00 ,$101.20 ,$14.72 ,$48.39 , N/A ,$7.06 ,$6.74 ,$15.46 ,$147.20 ,$99.91 ,$51.52 ,$165.60 ,$69.92 ,$29.44 ,$14.72 ,$88.32 
ST. MARY'S HOSPITAL - DECATUR,30200905,86677,HC H PYLORI AB-90,302,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$42.13 ,$33.92 ,$106.15 ,$16.85 ,$54.04 ,$94.57 ,$16.85 ,$112.91 ,$16.85 ,$104.80 ,$3.50 ,$16.85 ,$104.80 ,$32.02 ,$135.10 ,$96.50 ,$154.40 ,$42.13 ,$16.85 ,$135.10 ,$16.85 ,$115.80 ,$16.85 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$16.85 ,$106.54 ,$21.91 ,$21.91 ,$164.05 ,$42.13 ,$133.75 ,$16.85 ,$193.00 ,$106.15 ,$16.85 ,$50.76 , N/A ,$12.17 ,$11.61 ,$17.69 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$33.70 ,$16.85 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30200906,86682,HC HELMINTH ANTIBODY-90,302,1 ,$304.00 ,$197.60 ,$3.50 ,$304.00 ,$32.53 ,$30.40 ,$167.20 ,$13.01 ,$85.12 ,$102.63 ,$13.01 ,$102.63 ,$13.01 ,$165.07 ,$3.50 ,$13.01 ,$165.07 ,$24.72 ,$212.80 ,$152.00 ,$243.20 ,$32.53 ,$13.01 ,$212.80 ,$13.01 ,$182.40 ,$13.01 ,$228.00 ,$167.81 ,$151.39 ,$167.81 ,$13.01 ,$167.81 ,$18.79 ,$18.79 ,$258.40 ,$32.53 ,$210.67 ,$13.01 ,$304.00 ,$167.20 ,$13.01 ,$79.95 , N/A ,$7.06 ,$6.74 ,$13.66 ,$243.20 ,$165.07 ,$85.12 ,$273.60 ,$115.52 ,$26.02 ,$13.01 ,$145.92 
ST. MARY'S HOSPITAL - DECATUR,30200907,86684,HC HAEMOPHILUS INFLUENZA AB-90,302,1 ,$175.00 ,$113.75 ,$3.50 ,$175.00 ,$39.60 ,$37.02 ,$96.25 ,$15.84 ,$49.00 ,$85.75 ,$15.84 ,$102.38 ,$15.84 ,$95.03 ,$3.50 ,$15.84 ,$95.03 ,$30.10 ,$122.50 ,$87.50 ,$140.00 ,$39.60 ,$15.84 ,$122.50 ,$15.84 ,$105.00 ,$15.84 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$15.84 ,$96.60 ,$22.88 ,$22.88 ,$148.75 ,$39.60 ,$121.28 ,$15.84 ,$175.00 ,$96.25 ,$15.84 ,$46.03 , N/A ,$7.06 ,$6.74 ,$16.63 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$31.68 ,$15.84 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,30200908,86687,HC HTLV I AB-90,302,1 ,$163.00 ,$105.95 ,$3.50 ,$163.00 ,$22.73 ,$19.62 ,$89.65 ,$9.09 ,$45.64 ,$66.16 ,$9.09 ,$66.16 ,$9.09 ,$88.51 ,$3.50 ,$9.09 ,$88.51 ,$17.27 ,$114.10 ,$81.50 ,$130.40 ,$22.73 ,$9.09 ,$114.10 ,$9.09 ,$97.80 ,$9.09 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$9.09 ,$89.98 ,$12.12 ,$12.12 ,$138.55 ,$22.73 ,$112.96 ,$9.09 ,$163.00 ,$89.65 ,$9.09 ,$42.87 , N/A ,$7.06 ,$6.74 ,$9.54 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$18.18 ,$9.09 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,30200909,86689,HC HTLV OR HIV AB CONF-90,302,1 ,$305.00 ,$198.25 ,$3.50 ,$305.00 ,$48.38 ,$45.22 ,$167.75 ,$19.35 ,$85.40 ,$149.45 ,$19.35 ,$152.76 ,$19.35 ,$165.62 ,$3.50 ,$19.35 ,$165.62 ,$36.77 ,$213.50 ,$152.50 ,$244.00 ,$48.38 ,$19.35 ,$213.50 ,$19.35 ,$183.00 ,$19.35 ,$228.75 ,$168.36 ,$151.89 ,$168.36 ,$19.35 ,$168.36 ,$27.96 ,$27.96 ,$259.25 ,$48.38 ,$211.37 ,$19.35 ,$305.00 ,$167.75 ,$19.35 ,$80.22 , N/A ,$12.17 ,$11.61 ,$20.32 ,$244.00 ,$165.62 ,$85.40 ,$274.50 ,$115.90 ,$38.70 ,$19.35 ,$146.40 
ST. MARY'S HOSPITAL - DECATUR,30200910,86692,HC HEPATITIS D AB-90,302,1 ,$207.00 ,$134.55 ,$3.50 ,$207.00 ,$42.90 ,$40.10 ,$113.85 ,$17.16 ,$57.96 ,$101.43 ,$17.16 ,$121.10 ,$17.16 ,$112.40 ,$3.50 ,$17.16 ,$112.40 ,$32.60 ,$144.90 ,$103.50 ,$165.60 ,$42.90 ,$17.16 ,$144.90 ,$17.16 ,$124.20 ,$17.16 ,$155.25 ,$114.26 ,$103.09 ,$114.26 ,$17.16 ,$114.26 ,$24.79 ,$24.79 ,$175.95 ,$42.90 ,$143.45 ,$17.16 ,$207.00 ,$113.85 ,$17.16 ,$54.44 , N/A ,$7.06 ,$6.74 ,$18.02 ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$34.32 ,$17.16 ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,30200911,86694,HC HERPES SIMPLEX AB-90,302,1 ,$112.00 ,$72.80 ,$3.50 ,$112.00 ,$35.98 ,$33.64 ,$61.60 ,$14.39 ,$31.36 ,$54.88 ,$14.39 ,$65.52 ,$14.39 ,$60.82 ,$3.50 ,$14.39 ,$60.82 ,$27.34 ,$78.40 ,$56.00 ,$89.60 ,$35.98 ,$14.39 ,$78.40 ,$14.39 ,$67.20 ,$14.39 ,$84.00 ,$61.82 ,$55.78 ,$61.82 ,$14.39 ,$61.82 ,$20.79 ,$20.79 ,$95.20 ,$35.98 ,$77.62 ,$14.39 ,$112.00 ,$61.60 ,$14.39 ,$29.46 , N/A ,$12.17 ,$11.61 ,$15.11 ,$89.60 ,$60.82 ,$31.36 ,$100.80 ,$42.56 ,$28.78 ,$14.39 ,$53.76 
ST. MARY'S HOSPITAL - DECATUR,30200912,86695,HC HERPES SIMPLEX AB I-90,302,1 ,$112.00 ,$72.80 ,$3.50 ,$112.00 ,$32.98 ,$30.82 ,$61.60 ,$13.19 ,$31.36 ,$54.88 ,$13.19 ,$65.52 ,$13.19 ,$60.82 ,$3.50 ,$13.19 ,$60.82 ,$25.06 ,$78.40 ,$56.00 ,$89.60 ,$32.98 ,$13.19 ,$78.40 ,$13.19 ,$67.20 ,$13.19 ,$84.00 ,$61.82 ,$55.78 ,$61.82 ,$13.19 ,$61.82 ,$19.05 ,$19.05 ,$95.20 ,$32.98 ,$77.62 ,$13.19 ,$112.00 ,$61.60 ,$13.19 ,$29.46 , N/A ,$12.17 ,$11.61 ,$13.85 ,$89.60 ,$60.82 ,$31.36 ,$100.80 ,$42.56 ,$26.38 ,$13.19 ,$53.76 
ST. MARY'S HOSPITAL - DECATUR,30200913,86696,HC HERPES SIMPLEX AB II-90,302,1 ,$112.00 ,$72.80 ,$3.50 ,$112.00 ,$48.38 ,$45.22 ,$61.60 ,$19.35 ,$31.36 ,$54.88 ,$19.35 ,$65.52 ,$19.35 ,$60.82 ,$3.50 ,$19.35 ,$60.82 ,$36.77 ,$78.40 ,$56.00 ,$89.60 ,$48.38 ,$19.35 ,$78.40 ,$19.35 ,$67.20 ,$19.35 ,$84.00 ,$61.82 ,$55.78 ,$61.82 ,$19.35 ,$61.82 ,$27.96 ,$27.96 ,$95.20 ,$48.38 ,$77.62 ,$19.35 ,$112.00 ,$61.60 ,$19.35 ,$29.46 , N/A ,$7.06 ,$6.74 ,$20.32 ,$89.60 ,$60.82 ,$31.36 ,$100.80 ,$42.56 ,$38.70 ,$19.35 ,$53.76 
ST. MARY'S HOSPITAL - DECATUR,30200914,86698,HC HISTOPLASMA AB-90,302,1 ,$99.00 ,$64.35 ,$3.50 ,$99.00 ,$34.48 ,$29.20 ,$54.45 ,$13.79 ,$27.72 ,$48.51 ,$13.79 ,$57.92 ,$13.79 ,$53.76 ,$3.50 ,$13.79 ,$53.76 ,$26.20 ,$69.30 ,$49.50 ,$79.20 ,$34.48 ,$13.79 ,$69.30 ,$13.79 ,$59.40 ,$13.79 ,$74.25 ,$54.65 ,$49.30 ,$54.65 ,$13.79 ,$54.65 ,$18.04 ,$18.04 ,$84.15 ,$34.48 ,$68.61 ,$13.79 ,$99.00 ,$54.45 ,$13.79 ,$26.04 , N/A ,$12.17 ,$11.61 ,$14.48 ,$79.20 ,$53.76 ,$27.72 ,$89.10 ,$37.62 ,$27.58 ,$13.79 ,$47.52 
ST. MARY'S HOSPITAL - DECATUR,30200915,86701,HC HIV-1 AB-90,302,1 ,$199.00 ,$129.35 ,$3.50 ,$199.00 ,$22.23 ,$20.76 ,$109.45 ,$8.89 ,$55.72 ,$94.86 ,$8.89 ,$94.86 ,$8.89 ,$108.06 ,$3.50 ,$8.89 ,$108.06 ,$16.89 ,$139.30 ,$99.50 ,$159.20 ,$22.23 ,$8.89 ,$139.30 ,$8.89 ,$119.40 ,$8.89 ,$149.25 ,$109.85 ,$99.10 ,$109.85 ,$8.89 ,$109.85 ,$12.83 ,$12.83 ,$169.15 ,$22.23 ,$137.91 ,$8.89 ,$199.00 ,$109.45 ,$8.89 ,$52.34 , N/A ,$7.06 ,$6.74 ,$9.33 ,$159.20 ,$108.06 ,$55.72 ,$179.10 ,$75.62 ,$17.78 ,$8.89 ,$95.52 
ST. MARY'S HOSPITAL - DECATUR,30200918,86702,HC HIV-2 AB-90,302,1 ,$218.00 ,$141.70 ,$3.50 ,$218.00 ,$33.80 ,$31.58 ,$119.90 ,$13.52 ,$61.04 ,$106.66 ,$13.52 ,$106.66 ,$13.52 ,$118.37 ,$3.50 ,$13.52 ,$118.37 ,$25.69 ,$152.60 ,$109.00 ,$174.40 ,$33.80 ,$13.52 ,$152.60 ,$13.52 ,$130.80 ,$13.52 ,$163.50 ,$120.34 ,$108.56 ,$120.34 ,$13.52 ,$120.34 ,$19.53 ,$19.53 ,$185.30 ,$33.80 ,$151.07 ,$13.52 ,$218.00 ,$119.90 ,$13.52 ,$57.33 , N/A ,$7.06 ,$6.74 ,$14.20 ,$174.40 ,$118.37 ,$61.04 ,$196.20 ,$82.84 ,$27.04 ,$13.52 ,$104.64 
ST. MARY'S HOSPITAL - DECATUR,30200919,86704,HC HEP CORE AB-90,302,1 ,$144.00 ,$93.60 ,$3.50 ,$144.00 ,$30.13 ,$28.16 ,$79.20 ,$12.05 ,$40.32 ,$70.56 ,$12.05 ,$84.24 ,$12.05 ,$78.19 ,$3.50 ,$12.05 ,$78.19 ,$22.90 ,$100.80 ,$72.00 ,$115.20 ,$30.13 ,$12.05 ,$100.80 ,$12.05 ,$86.40 ,$12.05 ,$108.00 ,$79.49 ,$71.71 ,$79.49 ,$12.05 ,$79.49 ,$17.41 ,$17.41 ,$122.40 ,$30.13 ,$99.79 ,$12.05 ,$144.00 ,$79.20 ,$12.05 ,$37.87 , N/A ,$7.06 ,$6.74 ,$12.65 ,$115.20 ,$78.19 ,$40.32 ,$129.60 ,$54.72 ,$24.10 ,$12.05 ,$69.12 
ST. MARY'S HOSPITAL - DECATUR,30200923,86707,HC HEP B E AB-90,302,1 ,$131.00 ,$85.15 ,$3.50 ,$131.00 ,$28.93 ,$27.04 ,$72.05 ,$11.57 ,$36.68 ,$64.19 ,$11.57 ,$76.64 ,$11.57 ,$71.13 ,$3.50 ,$11.57 ,$71.13 ,$21.98 ,$91.70 ,$65.50 ,$104.80 ,$28.93 ,$11.57 ,$91.70 ,$11.57 ,$78.60 ,$11.57 ,$98.25 ,$72.31 ,$65.24 ,$72.31 ,$11.57 ,$72.31 ,$16.71 ,$16.71 ,$111.35 ,$28.93 ,$90.78 ,$11.57 ,$131.00 ,$72.05 ,$11.57 ,$34.45 , N/A ,$7.06 ,$6.74 ,$12.15 ,$104.80 ,$71.13 ,$36.68 ,$117.90 ,$49.78 ,$23.14 ,$11.57 ,$62.88 
ST. MARY'S HOSPITAL - DECATUR,30200924,86708,HC HEP A AB TOTAL-90,302,1 ,$159.00 ,$103.35 ,$3.50 ,$159.00 ,$30.98 ,$28.96 ,$87.45 ,$12.39 ,$44.52 ,$77.91 ,$12.39 ,$93.02 ,$12.39 ,$86.34 ,$3.50 ,$12.39 ,$86.34 ,$23.54 ,$111.30 ,$79.50 ,$127.20 ,$30.98 ,$12.39 ,$111.30 ,$12.39 ,$95.40 ,$12.39 ,$119.25 ,$87.77 ,$79.18 ,$87.77 ,$12.39 ,$87.77 ,$17.89 ,$17.89 ,$135.15 ,$30.98 ,$110.19 ,$12.39 ,$159.00 ,$87.45 ,$12.39 ,$41.82 , N/A ,$7.06 ,$6.74 ,$13.01 ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$24.78 ,$12.39 ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,30200925,86709,HC HEP A AB IGM-90,302,1 ,$211.00 ,$137.15 ,$3.50 ,$211.00 ,$28.15 ,$26.30 ,$116.05 ,$11.26 ,$59.08 ,$88.86 ,$11.26 ,$88.86 ,$11.26 ,$114.57 ,$3.50 ,$11.26 ,$114.57 ,$21.39 ,$147.70 ,$105.50 ,$168.80 ,$28.15 ,$11.26 ,$147.70 ,$11.26 ,$126.60 ,$11.26 ,$158.25 ,$116.47 ,$105.08 ,$116.47 ,$11.26 ,$116.47 ,$16.26 ,$16.26 ,$179.35 ,$28.15 ,$146.22 ,$11.26 ,$211.00 ,$116.05 ,$11.26 ,$55.49 , N/A ,$7.06 ,$6.74 ,$11.82 ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 ,$22.52 ,$11.26 ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,30200926,86710,HC INFLUENZA AB-90,302,1 ,$127.00 ,$82.55 ,$3.50 ,$127.00 ,$33.88 ,$31.68 ,$69.85 ,$13.55 ,$35.56 ,$62.23 ,$13.55 ,$74.30 ,$13.55 ,$68.96 ,$3.50 ,$13.55 ,$68.96 ,$25.75 ,$88.90 ,$63.50 ,$101.60 ,$33.88 ,$13.55 ,$88.90 ,$13.55 ,$76.20 ,$13.55 ,$95.25 ,$70.10 ,$63.25 ,$70.10 ,$13.55 ,$70.10 ,$19.58 ,$19.58 ,$107.95 ,$33.88 ,$88.01 ,$13.55 ,$127.00 ,$69.85 ,$13.55 ,$33.40 , N/A ,$7.06 ,$6.74 ,$14.23 ,$101.60 ,$68.96 ,$35.56 ,$114.30 ,$48.26 ,$27.10 ,$13.55 ,$60.96 
ST. MARY'S HOSPITAL - DECATUR,30200927,86713,HC LEGIONELLA AB-90,302,1 ,$196.00 ,$127.40 ,$3.50 ,$196.00 ,$38.25 ,$35.76 ,$107.80 ,$15.30 ,$54.88 ,$96.04 ,$15.30 ,$114.66 ,$15.30 ,$106.43 ,$3.50 ,$15.30 ,$106.43 ,$29.07 ,$137.20 ,$98.00 ,$156.80 ,$38.25 ,$15.30 ,$137.20 ,$15.30 ,$117.60 ,$15.30 ,$147.00 ,$108.19 ,$97.61 ,$108.19 ,$15.30 ,$108.19 ,$22.10 ,$22.10 ,$166.60 ,$38.25 ,$135.83 ,$15.30 ,$196.00 ,$107.80 ,$15.30 ,$51.55 , N/A ,$12.17 ,$11.61 ,$16.07 ,$156.80 ,$106.43 ,$54.88 ,$176.40 ,$74.48 ,$30.60 ,$15.30 ,$94.08 
ST. MARY'S HOSPITAL - DECATUR,30200928,86717,HC LESISHMANIA AB-90,302,1 ,$254.00 ,$165.10 ,$3.50 ,$254.00 ,$30.63 ,$28.62 ,$139.70 ,$12.25 ,$71.12 ,$96.63 ,$12.25 ,$96.63 ,$12.25 ,$137.92 ,$3.50 ,$12.25 ,$137.92 ,$23.28 ,$177.80 ,$127.00 ,$203.20 ,$30.63 ,$12.25 ,$177.80 ,$12.25 ,$152.40 ,$12.25 ,$190.50 ,$140.21 ,$126.49 ,$140.21 ,$12.25 ,$140.21 ,$17.69 ,$17.69 ,$215.90 ,$30.63 ,$176.02 ,$12.25 ,$254.00 ,$139.70 ,$12.25 ,$66.80 , N/A ,$12.17 ,$11.61 ,$12.86 ,$203.20 ,$137.92 ,$71.12 ,$228.60 ,$96.52 ,$24.50 ,$12.25 ,$121.92 
ST. MARY'S HOSPITAL - DECATUR,30200929,86720,HC LEPTOSPIRA AB-90,302,1 ,$173.00 ,$112.45 ,$3.50 ,$173.00 ,$40.50 ,$30.82 ,$95.15 ,$16.20 ,$48.44 ,$84.77 ,$16.20 ,$101.21 ,$16.20 ,$93.94 ,$3.50 ,$16.20 ,$93.94 ,$30.78 ,$121.10 ,$86.50 ,$138.40 ,$40.50 ,$16.20 ,$121.10 ,$16.20 ,$103.80 ,$16.20 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$16.20 ,$95.50 ,$21.06 ,$21.06 ,$147.05 ,$40.50 ,$119.89 ,$16.20 ,$173.00 ,$95.15 ,$16.20 ,$45.50 , N/A ,$12.17 ,$11.61 ,$17.01 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 ,$32.40 ,$16.20 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,30200930,86727,HC LYMPH CHORIOMENINGITIS AB-90,302,1 ,$112.00 ,$72.80 ,$3.50 ,$112.00 ,$32.18 ,$30.08 ,$61.60 ,$12.87 ,$31.36 ,$54.88 ,$12.87 ,$65.52 ,$12.87 ,$60.82 ,$3.50 ,$12.87 ,$60.82 ,$24.45 ,$78.40 ,$56.00 ,$89.60 ,$32.18 ,$12.87 ,$78.40 ,$12.87 ,$67.20 ,$12.87 ,$84.00 ,$61.82 ,$55.78 ,$61.82 ,$12.87 ,$61.82 ,$18.59 ,$18.59 ,$95.20 ,$32.18 ,$77.62 ,$12.87 ,$112.00 ,$61.60 ,$12.87 ,$29.46 , N/A ,$12.17 ,$11.61 ,$13.51 ,$89.60 ,$60.82 ,$31.36 ,$100.80 ,$42.56 ,$25.74 ,$12.87 ,$53.76 
ST. MARY'S HOSPITAL - DECATUR,30200931,86735,HC MUMPS AB-90,302,1 ,$199.00 ,$129.35 ,$3.50 ,$199.00 ,$32.63 ,$30.50 ,$109.45 ,$13.05 ,$55.72 ,$97.51 ,$13.05 ,$102.92 ,$13.05 ,$108.06 ,$3.50 ,$13.05 ,$108.06 ,$24.80 ,$139.30 ,$99.50 ,$159.20 ,$32.63 ,$13.05 ,$139.30 ,$13.05 ,$119.40 ,$13.05 ,$149.25 ,$109.85 ,$99.10 ,$109.85 ,$13.05 ,$109.85 ,$18.85 ,$18.85 ,$169.15 ,$32.63 ,$137.91 ,$13.05 ,$199.00 ,$109.45 ,$13.05 ,$52.34 , N/A ,$7.06 ,$6.74 ,$13.70 ,$159.20 ,$108.06 ,$55.72 ,$179.10 ,$75.62 ,$26.10 ,$13.05 ,$95.52 
ST. MARY'S HOSPITAL - DECATUR,30200932,86738,HC MYCOPLASMA AB-90,302,1 ,$129.00 ,$83.85 ,$3.50 ,$129.00 ,$33.10 ,$30.94 ,$70.95 ,$13.24 ,$36.12 ,$63.21 ,$13.24 ,$75.47 ,$13.24 ,$70.05 ,$3.50 ,$13.24 ,$70.05 ,$25.16 ,$90.30 ,$64.50 ,$103.20 ,$33.10 ,$13.24 ,$90.30 ,$13.24 ,$77.40 ,$13.24 ,$96.75 ,$71.21 ,$64.24 ,$71.21 ,$13.24 ,$71.21 ,$19.12 ,$19.12 ,$109.65 ,$33.10 ,$89.40 ,$13.24 ,$129.00 ,$70.95 ,$13.24 ,$33.93 , N/A ,$12.17 ,$11.61 ,$13.90 ,$103.20 ,$70.05 ,$36.12 ,$116.10 ,$49.02 ,$26.48 ,$13.24 ,$61.92 
ST. MARY'S HOSPITAL - DECATUR,30200935,86747,HC PARVOVIRUS AB-90,302,1 ,$131.00 ,$85.15 ,$3.50 ,$131.00 ,$37.58 ,$35.14 ,$72.05 ,$15.03 ,$36.68 ,$64.19 ,$15.03 ,$76.64 ,$15.03 ,$71.13 ,$3.50 ,$15.03 ,$71.13 ,$28.56 ,$91.70 ,$65.50 ,$104.80 ,$37.58 ,$15.03 ,$91.70 ,$15.03 ,$78.60 ,$15.03 ,$98.25 ,$72.31 ,$65.24 ,$72.31 ,$15.03 ,$72.31 ,$21.71 ,$21.71 ,$111.35 ,$37.58 ,$90.78 ,$15.03 ,$131.00 ,$72.05 ,$15.03 ,$34.45 , N/A ,$12.17 ,$11.61 ,$15.78 ,$104.80 ,$71.13 ,$36.68 ,$117.90 ,$49.78 ,$30.06 ,$15.03 ,$62.88 
ST. MARY'S HOSPITAL - DECATUR,30200937,86753,HC PROTOZOA AB-90,302,1 ,$186.00 ,$120.90 ,$3.50 ,$186.00 ,$30.98 ,$28.96 ,$102.30 ,$12.39 ,$52.08 ,$91.14 ,$12.39 ,$97.71 ,$12.39 ,$101.00 ,$3.50 ,$12.39 ,$101.00 ,$23.54 ,$130.20 ,$93.00 ,$148.80 ,$30.98 ,$12.39 ,$130.20 ,$12.39 ,$111.60 ,$12.39 ,$139.50 ,$102.67 ,$92.63 ,$102.67 ,$12.39 ,$102.67 ,$17.89 ,$17.89 ,$158.10 ,$30.98 ,$128.90 ,$12.39 ,$186.00 ,$102.30 ,$12.39 ,$48.92 , N/A ,$7.06 ,$6.74 ,$13.01 ,$148.80 ,$101.00 ,$52.08 ,$167.40 ,$70.68 ,$24.78 ,$12.39 ,$89.28 
ST. MARY'S HOSPITAL - DECATUR,30200938,86756,HC RSV AB-90,302,1 ,$141.00 ,$91.65 ,$3.50 ,$141.00 ,$39.73 ,$30.12 ,$77.55 ,$15.89 ,$39.48 ,$69.09 ,$15.89 ,$82.49 ,$15.89 ,$76.56 ,$3.50 ,$15.89 ,$76.56 ,$30.19 ,$98.70 ,$70.50 ,$112.80 ,$39.73 ,$15.89 ,$98.70 ,$15.89 ,$84.60 ,$15.89 ,$105.75 ,$77.83 ,$70.22 ,$77.83 ,$15.89 ,$77.83 ,$20.66 ,$20.66 ,$119.85 ,$39.73 ,$97.71 ,$15.89 ,$141.00 ,$77.55 ,$15.89 ,$37.08 , N/A ,$12.17 ,$11.61 ,$16.68 ,$112.80 ,$76.56 ,$39.48 ,$126.90 ,$53.58 ,$31.78 ,$15.89 ,$67.68 
ST. MARY'S HOSPITAL - DECATUR,30200939,86757,HC RICKETTSIA AB-90,302,1 ,$69.00 ,$44.85 ,$3.50 ,$69.00 ,$48.38 ,$45.22 ,$37.95 ,$19.35 ,$19.32 ,$33.81 ,$19.35 ,$40.37 ,$19.35 ,$37.47 ,$3.50 ,$19.35 ,$37.47 ,$36.77 ,$48.30 ,$34.50 ,$55.20 ,$48.38 ,$19.35 ,$48.30 ,$19.35 ,$41.40 ,$19.35 ,$51.75 ,$38.09 ,$34.36 ,$38.09 ,$19.35 ,$38.09 ,$27.96 ,$27.96 ,$58.65 ,$48.38 ,$47.82 ,$19.35 ,$69.00 ,$37.95 ,$19.35 ,$18.15 , N/A ,$12.17 ,$11.61 ,$20.32 ,$55.20 ,$37.47 ,$19.32 ,$62.10 ,$26.22 ,$38.70 ,$19.35 ,$33.12 
ST. MARY'S HOSPITAL - DECATUR,30200940,86762,HC RUBELLA AB-90,302,1 ,$170.00 ,$110.50 ,$3.50 ,$170.00 ,$35.98 ,$33.64 ,$93.50 ,$14.39 ,$47.60 ,$83.30 ,$14.39 ,$99.45 ,$14.39 ,$92.31 ,$3.50 ,$14.39 ,$92.31 ,$27.34 ,$119.00 ,$85.00 ,$136.00 ,$35.98 ,$14.39 ,$119.00 ,$14.39 ,$102.00 ,$14.39 ,$127.50 ,$93.84 ,$84.66 ,$93.84 ,$14.39 ,$93.84 ,$20.79 ,$20.79 ,$144.50 ,$35.98 ,$117.81 ,$14.39 ,$170.00 ,$93.50 ,$14.39 ,$44.71 , N/A ,$7.06 ,$6.74 ,$15.11 ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$28.78 ,$14.39 ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,30200941,86765,HC RUBEOLA AB-90,302,1 ,$189.00 ,$122.85 ,$3.50 ,$189.00 ,$32.20 ,$30.10 ,$103.95 ,$12.88 ,$52.92 ,$92.61 ,$12.88 ,$101.64 ,$12.88 ,$102.63 ,$3.50 ,$12.88 ,$102.63 ,$24.47 ,$132.30 ,$94.50 ,$151.20 ,$32.20 ,$12.88 ,$132.30 ,$12.88 ,$113.40 ,$12.88 ,$141.75 ,$104.33 ,$94.12 ,$104.33 ,$12.88 ,$104.33 ,$18.60 ,$18.60 ,$160.65 ,$32.20 ,$130.98 ,$12.88 ,$189.00 ,$103.95 ,$12.88 ,$49.71 , N/A ,$7.06 ,$6.74 ,$13.52 ,$151.20 ,$102.63 ,$52.92 ,$170.10 ,$71.82 ,$25.76 ,$12.88 ,$90.72 
ST. MARY'S HOSPITAL - DECATUR,30200942,86768,HC SALMONELLA-90,302,1 ,$122.00 ,$79.30 ,$3.50 ,$122.00 ,$32.98 ,$30.82 ,$67.10 ,$13.19 ,$34.16 ,$59.78 ,$13.19 ,$71.37 ,$13.19 ,$66.25 ,$3.50 ,$13.19 ,$66.25 ,$25.06 ,$85.40 ,$61.00 ,$97.60 ,$32.98 ,$13.19 ,$85.40 ,$13.19 ,$73.20 ,$13.19 ,$91.50 ,$67.34 ,$60.76 ,$67.34 ,$13.19 ,$67.34 ,$19.05 ,$19.05 ,$103.70 ,$32.98 ,$84.55 ,$13.19 ,$122.00 ,$67.10 ,$13.19 ,$32.09 , N/A ,$12.17 ,$11.61 ,$13.85 ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$26.38 ,$13.19 ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,30200943,86774,HC TETANUS AB-90,302,1 ,$198.00 ,$128.70 ,$3.50 ,$198.00 ,$37.00 ,$34.58 ,$108.90 ,$14.80 ,$55.44 ,$97.02 ,$14.80 ,$115.83 ,$14.80 ,$107.51 ,$3.50 ,$14.80 ,$107.51 ,$28.12 ,$138.60 ,$99.00 ,$158.40 ,$37.00 ,$14.80 ,$138.60 ,$14.80 ,$118.80 ,$14.80 ,$148.50 ,$109.30 ,$98.60 ,$109.30 ,$14.80 ,$109.30 ,$21.37 ,$21.37 ,$168.30 ,$37.00 ,$137.21 ,$14.80 ,$198.00 ,$108.90 ,$14.80 ,$52.07 , N/A ,$12.17 ,$11.61 ,$15.54 ,$158.40 ,$107.51 ,$55.44 ,$178.20 ,$75.24 ,$29.60 ,$14.80 ,$95.04 
ST. MARY'S HOSPITAL - DECATUR,30200944,86777,HC TOXOPLASMA AB-90,302,1 ,$144.00 ,$93.60 ,$3.50 ,$144.00 ,$35.98 ,$33.64 ,$79.20 ,$14.39 ,$40.32 ,$70.56 ,$14.39 ,$84.24 ,$14.39 ,$78.19 ,$3.50 ,$14.39 ,$78.19 ,$27.34 ,$100.80 ,$72.00 ,$115.20 ,$35.98 ,$14.39 ,$100.80 ,$14.39 ,$86.40 ,$14.39 ,$108.00 ,$79.49 ,$71.71 ,$79.49 ,$14.39 ,$79.49 ,$20.79 ,$20.79 ,$122.40 ,$35.98 ,$99.79 ,$14.39 ,$144.00 ,$79.20 ,$14.39 ,$37.87 , N/A ,$12.17 ,$11.61 ,$15.11 ,$115.20 ,$78.19 ,$40.32 ,$129.60 ,$54.72 ,$28.78 ,$14.39 ,$69.12 
ST. MARY'S HOSPITAL - DECATUR,30200945,86778,HC TOXOPLASMA AB IGM-90,302,1 ,$200.00 ,$130.00 ,$3.50 ,$200.00 ,$36.03 ,$33.66 ,$110.00 ,$14.41 ,$56.00 ,$98.00 ,$14.41 ,$113.63 ,$14.41 ,$108.60 ,$3.50 ,$14.41 ,$108.60 ,$27.38 ,$140.00 ,$100.00 ,$160.00 ,$36.03 ,$14.41 ,$140.00 ,$14.41 ,$120.00 ,$14.41 ,$150.00 ,$110.40 ,$99.60 ,$110.40 ,$14.41 ,$110.40 ,$20.81 ,$20.81 ,$170.00 ,$36.03 ,$138.60 ,$14.41 ,$200.00 ,$110.00 ,$14.41 ,$52.60 , N/A ,$12.17 ,$11.61 ,$15.13 ,$160.00 ,$108.60 ,$56.00 ,$180.00 ,$76.00 ,$28.82 ,$14.41 ,$96.00 
ST. MARY'S HOSPITAL - DECATUR,30200946,86780,HC TREPONEMA P AB CONFIRM-90,302,1 ,$378.00 ,$245.70 ,$3.50 ,$378.00 ,$33.10 ,$30.94 ,$207.90 ,$13.24 ,$105.84 ,$141.36 ,$13.24 ,$141.36 ,$13.24 ,$205.25 ,$3.50 ,$13.24 ,$205.25 ,$25.16 ,$264.60 ,$189.00 ,$302.40 ,$33.10 ,$13.24 ,$264.60 ,$13.24 ,$226.80 ,$13.24 ,$283.50 ,$208.66 ,$188.24 ,$208.66 ,$13.24 ,$208.66 ,$19.12 ,$19.12 ,$321.30 ,$33.10 ,$261.95 ,$13.24 ,$378.00 ,$207.90 ,$13.24 ,$99.41 , N/A ,$12.17 ,$11.61 ,$13.90 ,$302.40 ,$205.25 ,$105.84 ,$340.20 ,$143.64 ,$26.48 ,$13.24 ,$181.44 
ST. MARY'S HOSPITAL - DECATUR,30200947,86784,HC TRICHANELLA AB-90,302,1 ,$190.00 ,$123.50 ,$3.50 ,$190.00 ,$31.40 ,$29.36 ,$104.50 ,$12.56 ,$53.20 ,$93.10 ,$12.56 ,$99.09 ,$12.56 ,$103.17 ,$3.50 ,$12.56 ,$103.17 ,$23.86 ,$133.00 ,$95.00 ,$152.00 ,$31.40 ,$12.56 ,$133.00 ,$12.56 ,$114.00 ,$12.56 ,$142.50 ,$104.88 ,$94.62 ,$104.88 ,$12.56 ,$104.88 ,$18.15 ,$18.15 ,$161.50 ,$31.40 ,$131.67 ,$12.56 ,$190.00 ,$104.50 ,$12.56 ,$49.97 , N/A ,$12.17 ,$11.61 ,$13.19 ,$152.00 ,$103.17 ,$53.20 ,$171.00 ,$72.20 ,$25.12 ,$12.56 ,$91.20 
ST. MARY'S HOSPITAL - DECATUR,30200948,86787,HC VARICELLA ZOSTER AB-90,302,1 ,$176.00 ,$114.40 ,$3.50 ,$176.00 ,$32.20 ,$30.10 ,$96.80 ,$12.88 ,$49.28 ,$86.24 ,$12.88 ,$101.64 ,$12.88 ,$95.57 ,$3.50 ,$12.88 ,$95.57 ,$24.47 ,$123.20 ,$88.00 ,$140.80 ,$32.20 ,$12.88 ,$123.20 ,$12.88 ,$105.60 ,$12.88 ,$132.00 ,$97.15 ,$87.65 ,$97.15 ,$12.88 ,$97.15 ,$18.60 ,$18.60 ,$149.60 ,$32.20 ,$121.97 ,$12.88 ,$176.00 ,$96.80 ,$12.88 ,$46.29 , N/A ,$7.06 ,$6.74 ,$13.52 ,$140.80 ,$95.57 ,$49.28 ,$158.40 ,$66.88 ,$25.76 ,$12.88 ,$84.48 
ST. MARY'S HOSPITAL - DECATUR,30200949,86788,HC WEST NILE VIRUS AB IGM-90,302,1 ,$130.00 ,$84.50 ,$3.50 ,$130.00 ,$42.13 ,$39.36 ,$71.50 ,$16.85 ,$36.40 ,$63.70 ,$16.85 ,$76.05 ,$16.85 ,$70.59 ,$3.50 ,$16.85 ,$70.59 ,$32.02 ,$91.00 ,$65.00 ,$104.00 ,$42.13 ,$16.85 ,$91.00 ,$16.85 ,$78.00 ,$16.85 ,$97.50 ,$71.76 ,$64.74 ,$71.76 ,$16.85 ,$71.76 ,$24.34 ,$24.34 ,$110.50 ,$42.13 ,$90.09 ,$16.85 ,$130.00 ,$71.50 ,$16.85 ,$34.19 , N/A ,$12.17 ,$11.61 ,$17.69 ,$104.00 ,$70.59 ,$36.40 ,$117.00 ,$49.40 ,$33.70 ,$16.85 ,$62.40 
ST. MARY'S HOSPITAL - DECATUR,30200950,86789,HC WEST NILE AB-90,302,1 ,$130.00 ,$84.50 ,$3.50 ,$130.00 ,$35.98 ,$33.64 ,$71.50 ,$14.39 ,$36.40 ,$63.70 ,$14.39 ,$76.05 ,$14.39 ,$70.59 ,$3.50 ,$14.39 ,$70.59 ,$27.34 ,$91.00 ,$65.00 ,$104.00 ,$35.98 ,$14.39 ,$91.00 ,$14.39 ,$78.00 ,$14.39 ,$97.50 ,$71.76 ,$64.74 ,$71.76 ,$14.39 ,$71.76 ,$20.79 ,$20.79 ,$110.50 ,$35.98 ,$90.09 ,$14.39 ,$130.00 ,$71.50 ,$14.39 ,$34.19 , N/A ,$12.17 ,$11.61 ,$15.11 ,$104.00 ,$70.59 ,$36.40 ,$117.00 ,$49.40 ,$28.78 ,$14.39 ,$62.40 
ST. MARY'S HOSPITAL - DECATUR,30200951,86790,HC VIRUS AB NOT SPECIFIED-90,302,1 ,$167.00 ,$108.55 ,$3.50 ,$167.00 ,$32.20 ,$30.10 ,$91.85 ,$12.88 ,$46.76 ,$81.83 ,$12.88 ,$97.70 ,$12.88 ,$90.68 ,$3.50 ,$12.88 ,$90.68 ,$24.47 ,$116.90 ,$83.50 ,$133.60 ,$32.20 ,$12.88 ,$116.90 ,$12.88 ,$100.20 ,$12.88 ,$125.25 ,$92.18 ,$83.17 ,$92.18 ,$12.88 ,$92.18 ,$18.60 ,$18.60 ,$141.95 ,$32.20 ,$115.73 ,$12.88 ,$167.00 ,$91.85 ,$12.88 ,$43.92 , N/A ,$7.06 ,$6.74 ,$13.52 ,$133.60 ,$90.68 ,$46.76 ,$150.30 ,$63.46 ,$25.76 ,$12.88 ,$80.16 
ST. MARY'S HOSPITAL - DECATUR,30200952,86793,HC YERSINA-90,302,1 ,$148.00 ,$96.20 ,$3.50 ,$148.00 ,$32.98 ,$30.82 ,$81.40 ,$13.19 ,$41.44 ,$72.52 ,$13.19 ,$86.58 ,$13.19 ,$80.36 ,$3.50 ,$13.19 ,$80.36 ,$25.06 ,$103.60 ,$74.00 ,$118.40 ,$32.98 ,$13.19 ,$103.60 ,$13.19 ,$88.80 ,$13.19 ,$111.00 ,$81.70 ,$73.70 ,$81.70 ,$13.19 ,$81.70 ,$19.05 ,$19.05 ,$125.80 ,$32.98 ,$102.56 ,$13.19 ,$148.00 ,$81.40 ,$13.19 ,$38.92 , N/A ,$12.17 ,$11.61 ,$13.85 ,$118.40 ,$80.36 ,$41.44 ,$133.20 ,$56.24 ,$26.38 ,$13.19 ,$71.04 
ST. MARY'S HOSPITAL - DECATUR,30200953,86800,HC THYROGLOBULIN AB-90,302,1 ,$176.00 ,$114.40 ,$3.50 ,$176.00 ,$39.78 ,$37.16 ,$96.80 ,$15.91 ,$49.28 ,$86.24 ,$15.91 ,$102.96 ,$15.91 ,$95.57 ,$3.50 ,$15.91 ,$95.57 ,$30.23 ,$123.20 ,$88.00 ,$140.80 ,$39.78 ,$15.91 ,$123.20 ,$15.91 ,$105.60 ,$15.91 ,$132.00 ,$97.15 ,$87.65 ,$97.15 ,$15.91 ,$97.15 ,$22.97 ,$22.97 ,$149.60 ,$39.78 ,$121.97 ,$15.91 ,$176.00 ,$96.80 ,$15.91 ,$46.29 , N/A ,$18.45 ,$17.61 ,$16.71 ,$140.80 ,$95.57 ,$49.28 ,$158.40 ,$66.88 ,$31.82 ,$15.91 ,$84.48 
ST. MARY'S HOSPITAL - DECATUR,30200954,86803,HC HEP C AB-90,302,1 ,$452.00 ,$293.80 ,$3.50 ,$452.00 ,$35.68 ,$33.36 ,$248.60 ,$14.27 ,$126.56 ,$152.37 ,$14.27 ,$152.37 ,$14.27 ,$245.44 ,$3.50 ,$14.27 ,$245.44 ,$27.11 ,$316.40 ,$226.00 ,$361.60 ,$35.68 ,$14.27 ,$316.40 ,$14.27 ,$271.20 ,$14.27 ,$339.00 ,$249.50 ,$225.10 ,$249.50 ,$14.27 ,$249.50 ,$20.61 ,$20.61 ,$384.20 ,$35.68 ,$313.24 ,$14.27 ,$452.00 ,$248.60 ,$14.27 ,$118.88 , N/A ,$12.17 ,$11.61 ,$14.98 ,$361.60 ,$245.44 ,$126.56 ,$406.80 ,$171.76 ,$28.54 ,$14.27 ,$216.96 
ST. MARY'S HOSPITAL - DECATUR,30200958,86807,HC CYTOTOXIC PRA STND-90,302,1 ,"$1,021.00 ",$663.65 ,$3.50 ,"$1,021.00 ",$196.63 ,$92.48 ,$561.55 ,$78.65 ,$285.88 ,$500.29 ,$78.65 ,$502.51 ,$78.65 ,$554.40 ,$3.50 ,$78.65 ,$554.40 ,$149.44 ,$714.70 ,$510.50 ,$816.80 ,$196.63 ,$78.65 ,$714.70 ,$78.65 ,$612.60 ,$78.65 ,$765.75 ,$563.59 ,$508.46 ,$563.59 ,$78.65 ,$563.59 ,$102.25 ,$102.25 ,$867.85 ,$196.63 ,$707.55 ,$78.65 ,"$1,021.00 ",$561.55 ,$78.65 ,$268.52 , N/A ,$28.49 ,$27.20 ,$82.58 ,$816.80 ,$554.40 ,$285.88 ,$918.90 ,$387.98 ,$157.30 ,$78.65 ,$490.08 
ST. MARY'S HOSPITAL - DECATUR,30200960,86812,HC HLA TYPING SINGLE A/B/C-90,302,1 ,$240.00 ,$156.00 ,$3.50 ,$240.00 ,$64.53 ,$60.32 ,$132.00 ,$25.81 ,$67.20 ,$117.60 ,$25.81 ,$140.40 ,$25.81 ,$130.32 ,$3.50 ,$25.81 ,$130.32 ,$49.04 ,$168.00 ,$120.00 ,$192.00 ,$64.53 ,$25.81 ,$168.00 ,$25.81 ,$144.00 ,$25.81 ,$180.00 ,$132.48 ,$119.52 ,$132.48 ,$25.81 ,$132.48 ,$37.27 ,$37.27 ,$204.00 ,$64.53 ,$166.32 ,$25.81 ,$240.00 ,$132.00 ,$25.81 ,$63.12 , N/A ,$28.49 ,$27.20 ,$27.10 ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 ,$51.62 ,$25.81 ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,30200962,86816,HC HLA TYPING SINGLE DR/DQ-90,302,1 ,$582.00 ,$378.30 ,$3.50 ,$582.00 ,$75.43 ,$54.68 ,$320.10 ,$30.17 ,$162.96 ,$219.70 ,$30.17 ,$219.70 ,$30.17 ,$316.03 ,$3.50 ,$30.17 ,$316.03 ,$57.32 ,$407.40 ,$291.00 ,$465.60 ,$75.43 ,$30.17 ,$407.40 ,$30.17 ,$349.20 ,$30.17 ,$436.50 ,$321.26 ,$289.84 ,$321.26 ,$30.17 ,$321.26 ,$40.24 ,$40.24 ,$494.70 ,$75.43 ,$403.33 ,$30.17 ,$582.00 ,$320.10 ,$30.17 ,$153.07 , N/A ,$28.49 ,$27.20 ,$31.68 ,$465.60 ,$316.03 ,$162.96 ,$523.80 ,$221.16 ,$60.34 ,$30.17 ,$279.36 
ST. MARY'S HOSPITAL - DECATUR,30200974,86870,HC RBC AB ID PANEL-90,302,1 ,$357.00 ,$232.05 ,$6.74 ,$689.24 ,$689.23 ,$46.26 ,$196.35 ,$275.69 ,$99.96 ,$174.93 ,$275.69 ,$208.85 ,$275.69 ,$193.85 ,$64.67 ,$275.69 ,$193.85 ,$357.00 ,$249.90 ,$178.50 ,$285.60 ,$689.24 ,$275.69 ,$249.90 ,$275.69 ,$214.20 ,$275.69 ,$267.75 ,$197.06 ,$177.79 ,$197.06 ,$275.69 ,$197.06 ,$249.90 ,$249.90 ,$303.45 ,$357.00 ,$247.40 ,$275.69 ,$357.00 ,$196.35 ,$275.69 ,$93.89 , N/A ,$7.06 ,$6.74 ,$289.47 ,$285.60 ,$193.85 ,$99.96 ,$321.30 ,$135.66 ,$357.00 ,$275.69 ,$171.36 
ST. MARY'S HOSPITAL - DECATUR,30200978,86886,HC INDIRECT TITER-90,302,1 ,$215.00 ,$139.75 ,$3.50 ,$352.95 ,$352.95 ,$12.08 ,$118.25 ,$141.18 ,$60.20 ,$40.79 ,$141.18 ,$40.79 ,$141.18 ,$116.75 ,$3.50 ,$141.18 ,$116.75 ,$215.00 ,$150.50 ,$107.50 ,$172.00 ,$352.95 ,$141.18 ,$150.50 ,$141.18 ,$129.00 ,$141.18 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$141.18 ,$118.68 ,$7.48 ,$7.48 ,$182.75 ,$215.00 ,$149.00 ,$141.18 ,$215.00 ,$118.25 ,$141.18 ,$56.55 , N/A ,$7.06 ,$6.74 ,$148.24 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$10.36 ,$141.18 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,30200979,86886,HC INDIRECT TITER,302,1 ,$215.00 ,$139.75 ,$3.50 ,$352.95 ,$352.95 ,$12.08 ,$118.25 ,$141.18 ,$60.20 ,$40.79 ,$141.18 ,$40.79 ,$141.18 ,$116.75 ,$3.50 ,$141.18 ,$116.75 ,$215.00 ,$150.50 ,$107.50 ,$172.00 ,$352.95 ,$141.18 ,$150.50 ,$141.18 ,$129.00 ,$141.18 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$141.18 ,$118.68 ,$7.48 ,$7.48 ,$182.75 ,$215.00 ,$149.00 ,$141.18 ,$215.00 ,$118.25 ,$141.18 ,$56.55 , N/A ,$7.06 ,$6.74 ,$148.24 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$10.36 ,$141.18 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,30200984,86902,HC RBC AG SCR RGT SERUM T1-90,302,1 ,$149.00 ,$96.85 ,$3.50 ,$689.24 ,$689.23 ,$8.92 ,$81.95 ,$275.69 ,$41.72 ,$40.60 ,$275.69 ,$40.60 ,$149.00 ,$80.91 ,$3.50 ,$149.00 ,$80.91 ,$149.00 ,$104.30 ,$74.50 ,$119.20 ,$689.24 ,$275.69 ,$104.30 ,$275.69 ,$89.40 ,$275.69 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$275.69 ,$82.25 ,$8.26 ,$8.26 ,$126.65 ,$149.00 ,$103.26 ,$275.69 ,$149.00 ,$81.95 ,$275.69 ,$39.19 , N/A ,$4.38 ,$4.18 ,$289.47 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$12.70 ,$275.69 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30200986,86902,HC RBC AG SCR RGT SERUM T3-90,302,1 ,$149.00 ,$96.85 ,$3.50 ,$689.24 ,$689.23 ,$8.92 ,$81.95 ,$275.69 ,$41.72 ,$40.60 ,$275.69 ,$40.60 ,$149.00 ,$80.91 ,$3.50 ,$149.00 ,$80.91 ,$149.00 ,$104.30 ,$74.50 ,$119.20 ,$689.24 ,$275.69 ,$104.30 ,$275.69 ,$89.40 ,$275.69 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$275.69 ,$82.25 ,$8.26 ,$8.26 ,$126.65 ,$149.00 ,$103.26 ,$275.69 ,$149.00 ,$81.95 ,$275.69 ,$39.19 , N/A ,$4.38 ,$4.18 ,$289.47 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$12.70 ,$275.69 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30200987,86902,HC RBC AG SCR RGT SERUM T4-90,302,1 ,$149.00 ,$96.85 ,$3.50 ,$689.24 ,$689.23 ,$8.92 ,$81.95 ,$275.69 ,$41.72 ,$40.60 ,$275.69 ,$40.60 ,$149.00 ,$80.91 ,$3.50 ,$149.00 ,$80.91 ,$149.00 ,$104.30 ,$74.50 ,$119.20 ,$689.24 ,$275.69 ,$104.30 ,$275.69 ,$89.40 ,$275.69 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$275.69 ,$82.25 ,$8.26 ,$8.26 ,$126.65 ,$149.00 ,$103.26 ,$275.69 ,$149.00 ,$81.95 ,$275.69 ,$39.19 , N/A ,$4.38 ,$4.18 ,$289.47 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$12.70 ,$275.69 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30200991,86904,HC RBC AG SCR PAT SERUM,302,1 ,$149.00 ,$96.85 ,$3.50 ,$149.00 ,$80.10 ,$22.22 ,$81.95 ,$32.04 ,$41.72 ,$73.01 ,$32.04 ,$87.17 ,$32.04 ,$80.91 ,$3.50 ,$32.04 ,$80.91 ,$60.88 ,$104.30 ,$74.50 ,$119.20 ,$80.10 ,$32.04 ,$104.30 ,$32.04 ,$89.40 ,$32.04 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$32.04 ,$82.25 ,$21.24 ,$21.24 ,$126.65 ,$80.10 ,$103.26 ,$32.04 ,$149.00 ,$81.95 ,$32.04 ,$39.19 , N/A ,$4.38 ,$4.18 ,$33.64 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$32.68 ,$32.04 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30200999,86906,HC RH PHENOTYPE COMPLETE,302,1 ,$195.00 ,$126.75 ,$3.50 ,$195.00 ,$80.10 ,$18.12 ,$107.25 ,$32.04 ,$54.60 ,$61.14 ,$32.04 ,$61.14 ,$32.04 ,$105.89 ,$3.50 ,$32.04 ,$105.89 ,$60.88 ,$136.50 ,$97.50 ,$156.00 ,$80.10 ,$32.04 ,$136.50 ,$32.04 ,$117.00 ,$32.04 ,$146.25 ,$107.64 ,$97.11 ,$107.64 ,$32.04 ,$107.64 ,$11.19 ,$11.19 ,$165.75 ,$80.10 ,$135.14 ,$32.04 ,$195.00 ,$107.25 ,$32.04 ,$51.29 , N/A ,$4.38 ,$4.18 ,$33.64 ,$156.00 ,$105.89 ,$54.60 ,$175.50 ,$74.10 ,$15.50 ,$32.04 ,$93.60 
ST. MARY'S HOSPITAL - DECATUR,30201001,86940,HC HEOLYSIN AGG AUTO SCREEN-90,302,1 ,$53.00 ,$34.45 ,$3.50 ,$53.00 ,$21.93 ,$19.16 ,$29.15 ,$8.77 ,$14.84 ,$25.97 ,$8.77 ,$31.01 ,$8.77 ,$28.78 ,$3.50 ,$8.77 ,$28.78 ,$16.66 ,$37.10 ,$26.50 ,$42.40 ,$21.93 ,$8.77 ,$37.10 ,$8.77 ,$31.80 ,$8.77 ,$39.75 ,$29.26 ,$26.39 ,$29.26 ,$8.77 ,$29.26 ,$11.84 ,$11.84 ,$45.05 ,$21.93 ,$36.73 ,$8.77 ,$53.00 ,$29.15 ,$8.77 ,$13.94 , N/A ,$12.17 ,$11.61 ,$9.21 ,$42.40 ,$28.78 ,$14.84 ,$47.70 ,$20.14 ,$17.54 ,$8.77 ,$25.44 
ST. MARY'S HOSPITAL - DECATUR,30201008,86972,HC RBC PRETREAT DENSITY SEP,302,1 ,$283.00 ,$183.95 ,$27.20 ,$352.95 ,$352.95 ,$43.64 ,$155.65 ,$141.18 ,$79.24 ,$138.67 ,$141.18 ,$165.56 ,$141.18 ,$153.67 ,$61.05 ,$141.18 ,$153.67 ,$268.24 ,$198.10 ,$141.50 ,$226.40 ,$352.95 ,$141.18 ,$198.10 ,$141.18 ,$169.80 ,$141.18 ,$212.25 ,$156.22 ,$140.93 ,$156.22 ,$141.18 ,$156.22 ,$198.10 ,$198.10 ,$240.55 ,$283.00 ,$196.12 ,$141.18 ,$283.00 ,$155.65 ,$141.18 ,$74.43 , N/A ,$28.49 ,$27.20 ,$148.24 ,$226.40 ,$153.67 ,$79.24 ,$254.70 ,$107.54 ,$283.00 ,$141.18 ,$135.84 
ST. MARY'S HOSPITAL - DECATUR,30201010,86975,HC INCUBATION OF SERUM W/DRUG-90,302,1 ,$279.00 ,$181.35 ,$27.20 ,$642.28 ,$642.28 ,$33.64 ,$153.45 ,$256.91 ,$78.12 ,$136.71 ,$256.91 ,$163.22 ,$256.91 ,$151.50 ,$47.08 ,$256.91 ,$151.50 ,$279.00 ,$195.30 ,$139.50 ,$223.20 ,$642.27 ,$256.91 ,$195.30 ,$256.91 ,$167.40 ,$256.91 ,$209.25 ,$154.01 ,$138.94 ,$154.01 ,$256.91 ,$154.01 ,$195.30 ,$195.30 ,$237.15 ,$279.00 ,$193.35 ,$256.91 ,$279.00 ,$153.45 ,$256.91 ,$73.38 , N/A ,$28.49 ,$27.20 ,$269.76 ,$223.20 ,$151.50 ,$78.12 ,$251.10 ,$106.02 ,$279.00 ,$256.91 ,$133.92 
ST. MARY'S HOSPITAL - DECATUR,30201012,86976,HC RBC PRETREAT SERUM DIL-90,302,1 ,$28.00 ,$18.20 ,$7.36 ,$58.46 ,$58.45 ,$28.00 ,$15.40 ,$23.38 ,$7.84 ,$13.72 ,$23.38 ,$16.38 ,$23.38 ,$15.20 ,$28.00 ,$23.38 ,$15.20 ,$28.00 ,$19.60 ,$14.00 ,$22.40 ,$58.46 ,$23.38 ,$19.60 ,$23.38 ,$16.80 ,$23.38 ,$21.00 ,$15.46 ,$13.94 ,$15.46 ,$23.38 ,$15.46 ,$19.60 ,$19.60 ,$23.80 ,$28.00 ,$19.40 ,$23.38 ,$28.00 ,$15.40 ,$23.38 ,$7.36 , N/A ,$28.00 ,$27.20 ,$24.55 ,$22.40 ,$15.20 ,$7.84 ,$25.20 ,$10.64 ,$28.00 ,$23.38 ,$13.44 
ST. MARY'S HOSPITAL - DECATUR,30201017,86977,HC RBC PRETREAT NEUTRAL SERUM INHIBIT,302,1 ,$206.00 ,$133.90 ,$27.20 ,$352.95 ,$352.95 ,$37.32 ,$113.30 ,$141.18 ,$57.68 ,$100.94 ,$141.18 ,$120.51 ,$141.18 ,$111.86 ,$52.26 ,$141.18 ,$111.86 ,$206.00 ,$144.20 ,$103.00 ,$164.80 ,$352.95 ,$141.18 ,$144.20 ,$141.18 ,$123.60 ,$141.18 ,$154.50 ,$113.71 ,$102.59 ,$113.71 ,$141.18 ,$113.71 ,$144.20 ,$144.20 ,$175.10 ,$206.00 ,$142.76 ,$141.18 ,$206.00 ,$113.30 ,$141.18 ,$54.18 , N/A ,$28.49 ,$27.20 ,$148.24 ,$164.80 ,$111.86 ,$57.68 ,$185.40 ,$78.28 ,$206.00 ,$141.18 ,$98.88 
ST. MARY'S HOSPITAL - DECATUR,30201022,87801,HC INFECT MLT  ORG AMP-90,302,1 ,$426.00 ,$276.90 ,$3.50 ,$426.00 ,$175.50 ,$164.04 ,$234.30 ,$70.20 ,$119.28 ,$208.74 ,$70.20 ,$249.21 ,$70.20 ,$231.32 ,$3.50 ,$70.20 ,$231.32 ,$133.38 ,$298.20 ,$213.00 ,$340.80 ,$175.50 ,$70.20 ,$298.20 ,$70.20 ,$255.60 ,$70.20 ,$319.50 ,$235.15 ,$212.15 ,$235.15 ,$70.20 ,$235.15 ,$101.39 ,$101.39 ,$362.10 ,$175.50 ,$295.22 ,$70.20 ,$426.00 ,$234.30 ,$70.20 ,$112.04 , N/A ,$5.63 ,$5.38 ,$73.71 ,$340.80 ,$231.32 ,$119.28 ,$383.40 ,$161.88 ,$140.40 ,$70.20 ,$204.48 
ST. MARY'S HOSPITAL - DECATUR,30201025,86316,HC TUMOR AG OTHER AG QN-90,302,1 ,$27.00 ,$17.55 ,$3.50 ,$52.03 ,$52.03 ,$27.00 ,$14.85 ,$20.81 ,$7.56 ,$13.23 ,$20.81 ,$15.80 ,$20.81 ,$14.66 ,$3.50 ,$20.81 ,$14.66 ,$27.00 ,$18.90 ,$13.50 ,$21.60 ,$52.03 ,$20.81 ,$18.90 ,$20.81 ,$16.20 ,$20.81 ,$20.25 ,$14.90 ,$13.45 ,$14.90 ,$20.81 ,$14.90 ,$27.00 ,$27.00 ,$22.95 ,$27.00 ,$18.71 ,$20.81 ,$27.00 ,$14.85 ,$20.81 ,$7.10 , N/A ,$7.88 ,$7.52 ,$21.85 ,$21.60 ,$14.66 ,$7.56 ,$24.30 ,$10.26 ,$27.00 ,$20.81 ,$12.96 
ST. MARY'S HOSPITAL - DECATUR,30201026,86317,HC INFECTIOUS AB QN-90,302,1 ,$41.00 ,$26.65 ,$3.50 ,$41.00 ,$37.48 ,$35.04 ,$22.55 ,$14.99 ,$11.48 ,$20.09 ,$14.99 ,$23.99 ,$14.99 ,$22.26 ,$3.50 ,$14.99 ,$22.26 ,$28.48 ,$28.70 ,$20.50 ,$32.80 ,$37.48 ,$14.99 ,$28.70 ,$14.99 ,$24.60 ,$14.99 ,$30.75 ,$22.63 ,$20.42 ,$22.63 ,$14.99 ,$22.63 ,$21.65 ,$21.65 ,$34.85 ,$37.48 ,$28.41 ,$14.99 ,$41.00 ,$22.55 ,$14.99 ,$10.78 , N/A ,$12.17 ,$11.61 ,$15.74 ,$32.80 ,$22.26 ,$11.48 ,$36.90 ,$15.58 ,$29.98 ,$14.99 ,$19.68 
ST. MARY'S HOSPITAL - DECATUR,30201028,86329,HC IMMUNODIFFUSION NOS-90,302,1 ,$142.00 ,$92.30 ,$3.50 ,$142.00 ,$35.13 ,$32.82 ,$78.10 ,$14.05 ,$39.76 ,$69.58 ,$14.05 ,$83.07 ,$14.05 ,$77.11 ,$3.50 ,$14.05 ,$77.11 ,$26.70 ,$99.40 ,$71.00 ,$113.60 ,$35.13 ,$14.05 ,$99.40 ,$14.05 ,$85.20 ,$14.05 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$14.05 ,$78.38 ,$20.29 ,$20.29 ,$120.70 ,$35.13 ,$98.41 ,$14.05 ,$142.00 ,$78.10 ,$14.05 ,$37.35 , N/A ,$12.17 ,$11.61 ,$14.75 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$28.10 ,$14.05 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30201029,86331,HC IMMUNODIFF EL EA AG AB QL-90,302,1 ,$114.00 ,$74.10 ,$3.50 ,$114.00 ,$29.95 ,$28.00 ,$62.70 ,$11.98 ,$31.92 ,$55.86 ,$11.98 ,$66.69 ,$11.98 ,$61.90 ,$3.50 ,$11.98 ,$61.90 ,$22.76 ,$79.80 ,$57.00 ,$91.20 ,$29.95 ,$11.98 ,$79.80 ,$11.98 ,$68.40 ,$11.98 ,$85.50 ,$62.93 ,$56.77 ,$62.93 ,$11.98 ,$62.93 ,$17.30 ,$17.30 ,$96.90 ,$29.95 ,$79.00 ,$11.98 ,$114.00 ,$62.70 ,$11.98 ,$29.98 , N/A ,$12.17 ,$11.61 ,$12.58 ,$91.20 ,$61.90 ,$31.92 ,$102.60 ,$43.32 ,$23.96 ,$11.98 ,$54.72 
ST. MARY'S HOSPITAL - DECATUR,30201030,86332,HC IMMUNE COMPLEX ASSAY-90,302,1 ,$144.00 ,$93.60 ,$3.50 ,$144.00 ,$60.93 ,$56.96 ,$79.20 ,$24.37 ,$40.32 ,$70.56 ,$24.37 ,$84.24 ,$24.37 ,$78.19 ,$3.50 ,$24.37 ,$78.19 ,$46.30 ,$100.80 ,$72.00 ,$115.20 ,$60.93 ,$24.37 ,$100.80 ,$24.37 ,$86.40 ,$24.37 ,$108.00 ,$79.49 ,$71.71 ,$79.49 ,$24.37 ,$79.49 ,$35.20 ,$35.20 ,$122.40 ,$60.93 ,$99.79 ,$24.37 ,$144.00 ,$79.20 ,$24.37 ,$37.87 , N/A ,$12.17 ,$11.61 ,$25.59 ,$115.20 ,$78.19 ,$40.32 ,$129.60 ,$54.72 ,$48.74 ,$24.37 ,$69.12 
ST. MARY'S HOSPITAL - DECATUR,30201031,86334,HC IMMUNOFIX ELECTRO SERUM -90,302,1 ,$240.00 ,$156.00 ,$11.61 ,$240.00 ,$55.85 ,$52.20 ,$132.00 ,$22.34 ,$67.20 ,$117.60 ,$22.34 ,$140.40 ,$22.34 ,$130.32 ,$17.63 ,$22.34 ,$130.32 ,$42.45 ,$168.00 ,$120.00 ,$192.00 ,$55.85 ,$22.34 ,$168.00 ,$22.34 ,$144.00 ,$22.34 ,$180.00 ,$132.48 ,$119.52 ,$132.48 ,$22.34 ,$132.48 ,$32.28 ,$32.28 ,$204.00 ,$55.85 ,$166.32 ,$22.34 ,$240.00 ,$132.00 ,$22.34 ,$63.12 , N/A ,$12.17 ,$11.61 ,$23.46 ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 ,$44.68 ,$22.34 ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,30201032,86335,HC IMMUNOFIX ELECTRO OTH-90,302,1 ,$138.00 ,$89.70 ,$11.61 ,$138.00 ,$73.38 ,$68.58 ,$75.90 ,$29.35 ,$38.64 ,$67.62 ,$29.35 ,$80.73 ,$29.35 ,$74.93 ,$23.15 ,$29.35 ,$74.93 ,$55.77 ,$96.60 ,$69.00 ,$110.40 ,$73.38 ,$29.35 ,$96.60 ,$29.35 ,$82.80 ,$29.35 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$29.35 ,$76.18 ,$42.39 ,$42.39 ,$117.30 ,$73.38 ,$95.63 ,$29.35 ,$138.00 ,$75.90 ,$29.35 ,$36.29 , N/A ,$12.17 ,$11.61 ,$30.82 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$58.70 ,$29.35 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30201033,86336,HC INHIBIN A-90,302,1 ,$113.00 ,$73.45 ,$3.50 ,$113.00 ,$38.98 ,$36.42 ,$62.15 ,$15.59 ,$31.64 ,$55.37 ,$15.59 ,$66.11 ,$15.59 ,$61.36 ,$3.50 ,$15.59 ,$61.36 ,$29.62 ,$79.10 ,$56.50 ,$90.40 ,$38.98 ,$15.59 ,$79.10 ,$15.59 ,$67.80 ,$15.59 ,$84.75 ,$62.38 ,$56.27 ,$62.38 ,$15.59 ,$62.38 ,$22.52 ,$22.52 ,$96.05 ,$38.98 ,$78.31 ,$15.59 ,$113.00 ,$62.15 ,$15.59 ,$29.72 , N/A ,$7.88 ,$7.52 ,$16.37 ,$90.40 ,$61.36 ,$31.64 ,$101.70 ,$42.94 ,$31.18 ,$15.59 ,$54.24 
ST. MARY'S HOSPITAL - DECATUR,30201034,86337,HC INSULIN AB-90,302,1 ,$299.00 ,$194.35 ,$3.50 ,$299.00 ,$53.53 ,$50.04 ,$164.45 ,$21.41 ,$83.72 ,$146.51 ,$21.41 ,$168.88 ,$21.41 ,$162.36 ,$3.50 ,$21.41 ,$162.36 ,$40.68 ,$209.30 ,$149.50 ,$239.20 ,$53.53 ,$21.41 ,$209.30 ,$21.41 ,$179.40 ,$21.41 ,$224.25 ,$165.05 ,$148.90 ,$165.05 ,$21.41 ,$165.05 ,$30.93 ,$30.93 ,$254.15 ,$53.53 ,$207.21 ,$21.41 ,$299.00 ,$164.45 ,$21.41 ,$78.64 , N/A ,$18.45 ,$17.61 ,$22.48 ,$239.20 ,$162.36 ,$83.72 ,$269.10 ,$113.62 ,$42.82 ,$21.41 ,$143.52 
ST. MARY'S HOSPITAL - DECATUR,30201035,86340,HC INTRINSIC FACTOR AB-90,302,1 ,$215.00 ,$139.75 ,$3.50 ,$215.00 ,$37.70 ,$35.22 ,$118.25 ,$15.08 ,$60.20 ,$105.35 ,$15.08 ,$118.94 ,$15.08 ,$116.75 ,$3.50 ,$15.08 ,$116.75 ,$28.65 ,$150.50 ,$107.50 ,$172.00 ,$37.70 ,$15.08 ,$150.50 ,$15.08 ,$129.00 ,$15.08 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$15.08 ,$118.68 ,$21.78 ,$21.78 ,$182.75 ,$37.70 ,$149.00 ,$15.08 ,$215.00 ,$118.25 ,$15.08 ,$56.55 , N/A ,$18.45 ,$17.61 ,$15.83 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$30.16 ,$15.08 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,30201036,86341,HC ISLET CELL AB-90,302,1 ,$324.00 ,$210.60 ,$3.50 ,$324.00 ,$58.93 ,$46.24 ,$178.20 ,$23.57 ,$90.72 ,$156.10 ,$23.57 ,$156.10 ,$23.57 ,$175.93 ,$3.50 ,$23.57 ,$175.93 ,$44.78 ,$226.80 ,$162.00 ,$259.20 ,$58.93 ,$23.57 ,$226.80 ,$23.57 ,$194.40 ,$23.57 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$23.57 ,$178.85 ,$30.64 ,$30.64 ,$275.40 ,$58.93 ,$224.53 ,$23.57 ,$324.00 ,$178.20 ,$23.57 ,$85.21 , N/A ,$12.17 ,$11.61 ,$24.75 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$47.14 ,$23.57 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,30201038,86352,HC CELL FUNC W/BIOMARKER-90,302,1 ,$626.00 ,$406.90 ,$3.50 ,$626.00 ,$339.65 ,$317.48 ,$344.30 ,$135.86 ,$175.28 ,$306.74 ,$135.86 ,$366.21 ,$135.86 ,$339.92 ,$3.50 ,$135.86 ,$339.92 ,$258.13 ,$438.20 ,$313.00 ,$500.80 ,$339.65 ,$135.86 ,$438.20 ,$135.86 ,$375.60 ,$135.86 ,$469.50 ,$345.55 ,$311.75 ,$345.55 ,$135.86 ,$345.55 ,$196.25 ,$196.25 ,$532.10 ,$339.65 ,$433.82 ,$135.86 ,$626.00 ,$344.30 ,$135.86 ,$164.64 , N/A ,$12.17 ,$11.61 ,$142.65 ,$500.80 ,$339.92 ,$175.28 ,$563.40 ,$237.88 ,$271.72 ,$135.86 ,$300.48 
ST. MARY'S HOSPITAL - DECATUR,30201039,86353,HC LYMPHOCYTE TRANFORM MITOGENS-90,302,1 ,"$1,173.00 ",$762.45 ,$3.50 ,"$1,173.00 ",$122.58 ,$114.56 ,$645.15 ,$49.03 ,$328.44 ,$386.71 ,$49.03 ,$386.71 ,$49.03 ,$636.94 ,$3.50 ,$49.03 ,$636.94 ,$93.16 ,$821.10 ,$586.50 ,$938.40 ,$122.58 ,$49.03 ,$821.10 ,$49.03 ,$703.80 ,$49.03 ,$879.75 ,$647.50 ,$584.15 ,$647.50 ,$49.03 ,$647.50 ,$70.81 ,$70.81 ,$997.05 ,$122.58 ,$812.89 ,$49.03 ,"$1,173.00 ",$645.15 ,$49.03 ,$308.50 , N/A ,$12.17 ,$11.61 ,$51.48 ,$938.40 ,$636.94 ,$328.44 ,"$1,055.70 ",$445.74 ,$98.06 ,$49.03 ,$563.04 
ST. MARY'S HOSPITAL - DECATUR,30201040,86355,HC B CELLS TOTAL COUNT-90,302,1 ,$148.00 ,$96.20 ,$3.50 ,$148.00 ,$94.33 ,$88.14 ,$81.40 ,$37.73 ,$41.44 ,$72.52 ,$37.73 ,$86.58 ,$37.73 ,$80.36 ,$3.50 ,$37.73 ,$80.36 ,$71.69 ,$103.60 ,$74.00 ,$118.40 ,$94.33 ,$37.73 ,$103.60 ,$37.73 ,$88.80 ,$37.73 ,$111.00 ,$81.70 ,$73.70 ,$81.70 ,$37.73 ,$81.70 ,$54.50 ,$54.50 ,$125.80 ,$94.33 ,$102.56 ,$37.73 ,$148.00 ,$81.40 ,$37.73 ,$38.92 , N/A ,$12.17 ,$11.61 ,$39.62 ,$118.40 ,$80.36 ,$41.44 ,$133.20 ,$56.24 ,$75.46 ,$37.73 ,$71.04 
ST. MARY'S HOSPITAL - DECATUR,30201041,86356,HC MOL ANTIGEN QN EA-90,302,1 ,$148.00 ,$96.20 ,$3.50 ,$148.00 ,$66.95 ,$31.58 ,$81.40 ,$26.78 ,$41.44 ,$72.52 ,$26.78 ,$86.58 ,$26.78 ,$80.36 ,$3.50 ,$26.78 ,$80.36 ,$50.88 ,$103.60 ,$74.00 ,$118.40 ,$66.95 ,$26.78 ,$103.60 ,$26.78 ,$88.80 ,$26.78 ,$111.00 ,$81.70 ,$73.70 ,$81.70 ,$26.78 ,$81.70 ,$38.68 ,$38.68 ,$125.80 ,$66.95 ,$102.56 ,$26.78 ,$148.00 ,$81.40 ,$26.78 ,$38.92 , N/A ,$12.17 ,$11.61 ,$28.12 ,$118.40 ,$80.36 ,$41.44 ,$133.20 ,$56.24 ,$53.56 ,$26.78 ,$71.04 
ST. MARY'S HOSPITAL - DECATUR,30201042,86357,HC CD8 TOTAL COUNT-90,302,1 ,$148.00 ,$96.20 ,$3.50 ,$148.00 ,$94.33 ,$88.14 ,$81.40 ,$37.73 ,$41.44 ,$72.52 ,$37.73 ,$86.58 ,$37.73 ,$80.36 ,$3.50 ,$37.73 ,$80.36 ,$71.69 ,$103.60 ,$74.00 ,$118.40 ,$94.33 ,$37.73 ,$103.60 ,$37.73 ,$88.80 ,$37.73 ,$111.00 ,$81.70 ,$73.70 ,$81.70 ,$37.73 ,$81.70 ,$54.50 ,$54.50 ,$125.80 ,$94.33 ,$102.56 ,$37.73 ,$148.00 ,$81.40 ,$37.73 ,$38.92 , N/A ,$12.17 ,$11.61 ,$39.62 ,$118.40 ,$80.36 ,$41.44 ,$133.20 ,$56.24 ,$75.46 ,$37.73 ,$71.04 
ST. MARY'S HOSPITAL - DECATUR,30201043,86359,HC T CELLS TOTAL COUNT-90,302,1 ,$138.00 ,$89.70 ,$3.50 ,$138.00 ,$94.33 ,$88.14 ,$75.90 ,$37.73 ,$38.64 ,$67.62 ,$37.73 ,$80.73 ,$37.73 ,$74.93 ,$3.50 ,$37.73 ,$74.93 ,$71.69 ,$96.60 ,$69.00 ,$110.40 ,$94.33 ,$37.73 ,$96.60 ,$37.73 ,$82.80 ,$37.73 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$37.73 ,$76.18 ,$54.50 ,$54.50 ,$117.30 ,$94.33 ,$95.63 ,$37.73 ,$138.00 ,$75.90 ,$37.73 ,$36.29 , N/A ,$12.17 ,$11.61 ,$39.62 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$75.46 ,$37.73 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30201045,86360,HC ABS T CELLS CD4 CD8 RATIO-90,302,1 ,$201.00 ,$130.65 ,$3.50 ,$201.00 ,$117.45 ,$109.80 ,$110.55 ,$46.98 ,$56.28 ,$98.49 ,$46.98 ,$117.59 ,$46.98 ,$109.14 ,$3.50 ,$46.98 ,$109.14 ,$89.26 ,$140.70 ,$100.50 ,$160.80 ,$117.45 ,$46.98 ,$140.70 ,$46.98 ,$120.60 ,$46.98 ,$150.75 ,$110.95 ,$100.10 ,$110.95 ,$46.98 ,$110.95 ,$67.86 ,$67.86 ,$170.85 ,$117.45 ,$139.29 ,$46.98 ,$201.00 ,$110.55 ,$46.98 ,$52.86 , N/A ,$12.17 ,$11.61 ,$49.33 ,$160.80 ,$109.14 ,$56.28 ,$180.90 ,$76.38 ,$93.96 ,$46.98 ,$96.48 
ST. MARY'S HOSPITAL - DECATUR,30201047,86376,HC MICROSOMAL AB-90,302,1 ,$160.00 ,$104.00 ,$3.50 ,$160.00 ,$36.38 ,$33.98 ,$88.00 ,$14.55 ,$44.80 ,$78.40 ,$14.55 ,$93.60 ,$14.55 ,$86.88 ,$3.50 ,$14.55 ,$86.88 ,$27.65 ,$112.00 ,$80.00 ,$128.00 ,$36.38 ,$14.55 ,$112.00 ,$14.55 ,$96.00 ,$14.55 ,$120.00 ,$88.32 ,$79.68 ,$88.32 ,$14.55 ,$88.32 ,$21.02 ,$21.02 ,$136.00 ,$36.38 ,$110.88 ,$14.55 ,$160.00 ,$88.00 ,$14.55 ,$42.08 , N/A ,$18.45 ,$17.61 ,$15.28 ,$128.00 ,$86.88 ,$44.80 ,$144.00 ,$60.80 ,$29.10 ,$14.55 ,$76.80 
ST. MARY'S HOSPITAL - DECATUR,30201048,86382,HC NEUTRALIZATION TEST VIRAL-90,302,1 ,$205.00 ,$133.25 ,$3.50 ,$205.00 ,$42.28 ,$39.52 ,$112.75 ,$16.91 ,$57.40 ,$100.45 ,$16.91 ,$119.93 ,$16.91 ,$111.32 ,$3.50 ,$16.91 ,$111.32 ,$32.13 ,$143.50 ,$102.50 ,$164.00 ,$42.28 ,$16.91 ,$143.50 ,$16.91 ,$123.00 ,$16.91 ,$153.75 ,$113.16 ,$102.09 ,$113.16 ,$16.91 ,$113.16 ,$24.43 ,$24.43 ,$174.25 ,$42.28 ,$142.07 ,$16.91 ,$205.00 ,$112.75 ,$16.91 ,$53.92 , N/A ,$12.17 ,$11.61 ,$17.76 ,$164.00 ,$111.32 ,$57.40 ,$184.50 ,$77.90 ,$33.82 ,$16.91 ,$98.40 
ST. MARY'S HOSPITAL - DECATUR,30201049,86403,HC PARTICLE AGG SCREEN-90,302,1 ,$224.00 ,$145.60 ,$3.50 ,$224.00 ,$28.85 ,$11.64 ,$123.20 ,$11.54 ,$62.72 ,$108.82 ,$11.54 ,$108.82 ,$11.54 ,$121.63 ,$3.50 ,$11.54 ,$121.63 ,$21.93 ,$156.80 ,$112.00 ,$179.20 ,$28.85 ,$11.54 ,$156.80 ,$11.54 ,$134.40 ,$11.54 ,$168.00 ,$123.65 ,$111.55 ,$123.65 ,$11.54 ,$123.65 ,$15.00 ,$15.00 ,$190.40 ,$28.85 ,$155.23 ,$11.54 ,$224.00 ,$123.20 ,$11.54 ,$58.91 , N/A ,$7.06 ,$6.74 ,$12.12 ,$179.20 ,$121.63 ,$62.72 ,$201.60 ,$85.12 ,$23.08 ,$11.54 ,$107.52 
ST. MARY'S HOSPITAL - DECATUR,30201051,86406,HC PARTICLE AGGLUT TITER-90,302,1 ,$151.00 ,$98.15 ,$3.50 ,$151.00 ,$26.60 ,$24.86 ,$83.05 ,$10.64 ,$42.28 ,$73.99 ,$10.64 ,$83.85 ,$10.64 ,$81.99 ,$3.50 ,$10.64 ,$81.99 ,$20.22 ,$105.70 ,$75.50 ,$120.80 ,$26.60 ,$10.64 ,$105.70 ,$10.64 ,$90.60 ,$10.64 ,$113.25 ,$83.35 ,$75.20 ,$83.35 ,$10.64 ,$83.35 ,$15.37 ,$15.37 ,$128.35 ,$26.60 ,$104.64 ,$10.64 ,$151.00 ,$83.05 ,$10.64 ,$39.71 , N/A ,$7.06 ,$6.74 ,$11.17 ,$120.80 ,$81.99 ,$42.28 ,$135.90 ,$57.38 ,$21.28 ,$10.64 ,$72.48 
ST. MARY'S HOSPITAL - DECATUR,30201052,86431,HC RHEUMATOID FACTOR QN-90,302,1 ,$138.00 ,$89.70 ,$3.50 ,$138.00 ,$14.18 ,$13.26 ,$75.90 ,$5.67 ,$38.64 ,$44.73 ,$5.67 ,$44.73 ,$5.67 ,$74.93 ,$3.50 ,$5.67 ,$74.93 ,$10.77 ,$96.60 ,$69.00 ,$110.40 ,$14.18 ,$5.67 ,$96.60 ,$5.67 ,$82.80 ,$5.67 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$5.67 ,$76.18 ,$8.19 ,$8.19 ,$117.30 ,$14.18 ,$95.63 ,$5.67 ,$138.00 ,$75.90 ,$5.67 ,$36.29 , N/A ,$7.06 ,$6.74 ,$5.95 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$11.34 ,$5.67 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30201053,86480,HC TB QUANTIFERON GOLD-90,302,1 ,$350.00 ,$227.50 ,$3.50 ,$350.00 ,$154.95 ,$144.84 ,$192.50 ,$61.98 ,$98.00 ,$171.50 ,$61.98 ,$204.75 ,$61.98 ,$190.05 ,$3.50 ,$61.98 ,$190.05 ,$117.76 ,$245.00 ,$175.00 ,$280.00 ,$154.95 ,$61.98 ,$245.00 ,$61.98 ,$210.00 ,$61.98 ,$262.50 ,$193.20 ,$174.30 ,$193.20 ,$61.98 ,$193.20 ,$89.53 ,$89.53 ,$297.50 ,$154.95 ,$242.55 ,$61.98 ,$350.00 ,$192.50 ,$61.98 ,$92.05 , N/A ,$12.17 ,$11.61 ,$65.08 ,$280.00 ,$190.05 ,$98.00 ,$315.00 ,$133.00 ,$123.96 ,$61.98 ,$168.00 
ST. MARY'S HOSPITAL - DECATUR,30201054,86592,HC SYPHILIS VDRL RPR QL-90,302,1 ,$134.00 ,$87.10 ,$3.50 ,$134.00 ,$10.68 ,$9.98 ,$73.70 ,$4.27 ,$37.52 ,$33.72 ,$4.27 ,$33.72 ,$4.27 ,$72.76 ,$3.50 ,$4.27 ,$72.76 ,$8.11 ,$93.80 ,$67.00 ,$107.20 ,$10.68 ,$4.27 ,$93.80 ,$4.27 ,$80.40 ,$4.27 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$4.27 ,$73.97 ,$6.18 ,$6.18 ,$113.90 ,$10.68 ,$92.86 ,$4.27 ,$134.00 ,$73.70 ,$4.27 ,$35.24 , N/A ,$7.06 ,$6.74 ,$4.48 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$8.54 ,$4.27 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,30201055,86603,HC ADENOVIRUS AB-90,302,1 ,$166.00 ,$107.90 ,$3.50 ,$166.00 ,$32.18 ,$30.08 ,$91.30 ,$12.87 ,$46.48 ,$81.34 ,$12.87 ,$97.11 ,$12.87 ,$90.14 ,$3.50 ,$12.87 ,$90.14 ,$24.45 ,$116.20 ,$83.00 ,$132.80 ,$32.18 ,$12.87 ,$116.20 ,$12.87 ,$99.60 ,$12.87 ,$124.50 ,$91.63 ,$82.67 ,$91.63 ,$12.87 ,$91.63 ,$18.59 ,$18.59 ,$141.10 ,$32.18 ,$115.04 ,$12.87 ,$166.00 ,$91.30 ,$12.87 ,$43.66 , N/A ,$12.17 ,$11.61 ,$13.51 ,$132.80 ,$90.14 ,$46.48 ,$149.40 ,$63.08 ,$25.74 ,$12.87 ,$79.68 
ST. MARY'S HOSPITAL - DECATUR,30201056,86606,HC ASPERGILLUS AB-90,302,1 ,$137.00 ,$89.05 ,$3.50 ,$137.00 ,$37.63 ,$35.20 ,$75.35 ,$15.05 ,$38.36 ,$67.13 ,$15.05 ,$80.15 ,$15.05 ,$74.39 ,$3.50 ,$15.05 ,$74.39 ,$28.60 ,$95.90 ,$68.50 ,$109.60 ,$37.63 ,$15.05 ,$95.90 ,$15.05 ,$82.20 ,$15.05 ,$102.75 ,$75.62 ,$68.23 ,$75.62 ,$15.05 ,$75.62 ,$21.75 ,$21.75 ,$116.45 ,$37.63 ,$94.94 ,$15.05 ,$137.00 ,$75.35 ,$15.05 ,$36.03 , N/A ,$12.17 ,$11.61 ,$15.80 ,$109.60 ,$74.39 ,$38.36 ,$123.30 ,$52.06 ,$30.10 ,$15.05 ,$65.76 
ST. MARY'S HOSPITAL - DECATUR,30201057,86609,HC BACTERIUM AB NOS-90,302,1 ,$176.00 ,$114.40 ,$3.50 ,$176.00 ,$32.20 ,$30.10 ,$96.80 ,$12.88 ,$49.28 ,$86.24 ,$12.88 ,$101.64 ,$12.88 ,$95.57 ,$3.50 ,$12.88 ,$95.57 ,$24.47 ,$123.20 ,$88.00 ,$140.80 ,$32.20 ,$12.88 ,$123.20 ,$12.88 ,$105.60 ,$12.88 ,$132.00 ,$97.15 ,$87.65 ,$97.15 ,$12.88 ,$97.15 ,$18.60 ,$18.60 ,$149.60 ,$32.20 ,$121.97 ,$12.88 ,$176.00 ,$96.80 ,$12.88 ,$46.29 , N/A ,$18.71 ,$17.86 ,$13.52 ,$140.80 ,$95.57 ,$49.28 ,$158.40 ,$66.88 ,$25.76 ,$12.88 ,$84.48 
ST. MARY'S HOSPITAL - DECATUR,30201058,86611,HC BARTONELLA SCREEN AB-90,302,1 ,$62.00 ,$40.30 ,$3.50 ,$62.00 ,$25.45 ,$23.78 ,$34.10 ,$10.18 ,$17.36 ,$30.38 ,$10.18 ,$36.27 ,$10.18 ,$33.67 ,$3.50 ,$10.18 ,$33.67 ,$19.34 ,$43.40 ,$31.00 ,$49.60 ,$25.45 ,$10.18 ,$43.40 ,$10.18 ,$37.20 ,$10.18 ,$46.50 ,$34.22 ,$30.88 ,$34.22 ,$10.18 ,$34.22 ,$14.70 ,$14.70 ,$52.70 ,$25.45 ,$42.97 ,$10.18 ,$62.00 ,$34.10 ,$10.18 ,$16.31 , N/A ,$12.17 ,$11.61 ,$10.69 ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$20.36 ,$10.18 ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,30201059,86611,HC BARTONELLA SCREEN AB IGG-90,302,1 ,$65.00 ,$42.25 ,$3.50 ,$65.00 ,$25.45 ,$23.78 ,$35.75 ,$10.18 ,$18.20 ,$31.85 ,$10.18 ,$38.03 ,$10.18 ,$35.30 ,$3.50 ,$10.18 ,$35.30 ,$19.34 ,$45.50 ,$32.50 ,$52.00 ,$25.45 ,$10.18 ,$45.50 ,$10.18 ,$39.00 ,$10.18 ,$48.75 ,$35.88 ,$32.37 ,$35.88 ,$10.18 ,$35.88 ,$14.70 ,$14.70 ,$55.25 ,$25.45 ,$45.05 ,$10.18 ,$65.00 ,$35.75 ,$10.18 ,$17.10 , N/A ,$12.17 ,$11.61 ,$10.69 ,$52.00 ,$35.30 ,$18.20 ,$58.50 ,$24.70 ,$20.36 ,$10.18 ,$31.20 
ST. MARY'S HOSPITAL - DECATUR,30201060,86612,HC BLASTOMYCES AB-90,302,1 ,$99.00 ,$64.35 ,$3.50 ,$99.00 ,$32.25 ,$30.16 ,$54.45 ,$12.90 ,$27.72 ,$48.51 ,$12.90 ,$57.92 ,$12.90 ,$53.76 ,$3.50 ,$12.90 ,$53.76 ,$24.51 ,$69.30 ,$49.50 ,$79.20 ,$32.25 ,$12.90 ,$69.30 ,$12.90 ,$59.40 ,$12.90 ,$74.25 ,$54.65 ,$49.30 ,$54.65 ,$12.90 ,$54.65 ,$18.64 ,$18.64 ,$84.15 ,$32.25 ,$68.61 ,$12.90 ,$99.00 ,$54.45 ,$12.90 ,$26.04 , N/A ,$12.17 ,$11.61 ,$13.55 ,$79.20 ,$53.76 ,$27.72 ,$89.10 ,$37.62 ,$25.80 ,$12.90 ,$47.52 
ST. MARY'S HOSPITAL - DECATUR,30201061,86615,HC BORDETELLA AB-90,302,1 ,$139.00 ,$90.35 ,$3.50 ,$139.00 ,$32.98 ,$30.82 ,$76.45 ,$13.19 ,$38.92 ,$68.11 ,$13.19 ,$81.32 ,$13.19 ,$75.48 ,$3.50 ,$13.19 ,$75.48 ,$25.06 ,$97.30 ,$69.50 ,$111.20 ,$32.98 ,$13.19 ,$97.30 ,$13.19 ,$83.40 ,$13.19 ,$104.25 ,$76.73 ,$69.22 ,$76.73 ,$13.19 ,$76.73 ,$19.05 ,$19.05 ,$118.15 ,$32.98 ,$96.33 ,$13.19 ,$139.00 ,$76.45 ,$13.19 ,$36.56 , N/A ,$12.17 ,$11.61 ,$13.85 ,$111.20 ,$75.48 ,$38.92 ,$125.10 ,$52.82 ,$26.38 ,$13.19 ,$66.72 
ST. MARY'S HOSPITAL - DECATUR,30201062,86617,HC LYME DISEASE AB CONFIRM-90,302,1 ,$141.00 ,$91.65 ,$3.50 ,$141.00 ,$38.73 ,$36.22 ,$77.55 ,$15.49 ,$39.48 ,$69.09 ,$15.49 ,$82.49 ,$15.49 ,$76.56 ,$3.50 ,$15.49 ,$76.56 ,$29.43 ,$98.70 ,$70.50 ,$112.80 ,$38.73 ,$15.49 ,$98.70 ,$15.49 ,$84.60 ,$15.49 ,$105.75 ,$77.83 ,$70.22 ,$77.83 ,$15.49 ,$77.83 ,$22.37 ,$22.37 ,$119.85 ,$38.73 ,$97.71 ,$15.49 ,$141.00 ,$77.55 ,$15.49 ,$37.08 , N/A ,$12.17 ,$11.61 ,$16.26 ,$112.80 ,$76.56 ,$39.48 ,$126.90 ,$53.58 ,$30.98 ,$15.49 ,$67.68 
ST. MARY'S HOSPITAL - DECATUR,30201063,86618,HC LYME AB-90,302,1 ,$209.00 ,$135.85 ,$3.50 ,$209.00 ,$42.58 ,$39.80 ,$114.95 ,$17.03 ,$58.52 ,$102.41 ,$17.03 ,$122.27 ,$17.03 ,$113.49 ,$3.50 ,$17.03 ,$113.49 ,$32.36 ,$146.30 ,$104.50 ,$167.20 ,$42.58 ,$17.03 ,$146.30 ,$17.03 ,$125.40 ,$17.03 ,$156.75 ,$115.37 ,$104.08 ,$115.37 ,$17.03 ,$115.37 ,$24.60 ,$24.60 ,$177.65 ,$42.58 ,$144.84 ,$17.03 ,$209.00 ,$114.95 ,$17.03 ,$54.97 , N/A ,$12.17 ,$11.61 ,$17.88 ,$167.20 ,$113.49 ,$58.52 ,$188.10 ,$79.42 ,$34.06 ,$17.03 ,$100.32 
ST. MARY'S HOSPITAL - DECATUR,30201064,86619,HC BORRELIA AB-90,302,1 ,$130.00 ,$84.50 ,$3.50 ,$130.00 ,$33.45 ,$31.26 ,$71.50 ,$13.38 ,$36.40 ,$63.70 ,$13.38 ,$76.05 ,$13.38 ,$70.59 ,$3.50 ,$13.38 ,$70.59 ,$25.42 ,$91.00 ,$65.00 ,$104.00 ,$33.45 ,$13.38 ,$91.00 ,$13.38 ,$78.00 ,$13.38 ,$97.50 ,$71.76 ,$64.74 ,$71.76 ,$13.38 ,$71.76 ,$19.32 ,$19.32 ,$110.50 ,$33.45 ,$90.09 ,$13.38 ,$130.00 ,$71.50 ,$13.38 ,$34.19 , N/A ,$12.17 ,$11.61 ,$14.05 ,$104.00 ,$70.59 ,$36.40 ,$117.00 ,$49.40 ,$26.76 ,$13.38 ,$62.40 
ST. MARY'S HOSPITAL - DECATUR,30201065,86622,HC BRUCELLA AB-90,302,1 ,$109.00 ,$70.85 ,$3.50 ,$109.00 ,$22.33 ,$20.88 ,$59.95 ,$8.93 ,$30.52 ,$53.41 ,$8.93 ,$63.77 ,$8.93 ,$59.19 ,$3.50 ,$8.93 ,$59.19 ,$16.97 ,$76.30 ,$54.50 ,$87.20 ,$22.33 ,$8.93 ,$76.30 ,$8.93 ,$65.40 ,$8.93 ,$81.75 ,$60.17 ,$54.28 ,$60.17 ,$8.93 ,$60.17 ,$12.90 ,$12.90 ,$92.65 ,$22.33 ,$75.54 ,$8.93 ,$109.00 ,$59.95 ,$8.93 ,$28.67 , N/A ,$12.17 ,$11.61 ,$9.38 ,$87.20 ,$59.19 ,$30.52 ,$98.10 ,$41.42 ,$17.86 ,$8.93 ,$52.32 
ST. MARY'S HOSPITAL - DECATUR,30201066,86628,HC CANDIDA AB-90,302,1 ,$54.00 ,$35.10 ,$3.50 ,$54.00 ,$30.03 ,$28.06 ,$29.70 ,$12.01 ,$15.12 ,$26.46 ,$12.01 ,$31.59 ,$12.01 ,$29.32 ,$3.50 ,$12.01 ,$29.32 ,$22.82 ,$37.80 ,$27.00 ,$43.20 ,$30.03 ,$12.01 ,$37.80 ,$12.01 ,$32.40 ,$12.01 ,$40.50 ,$29.81 ,$26.89 ,$29.81 ,$12.01 ,$29.81 ,$17.34 ,$17.34 ,$45.90 ,$30.03 ,$37.42 ,$12.01 ,$54.00 ,$29.70 ,$12.01 ,$14.20 , N/A ,$5.63 ,$5.38 ,$12.61 ,$43.20 ,$29.32 ,$15.12 ,$48.60 ,$20.52 ,$24.02 ,$12.01 ,$25.92 
ST. MARY'S HOSPITAL - DECATUR,30201067,86631,HC CHLAMYDIA AB-90,302,1 ,$54.00 ,$35.10 ,$3.50 ,$54.00 ,$29.55 ,$27.64 ,$29.70 ,$11.82 ,$15.12 ,$26.46 ,$11.82 ,$31.59 ,$11.82 ,$29.32 ,$3.50 ,$11.82 ,$29.32 ,$22.46 ,$37.80 ,$27.00 ,$43.20 ,$29.55 ,$11.82 ,$37.80 ,$11.82 ,$32.40 ,$11.82 ,$40.50 ,$29.81 ,$26.89 ,$29.81 ,$11.82 ,$29.81 ,$17.08 ,$17.08 ,$45.90 ,$29.55 ,$37.42 ,$11.82 ,$54.00 ,$29.70 ,$11.82 ,$14.20 , N/A ,$5.63 ,$5.38 ,$12.41 ,$43.20 ,$29.32 ,$15.12 ,$48.60 ,$20.52 ,$23.64 ,$11.82 ,$25.92 
ST. MARY'S HOSPITAL - DECATUR,30201068,G0472,HC HEPATITIS C SCREEN HIGH RISK,302,1 ,$593.00 ,$385.45 ,$7.52 ,$593.00 ,$115.88 ,$38.76 ,$326.15 ,$46.35 ,$166.04 ,$290.57 ,$46.35 ,$346.91 ,$46.35 ,$322.00 ,$44.03 ,$46.35 ,$322.00 ,$88.07 ,$415.10 ,$296.50 ,$474.40 ,$115.88 ,$46.35 ,$415.10 ,$46.35 ,$355.80 ,$46.35 ,$444.75 ,$327.34 ,$295.31 ,$327.34 ,$46.35 ,$327.34 ,$60.26 ,$60.26 ,$504.05 ,$115.88 ,$410.95 ,$46.35 ,$593.00 ,$326.15 ,$46.35 ,$155.96 , N/A ,$7.88 ,$7.52 ,$48.67 ,$474.40 ,$322.00 ,$166.04 ,$533.70 ,$225.34 ,$92.70 ,$46.35 ,$284.64 
ST. MARY'S HOSPITAL - DECATUR,30201079,86711,HC AB JOHN CUNNINGHAM VIRUS-90,302,1 ,"$1,607.00 ","$1,044.55 ",$3.50 ,"$1,607.00 ",$42.23 ,$33.64 ,$883.85 ,$16.89 ,$449.96 ,$113.54 ,$16.89 ,$113.54 ,$16.89 ,$872.60 ,$3.50 ,$16.89 ,$872.60 ,$32.09 ,"$1,124.90 ",$803.50 ,"$1,285.60 ",$42.23 ,$16.89 ,"$1,124.90 ",$16.89 ,$964.20 ,$16.89 ,"$1,205.25 ",$887.06 ,$800.29 ,$887.06 ,$16.89 ,$887.06 ,$21.96 ,$21.96 ,"$1,365.95 ",$42.23 ,"$1,113.65 ",$16.89 ,"$1,607.00 ",$883.85 ,$16.89 ,$422.64 , N/A ,$7.06 ,$6.74 ,$17.73 ,"$1,285.60 ",$872.60 ,$449.96 ,"$1,446.30 ",$610.66 ,$33.78 ,$16.89 ,$771.36 
ST. MARY'S HOSPITAL - DECATUR,30201080,G0472,HC HEPATITIS C SCREEN HIGH RISK,302,1 ,$246.00 ,$159.90 ,$7.52 ,$246.00 ,$115.88 ,$38.76 ,$135.30 ,$46.35 ,$68.88 ,$120.54 ,$46.35 ,$143.91 ,$46.35 ,$133.58 ,$44.03 ,$46.35 ,$133.58 ,$88.07 ,$172.20 ,$123.00 ,$196.80 ,$115.88 ,$46.35 ,$172.20 ,$46.35 ,$147.60 ,$46.35 ,$184.50 ,$135.79 ,$122.51 ,$135.79 ,$46.35 ,$135.79 ,$60.26 ,$60.26 ,$209.10 ,$115.88 ,$170.48 ,$46.35 ,$246.00 ,$135.30 ,$46.35 ,$64.70 , N/A ,$7.88 ,$7.52 ,$48.67 ,$196.80 ,$133.58 ,$68.88 ,$221.40 ,$93.48 ,$92.70 ,$46.35 ,$118.08 
ST. MARY'S HOSPITAL - DECATUR,30201086,86703,HC HIV 1 HIV 2 AB SGL ASSAY-90,302,1 ,$12.00 ,$7.80 ,$3.16 ,$30.00 ,$30.00 ,$12.00 ,$6.60 ,$12.00 ,$3.36 ,$5.88 ,$12.00 ,$7.02 ,$12.00 ,$6.52 ,$3.50 ,$12.00 ,$6.52 ,$12.00 ,$8.40 ,$6.00 ,$9.60 ,$30.00 ,$12.00 ,$8.40 ,$12.00 ,$7.20 ,$12.00 ,$9.00 ,$6.62 ,$5.98 ,$6.62 ,$12.00 ,$6.62 ,$12.00 ,$12.00 ,$10.20 ,$12.00 ,$8.32 ,$12.00 ,$12.00 ,$6.60 ,$12.00 ,$3.16 , N/A ,$7.06 ,$6.74 ,$12.60 ,$9.60 ,$6.52 ,$3.36 ,$10.80 ,$4.56 ,$12.00 ,$12.00 ,$5.76 
ST. MARY'S HOSPITAL - DECATUR,30201088,86008,HC ALLERGEN IGE QN/SEMI-QN RECOMB/COMP EA-90,302,1 ,$27.00 ,$17.55 ,$3.50 ,$44.83 ,$44.83 ,$27.00 ,$14.85 ,$17.93 ,$7.56 ,$13.23 ,$17.93 ,$15.80 ,$17.93 ,$14.66 ,$3.50 ,$17.93 ,$14.66 ,$27.00 ,$18.90 ,$13.50 ,$21.60 ,$44.83 ,$17.93 ,$18.90 ,$17.93 ,$16.20 ,$17.93 ,$20.25 ,$14.90 ,$13.45 ,$14.90 ,$17.93 ,$14.90 ,$25.91 ,$25.91 ,$22.95 ,$27.00 ,$18.71 ,$17.93 ,$27.00 ,$14.85 ,$17.93 ,$7.10 , N/A ,$7.06 ,$6.74 ,$18.83 ,$21.60 ,$14.66 ,$7.56 ,$24.30 ,$10.26 ,$27.00 ,$17.93 ,$12.96 
ST. MARY'S HOSPITAL - DECATUR,30201091,86794,HC ZIKA VIRUS AB IGM-90,302,1 ,$356.00 ,$231.40 ,$3.50 ,$356.00 ,$42.13 ,$35.36 ,$195.80 ,$16.85 ,$99.68 ,$132.90 ,$16.85 ,$132.90 ,$16.85 ,$193.31 ,$3.50 ,$16.85 ,$193.31 ,$32.02 ,$249.20 ,$178.00 ,$284.80 ,$42.13 ,$16.85 ,$249.20 ,$16.85 ,$213.60 ,$16.85 ,$267.00 ,$196.51 ,$177.29 ,$196.51 ,$16.85 ,$196.51 ,$24.34 ,$24.34 ,$302.60 ,$42.13 ,$246.71 ,$16.85 ,$356.00 ,$195.80 ,$16.85 ,$93.63 , N/A ,$7.06 ,$6.74 ,$17.69 ,$284.80 ,$193.31 ,$99.68 ,$320.40 ,$135.28 ,$33.70 ,$16.85 ,$170.88 
ST. MARY'S HOSPITAL - DECATUR,30201092,86593,HC SYPHILIS VDRL RPR QN-90,302,1 ,$88.00 ,$57.20 ,$3.50 ,$88.00 ,$11.00 ,$10.28 ,$48.40 ,$4.40 ,$24.64 ,$34.80 ,$4.40 ,$34.80 ,$4.40 ,$47.78 ,$3.50 ,$4.40 ,$47.78 ,$8.36 ,$61.60 ,$44.00 ,$70.40 ,$11.00 ,$4.40 ,$61.60 ,$4.40 ,$52.80 ,$4.40 ,$66.00 ,$48.58 ,$43.82 ,$48.58 ,$4.40 ,$48.58 ,$6.36 ,$6.36 ,$74.80 ,$11.00 ,$60.98 ,$4.40 ,$88.00 ,$48.40 ,$4.40 ,$23.14 , N/A ,$7.06 ,$6.74 ,$4.62 ,$70.40 ,$47.78 ,$24.64 ,$79.20 ,$33.44 ,$8.80 ,$4.40 ,$42.24 
ST. MARY'S HOSPITAL - DECATUR,30201093,86003,HC ALLERGEN IGE QN EA,302,1 ,$112.00 ,$72.80 ,$3.50 ,$112.00 ,$13.05 ,$12.18 ,$61.60 ,$5.22 ,$31.36 ,$41.19 ,$5.22 ,$41.19 ,$5.22 ,$60.82 ,$3.50 ,$5.22 ,$60.82 ,$9.92 ,$78.40 ,$56.00 ,$89.60 ,$13.05 ,$5.22 ,$78.40 ,$5.22 ,$67.20 ,$5.22 ,$84.00 ,$61.82 ,$55.78 ,$61.82 ,$5.22 ,$61.82 ,$7.54 ,$7.54 ,$95.20 ,$13.05 ,$77.62 ,$5.22 ,$112.00 ,$61.60 ,$5.22 ,$29.46 , N/A ,$7.06 ,$6.74 ,$5.48 ,$89.60 ,$60.82 ,$31.36 ,$100.80 ,$42.56 ,$10.44 ,$5.22 ,$53.76 
ST. MARY'S HOSPITAL - DECATUR,30201094,86038,HC ANA SCREEN,302,1 ,$246.00 ,$159.90 ,$3.50 ,$246.00 ,$30.23 ,$28.26 ,$135.30 ,$12.09 ,$68.88 ,$95.35 ,$12.09 ,$95.35 ,$12.09 ,$133.58 ,$3.50 ,$12.09 ,$133.58 ,$22.97 ,$172.20 ,$123.00 ,$196.80 ,$30.23 ,$12.09 ,$172.20 ,$12.09 ,$147.60 ,$12.09 ,$184.50 ,$135.79 ,$122.51 ,$135.79 ,$12.09 ,$135.79 ,$17.46 ,$17.46 ,$209.10 ,$30.23 ,$170.48 ,$12.09 ,$246.00 ,$135.30 ,$12.09 ,$64.70 , N/A ,$7.06 ,$6.74 ,$12.69 ,$196.80 ,$133.58 ,$68.88 ,$221.40 ,$93.48 ,$24.18 ,$12.09 ,$118.08 
ST. MARY'S HOSPITAL - DECATUR,30201097,86147,HC CARDIOLIPIN AB EA,302,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$63.63 ,$59.44 ,$89.10 ,$25.45 ,$45.36 ,$79.38 ,$25.45 ,$94.77 ,$25.45 ,$87.97 ,$3.50 ,$25.45 ,$87.97 ,$48.36 ,$113.40 ,$81.00 ,$129.60 ,$63.63 ,$25.45 ,$113.40 ,$25.45 ,$97.20 ,$25.45 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$25.45 ,$89.42 ,$36.76 ,$36.76 ,$137.70 ,$63.63 ,$112.27 ,$25.45 ,$162.00 ,$89.10 ,$25.45 ,$42.61 , N/A ,$12.17 ,$11.61 ,$26.72 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$50.90 ,$25.45 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30201098,86225,HC DNA DOUBLE STRAND AB,302,1 ,$142.00 ,$92.30 ,$3.50 ,$142.00 ,$34.35 ,$32.10 ,$78.10 ,$13.74 ,$39.76 ,$69.58 ,$13.74 ,$83.07 ,$13.74 ,$77.11 ,$3.50 ,$13.74 ,$77.11 ,$26.11 ,$99.40 ,$71.00 ,$113.60 ,$34.35 ,$13.74 ,$99.40 ,$13.74 ,$85.20 ,$13.74 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$13.74 ,$78.38 ,$19.85 ,$19.85 ,$120.70 ,$34.35 ,$98.41 ,$13.74 ,$142.00 ,$78.10 ,$13.74 ,$37.35 , N/A ,$7.06 ,$6.74 ,$14.43 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$27.48 ,$13.74 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30201099,86235,HC ENA AB,302,1 ,$161.00 ,$104.65 ,$3.50 ,$161.00 ,$44.83 ,$41.42 ,$88.55 ,$17.93 ,$45.08 ,$78.89 ,$17.93 ,$94.19 ,$17.93 ,$87.42 ,$3.50 ,$17.93 ,$87.42 ,$34.07 ,$112.70 ,$80.50 ,$128.80 ,$44.83 ,$17.93 ,$112.70 ,$17.93 ,$96.60 ,$17.93 ,$120.75 ,$88.87 ,$80.18 ,$88.87 ,$17.93 ,$88.87 ,$25.91 ,$25.91 ,$136.85 ,$44.83 ,$111.57 ,$17.93 ,$161.00 ,$88.55 ,$17.93 ,$42.34 , N/A ,$12.17 ,$11.61 ,$18.83 ,$128.80 ,$87.42 ,$45.08 ,$144.90 ,$61.18 ,$35.86 ,$17.93 ,$77.28 
ST. MARY'S HOSPITAL - DECATUR,30201102,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,$240.00 ,$156.00 ,$11.61 ,$240.00 ,$55.85 ,$52.20 ,$132.00 ,$22.34 ,$67.20 ,$117.60 ,$22.34 ,$140.40 ,$22.34 ,$130.32 ,$17.63 ,$22.34 ,$130.32 ,$42.45 ,$168.00 ,$120.00 ,$192.00 ,$55.85 ,$22.34 ,$168.00 ,$22.34 ,$144.00 ,$22.34 ,$180.00 ,$132.48 ,$119.52 ,$132.48 ,$22.34 ,$132.48 ,$32.28 ,$32.28 ,$204.00 ,$55.85 ,$166.32 ,$22.34 ,$240.00 ,$132.00 ,$22.34 ,$63.12 , N/A ,$12.17 ,$11.61 ,$23.46 ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 ,$44.68 ,$22.34 ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,30201103,86335,HC IMMUNOFIX ELECTRO OTH,302,1 ,$138.00 ,$89.70 ,$11.61 ,$138.00 ,$73.38 ,$68.58 ,$75.90 ,$29.35 ,$38.64 ,$67.62 ,$29.35 ,$80.73 ,$29.35 ,$74.93 ,$23.15 ,$29.35 ,$74.93 ,$55.77 ,$96.60 ,$69.00 ,$110.40 ,$73.38 ,$29.35 ,$96.60 ,$29.35 ,$82.80 ,$29.35 ,$103.50 ,$76.18 ,$68.72 ,$76.18 ,$29.35 ,$76.18 ,$42.39 ,$42.39 ,$117.30 ,$73.38 ,$95.63 ,$29.35 ,$138.00 ,$75.90 ,$29.35 ,$36.29 , N/A ,$12.17 ,$11.61 ,$30.82 ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$58.70 ,$29.35 ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,30201106,86376,HC MICROSOMAL AB,302,1 ,$160.00 ,$104.00 ,$3.50 ,$160.00 ,$36.38 ,$33.98 ,$88.00 ,$14.55 ,$44.80 ,$78.40 ,$14.55 ,$93.60 ,$14.55 ,$86.88 ,$3.50 ,$14.55 ,$86.88 ,$27.65 ,$112.00 ,$80.00 ,$128.00 ,$36.38 ,$14.55 ,$112.00 ,$14.55 ,$96.00 ,$14.55 ,$120.00 ,$88.32 ,$79.68 ,$88.32 ,$14.55 ,$88.32 ,$21.02 ,$21.02 ,$136.00 ,$36.38 ,$110.88 ,$14.55 ,$160.00 ,$88.00 ,$14.55 ,$42.08 , N/A ,$18.45 ,$17.61 ,$15.28 ,$128.00 ,$86.88 ,$44.80 ,$144.00 ,$60.80 ,$29.10 ,$14.55 ,$76.80 
ST. MARY'S HOSPITAL - DECATUR,30201117,86644,HC CMV AB,302,1 ,$243.00 ,$157.95 ,$3.50 ,$243.00 ,$35.98 ,$33.64 ,$133.65 ,$14.39 ,$68.04 ,$113.54 ,$14.39 ,$113.54 ,$14.39 ,$131.95 ,$3.50 ,$14.39 ,$131.95 ,$27.34 ,$170.10 ,$121.50 ,$194.40 ,$35.98 ,$14.39 ,$170.10 ,$14.39 ,$145.80 ,$14.39 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$14.39 ,$134.14 ,$20.79 ,$20.79 ,$206.55 ,$35.98 ,$168.40 ,$14.39 ,$243.00 ,$133.65 ,$14.39 ,$63.91 , N/A ,$12.17 ,$11.61 ,$15.11 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$28.78 ,$14.39 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30201118,86645,HC CMV AB IGM,302,1 ,$243.00 ,$157.95 ,$3.50 ,$243.00 ,$42.13 ,$39.36 ,$133.65 ,$16.85 ,$68.04 ,$119.07 ,$16.85 ,$132.90 ,$16.85 ,$131.95 ,$3.50 ,$16.85 ,$131.95 ,$32.02 ,$170.10 ,$121.50 ,$194.40 ,$42.13 ,$16.85 ,$170.10 ,$16.85 ,$145.80 ,$16.85 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$16.85 ,$134.14 ,$24.34 ,$24.34 ,$206.55 ,$42.13 ,$168.40 ,$16.85 ,$243.00 ,$133.65 ,$16.85 ,$63.91 , N/A ,$12.17 ,$11.61 ,$17.69 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$33.70 ,$16.85 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30201119,86677,HC H PYLORI AB,302,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$42.13 ,$33.92 ,$106.15 ,$16.85 ,$54.04 ,$94.57 ,$16.85 ,$112.91 ,$16.85 ,$104.80 ,$3.50 ,$16.85 ,$104.80 ,$32.02 ,$135.10 ,$96.50 ,$154.40 ,$42.13 ,$16.85 ,$135.10 ,$16.85 ,$115.80 ,$16.85 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$16.85 ,$106.54 ,$21.91 ,$21.91 ,$164.05 ,$42.13 ,$133.75 ,$16.85 ,$193.00 ,$106.15 ,$16.85 ,$50.76 , N/A ,$12.17 ,$11.61 ,$17.69 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$33.70 ,$16.85 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30201121,86704,HC HEP CORE AB,302,1 ,$155.00 ,$100.75 ,$3.50 ,$155.00 ,$30.13 ,$28.16 ,$85.25 ,$12.05 ,$43.40 ,$75.95 ,$12.05 ,$90.68 ,$12.05 ,$84.17 ,$3.50 ,$12.05 ,$84.17 ,$22.90 ,$108.50 ,$77.50 ,$124.00 ,$30.13 ,$12.05 ,$108.50 ,$12.05 ,$93.00 ,$12.05 ,$116.25 ,$85.56 ,$77.19 ,$85.56 ,$12.05 ,$85.56 ,$17.41 ,$17.41 ,$131.75 ,$30.13 ,$107.42 ,$12.05 ,$155.00 ,$85.25 ,$12.05 ,$40.77 , N/A ,$7.06 ,$6.74 ,$12.65 ,$124.00 ,$84.17 ,$43.40 ,$139.50 ,$58.90 ,$24.10 ,$12.05 ,$74.40 
ST. MARY'S HOSPITAL - DECATUR,30201130,86787,HC VARICELLA ZOSTER AB,302,1 ,$176.00 ,$114.40 ,$3.50 ,$176.00 ,$32.20 ,$30.10 ,$96.80 ,$12.88 ,$49.28 ,$86.24 ,$12.88 ,$101.64 ,$12.88 ,$95.57 ,$3.50 ,$12.88 ,$95.57 ,$24.47 ,$123.20 ,$88.00 ,$140.80 ,$32.20 ,$12.88 ,$123.20 ,$12.88 ,$105.60 ,$12.88 ,$132.00 ,$97.15 ,$87.65 ,$97.15 ,$12.88 ,$97.15 ,$18.60 ,$18.60 ,$149.60 ,$32.20 ,$121.97 ,$12.88 ,$176.00 ,$96.80 ,$12.88 ,$46.29 , N/A ,$7.06 ,$6.74 ,$13.52 ,$140.80 ,$95.57 ,$49.28 ,$158.40 ,$66.88 ,$25.76 ,$12.88 ,$84.48 
ST. MARY'S HOSPITAL - DECATUR,30201131,86800,HC THYROGLOBULIN AB,302,1 ,$176.00 ,$114.40 ,$3.50 ,$176.00 ,$39.78 ,$37.16 ,$96.80 ,$15.91 ,$49.28 ,$86.24 ,$15.91 ,$102.96 ,$15.91 ,$95.57 ,$3.50 ,$15.91 ,$95.57 ,$30.23 ,$123.20 ,$88.00 ,$140.80 ,$39.78 ,$15.91 ,$123.20 ,$15.91 ,$105.60 ,$15.91 ,$132.00 ,$97.15 ,$87.65 ,$97.15 ,$15.91 ,$97.15 ,$22.97 ,$22.97 ,$149.60 ,$39.78 ,$121.97 ,$15.91 ,$176.00 ,$96.80 ,$15.91 ,$46.29 , N/A ,$18.45 ,$17.61 ,$16.71 ,$140.80 ,$95.57 ,$49.28 ,$158.40 ,$66.88 ,$31.82 ,$15.91 ,$84.48 
ST. MARY'S HOSPITAL - DECATUR,30201163,87427,HC SHIGA-LIKE TOXIN -90,302,1 ,$123.00 ,$79.95 ,$3.50 ,$123.00 ,$29.95 ,$28.04 ,$67.65 ,$11.98 ,$34.44 ,$60.27 ,$11.98 ,$71.96 ,$11.98 ,$66.79 ,$3.50 ,$11.98 ,$66.79 ,$22.76 ,$86.10 ,$61.50 ,$98.40 ,$29.95 ,$11.98 ,$86.10 ,$11.98 ,$73.80 ,$11.98 ,$92.25 ,$67.90 ,$61.25 ,$67.90 ,$11.98 ,$67.90 ,$17.32 ,$17.32 ,$104.55 ,$29.95 ,$85.24 ,$11.98 ,$123.00 ,$67.65 ,$11.98 ,$32.35 , N/A ,$7.06 ,$6.74 ,$12.58 ,$98.40 ,$66.79 ,$34.44 ,$110.70 ,$46.74 ,$23.96 ,$11.98 ,$59.04 
ST. MARY'S HOSPITAL - DECATUR,30201180,86940,HC HEMOLYSINS AGGLUTININS AUTO- 90,302,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$21.93 ,$19.16 ,$80.30 ,$8.77 ,$40.88 ,$64.68 ,$8.77 ,$64.68 ,$8.77 ,$79.28 ,$3.50 ,$8.77 ,$79.28 ,$16.66 ,$102.20 ,$73.00 ,$116.80 ,$21.93 ,$8.77 ,$102.20 ,$8.77 ,$87.60 ,$8.77 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$8.77 ,$80.59 ,$11.84 ,$11.84 ,$124.10 ,$21.93 ,$101.18 ,$8.77 ,$146.00 ,$80.30 ,$8.77 ,$38.40 , N/A ,$12.17 ,$11.61 ,$9.21 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$17.54 ,$8.77 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30201181,86328,HC IA NFCT AB SARSCOV2- 90,302,1 ,$150.00 ,$97.50 ,$6.74 ,$150.00 ,$113.20 ,$90.46 ,$82.50 ,$45.28 ,$42.00 ,$70.50 ,$45.28 ,$81.00 ,$45.28 ,$81.45 ,$60.00 ,$45.28 ,$81.45 ,$86.03 ,$105.00 ,$75.00 ,$120.00 ,$113.20 ,$45.28 ,$105.00 ,$45.28 ,$90.00 ,$45.28 ,$112.50 ,$82.80 ,$74.70 ,$82.80 ,$45.28 ,$82.80 ,$105.00 ,$105.00 ,$127.50 ,$113.20 ,$103.95 ,$45.28 ,$150.00 ,$82.50 ,$45.28 ,$39.45 , N/A ,$7.06 ,$6.74 ,$47.54 ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$90.56 ,$45.28 ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,30240178,86341,HC ISLET CELL AB-REF,302,1 ,$16.00 ,$10.40 ,$3.50 ,$40.00 ,$40.00 ,$16.00 ,$8.80 ,$16.00 ,$4.48 ,$7.84 ,$16.00 ,$9.36 ,$16.00 ,$8.69 ,$3.50 ,$16.00 ,$8.69 ,$16.00 ,$11.20 ,$8.00 ,$12.80 ,$40.00 ,$16.00 ,$11.20 ,$16.00 ,$9.60 ,$16.00 ,$12.00 ,$8.83 ,$7.97 ,$8.83 ,$16.00 ,$8.83 ,$16.00 ,$16.00 ,$13.60 ,$16.00 ,$11.09 ,$16.00 ,$16.00 ,$8.80 ,$16.00 ,$4.21 , N/A ,$12.17 ,$11.61 ,$16.80 ,$12.80 ,$8.69 ,$4.48 ,$14.40 ,$6.08 ,$16.00 ,$16.00 ,$7.68 
ST. MARY'S HOSPITAL - DECATUR,30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$136.00 ,$88.40 ,$3.50 ,$136.00 ,$9.50 ,$8.04 ,$74.80 ,$3.80 ,$38.08 ,$36.67 ,$3.80 ,$36.67 ,$3.80 ,$73.85 ,$3.50 ,$3.80 ,$73.85 ,$7.22 ,$95.20 ,$68.00 ,$108.80 ,$9.50 ,$3.80 ,$95.20 ,$3.80 ,$81.60 ,$3.80 ,$102.00 ,$75.07 ,$67.73 ,$75.07 ,$3.80 ,$75.07 ,$4.97 ,$4.97 ,$115.60 ,$9.50 ,$94.25 ,$3.80 ,$136.00 ,$74.80 ,$3.80 ,$35.77 , N/A ,$4.90 ,$4.67 ,$3.99 ,$108.80 ,$73.85 ,$38.08 ,$122.40 ,$51.68 ,$7.60 ,$3.80 ,$65.28 
ST. MARY'S HOSPITAL - DECATUR,30500104,85014,HC HEMATOCRIT,305,1 ,$75.00 ,$48.75 ,$2.37 ,$75.00 ,$5.93 ,$5.54 ,$41.25 ,$2.37 ,$21.00 ,$25.36 ,$2.37 ,$25.36 ,$2.37 ,$40.73 ,$3.50 ,$2.37 ,$40.73 ,$4.50 ,$52.50 ,$37.50 ,$60.00 ,$5.93 ,$2.37 ,$52.50 ,$2.37 ,$45.00 ,$2.37 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$2.37 ,$41.40 ,$3.42 ,$3.42 ,$63.75 ,$5.93 ,$51.98 ,$2.37 ,$2.37 ,$41.25 ,$2.37 ,$19.73 , N/A ,$4.90 ,$4.67 ,$2.49 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$4.74 ,$2.37 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,30500106,85018,HC HGB,305,1 ,$75.00 ,$48.75 ,$2.37 ,$75.00 ,$5.93 ,$5.54 ,$41.25 ,$2.37 ,$21.00 ,$25.36 ,$2.37 ,$25.36 ,$2.37 ,$40.73 ,$3.50 ,$2.37 ,$40.73 ,$4.50 ,$52.50 ,$37.50 ,$60.00 ,$5.93 ,$2.37 ,$52.50 ,$2.37 ,$45.00 ,$2.37 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$2.37 ,$41.40 ,$3.42 ,$3.42 ,$63.75 ,$5.93 ,$51.98 ,$2.37 ,$2.37 ,$41.25 ,$2.37 ,$19.73 , N/A ,$4.90 ,$4.67 ,$2.49 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$4.74 ,$2.37 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$130.00 ,$84.50 ,$3.50 ,$130.00 ,$19.43 ,$18.18 ,$71.50 ,$7.77 ,$36.40 ,$63.70 ,$7.77 ,$76.05 ,$7.77 ,$70.59 ,$3.50 ,$7.77 ,$70.59 ,$14.76 ,$91.00 ,$65.00 ,$104.00 ,$19.43 ,$7.77 ,$91.00 ,$7.77 ,$78.00 ,$7.77 ,$97.50 ,$71.76 ,$64.74 ,$71.76 ,$7.77 ,$71.76 ,$11.22 ,$11.22 ,$110.50 ,$19.43 ,$90.09 ,$7.77 ,$7.77 ,$71.50 ,$7.77 ,$34.19 , N/A ,$4.90 ,$4.67 ,$8.16 ,$104.00 ,$70.59 ,$36.40 ,$117.00 ,$49.40 ,$15.54 ,$7.77 ,$62.40 
ST. MARY'S HOSPITAL - DECATUR,30500108,85027,HC CBC W/O DIFF,305,1 ,$132.00 ,$85.80 ,$3.50 ,$132.00 ,$16.18 ,$15.12 ,$72.60 ,$6.47 ,$36.96 ,$64.68 ,$6.47 ,$69.01 ,$6.47 ,$71.68 ,$3.50 ,$6.47 ,$71.68 ,$12.29 ,$92.40 ,$66.00 ,$105.60 ,$16.18 ,$6.47 ,$92.40 ,$6.47 ,$79.20 ,$6.47 ,$99.00 ,$72.86 ,$65.74 ,$72.86 ,$6.47 ,$72.86 ,$9.33 ,$9.33 ,$112.20 ,$16.18 ,$91.48 ,$6.47 ,$6.47 ,$72.60 ,$6.47 ,$34.72 , N/A ,$4.90 ,$4.67 ,$6.79 ,$105.60 ,$71.68 ,$36.96 ,$118.80 ,$50.16 ,$12.94 ,$6.47 ,$63.36 
ST. MARY'S HOSPITAL - DECATUR,30500111,85045,HC RETIC COUNT AUTO,305,1 ,$128.00 ,$83.20 ,$3.50 ,$128.00 ,$9.98 ,$9.36 ,$70.40 ,$3.99 ,$35.84 ,$42.66 ,$3.99 ,$42.66 ,$3.99 ,$69.50 ,$3.50 ,$3.99 ,$69.50 ,$7.58 ,$89.60 ,$64.00 ,$102.40 ,$9.98 ,$3.99 ,$89.60 ,$3.99 ,$76.80 ,$3.99 ,$96.00 ,$70.66 ,$63.74 ,$70.66 ,$3.99 ,$70.66 ,$5.77 ,$5.77 ,$108.80 ,$9.98 ,$88.70 ,$3.99 ,$128.00 ,$70.40 ,$3.99 ,$33.66 , N/A ,$4.90 ,$4.67 ,$4.19 ,$102.40 ,$69.50 ,$35.84 ,$115.20 ,$48.64 ,$7.98 ,$3.99 ,$61.44 
ST. MARY'S HOSPITAL - DECATUR,30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$98.00 ,$63.70 ,$2.54 ,$98.00 ,$6.35 ,$5.94 ,$53.90 ,$2.54 ,$27.44 ,$27.03 ,$2.54 ,$27.03 ,$2.54 ,$53.21 ,$3.50 ,$2.54 ,$53.21 ,$4.83 ,$68.60 ,$49.00 ,$78.40 ,$6.35 ,$2.54 ,$68.60 ,$2.54 ,$58.80 ,$2.54 ,$73.50 ,$54.10 ,$48.80 ,$54.10 ,$2.54 ,$54.10 ,$3.67 ,$3.67 ,$83.30 ,$6.35 ,$67.91 ,$2.54 ,$98.00 ,$53.90 ,$2.54 ,$25.77 , N/A ,$4.90 ,$4.67 ,$2.67 ,$78.40 ,$53.21 ,$27.44 ,$88.20 ,$37.24 ,$5.08 ,$2.54 ,$47.04 
ST. MARY'S HOSPITAL - DECATUR,30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$185.00 ,$120.25 ,$3.50 ,$185.00 ,$11.20 ,$10.46 ,$101.75 ,$4.48 ,$51.80 ,$47.87 ,$4.48 ,$47.87 ,$4.48 ,$100.46 ,$3.50 ,$4.48 ,$100.46 ,$8.51 ,$129.50 ,$92.50 ,$148.00 ,$11.20 ,$4.48 ,$129.50 ,$4.48 ,$111.00 ,$4.48 ,$138.75 ,$102.12 ,$92.13 ,$102.12 ,$4.48 ,$102.12 ,$6.46 ,$6.46 ,$157.25 ,$11.20 ,$128.21 ,$4.48 ,$185.00 ,$101.75 ,$4.48 ,$48.66 , N/A ,$4.90 ,$4.67 ,$4.70 ,$148.00 ,$100.46 ,$51.80 ,$166.50 ,$70.30 ,$8.96 ,$4.48 ,$88.80 
ST. MARY'S HOSPITAL - DECATUR,30500115,85060,HC BLOOD SMEAR INTERP,305,1 ,$333.00 ,$216.45 ,$32.12 ,$333.00 , N/A ,$40.44 ,$183.15 , N/A ,$93.24 ,$163.17 , N/A ,$194.81 , N/A ,$180.82 ,$38.77 , N/A ,$180.82 , N/A ,$233.10 ,$166.50 ,$266.40 , N/A , N/A ,$233.10 , N/A ,$199.80 , N/A ,$249.75 ,$183.82 ,$165.83 ,$183.82 , N/A ,$183.82 ,$32.12 ,$32.12 ,$283.05 , N/A ,$230.77 , N/A ,$333.00 ,$183.15 , N/A ,$87.58 , N/A , N/A , N/A , N/A ,$266.40 ,$180.82 ,$93.24 ,$299.70 ,$126.54 ,$49.54 , N/A ,$159.84 
ST. MARY'S HOSPITAL - DECATUR,30500116,85097,HC BONE MARROW SMEAR INTERP,305,1 ,$333.00 ,$216.45 ,$21.49 ,"$1,550.85 ","$1,550.85 ",$79.78 ,$183.15 ,$620.34 ,$93.24 ,$163.17 ,$620.34 ,$194.81 ,$333.00 ,$180.82 ,$78.92 ,$333.00 ,$180.82 ,$333.00 ,$233.10 ,$166.50 ,$266.40 ,"$1,550.85 ",$620.34 ,$233.10 ,$620.34 ,$199.80 ,$620.34 ,$249.75 ,$183.82 ,$165.83 ,$183.82 ,$620.34 ,$183.82 ,$95.10 ,$95.10 ,$283.05 ,$333.00 ,$230.77 ,$620.34 ,$333.00 ,$183.15 ,$620.34 ,$87.58 , N/A ,$22.52 ,$21.49 ,$651.36 ,$266.40 ,$180.82 ,$93.24 ,$299.70 ,$126.54 ,$333.00 ,$620.34 ,$159.84 
ST. MARY'S HOSPITAL - DECATUR,30500168,85347,HC ACTIVATED CLOTTING TIME,305,1 ,$177.00 ,$115.05 ,$2.73 ,$177.00 ,$10.70 ,$8.34 ,$97.35 ,$4.28 ,$49.56 ,$33.62 ,$4.28 ,$33.62 ,$4.28 ,$96.11 ,$3.50 ,$4.28 ,$96.11 ,$8.13 ,$123.90 ,$88.50 ,$141.60 ,$10.70 ,$4.28 ,$123.90 ,$4.28 ,$106.20 ,$4.28 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$4.28 ,$97.70 ,$6.15 ,$6.15 ,$150.45 ,$10.70 ,$122.66 ,$4.28 ,$177.00 ,$97.35 ,$4.28 ,$46.55 , N/A ,$2.86 ,$2.73 ,$4.49 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$8.56 ,$4.28 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30500174,85362,HC FDP/FSP AGGLUT SQ,305,1 ,$229.00 ,$148.85 ,$2.73 ,$229.00 ,$17.23 ,$16.10 ,$125.95 ,$6.89 ,$64.12 ,$54.36 ,$6.89 ,$54.36 ,$6.89 ,$124.35 ,$3.50 ,$6.89 ,$124.35 ,$13.09 ,$160.30 ,$114.50 ,$183.20 ,$17.23 ,$6.89 ,$160.30 ,$6.89 ,$137.40 ,$6.89 ,$171.75 ,$126.41 ,$114.04 ,$126.41 ,$6.89 ,$126.41 ,$9.95 ,$9.95 ,$194.65 ,$17.23 ,$158.70 ,$6.89 ,$229.00 ,$125.95 ,$6.89 ,$60.23 , N/A ,$2.86 ,$2.73 ,$7.23 ,$183.20 ,$124.35 ,$64.12 ,$206.10 ,$87.02 ,$13.78 ,$6.89 ,$109.92 
ST. MARY'S HOSPITAL - DECATUR,30500175,85379,HC D DIMER QN,305,1 ,$227.00 ,$147.55 ,$3.50 ,$227.00 ,$25.45 ,$23.78 ,$124.85 ,$10.18 ,$63.56 ,$80.21 ,$10.18 ,$80.21 ,$10.18 ,$123.26 ,$3.50 ,$10.18 ,$123.26 ,$19.34 ,$158.90 ,$113.50 ,$181.60 ,$25.45 ,$10.18 ,$158.90 ,$10.18 ,$136.20 ,$10.18 ,$170.25 ,$125.30 ,$113.05 ,$125.30 ,$10.18 ,$125.30 ,$14.70 ,$14.70 ,$192.95 ,$25.45 ,$157.31 ,$10.18 ,$227.00 ,$124.85 ,$10.18 ,$59.70 , N/A ,$8.49 ,$8.11 ,$10.69 ,$181.60 ,$123.26 ,$63.56 ,$204.30 ,$86.26 ,$20.36 ,$10.18 ,$108.96 
ST. MARY'S HOSPITAL - DECATUR,30500176,85384,HC FIBRINOGEN,305,1 ,$227.00 ,$147.55 ,$2.73 ,$227.00 ,$24.30 ,$19.86 ,$124.85 ,$9.72 ,$63.56 ,$67.04 ,$9.72 ,$67.04 ,$9.72 ,$123.26 ,$3.50 ,$9.72 ,$123.26 ,$18.47 ,$158.90 ,$113.50 ,$181.60 ,$24.30 ,$9.72 ,$158.90 ,$9.72 ,$136.20 ,$9.72 ,$170.25 ,$125.30 ,$113.05 ,$125.30 ,$9.72 ,$125.30 ,$12.64 ,$12.64 ,$192.95 ,$24.30 ,$157.31 ,$9.72 ,$227.00 ,$124.85 ,$9.72 ,$59.70 , N/A ,$2.86 ,$2.73 ,$10.21 ,$181.60 ,$123.26 ,$63.56 ,$204.30 ,$86.26 ,$19.44 ,$9.72 ,$108.96 
ST. MARY'S HOSPITAL - DECATUR,30500185,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$311.00 ,$202.15 ,$3.50 ,$311.00 ,$19.33 ,$8.34 ,$171.05 ,$7.73 ,$87.08 ,$61.04 ,$7.73 ,$61.04 ,$7.73 ,$168.87 ,$3.50 ,$7.73 ,$168.87 ,$14.69 ,$217.70 ,$155.50 ,$248.80 ,$19.33 ,$7.73 ,$217.70 ,$7.73 ,$186.60 ,$7.73 ,$233.25 ,$171.67 ,$154.88 ,$171.67 ,$7.73 ,$171.67 ,$11.17 ,$11.17 ,$264.35 ,$19.33 ,$215.52 ,$7.73 ,$311.00 ,$171.05 ,$7.73 ,$81.79 , N/A ,$7.45 ,$7.11 ,$8.12 ,$248.80 ,$168.87 ,$87.08 ,$279.90 ,$118.18 ,$15.46 ,$7.73 ,$149.28 
ST. MARY'S HOSPITAL - DECATUR,30500187,85520,HC HEPARIN ASSAY,305,1 ,$389.00 ,$252.85 ,$3.50 ,$389.00 ,$32.73 ,$30.60 ,$213.95 ,$13.09 ,$108.92 ,$103.22 ,$13.09 ,$103.22 ,$13.09 ,$211.23 ,$3.50 ,$13.09 ,$211.23 ,$24.87 ,$272.30 ,$194.50 ,$311.20 ,$32.73 ,$13.09 ,$272.30 ,$13.09 ,$233.40 ,$13.09 ,$291.75 ,$214.73 ,$193.72 ,$214.73 ,$13.09 ,$214.73 ,$18.92 ,$18.92 ,$330.65 ,$32.73 ,$269.58 ,$13.09 ,$389.00 ,$213.95 ,$13.09 ,$102.31 , N/A ,$8.49 ,$8.11 ,$13.74 ,$311.20 ,$211.23 ,$108.92 ,$350.10 ,$147.82 ,$26.18 ,$13.09 ,$186.72 
ST. MARY'S HOSPITAL - DECATUR,30500192,85576,HC PLATELET AGGREGATION EA,305,1 ,$232.00 ,$150.80 ,$8.11 ,$232.00 ,$62.28 ,$50.20 ,$127.60 ,$24.91 ,$64.96 ,$113.68 ,$24.91 ,$135.72 ,$24.91 ,$125.98 ,$23.66 ,$24.91 ,$125.98 ,$47.33 ,$162.40 ,$116.00 ,$185.60 ,$62.28 ,$24.91 ,$162.40 ,$24.91 ,$139.20 ,$24.91 ,$174.00 ,$128.06 ,$115.54 ,$128.06 ,$24.91 ,$128.06 ,$32.38 ,$32.38 ,$197.20 ,$62.28 ,$160.78 ,$24.91 ,$232.00 ,$127.60 ,$24.91 ,$61.02 , N/A ,$8.49 ,$8.11 ,$26.16 ,$185.60 ,$125.98 ,$64.96 ,$208.80 ,$88.16 ,$49.82 ,$24.91 ,$111.36 
ST. MARY'S HOSPITAL - DECATUR,30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$136.00 ,$88.40 ,$2.73 ,$136.00 ,$10.73 ,$9.18 ,$74.80 ,$4.29 ,$38.08 ,$41.97 ,$4.29 ,$41.97 ,$4.29 ,$73.85 ,$3.50 ,$4.29 ,$73.85 ,$8.15 ,$95.20 ,$68.00 ,$108.80 ,$10.73 ,$4.29 ,$95.20 ,$4.29 ,$81.60 ,$4.29 ,$102.00 ,$75.07 ,$67.73 ,$75.07 ,$4.29 ,$75.07 ,$5.68 ,$5.68 ,$115.60 ,$10.73 ,$94.25 ,$4.29 ,$136.00 ,$74.80 ,$4.29 ,$35.77 , N/A ,$2.86 ,$2.73 ,$4.50 ,$108.80 ,$73.85 ,$38.08 ,$122.40 ,$51.68 ,$8.58 ,$4.29 ,$65.28 
ST. MARY'S HOSPITAL - DECATUR,30500202,85613,HC RUSSELL VIPER VENOM DIL,305,1 ,$229.00 ,$148.85 ,$3.50 ,$229.00 ,$23.95 ,$22.38 ,$125.95 ,$9.58 ,$64.12 ,$75.59 ,$9.58 ,$75.59 ,$9.58 ,$124.35 ,$3.50 ,$9.58 ,$124.35 ,$18.20 ,$160.30 ,$114.50 ,$183.20 ,$23.95 ,$9.58 ,$160.30 ,$9.58 ,$137.40 ,$9.58 ,$171.75 ,$126.41 ,$114.04 ,$126.41 ,$9.58 ,$126.41 ,$13.83 ,$13.83 ,$194.65 ,$23.95 ,$158.70 ,$9.58 ,$229.00 ,$125.95 ,$9.58 ,$60.23 , N/A ,$8.49 ,$8.11 ,$10.06 ,$183.20 ,$124.35 ,$64.12 ,$206.10 ,$87.02 ,$19.16 ,$9.58 ,$109.92 
ST. MARY'S HOSPITAL - DECATUR,30500205,85652,HC SED RATE AUTO,305,1 ,$177.00 ,$115.05 ,$2.70 ,$177.00 ,$6.75 ,$6.30 ,$97.35 ,$2.70 ,$49.56 ,$28.80 ,$2.70 ,$28.80 ,$2.70 ,$96.11 ,$3.50 ,$2.70 ,$96.11 ,$5.13 ,$123.90 ,$88.50 ,$141.60 ,$6.75 ,$2.70 ,$123.90 ,$2.70 ,$106.20 ,$2.70 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$2.70 ,$97.70 ,$3.90 ,$3.90 ,$150.45 ,$6.75 ,$122.66 ,$2.70 ,$177.00 ,$97.35 ,$2.70 ,$46.55 , N/A ,$4.90 ,$4.67 ,$2.84 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$5.40 ,$2.70 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30500206,85660,HC SICKLE CELL RBC,305,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$13.78 ,$12.90 ,$80.30 ,$5.51 ,$40.88 ,$43.45 ,$5.51 ,$43.45 ,$5.51 ,$79.28 ,$3.50 ,$5.51 ,$79.28 ,$10.47 ,$102.20 ,$73.00 ,$116.80 ,$13.78 ,$5.51 ,$102.20 ,$5.51 ,$87.60 ,$5.51 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$5.51 ,$80.59 ,$7.96 ,$7.96 ,$124.10 ,$13.78 ,$101.18 ,$5.51 ,$146.00 ,$80.30 ,$5.51 ,$38.40 , N/A ,$4.90 ,$4.67 ,$5.79 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$11.02 ,$5.51 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30500211,85730,HC PTT,305,1 ,$207.00 ,$134.55 ,$2.73 ,$207.00 ,$15.03 ,$14.02 ,$113.85 ,$6.01 ,$57.96 ,$64.19 ,$6.01 ,$64.19 ,$6.01 ,$112.40 ,$3.50 ,$6.01 ,$112.40 ,$11.42 ,$144.90 ,$103.50 ,$165.60 ,$15.03 ,$6.01 ,$144.90 ,$6.01 ,$124.20 ,$6.01 ,$155.25 ,$114.26 ,$103.09 ,$114.26 ,$6.01 ,$114.26 ,$8.67 ,$8.67 ,$175.95 ,$15.03 ,$143.45 ,$6.01 ,$207.00 ,$113.85 ,$6.01 ,$54.44 , N/A ,$2.86 ,$2.73 ,$6.31 ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$12.02 ,$6.01 ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,30500213,85732,HC PTT MIXING STUDY,305,1 ,$187.00 ,$121.55 ,$2.73 ,$187.00 ,$16.18 ,$15.12 ,$102.85 ,$6.47 ,$52.36 ,$51.02 ,$6.47 ,$51.02 ,$6.47 ,$101.54 ,$3.50 ,$6.47 ,$101.54 ,$12.29 ,$130.90 ,$93.50 ,$149.60 ,$16.18 ,$6.47 ,$130.90 ,$6.47 ,$112.20 ,$6.47 ,$140.25 ,$103.22 ,$93.13 ,$103.22 ,$6.47 ,$103.22 ,$9.33 ,$9.33 ,$158.95 ,$16.18 ,$129.59 ,$6.47 ,$187.00 ,$102.85 ,$6.47 ,$49.18 , N/A ,$2.86 ,$2.73 ,$6.79 ,$149.60 ,$101.54 ,$52.36 ,$168.30 ,$71.06 ,$12.94 ,$6.47 ,$89.76 
ST. MARY'S HOSPITAL - DECATUR,30500234,85014,HC HEMATOCRIT-90,305,1 ,$68.00 ,$44.20 ,$2.37 ,$68.00 ,$5.93 ,$5.54 ,$37.40 ,$2.37 ,$19.04 ,$25.36 ,$2.37 ,$25.36 ,$2.37 ,$36.92 ,$3.50 ,$2.37 ,$36.92 ,$4.50 ,$47.60 ,$34.00 ,$54.40 ,$5.93 ,$2.37 ,$47.60 ,$2.37 ,$40.80 ,$2.37 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$2.37 ,$37.54 ,$3.42 ,$3.42 ,$57.80 ,$5.93 ,$47.12 ,$2.37 ,$2.37 ,$37.40 ,$2.37 ,$17.88 , N/A ,$4.90 ,$4.67 ,$2.49 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$4.74 ,$2.37 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30500238,85018,HC HGB-90,305,1 ,$62.00 ,$40.30 ,$2.37 ,$62.00 ,$5.93 ,$5.54 ,$34.10 ,$2.37 ,$17.36 ,$25.36 ,$2.37 ,$25.36 ,$2.37 ,$33.67 ,$3.50 ,$2.37 ,$33.67 ,$4.50 ,$43.40 ,$31.00 ,$49.60 ,$5.93 ,$2.37 ,$43.40 ,$2.37 ,$37.20 ,$2.37 ,$46.50 ,$34.22 ,$30.88 ,$34.22 ,$2.37 ,$34.22 ,$3.42 ,$3.42 ,$52.70 ,$5.93 ,$42.97 ,$2.37 ,$2.37 ,$34.10 ,$2.37 ,$16.31 , N/A ,$4.90 ,$4.67 ,$2.49 ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$4.74 ,$2.37 ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,30500239,85025,HC CBC AUTO W/AUTO DIFF-90,305,1 ,$183.00 ,$118.95 ,$3.50 ,$183.00 ,$19.43 ,$18.18 ,$100.65 ,$7.77 ,$51.24 ,$82.97 ,$7.77 ,$82.97 ,$7.77 ,$99.37 ,$3.50 ,$7.77 ,$99.37 ,$14.76 ,$128.10 ,$91.50 ,$146.40 ,$19.43 ,$7.77 ,$128.10 ,$7.77 ,$109.80 ,$7.77 ,$137.25 ,$101.02 ,$91.13 ,$101.02 ,$7.77 ,$101.02 ,$11.22 ,$11.22 ,$155.55 ,$19.43 ,$126.82 ,$7.77 ,$7.77 ,$100.65 ,$7.77 ,$48.13 , N/A ,$4.90 ,$4.67 ,$8.16 ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$69.54 ,$15.54 ,$7.77 ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,30500244,85041,HC BLOOD COUNT RBC AUTO-90,305,1 ,$92.00 ,$59.80 ,$3.02 ,$92.00 ,$7.55 ,$6.16 ,$50.60 ,$3.02 ,$25.76 ,$32.24 ,$3.02 ,$32.24 ,$3.02 ,$49.96 ,$3.50 ,$3.02 ,$49.96 ,$5.74 ,$64.40 ,$46.00 ,$73.60 ,$7.55 ,$3.02 ,$64.40 ,$3.02 ,$55.20 ,$3.02 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$3.02 ,$50.78 ,$4.36 ,$4.36 ,$78.20 ,$7.55 ,$63.76 ,$3.02 ,$92.00 ,$50.60 ,$3.02 ,$24.20 , N/A ,$4.90 ,$4.67 ,$3.17 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$6.04 ,$3.02 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,30500247,85097,HC BONE MARROW SMEAR INTERP,305,1 ,$290.00 ,$188.50 ,$21.49 ,"$1,550.85 ","$1,550.85 ",$79.78 ,$159.50 ,$620.34 ,$81.20 ,$142.10 ,$620.34 ,$169.65 ,$290.00 ,$157.47 ,$78.92 ,$290.00 ,$157.47 ,$290.00 ,$203.00 ,$145.00 ,$232.00 ,"$1,550.85 ",$620.34 ,$203.00 ,$620.34 ,$174.00 ,$620.34 ,$217.50 ,$160.08 ,$144.42 ,$160.08 ,$620.34 ,$160.08 ,$95.10 ,$95.10 ,$246.50 ,$290.00 ,$200.97 ,$620.34 ,$290.00 ,$159.50 ,$620.34 ,$76.27 , N/A ,$22.52 ,$21.49 ,$651.36 ,$232.00 ,$157.47 ,$81.20 ,$261.00 ,$110.20 ,$290.00 ,$620.34 ,$139.20 
ST. MARY'S HOSPITAL - DECATUR,30500249,85210,HC FACTOR II-90,305,1 ,$473.00 ,$307.45 ,$2.73 ,$473.00 ,$32.45 ,$30.34 ,$260.15 ,$12.98 ,$132.44 ,$138.70 ,$12.98 ,$138.70 ,$12.98 ,$256.84 ,$3.50 ,$12.98 ,$256.84 ,$24.66 ,$331.10 ,$236.50 ,$378.40 ,$32.45 ,$12.98 ,$331.10 ,$12.98 ,$283.80 ,$12.98 ,$354.75 ,$261.10 ,$235.55 ,$261.10 ,$12.98 ,$261.10 ,$18.76 ,$18.76 ,$402.05 ,$32.45 ,$327.79 ,$12.98 ,$473.00 ,$260.15 ,$12.98 ,$124.40 , N/A ,$2.86 ,$2.73 ,$13.63 ,$378.40 ,$256.84 ,$132.44 ,$425.70 ,$179.74 ,$25.96 ,$12.98 ,$227.04 
ST. MARY'S HOSPITAL - DECATUR,30500250,85220,HC FACTOR V-90,305,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$44.13 ,$41.24 ,$235.95 ,$17.65 ,$120.12 ,$139.19 ,$17.65 ,$139.19 ,$17.65 ,$232.95 ,$3.50 ,$17.65 ,$232.95 ,$33.54 ,$300.30 ,$214.50 ,$343.20 ,$44.13 ,$17.65 ,$300.30 ,$17.65 ,$257.40 ,$17.65 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$17.65 ,$236.81 ,$25.49 ,$25.49 ,$364.65 ,$44.13 ,$297.30 ,$17.65 ,$429.00 ,$235.95 ,$17.65 ,$112.83 , N/A ,$8.49 ,$8.11 ,$18.53 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$35.30 ,$17.65 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30500251,85230,HC FACTOR VII-90,305,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$44.75 ,$41.84 ,$235.95 ,$17.90 ,$120.12 ,$141.26 ,$17.90 ,$141.26 ,$17.90 ,$232.95 ,$3.50 ,$17.90 ,$232.95 ,$34.01 ,$300.30 ,$214.50 ,$343.20 ,$44.75 ,$17.90 ,$300.30 ,$17.90 ,$257.40 ,$17.90 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$17.90 ,$236.81 ,$25.86 ,$25.86 ,$364.65 ,$44.75 ,$297.30 ,$17.90 ,$429.00 ,$235.95 ,$17.90 ,$112.83 , N/A ,$8.49 ,$8.11 ,$18.80 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$35.80 ,$17.90 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30500252,85240,HC FACTOR VIII AHG-90,305,1 ,$370.00 ,$240.50 ,$3.50 ,$370.00 ,$44.75 ,$41.84 ,$203.50 ,$17.90 ,$103.60 ,$141.26 ,$17.90 ,$141.26 ,$17.90 ,$200.91 ,$3.50 ,$17.90 ,$200.91 ,$34.01 ,$259.00 ,$185.00 ,$296.00 ,$44.75 ,$17.90 ,$259.00 ,$17.90 ,$222.00 ,$17.90 ,$277.50 ,$204.24 ,$184.26 ,$204.24 ,$17.90 ,$204.24 ,$25.86 ,$25.86 ,$314.50 ,$44.75 ,$256.41 ,$17.90 ,$370.00 ,$203.50 ,$17.90 ,$97.31 , N/A ,$8.49 ,$8.11 ,$18.80 ,$296.00 ,$200.91 ,$103.60 ,$333.00 ,$140.60 ,$35.80 ,$17.90 ,$177.60 
ST. MARY'S HOSPITAL - DECATUR,30500253,85245,HC FACTOR VIII VW RISTO-90,305,1 ,$313.00 ,$203.45 ,$3.50 ,$313.00 ,$57.35 ,$33.12 ,$172.15 ,$22.94 ,$87.64 ,$153.37 ,$22.94 ,$180.97 ,$22.94 ,$169.96 ,$3.50 ,$22.94 ,$169.96 ,$43.59 ,$219.10 ,$156.50 ,$250.40 ,$57.35 ,$22.94 ,$219.10 ,$22.94 ,$187.80 ,$22.94 ,$234.75 ,$172.78 ,$155.87 ,$172.78 ,$22.94 ,$172.78 ,$33.14 ,$33.14 ,$266.05 ,$57.35 ,$216.91 ,$22.94 ,$313.00 ,$172.15 ,$22.94 ,$82.32 , N/A ,$8.49 ,$8.11 ,$24.09 ,$250.40 ,$169.96 ,$87.64 ,$281.70 ,$118.94 ,$45.88 ,$22.94 ,$150.24 
ST. MARY'S HOSPITAL - DECATUR,30500254,85246,HC FACTOR VIII VW AG-90,305,1 ,$330.00 ,$214.50 ,$3.50 ,$330.00 ,$57.35 ,$33.12 ,$181.50 ,$22.94 ,$92.40 ,$161.70 ,$22.94 ,$180.97 ,$22.94 ,$179.19 ,$3.50 ,$22.94 ,$179.19 ,$43.59 ,$231.00 ,$165.00 ,$264.00 ,$57.35 ,$22.94 ,$231.00 ,$22.94 ,$198.00 ,$22.94 ,$247.50 ,$182.16 ,$164.34 ,$182.16 ,$22.94 ,$182.16 ,$33.14 ,$33.14 ,$280.50 ,$57.35 ,$228.69 ,$22.94 ,$330.00 ,$181.50 ,$22.94 ,$86.79 , N/A ,$8.49 ,$8.11 ,$24.09 ,$264.00 ,$179.19 ,$92.40 ,$297.00 ,$125.40 ,$45.88 ,$22.94 ,$158.40 
ST. MARY'S HOSPITAL - DECATUR,30500255,85247,HC FACTOR VW MULTIM ANALY-90,305,1 ,$442.00 ,$287.30 ,$3.50 ,$442.00 ,$57.35 ,$33.12 ,$243.10 ,$22.94 ,$123.76 ,$180.97 ,$22.94 ,$180.97 ,$22.94 ,$240.01 ,$3.50 ,$22.94 ,$240.01 ,$43.59 ,$309.40 ,$221.00 ,$353.60 ,$57.35 ,$22.94 ,$309.40 ,$22.94 ,$265.20 ,$22.94 ,$331.50 ,$243.98 ,$220.12 ,$243.98 ,$22.94 ,$243.98 ,$33.14 ,$33.14 ,$375.70 ,$57.35 ,$306.31 ,$22.94 ,$442.00 ,$243.10 ,$22.94 ,$116.25 , N/A ,$8.49 ,$8.11 ,$24.09 ,$353.60 ,$240.01 ,$123.76 ,$397.80 ,$167.96 ,$45.88 ,$22.94 ,$212.16 
ST. MARY'S HOSPITAL - DECATUR,30500256,85250,HC FACTOR IX-90,305,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$47.60 ,$44.48 ,$235.95 ,$19.04 ,$120.12 ,$150.20 ,$19.04 ,$150.20 ,$19.04 ,$232.95 ,$3.50 ,$19.04 ,$232.95 ,$36.18 ,$300.30 ,$214.50 ,$343.20 ,$47.60 ,$19.04 ,$300.30 ,$19.04 ,$257.40 ,$19.04 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$19.04 ,$236.81 ,$27.51 ,$27.51 ,$364.65 ,$47.60 ,$297.30 ,$19.04 ,$429.00 ,$235.95 ,$19.04 ,$112.83 , N/A ,$8.49 ,$8.11 ,$19.99 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$38.08 ,$19.04 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30500257,85260,HC FACTOR X-90,305,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$44.75 ,$41.84 ,$235.95 ,$17.90 ,$120.12 ,$141.26 ,$17.90 ,$141.26 ,$17.90 ,$232.95 ,$3.50 ,$17.90 ,$232.95 ,$34.01 ,$300.30 ,$214.50 ,$343.20 ,$44.75 ,$17.90 ,$300.30 ,$17.90 ,$257.40 ,$17.90 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$17.90 ,$236.81 ,$25.86 ,$25.86 ,$364.65 ,$44.75 ,$297.30 ,$17.90 ,$429.00 ,$235.95 ,$17.90 ,$112.83 , N/A ,$8.49 ,$8.11 ,$18.80 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$35.80 ,$17.90 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30500258,85270,HC FACTOR XI-90,305,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$44.75 ,$41.84 ,$235.95 ,$17.90 ,$120.12 ,$141.26 ,$17.90 ,$141.26 ,$17.90 ,$232.95 ,$3.50 ,$17.90 ,$232.95 ,$34.01 ,$300.30 ,$214.50 ,$343.20 ,$44.75 ,$17.90 ,$300.30 ,$17.90 ,$257.40 ,$17.90 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$17.90 ,$236.81 ,$25.86 ,$25.86 ,$364.65 ,$44.75 ,$297.30 ,$17.90 ,$429.00 ,$235.95 ,$17.90 ,$112.83 , N/A ,$8.49 ,$8.11 ,$18.80 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$35.80 ,$17.90 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30500259,85280,HC FACTOR XI-90,305,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$48.38 ,$45.22 ,$235.95 ,$19.35 ,$120.12 ,$152.66 ,$19.35 ,$152.66 ,$19.35 ,$232.95 ,$3.50 ,$19.35 ,$232.95 ,$36.77 ,$300.30 ,$214.50 ,$343.20 ,$48.38 ,$19.35 ,$300.30 ,$19.35 ,$257.40 ,$19.35 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$19.35 ,$236.81 ,$27.95 ,$27.95 ,$364.65 ,$48.38 ,$297.30 ,$19.35 ,$429.00 ,$235.95 ,$19.35 ,$112.83 , N/A ,$8.49 ,$8.11 ,$20.32 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$38.70 ,$19.35 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30500260,85291,HC FACTOR XII-90,305,1 ,$115.00 ,$74.75 ,$3.50 ,$115.00 ,$22.78 ,$20.78 ,$63.25 ,$9.11 ,$32.20 ,$56.35 ,$9.11 ,$67.28 ,$9.11 ,$62.45 ,$3.50 ,$9.11 ,$62.45 ,$17.31 ,$80.50 ,$57.50 ,$92.00 ,$22.78 ,$9.11 ,$80.50 ,$9.11 ,$69.00 ,$9.11 ,$86.25 ,$63.48 ,$57.27 ,$63.48 ,$9.11 ,$63.48 ,$12.84 ,$12.84 ,$97.75 ,$22.78 ,$79.70 ,$9.11 ,$115.00 ,$63.25 ,$9.11 ,$30.25 , N/A ,$8.49 ,$8.11 ,$9.57 ,$92.00 ,$62.45 ,$32.20 ,$103.50 ,$43.70 ,$18.22 ,$9.11 ,$55.20 
ST. MARY'S HOSPITAL - DECATUR,30500261,85300,HC ANTITHROMBIN III ACT-90,305,1 ,$307.00 ,$199.55 ,$3.50 ,$307.00 ,$29.63 ,$27.70 ,$168.85 ,$11.85 ,$85.96 ,$93.48 ,$11.85 ,$93.48 ,$11.85 ,$166.70 ,$3.50 ,$11.85 ,$166.70 ,$22.52 ,$214.90 ,$153.50 ,$245.60 ,$29.63 ,$11.85 ,$214.90 ,$11.85 ,$184.20 ,$11.85 ,$230.25 ,$169.46 ,$152.89 ,$169.46 ,$11.85 ,$169.46 ,$17.12 ,$17.12 ,$260.95 ,$29.63 ,$212.75 ,$11.85 ,$307.00 ,$168.85 ,$11.85 ,$80.74 , N/A ,$8.49 ,$8.11 ,$12.44 ,$245.60 ,$166.70 ,$85.96 ,$276.30 ,$116.66 ,$23.70 ,$11.85 ,$147.36 
ST. MARY'S HOSPITAL - DECATUR,30500262,85301,HC ANTITHROMBIN III AG-90,305,1 ,$261.00 ,$169.65 ,$3.50 ,$261.00 ,$27.03 ,$25.26 ,$143.55 ,$10.81 ,$73.08 ,$85.32 ,$10.81 ,$85.32 ,$10.81 ,$141.72 ,$3.50 ,$10.81 ,$141.72 ,$20.54 ,$182.70 ,$130.50 ,$208.80 ,$27.03 ,$10.81 ,$182.70 ,$10.81 ,$156.60 ,$10.81 ,$195.75 ,$144.07 ,$129.98 ,$144.07 ,$10.81 ,$144.07 ,$15.61 ,$15.61 ,$221.85 ,$27.03 ,$180.87 ,$10.81 ,$261.00 ,$143.55 ,$10.81 ,$68.64 , N/A ,$8.49 ,$8.11 ,$11.35 ,$208.80 ,$141.72 ,$73.08 ,$234.90 ,$99.18 ,$21.62 ,$10.81 ,$125.28 
ST. MARY'S HOSPITAL - DECATUR,30500263,85302,HC PROTEIN C AG-90,305,1 ,$354.00 ,$230.10 ,$3.50 ,$354.00 ,$30.03 ,$28.08 ,$194.70 ,$12.01 ,$99.12 ,$94.76 ,$12.01 ,$94.76 ,$12.01 ,$192.22 ,$3.50 ,$12.01 ,$192.22 ,$22.82 ,$247.80 ,$177.00 ,$283.20 ,$30.03 ,$12.01 ,$247.80 ,$12.01 ,$212.40 ,$12.01 ,$265.50 ,$195.41 ,$176.29 ,$195.41 ,$12.01 ,$195.41 ,$17.36 ,$17.36 ,$300.90 ,$30.03 ,$245.32 ,$12.01 ,$354.00 ,$194.70 ,$12.01 ,$93.10 , N/A ,$8.49 ,$8.11 ,$12.61 ,$283.20 ,$192.22 ,$99.12 ,$318.60 ,$134.52 ,$24.02 ,$12.01 ,$169.92 
ST. MARY'S HOSPITAL - DECATUR,30500264,85303,HC PROTEIN C ACTIVITY-90,305,1 ,$379.00 ,$246.35 ,$3.50 ,$379.00 ,$34.60 ,$32.32 ,$208.45 ,$13.84 ,$106.12 ,$109.11 ,$13.84 ,$109.11 ,$13.84 ,$205.80 ,$3.50 ,$13.84 ,$205.80 ,$26.30 ,$265.30 ,$189.50 ,$303.20 ,$34.60 ,$13.84 ,$265.30 ,$13.84 ,$227.40 ,$13.84 ,$284.25 ,$209.21 ,$188.74 ,$209.21 ,$13.84 ,$209.21 ,$19.98 ,$19.98 ,$322.15 ,$34.60 ,$262.65 ,$13.84 ,$379.00 ,$208.45 ,$13.84 ,$99.68 , N/A ,$8.49 ,$8.11 ,$14.53 ,$303.20 ,$205.80 ,$106.12 ,$341.10 ,$144.02 ,$27.68 ,$13.84 ,$181.92 
ST. MARY'S HOSPITAL - DECATUR,30500265,85305,HC PROTEIN S TOTAL-90,305,1 ,$178.00 ,$115.70 ,$3.50 ,$178.00 ,$29.03 ,$27.12 ,$97.90 ,$11.61 ,$49.84 ,$87.22 ,$11.61 ,$91.52 ,$11.61 ,$96.65 ,$3.50 ,$11.61 ,$96.65 ,$22.06 ,$124.60 ,$89.00 ,$142.40 ,$29.03 ,$11.61 ,$124.60 ,$11.61 ,$106.80 ,$11.61 ,$133.50 ,$98.26 ,$88.64 ,$98.26 ,$11.61 ,$98.26 ,$16.77 ,$16.77 ,$151.30 ,$29.03 ,$123.35 ,$11.61 ,$178.00 ,$97.90 ,$11.61 ,$46.81 , N/A ,$8.49 ,$8.11 ,$12.19 ,$142.40 ,$96.65 ,$49.84 ,$160.20 ,$67.64 ,$23.22 ,$11.61 ,$85.44 
ST. MARY'S HOSPITAL - DECATUR,30500266,85306,HC PROTEIN S FREE-90,305,1 ,$359.00 ,$233.35 ,$3.50 ,$359.00 ,$38.30 ,$35.80 ,$197.45 ,$15.32 ,$100.52 ,$120.91 ,$15.32 ,$120.91 ,$15.32 ,$194.94 ,$3.50 ,$15.32 ,$194.94 ,$29.11 ,$251.30 ,$179.50 ,$287.20 ,$38.30 ,$15.32 ,$251.30 ,$15.32 ,$215.40 ,$15.32 ,$269.25 ,$198.17 ,$178.78 ,$198.17 ,$15.32 ,$198.17 ,$22.14 ,$22.14 ,$305.15 ,$38.30 ,$248.79 ,$15.32 ,$359.00 ,$197.45 ,$15.32 ,$94.42 , N/A ,$8.49 ,$8.11 ,$16.09 ,$287.20 ,$194.94 ,$100.52 ,$323.10 ,$136.42 ,$30.64 ,$15.32 ,$172.32 
ST. MARY'S HOSPITAL - DECATUR,30500267,85307,HC ACTIVATED PROTEIN C RESIST-90,305,1 ,$456.00 ,$296.40 ,$3.50 ,$456.00 ,$38.30 ,$35.80 ,$250.80 ,$15.32 ,$127.68 ,$120.91 ,$15.32 ,$120.91 ,$15.32 ,$247.61 ,$3.50 ,$15.32 ,$247.61 ,$29.11 ,$319.20 ,$228.00 ,$364.80 ,$38.30 ,$15.32 ,$319.20 ,$15.32 ,$273.60 ,$15.32 ,$342.00 ,$251.71 ,$227.09 ,$251.71 ,$15.32 ,$251.71 ,$22.14 ,$22.14 ,$387.60 ,$38.30 ,$316.01 ,$15.32 ,$456.00 ,$250.80 ,$15.32 ,$119.93 , N/A ,$7.88 ,$7.52 ,$16.09 ,$364.80 ,$247.61 ,$127.68 ,$410.40 ,$173.28 ,$30.64 ,$15.32 ,$218.88 
ST. MARY'S HOSPITAL - DECATUR,30500268,85335,HC FACTOR INHIBITOR-90,305,1 ,$464.00 ,$301.60 ,$3.50 ,$464.00 ,$32.18 ,$30.08 ,$255.20 ,$12.87 ,$129.92 ,$101.54 ,$12.87 ,$101.54 ,$12.87 ,$251.95 ,$3.50 ,$12.87 ,$251.95 ,$24.45 ,$324.80 ,$232.00 ,$371.20 ,$32.18 ,$12.87 ,$324.80 ,$12.87 ,$278.40 ,$12.87 ,$348.00 ,$256.13 ,$231.07 ,$256.13 ,$12.87 ,$256.13 ,$18.59 ,$18.59 ,$394.40 ,$32.18 ,$321.55 ,$12.87 ,$464.00 ,$255.20 ,$12.87 ,$122.03 , N/A ,$8.49 ,$8.11 ,$13.51 ,$371.20 ,$251.95 ,$129.92 ,$417.60 ,$176.32 ,$25.74 ,$12.87 ,$222.72 
ST. MARY'S HOSPITAL - DECATUR,30500272,85379,HC D DIMER QN-90,305,1 ,$227.00 ,$147.55 ,$3.50 ,$227.00 ,$25.45 ,$23.78 ,$124.85 ,$10.18 ,$63.56 ,$80.21 ,$10.18 ,$80.21 ,$10.18 ,$123.26 ,$3.50 ,$10.18 ,$123.26 ,$19.34 ,$158.90 ,$113.50 ,$181.60 ,$25.45 ,$10.18 ,$158.90 ,$10.18 ,$136.20 ,$10.18 ,$170.25 ,$125.30 ,$113.05 ,$125.30 ,$10.18 ,$125.30 ,$14.70 ,$14.70 ,$192.95 ,$25.45 ,$157.31 ,$10.18 ,$227.00 ,$124.85 ,$10.18 ,$59.70 , N/A ,$8.49 ,$8.11 ,$10.69 ,$181.60 ,$123.26 ,$63.56 ,$204.30 ,$86.26 ,$20.36 ,$10.18 ,$108.96 
ST. MARY'S HOSPITAL - DECATUR,30500273,85384,HC FIBRINOGEN-90,305,1 ,$227.00 ,$147.55 ,$2.73 ,$227.00 ,$24.30 ,$19.86 ,$124.85 ,$9.72 ,$63.56 ,$67.04 ,$9.72 ,$67.04 ,$9.72 ,$123.26 ,$3.50 ,$9.72 ,$123.26 ,$18.47 ,$158.90 ,$113.50 ,$181.60 ,$24.30 ,$9.72 ,$158.90 ,$9.72 ,$136.20 ,$9.72 ,$170.25 ,$125.30 ,$113.05 ,$125.30 ,$9.72 ,$125.30 ,$12.64 ,$12.64 ,$192.95 ,$24.30 ,$157.31 ,$9.72 ,$227.00 ,$124.85 ,$9.72 ,$59.70 , N/A ,$2.86 ,$2.73 ,$10.21 ,$181.60 ,$123.26 ,$63.56 ,$204.30 ,$86.26 ,$19.44 ,$9.72 ,$108.96 
ST. MARY'S HOSPITAL - DECATUR,30500275,85390,HC FIBRINOLYSIS EPL/LY30 W/REP-90,305,1 ,$203.00 ,$131.95 ,$2.73 ,$203.00 ,$38.70 ,$6.64 ,$111.65 ,$15.48 ,$56.84 ,$98.89 ,$15.48 ,$98.89 ,$15.48 ,$110.23 ,$10.99 ,$15.48 ,$110.23 ,$29.41 ,$142.10 ,$101.50 ,$162.40 ,$38.70 ,$15.48 ,$142.10 ,$15.48 ,$121.80 ,$15.48 ,$152.25 ,$112.06 ,$101.09 ,$112.06 ,$15.48 ,$112.06 ,$20.12 ,$20.12 ,$172.55 ,$38.70 ,$140.68 ,$15.48 ,$203.00 ,$111.65 ,$15.48 ,$53.39 , N/A ,$2.86 ,$2.73 ,$16.25 ,$162.40 ,$110.23 ,$56.84 ,$182.70 ,$77.14 ,$30.96 ,$15.48 ,$97.44 
ST. MARY'S HOSPITAL - DECATUR,30500276,85397,HC COAGUL/FIBRINOLYSIS CLOT ACT-90,305,1 ,$573.00 ,$372.45 ,$3.50 ,$573.00 ,$77.15 ,$33.12 ,$315.15 ,$30.86 ,$160.44 ,$197.19 ,$30.86 ,$197.19 ,$30.86 ,$311.14 ,$3.50 ,$30.86 ,$311.14 ,$58.63 ,$401.10 ,$286.50 ,$458.40 ,$77.15 ,$30.86 ,$401.10 ,$30.86 ,$343.80 ,$30.86 ,$429.75 ,$316.30 ,$285.35 ,$316.30 ,$30.86 ,$316.30 ,$40.12 ,$40.12 ,$487.05 ,$77.15 ,$397.09 ,$30.86 ,$573.00 ,$315.15 ,$30.86 ,$150.70 , N/A ,$8.49 ,$8.11 ,$32.40 ,$458.40 ,$311.14 ,$160.44 ,$515.70 ,$217.74 ,$61.72 ,$30.86 ,$275.04 
ST. MARY'S HOSPITAL - DECATUR,30500277,85415,HC PLASMINGEN ACTIVATOR INHIB-90,305,1 ,$291.00 ,$189.15 ,$3.50 ,$291.00 ,$42.98 ,$40.18 ,$160.05 ,$17.19 ,$81.48 ,$135.56 ,$17.19 ,$135.56 ,$17.19 ,$158.01 ,$3.50 ,$17.19 ,$158.01 ,$32.66 ,$203.70 ,$145.50 ,$232.80 ,$42.98 ,$17.19 ,$203.70 ,$17.19 ,$174.60 ,$17.19 ,$218.25 ,$160.63 ,$144.92 ,$160.63 ,$17.19 ,$160.63 ,$24.83 ,$24.83 ,$247.35 ,$42.98 ,$201.66 ,$17.19 ,$291.00 ,$160.05 ,$17.19 ,$76.53 , N/A ,$8.49 ,$8.11 ,$18.05 ,$232.80 ,$158.01 ,$81.48 ,$261.90 ,$110.58 ,$34.38 ,$17.19 ,$139.68 
ST. MARY'S HOSPITAL - DECATUR,30500282,85461,HC FETAL HGB ROSETTE,305,1 ,$191.00 ,$124.15 ,$3.50 ,$191.00 ,$23.40 ,$15.50 ,$105.05 ,$9.36 ,$53.48 ,$59.77 ,$9.36 ,$59.77 ,$9.36 ,$103.71 ,$3.50 ,$9.36 ,$103.71 ,$17.78 ,$133.70 ,$95.50 ,$152.80 ,$23.40 ,$9.36 ,$133.70 ,$9.36 ,$114.60 ,$9.36 ,$143.25 ,$105.43 ,$95.12 ,$105.43 ,$9.36 ,$105.43 ,$12.17 ,$12.17 ,$162.35 ,$23.40 ,$132.36 ,$9.36 ,$191.00 ,$105.05 ,$9.36 ,$50.23 , N/A ,$4.90 ,$4.67 ,$9.83 ,$152.80 ,$103.71 ,$53.48 ,$171.90 ,$72.58 ,$18.72 ,$9.36 ,$91.68 
ST. MARY'S HOSPITAL - DECATUR,30500283,85520,HC HEPARIN ASSAY-90,305,1 ,$389.00 ,$252.85 ,$3.50 ,$389.00 ,$32.73 ,$30.60 ,$213.95 ,$13.09 ,$108.92 ,$103.22 ,$13.09 ,$103.22 ,$13.09 ,$211.23 ,$3.50 ,$13.09 ,$211.23 ,$24.87 ,$272.30 ,$194.50 ,$311.20 ,$32.73 ,$13.09 ,$272.30 ,$13.09 ,$233.40 ,$13.09 ,$291.75 ,$214.73 ,$193.72 ,$214.73 ,$13.09 ,$214.73 ,$18.92 ,$18.92 ,$330.65 ,$32.73 ,$269.58 ,$13.09 ,$389.00 ,$213.95 ,$13.09 ,$102.31 , N/A ,$8.49 ,$8.11 ,$13.74 ,$311.20 ,$211.23 ,$108.92 ,$350.10 ,$147.82 ,$26.18 ,$13.09 ,$186.72 
ST. MARY'S HOSPITAL - DECATUR,30500284,85536,HC IRON STAIN PERIPHERAL BLOOD,305,1 ,$149.00 ,$96.85 ,$3.50 ,$149.00 ,$17.20 ,$15.12 ,$81.95 ,$6.88 ,$41.72 ,$51.02 ,$6.88 ,$51.02 ,$6.88 ,$80.91 ,$3.50 ,$6.88 ,$80.91 ,$13.07 ,$104.30 ,$74.50 ,$119.20 ,$17.20 ,$6.88 ,$104.30 ,$6.88 ,$89.40 ,$6.88 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$6.88 ,$82.25 ,$9.33 ,$9.33 ,$126.65 ,$17.20 ,$103.26 ,$6.88 ,$149.00 ,$81.95 ,$6.88 ,$39.19 , N/A ,$4.90 ,$4.67 ,$7.22 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$13.76 ,$6.88 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30500285,85536,HC IRON STAIN PERIPHERAL BLOOD,305,1 ,$149.00 ,$96.85 ,$3.50 ,$149.00 ,$17.20 ,$15.12 ,$81.95 ,$6.88 ,$41.72 ,$51.02 ,$6.88 ,$51.02 ,$6.88 ,$80.91 ,$3.50 ,$6.88 ,$80.91 ,$13.07 ,$104.30 ,$74.50 ,$119.20 ,$17.20 ,$6.88 ,$104.30 ,$6.88 ,$89.40 ,$6.88 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$6.88 ,$82.25 ,$9.33 ,$9.33 ,$126.65 ,$17.20 ,$103.26 ,$6.88 ,$149.00 ,$81.95 ,$6.88 ,$39.19 , N/A ,$4.90 ,$4.67 ,$7.22 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$13.76 ,$6.88 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30500287,85549,HC MURAMIDASE-90,305,1 ,$279.00 ,$181.35 ,$3.50 ,$279.00 ,$46.88 ,$43.82 ,$153.45 ,$18.75 ,$78.12 ,$136.71 ,$18.75 ,$147.94 ,$18.75 ,$151.50 ,$3.50 ,$18.75 ,$151.50 ,$35.63 ,$195.30 ,$139.50 ,$223.20 ,$46.88 ,$18.75 ,$195.30 ,$18.75 ,$167.40 ,$18.75 ,$209.25 ,$154.01 ,$138.94 ,$154.01 ,$18.75 ,$154.01 ,$27.08 ,$27.08 ,$237.15 ,$46.88 ,$193.35 ,$18.75 ,$279.00 ,$153.45 ,$18.75 ,$73.38 , N/A ,$7.88 ,$7.52 ,$19.69 ,$223.20 ,$151.50 ,$78.12 ,$251.10 ,$106.02 ,$37.50 ,$18.75 ,$133.92 
ST. MARY'S HOSPITAL - DECATUR,30500288,85557,HC OSMOTIC FRAG RBC INCUB-90,305,1 ,$324.00 ,$210.60 ,$3.50 ,$324.00 ,$33.40 ,$13.32 ,$178.20 ,$13.36 ,$90.72 ,$105.38 ,$13.36 ,$105.38 ,$13.36 ,$175.93 ,$3.50 ,$13.36 ,$175.93 ,$25.38 ,$226.80 ,$162.00 ,$259.20 ,$33.40 ,$13.36 ,$226.80 ,$13.36 ,$194.40 ,$13.36 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$13.36 ,$178.85 ,$19.29 ,$19.29 ,$275.40 ,$33.40 ,$224.53 ,$13.36 ,$324.00 ,$178.20 ,$13.36 ,$85.21 , N/A ,$7.45 ,$7.11 ,$14.03 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$26.72 ,$13.36 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,30500289,85597,HC PLATELET NEUTRALIZATION-90,305,1 ,$300.00 ,$195.00 ,$3.50 ,$300.00 ,$44.95 ,$42.00 ,$165.00 ,$17.98 ,$84.00 ,$141.75 ,$17.98 ,$141.75 ,$17.98 ,$162.90 ,$3.50 ,$17.98 ,$162.90 ,$34.16 ,$210.00 ,$150.00 ,$240.00 ,$44.95 ,$17.98 ,$210.00 ,$17.98 ,$180.00 ,$17.98 ,$225.00 ,$165.60 ,$149.40 ,$165.60 ,$17.98 ,$165.60 ,$25.96 ,$25.96 ,$255.00 ,$44.95 ,$207.90 ,$17.98 ,$300.00 ,$165.00 ,$17.98 ,$78.90 , N/A ,$8.49 ,$8.11 ,$18.88 ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$35.96 ,$17.98 ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,30500290,85598,HC HEXAGN NEUTRALIZATION PHOSPH-90,305,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$44.95 ,$42.00 ,$106.15 ,$17.98 ,$54.04 ,$94.57 ,$17.98 ,$112.91 ,$17.98 ,$104.80 ,$3.50 ,$17.98 ,$104.80 ,$34.16 ,$135.10 ,$96.50 ,$154.40 ,$44.95 ,$17.98 ,$135.10 ,$17.98 ,$115.80 ,$17.98 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$17.98 ,$106.54 ,$25.96 ,$25.96 ,$164.05 ,$44.95 ,$133.75 ,$17.98 ,$193.00 ,$106.15 ,$17.98 ,$50.76 , N/A ,$8.49 ,$8.11 ,$18.88 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$35.96 ,$17.98 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30500292,85610,HC PROTHROMBIN TIME (PT)-90,305,1 ,$136.00 ,$88.40 ,$2.73 ,$136.00 ,$10.73 ,$9.18 ,$74.80 ,$4.29 ,$38.08 ,$41.97 ,$4.29 ,$41.97 ,$4.29 ,$73.85 ,$3.50 ,$4.29 ,$73.85 ,$8.15 ,$95.20 ,$68.00 ,$108.80 ,$10.73 ,$4.29 ,$95.20 ,$4.29 ,$81.60 ,$4.29 ,$102.00 ,$75.07 ,$67.73 ,$75.07 ,$4.29 ,$75.07 ,$5.68 ,$5.68 ,$115.60 ,$10.73 ,$94.25 ,$4.29 ,$136.00 ,$74.80 ,$4.29 ,$35.77 , N/A ,$2.86 ,$2.73 ,$4.50 ,$108.80 ,$73.85 ,$38.08 ,$122.40 ,$51.68 ,$8.58 ,$4.29 ,$65.28 
ST. MARY'S HOSPITAL - DECATUR,30500295,85611,HC PT MIX STUDY-90,305,1 ,$149.00 ,$96.85 ,$2.73 ,$149.00 ,$9.85 ,$9.22 ,$81.95 ,$3.94 ,$41.72 ,$31.16 ,$3.94 ,$31.16 ,$3.94 ,$80.91 ,$3.50 ,$3.94 ,$80.91 ,$7.49 ,$104.30 ,$74.50 ,$119.20 ,$9.85 ,$3.94 ,$104.30 ,$3.94 ,$89.40 ,$3.94 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$3.94 ,$82.25 ,$5.69 ,$5.69 ,$126.65 ,$9.85 ,$103.26 ,$3.94 ,$149.00 ,$81.95 ,$3.94 ,$39.19 , N/A ,$2.86 ,$2.73 ,$4.14 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$7.88 ,$3.94 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30500296,85611,HC PT MIX STUDY,305,1 ,$149.00 ,$96.85 ,$2.73 ,$149.00 ,$9.85 ,$9.22 ,$81.95 ,$3.94 ,$41.72 ,$31.16 ,$3.94 ,$31.16 ,$3.94 ,$80.91 ,$3.50 ,$3.94 ,$80.91 ,$7.49 ,$104.30 ,$74.50 ,$119.20 ,$9.85 ,$3.94 ,$104.30 ,$3.94 ,$89.40 ,$3.94 ,$111.75 ,$82.25 ,$74.20 ,$82.25 ,$3.94 ,$82.25 ,$5.69 ,$5.69 ,$126.65 ,$9.85 ,$103.26 ,$3.94 ,$149.00 ,$81.95 ,$3.94 ,$39.19 , N/A ,$2.86 ,$2.73 ,$4.14 ,$119.20 ,$80.91 ,$41.72 ,$134.10 ,$56.62 ,$7.88 ,$3.94 ,$71.52 
ST. MARY'S HOSPITAL - DECATUR,30500297,85613,HC RUSSELL VIPER VENOM SCR T1-90,305,1 ,$229.00 ,$148.85 ,$3.50 ,$229.00 ,$23.95 ,$22.38 ,$125.95 ,$9.58 ,$64.12 ,$75.59 ,$9.58 ,$75.59 ,$9.58 ,$124.35 ,$3.50 ,$9.58 ,$124.35 ,$18.20 ,$160.30 ,$114.50 ,$183.20 ,$23.95 ,$9.58 ,$160.30 ,$9.58 ,$137.40 ,$9.58 ,$171.75 ,$126.41 ,$114.04 ,$126.41 ,$9.58 ,$126.41 ,$13.83 ,$13.83 ,$194.65 ,$23.95 ,$158.70 ,$9.58 ,$229.00 ,$125.95 ,$9.58 ,$60.23 , N/A ,$8.49 ,$8.11 ,$10.06 ,$183.20 ,$124.35 ,$64.12 ,$206.10 ,$87.02 ,$19.16 ,$9.58 ,$109.92 
ST. MARY'S HOSPITAL - DECATUR,30500300,85635,HC REPTILASE TEST-90,305,1 ,$79.00 ,$51.35 ,$3.50 ,$79.00 ,$24.63 ,$9.92 ,$43.45 ,$9.85 ,$22.12 ,$38.71 ,$9.85 ,$46.22 ,$9.85 ,$42.90 ,$3.50 ,$9.85 ,$42.90 ,$18.72 ,$55.30 ,$39.50 ,$63.20 ,$24.63 ,$9.85 ,$55.30 ,$9.85 ,$47.40 ,$9.85 ,$59.25 ,$43.61 ,$39.34 ,$43.61 ,$9.85 ,$43.61 ,$14.22 ,$14.22 ,$67.15 ,$24.63 ,$54.75 ,$9.85 ,$79.00 ,$43.45 ,$9.85 ,$20.78 , N/A ,$7.45 ,$7.11 ,$10.34 ,$63.20 ,$42.90 ,$22.12 ,$71.10 ,$30.02 ,$19.70 ,$9.85 ,$37.92 
ST. MARY'S HOSPITAL - DECATUR,30500301,85660,HC SICKLE CELL RBC-90,305,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$13.78 ,$12.90 ,$80.30 ,$5.51 ,$40.88 ,$43.45 ,$5.51 ,$43.45 ,$5.51 ,$79.28 ,$3.50 ,$5.51 ,$79.28 ,$10.47 ,$102.20 ,$73.00 ,$116.80 ,$13.78 ,$5.51 ,$102.20 ,$5.51 ,$87.60 ,$5.51 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$5.51 ,$80.59 ,$7.96 ,$7.96 ,$124.10 ,$13.78 ,$101.18 ,$5.51 ,$146.00 ,$80.30 ,$5.51 ,$38.40 , N/A ,$4.90 ,$4.67 ,$5.79 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$11.02 ,$5.51 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30500302,85660,HC SICKLE CELL RBC-90,305,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$13.78 ,$12.90 ,$80.30 ,$5.51 ,$40.88 ,$43.45 ,$5.51 ,$43.45 ,$5.51 ,$79.28 ,$3.50 ,$5.51 ,$79.28 ,$10.47 ,$102.20 ,$73.00 ,$116.80 ,$13.78 ,$5.51 ,$102.20 ,$5.51 ,$87.60 ,$5.51 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$5.51 ,$80.59 ,$7.96 ,$7.96 ,$124.10 ,$13.78 ,$101.18 ,$5.51 ,$146.00 ,$80.30 ,$5.51 ,$38.40 , N/A ,$4.90 ,$4.67 ,$5.79 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$11.02 ,$5.51 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30500303,85660,HC SICKLE CELL RBC,305,1 ,$127.00 ,$82.55 ,$3.50 ,$127.00 ,$13.78 ,$12.90 ,$69.85 ,$5.51 ,$35.56 ,$43.45 ,$5.51 ,$43.45 ,$5.51 ,$68.96 ,$3.50 ,$5.51 ,$68.96 ,$10.47 ,$88.90 ,$63.50 ,$101.60 ,$13.78 ,$5.51 ,$88.90 ,$5.51 ,$76.20 ,$5.51 ,$95.25 ,$70.10 ,$63.25 ,$70.10 ,$5.51 ,$70.10 ,$7.96 ,$7.96 ,$107.95 ,$13.78 ,$88.01 ,$5.51 ,$127.00 ,$69.85 ,$5.51 ,$33.40 , N/A ,$4.90 ,$4.67 ,$5.79 ,$101.60 ,$68.96 ,$35.56 ,$114.30 ,$48.26 ,$11.02 ,$5.51 ,$60.96 
ST. MARY'S HOSPITAL - DECATUR,30500304,85670,HC THROMBIN TIME PLASMA-90,305,1 ,$97.00 ,$63.05 ,$2.73 ,$97.00 ,$14.43 ,$13.48 ,$53.35 ,$5.77 ,$27.16 ,$45.51 ,$5.77 ,$45.51 ,$5.77 ,$52.67 ,$3.50 ,$5.77 ,$52.67 ,$10.96 ,$67.90 ,$48.50 ,$77.60 ,$14.43 ,$5.77 ,$67.90 ,$5.77 ,$58.20 ,$5.77 ,$72.75 ,$53.54 ,$48.31 ,$53.54 ,$5.77 ,$53.54 ,$8.33 ,$8.33 ,$82.45 ,$14.43 ,$67.22 ,$5.77 ,$97.00 ,$53.35 ,$5.77 ,$25.51 , N/A ,$2.86 ,$2.73 ,$6.06 ,$77.60 ,$52.67 ,$27.16 ,$87.30 ,$36.86 ,$11.54 ,$5.77 ,$46.56 
ST. MARY'S HOSPITAL - DECATUR,30500305,85730,HC PTT-90,305,1 ,$207.00 ,$134.55 ,$2.73 ,$207.00 ,$15.03 ,$14.02 ,$113.85 ,$6.01 ,$57.96 ,$64.19 ,$6.01 ,$64.19 ,$6.01 ,$112.40 ,$3.50 ,$6.01 ,$112.40 ,$11.42 ,$144.90 ,$103.50 ,$165.60 ,$15.03 ,$6.01 ,$144.90 ,$6.01 ,$124.20 ,$6.01 ,$155.25 ,$114.26 ,$103.09 ,$114.26 ,$6.01 ,$114.26 ,$8.67 ,$8.67 ,$175.95 ,$15.03 ,$143.45 ,$6.01 ,$207.00 ,$113.85 ,$6.01 ,$54.44 , N/A ,$2.86 ,$2.73 ,$6.31 ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$12.02 ,$6.01 ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,30500307,85732,HC PTT MIXING STUDY T1-90,305,1 ,$187.00 ,$121.55 ,$2.73 ,$187.00 ,$16.18 ,$15.12 ,$102.85 ,$6.47 ,$52.36 ,$51.02 ,$6.47 ,$51.02 ,$6.47 ,$101.54 ,$3.50 ,$6.47 ,$101.54 ,$12.29 ,$130.90 ,$93.50 ,$149.60 ,$16.18 ,$6.47 ,$130.90 ,$6.47 ,$112.20 ,$6.47 ,$140.25 ,$103.22 ,$93.13 ,$103.22 ,$6.47 ,$103.22 ,$9.33 ,$9.33 ,$158.95 ,$16.18 ,$129.59 ,$6.47 ,$187.00 ,$102.85 ,$6.47 ,$49.18 , N/A ,$2.86 ,$2.73 ,$6.79 ,$149.60 ,$101.54 ,$52.36 ,$168.30 ,$71.06 ,$12.94 ,$6.47 ,$89.76 
ST. MARY'S HOSPITAL - DECATUR,30500310,85810,HC VISCOSITY-90,305,1 ,$207.00 ,$134.55 ,$3.50 ,$207.00 ,$29.18 ,$27.26 ,$113.85 ,$11.67 ,$57.96 ,$92.11 ,$11.67 ,$92.11 ,$11.67 ,$112.40 ,$3.50 ,$11.67 ,$112.40 ,$22.17 ,$144.90 ,$103.50 ,$165.60 ,$29.18 ,$11.67 ,$144.90 ,$11.67 ,$124.20 ,$11.67 ,$155.25 ,$114.26 ,$103.09 ,$114.26 ,$11.67 ,$114.26 ,$16.86 ,$16.86 ,$175.95 ,$29.18 ,$143.45 ,$11.67 ,$207.00 ,$113.85 ,$11.67 ,$54.44 , N/A ,$7.45 ,$7.11 ,$12.25 ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$23.34 ,$11.67 ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,30500311,89331,HC SPERM EVAL URINE,305,1 ,$239.00 ,$155.35 ,$3.50 ,$239.00 ,$48.98 ,$43.84 ,$131.45 ,$19.59 ,$66.92 ,$117.11 ,$19.59 ,$139.82 ,$19.59 ,$129.78 ,$3.50 ,$19.59 ,$129.78 ,$37.22 ,$167.30 ,$119.50 ,$191.20 ,$48.98 ,$19.59 ,$167.30 ,$19.59 ,$143.40 ,$19.59 ,$179.25 ,$131.93 ,$119.02 ,$131.93 ,$19.59 ,$131.93 ,$28.29 ,$28.29 ,$203.15 ,$48.98 ,$165.63 ,$19.59 ,$239.00 ,$131.45 ,$19.59 ,$62.86 , N/A ,$22.52 ,$21.49 ,$20.57 ,$191.20 ,$129.78 ,$66.92 ,$215.10 ,$90.82 ,$39.18 ,$19.59 ,$114.72 
ST. MARY'S HOSPITAL - DECATUR,30500325,85013,HC BLOOD COUNT SPUN MICROHEMATOCRIT,305,1 ,$56.00 ,$36.40 ,$3.50 ,$56.00 ,$17.50 ,$5.54 ,$30.80 ,$7.00 ,$15.68 ,$27.44 ,$7.00 ,$32.76 ,$7.00 ,$30.41 ,$3.50 ,$7.00 ,$30.41 ,$13.30 ,$39.20 ,$28.00 ,$44.80 ,$17.50 ,$7.00 ,$39.20 ,$7.00 ,$33.60 ,$7.00 ,$42.00 ,$30.91 ,$27.89 ,$30.91 ,$7.00 ,$30.91 ,$9.10 ,$9.10 ,$47.60 ,$17.50 ,$38.81 ,$7.00 ,$56.00 ,$30.80 ,$7.00 ,$14.73 , N/A ,$4.90 ,$4.67 ,$7.35 ,$44.80 ,$30.41 ,$15.68 ,$50.40 ,$21.28 ,$14.00 ,$7.00 ,$26.88 
ST. MARY'S HOSPITAL - DECATUR,30500342,85597,HC PLATELET NEUTRALIZATION,305,1 ,$300.00 ,$195.00 ,$3.50 ,$300.00 ,$44.95 ,$42.00 ,$165.00 ,$17.98 ,$84.00 ,$141.75 ,$17.98 ,$141.75 ,$17.98 ,$162.90 ,$3.50 ,$17.98 ,$162.90 ,$34.16 ,$210.00 ,$150.00 ,$240.00 ,$44.95 ,$17.98 ,$210.00 ,$17.98 ,$180.00 ,$17.98 ,$225.00 ,$165.60 ,$149.40 ,$165.60 ,$17.98 ,$165.60 ,$25.96 ,$25.96 ,$255.00 ,$44.95 ,$207.90 ,$17.98 ,$300.00 ,$165.00 ,$17.98 ,$78.90 , N/A ,$8.49 ,$8.11 ,$18.88 ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$35.96 ,$17.98 ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,30500847,85048,HC BLOOD COUNT LEUKO AUTO-90,305,1 ,$86.00 ,$55.90 ,$2.54 ,$86.00 ,$6.35 ,$5.94 ,$47.30 ,$2.54 ,$24.08 ,$27.03 ,$2.54 ,$27.03 ,$2.54 ,$46.70 ,$3.50 ,$2.54 ,$46.70 ,$4.83 ,$60.20 ,$43.00 ,$68.80 ,$6.35 ,$2.54 ,$60.20 ,$2.54 ,$51.60 ,$2.54 ,$64.50 ,$47.47 ,$42.83 ,$47.47 ,$2.54 ,$47.47 ,$3.67 ,$3.67 ,$73.10 ,$6.35 ,$59.60 ,$2.54 ,$86.00 ,$47.30 ,$2.54 ,$22.62 , N/A ,$4.90 ,$4.67 ,$2.67 ,$68.80 ,$46.70 ,$24.08 ,$77.40 ,$32.68 ,$5.08 ,$2.54 ,$41.28 
ST. MARY'S HOSPITAL - DECATUR,30500848,85004,HC WBC W/AUTO DIFFERENTIAL-90,305,1 ,$484.00 ,$314.60 ,$3.50 ,$484.00 ,$16.18 ,$15.12 ,$266.20 ,$6.47 ,$135.52 ,$69.01 ,$6.47 ,$69.01 ,$6.47 ,$262.81 ,$3.50 ,$6.47 ,$262.81 ,$12.29 ,$338.80 ,$242.00 ,$387.20 ,$16.18 ,$6.47 ,$338.80 ,$6.47 ,$290.40 ,$6.47 ,$363.00 ,$267.17 ,$241.03 ,$267.17 ,$6.47 ,$267.17 ,$9.33 ,$9.33 ,$411.40 ,$16.18 ,$335.41 ,$6.47 ,$484.00 ,$266.20 ,$6.47 ,$127.29 , N/A ,$4.90 ,$4.67 ,$6.79 ,$387.20 ,$262.81 ,$135.52 ,$435.60 ,$183.92 ,$12.94 ,$6.47 ,$232.32 
ST. MARY'S HOSPITAL - DECATUR,30600101,87015,HC CONCENTRATION INFECTIOUS AGENT,306,1 ,$96.00 ,$62.40 ,$3.50 ,$96.00 ,$16.70 ,$15.60 ,$52.80 ,$6.68 ,$26.88 ,$47.04 ,$6.68 ,$52.69 ,$6.68 ,$52.13 ,$3.50 ,$6.68 ,$52.13 ,$12.69 ,$67.20 ,$48.00 ,$76.80 ,$16.70 ,$6.68 ,$67.20 ,$6.68 ,$57.60 ,$6.68 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$6.68 ,$52.99 ,$9.65 ,$9.65 ,$81.60 ,$16.70 ,$66.53 ,$6.68 ,$96.00 ,$52.80 ,$6.68 ,$25.25 , N/A ,$5.63 ,$5.38 ,$7.01 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$13.36 ,$6.68 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30600102,87040,HC BLOOD CULTURE,306,1 ,$419.00 ,$272.35 ,$3.50 ,$419.00 ,$25.80 ,$24.12 ,$230.45 ,$10.32 ,$117.32 ,$81.39 ,$10.32 ,$81.39 ,$10.32 ,$227.52 ,$3.50 ,$10.32 ,$227.52 ,$19.61 ,$293.30 ,$209.50 ,$335.20 ,$25.80 ,$10.32 ,$293.30 ,$10.32 ,$251.40 ,$10.32 ,$314.25 ,$231.29 ,$208.66 ,$231.29 ,$10.32 ,$231.29 ,$14.91 ,$14.91 ,$356.15 ,$25.80 ,$290.37 ,$10.32 ,$419.00 ,$230.45 ,$10.32 ,$110.20 , N/A ,$18.71 ,$17.86 ,$10.84 ,$335.20 ,$227.52 ,$117.32 ,$377.10 ,$159.22 ,$20.64 ,$10.32 ,$201.12 
ST. MARY'S HOSPITAL - DECATUR,30600109,87070,HC BODY FLUID CULTURE,306,1 ,$366.00 ,$237.90 ,$3.50 ,$366.00 ,$21.55 ,$20.12 ,$201.30 ,$8.62 ,$102.48 ,$92.01 ,$8.62 ,$92.01 ,$8.62 ,$198.74 ,$3.50 ,$8.62 ,$198.74 ,$16.38 ,$256.20 ,$183.00 ,$292.80 ,$21.55 ,$8.62 ,$256.20 ,$8.62 ,$219.60 ,$8.62 ,$274.50 ,$202.03 ,$182.27 ,$202.03 ,$8.62 ,$202.03 ,$12.44 ,$12.44 ,$311.10 ,$21.55 ,$253.64 ,$8.62 ,$366.00 ,$201.30 ,$8.62 ,$96.26 , N/A ,$5.63 ,$5.38 ,$9.05 ,$292.80 ,$198.74 ,$102.48 ,$329.40 ,$139.08 ,$17.24 ,$8.62 ,$175.68 
ST. MARY'S HOSPITAL - DECATUR,30600119,87075,HC CULTURE ANAEROBIC,306,1 ,$365.00 ,$237.25 ,$3.50 ,$365.00 ,$23.68 ,$22.12 ,$200.75 ,$9.47 ,$102.20 ,$74.71 ,$9.47 ,$74.71 ,$9.47 ,$198.20 ,$3.50 ,$9.47 ,$198.20 ,$17.99 ,$255.50 ,$182.50 ,$292.00 ,$23.68 ,$9.47 ,$255.50 ,$9.47 ,$219.00 ,$9.47 ,$273.75 ,$201.48 ,$181.77 ,$201.48 ,$9.47 ,$201.48 ,$13.68 ,$13.68 ,$310.25 ,$23.68 ,$252.95 ,$9.47 ,$365.00 ,$200.75 ,$9.47 ,$96.00 , N/A ,$5.63 ,$5.38 ,$9.94 ,$292.00 ,$198.20 ,$102.20 ,$328.50 ,$138.70 ,$18.94 ,$9.47 ,$175.20 
ST. MARY'S HOSPITAL - DECATUR,30600121,87076,HC CULTURE ANAEROBIC ID,306,1 ,$152.00 ,$98.80 ,$3.50 ,$152.00 ,$20.20 ,$9.92 ,$83.60 ,$8.08 ,$42.56 ,$63.70 ,$8.08 ,$63.70 ,$8.08 ,$82.54 ,$3.50 ,$8.08 ,$82.54 ,$15.35 ,$106.40 ,$76.00 ,$121.60 ,$20.20 ,$8.08 ,$106.40 ,$8.08 ,$91.20 ,$8.08 ,$114.00 ,$83.90 ,$75.70 ,$83.90 ,$8.08 ,$83.90 ,$11.66 ,$11.66 ,$129.20 ,$20.20 ,$105.34 ,$8.08 ,$152.00 ,$83.60 ,$8.08 ,$39.98 , N/A ,$5.63 ,$5.38 ,$8.48 ,$121.60 ,$82.54 ,$42.56 ,$136.80 ,$57.76 ,$16.16 ,$8.08 ,$72.96 
ST. MARY'S HOSPITAL - DECATUR,30600134,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$172.00 ,$111.80 ,$3.50 ,$172.00 ,$20.18 ,$18.88 ,$94.60 ,$8.07 ,$48.16 ,$84.28 ,$8.07 ,$86.11 ,$8.07 ,$93.40 ,$3.50 ,$8.07 ,$93.40 ,$15.33 ,$120.40 ,$86.00 ,$137.60 ,$20.18 ,$8.07 ,$120.40 ,$8.07 ,$103.20 ,$8.07 ,$129.00 ,$94.94 ,$85.66 ,$94.94 ,$8.07 ,$94.94 ,$11.66 ,$11.66 ,$146.20 ,$20.18 ,$119.20 ,$8.07 ,$172.00 ,$94.60 ,$8.07 ,$45.24 , N/A ,$5.63 ,$5.38 ,$8.47 ,$137.60 ,$93.40 ,$48.16 ,$154.80 ,$65.36 ,$16.14 ,$8.07 ,$82.56 
ST. MARY'S HOSPITAL - DECATUR,30600135,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$419.00 ,$272.35 ,$3.50 ,$419.00 ,$20.23 ,$18.92 ,$230.45 ,$8.09 ,$117.32 ,$86.41 ,$8.09 ,$86.41 ,$8.09 ,$227.52 ,$3.50 ,$8.09 ,$227.52 ,$15.37 ,$293.30 ,$209.50 ,$335.20 ,$20.23 ,$8.09 ,$293.30 ,$8.09 ,$251.40 ,$8.09 ,$314.25 ,$231.29 ,$208.66 ,$231.29 ,$8.09 ,$231.29 ,$11.69 ,$11.69 ,$356.15 ,$20.23 ,$290.37 ,$8.09 ,$419.00 ,$230.45 ,$8.09 ,$110.20 , N/A ,$5.63 ,$5.38 ,$8.49 ,$335.20 ,$227.52 ,$117.32 ,$377.10 ,$159.22 ,$16.18 ,$8.09 ,$201.12 
ST. MARY'S HOSPITAL - DECATUR,30600138,87102,HC CULTURE FUNGUS OTHER,306,1 ,$421.00 ,$273.65 ,$3.50 ,$421.00 ,$21.03 ,$19.64 ,$231.55 ,$8.41 ,$117.88 ,$66.35 ,$8.41 ,$66.35 ,$8.41 ,$228.60 ,$3.50 ,$8.41 ,$228.60 ,$15.98 ,$294.70 ,$210.50 ,$336.80 ,$21.03 ,$8.41 ,$294.70 ,$8.41 ,$252.60 ,$8.41 ,$315.75 ,$232.39 ,$209.66 ,$232.39 ,$8.41 ,$232.39 ,$12.14 ,$12.14 ,$357.85 ,$21.03 ,$291.75 ,$8.41 ,$421.00 ,$231.55 ,$8.41 ,$110.72 , N/A ,$5.63 ,$5.38 ,$8.83 ,$336.80 ,$228.60 ,$117.88 ,$378.90 ,$159.98 ,$16.82 ,$8.41 ,$202.08 
ST. MARY'S HOSPITAL - DECATUR,30600140,87103,HC CULTURE FUNGUS BLOOD,306,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$51.15 ,$21.08 ,$235.95 ,$20.46 ,$120.12 ,$130.74 ,$20.46 ,$130.74 ,$20.46 ,$232.95 ,$3.50 ,$20.46 ,$232.95 ,$38.87 ,$300.30 ,$214.50 ,$343.20 ,$51.15 ,$20.46 ,$300.30 ,$20.46 ,$257.40 ,$20.46 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$20.46 ,$236.81 ,$26.60 ,$26.60 ,$364.65 ,$51.15 ,$297.30 ,$20.46 ,$429.00 ,$235.95 ,$20.46 ,$112.83 , N/A ,$18.71 ,$17.86 ,$21.48 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$40.92 ,$20.46 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30600142,87106,HC CULTURE FUNGUS ID,306,1 ,$295.00 ,$191.75 ,$3.50 ,$295.00 ,$25.80 ,$24.12 ,$162.25 ,$10.32 ,$82.60 ,$81.39 ,$10.32 ,$81.39 ,$10.32 ,$160.19 ,$3.50 ,$10.32 ,$160.19 ,$19.61 ,$206.50 ,$147.50 ,$236.00 ,$25.80 ,$10.32 ,$206.50 ,$10.32 ,$177.00 ,$10.32 ,$221.25 ,$162.84 ,$146.91 ,$162.84 ,$10.32 ,$162.84 ,$14.91 ,$14.91 ,$250.75 ,$25.80 ,$204.44 ,$10.32 ,$295.00 ,$162.25 ,$10.32 ,$77.59 , N/A ,$5.63 ,$5.38 ,$10.84 ,$236.00 ,$160.19 ,$82.60 ,$265.50 ,$112.10 ,$20.64 ,$10.32 ,$141.60 
ST. MARY'S HOSPITAL - DECATUR,30600148,87116,HC CULTURE AFB/TB/MYCOBACT,306,1 ,$238.00 ,$154.70 ,$3.50 ,$238.00 ,$27.00 ,$25.24 ,$130.90 ,$10.80 ,$66.64 ,$85.23 ,$10.80 ,$85.23 ,$10.80 ,$129.23 ,$3.50 ,$10.80 ,$129.23 ,$20.52 ,$166.60 ,$119.00 ,$190.40 ,$27.00 ,$10.80 ,$166.60 ,$10.80 ,$142.80 ,$10.80 ,$178.50 ,$131.38 ,$118.52 ,$131.38 ,$10.80 ,$131.38 ,$15.60 ,$15.60 ,$202.30 ,$27.00 ,$164.93 ,$10.80 ,$238.00 ,$130.90 ,$10.80 ,$62.59 , N/A ,$18.71 ,$17.86 ,$11.34 ,$190.40 ,$129.23 ,$66.64 ,$214.20 ,$90.44 ,$21.60 ,$10.80 ,$114.24 
ST. MARY'S HOSPITAL - DECATUR,30600160,87150,HC ID NUCLEAR ACID PROBE,306,1 ,$243.00 ,$157.95 ,$3.50 ,$243.00 ,$87.73 ,$82.00 ,$133.65 ,$35.09 ,$68.04 ,$119.07 ,$35.09 ,$142.16 ,$35.09 ,$131.95 ,$3.50 ,$35.09 ,$131.95 ,$66.67 ,$170.10 ,$121.50 ,$194.40 ,$87.73 ,$35.09 ,$170.10 ,$35.09 ,$145.80 ,$35.09 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$35.09 ,$134.14 ,$50.69 ,$50.69 ,$206.55 ,$87.73 ,$168.40 ,$35.09 ,$243.00 ,$133.65 ,$35.09 ,$63.91 , N/A ,$5.63 ,$5.38 ,$36.84 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$70.18 ,$35.09 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30600161,87168,HC EXAM ARTHROPOD,306,1 ,$90.00 ,$58.50 ,$3.50 ,$90.00 ,$10.68 ,$9.98 ,$49.50 ,$4.27 ,$25.20 ,$33.72 ,$4.27 ,$33.72 ,$4.27 ,$48.87 ,$3.50 ,$4.27 ,$48.87 ,$8.11 ,$63.00 ,$45.00 ,$72.00 ,$10.68 ,$4.27 ,$63.00 ,$4.27 ,$54.00 ,$4.27 ,$67.50 ,$49.68 ,$44.82 ,$49.68 ,$4.27 ,$49.68 ,$6.18 ,$6.18 ,$76.50 ,$10.68 ,$62.37 ,$4.27 ,$90.00 ,$49.50 ,$4.27 ,$23.67 , N/A ,$5.63 ,$5.38 ,$4.48 ,$72.00 ,$48.87 ,$25.20 ,$81.00 ,$34.20 ,$8.54 ,$4.27 ,$43.20 
ST. MARY'S HOSPITAL - DECATUR,30600162,87169,HC PARASITE ID,306,1 ,$224.00 ,$145.60 ,$3.50 ,$224.00 ,$10.78 ,$9.98 ,$123.20 ,$4.31 ,$62.72 ,$33.72 ,$4.31 ,$33.72 ,$4.31 ,$121.63 ,$3.50 ,$4.31 ,$121.63 ,$8.19 ,$156.80 ,$112.00 ,$179.20 ,$10.78 ,$4.31 ,$156.80 ,$4.31 ,$134.40 ,$4.31 ,$168.00 ,$123.65 ,$111.55 ,$123.65 ,$4.31 ,$123.65 ,$6.18 ,$6.18 ,$190.40 ,$10.78 ,$155.23 ,$4.31 ,$224.00 ,$123.20 ,$4.31 ,$58.91 , N/A ,$5.63 ,$5.38 ,$4.53 ,$179.20 ,$121.63 ,$62.72 ,$201.60 ,$85.12 ,$8.62 ,$4.31 ,$107.52 
ST. MARY'S HOSPITAL - DECATUR,30600163,87172,HC PINWORM EXAM,306,1 ,$262.00 ,$170.30 ,$3.50 ,$262.00 ,$10.68 ,$9.98 ,$144.10 ,$4.27 ,$73.36 ,$45.61 ,$4.27 ,$45.61 ,$4.27 ,$142.27 ,$3.50 ,$4.27 ,$142.27 ,$8.11 ,$183.40 ,$131.00 ,$209.60 ,$10.68 ,$4.27 ,$183.40 ,$4.27 ,$157.20 ,$4.27 ,$196.50 ,$144.62 ,$130.48 ,$144.62 ,$4.27 ,$144.62 ,$6.18 ,$6.18 ,$222.70 ,$10.68 ,$181.57 ,$4.27 ,$262.00 ,$144.10 ,$4.27 ,$68.91 , N/A ,$5.63 ,$5.38 ,$4.48 ,$209.60 ,$142.27 ,$73.36 ,$235.80 ,$99.56 ,$8.54 ,$4.27 ,$125.76 
ST. MARY'S HOSPITAL - DECATUR,30600166,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$87.00 ,$56.55 ,$3.50 ,$87.00 ,$11.88 ,$11.10 ,$47.85 ,$4.75 ,$24.36 ,$42.63 ,$4.75 ,$50.72 ,$4.75 ,$47.24 ,$3.50 ,$4.75 ,$47.24 ,$9.03 ,$60.90 ,$43.50 ,$69.60 ,$11.88 ,$4.75 ,$60.90 ,$4.75 ,$52.20 ,$4.75 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$4.75 ,$48.02 ,$6.85 ,$6.85 ,$73.95 ,$11.88 ,$60.29 ,$4.75 ,$87.00 ,$47.85 ,$4.75 ,$22.88 , N/A ,$5.63 ,$5.38 ,$4.99 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$9.50 ,$4.75 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30600169,87184,HC SENSITIVITY DISK KB,306,1 ,$270.00 ,$175.50 ,$3.50 ,$270.00 ,$18.70 ,$16.14 ,$148.50 ,$7.48 ,$75.60 ,$73.63 ,$7.48 ,$73.63 ,$7.48 ,$146.61 ,$3.50 ,$7.48 ,$146.61 ,$14.21 ,$189.00 ,$135.00 ,$216.00 ,$18.70 ,$7.48 ,$189.00 ,$7.48 ,$162.00 ,$7.48 ,$202.50 ,$149.04 ,$134.46 ,$149.04 ,$7.48 ,$149.04 ,$9.96 ,$9.96 ,$229.50 ,$18.70 ,$187.11 ,$7.48 ,$270.00 ,$148.50 ,$7.48 ,$71.01 , N/A ,$5.63 ,$5.38 ,$7.85 ,$216.00 ,$146.61 ,$75.60 ,$243.00 ,$102.60 ,$14.96 ,$7.48 ,$129.60 
ST. MARY'S HOSPITAL - DECATUR,30600171,87185,HC BETA LACTAMASE,306,1 ,$122.00 ,$79.30 ,$3.50 ,$122.00 ,$11.88 ,$11.10 ,$67.10 ,$4.75 ,$34.16 ,$37.45 ,$4.75 ,$37.45 ,$4.75 ,$66.25 ,$3.50 ,$4.75 ,$66.25 ,$9.03 ,$85.40 ,$61.00 ,$97.60 ,$11.88 ,$4.75 ,$85.40 ,$4.75 ,$73.20 ,$4.75 ,$91.50 ,$67.34 ,$60.76 ,$67.34 ,$4.75 ,$67.34 ,$6.85 ,$6.85 ,$103.70 ,$11.88 ,$84.55 ,$4.75 ,$122.00 ,$67.10 ,$4.75 ,$32.09 , N/A ,$5.63 ,$5.38 ,$4.99 ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$9.50 ,$4.75 ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,30600172,87186,HC SENSITIVITY MIC,306,1 ,$177.00 ,$115.05 ,$3.50 ,$177.00 ,$21.63 ,$20.20 ,$97.35 ,$8.65 ,$49.56 ,$68.22 ,$8.65 ,$68.22 ,$8.65 ,$96.11 ,$3.50 ,$8.65 ,$96.11 ,$16.44 ,$123.90 ,$88.50 ,$141.60 ,$21.63 ,$8.65 ,$123.90 ,$8.65 ,$106.20 ,$8.65 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$8.65 ,$97.70 ,$12.49 ,$12.49 ,$150.45 ,$21.63 ,$122.66 ,$8.65 ,$177.00 ,$97.35 ,$8.65 ,$46.55 , N/A ,$5.63 ,$5.38 ,$9.08 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$17.30 ,$8.65 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$191.00 ,$124.15 ,$3.50 ,$191.00 ,$10.68 ,$9.98 ,$105.05 ,$4.27 ,$53.48 ,$45.61 ,$4.27 ,$45.61 ,$4.27 ,$103.71 ,$3.50 ,$4.27 ,$103.71 ,$8.11 ,$133.70 ,$95.50 ,$152.80 ,$10.68 ,$4.27 ,$133.70 ,$4.27 ,$114.60 ,$4.27 ,$143.25 ,$105.43 ,$95.12 ,$105.43 ,$4.27 ,$105.43 ,$6.18 ,$6.18 ,$162.35 ,$10.68 ,$132.36 ,$4.27 ,$191.00 ,$105.05 ,$4.27 ,$50.23 , N/A ,$5.63 ,$5.38 ,$4.48 ,$152.80 ,$103.71 ,$53.48 ,$171.90 ,$72.58 ,$8.54 ,$4.27 ,$91.68 
ST. MARY'S HOSPITAL - DECATUR,30600176,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$75.00 ,$48.75 ,$3.50 ,$75.00 ,$13.48 ,$12.56 ,$41.25 ,$5.39 ,$21.00 ,$36.75 ,$5.39 ,$43.88 ,$5.39 ,$40.73 ,$3.50 ,$5.39 ,$40.73 ,$10.24 ,$52.50 ,$37.50 ,$60.00 ,$13.48 ,$5.39 ,$52.50 ,$5.39 ,$45.00 ,$5.39 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$5.39 ,$41.40 ,$7.79 ,$7.79 ,$63.75 ,$13.48 ,$51.98 ,$5.39 ,$75.00 ,$41.25 ,$5.39 ,$19.73 , N/A ,$5.63 ,$5.38 ,$5.66 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$10.78 ,$5.39 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,30600183,87210,HC SMEAR WET MOUNT,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$14.55 ,$9.98 ,$116.60 ,$5.82 ,$59.36 ,$50.33 ,$5.82 ,$50.33 ,$5.82 ,$115.12 ,$3.50 ,$5.82 ,$115.12 ,$11.06 ,$148.40 ,$106.00 ,$169.60 ,$14.55 ,$5.82 ,$148.40 ,$5.82 ,$127.20 ,$5.82 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$5.82 ,$117.02 ,$7.57 ,$7.57 ,$180.20 ,$14.55 ,$146.92 ,$5.82 ,$212.00 ,$116.60 ,$5.82 ,$55.76 , N/A ,$5.63 ,$5.38 ,$6.11 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$11.64 ,$5.82 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600185,87220,HC TISSUE KOH PREP,306,1 ,$139.00 ,$90.35 ,$3.50 ,$139.00 ,$10.68 ,$9.98 ,$76.45 ,$4.27 ,$38.92 ,$45.61 ,$4.27 ,$45.61 ,$4.27 ,$75.48 ,$3.50 ,$4.27 ,$75.48 ,$8.11 ,$97.30 ,$69.50 ,$111.20 ,$10.68 ,$4.27 ,$97.30 ,$4.27 ,$83.40 ,$4.27 ,$104.25 ,$76.73 ,$69.22 ,$76.73 ,$4.27 ,$76.73 ,$6.18 ,$6.18 ,$118.15 ,$10.68 ,$96.33 ,$4.27 ,$139.00 ,$76.45 ,$4.27 ,$36.56 , N/A ,$5.63 ,$5.38 ,$4.48 ,$111.20 ,$75.48 ,$38.92 ,$125.10 ,$52.82 ,$8.54 ,$4.27 ,$66.72 
ST. MARY'S HOSPITAL - DECATUR,30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$407.00 ,$264.55 ,$3.50 ,$407.00 ,$29.95 ,$28.04 ,$223.85 ,$11.98 ,$113.96 ,$94.56 ,$11.98 ,$94.56 ,$11.98 ,$221.00 ,$3.50 ,$11.98 ,$221.00 ,$22.76 ,$284.90 ,$203.50 ,$325.60 ,$29.95 ,$11.98 ,$284.90 ,$11.98 ,$244.20 ,$11.98 ,$305.25 ,$224.66 ,$202.69 ,$224.66 ,$11.98 ,$224.66 ,$17.32 ,$17.32 ,$345.95 ,$29.95 ,$282.05 ,$11.98 ,$407.00 ,$223.85 ,$11.98 ,$107.04 , N/A ,$7.06 ,$6.74 ,$12.58 ,$325.60 ,$221.00 ,$113.96 ,$366.30 ,$154.66 ,$23.96 ,$11.98 ,$195.36 
ST. MARY'S HOSPITAL - DECATUR,30600215,87328,HC EIA QL CRYPTOSPORIDIUM AG,306,1 ,$217.00 ,$141.05 ,$3.50 ,$217.00 ,$34.55 ,$28.04 ,$119.35 ,$13.82 ,$60.76 ,$94.56 ,$13.82 ,$94.56 ,$13.82 ,$117.83 ,$3.50 ,$13.82 ,$117.83 ,$26.26 ,$151.90 ,$108.50 ,$173.60 ,$34.55 ,$13.82 ,$151.90 ,$13.82 ,$130.20 ,$13.82 ,$162.75 ,$119.78 ,$108.07 ,$119.78 ,$13.82 ,$119.78 ,$17.97 ,$17.97 ,$184.45 ,$34.55 ,$150.38 ,$13.82 ,$217.00 ,$119.35 ,$13.82 ,$57.07 , N/A ,$7.06 ,$6.74 ,$14.51 ,$173.60 ,$117.83 ,$60.76 ,$195.30 ,$82.46 ,$27.64 ,$13.82 ,$104.16 
ST. MARY'S HOSPITAL - DECATUR,30600216,87329,HC EIA QL GIARDIA AG,306,1 ,$270.00 ,$175.50 ,$3.50 ,$270.00 ,$29.95 ,$28.04 ,$148.50 ,$11.98 ,$75.60 ,$94.56 ,$11.98 ,$94.56 ,$11.98 ,$146.61 ,$3.50 ,$11.98 ,$146.61 ,$22.76 ,$189.00 ,$135.00 ,$216.00 ,$29.95 ,$11.98 ,$189.00 ,$11.98 ,$162.00 ,$11.98 ,$202.50 ,$149.04 ,$134.46 ,$149.04 ,$11.98 ,$149.04 ,$17.32 ,$17.32 ,$229.50 ,$29.95 ,$187.11 ,$11.98 ,$270.00 ,$148.50 ,$11.98 ,$71.01 , N/A ,$7.06 ,$6.74 ,$12.58 ,$216.00 ,$146.61 ,$75.60 ,$243.00 ,$102.60 ,$23.96 ,$11.98 ,$129.60 
ST. MARY'S HOSPITAL - DECATUR,30600225,87400,HC EIA QL INFLUENZA A/B AG,306,1 ,$263.00 ,$170.95 ,$3.50 ,$263.00 ,$35.33 ,$28.04 ,$144.65 ,$14.13 ,$73.64 ,$127.99 ,$14.13 ,$127.99 ,$14.13 ,$142.81 ,$3.50 ,$14.13 ,$142.81 ,$26.85 ,$184.10 ,$131.50 ,$210.40 ,$35.33 ,$14.13 ,$184.10 ,$14.13 ,$157.80 ,$14.13 ,$197.25 ,$145.18 ,$130.97 ,$145.18 ,$14.13 ,$145.18 ,$18.37 ,$18.37 ,$223.55 ,$35.33 ,$182.26 ,$14.13 ,$263.00 ,$144.65 ,$14.13 ,$69.17 , N/A ,$12.17 ,$11.61 ,$14.84 ,$210.40 ,$142.81 ,$73.64 ,$236.70 ,$99.94 ,$28.26 ,$14.13 ,$126.24 
ST. MARY'S HOSPITAL - DECATUR,30600226,87420,HC RSV AG QL,306,1 ,$318.00 ,$206.70 ,$3.50 ,$318.00 ,$34.78 ,$28.04 ,$174.90 ,$13.91 ,$89.04 ,$94.56 ,$13.91 ,$94.56 ,$13.91 ,$172.67 ,$3.50 ,$13.91 ,$172.67 ,$26.43 ,$222.60 ,$159.00 ,$254.40 ,$34.78 ,$13.91 ,$222.60 ,$13.91 ,$190.80 ,$13.91 ,$238.50 ,$175.54 ,$158.36 ,$175.54 ,$13.91 ,$175.54 ,$18.08 ,$18.08 ,$270.30 ,$34.78 ,$220.37 ,$13.91 ,$318.00 ,$174.90 ,$13.91 ,$83.63 , N/A ,$18.71 ,$17.86 ,$14.61 ,$254.40 ,$172.67 ,$89.04 ,$286.20 ,$120.84 ,$27.82 ,$13.91 ,$152.64 
ST. MARY'S HOSPITAL - DECATUR,30600227,87425,HC EIA QL ROTAVIRUS AG,306,1 ,$262.00 ,$170.30 ,$3.50 ,$262.00 ,$29.95 ,$28.04 ,$144.10 ,$11.98 ,$73.36 ,$94.56 ,$11.98 ,$94.56 ,$11.98 ,$142.27 ,$3.50 ,$11.98 ,$142.27 ,$22.76 ,$183.40 ,$131.00 ,$209.60 ,$29.95 ,$11.98 ,$183.40 ,$11.98 ,$157.20 ,$11.98 ,$196.50 ,$144.62 ,$130.48 ,$144.62 ,$11.98 ,$144.62 ,$17.32 ,$17.32 ,$222.70 ,$29.95 ,$181.57 ,$11.98 ,$262.00 ,$144.10 ,$11.98 ,$68.91 , N/A ,$7.06 ,$6.74 ,$12.58 ,$209.60 ,$142.27 ,$73.36 ,$235.80 ,$99.56 ,$23.96 ,$11.98 ,$125.76 
ST. MARY'S HOSPITAL - DECATUR,30600228,87430,HC RAPID STREP,306,1 ,$200.00 ,$130.00 ,$3.50 ,$200.00 ,$42.03 ,$28.04 ,$110.00 ,$16.81 ,$56.00 ,$98.00 ,$16.81 ,$117.00 ,$16.81 ,$108.60 ,$3.50 ,$16.81 ,$108.60 ,$31.94 ,$140.00 ,$100.00 ,$160.00 ,$42.03 ,$16.81 ,$140.00 ,$16.81 ,$120.00 ,$16.81 ,$150.00 ,$110.40 ,$99.60 ,$110.40 ,$16.81 ,$110.40 ,$21.85 ,$21.85 ,$170.00 ,$42.03 ,$138.60 ,$16.81 ,$200.00 ,$110.00 ,$16.81 ,$52.60 , N/A ,$7.06 ,$6.74 ,$17.65 ,$160.00 ,$108.60 ,$56.00 ,$180.00 ,$76.00 ,$33.62 ,$16.81 ,$96.00 
ST. MARY'S HOSPITAL - DECATUR,30600236,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$274.00 ,$178.10 ,$3.50 ,$274.00 ,$87.73 ,$82.00 ,$150.70 ,$35.09 ,$76.72 ,$134.26 ,$35.09 ,$160.29 ,$35.09 ,$148.78 ,$3.50 ,$35.09 ,$148.78 ,$66.67 ,$191.80 ,$137.00 ,$219.20 ,$87.73 ,$35.09 ,$191.80 ,$35.09 ,$164.40 ,$35.09 ,$205.50 ,$151.25 ,$136.45 ,$151.25 ,$35.09 ,$151.25 ,$50.69 ,$50.69 ,$232.90 ,$87.73 ,$189.88 ,$35.09 ,$274.00 ,$150.70 ,$35.09 ,$72.06 , N/A ,$7.06 ,$6.74 ,$36.84 ,$219.20 ,$148.78 ,$76.72 ,$246.60 ,$104.12 ,$70.18 ,$35.09 ,$131.52 
ST. MARY'S HOSPITAL - DECATUR,30600237,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$478.00 ,$310.70 ,$3.50 ,$478.00 ,$93.18 ,$82.00 ,$262.90 ,$37.27 ,$133.84 ,$234.22 ,$37.27 ,$276.81 ,$37.27 ,$259.55 ,$3.50 ,$37.27 ,$259.55 ,$70.81 ,$334.60 ,$239.00 ,$382.40 ,$93.18 ,$37.27 ,$334.60 ,$37.27 ,$286.80 ,$37.27 ,$358.50 ,$263.86 ,$238.04 ,$263.86 ,$37.27 ,$263.86 ,$50.69 ,$50.69 ,$406.30 ,$93.18 ,$331.25 ,$37.27 ,$478.00 ,$262.90 ,$37.27 ,$125.71 , N/A ,$7.06 ,$6.74 ,$39.13 ,$382.40 ,$259.55 ,$133.84 ,$430.20 ,$181.64 ,$74.54 ,$37.27 ,$229.44 
ST. MARY'S HOSPITAL - DECATUR,30600249,87591,HC NEISSERIA AMP,306,1 ,$242.00 ,$157.30 ,$3.50 ,$242.00 ,$87.73 ,$82.00 ,$133.10 ,$35.09 ,$67.76 ,$118.58 ,$35.09 ,$141.57 ,$35.09 ,$131.41 ,$3.50 ,$35.09 ,$131.41 ,$66.67 ,$169.40 ,$121.00 ,$193.60 ,$87.73 ,$35.09 ,$169.40 ,$35.09 ,$145.20 ,$35.09 ,$181.50 ,$133.58 ,$120.52 ,$133.58 ,$35.09 ,$133.58 ,$50.69 ,$50.69 ,$205.70 ,$87.73 ,$167.71 ,$35.09 ,$242.00 ,$133.10 ,$35.09 ,$63.65 , N/A ,$18.71 ,$17.86 ,$36.84 ,$193.60 ,$131.41 ,$67.76 ,$217.80 ,$91.96 ,$70.18 ,$35.09 ,$116.16 
ST. MARY'S HOSPITAL - DECATUR,30600250,87624,HC HPV AMP,306,1 ,$56.00 ,$36.40 ,$3.50 ,$87.73 ,$87.73 ,$56.00 ,$30.80 ,$35.09 ,$15.68 ,$27.44 ,$35.09 ,$32.76 ,$35.09 ,$30.41 ,$3.50 ,$35.09 ,$30.41 ,$56.00 ,$39.20 ,$28.00 ,$44.80 ,$87.73 ,$35.09 ,$39.20 ,$35.09 ,$33.60 ,$35.09 ,$42.00 ,$30.91 ,$27.89 ,$30.91 ,$35.09 ,$30.91 ,$50.69 ,$50.69 ,$47.60 ,$56.00 ,$38.81 ,$35.09 ,$35.09 ,$30.80 ,$35.09 ,$14.73 , N/A ,$18.71 ,$17.86 ,$36.84 ,$44.80 ,$30.41 ,$15.68 ,$50.40 ,$21.28 ,$56.00 ,$35.09 ,$26.88 
ST. MARY'S HOSPITAL - DECATUR,30600252,87624,HC HPV AMP,306,1 ,$74.00 ,$48.10 ,$3.50 ,$87.73 ,$87.73 ,$74.00 ,$40.70 ,$35.09 ,$20.72 ,$36.26 ,$35.09 ,$43.29 ,$35.09 ,$40.18 ,$3.50 ,$35.09 ,$40.18 ,$66.67 ,$51.80 ,$37.00 ,$59.20 ,$87.73 ,$35.09 ,$51.80 ,$35.09 ,$44.40 ,$35.09 ,$55.50 ,$40.85 ,$36.85 ,$40.85 ,$35.09 ,$40.85 ,$50.69 ,$50.69 ,$62.90 ,$74.00 ,$51.28 ,$35.09 ,$35.09 ,$40.70 ,$35.09 ,$19.46 , N/A ,$18.71 ,$17.86 ,$36.84 ,$59.20 ,$40.18 ,$20.72 ,$66.60 ,$28.12 ,$70.18 ,$35.09 ,$35.52 
ST. MARY'S HOSPITAL - DECATUR,30600255,87641,HC MRSA AMP,306,1 ,$353.00 ,$229.45 ,$3.50 ,$353.00 ,$87.73 ,$82.00 ,$194.15 ,$35.09 ,$98.84 ,$172.97 ,$35.09 ,$206.51 ,$35.09 ,$191.68 ,$3.50 ,$35.09 ,$191.68 ,$66.67 ,$247.10 ,$176.50 ,$282.40 ,$87.73 ,$35.09 ,$247.10 ,$35.09 ,$211.80 ,$35.09 ,$264.75 ,$194.86 ,$175.79 ,$194.86 ,$35.09 ,$194.86 ,$50.69 ,$50.69 ,$300.05 ,$87.73 ,$244.63 ,$35.09 ,$353.00 ,$194.15 ,$35.09 ,$92.84 , N/A ,$18.71 ,$17.86 ,$36.84 ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$70.18 ,$35.09 ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,30600257,87653,HC INFECT AMP (GRP B STREP),306,1 ,$261.00 ,$169.65 ,$3.50 ,$261.00 ,$87.73 ,$82.00 ,$143.55 ,$35.09 ,$73.08 ,$127.89 ,$35.09 ,$152.69 ,$35.09 ,$141.72 ,$3.50 ,$35.09 ,$141.72 ,$66.67 ,$182.70 ,$130.50 ,$208.80 ,$87.73 ,$35.09 ,$182.70 ,$35.09 ,$156.60 ,$35.09 ,$195.75 ,$144.07 ,$129.98 ,$144.07 ,$35.09 ,$144.07 ,$50.69 ,$50.69 ,$221.85 ,$87.73 ,$180.87 ,$35.09 ,$261.00 ,$143.55 ,$35.09 ,$68.64 , N/A ,$18.71 ,$17.86 ,$36.84 ,$208.80 ,$141.72 ,$73.08 ,$234.90 ,$99.18 ,$70.18 ,$35.09 ,$125.28 
ST. MARY'S HOSPITAL - DECATUR,30600267,87799,HC INFECT AGENT QN,306,1 ,$604.00 ,$392.60 ,$3.50 ,$604.00 ,$107.10 ,$100.10 ,$332.20 ,$42.84 ,$169.12 ,$295.96 ,$42.84 ,$337.86 ,$42.84 ,$327.97 ,$3.50 ,$42.84 ,$327.97 ,$81.40 ,$422.80 ,$302.00 ,$483.20 ,$107.10 ,$42.84 ,$422.80 ,$42.84 ,$362.40 ,$42.84 ,$453.00 ,$333.41 ,$300.79 ,$333.41 ,$42.84 ,$333.41 ,$61.88 ,$61.88 ,$513.40 ,$107.10 ,$418.57 ,$42.84 ,$604.00 ,$332.20 ,$42.84 ,$158.85 , N/A ,$18.71 ,$17.86 ,$44.98 ,$483.20 ,$327.97 ,$169.12 ,$543.60 ,$229.52 ,$85.68 ,$42.84 ,$289.92 
ST. MARY'S HOSPITAL - DECATUR,30600271,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$118.00 ,$76.70 ,$3.50 ,$118.00 ,$40.18 ,$28.04 ,$64.90 ,$16.07 ,$33.04 ,$57.82 ,$16.07 ,$69.03 ,$16.07 ,$64.07 ,$3.50 ,$16.07 ,$64.07 ,$30.53 ,$82.60 ,$59.00 ,$94.40 ,$40.18 ,$16.07 ,$82.60 ,$16.07 ,$70.80 ,$16.07 ,$88.50 ,$65.14 ,$58.76 ,$65.14 ,$16.07 ,$65.14 ,$20.89 ,$20.89 ,$100.30 ,$40.18 ,$81.77 ,$16.07 ,$118.00 ,$64.90 ,$16.07 ,$31.03 , N/A ,$5.63 ,$5.38 ,$16.87 ,$94.40 ,$64.07 ,$33.04 ,$106.20 ,$44.84 ,$32.14 ,$16.07 ,$56.64 
ST. MARY'S HOSPITAL - DECATUR,30600283,87804,HC QL INFLUENZA A/B,306,1 ,$183.00 ,$118.95 ,$3.50 ,$183.00 ,$41.38 ,$28.04 ,$100.65 ,$16.55 ,$51.24 ,$89.67 ,$16.55 ,$107.06 ,$16.55 ,$99.37 ,$3.50 ,$16.55 ,$99.37 ,$31.45 ,$128.10 ,$91.50 ,$146.40 ,$41.38 ,$16.55 ,$128.10 ,$16.55 ,$109.80 ,$16.55 ,$137.25 ,$101.02 ,$91.13 ,$101.02 ,$16.55 ,$101.02 ,$21.52 ,$21.52 ,$155.55 ,$41.38 ,$126.82 ,$16.55 ,$183.00 ,$100.65 ,$16.55 ,$48.13 , N/A ,$5.63 ,$5.38 ,$17.38 ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$69.54 ,$33.10 ,$16.55 ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,30600303,87176,HC HOMOGENIZATION TISSUE,306,1 ,$91.00 ,$59.15 ,$3.50 ,$91.00 ,$14.70 ,$13.76 ,$50.05 ,$5.88 ,$25.48 ,$44.59 ,$5.88 ,$46.40 ,$5.88 ,$49.41 ,$3.50 ,$5.88 ,$49.41 ,$11.17 ,$63.70 ,$45.50 ,$72.80 ,$14.70 ,$5.88 ,$63.70 ,$5.88 ,$54.60 ,$5.88 ,$68.25 ,$50.23 ,$45.32 ,$50.23 ,$5.88 ,$50.23 ,$8.50 ,$8.50 ,$77.35 ,$14.70 ,$63.06 ,$5.88 ,$91.00 ,$50.05 ,$5.88 ,$23.93 , N/A ,$5.63 ,$5.38 ,$6.17 ,$72.80 ,$49.41 ,$25.48 ,$81.90 ,$34.58 ,$11.76 ,$5.88 ,$43.68 
ST. MARY'S HOSPITAL - DECATUR,30600314,87340,HC EIA QL HEPATITIS B AG,306,1 ,$300.00 ,$195.00 ,$3.50 ,$300.00 ,$25.83 ,$24.14 ,$165.00 ,$10.33 ,$84.00 ,$81.49 ,$10.33 ,$81.49 ,$10.33 ,$162.90 ,$3.50 ,$10.33 ,$162.90 ,$19.63 ,$210.00 ,$150.00 ,$240.00 ,$25.83 ,$10.33 ,$210.00 ,$10.33 ,$180.00 ,$10.33 ,$225.00 ,$165.60 ,$149.40 ,$165.60 ,$10.33 ,$165.60 ,$14.92 ,$14.92 ,$255.00 ,$25.83 ,$207.90 ,$10.33 ,$300.00 ,$165.00 ,$10.33 ,$78.90 , N/A ,$7.06 ,$6.74 ,$10.85 ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$20.66 ,$10.33 ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,30600318,87449,HC EIA QL MLT AG INF,306,1 ,$218.00 ,$141.70 ,$3.50 ,$218.00 ,$29.95 ,$28.04 ,$119.90 ,$11.98 ,$61.04 ,$106.82 ,$11.98 ,$127.53 ,$11.98 ,$118.37 ,$3.50 ,$11.98 ,$118.37 ,$22.76 ,$152.60 ,$109.00 ,$174.40 ,$29.95 ,$11.98 ,$152.60 ,$11.98 ,$130.80 ,$11.98 ,$163.50 ,$120.34 ,$108.56 ,$120.34 ,$11.98 ,$120.34 ,$17.32 ,$17.32 ,$185.30 ,$29.95 ,$151.07 ,$11.98 ,$218.00 ,$119.90 ,$11.98 ,$57.33 , N/A ,$7.06 ,$6.74 ,$12.58 ,$174.40 ,$118.37 ,$61.04 ,$196.20 ,$82.84 ,$23.96 ,$11.98 ,$104.64 
ST. MARY'S HOSPITAL - DECATUR,30600332,87651,HC INFECT AMP (GRP A STREP),306,1 ,$194.00 ,$126.10 ,$3.50 ,$194.00 ,$87.73 ,$82.00 ,$106.70 ,$35.09 ,$54.32 ,$95.06 ,$35.09 ,$113.49 ,$35.09 ,$105.34 ,$3.50 ,$35.09 ,$105.34 ,$66.67 ,$135.80 ,$97.00 ,$155.20 ,$87.73 ,$35.09 ,$135.80 ,$35.09 ,$116.40 ,$35.09 ,$145.50 ,$107.09 ,$96.61 ,$107.09 ,$35.09 ,$107.09 ,$50.69 ,$50.69 ,$164.90 ,$87.73 ,$134.44 ,$35.09 ,$194.00 ,$106.70 ,$35.09 ,$51.02 , N/A ,$18.71 ,$17.86 ,$36.84 ,$155.20 ,$105.34 ,$54.32 ,$174.60 ,$73.72 ,$70.18 ,$35.09 ,$93.12 
ST. MARY'S HOSPITAL - DECATUR,30600348,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,"$1,893.00 ","$1,230.45 ",$3.50 ,"$1,893.00 ","$1,041.95 ",$971.92 ,"$1,041.15 ",$416.78 ,$530.04 ,$927.57 ,$416.78 ,"$1,107.41 ",$416.78 ,"$1,027.90 ",$3.50 ,$416.78 ,"$1,027.90 ",$791.88 ,"$1,325.10 ",$946.50 ,"$1,514.40 ","$1,041.95 ",$416.78 ,"$1,325.10 ",$416.78 ,"$1,135.80 ",$416.78 ,"$1,419.75 ","$1,044.94 ",$942.71 ,"$1,044.94 ",$416.78 ,"$1,044.94 ",$602.02 ,$602.02 ,"$1,609.05 ","$1,041.95 ","$1,311.85 ",$416.78 ,"$1,893.00 ","$1,041.15 ",$416.78 ,$497.86 , N/A ,$18.71 ,$17.86 ,$437.62 ,"$1,514.40 ","$1,027.90 ",$530.04 ,"$1,703.70 ",$719.34 ,$833.56 ,$416.78 ,$908.64 
ST. MARY'S HOSPITAL - DECATUR,30600352,87563,"HC INFECT AMP (MYCOPLASMA/UREAPLASMA PNL, PCR)",306,1 ,$243.00 ,$157.95 ,$3.50 ,$243.00 ,$87.73 ,$59.66 ,$133.65 ,$35.09 ,$68.04 ,$114.21 ,$35.09 ,$131.22 ,$35.09 ,$131.95 ,$3.50 ,$35.09 ,$131.95 ,$66.67 ,$170.10 ,$121.50 ,$194.40 ,$87.73 ,$35.09 ,$170.10 ,$35.09 ,$145.80 ,$35.09 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$35.09 ,$134.14 ,$45.62 ,$45.62 ,$206.55 ,$87.73 ,$168.40 ,$35.09 ,$243.00 ,$133.65 ,$35.09 ,$63.91 , N/A ,$18.71 ,$17.86 ,$36.84 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$70.18 ,$35.09 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30600353,87015,HC CONCENTRATION INFECTIOUS AGENT-90,306,1 ,$96.00 ,$62.40 ,$3.50 ,$96.00 ,$16.70 ,$15.60 ,$52.80 ,$6.68 ,$26.88 ,$47.04 ,$6.68 ,$52.69 ,$6.68 ,$52.13 ,$3.50 ,$6.68 ,$52.13 ,$12.69 ,$67.20 ,$48.00 ,$76.80 ,$16.70 ,$6.68 ,$67.20 ,$6.68 ,$57.60 ,$6.68 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$6.68 ,$52.99 ,$9.65 ,$9.65 ,$81.60 ,$16.70 ,$66.53 ,$6.68 ,$96.00 ,$52.80 ,$6.68 ,$25.25 , N/A ,$5.63 ,$5.38 ,$7.01 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$13.36 ,$6.68 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30600355,87076,HC CULTURE ANAEROBIC ID-90,306,1 ,$152.00 ,$98.80 ,$3.50 ,$152.00 ,$20.20 ,$9.92 ,$83.60 ,$8.08 ,$42.56 ,$63.70 ,$8.08 ,$63.70 ,$8.08 ,$82.54 ,$3.50 ,$8.08 ,$82.54 ,$15.35 ,$106.40 ,$76.00 ,$121.60 ,$20.20 ,$8.08 ,$106.40 ,$8.08 ,$91.20 ,$8.08 ,$114.00 ,$83.90 ,$75.70 ,$83.90 ,$8.08 ,$83.90 ,$11.66 ,$11.66 ,$129.20 ,$20.20 ,$105.34 ,$8.08 ,$152.00 ,$83.60 ,$8.08 ,$39.98 , N/A ,$5.63 ,$5.38 ,$8.48 ,$121.60 ,$82.54 ,$42.56 ,$136.80 ,$57.76 ,$16.16 ,$8.08 ,$72.96 
ST. MARY'S HOSPITAL - DECATUR,30600356,87077,HC CULTURE AEROBIC ID ADDL-90,306,1 ,$195.00 ,$126.75 ,$3.50 ,$195.00 ,$20.20 ,$9.92 ,$107.25 ,$8.08 ,$54.60 ,$86.21 ,$8.08 ,$86.21 ,$8.08 ,$105.89 ,$3.50 ,$8.08 ,$105.89 ,$15.35 ,$136.50 ,$97.50 ,$156.00 ,$20.20 ,$8.08 ,$136.50 ,$8.08 ,$117.00 ,$8.08 ,$146.25 ,$107.64 ,$97.11 ,$107.64 ,$8.08 ,$107.64 ,$11.66 ,$11.66 ,$165.75 ,$20.20 ,$135.14 ,$8.08 ,$195.00 ,$107.25 ,$8.08 ,$51.29 , N/A ,$5.63 ,$5.38 ,$8.48 ,$156.00 ,$105.89 ,$54.60 ,$175.50 ,$74.10 ,$16.16 ,$8.08 ,$93.60 
ST. MARY'S HOSPITAL - DECATUR,30600357,87077,HC CULTURE AEROBIC ID ADDL T1,306,1 ,$195.00 ,$126.75 ,$3.50 ,$195.00 ,$20.20 ,$9.92 ,$107.25 ,$8.08 ,$54.60 ,$86.21 ,$8.08 ,$86.21 ,$8.08 ,$105.89 ,$3.50 ,$8.08 ,$105.89 ,$15.35 ,$136.50 ,$97.50 ,$156.00 ,$20.20 ,$8.08 ,$136.50 ,$8.08 ,$117.00 ,$8.08 ,$146.25 ,$107.64 ,$97.11 ,$107.64 ,$8.08 ,$107.64 ,$11.66 ,$11.66 ,$165.75 ,$20.20 ,$135.14 ,$8.08 ,$195.00 ,$107.25 ,$8.08 ,$51.29 , N/A ,$5.63 ,$5.38 ,$8.48 ,$156.00 ,$105.89 ,$54.60 ,$175.50 ,$74.10 ,$16.16 ,$8.08 ,$93.60 
ST. MARY'S HOSPITAL - DECATUR,30600359,87081,HC CULTURE SCR PRESUMP PATHOGENS-90,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$16.58 ,$15.50 ,$116.60 ,$6.63 ,$59.36 ,$70.78 ,$6.63 ,$70.78 ,$6.63 ,$115.12 ,$3.50 ,$6.63 ,$115.12 ,$12.60 ,$148.40 ,$106.00 ,$169.60 ,$16.58 ,$6.63 ,$148.40 ,$6.63 ,$127.20 ,$6.63 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$6.63 ,$117.02 ,$9.57 ,$9.57 ,$180.20 ,$16.58 ,$146.92 ,$6.63 ,$212.00 ,$116.60 ,$6.63 ,$55.76 , N/A ,$5.63 ,$5.38 ,$6.96 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$13.26 ,$6.63 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600360,87081,HC CULTURE SCR PRESUMP PATHOGENS T1,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$16.58 ,$15.50 ,$116.60 ,$6.63 ,$59.36 ,$70.78 ,$6.63 ,$70.78 ,$6.63 ,$115.12 ,$3.50 ,$6.63 ,$115.12 ,$12.60 ,$148.40 ,$106.00 ,$169.60 ,$16.58 ,$6.63 ,$148.40 ,$6.63 ,$127.20 ,$6.63 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$6.63 ,$117.02 ,$9.57 ,$9.57 ,$180.20 ,$16.58 ,$146.92 ,$6.63 ,$212.00 ,$116.60 ,$6.63 ,$55.76 , N/A ,$5.63 ,$5.38 ,$6.96 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$13.26 ,$6.63 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600361,87081,HC CULTURE SCR PRESUMP PATHOGENS T2,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$16.58 ,$15.50 ,$116.60 ,$6.63 ,$59.36 ,$70.78 ,$6.63 ,$70.78 ,$6.63 ,$115.12 ,$3.50 ,$6.63 ,$115.12 ,$12.60 ,$148.40 ,$106.00 ,$169.60 ,$16.58 ,$6.63 ,$148.40 ,$6.63 ,$127.20 ,$6.63 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$6.63 ,$117.02 ,$9.57 ,$9.57 ,$180.20 ,$16.58 ,$146.92 ,$6.63 ,$212.00 ,$116.60 ,$6.63 ,$55.76 , N/A ,$5.63 ,$5.38 ,$6.96 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$13.26 ,$6.63 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600363,87103,HC CULTURE FUNGUS BLOOD-90,306,1 ,$210.00 ,$136.50 ,$3.50 ,$210.00 ,$51.15 ,$21.08 ,$115.50 ,$20.46 ,$58.80 ,$102.90 ,$20.46 ,$122.85 ,$20.46 ,$114.03 ,$3.50 ,$20.46 ,$114.03 ,$38.87 ,$147.00 ,$105.00 ,$168.00 ,$51.15 ,$20.46 ,$147.00 ,$20.46 ,$126.00 ,$20.46 ,$157.50 ,$115.92 ,$104.58 ,$115.92 ,$20.46 ,$115.92 ,$26.60 ,$26.60 ,$178.50 ,$51.15 ,$145.53 ,$20.46 ,$210.00 ,$115.50 ,$20.46 ,$55.23 , N/A ,$18.71 ,$17.86 ,$21.48 ,$168.00 ,$114.03 ,$58.80 ,$189.00 ,$79.80 ,$40.92 ,$20.46 ,$100.80 
ST. MARY'S HOSPITAL - DECATUR,30600364,87106,HC CULTURE FUNGUS ID YEAST-90,306,1 ,$295.00 ,$191.75 ,$3.50 ,$295.00 ,$25.80 ,$24.12 ,$162.25 ,$10.32 ,$82.60 ,$81.39 ,$10.32 ,$81.39 ,$10.32 ,$160.19 ,$3.50 ,$10.32 ,$160.19 ,$19.61 ,$206.50 ,$147.50 ,$236.00 ,$25.80 ,$10.32 ,$206.50 ,$10.32 ,$177.00 ,$10.32 ,$221.25 ,$162.84 ,$146.91 ,$162.84 ,$10.32 ,$162.84 ,$14.91 ,$14.91 ,$250.75 ,$25.80 ,$204.44 ,$10.32 ,$295.00 ,$162.25 ,$10.32 ,$77.59 , N/A ,$5.63 ,$5.38 ,$10.84 ,$236.00 ,$160.19 ,$82.60 ,$265.50 ,$112.10 ,$20.64 ,$10.32 ,$141.60 
ST. MARY'S HOSPITAL - DECATUR,30600365,87107,HC CULTURE FUNGUS ID MOLD-90,306,1 ,$120.00 ,$78.00 ,$3.50 ,$120.00 ,$25.80 ,$24.12 ,$66.00 ,$10.32 ,$33.60 ,$58.80 ,$10.32 ,$70.20 ,$10.32 ,$65.16 ,$3.50 ,$10.32 ,$65.16 ,$19.61 ,$84.00 ,$60.00 ,$96.00 ,$25.80 ,$10.32 ,$84.00 ,$10.32 ,$72.00 ,$10.32 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$10.32 ,$66.24 ,$14.91 ,$14.91 ,$102.00 ,$25.80 ,$83.16 ,$10.32 ,$120.00 ,$66.00 ,$10.32 ,$31.56 , N/A ,$18.71 ,$17.86 ,$10.84 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$20.64 ,$10.32 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30600367,87110,HC CULTURE CHLAMYDIA-90,306,1 ,$87.00 ,$56.55 ,$3.50 ,$87.00 ,$49.00 ,$45.78 ,$47.85 ,$19.60 ,$24.36 ,$42.63 ,$19.60 ,$50.90 ,$19.60 ,$47.24 ,$3.50 ,$19.60 ,$47.24 ,$37.24 ,$60.90 ,$43.50 ,$69.60 ,$49.00 ,$19.60 ,$60.90 ,$19.60 ,$52.20 ,$19.60 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$19.60 ,$48.02 ,$28.30 ,$28.30 ,$73.95 ,$49.00 ,$60.29 ,$19.60 ,$87.00 ,$47.85 ,$19.60 ,$22.88 , N/A ,$5.63 ,$5.38 ,$20.58 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$39.20 ,$19.60 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30600368,87116,HC CULTURE AFB/TB/MYCOBACT-90,306,1 ,$104.00 ,$67.60 ,$3.50 ,$104.00 ,$27.00 ,$25.24 ,$57.20 ,$10.80 ,$29.12 ,$50.96 ,$10.80 ,$60.84 ,$10.80 ,$56.47 ,$3.50 ,$10.80 ,$56.47 ,$20.52 ,$72.80 ,$52.00 ,$83.20 ,$27.00 ,$10.80 ,$72.80 ,$10.80 ,$62.40 ,$10.80 ,$78.00 ,$57.41 ,$51.79 ,$57.41 ,$10.80 ,$57.41 ,$15.60 ,$15.60 ,$88.40 ,$27.00 ,$72.07 ,$10.80 ,$104.00 ,$57.20 ,$10.80 ,$27.35 , N/A ,$18.71 ,$17.86 ,$11.34 ,$83.20 ,$56.47 ,$29.12 ,$93.60 ,$39.52 ,$21.60 ,$10.80 ,$49.92 
ST. MARY'S HOSPITAL - DECATUR,30600370,87140,HC CULTURE TYPE IF EA ANTISERUM-90,306,1 ,$94.00 ,$61.10 ,$3.50 ,$94.00 ,$13.93 ,$13.04 ,$51.70 ,$5.57 ,$26.32 ,$43.94 ,$5.57 ,$43.94 ,$5.57 ,$51.04 ,$3.50 ,$5.57 ,$51.04 ,$10.58 ,$65.80 ,$47.00 ,$75.20 ,$13.93 ,$5.57 ,$65.80 ,$5.57 ,$56.40 ,$5.57 ,$70.50 ,$51.89 ,$46.81 ,$51.89 ,$5.57 ,$51.89 ,$8.05 ,$8.05 ,$79.90 ,$13.93 ,$65.14 ,$5.57 ,$94.00 ,$51.70 ,$5.57 ,$24.72 , N/A ,$18.71 ,$17.86 ,$5.85 ,$75.20 ,$51.04 ,$26.32 ,$84.60 ,$35.72 ,$11.14 ,$5.57 ,$45.12 
ST. MARY'S HOSPITAL - DECATUR,30600372,87147,HC CULTURE TYPE SEROLOGIC-90,306,1 ,$81.00 ,$52.65 ,$3.50 ,$81.00 ,$12.95 ,$12.08 ,$44.55 ,$5.18 ,$22.68 ,$39.69 ,$5.18 ,$40.79 ,$5.18 ,$43.98 ,$3.50 ,$5.18 ,$43.98 ,$9.84 ,$56.70 ,$40.50 ,$64.80 ,$12.95 ,$5.18 ,$56.70 ,$5.18 ,$48.60 ,$5.18 ,$60.75 ,$44.71 ,$40.34 ,$44.71 ,$5.18 ,$44.71 ,$7.48 ,$7.48 ,$68.85 ,$12.95 ,$56.13 ,$5.18 ,$81.00 ,$44.55 ,$5.18 ,$21.30 , N/A ,$5.63 ,$5.38 ,$5.44 ,$64.80 ,$43.98 ,$22.68 ,$72.90 ,$30.78 ,$10.36 ,$5.18 ,$38.88 
ST. MARY'S HOSPITAL - DECATUR,30600375,87149,HC CULTURE TYPING ID NUCLEIC ACID-90,306,1 ,$120.00 ,$78.00 ,$3.50 ,$120.00 ,$50.13 ,$46.86 ,$66.00 ,$20.05 ,$33.60 ,$58.80 ,$20.05 ,$70.20 ,$20.05 ,$65.16 ,$3.50 ,$20.05 ,$65.16 ,$38.10 ,$84.00 ,$60.00 ,$96.00 ,$50.13 ,$20.05 ,$84.00 ,$20.05 ,$72.00 ,$20.05 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$20.05 ,$66.24 ,$28.96 ,$28.96 ,$102.00 ,$50.13 ,$83.16 ,$20.05 ,$120.00 ,$66.00 ,$20.05 ,$31.56 , N/A ,$5.63 ,$5.38 ,$21.05 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$40.10 ,$20.05 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,30600376,87153,HC ID NUCLEAR ACID SEQ METH PROF-90,306,1 ,$136.00 ,$88.40 ,$3.50 ,$288.40 ,$288.40 ,$136.00 ,$74.80 ,$115.36 ,$38.08 ,$66.64 ,$115.36 ,$79.56 ,$115.36 ,$73.85 ,$3.50 ,$115.36 ,$73.85 ,$136.00 ,$95.20 ,$68.00 ,$108.80 ,$288.40 ,$115.36 ,$95.20 ,$115.36 ,$81.60 ,$115.36 ,$102.00 ,$75.07 ,$67.73 ,$75.07 ,$115.36 ,$75.07 ,$136.00 ,$136.00 ,$115.60 ,$136.00 ,$94.25 ,$115.36 ,$136.00 ,$74.80 ,$115.36 ,$35.77 , N/A ,$18.71 ,$17.86 ,$121.13 ,$108.80 ,$73.85 ,$38.08 ,$122.40 ,$51.68 ,$136.00 ,$115.36 ,$65.28 
ST. MARY'S HOSPITAL - DECATUR,30600379,87176,HC HOMOGENIZATION TISSUE-90,306,1 ,$91.00 ,$59.15 ,$3.50 ,$91.00 ,$14.70 ,$13.76 ,$50.05 ,$5.88 ,$25.48 ,$44.59 ,$5.88 ,$46.40 ,$5.88 ,$49.41 ,$3.50 ,$5.88 ,$49.41 ,$11.17 ,$63.70 ,$45.50 ,$72.80 ,$14.70 ,$5.88 ,$63.70 ,$5.88 ,$54.60 ,$5.88 ,$68.25 ,$50.23 ,$45.32 ,$50.23 ,$5.88 ,$50.23 ,$8.50 ,$8.50 ,$77.35 ,$14.70 ,$63.06 ,$5.88 ,$91.00 ,$50.05 ,$5.88 ,$23.93 , N/A ,$5.63 ,$5.38 ,$6.17 ,$72.80 ,$49.41 ,$25.48 ,$81.90 ,$34.58 ,$11.76 ,$5.88 ,$43.68 
ST. MARY'S HOSPITAL - DECATUR,30600380,87177,HC SMEAR OVA PARASITE CONC/ID-90,306,1 ,$84.00 ,$54.60 ,$3.50 ,$84.00 ,$22.25 ,$20.34 ,$46.20 ,$8.90 ,$23.52 ,$41.16 ,$8.90 ,$49.14 ,$8.90 ,$45.61 ,$3.50 ,$8.90 ,$45.61 ,$16.91 ,$58.80 ,$42.00 ,$67.20 ,$22.25 ,$8.90 ,$58.80 ,$8.90 ,$50.40 ,$8.90 ,$63.00 ,$46.37 ,$41.83 ,$46.37 ,$8.90 ,$46.37 ,$12.86 ,$12.86 ,$71.40 ,$22.25 ,$58.21 ,$8.90 ,$84.00 ,$46.20 ,$8.90 ,$22.09 , N/A ,$5.63 ,$5.38 ,$9.35 ,$67.20 ,$45.61 ,$23.52 ,$75.60 ,$31.92 ,$17.80 ,$8.90 ,$40.32 
ST. MARY'S HOSPITAL - DECATUR,30600381,87181,HC SENSITIVITY STUDY AGAR-90,306,1 ,$92.00 ,$59.80 ,$3.50 ,$92.00 ,$11.88 ,$11.10 ,$50.60 ,$4.75 ,$25.76 ,$45.08 ,$4.75 ,$50.72 ,$4.75 ,$49.96 ,$3.50 ,$4.75 ,$49.96 ,$9.03 ,$64.40 ,$46.00 ,$73.60 ,$11.88 ,$4.75 ,$64.40 ,$4.75 ,$55.20 ,$4.75 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$4.75 ,$50.78 ,$6.85 ,$6.85 ,$78.20 ,$11.88 ,$63.76 ,$4.75 ,$92.00 ,$50.60 ,$4.75 ,$24.20 , N/A ,$5.63 ,$5.38 ,$4.99 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$9.50 ,$4.75 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,30600382,87184,HC SENSITIVITY DISK KB-90,306,1 ,$270.00 ,$175.50 ,$3.50 ,$270.00 ,$18.70 ,$16.14 ,$148.50 ,$7.48 ,$75.60 ,$73.63 ,$7.48 ,$73.63 ,$7.48 ,$146.61 ,$3.50 ,$7.48 ,$146.61 ,$14.21 ,$189.00 ,$135.00 ,$216.00 ,$18.70 ,$7.48 ,$189.00 ,$7.48 ,$162.00 ,$7.48 ,$202.50 ,$149.04 ,$134.46 ,$149.04 ,$7.48 ,$149.04 ,$9.96 ,$9.96 ,$229.50 ,$18.70 ,$187.11 ,$7.48 ,$270.00 ,$148.50 ,$7.48 ,$71.01 , N/A ,$5.63 ,$5.38 ,$7.85 ,$216.00 ,$146.61 ,$75.60 ,$243.00 ,$102.60 ,$14.96 ,$7.48 ,$129.60 
ST. MARY'S HOSPITAL - DECATUR,30600383,87185,HC BETA LACTAMASE-90,306,1 ,$122.00 ,$79.30 ,$3.50 ,$122.00 ,$11.88 ,$11.10 ,$67.10 ,$4.75 ,$34.16 ,$37.45 ,$4.75 ,$37.45 ,$4.75 ,$66.25 ,$3.50 ,$4.75 ,$66.25 ,$9.03 ,$85.40 ,$61.00 ,$97.60 ,$11.88 ,$4.75 ,$85.40 ,$4.75 ,$73.20 ,$4.75 ,$91.50 ,$67.34 ,$60.76 ,$67.34 ,$4.75 ,$67.34 ,$6.85 ,$6.85 ,$103.70 ,$11.88 ,$84.55 ,$4.75 ,$122.00 ,$67.10 ,$4.75 ,$32.09 , N/A ,$5.63 ,$5.38 ,$4.99 ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$9.50 ,$4.75 ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,30600384,87186,HC SENSITIVITY MIC 15DG/MLTPLT-90,306,1 ,$177.00 ,$115.05 ,$3.50 ,$177.00 ,$21.63 ,$20.20 ,$97.35 ,$8.65 ,$49.56 ,$68.22 ,$8.65 ,$68.22 ,$8.65 ,$96.11 ,$3.50 ,$8.65 ,$96.11 ,$16.44 ,$123.90 ,$88.50 ,$141.60 ,$21.63 ,$8.65 ,$123.90 ,$8.65 ,$106.20 ,$8.65 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$8.65 ,$97.70 ,$12.49 ,$12.49 ,$150.45 ,$21.63 ,$122.66 ,$8.65 ,$177.00 ,$97.35 ,$8.65 ,$46.55 , N/A ,$5.63 ,$5.38 ,$9.08 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$17.30 ,$8.65 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30600387,87186,HC SENSITIVITY MIC 20DG/SGLPLT-90,306,1 ,$177.00 ,$115.05 ,$3.50 ,$177.00 ,$21.63 ,$20.20 ,$97.35 ,$8.65 ,$49.56 ,$68.22 ,$8.65 ,$68.22 ,$8.65 ,$96.11 ,$3.50 ,$8.65 ,$96.11 ,$16.44 ,$123.90 ,$88.50 ,$141.60 ,$21.63 ,$8.65 ,$123.90 ,$8.65 ,$106.20 ,$8.65 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$8.65 ,$97.70 ,$12.49 ,$12.49 ,$150.45 ,$21.63 ,$122.66 ,$8.65 ,$177.00 ,$97.35 ,$8.65 ,$46.55 , N/A ,$5.63 ,$5.38 ,$9.08 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$17.30 ,$8.65 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30600390,87188,HC MACROTUBE DIL METH EA AGNT-90,306,1 ,$125.00 ,$81.25 ,$3.50 ,$125.00 ,$16.60 ,$15.50 ,$68.75 ,$6.64 ,$35.00 ,$52.39 ,$6.64 ,$52.39 ,$6.64 ,$67.88 ,$3.50 ,$6.64 ,$67.88 ,$12.62 ,$87.50 ,$62.50 ,$100.00 ,$16.60 ,$6.64 ,$87.50 ,$6.64 ,$75.00 ,$6.64 ,$93.75 ,$69.00 ,$62.25 ,$69.00 ,$6.64 ,$69.00 ,$9.59 ,$9.59 ,$106.25 ,$16.60 ,$86.63 ,$6.64 ,$125.00 ,$68.75 ,$6.64 ,$32.88 , N/A ,$5.63 ,$5.38 ,$6.97 ,$100.00 ,$67.88 ,$35.00 ,$112.50 ,$47.50 ,$13.28 ,$6.64 ,$60.00 
ST. MARY'S HOSPITAL - DECATUR,30600392,87190,HC SENSITIVITY AFB-90,306,1 ,$119.00 ,$77.35 ,$3.50 ,$119.00 ,$18.28 ,$13.20 ,$65.45 ,$7.31 ,$33.32 ,$46.69 ,$7.31 ,$46.69 ,$7.31 ,$64.62 ,$3.50 ,$7.31 ,$64.62 ,$13.89 ,$83.30 ,$59.50 ,$95.20 ,$18.28 ,$7.31 ,$83.30 ,$7.31 ,$71.40 ,$7.31 ,$89.25 ,$65.69 ,$59.26 ,$65.69 ,$7.31 ,$65.69 ,$9.50 ,$9.50 ,$101.15 ,$18.28 ,$82.47 ,$7.31 ,$119.00 ,$65.45 ,$7.31 ,$31.30 , N/A ,$5.63 ,$5.38 ,$7.68 ,$95.20 ,$64.62 ,$33.32 ,$107.10 ,$45.22 ,$14.62 ,$7.31 ,$57.12 
ST. MARY'S HOSPITAL - DECATUR,30600395,87206,HC SMEAR ACID FAST/FLUOR-90,306,1 ,$75.00 ,$48.75 ,$3.50 ,$75.00 ,$13.48 ,$12.56 ,$41.25 ,$5.39 ,$21.00 ,$36.75 ,$5.39 ,$43.88 ,$5.39 ,$40.73 ,$3.50 ,$5.39 ,$40.73 ,$10.24 ,$52.50 ,$37.50 ,$60.00 ,$13.48 ,$5.39 ,$52.50 ,$5.39 ,$45.00 ,$5.39 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$5.39 ,$41.40 ,$7.79 ,$7.79 ,$63.75 ,$13.48 ,$51.98 ,$5.39 ,$75.00 ,$41.25 ,$5.39 ,$19.73 , N/A ,$5.63 ,$5.38 ,$5.66 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$10.78 ,$5.39 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,30600397,87207,HC SPECIAL STAIN INCL BODIES/PARASITES-90,306,1 ,$155.00 ,$100.75 ,$4.73 ,$155.00 ,$14.98 ,$14.00 ,$85.25 ,$5.99 ,$43.40 ,$47.28 ,$5.99 ,$47.28 ,$5.99 ,$84.17 ,$4.73 ,$5.99 ,$84.17 ,$11.38 ,$108.50 ,$77.50 ,$124.00 ,$14.98 ,$5.99 ,$108.50 ,$5.99 ,$93.00 ,$5.99 ,$116.25 ,$85.56 ,$77.19 ,$85.56 ,$5.99 ,$85.56 ,$8.66 ,$8.66 ,$131.75 ,$14.98 ,$107.42 ,$5.99 ,$155.00 ,$85.25 ,$5.99 ,$40.77 , N/A ,$5.63 ,$5.38 ,$6.29 ,$124.00 ,$84.17 ,$43.40 ,$139.50 ,$58.90 ,$11.98 ,$5.99 ,$74.40 
ST. MARY'S HOSPITAL - DECATUR,30600398,87207,HC SPECIAL STAIN INCL BODIES/PARASITES,306,1 ,$155.00 ,$100.75 ,$4.73 ,$155.00 ,$14.98 ,$14.00 ,$85.25 ,$5.99 ,$43.40 ,$47.28 ,$5.99 ,$47.28 ,$5.99 ,$84.17 ,$4.73 ,$5.99 ,$84.17 ,$11.38 ,$108.50 ,$77.50 ,$124.00 ,$14.98 ,$5.99 ,$108.50 ,$5.99 ,$93.00 ,$5.99 ,$116.25 ,$85.56 ,$77.19 ,$85.56 ,$5.99 ,$85.56 ,$8.66 ,$8.66 ,$131.75 ,$14.98 ,$107.42 ,$5.99 ,$155.00 ,$85.25 ,$5.99 ,$40.77 , N/A ,$5.63 ,$5.38 ,$6.29 ,$124.00 ,$84.17 ,$43.40 ,$139.50 ,$58.90 ,$11.98 ,$5.99 ,$74.40 
ST. MARY'S HOSPITAL - DECATUR,30600399,87209,HC OVA  AND  PARASITE W/STAIN-90,306,1 ,$131.00 ,$85.15 ,$3.50 ,$131.00 ,$44.95 ,$42.00 ,$72.05 ,$17.98 ,$36.68 ,$64.19 ,$17.98 ,$76.64 ,$17.98 ,$71.13 ,$3.50 ,$17.98 ,$71.13 ,$34.16 ,$91.70 ,$65.50 ,$104.80 ,$44.95 ,$17.98 ,$91.70 ,$17.98 ,$78.60 ,$17.98 ,$98.25 ,$72.31 ,$65.24 ,$72.31 ,$17.98 ,$72.31 ,$25.96 ,$25.96 ,$111.35 ,$44.95 ,$90.78 ,$17.98 ,$131.00 ,$72.05 ,$17.98 ,$34.45 , N/A ,$18.71 ,$17.86 ,$18.88 ,$104.80 ,$71.13 ,$36.68 ,$117.90 ,$49.78 ,$35.96 ,$17.98 ,$62.88 
ST. MARY'S HOSPITAL - DECATUR,30600402,87252,HC CULTURE VIRUS ID TISSUE-90,306,1 ,$372.00 ,$241.80 ,$3.50 ,$372.00 ,$65.18 ,$54.26 ,$204.60 ,$26.07 ,$104.16 ,$182.28 ,$26.07 ,$205.64 ,$26.07 ,$202.00 ,$3.50 ,$26.07 ,$202.00 ,$49.53 ,$260.40 ,$186.00 ,$297.60 ,$65.18 ,$26.07 ,$260.40 ,$26.07 ,$223.20 ,$26.07 ,$279.00 ,$205.34 ,$185.26 ,$205.34 ,$26.07 ,$205.34 ,$37.66 ,$37.66 ,$316.20 ,$65.18 ,$257.80 ,$26.07 ,$372.00 ,$204.60 ,$26.07 ,$97.84 , N/A ,$18.71 ,$17.86 ,$27.37 ,$297.60 ,$202.00 ,$104.16 ,$334.80 ,$141.36 ,$52.14 ,$26.07 ,$178.56 
ST. MARY'S HOSPITAL - DECATUR,30600403,87253,HC CULTURE VIRUS ID ADDL EA-90,306,1 ,$234.00 ,$152.10 ,$3.50 ,$234.00 ,$50.50 ,$47.20 ,$128.70 ,$20.20 ,$65.52 ,$114.66 ,$20.20 ,$136.89 ,$20.20 ,$127.06 ,$3.50 ,$20.20 ,$127.06 ,$38.38 ,$163.80 ,$117.00 ,$187.20 ,$50.50 ,$20.20 ,$163.80 ,$20.20 ,$140.40 ,$20.20 ,$175.50 ,$129.17 ,$116.53 ,$129.17 ,$20.20 ,$129.17 ,$29.19 ,$29.19 ,$198.90 ,$50.50 ,$162.16 ,$20.20 ,$234.00 ,$128.70 ,$20.20 ,$61.54 , N/A ,$18.71 ,$17.86 ,$21.21 ,$187.20 ,$127.06 ,$65.52 ,$210.60 ,$88.92 ,$40.40 ,$20.20 ,$112.32 
ST. MARY'S HOSPITAL - DECATUR,30600405,87254,HC VIRUS ISOL SHELL ID-90,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$48.90 ,$45.70 ,$116.60 ,$19.56 ,$59.36 ,$103.88 ,$19.56 ,$124.02 ,$19.56 ,$115.12 ,$3.50 ,$19.56 ,$115.12 ,$37.16 ,$148.40 ,$106.00 ,$169.60 ,$48.90 ,$19.56 ,$148.40 ,$19.56 ,$127.20 ,$19.56 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$19.56 ,$117.02 ,$28.25 ,$28.25 ,$180.20 ,$48.90 ,$146.92 ,$19.56 ,$212.00 ,$116.60 ,$19.56 ,$55.76 , N/A ,$18.71 ,$17.86 ,$20.54 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$39.12 ,$19.56 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600412,87280,HC IF RSV AG-90,306,1 ,$125.00 ,$81.25 ,$3.50 ,$125.00 ,$33.55 ,$28.04 ,$68.75 ,$13.42 ,$35.00 ,$61.25 ,$13.42 ,$73.13 ,$13.42 ,$67.88 ,$3.50 ,$13.42 ,$67.88 ,$25.50 ,$87.50 ,$62.50 ,$100.00 ,$33.55 ,$13.42 ,$87.50 ,$13.42 ,$75.00 ,$13.42 ,$93.75 ,$69.00 ,$62.25 ,$69.00 ,$13.42 ,$69.00 ,$17.45 ,$17.45 ,$106.25 ,$33.55 ,$86.63 ,$13.42 ,$125.00 ,$68.75 ,$13.42 ,$32.88 , N/A ,$7.06 ,$6.74 ,$14.09 ,$100.00 ,$67.88 ,$35.00 ,$112.50 ,$47.50 ,$26.84 ,$13.42 ,$60.00 
ST. MARY'S HOSPITAL - DECATUR,30600414,87299,HC ANTIBODY DETECT IF NOS-90,306,1 ,$136.00 ,$88.40 ,$3.50 ,$136.00 ,$40.25 ,$28.04 ,$74.80 ,$16.10 ,$38.08 ,$66.64 ,$16.10 ,$79.56 ,$16.10 ,$73.85 ,$3.50 ,$16.10 ,$73.85 ,$30.59 ,$95.20 ,$68.00 ,$108.80 ,$40.25 ,$16.10 ,$95.20 ,$16.10 ,$81.60 ,$16.10 ,$102.00 ,$75.07 ,$67.73 ,$75.07 ,$16.10 ,$75.07 ,$20.93 ,$20.93 ,$115.60 ,$40.25 ,$94.25 ,$16.10 ,$136.00 ,$74.80 ,$16.10 ,$35.77 , N/A ,$7.06 ,$6.74 ,$16.91 ,$108.80 ,$73.85 ,$38.08 ,$122.40 ,$51.68 ,$32.20 ,$16.10 ,$65.28 
ST. MARY'S HOSPITAL - DECATUR,30600415,87305,HC EIA QL ASPERGILLUS AG-90,306,1 ,$218.00 ,$141.70 ,$3.50 ,$218.00 ,$29.95 ,$28.04 ,$119.90 ,$11.98 ,$61.04 ,$94.56 ,$11.98 ,$94.56 ,$11.98 ,$118.37 ,$3.50 ,$11.98 ,$118.37 ,$22.76 ,$152.60 ,$109.00 ,$174.40 ,$29.95 ,$11.98 ,$152.60 ,$11.98 ,$130.80 ,$11.98 ,$163.50 ,$120.34 ,$108.56 ,$120.34 ,$11.98 ,$120.34 ,$17.32 ,$17.32 ,$185.30 ,$29.95 ,$151.07 ,$11.98 ,$218.00 ,$119.90 ,$11.98 ,$57.33 , N/A ,$5.63 ,$5.38 ,$12.58 ,$174.40 ,$118.37 ,$61.04 ,$196.20 ,$82.84 ,$23.96 ,$11.98 ,$104.64 
ST. MARY'S HOSPITAL - DECATUR,30600416,87327,HC EIA QL CRYPTOCOCCUS AG-90,306,1 ,$139.00 ,$90.35 ,$3.50 ,$139.00 ,$33.55 ,$28.04 ,$76.45 ,$13.42 ,$38.92 ,$68.11 ,$13.42 ,$81.32 ,$13.42 ,$75.48 ,$3.50 ,$13.42 ,$75.48 ,$25.50 ,$97.30 ,$69.50 ,$111.20 ,$33.55 ,$13.42 ,$97.30 ,$13.42 ,$83.40 ,$13.42 ,$104.25 ,$76.73 ,$69.22 ,$76.73 ,$13.42 ,$76.73 ,$17.45 ,$17.45 ,$118.15 ,$33.55 ,$96.33 ,$13.42 ,$139.00 ,$76.45 ,$13.42 ,$36.56 , N/A ,$7.06 ,$6.74 ,$14.09 ,$111.20 ,$75.48 ,$38.92 ,$125.10 ,$52.82 ,$26.84 ,$13.42 ,$66.72 
ST. MARY'S HOSPITAL - DECATUR,30600418,87328,HC EIA QL CRYPTOSPORIDIUM AG-90,306,1 ,$217.00 ,$141.05 ,$3.50 ,$217.00 ,$34.55 ,$28.04 ,$119.35 ,$13.82 ,$60.76 ,$94.56 ,$13.82 ,$94.56 ,$13.82 ,$117.83 ,$3.50 ,$13.82 ,$117.83 ,$26.26 ,$151.90 ,$108.50 ,$173.60 ,$34.55 ,$13.82 ,$151.90 ,$13.82 ,$130.20 ,$13.82 ,$162.75 ,$119.78 ,$108.07 ,$119.78 ,$13.82 ,$119.78 ,$17.97 ,$17.97 ,$184.45 ,$34.55 ,$150.38 ,$13.82 ,$217.00 ,$119.35 ,$13.82 ,$57.07 , N/A ,$7.06 ,$6.74 ,$14.51 ,$173.60 ,$117.83 ,$60.76 ,$195.30 ,$82.46 ,$27.64 ,$13.82 ,$104.16 
ST. MARY'S HOSPITAL - DECATUR,30600419,87338,HC EIA QL H PYLORI AG STOOL-90,306,1 ,$284.00 ,$184.60 ,$3.50 ,$284.00 ,$35.95 ,$33.60 ,$156.20 ,$14.38 ,$79.52 ,$139.16 ,$14.38 ,$153.64 ,$14.38 ,$154.21 ,$3.50 ,$14.38 ,$154.21 ,$27.32 ,$198.80 ,$142.00 ,$227.20 ,$35.95 ,$14.38 ,$198.80 ,$14.38 ,$170.40 ,$14.38 ,$213.00 ,$156.77 ,$141.43 ,$156.77 ,$14.38 ,$156.77 ,$20.77 ,$20.77 ,$241.40 ,$35.95 ,$196.81 ,$14.38 ,$284.00 ,$156.20 ,$14.38 ,$74.69 , N/A ,$7.06 ,$6.74 ,$15.10 ,$227.20 ,$154.21 ,$79.52 ,$255.60 ,$107.92 ,$28.76 ,$14.38 ,$136.32 
ST. MARY'S HOSPITAL - DECATUR,30600421,87340,HC EIA QL HEPATITIS B AG-90,306,1 ,$300.00 ,$195.00 ,$3.50 ,$300.00 ,$25.83 ,$24.14 ,$165.00 ,$10.33 ,$84.00 ,$81.49 ,$10.33 ,$81.49 ,$10.33 ,$162.90 ,$3.50 ,$10.33 ,$162.90 ,$19.63 ,$210.00 ,$150.00 ,$240.00 ,$25.83 ,$10.33 ,$210.00 ,$10.33 ,$180.00 ,$10.33 ,$225.00 ,$165.60 ,$149.40 ,$165.60 ,$10.33 ,$165.60 ,$14.92 ,$14.92 ,$255.00 ,$25.83 ,$207.90 ,$10.33 ,$300.00 ,$165.00 ,$10.33 ,$78.90 , N/A ,$7.06 ,$6.74 ,$10.85 ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$20.66 ,$10.33 ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,30600423,87341,HC EIA QL HEPATITIS B AG NEUT-90,306,1 ,$146.00 ,$94.90 ,$3.50 ,$146.00 ,$25.83 ,$24.14 ,$80.30 ,$10.33 ,$40.88 ,$71.54 ,$10.33 ,$81.49 ,$10.33 ,$79.28 ,$3.50 ,$10.33 ,$79.28 ,$19.63 ,$102.20 ,$73.00 ,$116.80 ,$25.83 ,$10.33 ,$102.20 ,$10.33 ,$87.60 ,$10.33 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$10.33 ,$80.59 ,$14.92 ,$14.92 ,$124.10 ,$25.83 ,$101.18 ,$10.33 ,$146.00 ,$80.30 ,$10.33 ,$38.40 , N/A ,$7.06 ,$6.74 ,$10.85 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$20.66 ,$10.33 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,30600424,87350,HC HEPATITIS BE AG QL-90,306,1 ,$109.00 ,$70.85 ,$3.50 ,$109.00 ,$28.83 ,$26.92 ,$59.95 ,$11.53 ,$30.52 ,$53.41 ,$11.53 ,$63.77 ,$11.53 ,$59.19 ,$3.50 ,$11.53 ,$59.19 ,$21.91 ,$76.30 ,$54.50 ,$87.20 ,$28.83 ,$11.53 ,$76.30 ,$11.53 ,$65.40 ,$11.53 ,$81.75 ,$60.17 ,$54.28 ,$60.17 ,$11.53 ,$60.17 ,$16.65 ,$16.65 ,$92.65 ,$28.83 ,$75.54 ,$11.53 ,$109.00 ,$59.95 ,$11.53 ,$28.67 , N/A ,$7.06 ,$6.74 ,$12.11 ,$87.20 ,$59.19 ,$30.52 ,$98.10 ,$41.42 ,$23.06 ,$11.53 ,$52.32 
ST. MARY'S HOSPITAL - DECATUR,30600426,87385,HC EIA QL HISTOPLASMA AG-90,306,1 ,$156.00 ,$101.40 ,$3.50 ,$156.00 ,$33.13 ,$28.04 ,$85.80 ,$13.25 ,$43.68 ,$76.44 ,$13.25 ,$91.26 ,$13.25 ,$84.71 ,$3.50 ,$13.25 ,$84.71 ,$25.18 ,$109.20 ,$78.00 ,$124.80 ,$33.13 ,$13.25 ,$109.20 ,$13.25 ,$93.60 ,$13.25 ,$117.00 ,$86.11 ,$77.69 ,$86.11 ,$13.25 ,$86.11 ,$17.32 ,$17.32 ,$132.60 ,$33.13 ,$108.11 ,$13.25 ,$156.00 ,$85.80 ,$13.25 ,$41.03 , N/A ,$7.06 ,$6.74 ,$13.91 ,$124.80 ,$84.71 ,$43.68 ,$140.40 ,$59.28 ,$26.50 ,$13.25 ,$74.88 
ST. MARY'S HOSPITAL - DECATUR,30600427,87389,HC HIV-1 AG W/HIV-1  AND  HIV-2 AB,306,1 ,$315.00 ,$204.75 ,$3.50 ,$315.00 ,$60.20 ,$56.28 ,$173.25 ,$24.08 ,$88.20 ,$154.35 ,$24.08 ,$184.28 ,$24.08 ,$171.05 ,$3.50 ,$24.08 ,$171.05 ,$45.75 ,$220.50 ,$157.50 ,$252.00 ,$60.20 ,$24.08 ,$220.50 ,$24.08 ,$189.00 ,$24.08 ,$236.25 ,$173.88 ,$156.87 ,$173.88 ,$24.08 ,$173.88 ,$34.78 ,$34.78 ,$267.75 ,$60.20 ,$218.30 ,$24.08 ,$315.00 ,$173.25 ,$24.08 ,$82.85 , N/A ,$7.06 ,$6.74 ,$25.28 ,$252.00 ,$171.05 ,$88.20 ,$283.50 ,$119.70 ,$48.16 ,$24.08 ,$151.20 
ST. MARY'S HOSPITAL - DECATUR,30600432,87449,HC EIA QL MLT AG INF-90,306,1 ,$156.00 ,$101.40 ,$3.50 ,$156.00 ,$29.95 ,$28.04 ,$85.80 ,$11.98 ,$43.68 ,$76.44 ,$11.98 ,$91.26 ,$11.98 ,$84.71 ,$3.50 ,$11.98 ,$84.71 ,$22.76 ,$109.20 ,$78.00 ,$124.80 ,$29.95 ,$11.98 ,$109.20 ,$11.98 ,$93.60 ,$11.98 ,$117.00 ,$86.11 ,$77.69 ,$86.11 ,$11.98 ,$86.11 ,$17.32 ,$17.32 ,$132.60 ,$29.95 ,$108.11 ,$11.98 ,$156.00 ,$85.80 ,$11.98 ,$41.03 , N/A ,$7.06 ,$6.74 ,$12.58 ,$124.80 ,$84.71 ,$43.68 ,$140.40 ,$59.28 ,$23.96 ,$11.98 ,$74.88 
ST. MARY'S HOSPITAL - DECATUR,30600433,87450,HC EIA QL SGL AG-90,306,1 ,$172.00 ,$111.80 ,$3.50 ,$172.00 , N/A ,$87.72 ,$94.60 , N/A ,$48.16 ,$75.69 , N/A ,$75.69 , N/A ,$93.40 ,$3.50 , N/A ,$93.40 , N/A ,$120.40 ,$86.00 ,$137.60 , N/A , N/A ,$120.40 , N/A ,$103.20 , N/A ,$129.00 ,$94.94 ,$85.66 ,$94.94 , N/A ,$94.94 ,$13.86 ,$13.86 ,$146.20 , N/A ,$119.20 , N/A ,$172.00 ,$94.60 , N/A ,$45.24 , N/A , N/A , N/A , N/A ,$137.60 ,$93.40 ,$48.16 ,$154.80 ,$65.36 ,$86.00 , N/A ,$82.56 
ST. MARY'S HOSPITAL - DECATUR,30600436,87471,HC INF AGT BARTONELLA HENSELAE-90,306,1 ,$528.00 ,$343.20 ,$3.50 ,$528.00 ,$87.73 ,$82.00 ,$290.40 ,$35.09 ,$147.84 ,$258.72 ,$35.09 ,$276.81 ,$35.09 ,$286.70 ,$3.50 ,$35.09 ,$286.70 ,$66.67 ,$369.60 ,$264.00 ,$422.40 ,$87.73 ,$35.09 ,$369.60 ,$35.09 ,$316.80 ,$35.09 ,$396.00 ,$291.46 ,$262.94 ,$291.46 ,$35.09 ,$291.46 ,$50.69 ,$50.69 ,$448.80 ,$87.73 ,$365.90 ,$35.09 ,$528.00 ,$290.40 ,$35.09 ,$138.86 , N/A ,$18.71 ,$17.86 ,$36.84 ,$422.40 ,$286.70 ,$147.84 ,$475.20 ,$200.64 ,$70.18 ,$35.09 ,$253.44 
ST. MARY'S HOSPITAL - DECATUR,30600438,87491,HC CHLAMYDIA TRACH AMP-90,306,1 ,$274.00 ,$178.10 ,$3.50 ,$274.00 ,$87.73 ,$82.00 ,$150.70 ,$35.09 ,$76.72 ,$134.26 ,$35.09 ,$160.29 ,$35.09 ,$148.78 ,$3.50 ,$35.09 ,$148.78 ,$66.67 ,$191.80 ,$137.00 ,$219.20 ,$87.73 ,$35.09 ,$191.80 ,$35.09 ,$164.40 ,$35.09 ,$205.50 ,$151.25 ,$136.45 ,$151.25 ,$35.09 ,$151.25 ,$50.69 ,$50.69 ,$232.90 ,$87.73 ,$189.88 ,$35.09 ,$274.00 ,$150.70 ,$35.09 ,$72.06 , N/A ,$7.06 ,$6.74 ,$36.84 ,$219.20 ,$148.78 ,$76.72 ,$246.60 ,$104.12 ,$70.18 ,$35.09 ,$131.52 
ST. MARY'S HOSPITAL - DECATUR,30600440,87493,HC CLOSTRIDUM DIFFICILE-90,306,1 ,$478.00 ,$310.70 ,$3.50 ,$478.00 ,$93.18 ,$82.00 ,$262.90 ,$37.27 ,$133.84 ,$234.22 ,$37.27 ,$276.81 ,$37.27 ,$259.55 ,$3.50 ,$37.27 ,$259.55 ,$70.81 ,$334.60 ,$239.00 ,$382.40 ,$93.18 ,$37.27 ,$334.60 ,$37.27 ,$286.80 ,$37.27 ,$358.50 ,$263.86 ,$238.04 ,$263.86 ,$37.27 ,$263.86 ,$50.69 ,$50.69 ,$406.30 ,$93.18 ,$331.25 ,$37.27 ,$478.00 ,$262.90 ,$37.27 ,$125.71 , N/A ,$7.06 ,$6.74 ,$39.13 ,$382.40 ,$259.55 ,$133.84 ,$430.20 ,$181.64 ,$74.54 ,$37.27 ,$229.44 
ST. MARY'S HOSPITAL - DECATUR,30600442,87496,HC INFECT AMP (CMV) MENI-90,306,1 ,$394.00 ,$256.10 ,$3.50 ,$394.00 ,$87.73 ,$82.00 ,$216.70 ,$35.09 ,$110.32 ,$193.06 ,$35.09 ,$230.49 ,$35.09 ,$213.94 ,$3.50 ,$35.09 ,$213.94 ,$66.67 ,$275.80 ,$197.00 ,$315.20 ,$87.73 ,$35.09 ,$275.80 ,$35.09 ,$236.40 ,$35.09 ,$295.50 ,$217.49 ,$196.21 ,$217.49 ,$35.09 ,$217.49 ,$50.69 ,$50.69 ,$334.90 ,$87.73 ,$273.04 ,$35.09 ,$394.00 ,$216.70 ,$35.09 ,$103.62 , N/A ,$18.71 ,$17.86 ,$36.84 ,$315.20 ,$213.94 ,$110.32 ,$354.60 ,$149.72 ,$70.18 ,$35.09 ,$189.12 
ST. MARY'S HOSPITAL - DECATUR,30600443,87497,HC CMV QN-90,306,1 ,$563.00 ,$365.95 ,$3.50 ,$563.00 ,$107.10 ,$100.10 ,$309.65 ,$42.84 ,$157.64 ,$275.87 ,$42.84 ,$329.36 ,$42.84 ,$305.71 ,$3.50 ,$42.84 ,$305.71 ,$81.40 ,$394.10 ,$281.50 ,$450.40 ,$107.10 ,$42.84 ,$394.10 ,$42.84 ,$337.80 ,$42.84 ,$422.25 ,$310.78 ,$280.37 ,$310.78 ,$42.84 ,$310.78 ,$61.88 ,$61.88 ,$478.55 ,$107.10 ,$390.16 ,$42.84 ,$563.00 ,$309.65 ,$42.84 ,$148.07 , N/A ,$18.71 ,$17.86 ,$44.98 ,$450.40 ,$305.71 ,$157.64 ,$506.70 ,$213.94 ,$85.68 ,$42.84 ,$270.24 
ST. MARY'S HOSPITAL - DECATUR,30600444,87498,HC ENTEROVIRUS AMP PROBE-90,306,1 ,$449.00 ,$291.85 ,$3.50 ,$449.00 ,$87.73 ,$82.00 ,$246.95 ,$35.09 ,$125.72 ,$220.01 ,$35.09 ,$262.67 ,$35.09 ,$243.81 ,$3.50 ,$35.09 ,$243.81 ,$66.67 ,$314.30 ,$224.50 ,$359.20 ,$87.73 ,$35.09 ,$314.30 ,$35.09 ,$269.40 ,$35.09 ,$336.75 ,$247.85 ,$223.60 ,$247.85 ,$35.09 ,$247.85 ,$50.69 ,$50.69 ,$381.65 ,$87.73 ,$311.16 ,$35.09 ,$449.00 ,$246.95 ,$35.09 ,$118.09 , N/A ,$18.71 ,$17.86 ,$36.84 ,$359.20 ,$243.81 ,$125.72 ,$404.10 ,$170.62 ,$70.18 ,$35.09 ,$215.52 
ST. MARY'S HOSPITAL - DECATUR,30600446,87502,HC INFLUENZA VIRUS MULTIPLE DNA/RNA-90,306,1 ,$371.00 ,$241.15 ,$3.50 ,$371.00 ,$239.50 ,$198.84 ,$204.05 ,$95.80 ,$103.88 ,$181.79 ,$95.80 ,$217.04 ,$95.80 ,$201.45 ,$3.50 ,$95.80 ,$201.45 ,$182.02 ,$259.70 ,$185.50 ,$296.80 ,$239.50 ,$95.80 ,$259.70 ,$95.80 ,$222.60 ,$95.80 ,$278.25 ,$204.79 ,$184.76 ,$204.79 ,$95.80 ,$204.79 ,$124.54 ,$124.54 ,$315.35 ,$239.50 ,$257.10 ,$95.80 ,$371.00 ,$204.05 ,$95.80 ,$97.57 , N/A ,$12.17 ,$11.61 ,$100.59 ,$296.80 ,$201.45 ,$103.88 ,$333.90 ,$140.98 ,$191.60 ,$95.80 ,$178.08 
ST. MARY'S HOSPITAL - DECATUR,30600448,87517,HC HEPATITIS B QN-90,306,1 ,$372.00 ,$241.80 ,$3.50 ,$372.00 ,$107.10 ,$100.10 ,$204.60 ,$42.84 ,$104.16 ,$182.28 ,$42.84 ,$217.62 ,$42.84 ,$202.00 ,$3.50 ,$42.84 ,$202.00 ,$81.40 ,$260.40 ,$186.00 ,$297.60 ,$107.10 ,$42.84 ,$260.40 ,$42.84 ,$223.20 ,$42.84 ,$279.00 ,$205.34 ,$185.26 ,$205.34 ,$42.84 ,$205.34 ,$61.88 ,$61.88 ,$316.20 ,$107.10 ,$257.80 ,$42.84 ,$372.00 ,$204.60 ,$42.84 ,$97.84 , N/A ,$18.71 ,$17.86 ,$44.98 ,$297.60 ,$202.00 ,$104.16 ,$334.80 ,$141.36 ,$85.68 ,$42.84 ,$178.56 
ST. MARY'S HOSPITAL - DECATUR,30600449,87521,HC HEPATITIS C PROBE AND RVRS TRNSC-90,306,1 ,$394.00 ,$256.10 ,$3.50 ,$394.00 ,$87.73 ,$82.00 ,$216.70 ,$35.09 ,$110.32 ,$193.06 ,$35.09 ,$230.49 ,$35.09 ,$213.94 ,$3.50 ,$35.09 ,$213.94 ,$66.67 ,$275.80 ,$197.00 ,$315.20 ,$87.73 ,$35.09 ,$275.80 ,$35.09 ,$236.40 ,$35.09 ,$295.50 ,$217.49 ,$196.21 ,$217.49 ,$35.09 ,$217.49 ,$50.69 ,$50.69 ,$334.90 ,$87.73 ,$273.04 ,$35.09 ,$394.00 ,$216.70 ,$35.09 ,$103.62 , N/A ,$18.71 ,$17.86 ,$36.84 ,$315.20 ,$213.94 ,$110.32 ,$354.60 ,$149.72 ,$70.18 ,$35.09 ,$189.12 
ST. MARY'S HOSPITAL - DECATUR,30600451,87522,HC HEPATITIS C QN-90,306,1 ,$735.00 ,$477.75 ,$3.50 ,$735.00 ,$107.10 ,$100.10 ,$404.25 ,$42.84 ,$205.80 ,$337.86 ,$42.84 ,$337.86 ,$42.84 ,$399.11 ,$3.50 ,$42.84 ,$399.11 ,$81.40 ,$514.50 ,$367.50 ,$588.00 ,$107.10 ,$42.84 ,$514.50 ,$42.84 ,$441.00 ,$42.84 ,$551.25 ,$405.72 ,$366.03 ,$405.72 ,$42.84 ,$405.72 ,$61.88 ,$61.88 ,$624.75 ,$107.10 ,$509.36 ,$42.84 ,$735.00 ,$404.25 ,$42.84 ,$193.31 , N/A ,$18.71 ,$17.86 ,$44.98 ,$588.00 ,$399.11 ,$205.80 ,$661.50 ,$279.30 ,$85.68 ,$42.84 ,$352.80 
ST. MARY'S HOSPITAL - DECATUR,30600453,87529,HC HERPES SIMPLEX AMP-90,306,1 ,$394.00 ,$256.10 ,$3.50 ,$394.00 ,$87.73 ,$82.00 ,$216.70 ,$35.09 ,$110.32 ,$193.06 ,$35.09 ,$230.49 ,$35.09 ,$213.94 ,$3.50 ,$35.09 ,$213.94 ,$66.67 ,$275.80 ,$197.00 ,$315.20 ,$87.73 ,$35.09 ,$275.80 ,$35.09 ,$236.40 ,$35.09 ,$295.50 ,$217.49 ,$196.21 ,$217.49 ,$35.09 ,$217.49 ,$50.69 ,$50.69 ,$334.90 ,$87.73 ,$273.04 ,$35.09 ,$394.00 ,$216.70 ,$35.09 ,$103.62 , N/A ,$18.71 ,$17.86 ,$36.84 ,$315.20 ,$213.94 ,$110.32 ,$354.60 ,$149.72 ,$70.18 ,$35.09 ,$189.12 
ST. MARY'S HOSPITAL - DECATUR,30600454,87530,HC HSV QUANT-90,306,1 ,$372.00 ,$241.80 ,$3.50 ,$372.00 ,$107.10 ,$100.10 ,$204.60 ,$42.84 ,$104.16 ,$182.28 ,$42.84 ,$217.62 ,$42.84 ,$202.00 ,$3.50 ,$42.84 ,$202.00 ,$81.40 ,$260.40 ,$186.00 ,$297.60 ,$107.10 ,$42.84 ,$260.40 ,$42.84 ,$223.20 ,$42.84 ,$279.00 ,$205.34 ,$185.26 ,$205.34 ,$42.84 ,$205.34 ,$61.88 ,$61.88 ,$316.20 ,$107.10 ,$257.80 ,$42.84 ,$372.00 ,$204.60 ,$42.84 ,$97.84 , N/A ,$18.71 ,$17.86 ,$44.98 ,$297.60 ,$202.00 ,$104.16 ,$334.80 ,$141.36 ,$85.68 ,$42.84 ,$178.56 
ST. MARY'S HOSPITAL - DECATUR,30600455,87532,HC INFECT AMP (HHSV6) MENI-90,306,1 ,$446.00 ,$289.90 ,$3.50 ,$446.00 ,$87.73 ,$82.00 ,$245.30 ,$35.09 ,$124.88 ,$218.54 ,$35.09 ,$260.91 ,$35.09 ,$242.18 ,$3.50 ,$35.09 ,$242.18 ,$66.67 ,$312.20 ,$223.00 ,$356.80 ,$87.73 ,$35.09 ,$312.20 ,$35.09 ,$267.60 ,$35.09 ,$334.50 ,$246.19 ,$222.11 ,$246.19 ,$35.09 ,$246.19 ,$50.69 ,$50.69 ,$379.10 ,$87.73 ,$309.08 ,$35.09 ,$446.00 ,$245.30 ,$35.09 ,$117.30 , N/A ,$18.71 ,$17.86 ,$36.84 ,$356.80 ,$242.18 ,$124.88 ,$401.40 ,$169.48 ,$70.18 ,$35.09 ,$214.08 
ST. MARY'S HOSPITAL - DECATUR,30600456,87535,HC PROBE HIV-1 AMP-90,306,1 ,$287.00 ,$186.55 ,$3.50 ,$287.00 ,$87.73 ,$82.00 ,$157.85 ,$35.09 ,$80.36 ,$140.63 ,$35.09 ,$167.90 ,$35.09 ,$155.84 ,$3.50 ,$35.09 ,$155.84 ,$66.67 ,$200.90 ,$143.50 ,$229.60 ,$87.73 ,$35.09 ,$200.90 ,$35.09 ,$172.20 ,$35.09 ,$215.25 ,$158.42 ,$142.93 ,$158.42 ,$35.09 ,$158.42 ,$50.69 ,$50.69 ,$243.95 ,$87.73 ,$198.89 ,$35.09 ,$287.00 ,$157.85 ,$35.09 ,$75.48 , N/A ,$18.71 ,$17.86 ,$36.84 ,$229.60 ,$155.84 ,$80.36 ,$258.30 ,$109.06 ,$70.18 ,$35.09 ,$137.76 
ST. MARY'S HOSPITAL - DECATUR,30600458,87536,HC HIV-1 QN-90,306,1 ,$650.00 ,$422.50 ,$3.50 ,$650.00 ,$212.75 ,$198.84 ,$357.50 ,$85.10 ,$182.00 ,$318.50 ,$85.10 ,$380.25 ,$85.10 ,$352.95 ,$3.50 ,$85.10 ,$352.95 ,$161.69 ,$455.00 ,$325.00 ,$520.00 ,$212.75 ,$85.10 ,$455.00 ,$85.10 ,$390.00 ,$85.10 ,$487.50 ,$358.80 ,$323.70 ,$358.80 ,$85.10 ,$358.80 ,$122.92 ,$122.92 ,$552.50 ,$212.75 ,$450.45 ,$85.10 ,$650.00 ,$357.50 ,$85.10 ,$170.95 , N/A ,$18.71 ,$17.86 ,$89.36 ,$520.00 ,$352.95 ,$182.00 ,$585.00 ,$247.00 ,$170.20 ,$85.10 ,$312.00 
ST. MARY'S HOSPITAL - DECATUR,30600459,87556,HC MTB COMPLEX PCR-90,306,1 ,$232.00 ,$150.80 ,$3.50 ,$232.00 ,$104.20 ,$82.00 ,$127.60 ,$41.68 ,$64.96 ,$113.68 ,$41.68 ,$135.72 ,$41.68 ,$125.98 ,$3.50 ,$41.68 ,$125.98 ,$79.19 ,$162.40 ,$116.00 ,$185.60 ,$104.20 ,$41.68 ,$162.40 ,$41.68 ,$139.20 ,$41.68 ,$174.00 ,$128.06 ,$115.54 ,$128.06 ,$41.68 ,$128.06 ,$54.18 ,$54.18 ,$197.20 ,$104.20 ,$160.78 ,$41.68 ,$232.00 ,$127.60 ,$41.68 ,$61.02 , N/A ,$18.71 ,$17.86 ,$43.76 ,$185.60 ,$125.98 ,$64.96 ,$208.80 ,$88.16 ,$83.36 ,$41.68 ,$111.36 
ST. MARY'S HOSPITAL - DECATUR,30600460,87591,HC NEISSERIA AMP-90,306,1 ,$242.00 ,$157.30 ,$3.50 ,$242.00 ,$87.73 ,$82.00 ,$133.10 ,$35.09 ,$67.76 ,$118.58 ,$35.09 ,$141.57 ,$35.09 ,$131.41 ,$3.50 ,$35.09 ,$131.41 ,$66.67 ,$169.40 ,$121.00 ,$193.60 ,$87.73 ,$35.09 ,$169.40 ,$35.09 ,$145.20 ,$35.09 ,$181.50 ,$133.58 ,$120.52 ,$133.58 ,$35.09 ,$133.58 ,$50.69 ,$50.69 ,$205.70 ,$87.73 ,$167.71 ,$35.09 ,$242.00 ,$133.10 ,$35.09 ,$63.65 , N/A ,$18.71 ,$17.86 ,$36.84 ,$193.60 ,$131.41 ,$67.76 ,$217.80 ,$91.96 ,$70.18 ,$35.09 ,$116.16 
ST. MARY'S HOSPITAL - DECATUR,30600464,87631,HC RESP VIRUS AMP 3-5 TARGETS-90,306,1 ,$308.00 ,$200.20 ,$3.50 ,$356.58 ,$356.58 ,$299.78 ,$169.40 ,$142.63 ,$86.24 ,$150.92 ,$142.63 ,$180.18 ,$142.63 ,$167.24 ,$3.50 ,$142.63 ,$167.24 ,$271.00 ,$215.60 ,$154.00 ,$246.40 ,$356.58 ,$142.63 ,$215.60 ,$142.63 ,$184.80 ,$142.63 ,$231.00 ,$170.02 ,$153.38 ,$170.02 ,$142.63 ,$170.02 ,$185.42 ,$185.42 ,$261.80 ,$308.00 ,$213.44 ,$142.63 ,$308.00 ,$169.40 ,$142.63 ,$81.00 , N/A ,$18.71 ,$17.86 ,$149.76 ,$246.40 ,$167.24 ,$86.24 ,$277.20 ,$117.04 ,$285.26 ,$142.63 ,$147.84 
ST. MARY'S HOSPITAL - DECATUR,30600465,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS-90,306,1 ,"$1,760.00 ","$1,144.00 ",$3.50 ,"$1,760.00 ","$1,041.95 ",$973.94 ,$968.00 ,$416.78 ,$492.80 ,$862.40 ,$416.78 ,"$1,029.60 ",$416.78 ,$955.68 ,$3.50 ,$416.78 ,$955.68 ,$791.88 ,"$1,232.00 ",$880.00 ,"$1,408.00 ","$1,041.95 ",$416.78 ,"$1,232.00 ",$416.78 ,"$1,056.00 ",$416.78 ,"$1,320.00 ",$971.52 ,$876.48 ,$971.52 ,$416.78 ,$971.52 ,$602.02 ,$602.02 ,"$1,496.00 ","$1,041.95 ","$1,219.68 ",$416.78 ,"$1,760.00 ",$968.00 ,$416.78 ,$462.88 , N/A ,$18.71 ,$17.86 ,$437.62 ,"$1,408.00 ",$955.68 ,$492.80 ,"$1,584.00 ",$668.80 ,$833.56 ,$416.78 ,$844.80 
ST. MARY'S HOSPITAL - DECATUR,30600471,87798,HC INFECT AMP-90,306,1 ,$451.00 ,$293.15 ,$3.50 ,$451.00 ,$87.73 ,$82.00 ,$248.05 ,$35.09 ,$126.28 ,$220.99 ,$35.09 ,$263.84 ,$35.09 ,$244.89 ,$3.50 ,$35.09 ,$244.89 ,$66.67 ,$315.70 ,$225.50 ,$360.80 ,$87.73 ,$35.09 ,$315.70 ,$35.09 ,$270.60 ,$35.09 ,$338.25 ,$248.95 ,$224.60 ,$248.95 ,$35.09 ,$248.95 ,$50.69 ,$50.69 ,$383.35 ,$87.73 ,$312.54 ,$35.09 ,$451.00 ,$248.05 ,$35.09 ,$118.61 , N/A ,$18.71 ,$17.86 ,$36.84 ,$360.80 ,$244.89 ,$126.28 ,$405.90 ,$171.38 ,$70.18 ,$35.09 ,$216.48 
ST. MARY'S HOSPITAL - DECATUR,30600478,87799,HC INFECT AGENT QN-90,306,1 ,$62.00 ,$40.30 ,$3.50 ,$107.10 ,$107.10 ,$62.00 ,$34.10 ,$42.84 ,$17.36 ,$30.38 ,$42.84 ,$36.27 ,$42.84 ,$33.67 ,$3.50 ,$42.84 ,$33.67 ,$62.00 ,$43.40 ,$31.00 ,$49.60 ,$107.10 ,$42.84 ,$43.40 ,$42.84 ,$37.20 ,$42.84 ,$46.50 ,$34.22 ,$30.88 ,$34.22 ,$42.84 ,$34.22 ,$61.88 ,$61.88 ,$52.70 ,$62.00 ,$42.97 ,$42.84 ,$62.00 ,$34.10 ,$42.84 ,$16.31 , N/A ,$18.71 ,$17.86 ,$44.98 ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$62.00 ,$42.84 ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,30600480,87899,HC INFECT AGENT DETECT OPTICAL-90,306,1 ,$102.00 ,$66.30 ,$3.50 ,$102.00 ,$40.18 ,$28.04 ,$56.10 ,$16.07 ,$28.56 ,$49.98 ,$16.07 ,$59.67 ,$16.07 ,$55.39 ,$3.50 ,$16.07 ,$55.39 ,$30.53 ,$71.40 ,$51.00 ,$81.60 ,$40.18 ,$16.07 ,$71.40 ,$16.07 ,$61.20 ,$16.07 ,$76.50 ,$56.30 ,$50.80 ,$56.30 ,$16.07 ,$56.30 ,$20.89 ,$20.89 ,$86.70 ,$40.18 ,$70.69 ,$16.07 ,$102.00 ,$56.10 ,$16.07 ,$26.83 , N/A ,$5.63 ,$5.38 ,$16.87 ,$81.60 ,$55.39 ,$28.56 ,$91.80 ,$38.76 ,$32.14 ,$16.07 ,$48.96 
ST. MARY'S HOSPITAL - DECATUR,30600481,87900,HC PHENOTYPE INFCT AGT DRG SUS-90,306,1 ,$647.00 ,$420.55 ,$3.50 ,$647.00 ,$325.88 ,$271.28 ,$355.85 ,$130.35 ,$181.16 ,$317.03 ,$130.35 ,$378.50 ,$130.35 ,$351.32 ,$3.50 ,$130.35 ,$351.32 ,$247.67 ,$452.90 ,$323.50 ,$517.60 ,$325.88 ,$130.35 ,$452.90 ,$130.35 ,$388.20 ,$130.35 ,$485.25 ,$357.14 ,$322.21 ,$357.14 ,$130.35 ,$357.14 ,$188.28 ,$188.28 ,$549.95 ,$325.88 ,$448.37 ,$130.35 ,$647.00 ,$355.85 ,$130.35 ,$170.16 , N/A ,$18.71 ,$17.86 ,$136.87 ,$517.60 ,$351.32 ,$181.16 ,$582.30 ,$245.86 ,$260.70 ,$130.35 ,$310.56 
ST. MARY'S HOSPITAL - DECATUR,30600482,87901,HC GENOTYPE HIV 1-90,306,1 ,"$1,444.00 ",$938.60 ,$3.50 ,"$1,444.00 ",$643.63 ,$601.60 ,$794.20 ,$257.45 ,$404.32 ,$707.56 ,$257.45 ,$844.74 ,$257.45 ,$784.09 ,$3.50 ,$257.45 ,$784.09 ,$489.16 ,"$1,010.80 ",$722.00 ,"$1,155.20 ",$643.63 ,$257.45 ,"$1,010.80 ",$257.45 ,$866.40 ,$257.45 ,"$1,083.00 ",$797.09 ,$719.11 ,$797.09 ,$257.45 ,$797.09 ,$371.87 ,$371.87 ,"$1,227.40 ",$643.63 ,"$1,000.69 ",$257.45 ,"$1,444.00 ",$794.20 ,$257.45 ,$379.77 , N/A ,$18.71 ,$17.86 ,$270.32 ,"$1,155.20 ",$784.09 ,$404.32 ,"$1,299.60 ",$548.72 ,$514.90 ,$257.45 ,$693.12 
ST. MARY'S HOSPITAL - DECATUR,30600483,87902,HC GENTOYPE HEP C-90,306,1 ,$417.00 ,$271.05 ,$3.50 ,$643.63 ,$643.63 ,$417.00 ,$229.35 ,$257.45 ,$116.76 ,$204.33 ,$257.45 ,$243.95 ,$257.45 ,$226.43 ,$3.50 ,$257.45 ,$226.43 ,$417.00 ,$291.90 ,$208.50 ,$333.60 ,$643.63 ,$257.45 ,$291.90 ,$257.45 ,$250.20 ,$257.45 ,$312.75 ,$230.18 ,$207.67 ,$230.18 ,$257.45 ,$230.18 ,$371.87 ,$371.87 ,$354.45 ,$417.00 ,$288.98 ,$257.45 ,$417.00 ,$229.35 ,$257.45 ,$109.67 , N/A ,$18.71 ,$17.86 ,$270.32 ,$333.60 ,$226.43 ,$116.76 ,$375.30 ,$158.46 ,$417.00 ,$257.45 ,$200.16 
ST. MARY'S HOSPITAL - DECATUR,30600484,87903,HC HIV 1 1-10 DRUGS-90,306,1 ,$188.00 ,$122.20 ,$3.50 ,$470.00 ,$470.00 ,$188.00 ,$103.40 ,$188.00 ,$52.64 ,$92.12 ,$188.00 ,$109.98 ,$188.00 ,$102.08 ,$3.50 ,$188.00 ,$102.08 ,$188.00 ,$131.60 ,$94.00 ,$150.40 ,$470.00 ,$188.00 ,$131.60 ,$188.00 ,$112.80 ,$188.00 ,$141.00 ,$103.78 ,$93.62 ,$103.78 ,$188.00 ,$103.78 ,$188.00 ,$188.00 ,$159.80 ,$188.00 ,$130.28 ,$188.00 ,$188.00 ,$103.40 ,$188.00 ,$49.44 , N/A ,$18.71 ,$17.86 ,$197.40 ,$150.40 ,$102.08 ,$52.64 ,$169.20 ,$71.44 ,$188.00 ,$188.00 ,$90.24 
ST. MARY'S HOSPITAL - DECATUR,30600485,87904,HC HIV 1 EA ADDL DRUG-90,306,1 ,$188.00 ,$122.20 ,$3.50 ,$188.00 ,$65.18 ,$54.26 ,$103.40 ,$26.07 ,$52.64 ,$92.12 ,$26.07 ,$109.98 ,$26.07 ,$102.08 ,$3.50 ,$26.07 ,$102.08 ,$49.53 ,$131.60 ,$94.00 ,$150.40 ,$65.18 ,$26.07 ,$131.60 ,$26.07 ,$112.80 ,$26.07 ,$141.00 ,$103.78 ,$93.62 ,$103.78 ,$26.07 ,$103.78 ,$37.66 ,$37.66 ,$159.80 ,$65.18 ,$130.28 ,$26.07 ,$188.00 ,$103.40 ,$26.07 ,$49.44 , N/A ,$18.71 ,$17.86 ,$27.37 ,$150.40 ,$102.08 ,$52.64 ,$169.20 ,$71.44 ,$52.14 ,$26.07 ,$90.24 
ST. MARY'S HOSPITAL - DECATUR,30600486,87906,HC GENOTYPE DNA/RNA HIV1-90,306,1 ,"$1,016.00 ",$660.40 ,$3.50 ,"$1,016.00 ",$321.83 ,$300.80 ,$558.80 ,$128.73 ,$284.48 ,$497.84 ,$128.73 ,$594.36 ,$128.73 ,$551.69 ,$3.50 ,$128.73 ,$551.69 ,$244.59 ,$711.20 ,$508.00 ,$812.80 ,$321.83 ,$128.73 ,$711.20 ,$128.73 ,$609.60 ,$128.73 ,$762.00 ,$560.83 ,$505.97 ,$560.83 ,$128.73 ,$560.83 ,$185.94 ,$185.94 ,$863.60 ,$321.83 ,$704.09 ,$128.73 ,"$1,016.00 ",$558.80 ,$128.73 ,$267.21 , N/A ,$12.17 ,$11.61 ,$135.17 ,$812.80 ,$551.69 ,$284.48 ,$914.40 ,$386.08 ,$257.46 ,$128.73 ,$487.68 
ST. MARY'S HOSPITAL - DECATUR,30600487,87999,HC TROFILE CORECEPT TROPSM ASY-90,306,1 ,"$3,314.00 ","$2,154.10 ",$5.38 ,"$3,314.00 ", N/A ,"$1,690.14 ","$1,822.70 ", N/A ,$927.92 ,"$1,557.58 ", N/A ,"$1,789.56 ", N/A ,"$1,799.50 ","$1,325.60 ", N/A ,"$1,799.50 ","$1,491.30 ","$2,319.80 ","$1,657.00 ","$2,651.20 ","$2,319.80 ", N/A ,"$2,319.80 ", N/A ,"$1,988.40 ", N/A ,"$2,485.50 ","$1,829.33 ","$1,650.37 ","$1,829.33 ", N/A ,"$1,829.33 ","$2,319.80 ","$2,319.80 ","$2,816.90 ", N/A ,"$2,296.60 ", N/A ,"$3,314.00 ","$1,822.70 ", N/A ,$871.58 , N/A ,$5.63 ,$5.38 , N/A ,"$2,651.20 ","$1,799.50 ",$927.92 ,"$2,982.60 ","$1,259.32 ","$1,657.00 ", N/A ,"$1,590.72 "
ST. MARY'S HOSPITAL - DECATUR,30600489,87210,HC SMEAR WET MOUNT-QW,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$14.55 ,$9.98 ,$116.60 ,$5.82 ,$59.36 ,$50.33 ,$5.82 ,$50.33 ,$5.82 ,$115.12 ,$3.50 ,$5.82 ,$115.12 ,$11.06 ,$148.40 ,$106.00 ,$169.60 ,$14.55 ,$5.82 ,$148.40 ,$5.82 ,$127.20 ,$5.82 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$5.82 ,$117.02 ,$7.57 ,$7.57 ,$180.20 ,$14.55 ,$146.92 ,$5.82 ,$212.00 ,$116.60 ,$5.82 ,$55.76 , N/A ,$5.63 ,$5.38 ,$6.11 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$11.64 ,$5.82 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600490,87272,HC IF CRYPTOSPORIDIUM AG-90,306,1 ,$141.00 ,$91.65 ,$3.50 ,$141.00 ,$29.95 ,$28.04 ,$77.55 ,$11.98 ,$39.48 ,$69.09 ,$11.98 ,$82.49 ,$11.98 ,$76.56 ,$3.50 ,$11.98 ,$76.56 ,$22.76 ,$98.70 ,$70.50 ,$112.80 ,$29.95 ,$11.98 ,$98.70 ,$11.98 ,$84.60 ,$11.98 ,$105.75 ,$77.83 ,$70.22 ,$77.83 ,$11.98 ,$77.83 ,$17.32 ,$17.32 ,$119.85 ,$29.95 ,$97.71 ,$11.98 ,$141.00 ,$77.55 ,$11.98 ,$37.08 , N/A ,$7.06 ,$6.74 ,$12.58 ,$112.80 ,$76.56 ,$39.48 ,$126.90 ,$53.58 ,$23.96 ,$11.98 ,$67.68 
ST. MARY'S HOSPITAL - DECATUR,30600491,87337,HC EIA QL ENTAMOEBA HISTOLYTICA-90,306,1 ,$142.00 ,$92.30 ,$3.50 ,$142.00 ,$29.95 ,$28.04 ,$78.10 ,$11.98 ,$39.76 ,$69.58 ,$11.98 ,$83.07 ,$11.98 ,$77.11 ,$3.50 ,$11.98 ,$77.11 ,$22.76 ,$99.40 ,$71.00 ,$113.60 ,$29.95 ,$11.98 ,$99.40 ,$11.98 ,$85.20 ,$11.98 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$11.98 ,$78.38 ,$17.32 ,$17.32 ,$120.70 ,$29.95 ,$98.41 ,$11.98 ,$142.00 ,$78.10 ,$11.98 ,$37.35 , N/A ,$7.06 ,$6.74 ,$12.58 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$23.96 ,$11.98 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30600492,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS-90,306,1 ,"$1,329.00 ",$863.85 ,$3.50 ,"$1,329.00 ","$1,041.95 ",$964.20 ,$730.95 ,$416.78 ,$372.12 ,$651.21 ,$416.78 ,$777.47 ,$416.78 ,$721.65 ,$3.50 ,$416.78 ,$721.65 ,$791.88 ,$930.30 ,$664.50 ,"$1,063.20 ","$1,041.95 ",$416.78 ,$930.30 ,$416.78 ,$797.40 ,$416.78 ,$996.75 ,$733.61 ,$661.84 ,$733.61 ,$416.78 ,$733.61 ,$602.02 ,$602.02 ,"$1,129.65 ","$1,041.95 ",$921.00 ,$416.78 ,"$1,329.00 ",$730.95 ,$416.78 ,$349.53 , N/A ,$18.71 ,$17.86 ,$437.62 ,"$1,063.20 ",$721.65 ,$372.12 ,"$1,196.10 ",$505.02 ,$833.56 ,$416.78 ,$637.92 
ST. MARY'S HOSPITAL - DECATUR,30600494,87301,HC IF POLYVALENT MULT ORG AG-90,306,1 ,$154.00 ,$100.10 ,$3.50 ,$154.00 ,$29.95 ,$28.04 ,$84.70 ,$11.98 ,$43.12 ,$75.46 ,$11.98 ,$90.09 ,$11.98 ,$83.62 ,$3.50 ,$11.98 ,$83.62 ,$22.76 ,$107.80 ,$77.00 ,$123.20 ,$29.95 ,$11.98 ,$107.80 ,$11.98 ,$92.40 ,$11.98 ,$115.50 ,$85.01 ,$76.69 ,$85.01 ,$11.98 ,$85.01 ,$17.32 ,$17.32 ,$130.90 ,$29.95 ,$106.72 ,$11.98 ,$154.00 ,$84.70 ,$11.98 ,$40.50 , N/A ,$7.06 ,$6.74 ,$12.58 ,$123.20 ,$83.62 ,$43.12 ,$138.60 ,$58.52 ,$23.96 ,$11.98 ,$73.92 
ST. MARY'S HOSPITAL - DECATUR,30600503,87389,HC HIV-1 AG W/HIV-1  AND  HIV-2 AB-90,306,1 ,$315.00 ,$204.75 ,$3.50 ,$315.00 ,$60.20 ,$56.28 ,$173.25 ,$24.08 ,$88.20 ,$154.35 ,$24.08 ,$184.28 ,$24.08 ,$171.05 ,$3.50 ,$24.08 ,$171.05 ,$45.75 ,$220.50 ,$157.50 ,$252.00 ,$60.20 ,$24.08 ,$220.50 ,$24.08 ,$189.00 ,$24.08 ,$236.25 ,$173.88 ,$156.87 ,$173.88 ,$24.08 ,$173.88 ,$34.78 ,$34.78 ,$267.75 ,$60.20 ,$218.30 ,$24.08 ,$315.00 ,$173.25 ,$24.08 ,$82.85 , N/A ,$7.06 ,$6.74 ,$25.28 ,$252.00 ,$171.05 ,$88.20 ,$283.50 ,$119.70 ,$48.16 ,$24.08 ,$151.20 
ST. MARY'S HOSPITAL - DECATUR,30600504,87046,HC STOOL CULTURE ADD ISO-90,306,1 ,$103.00 ,$66.95 ,$3.50 ,$103.00 ,$23.60 ,$22.04 ,$56.65 ,$9.44 ,$28.84 ,$50.47 ,$9.44 ,$60.26 ,$9.44 ,$55.93 ,$3.50 ,$9.44 ,$55.93 ,$17.94 ,$72.10 ,$51.50 ,$82.40 ,$23.60 ,$9.44 ,$72.10 ,$9.44 ,$61.80 ,$9.44 ,$77.25 ,$56.86 ,$51.29 ,$56.86 ,$9.44 ,$56.86 ,$13.64 ,$13.64 ,$87.55 ,$23.60 ,$71.38 ,$9.44 ,$103.00 ,$56.65 ,$9.44 ,$27.09 , N/A ,$5.63 ,$5.38 ,$9.91 ,$82.40 ,$55.93 ,$28.84 ,$92.70 ,$39.14 ,$18.88 ,$9.44 ,$49.44 
ST. MARY'S HOSPITAL - DECATUR,30600505,87329,HC EIA QL GIARDIA AG-90,306,1 ,$151.00 ,$98.15 ,$3.50 ,$151.00 ,$29.95 ,$28.04 ,$83.05 ,$11.98 ,$42.28 ,$73.99 ,$11.98 ,$88.34 ,$11.98 ,$81.99 ,$3.50 ,$11.98 ,$81.99 ,$22.76 ,$105.70 ,$75.50 ,$120.80 ,$29.95 ,$11.98 ,$105.70 ,$11.98 ,$90.60 ,$11.98 ,$113.25 ,$83.35 ,$75.20 ,$83.35 ,$11.98 ,$83.35 ,$17.32 ,$17.32 ,$128.35 ,$29.95 ,$104.64 ,$11.98 ,$151.00 ,$83.05 ,$11.98 ,$39.71 , N/A ,$7.06 ,$6.74 ,$12.58 ,$120.80 ,$81.99 ,$42.28 ,$135.90 ,$57.38 ,$23.96 ,$11.98 ,$72.48 
ST. MARY'S HOSPITAL - DECATUR,30600508,87625,HC HPV GENOTYPE 16 18/45,306,1 ,$248.00 ,$161.20 ,$3.50 ,$248.00 ,$101.38 ,$81.20 ,$136.40 ,$40.55 ,$69.44 ,$121.52 ,$40.55 ,$145.08 ,$40.55 ,$134.66 ,$3.50 ,$40.55 ,$134.66 ,$77.05 ,$173.60 ,$124.00 ,$198.40 ,$101.38 ,$40.55 ,$173.60 ,$40.55 ,$148.80 ,$40.55 ,$186.00 ,$136.90 ,$123.50 ,$136.90 ,$40.55 ,$136.90 ,$52.72 ,$52.72 ,$210.80 ,$101.38 ,$171.86 ,$40.55 ,$40.55 ,$136.40 ,$40.55 ,$65.22 , N/A ,$18.71 ,$17.86 ,$42.58 ,$198.40 ,$134.66 ,$69.44 ,$223.20 ,$94.24 ,$81.10 ,$40.55 ,$119.04 
ST. MARY'S HOSPITAL - DECATUR,30600509,87661,HC TRICHOMONAS VAG AMP PROBE,306,1 ,$226.00 ,$146.90 ,$3.50 ,$226.00 ,$87.73 ,$81.38 ,$124.30 ,$35.09 ,$63.28 ,$110.74 ,$35.09 ,$132.21 ,$35.09 ,$122.72 ,$3.50 ,$35.09 ,$122.72 ,$66.67 ,$158.20 ,$113.00 ,$180.80 ,$87.73 ,$35.09 ,$158.20 ,$35.09 ,$135.60 ,$35.09 ,$169.50 ,$124.75 ,$112.55 ,$124.75 ,$35.09 ,$124.75 ,$50.69 ,$50.69 ,$192.10 ,$87.73 ,$156.62 ,$35.09 ,$226.00 ,$124.30 ,$35.09 ,$59.44 , N/A ,$18.71 ,$17.86 ,$36.84 ,$180.80 ,$122.72 ,$63.28 ,$203.40 ,$85.88 ,$70.18 ,$35.09 ,$108.48 
ST. MARY'S HOSPITAL - DECATUR,30600513,87533,HC HHV-6 DNA QUANT-90,306,1 ,$662.00 ,$430.30 ,$3.50 ,$662.00 ,$104.40 ,$97.56 ,$364.10 ,$41.76 ,$185.36 ,$324.38 ,$41.76 ,$329.40 ,$41.76 ,$359.47 ,$3.50 ,$41.76 ,$359.47 ,$79.34 ,$463.40 ,$331.00 ,$529.60 ,$104.40 ,$41.76 ,$463.40 ,$41.76 ,$397.20 ,$41.76 ,$496.50 ,$365.42 ,$329.68 ,$365.42 ,$41.76 ,$365.42 ,$60.32 ,$60.32 ,$562.70 ,$104.40 ,$458.77 ,$41.76 ,$662.00 ,$364.10 ,$41.76 ,$174.11 , N/A ,$18.71 ,$17.86 ,$43.85 ,$529.60 ,$359.47 ,$185.36 ,$595.80 ,$251.56 ,$83.52 ,$41.76 ,$317.76 
ST. MARY'S HOSPITAL - DECATUR,30600515,87015,HC CONCENTRATION INFECTIOUS AGENT,306,1 ,$96.00 ,$62.40 ,$3.50 ,$96.00 ,$16.70 ,$15.60 ,$52.80 ,$6.68 ,$26.88 ,$47.04 ,$6.68 ,$52.69 ,$6.68 ,$52.13 ,$3.50 ,$6.68 ,$52.13 ,$12.69 ,$67.20 ,$48.00 ,$76.80 ,$16.70 ,$6.68 ,$67.20 ,$6.68 ,$57.60 ,$6.68 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$6.68 ,$52.99 ,$9.65 ,$9.65 ,$81.60 ,$16.70 ,$66.53 ,$6.68 ,$96.00 ,$52.80 ,$6.68 ,$25.25 , N/A ,$5.63 ,$5.38 ,$7.01 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$13.36 ,$6.68 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30600519,87070,HC BODY FLUID CULTURE,306,1 ,$366.00 ,$237.90 ,$3.50 ,$366.00 ,$21.55 ,$20.12 ,$201.30 ,$8.62 ,$102.48 ,$92.01 ,$8.62 ,$92.01 ,$8.62 ,$198.74 ,$3.50 ,$8.62 ,$198.74 ,$16.38 ,$256.20 ,$183.00 ,$292.80 ,$21.55 ,$8.62 ,$256.20 ,$8.62 ,$219.60 ,$8.62 ,$274.50 ,$202.03 ,$182.27 ,$202.03 ,$8.62 ,$202.03 ,$12.44 ,$12.44 ,$311.10 ,$21.55 ,$253.64 ,$8.62 ,$366.00 ,$201.30 ,$8.62 ,$96.26 , N/A ,$5.63 ,$5.38 ,$9.05 ,$292.80 ,$198.74 ,$102.48 ,$329.40 ,$139.08 ,$17.24 ,$8.62 ,$175.68 
ST. MARY'S HOSPITAL - DECATUR,30600522,87075,HC CULTURE ANAEROBIC,306,1 ,$365.00 ,$237.25 ,$3.50 ,$365.00 ,$23.68 ,$22.12 ,$200.75 ,$9.47 ,$102.20 ,$74.71 ,$9.47 ,$74.71 ,$9.47 ,$198.20 ,$3.50 ,$9.47 ,$198.20 ,$17.99 ,$255.50 ,$182.50 ,$292.00 ,$23.68 ,$9.47 ,$255.50 ,$9.47 ,$219.00 ,$9.47 ,$273.75 ,$201.48 ,$181.77 ,$201.48 ,$9.47 ,$201.48 ,$13.68 ,$13.68 ,$310.25 ,$23.68 ,$252.95 ,$9.47 ,$365.00 ,$200.75 ,$9.47 ,$96.00 , N/A ,$5.63 ,$5.38 ,$9.94 ,$292.00 ,$198.20 ,$102.20 ,$328.50 ,$138.70 ,$18.94 ,$9.47 ,$175.20 
ST. MARY'S HOSPITAL - DECATUR,30600523,87076,HC CULTURE ANAEROBIC ID,306,1 ,$152.00 ,$98.80 ,$3.50 ,$152.00 ,$20.20 ,$9.92 ,$83.60 ,$8.08 ,$42.56 ,$63.70 ,$8.08 ,$63.70 ,$8.08 ,$82.54 ,$3.50 ,$8.08 ,$82.54 ,$15.35 ,$106.40 ,$76.00 ,$121.60 ,$20.20 ,$8.08 ,$106.40 ,$8.08 ,$91.20 ,$8.08 ,$114.00 ,$83.90 ,$75.70 ,$83.90 ,$8.08 ,$83.90 ,$11.66 ,$11.66 ,$129.20 ,$20.20 ,$105.34 ,$8.08 ,$152.00 ,$83.60 ,$8.08 ,$39.98 , N/A ,$5.63 ,$5.38 ,$8.48 ,$121.60 ,$82.54 ,$42.56 ,$136.80 ,$57.76 ,$16.16 ,$8.08 ,$72.96 
ST. MARY'S HOSPITAL - DECATUR,30600524,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$186.00 ,$120.90 ,$3.50 ,$186.00 ,$20.20 ,$9.92 ,$102.30 ,$8.08 ,$52.08 ,$86.21 ,$8.08 ,$86.21 ,$8.08 ,$101.00 ,$3.50 ,$8.08 ,$101.00 ,$15.35 ,$130.20 ,$93.00 ,$148.80 ,$20.20 ,$8.08 ,$130.20 ,$8.08 ,$111.60 ,$8.08 ,$139.50 ,$102.67 ,$92.63 ,$102.67 ,$8.08 ,$102.67 ,$11.66 ,$11.66 ,$158.10 ,$20.20 ,$128.90 ,$8.08 ,$186.00 ,$102.30 ,$8.08 ,$48.92 , N/A ,$5.63 ,$5.38 ,$8.48 ,$148.80 ,$101.00 ,$52.08 ,$167.40 ,$70.68 ,$16.16 ,$8.08 ,$89.28 
ST. MARY'S HOSPITAL - DECATUR,30600526,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$16.58 ,$15.50 ,$116.60 ,$6.63 ,$59.36 ,$70.78 ,$6.63 ,$70.78 ,$6.63 ,$115.12 ,$3.50 ,$6.63 ,$115.12 ,$12.60 ,$148.40 ,$106.00 ,$169.60 ,$16.58 ,$6.63 ,$148.40 ,$6.63 ,$127.20 ,$6.63 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$6.63 ,$117.02 ,$9.57 ,$9.57 ,$180.20 ,$16.58 ,$146.92 ,$6.63 ,$212.00 ,$116.60 ,$6.63 ,$55.76 , N/A ,$5.63 ,$5.38 ,$6.96 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$13.26 ,$6.63 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600527,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$172.00 ,$111.80 ,$3.50 ,$172.00 ,$20.18 ,$18.88 ,$94.60 ,$8.07 ,$48.16 ,$84.28 ,$8.07 ,$86.11 ,$8.07 ,$93.40 ,$3.50 ,$8.07 ,$93.40 ,$15.33 ,$120.40 ,$86.00 ,$137.60 ,$20.18 ,$8.07 ,$120.40 ,$8.07 ,$103.20 ,$8.07 ,$129.00 ,$94.94 ,$85.66 ,$94.94 ,$8.07 ,$94.94 ,$11.66 ,$11.66 ,$146.20 ,$20.18 ,$119.20 ,$8.07 ,$172.00 ,$94.60 ,$8.07 ,$45.24 , N/A ,$5.63 ,$5.38 ,$8.47 ,$137.60 ,$93.40 ,$48.16 ,$154.80 ,$65.36 ,$16.14 ,$8.07 ,$82.56 
ST. MARY'S HOSPITAL - DECATUR,30600528,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$393.00 ,$255.45 ,$3.50 ,$393.00 ,$20.23 ,$18.92 ,$216.15 ,$8.09 ,$110.04 ,$86.41 ,$8.09 ,$86.41 ,$8.09 ,$213.40 ,$3.50 ,$8.09 ,$213.40 ,$15.37 ,$275.10 ,$196.50 ,$314.40 ,$20.23 ,$8.09 ,$275.10 ,$8.09 ,$235.80 ,$8.09 ,$294.75 ,$216.94 ,$195.71 ,$216.94 ,$8.09 ,$216.94 ,$11.69 ,$11.69 ,$334.05 ,$20.23 ,$272.35 ,$8.09 ,$393.00 ,$216.15 ,$8.09 ,$103.36 , N/A ,$5.63 ,$5.38 ,$8.49 ,$314.40 ,$213.40 ,$110.04 ,$353.70 ,$149.34 ,$16.18 ,$8.09 ,$188.64 
ST. MARY'S HOSPITAL - DECATUR,30600529,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL -90,306,1 ,$253.00 ,$164.45 ,$3.50 ,$253.00 ,$19.28 ,$18.02 ,$139.15 ,$7.71 ,$70.84 ,$60.75 ,$7.71 ,$60.75 ,$7.71 ,$137.38 ,$3.50 ,$7.71 ,$137.38 ,$14.65 ,$177.10 ,$126.50 ,$202.40 ,$19.28 ,$7.71 ,$177.10 ,$7.71 ,$151.80 ,$7.71 ,$189.75 ,$139.66 ,$125.99 ,$139.66 ,$7.71 ,$139.66 ,$11.13 ,$11.13 ,$215.05 ,$19.28 ,$175.33 ,$7.71 ,$253.00 ,$139.15 ,$7.71 ,$66.54 , N/A ,$5.63 ,$5.38 ,$8.10 ,$202.40 ,$137.38 ,$70.84 ,$227.70 ,$96.14 ,$15.42 ,$7.71 ,$121.44 
ST. MARY'S HOSPITAL - DECATUR,30600530,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL,306,1 ,$421.00 ,$273.65 ,$3.50 ,$421.00 ,$19.28 ,$18.02 ,$231.55 ,$7.71 ,$117.88 ,$60.75 ,$7.71 ,$60.75 ,$7.71 ,$228.60 ,$3.50 ,$7.71 ,$228.60 ,$14.65 ,$294.70 ,$210.50 ,$336.80 ,$19.28 ,$7.71 ,$294.70 ,$7.71 ,$252.60 ,$7.71 ,$315.75 ,$232.39 ,$209.66 ,$232.39 ,$7.71 ,$232.39 ,$11.13 ,$11.13 ,$357.85 ,$19.28 ,$291.75 ,$7.71 ,$421.00 ,$231.55 ,$7.71 ,$110.72 , N/A ,$5.63 ,$5.38 ,$8.10 ,$336.80 ,$228.60 ,$117.88 ,$378.90 ,$159.98 ,$15.42 ,$7.71 ,$202.08 
ST. MARY'S HOSPITAL - DECATUR,30600532,87103,HC CULTURE FUNGUS BLOOD,306,1 ,$429.00 ,$278.85 ,$3.50 ,$429.00 ,$51.15 ,$21.08 ,$235.95 ,$20.46 ,$120.12 ,$130.74 ,$20.46 ,$130.74 ,$20.46 ,$232.95 ,$3.50 ,$20.46 ,$232.95 ,$38.87 ,$300.30 ,$214.50 ,$343.20 ,$51.15 ,$20.46 ,$300.30 ,$20.46 ,$257.40 ,$20.46 ,$321.75 ,$236.81 ,$213.64 ,$236.81 ,$20.46 ,$236.81 ,$26.60 ,$26.60 ,$364.65 ,$51.15 ,$297.30 ,$20.46 ,$429.00 ,$235.95 ,$20.46 ,$112.83 , N/A ,$18.71 ,$17.86 ,$21.48 ,$343.20 ,$232.95 ,$120.12 ,$386.10 ,$163.02 ,$40.92 ,$20.46 ,$205.92 
ST. MARY'S HOSPITAL - DECATUR,30600533,87106,HC CULTURE FUNGUS ID YEAST,306,1 ,$295.00 ,$191.75 ,$3.50 ,$295.00 ,$25.80 ,$24.12 ,$162.25 ,$10.32 ,$82.60 ,$81.39 ,$10.32 ,$81.39 ,$10.32 ,$160.19 ,$3.50 ,$10.32 ,$160.19 ,$19.61 ,$206.50 ,$147.50 ,$236.00 ,$25.80 ,$10.32 ,$206.50 ,$10.32 ,$177.00 ,$10.32 ,$221.25 ,$162.84 ,$146.91 ,$162.84 ,$10.32 ,$162.84 ,$14.91 ,$14.91 ,$250.75 ,$25.80 ,$204.44 ,$10.32 ,$295.00 ,$162.25 ,$10.32 ,$77.59 , N/A ,$5.63 ,$5.38 ,$10.84 ,$236.00 ,$160.19 ,$82.60 ,$265.50 ,$112.10 ,$20.64 ,$10.32 ,$141.60 
ST. MARY'S HOSPITAL - DECATUR,30600534,87107,HC CULTURE FUNGUS ID MOLD,306,1 ,$101.00 ,$65.65 ,$3.50 ,$101.00 ,$25.80 ,$24.12 ,$55.55 ,$10.32 ,$28.28 ,$49.49 ,$10.32 ,$59.09 ,$10.32 ,$54.84 ,$3.50 ,$10.32 ,$54.84 ,$19.61 ,$70.70 ,$50.50 ,$80.80 ,$25.80 ,$10.32 ,$70.70 ,$10.32 ,$60.60 ,$10.32 ,$75.75 ,$55.75 ,$50.30 ,$55.75 ,$10.32 ,$55.75 ,$14.91 ,$14.91 ,$85.85 ,$25.80 ,$69.99 ,$10.32 ,$101.00 ,$55.55 ,$10.32 ,$26.56 , N/A ,$18.71 ,$17.86 ,$10.84 ,$80.80 ,$54.84 ,$28.28 ,$90.90 ,$38.38 ,$20.64 ,$10.32 ,$48.48 
ST. MARY'S HOSPITAL - DECATUR,30600535,87116,HC CULTURE AFB/TB/MYCOBACT,306,1 ,$237.00 ,$154.05 ,$3.50 ,$237.00 ,$27.00 ,$25.24 ,$130.35 ,$10.80 ,$66.36 ,$85.23 ,$10.80 ,$85.23 ,$10.80 ,$128.69 ,$3.50 ,$10.80 ,$128.69 ,$20.52 ,$165.90 ,$118.50 ,$189.60 ,$27.00 ,$10.80 ,$165.90 ,$10.80 ,$142.20 ,$10.80 ,$177.75 ,$130.82 ,$118.03 ,$130.82 ,$10.80 ,$130.82 ,$15.60 ,$15.60 ,$201.45 ,$27.00 ,$164.24 ,$10.80 ,$237.00 ,$130.35 ,$10.80 ,$62.33 , N/A ,$18.71 ,$17.86 ,$11.34 ,$189.60 ,$128.69 ,$66.36 ,$213.30 ,$90.06 ,$21.60 ,$10.80 ,$113.76 
ST. MARY'S HOSPITAL - DECATUR,30600536,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$58.00 ,$37.70 ,$3.50 ,$58.00 ,$12.95 ,$12.08 ,$31.90 ,$5.18 ,$16.24 ,$28.42 ,$5.18 ,$33.93 ,$5.18 ,$31.49 ,$3.50 ,$5.18 ,$31.49 ,$9.84 ,$40.60 ,$29.00 ,$46.40 ,$12.95 ,$5.18 ,$40.60 ,$5.18 ,$34.80 ,$5.18 ,$43.50 ,$32.02 ,$28.88 ,$32.02 ,$5.18 ,$32.02 ,$7.48 ,$7.48 ,$49.30 ,$12.95 ,$40.19 ,$5.18 ,$58.00 ,$31.90 ,$5.18 ,$15.25 , N/A ,$5.63 ,$5.38 ,$5.44 ,$46.40 ,$31.49 ,$16.24 ,$52.20 ,$22.04 ,$10.36 ,$5.18 ,$27.84 
ST. MARY'S HOSPITAL - DECATUR,30600537,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$226.00 ,$146.90 ,$3.50 ,$226.00 ,$50.13 ,$46.86 ,$124.30 ,$20.05 ,$63.28 ,$110.74 ,$20.05 ,$132.21 ,$20.05 ,$122.72 ,$3.50 ,$20.05 ,$122.72 ,$38.10 ,$158.20 ,$113.00 ,$180.80 ,$50.13 ,$20.05 ,$158.20 ,$20.05 ,$135.60 ,$20.05 ,$169.50 ,$124.75 ,$112.55 ,$124.75 ,$20.05 ,$124.75 ,$28.96 ,$28.96 ,$192.10 ,$50.13 ,$156.62 ,$20.05 ,$226.00 ,$124.30 ,$20.05 ,$59.44 , N/A ,$5.63 ,$5.38 ,$21.05 ,$180.80 ,$122.72 ,$63.28 ,$203.40 ,$85.88 ,$40.10 ,$20.05 ,$108.48 
ST. MARY'S HOSPITAL - DECATUR,30600538,87153,HC ID NUCLEAR ACID SEQ METH PROF,306,1 ,"$1,005.00 ",$653.25 ,$3.50 ,"$1,005.00 ",$288.40 ,$269.56 ,$552.75 ,$115.36 ,$281.40 ,$492.45 ,$115.36 ,$587.93 ,$115.36 ,$545.72 ,$3.50 ,$115.36 ,$545.72 ,$219.18 ,$703.50 ,$502.50 ,$804.00 ,$288.40 ,$115.36 ,$703.50 ,$115.36 ,$603.00 ,$115.36 ,$753.75 ,$554.76 ,$500.49 ,$554.76 ,$115.36 ,$554.76 ,$166.62 ,$166.62 ,$854.25 ,$288.40 ,$696.47 ,$115.36 ,"$1,005.00 ",$552.75 ,$115.36 ,$264.32 , N/A ,$18.71 ,$17.86 ,$121.13 ,$804.00 ,$545.72 ,$281.40 ,$904.50 ,$381.90 ,$230.72 ,$115.36 ,$482.40 
ST. MARY'S HOSPITAL - DECATUR,30600539,87153,HC ID NUCLEAR ACID SEQ METH ID,306,1 ,"$1,005.00 ",$653.25 ,$3.50 ,"$1,005.00 ",$288.40 ,$269.56 ,$552.75 ,$115.36 ,$281.40 ,$492.45 ,$115.36 ,$587.93 ,$115.36 ,$545.72 ,$3.50 ,$115.36 ,$545.72 ,$219.18 ,$703.50 ,$502.50 ,$804.00 ,$288.40 ,$115.36 ,$703.50 ,$115.36 ,$603.00 ,$115.36 ,$753.75 ,$554.76 ,$500.49 ,$554.76 ,$115.36 ,$554.76 ,$166.62 ,$166.62 ,$854.25 ,$288.40 ,$696.47 ,$115.36 ,"$1,005.00 ",$552.75 ,$115.36 ,$264.32 , N/A ,$18.71 ,$17.86 ,$121.13 ,$804.00 ,$545.72 ,$281.40 ,$904.50 ,$381.90 ,$230.72 ,$115.36 ,$482.40 
ST. MARY'S HOSPITAL - DECATUR,30600544,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$177.00 ,$115.05 ,$3.50 ,$177.00 ,$11.88 ,$11.10 ,$97.35 ,$4.75 ,$49.56 ,$50.72 ,$4.75 ,$50.72 ,$4.75 ,$96.11 ,$3.50 ,$4.75 ,$96.11 ,$9.03 ,$123.90 ,$88.50 ,$141.60 ,$11.88 ,$4.75 ,$123.90 ,$4.75 ,$106.20 ,$4.75 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$4.75 ,$97.70 ,$6.85 ,$6.85 ,$150.45 ,$11.88 ,$122.66 ,$4.75 ,$177.00 ,$97.35 ,$4.75 ,$46.55 , N/A ,$5.63 ,$5.38 ,$4.99 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$9.50 ,$4.75 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30600545,87184,HC SENSITIVITY DISK KB,306,1 ,$270.00 ,$175.50 ,$3.50 ,$270.00 ,$18.70 ,$16.14 ,$148.50 ,$7.48 ,$75.60 ,$73.63 ,$7.48 ,$73.63 ,$7.48 ,$146.61 ,$3.50 ,$7.48 ,$146.61 ,$14.21 ,$189.00 ,$135.00 ,$216.00 ,$18.70 ,$7.48 ,$189.00 ,$7.48 ,$162.00 ,$7.48 ,$202.50 ,$149.04 ,$134.46 ,$149.04 ,$7.48 ,$149.04 ,$9.96 ,$9.96 ,$229.50 ,$18.70 ,$187.11 ,$7.48 ,$270.00 ,$148.50 ,$7.48 ,$71.01 , N/A ,$5.63 ,$5.38 ,$7.85 ,$216.00 ,$146.61 ,$75.60 ,$243.00 ,$102.60 ,$14.96 ,$7.48 ,$129.60 
ST. MARY'S HOSPITAL - DECATUR,30600547,87186,HC SENSITIVITY MIC,306,1 ,$177.00 ,$115.05 ,$3.50 ,$177.00 ,$21.63 ,$20.20 ,$97.35 ,$8.65 ,$49.56 ,$68.22 ,$8.65 ,$68.22 ,$8.65 ,$96.11 ,$3.50 ,$8.65 ,$96.11 ,$16.44 ,$123.90 ,$88.50 ,$141.60 ,$21.63 ,$8.65 ,$123.90 ,$8.65 ,$106.20 ,$8.65 ,$132.75 ,$97.70 ,$88.15 ,$97.70 ,$8.65 ,$97.70 ,$12.49 ,$12.49 ,$150.45 ,$21.63 ,$122.66 ,$8.65 ,$177.00 ,$97.35 ,$8.65 ,$46.55 , N/A ,$5.63 ,$5.38 ,$9.08 ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$17.30 ,$8.65 ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,30600548,87188,HC MACROTUBE DIL METH 4DRG PNL,306,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$16.60 ,$15.50 ,$106.15 ,$6.64 ,$54.04 ,$52.39 ,$6.64 ,$52.39 ,$6.64 ,$104.80 ,$3.50 ,$6.64 ,$104.80 ,$12.62 ,$135.10 ,$96.50 ,$154.40 ,$16.60 ,$6.64 ,$135.10 ,$6.64 ,$115.80 ,$6.64 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$6.64 ,$106.54 ,$9.59 ,$9.59 ,$164.05 ,$16.60 ,$133.75 ,$6.64 ,$193.00 ,$106.15 ,$6.64 ,$50.76 , N/A ,$5.63 ,$5.38 ,$6.97 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$13.28 ,$6.64 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30600549,87188,HC MACROTUBE DIL METH EA AGNT,306,1 ,$193.00 ,$125.45 ,$3.50 ,$193.00 ,$16.60 ,$15.50 ,$106.15 ,$6.64 ,$54.04 ,$52.39 ,$6.64 ,$52.39 ,$6.64 ,$104.80 ,$3.50 ,$6.64 ,$104.80 ,$12.62 ,$135.10 ,$96.50 ,$154.40 ,$16.60 ,$6.64 ,$135.10 ,$6.64 ,$115.80 ,$6.64 ,$144.75 ,$106.54 ,$96.11 ,$106.54 ,$6.64 ,$106.54 ,$9.59 ,$9.59 ,$164.05 ,$16.60 ,$133.75 ,$6.64 ,$193.00 ,$106.15 ,$6.64 ,$50.76 , N/A ,$5.63 ,$5.38 ,$6.97 ,$154.40 ,$104.80 ,$54.04 ,$173.70 ,$73.34 ,$13.28 ,$6.64 ,$92.64 
ST. MARY'S HOSPITAL - DECATUR,30600550,87190,HC SENSITIVITY AFB,306,1 ,$162.00 ,$105.30 ,$3.50 ,$162.00 ,$18.28 ,$13.20 ,$89.10 ,$7.31 ,$45.36 ,$46.69 ,$7.31 ,$46.69 ,$7.31 ,$87.97 ,$3.50 ,$7.31 ,$87.97 ,$13.89 ,$113.40 ,$81.00 ,$129.60 ,$18.28 ,$7.31 ,$113.40 ,$7.31 ,$97.20 ,$7.31 ,$121.50 ,$89.42 ,$80.68 ,$89.42 ,$7.31 ,$89.42 ,$9.50 ,$9.50 ,$137.70 ,$18.28 ,$112.27 ,$7.31 ,$162.00 ,$89.10 ,$7.31 ,$42.61 , N/A ,$5.63 ,$5.38 ,$7.68 ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$14.62 ,$7.31 ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,30600551,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$191.00 ,$124.15 ,$3.50 ,$191.00 ,$10.68 ,$9.98 ,$105.05 ,$4.27 ,$53.48 ,$45.61 ,$4.27 ,$45.61 ,$4.27 ,$103.71 ,$3.50 ,$4.27 ,$103.71 ,$8.11 ,$133.70 ,$95.50 ,$152.80 ,$10.68 ,$4.27 ,$133.70 ,$4.27 ,$114.60 ,$4.27 ,$143.25 ,$105.43 ,$95.12 ,$105.43 ,$4.27 ,$105.43 ,$6.18 ,$6.18 ,$162.35 ,$10.68 ,$132.36 ,$4.27 ,$191.00 ,$105.05 ,$4.27 ,$50.23 , N/A ,$5.63 ,$5.38 ,$4.48 ,$152.80 ,$103.71 ,$53.48 ,$171.90 ,$72.58 ,$8.54 ,$4.27 ,$91.68 
ST. MARY'S HOSPITAL - DECATUR,30600552,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$421.00 ,$273.65 ,$3.50 ,$421.00 ,$13.48 ,$12.56 ,$231.55 ,$5.39 ,$117.88 ,$57.51 ,$5.39 ,$57.51 ,$5.39 ,$228.60 ,$3.50 ,$5.39 ,$228.60 ,$10.24 ,$294.70 ,$210.50 ,$336.80 ,$13.48 ,$5.39 ,$294.70 ,$5.39 ,$252.60 ,$5.39 ,$315.75 ,$232.39 ,$209.66 ,$232.39 ,$5.39 ,$232.39 ,$7.79 ,$7.79 ,$357.85 ,$13.48 ,$291.75 ,$5.39 ,$421.00 ,$231.55 ,$5.39 ,$110.72 , N/A ,$5.63 ,$5.38 ,$5.66 ,$336.80 ,$228.60 ,$117.88 ,$378.90 ,$159.98 ,$10.78 ,$5.39 ,$202.08 
ST. MARY'S HOSPITAL - DECATUR,30600555,87255,HC VIRUS ID NON-IMMUNOLOGIC OTHER THAN CYTOPATHIC-90,306,1 ,$254.00 ,$165.10 ,$3.50 ,$254.00 ,$84.65 ,$79.14 ,$139.70 ,$33.86 ,$71.12 ,$124.46 ,$33.86 ,$148.59 ,$33.86 ,$137.92 ,$3.50 ,$33.86 ,$137.92 ,$64.33 ,$177.80 ,$127.00 ,$203.20 ,$84.65 ,$33.86 ,$177.80 ,$33.86 ,$152.40 ,$33.86 ,$190.50 ,$140.21 ,$126.49 ,$140.21 ,$33.86 ,$140.21 ,$48.91 ,$48.91 ,$215.90 ,$84.65 ,$176.02 ,$33.86 ,$254.00 ,$139.70 ,$33.86 ,$66.80 , N/A ,$18.71 ,$17.86 ,$35.55 ,$203.20 ,$137.92 ,$71.12 ,$228.60 ,$96.52 ,$67.72 ,$33.86 ,$121.92 
ST. MARY'S HOSPITAL - DECATUR,30600557,87329,HC EIA QL GIARDIA AG,306,1 ,"$1,760.00 ","$1,144.00 ",$3.50 ,"$1,760.00 ",$29.95 ,$28.04 ,$968.00 ,$11.98 ,$492.80 ,$94.56 ,$11.98 ,$94.56 ,$11.98 ,$955.68 ,$3.50 ,$11.98 ,$955.68 ,$22.76 ,"$1,232.00 ",$880.00 ,"$1,408.00 ",$29.95 ,$11.98 ,"$1,232.00 ",$11.98 ,"$1,056.00 ",$11.98 ,"$1,320.00 ",$971.52 ,$876.48 ,$971.52 ,$11.98 ,$971.52 ,$17.32 ,$17.32 ,"$1,496.00 ",$29.95 ,"$1,219.68 ",$11.98 ,"$1,760.00 ",$968.00 ,$11.98 ,$462.88 , N/A ,$7.06 ,$6.74 ,$12.58 ,"$1,408.00 ",$955.68 ,$492.80 ,"$1,584.00 ",$668.80 ,$23.96 ,$11.98 ,$844.80 
ST. MARY'S HOSPITAL - DECATUR,30600558,87338,HC EIA QL H PYLORI AG STOOL,306,1 ,$266.00 ,$172.90 ,$3.50 ,$266.00 ,$35.95 ,$33.60 ,$146.30 ,$14.38 ,$74.48 ,$130.34 ,$14.38 ,$153.64 ,$14.38 ,$144.44 ,$3.50 ,$14.38 ,$144.44 ,$27.32 ,$186.20 ,$133.00 ,$212.80 ,$35.95 ,$14.38 ,$186.20 ,$14.38 ,$159.60 ,$14.38 ,$199.50 ,$146.83 ,$132.47 ,$146.83 ,$14.38 ,$146.83 ,$20.77 ,$20.77 ,$226.10 ,$35.95 ,$184.34 ,$14.38 ,$266.00 ,$146.30 ,$14.38 ,$69.96 , N/A ,$7.06 ,$6.74 ,$15.10 ,$212.80 ,$144.44 ,$74.48 ,$239.40 ,$101.08 ,$28.76 ,$14.38 ,$127.68 
ST. MARY'S HOSPITAL - DECATUR,30600566,87480,HC CANDIDA SPECIES DNA SCREEN,306,1 ,$132.00 ,$85.80 ,$3.50 ,$132.00 ,$50.13 ,$46.86 ,$72.60 ,$20.05 ,$36.96 ,$64.68 ,$20.05 ,$77.22 ,$20.05 ,$71.68 ,$3.50 ,$20.05 ,$71.68 ,$38.10 ,$92.40 ,$66.00 ,$105.60 ,$50.13 ,$20.05 ,$92.40 ,$20.05 ,$79.20 ,$20.05 ,$99.00 ,$72.86 ,$65.74 ,$72.86 ,$20.05 ,$72.86 ,$28.96 ,$28.96 ,$112.20 ,$50.13 ,$91.48 ,$20.05 ,$132.00 ,$72.60 ,$20.05 ,$34.72 , N/A ,$7.06 ,$6.74 ,$21.05 ,$105.60 ,$71.68 ,$36.96 ,$118.80 ,$50.16 ,$40.10 ,$20.05 ,$63.36 
ST. MARY'S HOSPITAL - DECATUR,30600568,87486,HC CHLAMYDIA PNEUM AMP PROBE,306,1 ,$258.00 ,$167.70 ,$3.50 ,$258.00 ,$87.73 ,$82.00 ,$141.90 ,$35.09 ,$72.24 ,$126.42 ,$35.09 ,$150.93 ,$35.09 ,$140.09 ,$3.50 ,$35.09 ,$140.09 ,$66.67 ,$180.60 ,$129.00 ,$206.40 ,$87.73 ,$35.09 ,$180.60 ,$35.09 ,$154.80 ,$35.09 ,$193.50 ,$142.42 ,$128.48 ,$142.42 ,$35.09 ,$142.42 ,$50.69 ,$50.69 ,$219.30 ,$87.73 ,$178.79 ,$35.09 ,$258.00 ,$141.90 ,$35.09 ,$67.85 , N/A ,$18.71 ,$17.86 ,$36.84 ,$206.40 ,$140.09 ,$72.24 ,$232.20 ,$98.04 ,$70.18 ,$35.09 ,$123.84 
ST. MARY'S HOSPITAL - DECATUR,30600571,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,"$1,246.00 ",$809.90 ,$3.50 ,"$1,246.00 ","$1,041.95 ",$964.20 ,$685.30 ,$416.78 ,$348.88 ,$610.54 ,$416.78 ,$728.91 ,$416.78 ,$676.58 ,$3.50 ,$416.78 ,$676.58 ,$791.88 ,$872.20 ,$623.00 ,$996.80 ,"$1,041.95 ",$416.78 ,$872.20 ,$416.78 ,$747.60 ,$416.78 ,$934.50 ,$687.79 ,$620.51 ,$687.79 ,$416.78 ,$687.79 ,$602.02 ,$602.02 ,"$1,059.10 ","$1,041.95 ",$863.48 ,$416.78 ,"$1,246.00 ",$685.30 ,$416.78 ,$327.70 , N/A ,$18.71 ,$17.86 ,$437.62 ,$996.80 ,$676.58 ,$348.88 ,"$1,121.40 ",$473.48 ,$833.56 ,$416.78 ,$598.08 
ST. MARY'S HOSPITAL - DECATUR,30600572,87510,HC G VAGINALIS DNA SCREEN,306,1 ,$132.00 ,$85.80 ,$3.50 ,$132.00 ,$50.13 ,$46.86 ,$72.60 ,$20.05 ,$36.96 ,$64.68 ,$20.05 ,$77.22 ,$20.05 ,$71.68 ,$3.50 ,$20.05 ,$71.68 ,$38.10 ,$92.40 ,$66.00 ,$105.60 ,$50.13 ,$20.05 ,$92.40 ,$20.05 ,$79.20 ,$20.05 ,$99.00 ,$72.86 ,$65.74 ,$72.86 ,$20.05 ,$72.86 ,$28.96 ,$28.96 ,$112.20 ,$50.13 ,$91.48 ,$20.05 ,$132.00 ,$72.60 ,$20.05 ,$34.72 , N/A ,$18.71 ,$17.86 ,$21.05 ,$105.60 ,$71.68 ,$36.96 ,$118.80 ,$50.16 ,$40.10 ,$20.05 ,$63.36 
ST. MARY'S HOSPITAL - DECATUR,30600573,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE,306,1 ,$282.00 ,$183.30 ,$3.50 ,$282.00 ,$87.73 ,$82.00 ,$155.10 ,$35.09 ,$78.96 ,$138.18 ,$35.09 ,$164.97 ,$35.09 ,$153.13 ,$3.50 ,$35.09 ,$153.13 ,$66.67 ,$197.40 ,$141.00 ,$225.60 ,$87.73 ,$35.09 ,$197.40 ,$35.09 ,$169.20 ,$35.09 ,$211.50 ,$155.66 ,$140.44 ,$155.66 ,$35.09 ,$155.66 ,$50.69 ,$50.69 ,$239.70 ,$87.73 ,$195.43 ,$35.09 ,$282.00 ,$155.10 ,$35.09 ,$74.17 , N/A ,$18.71 ,$17.86 ,$36.84 ,$225.60 ,$153.13 ,$78.96 ,$253.80 ,$107.16 ,$70.18 ,$35.09 ,$135.36 
ST. MARY'S HOSPITAL - DECATUR,30600577,87633,HC IF AG RESP VIRUS MAP 12-25 TARGETS,306,1 ,$68.00 ,$44.20 ,$3.50 ,$170.00 ,$170.00 ,$68.00 ,$37.40 ,$68.00 ,$19.04 ,$33.32 ,$68.00 ,$39.78 ,$68.00 ,$36.92 ,$3.50 ,$68.00 ,$36.92 ,$68.00 ,$47.60 ,$34.00 ,$54.40 ,$170.00 ,$68.00 ,$47.60 ,$68.00 ,$40.80 ,$68.00 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$68.00 ,$37.54 ,$68.00 ,$68.00 ,$57.80 ,$68.00 ,$47.12 ,$68.00 ,$68.00 ,$37.40 ,$68.00 ,$17.88 , N/A ,$18.71 ,$17.86 ,$71.40 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$68.00 ,$68.00 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30600580,87660,HC TRICHOMONAS DNA SCREEN,306,1 ,$132.00 ,$85.80 ,$3.50 ,$132.00 ,$50.13 ,$46.86 ,$72.60 ,$20.05 ,$36.96 ,$64.68 ,$20.05 ,$77.22 ,$20.05 ,$71.68 ,$3.50 ,$20.05 ,$71.68 ,$38.10 ,$92.40 ,$66.00 ,$105.60 ,$50.13 ,$20.05 ,$92.40 ,$20.05 ,$79.20 ,$20.05 ,$99.00 ,$72.86 ,$65.74 ,$72.86 ,$20.05 ,$72.86 ,$28.96 ,$28.96 ,$112.20 ,$50.13 ,$91.48 ,$20.05 ,$132.00 ,$72.60 ,$20.05 ,$34.72 , N/A ,$18.71 ,$17.86 ,$21.05 ,$105.60 ,$71.68 ,$36.96 ,$118.80 ,$50.16 ,$40.10 ,$20.05 ,$63.36 
ST. MARY'S HOSPITAL - DECATUR,30600581,87798,HC INFECT AMP,306,1 ,$68.00 ,$44.20 ,$3.50 ,$87.73 ,$87.73 ,$68.00 ,$37.40 ,$35.09 ,$19.04 ,$33.32 ,$35.09 ,$39.78 ,$35.09 ,$36.92 ,$3.50 ,$35.09 ,$36.92 ,$66.67 ,$47.60 ,$34.00 ,$54.40 ,$87.73 ,$35.09 ,$47.60 ,$35.09 ,$40.80 ,$35.09 ,$51.00 ,$37.54 ,$33.86 ,$37.54 ,$35.09 ,$37.54 ,$50.69 ,$50.69 ,$57.80 ,$68.00 ,$47.12 ,$35.09 ,$68.00 ,$37.40 ,$35.09 ,$17.88 , N/A ,$18.71 ,$17.86 ,$36.84 ,$54.40 ,$36.92 ,$19.04 ,$61.20 ,$25.84 ,$68.00 ,$35.09 ,$32.64 
ST. MARY'S HOSPITAL - DECATUR,30600582,87798,HC INFECT AMP DRUG RESIST TB,306,1 ,$350.00 ,$227.50 ,$3.50 ,$350.00 ,$87.73 ,$82.00 ,$192.50 ,$35.09 ,$98.00 ,$171.50 ,$35.09 ,$204.75 ,$35.09 ,$190.05 ,$3.50 ,$35.09 ,$190.05 ,$66.67 ,$245.00 ,$175.00 ,$280.00 ,$87.73 ,$35.09 ,$245.00 ,$35.09 ,$210.00 ,$35.09 ,$262.50 ,$193.20 ,$174.30 ,$193.20 ,$35.09 ,$193.20 ,$50.69 ,$50.69 ,$297.50 ,$87.73 ,$242.55 ,$35.09 ,$350.00 ,$192.50 ,$35.09 ,$92.05 , N/A ,$18.71 ,$17.86 ,$36.84 ,$280.00 ,$190.05 ,$98.00 ,$315.00 ,$133.00 ,$70.18 ,$35.09 ,$168.00 
ST. MARY'S HOSPITAL - DECATUR,30600585,87181,HC SENSITIVITY STUDY AGAR ACID FAST,306,1 ,$92.00 ,$59.80 ,$3.50 ,$92.00 ,$11.88 ,$11.10 ,$50.60 ,$4.75 ,$25.76 ,$45.08 ,$4.75 ,$50.72 ,$4.75 ,$49.96 ,$3.50 ,$4.75 ,$49.96 ,$9.03 ,$64.40 ,$46.00 ,$73.60 ,$11.88 ,$4.75 ,$64.40 ,$4.75 ,$55.20 ,$4.75 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$4.75 ,$50.78 ,$6.85 ,$6.85 ,$78.20 ,$11.88 ,$63.76 ,$4.75 ,$92.00 ,$50.60 ,$4.75 ,$24.20 , N/A ,$5.63 ,$5.38 ,$4.99 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$9.50 ,$4.75 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,30600586,87147,HC CULTURE TYPE SEROLOGIC-91,306,1 ,$58.00 ,$37.70 ,$3.50 ,$58.00 ,$12.95 ,$12.08 ,$31.90 ,$5.18 ,$16.24 ,$28.42 ,$5.18 ,$33.93 ,$5.18 ,$31.49 ,$3.50 ,$5.18 ,$31.49 ,$9.84 ,$40.60 ,$29.00 ,$46.40 ,$12.95 ,$5.18 ,$40.60 ,$5.18 ,$34.80 ,$5.18 ,$43.50 ,$32.02 ,$28.88 ,$32.02 ,$5.18 ,$32.02 ,$7.48 ,$7.48 ,$49.30 ,$12.95 ,$40.19 ,$5.18 ,$58.00 ,$31.90 ,$5.18 ,$15.25 , N/A ,$5.63 ,$5.38 ,$5.44 ,$46.40 ,$31.49 ,$16.24 ,$52.20 ,$22.04 ,$10.36 ,$5.18 ,$27.84 
ST. MARY'S HOSPITAL - DECATUR,30600592,87486,HC CHLAMYDIA PNEUM AMP PROBE-90,306,1 ,$257.00 ,$167.05 ,$3.50 ,$257.00 ,$87.73 ,$82.00 ,$141.35 ,$35.09 ,$71.96 ,$125.93 ,$35.09 ,$150.35 ,$35.09 ,$139.55 ,$3.50 ,$35.09 ,$139.55 ,$66.67 ,$179.90 ,$128.50 ,$205.60 ,$87.73 ,$35.09 ,$179.90 ,$35.09 ,$154.20 ,$35.09 ,$192.75 ,$141.86 ,$127.99 ,$141.86 ,$35.09 ,$141.86 ,$50.69 ,$50.69 ,$218.45 ,$87.73 ,$178.10 ,$35.09 ,$257.00 ,$141.35 ,$35.09 ,$67.59 , N/A ,$18.71 ,$17.86 ,$36.84 ,$205.60 ,$139.55 ,$71.96 ,$231.30 ,$97.66 ,$70.18 ,$35.09 ,$123.36 
ST. MARY'S HOSPITAL - DECATUR,30600598,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS-90,306,1 ,$701.00 ,$455.65 ,$3.50 ,"$1,041.95 ","$1,041.95 ",$701.00 ,$385.55 ,$416.78 ,$196.28 ,$343.49 ,$416.78 ,$410.09 ,$416.78 ,$380.64 ,$3.50 ,$416.78 ,$380.64 ,$701.00 ,$490.70 ,$350.50 ,$560.80 ,"$1,041.95 ",$416.78 ,$490.70 ,$416.78 ,$420.60 ,$416.78 ,$525.75 ,$386.95 ,$349.10 ,$386.95 ,$416.78 ,$386.95 ,$602.02 ,$602.02 ,$595.85 ,$701.00 ,$485.79 ,$416.78 ,$701.00 ,$385.55 ,$416.78 ,$184.36 , N/A ,$18.71 ,$17.86 ,$437.62 ,$560.80 ,$380.64 ,$196.28 ,$630.90 ,$266.38 ,$701.00 ,$416.78 ,$336.48 
ST. MARY'S HOSPITAL - DECATUR,30600601,87538,HC IF AGT NUC ACID HIV-2 AMPL PROBE TECH/REV TRANS-90,306,1 ,$782.00 ,$508.30 ,$3.50 ,$782.00 ,$87.73 ,$82.00 ,$430.10 ,$35.09 ,$218.96 ,$276.81 ,$35.09 ,$276.81 ,$35.09 ,$424.63 ,$3.50 ,$35.09 ,$424.63 ,$66.67 ,$547.40 ,$391.00 ,$625.60 ,$87.73 ,$35.09 ,$547.40 ,$35.09 ,$469.20 ,$35.09 ,$586.50 ,$431.66 ,$389.44 ,$431.66 ,$35.09 ,$431.66 ,$50.69 ,$50.69 ,$664.70 ,$87.73 ,$541.93 ,$35.09 ,$782.00 ,$430.10 ,$35.09 ,$205.67 , N/A ,$18.71 ,$17.86 ,$36.84 ,$625.60 ,$424.63 ,$218.96 ,$703.80 ,$297.16 ,$70.18 ,$35.09 ,$375.36 
ST. MARY'S HOSPITAL - DECATUR,30600606,87581,HC IF AG PROBE MYCOPLASMA PNEUMONIAE-90,306,1 ,$282.00 ,$183.30 ,$3.50 ,$282.00 ,$87.73 ,$82.00 ,$155.10 ,$35.09 ,$78.96 ,$138.18 ,$35.09 ,$164.97 ,$35.09 ,$153.13 ,$3.50 ,$35.09 ,$153.13 ,$66.67 ,$197.40 ,$141.00 ,$225.60 ,$87.73 ,$35.09 ,$197.40 ,$35.09 ,$169.20 ,$35.09 ,$211.50 ,$155.66 ,$140.44 ,$155.66 ,$35.09 ,$155.66 ,$50.69 ,$50.69 ,$239.70 ,$87.73 ,$195.43 ,$35.09 ,$282.00 ,$155.10 ,$35.09 ,$74.17 , N/A ,$18.71 ,$17.86 ,$36.84 ,$225.60 ,$153.13 ,$78.96 ,$253.80 ,$107.16 ,$70.18 ,$35.09 ,$135.36 
ST. MARY'S HOSPITAL - DECATUR,30600607,87661,HC TRICHOMONAS BAG AMP PROBE,306,1 ,$224.00 ,$145.60 ,$3.50 ,$224.00 ,$87.73 ,$81.38 ,$123.20 ,$35.09 ,$62.72 ,$109.76 ,$35.09 ,$131.04 ,$35.09 ,$121.63 ,$3.50 ,$35.09 ,$121.63 ,$66.67 ,$156.80 ,$112.00 ,$179.20 ,$87.73 ,$35.09 ,$156.80 ,$35.09 ,$134.40 ,$35.09 ,$168.00 ,$123.65 ,$111.55 ,$123.65 ,$35.09 ,$123.65 ,$50.69 ,$50.69 ,$190.40 ,$87.73 ,$155.23 ,$35.09 ,$224.00 ,$123.20 ,$35.09 ,$58.91 , N/A ,$18.71 ,$17.86 ,$36.84 ,$179.20 ,$121.63 ,$62.72 ,$201.60 ,$85.12 ,$70.18 ,$35.09 ,$107.52 
ST. MARY'S HOSPITAL - DECATUR,30600608,87045,HC STOOL CULTURE -90,306,1 ,$218.00 ,$141.70 ,$3.50 ,$218.00 ,$23.60 ,$22.04 ,$119.90 ,$9.44 ,$61.04 ,$74.51 ,$9.44 ,$74.51 ,$9.44 ,$118.37 ,$3.50 ,$9.44 ,$118.37 ,$17.94 ,$152.60 ,$109.00 ,$174.40 ,$23.60 ,$9.44 ,$152.60 ,$9.44 ,$130.80 ,$9.44 ,$163.50 ,$120.34 ,$108.56 ,$120.34 ,$9.44 ,$120.34 ,$13.64 ,$13.64 ,$185.30 ,$23.60 ,$151.07 ,$9.44 ,$218.00 ,$119.90 ,$9.44 ,$57.33 , N/A ,$5.63 ,$5.38 ,$9.91 ,$174.40 ,$118.37 ,$61.04 ,$196.20 ,$82.84 ,$18.88 ,$9.44 ,$104.64 
ST. MARY'S HOSPITAL - DECATUR,30600617,87801,HC INFECT MLT ORG AMP VAGINITIS,306,1 ,$532.00 ,$345.80 ,$3.50 ,$532.00 ,$175.50 ,$164.04 ,$292.60 ,$70.20 ,$148.96 ,$260.68 ,$70.20 ,$311.22 ,$70.20 ,$288.88 ,$3.50 ,$70.20 ,$288.88 ,$133.38 ,$372.40 ,$266.00 ,$425.60 ,$175.50 ,$70.20 ,$372.40 ,$70.20 ,$319.20 ,$70.20 ,$399.00 ,$293.66 ,$264.94 ,$293.66 ,$70.20 ,$293.66 ,$101.39 ,$101.39 ,$452.20 ,$175.50 ,$368.68 ,$70.20 ,$532.00 ,$292.60 ,$70.20 ,$139.92 , N/A ,$5.63 ,$5.38 ,$73.71 ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$140.40 ,$70.20 ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,30600618,87481,HC CANDIDA SPECIES DNA/RNA AMP PROBE TECH,306,1 ,$212.00 ,$137.80 ,$3.50 ,$212.00 ,$87.73 ,$82.00 ,$116.60 ,$35.09 ,$59.36 ,$103.88 ,$35.09 ,$124.02 ,$35.09 ,$115.12 ,$3.50 ,$35.09 ,$115.12 ,$66.67 ,$148.40 ,$106.00 ,$169.60 ,$87.73 ,$35.09 ,$148.40 ,$35.09 ,$127.20 ,$35.09 ,$159.00 ,$117.02 ,$105.58 ,$117.02 ,$35.09 ,$117.02 ,$50.69 ,$50.69 ,$180.20 ,$87.73 ,$146.92 ,$35.09 ,$212.00 ,$116.60 ,$35.09 ,$55.76 , N/A ,$7.06 ,$6.74 ,$36.84 ,$169.60 ,$115.12 ,$59.36 ,$190.80 ,$80.56 ,$70.18 ,$35.09 ,$101.76 
ST. MARY'S HOSPITAL - DECATUR,30600621,87551,HC MYCOBACTERIA DAN AMP PROBE-90,306,1 ,$350.00 ,$227.50 ,$3.50 ,$350.00 ,$120.60 ,$82.00 ,$192.50 ,$48.24 ,$98.00 ,$171.50 ,$48.24 ,$204.75 ,$48.24 ,$190.05 ,$3.50 ,$48.24 ,$190.05 ,$91.66 ,$245.00 ,$175.00 ,$280.00 ,$120.60 ,$48.24 ,$245.00 ,$48.24 ,$210.00 ,$48.24 ,$262.50 ,$193.20 ,$174.30 ,$193.20 ,$48.24 ,$193.20 ,$62.71 ,$62.71 ,$297.50 ,$120.60 ,$242.55 ,$48.24 ,$350.00 ,$192.50 ,$48.24 ,$92.05 , N/A ,$18.71 ,$17.86 ,$50.65 ,$280.00 ,$190.05 ,$98.00 ,$315.00 ,$133.00 ,$96.48 ,$48.24 ,$168.00 
ST. MARY'S HOSPITAL - DECATUR,30600623,87635,HC COVID-19 LAB TEST CDC-90,306,1 ,$438.00 ,$284.70 ,$17.86 ,$438.00 ,$128.28 ,$102.62 ,$240.90 ,$51.31 ,$122.64 ,$205.86 ,$51.31 ,$236.52 ,$51.31 ,$237.83 ,$175.20 ,$51.31 ,$237.83 ,$97.49 ,$306.60 ,$219.00 ,$350.40 ,$128.28 ,$51.31 ,$306.60 ,$51.31 ,$262.80 ,$51.31 ,$328.50 ,$241.78 ,$218.12 ,$241.78 ,$51.31 ,$241.78 ,$306.60 ,$306.60 ,$372.30 ,$128.28 ,$303.53 ,$51.31 ,$51.31 ,$240.90 ,$51.31 ,$115.19 , N/A ,$18.71 ,$17.86 ,$53.88 ,$350.40 ,$237.83 ,$122.64 ,$394.20 ,$166.44 ,$102.62 ,$51.31 ,$210.24 
ST. MARY'S HOSPITAL - DECATUR,30600626,87220,HC SCABIES- 90,306,1 ,$81.00 ,$52.65 ,$3.50 ,$81.00 ,$10.68 ,$9.98 ,$44.55 ,$4.27 ,$22.68 ,$39.69 ,$4.27 ,$45.61 ,$4.27 ,$43.98 ,$3.50 ,$4.27 ,$43.98 ,$8.11 ,$56.70 ,$40.50 ,$64.80 ,$10.68 ,$4.27 ,$56.70 ,$4.27 ,$48.60 ,$4.27 ,$60.75 ,$44.71 ,$40.34 ,$44.71 ,$4.27 ,$44.71 ,$6.18 ,$6.18 ,$68.85 ,$10.68 ,$56.13 ,$4.27 ,$81.00 ,$44.55 ,$4.27 ,$21.30 , N/A ,$5.63 ,$5.38 ,$4.48 ,$64.80 ,$43.98 ,$22.68 ,$72.90 ,$30.78 ,$8.54 ,$4.27 ,$38.88 
ST. MARY'S HOSPITAL - DECATUR,30600636,87811,HC COVID ANTIGEN TEST,306,1 ,$125.00 ,$81.25 ,$5.38 ,$125.00 ,$103.45 ,$82.76 ,$68.75 ,$41.38 ,$35.00 ,$58.75 ,$41.38 ,$67.50 ,$41.38 ,$67.88 ,$50.00 ,$41.38 ,$67.88 ,$78.62 ,$87.50 ,$62.50 ,$100.00 ,$103.45 ,$41.38 ,$87.50 ,$41.38 ,$75.00 ,$41.38 ,$93.75 ,$69.00 ,$62.25 ,$69.00 ,$41.38 ,$69.00 ,$87.50 ,$87.50 ,$106.25 ,$103.45 ,$86.63 ,$41.38 ,$125.00 ,$68.75 ,$41.38 ,$32.88 , N/A ,$5.63 ,$5.38 ,$43.45 ,$100.00 ,$67.88 ,$35.00 ,$112.50 ,$47.50 ,$83.04 ,$41.38 ,$60.00 
ST. MARY'S HOSPITAL - DECATUR,30600637,87635,HC COVID-19 LAB PCR TEST,306,1 ,$438.00 ,$284.70 ,$17.86 ,$438.00 ,$128.28 ,$102.62 ,$240.90 ,$51.31 ,$122.64 ,$205.86 ,$51.31 ,$236.52 ,$51.31 ,$237.83 ,$175.20 ,$51.31 ,$237.83 ,$97.49 ,$306.60 ,$219.00 ,$350.40 ,$128.28 ,$51.31 ,$306.60 ,$51.31 ,$262.80 ,$51.31 ,$328.50 ,$241.78 ,$218.12 ,$241.78 ,$51.31 ,$241.78 ,$306.60 ,$306.60 ,$372.30 ,$128.28 ,$303.53 ,$51.31 ,$51.31 ,$240.90 ,$51.31 ,$115.19 , N/A ,$18.71 ,$17.86 ,$53.88 ,$350.40 ,$237.83 ,$122.64 ,$394.20 ,$166.44 ,$102.62 ,$51.31 ,$210.24 
ST. MARY'S HOSPITAL - DECATUR,30600638,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION - 90,306,1 ,$82.00 ,$53.30 ,$17.86 ,$128.28 ,$128.28 ,$82.00 ,$45.10 ,$51.31 ,$22.96 ,$38.54 ,$51.31 ,$44.28 ,$51.31 ,$44.53 ,$32.80 ,$51.31 ,$44.53 ,$82.00 ,$57.40 ,$41.00 ,$65.60 ,$128.28 ,$51.31 ,$57.40 ,$51.31 ,$49.20 ,$51.31 ,$61.50 ,$45.26 ,$40.84 ,$45.26 ,$51.31 ,$45.26 ,$57.40 ,$57.40 ,$69.70 ,$82.00 ,$56.83 ,$51.31 ,$51.31 ,$45.10 ,$51.31 ,$21.57 , N/A ,$18.71 ,$17.86 ,$53.88 ,$65.60 ,$44.53 ,$22.96 ,$73.80 ,$31.16 ,$82.00 ,$51.31 ,$39.36 
ST. MARY'S HOSPITAL - DECATUR,30600640,0097U,HC GI PATHOGENS 22 TARGETS- 90,306,1 ,"$1,169.00 ",$759.85 ,$17.86 ,"$1,169.00 ",$907.60 ,$509.40 ,$642.95 ,$363.04 ,$327.32 ,$549.43 ,$363.04 ,$631.26 ,$363.04 ,$634.77 ,$467.60 ,$363.04 ,$634.77 ,$689.78 ,$818.30 ,$584.50 ,$935.20 ,$907.60 ,$363.04 ,$818.30 ,$363.04 ,$701.40 ,$363.04 ,$876.75 ,$645.29 ,$582.16 ,$645.29 ,$363.04 ,$645.29 ,$818.30 ,$818.30 ,$993.65 ,$907.60 ,$810.12 ,$363.04 ,"$1,169.00 ",$642.95 ,$363.04 ,$307.45 , N/A ,$18.71 ,$17.86 ,$381.19 ,$935.20 ,$634.77 ,$327.32 ,"$1,052.10 ",$444.22 ,$726.08 ,$363.04 ,$561.12 
ST. MARY'S HOSPITAL - DECATUR,30600641,81513,HC APTIMA BV MAAA SPEC CODE,306,1 ,$243.00 ,$157.95 ,$26.70 ,$356.58 ,$356.58 ,$242.48 ,$133.65 ,$142.63 ,$68.04 ,$114.21 ,$142.63 ,$131.22 ,$142.63 ,$131.95 ,$97.20 ,$142.63 ,$131.95 ,$243.00 ,$170.10 ,$121.50 ,$194.40 ,$356.58 ,$142.63 ,$170.10 ,$142.63 ,$145.80 ,$142.63 ,$182.25 ,$134.14 ,$121.01 ,$134.14 ,$142.63 ,$134.14 ,$170.10 ,$170.10 ,$206.55 ,$243.00 ,$168.40 ,$142.63 ,$243.00 ,$133.65 ,$142.63 ,$63.91 , N/A ,$27.97 ,$26.70 ,$149.76 ,$194.40 ,$131.95 ,$68.04 ,$218.70 ,$92.34 ,$243.00 ,$142.63 ,$116.64 
ST. MARY'S HOSPITAL - DECATUR,30600643,87425,HC EIA QL ROTAVIRUS AG- 90,306,1 ,$238.00 ,$154.70 ,$3.50 ,$238.00 ,$29.95 ,$28.04 ,$130.90 ,$11.98 ,$66.64 ,$94.56 ,$11.98 ,$94.56 ,$11.98 ,$129.23 ,$3.50 ,$11.98 ,$129.23 ,$22.76 ,$166.60 ,$119.00 ,$190.40 ,$29.95 ,$11.98 ,$166.60 ,$11.98 ,$142.80 ,$11.98 ,$178.50 ,$131.38 ,$118.52 ,$131.38 ,$11.98 ,$131.38 ,$17.32 ,$17.32 ,$202.30 ,$29.95 ,$164.93 ,$11.98 ,$238.00 ,$130.90 ,$11.98 ,$62.59 , N/A ,$7.06 ,$6.74 ,$12.58 ,$190.40 ,$129.23 ,$66.64 ,$214.20 ,$90.44 ,$23.96 ,$11.98 ,$114.24 
ST. MARY'S HOSPITAL - DECATUR,30650284,87425,HC IAAD IA ROTAUIRUS,306,1 ,$191.00 ,$124.15 ,$3.50 ,$191.00 ,$29.95 ,$28.04 ,$105.05 ,$11.98 ,$53.48 ,$93.59 ,$11.98 ,$94.56 ,$11.98 ,$103.71 ,$3.50 ,$11.98 ,$103.71 ,$22.76 ,$133.70 ,$95.50 ,$152.80 ,$29.95 ,$11.98 ,$133.70 ,$11.98 ,$114.60 ,$11.98 ,$143.25 ,$105.43 ,$95.12 ,$105.43 ,$11.98 ,$105.43 ,$17.32 ,$17.32 ,$162.35 ,$29.95 ,$132.36 ,$11.98 ,$191.00 ,$105.05 ,$11.98 ,$50.23 , N/A ,$7.06 ,$6.74 ,$12.58 ,$152.80 ,$103.71 ,$53.48 ,$171.90 ,$72.58 ,$23.96 ,$11.98 ,$91.68 
ST. MARY'S HOSPITAL - DECATUR,30682003,87910,HC INFECTIUS AGENT GENOTYPE ANALYSIS-90,306,1 ,"$1,166.00 ",$757.90 ,$3.50 ,"$1,166.00 ",$643.63 ,$601.60 ,$641.30 ,$257.45 ,$326.48 ,$571.34 ,$257.45 ,$682.11 ,$257.45 ,$633.14 ,$3.50 ,$257.45 ,$633.14 ,$489.16 ,$816.20 ,$583.00 ,$932.80 ,$643.63 ,$257.45 ,$816.20 ,$257.45 ,$699.60 ,$257.45 ,$874.50 ,$643.63 ,$580.67 ,$643.63 ,$257.45 ,$643.63 ,$371.87 ,$371.87 ,$991.10 ,$643.63 ,$808.04 ,$257.45 ,"$1,166.00 ",$641.30 ,$257.45 ,$306.66 , N/A ,$12.17 ,$11.61 ,$270.32 ,$932.80 ,$633.14 ,$326.48 ,"$1,049.40 ",$443.08 ,$514.90 ,$257.45 ,$559.68 
ST. MARY'S HOSPITAL - DECATUR,30682007,87651,HC INFECT AMP (GRP A STREP),306,1 ,$20.00 ,$13.00 ,$3.50 ,$50.00 ,$50.00 ,$20.00 ,$11.00 ,$20.00 ,$5.60 ,$9.80 ,$20.00 ,$11.70 ,$20.00 ,$10.86 ,$3.50 ,$20.00 ,$10.86 ,$20.00 ,$14.00 ,$10.00 ,$16.00 ,$50.00 ,$20.00 ,$14.00 ,$20.00 ,$12.00 ,$20.00 ,$15.00 ,$11.04 ,$9.96 ,$11.04 ,$20.00 ,$11.04 ,$20.00 ,$20.00 ,$17.00 ,$20.00 ,$13.86 ,$20.00 ,$20.00 ,$11.00 ,$20.00 ,$5.26 , N/A ,$18.71 ,$17.86 ,$21.00 ,$16.00 ,$10.86 ,$5.60 ,$18.00 ,$7.60 ,$20.00 ,$20.00 ,$9.60 
ST. MARY'S HOSPITAL - DECATUR,30682010,87635,HC COVID-19 LAB TEST NON-CDC-90,306,1 ,$438.00 ,$284.70 ,$17.86 ,$438.00 ,$128.28 ,$102.62 ,$240.90 ,$51.31 ,$122.64 ,$205.86 ,$51.31 ,$236.52 ,$51.31 ,$237.83 ,$175.20 ,$51.31 ,$237.83 ,$97.49 ,$306.60 ,$219.00 ,$350.40 ,$128.28 ,$51.31 ,$306.60 ,$51.31 ,$262.80 ,$51.31 ,$328.50 ,$241.78 ,$218.12 ,$241.78 ,$51.31 ,$241.78 ,$306.60 ,$306.60 ,$372.30 ,$128.28 ,$303.53 ,$51.31 ,$51.31 ,$240.90 ,$51.31 ,$115.19 , N/A ,$18.71 ,$17.86 ,$53.88 ,$350.40 ,$237.83 ,$122.64 ,$394.20 ,$166.44 ,$102.62 ,$51.31 ,$210.24 
ST. MARY'S HOSPITAL - DECATUR,30682012,87635,HC COVID-19 LAB TEST,306,1 ,$438.00 ,$284.70 ,$17.86 ,$438.00 ,$128.28 ,$102.62 ,$240.90 ,$51.31 ,$122.64 ,$205.86 ,$51.31 ,$236.52 ,$51.31 ,$237.83 ,$175.20 ,$51.31 ,$237.83 ,$97.49 ,$306.60 ,$219.00 ,$350.40 ,$128.28 ,$51.31 ,$306.60 ,$51.31 ,$262.80 ,$51.31 ,$328.50 ,$241.78 ,$218.12 ,$241.78 ,$51.31 ,$241.78 ,$306.60 ,$306.60 ,$372.30 ,$128.28 ,$303.53 ,$51.31 ,$51.31 ,$240.90 ,$51.31 ,$115.19 , N/A ,$18.71 ,$17.86 ,$53.88 ,$350.40 ,$237.83 ,$122.64 ,$394.20 ,$166.44 ,$102.62 ,$51.31 ,$210.24 
ST. MARY'S HOSPITAL - DECATUR,30682013,87635,HC COVID-19 LAB TEST,306,1 ,$398.00 ,$258.70 ,$17.86 ,$398.00 ,$128.28 ,$102.62 ,$218.90 ,$51.31 ,$111.44 ,$187.06 ,$51.31 ,$214.92 ,$51.31 ,$216.11 ,$159.20 ,$51.31 ,$216.11 ,$97.49 ,$278.60 ,$199.00 ,$318.40 ,$128.28 ,$51.31 ,$278.60 ,$51.31 ,$238.80 ,$51.31 ,$298.50 ,$219.70 ,$198.20 ,$219.70 ,$51.31 ,$219.70 ,$278.60 ,$278.60 ,$338.30 ,$128.28 ,$275.81 ,$51.31 ,$51.31 ,$218.90 ,$51.31 ,$104.67 , N/A ,$18.71 ,$17.86 ,$53.88 ,$318.40 ,$216.11 ,$111.44 ,$358.20 ,$151.24 ,$102.62 ,$51.31 ,$191.04 
ST. MARY'S HOSPITAL - DECATUR,30682015,86769,HC SARS-COV-2 COVID-19 ANTIBODY-90,306,1 ,$130.00 ,$84.50 ,$6.74 ,$130.00 ,$105.33 ,$84.26 ,$71.50 ,$42.13 ,$36.40 ,$61.10 ,$42.13 ,$70.20 ,$42.13 ,$70.59 ,$52.00 ,$42.13 ,$70.59 ,$80.05 ,$91.00 ,$65.00 ,$104.00 ,$105.33 ,$42.13 ,$91.00 ,$42.13 ,$78.00 ,$42.13 ,$97.50 ,$71.76 ,$64.74 ,$71.76 ,$42.13 ,$71.76 ,$91.00 ,$91.00 ,$110.50 ,$105.33 ,$90.09 ,$42.13 ,$130.00 ,$71.50 ,$42.13 ,$34.19 , N/A ,$7.06 ,$6.74 ,$44.24 ,$104.00 ,$70.59 ,$36.40 ,$117.00 ,$49.40 ,$84.26 ,$42.13 ,$62.40 
ST. MARY'S HOSPITAL - DECATUR,30682022,87102,HC CULTURE FUNGUS OTHER-90,306,1 ,$228.00 ,$148.20 ,$3.50 ,$228.00 ,$21.03 ,$19.64 ,$125.40 ,$8.41 ,$63.84 ,$66.35 ,$8.41 ,$66.35 ,$8.41 ,$123.80 ,$3.50 ,$8.41 ,$123.80 ,$15.98 ,$159.60 ,$114.00 ,$182.40 ,$21.03 ,$8.41 ,$159.60 ,$8.41 ,$136.80 ,$8.41 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$8.41 ,$125.86 ,$12.14 ,$12.14 ,$193.80 ,$21.03 ,$158.00 ,$8.41 ,$228.00 ,$125.40 ,$8.41 ,$59.96 , N/A ,$5.63 ,$5.38 ,$8.83 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$16.82 ,$8.41 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,30682023,87426,HC SARS COVID ANTIGEN TEST,306,1 ,$82.00 ,$53.30 ,$5.38 ,$88.33 ,$88.33 ,$82.00 ,$45.10 ,$35.33 ,$22.96 ,$38.54 ,$35.33 ,$44.28 ,$35.33 ,$44.53 ,$32.80 ,$35.33 ,$44.53 ,$67.13 ,$57.40 ,$41.00 ,$65.60 ,$88.33 ,$35.33 ,$57.40 ,$35.33 ,$49.20 ,$35.33 ,$61.50 ,$45.26 ,$40.84 ,$45.26 ,$35.33 ,$45.26 ,$57.40 ,$57.40 ,$69.70 ,$82.00 ,$56.83 ,$35.33 ,$37.79 ,$45.10 ,$35.33 ,$21.57 , N/A ,$5.63 ,$5.38 ,$37.10 ,$65.60 ,$44.53 ,$22.96 ,$73.80 ,$31.16 ,$82.00 ,$35.33 ,$39.36 
ST. MARY'S HOSPITAL - DECATUR,30682024,87635,HC SARS-COV-2 COVID-19 TEST,306,1 ,$82.00 ,$53.30 ,$17.86 ,$128.28 ,$128.28 ,$82.00 ,$45.10 ,$51.31 ,$22.96 ,$38.54 ,$51.31 ,$44.28 ,$51.31 ,$44.53 ,$32.80 ,$51.31 ,$44.53 ,$82.00 ,$57.40 ,$41.00 ,$65.60 ,$128.28 ,$51.31 ,$57.40 ,$51.31 ,$49.20 ,$51.31 ,$61.50 ,$45.26 ,$40.84 ,$45.26 ,$51.31 ,$45.26 ,$57.40 ,$57.40 ,$69.70 ,$82.00 ,$56.83 ,$51.31 ,$51.31 ,$45.10 ,$51.31 ,$21.57 , N/A ,$18.71 ,$17.86 ,$53.88 ,$65.60 ,$44.53 ,$22.96 ,$73.80 ,$31.16 ,$82.00 ,$51.31 ,$39.36 
ST. MARY'S HOSPITAL - DECATUR,30682025,87635,HC COVID-19 LAB TEST - 2 DAY COMPLETION,306,1 ,$82.00 ,$53.30 ,$17.86 ,$128.28 ,$128.28 ,$82.00 ,$45.10 ,$51.31 ,$22.96 ,$38.54 ,$51.31 ,$44.28 ,$51.31 ,$44.53 ,$32.80 ,$51.31 ,$44.53 ,$82.00 ,$57.40 ,$41.00 ,$65.60 ,$128.28 ,$51.31 ,$57.40 ,$51.31 ,$49.20 ,$51.31 ,$61.50 ,$45.26 ,$40.84 ,$45.26 ,$51.31 ,$45.26 ,$57.40 ,$57.40 ,$69.70 ,$82.00 ,$56.83 ,$51.31 ,$51.31 ,$45.10 ,$51.31 ,$21.57 , N/A ,$18.71 ,$17.86 ,$53.88 ,$65.60 ,$44.53 ,$22.96 ,$73.80 ,$31.16 ,$82.00 ,$51.31 ,$39.36 
ST. MARY'S HOSPITAL - DECATUR,30682026,87563,HC MYCROPLASMA GENITALIUM AMP PROBE- 90,306,1 ,$244.00 ,$158.60 ,$3.50 ,$244.00 ,$87.73 ,$59.66 ,$134.20 ,$35.09 ,$68.32 ,$114.68 ,$35.09 ,$131.76 ,$35.09 ,$132.49 ,$3.50 ,$35.09 ,$132.49 ,$66.67 ,$170.80 ,$122.00 ,$195.20 ,$87.73 ,$35.09 ,$170.80 ,$35.09 ,$146.40 ,$35.09 ,$183.00 ,$134.69 ,$121.51 ,$134.69 ,$35.09 ,$134.69 ,$45.62 ,$45.62 ,$207.40 ,$87.73 ,$169.09 ,$35.09 ,$244.00 ,$134.20 ,$35.09 ,$64.17 , N/A ,$18.71 ,$17.86 ,$36.84 ,$195.20 ,$132.49 ,$68.32 ,$219.60 ,$92.72 ,$70.18 ,$35.09 ,$117.12 
ST. MARY'S HOSPITAL - DECATUR,30700101,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$142.00 ,$92.30 ,$2.69 ,$142.00 ,$7.93 ,$7.40 ,$78.10 ,$3.17 ,$39.76 ,$33.91 ,$3.17 ,$33.91 ,$3.17 ,$77.11 ,$3.50 ,$3.17 ,$77.11 ,$6.02 ,$99.40 ,$71.00 ,$113.60 ,$7.93 ,$3.17 ,$99.40 ,$3.17 ,$85.20 ,$3.17 ,$106.50 ,$78.38 ,$70.72 ,$78.38 ,$3.17 ,$78.38 ,$4.58 ,$4.58 ,$120.70 ,$7.93 ,$98.41 ,$3.17 ,$3.17 ,$78.10 ,$3.17 ,$37.35 , N/A ,$2.82 ,$2.69 ,$3.33 ,$113.60 ,$77.11 ,$39.76 ,$127.80 ,$53.96 ,$6.34 ,$3.17 ,$68.16 
ST. MARY'S HOSPITAL - DECATUR,30700104,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$87.00 ,$56.55 ,$1.69 ,$87.00 ,$5.63 ,$5.26 ,$47.85 ,$2.25 ,$24.36 ,$23.99 ,$2.25 ,$23.99 ,$2.25 ,$47.24 ,$3.50 ,$2.25 ,$47.24 ,$4.28 ,$60.90 ,$43.50 ,$69.60 ,$5.63 ,$2.25 ,$60.90 ,$2.25 ,$52.20 ,$2.25 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$2.25 ,$48.02 ,$3.24 ,$3.24 ,$73.95 ,$5.63 ,$60.29 ,$2.25 ,$87.00 ,$47.85 ,$2.25 ,$22.88 , N/A ,$1.77 ,$1.69 ,$2.36 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$4.50 ,$2.25 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30700115,81015,HC URINALYSIS MICRO ONLY,307,1 ,$96.00 ,$62.40 ,$2.69 ,$96.00 ,$7.63 ,$7.10 ,$52.80 ,$3.05 ,$26.88 ,$32.54 ,$3.05 ,$32.54 ,$3.05 ,$52.13 ,$3.50 ,$3.05 ,$52.13 ,$5.80 ,$67.20 ,$48.00 ,$76.80 ,$7.63 ,$3.05 ,$67.20 ,$3.05 ,$57.60 ,$3.05 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$3.05 ,$52.99 ,$4.41 ,$4.41 ,$81.60 ,$7.63 ,$66.53 ,$3.05 ,$96.00 ,$52.80 ,$3.05 ,$25.25 , N/A ,$2.82 ,$2.69 ,$3.20 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$6.10 ,$3.05 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,30700116,81025,HC URINE PREGNANCY TEST,307,1 ,$192.00 ,$124.80 ,$2.69 ,$192.00 ,$21.53 ,$14.80 ,$105.60 ,$8.61 ,$53.76 ,$74.51 ,$8.61 ,$74.51 ,$8.61 ,$104.26 ,$3.50 ,$8.61 ,$104.26 ,$16.36 ,$134.40 ,$96.00 ,$153.60 ,$21.53 ,$8.61 ,$134.40 ,$8.61 ,$115.20 ,$8.61 ,$144.00 ,$105.98 ,$95.62 ,$105.98 ,$8.61 ,$105.98 ,$11.19 ,$11.19 ,$163.20 ,$21.53 ,$133.06 ,$8.61 ,$8.61 ,$105.60 ,$8.61 ,$50.50 , N/A ,$2.82 ,$2.69 ,$9.04 ,$153.60 ,$104.26 ,$53.76 ,$172.80 ,$72.96 ,$17.22 ,$8.61 ,$92.16 
ST. MARY'S HOSPITAL - DECATUR,30700122,81002,HC URINALYSIS NON AUTO W/O MICRO -90,307,1 ,$49.00 ,$31.85 ,$1.69 ,$49.00 ,$8.70 ,$5.98 ,$26.95 ,$3.48 ,$13.72 ,$24.01 ,$3.48 ,$28.67 ,$3.48 ,$26.61 ,$3.50 ,$3.48 ,$26.61 ,$6.61 ,$34.30 ,$24.50 ,$39.20 ,$8.70 ,$3.48 ,$34.30 ,$3.48 ,$29.40 ,$3.48 ,$36.75 ,$27.05 ,$24.40 ,$27.05 ,$3.48 ,$27.05 ,$4.52 ,$4.52 ,$41.65 ,$8.70 ,$33.96 ,$3.48 ,$49.00 ,$26.95 ,$3.48 ,$12.89 , N/A ,$1.77 ,$1.69 ,$3.65 ,$39.20 ,$26.61 ,$13.72 ,$44.10 ,$18.62 ,$6.96 ,$3.48 ,$23.52 
ST. MARY'S HOSPITAL - DECATUR,30700124,81003,HC URINALYSIS AUTO W/O MICRO -90,307,1 ,$87.00 ,$56.55 ,$1.69 ,$87.00 ,$5.63 ,$5.26 ,$47.85 ,$2.25 ,$24.36 ,$23.99 ,$2.25 ,$23.99 ,$2.25 ,$47.24 ,$3.50 ,$2.25 ,$47.24 ,$4.28 ,$60.90 ,$43.50 ,$69.60 ,$5.63 ,$2.25 ,$60.90 ,$2.25 ,$52.20 ,$2.25 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$2.25 ,$48.02 ,$3.24 ,$3.24 ,$73.95 ,$5.63 ,$60.29 ,$2.25 ,$87.00 ,$47.85 ,$2.25 ,$22.88 , N/A ,$1.77 ,$1.69 ,$2.36 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$4.50 ,$2.25 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,30700127,81005,HC URINALYSIS QL/SEMI QN -90,307,1 ,$76.00 ,$49.40 ,$2.17 ,$76.00 ,$5.43 ,$5.06 ,$41.80 ,$2.17 ,$21.28 ,$23.10 ,$2.17 ,$23.10 ,$2.17 ,$41.27 ,$3.50 ,$2.17 ,$41.27 ,$4.12 ,$53.20 ,$38.00 ,$60.80 ,$5.43 ,$2.17 ,$53.20 ,$2.17 ,$45.60 ,$2.17 ,$57.00 ,$41.95 ,$37.85 ,$41.95 ,$2.17 ,$41.95 ,$3.13 ,$3.13 ,$64.60 ,$5.43 ,$52.67 ,$2.17 ,$76.00 ,$41.80 ,$2.17 ,$19.99 , N/A ,$2.82 ,$2.69 ,$2.28 ,$60.80 ,$41.27 ,$21.28 ,$68.40 ,$28.88 ,$4.34 ,$2.17 ,$36.48 
ST. MARY'S HOSPITAL - DECATUR,30700129,81025,HC URINE PREGNANCY TEST,307,1 ,$192.00 ,$124.80 ,$2.69 ,$192.00 ,$21.53 ,$14.80 ,$105.60 ,$8.61 ,$53.76 ,$74.51 ,$8.61 ,$74.51 ,$8.61 ,$104.26 ,$3.50 ,$8.61 ,$104.26 ,$16.36 ,$134.40 ,$96.00 ,$153.60 ,$21.53 ,$8.61 ,$134.40 ,$8.61 ,$115.20 ,$8.61 ,$144.00 ,$105.98 ,$95.62 ,$105.98 ,$8.61 ,$105.98 ,$11.19 ,$11.19 ,$163.20 ,$21.53 ,$133.06 ,$8.61 ,$8.61 ,$105.60 ,$8.61 ,$50.50 , N/A ,$2.82 ,$2.69 ,$9.04 ,$153.60 ,$104.26 ,$53.76 ,$172.80 ,$72.96 ,$17.22 ,$8.61 ,$92.16 
ST. MARY'S HOSPITAL - DECATUR,30700131,81050,HC VOLUME MEASUREMENT URINE,307,1 ,$91.00 ,$59.15 ,$2.69 ,$91.00 ,$9.10 ,$7.00 ,$50.05 ,$3.64 ,$25.48 ,$23.69 ,$3.64 ,$23.69 ,$3.64 ,$49.41 ,$3.50 ,$3.64 ,$49.41 ,$6.92 ,$63.70 ,$45.50 ,$72.80 ,$9.10 ,$3.64 ,$63.70 ,$3.64 ,$54.60 ,$3.64 ,$68.25 ,$50.23 ,$45.32 ,$50.23 ,$3.64 ,$50.23 ,$4.73 ,$4.73 ,$77.35 ,$9.10 ,$63.06 ,$3.64 ,$91.00 ,$50.05 ,$3.64 ,$23.93 , N/A ,$2.82 ,$2.69 ,$3.82 ,$72.80 ,$49.41 ,$25.48 ,$81.90 ,$34.58 ,$7.28 ,$3.64 ,$43.68 
ST. MARY'S HOSPITAL - DECATUR,30700132,81002,HC URANALYSIS NON AUTO W/O MICRO-QW,307,1 ,$49.00 ,$31.85 ,$1.69 ,$49.00 ,$8.70 ,$5.98 ,$26.95 ,$3.48 ,$13.72 ,$24.01 ,$3.48 ,$28.67 ,$3.48 ,$26.61 ,$3.50 ,$3.48 ,$26.61 ,$6.61 ,$34.30 ,$24.50 ,$39.20 ,$8.70 ,$3.48 ,$34.30 ,$3.48 ,$29.40 ,$3.48 ,$36.75 ,$27.05 ,$24.40 ,$27.05 ,$3.48 ,$27.05 ,$4.52 ,$4.52 ,$41.65 ,$8.70 ,$33.96 ,$3.48 ,$49.00 ,$26.95 ,$3.48 ,$12.89 , N/A ,$1.77 ,$1.69 ,$3.65 ,$39.20 ,$26.61 ,$13.72 ,$44.10 ,$18.62 ,$6.96 ,$3.48 ,$23.52 
ST. MARY'S HOSPITAL - DECATUR,31000125,80500,HC CLINAL PATH CONSULT LTD -90,310,1 ,$162.00 ,$105.30 ,$29.67 ,$162.00 , N/A ,$30.56 ,$89.10 , N/A ,$45.36 ,$79.38 , N/A ,$94.77 , N/A ,$87.97 ,$31.12 , N/A ,$87.97 , N/A ,$113.40 ,$81.00 ,$129.60 , N/A , N/A ,$113.40 , N/A ,$97.20 , N/A ,$121.50 ,$89.42 ,$80.68 ,$89.42 , N/A ,$89.42 ,$29.67 ,$29.67 ,$137.70 , N/A ,$112.27 , N/A ,$162.00 ,$89.10 , N/A ,$42.61 , N/A , N/A , N/A , N/A ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$99.52 , N/A ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,31000126,80500,HC CLINAL PATH CONSULT LTD,310,1 ,$162.00 ,$105.30 ,$29.67 ,$162.00 , N/A ,$30.56 ,$89.10 , N/A ,$45.36 ,$79.38 , N/A ,$94.77 , N/A ,$87.97 ,$31.12 , N/A ,$87.97 , N/A ,$113.40 ,$81.00 ,$129.60 , N/A , N/A ,$113.40 , N/A ,$97.20 , N/A ,$121.50 ,$89.42 ,$80.68 ,$89.42 , N/A ,$89.42 ,$29.67 ,$29.67 ,$137.70 , N/A ,$112.27 , N/A ,$162.00 ,$89.10 , N/A ,$42.61 , N/A , N/A , N/A , N/A ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$99.52 , N/A ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,31000127,80500,HC CLINAL PATH CONSULT LTD,310,1 ,$162.00 ,$105.30 ,$29.67 ,$162.00 , N/A ,$30.56 ,$89.10 , N/A ,$45.36 ,$79.38 , N/A ,$94.77 , N/A ,$87.97 ,$31.12 , N/A ,$87.97 , N/A ,$113.40 ,$81.00 ,$129.60 , N/A , N/A ,$113.40 , N/A ,$97.20 , N/A ,$121.50 ,$89.42 ,$80.68 ,$89.42 , N/A ,$89.42 ,$29.67 ,$29.67 ,$137.70 , N/A ,$112.27 , N/A ,$162.00 ,$89.10 , N/A ,$42.61 , N/A , N/A , N/A , N/A ,$129.60 ,$87.97 ,$45.36 ,$145.80 ,$61.56 ,$99.52 , N/A ,$77.76 
ST. MARY'S HOSPITAL - DECATUR,31000128,81162,HC BRCA1  AND  BRCA2 FULL SEQ/DUPE/DEL ANALYSIS -90,310,1 ,"$2,420.00 ","$1,573.00 ",$3.50 ,"$4,562.20 ","$4,562.20 ","$2,420.00 ","$1,331.00 ","$1,824.88 ",$677.60 ,"$1,185.80 ","$1,824.88 ","$1,415.70 ","$1,824.88 ","$1,314.06 ",$3.50 ,"$1,824.88 ","$1,314.06 ","$2,420.00 ","$1,694.00 ","$1,210.00 ","$1,936.00 ","$4,562.20 ","$1,824.88 ","$1,694.00 ","$1,824.88 ","$1,452.00 ","$1,824.88 ","$1,815.00 ","$1,335.84 ","$1,205.16 ","$1,335.84 ","$1,824.88 ","$1,335.84 ","$2,420.00 ","$2,420.00 ","$2,057.00 ","$2,420.00 ","$1,677.06 ","$1,824.88 ","$2,420.00 ","$1,331.00 ","$1,824.88 ",$636.46 , N/A ,$258.42 ,$246.68 ,"$1,916.12 ","$1,936.00 ","$1,314.06 ",$677.60 ,"$2,178.00 ",$919.60 ,"$2,420.00 ","$1,824.88 ","$1,161.60 "
ST. MARY'S HOSPITAL - DECATUR,31000129,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN DIAG -90,310,1 ,$668.00 ,$434.20 ,$3.50 ,$668.00 ,$409.90 ,$116.78 ,$367.40 ,$163.96 ,$187.04 ,$327.32 ,$163.96 ,$390.78 ,$163.96 ,$362.72 ,$3.50 ,$163.96 ,$362.72 ,$311.52 ,$467.60 ,$334.00 ,$534.40 ,$409.90 ,$163.96 ,$467.60 ,$163.96 ,$400.80 ,$163.96 ,$501.00 ,$368.74 ,$332.66 ,$368.74 ,$163.96 ,$368.74 ,$236.83 ,$236.83 ,$567.80 ,$409.90 ,$462.92 ,$163.96 ,$668.00 ,$367.40 ,$163.96 ,$175.68 , N/A ,$91.06 ,$86.92 ,$172.16 ,$534.40 ,$362.72 ,$187.04 ,$601.20 ,$253.84 ,$327.92 ,$163.96 ,$320.64 
ST. MARY'S HOSPITAL - DECATUR,31000131,81207,HC BCR/ABL1 GENE MINOR BP DIAG -90,310,1 ,$560.00 ,$364.00 ,$3.50 ,$560.00 ,$362.10 ,$103.90 ,$308.00 ,$144.84 ,$156.80 ,$274.40 ,$144.84 ,$327.60 ,$144.84 ,$304.08 ,$3.50 ,$144.84 ,$304.08 ,$275.20 ,$392.00 ,$280.00 ,$448.00 ,$362.10 ,$144.84 ,$392.00 ,$144.84 ,$336.00 ,$144.84 ,$420.00 ,$309.12 ,$278.88 ,$309.12 ,$144.84 ,$309.12 ,$209.21 ,$209.21 ,$476.00 ,$362.10 ,$388.08 ,$144.84 ,$560.00 ,$308.00 ,$144.84 ,$147.28 , N/A ,$91.06 ,$86.92 ,$152.08 ,$448.00 ,$304.08 ,$156.80 ,$504.00 ,$212.80 ,$289.68 ,$144.84 ,$268.80 
ST. MARY'S HOSPITAL - DECATUR,31000133,81208,HC BCR/ABL1 GENE OTH BP QL/QN-90,310,1 ,$638.00 ,$414.70 ,$3.50 ,$638.00 ,$536.55 ,$103.90 ,$350.90 ,$214.62 ,$178.64 ,$312.62 ,$214.62 ,$373.23 ,$214.62 ,$346.43 ,$3.50 ,$214.62 ,$346.43 ,$407.78 ,$446.60 ,$319.00 ,$510.40 ,$536.55 ,$214.62 ,$446.60 ,$214.62 ,$382.80 ,$214.62 ,$478.50 ,$352.18 ,$317.72 ,$352.18 ,$214.62 ,$352.18 ,$279.01 ,$279.01 ,$542.30 ,$536.55 ,$442.13 ,$214.62 ,$638.00 ,$350.90 ,$214.62 ,$167.79 , N/A ,$91.06 ,$86.92 ,$225.35 ,$510.40 ,$346.43 ,$178.64 ,$574.20 ,$242.44 ,$429.24 ,$214.62 ,$306.24 
ST. MARY'S HOSPITAL - DECATUR,31000134,81210,HC BRAF GENE ANALYS V600E VAR-90,310,1 ,$674.00 ,$438.10 ,$3.50 ,$674.00 ,$438.50 ,$90.00 ,$370.70 ,$175.40 ,$188.72 ,$330.26 ,$175.40 ,$394.29 ,$175.40 ,$365.98 ,$3.50 ,$175.40 ,$365.98 ,$333.26 ,$471.80 ,$337.00 ,$539.20 ,$438.50 ,$175.40 ,$471.80 ,$175.40 ,$404.40 ,$175.40 ,$505.50 ,$372.05 ,$335.65 ,$372.05 ,$175.40 ,$372.05 ,$228.02 ,$228.02 ,$572.90 ,$438.50 ,$467.08 ,$175.40 ,$674.00 ,$370.70 ,$175.40 ,$177.26 , N/A ,$91.06 ,$86.92 ,$184.17 ,$539.20 ,$365.98 ,$188.72 ,$606.60 ,$256.12 ,$350.80 ,$175.40 ,$323.52 
ST. MARY'S HOSPITAL - DECATUR,31000137,81220,HC CYSTIC FIBROSIS GENE COMMON VARIANTS -90,310,1 ,$779.00 ,$506.35 ,$3.50 ,"$1,391.50 ","$1,391.50 ",$779.00 ,$428.45 ,$556.60 ,$218.12 ,$381.71 ,$556.60 ,$455.72 ,$556.60 ,$423.00 ,$3.50 ,$556.60 ,$423.00 ,$779.00 ,$545.30 ,$389.50 ,$623.20 ,"$1,391.50 ",$556.60 ,$545.30 ,$556.60 ,$467.40 ,$556.60 ,$584.25 ,$430.01 ,$387.94 ,$430.01 ,$556.60 ,$430.01 ,$723.58 ,$723.58 ,$662.15 ,$779.00 ,$539.85 ,$556.60 ,$779.00 ,$428.45 ,$556.60 ,$204.88 , N/A ,$27.97 ,$26.70 ,$584.43 ,$623.20 ,$423.00 ,$218.12 ,$701.10 ,$296.02 ,$779.00 ,$556.60 ,$373.92 
ST. MARY'S HOSPITAL - DECATUR,31000139,81229,HC CYTOGENOMIC MICROARRY ASSAY-90,310,1 ,"$3,100.00 ","$2,015.00 ",$3.50 ,"$3,100.00 ","$2,900.00 ",$367.20 ,"$1,705.00 ","$1,160.00 ",$868.00 ,"$1,519.00 ","$1,160.00 ","$1,813.50 ","$1,160.00 ","$1,683.30 ",$3.50 ,"$1,160.00 ","$1,683.30 ","$2,204.00 ","$2,170.00 ","$1,550.00 ","$2,480.00 ","$2,900.00 ","$1,160.00 ","$2,170.00 ","$1,160.00 ","$1,860.00 ","$1,160.00 ","$2,325.00 ","$1,711.20 ","$1,543.80 ","$1,711.20 ","$1,160.00 ","$1,711.20 ","$1,508.00 ","$1,508.00 ","$2,635.00 ","$2,900.00 ","$2,148.30 ","$1,160.00 ","$3,100.00 ","$1,705.00 ","$1,160.00 ",$815.30 , N/A ,$258.42 ,$246.68 ,"$1,218.00 ","$2,480.00 ","$1,683.30 ",$868.00 ,"$2,790.00 ","$1,178.00 ","$2,320.00 ","$1,160.00 ","$1,488.00 "
ST. MARY'S HOSPITAL - DECATUR,31000140,81225,HC CYP2C19 GENE ANYL COMMON VARIANTS-90,310,1 ,$571.00 ,$371.15 ,$3.50 ,$728.40 ,$728.40 ,$160.46 ,$314.05 ,$291.36 ,$159.88 ,$279.79 ,$291.36 ,$334.04 ,$291.36 ,$310.05 ,$3.50 ,$291.36 ,$310.05 ,$553.58 ,$399.70 ,$285.50 ,$456.80 ,$728.40 ,$291.36 ,$399.70 ,$291.36 ,$342.60 ,$291.36 ,$428.25 ,$315.19 ,$284.36 ,$315.19 ,$291.36 ,$315.19 ,$378.77 ,$378.77 ,$485.35 ,$571.00 ,$395.70 ,$291.36 ,$571.00 ,$314.05 ,$291.36 ,$150.17 , N/A ,$91.06 ,$86.92 ,$305.93 ,$456.80 ,$310.05 ,$159.88 ,$513.90 ,$216.98 ,$571.00 ,$291.36 ,$274.08 
ST. MARY'S HOSPITAL - DECATUR,31000141,81235,HC EGFR GENE COM VARIANTS -90,310,1 ,"$3,234.00 ","$2,102.10 ",$3.50 ,"$3,234.00 ",$811.45 ,$355.50 ,"$1,778.70 ",$324.58 ,$905.52 ,"$1,584.66 ",$324.58 ,"$1,891.89 ",$324.58 ,"$1,756.06 ",$3.50 ,$324.58 ,"$1,756.06 ",$616.70 ,"$2,263.80 ","$1,617.00 ","$2,587.20 ",$811.45 ,$324.58 ,"$2,263.80 ",$324.58 ,"$1,940.40 ",$324.58 ,"$2,425.50 ","$1,785.17 ","$1,610.53 ","$1,785.17 ",$324.58 ,"$1,785.17 ",$421.95 ,$421.95 ,"$2,748.90 ",$811.45 ,"$2,241.16 ",$324.58 ,"$3,234.00 ","$1,778.70 ",$324.58 ,$850.54 , N/A ,$91.06 ,$86.92 ,$340.81 ,"$2,587.20 ","$1,756.06 ",$905.52 ,"$2,910.60 ","$1,228.92 ",$649.16 ,$324.58 ,"$1,552.32 "
ST. MARY'S HOSPITAL - DECATUR,31000143,81240,HC F2 GENE ANAL 20210G A VAR -90,310,1 ,$729.00 ,$473.85 ,$3.50 ,$729.00 ,$164.23 ,$60.70 ,$400.95 ,$65.69 ,$204.12 ,$357.21 ,$65.69 ,$419.74 ,$65.69 ,$395.85 ,$3.50 ,$65.69 ,$395.85 ,$124.81 ,$510.30 ,$364.50 ,$583.20 ,$164.23 ,$65.69 ,$510.30 ,$65.69 ,$437.40 ,$65.69 ,$546.75 ,$402.41 ,$363.04 ,$402.41 ,$65.69 ,$402.41 ,$85.40 ,$85.40 ,$619.65 ,$164.23 ,$505.20 ,$65.69 ,$729.00 ,$400.95 ,$65.69 ,$191.73 , N/A ,$27.97 ,$26.70 ,$68.97 ,$583.20 ,$395.85 ,$204.12 ,$656.10 ,$277.02 ,$131.38 ,$65.69 ,$349.92 
ST. MARY'S HOSPITAL - DECATUR,31000145,81241,HC F5 GENE ANAL LEIDEN VAR -90,310,1 ,$729.00 ,$473.85 ,$3.50 ,$729.00 ,$183.43 ,$54.38 ,$400.95 ,$73.37 ,$204.12 ,$357.21 ,$73.37 ,$426.47 ,$73.37 ,$395.85 ,$3.50 ,$73.37 ,$395.85 ,$139.40 ,$510.30 ,$364.50 ,$583.20 ,$183.43 ,$73.37 ,$510.30 ,$73.37 ,$437.40 ,$73.37 ,$546.75 ,$402.41 ,$363.04 ,$402.41 ,$73.37 ,$402.41 ,$95.38 ,$95.38 ,$619.65 ,$183.43 ,$505.20 ,$73.37 ,$729.00 ,$400.95 ,$73.37 ,$191.73 , N/A ,$27.97 ,$26.70 ,$77.04 ,$583.20 ,$395.85 ,$204.12 ,$656.10 ,$277.02 ,$146.74 ,$73.37 ,$349.92 
ST. MARY'S HOSPITAL - DECATUR,31000146,81243,HC FMR1 GENE DETECTION -90,310,1 ,$763.00 ,$495.95 ,$3.50 ,$763.00 , N/A ,$105.70 ,$419.65 , N/A ,$213.64 ,$364.50 , N/A ,$364.50 , N/A ,$414.31 ,$3.50 , N/A ,$414.31 ,$343.35 ,$534.10 ,$381.50 ,$610.40 ,$534.10 , N/A ,$534.10 , N/A ,$457.80 , N/A ,$572.25 ,$421.18 ,$379.97 ,$421.18 , N/A ,$421.18 ,$74.15 ,$74.15 ,$648.55 , N/A ,$528.76 , N/A ,$763.00 ,$419.65 , N/A ,$200.67 , N/A ,$27.97 ,$26.70 , N/A ,$610.40 ,$414.31 ,$213.64 ,$686.70 ,$289.94 ,$114.08 , N/A ,$366.24 
ST. MARY'S HOSPITAL - DECATUR,31000148,81245,HC FLT3 GENE ANALYSIS INT TANDEM DUP VARIANTS -90,310,1 ,$657.00 ,$427.05 ,$3.50 ,$657.00 ,$413.78 ,$95.14 ,$361.35 ,$165.51 ,$183.96 ,$321.93 ,$165.51 ,$384.35 ,$165.51 ,$356.75 ,$3.50 ,$165.51 ,$356.75 ,$314.47 ,$459.90 ,$328.50 ,$525.60 ,$413.78 ,$165.51 ,$459.90 ,$165.51 ,$394.20 ,$165.51 ,$492.75 ,$362.66 ,$327.19 ,$362.66 ,$165.51 ,$362.66 ,$215.16 ,$215.16 ,$558.45 ,$413.78 ,$455.30 ,$165.51 ,$657.00 ,$361.35 ,$165.51 ,$172.79 , N/A ,$91.06 ,$86.92 ,$173.79 ,$525.60 ,$356.75 ,$183.96 ,$591.30 ,$249.66 ,$331.02 ,$165.51 ,$315.36 
ST. MARY'S HOSPITAL - DECATUR,31000149,81256,HC HFE GENE ANALYSIS -90,310,1 ,$954.00 ,$620.10 ,$3.50 ,$954.00 ,$163.40 ,$79.78 ,$524.70 ,$65.36 ,$267.12 ,$467.46 ,$65.36 ,$515.58 ,$65.36 ,$518.02 ,$3.50 ,$65.36 ,$518.02 ,$124.18 ,$667.80 ,$477.00 ,$763.20 ,$163.40 ,$65.36 ,$667.80 ,$65.36 ,$572.40 ,$65.36 ,$715.50 ,$526.61 ,$475.09 ,$526.61 ,$65.36 ,$526.61 ,$94.41 ,$94.41 ,$810.90 ,$163.40 ,$661.12 ,$65.36 ,$954.00 ,$524.70 ,$65.36 ,$250.90 , N/A ,$27.97 ,$26.70 ,$68.63 ,$763.20 ,$518.02 ,$267.12 ,$858.60 ,$362.52 ,$130.72 ,$65.36 ,$457.92 
ST. MARY'S HOSPITAL - DECATUR,31000150,81257,HC HBA1/HBA2 GENE ANALYSIS COM DELETE OR VARIANTS -90,310,1 ,"$1,052.00 ",$683.80 ,$3.50 ,"$1,052.00 ", N/A ,$155.64 ,$578.60 , N/A ,$294.56 ,$515.48 , N/A ,$615.42 , N/A ,$571.24 ,$3.50 , N/A ,$571.24 ,$473.40 ,$736.40 ,$526.00 ,$841.60 ,$736.40 , N/A ,$736.40 , N/A ,$631.20 , N/A ,$789.00 ,$580.70 ,$523.90 ,$580.70 , N/A ,$580.70 ,$132.94 ,$132.94 ,$894.20 , N/A ,$729.04 , N/A ,"$1,052.00 ",$578.60 , N/A ,$276.68 , N/A ,$27.97 ,$26.70 , N/A ,$841.60 ,$571.24 ,$294.56 ,$946.80 ,$399.76 ,$204.52 , N/A ,$504.96 
ST. MARY'S HOSPITAL - DECATUR,31000151,81261,HC IGH GENE ANALYSIS REARRANGEMENT AMP-90,310,1 ,"$1,043.00 ",$677.95 ,$3.50 ,"$1,043.00 ",$494.98 ,$125.08 ,$573.65 ,$197.99 ,$292.04 ,$511.07 ,$197.99 ,$610.16 ,$197.99 ,$566.35 ,$3.50 ,$197.99 ,$566.35 ,$376.18 ,$730.10 ,$521.50 ,$834.40 ,$494.98 ,$197.99 ,$730.10 ,$197.99 ,$625.80 ,$197.99 ,$782.25 ,$575.74 ,$519.41 ,$575.74 ,$197.99 ,$575.74 ,$285.99 ,$285.99 ,$886.55 ,$494.98 ,$722.80 ,$197.99 ,"$1,043.00 ",$573.65 ,$197.99 ,$274.31 , N/A ,$91.06 ,$86.92 ,$207.89 ,$834.40 ,$566.35 ,$292.04 ,$938.70 ,$396.34 ,$395.98 ,$197.99 ,$500.64 
ST. MARY'S HOSPITAL - DECATUR,31000153,81264,HC IGK GENE REARRANGE ANALYSIS-90,310,1 ,$870.00 ,$565.50 ,$3.50 ,$870.00 ,$431.83 ,$207.80 ,$478.50 ,$172.73 ,$243.60 ,$426.30 ,$172.73 ,$508.95 ,$172.73 ,$472.41 ,$3.50 ,$172.73 ,$472.41 ,$328.19 ,$609.00 ,$435.00 ,$696.00 ,$431.83 ,$172.73 ,$609.00 ,$172.73 ,$522.00 ,$172.73 ,$652.50 ,$480.24 ,$433.26 ,$480.24 ,$172.73 ,$480.24 ,$224.55 ,$224.55 ,$739.50 ,$431.83 ,$602.91 ,$172.73 ,$870.00 ,$478.50 ,$172.73 ,$228.81 , N/A ,$91.06 ,$86.92 ,$181.37 ,$696.00 ,$472.41 ,$243.60 ,$783.00 ,$330.60 ,$345.46 ,$172.73 ,$417.60 
ST. MARY'S HOSPITAL - DECATUR,31000154,81270,HC JAK2 GENE ANALYSIS-90,310,1 ,$910.00 ,$591.50 ,$3.50 ,$910.00 ,$229.15 ,$69.06 ,$500.50 ,$91.66 ,$254.80 ,$445.90 ,$91.66 ,$532.35 ,$91.66 ,$494.13 ,$3.50 ,$91.66 ,$494.13 ,$174.15 ,$637.00 ,$455.00 ,$728.00 ,$229.15 ,$91.66 ,$637.00 ,$91.66 ,$546.00 ,$91.66 ,$682.50 ,$502.32 ,$453.18 ,$502.32 ,$91.66 ,$502.32 ,$132.41 ,$132.41 ,$773.50 ,$229.15 ,$630.63 ,$91.66 ,$910.00 ,$500.50 ,$91.66 ,$239.33 , N/A ,$27.97 ,$26.70 ,$96.24 ,$728.00 ,$494.13 ,$254.80 ,$819.00 ,$345.80 ,$183.32 ,$91.66 ,$436.80 
ST. MARY'S HOSPITAL - DECATUR,31000155,81273,HC KIT GENE ANALYSIS D816 VAR-90,310,1 ,$908.00 ,$590.20 ,$3.50 ,$908.00 ,$312.18 ,$212.28 ,$499.40 ,$124.87 ,$254.24 ,$444.92 ,$124.87 ,$531.18 ,$124.87 ,$493.04 ,$3.50 ,$124.87 ,$493.04 ,$237.25 ,$635.60 ,$454.00 ,$726.40 ,$312.18 ,$124.87 ,$635.60 ,$124.87 ,$544.80 ,$124.87 ,$681.00 ,$501.22 ,$452.18 ,$501.22 ,$124.87 ,$501.22 ,$162.33 ,$162.33 ,$771.80 ,$312.18 ,$629.24 ,$124.87 ,$908.00 ,$499.40 ,$124.87 ,$238.80 , N/A ,$27.97 ,$26.70 ,$131.11 ,$726.40 ,$493.04 ,$254.24 ,$817.20 ,$345.04 ,$249.74 ,$124.87 ,$435.84 
ST. MARY'S HOSPITAL - DECATUR,31000156,81275,HC KRAS GENE ANALYSIS-90,310,1 ,$822.00 ,$534.30 ,$3.50 ,$822.00 ,$483.13 ,$180.62 ,$452.10 ,$193.25 ,$230.16 ,$402.78 ,$193.25 ,$480.87 ,$193.25 ,$446.35 ,$3.50 ,$193.25 ,$446.35 ,$367.18 ,$575.40 ,$411.00 ,$657.60 ,$483.13 ,$193.25 ,$575.40 ,$193.25 ,$493.20 ,$193.25 ,$616.50 ,$453.74 ,$409.36 ,$453.74 ,$193.25 ,$453.74 ,$251.23 ,$251.23 ,$698.70 ,$483.13 ,$569.65 ,$193.25 ,$822.00 ,$452.10 ,$193.25 ,$216.19 , N/A ,$91.06 ,$86.92 ,$202.91 ,$657.60 ,$446.35 ,$230.16 ,$739.80 ,$312.36 ,$386.50 ,$193.25 ,$394.56 
ST. MARY'S HOSPITAL - DECATUR,31000157,81291,HC MTHFR GENE ANALYSIS-90,310,1 ,$526.00 ,$341.90 ,$3.50 ,$526.00 ,$163.35 ,$93.00 ,$289.30 ,$65.34 ,$147.28 ,$257.74 ,$65.34 ,$307.71 ,$65.34 ,$285.62 ,$3.50 ,$65.34 ,$285.62 ,$124.15 ,$368.20 ,$263.00 ,$420.80 ,$163.35 ,$65.34 ,$368.20 ,$65.34 ,$315.60 ,$65.34 ,$394.50 ,$290.35 ,$261.95 ,$290.35 ,$65.34 ,$290.35 ,$84.94 ,$84.94 ,$447.10 ,$163.35 ,$364.52 ,$65.34 ,$526.00 ,$289.30 ,$65.34 ,$138.34 , N/A ,$27.97 ,$26.70 ,$68.61 ,$420.80 ,$285.62 ,$147.28 ,$473.40 ,$199.88 ,$130.68 ,$65.34 ,$252.48 
ST. MARY'S HOSPITAL - DECATUR,31000158,81292,HC MLH1 GENE FULL SEQ ANALYSIS-90,310,1 ,"$1,468.00 ",$954.20 ,$3.50 ,"$1,688.50 ","$1,688.50 ",$780.00 ,$807.40 ,$675.40 ,$411.04 ,$719.32 ,$675.40 ,$858.78 ,$675.40 ,$797.12 ,$3.50 ,$675.40 ,$797.12 ,"$1,283.26 ","$1,027.60 ",$734.00 ,"$1,174.40 ","$1,688.50 ",$675.40 ,"$1,027.60 ",$675.40 ,$880.80 ,$675.40 ,"$1,101.00 ",$810.34 ,$731.06 ,$810.34 ,$675.40 ,$810.34 ,$878.02 ,$878.02 ,"$1,247.80 ","$1,468.00 ","$1,017.32 ",$675.40 ,"$1,468.00 ",$807.40 ,$675.40 ,$386.08 , N/A ,$258.42 ,$246.68 ,$709.17 ,"$1,174.40 ",$797.12 ,$411.04 ,"$1,321.20 ",$557.84 ,"$1,350.80 ",$675.40 ,$704.64 
ST. MARY'S HOSPITAL - DECATUR,31000159,81294,HC MLH1 GENE DUPL/DELETE VARIANT-90,310,1 ,$531.00 ,$345.15 ,$3.50 ,$531.00 ,$506.00 ,$464.74 ,$292.05 ,$202.40 ,$148.68 ,$260.19 ,$202.40 ,$310.64 ,$202.40 ,$288.33 ,$3.50 ,$202.40 ,$288.33 ,$384.56 ,$371.70 ,$265.50 ,$424.80 ,$506.00 ,$202.40 ,$371.70 ,$202.40 ,$318.60 ,$202.40 ,$398.25 ,$293.11 ,$264.44 ,$293.11 ,$202.40 ,$293.11 ,$263.12 ,$263.12 ,$451.35 ,$506.00 ,$367.98 ,$202.40 ,$531.00 ,$292.05 ,$202.40 ,$139.65 , N/A ,$91.06 ,$86.92 ,$212.52 ,$424.80 ,$288.33 ,$148.68 ,$477.90 ,$201.78 ,$404.80 ,$202.40 ,$254.88 
ST. MARY'S HOSPITAL - DECATUR,31000160,81295,HC MLH2 GENE FULL SEQ ANALYSIS-90,310,1 ,$418.00 ,$271.70 ,$3.50 ,$954.25 ,$954.25 ,$418.00 ,$229.90 ,$381.70 ,$117.04 ,$204.82 ,$381.70 ,$244.53 ,$381.70 ,$226.97 ,$3.50 ,$381.70 ,$226.97 ,$418.00 ,$292.60 ,$209.00 ,$334.40 ,$954.25 ,$381.70 ,$292.60 ,$381.70 ,$250.80 ,$381.70 ,$313.50 ,$230.74 ,$208.16 ,$230.74 ,$381.70 ,$230.74 ,$418.00 ,$418.00 ,$355.30 ,$418.00 ,$289.67 ,$381.70 ,$418.00 ,$229.90 ,$381.70 ,$109.93 , N/A ,$91.06 ,$86.92 ,$400.79 ,$334.40 ,$226.97 ,$117.04 ,$376.20 ,$158.84 ,$418.00 ,$381.70 ,$200.64 
ST. MARY'S HOSPITAL - DECATUR,31000161,81297,HC MLH2 GENE DUPL/DELETE VARIANT-90,310,1 ,$418.00 ,$271.70 ,$3.50 ,$533.25 ,$533.25 ,$412.14 ,$229.90 ,$213.30 ,$117.04 ,$204.82 ,$213.30 ,$244.53 ,$213.30 ,$226.97 ,$3.50 ,$213.30 ,$226.97 ,$405.27 ,$292.60 ,$209.00 ,$334.40 ,$533.25 ,$213.30 ,$292.60 ,$213.30 ,$250.80 ,$213.30 ,$313.50 ,$230.74 ,$208.16 ,$230.74 ,$213.30 ,$230.74 ,$277.29 ,$277.29 ,$355.30 ,$418.00 ,$289.67 ,$213.30 ,$418.00 ,$229.90 ,$213.30 ,$109.93 , N/A ,$91.06 ,$86.92 ,$223.97 ,$334.40 ,$226.97 ,$117.04 ,$376.20 ,$158.84 ,$418.00 ,$213.30 ,$200.64 
ST. MARY'S HOSPITAL - DECATUR,31000163,81301,HC MICROSATELLITE INSTAB ANALYSIS-90,310,1 ,$857.00 ,$557.05 ,$3.50 ,$871.40 ,$871.40 ,$272.56 ,$471.35 ,$348.56 ,$239.96 ,$419.93 ,$348.56 ,$501.35 ,$348.56 ,$465.35 ,$3.50 ,$348.56 ,$465.35 ,$662.26 ,$599.90 ,$428.50 ,$685.60 ,$871.40 ,$348.56 ,$599.90 ,$348.56 ,$514.20 ,$348.56 ,$642.75 ,$473.06 ,$426.79 ,$473.06 ,$348.56 ,$473.06 ,$453.13 ,$453.13 ,$728.45 ,$857.00 ,$593.90 ,$348.56 ,$857.00 ,$471.35 ,$348.56 ,$225.39 , N/A ,$91.06 ,$86.92 ,$365.99 ,$685.60 ,$465.35 ,$239.96 ,$771.30 ,$325.66 ,$697.12 ,$348.56 ,$411.36 
ST. MARY'S HOSPITAL - DECATUR,31000164,81302,HC MECP2 GENE ANALYSIS FULL SEQ-90,310,1 ,"$1,392.00 ",$904.80 ,$3.50 ,"$1,392.00 ","$1,319.68 ",$387.14 ,$765.60 ,$527.87 ,$389.76 ,$682.08 ,$527.87 ,$814.32 ,$527.87 ,$755.86 ,$3.50 ,$527.87 ,$755.86 ,"$1,002.95 ",$974.40 ,$696.00 ,"$1,113.60 ","$1,319.68 ",$527.87 ,$974.40 ,$527.87 ,$835.20 ,$527.87 ,"$1,044.00 ",$768.38 ,$693.22 ,$768.38 ,$527.87 ,$768.38 ,$686.23 ,$686.23 ,"$1,183.20 ","$1,319.68 ",$964.66 ,$527.87 ,"$1,392.00 ",$765.60 ,$527.87 ,$366.10 , N/A ,$27.97 ,$26.70 ,$554.26 ,"$1,113.60 ",$755.86 ,$389.76 ,"$1,252.80 ",$528.96 ,"$1,055.74 ",$527.87 ,$668.16 
ST. MARY'S HOSPITAL - DECATUR,31000165,81304,HC MECP2 GENE ANALYSIS DUP/DEL-90,310,1 ,"$1,392.00 ",$904.80 ,$3.50 ,"$1,392.00 ",$375.00 ,$251.66 ,$765.60 ,$150.00 ,$389.76 ,$682.08 ,$150.00 ,$814.32 ,$150.00 ,$755.86 ,$3.50 ,$150.00 ,$755.86 ,$285.00 ,$974.40 ,$696.00 ,"$1,113.60 ",$375.00 ,$150.00 ,$974.40 ,$150.00 ,$835.20 ,$150.00 ,"$1,044.00 ",$768.38 ,$693.22 ,$768.38 ,$150.00 ,$768.38 ,$195.00 ,$195.00 ,"$1,183.20 ",$375.00 ,$964.66 ,$150.00 ,"$1,392.00 ",$765.60 ,$150.00 ,$366.10 , N/A ,$27.97 ,$26.70 ,$157.50 ,"$1,113.60 ",$755.86 ,$389.76 ,"$1,252.80 ",$528.96 ,$300.00 ,$150.00 ,$668.16 
ST. MARY'S HOSPITAL - DECATUR,31000166,81310,HC NPM1 GENE EXON 12 VARIANT-90,310,1 ,$771.00 ,$501.15 ,$3.50 ,$771.00 ,$616.30 ,$49.98 ,$424.05 ,$246.52 ,$215.88 ,$377.79 ,$246.52 ,$451.04 ,$246.52 ,$418.65 ,$3.50 ,$246.52 ,$418.65 ,$468.39 ,$539.70 ,$385.50 ,$616.80 ,$616.30 ,$246.52 ,$539.70 ,$246.52 ,$462.60 ,$246.52 ,$578.25 ,$425.59 ,$383.96 ,$425.59 ,$246.52 ,$425.59 ,$320.48 ,$320.48 ,$655.35 ,$616.30 ,$534.30 ,$246.52 ,$771.00 ,$424.05 ,$246.52 ,$202.77 , N/A ,$91.06 ,$86.92 ,$258.85 ,$616.80 ,$418.65 ,$215.88 ,$693.90 ,$292.98 ,$493.04 ,$246.52 ,$370.08 
ST. MARY'S HOSPITAL - DECATUR,31000168,81315,HC PML/RAR COMM BREAKPOINTS QL/QN-90,310,1 ,"$1,184.00 ",$769.60 ,$3.50 ,"$1,184.00 ",$518.28 ,$135.84 ,$651.20 ,$207.31 ,$331.52 ,$580.16 ,$207.31 ,$692.64 ,$207.31 ,$642.91 ,$3.50 ,$207.31 ,$642.91 ,$393.89 ,$828.80 ,$592.00 ,$947.20 ,$518.28 ,$207.31 ,$828.80 ,$207.31 ,$710.40 ,$207.31 ,$888.00 ,$653.57 ,$589.63 ,$653.57 ,$207.31 ,$653.57 ,$299.46 ,$299.46 ,"$1,006.40 ",$518.28 ,$820.51 ,$207.31 ,"$1,184.00 ",$651.20 ,$207.31 ,$311.39 , N/A ,$91.06 ,$86.92 ,$217.68 ,$947.20 ,$642.91 ,$331.52 ,"$1,065.60 ",$449.92 ,$414.62 ,$207.31 ,$568.32 
ST. MARY'S HOSPITAL - DECATUR,31000169,81321,HC PTEN GENE ANALYSIS FULL SEQUENCE -90,310,1 ,"$2,134.00 ","$1,387.10 ",$3.50 ,"$2,134.00 ","$1,500.00 ",$544.72 ,"$1,173.70 ",$600.00 ,$597.52 ,"$1,045.66 ",$600.00 ,"$1,248.39 ",$600.00 ,"$1,158.76 ",$3.50 ,$600.00 ,"$1,158.76 ","$1,140.00 ","$1,493.80 ","$1,067.00 ","$1,707.20 ","$1,500.00 ",$600.00 ,"$1,493.80 ",$600.00 ,"$1,280.40 ",$600.00 ,"$1,600.50 ","$1,177.97 ","$1,062.73 ","$1,177.97 ",$600.00 ,"$1,177.97 ",$780.00 ,$780.00 ,"$1,813.90 ","$1,500.00 ","$1,478.86 ",$600.00 ,"$2,134.00 ","$1,173.70 ",$600.00 ,$561.24 , N/A ,$258.42 ,$246.68 ,$630.00 ,"$1,707.20 ","$1,158.76 ",$597.52 ,"$1,920.60 ",$810.92 ,"$1,200.00 ",$600.00 ,"$1,024.32 "
ST. MARY'S HOSPITAL - DECATUR,31000170,81323,HC PTEN GENE ANALYSIS DUP/DEL-90,310,1 ,$988.00 ,$642.20 ,$3.50 ,$988.00 ,$750.00 ,$79.44 ,$543.40 ,$300.00 ,$276.64 ,$484.12 ,$300.00 ,$577.98 ,$300.00 ,$536.48 ,$3.50 ,$300.00 ,$536.48 ,$570.00 ,$691.60 ,$494.00 ,$790.40 ,$750.00 ,$300.00 ,$691.60 ,$300.00 ,$592.80 ,$300.00 ,$741.00 ,$545.38 ,$492.02 ,$545.38 ,$300.00 ,$545.38 ,$390.00 ,$390.00 ,$839.80 ,$750.00 ,$684.68 ,$300.00 ,$988.00 ,$543.40 ,$300.00 ,$259.84 , N/A ,$27.97 ,$26.70 ,$315.00 ,$790.40 ,$536.48 ,$276.64 ,$889.20 ,$375.44 ,$600.00 ,$300.00 ,$474.24 
ST. MARY'S HOSPITAL - DECATUR,31000172,81340,HC TRB GENE ANALYSIS-90,310,1 ,"$1,206.00 ",$783.90 ,$3.50 ,"$1,206.00 ",$522.30 ,$231.00 ,$663.30 ,$208.92 ,$337.68 ,$590.94 ,$208.92 ,$705.51 ,$208.92 ,$654.86 ,$3.50 ,$208.92 ,$654.86 ,$396.95 ,$844.20 ,$603.00 ,$964.80 ,$522.30 ,$208.92 ,$844.20 ,$208.92 ,$723.60 ,$208.92 ,$904.50 ,$665.71 ,$600.59 ,$665.71 ,$208.92 ,$665.71 ,$301.77 ,$301.77 ,"$1,025.10 ",$522.30 ,$835.76 ,$208.92 ,"$1,206.00 ",$663.30 ,$208.92 ,$317.18 , N/A ,$91.06 ,$86.92 ,$219.37 ,$964.80 ,$654.86 ,$337.68 ,"$1,085.40 ",$458.28 ,$417.84 ,$208.92 ,$578.88 
ST. MARY'S HOSPITAL - DECATUR,31000173,81342,HC TRB GENE ANALYSIS DIRECT PROBE-90,310,1 ,"$1,113.00 ",$723.45 ,$3.50 ,"$1,113.00 ",$503.75 ,$193.20 ,$612.15 ,$201.50 ,$311.64 ,$545.37 ,$201.50 ,$651.11 ,$201.50 ,$604.36 ,$3.50 ,$201.50 ,$604.36 ,$382.85 ,$779.10 ,$556.50 ,$890.40 ,$503.75 ,$201.50 ,$779.10 ,$201.50 ,$667.80 ,$201.50 ,$834.75 ,$614.38 ,$554.27 ,$614.38 ,$201.50 ,$614.38 ,$291.04 ,$291.04 ,$946.05 ,$503.75 ,$771.31 ,$201.50 ,"$1,113.00 ",$612.15 ,$201.50 ,$292.72 , N/A ,$91.06 ,$86.92 ,$211.58 ,$890.40 ,$604.36 ,$311.64 ,"$1,001.70 ",$422.94 ,$403.00 ,$201.50 ,$534.24 
ST. MARY'S HOSPITAL - DECATUR,31000174,81372,HC CLASS 1 TYPING COMPLETE LOW RESOLUTION-90,310,1 ,"$1,120.00 ",$728.00 ,$3.50 ,"$1,120.00 ","$1,008.98 ",$574.24 ,$616.00 ,$403.59 ,$313.60 ,$548.80 ,$403.59 ,$655.20 ,$403.59 ,$608.16 ,$3.50 ,$403.59 ,$608.16 ,$766.82 ,$784.00 ,$560.00 ,$896.00 ,"$1,008.98 ",$403.59 ,$784.00 ,$403.59 ,$672.00 ,$403.59 ,$840.00 ,$618.24 ,$557.76 ,$618.24 ,$403.59 ,$618.24 ,$524.67 ,$524.67 ,$952.00 ,"$1,008.98 ",$776.16 ,$403.59 ,"$1,120.00 ",$616.00 ,$403.59 ,$294.56 , N/A ,$91.06 ,$86.92 ,$423.77 ,$896.00 ,$608.16 ,$313.60 ,"$1,008.00 ",$425.60 ,$807.18 ,$403.59 ,$537.60 
ST. MARY'S HOSPITAL - DECATUR,31000176,81374,HC HLA CLS I TYPNG LW ANTGN EA-90,310,1 ,$458.00 ,$297.70 ,$3.50 ,$458.00 ,$185.83 ,$194.62 ,$251.90 ,$74.33 ,$128.24 ,$224.42 ,$74.33 ,$267.93 ,$74.33 ,$248.69 ,$3.50 ,$74.33 ,$248.69 ,$141.23 ,$320.60 ,$229.00 ,$366.40 ,$185.83 ,$74.33 ,$320.60 ,$74.33 ,$274.80 ,$74.33 ,$343.50 ,$252.82 ,$228.08 ,$252.82 ,$74.33 ,$252.82 ,$105.08 ,$105.08 ,$389.30 ,$185.83 ,$317.39 ,$74.33 ,$458.00 ,$251.90 ,$74.33 ,$120.45 , N/A ,$27.97 ,$26.70 ,$78.05 ,$366.40 ,$248.69 ,$128.24 ,$412.20 ,$174.04 ,$148.66 ,$74.33 ,$219.84 
ST. MARY'S HOSPITAL - DECATUR,31000177,81376,HC HLA CLASS 2 TYPE LOW RESOLUTION 1 LOCUS-90,310,1 ,$380.00 ,$247.00 ,$3.50 ,$380.00 ,$305.55 ,$113.68 ,$209.00 ,$122.22 ,$106.40 ,$186.20 ,$122.22 ,$222.30 ,$122.22 ,$206.34 ,$3.50 ,$122.22 ,$206.34 ,$232.22 ,$266.00 ,$190.00 ,$304.00 ,$305.55 ,$122.22 ,$266.00 ,$122.22 ,$228.00 ,$122.22 ,$285.00 ,$209.76 ,$189.24 ,$209.76 ,$122.22 ,$209.76 ,$176.54 ,$176.54 ,$323.00 ,$305.55 ,$263.34 ,$122.22 ,$380.00 ,$209.00 ,$122.22 ,$99.94 , N/A ,$91.06 ,$86.92 ,$128.33 ,$304.00 ,$206.34 ,$106.40 ,$342.00 ,$144.40 ,$244.44 ,$122.22 ,$182.40 
ST. MARY'S HOSPITAL - DECATUR,31000179,81381,HC HLA 1 TYPE 1 ALLELE HIGH RESOLUTION -90,310,1 ,$631.00 ,$410.15 ,$3.50 ,$631.00 ,$424.75 ,$194.58 ,$347.05 ,$169.90 ,$176.68 ,$309.19 ,$169.90 ,$369.14 ,$169.90 ,$342.63 ,$3.50 ,$169.90 ,$342.63 ,$322.81 ,$441.70 ,$315.50 ,$504.80 ,$424.75 ,$169.90 ,$441.70 ,$169.90 ,$378.60 ,$169.90 ,$473.25 ,$348.31 ,$314.24 ,$348.31 ,$169.90 ,$348.31 ,$220.87 ,$220.87 ,$536.35 ,$424.75 ,$437.28 ,$169.90 ,$631.00 ,$347.05 ,$169.90 ,$165.95 , N/A ,$27.97 ,$26.70 ,$178.40 ,$504.80 ,$342.63 ,$176.68 ,$567.90 ,$239.78 ,$339.80 ,$169.90 ,$302.88 
ST. MARY'S HOSPITAL - DECATUR,31000181,81400,HC MOLECULAR PATH PROC LEVEL 1-90,310,1 ,$898.00 ,$583.70 ,$3.50 ,$898.00 ,$159.90 ,$82.22 ,$493.90 ,$63.96 ,$251.44 ,$408.63 ,$63.96 ,$408.63 ,$63.96 ,$487.61 ,$3.50 ,$63.96 ,$487.61 ,$121.52 ,$628.60 ,$449.00 ,$718.40 ,$159.90 ,$63.96 ,$628.60 ,$63.96 ,$538.80 ,$63.96 ,$673.50 ,$495.70 ,$447.20 ,$495.70 ,$63.96 ,$495.70 ,$83.15 ,$83.15 ,$763.30 ,$159.90 ,$622.31 ,$63.96 ,$898.00 ,$493.90 ,$63.96 ,$236.17 , N/A ,$27.97 ,$26.70 ,$67.16 ,$718.40 ,$487.61 ,$251.44 ,$808.20 ,$341.24 ,$127.92 ,$63.96 ,$431.04 
ST. MARY'S HOSPITAL - DECATUR,31000183,81401,HC MOLECULAR PATH PROC LEVEL 2-90,310,1 ,$688.00 ,$447.20 ,$3.50 ,$688.00 , N/A ,$78.00 ,$378.40 , N/A ,$192.64 ,$337.12 , N/A ,$402.48 , N/A ,$373.58 ,$3.50 , N/A ,$373.58 ,$309.60 ,$481.60 ,$344.00 ,$550.40 ,$481.60 , N/A ,$481.60 , N/A ,$412.80 , N/A ,$516.00 ,$379.78 ,$342.62 ,$379.78 , N/A ,$379.78 ,$178.10 ,$178.10 ,$584.80 , N/A ,$476.78 , N/A ,$688.00 ,$378.40 , N/A ,$180.94 , N/A ,$27.97 ,$26.70 , N/A ,$550.40 ,$373.58 ,$192.64 ,$619.20 ,$261.44 ,$274.00 , N/A ,$330.24 
ST. MARY'S HOSPITAL - DECATUR,31000184,81403,HC MOLECULAR PATH PROC LEVEL 4-90,310,1 ,"$1,047.00 ",$680.55 ,$3.50 ,"$1,047.00 ", N/A ,$120.00 ,$575.85 , N/A ,$293.16 ,$513.03 , N/A ,$612.50 , N/A ,$568.52 ,$3.50 , N/A ,$568.52 ,$471.15 ,$732.90 ,$523.50 ,$837.60 ,$732.90 , N/A ,$732.90 , N/A ,$628.20 , N/A ,$785.25 ,$577.94 ,$521.41 ,$577.94 , N/A ,$577.94 ,$240.76 ,$240.76 ,$889.95 , N/A ,$725.57 , N/A ,"$1,047.00 ",$575.85 , N/A ,$275.36 , N/A ,$27.97 ,$26.70 , N/A ,$837.60 ,$568.52 ,$293.16 ,$942.30 ,$397.86 ,$370.40 , N/A ,$502.56 
ST. MARY'S HOSPITAL - DECATUR,31000186,81404,HC MOLECULAR PATH PROC LEVEL 5-90,310,1 ,"$1,392.00 ",$904.80 ,$3.50 ,"$1,392.00 ", N/A ,$210.00 ,$765.60 , N/A ,$389.76 ,$682.08 , N/A ,$814.32 , N/A ,$755.86 ,$3.50 , N/A ,$755.86 ,$626.40 ,$974.40 ,$696.00 ,"$1,113.60 ",$974.40 , N/A ,$974.40 , N/A ,$835.20 , N/A ,"$1,044.00 ",$768.38 ,$693.22 ,$768.38 , N/A ,$768.38 ,$357.28 ,$357.28 ,"$1,183.20 ", N/A ,$964.66 , N/A ,"$1,392.00 ",$765.60 , N/A ,$366.10 , N/A ,$27.97 ,$26.70 , N/A ,"$1,113.60 ",$755.86 ,$389.76 ,"$1,252.80 ",$528.96 ,$549.66 , N/A ,$668.16 
ST. MARY'S HOSPITAL - DECATUR,31000187,81405,HC MOLECULAR PATH PROC LEVEL 6-90,310,1 ,"$2,115.00 ","$1,374.75 ",$3.50 ,"$2,115.00 ", N/A ,$210.00 ,"$1,163.25 ", N/A ,$592.20 ,"$1,036.35 ", N/A ,"$1,237.28 ", N/A ,"$1,148.45 ",$3.50 , N/A ,"$1,148.45 ",$951.75 ,"$1,480.50 ","$1,057.50 ","$1,692.00 ","$1,480.50 ", N/A ,"$1,480.50 ", N/A ,"$1,269.00 ", N/A ,"$1,586.25 ","$1,167.48 ","$1,053.27 ","$1,167.48 ", N/A ,"$1,167.48 ",$391.76 ,$391.76 ,"$1,797.75 ", N/A ,"$1,465.70 ", N/A ,"$2,115.00 ","$1,163.25 ", N/A ,$556.25 , N/A ,$27.97 ,$26.70 , N/A ,"$1,692.00 ","$1,148.45 ",$592.20 ,"$1,903.50 ",$803.70 ,$602.70 , N/A ,"$1,015.20 "
ST. MARY'S HOSPITAL - DECATUR,31000188,81406,HC MOLECULAR PATH PROC LEVEL 7-90,310,1 ,"$3,043.00 ","$1,977.95 ",$3.50 ,"$3,043.00 ", N/A ,$119.60 ,"$1,673.65 ", N/A ,$852.04 ,"$1,491.07 ", N/A ,"$1,780.16 ", N/A ,"$1,652.35 ",$3.50 , N/A ,"$1,652.35 ","$1,369.35 ","$2,130.10 ","$1,521.50 ","$2,434.40 ","$2,130.10 ", N/A ,"$2,130.10 ", N/A ,"$1,825.80 ", N/A ,"$2,282.25 ","$1,679.74 ","$1,515.41 ","$1,679.74 ", N/A ,"$1,679.74 ",$367.74 ,$367.74 ,"$2,586.55 ", N/A ,"$2,108.80 ", N/A ,"$3,043.00 ","$1,673.65 ", N/A ,$800.31 , N/A ,$91.06 ,$86.92 , N/A ,"$2,434.40 ","$1,652.35 ",$852.04 ,"$2,738.70 ","$1,156.34 ",$565.76 , N/A ,"$1,460.64 "
ST. MARY'S HOSPITAL - DECATUR,31000189,81407,HC MOLECULAR PATH PROC LEVEL 8-90,310,1 ,"$4,127.00 ","$2,682.55 ",$3.50 ,"$4,127.00 ", N/A ,"$1,440.00 ","$2,269.85 ", N/A ,"$1,155.56 ","$2,022.23 ", N/A ,"$2,414.30 ", N/A ,"$2,240.96 ",$3.50 , N/A ,"$2,240.96 ","$1,857.15 ","$2,888.90 ","$2,063.50 ","$3,301.60 ","$2,888.90 ", N/A ,"$2,888.90 ", N/A ,"$2,476.20 ", N/A ,"$3,095.25 ","$2,278.10 ","$2,055.25 ","$2,278.10 ", N/A ,"$2,278.10 ","$1,100.15 ","$1,100.15 ","$3,507.95 ", N/A ,"$2,860.01 ", N/A ,"$4,127.00 ","$2,269.85 ", N/A ,"$1,085.40 ", N/A ,$91.06 ,$86.92 , N/A ,"$3,301.60 ","$2,240.96 ","$1,155.56 ","$3,714.30 ","$1,568.26 ","$1,692.54 ", N/A ,"$1,980.96 "
ST. MARY'S HOSPITAL - DECATUR,31000190,81408,HC MOLECULAR PATH PROC LEVEL 9-90,310,1 ,"$4,147.00 ","$2,695.55 ",$3.50 ,"$4,147.00 ", N/A ,"$1,440.00 ","$2,280.85 ", N/A ,"$1,161.16 ","$2,032.03 ", N/A ,"$2,426.00 ", N/A ,"$2,251.82 ",$3.50 , N/A ,"$2,251.82 ","$1,866.15 ","$2,902.90 ","$2,073.50 ","$3,317.60 ","$2,902.90 ", N/A ,"$2,902.90 ", N/A ,"$2,488.20 ", N/A ,"$3,110.25 ","$2,289.14 ","$2,065.21 ","$2,289.14 ", N/A ,"$2,289.14 ","$2,600.00 ","$2,600.00 ","$3,524.95 ", N/A ,"$2,873.87 ", N/A ,"$4,147.00 ","$2,280.85 ", N/A ,"$1,090.66 ", N/A ,$91.06 ,$86.92 , N/A ,"$3,317.60 ","$2,251.82 ","$1,161.16 ","$3,732.30 ","$1,575.86 ","$4,000.00 ", N/A ,"$1,990.56 "
ST. MARY'S HOSPITAL - DECATUR,31000191,81479,HC IBD CELIAC UNLISTED MOLECULAR PATH-90,310,1 ,$418.00 ,$271.70 ,$3.50 ,$418.00 , N/A ,$90.00 ,$229.90 , N/A ,$117.04 ,$34.41 , N/A ,$34.41 , N/A ,$226.97 ,$3.50 , N/A ,$226.97 ,$188.10 ,$292.60 ,$209.00 ,$334.40 ,$292.60 , N/A ,$292.60 , N/A ,$250.80 , N/A ,$313.50 ,$230.74 ,$208.16 ,$230.74 , N/A ,$230.74 ,$292.60 ,$292.60 ,$355.30 , N/A ,$289.67 , N/A ,$418.00 ,$229.90 , N/A ,$109.93 , N/A ,$27.97 ,$26.70 , N/A ,$334.40 ,$226.97 ,$117.04 ,$376.20 ,$158.84 ,$209.00 , N/A ,$200.64 
ST. MARY'S HOSPITAL - DECATUR,31000193,81508,HC FETAL CONGENTIAL ABNORM 2 PROTEINS-90,310,1 ,$408.00 ,$265.20 ,$3.50 ,$408.00 ,$135.75 ,$175.00 ,$224.40 ,$54.30 ,$114.24 ,$199.92 ,$54.30 ,$238.68 ,$54.30 ,$221.54 ,$3.50 ,$54.30 ,$221.54 ,$103.17 ,$285.60 ,$204.00 ,$326.40 ,$135.75 ,$54.30 ,$285.60 ,$54.30 ,$244.80 ,$54.30 ,$306.00 ,$225.22 ,$203.18 ,$225.22 ,$54.30 ,$225.22 ,$70.59 ,$70.59 ,$346.80 ,$135.75 ,$282.74 ,$54.30 ,$408.00 ,$224.40 ,$54.30 ,$107.30 , N/A ,$27.97 ,$26.70 ,$57.02 ,$326.40 ,$221.54 ,$114.24 ,$367.20 ,$155.04 ,$108.60 ,$54.30 ,$195.84 
ST. MARY'S HOSPITAL - DECATUR,31000194,81511,HC FETAL CONGENTIAL ABNORM 4 ANALYTES-90,310,1 ,$493.00 ,$320.45 ,$3.50 ,$493.00 ,$383.75 ,$245.00 ,$271.15 ,$153.50 ,$138.04 ,$241.57 ,$153.50 ,$288.41 ,$153.50 ,$267.70 ,$3.50 ,$153.50 ,$267.70 ,$291.65 ,$345.10 ,$246.50 ,$394.40 ,$383.75 ,$153.50 ,$345.10 ,$153.50 ,$295.80 ,$153.50 ,$369.75 ,$272.14 ,$245.51 ,$272.14 ,$153.50 ,$272.14 ,$199.55 ,$199.55 ,$419.05 ,$383.75 ,$341.65 ,$153.50 ,$493.00 ,$271.15 ,$153.50 ,$129.66 , N/A ,$27.97 ,$26.70 ,$161.18 ,$394.40 ,$267.70 ,$138.04 ,$443.70 ,$187.34 ,$307.00 ,$153.50 ,$236.64 
ST. MARY'S HOSPITAL - DECATUR,31000195,81201,HC APC GENE ANALYSIS FULL SEQUENCE-90,310,1 ,"$1,687.00 ","$1,096.55 ",$3.50 ,"$1,687.00 ", N/A ,"$1,147.12 ",$927.85 , N/A ,$472.36 ,$826.63 , N/A ,$986.90 , N/A ,$916.04 ,$3.50 , N/A ,$916.04 ,$759.15 ,"$1,180.90 ",$843.50 ,"$1,349.60 ","$1,180.90 ", N/A ,"$1,180.90 ", N/A ,"$1,012.20 ", N/A ,"$1,265.25 ",$931.22 ,$840.13 ,$931.22 , N/A ,$931.22 ,"$1,014.00 ","$1,014.00 ","$1,433.95 ", N/A ,"$1,169.09 ", N/A ,"$1,687.00 ",$927.85 , N/A ,$443.68 , N/A ,$27.97 ,$26.70 , N/A ,"$1,349.60 ",$916.04 ,$472.36 ,"$1,518.30 ",$641.06 ,"$1,560.00 ", N/A ,$809.76 
ST. MARY'S HOSPITAL - DECATUR,31000196,81203,HC APC GENE ANALYSIS DUPLICATE/DELETION VARIANTS-90,310,1 ,"$1,725.00 ","$1,121.25 ",$3.50 ,"$1,725.00 ",$500.00 ,$513.86 ,$948.75 ,$200.00 ,$483.00 ,$845.25 ,$200.00 ,"$1,009.13 ",$200.00 ,$936.68 ,$3.50 ,$200.00 ,$936.68 ,$380.00 ,"$1,207.50 ",$862.50 ,"$1,380.00 ",$500.00 ,$200.00 ,"$1,207.50 ",$200.00 ,"$1,035.00 ",$200.00 ,"$1,293.75 ",$952.20 ,$859.05 ,$952.20 ,$200.00 ,$952.20 ,$260.00 ,$260.00 ,"$1,466.25 ",$500.00 ,"$1,195.43 ",$200.00 ,"$1,725.00 ",$948.75 ,$200.00 ,$453.68 , N/A ,$27.97 ,$26.70 ,$210.00 ,"$1,380.00 ",$936.68 ,$483.00 ,"$1,552.50 ",$655.50 ,$400.00 ,$200.00 ,$828.00 
ST. MARY'S HOSPITAL - DECATUR,31000197,81252,HC GJB2 GENE ANALYSIS FULL GENE SEQUENCE-90,310,1 ,"$1,003.00 ",$651.95 ,$3.50 ,"$1,003.00 ",$252.80 ,$190.68 ,$551.65 ,$101.12 ,$280.84 ,$491.47 ,$101.12 ,$586.76 ,$101.12 ,$544.63 ,$3.50 ,$101.12 ,$544.63 ,$192.13 ,$702.10 ,$501.50 ,$802.40 ,$252.80 ,$101.12 ,$702.10 ,$101.12 ,$601.80 ,$101.12 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$101.12 ,$553.66 ,$131.46 ,$131.46 ,$852.55 ,$252.80 ,$695.08 ,$101.12 ,"$1,003.00 ",$551.65 ,$101.12 ,$263.79 , N/A ,$27.97 ,$26.70 ,$106.18 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$202.24 ,$101.12 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,31000198,81254,HC GJB6 GENE ANALYSIS COMMON VARIANTS-90,310,1 ,"$1,003.00 ",$651.95 ,$3.50 ,"$1,003.00 ",$87.50 ,$34.64 ,$551.65 ,$35.00 ,$280.84 ,$223.63 ,$35.00 ,$223.63 ,$35.00 ,$544.63 ,$3.50 ,$35.00 ,$544.63 ,$66.50 ,$702.10 ,$501.50 ,$802.40 ,$87.50 ,$35.00 ,$702.10 ,$35.00 ,$601.80 ,$35.00 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$35.00 ,$553.66 ,$45.50 ,$45.50 ,$852.55 ,$87.50 ,$695.08 ,$35.00 ,"$1,003.00 ",$551.65 ,$35.00 ,$263.79 , N/A ,$27.97 ,$26.70 ,$36.75 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$70.00 ,$35.00 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,31000199,81287,HC MGMT GENE METHYLATION ANALYSIS-90,310,1 ,$988.00 ,$642.20 ,$3.50 ,$988.00 ,$311.60 ,$700.00 ,$543.40 ,$124.64 ,$276.64 ,$484.12 ,$124.64 ,$577.98 ,$124.64 ,$536.48 ,$3.50 ,$124.64 ,$536.48 ,$236.82 ,$691.60 ,$494.00 ,$790.40 ,$311.60 ,$124.64 ,$691.60 ,$124.64 ,$592.80 ,$124.64 ,$741.00 ,$545.38 ,$492.02 ,$545.38 ,$124.64 ,$545.38 ,$162.03 ,$162.03 ,$839.80 ,$311.60 ,$684.68 ,$124.64 ,$988.00 ,$543.40 ,$124.64 ,$259.84 , N/A ,$27.97 ,$26.70 ,$130.87 ,$790.40 ,$536.48 ,$276.64 ,$889.20 ,$375.44 ,$249.28 ,$124.64 ,$474.24 
ST. MARY'S HOSPITAL - DECATUR,31000201,81311,HC NRAS GENE VARIANTS EXON 2 AND 3 - 90,310,1 ,"$1,449.00 ",$941.85 ,$3.50 ,"$1,449.00 ",$739.48 ,$502.84 ,$796.95 ,$295.79 ,$405.72 ,$710.01 ,$295.79 ,$847.67 ,$295.79 ,$786.81 ,$3.50 ,$295.79 ,$786.81 ,$562.00 ,"$1,014.30 ",$724.50 ,"$1,159.20 ",$739.48 ,$295.79 ,"$1,014.30 ",$295.79 ,$869.40 ,$295.79 ,"$1,086.75 ",$799.85 ,$721.60 ,$799.85 ,$295.79 ,$799.85 ,$384.53 ,$384.53 ,"$1,231.65 ",$739.48 ,"$1,004.16 ",$295.79 ,"$1,449.00 ",$796.95 ,$295.79 ,$381.09 , N/A ,$91.06 ,$86.92 ,$310.58 ,"$1,159.20 ",$786.81 ,$405.72 ,"$1,304.10 ",$550.62 ,$591.58 ,$295.79 ,$695.52 
ST. MARY'S HOSPITAL - DECATUR,31000203,88362,HC NERVE TEASING PREPARATIONS-90,310,1 ,"$1,076.00 ",$699.40 ,$23.65 ,"$1,550.85 ","$1,550.85 ",$314.34 ,$591.80 ,$620.34 ,$301.28 ,$527.24 ,$620.34 ,$629.46 ,$620.34 ,$584.27 ,$140.02 ,$620.34 ,$584.27 ,"$1,076.00 ",$753.20 ,$538.00 ,$860.80 ,"$1,550.85 ",$620.34 ,$753.20 ,$620.34 ,$645.60 ,$620.34 ,$807.00 ,$593.95 ,$535.85 ,$593.95 ,$620.34 ,$593.95 ,$116.52 ,$116.52 ,$914.60 ,"$1,076.00 ",$745.67 ,$620.34 ,"$1,076.00 ",$591.80 ,$620.34 ,$282.99 , N/A ,$24.77 ,$23.65 ,$651.36 ,$860.80 ,$584.27 ,$301.28 ,$968.40 ,$408.88 ,"$1,076.00 ",$620.34 ,$516.48 
ST. MARY'S HOSPITAL - DECATUR,31000204,81170,HC ABL1 GENE ANALYSIS KINASE DOMAIN-90,310,1 ,"$1,565.00 ","$1,017.25 ",$3.50 ,"$1,565.00 ",$750.00 ,$560.16 ,$860.75 ,$300.00 ,$438.20 ,$766.85 ,$300.00 ,$915.53 ,$300.00 ,$849.80 ,$3.50 ,$300.00 ,$849.80 ,$570.00 ,"$1,095.50 ",$782.50 ,"$1,252.00 ",$750.00 ,$300.00 ,"$1,095.50 ",$300.00 ,$939.00 ,$300.00 ,"$1,173.75 ",$863.88 ,$779.37 ,$863.88 ,$300.00 ,$863.88 ,$390.00 ,$390.00 ,"$1,330.25 ",$750.00 ,"$1,084.55 ",$300.00 ,"$1,565.00 ",$860.75 ,$300.00 ,$411.60 , N/A ,$91.06 ,$86.92 ,$315.00 ,"$1,252.00 ",$849.80 ,$438.20 ,"$1,408.50 ",$594.70 ,$600.00 ,$300.00 ,$751.20 
ST. MARY'S HOSPITAL - DECATUR,31000205,81219,HC CALR GENE ANALYSIS EXON 9-90,310,1 ,$494.00 ,$321.10 ,$3.50 ,$494.00 ,$304.08 ,$281.66 ,$271.70 ,$121.63 ,$138.32 ,$242.06 ,$121.63 ,$288.99 ,$121.63 ,$268.24 ,$3.50 ,$121.63 ,$268.24 ,$231.10 ,$345.80 ,$247.00 ,$395.20 ,$304.08 ,$121.63 ,$345.80 ,$121.63 ,$296.40 ,$121.63 ,$370.50 ,$272.69 ,$246.01 ,$272.69 ,$121.63 ,$272.69 ,$175.68 ,$175.68 ,$419.90 ,$304.08 ,$342.34 ,$121.63 ,$494.00 ,$271.70 ,$121.63 ,$129.92 , N/A ,$91.06 ,$86.92 ,$127.71 ,$395.20 ,$268.24 ,$138.32 ,$444.60 ,$187.72 ,$243.26 ,$121.63 ,$237.12 
ST. MARY'S HOSPITAL - DECATUR,31000206,81246,HC FLT3 GENE ANALYSIS TYROSINE KINASE VARIANTS,310,1 ,$499.00 ,$324.35 ,$3.50 ,$499.00 ,$207.50 ,$215.70 ,$274.45 ,$83.00 ,$139.72 ,$244.51 ,$83.00 ,$291.92 ,$83.00 ,$270.96 ,$3.50 ,$83.00 ,$270.96 ,$157.70 ,$349.30 ,$249.50 ,$399.20 ,$207.50 ,$83.00 ,$349.30 ,$83.00 ,$299.40 ,$83.00 ,$374.25 ,$275.45 ,$248.50 ,$275.45 ,$83.00 ,$275.45 ,$107.90 ,$107.90 ,$424.15 ,$207.50 ,$345.81 ,$83.00 ,$499.00 ,$274.45 ,$83.00 ,$131.24 , N/A ,$27.97 ,$26.70 ,$87.15 ,$399.20 ,$270.96 ,$139.72 ,$449.10 ,$189.62 ,$166.00 ,$83.00 ,$239.52 
ST. MARY'S HOSPITAL - DECATUR,31000207,81276,HC KRAS GENE ANALYSIS ADDL VAR-90,310,1 ,"$1,565.00 ","$1,017.25 ",$3.50 ,"$1,565.00 ",$483.13 ,$335.22 ,$860.75 ,$193.25 ,$438.20 ,$766.85 ,$193.25 ,$915.53 ,$193.25 ,$849.80 ,$3.50 ,$193.25 ,$849.80 ,$367.18 ,"$1,095.50 ",$782.50 ,"$1,252.00 ",$483.13 ,$193.25 ,"$1,095.50 ",$193.25 ,$939.00 ,$193.25 ,"$1,173.75 ",$863.88 ,$779.37 ,$863.88 ,$193.25 ,$863.88 ,$251.23 ,$251.23 ,"$1,330.25 ",$483.13 ,"$1,084.55 ",$193.25 ,"$1,565.00 ",$860.75 ,$193.25 ,$411.60 , N/A ,$91.06 ,$86.92 ,$202.91 ,"$1,252.00 ",$849.80 ,$438.20 ,"$1,408.50 ",$594.70 ,$386.50 ,$193.25 ,$751.20 
ST. MARY'S HOSPITAL - DECATUR,31000208,81402,HC MOLECULAR PATHOLOGY PROC LEVEL 3-90,310,1 ,$899.00 ,$584.35 ,$3.50 ,$899.00 , N/A ,$120.00 ,$494.45 , N/A ,$251.72 ,$440.51 , N/A ,$525.92 , N/A ,$488.16 ,$3.50 , N/A ,$488.16 ,$404.55 ,$629.30 ,$449.50 ,$719.20 ,$629.30 , N/A ,$629.30 , N/A ,$539.40 , N/A ,$674.25 ,$496.25 ,$447.70 ,$496.25 , N/A ,$496.25 ,$195.43 ,$195.43 ,$764.15 , N/A ,$623.01 , N/A ,$899.00 ,$494.45 , N/A ,$236.44 , N/A ,$27.97 ,$26.70 , N/A ,$719.20 ,$488.16 ,$251.72 ,$809.10 ,$341.62 ,$300.66 , N/A ,$431.52 
ST. MARY'S HOSPITAL - DECATUR,31000209,81232,HC DPYD GENE ANALYSIS COMMON VARIANT-90,310,1 ,$955.00 ,$620.75 ,$3.50 ,$955.00 ,$437.03 ,$297.18 ,$525.25 ,$174.81 ,$267.40 ,$467.95 ,$174.81 ,$558.68 ,$174.81 ,$518.57 ,$3.50 ,$174.81 ,$518.57 ,$332.14 ,$668.50 ,$477.50 ,$764.00 ,$437.03 ,$174.81 ,$668.50 ,$174.81 ,$573.00 ,$174.81 ,$716.25 ,$527.16 ,$475.59 ,$527.16 ,$174.81 ,$527.16 ,$227.25 ,$227.25 ,$811.75 ,$437.03 ,$661.82 ,$174.81 ,$955.00 ,$525.25 ,$174.81 ,$251.17 , N/A ,$91.06 ,$86.92 ,$183.55 ,$764.00 ,$518.57 ,$267.40 ,$859.50 ,$362.90 ,$349.62 ,$174.81 ,$458.40 
ST. MARY'S HOSPITAL - DECATUR,31000222,81120,HC IDH1 COMMON VARIANTS -90,310,1 ,$888.00 ,$577.20 ,$3.50 ,$888.00 ,$483.13 ,$328.52 ,$488.40 ,$193.25 ,$248.64 ,$435.12 ,$193.25 ,$519.48 ,$193.25 ,$482.18 ,$3.50 ,$193.25 ,$482.18 ,$367.18 ,$621.60 ,$444.00 ,$710.40 ,$483.13 ,$193.25 ,$621.60 ,$193.25 ,$532.80 ,$193.25 ,$666.00 ,$490.18 ,$442.22 ,$490.18 ,$193.25 ,$490.18 ,$251.23 ,$251.23 ,$754.80 ,$483.13 ,$615.38 ,$193.25 ,$888.00 ,$488.40 ,$193.25 ,$233.54 , N/A ,$27.97 ,$26.70 ,$202.91 ,$710.40 ,$482.18 ,$248.64 ,$799.20 ,$337.44 ,$386.50 ,$193.25 ,$426.24 
ST. MARY'S HOSPITAL - DECATUR,31000223,81121,HC IDH2 COMMON VARIANTS -90,310,1 ,$950.00 ,$617.50 ,$3.50 ,$950.00 ,$739.48 ,$502.84 ,$522.50 ,$295.79 ,$266.00 ,$465.50 ,$295.79 ,$555.75 ,$295.79 ,$515.85 ,$3.50 ,$295.79 ,$515.85 ,$562.00 ,$665.00 ,$475.00 ,$760.00 ,$739.48 ,$295.79 ,$665.00 ,$295.79 ,$570.00 ,$295.79 ,$712.50 ,$524.40 ,$473.10 ,$524.40 ,$295.79 ,$524.40 ,$384.53 ,$384.53 ,$807.50 ,$739.48 ,$658.35 ,$295.79 ,$950.00 ,$522.50 ,$295.79 ,$249.85 , N/A ,$258.42 ,$246.68 ,$310.58 ,$760.00 ,$515.85 ,$266.00 ,$855.00 ,$361.00 ,$591.58 ,$295.79 ,$456.00 
ST. MARY'S HOSPITAL - DECATUR,31000224,81335,HC TPMT GENE ANALYSIS COMMON VARIANTS-90,310,1 ,$218.00 ,$141.70 ,$3.50 ,$437.03 ,$437.03 ,$218.00 ,$119.90 ,$174.81 ,$61.04 ,$106.82 ,$174.81 ,$127.53 ,$174.81 ,$118.37 ,$3.50 ,$174.81 ,$118.37 ,$218.00 ,$152.60 ,$109.00 ,$174.40 ,$437.03 ,$174.81 ,$152.60 ,$174.81 ,$130.80 ,$174.81 ,$163.50 ,$120.34 ,$108.56 ,$120.34 ,$174.81 ,$120.34 ,$218.00 ,$218.00 ,$185.30 ,$218.00 ,$151.07 ,$174.81 ,$218.00 ,$119.90 ,$174.81 ,$57.33 , N/A ,$91.06 ,$86.92 ,$183.55 ,$174.40 ,$118.37 ,$61.04 ,$196.20 ,$82.84 ,$218.00 ,$174.81 ,$104.64 
ST. MARY'S HOSPITAL - DECATUR,31000226,81450,HC TARGET GENOMIC SEQ ANALYSIS HEMATOLYMPHOID 5-50 GENES-90,310,1 ,"$3,866.00 ","$2,512.90 ",$3.50 ,"$3,866.00 ","$1,898.83 ","$1,438.14 ","$2,126.30 ",$759.53 ,"$1,082.48 ","$1,894.34 ",$759.53 ,"$2,261.61 ",$759.53 ,"$2,099.24 ",$3.50 ,$759.53 ,"$2,099.24 ","$1,443.11 ","$2,706.20 ","$1,933.00 ","$3,092.80 ","$1,898.83 ",$759.53 ,"$2,706.20 ",$759.53 ,"$2,319.60 ",$759.53 ,"$2,899.50 ","$2,134.03 ","$1,925.27 ","$2,134.03 ",$759.53 ,"$2,134.03 ",$987.39 ,$987.39 ,"$3,286.10 ","$1,898.83 ","$2,679.14 ",$759.53 ,"$3,866.00 ","$2,126.30 ",$759.53 ,"$1,016.76 ", N/A ,$91.06 ,$86.92 ,$797.51 ,"$3,092.80 ","$2,099.24 ","$1,082.48 ","$3,479.40 ","$1,469.08 ","$1,519.06 ",$759.53 ,"$1,855.68 "
ST. MARY'S HOSPITAL - DECATUR,31000240,81519,HC ONCOLOGY BREAST MRNA EXP PROF 21 GENES-90,310,1 ,"$7,011.00 ","$4,557.15 ",$3.50 ,"$9,682.50 ","$9,682.50 ","$5,700.00 ","$3,856.05 ","$3,873.00 ","$1,963.08 ","$3,435.39 ","$3,873.00 ","$4,101.44 ","$3,873.00 ","$3,806.97 ",$3.50 ,"$3,873.00 ","$3,806.97 ","$7,011.00 ","$4,907.70 ","$3,505.50 ","$5,608.80 ","$9,682.50 ","$3,873.00 ","$4,907.70 ","$3,873.00 ","$4,206.60 ","$3,873.00 ","$5,258.25 ","$3,870.07 ","$3,491.48 ","$3,870.07 ","$3,873.00 ","$3,870.07 ","$5,034.90 ","$5,034.90 ","$5,959.35 ","$7,011.00 ","$4,858.62 ","$3,873.00 ","$7,011.00 ","$3,856.05 ","$3,873.00 ","$1,843.89 ", N/A ,$258.42 ,$246.68 ,"$4,066.65 ","$5,608.80 ","$3,806.97 ","$1,963.08 ","$6,309.90 ","$2,664.18 ","$7,011.00 ","$3,873.00 ","$3,365.28 "
ST. MARY'S HOSPITAL - DECATUR,31000242,81329,HC SMN1 GENE DOSAGE/DELETION ANALYSIS-90,310,1 ,$535.00 ,$347.75 ,$3.50 ,$535.00 ,$342.50 ,$232.90 ,$294.25 ,$137.00 ,$149.80 ,$251.45 ,$137.00 ,$288.90 ,$137.00 ,$290.51 ,$3.50 ,$137.00 ,$290.51 ,$260.30 ,$374.50 ,$267.50 ,$428.00 ,$342.50 ,$137.00 ,$374.50 ,$137.00 ,$321.00 ,$137.00 ,$401.25 ,$295.32 ,$266.43 ,$295.32 ,$137.00 ,$295.32 ,$178.10 ,$178.10 ,$454.75 ,$342.50 ,$370.76 ,$137.00 ,$535.00 ,$294.25 ,$137.00 ,$140.71 , N/A ,$27.97 ,$26.70 ,$143.85 ,$428.00 ,$290.51 ,$149.80 ,$481.50 ,$203.30 ,$274.00 ,$137.00 ,$256.80 
ST. MARY'S HOSPITAL - DECATUR,31000245,81271,HC HTT GENE ANALYSIS DETECT ABNORMAL ALLELES-90,310,1 ,$868.00 ,$564.20 ,$3.50 ,$868.00 ,$342.50 ,$232.90 ,$477.40 ,$137.00 ,$243.04 ,$407.96 ,$137.00 ,$468.72 ,$137.00 ,$471.32 ,$3.50 ,$137.00 ,$471.32 ,$260.30 ,$607.60 ,$434.00 ,$694.40 ,$342.50 ,$137.00 ,$607.60 ,$137.00 ,$520.80 ,$137.00 ,$651.00 ,$479.14 ,$432.26 ,$479.14 ,$137.00 ,$479.14 ,$178.10 ,$178.10 ,$737.80 ,$342.50 ,$601.52 ,$137.00 ,$868.00 ,$477.40 ,$137.00 ,$228.28 , N/A ,$27.97 ,$26.70 ,$143.85 ,$694.40 ,$471.32 ,$243.04 ,$781.20 ,$329.84 ,$274.00 ,$137.00 ,$416.64 
ST. MARY'S HOSPITAL - DECATUR,31000246,88020,HC NECROPSY GROSS/MICRO W/O CNS-90,310,1 ,$896.00 ,$582.40 ,$235.65 ,$896.00 , N/A ,$617.76 ,$492.80 , N/A ,$250.88 ,$421.12 , N/A ,$483.84 , N/A ,$486.53 ,$358.40 , N/A ,$486.53 , N/A ,$627.20 ,$448.00 ,$716.80 , N/A , N/A ,$627.20 , N/A ,$537.60 , N/A ,$672.00 ,$494.59 ,$446.21 ,$494.59 , N/A ,$494.59 ,$627.20 ,$627.20 ,$761.60 , N/A ,$620.93 , N/A ,$896.00 ,$492.80 , N/A ,$235.65 , N/A , N/A , N/A , N/A ,$716.80 ,$486.53 ,$250.88 ,$806.40 ,$340.48 ,$725.08 , N/A ,$430.08 
ST. MARY'S HOSPITAL - DECATUR,31000247,88025,HC NECROPSY GROSS/MICRO W/BRAIN-90,310,1 ,"$1,783.00 ","$1,158.95 ",$468.93 ,"$1,783.00 ", N/A ,$597.78 ,$980.65 , N/A ,$499.24 ,$838.01 , N/A ,$962.82 , N/A ,$968.17 ,$713.20 , N/A ,$968.17 , N/A ,"$1,248.10 ",$891.50 ,"$1,426.40 ", N/A , N/A ,"$1,248.10 ", N/A ,"$1,069.80 ", N/A ,"$1,337.25 ",$984.22 ,$887.93 ,$984.22 , N/A ,$984.22 ,"$1,248.10 ","$1,248.10 ","$1,515.55 ", N/A ,"$1,235.62 ", N/A ,"$1,783.00 ",$980.65 , N/A ,$468.93 , N/A , N/A , N/A , N/A ,"$1,426.40 ",$968.17 ,$499.24 ,"$1,604.70 ",$677.54 ,$701.36 , N/A ,$855.84 
ST. MARY'S HOSPITAL - DECATUR,31000248,81226,HC CYP2D6 GENE COM VARIANTS-90,310,1 ,"$1,585.00 ","$1,030.25 ",$3.50 ,"$1,585.00 ","$1,127.28 ",$245.96 ,$871.75 ,$450.91 ,$443.80 ,$776.65 ,$450.91 ,$927.23 ,$450.91 ,$860.66 ,$3.50 ,$450.91 ,$860.66 ,$856.73 ,"$1,109.50 ",$792.50 ,"$1,268.00 ","$1,127.28 ",$450.91 ,"$1,109.50 ",$450.91 ,$951.00 ,$450.91 ,"$1,188.75 ",$874.92 ,$789.33 ,$874.92 ,$450.91 ,$874.92 ,$586.18 ,$586.18 ,"$1,347.25 ","$1,127.28 ","$1,098.41 ",$450.91 ,"$1,585.00 ",$871.75 ,$450.91 ,$416.86 , N/A ,$258.42 ,$246.68 ,$473.46 ,"$1,268.00 ",$860.66 ,$443.80 ,"$1,426.50 ",$602.30 ,$901.82 ,$450.91 ,$760.80 
ST. MARY'S HOSPITAL - DECATUR,31000257,81512,HC FETAL CONGENITAL ABNORMAL ASSAY 5 ANALYTES-90,310,1 ,$605.00 ,$393.25 ,$3.50 ,$605.00 ,$173.80 ,$490.00 ,$332.75 ,$69.52 ,$169.40 ,$296.45 ,$69.52 ,$353.93 ,$69.52 ,$328.52 ,$3.50 ,$69.52 ,$328.52 ,$132.09 ,$423.50 ,$302.50 ,$484.00 ,$173.80 ,$69.52 ,$423.50 ,$69.52 ,$363.00 ,$69.52 ,$453.75 ,$333.96 ,$301.29 ,$333.96 ,$69.52 ,$333.96 ,$90.38 ,$90.38 ,$514.25 ,$173.80 ,$419.27 ,$69.52 ,$605.00 ,$332.75 ,$69.52 ,$159.12 , N/A ,$27.97 ,$26.70 ,$73.00 ,$484.00 ,$328.52 ,$169.40 ,$544.50 ,$229.90 ,$139.04 ,$69.52 ,$290.40 
ST. MARY'S HOSPITAL - DECATUR,31000264,81432,HC INHERITED BREAST CANCER GENOMIC SEQ ANALYSIS >10 GENES-90,310,1 ,"$4,742.00 ","$3,082.30 ",$3.50 ,"$4,742.00 ","$1,697.63 ","$1,583.52 ","$2,608.10 ",$679.05 ,"$1,327.76 ","$2,323.58 ",$679.05 ,"$2,774.07 ",$679.05 ,"$2,574.91 ",$3.50 ,$679.05 ,"$2,574.91 ","$1,290.20 ","$3,319.40 ","$2,371.00 ","$3,793.60 ","$1,697.63 ",$679.05 ,"$3,319.40 ",$679.05 ,"$2,845.20 ",$679.05 ,"$3,556.50 ","$2,617.58 ","$2,361.52 ","$2,617.58 ",$679.05 ,"$2,617.58 ",$980.85 ,$980.85 ,"$4,030.70 ","$1,697.63 ","$3,286.21 ",$679.05 ,"$4,742.00 ","$2,608.10 ",$679.05 ,"$1,247.15 ", N/A ,$27.97 ,$26.70 ,$713.00 ,"$3,793.60 ","$2,574.91 ","$1,327.76 ","$4,267.80 ","$1,801.96 ","$1,358.10 ",$679.05 ,"$2,276.16 "
ST. MARY'S HOSPITAL - DECATUR,31000277,81455,HC TARGETED GENOMIC SEQ ANLYS- 90,310,1 ,"$8,029.00 ","$5,218.85 ",$3.50 ,"$8,029.00 ","$7,299.00 ","$1,438.14 ","$4,415.95 ","$2,919.60 ","$2,248.12 ","$3,934.21 ","$2,919.60 ","$4,696.97 ","$2,919.60 ","$4,359.75 ",$3.50 ,"$2,919.60 ","$4,359.75 ","$5,547.24 ","$5,620.30 ","$4,014.50 ","$6,423.20 ","$7,299.00 ","$2,919.60 ","$5,620.30 ","$2,919.60 ","$4,817.40 ","$2,919.60 ","$6,021.75 ","$4,432.01 ","$3,998.44 ","$4,432.01 ","$2,919.60 ","$4,432.01 ","$3,795.48 ","$3,795.48 ","$6,824.65 ","$7,299.00 ","$5,564.10 ","$2,919.60 ","$8,029.00 ","$4,415.95 ","$2,919.60 ","$2,111.63 ", N/A ,$258.42 ,$246.68 ,"$3,065.58 ","$6,423.20 ","$4,359.75 ","$2,248.12 ","$7,226.10 ","$3,051.02 ","$5,839.20 ","$2,919.60 ","$3,853.92 "
ST. MARY'S HOSPITAL - DECATUR,31000280,81403,HC MOLECULAR PATHOLOGY PROC LEVEL 4-90,310,1 ,$952.00 ,$618.80 ,$3.50 ,$952.00 , N/A ,$120.00 ,$523.60 , N/A ,$266.56 ,$466.48 , N/A ,$556.92 , N/A ,$516.94 ,$3.50 , N/A ,$516.94 ,$428.40 ,$666.40 ,$476.00 ,$761.60 ,$666.40 , N/A ,$666.40 , N/A ,$571.20 , N/A ,$714.00 ,$525.50 ,$474.10 ,$525.50 , N/A ,$525.50 ,$240.76 ,$240.76 ,$809.20 , N/A ,$659.74 , N/A ,$952.00 ,$523.60 , N/A ,$250.38 , N/A ,$27.97 ,$26.70 , N/A ,$761.60 ,$516.94 ,$266.56 ,$856.80 ,$361.76 ,$370.40 , N/A ,$456.96 
ST. MARY'S HOSPITAL - DECATUR,31000284,81339,HC MPL GENE SEQ ANLY EXON- 90,310,1 ,$803.00 ,$521.95 ,$86.92 ,$803.00 ,$463.00 ,$314.84 ,$441.65 ,$185.20 ,$224.84 ,$377.41 ,$185.20 ,$433.62 ,$185.20 ,$436.03 ,$321.20 ,$185.20 ,$436.03 ,$351.88 ,$562.10 ,$401.50 ,$642.40 ,$463.00 ,$185.20 ,$562.10 ,$185.20 ,$481.80 ,$185.20 ,$602.25 ,$443.26 ,$399.89 ,$443.26 ,$185.20 ,$443.26 ,$562.10 ,$562.10 ,$682.55 ,$463.00 ,$556.48 ,$185.20 ,$803.00 ,$441.65 ,$185.20 ,$211.19 , N/A ,$91.06 ,$86.92 ,$194.46 ,$642.40 ,$436.03 ,$224.84 ,$722.70 ,$305.14 ,$370.40 ,$185.20 ,$385.44 
ST. MARY'S HOSPITAL - DECATUR,31040110,81345,HC TERT GENE TARGETED SEQ ALYS- 90,310,1 ,"$1,640.00 ","$1,066.00 ",$3.50 ,"$1,640.00 ",$463.00 ,$314.84 ,$902.00 ,$185.20 ,$459.20 ,$770.80 ,$185.20 ,$885.60 ,$185.20 ,$890.52 ,$3.50 ,$185.20 ,$890.52 ,$351.88 ,"$1,148.00 ",$820.00 ,"$1,312.00 ",$463.00 ,$185.20 ,"$1,148.00 ",$185.20 ,$984.00 ,$185.20 ,"$1,230.00 ",$905.28 ,$816.72 ,$905.28 ,$185.20 ,$905.28 ,$240.76 ,$240.76 ,"$1,394.00 ",$463.00 ,"$1,136.52 ",$185.20 ,"$1,640.00 ",$902.00 ,$185.20 ,$431.32 , N/A ,$91.06 ,$86.92 ,$194.46 ,"$1,312.00 ",$890.52 ,$459.20 ,"$1,476.00 ",$623.20 ,$370.40 ,$185.20 ,$787.20 
ST. MARY'S HOSPITAL - DECATUR,31100101,88104,HC CYTOPATH FLD SMEAR,311,1 ,$370.00 ,$240.50 ,$21.49 ,$370.00 ,$80.10 ,$73.86 ,$203.50 ,$32.04 ,$103.60 ,$181.30 ,$32.04 ,$216.45 ,$32.04 ,$200.91 ,$60.18 ,$32.04 ,$200.91 ,$60.88 ,$259.00 ,$185.00 ,$296.00 ,$80.10 ,$32.04 ,$259.00 ,$32.04 ,$222.00 ,$32.04 ,$277.50 ,$204.24 ,$184.26 ,$204.24 ,$32.04 ,$204.24 ,$50.08 ,$50.08 ,$314.50 ,$80.10 ,$256.41 ,$32.04 ,$370.00 ,$203.50 ,$32.04 ,$97.31 , N/A ,$22.52 ,$21.49 ,$33.64 ,$296.00 ,$200.91 ,$103.60 ,$333.00 ,$140.60 ,$67.68 ,$32.04 ,$177.60 
ST. MARY'S HOSPITAL - DECATUR,31100102,88108,HC CYTOPATH CONCENTRATION,311,1 ,$394.00 ,$256.10 ,$21.49 ,$394.00 ,$80.10 ,$88.04 ,$216.70 ,$32.04 ,$110.32 ,$193.06 ,$32.04 ,$230.49 ,$32.04 ,$213.94 ,$55.01 ,$32.04 ,$213.94 ,$60.88 ,$275.80 ,$197.00 ,$315.20 ,$80.10 ,$32.04 ,$275.80 ,$32.04 ,$236.40 ,$32.04 ,$295.50 ,$217.49 ,$196.21 ,$217.49 ,$32.04 ,$217.49 ,$45.77 ,$45.77 ,$334.90 ,$80.10 ,$273.04 ,$32.04 ,$394.00 ,$216.70 ,$32.04 ,$103.62 , N/A ,$22.52 ,$21.49 ,$33.64 ,$315.20 ,$213.94 ,$110.32 ,$354.60 ,$149.72 ,$67.68 ,$32.04 ,$189.12 
ST. MARY'S HOSPITAL - DECATUR,31100104,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$564.00 ,$366.60 ,$23.65 ,$564.00 ,$117.60 ,$79.64 ,$310.20 ,$47.04 ,$157.92 ,$276.36 ,$47.04 ,$329.94 ,$47.04 ,$306.25 ,$56.56 ,$47.04 ,$306.25 ,$89.37 ,$394.80 ,$282.00 ,$451.20 ,$117.60 ,$47.04 ,$394.80 ,$47.04 ,$338.40 ,$47.04 ,$423.00 ,$311.33 ,$280.87 ,$311.33 ,$47.04 ,$311.33 ,$47.06 ,$47.06 ,$479.40 ,$117.60 ,$390.85 ,$47.04 ,$564.00 ,$310.20 ,$47.04 ,$148.33 , N/A ,$24.77 ,$23.65 ,$49.39 ,$451.20 ,$306.25 ,$157.92 ,$507.60 ,$214.32 ,$99.52 ,$47.04 ,$270.72 
ST. MARY'S HOSPITAL - DECATUR,31100110,88160,HC CYTOPATH SMEAR NON GYN,311,1 ,$544.00 ,$353.60 ,$21.49 ,$544.00 ,$58.45 ,$59.14 ,$299.20 ,$23.38 ,$152.32 ,$266.56 ,$23.38 ,$318.24 ,$23.38 ,$295.39 ,$65.35 ,$23.38 ,$295.39 ,$44.43 ,$380.80 ,$272.00 ,$435.20 ,$58.46 ,$23.38 ,$380.80 ,$23.38 ,$326.40 ,$23.38 ,$408.00 ,$300.29 ,$270.91 ,$300.29 ,$23.38 ,$300.29 ,$54.39 ,$54.39 ,$462.40 ,$58.46 ,$376.99 ,$23.38 ,$544.00 ,$299.20 ,$23.38 ,$143.07 , N/A ,$22.52 ,$21.49 ,$24.55 ,$435.20 ,$295.39 ,$152.32 ,$489.60 ,$206.72 ,$49.34 ,$23.38 ,$261.12 
ST. MARY'S HOSPITAL - DECATUR,31100114,88172,HC FINE NEEDLE EVAL,311,1 ,$262.00 ,$170.30 ,$21.05 ,$352.95 ,$352.95 ,$30.22 ,$144.10 ,$141.18 ,$73.36 ,$128.38 ,$141.18 ,$153.27 ,$141.18 ,$142.27 ,$28.62 ,$141.18 ,$142.27 ,$262.00 ,$183.40 ,$131.00 ,$209.60 ,$352.95 ,$141.18 ,$183.40 ,$141.18 ,$157.20 ,$141.18 ,$196.50 ,$144.62 ,$130.48 ,$144.62 ,$141.18 ,$144.62 ,$23.82 ,$23.82 ,$222.70 ,$262.00 ,$181.57 ,$141.18 ,$21.05 ,$144.10 ,$141.18 ,$68.91 , N/A ,$22.52 ,$21.49 ,$148.24 ,$209.60 ,$142.27 ,$73.36 ,$235.80 ,$99.56 ,$262.00 ,$141.18 ,$125.76 
ST. MARY'S HOSPITAL - DECATUR,31100115,88173,HC FINE NEEDLE INTERP,311,1 ,$676.00 ,$439.40 ,$21.49 ,$676.00 ,$117.60 ,$123.80 ,$371.80 ,$47.04 ,$189.28 ,$331.24 ,$47.04 ,$395.46 ,$47.04 ,$367.07 ,$117.77 ,$47.04 ,$367.07 ,$89.37 ,$473.20 ,$338.00 ,$540.80 ,$117.60 ,$47.04 ,$473.20 ,$47.04 ,$405.60 ,$47.04 ,$507.00 ,$373.15 ,$336.65 ,$373.15 ,$47.04 ,$373.15 ,$98.01 ,$98.01 ,$574.60 ,$117.60 ,$468.47 ,$47.04 ,$89.83 ,$371.80 ,$47.04 ,$177.79 , N/A ,$22.52 ,$21.49 ,$49.39 ,$540.80 ,$367.07 ,$189.28 ,$608.40 ,$256.88 ,$99.52 ,$47.04 ,$324.48 
ST. MARY'S HOSPITAL - DECATUR,31100116,88177,HC FINE NEEDLE EVAL ADDL,311,1 ,$122.00 ,$79.30 ,$8.61 ,$122.00 , N/A ,$12.34 ,$67.10 , N/A ,$34.16 ,$59.78 , N/A ,$71.37 , N/A ,$66.25 ,$10.35 , N/A ,$66.25 , N/A ,$85.40 ,$61.00 ,$97.60 , N/A , N/A ,$85.40 , N/A ,$73.20 , N/A ,$91.50 ,$67.34 ,$60.76 ,$67.34 , N/A ,$67.34 ,$8.61 ,$8.61 ,$103.70 , N/A ,$84.55 , N/A ,$122.00 ,$67.10 , N/A ,$32.09 , N/A ,$22.52 ,$21.49 , N/A ,$97.60 ,$66.25 ,$34.16 ,$109.80 ,$46.36 ,$14.66 , N/A ,$58.56 
ST. MARY'S HOSPITAL - DECATUR,31100242,88175,HC CYTOPATH PAP DIAG INIT/REDO,311,1 ,$216.00 ,$140.40 ,$3.50 ,$216.00 ,$66.53 ,$61.60 ,$118.80 ,$26.61 ,$60.48 ,$105.84 ,$26.61 ,$126.36 ,$26.61 ,$117.29 ,$3.50 ,$26.61 ,$117.29 ,$50.56 ,$151.20 ,$108.00 ,$172.80 ,$66.53 ,$26.61 ,$151.20 ,$26.61 ,$129.60 ,$26.61 ,$162.00 ,$119.23 ,$107.57 ,$119.23 ,$26.61 ,$119.23 ,$38.27 ,$38.27 ,$183.60 ,$66.53 ,$149.69 ,$26.61 ,$20.26 ,$118.80 ,$26.61 ,$56.81 , N/A ,$16.32 ,$15.58 ,$27.94 ,$172.80 ,$117.29 ,$60.48 ,$194.40 ,$82.08 ,$53.22 ,$26.61 ,$103.68 
ST. MARY'S HOSPITAL - DECATUR,31100244,88184,HC FLOW CYTO 1ST MARKER-90,311,1 ,$163.00 ,$105.95 ,$23.65 ,$689.24 ,$689.23 ,$137.46 ,$89.65 ,$275.69 ,$45.64 ,$79.87 ,$275.69 ,$95.36 ,$163.00 ,$88.51 ,$97.60 ,$163.00 ,$88.51 ,$163.00 ,$114.10 ,$81.50 ,$130.40 ,$689.24 ,$275.69 ,$114.10 ,$275.69 ,$97.80 ,$275.69 ,$122.25 ,$89.98 ,$81.17 ,$89.98 ,$275.69 ,$89.98 ,$81.21 ,$81.21 ,$138.55 ,$163.00 ,$112.96 ,$275.69 ,$163.00 ,$89.65 ,$275.69 ,$42.87 , N/A ,$24.77 ,$23.65 ,$289.47 ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$163.00 ,$275.69 ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,31100245,88184,HC FLOW CYTO 1ST MARKER,311,1 ,$421.00 ,$273.65 ,$23.65 ,$689.24 ,$689.23 ,$137.46 ,$231.55 ,$275.69 ,$117.88 ,$206.29 ,$275.69 ,$246.29 ,$275.69 ,$228.60 ,$97.60 ,$275.69 ,$228.60 ,$421.00 ,$294.70 ,$210.50 ,$336.80 ,$689.24 ,$275.69 ,$294.70 ,$275.69 ,$252.60 ,$275.69 ,$315.75 ,$232.39 ,$209.66 ,$232.39 ,$275.69 ,$232.39 ,$81.21 ,$81.21 ,$357.85 ,$421.00 ,$291.75 ,$275.69 ,$421.00 ,$231.55 ,$275.69 ,$110.72 , N/A ,$24.77 ,$23.65 ,$289.47 ,$336.80 ,$228.60 ,$117.88 ,$378.90 ,$159.98 ,$421.00 ,$275.69 ,$202.08 
ST. MARY'S HOSPITAL - DECATUR,31100246,88185,HC FLOW CYTO EA ADD MARKER-90,311,1 ,$163.00 ,$105.95 ,$23.65 ,$163.00 , N/A ,$83.84 ,$89.65 , N/A ,$45.64 ,$79.87 , N/A ,$95.36 , N/A ,$88.51 ,$35.19 , N/A ,$88.51 , N/A ,$114.10 ,$81.50 ,$130.40 , N/A , N/A ,$114.10 , N/A ,$97.80 , N/A ,$122.25 ,$89.98 ,$81.17 ,$89.98 , N/A ,$89.98 ,$29.71 ,$29.71 ,$138.55 , N/A ,$112.96 , N/A ,$163.00 ,$89.65 , N/A ,$42.87 , N/A ,$24.77 ,$23.65 , N/A ,$130.40 ,$88.51 ,$45.64 ,$146.70 ,$61.94 ,$46.06 , N/A ,$78.24 
ST. MARY'S HOSPITAL - DECATUR,31100247,88185,HC FLOW CYTO EA ADD MARKER,311,1 ,$231.00 ,$150.15 ,$23.65 ,$231.00 , N/A ,$83.84 ,$127.05 , N/A ,$64.68 ,$113.19 , N/A ,$135.14 , N/A ,$125.43 ,$35.19 , N/A ,$125.43 , N/A ,$161.70 ,$115.50 ,$184.80 , N/A , N/A ,$161.70 , N/A ,$138.60 , N/A ,$173.25 ,$127.51 ,$115.04 ,$127.51 , N/A ,$127.51 ,$29.71 ,$29.71 ,$196.35 , N/A ,$160.08 , N/A ,$231.00 ,$127.05 , N/A ,$60.75 , N/A ,$24.77 ,$23.65 , N/A ,$184.80 ,$125.43 ,$64.68 ,$207.90 ,$87.78 ,$46.06 , N/A ,$110.88 
ST. MARY'S HOSPITAL - DECATUR,31100248,88187,HC FLOW CYTO INT 2-8 MARKERS-90,311,1 ,$170.00 ,$110.50 ,$21.49 ,$170.00 , N/A ,$115.34 ,$93.50 , N/A ,$47.60 ,$83.30 , N/A ,$99.45 , N/A ,$92.31 ,$59.74 , N/A ,$92.31 , N/A ,$119.00 ,$85.00 ,$136.00 , N/A , N/A ,$119.00 , N/A ,$102.00 , N/A ,$127.50 ,$93.84 ,$84.66 ,$93.84 , N/A ,$93.84 ,$49.71 ,$49.71 ,$144.50 , N/A ,$117.81 , N/A ,$170.00 ,$93.50 , N/A ,$44.71 , N/A ,$22.52 ,$21.49 , N/A ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$73.28 , N/A ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,31100249,88188,HC FLOW CYTO INT 9-15 MARKERS-90,311,1 ,$667.00 ,$433.55 ,$21.49 ,$667.00 , N/A ,$147.02 ,$366.85 , N/A ,$186.76 ,$326.83 , N/A ,$390.20 , N/A ,$362.18 ,$101.13 , N/A ,$362.18 , N/A ,$466.90 ,$333.50 ,$533.60 , N/A , N/A ,$466.90 , N/A ,$400.20 , N/A ,$500.25 ,$368.18 ,$332.17 ,$368.18 , N/A ,$368.18 ,$84.16 ,$84.16 ,$566.95 , N/A ,$462.23 , N/A ,$667.00 ,$366.85 , N/A ,$175.42 , N/A ,$22.52 ,$21.49 , N/A ,$533.60 ,$362.18 ,$186.76 ,$600.30 ,$253.46 ,$125.62 , N/A ,$320.16 
ST. MARY'S HOSPITAL - DECATUR,31100251,88230,HC TISSUE CULT NONNEO LYMPHOCYTE-90,311,1 ,$940.00 ,$611.00 ,$3.50 ,$940.00 ,$291.23 ,$272.24 ,$517.00 ,$116.49 ,$263.20 ,$460.60 ,$116.49 ,$549.90 ,$116.49 ,$510.42 ,$3.50 ,$116.49 ,$510.42 ,$221.33 ,$658.00 ,$470.00 ,$752.00 ,$291.23 ,$116.49 ,$658.00 ,$116.49 ,$564.00 ,$116.49 ,$705.00 ,$518.88 ,$468.12 ,$518.88 ,$116.49 ,$518.88 ,$168.27 ,$168.27 ,$799.00 ,$291.23 ,$651.42 ,$116.49 ,$940.00 ,$517.00 ,$116.49 ,$247.22 , N/A ,$24.77 ,$23.65 ,$122.31 ,$752.00 ,$510.42 ,$263.20 ,$846.00 ,$357.20 ,$232.98 ,$116.49 ,$451.20 
ST. MARY'S HOSPITAL - DECATUR,31100252,88233,HC TISSUE CULT SKIN/OTH SOLID-90,311,1 ,$697.00 ,$453.05 ,$3.50 ,$697.00 ,$351.83 ,$328.84 ,$383.35 ,$140.73 ,$195.16 ,$341.53 ,$140.73 ,$407.75 ,$140.73 ,$378.47 ,$3.50 ,$140.73 ,$378.47 ,$267.39 ,$487.90 ,$348.50 ,$557.60 ,$351.83 ,$140.73 ,$487.90 ,$140.73 ,$418.20 ,$140.73 ,$522.75 ,$384.74 ,$347.11 ,$384.74 ,$140.73 ,$384.74 ,$203.27 ,$203.27 ,$592.45 ,$351.83 ,$483.02 ,$140.73 ,$697.00 ,$383.35 ,$140.73 ,$183.31 , N/A ,$24.77 ,$23.65 ,$147.77 ,$557.60 ,$378.47 ,$195.16 ,$627.30 ,$264.86 ,$281.46 ,$140.73 ,$334.56 
ST. MARY'S HOSPITAL - DECATUR,31100253,88235,HC TISSUE CULT AMNIO/CHORION-90,311,1 ,"$1,097.00 ",$713.05 ,$3.50 ,"$1,097.00 ",$375.75 ,$344.12 ,$603.35 ,$150.30 ,$307.16 ,$537.53 ,$150.30 ,$641.75 ,$150.30 ,$595.67 ,$3.50 ,$150.30 ,$595.67 ,$285.57 ,$767.90 ,$548.50 ,$877.60 ,$375.75 ,$150.30 ,$767.90 ,$150.30 ,$658.20 ,$150.30 ,$822.75 ,$605.54 ,$546.31 ,$605.54 ,$150.30 ,$605.54 ,$212.72 ,$212.72 ,$932.45 ,$375.75 ,$760.22 ,$150.30 ,"$1,097.00 ",$603.35 ,$150.30 ,$288.51 , N/A ,$24.77 ,$23.65 ,$157.82 ,$877.60 ,$595.67 ,$307.16 ,$987.30 ,$416.86 ,$300.60 ,$150.30 ,$526.56 
ST. MARY'S HOSPITAL - DECATUR,31100255,88237,HC TISSUE CULT BONE/BLD-90,311,1 ,$554.00 ,$360.10 ,$3.50 ,$554.00 ,$359.38 ,$295.16 ,$304.70 ,$143.75 ,$155.12 ,$271.46 ,$143.75 ,$324.09 ,$143.75 ,$300.82 ,$3.50 ,$143.75 ,$300.82 ,$273.13 ,$387.80 ,$277.00 ,$443.20 ,$359.38 ,$143.75 ,$387.80 ,$143.75 ,$332.40 ,$143.75 ,$415.50 ,$305.81 ,$275.89 ,$305.81 ,$143.75 ,$305.81 ,$186.88 ,$186.88 ,$470.90 ,$359.38 ,$383.92 ,$143.75 ,$554.00 ,$304.70 ,$143.75 ,$145.70 , N/A ,$24.77 ,$23.65 ,$150.94 ,$443.20 ,$300.82 ,$155.12 ,$498.60 ,$210.52 ,$287.50 ,$143.75 ,$265.92 
ST. MARY'S HOSPITAL - DECATUR,31100257,88262,HC CHROM COUNT 15-20/2-90,311,1 ,$697.00 ,$453.05 ,$3.50 ,$697.00 ,$313.73 ,$291.26 ,$383.35 ,$125.49 ,$195.16 ,$341.53 ,$125.49 ,$407.75 ,$125.49 ,$378.47 ,$3.50 ,$125.49 ,$378.47 ,$238.43 ,$487.90 ,$348.50 ,$557.60 ,$313.73 ,$125.49 ,$487.90 ,$125.49 ,$418.20 ,$125.49 ,$522.75 ,$384.74 ,$347.11 ,$384.74 ,$125.49 ,$384.74 ,$180.04 ,$180.04 ,$592.45 ,$313.73 ,$483.02 ,$125.49 ,$697.00 ,$383.35 ,$125.49 ,$183.31 , N/A ,$27.97 ,$26.70 ,$131.76 ,$557.60 ,$378.47 ,$195.16 ,$627.30 ,$264.86 ,$250.98 ,$125.49 ,$334.56 
ST. MARY'S HOSPITAL - DECATUR,31100258,88264,HC CHROM ANLYS ANALYZE 20-90,311,1 ,$593.00 ,$385.45 ,$3.50 ,$593.00 ,$361.53 ,$291.26 ,$326.15 ,$144.61 ,$166.04 ,$290.57 ,$144.61 ,$346.91 ,$144.61 ,$322.00 ,$3.50 ,$144.61 ,$322.00 ,$274.76 ,$415.10 ,$296.50 ,$474.40 ,$361.53 ,$144.61 ,$415.10 ,$144.61 ,$355.80 ,$144.61 ,$444.75 ,$327.34 ,$295.31 ,$327.34 ,$144.61 ,$327.34 ,$187.99 ,$187.99 ,$504.05 ,$361.53 ,$410.95 ,$144.61 ,$593.00 ,$326.15 ,$144.61 ,$155.96 , N/A ,$27.97 ,$26.70 ,$151.84 ,$474.40 ,$322.00 ,$166.04 ,$533.70 ,$225.34 ,$289.22 ,$144.61 ,$284.64 
ST. MARY'S HOSPITAL - DECATUR,31100261,88271,HC MCG DNA PROBE(FISH)-90,311,1 ,$208.00 ,$135.20 ,$3.50 ,$208.00 ,$53.55 ,$33.84 ,$114.40 ,$21.42 ,$58.24 ,$101.92 ,$21.42 ,$121.68 ,$21.42 ,$112.94 ,$3.50 ,$21.42 ,$112.94 ,$40.70 ,$145.60 ,$104.00 ,$166.40 ,$53.55 ,$21.42 ,$145.60 ,$21.42 ,$124.80 ,$21.42 ,$156.00 ,$114.82 ,$103.58 ,$114.82 ,$21.42 ,$114.82 ,$30.94 ,$30.94 ,$176.80 ,$53.55 ,$144.14 ,$21.42 ,$208.00 ,$114.40 ,$21.42 ,$54.70 , N/A ,$27.97 ,$26.70 ,$22.49 ,$166.40 ,$112.94 ,$58.24 ,$187.20 ,$79.04 ,$42.84 ,$21.42 ,$99.84 
ST. MARY'S HOSPITAL - DECATUR,31100267,88273,HC MCG CHROM INSITU 10-30 -90,311,1 ,$92.00 ,$59.80 ,$3.50 ,$92.00 ,$87.03 ,$75.08 ,$50.60 ,$34.81 ,$25.76 ,$45.08 ,$34.81 ,$53.82 ,$34.81 ,$49.96 ,$3.50 ,$34.81 ,$49.96 ,$66.14 ,$64.40 ,$46.00 ,$73.60 ,$87.03 ,$34.81 ,$64.40 ,$34.81 ,$55.20 ,$34.81 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$34.81 ,$50.78 ,$46.41 ,$46.41 ,$78.20 ,$87.03 ,$63.76 ,$34.81 ,$92.00 ,$50.60 ,$34.81 ,$24.20 , N/A ,$27.97 ,$26.70 ,$36.55 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$69.62 ,$34.81 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,31100268,88274,HC MCG INTERPHASE INSITU 25 -90,311,1 ,$667.00 ,$433.55 ,$3.50 ,$667.00 ,$105.95 ,$81.34 ,$366.85 ,$42.38 ,$186.76 ,$274.65 ,$42.38 ,$274.65 ,$42.38 ,$362.18 ,$3.50 ,$42.38 ,$362.18 ,$80.52 ,$466.90 ,$333.50 ,$533.60 ,$105.95 ,$42.38 ,$466.90 ,$42.38 ,$400.20 ,$42.38 ,$500.25 ,$368.18 ,$332.17 ,$368.18 ,$42.38 ,$368.18 ,$55.09 ,$55.09 ,$566.95 ,$105.95 ,$462.23 ,$42.38 ,$667.00 ,$366.85 ,$42.38 ,$175.42 , N/A ,$27.97 ,$26.70 ,$44.50 ,$533.60 ,$362.18 ,$186.76 ,$600.30 ,$253.46 ,$84.76 ,$42.38 ,$320.16 
ST. MARY'S HOSPITAL - DECATUR,31100270,88275,HC MCG INTERPH INSITU FISH 100-90,311,1 ,$208.00 ,$135.20 ,$3.50 ,$208.00 ,$127.98 ,$93.84 ,$114.40 ,$51.19 ,$58.24 ,$101.92 ,$51.19 ,$121.68 ,$51.19 ,$112.94 ,$3.50 ,$51.19 ,$112.94 ,$97.26 ,$145.60 ,$104.00 ,$166.40 ,$127.98 ,$51.19 ,$145.60 ,$51.19 ,$124.80 ,$51.19 ,$156.00 ,$114.82 ,$103.58 ,$114.82 ,$51.19 ,$114.82 ,$66.55 ,$66.55 ,$176.80 ,$127.98 ,$144.14 ,$51.19 ,$208.00 ,$114.40 ,$51.19 ,$54.70 , N/A ,$27.97 ,$26.70 ,$53.75 ,$166.40 ,$112.94 ,$58.24 ,$187.20 ,$79.04 ,$102.38 ,$51.19 ,$99.84 
ST. MARY'S HOSPITAL - DECATUR,31100273,88280,HC CHROM ADDL KARYO-90,311,1 ,$92.00 ,$59.80 ,$3.50 ,$92.00 ,$83.68 ,$58.66 ,$50.60 ,$33.47 ,$25.76 ,$45.08 ,$33.47 ,$53.82 ,$33.47 ,$49.96 ,$3.50 ,$33.47 ,$49.96 ,$63.59 ,$64.40 ,$46.00 ,$73.60 ,$83.68 ,$33.47 ,$64.40 ,$33.47 ,$55.20 ,$33.47 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$33.47 ,$50.78 ,$43.51 ,$43.51 ,$78.20 ,$83.68 ,$63.76 ,$33.47 ,$92.00 ,$50.60 ,$33.47 ,$24.20 , N/A ,$27.97 ,$26.70 ,$35.14 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$66.94 ,$33.47 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,31100274,88289,HC CHROM ADDL HIGH RES-90,311,1 ,"$1,720.00 ","$1,118.00 ",$3.50 ,"$1,720.00 ",$86.08 ,$69.02 ,$946.00 ,$34.43 ,$481.60 ,$271.60 ,$34.43 ,$271.60 ,$34.43 ,$933.96 ,$3.50 ,$34.43 ,$933.96 ,$65.42 ,"$1,204.00 ",$860.00 ,"$1,376.00 ",$86.08 ,$34.43 ,"$1,204.00 ",$34.43 ,"$1,032.00 ",$34.43 ,"$1,290.00 ",$949.44 ,$856.56 ,$949.44 ,$34.43 ,$949.44 ,$49.74 ,$49.74 ,"$1,462.00 ",$86.08 ,"$1,191.96 ",$34.43 ,"$1,720.00 ",$946.00 ,$34.43 ,$452.36 , N/A ,$27.97 ,$26.70 ,$36.15 ,"$1,376.00 ",$933.96 ,$481.60 ,"$1,548.00 ",$653.60 ,$68.86 ,$34.43 ,$825.60 
ST. MARY'S HOSPITAL - DECATUR,31100275,88291,HC INTERPRETATION-90,311,1 ,$353.00 ,$229.45 ,$26.70 ,$353.00 , N/A ,$180.03 ,$194.15 , N/A ,$98.84 ,$172.97 , N/A ,$206.51 , N/A ,$191.68 ,$51.33 , N/A ,$191.68 , N/A ,$247.10 ,$176.50 ,$282.40 , N/A , N/A ,$247.10 , N/A ,$211.80 , N/A ,$264.75 ,$194.86 ,$175.79 ,$194.86 , N/A ,$194.86 ,$42.72 ,$42.72 ,$300.05 , N/A ,$244.63 , N/A ,$353.00 ,$194.15 , N/A ,$92.84 , N/A ,$27.97 ,$26.70 , N/A ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$67.70 , N/A ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,31100276,88291,HC INTERP POC ANEUPLOIDY DETECT-90,311,1 ,$353.00 ,$229.45 ,$26.70 ,$353.00 , N/A ,$180.03 ,$194.15 , N/A ,$98.84 ,$172.97 , N/A ,$206.51 , N/A ,$191.68 ,$51.33 , N/A ,$191.68 , N/A ,$247.10 ,$176.50 ,$282.40 , N/A , N/A ,$247.10 , N/A ,$211.80 , N/A ,$264.75 ,$194.86 ,$175.79 ,$194.86 , N/A ,$194.86 ,$42.72 ,$42.72 ,$300.05 , N/A ,$244.63 , N/A ,$353.00 ,$194.15 , N/A ,$92.84 , N/A ,$27.97 ,$26.70 , N/A ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$67.70 , N/A ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,31100277,88291,HC INTERP CHROMOSOMES POC/FETAL-90,311,1 ,$353.00 ,$229.45 ,$26.70 ,$353.00 , N/A ,$180.03 ,$194.15 , N/A ,$98.84 ,$172.97 , N/A ,$206.51 , N/A ,$191.68 ,$51.33 , N/A ,$191.68 , N/A ,$247.10 ,$176.50 ,$282.40 , N/A , N/A ,$247.10 , N/A ,$211.80 , N/A ,$264.75 ,$194.86 ,$175.79 ,$194.86 , N/A ,$194.86 ,$42.72 ,$42.72 ,$300.05 , N/A ,$244.63 , N/A ,$353.00 ,$194.15 , N/A ,$92.84 , N/A ,$27.97 ,$26.70 , N/A ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$67.70 , N/A ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,31100278,88291,HC INTERPRETATION,311,1 ,$168.00 ,$109.20 ,$26.70 ,$168.00 , N/A ,$85.68 ,$92.40 , N/A ,$47.04 ,$82.32 , N/A ,$98.28 , N/A ,$91.22 ,$51.33 , N/A ,$91.22 , N/A ,$117.60 ,$84.00 ,$134.40 , N/A , N/A ,$117.60 , N/A ,$100.80 , N/A ,$126.00 ,$92.74 ,$83.66 ,$92.74 , N/A ,$92.74 ,$42.72 ,$42.72 ,$142.80 , N/A ,$116.42 , N/A ,$168.00 ,$92.40 , N/A ,$44.18 , N/A ,$27.97 ,$26.70 , N/A ,$134.40 ,$91.22 ,$47.04 ,$151.20 ,$63.84 ,$67.70 , N/A ,$80.64 
ST. MARY'S HOSPITAL - DECATUR,31100279,88299,HC FSH MOL PATH CYTOGEN UNLSTD-90,311,1 ,$803.00 ,$521.95 ,$26.70 ,$803.00 ,$117.60 ,$409.53 ,$441.65 ,$47.04 ,$224.84 ,$377.41 ,$47.04 ,$433.62 ,$47.04 ,$436.03 ,$321.20 ,$47.04 ,$436.03 ,$89.37 ,$562.10 ,$401.50 ,$642.40 ,$117.60 ,$47.04 ,$562.10 ,$47.04 ,$481.80 ,$47.04 ,$602.25 ,$443.26 ,$399.89 ,$443.26 ,$47.04 ,$443.26 ,$562.10 ,$562.10 ,$682.55 ,$117.60 ,$556.48 ,$47.04 ,$803.00 ,$441.65 ,$47.04 ,$211.19 , N/A ,$27.97 ,$26.70 ,$49.39 ,$642.40 ,$436.03 ,$224.84 ,$722.70 ,$305.14 ,$99.52 ,$47.04 ,$385.44 
ST. MARY'S HOSPITAL - DECATUR,31100280,G0145,HC CYTOPATH PAP SCREEN INIT/REDO,311,1 ,$228.00 ,$148.20 ,$15.58 ,$228.00 ,$66.23 ,$61.60 ,$125.40 ,$26.49 ,$63.84 ,$111.72 ,$26.49 ,$133.38 ,$26.49 ,$123.80 ,$20.90 ,$26.49 ,$123.80 ,$50.33 ,$159.60 ,$114.00 ,$182.40 ,$66.23 ,$26.49 ,$159.60 ,$26.49 ,$136.80 ,$26.49 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$26.49 ,$125.86 ,$38.27 ,$38.27 ,$193.80 ,$66.23 ,$158.00 ,$26.49 ,$228.00 ,$125.40 ,$26.49 ,$59.96 , N/A ,$16.32 ,$15.58 ,$27.81 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$52.98 ,$26.49 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,31100282,88164,HC CYTOPATH SCR BETHESDA-90,311,1 ,$158.00 ,$102.70 ,$3.50 ,$158.00 ,$39.80 ,$24.70 ,$86.90 ,$15.92 ,$44.24 ,$77.42 ,$15.92 ,$92.43 ,$15.92 ,$85.79 ,$3.50 ,$15.92 ,$85.79 ,$30.25 ,$110.60 ,$79.00 ,$126.40 ,$39.80 ,$15.92 ,$110.60 ,$15.92 ,$94.80 ,$15.92 ,$118.50 ,$87.22 ,$78.68 ,$87.22 ,$15.92 ,$87.22 ,$19.49 ,$19.49 ,$134.30 ,$39.80 ,$109.49 ,$15.92 ,$15.15 ,$86.90 ,$15.92 ,$41.55 , N/A ,$16.32 ,$15.58 ,$16.72 ,$126.40 ,$85.79 ,$44.24 ,$142.20 ,$60.04 ,$30.30 ,$15.92 ,$75.84 
ST. MARY'S HOSPITAL - DECATUR,31100283,88120,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC-90,311,1 ,"$1,289.00 ",$837.85 ,$23.65 ,"$1,289.00 ",$352.95 ,$872.98 ,$708.95 ,$141.18 ,$360.92 ,$631.61 ,$141.18 ,$754.07 ,$141.18 ,$699.93 ,$787.80 ,$141.18 ,$699.93 ,$268.24 ,$902.30 ,$644.50 ,"$1,031.20 ",$352.95 ,$141.18 ,$902.30 ,$141.18 ,$773.40 ,$141.18 ,$966.75 ,$711.53 ,$641.92 ,$711.53 ,$141.18 ,$711.53 ,$655.58 ,$655.58 ,"$1,095.65 ",$352.95 ,$893.28 ,$141.18 ,"$1,289.00 ",$708.95 ,$141.18 ,$339.01 , N/A ,$24.77 ,$23.65 ,$148.24 ,"$1,031.20 ",$699.93 ,$360.92 ,"$1,160.10 ",$489.82 ,$298.32 ,$141.18 ,$618.72 
ST. MARY'S HOSPITAL - DECATUR,31100284,88369,HC MORPH ANALYSIS INST HYBRID EA SINGLE-90,311,1 ,$684.00 ,$444.60 ,$23.65 ,$684.00 , N/A ,$75.36 ,$376.20 , N/A ,$191.52 ,$335.16 , N/A ,$400.14 , N/A ,$371.41 ,$113.99 , N/A ,$371.41 , N/A ,$478.80 ,$342.00 ,$547.20 , N/A , N/A ,$478.80 , N/A ,$410.40 , N/A ,$513.00 ,$377.57 ,$340.63 ,$377.57 , N/A ,$377.57 ,$94.86 ,$94.86 ,$581.40 , N/A ,$474.01 , N/A ,$684.00 ,$376.20 , N/A ,$179.89 , N/A ,$24.77 ,$23.65 , N/A ,$547.20 ,$371.41 ,$191.52 ,$615.60 ,$259.92 ,$171.68 , N/A ,$328.32 
ST. MARY'S HOSPITAL - DECATUR,31100310,88121,HC CYTOPATH URINE 3-5 MOL PROBES EA SPEC COMP ASSIST-90,311,1 ,"$1,514.00 ",$984.10 ,$23.65 ,"$1,514.00 ",$689.23 ,$786.26 ,$832.70 ,$275.69 ,$423.92 ,$741.86 ,$275.69 ,$885.69 ,$275.69 ,$822.10 ,$627.77 ,$275.69 ,$822.10 ,$523.82 ,"$1,059.80 ",$757.00 ,"$1,211.20 ",$689.24 ,$275.69 ,"$1,059.80 ",$275.69 ,$908.40 ,$275.69 ,"$1,135.50 ",$835.73 ,$753.97 ,$835.73 ,$275.69 ,$835.73 ,$522.41 ,$522.41 ,"$1,286.90 ",$689.24 ,"$1,049.20 ",$275.69 ,"$1,514.00 ",$832.70 ,$275.69 ,$398.18 , N/A ,$24.77 ,$23.65 ,$289.47 ,"$1,211.20 ",$822.10 ,$423.92 ,"$1,362.60 ",$575.32 ,$582.52 ,$275.69 ,$726.72 
ST. MARY'S HOSPITAL - DECATUR,31140130,88189,HC FLOW CYTO INT 9-15 MARKERS-REF,311,1 ,$432.00 ,$280.80 ,$21.49 ,$432.00 , N/A ,$179.26 ,$237.60 , N/A ,$120.96 ,$211.68 , N/A ,$252.72 , N/A ,$234.58 ,$135.82 , N/A ,$234.58 , N/A ,$302.40 ,$216.00 ,$345.60 , N/A , N/A ,$302.40 , N/A ,$259.20 , N/A ,$324.00 ,$238.46 ,$215.14 ,$238.46 , N/A ,$238.46 ,$113.02 ,$113.02 ,$367.20 , N/A ,$299.38 , N/A ,$432.00 ,$237.60 , N/A ,$113.62 , N/A ,$22.52 ,$21.49 , N/A ,$345.60 ,$234.58 ,$120.96 ,$388.80 ,$164.16 ,$170.28 , N/A ,$207.36 
ST. MARY'S HOSPITAL - DECATUR,31200101,88300,HC GROSS ONLY LEVEL I,312,1 ,$228.00 ,$148.20 ,$13.91 ,$228.00 ,$58.45 ,$16.02 ,$125.40 ,$23.38 ,$63.84 ,$111.72 ,$23.38 ,$133.38 ,$23.38 ,$123.80 ,$16.72 ,$23.38 ,$123.80 ,$44.43 ,$159.60 ,$114.00 ,$182.40 ,$58.46 ,$23.38 ,$159.60 ,$23.38 ,$136.80 ,$23.38 ,$171.00 ,$125.86 ,$113.54 ,$125.86 ,$23.38 ,$125.86 ,$13.91 ,$13.91 ,$193.80 ,$58.46 ,$158.00 ,$23.38 ,$228.00 ,$125.40 ,$23.38 ,$59.96 , N/A ,$22.52 ,$21.49 ,$24.55 ,$182.40 ,$123.80 ,$63.84 ,$205.20 ,$86.64 ,$49.34 ,$23.38 ,$109.44 
ST. MARY'S HOSPITAL - DECATUR,31200102,88302,HC GROSS  AND  MICRO LEVEL II,312,1 ,$290.00 ,$188.50 ,$21.49 ,$290.00 ,$58.45 ,$37.58 ,$159.50 ,$23.38 ,$81.20 ,$142.10 ,$23.38 ,$169.65 ,$23.38 ,$157.47 ,$34.83 ,$23.38 ,$157.47 ,$44.43 ,$203.00 ,$145.00 ,$232.00 ,$58.46 ,$23.38 ,$203.00 ,$23.38 ,$174.00 ,$23.38 ,$217.50 ,$160.08 ,$144.42 ,$160.08 ,$23.38 ,$160.08 ,$28.98 ,$28.98 ,$246.50 ,$58.46 ,$200.97 ,$23.38 ,$290.00 ,$159.50 ,$23.38 ,$76.27 , N/A ,$22.52 ,$21.49 ,$24.55 ,$232.00 ,$157.47 ,$81.20 ,$261.00 ,$110.20 ,$49.34 ,$23.38 ,$139.20 
ST. MARY'S HOSPITAL - DECATUR,31200103,88304,HC GROSS  AND  MICRO LEVEL III,312,1 ,$443.00 ,$287.95 ,$21.49 ,$443.00 ,$117.60 ,$51.78 ,$243.65 ,$47.04 ,$124.04 ,$217.07 ,$47.04 ,$259.16 ,$47.04 ,$240.55 ,$42.07 ,$47.04 ,$240.55 ,$89.37 ,$310.10 ,$221.50 ,$354.40 ,$117.60 ,$47.04 ,$310.10 ,$47.04 ,$265.80 ,$47.04 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$47.04 ,$244.54 ,$35.01 ,$35.01 ,$376.55 ,$117.60 ,$307.00 ,$47.04 ,$443.00 ,$243.65 ,$47.04 ,$116.51 , N/A ,$22.52 ,$21.49 ,$49.39 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$99.52 ,$47.04 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,31200108,88305,HC GROSS  AND  MICRO LEVEL IV,312,1 ,$569.00 ,$369.85 ,$21.49 ,$569.00 ,$117.60 ,$51.78 ,$312.95 ,$47.04 ,$159.32 ,$278.81 ,$47.04 ,$332.87 ,$47.04 ,$308.97 ,$105.00 ,$47.04 ,$308.97 ,$89.37 ,$398.30 ,$284.50 ,$455.20 ,$117.60 ,$47.04 ,$398.30 ,$47.04 ,$341.40 ,$47.04 ,$426.75 ,$314.09 ,$283.36 ,$314.09 ,$47.04 ,$314.09 ,$36.74 ,$36.74 ,$483.65 ,$117.60 ,$394.32 ,$47.04 ,$35.62 ,$312.95 ,$47.04 ,$149.65 , N/A ,$22.52 ,$21.49 ,$49.39 ,$455.20 ,$308.97 ,$159.32 ,$512.10 ,$216.22 ,$99.52 ,$47.04 ,$273.12 
ST. MARY'S HOSPITAL - DECATUR,31200110,88307,HC GROSS  AND  MICRO LEVEL V,312,1 ,$958.00 ,$622.70 ,$23.65 ,$958.00 ,$689.23 ,$333.06 ,$526.90 ,$275.69 ,$268.24 ,$469.42 ,$275.69 ,$560.43 ,$275.69 ,$520.19 ,$268.34 ,$275.69 ,$520.19 ,$523.82 ,$670.60 ,$479.00 ,$766.40 ,$689.24 ,$275.69 ,$670.60 ,$275.69 ,$574.80 ,$275.69 ,$718.50 ,$528.82 ,$477.08 ,$528.82 ,$275.69 ,$528.82 ,$223.30 ,$223.30 ,$814.30 ,$689.24 ,$663.89 ,$275.69 ,$217.17 ,$526.90 ,$275.69 ,$251.95 , N/A ,$24.77 ,$23.65 ,$289.47 ,$766.40 ,$520.19 ,$268.24 ,$862.20 ,$364.04 ,$582.52 ,$275.69 ,$459.84 
ST. MARY'S HOSPITAL - DECATUR,31200113,88309,HC GROSS  AND  MICRO LEVEL VI,312,1 ,"$1,273.00 ",$827.45 ,$23.65 ,"$1,550.85 ","$1,550.85 ",$471.30 ,$700.15 ,$620.34 ,$356.44 ,$623.77 ,$620.34 ,$744.71 ,$620.34 ,$691.24 ,$376.64 ,$620.34 ,$691.24 ,"$1,178.64 ",$891.10 ,$636.50 ,"$1,018.40 ","$1,550.85 ",$620.34 ,$891.10 ,$620.34 ,$763.80 ,$620.34 ,$954.75 ,$702.70 ,$633.95 ,$702.70 ,$620.34 ,$702.70 ,$313.42 ,$313.42 ,"$1,082.05 ","$1,273.00 ",$882.19 ,$620.34 ,"$1,273.00 ",$700.15 ,$620.34 ,$334.80 , N/A ,$24.77 ,$23.65 ,$651.36 ,"$1,018.40 ",$691.24 ,$356.44 ,"$1,145.70 ",$483.74 ,"$1,273.00 ",$620.34 ,$611.04 
ST. MARY'S HOSPITAL - DECATUR,31200116,88311,HC DECALCIFICATION,312,1 ,$220.00 ,$143.00 ,$10.89 ,$220.00 , N/A ,$12.86 ,$121.00 , N/A ,$61.60 ,$107.80 , N/A ,$128.70 , N/A ,$119.46 ,$13.10 , N/A ,$119.46 , N/A ,$154.00 ,$110.00 ,$176.00 , N/A , N/A ,$154.00 , N/A ,$132.00 , N/A ,$165.00 ,$121.44 ,$109.56 ,$121.44 , N/A ,$121.44 ,$10.89 ,$10.89 ,$187.00 , N/A ,$152.46 , N/A ,$220.00 ,$121.00 , N/A ,$57.86 , N/A ,$22.52 ,$21.49 , N/A ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 ,$17.44 , N/A ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,31200123,88312,HC SPECIAL STAIN I,312,1 ,$306.00 ,$198.90 ,$21.49 ,$306.00 ,$117.60 ,$110.14 ,$168.30 ,$47.04 ,$85.68 ,$149.94 ,$47.04 ,$179.01 ,$47.04 ,$166.16 ,$106.75 ,$47.04 ,$166.16 ,$89.37 ,$214.20 ,$153.00 ,$244.80 ,$117.60 ,$47.04 ,$214.20 ,$47.04 ,$183.60 ,$47.04 ,$229.50 ,$168.91 ,$152.39 ,$168.91 ,$47.04 ,$168.91 ,$88.83 ,$88.83 ,$260.10 ,$117.60 ,$212.06 ,$47.04 ,$306.00 ,$168.30 ,$47.04 ,$80.48 , N/A ,$22.52 ,$21.49 ,$49.39 ,$244.80 ,$166.16 ,$85.68 ,$275.40 ,$116.28 ,$99.52 ,$47.04 ,$146.88 
ST. MARY'S HOSPITAL - DECATUR,31200125,88313,HC SPECIAL STAIN II,312,1 ,$356.00 ,$231.40 ,$21.49 ,$356.00 ,$80.10 ,$86.48 ,$195.80 ,$32.04 ,$99.68 ,$174.44 ,$32.04 ,$208.26 ,$32.04 ,$193.31 ,$88.12 ,$32.04 ,$193.31 ,$60.88 ,$249.20 ,$178.00 ,$284.80 ,$80.10 ,$32.04 ,$249.20 ,$32.04 ,$213.60 ,$32.04 ,$267.00 ,$196.51 ,$177.29 ,$196.51 ,$32.04 ,$196.51 ,$73.33 ,$73.33 ,$302.60 ,$80.10 ,$246.71 ,$32.04 ,$356.00 ,$195.80 ,$32.04 ,$93.63 , N/A ,$22.52 ,$21.49 ,$33.64 ,$284.80 ,$193.31 ,$99.68 ,$320.40 ,$135.28 ,$67.68 ,$32.04 ,$170.88 
ST. MARY'S HOSPITAL - DECATUR,31200159,88321,HC CONSULT REFERRED SLIDES,312,1 ,$443.00 ,$287.95 ,$21.49 ,$443.00 ,$80.10 ,$139.86 ,$243.65 ,$32.04 ,$124.04 ,$217.07 ,$32.04 ,$259.16 ,$32.04 ,$240.55 ,$133.95 ,$32.04 ,$240.55 ,$60.88 ,$310.10 ,$221.50 ,$354.40 ,$80.10 ,$32.04 ,$310.10 ,$32.04 ,$265.80 ,$32.04 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$32.04 ,$244.54 ,$129.97 ,$129.97 ,$376.55 ,$80.10 ,$307.00 ,$32.04 ,$443.00 ,$243.65 ,$32.04 ,$116.51 , N/A ,$22.52 ,$21.49 ,$33.64 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$67.68 ,$32.04 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,31200172,88329,HC CONSULT PATH SURGERY,312,1 ,$299.00 ,$194.35 ,$21.49 ,$299.00 ,$80.10 ,$59.72 ,$164.45 ,$32.04 ,$83.72 ,$146.51 ,$32.04 ,$174.92 ,$32.04 ,$162.36 ,$57.52 ,$32.04 ,$162.36 ,$60.88 ,$209.30 ,$149.50 ,$239.20 ,$80.10 ,$32.04 ,$209.30 ,$32.04 ,$179.40 ,$32.04 ,$224.25 ,$165.05 ,$148.90 ,$165.05 ,$32.04 ,$165.05 ,$66.38 ,$66.38 ,$254.15 ,$80.10 ,$207.21 ,$32.04 ,$299.00 ,$164.45 ,$32.04 ,$78.64 , N/A ,$22.52 ,$21.49 ,$33.64 ,$239.20 ,$162.36 ,$83.72 ,$269.10 ,$113.62 ,$67.68 ,$32.04 ,$143.52 
ST. MARY'S HOSPITAL - DECATUR,31200173,88331,HC CONSULT PATH SURG W/FROZEN,312,1 ,"$1,033.00 ",$671.45 ,$21.49 ,"$1,033.00 ",$352.95 ,$59.66 ,$568.15 ,$141.18 ,$289.24 ,$506.17 ,$141.18 ,$604.31 ,$141.18 ,$560.92 ,$48.28 ,$141.18 ,$560.92 ,$268.24 ,$723.10 ,$516.50 ,$826.40 ,$352.95 ,$141.18 ,$723.10 ,$141.18 ,$619.80 ,$141.18 ,$774.75 ,$570.22 ,$514.43 ,$570.22 ,$141.18 ,$570.22 ,$40.18 ,$40.18 ,$878.05 ,$352.95 ,$715.87 ,$141.18 ,$44.37 ,$568.15 ,$141.18 ,$271.68 , N/A ,$22.52 ,$21.49 ,$148.24 ,$826.40 ,$560.92 ,$289.24 ,$929.70 ,$392.54 ,$298.32 ,$141.18 ,$495.84 
ST. MARY'S HOSPITAL - DECATUR,31200174,88332,HC CONSULT PATH SURG ADDL FROZEN,312,1 ,$569.00 ,$369.85 ,$20.76 ,$569.00 , N/A ,$20.76 ,$312.95 , N/A ,$159.32 ,$278.81 , N/A ,$332.87 , N/A ,$308.97 ,$31.72 , N/A ,$308.97 , N/A ,$398.30 ,$284.50 ,$455.20 , N/A , N/A ,$398.30 , N/A ,$341.40 , N/A ,$426.75 ,$314.09 ,$283.36 ,$314.09 , N/A ,$314.09 ,$26.40 ,$26.40 ,$483.65 , N/A ,$394.32 , N/A ,$25.42 ,$312.95 , N/A ,$149.65 , N/A ,$22.52 ,$21.49 , N/A ,$455.20 ,$308.97 ,$159.32 ,$512.10 ,$216.22 ,$48.16 , N/A ,$273.12 
ST. MARY'S HOSPITAL - DECATUR,31200175,88333,HC CONSULT PATH SURG CYTO INIT,312,1 ,$492.00 ,$319.80 ,$21.49 ,"$1,550.85 ","$1,550.85 ",$66.50 ,$270.60 ,$620.34 ,$137.76 ,$241.08 ,$620.34 ,$287.82 ,$492.00 ,$267.16 ,$36.90 ,$492.00 ,$267.16 ,$492.00 ,$344.40 ,$246.00 ,$393.60 ,"$1,550.85 ",$620.34 ,$344.40 ,$620.34 ,$295.20 ,$620.34 ,$369.00 ,$271.58 ,$245.02 ,$271.58 ,$620.34 ,$271.58 ,$30.71 ,$30.71 ,$418.20 ,$492.00 ,$340.96 ,$620.34 ,$492.00 ,$270.60 ,$620.34 ,$129.40 , N/A ,$22.52 ,$21.49 ,$651.36 ,$393.60 ,$267.16 ,$137.76 ,$442.80 ,$186.96 ,$492.00 ,$620.34 ,$236.16 
ST. MARY'S HOSPITAL - DECATUR,31200176,88334,HC CONSULT PATH SURG EA ADDL,312,1 ,$492.00 ,$319.80 ,$20.24 ,$492.00 , N/A ,$42.30 ,$270.60 , N/A ,$137.76 ,$241.08 , N/A ,$287.82 , N/A ,$267.16 ,$24.32 , N/A ,$267.16 , N/A ,$344.40 ,$246.00 ,$393.60 , N/A , N/A ,$344.40 , N/A ,$295.20 , N/A ,$369.00 ,$271.58 ,$245.02 ,$271.58 , N/A ,$271.58 ,$20.24 ,$20.24 ,$418.20 , N/A ,$340.96 , N/A ,$492.00 ,$270.60 , N/A ,$129.40 , N/A ,$22.52 ,$21.49 , N/A ,$393.60 ,$267.16 ,$137.76 ,$442.80 ,$186.96 ,$38.38 , N/A ,$236.16 
ST. MARY'S HOSPITAL - DECATUR,31200220,88342,HC IMMUNOHISTOCHEM AB-INITIAL,312,1 ,$469.00 ,$304.85 ,$21.49 ,$469.00 ,$352.95 ,$113.28 ,$257.95 ,$141.18 ,$131.32 ,$229.81 ,$141.18 ,$274.37 ,$141.18 ,$254.67 ,$102.61 ,$141.18 ,$254.67 ,$268.24 ,$328.30 ,$234.50 ,$375.20 ,$352.95 ,$141.18 ,$328.30 ,$141.18 ,$281.40 ,$141.18 ,$351.75 ,$258.89 ,$233.56 ,$258.89 ,$141.18 ,$258.89 ,$85.38 ,$85.38 ,$398.65 ,$352.95 ,$325.02 ,$141.18 ,$74.24 ,$257.95 ,$141.18 ,$123.35 , N/A ,$22.52 ,$21.49 ,$148.24 ,$375.20 ,$254.67 ,$131.32 ,$422.10 ,$178.22 ,$298.32 ,$141.18 ,$225.12 
ST. MARY'S HOSPITAL - DECATUR,31200249,88344,HC IMMUNOHISTOCHEM EA AB STAIN,312,1 ,$614.00 ,$399.10 ,$21.49 ,$689.24 ,$689.23 ,$119.00 ,$337.70 ,$275.69 ,$171.92 ,$300.86 ,$275.69 ,$359.19 ,$275.69 ,$333.40 ,$192.63 ,$275.69 ,$333.40 ,$523.82 ,$429.80 ,$307.00 ,$491.20 ,$689.24 ,$275.69 ,$429.80 ,$275.69 ,$368.40 ,$275.69 ,$460.50 ,$338.93 ,$305.77 ,$338.93 ,$275.69 ,$338.93 ,$160.30 ,$160.30 ,$521.90 ,$614.00 ,$425.50 ,$275.69 ,$614.00 ,$337.70 ,$275.69 ,$161.48 , N/A ,$22.52 ,$21.49 ,$289.47 ,$491.20 ,$333.40 ,$171.92 ,$552.60 ,$233.32 ,$582.52 ,$275.69 ,$294.72 
ST. MARY'S HOSPITAL - DECATUR,31200252,88305,HC GROSS  AND  MICRO LEVEL IV-90,312,1 ,"$2,252.00 ","$1,463.80 ",$21.49 ,"$2,252.00 ",$117.60 ,$51.78 ,"$1,238.60 ",$47.04 ,$630.56 ,"$1,103.48 ",$47.04 ,"$1,317.42 ",$47.04 ,"$1,222.84 ",$105.00 ,$47.04 ,"$1,222.84 ",$89.37 ,"$1,576.40 ","$1,126.00 ","$1,801.60 ",$117.60 ,$47.04 ,"$1,576.40 ",$47.04 ,"$1,351.20 ",$47.04 ,"$1,689.00 ","$1,243.10 ","$1,121.50 ","$1,243.10 ",$47.04 ,"$1,243.10 ",$36.74 ,$36.74 ,"$1,914.20 ",$117.60 ,"$1,560.64 ",$47.04 ,$35.62 ,"$1,238.60 ",$47.04 ,$592.28 , N/A ,$22.52 ,$21.49 ,$49.39 ,"$1,801.60 ","$1,222.84 ",$630.56 ,"$2,026.80 ",$855.76 ,$99.52 ,$47.04 ,"$1,080.96 "
ST. MARY'S HOSPITAL - DECATUR,31200253,88305,HC CELLIENT CELL BLOCK,312,1 ,$569.00 ,$369.85 ,$21.49 ,$569.00 ,$117.60 ,$51.78 ,$312.95 ,$47.04 ,$159.32 ,$278.81 ,$47.04 ,$332.87 ,$47.04 ,$308.97 ,$105.00 ,$47.04 ,$308.97 ,$89.37 ,$398.30 ,$284.50 ,$455.20 ,$117.60 ,$47.04 ,$398.30 ,$47.04 ,$341.40 ,$47.04 ,$426.75 ,$314.09 ,$283.36 ,$314.09 ,$47.04 ,$314.09 ,$36.74 ,$36.74 ,$483.65 ,$117.60 ,$394.32 ,$47.04 ,$35.62 ,$312.95 ,$47.04 ,$149.65 , N/A ,$22.52 ,$21.49 ,$49.39 ,$455.20 ,$308.97 ,$159.32 ,$512.10 ,$216.22 ,$99.52 ,$47.04 ,$273.12 
ST. MARY'S HOSPITAL - DECATUR,31200255,88312,HC SPECIAL STAIN I-90,312,1 ,$306.00 ,$198.90 ,$21.49 ,$306.00 ,$117.60 ,$110.14 ,$168.30 ,$47.04 ,$85.68 ,$149.94 ,$47.04 ,$179.01 ,$47.04 ,$166.16 ,$106.75 ,$47.04 ,$166.16 ,$89.37 ,$214.20 ,$153.00 ,$244.80 ,$117.60 ,$47.04 ,$214.20 ,$47.04 ,$183.60 ,$47.04 ,$229.50 ,$168.91 ,$152.39 ,$168.91 ,$47.04 ,$168.91 ,$88.83 ,$88.83 ,$260.10 ,$117.60 ,$212.06 ,$47.04 ,$306.00 ,$168.30 ,$47.04 ,$80.48 , N/A ,$22.52 ,$21.49 ,$49.39 ,$244.80 ,$166.16 ,$85.68 ,$275.40 ,$116.28 ,$99.52 ,$47.04 ,$146.88 
ST. MARY'S HOSPITAL - DECATUR,31200256,88313,HC SPECIAL STAIN II-90,312,1 ,$356.00 ,$231.40 ,$21.49 ,$356.00 ,$80.10 ,$86.48 ,$195.80 ,$32.04 ,$99.68 ,$174.44 ,$32.04 ,$208.26 ,$32.04 ,$193.31 ,$88.12 ,$32.04 ,$193.31 ,$60.88 ,$249.20 ,$178.00 ,$284.80 ,$80.10 ,$32.04 ,$249.20 ,$32.04 ,$213.60 ,$32.04 ,$267.00 ,$196.51 ,$177.29 ,$196.51 ,$32.04 ,$196.51 ,$73.33 ,$73.33 ,$302.60 ,$80.10 ,$246.71 ,$32.04 ,$356.00 ,$195.80 ,$32.04 ,$93.63 , N/A ,$22.52 ,$21.49 ,$33.64 ,$284.80 ,$193.31 ,$99.68 ,$320.40 ,$135.28 ,$67.68 ,$32.04 ,$170.88 
ST. MARY'S HOSPITAL - DECATUR,31200257,88314,HC HISTOCHECMICAL STAIN ADD ON-90,312,1 ,$389.00 ,$252.85 ,$21.49 ,$389.00 , N/A ,$90.68 ,$213.95 , N/A ,$108.92 ,$190.61 , N/A ,$227.57 , N/A ,$211.23 ,$101.06 , N/A ,$211.23 , N/A ,$272.30 ,$194.50 ,$311.20 , N/A , N/A ,$272.30 , N/A ,$233.40 , N/A ,$291.75 ,$214.73 ,$193.72 ,$214.73 , N/A ,$214.73 ,$84.10 ,$84.10 ,$330.65 , N/A ,$269.58 , N/A ,$389.00 ,$213.95 , N/A ,$102.31 , N/A ,$22.52 ,$21.49 , N/A ,$311.20 ,$211.23 ,$108.92 ,$350.10 ,$147.82 ,$159.82 , N/A ,$186.72 
ST. MARY'S HOSPITAL - DECATUR,31200259,88319,HC HISTOCHEM ENZYME STAIN-90,312,1 ,$214.00 ,$139.10 ,$23.65 ,"$1,550.85 ","$1,550.85 ",$93.30 ,$117.70 ,$620.34 ,$59.92 ,$104.86 ,$620.34 ,$125.19 ,$214.00 ,$116.20 ,$102.09 ,$214.00 ,$116.20 ,$214.00 ,$149.80 ,$107.00 ,$171.20 ,"$1,550.85 ",$620.34 ,$149.80 ,$620.34 ,$128.40 ,$620.34 ,$160.50 ,$118.13 ,$106.57 ,$118.13 ,$620.34 ,$118.13 ,$84.96 ,$84.96 ,$181.90 ,$214.00 ,$148.30 ,$620.34 ,$214.00 ,$117.70 ,$620.34 ,$56.28 , N/A ,$24.77 ,$23.65 ,$651.36 ,$171.20 ,$116.20 ,$59.92 ,$192.60 ,$81.32 ,$214.00 ,$620.34 ,$102.72 
ST. MARY'S HOSPITAL - DECATUR,31200261,88321,HC CONSULT REFERRED SLIDES-90,312,1 ,$443.00 ,$287.95 ,$21.49 ,$443.00 ,$80.10 ,$139.86 ,$243.65 ,$32.04 ,$124.04 ,$217.07 ,$32.04 ,$259.16 ,$32.04 ,$240.55 ,$133.95 ,$32.04 ,$240.55 ,$60.88 ,$310.10 ,$221.50 ,$354.40 ,$80.10 ,$32.04 ,$310.10 ,$32.04 ,$265.80 ,$32.04 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$32.04 ,$244.54 ,$129.97 ,$129.97 ,$376.55 ,$80.10 ,$307.00 ,$32.04 ,$443.00 ,$243.65 ,$32.04 ,$116.51 , N/A ,$22.52 ,$21.49 ,$33.64 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$67.68 ,$32.04 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,31200262,88323,HC CONSULT/SLIDE PREP-90,312,1 ,$443.00 ,$287.95 ,$21.49 ,$443.00 ,$117.60 ,$90.68 ,$243.65 ,$47.04 ,$124.04 ,$217.07 ,$47.04 ,$259.16 ,$47.04 ,$240.55 ,$38.97 ,$47.04 ,$240.55 ,$89.37 ,$310.10 ,$221.50 ,$354.40 ,$117.60 ,$47.04 ,$310.10 ,$47.04 ,$265.80 ,$47.04 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$47.04 ,$244.54 ,$32.42 ,$32.42 ,$376.55 ,$117.60 ,$307.00 ,$47.04 ,$443.00 ,$243.65 ,$47.04 ,$116.51 , N/A ,$22.52 ,$21.49 ,$49.39 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$99.52 ,$47.04 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,31200264,88325,HC CONSULT PATH REV/REP-90,312,1 ,"$1,120.00 ",$728.00 ,$21.49 ,"$1,120.00 ",$352.95 ,$215.38 ,$616.00 ,$141.18 ,$313.60 ,$548.80 ,$141.18 ,$655.20 ,$141.18 ,$608.16 ,$237.24 ,$141.18 ,$608.16 ,$268.24 ,$784.00 ,$560.00 ,$896.00 ,$352.95 ,$141.18 ,$784.00 ,$141.18 ,$672.00 ,$141.18 ,$840.00 ,$618.24 ,$557.76 ,$618.24 ,$141.18 ,$618.24 ,$233.16 ,$233.16 ,$952.00 ,$352.95 ,$776.16 ,$141.18 ,"$1,120.00 ",$616.00 ,$141.18 ,$294.56 , N/A ,$22.52 ,$21.49 ,$148.24 ,$896.00 ,$608.16 ,$313.60 ,"$1,008.00 ",$425.60 ,$298.32 ,$141.18 ,$537.60 
ST. MARY'S HOSPITAL - DECATUR,31200265,88341,HC IMMUNOHISOCHEM EA AD SGL STN-90,312,1 ,$614.00 ,$399.10 ,$21.49 ,$614.00 , N/A ,$70.94 ,$337.70 , N/A ,$171.92 ,$300.86 , N/A ,$359.19 , N/A ,$333.40 ,$92.61 , N/A ,$333.40 , N/A ,$429.80 ,$307.00 ,$491.20 , N/A , N/A ,$429.80 , N/A ,$368.40 , N/A ,$460.50 ,$338.93 ,$305.77 ,$338.93 , N/A ,$338.93 ,$77.06 ,$77.06 ,$521.90 , N/A ,$425.50 , N/A ,$68.12 ,$337.70 , N/A ,$161.48 , N/A ,$22.52 ,$21.49 , N/A ,$491.20 ,$333.40 ,$171.92 ,$552.60 ,$233.32 ,$130.50 , N/A ,$294.72 
ST. MARY'S HOSPITAL - DECATUR,31200266,88341,HC IMMUNOHISOCHEMIS EA AD SGL STN,312,1 ,$614.00 ,$399.10 ,$21.49 ,$614.00 , N/A ,$70.94 ,$337.70 , N/A ,$171.92 ,$300.86 , N/A ,$359.19 , N/A ,$333.40 ,$92.61 , N/A ,$333.40 , N/A ,$429.80 ,$307.00 ,$491.20 , N/A , N/A ,$429.80 , N/A ,$368.40 , N/A ,$460.50 ,$338.93 ,$305.77 ,$338.93 , N/A ,$338.93 ,$77.06 ,$77.06 ,$521.90 , N/A ,$425.50 , N/A ,$68.12 ,$337.70 , N/A ,$161.48 , N/A ,$22.52 ,$21.49 , N/A ,$491.20 ,$333.40 ,$171.92 ,$552.60 ,$233.32 ,$130.50 , N/A ,$294.72 
ST. MARY'S HOSPITAL - DECATUR,31200267,88342,HC IMMUNOHISTOCHEM EA AB-90,312,1 ,$534.00 ,$347.10 ,$21.49 ,$534.00 ,$352.95 ,$113.28 ,$293.70 ,$141.18 ,$149.52 ,$261.66 ,$141.18 ,$312.39 ,$141.18 ,$289.96 ,$102.61 ,$141.18 ,$289.96 ,$268.24 ,$373.80 ,$267.00 ,$427.20 ,$352.95 ,$141.18 ,$373.80 ,$141.18 ,$320.40 ,$141.18 ,$400.50 ,$294.77 ,$265.93 ,$294.77 ,$141.18 ,$294.77 ,$85.38 ,$85.38 ,$453.90 ,$352.95 ,$370.06 ,$141.18 ,$74.24 ,$293.70 ,$141.18 ,$140.44 , N/A ,$22.52 ,$21.49 ,$148.24 ,$427.20 ,$289.96 ,$149.52 ,$480.60 ,$202.92 ,$298.32 ,$141.18 ,$256.32 
ST. MARY'S HOSPITAL - DECATUR,31200270,88342,HC IMMUNOHISOCHEMIST EA AB REPEAT,312,1 ,$469.00 ,$304.85 ,$21.49 ,$469.00 ,$352.95 ,$113.28 ,$257.95 ,$141.18 ,$131.32 ,$229.81 ,$141.18 ,$274.37 ,$141.18 ,$254.67 ,$102.61 ,$141.18 ,$254.67 ,$268.24 ,$328.30 ,$234.50 ,$375.20 ,$352.95 ,$141.18 ,$328.30 ,$141.18 ,$281.40 ,$141.18 ,$351.75 ,$258.89 ,$233.56 ,$258.89 ,$141.18 ,$258.89 ,$85.38 ,$85.38 ,$398.65 ,$352.95 ,$325.02 ,$141.18 ,$74.24 ,$257.95 ,$141.18 ,$123.35 , N/A ,$22.52 ,$21.49 ,$148.24 ,$375.20 ,$254.67 ,$131.32 ,$422.10 ,$178.22 ,$298.32 ,$141.18 ,$225.12 
ST. MARY'S HOSPITAL - DECATUR,31200271,88344,HC IMMUNOHISOCHEMISTR EA ADDL-90,312,1 ,$614.00 ,$399.10 ,$21.49 ,$689.24 ,$689.23 ,$119.00 ,$337.70 ,$275.69 ,$171.92 ,$300.86 ,$275.69 ,$359.19 ,$275.69 ,$333.40 ,$192.63 ,$275.69 ,$333.40 ,$523.82 ,$429.80 ,$307.00 ,$491.20 ,$689.24 ,$275.69 ,$429.80 ,$275.69 ,$368.40 ,$275.69 ,$460.50 ,$338.93 ,$305.77 ,$338.93 ,$275.69 ,$338.93 ,$160.30 ,$160.30 ,$521.90 ,$614.00 ,$425.50 ,$275.69 ,$614.00 ,$337.70 ,$275.69 ,$161.48 , N/A ,$22.52 ,$21.49 ,$289.47 ,$491.20 ,$333.40 ,$171.92 ,$552.60 ,$233.32 ,$582.52 ,$275.69 ,$294.72 
ST. MARY'S HOSPITAL - DECATUR,31200272,88346,HC IF DIRECT-90,312,1 ,$90.00 ,$58.50 ,$21.49 ,$689.24 ,$689.23 ,$90.00 ,$49.50 ,$275.69 ,$25.20 ,$44.10 ,$275.69 ,$52.65 ,$90.00 ,$48.87 ,$90.00 ,$90.00 ,$48.87 ,$90.00 ,$63.00 ,$45.00 ,$72.00 ,$689.24 ,$275.69 ,$63.00 ,$275.69 ,$54.00 ,$275.69 ,$67.50 ,$49.68 ,$44.82 ,$49.68 ,$275.69 ,$49.68 ,$88.83 ,$88.83 ,$76.50 ,$90.00 ,$62.37 ,$275.69 ,$90.00 ,$49.50 ,$275.69 ,$23.67 , N/A ,$22.52 ,$21.49 ,$289.47 ,$72.00 ,$48.87 ,$25.20 ,$81.00 ,$34.20 ,$90.00 ,$275.69 ,$43.20 
ST. MARY'S HOSPITAL - DECATUR,31200273,88348,HC ELECTRON MICRO DIAG-90,312,1 ,$704.00 ,$457.60 ,$23.65 ,"$1,550.85 ","$1,550.85 ",$704.00 ,$387.20 ,$620.34 ,$197.12 ,$344.96 ,$620.34 ,$411.84 ,$620.34 ,$382.27 ,$411.63 ,$620.34 ,$382.27 ,$704.00 ,$492.80 ,$352.00 ,$563.20 ,"$1,550.85 ",$620.34 ,$492.80 ,$620.34 ,$422.40 ,$620.34 ,$528.00 ,$388.61 ,$350.59 ,$388.61 ,$620.34 ,$388.61 ,$342.54 ,$342.54 ,$598.40 ,$704.00 ,$487.87 ,$620.34 ,$704.00 ,$387.20 ,$620.34 ,$185.15 , N/A ,$24.77 ,$23.65 ,$651.36 ,$563.20 ,$382.27 ,$197.12 ,$633.60 ,$267.52 ,$704.00 ,$620.34 ,$337.92 
ST. MARY'S HOSPITAL - DECATUR,31200274,88350,HC IMMUNOFLUOR PER SPEC EA ADDN SINGLE STAIN-90,312,1 ,$536.00 ,$348.40 ,$21.49 ,$536.00 , N/A ,$67.50 ,$294.80 , N/A ,$150.08 ,$262.64 , N/A ,$313.56 , N/A ,$291.05 ,$69.85 , N/A ,$291.05 , N/A ,$375.20 ,$268.00 ,$428.80 , N/A , N/A ,$375.20 , N/A ,$321.60 , N/A ,$402.00 ,$295.87 ,$266.93 ,$295.87 , N/A ,$295.87 ,$58.12 ,$58.12 ,$455.60 , N/A ,$371.45 , N/A ,$536.00 ,$294.80 , N/A ,$140.97 , N/A ,$22.52 ,$21.49 , N/A ,$428.80 ,$291.05 ,$150.08 ,$482.40 ,$203.68 ,$162.60 , N/A ,$257.28 
ST. MARY'S HOSPITAL - DECATUR,31200275,88360,HC MORPHO ANLYS TUMOR MAN-90,312,1 ,$632.00 ,$410.80 ,$23.65 ,$632.00 ,$352.95 ,$115.92 ,$347.60 ,$141.18 ,$176.96 ,$309.68 ,$141.18 ,$369.72 ,$141.18 ,$343.18 ,$122.79 ,$141.18 ,$343.18 ,$268.24 ,$442.40 ,$316.00 ,$505.60 ,$352.95 ,$141.18 ,$442.40 ,$141.18 ,$379.20 ,$141.18 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$141.18 ,$348.86 ,$102.18 ,$102.18 ,$537.20 ,$352.95 ,$437.98 ,$141.18 ,$86.62 ,$347.60 ,$141.18 ,$166.22 , N/A ,$24.77 ,$23.65 ,$148.24 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$298.32 ,$141.18 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,31200276,88361,HC MORPHO ANLYS COMP ASSIST-90,312,1 ,$323.00 ,$209.95 ,$23.65 ,$689.24 ,$689.23 ,$153.76 ,$177.65 ,$275.69 ,$90.44 ,$158.27 ,$275.69 ,$188.96 ,$275.69 ,$175.39 ,$124.34 ,$275.69 ,$175.39 ,$323.00 ,$226.10 ,$161.50 ,$258.40 ,$689.24 ,$275.69 ,$226.10 ,$275.69 ,$193.80 ,$275.69 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$275.69 ,$178.30 ,$103.47 ,$103.47 ,$274.55 ,$323.00 ,$223.84 ,$275.69 ,$84.07 ,$177.65 ,$275.69 ,$84.95 , N/A ,$24.77 ,$23.65 ,$289.47 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 ,$323.00 ,$275.69 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,31200278,88364,HC IN SITU HYBRID(FISH) EA ADL-90,312,1 ,$878.00 ,$570.70 ,$21.49 ,$878.00 , N/A ,$108.50 ,$482.90 , N/A ,$245.84 ,$430.22 , N/A ,$513.63 , N/A ,$476.75 ,$141.41 , N/A ,$476.75 , N/A ,$614.60 ,$439.00 ,$702.40 , N/A , N/A ,$614.60 , N/A ,$526.80 , N/A ,$658.50 ,$484.66 ,$437.24 ,$484.66 , N/A ,$484.66 ,$117.68 ,$117.68 ,$746.30 , N/A ,$608.45 , N/A ,$878.00 ,$482.90 , N/A ,$230.91 , N/A ,$22.52 ,$21.49 , N/A ,$702.40 ,$476.75 ,$245.84 ,$790.20 ,$333.64 ,$219.12 , N/A ,$421.44 
ST. MARY'S HOSPITAL - DECATUR,31200279,88365,HC IN SITU HYBRID (FISH)-90,312,1 ,$878.00 ,$570.70 ,$21.49 ,$878.00 ,$352.95 ,$186.36 ,$482.90 ,$141.18 ,$245.84 ,$430.22 ,$141.18 ,$513.63 ,$141.18 ,$476.75 ,$192.63 ,$141.18 ,$476.75 ,$268.24 ,$614.60 ,$439.00 ,$702.40 ,$352.95 ,$141.18 ,$614.60 ,$141.18 ,$526.80 ,$141.18 ,$658.50 ,$484.66 ,$437.24 ,$484.66 ,$141.18 ,$484.66 ,$160.30 ,$160.30 ,$746.30 ,$352.95 ,$608.45 ,$141.18 ,$878.00 ,$482.90 ,$141.18 ,$230.91 , N/A ,$22.52 ,$21.49 ,$148.24 ,$702.40 ,$476.75 ,$245.84 ,$790.20 ,$333.64 ,$298.32 ,$141.18 ,$421.44 
ST. MARY'S HOSPITAL - DECATUR,31200280,88367,HC FISH HER-2NEU-90,312,1 ,$983.00 ,$638.95 ,$23.65 ,$983.00 ,$689.23 ,$306.76 ,$540.65 ,$275.69 ,$275.24 ,$481.67 ,$275.69 ,$575.06 ,$275.69 ,$533.77 ,$107.78 ,$275.69 ,$533.77 ,$523.82 ,$688.10 ,$491.50 ,$786.40 ,$689.24 ,$275.69 ,$688.10 ,$275.69 ,$589.80 ,$275.69 ,$737.25 ,$542.62 ,$489.53 ,$542.62 ,$275.69 ,$542.62 ,$89.69 ,$89.69 ,$835.55 ,$689.24 ,$681.22 ,$275.69 ,$983.00 ,$540.65 ,$275.69 ,$258.53 , N/A ,$24.77 ,$23.65 ,$289.47 ,$786.40 ,$533.77 ,$275.24 ,$884.70 ,$373.54 ,$582.52 ,$275.69 ,$471.84 
ST. MARY'S HOSPITAL - DECATUR,31200281,88368,HC MORPHO ANLYS IN SITU HYBRID-90,312,1 ,$950.00 ,$617.50 ,$23.65 ,$950.00 ,$689.23 ,$263.66 ,$522.50 ,$275.69 ,$266.00 ,$465.50 ,$275.69 ,$555.75 ,$275.69 ,$515.85 ,$123.30 ,$275.69 ,$515.85 ,$523.82 ,$665.00 ,$475.00 ,$760.00 ,$689.24 ,$275.69 ,$665.00 ,$275.69 ,$570.00 ,$275.69 ,$712.50 ,$524.40 ,$473.10 ,$524.40 ,$275.69 ,$524.40 ,$102.61 ,$102.61 ,$807.50 ,$689.24 ,$658.35 ,$275.69 ,$950.00 ,$522.50 ,$275.69 ,$249.85 , N/A ,$24.77 ,$23.65 ,$289.47 ,$760.00 ,$515.85 ,$266.00 ,$855.00 ,$361.00 ,$582.52 ,$275.69 ,$456.00 
ST. MARY'S HOSPITAL - DECATUR,31200282,88373,HC MORPH ANLY AUTO EA ADDL-90,312,1 ,$424.00 ,$275.60 ,$23.65 ,$424.00 , N/A ,$60.98 ,$233.20 , N/A ,$118.72 ,$207.76 , N/A ,$248.04 , N/A ,$230.23 ,$68.81 , N/A ,$230.23 , N/A ,$296.80 ,$212.00 ,$339.20 , N/A , N/A ,$296.80 , N/A ,$254.40 , N/A ,$318.00 ,$234.05 ,$211.15 ,$234.05 , N/A ,$234.05 ,$57.27 ,$57.27 ,$360.40 , N/A ,$293.83 , N/A ,$424.00 ,$233.20 , N/A ,$111.51 , N/A ,$24.77 ,$23.65 , N/A ,$339.20 ,$230.23 ,$118.72 ,$381.60 ,$161.12 ,$94.22 , N/A ,$203.52 
ST. MARY'S HOSPITAL - DECATUR,31200283,88374,HC MORPH ANLY AUTO EA MULTIPLX-90,312,1 ,$569.00 ,$369.85 ,$23.65 ,$569.00 ,$352.95 ,$246.64 ,$312.95 ,$141.18 ,$159.32 ,$278.81 ,$141.18 ,$332.87 ,$141.18 ,$308.97 ,$408.91 ,$141.18 ,$308.97 ,$268.24 ,$398.30 ,$284.50 ,$455.20 ,$352.95 ,$141.18 ,$398.30 ,$141.18 ,$341.40 ,$141.18 ,$426.75 ,$314.09 ,$283.36 ,$314.09 ,$141.18 ,$314.09 ,$340.28 ,$340.28 ,$483.65 ,$352.95 ,$394.32 ,$141.18 ,$569.00 ,$312.95 ,$141.18 ,$149.65 , N/A ,$24.77 ,$23.65 ,$148.24 ,$455.20 ,$308.97 ,$159.32 ,$512.10 ,$216.22 ,$298.32 ,$141.18 ,$273.12 
ST. MARY'S HOSPITAL - DECATUR,31200284,88377,HC MORPH ANLZ INST HYB EA MTPL-90,312,1 ,$564.00 ,$366.60 ,$23.65 ,$564.00 ,$352.95 ,$229.50 ,$310.20 ,$141.18 ,$157.92 ,$276.36 ,$141.18 ,$329.94 ,$141.18 ,$306.25 ,$469.60 ,$141.18 ,$306.25 ,$268.24 ,$394.80 ,$282.00 ,$451.20 ,$352.95 ,$141.18 ,$394.80 ,$141.18 ,$338.40 ,$141.18 ,$423.00 ,$311.33 ,$280.87 ,$311.33 ,$141.18 ,$311.33 ,$390.79 ,$390.79 ,$479.40 ,$352.95 ,$390.85 ,$141.18 ,$564.00 ,$310.20 ,$141.18 ,$148.33 , N/A ,$24.77 ,$23.65 ,$148.24 ,$451.20 ,$306.25 ,$157.92 ,$507.60 ,$214.32 ,$298.32 ,$141.18 ,$270.72 
ST. MARY'S HOSPITAL - DECATUR,31200285,88380,HC MICRODISSECTION LASER CAPTR-90,312,1 ,"$1,055.00 ",$685.75 ,$23.65 ,"$1,055.00 ", N/A ,$538.05 ,$580.25 , N/A ,$295.40 ,$516.95 , N/A ,$617.18 , N/A ,$572.87 ,$113.64 , N/A ,$572.87 , N/A ,$738.50 ,$527.50 ,$844.00 , N/A , N/A ,$738.50 , N/A ,$633.00 , N/A ,$791.25 ,$582.36 ,$525.39 ,$582.36 , N/A ,$582.36 ,$94.56 ,$94.56 ,$896.75 , N/A ,$731.12 , N/A ,"$1,055.00 ",$580.25 , N/A ,$277.47 , N/A ,$24.77 ,$23.65 , N/A ,$844.00 ,$572.87 ,$295.40 ,$949.50 ,$400.90 ,$157.72 , N/A ,$506.40 
ST. MARY'S HOSPITAL - DECATUR,31200286,88381,HC MICRODISSECTION MANUAL-90,312,1 ,$670.00 ,$435.50 ,$23.65 ,$670.00 , N/A ,$341.70 ,$368.50 , N/A ,$187.60 ,$328.30 , N/A ,$391.95 , N/A ,$363.81 ,$187.11 , N/A ,$363.81 , N/A ,$469.00 ,$335.00 ,$536.00 , N/A , N/A ,$469.00 , N/A ,$402.00 , N/A ,$502.50 ,$369.84 ,$333.66 ,$369.84 , N/A ,$369.84 ,$155.70 ,$155.70 ,$569.50 , N/A ,$464.31 , N/A ,$670.00 ,$368.50 , N/A ,$176.21 , N/A ,$24.77 ,$23.65 , N/A ,$536.00 ,$363.81 ,$187.60 ,$603.00 ,$254.60 ,$360.10 , N/A ,$321.60 
ST. MARY'S HOSPITAL - DECATUR,31200287,88387,HC TISSUE EXAM MOLECULAR STUDY,312,1 ,$138.00 ,$89.70 ,$8.32 ,$138.00 , N/A ,$70.38 ,$75.90 , N/A ,$38.64 ,$67.62 , N/A ,$80.73 , N/A ,$74.93 ,$9.99 , N/A ,$74.93 , N/A ,$96.60 ,$69.00 ,$110.40 , N/A , N/A ,$96.60 , N/A ,$82.80 , N/A ,$103.50 ,$76.18 ,$68.72 ,$76.18 , N/A ,$76.18 ,$8.32 ,$8.32 ,$117.30 , N/A ,$95.63 , N/A ,$138.00 ,$75.90 , N/A ,$36.29 , N/A ,$22.52 ,$21.49 , N/A ,$110.40 ,$74.93 ,$38.64 ,$124.20 ,$52.44 ,$16.06 , N/A ,$66.24 
ST. MARY'S HOSPITAL - DECATUR,31200288,88388,HC TISSUE EXAM MOLECULR ST ADD ON,312,1 ,$111.00 ,$72.15 ,$13.48 ,$111.00 , N/A ,$56.61 ,$61.05 , N/A ,$31.08 ,$54.39 , N/A ,$64.94 , N/A ,$60.27 ,$16.20 , N/A ,$60.27 , N/A ,$77.70 ,$55.50 ,$88.80 , N/A , N/A ,$77.70 , N/A ,$66.60 , N/A ,$83.25 ,$61.27 ,$55.28 ,$61.27 , N/A ,$61.27 ,$13.48 ,$13.48 ,$94.35 , N/A ,$76.92 , N/A ,$111.00 ,$61.05 , N/A ,$29.19 , N/A ,$22.52 ,$21.49 , N/A ,$88.80 ,$60.27 ,$31.08 ,$99.90 ,$42.18 ,$27.92 , N/A ,$53.28 
ST. MARY'S HOSPITAL - DECATUR,32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$485.00 ,$315.25 ,$116.85 ,$485.00 , N/A ,$247.35 ,$266.75 , N/A ,$135.80 ,$227.95 , N/A ,$261.90 , N/A ,$263.36 ,$116.85 , N/A ,$263.36 , N/A ,$339.50 ,$242.50 ,$388.00 , N/A , N/A ,$339.50 , N/A ,$291.00 , N/A ,$363.75 ,$267.72 ,$241.53 ,$267.72 , N/A ,$267.72 ,$339.50 ,$339.50 ,$412.25 , N/A ,$336.11 , N/A ,$485.00 ,$266.75 , N/A ,$127.56 ,$485.00 , N/A , N/A , N/A ,$388.00 ,$263.36 ,$135.80 ,$436.50 ,$184.30 ,$485.00 , N/A ,$232.80 
ST. MARY'S HOSPITAL - DECATUR,32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$485.00 ,$315.25 ,$127.56 ,$485.00 , N/A ,$247.35 ,$266.75 , N/A ,$135.80 ,$227.95 , N/A ,$261.90 , N/A ,$263.36 ,$171.76 , N/A ,$263.36 , N/A ,$339.50 ,$242.50 ,$388.00 , N/A , N/A ,$339.50 , N/A ,$291.00 , N/A ,$363.75 ,$267.72 ,$241.53 ,$267.72 , N/A ,$267.72 ,$339.50 ,$339.50 ,$412.25 , N/A ,$336.11 , N/A ,$485.00 ,$266.75 , N/A ,$127.56 ,$485.00 ,$242.84 ,$231.80 , N/A ,$388.00 ,$263.36 ,$135.80 ,$436.50 ,$184.30 ,$485.00 , N/A ,$232.80 
ST. MARY'S HOSPITAL - DECATUR,32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$485.00 ,$315.25 ,$127.56 ,$485.00 , N/A ,$247.35 ,$266.75 , N/A ,$135.80 ,$227.95 , N/A ,$261.90 , N/A ,$263.36 ,$159.73 , N/A ,$263.36 , N/A ,$339.50 ,$242.50 ,$388.00 , N/A , N/A ,$339.50 , N/A ,$291.00 , N/A ,$363.75 ,$267.72 ,$241.53 ,$267.72 , N/A ,$267.72 ,$339.50 ,$339.50 ,$412.25 , N/A ,$336.11 , N/A ,$485.00 ,$266.75 , N/A ,$127.56 ,$485.00 ,$242.84 ,$231.80 , N/A ,$388.00 ,$263.36 ,$135.80 ,$436.50 ,$184.30 ,$485.00 , N/A ,$232.80 
ST. MARY'S HOSPITAL - DECATUR,32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$501.00 ,$325.65 ,$93.26 ,$501.00 , N/A ,$255.51 ,$275.55 , N/A ,$140.28 ,$235.47 , N/A ,$270.54 , N/A ,$272.04 ,$93.26 , N/A ,$272.04 , N/A ,$350.70 ,$250.50 ,$400.80 , N/A , N/A ,$350.70 , N/A ,$300.60 , N/A ,$375.75 ,$276.55 ,$249.50 ,$276.55 , N/A ,$276.55 ,$350.70 ,$350.70 ,$425.85 , N/A ,$347.19 , N/A ,$501.00 ,$275.55 , N/A ,$131.76 ,$501.00 , N/A , N/A , N/A ,$400.80 ,$272.04 ,$140.28 ,$450.90 ,$190.38 ,$500.00 , N/A ,$240.48 
ST. MARY'S HOSPITAL - DECATUR,32000018,32550,HC INSERT CATH PLEURAL INDWELL W/,320,1 ,"$8,729.00 ","$5,673.85 ",$386.80 ,"$8,729.00 ","$7,529.23 ","$4,451.79 ","$4,800.95 ","$3,011.69 ","$2,444.12 ","$4,102.63 ","$3,011.69 ","$4,713.66 ","$3,011.69 ","$4,739.85 ",$386.80 ,"$3,011.69 ","$4,739.85 ","$5,722.22 ","$6,110.30 ","$4,364.50 ","$6,983.20 ","$7,529.23 ","$3,011.69 ","$6,110.30 ","$3,011.69 ","$5,237.40 ","$3,011.69 ","$6,546.75 ","$4,818.41 ","$4,347.04 ","$4,818.41 ","$3,011.69 ","$4,818.41 ","$6,110.30 ","$6,110.30 ","$7,419.65 ","$7,529.23 ","$6,049.20 ","$3,011.69 ","$8,729.00 ","$4,800.95 ","$3,011.69 ","$2,295.73 ","$8,729.00 ",$483.89 ,$461.90 ,"$3,162.27 ","$6,983.20 ","$4,739.85 ","$2,444.12 ","$7,856.10 ","$3,317.02 ",$500.00 ,"$3,011.69 ","$4,189.92 "
ST. MARY'S HOSPITAL - DECATUR,32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,"$2,583.00 ","$1,678.95 ",$295.09 ,"$3,327.80 ","$3,327.80 ","$1,317.33 ","$1,420.65 ","$1,331.12 ",$723.24 ,"$1,214.01 ","$1,331.12 ","$1,394.82 ","$1,331.12 ","$1,402.57 ",$295.09 ,"$1,331.12 ","$1,402.57 ","$2,529.13 ","$1,808.10 ","$1,291.50 ","$2,066.40 ","$3,327.80 ","$1,331.12 ","$1,808.10 ","$1,331.12 ","$1,549.80 ","$1,331.12 ","$1,937.25 ","$1,425.82 ","$1,286.33 ","$1,425.82 ","$1,331.12 ","$1,425.82 ","$1,808.10 ","$1,808.10 ","$2,195.55 ","$2,583.00 ","$1,790.02 ","$1,331.12 ","$2,583.00 ","$1,420.65 ","$1,331.12 ",$679.33 ,"$2,583.00 ",$483.89 ,$461.90 ,"$1,397.68 ","$2,066.40 ","$1,402.57 ",$723.24 ,"$2,324.70 ",$981.54 ,$500.00 ,"$1,331.12 ","$1,239.84 "
ST. MARY'S HOSPITAL - DECATUR,32000020,32552,HC REMOVAL TUNNELED PLEURAL CATH,320,1 ,"$3,250.00 ","$2,112.50 ",$290.98 ,"$3,250.00 ","$1,279.15 ","$1,657.50 ","$1,787.50 ",$511.66 ,$910.00 ,"$1,527.50 ",$511.66 ,"$1,755.00 ",$511.66 ,"$1,764.75 ",$290.98 ,$511.66 ,"$1,764.75 ",$972.16 ,"$2,275.00 ","$1,625.00 ","$2,600.00 ","$1,279.16 ",$511.66 ,"$2,275.00 ",$511.66 ,"$1,950.00 ",$511.66 ,"$2,437.50 ","$1,794.00 ","$1,618.50 ","$1,794.00 ",$511.66 ,"$1,794.00 ","$2,275.00 ","$2,275.00 ","$2,762.50 ","$1,279.16 ","$2,252.25 ",$511.66 ,"$3,250.00 ","$1,787.50 ",$511.66 ,$854.75 ,"$3,250.00 ",$483.89 ,$461.90 ,$537.24 ,"$2,600.00 ","$1,764.75 ",$910.00 ,"$2,925.00 ","$1,235.00 ",$500.00 ,$511.66 ,"$1,560.00 "
ST. MARY'S HOSPITAL - DECATUR,32000026,36000,HC IV START > 3YR OLD,320,1 ,$423.00 ,$274.95 ,$16.51 ,$423.00 , N/A ,$215.73 ,$232.65 , N/A ,$118.44 ,$198.81 , N/A ,$228.42 , N/A ,$229.69 ,$16.51 , N/A ,$229.69 , N/A ,$296.10 ,$211.50 ,$338.40 , N/A , N/A ,$296.10 , N/A ,$253.80 , N/A ,$317.25 ,$233.50 ,$210.65 ,$233.50 , N/A ,$233.50 ,$296.10 ,$296.10 ,$359.55 , N/A ,$293.14 , N/A ,$423.00 ,$232.65 , N/A ,$111.25 ,$423.00 ,$195.12 ,$186.25 , N/A ,$338.40 ,$229.69 ,$118.44 ,$380.70 ,$160.74 ,$423.00 , N/A ,$203.04 
ST. MARY'S HOSPITAL - DECATUR,32000027,36002,HC INJ PSEUDOANEURYSM (THROMBIN),320,1 ,"$1,010.00 ",$656.50 ,$186.56 ,"$1,279.16 ","$1,279.15 ",$515.10 ,$555.50 ,$511.66 ,$282.80 ,$474.70 ,$511.66 ,$545.40 ,$511.66 ,$548.43 ,$186.56 ,$511.66 ,$548.43 ,$972.16 ,$707.00 ,$505.00 ,$808.00 ,"$1,279.16 ",$511.66 ,$707.00 ,$511.66 ,$606.00 ,$511.66 ,$757.50 ,$557.52 ,$502.98 ,$557.52 ,$511.66 ,$557.52 ,$707.00 ,$707.00 ,$858.50 ,"$1,010.00 ",$699.93 ,$511.66 ,"$1,010.00 ",$555.50 ,$511.66 ,$265.63 ,"$1,010.00 ", N/A , N/A ,$537.24 ,$808.00 ,$548.43 ,$282.80 ,$909.00 ,$383.80 ,$500.00 ,$511.66 ,$484.80 
ST. MARY'S HOSPITAL - DECATUR,32000028,36005,HC VENOGRAM INJECTION 36005,320,1 ,"$1,008.00 ",$655.20 ,$86.52 ,"$1,008.00 ", N/A ,$514.08 ,$554.40 , N/A ,$282.24 ,$473.76 , N/A ,$544.32 , N/A ,$547.34 ,$86.52 , N/A ,$547.34 , N/A ,$705.60 ,$504.00 ,$806.40 , N/A , N/A ,$705.60 , N/A ,$604.80 , N/A ,$756.00 ,$556.42 ,$501.98 ,$556.42 , N/A ,$556.42 ,$705.60 ,$705.60 ,$856.80 , N/A ,$698.54 , N/A ,"$1,008.00 ",$554.40 , N/A ,$265.10 ,"$1,008.00 ",$242.84 ,$231.80 , N/A ,$806.40 ,$547.34 ,$282.24 ,$907.20 ,$383.04 ,$500.00 , N/A ,$483.84 
ST. MARY'S HOSPITAL - DECATUR,32000029,36410,HC VENIPUNCTURE > AGE 3 REQUIR MD,361,1 ,$230.00 ,$149.50 ,$32.36 ,$230.00 , N/A ,$117.30 ,$126.50 , N/A ,$64.40 ,$108.10 , N/A ,$124.20 , N/A ,$124.89 ,$124.89 , N/A ,$124.89 , N/A ,$161.00 ,$115.00 ,$184.00 , N/A , N/A ,$161.00 , N/A ,$138.00 , N/A ,$172.50 ,$126.96 ,$114.54 ,$126.96 , N/A ,$126.96 ,$179.40 ,$179.40 ,$195.50 , N/A ,$159.39 , N/A ,$230.00 ,$126.50 , N/A ,$60.49 ,$230.00 ,$33.90 ,$32.36 , N/A ,$184.00 ,$124.89 ,$64.40 ,$207.00 , N/A , N/A , N/A ,$110.40 
ST. MARY'S HOSPITAL - DECATUR,32000030,36598,HC CONTRAST INJ CV CATH W/FLUORO,320,1 ,$670.00 ,$435.50 ,$81.45 ,"$1,136.50 ",$484.13 ,$341.70 ,$368.50 ,$193.65 ,$187.60 ,$314.90 ,$193.65 ,$361.80 ,$193.65 ,$363.81 ,$81.45 ,$193.65 ,$363.81 ,$367.93 ,$469.00 ,$335.00 ,$536.00 ,$484.12 ,$193.65 ,$469.00 ,$193.65 ,$402.00 ,$193.65 ,$502.50 ,$369.84 ,$333.66 ,$369.84 ,$193.65 ,$369.84 ,$469.00 ,$469.00 ,$569.50 ,$484.12 ,$464.31 ,$193.65 ,$670.00 ,$368.50 ,$193.65 ,$176.21 ,$670.00 ,$670.00 ,"$1,136.50 ",$203.33 ,$536.00 ,$363.81 ,$187.60 ,$603.00 ,$254.60 ,$500.00 ,$193.65 ,$321.60 
ST. MARY'S HOSPITAL - DECATUR,32000031,36598,HC CONTRAST INJ CENTRAL VENOUS CATH W/FLUORO,320,1 ,$670.00 ,$435.50 ,$81.45 ,"$1,136.50 ",$484.13 ,$341.70 ,$368.50 ,$193.65 ,$187.60 ,$314.90 ,$193.65 ,$361.80 ,$193.65 ,$363.81 ,$81.45 ,$193.65 ,$363.81 ,$367.93 ,$469.00 ,$335.00 ,$536.00 ,$484.12 ,$193.65 ,$469.00 ,$193.65 ,$402.00 ,$193.65 ,$502.50 ,$369.84 ,$333.66 ,$369.84 ,$193.65 ,$369.84 ,$469.00 ,$469.00 ,$569.50 ,$484.12 ,$464.31 ,$193.65 ,$670.00 ,$368.50 ,$193.65 ,$176.21 ,$670.00 ,$670.00 ,"$1,136.50 ",$203.33 ,$536.00 ,$363.81 ,$187.60 ,$603.00 ,$254.60 ,$500.00 ,$193.65 ,$321.60 
ST. MARY'S HOSPITAL - DECATUR,32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,$525.00 ,$341.25 ,$71.96 ,$642.28 ,$642.28 ,$267.75 ,$288.75 ,$256.91 ,$147.00 ,$246.75 ,$256.91 ,$283.50 ,$256.91 ,$285.08 ,$71.96 ,$256.91 ,$285.08 ,$488.12 ,$367.50 ,$262.50 ,$420.00 ,$642.27 ,$256.91 ,$367.50 ,$256.91 ,$315.00 ,$256.91 ,$393.75 ,$289.80 ,$261.45 ,$289.80 ,$256.91 ,$289.80 ,$367.50 ,$367.50 ,$446.25 ,$525.00 ,$363.83 ,$256.91 ,$525.00 ,$288.75 ,$256.91 ,$138.08 ,$525.00 ,$421.19 ,$402.05 ,$269.76 ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$500.00 ,$256.91 ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,32000043,47536,HC CHG PERC BIL DRAIN CATH,320,1 ,"$4,140.00 ","$2,691.00 ",$235.34 ,"$7,529.23 ","$7,529.23 ","$2,111.40 ","$2,277.00 ","$3,011.69 ","$1,159.20 ","$1,945.80 ","$3,011.69 ","$2,235.60 ","$3,011.69 ","$2,248.02 ",$235.34 ,"$3,011.69 ","$2,248.02 ","$4,140.00 ","$2,898.00 ","$2,070.00 ","$3,312.00 ","$7,529.23 ","$3,011.69 ","$2,898.00 ","$3,011.69 ","$2,484.00 ","$3,011.69 ","$3,105.00 ","$2,285.28 ","$2,061.72 ","$2,285.28 ","$3,011.69 ","$2,285.28 ","$2,898.00 ","$2,898.00 ","$3,519.00 ","$4,140.00 ","$2,869.02 ","$3,011.69 ","$4,140.00 ","$2,277.00 ","$3,011.69 ","$1,088.82 ","$4,140.00 ","$1,177.58 ","$1,124.06 ","$3,162.27 ","$3,312.00 ","$2,248.02 ","$1,159.20 ","$3,726.00 ","$1,573.20 ",$500.00 ,"$3,011.69 ","$1,987.20 "
ST. MARY'S HOSPITAL - DECATUR,32000051,49406,HC DRN ABSC RETROPERITONEAL PERC,320,1 ,"$5,699.00 ","$3,704.35 ",$351.25 ,"$5,699.00 ","$3,329.73 ","$2,906.49 ","$3,134.45 ","$1,331.89 ","$1,595.72 ","$2,678.53 ","$1,331.89 ","$3,077.46 ","$1,331.89 ","$3,094.56 ",$351.25 ,"$1,331.89 ","$3,094.56 ","$2,530.59 ","$3,989.30 ","$2,849.50 ","$4,559.20 ","$3,329.72 ","$1,331.89 ","$3,989.30 ","$1,331.89 ","$3,419.40 ","$1,331.89 ","$4,274.25 ","$3,145.85 ","$2,838.10 ","$3,145.85 ","$1,331.89 ","$3,145.85 ","$3,989.30 ","$3,989.30 ","$4,844.15 ","$3,329.72 ","$3,949.41 ","$1,331.89 ","$5,699.00 ","$3,134.45 ","$1,331.89 ","$1,498.84 ","$5,699.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$4,559.20 ","$3,094.56 ","$1,595.72 ","$5,129.10 ","$2,165.62 ",$500.00 ,"$1,331.89 ","$2,735.52 "
ST. MARY'S HOSPITAL - DECATUR,32000053,49423,HC EXCHG CATH ABSC/CYST DRAIN,320,1 ,"$3,145.00 ","$2,044.25 ",$127.24 ,"$3,843.71 ","$3,843.70 ","$1,603.95 ","$1,729.75 ","$1,537.48 ",$880.60 ,"$1,478.15 ","$1,537.48 ","$1,698.30 ","$1,537.48 ","$1,707.74 ",$127.24 ,"$1,537.48 ","$1,707.74 ","$2,921.22 ","$2,201.50 ","$1,572.50 ","$2,516.00 ","$3,843.71 ","$1,537.48 ","$2,201.50 ","$1,537.48 ","$1,887.00 ","$1,537.48 ","$2,358.75 ","$1,736.04 ","$1,566.21 ","$1,736.04 ","$1,537.48 ","$1,736.04 ","$2,201.50 ","$2,201.50 ","$2,673.25 ","$3,145.00 ","$2,179.49 ","$1,537.48 ","$3,145.00 ","$1,729.75 ","$1,537.48 ",$827.14 ,"$3,145.00 ",$483.89 ,$461.90 ,"$1,614.35 ","$2,516.00 ","$1,707.74 ",$880.60 ,"$2,830.50 ","$1,195.10 ",$500.00 ,"$1,537.48 ","$1,509.60 "
ST. MARY'S HOSPITAL - DECATUR,32000054,49424,HC INJ CONTRAST ABSC/CYST,320,1 ,$839.00 ,$545.35 ,$67.55 ,$839.00 , N/A ,$427.89 ,$461.45 , N/A ,$234.92 ,$394.33 , N/A ,$453.06 , N/A ,$455.58 ,$67.55 , N/A ,$455.58 , N/A ,$587.30 ,$419.50 ,$671.20 , N/A , N/A ,$587.30 , N/A ,$503.40 , N/A ,$629.25 ,$463.13 ,$417.82 ,$463.13 , N/A ,$463.13 ,$587.30 ,$587.30 ,$713.15 , N/A ,$581.43 , N/A ,$839.00 ,$461.45 , N/A ,$220.66 ,$839.00 ,$242.84 ,$231.80 , N/A ,$671.20 ,$455.58 ,$234.92 ,$755.10 ,$318.82 ,$500.00 , N/A ,$402.72 
ST. MARY'S HOSPITAL - DECATUR,32000057,49441,HC INSERT DUODEN/JEJUN TBE FLUORO,320,1 ,"$5,303.00 ","$3,446.95 ",$430.15 ,"$5,303.00 ","$3,843.70 ","$2,704.53 ","$2,916.65 ","$1,537.48 ","$1,484.84 ","$2,492.41 ","$1,537.48 ","$2,863.62 ","$1,537.48 ","$2,879.53 ",$430.15 ,"$1,537.48 ","$2,879.53 ","$2,921.22 ","$3,712.10 ","$2,651.50 ","$4,242.40 ","$3,843.71 ","$1,537.48 ","$3,712.10 ","$1,537.48 ","$3,181.80 ","$1,537.48 ","$3,977.25 ","$2,927.26 ","$2,640.89 ","$2,927.26 ","$1,537.48 ","$2,927.26 ","$3,712.10 ","$3,712.10 ","$4,507.55 ","$3,843.71 ","$3,674.98 ","$1,537.48 ","$5,303.00 ","$2,916.65 ","$1,537.48 ","$1,394.69 ","$5,303.00 ",$547.46 ,$522.57 ,"$1,614.35 ","$4,242.40 ","$2,879.53 ","$1,484.84 ","$4,772.70 ","$2,015.14 ",$500.00 ,"$1,537.48 ","$2,545.44 "
ST. MARY'S HOSPITAL - DECATUR,32000060,49450,HC RPLC G/CEC/OTH TB UNDER FLUORO,320,1 ,"$2,616.00 ","$1,700.40 ",$118.21 ,"$2,616.00 ","$1,914.88 ","$1,334.16 ","$1,438.80 ",$765.95 ,$732.48 ,"$1,229.52 ",$765.95 ,"$1,412.64 ",$765.95 ,"$1,420.49 ",$118.21 ,$765.95 ,"$1,420.49 ","$1,455.30 ","$1,831.20 ","$1,308.00 ","$2,092.80 ","$1,914.87 ",$765.95 ,"$1,831.20 ",$765.95 ,"$1,569.60 ",$765.95 ,"$1,962.00 ","$1,444.03 ","$1,302.77 ","$1,444.03 ",$765.95 ,"$1,444.03 ","$1,831.20 ","$1,831.20 ","$2,223.60 ","$1,914.87 ","$1,812.89 ",$765.95 ,"$2,616.00 ","$1,438.80 ",$765.95 ,$688.01 ,"$2,616.00 ",$421.19 ,$402.05 ,$804.25 ,"$2,092.80 ","$1,420.49 ",$732.48 ,"$2,354.40 ",$994.08 ,$500.00 ,$765.95 ,"$1,255.68 "
ST. MARY'S HOSPITAL - DECATUR,32000062,49452,HC RPLC GASTRO-JEJUN TB FLUORO,361,1 ,"$2,525.00 ","$1,641.25 ",$402.05 ,"$2,525.00 ","$1,914.88 ","$2,525.00 ","$1,388.75 ",$765.95 ,$707.00 ,"$1,186.75 ",$765.95 ,"$1,363.50 ",$765.95 ,"$1,371.08 ","$1,371.08 ",$765.95 ,"$1,371.08 ","$1,455.30 ","$1,767.50 ","$1,262.50 ","$2,020.00 ","$1,914.87 ",$765.95 ,"$1,767.50 ",$765.95 ,"$1,515.00 ",$765.95 ,"$1,893.75 ","$1,393.80 ","$1,257.45 ","$1,393.80 ",$765.95 ,"$1,393.80 ","$1,969.50 ","$1,969.50 ","$2,146.25 ","$1,914.87 ","$1,749.83 ",$765.95 ,"$2,525.00 ","$1,388.75 ",$765.95 ,$664.08 ,"$2,525.00 ",$421.19 ,$402.05 ,$804.25 ,"$2,020.00 ","$1,371.08 ",$707.00 ,"$2,272.50 ","$1,795.00 ","$2,100.00 ",$765.95 ,"$1,212.00 "
ST. MARY'S HOSPITAL - DECATUR,32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,"$1,165.00 ",$757.25 ,$54.56 ,"$1,165.00 ",$544.53 ,$594.15 ,$640.75 ,$217.81 ,$326.20 ,$547.55 ,$217.81 ,$629.10 ,$217.81 ,$632.60 ,$54.56 ,$217.81 ,$632.60 ,$413.84 ,$815.50 ,$582.50 ,$932.00 ,$544.53 ,$217.81 ,$815.50 ,$217.81 ,$699.00 ,$217.81 ,$873.75 ,$643.08 ,$580.17 ,$643.08 ,$217.81 ,$643.08 ,$815.50 ,$815.50 ,$990.25 ,$544.53 ,$807.35 ,$217.81 ,"$1,165.00 ",$640.75 ,$217.81 ,$306.40 ,"$1,165.00 ",$242.84 ,$231.80 ,$228.70 ,$932.00 ,$632.60 ,$326.20 ,"$1,048.50 ",$442.70 ,$500.00 ,$217.81 ,$559.20 
ST. MARY'S HOSPITAL - DECATUR,32000077,50693,HC INTRO GUIDE RENAL PELVIS URET DIL,320,1 ,"$7,500.00 ","$4,875.00 ",$500.00 ,"$7,500.00 ","$7,275.95 ","$3,825.00 ","$4,125.00 ","$2,910.38 ","$2,100.00 ","$3,525.00 ","$2,910.38 ","$4,050.00 ","$2,910.38 ","$4,072.50 ",$536.62 ,"$2,910.38 ","$4,072.50 ","$5,529.72 ","$5,250.00 ","$3,750.00 ","$6,000.00 ","$7,275.94 ","$2,910.38 ","$5,250.00 ","$2,910.38 ","$4,500.00 ","$2,910.38 ","$5,625.00 ","$4,140.00 ","$3,735.00 ","$4,140.00 ","$2,910.38 ","$4,140.00 ","$5,250.00 ","$5,250.00 ","$6,375.00 ","$7,275.94 ","$5,197.50 ","$2,910.38 ","$7,500.00 ","$4,125.00 ","$2,910.38 ","$1,972.50 ","$7,500.00 ","$1,615.02 ","$1,541.61 ","$3,055.90 ","$6,000.00 ","$4,072.50 ","$2,100.00 ","$6,750.00 ","$2,850.00 ",$500.00 ,"$2,910.38 ","$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,32000079,50435,HC CHANGE NEPHROSTOMY TUBE,320,1 ,"$4,689.00 ","$3,047.85 ",$260.86 ,"$4,689.00 ","$4,237.25 ","$2,391.39 ","$2,578.95 ","$1,694.90 ","$1,312.92 ","$2,203.83 ","$1,694.90 ","$2,532.06 ","$1,694.90 ","$2,546.13 ",$260.86 ,"$1,694.90 ","$2,546.13 ","$3,220.31 ","$3,282.30 ","$2,344.50 ","$3,751.20 ","$4,237.26 ","$1,694.90 ","$3,282.30 ","$1,694.90 ","$2,813.40 ","$1,694.90 ","$3,516.75 ","$2,588.33 ","$2,335.12 ","$2,588.33 ","$1,694.90 ","$2,588.33 ","$3,282.30 ","$3,282.30 ","$3,985.65 ","$4,237.26 ","$3,249.48 ","$1,694.90 ","$4,689.00 ","$2,578.95 ","$1,694.90 ","$1,233.21 ","$4,689.00 ",$759.25 ,$724.74 ,"$1,779.65 ","$3,751.20 ","$2,546.13 ","$1,312.92 ","$4,220.10 ","$1,781.82 ",$500.00 ,"$1,694.90 ","$2,250.72 "
ST. MARY'S HOSPITAL - DECATUR,32000085,51600,HC INJ CYSTOGRAM,320,1 ,$91.00 ,$59.15 ,$23.93 ,$231.80 , N/A ,$46.41 ,$50.05 , N/A ,$25.48 ,$42.77 , N/A ,$49.14 , N/A ,$49.41 ,$91.00 , N/A ,$49.41 , N/A ,$63.70 ,$45.50 ,$72.80 , N/A , N/A ,$63.70 , N/A ,$54.60 , N/A ,$68.25 ,$50.23 ,$45.32 ,$50.23 , N/A ,$50.23 ,$63.70 ,$63.70 ,$77.35 , N/A ,$63.06 , N/A ,$91.00 ,$50.05 , N/A ,$23.93 ,$91.00 ,$91.00 ,$231.80 , N/A ,$72.80 ,$49.41 ,$25.48 ,$81.90 ,$34.58 ,$91.00 , N/A ,$43.68 
ST. MARY'S HOSPITAL - DECATUR,32000086,51610,HC INJ URETHROCYSTOGRAM RETRO,320,1 ,$91.00 ,$59.15 ,$23.93 ,$231.80 , N/A ,$46.41 ,$50.05 , N/A ,$25.48 ,$42.77 , N/A ,$49.14 , N/A ,$49.41 ,$91.00 , N/A ,$49.41 , N/A ,$63.70 ,$45.50 ,$72.80 , N/A , N/A ,$63.70 , N/A ,$54.60 , N/A ,$68.25 ,$50.23 ,$45.32 ,$50.23 , N/A ,$50.23 ,$63.70 ,$63.70 ,$77.35 , N/A ,$63.06 , N/A ,$91.00 ,$50.05 , N/A ,$23.93 ,$91.00 ,$91.00 ,$231.80 , N/A ,$72.80 ,$49.41 ,$25.48 ,$81.90 ,$34.58 ,$91.00 , N/A ,$43.68 
ST. MARY'S HOSPITAL - DECATUR,32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,$91.00 ,$59.15 ,$23.93 ,$231.80 , N/A ,$46.41 ,$50.05 , N/A ,$25.48 ,$42.77 , N/A ,$49.14 , N/A ,$49.41 ,$91.00 , N/A ,$49.41 , N/A ,$63.70 ,$45.50 ,$72.80 , N/A , N/A ,$63.70 , N/A ,$54.60 , N/A ,$68.25 ,$50.23 ,$45.32 ,$50.23 , N/A ,$50.23 ,$63.70 ,$63.70 ,$77.35 , N/A ,$63.06 , N/A ,$91.00 ,$50.05 , N/A ,$23.93 ,$91.00 ,$91.00 ,$231.80 , N/A ,$72.80 ,$49.41 ,$25.48 ,$81.90 ,$34.58 ,$91.00 , N/A ,$43.68 
ST. MARY'S HOSPITAL - DECATUR,32000089,61070,HC PUNCT ASP/INJ SHUNT TUBE,320,1 ,"$2,623.00 ","$1,704.95 ",$115.17 ,"$2,623.00 ","$1,502.73 ","$1,337.73 ","$1,442.65 ",$601.09 ,$734.44 ,"$1,232.81 ",$601.09 ,"$1,416.42 ",$601.09 ,"$1,424.29 ",$115.17 ,$601.09 ,"$1,424.29 ","$1,142.07 ","$1,836.10 ","$1,311.50 ","$2,098.40 ","$1,502.72 ",$601.09 ,"$1,836.10 ",$601.09 ,"$1,573.80 ",$601.09 ,"$1,967.25 ","$1,447.90 ","$1,306.25 ","$1,447.90 ",$601.09 ,"$1,447.90 ","$1,836.10 ","$1,836.10 ","$2,229.55 ","$1,502.72 ","$1,817.74 ",$601.09 ,"$2,623.00 ","$1,442.65 ",$601.09 ,$689.85 ,"$2,623.00 ",$242.84 ,$231.80 ,$631.14 ,"$2,098.40 ","$1,424.29 ",$734.44 ,"$2,360.70 ",$996.74 ,$500.00 ,$601.09 ,"$1,259.04 "
ST. MARY'S HOSPITAL - DECATUR,32000090,62272,HC LUMBAR PUNCTURE DRAIN,320,1 ,"$1,450.00 ",$942.50 ,$171.12 ,"$1,502.73 ","$1,502.73 ",$739.50 ,$797.50 ,$601.09 ,$406.00 ,$681.50 ,$601.09 ,$783.00 ,$601.09 ,$787.35 ,$171.12 ,$601.09 ,$787.35 ,"$1,142.07 ","$1,015.00 ",$725.00 ,"$1,160.00 ","$1,502.72 ",$601.09 ,"$1,015.00 ",$601.09 ,$870.00 ,$601.09 ,"$1,087.50 ",$800.40 ,$722.10 ,$800.40 ,$601.09 ,$800.40 ,"$1,015.00 ","$1,015.00 ","$1,232.50 ","$1,450.00 ","$1,004.85 ",$601.09 ,"$1,450.00 ",$797.50 ,$601.09 ,$381.35 ,"$1,450.00 ",$361.39 ,$344.97 ,$631.14 ,"$1,160.00 ",$787.35 ,$406.00 ,"$1,305.00 ",$551.00 ,$500.00 ,$601.09 ,$696.00 
ST. MARY'S HOSPITAL - DECATUR,32000091,62284,HC INJ MYELOGRAM,320,1 ,"$1,106.00 ",$718.90 ,$178.85 ,"$1,106.00 ", N/A ,$564.06 ,$608.30 , N/A ,$309.68 ,$519.82 , N/A ,$597.24 , N/A ,$600.56 ,$178.85 , N/A ,$600.56 , N/A ,$774.20 ,$553.00 ,$884.80 , N/A , N/A ,$774.20 , N/A ,$663.60 , N/A ,$829.50 ,$610.51 ,$550.79 ,$610.51 , N/A ,$610.51 ,$774.20 ,$774.20 ,$940.10 , N/A ,$766.46 , N/A ,"$1,106.00 ",$608.30 , N/A ,$290.88 ,"$1,106.00 ",$423.62 ,$404.37 , N/A ,$884.80 ,$600.56 ,$309.68 ,$995.40 ,$420.28 ,$500.00 , N/A ,$530.88 
ST. MARY'S HOSPITAL - DECATUR,32000092,62287,HC DECOMP DISC LUMBAR PERC,320,1 ,"$11,363.00 ","$7,385.95 ",$500.00 ,"$11,363.00 ","$4,155.38 ","$5,795.13 ","$6,249.65 ","$1,662.15 ","$3,181.64 ","$5,340.61 ","$1,662.15 ","$6,136.02 ","$1,662.15 ","$6,170.11 ","$1,167.43 ","$1,662.15 ","$6,170.11 ","$3,158.08 ","$7,954.10 ","$5,681.50 ","$9,090.40 ","$4,155.37 ","$1,662.15 ","$7,954.10 ","$1,662.15 ","$6,817.80 ","$1,662.15 ","$8,522.25 ","$6,272.38 ","$5,658.77 ","$6,272.38 ","$1,662.15 ","$6,272.38 ","$7,954.10 ","$7,954.10 ","$9,658.55 ","$4,155.37 ","$7,874.56 ","$1,662.15 ","$11,363.00 ","$6,249.65 ","$1,662.15 ","$2,988.47 ","$11,363.00 ","$3,107.10 ","$2,965.87 ","$1,745.26 ","$9,090.40 ","$6,170.11 ","$3,181.64 ","$10,226.70 ","$4,317.94 ",$500.00 ,"$1,662.15 ","$5,454.24 "
ST. MARY'S HOSPITAL - DECATUR,32000093,62290,HC INJ DISKOGRAM LUMBAR EA LEVEL,320,1 ,"$2,088.00 ","$1,357.20 ",$336.34 ,"$2,088.00 ", N/A ,"$1,064.88 ","$1,148.40 ", N/A ,$584.64 ,$981.36 , N/A ,"$1,127.52 ", N/A ,"$1,133.78 ",$336.34 , N/A ,"$1,133.78 ", N/A ,"$1,461.60 ","$1,044.00 ","$1,670.40 ", N/A , N/A ,"$1,461.60 ", N/A ,"$1,252.80 ", N/A ,"$1,566.00 ","$1,152.58 ","$1,039.82 ","$1,152.58 ", N/A ,"$1,152.58 ","$1,461.60 ","$1,461.60 ","$1,774.80 ", N/A ,"$1,446.98 ", N/A ,"$2,088.00 ","$1,148.40 ", N/A ,$549.14 ,"$2,088.00 ",$423.62 ,$404.37 , N/A ,"$1,670.40 ","$1,133.78 ",$584.64 ,"$1,879.20 ",$793.44 ,$500.00 , N/A ,"$1,002.24 "
ST. MARY'S HOSPITAL - DECATUR,32000094,62291,HC INJ DISKOGRAM CERVICAL EA LVL,320,1 ,"$1,805.00 ","$1,173.25 ",$325.18 ,"$1,805.00 ", N/A ,$920.55 ,$992.75 , N/A ,$505.40 ,$848.35 , N/A ,$974.70 , N/A ,$980.12 ,$325.18 , N/A ,$980.12 , N/A ,"$1,263.50 ",$902.50 ,"$1,444.00 ", N/A , N/A ,"$1,263.50 ", N/A ,"$1,083.00 ", N/A ,"$1,353.75 ",$996.36 ,$898.89 ,$996.36 , N/A ,$996.36 ,"$1,263.50 ","$1,263.50 ","$1,534.25 ", N/A ,"$1,250.87 ", N/A ,"$1,805.00 ",$992.75 , N/A ,$474.72 ,"$1,805.00 ",$423.62 ,$404.37 , N/A ,"$1,444.00 ",$980.12 ,$505.40 ,"$1,624.50 ",$685.90 ,$500.00 , N/A ,$866.40 
ST. MARY'S HOSPITAL - DECATUR,32000097,62350,HC IMPLANT/REVISE SPINAL CATHETER,320,1 ,"$11,463.00 ","$7,450.95 ",$500.00 ,"$13,494.98 ","$13,494.98 ","$5,846.13 ","$6,304.65 ","$5,397.99 ","$3,209.64 ","$5,387.61 ","$5,397.99 ","$6,190.02 ","$5,397.99 ","$6,224.41 ",$808.53 ,"$5,397.99 ","$6,224.41 ","$10,256.17 ","$8,024.10 ","$5,731.50 ","$9,170.40 ","$13,494.97 ","$5,397.99 ","$8,024.10 ","$5,397.99 ","$6,877.80 ","$5,397.99 ","$8,597.25 ","$6,327.58 ","$5,708.57 ","$6,327.58 ","$5,397.99 ","$6,327.58 ","$8,024.10 ","$8,024.10 ","$9,743.55 ","$11,463.00 ","$7,943.86 ","$5,397.99 ","$11,463.00 ","$6,304.65 ","$5,397.99 ","$3,014.77 ","$11,463.00 ","$3,732.85 ","$3,563.18 ","$5,667.89 ","$9,170.40 ","$6,224.41 ","$3,209.64 ","$10,316.70 ","$4,355.94 ",$500.00 ,"$5,397.99 ","$5,502.24 "
ST. MARY'S HOSPITAL - DECATUR,32000098,70030,HC XRAY EYE (FOREIGN BODY),320,1 ,$353.00 ,$229.45 ,$29.46 ,$353.00 ,$191.43 ,$39.94 ,$194.15 ,$76.57 ,$98.84 ,$172.97 ,$76.57 ,$206.51 ,$76.57 ,$191.68 ,$43.39 ,$76.57 ,$191.68 ,$145.48 ,$247.10 ,$176.50 ,$282.40 ,$191.42 ,$76.57 ,$247.10 ,$76.57 ,$211.80 ,$76.57 ,$264.75 ,$194.86 ,$175.79 ,$194.86 ,$76.57 ,$194.86 ,$29.46 ,$29.46 ,$300.05 ,$191.42 ,$244.63 ,$76.57 ,$353.00 ,$194.15 ,$76.57 ,$92.84 ,$353.00 ,$38.93 ,$37.16 ,$80.40 ,$282.40 ,$191.68 ,$98.84 ,$317.70 ,$134.14 ,$353.00 ,$76.57 ,$169.44 
ST. MARY'S HOSPITAL - DECATUR,32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$632.00 ,$410.80 ,$37.16 ,$632.00 ,$257.65 ,$52.31 ,$347.60 ,$103.06 ,$176.96 ,$309.68 ,$103.06 ,$356.83 ,$103.06 ,$343.18 ,$56.56 ,$103.06 ,$343.18 ,$195.81 ,$442.40 ,$316.00 ,$505.60 ,$257.64 ,$103.06 ,$442.40 ,$103.06 ,$379.20 ,$103.06 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$103.06 ,$348.86 ,$38.42 ,$38.42 ,$537.20 ,$257.64 ,$437.98 ,$103.06 ,$632.00 ,$347.60 ,$103.06 ,$166.22 ,$632.00 ,$38.93 ,$37.16 ,$108.21 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$500.00 ,$103.06 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,32000101,70130,HC MASTOIDS MN 3VW PER SIDE,320,1 ,$302.00 ,$196.30 ,$37.16 ,$302.00 ,$257.65 ,$80.19 ,$166.10 ,$103.06 ,$84.56 ,$147.98 ,$103.06 ,$176.67 ,$103.06 ,$163.99 ,$82.16 ,$103.06 ,$163.99 ,$195.81 ,$211.40 ,$151.00 ,$241.60 ,$257.64 ,$103.06 ,$211.40 ,$103.06 ,$181.20 ,$103.06 ,$226.50 ,$166.70 ,$150.40 ,$166.70 ,$103.06 ,$166.70 ,$55.80 ,$55.80 ,$256.70 ,$257.64 ,$209.29 ,$103.06 ,$302.00 ,$166.10 ,$103.06 ,$79.43 ,$302.00 ,$38.93 ,$37.16 ,$108.21 ,$241.60 ,$163.99 ,$84.56 ,$271.80 ,$114.76 ,$302.00 ,$103.06 ,$144.96 
ST. MARY'S HOSPITAL - DECATUR,32000103,70140,HC FACIAL BONES < 3 VIEWS,320,1 ,$573.00 ,$372.45 ,$28.47 ,$573.00 ,$191.43 ,$38.68 ,$315.15 ,$76.57 ,$160.44 ,$272.39 ,$76.57 ,$272.39 ,$76.57 ,$311.14 ,$41.93 ,$76.57 ,$311.14 ,$145.48 ,$401.10 ,$286.50 ,$458.40 ,$191.42 ,$76.57 ,$401.10 ,$76.57 ,$343.80 ,$76.57 ,$429.75 ,$316.30 ,$285.35 ,$316.30 ,$76.57 ,$316.30 ,$28.47 ,$28.47 ,$487.05 ,$191.42 ,$397.09 ,$76.57 ,$573.00 ,$315.15 ,$76.57 ,$150.70 ,$573.00 ,$38.93 ,$37.16 ,$80.40 ,$458.40 ,$311.14 ,$160.44 ,$515.70 ,$217.74 ,$500.00 ,$76.57 ,$275.04 
ST. MARY'S HOSPITAL - DECATUR,32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$891.00 ,$579.15 ,$37.16 ,$891.00 ,$257.65 ,$57.26 ,$490.05 ,$103.06 ,$249.48 ,$396.54 ,$103.06 ,$396.54 ,$103.06 ,$483.81 ,$62.41 ,$103.06 ,$483.81 ,$195.81 ,$623.70 ,$445.50 ,$712.80 ,$257.64 ,$103.06 ,$623.70 ,$103.06 ,$534.60 ,$103.06 ,$668.25 ,$491.83 ,$443.72 ,$491.83 ,$103.06 ,$491.83 ,$42.39 ,$42.39 ,$757.35 ,$257.64 ,$617.46 ,$103.06 ,$891.00 ,$490.05 ,$103.06 ,$234.33 ,$891.00 ,$38.93 ,$37.16 ,$108.21 ,$712.80 ,$483.81 ,$249.48 ,$801.90 ,$338.58 ,$500.00 ,$103.06 ,$427.68 
ST. MARY'S HOSPITAL - DECATUR,32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$630.00 ,$409.50 ,$35.93 ,$630.00 ,$191.43 ,$47.97 ,$346.50 ,$76.57 ,$176.40 ,$308.70 ,$76.57 ,$341.89 ,$76.57 ,$342.09 ,$52.90 ,$76.57 ,$342.09 ,$145.48 ,$441.00 ,$315.00 ,$504.00 ,$191.42 ,$76.57 ,$441.00 ,$76.57 ,$378.00 ,$76.57 ,$472.50 ,$347.76 ,$313.74 ,$347.76 ,$76.57 ,$347.76 ,$35.93 ,$35.93 ,$535.50 ,$191.42 ,$436.59 ,$76.57 ,$630.00 ,$346.50 ,$76.57 ,$165.69 ,$630.00 ,$38.93 ,$37.16 ,$80.40 ,$504.00 ,$342.09 ,$176.40 ,$567.00 ,$239.40 ,$500.00 ,$76.57 ,$302.40 
ST. MARY'S HOSPITAL - DECATUR,32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$726.00 ,$471.90 ,$37.16 ,$726.00 ,$257.65 ,$57.26 ,$399.30 ,$103.06 ,$203.28 ,$355.74 ,$103.06 ,$396.54 ,$103.06 ,$394.22 ,$61.68 ,$103.06 ,$394.22 ,$195.81 ,$508.20 ,$363.00 ,$580.80 ,$257.64 ,$103.06 ,$508.20 ,$103.06 ,$435.60 ,$103.06 ,$544.50 ,$400.75 ,$361.55 ,$400.75 ,$103.06 ,$400.75 ,$41.88 ,$41.88 ,$617.10 ,$257.64 ,$503.12 ,$103.06 ,$726.00 ,$399.30 ,$103.06 ,$190.94 ,$726.00 ,$38.93 ,$37.16 ,$108.21 ,$580.80 ,$394.22 ,$203.28 ,$653.40 ,$275.88 ,$500.00 ,$103.06 ,$348.48 
ST. MARY'S HOSPITAL - DECATUR,32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$556.00 ,$361.40 ,$31.95 ,$556.00 ,$191.43 ,$43.02 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$297.26 ,$76.57 ,$301.91 ,$47.05 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$31.95 ,$31.95 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$851.00 ,$553.15 ,$36.92 ,$851.00 ,$191.43 ,$51.08 ,$468.05 ,$76.57 ,$238.28 ,$351.82 ,$76.57 ,$351.82 ,$76.57 ,$462.09 ,$54.36 ,$76.57 ,$462.09 ,$145.48 ,$595.70 ,$425.50 ,$680.80 ,$191.42 ,$76.57 ,$595.70 ,$76.57 ,$510.60 ,$76.57 ,$638.25 ,$469.75 ,$423.80 ,$469.75 ,$76.57 ,$469.75 ,$36.92 ,$36.92 ,$723.35 ,$191.42 ,$589.74 ,$76.57 ,$851.00 ,$468.05 ,$76.57 ,$223.81 ,$851.00 ,$38.93 ,$37.16 ,$80.40 ,$680.80 ,$462.09 ,$238.28 ,$765.90 ,$323.38 ,$500.00 ,$76.57 ,$408.48 
ST. MARY'S HOSPITAL - DECATUR,32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$632.00 ,$410.80 ,$35.43 ,$632.00 ,$257.65 ,$47.97 ,$347.60 ,$103.06 ,$176.96 ,$309.68 ,$103.06 ,$336.97 ,$103.06 ,$343.18 ,$52.17 ,$103.06 ,$343.18 ,$195.81 ,$442.40 ,$316.00 ,$505.60 ,$257.64 ,$103.06 ,$442.40 ,$103.06 ,$379.20 ,$103.06 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$103.06 ,$348.86 ,$35.43 ,$35.43 ,$537.20 ,$257.64 ,$437.98 ,$103.06 ,$632.00 ,$347.60 ,$103.06 ,$166.22 ,$632.00 ,$38.93 ,$37.16 ,$108.21 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$500.00 ,$103.06 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,32000111,70250,HC SKULL LESS THAN 4 VIEWS OR,320,1 ,$632.00 ,$410.80 ,$35.43 ,$632.00 ,$257.65 ,$47.97 ,$347.60 ,$103.06 ,$176.96 ,$309.68 ,$103.06 ,$336.97 ,$103.06 ,$343.18 ,$52.17 ,$103.06 ,$343.18 ,$195.81 ,$442.40 ,$316.00 ,$505.60 ,$257.64 ,$103.06 ,$442.40 ,$103.06 ,$379.20 ,$103.06 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$103.06 ,$348.86 ,$35.43 ,$35.43 ,$537.20 ,$257.64 ,$437.98 ,$103.06 ,$632.00 ,$347.60 ,$103.06 ,$166.22 ,$632.00 ,$38.93 ,$37.16 ,$108.21 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$500.00 ,$103.06 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$980.00 ,$637.00 ,$37.16 ,$980.00 ,$257.65 ,$57.89 ,$539.00 ,$103.06 ,$274.40 ,$396.54 ,$103.06 ,$396.54 ,$103.06 ,$532.14 ,$61.68 ,$103.06 ,$532.14 ,$195.81 ,$686.00 ,$490.00 ,$784.00 ,$257.64 ,$103.06 ,$686.00 ,$103.06 ,$588.00 ,$103.06 ,$735.00 ,$540.96 ,$488.04 ,$540.96 ,$103.06 ,$540.96 ,$41.88 ,$41.88 ,$833.00 ,$257.64 ,$679.14 ,$103.06 ,$980.00 ,$539.00 ,$103.06 ,$257.74 ,$980.00 ,$38.93 ,$37.16 ,$108.21 ,$784.00 ,$532.14 ,$274.40 ,$882.00 ,$372.40 ,$500.00 ,$103.06 ,$470.40 
ST. MARY'S HOSPITAL - DECATUR,32000113,70330,HC TEMPOROMANDIBULAR JOINTS BILAT,320,1 ,$230.00 ,$149.50 ,$37.16 ,$230.00 ,$191.43 ,$69.03 ,$126.50 ,$76.57 ,$64.40 ,$112.70 ,$76.57 ,$134.55 ,$76.57 ,$124.89 ,$76.31 ,$76.57 ,$124.89 ,$145.48 ,$161.00 ,$115.00 ,$184.00 ,$191.42 ,$76.57 ,$161.00 ,$76.57 ,$138.00 ,$76.57 ,$172.50 ,$126.96 ,$114.54 ,$126.96 ,$76.57 ,$126.96 ,$51.83 ,$51.83 ,$195.50 ,$191.42 ,$159.39 ,$76.57 ,$230.00 ,$126.50 ,$76.57 ,$60.49 ,$230.00 ,$38.93 ,$37.16 ,$80.40 ,$184.00 ,$124.89 ,$64.40 ,$207.00 ,$87.40 ,$230.00 ,$76.57 ,$110.40 
ST. MARY'S HOSPITAL - DECATUR,32000114,70336,HC MRI TMJ,320,1 ,"$5,742.00 ","$3,732.30 ",$156.11 ,"$5,742.00 ",$544.53 ,$574.79 ,"$3,158.10 ",$217.81 ,"$1,607.76 ","$2,813.58 ",$217.81 ,"$3,359.07 ",$217.81 ,"$3,117.91 ",$495.70 ,$217.81 ,"$3,117.91 ",$413.84 ,"$4,019.40 ","$2,871.00 ","$4,593.60 ",$544.53 ,$217.81 ,"$4,019.40 ",$217.81 ,"$3,445.20 ",$217.81 ,"$4,306.50 ","$3,169.58 ","$2,859.52 ","$3,169.58 ",$217.81 ,"$3,169.58 ",$318.27 ,$318.27 ,"$4,880.70 ",$544.53 ,"$3,979.21 ",$217.81 ,"$5,742.00 ","$3,158.10 ",$217.81 ,"$1,510.15 ","$5,742.00 ",$163.55 ,$156.11 ,$228.70 ,"$4,593.60 ","$3,117.91 ","$1,607.76 ","$5,167.80 ","$2,181.96 ",$500.00 ,$217.81 ,"$2,756.16 "
ST. MARY'S HOSPITAL - DECATUR,32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$366.00 ,$237.90 ,$30.47 ,$366.00 ,$191.43 ,$37.44 ,$201.30 ,$76.57 ,$102.48 ,$179.34 ,$76.57 ,$214.11 ,$76.57 ,$198.74 ,$44.85 ,$76.57 ,$198.74 ,$145.48 ,$256.20 ,$183.00 ,$292.80 ,$191.42 ,$76.57 ,$256.20 ,$76.57 ,$219.60 ,$76.57 ,$274.50 ,$202.03 ,$182.27 ,$202.03 ,$76.57 ,$202.03 ,$30.47 ,$30.47 ,$311.10 ,$191.42 ,$253.64 ,$76.57 ,$366.00 ,$201.30 ,$76.57 ,$96.26 ,$366.00 ,$38.93 ,$37.16 ,$80.40 ,$292.80 ,$198.74 ,$102.48 ,$329.40 ,$139.08 ,$366.00 ,$76.57 ,$175.68 
ST. MARY'S HOSPITAL - DECATUR,32000121,71045,HC XR CHEST 1V,320,1 ,$515.00 ,$334.75 ,$18.14 ,$515.00 ,$191.43 ,$20.09 ,$283.25 ,$76.57 ,$144.20 ,$153.25 ,$76.57 ,$153.25 ,$76.57 ,$279.65 ,$32.42 ,$76.57 ,$279.65 ,$145.48 ,$360.50 ,$257.50 ,$412.00 ,$191.42 ,$76.57 ,$360.50 ,$76.57 ,$309.00 ,$76.57 ,$386.25 ,$284.28 ,$256.47 ,$284.28 ,$76.57 ,$284.28 ,$22.02 ,$22.02 ,$437.75 ,$191.42 ,$356.90 ,$76.57 ,$18.14 ,$283.25 ,$76.57 ,$135.45 ,$515.00 ,$38.93 ,$37.16 ,$80.40 ,$412.00 ,$279.65 ,$144.20 ,$463.50 ,$195.70 ,$500.00 ,$76.57 ,$247.20 
ST. MARY'S HOSPITAL - DECATUR,32000127,71046,HC XR CHEST 2V,320,1 ,$600.00 ,$390.00 ,$24.70 ,$600.00 ,$191.43 ,$36.65 ,$330.00 ,$76.57 ,$168.00 ,$277.40 ,$76.57 ,$277.40 ,$76.57 ,$325.80 ,$42.66 ,$76.57 ,$325.80 ,$145.48 ,$420.00 ,$300.00 ,$480.00 ,$191.42 ,$76.57 ,$420.00 ,$76.57 ,$360.00 ,$76.57 ,$450.00 ,$331.20 ,$298.80 ,$331.20 ,$76.57 ,$331.20 ,$28.97 ,$28.97 ,$510.00 ,$191.42 ,$415.80 ,$76.57 ,$24.70 ,$330.00 ,$76.57 ,$157.80 ,$600.00 ,$38.93 ,$37.16 ,$80.40 ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$500.00 ,$76.57 ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$521.00 ,$338.65 ,$35.93 ,$521.00 ,$191.43 ,$46.58 ,$286.55 ,$76.57 ,$145.88 ,$255.29 ,$76.57 ,$304.79 ,$76.57 ,$282.90 ,$52.90 ,$76.57 ,$282.90 ,$145.48 ,$364.70 ,$260.50 ,$416.80 ,$191.42 ,$76.57 ,$364.70 ,$76.57 ,$312.60 ,$76.57 ,$390.75 ,$287.59 ,$259.46 ,$287.59 ,$76.57 ,$287.59 ,$35.93 ,$35.93 ,$442.85 ,$191.42 ,$361.05 ,$76.57 ,$521.00 ,$286.55 ,$76.57 ,$137.02 ,$521.00 ,$38.93 ,$37.16 ,$80.40 ,$416.80 ,$282.90 ,$145.88 ,$468.90 ,$197.98 ,$500.00 ,$76.57 ,$250.08 
ST. MARY'S HOSPITAL - DECATUR,32000131,71048,HC XR CHEST PA/LAT W/OBLIQUES,320,1 ,$730.00 ,$474.50 ,$37.16 ,$730.00 ,$257.65 ,$47.90 ,$401.50 ,$103.06 ,$204.40 ,$357.70 ,$103.06 ,$361.74 ,$103.06 ,$396.39 ,$55.09 ,$103.06 ,$396.39 ,$195.81 ,$511.00 ,$365.00 ,$584.00 ,$257.64 ,$103.06 ,$511.00 ,$103.06 ,$438.00 ,$103.06 ,$547.50 ,$402.96 ,$363.54 ,$402.96 ,$103.06 ,$402.96 ,$37.41 ,$37.41 ,$620.50 ,$257.64 ,$505.89 ,$103.06 ,$730.00 ,$401.50 ,$103.06 ,$191.99 ,$730.00 ,$38.93 ,$37.16 ,$108.21 ,$584.00 ,$396.39 ,$204.40 ,$657.00 ,$277.40 ,$500.00 ,$103.06 ,$350.40 
ST. MARY'S HOSPITAL - DECATUR,32000133,71048,HC XR CHEST 4+V,320,1 ,$730.00 ,$474.50 ,$37.16 ,$730.00 ,$257.65 ,$47.90 ,$401.50 ,$103.06 ,$204.40 ,$357.70 ,$103.06 ,$361.74 ,$103.06 ,$396.39 ,$55.09 ,$103.06 ,$396.39 ,$195.81 ,$511.00 ,$365.00 ,$584.00 ,$257.64 ,$103.06 ,$511.00 ,$103.06 ,$438.00 ,$103.06 ,$547.50 ,$402.96 ,$363.54 ,$402.96 ,$103.06 ,$402.96 ,$37.41 ,$37.41 ,$620.50 ,$257.64 ,$505.89 ,$103.06 ,$730.00 ,$401.50 ,$103.06 ,$191.99 ,$730.00 ,$38.93 ,$37.16 ,$108.21 ,$584.00 ,$396.39 ,$204.40 ,$657.00 ,$277.40 ,$500.00 ,$103.06 ,$350.40 
ST. MARY'S HOSPITAL - DECATUR,32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$600.00 ,$390.00 ,$24.70 ,$600.00 ,$191.43 ,$36.65 ,$330.00 ,$76.57 ,$168.00 ,$277.40 ,$76.57 ,$277.40 ,$76.57 ,$325.80 ,$42.66 ,$76.57 ,$325.80 ,$145.48 ,$420.00 ,$300.00 ,$480.00 ,$191.42 ,$76.57 ,$420.00 ,$76.57 ,$360.00 ,$76.57 ,$450.00 ,$331.20 ,$298.80 ,$331.20 ,$76.57 ,$331.20 ,$28.97 ,$28.97 ,$510.00 ,$191.42 ,$415.80 ,$76.57 ,$24.70 ,$330.00 ,$76.57 ,$157.80 ,$600.00 ,$38.93 ,$37.16 ,$80.40 ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$500.00 ,$76.57 ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,32000137,71100,HC XR RIBS 2V UNI,320,1 ,$704.00 ,$457.60 ,$32.45 ,$704.00 ,$191.43 ,$41.18 ,$387.20 ,$76.57 ,$197.12 ,$312.10 ,$76.57 ,$312.10 ,$76.57 ,$382.27 ,$47.78 ,$76.57 ,$382.27 ,$145.48 ,$492.80 ,$352.00 ,$563.20 ,$191.42 ,$76.57 ,$492.80 ,$76.57 ,$422.40 ,$76.57 ,$528.00 ,$388.61 ,$350.59 ,$388.61 ,$76.57 ,$388.61 ,$32.45 ,$32.45 ,$598.40 ,$191.42 ,$487.87 ,$76.57 ,$704.00 ,$387.20 ,$76.57 ,$185.15 ,$704.00 ,$38.93 ,$37.16 ,$80.40 ,$563.20 ,$382.27 ,$197.12 ,$633.60 ,$267.52 ,$500.00 ,$76.57 ,$337.92 
ST. MARY'S HOSPITAL - DECATUR,32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$615.00 ,$399.75 ,$35.93 ,$615.00 ,$257.65 ,$50.45 ,$338.25 ,$103.06 ,$172.20 ,$301.35 ,$103.06 ,$346.90 ,$103.06 ,$333.95 ,$52.90 ,$103.06 ,$333.95 ,$195.81 ,$430.50 ,$307.50 ,$492.00 ,$257.64 ,$103.06 ,$430.50 ,$103.06 ,$369.00 ,$103.06 ,$461.25 ,$339.48 ,$306.27 ,$339.48 ,$103.06 ,$339.48 ,$35.93 ,$35.93 ,$522.75 ,$257.64 ,$426.20 ,$103.06 ,$615.00 ,$338.25 ,$103.06 ,$161.75 ,$615.00 ,$38.93 ,$37.16 ,$108.21 ,$492.00 ,$333.95 ,$172.20 ,$553.50 ,$233.70 ,$500.00 ,$103.06 ,$295.20 
ST. MARY'S HOSPITAL - DECATUR,32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$870.00 ,$565.50 ,$36.92 ,$870.00 ,$257.65 ,$52.31 ,$478.50 ,$103.06 ,$243.60 ,$356.83 ,$103.06 ,$356.83 ,$103.06 ,$472.41 ,$54.36 ,$103.06 ,$472.41 ,$195.81 ,$609.00 ,$435.00 ,$696.00 ,$257.64 ,$103.06 ,$609.00 ,$103.06 ,$522.00 ,$103.06 ,$652.50 ,$480.24 ,$433.26 ,$480.24 ,$103.06 ,$480.24 ,$36.92 ,$36.92 ,$739.50 ,$257.64 ,$602.91 ,$103.06 ,$870.00 ,$478.50 ,$103.06 ,$228.81 ,$870.00 ,$38.93 ,$37.16 ,$108.21 ,$696.00 ,$472.41 ,$243.60 ,$783.00 ,$330.60 ,$500.00 ,$103.06 ,$417.60 
ST. MARY'S HOSPITAL - DECATUR,32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$744.00 ,$483.60 ,$37.16 ,$744.00 ,$257.65 ,$71.51 ,$409.20 ,$103.06 ,$208.32 ,$364.56 ,$103.06 ,$431.24 ,$103.06 ,$403.99 ,$66.80 ,$103.06 ,$403.99 ,$195.81 ,$520.80 ,$372.00 ,$595.20 ,$257.64 ,$103.06 ,$520.80 ,$103.06 ,$446.40 ,$103.06 ,$558.00 ,$410.69 ,$370.51 ,$410.69 ,$103.06 ,$410.69 ,$45.36 ,$45.36 ,$632.40 ,$257.64 ,$515.59 ,$103.06 ,$744.00 ,$409.20 ,$103.06 ,$195.67 ,$744.00 ,$38.93 ,$37.16 ,$108.21 ,$595.20 ,$403.99 ,$208.32 ,$669.60 ,$282.72 ,$500.00 ,$103.06 ,$357.12 
ST. MARY'S HOSPITAL - DECATUR,32000141,71120,HC XR STERNUM 2+V,320,1 ,$664.00 ,$431.60 ,$29.46 ,$664.00 ,$191.43 ,$41.78 ,$365.20 ,$76.57 ,$185.92 ,$277.40 ,$76.57 ,$277.40 ,$76.57 ,$360.55 ,$43.39 ,$76.57 ,$360.55 ,$145.48 ,$464.80 ,$332.00 ,$531.20 ,$191.42 ,$76.57 ,$464.80 ,$76.57 ,$398.40 ,$76.57 ,$498.00 ,$366.53 ,$330.67 ,$366.53 ,$76.57 ,$366.53 ,$29.46 ,$29.46 ,$564.40 ,$191.42 ,$460.15 ,$76.57 ,$664.00 ,$365.20 ,$76.57 ,$174.63 ,$664.00 ,$38.93 ,$37.16 ,$80.40 ,$531.20 ,$360.55 ,$185.92 ,$597.60 ,$252.32 ,$500.00 ,$76.57 ,$318.72 
ST. MARY'S HOSPITAL - DECATUR,32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$556.00 ,$361.40 ,$36.92 ,$556.00 ,$191.43 ,$50.45 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$325.26 ,$76.57 ,$301.91 ,$54.36 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$36.92 ,$36.92 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$3,365.00 ","$2,187.25 ",$92.72 ,"$3,365.00 ",$257.65 ,$750.00 ,"$1,850.75 ",$103.06 ,$942.20 ,"$1,648.85 ",$103.06 ,"$1,860.52 ",$103.06 ,"$1,827.20 ",$205.79 ,$103.06 ,"$1,827.20 ",$195.81 ,"$2,355.50 ","$1,682.50 ","$2,692.00 ",$257.64 ,$103.06 ,"$2,355.50 ",$103.06 ,"$2,019.00 ",$103.06 ,"$2,523.75 ","$1,857.48 ","$1,675.77 ","$1,857.48 ",$103.06 ,"$1,857.48 ",$139.76 ,$139.76 ,"$2,860.25 ",$257.64 ,"$2,331.95 ",$103.06 ,"$3,365.00 ","$1,850.75 ",$103.06 ,$885.00 ,"$3,365.00 ",$97.13 ,$92.72 ,$108.21 ,"$2,692.00 ","$1,827.20 ",$942.20 ,"$3,028.50 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,615.20 "
ST. MARY'S HOSPITAL - DECATUR,32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$3,643.00 ","$2,367.95 ",$92.72 ,"$3,643.00 ",$422.73 ,$750.00 ,"$2,003.65 ",$169.09 ,"$1,020.04 ","$1,785.07 ",$169.09 ,"$2,131.16 ",$169.09 ,"$1,978.15 ",$275.28 ,$169.09 ,"$1,978.15 ",$321.27 ,"$2,550.10 ","$1,821.50 ","$2,914.40 ",$422.72 ,$169.09 ,"$2,550.10 ",$169.09 ,"$2,185.80 ",$169.09 ,"$2,732.25 ","$2,010.94 ","$1,814.21 ","$2,010.94 ",$169.09 ,"$2,010.94 ",$186.96 ,$186.96 ,"$3,096.55 ",$422.72 ,"$2,524.60 ",$169.09 ,"$3,643.00 ","$2,003.65 ",$169.09 ,$958.11 ,"$3,643.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,914.40 ","$1,978.15 ","$1,020.04 ","$3,278.70 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,748.64 "
ST. MARY'S HOSPITAL - DECATUR,32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$3,732.00 ","$2,425.80 ",$92.72 ,"$3,732.00 ",$422.73 ,$750.00 ,"$2,052.60 ",$169.09 ,"$1,044.96 ","$1,828.68 ",$169.09 ,"$2,183.22 ",$169.09 ,"$2,026.48 ",$336.00 ,$169.09 ,"$2,026.48 ",$321.27 ,"$2,612.40 ","$1,866.00 ","$2,985.60 ",$422.72 ,$169.09 ,"$2,612.40 ",$169.09 ,"$2,239.20 ",$169.09 ,"$2,799.00 ","$2,060.06 ","$1,858.54 ","$2,060.06 ",$169.09 ,"$2,060.06 ",$228.18 ,$228.18 ,"$3,172.20 ",$422.72 ,"$2,586.28 ",$169.09 ,"$3,732.00 ","$2,052.60 ",$169.09 ,$981.52 ,"$3,732.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,985.60 ","$2,026.48 ","$1,044.96 ","$3,358.80 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,791.36 "
ST. MARY'S HOSPITAL - DECATUR,32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$4,707.00 ","$3,059.55 ",$169.09 ,"$4,707.00 ",$422.73 ,$750.00 ,"$2,588.85 ",$169.09 ,"$1,317.96 ","$2,306.43 ",$169.09 ,"$2,753.60 ",$169.09 ,"$2,555.90 ",$432.79 ,$169.09 ,"$2,555.90 ",$321.27 ,"$3,294.90 ","$2,353.50 ","$3,765.60 ",$422.72 ,$169.09 ,"$3,294.90 ",$169.09 ,"$2,824.20 ",$169.09 ,"$3,530.25 ","$2,598.26 ","$2,344.09 ","$2,598.26 ",$169.09 ,"$2,598.26 ",$278.52 ,$278.52 ,"$4,000.95 ",$422.72 ,"$3,261.95 ",$169.09 ,"$4,707.00 ","$2,588.85 ",$169.09 ,"$1,237.94 ","$4,707.00 ",$219.49 ,$209.52 ,$177.54 ,"$3,765.60 ","$2,555.90 ","$1,317.96 ","$4,236.30 ",$523.00 ,"$1,050.00 ",$169.09 ,"$2,259.36 "
ST. MARY'S HOSPITAL - DECATUR,32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$4,256.00 ","$2,766.40 ",$217.81 ,"$4,256.00 ",$544.53 ,"$1,100.00 ","$2,340.80 ",$217.81 ,"$1,191.68 ","$2,085.44 ",$217.81 ,"$2,489.76 ",$217.81 ,"$2,311.01 ",$683.70 ,$217.81 ,"$2,311.01 ",$413.84 ,"$2,979.20 ","$2,128.00 ","$3,404.80 ",$544.53 ,$217.81 ,"$2,979.20 ",$217.81 ,"$2,553.60 ",$217.81 ,"$3,192.00 ","$2,349.31 ","$2,119.49 ","$2,349.31 ",$217.81 ,"$2,349.31 ",$317.61 ,$317.61 ,"$3,617.60 ",$544.53 ,"$2,949.41 ",$217.81 ,"$4,256.00 ","$2,340.80 ",$217.81 ,"$1,119.33 ","$4,256.00 ",$333.11 ,$317.97 ,$228.70 ,"$3,404.80 ","$2,311.01 ","$1,191.68 ","$3,830.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,042.88 "
ST. MARY'S HOSPITAL - DECATUR,32000152,71551,HC MRI CHEST W/CONTRAST,610,1 ,"$4,588.00 ","$2,982.20 ",$317.97 ,"$4,588.00 ","$1,693.08 ","$1,100.00 ","$2,523.40 ",$677.23 ,"$1,284.64 ","$2,248.12 ",$677.23 ,"$2,683.98 ",$677.23 ,"$2,491.28 ",$744.42 ,$677.23 ,"$2,491.28 ","$1,286.73 ","$3,211.60 ","$2,294.00 ","$3,670.40 ","$1,693.07 ",$677.23 ,"$3,211.60 ",$677.23 ,"$2,752.80 ",$677.23 ,"$3,441.00 ","$2,532.58 ","$2,284.82 ","$2,532.58 ",$677.23 ,"$2,532.58 ",$505.56 ,$505.56 ,"$3,899.80 ","$1,693.07 ","$3,179.48 ",$677.23 ,"$4,588.00 ","$2,523.40 ",$677.23 ,"$1,206.64 ","$4,588.00 ",$333.11 ,$317.97 ,$711.09 ,"$3,670.40 ","$2,491.28 ","$1,284.64 ","$4,129.20 ",$788.00 ,"$1,350.00 ",$677.23 ,"$2,202.24 "
ST. MARY'S HOSPITAL - DECATUR,32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$5,960.00 ","$3,874.00 ",$317.97 ,"$5,960.00 ",$871.45 ,"$1,100.00 ","$3,278.00 ",$348.58 ,"$1,668.80 ","$2,920.40 ",$348.58 ,"$3,486.60 ",$348.58 ,"$3,236.28 ",$932.65 ,$348.58 ,"$3,236.28 ",$662.31 ,"$4,172.00 ","$2,980.00 ","$4,768.00 ",$871.46 ,$348.58 ,"$4,172.00 ",$348.58 ,"$3,576.00 ",$348.58 ,"$4,470.00 ","$3,289.92 ","$2,968.08 ","$3,289.92 ",$348.58 ,"$3,289.92 ",$532.55 ,$532.55 ,"$5,066.00 ",$871.46 ,"$4,130.28 ",$348.58 ,"$5,960.00 ","$3,278.00 ",$348.58 ,"$1,567.48 ","$5,960.00 ",$333.11 ,$317.97 ,$366.01 ,"$4,768.00 ","$3,236.28 ","$1,668.80 ","$5,364.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,860.80 "
ST. MARY'S HOSPITAL - DECATUR,32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$564.00 ,$366.60 ,$21.53 ,$564.00 ,$191.43 ,$30.65 ,$310.20 ,$76.57 ,$157.92 ,$207.81 ,$76.57 ,$207.81 ,$76.57 ,$306.25 ,$31.69 ,$76.57 ,$306.25 ,$145.48 ,$394.80 ,$282.00 ,$451.20 ,$191.42 ,$76.57 ,$394.80 ,$76.57 ,$338.40 ,$76.57 ,$423.00 ,$311.33 ,$280.87 ,$311.33 ,$76.57 ,$311.33 ,$21.53 ,$21.53 ,$479.40 ,$191.42 ,$390.85 ,$76.57 ,$564.00 ,$310.20 ,$76.57 ,$148.33 ,$564.00 ,$38.93 ,$37.16 ,$80.40 ,$451.20 ,$306.25 ,$157.92 ,$507.60 ,$214.32 ,$500.00 ,$76.57 ,$270.72 
ST. MARY'S HOSPITAL - DECATUR,32000156,72020,HC XR C-SPINE 1V,320,1 ,$564.00 ,$366.60 ,$21.53 ,$564.00 ,$191.43 ,$30.65 ,$310.20 ,$76.57 ,$157.92 ,$207.81 ,$76.57 ,$207.81 ,$76.57 ,$306.25 ,$31.69 ,$76.57 ,$306.25 ,$145.48 ,$394.80 ,$282.00 ,$451.20 ,$191.42 ,$76.57 ,$394.80 ,$76.57 ,$338.40 ,$76.57 ,$423.00 ,$311.33 ,$280.87 ,$311.33 ,$76.57 ,$311.33 ,$21.53 ,$21.53 ,$479.40 ,$191.42 ,$390.85 ,$76.57 ,$564.00 ,$310.20 ,$76.57 ,$148.33 ,$564.00 ,$38.93 ,$37.16 ,$80.40 ,$451.20 ,$306.25 ,$157.92 ,$507.60 ,$214.32 ,$500.00 ,$76.57 ,$270.72 
ST. MARY'S HOSPITAL - DECATUR,32000161,72020,HC XR L-SPINE 1V,320,1 ,$564.00 ,$366.60 ,$21.53 ,$564.00 ,$191.43 ,$30.65 ,$310.20 ,$76.57 ,$157.92 ,$207.81 ,$76.57 ,$207.81 ,$76.57 ,$306.25 ,$31.69 ,$76.57 ,$306.25 ,$145.48 ,$394.80 ,$282.00 ,$451.20 ,$191.42 ,$76.57 ,$394.80 ,$76.57 ,$338.40 ,$76.57 ,$423.00 ,$311.33 ,$280.87 ,$311.33 ,$76.57 ,$311.33 ,$21.53 ,$21.53 ,$479.40 ,$191.42 ,$390.85 ,$76.57 ,$564.00 ,$310.20 ,$76.57 ,$148.33 ,$564.00 ,$38.93 ,$37.16 ,$80.40 ,$451.20 ,$306.25 ,$157.92 ,$507.60 ,$214.32 ,$500.00 ,$76.57 ,$270.72 
ST. MARY'S HOSPITAL - DECATUR,32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$652.00 ,$423.80 ,$35.43 ,$652.00 ,$191.43 ,$46.13 ,$358.60 ,$76.57 ,$182.56 ,$312.10 ,$76.57 ,$312.10 ,$76.57 ,$354.04 ,$52.17 ,$76.57 ,$354.04 ,$145.48 ,$456.40 ,$326.00 ,$521.60 ,$191.42 ,$76.57 ,$456.40 ,$76.57 ,$391.20 ,$76.57 ,$489.00 ,$359.90 ,$324.70 ,$359.90 ,$76.57 ,$359.90 ,$35.43 ,$35.43 ,$554.20 ,$191.42 ,$451.84 ,$76.57 ,$652.00 ,$358.60 ,$76.57 ,$171.48 ,$652.00 ,$38.93 ,$37.16 ,$80.40 ,$521.60 ,$354.04 ,$182.56 ,$586.80 ,$247.76 ,$500.00 ,$76.57 ,$312.96 
ST. MARY'S HOSPITAL - DECATUR,32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,"$1,069.00 ",$694.85 ,$37.16 ,"$1,069.00 ",$257.65 ,$62.21 ,$587.95 ,$103.06 ,$299.32 ,$523.81 ,$103.06 ,$527.38 ,$103.06 ,$580.47 ,$71.19 ,$103.06 ,$580.47 ,$195.81 ,$748.30 ,$534.50 ,$855.20 ,$257.64 ,$103.06 ,$748.30 ,$103.06 ,$641.40 ,$103.06 ,$801.75 ,$590.09 ,$532.36 ,$590.09 ,$103.06 ,$590.09 ,$48.35 ,$48.35 ,$908.65 ,$257.64 ,$740.82 ,$103.06 ,"$1,069.00 ",$587.95 ,$103.06 ,$281.15 ,"$1,069.00 ",$38.93 ,$37.16 ,$108.21 ,$855.20 ,$580.47 ,$299.32 ,$962.10 ,$406.22 ,$500.00 ,$103.06 ,$513.12 
ST. MARY'S HOSPITAL - DECATUR,32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,"$1,153.00 ",$749.45 ,$37.16 ,"$1,153.00 ",$257.65 ,$83.90 ,$634.15 ,$103.06 ,$322.84 ,$530.62 ,$103.06 ,$530.62 ,$103.06 ,$626.08 ,$85.82 ,$103.06 ,$626.08 ,$195.81 ,$807.10 ,$576.50 ,$922.40 ,$257.64 ,$103.06 ,$807.10 ,$103.06 ,$691.80 ,$103.06 ,$864.75 ,$636.46 ,$574.19 ,$636.46 ,$103.06 ,$636.46 ,$58.28 ,$58.28 ,$980.05 ,$257.64 ,$799.03 ,$103.06 ,"$1,153.00 ",$634.15 ,$103.06 ,$303.24 ,"$1,153.00 ",$38.93 ,$37.16 ,$108.21 ,$922.40 ,$626.08 ,$322.84 ,"$1,037.70 ",$438.14 ,$500.00 ,$103.06 ,$553.44 
ST. MARY'S HOSPITAL - DECATUR,32000172,72070,HC XR T-SPINE 2V,320,1 ,$632.00 ,$410.80 ,$31.95 ,$632.00 ,$257.65 ,$43.65 ,$347.60 ,$103.06 ,$176.96 ,$309.68 ,$103.06 ,$322.03 ,$103.06 ,$343.18 ,$47.05 ,$103.06 ,$343.18 ,$195.81 ,$442.40 ,$316.00 ,$505.60 ,$257.64 ,$103.06 ,$442.40 ,$103.06 ,$379.20 ,$103.06 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$103.06 ,$348.86 ,$31.95 ,$31.95 ,$537.20 ,$257.64 ,$437.98 ,$103.06 ,$632.00 ,$347.60 ,$103.06 ,$166.22 ,$632.00 ,$38.93 ,$37.16 ,$108.21 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$500.00 ,$103.06 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,32000174,72072,HC XR T-SPINE 3V,320,1 ,$813.00 ,$528.45 ,$35.43 ,$813.00 ,$257.65 ,$50.45 ,$447.15 ,$103.06 ,$227.64 ,$336.97 ,$103.06 ,$336.97 ,$103.06 ,$441.46 ,$52.17 ,$103.06 ,$441.46 ,$195.81 ,$569.10 ,$406.50 ,$650.40 ,$257.64 ,$103.06 ,$569.10 ,$103.06 ,$487.80 ,$103.06 ,$609.75 ,$448.78 ,$404.87 ,$448.78 ,$103.06 ,$448.78 ,$35.43 ,$35.43 ,$691.05 ,$257.64 ,$563.41 ,$103.06 ,$813.00 ,$447.15 ,$103.06 ,$213.82 ,$813.00 ,$38.93 ,$37.16 ,$108.21 ,$650.40 ,$441.46 ,$227.64 ,$731.70 ,$308.94 ,$500.00 ,$103.06 ,$390.24 
ST. MARY'S HOSPITAL - DECATUR,32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$669.00 ,$434.85 ,$35.43 ,$669.00 ,$257.65 ,$46.73 ,$367.95 ,$103.06 ,$187.32 ,$327.81 ,$103.06 ,$336.97 ,$103.06 ,$363.27 ,$52.17 ,$103.06 ,$363.27 ,$195.81 ,$468.30 ,$334.50 ,$535.20 ,$257.64 ,$103.06 ,$468.30 ,$103.06 ,$401.40 ,$103.06 ,$501.75 ,$369.29 ,$333.16 ,$369.29 ,$103.06 ,$369.29 ,$35.43 ,$35.43 ,$568.65 ,$257.64 ,$463.62 ,$103.06 ,$669.00 ,$367.95 ,$103.06 ,$175.95 ,$669.00 ,$38.93 ,$37.16 ,$108.21 ,$535.20 ,$363.27 ,$187.32 ,$602.10 ,$254.22 ,$500.00 ,$103.06 ,$321.12 
ST. MARY'S HOSPITAL - DECATUR,32000181,72110,HC XR L-SPINE 4+V,320,1 ,"$1,110.00 ",$721.50 ,$37.16 ,"$1,110.00 ",$257.65 ,$63.45 ,$610.50 ,$103.06 ,$310.80 ,$543.90 ,$103.06 ,$590.29 ,$103.06 ,$602.73 ,$72.65 ,$103.06 ,$602.73 ,$195.81 ,$777.00 ,$555.00 ,$888.00 ,$257.64 ,$103.06 ,$777.00 ,$103.06 ,$666.00 ,$103.06 ,$832.50 ,$612.72 ,$552.78 ,$612.72 ,$103.06 ,$612.72 ,$49.34 ,$49.34 ,$943.50 ,$257.64 ,$769.23 ,$103.06 ,"$1,110.00 ",$610.50 ,$103.06 ,$291.93 ,"$1,110.00 ",$38.93 ,$37.16 ,$108.21 ,$888.00 ,$602.73 ,$310.80 ,$999.00 ,$421.80 ,$500.00 ,$103.06 ,$532.80 
ST. MARY'S HOSPITAL - DECATUR,32000183,72120,HC XR L-SPINE BENDING ONLY MIN 4V,320,1 ,$966.00 ,$627.90 ,$37.16 ,$966.00 ,$257.65 ,$58.50 ,$531.30 ,$103.06 ,$270.48 ,$416.40 ,$103.06 ,$416.40 ,$103.06 ,$524.54 ,$65.34 ,$103.06 ,$524.54 ,$195.81 ,$676.20 ,$483.00 ,$772.80 ,$257.64 ,$103.06 ,$676.20 ,$103.06 ,$579.60 ,$103.06 ,$724.50 ,$533.23 ,$481.07 ,$533.23 ,$103.06 ,$533.23 ,$44.37 ,$44.37 ,$821.10 ,$257.64 ,$669.44 ,$103.06 ,$966.00 ,$531.30 ,$103.06 ,$254.06 ,$966.00 ,$38.93 ,$37.16 ,$108.21 ,$772.80 ,$524.54 ,$270.48 ,$869.40 ,$367.08 ,$500.00 ,$103.06 ,$463.68 
ST. MARY'S HOSPITAL - DECATUR,32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,"$1,162.00 ",$755.30 ,$37.16 ,"$1,162.00 ",$257.65 ,$90.09 ,$639.10 ,$103.06 ,$325.36 ,$569.38 ,$103.06 ,$634.82 ,$103.06 ,$630.97 ,$85.82 ,$103.06 ,$630.97 ,$195.81 ,$813.40 ,$581.00 ,$929.60 ,$257.64 ,$103.06 ,$813.40 ,$103.06 ,$697.20 ,$103.06 ,$871.50 ,$641.42 ,$578.68 ,$641.42 ,$103.06 ,$641.42 ,$58.28 ,$58.28 ,$987.70 ,$257.64 ,$805.27 ,$103.06 ,"$1,162.00 ",$639.10 ,$103.06 ,$305.61 ,"$1,162.00 ",$38.93 ,$37.16 ,$108.21 ,$929.60 ,$630.97 ,$325.36 ,"$1,045.80 ",$441.56 ,$500.00 ,$103.06 ,$557.76 
ST. MARY'S HOSPITAL - DECATUR,32000186,72170,HC XR PELVIS 1-2V,320,1 ,$674.00 ,$438.10 ,$33.95 ,$674.00 ,$257.65 ,$38.07 ,$370.70 ,$103.06 ,$188.72 ,$327.04 ,$103.06 ,$327.04 ,$103.06 ,$365.98 ,$49.97 ,$103.06 ,$365.98 ,$195.81 ,$471.80 ,$337.00 ,$539.20 ,$257.64 ,$103.06 ,$471.80 ,$103.06 ,$404.40 ,$103.06 ,$505.50 ,$372.05 ,$335.65 ,$372.05 ,$103.06 ,$372.05 ,$33.95 ,$33.95 ,$572.90 ,$257.64 ,$467.08 ,$103.06 ,$674.00 ,$370.70 ,$103.06 ,$177.26 ,$674.00 ,$38.93 ,$37.16 ,$108.21 ,$539.20 ,$365.98 ,$188.72 ,$606.60 ,$256.12 ,$500.00 ,$103.06 ,$323.52 
ST. MARY'S HOSPITAL - DECATUR,32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$700.00 ,$455.00 ,$37.16 ,$700.00 ,$257.65 ,$61.61 ,$385.00 ,$103.06 ,$196.00 ,$343.00 ,$103.06 ,$381.60 ,$103.06 ,$380.10 ,$59.48 ,$103.06 ,$380.10 ,$195.81 ,$490.00 ,$350.00 ,$560.00 ,$257.64 ,$103.06 ,$490.00 ,$103.06 ,$420.00 ,$103.06 ,$525.00 ,$386.40 ,$348.60 ,$386.40 ,$103.06 ,$386.40 ,$40.40 ,$40.40 ,$595.00 ,$257.64 ,$485.10 ,$103.06 ,$700.00 ,$385.00 ,$103.06 ,$184.10 ,$700.00 ,$38.93 ,$37.16 ,$108.21 ,$560.00 ,$380.10 ,$196.00 ,$630.00 ,$266.00 ,$500.00 ,$103.06 ,$336.00 
ST. MARY'S HOSPITAL - DECATUR,32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$674.00 ,$438.10 ,$35.43 ,$674.00 ,$257.65 ,$48.60 ,$370.70 ,$103.06 ,$188.72 ,$330.26 ,$103.06 ,$331.96 ,$103.06 ,$365.98 ,$52.17 ,$103.06 ,$365.98 ,$195.81 ,$471.80 ,$337.00 ,$539.20 ,$257.64 ,$103.06 ,$471.80 ,$103.06 ,$404.40 ,$103.06 ,$505.50 ,$372.05 ,$335.65 ,$372.05 ,$103.06 ,$372.05 ,$35.43 ,$35.43 ,$572.90 ,$257.64 ,$467.08 ,$103.06 ,$674.00 ,$370.70 ,$103.06 ,$177.26 ,$674.00 ,$38.93 ,$37.16 ,$108.21 ,$539.20 ,$365.98 ,$188.72 ,$606.60 ,$256.12 ,$500.00 ,$103.06 ,$323.52 
ST. MARY'S HOSPITAL - DECATUR,32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$671.00 ,$436.15 ,$30.47 ,$671.00 ,$191.43 ,$39.31 ,$369.05 ,$76.57 ,$187.88 ,$277.40 ,$76.57 ,$277.40 ,$76.57 ,$364.35 ,$44.85 ,$76.57 ,$364.35 ,$145.48 ,$469.70 ,$335.50 ,$536.80 ,$191.42 ,$76.57 ,$469.70 ,$76.57 ,$402.60 ,$76.57 ,$503.25 ,$370.39 ,$334.16 ,$370.39 ,$76.57 ,$370.39 ,$30.47 ,$30.47 ,$570.35 ,$191.42 ,$465.00 ,$76.57 ,$671.00 ,$369.05 ,$76.57 ,$176.47 ,$671.00 ,$38.93 ,$37.16 ,$80.40 ,$536.80 ,$364.35 ,$187.88 ,$603.90 ,$254.98 ,$500.00 ,$76.57 ,$322.08 
ST. MARY'S HOSPITAL - DECATUR,32000194,62302,HC XR MYELOGRAM C-SPINE,320,1 ,"$4,631.00 ","$3,010.15 ",$246.23 ,"$4,631.00 ","$1,693.08 ","$2,361.81 ","$2,547.05 ",$677.23 ,"$1,296.68 ","$2,012.69 ",$677.23 ,"$2,012.69 ",$677.23 ,"$2,514.63 ",$246.23 ,$677.23 ,"$2,514.63 ","$1,286.73 ","$3,241.70 ","$2,315.50 ","$3,704.80 ","$1,693.07 ",$677.23 ,"$3,241.70 ",$677.23 ,"$2,778.60 ",$677.23 ,"$3,473.25 ","$2,556.31 ","$2,306.24 ","$2,556.31 ",$677.23 ,"$2,556.31 ","$3,241.70 ","$3,241.70 ","$3,936.35 ","$1,693.07 ","$3,209.28 ",$677.23 ,"$4,631.00 ","$2,547.05 ",$677.23 ,"$1,217.95 ","$4,631.00 ",$423.62 ,$404.37 ,$711.09 ,"$3,704.80 ","$2,514.63 ","$1,296.68 ","$4,167.90 ","$1,759.78 ",$500.00 ,$677.23 ,"$2,222.88 "
ST. MARY'S HOSPITAL - DECATUR,32000195,62303,HC XR MYELOGRAM T-SPINE,320,1 ,"$4,631.00 ","$3,010.15 ",$246.23 ,"$4,631.00 ","$1,693.08 ","$2,361.81 ","$2,547.05 ",$677.23 ,"$1,296.68 ","$2,007.88 ",$677.23 ,"$2,007.88 ",$677.23 ,"$2,514.63 ",$246.23 ,$677.23 ,"$2,514.63 ","$1,286.73 ","$3,241.70 ","$2,315.50 ","$3,704.80 ","$1,693.07 ",$677.23 ,"$3,241.70 ",$677.23 ,"$2,778.60 ",$677.23 ,"$3,473.25 ","$2,556.31 ","$2,306.24 ","$2,556.31 ",$677.23 ,"$2,556.31 ","$3,241.70 ","$3,241.70 ","$3,936.35 ","$1,693.07 ","$3,209.28 ",$677.23 ,"$4,631.00 ","$2,547.05 ",$677.23 ,"$1,217.95 ","$4,631.00 ",$423.62 ,$404.37 ,$711.09 ,"$3,704.80 ","$2,514.63 ","$1,296.68 ","$4,167.90 ","$1,759.78 ",$500.00 ,$677.23 ,"$2,222.88 "
ST. MARY'S HOSPITAL - DECATUR,32000196,62304,HC XR MYELOGRAM L-SPINE,320,1 ,"$4,631.00 ","$3,010.15 ",$242.08 ,"$4,631.00 ","$1,693.08 ","$2,361.81 ","$2,547.05 ",$677.23 ,"$1,296.68 ","$1,969.93 ",$677.23 ,"$1,969.93 ",$677.23 ,"$2,514.63 ",$242.08 ,$677.23 ,"$2,514.63 ","$1,286.73 ","$3,241.70 ","$2,315.50 ","$3,704.80 ","$1,693.07 ",$677.23 ,"$3,241.70 ",$677.23 ,"$2,778.60 ",$677.23 ,"$3,473.25 ","$2,556.31 ","$2,306.24 ","$2,556.31 ",$677.23 ,"$2,556.31 ","$3,241.70 ","$3,241.70 ","$3,936.35 ","$1,693.07 ","$3,209.28 ",$677.23 ,"$4,631.00 ","$2,547.05 ",$677.23 ,"$1,217.95 ","$4,631.00 ",$423.62 ,$404.37 ,$711.09 ,"$3,704.80 ","$2,514.63 ","$1,296.68 ","$4,167.90 ","$1,759.78 ",$500.00 ,$677.23 ,"$2,222.88 "
ST. MARY'S HOSPITAL - DECATUR,32000197,62305,HC XR MYELOGRAM >2 REGIONS,320,1 ,"$7,258.00 ","$4,717.70 ",$252.65 ,"$7,258.00 ","$1,693.08 ","$3,701.58 ","$3,991.90 ",$677.23 ,"$2,032.24 ","$2,055.85 ",$677.23 ,"$2,055.85 ",$677.23 ,"$3,941.09 ",$252.65 ,$677.23 ,"$3,941.09 ","$1,286.73 ","$5,080.60 ","$3,629.00 ","$5,806.40 ","$1,693.07 ",$677.23 ,"$5,080.60 ",$677.23 ,"$4,354.80 ",$677.23 ,"$5,443.50 ","$4,006.42 ","$3,614.48 ","$4,006.42 ",$677.23 ,"$4,006.42 ","$5,080.60 ","$5,080.60 ","$6,169.30 ","$1,693.07 ","$5,029.79 ",$677.23 ,"$7,258.00 ","$3,991.90 ",$677.23 ,"$1,908.85 ","$7,258.00 ",$423.62 ,$404.37 ,$711.09 ,"$5,806.40 ","$3,941.09 ","$2,032.24 ","$6,532.20 ","$2,758.04 ",$500.00 ,$677.23 ,"$3,483.84 "
ST. MARY'S HOSPITAL - DECATUR,32000198,72285,HC XR DISKOGRAM C- OR T-SPINE,320,1 ,"$3,080.00 ","$2,002.00 ",$81.14 ,"$4,155.38 ","$4,155.38 ",$108.68 ,"$1,694.00 ","$1,662.15 ",$862.40 ,$734.20 ,"$1,662.15 ",$734.20 ,"$1,662.15 ","$1,672.44 ",$119.47 ,"$1,662.15 ","$1,672.44 ","$3,080.00 ","$2,156.00 ","$1,540.00 ","$2,464.00 ","$4,155.37 ","$1,662.15 ","$2,156.00 ","$1,662.15 ","$1,848.00 ","$1,662.15 ","$2,310.00 ","$1,700.16 ","$1,533.84 ","$1,700.16 ","$1,662.15 ","$1,700.16 ",$81.14 ,$81.14 ,"$2,618.00 ","$3,080.00 ","$2,134.44 ","$1,662.15 ","$3,080.00 ","$1,694.00 ","$1,662.15 ",$810.04 ,"$3,080.00 ",$221.84 ,$211.75 ,"$1,745.26 ","$2,464.00 ","$1,672.44 ",$862.40 ,"$2,772.00 ","$1,170.40 ",$500.00 ,"$1,662.15 ","$1,478.40 "
ST. MARY'S HOSPITAL - DECATUR,32000200,72295,HC XR DISKOGRAM L-SPINE,320,1 ,"$3,001.00 ","$1,950.65 ",$83.12 ,"$4,155.38 ","$4,155.38 ",$112.39 ,"$1,650.55 ","$1,662.15 ",$840.28 ,$758.97 ,"$1,662.15 ",$758.97 ,"$1,662.15 ","$1,629.54 ",$122.39 ,"$1,662.15 ","$1,629.54 ","$3,001.00 ","$2,100.70 ","$1,500.50 ","$2,400.80 ","$4,155.37 ","$1,662.15 ","$2,100.70 ","$1,662.15 ","$1,800.60 ","$1,662.15 ","$2,250.75 ","$1,656.55 ","$1,494.50 ","$1,656.55 ","$1,662.15 ","$1,656.55 ",$83.12 ,$83.12 ,"$2,550.85 ","$3,001.00 ","$2,079.69 ","$1,662.15 ","$3,001.00 ","$1,650.55 ","$1,662.15 ",$789.26 ,"$3,001.00 ",$221.84 ,$211.75 ,"$1,745.26 ","$2,400.80 ","$1,629.54 ",$840.28 ,"$2,700.90 ","$1,140.38 ",$500.00 ,"$1,662.15 ","$1,440.48 "
ST. MARY'S HOSPITAL - DECATUR,32000201,73000,HC XRAY CLAVICLE,320,1 ,$556.00 ,$361.40 ,$28.97 ,$556.00 ,$191.43 ,$39.94 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$277.40 ,$76.57 ,$301.91 ,$42.66 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$28.97 ,$28.97 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000204,73010,HC XRAY SCAPULA,320,1 ,$669.00 ,$434.85 ,$31.95 ,$669.00 ,$257.65 ,$43.65 ,$367.95 ,$103.06 ,$187.32 ,$302.17 ,$103.06 ,$302.17 ,$103.06 ,$363.27 ,$47.05 ,$103.06 ,$363.27 ,$195.81 ,$468.30 ,$334.50 ,$535.20 ,$257.64 ,$103.06 ,$468.30 ,$103.06 ,$401.40 ,$103.06 ,$501.75 ,$369.29 ,$333.16 ,$369.29 ,$103.06 ,$369.29 ,$31.95 ,$31.95 ,$568.65 ,$257.64 ,$463.62 ,$103.06 ,$669.00 ,$367.95 ,$103.06 ,$175.95 ,$669.00 ,$38.93 ,$37.16 ,$108.21 ,$535.20 ,$363.27 ,$187.32 ,$602.10 ,$254.22 ,$500.00 ,$103.06 ,$321.12 
ST. MARY'S HOSPITAL - DECATUR,32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$556.00 ,$361.40 ,$22.02 ,$556.00 ,$191.43 ,$31.25 ,$305.80 ,$76.57 ,$155.68 ,$212.82 ,$76.57 ,$212.82 ,$76.57 ,$301.91 ,$32.42 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$22.02 ,$22.02 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$703.00 ,$456.95 ,$28.97 ,$703.00 ,$191.43 ,$40.55 ,$386.65 ,$76.57 ,$196.84 ,$344.47 ,$76.57 ,$357.62 ,$76.57 ,$381.73 ,$42.66 ,$76.57 ,$381.73 ,$145.48 ,$492.10 ,$351.50 ,$562.40 ,$191.42 ,$76.57 ,$492.10 ,$76.57 ,$421.80 ,$76.57 ,$527.25 ,$388.06 ,$350.09 ,$388.06 ,$76.57 ,$388.06 ,$28.97 ,$28.97 ,$597.55 ,$191.42 ,$487.18 ,$76.57 ,$703.00 ,$386.65 ,$76.57 ,$184.89 ,$703.00 ,$38.93 ,$37.16 ,$80.40 ,$562.40 ,$381.73 ,$196.84 ,$632.70 ,$267.14 ,$500.00 ,$76.57 ,$337.44 
ST. MARY'S HOSPITAL - DECATUR,32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,"$1,830.00 ","$1,189.50 ",$116.40 ,"$1,830.00 ",$871.45 ,$150.17 ,"$1,006.50 ",$348.58 ,$512.40 ,$896.70 ,$348.58 ,"$1,037.07 ",$348.58 ,$993.69 ,$171.41 ,$348.58 ,$993.69 ,$662.31 ,"$1,281.00 ",$915.00 ,"$1,464.00 ",$871.46 ,$348.58 ,"$1,281.00 ",$348.58 ,"$1,098.00 ",$348.58 ,"$1,372.50 ","$1,010.16 ",$911.34 ,"$1,010.16 ",$348.58 ,"$1,010.16 ",$116.40 ,$116.40 ,"$1,555.50 ",$871.46 ,"$1,268.19 ",$348.58 ,"$1,830.00 ","$1,006.50 ",$348.58 ,$481.29 ,"$1,830.00 ",$221.84 ,$211.75 ,$366.01 ,"$1,464.00 ",$993.69 ,$512.40 ,"$1,647.00 ",$695.40 ,$500.00 ,$348.58 ,$878.40 
ST. MARY'S HOSPITAL - DECATUR,32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$755.00 ,$490.75 ,$37.16 ,$755.00 ,$191.43 ,$56.66 ,$415.25 ,$76.57 ,$211.40 ,$356.83 ,$76.57 ,$356.83 ,$76.57 ,$409.97 ,$55.09 ,$76.57 ,$409.97 ,$145.48 ,$528.50 ,$377.50 ,$604.00 ,$191.42 ,$76.57 ,$528.50 ,$76.57 ,$453.00 ,$76.57 ,$566.25 ,$416.76 ,$375.99 ,$416.76 ,$76.57 ,$416.76 ,$37.41 ,$37.41 ,$641.75 ,$191.42 ,$523.22 ,$76.57 ,$755.00 ,$415.25 ,$76.57 ,$198.57 ,$755.00 ,$38.93 ,$37.16 ,$80.40 ,$604.00 ,$409.97 ,$211.40 ,$679.50 ,$286.90 ,$500.00 ,$76.57 ,$362.40 
ST. MARY'S HOSPITAL - DECATUR,32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$674.00 ,$438.10 ,$30.47 ,$674.00 ,$191.43 ,$39.31 ,$370.70 ,$76.57 ,$188.72 ,$292.25 ,$76.57 ,$292.25 ,$76.57 ,$365.98 ,$44.85 ,$76.57 ,$365.98 ,$145.48 ,$471.80 ,$337.00 ,$539.20 ,$191.42 ,$76.57 ,$471.80 ,$76.57 ,$404.40 ,$76.57 ,$505.50 ,$372.05 ,$335.65 ,$372.05 ,$76.57 ,$372.05 ,$30.47 ,$30.47 ,$572.90 ,$191.42 ,$467.08 ,$76.57 ,$674.00 ,$370.70 ,$76.57 ,$177.26 ,$674.00 ,$38.93 ,$37.16 ,$80.40 ,$539.20 ,$365.98 ,$188.72 ,$606.60 ,$256.12 ,$500.00 ,$76.57 ,$323.52 
ST. MARY'S HOSPITAL - DECATUR,32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$556.00 ,$361.40 ,$26.49 ,$556.00 ,$191.43 ,$39.94 ,$305.80 ,$76.57 ,$155.68 ,$272.39 ,$76.57 ,$272.39 ,$76.57 ,$301.91 ,$39.00 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$26.49 ,$26.49 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$585.00 ,$380.25 ,$29.46 ,$585.00 ,$191.43 ,$47.97 ,$321.75 ,$76.57 ,$163.80 ,$286.65 ,$76.57 ,$322.03 ,$76.57 ,$317.66 ,$43.39 ,$76.57 ,$317.66 ,$145.48 ,$409.50 ,$292.50 ,$468.00 ,$191.42 ,$76.57 ,$409.50 ,$76.57 ,$351.00 ,$76.57 ,$438.75 ,$322.92 ,$291.33 ,$322.92 ,$76.57 ,$322.92 ,$29.46 ,$29.46 ,$497.25 ,$191.42 ,$405.41 ,$76.57 ,$585.00 ,$321.75 ,$76.57 ,$153.86 ,$585.00 ,$38.93 ,$37.16 ,$80.40 ,$468.00 ,$317.66 ,$163.80 ,$526.50 ,$222.30 ,$500.00 ,$76.57 ,$280.80 
ST. MARY'S HOSPITAL - DECATUR,32000222,73085,HC XRAY ELBOW ARTHRO,320,1 ,$993.00 ,$645.45 ,$107.96 ,$993.00 ,$871.45 ,$140.27 ,$546.15 ,$348.58 ,$278.04 ,$486.57 ,$348.58 ,$580.91 ,$348.58 ,$539.20 ,$158.97 ,$348.58 ,$539.20 ,$662.31 ,$695.10 ,$496.50 ,$794.40 ,$871.46 ,$348.58 ,$695.10 ,$348.58 ,$595.80 ,$348.58 ,$744.75 ,$548.14 ,$494.51 ,$548.14 ,$348.58 ,$548.14 ,$107.96 ,$107.96 ,$844.05 ,$871.46 ,$688.15 ,$348.58 ,$993.00 ,$546.15 ,$348.58 ,$261.16 ,$993.00 ,$221.84 ,$211.75 ,$366.01 ,$794.40 ,$539.20 ,$278.04 ,$893.70 ,$377.34 ,$500.00 ,$348.58 ,$476.64 
ST. MARY'S HOSPITAL - DECATUR,32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$593.00 ,$385.45 ,$27.48 ,$593.00 ,$191.43 ,$38.07 ,$326.15 ,$76.57 ,$166.04 ,$247.62 ,$76.57 ,$247.62 ,$76.57 ,$322.00 ,$40.46 ,$76.57 ,$322.00 ,$145.48 ,$415.10 ,$296.50 ,$474.40 ,$191.42 ,$76.57 ,$415.10 ,$76.57 ,$355.80 ,$76.57 ,$444.75 ,$327.34 ,$295.31 ,$327.34 ,$76.57 ,$327.34 ,$27.48 ,$27.48 ,$504.05 ,$191.42 ,$410.95 ,$76.57 ,$593.00 ,$326.15 ,$76.57 ,$155.96 ,$593.00 ,$38.93 ,$37.16 ,$80.40 ,$474.40 ,$322.00 ,$166.04 ,$533.70 ,$225.34 ,$500.00 ,$76.57 ,$284.64 
ST. MARY'S HOSPITAL - DECATUR,32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$632.00 ,$410.80 ,$28.97 ,$632.00 ,$257.65 ,$46.73 ,$347.60 ,$103.06 ,$176.96 ,$272.39 ,$103.06 ,$272.39 ,$103.06 ,$343.18 ,$42.66 ,$103.06 ,$343.18 ,$195.81 ,$442.40 ,$316.00 ,$505.60 ,$257.64 ,$103.06 ,$442.40 ,$103.06 ,$379.20 ,$103.06 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$103.06 ,$348.86 ,$28.97 ,$28.97 ,$537.20 ,$257.64 ,$437.98 ,$103.06 ,$632.00 ,$347.60 ,$103.06 ,$166.22 ,$632.00 ,$38.93 ,$37.16 ,$108.21 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$500.00 ,$103.06 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$556.00 ,$361.40 ,$32.94 ,$556.00 ,$191.43 ,$44.26 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$322.03 ,$76.57 ,$301.91 ,$48.51 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$32.94 ,$32.94 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$689.00 ,$447.85 ,$37.16 ,$689.00 ,$191.43 ,$56.03 ,$378.95 ,$76.57 ,$192.92 ,$337.61 ,$76.57 ,$371.67 ,$76.57 ,$374.13 ,$57.29 ,$76.57 ,$374.13 ,$145.48 ,$482.30 ,$344.50 ,$551.20 ,$191.42 ,$76.57 ,$482.30 ,$76.57 ,$413.40 ,$76.57 ,$516.75 ,$380.33 ,$343.12 ,$380.33 ,$76.57 ,$380.33 ,$38.91 ,$38.91 ,$585.65 ,$191.42 ,$477.48 ,$76.57 ,$689.00 ,$378.95 ,$76.57 ,$181.21 ,$689.00 ,$38.93 ,$37.16 ,$80.40 ,$551.20 ,$374.13 ,$192.92 ,$620.10 ,$261.82 ,$500.00 ,$76.57 ,$330.72 
ST. MARY'S HOSPITAL - DECATUR,32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,"$1,823.00 ","$1,184.95 ",$125.36 ,"$1,823.00 ",$871.45 ,$159.46 ,"$1,002.65 ",$348.58 ,$510.44 ,$893.27 ,$348.58 ,"$1,066.46 ",$348.58 ,$989.89 ,$184.57 ,$348.58 ,$989.89 ,$662.31 ,"$1,276.10 ",$911.50 ,"$1,458.40 ",$871.46 ,$348.58 ,"$1,276.10 ",$348.58 ,"$1,093.80 ",$348.58 ,"$1,367.25 ","$1,006.30 ",$907.85 ,"$1,006.30 ",$348.58 ,"$1,006.30 ",$125.36 ,$125.36 ,"$1,549.55 ",$871.46 ,"$1,263.34 ",$348.58 ,"$1,823.00 ","$1,002.65 ",$348.58 ,$479.45 ,"$1,823.00 ",$221.84 ,$211.75 ,$366.01 ,"$1,458.40 ",$989.89 ,$510.44 ,"$1,640.70 ",$692.74 ,$500.00 ,$348.58 ,$875.04 
ST. MARY'S HOSPITAL - DECATUR,32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$556.00 ,$361.40 ,$28.97 ,$556.00 ,$257.65 ,$37.44 ,$305.80 ,$103.06 ,$155.68 ,$272.44 ,$103.06 ,$282.32 ,$103.06 ,$301.91 ,$42.66 ,$103.06 ,$301.91 ,$195.81 ,$389.20 ,$278.00 ,$444.80 ,$257.64 ,$103.06 ,$389.20 ,$103.06 ,$333.60 ,$103.06 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$103.06 ,$306.91 ,$28.97 ,$28.97 ,$472.60 ,$257.64 ,$385.31 ,$103.06 ,$556.00 ,$305.80 ,$103.06 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$108.21 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$103.06 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$674.00 ,$438.10 ,$34.44 ,$674.00 ,$191.43 ,$46.13 ,$370.70 ,$76.57 ,$188.72 ,$327.04 ,$76.57 ,$327.04 ,$76.57 ,$365.98 ,$50.71 ,$76.57 ,$365.98 ,$145.48 ,$471.80 ,$337.00 ,$539.20 ,$191.42 ,$76.57 ,$471.80 ,$76.57 ,$404.40 ,$76.57 ,$505.50 ,$372.05 ,$335.65 ,$372.05 ,$76.57 ,$372.05 ,$34.44 ,$34.44 ,$572.90 ,$191.42 ,$467.08 ,$76.57 ,$674.00 ,$370.70 ,$76.57 ,$177.26 ,$674.00 ,$38.93 ,$37.16 ,$80.40 ,$539.20 ,$365.98 ,$188.72 ,$606.60 ,$256.12 ,$500.00 ,$76.57 ,$323.52 
ST. MARY'S HOSPITAL - DECATUR,32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$556.00 ,$361.40 ,$37.16 ,$556.00 ,$191.43 ,$51.71 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$325.26 ,$76.57 ,$301.91 ,$55.09 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$37.41 ,$37.41 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,"$1,657.00 ","$1,077.05 ",$116.91 ,"$1,657.00 ",$871.45 ,$146.45 ,$911.35 ,$348.58 ,$463.96 ,$811.93 ,$348.58 ,$969.35 ,$348.58 ,$899.75 ,$172.14 ,$348.58 ,$899.75 ,$662.31 ,"$1,159.90 ",$828.50 ,"$1,325.60 ",$871.46 ,$348.58 ,"$1,159.90 ",$348.58 ,$994.20 ,$348.58 ,"$1,242.75 ",$914.66 ,$825.19 ,$914.66 ,$348.58 ,$914.66 ,$116.91 ,$116.91 ,"$1,408.45 ",$871.46 ,"$1,148.30 ",$348.58 ,"$1,657.00 ",$911.35 ,$348.58 ,$435.79 ,"$1,657.00 ",$221.84 ,$211.75 ,$366.01 ,"$1,325.60 ",$899.75 ,$463.96 ,"$1,491.30 ",$629.66 ,$500.00 ,$348.58 ,$795.36 
ST. MARY'S HOSPITAL - DECATUR,32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$666.00 ,$432.90 ,$33.44 ,$666.00 ,$191.43 ,$41.78 ,$366.30 ,$76.57 ,$186.48 ,$324.29 ,$76.57 ,$324.29 ,$76.57 ,$361.64 ,$49.24 ,$76.57 ,$361.64 ,$145.48 ,$466.20 ,$333.00 ,$532.80 ,$191.42 ,$76.57 ,$466.20 ,$76.57 ,$399.60 ,$76.57 ,$499.50 ,$367.63 ,$331.67 ,$367.63 ,$76.57 ,$367.63 ,$33.44 ,$33.44 ,$566.10 ,$191.42 ,$461.54 ,$76.57 ,$666.00 ,$366.30 ,$76.57 ,$175.16 ,$666.00 ,$38.93 ,$37.16 ,$80.40 ,$532.80 ,$361.64 ,$186.48 ,$599.40 ,$253.08 ,$500.00 ,$76.57 ,$319.68 
ST. MARY'S HOSPITAL - DECATUR,32000263,73562,HC XRAY KNEE (3 V),320,1 ,$717.00 ,$466.05 ,$37.16 ,$717.00 ,$191.43 ,$53.55 ,$394.35 ,$76.57 ,$200.76 ,$351.33 ,$76.57 ,$419.45 ,$76.57 ,$389.33 ,$57.29 ,$76.57 ,$389.33 ,$145.48 ,$501.90 ,$358.50 ,$573.60 ,$191.42 ,$76.57 ,$501.90 ,$76.57 ,$430.20 ,$76.57 ,$537.75 ,$395.78 ,$357.07 ,$395.78 ,$76.57 ,$395.78 ,$38.91 ,$38.91 ,$609.45 ,$191.42 ,$496.88 ,$76.57 ,$717.00 ,$394.35 ,$76.57 ,$188.57 ,$717.00 ,$38.93 ,$37.16 ,$80.40 ,$573.60 ,$389.33 ,$200.76 ,$645.30 ,$272.46 ,$500.00 ,$76.57 ,$344.16 
ST. MARY'S HOSPITAL - DECATUR,32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$734.00 ,$477.10 ,$37.16 ,$734.00 ,$257.65 ,$61.61 ,$403.70 ,$103.06 ,$205.52 ,$359.66 ,$103.06 ,$404.31 ,$103.06 ,$398.56 ,$62.41 ,$103.06 ,$398.56 ,$195.81 ,$513.80 ,$367.00 ,$587.20 ,$257.64 ,$103.06 ,$513.80 ,$103.06 ,$440.40 ,$103.06 ,$550.50 ,$405.17 ,$365.53 ,$405.17 ,$103.06 ,$405.17 ,$42.39 ,$42.39 ,$623.90 ,$257.64 ,$508.66 ,$103.06 ,$734.00 ,$403.70 ,$103.06 ,$193.04 ,$734.00 ,$38.93 ,$37.16 ,$108.21 ,$587.20 ,$398.56 ,$205.52 ,$660.60 ,$278.92 ,$500.00 ,$103.06 ,$352.32 
ST. MARY'S HOSPITAL - DECATUR,32000267,73565,HC XR KNEE STAND,320,1 ,$615.00 ,$399.75 ,$37.16 ,$615.00 ,$191.43 ,$50.45 ,$338.25 ,$76.57 ,$172.20 ,$301.35 ,$76.57 ,$359.78 ,$76.57 ,$333.95 ,$58.75 ,$76.57 ,$333.95 ,$145.48 ,$430.50 ,$307.50 ,$492.00 ,$191.42 ,$76.57 ,$430.50 ,$76.57 ,$369.00 ,$76.57 ,$461.25 ,$339.48 ,$306.27 ,$339.48 ,$76.57 ,$339.48 ,$39.90 ,$39.90 ,$522.75 ,$191.42 ,$426.20 ,$76.57 ,$615.00 ,$338.25 ,$76.57 ,$161.75 ,$615.00 ,$38.93 ,$37.16 ,$80.40 ,$492.00 ,$333.95 ,$172.20 ,$553.50 ,$233.70 ,$500.00 ,$76.57 ,$295.20 
ST. MARY'S HOSPITAL - DECATUR,32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,"$1,823.00 ","$1,184.95 ",$137.78 ,"$1,823.00 ",$871.45 ,$194.13 ,"$1,002.65 ",$348.58 ,$510.44 ,$893.27 ,$348.58 ,"$1,066.46 ",$348.58 ,$989.89 ,$202.86 ,$348.58 ,$989.89 ,$662.31 ,"$1,276.10 ",$911.50 ,"$1,458.40 ",$871.46 ,$348.58 ,"$1,276.10 ",$348.58 ,"$1,093.80 ",$348.58 ,"$1,367.25 ","$1,006.30 ",$907.85 ,"$1,006.30 ",$348.58 ,"$1,006.30 ",$137.78 ,$137.78 ,"$1,549.55 ",$871.46 ,"$1,263.34 ",$348.58 ,"$1,823.00 ","$1,002.65 ",$348.58 ,$479.45 ,"$1,823.00 ",$221.84 ,$211.75 ,$366.01 ,"$1,458.40 ",$989.89 ,$510.44 ,"$1,640.70 ",$692.74 ,$500.00 ,$348.58 ,$875.04 
ST. MARY'S HOSPITAL - DECATUR,32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$679.00 ,$441.35 ,$29.97 ,$679.00 ,$191.43 ,$36.83 ,$373.45 ,$76.57 ,$190.12 ,$289.30 ,$76.57 ,$289.30 ,$76.57 ,$368.70 ,$44.12 ,$76.57 ,$368.70 ,$145.48 ,$475.30 ,$339.50 ,$543.20 ,$191.42 ,$76.57 ,$475.30 ,$76.57 ,$407.40 ,$76.57 ,$509.25 ,$374.81 ,$338.14 ,$374.81 ,$76.57 ,$374.81 ,$29.97 ,$29.97 ,$577.15 ,$191.42 ,$470.55 ,$76.57 ,$679.00 ,$373.45 ,$76.57 ,$178.58 ,$679.00 ,$38.93 ,$37.16 ,$80.40 ,$543.20 ,$368.70 ,$190.12 ,$611.10 ,$258.02 ,$500.00 ,$76.57 ,$325.92 
ST. MARY'S HOSPITAL - DECATUR,32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$936.00 ,$608.40 ,$28.97 ,$936.00 ,$191.43 ,$38.68 ,$514.80 ,$76.57 ,$262.08 ,$274.26 ,$76.57 ,$274.26 ,$76.57 ,$508.25 ,$42.66 ,$76.57 ,$508.25 ,$145.48 ,$655.20 ,$468.00 ,$748.80 ,$191.42 ,$76.57 ,$655.20 ,$76.57 ,$561.60 ,$76.57 ,$702.00 ,$516.67 ,$466.13 ,$516.67 ,$76.57 ,$516.67 ,$28.97 ,$28.97 ,$795.60 ,$191.42 ,$648.65 ,$76.57 ,$936.00 ,$514.80 ,$76.57 ,$246.17 ,$936.00 ,$38.93 ,$37.16 ,$80.40 ,$748.80 ,$508.25 ,$262.08 ,$842.40 ,$355.68 ,$500.00 ,$76.57 ,$449.28 
ST. MARY'S HOSPITAL - DECATUR,32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$556.00 ,$361.40 ,$31.46 ,$556.00 ,$191.43 ,$39.94 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$304.34 ,$76.57 ,$301.91 ,$46.32 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$31.46 ,$31.46 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$664.00 ,$431.60 ,$34.44 ,$664.00 ,$191.43 ,$47.97 ,$365.20 ,$76.57 ,$185.92 ,$324.29 ,$76.57 ,$324.29 ,$76.57 ,$360.55 ,$50.71 ,$76.57 ,$360.55 ,$145.48 ,$464.80 ,$332.00 ,$531.20 ,$191.42 ,$76.57 ,$464.80 ,$76.57 ,$398.40 ,$76.57 ,$498.00 ,$366.53 ,$330.67 ,$366.53 ,$76.57 ,$366.53 ,$34.44 ,$34.44 ,$564.40 ,$191.42 ,$460.15 ,$76.57 ,$664.00 ,$365.20 ,$76.57 ,$174.63 ,$664.00 ,$38.93 ,$37.16 ,$80.40 ,$531.20 ,$360.55 ,$185.92 ,$597.60 ,$252.32 ,$500.00 ,$76.57 ,$318.72 
ST. MARY'S HOSPITAL - DECATUR,32000278,73615,HC XRAY ARTHRO ANKLE,320,1 ,"$1,187.00 ",$771.55 ,$124.86 ,"$1,187.00 ",$871.45 ,$147.06 ,$652.85 ,$348.58 ,$332.36 ,$581.63 ,$348.58 ,$694.40 ,$348.58 ,$644.54 ,$183.84 ,$348.58 ,$644.54 ,$662.31 ,$830.90 ,$593.50 ,$949.60 ,$871.46 ,$348.58 ,$830.90 ,$348.58 ,$712.20 ,$348.58 ,$890.25 ,$655.22 ,$591.13 ,$655.22 ,$348.58 ,$655.22 ,$124.86 ,$124.86 ,"$1,008.95 ",$871.46 ,$822.59 ,$348.58 ,"$1,187.00 ",$652.85 ,$348.58 ,$312.18 ,"$1,187.00 ",$221.84 ,$211.75 ,$366.01 ,$949.60 ,$644.54 ,$332.36 ,"$1,068.30 ",$451.06 ,$500.00 ,$348.58 ,$569.76 
ST. MARY'S HOSPITAL - DECATUR,32000279,73620,HC XRAY FOOT (2 V),320,1 ,$556.00 ,$361.40 ,$26.99 ,$556.00 ,$191.43 ,$38.68 ,$305.80 ,$76.57 ,$155.68 ,$264.33 ,$76.57 ,$264.33 ,$76.57 ,$301.91 ,$39.73 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$26.99 ,$26.99 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$666.00 ,$432.90 ,$31.95 ,$666.00 ,$191.43 ,$44.89 ,$366.30 ,$76.57 ,$186.48 ,$299.32 ,$76.57 ,$299.32 ,$76.57 ,$361.64 ,$47.05 ,$76.57 ,$361.64 ,$145.48 ,$466.20 ,$333.00 ,$532.80 ,$191.42 ,$76.57 ,$466.20 ,$76.57 ,$399.60 ,$76.57 ,$499.50 ,$367.63 ,$331.67 ,$367.63 ,$76.57 ,$367.63 ,$31.95 ,$31.95 ,$566.10 ,$191.42 ,$461.54 ,$76.57 ,$666.00 ,$366.30 ,$76.57 ,$175.16 ,$666.00 ,$38.93 ,$37.16 ,$80.40 ,$532.80 ,$361.64 ,$186.48 ,$599.40 ,$253.08 ,$500.00 ,$76.57 ,$319.68 
ST. MARY'S HOSPITAL - DECATUR,32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$556.00 ,$361.40 ,$26.49 ,$556.00 ,$191.43 ,$39.94 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$274.26 ,$76.57 ,$301.91 ,$39.00 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$26.49 ,$26.49 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$556.00 ,$361.40 ,$30.96 ,$556.00 ,$191.43 ,$46.13 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$309.25 ,$76.57 ,$301.91 ,$45.58 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$30.96 ,$30.96 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 ,$38.93 ,$37.16 ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$500.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$438.00 ,$284.70 ,$26.99 ,$438.00 ,$191.43 ,$34.00 ,$240.90 ,$76.57 ,$122.64 ,$214.62 ,$76.57 ,$256.23 ,$76.57 ,$237.83 ,$39.73 ,$76.57 ,$237.83 ,$145.48 ,$306.60 ,$219.00 ,$350.40 ,$191.42 ,$76.57 ,$306.60 ,$76.57 ,$262.80 ,$76.57 ,$328.50 ,$241.78 ,$218.12 ,$241.78 ,$76.57 ,$241.78 ,$26.99 ,$26.99 ,$372.30 ,$191.42 ,$303.53 ,$76.57 ,$438.00 ,$240.90 ,$76.57 ,$115.19 ,$438.00 ,$38.93 ,$37.16 ,$80.40 ,$350.40 ,$237.83 ,$122.64 ,$394.20 ,$166.44 ,$438.00 ,$76.57 ,$210.24 
ST. MARY'S HOSPITAL - DECATUR,32000294,74019,HC XRAY ABDOMEN AP  AND  LAT (2 V OR 3 V),320,1 ,$574.00 ,$373.10 ,$32.45 ,$574.00 ,$257.65 ,$40.61 ,$315.70 ,$103.06 ,$160.72 ,$281.26 ,$103.06 ,$310.33 ,$103.06 ,$311.68 ,$47.78 ,$103.06 ,$311.68 ,$195.81 ,$401.80 ,$287.00 ,$459.20 ,$257.64 ,$103.06 ,$401.80 ,$103.06 ,$344.40 ,$103.06 ,$430.50 ,$316.85 ,$285.85 ,$316.85 ,$103.06 ,$316.85 ,$32.45 ,$32.45 ,$487.90 ,$257.64 ,$397.78 ,$103.06 ,$574.00 ,$315.70 ,$103.06 ,$150.96 ,$574.00 ,$38.93 ,$37.16 ,$108.21 ,$459.20 ,$311.68 ,$160.72 ,$516.60 ,$218.12 ,$500.00 ,$103.06 ,$275.52 
ST. MARY'S HOSPITAL - DECATUR,32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,$700.00 ,$455.00 ,$37.16 ,$700.00 ,$257.65 ,$63.45 ,$385.00 ,$103.06 ,$196.00 ,$343.00 ,$103.06 ,$404.31 ,$103.06 ,$380.10 ,$62.41 ,$103.06 ,$380.10 ,$195.81 ,$490.00 ,$350.00 ,$560.00 ,$257.64 ,$103.06 ,$490.00 ,$103.06 ,$420.00 ,$103.06 ,$525.00 ,$386.40 ,$348.60 ,$386.40 ,$103.06 ,$386.40 ,$42.39 ,$42.39 ,$595.00 ,$257.64 ,$485.10 ,$103.06 ,$700.00 ,$385.00 ,$103.06 ,$184.10 ,$700.00 ,$38.93 ,$37.16 ,$108.21 ,$560.00 ,$380.10 ,$196.00 ,$630.00 ,$266.00 ,$500.00 ,$103.06 ,$336.00 
ST. MARY'S HOSPITAL - DECATUR,32000299,74190,HC S AND I PERITONEOGRAM,320,1 ,$976.00 ,$634.40 ,$73.57 ,"$1,143.48 ","$1,143.48 ",$465.39 ,$536.80 ,$457.39 ,$273.28 ,$478.24 ,$457.39 ,$526.49 ,$457.39 ,$529.97 ,$73.57 ,$457.39 ,$529.97 ,$869.04 ,$683.20 ,$488.00 ,$780.80 ,"$1,143.47 ",$457.39 ,$683.20 ,$457.39 ,$585.60 ,$457.39 ,$732.00 ,$538.75 ,$486.05 ,$538.75 ,$457.39 ,$538.75 ,$74.36 ,$74.36 ,$829.60 ,$976.00 ,$676.37 ,$457.39 ,$976.00 ,$536.80 ,$457.39 ,$256.69 ,$976.00 ,$221.84 ,$211.75 ,$480.26 ,$780.80 ,$529.97 ,$273.28 ,$878.40 ,$370.88 ,$500.00 ,$457.39 ,$468.48 
ST. MARY'S HOSPITAL - DECATUR,32000300,74220,HC XRAY ESOPHAGUS,320,1 ,"$1,068.00 ",$694.20 ,$37.16 ,"$1,068.00 ",$422.73 ,$130.34 ,$587.40 ,$169.09 ,$299.04 ,$523.32 ,$169.09 ,$624.78 ,$169.09 ,$579.92 ,$129.71 ,$169.09 ,$579.92 ,$321.27 ,$747.60 ,$534.00 ,$854.40 ,$422.72 ,$169.09 ,$747.60 ,$169.09 ,$640.80 ,$169.09 ,$801.00 ,$589.54 ,$531.86 ,$589.54 ,$169.09 ,$589.54 ,$88.10 ,$88.10 ,$907.80 ,$422.72 ,$740.12 ,$169.09 ,"$1,068.00 ",$587.40 ,$169.09 ,$280.88 ,"$1,068.00 ",$38.93 ,$37.16 ,$177.54 ,$854.40 ,$579.92 ,$299.04 ,$961.20 ,$405.84 ,$500.00 ,$169.09 ,$512.64 
ST. MARY'S HOSPITAL - DECATUR,32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,$690.00 ,$448.50 ,$81.71 ,$690.00 ,$422.73 ,$123.53 ,$379.50 ,$169.09 ,$193.20 ,$338.10 ,$169.09 ,$403.65 ,$169.09 ,$374.67 ,$207.25 ,$169.09 ,$374.67 ,$321.27 ,$483.00 ,$345.00 ,$552.00 ,$422.72 ,$169.09 ,$483.00 ,$169.09 ,$414.00 ,$169.09 ,$517.50 ,$380.88 ,$343.62 ,$380.88 ,$169.09 ,$380.88 ,$140.75 ,$140.75 ,$586.50 ,$422.72 ,$478.17 ,$169.09 ,$690.00 ,$379.50 ,$169.09 ,$181.47 ,$690.00 ,$85.60 ,$81.71 ,$177.54 ,$552.00 ,$374.67 ,$193.20 ,$621.00 ,$262.20 ,$500.00 ,$169.09 ,$331.20 
ST. MARY'S HOSPITAL - DECATUR,32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,$979.00 ,$636.35 ,$81.71 ,$979.00 ,$422.73 ,$152.03 ,$538.45 ,$169.09 ,$274.12 ,$479.71 ,$169.09 ,$572.72 ,$169.09 ,$531.60 ,$180.18 ,$169.09 ,$531.60 ,$321.27 ,$685.30 ,$489.50 ,$783.20 ,$422.72 ,$169.09 ,$685.30 ,$169.09 ,$587.40 ,$169.09 ,$734.25 ,$540.41 ,$487.54 ,$540.41 ,$169.09 ,$540.41 ,$122.37 ,$122.37 ,$832.15 ,$422.72 ,$678.45 ,$169.09 ,$979.00 ,$538.45 ,$169.09 ,$257.48 ,$979.00 ,$85.60 ,$81.71 ,$177.54 ,$783.20 ,$531.60 ,$274.12 ,$881.10 ,$372.02 ,$500.00 ,$169.09 ,$469.92 
ST. MARY'S HOSPITAL - DECATUR,32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,$906.00 ,$588.90 ,$81.71 ,$906.00 ,$422.73 ,$179.89 ,$498.30 ,$169.09 ,$253.68 ,$443.94 ,$169.09 ,$530.01 ,$169.09 ,$491.96 ,$209.45 ,$169.09 ,$491.96 ,$321.27 ,$634.20 ,$453.00 ,$724.80 ,$422.72 ,$169.09 ,$634.20 ,$169.09 ,$543.60 ,$169.09 ,$679.50 ,$500.11 ,$451.19 ,$500.11 ,$169.09 ,$500.11 ,$142.25 ,$142.25 ,$770.10 ,$422.72 ,$627.86 ,$169.09 ,$906.00 ,$498.30 ,$169.09 ,$238.28 ,$906.00 ,$85.60 ,$81.71 ,$177.54 ,$724.80 ,$491.96 ,$253.68 ,$815.40 ,$344.28 ,$500.00 ,$169.09 ,$434.88 
ST. MARY'S HOSPITAL - DECATUR,32000311,74250,HC XRAY SMALL BOWEL,320,1 ,$891.00 ,$579.15 ,$81.71 ,$891.00 ,$422.73 ,$150.77 ,$490.05 ,$169.09 ,$249.48 ,$436.59 ,$169.09 ,$521.24 ,$169.09 ,$483.81 ,$183.84 ,$169.09 ,$483.81 ,$321.27 ,$623.70 ,$445.50 ,$712.80 ,$422.72 ,$169.09 ,$623.70 ,$169.09 ,$534.60 ,$169.09 ,$668.25 ,$491.83 ,$443.72 ,$491.83 ,$169.09 ,$491.83 ,$124.86 ,$124.86 ,$757.35 ,$422.72 ,$617.46 ,$169.09 ,$891.00 ,$490.05 ,$169.09 ,$234.33 ,$891.00 ,$85.60 ,$81.71 ,$177.54 ,$712.80 ,$483.81 ,$249.48 ,$801.90 ,$338.58 ,$500.00 ,$169.09 ,$427.68 
ST. MARY'S HOSPITAL - DECATUR,32000312,74018,HC SITZ MARKER STUDY,320,1 ,$891.00 ,$579.15 ,$26.99 ,$891.00 ,$191.43 ,$34.00 ,$490.05 ,$76.57 ,$249.48 ,$260.10 ,$76.57 ,$260.10 ,$76.57 ,$483.81 ,$39.73 ,$76.57 ,$483.81 ,$145.48 ,$623.70 ,$445.50 ,$712.80 ,$191.42 ,$76.57 ,$623.70 ,$76.57 ,$534.60 ,$76.57 ,$668.25 ,$491.83 ,$443.72 ,$491.83 ,$76.57 ,$491.83 ,$26.99 ,$26.99 ,$757.35 ,$191.42 ,$617.46 ,$76.57 ,$891.00 ,$490.05 ,$76.57 ,$234.33 ,$891.00 ,$38.93 ,$37.16 ,$80.40 ,$712.80 ,$483.81 ,$249.48 ,$801.90 ,$338.58 ,$500.00 ,$76.57 ,$427.68 
ST. MARY'S HOSPITAL - DECATUR,32000314,74251,HC SMALL BOWEL VIA ENTEROCLY TUBE,320,1 ,"$1,015.00 ",$659.75 ,$81.71 ,"$1,015.00 ",$422.73 ,$223.58 ,$558.25 ,$169.09 ,$284.20 ,$497.35 ,$169.09 ,$593.78 ,$169.09 ,$551.15 ,$818.07 ,$169.09 ,$551.15 ,$321.27 ,$710.50 ,$507.50 ,$812.00 ,$422.72 ,$169.09 ,$710.50 ,$169.09 ,$609.00 ,$169.09 ,$761.25 ,$560.28 ,$505.47 ,$560.28 ,$169.09 ,$560.28 ,$318.11 ,$318.11 ,$862.75 ,$422.72 ,$703.40 ,$169.09 ,"$1,015.00 ",$558.25 ,$169.09 ,$266.95 ,"$1,015.00 ",$85.60 ,$81.71 ,$177.54 ,$812.00 ,$551.15 ,$284.20 ,$913.50 ,$385.70 ,$500.00 ,$169.09 ,$487.20 
ST. MARY'S HOSPITAL - DECATUR,32000315,74270,HC XRAY COLON BARIUM,320,1 ,"$1,089.00 ",$707.85 ,$81.71 ,"$1,089.00 ",$422.73 ,$223.85 ,$598.95 ,$169.09 ,$304.92 ,$533.61 ,$169.09 ,$637.07 ,$169.09 ,$591.33 ,$260.65 ,$169.09 ,$591.33 ,$321.27 ,$762.30 ,$544.50 ,$871.20 ,$422.72 ,$169.09 ,$762.30 ,$169.09 ,$653.40 ,$169.09 ,$816.75 ,$601.13 ,$542.32 ,$601.13 ,$169.09 ,$601.13 ,$177.02 ,$177.02 ,$925.65 ,$422.72 ,$754.68 ,$169.09 ,"$1,089.00 ",$598.95 ,$169.09 ,$286.41 ,"$1,089.00 ",$85.60 ,$81.71 ,$177.54 ,$871.20 ,$591.33 ,$304.92 ,$980.10 ,$413.82 ,$500.00 ,$169.09 ,$522.72 
ST. MARY'S HOSPITAL - DECATUR,32000318,74270,HC XRAY BARM ENEMA/COLSTMY,320,1 ,"$1,089.00 ",$707.85 ,$81.71 ,"$1,089.00 ",$422.73 ,$223.85 ,$598.95 ,$169.09 ,$304.92 ,$533.61 ,$169.09 ,$637.07 ,$169.09 ,$591.33 ,$260.65 ,$169.09 ,$591.33 ,$321.27 ,$762.30 ,$544.50 ,$871.20 ,$422.72 ,$169.09 ,$762.30 ,$169.09 ,$653.40 ,$169.09 ,$816.75 ,$601.13 ,$542.32 ,$601.13 ,$169.09 ,$601.13 ,$177.02 ,$177.02 ,$925.65 ,$422.72 ,$754.68 ,$169.09 ,"$1,089.00 ",$598.95 ,$169.09 ,$286.41 ,"$1,089.00 ",$85.60 ,$81.71 ,$177.54 ,$871.20 ,$591.33 ,$304.92 ,$980.10 ,$413.82 ,$500.00 ,$169.09 ,$522.72 
ST. MARY'S HOSPITAL - DECATUR,32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,"$1,089.00 ",$707.85 ,$81.71 ,"$1,089.00 ",$422.73 ,$223.85 ,$598.95 ,$169.09 ,$304.92 ,$533.61 ,$169.09 ,$637.07 ,$169.09 ,$591.33 ,$260.65 ,$169.09 ,$591.33 ,$321.27 ,$762.30 ,$544.50 ,$871.20 ,$422.72 ,$169.09 ,$762.30 ,$169.09 ,$653.40 ,$169.09 ,$816.75 ,$601.13 ,$542.32 ,$601.13 ,$169.09 ,$601.13 ,$177.02 ,$177.02 ,$925.65 ,$422.72 ,$754.68 ,$169.09 ,"$1,089.00 ",$598.95 ,$169.09 ,$286.41 ,"$1,089.00 ",$85.60 ,$81.71 ,$177.54 ,$871.20 ,$591.33 ,$304.92 ,$980.10 ,$413.82 ,$500.00 ,$169.09 ,$522.72 
ST. MARY'S HOSPITAL - DECATUR,32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,"$1,579.00 ","$1,026.35 ",$81.71 ,"$1,579.00 ",$422.73 ,$223.85 ,$868.45 ,$169.09 ,$442.12 ,$773.71 ,$169.09 ,$923.72 ,$169.09 ,$857.40 ,$365.99 ,$169.09 ,$857.40 ,$321.27 ,"$1,105.30 ",$789.50 ,"$1,263.20 ",$422.72 ,$169.09 ,"$1,105.30 ",$169.09 ,$947.40 ,$169.09 ,"$1,184.25 ",$871.61 ,$786.34 ,$871.61 ,$169.09 ,$871.61 ,$248.55 ,$248.55 ,"$1,342.15 ",$422.72 ,"$1,094.25 ",$169.09 ,"$1,579.00 ",$868.45 ,$169.09 ,$415.28 ,"$1,579.00 ",$85.60 ,$81.71 ,$177.54 ,"$1,263.20 ",$857.40 ,$442.12 ,"$1,421.10 ",$600.02 ,$500.00 ,$169.09 ,$757.92 
ST. MARY'S HOSPITAL - DECATUR,32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,$936.00 ,$608.40 ,$47.34 ,$936.00 , N/A ,$61.54 ,$514.80 , N/A ,$262.08 ,$458.64 , N/A ,$506.54 , N/A ,$508.25 ,$72.11 , N/A ,$508.25 , N/A ,$655.20 ,$468.00 ,$748.80 , N/A , N/A ,$655.20 , N/A ,$561.60 , N/A ,$702.00 ,$516.67 ,$466.13 ,$516.67 , N/A ,$516.67 ,$47.34 ,$47.34 ,$795.60 , N/A ,$648.65 , N/A ,$936.00 ,$514.80 , N/A ,$246.17 ,$936.00 ,$221.84 ,$211.75 , N/A ,$748.80 ,$508.25 ,$262.08 ,$842.40 ,$355.68 ,$500.00 , N/A ,$449.28 
ST. MARY'S HOSPITAL - DECATUR,32000325,47531,HC XRAY CHOLANGIOGRAM THRU CATH,320,1 ,"$1,253.00 ",$814.45 ,$81.71 ,"$7,529.23 ","$7,529.23 ",$639.03 ,$689.15 ,"$3,011.69 ",$350.84 ,$588.91 ,"$3,011.69 ",$676.62 ,"$1,253.00 ",$680.38 ,$125.69 ,"$1,253.00 ",$680.38 ,"$1,253.00 ",$877.10 ,$626.50 ,"$1,002.40 ","$7,529.23 ","$3,011.69 ",$877.10 ,"$3,011.69 ",$751.80 ,"$3,011.69 ",$939.75 ,$691.66 ,$623.99 ,$691.66 ,"$3,011.69 ",$691.66 ,$877.10 ,$877.10 ,"$1,065.05 ","$1,253.00 ",$868.33 ,"$3,011.69 ","$1,253.00 ",$689.15 ,"$3,011.69 ",$329.54 ,"$1,253.00 ",$85.60 ,$81.71 ,"$3,162.27 ","$1,002.40 ",$680.38 ,$350.84 ,"$1,127.70 ",$476.14 ,$500.00 ,"$3,011.69 ",$601.44 
ST. MARY'S HOSPITAL - DECATUR,32000326,47532,HC PERCUTAN CHOLANGIOGRAM,320,1 ,"$2,712.00 ","$1,762.80 ",$231.80 ,"$7,529.23 ","$7,529.23 ","$1,383.12 ","$1,491.60 ","$3,011.69 ",$759.36 ,"$1,274.64 ","$3,011.69 ","$1,464.48 ","$2,712.00 ","$1,472.62 ",$379.53 ,"$2,712.00 ","$1,472.62 ","$2,712.00 ","$1,898.40 ","$1,356.00 ","$2,169.60 ","$7,529.23 ","$3,011.69 ","$1,898.40 ","$3,011.69 ","$1,627.20 ","$3,011.69 ","$2,034.00 ","$1,497.02 ","$1,350.58 ","$1,497.02 ","$3,011.69 ","$1,497.02 ","$1,898.40 ","$1,898.40 ","$2,305.20 ","$2,712.00 ","$1,879.42 ","$3,011.69 ","$2,712.00 ","$1,491.60 ","$3,011.69 ",$713.26 ,"$2,712.00 ",$242.84 ,$231.80 ,"$3,162.27 ","$2,169.60 ","$1,472.62 ",$759.36 ,"$2,440.80 ","$1,030.56 ",$500.00 ,"$3,011.69 ","$1,301.76 "
ST. MARY'S HOSPITAL - DECATUR,32000330,74330,HC XRAY ERCP CATH BILIARY AND PANCREAS,320,1 ,"$1,272.00 ",$826.80 ,$179.49 ,"$1,272.00 ", N/A ,$226.33 ,$699.60 , N/A ,$356.16 ,$623.28 , N/A ,$744.12 , N/A ,$690.70 ,$259.21 , N/A ,$690.70 , N/A ,$890.40 ,$636.00 ,"$1,017.60 ", N/A , N/A ,$890.40 , N/A ,$763.20 , N/A ,$954.00 ,$702.14 ,$633.46 ,$702.14 , N/A ,$702.14 ,$179.49 ,$179.49 ,"$1,081.20 ", N/A ,$881.50 , N/A ,"$1,272.00 ",$699.60 , N/A ,$334.54 ,"$1,272.00 ",$221.84 ,$211.75 , N/A ,"$1,017.60 ",$690.70 ,$356.16 ,"$1,144.80 ",$483.36 ,$500.00 , N/A ,$610.56 
ST. MARY'S HOSPITAL - DECATUR,32000337,74410,HC XRAY UROGRAM IVP DRIP TECH,320,1 ,"$1,637.00 ","$1,064.05 ",$135.29 ,"$1,637.00 ",$422.73 ,$166.28 ,$900.35 ,$169.09 ,$458.36 ,$802.13 ,$169.09 ,$957.65 ,$169.09 ,$888.89 ,$199.20 ,$169.09 ,$888.89 ,$321.27 ,"$1,145.90 ",$818.50 ,"$1,309.60 ",$422.72 ,$169.09 ,"$1,145.90 ",$169.09 ,$982.20 ,$169.09 ,"$1,227.75 ",$903.62 ,$815.23 ,$903.62 ,$169.09 ,$903.62 ,$135.29 ,$135.29 ,"$1,391.45 ",$422.72 ,"$1,134.44 ",$169.09 ,"$1,637.00 ",$900.35 ,$169.09 ,$430.53 ,"$1,637.00 ",$242.84 ,$231.80 ,$177.54 ,"$1,309.60 ",$888.89 ,$458.36 ,"$1,473.30 ",$622.06 ,$500.00 ,$169.09 ,$785.76 
ST. MARY'S HOSPITAL - DECATUR,32000339,74420,HC XRAY UROGRAM RETROGRADE,320,1 ,"$1,243.00 ",$807.95 ,$64.25 ,"$1,243.00 ",$871.45 ,$381.78 ,$683.65 ,$348.58 ,$348.04 ,$609.07 ,$348.58 ,$727.16 ,$348.58 ,$674.95 ,$94.60 ,$348.58 ,$674.95 ,$662.31 ,$870.10 ,$621.50 ,$994.40 ,$871.46 ,$348.58 ,$870.10 ,$348.58 ,$745.80 ,$348.58 ,$932.25 ,$686.14 ,$619.01 ,$686.14 ,$348.58 ,$686.14 ,$64.25 ,$64.25 ,"$1,056.55 ",$871.46 ,$861.40 ,$348.58 ,"$1,243.00 ",$683.65 ,$348.58 ,$326.91 ,"$1,243.00 ",$242.84 ,$231.80 ,$366.01 ,$994.40 ,$674.95 ,$348.04 ,"$1,118.70 ",$472.34 ,$500.00 ,$348.58 ,$596.64 
ST. MARY'S HOSPITAL - DECATUR,32000340,74425,HC XRAY UROGRAM ANTEGRADE,320,1 ,$838.00 ,$544.70 ,$74.36 ,$871.46 ,$871.45 ,$381.78 ,$460.90 ,$348.58 ,$234.64 ,$410.62 ,$348.58 ,$490.23 ,$348.58 ,$455.03 ,$100.37 ,$348.58 ,$455.03 ,$662.31 ,$586.60 ,$419.00 ,$670.40 ,$871.46 ,$348.58 ,$586.60 ,$348.58 ,$502.80 ,$348.58 ,$628.50 ,$462.58 ,$417.32 ,$462.58 ,$348.58 ,$462.58 ,$74.36 ,$74.36 ,$712.30 ,$838.00 ,$580.73 ,$348.58 ,$838.00 ,$460.90 ,$348.58 ,$220.39 ,$838.00 ,$221.84 ,$211.75 ,$366.01 ,$670.40 ,$455.03 ,$234.64 ,$754.20 ,$318.44 ,$500.00 ,$348.58 ,$402.24 
ST. MARY'S HOSPITAL - DECATUR,32000341,50431,HC ANGIO NEPHROSTGRAM,320,1 ,"$2,230.00 ","$1,449.50 ",$170.10 ,"$2,230.00 ","$1,361.48 ","$1,137.30 ","$1,226.50 ",$544.59 ,$624.40 ,"$1,048.10 ",$544.59 ,"$1,204.20 ",$544.59 ,"$1,210.89 ",$170.10 ,$544.59 ,"$1,210.89 ","$1,034.71 ","$1,561.00 ","$1,115.00 ","$1,784.00 ","$1,361.46 ",$544.59 ,"$1,561.00 ",$544.59 ,"$1,338.00 ",$544.59 ,"$1,672.50 ","$1,230.96 ","$1,110.54 ","$1,230.96 ",$544.59 ,"$1,230.96 ","$1,561.00 ","$1,561.00 ","$1,895.50 ","$1,361.46 ","$1,545.39 ",$544.59 ,"$2,230.00 ","$1,226.50 ",$544.59 ,$586.49 ,"$2,230.00 ",$242.84 ,$231.80 ,$571.82 ,"$1,784.00 ","$1,210.89 ",$624.40 ,"$2,007.00 ",$847.40 ,$500.00 ,$544.59 ,"$1,070.40 "
ST. MARY'S HOSPITAL - DECATUR,32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,"$1,310.00 ",$851.50 ,$32.45 ,"$1,310.00 ",$871.45 ,$48.60 ,$720.50 ,$348.58 ,$366.80 ,$314.27 ,$348.58 ,$314.27 ,$348.58 ,$711.33 ,$47.78 ,$348.58 ,$711.33 ,$662.31 ,$917.00 ,$655.00 ,"$1,048.00 ",$871.46 ,$348.58 ,$917.00 ,$348.58 ,$786.00 ,$348.58 ,$982.50 ,$723.12 ,$652.38 ,$723.12 ,$348.58 ,$723.12 ,$32.45 ,$32.45 ,"$1,113.50 ",$871.46 ,$907.83 ,$348.58 ,"$1,310.00 ",$720.50 ,$348.58 ,$344.53 ,"$1,310.00 ",$221.84 ,$211.75 ,$366.01 ,"$1,048.00 ",$711.33 ,$366.80 ,"$1,179.00 ",$497.80 ,$500.00 ,$348.58 ,$628.80 
ST. MARY'S HOSPITAL - DECATUR,32000344,74450,HC CYSTOURETHROGRAM RETROGRADE,320,1 ,"$1,637.00 ","$1,064.05 ",$83.03 ,"$1,637.00 ",$544.53 ,$381.78 ,$900.35 ,$217.81 ,$458.36 ,$802.13 ,$217.81 ,$819.43 ,$217.81 ,$888.89 ,$116.69 ,$217.81 ,$888.89 ,$413.84 ,"$1,145.90 ",$818.50 ,"$1,309.60 ",$544.53 ,$217.81 ,"$1,145.90 ",$217.81 ,$982.20 ,$217.81 ,"$1,227.75 ",$903.62 ,$815.23 ,$903.62 ,$217.81 ,$903.62 ,$83.03 ,$83.03 ,"$1,391.45 ",$544.53 ,"$1,134.44 ",$217.81 ,"$1,637.00 ",$900.35 ,$217.81 ,$430.53 ,"$1,637.00 ",$221.84 ,$211.75 ,$228.70 ,"$1,309.60 ",$888.89 ,$458.36 ,"$1,473.30 ",$622.06 ,$500.00 ,$217.81 ,$785.76 
ST. MARY'S HOSPITAL - DECATUR,32000346,74455,HC XRAY VOID CYSTOURETHGRAM,320,1 ,"$1,243.00 ",$807.95 ,$103.49 ,"$1,243.00 ",$544.53 ,$129.74 ,$683.65 ,$217.81 ,$348.04 ,$609.07 ,$217.81 ,$727.16 ,$217.81 ,$674.95 ,$152.39 ,$217.81 ,$674.95 ,$413.84 ,$870.10 ,$621.50 ,$994.40 ,$544.53 ,$217.81 ,$870.10 ,$217.81 ,$745.80 ,$217.81 ,$932.25 ,$686.14 ,$619.01 ,$686.14 ,$217.81 ,$686.14 ,$103.49 ,$103.49 ,"$1,056.55 ",$544.53 ,$861.40 ,$217.81 ,"$1,243.00 ",$683.65 ,$217.81 ,$326.91 ,"$1,243.00 ",$221.84 ,$211.75 ,$228.70 ,$994.40 ,$674.95 ,$348.04 ,"$1,118.70 ",$472.34 ,$500.00 ,$217.81 ,$596.64 
ST. MARY'S HOSPITAL - DECATUR,32000349,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT,320,1 ,"$6,955.00 ","$4,520.75 ",$500.00 ,"$6,955.00 ","$4,237.25 ","$3,547.05 ","$3,825.25 ","$1,694.90 ","$1,947.40 ","$3,268.85 ","$1,694.90 ","$3,755.70 ","$1,694.90 ","$3,776.57 ",$540.27 ,"$1,694.90 ","$3,776.57 ","$3,220.31 ","$4,868.50 ","$3,477.50 ","$5,564.00 ","$4,237.26 ","$1,694.90 ","$4,868.50 ","$1,694.90 ","$4,173.00 ","$1,694.90 ","$5,216.25 ","$3,839.16 ","$3,463.59 ","$3,839.16 ","$1,694.90 ","$3,839.16 ","$4,868.50 ","$4,868.50 ","$5,911.75 ","$4,237.26 ","$4,819.82 ","$1,694.90 ","$6,955.00 ","$3,825.25 ","$1,694.90 ","$1,829.17 ","$6,955.00 ",$759.25 ,$724.74 ,"$1,779.65 ","$5,564.00 ","$3,776.57 ","$1,947.40 ","$6,259.50 ","$2,642.90 ",$500.00 ,"$1,694.90 ","$3,338.40 "
ST. MARY'S HOSPITAL - DECATUR,32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,"$1,900.00 ","$1,235.00 ",$88.59 ,"$1,900.00 ",$544.53 ,$111.76 ,"$1,045.00 ",$217.81 ,$532.00 ,$789.25 ,$217.81 ,$789.25 ,$217.81 ,"$1,031.70 ",$130.44 ,$217.81 ,"$1,031.70 ",$413.84 ,"$1,330.00 ",$950.00 ,"$1,520.00 ",$544.53 ,$217.81 ,"$1,330.00 ",$217.81 ,"$1,140.00 ",$217.81 ,"$1,425.00 ","$1,048.80 ",$946.20 ,"$1,048.80 ",$217.81 ,"$1,048.80 ",$88.59 ,$88.59 ,"$1,615.00 ",$544.53 ,"$1,316.70 ",$217.81 ,"$1,900.00 ","$1,045.00 ",$217.81 ,$499.70 ,"$1,900.00 ",$221.84 ,$211.75 ,$228.70 ,"$1,520.00 ","$1,031.70 ",$532.00 ,"$1,710.00 ",$722.00 ,$500.00 ,$217.81 ,$912.00 
ST. MARY'S HOSPITAL - DECATUR,32000355,75605,HC THORACIC AORTA,320,1 ,"$5,119.00 ","$3,327.35 ",$109.46 ,"$11,285.10 ","$11,285.10 ",$186.71 ,"$2,815.45 ","$4,514.04 ","$1,433.32 ","$1,164.27 ","$4,514.04 ","$1,164.27 ","$4,514.04 ","$2,779.62 ",$161.17 ,"$4,514.04 ","$2,779.62 ","$5,119.00 ","$3,583.30 ","$2,559.50 ","$4,095.20 ","$11,285.10 ","$4,514.04 ","$3,583.30 ","$4,514.04 ","$3,071.40 ","$4,514.04 ","$3,839.25 ","$2,825.69 ","$2,549.26 ","$2,825.69 ","$4,514.04 ","$2,825.69 ",$109.46 ,$109.46 ,"$4,351.15 ","$5,119.00 ","$3,547.47 ","$4,514.04 ","$5,119.00 ","$2,815.45 ","$4,514.04 ","$1,346.30 ","$5,119.00 ",$221.84 ,$211.75 ,"$4,739.74 ","$4,095.20 ","$2,779.62 ","$1,433.32 ","$4,607.10 ","$1,945.22 ",$500.00 ,"$4,514.04 ","$2,457.12 "
ST. MARY'S HOSPITAL - DECATUR,32000356,75625,HC ABDOMINAL AORTAGRAM 75625,320,1 ,"$4,224.00 ","$2,745.60 ",$106.97 ,"$6,774.50 ","$6,774.50 ",$187.31 ,"$2,323.20 ","$2,709.80 ","$1,182.72 ","$1,149.23 ","$2,709.80 ","$1,149.23 ","$2,709.80 ","$2,293.63 ",$157.51 ,"$2,709.80 ","$2,293.63 ","$4,224.00 ","$2,956.80 ","$2,112.00 ","$3,379.20 ","$6,774.49 ","$2,709.80 ","$2,956.80 ","$2,709.80 ","$2,534.40 ","$2,709.80 ","$3,168.00 ","$2,331.65 ","$2,103.55 ","$2,331.65 ","$2,709.80 ","$2,331.65 ",$106.97 ,$106.97 ,"$3,590.40 ","$4,224.00 ","$2,927.23 ","$2,709.80 ","$4,224.00 ","$2,323.20 ","$2,709.80 ","$1,110.91 ","$4,224.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$3,379.20 ","$2,293.63 ","$1,182.72 ","$3,801.60 ","$1,605.12 ",$500.00 ,"$2,709.80 ","$2,027.52 "
ST. MARY'S HOSPITAL - DECATUR,32000357,75630,HC AORTA WITH RUNOFF 75630,320,1 ,"$5,782.00 ","$3,758.30 ",$108.96 ,"$6,774.50 ","$6,774.50 ",$185.47 ,"$3,180.10 ","$2,709.80 ","$1,618.96 ","$1,164.27 ","$2,709.80 ","$1,164.27 ","$2,709.80 ","$3,139.63 ",$160.43 ,"$2,709.80 ","$3,139.63 ","$5,148.61 ","$4,047.40 ","$2,891.00 ","$4,625.60 ","$6,774.49 ","$2,709.80 ","$4,047.40 ","$2,709.80 ","$3,469.20 ","$2,709.80 ","$4,336.50 ","$3,191.66 ","$2,879.44 ","$3,191.66 ","$2,709.80 ","$3,191.66 ",$108.96 ,$108.96 ,"$4,914.70 ","$5,782.00 ","$4,006.93 ","$2,709.80 ","$5,782.00 ","$3,180.10 ","$2,709.80 ","$1,520.67 ","$5,782.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$4,625.60 ","$3,139.63 ","$1,618.96 ","$5,203.80 ","$2,197.16 ",$500.00 ,"$2,709.80 ","$2,775.36 "
ST. MARY'S HOSPITAL - DECATUR,32000371,75710,HC ANGIO EXTREMITY UNI 75710,320,1 ,"$4,092.00 ","$2,659.80 ",$113.43 ,"$6,774.50 ","$6,774.50 ",$235.01 ,"$2,250.60 ","$2,709.80 ","$1,145.76 ","$1,214.30 ","$2,709.80 ","$1,214.30 ","$2,709.80 ","$2,221.96 ",$167.02 ,"$2,709.80 ","$2,221.96 ","$4,092.00 ","$2,864.40 ","$2,046.00 ","$3,273.60 ","$6,774.49 ","$2,709.80 ","$2,864.40 ","$2,709.80 ","$2,455.20 ","$2,709.80 ","$3,069.00 ","$2,258.78 ","$2,037.82 ","$2,258.78 ","$2,709.80 ","$2,258.78 ",$113.43 ,$113.43 ,"$3,478.20 ","$4,092.00 ","$2,835.76 ","$2,709.80 ","$4,092.00 ","$2,250.60 ","$2,709.80 ","$1,076.20 ","$4,092.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$3,273.60 ","$2,221.96 ","$1,145.76 ","$3,682.80 ","$1,554.96 ",$500.00 ,"$2,709.80 ","$1,964.16 "
ST. MARY'S HOSPITAL - DECATUR,32000373,75716,HC ANGIO EXTREMITY BILAT 75716,320,1 ,"$5,515.00 ","$3,584.75 ",$114.92 ,"$6,774.50 ","$6,774.50 ",$284.51 ,"$3,033.25 ","$2,709.80 ","$1,544.20 ","$1,399.20 ","$2,709.80 ","$1,399.20 ","$2,709.80 ","$2,994.65 ",$169.21 ,"$2,709.80 ","$2,994.65 ","$5,148.61 ","$3,860.50 ","$2,757.50 ","$4,412.00 ","$6,774.49 ","$2,709.80 ","$3,860.50 ","$2,709.80 ","$3,309.00 ","$2,709.80 ","$4,136.25 ","$3,044.28 ","$2,746.47 ","$3,044.28 ","$2,709.80 ","$3,044.28 ",$114.92 ,$114.92 ,"$4,687.75 ","$5,515.00 ","$3,821.90 ","$2,709.80 ","$5,515.00 ","$3,033.25 ","$2,709.80 ","$1,450.45 ","$5,515.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$4,412.00 ","$2,994.65 ","$1,544.20 ","$4,963.50 ","$2,095.70 ",$500.00 ,"$2,709.80 ","$2,647.20 "
ST. MARY'S HOSPITAL - DECATUR,32000375,36251,HC ANGIO SEL RENAL UNILA 36251,320,1 ,"$7,333.00 ","$4,766.45 ",$484.91 ,"$7,333.00 ","$6,774.50 ","$3,739.83 ","$4,033.15 ","$2,709.80 ","$2,053.24 ","$3,446.51 ","$2,709.80 ","$3,959.82 ","$2,709.80 ","$3,981.82 ",$484.91 ,"$2,709.80 ","$3,981.82 ","$5,148.61 ","$5,133.10 ","$3,666.50 ","$5,866.40 ","$6,774.49 ","$2,709.80 ","$5,133.10 ","$2,709.80 ","$4,399.80 ","$2,709.80 ","$5,499.75 ","$4,047.82 ","$3,651.83 ","$4,047.82 ","$2,709.80 ","$4,047.82 ","$5,133.10 ","$5,133.10 ","$6,233.05 ","$6,774.49 ","$5,081.77 ","$2,709.80 ","$7,333.00 ","$4,033.15 ","$2,709.80 ","$1,928.58 ","$7,333.00 ","$1,871.71 ","$1,786.63 ","$2,845.29 ","$5,866.40 ","$3,981.82 ","$2,053.24 ","$6,599.70 ","$2,786.54 ",$500.00 ,"$2,709.80 ","$3,519.84 "
ST. MARY'S HOSPITAL - DECATUR,32000376,36252,HC ANGIO SEL RENAL BILAT 36252,320,1 ,"$8,915.00 ","$5,794.75 ",$500.00 ,"$8,915.00 ","$6,774.50 ","$4,546.65 ","$4,903.25 ","$2,709.80 ","$2,496.20 ","$4,190.05 ","$2,709.80 ","$4,814.10 ","$2,709.80 ","$4,840.85 ",$676.24 ,"$2,709.80 ","$4,840.85 ","$5,148.61 ","$6,240.50 ","$4,457.50 ","$7,132.00 ","$6,774.49 ","$2,709.80 ","$6,240.50 ","$2,709.80 ","$5,349.00 ","$2,709.80 ","$6,686.25 ","$4,921.08 ","$4,439.67 ","$4,921.08 ","$2,709.80 ","$4,921.08 ","$6,240.50 ","$6,240.50 ","$7,577.75 ","$6,774.49 ","$6,178.10 ","$2,709.80 ","$8,915.00 ","$4,903.25 ","$2,709.80 ","$2,344.65 ","$8,915.00 ","$1,871.71 ","$1,786.63 ","$2,845.29 ","$7,132.00 ","$4,840.85 ","$2,496.20 ","$8,023.50 ","$3,387.70 ",$500.00 ,"$2,709.80 ","$4,279.20 "
ST. MARY'S HOSPITAL - DECATUR,32000378,75726,"HC ANGIO VISERAL, SEL, OR SUPRASEL 75726",320,1 ,"$5,155.00 ","$3,350.75 ",$125.36 ,"$11,285.10 ","$11,285.10 ",$233.78 ,"$2,835.25 ","$4,514.04 ","$1,443.40 ","$1,329.21 ","$4,514.04 ","$1,329.21 ","$4,514.04 ","$2,799.17 ",$184.57 ,"$4,514.04 ","$2,799.17 ","$5,155.00 ","$3,608.50 ","$2,577.50 ","$4,124.00 ","$11,285.10 ","$4,514.04 ","$3,608.50 ","$4,514.04 ","$3,093.00 ","$4,514.04 ","$3,866.25 ","$2,845.56 ","$2,567.19 ","$2,845.56 ","$4,514.04 ","$2,845.56 ",$125.36 ,$125.36 ,"$4,381.75 ","$5,155.00 ","$3,572.42 ","$4,514.04 ","$5,155.00 ","$2,835.25 ","$4,514.04 ","$1,355.77 ","$5,155.00 ",$221.84 ,$211.75 ,"$4,739.74 ","$4,124.00 ","$2,799.17 ","$1,443.40 ","$4,639.50 ","$1,958.90 ",$500.00 ,"$4,514.04 ","$2,474.40 "
ST. MARY'S HOSPITAL - DECATUR,32000384,75736,HC ANGIO PELVIC SELECT,320,1 ,"$5,318.00 ","$3,456.70 ",$140.42 ,"$11,285.10 ","$11,285.10 ",$225.72 ,"$2,924.90 ","$4,514.04 ","$1,489.04 ","$1,488.56 ","$4,514.04 ","$1,488.56 ","$4,514.04 ","$2,887.67 ",$206.75 ,"$4,514.04 ","$2,887.67 ","$5,318.00 ","$3,722.60 ","$2,659.00 ","$4,254.40 ","$11,285.10 ","$4,514.04 ","$3,722.60 ","$4,514.04 ","$3,190.80 ","$4,514.04 ","$3,988.50 ","$2,935.54 ","$2,648.36 ","$2,935.54 ","$4,514.04 ","$2,935.54 ",$140.42 ,$140.42 ,"$4,520.30 ","$5,318.00 ","$3,685.37 ","$4,514.04 ","$5,318.00 ","$2,924.90 ","$4,514.04 ","$1,398.63 ","$5,318.00 ",$221.84 ,$211.75 ,"$4,739.74 ","$4,254.40 ","$2,887.67 ","$1,489.04 ","$4,786.20 ","$2,020.84 ",$500.00 ,"$4,514.04 ","$2,552.64 "
ST. MARY'S HOSPITAL - DECATUR,32000389,75774,HC ANGIO EA VESSEL ADDL 75774,320,1 ,"$3,448.00 ","$2,241.20 ",$91.56 ,"$3,448.00 ", N/A ,$155.75 ,"$1,896.40 ", N/A ,$965.44 ,$984.28 , N/A ,$984.28 , N/A ,"$1,872.26 ",$134.83 , N/A ,"$1,872.26 ", N/A ,"$2,413.60 ","$1,724.00 ","$2,758.40 ", N/A , N/A ,"$2,413.60 ", N/A ,"$2,068.80 ", N/A ,"$2,586.00 ","$1,903.30 ","$1,717.10 ","$1,903.30 ", N/A ,"$1,903.30 ",$91.56 ,$91.56 ,"$2,930.80 ", N/A ,"$2,389.46 ", N/A ,"$3,448.00 ","$1,896.40 ", N/A ,$906.82 ,"$3,448.00 ",$221.84 ,$211.75 , N/A ,"$2,758.40 ","$1,872.26 ",$965.44 ,"$3,103.20 ","$1,310.24 ",$500.00 , N/A ,"$1,655.04 "
ST. MARY'S HOSPITAL - DECATUR,32000393,75809,HC SHUNTOGRAM NONVASCULAR,320,1 ,"$1,911.00 ","$1,242.15 ",$100.02 ,"$1,911.00 ",$257.65 ,$129.11 ,"$1,051.05 ",$103.06 ,$535.08 ,$936.39 ,$103.06 ,"$1,064.29 ",$103.06 ,"$1,037.67 ",$147.27 ,$103.06 ,"$1,037.67 ",$195.81 ,"$1,337.70 ",$955.50 ,"$1,528.80 ",$257.64 ,$103.06 ,"$1,337.70 ",$103.06 ,"$1,146.60 ",$103.06 ,"$1,433.25 ","$1,054.87 ",$951.68 ,"$1,054.87 ",$103.06 ,"$1,054.87 ",$100.02 ,$100.02 ,"$1,624.35 ",$257.64 ,"$1,324.32 ",$103.06 ,"$1,911.00 ","$1,051.05 ",$103.06 ,$502.59 ,"$1,911.00 ",$221.84 ,$211.75 ,$108.21 ,"$1,528.80 ","$1,037.67 ",$535.08 ,"$1,719.90 ",$726.18 ,$500.00 ,$103.06 ,$917.28 
ST. MARY'S HOSPITAL - DECATUR,32000395,75820,HC VENOGRAM EXTREMITY UNI 75820,320,1 ,"$1,899.00 ","$1,234.35 ",$107.46 ,"$3,327.80 ","$3,327.80 ",$173.07 ,"$1,044.45 ","$1,331.12 ",$531.72 ,$930.51 ,"$1,331.12 ","$1,110.92 ","$1,331.12 ","$1,031.16 ",$158.24 ,"$1,331.12 ","$1,031.16 ","$1,899.00 ","$1,329.30 ",$949.50 ,"$1,519.20 ","$3,327.80 ","$1,331.12 ","$1,329.30 ","$1,331.12 ","$1,139.40 ","$1,331.12 ","$1,424.25 ","$1,048.25 ",$945.70 ,"$1,048.25 ","$1,331.12 ","$1,048.25 ",$107.46 ,$107.46 ,"$1,614.15 ","$1,899.00 ","$1,316.01 ","$1,331.12 ","$1,899.00 ","$1,044.45 ","$1,331.12 ",$499.44 ,"$1,899.00 ",$221.84 ,$211.75 ,"$1,397.68 ","$1,519.20 ","$1,031.16 ",$531.72 ,"$1,709.10 ",$721.62 ,$500.00 ,"$1,331.12 ",$911.52 
ST. MARY'S HOSPITAL - DECATUR,32000397,75822,HC VENOGRAM EXTREMITY BILAT,320,1 ,"$2,399.00 ","$1,559.35 ",$109.95 ,"$3,327.80 ","$3,327.80 ",$199.08 ,"$1,319.45 ","$1,331.12 ",$671.72 ,"$1,175.51 ","$1,331.12 ","$1,184.22 ","$1,331.12 ","$1,302.66 ",$161.90 ,"$1,331.12 ","$1,302.66 ","$2,399.00 ","$1,679.30 ","$1,199.50 ","$1,919.20 ","$3,327.80 ","$1,331.12 ","$1,679.30 ","$1,331.12 ","$1,439.40 ","$1,331.12 ","$1,799.25 ","$1,324.25 ","$1,194.70 ","$1,324.25 ","$1,331.12 ","$1,324.25 ",$109.95 ,$109.95 ,"$2,039.15 ","$2,399.00 ","$1,662.51 ","$1,331.12 ","$2,399.00 ","$1,319.45 ","$1,331.12 ",$630.94 ,"$2,399.00 ",$221.84 ,$211.75 ,"$1,397.68 ","$1,919.20 ","$1,302.66 ",$671.72 ,"$2,159.10 ",$911.62 ,$500.00 ,"$1,331.12 ","$1,151.52 "
ST. MARY'S HOSPITAL - DECATUR,32000398,75825,HC VENOGRAPHY CAVAL INFERIOR,320,1 ,"$4,013.00 ","$2,608.45 ",$104.49 ,"$6,774.50 ","$6,774.50 ",$177.41 ,"$2,207.15 ","$2,709.80 ","$1,123.64 ","$1,114.23 ","$2,709.80 ","$1,114.23 ","$2,709.80 ","$2,179.06 ",$153.85 ,"$2,709.80 ","$2,179.06 ","$4,013.00 ","$2,809.10 ","$2,006.50 ","$3,210.40 ","$6,774.49 ","$2,709.80 ","$2,809.10 ","$2,709.80 ","$2,407.80 ","$2,709.80 ","$3,009.75 ","$2,215.18 ","$1,998.47 ","$2,215.18 ","$2,709.80 ","$2,215.18 ",$104.49 ,$104.49 ,"$3,411.05 ","$4,013.00 ","$2,781.01 ","$2,709.80 ","$4,013.00 ","$2,207.15 ","$2,709.80 ","$1,055.42 ","$4,013.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$3,210.40 ","$2,179.06 ","$1,123.64 ","$3,611.70 ","$1,524.94 ",$500.00 ,"$2,709.80 ","$1,926.24 "
ST. MARY'S HOSPITAL - DECATUR,32000399,75827,HC VENOGRAPHY CAVAL SUPERIOR,320,1 ,"$3,930.00 ","$2,554.50 ",$110.45 ,"$3,930.00 ","$3,327.80 ",$184.23 ,"$2,161.50 ","$1,331.12 ","$1,100.40 ","$1,169.28 ","$1,331.12 ","$1,169.28 ","$1,331.12 ","$2,133.99 ",$162.63 ,"$1,331.12 ","$2,133.99 ","$2,529.13 ","$2,751.00 ","$1,965.00 ","$3,144.00 ","$3,327.80 ","$1,331.12 ","$2,751.00 ","$1,331.12 ","$2,358.00 ","$1,331.12 ","$2,947.50 ","$2,169.36 ","$1,957.14 ","$2,169.36 ","$1,331.12 ","$2,169.36 ",$110.45 ,$110.45 ,"$3,340.50 ","$3,327.80 ","$2,723.49 ","$1,331.12 ","$3,930.00 ","$2,161.50 ","$1,331.12 ","$1,033.59 ","$3,930.00 ",$221.84 ,$211.75 ,"$1,397.68 ","$3,144.00 ","$2,133.99 ","$1,100.40 ","$3,537.00 ","$1,493.40 ",$500.00 ,"$1,331.12 ","$1,886.40 "
ST. MARY'S HOSPITAL - DECATUR,32000400,75831,HC VENOGRAM RENAL UNILAT,320,1 ,"$3,531.00 ","$2,295.15 ",$113.43 ,"$6,774.50 ","$6,774.50 ",$187.94 ,"$1,942.05 ","$2,709.80 ",$988.68 ,"$1,204.27 ","$2,709.80 ","$1,204.27 ","$2,709.80 ","$1,917.33 ",$167.02 ,"$2,709.80 ","$1,917.33 ","$3,531.00 ","$2,471.70 ","$1,765.50 ","$2,824.80 ","$6,774.49 ","$2,709.80 ","$2,471.70 ","$2,709.80 ","$2,118.60 ","$2,709.80 ","$2,648.25 ","$1,949.11 ","$1,758.44 ","$1,949.11 ","$2,709.80 ","$1,949.11 ",$113.43 ,$113.43 ,"$3,001.35 ","$3,531.00 ","$2,446.98 ","$2,709.80 ","$3,531.00 ","$1,942.05 ","$2,709.80 ",$928.65 ,"$3,531.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$2,824.80 ","$1,917.33 ",$988.68 ,"$3,177.90 ","$1,341.78 ",$500.00 ,"$2,709.80 ","$1,694.88 "
ST. MARY'S HOSPITAL - DECATUR,32000401,75833,HC VENOGRAM RENAL BILAT,320,1 ,"$3,857.00 ","$2,507.05 ",$123.53 ,"$6,774.50 ","$6,774.50 ",$218.90 ,"$2,121.35 ","$2,709.80 ","$1,079.96 ","$1,323.51 ","$2,709.80 ","$1,323.51 ","$2,709.80 ","$2,094.35 ",$181.88 ,"$2,709.80 ","$2,094.35 ","$3,857.00 ","$2,699.90 ","$1,928.50 ","$3,085.60 ","$6,774.49 ","$2,709.80 ","$2,699.90 ","$2,709.80 ","$2,314.20 ","$2,709.80 ","$2,892.75 ","$2,129.06 ","$1,920.79 ","$2,129.06 ","$2,709.80 ","$2,129.06 ",$123.53 ,$123.53 ,"$3,278.45 ","$3,857.00 ","$2,672.90 ","$2,709.80 ","$3,857.00 ","$2,121.35 ","$2,709.80 ","$1,014.39 ","$3,857.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$3,085.60 ","$2,094.35 ","$1,079.96 ","$3,471.30 ","$1,465.66 ",$500.00 ,"$2,709.80 ","$1,851.36 "
ST. MARY'S HOSPITAL - DECATUR,32000404,75860,HC VENOGRAPHY SINUS/ JUGULAR,320,1 ,"$2,295.00 ","$1,491.75 ",$118.89 ,"$6,774.50 ","$6,774.50 ",$186.71 ,"$1,262.25 ","$2,709.80 ",$642.60 ,"$1,124.55 ","$2,709.80 ","$1,249.29 ","$2,295.00 ","$1,246.19 ",$175.06 ,"$2,295.00 ","$1,246.19 ","$2,295.00 ","$1,606.50 ","$1,147.50 ","$1,836.00 ","$6,774.49 ","$2,709.80 ","$1,606.50 ","$2,709.80 ","$1,377.00 ","$2,709.80 ","$1,721.25 ","$1,266.84 ","$1,142.91 ","$1,266.84 ","$2,709.80 ","$1,266.84 ",$118.89 ,$118.89 ,"$1,950.75 ","$2,295.00 ","$1,590.44 ","$2,709.80 ","$2,295.00 ","$1,262.25 ","$2,709.80 ",$603.59 ,"$2,295.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$1,836.00 ","$1,246.19 ",$642.60 ,"$2,065.50 ",$872.10 ,$500.00 ,"$2,709.80 ","$1,101.60 "
ST. MARY'S HOSPITAL - DECATUR,32000417,75898,HC TRANSCATH ANGIO EXIST 75898,320,1 ,"$1,932.00 ","$1,255.80 ",$59.91 ,"$6,774.50 ","$6,774.50 ",$602.89 ,"$1,062.60 ","$2,709.80 ",$540.96 ,$655.86 ,"$2,709.80 ",$655.86 ,"$1,932.00 ","$1,049.08 ",$94.28 ,"$1,932.00 ","$1,049.08 ","$1,932.00 ","$1,352.40 ",$966.00 ,"$1,545.60 ","$6,774.49 ","$2,709.80 ","$1,352.40 ","$2,709.80 ","$1,159.20 ","$2,709.80 ","$1,449.00 ","$1,066.46 ",$962.14 ,"$1,066.46 ","$2,709.80 ","$1,066.46 ",$59.91 ,$59.91 ,"$1,642.20 ","$1,932.00 ","$1,338.88 ","$2,709.80 ","$1,932.00 ","$1,062.60 ","$2,709.80 ",$508.12 ,"$1,932.00 ",$242.84 ,$231.80 ,"$2,845.29 ","$1,545.60 ","$1,049.08 ",$540.96 ,"$1,738.80 ",$734.16 ,$500.00 ,"$2,709.80 ",$927.36 
ST. MARY'S HOSPITAL - DECATUR,32000423,37191,HC IVC FILTER PLACEMENT 37191,320,1 ,"$13,303.00 ","$8,646.95 ",$500.00 ,"$13,303.00 ","$11,285.10 ","$6,784.53 ","$7,316.65 ","$4,514.04 ","$3,724.84 ","$6,252.41 ","$4,514.04 ","$7,183.62 ","$4,514.04 ","$7,223.53 ",$568.66 ,"$4,514.04 ","$7,223.53 ","$8,576.68 ","$9,312.10 ","$6,651.50 ","$10,642.40 ","$11,285.10 ","$4,514.04 ","$9,312.10 ","$4,514.04 ","$7,981.80 ","$4,514.04 ","$9,977.25 ","$7,343.26 ","$6,624.89 ","$7,343.26 ","$4,514.04 ","$7,343.26 ","$9,312.10 ","$9,312.10 ","$11,307.55 ","$11,285.10 ","$9,218.98 ","$4,514.04 ","$13,303.00 ","$7,316.65 ","$4,514.04 ","$3,498.69 ","$13,303.00 ","$2,784.85 ","$2,658.26 ","$4,739.74 ","$10,642.40 ","$7,223.53 ","$3,724.84 ","$11,972.70 ","$5,055.14 ",$500.00 ,"$4,514.04 ","$6,385.44 "
ST. MARY'S HOSPITAL - DECATUR,32000438,47533,HC TRANSHEPATIC DRAINAGE,320,1 ,"$6,746.00 ","$4,384.90 ",$475.24 ,"$7,529.23 ","$7,529.23 ","$3,440.46 ","$3,710.30 ","$3,011.69 ","$1,888.88 ","$3,170.62 ","$3,011.69 ","$3,642.84 ","$3,011.69 ","$3,663.08 ",$475.24 ,"$3,011.69 ","$3,663.08 ","$5,722.22 ","$4,722.20 ","$3,373.00 ","$5,396.80 ","$7,529.23 ","$3,011.69 ","$4,722.20 ","$3,011.69 ","$4,047.60 ","$3,011.69 ","$5,059.50 ","$3,723.79 ","$3,359.51 ","$3,723.79 ","$3,011.69 ","$3,723.79 ","$4,722.20 ","$4,722.20 ","$5,734.10 ","$6,746.00 ","$4,674.98 ","$3,011.69 ","$6,746.00 ","$3,710.30 ","$3,011.69 ","$1,774.20 ","$6,746.00 ","$1,177.58 ","$1,124.06 ","$3,162.27 ","$5,396.80 ","$3,663.08 ","$1,888.88 ","$6,071.40 ","$2,563.48 ",$500.00 ,"$3,011.69 ","$3,238.08 "
ST. MARY'S HOSPITAL - DECATUR,32000440,75984,HC CHANGE PERC DRAINAGE TUBE OR CATH,320,1 ,"$1,142.00 ",$742.30 ,$94.55 ,"$1,142.00 ", N/A ,$144.59 ,$628.10 , N/A ,$319.76 ,$559.58 , N/A ,$668.07 , N/A ,$620.11 ,$139.22 , N/A ,$620.11 , N/A ,$799.40 ,$571.00 ,$913.60 , N/A , N/A ,$799.40 , N/A ,$685.20 , N/A ,$856.50 ,$630.38 ,$568.72 ,$630.38 , N/A ,$630.38 ,$94.55 ,$94.55 ,$970.70 , N/A ,$791.41 , N/A ,"$1,142.00 ",$628.10 , N/A ,$300.35 ,"$1,142.00 ",$221.84 ,$211.75 , N/A ,$913.60 ,$620.11 ,$319.76 ,"$1,027.80 ",$433.96 ,$500.00 , N/A ,$548.16 
ST. MARY'S HOSPITAL - DECATUR,32000444,49406,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER,320,1 ,"$5,699.00 ","$3,704.35 ",$351.25 ,"$5,699.00 ","$3,329.73 ","$2,906.49 ","$3,134.45 ","$1,331.89 ","$1,595.72 ","$2,678.53 ","$1,331.89 ","$3,077.46 ","$1,331.89 ","$3,094.56 ",$351.25 ,"$1,331.89 ","$3,094.56 ","$2,530.59 ","$3,989.30 ","$2,849.50 ","$4,559.20 ","$3,329.72 ","$1,331.89 ","$3,989.30 ","$1,331.89 ","$3,419.40 ","$1,331.89 ","$4,274.25 ","$3,145.85 ","$2,838.10 ","$3,145.85 ","$1,331.89 ","$3,145.85 ","$3,989.30 ","$3,989.30 ","$4,844.15 ","$3,329.72 ","$3,949.41 ","$1,331.89 ","$5,699.00 ","$3,134.45 ","$1,331.89 ","$1,498.84 ","$5,699.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$4,559.20 ","$3,094.56 ","$1,595.72 ","$5,129.10 ","$2,165.62 ",$500.00 ,"$1,331.89 ","$2,735.52 "
ST. MARY'S HOSPITAL - DECATUR,32000445,75989,HC GUID FOR PERC DRAIN ABSCESS,320,1 ,"$2,268.00 ","$1,474.20 ",$88.10 ,"$2,268.00 ", N/A ,$143.66 ,"$1,247.40 ", N/A ,$635.04 ,$894.24 , N/A ,$894.24 , N/A ,"$1,231.52 ",$129.71 , N/A ,"$1,231.52 ", N/A ,"$1,587.60 ","$1,134.00 ","$1,814.40 ", N/A , N/A ,"$1,587.60 ", N/A ,"$1,360.80 ", N/A ,"$1,701.00 ","$1,251.94 ","$1,129.46 ","$1,251.94 ", N/A ,"$1,251.94 ",$88.10 ,$88.10 ,"$1,927.80 ", N/A ,"$1,571.72 ", N/A ,"$2,268.00 ","$1,247.40 ", N/A ,$596.48 ,"$2,268.00 ",$221.84 ,$211.75 , N/A ,"$1,814.40 ","$1,231.52 ",$635.04 ,"$2,041.20 ",$861.84 ,$500.00 , N/A ,"$1,088.64 "
ST. MARY'S HOSPITAL - DECATUR,32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$850.00 ,$552.50 ,$37.16 ,$850.00 ,$544.53 ,$81.43 ,$467.50 ,$217.81 ,$238.00 ,$416.50 ,$217.81 ,$497.25 ,$217.81 ,$461.55 ,$65.34 ,$217.81 ,$461.55 ,$413.84 ,$595.00 ,$425.00 ,$680.00 ,$544.53 ,$217.81 ,$595.00 ,$217.81 ,$510.00 ,$217.81 ,$637.50 ,$469.20 ,$423.30 ,$469.20 ,$217.81 ,$469.20 ,$44.37 ,$44.37 ,$722.50 ,$544.53 ,$589.05 ,$217.81 ,$850.00 ,$467.50 ,$217.81 ,$223.55 ,$850.00 ,$38.93 ,$37.16 ,$228.70 ,$680.00 ,$461.55 ,$238.00 ,$765.00 ,$323.00 ,$500.00 ,$217.81 ,$408.00 
ST. MARY'S HOSPITAL - DECATUR,32000464,76010,HC BABYGRAM,320,1 ,$458.00 ,$297.70 ,$25.50 ,$458.00 ,$191.43 ,$34.36 ,$251.90 ,$76.57 ,$128.24 ,$224.42 ,$76.57 ,$244.28 ,$76.57 ,$248.69 ,$37.54 ,$76.57 ,$248.69 ,$145.48 ,$320.60 ,$229.00 ,$366.40 ,$191.42 ,$76.57 ,$320.60 ,$76.57 ,$274.80 ,$76.57 ,$343.50 ,$252.82 ,$228.08 ,$252.82 ,$76.57 ,$252.82 ,$25.50 ,$25.50 ,$389.30 ,$191.42 ,$317.39 ,$76.57 ,$458.00 ,$251.90 ,$76.57 ,$120.45 ,$458.00 ,$38.93 ,$37.16 ,$80.40 ,$366.40 ,$248.69 ,$128.24 ,$412.20 ,$174.04 ,$458.00 ,$76.57 ,$219.84 
ST. MARY'S HOSPITAL - DECATUR,32000465,76080,HC ABSCESS FISTULA OR SINUS TRACT,320,1 ,$768.00 ,$499.20 ,$43.38 ,"$1,143.48 ","$1,143.48 ",$65.32 ,$422.40 ,$457.39 ,$215.04 ,$376.32 ,$457.39 ,$409.32 ,$457.39 ,$417.02 ,$63.87 ,$457.39 ,$417.02 ,$768.00 ,$537.60 ,$384.00 ,$614.40 ,"$1,143.47 ",$457.39 ,$537.60 ,$457.39 ,$460.80 ,$457.39 ,$576.00 ,$423.94 ,$382.46 ,$423.94 ,$457.39 ,$423.94 ,$43.38 ,$43.38 ,$652.80 ,$768.00 ,$532.22 ,$457.39 ,$768.00 ,$422.40 ,$457.39 ,$201.98 ,$768.00 ,$221.84 ,$211.75 ,$480.26 ,$614.40 ,$417.02 ,$215.04 ,$691.20 ,$291.84 ,$500.00 ,$457.39 ,$368.64 
ST. MARY'S HOSPITAL - DECATUR,32000466,76080,HC ABSCESS FISTULA DRAINAGE CATH CHECK,320,1 ,"$1,449.00 ",$941.85 ,$43.38 ,"$1,449.00 ","$1,143.48 ",$65.32 ,$796.95 ,$457.39 ,$405.72 ,$409.32 ,$457.39 ,$409.32 ,$457.39 ,$786.81 ,$63.87 ,$457.39 ,$786.81 ,$869.04 ,"$1,014.30 ",$724.50 ,"$1,159.20 ","$1,143.47 ",$457.39 ,"$1,014.30 ",$457.39 ,$869.40 ,$457.39 ,"$1,086.75 ",$799.85 ,$721.60 ,$799.85 ,$457.39 ,$799.85 ,$43.38 ,$43.38 ,"$1,231.65 ","$1,143.47 ","$1,004.16 ",$457.39 ,"$1,449.00 ",$796.95 ,$457.39 ,$381.09 ,"$1,449.00 ",$221.84 ,$211.75 ,$480.26 ,"$1,159.20 ",$786.81 ,$405.72 ,"$1,304.10 ",$550.62 ,$500.00 ,$457.39 ,$695.52 
ST. MARY'S HOSPITAL - DECATUR,32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$603.00 ,$391.95 ,$12.08 ,"$1,143.48 ","$1,143.48 ",$20.72 ,$331.65 ,$457.39 ,$168.84 ,$129.26 ,$457.39 ,$129.26 ,$457.39 ,$327.43 ,$17.79 ,$457.39 ,$327.43 ,$603.00 ,$422.10 ,$301.50 ,$482.40 ,"$1,143.47 ",$457.39 ,$422.10 ,$457.39 ,$361.80 ,$457.39 ,$452.25 ,$332.86 ,$300.29 ,$332.86 ,$457.39 ,$332.86 ,$12.08 ,$12.08 ,$512.55 ,$603.00 ,$417.88 ,$457.39 ,$28.70 ,$331.65 ,$457.39 ,$158.59 ,$603.00 ,$38.93 ,$37.16 ,$480.26 ,$482.40 ,$327.43 ,$168.84 ,$542.70 ,$229.14 ,$500.00 ,$457.39 ,$289.44 
ST. MARY'S HOSPITAL - DECATUR,32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,"$1,028.00 ",$668.20 ,$100.52 ,"$1,028.00 ", N/A ,$187.31 ,$565.40 , N/A ,$287.84 ,$503.72 , N/A ,$601.38 , N/A ,$558.20 ,$148.00 , N/A ,$558.20 , N/A ,$719.60 ,$514.00 ,$822.40 , N/A , N/A ,$719.60 , N/A ,$616.80 , N/A ,$771.00 ,$567.46 ,$511.94 ,$567.46 , N/A ,$567.46 ,$100.52 ,$100.52 ,$873.80 , N/A ,$712.40 , N/A ,"$1,028.00 ",$565.40 , N/A ,$270.36 ,"$1,028.00 ",$221.84 ,$211.75 , N/A ,$822.40 ,$558.20 ,$287.84 ,$925.20 ,$390.64 ,$500.00 , N/A ,$493.44 
ST. MARY'S HOSPITAL - DECATUR,32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$555.00 ,$360.75 ,$96.28 ,$555.00 , N/A ,$96.28 ,$305.25 , N/A ,$155.40 ,$271.95 , N/A ,$324.68 , N/A ,$301.37 ,$151.66 , N/A ,$301.37 , N/A ,$388.50 ,$277.50 ,$444.00 , N/A , N/A ,$388.50 , N/A ,$333.00 , N/A ,$416.25 ,$306.36 ,$276.39 ,$306.36 , N/A ,$306.36 ,$102.99 ,$102.99 ,$471.75 , N/A ,$384.62 , N/A ,$555.00 ,$305.25 , N/A ,$145.97 ,$555.00 ,$221.84 ,$211.75 , N/A ,$444.00 ,$301.37 ,$155.40 ,$499.50 ,$210.90 ,$500.00 , N/A ,$266.40 
ST. MARY'S HOSPITAL - DECATUR,32000481,77003,HC FLUORO NEEDLE LOCALIZATION,320,1 ,"$1,422.00 ",$924.30 ,$95.04 ,"$1,422.00 ", N/A ,$119.81 ,$782.10 , N/A ,$398.16 ,$696.78 , N/A ,$831.87 , N/A ,$772.15 ,$139.95 , N/A ,$772.15 , N/A ,$995.40 ,$711.00 ,"$1,137.60 ", N/A , N/A ,$995.40 , N/A ,$853.20 , N/A ,"$1,066.50 ",$784.94 ,$708.16 ,$784.94 , N/A ,$784.94 ,$95.04 ,$95.04 ,"$1,208.70 ", N/A ,$985.45 , N/A ,"$1,422.00 ",$782.10 , N/A ,$373.99 ,"$1,422.00 ",$221.84 ,$211.75 , N/A ,"$1,137.60 ",$772.15 ,$398.16 ,"$1,279.80 ",$540.36 ,$500.00 , N/A ,$682.56 
ST. MARY'S HOSPITAL - DECATUR,32000483,19283,HC MAMM STER GUIDE BRST NDL PL,320,1 ,"$3,074.00 ","$1,998.10 ",$79.74 ,"$3,074.00 ","$1,472.65 ","$1,567.74 ","$1,690.70 ",$589.06 ,$860.72 ,"$1,444.78 ",$589.06 ,"$1,659.96 ",$589.06 ,"$1,669.18 ",$176.38 ,$589.06 ,"$1,669.18 ","$1,119.21 ","$2,151.80 ","$1,537.00 ","$2,459.20 ","$1,472.64 ",$589.06 ,"$2,151.80 ",$589.06 ,"$1,844.40 ",$589.06 ,"$2,305.50 ","$1,696.85 ","$1,530.85 ","$1,696.85 ",$589.06 ,"$1,696.85 ","$2,151.80 ","$2,151.80 ","$2,612.90 ","$1,472.64 ","$2,130.28 ",$589.06 ,$294.90 ,"$1,690.70 ",$589.06 ,$808.46 ,"$3,074.00 ",$83.53 ,$79.74 ,$618.51 ,"$2,459.20 ","$1,669.18 ",$860.72 ,"$2,766.60 ","$1,168.12 ",$500.00 ,$589.06 ,"$1,475.52 "
ST. MARY'S HOSPITAL - DECATUR,32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$4,538.00 ","$2,949.70 ",$292.07 ,"$4,538.00 ","$3,329.73 ","$2,314.38 ","$2,495.90 ","$1,331.89 ","$1,270.64 ","$2,132.86 ","$1,331.89 ","$2,450.52 ","$1,331.89 ","$2,464.13 ",$292.07 ,"$1,331.89 ","$2,464.13 ","$2,530.59 ","$3,176.60 ","$2,269.00 ","$3,630.40 ","$3,329.72 ","$1,331.89 ","$3,176.60 ","$1,331.89 ","$2,722.80 ","$1,331.89 ","$3,403.50 ","$2,504.98 ","$2,259.92 ","$2,504.98 ","$1,331.89 ","$2,504.98 ","$3,176.60 ","$3,176.60 ","$3,857.30 ","$3,329.72 ","$3,144.83 ","$1,331.89 ",$619.99 ,"$2,495.90 ","$1,331.89 ","$1,193.49 ","$4,538.00 ",$862.27 ,$823.07 ,"$1,398.48 ","$3,630.40 ","$2,464.13 ","$1,270.64 ","$4,084.20 ","$1,724.44 ",$500.00 ,"$1,331.89 ","$2,178.24 "
ST. MARY'S HOSPITAL - DECATUR,32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,"$1,812.00 ","$1,177.80 ",$79.74 ,"$1,812.00 ","$1,472.65 ",$924.12 ,$996.60 ,$589.06 ,$507.36 ,$851.64 ,$589.06 ,$978.48 ,$589.06 ,$983.92 ,$174.74 ,$589.06 ,$983.92 ,"$1,119.21 ","$1,268.40 ",$906.00 ,"$1,449.60 ","$1,472.64 ",$589.06 ,"$1,268.40 ",$589.06 ,"$1,087.20 ",$589.06 ,"$1,359.00 ","$1,000.22 ",$902.38 ,"$1,000.22 ",$589.06 ,"$1,000.22 ","$1,268.40 ","$1,268.40 ","$1,540.20 ","$1,472.64 ","$1,255.72 ",$589.06 ,$266.06 ,$996.60 ,$589.06 ,$476.56 ,"$1,812.00 ",$83.53 ,$79.74 ,$618.51 ,"$1,449.60 ",$983.92 ,$507.36 ,"$1,630.80 ",$688.56 ,$500.00 ,$589.06 ,$869.76 
ST. MARY'S HOSPITAL - DECATUR,32000490,77053,HC GALACTOGRAM SINGLE DUCT,320,1 ,"$1,090.00 ",$708.50 ,$40.72 ,"$1,090.00 ",$544.53 ,$78.32 ,$599.50 ,$217.81 ,$305.20 ,$534.10 ,$217.81 ,$574.27 ,$217.81 ,$591.87 ,$81.43 ,$217.81 ,$591.87 ,$413.84 ,$763.00 ,$545.00 ,$872.00 ,$544.53 ,$217.81 ,$763.00 ,$217.81 ,$654.00 ,$217.81 ,$817.50 ,$601.68 ,$542.82 ,$601.68 ,$217.81 ,$601.68 ,$55.31 ,$55.31 ,$926.50 ,$544.53 ,$755.37 ,$217.81 ,$40.72 ,$599.50 ,$217.81 ,$286.67 ,"$1,090.00 ",$221.84 ,$211.75 ,$228.70 ,$872.00 ,$591.87 ,$305.20 ,$981.00 ,$414.20 ,$500.00 ,$217.81 ,$523.20 
ST. MARY'S HOSPITAL - DECATUR,32000491,77054,HC GALACTOGRAM MULTI DUCT,320,1 ,"$1,103.00 ",$716.95 ,$73.19 ,"$1,103.00 ",$544.53 ,$107.44 ,$606.65 ,$217.81 ,$308.84 ,$540.47 ,$217.81 ,$645.26 ,$217.81 ,$598.93 ,$107.76 ,$217.81 ,$598.93 ,$413.84 ,$772.10 ,$551.50 ,$882.40 ,$544.53 ,$217.81 ,$772.10 ,$217.81 ,$661.80 ,$217.81 ,$827.25 ,$608.86 ,$549.29 ,$608.86 ,$217.81 ,$608.86 ,$73.19 ,$73.19 ,$937.55 ,$544.53 ,$764.38 ,$217.81 ,"$1,103.00 ",$606.65 ,$217.81 ,$290.09 ,"$1,103.00 ",$221.84 ,$211.75 ,$228.70 ,$882.40 ,$598.93 ,$308.84 ,$992.70 ,$419.14 ,$500.00 ,$217.81 ,$529.44 
ST. MARY'S HOSPITAL - DECATUR,32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$421.00 ,$273.65 ,$32.45 ,$421.00 ,$257.65 ,$45.50 ,$231.55 ,$103.06 ,$117.88 ,$206.29 ,$103.06 ,$246.29 ,$103.06 ,$228.60 ,$47.78 ,$103.06 ,$228.60 ,$195.81 ,$294.70 ,$210.50 ,$336.80 ,$257.64 ,$103.06 ,$294.70 ,$103.06 ,$252.60 ,$103.06 ,$315.75 ,$232.39 ,$209.66 ,$232.39 ,$103.06 ,$232.39 ,$32.45 ,$32.45 ,$357.85 ,$257.64 ,$291.75 ,$103.06 ,$421.00 ,$231.55 ,$103.06 ,$110.72 ,$421.00 ,$38.93 ,$37.16 ,$108.21 ,$336.80 ,$228.60 ,$117.88 ,$378.90 ,$159.98 ,$421.00 ,$103.06 ,$202.08 
ST. MARY'S HOSPITAL - DECATUR,32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,"$1,162.00 ",$755.30 ,$37.16 ,"$1,162.00 ",$257.65 ,$129.11 ,$639.10 ,$103.06 ,$325.36 ,$569.38 ,$103.06 ,$679.77 ,$103.06 ,$630.97 ,$134.10 ,$103.06 ,$630.97 ,$195.81 ,$813.40 ,$581.00 ,$929.60 ,$257.64 ,$103.06 ,$813.40 ,$103.06 ,$697.20 ,$103.06 ,$871.50 ,$641.42 ,$578.68 ,$641.42 ,$103.06 ,$641.42 ,$91.07 ,$91.07 ,$987.70 ,$257.64 ,$805.27 ,$103.06 ,"$1,162.00 ",$639.10 ,$103.06 ,$305.61 ,"$1,162.00 ",$38.93 ,$37.16 ,$108.21 ,$929.60 ,$630.97 ,$325.36 ,"$1,045.80 ",$441.56 ,$500.00 ,$103.06 ,$557.76 
ST. MARY'S HOSPITAL - DECATUR,32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,$847.00 ,$550.55 ,$37.16 ,$847.00 ,$257.65 ,$129.11 ,$465.85 ,$103.06 ,$237.16 ,$415.03 ,$103.06 ,$495.50 ,$103.06 ,$459.92 ,$135.56 ,$103.06 ,$459.92 ,$195.81 ,$592.90 ,$423.50 ,$677.60 ,$257.64 ,$103.06 ,$592.90 ,$103.06 ,$508.20 ,$103.06 ,$635.25 ,$467.54 ,$421.81 ,$467.54 ,$103.06 ,$467.54 ,$92.07 ,$92.07 ,$719.95 ,$257.64 ,$586.97 ,$103.06 ,$847.00 ,$465.85 ,$103.06 ,$222.76 ,$847.00 ,$38.93 ,$37.16 ,$108.21 ,$677.60 ,$459.92 ,$237.16 ,$762.30 ,$321.86 ,$500.00 ,$103.06 ,$406.56 
ST. MARY'S HOSPITAL - DECATUR,32000496,77080,HC BONE DENSITY DXA,320,1 ,$758.00 ,$492.70 ,$42.39 ,$758.00 ,$257.65 ,$73.98 ,$416.90 ,$103.06 ,$212.24 ,$371.42 ,$103.06 ,$443.43 ,$103.06 ,$411.59 ,$62.41 ,$103.06 ,$411.59 ,$195.81 ,$530.60 ,$379.00 ,$606.40 ,$257.64 ,$103.06 ,$530.60 ,$103.06 ,$454.80 ,$103.06 ,$568.50 ,$418.42 ,$377.48 ,$418.42 ,$103.06 ,$418.42 ,$42.39 ,$42.39 ,$644.30 ,$257.64 ,$525.29 ,$103.06 ,$758.00 ,$416.90 ,$103.06 ,$199.35 ,$758.00 ,$61.49 ,$58.70 ,$108.21 ,$606.40 ,$411.59 ,$212.24 ,$682.20 ,$288.04 ,$500.00 ,$103.06 ,$363.84 
ST. MARY'S HOSPITAL - DECATUR,32000499,0238T,HC TRNLUM PERIP ATHRC ILIAC ARTY 0238T,320,1 ,"$23,748.00 ","$15,436.20 ",$500.00 ,"$38,006.63 ","$38,006.63 ","$4,654.96 ","$13,061.40 ","$15,202.65 ","$6,649.44 ","$11,161.56 ","$15,202.65 ","$12,823.92 ","$15,202.65 ","$12,895.16 ","$9,499.20 ","$15,202.65 ","$12,895.16 ","$23,748.00 ","$16,623.60 ","$11,874.00 ","$18,998.40 ","$38,006.61 ","$15,202.65 ","$16,623.60 ","$15,202.65 ","$14,248.80 ","$15,202.65 ","$17,811.00 ","$13,108.90 ","$11,826.50 ","$13,108.90 ","$15,202.65 ","$13,108.90 ","$16,623.60 ","$16,623.60 ","$20,185.80 ","$23,748.00 ","$16,457.36 ","$15,202.65 ","$23,748.00 ","$13,061.40 ","$15,202.65 ","$6,245.72 ","$23,748.00 ","$3,461.35 ","$3,304.01 ","$15,962.78 ","$18,998.40 ","$12,895.16 ","$6,649.44 ","$21,373.20 ","$9,024.24 ",$500.00 ,"$15,202.65 ","$11,399.04 "
ST. MARY'S HOSPITAL - DECATUR,32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$850.00 ,$552.50 ,$37.16 ,$850.00 ,$544.53 ,$81.43 ,$467.50 ,$217.81 ,$238.00 ,$416.50 ,$217.81 ,$497.25 ,$217.81 ,$461.55 ,$65.34 ,$217.81 ,$461.55 ,$413.84 ,$595.00 ,$425.00 ,$680.00 ,$544.53 ,$217.81 ,$595.00 ,$217.81 ,$510.00 ,$217.81 ,$637.50 ,$469.20 ,$423.30 ,$469.20 ,$217.81 ,$469.20 ,$44.37 ,$44.37 ,$722.50 ,$544.53 ,$589.05 ,$217.81 ,$850.00 ,$467.50 ,$217.81 ,$223.55 ,$850.00 ,$38.93 ,$37.16 ,$228.70 ,$680.00 ,$461.55 ,$238.00 ,$765.00 ,$323.00 ,$500.00 ,$217.81 ,$408.00 
ST. MARY'S HOSPITAL - DECATUR,32000503,20501,HC INJ TRACT SINOGRAM DIAG,320,1 ,"$1,318.00 ",$856.70 ,$86.84 ,"$1,318.00 ", N/A ,$672.18 ,$724.90 , N/A ,$369.04 ,$619.46 , N/A ,$711.72 , N/A ,$715.67 ,$86.84 , N/A ,$715.67 , N/A ,$922.60 ,$659.00 ,"$1,054.40 ", N/A , N/A ,$922.60 , N/A ,$790.80 , N/A ,$988.50 ,$727.54 ,$656.36 ,$727.54 , N/A ,$727.54 ,$922.60 ,$922.60 ,"$1,120.30 ", N/A ,$913.37 , N/A ,"$1,318.00 ",$724.90 , N/A ,$346.63 ,"$1,318.00 ",$242.84 ,$231.80 , N/A ,"$1,054.40 ",$715.67 ,$369.04 ,"$1,186.20 ",$500.84 ,$500.00 , N/A ,$632.64 
ST. MARY'S HOSPITAL - DECATUR,32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,$898.00 ,$583.70 ,$98.63 ,$898.00 ,$618.28 ,$457.98 ,$493.90 ,$247.31 ,$251.44 ,$422.06 ,$247.31 ,$484.92 ,$247.31 ,$487.61 ,$98.63 ,$247.31 ,$487.61 ,$469.90 ,$628.60 ,$449.00 ,$718.40 ,$618.29 ,$247.31 ,$628.60 ,$247.31 ,$538.80 ,$247.31 ,$673.50 ,$495.70 ,$447.20 ,$495.70 ,$247.31 ,$495.70 ,$628.60 ,$628.60 ,$763.30 ,$618.29 ,$622.31 ,$247.31 ,$898.00 ,$493.90 ,$247.31 ,$236.17 ,$898.00 ,$226.42 ,$216.13 ,$259.68 ,$718.40 ,$487.61 ,$251.44 ,$808.20 ,$341.24 ,$500.00 ,$247.31 ,$431.04 
ST. MARY'S HOSPITAL - DECATUR,32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,$911.00 ,$592.15 ,$86.19 ,$911.00 ,$618.28 ,$464.61 ,$501.05 ,$247.31 ,$255.08 ,$428.17 ,$247.31 ,$491.94 ,$247.31 ,$494.67 ,$86.19 ,$247.31 ,$494.67 ,$469.90 ,$637.70 ,$455.50 ,$728.80 ,$618.29 ,$247.31 ,$637.70 ,$247.31 ,$546.60 ,$247.31 ,$683.25 ,$502.87 ,$453.68 ,$502.87 ,$247.31 ,$502.87 ,$637.70 ,$637.70 ,$774.35 ,$618.29 ,$631.32 ,$247.31 ,$911.00 ,$501.05 ,$247.31 ,$239.59 ,$911.00 ,$226.42 ,$216.13 ,$259.68 ,$728.80 ,$494.67 ,$255.08 ,$819.90 ,$346.18 ,$500.00 ,$247.31 ,$437.28 
ST. MARY'S HOSPITAL - DECATUR,32000506,20553,HC INJ TRIGGER PT 3+ MUSC GROUP,320,1 ,"$1,133.00 ",$736.45 ,$98.06 ,"$1,133.00 ",$618.28 ,$577.83 ,$623.15 ,$247.31 ,$317.24 ,$532.51 ,$247.31 ,$611.82 ,$247.31 ,$615.22 ,$98.06 ,$247.31 ,$615.22 ,$469.90 ,$793.10 ,$566.50 ,$906.40 ,$618.29 ,$247.31 ,$793.10 ,$247.31 ,$679.80 ,$247.31 ,$849.75 ,$625.42 ,$564.23 ,$625.42 ,$247.31 ,$625.42 ,$793.10 ,$793.10 ,$963.05 ,$618.29 ,$785.17 ,$247.31 ,"$1,133.00 ",$623.15 ,$247.31 ,$297.98 ,"$1,133.00 ",$226.42 ,$216.13 ,$259.68 ,$906.40 ,$615.22 ,$317.24 ,"$1,019.70 ",$430.54 ,$500.00 ,$247.31 ,$543.84 
ST. MARY'S HOSPITAL - DECATUR,32000509,77072,HC BONE AGE STUDIES,320,1 ,$931.00 ,$605.15 ,$20.52 ,$931.00 ,$257.65 ,$26.93 ,$512.05 ,$103.06 ,$260.68 ,$194.34 ,$103.06 ,$194.34 ,$103.06 ,$505.53 ,$30.22 ,$103.06 ,$505.53 ,$195.81 ,$651.70 ,$465.50 ,$744.80 ,$257.64 ,$103.06 ,$651.70 ,$103.06 ,$558.60 ,$103.06 ,$698.25 ,$513.91 ,$463.64 ,$513.91 ,$103.06 ,$513.91 ,$20.52 ,$20.52 ,$791.35 ,$257.64 ,$645.18 ,$103.06 ,$931.00 ,$512.05 ,$103.06 ,$244.85 ,$931.00 ,$38.93 ,$37.16 ,$108.21 ,$744.80 ,$505.53 ,$260.68 ,$837.90 ,$353.78 ,$500.00 ,$103.06 ,$446.88 
ST. MARY'S HOSPITAL - DECATUR,32000515,G0278,HC ILIAC ARTERY ANGIO W CATH G0278,320,1 ,"$4,227.00 ","$2,747.55 ",$32.25 ,"$4,227.00 ", N/A ,"$2,155.77 ","$2,324.85 ", N/A ,"$1,183.56 ",$222.65 , N/A ,$222.65 , N/A ,"$2,295.26 ",$32.25 , N/A ,"$2,295.26 ", N/A ,"$2,958.90 ","$2,113.50 ","$3,381.60 ", N/A , N/A ,"$2,958.90 ", N/A ,"$2,536.20 ", N/A ,"$3,170.25 ","$2,333.30 ","$2,105.05 ","$2,333.30 ", N/A ,"$2,333.30 ","$2,958.90 ","$2,958.90 ","$3,592.95 ", N/A ,"$2,929.31 ", N/A ,"$4,227.00 ","$2,324.85 ", N/A ,"$1,111.70 ","$4,227.00 ", N/A , N/A , N/A ,"$3,381.60 ","$2,295.26 ","$1,183.56 ","$3,804.30 ","$1,606.26 ",$500.00 , N/A ,"$2,028.96 "
ST. MARY'S HOSPITAL - DECATUR,32000530,32554,HC THORACENTESIS W/O IMAGING 32554,320,1 ,"$3,094.00 ","$2,011.10 ",$166.75 ,"$3,094.00 ","$1,279.15 ","$1,577.94 ","$1,701.70 ",$511.66 ,$866.32 ,"$1,454.18 ",$511.66 ,"$1,670.76 ",$511.66 ,"$1,680.04 ",$166.75 ,$511.66 ,"$1,680.04 ",$972.16 ,"$2,165.80 ","$1,547.00 ","$2,475.20 ","$1,279.16 ",$511.66 ,"$2,165.80 ",$511.66 ,"$1,856.40 ",$511.66 ,"$2,320.50 ","$1,707.89 ","$1,540.81 ","$1,707.89 ",$511.66 ,"$1,707.89 ","$2,165.80 ","$2,165.80 ","$2,629.90 ","$1,279.16 ","$2,144.14 ",$511.66 ,"$3,094.00 ","$1,701.70 ",$511.66 ,$813.72 ,"$3,094.00 ",$483.89 ,$461.90 ,$537.24 ,"$2,475.20 ","$1,680.04 ",$866.32 ,"$2,784.60 ","$1,175.72 ",$500.00 ,$511.66 ,"$1,485.12 "
ST. MARY'S HOSPITAL - DECATUR,32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,"$3,042.00 ","$1,977.30 ",$207.23 ,"$3,042.00 ","$1,279.15 ","$1,551.42 ","$1,673.10 ",$511.66 ,$851.76 ,"$1,429.74 ",$511.66 ,"$1,642.68 ",$511.66 ,"$1,651.81 ",$207.23 ,$511.66 ,"$1,651.81 ",$972.16 ,"$2,129.40 ","$1,521.00 ","$2,433.60 ","$1,279.16 ",$511.66 ,"$2,129.40 ",$511.66 ,"$1,825.20 ",$511.66 ,"$2,281.50 ","$1,679.18 ","$1,514.92 ","$1,679.18 ",$511.66 ,"$1,679.18 ","$2,129.40 ","$2,129.40 ","$2,585.70 ","$1,279.16 ","$2,108.11 ",$511.66 ,"$3,042.00 ","$1,673.10 ",$511.66 ,$800.05 ,"$3,042.00 ",$483.89 ,$461.90 ,$537.24 ,"$2,433.60 ","$1,651.81 ",$851.76 ,"$2,737.80 ","$1,155.96 ",$500.00 ,$511.66 ,"$1,460.16 "
ST. MARY'S HOSPITAL - DECATUR,32000532,32556,HC PLEURAL DRAINAGE W/O IMAGING 32556,450,1 ,"$2,546.00 ","$1,654.90 ",$325.00 ,"$3,843.71 ","$3,843.70 ","$1,298.46 ","$1,400.30 ","$1,537.48 ",$712.88 ,"$1,349.38 ","$1,537.48 ","$1,425.76 ","$1,537.48 ","$1,382.48 ","$1,382.48 ","$1,537.48 ","$1,382.48 ","$2,546.00 ","$1,782.20 ","$1,273.00 ","$2,036.80 ","$3,843.71 ","$1,537.48 ","$1,782.20 ","$1,537.48 ","$1,527.60 ","$1,537.48 ","$1,909.50 ","$1,405.39 ","$1,267.91 ","$1,405.39 ","$1,537.48 ","$1,405.39 ","$1,985.88 ","$1,985.88 ","$2,164.10 ","$2,546.00 ","$1,764.38 ","$1,537.48 ","$2,546.00 ","$1,400.30 ","$1,537.48 ",$669.60 ,"$2,546.00 ", N/A , N/A ,"$1,614.35 ","$2,036.80 ","$1,382.48 ",$712.88 ,"$2,291.40 ",$967.48 ,$325.00 ,"$1,537.48 ","$1,222.08 "
ST. MARY'S HOSPITAL - DECATUR,32000533,32557,HC PLEURAL DRAINAGE W/IMAGING 32557,320,1 ,"$5,889.00 ","$3,827.85 ",$282.86 ,"$5,889.00 ","$3,327.80 ","$3,003.39 ","$3,238.95 ","$1,331.12 ","$1,648.92 ","$2,767.83 ","$1,331.12 ","$3,180.06 ","$1,331.12 ","$3,197.73 ",$282.86 ,"$1,331.12 ","$3,197.73 ","$2,529.13 ","$4,122.30 ","$2,944.50 ","$4,711.20 ","$3,327.80 ","$1,331.12 ","$4,122.30 ","$1,331.12 ","$3,533.40 ","$1,331.12 ","$4,416.75 ","$3,250.73 ","$2,932.72 ","$3,250.73 ","$1,331.12 ","$3,250.73 ","$4,122.30 ","$4,122.30 ","$5,005.65 ","$3,327.80 ","$4,081.08 ","$1,331.12 ","$5,889.00 ","$3,238.95 ","$1,331.12 ","$1,548.81 ","$5,889.00 ",$483.89 ,$461.90 ,"$1,397.68 ","$4,711.20 ","$3,197.73 ","$1,648.92 ","$5,300.10 ","$2,237.82 ",$500.00 ,"$1,331.12 ","$2,826.72 "
ST. MARY'S HOSPITAL - DECATUR,32000542,20551,HC INJ TENDON ORIGIN,320,1 ,"$1,211.00 ",$787.15 ,$91.43 ,"$1,211.00 ",$618.28 ,$617.61 ,$666.05 ,$247.31 ,$339.08 ,$569.17 ,$247.31 ,$653.94 ,$247.31 ,$657.57 ,$91.43 ,$247.31 ,$657.57 ,$469.90 ,$847.70 ,$605.50 ,$968.80 ,$618.29 ,$247.31 ,$847.70 ,$247.31 ,$726.60 ,$247.31 ,$908.25 ,$668.47 ,$603.08 ,$668.47 ,$247.31 ,$668.47 ,$847.70 ,$847.70 ,"$1,029.35 ",$618.29 ,$839.22 ,$247.31 ,"$1,211.00 ",$666.05 ,$247.31 ,$318.49 ,"$1,211.00 ",$226.42 ,$216.13 ,$259.68 ,$968.80 ,$657.57 ,$339.08 ,"$1,089.90 ",$460.18 ,$500.00 ,$247.31 ,$581.28 
ST. MARY'S HOSPITAL - DECATUR,32000543,72074,HC XR T-SPINE 4 + VIEWS,320,1 ,$966.00 ,$627.90 ,$37.16 ,$966.00 ,$257.65 ,$64.08 ,$531.30 ,$103.06 ,$270.48 ,$396.54 ,$103.06 ,$396.54 ,$103.06 ,$524.54 ,$59.48 ,$103.06 ,$524.54 ,$195.81 ,$676.20 ,$483.00 ,$772.80 ,$257.64 ,$103.06 ,$676.20 ,$103.06 ,$579.60 ,$103.06 ,$724.50 ,$533.23 ,$481.07 ,$533.23 ,$103.06 ,$533.23 ,$40.40 ,$40.40 ,$821.10 ,$257.64 ,$669.44 ,$103.06 ,$966.00 ,$531.30 ,$103.06 ,$254.06 ,$966.00 ,$38.93 ,$37.16 ,$108.21 ,$772.80 ,$524.54 ,$270.48 ,$869.40 ,$367.08 ,$500.00 ,$103.06 ,$463.68 
ST. MARY'S HOSPITAL - DECATUR,32000556,77071,HC XR JOINT STRESS BY PHYS,320,1 ,$966.00 ,$627.90 ,$73.94 ,$966.00 ,$191.43 ,$99.95 ,$531.30 ,$76.57 ,$270.48 ,$473.34 ,$76.57 ,$565.11 ,$76.57 ,$524.54 ,$108.86 ,$76.57 ,$524.54 ,$145.48 ,$676.20 ,$483.00 ,$772.80 ,$191.42 ,$76.57 ,$676.20 ,$76.57 ,$579.60 ,$76.57 ,$724.50 ,$533.23 ,$481.07 ,$533.23 ,$76.57 ,$533.23 ,$73.94 ,$73.94 ,$821.10 ,$191.42 ,$669.44 ,$76.57 ,$966.00 ,$531.30 ,$76.57 ,$254.06 ,$966.00 , N/A , N/A ,$80.40 ,$772.80 ,$524.54 ,$270.48 ,$869.40 ,$367.08 ,$500.00 ,$76.57 ,$463.68 
ST. MARY'S HOSPITAL - DECATUR,32000563,49407,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER TV OR TR,320,1 ,"$6,673.00 ","$4,337.45 ",$372.71 ,"$6,673.00 ","$3,329.73 ","$3,403.23 ","$3,670.15 ","$1,331.89 ","$1,868.44 ","$3,136.31 ","$1,331.89 ","$3,603.42 ","$1,331.89 ","$3,623.44 ",$372.71 ,"$1,331.89 ","$3,623.44 ","$2,530.59 ","$4,671.10 ","$3,336.50 ","$5,338.40 ","$3,329.72 ","$1,331.89 ","$4,671.10 ","$1,331.89 ","$4,003.80 ","$1,331.89 ","$5,004.75 ","$3,683.50 ","$3,323.15 ","$3,683.50 ","$1,331.89 ","$3,683.50 ","$4,671.10 ","$4,671.10 ","$5,672.05 ","$3,329.72 ","$4,624.39 ","$1,331.89 ","$6,673.00 ","$3,670.15 ","$1,331.89 ","$1,755.00 ","$6,673.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$5,338.40 ","$3,623.44 ","$1,868.44 ","$6,005.70 ","$2,535.74 ",$500.00 ,"$1,331.89 ","$3,203.04 "
ST. MARY'S HOSPITAL - DECATUR,32000564,0075T,HC STENT VERTEBRAL EXTRACRANIAL 0075T,320,1 ,"$8,391.00 ","$5,454.15 ",$500.00 ,"$8,391.00 ", N/A ,$805.18 ,"$4,615.05 ", N/A ,"$2,349.48 ","$3,943.77 ", N/A ,"$4,531.14 ", N/A ,"$4,556.31 ","$3,356.40 ", N/A ,"$4,556.31 ", N/A ,"$5,873.70 ","$4,195.50 ","$6,712.80 ", N/A , N/A ,"$5,873.70 ", N/A ,"$5,034.60 ", N/A ,"$6,293.25 ","$4,631.83 ","$4,178.72 ","$4,631.83 ", N/A ,"$4,631.83 ","$5,873.70 ","$5,873.70 ","$7,132.35 ", N/A ,"$5,814.96 ", N/A ,"$8,391.00 ","$4,615.05 ", N/A ,"$2,206.83 ","$8,391.00 ", N/A , N/A , N/A ,"$6,712.80 ","$4,556.31 ","$2,349.48 ","$7,551.90 ","$3,188.58 ",$500.00 , N/A ,"$4,027.68 "
ST. MARY'S HOSPITAL - DECATUR,32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$632.00 ,$410.80 ,$35.43 ,$632.00 ,$191.43 ,$49.21 ,$347.60 ,$76.57 ,$176.96 ,$309.68 ,$76.57 ,$336.97 ,$76.57 ,$343.18 ,$52.17 ,$76.57 ,$343.18 ,$145.48 ,$442.40 ,$316.00 ,$505.60 ,$191.42 ,$76.57 ,$442.40 ,$76.57 ,$379.20 ,$76.57 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$76.57 ,$348.86 ,$35.43 ,$35.43 ,$537.20 ,$191.42 ,$437.98 ,$76.57 ,$632.00 ,$347.60 ,$76.57 ,$166.22 ,$632.00 ,$38.93 ,$37.16 ,$80.40 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$500.00 ,$76.57 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$717.00 ,$466.05 ,$37.16 ,$717.00 ,$191.43 ,$46.53 ,$394.35 ,$76.57 ,$200.76 ,$351.33 ,$76.57 ,$356.83 ,$76.57 ,$389.33 ,$55.09 ,$76.57 ,$389.33 ,$145.48 ,$501.90 ,$358.50 ,$573.60 ,$191.42 ,$76.57 ,$501.90 ,$76.57 ,$430.20 ,$76.57 ,$537.75 ,$395.78 ,$357.07 ,$395.78 ,$76.57 ,$395.78 ,$37.41 ,$37.41 ,$609.45 ,$191.42 ,$496.88 ,$76.57 ,$717.00 ,$394.35 ,$76.57 ,$188.57 ,$717.00 ,$38.93 ,$37.16 ,$80.40 ,$573.60 ,$389.33 ,$200.76 ,$645.30 ,$272.46 ,$500.00 ,$76.57 ,$344.16 
ST. MARY'S HOSPITAL - DECATUR,32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,"$1,101.00 ",$715.65 ,$37.16 ,"$1,101.00 ",$257.65 ,$84.33 ,$605.55 ,$103.06 ,$308.28 ,$539.49 ,$103.06 ,$644.09 ,$103.06 ,$597.84 ,$100.45 ,$103.06 ,$597.84 ,$195.81 ,$770.70 ,$550.50 ,$880.80 ,$257.64 ,$103.06 ,$770.70 ,$103.06 ,$660.60 ,$103.06 ,$825.75 ,$607.75 ,$548.30 ,$607.75 ,$103.06 ,$607.75 ,$68.22 ,$68.22 ,$935.85 ,$257.64 ,$762.99 ,$103.06 ,"$1,101.00 ",$605.55 ,$103.06 ,$289.56 ,"$1,101.00 ",$38.93 ,$37.16 ,$108.21 ,$880.80 ,$597.84 ,$308.28 ,$990.90 ,$418.38 ,$500.00 ,$103.06 ,$528.48 
ST. MARY'S HOSPITAL - DECATUR,32000572,72083,HC XR SPINE/CERV SCOLIOSIS 4-5VW,320,1 ,"$1,184.00 ",$769.60 ,$37.16 ,"$1,184.00 ",$257.65 ,$91.49 ,$651.20 ,$103.06 ,$331.52 ,$580.16 ,$103.06 ,$692.64 ,$103.06 ,$642.91 ,$120.20 ,$103.06 ,$642.91 ,$195.81 ,$828.80 ,$592.00 ,$947.20 ,$257.64 ,$103.06 ,$828.80 ,$103.06 ,$710.40 ,$103.06 ,$888.00 ,$653.57 ,$589.63 ,$653.57 ,$103.06 ,$653.57 ,$81.63 ,$81.63 ,"$1,006.40 ",$257.64 ,$820.51 ,$103.06 ,"$1,184.00 ",$651.20 ,$103.06 ,$311.39 ,"$1,184.00 ",$38.93 ,$37.16 ,$108.21 ,$947.20 ,$642.91 ,$331.52 ,"$1,065.60 ",$449.92 ,$500.00 ,$103.06 ,$568.32 
ST. MARY'S HOSPITAL - DECATUR,32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$421.00 ,$273.65 ,$29.97 ,$421.00 ,$191.43 ,$36.74 ,$231.55 ,$76.57 ,$117.88 ,$206.29 ,$76.57 ,$246.29 ,$76.57 ,$228.60 ,$44.12 ,$76.57 ,$228.60 ,$145.48 ,$294.70 ,$210.50 ,$336.80 ,$191.42 ,$76.57 ,$294.70 ,$76.57 ,$252.60 ,$76.57 ,$315.75 ,$232.39 ,$209.66 ,$232.39 ,$76.57 ,$232.39 ,$29.97 ,$29.97 ,$357.85 ,$191.42 ,$291.75 ,$76.57 ,$421.00 ,$231.55 ,$76.57 ,$110.72 ,$421.00 ,$38.93 ,$37.16 ,$80.40 ,$336.80 ,$228.60 ,$117.88 ,$378.90 ,$159.98 ,$421.00 ,$76.57 ,$202.08 
ST. MARY'S HOSPITAL - DECATUR,32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$571.00 ,$371.15 ,$37.16 ,$571.00 ,$191.43 ,$54.99 ,$314.05 ,$76.57 ,$159.88 ,$279.79 ,$76.57 ,$334.04 ,$76.57 ,$310.05 ,$65.34 ,$76.57 ,$310.05 ,$145.48 ,$399.70 ,$285.50 ,$456.80 ,$191.42 ,$76.57 ,$399.70 ,$76.57 ,$342.60 ,$76.57 ,$428.25 ,$315.19 ,$284.36 ,$315.19 ,$76.57 ,$315.19 ,$44.37 ,$44.37 ,$485.35 ,$191.42 ,$395.70 ,$76.57 ,$571.00 ,$314.05 ,$76.57 ,$150.17 ,$571.00 ,$38.93 ,$37.16 ,$80.40 ,$456.80 ,$310.05 ,$159.88 ,$513.90 ,$216.98 ,$500.00 ,$76.57 ,$274.08 
ST. MARY'S HOSPITAL - DECATUR,32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$571.00 ,$371.15 ,$37.16 ,$571.00 ,$257.65 ,$51.08 ,$314.05 ,$103.06 ,$159.88 ,$279.79 ,$103.06 ,$334.04 ,$103.06 ,$310.05 ,$55.83 ,$103.06 ,$310.05 ,$195.81 ,$399.70 ,$285.50 ,$456.80 ,$257.64 ,$103.06 ,$399.70 ,$103.06 ,$342.60 ,$103.06 ,$428.25 ,$315.19 ,$284.36 ,$315.19 ,$103.06 ,$315.19 ,$37.92 ,$37.92 ,$485.35 ,$257.64 ,$395.70 ,$103.06 ,$571.00 ,$314.05 ,$103.06 ,$150.17 ,$571.00 ,$38.93 ,$37.16 ,$108.21 ,$456.80 ,$310.05 ,$159.88 ,$513.90 ,$216.98 ,$500.00 ,$103.06 ,$274.08 
ST. MARY'S HOSPITAL - DECATUR,32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$716.00 ,$465.40 ,$37.16 ,$716.00 ,$257.65 ,$61.52 ,$393.80 ,$103.06 ,$200.48 ,$350.84 ,$103.06 ,$418.86 ,$103.06 ,$388.79 ,$71.92 ,$103.06 ,$388.79 ,$195.81 ,$501.20 ,$358.00 ,$572.80 ,$257.64 ,$103.06 ,$501.20 ,$103.06 ,$429.60 ,$103.06 ,$537.00 ,$395.23 ,$356.57 ,$395.23 ,$103.06 ,$395.23 ,$48.84 ,$48.84 ,$608.60 ,$257.64 ,$496.19 ,$103.06 ,$716.00 ,$393.80 ,$103.06 ,$188.31 ,$716.00 ,$38.93 ,$37.16 ,$108.21 ,$572.80 ,$388.79 ,$200.48 ,$644.40 ,$272.08 ,$500.00 ,$103.06 ,$343.68 
ST. MARY'S HOSPITAL - DECATUR,32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,"$1,030.00 ",$669.50 ,$37.16 ,"$1,030.00 ",$257.65 ,$73.89 ,$566.50 ,$103.06 ,$288.40 ,$504.70 ,$103.06 ,$574.27 ,$103.06 ,$559.29 ,$87.28 ,$103.06 ,$559.29 ,$195.81 ,$721.00 ,$515.00 ,$824.00 ,$257.64 ,$103.06 ,$721.00 ,$103.06 ,$618.00 ,$103.06 ,$772.50 ,$568.56 ,$512.94 ,$568.56 ,$103.06 ,$568.56 ,$59.28 ,$59.28 ,$875.50 ,$257.64 ,$713.79 ,$103.06 ,"$1,030.00 ",$566.50 ,$103.06 ,$270.89 ,"$1,030.00 ",$38.93 ,$37.16 ,$108.21 ,$824.00 ,$559.29 ,$288.40 ,$927.00 ,$391.40 ,$500.00 ,$103.06 ,$494.40 
ST. MARY'S HOSPITAL - DECATUR,32000580,73551,HC XR FEMUR 1VIEW,320,1 ,$548.00 ,$356.20 ,$27.98 ,$548.00 ,$191.43 ,$35.44 ,$301.40 ,$76.57 ,$153.44 ,$268.52 ,$76.57 ,$279.27 ,$76.57 ,$297.56 ,$41.20 ,$76.57 ,$297.56 ,$145.48 ,$383.60 ,$274.00 ,$438.40 ,$191.42 ,$76.57 ,$383.60 ,$76.57 ,$328.80 ,$76.57 ,$411.00 ,$302.50 ,$272.90 ,$302.50 ,$76.57 ,$302.50 ,$27.98 ,$27.98 ,$465.80 ,$191.42 ,$379.76 ,$76.57 ,$548.00 ,$301.40 ,$76.57 ,$144.12 ,$548.00 ,$38.93 ,$37.16 ,$80.40 ,$438.40 ,$297.56 ,$153.44 ,$493.20 ,$208.24 ,$500.00 ,$76.57 ,$263.04 
ST. MARY'S HOSPITAL - DECATUR,32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$676.00 ,$439.40 ,$33.95 ,$676.00 ,$191.43 ,$41.96 ,$371.80 ,$76.57 ,$189.28 ,$331.24 ,$76.57 ,$334.32 ,$76.57 ,$367.07 ,$49.97 ,$76.57 ,$367.07 ,$145.48 ,$473.20 ,$338.00 ,$540.80 ,$191.42 ,$76.57 ,$473.20 ,$76.57 ,$405.60 ,$76.57 ,$507.00 ,$373.15 ,$336.65 ,$373.15 ,$76.57 ,$373.15 ,$33.95 ,$33.95 ,$574.60 ,$191.42 ,$468.47 ,$76.57 ,$676.00 ,$371.80 ,$76.57 ,$177.79 ,$676.00 ,$38.93 ,$37.16 ,$80.40 ,$540.80 ,$367.07 ,$189.28 ,$608.40 ,$256.88 ,$500.00 ,$76.57 ,$324.48 
ST. MARY'S HOSPITAL - DECATUR,32000583,72200,HC XR SACROILIC JOINT <3VIEWS,320,1 ,$619.00 ,$402.35 ,$30.96 ,$619.00 ,$257.65 ,$40.55 ,$340.45 ,$103.06 ,$173.32 ,$277.40 ,$103.06 ,$277.40 ,$103.06 ,$336.12 ,$45.58 ,$103.06 ,$336.12 ,$195.81 ,$433.30 ,$309.50 ,$495.20 ,$257.64 ,$103.06 ,$433.30 ,$103.06 ,$371.40 ,$103.06 ,$464.25 ,$341.69 ,$308.26 ,$341.69 ,$103.06 ,$341.69 ,$30.96 ,$30.96 ,$526.15 ,$257.64 ,$428.97 ,$103.06 ,$619.00 ,$340.45 ,$103.06 ,$162.80 ,$619.00 ,$38.93 ,$37.16 ,$108.21 ,$495.20 ,$336.12 ,$173.32 ,$557.10 ,$235.22 ,$500.00 ,$103.06 ,$297.12 
ST. MARY'S HOSPITAL - DECATUR,32000589,74019,HC XR ABDOMEN 2V,320,1 ,$574.00 ,$373.10 ,$32.45 ,$574.00 ,$257.65 ,$40.61 ,$315.70 ,$103.06 ,$160.72 ,$281.26 ,$103.06 ,$310.33 ,$103.06 ,$311.68 ,$47.78 ,$103.06 ,$311.68 ,$195.81 ,$401.80 ,$287.00 ,$459.20 ,$257.64 ,$103.06 ,$401.80 ,$103.06 ,$344.40 ,$103.06 ,$430.50 ,$316.85 ,$285.85 ,$316.85 ,$103.06 ,$316.85 ,$32.45 ,$32.45 ,$487.90 ,$257.64 ,$397.78 ,$103.06 ,$574.00 ,$315.70 ,$103.06 ,$150.96 ,$574.00 ,$38.93 ,$37.16 ,$108.21 ,$459.20 ,$311.68 ,$160.72 ,$516.60 ,$218.12 ,$500.00 ,$103.06 ,$275.52 
ST. MARY'S HOSPITAL - DECATUR,32000606,76125,HC CINERADIOGRAPHY/VIDEORADIOGRAPHY EXAM,320,1 ,$690.00 ,$448.50 ,$37.16 ,$690.00 , N/A ,$57.80 ,$379.50 , N/A ,$193.20 ,$338.10 , N/A ,$403.65 , N/A ,$374.67 ,$66.03 , N/A ,$374.67 , N/A ,$483.00 ,$345.00 ,$552.00 , N/A , N/A ,$483.00 , N/A ,$414.00 , N/A ,$517.50 ,$380.88 ,$343.62 ,$380.88 , N/A ,$380.88 ,$44.91 ,$44.91 ,$586.50 , N/A ,$478.17 , N/A ,$690.00 ,$379.50 , N/A ,$181.47 ,$690.00 ,$38.93 ,$37.16 , N/A ,$552.00 ,$374.67 ,$193.20 ,$621.00 ,$262.20 ,$500.00 , N/A ,$331.20 
ST. MARY'S HOSPITAL - DECATUR,32000611,G1004,HC RAD AUC CDSM NATL DECISION SUPPORT COMPANY,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,"$1,230.00 ",$799.50 ,$37.16 ,"$1,230.00 ", N/A ,$88.00 ,$676.50 , N/A ,$344.40 ,$578.10 , N/A ,$664.20 , N/A ,$667.89 ,$96.98 , N/A ,$667.89 , N/A ,$861.00 ,$615.00 ,$984.00 , N/A , N/A ,$861.00 , N/A ,$738.00 , N/A ,$922.50 ,$678.96 ,$612.54 ,$678.96 , N/A ,$678.96 ,$65.96 ,$65.96 ,"$1,045.50 ", N/A ,$852.39 , N/A ,"$1,230.00 ",$676.50 , N/A ,$323.49 ,"$1,230.00 ",$38.93 ,$37.16 , N/A ,$984.00 ,$667.89 ,$344.40 ,"$1,107.00 ",$467.40 ,$500.00 , N/A ,$590.40 
ST. MARY'S HOSPITAL - DECATUR,32000613,G1002,HC RAD AUC CDSM MEDCURRENT,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000614,G1003,HC RAD AUC CDSM MEDICALIS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000615,G1005,HC RAD AUC CDSM NATIONAL IMAGING ASSOCIATES,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000616,G1006,HC RAD AUC CDSM TEST APPROPRIATE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000617,G1007,HC RAD AUC CDSM AIM SPECIALTY HEALTH,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000618,G1008,HC RAD AUC CDSM CRANBERRY PEAK,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000619,G1009,HC RAD AUC CDSM SAGE HEALTH MGMT SOLUTIONS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000620,G1010,HC RAD AUC CDSM STANSON,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000621,G1011,HC RAD AUC CDSM QUALIFIED TOOL NOS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,32000623,G1001,HC RAD AUC CDSM EVICORE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,33100001,96405,HC CHEMO IV INTRALESION UP TO 7 LESIONS,331,1 ,"$1,005.00 ",$653.25 ,$58.48 ,"$1,005.00 ",$146.73 ,$512.55 ,$552.75 ,$58.69 ,$281.40 ,$492.45 ,$58.69 ,$501.13 ,$58.69 ,$545.72 ,$58.48 ,$58.69 ,$545.72 ,$111.51 ,$703.50 ,$502.50 ,$804.00 ,$146.72 ,$58.69 ,$703.50 ,$58.69 ,$603.00 ,$58.69 ,$753.75 ,$554.76 ,$500.49 ,$554.76 ,$58.69 ,$554.76 ,$703.50 ,$703.50 ,$854.25 ,$146.72 ,$696.47 ,$58.69 ,"$1,005.00 ",$552.75 ,$58.69 ,$264.32 ,"$1,005.00 ",$214.47 ,$204.72 ,$61.62 ,$804.00 ,$545.72 ,$281.40 ,$904.50 ,$381.90 ,$750.00 ,$58.69 ,$482.40 
ST. MARY'S HOSPITAL - DECATUR,33300010,77290,HC SIMULATION COMPLEX,333,1 ,"$1,963.00 ","$1,275.95 ",$250.00 ,"$1,963.00 ",$801.38 ,$827.69 ,"$1,079.65 ",$320.55 ,$549.64 ,$961.87 ,$320.55 ,"$1,148.36 ",$320.55 ,"$1,065.91 ",$885.37 ,$320.55 ,"$1,065.91 ",$609.05 ,"$1,374.10 ",$981.50 ,"$1,570.40 ",$801.39 ,$320.55 ,"$1,374.10 ",$320.55 ,"$1,177.80 ",$320.55 ,"$1,472.25 ","$1,083.58 ",$977.57 ,"$1,083.58 ",$320.55 ,"$1,083.58 ",$601.29 ,$601.29 ,"$1,668.55 ",$801.39 ,"$1,360.36 ",$320.55 ,"$1,963.00 ","$1,079.65 ",$320.55 ,$516.27 ,"$1,963.00 ",$423.49 ,$404.24 ,$336.58 ,"$1,570.40 ","$1,065.91 ",$549.64 ,"$1,766.70 ",$745.94 ,$250.00 ,$320.55 ,$942.24 
ST. MARY'S HOSPITAL - DECATUR,33300011,77295,HC SIMULATION 3-D,333,1 ,"$7,268.00 ","$4,724.20 ",$250.00 ,"$7,268.00 ","$2,988.35 ",$400.01 ,"$3,997.40 ","$1,195.34 ","$2,035.04 ","$3,561.32 ","$1,195.34 ","$3,916.37 ","$1,195.34 ","$3,946.52 ",$552.72 ,"$1,195.34 ","$3,946.52 ","$2,271.15 ","$5,087.60 ","$3,634.00 ","$5,814.40 ","$2,988.36 ","$1,195.34 ","$5,087.60 ","$1,195.34 ","$4,360.80 ","$1,195.34 ","$5,451.00 ","$4,011.94 ","$3,619.46 ","$4,011.94 ","$1,195.34 ","$4,011.94 ",$375.38 ,$375.38 ,"$6,177.80 ","$2,988.36 ","$5,036.72 ","$1,195.34 ","$7,268.00 ","$3,997.40 ","$1,195.34 ","$1,911.48 ","$7,268.00 ",$423.49 ,$404.24 ,"$1,255.11 ","$5,814.40 ","$3,946.52 ","$2,035.04 ","$6,541.20 ","$2,761.84 ",$250.00 ,"$1,195.34 ","$3,488.64 "
ST. MARY'S HOSPITAL - DECATUR,33300015,77300,HC DOSIMETRY CALCULATION BASIC,333,1 ,$785.00 ,$510.25 ,$47.85 ,$785.00 ,$300.28 ,$65.95 ,$431.75 ,$120.11 ,$219.80 ,$384.65 ,$120.11 ,$459.23 ,$120.11 ,$426.26 ,$70.46 ,$120.11 ,$426.26 ,$228.21 ,$549.50 ,$392.50 ,$628.00 ,$300.28 ,$120.11 ,$549.50 ,$120.11 ,$471.00 ,$120.11 ,$588.75 ,$433.32 ,$390.93 ,$433.32 ,$120.11 ,$433.32 ,$47.85 ,$47.85 ,$667.25 ,$300.28 ,$544.01 ,$120.11 ,$785.00 ,$431.75 ,$120.11 ,$206.46 ,$785.00 ,$68.67 ,$65.55 ,$126.12 ,$628.00 ,$426.26 ,$219.80 ,$706.50 ,$298.30 ,$250.00 ,$120.11 ,$376.80 
ST. MARY'S HOSPITAL - DECATUR,33300017,77301,HC IMRT TX PLAN,333,1 ,"$7,478.00 ","$4,860.70 ",$250.00 ,"$7,478.00 ","$2,988.35 ","$2,908.49 ","$4,112.90 ","$1,195.34 ","$2,093.84 ","$3,664.22 ","$1,195.34 ","$4,374.63 ","$1,195.34 ","$4,060.55 ","$3,160.58 ","$1,195.34 ","$4,060.55 ","$2,271.15 ","$5,234.60 ","$3,739.00 ","$5,982.40 ","$2,988.36 ","$1,195.34 ","$5,234.60 ","$1,195.34 ","$4,486.80 ","$1,195.34 ","$5,608.50 ","$4,127.86 ","$3,724.04 ","$4,127.86 ","$1,195.34 ","$4,127.86 ","$2,146.44 ","$2,146.44 ","$6,356.30 ","$2,988.36 ","$5,182.25 ","$1,195.34 ","$7,478.00 ","$4,112.90 ","$1,195.34 ","$1,966.71 ","$7,478.00 ",$299.17 ,$285.57 ,"$1,255.11 ","$5,982.40 ","$4,060.55 ","$2,093.84 ","$6,730.20 ","$2,841.64 ",$250.00 ,"$1,195.34 ","$3,589.44 "
ST. MARY'S HOSPITAL - DECATUR,33300022,77307,HC ISODOSE PLAN COMPLEX,333,1 ,"$1,843.00 ","$1,197.95 ",$194.22 ,"$1,843.00 ",$801.38 ,$245.45 ,"$1,013.65 ",$320.55 ,$516.04 ,$903.07 ,$320.55 ,"$1,078.16 ",$320.55 ,"$1,000.75 ",$285.98 ,$320.55 ,"$1,000.75 ",$609.05 ,"$1,290.10 ",$921.50 ,"$1,474.40 ",$801.39 ,$320.55 ,"$1,290.10 ",$320.55 ,"$1,105.80 ",$320.55 ,"$1,382.25 ","$1,017.34 ",$917.81 ,"$1,017.34 ",$320.55 ,"$1,017.34 ",$194.22 ,$194.22 ,"$1,566.55 ",$801.39 ,"$1,277.20 ",$320.55 ,"$1,843.00 ","$1,013.65 ",$320.55 ,$484.71 ,"$1,843.00 ",$299.17 ,$285.57 ,$336.58 ,"$1,474.40 ","$1,000.75 ",$516.04 ,"$1,658.70 ",$700.34 ,$250.00 ,$320.55 ,$884.64 
ST. MARY'S HOSPITAL - DECATUR,33300032,77334,HC TREATMENT DEVICE COMPLEX,333,1 ,"$2,039.00 ","$1,325.35 ",$95.54 ,"$2,039.00 ",$801.38 ,$162.54 ,"$1,121.45 ",$320.55 ,$570.92 ,$999.11 ,$320.55 ,"$1,192.82 ",$320.55 ,"$1,107.18 ",$140.68 ,$320.55 ,"$1,107.18 ",$609.05 ,"$1,427.30 ","$1,019.50 ","$1,631.20 ",$801.39 ,$320.55 ,"$1,427.30 ",$320.55 ,"$1,223.40 ",$320.55 ,"$1,529.25 ","$1,125.53 ","$1,015.42 ","$1,125.53 ",$320.55 ,"$1,125.53 ",$95.54 ,$95.54 ,"$1,733.15 ",$801.39 ,"$1,413.03 ",$320.55 ,"$2,039.00 ","$1,121.45 ",$320.55 ,$536.26 ,"$2,039.00 ",$144.58 ,$138.01 ,$336.58 ,"$1,631.20 ","$1,107.18 ",$570.92 ,"$1,835.10 ",$774.82 ,$250.00 ,$320.55 ,$978.72 
ST. MARY'S HOSPITAL - DECATUR,33300033,77336,HC MEDICAL PHYSICS CONTINUING,333,1 ,$712.00 ,$462.80 ,$80.15 ,$712.00 ,$300.28 ,$80.19 ,$391.60 ,$120.11 ,$199.36 ,$348.88 ,$120.11 ,$416.52 ,$120.11 ,$386.62 ,$166.70 ,$120.11 ,$386.62 ,$228.21 ,$498.40 ,$356.00 ,$569.60 ,$300.28 ,$120.11 ,$498.40 ,$120.11 ,$427.20 ,$120.11 ,$534.00 ,$393.02 ,$354.58 ,$393.02 ,$120.11 ,$393.02 ,$113.22 ,$113.22 ,$605.20 ,$300.28 ,$493.42 ,$120.11 ,$712.00 ,$391.60 ,$120.11 ,$187.26 ,$712.00 ,$83.96 ,$80.15 ,$126.12 ,$569.60 ,$386.62 ,$199.36 ,$640.80 ,$270.56 ,$250.00 ,$120.11 ,$341.76 
ST. MARY'S HOSPITAL - DECATUR,33300034,77338,HC MLC DEVICE FOR IMRT,333,1 ,"$2,039.00 ","$1,325.35 ",$250.00 ,"$2,039.00 ",$801.38 ,$525.71 ,"$1,121.45 ",$320.55 ,$570.92 ,$999.11 ,$320.55 ,"$1,192.82 ",$320.55 ,"$1,107.18 ",$569.04 ,$320.55 ,"$1,107.18 ",$609.05 ,"$1,427.30 ","$1,019.50 ","$1,631.20 ",$801.39 ,$320.55 ,"$1,427.30 ",$320.55 ,"$1,223.40 ",$320.55 ,"$1,529.25 ","$1,125.53 ","$1,015.42 ","$1,125.53 ",$320.55 ,"$1,125.53 ",$386.46 ,$386.46 ,"$1,733.15 ",$801.39 ,"$1,413.03 ",$320.55 ,"$2,039.00 ","$1,121.45 ",$320.55 ,$536.26 ,"$2,039.00 ",$576.26 ,$550.06 ,$336.58 ,"$1,631.20 ","$1,107.18 ",$570.92 ,"$1,835.10 ",$774.82 ,$250.00 ,$320.55 ,$978.72 
ST. MARY'S HOSPITAL - DECATUR,33300036,77370,HC SPECIAL MED PHYSICS CONSULT,333,1 ,$987.00 ,$641.55 ,$80.15 ,$987.00 ,$300.28 ,$216.07 ,$542.85 ,$120.11 ,$276.36 ,$483.63 ,$120.11 ,$577.40 ,$120.11 ,$535.94 ,$260.26 ,$120.11 ,$535.94 ,$228.21 ,$690.90 ,$493.50 ,$789.60 ,$300.28 ,$120.11 ,$690.90 ,$120.11 ,$592.20 ,$120.11 ,$740.25 ,$544.82 ,$491.53 ,$544.82 ,$120.11 ,$544.82 ,$176.75 ,$176.75 ,$838.95 ,$300.28 ,$683.99 ,$120.11 ,$987.00 ,$542.85 ,$120.11 ,$259.58 ,$987.00 ,$83.96 ,$80.15 ,$126.12 ,$789.60 ,$535.94 ,$276.36 ,$888.30 ,$375.06 ,$250.00 ,$120.11 ,$473.76 
ST. MARY'S HOSPITAL - DECATUR,33300045,77412,HC RAD THRPY COMPLEX,333,1 ,"$1,116.00 ",$725.40 ,$228.81 ,"$1,116.00 ",$572.03 ,$437.54 ,$613.80 ,$228.81 ,$312.48 ,$546.84 ,$228.81 ,$652.86 ,$228.81 ,$605.99 ,$545.22 ,$228.81 ,$605.99 ,$434.75 ,$781.20 ,$558.00 ,$892.80 ,$572.03 ,$228.81 ,$781.20 ,$228.81 ,$669.60 ,$228.81 ,$837.00 ,$616.03 ,$555.77 ,$616.03 ,$228.81 ,$616.03 ,$781.20 ,$781.20 ,$948.60 ,$572.03 ,$773.39 ,$228.81 ,"$1,116.00 ",$613.80 ,$228.81 ,$293.51 ,"$1,116.00 ",$576.26 ,$550.06 ,$240.25 ,$892.80 ,$605.99 ,$312.48 ,"$1,004.40 ",$424.08 ,$250.00 ,$228.81 ,$535.68 
ST. MARY'S HOSPITAL - DECATUR,33300051,77386,HC IMRT TREATMENT COMPLEX,333,1 ,"$2,949.00 ","$1,916.85 ",$250.00 ,"$2,949.00 ","$1,283.98 ",$729.27 ,"$1,621.95 ",$513.59 ,$825.72 ,"$1,445.01 ",$513.59 ,"$1,725.17 ",$513.59 ,"$1,601.31 ",$733.95 ,$513.59 ,"$1,601.31 ",$975.82 ,"$2,064.30 ","$1,474.50 ","$2,359.20 ","$1,283.98 ",$513.59 ,"$2,064.30 ",$513.59 ,"$1,769.40 ",$513.59 ,"$2,211.75 ","$1,627.85 ","$1,468.60 ","$1,627.85 ",$513.59 ,"$1,627.85 ","$2,064.30 ","$2,064.30 ","$2,506.65 ","$1,283.98 ","$2,043.66 ",$513.59 ,"$2,949.00 ","$1,621.95 ",$513.59 ,$775.59 ,"$2,949.00 ",$576.26 ,$550.06 ,$539.27 ,"$2,359.20 ","$1,601.31 ",$825.72 ,"$2,654.10 ","$1,120.62 ",$250.00 ,$513.59 ,"$1,415.52 "
ST. MARY'S HOSPITAL - DECATUR,33300054,77385,HC IMRT TREATMENT SIMPLE,333,1 ,"$2,949.00 ","$1,916.85 ",$250.00 ,"$2,949.00 ","$1,283.98 ",$726.57 ,"$1,621.95 ",$513.59 ,$825.72 ,"$1,445.01 ",$513.59 ,"$1,725.17 ",$513.59 ,"$1,601.31 ",$736.83 ,$513.59 ,"$1,601.31 ",$975.82 ,"$2,064.30 ","$1,474.50 ","$2,359.20 ","$1,283.98 ",$513.59 ,"$2,064.30 ",$513.59 ,"$1,769.40 ",$513.59 ,"$2,211.75 ","$1,627.85 ","$1,468.60 ","$1,627.85 ",$513.59 ,"$1,627.85 ","$2,064.30 ","$2,064.30 ","$2,506.65 ","$1,283.98 ","$2,043.66 ",$513.59 ,"$2,949.00 ","$1,621.95 ",$513.59 ,$775.59 ,"$2,949.00 ",$576.26 ,$550.06 ,$539.27 ,"$2,359.20 ","$1,601.31 ",$825.72 ,"$2,654.10 ","$1,120.62 ",$250.00 ,$513.59 ,"$1,415.52 "
ST. MARY'S HOSPITAL - DECATUR,33300055,77387,HC STEREOSCOPIC X RAY GUIDANCE,333,1 ,$622.00 ,$404.30 ,$70.13 ,$622.00 , N/A ,$70.13 ,$342.10 , N/A ,$174.16 ,$292.34 , N/A ,$335.88 , N/A ,$337.75 ,$400.00 , N/A ,$337.75 , N/A ,$435.40 ,$311.00 ,$497.60 , N/A , N/A ,$435.40 , N/A ,$373.20 , N/A ,$466.50 ,$343.34 ,$309.76 ,$343.34 , N/A ,$343.34 ,$435.40 ,$435.40 ,$528.70 , N/A ,$431.05 , N/A ,$622.00 ,$342.10 , N/A ,$163.59 ,$622.00 , N/A , N/A , N/A ,$497.60 ,$337.75 ,$174.16 ,$559.80 ,$236.36 ,$250.00 , N/A ,$298.56 
ST. MARY'S HOSPITAL - DECATUR,33300057,77470,HC SPECIAL TREATMENT PROCEDURE,333,1 ,"$2,378.00 ","$1,545.70 ",$35.93 ,"$2,378.00 ","$1,283.98 ",$87.62 ,"$1,307.90 ",$513.59 ,$665.84 ,$565.13 ,$513.59 ,$565.13 ,$513.59 ,"$1,291.25 ",$52.90 ,$513.59 ,"$1,291.25 ",$975.82 ,"$1,664.60 ","$1,189.00 ","$1,902.40 ","$1,283.98 ",$513.59 ,"$1,664.60 ",$513.59 ,"$1,426.80 ",$513.59 ,"$1,783.50 ","$1,312.66 ","$1,184.24 ","$1,312.66 ",$513.59 ,"$1,312.66 ",$35.93 ,$35.93 ,"$2,021.30 ","$1,283.98 ","$1,647.95 ",$513.59 ,"$2,378.00 ","$1,307.90 ",$513.59 ,$625.41 ,"$2,378.00 ",$814.07 ,$777.06 ,$539.27 ,"$1,902.40 ","$1,291.25 ",$665.84 ,"$2,140.20 ",$903.64 ,$250.00 ,$513.59 ,"$1,141.44 "
ST. MARY'S HOSPITAL - DECATUR,33300071,77372,HC SRS TREATMENT,333,1 ,"$20,594.00 ","$13,386.10 ","$1,430.21 ","$20,594.00 ","$18,405.08 ","$1,430.21 ","$11,326.70 ","$7,362.03 ","$5,766.32 ","$10,091.06 ","$7,362.03 ","$12,047.49 ","$7,362.03 ","$11,182.54 ","$2,215.81 ","$7,362.03 ","$11,182.54 ","$13,987.86 ","$14,415.80 ","$10,297.00 ","$16,475.20 ","$18,405.08 ","$7,362.03 ","$14,415.80 ","$7,362.03 ","$12,356.40 ","$7,362.03 ","$15,445.50 ","$11,367.89 ","$10,255.81 ","$11,367.89 ","$7,362.03 ","$11,367.89 ","$1,504.82 ","$1,504.82 ","$17,504.90 ","$18,405.08 ","$14,271.64 ","$7,362.03 ","$20,594.00 ","$11,326.70 ","$7,362.03 ","$5,416.22 ","$20,594.00 ","$3,180.23 ","$3,035.68 ","$7,730.13 ","$16,475.20 ","$11,182.54 ","$5,766.32 ","$18,534.60 ","$7,825.72 ","$11,203.14 ","$7,362.03 ","$9,885.12 "
ST. MARY'S HOSPITAL - DECATUR,33300072,77373,HC SRT TREATMENT,333,1 ,"$7,602.00 ","$4,941.30 ",$550.06 ,"$7,602.00 ","$4,104.33 ","$2,311.45 ","$4,181.10 ","$1,641.73 ","$2,128.56 ","$3,724.98 ","$1,641.73 ","$4,447.17 ","$1,641.73 ","$4,127.89 ","$2,682.71 ","$1,641.73 ","$4,127.89 ","$3,119.28 ","$5,321.40 ","$3,801.00 ","$6,081.60 ","$4,104.32 ","$1,641.73 ","$5,321.40 ","$1,641.73 ","$4,561.20 ","$1,641.73 ","$5,701.50 ","$4,196.30 ","$3,785.80 ","$4,196.30 ","$1,641.73 ","$4,196.30 ","$1,821.90 ","$1,821.90 ","$6,461.70 ","$4,104.32 ","$5,268.19 ","$1,641.73 ","$7,602.00 ","$4,181.10 ","$1,641.73 ","$1,999.33 ","$7,602.00 ",$576.26 ,$550.06 ,"$1,723.82 ","$6,081.60 ","$4,127.89 ","$2,128.56 ","$6,841.80 ","$2,888.76 ","$4,135.49 ","$1,641.73 ","$3,648.96 "
ST. MARY'S HOSPITAL - DECATUR,33301001,31575,HC LARYNGOSCOPY FLEX FIBEROPTC,333,1 ,$605.00 ,$393.25 ,$121.11 ,$605.00 ,$389.55 ,$308.55 ,$332.75 ,$155.82 ,$169.40 ,$284.35 ,$155.82 ,$326.70 ,$155.82 ,$328.52 ,$121.11 ,$155.82 ,$328.52 ,$296.07 ,$423.50 ,$302.50 ,$484.00 ,$389.56 ,$155.82 ,$423.50 ,$155.82 ,$363.00 ,$155.82 ,$453.75 ,$333.96 ,$301.29 ,$333.96 ,$155.82 ,$333.96 ,$423.50 ,$423.50 ,$514.25 ,$389.56 ,$419.27 ,$155.82 ,$605.00 ,$332.75 ,$155.82 ,$159.12 ,$605.00 ,$282.50 ,$269.66 ,$163.61 ,$484.00 ,$328.52 ,$169.40 ,$544.50 ,$229.90 ,$250.00 ,$155.82 ,$290.40 
ST. MARY'S HOSPITAL - DECATUR,33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$276.00 ,$179.40 ,$58.69 ,$276.00 ,$146.73 ,$140.76 ,$151.80 ,$58.69 ,$77.28 ,$135.24 ,$58.69 ,$161.46 ,$58.69 ,$149.87 ,$148.56 ,$58.69 ,$149.87 ,$111.51 ,$193.20 ,$138.00 ,$220.80 ,$146.72 ,$58.69 ,$193.20 ,$58.69 ,$165.60 ,$58.69 ,$207.00 ,$152.35 ,$137.45 ,$152.35 ,$58.69 ,$152.35 ,$193.20 ,$193.20 ,$234.60 ,$146.72 ,$191.27 ,$58.69 ,$276.00 ,$151.80 ,$58.69 ,$72.59 ,$276.00 , N/A , N/A ,$61.62 ,$220.80 ,$149.87 ,$77.28 ,$248.40 ,$104.88 ,$276.00 ,$58.69 ,$132.48 
ST. MARY'S HOSPITAL - DECATUR,33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$343.00 ,$222.95 ,$90.21 ,$484.13 ,$484.13 ,$174.93 ,$188.65 ,$193.65 ,$96.04 ,$168.07 ,$193.65 ,$200.66 ,$193.65 ,$186.25 ,$202.05 ,$193.65 ,$186.25 ,$343.00 ,$240.10 ,$171.50 ,$274.40 ,$484.12 ,$193.65 ,$240.10 ,$193.65 ,$205.80 ,$193.65 ,$257.25 ,$189.34 ,$170.81 ,$189.34 ,$193.65 ,$189.34 ,$240.10 ,$240.10 ,$291.55 ,$343.00 ,$237.70 ,$193.65 ,$343.00 ,$188.65 ,$193.65 ,$90.21 ,$343.00 , N/A , N/A ,$203.33 ,$274.40 ,$186.25 ,$96.04 ,$308.70 ,$130.34 ,$343.00 ,$193.65 ,$164.64 
ST. MARY'S HOSPITAL - DECATUR,33500004,96411,HC CHEMO IV PUSH ADDL DRUG,335,1 ,$146.00 ,$94.90 ,$38.40 ,$146.73 ,$146.73 ,$74.46 ,$80.30 ,$58.69 ,$40.88 ,$71.54 ,$58.69 ,$85.41 ,$58.69 ,$79.28 ,$109.55 ,$58.69 ,$79.28 ,$111.51 ,$102.20 ,$73.00 ,$116.80 ,$146.72 ,$58.69 ,$102.20 ,$58.69 ,$87.60 ,$58.69 ,$109.50 ,$80.59 ,$72.71 ,$80.59 ,$58.69 ,$80.59 ,$102.20 ,$102.20 ,$124.10 ,$146.00 ,$101.18 ,$58.69 ,$146.00 ,$80.30 ,$58.69 ,$38.40 ,$146.00 , N/A , N/A ,$61.62 ,$116.80 ,$79.28 ,$40.88 ,$131.40 ,$55.48 ,$146.00 ,$58.69 ,$70.08 
ST. MARY'S HOSPITAL - DECATUR,33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$959.00 ,$623.35 ,$208.90 ,$959.00 ,$754.55 ,$489.09 ,$527.45 ,$301.82 ,$268.52 ,$469.91 ,$301.82 ,$561.02 ,$301.82 ,$520.74 ,$278.40 ,$301.82 ,$520.74 ,$573.46 ,$671.30 ,$479.50 ,$767.20 ,$754.56 ,$301.82 ,$671.30 ,$301.82 ,$575.40 ,$301.82 ,$719.25 ,$529.37 ,$477.58 ,$529.37 ,$301.82 ,$529.37 ,$671.30 ,$671.30 ,$815.15 ,$754.56 ,$664.59 ,$301.82 ,$959.00 ,$527.45 ,$301.82 ,$252.22 ,$959.00 ,$218.85 ,$208.90 ,$316.91 ,$767.20 ,$520.74 ,$268.52 ,$863.10 ,$364.42 ,$750.00 ,$301.82 ,$460.32 
ST. MARY'S HOSPITAL - DECATUR,33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$156.00 ,$101.40 ,$41.03 ,$326.57 ,$146.73 ,$79.56 ,$85.80 ,$58.69 ,$43.68 ,$76.44 ,$58.69 ,$91.26 ,$58.69 ,$84.71 ,$57.68 ,$58.69 ,$84.71 ,$111.51 ,$109.20 ,$78.00 ,$124.80 ,$146.72 ,$58.69 ,$109.20 ,$58.69 ,$93.60 ,$58.69 ,$117.00 ,$86.11 ,$77.69 ,$86.11 ,$58.69 ,$86.11 ,$109.20 ,$109.20 ,$132.60 ,$146.72 ,$108.11 ,$58.69 ,$156.00 ,$85.80 ,$58.69 ,$41.03 ,$156.00 ,$156.00 ,$326.57 ,$61.62 ,$124.80 ,$84.71 ,$43.68 ,$140.40 ,$59.28 ,$156.00 ,$58.69 ,$74.88 
ST. MARY'S HOSPITAL - DECATUR,33500007,96416,HC CHEMO ADMIN INTRAV INFUS >8HR,335,1 ,$923.00 ,$599.95 ,$242.75 ,$923.00 ,$754.55 ,$470.73 ,$507.65 ,$301.82 ,$258.44 ,$452.27 ,$301.82 ,$539.96 ,$301.82 ,$501.19 ,$305.64 ,$301.82 ,$501.19 ,$573.46 ,$646.10 ,$461.50 ,$738.40 ,$754.56 ,$301.82 ,$646.10 ,$301.82 ,$553.80 ,$301.82 ,$692.25 ,$509.50 ,$459.65 ,$509.50 ,$301.82 ,$509.50 ,$646.10 ,$646.10 ,$784.55 ,$754.56 ,$639.64 ,$301.82 ,$923.00 ,$507.65 ,$301.82 ,$242.75 ,$923.00 ,$342.12 ,$326.57 ,$316.91 ,$738.40 ,$501.19 ,$258.44 ,$830.70 ,$350.74 ,$750.00 ,$301.82 ,$443.04 
ST. MARY'S HOSPITAL - DECATUR,33500008,96417,HC CHEMO IV INFUSION EA ADDL <1H,335,1 ,$334.00 ,$217.10 ,$58.69 ,$334.00 ,$146.73 ,$170.34 ,$183.70 ,$58.69 ,$93.52 ,$163.66 ,$58.69 ,$195.39 ,$58.69 ,$181.36 ,$127.45 ,$58.69 ,$181.36 ,$111.51 ,$233.80 ,$167.00 ,$267.20 ,$146.72 ,$58.69 ,$233.80 ,$58.69 ,$200.40 ,$58.69 ,$250.50 ,$184.37 ,$166.33 ,$184.37 ,$58.69 ,$184.37 ,$233.80 ,$233.80 ,$283.90 ,$146.72 ,$231.46 ,$58.69 ,$334.00 ,$183.70 ,$58.69 ,$87.84 ,$334.00 ,$218.85 ,$208.90 ,$61.62 ,$267.20 ,$181.36 ,$93.52 ,$300.60 ,$126.92 ,$334.00 ,$58.69 ,$160.32 
ST. MARY'S HOSPITAL - DECATUR,33500012,96450,HC CHEMO CNS,335,1 ,$742.00 ,$482.30 ,$159.56 ,$754.56 ,$754.55 ,$378.42 ,$408.10 ,$301.82 ,$207.76 ,$363.58 ,$301.82 ,$434.07 ,$301.82 ,$402.91 ,$159.56 ,$301.82 ,$402.91 ,$573.46 ,$519.40 ,$371.00 ,$593.60 ,$754.56 ,$301.82 ,$519.40 ,$301.82 ,$445.20 ,$301.82 ,$556.50 ,$409.58 ,$369.52 ,$409.58 ,$301.82 ,$409.58 ,$519.40 ,$519.40 ,$630.70 ,$742.00 ,$514.21 ,$301.82 ,$742.00 ,$408.10 ,$301.82 ,$195.15 ,$742.00 ,$342.12 ,$326.57 ,$316.91 ,$593.60 ,$402.91 ,$207.76 ,$667.80 ,$281.96 ,$742.00 ,$301.82 ,$356.16 
ST. MARY'S HOSPITAL - DECATUR,33500013,96402,HC CHEMOTHERAPY INJECTION-HORMONAL ANTI-NEO,335,1 ,$273.00 ,$177.45 ,$58.13 ,$273.00 ,$146.73 ,$139.23 ,$150.15 ,$58.69 ,$76.44 ,$133.77 ,$58.69 ,$159.71 ,$58.69 ,$148.24 ,$58.13 ,$58.69 ,$148.24 ,$111.51 ,$191.10 ,$136.50 ,$218.40 ,$146.72 ,$58.69 ,$191.10 ,$58.69 ,$163.80 ,$58.69 ,$204.75 ,$150.70 ,$135.95 ,$150.70 ,$58.69 ,$150.70 ,$191.10 ,$191.10 ,$232.05 ,$146.72 ,$189.19 ,$58.69 ,$273.00 ,$150.15 ,$58.69 ,$71.80 ,$273.00 , N/A , N/A ,$61.62 ,$218.40 ,$148.24 ,$76.44 ,$245.70 ,$103.74 ,$273.00 ,$58.69 ,$131.04 
ST. MARY'S HOSPITAL - DECATUR,33500014,96521,HC REFILLING/MAINTENANCE PORTABLE PUMP,335,1 ,$436.00 ,$283.40 ,$79.74 ,$484.13 ,$484.13 ,$222.36 ,$239.80 ,$193.65 ,$122.08 ,$213.64 ,$193.65 ,$255.06 ,$193.65 ,$236.75 ,$272.63 ,$193.65 ,$236.75 ,$367.93 ,$305.20 ,$218.00 ,$348.80 ,$484.12 ,$193.65 ,$305.20 ,$193.65 ,$261.60 ,$193.65 ,$327.00 ,$240.67 ,$217.13 ,$240.67 ,$193.65 ,$240.67 ,$305.20 ,$305.20 ,$370.60 ,$436.00 ,$302.15 ,$193.65 ,$436.00 ,$239.80 ,$193.65 ,$114.67 ,$436.00 ,$83.53 ,$79.74 ,$203.33 ,$348.80 ,$236.75 ,$122.08 ,$392.40 ,$165.68 ,$436.00 ,$193.65 ,$209.28 
ST. MARY'S HOSPITAL - DECATUR,33500025,96542,HC CHEMOTHERAPY INJECTION SUBARACHNOID OR INTRAVENTRICULAR,335,1 ,$539.00 ,$350.35 ,$83.49 ,$539.00 ,$484.13 ,$274.89 ,$296.45 ,$193.65 ,$150.92 ,$264.11 ,$193.65 ,$315.32 ,$193.65 ,$292.68 ,$83.49 ,$193.65 ,$292.68 ,$367.93 ,$377.30 ,$269.50 ,$431.20 ,$484.12 ,$193.65 ,$377.30 ,$193.65 ,$323.40 ,$193.65 ,$404.25 ,$297.53 ,$268.42 ,$297.53 ,$193.65 ,$297.53 ,$377.30 ,$377.30 ,$458.15 ,$484.12 ,$373.53 ,$193.65 ,$539.00 ,$296.45 ,$193.65 ,$141.76 ,$539.00 , N/A , N/A ,$203.33 ,$431.20 ,$292.68 ,$150.92 ,$485.10 ,$204.82 ,$539.00 ,$193.65 ,$258.72 
ST. MARY'S HOSPITAL - DECATUR,33500026,96549,HC CHEMO ADMIN PROLONGED WITH PUMP,335,1 ,$376.00 ,$244.40 ,$37.88 ,$376.00 ,$94.70 ,$191.76 ,$206.80 ,$37.88 ,$105.28 ,$176.72 ,$37.88 ,$203.04 ,$37.88 ,$204.17 ,$150.40 ,$37.88 ,$204.17 ,$71.97 ,$263.20 ,$188.00 ,$300.80 ,$94.70 ,$37.88 ,$263.20 ,$37.88 ,$225.60 ,$37.88 ,$282.00 ,$207.55 ,$187.25 ,$207.55 ,$37.88 ,$207.55 ,$263.20 ,$263.20 ,$319.60 ,$94.70 ,$260.57 ,$37.88 ,$376.00 ,$206.80 ,$37.88 ,$98.89 ,$376.00 ,$218.85 ,$208.90 ,$39.77 ,$300.80 ,$204.17 ,$105.28 ,$338.40 ,$142.88 ,$376.00 ,$37.88 ,$180.48 
ST. MARY'S HOSPITAL - DECATUR,34000002,78012,HC THYROID UPTAKE SGL/MULT 78012,340,1 ,$444.00 ,$288.60 ,$103.16 ,$892.08 ,$892.08 ,$134.69 ,$244.20 ,$356.83 ,$124.32 ,$217.56 ,$356.83 ,$259.74 ,$356.83 ,$241.09 ,$151.89 ,$356.83 ,$241.09 ,$444.00 ,$310.80 ,$222.00 ,$355.20 ,$892.08 ,$356.83 ,$310.80 ,$356.83 ,$266.40 ,$356.83 ,$333.00 ,$245.09 ,$221.11 ,$245.09 ,$356.83 ,$245.09 ,$103.16 ,$103.16 ,$377.40 ,$444.00 ,$307.69 ,$356.83 ,$444.00 ,$244.20 ,$356.83 ,$116.77 ,$444.00 ,$294.36 ,$280.98 ,$374.67 ,$355.20 ,$241.09 ,$124.32 ,$399.60 ,$168.72 ,$444.00 ,$356.83 ,$213.12 
ST. MARY'S HOSPITAL - DECATUR,34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,296.00 ",$842.40 ,$280.98 ,"$1,296.00 ",$892.08 ,$399.08 ,$712.80 ,$356.83 ,$362.88 ,$635.04 ,$356.83 ,$758.16 ,$356.83 ,$703.73 ,$457.89 ,$356.83 ,$703.73 ,$677.98 ,$907.20 ,$648.00 ,"$1,036.80 ",$892.08 ,$356.83 ,$907.20 ,$356.83 ,$777.60 ,$356.83 ,$972.00 ,$715.39 ,$645.41 ,$715.39 ,$356.83 ,$715.39 ,$310.97 ,$310.97 ,"$1,101.60 ",$892.08 ,$898.13 ,$356.83 ,"$1,296.00 ",$712.80 ,$356.83 ,$340.85 ,"$1,296.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,036.80 ",$703.73 ,$362.88 ,"$1,166.40 ",$492.48 ,"$1,296.00 ",$356.83 ,$622.08 
ST. MARY'S HOSPITAL - DECATUR,34000006,78013,HC NM THYROID SCAN,340,1 ,"$1,043.00 ",$677.95 ,$249.86 ,"$1,043.00 ",$892.08 ,$273.69 ,$573.65 ,$356.83 ,$292.04 ,$511.07 ,$356.83 ,$610.16 ,$356.83 ,$566.35 ,$367.92 ,$356.83 ,$566.35 ,$677.98 ,$730.10 ,$521.50 ,$834.40 ,$892.08 ,$356.83 ,$730.10 ,$356.83 ,$625.80 ,$356.83 ,$782.25 ,$575.74 ,$519.41 ,$575.74 ,$356.83 ,$575.74 ,$249.86 ,$249.86 ,$886.55 ,$892.08 ,$722.80 ,$356.83 ,"$1,043.00 ",$573.65 ,$356.83 ,$274.31 ,"$1,043.00 ",$294.36 ,$280.98 ,$374.67 ,$834.40 ,$566.35 ,$292.04 ,$938.70 ,$396.34 ,"$1,043.00 ",$356.83 ,$500.64 
ST. MARY'S HOSPITAL - DECATUR,34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$1,569.00 ","$1,019.85 ",$250.77 ,"$1,569.00 ",$892.08 ,$425.09 ,$862.95 ,$356.83 ,$439.32 ,$768.81 ,$356.83 ,$917.87 ,$356.83 ,$851.97 ,$549.33 ,$356.83 ,$851.97 ,$677.98 ,"$1,098.30 ",$784.50 ,"$1,255.20 ",$892.08 ,$356.83 ,"$1,098.30 ",$356.83 ,$941.40 ,$356.83 ,"$1,176.75 ",$866.09 ,$781.36 ,$866.09 ,$356.83 ,$866.09 ,$373.07 ,$373.07 ,"$1,333.65 ",$892.08 ,"$1,087.32 ",$356.83 ,"$1,569.00 ",$862.95 ,$356.83 ,$412.65 ,"$1,569.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,255.20 ",$851.97 ,$439.32 ,"$1,412.10 ",$596.22 ,"$1,569.00 ",$356.83 ,$753.12 
ST. MARY'S HOSPITAL - DECATUR,34000011,78104,HC BONE MARROW IMAGING WHOLE BODY,340,1 ,"$1,494.00 ",$971.10 ,$280.98 ,"$1,494.00 ",$892.08 ,$397.85 ,$821.70 ,$356.83 ,$418.32 ,$732.06 ,$356.83 ,$873.99 ,$356.83 ,$811.24 ,$443.26 ,$356.83 ,$811.24 ,$677.98 ,"$1,045.80 ",$747.00 ,"$1,195.20 ",$892.08 ,$356.83 ,"$1,045.80 ",$356.83 ,$896.40 ,$356.83 ,"$1,120.50 ",$824.69 ,$744.01 ,$824.69 ,$356.83 ,$824.69 ,$301.04 ,$301.04 ,"$1,269.90 ",$892.08 ,"$1,035.34 ",$356.83 ,"$1,494.00 ",$821.70 ,$356.83 ,$392.92 ,"$1,494.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,195.20 ",$811.24 ,$418.32 ,"$1,344.60 ",$567.72 ,"$1,494.00 ",$356.83 ,$717.12 
ST. MARY'S HOSPITAL - DECATUR,34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$2,070.00 ","$1,345.50 ",$280.98 ,"$2,070.00 ","$1,158.08 ",$510.57 ,"$1,138.50 ",$463.23 ,$579.60 ,"$1,014.30 ",$463.23 ,"$1,210.95 ",$463.23 ,"$1,124.01 ",$630.03 ,$463.23 ,"$1,124.01 ",$880.13 ,"$1,449.00 ","$1,035.00 ","$1,656.00 ","$1,158.07 ",$463.23 ,"$1,449.00 ",$463.23 ,"$1,242.00 ",$463.23 ,"$1,552.50 ","$1,142.64 ","$1,030.86 ","$1,142.64 ",$463.23 ,"$1,142.64 ",$427.88 ,$427.88 ,"$1,759.50 ","$1,158.07 ","$1,434.51 ",$463.23 ,"$2,070.00 ","$1,138.50 ",$463.23 ,$544.41 ,"$2,070.00 ",$294.36 ,$280.98 ,$486.39 ,"$1,656.00 ","$1,124.01 ",$579.60 ,"$1,863.00 ",$786.60 ,"$2,070.00 ",$463.23 ,$993.60 
ST. MARY'S HOSPITAL - DECATUR,34000019,78215,HC LIVER SPLEEN STATIC,340,1 ,"$1,609.00 ","$1,045.85 ",$244.89 ,"$1,609.00 ",$892.08 ,$324.16 ,$884.95 ,$356.83 ,$450.52 ,$788.41 ,$356.83 ,$941.27 ,$356.83 ,$873.69 ,$360.60 ,$356.83 ,$873.69 ,$677.98 ,"$1,126.30 ",$804.50 ,"$1,287.20 ",$892.08 ,$356.83 ,"$1,126.30 ",$356.83 ,$965.40 ,$356.83 ,"$1,206.75 ",$888.17 ,$801.28 ,$888.17 ,$356.83 ,$888.17 ,$244.89 ,$244.89 ,"$1,367.65 ",$892.08 ,"$1,115.04 ",$356.83 ,"$1,609.00 ",$884.95 ,$356.83 ,$423.17 ,"$1,609.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,287.20 ",$873.69 ,$450.52 ,"$1,448.10 ",$611.42 ,"$1,609.00 ",$356.83 ,$772.32 
ST. MARY'S HOSPITAL - DECATUR,34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$1,280.00 ",$832.00 ,$280.98 ,"$1,280.00 ",$892.08 ,$573.12 ,$704.00 ,$356.83 ,$358.40 ,$627.20 ,$356.83 ,$748.80 ,$356.83 ,$695.04 ,$621.25 ,$356.83 ,$695.04 ,$677.98 ,$896.00 ,$640.00 ,"$1,024.00 ",$892.08 ,$356.83 ,$896.00 ,$356.83 ,$768.00 ,$356.83 ,$960.00 ,$706.56 ,$637.44 ,$706.56 ,$356.83 ,$706.56 ,$421.91 ,$421.91 ,"$1,088.00 ",$892.08 ,$887.04 ,$356.83 ,"$1,280.00 ",$704.00 ,$356.83 ,$336.64 ,"$1,280.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,024.00 ",$695.04 ,$358.40 ,"$1,152.00 ",$486.40 ,"$1,280.00 ",$356.83 ,$614.40 
ST. MARY'S HOSPITAL - DECATUR,34000025,78262,HC GASTROESOPHAGEAL REFLUX,340,1 ,"$1,244.00 ",$808.60 ,$280.98 ,"$1,244.00 ",$892.08 ,$412.72 ,$684.20 ,$356.83 ,$348.32 ,$609.56 ,$356.83 ,$727.74 ,$356.83 ,$675.49 ,$440.34 ,$356.83 ,$675.49 ,$677.98 ,$870.80 ,$622.00 ,$995.20 ,$892.08 ,$356.83 ,$870.80 ,$356.83 ,$746.40 ,$356.83 ,$933.00 ,$686.69 ,$619.51 ,$686.69 ,$356.83 ,$686.69 ,$299.04 ,$299.04 ,"$1,057.40 ",$892.08 ,$862.09 ,$356.83 ,"$1,244.00 ",$684.20 ,$356.83 ,$327.17 ,"$1,244.00 ",$294.36 ,$280.98 ,$374.67 ,$995.20 ,$675.49 ,$348.32 ,"$1,119.60 ",$472.72 ,"$1,244.00 ",$356.83 ,$597.12 
ST. MARY'S HOSPITAL - DECATUR,34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$2,229.00 ","$1,448.85 ",$280.98 ,"$2,229.00 ",$892.08 ,$468.45 ,"$1,225.95 ",$356.83 ,$624.12 ,"$1,092.21 ",$356.83 ,"$1,303.97 ",$356.83 ,"$1,210.35 ",$626.37 ,$356.83 ,"$1,210.35 ",$677.98 ,"$1,560.30 ","$1,114.50 ","$1,783.20 ",$892.08 ,$356.83 ,"$1,560.30 ",$356.83 ,"$1,337.40 ",$356.83 ,"$1,671.75 ","$1,230.41 ","$1,110.04 ","$1,230.41 ",$356.83 ,"$1,230.41 ",$425.39 ,$425.39 ,"$1,894.65 ",$892.08 ,"$1,544.70 ",$356.83 ,"$2,229.00 ","$1,225.95 ",$356.83 ,$586.23 ,"$2,229.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,783.20 ","$1,210.35 ",$624.12 ,"$2,006.10 ",$847.02 ,"$2,229.00 ",$356.83 ,"$1,069.92 "
ST. MARY'S HOSPITAL - DECATUR,34000027,78278,HC GI BLEED SCAN,340,1 ,"$1,938.00 ","$1,259.70 ",$280.98 ,"$1,938.00 ",$892.08 ,$467.55 ,"$1,065.90 ",$356.83 ,$542.64 ,$949.62 ,$356.83 ,"$1,133.73 ",$356.83 ,"$1,052.33 ",$635.15 ,$356.83 ,"$1,052.33 ",$677.98 ,"$1,356.60 ",$969.00 ,"$1,550.40 ",$892.08 ,$356.83 ,"$1,356.60 ",$356.83 ,"$1,162.80 ",$356.83 ,"$1,453.50 ","$1,069.78 ",$965.12 ,"$1,069.78 ",$356.83 ,"$1,069.78 ",$431.36 ,$431.36 ,"$1,647.30 ",$892.08 ,"$1,343.03 ",$356.83 ,"$1,938.00 ","$1,065.90 ",$356.83 ,$509.69 ,"$1,938.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,550.40 ","$1,052.33 ",$542.64 ,"$1,744.20 ",$736.44 ,"$1,938.00 ",$356.83 ,$930.24 
ST. MARY'S HOSPITAL - DECATUR,34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,561.00 ","$1,014.65 ",$250.77 ,"$1,561.00 ",$892.08 ,$467.55 ,$858.55 ,$356.83 ,$437.08 ,$764.89 ,$356.83 ,$913.19 ,$356.83 ,$847.62 ,$628.57 ,$356.83 ,$847.62 ,$677.98 ,"$1,092.70 ",$780.50 ,"$1,248.80 ",$892.08 ,$356.83 ,"$1,092.70 ",$356.83 ,$936.60 ,$356.83 ,"$1,170.75 ",$861.67 ,$777.38 ,$861.67 ,$356.83 ,$861.67 ,$426.89 ,$426.89 ,"$1,326.85 ",$892.08 ,"$1,081.77 ",$356.83 ,"$1,561.00 ",$858.55 ,$356.83 ,$410.54 ,"$1,561.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,248.80 ",$847.62 ,$437.08 ,"$1,404.90 ",$593.18 ,"$1,561.00 ",$356.83 ,$749.28 
ST. MARY'S HOSPITAL - DECATUR,34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,229.00 ",$798.85 ,$250.77 ,"$1,229.00 ",$892.08 ,$284.51 ,$675.95 ,$356.83 ,$344.12 ,$602.21 ,$356.83 ,$718.97 ,$356.83 ,$667.35 ,$421.09 ,$356.83 ,$667.35 ,$677.98 ,$860.30 ,$614.50 ,$983.20 ,$892.08 ,$356.83 ,$860.30 ,$356.83 ,$737.40 ,$356.83 ,$921.75 ,$678.41 ,$612.04 ,$678.41 ,$356.83 ,$678.41 ,$285.98 ,$285.98 ,"$1,044.65 ",$892.08 ,$851.70 ,$356.83 ,"$1,229.00 ",$675.95 ,$356.83 ,$323.23 ,"$1,229.00 ",$262.71 ,$250.77 ,$374.67 ,$983.20 ,$667.35 ,$344.12 ,"$1,106.10 ",$467.02 ,"$1,229.00 ",$356.83 ,$589.92 
ST. MARY'S HOSPITAL - DECATUR,34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,404.00 ",$912.60 ,$250.77 ,"$1,404.00 ",$892.08 ,$373.07 ,$772.20 ,$356.83 ,$393.12 ,$687.96 ,$356.83 ,$821.34 ,$356.83 ,$762.37 ,$506.17 ,$356.83 ,$762.37 ,$677.98 ,$982.80 ,$702.00 ,"$1,123.20 ",$892.08 ,$356.83 ,$982.80 ,$356.83 ,$842.40 ,$356.83 ,"$1,053.00 ",$775.01 ,$699.19 ,$775.01 ,$356.83 ,$775.01 ,$343.76 ,$343.76 ,"$1,193.40 ",$892.08 ,$972.97 ,$356.83 ,"$1,404.00 ",$772.20 ,$356.83 ,$369.25 ,"$1,404.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,123.20 ",$762.37 ,$393.12 ,"$1,263.60 ",$533.52 ,"$1,404.00 ",$356.83 ,$673.92 
ST. MARY'S HOSPITAL - DECATUR,34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$1,825.00 ","$1,186.25 ",$250.77 ,"$1,825.00 ",$892.08 ,$397.24 ,"$1,003.75 ",$356.83 ,$511.00 ,$894.25 ,$356.83 ,"$1,067.63 ",$356.83 ,$990.98 ,$550.06 ,$356.83 ,$990.98 ,$677.98 ,"$1,277.50 ",$912.50 ,"$1,460.00 ",$892.08 ,$356.83 ,"$1,277.50 ",$356.83 ,"$1,095.00 ",$356.83 ,"$1,368.75 ","$1,007.40 ",$908.85 ,"$1,007.40 ",$356.83 ,"$1,007.40 ",$373.56 ,$373.56 ,"$1,551.25 ",$892.08 ,"$1,264.73 ",$356.83 ,"$1,825.00 ","$1,003.75 ",$356.83 ,$479.98 ,"$1,825.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,460.00 ",$990.98 ,$511.00 ,"$1,642.50 ",$693.50 ,"$1,825.00 ",$356.83 ,$876.00 
ST. MARY'S HOSPITAL - DECATUR,34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$1,912.00 ","$1,242.80 ",$250.77 ,"$1,912.00 ",$892.08 ,$477.74 ,"$1,051.60 ",$356.83 ,$535.36 ,$936.88 ,$356.83 ,"$1,118.52 ",$356.83 ,"$1,038.22 ",$627.10 ,$356.83 ,"$1,038.22 ",$677.98 ,"$1,338.40 ",$956.00 ,"$1,529.60 ",$892.08 ,$356.83 ,"$1,338.40 ",$356.83 ,"$1,147.20 ",$356.83 ,"$1,434.00 ","$1,055.42 ",$952.18 ,"$1,055.42 ",$356.83 ,"$1,055.42 ",$425.88 ,$425.88 ,"$1,625.20 ",$892.08 ,"$1,325.02 ",$356.83 ,"$1,912.00 ","$1,051.60 ",$356.83 ,$502.86 ,"$1,912.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,529.60 ","$1,038.22 ",$535.36 ,"$1,720.80 ",$726.56 ,"$1,912.00 ",$356.83 ,$917.76 
ST. MARY'S HOSPITAL - DECATUR,34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$3,888.00 ","$2,527.20 ",$280.98 ,"$3,888.00 ","$3,092.53 ",$537.82 ,"$2,138.40 ","$1,237.01 ","$1,088.64 ","$1,905.12 ","$1,237.01 ","$2,274.48 ","$1,237.01 ","$2,111.18 ",$575.90 ,"$1,237.01 ","$2,111.18 ","$2,350.31 ","$2,721.60 ","$1,944.00 ","$3,110.40 ","$3,092.51 ","$1,237.01 ","$2,721.60 ","$1,237.01 ","$2,332.80 ","$1,237.01 ","$2,916.00 ","$2,146.18 ","$1,936.22 ","$2,146.18 ","$1,237.01 ","$2,146.18 ",$391.11 ,$391.11 ,"$3,304.80 ","$3,092.51 ","$2,694.38 ","$1,237.01 ","$3,888.00 ","$2,138.40 ","$1,237.01 ","$1,022.54 ","$3,888.00 ",$294.36 ,$280.98 ,"$1,298.86 ","$3,110.40 ","$2,111.18 ","$1,088.64 ","$3,499.20 ","$1,477.44 ","$2,400.00 ","$1,237.01 ","$1,866.24 "
ST. MARY'S HOSPITAL - DECATUR,34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$6,411.00 ","$4,167.15 ",$565.31 ,"$6,411.00 ","$3,092.53 ",$775.91 ,"$3,526.05 ","$1,237.01 ","$1,795.08 ","$3,141.39 ","$1,237.01 ","$3,750.44 ","$1,237.01 ","$3,481.17 ",$832.39 ,"$1,237.01 ","$3,481.17 ","$2,350.31 ","$4,487.70 ","$3,205.50 ","$5,128.80 ","$3,092.51 ","$1,237.01 ","$4,487.70 ","$1,237.01 ","$3,846.60 ","$1,237.01 ","$4,808.25 ","$3,538.87 ","$3,192.68 ","$3,538.87 ","$1,237.01 ","$3,538.87 ",$565.31 ,$565.31 ,"$5,449.35 ","$3,092.51 ","$4,442.82 ","$1,237.01 ","$6,411.00 ","$3,526.05 ","$1,237.01 ","$1,686.09 ","$6,411.00 ",$644.50 ,$615.21 ,"$1,298.86 ","$5,128.80 ","$3,481.17 ","$1,795.08 ","$5,769.90 ","$2,436.18 ","$2,400.00 ","$1,237.01 ","$3,077.28 "
ST. MARY'S HOSPITAL - DECATUR,34000044,78472,HC MUGA RESTING SGL,340,1 ,"$2,079.00 ","$1,351.35 ",$250.77 ,"$2,079.00 ",$892.08 ,$350.78 ,"$1,143.45 ",$356.83 ,$582.12 ,"$1,018.71 ",$356.83 ,"$1,216.22 ",$356.83 ,"$1,128.90 ",$382.55 ,$356.83 ,"$1,128.90 ",$677.98 ,"$1,455.30 ","$1,039.50 ","$1,663.20 ",$892.08 ,$356.83 ,"$1,455.30 ",$356.83 ,"$1,247.40 ",$356.83 ,"$1,559.25 ","$1,147.61 ","$1,035.34 ","$1,147.61 ",$356.83 ,"$1,147.61 ",$259.80 ,$259.80 ,"$1,767.15 ",$892.08 ,"$1,440.75 ",$356.83 ,"$2,079.00 ","$1,143.45 ",$356.83 ,$546.78 ,"$2,079.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,663.20 ","$1,128.90 ",$582.12 ,"$1,871.10 ",$790.02 ,"$2,079.00 ",$356.83 ,$997.92 
ST. MARY'S HOSPITAL - DECATUR,34000047,78580,HC LUNG PERFUS,340,1 ,"$1,335.00 ",$867.75 ,$280.98 ,"$1,335.00 ",$892.08 ,$383.00 ,$734.25 ,$356.83 ,$373.80 ,$654.15 ,$356.83 ,$780.98 ,$356.83 ,$724.91 ,$427.17 ,$356.83 ,$724.91 ,$677.98 ,$934.50 ,$667.50 ,"$1,068.00 ",$892.08 ,$356.83 ,$934.50 ,$356.83 ,$801.00 ,$356.83 ,"$1,001.25 ",$736.92 ,$664.83 ,$736.92 ,$356.83 ,$736.92 ,$290.10 ,$290.10 ,"$1,134.75 ",$892.08 ,$925.16 ,$356.83 ,"$1,335.00 ",$734.25 ,$356.83 ,$351.11 ,"$1,335.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,068.00 ",$724.91 ,$373.80 ,"$1,201.50 ",$507.30 ,"$1,335.00 ",$356.83 ,$640.80 
ST. MARY'S HOSPITAL - DECATUR,34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$2,110.00 ","$1,371.50 ",$280.98 ,"$2,110.00 ","$1,158.08 ",$613.37 ,"$1,160.50 ",$463.23 ,$590.80 ,"$1,033.90 ",$463.23 ,"$1,234.35 ",$463.23 ,"$1,145.73 ",$596.38 ,$463.23 ,"$1,145.73 ",$880.13 ,"$1,477.00 ","$1,055.00 ","$1,688.00 ","$1,158.07 ",$463.23 ,"$1,477.00 ",$463.23 ,"$1,266.00 ",$463.23 ,"$1,582.50 ","$1,164.72 ","$1,050.78 ","$1,164.72 ",$463.23 ,"$1,164.72 ",$405.02 ,$405.02 ,"$1,793.50 ","$1,158.07 ","$1,462.23 ",$463.23 ,"$2,110.00 ","$1,160.50 ",$463.23 ,$554.93 ,"$2,110.00 ",$294.36 ,$280.98 ,$486.39 ,"$1,688.00 ","$1,145.73 ",$590.80 ,"$1,899.00 ",$801.80 ,"$2,110.00 ",$463.23 ,"$1,012.80 "
ST. MARY'S HOSPITAL - DECATUR,34000052,78579,HC LUNG SCAN-VENTILATION,340,1 ,"$1,475.00 ",$958.75 ,$232.82 ,"$1,475.00 ",$892.08 ,$361.64 ,$811.25 ,$356.83 ,$413.00 ,$722.75 ,$356.83 ,$862.88 ,$356.83 ,$800.93 ,$342.81 ,$356.83 ,$800.93 ,$677.98 ,"$1,032.50 ",$737.50 ,"$1,180.00 ",$892.08 ,$356.83 ,"$1,032.50 ",$356.83 ,$885.00 ,$356.83 ,"$1,106.25 ",$814.20 ,$734.55 ,$814.20 ,$356.83 ,$814.20 ,$232.82 ,$232.82 ,"$1,253.75 ",$892.08 ,"$1,022.18 ",$356.83 ,"$1,475.00 ",$811.25 ,$356.83 ,$387.93 ,"$1,475.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,180.00 ",$800.93 ,$413.00 ,"$1,327.50 ",$560.50 ,"$1,475.00 ",$356.83 ,$708.00 
ST. MARY'S HOSPITAL - DECATUR,34000054,78606,HC BRAIN SC W/VASCULAR FLOW > 4 VIEWS,340,1 ,"$2,313.00 ","$1,503.45 ",$250.77 ,"$2,313.00 ","$1,158.08 ",$570.65 ,"$1,272.15 ",$463.23 ,$647.64 ,"$1,133.37 ",$463.23 ,"$1,353.11 ",$463.23 ,"$1,255.96 ",$630.76 ,$463.23 ,"$1,255.96 ",$880.13 ,"$1,619.10 ","$1,156.50 ","$1,850.40 ","$1,158.07 ",$463.23 ,"$1,619.10 ",$463.23 ,"$1,387.80 ",$463.23 ,"$1,734.75 ","$1,276.78 ","$1,151.87 ","$1,276.78 ",$463.23 ,"$1,276.78 ",$428.37 ,$428.37 ,"$1,966.05 ","$1,158.07 ","$1,602.91 ",$463.23 ,"$2,313.00 ","$1,272.15 ",$463.23 ,$608.32 ,"$2,313.00 ",$262.71 ,$250.77 ,$486.39 ,"$1,850.40 ","$1,255.96 ",$647.64 ,"$2,081.70 ",$878.94 ,"$2,313.00 ",$463.23 ,"$1,110.24 "
ST. MARY'S HOSPITAL - DECATUR,34000056,78630,HC CISTERNOGRAPHY,340,1 ,"$2,305.00 ","$1,498.25 ",$280.98 ,"$2,305.00 ","$1,158.08 ",$589.84 ,"$1,267.75 ",$463.23 ,$645.40 ,"$1,129.45 ",$463.23 ,"$1,348.43 ",$463.23 ,"$1,251.62 ",$643.20 ,$463.23 ,"$1,251.62 ",$880.13 ,"$1,613.50 ","$1,152.50 ","$1,844.00 ","$1,158.07 ",$463.23 ,"$1,613.50 ",$463.23 ,"$1,383.00 ",$463.23 ,"$1,728.75 ","$1,272.36 ","$1,147.89 ","$1,272.36 ",$463.23 ,"$1,272.36 ",$436.82 ,$436.82 ,"$1,959.25 ","$1,158.07 ","$1,597.37 ",$463.23 ,"$2,305.00 ","$1,267.75 ",$463.23 ,$606.22 ,"$2,305.00 ",$294.36 ,$280.98 ,$486.39 ,"$1,844.00 ","$1,251.62 ",$645.40 ,"$2,074.50 ",$875.90 ,"$2,305.00 ",$463.23 ,"$1,106.40 "
ST. MARY'S HOSPITAL - DECATUR,34000058,78650,HC CSF LEAK DETECTION,340,1 ,"$1,511.00 ",$982.15 ,$250.77 ,"$3,092.53 ","$3,092.53 ",$574.36 ,$831.05 ,"$1,237.01 ",$423.08 ,$740.39 ,"$1,237.01 ",$883.94 ,"$1,237.01 ",$820.47 ,$525.42 ,"$1,237.01 ",$820.47 ,"$1,511.00 ","$1,057.70 ",$755.50 ,"$1,208.80 ","$3,092.51 ","$1,237.01 ","$1,057.70 ","$1,237.01 ",$906.60 ,"$1,237.01 ","$1,133.25 ",$834.07 ,$752.48 ,$834.07 ,"$1,237.01 ",$834.07 ,$356.84 ,$356.84 ,"$1,284.35 ","$1,511.00 ","$1,047.12 ","$1,237.01 ","$1,511.00 ",$831.05 ,"$1,237.01 ",$397.39 ,"$1,511.00 ",$262.71 ,$250.77 ,"$1,298.86 ","$1,208.80 ",$820.47 ,$423.08 ,"$1,359.90 ",$574.18 ,"$1,511.00 ","$1,237.01 ",$725.28 
ST. MARY'S HOSPITAL - DECATUR,34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$1,902.00 ","$1,236.30 ",$250.77 ,"$1,902.00 ","$1,158.08 ",$351.41 ,"$1,046.10 ",$463.23 ,$532.56 ,$931.98 ,$463.23 ,"$1,112.67 ",$463.23 ,"$1,032.79 ",$393.52 ,$463.23 ,"$1,032.79 ",$880.13 ,"$1,331.40 ",$951.00 ,"$1,521.60 ","$1,158.07 ",$463.23 ,"$1,331.40 ",$463.23 ,"$1,141.20 ",$463.23 ,"$1,426.50 ","$1,049.90 ",$947.20 ,"$1,049.90 ",$463.23 ,"$1,049.90 ",$267.26 ,$267.26 ,"$1,616.70 ","$1,158.07 ","$1,318.09 ",$463.23 ,"$1,902.00 ","$1,046.10 ",$463.23 ,$500.23 ,"$1,902.00 ",$262.71 ,$250.77 ,$486.39 ,"$1,521.60 ","$1,032.79 ",$532.56 ,"$1,711.80 ",$722.76 ,"$1,902.00 ",$463.23 ,$912.96 
ST. MARY'S HOSPITAL - DECATUR,34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$1,902.00 ","$1,236.30 ",$170.04 ,"$1,902.00 ","$1,158.08 ",$217.01 ,"$1,046.10 ",$463.23 ,$532.56 ,$931.98 ,$463.23 ,"$1,112.67 ",$463.23 ,"$1,032.79 ",$250.37 ,$463.23 ,"$1,032.79 ",$880.13 ,"$1,331.40 ",$951.00 ,"$1,521.60 ","$1,158.07 ",$463.23 ,"$1,331.40 ",$463.23 ,"$1,141.20 ",$463.23 ,"$1,426.50 ","$1,049.90 ",$947.20 ,"$1,049.90 ",$463.23 ,"$1,049.90 ",$170.04 ,$170.04 ,"$1,616.70 ","$1,158.07 ","$1,318.09 ",$463.23 ,"$1,902.00 ","$1,046.10 ",$463.23 ,$500.23 ,"$1,902.00 ",$262.71 ,$250.77 ,$486.39 ,"$1,521.60 ","$1,032.79 ",$532.56 ,"$1,711.80 ",$722.76 ,"$1,902.00 ",$463.23 ,$912.96 
ST. MARY'S HOSPITAL - DECATUR,34000067,78761,HC TESTICULAR IMAG W/FLOW,340,1 ,"$1,193.00 ",$775.45 ,$250.77 ,"$1,193.00 ",$892.08 ,$343.35 ,$656.15 ,$356.83 ,$334.04 ,$584.57 ,$356.83 ,$697.91 ,$356.83 ,$647.80 ,$371.57 ,$356.83 ,$647.80 ,$677.98 ,$835.10 ,$596.50 ,$954.40 ,$892.08 ,$356.83 ,$835.10 ,$356.83 ,$715.80 ,$356.83 ,$894.75 ,$658.54 ,$594.11 ,$658.54 ,$356.83 ,$658.54 ,$252.35 ,$252.35 ,"$1,014.05 ",$892.08 ,$826.75 ,$356.83 ,"$1,193.00 ",$656.15 ,$356.83 ,$313.76 ,"$1,193.00 ",$262.71 ,$250.77 ,$374.67 ,$954.40 ,$647.80 ,$334.04 ,"$1,073.70 ",$453.34 ,"$1,193.00 ",$356.83 ,$572.64 
ST. MARY'S HOSPITAL - DECATUR,34000068,78800,HC TUMOR LOCAL LIMITED,340,1 ,"$2,300.00 ","$1,495.00 ",$231.48 ,"$2,300.00 ",$892.08 ,$298.15 ,"$1,265.00 ",$356.83 ,$644.00 ,"$1,127.00 ",$356.83 ,"$1,345.50 ",$356.83 ,"$1,248.90 ",$340.85 ,$356.83 ,"$1,248.90 ",$677.98 ,"$1,610.00 ","$1,150.00 ","$1,840.00 ",$892.08 ,$356.83 ,"$1,610.00 ",$356.83 ,"$1,380.00 ",$356.83 ,"$1,725.00 ","$1,269.60 ","$1,145.40 ","$1,269.60 ",$356.83 ,"$1,269.60 ",$231.48 ,$231.48 ,"$1,955.00 ",$892.08 ,"$1,593.90 ",$356.83 ,"$2,300.00 ","$1,265.00 ",$356.83 ,$604.90 ,"$2,300.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,840.00 ","$1,248.90 ",$644.00 ,"$2,070.00 ",$874.00 ,"$2,300.00 ",$356.83 ,"$1,104.00 "
ST. MARY'S HOSPITAL - DECATUR,34000069,78801,HC TUMOR LOCAL MULTIPLE,340,1 ,"$2,852.00 ","$1,853.80 ",$280.98 ,"$2,852.00 ",$892.08 ,$389.18 ,"$1,568.60 ",$356.83 ,$798.56 ,"$1,397.48 ",$356.83 ,"$1,668.42 ",$356.83 ,"$1,548.64 ",$461.55 ,$356.83 ,"$1,548.64 ",$677.98 ,"$1,996.40 ","$1,426.00 ","$2,281.60 ",$892.08 ,$356.83 ,"$1,996.40 ",$356.83 ,"$1,711.20 ",$356.83 ,"$2,139.00 ","$1,574.30 ","$1,420.30 ","$1,574.30 ",$356.83 ,"$1,574.30 ",$313.46 ,$313.46 ,"$2,424.20 ",$892.08 ,"$1,976.44 ",$356.83 ,"$2,852.00 ","$1,568.60 ",$356.83 ,$750.08 ,"$2,852.00 ",$294.36 ,$280.98 ,$374.67 ,"$2,281.60 ","$1,548.64 ",$798.56 ,"$2,566.80 ","$1,083.76 ","$2,400.00 ",$356.83 ,"$1,368.96 "
ST. MARY'S HOSPITAL - DECATUR,34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$3,642.00 ","$2,367.30 ",$414.47 ,"$3,642.00 ","$3,092.53 ",$547.72 ,"$2,003.10 ","$1,237.01 ","$1,019.76 ","$1,784.58 ","$1,237.01 ","$2,130.57 ","$1,237.01 ","$1,977.61 ",$610.28 ,"$1,237.01 ","$1,977.61 ","$2,350.31 ","$2,549.40 ","$1,821.00 ","$2,913.60 ","$3,092.51 ","$1,237.01 ","$2,549.40 ","$1,237.01 ","$2,185.20 ","$1,237.01 ","$2,731.50 ","$2,010.38 ","$1,813.72 ","$2,010.38 ","$1,237.01 ","$2,010.38 ",$414.47 ,$414.47 ,"$3,095.70 ","$3,092.51 ","$2,523.91 ","$1,237.01 ","$3,642.00 ","$2,003.10 ","$1,237.01 ",$957.85 ,"$3,642.00 ",$644.50 ,$615.21 ,"$1,298.86 ","$2,913.60 ","$1,977.61 ","$1,019.76 ","$3,277.80 ","$1,383.96 ","$2,400.00 ","$1,237.01 ","$1,748.16 "
ST. MARY'S HOSPITAL - DECATUR,34000075,78803,HC TUMOR IMAGING (SPECT) OCTREO,340,1 ,"$3,642.00 ","$2,367.30 ",$414.47 ,"$3,642.00 ","$3,092.53 ",$547.72 ,"$2,003.10 ","$1,237.01 ","$1,019.76 ","$1,784.58 ","$1,237.01 ","$2,130.57 ","$1,237.01 ","$1,977.61 ",$610.28 ,"$1,237.01 ","$1,977.61 ","$2,350.31 ","$2,549.40 ","$1,821.00 ","$2,913.60 ","$3,092.51 ","$1,237.01 ","$2,549.40 ","$1,237.01 ","$2,185.20 ","$1,237.01 ","$2,731.50 ","$2,010.38 ","$1,813.72 ","$2,010.38 ","$1,237.01 ","$2,010.38 ",$414.47 ,$414.47 ,"$3,095.70 ","$3,092.51 ","$2,523.91 ","$1,237.01 ","$3,642.00 ","$2,003.10 ","$1,237.01 ",$957.85 ,"$3,642.00 ",$644.50 ,$615.21 ,"$1,298.86 ","$2,913.60 ","$1,977.61 ","$1,019.76 ","$3,277.80 ","$1,383.96 ","$2,400.00 ","$1,237.01 ","$1,748.16 "
ST. MARY'S HOSPITAL - DECATUR,34000077,78804,HC TUMOR/INF-WHOLE BODY-MULT DAY,340,1 ,"$3,642.00 ","$2,367.30 ",$615.21 ,"$3,642.00 ","$3,092.53 ",$977.49 ,"$2,003.10 ","$1,237.01 ","$1,019.76 ","$1,784.58 ","$1,237.01 ","$2,130.57 ","$1,237.01 ","$1,977.61 ","$1,091.58 ","$1,237.01 ","$1,977.61 ","$2,350.31 ","$2,549.40 ","$1,821.00 ","$2,913.60 ","$3,092.51 ","$1,237.01 ","$2,549.40 ","$1,237.01 ","$2,185.20 ","$1,237.01 ","$2,731.50 ","$2,010.38 ","$1,813.72 ","$2,010.38 ","$1,237.01 ","$2,010.38 ",$741.33 ,$741.33 ,"$3,095.70 ","$3,092.51 ","$2,523.91 ","$1,237.01 ","$3,642.00 ","$2,003.10 ","$1,237.01 ",$957.85 ,"$3,642.00 ",$644.50 ,$615.21 ,"$1,298.86 ","$2,913.60 ","$1,977.61 ","$1,019.76 ","$3,277.80 ","$1,383.96 ","$2,400.00 ","$1,237.01 ","$1,748.16 "
ST. MARY'S HOSPITAL - DECATUR,34000081,79005,HC NM RADIOPAHARM THRPY ORAL,340,1 ,"$4,217.00 ","$2,741.05 ",$70.37 ,"$4,217.00 ",$598.80 ,$90.72 ,"$2,319.35 ",$239.52 ,"$1,180.76 ",$708.55 ,$239.52 ,$708.55 ,$239.52 ,"$2,289.83 ",$103.60 ,$239.52 ,"$2,289.83 ",$455.09 ,"$2,951.90 ","$2,108.50 ","$3,373.60 ",$598.80 ,$239.52 ,"$2,951.90 ",$239.52 ,"$2,530.20 ",$239.52 ,"$3,162.75 ","$2,327.78 ","$2,100.07 ","$2,327.78 ",$239.52 ,"$2,327.78 ",$70.37 ,$70.37 ,"$3,584.45 ",$598.80 ,"$2,922.38 ",$239.52 ,"$4,217.00 ","$2,319.35 ",$239.52 ,"$1,109.07 ","$4,217.00 ",$213.79 ,$204.07 ,$251.50 ,"$3,373.60 ","$2,289.83 ","$1,180.76 ","$3,795.30 ","$1,602.46 ","$2,400.00 ",$239.52 ,"$2,024.16 "
ST. MARY'S HOSPITAL - DECATUR,34000083,79101,HC NM RADIOPAHARM THRPY IV,340,1 ,"$1,646.00 ","$1,069.90 ",$69.71 ,"$1,646.00 ",$598.80 ,$93.80 ,$905.30 ,$239.52 ,$460.88 ,$694.29 ,$239.52 ,$694.29 ,$239.52 ,$893.78 ,$102.64 ,$239.52 ,$893.78 ,$455.09 ,"$1,152.20 ",$823.00 ,"$1,316.80 ",$598.80 ,$239.52 ,"$1,152.20 ",$239.52 ,$987.60 ,$239.52 ,"$1,234.50 ",$908.59 ,$819.71 ,$908.59 ,$239.52 ,$908.59 ,$69.71 ,$69.71 ,"$1,399.10 ",$598.80 ,"$1,140.68 ",$239.52 ,"$1,646.00 ",$905.30 ,$239.52 ,$432.90 ,"$1,646.00 ",$213.79 ,$204.07 ,$251.50 ,"$1,316.80 ",$893.78 ,$460.88 ,"$1,481.40 ",$625.48 ,"$1,646.00 ",$239.52 ,$790.08 
ST. MARY'S HOSPITAL - DECATUR,34000090,78597,HC PULM PERF DIFF W/IMG,340,1 ,"$2,008.00 ","$1,305.20 ",$237.78 ,"$2,008.00 ",$892.08 ,$378.36 ,"$1,104.40 ",$356.83 ,$562.24 ,$983.92 ,$356.83 ,"$1,174.68 ",$356.83 ,"$1,090.34 ",$350.13 ,$356.83 ,"$1,090.34 ",$677.98 ,"$1,405.60 ","$1,004.00 ","$1,606.40 ",$892.08 ,$356.83 ,"$1,405.60 ",$356.83 ,"$1,204.80 ",$356.83 ,"$1,506.00 ","$1,108.42 ",$999.98 ,"$1,108.42 ",$356.83 ,"$1,108.42 ",$237.78 ,$237.78 ,"$1,706.80 ",$892.08 ,"$1,391.54 ",$356.83 ,"$2,008.00 ","$1,104.40 ",$356.83 ,$528.10 ,"$2,008.00 ",$294.36 ,$280.98 ,$374.67 ,"$1,606.40 ","$1,090.34 ",$562.24 ,"$1,807.20 ",$763.04 ,"$2,008.00 ",$356.83 ,$963.84 
ST. MARY'S HOSPITAL - DECATUR,34000091,78598,HC NM PULM VENT AND PERF DIFF W/IMG,340,1 ,"$2,650.00 ","$1,722.50 ",$280.98 ,"$2,650.00 ","$1,158.08 ",$587.97 ,"$1,457.50 ",$463.23 ,$742.00 ,"$1,298.50 ",$463.23 ,"$1,550.25 ",$463.23 ,"$1,438.95 ",$559.07 ,$463.23 ,"$1,438.95 ",$880.13 ,"$1,855.00 ","$1,325.00 ","$2,120.00 ","$1,158.07 ",$463.23 ,"$1,855.00 ",$463.23 ,"$1,590.00 ",$463.23 ,"$1,987.50 ","$1,462.80 ","$1,319.70 ","$1,462.80 ",$463.23 ,"$1,462.80 ",$379.68 ,$379.68 ,"$2,252.50 ","$1,158.07 ","$1,836.45 ",$463.23 ,"$2,650.00 ","$1,457.50 ",$463.23 ,$696.95 ,"$2,650.00 ",$294.36 ,$280.98 ,$486.39 ,"$2,120.00 ","$1,438.95 ",$742.00 ,"$2,385.00 ","$1,007.00 ","$2,400.00 ",$463.23 ,"$1,272.00 "
ST. MARY'S HOSPITAL - DECATUR,34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,"$2,237.00 ","$1,454.05 ",$280.98 ,"$2,237.00 ","$1,158.08 ",$573.12 ,"$1,230.35 ",$463.23 ,$626.36 ,"$1,096.13 ",$463.23 ,"$1,308.65 ",$463.23 ,"$1,214.69 ",$849.72 ,$463.23 ,"$1,214.69 ",$880.13 ,"$1,565.90 ","$1,118.50 ","$1,789.60 ","$1,158.07 ",$463.23 ,"$1,565.90 ",$463.23 ,"$1,342.20 ",$463.23 ,"$1,677.75 ","$1,234.82 ","$1,114.03 ","$1,234.82 ",$463.23 ,"$1,234.82 ",$577.07 ,$577.07 ,"$1,901.45 ","$1,158.07 ","$1,550.24 ",$463.23 ,"$2,237.00 ","$1,230.35 ",$463.23 ,$588.33 ,"$2,237.00 ",$294.36 ,$280.98 ,$486.39 ,"$1,789.60 ","$1,214.69 ",$626.36 ,"$2,013.30 ",$850.06 ,"$2,237.00 ",$463.23 ,"$1,073.76 "
ST. MARY'S HOSPITAL - DECATUR,34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$2,110.00 ","$1,371.50 ",$250.77 ,"$2,110.00 ",$892.08 ,$556.40 ,"$1,160.50 ",$356.83 ,$590.80 ,"$1,033.90 ",$356.83 ,"$1,234.35 ",$356.83 ,"$1,145.73 ",$630.03 ,$356.83 ,"$1,145.73 ",$677.98 ,"$1,477.00 ","$1,055.00 ","$1,688.00 ",$892.08 ,$356.83 ,"$1,477.00 ",$356.83 ,"$1,266.00 ",$356.83 ,"$1,582.50 ","$1,164.72 ","$1,050.78 ","$1,164.72 ",$356.83 ,"$1,164.72 ",$427.88 ,$427.88 ,"$1,793.50 ",$892.08 ,"$1,462.23 ",$356.83 ,"$2,110.00 ","$1,160.50 ",$356.83 ,$554.93 ,"$2,110.00 ",$262.71 ,$250.77 ,$374.67 ,"$1,688.00 ","$1,145.73 ",$590.80 ,"$1,899.00 ",$801.80 ,"$2,110.00 ",$356.83 ,"$1,012.80 "
ST. MARY'S HOSPITAL - DECATUR,34100007,A9538,HC NM PYROPHOSPHATE 99M VIAL,343,1 ,$205.00 ,$133.25 ,$48.00 ,$205.00 , N/A , N/A ,$112.75 , N/A ,$57.40 ,$100.45 , N/A ,$119.93 , N/A ,$111.32 ,$48.00 , N/A ,$111.32 , N/A ,$143.50 ,$102.50 ,$164.00 , N/A , N/A ,$143.50 , N/A ,$123.00 , N/A ,$153.75 ,$113.16 ,$102.09 ,$113.16 , N/A ,$113.16 ,$143.50 ,$143.50 ,$174.25 , N/A ,$142.07 , N/A ,$205.00 ,$112.75 , N/A ,$53.92 ,$205.00 , N/A , N/A , N/A ,$164.00 ,$111.32 ,$57.40 ,$184.50 ,$77.90 ,$71.38 , N/A ,$98.40 
ST. MARY'S HOSPITAL - DECATUR,34100011,78457,HC NM VENOUS TRHOMBO UNILATERAL,341,1 ,"$1,113.00 ",$723.45 ,$219.56 ,"$1,158.08 ","$1,158.08 ",$316.10 ,$612.15 ,$463.23 ,$311.64 ,$545.37 ,$463.23 ,$651.11 ,$463.23 ,$604.36 ,$323.29 ,$463.23 ,$604.36 ,$880.13 ,$779.10 ,$556.50 ,$890.40 ,"$1,158.07 ",$463.23 ,$779.10 ,$463.23 ,$667.80 ,$463.23 ,$834.75 ,$614.38 ,$554.27 ,$614.38 ,$463.23 ,$614.38 ,$219.56 ,$219.56 ,$946.05 ,"$1,113.00 ",$771.31 ,$463.23 ,"$1,113.00 ",$612.15 ,$463.23 ,$292.72 ,"$1,113.00 ",$262.71 ,$250.77 ,$486.39 ,$890.40 ,$604.36 ,$311.64 ,"$1,001.70 ",$422.94 ,"$1,113.00 ",$463.23 ,$534.24 
ST. MARY'S HOSPITAL - DECATUR,34100032,78494,HC MUGA RESTING W/SPECT,341,1 ,"$1,765.00 ","$1,147.25 ",$241.92 ,"$1,765.00 ",$892.08 ,$329.11 ,$970.75 ,$356.83 ,$494.20 ,$864.85 ,$356.83 ,"$1,032.53 ",$356.83 ,$958.40 ,$356.21 ,$356.83 ,$958.40 ,$677.98 ,"$1,235.50 ",$882.50 ,"$1,412.00 ",$892.08 ,$356.83 ,"$1,235.50 ",$356.83 ,"$1,059.00 ",$356.83 ,"$1,323.75 ",$974.28 ,$878.97 ,$974.28 ,$356.83 ,$974.28 ,$241.92 ,$241.92 ,"$1,500.25 ",$892.08 ,"$1,223.15 ",$356.83 ,"$1,765.00 ",$970.75 ,$356.83 ,$464.20 ,"$1,765.00 ",$644.50 ,$615.21 ,$374.67 ,"$1,412.00 ",$958.40 ,$494.20 ,"$1,588.50 ",$670.70 ,"$1,765.00 ",$356.83 ,$847.20 
ST. MARY'S HOSPITAL - DECATUR,34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,"$1,162.00 ",$755.30 ,$128.10 ,"$1,162.00 ", N/A , N/A ,$639.10 , N/A ,$325.36 ,$569.38 , N/A ,$679.77 , N/A ,$630.97 ,$128.10 , N/A ,$630.97 , N/A ,$813.40 ,$581.00 ,$929.60 , N/A , N/A ,$813.40 , N/A ,$697.20 , N/A ,$871.50 ,$641.42 ,$578.68 ,$641.42 , N/A ,$641.42 ,$813.40 ,$813.40 ,$987.70 , N/A ,$805.27 , N/A ,"$1,162.00 ",$639.10 , N/A ,$305.61 ,"$1,162.00 ", N/A , N/A , N/A ,$929.60 ,$630.97 ,$325.36 ,"$1,045.80 ",$441.56 ,$584.10 , N/A ,$557.76 
ST. MARY'S HOSPITAL - DECATUR,34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$367.00 ,$238.55 ,$15.60 ,$367.00 , N/A , N/A ,$201.85 , N/A ,$102.76 ,$153.35 , N/A ,$153.35 , N/A ,$199.28 ,$15.60 , N/A ,$199.28 , N/A ,$256.90 ,$183.50 ,$293.60 , N/A , N/A ,$256.90 , N/A ,$220.20 , N/A ,$275.25 ,$202.58 ,$182.77 ,$202.58 , N/A ,$202.58 ,$256.90 ,$256.90 ,$311.95 , N/A ,$254.33 , N/A ,$367.00 ,$201.85 , N/A ,$96.52 ,$367.00 , N/A , N/A , N/A ,$293.60 ,$199.28 ,$102.76 ,$330.30 ,$139.46 ,$26.83 , N/A ,$176.16 
ST. MARY'S HOSPITAL - DECATUR,34300006,A9505,HC DIAGNUCLIDE THALL 201 PER MCI,343,1 ,$433.00 ,$281.45 ,$113.88 ,$433.00 , N/A , N/A ,$238.15 , N/A ,$121.24 ,$212.17 , N/A ,$253.31 , N/A ,$235.12 ,$182.89 , N/A ,$235.12 , N/A ,$303.10 ,$216.50 ,$346.40 , N/A , N/A ,$303.10 , N/A ,$259.80 , N/A ,$324.75 ,$239.02 ,$215.63 ,$239.02 , N/A ,$239.02 ,$303.10 ,$303.10 ,$368.05 , N/A ,$300.07 , N/A ,$433.00 ,$238.15 , N/A ,$113.88 ,$433.00 , N/A , N/A , N/A ,$346.40 ,$235.12 ,$121.24 ,$389.70 ,$164.54 ,$203.28 , N/A ,$207.84 
ST. MARY'S HOSPITAL - DECATUR,34300008,A9508,HC DIAGNUCLIDE I131 PER .5 MCI,343,1 ,"$6,171.00 ","$4,011.15 ",$887.00 ,"$6,171.00 ", N/A , N/A ,"$3,394.05 ", N/A ,"$1,727.88 ","$3,023.79 ", N/A ,"$3,610.04 ", N/A ,"$3,350.85 ",$887.00 , N/A ,"$3,350.85 ", N/A ,"$4,319.70 ","$3,085.50 ","$4,936.80 ", N/A , N/A ,"$4,319.70 ", N/A ,"$3,702.60 ", N/A ,"$4,628.25 ","$3,406.39 ","$3,073.16 ","$3,406.39 ", N/A ,"$3,406.39 ","$4,319.70 ","$4,319.70 ","$5,245.35 ", N/A ,"$4,276.50 ", N/A ,"$6,171.00 ","$3,394.05 ", N/A ,"$1,622.97 ","$6,171.00 ", N/A , N/A , N/A ,"$4,936.80 ","$3,350.85 ","$1,727.88 ","$5,553.90 ","$2,344.98 ","$1,636.49 ", N/A ,"$2,962.08 "
ST. MARY'S HOSPITAL - DECATUR,34300009,A9512,HC TECHNETIUM TC99 PERTECH PER MCI,343,1 ,$143.00 ,$92.95 ,$19.42 ,$143.00 , N/A , N/A ,$78.65 , N/A ,$40.04 ,$67.21 , N/A ,$77.22 , N/A ,$77.65 ,$57.20 , N/A ,$77.65 , N/A ,$100.10 ,$71.50 ,$114.40 , N/A , N/A ,$100.10 , N/A ,$85.80 , N/A ,$107.25 ,$78.94 ,$71.21 ,$78.94 , N/A ,$78.94 ,$100.10 ,$100.10 ,$121.55 , N/A ,$99.10 , N/A ,$143.00 ,$78.65 , N/A ,$37.61 ,$143.00 , N/A , N/A , N/A ,$114.40 ,$77.65 ,$40.04 ,$128.70 ,$54.34 ,$19.42 , N/A ,$68.64 
ST. MARY'S HOSPITAL - DECATUR,34300010,A9516,HC DIAGNUCLIDE I123 CAPS 100 MICR,343,1 ,$446.00 ,$289.90 ,$117.30 ,$446.00 , N/A , N/A ,$245.30 , N/A ,$124.88 ,$218.54 , N/A ,$260.91 , N/A ,$242.18 ,$217.00 , N/A ,$242.18 , N/A ,$312.20 ,$223.00 ,$356.80 , N/A , N/A ,$312.20 , N/A ,$267.60 , N/A ,$334.50 ,$246.19 ,$222.11 ,$246.19 , N/A ,$246.19 ,$312.20 ,$312.20 ,$379.10 , N/A ,$309.08 , N/A ,$446.00 ,$245.30 , N/A ,$117.30 ,$446.00 , N/A , N/A , N/A ,$356.80 ,$242.18 ,$124.88 ,$401.40 ,$169.48 ,$186.71 , N/A ,$214.08 
ST. MARY'S HOSPITAL - DECATUR,34300011,A9517,HC DIAGNUCLIDE I131 CAPS PER MCI,343,1 ,$231.00 ,$150.15 ,$20.12 ,$449.75 ,$50.30 ,$117.81 ,$127.05 ,$20.12 ,$64.68 ,$113.19 ,$20.12 ,$135.14 ,$20.12 ,$125.43 ,$42.84 ,$20.12 ,$125.43 ,$38.23 ,$161.70 ,$115.50 ,$184.80 ,$50.30 ,$20.12 ,$161.70 ,$20.12 ,$138.60 ,$20.12 ,$173.25 ,$127.51 ,$115.04 ,$127.51 ,$20.12 ,$127.51 ,$161.70 ,$161.70 ,$196.35 ,$50.30 ,$160.08 ,$20.12 ,$231.00 ,$127.05 ,$20.12 ,$60.75 ,$231.00 ,$231.00 ,$449.75 ,$21.13 ,$184.80 ,$125.43 ,$64.68 ,$207.90 ,$87.78 ,$33.20 ,$20.12 ,$110.88 
ST. MARY'S HOSPITAL - DECATUR,34300012,A9521,HC DIAGNUCLIDE CERETEC,343,1 ,"$5,863.00 ","$3,810.95 ","$1,541.97 ","$5,863.00 ", N/A , N/A ,"$3,224.65 ", N/A ,"$1,641.64 ","$2,872.87 ", N/A ,"$3,429.86 ", N/A ,"$3,183.61 ","$1,747.16 ", N/A ,"$3,183.61 ", N/A ,"$4,104.10 ","$2,931.50 ","$4,690.40 ", N/A , N/A ,"$4,104.10 ", N/A ,"$3,517.80 ", N/A ,"$4,397.25 ","$3,236.38 ","$2,919.77 ","$3,236.38 ", N/A ,"$3,236.38 ","$4,104.10 ","$4,104.10 ","$4,983.55 ", N/A ,"$4,063.06 ", N/A ,"$5,863.00 ","$3,224.65 ", N/A ,"$1,541.97 ","$5,863.00 ", N/A , N/A , N/A ,"$4,690.40 ","$3,183.61 ","$1,641.64 ","$5,276.70 ","$2,227.94 ","$2,588.93 ", N/A ,"$2,814.24 "
ST. MARY'S HOSPITAL - DECATUR,34300014,A9528,HC DIAGNUCLIDE I131 NECK/CHST,343,1 ,$218.00 ,$141.70 ,$57.33 ,$218.00 , N/A , N/A ,$119.90 , N/A ,$61.04 ,$102.46 , N/A ,$117.72 , N/A ,$118.37 ,$87.20 , N/A ,$118.37 , N/A ,$152.60 ,$109.00 ,$174.40 , N/A , N/A ,$152.60 , N/A ,$130.80 , N/A ,$163.50 ,$120.34 ,$108.56 ,$120.34 , N/A ,$120.34 ,$152.60 ,$152.60 ,$185.30 , N/A ,$151.07 , N/A ,$218.00 ,$119.90 , N/A ,$57.33 ,$218.00 , N/A , N/A , N/A ,$174.40 ,$118.37 ,$61.04 ,$196.20 ,$82.84 ,$166.73 , N/A ,$104.64 
ST. MARY'S HOSPITAL - DECATUR,34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$532.00 ,$345.80 ,$66.38 ,$532.00 , N/A , N/A ,$292.60 , N/A ,$148.96 ,$260.68 , N/A ,$311.22 , N/A ,$288.88 ,$66.38 , N/A ,$288.88 , N/A ,$372.40 ,$266.00 ,$425.60 , N/A , N/A ,$372.40 , N/A ,$319.20 , N/A ,$399.00 ,$293.66 ,$264.94 ,$293.66 , N/A ,$293.66 ,$372.40 ,$372.40 ,$452.20 , N/A ,$368.68 , N/A ,$532.00 ,$292.60 , N/A ,$139.92 ,$532.00 , N/A , N/A , N/A ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$138.60 , N/A ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,34300017,A9539,HC DIAGNUCLIDE DTPA KIDNEY PER DOSE,343,1 ,$447.00 ,$290.55 ,$37.60 ,$447.00 , N/A , N/A ,$245.85 , N/A ,$125.16 ,$219.03 , N/A ,$261.50 , N/A ,$242.72 ,$37.60 , N/A ,$242.72 , N/A ,$312.90 ,$223.50 ,$357.60 , N/A , N/A ,$312.90 , N/A ,$268.20 , N/A ,$335.25 ,$246.74 ,$222.61 ,$246.74 , N/A ,$246.74 ,$312.90 ,$312.90 ,$379.95 , N/A ,$309.77 , N/A ,$447.00 ,$245.85 , N/A ,$117.56 ,$447.00 , N/A , N/A , N/A ,$357.60 ,$242.72 ,$125.16 ,$402.30 ,$169.86 ,$51.96 , N/A ,$214.56 
ST. MARY'S HOSPITAL - DECATUR,34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$337.00 ,$219.05 ,$36.00 ,$337.00 , N/A , N/A ,$185.35 , N/A ,$94.36 ,$165.13 , N/A ,$197.15 , N/A ,$182.99 ,$36.00 , N/A ,$182.99 , N/A ,$235.90 ,$168.50 ,$269.60 , N/A , N/A ,$235.90 , N/A ,$202.20 , N/A ,$252.75 ,$186.02 ,$167.83 ,$186.02 , N/A ,$186.02 ,$235.90 ,$235.90 ,$286.45 , N/A ,$233.54 , N/A ,$337.00 ,$185.35 , N/A ,$88.63 ,$337.00 , N/A , N/A , N/A ,$269.60 ,$182.99 ,$94.36 ,$303.30 ,$128.06 ,$55.95 , N/A ,$161.76 
ST. MARY'S HOSPITAL - DECATUR,34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$673.00 ,$437.45 ,$64.17 ,$673.00 , N/A , N/A ,$370.15 , N/A ,$188.44 ,$329.77 , N/A ,$393.71 , N/A ,$365.44 ,$64.17 , N/A ,$365.44 , N/A ,$471.10 ,$336.50 ,$538.40 , N/A , N/A ,$471.10 , N/A ,$403.80 , N/A ,$504.75 ,$371.50 ,$335.15 ,$371.50 , N/A ,$371.50 ,$471.10 ,$471.10 ,$572.05 , N/A ,$466.39 , N/A ,$673.00 ,$370.15 , N/A ,$177.00 ,$673.00 , N/A , N/A , N/A ,$538.40 ,$365.44 ,$188.44 ,$605.70 ,$255.74 ,$408.26 , N/A ,$323.04 
ST. MARY'S HOSPITAL - DECATUR,34300024,A9547,HC DIAGNUCLIDE IN OXINE .5 MCI,343,1 ,"$6,135.00 ","$3,987.75 ",$521.90 ,"$6,135.00 ", N/A , N/A ,"$3,374.25 ", N/A ,"$1,717.80 ","$3,006.15 ", N/A ,"$3,588.98 ", N/A ,"$3,331.31 ","$2,145.75 ", N/A ,"$3,331.31 ", N/A ,"$4,294.50 ","$3,067.50 ","$4,908.00 ", N/A , N/A ,"$4,294.50 ", N/A ,"$3,681.00 ", N/A ,"$4,601.25 ","$3,386.52 ","$3,055.23 ","$3,386.52 ", N/A ,"$3,386.52 ","$4,294.50 ","$4,294.50 ","$5,214.75 ", N/A ,"$4,251.56 ", N/A ,"$6,135.00 ","$3,374.25 ", N/A ,"$1,613.51 ","$6,135.00 ", N/A , N/A , N/A ,"$4,908.00 ","$3,331.31 ","$1,717.80 ","$5,521.50 ","$2,331.30 ",$521.90 , N/A ,"$2,944.80 "
ST. MARY'S HOSPITAL - DECATUR,34300026,A9548,HC DIAGNUCLIDE IN-111 DTPA,343,1 ,"$4,198.00 ","$2,728.70 ",$312.91 ,"$4,198.00 ", N/A , N/A ,"$2,308.90 ", N/A ,"$1,175.44 ","$2,057.02 ", N/A ,"$2,455.83 ", N/A ,"$2,279.51 ",$495.83 , N/A ,"$2,279.51 ", N/A ,"$2,938.60 ","$2,099.00 ","$3,358.40 ", N/A , N/A ,"$2,938.60 ", N/A ,"$2,518.80 ", N/A ,"$3,148.50 ","$2,317.30 ","$2,090.60 ","$2,317.30 ", N/A ,"$2,317.30 ","$2,938.60 ","$2,938.60 ","$3,568.30 ", N/A ,"$2,909.21 ", N/A ,"$4,198.00 ","$2,308.90 ", N/A ,"$1,104.07 ","$4,198.00 ", N/A , N/A , N/A ,"$3,358.40 ","$2,279.51 ","$1,175.44 ","$3,778.20 ","$1,595.24 ",$312.91 , N/A ,"$2,015.04 "
ST. MARY'S HOSPITAL - DECATUR,34300029,A9552,HC DIAGNUCLIDE 18FDG,343,1 ,"$2,176.00 ","$1,414.40 ",$491.06 ,"$2,176.00 ", N/A , N/A ,"$1,196.80 ", N/A ,$609.28 ,"$1,066.24 ", N/A ,"$1,272.96 ", N/A ,"$1,181.57 ",$723.00 , N/A ,"$1,181.57 ", N/A ,"$1,523.20 ","$1,088.00 ","$1,740.80 ", N/A , N/A ,"$1,523.20 ", N/A ,"$1,305.60 ", N/A ,"$1,632.00 ","$1,201.15 ","$1,083.65 ","$1,201.15 ", N/A ,"$1,201.15 ","$1,523.20 ","$1,523.20 ","$1,849.60 ", N/A ,"$1,507.97 ", N/A ,"$2,176.00 ","$1,196.80 ", N/A ,$572.29 ,"$2,176.00 ", N/A , N/A , N/A ,"$1,740.80 ","$1,181.57 ",$609.28 ,"$1,958.40 ",$826.88 ,$491.06 , N/A ,"$1,044.48 "
ST. MARY'S HOSPITAL - DECATUR,34300031,A9556,HC DIAGNUCLIDE GA67 PER MCI,343,1 ,$177.00 ,$115.05 ,$38.82 ,$177.00 , N/A , N/A ,$97.35 , N/A ,$49.56 ,$86.73 , N/A ,$103.55 , N/A ,$96.11 ,$131.09 , N/A ,$96.11 , N/A ,$123.90 ,$88.50 ,$141.60 , N/A , N/A ,$123.90 , N/A ,$106.20 , N/A ,$132.75 ,$97.70 ,$88.15 ,$97.70 , N/A ,$97.70 ,$123.90 ,$123.90 ,$150.45 , N/A ,$122.66 , N/A ,$177.00 ,$97.35 , N/A ,$46.55 ,$177.00 , N/A , N/A , N/A ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$38.82 , N/A ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,34300033,A9558,HC DIAGNUCLIDE XE133 10 MCI,343,1 ,$433.00 ,$281.45 ,$113.88 ,$433.00 , N/A , N/A ,$238.15 , N/A ,$121.24 ,$212.17 , N/A ,$253.31 , N/A ,$235.12 ,$251.65 , N/A ,$235.12 , N/A ,$303.10 ,$216.50 ,$346.40 , N/A , N/A ,$303.10 , N/A ,$259.80 , N/A ,$324.75 ,$239.02 ,$215.63 ,$239.02 , N/A ,$239.02 ,$303.10 ,$303.10 ,$368.05 , N/A ,$300.07 , N/A ,$433.00 ,$238.15 , N/A ,$113.88 ,$433.00 , N/A , N/A , N/A ,$346.40 ,$235.12 ,$121.24 ,$389.70 ,$164.54 ,$358.02 , N/A ,$207.84 
ST. MARY'S HOSPITAL - DECATUR,34300035,A9560,HC TC99M GI BLD MUGA UP TO 30MCI,343,1 ,$660.00 ,$429.00 ,$112.08 ,$660.00 , N/A , N/A ,$363.00 , N/A ,$184.80 ,$323.40 , N/A ,$386.10 , N/A ,$358.38 ,$112.08 , N/A ,$358.38 , N/A ,$462.00 ,$330.00 ,$528.00 , N/A , N/A ,$462.00 , N/A ,$396.00 , N/A ,$495.00 ,$364.32 ,$328.68 ,$364.32 , N/A ,$364.32 ,$462.00 ,$462.00 ,$561.00 , N/A ,$457.38 , N/A ,$660.00 ,$363.00 , N/A ,$173.58 ,$660.00 , N/A , N/A , N/A ,$528.00 ,$358.38 ,$184.80 ,$594.00 ,$250.80 ,$165.59 , N/A ,$316.80 
ST. MARY'S HOSPITAL - DECATUR,34300036,A9560,HC RBC TAG KIT WITH TC99,343,1 ,$660.00 ,$429.00 ,$112.08 ,$660.00 , N/A , N/A ,$363.00 , N/A ,$184.80 ,$323.40 , N/A ,$386.10 , N/A ,$358.38 ,$112.08 , N/A ,$358.38 , N/A ,$462.00 ,$330.00 ,$528.00 , N/A , N/A ,$462.00 , N/A ,$396.00 , N/A ,$495.00 ,$364.32 ,$328.68 ,$364.32 , N/A ,$364.32 ,$462.00 ,$462.00 ,$561.00 , N/A ,$457.38 , N/A ,$660.00 ,$363.00 , N/A ,$173.58 ,$660.00 , N/A , N/A , N/A ,$528.00 ,$358.38 ,$184.80 ,$594.00 ,$250.80 ,$165.59 , N/A ,$316.80 
ST. MARY'S HOSPITAL - DECATUR,34300037,A9562,HC DIAG NUCLDE MAG 3 PER DOSE,343,1 ,"$1,258.00 ",$817.70 ,$330.85 ,"$1,258.00 ", N/A , N/A ,$691.90 , N/A ,$352.24 ,$616.42 , N/A ,$735.93 , N/A ,$683.09 ,$929.73 , N/A ,$683.09 , N/A ,$880.60 ,$629.00 ,"$1,006.40 ", N/A , N/A ,$880.60 , N/A ,$754.80 , N/A ,$943.50 ,$694.42 ,$626.48 ,$694.42 , N/A ,$694.42 ,$880.60 ,$880.60 ,"$1,069.30 ", N/A ,$871.79 , N/A ,"$1,258.00 ",$691.90 , N/A ,$330.85 ,"$1,258.00 ", N/A , N/A , N/A ,"$1,006.40 ",$683.09 ,$352.24 ,"$1,132.20 ",$478.04 ,"$1,258.00 ", N/A ,$603.84 
ST. MARY'S HOSPITAL - DECATUR,34300038,A9572,HC DIAGNUCLIDE OCTREOTIDE PER DOSE UP TO 6MCI,343,1 ,"$12,839.00 ","$8,345.35 ","$3,376.66 ","$12,839.00 ", N/A , N/A ,"$7,061.45 ", N/A ,"$3,594.92 ","$6,291.11 ", N/A ,"$7,510.82 ", N/A ,"$6,971.58 ","$6,811.20 ", N/A ,"$6,971.58 ", N/A ,"$8,987.30 ","$6,419.50 ","$10,271.20 ", N/A , N/A ,"$8,987.30 ", N/A ,"$7,703.40 ", N/A ,"$9,629.25 ","$7,087.13 ","$6,393.82 ","$7,087.13 ", N/A ,"$7,087.13 ","$8,987.30 ","$8,987.30 ","$10,913.15 ", N/A ,"$8,897.43 ", N/A ,"$12,839.00 ","$7,061.45 ", N/A ,"$3,376.66 ","$12,839.00 ", N/A , N/A , N/A ,"$10,271.20 ","$6,971.58 ","$3,594.92 ","$11,555.10 ","$4,878.82 ","$10,241.50 ", N/A ,"$6,162.72 "
ST. MARY'S HOSPITAL - DECATUR,34300040,A9604,HC THER ISOTOP SAMARIUM 153 UP TO 150MCI,343,1 ,"$19,543.00 ","$12,702.95 ","$1,001.18 ","$43,149.63 ","$43,149.63 ","$9,966.93 ","$10,748.65 ","$17,259.85 ","$5,472.04 ","$9,576.07 ","$17,259.85 ","$11,432.66 ","$17,259.85 ","$10,611.85 ","$18,261.17 ","$17,259.85 ","$10,611.85 ","$19,543.00 ","$13,680.10 ","$9,771.50 ","$15,634.40 ","$43,149.63 ","$17,259.85 ","$13,680.10 ","$17,259.85 ","$11,725.80 ","$17,259.85 ","$14,657.25 ","$10,787.74 ","$9,732.41 ","$10,787.74 ","$17,259.85 ","$10,787.74 ","$13,680.10 ","$13,680.10 ","$16,611.55 ","$19,543.00 ","$13,543.30 ","$17,259.85 ","$19,543.00 ","$10,748.65 ","$17,259.85 ","$5,139.81 ","$19,543.00 ","$1,048.85 ","$1,001.18 ","$18,122.84 ","$15,634.40 ","$10,611.85 ","$5,472.04 ","$17,588.70 ","$7,426.34 ","$19,543.00 ","$17,259.85 ","$9,380.64 "
ST. MARY'S HOSPITAL - DECATUR,34300041,J2805,HC DIAGNUCLIDE CCK,636,1 ,$253.00 ,$164.45 ,$66.54 ,$253.00 , N/A ,$129.03 ,$139.15 , N/A ,$70.84 ,$123.97 , N/A ,$136.62 , N/A ,$137.38 ,$101.20 , N/A ,$137.38 , N/A ,$177.10 ,$126.50 ,$202.40 , N/A , N/A ,$177.10 , N/A ,$151.80 , N/A ,$189.75 ,$139.66 ,$125.99 ,$139.66 , N/A ,$139.66 ,$197.34 ,$197.34 ,$215.05 , N/A ,$175.33 , N/A ,$253.00 ,$139.15 , N/A ,$66.54 ,$253.00 ,$95.48 ,$91.14 , N/A ,$202.40 ,$137.38 ,$70.84 ,$227.70 ,$96.14 ,$190.82 , N/A ,$121.44 
ST. MARY'S HOSPITAL - DECATUR,34300057,A9569,HC TC99M EXAMETAZIME CERETEC DX PER DOSE,343,1 ,"$7,864.00 ","$5,111.60 ","$1,747.16 ","$7,864.00 ", N/A , N/A ,"$4,325.20 ", N/A ,"$2,201.92 ","$3,853.36 ", N/A ,"$4,600.44 ", N/A ,"$4,270.15 ","$1,747.16 ", N/A ,"$4,270.15 ", N/A ,"$5,504.80 ","$3,932.00 ","$6,291.20 ", N/A , N/A ,"$5,504.80 ", N/A ,"$4,718.40 ", N/A ,"$5,898.00 ","$4,340.93 ","$3,916.27 ","$4,340.93 ", N/A ,"$4,340.93 ","$5,504.80 ","$5,504.80 ","$6,684.40 ", N/A ,"$5,449.75 ", N/A ,"$7,864.00 ","$4,325.20 ", N/A ,"$2,068.23 ","$7,864.00 ", N/A , N/A , N/A ,"$6,291.20 ","$4,270.15 ","$2,201.92 ","$7,077.60 ","$2,988.32 ","$2,760.22 ", N/A ,"$3,774.72 "
ST. MARY'S HOSPITAL - DECATUR,34300058,A9500,HC SESTAMIBI PER STUDY DOSE,343,1 ,"$1,162.00 ",$755.30 ,$128.10 ,"$1,162.00 ", N/A , N/A ,$639.10 , N/A ,$325.36 ,$569.38 , N/A ,$679.77 , N/A ,$630.97 ,$128.10 , N/A ,$630.97 , N/A ,$813.40 ,$581.00 ,$929.60 , N/A , N/A ,$813.40 , N/A ,$697.20 , N/A ,$871.50 ,$641.42 ,$578.68 ,$641.42 , N/A ,$641.42 ,$813.40 ,$813.40 ,$987.70 , N/A ,$805.27 , N/A ,"$1,162.00 ",$639.10 , N/A ,$305.61 ,"$1,162.00 ", N/A , N/A , N/A ,$929.60 ,$630.97 ,$325.36 ,"$1,045.80 ",$441.56 ,$584.10 , N/A ,$557.76 
ST. MARY'S HOSPITAL - DECATUR,34300059,A9510,HC DIAGNUCLIDE TC-99 DISOFENIN DIAG PER STUDY UP TO 15MCI,343,1 ,$532.00 ,$345.80 ,$84.00 ,$532.00 , N/A , N/A ,$292.60 , N/A ,$148.96 ,$260.68 , N/A ,$311.22 , N/A ,$288.88 ,$84.00 , N/A ,$288.88 , N/A ,$372.40 ,$266.00 ,$425.60 , N/A , N/A ,$372.40 , N/A ,$319.20 , N/A ,$399.00 ,$293.66 ,$264.94 ,$293.66 , N/A ,$293.66 ,$372.40 ,$372.40 ,$452.20 , N/A ,$368.68 , N/A ,$532.00 ,$292.60 , N/A ,$139.92 ,$532.00 , N/A , N/A , N/A ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$106.21 , N/A ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,34300060,A9520,HC DIAGNUCLIDE TC-99 TILMANOCEPT DIAG UP TO 0.5 MCI,343,1 ,"$2,609.00 ","$1,695.85 ",$563.76 ,"$2,609.00 ", N/A , N/A ,"$1,434.95 ", N/A ,$730.52 ,"$1,278.41 ", N/A ,"$1,526.27 ", N/A ,"$1,416.69 ",$563.76 , N/A ,"$1,416.69 ", N/A ,"$1,826.30 ","$1,304.50 ","$2,087.20 ", N/A , N/A ,"$1,826.30 ", N/A ,"$1,565.40 ", N/A ,"$1,956.75 ","$1,440.17 ","$1,299.28 ","$1,440.17 ", N/A ,"$1,440.17 ","$1,826.30 ","$1,826.30 ","$2,217.65 ", N/A ,"$1,808.04 ", N/A ,"$2,609.00 ","$1,434.95 ", N/A ,$686.17 ,"$2,609.00 ", N/A , N/A , N/A ,"$2,087.20 ","$1,416.69 ",$730.52 ,"$2,348.10 ",$991.42 , N/A , N/A ,"$1,252.32 "
ST. MARY'S HOSPITAL - DECATUR,34300061,A9557,HC DIAGNUCLIDE TC-99 BICISATE PER STUDY UP TO 25MCI,343,1 ,"$4,992.00 ","$3,244.80 ",$446.51 ,"$4,992.00 ", N/A , N/A ,"$2,745.60 ", N/A ,"$1,397.76 ","$2,446.08 ", N/A ,"$2,920.32 ", N/A ,"$2,710.66 ",$446.51 , N/A ,"$2,710.66 ", N/A ,"$3,494.40 ","$2,496.00 ","$3,993.60 ", N/A , N/A ,"$3,494.40 ", N/A ,"$2,995.20 ", N/A ,"$3,744.00 ","$2,755.58 ","$2,486.02 ","$2,755.58 ", N/A ,"$2,755.58 ","$3,494.40 ","$3,494.40 ","$4,243.20 ", N/A ,"$3,459.46 ", N/A ,"$4,992.00 ","$2,745.60 ", N/A ,"$1,312.90 ","$4,992.00 ", N/A , N/A , N/A ,"$3,993.60 ","$2,710.66 ","$1,397.76 ","$4,492.80 ","$1,896.96 ",$663.50 , N/A ,"$2,396.16 "
ST. MARY'S HOSPITAL - DECATUR,34300062,A9562,HC DIAGNUCLIDE TC-99 MERTIATIDE PER STUDY UP TO 15MCI,343,1 ,$839.00 ,$545.35 ,$220.66 ,$839.00 , N/A , N/A ,$461.45 , N/A ,$234.92 ,$411.11 , N/A ,$490.82 , N/A ,$455.58 ,$839.00 , N/A ,$455.58 , N/A ,$587.30 ,$419.50 ,$671.20 , N/A , N/A ,$587.30 , N/A ,$503.40 , N/A ,$629.25 ,$463.13 ,$417.82 ,$463.13 , N/A ,$463.13 ,$587.30 ,$587.30 ,$713.15 , N/A ,$581.43 , N/A ,$839.00 ,$461.45 , N/A ,$220.66 ,$839.00 , N/A , N/A , N/A ,$671.20 ,$455.58 ,$234.92 ,$755.10 ,$318.82 ,$839.00 , N/A ,$402.72 
ST. MARY'S HOSPITAL - DECATUR,34300063,A9567,HC DIAGNUCLIDE TC-99 PETETATE AERO PER STUDY UP TO 75MCI,343,1 ,$363.00 ,$235.95 ,$35.97 ,$363.00 , N/A , N/A ,$199.65 , N/A ,$101.64 ,$177.87 , N/A ,$212.36 , N/A ,$197.11 ,$70.00 , N/A ,$197.11 , N/A ,$254.10 ,$181.50 ,$290.40 , N/A , N/A ,$254.10 , N/A ,$217.80 , N/A ,$272.25 ,$200.38 ,$180.77 ,$200.38 , N/A ,$200.38 ,$254.10 ,$254.10 ,$308.55 , N/A ,$251.56 , N/A ,$363.00 ,$199.65 , N/A ,$95.47 ,$363.00 , N/A , N/A , N/A ,$290.40 ,$197.11 ,$101.64 ,$326.70 ,$137.94 ,$35.97 , N/A ,$174.24 
ST. MARY'S HOSPITAL - DECATUR,34300064,A9570,HC DIAGNUCLIDE INDIUM IN-111 WBC DIAG PER STUDY,343,1 ,"$7,830.00 ","$5,089.50 ","$2,059.29 ","$7,830.00 ", N/A , N/A ,"$4,306.50 ", N/A ,"$2,192.40 ","$3,836.70 ", N/A ,"$4,580.55 ", N/A ,"$4,251.69 ","$4,291.50 ", N/A ,"$4,251.69 ", N/A ,"$5,481.00 ","$3,915.00 ","$6,264.00 ", N/A , N/A ,"$5,481.00 ", N/A ,"$4,698.00 ", N/A ,"$5,872.50 ","$4,322.16 ","$3,899.34 ","$4,322.16 ", N/A ,"$4,322.16 ","$5,481.00 ","$5,481.00 ","$6,655.50 ", N/A ,"$5,426.19 ", N/A ,"$7,830.00 ","$4,306.50 ", N/A ,"$2,059.29 ","$7,830.00 ", N/A , N/A , N/A ,"$6,264.00 ","$4,251.69 ","$2,192.40 ","$7,047.00 ","$2,975.40 ","$6,362.10 ", N/A ,"$3,758.40 "
ST. MARY'S HOSPITAL - DECATUR,35000002,20615,HC ASP/INJ CYST BONE,350,1 ,"$3,477.00 ","$2,260.05 ",$363.34 ,"$3,477.00 ","$1,472.65 ",$750.00 ,"$1,912.35 ",$589.06 ,$973.56 ,"$1,634.19 ",$589.06 ,"$1,877.58 ",$589.06 ,"$1,888.01 ",$363.34 ,$589.06 ,"$1,888.01 ","$1,119.21 ","$2,433.90 ","$1,738.50 ","$2,781.60 ","$1,472.64 ",$589.06 ,"$2,433.90 ",$589.06 ,"$2,086.20 ",$589.06 ,"$2,607.75 ","$1,919.30 ","$1,731.55 ","$1,919.30 ",$589.06 ,"$1,919.30 ","$2,433.90 ","$2,433.90 ","$2,955.45 ","$1,472.64 ","$2,409.56 ",$589.06 ,"$3,477.00 ","$1,912.35 ",$589.06 ,$914.45 ,"$3,477.00 ","$1,245.13 ","$1,188.54 ",$618.51 ,"$2,781.60 ","$1,888.01 ",$973.56 ,"$3,129.30 ",$523.00 ,"$1,050.00 ",$589.06 ,"$1,668.96 "
ST. MARY'S HOSPITAL - DECATUR,35000006,21550,HC BX TISSUE NECK/THORAX,350,1 ,"$4,783.00 ","$3,108.95 ",$353.08 ,"$4,783.00 ","$3,329.73 ",$750.00 ,"$2,630.65 ","$1,331.89 ","$1,339.24 ","$2,248.01 ","$1,331.89 ","$2,582.82 ","$1,331.89 ","$2,597.17 ",$353.08 ,"$1,331.89 ","$2,597.17 ","$2,530.59 ","$3,348.10 ","$2,391.50 ","$3,826.40 ","$3,329.72 ","$1,331.89 ","$3,348.10 ","$1,331.89 ","$2,869.80 ","$1,331.89 ","$3,587.25 ","$2,640.22 ","$2,381.93 ","$2,640.22 ","$1,331.89 ","$2,640.22 ","$3,348.10 ","$3,348.10 ","$4,065.55 ","$3,329.72 ","$3,314.62 ","$1,331.89 ","$4,783.00 ","$2,630.65 ","$1,331.89 ","$1,257.93 ","$4,783.00 ",$450.77 ,$430.28 ,"$1,398.48 ","$3,826.40 ","$2,597.17 ","$1,339.24 ","$4,304.70 ",$523.00 ,"$1,050.00 ","$1,331.89 ","$2,295.84 "
ST. MARY'S HOSPITAL - DECATUR,35000018,47000,HC BX LIVER NEEDLE PERC,350,1 ,"$2,865.00 ","$1,862.25 ",$157.52 ,"$3,329.73 ","$3,329.73 ",$750.00 ,"$1,575.75 ","$1,331.89 ",$802.20 ,"$1,346.55 ","$1,331.89 ","$1,547.10 ","$1,331.89 ","$1,555.70 ",$157.52 ,"$1,331.89 ","$1,555.70 ","$2,530.59 ","$2,005.50 ","$1,432.50 ","$2,292.00 ","$3,329.72 ","$1,331.89 ","$2,005.50 ","$1,331.89 ","$1,719.00 ","$1,331.89 ","$2,148.75 ","$1,581.48 ","$1,426.77 ","$1,581.48 ","$1,331.89 ","$1,581.48 ","$2,005.50 ","$2,005.50 ","$2,435.25 ","$2,865.00 ","$1,985.45 ","$1,331.89 ","$2,865.00 ","$1,575.75 ","$1,331.89 ",$753.50 ,"$2,865.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$2,292.00 ","$1,555.70 ",$802.20 ,"$2,578.50 ",$523.00 ,"$1,050.00 ","$1,331.89 ","$1,375.20 "
ST. MARY'S HOSPITAL - DECATUR,35000020,49405,HC PERC DRN ABSC/HEM/CYST VISCERAL,350,1 ,"$4,698.00 ","$3,053.70 ",$351.25 ,"$4,698.00 ","$3,329.73 ",$750.00 ,"$2,583.90 ","$1,331.89 ","$1,315.44 ","$2,208.06 ","$1,331.89 ","$2,536.92 ","$1,331.89 ","$2,551.01 ",$351.25 ,"$1,331.89 ","$2,551.01 ","$2,530.59 ","$3,288.60 ","$2,349.00 ","$3,758.40 ","$3,329.72 ","$1,331.89 ","$3,288.60 ","$1,331.89 ","$2,818.80 ","$1,331.89 ","$3,523.50 ","$2,593.30 ","$2,339.60 ","$2,593.30 ","$1,331.89 ","$2,593.30 ","$3,288.60 ","$3,288.60 ","$3,993.30 ","$3,329.72 ","$3,255.71 ","$1,331.89 ","$4,698.00 ","$2,583.90 ","$1,331.89 ","$1,235.57 ","$4,698.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$3,758.40 ","$2,551.01 ","$1,315.44 ","$4,228.20 ",$523.00 ,"$1,050.00 ","$1,331.89 ","$2,255.04 "
ST. MARY'S HOSPITAL - DECATUR,35000023,48102,HC BX PANCREAS NEEDLE PERC,350,1 ,"$2,303.00 ","$1,496.95 ",$425.89 ,"$3,329.73 ","$3,329.73 ",$750.00 ,"$1,266.65 ","$1,331.89 ",$644.84 ,"$1,082.41 ","$1,331.89 ","$1,243.62 ","$1,331.89 ","$1,250.53 ",$425.89 ,"$1,331.89 ","$1,250.53 ","$2,303.00 ","$1,612.10 ","$1,151.50 ","$1,842.40 ","$3,329.72 ","$1,331.89 ","$1,612.10 ","$1,331.89 ","$1,381.80 ","$1,331.89 ","$1,727.25 ","$1,271.26 ","$1,146.89 ","$1,271.26 ","$1,331.89 ","$1,271.26 ","$1,612.10 ","$1,612.10 ","$1,957.55 ","$2,303.00 ","$1,595.98 ","$1,331.89 ","$2,303.00 ","$1,266.65 ","$1,331.89 ",$605.69 ,"$2,303.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$1,842.40 ","$1,250.53 ",$644.84 ,"$2,072.70 ",$523.00 ,"$1,050.00 ","$1,331.89 ","$1,105.44 "
ST. MARY'S HOSPITAL - DECATUR,35000025,49180,HC ABDOM/RETRO/MASS BIOP,350,1 ,"$3,485.00 ","$2,265.25 ",$151.10 ,"$3,485.00 ","$3,329.73 ",$750.00 ,"$1,916.75 ","$1,331.89 ",$975.80 ,"$1,637.95 ","$1,331.89 ","$1,881.90 ","$1,331.89 ","$1,892.36 ",$151.10 ,"$1,331.89 ","$1,892.36 ","$2,530.59 ","$2,439.50 ","$1,742.50 ","$2,788.00 ","$3,329.72 ","$1,331.89 ","$2,439.50 ","$1,331.89 ","$2,091.00 ","$1,331.89 ","$2,613.75 ","$1,923.72 ","$1,735.53 ","$1,923.72 ","$1,331.89 ","$1,923.72 ","$2,439.50 ","$2,439.50 ","$2,962.25 ","$3,329.72 ","$2,415.11 ","$1,331.89 ","$3,485.00 ","$1,916.75 ","$1,331.89 ",$916.56 ,"$3,485.00 ",$425.48 ,$406.14 ,"$1,398.48 ","$2,788.00 ","$1,892.36 ",$975.80 ,"$3,136.50 ",$523.00 ,"$1,050.00 ","$1,331.89 ","$1,672.80 "
ST. MARY'S HOSPITAL - DECATUR,35000026,50200,"HC PERC BIOPSY/KIDNEY, NEEDLE",350,1 ,"$2,839.00 ","$1,845.35 ",$334.77 ,"$3,329.73 ","$3,329.73 ",$750.00 ,"$1,561.45 ","$1,331.89 ",$794.92 ,"$1,334.33 ","$1,331.89 ","$1,533.06 ","$1,331.89 ","$1,541.58 ",$334.77 ,"$1,331.89 ","$1,541.58 ","$2,530.59 ","$1,987.30 ","$1,419.50 ","$2,271.20 ","$3,329.72 ","$1,331.89 ","$1,987.30 ","$1,331.89 ","$1,703.40 ","$1,331.89 ","$2,129.25 ","$1,567.13 ","$1,413.82 ","$1,567.13 ","$1,331.89 ","$1,567.13 ","$1,987.30 ","$1,987.30 ","$2,413.15 ","$2,839.00 ","$1,967.43 ","$1,331.89 ","$2,839.00 ","$1,561.45 ","$1,331.89 ",$746.66 ,"$2,839.00 ",$425.48 ,$406.14 ,"$1,398.48 ","$2,271.20 ","$1,541.58 ",$794.92 ,"$2,555.10 ",$523.00 ,"$1,050.00 ","$1,331.89 ","$1,362.72 "
ST. MARY'S HOSPITAL - DECATUR,35000027,50390,HC RENAL CYST/PELVIS ASP/INJ,350,1 ,"$2,969.00 ","$1,929.85 ",$252.10 ,"$2,969.00 ","$1,472.65 ",$750.00 ,"$1,632.95 ",$589.06 ,$831.32 ,"$1,395.43 ",$589.06 ,"$1,603.26 ",$589.06 ,"$1,612.17 ",$252.10 ,$589.06 ,"$1,612.17 ","$1,119.21 ","$2,078.30 ","$1,484.50 ","$2,375.20 ","$1,472.64 ",$589.06 ,"$2,078.30 ",$589.06 ,"$1,781.40 ",$589.06 ,"$2,226.75 ","$1,638.89 ","$1,478.56 ","$1,638.89 ",$589.06 ,"$1,638.89 ","$2,078.30 ","$2,078.30 ","$2,523.65 ","$1,472.64 ","$2,057.52 ",$589.06 ,"$2,969.00 ","$1,632.95 ",$589.06 ,$780.85 ,"$2,969.00 ",$425.48 ,$406.14 ,$618.51 ,"$2,375.20 ","$1,612.17 ",$831.32 ,"$2,672.10 ",$523.00 ,"$1,050.00 ",$589.06 ,"$1,425.12 "
ST. MARY'S HOSPITAL - DECATUR,35000029,60699,HC UNLISTED PROCEDURE ENDOCRINE SYSTEM,350,1 ,"$14,111.00 ","$9,172.15 ",$523.00 ,"$14,111.00 ","$11,974.33 ",$750.00 ,"$7,761.05 ","$4,789.73 ","$3,951.08 ","$6,632.17 ","$4,789.73 ","$7,619.94 ","$4,789.73 ","$7,662.27 ","$5,644.40 ","$4,789.73 ","$7,662.27 ","$9,100.48 ","$9,877.70 ","$7,055.50 ","$11,288.80 ","$11,974.31 ","$4,789.73 ","$9,877.70 ","$4,789.73 ","$8,466.60 ","$4,789.73 ","$10,583.25 ","$7,789.27 ","$7,027.28 ","$7,789.27 ","$4,789.73 ","$7,789.27 ","$9,877.70 ","$9,877.70 ","$11,994.35 ","$11,974.31 ","$9,778.92 ","$4,789.73 ","$14,111.00 ","$7,761.05 ","$4,789.73 ","$3,711.19 ","$14,111.00 ","$1,692.87 ","$1,615.92 ","$5,029.22 ","$11,288.80 ","$7,662.27 ","$3,951.08 ","$12,699.90 ",$523.00 ,"$1,050.00 ","$4,789.73 ","$6,773.28 "
ST. MARY'S HOSPITAL - DECATUR,35000032,64430,HC INJ ANEST AGENT PUDENDAL NERVE,350,1 ,"$2,294.00 ","$1,491.10 ",$161.30 ,"$2,294.00 ","$1,948.10 ",$750.00 ,"$1,261.70 ",$779.24 ,$642.32 ,"$1,078.18 ",$779.24 ,"$1,238.76 ",$779.24 ,"$1,245.64 ",$161.30 ,$779.24 ,"$1,245.64 ","$1,480.55 ","$1,605.80 ","$1,147.00 ","$1,835.20 ","$1,948.10 ",$779.24 ,"$1,605.80 ",$779.24 ,"$1,376.40 ",$779.24 ,"$1,720.50 ","$1,266.29 ","$1,142.41 ","$1,266.29 ",$779.24 ,"$1,266.29 ","$1,605.80 ","$1,605.80 ","$1,949.90 ","$1,948.10 ","$1,589.74 ",$779.24 ,"$2,294.00 ","$1,261.70 ",$779.24 ,$603.32 ,"$2,294.00 ",$307.62 ,$293.63 ,$818.20 ,"$1,835.20 ","$1,245.64 ",$642.32 ,"$2,064.60 ",$523.00 ,"$1,050.00 ",$779.24 ,"$1,101.12 "
ST. MARY'S HOSPITAL - DECATUR,35000034,64530,HC INJ CELIAC PLEXUS BLOCK,350,1 ,"$2,395.00 ","$1,556.75 ",$183.31 ,"$2,395.00 ","$1,948.10 ",$750.00 ,"$1,317.25 ",$779.24 ,$670.60 ,"$1,125.65 ",$779.24 ,"$1,293.30 ",$779.24 ,"$1,300.49 ",$183.31 ,$779.24 ,"$1,300.49 ","$1,480.55 ","$1,676.50 ","$1,197.50 ","$1,916.00 ","$1,948.10 ",$779.24 ,"$1,676.50 ",$779.24 ,"$1,437.00 ",$779.24 ,"$1,796.25 ","$1,322.04 ","$1,192.71 ","$1,322.04 ",$779.24 ,"$1,322.04 ","$1,676.50 ","$1,676.50 ","$2,035.75 ","$1,948.10 ","$1,659.74 ",$779.24 ,"$2,395.00 ","$1,317.25 ",$779.24 ,$629.89 ,"$2,395.00 ",$307.62 ,$293.63 ,$818.20 ,"$1,916.00 ","$1,300.49 ",$670.60 ,"$2,155.50 ",$523.00 ,"$1,050.00 ",$779.24 ,"$1,149.60 "
ST. MARY'S HOSPITAL - DECATUR,35000035,64680,HC DEST NERVE CELIAC PLEXUS,350,1 ,"$5,343.00 ","$3,472.95 ",$324.25 ,"$5,343.00 ","$1,948.10 ",$750.00 ,"$2,938.65 ",$779.24 ,"$1,496.04 ","$2,511.21 ",$779.24 ,"$2,885.22 ",$779.24 ,"$2,901.25 ",$324.25 ,$779.24 ,"$2,901.25 ","$1,480.55 ","$3,740.10 ","$2,671.50 ","$4,274.40 ","$1,948.10 ",$779.24 ,"$3,740.10 ",$779.24 ,"$3,205.80 ",$779.24 ,"$4,007.25 ","$2,949.34 ","$2,660.81 ","$2,949.34 ",$779.24 ,"$2,949.34 ","$3,740.10 ","$3,740.10 ","$4,541.55 ","$1,948.10 ","$3,702.70 ",$779.24 ,"$5,343.00 ","$2,938.65 ",$779.24 ,"$1,405.21 ","$5,343.00 ",$748.42 ,$714.40 ,$818.20 ,"$4,274.40 ","$2,901.25 ","$1,496.04 ","$4,808.70 ",$523.00 ,"$1,050.00 ",$779.24 ,"$2,564.64 "
ST. MARY'S HOSPITAL - DECATUR,35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$2,911.00 ","$1,892.15 ",$102.00 ,"$2,911.00 ",$257.65 ,$750.00 ,"$1,601.05 ",$103.06 ,$815.08 ,"$1,032.05 ",$103.06 ,"$1,032.05 ",$103.06 ,"$1,580.67 ",$150.19 ,$103.06 ,"$1,580.67 ",$195.81 ,"$2,037.70 ","$1,455.50 ","$2,328.80 ",$257.64 ,$103.06 ,"$2,037.70 ",$103.06 ,"$1,746.60 ",$103.06 ,"$2,183.25 ","$1,606.87 ","$1,449.68 ","$1,606.87 ",$103.06 ,"$1,606.87 ",$102.00 ,$102.00 ,"$2,474.35 ",$257.64 ,"$2,017.32 ",$103.06 ,"$2,911.00 ","$1,601.05 ",$103.06 ,$765.59 ,"$2,911.00 ",$199.88 ,$190.80 ,$108.21 ,"$2,328.80 ","$1,580.67 ",$815.08 ,"$2,619.90 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,397.28 "
ST. MARY'S HOSPITAL - DECATUR,35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$2,949.00 ","$1,916.85 ",$148.70 ,"$2,949.00 ",$422.73 ,$750.00 ,"$1,621.95 ",$169.09 ,$825.72 ,"$1,445.01 ",$169.09 ,"$1,493.87 ",$169.09 ,"$1,601.31 ",$218.96 ,$169.09 ,"$1,601.31 ",$321.27 ,"$2,064.30 ","$1,474.50 ","$2,359.20 ",$422.72 ,$169.09 ,"$2,064.30 ",$169.09 ,"$1,769.40 ",$169.09 ,"$2,211.75 ","$1,627.85 ","$1,468.60 ","$1,627.85 ",$169.09 ,"$1,627.85 ",$148.70 ,$148.70 ,"$2,506.65 ",$422.72 ,"$2,043.66 ",$169.09 ,"$2,949.00 ","$1,621.95 ",$169.09 ,$775.59 ,"$2,949.00 ",$199.88 ,$190.80 ,$177.54 ,"$2,359.20 ","$1,601.31 ",$825.72 ,"$2,654.10 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,415.52 "
ST. MARY'S HOSPITAL - DECATUR,35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$3,552.00 ","$2,308.80 ",$169.09 ,"$3,552.00 ",$422.73 ,$750.00 ,"$1,953.60 ",$169.09 ,$994.56 ,"$1,740.48 ",$169.09 ,"$1,796.73 ",$169.09 ,"$1,928.74 ",$262.12 ,$169.09 ,"$1,928.74 ",$321.27 ,"$2,486.40 ","$1,776.00 ","$2,841.60 ",$422.72 ,$169.09 ,"$2,486.40 ",$169.09 ,"$2,131.20 ",$169.09 ,"$2,664.00 ","$1,960.70 ","$1,768.90 ","$1,960.70 ",$169.09 ,"$1,960.70 ",$178.01 ,$178.01 ,"$3,019.20 ",$422.72 ,"$2,461.54 ",$169.09 ,"$3,552.00 ","$1,953.60 ",$169.09 ,$934.18 ,"$3,552.00 ",$199.88 ,$190.80 ,$177.54 ,"$2,841.60 ","$1,928.74 ",$994.56 ,"$3,196.80 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,704.96 "
ST. MARY'S HOSPITAL - DECATUR,35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$2,949.00 ","$1,916.85 ",$92.72 ,"$2,949.00 ",$257.65 ,$750.00 ,"$1,621.95 ",$103.06 ,$825.72 ,"$1,445.01 ",$103.06 ,"$1,725.17 ",$103.06 ,"$1,601.31 ",$346.24 ,$103.06 ,"$1,601.31 ",$195.81 ,"$2,064.30 ","$1,474.50 ","$2,359.20 ",$257.64 ,$103.06 ,"$2,064.30 ",$103.06 ,"$1,769.40 ",$103.06 ,"$2,211.75 ","$1,627.85 ","$1,468.60 ","$1,627.85 ",$103.06 ,"$1,627.85 ",$155.66 ,$155.66 ,"$2,506.65 ",$257.64 ,"$2,043.66 ",$103.06 ,"$2,949.00 ","$1,621.95 ",$103.06 ,$775.59 ,"$2,949.00 ",$97.13 ,$92.72 ,$108.21 ,"$2,359.20 ","$1,601.31 ",$825.72 ,"$2,654.10 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,415.52 "
ST. MARY'S HOSPITAL - DECATUR,35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$2,956.00 ","$1,921.40 ",$92.72 ,"$2,956.00 ",$422.73 ,$750.00 ,"$1,625.80 ",$169.09 ,$827.68 ,"$1,448.44 ",$169.09 ,"$1,729.26 ",$169.09 ,"$1,605.11 ",$423.78 ,$169.09 ,"$1,605.11 ",$321.27 ,"$2,069.20 ","$1,478.00 ","$2,364.80 ",$422.72 ,$169.09 ,"$2,069.20 ",$169.09 ,"$1,773.60 ",$169.09 ,"$2,217.00 ","$1,631.71 ","$1,472.09 ","$1,631.71 ",$169.09 ,"$1,631.71 ",$278.37 ,$278.37 ,"$2,512.60 ",$422.72 ,"$2,048.51 ",$169.09 ,"$2,956.00 ","$1,625.80 ",$169.09 ,$777.43 ,"$2,956.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,364.80 ","$1,605.11 ",$827.68 ,"$2,660.40 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,418.88 "
ST. MARY'S HOSPITAL - DECATUR,35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$3,398.00 ","$2,208.70 ",$92.72 ,"$3,398.00 ",$422.73 ,$750.00 ,"$1,868.90 ",$169.09 ,$951.44 ,"$1,665.02 ",$169.09 ,"$1,987.83 ",$169.09 ,"$1,845.11 ",$467.90 ,$169.09 ,"$1,845.11 ",$321.27 ,"$2,378.60 ","$1,699.00 ","$2,718.40 ",$422.72 ,$169.09 ,"$2,378.60 ",$169.09 ,"$2,038.80 ",$169.09 ,"$2,548.50 ","$1,875.70 ","$1,692.20 ","$1,875.70 ",$169.09 ,"$1,875.70 ",$278.52 ,$278.52 ,"$2,888.30 ",$422.72 ,"$2,354.81 ",$169.09 ,"$3,398.00 ","$1,868.90 ",$169.09 ,$893.67 ,"$3,398.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,718.40 ","$1,845.11 ",$951.44 ,"$3,058.20 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,631.04 "
ST. MARY'S HOSPITAL - DECATUR,35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$2,911.00 ","$1,892.15 ",$92.72 ,"$2,911.00 ",$257.65 ,$750.00 ,"$1,601.05 ",$103.06 ,$815.08 ,"$1,426.39 ",$103.06 ,"$1,702.94 ",$103.06 ,"$1,580.67 ",$197.74 ,$103.06 ,"$1,580.67 ",$195.81 ,"$2,037.70 ","$1,455.50 ","$2,328.80 ",$257.64 ,$103.06 ,"$2,037.70 ",$103.06 ,"$1,746.60 ",$103.06 ,"$2,183.25 ","$1,606.87 ","$1,449.68 ","$1,606.87 ",$103.06 ,"$1,606.87 ",$134.30 ,$134.30 ,"$2,474.35 ",$257.64 ,"$2,017.32 ",$103.06 ,"$2,911.00 ","$1,601.05 ",$103.06 ,$765.59 ,"$2,911.00 ",$97.13 ,$92.72 ,$108.21 ,"$2,328.80 ","$1,580.67 ",$815.08 ,"$2,619.90 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,397.28 "
ST. MARY'S HOSPITAL - DECATUR,35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$2,911.00 ","$1,892.15 ",$92.72 ,"$2,911.00 ",$422.73 ,$750.00 ,"$1,601.05 ",$169.09 ,$815.08 ,"$1,426.39 ",$169.09 ,"$1,563.36 ",$169.09 ,"$1,580.67 ",$227.73 ,$169.09 ,"$1,580.67 ",$321.27 ,"$2,037.70 ","$1,455.50 ","$2,328.80 ",$422.72 ,$169.09 ,"$2,037.70 ",$169.09 ,"$1,746.60 ",$169.09 ,"$2,183.25 ","$1,606.87 ","$1,449.68 ","$1,606.87 ",$169.09 ,"$1,606.87 ",$154.67 ,$154.67 ,"$2,474.35 ",$422.72 ,"$2,017.32 ",$169.09 ,"$2,911.00 ","$1,601.05 ",$169.09 ,$765.59 ,"$2,911.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,328.80 ","$1,580.67 ",$815.08 ,"$2,619.90 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,397.28 "
ST. MARY'S HOSPITAL - DECATUR,35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$3,407.00 ","$2,214.55 ",$92.72 ,"$3,407.00 ",$422.73 ,$750.00 ,"$1,873.85 ",$169.09 ,$953.96 ,"$1,669.43 ",$169.09 ,"$1,975.44 ",$169.09 ,"$1,850.00 ",$287.72 ,$169.09 ,"$1,850.00 ",$321.27 ,"$2,384.90 ","$1,703.50 ","$2,725.60 ",$422.72 ,$169.09 ,"$2,384.90 ",$169.09 ,"$2,044.20 ",$169.09 ,"$2,555.25 ","$1,880.66 ","$1,696.69 ","$1,880.66 ",$169.09 ,"$1,880.66 ",$195.41 ,$195.41 ,"$2,895.95 ",$422.72 ,"$2,361.05 ",$169.09 ,"$3,407.00 ","$1,873.85 ",$169.09 ,$896.04 ,"$3,407.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,725.60 ","$1,850.00 ",$953.96 ,"$3,066.30 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,635.36 "
ST. MARY'S HOSPITAL - DECATUR,35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$2,911.00 ","$1,892.15 ",$92.72 ,"$2,911.00 ",$257.65 ,$750.00 ,"$1,601.05 ",$103.06 ,$815.08 ,"$1,426.39 ",$103.06 ,"$1,459.07 ",$103.06 ,"$1,580.67 ",$205.79 ,$103.06 ,"$1,580.67 ",$195.81 ,"$2,037.70 ","$1,455.50 ","$2,328.80 ",$257.64 ,$103.06 ,"$2,037.70 ",$103.06 ,"$1,746.60 ",$103.06 ,"$2,183.25 ","$1,606.87 ","$1,449.68 ","$1,606.87 ",$103.06 ,"$1,606.87 ",$139.76 ,$139.76 ,"$2,474.35 ",$257.64 ,"$2,017.32 ",$103.06 ,"$2,911.00 ","$1,601.05 ",$103.06 ,$765.59 ,"$2,911.00 ",$97.13 ,$92.72 ,$108.21 ,"$2,328.80 ","$1,580.67 ",$815.08 ,"$2,619.90 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,397.28 "
ST. MARY'S HOSPITAL - DECATUR,35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$3,037.00 ","$1,974.05 ",$92.72 ,"$3,037.00 ",$422.73 ,$750.00 ,"$1,670.35 ",$169.09 ,$850.36 ,"$1,488.13 ",$169.09 ,"$1,776.65 ",$169.09 ,"$1,649.09 ",$273.82 ,$169.09 ,"$1,649.09 ",$321.27 ,"$2,125.90 ","$1,518.50 ","$2,429.60 ",$422.72 ,$169.09 ,"$2,125.90 ",$169.09 ,"$1,822.20 ",$169.09 ,"$2,277.75 ","$1,676.42 ","$1,512.43 ","$1,676.42 ",$169.09 ,"$1,676.42 ",$185.96 ,$185.96 ,"$2,581.45 ",$422.72 ,"$2,104.64 ",$169.09 ,"$3,037.00 ","$1,670.35 ",$169.09 ,$798.73 ,"$3,037.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,429.60 ","$1,649.09 ",$850.36 ,"$2,733.30 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,457.76 "
ST. MARY'S HOSPITAL - DECATUR,35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$3,316.00 ","$2,155.40 ",$92.72 ,"$3,316.00 ",$422.73 ,$750.00 ,"$1,823.80 ",$169.09 ,$928.48 ,"$1,624.84 ",$169.09 ,"$1,939.86 ",$169.09 ,"$1,800.59 ",$335.27 ,$169.09 ,"$1,800.59 ",$321.27 ,"$2,321.20 ","$1,658.00 ","$2,652.80 ",$422.72 ,$169.09 ,"$2,321.20 ",$169.09 ,"$1,989.60 ",$169.09 ,"$2,487.00 ","$1,830.43 ","$1,651.37 ","$1,830.43 ",$169.09 ,"$1,830.43 ",$227.69 ,$227.69 ,"$2,818.60 ",$422.72 ,"$2,297.99 ",$169.09 ,"$3,316.00 ","$1,823.80 ",$169.09 ,$872.11 ,"$3,316.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,652.80 ","$1,800.59 ",$928.48 ,"$2,984.40 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,591.68 "
ST. MARY'S HOSPITAL - DECATUR,35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$4,868.00 ","$3,164.20 ",$169.09 ,"$4,868.00 ",$422.73 ,$750.00 ,"$2,677.40 ",$169.09 ,"$1,363.04 ","$2,385.32 ",$169.09 ,"$2,847.78 ",$169.09 ,"$2,643.32 ",$426.21 ,$169.09 ,"$2,643.32 ",$321.27 ,"$3,407.60 ","$2,434.00 ","$3,894.40 ",$422.72 ,$169.09 ,"$3,407.60 ",$169.09 ,"$2,920.80 ",$169.09 ,"$3,651.00 ","$2,687.14 ","$2,424.26 ","$2,687.14 ",$169.09 ,"$2,687.14 ",$278.52 ,$278.52 ,"$4,137.80 ",$422.72 ,"$3,373.52 ",$169.09 ,"$4,868.00 ","$2,677.40 ",$169.09 ,"$1,280.28 ","$4,868.00 ",$256.00 ,$244.37 ,$177.54 ,"$3,894.40 ","$2,643.32 ","$1,363.04 ","$4,381.20 ",$523.00 ,"$1,050.00 ",$169.09 ,"$2,336.64 "
ST. MARY'S HOSPITAL - DECATUR,35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$4,022.00 ","$2,614.30 ",$92.72 ,"$4,022.00 ",$422.73 ,$750.00 ,"$2,212.10 ",$169.09 ,"$1,126.16 ","$1,970.78 ",$169.09 ,"$2,352.87 ",$169.09 ,"$2,183.95 ",$424.74 ,$169.09 ,"$2,183.95 ",$321.27 ,"$2,815.40 ","$2,011.00 ","$3,217.60 ",$422.72 ,$169.09 ,"$2,815.40 ",$169.09 ,"$2,413.20 ",$169.09 ,"$3,016.50 ","$2,220.14 ","$2,002.96 ","$2,220.14 ",$169.09 ,"$2,220.14 ",$278.52 ,$278.52 ,"$3,418.70 ",$422.72 ,"$2,787.25 ",$169.09 ,"$4,022.00 ","$2,212.10 ",$169.09 ,"$1,057.79 ","$4,022.00 ",$97.13 ,$92.72 ,$177.54 ,"$3,217.60 ","$2,183.95 ","$1,126.16 ","$3,619.80 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,930.56 "
ST. MARY'S HOSPITAL - DECATUR,35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$4,695.00 ","$3,051.75 ",$217.81 ,"$4,695.00 ",$544.53 ,"$1,100.00 ","$2,582.25 ",$217.81 ,"$1,314.60 ","$2,300.55 ",$217.81 ,"$2,746.58 ",$217.81 ,"$2,549.39 ",$406.96 ,$217.81 ,"$2,549.39 ",$413.84 ,"$3,286.50 ","$2,347.50 ","$3,756.00 ",$544.53 ,$217.81 ,"$3,286.50 ",$217.81 ,"$2,817.00 ",$217.81 ,"$3,521.25 ","$2,591.64 ","$2,338.11 ","$2,591.64 ",$217.81 ,"$2,591.64 ",$276.38 ,$276.38 ,"$3,990.75 ",$544.53 ,"$3,253.64 ",$217.81 ,"$4,695.00 ","$2,582.25 ",$217.81 ,"$1,234.79 ","$4,695.00 ",$242.32 ,$231.30 ,$228.70 ,"$3,756.00 ","$2,549.39 ","$1,314.60 ","$4,225.50 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,253.60 "
ST. MARY'S HOSPITAL - DECATUR,35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$4,360.00 ","$2,834.00 ",$103.06 ,"$4,360.00 ",$257.65 ,$750.00 ,"$2,398.00 ",$103.06 ,"$1,220.80 ","$1,841.45 ",$103.06 ,"$1,841.45 ",$103.06 ,"$2,367.48 ",$267.97 ,$103.06 ,"$2,367.48 ",$195.81 ,"$3,052.00 ","$2,180.00 ","$3,488.00 ",$257.64 ,$103.06 ,"$3,052.00 ",$103.06 ,"$2,616.00 ",$103.06 ,"$3,270.00 ","$2,406.72 ","$2,171.28 ","$2,406.72 ",$103.06 ,"$2,406.72 ",$155.16 ,$155.16 ,"$3,706.00 ",$257.64 ,"$3,021.48 ",$103.06 ,"$4,360.00 ","$2,398.00 ",$103.06 ,"$1,146.68 ","$4,360.00 ",$110.24 ,$105.23 ,$108.21 ,"$3,488.00 ","$2,367.48 ","$1,220.80 ","$3,924.00 ",$523.00 ,"$1,050.00 ",$103.06 ,"$2,092.80 "
ST. MARY'S HOSPITAL - DECATUR,35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,"$4,360.00 ","$2,834.00 ",$105.23 ,"$4,360.00 ",$871.45 ,$750.00 ,"$2,398.00 ",$348.58 ,"$1,220.80 ","$2,136.40 ",$348.58 ,"$2,342.88 ",$348.58 ,"$2,367.48 ",$341.12 ,$348.58 ,"$2,367.48 ",$662.31 ,"$3,052.00 ","$2,180.00 ","$3,488.00 ",$871.46 ,$348.58 ,"$3,052.00 ",$348.58 ,"$2,616.00 ",$348.58 ,"$3,270.00 ","$2,406.72 ","$2,171.28 ","$2,406.72 ",$348.58 ,"$2,406.72 ",$231.66 ,$231.66 ,"$3,706.00 ",$871.46 ,"$3,021.48 ",$348.58 ,"$4,360.00 ","$2,398.00 ",$348.58 ,"$1,146.68 ","$4,360.00 ",$110.24 ,$105.23 ,$366.01 ,"$3,488.00 ","$2,367.48 ","$1,220.80 ","$3,924.00 ",$523.00 ,"$1,050.00 ",$348.58 ,"$2,092.80 "
ST. MARY'S HOSPITAL - DECATUR,35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,"$4,360.00 ","$2,834.00 ",$105.23 ,"$4,360.00 ",$422.73 ,$750.00 ,"$2,398.00 ",$169.09 ,"$1,220.80 ","$2,136.40 ",$169.09 ,"$2,550.60 ",$169.09 ,"$2,367.48 ",$423.05 ,$169.09 ,"$2,367.48 ",$321.27 ,"$3,052.00 ","$2,180.00 ","$3,488.00 ",$422.72 ,$169.09 ,"$3,052.00 ",$169.09 ,"$2,616.00 ",$169.09 ,"$3,270.00 ","$2,406.72 ","$2,171.28 ","$2,406.72 ",$169.09 ,"$2,406.72 ",$278.37 ,$278.37 ,"$3,706.00 ",$422.72 ,"$3,021.48 ",$169.09 ,"$4,360.00 ","$2,398.00 ",$169.09 ,"$1,146.68 ","$4,360.00 ",$110.24 ,$105.23 ,$177.54 ,"$3,488.00 ","$2,367.48 ","$1,220.80 ","$3,924.00 ",$523.00 ,"$1,050.00 ",$169.09 ,"$2,092.80 "
ST. MARY'S HOSPITAL - DECATUR,35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$4,155.00 ","$2,700.75 ",$103.06 ,"$4,155.00 ",$257.65 ,$750.00 ,"$2,285.25 ",$103.06 ,"$1,163.40 ","$1,831.53 ",$103.06 ,"$1,831.53 ",$103.06 ,"$2,256.17 ",$267.24 ,$103.06 ,"$2,256.17 ",$195.81 ,"$2,908.50 ","$2,077.50 ","$3,324.00 ",$257.64 ,$103.06 ,"$2,908.50 ",$103.06 ,"$2,493.00 ",$103.06 ,"$3,116.25 ","$2,293.56 ","$2,069.19 ","$2,293.56 ",$103.06 ,"$2,293.56 ",$155.16 ,$155.16 ,"$3,531.75 ",$257.64 ,"$2,879.42 ",$103.06 ,"$4,155.00 ","$2,285.25 ",$103.06 ,"$1,092.77 ","$4,155.00 ",$110.24 ,$105.23 ,$108.21 ,"$3,324.00 ","$2,256.17 ","$1,163.40 ","$3,739.50 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,994.40 "
ST. MARY'S HOSPITAL - DECATUR,35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,"$4,048.00 ","$2,631.20 ",$105.23 ,"$4,048.00 ",$422.73 ,$750.00 ,"$2,226.40 ",$169.09 ,"$1,133.44 ","$1,983.52 ",$169.09 ,"$2,357.82 ",$169.09 ,"$2,198.06 ",$344.05 ,$169.09 ,"$2,198.06 ",$321.27 ,"$2,833.60 ","$2,024.00 ","$3,238.40 ",$422.72 ,$169.09 ,"$2,833.60 ",$169.09 ,"$2,428.80 ",$169.09 ,"$3,036.00 ","$2,234.50 ","$2,015.90 ","$2,234.50 ",$169.09 ,"$2,234.50 ",$233.66 ,$233.66 ,"$3,440.80 ",$422.72 ,"$2,805.26 ",$169.09 ,"$4,048.00 ","$2,226.40 ",$169.09 ,"$1,064.62 ","$4,048.00 ",$110.24 ,$105.23 ,$177.54 ,"$3,238.40 ","$2,198.06 ","$1,133.44 ","$3,643.20 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,943.04 "
ST. MARY'S HOSPITAL - DECATUR,35000060,72130,HC CT T-SPINE W AND W/O CONTRAST,350,1 ,"$4,048.00 ","$2,631.20 ",$105.23 ,"$4,048.00 ",$422.73 ,$750.00 ,"$2,226.40 ",$169.09 ,"$1,133.44 ","$1,983.52 ",$169.09 ,"$2,368.08 ",$169.09 ,"$2,198.06 ",$423.78 ,$169.09 ,"$2,198.06 ",$321.27 ,"$2,833.60 ","$2,024.00 ","$3,238.40 ",$422.72 ,$169.09 ,"$2,833.60 ",$169.09 ,"$2,428.80 ",$169.09 ,"$3,036.00 ","$2,234.50 ","$2,015.90 ","$2,234.50 ",$169.09 ,"$2,234.50 ",$278.37 ,$278.37 ,"$3,440.80 ",$422.72 ,"$2,805.26 ",$169.09 ,"$4,048.00 ","$2,226.40 ",$169.09 ,"$1,064.62 ","$4,048.00 ",$110.24 ,$105.23 ,$177.54 ,"$3,238.40 ","$2,198.06 ","$1,133.44 ","$3,643.20 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,943.04 "
ST. MARY'S HOSPITAL - DECATUR,35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$4,142.00 ","$2,692.30 ",$103.06 ,"$4,142.00 ",$257.65 ,$750.00 ,"$2,278.10 ",$103.06 ,"$1,159.76 ","$1,821.60 ",$103.06 ,"$1,821.60 ",$103.06 ,"$2,249.11 ",$265.77 ,$103.06 ,"$2,249.11 ",$195.81 ,"$2,899.40 ","$2,071.00 ","$3,313.60 ",$257.64 ,$103.06 ,"$2,899.40 ",$103.06 ,"$2,485.20 ",$103.06 ,"$3,106.50 ","$2,286.38 ","$2,062.72 ","$2,286.38 ",$103.06 ,"$2,286.38 ",$155.16 ,$155.16 ,"$3,520.70 ",$257.64 ,"$2,870.41 ",$103.06 ,"$4,142.00 ","$2,278.10 ",$103.06 ,"$1,089.35 ","$4,142.00 ",$110.24 ,$105.23 ,$108.21 ,"$3,313.60 ","$2,249.11 ","$1,159.76 ","$3,727.80 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,988.16 "
ST. MARY'S HOSPITAL - DECATUR,35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$4,213.00 ","$2,738.45 ",$105.23 ,"$4,213.00 ",$871.45 ,$750.00 ,"$2,317.15 ",$348.58 ,"$1,179.64 ","$2,064.37 ",$348.58 ,"$2,342.88 ",$348.58 ,"$2,287.66 ",$341.85 ,$348.58 ,"$2,287.66 ",$662.31 ,"$2,949.10 ","$2,106.50 ","$3,370.40 ",$871.46 ,$348.58 ,"$2,949.10 ",$348.58 ,"$2,527.80 ",$348.58 ,"$3,159.75 ","$2,325.58 ","$2,098.07 ","$2,325.58 ",$348.58 ,"$2,325.58 ",$232.16 ,$232.16 ,"$3,581.05 ",$871.46 ,"$2,919.61 ",$348.58 ,"$4,213.00 ","$2,317.15 ",$348.58 ,"$1,108.02 ","$4,213.00 ",$110.24 ,$105.23 ,$366.01 ,"$3,370.40 ","$2,287.66 ","$1,179.64 ","$3,791.70 ",$523.00 ,"$1,050.00 ",$348.58 ,"$2,022.24 "
ST. MARY'S HOSPITAL - DECATUR,35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$4,132.00 ","$2,685.80 ",$105.23 ,"$4,132.00 ",$422.73 ,$750.00 ,"$2,272.60 ",$169.09 ,"$1,156.96 ","$2,024.68 ",$169.09 ,"$2,417.22 ",$169.09 ,"$2,243.68 ",$420.86 ,$169.09 ,"$2,243.68 ",$321.27 ,"$2,892.40 ","$2,066.00 ","$3,305.60 ",$422.72 ,$169.09 ,"$2,892.40 ",$169.09 ,"$2,479.20 ",$169.09 ,"$3,099.00 ","$2,280.86 ","$2,057.74 ","$2,280.86 ",$169.09 ,"$2,280.86 ",$278.37 ,$278.37 ,"$3,512.20 ",$422.72 ,"$2,863.48 ",$169.09 ,"$4,132.00 ","$2,272.60 ",$169.09 ,"$1,086.72 ","$4,132.00 ",$110.24 ,$105.23 ,$177.54 ,"$3,305.60 ","$2,243.68 ","$1,156.96 ","$3,718.80 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,983.36 "
ST. MARY'S HOSPITAL - DECATUR,35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$3,782.00 ","$2,458.30 ",$169.09 ,"$3,782.00 ",$422.73 ,$750.00 ,"$2,080.10 ",$169.09 ,"$1,058.96 ","$1,853.18 ",$169.09 ,"$2,212.47 ",$169.09 ,"$2,053.63 ",$460.59 ,$169.09 ,"$2,053.63 ",$321.27 ,"$2,647.40 ","$1,891.00 ","$3,025.60 ",$422.72 ,$169.09 ,"$2,647.40 ",$169.09 ,"$2,269.20 ",$169.09 ,"$2,836.50 ","$2,087.66 ","$1,883.44 ","$2,087.66 ",$169.09 ,"$2,087.66 ",$278.52 ,$278.52 ,"$3,214.70 ",$422.72 ,"$2,620.93 ",$169.09 ,"$3,782.00 ","$2,080.10 ",$169.09 ,$994.67 ,"$3,782.00 ",$219.49 ,$209.52 ,$177.54 ,"$3,025.60 ","$2,053.63 ","$1,058.96 ","$3,403.80 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,815.36 "
ST. MARY'S HOSPITAL - DECATUR,35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$3,320.00 ","$2,158.00 ",$103.06 ,"$3,320.00 ",$257.65 ,$750.00 ,"$1,826.00 ",$103.06 ,$929.60 ,"$1,626.80 ",$103.06 ,"$1,627.85 ",$103.06 ,"$1,802.76 ",$186.77 ,$103.06 ,"$1,802.76 ",$195.81 ,"$2,324.00 ","$1,660.00 ","$2,656.00 ",$257.64 ,$103.06 ,"$2,324.00 ",$103.06 ,"$1,992.00 ",$103.06 ,"$2,490.00 ","$1,832.64 ","$1,653.36 ","$1,832.64 ",$103.06 ,"$1,832.64 ",$126.84 ,$126.84 ,"$2,822.00 ",$257.64 ,"$2,300.76 ",$103.06 ,"$3,320.00 ","$1,826.00 ",$103.06 ,$873.16 ,"$3,320.00 ",$219.71 ,$209.73 ,$108.21 ,"$2,656.00 ","$1,802.76 ",$929.60 ,"$2,988.00 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,593.60 "
ST. MARY'S HOSPITAL - DECATUR,35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$3,782.00 ","$2,458.30 ",$169.09 ,"$3,782.00 ",$422.73 ,$750.00 ,"$2,080.10 ",$169.09 ,"$1,058.96 ","$1,853.18 ",$169.09 ,"$2,212.47 ",$169.09 ,"$2,053.63 ",$360.87 ,$169.09 ,"$2,053.63 ",$321.27 ,"$2,647.40 ","$1,891.00 ","$3,025.60 ",$422.72 ,$169.09 ,"$2,647.40 ",$169.09 ,"$2,269.20 ",$169.09 ,"$2,836.50 ","$2,087.66 ","$1,883.44 ","$2,087.66 ",$169.09 ,"$2,087.66 ",$245.09 ,$245.09 ,"$3,214.70 ",$422.72 ,"$2,620.93 ",$169.09 ,"$3,782.00 ","$2,080.10 ",$169.09 ,$994.67 ,"$3,782.00 ",$219.71 ,$209.73 ,$177.54 ,"$3,025.60 ","$2,053.63 ","$1,058.96 ","$3,403.80 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,815.36 "
ST. MARY'S HOSPITAL - DECATUR,35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$4,163.00 ","$2,705.95 ",$169.09 ,"$4,163.00 ",$422.73 ,$750.00 ,"$2,289.65 ",$169.09 ,"$1,165.64 ","$2,039.87 ",$169.09 ,"$2,435.36 ",$169.09 ,"$2,260.51 ",$420.86 ,$169.09 ,"$2,260.51 ",$321.27 ,"$2,914.10 ","$2,081.50 ","$3,330.40 ",$422.72 ,$169.09 ,"$2,914.10 ",$169.09 ,"$2,497.80 ",$169.09 ,"$3,122.25 ","$2,297.98 ","$2,073.17 ","$2,297.98 ",$169.09 ,"$2,297.98 ",$278.37 ,$278.37 ,"$3,538.55 ",$422.72 ,"$2,884.96 ",$169.09 ,"$4,163.00 ","$2,289.65 ",$169.09 ,"$1,094.87 ","$4,163.00 ",$219.71 ,$209.73 ,$177.54 ,"$3,330.40 ","$2,260.51 ","$1,165.64 ","$3,746.70 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,998.24 "
ST. MARY'S HOSPITAL - DECATUR,35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$3,320.00 ","$2,158.00 ",$92.72 ,"$3,320.00 ",$257.65 ,$750.00 ,"$1,826.00 ",$103.06 ,$929.60 ,"$1,626.80 ",$103.06 ,"$1,816.58 ",$103.06 ,"$1,802.76 ",$265.04 ,$103.06 ,"$1,802.76 ",$195.81 ,"$2,324.00 ","$1,660.00 ","$2,656.00 ",$257.64 ,$103.06 ,"$2,324.00 ",$103.06 ,"$1,992.00 ",$103.06 ,"$2,490.00 ","$1,832.64 ","$1,653.36 ","$1,832.64 ",$103.06 ,"$1,832.64 ",$155.16 ,$155.16 ,"$2,822.00 ",$257.64 ,"$2,300.76 ",$103.06 ,"$3,320.00 ","$1,826.00 ",$103.06 ,$873.16 ,"$3,320.00 ",$97.13 ,$92.72 ,$108.21 ,"$2,656.00 ","$1,802.76 ",$929.60 ,"$2,988.00 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,593.60 "
ST. MARY'S HOSPITAL - DECATUR,35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$3,320.00 ","$2,158.00 ",$92.72 ,"$3,320.00 ",$871.45 ,$750.00 ,"$1,826.00 ",$348.58 ,$929.60 ,"$1,626.80 ",$348.58 ,"$1,942.20 ",$348.58 ,"$1,802.76 ",$338.19 ,$348.58 ,"$1,802.76 ",$662.31 ,"$2,324.00 ","$1,660.00 ","$2,656.00 ",$871.46 ,$348.58 ,"$2,324.00 ",$348.58 ,"$1,992.00 ",$348.58 ,"$2,490.00 ","$1,832.64 ","$1,653.36 ","$1,832.64 ",$348.58 ,"$1,832.64 ",$229.68 ,$229.68 ,"$2,822.00 ",$871.46 ,"$2,300.76 ",$348.58 ,"$3,320.00 ","$1,826.00 ",$348.58 ,$873.16 ,"$3,320.00 ",$97.13 ,$92.72 ,$366.01 ,"$2,656.00 ","$1,802.76 ",$929.60 ,"$2,988.00 ",$523.00 ,"$1,050.00 ",$348.58 ,"$1,593.60 "
ST. MARY'S HOSPITAL - DECATUR,35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$3,320.00 ","$2,158.00 ",$92.72 ,"$3,320.00 ",$422.73 ,$750.00 ,"$1,826.00 ",$169.09 ,$929.60 ,"$1,626.80 ",$169.09 ,"$1,942.20 ",$169.09 ,"$1,802.76 ",$445.00 ,$169.09 ,"$1,802.76 ",$321.27 ,"$2,324.00 ","$1,660.00 ","$2,656.00 ",$422.72 ,$169.09 ,"$2,324.00 ",$169.09 ,"$1,992.00 ",$169.09 ,"$2,490.00 ","$1,832.64 ","$1,653.36 ","$1,832.64 ",$169.09 ,"$1,832.64 ",$278.37 ,$278.37 ,"$2,822.00 ",$422.72 ,"$2,300.76 ",$169.09 ,"$3,320.00 ","$1,826.00 ",$169.09 ,$873.16 ,"$3,320.00 ",$97.13 ,$92.72 ,$177.54 ,"$2,656.00 ","$1,802.76 ",$929.60 ,"$2,988.00 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,593.60 "
ST. MARY'S HOSPITAL - DECATUR,35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$3,065.00 ","$1,992.25 ",$169.09 ,"$3,065.00 ",$422.73 ,$750.00 ,"$1,685.75 ",$169.09 ,$858.20 ,"$1,501.85 ",$169.09 ,"$1,793.03 ",$169.09 ,"$1,664.30 ",$489.85 ,$169.09 ,"$1,664.30 ",$321.27 ,"$2,145.50 ","$1,532.50 ","$2,452.00 ",$422.72 ,$169.09 ,"$2,145.50 ",$169.09 ,"$1,839.00 ",$169.09 ,"$2,298.75 ","$1,691.88 ","$1,526.37 ","$1,691.88 ",$169.09 ,"$1,691.88 ",$278.52 ,$278.52 ,"$2,605.25 ",$422.72 ,"$2,124.05 ",$169.09 ,"$3,065.00 ","$1,685.75 ",$169.09 ,$806.10 ,"$3,065.00 ",$219.49 ,$209.52 ,$177.54 ,"$2,452.00 ","$1,664.30 ",$858.20 ,"$2,758.50 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,471.20 "
ST. MARY'S HOSPITAL - DECATUR,35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$3,320.00 ","$2,158.00 ",$92.72 ,"$3,320.00 ",$257.65 ,$750.00 ,"$1,826.00 ",$103.06 ,$929.60 ,"$1,626.80 ",$103.06 ,"$1,834.18 ",$103.06 ,"$1,802.76 ",$265.77 ,$103.06 ,"$1,802.76 ",$195.81 ,"$2,324.00 ","$1,660.00 ","$2,656.00 ",$257.64 ,$103.06 ,"$2,324.00 ",$103.06 ,"$1,992.00 ",$103.06 ,"$2,490.00 ","$1,832.64 ","$1,653.36 ","$1,832.64 ",$103.06 ,"$1,832.64 ",$155.16 ,$155.16 ,"$2,822.00 ",$257.64 ,"$2,300.76 ",$103.06 ,"$3,320.00 ","$1,826.00 ",$103.06 ,$873.16 ,"$3,320.00 ",$97.13 ,$92.72 ,$108.21 ,"$2,656.00 ","$1,802.76 ",$929.60 ,"$2,988.00 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,593.60 "
ST. MARY'S HOSPITAL - DECATUR,35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$4,238.00 ","$2,754.70 ",$92.72 ,"$4,238.00 ",$422.73 ,$750.00 ,"$2,330.90 ",$169.09 ,"$1,186.64 ","$2,076.62 ",$169.09 ,"$2,369.23 ",$169.09 ,"$2,301.23 ",$344.05 ,$169.09 ,"$2,301.23 ",$321.27 ,"$2,966.60 ","$2,119.00 ","$3,390.40 ",$422.72 ,$169.09 ,"$2,966.60 ",$169.09 ,"$2,542.80 ",$169.09 ,"$3,178.50 ","$2,339.38 ","$2,110.52 ","$2,339.38 ",$169.09 ,"$2,339.38 ",$233.66 ,$233.66 ,"$3,602.30 ",$422.72 ,"$2,936.93 ",$169.09 ,"$4,238.00 ","$2,330.90 ",$169.09 ,"$1,114.59 ","$4,238.00 ",$97.13 ,$92.72 ,$177.54 ,"$3,390.40 ","$2,301.23 ","$1,186.64 ","$3,814.20 ",$523.00 ,"$1,050.00 ",$169.09 ,"$2,034.24 "
ST. MARY'S HOSPITAL - DECATUR,35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,"$3,903.00 ","$2,536.95 ",$92.72 ,"$3,903.00 ",$422.73 ,$750.00 ,"$2,146.65 ",$169.09 ,"$1,092.84 ","$1,912.47 ",$169.09 ,"$2,283.26 ",$169.09 ,"$2,119.33 ",$436.95 ,$169.09 ,"$2,119.33 ",$321.27 ,"$2,732.10 ","$1,951.50 ","$3,122.40 ",$422.72 ,$169.09 ,"$2,732.10 ",$169.09 ,"$2,341.80 ",$169.09 ,"$2,927.25 ","$2,154.46 ","$1,943.69 ","$2,154.46 ",$169.09 ,"$2,154.46 ",$278.37 ,$278.37 ,"$3,317.55 ",$422.72 ,"$2,704.78 ",$169.09 ,"$3,903.00 ","$2,146.65 ",$169.09 ,"$1,026.49 ","$3,903.00 ",$97.13 ,$92.72 ,$177.54 ,"$3,122.40 ","$2,119.33 ","$1,092.84 ","$3,512.70 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,873.44 "
ST. MARY'S HOSPITAL - DECATUR,35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$3,225.00 ","$2,096.25 ",$169.09 ,"$3,225.00 ",$422.73 ,$750.00 ,"$1,773.75 ",$169.09 ,$903.00 ,"$1,580.25 ",$169.09 ,"$1,886.63 ",$169.09 ,"$1,751.18 ",$536.90 ,$169.09 ,"$1,751.18 ",$321.27 ,"$2,257.50 ","$1,612.50 ","$2,580.00 ",$422.72 ,$169.09 ,"$2,257.50 ",$169.09 ,"$1,935.00 ",$169.09 ,"$2,418.75 ","$1,780.20 ","$1,606.05 ","$1,780.20 ",$169.09 ,"$1,780.20 ",$278.03 ,$278.03 ,"$2,741.25 ",$422.72 ,"$2,234.93 ",$169.09 ,"$3,225.00 ","$1,773.75 ",$169.09 ,$848.18 ,"$3,225.00 ",$219.49 ,$209.52 ,$177.54 ,"$2,580.00 ","$1,751.18 ",$903.00 ,"$2,902.50 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,548.00 "
ST. MARY'S HOSPITAL - DECATUR,35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$3,365.00 ","$2,187.25 ",$103.06 ,"$3,365.00 ",$257.65 ,$750.00 ,"$1,850.75 ",$103.06 ,$942.20 ,"$1,602.68 ",$103.06 ,"$1,602.68 ",$103.06 ,"$1,827.20 ",$184.57 ,$103.06 ,"$1,827.20 ",$195.81 ,"$2,355.50 ","$1,682.50 ","$2,692.00 ",$257.64 ,$103.06 ,"$2,355.50 ",$103.06 ,"$2,019.00 ",$103.06 ,"$2,523.75 ","$1,857.48 ","$1,675.77 ","$1,857.48 ",$103.06 ,"$1,857.48 ",$125.36 ,$125.36 ,"$2,860.25 ",$257.64 ,"$2,331.95 ",$103.06 ,"$3,365.00 ","$1,850.75 ",$103.06 ,$885.00 ,"$3,365.00 ",$219.71 ,$209.73 ,$108.21 ,"$2,692.00 ","$1,827.20 ",$942.20 ,"$3,028.50 ",$523.00 ,"$1,050.00 ",$103.06 ,"$1,615.20 "
ST. MARY'S HOSPITAL - DECATUR,35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$4,188.00 ","$2,722.20 ",$169.09 ,"$4,188.00 ",$422.73 ,$750.00 ,"$2,303.40 ",$169.09 ,"$1,172.64 ","$2,052.12 ",$169.09 ,"$2,449.98 ",$169.09 ,"$2,274.08 ",$359.41 ,$169.09 ,"$2,274.08 ",$321.27 ,"$2,931.60 ","$2,094.00 ","$3,350.40 ",$422.72 ,$169.09 ,"$2,931.60 ",$169.09 ,"$2,512.80 ",$169.09 ,"$3,141.00 ","$2,311.78 ","$2,085.62 ","$2,311.78 ",$169.09 ,"$2,311.78 ",$244.08 ,$244.08 ,"$3,559.80 ",$422.72 ,"$2,902.28 ",$169.09 ,"$4,188.00 ","$2,303.40 ",$169.09 ,"$1,101.44 ","$4,188.00 ",$219.71 ,$209.73 ,$177.54 ,"$3,350.40 ","$2,274.08 ","$1,172.64 ","$3,769.20 ",$523.00 ,"$1,050.00 ",$169.09 ,"$2,010.24 "
ST. MARY'S HOSPITAL - DECATUR,35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$4,578.00 ","$2,975.70 ",$169.09 ,"$4,578.00 ",$422.73 ,$750.00 ,"$2,517.90 ",$169.09 ,"$1,281.84 ","$2,243.22 ",$169.09 ,"$2,678.13 ",$169.09 ,"$2,485.85 ",$412.08 ,$169.09 ,"$2,485.85 ",$321.27 ,"$3,204.60 ","$2,289.00 ","$3,662.40 ",$422.72 ,$169.09 ,"$3,204.60 ",$169.09 ,"$2,746.80 ",$169.09 ,"$3,433.50 ","$2,527.06 ","$2,279.84 ","$2,527.06 ",$169.09 ,"$2,527.06 ",$278.37 ,$278.37 ,"$3,891.30 ",$422.72 ,"$3,172.55 ",$169.09 ,"$4,578.00 ","$2,517.90 ",$169.09 ,"$1,204.01 ","$4,578.00 ",$219.71 ,$209.73 ,$177.54 ,"$3,662.40 ","$2,485.85 ","$1,281.84 ","$4,120.20 ",$523.00 ,"$1,050.00 ",$169.09 ,"$2,197.44 "
ST. MARY'S HOSPITAL - DECATUR,35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$5,485.00 ","$3,565.25 ",$169.09 ,"$5,485.00 ",$422.73 ,$750.00 ,"$3,016.75 ",$169.09 ,"$1,535.80 ","$2,687.65 ",$169.09 ,"$3,068.43 ",$169.09 ,"$2,978.36 ",$461.32 ,$169.09 ,"$2,978.36 ",$321.27 ,"$3,839.50 ","$2,742.50 ","$4,388.00 ",$422.72 ,$169.09 ,"$3,839.50 ",$169.09 ,"$3,291.00 ",$169.09 ,"$4,113.75 ","$3,027.72 ","$2,731.53 ","$3,027.72 ",$169.09 ,"$3,027.72 ",$278.52 ,$278.52 ,"$4,662.25 ",$422.72 ,"$3,801.11 ",$169.09 ,"$5,485.00 ","$3,016.75 ",$169.09 ,"$1,442.56 ","$5,485.00 ",$219.49 ,$209.52 ,$177.54 ,"$4,388.00 ","$2,978.36 ","$1,535.80 ","$4,936.50 ",$523.00 ,"$1,050.00 ",$169.09 ,"$2,632.80 "
ST. MARY'S HOSPITAL - DECATUR,35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$6,684.00 ","$4,344.60 ",$157.64 ,"$6,684.00 ",$544.53 ,$750.00 ,"$3,676.20 ",$217.81 ,"$1,871.52 ","$2,017.80 ",$217.81 ,"$2,017.80 ",$217.81 ,"$3,629.41 ",$232.12 ,$217.81 ,"$3,629.41 ",$413.84 ,"$4,678.80 ","$3,342.00 ","$5,347.20 ",$544.53 ,$217.81 ,"$4,678.80 ",$217.81 ,"$4,010.40 ",$217.81 ,"$5,013.00 ","$3,689.57 ","$3,328.63 ","$3,689.57 ",$217.81 ,"$3,689.57 ",$157.64 ,$157.64 ,"$5,681.40 ",$544.53 ,"$4,632.01 ",$217.81 ,"$6,684.00 ","$3,676.20 ",$217.81 ,"$1,757.89 ","$6,684.00 ",$219.71 ,$209.73 ,$228.70 ,"$5,347.20 ","$3,629.41 ","$1,871.52 ","$6,015.60 ",$523.00 ,"$1,050.00 ",$217.81 ,"$3,208.32 "
ST. MARY'S HOSPITAL - DECATUR,35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$7,971.00 ","$5,181.15 ",$209.73 ,"$7,971.00 ",$871.45 ,$750.00 ,"$4,384.05 ",$348.58 ,"$2,231.88 ","$3,905.79 ",$348.58 ,"$3,916.96 ",$348.58 ,"$4,328.25 ",$467.67 ,$348.58 ,"$4,328.25 ",$662.31 ,"$5,579.70 ","$3,985.50 ","$6,376.80 ",$871.46 ,$348.58 ,"$5,579.70 ",$348.58 ,"$4,782.60 ",$348.58 ,"$5,978.25 ","$4,399.99 ","$3,969.56 ","$4,399.99 ",$348.58 ,"$4,399.99 ",$317.61 ,$317.61 ,"$6,775.35 ",$871.46 ,"$5,523.90 ",$348.58 ,"$7,971.00 ","$4,384.05 ",$348.58 ,"$2,096.37 ","$7,971.00 ",$219.71 ,$209.73 ,$366.01 ,"$6,376.80 ","$4,328.25 ","$2,231.88 ","$7,173.90 ",$523.00 ,"$1,050.00 ",$348.58 ,"$3,826.08 "
ST. MARY'S HOSPITAL - DECATUR,35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$8,741.00 ","$5,681.65 ",$209.73 ,"$8,741.00 ",$871.45 ,$750.00 ,"$4,807.55 ",$348.58 ,"$2,447.48 ","$4,283.09 ",$348.58 ,"$4,500.86 ",$348.58 ,"$4,746.36 ",$534.47 ,$348.58 ,"$4,746.36 ",$662.31 ,"$6,118.70 ","$4,370.50 ","$6,992.80 ",$871.46 ,$348.58 ,"$6,118.70 ",$348.58 ,"$5,244.60 ",$348.58 ,"$6,555.75 ","$4,825.03 ","$4,353.02 ","$4,825.03 ",$348.58 ,"$4,825.03 ",$362.97 ,$362.97 ,"$7,429.85 ",$871.46 ,"$6,057.51 ",$348.58 ,"$8,741.00 ","$4,807.55 ",$348.58 ,"$2,298.88 ","$8,741.00 ",$219.71 ,$209.73 ,$366.01 ,"$6,992.80 ","$4,746.36 ","$2,447.48 ","$7,866.90 ",$523.00 ,"$1,050.00 ",$348.58 ,"$4,195.68 "
ST. MARY'S HOSPITAL - DECATUR,35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,$39.00 ,$25.35 ,$10.26 ,$191.43 ,$191.43 ,$39.00 ,$21.45 ,$76.57 ,$10.92 ,$19.11 ,$76.57 ,$22.82 ,$39.00 ,$21.18 ,$39.00 ,$39.00 ,$21.18 ,$39.00 ,$27.30 ,$19.50 ,$31.20 ,$191.42 ,$76.57 ,$27.30 ,$76.57 ,$23.40 ,$76.57 ,$29.25 ,$21.53 ,$19.42 ,$21.53 ,$76.57 ,$21.53 ,$39.00 ,$39.00 ,$33.15 ,$39.00 ,$27.03 ,$76.57 ,$39.00 ,$21.45 ,$76.57 ,$10.26 ,$39.00 , N/A , N/A ,$80.40 ,$31.20 ,$21.18 ,$10.92 ,$35.10 ,$39.00 ,$39.00 ,$76.57 ,$18.72 
ST. MARY'S HOSPITAL - DECATUR,35000088,N/A,HC CT HRT W/O DYE W/CA TEST (PROMO),350,1 ,$39.00 ,$25.35 ,$10.26 ,$39.00 , N/A ,$39.00 ,$21.45 , N/A ,$10.92 ,$18.33 , N/A ,$21.06 , N/A ,$21.18 ,$15.60 , N/A ,$21.18 , N/A ,$27.30 ,$19.50 ,$31.20 , N/A , N/A ,$27.30 , N/A ,$23.40 , N/A ,$29.25 ,$21.53 ,$19.42 ,$21.53 , N/A ,$21.53 ,$27.30 ,$27.30 ,$33.15 , N/A ,$27.03 , N/A ,$39.00 ,$21.45 , N/A ,$10.26 ,$39.00 , N/A , N/A , N/A ,$31.20 ,$21.18 ,$10.92 ,$35.10 ,$39.00 ,$39.00 , N/A ,$18.72 
ST. MARY'S HOSPITAL - DECATUR,35000089,75572,HC CT HEART WO/W CONT FUNCT EVAL,350,1 ,"$2,825.00 ","$1,836.25 ",$169.09 ,"$2,825.00 ",$422.73 ,$750.00 ,"$1,553.75 ",$169.09 ,$791.00 ,"$1,384.25 ",$169.09 ,"$1,652.63 ",$169.09 ,"$1,533.98 ",$369.88 ,$169.09 ,"$1,533.98 ",$321.27 ,"$1,977.50 ","$1,412.50 ","$2,260.00 ",$422.72 ,$169.09 ,"$1,977.50 ",$169.09 ,"$1,695.00 ",$169.09 ,"$2,118.75 ","$1,559.40 ","$1,406.85 ","$1,559.40 ",$169.09 ,"$1,559.40 ",$251.19 ,$251.19 ,"$2,401.25 ",$422.72 ,"$1,957.73 ",$169.09 ,"$2,825.00 ","$1,553.75 ",$169.09 ,$742.98 ,"$2,825.00 ", N/A , N/A ,$177.54 ,"$2,260.00 ","$1,533.98 ",$791.00 ,"$2,542.50 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,356.00 "
ST. MARY'S HOSPITAL - DECATUR,35000094,75574,HC CTA HEART CORONARY W/CONTRAST 3D POST,350,1 ,"$3,747.00 ","$2,435.55 ",$169.09 ,"$3,747.00 ",$422.73 ,$750.00 ,"$2,060.85 ",$169.09 ,"$1,049.16 ","$1,836.03 ",$169.09 ,"$2,192.00 ",$169.09 ,"$2,034.62 ",$562.50 ,$169.09 ,"$2,034.62 ",$321.27 ,"$2,622.90 ","$1,873.50 ","$2,997.60 ",$422.72 ,$169.09 ,"$2,622.90 ",$169.09 ,"$2,248.20 ",$169.09 ,"$2,810.25 ","$2,068.34 ","$1,866.01 ","$2,068.34 ",$169.09 ,"$2,068.34 ",$278.52 ,$278.52 ,"$3,184.95 ",$422.72 ,"$2,596.67 ",$169.09 ,"$3,747.00 ","$2,060.85 ",$169.09 ,$985.46 ,"$3,747.00 ", N/A , N/A ,$177.54 ,"$2,997.60 ","$2,034.62 ","$1,049.16 ","$3,372.30 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,798.56 "
ST. MARY'S HOSPITAL - DECATUR,35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$2,397.00 ","$1,558.05 ",$169.09 ,"$2,397.00 ",$422.73 ,$750.00 ,"$1,318.35 ",$169.09 ,$671.16 ,"$1,174.53 ",$169.09 ,"$1,402.25 ",$169.09 ,"$1,301.57 ",$664.91 ,$169.09 ,"$1,301.57 ",$321.27 ,"$1,677.90 ","$1,198.50 ","$1,917.60 ",$422.72 ,$169.09 ,"$1,677.90 ",$169.09 ,"$1,438.20 ",$169.09 ,"$1,797.75 ","$1,323.14 ","$1,193.71 ","$1,323.14 ",$169.09 ,"$1,323.14 ",$278.52 ,$278.52 ,"$2,037.45 ",$422.72 ,"$1,661.12 ",$169.09 ,"$2,397.00 ","$1,318.35 ",$169.09 ,$630.41 ,"$2,397.00 ",$219.49 ,$209.52 ,$177.54 ,"$1,917.60 ","$1,301.57 ",$671.16 ,"$2,157.30 ",$523.00 ,"$1,050.00 ",$169.09 ,"$1,150.56 "
ST. MARY'S HOSPITAL - DECATUR,35000099,76376,HC 3D RENDER CT NOT REQUIRE INDEP,350,1 ,"$1,854.00 ","$1,205.10 ",$18.54 ,"$1,854.00 ", N/A ,$945.54 ,"$1,019.70 ", N/A ,$519.12 ,$244.37 , N/A ,$244.37 , N/A ,"$1,006.72 ",$27.30 , N/A ,"$1,006.72 ", N/A ,"$1,297.80 ",$927.00 ,"$1,483.20 ", N/A , N/A ,"$1,297.80 ", N/A ,"$1,112.40 ", N/A ,"$1,390.50 ","$1,023.41 ",$923.29 ,"$1,023.41 ", N/A ,"$1,023.41 ",$18.54 ,$18.54 ,"$1,575.90 ", N/A ,"$1,284.82 ", N/A ,"$1,854.00 ","$1,019.70 ", N/A ,$487.60 ,"$1,854.00 ", N/A , N/A , N/A ,"$1,483.20 ","$1,006.72 ",$519.12 ,"$1,668.60 ",$523.00 ,"$1,050.00 ", N/A ,$889.92 
ST. MARY'S HOSPITAL - DECATUR,35000100,76377,HC 3D RENDER CT REQUIRES INDEPENDENT,350,1 ,$270.00 ,$175.50 ,$43.88 ,$270.00 , N/A ,$137.70 ,$148.50 , N/A ,$75.60 ,$132.30 , N/A ,$157.95 , N/A ,$146.61 ,$64.60 , N/A ,$146.61 , N/A ,$189.00 ,$135.00 ,$216.00 , N/A , N/A ,$189.00 , N/A ,$162.00 , N/A ,$202.50 ,$149.04 ,$134.46 ,$149.04 , N/A ,$149.04 ,$43.88 ,$43.88 ,$229.50 , N/A ,$187.11 , N/A ,$270.00 ,$148.50 , N/A ,$71.01 ,$270.00 , N/A , N/A , N/A ,$216.00 ,$146.61 ,$75.60 ,$243.00 ,$270.00 ,$270.00 , N/A ,$129.60 
ST. MARY'S HOSPITAL - DECATUR,35000104,77011,HC CT GUIDED LOCALIZATION STEREO,350,1 ,"$2,482.00 ","$1,613.30 ",$71.51 ,"$2,482.00 ", N/A ,$750.00 ,"$1,365.10 ", N/A ,$694.96 ,"$1,216.18 ", N/A ,"$1,451.97 ", N/A ,"$1,347.73 ",$342.58 , N/A ,"$1,347.73 ", N/A ,"$1,737.40 ","$1,241.00 ","$1,985.60 ", N/A , N/A ,"$1,737.40 ", N/A ,"$1,489.20 ", N/A ,"$1,861.50 ","$1,370.06 ","$1,236.04 ","$1,370.06 ", N/A ,"$1,370.06 ",$232.67 ,$232.67 ,"$2,109.70 ", N/A ,"$1,720.03 ", N/A ,"$2,482.00 ","$1,365.10 ", N/A ,$652.77 ,"$2,482.00 ",$74.91 ,$71.51 , N/A ,"$1,985.60 ","$1,347.73 ",$694.96 ,"$2,233.80 ",$523.00 ,"$1,050.00 ", N/A ,"$1,191.36 "
ST. MARY'S HOSPITAL - DECATUR,35000106,77012,HC CT GUIDED NEEDLE PLACEMENT,350,1 ,"$3,525.00 ","$2,291.25 ",$71.51 ,"$3,525.00 ", N/A ,$750.00 ,"$1,938.75 ", N/A ,$987.00 ,"$1,200.24 ", N/A ,"$1,200.24 ", N/A ,"$1,914.08 ",$158.97 , N/A ,"$1,914.08 ", N/A ,"$2,467.50 ","$1,762.50 ","$2,820.00 ", N/A , N/A ,"$2,467.50 ", N/A ,"$2,115.00 ", N/A ,"$2,643.75 ","$1,945.80 ","$1,755.45 ","$1,945.80 ", N/A ,"$1,945.80 ",$107.96 ,$107.96 ,"$2,996.25 ", N/A ,"$2,442.83 ", N/A ,"$3,525.00 ","$1,938.75 ", N/A ,$927.08 ,"$3,525.00 ",$74.91 ,$71.51 , N/A ,"$2,820.00 ","$1,914.08 ",$987.00 ,"$3,172.50 ",$523.00 ,"$1,050.00 ", N/A ,"$1,692.00 "
ST. MARY'S HOSPITAL - DECATUR,35000111,77014,HC CT GUIDED THRPY PLACEMENT UNENHAN,350,1 ,$519.00 ,$337.35 ,$71.51 ,$519.00 , N/A ,$519.00 ,$285.45 , N/A ,$145.32 ,$254.31 , N/A ,$303.62 , N/A ,$281.82 ,$156.78 , N/A ,$281.82 , N/A ,$363.30 ,$259.50 ,$415.20 , N/A , N/A ,$363.30 , N/A ,$311.40 , N/A ,$389.25 ,$286.49 ,$258.46 ,$286.49 , N/A ,$286.49 ,$106.47 ,$106.47 ,$441.15 , N/A ,$359.67 , N/A ,$519.00 ,$285.45 , N/A ,$136.50 ,$519.00 ,$74.91 ,$71.51 , N/A ,$415.20 ,$281.82 ,$145.32 ,$467.10 ,$519.00 ,$519.00 , N/A ,$249.12 
ST. MARY'S HOSPITAL - DECATUR,35000116,64510,HC INJECT STELLATE GANGLION,350,1 ,"$1,171.00 ",$761.15 ,$148.01 ,"$1,948.10 ","$1,948.10 ",$750.00 ,$644.05 ,$779.24 ,$327.88 ,$550.37 ,$779.24 ,$632.34 ,$779.24 ,$635.85 ,$148.01 ,$779.24 ,$635.85 ,"$1,171.00 ",$819.70 ,$585.50 ,$936.80 ,"$1,948.10 ",$779.24 ,$819.70 ,$779.24 ,$702.60 ,$779.24 ,$878.25 ,$646.39 ,$583.16 ,$646.39 ,$779.24 ,$646.39 ,$819.70 ,$819.70 ,$995.35 ,"$1,171.00 ",$811.50 ,$779.24 ,"$1,171.00 ",$644.05 ,$779.24 ,$307.97 ,"$1,171.00 ",$557.90 ,$532.54 ,$818.20 ,$936.80 ,$635.85 ,$327.88 ,"$1,053.90 ",$523.00 ,"$1,050.00 ",$779.24 ,$562.08 
ST. MARY'S HOSPITAL - DECATUR,35000120,74174,HC CT ANGIO ABD/PELV W  AND  WO CONTRAST,350,1 ,"$8,651.00 ","$5,623.15 ",$209.73 ,"$8,651.00 ",$871.45 ,$750.00 ,"$4,758.05 ",$348.58 ,"$2,422.28 ","$3,948.42 ",$348.58 ,"$3,948.42 ",$348.58 ,"$4,697.49 ",$590.07 ,$348.58 ,"$4,697.49 ",$662.31 ,"$6,055.70 ","$4,325.50 ","$6,920.80 ",$871.46 ,$348.58 ,"$6,055.70 ",$348.58 ,"$5,190.60 ",$348.58 ,"$6,488.25 ","$4,775.35 ","$4,308.20 ","$4,775.35 ",$348.58 ,"$4,775.35 ",$400.73 ,$400.73 ,"$7,353.35 ",$871.46 ,"$5,995.14 ",$348.58 ,"$8,651.00 ","$4,758.05 ",$348.58 ,"$2,275.21 ","$8,651.00 ",$219.71 ,$209.73 ,$366.01 ,"$6,920.80 ","$4,697.49 ","$2,422.28 ","$7,785.90 ",$523.00 ,"$1,050.00 ",$348.58 ,"$4,152.48 "
ST. MARY'S HOSPITAL - DECATUR,35000132,G0260,HC INJECTION SACRO JOINT W/ ANESTH,350,1 ,"$5,377.00 ","$3,495.05 ",$216.13 ,"$5,377.00 ","$1,502.73 ",$750.00 ,"$2,957.35 ",$601.09 ,"$1,505.56 ","$2,527.19 ",$601.09 ,"$2,903.58 ",$601.09 ,"$2,919.71 ","$2,150.80 ",$601.09 ,"$2,919.71 ","$1,142.07 ","$3,763.90 ","$2,688.50 ","$4,301.60 ","$1,502.72 ",$601.09 ,"$3,763.90 ",$601.09 ,"$3,226.20 ",$601.09 ,"$4,032.75 ","$2,968.10 ","$2,677.75 ","$2,968.10 ",$601.09 ,"$2,968.10 ","$3,763.90 ","$3,763.90 ","$4,570.45 ","$1,502.72 ","$3,726.26 ",$601.09 ,"$5,377.00 ","$2,957.35 ",$601.09 ,"$1,414.15 ","$5,377.00 ",$226.42 ,$216.13 ,$631.14 ,"$4,301.60 ","$2,919.71 ","$1,505.56 ","$4,839.30 ",$523.00 ,"$1,050.00 ",$601.09 ,"$2,580.96 "
ST. MARY'S HOSPITAL - DECATUR,35000135,22513,HC VERTEBROPLASTY INJ PERC THOR  KYPHOPLASTY,350,1 ,"$14,566.00 ","$9,467.90 ",$523.00 ,"$14,822.93 ","$14,822.93 ",$750.00 ,"$8,011.30 ","$5,929.17 ","$4,078.48 ","$6,846.02 ","$5,929.17 ","$7,865.64 ","$5,929.17 ","$7,909.34 ","$1,194.91 ","$5,929.17 ","$7,909.34 ","$11,265.42 ","$10,196.20 ","$7,283.00 ","$11,652.80 ","$14,822.92 ","$5,929.17 ","$10,196.20 ","$5,929.17 ","$8,739.60 ","$5,929.17 ","$10,924.50 ","$8,040.43 ","$7,253.87 ","$8,040.43 ","$5,929.17 ","$8,040.43 ","$10,196.20 ","$10,196.20 ","$12,381.10 ","$14,566.00 ","$10,094.24 ","$5,929.17 ","$14,566.00 ","$8,011.30 ","$5,929.17 ","$3,830.86 ","$14,566.00 ","$8,707.59 ","$8,311.79 ","$6,225.63 ","$11,652.80 ","$7,909.34 ","$4,078.48 ","$13,109.40 ",$523.00 ,"$1,050.00 ","$5,929.17 ","$6,991.68 "
ST. MARY'S HOSPITAL - DECATUR,35000136,22514,HC VERTEBROPLASTY INJ PERC LUMBAR KYPHOPLASTY,350,1 ,"$13,557.00 ","$8,812.05 ",$523.00 ,"$14,822.93 ","$14,822.93 ",$750.00 ,"$7,456.35 ","$5,929.17 ","$3,795.96 ","$6,371.79 ","$5,929.17 ","$7,320.78 ","$5,929.17 ","$7,361.45 ","$1,112.71 ","$5,929.17 ","$7,361.45 ","$11,265.42 ","$9,489.90 ","$6,778.50 ","$10,845.60 ","$14,822.92 ","$5,929.17 ","$9,489.90 ","$5,929.17 ","$8,134.20 ","$5,929.17 ","$10,167.75 ","$7,483.46 ","$6,751.39 ","$7,483.46 ","$5,929.17 ","$7,483.46 ","$9,489.90 ","$9,489.90 ","$11,523.45 ","$13,557.00 ","$9,395.00 ","$5,929.17 ","$13,557.00 ","$7,456.35 ","$5,929.17 ","$3,565.49 ","$13,557.00 ","$8,707.59 ","$8,311.79 ","$6,225.63 ","$10,845.60 ","$7,361.45 ","$3,795.96 ","$12,201.30 ",$523.00 ,"$1,050.00 ","$5,929.17 ","$6,507.36 "
ST. MARY'S HOSPITAL - DECATUR,35000152,0503T,HC CORONARY FFR CTA DATA ANALYSIS,350,1 ,"$4,400.00 ","$2,860.00 ",$169.13 ,"$4,400.00 ","$2,202.45 ",$750.00 ,"$2,420.00 ",$880.98 ,"$1,232.00 ","$2,068.00 ",$880.98 ,"$2,376.00 ",$880.98 ,"$2,389.20 ","$1,760.00 ",$880.98 ,"$2,389.20 ","$1,673.86 ","$3,080.00 ","$2,200.00 ","$3,520.00 ","$2,202.45 ",$880.98 ,"$3,080.00 ",$880.98 ,"$2,640.00 ",$880.98 ,"$3,300.00 ","$2,428.80 ","$2,191.20 ","$2,428.80 ",$880.98 ,"$2,428.80 ","$3,080.00 ","$3,080.00 ","$3,740.00 ","$2,202.45 ","$3,049.20 ",$880.98 ,"$4,400.00 ","$2,420.00 ",$880.98 ,"$1,157.20 ","$4,400.00 ",$177.19 ,$169.13 ,$925.03 ,"$3,520.00 ","$2,389.20 ","$1,232.00 ","$3,960.00 ",$523.00 ,"$1,050.00 ",$880.98 ,"$2,112.00 "
ST. MARY'S HOSPITAL - DECATUR,35000153,0502T,HC CORONARY FFR CTA DATA PREP  AND  TRANSMISSION,350,1 ,$636.00 ,$413.40 ,$167.27 ,$636.00 , N/A ,$636.00 ,$349.80 , N/A ,$178.08 ,$298.92 , N/A ,$343.44 , N/A ,$345.35 ,$254.40 , N/A ,$345.35 , N/A ,$445.20 ,$318.00 ,$508.80 , N/A , N/A ,$445.20 , N/A ,$381.60 , N/A ,$477.00 ,$351.07 ,$316.73 ,$351.07 , N/A ,$351.07 ,$445.20 ,$445.20 ,$540.60 , N/A ,$440.75 , N/A ,$636.00 ,$349.80 , N/A ,$167.27 ,$636.00 ,$177.19 ,$169.13 , N/A ,$508.80 ,$345.35 ,$178.08 ,$572.40 ,$523.00 ,$636.00 , N/A ,$305.28 
ST. MARY'S HOSPITAL - DECATUR,35000154,71271,HC CT THORAX LOW DOSE LUNG SCN W/O CONTAST,350,1 ,$59.00 ,$38.35 ,$15.52 ,$257.65 ,$257.65 ,$59.00 ,$32.45 ,$103.06 ,$16.52 ,$27.73 ,$103.06 ,$31.86 ,$59.00 ,$32.04 ,$23.60 ,$59.00 ,$32.04 ,$59.00 ,$41.30 ,$29.50 ,$47.20 ,$257.64 ,$103.06 ,$41.30 ,$103.06 ,$35.40 ,$103.06 ,$44.25 ,$32.57 ,$29.38 ,$32.57 ,$103.06 ,$32.57 ,$41.30 ,$41.30 ,$50.15 ,$59.00 ,$40.89 ,$103.06 ,$59.00 ,$32.45 ,$103.06 ,$15.52 ,$59.00 ,$59.00 ,$92.72 ,$108.21 ,$47.20 ,$32.04 ,$16.52 ,$53.10 ,$59.00 ,$59.00 ,$103.06 ,$28.32 
ST. MARY'S HOSPITAL - DECATUR,36000027,10060,HC I AND D ABSC SMP FAC,360,1 ,$506.00 ,$328.90 ,$133.08 ,$506.00 ,$424.98 ,$506.00 ,$278.30 ,$169.99 ,$141.68 ,$237.82 ,$169.99 ,$273.24 ,$169.99 ,$274.76 ,$274.76 ,$169.99 ,$274.76 ,$322.97 ,$354.20 ,$253.00 ,$404.80 ,$424.97 ,$169.99 ,$354.20 ,$169.99 ,$303.60 ,$169.99 ,$379.50 ,$279.31 ,$251.99 ,$279.31 ,$169.99 ,$279.31 ,$394.68 ,$394.68 ,$430.10 ,$424.97 ,$350.66 ,$169.99 ,$506.00 ,$278.30 ,$169.99 ,$133.08 ,$506.00 ,$210.19 ,$200.63 ,$178.49 ,$404.80 ,$274.76 ,$141.68 ,$455.40 ,$506.00 ,$506.00 ,$169.99 ,$242.88 
ST. MARY'S HOSPITAL - DECATUR,36000029,10140,HC I AND D HEMATOMA/SEROMA/FLUID,360,1 ,"$1,140.00 ",$741.00 ,$299.82 ,"$3,329.73 ","$3,329.73 ","$1,140.00 ",$627.00 ,"$1,331.89 ",$319.20 ,$535.80 ,"$1,331.89 ",$615.60 ,"$1,140.00 ",$619.02 ,$619.02 ,"$1,140.00 ",$619.02 ,"$1,140.00 ",$798.00 ,$570.00 ,$912.00 ,"$3,329.72 ","$1,331.89 ",$798.00 ,"$1,331.89 ",$684.00 ,"$1,331.89 ",$855.00 ,$629.28 ,$567.72 ,$629.28 ,"$1,331.89 ",$629.28 ,$889.20 ,$889.20 ,$969.00 ,"$1,140.00 ",$790.02 ,"$1,331.89 ","$1,140.00 ",$627.00 ,"$1,331.89 ",$299.82 ,"$1,140.00 ",$733.10 ,$699.77 ,"$1,398.48 ",$912.00 ,$619.02 ,$319.20 ,"$1,026.00 ","$1,140.00 ","$1,140.00 ","$1,331.89 ",$547.20 
ST. MARY'S HOSPITAL - DECATUR,36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$813.00 ,$528.45 ,$200.63 ,$817.95 ,$817.95 ,$813.00 ,$447.15 ,$327.18 ,$227.64 ,$382.11 ,$327.18 ,$439.02 ,$327.18 ,$441.46 ,$441.46 ,$327.18 ,$441.46 ,$621.65 ,$569.10 ,$406.50 ,$650.40 ,$817.95 ,$327.18 ,$569.10 ,$327.18 ,$487.80 ,$327.18 ,$609.75 ,$448.78 ,$404.87 ,$448.78 ,$327.18 ,$448.78 ,$634.14 ,$634.14 ,$691.05 ,$813.00 ,$563.41 ,$327.18 ,$813.00 ,$447.15 ,$327.18 ,$213.82 ,$813.00 ,$210.19 ,$200.63 ,$343.54 ,$650.40 ,$441.46 ,$227.64 ,$731.70 ,$737.00 ,$813.00 ,$327.18 ,$390.24 
ST. MARY'S HOSPITAL - DECATUR,36000035,10030,HC GUIDE CATHET FLUID DRAINAGE,360,1 ,"$3,938.00 ","$2,559.70 ",$589.06 ,"$3,938.00 ","$1,472.65 ","$3,500.00 ","$2,165.90 ",$589.06 ,"$1,102.64 ","$1,850.86 ",$589.06 ,"$2,126.52 ",$589.06 ,"$2,138.33 ","$2,138.33 ",$589.06 ,"$2,138.33 ","$1,119.21 ","$2,756.60 ","$1,969.00 ","$3,150.40 ","$1,472.64 ",$589.06 ,"$2,756.60 ",$589.06 ,"$2,362.80 ",$589.06 ,"$2,953.50 ","$2,173.78 ","$1,961.12 ","$2,173.78 ",$589.06 ,"$2,173.78 ","$3,071.64 ","$3,071.64 ","$3,347.30 ","$1,472.64 ","$2,729.03 ",$589.06 ,"$3,938.00 ","$2,165.90 ",$589.06 ,"$1,035.69 ","$3,938.00 ",$733.10 ,$699.77 ,$618.51 ,"$3,150.40 ","$2,138.33 ","$1,102.64 ","$3,544.20 ","$1,483.00 ","$1,666.00 ",$589.06 ,"$1,890.24 "
ST. MARY'S HOSPITAL - DECATUR,36000078,19000,HC ASP CYST BREAST,360,1 ,"$1,208.00 ",$785.20 ,$177.68 ,"$1,472.65 ","$1,472.65 ","$1,208.00 ",$664.40 ,$589.06 ,$338.24 ,$567.76 ,$589.06 ,$652.32 ,$589.06 ,$655.94 ,$655.94 ,$589.06 ,$655.94 ,"$1,119.21 ",$845.60 ,$604.00 ,$966.40 ,"$1,472.64 ",$589.06 ,$845.60 ,$589.06 ,$724.80 ,$589.06 ,$906.00 ,$666.82 ,$601.58 ,$666.82 ,$589.06 ,$666.82 ,$942.24 ,$942.24 ,"$1,026.80 ","$1,208.00 ",$837.14 ,$589.06 ,$177.68 ,$664.40 ,$589.06 ,$317.70 ,"$1,208.00 ",$425.48 ,$406.14 ,$618.51 ,$966.40 ,$655.94 ,$338.24 ,"$1,087.20 ","$1,208.00 ","$1,208.00 ",$589.06 ,$579.84 
ST. MARY'S HOSPITAL - DECATUR,36000079,19001,HC ASP CYST BREAST EA ADDL,360,1 ,$838.00 ,$544.70 ,$29.74 ,$838.00 , N/A ,$838.00 ,$460.90 , N/A ,$234.64 ,$393.86 , N/A ,$452.52 , N/A ,$455.03 ,$455.03 , N/A ,$455.03 , N/A ,$586.60 ,$419.00 ,$670.40 , N/A , N/A ,$586.60 , N/A ,$502.80 , N/A ,$628.50 ,$462.58 ,$417.32 ,$462.58 , N/A ,$462.58 ,$653.64 ,$653.64 ,$712.30 , N/A ,$580.73 , N/A ,$29.74 ,$460.90 , N/A ,$220.39 ,$838.00 ,$425.48 ,$406.14 , N/A ,$670.40 ,$455.03 ,$234.64 ,$754.20 ,$737.00 ,$838.00 , N/A ,$402.24 
ST. MARY'S HOSPITAL - DECATUR,36000080,19020,HC BREAST ABSCESS DRAINAGE,360,1 ,"$3,340.00 ","$2,171.00 ",$699.77 ,"$3,340.00 ","$3,329.73 ","$3,340.00 ","$1,837.00 ","$1,331.89 ",$935.20 ,"$1,569.80 ","$1,331.89 ","$1,803.60 ","$1,331.89 ","$1,813.62 ","$1,813.62 ","$1,331.89 ","$1,813.62 ","$2,530.59 ","$2,338.00 ","$1,670.00 ","$2,672.00 ","$3,329.72 ","$1,331.89 ","$2,338.00 ","$1,331.89 ","$2,004.00 ","$1,331.89 ","$2,505.00 ","$1,843.68 ","$1,663.32 ","$1,843.68 ","$1,331.89 ","$1,843.68 ","$2,605.20 ","$2,605.20 ","$2,839.00 ","$3,329.72 ","$2,314.62 ","$1,331.89 ","$3,340.00 ","$1,837.00 ","$1,331.89 ",$878.42 ,"$3,340.00 ",$733.10 ,$699.77 ,"$1,398.48 ","$2,672.00 ","$1,813.62 ",$935.20 ,"$3,006.00 ","$2,198.00 ","$2,500.00 ","$1,331.89 ","$1,603.20 "
ST. MARY'S HOSPITAL - DECATUR,36000081,19030,HC INJECTION GALACTOGRAM,360,1 ,"$1,261.00 ",$819.65 ,$331.64 ,"$1,261.00 ", N/A ,"$1,261.00 ",$693.55 , N/A ,$353.08 ,$592.67 , N/A ,$680.94 , N/A ,$684.72 ,$684.72 , N/A ,$684.72 , N/A ,$882.70 ,$630.50 ,"$1,008.80 ", N/A , N/A ,$882.70 , N/A ,$756.60 , N/A ,$945.75 ,$696.07 ,$627.98 ,$696.07 , N/A ,$696.07 ,$983.58 ,$983.58 ,"$1,071.85 ", N/A ,$873.87 , N/A ,"$1,261.00 ",$693.55 , N/A ,$331.64 ,"$1,261.00 ", N/A , N/A , N/A ,"$1,008.80 ",$684.72 ,$353.08 ,"$1,134.90 ",$737.00 ,$900.00 , N/A ,$605.28 
ST. MARY'S HOSPITAL - DECATUR,36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$3,624.00 ","$2,355.60 ",$620.94 ,"$3,624.00 ","$3,329.73 ","$3,500.00 ","$1,993.20 ","$1,331.89 ","$1,014.72 ","$1,703.28 ","$1,331.89 ","$1,956.96 ","$1,331.89 ","$1,967.83 ","$1,967.83 ","$1,331.89 ","$1,967.83 ","$2,530.59 ","$2,536.80 ","$1,812.00 ","$2,899.20 ","$3,329.72 ","$1,331.89 ","$2,536.80 ","$1,331.89 ","$2,174.40 ","$1,331.89 ","$2,718.00 ","$2,000.45 ","$1,804.75 ","$2,000.45 ","$1,331.89 ","$2,000.45 ","$2,826.72 ","$2,826.72 ","$3,080.40 ","$3,329.72 ","$2,511.43 ","$1,331.89 ",$620.94 ,"$1,993.20 ","$1,331.89 ",$953.11 ,"$3,624.00 ",$862.27 ,$823.07 ,"$1,398.48 ","$2,899.20 ","$1,967.83 ","$1,014.72 ","$3,261.60 ","$1,795.00 ","$2,100.00 ","$1,331.89 ","$1,739.52 "
ST. MARY'S HOSPITAL - DECATUR,36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$2,128.00 ","$1,383.20 ",$79.74 ,"$2,128.00 ","$1,472.65 ","$2,128.00 ","$1,170.40 ",$589.06 ,$595.84 ,"$1,000.16 ",$589.06 ,"$1,149.12 ",$589.06 ,"$1,155.50 ","$1,155.50 ",$589.06 ,"$1,155.50 ","$1,119.21 ","$1,489.60 ","$1,064.00 ","$1,702.40 ","$1,472.64 ",$589.06 ,"$1,489.60 ",$589.06 ,"$1,276.80 ",$589.06 ,"$1,596.00 ","$1,174.66 ","$1,059.74 ","$1,174.66 ",$589.06 ,"$1,174.66 ","$1,659.84 ","$1,659.84 ","$1,808.80 ","$1,472.64 ","$1,474.70 ",$589.06 ,$464.28 ,"$1,170.40 ",$589.06 ,$559.66 ,"$2,128.00 ",$83.53 ,$79.74 ,$618.51 ,"$1,702.40 ","$1,155.50 ",$595.84 ,"$1,915.20 ","$1,483.00 ","$1,666.00 ",$589.06 ,"$1,021.44 "
ST. MARY'S HOSPITAL - DECATUR,36000088,20206,HC BX MUSCLE NEEDLE PERC,360,1 ,"$3,091.00 ","$2,009.15 ",$406.14 ,"$3,329.73 ","$3,329.73 ","$2,800.00 ","$1,700.05 ","$1,331.89 ",$865.48 ,"$1,452.77 ","$1,331.89 ","$1,669.14 ","$1,331.89 ","$1,678.41 ","$1,678.41 ","$1,331.89 ","$1,678.41 ","$2,530.59 ","$2,163.70 ","$1,545.50 ","$2,472.80 ","$3,329.72 ","$1,331.89 ","$2,163.70 ","$1,331.89 ","$1,854.60 ","$1,331.89 ","$2,318.25 ","$1,706.23 ","$1,539.32 ","$1,706.23 ","$1,331.89 ","$1,706.23 ","$2,410.98 ","$2,410.98 ","$2,627.35 ","$3,091.00 ","$2,142.06 ","$1,331.89 ","$3,091.00 ","$1,700.05 ","$1,331.89 ",$812.93 ,"$3,091.00 ",$425.48 ,$406.14 ,"$1,398.48 ","$2,472.80 ","$1,678.41 ",$865.48 ,"$2,781.90 ","$1,795.00 ","$2,100.00 ","$1,331.89 ","$1,483.68 "
ST. MARY'S HOSPITAL - DECATUR,36000089,20220,HC BX BONE NEEDLE SUPERFIC FAC,360,1 ,"$2,782.00 ","$1,808.30 ",$430.28 ,"$3,329.73 ","$3,329.73 ","$2,782.00 ","$1,530.10 ","$1,331.89 ",$778.96 ,"$1,307.54 ","$1,331.89 ","$1,502.28 ","$1,331.89 ","$1,510.63 ","$1,510.63 ","$1,331.89 ","$1,510.63 ","$2,530.59 ","$1,947.40 ","$1,391.00 ","$2,225.60 ","$3,329.72 ","$1,331.89 ","$1,947.40 ","$1,331.89 ","$1,669.20 ","$1,331.89 ","$2,086.50 ","$1,535.66 ","$1,385.44 ","$1,535.66 ","$1,331.89 ","$1,535.66 ","$2,169.96 ","$2,169.96 ","$2,364.70 ","$2,782.00 ","$1,927.93 ","$1,331.89 ","$2,782.00 ","$1,530.10 ","$1,331.89 ",$731.67 ,"$2,782.00 ",$450.77 ,$430.28 ,"$1,398.48 ","$2,225.60 ","$1,510.63 ",$778.96 ,"$2,503.80 ","$1,483.00 ","$1,666.00 ","$1,331.89 ","$1,335.36 "
ST. MARY'S HOSPITAL - DECATUR,36000090,20225,HC BX BONE NEEDLE DEEP,360,1 ,"$4,103.00 ","$2,666.95 ",$430.28 ,"$4,103.00 ","$3,329.73 ","$3,500.00 ","$2,256.65 ","$1,331.89 ","$1,148.84 ","$1,928.41 ","$1,331.89 ","$2,215.62 ","$1,331.89 ","$2,227.93 ","$2,227.93 ","$1,331.89 ","$2,227.93 ","$2,530.59 ","$2,872.10 ","$2,051.50 ","$3,282.40 ","$3,329.72 ","$1,331.89 ","$2,872.10 ","$1,331.89 ","$2,461.80 ","$1,331.89 ","$3,077.25 ","$2,264.86 ","$2,043.29 ","$2,264.86 ","$1,331.89 ","$2,264.86 ","$3,200.34 ","$3,200.34 ","$3,487.55 ","$3,329.72 ","$2,843.38 ","$1,331.89 ","$4,103.00 ","$2,256.65 ","$1,331.89 ","$1,079.09 ","$4,103.00 ",$450.77 ,$430.28 ,"$1,398.48 ","$3,282.40 ","$2,227.93 ","$1,148.84 ","$3,692.70 ","$1,795.00 ","$2,100.00 ","$1,331.89 ","$1,969.44 "
ST. MARY'S HOSPITAL - DECATUR,36000101,29085,HC CAST APPL; HAND AND FOREARM,360,1 ,$419.00 ,$272.35 ,$110.20 ,$419.00 ,$334.35 ,$213.69 ,$230.45 ,$133.74 ,$117.32 ,$196.93 ,$133.74 ,$226.26 ,$133.74 ,$227.52 ,$227.52 ,$133.74 ,$227.52 ,$254.10 ,$293.30 ,$209.50 ,$335.20 ,$334.34 ,$133.74 ,$293.30 ,$133.74 ,$251.40 ,$133.74 ,$314.25 ,$231.29 ,$208.66 ,$231.29 ,$133.74 ,$231.29 ,$326.82 ,$326.82 ,$356.15 ,$334.34 ,$290.37 ,$133.74 ,$419.00 ,$230.45 ,$133.74 ,$110.20 ,$419.00 ,$227.41 ,$217.08 ,$140.43 ,$335.20 ,$227.52 ,$117.32 ,$377.10 ,$419.00 ,$419.00 ,$133.74 ,$201.12 
ST. MARY'S HOSPITAL - DECATUR,36000108,19082,HC BREAST LOC BX PERC STEREO ADDN LESION,360,1 ,"$3,532.00 ","$2,295.80 ",$494.86 ,"$3,532.00 ", N/A ,"$2,800.00 ","$1,942.60 ", N/A ,$988.96 ,"$1,660.04 ", N/A ,"$1,907.28 ", N/A ,"$1,917.88 ","$1,917.88 ", N/A ,"$1,917.88 ", N/A ,"$2,472.40 ","$1,766.00 ","$2,825.60 ", N/A , N/A ,"$2,472.40 ", N/A ,"$2,119.20 ", N/A ,"$2,649.00 ","$1,949.66 ","$1,758.94 ","$1,949.66 ", N/A ,"$1,949.66 ","$2,754.96 ","$2,754.96 ","$3,002.20 ", N/A ,"$2,447.68 ", N/A ,$494.86 ,"$1,942.60 ", N/A ,$928.92 ,"$3,532.00 ",$862.27 ,$823.07 , N/A ,"$2,825.60 ","$1,917.88 ",$988.96 ,"$3,178.80 ",$737.00 ,$900.00 , N/A ,"$1,695.36 "
ST. MARY'S HOSPITAL - DECATUR,36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,"$6,577.00 ","$4,275.05 ",$485.95 ,"$6,577.00 ", N/A ,"$2,800.00 ","$3,617.35 ", N/A ,"$1,841.56 ","$3,091.19 ", N/A ,"$3,551.58 ", N/A ,"$3,571.31 ","$3,571.31 ", N/A ,"$3,571.31 ", N/A ,"$3,500.00 ","$3,288.50 ","$5,261.60 ", N/A , N/A ,"$4,603.90 ", N/A ,"$3,946.20 ", N/A ,"$4,932.75 ","$3,630.50 ","$3,275.35 ","$3,630.50 ", N/A ,"$3,630.50 ","$5,130.06 ","$5,130.06 ","$5,590.45 ", N/A ,"$4,557.86 ", N/A ,$485.95 ,"$3,617.35 ", N/A ,"$1,729.75 ","$6,577.00 ",$862.27 ,$823.07 , N/A ,"$5,261.60 ","$3,571.31 ","$1,841.56 ","$5,919.30 ",$737.00 ,$900.00 , N/A ,"$3,156.96 "
ST. MARY'S HOSPITAL - DECATUR,36000110,19085,HC BX BREAST 1ST LESION MR IMAG,360,1 ,"$5,754.00 ","$3,740.10 ",$823.07 ,"$5,754.00 ","$3,329.73 ","$5,500.00 ","$3,164.70 ","$1,331.89 ","$1,611.12 ","$2,704.38 ","$1,331.89 ","$3,107.16 ","$1,331.89 ","$3,124.42 ","$3,124.42 ","$1,331.89 ","$3,124.42 ","$2,530.59 ","$3,500.00 ","$2,877.00 ","$4,603.20 ","$3,329.72 ","$1,331.89 ","$4,027.80 ","$1,331.89 ","$3,452.40 ","$1,331.89 ","$4,315.50 ","$3,176.21 ","$2,865.49 ","$3,176.21 ","$1,331.89 ","$3,176.21 ","$4,488.12 ","$4,488.12 ","$4,890.90 ","$3,329.72 ","$3,987.52 ","$1,331.89 ",$949.78 ,"$3,164.70 ","$1,331.89 ","$1,513.30 ","$5,754.00 ",$862.27 ,$823.07 ,"$1,398.48 ","$4,603.20 ","$3,124.42 ","$1,611.12 ","$5,178.60 ","$1,795.00 ","$2,100.00 ","$1,331.89 ","$2,761.92 "
ST. MARY'S HOSPITAL - DECATUR,36000114,19282,HC BREAST NDL LOC BX ADDN LESION,360,1 ,"$1,812.00 ","$1,177.80 ",$79.74 ,"$1,812.00 ", N/A ,"$1,812.00 ",$996.60 , N/A ,$507.36 ,$851.64 , N/A ,$978.48 , N/A ,$983.92 ,$983.92 , N/A ,$983.92 , N/A ,"$1,268.40 ",$906.00 ,"$1,449.60 ", N/A , N/A ,"$1,268.40 ", N/A ,"$1,087.20 ", N/A ,"$1,359.00 ","$1,000.22 ",$902.38 ,"$1,000.22 ", N/A ,"$1,000.22 ","$1,413.36 ","$1,413.36 ","$1,540.20 ", N/A ,"$1,255.72 ", N/A ,$189.78 ,$996.60 , N/A ,$476.56 ,"$1,812.00 ",$83.53 ,$79.74 , N/A ,"$1,449.60 ",$983.92 ,$507.36 ,"$1,630.80 ",$737.00 ,$900.00 , N/A ,$869.76 
ST. MARY'S HOSPITAL - DECATUR,36000115,19284,HC BREAST STEREO NDL LOC BX ADDN LESION,360,1 ,"$3,074.00 ","$1,998.10 ",$79.74 ,"$3,074.00 ", N/A ,"$2,800.00 ","$1,690.70 ", N/A ,$860.72 ,"$1,444.78 ", N/A ,"$1,659.96 ", N/A ,"$1,669.18 ","$1,669.18 ", N/A ,"$1,669.18 ", N/A ,"$2,151.80 ","$1,537.00 ","$2,459.20 ", N/A , N/A ,"$2,151.80 ", N/A ,"$1,844.40 ", N/A ,"$2,305.50 ","$1,696.85 ","$1,530.85 ","$1,696.85 ", N/A ,"$1,696.85 ","$2,397.72 ","$2,397.72 ","$2,612.90 ", N/A ,"$2,130.28 ", N/A ,$225.18 ,"$1,690.70 ", N/A ,$808.46 ,"$3,074.00 ",$83.53 ,$79.74 , N/A ,"$2,459.20 ","$1,669.18 ",$860.72 ,"$2,766.60 ",$737.00 ,$900.00 , N/A ,"$1,475.52 "
ST. MARY'S HOSPITAL - DECATUR,36000118,36470,HC INJ SCLEROSING SOLUTION SINGLE VEIN,360,1 ,"$2,119.00 ","$1,377.35 ",$327.18 ,"$2,119.00 ",$817.95 ,"$2,119.00 ","$1,165.45 ",$327.18 ,$593.32 ,$995.93 ,$327.18 ,"$1,144.26 ",$327.18 ,"$1,150.62 ","$1,150.62 ",$327.18 ,"$1,150.62 ",$621.65 ,"$1,483.30 ","$1,059.50 ","$1,695.20 ",$817.95 ,$327.18 ,"$1,483.30 ",$327.18 ,"$1,271.40 ",$327.18 ,"$1,589.25 ","$1,169.69 ","$1,055.26 ","$1,169.69 ",$327.18 ,"$1,169.69 ","$1,652.82 ","$1,652.82 ","$1,801.15 ",$817.95 ,"$1,468.47 ",$327.18 ,"$2,119.00 ","$1,165.45 ",$327.18 ,$557.30 ,"$2,119.00 ",$613.89 ,$585.98 ,$343.54 ,"$1,695.20 ","$1,150.62 ",$593.32 ,"$1,907.10 ",$737.00 ,$900.00 ,$327.18 ,"$1,017.12 "
ST. MARY'S HOSPITAL - DECATUR,36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$4,160.00 ","$2,704.00 ","$1,094.08 ","$6,774.50 ","$6,774.50 ","$2,800.00 ","$2,288.00 ","$2,709.80 ","$1,164.80 ","$1,955.20 ","$2,709.80 ","$2,246.40 ","$2,709.80 ","$2,258.88 ","$2,258.88 ","$2,709.80 ","$2,258.88 ","$4,160.00 ","$2,912.00 ","$2,080.00 ","$3,328.00 ","$6,774.49 ","$2,709.80 ","$2,912.00 ","$2,709.80 ","$2,496.00 ","$2,709.80 ","$3,120.00 ","$2,296.32 ","$2,071.68 ","$2,296.32 ","$2,709.80 ","$2,296.32 ","$3,244.80 ","$3,244.80 ","$3,536.00 ","$4,160.00 ","$2,882.88 ","$2,709.80 ","$4,160.00 ","$2,288.00 ","$2,709.80 ","$1,094.08 ","$4,160.00 ","$1,190.62 ","$1,136.50 ","$2,845.29 ","$3,328.00 ","$2,258.88 ","$1,164.80 ","$3,744.00 ","$1,483.00 ","$1,666.00 ","$2,709.80 ","$1,996.80 "
ST. MARY'S HOSPITAL - DECATUR,36000124,36557,HC INSERT TUNNELED CVC <5 YEARS OLD,360,1 ,"$7,368.00 ","$4,789.20 ","$1,937.78 ","$11,285.10 ","$11,285.10 ","$3,500.00 ","$4,052.40 ","$4,514.04 ","$2,063.04 ","$3,462.96 ","$4,514.04 ","$3,978.72 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$7,368.00 ","$3,500.00 ","$3,684.00 ","$5,894.40 ","$11,285.10 ","$4,514.04 ","$5,157.60 ","$4,514.04 ","$4,420.80 ","$4,514.04 ","$5,526.00 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,514.04 ","$4,057.00 ","$5,747.04 ","$5,747.04 ","$6,262.80 ","$7,368.00 ","$4,981.00 ","$4,514.04 ","$7,368.00 ","$4,052.40 ","$4,514.04 ","$1,937.78 ","$7,368.00 ", N/A , N/A ,"$4,739.74 ","$5,894.40 ","$3,913.45 ","$2,063.04 ","$6,631.20 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$3,536.64 "
ST. MARY'S HOSPITAL - DECATUR,36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$9,585.00 ","$6,230.25 ","$1,136.50 ","$9,585.00 ","$6,774.50 ","$3,500.00 ","$5,271.75 ","$2,709.80 ","$2,683.80 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,792.50 ","$7,668.00 ","$6,774.49 ","$2,709.80 ","$6,709.50 ","$2,709.80 ","$5,751.00 ","$2,709.80 ","$7,188.75 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$2,709.80 ","$4,057.00 ","$7,476.30 ","$7,476.30 ","$8,147.25 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$9,585.00 ","$5,271.75 ","$2,709.80 ","$2,520.86 ","$9,585.00 ","$1,190.62 ","$1,136.50 ","$2,845.29 ","$7,668.00 ","$3,913.45 ","$2,683.80 ","$8,626.50 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$4,600.80 "
ST. MARY'S HOSPITAL - DECATUR,36000127,36561,HC INSERT TUNEL CV CATH>5YR W/PORT,360,1 ,"$8,376.00 ","$5,444.40 ","$1,136.50 ","$8,376.00 ","$6,774.50 ","$5,500.00 ","$4,606.80 ","$2,709.80 ","$2,345.28 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,188.00 ","$6,700.80 ","$6,774.49 ","$2,709.80 ","$5,863.20 ","$2,709.80 ","$5,025.60 ","$2,709.80 ","$6,282.00 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$2,709.80 ","$4,057.00 ","$6,533.28 ","$6,533.28 ","$7,119.60 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$8,376.00 ","$4,606.80 ","$2,709.80 ","$2,202.89 ","$8,376.00 ","$1,190.62 ","$1,136.50 ","$2,845.29 ","$6,700.80 ","$3,913.45 ","$2,345.28 ","$7,538.40 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$4,020.48 "
ST. MARY'S HOSPITAL - DECATUR,36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$4,160.00 ","$2,704.00 ",$330.83 ,"$4,160.00 ","$3,327.80 ","$2,800.00 ","$2,288.00 ","$1,331.12 ","$1,164.80 ","$1,955.20 ","$1,331.12 ","$2,246.40 ","$1,331.12 ","$2,258.88 ","$2,258.88 ","$1,331.12 ","$2,258.88 ","$2,529.13 ","$2,912.00 ","$2,080.00 ","$3,328.00 ","$3,327.80 ","$1,331.12 ","$2,912.00 ","$1,331.12 ","$2,496.00 ","$1,331.12 ","$3,120.00 ","$2,296.32 ","$2,071.68 ","$2,296.32 ","$1,331.12 ","$2,296.32 ","$3,244.80 ","$3,244.80 ","$3,536.00 ","$3,327.80 ","$2,882.88 ","$1,331.12 ","$4,160.00 ","$2,288.00 ","$1,331.12 ","$1,094.08 ","$4,160.00 ",$346.59 ,$330.83 ,"$1,397.68 ","$3,328.00 ","$2,258.88 ","$1,164.80 ","$3,744.00 ","$1,483.00 ","$1,666.00 ","$1,331.12 ","$1,996.80 "
ST. MARY'S HOSPITAL - DECATUR,36000135,36580,HC REPL CATH CV NON-TNL W/O PORT,360,1 ,"$3,249.00 ","$2,111.85 ",$330.83 ,"$3,327.80 ","$3,327.80 ","$2,800.00 ","$1,786.95 ","$1,331.12 ",$909.72 ,"$1,527.03 ","$1,331.12 ","$1,754.46 ","$1,331.12 ","$1,764.21 ","$1,764.21 ","$1,331.12 ","$1,764.21 ","$2,529.13 ","$2,274.30 ","$1,624.50 ","$2,599.20 ","$3,327.80 ","$1,331.12 ","$2,274.30 ","$1,331.12 ","$1,949.40 ","$1,331.12 ","$2,436.75 ","$1,793.45 ","$1,618.00 ","$1,793.45 ","$1,331.12 ","$1,793.45 ","$2,534.22 ","$2,534.22 ","$2,761.65 ","$3,249.00 ","$2,251.56 ","$1,331.12 ","$3,249.00 ","$1,786.95 ","$1,331.12 ",$854.49 ,"$3,249.00 ",$346.59 ,$330.83 ,"$1,397.68 ","$2,599.20 ","$1,764.21 ",$909.72 ,"$2,924.10 ","$1,483.00 ","$1,666.00 ","$1,331.12 ","$1,559.52 "
ST. MARY'S HOSPITAL - DECATUR,36000136,36581,HC REPL CATH CV TNL W/O PORT,360,1 ,"$8,694.00 ","$5,651.10 ","$1,136.50 ","$8,694.00 ","$6,774.50 ","$3,500.00 ","$4,781.70 ","$2,709.80 ","$2,434.32 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,347.00 ","$6,955.20 ","$6,774.49 ","$2,709.80 ","$6,085.80 ","$2,709.80 ","$5,216.40 ","$2,709.80 ","$6,520.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$2,709.80 ","$4,057.00 ","$6,781.32 ","$6,781.32 ","$7,389.90 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$8,694.00 ","$4,781.70 ","$2,709.80 ","$2,286.52 ","$8,694.00 ","$1,190.62 ","$1,136.50 ","$2,845.29 ","$6,955.20 ","$3,913.45 ","$2,434.32 ","$7,824.60 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$4,173.12 "
ST. MARY'S HOSPITAL - DECATUR,36000137,36582,HC REPL DEVICE CV TNL W/PORT,360,1 ,"$11,697.00 ","$7,603.05 ","$1,136.50 ","$11,697.00 ","$6,774.50 ","$5,500.00 ","$6,433.35 ","$2,709.80 ","$3,275.16 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$5,848.50 ","$9,357.60 ","$6,774.49 ","$2,709.80 ","$8,187.90 ","$2,709.80 ","$7,018.20 ","$2,709.80 ","$8,772.75 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$2,709.80 ","$4,057.00 ","$8,112.00 ","$8,112.00 ","$9,942.45 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$11,697.00 ","$6,433.35 ","$2,709.80 ","$3,076.31 ","$11,697.00 ","$1,190.62 ","$1,136.50 ","$2,845.29 ","$9,357.60 ","$3,913.45 ","$3,275.16 ","$10,527.30 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$5,614.56 "
ST. MARY'S HOSPITAL - DECATUR,36000139,36584,HC REPL PICC W/O PORT/PUMP,360,1 ,"$5,211.00 ","$3,387.15 ",$94.70 ,"$5,211.00 ","$3,327.80 ","$2,800.00 ","$2,866.05 ","$1,331.12 ","$1,459.08 ","$2,449.17 ","$1,331.12 ","$2,813.94 ","$1,331.12 ","$2,829.57 ","$2,829.57 ","$1,331.12 ","$2,829.57 ","$2,529.13 ","$3,500.00 ","$2,605.50 ","$4,168.80 ","$3,327.80 ","$1,331.12 ","$3,647.70 ","$1,331.12 ","$3,126.60 ","$1,331.12 ","$3,908.25 ","$2,876.47 ","$2,595.08 ","$2,876.47 ","$1,331.12 ","$2,876.47 ","$4,064.58 ","$4,064.58 ","$4,429.35 ","$3,327.80 ","$3,611.22 ","$1,331.12 ","$5,211.00 ","$2,866.05 ","$1,331.12 ","$1,370.49 ","$5,211.00 ",$99.21 ,$94.70 ,"$1,397.68 ","$4,168.80 ","$2,829.57 ","$1,459.08 ","$4,689.90 ","$1,483.00 ","$1,666.00 ","$1,331.12 ","$2,501.28 "
ST. MARY'S HOSPITAL - DECATUR,36000141,36589,HC REMOVE TUNNELED CATH-NO PORT,360,1 ,"$5,742.00 ","$3,732.30 ",$94.70 ,"$5,742.00 ","$1,279.15 ","$2,800.00 ","$3,158.10 ",$511.66 ,"$1,607.76 ","$2,698.74 ",$511.66 ,"$3,100.68 ",$511.66 ,"$3,117.91 ","$3,117.91 ",$511.66 ,"$3,117.91 ",$972.16 ,"$3,500.00 ","$2,871.00 ","$4,593.60 ","$1,279.16 ",$511.66 ,"$4,019.40 ",$511.66 ,"$3,445.20 ",$511.66 ,"$4,306.50 ","$3,169.58 ","$2,859.52 ","$3,169.58 ",$511.66 ,"$3,169.58 ","$4,478.76 ","$4,478.76 ","$4,880.70 ","$1,279.16 ","$3,979.21 ",$511.66 ,"$5,742.00 ","$3,158.10 ",$511.66 ,"$1,510.15 ","$5,742.00 ",$99.21 ,$94.70 ,$537.24 ,"$4,593.60 ","$3,117.91 ","$1,607.76 ","$5,167.80 ","$1,483.00 ","$1,666.00 ",$511.66 ,"$2,756.16 "
ST. MARY'S HOSPITAL - DECATUR,36000142,36590,HC REM TNL CV ACC W/PORT/PUMP,360,1 ,"$7,382.00 ","$4,798.30 ",$860.56 ,"$7,382.00 ","$3,327.80 ","$2,800.00 ","$4,060.10 ","$1,331.12 ","$2,066.96 ","$3,469.54 ","$1,331.12 ","$3,986.28 ","$1,331.12 ","$3,913.45 ","$3,913.45 ","$1,331.12 ","$3,913.45 ","$2,529.13 ","$3,500.00 ","$3,691.00 ","$5,905.60 ","$3,327.80 ","$1,331.12 ","$5,167.40 ","$1,331.12 ","$4,429.20 ","$1,331.12 ","$5,536.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$1,331.12 ","$4,057.00 ","$5,757.96 ","$5,757.96 ","$6,274.70 ","$3,327.80 ","$4,981.00 ","$1,331.12 ","$7,382.00 ","$4,060.10 ","$1,331.12 ","$1,941.47 ","$7,382.00 ",$901.54 ,$860.56 ,"$1,397.68 ","$5,905.60 ","$3,913.45 ","$2,066.96 ","$6,643.80 ","$1,795.00 ","$2,100.00 ","$1,331.12 ","$3,543.36 "
ST. MARY'S HOSPITAL - DECATUR,36000148,36620,HC CATH/CANN ARTERY PERC 36620,360,1 ,"$1,149.00 ",$746.85 ,$302.19 ,"$1,786.63 ", N/A ,"$1,149.00 ",$631.95 , N/A ,$321.72 ,$540.03 , N/A ,$620.46 , N/A ,$623.91 ,$623.91 , N/A ,$623.91 , N/A ,$804.30 ,$574.50 ,$919.20 , N/A , N/A ,$804.30 , N/A ,$689.40 , N/A ,$861.75 ,$634.25 ,$572.20 ,$634.25 , N/A ,$634.25 ,$896.22 ,$896.22 ,$976.65 , N/A ,$796.26 , N/A ,"$1,149.00 ",$631.95 , N/A ,$302.19 ,"$1,149.00 ","$1,149.00 ","$1,786.63 ", N/A ,$919.20 ,$623.91 ,$321.72 ,"$1,034.10 ",$737.00 ,$900.00 , N/A ,$551.52 
ST. MARY'S HOSPITAL - DECATUR,36000158,38221,HC BX BONE MARROW ONLY,360,1 ,"$3,923.00 ","$2,549.95 ",$406.14 ,"$3,923.00 ","$3,329.73 ","$2,800.00 ","$2,157.65 ","$1,331.89 ","$1,098.44 ","$1,843.81 ","$1,331.89 ","$2,118.42 ","$1,331.89 ","$2,130.19 ","$2,130.19 ","$1,331.89 ","$2,130.19 ","$2,530.59 ","$2,746.10 ","$1,961.50 ","$3,138.40 ","$3,329.72 ","$1,331.89 ","$2,746.10 ","$1,331.89 ","$2,353.80 ","$1,331.89 ","$2,942.25 ","$2,165.50 ","$1,953.65 ","$2,165.50 ","$1,331.89 ","$2,165.50 ","$3,059.94 ","$3,059.94 ","$3,334.55 ","$3,329.72 ","$2,718.64 ","$1,331.89 ","$3,923.00 ","$2,157.65 ","$1,331.89 ","$1,031.75 ","$3,923.00 ",$425.48 ,$406.14 ,"$1,398.48 ","$3,138.40 ","$2,130.19 ","$1,098.44 ","$3,530.70 ","$1,483.00 ","$1,666.00 ","$1,331.89 ","$1,883.04 "
ST. MARY'S HOSPITAL - DECATUR,36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,"$2,604.00 ","$1,692.60 ",$430.28 ,"$3,329.73 ","$3,329.73 ","$2,604.00 ","$1,432.20 ","$1,331.89 ",$729.12 ,"$1,223.88 ","$1,331.89 ","$1,406.16 ","$1,331.89 ","$1,413.97 ","$1,413.97 ","$1,331.89 ","$1,413.97 ","$2,530.59 ","$1,822.80 ","$1,302.00 ","$2,083.20 ","$3,329.72 ","$1,331.89 ","$1,822.80 ","$1,331.89 ","$1,562.40 ","$1,331.89 ","$1,953.00 ","$1,437.41 ","$1,296.79 ","$1,437.41 ","$1,331.89 ","$1,437.41 ","$2,031.12 ","$2,031.12 ","$2,213.40 ","$2,604.00 ","$1,804.57 ","$1,331.89 ","$2,604.00 ","$1,432.20 ","$1,331.89 ",$684.85 ,"$2,604.00 ",$450.77 ,$430.28 ,"$1,398.48 ","$2,083.20 ","$1,413.97 ",$729.12 ,"$2,343.60 ","$1,795.00 ","$2,100.00 ","$1,331.89 ","$1,249.92 "
ST. MARY'S HOSPITAL - DECATUR,36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,"$2,085.00 ","$1,355.25 ",$356.83 ,"$2,085.00 ",$892.08 ,"$2,085.00 ","$1,146.75 ",$356.83 ,$583.80 ,$979.95 ,$356.83 ,"$1,125.90 ",$356.83 ,"$1,132.16 ","$1,132.16 ",$356.83 ,"$1,132.16 ",$677.98 ,"$1,459.50 ","$1,042.50 ","$1,668.00 ",$892.08 ,$356.83 ,"$1,459.50 ",$356.83 ,"$1,251.00 ",$356.83 ,"$1,563.75 ","$1,150.92 ","$1,038.33 ","$1,150.92 ",$356.83 ,"$1,150.92 ","$1,626.30 ","$1,626.30 ","$1,772.25 ",$892.08 ,"$1,444.91 ",$356.83 ,"$2,085.00 ","$1,146.75 ",$356.83 ,$548.36 ,"$2,085.00 ", N/A , N/A ,$374.67 ,"$1,668.00 ","$1,132.16 ",$583.80 ,"$1,876.50 ",$737.00 ,$900.00 ,$356.83 ,"$1,000.80 "
ST. MARY'S HOSPITAL - DECATUR,36000162,38999,HC HEMIC OR LYMPHATIC SYSTEM UNLISTED,360,1 ,"$4,861.00 ","$3,159.65 ",$375.72 ,"$4,861.00 ",$939.30 ,"$2,800.00 ","$2,673.55 ",$375.72 ,"$1,361.08 ","$2,284.67 ",$375.72 ,"$2,624.94 ",$375.72 ,"$2,639.52 ","$2,639.52 ",$375.72 ,"$2,639.52 ",$713.87 ,"$3,402.70 ","$2,430.50 ","$3,888.80 ",$939.30 ,$375.72 ,"$3,402.70 ",$375.72 ,"$2,916.60 ",$375.72 ,"$3,645.75 ","$2,683.27 ","$2,420.78 ","$2,683.27 ",$375.72 ,"$2,683.27 ","$3,791.58 ","$3,791.58 ","$4,131.85 ",$939.30 ,"$3,368.67 ",$375.72 ,"$4,861.00 ","$2,673.55 ",$375.72 ,"$1,278.44 ","$4,861.00 ","$1,692.87 ","$1,615.92 ",$394.51 ,"$3,888.80 ","$2,639.52 ","$1,361.08 ","$4,374.90 ",$737.00 ,$900.00 ,$375.72 ,"$2,333.28 "
ST. MARY'S HOSPITAL - DECATUR,36000171,47490,HC CHOLECYSTOSTOMY PERC,360,1 ,"$4,459.00 ","$2,898.35 ","$1,124.06 ","$7,529.23 ","$7,529.23 ","$4,459.00 ","$2,452.45 ","$3,011.69 ","$1,248.52 ","$2,095.73 ","$3,011.69 ","$2,407.86 ","$3,011.69 ","$2,421.24 ","$2,421.24 ","$3,011.69 ","$2,421.24 ","$4,459.00 ","$3,121.30 ","$2,229.50 ","$3,567.20 ","$7,529.23 ","$3,011.69 ","$3,121.30 ","$3,011.69 ","$2,675.40 ","$3,011.69 ","$3,344.25 ","$2,461.37 ","$2,220.58 ","$2,461.37 ","$3,011.69 ","$2,461.37 ","$3,478.02 ","$3,478.02 ","$3,790.15 ","$4,459.00 ","$3,090.09 ","$3,011.69 ","$4,459.00 ","$2,452.45 ","$3,011.69 ","$1,172.72 ","$4,459.00 ","$1,177.58 ","$1,124.06 ","$3,162.27 ","$3,567.20 ","$2,421.24 ","$1,248.52 ","$4,013.10 ","$2,641.00 ","$3,250.00 ","$3,011.69 ","$2,140.32 "
ST. MARY'S HOSPITAL - DECATUR,36000176,49418,HC INSERT INTRAPERITONEAL CATH,360,1 ,"$7,084.00 ","$4,604.60 ",$402.05 ,"$7,529.23 ","$7,529.23 ","$3,500.00 ","$3,896.20 ","$3,011.69 ","$1,983.52 ","$3,329.48 ","$3,011.69 ","$3,825.36 ","$3,011.69 ","$3,846.61 ","$3,846.61 ","$3,011.69 ","$3,846.61 ","$5,722.22 ","$3,500.00 ","$3,542.00 ","$5,667.20 ","$7,529.23 ","$3,011.69 ","$4,958.80 ","$3,011.69 ","$4,250.40 ","$3,011.69 ","$5,313.00 ","$3,910.37 ","$3,527.83 ","$3,910.37 ","$3,011.69 ","$3,910.37 ","$5,525.52 ","$5,525.52 ","$6,021.40 ","$7,084.00 ","$4,909.21 ","$3,011.69 ","$7,084.00 ","$3,896.20 ","$3,011.69 ","$1,863.09 ","$7,084.00 ",$421.19 ,$402.05 ,"$3,162.27 ","$5,667.20 ","$3,846.61 ","$1,983.52 ","$6,375.60 ","$2,641.00 ","$3,250.00 ","$3,011.69 ","$3,400.32 "
ST. MARY'S HOSPITAL - DECATUR,36000187,54150,HC CIRCUMCISION OP,360,1 ,$361.00 ,$234.65 ,$94.94 ,"$4,237.26 ","$4,237.25 ",$361.00 ,$198.55 ,"$1,694.90 ",$101.08 ,$169.67 ,"$1,694.90 ",$194.94 ,$361.00 ,$196.02 ,$196.02 ,$361.00 ,$196.02 ,$361.00 ,$252.70 ,$180.50 ,$288.80 ,"$4,237.26 ","$1,694.90 ",$252.70 ,"$1,694.90 ",$216.60 ,"$1,694.90 ",$270.75 ,$199.27 ,$179.78 ,$199.27 ,"$1,694.90 ",$199.27 ,$281.58 ,$281.58 ,$306.85 ,$361.00 ,$250.17 ,"$1,694.90 ",$361.00 ,$198.55 ,"$1,694.90 ",$94.94 ,$361.00 ,$361.00 ,"$1,000.84 ","$1,779.65 ",$288.80 ,$196.02 ,$101.08 ,$324.90 ,$361.00 ,$361.00 ,"$1,694.90 ",$173.28 
ST. MARY'S HOSPITAL - DECATUR,36000189,58100,HC BIOPSY OF UTERUS PERCUTANEOUS,360,1 ,$553.00 ,$359.45 ,$114.03 ,$553.00 ,$403.15 ,$553.00 ,$304.15 ,$161.26 ,$154.84 ,$259.91 ,$161.26 ,$298.62 ,$161.26 ,$300.28 ,$300.28 ,$161.26 ,$300.28 ,$306.40 ,$387.10 ,$276.50 ,$442.40 ,$403.16 ,$161.26 ,$387.10 ,$161.26 ,$331.80 ,$161.26 ,$414.75 ,$305.26 ,$275.39 ,$305.26 ,$161.26 ,$305.26 ,$431.34 ,$431.34 ,$470.05 ,$403.16 ,$383.23 ,$161.26 ,$114.03 ,$304.15 ,$161.26 ,$145.44 ,$553.00 ,$125.53 ,$119.83 ,$169.32 ,$442.40 ,$300.28 ,$154.84 ,$497.70 ,$553.00 ,$553.00 ,$161.26 ,$265.44 
ST. MARY'S HOSPITAL - DECATUR,36000193,62267,HC DISC ASPIRATION,360,1 ,"$2,208.00 ","$1,435.20 ",$532.54 ,"$2,208.00 ","$1,472.65 ","$2,208.00 ","$1,214.40 ",$589.06 ,$618.24 ,"$1,037.76 ",$589.06 ,"$1,192.32 ",$589.06 ,"$1,198.94 ","$1,198.94 ",$589.06 ,"$1,198.94 ","$1,119.21 ","$1,545.60 ","$1,104.00 ","$1,766.40 ","$1,472.64 ",$589.06 ,"$1,545.60 ",$589.06 ,"$1,324.80 ",$589.06 ,"$1,656.00 ","$1,218.82 ","$1,099.58 ","$1,218.82 ",$589.06 ,"$1,218.82 ","$1,722.24 ","$1,722.24 ","$1,876.80 ","$1,472.64 ","$1,530.14 ",$589.06 ,"$2,208.00 ","$1,214.40 ",$589.06 ,$580.70 ,"$2,208.00 ",$557.90 ,$532.54 ,$618.51 ,"$1,766.40 ","$1,198.94 ",$618.24 ,"$1,987.20 ","$1,483.00 ","$1,666.00 ",$589.06 ,"$1,059.84 "
ST. MARY'S HOSPITAL - DECATUR,36000194,62270,HC LUMBAR PUNCTURE,360,1 ,"$1,571.00 ","$1,021.15 ",$344.97 ,"$1,571.00 ","$1,502.73 ","$1,571.00 ",$864.05 ,$601.09 ,$439.88 ,$738.37 ,$601.09 ,$848.34 ,$601.09 ,$853.05 ,$853.05 ,$601.09 ,$853.05 ,"$1,142.07 ","$1,099.70 ",$785.50 ,"$1,256.80 ","$1,502.72 ",$601.09 ,"$1,099.70 ",$601.09 ,$942.60 ,$601.09 ,"$1,178.25 ",$867.19 ,$782.36 ,$867.19 ,$601.09 ,$867.19 ,"$1,225.38 ","$1,225.38 ","$1,335.35 ","$1,502.72 ","$1,088.70 ",$601.09 ,"$1,571.00 ",$864.05 ,$601.09 ,$413.17 ,"$1,571.00 ",$361.39 ,$344.97 ,$631.14 ,"$1,256.80 ",$853.05 ,$439.88 ,"$1,413.90 ","$1,483.00 ","$1,571.00 ",$601.09 ,$754.08 
ST. MARY'S HOSPITAL - DECATUR,36000223,36575,HC REPAIR CATH CV W/O PORT/PUMP,360,1 ,"$3,205.00 ","$2,083.25 ",$330.83 ,"$3,205.00 ","$1,279.15 ","$3,205.00 ","$1,762.75 ",$511.66 ,$897.40 ,"$1,506.35 ",$511.66 ,"$1,730.70 ",$511.66 ,"$1,740.32 ","$1,740.32 ",$511.66 ,"$1,740.32 ",$972.16 ,"$2,243.50 ","$1,602.50 ","$2,564.00 ","$1,279.16 ",$511.66 ,"$2,243.50 ",$511.66 ,"$1,923.00 ",$511.66 ,"$2,403.75 ","$1,769.16 ","$1,596.09 ","$1,769.16 ",$511.66 ,"$1,769.16 ","$2,499.90 ","$2,499.90 ","$2,724.25 ","$1,279.16 ","$2,221.07 ",$511.66 ,"$3,205.00 ","$1,762.75 ",$511.66 ,$842.92 ,"$3,205.00 ",$346.59 ,$330.83 ,$537.24 ,"$2,564.00 ","$1,740.32 ",$897.40 ,"$2,884.50 ","$1,483.00 ","$1,666.00 ",$511.66 ,"$1,538.40 "
ST. MARY'S HOSPITAL - DECATUR,36000308,27096,HC INJECTION SACRAL JOINT W/IMAGING GUIDANCE,360,1 ,"$1,866.00 ","$1,212.90 ",$216.13 ,"$1,866.00 ", N/A ,"$1,866.00 ","$1,026.30 ", N/A ,$522.48 ,$877.02 , N/A ,"$1,007.64 ", N/A ,"$1,013.24 ","$1,013.24 ", N/A ,"$1,013.24 ", N/A ,"$1,306.20 ",$933.00 ,"$1,492.80 ", N/A , N/A ,"$1,306.20 ", N/A ,"$1,119.60 ", N/A ,"$1,399.50 ","$1,030.03 ",$929.27 ,"$1,030.03 ", N/A ,"$1,030.03 ","$1,455.48 ","$1,455.48 ","$1,586.10 ", N/A ,"$1,293.14 ", N/A ,"$1,866.00 ","$1,026.30 ", N/A ,$490.76 ,"$1,866.00 ",$226.42 ,$216.13 , N/A ,"$1,492.80 ","$1,013.24 ",$522.48 ,"$1,679.40 ",$737.00 ,$900.00 , N/A ,$895.68 
ST. MARY'S HOSPITAL - DECATUR,36000310,64421,HC INJ ANES INTERCOSTAL NERVE EA ADDNT LEVEL,360,1 ,"$1,868.00 ","$1,214.20 ",$293.63 ,"$1,948.10 ","$1,948.10 ","$1,868.00 ","$1,027.40 ",$779.24 ,$523.04 ,$877.96 ,$779.24 ,"$1,008.72 ",$779.24 ,"$1,014.32 ","$1,014.32 ",$779.24 ,"$1,014.32 ","$1,480.55 ","$1,307.60 ",$934.00 ,"$1,494.40 ","$1,948.10 ",$779.24 ,"$1,307.60 ",$779.24 ,"$1,120.80 ",$779.24 ,"$1,401.00 ","$1,031.14 ",$930.26 ,"$1,031.14 ",$779.24 ,"$1,031.14 ","$1,457.04 ","$1,457.04 ","$1,587.80 ","$1,868.00 ","$1,294.52 ",$779.24 ,"$1,868.00 ","$1,027.40 ",$779.24 ,$491.28 ,"$1,868.00 ",$307.62 ,$293.63 ,$818.20 ,"$1,494.40 ","$1,014.32 ",$523.04 ,"$1,681.20 ","$1,483.00 ","$1,666.00 ",$779.24 ,$896.64 
ST. MARY'S HOSPITAL - DECATUR,36000311,64420,HC INJ INTERCOSTAL NERVE;SINGLE,360,1 ,"$1,497.00 ",$973.05 ,$293.63 ,"$1,502.73 ","$1,502.73 ","$1,497.00 ",$823.35 ,$601.09 ,$419.16 ,$703.59 ,$601.09 ,$808.38 ,$601.09 ,$812.87 ,$812.87 ,$601.09 ,$812.87 ,"$1,142.07 ","$1,047.90 ",$748.50 ,"$1,197.60 ","$1,502.72 ",$601.09 ,"$1,047.90 ",$601.09 ,$898.20 ,$601.09 ,"$1,122.75 ",$826.34 ,$745.51 ,$826.34 ,$601.09 ,$826.34 ,"$1,167.66 ","$1,167.66 ","$1,272.45 ","$1,497.00 ","$1,037.42 ",$601.09 ,"$1,497.00 ",$823.35 ,$601.09 ,$393.71 ,"$1,497.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,197.60 ",$812.87 ,$419.16 ,"$1,347.30 ","$1,483.00 ","$1,497.00 ",$601.09 ,$718.56 
ST. MARY'S HOSPITAL - DECATUR,36000326,64405,HC NERVE BLOCK; OCCIPITAL,360,1 ,"$4,530.00 ","$2,944.50 ",$247.31 ,"$4,530.00 ",$618.28 ,"$2,800.00 ","$2,491.50 ",$247.31 ,"$1,268.40 ","$2,129.10 ",$247.31 ,"$2,446.20 ",$247.31 ,"$2,459.79 ","$2,459.79 ",$247.31 ,"$2,459.79 ",$469.90 ,"$3,171.00 ","$2,265.00 ","$3,624.00 ",$618.29 ,$247.31 ,"$3,171.00 ",$247.31 ,"$2,718.00 ",$247.31 ,"$3,397.50 ","$2,500.56 ","$2,255.94 ","$2,500.56 ",$247.31 ,"$2,500.56 ","$3,533.40 ","$3,533.40 ","$3,850.50 ",$618.29 ,"$3,139.29 ",$247.31 ,"$4,530.00 ","$2,491.50 ",$247.31 ,"$1,191.39 ","$4,530.00 ",$307.62 ,$293.63 ,$259.68 ,"$3,624.00 ","$2,459.79 ","$1,268.40 ","$4,077.00 ",$737.00 ,$900.00 ,$247.31 ,"$2,174.40 "
ST. MARY'S HOSPITAL - DECATUR,36000331,64520,HC NERVE BLOCK;L/S PARAVERTEBAL SYMP,360,1 ,"$2,479.00 ","$1,611.35 ",$532.54 ,"$2,479.00 ","$1,948.10 ","$2,479.00 ","$1,363.45 ",$779.24 ,$694.12 ,"$1,165.13 ",$779.24 ,"$1,338.66 ",$779.24 ,"$1,346.10 ","$1,346.10 ",$779.24 ,"$1,346.10 ","$1,480.55 ","$1,735.30 ","$1,239.50 ","$1,983.20 ","$1,948.10 ",$779.24 ,"$1,735.30 ",$779.24 ,"$1,487.40 ",$779.24 ,"$1,859.25 ","$1,368.41 ","$1,234.54 ","$1,368.41 ",$779.24 ,"$1,368.41 ","$1,933.62 ","$1,933.62 ","$2,107.15 ","$1,948.10 ","$1,717.95 ",$779.24 ,"$2,479.00 ","$1,363.45 ",$779.24 ,$651.98 ,"$2,479.00 ",$557.90 ,$532.54 ,$818.20 ,"$1,983.20 ","$1,346.10 ",$694.12 ,"$2,231.10 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$1,189.92 "
ST. MARY'S HOSPITAL - DECATUR,36000334,63650,HC IMPLANT NEUROELECTRODES,360,1 ,"$7,887.00 ","$5,126.55 ","$2,074.28 ","$14,587.50 ","$14,587.50 ","$3,500.00 ","$4,337.85 ","$5,835.00 ","$2,208.36 ","$3,523.99 ","$5,835.00 ","$4,049.96 ","$5,835.00 ","$3,913.45 ","$3,913.45 ","$5,835.00 ","$3,913.45 ","$7,887.00 ","$3,500.00 ","$3,943.50 ","$6,309.60 ","$14,587.50 ","$5,835.00 ","$5,520.90 ","$5,835.00 ","$4,732.20 ","$5,835.00 ","$5,915.25 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$5,835.00 ","$4,057.00 ","$6,151.86 ","$6,151.86 ","$6,703.95 ","$7,887.00 ","$4,981.00 ","$5,835.00 ","$7,887.00 ","$4,337.85 ","$5,835.00 ","$2,074.28 ","$7,887.00 ","$3,429.66 ","$3,273.76 ","$6,126.75 ","$6,309.60 ","$3,913.45 ","$2,208.36 ","$7,098.30 ","$2,861.00 ","$5,100.00 ","$5,835.00 ","$3,785.76 "
ST. MARY'S HOSPITAL - DECATUR,36000355,36831,HC THROMBECTOMY OPEN AV FISTULA W/O REVISION,360,1 ,"$6,456.00 ","$4,196.40 ","$1,697.93 ","$11,285.10 ","$11,285.10 ","$6,456.00 ","$3,550.80 ","$4,514.04 ","$1,807.68 ","$3,034.32 ","$4,514.04 ","$3,486.24 ","$4,514.04 ","$3,505.61 ","$3,505.61 ","$4,514.04 ","$3,505.61 ","$6,456.00 ","$3,500.00 ","$3,228.00 ","$5,164.80 ","$11,285.10 ","$4,514.04 ","$4,519.20 ","$4,514.04 ","$3,873.60 ","$4,514.04 ","$4,842.00 ","$3,563.71 ","$3,215.09 ","$3,563.71 ","$4,514.04 ","$3,563.71 ","$5,035.68 ","$5,035.68 ","$5,487.60 ","$6,456.00 ","$4,474.01 ","$4,514.04 ","$6,456.00 ","$3,550.80 ","$4,514.04 ","$1,697.93 ","$6,456.00 ","$2,179.58 ","$2,080.51 ","$4,739.74 ","$5,164.80 ","$3,505.61 ","$1,807.68 ","$5,810.40 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$3,098.88 "
ST. MARY'S HOSPITAL - DECATUR,36000357,36833,HC AV FISTULA OPEN WITH THROMBECTOMY,360,1 ,"$13,847.00 ","$9,000.55 ","$2,658.26 ","$13,847.00 ","$11,285.10 ","$6,200.00 ","$7,615.85 ","$4,514.04 ","$3,877.16 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$6,923.50 ","$11,077.60 ","$11,285.10 ","$4,514.04 ","$9,692.90 ","$4,514.04 ","$8,308.20 ","$4,514.04 ","$10,385.25 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,514.04 ","$4,057.00 ","$8,112.00 ","$8,112.00 ","$11,769.95 ","$11,285.10 ","$4,981.00 ","$4,514.04 ","$13,847.00 ","$7,615.85 ","$4,514.04 ","$3,641.76 ","$13,847.00 ","$2,784.85 ","$2,658.26 ","$4,739.74 ","$11,077.60 ","$3,913.45 ","$3,877.16 ","$12,462.30 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$6,646.56 "
ST. MARY'S HOSPITAL - DECATUR,36000371,35875,HC THROMBECTOMY ART/VEN GRAFT,360,1 ,"$13,302.00 ","$8,646.30 ","$2,658.26 ","$13,302.00 ","$11,285.10 ","$12,000.00 ","$7,316.10 ","$4,514.04 ","$3,724.56 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$6,651.00 ","$10,641.60 ","$11,285.10 ","$4,514.04 ","$9,311.40 ","$4,514.04 ","$7,981.20 ","$4,514.04 ","$9,976.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,514.04 ","$4,057.00 ","$8,112.00 ","$8,112.00 ","$11,306.70 ","$11,285.10 ","$4,981.00 ","$4,514.04 ","$13,302.00 ","$7,316.10 ","$4,514.04 ","$3,498.43 ","$13,302.00 ","$2,784.85 ","$2,658.26 ","$4,739.74 ","$10,641.60 ","$3,913.45 ","$3,724.56 ","$11,971.80 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$6,384.96 "
ST. MARY'S HOSPITAL - DECATUR,36000372,35876,HC THROMBECTOMY W/REV ART/VEN GRAFT,360,1 ,"$13,302.00 ","$8,646.30 ","$2,658.26 ","$13,302.00 ","$11,285.10 ","$12,000.00 ","$7,316.10 ","$4,514.04 ","$3,724.56 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$6,651.00 ","$10,641.60 ","$11,285.10 ","$4,514.04 ","$9,311.40 ","$4,514.04 ","$7,981.20 ","$4,514.04 ","$9,976.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,514.04 ","$4,057.00 ","$8,112.00 ","$8,112.00 ","$11,306.70 ","$11,285.10 ","$4,981.00 ","$4,514.04 ","$13,302.00 ","$7,316.10 ","$4,514.04 ","$3,498.43 ","$13,302.00 ","$2,784.85 ","$2,658.26 ","$4,739.74 ","$10,641.60 ","$3,913.45 ","$3,724.56 ","$11,971.80 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$6,384.96 "
ST. MARY'S HOSPITAL - DECATUR,36000388,61630,HC ANGIOPLASTY BALLOON INTRACRANIAL PERC,360,1 ,"$4,320.00 ","$2,808.00 ","$1,136.16 ","$4,320.00 ", N/A ,"$4,320.00 ","$2,376.00 ", N/A ,"$1,209.60 ","$2,030.40 ", N/A ,"$2,332.80 ", N/A ,"$2,345.76 ","$2,345.76 ", N/A ,"$2,345.76 ", N/A ,"$3,024.00 ","$2,160.00 ","$3,456.00 ", N/A , N/A ,"$3,024.00 ", N/A ,"$2,592.00 ", N/A ,"$3,240.00 ","$2,384.64 ","$2,151.36 ","$2,384.64 ", N/A ,"$2,384.64 ","$3,369.60 ","$3,369.60 ","$3,672.00 ", N/A ,"$2,993.76 ", N/A ,"$4,320.00 ","$2,376.00 ", N/A ,"$1,136.16 ","$4,320.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$3,456.00 ","$2,345.76 ","$1,209.60 ","$3,888.00 ","$2,641.00 ","$2,034.00 ", N/A ,"$2,073.60 "
ST. MARY'S HOSPITAL - DECATUR,36000583,33221,HC INSERT PACEMAKER PULSE GENERATOR MULT LEADS,360,1 ,"$10,378.00 ","$6,745.70 ","$2,729.41 ","$44,074.03 ","$44,074.03 ","$5,500.00 ","$5,707.90 ","$17,629.61 ","$2,905.84 ","$3,523.99 ","$17,629.61 ","$4,049.96 ","$10,378.00 ","$3,913.45 ","$3,913.45 ","$10,378.00 ","$3,913.45 ","$10,378.00 ","$3,500.00 ","$5,189.00 ","$8,302.40 ","$44,074.02 ","$17,629.61 ","$7,264.60 ","$17,629.61 ","$6,226.80 ","$17,629.61 ","$7,783.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$17,629.61 ","$4,057.00 ","$8,094.84 ","$8,094.84 ","$8,821.30 ","$10,378.00 ","$4,981.00 ","$17,629.61 ","$10,378.00 ","$5,707.90 ","$17,629.61 ","$2,729.41 ","$10,378.00 ","$5,626.94 ","$5,371.17 ","$18,511.09 ","$8,302.40 ","$3,913.45 ","$2,905.84 ","$9,340.20 ","$3,243.00 ","$10,378.00 ","$17,629.61 ","$4,981.44 "
ST. MARY'S HOSPITAL - DECATUR,36000585,33220,HC REPAIR PACEMAKER DUAL LEAD,360,1 ,"$5,132.00 ","$3,335.80 ","$1,349.72 ","$8,149.00 ","$8,149.00 ","$5,132.00 ","$2,822.60 ","$3,259.60 ","$1,436.96 ","$2,412.04 ","$3,259.60 ","$2,771.28 ","$3,259.60 ","$2,786.68 ","$2,786.68 ","$3,259.60 ","$2,786.68 ","$5,132.00 ","$3,500.00 ","$2,566.00 ","$4,105.60 ","$8,149.00 ","$3,259.60 ","$3,592.40 ","$3,259.60 ","$3,079.20 ","$3,259.60 ","$3,849.00 ","$2,832.86 ","$2,555.74 ","$2,832.86 ","$3,259.60 ","$2,832.86 ","$4,002.96 ","$4,002.96 ","$4,362.20 ","$5,132.00 ","$3,556.48 ","$3,259.60 ","$5,132.00 ","$2,822.60 ","$3,259.60 ","$1,349.72 ","$5,132.00 ","$4,072.68 ","$3,887.56 ","$3,422.58 ","$4,105.60 ","$2,786.68 ","$1,436.96 ","$4,618.80 ","$2,641.00 ","$3,250.00 ","$3,259.60 ","$2,463.36 "
ST. MARY'S HOSPITAL - DECATUR,36000586,33218,HC REPAIR PACEMAKER SINGLE LEAD,360,1 ,"$3,081.00 ","$2,002.65 ",$810.30 ,"$8,149.00 ","$8,149.00 ","$3,081.00 ","$1,694.55 ","$3,259.60 ",$862.68 ,"$1,448.07 ","$3,259.60 ","$1,663.74 ","$3,081.00 ","$1,672.98 ","$1,672.98 ","$3,081.00 ","$1,672.98 ","$3,081.00 ","$2,156.70 ","$1,540.50 ","$2,464.80 ","$8,149.00 ","$3,259.60 ","$2,156.70 ","$3,259.60 ","$1,848.60 ","$3,259.60 ","$2,310.75 ","$1,700.71 ","$1,534.34 ","$1,700.71 ","$3,259.60 ","$1,700.71 ","$2,403.18 ","$2,403.18 ","$2,618.85 ","$3,081.00 ","$2,135.13 ","$3,259.60 ","$3,081.00 ","$1,694.55 ","$3,259.60 ",$810.30 ,"$3,081.00 ","$3,081.00 ","$3,887.56 ","$3,422.58 ","$2,464.80 ","$1,672.98 ",$862.68 ,"$2,772.90 ","$2,641.00 ","$3,081.00 ","$3,259.60 ","$1,478.88 "
ST. MARY'S HOSPITAL - DECATUR,36000589,19020,HC MASTOTOMY W/EXPL/DRAIN ABSCESS DEEP-LT,360,1 ,"$3,340.00 ","$2,171.00 ",$699.77 ,"$3,340.00 ","$3,329.73 ","$3,340.00 ","$1,837.00 ","$1,331.89 ",$935.20 ,"$1,569.80 ","$1,331.89 ","$1,803.60 ","$1,331.89 ","$1,813.62 ","$1,813.62 ","$1,331.89 ","$1,813.62 ","$2,530.59 ","$2,338.00 ","$1,670.00 ","$2,672.00 ","$3,329.72 ","$1,331.89 ","$2,338.00 ","$1,331.89 ","$2,004.00 ","$1,331.89 ","$2,505.00 ","$1,843.68 ","$1,663.32 ","$1,843.68 ","$1,331.89 ","$1,843.68 ","$2,605.20 ","$2,605.20 ","$2,839.00 ","$3,329.72 ","$2,314.62 ","$1,331.89 ","$3,340.00 ","$1,837.00 ","$1,331.89 ",$878.42 ,"$3,340.00 ",$733.10 ,$699.77 ,"$1,398.48 ","$2,672.00 ","$1,813.62 ",$935.20 ,"$3,006.00 ","$2,198.00 ","$2,500.00 ","$1,331.89 ","$1,603.20 "
ST. MARY'S HOSPITAL - DECATUR,36000590,19020,HC MASTOTOMY W/EXPL/DRAIN ABSCESS DEEP-RT,360,1 ,"$3,340.00 ","$2,171.00 ",$699.77 ,"$3,340.00 ","$3,329.73 ","$3,340.00 ","$1,837.00 ","$1,331.89 ",$935.20 ,"$1,569.80 ","$1,331.89 ","$1,803.60 ","$1,331.89 ","$1,813.62 ","$1,813.62 ","$1,331.89 ","$1,813.62 ","$2,530.59 ","$2,338.00 ","$1,670.00 ","$2,672.00 ","$3,329.72 ","$1,331.89 ","$2,338.00 ","$1,331.89 ","$2,004.00 ","$1,331.89 ","$2,505.00 ","$1,843.68 ","$1,663.32 ","$1,843.68 ","$1,331.89 ","$1,843.68 ","$2,605.20 ","$2,605.20 ","$2,839.00 ","$3,329.72 ","$2,314.62 ","$1,331.89 ","$3,340.00 ","$1,837.00 ","$1,331.89 ",$878.42 ,"$3,340.00 ",$733.10 ,$699.77 ,"$1,398.48 ","$2,672.00 ","$1,813.62 ",$935.20 ,"$3,006.00 ","$2,198.00 ","$2,500.00 ","$1,331.89 ","$1,603.20 "
ST. MARY'S HOSPITAL - DECATUR,36000602,34101,HC EMBOLECTOMY AXILL/BRACH/INNOMINATE/SUBCL ARTERY ARM-LT,360,1 ,"$6,393.00 ","$4,155.45 ","$1,681.36 ","$11,285.10 ","$11,285.10 ","$5,500.00 ","$3,516.15 ","$4,514.04 ","$1,790.04 ","$3,004.71 ","$4,514.04 ","$3,452.22 ","$4,514.04 ","$3,471.40 ","$3,471.40 ","$4,514.04 ","$3,471.40 ","$6,393.00 ","$3,500.00 ","$3,196.50 ","$5,114.40 ","$11,285.10 ","$4,514.04 ","$4,475.10 ","$4,514.04 ","$3,835.80 ","$4,514.04 ","$4,794.75 ","$3,528.94 ","$3,183.71 ","$3,528.94 ","$4,514.04 ","$3,528.94 ","$4,986.54 ","$4,986.54 ","$5,434.05 ","$6,393.00 ","$4,430.35 ","$4,514.04 ","$6,393.00 ","$3,516.15 ","$4,514.04 ","$1,681.36 ","$6,393.00 ","$2,179.58 ","$2,080.51 ","$4,739.74 ","$5,114.40 ","$3,471.40 ","$1,790.04 ","$5,753.70 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$3,068.64 "
ST. MARY'S HOSPITAL - DECATUR,36000603,34101,HC EMBOLECTOMY AXILL/BRACH/INNOMINATE/SUBCL ARTERY ARM-RT,360,1 ,"$6,393.00 ","$4,155.45 ","$1,681.36 ","$11,285.10 ","$11,285.10 ","$5,500.00 ","$3,516.15 ","$4,514.04 ","$1,790.04 ","$3,004.71 ","$4,514.04 ","$3,452.22 ","$4,514.04 ","$3,471.40 ","$3,471.40 ","$4,514.04 ","$3,471.40 ","$6,393.00 ","$3,500.00 ","$3,196.50 ","$5,114.40 ","$11,285.10 ","$4,514.04 ","$4,475.10 ","$4,514.04 ","$3,835.80 ","$4,514.04 ","$4,794.75 ","$3,528.94 ","$3,183.71 ","$3,528.94 ","$4,514.04 ","$3,528.94 ","$4,986.54 ","$4,986.54 ","$5,434.05 ","$6,393.00 ","$4,430.35 ","$4,514.04 ","$6,393.00 ","$3,516.15 ","$4,514.04 ","$1,681.36 ","$6,393.00 ","$2,179.58 ","$2,080.51 ","$4,739.74 ","$5,114.40 ","$3,471.40 ","$1,790.04 ","$5,753.70 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$3,068.64 "
ST. MARY'S HOSPITAL - DECATUR,36000604,34111,HC EMBOLECTOMY RADIAL/ULNAR ARTERY ARM-LT,360,1 ,"$6,075.00 ","$3,948.75 ","$1,597.73 ","$11,285.10 ","$11,285.10 ","$6,075.00 ","$3,341.25 ","$4,514.04 ","$1,701.00 ","$2,855.25 ","$4,514.04 ","$3,280.50 ","$4,514.04 ","$3,298.73 ","$3,298.73 ","$4,514.04 ","$3,298.73 ","$6,075.00 ","$3,500.00 ","$3,037.50 ","$4,860.00 ","$11,285.10 ","$4,514.04 ","$4,252.50 ","$4,514.04 ","$3,645.00 ","$4,514.04 ","$4,556.25 ","$3,353.40 ","$3,025.35 ","$3,353.40 ","$4,514.04 ","$3,353.40 ","$4,738.50 ","$4,738.50 ","$5,163.75 ","$6,075.00 ","$4,209.98 ","$4,514.04 ","$6,075.00 ","$3,341.25 ","$4,514.04 ","$1,597.73 ","$6,075.00 ","$2,179.58 ","$2,080.51 ","$4,739.74 ","$4,860.00 ","$3,298.73 ","$1,701.00 ","$5,467.50 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$2,916.00 "
ST. MARY'S HOSPITAL - DECATUR,36000605,34111,HC EMBOLECTOMY RADIAL/ULNAR ARTERY ARM-RT,360,1 ,"$6,075.00 ","$3,948.75 ","$1,597.73 ","$11,285.10 ","$11,285.10 ","$6,075.00 ","$3,341.25 ","$4,514.04 ","$1,701.00 ","$2,855.25 ","$4,514.04 ","$3,280.50 ","$4,514.04 ","$3,298.73 ","$3,298.73 ","$4,514.04 ","$3,298.73 ","$6,075.00 ","$3,500.00 ","$3,037.50 ","$4,860.00 ","$11,285.10 ","$4,514.04 ","$4,252.50 ","$4,514.04 ","$3,645.00 ","$4,514.04 ","$4,556.25 ","$3,353.40 ","$3,025.35 ","$3,353.40 ","$4,514.04 ","$3,353.40 ","$4,738.50 ","$4,738.50 ","$5,163.75 ","$6,075.00 ","$4,209.98 ","$4,514.04 ","$6,075.00 ","$3,341.25 ","$4,514.04 ","$1,597.73 ","$6,075.00 ","$2,179.58 ","$2,080.51 ","$4,739.74 ","$4,860.00 ","$3,298.73 ","$1,701.00 ","$5,467.50 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$2,916.00 "
ST. MARY'S HOSPITAL - DECATUR,36000606,34201,HC EMBOLECTOMY FEMOPOP AORTOILIAC ARTERY LEG-LT,360,1 ,"$7,981.00 ","$5,187.65 ","$2,099.00 ","$11,285.10 ","$11,285.10 ","$7,500.00 ","$4,389.55 ","$4,514.04 ","$2,234.68 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$7,981.00 ","$3,500.00 ","$3,990.50 ","$6,384.80 ","$11,285.10 ","$4,514.04 ","$5,586.70 ","$4,514.04 ","$4,788.60 ","$4,514.04 ","$5,985.75 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,514.04 ","$4,057.00 ","$6,225.18 ","$6,225.18 ","$6,783.85 ","$7,981.00 ","$4,981.00 ","$4,514.04 ","$7,981.00 ","$4,389.55 ","$4,514.04 ","$2,099.00 ","$7,981.00 ","$2,784.85 ","$2,658.26 ","$4,739.74 ","$6,384.80 ","$3,913.45 ","$2,234.68 ","$7,182.90 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$3,830.88 "
ST. MARY'S HOSPITAL - DECATUR,36000607,34201,HC EMBOLECTOMY FEMOPOP AORTOILIAC ARTERY LEG-RT,360,1 ,"$7,981.00 ","$5,187.65 ","$2,099.00 ","$11,285.10 ","$11,285.10 ","$7,500.00 ","$4,389.55 ","$4,514.04 ","$2,234.68 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$7,981.00 ","$3,500.00 ","$3,990.50 ","$6,384.80 ","$11,285.10 ","$4,514.04 ","$5,586.70 ","$4,514.04 ","$4,788.60 ","$4,514.04 ","$5,985.75 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,514.04 ","$4,057.00 ","$6,225.18 ","$6,225.18 ","$6,783.85 ","$7,981.00 ","$4,981.00 ","$4,514.04 ","$7,981.00 ","$4,389.55 ","$4,514.04 ","$2,099.00 ","$7,981.00 ","$2,784.85 ","$2,658.26 ","$4,739.74 ","$6,384.80 ","$3,913.45 ","$2,234.68 ","$7,182.90 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$3,830.88 "
ST. MARY'S HOSPITAL - DECATUR,36000609,34813,HC PLACE FEMORAL ENDOVASC GRAFT,360,1 ,"$3,199.00 ","$2,079.35 ",$841.34 ,"$3,199.00 ", N/A ,"$3,199.00 ","$1,759.45 ", N/A ,$895.72 ,"$1,503.53 ", N/A ,"$1,727.46 ", N/A ,"$1,737.06 ","$1,737.06 ", N/A ,"$1,737.06 ", N/A ,"$2,239.30 ","$1,599.50 ","$2,559.20 ", N/A , N/A ,"$2,239.30 ", N/A ,"$1,919.40 ", N/A ,"$2,399.25 ","$1,765.85 ","$1,593.10 ","$1,765.85 ", N/A ,"$1,765.85 ","$2,495.22 ","$2,495.22 ","$2,719.15 ", N/A ,"$2,216.91 ", N/A ,"$3,199.00 ","$1,759.45 ", N/A ,$841.34 ,"$3,199.00 ", N/A , N/A , N/A ,"$2,559.20 ","$1,737.06 ",$895.72 ,"$2,879.10 ","$2,641.00 ","$2,034.00 ", N/A ,"$1,535.52 "
ST. MARY'S HOSPITAL - DECATUR,36000610,34834,HC EXPOSE BRACHIAL ARTERY ENDOVASC PROSTHESIS,360,1 ,"$7,075.00 ","$4,598.75 ","$1,860.73 ","$7,075.00 ", N/A ,"$7,075.00 ","$3,891.25 ", N/A ,"$1,981.00 ","$3,325.25 ", N/A ,"$3,820.50 ", N/A ,"$3,841.73 ","$3,841.73 ", N/A ,"$3,841.73 ", N/A ,"$3,500.00 ","$3,537.50 ","$5,660.00 ", N/A , N/A ,"$4,952.50 ", N/A ,"$4,245.00 ", N/A ,"$5,306.25 ","$3,905.40 ","$3,523.35 ","$3,905.40 ", N/A ,"$3,905.40 ","$5,518.50 ","$5,518.50 ","$6,013.75 ", N/A ,"$4,902.98 ", N/A ,"$7,075.00 ","$3,891.25 ", N/A ,"$1,860.73 ","$7,075.00 ", N/A , N/A , N/A ,"$5,660.00 ","$3,841.73 ","$1,981.00 ","$6,367.50 ","$2,641.00 ","$2,034.00 ", N/A ,"$3,396.00 "
ST. MARY'S HOSPITAL - DECATUR,36000616,34846,HC RPR ENDOVASC VISCERAL /INFRARENAL AORTA 2ND GRAFT,360,1 ,"$19,471.00 ","$12,656.15 ","$2,034.00 ","$19,471.00 ", N/A ,"$7,500.00 ","$10,709.05 ", N/A ,"$5,451.88 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,735.50 ","$15,576.80 ", N/A , N/A ,"$13,629.70 ", N/A ,"$11,682.60 ", N/A ,"$14,603.25 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$8,112.00 ","$8,112.00 ","$16,550.35 ", N/A ,"$4,981.00 ", N/A ,"$19,471.00 ","$10,709.05 ", N/A ,"$5,120.87 ","$19,471.00 ", N/A , N/A , N/A ,"$15,576.80 ","$3,913.45 ","$5,451.88 ","$17,523.90 ","$2,641.00 ","$2,034.00 ", N/A ,"$9,346.08 "
ST. MARY'S HOSPITAL - DECATUR,36000621,35131,HC REPAIR DEFECTIVE ILIAC ARTERY,360,1 ,"$1,910.00 ","$1,241.50 ",$502.33 ,"$1,910.00 ", N/A ,"$1,910.00 ","$1,050.50 ", N/A ,$534.80 ,$897.70 , N/A ,"$1,031.40 ", N/A ,"$1,037.13 ","$1,037.13 ", N/A ,"$1,037.13 ", N/A ,"$1,337.00 ",$955.00 ,"$1,528.00 ", N/A , N/A ,"$1,337.00 ", N/A ,"$1,146.00 ", N/A ,"$1,432.50 ","$1,054.32 ",$951.18 ,"$1,054.32 ", N/A ,"$1,054.32 ","$1,489.80 ","$1,489.80 ","$1,623.50 ", N/A ,"$1,323.63 ", N/A ,"$1,910.00 ","$1,050.50 ", N/A ,$502.33 ,"$1,910.00 ", N/A , N/A , N/A ,"$1,528.00 ","$1,037.13 ",$534.80 ,"$1,719.00 ","$1,910.00 ","$1,910.00 ", N/A ,$916.80 
ST. MARY'S HOSPITAL - DECATUR,36000622,35190,HC REPAIR BLOOD VESSEL LESION,360,1 ,"$6,635.00 ","$4,312.75 ","$1,610.51 ","$11,285.10 ","$11,285.10 ","$6,635.00 ","$3,649.25 ","$4,514.04 ","$1,857.80 ","$3,118.45 ","$4,514.04 ","$3,582.90 ","$4,514.04 ","$3,602.81 ","$3,602.81 ","$4,514.04 ","$3,602.81 ","$6,635.00 ","$3,500.00 ","$3,317.50 ","$5,308.00 ","$11,285.10 ","$4,514.04 ","$4,644.50 ","$4,514.04 ","$3,981.00 ","$4,514.04 ","$4,976.25 ","$3,662.52 ","$3,304.23 ","$3,662.52 ","$4,514.04 ","$3,662.52 ","$5,175.30 ","$5,175.30 ","$5,639.75 ","$6,635.00 ","$4,598.06 ","$4,514.04 ","$6,635.00 ","$3,649.25 ","$4,514.04 ","$1,745.01 ","$6,635.00 ","$1,687.20 ","$1,610.51 ","$4,739.74 ","$5,308.00 ","$3,602.81 ","$1,857.80 ","$5,971.50 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$3,184.80 "
ST. MARY'S HOSPITAL - DECATUR,36000623,35266,HC RPR BLOOD VESSEL W/GRAFT NON-VEIN UPPR EXTREMITY,360,1 ,"$11,046.00 ","$7,179.90 ","$1,610.51 ","$11,285.10 ","$11,285.10 ","$8,000.00 ","$6,075.30 ","$4,514.04 ","$3,092.88 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$5,523.00 ","$8,836.80 ","$11,285.10 ","$4,514.04 ","$7,732.20 ","$4,514.04 ","$6,627.60 ","$4,514.04 ","$8,284.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,514.04 ","$4,057.00 ","$8,112.00 ","$8,112.00 ","$9,389.10 ","$11,046.00 ","$4,981.00 ","$4,514.04 ","$11,046.00 ","$6,075.30 ","$4,514.04 ","$2,905.10 ","$11,046.00 ","$1,687.20 ","$1,610.51 ","$4,739.74 ","$8,836.80 ","$3,913.45 ","$3,092.88 ","$9,941.40 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$5,302.08 "
ST. MARY'S HOSPITAL - DECATUR,36000624,35301,HC THROMB/ARTERECT W/GRAFT CAROTID/VERTB/SUBCLAV,360,1 ,"$9,425.00 ","$6,126.25 ","$2,034.00 ","$9,425.00 ", N/A ,"$7,500.00 ","$5,183.75 ", N/A ,"$2,639.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,712.50 ","$7,540.00 ", N/A , N/A ,"$6,597.50 ", N/A ,"$5,655.00 ", N/A ,"$7,068.75 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$7,351.50 ","$7,351.50 ","$8,011.25 ", N/A ,"$4,981.00 ", N/A ,"$9,425.00 ","$5,183.75 ", N/A ,"$2,478.78 ","$9,425.00 ","$2,784.85 ","$2,658.26 ", N/A ,"$7,540.00 ","$3,913.45 ","$2,639.00 ","$8,482.50 ","$2,641.00 ","$2,034.00 ", N/A ,"$4,524.00 "
ST. MARY'S HOSPITAL - DECATUR,36000625,35302,HC THROMB/ARTERECT W/GRAFT FEMORAL ARTERY,360,1 ,$537.00 ,$349.05 ,$141.23 ,$537.00 , N/A ,$537.00 ,$295.35 , N/A ,$150.36 ,$252.39 , N/A ,$289.98 , N/A ,$291.59 ,$291.59 , N/A ,$291.59 , N/A ,$375.90 ,$268.50 ,$429.60 , N/A , N/A ,$375.90 , N/A ,$322.20 , N/A ,$402.75 ,$296.42 ,$267.43 ,$296.42 , N/A ,$296.42 ,$418.86 ,$418.86 ,$456.45 , N/A ,$372.14 , N/A ,$537.00 ,$295.35 , N/A ,$141.23 ,$537.00 , N/A , N/A , N/A ,$429.60 ,$291.59 ,$150.36 ,$483.30 ,$537.00 ,$537.00 , N/A ,$257.76 
ST. MARY'S HOSPITAL - DECATUR,36000626,35303,HC THROMB/ARTERECT W/GRAFT POPLITEAL ARTERY,360,1 ,"$6,166.00 ","$4,007.90 ","$1,621.66 ","$6,166.00 ", N/A ,"$6,166.00 ","$3,391.30 ", N/A ,"$1,726.48 ","$2,898.02 ", N/A ,"$3,329.64 ", N/A ,"$3,348.14 ","$3,348.14 ", N/A ,"$3,348.14 ", N/A ,"$3,500.00 ","$3,083.00 ","$4,932.80 ", N/A , N/A ,"$4,316.20 ", N/A ,"$3,699.60 ", N/A ,"$4,624.50 ","$3,403.63 ","$3,070.67 ","$3,403.63 ", N/A ,"$3,403.63 ","$4,809.48 ","$4,809.48 ","$5,241.10 ", N/A ,"$4,273.04 ", N/A ,"$6,166.00 ","$3,391.30 ", N/A ,"$1,621.66 ","$6,166.00 ","$2,179.58 ","$2,080.51 ", N/A ,"$4,932.80 ","$3,348.14 ","$1,726.48 ","$5,549.40 ","$2,641.00 ","$2,034.00 ", N/A ,"$2,959.68 "
ST. MARY'S HOSPITAL - DECATUR,36000627,35355,HC THROMB/ARTERECT W/GRAFT ILIOFEMORAL-LT,360,1 ,"$6,282.00 ","$4,083.30 ","$1,652.17 ","$6,282.00 ", N/A ,"$6,282.00 ","$3,455.10 ", N/A ,"$1,758.96 ","$2,952.54 ", N/A ,"$3,392.28 ", N/A ,"$3,411.13 ","$3,411.13 ", N/A ,"$3,411.13 ", N/A ,"$3,500.00 ","$3,141.00 ","$5,025.60 ", N/A , N/A ,"$4,397.40 ", N/A ,"$3,769.20 ", N/A ,"$4,711.50 ","$3,467.66 ","$3,128.44 ","$3,467.66 ", N/A ,"$3,467.66 ","$4,899.96 ","$4,899.96 ","$5,339.70 ", N/A ,"$4,353.43 ", N/A ,"$6,282.00 ","$3,455.10 ", N/A ,"$1,652.17 ","$6,282.00 ", N/A , N/A , N/A ,"$5,025.60 ","$3,411.13 ","$1,758.96 ","$5,653.80 ","$2,641.00 ","$2,034.00 ", N/A ,"$3,015.36 "
ST. MARY'S HOSPITAL - DECATUR,36000628,35355,HC THROMB/ARTERECT W/GRAFT ILIOFEMORAL-RT,360,1 ,"$6,282.00 ","$4,083.30 ","$1,652.17 ","$6,282.00 ", N/A ,"$6,282.00 ","$3,455.10 ", N/A ,"$1,758.96 ","$2,952.54 ", N/A ,"$3,392.28 ", N/A ,"$3,411.13 ","$3,411.13 ", N/A ,"$3,411.13 ", N/A ,"$3,500.00 ","$3,141.00 ","$5,025.60 ", N/A , N/A ,"$4,397.40 ", N/A ,"$3,769.20 ", N/A ,"$4,711.50 ","$3,467.66 ","$3,128.44 ","$3,467.66 ", N/A ,"$3,467.66 ","$4,899.96 ","$4,899.96 ","$5,339.70 ", N/A ,"$4,353.43 ", N/A ,"$6,282.00 ","$3,455.10 ", N/A ,"$1,652.17 ","$6,282.00 ", N/A , N/A , N/A ,"$5,025.60 ","$3,411.13 ","$1,758.96 ","$5,653.80 ","$2,641.00 ","$2,034.00 ", N/A ,"$3,015.36 "
ST. MARY'S HOSPITAL - DECATUR,36000629,35371,HC THROMB/ARTERECT W/GRAFT COMMON FEMORAL-LT,360,1 ,"$6,564.00 ","$4,266.60 ","$1,726.33 ","$6,564.00 ", N/A ,"$6,564.00 ","$3,610.20 ", N/A ,"$1,837.92 ","$3,085.08 ", N/A ,"$3,544.56 ", N/A ,"$3,564.25 ","$3,564.25 ", N/A ,"$3,564.25 ", N/A ,"$3,500.00 ","$3,282.00 ","$5,251.20 ", N/A , N/A ,"$4,594.80 ", N/A ,"$3,938.40 ", N/A ,"$4,923.00 ","$3,623.33 ","$3,268.87 ","$3,623.33 ", N/A ,"$3,623.33 ","$5,119.92 ","$5,119.92 ","$5,579.40 ", N/A ,"$4,548.85 ", N/A ,"$6,564.00 ","$3,610.20 ", N/A ,"$1,726.33 ","$6,564.00 ","$2,784.85 ","$2,658.26 ", N/A ,"$5,251.20 ","$3,564.25 ","$1,837.92 ","$5,907.60 ","$2,641.00 ","$2,034.00 ", N/A ,"$3,150.72 "
ST. MARY'S HOSPITAL - DECATUR,36000630,35371,HC THROMB/ARTERECT W/GRAFT COMMON FEMORAL-RT,360,1 ,"$6,564.00 ","$4,266.60 ","$1,726.33 ","$6,564.00 ", N/A ,"$6,564.00 ","$3,610.20 ", N/A ,"$1,837.92 ","$3,085.08 ", N/A ,"$3,544.56 ", N/A ,"$3,564.25 ","$3,564.25 ", N/A ,"$3,564.25 ", N/A ,"$3,500.00 ","$3,282.00 ","$5,251.20 ", N/A , N/A ,"$4,594.80 ", N/A ,"$3,938.40 ", N/A ,"$4,923.00 ","$3,623.33 ","$3,268.87 ","$3,623.33 ", N/A ,"$3,623.33 ","$5,119.92 ","$5,119.92 ","$5,579.40 ", N/A ,"$4,548.85 ", N/A ,"$6,564.00 ","$3,610.20 ", N/A ,"$1,726.33 ","$6,564.00 ","$2,784.85 ","$2,658.26 ", N/A ,"$5,251.20 ","$3,564.25 ","$1,837.92 ","$5,907.60 ","$2,641.00 ","$2,034.00 ", N/A ,"$3,150.72 "
ST. MARY'S HOSPITAL - DECATUR,36000631,35371,HC THROMB/ARTERECT W/GRAFT COMMON FEMORAL-BIL,360,1 ,"$6,564.00 ","$4,266.60 ","$1,726.33 ","$6,564.00 ", N/A ,"$6,564.00 ","$3,610.20 ", N/A ,"$1,837.92 ","$3,085.08 ", N/A ,"$3,544.56 ", N/A ,"$3,564.25 ","$3,564.25 ", N/A ,"$3,564.25 ", N/A ,"$3,500.00 ","$3,282.00 ","$5,251.20 ", N/A , N/A ,"$4,594.80 ", N/A ,"$3,938.40 ", N/A ,"$4,923.00 ","$3,623.33 ","$3,268.87 ","$3,623.33 ", N/A ,"$3,623.33 ","$5,119.92 ","$5,119.92 ","$5,579.40 ", N/A ,"$4,548.85 ", N/A ,"$6,564.00 ","$3,610.20 ", N/A ,"$1,726.33 ","$6,564.00 ","$4,177.27 ","$3,987.40 ", N/A ,"$5,251.20 ","$3,564.25 ","$1,837.92 ","$5,907.60 ","$3,961.50 ","$3,051.00 ", N/A ,"$3,150.72 "
ST. MARY'S HOSPITAL - DECATUR,36000632,35372,HC THROMB/ARTERECT W/GRAFT DEEP FEMORAL-LT,360,1 ,$818.00 ,$531.70 ,$215.13 ,$818.00 , N/A ,$818.00 ,$449.90 , N/A ,$229.04 ,$384.46 , N/A ,$441.72 , N/A ,$444.17 ,$444.17 , N/A ,$444.17 , N/A ,$572.60 ,$409.00 ,$654.40 , N/A , N/A ,$572.60 , N/A ,$490.80 , N/A ,$613.50 ,$451.54 ,$407.36 ,$451.54 , N/A ,$451.54 ,$638.04 ,$638.04 ,$695.30 , N/A ,$566.87 , N/A ,$818.00 ,$449.90 , N/A ,$215.13 ,$818.00 , N/A , N/A , N/A ,$654.40 ,$444.17 ,$229.04 ,$736.20 ,$818.00 ,$818.00 , N/A ,$392.64 
ST. MARY'S HOSPITAL - DECATUR,36000633,35372,HC THROMB/ARTERECT W/GRAFT DEEP FEMORAL-RT,360,1 ,$818.00 ,$531.70 ,$215.13 ,$818.00 , N/A ,$818.00 ,$449.90 , N/A ,$229.04 ,$384.46 , N/A ,$441.72 , N/A ,$444.17 ,$444.17 , N/A ,$444.17 , N/A ,$572.60 ,$409.00 ,$654.40 , N/A , N/A ,$572.60 , N/A ,$490.80 , N/A ,$613.50 ,$451.54 ,$407.36 ,$451.54 , N/A ,$451.54 ,$638.04 ,$638.04 ,$695.30 , N/A ,$566.87 , N/A ,$818.00 ,$449.90 , N/A ,$215.13 ,$818.00 , N/A , N/A , N/A ,$654.40 ,$444.17 ,$229.04 ,$736.20 ,$818.00 ,$818.00 , N/A ,$392.64 
ST. MARY'S HOSPITAL - DECATUR,36000635,35656,HC ARTERY BYPASS GRAFT FEMORAL-POPLITEAL,360,1 ,"$1,362.00 ",$885.30 ,$358.21 ,"$1,362.00 ", N/A ,"$1,362.00 ",$749.10 , N/A ,$381.36 ,$640.14 , N/A ,$735.48 , N/A ,$739.57 ,$739.57 , N/A ,$739.57 , N/A ,$953.40 ,$681.00 ,"$1,089.60 ", N/A , N/A ,$953.40 , N/A ,$817.20 , N/A ,"$1,021.50 ",$751.82 ,$678.28 ,$751.82 , N/A ,$751.82 ,"$1,062.36 ","$1,062.36 ","$1,157.70 ", N/A ,$943.87 , N/A ,"$1,362.00 ",$749.10 , N/A ,$358.21 ,"$1,362.00 ", N/A , N/A , N/A ,"$1,089.60 ",$739.57 ,$381.36 ,"$1,225.80 ","$1,362.00 ","$1,362.00 ", N/A ,$653.76 
ST. MARY'S HOSPITAL - DECATUR,36000636,35661,HC ARTERY BYPASS GRAFT FEMORAL-FEMORAL,360,1 ,$943.00 ,$612.95 ,$248.01 ,$943.00 , N/A ,$943.00 ,$518.65 , N/A ,$264.04 ,$443.21 , N/A ,$509.22 , N/A ,$512.05 ,$512.05 , N/A ,$512.05 , N/A ,$660.10 ,$471.50 ,$754.40 , N/A , N/A ,$660.10 , N/A ,$565.80 , N/A ,$707.25 ,$520.54 ,$469.61 ,$520.54 , N/A ,$520.54 ,$735.54 ,$735.54 ,$801.55 , N/A ,$653.50 , N/A ,$943.00 ,$518.65 , N/A ,$248.01 ,$943.00 , N/A , N/A , N/A ,$754.40 ,$512.05 ,$264.04 ,$848.70 ,$943.00 ,$943.00 , N/A ,$452.64 
ST. MARY'S HOSPITAL - DECATUR,36000637,35665,HC ARTERY BYPASS GRAFT ILIOFEMORAL-LT,360,1 ,"$3,346.00 ","$2,174.90 ",$880.00 ,"$3,346.00 ", N/A ,"$3,346.00 ","$1,840.30 ", N/A ,$936.88 ,"$1,572.62 ", N/A ,"$1,806.84 ", N/A ,"$1,816.88 ","$1,816.88 ", N/A ,"$1,816.88 ", N/A ,"$2,342.20 ","$1,673.00 ","$2,676.80 ", N/A , N/A ,"$2,342.20 ", N/A ,"$2,007.60 ", N/A ,"$2,509.50 ","$1,846.99 ","$1,666.31 ","$1,846.99 ", N/A ,"$1,846.99 ","$2,609.88 ","$2,609.88 ","$2,844.10 ", N/A ,"$2,318.78 ", N/A ,"$3,346.00 ","$1,840.30 ", N/A ,$880.00 ,"$3,346.00 ", N/A , N/A , N/A ,"$2,676.80 ","$1,816.88 ",$936.88 ,"$3,011.40 ","$2,641.00 ","$2,034.00 ", N/A ,"$1,606.08 "
ST. MARY'S HOSPITAL - DECATUR,36000638,35665,HC ARTERY BYPASS GRAFT ILIOFEMORAL-RT,360,1 ,"$3,346.00 ","$2,174.90 ",$880.00 ,"$3,346.00 ", N/A ,"$3,346.00 ","$1,840.30 ", N/A ,$936.88 ,"$1,572.62 ", N/A ,"$1,806.84 ", N/A ,"$1,816.88 ","$1,816.88 ", N/A ,"$1,816.88 ", N/A ,"$2,342.20 ","$1,673.00 ","$2,676.80 ", N/A , N/A ,"$2,342.20 ", N/A ,"$2,007.60 ", N/A ,"$2,509.50 ","$1,846.99 ","$1,666.31 ","$1,846.99 ", N/A ,"$1,846.99 ","$2,609.88 ","$2,609.88 ","$2,844.10 ", N/A ,"$2,318.78 ", N/A ,"$3,346.00 ","$1,840.30 ", N/A ,$880.00 ,"$3,346.00 ", N/A , N/A , N/A ,"$2,676.80 ","$1,816.88 ",$936.88 ,"$3,011.40 ","$2,641.00 ","$2,034.00 ", N/A ,"$1,606.08 "
ST. MARY'S HOSPITAL - DECATUR,36000640,35666,HC ARTERY BYPASS GRAFT TIBIAL,360,1 ,"$3,346.00 ","$2,174.90 ",$880.00 ,"$3,346.00 ", N/A ,"$3,346.00 ","$1,840.30 ", N/A ,$936.88 ,"$1,572.62 ", N/A ,"$1,806.84 ", N/A ,"$1,816.88 ","$1,816.88 ", N/A ,"$1,816.88 ", N/A ,"$2,342.20 ","$1,673.00 ","$2,676.80 ", N/A , N/A ,"$2,342.20 ", N/A ,"$2,007.60 ", N/A ,"$2,509.50 ","$1,846.99 ","$1,666.31 ","$1,846.99 ", N/A ,"$1,846.99 ","$2,609.88 ","$2,609.88 ","$2,844.10 ", N/A ,"$2,318.78 ", N/A ,"$3,346.00 ","$1,840.30 ", N/A ,$880.00 ,"$3,346.00 ", N/A , N/A , N/A ,"$2,676.80 ","$1,816.88 ",$936.88 ,"$3,011.40 ","$2,641.00 ","$2,034.00 ", N/A ,"$1,606.08 "
ST. MARY'S HOSPITAL - DECATUR,36000674,64600,HC DESTROY NERVE TRIGEMINAL 1ST BRANCH,360,1 ,"$7,920.00 ","$5,148.00 ",$714.40 ,"$7,920.00 ","$1,948.10 ","$2,800.00 ","$4,356.00 ",$779.24 ,"$2,217.60 ","$3,523.99 ",$779.24 ,"$4,049.96 ",$779.24 ,"$3,913.45 ","$3,913.45 ",$779.24 ,"$3,913.45 ","$1,480.55 ","$3,500.00 ","$3,960.00 ","$6,336.00 ","$1,948.10 ",$779.24 ,"$5,544.00 ",$779.24 ,"$4,752.00 ",$779.24 ,"$5,940.00 ","$4,057.00 ","$3,651.00 ","$4,057.00 ",$779.24 ,"$4,057.00 ","$6,177.60 ","$6,177.60 ","$6,732.00 ","$1,948.10 ","$4,981.00 ",$779.24 ,"$7,920.00 ","$4,356.00 ",$779.24 ,"$2,082.96 ","$7,920.00 ",$748.42 ,$714.40 ,$818.20 ,"$6,336.00 ","$3,913.45 ","$2,217.60 ","$7,128.00 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$3,801.60 "
ST. MARY'S HOSPITAL - DECATUR,36000692,34703,HC ENDOVASC RPR AORTA-UNILAC GRAFT OTHER THAN RUPTURE,360,1 ,"$28,918.00 ","$18,796.70 ","$2,034.00 ","$28,918.00 ", N/A ,"$8,000.00 ","$15,904.90 ", N/A ,"$8,097.04 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$14,459.00 ","$23,134.40 ", N/A , N/A ,"$20,242.60 ", N/A ,"$17,350.80 ", N/A ,"$21,688.50 ","$5,989.24 ","$6,511.48 ","$5,989.24 ", N/A ,"$5,989.24 ","$8,112.00 ","$8,112.00 ","$24,580.30 ", N/A ,"$4,981.00 ", N/A ,"$28,918.00 ","$15,904.90 ", N/A ,"$7,605.43 ","$28,918.00 ", N/A , N/A , N/A ,"$23,134.40 ","$3,913.45 ","$8,097.04 ","$26,026.20 ","$2,641.00 ","$2,034.00 ", N/A ,"$13,880.64 "
ST. MARY'S HOSPITAL - DECATUR,36000694,34705,HC ENDOVASC RPR AORTA-BILIAC GRAFT OTHER THAN RUPTURE,360,1 ,"$14,078.00 ","$9,150.70 ","$2,034.00 ","$14,078.00 ", N/A ,"$8,000.00 ","$7,742.90 ", N/A ,"$3,941.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$7,039.00 ","$11,262.40 ", N/A , N/A ,"$9,854.60 ", N/A ,"$8,446.80 ", N/A ,"$10,558.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$8,112.00 ","$8,112.00 ","$11,966.30 ", N/A ,"$4,981.00 ", N/A ,"$14,078.00 ","$7,742.90 ", N/A ,"$3,702.51 ","$14,078.00 ", N/A , N/A , N/A ,"$11,262.40 ","$3,913.45 ","$3,941.84 ","$12,670.20 ","$2,641.00 ","$2,034.00 ", N/A ,"$6,757.44 "
ST. MARY'S HOSPITAL - DECATUR,36000695,34706,HC ENDOVASC RPR AORTA-BILIAC GRAFT W/RUPTURE,360,1 ,"$14,078.00 ","$9,150.70 ","$2,034.00 ","$14,078.00 ", N/A ,"$8,000.00 ","$7,742.90 ", N/A ,"$3,941.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$7,039.00 ","$11,262.40 ", N/A , N/A ,"$9,854.60 ", N/A ,"$8,446.80 ", N/A ,"$10,558.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$8,112.00 ","$8,112.00 ","$11,966.30 ", N/A ,"$4,981.00 ", N/A ,"$14,078.00 ","$7,742.90 ", N/A ,"$3,702.51 ","$14,078.00 ", N/A , N/A , N/A ,"$11,262.40 ","$3,913.45 ","$3,941.84 ","$12,670.20 ","$2,641.00 ","$2,034.00 ", N/A ,"$6,757.44 "
ST. MARY'S HOSPITAL - DECATUR,36000696,34709,HC PLACE PROSTH ILIAC ARTERY PER VESSEL,360,1 ,$938.00 ,$609.70 ,$246.69 ,$938.00 , N/A ,$938.00 ,$515.90 , N/A ,$262.64 ,$440.86 , N/A ,$506.52 , N/A ,$509.33 ,$509.33 , N/A ,$509.33 , N/A ,$656.60 ,$469.00 ,$750.40 , N/A , N/A ,$656.60 , N/A ,$562.80 , N/A ,$703.50 ,$517.78 ,$467.12 ,$517.78 , N/A ,$517.78 ,$731.64 ,$731.64 ,$797.30 , N/A ,$650.03 , N/A ,$938.00 ,$515.90 , N/A ,$246.69 ,$938.00 , N/A , N/A , N/A ,$750.40 ,$509.33 ,$262.64 ,$844.20 ,$938.00 ,$938.00 , N/A ,$450.24 
ST. MARY'S HOSPITAL - DECATUR,36000697,34710,HC PLACE PROSTH REPAIR ABDOM ARTERY INIT VESSEL,360,1 ,$938.00 ,$609.70 ,$246.69 ,$938.00 , N/A ,$938.00 ,$515.90 , N/A ,$262.64 ,$440.86 , N/A ,$506.52 , N/A ,$509.33 ,$509.33 , N/A ,$509.33 , N/A ,$656.60 ,$469.00 ,$750.40 , N/A , N/A ,$656.60 , N/A ,$562.80 , N/A ,$703.50 ,$517.78 ,$467.12 ,$517.78 , N/A ,$517.78 ,$731.64 ,$731.64 ,$797.30 , N/A ,$650.03 , N/A ,$938.00 ,$515.90 , N/A ,$246.69 ,$938.00 , N/A , N/A , N/A ,$750.40 ,$509.33 ,$262.64 ,$844.20 ,$938.00 ,$938.00 , N/A ,$450.24 
ST. MARY'S HOSPITAL - DECATUR,36000699,34707,HC ENDOVASC RPR ILIAC ARTERY OTHER THAN RUPTURE,360,1 ,"$8,540.00 ","$5,551.00 ","$2,034.00 ","$8,540.00 ", N/A ,"$8,540.00 ","$4,697.00 ", N/A ,"$2,391.20 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,270.00 ","$6,832.00 ", N/A , N/A ,"$5,978.00 ", N/A ,"$5,124.00 ", N/A ,"$6,405.00 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$6,661.20 ","$6,661.20 ","$7,259.00 ", N/A ,"$4,981.00 ", N/A ,"$8,540.00 ","$4,697.00 ", N/A ,"$2,246.02 ","$8,540.00 ", N/A , N/A , N/A ,"$6,832.00 ","$3,913.45 ","$2,391.20 ","$7,686.00 ","$2,641.00 ","$2,034.00 ", N/A ,"$4,099.20 "
ST. MARY'S HOSPITAL - DECATUR,36000707,35351,HC RECHANNEL ARTERY ILIAC W/GRAFT-LT,360,1 ,"$6,321.00 ","$4,108.65 ","$1,662.42 ","$6,321.00 ", N/A ,"$6,321.00 ","$3,476.55 ", N/A ,"$1,769.88 ","$2,970.87 ", N/A ,"$3,413.34 ", N/A ,"$3,432.30 ","$3,432.30 ", N/A ,"$3,432.30 ", N/A ,"$3,500.00 ","$3,160.50 ","$5,056.80 ", N/A , N/A ,"$4,424.70 ", N/A ,"$3,792.60 ", N/A ,"$4,740.75 ","$3,489.19 ","$3,147.86 ","$3,489.19 ", N/A ,"$3,489.19 ","$4,930.38 ","$4,930.38 ","$5,372.85 ", N/A ,"$4,380.45 ", N/A ,"$6,321.00 ","$3,476.55 ", N/A ,"$1,662.42 ","$6,321.00 ", N/A , N/A , N/A ,"$5,056.80 ","$3,432.30 ","$1,769.88 ","$5,688.90 ","$2,641.00 ","$2,034.00 ", N/A ,"$3,034.08 "
ST. MARY'S HOSPITAL - DECATUR,36000708,35351,HC RECHANNEL ARTERY ILIAC W/GRAFT-RT,360,1 ,"$6,321.00 ","$4,108.65 ","$1,662.42 ","$6,321.00 ", N/A ,"$6,321.00 ","$3,476.55 ", N/A ,"$1,769.88 ","$2,970.87 ", N/A ,"$3,413.34 ", N/A ,"$3,432.30 ","$3,432.30 ", N/A ,"$3,432.30 ", N/A ,"$3,500.00 ","$3,160.50 ","$5,056.80 ", N/A , N/A ,"$4,424.70 ", N/A ,"$3,792.60 ", N/A ,"$4,740.75 ","$3,489.19 ","$3,147.86 ","$3,489.19 ", N/A ,"$3,489.19 ","$4,930.38 ","$4,930.38 ","$5,372.85 ", N/A ,"$4,380.45 ", N/A ,"$6,321.00 ","$3,476.55 ", N/A ,"$1,662.42 ","$6,321.00 ", N/A , N/A , N/A ,"$5,056.80 ","$3,432.30 ","$1,769.88 ","$5,688.90 ","$2,641.00 ","$2,034.00 ", N/A ,"$3,034.08 "
ST. MARY'S HOSPITAL - DECATUR,36000719,41010,HC INCISION LINGUAL FRENUM,360,1 ,"$6,218.00 ","$4,041.70 ",$854.48 ,"$6,218.00 ","$3,201.23 ","$2,800.00 ","$3,419.90 ","$1,280.49 ","$1,741.04 ","$2,922.46 ","$1,280.49 ","$3,357.72 ","$1,280.49 ","$3,376.37 ","$3,376.37 ","$1,280.49 ","$3,376.37 ","$2,432.94 ","$3,500.00 ","$3,109.00 ","$4,974.40 ","$3,201.24 ","$1,280.49 ","$4,352.60 ","$1,280.49 ","$3,730.80 ","$1,280.49 ","$4,663.50 ","$3,432.34 ","$3,096.56 ","$3,432.34 ","$1,280.49 ","$3,432.34 ","$4,850.04 ","$4,850.04 ","$5,285.30 ","$3,201.24 ","$4,309.07 ","$1,280.49 ","$6,218.00 ","$3,419.90 ","$1,280.49 ","$1,635.33 ","$6,218.00 ",$895.17 ,$854.48 ,"$1,344.51 ","$4,974.40 ","$3,376.37 ","$1,741.04 ","$5,596.20 ","$1,795.00 ","$2,100.00 ","$1,280.49 ","$2,984.64 "
ST. MARY'S HOSPITAL - DECATUR,36000723,34717,HC ENDOVASC REPAIR ARTERY ILIAC W/ENDOGRAFT,360,1 ,"$3,783.00 ","$2,458.95 ",$994.93 ,"$7,167.23 ", N/A ,"$1,929.33 ","$2,080.65 ", N/A ,"$1,059.24 ","$1,778.01 ", N/A ,"$2,042.82 ", N/A ,"$2,054.17 ","$2,054.17 ", N/A ,"$2,054.17 ", N/A ,"$2,648.10 ","$1,891.50 ","$3,026.40 ", N/A , N/A ,"$2,648.10 ", N/A ,"$2,269.80 ", N/A ,"$2,837.25 ","$2,088.22 ","$1,883.93 ","$2,088.22 ", N/A ,"$2,088.22 ","$2,950.74 ","$2,950.74 ","$3,215.55 ", N/A ,"$2,621.62 ", N/A ,"$3,783.00 ","$2,080.65 ", N/A ,$994.93 ,"$3,783.00 ","$3,783.00 ","$7,167.23 ", N/A ,"$3,026.40 ","$2,054.17 ","$1,059.24 ","$3,404.70 ","$2,641.00 ","$2,034.00 ", N/A ,"$1,815.84 "
ST. MARY'S HOSPITAL - DECATUR,36000724,34718,HC ENDOVASC REPAIR ARTERY ILIAC W/O ENDOGRAFT,360,1 ,"$3,000.00 ","$1,950.00 ",$789.00 ,"$7,167.23 ", N/A ,"$1,530.00 ","$1,650.00 ", N/A ,$840.00 ,"$1,410.00 ", N/A ,"$1,620.00 ", N/A ,"$1,629.00 ","$1,629.00 ", N/A ,"$1,629.00 ", N/A ,"$2,100.00 ","$1,500.00 ","$2,400.00 ", N/A , N/A ,"$2,100.00 ", N/A ,"$1,800.00 ", N/A ,"$2,250.00 ","$1,656.00 ","$1,494.00 ","$1,656.00 ", N/A ,"$1,656.00 ","$2,340.00 ","$2,340.00 ","$2,550.00 ", N/A ,"$2,079.00 ", N/A ,"$3,000.00 ","$1,650.00 ", N/A ,$789.00 ,"$3,000.00 ","$3,000.00 ","$7,167.23 ", N/A ,"$2,400.00 ","$1,629.00 ",$840.00 ,"$2,700.00 ","$2,641.00 ","$2,034.00 ", N/A ,"$1,440.00 "
ST. MARY'S HOSPITAL - DECATUR,36000755,41018,HC I AND D MASTICATOR SPACE,360,1 ,"$3,773.00 ","$2,452.45 ",$854.48 ,"$3,773.00 ","$3,201.23 ","$2,800.00 ","$2,075.15 ","$1,280.49 ","$1,056.44 ","$1,773.31 ","$1,280.49 ","$2,037.42 ","$1,280.49 ","$2,048.74 ","$2,048.74 ","$1,280.49 ","$2,048.74 ","$2,432.94 ","$2,641.10 ","$1,886.50 ","$3,018.40 ","$3,201.24 ","$1,280.49 ","$2,641.10 ","$1,280.49 ","$2,263.80 ","$1,280.49 ","$2,829.75 ","$2,082.70 ","$1,878.95 ","$2,082.70 ","$1,280.49 ","$2,082.70 ","$2,942.94 ","$2,942.94 ","$3,207.05 ","$3,201.24 ","$2,614.69 ","$1,280.49 ","$3,773.00 ","$2,075.15 ","$1,280.49 ",$992.30 ,"$3,773.00 ",$895.17 ,$854.48 ,"$1,344.51 ","$3,018.40 ","$2,048.74 ","$1,056.44 ","$3,395.70 ","$1,795.00 ","$2,100.00 ","$1,280.49 ","$1,811.04 "
ST. MARY'S HOSPITAL - DECATUR,36000760,59871,HC REM CERCLAGE SUTURE,360,1 ,"$7,315.00 ","$4,754.75 ","$1,923.85 ","$7,315.00 ","$6,208.95 ","$7,315.00 ","$4,023.25 ","$2,483.58 ","$2,048.20 ","$3,438.05 ","$2,483.58 ","$3,950.10 ","$2,483.58 ","$3,913.45 ","$3,913.45 ","$2,483.58 ","$3,913.45 ","$4,718.80 ","$3,500.00 ","$3,657.50 ","$5,852.00 ","$6,208.94 ","$2,483.58 ","$5,120.50 ","$2,483.58 ","$4,389.00 ","$2,483.58 ","$5,486.25 ","$4,037.88 ","$3,642.87 ","$4,037.88 ","$2,483.58 ","$4,037.88 ","$5,705.70 ","$5,705.70 ","$6,217.75 ","$6,208.94 ","$4,981.00 ","$2,483.58 ","$7,315.00 ","$4,023.25 ","$2,483.58 ","$1,923.85 ","$7,315.00 ", N/A , N/A ,"$2,607.76 ","$5,852.00 ","$3,913.45 ","$2,048.20 ","$6,583.50 ","$2,641.00 ","$3,250.00 ","$2,483.58 ","$3,511.20 "
ST. MARY'S HOSPITAL - DECATUR,36060013,N/A,HC OR LEVEL 1 INITIAL 15MIN,360,1 ,"$2,322.00 ","$1,509.30 ",$610.69 ,"$2,322.00 ", N/A ,"$1,184.22 ","$1,277.10 ", N/A ,$650.16 ,"$1,091.34 ", N/A ,"$1,253.88 ", N/A ,"$1,260.85 ","$1,260.85 ", N/A ,"$1,260.85 ", N/A ,"$1,625.40 ","$1,161.00 ","$1,857.60 ", N/A , N/A ,"$1,625.40 ", N/A ,"$1,393.20 ", N/A ,"$1,741.50 ","$1,281.74 ","$1,156.36 ","$1,281.74 ", N/A ,"$1,281.74 ","$1,811.16 ","$1,811.16 ","$1,973.70 ", N/A ,"$1,609.15 ", N/A ,"$2,322.00 ","$1,277.10 ", N/A ,$610.69 ,"$2,322.00 ", N/A , N/A , N/A ,"$1,857.60 ","$1,260.85 ",$650.16 ,"$2,089.80 ", N/A , N/A , N/A ,"$1,114.56 "
ST. MARY'S HOSPITAL - DECATUR,36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,$588.00 ,$382.20 ,$154.64 ,$588.00 , N/A ,$299.88 ,$323.40 , N/A ,$164.64 ,$276.36 , N/A ,$317.52 , N/A ,$319.28 ,$319.28 , N/A ,$319.28 , N/A ,$411.60 ,$294.00 ,$470.40 , N/A , N/A ,$411.60 , N/A ,$352.80 , N/A ,$441.00 ,$324.58 ,$292.82 ,$324.58 , N/A ,$324.58 ,$458.64 ,$458.64 ,$499.80 , N/A ,$407.48 , N/A ,$588.00 ,$323.40 , N/A ,$154.64 ,$588.00 , N/A , N/A , N/A ,$470.40 ,$319.28 ,$164.64 ,$529.20 , N/A , N/A , N/A ,$282.24 
ST. MARY'S HOSPITAL - DECATUR,36060015,N/A,HC OR LEVEL 2 INITIAL 15MIN,360,1 ,"$4,124.00 ","$2,680.60 ","$1,084.61 ","$4,124.00 ", N/A ,"$2,103.24 ","$2,268.20 ", N/A ,"$1,154.72 ","$1,938.28 ", N/A ,"$2,226.96 ", N/A ,"$2,239.33 ","$2,239.33 ", N/A ,"$2,239.33 ", N/A ,"$2,886.80 ","$2,062.00 ","$3,299.20 ", N/A , N/A ,"$2,886.80 ", N/A ,"$2,474.40 ", N/A ,"$3,093.00 ","$2,276.45 ","$2,053.75 ","$2,276.45 ", N/A ,"$2,276.45 ","$3,216.72 ","$3,216.72 ","$3,505.40 ", N/A ,"$2,857.93 ", N/A ,"$4,124.00 ","$2,268.20 ", N/A ,"$1,084.61 ","$4,124.00 ", N/A , N/A , N/A ,"$3,299.20 ","$2,239.33 ","$1,154.72 ","$3,711.60 ", N/A , N/A , N/A ,"$1,979.52 "
ST. MARY'S HOSPITAL - DECATUR,36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,"$1,045.00 ",$679.25 ,$274.84 ,"$1,045.00 ", N/A ,$532.95 ,$574.75 , N/A ,$292.60 ,$491.15 , N/A ,$564.30 , N/A ,$567.44 ,$567.44 , N/A ,$567.44 , N/A ,$731.50 ,$522.50 ,$836.00 , N/A , N/A ,$731.50 , N/A ,$627.00 , N/A ,$783.75 ,$576.84 ,$520.41 ,$576.84 , N/A ,$576.84 ,$815.10 ,$815.10 ,$888.25 , N/A ,$724.19 , N/A ,"$1,045.00 ",$574.75 , N/A ,$274.84 ,"$1,045.00 ", N/A , N/A , N/A ,$836.00 ,$567.44 ,$292.60 ,$940.50 , N/A , N/A , N/A ,$501.60 
ST. MARY'S HOSPITAL - DECATUR,36060017,N/A,HC OR LEVEL 3 INITIAL 15MIN,360,1 ,"$6,229.00 ","$4,048.85 ","$1,638.23 ","$6,229.00 ", N/A ,"$3,176.79 ","$3,425.95 ", N/A ,"$1,744.12 ","$2,927.63 ", N/A ,"$3,363.66 ", N/A ,"$3,382.35 ","$3,382.35 ", N/A ,"$3,382.35 ", N/A ,"$3,500.00 ","$3,114.50 ","$4,983.20 ", N/A , N/A ,"$4,360.30 ", N/A ,"$3,737.40 ", N/A ,"$4,671.75 ","$3,438.41 ","$3,102.04 ","$3,438.41 ", N/A ,"$3,438.41 ","$4,858.62 ","$4,858.62 ","$5,294.65 ", N/A ,"$4,316.70 ", N/A ,"$6,229.00 ","$3,425.95 ", N/A ,"$1,638.23 ","$6,229.00 ", N/A , N/A , N/A ,"$4,983.20 ","$3,382.35 ","$1,744.12 ","$5,606.10 ", N/A , N/A , N/A ,"$2,989.92 "
ST. MARY'S HOSPITAL - DECATUR,36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,"$1,585.00 ","$1,030.25 ",$416.86 ,"$1,585.00 ", N/A ,$808.35 ,$871.75 , N/A ,$443.80 ,$744.95 , N/A ,$855.90 , N/A ,$860.66 ,$860.66 , N/A ,$860.66 , N/A ,"$1,109.50 ",$792.50 ,"$1,268.00 ", N/A , N/A ,"$1,109.50 ", N/A ,$951.00 , N/A ,"$1,188.75 ",$874.92 ,$789.33 ,$874.92 , N/A ,$874.92 ,"$1,236.30 ","$1,236.30 ","$1,347.25 ", N/A ,"$1,098.41 ", N/A ,"$1,585.00 ",$871.75 , N/A ,$416.86 ,"$1,585.00 ", N/A , N/A , N/A ,"$1,268.00 ",$860.66 ,$443.80 ,"$1,426.50 ", N/A , N/A , N/A ,$760.80 
ST. MARY'S HOSPITAL - DECATUR,36060019,N/A,HC OR LEVEL 4 INITIAL 15MIN,360,1 ,"$7,472.00 ","$4,856.80 ","$1,965.14 ","$7,472.00 ", N/A ,"$3,810.72 ","$4,109.60 ", N/A ,"$2,092.16 ","$3,511.84 ", N/A ,"$4,034.88 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,736.00 ","$5,977.60 ", N/A , N/A ,"$5,230.40 ", N/A ,"$4,483.20 ", N/A ,"$5,604.00 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$5,828.16 ","$5,828.16 ","$6,351.20 ", N/A ,"$4,981.00 ", N/A ,"$7,472.00 ","$4,109.60 ", N/A ,"$1,965.14 ","$7,472.00 ", N/A , N/A , N/A ,"$5,977.60 ","$3,913.45 ","$2,092.16 ","$6,724.80 ", N/A , N/A , N/A ,"$3,586.56 "
ST. MARY'S HOSPITAL - DECATUR,36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,"$1,895.00 ","$1,231.75 ",$498.39 ,"$1,895.00 ", N/A ,$966.45 ,"$1,042.25 ", N/A ,$530.60 ,$890.65 , N/A ,"$1,023.30 ", N/A ,"$1,028.99 ","$1,028.99 ", N/A ,"$1,028.99 ", N/A ,"$1,326.50 ",$947.50 ,"$1,516.00 ", N/A , N/A ,"$1,326.50 ", N/A ,"$1,137.00 ", N/A ,"$1,421.25 ","$1,046.04 ",$943.71 ,"$1,046.04 ", N/A ,"$1,046.04 ","$1,478.10 ","$1,478.10 ","$1,610.75 ", N/A ,"$1,313.24 ", N/A ,"$1,895.00 ","$1,042.25 ", N/A ,$498.39 ,"$1,895.00 ", N/A , N/A , N/A ,"$1,516.00 ","$1,028.99 ",$530.60 ,"$1,705.50 ", N/A , N/A , N/A ,$909.60 
ST. MARY'S HOSPITAL - DECATUR,36060021,N/A,HC OR LEVEL 5 INITIAL 15MIN,360,1 ,"$8,709.00 ","$5,660.85 ","$2,290.47 ","$8,709.00 ", N/A ,"$4,441.59 ","$4,789.95 ", N/A ,"$2,438.52 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,354.50 ","$6,967.20 ", N/A , N/A ,"$6,096.30 ", N/A ,"$5,225.40 ", N/A ,"$6,531.75 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$6,793.02 ","$6,793.02 ","$7,402.65 ", N/A ,"$4,981.00 ", N/A ,"$8,709.00 ","$4,789.95 ", N/A ,"$2,290.47 ","$8,709.00 ", N/A , N/A , N/A ,"$6,967.20 ","$3,913.45 ","$2,438.52 ","$7,838.10 ", N/A , N/A , N/A ,"$4,180.32 "
ST. MARY'S HOSPITAL - DECATUR,36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,"$2,210.00 ","$1,436.50 ",$581.23 ,"$2,210.00 ", N/A ,"$1,127.10 ","$1,215.50 ", N/A ,$618.80 ,"$1,038.70 ", N/A ,"$1,193.40 ", N/A ,"$1,200.03 ","$1,200.03 ", N/A ,"$1,200.03 ", N/A ,"$1,547.00 ","$1,105.00 ","$1,768.00 ", N/A , N/A ,"$1,547.00 ", N/A ,"$1,326.00 ", N/A ,"$1,657.50 ","$1,219.92 ","$1,100.58 ","$1,219.92 ", N/A ,"$1,219.92 ","$1,723.80 ","$1,723.80 ","$1,878.50 ", N/A ,"$1,531.53 ", N/A ,"$2,210.00 ","$1,215.50 ", N/A ,$581.23 ,"$2,210.00 ", N/A , N/A , N/A ,"$1,768.00 ","$1,200.03 ",$618.80 ,"$1,989.00 ", N/A , N/A , N/A ,"$1,060.80 "
ST. MARY'S HOSPITAL - DECATUR,36063344,0441T,HC ABLATION PERC LWR EXTREMITY/PERPH NERVE,360,1 ,"$4,595.00 ","$2,986.75 ",$714.40 ,"$4,595.00 ","$4,155.38 ","$2,800.00 ","$2,527.25 ","$1,662.15 ","$1,286.60 ","$2,159.65 ","$1,662.15 ","$2,481.30 ","$1,662.15 ","$2,495.09 ","$2,495.09 ","$1,662.15 ","$2,495.09 ","$3,158.08 ","$3,216.50 ","$2,297.50 ","$3,676.00 ","$4,155.37 ","$1,662.15 ","$3,216.50 ","$1,662.15 ","$2,757.00 ","$1,662.15 ","$3,446.25 ","$2,536.44 ","$2,288.31 ","$2,536.44 ","$1,662.15 ","$2,536.44 ","$3,584.10 ","$3,584.10 ","$3,905.75 ","$4,155.37 ","$3,184.34 ","$1,662.15 ","$4,595.00 ","$2,527.25 ","$1,662.15 ","$1,208.49 ","$4,595.00 ",$748.42 ,$714.40 ,"$1,745.26 ","$3,676.00 ","$2,495.09 ","$1,286.60 ","$4,135.50 ","$2,810.00 ","$4,300.00 ","$1,662.15 ","$2,205.60 "
ST. MARY'S HOSPITAL - DECATUR,36080004,64517,HC NERVE BLOCK INJ HYPOGAS PLXS,360,1 ,"$3,138.00 ","$2,039.70 ",$293.63 ,"$3,138.00 ","$1,948.10 ","$3,138.00 ","$1,725.90 ",$779.24 ,$878.64 ,"$1,474.86 ",$779.24 ,"$1,694.52 ",$779.24 ,"$1,703.93 ","$1,703.93 ",$779.24 ,"$1,703.93 ","$1,480.55 ","$2,196.60 ","$1,569.00 ","$2,510.40 ","$1,948.10 ",$779.24 ,"$2,196.60 ",$779.24 ,"$1,882.80 ",$779.24 ,"$2,353.50 ","$1,732.18 ","$1,562.72 ","$1,732.18 ",$779.24 ,"$1,732.18 ","$2,447.64 ","$2,447.64 ","$2,667.30 ","$1,948.10 ","$2,174.63 ",$779.24 ,"$3,138.00 ","$1,725.90 ",$779.24 ,$825.29 ,"$3,138.00 ",$307.62 ,$293.63 ,$818.20 ,"$2,510.40 ","$1,703.93 ",$878.64 ,"$2,824.20 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$1,506.24 "
ST. MARY'S HOSPITAL - DECATUR,36080006,64400,HC NERVE BLOCK TRIGEMINAL,360,1 ,"$1,596.00 ","$1,037.40 ",$247.31 ,"$1,596.00 ",$618.28 ,"$1,596.00 ",$877.80 ,$247.31 ,$446.88 ,$750.12 ,$247.31 ,$861.84 ,$247.31 ,$866.63 ,$866.63 ,$247.31 ,$866.63 ,$469.90 ,"$1,117.20 ",$798.00 ,"$1,276.80 ",$618.29 ,$247.31 ,"$1,117.20 ",$247.31 ,$957.60 ,$247.31 ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 ,$247.31 ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ",$618.29 ,"$1,106.03 ",$247.31 ,"$1,596.00 ",$877.80 ,$247.31 ,$419.75 ,"$1,596.00 ",$307.62 ,$293.63 ,$259.68 ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$737.00 ,$900.00 ,$247.31 ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,36100008,50694,HC PL URT STNT W G SI NEW ACCESS WO NEPH CATH,361,1 ,"$7,590.00 ","$4,933.50 ","$1,541.61 ","$7,590.00 ","$7,275.95 ","$5,500.00 ","$4,174.50 ","$2,910.38 ","$2,125.20 ","$3,523.99 ","$2,910.38 ","$4,049.96 ","$2,910.38 ","$3,913.45 ","$3,913.45 ","$2,910.38 ","$3,913.45 ","$5,529.72 ","$3,500.00 ","$3,795.00 ","$6,072.00 ","$7,275.94 ","$2,910.38 ","$5,313.00 ","$2,910.38 ","$4,554.00 ","$2,910.38 ","$5,692.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$2,910.38 ","$4,057.00 ","$5,920.20 ","$5,920.20 ","$6,451.50 ","$7,275.94 ","$4,981.00 ","$2,910.38 ","$7,590.00 ","$4,174.50 ","$2,910.38 ","$1,996.17 ","$7,590.00 ","$1,615.02 ","$1,541.61 ","$3,055.90 ","$6,072.00 ","$3,913.45 ","$2,125.20 ","$6,831.00 ","$2,641.00 ","$3,250.00 ","$2,910.38 ","$3,643.20 "
ST. MARY'S HOSPITAL - DECATUR,36100012,50706,HC BALLOON DILATION URETERAL IG SI,361,1 ,"$7,500.00 ","$4,875.00 ",$737.00 ,"$7,500.00 ", N/A ,"$2,800.00 ","$4,125.00 ", N/A ,"$2,100.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,750.00 ","$6,000.00 ", N/A , N/A ,"$5,250.00 ", N/A ,"$4,500.00 ", N/A ,"$5,625.00 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$5,850.00 ","$5,850.00 ","$6,375.00 ", N/A ,"$4,981.00 ", N/A ,"$7,500.00 ","$4,125.00 ", N/A ,"$1,972.50 ","$7,500.00 ", N/A , N/A , N/A ,"$6,000.00 ","$3,913.45 ","$2,100.00 ","$6,750.00 ",$737.00 ,$900.00 , N/A ,"$3,600.00 "
ST. MARY'S HOSPITAL - DECATUR,36100014,10035,HC PLACE DEVICE LOCALZTN PERC W/GUIDE 1ST LESION,361,1 ,$667.00 ,$433.55 ,$175.42 ,"$1,472.65 ","$1,472.65 ",$667.00 ,$366.85 ,$589.06 ,$186.76 ,$313.49 ,$589.06 ,$360.18 ,$589.06 ,$362.18 ,$362.18 ,$589.06 ,$362.18 ,$667.00 ,$466.90 ,$333.50 ,$533.60 ,"$1,472.64 ",$589.06 ,$466.90 ,$589.06 ,$400.20 ,$589.06 ,$500.25 ,$368.18 ,$332.17 ,$368.18 ,$589.06 ,$368.18 ,$520.26 ,$520.26 ,$566.95 ,$667.00 ,$462.23 ,$589.06 ,$667.00 ,$366.85 ,$589.06 ,$175.42 ,$667.00 ,$210.19 ,$200.63 ,$618.51 ,$533.60 ,$362.18 ,$186.76 ,$600.30 ,$667.00 ,$667.00 ,$589.06 ,$320.16 
ST. MARY'S HOSPITAL - DECATUR,36100015,11010,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISSUE,361,1 ,"$1,117.00 ",$726.05 ,$293.77 ,"$1,472.65 ","$1,472.65 ","$1,117.00 ",$614.35 ,$589.06 ,$312.76 ,$524.99 ,$589.06 ,$603.18 ,$589.06 ,$606.53 ,$606.53 ,$589.06 ,$606.53 ,"$1,117.00 ",$781.90 ,$558.50 ,$893.60 ,"$1,472.64 ",$589.06 ,$781.90 ,$589.06 ,$670.20 ,$589.06 ,$837.75 ,$616.58 ,$556.27 ,$616.58 ,$589.06 ,$616.58 ,$871.26 ,$871.26 ,$949.45 ,"$1,117.00 ",$774.08 ,$589.06 ,"$1,117.00 ",$614.35 ,$589.06 ,$293.77 ,"$1,117.00 ",$901.54 ,$860.56 ,$618.51 ,$893.60 ,$606.53 ,$312.76 ,"$1,005.30 ","$1,117.00 ","$1,117.00 ",$589.06 ,$536.16 
ST. MARY'S HOSPITAL - DECATUR,36100017,11012,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISS/MUSCLE/BONE,361,1 ,"$1,117.00 ",$726.05 ,$293.77 ,"$5,611.10 ","$5,611.10 ","$1,117.00 ",$614.35 ,"$2,244.44 ",$312.76 ,$524.99 ,"$2,244.44 ",$603.18 ,"$1,117.00 ",$606.53 ,$606.53 ,"$1,117.00 ",$606.53 ,"$1,117.00 ",$781.90 ,$558.50 ,$893.60 ,"$5,611.09 ","$2,244.44 ",$781.90 ,"$2,244.44 ",$670.20 ,"$2,244.44 ",$837.75 ,$616.58 ,$556.27 ,$616.58 ,"$2,244.44 ",$616.58 ,$871.26 ,$871.26 ,$949.45 ,"$1,117.00 ",$774.08 ,"$2,244.44 ","$1,117.00 ",$614.35 ,"$2,244.44 ",$293.77 ,"$1,117.00 ",$901.54 ,$860.56 ,"$2,356.66 ",$893.60 ,$606.53 ,$312.76 ,"$1,005.30 ","$1,117.00 ","$1,117.00 ","$2,244.44 ",$536.16 
ST. MARY'S HOSPITAL - DECATUR,36100026,36510,HC UMBILICAL CATHETER INSERTION NEWBORN,361,1 ,$198.00 ,$128.70 ,$52.07 ,$198.00 , N/A ,$198.00 ,$108.90 , N/A ,$55.44 ,$93.06 , N/A ,$106.92 , N/A ,$107.51 ,$107.51 , N/A ,$107.51 , N/A ,$138.60 ,$99.00 ,$158.40 , N/A , N/A ,$138.60 , N/A ,$118.80 , N/A ,$148.50 ,$109.30 ,$98.60 ,$109.30 , N/A ,$109.30 ,$154.44 ,$154.44 ,$168.30 , N/A ,$137.21 , N/A ,$198.00 ,$108.90 , N/A ,$52.07 ,$198.00 , N/A , N/A , N/A ,$158.40 ,$107.51 ,$55.44 ,$178.20 ,$198.00 ,$198.00 , N/A ,$95.04 
ST. MARY'S HOSPITAL - DECATUR,36100037,62355,HC REMOVE SPINAL CATHETER,361,1 ,"$8,002.00 ","$5,201.30 ","$1,662.15 ","$8,002.00 ","$4,155.38 ","$3,500.00 ","$4,401.10 ","$1,662.15 ","$2,240.56 ","$3,523.99 ","$1,662.15 ","$4,049.96 ","$1,662.15 ","$3,913.45 ","$3,913.45 ","$1,662.15 ","$3,913.45 ","$3,158.08 ","$3,500.00 ","$4,001.00 ","$6,401.60 ","$4,155.37 ","$1,662.15 ","$5,601.40 ","$1,662.15 ","$4,801.20 ","$1,662.15 ","$6,001.50 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$1,662.15 ","$4,057.00 ","$6,241.56 ","$6,241.56 ","$6,801.70 ","$4,155.37 ","$4,981.00 ","$1,662.15 ","$8,002.00 ","$4,401.10 ","$1,662.15 ","$2,104.53 ","$8,002.00 ","$2,755.67 ","$2,630.41 ","$1,745.26 ","$6,401.60 ","$3,913.45 ","$2,240.56 ","$7,201.80 ","$2,198.00 ","$2,500.00 ","$1,662.15 ","$3,840.96 "
ST. MARY'S HOSPITAL - DECATUR,36100039,63663,HC REVISE SPINE ELECTRD PERQ ARRAY W/FLUORO,361,1 ,"$10,120.00 ","$6,578.00 ","$2,630.41 ","$14,587.50 ","$14,587.50 ","$2,800.00 ","$5,566.00 ","$5,835.00 ","$2,833.60 ","$3,523.99 ","$5,835.00 ","$4,049.96 ","$5,835.00 ","$3,913.45 ","$3,913.45 ","$5,835.00 ","$3,913.45 ","$10,120.00 ","$3,500.00 ","$5,060.00 ","$8,096.00 ","$14,587.50 ","$5,835.00 ","$7,084.00 ","$5,835.00 ","$6,072.00 ","$5,835.00 ","$7,590.00 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$5,835.00 ","$4,057.00 ","$7,893.60 ","$7,893.60 ","$8,602.00 ","$10,120.00 ","$4,981.00 ","$5,835.00 ","$10,120.00 ","$5,566.00 ","$5,835.00 ","$2,661.56 ","$10,120.00 ","$2,755.67 ","$2,630.41 ","$6,126.75 ","$8,096.00 ","$3,913.45 ","$2,833.60 ","$9,108.00 ","$2,861.00 ","$5,100.00 ","$5,835.00 ","$4,857.60 "
ST. MARY'S HOSPITAL - DECATUR,36100042,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-BIL,361,1 ,$623.00 ,$404.95 ,$163.85 ,$927.43 ,$927.43 ,$623.00 ,$342.65 ,$370.97 ,$174.44 ,$292.81 ,$370.97 ,$336.42 ,$370.97 ,$338.29 ,$338.29 ,$370.97 ,$338.29 ,$623.00 ,$436.10 ,$311.50 ,$498.40 ,$927.43 ,$370.97 ,$436.10 ,$370.97 ,$373.80 ,$370.97 ,$467.25 ,$343.90 ,$310.25 ,$343.90 ,$370.97 ,$343.90 ,$485.94 ,$485.94 ,$529.55 ,$623.00 ,$431.74 ,$370.97 ,$623.00 ,$342.65 ,$370.97 ,$163.85 ,$623.00 ,$339.64 ,$324.20 ,$389.52 ,$498.40 ,$338.29 ,$174.44 ,$560.70 ,$623.00 ,$623.00 ,$370.97 ,$299.04 
ST. MARY'S HOSPITAL - DECATUR,36100043,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-BIL,361,1 ,$833.00 ,$541.45 ,$219.08 ,$927.43 ,$927.43 ,$833.00 ,$458.15 ,$370.97 ,$233.24 ,$391.51 ,$370.97 ,$449.82 ,$370.97 ,$452.32 ,$452.32 ,$370.97 ,$452.32 ,$704.85 ,$583.10 ,$416.50 ,$666.40 ,$927.43 ,$370.97 ,$583.10 ,$370.97 ,$499.80 ,$370.97 ,$624.75 ,$459.82 ,$414.83 ,$459.82 ,$370.97 ,$459.82 ,$649.74 ,$649.74 ,$708.05 ,$833.00 ,$577.27 ,$370.97 ,$833.00 ,$458.15 ,$370.97 ,$219.08 ,$833.00 ,$339.64 ,$324.20 ,$389.52 ,$666.40 ,$452.32 ,$233.24 ,$749.70 ,$833.00 ,$833.00 ,$370.97 ,$399.84 
ST. MARY'S HOSPITAL - DECATUR,36100044,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-BIL,361,1 ,"$1,543.00 ","$1,002.95 ",$324.20 ,"$1,543.00 ",$927.43 ,"$1,543.00 ",$848.65 ,$370.97 ,$432.04 ,$725.21 ,$370.97 ,$833.22 ,$370.97 ,$837.85 ,$837.85 ,$370.97 ,$837.85 ,$704.85 ,"$1,080.10 ",$771.50 ,"$1,234.40 ",$927.43 ,$370.97 ,"$1,080.10 ",$370.97 ,$925.80 ,$370.97 ,"$1,157.25 ",$851.74 ,$768.41 ,$851.74 ,$370.97 ,$851.74 ,"$1,203.54 ","$1,203.54 ","$1,311.55 ",$927.43 ,"$1,069.30 ",$370.97 ,"$1,543.00 ",$848.65 ,$370.97 ,$405.81 ,"$1,543.00 ",$339.64 ,$324.20 ,$389.52 ,"$1,234.40 ",$837.85 ,$432.04 ,"$1,388.70 ","$1,105.50 ","$1,350.00 ",$370.97 ,$740.64 
ST. MARY'S HOSPITAL - DECATUR,36100046,15271,HC APPL SKIN SUB TAL <100 INIT 25CM-LT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$4,053.30 ","$4,053.30 ",$498.00 ,$273.90 ,"$1,621.32 ",$139.44 ,$234.06 ,"$1,621.32 ",$268.92 ,$498.00 ,$270.41 ,$270.41 ,$498.00 ,$270.41 ,$498.00 ,$348.60 ,$249.00 ,$398.40 ,"$4,053.30 ","$1,621.32 ",$348.60 ,"$1,621.32 ",$298.80 ,"$1,621.32 ",$373.50 ,$274.90 ,$248.00 ,$274.90 ,"$1,621.32 ",$274.90 ,$388.44 ,$388.44 ,$423.30 ,$498.00 ,$345.11 ,"$1,621.32 ",$498.00 ,$273.90 ,"$1,621.32 ",$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ","$1,702.39 ",$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 ,"$1,621.32 ",$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100047,15271,HC APPL SKIN SUB TAL <100 INIT 25CM-RT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$4,053.30 ","$4,053.30 ",$498.00 ,$273.90 ,"$1,621.32 ",$139.44 ,$234.06 ,"$1,621.32 ",$268.92 ,$498.00 ,$270.41 ,$270.41 ,$498.00 ,$270.41 ,$498.00 ,$348.60 ,$249.00 ,$398.40 ,"$4,053.30 ","$1,621.32 ",$348.60 ,"$1,621.32 ",$298.80 ,"$1,621.32 ",$373.50 ,$274.90 ,$248.00 ,$274.90 ,"$1,621.32 ",$274.90 ,$388.44 ,$388.44 ,$423.30 ,$498.00 ,$345.11 ,"$1,621.32 ",$498.00 ,$273.90 ,"$1,621.32 ",$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ","$1,702.39 ",$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 ,"$1,621.32 ",$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100048,15272,HC APPL SKIN SUB TAL <100 ADDL 25CM-LT,361,1 ,$183.00 ,$118.95 ,$48.13 ,"$1,057.63 ", N/A ,$183.00 ,$100.65 , N/A ,$51.24 ,$86.01 , N/A ,$98.82 , N/A ,$99.37 ,$99.37 , N/A ,$99.37 , N/A ,$128.10 ,$91.50 ,$146.40 , N/A , N/A ,$128.10 , N/A ,$109.80 , N/A ,$137.25 ,$101.02 ,$91.13 ,$101.02 , N/A ,$101.02 ,$142.74 ,$142.74 ,$155.55 , N/A ,$126.82 , N/A ,$183.00 ,$100.65 , N/A ,$48.13 ,$183.00 ,$183.00 ,"$1,057.63 ", N/A ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$183.00 ,$183.00 , N/A ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,36100049,15272,HC APPL SKIN SUB TAL <100 ADDL 25CM-RT,361,1 ,$183.00 ,$118.95 ,$48.13 ,"$1,057.63 ", N/A ,$183.00 ,$100.65 , N/A ,$51.24 ,$86.01 , N/A ,$98.82 , N/A ,$99.37 ,$99.37 , N/A ,$99.37 , N/A ,$128.10 ,$91.50 ,$146.40 , N/A , N/A ,$128.10 , N/A ,$109.80 , N/A ,$137.25 ,$101.02 ,$91.13 ,$101.02 , N/A ,$101.02 ,$142.74 ,$142.74 ,$155.55 , N/A ,$126.82 , N/A ,$183.00 ,$100.65 , N/A ,$48.13 ,$183.00 ,$183.00 ,"$1,057.63 ", N/A ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$183.00 ,$183.00 , N/A ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,36100050,15273,HC APPL SKIN SUB TAL >100 INIT 100CM-LT,361,1 ,$759.00 ,$493.35 ,$199.62 ,"$8,332.98 ","$8,332.98 ",$759.00 ,$417.45 ,"$3,333.19 ",$212.52 ,$356.73 ,"$3,333.19 ",$409.86 ,$759.00 ,$412.14 ,$412.14 ,$759.00 ,$412.14 ,$759.00 ,$531.30 ,$379.50 ,$607.20 ,"$8,332.98 ","$3,333.19 ",$531.30 ,"$3,333.19 ",$455.40 ,"$3,333.19 ",$569.25 ,$418.97 ,$377.98 ,$418.97 ,"$3,333.19 ",$418.97 ,$592.02 ,$592.02 ,$645.15 ,$759.00 ,$525.99 ,"$3,333.19 ",$759.00 ,$417.45 ,"$3,333.19 ",$199.62 ,$759.00 ,$759.00 ,"$1,057.63 ","$3,499.85 ",$607.20 ,$412.14 ,$212.52 ,$683.10 ,$759.00 ,$759.00 ,"$3,333.19 ",$364.32 
ST. MARY'S HOSPITAL - DECATUR,36100051,15273,HC APPL SKIN SUB TAL >100 INIT 100CM-RT,361,1 ,$759.00 ,$493.35 ,$199.62 ,"$8,332.98 ","$8,332.98 ",$759.00 ,$417.45 ,"$3,333.19 ",$212.52 ,$356.73 ,"$3,333.19 ",$409.86 ,$759.00 ,$412.14 ,$412.14 ,$759.00 ,$412.14 ,$759.00 ,$531.30 ,$379.50 ,$607.20 ,"$8,332.98 ","$3,333.19 ",$531.30 ,"$3,333.19 ",$455.40 ,"$3,333.19 ",$569.25 ,$418.97 ,$377.98 ,$418.97 ,"$3,333.19 ",$418.97 ,$592.02 ,$592.02 ,$645.15 ,$759.00 ,$525.99 ,"$3,333.19 ",$759.00 ,$417.45 ,"$3,333.19 ",$199.62 ,$759.00 ,$759.00 ,"$1,057.63 ","$3,499.85 ",$607.20 ,$412.14 ,$212.52 ,$683.10 ,$759.00 ,$759.00 ,"$3,333.19 ",$364.32 
ST. MARY'S HOSPITAL - DECATUR,36100052,15274,HC APPL SKIN SUB TAL >100 ADDL 100CM-LT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$1,057.63 ", N/A ,$498.00 ,$273.90 , N/A ,$139.44 ,$234.06 , N/A ,$268.92 , N/A ,$270.41 ,$270.41 , N/A ,$270.41 , N/A ,$348.60 ,$249.00 ,$398.40 , N/A , N/A ,$348.60 , N/A ,$298.80 , N/A ,$373.50 ,$274.90 ,$248.00 ,$274.90 , N/A ,$274.90 ,$388.44 ,$388.44 ,$423.30 , N/A ,$345.11 , N/A ,$498.00 ,$273.90 , N/A ,$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ", N/A ,$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 , N/A ,$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100053,15274,HC APPL SKIN SUB TAL >100 ADDL 100CM-RT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$1,057.63 ", N/A ,$498.00 ,$273.90 , N/A ,$139.44 ,$234.06 , N/A ,$268.92 , N/A ,$270.41 ,$270.41 , N/A ,$270.41 , N/A ,$348.60 ,$249.00 ,$398.40 , N/A , N/A ,$348.60 , N/A ,$298.80 , N/A ,$373.50 ,$274.90 ,$248.00 ,$274.90 , N/A ,$274.90 ,$388.44 ,$388.44 ,$423.30 , N/A ,$345.11 , N/A ,$498.00 ,$273.90 , N/A ,$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ", N/A ,$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 , N/A ,$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100054,15275,HC APPL SKIN SUB OTH <100 INIT 25CM-LT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$4,053.30 ","$4,053.30 ",$498.00 ,$273.90 ,"$1,621.32 ",$139.44 ,$234.06 ,"$1,621.32 ",$268.92 ,$498.00 ,$270.41 ,$270.41 ,$498.00 ,$270.41 ,$498.00 ,$348.60 ,$249.00 ,$398.40 ,"$4,053.30 ","$1,621.32 ",$348.60 ,"$1,621.32 ",$298.80 ,"$1,621.32 ",$373.50 ,$274.90 ,$248.00 ,$274.90 ,"$1,621.32 ",$274.90 ,$388.44 ,$388.44 ,$423.30 ,$498.00 ,$345.11 ,"$1,621.32 ",$498.00 ,$273.90 ,"$1,621.32 ",$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ","$1,702.39 ",$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 ,"$1,621.32 ",$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100055,15275,HC APPL SKIN SUB OTH <100 INIT 25CM-RT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$4,053.30 ","$4,053.30 ",$498.00 ,$273.90 ,"$1,621.32 ",$139.44 ,$234.06 ,"$1,621.32 ",$268.92 ,$498.00 ,$270.41 ,$270.41 ,$498.00 ,$270.41 ,$498.00 ,$348.60 ,$249.00 ,$398.40 ,"$4,053.30 ","$1,621.32 ",$348.60 ,"$1,621.32 ",$298.80 ,"$1,621.32 ",$373.50 ,$274.90 ,$248.00 ,$274.90 ,"$1,621.32 ",$274.90 ,$388.44 ,$388.44 ,$423.30 ,$498.00 ,$345.11 ,"$1,621.32 ",$498.00 ,$273.90 ,"$1,621.32 ",$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ","$1,702.39 ",$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 ,"$1,621.32 ",$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100056,15276,HC APPL SKIN SUB OTH <100 ADDL 25CM-LT,361,1 ,$366.00 ,$237.90 ,$96.26 ,"$1,057.63 ", N/A ,$366.00 ,$201.30 , N/A ,$102.48 ,$172.02 , N/A ,$197.64 , N/A ,$198.74 ,$198.74 , N/A ,$198.74 , N/A ,$256.20 ,$183.00 ,$292.80 , N/A , N/A ,$256.20 , N/A ,$219.60 , N/A ,$274.50 ,$202.03 ,$182.27 ,$202.03 , N/A ,$202.03 ,$285.48 ,$285.48 ,$311.10 , N/A ,$253.64 , N/A ,$366.00 ,$201.30 , N/A ,$96.26 ,$366.00 ,$366.00 ,"$1,057.63 ", N/A ,$292.80 ,$198.74 ,$102.48 ,$329.40 ,$366.00 ,$366.00 , N/A ,$175.68 
ST. MARY'S HOSPITAL - DECATUR,36100057,15276,HC APPL SKIN SUB OTH <100 ADDL 25CM-RT,361,1 ,$366.00 ,$237.90 ,$96.26 ,"$1,057.63 ", N/A ,$366.00 ,$201.30 , N/A ,$102.48 ,$172.02 , N/A ,$197.64 , N/A ,$198.74 ,$198.74 , N/A ,$198.74 , N/A ,$256.20 ,$183.00 ,$292.80 , N/A , N/A ,$256.20 , N/A ,$219.60 , N/A ,$274.50 ,$202.03 ,$182.27 ,$202.03 , N/A ,$202.03 ,$285.48 ,$285.48 ,$311.10 , N/A ,$253.64 , N/A ,$366.00 ,$201.30 , N/A ,$96.26 ,$366.00 ,$366.00 ,"$1,057.63 ", N/A ,$292.80 ,$198.74 ,$102.48 ,$329.40 ,$366.00 ,$366.00 , N/A ,$175.68 
ST. MARY'S HOSPITAL - DECATUR,36100058,15277,HC APPL SKIN SUB OTH >100 INIT 100CM-LT,361,1 ,$753.00 ,$489.45 ,$198.04 ,"$4,053.30 ","$4,053.30 ",$753.00 ,$414.15 ,"$1,621.32 ",$210.84 ,$353.91 ,"$1,621.32 ",$406.62 ,$753.00 ,$408.88 ,$408.88 ,$753.00 ,$408.88 ,$753.00 ,$527.10 ,$376.50 ,$602.40 ,"$4,053.30 ","$1,621.32 ",$527.10 ,"$1,621.32 ",$451.80 ,"$1,621.32 ",$564.75 ,$415.66 ,$374.99 ,$415.66 ,"$1,621.32 ",$415.66 ,$587.34 ,$587.34 ,$640.05 ,$753.00 ,$521.83 ,"$1,621.32 ",$753.00 ,$414.15 ,"$1,621.32 ",$198.04 ,$753.00 ,$753.00 ,"$1,057.63 ","$1,702.39 ",$602.40 ,$408.88 ,$210.84 ,$677.70 ,$753.00 ,$753.00 ,"$1,621.32 ",$361.44 
ST. MARY'S HOSPITAL - DECATUR,36100059,15277,HC APPL SKIN SUB OTH >100 INIT 100CM-RT,361,1 ,$753.00 ,$489.45 ,$198.04 ,"$4,053.30 ","$4,053.30 ",$753.00 ,$414.15 ,"$1,621.32 ",$210.84 ,$353.91 ,"$1,621.32 ",$406.62 ,$753.00 ,$408.88 ,$408.88 ,$753.00 ,$408.88 ,$753.00 ,$527.10 ,$376.50 ,$602.40 ,"$4,053.30 ","$1,621.32 ",$527.10 ,"$1,621.32 ",$451.80 ,"$1,621.32 ",$564.75 ,$415.66 ,$374.99 ,$415.66 ,"$1,621.32 ",$415.66 ,$587.34 ,$587.34 ,$640.05 ,$753.00 ,$521.83 ,"$1,621.32 ",$753.00 ,$414.15 ,"$1,621.32 ",$198.04 ,$753.00 ,$753.00 ,"$1,057.63 ","$1,702.39 ",$602.40 ,$408.88 ,$210.84 ,$677.70 ,$753.00 ,$753.00 ,"$1,621.32 ",$361.44 
ST. MARY'S HOSPITAL - DECATUR,36100060,15278,HC APPL SKIN SUB OTH >100 ADDL 100CM-LT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$1,057.63 ", N/A ,$498.00 ,$273.90 , N/A ,$139.44 ,$234.06 , N/A ,$268.92 , N/A ,$270.41 ,$270.41 , N/A ,$270.41 , N/A ,$348.60 ,$249.00 ,$398.40 , N/A , N/A ,$348.60 , N/A ,$298.80 , N/A ,$373.50 ,$274.90 ,$248.00 ,$274.90 , N/A ,$274.90 ,$388.44 ,$388.44 ,$423.30 , N/A ,$345.11 , N/A ,$498.00 ,$273.90 , N/A ,$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ", N/A ,$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 , N/A ,$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100061,15278,HC APPL SKIN SUB OTH >100 ADDL 100CM-RT,361,1 ,$498.00 ,$323.70 ,$130.97 ,"$1,057.63 ", N/A ,$498.00 ,$273.90 , N/A ,$139.44 ,$234.06 , N/A ,$268.92 , N/A ,$270.41 ,$270.41 , N/A ,$270.41 , N/A ,$348.60 ,$249.00 ,$398.40 , N/A , N/A ,$348.60 , N/A ,$298.80 , N/A ,$373.50 ,$274.90 ,$248.00 ,$274.90 , N/A ,$274.90 ,$388.44 ,$388.44 ,$423.30 , N/A ,$345.11 , N/A ,$498.00 ,$273.90 , N/A ,$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ", N/A ,$398.40 ,$270.41 ,$139.44 ,$448.20 ,$498.00 ,$498.00 , N/A ,$239.04 
ST. MARY'S HOSPITAL - DECATUR,36100062,19100,HC BREAST BIOPSY NEEDLE W/O IMAG GUIDE,361,1 ,"$4,312.00 ","$2,802.80 ",$177.68 ,"$4,312.00 ","$3,329.73 ","$2,800.00 ","$2,371.60 ","$1,331.89 ","$1,207.36 ","$2,026.64 ","$1,331.89 ","$2,328.48 ","$1,331.89 ","$2,341.42 ","$2,341.42 ","$1,331.89 ","$2,341.42 ","$2,530.59 ","$3,018.40 ","$2,156.00 ","$3,449.60 ","$3,329.72 ","$1,331.89 ","$3,018.40 ","$1,331.89 ","$2,587.20 ","$1,331.89 ","$3,234.00 ","$2,380.22 ","$2,147.38 ","$2,380.22 ","$1,331.89 ","$2,380.22 ","$3,363.36 ","$3,363.36 ","$3,665.20 ","$3,329.72 ","$2,988.22 ","$1,331.89 ",$177.68 ,"$2,371.60 ","$1,331.89 ","$1,134.06 ","$4,312.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$3,449.60 ","$2,341.42 ","$1,207.36 ","$3,880.80 ","$1,795.00 ","$2,100.00 ","$1,331.89 ","$2,069.76 "
ST. MARY'S HOSPITAL - DECATUR,36100063,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-LT,361,1 ,$623.00 ,$404.95 ,$163.85 ,$623.00 ,$618.28 ,$623.00 ,$342.65 ,$247.31 ,$174.44 ,$292.81 ,$247.31 ,$336.42 ,$247.31 ,$338.29 ,$338.29 ,$247.31 ,$338.29 ,$469.90 ,$436.10 ,$311.50 ,$498.40 ,$618.29 ,$247.31 ,$436.10 ,$247.31 ,$373.80 ,$247.31 ,$467.25 ,$343.90 ,$310.25 ,$343.90 ,$247.31 ,$343.90 ,$485.94 ,$485.94 ,$529.55 ,$618.29 ,$431.74 ,$247.31 ,$623.00 ,$342.65 ,$247.31 ,$163.85 ,$623.00 ,$226.42 ,$216.13 ,$259.68 ,$498.40 ,$338.29 ,$174.44 ,$560.70 ,$623.00 ,$623.00 ,$247.31 ,$299.04 
ST. MARY'S HOSPITAL - DECATUR,36100064,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-RT,361,1 ,$623.00 ,$404.95 ,$163.85 ,$623.00 ,$618.28 ,$623.00 ,$342.65 ,$247.31 ,$174.44 ,$292.81 ,$247.31 ,$336.42 ,$247.31 ,$338.29 ,$338.29 ,$247.31 ,$338.29 ,$469.90 ,$436.10 ,$311.50 ,$498.40 ,$618.29 ,$247.31 ,$436.10 ,$247.31 ,$373.80 ,$247.31 ,$467.25 ,$343.90 ,$310.25 ,$343.90 ,$247.31 ,$343.90 ,$485.94 ,$485.94 ,$529.55 ,$618.29 ,$431.74 ,$247.31 ,$623.00 ,$342.65 ,$247.31 ,$163.85 ,$623.00 ,$226.42 ,$216.13 ,$259.68 ,$498.40 ,$338.29 ,$174.44 ,$560.70 ,$623.00 ,$623.00 ,$247.31 ,$299.04 
ST. MARY'S HOSPITAL - DECATUR,36100065,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-LT,361,1 ,$833.00 ,$541.45 ,$216.13 ,$833.00 ,$618.28 ,$833.00 ,$458.15 ,$247.31 ,$233.24 ,$391.51 ,$247.31 ,$449.82 ,$247.31 ,$452.32 ,$452.32 ,$247.31 ,$452.32 ,$469.90 ,$583.10 ,$416.50 ,$666.40 ,$618.29 ,$247.31 ,$583.10 ,$247.31 ,$499.80 ,$247.31 ,$624.75 ,$459.82 ,$414.83 ,$459.82 ,$247.31 ,$459.82 ,$649.74 ,$649.74 ,$708.05 ,$618.29 ,$577.27 ,$247.31 ,$833.00 ,$458.15 ,$247.31 ,$219.08 ,$833.00 ,$226.42 ,$216.13 ,$259.68 ,$666.40 ,$452.32 ,$233.24 ,$749.70 ,$737.00 ,$833.00 ,$247.31 ,$399.84 
ST. MARY'S HOSPITAL - DECATUR,36100066,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-RT,361,1 ,$833.00 ,$541.45 ,$216.13 ,$833.00 ,$618.28 ,$833.00 ,$458.15 ,$247.31 ,$233.24 ,$391.51 ,$247.31 ,$449.82 ,$247.31 ,$452.32 ,$452.32 ,$247.31 ,$452.32 ,$469.90 ,$583.10 ,$416.50 ,$666.40 ,$618.29 ,$247.31 ,$583.10 ,$247.31 ,$499.80 ,$247.31 ,$624.75 ,$459.82 ,$414.83 ,$459.82 ,$247.31 ,$459.82 ,$649.74 ,$649.74 ,$708.05 ,$618.29 ,$577.27 ,$247.31 ,$833.00 ,$458.15 ,$247.31 ,$219.08 ,$833.00 ,$226.42 ,$216.13 ,$259.68 ,$666.40 ,$452.32 ,$233.24 ,$749.70 ,$737.00 ,$833.00 ,$247.31 ,$399.84 
ST. MARY'S HOSPITAL - DECATUR,36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,"$1,541.00 ","$1,001.65 ",$216.13 ,"$1,541.00 ",$618.28 ,"$1,541.00 ",$847.55 ,$247.31 ,$431.48 ,$724.27 ,$247.31 ,$832.14 ,$247.31 ,$836.76 ,$836.76 ,$247.31 ,$836.76 ,$469.90 ,"$1,078.70 ",$770.50 ,"$1,232.80 ",$618.29 ,$247.31 ,"$1,078.70 ",$247.31 ,$924.60 ,$247.31 ,"$1,155.75 ",$850.63 ,$767.42 ,$850.63 ,$247.31 ,$850.63 ,"$1,201.98 ","$1,201.98 ","$1,309.85 ",$618.29 ,"$1,067.91 ",$247.31 ,"$1,541.00 ",$847.55 ,$247.31 ,$405.28 ,"$1,541.00 ",$226.42 ,$216.13 ,$259.68 ,"$1,232.80 ",$836.76 ,$431.48 ,"$1,386.90 ",$737.00 ,$900.00 ,$247.31 ,$739.68 
ST. MARY'S HOSPITAL - DECATUR,36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,"$1,541.00 ","$1,001.65 ",$216.13 ,"$1,541.00 ",$618.28 ,"$1,541.00 ",$847.55 ,$247.31 ,$431.48 ,$724.27 ,$247.31 ,$832.14 ,$247.31 ,$836.76 ,$836.76 ,$247.31 ,$836.76 ,$469.90 ,"$1,078.70 ",$770.50 ,"$1,232.80 ",$618.29 ,$247.31 ,"$1,078.70 ",$247.31 ,$924.60 ,$247.31 ,"$1,155.75 ",$850.63 ,$767.42 ,$850.63 ,$247.31 ,$850.63 ,"$1,201.98 ","$1,201.98 ","$1,309.85 ",$618.29 ,"$1,067.91 ",$247.31 ,"$1,541.00 ",$847.55 ,$247.31 ,$405.28 ,"$1,541.00 ",$226.42 ,$216.13 ,$259.68 ,"$1,232.80 ",$836.76 ,$431.48 ,"$1,386.90 ",$737.00 ,$900.00 ,$247.31 ,$739.68 
ST. MARY'S HOSPITAL - DECATUR,36100069,29125,HC APPL SHRT ARM SPLNT STAT-LT,361,1 ,$743.00 ,$482.95 ,$106.74 ,$743.00 ,$266.85 ,$378.93 ,$408.65 ,$106.74 ,$208.04 ,$349.21 ,$106.74 ,$401.22 ,$106.74 ,$403.45 ,$403.45 ,$106.74 ,$403.45 ,$202.80 ,$520.10 ,$371.50 ,$594.40 ,$266.84 ,$106.74 ,$520.10 ,$106.74 ,$445.80 ,$106.74 ,$557.25 ,$410.14 ,$370.01 ,$410.14 ,$106.74 ,$410.14 ,$579.54 ,$579.54 ,$631.55 ,$266.84 ,$514.90 ,$106.74 ,$743.00 ,$408.65 ,$106.74 ,$195.41 ,$743.00 ,$176.28 ,$168.26 ,$112.08 ,$594.40 ,$403.45 ,$208.04 ,$668.70 ,$737.00 ,$743.00 ,$106.74 ,$356.64 
ST. MARY'S HOSPITAL - DECATUR,36100070,29125,HC APPL SHRT ARM SPLNT STAT-RT,361,1 ,$743.00 ,$482.95 ,$106.74 ,$743.00 ,$266.85 ,$378.93 ,$408.65 ,$106.74 ,$208.04 ,$349.21 ,$106.74 ,$401.22 ,$106.74 ,$403.45 ,$403.45 ,$106.74 ,$403.45 ,$202.80 ,$520.10 ,$371.50 ,$594.40 ,$266.84 ,$106.74 ,$520.10 ,$106.74 ,$445.80 ,$106.74 ,$557.25 ,$410.14 ,$370.01 ,$410.14 ,$106.74 ,$410.14 ,$579.54 ,$579.54 ,$631.55 ,$266.84 ,$514.90 ,$106.74 ,$743.00 ,$408.65 ,$106.74 ,$195.41 ,$743.00 ,$176.28 ,$168.26 ,$112.08 ,$594.40 ,$403.45 ,$208.04 ,$668.70 ,$737.00 ,$743.00 ,$106.74 ,$356.64 
ST. MARY'S HOSPITAL - DECATUR,36100101,62321,HC INJ INTRLAMNR CERV/THOR W/GUIDE,361,1 ,"$4,862.00 ","$3,160.30 ",$293.63 ,"$4,862.00 ","$1,502.73 ","$2,800.00 ","$2,674.10 ",$601.09 ,"$1,361.36 ","$2,285.14 ",$601.09 ,"$2,625.48 ",$601.09 ,"$2,640.07 ","$2,640.07 ",$601.09 ,"$2,640.07 ","$1,142.07 ","$3,403.40 ","$2,431.00 ","$3,889.60 ","$1,502.72 ",$601.09 ,"$3,403.40 ",$601.09 ,"$2,917.20 ",$601.09 ,"$3,646.50 ","$2,683.82 ","$2,421.28 ","$2,683.82 ",$601.09 ,"$2,683.82 ","$3,792.36 ","$3,792.36 ","$4,132.70 ","$1,502.72 ","$3,369.37 ",$601.09 ,"$4,862.00 ","$2,674.10 ",$601.09 ,"$1,278.71 ","$4,862.00 ",$307.62 ,$293.63 ,$631.14 ,"$3,889.60 ","$2,640.07 ","$1,361.36 ","$4,375.80 ","$1,483.00 ","$1,666.00 ",$601.09 ,"$2,333.76 "
ST. MARY'S HOSPITAL - DECATUR,36100102,62322,HC INJ INTRLAMNR LUM/SAC W/O GUIDE,361,1 ,"$2,381.00 ","$1,547.65 ",$293.63 ,"$2,381.00 ","$1,502.73 ","$2,381.00 ","$1,309.55 ",$601.09 ,$666.68 ,"$1,119.07 ",$601.09 ,"$1,285.74 ",$601.09 ,"$1,292.88 ","$1,292.88 ",$601.09 ,"$1,292.88 ","$1,142.07 ","$1,666.70 ","$1,190.50 ","$1,904.80 ","$1,502.72 ",$601.09 ,"$1,666.70 ",$601.09 ,"$1,428.60 ",$601.09 ,"$1,785.75 ","$1,314.31 ","$1,185.74 ","$1,314.31 ",$601.09 ,"$1,314.31 ","$1,857.18 ","$1,857.18 ","$2,023.85 ","$1,502.72 ","$1,650.03 ",$601.09 ,"$2,381.00 ","$1,309.55 ",$601.09 ,$626.20 ,"$2,381.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,904.80 ","$1,292.88 ",$666.68 ,"$2,142.90 ","$1,483.00 ","$1,666.00 ",$601.09 ,"$1,142.88 "
ST. MARY'S HOSPITAL - DECATUR,36100103,62323,HC INJ INTRLAMNR LUM/SAC W/GUIDE,361,1 ,"$3,592.00 ","$2,334.80 ",$293.63 ,"$3,592.00 ","$1,502.73 ","$2,800.00 ","$1,975.60 ",$601.09 ,"$1,005.76 ","$1,688.24 ",$601.09 ,"$1,939.68 ",$601.09 ,"$1,950.46 ","$1,950.46 ",$601.09 ,"$1,950.46 ","$1,142.07 ","$2,514.40 ","$1,796.00 ","$2,873.60 ","$1,502.72 ",$601.09 ,"$2,514.40 ",$601.09 ,"$2,155.20 ",$601.09 ,"$2,694.00 ","$1,982.78 ","$1,788.82 ","$1,982.78 ",$601.09 ,"$1,982.78 ","$2,801.76 ","$2,801.76 ","$3,053.20 ","$1,502.72 ","$2,489.26 ",$601.09 ,"$3,592.00 ","$1,975.60 ",$601.09 ,$944.70 ,"$3,592.00 ",$307.62 ,$293.63 ,$631.14 ,"$2,873.60 ","$1,950.46 ","$1,005.76 ","$3,232.80 ","$1,483.00 ","$1,666.00 ",$601.09 ,"$1,724.16 "
ST. MARY'S HOSPITAL - DECATUR,36100104,62324,HC INJ W/CATH CERV/THOR W/O GUIDE,361,1 ,"$3,588.00 ","$2,332.20 ",$532.54 ,"$3,588.00 ","$1,948.10 ","$2,800.00 ","$1,973.40 ",$779.24 ,"$1,004.64 ","$1,686.36 ",$779.24 ,"$1,937.52 ",$779.24 ,"$1,948.28 ","$1,948.28 ",$779.24 ,"$1,948.28 ","$1,480.55 ","$2,511.60 ","$1,794.00 ","$2,870.40 ","$1,948.10 ",$779.24 ,"$2,511.60 ",$779.24 ,"$2,152.80 ",$779.24 ,"$2,691.00 ","$1,980.58 ","$1,786.82 ","$1,980.58 ",$779.24 ,"$1,980.58 ","$2,798.64 ","$2,798.64 ","$3,049.80 ","$1,948.10 ","$2,486.48 ",$779.24 ,"$3,588.00 ","$1,973.40 ",$779.24 ,$943.64 ,"$3,588.00 ",$557.90 ,$532.54 ,$818.20 ,"$2,870.40 ","$1,948.28 ","$1,004.64 ","$3,229.20 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$1,722.24 "
ST. MARY'S HOSPITAL - DECATUR,36100105,62325,HC INJ W/CATH CERV/THOR W/GUIDE,361,1 ,"$5,698.00 ","$3,703.70 ",$532.54 ,"$5,698.00 ","$1,948.10 ","$2,800.00 ","$3,133.90 ",$779.24 ,"$1,595.44 ","$2,678.06 ",$779.24 ,"$3,076.92 ",$779.24 ,"$3,094.01 ","$3,094.01 ",$779.24 ,"$3,094.01 ","$1,480.55 ","$3,500.00 ","$2,849.00 ","$4,558.40 ","$1,948.10 ",$779.24 ,"$3,988.60 ",$779.24 ,"$3,418.80 ",$779.24 ,"$4,273.50 ","$3,145.30 ","$2,837.60 ","$3,145.30 ",$779.24 ,"$3,145.30 ","$4,444.44 ","$4,444.44 ","$4,843.30 ","$1,948.10 ","$3,948.71 ",$779.24 ,"$5,698.00 ","$3,133.90 ",$779.24 ,"$1,498.57 ","$5,698.00 ",$557.90 ,$532.54 ,$818.20 ,"$4,558.40 ","$3,094.01 ","$1,595.44 ","$5,128.20 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$2,735.04 "
ST. MARY'S HOSPITAL - DECATUR,36100107,62327,HC INJ W/CATH LUM/SAC W/GUIDE,361,1 ,"$4,261.00 ","$2,769.65 ",$532.54 ,"$4,261.00 ","$1,948.10 ","$2,800.00 ","$2,343.55 ",$779.24 ,"$1,193.08 ","$2,002.67 ",$779.24 ,"$2,300.94 ",$779.24 ,"$2,313.72 ","$2,313.72 ",$779.24 ,"$2,313.72 ","$1,480.55 ","$2,982.70 ","$2,130.50 ","$3,408.80 ","$1,948.10 ",$779.24 ,"$2,982.70 ",$779.24 ,"$2,556.60 ",$779.24 ,"$3,195.75 ","$2,352.07 ","$2,121.98 ","$2,352.07 ",$779.24 ,"$2,352.07 ","$3,323.58 ","$3,323.58 ","$3,621.85 ","$1,948.10 ","$2,952.87 ",$779.24 ,"$4,261.00 ","$2,343.55 ",$779.24 ,"$1,120.64 ","$4,261.00 ",$557.90 ,$532.54 ,$818.20 ,"$3,408.80 ","$2,313.72 ","$1,193.08 ","$3,834.90 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$2,045.28 "
ST. MARY'S HOSPITAL - DECATUR,36100108,29445,HC APPL CAST LEG RIGID CONTACT -BIL,361,1 ,"$1,215.00 ",$789.75 ,$319.55 ,"$1,215.00 ",$856.35 ,$619.65 ,$668.25 ,$342.54 ,$340.20 ,$571.05 ,$342.54 ,$656.10 ,$342.54 ,$659.75 ,$659.75 ,$342.54 ,$659.75 ,$650.83 ,$850.50 ,$607.50 ,$972.00 ,$856.35 ,$342.54 ,$850.50 ,$342.54 ,$729.00 ,$342.54 ,$911.25 ,$670.68 ,$605.07 ,$670.68 ,$342.54 ,$670.68 ,$947.70 ,$947.70 ,"$1,032.75 ",$856.35 ,$842.00 ,$342.54 ,"$1,215.00 ",$668.25 ,$342.54 ,$319.55 ,"$1,215.00 ",$341.13 ,$325.63 ,$359.67 ,$972.00 ,$659.75 ,$340.20 ,"$1,093.50 ","$1,105.50 ","$1,215.00 ",$342.54 ,$583.20 
ST. MARY'S HOSPITAL - DECATUR,36100109,29445,HC APPL CAST LEG RIGID CONTACT -LT,361,1 ,"$1,215.00 ",$789.75 ,$217.08 ,"$1,215.00 ",$570.90 ,$619.65 ,$668.25 ,$228.36 ,$340.20 ,$571.05 ,$228.36 ,$656.10 ,$228.36 ,$659.75 ,$659.75 ,$228.36 ,$659.75 ,$433.88 ,$850.50 ,$607.50 ,$972.00 ,$570.90 ,$228.36 ,$850.50 ,$228.36 ,$729.00 ,$228.36 ,$911.25 ,$670.68 ,$605.07 ,$670.68 ,$228.36 ,$670.68 ,$947.70 ,$947.70 ,"$1,032.75 ",$570.90 ,$842.00 ,$228.36 ,"$1,215.00 ",$668.25 ,$228.36 ,$319.55 ,"$1,215.00 ",$227.41 ,$217.08 ,$239.78 ,$972.00 ,$659.75 ,$340.20 ,"$1,093.50 ",$737.00 ,$900.00 ,$228.36 ,$583.20 
ST. MARY'S HOSPITAL - DECATUR,36100110,29445,HC APPL CAST LEG RIGID CONTACT -RT,361,1 ,"$1,215.00 ",$789.75 ,$217.08 ,"$1,215.00 ",$570.90 ,$619.65 ,$668.25 ,$228.36 ,$340.20 ,$571.05 ,$228.36 ,$656.10 ,$228.36 ,$659.75 ,$659.75 ,$228.36 ,$659.75 ,$433.88 ,$850.50 ,$607.50 ,$972.00 ,$570.90 ,$228.36 ,$850.50 ,$228.36 ,$729.00 ,$228.36 ,$911.25 ,$670.68 ,$605.07 ,$670.68 ,$228.36 ,$670.68 ,$947.70 ,$947.70 ,"$1,032.75 ",$570.90 ,$842.00 ,$228.36 ,"$1,215.00 ",$668.25 ,$228.36 ,$319.55 ,"$1,215.00 ",$227.41 ,$217.08 ,$239.78 ,$972.00 ,$659.75 ,$340.20 ,"$1,093.50 ",$737.00 ,$900.00 ,$228.36 ,$583.20 
ST. MARY'S HOSPITAL - DECATUR,36100119,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-BIL,361,1 ,"$1,201.00 ",$780.65 ,$315.86 ,"$1,201.00 ", N/A ,"$1,201.00 ",$660.55 , N/A ,$336.28 ,$564.47 , N/A ,$648.54 , N/A ,$652.14 ,$652.14 , N/A ,$652.14 , N/A ,$840.70 ,$600.50 ,$960.80 , N/A , N/A ,$840.70 , N/A ,$720.60 , N/A ,$900.75 ,$662.95 ,$598.10 ,$662.95 , N/A ,$662.95 ,$936.78 ,$936.78 ,"$1,020.85 ", N/A ,$832.29 , N/A ,"$1,201.00 ",$660.55 , N/A ,$315.86 ,"$1,201.00 ",$836.85 ,$798.81 , N/A ,$960.80 ,$652.14 ,$336.28 ,"$1,080.90 ","$1,105.50 ","$1,201.00 ", N/A ,$576.48 
ST. MARY'S HOSPITAL - DECATUR,36100120,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-LT,361,1 ,"$1,201.00 ",$780.65 ,$315.86 ,"$1,201.00 ", N/A ,"$1,201.00 ",$660.55 , N/A ,$336.28 ,$564.47 , N/A ,$648.54 , N/A ,$652.14 ,$652.14 , N/A ,$652.14 , N/A ,$840.70 ,$600.50 ,$960.80 , N/A , N/A ,$840.70 , N/A ,$720.60 , N/A ,$900.75 ,$662.95 ,$598.10 ,$662.95 , N/A ,$662.95 ,$936.78 ,$936.78 ,"$1,020.85 ", N/A ,$832.29 , N/A ,"$1,201.00 ",$660.55 , N/A ,$315.86 ,"$1,201.00 ",$557.90 ,$532.54 , N/A ,$960.80 ,$652.14 ,$336.28 ,"$1,080.90 ",$737.00 ,$900.00 , N/A ,$576.48 
ST. MARY'S HOSPITAL - DECATUR,36100121,64634,HC DESTROY NERVE CERVICAL/THORACIC EA ADDL-RT,361,1 ,"$1,201.00 ",$780.65 ,$315.86 ,"$1,201.00 ", N/A ,"$1,201.00 ",$660.55 , N/A ,$336.28 ,$564.47 , N/A ,$648.54 , N/A ,$652.14 ,$652.14 , N/A ,$652.14 , N/A ,$840.70 ,$600.50 ,$960.80 , N/A , N/A ,$840.70 , N/A ,$720.60 , N/A ,$900.75 ,$662.95 ,$598.10 ,$662.95 , N/A ,$662.95 ,$936.78 ,$936.78 ,"$1,020.85 ", N/A ,$832.29 , N/A ,"$1,201.00 ",$660.55 , N/A ,$315.86 ,"$1,201.00 ",$557.90 ,$532.54 , N/A ,$960.80 ,$652.14 ,$336.28 ,"$1,080.90 ",$737.00 ,$900.00 , N/A ,$576.48 
ST. MARY'S HOSPITAL - DECATUR,36100122,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-BIL,361,1 ,"$5,343.00 ","$3,472.95 ",$798.81 ,"$5,343.00 ","$4,155.38 ","$4,200.00 ","$2,938.65 ","$1,662.15 ","$1,496.04 ","$2,511.21 ","$1,662.15 ","$2,885.22 ","$1,662.15 ","$2,901.25 ","$2,901.25 ","$1,662.15 ","$2,901.25 ","$3,158.08 ","$3,500.00 ","$2,671.50 ","$4,274.40 ","$4,155.37 ","$1,662.15 ","$3,740.10 ","$1,662.15 ","$3,205.80 ","$1,662.15 ","$4,007.25 ","$2,949.34 ","$2,660.81 ","$2,949.34 ","$1,662.15 ","$2,949.34 ","$4,167.54 ","$4,167.54 ","$4,541.55 ","$4,155.37 ","$3,702.70 ","$1,662.15 ","$5,343.00 ","$2,938.65 ","$1,662.15 ","$1,405.21 ","$5,343.00 ",$836.85 ,$798.81 ,"$1,745.26 ","$4,274.40 ","$2,901.25 ","$1,496.04 ","$4,808.70 ","$3,297.00 ","$3,750.00 ","$1,662.15 ","$2,564.64 "
ST. MARY'S HOSPITAL - DECATUR,36100123,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-LT,361,1 ,"$5,343.00 ","$3,472.95 ",$532.54 ,"$5,343.00 ","$4,155.38 ","$2,800.00 ","$2,938.65 ","$1,662.15 ","$1,496.04 ","$2,511.21 ","$1,662.15 ","$2,885.22 ","$1,662.15 ","$2,901.25 ","$2,901.25 ","$1,662.15 ","$2,901.25 ","$3,158.08 ","$3,500.00 ","$2,671.50 ","$4,274.40 ","$4,155.37 ","$1,662.15 ","$3,740.10 ","$1,662.15 ","$3,205.80 ","$1,662.15 ","$4,007.25 ","$2,949.34 ","$2,660.81 ","$2,949.34 ","$1,662.15 ","$2,949.34 ","$4,167.54 ","$4,167.54 ","$4,541.55 ","$4,155.37 ","$3,702.70 ","$1,662.15 ","$5,343.00 ","$2,938.65 ","$1,662.15 ","$1,405.21 ","$5,343.00 ",$557.90 ,$532.54 ,"$1,745.26 ","$4,274.40 ","$2,901.25 ","$1,496.04 ","$4,808.70 ","$2,198.00 ","$2,500.00 ","$1,662.15 ","$2,564.64 "
ST. MARY'S HOSPITAL - DECATUR,36100124,64633,HC DESTROY NERVE CERVICAL/THORACIC SGL-RT,361,1 ,"$5,343.00 ","$3,472.95 ",$532.54 ,"$5,343.00 ","$4,155.38 ","$2,800.00 ","$2,938.65 ","$1,662.15 ","$1,496.04 ","$2,511.21 ","$1,662.15 ","$2,885.22 ","$1,662.15 ","$2,901.25 ","$2,901.25 ","$1,662.15 ","$2,901.25 ","$3,158.08 ","$3,500.00 ","$2,671.50 ","$4,274.40 ","$4,155.37 ","$1,662.15 ","$3,740.10 ","$1,662.15 ","$3,205.80 ","$1,662.15 ","$4,007.25 ","$2,949.34 ","$2,660.81 ","$2,949.34 ","$1,662.15 ","$2,949.34 ","$4,167.54 ","$4,167.54 ","$4,541.55 ","$4,155.37 ","$3,702.70 ","$1,662.15 ","$5,343.00 ","$2,938.65 ","$1,662.15 ","$1,405.21 ","$5,343.00 ",$557.90 ,$532.54 ,"$1,745.26 ","$4,274.40 ","$2,901.25 ","$1,496.04 ","$4,808.70 ","$2,198.00 ","$2,500.00 ","$1,662.15 ","$2,564.64 "
ST. MARY'S HOSPITAL - DECATUR,36100125,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-BIL,361,1 ,"$1,109.00 ",$720.85 ,$291.67 ,"$1,109.00 ", N/A ,"$1,109.00 ",$609.95 , N/A ,$310.52 ,$521.23 , N/A ,$598.86 , N/A ,$602.19 ,$602.19 , N/A ,$602.19 , N/A ,$776.30 ,$554.50 ,$887.20 , N/A , N/A ,$776.30 , N/A ,$665.40 , N/A ,$831.75 ,$612.17 ,$552.28 ,$612.17 , N/A ,$612.17 ,$865.02 ,$865.02 ,$942.65 , N/A ,$768.54 , N/A ,"$1,109.00 ",$609.95 , N/A ,$291.67 ,"$1,109.00 ",$836.85 ,$798.81 , N/A ,$887.20 ,$602.19 ,$310.52 ,$998.10 ,"$1,105.50 ","$1,109.00 ", N/A ,$532.32 
ST. MARY'S HOSPITAL - DECATUR,36100126,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-LT,361,1 ,"$1,109.00 ",$720.85 ,$291.67 ,"$1,109.00 ", N/A ,"$1,109.00 ",$609.95 , N/A ,$310.52 ,$521.23 , N/A ,$598.86 , N/A ,$602.19 ,$602.19 , N/A ,$602.19 , N/A ,$776.30 ,$554.50 ,$887.20 , N/A , N/A ,$776.30 , N/A ,$665.40 , N/A ,$831.75 ,$612.17 ,$552.28 ,$612.17 , N/A ,$612.17 ,$865.02 ,$865.02 ,$942.65 , N/A ,$768.54 , N/A ,"$1,109.00 ",$609.95 , N/A ,$291.67 ,"$1,109.00 ",$557.90 ,$532.54 , N/A ,$887.20 ,$602.19 ,$310.52 ,$998.10 ,$737.00 ,$900.00 , N/A ,$532.32 
ST. MARY'S HOSPITAL - DECATUR,36100127,64636,HC DESTROY NERVE LUMBAR/SACRAL EA ADDL-RT,361,1 ,"$1,109.00 ",$720.85 ,$291.67 ,"$1,109.00 ", N/A ,"$1,109.00 ",$609.95 , N/A ,$310.52 ,$521.23 , N/A ,$598.86 , N/A ,$602.19 ,$602.19 , N/A ,$602.19 , N/A ,$776.30 ,$554.50 ,$887.20 , N/A , N/A ,$776.30 , N/A ,$665.40 , N/A ,$831.75 ,$612.17 ,$552.28 ,$612.17 , N/A ,$612.17 ,$865.02 ,$865.02 ,$942.65 , N/A ,$768.54 , N/A ,"$1,109.00 ",$609.95 , N/A ,$291.67 ,"$1,109.00 ",$557.90 ,$532.54 , N/A ,$887.20 ,$602.19 ,$310.52 ,$998.10 ,$737.00 ,$900.00 , N/A ,$532.32 
ST. MARY'S HOSPITAL - DECATUR,36100128,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-BIL,361,1 ,"$5,343.00 ","$3,472.95 ",$798.81 ,"$5,343.00 ","$4,155.38 ","$4,200.00 ","$2,938.65 ","$1,662.15 ","$1,496.04 ","$2,511.21 ","$1,662.15 ","$2,885.22 ","$1,662.15 ","$2,901.25 ","$2,901.25 ","$1,662.15 ","$2,901.25 ","$3,158.08 ","$3,500.00 ","$2,671.50 ","$4,274.40 ","$4,155.37 ","$1,662.15 ","$3,740.10 ","$1,662.15 ","$3,205.80 ","$1,662.15 ","$4,007.25 ","$2,949.34 ","$2,660.81 ","$2,949.34 ","$1,662.15 ","$2,949.34 ","$4,167.54 ","$4,167.54 ","$4,541.55 ","$4,155.37 ","$3,702.70 ","$1,662.15 ","$5,343.00 ","$2,938.65 ","$1,662.15 ","$1,405.21 ","$5,343.00 ",$836.85 ,$798.81 ,"$1,745.26 ","$4,274.40 ","$2,901.25 ","$1,496.04 ","$4,808.70 ","$3,297.00 ","$3,750.00 ","$1,662.15 ","$2,564.64 "
ST. MARY'S HOSPITAL - DECATUR,36100129,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-LT,361,1 ,"$5,343.00 ","$3,472.95 ",$532.54 ,"$5,343.00 ","$4,155.38 ","$2,800.00 ","$2,938.65 ","$1,662.15 ","$1,496.04 ","$2,511.21 ","$1,662.15 ","$2,885.22 ","$1,662.15 ","$2,901.25 ","$2,901.25 ","$1,662.15 ","$2,901.25 ","$3,158.08 ","$3,500.00 ","$2,671.50 ","$4,274.40 ","$4,155.37 ","$1,662.15 ","$3,740.10 ","$1,662.15 ","$3,205.80 ","$1,662.15 ","$4,007.25 ","$2,949.34 ","$2,660.81 ","$2,949.34 ","$1,662.15 ","$2,949.34 ","$4,167.54 ","$4,167.54 ","$4,541.55 ","$4,155.37 ","$3,702.70 ","$1,662.15 ","$5,343.00 ","$2,938.65 ","$1,662.15 ","$1,405.21 ","$5,343.00 ",$557.90 ,$532.54 ,"$1,745.26 ","$4,274.40 ","$2,901.25 ","$1,496.04 ","$4,808.70 ","$2,198.00 ","$2,500.00 ","$1,662.15 ","$2,564.64 "
ST. MARY'S HOSPITAL - DECATUR,36100130,64635,HC DESTROY NERVE LUMBAR/SACRAL SGL-RT,361,1 ,"$5,343.00 ","$3,472.95 ",$532.54 ,"$5,343.00 ","$4,155.38 ","$2,800.00 ","$2,938.65 ","$1,662.15 ","$1,496.04 ","$2,511.21 ","$1,662.15 ","$2,885.22 ","$1,662.15 ","$2,901.25 ","$2,901.25 ","$1,662.15 ","$2,901.25 ","$3,158.08 ","$3,500.00 ","$2,671.50 ","$4,274.40 ","$4,155.37 ","$1,662.15 ","$3,740.10 ","$1,662.15 ","$3,205.80 ","$1,662.15 ","$4,007.25 ","$2,949.34 ","$2,660.81 ","$2,949.34 ","$1,662.15 ","$2,949.34 ","$4,167.54 ","$4,167.54 ","$4,541.55 ","$4,155.37 ","$3,702.70 ","$1,662.15 ","$5,343.00 ","$2,938.65 ","$1,662.15 ","$1,405.21 ","$5,343.00 ",$557.90 ,$532.54 ,"$1,745.26 ","$4,274.40 ","$2,901.25 ","$1,496.04 ","$4,808.70 ","$2,198.00 ","$2,500.00 ","$1,662.15 ","$2,564.64 "
ST. MARY'S HOSPITAL - DECATUR,36100131,64640,HC DESTROY NERVE PERIPHERAL-BIL,361,1 ,"$3,581.00 ","$2,327.65 ",$798.81 ,"$3,581.00 ","$2,922.15 ","$3,581.00 ","$1,969.55 ","$1,168.86 ","$1,002.68 ","$1,683.07 ","$1,168.86 ","$1,933.74 ","$1,168.86 ","$1,944.48 ","$1,944.48 ","$1,168.86 ","$1,944.48 ","$2,220.83 ","$2,506.70 ","$1,790.50 ","$2,864.80 ","$2,922.15 ","$1,168.86 ","$2,506.70 ","$1,168.86 ","$2,148.60 ","$1,168.86 ","$2,685.75 ","$1,976.71 ","$1,783.34 ","$1,976.71 ","$1,168.86 ","$1,976.71 ","$2,793.18 ","$2,793.18 ","$3,043.85 ","$2,922.15 ","$2,481.63 ","$1,168.86 ","$3,581.00 ","$1,969.55 ","$1,168.86 ",$941.80 ,"$3,581.00 ",$836.85 ,$798.81 ,"$1,227.30 ","$2,864.80 ","$1,944.48 ","$1,002.68 ","$3,222.90 ","$2,224.50 ","$2,499.00 ","$1,168.86 ","$1,718.88 "
ST. MARY'S HOSPITAL - DECATUR,36100132,64640,HC DESTROY NERVE PERIPHERAL-LT,361,1 ,"$3,581.00 ","$2,327.65 ",$532.54 ,"$3,581.00 ","$1,948.10 ","$2,800.00 ","$1,969.55 ",$779.24 ,"$1,002.68 ","$1,683.07 ",$779.24 ,"$1,933.74 ",$779.24 ,"$1,944.48 ","$1,944.48 ",$779.24 ,"$1,944.48 ","$1,480.55 ","$2,506.70 ","$1,790.50 ","$2,864.80 ","$1,948.10 ",$779.24 ,"$2,506.70 ",$779.24 ,"$2,148.60 ",$779.24 ,"$2,685.75 ","$1,976.71 ","$1,783.34 ","$1,976.71 ",$779.24 ,"$1,976.71 ","$2,793.18 ","$2,793.18 ","$3,043.85 ","$1,948.10 ","$2,481.63 ",$779.24 ,"$3,581.00 ","$1,969.55 ",$779.24 ,$941.80 ,"$3,581.00 ",$557.90 ,$532.54 ,$818.20 ,"$2,864.80 ","$1,944.48 ","$1,002.68 ","$3,222.90 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$1,718.88 "
ST. MARY'S HOSPITAL - DECATUR,36100133,64640,HC DESTROY NERVE PERIPHERAL-RT,361,1 ,"$3,581.00 ","$2,327.65 ",$532.54 ,"$3,581.00 ","$1,948.10 ","$2,800.00 ","$1,969.55 ",$779.24 ,"$1,002.68 ","$1,683.07 ",$779.24 ,"$1,933.74 ",$779.24 ,"$1,944.48 ","$1,944.48 ",$779.24 ,"$1,944.48 ","$1,480.55 ","$2,506.70 ","$1,790.50 ","$2,864.80 ","$1,948.10 ",$779.24 ,"$2,506.70 ",$779.24 ,"$2,148.60 ",$779.24 ,"$2,685.75 ","$1,976.71 ","$1,783.34 ","$1,976.71 ",$779.24 ,"$1,976.71 ","$2,793.18 ","$2,793.18 ","$3,043.85 ","$1,948.10 ","$2,481.63 ",$779.24 ,"$3,581.00 ","$1,969.55 ",$779.24 ,$941.80 ,"$3,581.00 ",$557.90 ,$532.54 ,$818.20 ,"$2,864.80 ","$1,944.48 ","$1,002.68 ","$3,222.90 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$1,718.88 "
ST. MARY'S HOSPITAL - DECATUR,36100146,51720,HC INSTILL ANTICARCINOG BLADDER,361,1 ,"$1,156.00 ",$751.40 ,$251.89 ,"$1,156.00 ",$629.73 ,$589.56 ,$635.80 ,$251.89 ,$323.68 ,$543.32 ,$251.89 ,$624.24 ,$251.89 ,$627.71 ,$627.71 ,$251.89 ,$627.71 ,$478.60 ,$809.20 ,$578.00 ,$924.80 ,$629.73 ,$251.89 ,$809.20 ,$251.89 ,$693.60 ,$251.89 ,$867.00 ,$638.11 ,$575.69 ,$638.11 ,$251.89 ,$638.11 ,$901.68 ,$901.68 ,$982.60 ,$629.73 ,$801.11 ,$251.89 ,"$1,156.00 ",$635.80 ,$251.89 ,$304.03 ,"$1,156.00 ",$759.25 ,$724.74 ,$264.48 ,$924.80 ,$627.71 ,$323.68 ,"$1,040.40 ",$737.00 ,$900.00 ,$251.89 ,$554.88 
ST. MARY'S HOSPITAL - DECATUR,36100147,31520,HC LARYNGSCPY WW/O TRACH DX NEWB,361,1 ,$259.00 ,$168.35 ,$68.12 ,$889.51 ,$889.50 ,$259.00 ,$142.45 ,$355.80 ,$72.52 ,$121.73 ,$355.80 ,$139.86 ,$259.00 ,$140.64 ,$140.64 ,$259.00 ,$140.64 ,$259.00 ,$181.30 ,$129.50 ,$207.20 ,$889.51 ,$355.80 ,$181.30 ,$355.80 ,$155.40 ,$355.80 ,$194.25 ,$142.97 ,$128.98 ,$142.97 ,$355.80 ,$142.97 ,$202.02 ,$202.02 ,$220.15 ,$259.00 ,$179.49 ,$355.80 ,$259.00 ,$142.45 ,$355.80 ,$68.12 ,$259.00 , N/A , N/A ,$373.59 ,$207.20 ,$140.64 ,$72.52 ,$233.10 ,$259.00 ,$259.00 ,$355.80 ,$124.32 
ST. MARY'S HOSPITAL - DECATUR,36100150,36511,HC WBC APHERESIS THERAPY,361,1 ,"$5,564.00 ","$3,616.60 ","$1,291.13 ","$5,564.00 ","$3,227.83 ","$3,500.00 ","$3,060.20 ","$1,291.13 ","$1,557.92 ","$2,615.08 ","$1,291.13 ","$3,004.56 ","$1,291.13 ","$3,021.25 ","$3,021.25 ","$1,291.13 ","$3,021.25 ","$2,453.16 ","$3,500.00 ","$2,782.00 ","$4,451.20 ","$3,227.84 ","$1,291.13 ","$3,894.80 ","$1,291.13 ","$3,338.40 ","$1,291.13 ","$4,173.00 ","$3,071.33 ","$2,770.87 ","$3,071.33 ","$1,291.13 ","$3,071.33 ","$4,339.92 ","$4,339.92 ","$4,729.40 ","$3,227.84 ","$3,855.85 ","$1,291.13 ","$5,564.00 ","$3,060.20 ","$1,291.13 ","$1,463.33 ","$5,564.00 ","$1,808.87 ","$1,726.65 ","$1,355.69 ","$4,451.20 ","$3,021.25 ","$1,557.92 ","$5,007.60 ","$1,795.00 ","$2,100.00 ","$1,291.13 ","$2,670.72 "
ST. MARY'S HOSPITAL - DECATUR,36100151,36512,HC RBC APHERESIS THERAPY,361,1 ,"$5,564.00 ","$3,616.60 ","$1,291.13 ","$5,564.00 ","$3,227.83 ","$3,500.00 ","$3,060.20 ","$1,291.13 ","$1,557.92 ","$2,615.08 ","$1,291.13 ","$3,004.56 ","$1,291.13 ","$3,021.25 ","$3,021.25 ","$1,291.13 ","$3,021.25 ","$2,453.16 ","$3,500.00 ","$2,782.00 ","$4,451.20 ","$3,227.84 ","$1,291.13 ","$3,894.80 ","$1,291.13 ","$3,338.40 ","$1,291.13 ","$4,173.00 ","$3,071.33 ","$2,770.87 ","$3,071.33 ","$1,291.13 ","$3,071.33 ","$4,339.92 ","$4,339.92 ","$4,729.40 ","$3,227.84 ","$3,855.85 ","$1,291.13 ","$5,564.00 ","$3,060.20 ","$1,291.13 ","$1,463.33 ","$5,564.00 ","$1,808.87 ","$1,726.65 ","$1,355.69 ","$4,451.20 ","$3,021.25 ","$1,557.92 ","$5,007.60 ","$1,795.00 ","$2,100.00 ","$1,291.13 ","$2,670.72 "
ST. MARY'S HOSPITAL - DECATUR,36100152,36513,HC PLATELET PHERESIS THERAPY,361,1 ,"$5,564.00 ","$3,616.60 ",$375.72 ,"$5,564.00 ",$939.30 ,"$3,500.00 ","$3,060.20 ",$375.72 ,"$1,557.92 ","$2,615.08 ",$375.72 ,"$3,004.56 ",$375.72 ,"$3,021.25 ","$3,021.25 ",$375.72 ,"$3,021.25 ",$713.87 ,"$3,500.00 ","$2,782.00 ","$4,451.20 ",$939.30 ,$375.72 ,"$3,894.80 ",$375.72 ,"$3,338.40 ",$375.72 ,"$4,173.00 ","$3,071.33 ","$2,770.87 ","$3,071.33 ",$375.72 ,"$3,071.33 ","$4,339.92 ","$4,339.92 ","$4,729.40 ",$939.30 ,"$3,855.85 ",$375.72 ,"$5,564.00 ","$3,060.20 ",$375.72 ,"$1,463.33 ","$5,564.00 ",$464.32 ,$443.22 ,$394.51 ,"$4,451.20 ","$3,021.25 ","$1,557.92 ","$5,007.60 ",$737.00 ,$900.00 ,$375.72 ,"$2,670.72 "
ST. MARY'S HOSPITAL - DECATUR,36100154,38220,HC ASP BONE MARROW ONLY,361,1 ,"$3,923.00 ","$2,549.95 ",$406.14 ,"$3,923.00 ","$3,329.73 ","$2,800.00 ","$2,157.65 ","$1,331.89 ","$1,098.44 ","$1,843.81 ","$1,331.89 ","$2,118.42 ","$1,331.89 ","$2,130.19 ","$2,130.19 ","$1,331.89 ","$2,130.19 ","$2,530.59 ","$2,746.10 ","$1,961.50 ","$3,138.40 ","$3,329.72 ","$1,331.89 ","$2,746.10 ","$1,331.89 ","$2,353.80 ","$1,331.89 ","$2,942.25 ","$2,165.50 ","$1,953.65 ","$2,165.50 ","$1,331.89 ","$2,165.50 ","$3,059.94 ","$3,059.94 ","$3,334.55 ","$3,329.72 ","$2,718.64 ","$1,331.89 ","$3,923.00 ","$2,157.65 ","$1,331.89 ","$1,031.75 ","$3,923.00 ",$425.48 ,$406.14 ,"$1,398.48 ","$3,138.40 ","$2,130.19 ","$1,098.44 ","$3,530.70 ","$1,483.00 ","$1,666.00 ","$1,331.89 ","$1,883.04 "
ST. MARY'S HOSPITAL - DECATUR,36100155,38221,HC BX BONE MARROW ONLY NEEDLE,361,1 ,"$3,923.00 ","$2,549.95 ",$406.14 ,"$3,923.00 ","$3,329.73 ","$2,800.00 ","$2,157.65 ","$1,331.89 ","$1,098.44 ","$1,843.81 ","$1,331.89 ","$2,118.42 ","$1,331.89 ","$2,130.19 ","$2,130.19 ","$1,331.89 ","$2,130.19 ","$2,530.59 ","$2,746.10 ","$1,961.50 ","$3,138.40 ","$3,329.72 ","$1,331.89 ","$2,746.10 ","$1,331.89 ","$2,353.80 ","$1,331.89 ","$2,942.25 ","$2,165.50 ","$1,953.65 ","$2,165.50 ","$1,331.89 ","$2,165.50 ","$3,059.94 ","$3,059.94 ","$3,334.55 ","$3,329.72 ","$2,718.64 ","$1,331.89 ","$3,923.00 ","$2,157.65 ","$1,331.89 ","$1,031.75 ","$3,923.00 ",$425.48 ,$406.14 ,"$1,398.48 ","$3,138.40 ","$2,130.19 ","$1,098.44 ","$3,530.70 ","$1,483.00 ","$1,666.00 ","$1,331.89 ","$1,883.04 "
ST. MARY'S HOSPITAL - DECATUR,36100157,10021,HC ASP FINE NDL W/O IMAGING GUIDE,361,1 ,$905.00 ,$588.25 ,$112.87 ,$905.00 ,$817.95 ,$905.00 ,$497.75 ,$327.18 ,$253.40 ,$425.35 ,$327.18 ,$488.70 ,$327.18 ,$491.42 ,$491.42 ,$327.18 ,$491.42 ,$621.65 ,$633.50 ,$452.50 ,$724.00 ,$817.95 ,$327.18 ,$633.50 ,$327.18 ,$543.00 ,$327.18 ,$678.75 ,$499.56 ,$450.69 ,$499.56 ,$327.18 ,$499.56 ,$705.90 ,$705.90 ,$769.25 ,$817.95 ,$627.17 ,$327.18 ,$112.87 ,$497.75 ,$327.18 ,$238.02 ,$905.00 ,$425.48 ,$406.14 ,$343.54 ,$724.00 ,$491.42 ,$253.40 ,$814.50 ,$737.00 ,$900.00 ,$327.18 ,$434.40 
ST. MARY'S HOSPITAL - DECATUR,36100162,22526,HC ANNULOPLASTY UNI/BI INTRADISCAL SGL LVL,361,1 ,"$4,498.00 ","$2,923.70 ","$1,182.97 ","$4,498.00 ", N/A ,"$4,498.00 ","$2,473.90 ", N/A ,"$1,259.44 ","$2,114.06 ", N/A ,"$2,428.92 ", N/A ,"$2,442.41 ","$2,442.41 ", N/A ,"$2,442.41 ", N/A ,"$3,148.60 ","$2,249.00 ","$3,598.40 ", N/A , N/A ,"$3,148.60 ", N/A ,"$2,698.80 ", N/A ,"$3,373.50 ","$2,482.90 ","$2,240.00 ","$2,482.90 ", N/A ,"$2,482.90 ","$3,508.44 ","$3,508.44 ","$3,823.30 ", N/A ,"$3,117.11 ", N/A ,"$4,498.00 ","$2,473.90 ", N/A ,"$1,182.97 ","$4,498.00 ","$3,429.66 ","$3,273.76 ", N/A ,"$3,598.40 ","$2,442.41 ","$1,259.44 ","$4,048.20 ","$2,641.00 ","$3,250.00 ", N/A ,"$2,159.04 "
ST. MARY'S HOSPITAL - DECATUR,36100175,46221,HC HEMORRHOIDECTOMY INTERNAL W/LIGATION,361,1 ,"$3,777.00 ","$2,455.05 ",$430.28 ,"$3,777.00 ","$1,878.00 ","$2,800.00 ","$2,077.35 ",$751.20 ,"$1,057.56 ","$1,775.19 ",$751.20 ,"$2,039.58 ",$751.20 ,"$2,050.91 ","$2,050.91 ",$751.20 ,"$2,050.91 ","$1,427.28 ","$2,643.90 ","$1,888.50 ","$3,021.60 ","$1,878.00 ",$751.20 ,"$2,643.90 ",$751.20 ,"$2,266.20 ",$751.20 ,"$2,832.75 ","$2,084.90 ","$1,880.95 ","$2,084.90 ",$751.20 ,"$2,084.90 ","$2,946.06 ","$2,946.06 ","$3,210.45 ","$1,878.00 ","$2,617.46 ",$751.20 ,"$3,777.00 ","$2,077.35 ",$751.20 ,$993.35 ,"$3,777.00 ",$450.77 ,$430.28 ,$788.76 ,"$3,021.60 ","$2,050.91 ","$1,057.56 ","$3,399.30 ","$1,483.00 ","$1,666.00 ",$751.20 ,"$1,812.96 "
ST. MARY'S HOSPITAL - DECATUR,36100178,62264,HC INJ LYSIS EPID ADHESIONS W/RAD LOCAL 1 DAY,361,1 ,"$2,681.00 ","$1,742.65 ",$532.54 ,"$2,681.00 ","$1,948.10 ","$2,681.00 ","$1,474.55 ",$779.24 ,$750.68 ,"$1,260.07 ",$779.24 ,"$1,447.74 ",$779.24 ,"$1,455.78 ","$1,455.78 ",$779.24 ,"$1,455.78 ","$1,480.55 ","$1,876.70 ","$1,340.50 ","$2,144.80 ","$1,948.10 ",$779.24 ,"$1,876.70 ",$779.24 ,"$1,608.60 ",$779.24 ,"$2,010.75 ","$1,479.91 ","$1,335.14 ","$1,479.91 ",$779.24 ,"$1,479.91 ","$2,091.18 ","$2,091.18 ","$2,278.85 ","$1,948.10 ","$1,857.93 ",$779.24 ,"$2,681.00 ","$1,474.55 ",$779.24 ,$705.10 ,"$2,681.00 ",$557.90 ,$532.54 ,$818.20 ,"$2,144.80 ","$1,455.78 ",$750.68 ,"$2,412.90 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$1,286.88 "
ST. MARY'S HOSPITAL - DECATUR,36100185,62326,HC INJ W/CATH LUM/SAC W/O GUIDE,361,1 ,"$4,261.00 ","$2,769.65 ",$532.54 ,"$4,261.00 ","$1,948.10 ","$2,800.00 ","$2,343.55 ",$779.24 ,"$1,193.08 ","$2,002.67 ",$779.24 ,"$2,300.94 ",$779.24 ,"$2,313.72 ","$2,313.72 ",$779.24 ,"$2,313.72 ","$1,480.55 ","$2,982.70 ","$2,130.50 ","$3,408.80 ","$1,948.10 ",$779.24 ,"$2,982.70 ",$779.24 ,"$2,556.60 ",$779.24 ,"$3,195.75 ","$2,352.07 ","$2,121.98 ","$2,352.07 ",$779.24 ,"$2,352.07 ","$3,323.58 ","$3,323.58 ","$3,621.85 ","$1,948.10 ","$2,952.87 ",$779.24 ,"$4,261.00 ","$2,343.55 ",$779.24 ,"$1,120.64 ","$4,261.00 ",$557.90 ,$532.54 ,$818.20 ,"$3,408.80 ","$2,313.72 ","$1,193.08 ","$3,834.90 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$2,045.28 "
ST. MARY'S HOSPITAL - DECATUR,36100186,62327,HC INJ W/CATH LUM/SAC W/GUIDE,361,1 ,"$4,261.00 ","$2,769.65 ",$532.54 ,"$4,261.00 ","$1,948.10 ","$2,800.00 ","$2,343.55 ",$779.24 ,"$1,193.08 ","$2,002.67 ",$779.24 ,"$2,300.94 ",$779.24 ,"$2,313.72 ","$2,313.72 ",$779.24 ,"$2,313.72 ","$1,480.55 ","$2,982.70 ","$2,130.50 ","$3,408.80 ","$1,948.10 ",$779.24 ,"$2,982.70 ",$779.24 ,"$2,556.60 ",$779.24 ,"$3,195.75 ","$2,352.07 ","$2,121.98 ","$2,352.07 ",$779.24 ,"$2,352.07 ","$3,323.58 ","$3,323.58 ","$3,621.85 ","$1,948.10 ","$2,952.87 ",$779.24 ,"$4,261.00 ","$2,343.55 ",$779.24 ,"$1,120.64 ","$4,261.00 ",$557.90 ,$532.54 ,$818.20 ,"$3,408.80 ","$2,313.72 ","$1,193.08 ","$3,834.90 ","$1,483.00 ","$1,666.00 ",$779.24 ,"$2,045.28 "
ST. MARY'S HOSPITAL - DECATUR,36100187,64415,HC INTRASCALENE BLOCK SINGLE-LT,361,1 ,$856.00 ,$556.40 ,$225.13 ,"$1,948.10 ","$1,948.10 ",$856.00 ,$470.80 ,$779.24 ,$239.68 ,$402.32 ,$779.24 ,$462.24 ,$779.24 ,$464.81 ,$464.81 ,$779.24 ,$464.81 ,$856.00 ,$599.20 ,$428.00 ,$684.80 ,"$1,948.10 ",$779.24 ,$599.20 ,$779.24 ,$513.60 ,$779.24 ,$642.00 ,$472.51 ,$426.29 ,$472.51 ,$779.24 ,$472.51 ,$667.68 ,$667.68 ,$727.60 ,$856.00 ,$593.21 ,$779.24 ,$856.00 ,$470.80 ,$779.24 ,$225.13 ,$856.00 ,$307.62 ,$293.63 ,$818.20 ,$684.80 ,$464.81 ,$239.68 ,$770.40 ,$856.00 ,$856.00 ,$779.24 ,$410.88 
ST. MARY'S HOSPITAL - DECATUR,36100188,64415,HC INTRASCALENE BLOCK SINGLE-RT,361,1 ,$856.00 ,$556.40 ,$225.13 ,"$1,948.10 ","$1,948.10 ",$856.00 ,$470.80 ,$779.24 ,$239.68 ,$402.32 ,$779.24 ,$462.24 ,$779.24 ,$464.81 ,$464.81 ,$779.24 ,$464.81 ,$856.00 ,$599.20 ,$428.00 ,$684.80 ,"$1,948.10 ",$779.24 ,$599.20 ,$779.24 ,$513.60 ,$779.24 ,$642.00 ,$472.51 ,$426.29 ,$472.51 ,$779.24 ,$472.51 ,$667.68 ,$667.68 ,$727.60 ,$856.00 ,$593.21 ,$779.24 ,$856.00 ,$470.80 ,$779.24 ,$225.13 ,$856.00 ,$307.62 ,$293.63 ,$818.20 ,$684.80 ,$464.81 ,$239.68 ,$770.40 ,$856.00 ,$856.00 ,$779.24 ,$410.88 
ST. MARY'S HOSPITAL - DECATUR,36100191,64418,HC NERVE BLOCK;SUPRACAPULAR-LT,361,1 ,"$1,080.00 ",$702.00 ,$284.04 ,"$1,502.73 ","$1,502.73 ","$1,080.00 ",$594.00 ,$601.09 ,$302.40 ,$507.60 ,$601.09 ,$583.20 ,$601.09 ,$586.44 ,$586.44 ,$601.09 ,$586.44 ,"$1,080.00 ",$756.00 ,$540.00 ,$864.00 ,"$1,502.72 ",$601.09 ,$756.00 ,$601.09 ,$648.00 ,$601.09 ,$810.00 ,$596.16 ,$537.84 ,$596.16 ,$601.09 ,$596.16 ,$842.40 ,$842.40 ,$918.00 ,"$1,080.00 ",$748.44 ,$601.09 ,"$1,080.00 ",$594.00 ,$601.09 ,$284.04 ,"$1,080.00 ",$307.62 ,$293.63 ,$631.14 ,$864.00 ,$586.44 ,$302.40 ,$972.00 ,"$1,080.00 ","$1,080.00 ",$601.09 ,$518.40 
ST. MARY'S HOSPITAL - DECATUR,36100192,64418,HC NERVE BLOCK;SUPRACAPULAR-RT,361,1 ,"$1,080.00 ",$702.00 ,$284.04 ,"$1,502.73 ","$1,502.73 ","$1,080.00 ",$594.00 ,$601.09 ,$302.40 ,$507.60 ,$601.09 ,$583.20 ,$601.09 ,$586.44 ,$586.44 ,$601.09 ,$586.44 ,"$1,080.00 ",$756.00 ,$540.00 ,$864.00 ,"$1,502.72 ",$601.09 ,$756.00 ,$601.09 ,$648.00 ,$601.09 ,$810.00 ,$596.16 ,$537.84 ,$596.16 ,$601.09 ,$596.16 ,$842.40 ,$842.40 ,$918.00 ,"$1,080.00 ",$748.44 ,$601.09 ,"$1,080.00 ",$594.00 ,$601.09 ,$284.04 ,"$1,080.00 ",$307.62 ,$293.63 ,$631.14 ,$864.00 ,$586.44 ,$302.40 ,$972.00 ,"$1,080.00 ","$1,080.00 ",$601.09 ,$518.40 
ST. MARY'S HOSPITAL - DECATUR,36100193,64445,HC NERVE BLOCK;SCIATIC SINGLE-LT,361,1 ,"$2,169.00 ","$1,409.85 ",$293.63 ,"$2,169.00 ","$1,502.73 ","$2,169.00 ","$1,192.95 ",$601.09 ,$607.32 ,"$1,019.43 ",$601.09 ,"$1,171.26 ",$601.09 ,"$1,177.77 ","$1,177.77 ",$601.09 ,"$1,177.77 ","$1,142.07 ","$1,518.30 ","$1,084.50 ","$1,735.20 ","$1,502.72 ",$601.09 ,"$1,518.30 ",$601.09 ,"$1,301.40 ",$601.09 ,"$1,626.75 ","$1,197.29 ","$1,080.16 ","$1,197.29 ",$601.09 ,"$1,197.29 ","$1,691.82 ","$1,691.82 ","$1,843.65 ","$1,502.72 ","$1,503.12 ",$601.09 ,"$2,169.00 ","$1,192.95 ",$601.09 ,$570.45 ,"$2,169.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,735.20 ","$1,177.77 ",$607.32 ,"$1,952.10 ","$1,483.00 ","$1,666.00 ",$601.09 ,"$1,041.12 "
ST. MARY'S HOSPITAL - DECATUR,36100194,64445,HC NERVE BLOCK;SCIATIC SINGLE-RT,361,1 ,"$2,169.00 ","$1,409.85 ",$293.63 ,"$2,169.00 ","$1,502.73 ","$2,169.00 ","$1,192.95 ",$601.09 ,$607.32 ,"$1,019.43 ",$601.09 ,"$1,171.26 ",$601.09 ,"$1,177.77 ","$1,177.77 ",$601.09 ,"$1,177.77 ","$1,142.07 ","$1,518.30 ","$1,084.50 ","$1,735.20 ","$1,502.72 ",$601.09 ,"$1,518.30 ",$601.09 ,"$1,301.40 ",$601.09 ,"$1,626.75 ","$1,197.29 ","$1,080.16 ","$1,197.29 ",$601.09 ,"$1,197.29 ","$1,691.82 ","$1,691.82 ","$1,843.65 ","$1,502.72 ","$1,503.12 ",$601.09 ,"$2,169.00 ","$1,192.95 ",$601.09 ,$570.45 ,"$2,169.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,735.20 ","$1,177.77 ",$607.32 ,"$1,952.10 ","$1,483.00 ","$1,666.00 ",$601.09 ,"$1,041.12 "
ST. MARY'S HOSPITAL - DECATUR,36100198,64480,HC INJ TRANSF CERV/THORACIC ADDL-LT,361,1 ,"$3,410.00 ","$2,216.50 ",$532.54 ,"$3,410.00 ", N/A ,"$2,800.00 ","$1,875.50 ", N/A ,$954.80 ,"$1,602.70 ", N/A ,"$1,841.40 ", N/A ,"$1,851.63 ","$1,851.63 ", N/A ,"$1,851.63 ", N/A ,"$2,387.00 ","$1,705.00 ","$2,728.00 ", N/A , N/A ,"$2,387.00 ", N/A ,"$2,046.00 ", N/A ,"$2,557.50 ","$1,882.32 ","$1,698.18 ","$1,882.32 ", N/A ,"$1,882.32 ","$2,659.80 ","$2,659.80 ","$2,898.50 ", N/A ,"$2,363.13 ", N/A ,"$3,410.00 ","$1,875.50 ", N/A ,$896.83 ,"$3,410.00 ",$557.90 ,$532.54 , N/A ,"$2,728.00 ","$1,851.63 ",$954.80 ,"$3,069.00 ",$737.00 ,$900.00 , N/A ,"$1,636.80 "
ST. MARY'S HOSPITAL - DECATUR,36100199,64480,HC INJ TRANSF CERV/THORACIC ADDL-RT,361,1 ,"$3,410.00 ","$2,216.50 ",$532.54 ,"$3,410.00 ", N/A ,"$2,800.00 ","$1,875.50 ", N/A ,$954.80 ,"$1,602.70 ", N/A ,"$1,841.40 ", N/A ,"$1,851.63 ","$1,851.63 ", N/A ,"$1,851.63 ", N/A ,"$2,387.00 ","$1,705.00 ","$2,728.00 ", N/A , N/A ,"$2,387.00 ", N/A ,"$2,046.00 ", N/A ,"$2,557.50 ","$1,882.32 ","$1,698.18 ","$1,882.32 ", N/A ,"$1,882.32 ","$2,659.80 ","$2,659.80 ","$2,898.50 ", N/A ,"$2,363.13 ", N/A ,"$3,410.00 ","$1,875.50 ", N/A ,$896.83 ,"$3,410.00 ",$557.90 ,$532.54 , N/A ,"$2,728.00 ","$1,851.63 ",$954.80 ,"$3,069.00 ",$737.00 ,$900.00 , N/A ,"$1,636.80 "
ST. MARY'S HOSPITAL - DECATUR,36100200,64480,HC INJ TRANSF CERV/THORACIC ADDL,361,1 ,"$3,410.00 ","$2,216.50 ",$532.54 ,"$3,410.00 ", N/A ,"$2,800.00 ","$1,875.50 ", N/A ,$954.80 ,"$1,602.70 ", N/A ,"$1,841.40 ", N/A ,"$1,851.63 ","$1,851.63 ", N/A ,"$1,851.63 ", N/A ,"$2,387.00 ","$1,705.00 ","$2,728.00 ", N/A , N/A ,"$2,387.00 ", N/A ,"$2,046.00 ", N/A ,"$2,557.50 ","$1,882.32 ","$1,698.18 ","$1,882.32 ", N/A ,"$1,882.32 ","$2,659.80 ","$2,659.80 ","$2,898.50 ", N/A ,"$2,363.13 ", N/A ,"$3,410.00 ","$1,875.50 ", N/A ,$896.83 ,"$3,410.00 ",$557.90 ,$532.54 , N/A ,"$2,728.00 ","$1,851.63 ",$954.80 ,"$3,069.00 ",$737.00 ,$900.00 , N/A ,"$1,636.80 "
ST. MARY'S HOSPITAL - DECATUR,36100204,51785,HC EMG ANAL/URETHRAL SPHINCTER,361,1 ,"$1,124.00 ",$730.60 ,$251.89 ,"$1,124.00 ",$629.73 ,"$1,124.00 ",$618.20 ,$251.89 ,$314.72 ,$528.28 ,$251.89 ,$606.96 ,$251.89 ,$610.33 ,$610.33 ,$251.89 ,$610.33 ,$478.60 ,$786.80 ,$562.00 ,$899.20 ,$629.73 ,$251.89 ,$786.80 ,$251.89 ,$674.40 ,$251.89 ,$843.00 ,$620.45 ,$559.75 ,$620.45 ,$251.89 ,$620.45 ,$876.72 ,$876.72 ,$955.40 ,$629.73 ,$778.93 ,$251.89 ,"$1,124.00 ",$618.20 ,$251.89 ,$295.61 ,"$1,124.00 ",$290.13 ,$276.94 ,$264.48 ,$899.20 ,$610.33 ,$314.72 ,"$1,011.60 ",$737.00 ,$900.00 ,$251.89 ,$539.52 
ST. MARY'S HOSPITAL - DECATUR,36100205,93799,HC THROMBECTOMY CORN ASPIRATION,361,1 ,"$2,011.00 ","$1,307.15 ",$17.20 ,"$2,011.00 ",$330.40 ,"$1,025.61 ","$1,106.05 ",$132.16 ,$563.08 ,$945.17 ,$132.16 ,"$1,085.94 ",$132.16 ,"$1,091.97 ","$1,091.97 ",$132.16 ,"$1,091.97 ",$251.11 ,"$1,407.70 ","$1,005.50 ","$1,608.80 ",$330.40 ,$132.16 ,"$1,407.70 ",$132.16 ,"$1,206.60 ",$132.16 ,"$1,508.25 ","$1,110.07 ","$1,001.48 ","$1,110.07 ",$132.16 ,"$1,110.07 ","$1,568.58 ","$1,568.58 ","$1,709.35 ",$330.40 ,"$1,393.62 ",$132.16 ,"$2,011.00 ","$1,106.05 ",$132.16 ,$528.89 ,"$2,011.00 ",$18.02 ,$17.20 ,$138.77 ,"$1,608.80 ","$1,091.97 ",$563.08 ,"$1,809.90 ",$737.00 ,$900.00 ,$132.16 ,$965.28 
ST. MARY'S HOSPITAL - DECATUR,36100220,60699,HC BX ADRENAL GLAND PERC,361,1 ,"$14,111.00 ","$9,172.15 ","$1,615.92 ","$14,111.00 ","$11,974.33 ","$2,800.00 ","$7,761.05 ","$4,789.73 ","$3,951.08 ","$3,523.99 ","$4,789.73 ","$4,049.96 ","$4,789.73 ","$3,913.45 ","$3,913.45 ","$4,789.73 ","$3,913.45 ","$9,100.48 ","$3,500.00 ","$7,055.50 ","$11,288.80 ","$11,974.31 ","$4,789.73 ","$9,877.70 ","$4,789.73 ","$8,466.60 ","$4,789.73 ","$10,583.25 ","$4,057.00 ","$3,651.00 ","$4,057.00 ","$4,789.73 ","$4,057.00 ","$8,112.00 ","$8,112.00 ","$11,994.35 ","$11,974.31 ","$4,981.00 ","$4,789.73 ","$14,111.00 ","$7,761.05 ","$4,789.73 ","$3,711.19 ","$14,111.00 ","$1,692.87 ","$1,615.92 ","$5,029.22 ","$11,288.80 ","$3,913.45 ","$3,951.08 ","$12,699.90 ","$2,861.00 ","$5,100.00 ","$4,789.73 ","$6,773.28 "
ST. MARY'S HOSPITAL - DECATUR,36100235,11102,HC BIOPSY SKIN TANGENTIAL INIT LESN,361,1 ,$501.00 ,$325.65 ,$131.76 ,$501.00 ,$424.98 ,$501.00 ,$275.55 ,$169.99 ,$140.28 ,$235.47 ,$169.99 ,$270.54 ,$169.99 ,$272.04 ,$272.04 ,$169.99 ,$272.04 ,$322.97 ,$350.70 ,$250.50 ,$400.80 ,$424.97 ,$169.99 ,$350.70 ,$169.99 ,$300.60 ,$169.99 ,$375.75 ,$276.55 ,$249.50 ,$276.55 ,$169.99 ,$276.55 ,$390.78 ,$390.78 ,$425.85 ,$424.97 ,$347.19 ,$169.99 ,$501.00 ,$275.55 ,$169.99 ,$131.76 ,$501.00 ,$450.77 ,$430.28 ,$178.49 ,$400.80 ,$272.04 ,$140.28 ,$450.90 ,$501.00 ,$501.00 ,$169.99 ,$240.48 
ST. MARY'S HOSPITAL - DECATUR,36100238,10005,HC ASP FINE NDL W/US GUIDE INIT LESN,361,1 ,$766.00 ,$497.90 ,$148.00 ,"$1,472.65 ","$1,472.65 ",$766.00 ,$421.30 ,$589.06 ,$214.48 ,$360.02 ,$589.06 ,$413.64 ,$589.06 ,$415.94 ,$415.94 ,$589.06 ,$415.94 ,$766.00 ,$536.20 ,$383.00 ,$612.80 ,"$1,472.64 ",$589.06 ,$536.20 ,$589.06 ,$459.60 ,$589.06 ,$574.50 ,$422.83 ,$381.47 ,$422.83 ,$589.06 ,$422.83 ,$597.48 ,$597.48 ,$651.10 ,$766.00 ,$530.84 ,$589.06 ,$148.00 ,$421.30 ,$589.06 ,$201.46 ,$766.00 ,$425.48 ,$406.14 ,$618.51 ,$612.80 ,$415.94 ,$214.48 ,$689.40 ,$766.00 ,$766.00 ,$589.06 ,$367.68 
ST. MARY'S HOSPITAL - DECATUR,36100239,10006,HC ASP FINE NDL W/US GUIDE EA ADDL LESN,361,1 ,$766.00 ,$497.90 ,$66.21 ,$766.00 , N/A ,$766.00 ,$421.30 , N/A ,$214.48 ,$360.02 , N/A ,$413.64 , N/A ,$415.94 ,$415.94 , N/A ,$415.94 , N/A ,$536.20 ,$383.00 ,$612.80 , N/A , N/A ,$536.20 , N/A ,$459.60 , N/A ,$574.50 ,$422.83 ,$381.47 ,$422.83 , N/A ,$422.83 ,$597.48 ,$597.48 ,$651.10 , N/A ,$530.84 , N/A ,$66.21 ,$421.30 , N/A ,$201.46 ,$766.00 ,$425.48 ,$406.14 , N/A ,$612.80 ,$415.94 ,$214.48 ,$689.40 ,$737.00 ,$766.00 , N/A ,$367.68 
ST. MARY'S HOSPITAL - DECATUR,36100247,36573,HC INS PER CV CATH W/O PORT W/GUIDANCE 5>,361,1 ,"$4,390.00 ","$2,853.50 ",$330.83 ,"$4,390.00 ","$3,327.80 ","$2,800.00 ","$2,414.50 ","$1,331.12 ","$1,229.20 ","$2,063.30 ","$1,331.12 ","$2,370.60 ","$1,331.12 ","$2,383.77 ","$2,383.77 ","$1,331.12 ","$2,383.77 ","$2,529.13 ","$3,073.00 ","$2,195.00 ","$3,512.00 ","$3,327.80 ","$1,331.12 ","$3,073.00 ","$1,331.12 ","$2,634.00 ","$1,331.12 ","$3,292.50 ","$2,423.28 ","$2,186.22 ","$2,423.28 ","$1,331.12 ","$2,423.28 ","$3,424.20 ","$3,424.20 ","$3,731.50 ","$3,327.80 ","$3,042.27 ","$1,331.12 ","$4,390.00 ","$2,414.50 ","$1,331.12 ","$1,154.57 ","$4,390.00 ",$346.59 ,$330.83 ,"$1,397.68 ","$3,512.00 ","$2,383.77 ","$1,229.20 ","$3,951.00 ","$1,795.00 ","$2,100.00 ","$1,331.12 ","$2,107.20 "
ST. MARY'S HOSPITAL - DECATUR,36100264,33016,HC PERICARDIOCENTESIS W/ OR W/O IMAGING,361,1 ,"$2,939.00 ","$1,910.35 ",$772.96 ,"$3,327.80 ","$3,327.80 ","$2,939.00 ","$1,616.45 ","$1,331.12 ",$822.92 ,"$1,381.33 ","$1,331.12 ","$1,587.06 ","$1,331.12 ","$1,595.88 ","$1,595.88 ","$1,331.12 ","$1,595.88 ","$2,529.13 ","$2,057.30 ","$1,469.50 ","$2,351.20 ","$3,327.80 ","$1,331.12 ","$2,057.30 ","$1,331.12 ","$1,763.40 ","$1,331.12 ","$2,204.25 ","$1,622.33 ","$1,463.62 ","$1,622.33 ","$1,331.12 ","$1,622.33 ","$2,292.42 ","$2,292.42 ","$2,498.15 ","$2,939.00 ","$2,036.73 ","$1,331.12 ","$2,939.00 ","$1,616.45 ","$1,331.12 ",$772.96 ,"$2,939.00 ","$2,179.58 ","$2,080.51 ","$1,397.68 ","$2,351.20 ","$1,595.88 ",$822.92 ,"$2,645.10 ","$1,483.00 ","$1,666.00 ","$1,331.12 ","$1,410.72 "
ST. MARY'S HOSPITAL - DECATUR,36100265,33017,HC PERICARDIAL DRAINAGE =>6 YRS W/O CONGENITAL CARDIAC ANOMALY,361,1 ,"$1,158.00 ",$752.70 ,$304.55 ,"$2,080.51 ", N/A ,$590.58 ,$636.90 , N/A ,$324.24 ,$544.26 , N/A ,$625.32 , N/A ,$628.79 ,$628.79 , N/A ,$628.79 , N/A ,$810.60 ,$579.00 ,$926.40 , N/A , N/A ,$810.60 , N/A ,$694.80 , N/A ,$868.50 ,$639.22 ,$576.68 ,$639.22 , N/A ,$639.22 ,$903.24 ,$903.24 ,$984.30 , N/A ,$802.49 , N/A ,"$1,158.00 ",$636.90 , N/A ,$304.55 ,"$1,158.00 ","$1,158.00 ","$2,080.51 ", N/A ,$926.40 ,$628.79 ,$324.24 ,"$1,042.20 ","$1,158.00 ","$1,158.00 ", N/A ,$555.84 
ST. MARY'S HOSPITAL - DECATUR,36100270,62328,HC LUMBAR PUNCTURE DIAGNOSTIC W/FLUORO OR CT GUID,361,1 ,"$1,851.00 ","$1,203.15 ",$344.97 ,"$1,851.00 ","$1,502.73 ","$1,851.00 ","$1,018.05 ",$601.09 ,$518.28 ,$869.97 ,$601.09 ,$999.54 ,$601.09 ,"$1,005.09 ","$1,005.09 ",$601.09 ,"$1,005.09 ","$1,142.07 ","$1,295.70 ",$925.50 ,"$1,480.80 ","$1,502.72 ",$601.09 ,"$1,295.70 ",$601.09 ,"$1,110.60 ",$601.09 ,"$1,388.25 ","$1,021.75 ",$921.80 ,"$1,021.75 ",$601.09 ,"$1,021.75 ","$1,443.78 ","$1,443.78 ","$1,573.35 ","$1,502.72 ","$1,282.74 ",$601.09 ,"$1,851.00 ","$1,018.05 ",$601.09 ,$486.81 ,"$1,851.00 ",$361.39 ,$344.97 ,$631.14 ,"$1,480.80 ","$1,005.09 ",$518.28 ,"$1,665.90 ","$1,483.00 ","$1,666.00 ",$601.09 ,$888.48 
ST. MARY'S HOSPITAL - DECATUR,36100273,64454,HC INJ ANESTHETIC/STEROID GENICULAR NERVES W/FLUORO OR CT GUID,361,1 ,"$1,730.00 ","$1,124.50 ",$293.63 ,"$1,730.00 ","$1,502.73 ","$1,730.00 ",$951.50 ,$601.09 ,$484.40 ,$813.10 ,$601.09 ,$934.20 ,$601.09 ,$939.39 ,$939.39 ,$601.09 ,$939.39 ,"$1,142.07 ","$1,211.00 ",$865.00 ,"$1,384.00 ","$1,502.72 ",$601.09 ,"$1,211.00 ",$601.09 ,"$1,038.00 ",$601.09 ,"$1,297.50 ",$954.96 ,$861.54 ,$954.96 ,$601.09 ,$954.96 ,"$1,349.40 ","$1,349.40 ","$1,470.50 ","$1,502.72 ","$1,198.89 ",$601.09 ,"$1,730.00 ",$951.50 ,$601.09 ,$454.99 ,"$1,730.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,384.00 ",$939.39 ,$484.40 ,"$1,557.00 ","$1,483.00 ","$1,666.00 ",$601.09 ,$830.40 
ST. MARY'S HOSPITAL - DECATUR,36100274,64624,HC DESTRUST NEUROLYTIC AGENT GENICULAR NERVE W/IMG GUID,361,1 ,"$4,957.00 ","$3,222.05 ",$532.54 ,"$4,957.00 ","$4,155.38 ","$2,800.00 ","$2,726.35 ","$1,662.15 ","$1,387.96 ","$2,329.79 ","$1,662.15 ","$2,676.78 ","$1,662.15 ","$2,691.65 ","$2,691.65 ","$1,662.15 ","$2,691.65 ","$3,158.08 ","$3,469.90 ","$2,478.50 ","$3,965.60 ","$4,155.37 ","$1,662.15 ","$3,469.90 ","$1,662.15 ","$2,974.20 ","$1,662.15 ","$3,717.75 ","$2,736.26 ","$2,468.59 ","$2,736.26 ","$1,662.15 ","$2,736.26 ","$3,866.46 ","$3,866.46 ","$4,213.45 ","$4,155.37 ","$3,435.20 ","$1,662.15 ","$4,957.00 ","$2,726.35 ","$1,662.15 ","$1,303.69 ","$4,957.00 ",$557.90 ,$532.54 ,"$1,745.26 ","$3,965.60 ","$2,691.65 ","$1,387.96 ","$4,461.30 ","$2,198.00 ","$2,500.00 ","$1,662.15 ","$2,379.36 "
ST. MARY'S HOSPITAL - DECATUR,36100281,32408,HC CORE NDL BX LUNG/MEDIASTINUM PERQ W IMG,361,1 ,"$1,604.00 ","$1,042.60 ",$421.85 ,"$3,329.73 ","$3,329.73 ","$1,604.00 ",$882.20 ,"$1,331.89 ",$449.12 ,$753.88 ,"$1,331.89 ",$866.16 ,"$1,331.89 ",$870.97 ,$870.97 ,"$1,331.89 ",$870.97 ,"$1,604.00 ","$1,122.80 ",$802.00 ,"$1,283.20 ","$3,329.72 ","$1,331.89 ","$1,122.80 ","$1,331.89 ",$962.40 ,"$1,331.89 ","$1,203.00 ",$885.41 ,$798.79 ,$885.41 ,"$1,331.89 ",$885.41 ,"$1,251.12 ","$1,251.12 ","$1,363.40 ","$1,604.00 ","$1,111.57 ","$1,331.89 ","$1,604.00 ",$882.20 ,"$1,331.89 ",$421.85 ,"$1,604.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$1,283.20 ",$870.97 ,$449.12 ,"$1,443.60 ","$1,604.00 ","$1,604.00 ","$1,331.89 ",$769.92 
ST. MARY'S HOSPITAL - DECATUR,36100284,53060,HC DRAIN OF SKENE GLAND ABS OR CYST,450,1 ,"$5,000.00 ","$3,250.00 ",$325.00 ,"$5,000.00 ","$4,237.25 ","$2,200.00 ","$2,750.00 ","$1,694.90 ","$1,400.00 ","$2,650.00 ","$1,694.90 ","$2,800.00 ","$1,694.90 ","$2,715.00 ","$2,715.00 ","$1,694.90 ","$2,715.00 ","$3,220.31 ","$3,500.00 ","$2,500.00 ","$4,000.00 ","$4,237.26 ","$1,694.90 ","$3,500.00 ","$1,694.90 ","$3,000.00 ","$1,694.90 ","$3,750.00 ","$2,490.00 ","$2,240.00 ","$2,490.00 ","$1,694.90 ","$2,490.00 ","$3,786.00 ","$3,786.00 ","$4,250.00 ","$4,237.26 ","$3,465.00 ","$1,694.90 ","$5,000.00 ","$2,750.00 ","$1,694.90 ","$1,315.00 ","$5,000.00 ", N/A , N/A ,"$1,779.65 ","$4,000.00 ","$2,715.00 ","$1,400.00 ","$4,500.00 ","$1,900.00 ",$325.00 ,"$1,694.90 ","$2,400.00 "
ST. MARY'S HOSPITAL - DECATUR,37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,"$1,048.00 ",$681.20 ,$200.27 ,"$1,048.00 ",$500.68 ,"$1,048.00 ",$576.40 ,$200.27 ,$293.44 ,$492.56 ,$200.27 ,$565.92 ,$200.27 ,$569.06 ,$569.06 ,$200.27 ,$569.06 ,$380.51 ,$733.60 ,$524.00 ,$838.40 ,$500.67 ,$200.27 ,$733.60 ,$200.27 ,$628.80 ,$200.27 ,$786.00 ,$578.50 ,$521.90 ,$578.50 ,$200.27 ,$578.50 ,$817.44 ,$817.44 ,$890.80 ,$500.67 ,$726.26 ,$200.27 ,"$1,048.00 ",$576.40 ,$200.27 ,$275.62 ,"$1,048.00 ",$472.46 ,$450.99 ,$210.28 ,$838.40 ,$569.06 ,$293.44 ,$943.20 ,$737.00 ,$900.00 ,$200.27 ,$503.04 
ST. MARY'S HOSPITAL - DECATUR,37000062,N/A,HC ANESTHESIA GENERAL ADDL 15MIN,370,1 ,$183.00 ,$118.95 ,$48.13 ,$183.00 , N/A ,$93.33 ,$100.65 , N/A ,$51.24 ,$86.01 , N/A ,$98.82 , N/A ,$99.37 , N/A , N/A ,$99.37 , N/A ,$128.10 ,$91.50 ,$146.40 , N/A , N/A ,$128.10 , N/A ,$109.80 , N/A ,$137.25 ,$101.02 ,$91.13 ,$101.02 , N/A ,$101.02 ,$142.74 ,$142.74 ,$155.55 , N/A ,$126.82 , N/A ,$183.00 ,$100.65 , N/A ,$48.13 ,$183.00 , N/A , N/A , N/A ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$69.54 ,$118.95 , N/A ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,37000064,N/A,HC ANESTHESIA REGIONAL BLOCK ADDL 15MIN,370,1 ,$135.00 ,$87.75 ,$35.51 ,$135.00 , N/A ,$68.85 ,$74.25 , N/A ,$37.80 ,$63.45 , N/A ,$72.90 , N/A ,$73.31 , N/A , N/A ,$73.31 , N/A ,$94.50 ,$67.50 ,$108.00 , N/A , N/A ,$94.50 , N/A ,$81.00 , N/A ,$101.25 ,$74.52 ,$67.23 ,$74.52 , N/A ,$74.52 ,$105.30 ,$105.30 ,$114.75 , N/A ,$93.56 , N/A ,$135.00 ,$74.25 , N/A ,$35.51 ,$135.00 , N/A , N/A , N/A ,$108.00 ,$73.31 ,$37.80 ,$121.50 ,$51.30 ,$87.75 , N/A ,$64.80 
ST. MARY'S HOSPITAL - DECATUR,37000077,N/A,HC MONITORED ANESTHESIA ADDL 15 MINS,370,1 ,$134.00 ,$87.10 ,$35.24 ,$134.00 , N/A ,$68.34 ,$73.70 , N/A ,$37.52 ,$62.98 , N/A ,$72.36 , N/A ,$72.76 , N/A , N/A ,$72.76 , N/A ,$93.80 ,$67.00 ,$107.20 , N/A , N/A ,$93.80 , N/A ,$80.40 , N/A ,$100.50 ,$73.97 ,$66.73 ,$73.97 , N/A ,$73.97 ,$104.52 ,$104.52 ,$113.90 , N/A ,$92.86 , N/A ,$134.00 ,$73.70 , N/A ,$35.24 ,$134.00 , N/A , N/A , N/A ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$87.10 , N/A ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,37000083,N/A,HC ANESTHESIA GENERAL INIT 30 MIN,370,1 ,"$1,601.00 ","$1,040.65 ",$421.06 ,"$1,601.00 ", N/A ,$816.51 ,$880.55 , N/A ,$448.28 ,$752.47 , N/A ,$864.54 , N/A ,$869.34 , N/A , N/A ,$869.34 , N/A ,"$1,120.70 ",$800.50 ,"$1,280.80 ", N/A , N/A ,"$1,120.70 ", N/A ,$960.60 , N/A ,"$1,200.75 ",$883.75 ,$797.30 ,$883.75 , N/A ,$883.75 ,"$1,248.78 ","$1,248.78 ","$1,360.85 ", N/A ,"$1,109.49 ", N/A ,"$1,601.00 ",$880.55 , N/A ,$421.06 ,"$1,601.00 ", N/A , N/A , N/A ,"$1,280.80 ",$869.34 ,$448.28 ,"$1,440.90 ",$608.38 ,"$1,040.65 ", N/A ,$768.48 
ST. MARY'S HOSPITAL - DECATUR,37000086,N/A,HC ANESTHESIA REGIONAL BLOCK INITIAL 30MIN,370,1 ,"$1,199.00 ",$779.35 ,$315.34 ,"$1,199.00 ", N/A ,$611.49 ,$659.45 , N/A ,$335.72 ,$563.53 , N/A ,$647.46 , N/A ,$651.06 , N/A , N/A ,$651.06 , N/A ,$839.30 ,$599.50 ,$959.20 , N/A , N/A ,$839.30 , N/A ,$719.40 , N/A ,$899.25 ,$661.85 ,$597.10 ,$661.85 , N/A ,$661.85 ,$935.22 ,$935.22 ,"$1,019.15 ", N/A ,$830.91 , N/A ,"$1,199.00 ",$659.45 , N/A ,$315.34 ,"$1,199.00 ", N/A , N/A , N/A ,$959.20 ,$651.06 ,$335.72 ,"$1,079.10 ",$455.62 ,$779.35 , N/A ,$575.52 
ST. MARY'S HOSPITAL - DECATUR,37000087,N/A,HC ANESTHESIA SPINAL EPIDURAL INIT 30MIN,370,1 ,"$1,601.00 ","$1,040.65 ",$421.06 ,"$1,601.00 ", N/A ,$816.51 ,$880.55 , N/A ,$448.28 ,$752.47 , N/A ,$864.54 , N/A ,$869.34 , N/A , N/A ,$869.34 , N/A ,"$1,120.70 ",$800.50 ,"$1,280.80 ", N/A , N/A ,"$1,120.70 ", N/A ,$960.60 , N/A ,"$1,200.75 ",$883.75 ,$797.30 ,$883.75 , N/A ,$883.75 ,"$1,248.78 ","$1,248.78 ","$1,360.85 ", N/A ,"$1,109.49 ", N/A ,"$1,601.00 ",$880.55 , N/A ,$421.06 ,"$1,601.00 ", N/A , N/A , N/A ,"$1,280.80 ",$869.34 ,$448.28 ,"$1,440.90 ",$608.38 ,"$1,040.65 ", N/A ,$768.48 
ST. MARY'S HOSPITAL - DECATUR,37000088,N/A,HC ANESTHESIA SPINAL EPIDURAL ADDL 15MIN,370,1 ,$177.00 ,$115.05 ,$46.55 ,$177.00 , N/A ,$90.27 ,$97.35 , N/A ,$49.56 ,$83.19 , N/A ,$95.58 , N/A ,$96.11 , N/A , N/A ,$96.11 , N/A ,$123.90 ,$88.50 ,$141.60 , N/A , N/A ,$123.90 , N/A ,$106.20 , N/A ,$132.75 ,$97.70 ,$88.15 ,$97.70 , N/A ,$97.70 ,$138.06 ,$138.06 ,$150.45 , N/A ,$122.66 , N/A ,$177.00 ,$97.35 , N/A ,$46.55 ,$177.00 , N/A , N/A , N/A ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$115.05 , N/A ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,37000089,N/A,HC MONITORED ANESTHESIA INITIAL 30MINS,370,1 ,"$1,203.00 ",$781.95 ,$316.39 ,"$1,203.00 ", N/A ,$613.53 ,$661.65 , N/A ,$336.84 ,$565.41 , N/A ,$649.62 , N/A ,$653.23 , N/A , N/A ,$653.23 , N/A ,$842.10 ,$601.50 ,$962.40 , N/A , N/A ,$842.10 , N/A ,$721.80 , N/A ,$902.25 ,$664.06 ,$599.09 ,$664.06 , N/A ,$664.06 ,$938.34 ,$938.34 ,"$1,022.55 ", N/A ,$833.68 , N/A ,"$1,203.00 ",$661.65 , N/A ,$316.39 ,"$1,203.00 ", N/A , N/A , N/A ,$962.40 ,$653.23 ,$336.84 ,"$1,082.70 ",$457.14 ,$781.95 , N/A ,$577.44 
ST. MARY'S HOSPITAL - DECATUR,39000143,86945,HC BLOOD PRODUCT IRRADIATION,390,1 ,$158.00 ,$102.70 ,$4.18 ,$158.00 ,$80.10 ,$31.54 ,$86.90 ,$32.04 ,$44.24 ,$77.42 ,$32.04 ,$92.43 ,$32.04 ,$85.79 ,$43.98 ,$32.04 ,$85.79 ,$60.88 ,$110.60 ,$79.00 ,$126.40 ,$80.10 ,$32.04 ,$110.60 ,$32.04 ,$94.80 ,$32.04 ,$118.50 ,$87.22 ,$78.68 ,$87.22 ,$32.04 ,$87.22 ,$123.24 ,$123.24 ,$134.30 ,$80.10 ,$109.49 ,$32.04 ,$158.00 ,$86.90 ,$32.04 ,$41.55 ,$158.00 ,$4.38 ,$4.18 ,$33.64 ,$126.40 ,$85.79 ,$44.24 ,$142.20 ,$60.04 ,$158.00 ,$32.04 ,$75.84 
ST. MARY'S HOSPITAL - DECATUR,39000148,P9017,HC FRESH FROZEN PLASMA EA,390,1 ,$105.00 ,$68.25 ,$27.62 ,$443.22 ,$211.00 ,$53.55 ,$57.75 ,$84.40 ,$29.40 ,$49.35 ,$84.40 ,$56.70 ,$84.40 ,$57.02 ,$42.00 ,$84.40 ,$57.02 ,$105.00 ,$73.50 ,$52.50 ,$84.00 ,$211.00 ,$84.40 ,$73.50 ,$84.40 ,$63.00 ,$84.40 ,$78.75 ,$57.96 ,$52.29 ,$57.96 ,$84.40 ,$57.96 ,$81.90 ,$81.90 ,$89.25 ,$105.00 ,$72.77 ,$84.40 ,$105.00 ,$57.75 ,$84.40 ,$27.62 ,$105.00 ,$105.00 ,$443.22 ,$88.62 ,$84.00 ,$57.02 ,$29.40 ,$94.50 ,$39.90 ,$105.00 ,$84.40 ,$50.40 
ST. MARY'S HOSPITAL - DECATUR,39000149,P9021,HC RED CELLS PACKED EA,390,1 ,$444.00 ,$288.60 ,$116.77 ,$444.00 ,$351.33 ,$226.44 ,$244.20 ,$140.53 ,$124.32 ,$208.68 ,$140.53 ,$239.76 ,$140.53 ,$241.09 ,$177.60 ,$140.53 ,$241.09 ,$267.01 ,$310.80 ,$222.00 ,$355.20 ,$351.33 ,$140.53 ,$310.80 ,$140.53 ,$266.40 ,$140.53 ,$333.00 ,$245.09 ,$221.11 ,$245.09 ,$140.53 ,$245.09 ,$346.32 ,$346.32 ,$377.40 ,$351.33 ,$307.69 ,$140.53 ,$444.00 ,$244.20 ,$140.53 ,$116.77 ,$444.00 ,$444.00 ,$443.22 ,$147.56 ,$355.20 ,$241.09 ,$124.32 ,$399.60 ,$168.72 ,$444.00 ,$140.53 ,$213.12 
ST. MARY'S HOSPITAL - DECATUR,39000160,P9059,HC PLASMA FROZEN 8-24 HRS EA UNIT,390,1 ,$105.00 ,$68.25 ,$27.62 ,$443.22 ,$181.60 ,$53.55 ,$57.75 ,$72.64 ,$29.40 ,$49.35 ,$72.64 ,$56.70 ,$72.64 ,$57.02 ,$42.00 ,$72.64 ,$57.02 ,$105.00 ,$73.50 ,$52.50 ,$84.00 ,$181.60 ,$72.64 ,$73.50 ,$72.64 ,$63.00 ,$72.64 ,$78.75 ,$57.96 ,$52.29 ,$57.96 ,$72.64 ,$57.96 ,$81.90 ,$81.90 ,$89.25 ,$105.00 ,$72.77 ,$72.64 ,$105.00 ,$57.75 ,$72.64 ,$27.62 ,$105.00 ,$105.00 ,$443.22 ,$76.27 ,$84.00 ,$57.02 ,$29.40 ,$94.50 ,$39.90 ,$105.00 ,$72.64 ,$50.40 
ST. MARY'S HOSPITAL - DECATUR,39000162,P9012,HC CRYOPRECIPITATE EA UNIT T1,390,1 ,$94.00 ,$61.10 ,$24.72 ,$443.22 ,$203.83 ,$47.94 ,$51.70 ,$81.53 ,$26.32 ,$44.18 ,$81.53 ,$50.76 ,$81.53 ,$51.04 ,$37.60 ,$81.53 ,$51.04 ,$94.00 ,$65.80 ,$47.00 ,$75.20 ,$203.83 ,$81.53 ,$65.80 ,$81.53 ,$56.40 ,$81.53 ,$70.50 ,$51.89 ,$46.81 ,$51.89 ,$81.53 ,$51.89 ,$73.32 ,$73.32 ,$79.90 ,$94.00 ,$65.14 ,$81.53 ,$94.00 ,$51.70 ,$81.53 ,$24.72 ,$94.00 ,$94.00 ,$443.22 ,$85.61 ,$75.20 ,$51.04 ,$26.32 ,$84.60 ,$35.72 ,$94.00 ,$81.53 ,$45.12 
ST. MARY'S HOSPITAL - DECATUR,39000164,P9016,HC RED CELLS L/R EA T1,390,1 ,$389.00 ,$252.85 ,$102.31 ,$480.98 ,$480.98 ,$198.39 ,$213.95 ,$192.39 ,$108.92 ,$182.83 ,$192.39 ,$210.06 ,$192.39 ,$211.23 ,$155.60 ,$192.39 ,$211.23 ,$365.54 ,$272.30 ,$194.50 ,$311.20 ,$480.98 ,$192.39 ,$272.30 ,$192.39 ,$233.40 ,$192.39 ,$291.75 ,$214.73 ,$193.72 ,$214.73 ,$192.39 ,$214.73 ,$303.42 ,$303.42 ,$330.65 ,$389.00 ,$269.58 ,$192.39 ,$389.00 ,$213.95 ,$192.39 ,$102.31 ,$389.00 ,$389.00 ,$443.22 ,$202.01 ,$311.20 ,$211.23 ,$108.92 ,$350.10 ,$147.82 ,$389.00 ,$192.39 ,$186.72 
ST. MARY'S HOSPITAL - DECATUR,39000168,P9022,HC RED CELLS WASHED EA UNIT T1,390,1 ,"$1,095.00 ",$711.75 ,$287.99 ,"$1,095.00 ",$969.63 ,$558.45 ,$602.25 ,$387.85 ,$306.60 ,$514.65 ,$387.85 ,$591.30 ,$387.85 ,$594.59 ,$438.00 ,$387.85 ,$594.59 ,$736.92 ,$766.50 ,$547.50 ,$876.00 ,$969.63 ,$387.85 ,$766.50 ,$387.85 ,$657.00 ,$387.85 ,$821.25 ,$604.44 ,$545.31 ,$604.44 ,$387.85 ,$604.44 ,$854.10 ,$854.10 ,$930.75 ,$969.63 ,$758.84 ,$387.85 ,"$1,095.00 ",$602.25 ,$387.85 ,$287.99 ,"$1,095.00 ",$464.32 ,$443.22 ,$407.24 ,$876.00 ,$594.59 ,$306.60 ,$985.50 ,$416.10 ,$597.00 ,$387.85 ,$525.60 
ST. MARY'S HOSPITAL - DECATUR,39000173,P9035,HC PLATELETS PHER L/R EA T1,390,1 ,$909.00 ,$590.85 ,$239.07 ,"$1,242.28 ","$1,242.28 ",$463.59 ,$499.95 ,$496.91 ,$254.52 ,$427.23 ,$496.91 ,$490.86 ,$496.91 ,$493.59 ,$363.60 ,$496.91 ,$493.59 ,$909.00 ,$636.30 ,$454.50 ,$727.20 ,"$1,242.28 ",$496.91 ,$636.30 ,$496.91 ,$545.40 ,$496.91 ,$681.75 ,$501.77 ,$452.68 ,$501.77 ,$496.91 ,$501.77 ,$709.02 ,$709.02 ,$772.65 ,$909.00 ,$629.94 ,$496.91 ,$909.00 ,$499.95 ,$496.91 ,$239.07 ,$909.00 ,$464.32 ,$443.22 ,$521.76 ,$727.20 ,$493.59 ,$254.52 ,$818.10 ,$345.42 ,$597.00 ,$496.91 ,$436.32 
ST. MARY'S HOSPITAL - DECATUR,39000179,P9037,HC PLATELETS PHER L/R IRR EA T1,390,1 ,$860.00 ,$559.00 ,$226.18 ,"$1,575.80 ","$1,575.80 ",$438.60 ,$473.00 ,$630.32 ,$240.80 ,$404.20 ,$630.32 ,$464.40 ,$630.32 ,$466.98 ,$344.00 ,$630.32 ,$466.98 ,$860.00 ,$602.00 ,$430.00 ,$688.00 ,"$1,575.80 ",$630.32 ,$602.00 ,$630.32 ,$516.00 ,$630.32 ,$645.00 ,$474.72 ,$428.28 ,$474.72 ,$630.32 ,$474.72 ,$670.80 ,$670.80 ,$731.00 ,$860.00 ,$595.98 ,$630.32 ,$860.00 ,$473.00 ,$630.32 ,$226.18 ,$860.00 ,$464.32 ,$443.22 ,$661.84 ,$688.00 ,$466.98 ,$240.80 ,$774.00 ,$326.80 ,$597.00 ,$630.32 ,$412.80 
ST. MARY'S HOSPITAL - DECATUR,39000187,P9040,HC RED CELLS L/R IRR EA T1,390,1 ,$453.00 ,$294.45 ,$119.14 ,$665.08 ,$665.08 ,$231.03 ,$249.15 ,$266.03 ,$126.84 ,$212.91 ,$266.03 ,$244.62 ,$266.03 ,$245.98 ,$181.20 ,$266.03 ,$245.98 ,$453.00 ,$317.10 ,$226.50 ,$362.40 ,$665.08 ,$266.03 ,$317.10 ,$266.03 ,$271.80 ,$266.03 ,$339.75 ,$250.06 ,$225.59 ,$250.06 ,$266.03 ,$250.06 ,$353.34 ,$353.34 ,$385.05 ,$453.00 ,$313.93 ,$266.03 ,$453.00 ,$249.15 ,$266.03 ,$119.14 ,$453.00 ,$453.00 ,$443.22 ,$279.33 ,$362.40 ,$245.98 ,$126.84 ,$407.70 ,$172.14 ,$453.00 ,$266.03 ,$217.44 
ST. MARY'S HOSPITAL - DECATUR,39000190,P9044,HC PLASMA CRYOPREC REDUC EA UN,390,1 ,$343.00 ,$222.95 ,$67.08 ,$443.22 ,$167.70 ,$174.93 ,$188.65 ,$67.08 ,$96.04 ,$161.21 ,$67.08 ,$185.22 ,$67.08 ,$186.25 ,$137.20 ,$67.08 ,$186.25 ,$127.45 ,$240.10 ,$171.50 ,$274.40 ,$167.70 ,$67.08 ,$240.10 ,$67.08 ,$205.80 ,$67.08 ,$257.25 ,$189.34 ,$170.81 ,$189.34 ,$67.08 ,$189.34 ,$267.54 ,$267.54 ,$291.55 ,$167.70 ,$237.70 ,$67.08 ,$343.00 ,$188.65 ,$67.08 ,$90.21 ,$343.00 ,$343.00 ,$443.22 ,$70.43 ,$274.40 ,$186.25 ,$96.04 ,$308.70 ,$130.34 ,$343.00 ,$67.08 ,$164.64 
ST. MARY'S HOSPITAL - DECATUR,39000193,P9054,HC BLOOD L/R DEG WASH EA UN T1,390,1 ,"$1,294.00 ",$841.10 ,$317.22 ,"$1,294.00 ",$793.05 ,$659.94 ,$711.70 ,$317.22 ,$362.32 ,$608.18 ,$317.22 ,$698.76 ,$317.22 ,$702.64 ,$517.60 ,$317.22 ,$702.64 ,$602.72 ,$905.80 ,$647.00 ,"$1,035.20 ",$793.05 ,$317.22 ,$905.80 ,$317.22 ,$776.40 ,$317.22 ,$970.50 ,$714.29 ,$644.41 ,$714.29 ,$317.22 ,$714.29 ,"$1,009.32 ","$1,009.32 ","$1,099.90 ",$793.05 ,$896.74 ,$317.22 ,"$1,294.00 ",$711.70 ,$317.22 ,$340.32 ,"$1,294.00 ",$464.32 ,$443.22 ,$333.08 ,"$1,035.20 ",$702.64 ,$362.32 ,"$1,164.60 ",$491.72 ,$597.00 ,$317.22 ,$621.12 
ST. MARY'S HOSPITAL - DECATUR,39000212,P9053,HC PLATELETS LEUKOCUTES RED CMV NEG IRR,390,1 ,"$2,609.00 ","$1,695.85 ",$443.22 ,"$2,609.00 ","$1,141.78 ","$1,330.59 ","$1,434.95 ",$456.71 ,$730.52 ,"$1,226.23 ",$456.71 ,"$1,408.86 ",$456.71 ,"$1,416.69 ","$1,043.60 ",$456.71 ,"$1,416.69 ",$867.75 ,"$1,826.30 ","$1,304.50 ","$2,087.20 ","$1,141.78 ",$456.71 ,"$1,826.30 ",$456.71 ,"$1,565.40 ",$456.71 ,"$1,956.75 ","$1,440.17 ","$1,299.28 ","$1,440.17 ",$456.71 ,"$1,440.17 ","$2,035.02 ","$2,035.02 ","$2,217.65 ","$1,141.78 ","$1,808.04 ",$456.71 ,"$2,609.00 ","$1,434.95 ",$456.71 ,$686.17 ,"$2,609.00 ",$464.32 ,$443.22 ,$479.55 ,"$2,087.20 ","$1,416.69 ",$730.52 ,"$2,348.10 ",$991.42 ,$597.00 ,$456.71 ,"$1,252.32 "
ST. MARY'S HOSPITAL - DECATUR,39100001,36430,HC BLOOD PROD ADMIN,391,1 ,"$1,719.00 ","$1,117.35 ",$70.73 ,"$1,719.00 ",$939.30 ,$876.69 ,$945.45 ,$375.72 ,$481.32 ,$807.93 ,$375.72 ,$928.26 ,$375.72 ,$933.42 ,$70.73 ,$375.72 ,$933.42 ,$713.87 ,"$1,203.30 ",$859.50 ,"$1,375.20 ",$939.30 ,$375.72 ,"$1,203.30 ",$375.72 ,"$1,031.40 ",$375.72 ,"$1,289.25 ",$948.89 ,$856.06 ,$948.89 ,$375.72 ,$948.89 ,"$1,340.82 ","$1,340.82 ","$1,461.15 ",$939.30 ,"$1,191.27 ",$375.72 ,"$1,719.00 ",$945.45 ,$375.72 ,$452.10 ,"$1,719.00 ",$464.32 ,$443.22 ,$394.51 ,"$1,375.20 ",$933.42 ,$481.32 ,"$1,547.10 ",$653.22 ,$597.00 ,$375.72 ,$825.12 
ST. MARY'S HOSPITAL - DECATUR,40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$368.00 ,$239.20 ,$46.13 ,$368.00 ,$263.78 ,$222.91 ,$202.40 ,$105.51 ,$103.04 ,$180.32 ,$105.51 ,$215.28 ,$105.51 ,$199.82 ,$244.56 ,$105.51 ,$199.82 ,$200.47 ,$257.60 ,$184.00 ,$294.40 ,$263.78 ,$105.51 ,$257.60 ,$105.51 ,$220.80 ,$105.51 ,$276.00 ,$203.14 ,$183.26 ,$203.14 ,$105.51 ,$203.14 ,$166.08 ,$166.08 ,$312.80 ,$263.78 ,$255.02 ,$105.51 ,$122.32 ,$202.40 ,$105.51 ,$96.78 ,$368.00 ,$48.32 ,$46.13 ,$110.79 ,$294.40 ,$199.82 ,$103.04 ,$331.20 ,$139.84 ,$265.00 ,$105.51 ,$176.64 
ST. MARY'S HOSPITAL - DECATUR,40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$368.00 ,$239.20 ,$46.13 ,$368.00 ,$263.78 ,$222.91 ,$202.40 ,$105.51 ,$103.04 ,$180.32 ,$105.51 ,$215.28 ,$105.51 ,$199.82 ,$244.56 ,$105.51 ,$199.82 ,$200.47 ,$257.60 ,$184.00 ,$294.40 ,$263.78 ,$105.51 ,$257.60 ,$105.51 ,$220.80 ,$105.51 ,$276.00 ,$203.14 ,$183.26 ,$203.14 ,$105.51 ,$203.14 ,$166.08 ,$166.08 ,$312.80 ,$263.78 ,$255.02 ,$105.51 ,$122.32 ,$202.40 ,$105.51 ,$96.78 ,$368.00 ,$48.32 ,$46.13 ,$110.79 ,$294.40 ,$199.82 ,$103.04 ,$331.20 ,$139.84 ,$265.00 ,$105.51 ,$176.64 
ST. MARY'S HOSPITAL - DECATUR,40100006,77066,HC MAMMOGRAM DIAG W/CAD UPGRADE BIL,401,1 ,$368.00 ,$239.20 ,$46.13 ,$368.00 ,$263.78 ,$222.91 ,$202.40 ,$105.51 ,$103.04 ,$180.32 ,$105.51 ,$215.28 ,$105.51 ,$199.82 ,$244.56 ,$105.51 ,$199.82 ,$200.47 ,$257.60 ,$184.00 ,$294.40 ,$263.78 ,$105.51 ,$257.60 ,$105.51 ,$220.80 ,$105.51 ,$276.00 ,$203.14 ,$183.26 ,$203.14 ,$105.51 ,$203.14 ,$166.08 ,$166.08 ,$312.80 ,$263.78 ,$255.02 ,$105.51 ,$122.32 ,$202.40 ,$105.51 ,$96.78 ,$368.00 ,$48.32 ,$46.13 ,$110.79 ,$294.40 ,$199.82 ,$103.04 ,$331.20 ,$139.84 ,$265.00 ,$105.51 ,$176.64 
ST. MARY'S HOSPITAL - DECATUR,40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$323.00 ,$209.95 ,$46.13 ,$323.00 ,$206.95 ,$174.31 ,$177.65 ,$82.78 ,$90.44 ,$158.27 ,$82.78 ,$188.96 ,$82.78 ,$175.39 ,$191.16 ,$82.78 ,$175.39 ,$157.28 ,$226.10 ,$161.50 ,$258.40 ,$206.95 ,$82.78 ,$226.10 ,$82.78 ,$193.80 ,$82.78 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$82.78 ,$178.30 ,$129.83 ,$129.83 ,$274.55 ,$206.95 ,$223.84 ,$82.78 ,$95.73 ,$177.65 ,$82.78 ,$84.95 ,$323.00 ,$48.32 ,$46.13 ,$86.92 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 ,$265.00 ,$82.78 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$323.00 ,$209.95 ,$46.13 ,$323.00 ,$206.95 ,$174.31 ,$177.65 ,$82.78 ,$90.44 ,$158.27 ,$82.78 ,$188.96 ,$82.78 ,$175.39 ,$191.16 ,$82.78 ,$175.39 ,$157.28 ,$226.10 ,$161.50 ,$258.40 ,$206.95 ,$82.78 ,$226.10 ,$82.78 ,$193.80 ,$82.78 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$82.78 ,$178.30 ,$129.83 ,$129.83 ,$274.55 ,$206.95 ,$223.84 ,$82.78 ,$95.73 ,$177.65 ,$82.78 ,$84.95 ,$323.00 ,$48.32 ,$46.13 ,$86.92 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 ,$265.00 ,$82.78 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,40100010,77065,HC MAMMOGRAM DIAG UNIL W/CAD UPGRADE,401,1 ,$323.00 ,$209.95 ,$46.13 ,$323.00 ,$206.95 ,$174.31 ,$177.65 ,$82.78 ,$90.44 ,$158.27 ,$82.78 ,$188.96 ,$82.78 ,$175.39 ,$191.16 ,$82.78 ,$175.39 ,$157.28 ,$226.10 ,$161.50 ,$258.40 ,$206.95 ,$82.78 ,$226.10 ,$82.78 ,$193.80 ,$82.78 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$82.78 ,$178.30 ,$129.83 ,$129.83 ,$274.55 ,$206.95 ,$223.84 ,$82.78 ,$95.73 ,$177.65 ,$82.78 ,$84.95 ,$323.00 ,$48.32 ,$46.13 ,$86.92 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 ,$265.00 ,$82.78 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$161.00 ,$104.65 ,$22.09 ,$161.00 ,$55.23 ,$82.11 ,$88.55 ,$22.09 ,$45.08 ,$78.89 ,$22.09 ,$94.19 ,$22.09 ,$87.42 ,$23.18 ,$22.09 ,$87.42 ,$41.97 ,$112.70 ,$80.50 ,$128.80 ,$55.23 ,$22.09 ,$112.70 ,$22.09 ,$96.60 ,$22.09 ,$120.75 ,$88.87 ,$80.18 ,$88.87 ,$22.09 ,$88.87 ,$34.77 ,$34.77 ,$136.85 ,$55.23 ,$111.57 ,$22.09 ,$26.59 ,$88.55 ,$22.09 ,$42.34 ,$161.00 ,$48.32 ,$46.13 ,$23.19 ,$128.80 ,$87.42 ,$45.08 ,$144.90 ,$61.18 ,$161.00 ,$22.09 ,$77.28 
ST. MARY'S HOSPITAL - DECATUR,40200004,21920,HC BX SOFT TISSUE BACK/FLANK SUP,402,1 ,"$4,380.00 ","$2,847.00 ",$356.25 ,"$4,380.00 ","$3,329.73 ","$2,233.80 ","$2,409.00 ","$1,331.89 ","$1,226.40 ","$2,058.60 ","$1,331.89 ","$2,365.20 ","$1,331.89 ","$2,378.34 ",$356.25 ,"$1,331.89 ","$2,378.34 ","$2,530.59 ","$3,066.00 ","$2,190.00 ","$3,504.00 ","$3,329.72 ","$1,331.89 ","$3,066.00 ","$1,331.89 ","$2,628.00 ","$1,331.89 ","$3,285.00 ","$2,417.76 ","$2,181.24 ","$2,417.76 ","$1,331.89 ","$2,417.76 ","$3,066.00 ","$3,066.00 ","$3,723.00 ","$3,329.72 ","$3,035.34 ","$1,331.89 ","$4,380.00 ","$2,409.00 ","$1,331.89 ","$1,151.94 ","$4,380.00 ",$450.77 ,$430.28 ,"$1,398.48 ","$3,504.00 ","$2,378.34 ","$1,226.40 ","$3,942.00 ","$1,664.40 ",$775.00 ,"$1,331.89 ","$2,102.40 "
ST. MARY'S HOSPITAL - DECATUR,40200007,51798,HC US BLADDER SCAN,402,1 ,$399.00 ,$259.35 ,$41.02 ,$399.00 ,$131.73 ,$203.49 ,$219.45 ,$52.69 ,$111.72 ,$187.53 ,$52.69 ,$215.46 ,$52.69 ,$216.66 ,$41.02 ,$52.69 ,$216.66 ,$100.11 ,$279.30 ,$199.50 ,$319.20 ,$131.73 ,$52.69 ,$279.30 ,$52.69 ,$239.40 ,$52.69 ,$299.25 ,$220.25 ,$198.70 ,$220.25 ,$52.69 ,$220.25 ,$279.30 ,$279.30 ,$339.15 ,$131.73 ,$276.51 ,$52.69 ,$399.00 ,$219.45 ,$52.69 ,$104.94 ,$399.00 ,$83.53 ,$79.74 ,$55.32 ,$319.20 ,$216.66 ,$111.72 ,$359.10 ,$151.62 ,$399.00 ,$52.69 ,$191.52 
ST. MARY'S HOSPITAL - DECATUR,40200009,49407,HC DRAIN ABSC PELVIC TRNSVAG PERC,402,1 ,"$6,673.00 ","$4,337.45 ",$372.71 ,"$6,673.00 ","$3,329.73 ","$3,403.23 ","$3,670.15 ","$1,331.89 ","$1,868.44 ","$3,136.31 ","$1,331.89 ","$3,603.42 ","$1,331.89 ","$3,623.44 ",$372.71 ,"$1,331.89 ","$3,623.44 ","$2,530.59 ","$4,671.10 ","$3,336.50 ","$5,338.40 ","$3,329.72 ","$1,331.89 ","$4,671.10 ","$1,331.89 ","$4,003.80 ","$1,331.89 ","$5,004.75 ","$3,683.50 ","$3,323.15 ","$3,683.50 ","$1,331.89 ","$3,683.50 ","$4,671.10 ","$4,671.10 ","$5,672.05 ","$3,329.72 ","$4,624.39 ","$1,331.89 ","$6,673.00 ","$3,670.15 ","$1,331.89 ","$1,755.00 ","$6,673.00 ",$483.89 ,$461.90 ,"$1,398.48 ","$5,338.40 ","$3,623.44 ","$1,868.44 ","$6,005.70 ","$2,535.74 ",$775.00 ,"$1,331.89 ","$3,203.04 "
ST. MARY'S HOSPITAL - DECATUR,40200010,59000,HC AMNIOCENTESIS DIAGNOSTIC,402,1 ,"$1,527.00 ",$992.55 ,$152.06 ,"$1,527.00 ","$1,500.28 ",$778.77 ,$839.85 ,$600.11 ,$427.56 ,$717.69 ,$600.11 ,$824.58 ,$600.11 ,$829.16 ,$152.06 ,$600.11 ,$829.16 ,"$1,140.22 ","$1,068.90 ",$763.50 ,"$1,221.60 ","$1,500.29 ",$600.11 ,"$1,068.90 ",$600.11 ,$916.20 ,$600.11 ,"$1,145.25 ",$842.90 ,$760.45 ,$842.90 ,$600.11 ,$842.90 ,"$1,068.90 ","$1,068.90 ","$1,297.95 ","$1,500.29 ","$1,058.21 ",$600.11 ,"$1,527.00 ",$839.85 ,$600.11 ,$401.60 ,"$1,527.00 ", N/A , N/A ,$630.12 ,"$1,221.60 ",$829.16 ,$427.56 ,"$1,374.30 ",$580.26 ,$775.00 ,$600.11 ,$732.96 
ST. MARY'S HOSPITAL - DECATUR,40200012,76506,HC US ENCEPHALOGRAM,402,1 ,$407.00 ,$264.55 ,$101.56 ,$407.00 ,$257.65 ,$117.97 ,$223.85 ,$103.06 ,$113.96 ,$199.43 ,$103.06 ,$238.10 ,$103.06 ,$221.00 ,$172.14 ,$103.06 ,$221.00 ,$195.81 ,$284.90 ,$203.50 ,$325.60 ,$257.64 ,$103.06 ,$284.90 ,$103.06 ,$244.20 ,$103.06 ,$305.25 ,$224.66 ,$202.69 ,$224.66 ,$103.06 ,$224.66 ,$116.91 ,$116.91 ,$345.95 ,$257.64 ,$282.05 ,$103.06 ,$407.00 ,$223.85 ,$103.06 ,$107.04 ,$407.00 ,$106.39 ,$101.56 ,$108.21 ,$325.60 ,$221.00 ,$113.96 ,$366.30 ,$154.66 ,$407.00 ,$103.06 ,$195.36 
ST. MARY'S HOSPITAL - DECATUR,40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,$899.00 ,$584.35 ,$101.56 ,$899.00 ,$257.65 ,$178.04 ,$494.45 ,$103.06 ,$251.72 ,$440.51 ,$103.06 ,$525.92 ,$103.06 ,$488.16 ,$179.45 ,$103.06 ,$488.16 ,$195.81 ,$629.30 ,$449.50 ,$719.20 ,$257.64 ,$103.06 ,$629.30 ,$103.06 ,$539.40 ,$103.06 ,$674.25 ,$496.25 ,$447.70 ,$496.25 ,$103.06 ,$496.25 ,$121.88 ,$121.88 ,$764.15 ,$257.64 ,$623.01 ,$103.06 ,$899.00 ,$494.45 ,$103.06 ,$236.44 ,$899.00 ,$106.39 ,$101.56 ,$108.21 ,$719.20 ,$488.16 ,$251.72 ,$809.10 ,$341.62 ,$775.00 ,$103.06 ,$431.52 
ST. MARY'S HOSPITAL - DECATUR,40200014,76604,HC US CHEST,402,1 ,$651.00 ,$423.15 ,$86.60 ,$651.00 ,$257.65 ,$115.49 ,$358.05 ,$103.06 ,$182.28 ,$318.99 ,$103.06 ,$380.84 ,$103.06 ,$353.49 ,$127.52 ,$103.06 ,$353.49 ,$195.81 ,$455.70 ,$325.50 ,$520.80 ,$257.64 ,$103.06 ,$455.70 ,$103.06 ,$390.60 ,$103.06 ,$488.25 ,$359.35 ,$324.20 ,$359.35 ,$103.06 ,$359.35 ,$86.60 ,$86.60 ,$553.35 ,$257.64 ,$451.14 ,$103.06 ,$651.00 ,$358.05 ,$103.06 ,$171.21 ,$651.00 ,$106.39 ,$101.56 ,$108.21 ,$520.80 ,$353.49 ,$182.28 ,$585.90 ,$247.38 ,$651.00 ,$103.06 ,$312.48 
ST. MARY'S HOSPITAL - DECATUR,40200015,76641,HC US BREAST COMPLETE,402,1 ,$823.00 ,$534.95 ,$76.42 ,$823.00 ,$257.65 ,$131.06 ,$452.65 ,$103.06 ,$230.44 ,$403.27 ,$103.06 ,$481.46 ,$103.06 ,$446.89 ,$145.07 ,$103.06 ,$446.89 ,$195.81 ,$576.10 ,$411.50 ,$658.40 ,$257.64 ,$103.06 ,$576.10 ,$103.06 ,$493.80 ,$103.06 ,$617.25 ,$454.30 ,$409.85 ,$454.30 ,$103.06 ,$454.30 ,$98.52 ,$98.52 ,$699.55 ,$257.64 ,$570.34 ,$103.06 ,$76.42 ,$452.65 ,$103.06 ,$216.45 ,$823.00 ,$106.39 ,$101.56 ,$108.21 ,$658.40 ,$446.89 ,$230.44 ,$740.70 ,$312.74 ,$775.00 ,$103.06 ,$395.04 
ST. MARY'S HOSPITAL - DECATUR,40200016,76642,HC US BREAST LIMITED,402,1 ,$606.00 ,$393.90 ,$58.57 ,$606.00 ,$191.43 ,$100.49 ,$333.30 ,$76.57 ,$169.68 ,$296.94 ,$76.57 ,$354.51 ,$76.57 ,$329.06 ,$109.96 ,$76.57 ,$329.06 ,$145.48 ,$424.20 ,$303.00 ,$484.80 ,$191.42 ,$76.57 ,$424.20 ,$76.57 ,$363.60 ,$76.57 ,$454.50 ,$334.51 ,$301.79 ,$334.51 ,$76.57 ,$334.51 ,$74.67 ,$74.67 ,$515.10 ,$191.42 ,$419.96 ,$76.57 ,$58.57 ,$333.30 ,$76.57 ,$159.38 ,$606.00 ,$106.39 ,$101.56 ,$80.40 ,$484.80 ,$329.06 ,$169.68 ,$545.40 ,$230.28 ,$606.00 ,$76.57 ,$290.88 
ST. MARY'S HOSPITAL - DECATUR,40200017,76700,HC US ABDOMEN CMPL,402,1 ,"$1,452.00 ",$943.80 ,$101.56 ,"$1,452.00 ",$257.65 ,$181.13 ,$798.60 ,$103.06 ,$406.56 ,$711.48 ,$103.06 ,$849.42 ,$103.06 ,$788.44 ,$167.02 ,$103.06 ,$788.44 ,$195.81 ,"$1,016.40 ",$726.00 ,"$1,161.60 ",$257.64 ,$103.06 ,"$1,016.40 ",$103.06 ,$871.20 ,$103.06 ,"$1,089.00 ",$801.50 ,$723.10 ,$801.50 ,$103.06 ,$801.50 ,$113.43 ,$113.43 ,"$1,234.20 ",$257.64 ,"$1,006.24 ",$103.06 ,"$1,452.00 ",$798.60 ,$103.06 ,$381.88 ,"$1,452.00 ",$106.39 ,$101.56 ,$108.21 ,"$1,161.60 ",$788.44 ,$406.56 ,"$1,306.80 ",$551.76 ,$775.00 ,$103.06 ,$696.96 
ST. MARY'S HOSPITAL - DECATUR,40200018,76705,HC US ABDOMEN LTD,402,1 ,$979.00 ,$636.35 ,$86.10 ,$979.00 ,$257.65 ,$149.54 ,$538.45 ,$103.06 ,$274.12 ,$479.71 ,$103.06 ,$572.72 ,$103.06 ,$531.60 ,$126.78 ,$103.06 ,$531.60 ,$195.81 ,$685.30 ,$489.50 ,$783.20 ,$257.64 ,$103.06 ,$685.30 ,$103.06 ,$587.40 ,$103.06 ,$734.25 ,$540.41 ,$487.54 ,$540.41 ,$103.06 ,$540.41 ,$86.10 ,$86.10 ,$832.15 ,$257.64 ,$678.45 ,$103.06 ,$979.00 ,$538.45 ,$103.06 ,$257.48 ,$979.00 ,$106.39 ,$101.56 ,$108.21 ,$783.20 ,$531.60 ,$274.12 ,$881.10 ,$372.02 ,$775.00 ,$103.06 ,$469.92 
ST. MARY'S HOSPITAL - DECATUR,40200019,76770,HC US RETROPERITIONEAL,402,1 ,"$1,184.00 ",$769.60 ,$101.56 ,"$1,184.00 ",$257.65 ,$181.13 ,$651.20 ,$103.06 ,$331.52 ,$580.16 ,$103.06 ,$692.64 ,$103.06 ,$642.91 ,$156.04 ,$103.06 ,$642.91 ,$195.81 ,$828.80 ,$592.00 ,$947.20 ,$257.64 ,$103.06 ,$828.80 ,$103.06 ,$710.40 ,$103.06 ,$888.00 ,$653.57 ,$589.63 ,$653.57 ,$103.06 ,$653.57 ,$105.98 ,$105.98 ,"$1,006.40 ",$257.64 ,$820.51 ,$103.06 ,"$1,184.00 ",$651.20 ,$103.06 ,$311.39 ,"$1,184.00 ",$106.39 ,$101.56 ,$108.21 ,$947.20 ,$642.91 ,$331.52 ,"$1,065.60 ",$449.92 ,$775.00 ,$103.06 ,$568.32 
ST. MARY'S HOSPITAL - DECATUR,40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,"$1,163.00 ",$755.95 ,$41.39 ,"$1,163.00 ",$257.65 ,$151.40 ,$639.65 ,$103.06 ,$325.64 ,$527.38 ,$103.06 ,$527.38 ,$103.06 ,$631.51 ,$60.95 ,$103.06 ,$631.51 ,$195.81 ,$814.10 ,$581.50 ,$930.40 ,$257.64 ,$103.06 ,$814.10 ,$103.06 ,$697.80 ,$103.06 ,$872.25 ,$641.98 ,$579.17 ,$641.98 ,$103.06 ,$641.98 ,$41.39 ,$41.39 ,$988.55 ,$257.64 ,$805.96 ,$103.06 ,"$1,163.00 ",$639.65 ,$103.06 ,$305.87 ,"$1,163.00 ",$106.39 ,$101.56 ,$108.21 ,$930.40 ,$631.51 ,$325.64 ,"$1,046.70 ",$441.94 ,$775.00 ,$103.06 ,$558.24 
ST. MARY'S HOSPITAL - DECATUR,40200021,76776,HC US KIDNEY TRANSPLANT W/DOPPLER,402,1 ,"$1,209.00 ",$785.85 ,$101.56 ,"$1,209.00 ",$257.65 ,$218.90 ,$664.95 ,$103.06 ,$338.52 ,$592.41 ,$103.06 ,$707.27 ,$103.06 ,$656.49 ,$241.63 ,$103.06 ,$656.49 ,$195.81 ,$846.30 ,$604.50 ,$967.20 ,$257.64 ,$103.06 ,$846.30 ,$103.06 ,$725.40 ,$103.06 ,$906.75 ,$667.37 ,$602.08 ,$667.37 ,$103.06 ,$667.37 ,$164.10 ,$164.10 ,"$1,027.65 ",$257.64 ,$837.84 ,$103.06 ,"$1,209.00 ",$664.95 ,$103.06 ,$317.97 ,"$1,209.00 ",$106.39 ,$101.56 ,$108.21 ,$967.20 ,$656.49 ,$338.52 ,"$1,088.10 ",$459.42 ,$775.00 ,$103.06 ,$580.32 
ST. MARY'S HOSPITAL - DECATUR,40200022,76800,HC US SPINAL CANAL  AND  CONTENTS,402,1 ,$899.00 ,$584.35 ,$101.56 ,$899.00 ,$257.65 ,$143.98 ,$494.45 ,$103.06 ,$251.72 ,$440.51 ,$103.06 ,$525.92 ,$103.06 ,$488.16 ,$172.87 ,$103.06 ,$488.16 ,$195.81 ,$629.30 ,$449.50 ,$719.20 ,$257.64 ,$103.06 ,$629.30 ,$103.06 ,$539.40 ,$103.06 ,$674.25 ,$496.25 ,$447.70 ,$496.25 ,$103.06 ,$496.25 ,$117.41 ,$117.41 ,$764.15 ,$257.64 ,$623.01 ,$103.06 ,$899.00 ,$494.45 ,$103.06 ,$236.44 ,$899.00 ,$106.39 ,$101.56 ,$108.21 ,$719.20 ,$488.16 ,$251.72 ,$809.10 ,$341.62 ,$775.00 ,$103.06 ,$431.52 
ST. MARY'S HOSPITAL - DECATUR,40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,$890.00 ,$578.50 ,$101.51 ,$890.00 ,$257.65 ,$147.69 ,$489.50 ,$103.06 ,$249.20 ,$436.10 ,$103.06 ,$520.65 ,$103.06 ,$483.27 ,$149.46 ,$103.06 ,$483.27 ,$195.81 ,$623.00 ,$445.00 ,$712.00 ,$257.64 ,$103.06 ,$623.00 ,$103.06 ,$534.00 ,$103.06 ,$667.50 ,$491.28 ,$443.22 ,$491.28 ,$103.06 ,$491.28 ,$101.51 ,$101.51 ,$756.50 ,$257.64 ,$616.77 ,$103.06 ,$890.00 ,$489.50 ,$103.06 ,$234.07 ,$890.00 , N/A , N/A ,$108.21 ,$712.00 ,$483.27 ,$249.20 ,$801.00 ,$338.20 ,$775.00 ,$103.06 ,$427.20 
ST. MARY'S HOSPITAL - DECATUR,40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$563.00 ,$365.95 ,$30.30 ,$563.00 , N/A ,$48.60 ,$309.65 , N/A ,$157.64 ,$275.87 , N/A ,$319.97 , N/A ,$305.71 ,$44.62 , N/A ,$305.71 , N/A ,$394.10 ,$281.50 ,$450.40 , N/A , N/A ,$394.10 , N/A ,$337.80 , N/A ,$422.25 ,$310.78 ,$280.37 ,$310.78 , N/A ,$310.78 ,$30.30 ,$30.30 ,$478.55 , N/A ,$390.16 , N/A ,$563.00 ,$309.65 , N/A ,$148.07 ,$563.00 , N/A , N/A , N/A ,$450.40 ,$305.71 ,$157.64 ,$506.70 ,$213.94 ,$563.00 , N/A ,$270.24 
ST. MARY'S HOSPITAL - DECATUR,40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,"$1,172.00 ",$761.80 ,$103.06 ,"$1,172.00 ",$257.65 ,$181.13 ,$644.60 ,$103.06 ,$328.16 ,$574.28 ,$103.06 ,$685.62 ,$103.06 ,$636.40 ,$186.04 ,$103.06 ,$636.40 ,$195.81 ,$820.40 ,$586.00 ,$937.60 ,$257.64 ,$103.06 ,$820.40 ,$103.06 ,$703.20 ,$103.06 ,$879.00 ,$646.94 ,$583.66 ,$646.94 ,$103.06 ,$646.94 ,$126.35 ,$126.35 ,$996.20 ,$257.64 ,$812.20 ,$103.06 ,"$1,172.00 ",$644.60 ,$103.06 ,$308.24 ,"$1,172.00 ", N/A , N/A ,$108.21 ,$937.60 ,$636.40 ,$328.16 ,"$1,054.80 ",$445.36 ,$775.00 ,$103.06 ,$562.56 
ST. MARY'S HOSPITAL - DECATUR,40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,$563.00 ,$365.95 ,$59.61 ,$563.00 , N/A ,$92.57 ,$309.65 , N/A ,$157.64 ,$275.87 , N/A ,$329.36 , N/A ,$305.71 ,$87.78 , N/A ,$305.71 , N/A ,$394.10 ,$281.50 ,$450.40 , N/A , N/A ,$394.10 , N/A ,$337.80 , N/A ,$422.25 ,$310.78 ,$280.37 ,$310.78 , N/A ,$310.78 ,$59.61 ,$59.61 ,$478.55 , N/A ,$390.16 , N/A ,$563.00 ,$309.65 , N/A ,$148.07 ,$563.00 , N/A , N/A , N/A ,$450.40 ,$305.71 ,$157.64 ,$506.70 ,$213.94 ,$563.00 , N/A ,$270.24 
ST. MARY'S HOSPITAL - DECATUR,40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,"$1,221.00 ",$793.65 ,$117.06 ,"$1,221.00 ",$544.53 ,$174.94 ,$671.55 ,$217.81 ,$341.88 ,$598.29 ,$217.81 ,$714.29 ,$217.81 ,$663.00 ,$172.37 ,$217.81 ,$663.00 ,$413.84 ,$854.70 ,$610.50 ,$976.80 ,$544.53 ,$217.81 ,$854.70 ,$217.81 ,$732.60 ,$217.81 ,$915.75 ,$673.99 ,$608.06 ,$673.99 ,$217.81 ,$673.99 ,$117.06 ,$117.06 ,"$1,037.85 ",$544.53 ,$846.15 ,$217.81 ,"$1,221.00 ",$671.55 ,$217.81 ,$321.12 ,"$1,221.00 ", N/A , N/A ,$228.70 ,$976.80 ,$663.00 ,$341.88 ,"$1,098.90 ",$463.98 ,$775.00 ,$217.81 ,$586.08 
ST. MARY'S HOSPITAL - DECATUR,40200029,76812,HC US PREGNANCY DETAILED ADDL,402,1 ,$906.00 ,$588.90 ,$117.97 ,$906.00 , N/A ,$117.97 ,$498.30 , N/A ,$253.68 ,$443.94 , N/A ,$530.01 , N/A ,$491.96 ,$227.00 , N/A ,$491.96 , N/A ,$634.20 ,$453.00 ,$724.80 , N/A , N/A ,$634.20 , N/A ,$543.60 , N/A ,$679.50 ,$500.11 ,$451.19 ,$500.11 , N/A ,$500.11 ,$154.17 ,$154.17 ,$770.10 , N/A ,$627.86 , N/A ,$906.00 ,$498.30 , N/A ,$238.28 ,$906.00 , N/A , N/A , N/A ,$724.80 ,$491.96 ,$253.68 ,$815.40 ,$344.28 ,$775.00 , N/A ,$434.88 
ST. MARY'S HOSPITAL - DECATUR,40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,"$1,172.00 ",$761.80 ,$99.02 ,"$1,172.00 ",$257.65 ,$117.97 ,$644.60 ,$103.06 ,$328.16 ,$574.28 ,$103.06 ,$685.62 ,$103.06 ,$636.40 ,$145.80 ,$103.06 ,$636.40 ,$195.81 ,$820.40 ,$586.00 ,$937.60 ,$257.64 ,$103.06 ,$820.40 ,$103.06 ,$703.20 ,$103.06 ,$879.00 ,$646.94 ,$583.66 ,$646.94 ,$103.06 ,$646.94 ,$99.02 ,$99.02 ,$996.20 ,$257.64 ,$812.20 ,$103.06 ,"$1,172.00 ",$644.60 ,$103.06 ,$308.24 ,"$1,172.00 ", N/A , N/A ,$108.21 ,$937.60 ,$636.40 ,$328.16 ,"$1,054.80 ",$445.36 ,$775.00 ,$103.06 ,$562.56 
ST. MARY'S HOSPITAL - DECATUR,40200031,76815,HC US FETAL HEART BEAT,402,1 ,$737.00 ,$479.05 ,$72.20 ,$737.00 ,$257.65 ,$111.15 ,$405.35 ,$103.06 ,$206.36 ,$361.13 ,$103.06 ,$431.15 ,$103.06 ,$400.19 ,$106.30 ,$103.06 ,$400.19 ,$195.81 ,$515.90 ,$368.50 ,$589.60 ,$257.64 ,$103.06 ,$515.90 ,$103.06 ,$442.20 ,$103.06 ,$552.75 ,$406.82 ,$367.03 ,$406.82 ,$103.06 ,$406.82 ,$72.20 ,$72.20 ,$626.45 ,$257.64 ,$510.74 ,$103.06 ,$737.00 ,$405.35 ,$103.06 ,$193.83 ,$737.00 , N/A , N/A ,$108.21 ,$589.60 ,$400.19 ,$206.36 ,$663.30 ,$280.06 ,$737.00 ,$103.06 ,$353.76 
ST. MARY'S HOSPITAL - DECATUR,40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,$563.00 ,$365.95 ,$82.13 ,$563.00 ,$257.65 ,$117.97 ,$309.65 ,$103.06 ,$157.64 ,$275.87 ,$103.06 ,$329.36 ,$103.06 ,$305.71 ,$120.93 ,$103.06 ,$305.71 ,$195.81 ,$394.10 ,$281.50 ,$450.40 ,$257.64 ,$103.06 ,$394.10 ,$103.06 ,$337.80 ,$103.06 ,$422.25 ,$310.78 ,$280.37 ,$310.78 ,$103.06 ,$310.78 ,$82.13 ,$82.13 ,$478.55 ,$257.64 ,$390.16 ,$103.06 ,$563.00 ,$309.65 ,$103.06 ,$148.07 ,$563.00 , N/A , N/A ,$108.21 ,$450.40 ,$305.71 ,$157.64 ,$506.70 ,$213.94 ,$563.00 ,$103.06 ,$270.24 
ST. MARY'S HOSPITAL - DECATUR,40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,$914.00 ,$594.10 ,$69.71 ,$914.00 ,$257.65 ,$98.15 ,$502.70 ,$103.06 ,$255.92 ,$447.86 ,$103.06 ,$534.69 ,$103.06 ,$496.30 ,$102.64 ,$103.06 ,$496.30 ,$195.81 ,$639.80 ,$457.00 ,$731.20 ,$257.64 ,$103.06 ,$639.80 ,$103.06 ,$548.40 ,$103.06 ,$685.50 ,$504.53 ,$455.17 ,$504.53 ,$103.06 ,$504.53 ,$69.71 ,$69.71 ,$776.90 ,$257.64 ,$633.40 ,$103.06 ,$914.00 ,$502.70 ,$103.06 ,$240.38 ,$914.00 , N/A , N/A ,$108.21 ,$731.20 ,$496.30 ,$255.92 ,$822.60 ,$347.32 ,$775.00 ,$103.06 ,$438.72 
ST. MARY'S HOSPITAL - DECATUR,40200035,76819,HC US FETAL BIO PROFILE W/O NST EA ADDN,402,1 ,$914.00 ,$594.10 ,$69.71 ,$914.00 ,$257.65 ,$98.15 ,$502.70 ,$103.06 ,$255.92 ,$447.86 ,$103.06 ,$534.69 ,$103.06 ,$496.30 ,$102.64 ,$103.06 ,$496.30 ,$195.81 ,$639.80 ,$457.00 ,$731.20 ,$257.64 ,$103.06 ,$639.80 ,$103.06 ,$548.40 ,$103.06 ,$685.50 ,$504.53 ,$455.17 ,$504.53 ,$103.06 ,$504.53 ,$69.71 ,$69.71 ,$776.90 ,$257.64 ,$633.40 ,$103.06 ,$914.00 ,$502.70 ,$103.06 ,$240.38 ,$914.00 , N/A , N/A ,$108.21 ,$731.20 ,$496.30 ,$255.92 ,$822.60 ,$347.32 ,$775.00 ,$103.06 ,$438.72 
ST. MARY'S HOSPITAL - DECATUR,40200036,76820,HC US FETAL DOPLR VELO UMB,402,1 ,$516.00 ,$335.40 ,$30.02 ,$516.00 ,$257.65 ,$30.02 ,$283.80 ,$103.06 ,$144.48 ,$252.84 ,$103.06 ,$301.86 ,$103.06 ,$280.19 ,$45.58 ,$103.06 ,$280.19 ,$195.81 ,$361.20 ,$258.00 ,$412.80 ,$257.64 ,$103.06 ,$361.20 ,$103.06 ,$309.60 ,$103.06 ,$387.00 ,$284.83 ,$256.97 ,$284.83 ,$103.06 ,$284.83 ,$30.96 ,$30.96 ,$438.60 ,$257.64 ,$357.59 ,$103.06 ,$516.00 ,$283.80 ,$103.06 ,$135.71 ,$516.00 , N/A , N/A ,$108.21 ,$412.80 ,$280.19 ,$144.48 ,$464.40 ,$196.08 ,$516.00 ,$103.06 ,$247.68 
ST. MARY'S HOSPITAL - DECATUR,40200038,76830,HC US TRANSVAGINAL,402,1 ,"$1,076.00 ",$699.40 ,$77.72 ,"$1,076.00 ",$257.65 ,$77.72 ,$591.80 ,$103.06 ,$301.28 ,$527.24 ,$103.06 ,$629.46 ,$103.06 ,$584.27 ,$179.45 ,$103.06 ,$584.27 ,$195.81 ,$753.20 ,$538.00 ,$860.80 ,$257.64 ,$103.06 ,$753.20 ,$103.06 ,$645.60 ,$103.06 ,$807.00 ,$593.95 ,$535.85 ,$593.95 ,$103.06 ,$593.95 ,$121.88 ,$121.88 ,$914.60 ,$257.64 ,$745.67 ,$103.06 ,"$1,076.00 ",$591.80 ,$103.06 ,$282.99 ,"$1,076.00 ",$106.39 ,$101.56 ,$108.21 ,$860.80 ,$584.27 ,$301.28 ,$968.40 ,$408.88 ,$775.00 ,$103.06 ,$516.48 
ST. MARY'S HOSPITAL - DECATUR,40200039,76831,HC US HYSTEROSONOGRAM,402,1 ,$959.00 ,$623.35 ,$114.92 ,$959.00 ,$544.53 ,$169.99 ,$527.45 ,$217.81 ,$268.52 ,$469.91 ,$217.81 ,$561.02 ,$217.81 ,$520.74 ,$169.21 ,$217.81 ,$520.74 ,$413.84 ,$671.30 ,$479.50 ,$767.20 ,$544.53 ,$217.81 ,$671.30 ,$217.81 ,$575.40 ,$217.81 ,$719.25 ,$529.37 ,$477.58 ,$529.37 ,$217.81 ,$529.37 ,$114.92 ,$114.92 ,$815.15 ,$544.53 ,$664.59 ,$217.81 ,$959.00 ,$527.45 ,$217.81 ,$252.22 ,$959.00 ,$242.84 ,$231.80 ,$228.70 ,$767.20 ,$520.74 ,$268.52 ,$863.10 ,$364.42 ,$775.00 ,$217.81 ,$460.32 
ST. MARY'S HOSPITAL - DECATUR,40200040,76856,HC US PELVIS NON OB,402,1 ,"$1,105.00 ",$718.25 ,$81.89 ,"$1,105.00 ",$257.65 ,$171.23 ,$607.75 ,$103.06 ,$309.40 ,$541.45 ,$103.06 ,$646.43 ,$103.06 ,$600.02 ,$154.58 ,$103.06 ,$600.02 ,$195.81 ,$773.50 ,$552.50 ,$884.00 ,$257.64 ,$103.06 ,$773.50 ,$103.06 ,$663.00 ,$103.06 ,$828.75 ,$609.96 ,$550.29 ,$609.96 ,$103.06 ,$609.96 ,$104.99 ,$104.99 ,$939.25 ,$257.64 ,$765.77 ,$103.06 ,$81.89 ,$607.75 ,$103.06 ,$290.62 ,"$1,105.00 ",$106.39 ,$101.56 ,$108.21 ,$884.00 ,$600.02 ,$309.40 ,$994.50 ,$419.90 ,$775.00 ,$103.06 ,$530.40 
ST. MARY'S HOSPITAL - DECATUR,40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$431.00 ,$280.15 ,$33.44 ,$431.00 ,$257.65 ,$117.97 ,$237.05 ,$103.06 ,$120.68 ,$211.19 ,$103.06 ,$252.14 ,$103.06 ,$234.03 ,$49.24 ,$103.06 ,$234.03 ,$195.81 ,$301.70 ,$215.50 ,$344.80 ,$257.64 ,$103.06 ,$301.70 ,$103.06 ,$258.60 ,$103.06 ,$323.25 ,$237.91 ,$214.64 ,$237.91 ,$103.06 ,$237.91 ,$33.44 ,$33.44 ,$366.35 ,$257.64 ,$298.68 ,$103.06 ,$431.00 ,$237.05 ,$103.06 ,$113.35 ,$431.00 ,$106.39 ,$101.56 ,$108.21 ,$344.80 ,$234.03 ,$120.68 ,$387.90 ,$163.78 ,$431.00 ,$103.06 ,$206.88 
ST. MARY'S HOSPITAL - DECATUR,40200042,76870,HC US SCROTUM,402,1 ,$961.00 ,$624.65 ,$101.56 ,$961.00 ,$257.65 ,$174.94 ,$528.55 ,$103.06 ,$269.08 ,$470.89 ,$103.06 ,$562.19 ,$103.06 ,$521.82 ,$150.92 ,$103.06 ,$521.82 ,$195.81 ,$672.70 ,$480.50 ,$768.80 ,$257.64 ,$103.06 ,$672.70 ,$103.06 ,$576.60 ,$103.06 ,$720.75 ,$530.47 ,$478.58 ,$530.47 ,$103.06 ,$530.47 ,$102.50 ,$102.50 ,$816.85 ,$257.64 ,$665.97 ,$103.06 ,$961.00 ,$528.55 ,$103.06 ,$252.74 ,$961.00 ,$106.39 ,$101.56 ,$108.21 ,$768.80 ,$521.82 ,$269.08 ,$864.90 ,$365.18 ,$775.00 ,$103.06 ,$461.28 
ST. MARY'S HOSPITAL - DECATUR,40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$899.00 ,$584.35 ,$80.15 ,$899.00 ,$257.65 ,$170.60 ,$494.45 ,$103.06 ,$251.72 ,$440.51 ,$103.06 ,$525.92 ,$103.06 ,$488.16 ,$118.01 ,$103.06 ,$488.16 ,$195.81 ,$629.30 ,$449.50 ,$719.20 ,$257.64 ,$103.06 ,$629.30 ,$103.06 ,$539.40 ,$103.06 ,$674.25 ,$496.25 ,$447.70 ,$496.25 ,$103.06 ,$496.25 ,$80.15 ,$80.15 ,$764.15 ,$257.64 ,$623.01 ,$103.06 ,$899.00 ,$494.45 ,$103.06 ,$236.44 ,$899.00 ,$106.39 ,$101.56 ,$108.21 ,$719.20 ,$488.16 ,$251.72 ,$809.10 ,$341.62 ,$775.00 ,$103.06 ,$431.52 
ST. MARY'S HOSPITAL - DECATUR,40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$627.00 ,$407.55 ,$21.35 ,$627.00 ,$257.65 ,$21.35 ,$344.85 ,$103.06 ,$175.56 ,$307.23 ,$103.06 ,$366.80 ,$103.06 ,$340.46 ,$67.53 ,$103.06 ,$340.46 ,$195.81 ,$438.90 ,$313.50 ,$501.60 ,$257.64 ,$103.06 ,$438.90 ,$103.06 ,$376.20 ,$103.06 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$103.06 ,$346.10 ,$45.86 ,$45.86 ,$532.95 ,$257.64 ,$434.51 ,$103.06 ,$627.00 ,$344.85 ,$103.06 ,$164.90 ,$627.00 ,$106.39 ,$101.56 ,$108.21 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$627.00 ,$103.06 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,40200048,76885,HC US HIPS INFANT DYNAMIC,402,1 ,$556.00 ,$361.40 ,$76.57 ,$556.00 ,$191.43 ,$117.97 ,$305.80 ,$76.57 ,$155.68 ,$272.44 ,$76.57 ,$325.26 ,$76.57 ,$301.91 ,$218.96 ,$76.57 ,$301.91 ,$145.48 ,$389.20 ,$278.00 ,$444.80 ,$191.42 ,$76.57 ,$389.20 ,$76.57 ,$333.60 ,$76.57 ,$417.00 ,$306.91 ,$276.89 ,$306.91 ,$76.57 ,$306.91 ,$86.10 ,$86.10 ,$472.60 ,$191.42 ,$385.31 ,$76.57 ,$556.00 ,$305.80 ,$76.57 ,$146.23 ,$556.00 , N/A , N/A ,$80.40 ,$444.80 ,$301.91 ,$155.68 ,$500.40 ,$211.28 ,$556.00 ,$76.57 ,$266.88 
ST. MARY'S HOSPITAL - DECATUR,40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,$893.00 ,$580.45 ,$27.33 ,$893.00 , N/A ,$39.94 ,$491.15 , N/A ,$250.04 ,$239.95 , N/A ,$239.95 , N/A ,$484.90 ,$40.23 , N/A ,$484.90 , N/A ,$625.10 ,$446.50 ,$714.40 , N/A , N/A ,$625.10 , N/A ,$535.80 , N/A ,$669.75 ,$492.94 ,$444.71 ,$492.94 , N/A ,$492.94 ,$27.33 ,$27.33 ,$759.05 , N/A ,$618.85 , N/A ,$893.00 ,$491.15 , N/A ,$234.86 ,$893.00 ,$77.64 ,$74.11 , N/A ,$714.40 ,$484.90 ,$250.04 ,$803.70 ,$339.34 ,$775.00 , N/A ,$428.64 
ST. MARY'S HOSPITAL - DECATUR,40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,"$1,201.00 ",$780.65 ,$29.07 ,"$1,201.00 ", N/A ,$320.47 ,$660.55 , N/A ,$336.28 ,$456.31 , N/A ,$456.31 , N/A ,$652.14 ,$51.44 , N/A ,$652.14 , N/A ,$840.70 ,$600.50 ,$960.80 , N/A , N/A ,$840.70 , N/A ,$720.60 , N/A ,$900.75 ,$662.95 ,$598.10 ,$662.95 , N/A ,$662.95 ,$34.94 ,$34.94 ,"$1,020.85 ", N/A ,$832.29 , N/A ,$29.07 ,$660.55 , N/A ,$315.86 ,"$1,201.00 ",$77.64 ,$74.11 , N/A ,$960.80 ,$652.14 ,$336.28 ,"$1,080.90 ",$456.38 ,$775.00 , N/A ,$576.48 
ST. MARY'S HOSPITAL - DECATUR,40200059,76946,HC US GUIDED AMNIOCENTESIS,402,1 ,$579.00 ,$376.35 ,$18.54 ,$579.00 , N/A ,$25.67 ,$318.45 , N/A ,$162.12 ,$189.33 , N/A ,$189.33 , N/A ,$314.40 ,$27.30 , N/A ,$314.40 , N/A ,$405.30 ,$289.50 ,$463.20 , N/A , N/A ,$405.30 , N/A ,$347.40 , N/A ,$434.25 ,$319.61 ,$288.34 ,$319.61 , N/A ,$319.61 ,$18.54 ,$18.54 ,$492.15 , N/A ,$401.25 , N/A ,$579.00 ,$318.45 , N/A ,$152.28 ,$579.00 ,$77.64 ,$74.11 , N/A ,$463.20 ,$314.40 ,$162.12 ,$521.10 ,$220.02 ,$579.00 , N/A ,$277.92 
ST. MARY'S HOSPITAL - DECATUR,40200062,76998,HC US INTRAOPERATIVE,402,1 ,$627.00 ,$407.55 ,$74.11 ,$627.00 , N/A ,$131.45 ,$344.85 , N/A ,$175.56 ,$307.23 , N/A ,$366.80 , N/A ,$340.46 ,$145.20 , N/A ,$340.46 , N/A ,$438.90 ,$313.50 ,$501.60 , N/A , N/A ,$438.90 , N/A ,$376.20 , N/A ,$470.25 ,$346.10 ,$312.25 ,$346.10 , N/A ,$346.10 ,$438.90 ,$438.90 ,$532.95 , N/A ,$434.51 , N/A ,$627.00 ,$344.85 , N/A ,$164.90 ,$627.00 ,$77.64 ,$74.11 , N/A ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$627.00 , N/A ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,"$2,764.00 ","$1,796.60 ",$101.56 ,"$2,764.00 ",$544.53 ,"$1,409.64 ","$1,520.20 ",$217.81 ,$773.92 ,"$1,354.36 ",$217.81 ,"$1,616.94 ",$217.81 ,"$1,500.85 ",$411.87 ,$217.81 ,"$1,500.85 ",$413.84 ,"$1,934.80 ","$1,382.00 ","$2,211.20 ",$544.53 ,$217.81 ,"$1,934.80 ",$217.81 ,"$1,658.40 ",$217.81 ,"$2,073.00 ","$1,525.73 ","$1,376.47 ","$1,525.73 ",$217.81 ,"$1,525.73 ","$1,934.80 ","$1,934.80 ","$2,349.40 ",$544.53 ,"$1,915.45 ",$217.81 ,"$2,764.00 ","$1,520.20 ",$217.81 ,$726.93 ,"$2,764.00 ",$106.39 ,$101.56 ,$228.70 ,"$2,211.20 ","$1,500.85 ",$773.92 ,"$2,487.60 ","$1,050.32 ",$775.00 ,$217.81 ,"$1,326.72 "
ST. MARY'S HOSPITAL - DECATUR,40200068,93976,HC DUPLEX ABD/PEL/RETRO LTD,402,1 ,"$1,579.00 ","$1,026.35 ",$101.56 ,"$1,579.00 ",$257.65 ,$805.29 ,$868.45 ,$103.06 ,$442.12 ,$773.71 ,$103.06 ,$923.72 ,$103.06 ,$857.40 ,$231.65 ,$103.06 ,$857.40 ,$195.81 ,"$1,105.30 ",$789.50 ,"$1,263.20 ",$257.64 ,$103.06 ,"$1,105.30 ",$103.06 ,$947.40 ,$103.06 ,"$1,184.25 ",$871.61 ,$786.34 ,$871.61 ,$103.06 ,$871.61 ,"$1,105.30 ","$1,105.30 ","$1,342.15 ",$257.64 ,"$1,094.25 ",$103.06 ,"$1,579.00 ",$868.45 ,$103.06 ,$415.28 ,"$1,579.00 ",$106.39 ,$101.56 ,$108.21 ,"$1,263.20 ",$857.40 ,$442.12 ,"$1,421.10 ",$600.02 ,$775.00 ,$103.06 ,$757.92 
ST. MARY'S HOSPITAL - DECATUR,40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,"$1,579.00 ","$1,026.35 ",$101.56 ,"$1,579.00 ",$257.65 ,$805.29 ,$868.45 ,$103.06 ,$442.12 ,$773.71 ,$103.06 ,$923.72 ,$103.06 ,$857.40 ,$231.65 ,$103.06 ,$857.40 ,$195.81 ,"$1,105.30 ",$789.50 ,"$1,263.20 ",$257.64 ,$103.06 ,"$1,105.30 ",$103.06 ,$947.40 ,$103.06 ,"$1,184.25 ",$871.61 ,$786.34 ,$871.61 ,$103.06 ,$871.61 ,"$1,105.30 ","$1,105.30 ","$1,342.15 ",$257.64 ,"$1,094.25 ",$103.06 ,"$1,579.00 ",$868.45 ,$103.06 ,$415.28 ,"$1,579.00 ",$106.39 ,$101.56 ,$108.21 ,"$1,263.20 ",$857.40 ,$442.12 ,"$1,421.10 ",$600.02 ,$775.00 ,$103.06 ,$757.92 
ST. MARY'S HOSPITAL - DECATUR,40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,921,1 ,"$1,407.00 ",$914.55 ,$101.56 ,"$1,407.00 ",$544.53 ,$717.57 ,$773.85 ,$217.81 ,$393.96 ,$689.43 ,$217.81 ,$823.10 ,$217.81 ,$764.00 ,$278.67 ,$217.81 ,$764.00 ,$413.84 ,$984.90 ,$703.50 ,"$1,125.60 ",$544.53 ,$217.81 ,$984.90 ,$217.81 ,$844.20 ,$217.81 ,"$1,055.25 ",$776.66 ,$700.69 ,$776.66 ,$217.81 ,$776.66 ,"$1,097.46 ","$1,097.46 ","$1,195.95 ",$544.53 ,$975.05 ,$217.81 ,"$1,407.00 ",$773.85 ,$217.81 ,$370.04 ,"$1,407.00 ",$106.39 ,$101.56 ,$228.70 ,"$1,125.60 ",$764.00 ,$393.96 ,"$1,266.30 ",$534.66 ,$765.41 ,$217.81 ,$675.36 
ST. MARY'S HOSPITAL - DECATUR,40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,$954.00 ,$620.10 ,$101.56 ,$954.00 ,$257.65 ,$486.54 ,$524.70 ,$103.06 ,$267.12 ,$467.46 ,$103.06 ,$558.09 ,$103.06 ,$518.02 ,$178.24 ,$103.06 ,$518.02 ,$195.81 ,$667.80 ,$477.00 ,$763.20 ,$257.64 ,$103.06 ,$667.80 ,$103.06 ,$572.40 ,$103.06 ,$715.50 ,$526.61 ,$475.09 ,$526.61 ,$103.06 ,$526.61 ,$667.80 ,$667.80 ,$810.90 ,$257.64 ,$661.12 ,$103.06 ,$954.00 ,$524.70 ,$103.06 ,$250.90 ,$954.00 ,$106.39 ,$101.56 ,$108.21 ,$763.20 ,$518.02 ,$267.12 ,$858.60 ,$362.52 ,$775.00 ,$103.06 ,$457.92 
ST. MARY'S HOSPITAL - DECATUR,40200075,76706,HC US AORTA (SCREENING),402,1 ,$714.00 ,$464.10 ,$101.56 ,$714.00 ,$257.65 ,$123.05 ,$392.70 ,$103.06 ,$199.92 ,$349.86 ,$103.06 ,$417.69 ,$103.06 ,$387.70 ,$177.26 ,$103.06 ,$387.70 ,$195.81 ,$499.80 ,$357.00 ,$571.20 ,$257.64 ,$103.06 ,$499.80 ,$103.06 ,$428.40 ,$103.06 ,$535.50 ,$394.13 ,$355.57 ,$394.13 ,$103.06 ,$394.13 ,$120.38 ,$120.38 ,$606.90 ,$257.64 ,$494.80 ,$103.06 ,$714.00 ,$392.70 ,$103.06 ,$187.78 ,$714.00 ,$106.39 ,$101.56 ,$108.21 ,$571.20 ,$387.70 ,$199.92 ,$642.60 ,$271.32 ,$714.00 ,$103.06 ,$342.72 
ST. MARY'S HOSPITAL - DECATUR,40200091,76886,HC US HIPS INFANT STATIC,402,1 ,$792.00 ,$514.80 ,$76.57 ,$792.00 ,$191.43 ,$117.97 ,$435.60 ,$76.57 ,$221.76 ,$388.08 ,$76.57 ,$463.32 ,$76.57 ,$430.06 ,$152.39 ,$76.57 ,$430.06 ,$145.48 ,$554.40 ,$396.00 ,$633.60 ,$191.42 ,$76.57 ,$554.40 ,$76.57 ,$475.20 ,$76.57 ,$594.00 ,$437.18 ,$394.42 ,$437.18 ,$76.57 ,$437.18 ,$86.10 ,$86.10 ,$673.20 ,$191.42 ,$548.86 ,$76.57 ,$792.00 ,$435.60 ,$76.57 ,$208.30 ,$792.00 , N/A , N/A ,$80.40 ,$633.60 ,$430.06 ,$221.76 ,$712.80 ,$300.96 ,$775.00 ,$76.57 ,$380.16 
ST. MARY'S HOSPITAL - DECATUR,40200097,76816,HC US OB GROWTH FOLLOWUP EA ADDN,402,1 ,"$1,172.00 ",$761.80 ,$99.02 ,"$1,172.00 ",$257.65 ,$117.97 ,$644.60 ,$103.06 ,$328.16 ,$574.28 ,$103.06 ,$685.62 ,$103.06 ,$636.40 ,$145.80 ,$103.06 ,$636.40 ,$195.81 ,$820.40 ,$586.00 ,$937.60 ,$257.64 ,$103.06 ,$820.40 ,$103.06 ,$703.20 ,$103.06 ,$879.00 ,$646.94 ,$583.66 ,$646.94 ,$103.06 ,$646.94 ,$99.02 ,$99.02 ,$996.20 ,$257.64 ,$812.20 ,$103.06 ,"$1,172.00 ",$644.60 ,$103.06 ,$308.24 ,"$1,172.00 ", N/A , N/A ,$108.21 ,$937.60 ,$636.40 ,$328.16 ,"$1,054.80 ",$445.36 ,$775.00 ,$103.06 ,$562.56 
ST. MARY'S HOSPITAL - DECATUR,40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$313.00 ,$203.45 ,$46.13 ,$313.00 ,$218.00 ,$184.14 ,$172.15 ,$87.20 ,$87.64 ,$153.37 ,$87.20 ,$183.11 ,$87.20 ,$169.96 ,$202.13 ,$87.20 ,$169.96 ,$165.68 ,$219.10 ,$156.50 ,$250.40 ,$218.00 ,$87.20 ,$219.10 ,$87.20 ,$187.80 ,$87.20 ,$234.75 ,$172.78 ,$155.87 ,$172.78 ,$87.20 ,$172.78 ,$137.28 ,$137.28 ,$266.05 ,$218.00 ,$216.91 ,$87.20 ,$101.20 ,$172.15 ,$87.20 ,$82.32 ,$313.00 ,$48.32 ,$46.13 ,$91.56 ,$250.40 ,$169.96 ,$87.64 ,$281.70 ,$118.94 ,$265.00 ,$87.20 ,$150.24 
ST. MARY'S HOSPITAL - DECATUR,40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$313.00 ,$203.45 ,$46.13 ,$313.00 ,$218.00 ,$184.14 ,$172.15 ,$87.20 ,$87.64 ,$153.37 ,$87.20 ,$183.11 ,$87.20 ,$169.96 ,$202.13 ,$87.20 ,$169.96 ,$165.68 ,$219.10 ,$156.50 ,$250.40 ,$218.00 ,$87.20 ,$219.10 ,$87.20 ,$187.80 ,$87.20 ,$234.75 ,$172.78 ,$155.87 ,$172.78 ,$87.20 ,$172.78 ,$137.28 ,$137.28 ,$266.05 ,$218.00 ,$216.91 ,$87.20 ,$101.20 ,$172.15 ,$87.20 ,$82.32 ,$313.00 ,$48.32 ,$46.13 ,$91.56 ,$250.40 ,$169.96 ,$87.64 ,$281.70 ,$118.94 ,$265.00 ,$87.20 ,$150.24 
ST. MARY'S HOSPITAL - DECATUR,40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$148.00 ,$96.20 ,$22.09 ,$148.00 ,$55.23 ,$47.12 ,$81.40 ,$22.09 ,$41.44 ,$72.52 ,$22.09 ,$86.58 ,$22.09 ,$80.36 ,$23.18 ,$22.09 ,$80.36 ,$41.97 ,$103.60 ,$74.00 ,$118.40 ,$55.23 ,$22.09 ,$103.60 ,$22.09 ,$88.80 ,$22.09 ,$111.00 ,$81.70 ,$73.70 ,$81.70 ,$22.09 ,$81.70 ,$34.77 ,$34.77 ,$125.80 ,$55.23 ,$102.56 ,$22.09 ,$26.59 ,$81.40 ,$22.09 ,$38.92 ,$148.00 ,$48.32 ,$46.13 ,$23.19 ,$118.40 ,$80.36 ,$41.44 ,$133.20 ,$56.24 ,$148.00 ,$22.09 ,$71.04 
ST. MARY'S HOSPITAL - DECATUR,40400003,78814,HC PET W/CT TUMR LIMITED AREA,404,1 ,"$6,837.00 ","$4,444.05 ",$816.95 ,"$6,837.00 ","$3,502.50 ","$3,000.00 ","$3,760.35 ","$1,401.00 ","$1,914.36 ","$3,350.13 ","$1,401.00 ","$3,999.65 ","$1,401.00 ","$3,712.49 ","$2,053.19 ","$1,401.00 ","$3,712.49 ","$2,661.91 ","$4,785.90 ","$3,418.50 ","$5,469.60 ","$3,502.51 ","$1,401.00 ","$4,785.90 ","$1,401.00 ","$4,102.20 ","$1,401.00 ","$5,127.75 ","$3,774.02 ","$3,404.83 ","$3,774.02 ","$1,401.00 ","$3,774.02 ","$5,332.86 ","$5,332.86 ","$5,811.45 ","$3,502.51 ","$4,738.04 ","$1,401.00 ","$6,837.00 ","$3,760.35 ","$1,401.00 ","$1,798.13 ","$6,837.00 ",$855.86 ,$816.95 ,"$1,471.05 ","$5,469.60 ","$3,712.49 ","$1,914.36 ","$6,153.30 ","$1,704.00 ","$2,775.00 ","$1,401.00 ","$3,281.76 "
ST. MARY'S HOSPITAL - DECATUR,40400004,78815,HC PET W/CT TUMR SKULL MID-THIGH,404,1 ,"$6,990.00 ","$4,543.50 ",$816.95 ,"$6,990.00 ","$3,502.50 ","$3,000.00 ","$3,844.50 ","$1,401.00 ","$1,957.20 ","$3,425.10 ","$1,401.00 ","$4,089.15 ","$1,401.00 ","$3,795.57 ","$2,053.19 ","$1,401.00 ","$3,795.57 ","$2,661.91 ","$4,893.00 ","$3,495.00 ","$5,592.00 ","$3,502.51 ","$1,401.00 ","$4,893.00 ","$1,401.00 ","$4,194.00 ","$1,401.00 ","$5,242.50 ","$3,858.48 ","$3,481.02 ","$3,858.48 ","$1,401.00 ","$3,858.48 ","$5,452.20 ","$5,452.20 ","$5,941.50 ","$3,502.51 ","$4,844.07 ","$1,401.00 ","$6,990.00 ","$3,844.50 ","$1,401.00 ","$1,838.37 ","$6,990.00 ",$855.86 ,$816.95 ,"$1,471.05 ","$5,592.00 ","$3,795.57 ","$1,957.20 ","$6,291.00 ","$1,704.00 ","$2,775.00 ","$1,401.00 ","$3,355.20 "
ST. MARY'S HOSPITAL - DECATUR,40400005,78816,HC PET W/CT MELAN IMAG WHOLE BODY,404,1 ,"$8,309.00 ","$5,400.85 ",$816.95 ,"$8,309.00 ","$3,502.50 ","$3,000.00 ","$4,569.95 ","$1,401.00 ","$2,326.52 ","$4,071.41 ","$1,401.00 ","$4,860.77 ","$1,401.00 ","$4,511.79 ","$2,053.19 ","$1,401.00 ","$4,511.79 ","$2,661.91 ","$5,816.30 ","$4,154.50 ","$6,647.20 ","$3,502.51 ","$1,401.00 ","$5,816.30 ","$1,401.00 ","$4,985.40 ","$1,401.00 ","$6,231.75 ","$4,586.57 ","$4,137.88 ","$4,586.57 ","$1,401.00 ","$4,586.57 ","$6,481.02 ","$6,481.02 ","$7,062.65 ","$3,502.51 ","$5,758.14 ","$1,401.00 ","$8,309.00 ","$4,569.95 ","$1,401.00 ","$2,185.27 ","$8,309.00 ",$855.86 ,$816.95 ,"$1,471.05 ","$6,647.20 ","$4,511.79 ","$2,326.52 ","$7,478.10 ","$1,704.00 ","$2,775.00 ","$1,401.00 ","$3,988.32 "
ST. MARY'S HOSPITAL - DECATUR,41000002,31502,HC CHG TUBE TRACHEOTOMY,410,1 ,$998.00 ,$648.70 ,$65.06 ,$998.00 ,$500.68 ,$508.98 ,$548.90 ,$200.27 ,$279.44 ,$469.06 ,$200.27 ,$538.92 ,$200.27 ,$541.91 ,$65.06 ,$200.27 ,$541.91 ,$380.51 ,$698.60 ,$499.00 ,$798.40 ,$500.67 ,$200.27 ,$698.60 ,$200.27 ,$598.80 ,$200.27 ,$748.50 ,$550.90 ,$497.00 ,$550.90 ,$200.27 ,$550.90 ,$778.44 ,$778.44 ,$848.30 ,$500.67 ,$691.61 ,$200.27 ,$998.00 ,$548.90 ,$200.27 ,$262.47 ,$998.00 ,$146.19 ,$139.55 ,$210.28 ,$798.40 ,$541.91 ,$279.44 ,$898.20 ,$379.24 ,$359.00 ,$200.27 ,$479.04 
ST. MARY'S HOSPITAL - DECATUR,41000005,92950,HC CPR,480,1 ,$880.00 ,$572.00 ,$231.44 ,$880.00 ,$626.30 ,$448.80 ,$484.00 ,$250.52 ,$246.40 ,$431.20 ,$250.52 ,$514.80 ,$250.52 ,$477.84 ,$398.18 ,$250.52 ,$477.84 ,$475.99 ,$616.00 ,$440.00 ,$704.00 ,$626.30 ,$250.52 ,$616.00 ,$250.52 ,$528.00 ,$250.52 ,$660.00 ,$485.76 ,$438.24 ,$485.76 ,$250.52 ,$485.76 ,$686.40 ,$686.40 ,$748.00 ,$626.30 ,$609.84 ,$250.52 ,$880.00 ,$484.00 ,$250.52 ,$231.44 ,$880.00 ,$472.46 ,$450.99 ,$263.05 ,$704.00 ,$477.84 ,$246.40 ,$792.00 ,$334.40 ,$880.00 ,$250.52 ,$422.40 
ST. MARY'S HOSPITAL - DECATUR,41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,"$1,353.00 ",$879.45 ,$223.33 ,"$1,353.00 ","$1,152.88 ",$690.03 ,$744.15 ,$461.15 ,$378.84 ,$662.97 ,$461.15 ,$791.51 ,$461.15 ,$734.68 ,$223.33 ,$461.15 ,$734.68 ,$876.18 ,$947.10 ,$676.50 ,"$1,082.40 ","$1,152.87 ",$461.15 ,$947.10 ,$461.15 ,$811.80 ,$461.15 ,"$1,014.75 ",$746.86 ,$673.79 ,$746.86 ,$461.15 ,$746.86 ,"$1,055.34 ","$1,055.34 ","$1,150.05 ","$1,152.87 ",$937.63 ,$461.15 ,"$1,353.00 ",$744.15 ,$461.15 ,$355.84 ,"$1,353.00 ",$512.26 ,$488.97 ,$484.21 ,"$1,082.40 ",$734.68 ,$378.84 ,"$1,217.70 ",$514.14 ,$359.00 ,$461.15 ,$649.44 
ST. MARY'S HOSPITAL - DECATUR,41000010,94002,HC VENTIL HI FREQ INTL DAY,410,1 ,"$1,353.00 ",$879.45 ,$223.33 ,"$1,353.00 ","$1,152.88 ",$690.03 ,$744.15 ,$461.15 ,$378.84 ,$662.97 ,$461.15 ,$791.51 ,$461.15 ,$734.68 ,$223.33 ,$461.15 ,$734.68 ,$876.18 ,$947.10 ,$676.50 ,"$1,082.40 ","$1,152.87 ",$461.15 ,$947.10 ,$461.15 ,$811.80 ,$461.15 ,"$1,014.75 ",$746.86 ,$673.79 ,$746.86 ,$461.15 ,$746.86 ,"$1,055.34 ","$1,055.34 ","$1,150.05 ","$1,152.87 ",$937.63 ,$461.15 ,"$1,353.00 ",$744.15 ,$461.15 ,$355.84 ,"$1,353.00 ",$512.26 ,$488.97 ,$484.21 ,"$1,082.40 ",$734.68 ,$378.84 ,"$1,217.70 ",$514.14 ,$359.00 ,$461.15 ,$649.44 
ST. MARY'S HOSPITAL - DECATUR,41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$986.00 ,$640.90 ,$91.64 ,$986.00 ,$444.83 ,$502.86 ,$542.30 ,$177.93 ,$276.08 ,$483.14 ,$177.93 ,$576.81 ,$177.93 ,$535.40 ,$91.64 ,$177.93 ,$535.40 ,$338.07 ,$690.20 ,$493.00 ,$788.80 ,$444.82 ,$177.93 ,$690.20 ,$177.93 ,$591.60 ,$177.93 ,$739.50 ,$544.27 ,$491.03 ,$544.27 ,$177.93 ,$544.27 ,$769.08 ,$769.08 ,$838.10 ,$444.82 ,$683.30 ,$177.93 ,$986.00 ,$542.30 ,$177.93 ,$259.32 ,$986.00 ,$512.26 ,$488.97 ,$186.83 ,$788.80 ,$535.40 ,$276.08 ,$887.40 ,$374.68 ,$359.00 ,$177.93 ,$473.28 
ST. MARY'S HOSPITAL - DECATUR,41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,"$1,353.00 ",$879.45 ,$223.33 ,"$1,353.00 ","$1,152.88 ",$690.03 ,$744.15 ,$461.15 ,$378.84 ,$662.97 ,$461.15 ,$791.51 ,$461.15 ,$734.68 ,$223.33 ,$461.15 ,$734.68 ,$876.18 ,$947.10 ,$676.50 ,"$1,082.40 ","$1,152.87 ",$461.15 ,$947.10 ,$461.15 ,$811.80 ,$461.15 ,"$1,014.75 ",$746.86 ,$673.79 ,$746.86 ,$461.15 ,$746.86 ,"$1,055.34 ","$1,055.34 ","$1,150.05 ","$1,152.87 ",$937.63 ,$461.15 ,"$1,353.00 ",$744.15 ,$461.15 ,$355.84 ,"$1,353.00 ",$512.26 ,$488.97 ,$484.21 ,"$1,082.40 ",$734.68 ,$378.84 ,"$1,217.70 ",$514.14 ,$359.00 ,$461.15 ,$649.44 
ST. MARY'S HOSPITAL - DECATUR,41000017,94002,HC VENT PEDS INIT DAY,410,1 ,"$1,353.00 ",$879.45 ,$223.33 ,"$1,353.00 ","$1,152.88 ",$690.03 ,$744.15 ,$461.15 ,$378.84 ,$662.97 ,$461.15 ,$791.51 ,$461.15 ,$734.68 ,$223.33 ,$461.15 ,$734.68 ,$876.18 ,$947.10 ,$676.50 ,"$1,082.40 ","$1,152.87 ",$461.15 ,$947.10 ,$461.15 ,$811.80 ,$461.15 ,"$1,014.75 ",$746.86 ,$673.79 ,$746.86 ,$461.15 ,$746.86 ,"$1,055.34 ","$1,055.34 ","$1,150.05 ","$1,152.87 ",$937.63 ,$461.15 ,"$1,353.00 ",$744.15 ,$461.15 ,$355.84 ,"$1,353.00 ",$512.26 ,$488.97 ,$484.21 ,"$1,082.40 ",$734.68 ,$378.84 ,"$1,217.70 ",$514.14 ,$359.00 ,$461.15 ,$649.44 
ST. MARY'S HOSPITAL - DECATUR,41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,"$1,353.00 ",$879.45 ,$159.40 ,"$1,353.00 ","$1,152.88 ",$690.03 ,$744.15 ,$461.15 ,$378.84 ,$635.91 ,$461.15 ,$730.62 ,$461.15 ,$734.68 ,$159.40 ,$461.15 ,$734.68 ,$876.18 ,$947.10 ,$676.50 ,"$1,082.40 ","$1,152.87 ",$461.15 ,$947.10 ,$461.15 ,$811.80 ,$461.15 ,"$1,014.75 ",$746.86 ,$673.79 ,$746.86 ,$461.15 ,$746.86 ,"$1,055.34 ","$1,055.34 ","$1,150.05 ","$1,152.87 ",$937.63 ,$461.15 ,"$1,353.00 ",$744.15 ,$461.15 ,$355.84 ,"$1,353.00 ",$512.26 ,$488.97 ,$484.21 ,"$1,082.40 ",$734.68 ,$378.84 ,"$1,217.70 ",$514.14 ,$359.00 ,$461.15 ,$649.44 
ST. MARY'S HOSPITAL - DECATUR,41000028,94003,HC VENT HI FREQ SUBQ DAY,410,1 ,"$1,353.00 ",$879.45 ,$159.40 ,"$1,353.00 ","$1,152.88 ",$690.03 ,$744.15 ,$461.15 ,$378.84 ,$635.91 ,$461.15 ,$730.62 ,$461.15 ,$734.68 ,$159.40 ,$461.15 ,$734.68 ,$876.18 ,$947.10 ,$676.50 ,"$1,082.40 ","$1,152.87 ",$461.15 ,$947.10 ,$461.15 ,$811.80 ,$461.15 ,"$1,014.75 ",$746.86 ,$673.79 ,$746.86 ,$461.15 ,$746.86 ,"$1,055.34 ","$1,055.34 ","$1,150.05 ","$1,152.87 ",$937.63 ,$461.15 ,"$1,353.00 ",$744.15 ,$461.15 ,$355.84 ,"$1,353.00 ",$512.26 ,$488.97 ,$484.21 ,"$1,082.40 ",$734.68 ,$378.84 ,"$1,217.70 ",$514.14 ,$359.00 ,$461.15 ,$649.44 
ST. MARY'S HOSPITAL - DECATUR,41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$492.00 ,$319.80 ,$91.64 ,$492.00 ,$444.83 ,$250.92 ,$270.60 ,$177.93 ,$137.76 ,$241.08 ,$177.93 ,$287.82 ,$177.93 ,$267.16 ,$91.64 ,$177.93 ,$267.16 ,$338.07 ,$344.40 ,$246.00 ,$393.60 ,$444.82 ,$177.93 ,$344.40 ,$177.93 ,$295.20 ,$177.93 ,$369.00 ,$271.58 ,$245.02 ,$271.58 ,$177.93 ,$271.58 ,$383.76 ,$383.76 ,$418.20 ,$444.82 ,$340.96 ,$177.93 ,$492.00 ,$270.60 ,$177.93 ,$129.40 ,$492.00 ,$492.00 ,$488.97 ,$186.83 ,$393.60 ,$267.16 ,$137.76 ,$442.80 ,$186.96 ,$359.00 ,$177.93 ,$236.16 
ST. MARY'S HOSPITAL - DECATUR,41000031,94003,HC VENT NEONATL SUBQ DAY,410,1 ,"$1,353.00 ",$879.45 ,$159.40 ,"$1,353.00 ","$1,152.88 ",$690.03 ,$744.15 ,$461.15 ,$378.84 ,$635.91 ,$461.15 ,$730.62 ,$461.15 ,$734.68 ,$159.40 ,$461.15 ,$734.68 ,$876.18 ,$947.10 ,$676.50 ,"$1,082.40 ","$1,152.87 ",$461.15 ,$947.10 ,$461.15 ,$811.80 ,$461.15 ,"$1,014.75 ",$746.86 ,$673.79 ,$746.86 ,$461.15 ,$746.86 ,"$1,055.34 ","$1,055.34 ","$1,150.05 ","$1,152.87 ",$937.63 ,$461.15 ,"$1,353.00 ",$744.15 ,$461.15 ,$355.84 ,"$1,353.00 ",$512.26 ,$488.97 ,$484.21 ,"$1,082.40 ",$734.68 ,$378.84 ,"$1,217.70 ",$514.14 ,$359.00 ,$461.15 ,$649.44 
ST. MARY'S HOSPITAL - DECATUR,41000034,94640,HC IPPB,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000038,94640,HC AEROSOL GENTR SHORT-TERM,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000040,94640,HC EZ PAP TREATMENT,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000043,94640,HC PERI NEB WITH INSTRUCTION,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000044,94640,HC UPDRAFT W/INSTRUCT AND EVAL,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000047,94640,HC HIGH EFF NEB AERO W/INSTR/TEACH DEVICE,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000049,94642,HC AEROSOL INHALATION PENTAMIDINE,410,1 ,$677.00 ,$440.05 ,$102.95 ,$677.00 ,$444.83 ,$345.27 ,$372.35 ,$177.93 ,$189.56 ,$331.73 ,$177.93 ,$396.05 ,$177.93 ,$367.61 ,$102.95 ,$177.93 ,$367.61 ,$338.07 ,$473.90 ,$338.50 ,$541.60 ,$444.82 ,$177.93 ,$473.90 ,$177.93 ,$406.20 ,$177.93 ,$507.75 ,$373.70 ,$337.15 ,$373.70 ,$177.93 ,$373.70 ,$528.06 ,$528.06 ,$575.45 ,$444.82 ,$469.16 ,$177.93 ,$677.00 ,$372.35 ,$177.93 ,$178.05 ,$677.00 ,$169.65 ,$161.94 ,$186.83 ,$541.60 ,$367.61 ,$189.56 ,$609.30 ,$257.26 ,$359.00 ,$177.93 ,$324.96 
ST. MARY'S HOSPITAL - DECATUR,41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$376.00 ,$244.40 ,$49.93 ,$376.00 ,$266.85 ,$191.76 ,$206.80 ,$106.74 ,$105.28 ,$184.24 ,$106.74 ,$219.96 ,$106.74 ,$204.17 ,$109.35 ,$106.74 ,$204.17 ,$202.80 ,$263.20 ,$188.00 ,$300.80 ,$266.84 ,$106.74 ,$263.20 ,$106.74 ,$225.60 ,$106.74 ,$282.00 ,$207.55 ,$187.25 ,$207.55 ,$106.74 ,$207.55 ,$293.28 ,$293.28 ,$319.60 ,$266.84 ,$260.57 ,$106.74 ,$376.00 ,$206.80 ,$106.74 ,$98.89 ,$376.00 ,$52.31 ,$49.93 ,$112.08 ,$300.80 ,$204.17 ,$105.28 ,$338.40 ,$142.88 ,$359.00 ,$106.74 ,$180.48 
ST. MARY'S HOSPITAL - DECATUR,41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$312.00 ,$202.80 ,$36.87 ,$312.00 , N/A ,$159.12 ,$171.60 , N/A ,$87.36 ,$152.88 , N/A ,$182.52 , N/A ,$169.42 ,$36.87 , N/A ,$169.42 , N/A ,$218.40 ,$156.00 ,$249.60 , N/A , N/A ,$218.40 , N/A ,$187.20 , N/A ,$234.00 ,$172.22 ,$155.38 ,$172.22 , N/A ,$172.22 ,$243.36 ,$243.36 ,$265.20 , N/A ,$216.22 , N/A ,$312.00 ,$171.60 , N/A ,$82.06 ,$312.00 ,$52.31 ,$49.93 , N/A ,$249.60 ,$169.42 ,$87.36 ,$280.80 ,$118.56 ,$312.00 , N/A ,$149.76 
ST. MARY'S HOSPITAL - DECATUR,41000052,94660,HC CPAP,410,1 ,$995.00 ,$646.75 ,$91.64 ,$995.00 ,$444.83 ,$507.45 ,$547.25 ,$177.93 ,$278.60 ,$487.55 ,$177.93 ,$582.08 ,$177.93 ,$540.29 ,$91.64 ,$177.93 ,$540.29 ,$338.07 ,$696.50 ,$497.50 ,$796.00 ,$444.82 ,$177.93 ,$696.50 ,$177.93 ,$597.00 ,$177.93 ,$746.25 ,$549.24 ,$495.51 ,$549.24 ,$177.93 ,$549.24 ,$776.10 ,$776.10 ,$845.75 ,$444.82 ,$689.54 ,$177.93 ,$995.00 ,$547.25 ,$177.93 ,$261.69 ,$995.00 ,$512.26 ,$488.97 ,$186.83 ,$796.00 ,$540.29 ,$278.60 ,$895.50 ,$378.10 ,$359.00 ,$177.93 ,$477.60 
ST. MARY'S HOSPITAL - DECATUR,41000053,94660,HC CPAP DAILY EST PT,410,1 ,$343.00 ,$222.95 ,$90.21 ,$488.97 ,$444.83 ,$174.93 ,$188.65 ,$177.93 ,$96.04 ,$168.07 ,$177.93 ,$200.66 ,$177.93 ,$186.25 ,$91.64 ,$177.93 ,$186.25 ,$338.07 ,$240.10 ,$171.50 ,$274.40 ,$444.82 ,$177.93 ,$240.10 ,$177.93 ,$205.80 ,$177.93 ,$257.25 ,$189.34 ,$170.81 ,$189.34 ,$177.93 ,$189.34 ,$267.54 ,$267.54 ,$291.55 ,$343.00 ,$237.70 ,$177.93 ,$343.00 ,$188.65 ,$177.93 ,$90.21 ,$343.00 ,$343.00 ,$488.97 ,$186.83 ,$274.40 ,$186.25 ,$96.04 ,$308.70 ,$130.34 ,$343.00 ,$177.93 ,$164.64 
ST. MARY'S HOSPITAL - DECATUR,41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$183.00 ,$118.95 ,$24.10 ,$444.83 ,$444.83 ,$93.33 ,$100.65 ,$177.93 ,$51.24 ,$89.67 ,$177.93 ,$107.06 ,$177.93 ,$99.37 ,$37.65 ,$177.93 ,$99.37 ,$183.00 ,$128.10 ,$91.50 ,$146.40 ,$444.82 ,$177.93 ,$128.10 ,$177.93 ,$109.80 ,$177.93 ,$137.25 ,$101.02 ,$91.13 ,$101.02 ,$177.93 ,$101.02 ,$142.74 ,$142.74 ,$155.55 ,$183.00 ,$126.82 ,$177.93 ,$183.00 ,$100.65 ,$177.93 ,$48.13 ,$183.00 ,$25.25 ,$24.10 ,$186.83 ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$69.54 ,$183.00 ,$177.93 ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$299.00 ,$194.35 ,$55.82 ,$299.00 ,$266.85 ,$152.49 ,$164.45 ,$106.74 ,$83.72 ,$146.51 ,$106.74 ,$174.92 ,$106.74 ,$162.36 ,$55.82 ,$106.74 ,$162.36 ,$202.80 ,$209.30 ,$149.50 ,$239.20 ,$266.84 ,$106.74 ,$209.30 ,$106.74 ,$179.40 ,$106.74 ,$224.25 ,$165.05 ,$148.90 ,$165.05 ,$106.74 ,$165.05 ,$233.22 ,$233.22 ,$254.15 ,$266.84 ,$207.21 ,$106.74 ,$299.00 ,$164.45 ,$106.74 ,$78.64 ,$299.00 ,$169.65 ,$161.94 ,$112.08 ,$239.20 ,$162.36 ,$83.72 ,$269.10 ,$113.62 ,$299.00 ,$106.74 ,$143.52 
ST. MARY'S HOSPITAL - DECATUR,41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$299.00 ,$194.35 ,$55.82 ,$299.00 ,$266.85 ,$152.49 ,$164.45 ,$106.74 ,$83.72 ,$146.51 ,$106.74 ,$174.92 ,$106.74 ,$162.36 ,$55.82 ,$106.74 ,$162.36 ,$202.80 ,$209.30 ,$149.50 ,$239.20 ,$266.84 ,$106.74 ,$209.30 ,$106.74 ,$179.40 ,$106.74 ,$224.25 ,$165.05 ,$148.90 ,$165.05 ,$106.74 ,$165.05 ,$233.22 ,$233.22 ,$254.15 ,$266.84 ,$207.21 ,$106.74 ,$299.00 ,$164.45 ,$106.74 ,$78.64 ,$299.00 ,$169.65 ,$161.94 ,$112.08 ,$239.20 ,$162.36 ,$83.72 ,$269.10 ,$113.62 ,$299.00 ,$106.74 ,$143.52 
ST. MARY'S HOSPITAL - DECATUR,41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$261.00 ,$169.65 ,$68.64 ,$266.85 ,$266.85 ,$133.11 ,$143.55 ,$106.74 ,$73.08 ,$122.67 ,$106.74 ,$140.94 ,$106.74 ,$141.72 ,$72.19 ,$106.74 ,$141.72 ,$202.80 ,$182.70 ,$130.50 ,$208.80 ,$266.84 ,$106.74 ,$182.70 ,$106.74 ,$156.60 ,$106.74 ,$195.75 ,$144.07 ,$129.98 ,$144.07 ,$106.74 ,$144.07 ,$203.58 ,$203.58 ,$221.85 ,$261.00 ,$180.87 ,$106.74 ,$261.00 ,$143.55 ,$106.74 ,$68.64 ,$261.00 ,$169.65 ,$161.94 ,$112.08 ,$208.80 ,$141.72 ,$73.08 ,$234.90 ,$99.18 ,$261.00 ,$106.74 ,$125.28 
ST. MARY'S HOSPITAL - DECATUR,41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$261.00 ,$169.65 ,$68.64 ,$266.85 ,$266.85 ,$133.11 ,$143.55 ,$106.74 ,$73.08 ,$122.67 ,$106.74 ,$140.94 ,$106.74 ,$141.72 ,$72.19 ,$106.74 ,$141.72 ,$202.80 ,$182.70 ,$130.50 ,$208.80 ,$266.84 ,$106.74 ,$182.70 ,$106.74 ,$156.60 ,$106.74 ,$195.75 ,$144.07 ,$129.98 ,$144.07 ,$106.74 ,$144.07 ,$203.58 ,$203.58 ,$221.85 ,$261.00 ,$180.87 ,$106.74 ,$261.00 ,$143.55 ,$106.74 ,$68.64 ,$261.00 ,$169.65 ,$161.94 ,$112.08 ,$208.80 ,$141.72 ,$73.08 ,$234.90 ,$99.18 ,$261.00 ,$106.74 ,$125.28 
ST. MARY'S HOSPITAL - DECATUR,41000063,94772,HC PNEUMOGRAM PEDIATRIC,410,1 ,"$1,263.00 ",$820.95 ,$152.57 ,"$1,263.00 ","$1,155.18 ",$644.13 ,$694.65 ,$462.07 ,$353.64 ,$593.61 ,$462.07 ,$682.02 ,$462.07 ,$685.81 ,$505.20 ,$462.07 ,$685.81 ,$877.93 ,$884.10 ,$631.50 ,"$1,010.40 ","$1,155.17 ",$462.07 ,$884.10 ,$462.07 ,$757.80 ,$462.07 ,$947.25 ,$697.18 ,$628.97 ,$697.18 ,$462.07 ,$697.18 ,$985.14 ,$985.14 ,"$1,073.55 ","$1,155.17 ",$875.26 ,$462.07 ,"$1,263.00 ",$694.65 ,$462.07 ,$332.17 ,"$1,263.00 ",$159.83 ,$152.57 ,$485.17 ,"$1,010.40 ",$685.81 ,$353.64 ,"$1,136.70 ",$479.94 ,$359.00 ,$462.07 ,$606.24 
ST. MARY'S HOSPITAL - DECATUR,41000067,94799,HC PEP THERAPY FLUTTER,410,1 ,$287.00 ,$186.55 ,$49.93 ,$330.40 ,$330.40 ,$146.37 ,$157.85 ,$132.16 ,$80.36 ,$134.89 ,$132.16 ,$154.98 ,$132.16 ,$155.84 ,$114.80 ,$132.16 ,$155.84 ,$251.11 ,$200.90 ,$143.50 ,$229.60 ,$330.40 ,$132.16 ,$200.90 ,$132.16 ,$172.20 ,$132.16 ,$215.25 ,$158.42 ,$142.93 ,$158.42 ,$132.16 ,$158.42 ,$223.86 ,$223.86 ,$243.95 ,$287.00 ,$198.89 ,$132.16 ,$287.00 ,$157.85 ,$132.16 ,$75.48 ,$287.00 ,$52.31 ,$49.93 ,$138.77 ,$229.60 ,$155.84 ,$80.36 ,$258.30 ,$109.06 ,$287.00 ,$132.16 ,$137.76 
ST. MARY'S HOSPITAL - DECATUR,41000068,G0237,HC RESP STRENGTH/ENDURANCE,410,1 ,$64.00 ,$41.60 ,$16.83 ,$161.94 ,$58.45 ,$32.64 ,$35.20 ,$23.38 ,$17.92 ,$31.36 ,$23.38 ,$37.44 ,$23.38 ,$34.75 ,$17.32 ,$23.38 ,$34.75 ,$44.43 ,$44.80 ,$32.00 ,$51.20 ,$58.46 ,$23.38 ,$44.80 ,$23.38 ,$38.40 ,$23.38 ,$48.00 ,$35.33 ,$31.87 ,$35.33 ,$23.38 ,$35.33 ,$49.92 ,$49.92 ,$54.40 ,$58.46 ,$44.35 ,$23.38 ,$64.00 ,$35.20 ,$23.38 ,$16.83 ,$64.00 ,$64.00 ,$161.94 ,$24.55 ,$51.20 ,$34.75 ,$17.92 ,$57.60 ,$24.32 ,$64.00 ,$23.38 ,$30.72 
ST. MARY'S HOSPITAL - DECATUR,41000069,G0238,HC RESP THRP FUNCTION,410,1 ,$64.00 ,$41.60 ,$16.83 ,$161.94 ,$58.45 ,$32.64 ,$35.20 ,$23.38 ,$17.92 ,$31.36 ,$23.38 ,$37.44 ,$23.38 ,$34.75 ,$17.95 ,$23.38 ,$34.75 ,$44.43 ,$44.80 ,$32.00 ,$51.20 ,$58.46 ,$23.38 ,$44.80 ,$23.38 ,$38.40 ,$23.38 ,$48.00 ,$35.33 ,$31.87 ,$35.33 ,$23.38 ,$35.33 ,$49.92 ,$49.92 ,$54.40 ,$58.46 ,$44.35 ,$23.38 ,$64.00 ,$35.20 ,$23.38 ,$16.83 ,$64.00 ,$64.00 ,$161.94 ,$24.55 ,$51.20 ,$34.75 ,$17.92 ,$57.60 ,$24.32 ,$64.00 ,$23.38 ,$30.72 
ST. MARY'S HOSPITAL - DECATUR,41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$92.00 ,$59.80 ,$1.58 ,$92.00 ,$80.10 ,$46.92 ,$50.60 ,$32.04 ,$25.76 ,$45.08 ,$32.04 ,$53.82 ,$32.04 ,$49.96 ,$22.39 ,$32.04 ,$49.96 ,$60.88 ,$64.40 ,$46.00 ,$73.60 ,$80.10 ,$32.04 ,$64.40 ,$32.04 ,$55.20 ,$32.04 ,$69.00 ,$50.78 ,$45.82 ,$50.78 ,$32.04 ,$50.78 ,$71.76 ,$71.76 ,$78.20 ,$80.10 ,$63.76 ,$32.04 ,$92.00 ,$50.60 ,$32.04 ,$24.20 ,$92.00 ,$1.65 ,$1.58 ,$33.64 ,$73.60 ,$49.96 ,$25.76 ,$82.80 ,$34.96 ,$92.00 ,$32.04 ,$44.16 
ST. MARY'S HOSPITAL - DECATUR,41000074,94640,HC IPPB SUBSQ,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000075,94640,HC IPV INIT,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000077,94762,HC PULSE OX PER DAY,410,1 ,$415.00 ,$269.75 ,$49.93 ,$415.00 ,$330.40 ,$211.65 ,$228.25 ,$132.16 ,$116.20 ,$203.35 ,$132.16 ,$242.78 ,$132.16 ,$225.35 ,$55.58 ,$132.16 ,$225.35 ,$251.11 ,$290.50 ,$207.50 ,$332.00 ,$330.40 ,$132.16 ,$290.50 ,$132.16 ,$249.00 ,$132.16 ,$311.25 ,$229.08 ,$206.67 ,$229.08 ,$132.16 ,$229.08 ,$323.70 ,$323.70 ,$352.75 ,$330.40 ,$287.60 ,$132.16 ,$415.00 ,$228.25 ,$132.16 ,$109.15 ,$415.00 ,$52.31 ,$49.93 ,$138.77 ,$332.00 ,$225.35 ,$116.20 ,$373.50 ,$157.70 ,$359.00 ,$132.16 ,$199.20 
ST. MARY'S HOSPITAL - DECATUR,41000082,94640,HC EZPAP TREATMENT SUBSQ,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$995.00 ,$646.75 ,$91.64 ,$995.00 ,$444.83 ,$507.45 ,$547.25 ,$177.93 ,$278.60 ,$487.55 ,$177.93 ,$582.08 ,$177.93 ,$540.29 ,$91.64 ,$177.93 ,$540.29 ,$338.07 ,$696.50 ,$497.50 ,$796.00 ,$444.82 ,$177.93 ,$696.50 ,$177.93 ,$597.00 ,$177.93 ,$746.25 ,$549.24 ,$495.51 ,$549.24 ,$177.93 ,$549.24 ,$776.10 ,$776.10 ,$845.75 ,$444.82 ,$689.54 ,$177.93 ,$995.00 ,$547.25 ,$177.93 ,$261.69 ,$995.00 ,$512.26 ,$488.97 ,$186.83 ,$796.00 ,$540.29 ,$278.60 ,$895.50 ,$378.10 ,$359.00 ,$177.93 ,$477.60 
ST. MARY'S HOSPITAL - DECATUR,41000086,94640,HC IPV SUBSQ,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000093,94640,HC HELIOX INIT,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,41000094,94640,HC HELIOX SUBSQ,410,1 ,$524.00 ,$340.60 ,$39.99 ,$524.00 ,$444.83 ,$267.24 ,$288.20 ,$177.93 ,$146.72 ,$256.76 ,$177.93 ,$281.92 ,$177.93 ,$284.53 ,$39.99 ,$177.93 ,$284.53 ,$338.07 ,$366.80 ,$262.00 ,$419.20 ,$444.82 ,$177.93 ,$366.80 ,$177.93 ,$314.40 ,$177.93 ,$393.00 ,$289.25 ,$260.95 ,$289.25 ,$177.93 ,$289.25 ,$408.72 ,$408.72 ,$445.40 ,$444.82 ,$363.13 ,$177.93 ,$524.00 ,$288.20 ,$177.93 ,$137.81 ,$524.00 ,$169.65 ,$161.94 ,$186.83 ,$419.20 ,$284.53 ,$146.72 ,$471.60 ,$199.12 ,$359.00 ,$177.93 ,$251.52 
ST. MARY'S HOSPITAL - DECATUR,42000006,G0283,HC APPL NEUROSTIMULATOR TRANSCUT,420,1 ,$275.00 ,$178.75 ,$10.00 ,$275.00 ,$30.00 ,$130.00 ,$151.25 ,$12.00 ,$77.00 ,$98.30 ,$12.00 ,$98.30 ,$12.00 ,$149.33 ,$10.00 ,$12.00 ,$149.33 ,$22.80 ,$192.50 ,$137.50 ,$220.00 ,$30.00 ,$12.00 ,$192.50 ,$12.00 ,$165.00 ,$12.00 ,$206.25 ,$151.80 ,$136.95 ,$151.80 ,$12.00 ,$151.80 ,$189.00 ,$189.00 ,$233.75 ,$30.00 ,$190.58 ,$12.00 ,$275.00 ,$151.25 ,$12.00 ,$72.33 ,$275.00 ,$19.32 ,$18.44 ,$12.60 ,$220.00 ,$149.33 ,$77.00 ,$247.50 ,$104.50 ,$225.00 ,$12.00 ,$132.00 
ST. MARY'S HOSPITAL - DECATUR,42000008,95992,HC CANNALITH REPOSITIONING,420,1 ,$150.00 ,$97.50 ,$39.45 ,$225.63 ,$107.65 ,$130.00 ,$82.50 ,$43.06 ,$42.00 ,$70.50 ,$43.06 ,$81.00 ,$43.06 ,$81.45 ,$58.85 ,$43.06 ,$81.45 ,$81.81 ,$105.00 ,$75.00 ,$120.00 ,$107.65 ,$43.06 ,$105.00 ,$43.06 ,$90.00 ,$43.06 ,$112.50 ,$82.80 ,$74.70 ,$82.80 ,$43.06 ,$82.80 ,$150.00 ,$150.00 ,$127.50 ,$107.65 ,$103.95 ,$43.06 ,$150.00 ,$82.50 ,$43.06 ,$39.45 ,$150.00 ,$150.00 ,$225.63 ,$45.21 ,$120.00 ,$81.45 ,$42.00 ,$135.00 ,$57.00 ,$150.00 ,$43.06 ,$72.00 
ST. MARY'S HOSPITAL - DECATUR,42000009,97012,HC TRACTION MECH APP,420,1 ,$240.00 ,$156.00 ,$14.11 ,$240.00 ,$35.28 ,$130.00 ,$132.00 ,$14.11 ,$67.20 ,$117.60 ,$14.11 ,$140.40 ,$14.11 ,$130.32 ,$19.87 ,$14.11 ,$130.32 ,$26.81 ,$168.00 ,$120.00 ,$192.00 ,$35.28 ,$14.11 ,$168.00 ,$14.11 ,$144.00 ,$14.11 ,$180.00 ,$132.48 ,$119.52 ,$132.48 ,$14.11 ,$132.48 ,$189.00 ,$189.00 ,$204.00 ,$35.28 ,$166.32 ,$14.11 ,$240.00 ,$132.00 ,$14.11 ,$63.12 ,$240.00 ,$19.32 ,$18.44 ,$14.82 ,$192.00 ,$130.32 ,$67.20 ,$216.00 ,$91.20 ,$225.00 ,$14.11 ,$115.20 
ST. MARY'S HOSPITAL - DECATUR,42000016,97022,HC WHIRLPOOL 15 MINUTES,420,1 ,$215.00 ,$139.75 ,$16.71 ,$215.00 ,$41.78 ,$130.00 ,$118.25 ,$16.71 ,$60.20 ,$105.35 ,$16.71 ,$125.78 ,$16.71 ,$116.75 ,$20.02 ,$16.71 ,$116.75 ,$31.75 ,$150.50 ,$107.50 ,$172.00 ,$41.78 ,$16.71 ,$150.50 ,$16.71 ,$129.00 ,$16.71 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$16.71 ,$118.68 ,$189.00 ,$189.00 ,$182.75 ,$41.78 ,$149.00 ,$16.71 ,$215.00 ,$118.25 ,$16.71 ,$56.55 ,$215.00 ,$19.32 ,$18.44 ,$17.55 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$215.00 ,$16.71 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,42000017,97022,HC WHIRLPOOL 30 MINUTES,420,1 ,$215.00 ,$139.75 ,$16.71 ,$215.00 ,$41.78 ,$130.00 ,$118.25 ,$16.71 ,$60.20 ,$105.35 ,$16.71 ,$125.78 ,$16.71 ,$116.75 ,$20.02 ,$16.71 ,$116.75 ,$31.75 ,$150.50 ,$107.50 ,$172.00 ,$41.78 ,$16.71 ,$150.50 ,$16.71 ,$129.00 ,$16.71 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$16.71 ,$118.68 ,$189.00 ,$189.00 ,$182.75 ,$41.78 ,$149.00 ,$16.71 ,$215.00 ,$118.25 ,$16.71 ,$56.55 ,$215.00 ,$19.32 ,$18.44 ,$17.55 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$215.00 ,$16.71 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,42000018,97022,HC WHIRLPOOL 45 MINUTES,420,1 ,$215.00 ,$139.75 ,$16.71 ,$215.00 ,$41.78 ,$130.00 ,$118.25 ,$16.71 ,$60.20 ,$105.35 ,$16.71 ,$125.78 ,$16.71 ,$116.75 ,$20.02 ,$16.71 ,$116.75 ,$31.75 ,$150.50 ,$107.50 ,$172.00 ,$41.78 ,$16.71 ,$150.50 ,$16.71 ,$129.00 ,$16.71 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$16.71 ,$118.68 ,$189.00 ,$189.00 ,$182.75 ,$41.78 ,$149.00 ,$16.71 ,$215.00 ,$118.25 ,$16.71 ,$56.55 ,$215.00 ,$19.32 ,$18.44 ,$17.55 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$215.00 ,$16.71 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,42000019,97022,HC WHIRLPOOL 60 MINUTES,420,1 ,$215.00 ,$139.75 ,$16.71 ,$215.00 ,$41.78 ,$130.00 ,$118.25 ,$16.71 ,$60.20 ,$105.35 ,$16.71 ,$125.78 ,$16.71 ,$116.75 ,$20.02 ,$16.71 ,$116.75 ,$31.75 ,$150.50 ,$107.50 ,$172.00 ,$41.78 ,$16.71 ,$150.50 ,$16.71 ,$129.00 ,$16.71 ,$161.25 ,$118.68 ,$107.07 ,$118.68 ,$16.71 ,$118.68 ,$189.00 ,$189.00 ,$182.75 ,$41.78 ,$149.00 ,$16.71 ,$215.00 ,$118.25 ,$16.71 ,$56.55 ,$215.00 ,$19.32 ,$18.44 ,$17.55 ,$172.00 ,$116.75 ,$60.20 ,$193.50 ,$81.70 ,$215.00 ,$16.71 ,$103.20 
ST. MARY'S HOSPITAL - DECATUR,42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$200.00 ,$130.00 ,$14.43 ,$225.63 ,$36.08 ,$130.00 ,$110.00 ,$14.43 ,$56.00 ,$98.00 ,$14.43 ,$117.00 ,$14.43 ,$108.60 ,$16.88 ,$14.43 ,$108.60 ,$27.42 ,$140.00 ,$100.00 ,$160.00 ,$36.08 ,$14.43 ,$140.00 ,$14.43 ,$120.00 ,$14.43 ,$150.00 ,$110.40 ,$99.60 ,$110.40 ,$14.43 ,$110.40 ,$189.00 ,$189.00 ,$170.00 ,$36.08 ,$138.60 ,$14.43 ,$200.00 ,$110.00 ,$14.43 ,$52.60 ,$200.00 ,$200.00 ,$225.63 ,$15.15 ,$160.00 ,$108.60 ,$56.00 ,$180.00 ,$76.00 ,$200.00 ,$14.43 ,$96.00 
ST. MARY'S HOSPITAL - DECATUR,42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$305.00 ,$198.25 ,$19.19 ,$305.00 ,$47.98 ,$130.00 ,$167.75 ,$19.19 ,$85.40 ,$149.45 ,$19.19 ,$161.90 ,$19.19 ,$165.62 ,$23.35 ,$19.19 ,$165.62 ,$36.46 ,$213.50 ,$152.50 ,$244.00 ,$47.98 ,$19.19 ,$213.50 ,$19.19 ,$183.00 ,$19.19 ,$228.75 ,$168.36 ,$151.89 ,$168.36 ,$19.19 ,$168.36 ,$189.00 ,$189.00 ,$259.25 ,$47.98 ,$211.37 ,$19.19 ,$305.00 ,$167.75 ,$19.19 ,$80.22 ,$305.00 ,$236.38 ,$225.63 ,$20.15 ,$244.00 ,$165.62 ,$85.40 ,$274.50 ,$115.90 ,$225.00 ,$19.19 ,$146.40 
ST. MARY'S HOSPITAL - DECATUR,42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$284.00 ,$184.60 ,$13.99 ,$284.00 ,$34.98 ,$130.00 ,$156.20 ,$13.99 ,$79.52 ,$126.12 ,$13.99 ,$126.12 ,$13.99 ,$154.21 ,$16.76 ,$13.99 ,$154.21 ,$26.58 ,$198.80 ,$142.00 ,$227.20 ,$34.98 ,$13.99 ,$198.80 ,$13.99 ,$170.40 ,$13.99 ,$213.00 ,$156.77 ,$141.43 ,$156.77 ,$13.99 ,$156.77 ,$189.00 ,$189.00 ,$241.40 ,$34.98 ,$196.81 ,$13.99 ,$284.00 ,$156.20 ,$13.99 ,$74.69 ,$284.00 ,$236.38 ,$225.63 ,$14.69 ,$227.20 ,$154.21 ,$79.52 ,$255.60 ,$107.92 ,$225.00 ,$13.99 ,$136.32 
ST. MARY'S HOSPITAL - DECATUR,42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$286.00 ,$185.90 ,$29.02 ,$286.00 ,$72.55 ,$130.00 ,$157.30 ,$29.02 ,$80.08 ,$140.14 ,$29.02 ,$167.31 ,$29.02 ,$155.30 ,$39.56 ,$29.02 ,$155.30 ,$55.14 ,$200.20 ,$143.00 ,$228.80 ,$72.55 ,$29.02 ,$200.20 ,$29.02 ,$171.60 ,$29.02 ,$214.50 ,$157.87 ,$142.43 ,$157.87 ,$29.02 ,$157.87 ,$189.00 ,$189.00 ,$243.10 ,$72.55 ,$198.20 ,$29.02 ,$286.00 ,$157.30 ,$29.02 ,$75.22 ,$286.00 ,$236.38 ,$225.63 ,$30.47 ,$228.80 ,$155.30 ,$80.08 ,$257.40 ,$108.68 ,$225.00 ,$29.02 ,$137.28 
ST. MARY'S HOSPITAL - DECATUR,42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$294.00 ,$191.10 ,$33.59 ,$294.00 ,$83.98 ,$130.00 ,$161.70 ,$33.59 ,$82.32 ,$144.06 ,$33.59 ,$171.99 ,$33.59 ,$159.64 ,$41.19 ,$33.59 ,$159.64 ,$63.82 ,$205.80 ,$147.00 ,$235.20 ,$83.98 ,$33.59 ,$205.80 ,$33.59 ,$176.40 ,$33.59 ,$220.50 ,$162.29 ,$146.41 ,$162.29 ,$33.59 ,$162.29 ,$189.00 ,$189.00 ,$249.90 ,$83.98 ,$203.74 ,$33.59 ,$294.00 ,$161.70 ,$33.59 ,$77.32 ,$294.00 ,$236.38 ,$225.63 ,$35.27 ,$235.20 ,$159.64 ,$82.32 ,$264.60 ,$111.72 ,$225.00 ,$33.59 ,$141.12 
ST. MARY'S HOSPITAL - DECATUR,42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$233.00 ,$151.45 ,$29.02 ,$233.00 ,$72.55 ,$130.00 ,$128.15 ,$29.02 ,$65.24 ,$114.17 ,$29.02 ,$136.31 ,$29.02 ,$126.52 ,$34.34 ,$29.02 ,$126.52 ,$55.14 ,$163.10 ,$116.50 ,$186.40 ,$72.55 ,$29.02 ,$163.10 ,$29.02 ,$139.80 ,$29.02 ,$174.75 ,$128.62 ,$116.03 ,$128.62 ,$29.02 ,$128.62 ,$189.00 ,$189.00 ,$198.05 ,$72.55 ,$161.47 ,$29.02 ,$233.00 ,$128.15 ,$29.02 ,$61.28 ,$233.00 ,$233.00 ,$225.63 ,$30.47 ,$186.40 ,$126.52 ,$65.24 ,$209.70 ,$88.54 ,$225.00 ,$29.02 ,$111.84 
ST. MARY'S HOSPITAL - DECATUR,42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$265.00 ,$172.25 ,$25.16 ,$265.00 ,$66.88 ,$130.00 ,$145.75 ,$26.75 ,$74.20 ,$129.85 ,$26.75 ,$155.03 ,$26.75 ,$143.90 ,$25.16 ,$26.75 ,$143.90 ,$50.83 ,$185.50 ,$132.50 ,$212.00 ,$66.88 ,$26.75 ,$185.50 ,$26.75 ,$159.00 ,$26.75 ,$198.75 ,$146.28 ,$131.97 ,$146.28 ,$26.75 ,$146.28 ,$189.00 ,$189.00 ,$225.25 ,$66.88 ,$183.65 ,$26.75 ,$265.00 ,$145.75 ,$26.75 ,$69.70 ,$265.00 ,$236.38 ,$225.63 ,$28.09 ,$212.00 ,$143.90 ,$74.20 ,$238.50 ,$100.70 ,$225.00 ,$26.75 ,$127.20 
ST. MARY'S HOSPITAL - DECATUR,42000063,97150,HC GROUP TREATMENT 15MIN,420,1 ,$331.00 ,$215.15 ,$17.39 ,$331.00 ,$43.48 ,$130.00 ,$182.05 ,$17.39 ,$92.68 ,$162.19 ,$17.39 ,$190.80 ,$17.39 ,$179.73 ,$20.80 ,$17.39 ,$179.73 ,$33.04 ,$231.70 ,$165.50 ,$264.80 ,$43.48 ,$17.39 ,$231.70 ,$17.39 ,$198.60 ,$17.39 ,$248.25 ,$182.71 ,$164.84 ,$182.71 ,$17.39 ,$182.71 ,$189.00 ,$189.00 ,$281.35 ,$43.48 ,$229.38 ,$17.39 ,$331.00 ,$182.05 ,$17.39 ,$87.05 ,$331.00 ,$77.12 ,$73.62 ,$18.26 ,$264.80 ,$179.73 ,$92.68 ,$297.90 ,$125.78 ,$225.00 ,$17.39 ,$158.88 
ST. MARY'S HOSPITAL - DECATUR,42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$293.00 ,$190.45 ,$36.24 ,$293.00 ,$90.60 ,$130.00 ,$161.15 ,$36.24 ,$82.04 ,$143.57 ,$36.24 ,$171.41 ,$36.24 ,$159.10 ,$44.55 ,$36.24 ,$159.10 ,$68.86 ,$205.10 ,$146.50 ,$234.40 ,$90.60 ,$36.24 ,$205.10 ,$36.24 ,$175.80 ,$36.24 ,$219.75 ,$161.74 ,$145.91 ,$161.74 ,$36.24 ,$161.74 ,$189.00 ,$189.00 ,$249.05 ,$90.60 ,$203.05 ,$36.24 ,$293.00 ,$161.15 ,$36.24 ,$77.06 ,$293.00 ,$236.38 ,$225.63 ,$38.05 ,$234.40 ,$159.10 ,$82.04 ,$263.70 ,$111.34 ,$225.00 ,$36.24 ,$140.64 
ST. MARY'S HOSPITAL - DECATUR,42000083,97598,HC DEBR SKIN PART THICKNESS EA ADDN>20CM FACIL,420,1 ,"$1,454.00 ",$945.10 ,$13.92 ,"$1,454.00 ", N/A ,$130.00 ,$799.70 , N/A ,$407.12 ,$107.15 , N/A ,$107.15 , N/A ,$789.52 ,$13.92 , N/A ,$789.52 , N/A ,"$1,017.80 ",$727.00 ,"$1,163.20 ", N/A , N/A ,"$1,017.80 ", N/A ,$872.40 , N/A ,"$1,090.50 ",$802.61 ,$724.09 ,$802.61 , N/A ,$802.61 ,$189.00 ,$189.00 ,"$1,235.90 ", N/A ,"$1,007.62 ", N/A ,"$1,454.00 ",$799.70 , N/A ,$382.40 ,"$1,454.00 ",$83.53 ,$79.74 , N/A ,"$1,163.20 ",$789.52 ,$407.12 ,"$1,308.60 ",$552.52 ,$225.00 , N/A ,$697.92 
ST. MARY'S HOSPITAL - DECATUR,42000084,97602,HC DEBRIDEMENT NONSELECTIVE,420,1 ,$758.00 ,$492.70 ,$48.02 ,$758.00 , N/A ,$130.00 ,$416.90 , N/A ,$212.24 ,$371.42 , N/A ,$373.93 , N/A ,$411.59 ,$48.02 , N/A ,$411.59 , N/A ,$530.60 ,$379.00 ,$606.40 , N/A , N/A ,$530.60 , N/A ,$454.80 , N/A ,$568.50 ,$418.42 ,$377.48 ,$418.42 , N/A ,$418.42 ,$189.00 ,$189.00 ,$644.30 , N/A ,$525.29 , N/A ,$758.00 ,$416.90 , N/A ,$199.35 ,$758.00 ,$201.22 ,$192.08 , N/A ,$606.40 ,$411.59 ,$212.24 ,$682.20 ,$288.04 ,$225.00 , N/A ,$363.84 
ST. MARY'S HOSPITAL - DECATUR,42000085,97605,HC NWPT <50 SQ CM FAC,420,1 ,"$1,364.00 ",$886.60 ,$32.14 ,"$1,364.00 ",$103.28 ,$130.00 ,$750.20 ,$41.31 ,$381.92 ,$246.93 ,$41.31 ,$246.93 ,$41.31 ,$740.65 ,$32.14 ,$41.31 ,$740.65 ,$78.49 ,$954.80 ,$682.00 ,"$1,091.20 ",$103.28 ,$41.31 ,$954.80 ,$41.31 ,$818.40 ,$41.31 ,"$1,023.00 ",$752.93 ,$679.27 ,$752.93 ,$41.31 ,$752.93 ,$189.00 ,$189.00 ,"$1,159.40 ",$103.28 ,$945.25 ,$41.31 ,"$1,364.00 ",$750.20 ,$41.31 ,$358.73 ,"$1,364.00 ",$201.22 ,$192.08 ,$43.38 ,"$1,091.20 ",$740.65 ,$381.92 ,"$1,227.60 ",$518.32 ,$225.00 ,$41.31 ,$654.72 
ST. MARY'S HOSPITAL - DECATUR,42000089,97606,HC NWPT >50 SQ CM FAC,420,1 ,"$1,454.00 ",$945.10 ,$34.74 ,"$1,454.00 ",$121.80 ,$130.00 ,$799.70 ,$48.72 ,$407.12 ,$266.49 ,$48.72 ,$266.49 ,$48.72 ,$789.52 ,$34.74 ,$48.72 ,$789.52 ,$92.57 ,"$1,017.80 ",$727.00 ,"$1,163.20 ",$121.80 ,$48.72 ,"$1,017.80 ",$48.72 ,$872.40 ,$48.72 ,"$1,090.50 ",$802.61 ,$724.09 ,$802.61 ,$48.72 ,$802.61 ,$189.00 ,$189.00 ,"$1,235.90 ",$121.80 ,"$1,007.62 ",$48.72 ,"$1,454.00 ",$799.70 ,$48.72 ,$382.40 ,"$1,454.00 ",$201.22 ,$192.08 ,$51.16 ,"$1,163.20 ",$789.52 ,$407.12 ,"$1,308.60 ",$552.52 ,$225.00 ,$48.72 ,$697.92 
ST. MARY'S HOSPITAL - DECATUR,42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$244.00 ,$158.60 ,$32.80 ,$244.00 ,$82.00 ,$124.44 ,$134.20 ,$32.80 ,$68.32 ,$119.56 ,$32.80 ,$142.74 ,$32.80 ,$132.49 ,$41.89 ,$32.80 ,$132.49 ,$62.32 ,$170.80 ,$122.00 ,$195.20 ,$82.00 ,$32.80 ,$170.80 ,$32.80 ,$146.40 ,$32.80 ,$183.00 ,$134.69 ,$121.51 ,$134.69 ,$32.80 ,$134.69 ,$189.00 ,$189.00 ,$207.40 ,$82.00 ,$169.09 ,$32.80 ,$244.00 ,$134.20 ,$32.80 ,$64.17 ,$244.00 ,$236.38 ,$225.63 ,$34.44 ,$195.20 ,$132.49 ,$68.32 ,$219.60 ,$92.72 ,$225.00 ,$32.80 ,$117.12 
ST. MARY'S HOSPITAL - DECATUR,42000094,97761,HC PROSTHETIC TRAINING EA 15 MIN,420,1 ,$333.00 ,$216.45 ,$40.53 ,$333.00 ,$101.33 ,$130.00 ,$183.15 ,$40.53 ,$93.24 ,$163.17 ,$40.53 ,$194.81 ,$40.53 ,$180.82 ,$48.94 ,$40.53 ,$180.82 ,$77.01 ,$233.10 ,$166.50 ,$266.40 ,$101.33 ,$40.53 ,$233.10 ,$40.53 ,$199.80 ,$40.53 ,$249.75 ,$183.82 ,$165.83 ,$183.82 ,$40.53 ,$183.82 ,$189.00 ,$189.00 ,$283.05 ,$101.33 ,$230.77 ,$40.53 ,$333.00 ,$183.15 ,$40.53 ,$87.58 ,$333.00 ,$236.38 ,$225.63 ,$42.56 ,$266.40 ,$180.82 ,$93.24 ,$299.70 ,$126.54 ,$225.00 ,$40.53 ,$159.84 
ST. MARY'S HOSPITAL - DECATUR,42000095,97763,HC ORTHTC/PRSTHTC CHECK EA 15MIN,420,1 ,$126.00 ,$81.90 ,$33.14 ,$225.63 ,$130.38 ,$126.00 ,$69.30 ,$52.15 ,$35.28 ,$61.74 ,$52.15 ,$73.71 ,$52.15 ,$68.42 ,$59.79 ,$52.15 ,$68.42 ,$99.09 ,$88.20 ,$63.00 ,$100.80 ,$130.38 ,$52.15 ,$88.20 ,$52.15 ,$75.60 ,$52.15 ,$94.50 ,$69.55 ,$62.75 ,$69.55 ,$52.15 ,$69.55 ,$126.00 ,$126.00 ,$107.10 ,$126.00 ,$87.32 ,$52.15 ,$126.00 ,$69.30 ,$52.15 ,$33.14 ,$126.00 ,$126.00 ,$225.63 ,$54.76 ,$100.80 ,$68.42 ,$35.28 ,$113.40 ,$47.88 ,$126.00 ,$52.15 ,$60.48 
ST. MARY'S HOSPITAL - DECATUR,42000110,G0283,HC ELECT STIM(UNATTEND) OTHER,420,1 ,$484.00 ,$314.60 ,$10.00 ,$484.00 ,$30.00 ,$130.00 ,$266.20 ,$12.00 ,$135.52 ,$98.30 ,$12.00 ,$98.30 ,$12.00 ,$262.81 ,$10.00 ,$12.00 ,$262.81 ,$22.80 ,$338.80 ,$242.00 ,$387.20 ,$30.00 ,$12.00 ,$338.80 ,$12.00 ,$290.40 ,$12.00 ,$363.00 ,$267.17 ,$241.03 ,$267.17 ,$12.00 ,$267.17 ,$189.00 ,$189.00 ,$411.40 ,$30.00 ,$335.41 ,$12.00 ,$484.00 ,$266.20 ,$12.00 ,$127.29 ,$484.00 ,$19.32 ,$18.44 ,$12.60 ,$387.20 ,$262.81 ,$135.52 ,$435.60 ,$183.92 ,$225.00 ,$12.00 ,$232.32 
ST. MARY'S HOSPITAL - DECATUR,42000160,97113,HC THERAPEUTIC ACT W/AQUA,420,1 ,$294.00 ,$191.10 ,$36.05 ,$294.00 ,$90.13 ,$130.00 ,$161.70 ,$36.05 ,$82.32 ,$144.06 ,$36.05 ,$171.99 ,$36.05 ,$159.64 ,$43.54 ,$36.05 ,$159.64 ,$68.50 ,$205.80 ,$147.00 ,$235.20 ,$90.13 ,$36.05 ,$205.80 ,$36.05 ,$176.40 ,$36.05 ,$220.50 ,$162.29 ,$146.41 ,$162.29 ,$36.05 ,$162.29 ,$189.00 ,$189.00 ,$249.90 ,$90.13 ,$203.74 ,$36.05 ,$294.00 ,$161.70 ,$36.05 ,$77.32 ,$294.00 ,$236.38 ,$225.63 ,$37.85 ,$235.20 ,$159.64 ,$82.32 ,$264.60 ,$111.72 ,$225.00 ,$36.05 ,$141.12 
ST. MARY'S HOSPITAL - DECATUR,42000204,97010,HC HOT/COLD PACK 15MIN,420,1 ,$83.00 ,$53.95 ,$3.00 ,$83.00 , N/A ,$83.00 ,$45.65 , N/A ,$23.24 ,$29.49 , N/A ,$29.49 , N/A ,$45.07 ,$3.00 , N/A ,$45.07 , N/A ,$58.10 ,$41.50 ,$66.40 , N/A , N/A ,$58.10 , N/A ,$49.80 , N/A ,$62.25 ,$45.82 ,$41.33 ,$45.82 , N/A ,$45.82 ,$83.00 ,$83.00 ,$70.55 , N/A ,$57.52 , N/A ,$83.00 ,$45.65 , N/A ,$21.83 ,$83.00 ,$19.32 ,$18.44 , N/A ,$66.40 ,$45.07 ,$23.24 ,$74.70 ,$31.54 ,$83.00 , N/A ,$39.84 
ST. MARY'S HOSPITAL - DECATUR,42000205,97010,HC HOT/COLD PACK 30MIN,420,1 ,$83.00 ,$53.95 ,$3.00 ,$83.00 , N/A ,$83.00 ,$45.65 , N/A ,$23.24 ,$29.49 , N/A ,$29.49 , N/A ,$45.07 ,$3.00 , N/A ,$45.07 , N/A ,$58.10 ,$41.50 ,$66.40 , N/A , N/A ,$58.10 , N/A ,$49.80 , N/A ,$62.25 ,$45.82 ,$41.33 ,$45.82 , N/A ,$45.82 ,$83.00 ,$83.00 ,$70.55 , N/A ,$57.52 , N/A ,$83.00 ,$45.65 , N/A ,$21.83 ,$83.00 ,$19.32 ,$18.44 , N/A ,$66.40 ,$45.07 ,$23.24 ,$74.70 ,$31.54 ,$83.00 , N/A ,$39.84 
ST. MARY'S HOSPITAL - DECATUR,42000206,G0283,HC ELECT STIM (UNATTEND) OTHER 15MIN,420,1 ,$422.00 ,$274.30 ,$10.00 ,$422.00 ,$30.00 ,$130.00 ,$232.10 ,$12.00 ,$118.16 ,$98.30 ,$12.00 ,$98.30 ,$12.00 ,$229.15 ,$10.00 ,$12.00 ,$229.15 ,$22.80 ,$295.40 ,$211.00 ,$337.60 ,$30.00 ,$12.00 ,$295.40 ,$12.00 ,$253.20 ,$12.00 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$12.00 ,$232.94 ,$189.00 ,$189.00 ,$358.70 ,$30.00 ,$292.45 ,$12.00 ,$422.00 ,$232.10 ,$12.00 ,$110.99 ,$422.00 ,$19.32 ,$18.44 ,$12.60 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$225.00 ,$12.00 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,42000207,G0283,HC ELECT STIM (UNATTEND) OTHER 30MIN,420,1 ,$422.00 ,$274.30 ,$10.00 ,$422.00 ,$30.00 ,$130.00 ,$232.10 ,$12.00 ,$118.16 ,$98.30 ,$12.00 ,$98.30 ,$12.00 ,$229.15 ,$10.00 ,$12.00 ,$229.15 ,$22.80 ,$295.40 ,$211.00 ,$337.60 ,$30.00 ,$12.00 ,$295.40 ,$12.00 ,$253.20 ,$12.00 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$12.00 ,$232.94 ,$189.00 ,$189.00 ,$358.70 ,$30.00 ,$292.45 ,$12.00 ,$422.00 ,$232.10 ,$12.00 ,$110.99 ,$422.00 ,$19.32 ,$18.44 ,$12.60 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$225.00 ,$12.00 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,42000208,G0283,HC ELECT STIM (UNATTEND) OTHER 45MIN,420,1 ,$422.00 ,$274.30 ,$10.00 ,$422.00 ,$30.00 ,$130.00 ,$232.10 ,$12.00 ,$118.16 ,$98.30 ,$12.00 ,$98.30 ,$12.00 ,$229.15 ,$10.00 ,$12.00 ,$229.15 ,$22.80 ,$295.40 ,$211.00 ,$337.60 ,$30.00 ,$12.00 ,$295.40 ,$12.00 ,$253.20 ,$12.00 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$12.00 ,$232.94 ,$189.00 ,$189.00 ,$358.70 ,$30.00 ,$292.45 ,$12.00 ,$422.00 ,$232.10 ,$12.00 ,$110.99 ,$422.00 ,$19.32 ,$18.44 ,$12.60 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$225.00 ,$12.00 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,42000209,G0283,HC ELECT STIM (UNATTEND) OTHER 60MIN,420,1 ,$422.00 ,$274.30 ,$10.00 ,$422.00 ,$30.00 ,$130.00 ,$232.10 ,$12.00 ,$118.16 ,$98.30 ,$12.00 ,$98.30 ,$12.00 ,$229.15 ,$10.00 ,$12.00 ,$229.15 ,$22.80 ,$295.40 ,$211.00 ,$337.60 ,$30.00 ,$12.00 ,$295.40 ,$12.00 ,$253.20 ,$12.00 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$12.00 ,$232.94 ,$189.00 ,$189.00 ,$358.70 ,$30.00 ,$292.45 ,$12.00 ,$422.00 ,$232.10 ,$12.00 ,$110.99 ,$422.00 ,$19.32 ,$18.44 ,$12.60 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$225.00 ,$12.00 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,42000210,97016,HC APPLY VASOPNEUMATIC DEVICE 15MIN,420,1 ,$143.00 ,$92.95 ,$11.69 ,$143.00 ,$29.23 ,$130.00 ,$78.65 ,$11.69 ,$40.04 ,$70.07 ,$11.69 ,$83.66 ,$11.69 ,$77.65 ,$14.37 ,$11.69 ,$77.65 ,$22.21 ,$100.10 ,$71.50 ,$114.40 ,$29.23 ,$11.69 ,$100.10 ,$11.69 ,$85.80 ,$11.69 ,$107.25 ,$78.94 ,$71.21 ,$78.94 ,$11.69 ,$78.94 ,$143.00 ,$143.00 ,$121.55 ,$29.23 ,$99.10 ,$11.69 ,$143.00 ,$78.65 ,$11.69 ,$37.61 ,$143.00 ,$19.32 ,$18.44 ,$12.27 ,$114.40 ,$77.65 ,$40.04 ,$128.70 ,$54.34 ,$143.00 ,$11.69 ,$68.64 
ST. MARY'S HOSPITAL - DECATUR,42400043,97161,HC PT EVAL LOW COMPLEXITY 15MIN,424,1 ,$388.00 ,$252.20 ,$90.33 ,$388.00 ,$246.90 ,$130.00 ,$213.40 ,$98.76 ,$108.64 ,$190.12 ,$98.76 ,$226.98 ,$98.76 ,$210.68 ,$90.33 ,$98.76 ,$210.68 ,$187.64 ,$271.60 ,$194.00 ,$310.40 ,$246.90 ,$98.76 ,$271.60 ,$98.76 ,$232.80 ,$98.76 ,$291.00 ,$214.18 ,$193.22 ,$214.18 ,$98.76 ,$214.18 ,$189.00 ,$189.00 ,$329.80 ,$246.90 ,$268.88 ,$98.76 ,$388.00 ,$213.40 ,$98.76 ,$102.04 ,$388.00 ,$236.38 ,$225.63 ,$103.70 ,$310.40 ,$210.68 ,$108.64 ,$349.20 ,$147.44 ,$225.00 ,$98.76 ,$186.24 
ST. MARY'S HOSPITAL - DECATUR,42400044,97161,HC PT EVAL LOW COMPLEXITY 30MIN,424,1 ,$388.00 ,$252.20 ,$90.33 ,$388.00 ,$246.90 ,$130.00 ,$213.40 ,$98.76 ,$108.64 ,$190.12 ,$98.76 ,$226.98 ,$98.76 ,$210.68 ,$90.33 ,$98.76 ,$210.68 ,$187.64 ,$271.60 ,$194.00 ,$310.40 ,$246.90 ,$98.76 ,$271.60 ,$98.76 ,$232.80 ,$98.76 ,$291.00 ,$214.18 ,$193.22 ,$214.18 ,$98.76 ,$214.18 ,$189.00 ,$189.00 ,$329.80 ,$246.90 ,$268.88 ,$98.76 ,$388.00 ,$213.40 ,$98.76 ,$102.04 ,$388.00 ,$236.38 ,$225.63 ,$103.70 ,$310.40 ,$210.68 ,$108.64 ,$349.20 ,$147.44 ,$225.00 ,$98.76 ,$186.24 
ST. MARY'S HOSPITAL - DECATUR,42400045,97161,HC PT EVAL LOW COMPLEXITY 45MIN,424,1 ,$388.00 ,$252.20 ,$90.33 ,$388.00 ,$246.90 ,$130.00 ,$213.40 ,$98.76 ,$108.64 ,$190.12 ,$98.76 ,$226.98 ,$98.76 ,$210.68 ,$90.33 ,$98.76 ,$210.68 ,$187.64 ,$271.60 ,$194.00 ,$310.40 ,$246.90 ,$98.76 ,$271.60 ,$98.76 ,$232.80 ,$98.76 ,$291.00 ,$214.18 ,$193.22 ,$214.18 ,$98.76 ,$214.18 ,$189.00 ,$189.00 ,$329.80 ,$246.90 ,$268.88 ,$98.76 ,$388.00 ,$213.40 ,$98.76 ,$102.04 ,$388.00 ,$236.38 ,$225.63 ,$103.70 ,$310.40 ,$210.68 ,$108.64 ,$349.20 ,$147.44 ,$225.00 ,$98.76 ,$186.24 
ST. MARY'S HOSPITAL - DECATUR,42400046,97161,HC PT EVAL LOW COMPLEXITY 60MIN,424,1 ,$388.00 ,$252.20 ,$90.33 ,$388.00 ,$246.90 ,$130.00 ,$213.40 ,$98.76 ,$108.64 ,$190.12 ,$98.76 ,$226.98 ,$98.76 ,$210.68 ,$90.33 ,$98.76 ,$210.68 ,$187.64 ,$271.60 ,$194.00 ,$310.40 ,$246.90 ,$98.76 ,$271.60 ,$98.76 ,$232.80 ,$98.76 ,$291.00 ,$214.18 ,$193.22 ,$214.18 ,$98.76 ,$214.18 ,$189.00 ,$189.00 ,$329.80 ,$246.90 ,$268.88 ,$98.76 ,$388.00 ,$213.40 ,$98.76 ,$102.04 ,$388.00 ,$236.38 ,$225.63 ,$103.70 ,$310.40 ,$210.68 ,$108.64 ,$349.20 ,$147.44 ,$225.00 ,$98.76 ,$186.24 
ST. MARY'S HOSPITAL - DECATUR,42400055,97162,HC PT EVAL MOD COMPLEXITY 15MIN,424,1 ,$519.00 ,$337.35 ,$98.76 ,$519.00 ,$246.90 ,$130.00 ,$285.45 ,$98.76 ,$145.32 ,$254.31 ,$98.76 ,$303.62 ,$98.76 ,$281.82 ,$100.36 ,$98.76 ,$281.82 ,$187.64 ,$363.30 ,$259.50 ,$415.20 ,$246.90 ,$98.76 ,$363.30 ,$98.76 ,$311.40 ,$98.76 ,$389.25 ,$286.49 ,$258.46 ,$286.49 ,$98.76 ,$286.49 ,$189.00 ,$189.00 ,$441.15 ,$246.90 ,$359.67 ,$98.76 ,$519.00 ,$285.45 ,$98.76 ,$136.50 ,$519.00 ,$236.38 ,$225.63 ,$103.70 ,$415.20 ,$281.82 ,$145.32 ,$467.10 ,$197.22 ,$225.00 ,$98.76 ,$249.12 
ST. MARY'S HOSPITAL - DECATUR,42400056,97162,HC PT EVAL MOD COMPLEXITY 30MIN,424,1 ,$519.00 ,$337.35 ,$98.76 ,$519.00 ,$246.90 ,$130.00 ,$285.45 ,$98.76 ,$145.32 ,$254.31 ,$98.76 ,$303.62 ,$98.76 ,$281.82 ,$100.36 ,$98.76 ,$281.82 ,$187.64 ,$363.30 ,$259.50 ,$415.20 ,$246.90 ,$98.76 ,$363.30 ,$98.76 ,$311.40 ,$98.76 ,$389.25 ,$286.49 ,$258.46 ,$286.49 ,$98.76 ,$286.49 ,$189.00 ,$189.00 ,$441.15 ,$246.90 ,$359.67 ,$98.76 ,$519.00 ,$285.45 ,$98.76 ,$136.50 ,$519.00 ,$236.38 ,$225.63 ,$103.70 ,$415.20 ,$281.82 ,$145.32 ,$467.10 ,$197.22 ,$225.00 ,$98.76 ,$249.12 
ST. MARY'S HOSPITAL - DECATUR,42400057,97162,HC PT EVAL MOD COMPLEXITY 45MIN,424,1 ,$519.00 ,$337.35 ,$98.76 ,$519.00 ,$246.90 ,$130.00 ,$285.45 ,$98.76 ,$145.32 ,$254.31 ,$98.76 ,$303.62 ,$98.76 ,$281.82 ,$100.36 ,$98.76 ,$281.82 ,$187.64 ,$363.30 ,$259.50 ,$415.20 ,$246.90 ,$98.76 ,$363.30 ,$98.76 ,$311.40 ,$98.76 ,$389.25 ,$286.49 ,$258.46 ,$286.49 ,$98.76 ,$286.49 ,$189.00 ,$189.00 ,$441.15 ,$246.90 ,$359.67 ,$98.76 ,$519.00 ,$285.45 ,$98.76 ,$136.50 ,$519.00 ,$236.38 ,$225.63 ,$103.70 ,$415.20 ,$281.82 ,$145.32 ,$467.10 ,$197.22 ,$225.00 ,$98.76 ,$249.12 
ST. MARY'S HOSPITAL - DECATUR,42400058,97162,HC PT EVAL MOD COMPLEXITY 60MIN,424,1 ,$519.00 ,$337.35 ,$98.76 ,$519.00 ,$246.90 ,$130.00 ,$285.45 ,$98.76 ,$145.32 ,$254.31 ,$98.76 ,$303.62 ,$98.76 ,$281.82 ,$100.36 ,$98.76 ,$281.82 ,$187.64 ,$363.30 ,$259.50 ,$415.20 ,$246.90 ,$98.76 ,$363.30 ,$98.76 ,$311.40 ,$98.76 ,$389.25 ,$286.49 ,$258.46 ,$286.49 ,$98.76 ,$286.49 ,$189.00 ,$189.00 ,$441.15 ,$246.90 ,$359.67 ,$98.76 ,$519.00 ,$285.45 ,$98.76 ,$136.50 ,$519.00 ,$236.38 ,$225.63 ,$103.70 ,$415.20 ,$281.82 ,$145.32 ,$467.10 ,$197.22 ,$225.00 ,$98.76 ,$249.12 
ST. MARY'S HOSPITAL - DECATUR,42400067,97163,HC PT EVAL HIGH COMPLEXITY 15MIN,424,1 ,$647.00 ,$420.55 ,$98.76 ,$647.00 ,$246.90 ,$130.00 ,$355.85 ,$98.76 ,$181.16 ,$317.03 ,$98.76 ,$378.50 ,$98.76 ,$351.32 ,$110.39 ,$98.76 ,$351.32 ,$187.64 ,$452.90 ,$323.50 ,$517.60 ,$246.90 ,$98.76 ,$452.90 ,$98.76 ,$388.20 ,$98.76 ,$485.25 ,$357.14 ,$322.21 ,$357.14 ,$98.76 ,$357.14 ,$189.00 ,$189.00 ,$549.95 ,$246.90 ,$448.37 ,$98.76 ,$647.00 ,$355.85 ,$98.76 ,$170.16 ,$647.00 ,$236.38 ,$225.63 ,$103.70 ,$517.60 ,$351.32 ,$181.16 ,$582.30 ,$245.86 ,$225.00 ,$98.76 ,$310.56 
ST. MARY'S HOSPITAL - DECATUR,42400068,97163,HC PT EVAL HIGH COMPLEXITY 30MIN,424,1 ,$647.00 ,$420.55 ,$98.76 ,$647.00 ,$246.90 ,$130.00 ,$355.85 ,$98.76 ,$181.16 ,$317.03 ,$98.76 ,$378.50 ,$98.76 ,$351.32 ,$110.39 ,$98.76 ,$351.32 ,$187.64 ,$452.90 ,$323.50 ,$517.60 ,$246.90 ,$98.76 ,$452.90 ,$98.76 ,$388.20 ,$98.76 ,$485.25 ,$357.14 ,$322.21 ,$357.14 ,$98.76 ,$357.14 ,$189.00 ,$189.00 ,$549.95 ,$246.90 ,$448.37 ,$98.76 ,$647.00 ,$355.85 ,$98.76 ,$170.16 ,$647.00 ,$236.38 ,$225.63 ,$103.70 ,$517.60 ,$351.32 ,$181.16 ,$582.30 ,$245.86 ,$225.00 ,$98.76 ,$310.56 
ST. MARY'S HOSPITAL - DECATUR,42400069,97163,HC PT EVAL HIGH COMPLEXITY 45MIN,424,1 ,$647.00 ,$420.55 ,$98.76 ,$647.00 ,$246.90 ,$130.00 ,$355.85 ,$98.76 ,$181.16 ,$317.03 ,$98.76 ,$378.50 ,$98.76 ,$351.32 ,$110.39 ,$98.76 ,$351.32 ,$187.64 ,$452.90 ,$323.50 ,$517.60 ,$246.90 ,$98.76 ,$452.90 ,$98.76 ,$388.20 ,$98.76 ,$485.25 ,$357.14 ,$322.21 ,$357.14 ,$98.76 ,$357.14 ,$189.00 ,$189.00 ,$549.95 ,$246.90 ,$448.37 ,$98.76 ,$647.00 ,$355.85 ,$98.76 ,$170.16 ,$647.00 ,$236.38 ,$225.63 ,$103.70 ,$517.60 ,$351.32 ,$181.16 ,$582.30 ,$245.86 ,$225.00 ,$98.76 ,$310.56 
ST. MARY'S HOSPITAL - DECATUR,42400070,97163,HC PT EVAL HIGH COMPLEXITY 60MIN,424,1 ,$647.00 ,$420.55 ,$98.76 ,$647.00 ,$246.90 ,$130.00 ,$355.85 ,$98.76 ,$181.16 ,$317.03 ,$98.76 ,$378.50 ,$98.76 ,$351.32 ,$110.39 ,$98.76 ,$351.32 ,$187.64 ,$452.90 ,$323.50 ,$517.60 ,$246.90 ,$98.76 ,$452.90 ,$98.76 ,$388.20 ,$98.76 ,$485.25 ,$357.14 ,$322.21 ,$357.14 ,$98.76 ,$357.14 ,$189.00 ,$189.00 ,$549.95 ,$246.90 ,$448.37 ,$98.76 ,$647.00 ,$355.85 ,$98.76 ,$170.16 ,$647.00 ,$236.38 ,$225.63 ,$103.70 ,$517.60 ,$351.32 ,$181.16 ,$582.30 ,$245.86 ,$225.00 ,$98.76 ,$310.56 
ST. MARY'S HOSPITAL - DECATUR,42400079,97164,HC PT RE-EVAL 15MIN,424,1 ,$175.00 ,$113.75 ,$46.03 ,$225.63 ,$169.20 ,$130.00 ,$96.25 ,$67.68 ,$49.00 ,$85.75 ,$67.68 ,$102.38 ,$67.68 ,$95.03 ,$61.49 ,$67.68 ,$95.03 ,$128.59 ,$122.50 ,$87.50 ,$140.00 ,$169.20 ,$67.68 ,$122.50 ,$67.68 ,$105.00 ,$67.68 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$67.68 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$169.20 ,$121.28 ,$67.68 ,$175.00 ,$96.25 ,$67.68 ,$46.03 ,$175.00 ,$175.00 ,$225.63 ,$71.06 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$67.68 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,42400080,97164,HC PT RE-EVAL 30MIN,424,1 ,$175.00 ,$113.75 ,$46.03 ,$225.63 ,$169.20 ,$130.00 ,$96.25 ,$67.68 ,$49.00 ,$85.75 ,$67.68 ,$102.38 ,$67.68 ,$95.03 ,$61.49 ,$67.68 ,$95.03 ,$128.59 ,$122.50 ,$87.50 ,$140.00 ,$169.20 ,$67.68 ,$122.50 ,$67.68 ,$105.00 ,$67.68 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$67.68 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$169.20 ,$121.28 ,$67.68 ,$175.00 ,$96.25 ,$67.68 ,$46.03 ,$175.00 ,$175.00 ,$225.63 ,$71.06 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$67.68 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,42400081,97164,HC PT RE-EVAL 45MIN,424,1 ,$175.00 ,$113.75 ,$46.03 ,$225.63 ,$169.20 ,$130.00 ,$96.25 ,$67.68 ,$49.00 ,$85.75 ,$67.68 ,$102.38 ,$67.68 ,$95.03 ,$61.49 ,$67.68 ,$95.03 ,$128.59 ,$122.50 ,$87.50 ,$140.00 ,$169.20 ,$67.68 ,$122.50 ,$67.68 ,$105.00 ,$67.68 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$67.68 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$169.20 ,$121.28 ,$67.68 ,$175.00 ,$96.25 ,$67.68 ,$46.03 ,$175.00 ,$175.00 ,$225.63 ,$71.06 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$67.68 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,42400082,97164,HC PT RE-EVAL 60MIN,424,1 ,$175.00 ,$113.75 ,$46.03 ,$225.63 ,$169.20 ,$130.00 ,$96.25 ,$67.68 ,$49.00 ,$85.75 ,$67.68 ,$102.38 ,$67.68 ,$95.03 ,$61.49 ,$67.68 ,$95.03 ,$128.59 ,$122.50 ,$87.50 ,$140.00 ,$169.20 ,$67.68 ,$122.50 ,$67.68 ,$105.00 ,$67.68 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$67.68 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$169.20 ,$121.28 ,$67.68 ,$175.00 ,$96.25 ,$67.68 ,$46.03 ,$175.00 ,$175.00 ,$225.63 ,$71.06 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$67.68 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,42400087,97161,HC PT EVAL LOW COMPLEXITY,424,1 ,$388.00 ,$252.20 ,$90.33 ,$388.00 ,$246.90 ,$130.00 ,$213.40 ,$98.76 ,$108.64 ,$190.12 ,$98.76 ,$226.98 ,$98.76 ,$210.68 ,$90.33 ,$98.76 ,$210.68 ,$187.64 ,$271.60 ,$194.00 ,$310.40 ,$246.90 ,$98.76 ,$271.60 ,$98.76 ,$232.80 ,$98.76 ,$291.00 ,$214.18 ,$193.22 ,$214.18 ,$98.76 ,$214.18 ,$189.00 ,$189.00 ,$329.80 ,$246.90 ,$268.88 ,$98.76 ,$388.00 ,$213.40 ,$98.76 ,$102.04 ,$388.00 ,$236.38 ,$225.63 ,$103.70 ,$310.40 ,$210.68 ,$108.64 ,$349.20 ,$147.44 ,$225.00 ,$98.76 ,$186.24 
ST. MARY'S HOSPITAL - DECATUR,42400088,97162,HC PT EVAL MOD COMPLEXITY,424,1 ,$519.00 ,$337.35 ,$98.76 ,$519.00 ,$246.90 ,$130.00 ,$285.45 ,$98.76 ,$145.32 ,$254.31 ,$98.76 ,$303.62 ,$98.76 ,$281.82 ,$100.36 ,$98.76 ,$281.82 ,$187.64 ,$363.30 ,$259.50 ,$415.20 ,$246.90 ,$98.76 ,$363.30 ,$98.76 ,$311.40 ,$98.76 ,$389.25 ,$286.49 ,$258.46 ,$286.49 ,$98.76 ,$286.49 ,$189.00 ,$189.00 ,$441.15 ,$246.90 ,$359.67 ,$98.76 ,$519.00 ,$285.45 ,$98.76 ,$136.50 ,$519.00 ,$236.38 ,$225.63 ,$103.70 ,$415.20 ,$281.82 ,$145.32 ,$467.10 ,$197.22 ,$225.00 ,$98.76 ,$249.12 
ST. MARY'S HOSPITAL - DECATUR,42400089,97163,HC PT EVAL HIGH COMPLEXITY,424,1 ,$647.00 ,$420.55 ,$98.76 ,$647.00 ,$246.90 ,$130.00 ,$355.85 ,$98.76 ,$181.16 ,$317.03 ,$98.76 ,$378.50 ,$98.76 ,$351.32 ,$110.39 ,$98.76 ,$351.32 ,$187.64 ,$452.90 ,$323.50 ,$517.60 ,$246.90 ,$98.76 ,$452.90 ,$98.76 ,$388.20 ,$98.76 ,$485.25 ,$357.14 ,$322.21 ,$357.14 ,$98.76 ,$357.14 ,$189.00 ,$189.00 ,$549.95 ,$246.90 ,$448.37 ,$98.76 ,$647.00 ,$355.85 ,$98.76 ,$170.16 ,$647.00 ,$236.38 ,$225.63 ,$103.70 ,$517.60 ,$351.32 ,$181.16 ,$582.30 ,$245.86 ,$225.00 ,$98.76 ,$310.56 
ST. MARY'S HOSPITAL - DECATUR,43000012,97018,HC PARAFFIN BATH,430,1 ,$231.00 ,$150.15 ,$5.64 ,$231.00 ,$14.10 ,$130.00 ,$127.05 ,$5.64 ,$64.68 ,$108.57 ,$5.64 ,$124.74 ,$5.64 ,$125.43 ,$14.08 ,$5.64 ,$125.43 ,$10.72 ,$161.70 ,$115.50 ,$184.80 ,$14.10 ,$5.64 ,$161.70 ,$5.64 ,$138.60 ,$5.64 ,$173.25 ,$127.51 ,$115.04 ,$127.51 ,$5.64 ,$127.51 ,$189.00 ,$189.00 ,$196.35 ,$14.10 ,$160.08 ,$5.64 ,$231.00 ,$127.05 ,$5.64 ,$60.75 ,$231.00 ,$19.32 ,$18.44 ,$5.92 ,$184.80 ,$125.43 ,$64.68 ,$207.90 ,$87.78 ,$225.00 ,$5.64 ,$110.88 
ST. MARY'S HOSPITAL - DECATUR,43000015,97533,HC PERCEPTUAL ACTIVITY EA 15 MIN,430,1 ,$385.00 ,$250.25 ,$47.71 ,$385.00 ,$154.83 ,$130.00 ,$211.75 ,$61.93 ,$107.80 ,$188.65 ,$61.93 ,$225.23 ,$61.93 ,$209.06 ,$47.71 ,$61.93 ,$209.06 ,$117.67 ,$269.50 ,$192.50 ,$308.00 ,$154.83 ,$61.93 ,$269.50 ,$61.93 ,$231.00 ,$61.93 ,$288.75 ,$212.52 ,$191.73 ,$212.52 ,$61.93 ,$212.52 ,$189.00 ,$189.00 ,$327.25 ,$154.83 ,$266.81 ,$61.93 ,$385.00 ,$211.75 ,$61.93 ,$101.26 ,$385.00 ,$376.04 ,$358.94 ,$65.03 ,$308.00 ,$209.06 ,$107.80 ,$346.50 ,$146.30 ,$225.00 ,$61.93 ,$184.80 
ST. MARY'S HOSPITAL - DECATUR,43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$264.00 ,$171.60 ,$32.17 ,$358.94 ,$80.43 ,$130.00 ,$145.20 ,$32.17 ,$73.92 ,$129.36 ,$32.17 ,$154.44 ,$32.17 ,$143.35 ,$38.51 ,$32.17 ,$143.35 ,$61.12 ,$184.80 ,$132.00 ,$211.20 ,$80.43 ,$32.17 ,$184.80 ,$32.17 ,$158.40 ,$32.17 ,$198.00 ,$145.73 ,$131.47 ,$145.73 ,$32.17 ,$145.73 ,$189.00 ,$189.00 ,$224.40 ,$80.43 ,$182.95 ,$32.17 ,$264.00 ,$145.20 ,$32.17 ,$69.43 ,$264.00 ,$264.00 ,$358.94 ,$33.78 ,$211.20 ,$143.35 ,$73.92 ,$237.60 ,$100.32 ,$225.00 ,$32.17 ,$126.72 
ST. MARY'S HOSPITAL - DECATUR,43000023,97537,HC WORK TASK ANALYSIS EA 15 MIN,430,1 ,$307.00 ,$199.55 ,$31.32 ,$358.94 ,$78.30 ,$130.00 ,$168.85 ,$31.32 ,$85.96 ,$150.43 ,$31.32 ,$179.60 ,$31.32 ,$166.70 ,$37.10 ,$31.32 ,$166.70 ,$59.51 ,$214.90 ,$153.50 ,$245.60 ,$78.30 ,$31.32 ,$214.90 ,$31.32 ,$184.20 ,$31.32 ,$230.25 ,$169.46 ,$152.89 ,$169.46 ,$31.32 ,$169.46 ,$189.00 ,$189.00 ,$260.95 ,$78.30 ,$212.75 ,$31.32 ,$307.00 ,$168.85 ,$31.32 ,$80.74 ,$307.00 ,$307.00 ,$358.94 ,$32.89 ,$245.60 ,$166.70 ,$85.96 ,$276.30 ,$116.66 ,$225.00 ,$31.32 ,$147.36 
ST. MARY'S HOSPITAL - DECATUR,43000024,97542,HC SEATING CLINIC EA 15 MIN,430,1 ,$190.00 ,$123.50 ,$31.32 ,$358.94 ,$78.30 ,$130.00 ,$104.50 ,$31.32 ,$53.20 ,$93.10 ,$31.32 ,$111.15 ,$31.32 ,$103.17 ,$37.48 ,$31.32 ,$103.17 ,$59.51 ,$133.00 ,$95.00 ,$152.00 ,$78.30 ,$31.32 ,$133.00 ,$31.32 ,$114.00 ,$31.32 ,$142.50 ,$104.88 ,$94.62 ,$104.88 ,$31.32 ,$104.88 ,$189.00 ,$189.00 ,$161.50 ,$78.30 ,$131.67 ,$31.32 ,$190.00 ,$104.50 ,$31.32 ,$49.97 ,$190.00 ,$190.00 ,$358.94 ,$32.89 ,$152.00 ,$103.17 ,$53.20 ,$171.00 ,$72.20 ,$190.00 ,$31.32 ,$91.20 
ST. MARY'S HOSPITAL - DECATUR,43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$324.00 ,$210.60 ,$47.16 ,$324.00 ,$117.90 ,$130.00 ,$178.20 ,$47.16 ,$90.72 ,$158.76 ,$47.16 ,$189.54 ,$47.16 ,$175.93 ,$56.62 ,$47.16 ,$175.93 ,$89.60 ,$226.80 ,$162.00 ,$259.20 ,$117.90 ,$47.16 ,$226.80 ,$47.16 ,$194.40 ,$47.16 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$47.16 ,$178.85 ,$189.00 ,$189.00 ,$275.40 ,$117.90 ,$224.53 ,$47.16 ,$324.00 ,$178.20 ,$47.16 ,$85.21 ,$324.00 ,$236.38 ,$225.63 ,$49.52 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$225.00 ,$47.16 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,43000038,97018,HC PARAFFIN BATH THERAPY 15MIN,430,1 ,$231.00 ,$150.15 ,$5.64 ,$231.00 ,$14.10 ,$130.00 ,$127.05 ,$5.64 ,$64.68 ,$108.57 ,$5.64 ,$124.74 ,$5.64 ,$125.43 ,$14.08 ,$5.64 ,$125.43 ,$10.72 ,$161.70 ,$115.50 ,$184.80 ,$14.10 ,$5.64 ,$161.70 ,$5.64 ,$138.60 ,$5.64 ,$173.25 ,$127.51 ,$115.04 ,$127.51 ,$5.64 ,$127.51 ,$189.00 ,$189.00 ,$196.35 ,$14.10 ,$160.08 ,$5.64 ,$231.00 ,$127.05 ,$5.64 ,$60.75 ,$231.00 ,$19.32 ,$18.44 ,$5.92 ,$184.80 ,$125.43 ,$64.68 ,$207.90 ,$87.78 ,$225.00 ,$5.64 ,$110.88 
ST. MARY'S HOSPITAL - DECATUR,43000039,97018,HC PARAFFIN BATH THERAPY 30MIN,430,1 ,$231.00 ,$150.15 ,$5.64 ,$231.00 ,$14.10 ,$130.00 ,$127.05 ,$5.64 ,$64.68 ,$108.57 ,$5.64 ,$124.74 ,$5.64 ,$125.43 ,$14.08 ,$5.64 ,$125.43 ,$10.72 ,$161.70 ,$115.50 ,$184.80 ,$14.10 ,$5.64 ,$161.70 ,$5.64 ,$138.60 ,$5.64 ,$173.25 ,$127.51 ,$115.04 ,$127.51 ,$5.64 ,$127.51 ,$189.00 ,$189.00 ,$196.35 ,$14.10 ,$160.08 ,$5.64 ,$231.00 ,$127.05 ,$5.64 ,$60.75 ,$231.00 ,$19.32 ,$18.44 ,$5.92 ,$184.80 ,$125.43 ,$64.68 ,$207.90 ,$87.78 ,$225.00 ,$5.64 ,$110.88 
ST. MARY'S HOSPITAL - DECATUR,43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$463.00 ,$300.95 ,$18.44 ,$463.00 ,$57.15 ,$130.00 ,$254.65 ,$22.86 ,$129.64 ,$217.61 ,$22.86 ,$250.02 ,$22.86 ,$251.41 ,$27.01 ,$22.86 ,$251.41 ,$43.43 ,$324.10 ,$231.50 ,$370.40 ,$57.15 ,$22.86 ,$324.10 ,$22.86 ,$277.80 ,$22.86 ,$347.25 ,$255.58 ,$230.57 ,$255.58 ,$22.86 ,$255.58 ,$189.00 ,$189.00 ,$393.55 ,$57.15 ,$320.86 ,$22.86 ,$463.00 ,$254.65 ,$22.86 ,$121.77 ,$463.00 ,$19.32 ,$18.44 ,$24.00 ,$370.40 ,$251.41 ,$129.64 ,$416.70 ,$175.94 ,$225.00 ,$22.86 ,$222.24 
ST. MARY'S HOSPITAL - DECATUR,43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$355.00 ,$230.75 ,$18.44 ,$355.00 ,$55.40 ,$130.00 ,$195.25 ,$22.16 ,$99.40 ,$166.85 ,$22.16 ,$191.70 ,$22.16 ,$192.77 ,$26.20 ,$22.16 ,$192.77 ,$42.10 ,$248.50 ,$177.50 ,$284.00 ,$55.40 ,$22.16 ,$248.50 ,$22.16 ,$213.00 ,$22.16 ,$266.25 ,$195.96 ,$176.79 ,$195.96 ,$22.16 ,$195.96 ,$189.00 ,$189.00 ,$301.75 ,$55.40 ,$246.02 ,$22.16 ,$355.00 ,$195.25 ,$22.16 ,$93.37 ,$355.00 ,$19.32 ,$18.44 ,$23.27 ,$284.00 ,$192.77 ,$99.40 ,$319.50 ,$134.90 ,$225.00 ,$22.16 ,$170.40 
ST. MARY'S HOSPITAL - DECATUR,43400034,97165,HC OT EVAL LOW COMPLEXITY 15MIN,434,1 ,$380.00 ,$247.00 ,$97.40 ,$380.00 ,$248.50 ,$130.00 ,$209.00 ,$99.40 ,$106.40 ,$186.20 ,$99.40 ,$222.30 ,$99.40 ,$206.34 ,$97.40 ,$99.40 ,$206.34 ,$188.86 ,$266.00 ,$190.00 ,$304.00 ,$248.50 ,$99.40 ,$266.00 ,$99.40 ,$228.00 ,$99.40 ,$285.00 ,$209.76 ,$189.24 ,$209.76 ,$99.40 ,$209.76 ,$189.00 ,$189.00 ,$323.00 ,$248.50 ,$263.34 ,$99.40 ,$380.00 ,$209.00 ,$99.40 ,$99.94 ,$380.00 ,$376.04 ,$358.94 ,$104.37 ,$304.00 ,$206.34 ,$106.40 ,$342.00 ,$144.40 ,$225.00 ,$99.40 ,$182.40 
ST. MARY'S HOSPITAL - DECATUR,43400035,97165,HC OT EVAL LOW COMPLEXITY 30MIN,434,1 ,$380.00 ,$247.00 ,$97.40 ,$380.00 ,$248.50 ,$130.00 ,$209.00 ,$99.40 ,$106.40 ,$186.20 ,$99.40 ,$222.30 ,$99.40 ,$206.34 ,$97.40 ,$99.40 ,$206.34 ,$188.86 ,$266.00 ,$190.00 ,$304.00 ,$248.50 ,$99.40 ,$266.00 ,$99.40 ,$228.00 ,$99.40 ,$285.00 ,$209.76 ,$189.24 ,$209.76 ,$99.40 ,$209.76 ,$189.00 ,$189.00 ,$323.00 ,$248.50 ,$263.34 ,$99.40 ,$380.00 ,$209.00 ,$99.40 ,$99.94 ,$380.00 ,$376.04 ,$358.94 ,$104.37 ,$304.00 ,$206.34 ,$106.40 ,$342.00 ,$144.40 ,$225.00 ,$99.40 ,$182.40 
ST. MARY'S HOSPITAL - DECATUR,43400036,97165,HC OT EVAL LOW COMPLEXITY 45MIN,434,1 ,$380.00 ,$247.00 ,$97.40 ,$380.00 ,$248.50 ,$130.00 ,$209.00 ,$99.40 ,$106.40 ,$186.20 ,$99.40 ,$222.30 ,$99.40 ,$206.34 ,$97.40 ,$99.40 ,$206.34 ,$188.86 ,$266.00 ,$190.00 ,$304.00 ,$248.50 ,$99.40 ,$266.00 ,$99.40 ,$228.00 ,$99.40 ,$285.00 ,$209.76 ,$189.24 ,$209.76 ,$99.40 ,$209.76 ,$189.00 ,$189.00 ,$323.00 ,$248.50 ,$263.34 ,$99.40 ,$380.00 ,$209.00 ,$99.40 ,$99.94 ,$380.00 ,$376.04 ,$358.94 ,$104.37 ,$304.00 ,$206.34 ,$106.40 ,$342.00 ,$144.40 ,$225.00 ,$99.40 ,$182.40 
ST. MARY'S HOSPITAL - DECATUR,43400037,97165,HC OT EVAL LOW COMPLEXITY 60MIN,434,1 ,$380.00 ,$247.00 ,$97.40 ,$380.00 ,$248.50 ,$130.00 ,$209.00 ,$99.40 ,$106.40 ,$186.20 ,$99.40 ,$222.30 ,$99.40 ,$206.34 ,$97.40 ,$99.40 ,$206.34 ,$188.86 ,$266.00 ,$190.00 ,$304.00 ,$248.50 ,$99.40 ,$266.00 ,$99.40 ,$228.00 ,$99.40 ,$285.00 ,$209.76 ,$189.24 ,$209.76 ,$99.40 ,$209.76 ,$189.00 ,$189.00 ,$323.00 ,$248.50 ,$263.34 ,$99.40 ,$380.00 ,$209.00 ,$99.40 ,$99.94 ,$380.00 ,$376.04 ,$358.94 ,$104.37 ,$304.00 ,$206.34 ,$106.40 ,$342.00 ,$144.40 ,$225.00 ,$99.40 ,$182.40 
ST. MARY'S HOSPITAL - DECATUR,43400046,97166,HC OT EVAL MOD COMPLEXITY 15MIN,434,1 ,$505.00 ,$328.25 ,$97.40 ,$505.00 ,$248.50 ,$130.00 ,$277.75 ,$99.40 ,$141.40 ,$247.45 ,$99.40 ,$295.43 ,$99.40 ,$274.22 ,$97.40 ,$99.40 ,$274.22 ,$188.86 ,$353.50 ,$252.50 ,$404.00 ,$248.50 ,$99.40 ,$353.50 ,$99.40 ,$303.00 ,$99.40 ,$378.75 ,$278.76 ,$251.49 ,$278.76 ,$99.40 ,$278.76 ,$189.00 ,$189.00 ,$429.25 ,$248.50 ,$349.97 ,$99.40 ,$505.00 ,$277.75 ,$99.40 ,$132.82 ,$505.00 ,$376.04 ,$358.94 ,$104.37 ,$404.00 ,$274.22 ,$141.40 ,$454.50 ,$191.90 ,$225.00 ,$99.40 ,$242.40 
ST. MARY'S HOSPITAL - DECATUR,43400047,97166,HC OT EVAL MOD COMPLEXITY 30MIN,434,1 ,$505.00 ,$328.25 ,$97.40 ,$505.00 ,$248.50 ,$130.00 ,$277.75 ,$99.40 ,$141.40 ,$247.45 ,$99.40 ,$295.43 ,$99.40 ,$274.22 ,$97.40 ,$99.40 ,$274.22 ,$188.86 ,$353.50 ,$252.50 ,$404.00 ,$248.50 ,$99.40 ,$353.50 ,$99.40 ,$303.00 ,$99.40 ,$378.75 ,$278.76 ,$251.49 ,$278.76 ,$99.40 ,$278.76 ,$189.00 ,$189.00 ,$429.25 ,$248.50 ,$349.97 ,$99.40 ,$505.00 ,$277.75 ,$99.40 ,$132.82 ,$505.00 ,$376.04 ,$358.94 ,$104.37 ,$404.00 ,$274.22 ,$141.40 ,$454.50 ,$191.90 ,$225.00 ,$99.40 ,$242.40 
ST. MARY'S HOSPITAL - DECATUR,43400048,97166,HC OT EVAL MOD COMPLEXITY 45MIN,434,1 ,$505.00 ,$328.25 ,$97.40 ,$505.00 ,$248.50 ,$130.00 ,$277.75 ,$99.40 ,$141.40 ,$247.45 ,$99.40 ,$295.43 ,$99.40 ,$274.22 ,$97.40 ,$99.40 ,$274.22 ,$188.86 ,$353.50 ,$252.50 ,$404.00 ,$248.50 ,$99.40 ,$353.50 ,$99.40 ,$303.00 ,$99.40 ,$378.75 ,$278.76 ,$251.49 ,$278.76 ,$99.40 ,$278.76 ,$189.00 ,$189.00 ,$429.25 ,$248.50 ,$349.97 ,$99.40 ,$505.00 ,$277.75 ,$99.40 ,$132.82 ,$505.00 ,$376.04 ,$358.94 ,$104.37 ,$404.00 ,$274.22 ,$141.40 ,$454.50 ,$191.90 ,$225.00 ,$99.40 ,$242.40 
ST. MARY'S HOSPITAL - DECATUR,43400049,97166,HC OT EVAL MOD COMPLEXITY 60MIN,434,1 ,$505.00 ,$328.25 ,$97.40 ,$505.00 ,$248.50 ,$130.00 ,$277.75 ,$99.40 ,$141.40 ,$247.45 ,$99.40 ,$295.43 ,$99.40 ,$274.22 ,$97.40 ,$99.40 ,$274.22 ,$188.86 ,$353.50 ,$252.50 ,$404.00 ,$248.50 ,$99.40 ,$353.50 ,$99.40 ,$303.00 ,$99.40 ,$378.75 ,$278.76 ,$251.49 ,$278.76 ,$99.40 ,$278.76 ,$189.00 ,$189.00 ,$429.25 ,$248.50 ,$349.97 ,$99.40 ,$505.00 ,$277.75 ,$99.40 ,$132.82 ,$505.00 ,$376.04 ,$358.94 ,$104.37 ,$404.00 ,$274.22 ,$141.40 ,$454.50 ,$191.90 ,$225.00 ,$99.40 ,$242.40 
ST. MARY'S HOSPITAL - DECATUR,43400058,97167,HC OT EVAL HIGH COMPLEXITY 15MIN,434,1 ,$632.00 ,$410.80 ,$97.40 ,$632.00 ,$248.50 ,$130.00 ,$347.60 ,$99.40 ,$176.96 ,$309.68 ,$99.40 ,$369.72 ,$99.40 ,$343.18 ,$97.40 ,$99.40 ,$343.18 ,$188.86 ,$442.40 ,$316.00 ,$505.60 ,$248.50 ,$99.40 ,$442.40 ,$99.40 ,$379.20 ,$99.40 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$99.40 ,$348.86 ,$189.00 ,$189.00 ,$537.20 ,$248.50 ,$437.98 ,$99.40 ,$632.00 ,$347.60 ,$99.40 ,$166.22 ,$632.00 ,$376.04 ,$358.94 ,$104.37 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$225.00 ,$99.40 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,43400059,97167,HC OT EVAL HIGH COMPLEXITY 30MIN,434,1 ,$632.00 ,$410.80 ,$97.40 ,$632.00 ,$248.50 ,$130.00 ,$347.60 ,$99.40 ,$176.96 ,$309.68 ,$99.40 ,$369.72 ,$99.40 ,$343.18 ,$97.40 ,$99.40 ,$343.18 ,$188.86 ,$442.40 ,$316.00 ,$505.60 ,$248.50 ,$99.40 ,$442.40 ,$99.40 ,$379.20 ,$99.40 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$99.40 ,$348.86 ,$189.00 ,$189.00 ,$537.20 ,$248.50 ,$437.98 ,$99.40 ,$632.00 ,$347.60 ,$99.40 ,$166.22 ,$632.00 ,$376.04 ,$358.94 ,$104.37 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$225.00 ,$99.40 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,43400060,97167,HC OT EVAL HIGH COMPLEXITY 45MIN,434,1 ,$632.00 ,$410.80 ,$97.40 ,$632.00 ,$248.50 ,$130.00 ,$347.60 ,$99.40 ,$176.96 ,$309.68 ,$99.40 ,$369.72 ,$99.40 ,$343.18 ,$97.40 ,$99.40 ,$343.18 ,$188.86 ,$442.40 ,$316.00 ,$505.60 ,$248.50 ,$99.40 ,$442.40 ,$99.40 ,$379.20 ,$99.40 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$99.40 ,$348.86 ,$189.00 ,$189.00 ,$537.20 ,$248.50 ,$437.98 ,$99.40 ,$632.00 ,$347.60 ,$99.40 ,$166.22 ,$632.00 ,$376.04 ,$358.94 ,$104.37 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$225.00 ,$99.40 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,43400061,97167,HC OT EVAL HIGH COMPLEXITY 60MIN,434,1 ,$632.00 ,$410.80 ,$97.40 ,$632.00 ,$248.50 ,$130.00 ,$347.60 ,$99.40 ,$176.96 ,$309.68 ,$99.40 ,$369.72 ,$99.40 ,$343.18 ,$97.40 ,$99.40 ,$343.18 ,$188.86 ,$442.40 ,$316.00 ,$505.60 ,$248.50 ,$99.40 ,$442.40 ,$99.40 ,$379.20 ,$99.40 ,$474.00 ,$348.86 ,$314.74 ,$348.86 ,$99.40 ,$348.86 ,$189.00 ,$189.00 ,$537.20 ,$248.50 ,$437.98 ,$99.40 ,$632.00 ,$347.60 ,$99.40 ,$166.22 ,$632.00 ,$376.04 ,$358.94 ,$104.37 ,$505.60 ,$343.18 ,$176.96 ,$568.80 ,$240.16 ,$225.00 ,$99.40 ,$303.36 
ST. MARY'S HOSPITAL - DECATUR,43400070,97168,HC OT RE-EVAL 15MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,43400071,97168,HC OT RE-EVAL 30MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,43400072,97168,HC OT RE-EVAL 45MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,43400073,97168,HC OT RE-EVAL 60MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,43400074,97168,HC OT RE-EVAL 75MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,43400075,97168,HC OT RE-EVAL 90MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,43400076,97168,HC OT RE-EVAL 105MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,43400077,97168,HC OT RE-EVAL 120MIN,434,1 ,$175.00 ,$113.75 ,$46.03 ,$358.94 ,$170.00 ,$130.00 ,$96.25 ,$68.00 ,$49.00 ,$85.75 ,$68.00 ,$102.38 ,$68.00 ,$95.03 ,$69.96 ,$68.00 ,$95.03 ,$129.20 ,$122.50 ,$87.50 ,$140.00 ,$170.00 ,$68.00 ,$122.50 ,$68.00 ,$105.00 ,$68.00 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$68.00 ,$96.60 ,$175.00 ,$175.00 ,$148.75 ,$170.00 ,$121.28 ,$68.00 ,$175.00 ,$96.25 ,$68.00 ,$46.03 ,$175.00 ,$175.00 ,$358.94 ,$71.40 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$68.00 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$453.00 ,$294.45 ,$75.75 ,$453.00 ,$189.38 ,$130.00 ,$249.15 ,$75.75 ,$126.84 ,$221.97 ,$75.75 ,$265.01 ,$75.75 ,$245.98 ,$120.43 ,$75.75 ,$245.98 ,$143.93 ,$317.10 ,$226.50 ,$362.40 ,$189.38 ,$75.75 ,$317.10 ,$75.75 ,$271.80 ,$75.75 ,$339.75 ,$250.06 ,$225.59 ,$250.06 ,$75.75 ,$250.06 ,$189.00 ,$189.00 ,$385.05 ,$189.38 ,$313.93 ,$75.75 ,$453.00 ,$249.15 ,$75.75 ,$119.14 ,$453.00 ,$174.72 ,$166.78 ,$79.54 ,$362.40 ,$245.98 ,$126.84 ,$407.70 ,$172.14 ,$225.00 ,$75.75 ,$217.44 
ST. MARY'S HOSPITAL - DECATUR,44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$453.00 ,$294.45 ,$75.75 ,$453.00 ,$189.38 ,$130.00 ,$249.15 ,$75.75 ,$126.84 ,$221.97 ,$75.75 ,$265.01 ,$75.75 ,$245.98 ,$120.43 ,$75.75 ,$245.98 ,$143.93 ,$317.10 ,$226.50 ,$362.40 ,$189.38 ,$75.75 ,$317.10 ,$75.75 ,$271.80 ,$75.75 ,$339.75 ,$250.06 ,$225.59 ,$250.06 ,$75.75 ,$250.06 ,$189.00 ,$189.00 ,$385.05 ,$189.38 ,$313.93 ,$75.75 ,$453.00 ,$249.15 ,$75.75 ,$119.14 ,$453.00 ,$174.72 ,$166.78 ,$79.54 ,$362.40 ,$245.98 ,$126.84 ,$407.70 ,$172.14 ,$225.00 ,$75.75 ,$217.44 
ST. MARY'S HOSPITAL - DECATUR,44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$453.00 ,$294.45 ,$75.75 ,$453.00 ,$189.38 ,$130.00 ,$249.15 ,$75.75 ,$126.84 ,$221.97 ,$75.75 ,$265.01 ,$75.75 ,$245.98 ,$120.43 ,$75.75 ,$245.98 ,$143.93 ,$317.10 ,$226.50 ,$362.40 ,$189.38 ,$75.75 ,$317.10 ,$75.75 ,$271.80 ,$75.75 ,$339.75 ,$250.06 ,$225.59 ,$250.06 ,$75.75 ,$250.06 ,$189.00 ,$189.00 ,$385.05 ,$189.38 ,$313.93 ,$75.75 ,$453.00 ,$249.15 ,$75.75 ,$119.14 ,$453.00 ,$174.72 ,$166.78 ,$79.54 ,$362.40 ,$245.98 ,$126.84 ,$407.70 ,$172.14 ,$225.00 ,$75.75 ,$217.44 
ST. MARY'S HOSPITAL - DECATUR,44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$453.00 ,$294.45 ,$75.75 ,$453.00 ,$189.38 ,$130.00 ,$249.15 ,$75.75 ,$126.84 ,$221.97 ,$75.75 ,$265.01 ,$75.75 ,$245.98 ,$120.43 ,$75.75 ,$245.98 ,$143.93 ,$317.10 ,$226.50 ,$362.40 ,$189.38 ,$75.75 ,$317.10 ,$75.75 ,$271.80 ,$75.75 ,$339.75 ,$250.06 ,$225.59 ,$250.06 ,$75.75 ,$250.06 ,$189.00 ,$189.00 ,$385.05 ,$189.38 ,$313.93 ,$75.75 ,$453.00 ,$249.15 ,$75.75 ,$119.14 ,$453.00 ,$174.72 ,$166.78 ,$79.54 ,$362.40 ,$245.98 ,$126.84 ,$407.70 ,$172.14 ,$225.00 ,$75.75 ,$217.44 
ST. MARY'S HOSPITAL - DECATUR,44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$257.00 ,$167.05 ,$67.59 ,$257.00 ,$209.43 ,$130.00 ,$141.35 ,$83.77 ,$71.96 ,$125.93 ,$83.77 ,$150.35 ,$83.77 ,$139.55 ,$146.42 ,$83.77 ,$139.55 ,$159.16 ,$179.90 ,$128.50 ,$205.60 ,$209.43 ,$83.77 ,$179.90 ,$83.77 ,$154.20 ,$83.77 ,$192.75 ,$141.86 ,$127.99 ,$141.86 ,$83.77 ,$141.86 ,$189.00 ,$189.00 ,$218.45 ,$209.43 ,$178.10 ,$83.77 ,$257.00 ,$141.35 ,$83.77 ,$67.59 ,$257.00 ,$174.72 ,$166.78 ,$87.96 ,$205.60 ,$139.55 ,$71.96 ,$231.30 ,$97.66 ,$225.00 ,$83.77 ,$123.36 
ST. MARY'S HOSPITAL - DECATUR,44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$257.00 ,$167.05 ,$67.59 ,$257.00 ,$209.43 ,$130.00 ,$141.35 ,$83.77 ,$71.96 ,$125.93 ,$83.77 ,$150.35 ,$83.77 ,$139.55 ,$146.42 ,$83.77 ,$139.55 ,$159.16 ,$179.90 ,$128.50 ,$205.60 ,$209.43 ,$83.77 ,$179.90 ,$83.77 ,$154.20 ,$83.77 ,$192.75 ,$141.86 ,$127.99 ,$141.86 ,$83.77 ,$141.86 ,$189.00 ,$189.00 ,$218.45 ,$209.43 ,$178.10 ,$83.77 ,$257.00 ,$141.35 ,$83.77 ,$67.59 ,$257.00 ,$174.72 ,$166.78 ,$87.96 ,$205.60 ,$139.55 ,$71.96 ,$231.30 ,$97.66 ,$225.00 ,$83.77 ,$123.36 
ST. MARY'S HOSPITAL - DECATUR,44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$257.00 ,$167.05 ,$67.59 ,$257.00 ,$209.43 ,$130.00 ,$141.35 ,$83.77 ,$71.96 ,$125.93 ,$83.77 ,$150.35 ,$83.77 ,$139.55 ,$146.42 ,$83.77 ,$139.55 ,$159.16 ,$179.90 ,$128.50 ,$205.60 ,$209.43 ,$83.77 ,$179.90 ,$83.77 ,$154.20 ,$83.77 ,$192.75 ,$141.86 ,$127.99 ,$141.86 ,$83.77 ,$141.86 ,$189.00 ,$189.00 ,$218.45 ,$209.43 ,$178.10 ,$83.77 ,$257.00 ,$141.35 ,$83.77 ,$67.59 ,$257.00 ,$174.72 ,$166.78 ,$87.96 ,$205.60 ,$139.55 ,$71.96 ,$231.30 ,$97.66 ,$225.00 ,$83.77 ,$123.36 
ST. MARY'S HOSPITAL - DECATUR,44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$257.00 ,$167.05 ,$67.59 ,$257.00 ,$209.43 ,$130.00 ,$141.35 ,$83.77 ,$71.96 ,$125.93 ,$83.77 ,$150.35 ,$83.77 ,$139.55 ,$146.42 ,$83.77 ,$139.55 ,$159.16 ,$179.90 ,$128.50 ,$205.60 ,$209.43 ,$83.77 ,$179.90 ,$83.77 ,$154.20 ,$83.77 ,$192.75 ,$141.86 ,$127.99 ,$141.86 ,$83.77 ,$141.86 ,$189.00 ,$189.00 ,$218.45 ,$209.43 ,$178.10 ,$83.77 ,$257.00 ,$141.35 ,$83.77 ,$67.59 ,$257.00 ,$174.72 ,$166.78 ,$87.96 ,$205.60 ,$139.55 ,$71.96 ,$231.30 ,$97.66 ,$225.00 ,$83.77 ,$123.36 
ST. MARY'S HOSPITAL - DECATUR,44000042,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 15MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$255.28 ,$255.28 ,$130.00 ,$87.45 ,$102.11 ,$44.52 ,$77.91 ,$102.11 ,$93.02 ,$102.11 ,$86.34 ,$156.75 ,$102.11 ,$86.34 ,$159.00 ,$111.30 ,$79.50 ,$127.20 ,$255.28 ,$102.11 ,$111.30 ,$102.11 ,$95.40 ,$102.11 ,$119.25 ,$87.77 ,$79.18 ,$87.77 ,$102.11 ,$87.77 ,$159.00 ,$159.00 ,$135.15 ,$159.00 ,$110.19 ,$102.11 ,$159.00 ,$87.45 ,$102.11 ,$41.82 ,$159.00 ,$159.00 ,$166.78 ,$107.22 ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 ,$102.11 ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44000043,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 30MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$255.28 ,$255.28 ,$130.00 ,$87.45 ,$102.11 ,$44.52 ,$77.91 ,$102.11 ,$93.02 ,$102.11 ,$86.34 ,$156.75 ,$102.11 ,$86.34 ,$159.00 ,$111.30 ,$79.50 ,$127.20 ,$255.28 ,$102.11 ,$111.30 ,$102.11 ,$95.40 ,$102.11 ,$119.25 ,$87.77 ,$79.18 ,$87.77 ,$102.11 ,$87.77 ,$159.00 ,$159.00 ,$135.15 ,$159.00 ,$110.19 ,$102.11 ,$159.00 ,$87.45 ,$102.11 ,$41.82 ,$159.00 ,$159.00 ,$166.78 ,$107.22 ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 ,$102.11 ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44000044,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 45MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$255.28 ,$255.28 ,$130.00 ,$87.45 ,$102.11 ,$44.52 ,$77.91 ,$102.11 ,$93.02 ,$102.11 ,$86.34 ,$156.75 ,$102.11 ,$86.34 ,$159.00 ,$111.30 ,$79.50 ,$127.20 ,$255.28 ,$102.11 ,$111.30 ,$102.11 ,$95.40 ,$102.11 ,$119.25 ,$87.77 ,$79.18 ,$87.77 ,$102.11 ,$87.77 ,$159.00 ,$159.00 ,$135.15 ,$159.00 ,$110.19 ,$102.11 ,$159.00 ,$87.45 ,$102.11 ,$41.82 ,$159.00 ,$159.00 ,$166.78 ,$107.22 ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 ,$102.11 ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44000045,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 60MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$255.28 ,$255.28 ,$130.00 ,$87.45 ,$102.11 ,$44.52 ,$77.91 ,$102.11 ,$93.02 ,$102.11 ,$86.34 ,$156.75 ,$102.11 ,$86.34 ,$159.00 ,$111.30 ,$79.50 ,$127.20 ,$255.28 ,$102.11 ,$111.30 ,$102.11 ,$95.40 ,$102.11 ,$119.25 ,$87.77 ,$79.18 ,$87.77 ,$102.11 ,$87.77 ,$159.00 ,$159.00 ,$135.15 ,$159.00 ,$110.19 ,$102.11 ,$159.00 ,$87.45 ,$102.11 ,$41.82 ,$159.00 ,$159.00 ,$166.78 ,$107.22 ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 ,$102.11 ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44000055,96125,HC COGNITIVE PERF TESTING PER HOUR,440,1 ,$336.00 ,$218.40 ,$88.37 ,$536.51 ,$256.48 ,$130.00 ,$184.80 ,$102.59 ,$94.08 ,$164.64 ,$102.59 ,$196.56 ,$102.59 ,$182.45 ,$251.09 ,$102.59 ,$182.45 ,$194.92 ,$235.20 ,$168.00 ,$268.80 ,$256.48 ,$102.59 ,$235.20 ,$102.59 ,$201.60 ,$102.59 ,$252.00 ,$185.47 ,$167.33 ,$185.47 ,$102.59 ,$185.47 ,$189.00 ,$189.00 ,$285.60 ,$256.48 ,$232.85 ,$102.59 ,$336.00 ,$184.80 ,$102.59 ,$88.37 ,$336.00 ,$336.00 ,$536.51 ,$107.72 ,$268.80 ,$182.45 ,$94.08 ,$302.40 ,$127.68 ,$225.00 ,$102.59 ,$161.28 
ST. MARY'S HOSPITAL - DECATUR,44000062,92606,HC THERAP SVC NON-SPEECH DVC -15 MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$166.78 , N/A ,$130.00 ,$87.45 , N/A ,$44.52 ,$74.73 , N/A ,$85.86 , N/A ,$86.34 ,$105.30 , N/A ,$86.34 , N/A ,$111.30 ,$79.50 ,$127.20 , N/A , N/A ,$111.30 , N/A ,$95.40 , N/A ,$119.25 ,$87.77 ,$79.18 ,$87.77 , N/A ,$87.77 ,$159.00 ,$159.00 ,$135.15 , N/A ,$110.19 , N/A ,$159.00 ,$87.45 , N/A ,$41.82 ,$159.00 ,$159.00 ,$166.78 , N/A ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 , N/A ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44000063,92606,HC THERAP SVC NON-SPEECH DVC -30 MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$166.78 , N/A ,$130.00 ,$87.45 , N/A ,$44.52 ,$74.73 , N/A ,$85.86 , N/A ,$86.34 ,$105.30 , N/A ,$86.34 , N/A ,$111.30 ,$79.50 ,$127.20 , N/A , N/A ,$111.30 , N/A ,$95.40 , N/A ,$119.25 ,$87.77 ,$79.18 ,$87.77 , N/A ,$87.77 ,$159.00 ,$159.00 ,$135.15 , N/A ,$110.19 , N/A ,$159.00 ,$87.45 , N/A ,$41.82 ,$159.00 ,$159.00 ,$166.78 , N/A ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 , N/A ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44000064,92606,HC THERAP SVC NON-SPEECH DVC -45 MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$166.78 , N/A ,$130.00 ,$87.45 , N/A ,$44.52 ,$74.73 , N/A ,$85.86 , N/A ,$86.34 ,$105.30 , N/A ,$86.34 , N/A ,$111.30 ,$79.50 ,$127.20 , N/A , N/A ,$111.30 , N/A ,$95.40 , N/A ,$119.25 ,$87.77 ,$79.18 ,$87.77 , N/A ,$87.77 ,$159.00 ,$159.00 ,$135.15 , N/A ,$110.19 , N/A ,$159.00 ,$87.45 , N/A ,$41.82 ,$159.00 ,$159.00 ,$166.78 , N/A ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 , N/A ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44000065,92606,HC THERAP SVC NON-SPEECH DVC -60 MIN,440,1 ,$159.00 ,$103.35 ,$41.82 ,$166.78 , N/A ,$130.00 ,$87.45 , N/A ,$44.52 ,$74.73 , N/A ,$85.86 , N/A ,$86.34 ,$105.30 , N/A ,$86.34 , N/A ,$111.30 ,$79.50 ,$127.20 , N/A , N/A ,$111.30 , N/A ,$95.40 , N/A ,$119.25 ,$87.77 ,$79.18 ,$87.77 , N/A ,$87.77 ,$159.00 ,$159.00 ,$135.15 , N/A ,$110.19 , N/A ,$159.00 ,$87.45 , N/A ,$41.82 ,$159.00 ,$159.00 ,$166.78 , N/A ,$127.20 ,$86.34 ,$44.52 ,$143.10 ,$60.42 ,$159.00 , N/A ,$76.32 
ST. MARY'S HOSPITAL - DECATUR,44200001,96105,HC ASSESS. APHASIA PER HOUR,442,1 ,$683.00 ,$443.95 ,$97.47 ,$683.00 ,$243.68 ,$130.00 ,$375.65 ,$97.47 ,$191.24 ,$334.67 ,$97.47 ,$399.56 ,$97.47 ,$370.87 ,$239.70 ,$97.47 ,$370.87 ,$185.19 ,$478.10 ,$341.50 ,$546.40 ,$243.68 ,$97.47 ,$478.10 ,$97.47 ,$409.80 ,$97.47 ,$512.25 ,$377.02 ,$340.13 ,$377.02 ,$97.47 ,$377.02 ,$189.00 ,$189.00 ,$580.55 ,$243.68 ,$473.32 ,$97.47 ,$683.00 ,$375.65 ,$97.47 ,$179.63 ,$683.00 ,$562.06 ,$536.51 ,$102.34 ,$546.40 ,$370.87 ,$191.24 ,$614.70 ,$259.54 ,$225.00 ,$97.47 ,$327.84 
ST. MARY'S HOSPITAL - DECATUR,44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$600.00 ,$390.00 ,$84.15 ,$600.00 ,$210.38 ,$130.00 ,$330.00 ,$84.15 ,$168.00 ,$294.00 ,$84.15 ,$351.00 ,$84.15 ,$325.80 ,$144.89 ,$84.15 ,$325.80 ,$159.89 ,$420.00 ,$300.00 ,$480.00 ,$210.38 ,$84.15 ,$420.00 ,$84.15 ,$360.00 ,$84.15 ,$450.00 ,$331.20 ,$298.80 ,$331.20 ,$84.15 ,$331.20 ,$189.00 ,$189.00 ,$510.00 ,$210.38 ,$415.80 ,$84.15 ,$600.00 ,$330.00 ,$84.15 ,$157.80 ,$600.00 ,$174.72 ,$166.78 ,$88.36 ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$225.00 ,$84.15 ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,44400018,92610,HC DYSPHAGIA EVALUATION  30MIN,444,1 ,$600.00 ,$390.00 ,$84.15 ,$600.00 ,$210.38 ,$130.00 ,$330.00 ,$84.15 ,$168.00 ,$294.00 ,$84.15 ,$351.00 ,$84.15 ,$325.80 ,$144.89 ,$84.15 ,$325.80 ,$159.89 ,$420.00 ,$300.00 ,$480.00 ,$210.38 ,$84.15 ,$420.00 ,$84.15 ,$360.00 ,$84.15 ,$450.00 ,$331.20 ,$298.80 ,$331.20 ,$84.15 ,$331.20 ,$189.00 ,$189.00 ,$510.00 ,$210.38 ,$415.80 ,$84.15 ,$600.00 ,$330.00 ,$84.15 ,$157.80 ,$600.00 ,$174.72 ,$166.78 ,$88.36 ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$225.00 ,$84.15 ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$600.00 ,$390.00 ,$84.15 ,$600.00 ,$210.38 ,$130.00 ,$330.00 ,$84.15 ,$168.00 ,$294.00 ,$84.15 ,$351.00 ,$84.15 ,$325.80 ,$144.89 ,$84.15 ,$325.80 ,$159.89 ,$420.00 ,$300.00 ,$480.00 ,$210.38 ,$84.15 ,$420.00 ,$84.15 ,$360.00 ,$84.15 ,$450.00 ,$331.20 ,$298.80 ,$331.20 ,$84.15 ,$331.20 ,$189.00 ,$189.00 ,$510.00 ,$210.38 ,$415.80 ,$84.15 ,$600.00 ,$330.00 ,$84.15 ,$157.80 ,$600.00 ,$174.72 ,$166.78 ,$88.36 ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$225.00 ,$84.15 ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$600.00 ,$390.00 ,$84.15 ,$600.00 ,$210.38 ,$130.00 ,$330.00 ,$84.15 ,$168.00 ,$294.00 ,$84.15 ,$351.00 ,$84.15 ,$325.80 ,$144.89 ,$84.15 ,$325.80 ,$159.89 ,$420.00 ,$300.00 ,$480.00 ,$210.38 ,$84.15 ,$420.00 ,$84.15 ,$360.00 ,$84.15 ,$450.00 ,$331.20 ,$298.80 ,$331.20 ,$84.15 ,$331.20 ,$189.00 ,$189.00 ,$510.00 ,$210.38 ,$415.80 ,$84.15 ,$600.00 ,$330.00 ,$84.15 ,$157.80 ,$600.00 ,$174.72 ,$166.78 ,$88.36 ,$480.00 ,$325.80 ,$168.00 ,$540.00 ,$228.00 ,$225.00 ,$84.15 ,$288.00 
ST. MARY'S HOSPITAL - DECATUR,44400029,92611,HC DYSPHAGIA EVAL-VIDEO 15MIN,444,1 ,$627.00 ,$407.55 ,$37.16 ,$627.00 ,$226.13 ,$130.00 ,$344.85 ,$90.45 ,$175.56 ,$307.23 ,$90.45 ,$366.80 ,$90.45 ,$340.46 ,$130.78 ,$90.45 ,$340.46 ,$171.86 ,$438.90 ,$313.50 ,$501.60 ,$226.13 ,$90.45 ,$438.90 ,$90.45 ,$376.20 ,$90.45 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$90.45 ,$346.10 ,$189.00 ,$189.00 ,$532.95 ,$226.13 ,$434.51 ,$90.45 ,$627.00 ,$344.85 ,$90.45 ,$164.90 ,$627.00 ,$38.93 ,$37.16 ,$94.97 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$225.00 ,$90.45 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,44400030,92611,HC DYSPHAGIA EVAL-VIDEO 30MIN,444,1 ,$627.00 ,$407.55 ,$37.16 ,$627.00 ,$226.13 ,$130.00 ,$344.85 ,$90.45 ,$175.56 ,$307.23 ,$90.45 ,$366.80 ,$90.45 ,$340.46 ,$130.78 ,$90.45 ,$340.46 ,$171.86 ,$438.90 ,$313.50 ,$501.60 ,$226.13 ,$90.45 ,$438.90 ,$90.45 ,$376.20 ,$90.45 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$90.45 ,$346.10 ,$189.00 ,$189.00 ,$532.95 ,$226.13 ,$434.51 ,$90.45 ,$627.00 ,$344.85 ,$90.45 ,$164.90 ,$627.00 ,$38.93 ,$37.16 ,$94.97 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$225.00 ,$90.45 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,44400031,92611,HC DYSPHAGIA EVAL-VIDEO 45MIN,444,1 ,$627.00 ,$407.55 ,$37.16 ,$627.00 ,$226.13 ,$130.00 ,$344.85 ,$90.45 ,$175.56 ,$307.23 ,$90.45 ,$366.80 ,$90.45 ,$340.46 ,$130.78 ,$90.45 ,$340.46 ,$171.86 ,$438.90 ,$313.50 ,$501.60 ,$226.13 ,$90.45 ,$438.90 ,$90.45 ,$376.20 ,$90.45 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$90.45 ,$346.10 ,$189.00 ,$189.00 ,$532.95 ,$226.13 ,$434.51 ,$90.45 ,$627.00 ,$344.85 ,$90.45 ,$164.90 ,$627.00 ,$38.93 ,$37.16 ,$94.97 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$225.00 ,$90.45 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,44400032,92611,HC DYSPHAGIA EVAL-VIDEO 60MIN,444,1 ,$627.00 ,$407.55 ,$37.16 ,$627.00 ,$226.13 ,$130.00 ,$344.85 ,$90.45 ,$175.56 ,$307.23 ,$90.45 ,$366.80 ,$90.45 ,$340.46 ,$130.78 ,$90.45 ,$340.46 ,$171.86 ,$438.90 ,$313.50 ,$501.60 ,$226.13 ,$90.45 ,$438.90 ,$90.45 ,$376.20 ,$90.45 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$90.45 ,$346.10 ,$189.00 ,$189.00 ,$532.95 ,$226.13 ,$434.51 ,$90.45 ,$627.00 ,$344.85 ,$90.45 ,$164.90 ,$627.00 ,$38.93 ,$37.16 ,$94.97 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$225.00 ,$90.45 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,44400033,92611,HC DYSPHAGIA EVAL-VIDEO,444,1 ,$627.00 ,$407.55 ,$37.16 ,$627.00 ,$226.13 ,$130.00 ,$344.85 ,$90.45 ,$175.56 ,$307.23 ,$90.45 ,$366.80 ,$90.45 ,$340.46 ,$130.78 ,$90.45 ,$340.46 ,$171.86 ,$438.90 ,$313.50 ,$501.60 ,$226.13 ,$90.45 ,$438.90 ,$90.45 ,$376.20 ,$90.45 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$90.45 ,$346.10 ,$189.00 ,$189.00 ,$532.95 ,$226.13 ,$434.51 ,$90.45 ,$627.00 ,$344.85 ,$90.45 ,$164.90 ,$627.00 ,$38.93 ,$37.16 ,$94.97 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$225.00 ,$90.45 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,44400040,92521,HC EVALUATION OF SPEECH FLUENCY 15 MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$328.45 ,$130.00 ,$382.25 ,$131.38 ,$194.60 ,$340.55 ,$131.38 ,$406.58 ,$131.38 ,$377.39 ,$187.79 ,$131.38 ,$377.39 ,$249.62 ,$486.50 ,$347.50 ,$556.00 ,$328.45 ,$131.38 ,$486.50 ,$131.38 ,$417.00 ,$131.38 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$131.38 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$328.45 ,$481.64 ,$131.38 ,$695.00 ,$382.25 ,$131.38 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$137.95 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$131.38 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400041,92522,HC EVALUATE SPEECH PRODUCTION 15MIN,444,1 ,$695.00 ,$451.75 ,$110.52 ,$695.00 ,$276.30 ,$130.00 ,$382.25 ,$110.52 ,$194.60 ,$340.55 ,$110.52 ,$406.58 ,$110.52 ,$377.39 ,$153.05 ,$110.52 ,$377.39 ,$209.99 ,$486.50 ,$347.50 ,$556.00 ,$276.30 ,$110.52 ,$486.50 ,$110.52 ,$417.00 ,$110.52 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$110.52 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$276.30 ,$481.64 ,$110.52 ,$695.00 ,$382.25 ,$110.52 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$116.05 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$110.52 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$559.90 ,$130.00 ,$382.25 ,$223.96 ,$194.60 ,$340.55 ,$223.96 ,$406.58 ,$223.96 ,$377.39 ,$324.11 ,$223.96 ,$377.39 ,$425.52 ,$486.50 ,$347.50 ,$556.00 ,$559.90 ,$223.96 ,$486.50 ,$223.96 ,$417.00 ,$223.96 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$223.96 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$559.90 ,$481.64 ,$223.96 ,$695.00 ,$382.25 ,$223.96 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$235.16 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$223.96 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400043,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 15MIN,444,1 ,$695.00 ,$451.75 ,$108.95 ,$695.00 ,$272.38 ,$130.00 ,$382.25 ,$108.95 ,$194.60 ,$340.55 ,$108.95 ,$406.58 ,$108.95 ,$377.39 ,$147.88 ,$108.95 ,$377.39 ,$207.01 ,$486.50 ,$347.50 ,$556.00 ,$272.38 ,$108.95 ,$486.50 ,$108.95 ,$417.00 ,$108.95 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$108.95 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$272.38 ,$481.64 ,$108.95 ,$695.00 ,$382.25 ,$108.95 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$114.40 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$108.95 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400045,92607,HC EVAL AAC; SP GEN 1ST HR,444,1 ,$292.00 ,$189.80 ,$76.80 ,$304.73 ,$304.73 ,$130.00 ,$160.60 ,$121.89 ,$81.76 ,$143.08 ,$121.89 ,$170.82 ,$121.89 ,$158.56 ,$188.17 ,$121.89 ,$158.56 ,$231.59 ,$204.40 ,$146.00 ,$233.60 ,$304.73 ,$121.89 ,$204.40 ,$121.89 ,$175.20 ,$121.89 ,$219.00 ,$161.18 ,$145.42 ,$161.18 ,$121.89 ,$161.18 ,$189.00 ,$189.00 ,$248.20 ,$292.00 ,$202.36 ,$121.89 ,$292.00 ,$160.60 ,$121.89 ,$76.80 ,$292.00 ,$174.72 ,$166.78 ,$127.98 ,$233.60 ,$158.56 ,$81.76 ,$262.80 ,$110.96 ,$225.00 ,$121.89 ,$140.16 
ST. MARY'S HOSPITAL - DECATUR,44400046,92608,HC EVAL AAC ADD 1/2 HR,444,1 ,$106.00 ,$68.90 ,$27.88 ,$166.78 ,$120.68 ,$106.00 ,$58.30 ,$48.27 ,$29.68 ,$51.94 ,$48.27 ,$62.01 ,$48.27 ,$57.56 ,$74.68 ,$48.27 ,$57.56 ,$91.71 ,$74.20 ,$53.00 ,$84.80 ,$120.68 ,$48.27 ,$74.20 ,$48.27 ,$63.60 ,$48.27 ,$79.50 ,$58.51 ,$52.79 ,$58.51 ,$48.27 ,$58.51 ,$106.00 ,$106.00 ,$90.10 ,$106.00 ,$73.46 ,$48.27 ,$106.00 ,$58.30 ,$48.27 ,$27.88 ,$106.00 ,$106.00 ,$166.78 ,$50.68 ,$84.80 ,$57.56 ,$29.68 ,$95.40 ,$40.28 ,$106.00 ,$48.27 ,$50.88 
ST. MARY'S HOSPITAL - DECATUR,44400047,92605,HC EVAL NON SP GEN DEVICE,444,1 ,$239.00 ,$155.35 ,$62.86 ,$239.00 , N/A ,$130.00 ,$131.45 , N/A ,$66.92 ,$112.33 , N/A ,$129.06 , N/A ,$129.78 ,$131.87 , N/A ,$129.78 , N/A ,$167.30 ,$119.50 ,$191.20 , N/A , N/A ,$167.30 , N/A ,$143.40 , N/A ,$179.25 ,$131.93 ,$119.02 ,$131.93 , N/A ,$131.93 ,$189.00 ,$189.00 ,$203.15 , N/A ,$165.63 , N/A ,$239.00 ,$131.45 , N/A ,$62.86 ,$239.00 ,$174.72 ,$166.78 , N/A ,$191.20 ,$129.78 ,$66.92 ,$215.10 ,$90.82 ,$225.00 , N/A ,$114.72 
ST. MARY'S HOSPITAL - DECATUR,44400052,92521,HC EVALUATION OF SPEECH FLUENCY 30MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$328.45 ,$130.00 ,$382.25 ,$131.38 ,$194.60 ,$340.55 ,$131.38 ,$406.58 ,$131.38 ,$377.39 ,$187.79 ,$131.38 ,$377.39 ,$249.62 ,$486.50 ,$347.50 ,$556.00 ,$328.45 ,$131.38 ,$486.50 ,$131.38 ,$417.00 ,$131.38 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$131.38 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$328.45 ,$481.64 ,$131.38 ,$695.00 ,$382.25 ,$131.38 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$137.95 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$131.38 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400053,92521,HC EVALUATION OF SPEECH FLUENCY 45MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$328.45 ,$130.00 ,$382.25 ,$131.38 ,$194.60 ,$340.55 ,$131.38 ,$406.58 ,$131.38 ,$377.39 ,$187.79 ,$131.38 ,$377.39 ,$249.62 ,$486.50 ,$347.50 ,$556.00 ,$328.45 ,$131.38 ,$486.50 ,$131.38 ,$417.00 ,$131.38 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$131.38 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$328.45 ,$481.64 ,$131.38 ,$695.00 ,$382.25 ,$131.38 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$137.95 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$131.38 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400054,92521,HC EVALUATION OF SPEECH FLUENCY 60MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$328.45 ,$130.00 ,$382.25 ,$131.38 ,$194.60 ,$340.55 ,$131.38 ,$406.58 ,$131.38 ,$377.39 ,$187.79 ,$131.38 ,$377.39 ,$249.62 ,$486.50 ,$347.50 ,$556.00 ,$328.45 ,$131.38 ,$486.50 ,$131.38 ,$417.00 ,$131.38 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$131.38 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$328.45 ,$481.64 ,$131.38 ,$695.00 ,$382.25 ,$131.38 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$137.95 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$131.38 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400055,92522,HC EVALUATE SPEECH PRODUCTION 30MIN,444,1 ,$695.00 ,$451.75 ,$110.52 ,$695.00 ,$276.30 ,$130.00 ,$382.25 ,$110.52 ,$194.60 ,$340.55 ,$110.52 ,$406.58 ,$110.52 ,$377.39 ,$153.05 ,$110.52 ,$377.39 ,$209.99 ,$486.50 ,$347.50 ,$556.00 ,$276.30 ,$110.52 ,$486.50 ,$110.52 ,$417.00 ,$110.52 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$110.52 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$276.30 ,$481.64 ,$110.52 ,$695.00 ,$382.25 ,$110.52 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$116.05 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$110.52 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400056,92522,HC EVALUATE SPEECH PRODUCTION 45MIN,444,1 ,$695.00 ,$451.75 ,$110.52 ,$695.00 ,$276.30 ,$130.00 ,$382.25 ,$110.52 ,$194.60 ,$340.55 ,$110.52 ,$406.58 ,$110.52 ,$377.39 ,$153.05 ,$110.52 ,$377.39 ,$209.99 ,$486.50 ,$347.50 ,$556.00 ,$276.30 ,$110.52 ,$486.50 ,$110.52 ,$417.00 ,$110.52 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$110.52 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$276.30 ,$481.64 ,$110.52 ,$695.00 ,$382.25 ,$110.52 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$116.05 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$110.52 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400057,92522,HC EVALUATE SPEECH PRODUCTION 60MIN,444,1 ,$695.00 ,$451.75 ,$110.52 ,$695.00 ,$276.30 ,$130.00 ,$382.25 ,$110.52 ,$194.60 ,$340.55 ,$110.52 ,$406.58 ,$110.52 ,$377.39 ,$153.05 ,$110.52 ,$377.39 ,$209.99 ,$486.50 ,$347.50 ,$556.00 ,$276.30 ,$110.52 ,$486.50 ,$110.52 ,$417.00 ,$110.52 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$110.52 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$276.30 ,$481.64 ,$110.52 ,$695.00 ,$382.25 ,$110.52 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$116.05 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$110.52 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$559.90 ,$130.00 ,$382.25 ,$223.96 ,$194.60 ,$340.55 ,$223.96 ,$406.58 ,$223.96 ,$377.39 ,$324.11 ,$223.96 ,$377.39 ,$425.52 ,$486.50 ,$347.50 ,$556.00 ,$559.90 ,$223.96 ,$486.50 ,$223.96 ,$417.00 ,$223.96 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$223.96 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$559.90 ,$481.64 ,$223.96 ,$695.00 ,$382.25 ,$223.96 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$235.16 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$223.96 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$559.90 ,$130.00 ,$382.25 ,$223.96 ,$194.60 ,$340.55 ,$223.96 ,$406.58 ,$223.96 ,$377.39 ,$324.11 ,$223.96 ,$377.39 ,$425.52 ,$486.50 ,$347.50 ,$556.00 ,$559.90 ,$223.96 ,$486.50 ,$223.96 ,$417.00 ,$223.96 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$223.96 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$559.90 ,$481.64 ,$223.96 ,$695.00 ,$382.25 ,$223.96 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$235.16 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$223.96 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$695.00 ,$451.75 ,$130.00 ,$695.00 ,$559.90 ,$130.00 ,$382.25 ,$223.96 ,$194.60 ,$340.55 ,$223.96 ,$406.58 ,$223.96 ,$377.39 ,$324.11 ,$223.96 ,$377.39 ,$425.52 ,$486.50 ,$347.50 ,$556.00 ,$559.90 ,$223.96 ,$486.50 ,$223.96 ,$417.00 ,$223.96 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$223.96 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$559.90 ,$481.64 ,$223.96 ,$695.00 ,$382.25 ,$223.96 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$235.16 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$223.96 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400061,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 30MIN,444,1 ,$695.00 ,$451.75 ,$108.95 ,$695.00 ,$272.38 ,$130.00 ,$382.25 ,$108.95 ,$194.60 ,$340.55 ,$108.95 ,$406.58 ,$108.95 ,$377.39 ,$147.88 ,$108.95 ,$377.39 ,$207.01 ,$486.50 ,$347.50 ,$556.00 ,$272.38 ,$108.95 ,$486.50 ,$108.95 ,$417.00 ,$108.95 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$108.95 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$272.38 ,$481.64 ,$108.95 ,$695.00 ,$382.25 ,$108.95 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$114.40 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$108.95 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400062,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 45MIN,444,1 ,$695.00 ,$451.75 ,$108.95 ,$695.00 ,$272.38 ,$130.00 ,$382.25 ,$108.95 ,$194.60 ,$340.55 ,$108.95 ,$406.58 ,$108.95 ,$377.39 ,$147.88 ,$108.95 ,$377.39 ,$207.01 ,$486.50 ,$347.50 ,$556.00 ,$272.38 ,$108.95 ,$486.50 ,$108.95 ,$417.00 ,$108.95 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$108.95 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$272.38 ,$481.64 ,$108.95 ,$695.00 ,$382.25 ,$108.95 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$114.40 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$108.95 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400063,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 60MIN,444,1 ,$695.00 ,$451.75 ,$108.95 ,$695.00 ,$272.38 ,$130.00 ,$382.25 ,$108.95 ,$194.60 ,$340.55 ,$108.95 ,$406.58 ,$108.95 ,$377.39 ,$147.88 ,$108.95 ,$377.39 ,$207.01 ,$486.50 ,$347.50 ,$556.00 ,$272.38 ,$108.95 ,$486.50 ,$108.95 ,$417.00 ,$108.95 ,$521.25 ,$383.64 ,$346.11 ,$383.64 ,$108.95 ,$383.64 ,$189.00 ,$189.00 ,$590.75 ,$272.38 ,$481.64 ,$108.95 ,$695.00 ,$382.25 ,$108.95 ,$182.79 ,$695.00 ,$174.72 ,$166.78 ,$114.40 ,$556.00 ,$377.39 ,$194.60 ,$625.50 ,$264.10 ,$225.00 ,$108.95 ,$333.60 
ST. MARY'S HOSPITAL - DECATUR,44400084,92611,HC DYSPHAGIA EVAL-VIDEO 75MIN,444,1 ,$627.00 ,$407.55 ,$37.16 ,$627.00 ,$226.13 ,$130.00 ,$344.85 ,$90.45 ,$175.56 ,$307.23 ,$90.45 ,$366.80 ,$90.45 ,$340.46 ,$130.78 ,$90.45 ,$340.46 ,$171.86 ,$438.90 ,$313.50 ,$501.60 ,$226.13 ,$90.45 ,$438.90 ,$90.45 ,$376.20 ,$90.45 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$90.45 ,$346.10 ,$189.00 ,$189.00 ,$532.95 ,$226.13 ,$434.51 ,$90.45 ,$627.00 ,$344.85 ,$90.45 ,$164.90 ,$627.00 ,$38.93 ,$37.16 ,$94.97 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$225.00 ,$90.45 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,44400085,92611,HC DYSPHAGIA EVAL-VIDEO 90MIN,444,1 ,$627.00 ,$407.55 ,$37.16 ,$627.00 ,$226.13 ,$130.00 ,$344.85 ,$90.45 ,$175.56 ,$307.23 ,$90.45 ,$366.80 ,$90.45 ,$340.46 ,$130.78 ,$90.45 ,$340.46 ,$171.86 ,$438.90 ,$313.50 ,$501.60 ,$226.13 ,$90.45 ,$438.90 ,$90.45 ,$376.20 ,$90.45 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$90.45 ,$346.10 ,$189.00 ,$189.00 ,$532.95 ,$226.13 ,$434.51 ,$90.45 ,$627.00 ,$344.85 ,$90.45 ,$164.90 ,$627.00 ,$38.93 ,$37.16 ,$94.97 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$225.00 ,$90.45 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,45000002,10061,HC I AND D ABSC CMPLX,450,1 ,"$1,140.00 ",$741.00 ,$299.82 ,"$1,140.00 ",$817.95 ,$581.40 ,$627.00 ,$327.18 ,$319.20 ,$604.20 ,$327.18 ,$638.40 ,$327.18 ,$619.02 ,$619.02 ,$327.18 ,$619.02 ,$621.65 ,$798.00 ,$570.00 ,$912.00 ,$817.95 ,$327.18 ,$798.00 ,$327.18 ,$684.00 ,$327.18 ,$855.00 ,$629.28 ,$567.72 ,$629.28 ,$327.18 ,$629.28 ,$889.20 ,$889.20 ,$969.00 ,$817.95 ,$790.02 ,$327.18 ,"$1,140.00 ",$627.00 ,$327.18 ,$299.82 ,"$1,140.00 ", N/A , N/A ,$343.54 ,$912.00 ,$619.02 ,$319.20 ,"$1,026.00 ",$433.20 ,$325.00 ,$327.18 ,$547.20 
ST. MARY'S HOSPITAL - DECATUR,45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$476.00 ,$309.40 ,$125.19 ,"$1,472.65 ","$1,472.65 ",$242.76 ,$261.80 ,$589.06 ,$133.28 ,$252.28 ,$589.06 ,$266.56 ,$476.00 ,$258.47 ,$258.47 ,$476.00 ,$258.47 ,$476.00 ,$333.20 ,$238.00 ,$380.80 ,"$1,472.64 ",$589.06 ,$333.20 ,$589.06 ,$285.60 ,$589.06 ,$357.00 ,$262.75 ,$237.05 ,$262.75 ,$589.06 ,$262.75 ,$371.28 ,$371.28 ,$404.60 ,$476.00 ,$329.87 ,$589.06 ,$476.00 ,$261.80 ,$589.06 ,$125.19 ,$476.00 , N/A , N/A ,$618.51 ,$380.80 ,$258.47 ,$133.28 ,$428.40 ,$180.88 ,$325.00 ,$589.06 ,$228.48 
ST. MARY'S HOSPITAL - DECATUR,45000004,10081,HC I AND D CYST PILONIDAL CPLX,450,1 ,"$1,770.00 ","$1,150.50 ",$325.00 ,"$1,770.00 ","$1,472.65 ",$902.70 ,$973.50 ,$589.06 ,$495.60 ,$938.10 ,$589.06 ,$991.20 ,$589.06 ,$961.11 ,$961.11 ,$589.06 ,$961.11 ,"$1,119.21 ","$1,239.00 ",$885.00 ,"$1,416.00 ","$1,472.64 ",$589.06 ,"$1,239.00 ",$589.06 ,"$1,062.00 ",$589.06 ,"$1,327.50 ",$977.04 ,$881.46 ,$977.04 ,$589.06 ,$977.04 ,"$1,380.60 ","$1,380.60 ","$1,504.50 ","$1,472.64 ","$1,226.61 ",$589.06 ,"$1,770.00 ",$973.50 ,$589.06 ,$465.51 ,"$1,770.00 ", N/A , N/A ,$618.51 ,"$1,416.00 ",$961.11 ,$495.60 ,"$1,593.00 ",$672.60 ,$325.00 ,$589.06 ,$849.60 
ST. MARY'S HOSPITAL - DECATUR,45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$476.00 ,$309.40 ,$125.19 ,$817.95 ,$817.95 ,$242.76 ,$261.80 ,$327.18 ,$133.28 ,$252.28 ,$327.18 ,$266.56 ,$327.18 ,$258.47 ,$258.47 ,$327.18 ,$258.47 ,$476.00 ,$333.20 ,$238.00 ,$380.80 ,$817.95 ,$327.18 ,$333.20 ,$327.18 ,$285.60 ,$327.18 ,$357.00 ,$262.75 ,$237.05 ,$262.75 ,$327.18 ,$262.75 ,$371.28 ,$371.28 ,$404.60 ,$476.00 ,$329.87 ,$327.18 ,$476.00 ,$261.80 ,$327.18 ,$125.19 ,$476.00 , N/A , N/A ,$343.54 ,$380.80 ,$258.47 ,$133.28 ,$428.40 ,$180.88 ,$325.00 ,$327.18 ,$228.48 
ST. MARY'S HOSPITAL - DECATUR,45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$299.00 ,$194.35 ,$78.64 ,$424.98 ,$424.98 ,$152.49 ,$164.45 ,$169.99 ,$83.72 ,$158.47 ,$169.99 ,$167.44 ,$169.99 ,$162.36 ,$162.36 ,$169.99 ,$162.36 ,$299.00 ,$209.30 ,$149.50 ,$239.20 ,$424.97 ,$169.99 ,$209.30 ,$169.99 ,$179.40 ,$169.99 ,$224.25 ,$165.05 ,$148.90 ,$165.05 ,$169.99 ,$165.05 ,$233.22 ,$233.22 ,$254.15 ,$299.00 ,$207.21 ,$169.99 ,$299.00 ,$164.45 ,$169.99 ,$78.64 ,$299.00 , N/A , N/A ,$178.49 ,$239.20 ,$162.36 ,$83.72 ,$269.10 ,$113.62 ,$299.00 ,$169.99 ,$143.52 
ST. MARY'S HOSPITAL - DECATUR,45000010,11732,HC AVULSION NAIL PL PT/CO EA ADDL FAC,450,1 ,$197.00 ,$128.05 ,$51.81 ,$197.00 , N/A ,$100.47 ,$108.35 , N/A ,$55.16 ,$104.41 , N/A ,$110.32 , N/A ,$106.97 ,$106.97 , N/A ,$106.97 , N/A ,$137.90 ,$98.50 ,$157.60 , N/A , N/A ,$137.90 , N/A ,$118.20 , N/A ,$147.75 ,$108.74 ,$98.11 ,$108.74 , N/A ,$108.74 ,$153.66 ,$153.66 ,$167.45 , N/A ,$136.52 , N/A ,$197.00 ,$108.35 , N/A ,$51.81 ,$197.00 , N/A , N/A , N/A ,$157.60 ,$106.97 ,$55.16 ,$177.30 ,$74.86 ,$197.00 , N/A ,$94.56 
ST. MARY'S HOSPITAL - DECATUR,45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000012,11760,HC REPAIR NAIL BED,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000013,11765,HC EXC WEDGE SKIN NAIL FOLD,450,1 ,"$1,147.00 ",$745.55 ,$301.66 ,"$1,147.00 ",$817.95 ,$584.97 ,$630.85 ,$327.18 ,$321.16 ,$607.91 ,$327.18 ,$642.32 ,$327.18 ,$622.82 ,$622.82 ,$327.18 ,$622.82 ,$621.65 ,$802.90 ,$573.50 ,$917.60 ,$817.95 ,$327.18 ,$802.90 ,$327.18 ,$688.20 ,$327.18 ,$860.25 ,$633.14 ,$571.21 ,$633.14 ,$327.18 ,$633.14 ,$894.66 ,$894.66 ,$974.95 ,$817.95 ,$794.87 ,$327.18 ,"$1,147.00 ",$630.85 ,$327.18 ,$301.66 ,"$1,147.00 ", N/A , N/A ,$343.54 ,$917.60 ,$622.82 ,$321.16 ,"$1,032.30 ",$435.86 ,$325.00 ,$327.18 ,$550.56 
ST. MARY'S HOSPITAL - DECATUR,45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$497.00 ,$323.05 ,$130.71 ,$497.00 , N/A ,$253.47 ,$273.35 ,$169.99 ,$139.16 ,$263.41 ,$169.99 ,$278.32 ,$169.99 ,$269.87 ,$269.87 ,$169.99 ,$269.87 ,$322.97 ,$347.90 ,$248.50 ,$397.60 ,$424.97 , N/A ,$347.90 ,$169.99 ,$298.20 ,$169.99 ,$372.75 ,$274.34 ,$247.51 ,$274.34 ,$169.99 ,$274.34 ,$387.66 ,$387.66 ,$422.45 , N/A ,$344.42 ,$169.99 ,$497.00 ,$273.35 ,$169.99 ,$130.71 ,$497.00 , N/A , N/A , N/A ,$397.60 ,$269.87 ,$139.16 ,$447.30 ,$188.86 ,$325.00 ,$169.99 ,$238.56 
ST. MARY'S HOSPITAL - DECATUR,45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$761.00 ,$494.65 ,$169.99 ,$761.00 ,$424.98 ,$388.11 ,$418.55 ,$169.99 ,$213.08 ,$403.33 ,$169.99 ,$426.16 ,$169.99 ,$413.22 ,$413.22 ,$169.99 ,$413.22 ,$322.97 ,$532.70 ,$380.50 ,$608.80 ,$424.97 ,$169.99 ,$532.70 ,$169.99 ,$456.60 ,$169.99 ,$570.75 ,$420.07 ,$378.98 ,$420.07 ,$169.99 ,$420.07 ,$593.58 ,$593.58 ,$646.85 ,$424.97 ,$527.37 ,$169.99 ,$761.00 ,$418.55 ,$169.99 ,$200.14 ,$761.00 , N/A , N/A ,$178.49 ,$608.80 ,$413.22 ,$213.08 ,$684.90 ,$289.18 ,$325.00 ,$169.99 ,$365.28 
ST. MARY'S HOSPITAL - DECATUR,45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$471.00 ,$306.15 ,$123.87 ,$471.00 ,$424.98 ,$240.21 ,$259.05 ,$169.99 ,$131.88 ,$249.63 ,$169.99 ,$263.76 ,$169.99 ,$255.75 ,$255.75 ,$169.99 ,$255.75 ,$322.97 ,$329.70 ,$235.50 ,$376.80 ,$424.97 ,$169.99 ,$329.70 ,$169.99 ,$282.60 ,$169.99 ,$353.25 ,$259.99 ,$234.56 ,$259.99 ,$169.99 ,$259.99 ,$367.38 ,$367.38 ,$400.35 ,$424.97 ,$326.40 ,$169.99 ,$471.00 ,$259.05 ,$169.99 ,$123.87 ,$471.00 , N/A , N/A ,$178.49 ,$376.80 ,$255.75 ,$131.88 ,$423.90 ,$178.98 ,$325.00 ,$169.99 ,$226.08 
ST. MARY'S HOSPITAL - DECATUR,45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000018,12006,HC SIMP S/N/AX/GN/TRK/EXT 20.1-30,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000019,12007,HC SIMP S/N/AX/GN/TRK/EXT > 30CM,450,1 ,"$1,522.00 ",$989.30 ,$169.99 ,"$1,522.00 ",$424.98 ,$776.22 ,$837.10 ,$169.99 ,$426.16 ,$806.66 ,$169.99 ,$852.32 ,$169.99 ,$826.45 ,$826.45 ,$169.99 ,$826.45 ,$322.97 ,"$1,065.40 ",$761.00 ,"$1,217.60 ",$424.97 ,$169.99 ,"$1,065.40 ",$169.99 ,$913.20 ,$169.99 ,"$1,141.50 ",$840.14 ,$757.96 ,$840.14 ,$169.99 ,$840.14 ,"$1,187.16 ","$1,187.16 ","$1,293.70 ",$424.97 ,"$1,054.75 ",$169.99 ,"$1,522.00 ",$837.10 ,$169.99 ,$400.29 ,"$1,522.00 ", N/A , N/A ,$178.49 ,"$1,217.60 ",$826.45 ,$426.16 ,"$1,369.80 ",$578.36 ,$325.00 ,$169.99 ,$730.56 
ST. MARY'S HOSPITAL - DECATUR,45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$445.00 ,$289.25 ,$117.04 ,$445.00 ,$424.98 ,$226.95 ,$244.75 ,$169.99 ,$124.60 ,$235.85 ,$169.99 ,$249.20 ,$169.99 ,$241.64 ,$241.64 ,$169.99 ,$241.64 ,$322.97 ,$311.50 ,$222.50 ,$356.00 ,$424.97 ,$169.99 ,$311.50 ,$169.99 ,$267.00 ,$169.99 ,$333.75 ,$245.64 ,$221.61 ,$245.64 ,$169.99 ,$245.64 ,$347.10 ,$347.10 ,$378.25 ,$424.97 ,$308.39 ,$169.99 ,$445.00 ,$244.75 ,$169.99 ,$117.04 ,$445.00 , N/A , N/A ,$178.49 ,$356.00 ,$241.64 ,$124.60 ,$400.50 ,$169.10 ,$325.00 ,$169.99 ,$213.60 
ST. MARY'S HOSPITAL - DECATUR,45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$445.00 ,$289.25 ,$117.04 ,$445.00 ,$424.98 ,$226.95 ,$244.75 ,$169.99 ,$124.60 ,$235.85 ,$169.99 ,$249.20 ,$169.99 ,$241.64 ,$241.64 ,$169.99 ,$241.64 ,$322.97 ,$311.50 ,$222.50 ,$356.00 ,$424.97 ,$169.99 ,$311.50 ,$169.99 ,$267.00 ,$169.99 ,$333.75 ,$245.64 ,$221.61 ,$245.64 ,$169.99 ,$245.64 ,$347.10 ,$347.10 ,$378.25 ,$424.97 ,$308.39 ,$169.99 ,$445.00 ,$244.75 ,$169.99 ,$117.04 ,$445.00 , N/A , N/A ,$178.49 ,$356.00 ,$241.64 ,$124.60 ,$400.50 ,$169.10 ,$325.00 ,$169.99 ,$213.60 
ST. MARY'S HOSPITAL - DECATUR,45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$422.00 ,$274.30 ,$110.99 ,$424.98 ,$424.98 ,$215.22 ,$232.10 ,$169.99 ,$118.16 ,$223.66 ,$169.99 ,$236.32 ,$169.99 ,$229.15 ,$229.15 ,$169.99 ,$229.15 ,$322.97 ,$295.40 ,$211.00 ,$337.60 ,$424.97 ,$169.99 ,$295.40 ,$169.99 ,$253.20 ,$169.99 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$169.99 ,$232.94 ,$329.16 ,$329.16 ,$358.70 ,$422.00 ,$292.45 ,$169.99 ,$422.00 ,$232.10 ,$169.99 ,$110.99 ,$422.00 , N/A , N/A ,$178.49 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$325.00 ,$169.99 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$422.00 ,$274.30 ,$110.99 ,$424.98 ,$424.98 ,$215.22 ,$232.10 ,$169.99 ,$118.16 ,$223.66 ,$169.99 ,$236.32 ,$169.99 ,$229.15 ,$229.15 ,$169.99 ,$229.15 ,$322.97 ,$295.40 ,$211.00 ,$337.60 ,$424.97 ,$169.99 ,$295.40 ,$169.99 ,$253.20 ,$169.99 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$169.99 ,$232.94 ,$329.16 ,$329.16 ,$358.70 ,$422.00 ,$292.45 ,$169.99 ,$422.00 ,$232.10 ,$169.99 ,$110.99 ,$422.00 , N/A , N/A ,$178.49 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$325.00 ,$169.99 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000025,12017,HC SIMP F/E/E/N/L/MM 20.1-30.0CM,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000029,12031,HC INTRM S/A/T/EXT 2.5CM OR <,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,$964.00 ,$626.60 ,$253.53 ,$964.00 ,$817.95 ,$491.64 ,$530.20 ,$327.18 ,$269.92 ,$510.92 ,$327.18 ,$539.84 ,$327.18 ,$523.45 ,$523.45 ,$327.18 ,$523.45 ,$621.65 ,$674.80 ,$482.00 ,$771.20 ,$817.95 ,$327.18 ,$674.80 ,$327.18 ,$578.40 ,$327.18 ,$723.00 ,$532.13 ,$480.07 ,$532.13 ,$327.18 ,$532.13 ,$751.92 ,$751.92 ,$819.40 ,$817.95 ,$668.05 ,$327.18 ,$964.00 ,$530.20 ,$327.18 ,$253.53 ,$964.00 , N/A , N/A ,$343.54 ,$771.20 ,$523.45 ,$269.92 ,$867.60 ,$366.32 ,$325.00 ,$327.18 ,$462.72 
ST. MARY'S HOSPITAL - DECATUR,45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,$480.00 ,$312.00 ,$126.24 ,$817.95 ,$817.95 ,$244.80 ,$264.00 ,$327.18 ,$134.40 ,$254.40 ,$327.18 ,$268.80 ,$327.18 ,$260.64 ,$260.64 ,$327.18 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,$817.95 ,$327.18 ,$336.00 ,$327.18 ,$288.00 ,$327.18 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$327.18 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$327.18 ,$480.00 ,$264.00 ,$327.18 ,$126.24 ,$480.00 , N/A , N/A ,$343.54 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$327.18 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$480.00 ,$312.00 ,$126.24 ,$817.95 ,$817.95 ,$244.80 ,$264.00 ,$327.18 ,$134.40 ,$254.40 ,$327.18 ,$268.80 ,$327.18 ,$260.64 ,$260.64 ,$327.18 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,$817.95 ,$327.18 ,$336.00 ,$327.18 ,$288.00 ,$327.18 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$327.18 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$327.18 ,$480.00 ,$264.00 ,$327.18 ,$126.24 ,$480.00 , N/A , N/A ,$343.54 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$327.18 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000037,12044,HC INTRM N/H/F/GEN 7.6-12.5CM,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$472.00 ,$306.80 ,$124.14 ,$817.95 ,$817.95 ,$240.72 ,$259.60 ,$327.18 ,$132.16 ,$250.16 ,$327.18 ,$264.32 ,$327.18 ,$256.30 ,$256.30 ,$327.18 ,$256.30 ,$472.00 ,$330.40 ,$236.00 ,$377.60 ,$817.95 ,$327.18 ,$330.40 ,$327.18 ,$283.20 ,$327.18 ,$354.00 ,$260.54 ,$235.06 ,$260.54 ,$327.18 ,$260.54 ,$368.16 ,$368.16 ,$401.20 ,$472.00 ,$327.10 ,$327.18 ,$472.00 ,$259.60 ,$327.18 ,$124.14 ,$472.00 , N/A , N/A ,$343.54 ,$377.60 ,$256.30 ,$132.16 ,$424.80 ,$179.36 ,$325.00 ,$327.18 ,$226.56 
ST. MARY'S HOSPITAL - DECATUR,45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$472.00 ,$306.80 ,$124.14 ,$817.95 ,$817.95 ,$240.72 ,$259.60 ,$327.18 ,$132.16 ,$250.16 ,$327.18 ,$264.32 ,$327.18 ,$256.30 ,$256.30 ,$327.18 ,$256.30 ,$472.00 ,$330.40 ,$236.00 ,$377.60 ,$817.95 ,$327.18 ,$330.40 ,$327.18 ,$283.20 ,$327.18 ,$354.00 ,$260.54 ,$235.06 ,$260.54 ,$327.18 ,$260.54 ,$368.16 ,$368.16 ,$401.20 ,$472.00 ,$327.10 ,$327.18 ,$472.00 ,$259.60 ,$327.18 ,$124.14 ,$472.00 , N/A , N/A ,$343.54 ,$377.60 ,$256.30 ,$132.16 ,$424.80 ,$179.36 ,$325.00 ,$327.18 ,$226.56 
ST. MARY'S HOSPITAL - DECATUR,45000043,12053,HC INTRM F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$472.00 ,$306.80 ,$124.14 ,$817.95 ,$817.95 ,$240.72 ,$259.60 ,$327.18 ,$132.16 ,$250.16 ,$327.18 ,$264.32 ,$327.18 ,$256.30 ,$256.30 ,$327.18 ,$256.30 ,$472.00 ,$330.40 ,$236.00 ,$377.60 ,$817.95 ,$327.18 ,$330.40 ,$327.18 ,$283.20 ,$327.18 ,$354.00 ,$260.54 ,$235.06 ,$260.54 ,$327.18 ,$260.54 ,$368.16 ,$368.16 ,$401.20 ,$472.00 ,$327.10 ,$327.18 ,$472.00 ,$259.60 ,$327.18 ,$124.14 ,$472.00 , N/A , N/A ,$343.54 ,$377.60 ,$256.30 ,$132.16 ,$424.80 ,$179.36 ,$325.00 ,$327.18 ,$226.56 
ST. MARY'S HOSPITAL - DECATUR,45000044,12054,HC INTRM F/E/E/N/L/MM 7.6-12.5CM,450,1 ,$480.00 ,$312.00 ,$126.24 ,$817.95 ,$817.95 ,$244.80 ,$264.00 ,$327.18 ,$134.40 ,$254.40 ,$327.18 ,$268.80 ,$327.18 ,$260.64 ,$260.64 ,$327.18 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,$817.95 ,$327.18 ,$336.00 ,$327.18 ,$288.00 ,$327.18 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$327.18 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$327.18 ,$480.00 ,$264.00 ,$327.18 ,$126.24 ,$480.00 , N/A , N/A ,$343.54 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$327.18 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000051,13120,HC CMPLX S/A/L 1.1-2.5 CM,450,1 ,$800.00 ,$520.00 ,$210.40 ,"$1,239.43 ","$1,239.43 ",$408.00 ,$440.00 ,$495.77 ,$224.00 ,$424.00 ,$495.77 ,$448.00 ,$495.77 ,$434.40 ,$434.40 ,$495.77 ,$434.40 ,$800.00 ,$560.00 ,$400.00 ,$640.00 ,"$1,239.42 ",$495.77 ,$560.00 ,$495.77 ,$480.00 ,$495.77 ,$600.00 ,$441.60 ,$398.40 ,$441.60 ,$495.77 ,$441.60 ,$624.00 ,$624.00 ,$680.00 ,$800.00 ,$554.40 ,$495.77 ,$800.00 ,$440.00 ,$495.77 ,$210.40 ,$800.00 , N/A , N/A ,$520.56 ,$640.00 ,$434.40 ,$224.00 ,$720.00 ,$304.00 ,$325.00 ,$495.77 ,$384.00 
ST. MARY'S HOSPITAL - DECATUR,45000052,13121,HC CMPLX S/A/L 2.6-7.5 CM,450,1 ,$889.00 ,$577.85 ,$233.81 ,"$1,239.43 ","$1,239.43 ",$453.39 ,$488.95 ,$495.77 ,$248.92 ,$471.17 ,$495.77 ,$497.84 ,$495.77 ,$482.73 ,$482.73 ,$495.77 ,$482.73 ,$889.00 ,$622.30 ,$444.50 ,$711.20 ,"$1,239.42 ",$495.77 ,$622.30 ,$495.77 ,$533.40 ,$495.77 ,$666.75 ,$490.73 ,$442.72 ,$490.73 ,$495.77 ,$490.73 ,$693.42 ,$693.42 ,$755.65 ,$889.00 ,$616.08 ,$495.77 ,$889.00 ,$488.95 ,$495.77 ,$233.81 ,$889.00 , N/A , N/A ,$520.56 ,$711.20 ,$482.73 ,$248.92 ,$800.10 ,$337.82 ,$325.00 ,$495.77 ,$426.72 
ST. MARY'S HOSPITAL - DECATUR,45000053,13122,HC CMPLX S/A/L EA ADDL 5 CM OR LESS,450,1 ,$571.00 ,$371.15 ,$150.17 ,$571.00 , N/A ,$291.21 ,$314.05 , N/A ,$159.88 ,$302.63 , N/A ,$319.76 , N/A ,$310.05 ,$310.05 , N/A ,$310.05 , N/A ,$399.70 ,$285.50 ,$456.80 , N/A , N/A ,$399.70 , N/A ,$342.60 , N/A ,$428.25 ,$315.19 ,$284.36 ,$315.19 , N/A ,$315.19 ,$445.38 ,$445.38 ,$485.35 , N/A ,$395.70 , N/A ,$571.00 ,$314.05 , N/A ,$150.17 ,$571.00 , N/A , N/A , N/A ,$456.80 ,$310.05 ,$159.88 ,$513.90 ,$216.98 ,$325.00 , N/A ,$274.08 
ST. MARY'S HOSPITAL - DECATUR,45000054,13131,HC CMPLX F/C/C/M/N/A/G/H/F 1.1-2.5 CM,450,1 ,"$1,756.00 ","$1,141.40 ",$325.00 ,"$1,756.00 ",$817.95 ,$895.56 ,$965.80 ,$327.18 ,$491.68 ,$930.68 ,$327.18 ,$983.36 ,$327.18 ,$953.51 ,$953.51 ,$327.18 ,$953.51 ,$621.65 ,"$1,229.20 ",$878.00 ,"$1,404.80 ",$817.95 ,$327.18 ,"$1,229.20 ",$327.18 ,"$1,053.60 ",$327.18 ,"$1,317.00 ",$969.31 ,$874.49 ,$969.31 ,$327.18 ,$969.31 ,"$1,369.68 ","$1,369.68 ","$1,492.60 ",$817.95 ,"$1,216.91 ",$327.18 ,"$1,756.00 ",$965.80 ,$327.18 ,$461.83 ,"$1,756.00 ", N/A , N/A ,$343.54 ,"$1,404.80 ",$953.51 ,$491.68 ,"$1,580.40 ",$667.28 ,$325.00 ,$327.18 ,$842.88 
ST. MARY'S HOSPITAL - DECATUR,45000055,13132,HC CMPLX F/C/C/M/N/A/G/H/F 2.6-7.5 CM,450,1 ,"$1,085.00 ",$705.25 ,$285.36 ,"$1,239.43 ","$1,239.43 ",$553.35 ,$596.75 ,$495.77 ,$303.80 ,$575.05 ,$495.77 ,$607.60 ,$495.77 ,$589.16 ,$589.16 ,$495.77 ,$589.16 ,$941.96 ,$759.50 ,$542.50 ,$868.00 ,"$1,239.42 ",$495.77 ,$759.50 ,$495.77 ,$651.00 ,$495.77 ,$813.75 ,$598.92 ,$540.33 ,$598.92 ,$495.77 ,$598.92 ,$846.30 ,$846.30 ,$922.25 ,"$1,085.00 ",$751.91 ,$495.77 ,"$1,085.00 ",$596.75 ,$495.77 ,$285.36 ,"$1,085.00 ", N/A , N/A ,$520.56 ,$868.00 ,$589.16 ,$303.80 ,$976.50 ,$412.30 ,$325.00 ,$495.77 ,$520.80 
ST. MARY'S HOSPITAL - DECATUR,45000056,13133,HC CMPLX F/C/C/M/N/A/G/H/F EA ADDL 5 CM OR LESS,450,1 ,"$1,641.00 ","$1,066.65 ",$325.00 ,"$1,641.00 ", N/A ,$836.91 ,$902.55 , N/A ,$459.48 ,$869.73 , N/A ,$918.96 , N/A ,$891.06 ,$891.06 , N/A ,$891.06 , N/A ,"$1,148.70 ",$820.50 ,"$1,312.80 ", N/A , N/A ,"$1,148.70 ", N/A ,$984.60 , N/A ,"$1,230.75 ",$905.83 ,$817.22 ,$905.83 , N/A ,$905.83 ,"$1,279.98 ","$1,279.98 ","$1,394.85 ", N/A ,"$1,137.21 ", N/A ,"$1,641.00 ",$902.55 , N/A ,$431.58 ,"$1,641.00 ", N/A , N/A , N/A ,"$1,312.80 ",$891.06 ,$459.48 ,"$1,476.90 ",$623.58 ,$325.00 , N/A ,$787.68 
ST. MARY'S HOSPITAL - DECATUR,45000059,13152,HC CMPLX E/N/E/L 2.6-7.5 CM,450,1 ,"$3,345.00 ","$2,174.25 ",$325.00 ,"$3,345.00 ","$1,239.43 ","$1,705.95 ","$1,839.75 ",$495.77 ,$936.60 ,"$1,772.85 ",$495.77 ,"$1,873.20 ",$495.77 ,"$1,816.34 ","$1,816.34 ",$495.77 ,"$1,816.34 ",$941.96 ,"$2,341.50 ","$1,672.50 ","$2,676.00 ","$1,239.42 ",$495.77 ,"$2,341.50 ",$495.77 ,"$2,007.00 ",$495.77 ,"$2,508.75 ","$1,665.81 ","$1,498.56 ","$1,665.81 ",$495.77 ,"$1,665.81 ","$2,609.10 ","$2,609.10 ","$2,843.25 ","$1,239.42 ","$2,318.09 ",$495.77 ,"$3,345.00 ","$1,839.75 ",$495.77 ,$879.74 ,"$3,345.00 ", N/A , N/A ,$520.56 ,"$2,676.00 ","$1,816.34 ",$936.60 ,"$3,010.50 ","$1,271.10 ",$325.00 ,$495.77 ,"$1,605.60 "
ST. MARY'S HOSPITAL - DECATUR,45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,"$1,225.00 ",$796.25 ,$169.99 ,"$1,225.00 ",$424.98 ,$624.75 ,$673.75 ,$169.99 ,$343.00 ,$649.25 ,$169.99 ,$686.00 ,$169.99 ,$665.18 ,$665.18 ,$169.99 ,$665.18 ,$322.97 ,$857.50 ,$612.50 ,$980.00 ,$424.97 ,$169.99 ,$857.50 ,$169.99 ,$735.00 ,$169.99 ,$918.75 ,$676.20 ,$610.05 ,$676.20 ,$169.99 ,$676.20 ,$955.50 ,$955.50 ,"$1,041.25 ",$424.97 ,$848.93 ,$169.99 ,"$1,225.00 ",$673.75 ,$169.99 ,$322.18 ,"$1,225.00 ", N/A , N/A ,$178.49 ,$980.00 ,$665.18 ,$343.00 ,"$1,102.50 ",$465.50 ,$325.00 ,$169.99 ,$588.00 
ST. MARY'S HOSPITAL - DECATUR,45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$288.00 ,$187.20 ,$75.74 ,$424.98 ,$424.98 ,$146.88 ,$158.40 ,$169.99 ,$80.64 ,$152.64 ,$169.99 ,$161.28 ,$169.99 ,$156.38 ,$156.38 ,$169.99 ,$156.38 ,$288.00 ,$201.60 ,$144.00 ,$230.40 ,$424.97 ,$169.99 ,$201.60 ,$169.99 ,$172.80 ,$169.99 ,$216.00 ,$158.98 ,$143.42 ,$158.98 ,$169.99 ,$158.98 ,$224.64 ,$224.64 ,$244.80 ,$288.00 ,$199.58 ,$169.99 ,$288.00 ,$158.40 ,$169.99 ,$75.74 ,$288.00 , N/A , N/A ,$178.49 ,$230.40 ,$156.38 ,$80.64 ,$259.20 ,$109.44 ,$288.00 ,$169.99 ,$138.24 
ST. MARY'S HOSPITAL - DECATUR,45000063,16025,HC DRESS/DEB BURN 5-10% TOTAL MED,450,1 ,$939.00 ,$610.35 ,$169.99 ,$939.00 ,$424.98 ,$478.89 ,$516.45 ,$169.99 ,$262.92 ,$497.67 ,$169.99 ,$525.84 ,$169.99 ,$509.88 ,$509.88 ,$169.99 ,$509.88 ,$322.97 ,$657.30 ,$469.50 ,$751.20 ,$424.97 ,$169.99 ,$657.30 ,$169.99 ,$563.40 ,$169.99 ,$704.25 ,$518.33 ,$467.62 ,$518.33 ,$169.99 ,$518.33 ,$732.42 ,$732.42 ,$798.15 ,$424.97 ,$650.73 ,$169.99 ,$939.00 ,$516.45 ,$169.99 ,$246.96 ,$939.00 , N/A , N/A ,$178.49 ,$751.20 ,$509.88 ,$262.92 ,$845.10 ,$356.82 ,$325.00 ,$169.99 ,$450.72 
ST. MARY'S HOSPITAL - DECATUR,45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,"$1,194.00 ",$776.10 ,$314.02 ,"$1,194.00 ",$817.95 ,$608.94 ,$656.70 ,$327.18 ,$334.32 ,$632.82 ,$327.18 ,$668.64 ,$327.18 ,$648.34 ,$648.34 ,$327.18 ,$648.34 ,$621.65 ,$835.80 ,$597.00 ,$955.20 ,$817.95 ,$327.18 ,$835.80 ,$327.18 ,$716.40 ,$327.18 ,$895.50 ,$659.09 ,$594.61 ,$659.09 ,$327.18 ,$659.09 ,$931.32 ,$931.32 ,"$1,014.90 ",$817.95 ,$827.44 ,$327.18 ,"$1,194.00 ",$656.70 ,$327.18 ,$314.02 ,"$1,194.00 ", N/A , N/A ,$343.54 ,$955.20 ,$648.34 ,$334.32 ,"$1,074.60 ",$453.72 ,$325.00 ,$327.18 ,$573.12 
ST. MARY'S HOSPITAL - DECATUR,45000067,17250,HC CAUT CHEM TISSUE GRANULATION,450,1 ,$843.00 ,$547.95 ,$169.99 ,$843.00 ,$424.98 ,$429.93 ,$463.65 ,$169.99 ,$236.04 ,$446.79 ,$169.99 ,$472.08 ,$169.99 ,$457.75 ,$457.75 ,$169.99 ,$457.75 ,$322.97 ,$590.10 ,$421.50 ,$674.40 ,$424.97 ,$169.99 ,$590.10 ,$169.99 ,$505.80 ,$169.99 ,$632.25 ,$465.34 ,$419.81 ,$465.34 ,$169.99 ,$465.34 ,$657.54 ,$657.54 ,$716.55 ,$424.97 ,$584.20 ,$169.99 ,$843.00 ,$463.65 ,$169.99 ,$221.71 ,$843.00 , N/A , N/A ,$178.49 ,$674.40 ,$457.75 ,$236.04 ,$758.70 ,$320.34 ,$325.00 ,$169.99 ,$404.64 
ST. MARY'S HOSPITAL - DECATUR,45000068,20103,HC EXPL PENTR WOUND EXTREMITY,450,1 ,"$1,178.00 ",$765.70 ,$309.81 ,"$1,472.65 ","$1,472.65 ",$600.78 ,$647.90 ,$589.06 ,$329.84 ,$624.34 ,$589.06 ,$659.68 ,$589.06 ,$639.65 ,$639.65 ,$589.06 ,$639.65 ,"$1,119.21 ",$824.60 ,$589.00 ,$942.40 ,"$1,472.64 ",$589.06 ,$824.60 ,$589.06 ,$706.80 ,$589.06 ,$883.50 ,$650.26 ,$586.64 ,$650.26 ,$589.06 ,$650.26 ,$918.84 ,$918.84 ,"$1,001.30 ","$1,178.00 ",$816.35 ,$589.06 ,"$1,178.00 ",$647.90 ,$589.06 ,$309.81 ,"$1,178.00 ", N/A , N/A ,$618.51 ,$942.40 ,$639.65 ,$329.84 ,"$1,060.20 ",$447.64 ,$325.00 ,$589.06 ,$565.44 
ST. MARY'S HOSPITAL - DECATUR,45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,$623.00 ,$404.95 ,$163.85 ,$623.00 ,$618.28 ,$317.73 ,$342.65 ,$247.31 ,$174.44 ,$330.19 ,$247.31 ,$348.88 ,$247.31 ,$338.29 ,$338.29 ,$247.31 ,$338.29 ,$469.90 ,$436.10 ,$311.50 ,$498.40 ,$618.29 ,$247.31 ,$436.10 ,$247.31 ,$373.80 ,$247.31 ,$467.25 ,$343.90 ,$310.25 ,$343.90 ,$247.31 ,$343.90 ,$485.94 ,$485.94 ,$529.55 ,$618.29 ,$431.74 ,$247.31 ,$623.00 ,$342.65 ,$247.31 ,$163.85 ,$623.00 , N/A , N/A ,$259.68 ,$498.40 ,$338.29 ,$174.44 ,$560.70 ,$236.74 ,$325.00 ,$247.31 ,$299.04 
ST. MARY'S HOSPITAL - DECATUR,45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$833.00 ,$541.45 ,$219.08 ,$833.00 ,$618.28 ,$424.83 ,$458.15 ,$247.31 ,$233.24 ,$441.49 ,$247.31 ,$466.48 ,$247.31 ,$452.32 ,$452.32 ,$247.31 ,$452.32 ,$469.90 ,$583.10 ,$416.50 ,$666.40 ,$618.29 ,$247.31 ,$583.10 ,$247.31 ,$499.80 ,$247.31 ,$624.75 ,$459.82 ,$414.83 ,$459.82 ,$247.31 ,$459.82 ,$649.74 ,$649.74 ,$708.05 ,$618.29 ,$577.27 ,$247.31 ,$833.00 ,$458.15 ,$247.31 ,$219.08 ,$833.00 , N/A , N/A ,$259.68 ,$666.40 ,$452.32 ,$233.24 ,$749.70 ,$316.54 ,$325.00 ,$247.31 ,$399.84 
ST. MARY'S HOSPITAL - DECATUR,45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,"$1,541.00 ","$1,001.65 ",$247.31 ,"$1,541.00 ",$618.28 ,$785.91 ,$847.55 ,$247.31 ,$431.48 ,$816.73 ,$247.31 ,$862.96 ,$247.31 ,$836.76 ,$836.76 ,$247.31 ,$836.76 ,$469.90 ,"$1,078.70 ",$770.50 ,"$1,232.80 ",$618.29 ,$247.31 ,"$1,078.70 ",$247.31 ,$924.60 ,$247.31 ,"$1,155.75 ",$850.63 ,$767.42 ,$850.63 ,$247.31 ,$850.63 ,"$1,201.98 ","$1,201.98 ","$1,309.85 ",$618.29 ,"$1,067.91 ",$247.31 ,"$1,541.00 ",$847.55 ,$247.31 ,$405.28 ,"$1,541.00 ", N/A , N/A ,$259.68 ,"$1,232.80 ",$836.76 ,$431.48 ,"$1,386.90 ",$585.58 ,$325.00 ,$247.31 ,$739.68 
ST. MARY'S HOSPITAL - DECATUR,45000072,20612,HC INJ GANGLION CYST,450,1 ,"$1,008.00 ",$655.20 ,$247.31 ,"$1,008.00 ",$618.28 ,$514.08 ,$554.40 ,$247.31 ,$282.24 ,$534.24 ,$247.31 ,$564.48 ,$247.31 ,$547.34 ,$547.34 ,$247.31 ,$547.34 ,$469.90 ,$705.60 ,$504.00 ,$806.40 ,$618.29 ,$247.31 ,$705.60 ,$247.31 ,$604.80 ,$247.31 ,$756.00 ,$556.42 ,$501.98 ,$556.42 ,$247.31 ,$556.42 ,$786.24 ,$786.24 ,$856.80 ,$618.29 ,$698.54 ,$247.31 ,"$1,008.00 ",$554.40 ,$247.31 ,$265.10 ,"$1,008.00 ", N/A , N/A ,$259.68 ,$806.40 ,$547.34 ,$282.24 ,$907.20 ,$383.04 ,$325.00 ,$247.31 ,$483.84 
ST. MARY'S HOSPITAL - DECATUR,45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,"$2,603.00 ","$1,691.95 ",$195.10 ,"$2,603.00 ",$487.75 ,"$1,327.53 ","$1,431.65 ",$195.10 ,$728.84 ,"$1,379.59 ",$195.10 ,"$1,457.68 ",$195.10 ,"$1,413.43 ","$1,413.43 ",$195.10 ,"$1,413.43 ",$370.70 ,"$1,822.10 ","$1,301.50 ","$2,082.40 ",$487.76 ,$195.10 ,"$1,822.10 ",$195.10 ,"$1,561.80 ",$195.10 ,"$1,952.25 ","$1,436.86 ","$1,296.29 ","$1,436.86 ",$195.10 ,"$1,436.86 ","$2,030.34 ","$2,030.34 ","$2,212.55 ",$487.76 ,"$1,803.88 ",$195.10 ,"$2,603.00 ","$1,431.65 ",$195.10 ,$684.59 ,"$2,603.00 ", N/A , N/A ,$204.86 ,"$2,082.40 ","$1,413.43 ",$728.84 ,"$2,342.70 ",$989.14 ,$325.00 ,$195.10 ,"$1,249.44 "
ST. MARY'S HOSPITAL - DECATUR,45000077,24605,HC CL TX ELBOW DISLOCATION W ANESTH,450,1 ,"$3,821.00 ","$2,483.65 ",$325.00 ,"$3,821.00 ","$3,296.18 ","$1,948.71 ","$2,101.55 ","$1,318.47 ","$1,069.88 ","$2,025.13 ","$1,318.47 ","$2,139.76 ","$1,318.47 ","$2,074.80 ","$2,074.80 ","$1,318.47 ","$2,074.80 ","$2,505.09 ","$2,674.70 ","$1,910.50 ","$3,056.80 ","$3,296.17 ","$1,318.47 ","$2,674.70 ","$1,318.47 ","$2,292.60 ","$1,318.47 ","$2,865.75 ","$1,902.86 ","$1,711.81 ","$1,902.86 ","$1,318.47 ","$1,902.86 ","$2,980.38 ","$2,980.38 ","$3,247.85 ","$3,296.17 ","$2,647.95 ","$1,318.47 ","$3,821.00 ","$2,101.55 ","$1,318.47 ","$1,004.92 ","$3,821.00 ", N/A , N/A ,"$1,384.39 ","$3,056.80 ","$2,074.80 ","$1,069.88 ","$3,438.90 ","$1,451.98 ",$325.00 ,"$1,318.47 ","$1,834.08 "
ST. MARY'S HOSPITAL - DECATUR,45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$480.00 ,$312.00 ,$126.24 ,$487.76 ,$487.75 ,$244.80 ,$264.00 ,$195.10 ,$134.40 ,$254.40 ,$195.10 ,$268.80 ,$195.10 ,$260.64 ,$260.64 ,$195.10 ,$260.64 ,$370.70 ,$336.00 ,$240.00 ,$384.00 ,$487.76 ,$195.10 ,$336.00 ,$195.10 ,$288.00 ,$195.10 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$195.10 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$195.10 ,$480.00 ,$264.00 ,$195.10 ,$126.24 ,$480.00 , N/A , N/A ,$204.86 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$195.10 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000081,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP,450,1 ,$548.00 ,$356.20 ,$144.12 ,"$3,296.18 ","$3,296.18 ",$279.48 ,$301.40 ,"$1,318.47 ",$153.44 ,$290.44 ,"$1,318.47 ",$306.88 ,$548.00 ,$297.56 ,$297.56 ,$548.00 ,$297.56 ,$548.00 ,$383.60 ,$274.00 ,$438.40 ,"$3,296.17 ","$1,318.47 ",$383.60 ,"$1,318.47 ",$328.80 ,"$1,318.47 ",$411.00 ,$302.50 ,$272.90 ,$302.50 ,"$1,318.47 ",$302.50 ,$427.44 ,$427.44 ,$465.80 ,$548.00 ,$379.76 ,"$1,318.47 ",$548.00 ,$301.40 ,"$1,318.47 ",$144.12 ,$548.00 , N/A , N/A ,"$1,384.39 ",$438.40 ,$297.56 ,$153.44 ,$493.20 ,$208.24 ,$325.00 ,"$1,318.47 ",$263.04 
ST. MARY'S HOSPITAL - DECATUR,45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,$548.00 ,$356.20 ,$144.12 ,"$3,296.18 ","$3,296.18 ",$279.48 ,$301.40 ,"$1,318.47 ",$153.44 ,$290.44 ,"$1,318.47 ",$306.88 ,$548.00 ,$297.56 ,$297.56 ,$548.00 ,$297.56 ,$548.00 ,$383.60 ,$274.00 ,$438.40 ,"$3,296.17 ","$1,318.47 ",$383.60 ,"$1,318.47 ",$328.80 ,"$1,318.47 ",$411.00 ,$302.50 ,$272.90 ,$302.50 ,"$1,318.47 ",$302.50 ,$427.44 ,$427.44 ,$465.80 ,$548.00 ,$379.76 ,"$1,318.47 ",$548.00 ,$301.40 ,"$1,318.47 ",$144.12 ,$548.00 , N/A , N/A ,"$1,384.39 ",$438.40 ,$297.56 ,$153.44 ,$493.20 ,$208.24 ,$325.00 ,"$1,318.47 ",$263.04 
ST. MARY'S HOSPITAL - DECATUR,45000083,26010,HC DRAIN ABSC FINGER SIMPLE,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000084,26011,HC DRAIN ABSC FINGER COMPLCD,450,1 ,"$3,924.00 ","$2,550.60 ",$325.00 ,"$3,924.00 ","$3,329.73 ","$2,001.24 ","$2,158.20 ","$1,331.89 ","$1,098.72 ","$2,079.72 ","$1,331.89 ","$2,197.44 ","$1,331.89 ","$2,130.73 ","$2,130.73 ","$1,331.89 ","$2,130.73 ","$2,530.59 ","$2,746.80 ","$1,962.00 ","$3,139.20 ","$3,329.72 ","$1,331.89 ","$2,746.80 ","$1,331.89 ","$2,354.40 ","$1,331.89 ","$2,943.00 ","$1,954.15 ","$1,757.95 ","$1,954.15 ","$1,331.89 ","$1,954.15 ","$3,060.72 ","$3,060.72 ","$3,335.40 ","$3,329.72 ","$2,719.33 ","$1,331.89 ","$3,924.00 ","$2,158.20 ","$1,331.89 ","$1,032.01 ","$3,924.00 ", N/A , N/A ,"$1,398.48 ","$3,139.20 ","$2,130.73 ","$1,098.72 ","$3,531.60 ","$1,491.12 ",$325.00 ,"$1,331.89 ","$1,883.52 "
ST. MARY'S HOSPITAL - DECATUR,45000085,26410,HC RPR TENDON HAND EXTEN W/O,450,1 ,"$3,673.00 ","$2,387.45 ",$325.00 ,"$3,673.00 ","$3,296.18 ","$1,873.23 ","$2,020.15 ","$1,318.47 ","$1,028.44 ","$1,946.69 ","$1,318.47 ","$2,056.88 ","$1,318.47 ","$1,994.44 ","$1,994.44 ","$1,318.47 ","$1,994.44 ","$2,505.09 ","$2,571.10 ","$1,836.50 ","$2,938.40 ","$3,296.17 ","$1,318.47 ","$2,571.10 ","$1,318.47 ","$2,203.80 ","$1,318.47 ","$2,754.75 ","$1,829.15 ","$1,645.50 ","$1,829.15 ","$1,318.47 ","$1,829.15 ","$2,864.94 ","$2,864.94 ","$3,122.05 ","$3,296.17 ","$2,545.39 ","$1,318.47 ","$3,673.00 ","$2,020.15 ","$1,318.47 ",$966.00 ,"$3,673.00 ", N/A , N/A ,"$1,384.39 ","$2,938.40 ","$1,994.44 ","$1,028.44 ","$3,305.70 ","$1,395.74 ",$325.00 ,"$1,318.47 ","$1,763.04 "
ST. MARY'S HOSPITAL - DECATUR,45000087,26725,HC TX FX PHALANX PROX W/MAN CLS,450,1 ,"$1,079.00 ",$701.35 ,$195.10 ,"$1,079.00 ",$487.75 ,$550.29 ,$593.45 ,$195.10 ,$302.12 ,$571.87 ,$195.10 ,$604.24 ,$195.10 ,$585.90 ,$585.90 ,$195.10 ,$585.90 ,$370.70 ,$755.30 ,$539.50 ,$863.20 ,$487.76 ,$195.10 ,$755.30 ,$195.10 ,$647.40 ,$195.10 ,$809.25 ,$595.61 ,$537.34 ,$595.61 ,$195.10 ,$595.61 ,$841.62 ,$841.62 ,$917.15 ,$487.76 ,$747.75 ,$195.10 ,"$1,079.00 ",$593.45 ,$195.10 ,$283.78 ,"$1,079.00 ", N/A , N/A ,$204.86 ,$863.20 ,$585.90 ,$302.12 ,$971.10 ,$410.02 ,$325.00 ,$195.10 ,$517.92 
ST. MARY'S HOSPITAL - DECATUR,45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000091,26951,HC AMPUT FINGER/THUMB SGL CLSR,450,1 ,"$5,282.00 ","$3,433.30 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$2,905.10 ","$2,680.74 ","$1,478.96 ","$2,799.46 ","$2,680.74 ","$2,957.92 ","$2,680.74 ","$2,868.13 ","$2,868.13 ","$2,680.74 ","$2,868.13 ","$5,093.40 ","$3,697.40 ","$2,641.00 ","$4,225.60 ","$6,701.85 ","$2,680.74 ","$3,697.40 ","$2,680.74 ","$3,169.20 ","$2,680.74 ","$3,961.50 ","$2,630.44 ","$2,366.34 ","$2,630.44 ","$2,680.74 ","$2,630.44 ","$3,786.00 ","$3,786.00 ","$4,489.70 ","$5,282.00 ","$3,660.43 ","$2,680.74 ","$5,282.00 ","$2,905.10 ","$2,680.74 ","$1,389.17 ","$5,282.00 ", N/A , N/A ,"$2,814.78 ","$4,225.60 ","$2,868.13 ","$1,478.96 ","$4,753.80 ","$2,007.16 ",$325.00 ,"$2,680.74 ","$2,535.36 "
ST. MARY'S HOSPITAL - DECATUR,45000092,27250,HC TX DISCL HIP CLOSED W/O ANES,450,1 ,"$1,764.00 ","$1,146.60 ",$195.10 ,"$1,764.00 ",$487.75 ,$899.64 ,$970.20 ,$195.10 ,$493.92 ,$934.92 ,$195.10 ,$987.84 ,$195.10 ,$957.85 ,$957.85 ,$195.10 ,$957.85 ,$370.70 ,"$1,234.80 ",$882.00 ,"$1,411.20 ",$487.76 ,$195.10 ,"$1,234.80 ",$195.10 ,"$1,058.40 ",$195.10 ,"$1,323.00 ",$973.73 ,$878.47 ,$973.73 ,$195.10 ,$973.73 ,"$1,375.92 ","$1,375.92 ","$1,499.40 ",$487.76 ,"$1,222.45 ",$195.10 ,"$1,764.00 ",$970.20 ,$195.10 ,$463.93 ,"$1,764.00 ", N/A , N/A ,$204.86 ,"$1,411.20 ",$957.85 ,$493.92 ,"$1,587.60 ",$670.32 ,$325.00 ,$195.10 ,$846.72 
ST. MARY'S HOSPITAL - DECATUR,45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,$296.00 ,$192.40 ,$77.85 ,$487.76 ,$487.75 ,$150.96 ,$162.80 ,$195.10 ,$82.88 ,$156.88 ,$195.10 ,$165.76 ,$195.10 ,$160.73 ,$160.73 ,$195.10 ,$160.73 ,$296.00 ,$207.20 ,$148.00 ,$236.80 ,$487.76 ,$195.10 ,$207.20 ,$195.10 ,$177.60 ,$195.10 ,$222.00 ,$163.39 ,$147.41 ,$163.39 ,$195.10 ,$163.39 ,$230.88 ,$230.88 ,$251.60 ,$296.00 ,$205.13 ,$195.10 ,$296.00 ,$162.80 ,$195.10 ,$77.85 ,$296.00 , N/A , N/A ,$204.86 ,$236.80 ,$160.73 ,$82.88 ,$266.40 ,$112.48 ,$296.00 ,$195.10 ,$142.08 
ST. MARY'S HOSPITAL - DECATUR,45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,"$1,194.00 ",$776.10 ,$195.10 ,"$1,194.00 ",$487.75 ,$608.94 ,$656.70 ,$195.10 ,$334.32 ,$632.82 ,$195.10 ,$668.64 ,$195.10 ,$648.34 ,$648.34 ,$195.10 ,$648.34 ,$370.70 ,$835.80 ,$597.00 ,$955.20 ,$487.76 ,$195.10 ,$835.80 ,$195.10 ,$716.40 ,$195.10 ,$895.50 ,$659.09 ,$594.61 ,$659.09 ,$195.10 ,$659.09 ,$931.32 ,$931.32 ,"$1,014.90 ",$487.76 ,$827.44 ,$195.10 ,"$1,194.00 ",$656.70 ,$195.10 ,$314.02 ,"$1,194.00 ", N/A , N/A ,$204.86 ,$955.20 ,$648.34 ,$334.32 ,"$1,074.60 ",$453.72 ,$325.00 ,$195.10 ,$573.12 
ST. MARY'S HOSPITAL - DECATUR,45000097,28190,HC REM FB FOOT SUBQ,450,1 ,"$1,825.00 ","$1,186.25 ",$325.00 ,"$1,825.00 ","$1,472.65 ",$930.75 ,"$1,003.75 ",$589.06 ,$511.00 ,$967.25 ,$589.06 ,"$1,022.00 ",$589.06 ,$990.98 ,$990.98 ,$589.06 ,$990.98 ,"$1,119.21 ","$1,277.50 ",$912.50 ,"$1,460.00 ","$1,472.64 ",$589.06 ,"$1,277.50 ",$589.06 ,"$1,095.00 ",$589.06 ,"$1,368.75 ","$1,007.40 ",$908.85 ,"$1,007.40 ",$589.06 ,"$1,007.40 ","$1,423.50 ","$1,423.50 ","$1,551.25 ","$1,472.64 ","$1,264.73 ",$589.06 ,"$1,825.00 ","$1,003.75 ",$589.06 ,$479.98 ,"$1,825.00 ", N/A , N/A ,$618.51 ,"$1,460.00 ",$990.98 ,$511.00 ,"$1,642.50 ",$693.50 ,$325.00 ,$589.06 ,$876.00 
ST. MARY'S HOSPITAL - DECATUR,45000098,29065,HC APPL CAST ARM LONG,450,1 ,$702.00 ,$456.30 ,$184.63 ,$702.00 ,$570.90 ,$358.02 ,$386.10 ,$228.36 ,$196.56 ,$372.06 ,$228.36 ,$393.12 ,$228.36 ,$381.19 ,$381.19 ,$228.36 ,$381.19 ,$433.88 ,$491.40 ,$351.00 ,$561.60 ,$570.90 ,$228.36 ,$491.40 ,$228.36 ,$421.20 ,$228.36 ,$526.50 ,$387.50 ,$349.60 ,$387.50 ,$228.36 ,$387.50 ,$547.56 ,$547.56 ,$596.70 ,$570.90 ,$486.49 ,$228.36 ,$702.00 ,$386.10 ,$228.36 ,$184.63 ,$702.00 , N/A , N/A ,$239.78 ,$561.60 ,$381.19 ,$196.56 ,$631.80 ,$266.76 ,$325.00 ,$228.36 ,$336.96 
ST. MARY'S HOSPITAL - DECATUR,45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,$316.00 ,$205.40 ,$83.11 ,$570.90 ,$570.90 ,$161.16 ,$173.80 ,$228.36 ,$88.48 ,$167.48 ,$228.36 ,$176.96 ,$228.36 ,$171.59 ,$171.59 ,$228.36 ,$171.59 ,$316.00 ,$221.20 ,$158.00 ,$252.80 ,$570.90 ,$228.36 ,$221.20 ,$228.36 ,$189.60 ,$228.36 ,$237.00 ,$174.43 ,$157.37 ,$174.43 ,$228.36 ,$174.43 ,$246.48 ,$246.48 ,$268.60 ,$316.00 ,$218.99 ,$228.36 ,$316.00 ,$173.80 ,$228.36 ,$83.11 ,$316.00 , N/A , N/A ,$239.78 ,$252.80 ,$171.59 ,$88.48 ,$284.40 ,$120.08 ,$316.00 ,$228.36 ,$151.68 
ST. MARY'S HOSPITAL - DECATUR,45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$869.00 ,$564.85 ,$133.74 ,$869.00 ,$334.35 ,$443.19 ,$477.95 ,$133.74 ,$243.32 ,$460.57 ,$133.74 ,$486.64 ,$133.74 ,$471.87 ,$471.87 ,$133.74 ,$471.87 ,$254.10 ,$608.30 ,$434.50 ,$695.20 ,$334.34 ,$133.74 ,$608.30 ,$133.74 ,$521.40 ,$133.74 ,$651.75 ,$479.69 ,$432.76 ,$479.69 ,$133.74 ,$479.69 ,$677.82 ,$677.82 ,$738.65 ,$334.34 ,$602.22 ,$133.74 ,$869.00 ,$477.95 ,$133.74 ,$228.55 ,$869.00 , N/A , N/A ,$140.43 ,$695.20 ,$471.87 ,$243.32 ,$782.10 ,$330.22 ,$325.00 ,$133.74 ,$417.12 
ST. MARY'S HOSPITAL - DECATUR,45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$743.00 ,$482.95 ,$106.74 ,$743.00 ,$266.85 ,$378.93 ,$408.65 ,$106.74 ,$208.04 ,$393.79 ,$106.74 ,$416.08 ,$106.74 ,$403.45 ,$403.45 ,$106.74 ,$403.45 ,$202.80 ,$520.10 ,$371.50 ,$594.40 ,$266.84 ,$106.74 ,$520.10 ,$106.74 ,$445.80 ,$106.74 ,$557.25 ,$410.14 ,$370.01 ,$410.14 ,$106.74 ,$410.14 ,$579.54 ,$579.54 ,$631.55 ,$266.84 ,$514.90 ,$106.74 ,$743.00 ,$408.65 ,$106.74 ,$195.41 ,$743.00 , N/A , N/A ,$112.08 ,$594.40 ,$403.45 ,$208.04 ,$668.70 ,$282.34 ,$325.00 ,$106.74 ,$356.64 
ST. MARY'S HOSPITAL - DECATUR,45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45000105,29240,HC STRAPPING SHLDR,450,1 ,$987.00 ,$641.55 ,$106.74 ,$987.00 ,$266.85 ,$503.37 ,$542.85 ,$106.74 ,$276.36 ,$523.11 ,$106.74 ,$552.72 ,$106.74 ,$535.94 ,$535.94 ,$106.74 ,$535.94 ,$202.80 ,$690.90 ,$493.50 ,$789.60 ,$266.84 ,$106.74 ,$690.90 ,$106.74 ,$592.20 ,$106.74 ,$740.25 ,$544.82 ,$491.53 ,$544.82 ,$106.74 ,$544.82 ,$769.86 ,$769.86 ,$838.95 ,$266.84 ,$683.99 ,$106.74 ,$987.00 ,$542.85 ,$106.74 ,$259.58 ,$987.00 , N/A , N/A ,$112.08 ,$789.60 ,$535.94 ,$276.36 ,$888.30 ,$375.06 ,$325.00 ,$106.74 ,$473.76 
ST. MARY'S HOSPITAL - DECATUR,45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$677.00 ,$440.05 ,$178.05 ,$677.00 ,$570.90 ,$345.27 ,$372.35 ,$228.36 ,$189.56 ,$358.81 ,$228.36 ,$379.12 ,$228.36 ,$367.61 ,$367.61 ,$228.36 ,$367.61 ,$433.88 ,$473.90 ,$338.50 ,$541.60 ,$570.90 ,$228.36 ,$473.90 ,$228.36 ,$406.20 ,$228.36 ,$507.75 ,$373.70 ,$337.15 ,$373.70 ,$228.36 ,$373.70 ,$528.06 ,$528.06 ,$575.45 ,$570.90 ,$469.16 ,$228.36 ,$677.00 ,$372.35 ,$228.36 ,$178.05 ,$677.00 , N/A , N/A ,$239.78 ,$541.60 ,$367.61 ,$189.56 ,$609.30 ,$257.26 ,$325.00 ,$228.36 ,$324.96 
ST. MARY'S HOSPITAL - DECATUR,45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$680.00 ,$442.00 ,$133.74 ,$680.00 ,$334.35 ,$346.80 ,$374.00 ,$133.74 ,$190.40 ,$360.40 ,$133.74 ,$380.80 ,$133.74 ,$369.24 ,$369.24 ,$133.74 ,$369.24 ,$254.10 ,$476.00 ,$340.00 ,$544.00 ,$334.34 ,$133.74 ,$476.00 ,$133.74 ,$408.00 ,$133.74 ,$510.00 ,$375.36 ,$338.64 ,$375.36 ,$133.74 ,$375.36 ,$530.40 ,$530.40 ,$578.00 ,$334.34 ,$471.24 ,$133.74 ,$680.00 ,$374.00 ,$133.74 ,$178.84 ,$680.00 , N/A , N/A ,$140.43 ,$544.00 ,$369.24 ,$190.40 ,$612.00 ,$258.40 ,$325.00 ,$133.74 ,$326.40 
ST. MARY'S HOSPITAL - DECATUR,45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$638.00 ,$414.70 ,$133.74 ,$638.00 ,$334.35 ,$325.38 ,$350.90 ,$133.74 ,$178.64 ,$338.14 ,$133.74 ,$357.28 ,$133.74 ,$346.43 ,$346.43 ,$133.74 ,$346.43 ,$254.10 ,$446.60 ,$319.00 ,$510.40 ,$334.34 ,$133.74 ,$446.60 ,$133.74 ,$382.80 ,$133.74 ,$478.50 ,$352.18 ,$317.72 ,$352.18 ,$133.74 ,$352.18 ,$497.64 ,$497.64 ,$542.30 ,$334.34 ,$442.13 ,$133.74 ,$638.00 ,$350.90 ,$133.74 ,$167.79 ,$638.00 , N/A , N/A ,$140.43 ,$510.40 ,$346.43 ,$178.64 ,$574.20 ,$242.44 ,$325.00 ,$133.74 ,$306.24 
ST. MARY'S HOSPITAL - DECATUR,45000109,29705,HC REM/BIV CAST ARM/LEG,450,1 ,$513.00 ,$333.45 ,$134.92 ,$570.90 ,$570.90 ,$261.63 ,$282.15 ,$228.36 ,$143.64 ,$271.89 ,$228.36 ,$287.28 ,$228.36 ,$278.56 ,$278.56 ,$228.36 ,$278.56 ,$433.88 ,$359.10 ,$256.50 ,$410.40 ,$570.90 ,$228.36 ,$359.10 ,$228.36 ,$307.80 ,$228.36 ,$384.75 ,$283.18 ,$255.47 ,$283.18 ,$228.36 ,$283.18 ,$400.14 ,$400.14 ,$436.05 ,$513.00 ,$355.51 ,$228.36 ,$513.00 ,$282.15 ,$228.36 ,$134.92 ,$513.00 , N/A , N/A ,$239.78 ,$410.40 ,$278.56 ,$143.64 ,$461.70 ,$194.94 ,$325.00 ,$228.36 ,$246.24 
ST. MARY'S HOSPITAL - DECATUR,45000110,30300,HC REM FB INTRANASAL,450,1 ,$173.00 ,$112.45 ,$45.50 ,$266.85 ,$266.85 ,$88.23 ,$95.15 ,$106.74 ,$48.44 ,$91.69 ,$106.74 ,$96.88 ,$106.74 ,$93.94 ,$93.94 ,$106.74 ,$93.94 ,$173.00 ,$121.10 ,$86.50 ,$138.40 ,$266.84 ,$106.74 ,$121.10 ,$106.74 ,$103.80 ,$106.74 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$106.74 ,$95.50 ,$134.94 ,$134.94 ,$147.05 ,$173.00 ,$119.89 ,$106.74 ,$173.00 ,$95.15 ,$106.74 ,$45.50 ,$173.00 , N/A , N/A ,$112.08 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 ,$173.00 ,$106.74 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$935.00 ,$607.75 ,$106.74 ,$935.00 ,$266.85 ,$476.85 ,$514.25 ,$106.74 ,$261.80 ,$495.55 ,$106.74 ,$523.60 ,$106.74 ,$507.71 ,$507.71 ,$106.74 ,$507.71 ,$202.80 ,$654.50 ,$467.50 ,$748.00 ,$266.84 ,$106.74 ,$654.50 ,$106.74 ,$561.00 ,$106.74 ,$701.25 ,$516.12 ,$465.63 ,$516.12 ,$106.74 ,$516.12 ,$729.30 ,$729.30 ,$794.75 ,$266.84 ,$647.96 ,$106.74 ,$935.00 ,$514.25 ,$106.74 ,$245.91 ,$935.00 , N/A , N/A ,$112.08 ,$748.00 ,$507.71 ,$261.80 ,$841.50 ,$355.30 ,$325.00 ,$106.74 ,$448.80 
ST. MARY'S HOSPITAL - DECATUR,45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$488.00 ,$317.20 ,$106.74 ,$488.00 ,$266.85 ,$248.88 ,$268.40 ,$106.74 ,$136.64 ,$258.64 ,$106.74 ,$273.28 ,$106.74 ,$264.98 ,$264.98 ,$106.74 ,$264.98 ,$202.80 ,$341.60 ,$244.00 ,$390.40 ,$266.84 ,$106.74 ,$341.60 ,$106.74 ,$292.80 ,$106.74 ,$366.00 ,$269.38 ,$243.02 ,$269.38 ,$106.74 ,$269.38 ,$380.64 ,$380.64 ,$414.80 ,$266.84 ,$338.18 ,$106.74 ,$488.00 ,$268.40 ,$106.74 ,$128.34 ,$488.00 , N/A , N/A ,$112.08 ,$390.40 ,$264.98 ,$136.64 ,$439.20 ,$185.44 ,$325.00 ,$106.74 ,$234.24 
ST. MARY'S HOSPITAL - DECATUR,45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$946.00 ,$614.90 ,$106.74 ,$946.00 ,$266.85 ,$482.46 ,$520.30 ,$106.74 ,$264.88 ,$501.38 ,$106.74 ,$529.76 ,$106.74 ,$513.68 ,$513.68 ,$106.74 ,$513.68 ,$202.80 ,$662.20 ,$473.00 ,$756.80 ,$266.84 ,$106.74 ,$662.20 ,$106.74 ,$567.60 ,$106.74 ,$709.50 ,$522.19 ,$471.11 ,$522.19 ,$106.74 ,$522.19 ,$737.88 ,$737.88 ,$804.10 ,$266.84 ,$655.58 ,$106.74 ,$946.00 ,$520.30 ,$106.74 ,$248.80 ,$946.00 , N/A , N/A ,$112.08 ,$756.80 ,$513.68 ,$264.88 ,$851.40 ,$359.48 ,$325.00 ,$106.74 ,$454.08 
ST. MARY'S HOSPITAL - DECATUR,45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$770.00 ,$500.50 ,$202.51 ,$770.00 ,$642.28 ,$392.70 ,$423.50 ,$256.91 ,$215.60 ,$408.10 ,$256.91 ,$431.20 ,$256.91 ,$418.11 ,$418.11 ,$256.91 ,$418.11 ,$488.12 ,$539.00 ,$385.00 ,$616.00 ,$642.27 ,$256.91 ,$539.00 ,$256.91 ,$462.00 ,$256.91 ,$577.50 ,$425.04 ,$383.46 ,$425.04 ,$256.91 ,$425.04 ,$600.60 ,$600.60 ,$654.50 ,$642.27 ,$533.61 ,$256.91 ,$770.00 ,$423.50 ,$256.91 ,$202.51 ,$770.00 , N/A , N/A ,$269.76 ,$616.00 ,$418.11 ,$215.60 ,$693.00 ,$292.60 ,$325.00 ,$256.91 ,$369.60 
ST. MARY'S HOSPITAL - DECATUR,45000133,40650,HC RPR LIP FULL THICK VERMILN,450,1 ,"$1,773.00 ","$1,152.45 ",$325.00 ,"$1,773.00 ","$1,070.30 ",$904.23 ,$975.15 ,$428.12 ,$496.44 ,$939.69 ,$428.12 ,$992.88 ,$428.12 ,$962.74 ,$962.74 ,$428.12 ,$962.74 ,$813.42 ,"$1,241.10 ",$886.50 ,"$1,418.40 ","$1,070.29 ",$428.12 ,"$1,241.10 ",$428.12 ,"$1,063.80 ",$428.12 ,"$1,329.75 ",$978.70 ,$882.95 ,$978.70 ,$428.12 ,$978.70 ,"$1,382.94 ","$1,382.94 ","$1,507.05 ","$1,070.29 ","$1,228.69 ",$428.12 ,"$1,773.00 ",$975.15 ,$428.12 ,$466.30 ,"$1,773.00 ", N/A , N/A ,$449.53 ,"$1,418.40 ",$962.74 ,$496.44 ,"$1,595.70 ",$673.74 ,$325.00 ,$428.12 ,$851.04 
ST. MARY'S HOSPITAL - DECATUR,45000136,40800,HC DRAINAGE MOUTH LESION,450,1 ,"$1,735.00 ","$1,127.75 ",$325.00 ,"$1,735.00 ","$1,472.65 ",$884.85 ,$954.25 ,$589.06 ,$485.80 ,$919.55 ,$589.06 ,$971.60 ,$589.06 ,$942.11 ,$942.11 ,$589.06 ,$942.11 ,"$1,119.21 ","$1,214.50 ",$867.50 ,"$1,388.00 ","$1,472.64 ",$589.06 ,"$1,214.50 ",$589.06 ,"$1,041.00 ",$589.06 ,"$1,301.25 ",$957.72 ,$864.03 ,$957.72 ,$589.06 ,$957.72 ,"$1,353.30 ","$1,353.30 ","$1,474.75 ","$1,472.64 ","$1,202.36 ",$589.06 ,"$1,735.00 ",$954.25 ,$589.06 ,$456.31 ,"$1,735.00 ", N/A , N/A ,$618.51 ,"$1,388.00 ",$942.11 ,$485.80 ,"$1,561.50 ",$659.30 ,$325.00 ,$589.06 ,$832.80 
ST. MARY'S HOSPITAL - DECATUR,45000137,40830,HC LAC REPAIR VESTIBULE MOUTH 2.5 CM OR LESS,450,1 ,$273.00 ,$177.45 ,$71.80 ,$500.68 ,$500.68 ,$139.23 ,$150.15 ,$200.27 ,$76.44 ,$144.69 ,$200.27 ,$152.88 ,$200.27 ,$148.24 ,$148.24 ,$200.27 ,$148.24 ,$273.00 ,$191.10 ,$136.50 ,$218.40 ,$500.67 ,$200.27 ,$191.10 ,$200.27 ,$163.80 ,$200.27 ,$204.75 ,$150.70 ,$135.95 ,$150.70 ,$200.27 ,$150.70 ,$212.94 ,$212.94 ,$232.05 ,$273.00 ,$189.19 ,$200.27 ,$273.00 ,$150.15 ,$200.27 ,$71.80 ,$273.00 , N/A , N/A ,$210.28 ,$218.40 ,$148.24 ,$76.44 ,$245.70 ,$103.74 ,$273.00 ,$200.27 ,$131.04 
ST. MARY'S HOSPITAL - DECATUR,45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$473.00 ,$307.45 ,$124.40 ,$642.28 ,$642.28 ,$241.23 ,$260.15 ,$256.91 ,$132.44 ,$250.69 ,$256.91 ,$264.88 ,$256.91 ,$256.84 ,$256.84 ,$256.91 ,$256.84 ,$473.00 ,$331.10 ,$236.50 ,$378.40 ,$642.27 ,$256.91 ,$331.10 ,$256.91 ,$283.80 ,$256.91 ,$354.75 ,$261.10 ,$235.55 ,$261.10 ,$256.91 ,$261.10 ,$368.94 ,$368.94 ,$402.05 ,$473.00 ,$327.79 ,$256.91 ,$473.00 ,$260.15 ,$256.91 ,$124.40 ,$473.00 , N/A , N/A ,$269.76 ,$378.40 ,$256.84 ,$132.44 ,$425.70 ,$179.74 ,$325.00 ,$256.91 ,$227.04 
ST. MARY'S HOSPITAL - DECATUR,45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,"$1,065.00 ",$692.25 ,$106.74 ,"$1,065.00 ",$266.85 ,$543.15 ,$585.75 ,$106.74 ,$298.20 ,$564.45 ,$106.74 ,$596.40 ,$106.74 ,$578.30 ,$578.30 ,$106.74 ,$578.30 ,$202.80 ,$745.50 ,$532.50 ,$852.00 ,$266.84 ,$106.74 ,$745.50 ,$106.74 ,$639.00 ,$106.74 ,$798.75 ,$587.88 ,$530.37 ,$587.88 ,$106.74 ,$587.88 ,$830.70 ,$830.70 ,$905.25 ,$266.84 ,$738.05 ,$106.74 ,"$1,065.00 ",$585.75 ,$106.74 ,$280.10 ,"$1,065.00 ", N/A , N/A ,$112.08 ,$852.00 ,$578.30 ,$298.20 ,$958.50 ,$404.70 ,$325.00 ,$106.74 ,$511.20 
ST. MARY'S HOSPITAL - DECATUR,45000140,42700,HC I AND D ABSC PERITONSILLAR,450,1 ,$786.00 ,$510.90 ,$200.27 ,$786.00 ,$500.68 ,$400.86 ,$432.30 ,$200.27 ,$220.08 ,$416.58 ,$200.27 ,$440.16 ,$200.27 ,$426.80 ,$426.80 ,$200.27 ,$426.80 ,$380.51 ,$550.20 ,$393.00 ,$628.80 ,$500.67 ,$200.27 ,$550.20 ,$200.27 ,$471.60 ,$200.27 ,$589.50 ,$433.87 ,$391.43 ,$433.87 ,$200.27 ,$433.87 ,$613.08 ,$613.08 ,$668.10 ,$500.67 ,$544.70 ,$200.27 ,$786.00 ,$432.30 ,$200.27 ,$206.72 ,$786.00 , N/A , N/A ,$210.28 ,$628.80 ,$426.80 ,$220.08 ,$707.40 ,$298.68 ,$325.00 ,$200.27 ,$377.28 
ST. MARY'S HOSPITAL - DECATUR,45000143,43753,HC GASTRIC LAVAGE,450,1 ,$153.00 ,$99.45 ,$40.24 ,$626.30 ,$626.30 ,$78.03 ,$84.15 ,$250.52 ,$42.84 ,$81.09 ,$250.52 ,$85.68 ,$153.00 ,$83.08 ,$83.08 ,$153.00 ,$83.08 ,$153.00 ,$107.10 ,$76.50 ,$122.40 ,$626.30 ,$250.52 ,$107.10 ,$250.52 ,$91.80 ,$250.52 ,$114.75 ,$84.46 ,$76.19 ,$84.46 ,$250.52 ,$84.46 ,$119.34 ,$119.34 ,$130.05 ,$153.00 ,$106.03 ,$250.52 ,$153.00 ,$84.15 ,$250.52 ,$40.24 ,$153.00 , N/A , N/A ,$263.05 ,$122.40 ,$83.08 ,$42.84 ,$137.70 ,$58.14 ,$153.00 ,$250.52 ,$73.44 
ST. MARY'S HOSPITAL - DECATUR,45000146,46040,HC INCISION RECTAL ABSCESS,450,1 ,"$7,163.00 ","$4,655.95 ",$325.00 ,"$7,163.00 ","$2,454.00 ","$2,200.00 ","$3,939.65 ",$981.60 ,"$2,005.64 ","$3,796.39 ",$981.60 ,"$4,011.28 ",$981.60 ,"$3,100.00 ","$3,100.00 ",$981.60 ,"$3,100.00 ","$1,865.04 ","$5,014.10 ","$3,581.50 ","$5,730.40 ","$2,454.00 ",$981.60 ,"$5,014.10 ",$981.60 ,"$4,297.80 ",$981.60 ,"$5,372.25 ","$3,567.17 ","$3,209.02 ","$3,567.17 ",$981.60 ,"$3,567.17 ","$3,786.00 ","$3,786.00 ","$6,088.55 ","$2,454.00 ","$4,963.96 ",$981.60 ,"$7,163.00 ","$3,939.65 ",$981.60 ,"$1,883.87 ","$7,163.00 ", N/A , N/A ,"$1,030.68 ","$5,730.40 ","$3,100.00 ","$2,005.64 ","$6,446.70 ","$2,721.94 ",$325.00 ,$981.60 ,"$3,438.24 "
ST. MARY'S HOSPITAL - DECATUR,45000147,46050,HC I AND D ABSC PERIANAL SUPFIC,450,1 ,$830.00 ,$539.50 ,$218.29 ,"$1,878.00 ","$1,878.00 ",$423.30 ,$456.50 ,$751.20 ,$232.40 ,$439.90 ,$751.20 ,$464.80 ,$751.20 ,$450.69 ,$450.69 ,$751.20 ,$450.69 ,$830.00 ,$581.00 ,$415.00 ,$664.00 ,"$1,878.00 ",$751.20 ,$581.00 ,$751.20 ,$498.00 ,$751.20 ,$622.50 ,$458.16 ,$413.34 ,$458.16 ,$751.20 ,$458.16 ,$647.40 ,$647.40 ,$705.50 ,$830.00 ,$575.19 ,$751.20 ,$830.00 ,$456.50 ,$751.20 ,$218.29 ,$830.00 , N/A , N/A ,$788.76 ,$664.00 ,$450.69 ,$232.40 ,$747.00 ,$315.40 ,$325.00 ,$751.20 ,$398.40 
ST. MARY'S HOSPITAL - DECATUR,45000148,46083,HC INC HEMORRHOID EXTERNAL,450,1 ,"$1,077.00 ",$700.05 ,$251.89 ,"$1,077.00 ",$629.73 ,$549.27 ,$592.35 ,$251.89 ,$301.56 ,$570.81 ,$251.89 ,$603.12 ,$251.89 ,$584.81 ,$584.81 ,$251.89 ,$584.81 ,$478.60 ,$753.90 ,$538.50 ,$861.60 ,$629.73 ,$251.89 ,$753.90 ,$251.89 ,$646.20 ,$251.89 ,$807.75 ,$594.50 ,$536.35 ,$594.50 ,$251.89 ,$594.50 ,$840.06 ,$840.06 ,$915.45 ,$629.73 ,$746.36 ,$251.89 ,"$1,077.00 ",$592.35 ,$251.89 ,$283.25 ,"$1,077.00 ", N/A , N/A ,$264.48 ,$861.60 ,$584.81 ,$301.56 ,$969.30 ,$409.26 ,$325.00 ,$251.89 ,$516.96 
ST. MARY'S HOSPITAL - DECATUR,45000149,46320,HC EXCISION THROMBOSED HEMORRHOID; EXTERNAL,450,1 ,"$9,376.00 ","$6,094.40 ",$325.00 ,"$9,376.00 ","$2,454.00 ","$2,200.00 ","$5,156.80 ",$981.60 ,"$2,625.28 ","$4,656.42 ",$981.60 ,"$5,250.56 ",$981.60 ,"$3,100.00 ","$3,100.00 ",$981.60 ,"$3,100.00 ","$1,865.04 ","$6,563.20 ","$4,688.00 ","$7,500.80 ","$2,454.00 ",$981.60 ,"$6,563.20 ",$981.60 ,"$5,625.60 ",$981.60 ,"$7,032.00 ","$4,669.25 ","$4,200.45 ","$4,669.25 ",$981.60 ,"$4,669.25 ","$3,786.00 ","$3,786.00 ","$7,969.60 ","$2,454.00 ","$6,497.57 ",$981.60 ,"$9,376.00 ","$5,156.80 ",$981.60 ,"$2,465.89 ","$9,376.00 ", N/A , N/A ,"$1,030.68 ","$7,500.80 ","$3,100.00 ","$2,625.28 ","$8,438.40 ","$3,562.88 ",$325.00 ,$981.60 ,"$4,500.48 "
ST. MARY'S HOSPITAL - DECATUR,45000150,46600,HC ANOSCOPY,450,1 ,$630.00 ,$409.50 ,$106.74 ,$630.00 ,$266.85 ,$321.30 ,$346.50 ,$106.74 ,$176.40 ,$333.90 ,$106.74 ,$352.80 ,$106.74 ,$342.09 ,$342.09 ,$106.74 ,$342.09 ,$202.80 ,$441.00 ,$315.00 ,$504.00 ,$266.84 ,$106.74 ,$441.00 ,$106.74 ,$378.00 ,$106.74 ,$472.50 ,$347.76 ,$313.74 ,$347.76 ,$106.74 ,$347.76 ,$491.40 ,$491.40 ,$535.50 ,$266.84 ,$436.59 ,$106.74 ,$630.00 ,$346.50 ,$106.74 ,$165.69 ,$630.00 , N/A , N/A ,$112.08 ,$504.00 ,$342.09 ,$176.40 ,$567.00 ,$239.40 ,$325.00 ,$106.74 ,$302.40 
ST. MARY'S HOSPITAL - DECATUR,45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$304.00 ,$197.60 ,$79.95 ,$629.73 ,$629.73 ,$155.04 ,$167.20 ,$251.89 ,$85.12 ,$161.12 ,$251.89 ,$170.24 ,$251.89 ,$165.07 ,$165.07 ,$251.89 ,$165.07 ,$304.00 ,$212.80 ,$152.00 ,$243.20 ,$629.73 ,$251.89 ,$212.80 ,$251.89 ,$182.40 ,$251.89 ,$228.00 ,$167.81 ,$151.39 ,$167.81 ,$251.89 ,$167.81 ,$237.12 ,$237.12 ,$258.40 ,$304.00 ,$210.67 ,$251.89 ,$304.00 ,$167.20 ,$251.89 ,$79.95 ,$304.00 , N/A , N/A ,$264.48 ,$243.20 ,$165.07 ,$85.12 ,$273.60 ,$115.52 ,$304.00 ,$251.89 ,$145.92 
ST. MARY'S HOSPITAL - DECATUR,45000157,51705,HC CHG TUBE CYSTOSTOMY SMP,450,1 ,$939.00 ,$610.35 ,$246.96 ,$939.00 ,$629.73 ,$478.89 ,$516.45 ,$251.89 ,$262.92 ,$497.67 ,$251.89 ,$525.84 ,$251.89 ,$509.88 ,$509.88 ,$251.89 ,$509.88 ,$478.60 ,$657.30 ,$469.50 ,$751.20 ,$629.73 ,$251.89 ,$657.30 ,$251.89 ,$563.40 ,$251.89 ,$704.25 ,$518.33 ,$467.62 ,$518.33 ,$251.89 ,$518.33 ,$732.42 ,$732.42 ,$798.15 ,$629.73 ,$650.73 ,$251.89 ,$939.00 ,$516.45 ,$251.89 ,$246.96 ,$939.00 , N/A , N/A ,$264.48 ,$751.20 ,$509.88 ,$262.92 ,$845.10 ,$356.82 ,$325.00 ,$251.89 ,$450.72 
ST. MARY'S HOSPITAL - DECATUR,45000159,54220,HC IRRIG CORPORA CAVNOSA,450,1 ,"$1,228.00 ",$798.20 ,$251.89 ,"$1,228.00 ",$629.73 ,$626.28 ,$675.40 ,$251.89 ,$343.84 ,$650.84 ,$251.89 ,$687.68 ,$251.89 ,$666.80 ,$666.80 ,$251.89 ,$666.80 ,$478.60 ,$859.60 ,$614.00 ,$982.40 ,$629.73 ,$251.89 ,$859.60 ,$251.89 ,$736.80 ,$251.89 ,$921.00 ,$677.86 ,$611.54 ,$677.86 ,$251.89 ,$677.86 ,$957.84 ,$957.84 ,"$1,043.80 ",$629.73 ,$851.00 ,$251.89 ,"$1,228.00 ",$675.40 ,$251.89 ,$322.96 ,"$1,228.00 ", N/A , N/A ,$264.48 ,$982.40 ,$666.80 ,$343.84 ,"$1,105.20 ",$466.64 ,$325.00 ,$251.89 ,$589.44 
ST. MARY'S HOSPITAL - DECATUR,45000160,54450,HC MANIP FORESKIN STRETCH,450,1 ,"$2,467.00 ","$1,603.55 ",$251.89 ,"$2,467.00 ",$629.73 ,"$1,258.17 ","$1,356.85 ",$251.89 ,$690.76 ,"$1,307.51 ",$251.89 ,"$1,381.52 ",$251.89 ,"$1,339.58 ","$1,339.58 ",$251.89 ,"$1,339.58 ",$478.60 ,"$1,726.90 ","$1,233.50 ","$1,973.60 ",$629.73 ,$251.89 ,"$1,726.90 ",$251.89 ,"$1,480.20 ",$251.89 ,"$1,850.25 ","$1,361.78 ","$1,228.57 ","$1,361.78 ",$251.89 ,"$1,361.78 ","$1,924.26 ","$1,924.26 ","$2,096.95 ",$629.73 ,"$1,709.63 ",$251.89 ,"$2,467.00 ","$1,356.85 ",$251.89 ,$648.82 ,"$2,467.00 ", N/A , N/A ,$264.48 ,"$1,973.60 ","$1,339.58 ",$690.76 ,"$2,220.30 ",$937.46 ,$325.00 ,$251.89 ,"$1,184.16 "
ST. MARY'S HOSPITAL - DECATUR,45000161,54700,HC I AND D EPIDIDYMIS TESTIS OR SCROTAL SPACE,450,1 ,"$9,730.00 ","$6,324.50 ",$325.00 ,"$9,730.00 ","$4,237.25 ","$2,200.00 ","$5,351.50 ","$1,694.90 ","$2,724.40 ","$4,656.42 ","$1,694.90 ","$5,448.80 ","$1,694.90 ","$3,100.00 ","$3,100.00 ","$1,694.90 ","$3,100.00 ","$3,220.31 ","$6,811.00 ","$4,865.00 ","$7,784.00 ","$4,237.26 ","$1,694.90 ","$6,811.00 ","$1,694.90 ","$5,838.00 ","$1,694.90 ","$7,297.50 ","$4,845.54 ","$4,359.04 ","$4,845.54 ","$1,694.90 ","$4,845.54 ","$3,786.00 ","$3,786.00 ","$8,270.50 ","$4,237.26 ","$6,742.89 ","$1,694.90 ","$9,730.00 ","$5,351.50 ","$1,694.90 ","$2,558.99 ","$9,730.00 ", N/A , N/A ,"$1,779.65 ","$7,784.00 ","$3,100.00 ","$2,724.40 ","$8,757.00 ","$3,697.40 ",$325.00 ,"$1,694.90 ","$4,670.40 "
ST. MARY'S HOSPITAL - DECATUR,45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$926.00 ,$601.90 ,$243.54 ,$926.00 ,$667.43 ,$472.26 ,$509.30 ,$266.97 ,$259.28 ,$490.78 ,$266.97 ,$518.56 ,$266.97 ,$502.82 ,$502.82 ,$266.97 ,$502.82 ,$507.25 ,$648.20 ,$463.00 ,$740.80 ,$667.43 ,$266.97 ,$648.20 ,$266.97 ,$555.60 ,$266.97 ,$694.50 ,$511.15 ,$461.15 ,$511.15 ,$266.97 ,$511.15 ,$722.28 ,$722.28 ,$787.10 ,$667.43 ,$641.72 ,$266.97 ,$926.00 ,$509.30 ,$266.97 ,$243.54 ,$926.00 , N/A , N/A ,$280.32 ,$740.80 ,$502.82 ,$259.28 ,$833.40 ,$351.88 ,$325.00 ,$266.97 ,$444.48 
ST. MARY'S HOSPITAL - DECATUR,45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$889.00 ,$577.85 ,$161.26 ,$889.00 ,$403.15 ,$453.39 ,$488.95 ,$161.26 ,$248.92 ,$471.17 ,$161.26 ,$497.84 ,$161.26 ,$482.73 ,$482.73 ,$161.26 ,$482.73 ,$306.40 ,$622.30 ,$444.50 ,$711.20 ,$403.16 ,$161.26 ,$622.30 ,$161.26 ,$533.40 ,$161.26 ,$666.75 ,$490.73 ,$442.72 ,$490.73 ,$161.26 ,$490.73 ,$693.42 ,$693.42 ,$755.65 ,$403.16 ,$616.08 ,$161.26 ,$889.00 ,$488.95 ,$161.26 ,$233.81 ,$889.00 , N/A , N/A ,$169.32 ,$711.20 ,$482.73 ,$248.92 ,$800.10 ,$337.82 ,$325.00 ,$161.26 ,$426.72 
ST. MARY'S HOSPITAL - DECATUR,45000165,58301,HC REM DVC INTRAUTERINE,450,1 ,$743.00 ,$482.95 ,$195.41 ,$743.00 ,$667.43 ,$378.93 ,$408.65 ,$266.97 ,$208.04 ,$393.79 ,$266.97 ,$416.08 ,$266.97 ,$403.45 ,$403.45 ,$266.97 ,$403.45 ,$507.25 ,$520.10 ,$371.50 ,$594.40 ,$667.43 ,$266.97 ,$520.10 ,$266.97 ,$445.80 ,$266.97 ,$557.25 ,$410.14 ,$370.01 ,$410.14 ,$266.97 ,$410.14 ,$579.54 ,$579.54 ,$631.55 ,$667.43 ,$514.90 ,$266.97 ,$743.00 ,$408.65 ,$266.97 ,$195.41 ,$743.00 , N/A , N/A ,$280.32 ,$594.40 ,$403.45 ,$208.04 ,$668.70 ,$282.34 ,$325.00 ,$266.97 ,$356.64 
ST. MARY'S HOSPITAL - DECATUR,45000166,59414,HC DELIVERY OF PLACENTA,450,1 ,"$1,370.00 ",$890.50 ,$325.00 ,"$6,208.95 ","$6,208.95 ",$698.70 ,$753.50 ,"$2,483.58 ",$383.60 ,$726.10 ,"$2,483.58 ",$767.20 ,"$1,370.00 ",$743.91 ,$743.91 ,"$1,370.00 ",$743.91 ,"$1,370.00 ",$959.00 ,$685.00 ,"$1,096.00 ","$6,208.94 ","$2,483.58 ",$959.00 ,"$2,483.58 ",$822.00 ,"$2,483.58 ","$1,027.50 ",$756.24 ,$682.26 ,$756.24 ,"$2,483.58 ",$756.24 ,"$1,068.60 ","$1,068.60 ","$1,164.50 ","$1,370.00 ",$949.41 ,"$2,483.58 ","$1,370.00 ",$753.50 ,"$2,483.58 ",$360.31 ,"$1,370.00 ", N/A , N/A ,"$2,607.76 ","$1,096.00 ",$743.91 ,$383.60 ,"$1,233.00 ",$520.60 ,$325.00 ,"$2,483.58 ",$657.60 
ST. MARY'S HOSPITAL - DECATUR,45000168,64400,HC DENTAL BLOCK,450,1 ,"$1,596.00 ","$1,037.40 ",$247.31 ,"$1,596.00 ",$618.28 ,$813.96 ,$877.80 ,$247.31 ,$446.88 ,$845.88 ,$247.31 ,$893.76 ,$247.31 ,$866.63 ,$866.63 ,$247.31 ,$866.63 ,$469.90 ,"$1,117.20 ",$798.00 ,"$1,276.80 ",$618.29 ,$247.31 ,"$1,117.20 ",$247.31 ,$957.60 ,$247.31 ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 ,$247.31 ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ",$618.29 ,"$1,106.03 ",$247.31 ,"$1,596.00 ",$877.80 ,$247.31 ,$419.75 ,"$1,596.00 ", N/A , N/A ,$259.68 ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$606.48 ,$325.00 ,$247.31 ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,$833.00 ,$541.45 ,$219.08 ,$833.00 ,$618.28 ,$424.83 ,$458.15 ,$247.31 ,$233.24 ,$441.49 ,$247.31 ,$466.48 ,$247.31 ,$452.32 ,$452.32 ,$247.31 ,$452.32 ,$469.90 ,$583.10 ,$416.50 ,$666.40 ,$618.29 ,$247.31 ,$583.10 ,$247.31 ,$499.80 ,$247.31 ,$624.75 ,$459.82 ,$414.83 ,$459.82 ,$247.31 ,$459.82 ,$649.74 ,$649.74 ,$708.05 ,$618.29 ,$577.27 ,$247.31 ,$833.00 ,$458.15 ,$247.31 ,$219.08 ,$833.00 , N/A , N/A ,$259.68 ,$666.40 ,$452.32 ,$233.24 ,$749.70 ,$316.54 ,$325.00 ,$247.31 ,$399.84 
ST. MARY'S HOSPITAL - DECATUR,45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,"$1,890.00 ","$1,228.50 ",$325.00 ,"$1,890.00 ","$1,502.73 ",$963.90 ,"$1,039.50 ",$601.09 ,$529.20 ,"$1,001.70 ",$601.09 ,"$1,058.40 ",$601.09 ,"$1,026.27 ","$1,026.27 ",$601.09 ,"$1,026.27 ","$1,142.07 ","$1,323.00 ",$945.00 ,"$1,512.00 ","$1,502.72 ",$601.09 ,"$1,323.00 ",$601.09 ,"$1,134.00 ",$601.09 ,"$1,417.50 ","$1,043.28 ",$941.22 ,"$1,043.28 ",$601.09 ,"$1,043.28 ","$1,474.20 ","$1,474.20 ","$1,606.50 ","$1,502.72 ","$1,309.77 ",$601.09 ,"$1,890.00 ","$1,039.50 ",$601.09 ,$497.07 ,"$1,890.00 ", N/A , N/A ,$631.14 ,"$1,512.00 ","$1,026.27 ",$529.20 ,"$1,701.00 ",$718.20 ,$325.00 ,$601.09 ,$907.20 
ST. MARY'S HOSPITAL - DECATUR,45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,"$1,003.00 ",$651.95 ,$106.74 ,"$1,003.00 ",$266.85 ,$511.53 ,$551.65 ,$106.74 ,$280.84 ,$531.59 ,$106.74 ,$561.68 ,$106.74 ,$544.63 ,$544.63 ,$106.74 ,$544.63 ,$202.80 ,$702.10 ,$501.50 ,$802.40 ,$266.84 ,$106.74 ,$702.10 ,$106.74 ,$601.80 ,$106.74 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$106.74 ,$553.66 ,$782.34 ,$782.34 ,$852.55 ,$266.84 ,$695.08 ,$106.74 ,"$1,003.00 ",$551.65 ,$106.74 ,$263.79 ,"$1,003.00 ", N/A , N/A ,$112.08 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$325.00 ,$106.74 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,45000173,65220,HC REM FB CORNL W/O SLIT LA,450,1 ,"$1,014.00 ",$659.10 ,$256.91 ,"$1,014.00 ",$642.28 ,$517.14 ,$557.70 ,$256.91 ,$283.92 ,$537.42 ,$256.91 ,$567.84 ,$256.91 ,$550.60 ,$550.60 ,$256.91 ,$550.60 ,$488.12 ,$709.80 ,$507.00 ,$811.20 ,$642.27 ,$256.91 ,$709.80 ,$256.91 ,$608.40 ,$256.91 ,$760.50 ,$559.73 ,$504.97 ,$559.73 ,$256.91 ,$559.73 ,$790.92 ,$790.92 ,$861.90 ,$642.27 ,$702.70 ,$256.91 ,"$1,014.00 ",$557.70 ,$256.91 ,$266.68 ,"$1,014.00 ", N/A , N/A ,$269.76 ,$811.20 ,$550.60 ,$283.92 ,$912.60 ,$385.32 ,$325.00 ,$256.91 ,$486.72 
ST. MARY'S HOSPITAL - DECATUR,45000174,65222,HC REM FB CORNL W/ SLIT LA,450,1 ,$397.00 ,$258.05 ,$104.41 ,$397.00 ,$266.85 ,$202.47 ,$218.35 ,$106.74 ,$111.16 ,$210.41 ,$106.74 ,$222.32 ,$106.74 ,$215.57 ,$215.57 ,$106.74 ,$215.57 ,$202.80 ,$277.90 ,$198.50 ,$317.60 ,$266.84 ,$106.74 ,$277.90 ,$106.74 ,$238.20 ,$106.74 ,$297.75 ,$219.14 ,$197.71 ,$219.14 ,$106.74 ,$219.14 ,$309.66 ,$309.66 ,$337.45 ,$266.84 ,$275.12 ,$106.74 ,$397.00 ,$218.35 ,$106.74 ,$104.41 ,$397.00 , N/A , N/A ,$112.08 ,$317.60 ,$215.57 ,$111.16 ,$357.30 ,$150.86 ,$325.00 ,$106.74 ,$190.56 
ST. MARY'S HOSPITAL - DECATUR,45000177,67700,HC I AND D ABSCESS EYELID,450,1 ,"$1,296.00 ",$842.40 ,$247.62 ,"$1,296.00 ",$619.05 ,$660.96 ,$712.80 ,$247.62 ,$362.88 ,$686.88 ,$247.62 ,$725.76 ,$247.62 ,$703.73 ,$703.73 ,$247.62 ,$703.73 ,$470.48 ,$907.20 ,$648.00 ,"$1,036.80 ",$619.05 ,$247.62 ,$907.20 ,$247.62 ,$777.60 ,$247.62 ,$972.00 ,$715.39 ,$645.41 ,$715.39 ,$247.62 ,$715.39 ,"$1,010.88 ","$1,010.88 ","$1,101.60 ",$619.05 ,$898.13 ,$247.62 ,"$1,296.00 ",$712.80 ,$247.62 ,$340.85 ,"$1,296.00 ", N/A , N/A ,$260.00 ,"$1,036.80 ",$703.73 ,$362.88 ,"$1,166.40 ",$492.48 ,$325.00 ,$247.62 ,$622.08 
ST. MARY'S HOSPITAL - DECATUR,45000179,69000,HC DRAIN ABSC/HEMA EAR EXT SMP,450,1 ,"$1,243.00 ",$807.95 ,$325.00 ,"$1,472.65 ","$1,472.65 ",$633.93 ,$683.65 ,$589.06 ,$348.04 ,$658.79 ,$589.06 ,$696.08 ,$589.06 ,$674.95 ,$674.95 ,$589.06 ,$674.95 ,"$1,119.21 ",$870.10 ,$621.50 ,$994.40 ,"$1,472.64 ",$589.06 ,$870.10 ,$589.06 ,$745.80 ,$589.06 ,$932.25 ,$686.14 ,$619.01 ,$686.14 ,$589.06 ,$686.14 ,$969.54 ,$969.54 ,"$1,056.55 ","$1,243.00 ",$861.40 ,$589.06 ,"$1,243.00 ",$683.65 ,$589.06 ,$326.91 ,"$1,243.00 ", N/A , N/A ,$618.51 ,$994.40 ,$674.95 ,$348.04 ,"$1,118.70 ",$472.34 ,$325.00 ,$589.06 ,$596.64 
ST. MARY'S HOSPITAL - DECATUR,45000181,69200,HC FB REMOVAL EAR,450,1 ,$555.00 ,$360.75 ,$106.74 ,$555.00 ,$266.85 ,$283.05 ,$305.25 ,$106.74 ,$155.40 ,$294.15 ,$106.74 ,$310.80 ,$106.74 ,$301.37 ,$301.37 ,$106.74 ,$301.37 ,$202.80 ,$388.50 ,$277.50 ,$444.00 ,$266.84 ,$106.74 ,$388.50 ,$106.74 ,$333.00 ,$106.74 ,$416.25 ,$306.36 ,$276.39 ,$306.36 ,$106.74 ,$306.36 ,$432.90 ,$432.90 ,$471.75 ,$266.84 ,$384.62 ,$106.74 ,$555.00 ,$305.25 ,$106.74 ,$145.97 ,$555.00 , N/A , N/A ,$112.08 ,$444.00 ,$301.37 ,$155.40 ,$499.50 ,$210.90 ,$325.00 ,$106.74 ,$266.40 
ST. MARY'S HOSPITAL - DECATUR,45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$357.00 ,$232.05 ,$52.69 ,$357.00 ,$131.73 ,$182.07 ,$196.35 ,$52.69 ,$99.96 ,$189.21 ,$52.69 ,$199.92 ,$52.69 ,$193.85 ,$193.85 ,$52.69 ,$193.85 ,$100.11 ,$249.90 ,$178.50 ,$285.60 ,$131.73 ,$52.69 ,$249.90 ,$52.69 ,$214.20 ,$52.69 ,$267.75 ,$197.06 ,$177.79 ,$197.06 ,$52.69 ,$197.06 ,$278.46 ,$278.46 ,$303.45 ,$131.73 ,$247.40 ,$52.69 ,$357.00 ,$196.35 ,$52.69 ,$93.89 ,$357.00 , N/A , N/A ,$55.32 ,$285.60 ,$193.85 ,$99.96 ,$321.30 ,$135.66 ,$325.00 ,$52.69 ,$171.36 
ST. MARY'S HOSPITAL - DECATUR,45000187,92977,HC THROMBOLYSIS CORONARY IV INFS,450,1 ,$525.00 ,$341.25 ,$138.08 ,$754.56 ,$754.55 ,$267.75 ,$288.75 ,$301.82 ,$147.00 ,$278.25 ,$301.82 ,$294.00 ,$301.82 ,$285.08 ,$285.08 ,$301.82 ,$285.08 ,$525.00 ,$367.50 ,$262.50 ,$420.00 ,$754.56 ,$301.82 ,$367.50 ,$301.82 ,$315.00 ,$301.82 ,$393.75 ,$289.80 ,$261.45 ,$289.80 ,$301.82 ,$289.80 ,$409.50 ,$409.50 ,$446.25 ,$525.00 ,$363.83 ,$301.82 ,$525.00 ,$288.75 ,$301.82 ,$138.08 ,$525.00 , N/A , N/A ,$316.91 ,$420.00 ,$285.08 ,$147.00 ,$472.50 ,$199.50 ,$325.00 ,$301.82 ,$252.00 
ST. MARY'S HOSPITAL - DECATUR,45000188,99281,HC ER LEVEL 1,450,1 ,$198.00 ,$128.70 ,$52.07 ,$198.00 ,$171.65 ,$100.98 ,$108.90 ,$68.66 ,$55.44 ,$104.94 ,$68.66 ,$110.88 ,$68.66 ,$107.51 ,$107.51 ,$68.66 ,$107.51 ,$130.46 ,$138.60 ,$99.00 ,$158.40 ,$171.65 ,$68.66 ,$138.60 ,$68.66 ,$118.80 ,$68.66 ,$148.50 ,$109.30 ,$98.60 ,$109.30 ,$68.66 ,$109.30 ,$154.44 ,$154.44 ,$168.30 ,$171.65 ,$137.21 ,$68.66 ,$198.00 ,$108.90 ,$68.66 ,$52.07 ,$198.00 , N/A , N/A ,$72.09 ,$158.40 ,$107.51 ,$55.44 ,$178.20 ,$198.00 ,$198.00 ,$68.66 ,$95.04 
ST. MARY'S HOSPITAL - DECATUR,45000189,99282,HC ER LEVEL 2,450,1 ,$390.00 ,$253.50 ,$102.57 ,$390.00 ,$310.85 ,$198.90 ,$214.50 ,$124.34 ,$109.20 ,$206.70 ,$124.34 ,$218.40 ,$124.34 ,$211.77 ,$211.77 ,$124.34 ,$211.77 ,$236.24 ,$273.00 ,$195.00 ,$312.00 ,$310.85 ,$124.34 ,$273.00 ,$124.34 ,$234.00 ,$124.34 ,$292.50 ,$215.28 ,$194.22 ,$215.28 ,$124.34 ,$215.28 ,$304.20 ,$304.20 ,$331.50 ,$310.85 ,$270.27 ,$124.34 ,$390.00 ,$214.50 ,$124.34 ,$102.57 ,$390.00 , N/A , N/A ,$130.56 ,$312.00 ,$211.77 ,$109.20 ,$351.00 ,$266.00 ,$390.00 ,$124.34 ,$187.20 
ST. MARY'S HOSPITAL - DECATUR,45000190,99283,HC ER LEVEL 3,450,1 ,"$1,039.00 ",$675.35 ,$219.06 ,"$1,039.00 ",$547.65 ,$529.89 ,$571.45 ,$219.06 ,$290.92 ,$550.67 ,$219.06 ,$581.84 ,$219.06 ,$564.18 ,$564.18 ,$219.06 ,$564.18 ,$416.22 ,$727.30 ,$519.50 ,$831.20 ,$547.66 ,$219.06 ,$727.30 ,$219.06 ,$623.40 ,$219.06 ,$779.25 ,$573.53 ,$517.42 ,$573.53 ,$219.06 ,$573.53 ,$810.42 ,$810.42 ,$883.15 ,$547.66 ,$720.03 ,$219.06 ,"$1,039.00 ",$571.45 ,$219.06 ,$273.26 ,"$1,039.00 ", N/A , N/A ,$230.01 ,$831.20 ,$564.18 ,$290.92 ,$935.10 ,$475.00 ,"$1,039.00 ",$219.06 ,$498.72 
ST. MARY'S HOSPITAL - DECATUR,45000191,99284,HC ER LEVEL 4,450,1 ,"$1,326.00 ",$861.90 ,$93.87 ,"$1,326.00 ",$860.88 ,$676.26 ,$729.30 ,$344.35 ,$371.28 ,$702.78 ,$344.35 ,$742.56 ,$344.35 ,$720.02 ,$720.02 ,$344.35 ,$720.02 ,$654.26 ,$928.20 ,$663.00 ,"$1,060.80 ",$860.87 ,$344.35 ,$928.20 ,$344.35 ,$795.60 ,$344.35 ,$994.50 ,$731.95 ,$660.35 ,$731.95 ,$344.35 ,$731.95 ,"$1,034.28 ","$1,034.28 ","$1,127.10 ",$860.87 ,$918.92 ,$344.35 ,"$1,326.00 ",$729.30 ,$344.35 ,$348.74 ,"$1,326.00 ",$98.34 ,$93.87 ,$361.57 ,"$1,060.80 ",$720.02 ,$371.28 ,"$1,193.40 ",$963.00 ,"$1,326.00 ",$344.35 ,$636.48 
ST. MARY'S HOSPITAL - DECATUR,45000192,99285,HC ER LEVEL 5,450,1 ,"$2,205.00 ","$1,433.25 ",$93.87 ,"$2,205.00 ","$1,235.68 ","$1,124.55 ","$1,212.75 ",$494.27 ,$617.40 ,"$1,168.65 ",$494.27 ,"$1,234.80 ",$494.27 ,"$1,197.32 ","$1,197.32 ",$494.27 ,"$1,197.32 ",$939.11 ,"$1,543.50 ","$1,102.50 ","$1,764.00 ","$1,235.67 ",$494.27 ,"$1,543.50 ",$494.27 ,"$1,323.00 ",$494.27 ,"$1,653.75 ","$1,217.16 ","$1,098.09 ","$1,217.16 ",$494.27 ,"$1,217.16 ","$1,719.90 ","$1,719.90 ","$1,874.25 ","$1,235.67 ","$1,528.07 ",$494.27 ,"$2,205.00 ","$1,212.75 ",$494.27 ,$579.92 ,"$2,205.00 ",$98.34 ,$93.87 ,$518.98 ,"$1,764.00 ","$1,197.32 ",$617.40 ,"$1,984.50 ","$1,441.00 ","$2,205.00 ",$494.27 ,"$1,058.40 "
ST. MARY'S HOSPITAL - DECATUR,45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$3,354.00 ","$2,180.10 ",$93.87 ,"$3,354.00 ","$1,762.75 ","$1,710.54 ","$1,844.70 ",$705.10 ,$939.12 ,"$1,777.62 ",$705.10 ,"$1,878.24 ",$705.10 ,"$1,821.22 ","$1,821.22 ",$705.10 ,"$1,821.22 ","$1,339.69 ","$2,347.80 ","$1,677.00 ","$2,683.20 ","$1,762.75 ",$705.10 ,"$2,347.80 ",$705.10 ,"$2,012.40 ",$705.10 ,"$2,515.50 ","$1,670.29 ","$1,502.59 ","$1,670.29 ",$705.10 ,"$1,670.29 ","$2,616.12 ","$2,616.12 ","$2,850.90 ","$1,762.75 ","$2,324.32 ",$705.10 ,"$3,354.00 ","$1,844.70 ",$705.10 ,$882.10 ,"$3,354.00 ",$98.34 ,$93.87 ,$740.36 ,"$2,683.20 ","$1,821.22 ",$939.12 ,"$3,018.60 ","$1,274.52 ","$3,354.00 ",$705.10 ,"$1,609.92 "
ST. MARY'S HOSPITAL - DECATUR,45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,"$1,055.00 ",$685.75 ,$277.47 ,"$1,055.00 ", N/A ,$538.05 ,$580.25 , N/A ,$295.40 ,$559.15 , N/A ,$590.80 , N/A ,$572.87 ,$572.87 , N/A ,$572.87 , N/A ,$738.50 ,$527.50 ,$844.00 , N/A , N/A ,$738.50 , N/A ,$633.00 , N/A ,$791.25 ,$582.36 ,$525.39 ,$582.36 , N/A ,$582.36 ,$822.90 ,$822.90 ,$896.75 , N/A ,$731.12 , N/A ,"$1,055.00 ",$580.25 , N/A ,$277.47 ,"$1,055.00 ", N/A , N/A , N/A ,$844.00 ,$572.87 ,$295.40 ,$949.50 ,$400.90 ,$325.00 , N/A ,$506.40 
ST. MARY'S HOSPITAL - DECATUR,45000196,27810,HC TX FX BIM ANKLE W/MAN CLS,450,1 ,$513.00 ,$333.45 ,$134.92 ,"$3,296.18 ","$3,296.18 ",$261.63 ,$282.15 ,"$1,318.47 ",$143.64 ,$271.89 ,"$1,318.47 ",$287.28 ,$513.00 ,$278.56 ,$278.56 ,$513.00 ,$278.56 ,$513.00 ,$359.10 ,$256.50 ,$410.40 ,"$3,296.17 ","$1,318.47 ",$359.10 ,"$1,318.47 ",$307.80 ,"$1,318.47 ",$384.75 ,$283.18 ,$255.47 ,$283.18 ,"$1,318.47 ",$283.18 ,$400.14 ,$400.14 ,$436.05 ,$513.00 ,$355.51 ,"$1,318.47 ",$513.00 ,$282.15 ,"$1,318.47 ",$134.92 ,$513.00 , N/A , N/A ,"$1,384.39 ",$410.40 ,$278.56 ,$143.64 ,$461.70 ,$194.94 ,$325.00 ,"$1,318.47 ",$246.24 
ST. MARY'S HOSPITAL - DECATUR,45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,$749.00 ,$486.85 ,$195.10 ,$749.00 ,$487.75 ,$381.99 ,$411.95 ,$195.10 ,$209.72 ,$396.97 ,$195.10 ,$419.44 ,$195.10 ,$406.71 ,$406.71 ,$195.10 ,$406.71 ,$370.70 ,$524.30 ,$374.50 ,$599.20 ,$487.76 ,$195.10 ,$524.30 ,$195.10 ,$449.40 ,$195.10 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$195.10 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$487.76 ,$519.06 ,$195.10 ,$749.00 ,$411.95 ,$195.10 ,$196.99 ,$749.00 , N/A , N/A ,$204.86 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$195.10 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$884.00 ,$574.60 ,$195.10 ,$884.00 ,$487.75 ,$450.84 ,$486.20 ,$195.10 ,$247.52 ,$468.52 ,$195.10 ,$495.04 ,$195.10 ,$480.01 ,$480.01 ,$195.10 ,$480.01 ,$370.70 ,$618.80 ,$442.00 ,$707.20 ,$487.76 ,$195.10 ,$618.80 ,$195.10 ,$530.40 ,$195.10 ,$663.00 ,$487.97 ,$440.23 ,$487.97 ,$195.10 ,$487.97 ,$689.52 ,$689.52 ,$751.40 ,$487.76 ,$612.61 ,$195.10 ,$884.00 ,$486.20 ,$195.10 ,$232.49 ,$884.00 , N/A , N/A ,$204.86 ,$707.20 ,$480.01 ,$247.52 ,$795.60 ,$335.92 ,$325.00 ,$195.10 ,$424.32 
ST. MARY'S HOSPITAL - DECATUR,45000200,35206,HC RPR VESSEL EXTREM UPR,450,1 ,"$5,359.00 ","$3,483.35 ",$325.00 ,"$6,774.50 ","$6,774.50 ","$2,200.00 ","$2,947.45 ","$2,709.80 ","$1,500.52 ","$2,840.27 ","$2,709.80 ","$3,001.04 ","$2,709.80 ","$2,909.94 ","$2,909.94 ","$2,709.80 ","$2,909.94 ","$5,148.61 ","$3,751.30 ","$2,679.50 ","$4,287.20 ","$6,774.49 ","$2,709.80 ","$3,751.30 ","$2,709.80 ","$3,215.40 ","$2,709.80 ","$4,019.25 ","$2,668.78 ","$2,400.83 ","$2,668.78 ","$2,709.80 ","$2,668.78 ","$3,786.00 ","$3,786.00 ","$4,555.15 ","$5,359.00 ","$3,713.79 ","$2,709.80 ","$5,359.00 ","$2,947.45 ","$2,709.80 ","$1,409.42 ","$5,359.00 ", N/A , N/A ,"$2,845.29 ","$4,287.20 ","$2,909.94 ","$1,500.52 ","$4,823.10 ","$2,036.42 ",$325.00 ,"$2,709.80 ","$2,572.32 "
ST. MARY'S HOSPITAL - DECATUR,45000203,27840,HC TX DISL ANKE W/O ANES CLS,450,1 ,$773.00 ,$502.45 ,$195.10 ,$773.00 ,$487.75 ,$394.23 ,$425.15 ,$195.10 ,$216.44 ,$409.69 ,$195.10 ,$432.88 ,$195.10 ,$419.74 ,$419.74 ,$195.10 ,$419.74 ,$370.70 ,$541.10 ,$386.50 ,$618.40 ,$487.76 ,$195.10 ,$541.10 ,$195.10 ,$463.80 ,$195.10 ,$579.75 ,$426.70 ,$384.95 ,$426.70 ,$195.10 ,$426.70 ,$602.94 ,$602.94 ,$657.05 ,$487.76 ,$535.69 ,$195.10 ,$773.00 ,$425.15 ,$195.10 ,$203.30 ,$773.00 , N/A , N/A ,$204.86 ,$618.40 ,$419.74 ,$216.44 ,$695.70 ,$293.74 ,$325.00 ,$195.10 ,$371.04 
ST. MARY'S HOSPITAL - DECATUR,45000204,23931,HC I AND D BURSA ELBOW/ARM,450,1 ,"$3,924.00 ","$2,550.60 ",$325.00 ,"$3,924.00 ","$3,329.73 ","$2,001.24 ","$2,158.20 ","$1,331.89 ","$1,098.72 ","$2,079.72 ","$1,331.89 ","$2,197.44 ","$1,331.89 ","$2,130.73 ","$2,130.73 ","$1,331.89 ","$2,130.73 ","$2,530.59 ","$2,746.80 ","$1,962.00 ","$3,139.20 ","$3,329.72 ","$1,331.89 ","$2,746.80 ","$1,331.89 ","$2,354.40 ","$1,331.89 ","$2,943.00 ","$1,954.15 ","$1,757.95 ","$1,954.15 ","$1,331.89 ","$1,954.15 ","$3,060.72 ","$3,060.72 ","$3,335.40 ","$3,329.72 ","$2,719.33 ","$1,331.89 ","$3,924.00 ","$2,158.20 ","$1,331.89 ","$1,032.01 ","$3,924.00 ", N/A , N/A ,"$1,398.48 ","$3,139.20 ","$2,130.73 ","$1,098.72 ","$3,531.60 ","$1,491.12 ",$325.00 ,"$1,331.89 ","$1,883.52 "
ST. MARY'S HOSPITAL - DECATUR,45000210,25680,HC CLSD WRIST FX W/MANIP,450,1 ,"$1,270.00 ",$825.50 ,$195.10 ,"$1,270.00 ",$487.75 ,$647.70 ,$698.50 ,$195.10 ,$355.60 ,$673.10 ,$195.10 ,$711.20 ,$195.10 ,$689.61 ,$689.61 ,$195.10 ,$689.61 ,$370.70 ,$889.00 ,$635.00 ,"$1,016.00 ",$487.76 ,$195.10 ,$889.00 ,$195.10 ,$762.00 ,$195.10 ,$952.50 ,$701.04 ,$632.46 ,$701.04 ,$195.10 ,$701.04 ,$990.60 ,$990.60 ,"$1,079.50 ",$487.76 ,$880.11 ,$195.10 ,"$1,270.00 ",$698.50 ,$195.10 ,$334.01 ,"$1,270.00 ", N/A , N/A ,$204.86 ,"$1,016.00 ",$689.61 ,$355.60 ,"$1,143.00 ",$482.60 ,$325.00 ,$195.10 ,$609.60 
ST. MARY'S HOSPITAL - DECATUR,45000212,25690,HC CLSD WRIST DISLOC,450,1 ,"$6,096.00 ","$3,962.40 ",$325.00 ,"$6,096.00 ","$3,296.18 ","$2,200.00 ","$3,352.80 ","$1,318.47 ","$1,706.88 ","$3,230.88 ","$1,318.47 ","$3,413.76 ","$1,318.47 ","$3,100.00 ","$3,100.00 ","$1,318.47 ","$3,100.00 ","$2,505.09 ","$4,267.20 ","$3,048.00 ","$4,876.80 ","$3,296.17 ","$1,318.47 ","$4,267.20 ","$1,318.47 ","$3,657.60 ","$1,318.47 ","$4,572.00 ","$3,035.81 ","$2,731.01 ","$3,035.81 ","$1,318.47 ","$3,035.81 ","$3,786.00 ","$3,786.00 ","$5,181.60 ","$3,296.17 ","$4,224.53 ","$1,318.47 ","$6,096.00 ","$3,352.80 ","$1,318.47 ","$1,603.25 ","$6,096.00 ", N/A , N/A ,"$1,384.39 ","$4,876.80 ","$3,100.00 ","$1,706.88 ","$5,486.40 ","$2,316.48 ",$325.00 ,"$1,318.47 ","$2,926.08 "
ST. MARY'S HOSPITAL - DECATUR,45000214,37195,HC THROMBOLYSIS;CEREB IV,450,1 ,"$1,071.00 ",$696.15 ,$281.67 ,"$1,071.00 ",$754.55 ,$546.21 ,$589.05 ,$301.82 ,$299.88 ,$567.63 ,$301.82 ,$599.76 ,$301.82 ,$581.55 ,$581.55 ,$301.82 ,$581.55 ,$573.46 ,$749.70 ,$535.50 ,$856.80 ,$754.56 ,$301.82 ,$749.70 ,$301.82 ,$642.60 ,$301.82 ,$803.25 ,$591.19 ,$533.36 ,$591.19 ,$301.82 ,$591.19 ,$835.38 ,$835.38 ,$910.35 ,$754.56 ,$742.20 ,$301.82 ,"$1,071.00 ",$589.05 ,$301.82 ,$281.67 ,"$1,071.00 ", N/A , N/A ,$316.91 ,$856.80 ,$581.55 ,$299.88 ,$963.90 ,$406.98 ,$325.00 ,$301.82 ,$514.08 
ST. MARY'S HOSPITAL - DECATUR,45000215,27786,HC DIST FIB FX W/O MANIP,450,1 ,$765.00 ,$497.25 ,$195.10 ,$765.00 ,$487.75 ,$390.15 ,$420.75 ,$195.10 ,$214.20 ,$405.45 ,$195.10 ,$428.40 ,$195.10 ,$415.40 ,$415.40 ,$195.10 ,$415.40 ,$370.70 ,$535.50 ,$382.50 ,$612.00 ,$487.76 ,$195.10 ,$535.50 ,$195.10 ,$459.00 ,$195.10 ,$573.75 ,$422.28 ,$380.97 ,$422.28 ,$195.10 ,$422.28 ,$596.70 ,$596.70 ,$650.25 ,$487.76 ,$530.15 ,$195.10 ,$765.00 ,$420.75 ,$195.10 ,$201.20 ,$765.00 , N/A , N/A ,$204.86 ,$612.00 ,$415.40 ,$214.20 ,$688.50 ,$290.70 ,$325.00 ,$195.10 ,$367.20 
ST. MARY'S HOSPITAL - DECATUR,45000216,41899,HC DENTOALVEOLAR STRUCT PROC,450,1 ,"$7,890.00 ","$5,128.50 ",$200.27 ,"$7,890.00 ",$500.68 ,"$2,200.00 ","$4,339.50 ",$200.27 ,"$2,209.20 ","$4,181.70 ",$200.27 ,"$4,418.40 ",$200.27 ,"$3,100.00 ","$3,100.00 ",$200.27 ,"$3,100.00 ",$380.51 ,"$5,523.00 ","$3,945.00 ","$6,312.00 ",$500.67 ,$200.27 ,"$5,523.00 ",$200.27 ,"$4,734.00 ",$200.27 ,"$5,917.50 ","$3,929.22 ","$3,534.72 ","$3,929.22 ",$200.27 ,"$3,929.22 ","$3,786.00 ","$3,786.00 ","$6,706.50 ",$500.67 ,"$5,467.77 ",$200.27 ,"$7,890.00 ","$4,339.50 ",$200.27 ,"$2,075.07 ","$7,890.00 ", N/A , N/A ,$210.28 ,"$6,312.00 ","$3,100.00 ","$2,209.20 ","$7,101.00 ","$2,998.20 ",$325.00 ,$200.27 ,"$3,787.20 "
ST. MARY'S HOSPITAL - DECATUR,45000219,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP,450,1 ,$362.00 ,$235.30 ,$95.21 ,"$3,296.18 ","$3,296.18 ",$184.62 ,$199.10 ,"$1,318.47 ",$101.36 ,$191.86 ,"$1,318.47 ",$202.72 ,$362.00 ,$196.57 ,$196.57 ,$362.00 ,$196.57 ,$362.00 ,$253.40 ,$181.00 ,$289.60 ,"$3,296.17 ","$1,318.47 ",$253.40 ,"$1,318.47 ",$217.20 ,"$1,318.47 ",$271.50 ,$199.82 ,$180.28 ,$199.82 ,"$1,318.47 ",$199.82 ,$282.36 ,$282.36 ,$307.70 ,$362.00 ,$250.87 ,"$1,318.47 ",$362.00 ,$199.10 ,"$1,318.47 ",$95.21 ,$362.00 , N/A , N/A ,"$1,384.39 ",$289.60 ,$196.57 ,$101.36 ,$325.80 ,$137.56 ,$325.00 ,"$1,318.47 ",$173.76 
ST. MARY'S HOSPITAL - DECATUR,45000220,29280,HC STRAPPING HAND/FINGER,450,1 ,$558.00 ,$362.70 ,$52.69 ,$558.00 ,$131.73 ,$284.58 ,$306.90 ,$52.69 ,$156.24 ,$295.74 ,$52.69 ,$312.48 ,$52.69 ,$302.99 ,$302.99 ,$52.69 ,$302.99 ,$100.11 ,$390.60 ,$279.00 ,$446.40 ,$131.73 ,$52.69 ,$390.60 ,$52.69 ,$334.80 ,$52.69 ,$418.50 ,$308.02 ,$277.88 ,$308.02 ,$52.69 ,$308.02 ,$435.24 ,$435.24 ,$474.30 ,$131.73 ,$386.69 ,$52.69 ,$558.00 ,$306.90 ,$52.69 ,$146.75 ,$558.00 , N/A , N/A ,$55.32 ,$446.40 ,$302.99 ,$156.24 ,$502.20 ,$212.04 ,$325.00 ,$52.69 ,$267.84 
ST. MARY'S HOSPITAL - DECATUR,45000222,29540,HC STRAPPING; ANKLE,450,1 ,$413.00 ,$268.45 ,$108.62 ,$413.00 ,$334.35 ,$210.63 ,$227.15 ,$133.74 ,$115.64 ,$218.89 ,$133.74 ,$231.28 ,$133.74 ,$224.26 ,$224.26 ,$133.74 ,$224.26 ,$254.10 ,$289.10 ,$206.50 ,$330.40 ,$334.34 ,$133.74 ,$289.10 ,$133.74 ,$247.80 ,$133.74 ,$309.75 ,$227.98 ,$205.67 ,$227.98 ,$133.74 ,$227.98 ,$322.14 ,$322.14 ,$351.05 ,$334.34 ,$286.21 ,$133.74 ,$413.00 ,$227.15 ,$133.74 ,$108.62 ,$413.00 , N/A , N/A ,$140.43 ,$330.40 ,$224.26 ,$115.64 ,$371.70 ,$156.94 ,$325.00 ,$133.74 ,$198.24 
ST. MARY'S HOSPITAL - DECATUR,45000227,25600,HC CLSD DIS.RADIUS W/O MANIP,450,1 ,$560.00 ,$364.00 ,$147.28 ,$560.00 ,$487.75 ,$285.60 ,$308.00 ,$195.10 ,$156.80 ,$296.80 ,$195.10 ,$313.60 ,$195.10 ,$304.08 ,$304.08 ,$195.10 ,$304.08 ,$370.70 ,$392.00 ,$280.00 ,$448.00 ,$487.76 ,$195.10 ,$392.00 ,$195.10 ,$336.00 ,$195.10 ,$420.00 ,$309.12 ,$278.88 ,$309.12 ,$195.10 ,$309.12 ,$436.80 ,$436.80 ,$476.00 ,$487.76 ,$388.08 ,$195.10 ,$560.00 ,$308.00 ,$195.10 ,$147.28 ,$560.00 , N/A , N/A ,$204.86 ,$448.00 ,$304.08 ,$156.80 ,$504.00 ,$212.80 ,$325.00 ,$195.10 ,$268.80 
ST. MARY'S HOSPITAL - DECATUR,45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,$785.00 ,$510.25 ,$195.10 ,$785.00 ,$487.75 ,$400.35 ,$431.75 ,$195.10 ,$219.80 ,$416.05 ,$195.10 ,$439.60 ,$195.10 ,$426.26 ,$426.26 ,$195.10 ,$426.26 ,$370.70 ,$549.50 ,$392.50 ,$628.00 ,$487.76 ,$195.10 ,$549.50 ,$195.10 ,$471.00 ,$195.10 ,$588.75 ,$433.32 ,$390.93 ,$433.32 ,$195.10 ,$433.32 ,$612.30 ,$612.30 ,$667.25 ,$487.76 ,$544.01 ,$195.10 ,$785.00 ,$431.75 ,$195.10 ,$206.46 ,$785.00 , N/A , N/A ,$204.86 ,$628.00 ,$426.26 ,$219.80 ,$706.50 ,$298.30 ,$325.00 ,$195.10 ,$376.80 
ST. MARY'S HOSPITAL - DECATUR,45000231,25505,HC RADIUS FX W MANIP,450,1 ,$718.00 ,$466.70 ,$188.83 ,"$3,296.18 ","$3,296.18 ",$366.18 ,$394.90 ,"$1,318.47 ",$201.04 ,$380.54 ,"$1,318.47 ",$402.08 ,$718.00 ,$389.87 ,$389.87 ,$718.00 ,$389.87 ,$718.00 ,$502.60 ,$359.00 ,$574.40 ,"$3,296.17 ","$1,318.47 ",$502.60 ,"$1,318.47 ",$430.80 ,"$1,318.47 ",$538.50 ,$396.34 ,$357.56 ,$396.34 ,"$1,318.47 ",$396.34 ,$560.04 ,$560.04 ,$610.30 ,$718.00 ,$497.57 ,"$1,318.47 ",$718.00 ,$394.90 ,"$1,318.47 ",$188.83 ,$718.00 , N/A , N/A ,"$1,384.39 ",$574.40 ,$389.87 ,$201.04 ,$646.20 ,$272.84 ,$325.00 ,"$1,318.47 ",$344.64 
ST. MARY'S HOSPITAL - DECATUR,45000232,26600,HC CLSD METACARPAL W/O MANIP,450,1 ,$748.00 ,$486.20 ,$195.10 ,$748.00 ,$487.75 ,$381.48 ,$411.40 ,$195.10 ,$209.44 ,$396.44 ,$195.10 ,$418.88 ,$195.10 ,$406.16 ,$406.16 ,$195.10 ,$406.16 ,$370.70 ,$523.60 ,$374.00 ,$598.40 ,$487.76 ,$195.10 ,$523.60 ,$195.10 ,$448.80 ,$195.10 ,$561.00 ,$412.90 ,$372.50 ,$412.90 ,$195.10 ,$412.90 ,$583.44 ,$583.44 ,$635.80 ,$487.76 ,$518.36 ,$195.10 ,$748.00 ,$411.40 ,$195.10 ,$196.72 ,$748.00 , N/A , N/A ,$204.86 ,$598.40 ,$406.16 ,$209.44 ,$673.20 ,$284.24 ,$325.00 ,$195.10 ,$359.04 
ST. MARY'S HOSPITAL - DECATUR,45000238,26670,HC HAND DISL W/MANIP W/O ANES,450,1 ,"$1,300.00 ",$845.00 ,$195.10 ,"$1,300.00 ",$487.75 ,$663.00 ,$715.00 ,$195.10 ,$364.00 ,$689.00 ,$195.10 ,$728.00 ,$195.10 ,$705.90 ,$705.90 ,$195.10 ,$705.90 ,$370.70 ,$910.00 ,$650.00 ,"$1,040.00 ",$487.76 ,$195.10 ,$910.00 ,$195.10 ,$780.00 ,$195.10 ,$975.00 ,$717.60 ,$647.40 ,$717.60 ,$195.10 ,$717.60 ,"$1,014.00 ","$1,014.00 ","$1,105.00 ",$487.76 ,$900.90 ,$195.10 ,"$1,300.00 ",$715.00 ,$195.10 ,$341.90 ,"$1,300.00 ", N/A , N/A ,$204.86 ,"$1,040.00 ",$705.90 ,$364.00 ,"$1,170.00 ",$494.00 ,$325.00 ,$195.10 ,$624.00 
ST. MARY'S HOSPITAL - DECATUR,45000248,28475,HC CLSD METATARSAL W/MANIP,450,1 ,$586.00 ,$380.90 ,$154.12 ,$586.00 ,$487.75 ,$298.86 ,$322.30 ,$195.10 ,$164.08 ,$310.58 ,$195.10 ,$328.16 ,$195.10 ,$318.20 ,$318.20 ,$195.10 ,$318.20 ,$370.70 ,$410.20 ,$293.00 ,$468.80 ,$487.76 ,$195.10 ,$410.20 ,$195.10 ,$351.60 ,$195.10 ,$439.50 ,$323.47 ,$291.83 ,$323.47 ,$195.10 ,$323.47 ,$457.08 ,$457.08 ,$498.10 ,$487.76 ,$406.10 ,$195.10 ,$586.00 ,$322.30 ,$195.10 ,$154.12 ,$586.00 , N/A , N/A ,$204.86 ,$468.80 ,$318.20 ,$164.08 ,$527.40 ,$222.68 ,$325.00 ,$195.10 ,$281.28 
ST. MARY'S HOSPITAL - DECATUR,45000249,28515,HC TOE FX W/MANIP,450,1 ,"$1,258.00 ",$817.70 ,$195.10 ,"$1,258.00 ",$487.75 ,$641.58 ,$691.90 ,$195.10 ,$352.24 ,$666.74 ,$195.10 ,$704.48 ,$195.10 ,$683.09 ,$683.09 ,$195.10 ,$683.09 ,$370.70 ,$880.60 ,$629.00 ,"$1,006.40 ",$487.76 ,$195.10 ,$880.60 ,$195.10 ,$754.80 ,$195.10 ,$943.50 ,$694.42 ,$626.48 ,$694.42 ,$195.10 ,$694.42 ,$981.24 ,$981.24 ,"$1,069.30 ",$487.76 ,$871.79 ,$195.10 ,"$1,258.00 ",$691.90 ,$195.10 ,$330.85 ,"$1,258.00 ", N/A , N/A ,$204.86 ,"$1,006.40 ",$683.09 ,$352.24 ,"$1,132.20 ",$478.04 ,$325.00 ,$195.10 ,$603.84 
ST. MARY'S HOSPITAL - DECATUR,45000258,29345,HC LONG LEG CAST,450,1 ,$854.00 ,$555.10 ,$224.60 ,$854.00 ,$570.90 ,$435.54 ,$469.70 ,$228.36 ,$239.12 ,$452.62 ,$228.36 ,$478.24 ,$228.36 ,$463.72 ,$463.72 ,$228.36 ,$463.72 ,$433.88 ,$597.80 ,$427.00 ,$683.20 ,$570.90 ,$228.36 ,$597.80 ,$228.36 ,$512.40 ,$228.36 ,$640.50 ,$471.41 ,$425.29 ,$471.41 ,$228.36 ,$471.41 ,$666.12 ,$666.12 ,$725.90 ,$570.90 ,$591.82 ,$228.36 ,$854.00 ,$469.70 ,$228.36 ,$224.60 ,$854.00 , N/A , N/A ,$239.78 ,$683.20 ,$463.72 ,$239.12 ,$768.60 ,$324.52 ,$325.00 ,$228.36 ,$409.92 
ST. MARY'S HOSPITAL - DECATUR,45000265,55899,HC INC AND DRAINAGE;SCROTUM,450,1 ,$463.00 ,$300.95 ,$121.77 ,$629.73 ,$629.73 ,$236.13 ,$254.65 ,$251.89 ,$129.64 ,$245.39 ,$251.89 ,$259.28 ,$251.89 ,$251.41 ,$251.41 ,$251.89 ,$251.41 ,$463.00 ,$324.10 ,$231.50 ,$370.40 ,$629.73 ,$251.89 ,$324.10 ,$251.89 ,$277.80 ,$251.89 ,$347.25 ,$255.58 ,$230.57 ,$255.58 ,$251.89 ,$255.58 ,$361.14 ,$361.14 ,$393.55 ,$463.00 ,$320.86 ,$251.89 ,$463.00 ,$254.65 ,$251.89 ,$121.77 ,$463.00 , N/A , N/A ,$264.48 ,$370.40 ,$251.41 ,$129.64 ,$416.70 ,$175.94 ,$325.00 ,$251.89 ,$222.24 
ST. MARY'S HOSPITAL - DECATUR,45000270,20606,HC ARTHROCNT ASP/INJ JT INTRM W/ULTRA,450,1 ,"$2,073.00 ","$1,347.45 ",$325.00 ,"$2,073.00 ","$1,502.73 ","$1,057.23 ","$1,140.15 ",$601.09 ,$580.44 ,"$1,098.69 ",$601.09 ,"$1,160.88 ",$601.09 ,"$1,125.64 ","$1,125.64 ",$601.09 ,"$1,125.64 ","$1,142.07 ","$1,451.10 ","$1,036.50 ","$1,658.40 ","$1,502.72 ",$601.09 ,"$1,451.10 ",$601.09 ,"$1,243.80 ",$601.09 ,"$1,554.75 ","$1,144.30 ","$1,032.35 ","$1,144.30 ",$601.09 ,"$1,144.30 ","$1,616.94 ","$1,616.94 ","$1,762.05 ","$1,502.72 ","$1,436.59 ",$601.09 ,"$2,073.00 ","$1,140.15 ",$601.09 ,$545.20 ,"$2,073.00 ", N/A , N/A ,$631.14 ,"$1,658.40 ","$1,125.64 ",$580.44 ,"$1,865.70 ",$787.74 ,$325.00 ,$601.09 ,$995.04 
ST. MARY'S HOSPITAL - DECATUR,45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,"$4,028.00 ","$2,618.20 ",$247.31 ,"$4,028.00 ",$618.28 ,"$2,054.28 ","$2,215.40 ",$247.31 ,"$1,127.84 ","$2,134.84 ",$247.31 ,"$2,255.68 ",$247.31 ,"$2,187.20 ","$2,187.20 ",$247.31 ,"$2,187.20 ",$469.90 ,"$2,819.60 ","$2,014.00 ","$3,222.40 ",$618.29 ,$247.31 ,"$2,819.60 ",$247.31 ,"$2,416.80 ",$247.31 ,"$3,021.00 ","$2,005.94 ","$1,804.54 ","$2,005.94 ",$247.31 ,"$2,005.94 ","$3,141.84 ","$3,141.84 ","$3,423.80 ",$618.29 ,"$2,791.40 ",$247.31 ,"$4,028.00 ","$2,215.40 ",$247.31 ,"$1,059.36 ","$4,028.00 ", N/A , N/A ,$259.68 ,"$3,222.40 ","$2,187.20 ","$1,127.84 ","$3,625.20 ","$1,530.64 ",$325.00 ,$247.31 ,"$1,933.44 "
ST. MARY'S HOSPITAL - DECATUR,45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$185.00 ,$120.25 ,$48.66 ,$185.00 ,$131.73 ,$94.35 ,$101.75 ,$52.69 ,$51.80 ,$98.05 ,$52.69 ,$103.60 ,$52.69 ,$100.46 ,$100.46 ,$52.69 ,$100.46 ,$100.11 ,$129.50 ,$92.50 ,$148.00 ,$131.73 ,$52.69 ,$129.50 ,$52.69 ,$111.00 ,$52.69 ,$138.75 ,$102.12 ,$92.13 ,$102.12 ,$52.69 ,$102.12 ,$144.30 ,$144.30 ,$157.25 ,$131.73 ,$128.21 ,$52.69 ,$185.00 ,$101.75 ,$52.69 ,$48.66 ,$185.00 , N/A , N/A ,$55.32 ,$148.00 ,$100.46 ,$51.80 ,$166.50 ,$70.30 ,$185.00 ,$52.69 ,$88.80 
ST. MARY'S HOSPITAL - DECATUR,45000274,99281,HC ER LEVEL 1-25,450,1 ,$198.00 ,$128.70 ,$52.07 ,$198.00 ,$171.65 ,$100.98 ,$108.90 ,$68.66 ,$55.44 ,$104.94 ,$68.66 ,$110.88 ,$68.66 ,$107.51 ,$107.51 ,$68.66 ,$107.51 ,$130.46 ,$138.60 ,$99.00 ,$158.40 ,$171.65 ,$68.66 ,$138.60 ,$68.66 ,$118.80 ,$68.66 ,$148.50 ,$109.30 ,$98.60 ,$109.30 ,$68.66 ,$109.30 ,$154.44 ,$154.44 ,$168.30 ,$171.65 ,$137.21 ,$68.66 ,$198.00 ,$108.90 ,$68.66 ,$52.07 ,$198.00 , N/A , N/A ,$72.09 ,$158.40 ,$107.51 ,$55.44 ,$178.20 ,$198.00 ,$198.00 ,$68.66 ,$95.04 
ST. MARY'S HOSPITAL - DECATUR,45000275,99282,HC ER LEVEL 2-25,450,1 ,$390.00 ,$253.50 ,$102.57 ,$390.00 ,$310.85 ,$198.90 ,$214.50 ,$124.34 ,$109.20 ,$206.70 ,$124.34 ,$218.40 ,$124.34 ,$211.77 ,$211.77 ,$124.34 ,$211.77 ,$236.24 ,$273.00 ,$195.00 ,$312.00 ,$310.85 ,$124.34 ,$273.00 ,$124.34 ,$234.00 ,$124.34 ,$292.50 ,$215.28 ,$194.22 ,$215.28 ,$124.34 ,$215.28 ,$304.20 ,$304.20 ,$331.50 ,$310.85 ,$270.27 ,$124.34 ,$390.00 ,$214.50 ,$124.34 ,$102.57 ,$390.00 , N/A , N/A ,$130.56 ,$312.00 ,$211.77 ,$109.20 ,$351.00 ,$266.00 ,$390.00 ,$124.34 ,$187.20 
ST. MARY'S HOSPITAL - DECATUR,45000276,99283,HC ER LEVEL 3-25,450,1 ,"$1,039.00 ",$675.35 ,$219.06 ,"$1,039.00 ",$547.65 ,$529.89 ,$571.45 ,$219.06 ,$290.92 ,$550.67 ,$219.06 ,$581.84 ,$219.06 ,$564.18 ,$564.18 ,$219.06 ,$564.18 ,$416.22 ,$727.30 ,$519.50 ,$831.20 ,$547.66 ,$219.06 ,$727.30 ,$219.06 ,$623.40 ,$219.06 ,$779.25 ,$573.53 ,$517.42 ,$573.53 ,$219.06 ,$573.53 ,$810.42 ,$810.42 ,$883.15 ,$547.66 ,$720.03 ,$219.06 ,"$1,039.00 ",$571.45 ,$219.06 ,$273.26 ,"$1,039.00 ", N/A , N/A ,$230.01 ,$831.20 ,$564.18 ,$290.92 ,$935.10 ,$475.00 ,"$1,039.00 ",$219.06 ,$498.72 
ST. MARY'S HOSPITAL - DECATUR,45000277,99284,HC ER LEVEL 4-25,450,1 ,"$1,326.00 ",$861.90 ,$93.87 ,"$1,326.00 ",$860.88 ,$676.26 ,$729.30 ,$344.35 ,$371.28 ,$702.78 ,$344.35 ,$742.56 ,$344.35 ,$720.02 ,$720.02 ,$344.35 ,$720.02 ,$654.26 ,$928.20 ,$663.00 ,"$1,060.80 ",$860.87 ,$344.35 ,$928.20 ,$344.35 ,$795.60 ,$344.35 ,$994.50 ,$731.95 ,$660.35 ,$731.95 ,$344.35 ,$731.95 ,"$1,034.28 ","$1,034.28 ","$1,127.10 ",$860.87 ,$918.92 ,$344.35 ,"$1,326.00 ",$729.30 ,$344.35 ,$348.74 ,"$1,326.00 ",$98.34 ,$93.87 ,$361.57 ,"$1,060.80 ",$720.02 ,$371.28 ,"$1,193.40 ",$963.00 ,"$1,326.00 ",$344.35 ,$636.48 
ST. MARY'S HOSPITAL - DECATUR,45000278,99285,HC ER LEVEL 5-25,450,1 ,"$2,205.00 ","$1,433.25 ",$93.87 ,"$2,205.00 ","$1,235.68 ","$1,124.55 ","$1,212.75 ",$494.27 ,$617.40 ,"$1,168.65 ",$494.27 ,"$1,234.80 ",$494.27 ,"$1,197.32 ","$1,197.32 ",$494.27 ,"$1,197.32 ",$939.11 ,"$1,543.50 ","$1,102.50 ","$1,764.00 ","$1,235.67 ",$494.27 ,"$1,543.50 ",$494.27 ,"$1,323.00 ",$494.27 ,"$1,653.75 ","$1,217.16 ","$1,098.09 ","$1,217.16 ",$494.27 ,"$1,217.16 ","$1,719.90 ","$1,719.90 ","$1,874.25 ","$1,235.67 ","$1,528.07 ",$494.27 ,"$2,205.00 ","$1,212.75 ",$494.27 ,$579.92 ,"$2,205.00 ",$98.34 ,$93.87 ,$518.98 ,"$1,764.00 ","$1,197.32 ",$617.40 ,"$1,984.50 ","$1,441.00 ","$2,205.00 ",$494.27 ,"$1,058.40 "
ST. MARY'S HOSPITAL - DECATUR,45000279,99291,HC CRITICAL CARE 30-74 MIN -25,450,1 ,"$3,354.00 ","$2,180.10 ",$93.87 ,"$3,354.00 ","$1,762.75 ","$1,710.54 ","$1,844.70 ",$705.10 ,$939.12 ,"$1,777.62 ",$705.10 ,"$1,878.24 ",$705.10 ,"$1,821.22 ","$1,821.22 ",$705.10 ,"$1,821.22 ","$1,339.69 ","$2,347.80 ","$1,677.00 ","$2,683.20 ","$1,762.75 ",$705.10 ,"$2,347.80 ",$705.10 ,"$2,012.40 ",$705.10 ,"$2,515.50 ","$1,670.29 ","$1,502.59 ","$1,670.29 ",$705.10 ,"$1,670.29 ","$2,616.12 ","$2,616.12 ","$2,850.90 ","$1,762.75 ","$2,324.32 ",$705.10 ,"$3,354.00 ","$1,844.70 ",$705.10 ,$882.10 ,"$3,354.00 ",$98.34 ,$93.87 ,$740.36 ,"$2,683.20 ","$1,821.22 ",$939.12 ,"$3,018.60 ","$1,274.52 ","$3,354.00 ",$705.10 ,"$1,609.92 "
ST. MARY'S HOSPITAL - DECATUR,45000287,11402,HC EXCISION LESION BENIGN TRUNK/ARM/LEG 1.1-2.0CM,450,1 ,"$4,494.00 ","$2,921.10 ",$325.00 ,"$4,494.00 ","$1,472.65 ","$2,200.00 ","$2,471.70 ",$589.06 ,"$1,258.32 ","$2,381.82 ",$589.06 ,"$2,516.64 ",$589.06 ,"$2,440.24 ","$2,440.24 ",$589.06 ,"$2,440.24 ","$1,119.21 ","$3,145.80 ","$2,247.00 ","$3,595.20 ","$1,472.64 ",$589.06 ,"$3,145.80 ",$589.06 ,"$2,696.40 ",$589.06 ,"$3,370.50 ","$2,238.01 ","$2,013.31 ","$2,238.01 ",$589.06 ,"$2,238.01 ","$3,505.32 ","$3,505.32 ","$3,819.90 ","$1,472.64 ","$3,114.34 ",$589.06 ,"$4,494.00 ","$2,471.70 ",$589.06 ,"$1,181.92 ","$4,494.00 ", N/A , N/A ,$618.51 ,"$3,595.20 ","$2,440.24 ","$1,258.32 ","$4,044.60 ","$1,707.72 ",$325.00 ,$589.06 ,"$2,157.12 "
ST. MARY'S HOSPITAL - DECATUR,45000290,11420,HC EXCISION LESION BENIGN SCALP/NECK/HAND/FEET <0.5CM,450,1 ,"$1,992.00 ","$1,294.80 ",$325.00 ,"$3,329.73 ","$3,329.73 ","$1,015.92 ","$1,095.60 ","$1,331.89 ",$557.76 ,"$1,055.76 ","$1,331.89 ","$1,115.52 ","$1,331.89 ","$1,081.66 ","$1,081.66 ","$1,331.89 ","$1,081.66 ","$1,992.00 ","$1,394.40 ",$996.00 ,"$1,593.60 ","$3,329.72 ","$1,331.89 ","$1,394.40 ","$1,331.89 ","$1,195.20 ","$1,331.89 ","$1,494.00 ","$1,099.58 ",$992.02 ,"$1,099.58 ","$1,331.89 ","$1,099.58 ","$1,553.76 ","$1,553.76 ","$1,693.20 ","$1,992.00 ","$1,380.46 ","$1,331.89 ","$1,992.00 ","$1,095.60 ","$1,331.89 ",$523.90 ,"$1,992.00 ", N/A , N/A ,"$1,398.48 ","$1,593.60 ","$1,081.66 ",$557.76 ,"$1,792.80 ",$756.96 ,$325.00 ,"$1,331.89 ",$956.16 
ST. MARY'S HOSPITAL - DECATUR,45000291,11422,HC EXCISION LESION BENIGN SCALP/NECK/HAND/FEET 1.1-2.0CM,450,1 ,"$4,577.00 ","$2,975.05 ",$325.00 ,"$4,577.00 ","$3,329.73 ","$2,200.00 ","$2,517.35 ","$1,331.89 ","$1,281.56 ","$2,425.81 ","$1,331.89 ","$2,563.12 ","$1,331.89 ","$2,485.31 ","$2,485.31 ","$1,331.89 ","$2,485.31 ","$2,530.59 ","$3,203.90 ","$2,288.50 ","$3,661.60 ","$3,329.72 ","$1,331.89 ","$3,203.90 ","$1,331.89 ","$2,746.20 ","$1,331.89 ","$3,432.75 ","$2,279.35 ","$2,050.50 ","$2,279.35 ","$1,331.89 ","$2,279.35 ","$3,570.06 ","$3,570.06 ","$3,890.45 ","$3,329.72 ","$3,171.86 ","$1,331.89 ","$4,577.00 ","$2,517.35 ","$1,331.89 ","$1,203.75 ","$4,577.00 ", N/A , N/A ,"$1,398.48 ","$3,661.60 ","$2,485.31 ","$1,281.56 ","$4,119.30 ","$1,739.26 ",$325.00 ,"$1,331.89 ","$2,196.96 "
ST. MARY'S HOSPITAL - DECATUR,45000298,20102,HC EXPLORE WOUND ABDOMEN/FLANK/BACK,450,1 ,"$6,677.00 ","$4,340.05 ",$325.00 ,"$6,677.00 ","$4,053.30 ","$2,200.00 ","$3,672.35 ","$1,621.32 ","$1,869.56 ","$3,538.81 ","$1,621.32 ","$3,739.12 ","$1,621.32 ","$3,100.00 ","$3,100.00 ","$1,621.32 ","$3,100.00 ","$3,080.51 ","$4,673.90 ","$3,338.50 ","$5,341.60 ","$4,053.30 ","$1,621.32 ","$4,673.90 ","$1,621.32 ","$4,006.20 ","$1,621.32 ","$5,007.75 ","$3,325.15 ","$2,991.30 ","$3,325.15 ","$1,621.32 ","$3,325.15 ","$3,786.00 ","$3,786.00 ","$5,675.45 ","$4,053.30 ","$4,627.16 ","$1,621.32 ","$6,677.00 ","$3,672.35 ","$1,621.32 ","$1,756.05 ","$6,677.00 ", N/A , N/A ,"$1,702.39 ","$5,341.60 ","$3,100.00 ","$1,869.56 ","$6,009.30 ","$2,537.26 ",$325.00 ,"$1,621.32 ","$3,204.96 "
ST. MARY'S HOSPITAL - DECATUR,45000301,24200,HC REMOVE FOREIGN BODY UPPER ARM/ELBOW SUBQ,450,1 ,$979.00 ,$636.35 ,$257.48 ,"$3,329.73 ","$3,329.73 ",$499.29 ,$538.45 ,"$1,331.89 ",$274.12 ,$518.87 ,"$1,331.89 ",$548.24 ,$979.00 ,$531.60 ,$531.60 ,$979.00 ,$531.60 ,$979.00 ,$685.30 ,$489.50 ,$783.20 ,"$3,329.72 ","$1,331.89 ",$685.30 ,"$1,331.89 ",$587.40 ,"$1,331.89 ",$734.25 ,$540.41 ,$487.54 ,$540.41 ,"$1,331.89 ",$540.41 ,$763.62 ,$763.62 ,$832.15 ,$979.00 ,$678.45 ,"$1,331.89 ",$979.00 ,$538.45 ,"$1,331.89 ",$257.48 ,$979.00 , N/A , N/A ,"$1,398.48 ",$783.20 ,$531.60 ,$274.12 ,$881.10 ,$372.02 ,$325.00 ,"$1,331.89 ",$469.92 
ST. MARY'S HOSPITAL - DECATUR,45000303,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP,450,1 ,"$5,201.00 ","$3,380.65 ",$325.00 ,"$5,201.00 ","$3,296.18 ","$2,200.00 ","$2,860.55 ","$1,318.47 ","$1,456.28 ","$2,756.53 ","$1,318.47 ","$2,912.56 ","$1,318.47 ","$2,824.14 ","$2,824.14 ","$1,318.47 ","$2,824.14 ","$2,505.09 ","$3,640.70 ","$2,600.50 ","$4,160.80 ","$3,296.17 ","$1,318.47 ","$3,640.70 ","$1,318.47 ","$3,120.60 ","$1,318.47 ","$3,900.75 ","$2,590.10 ","$2,330.05 ","$2,590.10 ","$1,318.47 ","$2,590.10 ","$3,786.00 ","$3,786.00 ","$4,420.85 ","$3,296.17 ","$3,604.29 ","$1,318.47 ","$5,201.00 ","$2,860.55 ","$1,318.47 ","$1,367.86 ","$5,201.00 ", N/A , N/A ,"$1,384.39 ","$4,160.80 ","$2,824.14 ","$1,456.28 ","$4,680.90 ","$1,976.38 ",$325.00 ,"$1,318.47 ","$2,496.48 "
ST. MARY'S HOSPITAL - DECATUR,45000304,25650,HC CLOSED TX ULNAR STYLOID FX,450,1 ,$816.00 ,$530.40 ,$195.10 ,$816.00 ,$487.75 ,$416.16 ,$448.80 ,$195.10 ,$228.48 ,$432.48 ,$195.10 ,$456.96 ,$195.10 ,$443.09 ,$443.09 ,$195.10 ,$443.09 ,$370.70 ,$571.20 ,$408.00 ,$652.80 ,$487.76 ,$195.10 ,$571.20 ,$195.10 ,$489.60 ,$195.10 ,$612.00 ,$450.43 ,$406.37 ,$450.43 ,$195.10 ,$450.43 ,$636.48 ,$636.48 ,$693.60 ,$487.76 ,$565.49 ,$195.10 ,$816.00 ,$448.80 ,$195.10 ,$214.61 ,$816.00 , N/A , N/A ,$204.86 ,$652.80 ,$443.09 ,$228.48 ,$734.40 ,$310.08 ,$325.00 ,$195.10 ,$391.68 
ST. MARY'S HOSPITAL - DECATUR,45000306,28192,HC REMOVE FOREIGN BODY FOOT DEEP,450,1 ,"$6,989.00 ","$4,542.85 ",$325.00 ,"$6,989.00 ","$3,329.73 ","$2,200.00 ","$3,843.95 ","$1,331.89 ","$1,956.92 ","$3,704.17 ","$1,331.89 ","$3,913.84 ","$1,331.89 ","$3,100.00 ","$3,100.00 ","$1,331.89 ","$3,100.00 ","$2,530.59 ","$4,892.30 ","$3,494.50 ","$5,591.20 ","$3,329.72 ","$1,331.89 ","$4,892.30 ","$1,331.89 ","$4,193.40 ","$1,331.89 ","$5,241.75 ","$3,480.52 ","$3,131.07 ","$3,480.52 ","$1,331.89 ","$3,480.52 ","$3,786.00 ","$3,786.00 ","$5,940.65 ","$3,329.72 ","$4,843.38 ","$1,331.89 ","$6,989.00 ","$3,843.95 ","$1,331.89 ","$1,838.11 ","$6,989.00 ", N/A , N/A ,"$1,398.48 ","$5,591.20 ","$3,100.00 ","$1,956.92 ","$6,290.10 ","$2,655.82 ",$325.00 ,"$1,331.89 ","$3,354.72 "
ST. MARY'S HOSPITAL - DECATUR,45000309,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES,450,1 ,$996.00 ,$647.40 ,$195.10 ,$996.00 ,$487.75 ,$507.96 ,$547.80 ,$195.10 ,$278.88 ,$527.88 ,$195.10 ,$557.76 ,$195.10 ,$540.83 ,$540.83 ,$195.10 ,$540.83 ,$370.70 ,$697.20 ,$498.00 ,$796.80 ,$487.76 ,$195.10 ,$697.20 ,$195.10 ,$597.60 ,$195.10 ,$747.00 ,$549.79 ,$496.01 ,$549.79 ,$195.10 ,$549.79 ,$776.88 ,$776.88 ,$846.60 ,$487.76 ,$690.23 ,$195.10 ,$996.00 ,$547.80 ,$195.10 ,$261.95 ,$996.00 , N/A , N/A ,$204.86 ,$796.80 ,$540.83 ,$278.88 ,$896.40 ,$378.48 ,$325.00 ,$195.10 ,$478.08 
ST. MARY'S HOSPITAL - DECATUR,45000310,31505,HC LARYNGOSCOPY INDIRECT,450,1 ,$97.00 ,$63.05 ,$25.51 ,$389.56 ,$389.55 ,$49.47 ,$53.35 ,$155.82 ,$27.16 ,$51.41 ,$155.82 ,$54.32 ,$97.00 ,$52.67 ,$52.67 ,$97.00 ,$52.67 ,$97.00 ,$67.90 ,$48.50 ,$77.60 ,$389.56 ,$155.82 ,$67.90 ,$155.82 ,$58.20 ,$155.82 ,$72.75 ,$53.54 ,$48.31 ,$53.54 ,$155.82 ,$53.54 ,$75.66 ,$75.66 ,$82.45 ,$97.00 ,$67.22 ,$155.82 ,$97.00 ,$53.35 ,$155.82 ,$25.51 ,$97.00 , N/A , N/A ,$163.61 ,$77.60 ,$52.67 ,$27.16 ,$87.30 ,$36.86 ,$97.00 ,$155.82 ,$46.56 
ST. MARY'S HOSPITAL - DECATUR,45000311,40804,HC REMOVE FOREIGN BODY MOUTH SIMPLE,450,1 ,$908.00 ,$590.20 ,$238.80 ,"$1,914.88 ","$1,914.88 ",$463.08 ,$499.40 ,$765.95 ,$254.24 ,$481.24 ,$765.95 ,$508.48 ,$765.95 ,$493.04 ,$493.04 ,$765.95 ,$493.04 ,$908.00 ,$635.60 ,$454.00 ,$726.40 ,"$1,914.87 ",$765.95 ,$635.60 ,$765.95 ,$544.80 ,$765.95 ,$681.00 ,$501.22 ,$452.18 ,$501.22 ,$765.95 ,$501.22 ,$708.24 ,$708.24 ,$771.80 ,$908.00 ,$629.24 ,$765.95 ,$908.00 ,$499.40 ,$765.95 ,$238.80 ,$908.00 , N/A , N/A ,$804.25 ,$726.40 ,$493.04 ,$254.24 ,$817.20 ,$345.04 ,$325.00 ,$765.95 ,$435.84 
ST. MARY'S HOSPITAL - DECATUR,45000328,27550,HC CLSD TX KNEE DISLOC W/O ANESTH,450,1 ,$926.00 ,$601.90 ,$195.10 ,$926.00 ,$487.75 ,$472.26 ,$509.30 ,$195.10 ,$259.28 ,$490.78 ,$195.10 ,$518.56 ,$195.10 ,$502.82 ,$502.82 ,$195.10 ,$502.82 ,$370.70 ,$648.20 ,$463.00 ,$740.80 ,$487.76 ,$195.10 ,$648.20 ,$195.10 ,$555.60 ,$195.10 ,$694.50 ,$511.15 ,$461.15 ,$511.15 ,$195.10 ,$511.15 ,$722.28 ,$722.28 ,$787.10 ,$487.76 ,$641.72 ,$195.10 ,$926.00 ,$509.30 ,$195.10 ,$243.54 ,$926.00 , N/A , N/A ,$204.86 ,$740.80 ,$502.82 ,$259.28 ,$833.40 ,$351.88 ,$325.00 ,$195.10 ,$444.48 
ST. MARY'S HOSPITAL - DECATUR,45000329,27752,HC CLSD TX FX TIBIAL SHAFT W/MANIP,450,1 ,$279.00 ,$181.35 ,$73.38 ,"$3,296.18 ","$3,296.18 ",$142.29 ,$153.45 ,"$1,318.47 ",$78.12 ,$147.87 ,"$1,318.47 ",$156.24 ,$279.00 ,$151.50 ,$151.50 ,$279.00 ,$151.50 ,$279.00 ,$195.30 ,$139.50 ,$223.20 ,"$3,296.17 ","$1,318.47 ",$195.30 ,"$1,318.47 ",$167.40 ,"$1,318.47 ",$209.25 ,$154.01 ,$138.94 ,$154.01 ,"$1,318.47 ",$154.01 ,$217.62 ,$217.62 ,$237.15 ,$279.00 ,$193.35 ,"$1,318.47 ",$279.00 ,$153.45 ,"$1,318.47 ",$73.38 ,$279.00 , N/A , N/A ,"$1,384.39 ",$223.20 ,$151.50 ,$78.12 ,$251.10 ,$106.02 ,$279.00 ,"$1,318.47 ",$133.92 
ST. MARY'S HOSPITAL - DECATUR,45000330,27760,HC CLSD TX FX MEDIAL MALLEOLUS W/O MANIP,450,1 ,$773.00 ,$502.45 ,$195.10 ,$773.00 ,$487.75 ,$394.23 ,$425.15 ,$195.10 ,$216.44 ,$409.69 ,$195.10 ,$432.88 ,$195.10 ,$419.74 ,$419.74 ,$195.10 ,$419.74 ,$370.70 ,$541.10 ,$386.50 ,$618.40 ,$487.76 ,$195.10 ,$541.10 ,$195.10 ,$463.80 ,$195.10 ,$579.75 ,$426.70 ,$384.95 ,$426.70 ,$195.10 ,$426.70 ,$602.94 ,$602.94 ,$657.05 ,$487.76 ,$535.69 ,$195.10 ,$773.00 ,$425.15 ,$195.10 ,$203.30 ,$773.00 , N/A , N/A ,$204.86 ,$618.40 ,$419.74 ,$216.44 ,$695.70 ,$293.74 ,$325.00 ,$195.10 ,$371.04 
ST. MARY'S HOSPITAL - DECATUR,45000331,27788,HC CLOSED TX FX DISTAL FIBULAR W/MANIP,450,1 ,$597.00 ,$388.05 ,$157.01 ,$597.00 ,$487.75 ,$304.47 ,$328.35 ,$195.10 ,$167.16 ,$316.41 ,$195.10 ,$334.32 ,$195.10 ,$324.17 ,$324.17 ,$195.10 ,$324.17 ,$370.70 ,$417.90 ,$298.50 ,$477.60 ,$487.76 ,$195.10 ,$417.90 ,$195.10 ,$358.20 ,$195.10 ,$447.75 ,$329.54 ,$297.31 ,$329.54 ,$195.10 ,$329.54 ,$465.66 ,$465.66 ,$507.45 ,$487.76 ,$413.72 ,$195.10 ,$597.00 ,$328.35 ,$195.10 ,$157.01 ,$597.00 , N/A , N/A ,$204.86 ,$477.60 ,$324.17 ,$167.16 ,$537.30 ,$226.86 ,$325.00 ,$195.10 ,$286.56 
ST. MARY'S HOSPITAL - DECATUR,45000334,29260,HC STRAPPING ELBOW/WRIST,450,1 ,$987.00 ,$641.55 ,$52.69 ,$987.00 ,$131.73 ,$503.37 ,$542.85 ,$52.69 ,$276.36 ,$523.11 ,$52.69 ,$552.72 ,$52.69 ,$535.94 ,$535.94 ,$52.69 ,$535.94 ,$100.11 ,$690.90 ,$493.50 ,$789.60 ,$131.73 ,$52.69 ,$690.90 ,$52.69 ,$592.20 ,$52.69 ,$740.25 ,$544.82 ,$491.53 ,$544.82 ,$52.69 ,$544.82 ,$769.86 ,$769.86 ,$838.95 ,$131.73 ,$683.99 ,$52.69 ,$987.00 ,$542.85 ,$52.69 ,$259.58 ,$987.00 , N/A , N/A ,$55.32 ,$789.60 ,$535.94 ,$276.36 ,$888.30 ,$375.06 ,$325.00 ,$52.69 ,$473.76 
ST. MARY'S HOSPITAL - DECATUR,45000335,29530,HC STRAPPING KNEE,450,1 ,$484.00 ,$314.60 ,$106.74 ,$484.00 ,$266.85 ,$246.84 ,$266.20 ,$106.74 ,$135.52 ,$256.52 ,$106.74 ,$271.04 ,$106.74 ,$262.81 ,$262.81 ,$106.74 ,$262.81 ,$202.80 ,$338.80 ,$242.00 ,$387.20 ,$266.84 ,$106.74 ,$338.80 ,$106.74 ,$290.40 ,$106.74 ,$363.00 ,$267.17 ,$241.03 ,$267.17 ,$106.74 ,$267.17 ,$377.52 ,$377.52 ,$411.40 ,$266.84 ,$335.41 ,$106.74 ,$484.00 ,$266.20 ,$106.74 ,$127.29 ,$484.00 , N/A , N/A ,$112.08 ,$387.20 ,$262.81 ,$135.52 ,$435.60 ,$183.92 ,$325.00 ,$106.74 ,$232.32 
ST. MARY'S HOSPITAL - DECATUR,45000336,29550,HC STRAPPING TOES,450,1 ,$371.00 ,$241.15 ,$52.69 ,$371.00 ,$131.73 ,$189.21 ,$204.05 ,$52.69 ,$103.88 ,$196.63 ,$52.69 ,$207.76 ,$52.69 ,$201.45 ,$201.45 ,$52.69 ,$201.45 ,$100.11 ,$259.70 ,$185.50 ,$296.80 ,$131.73 ,$52.69 ,$259.70 ,$52.69 ,$222.60 ,$52.69 ,$278.25 ,$204.79 ,$184.76 ,$204.79 ,$52.69 ,$204.79 ,$289.38 ,$289.38 ,$315.35 ,$131.73 ,$257.10 ,$52.69 ,$371.00 ,$204.05 ,$52.69 ,$97.57 ,$371.00 , N/A , N/A ,$55.32 ,$296.80 ,$201.45 ,$103.88 ,$333.90 ,$140.98 ,$325.00 ,$52.69 ,$178.08 
ST. MARY'S HOSPITAL - DECATUR,45000337,29730,HC WINDOWING OF CAST,450,1 ,$533.00 ,$346.45 ,$133.74 ,$533.00 ,$334.35 ,$271.83 ,$293.15 ,$133.74 ,$149.24 ,$282.49 ,$133.74 ,$298.48 ,$133.74 ,$289.42 ,$289.42 ,$133.74 ,$289.42 ,$254.10 ,$373.10 ,$266.50 ,$426.40 ,$334.34 ,$133.74 ,$373.10 ,$133.74 ,$319.80 ,$133.74 ,$399.75 ,$294.22 ,$265.43 ,$294.22 ,$133.74 ,$294.22 ,$415.74 ,$415.74 ,$453.05 ,$334.34 ,$369.37 ,$133.74 ,$533.00 ,$293.15 ,$133.74 ,$140.18 ,$533.00 , N/A , N/A ,$140.43 ,$426.40 ,$289.42 ,$149.24 ,$479.70 ,$202.54 ,$325.00 ,$133.74 ,$255.84 
ST. MARY'S HOSPITAL - DECATUR,45000338,30906,HC CONTROL NASAL HEMORRHAGE SUBSQ,450,1 ,$959.00 ,$623.35 ,$200.27 ,$959.00 ,$500.68 ,$489.09 ,$527.45 ,$200.27 ,$268.52 ,$508.27 ,$200.27 ,$537.04 ,$200.27 ,$520.74 ,$520.74 ,$200.27 ,$520.74 ,$380.51 ,$671.30 ,$479.50 ,$767.20 ,$500.67 ,$200.27 ,$671.30 ,$200.27 ,$575.40 ,$200.27 ,$719.25 ,$529.37 ,$477.58 ,$529.37 ,$200.27 ,$529.37 ,$748.02 ,$748.02 ,$815.15 ,$500.67 ,$664.59 ,$200.27 ,$959.00 ,$527.45 ,$200.27 ,$252.22 ,$959.00 , N/A , N/A ,$210.28 ,$767.20 ,$520.74 ,$268.52 ,$863.10 ,$364.42 ,$325.00 ,$200.27 ,$460.32 
ST. MARY'S HOSPITAL - DECATUR,45000350,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-LT,450,1 ,$185.00 ,$120.25 ,$48.66 ,$185.00 ,$131.73 ,$94.35 ,$101.75 ,$52.69 ,$51.80 ,$98.05 ,$52.69 ,$103.60 ,$52.69 ,$100.46 ,$100.46 ,$52.69 ,$100.46 ,$100.11 ,$129.50 ,$92.50 ,$148.00 ,$131.73 ,$52.69 ,$129.50 ,$52.69 ,$111.00 ,$52.69 ,$138.75 ,$102.12 ,$92.13 ,$102.12 ,$52.69 ,$102.12 ,$144.30 ,$144.30 ,$157.25 ,$131.73 ,$128.21 ,$52.69 ,$185.00 ,$101.75 ,$52.69 ,$48.66 ,$185.00 , N/A , N/A ,$55.32 ,$148.00 ,$100.46 ,$51.80 ,$166.50 ,$70.30 ,$185.00 ,$52.69 ,$88.80 
ST. MARY'S HOSPITAL - DECATUR,45000351,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-RT,450,1 ,$185.00 ,$120.25 ,$48.66 ,$185.00 ,$131.73 ,$94.35 ,$101.75 ,$52.69 ,$51.80 ,$98.05 ,$52.69 ,$103.60 ,$52.69 ,$100.46 ,$100.46 ,$52.69 ,$100.46 ,$100.11 ,$129.50 ,$92.50 ,$148.00 ,$131.73 ,$52.69 ,$129.50 ,$52.69 ,$111.00 ,$52.69 ,$138.75 ,$102.12 ,$92.13 ,$102.12 ,$52.69 ,$102.12 ,$144.30 ,$144.30 ,$157.25 ,$131.73 ,$128.21 ,$52.69 ,$185.00 ,$101.75 ,$52.69 ,$48.66 ,$185.00 , N/A , N/A ,$55.32 ,$148.00 ,$100.46 ,$51.80 ,$166.50 ,$70.30 ,$185.00 ,$52.69 ,$88.80 
ST. MARY'S HOSPITAL - DECATUR,45000352,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-50,450,1 ,$185.00 ,$120.25 ,$48.66 ,$185.00 ,$131.73 ,$94.35 ,$101.75 ,$52.69 ,$51.80 ,$98.05 ,$52.69 ,$103.60 ,$52.69 ,$100.46 ,$100.46 ,$52.69 ,$100.46 ,$100.11 ,$129.50 ,$92.50 ,$148.00 ,$131.73 ,$52.69 ,$129.50 ,$52.69 ,$111.00 ,$52.69 ,$138.75 ,$102.12 ,$92.13 ,$102.12 ,$52.69 ,$102.12 ,$144.30 ,$144.30 ,$157.25 ,$131.73 ,$128.21 ,$52.69 ,$185.00 ,$101.75 ,$52.69 ,$48.66 ,$185.00 , N/A , N/A ,$55.32 ,$148.00 ,$100.46 ,$51.80 ,$166.50 ,$70.30 ,$185.00 ,$52.69 ,$88.80 
ST. MARY'S HOSPITAL - DECATUR,45000353,21480,HC TX DISL JAW CLS-LT,450,1 ,$884.00 ,$574.60 ,$195.10 ,$884.00 ,$487.75 ,$450.84 ,$486.20 ,$195.10 ,$247.52 ,$468.52 ,$195.10 ,$495.04 ,$195.10 ,$480.01 ,$480.01 ,$195.10 ,$480.01 ,$370.70 ,$618.80 ,$442.00 ,$707.20 ,$487.76 ,$195.10 ,$618.80 ,$195.10 ,$530.40 ,$195.10 ,$663.00 ,$487.97 ,$440.23 ,$487.97 ,$195.10 ,$487.97 ,$689.52 ,$689.52 ,$751.40 ,$487.76 ,$612.61 ,$195.10 ,$884.00 ,$486.20 ,$195.10 ,$232.49 ,$884.00 , N/A , N/A ,$204.86 ,$707.20 ,$480.01 ,$247.52 ,$795.60 ,$335.92 ,$325.00 ,$195.10 ,$424.32 
ST. MARY'S HOSPITAL - DECATUR,45000354,21480,HC TX DISL JAW CLS-RT,450,1 ,$884.00 ,$574.60 ,$195.10 ,$884.00 ,$487.75 ,$450.84 ,$486.20 ,$195.10 ,$247.52 ,$468.52 ,$195.10 ,$495.04 ,$195.10 ,$480.01 ,$480.01 ,$195.10 ,$480.01 ,$370.70 ,$618.80 ,$442.00 ,$707.20 ,$487.76 ,$195.10 ,$618.80 ,$195.10 ,$530.40 ,$195.10 ,$663.00 ,$487.97 ,$440.23 ,$487.97 ,$195.10 ,$487.97 ,$689.52 ,$689.52 ,$751.40 ,$487.76 ,$612.61 ,$195.10 ,$884.00 ,$486.20 ,$195.10 ,$232.49 ,$884.00 , N/A , N/A ,$204.86 ,$707.20 ,$480.01 ,$247.52 ,$795.60 ,$335.92 ,$325.00 ,$195.10 ,$424.32 
ST. MARY'S HOSPITAL - DECATUR,45000357,23650,HC TX DISL SHLDR W/MAN CLS-LT,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000358,23650,HC TX DISL SHLDR W/MAN CLS-RT,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000365,24600,HC TX DISL ELBOW W/O ANES CLS-LT,450,1 ,"$2,603.00 ","$1,691.95 ",$195.10 ,"$2,603.00 ",$487.75 ,"$1,327.53 ","$1,431.65 ",$195.10 ,$728.84 ,"$1,379.59 ",$195.10 ,"$1,457.68 ",$195.10 ,"$1,413.43 ","$1,413.43 ",$195.10 ,"$1,413.43 ",$370.70 ,"$1,822.10 ","$1,301.50 ","$2,082.40 ",$487.76 ,$195.10 ,"$1,822.10 ",$195.10 ,"$1,561.80 ",$195.10 ,"$1,952.25 ","$1,436.86 ","$1,296.29 ","$1,436.86 ",$195.10 ,"$1,436.86 ","$2,030.34 ","$2,030.34 ","$2,212.55 ",$487.76 ,"$1,803.88 ",$195.10 ,"$2,603.00 ","$1,431.65 ",$195.10 ,$684.59 ,"$2,603.00 ", N/A , N/A ,$204.86 ,"$2,082.40 ","$1,413.43 ",$728.84 ,"$2,342.70 ",$989.14 ,$325.00 ,$195.10 ,"$1,249.44 "
ST. MARY'S HOSPITAL - DECATUR,45000366,24600,HC TX DISL ELBOW W/O ANES CLS-RT,450,1 ,"$2,603.00 ","$1,691.95 ",$195.10 ,"$2,603.00 ",$487.75 ,"$1,327.53 ","$1,431.65 ",$195.10 ,$728.84 ,"$1,379.59 ",$195.10 ,"$1,457.68 ",$195.10 ,"$1,413.43 ","$1,413.43 ",$195.10 ,"$1,413.43 ",$370.70 ,"$1,822.10 ","$1,301.50 ","$2,082.40 ",$487.76 ,$195.10 ,"$1,822.10 ",$195.10 ,"$1,561.80 ",$195.10 ,"$1,952.25 ","$1,436.86 ","$1,296.29 ","$1,436.86 ",$195.10 ,"$1,436.86 ","$2,030.34 ","$2,030.34 ","$2,212.55 ",$487.76 ,"$1,803.88 ",$195.10 ,"$2,603.00 ","$1,431.65 ",$195.10 ,$684.59 ,"$2,603.00 ", N/A , N/A ,$204.86 ,"$2,082.40 ","$1,413.43 ",$728.84 ,"$2,342.70 ",$989.14 ,$325.00 ,$195.10 ,"$1,249.44 "
ST. MARY'S HOSPITAL - DECATUR,45000369,24640,HC DISLOCATION NURSEMAID ELBOW-LT,450,1 ,$480.00 ,$312.00 ,$126.24 ,$487.76 ,$487.75 ,$244.80 ,$264.00 ,$195.10 ,$134.40 ,$254.40 ,$195.10 ,$268.80 ,$195.10 ,$260.64 ,$260.64 ,$195.10 ,$260.64 ,$370.70 ,$336.00 ,$240.00 ,$384.00 ,$487.76 ,$195.10 ,$336.00 ,$195.10 ,$288.00 ,$195.10 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$195.10 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$195.10 ,$480.00 ,$264.00 ,$195.10 ,$126.24 ,$480.00 , N/A , N/A ,$204.86 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$195.10 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000370,24640,HC DISLOCATION NURSEMAID ELBOW-RT,450,1 ,$480.00 ,$312.00 ,$126.24 ,$487.76 ,$487.75 ,$244.80 ,$264.00 ,$195.10 ,$134.40 ,$254.40 ,$195.10 ,$268.80 ,$195.10 ,$260.64 ,$260.64 ,$195.10 ,$260.64 ,$370.70 ,$336.00 ,$240.00 ,$384.00 ,$487.76 ,$195.10 ,$336.00 ,$195.10 ,$288.00 ,$195.10 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$195.10 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$195.10 ,$480.00 ,$264.00 ,$195.10 ,$126.24 ,$480.00 , N/A , N/A ,$204.86 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$195.10 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000371,25505,HC RADIUS FX W MANIP-LT,450,1 ,$718.00 ,$466.70 ,$188.83 ,"$3,296.18 ","$3,296.18 ",$366.18 ,$394.90 ,"$1,318.47 ",$201.04 ,$380.54 ,"$1,318.47 ",$402.08 ,$718.00 ,$389.87 ,$389.87 ,$718.00 ,$389.87 ,$718.00 ,$502.60 ,$359.00 ,$574.40 ,"$3,296.17 ","$1,318.47 ",$502.60 ,"$1,318.47 ",$430.80 ,"$1,318.47 ",$538.50 ,$396.34 ,$357.56 ,$396.34 ,"$1,318.47 ",$396.34 ,$560.04 ,$560.04 ,$610.30 ,$718.00 ,$497.57 ,"$1,318.47 ",$718.00 ,$394.90 ,"$1,318.47 ",$188.83 ,$718.00 , N/A , N/A ,"$1,384.39 ",$574.40 ,$389.87 ,$201.04 ,$646.20 ,$272.84 ,$325.00 ,"$1,318.47 ",$344.64 
ST. MARY'S HOSPITAL - DECATUR,45000372,25505,HC RADIUS FX W MANIP-RT,450,1 ,$718.00 ,$466.70 ,$188.83 ,"$3,296.18 ","$3,296.18 ",$366.18 ,$394.90 ,"$1,318.47 ",$201.04 ,$380.54 ,"$1,318.47 ",$402.08 ,$718.00 ,$389.87 ,$389.87 ,$718.00 ,$389.87 ,$718.00 ,$502.60 ,$359.00 ,$574.40 ,"$3,296.17 ","$1,318.47 ",$502.60 ,"$1,318.47 ",$430.80 ,"$1,318.47 ",$538.50 ,$396.34 ,$357.56 ,$396.34 ,"$1,318.47 ",$396.34 ,$560.04 ,$560.04 ,$610.30 ,$718.00 ,$497.57 ,"$1,318.47 ",$718.00 ,$394.90 ,"$1,318.47 ",$188.83 ,$718.00 , N/A , N/A ,"$1,384.39 ",$574.40 ,$389.87 ,$201.04 ,$646.20 ,$272.84 ,$325.00 ,"$1,318.47 ",$344.64 
ST. MARY'S HOSPITAL - DECATUR,45000373,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP-LT,450,1 ,$548.00 ,$356.20 ,$144.12 ,"$3,296.18 ","$3,296.18 ",$279.48 ,$301.40 ,"$1,318.47 ",$153.44 ,$290.44 ,"$1,318.47 ",$306.88 ,$548.00 ,$297.56 ,$297.56 ,$548.00 ,$297.56 ,$548.00 ,$383.60 ,$274.00 ,$438.40 ,"$3,296.17 ","$1,318.47 ",$383.60 ,"$1,318.47 ",$328.80 ,"$1,318.47 ",$411.00 ,$302.50 ,$272.90 ,$302.50 ,"$1,318.47 ",$302.50 ,$427.44 ,$427.44 ,$465.80 ,$548.00 ,$379.76 ,"$1,318.47 ",$548.00 ,$301.40 ,"$1,318.47 ",$144.12 ,$548.00 , N/A , N/A ,"$1,384.39 ",$438.40 ,$297.56 ,$153.44 ,$493.20 ,$208.24 ,$325.00 ,"$1,318.47 ",$263.04 
ST. MARY'S HOSPITAL - DECATUR,45000374,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP-RT,450,1 ,$548.00 ,$356.20 ,$144.12 ,"$3,296.18 ","$3,296.18 ",$279.48 ,$301.40 ,"$1,318.47 ",$153.44 ,$290.44 ,"$1,318.47 ",$306.88 ,$548.00 ,$297.56 ,$297.56 ,$548.00 ,$297.56 ,$548.00 ,$383.60 ,$274.00 ,$438.40 ,"$3,296.17 ","$1,318.47 ",$383.60 ,"$1,318.47 ",$328.80 ,"$1,318.47 ",$411.00 ,$302.50 ,$272.90 ,$302.50 ,"$1,318.47 ",$302.50 ,$427.44 ,$427.44 ,$465.80 ,$548.00 ,$379.76 ,"$1,318.47 ",$548.00 ,$301.40 ,"$1,318.47 ",$144.12 ,$548.00 , N/A , N/A ,"$1,384.39 ",$438.40 ,$297.56 ,$153.44 ,$493.20 ,$208.24 ,$325.00 ,"$1,318.47 ",$263.04 
ST. MARY'S HOSPITAL - DECATUR,45000375,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-LT",450,1 ,$548.00 ,$356.20 ,$144.12 ,"$3,296.18 ","$3,296.18 ",$279.48 ,$301.40 ,"$1,318.47 ",$153.44 ,$290.44 ,"$1,318.47 ",$306.88 ,$548.00 ,$297.56 ,$297.56 ,$548.00 ,$297.56 ,$548.00 ,$383.60 ,$274.00 ,$438.40 ,"$3,296.17 ","$1,318.47 ",$383.60 ,"$1,318.47 ",$328.80 ,"$1,318.47 ",$411.00 ,$302.50 ,$272.90 ,$302.50 ,"$1,318.47 ",$302.50 ,$427.44 ,$427.44 ,$465.80 ,$548.00 ,$379.76 ,"$1,318.47 ",$548.00 ,$301.40 ,"$1,318.47 ",$144.12 ,$548.00 , N/A , N/A ,"$1,384.39 ",$438.40 ,$297.56 ,$153.44 ,$493.20 ,$208.24 ,$325.00 ,"$1,318.47 ",$263.04 
ST. MARY'S HOSPITAL - DECATUR,45000376,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-RT",450,1 ,$548.00 ,$356.20 ,$144.12 ,"$3,296.18 ","$3,296.18 ",$279.48 ,$301.40 ,"$1,318.47 ",$153.44 ,$290.44 ,"$1,318.47 ",$306.88 ,$548.00 ,$297.56 ,$297.56 ,$548.00 ,$297.56 ,$548.00 ,$383.60 ,$274.00 ,$438.40 ,"$3,296.17 ","$1,318.47 ",$383.60 ,"$1,318.47 ",$328.80 ,"$1,318.47 ",$411.00 ,$302.50 ,$272.90 ,$302.50 ,"$1,318.47 ",$302.50 ,$427.44 ,$427.44 ,$465.80 ,$548.00 ,$379.76 ,"$1,318.47 ",$548.00 ,$301.40 ,"$1,318.47 ",$144.12 ,$548.00 , N/A , N/A ,"$1,384.39 ",$438.40 ,$297.56 ,$153.44 ,$493.20 ,$208.24 ,$325.00 ,"$1,318.47 ",$263.04 
ST. MARY'S HOSPITAL - DECATUR,45000379,26600,HC CLSD METACARPAL W/O MANIP-LT,450,1 ,$748.00 ,$486.20 ,$195.10 ,$748.00 ,$487.75 ,$381.48 ,$411.40 ,$195.10 ,$209.44 ,$396.44 ,$195.10 ,$418.88 ,$195.10 ,$406.16 ,$406.16 ,$195.10 ,$406.16 ,$370.70 ,$523.60 ,$374.00 ,$598.40 ,$487.76 ,$195.10 ,$523.60 ,$195.10 ,$448.80 ,$195.10 ,$561.00 ,$412.90 ,$372.50 ,$412.90 ,$195.10 ,$412.90 ,$583.44 ,$583.44 ,$635.80 ,$487.76 ,$518.36 ,$195.10 ,$748.00 ,$411.40 ,$195.10 ,$196.72 ,$748.00 , N/A , N/A ,$204.86 ,$598.40 ,$406.16 ,$209.44 ,$673.20 ,$284.24 ,$325.00 ,$195.10 ,$359.04 
ST. MARY'S HOSPITAL - DECATUR,45000380,26600,HC CLSD METACARPAL W/O MANIP-RT,450,1 ,$748.00 ,$486.20 ,$195.10 ,$748.00 ,$487.75 ,$381.48 ,$411.40 ,$195.10 ,$209.44 ,$396.44 ,$195.10 ,$418.88 ,$195.10 ,$406.16 ,$406.16 ,$195.10 ,$406.16 ,$370.70 ,$523.60 ,$374.00 ,$598.40 ,$487.76 ,$195.10 ,$523.60 ,$195.10 ,$448.80 ,$195.10 ,$561.00 ,$412.90 ,$372.50 ,$412.90 ,$195.10 ,$412.90 ,$583.44 ,$583.44 ,$635.80 ,$487.76 ,$518.36 ,$195.10 ,$748.00 ,$411.40 ,$195.10 ,$196.72 ,$748.00 , N/A , N/A ,$204.86 ,$598.40 ,$406.16 ,$209.44 ,$673.20 ,$284.24 ,$325.00 ,$195.10 ,$359.04 
ST. MARY'S HOSPITAL - DECATUR,45000381,26605,HC CLSD METACARPAL FX W/MANIP-LT,450,1 ,$785.00 ,$510.25 ,$195.10 ,$785.00 ,$487.75 ,$400.35 ,$431.75 ,$195.10 ,$219.80 ,$416.05 ,$195.10 ,$439.60 ,$195.10 ,$426.26 ,$426.26 ,$195.10 ,$426.26 ,$370.70 ,$549.50 ,$392.50 ,$628.00 ,$487.76 ,$195.10 ,$549.50 ,$195.10 ,$471.00 ,$195.10 ,$588.75 ,$433.32 ,$390.93 ,$433.32 ,$195.10 ,$433.32 ,$612.30 ,$612.30 ,$667.25 ,$487.76 ,$544.01 ,$195.10 ,$785.00 ,$431.75 ,$195.10 ,$206.46 ,$785.00 , N/A , N/A ,$204.86 ,$628.00 ,$426.26 ,$219.80 ,$706.50 ,$298.30 ,$325.00 ,$195.10 ,$376.80 
ST. MARY'S HOSPITAL - DECATUR,45000382,26605,HC CLSD METACARPAL FX W/MANIP-RT,450,1 ,$785.00 ,$510.25 ,$195.10 ,$785.00 ,$487.75 ,$400.35 ,$431.75 ,$195.10 ,$219.80 ,$416.05 ,$195.10 ,$439.60 ,$195.10 ,$426.26 ,$426.26 ,$195.10 ,$426.26 ,$370.70 ,$549.50 ,$392.50 ,$628.00 ,$487.76 ,$195.10 ,$549.50 ,$195.10 ,$471.00 ,$195.10 ,$588.75 ,$433.32 ,$390.93 ,$433.32 ,$195.10 ,$433.32 ,$612.30 ,$612.30 ,$667.25 ,$487.76 ,$544.01 ,$195.10 ,$785.00 ,$431.75 ,$195.10 ,$206.46 ,$785.00 , N/A , N/A ,$204.86 ,$628.00 ,$426.26 ,$219.80 ,$706.50 ,$298.30 ,$325.00 ,$195.10 ,$376.80 
ST. MARY'S HOSPITAL - DECATUR,45000386,26670,HC HAND DISL W/MANIP W/O ANES-RT,450,1 ,"$1,300.00 ",$845.00 ,$195.10 ,"$1,300.00 ",$487.75 ,$663.00 ,$715.00 ,$195.10 ,$364.00 ,$689.00 ,$195.10 ,$728.00 ,$195.10 ,$705.90 ,$705.90 ,$195.10 ,$705.90 ,$370.70 ,$910.00 ,$650.00 ,"$1,040.00 ",$487.76 ,$195.10 ,$910.00 ,$195.10 ,$780.00 ,$195.10 ,$975.00 ,$717.60 ,$647.40 ,$717.60 ,$195.10 ,$717.60 ,"$1,014.00 ","$1,014.00 ","$1,105.00 ",$487.76 ,$900.90 ,$195.10 ,"$1,300.00 ",$715.00 ,$195.10 ,$341.90 ,"$1,300.00 ", N/A , N/A ,$204.86 ,"$1,040.00 ",$705.90 ,$364.00 ,"$1,170.00 ",$494.00 ,$325.00 ,$195.10 ,$624.00 
ST. MARY'S HOSPITAL - DECATUR,45000387,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-LT,450,1 ,$296.00 ,$192.40 ,$77.85 ,$487.76 ,$487.75 ,$150.96 ,$162.80 ,$195.10 ,$82.88 ,$156.88 ,$195.10 ,$165.76 ,$195.10 ,$160.73 ,$160.73 ,$195.10 ,$160.73 ,$296.00 ,$207.20 ,$148.00 ,$236.80 ,$487.76 ,$195.10 ,$207.20 ,$195.10 ,$177.60 ,$195.10 ,$222.00 ,$163.39 ,$147.41 ,$163.39 ,$195.10 ,$163.39 ,$230.88 ,$230.88 ,$251.60 ,$296.00 ,$205.13 ,$195.10 ,$296.00 ,$162.80 ,$195.10 ,$77.85 ,$296.00 , N/A , N/A ,$204.86 ,$236.80 ,$160.73 ,$82.88 ,$266.40 ,$112.48 ,$296.00 ,$195.10 ,$142.08 
ST. MARY'S HOSPITAL - DECATUR,45000388,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-RT,450,1 ,$296.00 ,$192.40 ,$77.85 ,$487.76 ,$487.75 ,$150.96 ,$162.80 ,$195.10 ,$82.88 ,$156.88 ,$195.10 ,$165.76 ,$195.10 ,$160.73 ,$160.73 ,$195.10 ,$160.73 ,$296.00 ,$207.20 ,$148.00 ,$236.80 ,$487.76 ,$195.10 ,$207.20 ,$195.10 ,$177.60 ,$195.10 ,$222.00 ,$163.39 ,$147.41 ,$163.39 ,$195.10 ,$163.39 ,$230.88 ,$230.88 ,$251.60 ,$296.00 ,$205.13 ,$195.10 ,$296.00 ,$162.80 ,$195.10 ,$77.85 ,$296.00 , N/A , N/A ,$204.86 ,$236.80 ,$160.73 ,$82.88 ,$266.40 ,$112.48 ,$296.00 ,$195.10 ,$142.08 
ST. MARY'S HOSPITAL - DECATUR,45000389,27550,HC CLSD TX KNEE DISLOC W/O ANESTH-LT,450,1 ,$926.00 ,$601.90 ,$195.10 ,$926.00 ,$487.75 ,$472.26 ,$509.30 ,$195.10 ,$259.28 ,$490.78 ,$195.10 ,$518.56 ,$195.10 ,$502.82 ,$502.82 ,$195.10 ,$502.82 ,$370.70 ,$648.20 ,$463.00 ,$740.80 ,$487.76 ,$195.10 ,$648.20 ,$195.10 ,$555.60 ,$195.10 ,$694.50 ,$511.15 ,$461.15 ,$511.15 ,$195.10 ,$511.15 ,$722.28 ,$722.28 ,$787.10 ,$487.76 ,$641.72 ,$195.10 ,$926.00 ,$509.30 ,$195.10 ,$243.54 ,$926.00 , N/A , N/A ,$204.86 ,$740.80 ,$502.82 ,$259.28 ,$833.40 ,$351.88 ,$325.00 ,$195.10 ,$444.48 
ST. MARY'S HOSPITAL - DECATUR,45000390,27550,HC CLSD TX KNEE DISLOC W/O ANESTH-RT,450,1 ,$926.00 ,$601.90 ,$195.10 ,$926.00 ,$487.75 ,$472.26 ,$509.30 ,$195.10 ,$259.28 ,$490.78 ,$195.10 ,$518.56 ,$195.10 ,$502.82 ,$502.82 ,$195.10 ,$502.82 ,$370.70 ,$648.20 ,$463.00 ,$740.80 ,$487.76 ,$195.10 ,$648.20 ,$195.10 ,$555.60 ,$195.10 ,$694.50 ,$511.15 ,$461.15 ,$511.15 ,$195.10 ,$511.15 ,$722.28 ,$722.28 ,$787.10 ,$487.76 ,$641.72 ,$195.10 ,$926.00 ,$509.30 ,$195.10 ,$243.54 ,$926.00 , N/A , N/A ,$204.86 ,$740.80 ,$502.82 ,$259.28 ,$833.40 ,$351.88 ,$325.00 ,$195.10 ,$444.48 
ST. MARY'S HOSPITAL - DECATUR,45000391,27560,HC TX DSL PTLR W/O ANS CL-LT,450,1 ,"$1,194.00 ",$776.10 ,$195.10 ,"$1,194.00 ",$487.75 ,$608.94 ,$656.70 ,$195.10 ,$334.32 ,$632.82 ,$195.10 ,$668.64 ,$195.10 ,$648.34 ,$648.34 ,$195.10 ,$648.34 ,$370.70 ,$835.80 ,$597.00 ,$955.20 ,$487.76 ,$195.10 ,$835.80 ,$195.10 ,$716.40 ,$195.10 ,$895.50 ,$659.09 ,$594.61 ,$659.09 ,$195.10 ,$659.09 ,$931.32 ,$931.32 ,"$1,014.90 ",$487.76 ,$827.44 ,$195.10 ,"$1,194.00 ",$656.70 ,$195.10 ,$314.02 ,"$1,194.00 ", N/A , N/A ,$204.86 ,$955.20 ,$648.34 ,$334.32 ,"$1,074.60 ",$453.72 ,$325.00 ,$195.10 ,$573.12 
ST. MARY'S HOSPITAL - DECATUR,45000392,27560,HC TX DSL PTLR W/O ANS CL-RT,450,1 ,"$1,194.00 ",$776.10 ,$195.10 ,"$1,194.00 ",$487.75 ,$608.94 ,$656.70 ,$195.10 ,$334.32 ,$632.82 ,$195.10 ,$668.64 ,$195.10 ,$648.34 ,$648.34 ,$195.10 ,$648.34 ,$370.70 ,$835.80 ,$597.00 ,$955.20 ,$487.76 ,$195.10 ,$835.80 ,$195.10 ,$716.40 ,$195.10 ,$895.50 ,$659.09 ,$594.61 ,$659.09 ,$195.10 ,$659.09 ,$931.32 ,$931.32 ,"$1,014.90 ",$487.76 ,$827.44 ,$195.10 ,"$1,194.00 ",$656.70 ,$195.10 ,$314.02 ,"$1,194.00 ", N/A , N/A ,$204.86 ,$955.20 ,$648.34 ,$334.32 ,"$1,074.60 ",$453.72 ,$325.00 ,$195.10 ,$573.12 
ST. MARY'S HOSPITAL - DECATUR,45000397,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP-LT,450,1 ,$362.00 ,$235.30 ,$95.21 ,"$3,296.18 ","$3,296.18 ",$184.62 ,$199.10 ,"$1,318.47 ",$101.36 ,$191.86 ,"$1,318.47 ",$202.72 ,$362.00 ,$196.57 ,$196.57 ,$362.00 ,$196.57 ,$362.00 ,$253.40 ,$181.00 ,$289.60 ,"$3,296.17 ","$1,318.47 ",$253.40 ,"$1,318.47 ",$217.20 ,"$1,318.47 ",$271.50 ,$199.82 ,$180.28 ,$199.82 ,"$1,318.47 ",$199.82 ,$282.36 ,$282.36 ,$307.70 ,$362.00 ,$250.87 ,"$1,318.47 ",$362.00 ,$199.10 ,"$1,318.47 ",$95.21 ,$362.00 , N/A , N/A ,"$1,384.39 ",$289.60 ,$196.57 ,$101.36 ,$325.80 ,$137.56 ,$325.00 ,"$1,318.47 ",$173.76 
ST. MARY'S HOSPITAL - DECATUR,45000398,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP-RT,450,1 ,$362.00 ,$235.30 ,$95.21 ,"$3,296.18 ","$3,296.18 ",$184.62 ,$199.10 ,"$1,318.47 ",$101.36 ,$191.86 ,"$1,318.47 ",$202.72 ,$362.00 ,$196.57 ,$196.57 ,$362.00 ,$196.57 ,$362.00 ,$253.40 ,$181.00 ,$289.60 ,"$3,296.17 ","$1,318.47 ",$253.40 ,"$1,318.47 ",$217.20 ,"$1,318.47 ",$271.50 ,$199.82 ,$180.28 ,$199.82 ,"$1,318.47 ",$199.82 ,$282.36 ,$282.36 ,$307.70 ,$362.00 ,$250.87 ,"$1,318.47 ",$362.00 ,$199.10 ,"$1,318.47 ",$95.21 ,$362.00 , N/A , N/A ,"$1,384.39 ",$289.60 ,$196.57 ,$101.36 ,$325.80 ,$137.56 ,$325.00 ,"$1,318.47 ",$173.76 
ST. MARY'S HOSPITAL - DECATUR,45000403,29065,HC APPL CAST ARM LONG-LT,450,1 ,$702.00 ,$456.30 ,$184.63 ,$702.00 ,$570.90 ,$358.02 ,$386.10 ,$228.36 ,$196.56 ,$372.06 ,$228.36 ,$393.12 ,$228.36 ,$381.19 ,$381.19 ,$228.36 ,$381.19 ,$433.88 ,$491.40 ,$351.00 ,$561.60 ,$570.90 ,$228.36 ,$491.40 ,$228.36 ,$421.20 ,$228.36 ,$526.50 ,$387.50 ,$349.60 ,$387.50 ,$228.36 ,$387.50 ,$547.56 ,$547.56 ,$596.70 ,$570.90 ,$486.49 ,$228.36 ,$702.00 ,$386.10 ,$228.36 ,$184.63 ,$702.00 , N/A , N/A ,$239.78 ,$561.60 ,$381.19 ,$196.56 ,$631.80 ,$266.76 ,$325.00 ,$228.36 ,$336.96 
ST. MARY'S HOSPITAL - DECATUR,45000404,29065,HC APPL CAST ARM LONG-RT,450,1 ,$702.00 ,$456.30 ,$184.63 ,$702.00 ,$570.90 ,$358.02 ,$386.10 ,$228.36 ,$196.56 ,$372.06 ,$228.36 ,$393.12 ,$228.36 ,$381.19 ,$381.19 ,$228.36 ,$381.19 ,$433.88 ,$491.40 ,$351.00 ,$561.60 ,$570.90 ,$228.36 ,$491.40 ,$228.36 ,$421.20 ,$228.36 ,$526.50 ,$387.50 ,$349.60 ,$387.50 ,$228.36 ,$387.50 ,$547.56 ,$547.56 ,$596.70 ,$570.90 ,$486.49 ,$228.36 ,$702.00 ,$386.10 ,$228.36 ,$184.63 ,$702.00 , N/A , N/A ,$239.78 ,$561.60 ,$381.19 ,$196.56 ,$631.80 ,$266.76 ,$325.00 ,$228.36 ,$336.96 
ST. MARY'S HOSPITAL - DECATUR,45000405,29105,HC APPL SPLNT ARM LONG-LT,450,1 ,$869.00 ,$564.85 ,$133.74 ,$869.00 ,$334.35 ,$443.19 ,$477.95 ,$133.74 ,$243.32 ,$460.57 ,$133.74 ,$486.64 ,$133.74 ,$471.87 ,$471.87 ,$133.74 ,$471.87 ,$254.10 ,$608.30 ,$434.50 ,$695.20 ,$334.34 ,$133.74 ,$608.30 ,$133.74 ,$521.40 ,$133.74 ,$651.75 ,$479.69 ,$432.76 ,$479.69 ,$133.74 ,$479.69 ,$677.82 ,$677.82 ,$738.65 ,$334.34 ,$602.22 ,$133.74 ,$869.00 ,$477.95 ,$133.74 ,$228.55 ,$869.00 , N/A , N/A ,$140.43 ,$695.20 ,$471.87 ,$243.32 ,$782.10 ,$330.22 ,$325.00 ,$133.74 ,$417.12 
ST. MARY'S HOSPITAL - DECATUR,45000406,29105,HC APPL SPLNT ARM LONG-RT,450,1 ,$869.00 ,$564.85 ,$133.74 ,$869.00 ,$334.35 ,$443.19 ,$477.95 ,$133.74 ,$243.32 ,$460.57 ,$133.74 ,$486.64 ,$133.74 ,$471.87 ,$471.87 ,$133.74 ,$471.87 ,$254.10 ,$608.30 ,$434.50 ,$695.20 ,$334.34 ,$133.74 ,$608.30 ,$133.74 ,$521.40 ,$133.74 ,$651.75 ,$479.69 ,$432.76 ,$479.69 ,$133.74 ,$479.69 ,$677.82 ,$677.82 ,$738.65 ,$334.34 ,$602.22 ,$133.74 ,$869.00 ,$477.95 ,$133.74 ,$228.55 ,$869.00 , N/A , N/A ,$140.43 ,$695.20 ,$471.87 ,$243.32 ,$782.10 ,$330.22 ,$325.00 ,$133.74 ,$417.12 
ST. MARY'S HOSPITAL - DECATUR,45000407,29126,HC APPL SHRT ARM SPLNT DYNAM-LT,450,1 ,$800.00 ,$520.00 ,$106.74 ,$800.00 ,$266.85 ,$408.00 ,$440.00 ,$106.74 ,$224.00 ,$424.00 ,$106.74 ,$448.00 ,$106.74 ,$434.40 ,$434.40 ,$106.74 ,$434.40 ,$202.80 ,$560.00 ,$400.00 ,$640.00 ,$266.84 ,$106.74 ,$560.00 ,$106.74 ,$480.00 ,$106.74 ,$600.00 ,$441.60 ,$398.40 ,$441.60 ,$106.74 ,$441.60 ,$624.00 ,$624.00 ,$680.00 ,$266.84 ,$554.40 ,$106.74 ,$800.00 ,$440.00 ,$106.74 ,$210.40 ,$800.00 , N/A , N/A ,$112.08 ,$640.00 ,$434.40 ,$224.00 ,$720.00 ,$304.00 ,$325.00 ,$106.74 ,$384.00 
ST. MARY'S HOSPITAL - DECATUR,45000408,29126,HC APPL SHRT ARM SPLNT DYNAM-RT,450,1 ,$800.00 ,$520.00 ,$106.74 ,$800.00 ,$266.85 ,$408.00 ,$440.00 ,$106.74 ,$224.00 ,$424.00 ,$106.74 ,$448.00 ,$106.74 ,$434.40 ,$434.40 ,$106.74 ,$434.40 ,$202.80 ,$560.00 ,$400.00 ,$640.00 ,$266.84 ,$106.74 ,$560.00 ,$106.74 ,$480.00 ,$106.74 ,$600.00 ,$441.60 ,$398.40 ,$441.60 ,$106.74 ,$441.60 ,$624.00 ,$624.00 ,$680.00 ,$266.84 ,$554.40 ,$106.74 ,$800.00 ,$440.00 ,$106.74 ,$210.40 ,$800.00 , N/A , N/A ,$112.08 ,$640.00 ,$434.40 ,$224.00 ,$720.00 ,$304.00 ,$325.00 ,$106.74 ,$384.00 
ST. MARY'S HOSPITAL - DECATUR,45000409,29240,HC STRAPPING SHLDR-LT,450,1 ,$987.00 ,$641.55 ,$106.74 ,$987.00 ,$266.85 ,$503.37 ,$542.85 ,$106.74 ,$276.36 ,$523.11 ,$106.74 ,$552.72 ,$106.74 ,$535.94 ,$535.94 ,$106.74 ,$535.94 ,$202.80 ,$690.90 ,$493.50 ,$789.60 ,$266.84 ,$106.74 ,$690.90 ,$106.74 ,$592.20 ,$106.74 ,$740.25 ,$544.82 ,$491.53 ,$544.82 ,$106.74 ,$544.82 ,$769.86 ,$769.86 ,$838.95 ,$266.84 ,$683.99 ,$106.74 ,$987.00 ,$542.85 ,$106.74 ,$259.58 ,$987.00 , N/A , N/A ,$112.08 ,$789.60 ,$535.94 ,$276.36 ,$888.30 ,$375.06 ,$325.00 ,$106.74 ,$473.76 
ST. MARY'S HOSPITAL - DECATUR,45000410,29240,HC STRAPPING SHLDR-RT,450,1 ,$987.00 ,$641.55 ,$106.74 ,$987.00 ,$266.85 ,$503.37 ,$542.85 ,$106.74 ,$276.36 ,$523.11 ,$106.74 ,$552.72 ,$106.74 ,$535.94 ,$535.94 ,$106.74 ,$535.94 ,$202.80 ,$690.90 ,$493.50 ,$789.60 ,$266.84 ,$106.74 ,$690.90 ,$106.74 ,$592.20 ,$106.74 ,$740.25 ,$544.82 ,$491.53 ,$544.82 ,$106.74 ,$544.82 ,$769.86 ,$769.86 ,$838.95 ,$266.84 ,$683.99 ,$106.74 ,$987.00 ,$542.85 ,$106.74 ,$259.58 ,$987.00 , N/A , N/A ,$112.08 ,$789.60 ,$535.94 ,$276.36 ,$888.30 ,$375.06 ,$325.00 ,$106.74 ,$473.76 
ST. MARY'S HOSPITAL - DECATUR,45000411,29260,HC STRAPPING ELBOW/WRIST-LT,450,1 ,$987.00 ,$641.55 ,$52.69 ,$987.00 ,$131.73 ,$503.37 ,$542.85 ,$52.69 ,$276.36 ,$523.11 ,$52.69 ,$552.72 ,$52.69 ,$535.94 ,$535.94 ,$52.69 ,$535.94 ,$100.11 ,$690.90 ,$493.50 ,$789.60 ,$131.73 ,$52.69 ,$690.90 ,$52.69 ,$592.20 ,$52.69 ,$740.25 ,$544.82 ,$491.53 ,$544.82 ,$52.69 ,$544.82 ,$769.86 ,$769.86 ,$838.95 ,$131.73 ,$683.99 ,$52.69 ,$987.00 ,$542.85 ,$52.69 ,$259.58 ,$987.00 , N/A , N/A ,$55.32 ,$789.60 ,$535.94 ,$276.36 ,$888.30 ,$375.06 ,$325.00 ,$52.69 ,$473.76 
ST. MARY'S HOSPITAL - DECATUR,45000412,29260,HC STRAPPING ELBOW/WRIST-RT,450,1 ,$987.00 ,$641.55 ,$52.69 ,$987.00 ,$131.73 ,$503.37 ,$542.85 ,$52.69 ,$276.36 ,$523.11 ,$52.69 ,$552.72 ,$52.69 ,$535.94 ,$535.94 ,$52.69 ,$535.94 ,$100.11 ,$690.90 ,$493.50 ,$789.60 ,$131.73 ,$52.69 ,$690.90 ,$52.69 ,$592.20 ,$52.69 ,$740.25 ,$544.82 ,$491.53 ,$544.82 ,$52.69 ,$544.82 ,$769.86 ,$769.86 ,$838.95 ,$131.73 ,$683.99 ,$52.69 ,$987.00 ,$542.85 ,$52.69 ,$259.58 ,$987.00 , N/A , N/A ,$55.32 ,$789.60 ,$535.94 ,$276.36 ,$888.30 ,$375.06 ,$325.00 ,$52.69 ,$473.76 
ST. MARY'S HOSPITAL - DECATUR,45000413,29345,HC LONG LEG CAST-LT,450,1 ,$854.00 ,$555.10 ,$224.60 ,$854.00 ,$570.90 ,$435.54 ,$469.70 ,$228.36 ,$239.12 ,$452.62 ,$228.36 ,$478.24 ,$228.36 ,$463.72 ,$463.72 ,$228.36 ,$463.72 ,$433.88 ,$597.80 ,$427.00 ,$683.20 ,$570.90 ,$228.36 ,$597.80 ,$228.36 ,$512.40 ,$228.36 ,$640.50 ,$471.41 ,$425.29 ,$471.41 ,$228.36 ,$471.41 ,$666.12 ,$666.12 ,$725.90 ,$570.90 ,$591.82 ,$228.36 ,$854.00 ,$469.70 ,$228.36 ,$224.60 ,$854.00 , N/A , N/A ,$239.78 ,$683.20 ,$463.72 ,$239.12 ,$768.60 ,$324.52 ,$325.00 ,$228.36 ,$409.92 
ST. MARY'S HOSPITAL - DECATUR,45000414,29345,HC LONG LEG CAST-RT,450,1 ,$854.00 ,$555.10 ,$224.60 ,$854.00 ,$570.90 ,$435.54 ,$469.70 ,$228.36 ,$239.12 ,$452.62 ,$228.36 ,$478.24 ,$228.36 ,$463.72 ,$463.72 ,$228.36 ,$463.72 ,$433.88 ,$597.80 ,$427.00 ,$683.20 ,$570.90 ,$228.36 ,$597.80 ,$228.36 ,$512.40 ,$228.36 ,$640.50 ,$471.41 ,$425.29 ,$471.41 ,$228.36 ,$471.41 ,$666.12 ,$666.12 ,$725.90 ,$570.90 ,$591.82 ,$228.36 ,$854.00 ,$469.70 ,$228.36 ,$224.60 ,$854.00 , N/A , N/A ,$239.78 ,$683.20 ,$463.72 ,$239.12 ,$768.60 ,$324.52 ,$325.00 ,$228.36 ,$409.92 
ST. MARY'S HOSPITAL - DECATUR,45000415,29405,HC APPLY SHORT LEG CAST-LT,450,1 ,$677.00 ,$440.05 ,$178.05 ,$677.00 ,$570.90 ,$345.27 ,$372.35 ,$228.36 ,$189.56 ,$358.81 ,$228.36 ,$379.12 ,$228.36 ,$367.61 ,$367.61 ,$228.36 ,$367.61 ,$433.88 ,$473.90 ,$338.50 ,$541.60 ,$570.90 ,$228.36 ,$473.90 ,$228.36 ,$406.20 ,$228.36 ,$507.75 ,$373.70 ,$337.15 ,$373.70 ,$228.36 ,$373.70 ,$528.06 ,$528.06 ,$575.45 ,$570.90 ,$469.16 ,$228.36 ,$677.00 ,$372.35 ,$228.36 ,$178.05 ,$677.00 , N/A , N/A ,$239.78 ,$541.60 ,$367.61 ,$189.56 ,$609.30 ,$257.26 ,$325.00 ,$228.36 ,$324.96 
ST. MARY'S HOSPITAL - DECATUR,45000416,29405,HC APPLY SHORT LEG CAST-RT,450,1 ,$677.00 ,$440.05 ,$178.05 ,$677.00 ,$570.90 ,$345.27 ,$372.35 ,$228.36 ,$189.56 ,$358.81 ,$228.36 ,$379.12 ,$228.36 ,$367.61 ,$367.61 ,$228.36 ,$367.61 ,$433.88 ,$473.90 ,$338.50 ,$541.60 ,$570.90 ,$228.36 ,$473.90 ,$228.36 ,$406.20 ,$228.36 ,$507.75 ,$373.70 ,$337.15 ,$373.70 ,$228.36 ,$373.70 ,$528.06 ,$528.06 ,$575.45 ,$570.90 ,$469.16 ,$228.36 ,$677.00 ,$372.35 ,$228.36 ,$178.05 ,$677.00 , N/A , N/A ,$239.78 ,$541.60 ,$367.61 ,$189.56 ,$609.30 ,$257.26 ,$325.00 ,$228.36 ,$324.96 
ST. MARY'S HOSPITAL - DECATUR,45000417,29505,HC APPL LONG LEG SPLNT-LT,450,1 ,$680.00 ,$442.00 ,$133.74 ,$680.00 ,$334.35 ,$346.80 ,$374.00 ,$133.74 ,$190.40 ,$360.40 ,$133.74 ,$380.80 ,$133.74 ,$369.24 ,$369.24 ,$133.74 ,$369.24 ,$254.10 ,$476.00 ,$340.00 ,$544.00 ,$334.34 ,$133.74 ,$476.00 ,$133.74 ,$408.00 ,$133.74 ,$510.00 ,$375.36 ,$338.64 ,$375.36 ,$133.74 ,$375.36 ,$530.40 ,$530.40 ,$578.00 ,$334.34 ,$471.24 ,$133.74 ,$680.00 ,$374.00 ,$133.74 ,$178.84 ,$680.00 , N/A , N/A ,$140.43 ,$544.00 ,$369.24 ,$190.40 ,$612.00 ,$258.40 ,$325.00 ,$133.74 ,$326.40 
ST. MARY'S HOSPITAL - DECATUR,45000418,29505,HC APPL LONG LEG SPLNT-RT,450,1 ,$680.00 ,$442.00 ,$133.74 ,$680.00 ,$334.35 ,$346.80 ,$374.00 ,$133.74 ,$190.40 ,$360.40 ,$133.74 ,$380.80 ,$133.74 ,$369.24 ,$369.24 ,$133.74 ,$369.24 ,$254.10 ,$476.00 ,$340.00 ,$544.00 ,$334.34 ,$133.74 ,$476.00 ,$133.74 ,$408.00 ,$133.74 ,$510.00 ,$375.36 ,$338.64 ,$375.36 ,$133.74 ,$375.36 ,$530.40 ,$530.40 ,$578.00 ,$334.34 ,$471.24 ,$133.74 ,$680.00 ,$374.00 ,$133.74 ,$178.84 ,$680.00 , N/A , N/A ,$140.43 ,$544.00 ,$369.24 ,$190.40 ,$612.00 ,$258.40 ,$325.00 ,$133.74 ,$326.40 
ST. MARY'S HOSPITAL - DECATUR,45000419,29515,HC APPL SHRT LEG SPLNT FAC-LT,450,1 ,$638.00 ,$414.70 ,$133.74 ,$638.00 ,$334.35 ,$325.38 ,$350.90 ,$133.74 ,$178.64 ,$338.14 ,$133.74 ,$357.28 ,$133.74 ,$346.43 ,$346.43 ,$133.74 ,$346.43 ,$254.10 ,$446.60 ,$319.00 ,$510.40 ,$334.34 ,$133.74 ,$446.60 ,$133.74 ,$382.80 ,$133.74 ,$478.50 ,$352.18 ,$317.72 ,$352.18 ,$133.74 ,$352.18 ,$497.64 ,$497.64 ,$542.30 ,$334.34 ,$442.13 ,$133.74 ,$638.00 ,$350.90 ,$133.74 ,$167.79 ,$638.00 , N/A , N/A ,$140.43 ,$510.40 ,$346.43 ,$178.64 ,$574.20 ,$242.44 ,$325.00 ,$133.74 ,$306.24 
ST. MARY'S HOSPITAL - DECATUR,45000420,29515,HC APPL SHRT LEG SPLNT FAC-RT,450,1 ,$638.00 ,$414.70 ,$133.74 ,$638.00 ,$334.35 ,$325.38 ,$350.90 ,$133.74 ,$178.64 ,$338.14 ,$133.74 ,$357.28 ,$133.74 ,$346.43 ,$346.43 ,$133.74 ,$346.43 ,$254.10 ,$446.60 ,$319.00 ,$510.40 ,$334.34 ,$133.74 ,$446.60 ,$133.74 ,$382.80 ,$133.74 ,$478.50 ,$352.18 ,$317.72 ,$352.18 ,$133.74 ,$352.18 ,$497.64 ,$497.64 ,$542.30 ,$334.34 ,$442.13 ,$133.74 ,$638.00 ,$350.90 ,$133.74 ,$167.79 ,$638.00 , N/A , N/A ,$140.43 ,$510.40 ,$346.43 ,$178.64 ,$574.20 ,$242.44 ,$325.00 ,$133.74 ,$306.24 
ST. MARY'S HOSPITAL - DECATUR,45000421,29530,HC STRAPPING KNEE-LT,450,1 ,$484.00 ,$314.60 ,$106.74 ,$484.00 ,$266.85 ,$246.84 ,$266.20 ,$106.74 ,$135.52 ,$256.52 ,$106.74 ,$271.04 ,$106.74 ,$262.81 ,$262.81 ,$106.74 ,$262.81 ,$202.80 ,$338.80 ,$242.00 ,$387.20 ,$266.84 ,$106.74 ,$338.80 ,$106.74 ,$290.40 ,$106.74 ,$363.00 ,$267.17 ,$241.03 ,$267.17 ,$106.74 ,$267.17 ,$377.52 ,$377.52 ,$411.40 ,$266.84 ,$335.41 ,$106.74 ,$484.00 ,$266.20 ,$106.74 ,$127.29 ,$484.00 , N/A , N/A ,$112.08 ,$387.20 ,$262.81 ,$135.52 ,$435.60 ,$183.92 ,$325.00 ,$106.74 ,$232.32 
ST. MARY'S HOSPITAL - DECATUR,45000422,29530,HC STRAPPING KNEE-RT,450,1 ,$484.00 ,$314.60 ,$106.74 ,$484.00 ,$266.85 ,$246.84 ,$266.20 ,$106.74 ,$135.52 ,$256.52 ,$106.74 ,$271.04 ,$106.74 ,$262.81 ,$262.81 ,$106.74 ,$262.81 ,$202.80 ,$338.80 ,$242.00 ,$387.20 ,$266.84 ,$106.74 ,$338.80 ,$106.74 ,$290.40 ,$106.74 ,$363.00 ,$267.17 ,$241.03 ,$267.17 ,$106.74 ,$267.17 ,$377.52 ,$377.52 ,$411.40 ,$266.84 ,$335.41 ,$106.74 ,$484.00 ,$266.20 ,$106.74 ,$127.29 ,$484.00 , N/A , N/A ,$112.08 ,$387.20 ,$262.81 ,$135.52 ,$435.60 ,$183.92 ,$325.00 ,$106.74 ,$232.32 
ST. MARY'S HOSPITAL - DECATUR,45000425,30901,HC CNTRL NOSEBLEED ANT SMP-LT,450,1 ,$935.00 ,$607.75 ,$106.74 ,$935.00 ,$266.85 ,$476.85 ,$514.25 ,$106.74 ,$261.80 ,$495.55 ,$106.74 ,$523.60 ,$106.74 ,$507.71 ,$507.71 ,$106.74 ,$507.71 ,$202.80 ,$654.50 ,$467.50 ,$748.00 ,$266.84 ,$106.74 ,$654.50 ,$106.74 ,$561.00 ,$106.74 ,$701.25 ,$516.12 ,$465.63 ,$516.12 ,$106.74 ,$516.12 ,$729.30 ,$729.30 ,$794.75 ,$266.84 ,$647.96 ,$106.74 ,$935.00 ,$514.25 ,$106.74 ,$245.91 ,$935.00 , N/A , N/A ,$112.08 ,$748.00 ,$507.71 ,$261.80 ,$841.50 ,$355.30 ,$325.00 ,$106.74 ,$448.80 
ST. MARY'S HOSPITAL - DECATUR,45000426,30901,HC CNTRL NOSEBLEED ANT SMP-RT,450,1 ,$935.00 ,$607.75 ,$106.74 ,$935.00 ,$266.85 ,$476.85 ,$514.25 ,$106.74 ,$261.80 ,$495.55 ,$106.74 ,$523.60 ,$106.74 ,$507.71 ,$507.71 ,$106.74 ,$507.71 ,$202.80 ,$654.50 ,$467.50 ,$748.00 ,$266.84 ,$106.74 ,$654.50 ,$106.74 ,$561.00 ,$106.74 ,$701.25 ,$516.12 ,$465.63 ,$516.12 ,$106.74 ,$516.12 ,$729.30 ,$729.30 ,$794.75 ,$266.84 ,$647.96 ,$106.74 ,$935.00 ,$514.25 ,$106.74 ,$245.91 ,$935.00 , N/A , N/A ,$112.08 ,$748.00 ,$507.71 ,$261.80 ,$841.50 ,$355.30 ,$325.00 ,$106.74 ,$448.80 
ST. MARY'S HOSPITAL - DECATUR,45000427,30903,HC CNTRL NOSEBLEED ANT CPLX-LT,450,1 ,$488.00 ,$317.20 ,$106.74 ,$488.00 ,$266.85 ,$248.88 ,$268.40 ,$106.74 ,$136.64 ,$258.64 ,$106.74 ,$273.28 ,$106.74 ,$264.98 ,$264.98 ,$106.74 ,$264.98 ,$202.80 ,$341.60 ,$244.00 ,$390.40 ,$266.84 ,$106.74 ,$341.60 ,$106.74 ,$292.80 ,$106.74 ,$366.00 ,$269.38 ,$243.02 ,$269.38 ,$106.74 ,$269.38 ,$380.64 ,$380.64 ,$414.80 ,$266.84 ,$338.18 ,$106.74 ,$488.00 ,$268.40 ,$106.74 ,$128.34 ,$488.00 , N/A , N/A ,$112.08 ,$390.40 ,$264.98 ,$136.64 ,$439.20 ,$185.44 ,$325.00 ,$106.74 ,$234.24 
ST. MARY'S HOSPITAL - DECATUR,45000428,30903,HC CNTRL NOSEBLEED ANT CPLX-RT,450,1 ,$488.00 ,$317.20 ,$106.74 ,$488.00 ,$266.85 ,$248.88 ,$268.40 ,$106.74 ,$136.64 ,$258.64 ,$106.74 ,$273.28 ,$106.74 ,$264.98 ,$264.98 ,$106.74 ,$264.98 ,$202.80 ,$341.60 ,$244.00 ,$390.40 ,$266.84 ,$106.74 ,$341.60 ,$106.74 ,$292.80 ,$106.74 ,$366.00 ,$269.38 ,$243.02 ,$269.38 ,$106.74 ,$269.38 ,$380.64 ,$380.64 ,$414.80 ,$266.84 ,$338.18 ,$106.74 ,$488.00 ,$268.40 ,$106.74 ,$128.34 ,$488.00 , N/A , N/A ,$112.08 ,$390.40 ,$264.98 ,$136.64 ,$439.20 ,$185.44 ,$325.00 ,$106.74 ,$234.24 
ST. MARY'S HOSPITAL - DECATUR,45000431,32551,HC TUBE THORACOSTOMY-LT,450,1 ,"$2,583.00 ","$1,678.95 ",$325.00 ,"$3,327.80 ","$3,327.80 ","$1,317.33 ","$1,420.65 ","$1,331.12 ",$723.24 ,"$1,368.99 ","$1,331.12 ","$1,446.48 ","$1,331.12 ","$1,402.57 ","$1,402.57 ","$1,331.12 ","$1,402.57 ","$2,529.13 ","$1,808.10 ","$1,291.50 ","$2,066.40 ","$3,327.80 ","$1,331.12 ","$1,808.10 ","$1,331.12 ","$1,549.80 ","$1,331.12 ","$1,937.25 ","$1,425.82 ","$1,286.33 ","$1,425.82 ","$1,331.12 ","$1,425.82 ","$2,014.74 ","$2,014.74 ","$2,195.55 ","$2,583.00 ","$1,790.02 ","$1,331.12 ","$2,583.00 ","$1,420.65 ","$1,331.12 ",$679.33 ,"$2,583.00 ", N/A , N/A ,"$1,397.68 ","$2,066.40 ","$1,402.57 ",$723.24 ,"$2,324.70 ",$981.54 ,$325.00 ,"$1,331.12 ","$1,239.84 "
ST. MARY'S HOSPITAL - DECATUR,45000432,32551,HC TUBE THORACOSTOMY-RT,450,1 ,"$2,583.00 ","$1,678.95 ",$325.00 ,"$3,327.80 ","$3,327.80 ","$1,317.33 ","$1,420.65 ","$1,331.12 ",$723.24 ,"$1,368.99 ","$1,331.12 ","$1,446.48 ","$1,331.12 ","$1,402.57 ","$1,402.57 ","$1,331.12 ","$1,402.57 ","$2,529.13 ","$1,808.10 ","$1,291.50 ","$2,066.40 ","$3,327.80 ","$1,331.12 ","$1,808.10 ","$1,331.12 ","$1,549.80 ","$1,331.12 ","$1,937.25 ","$1,425.82 ","$1,286.33 ","$1,425.82 ","$1,331.12 ","$1,425.82 ","$2,014.74 ","$2,014.74 ","$2,195.55 ","$2,583.00 ","$1,790.02 ","$1,331.12 ","$2,583.00 ","$1,420.65 ","$1,331.12 ",$679.33 ,"$2,583.00 ", N/A , N/A ,"$1,397.68 ","$2,066.40 ","$1,402.57 ",$723.24 ,"$2,324.70 ",$981.54 ,$325.00 ,"$1,331.12 ","$1,239.84 "
ST. MARY'S HOSPITAL - DECATUR,45000433,32554,HC THORACENTESIS ASPIRATION WO IMAGING-LT,450,1 ,"$3,094.00 ","$2,011.10 ",$325.00 ,"$3,094.00 ","$1,279.15 ","$1,577.94 ","$1,701.70 ",$511.66 ,$866.32 ,"$1,639.82 ",$511.66 ,"$1,732.64 ",$511.66 ,"$1,680.04 ","$1,680.04 ",$511.66 ,"$1,680.04 ",$972.16 ,"$2,165.80 ","$1,547.00 ","$2,475.20 ","$1,279.16 ",$511.66 ,"$2,165.80 ",$511.66 ,"$1,856.40 ",$511.66 ,"$2,320.50 ","$1,566.00 ","$1,408.00 ","$1,566.00 ",$511.66 ,"$1,566.00 ","$2,413.32 ","$2,413.32 ","$2,629.90 ","$1,279.16 ","$2,144.14 ",$511.66 ,"$3,094.00 ","$1,701.70 ",$511.66 ,$813.72 ,"$3,094.00 ", N/A , N/A ,$537.24 ,"$2,475.20 ","$1,680.04 ",$866.32 ,"$2,784.60 ","$1,175.72 ",$325.00 ,$511.66 ,"$1,485.12 "
ST. MARY'S HOSPITAL - DECATUR,45000434,32554,HC THORACENTESIS ASPIRATION WO IMAGING-RT,450,1 ,"$3,094.00 ","$2,011.10 ",$325.00 ,"$3,094.00 ","$1,279.15 ","$1,577.94 ","$1,701.70 ",$511.66 ,$866.32 ,"$1,639.82 ",$511.66 ,"$1,732.64 ",$511.66 ,"$1,680.04 ","$1,680.04 ",$511.66 ,"$1,680.04 ",$972.16 ,"$2,165.80 ","$1,547.00 ","$2,475.20 ","$1,279.16 ",$511.66 ,"$2,165.80 ",$511.66 ,"$1,856.40 ",$511.66 ,"$2,320.50 ","$1,566.00 ","$1,408.00 ","$1,566.00 ",$511.66 ,"$1,566.00 ","$2,413.32 ","$2,413.32 ","$2,629.90 ","$1,279.16 ","$2,144.14 ",$511.66 ,"$3,094.00 ","$1,701.70 ",$511.66 ,$813.72 ,"$3,094.00 ", N/A , N/A ,$537.24 ,"$2,475.20 ","$1,680.04 ",$866.32 ,"$2,784.60 ","$1,175.72 ",$325.00 ,$511.66 ,"$1,485.12 "
ST. MARY'S HOSPITAL - DECATUR,45000439,64450,HC INJ ANES OTHER THAN PERIPHERAL-LT,450,1 ,"$1,890.00 ","$1,228.50 ",$325.00 ,"$1,890.00 ","$1,502.73 ",$963.90 ,"$1,039.50 ",$601.09 ,$529.20 ,"$1,001.70 ",$601.09 ,"$1,058.40 ",$601.09 ,"$1,026.27 ","$1,026.27 ",$601.09 ,"$1,026.27 ","$1,142.07 ","$1,323.00 ",$945.00 ,"$1,512.00 ","$1,502.72 ",$601.09 ,"$1,323.00 ",$601.09 ,"$1,134.00 ",$601.09 ,"$1,417.50 ","$1,043.28 ",$941.22 ,"$1,043.28 ",$601.09 ,"$1,043.28 ","$1,474.20 ","$1,474.20 ","$1,606.50 ","$1,502.72 ","$1,309.77 ",$601.09 ,"$1,890.00 ","$1,039.50 ",$601.09 ,$497.07 ,"$1,890.00 ", N/A , N/A ,$631.14 ,"$1,512.00 ","$1,026.27 ",$529.20 ,"$1,701.00 ",$718.20 ,$325.00 ,$601.09 ,$907.20 
ST. MARY'S HOSPITAL - DECATUR,45000440,64450,HC INJ ANES OTHER THAN PERIPHERAL-RT,450,1 ,"$1,890.00 ","$1,228.50 ",$325.00 ,"$1,890.00 ","$1,502.73 ",$963.90 ,"$1,039.50 ",$601.09 ,$529.20 ,"$1,001.70 ",$601.09 ,"$1,058.40 ",$601.09 ,"$1,026.27 ","$1,026.27 ",$601.09 ,"$1,026.27 ","$1,142.07 ","$1,323.00 ",$945.00 ,"$1,512.00 ","$1,502.72 ",$601.09 ,"$1,323.00 ",$601.09 ,"$1,134.00 ",$601.09 ,"$1,417.50 ","$1,043.28 ",$941.22 ,"$1,043.28 ",$601.09 ,"$1,043.28 ","$1,474.20 ","$1,474.20 ","$1,606.50 ","$1,502.72 ","$1,309.77 ",$601.09 ,"$1,890.00 ","$1,039.50 ",$601.09 ,$497.07 ,"$1,890.00 ", N/A , N/A ,$631.14 ,"$1,512.00 ","$1,026.27 ",$529.20 ,"$1,701.00 ",$718.20 ,$325.00 ,$601.09 ,$907.20 
ST. MARY'S HOSPITAL - DECATUR,45000443,65220,HC REMOVE FB CORNL W/O SLIT LAMP-LT,450,1 ,"$1,014.00 ",$659.10 ,$256.91 ,"$1,014.00 ",$642.28 ,$517.14 ,$557.70 ,$256.91 ,$283.92 ,$537.42 ,$256.91 ,$567.84 ,$256.91 ,$550.60 ,$550.60 ,$256.91 ,$550.60 ,$488.12 ,$709.80 ,$507.00 ,$811.20 ,$642.27 ,$256.91 ,$709.80 ,$256.91 ,$608.40 ,$256.91 ,$760.50 ,$559.73 ,$504.97 ,$559.73 ,$256.91 ,$559.73 ,$790.92 ,$790.92 ,$861.90 ,$642.27 ,$702.70 ,$256.91 ,"$1,014.00 ",$557.70 ,$256.91 ,$266.68 ,"$1,014.00 ", N/A , N/A ,$269.76 ,$811.20 ,$550.60 ,$283.92 ,$912.60 ,$385.32 ,$325.00 ,$256.91 ,$486.72 
ST. MARY'S HOSPITAL - DECATUR,45000444,65220,HC REMOVE FB CORNL W/O SLIT LAMP-RT,450,1 ,"$1,014.00 ",$659.10 ,$256.91 ,"$1,014.00 ",$642.28 ,$517.14 ,$557.70 ,$256.91 ,$283.92 ,$537.42 ,$256.91 ,$567.84 ,$256.91 ,$550.60 ,$550.60 ,$256.91 ,$550.60 ,$488.12 ,$709.80 ,$507.00 ,$811.20 ,$642.27 ,$256.91 ,$709.80 ,$256.91 ,$608.40 ,$256.91 ,$760.50 ,$559.73 ,$504.97 ,$559.73 ,$256.91 ,$559.73 ,$790.92 ,$790.92 ,$861.90 ,$642.27 ,$702.70 ,$256.91 ,"$1,014.00 ",$557.70 ,$256.91 ,$266.68 ,"$1,014.00 ", N/A , N/A ,$269.76 ,$811.20 ,$550.60 ,$283.92 ,$912.60 ,$385.32 ,$325.00 ,$256.91 ,$486.72 
ST. MARY'S HOSPITAL - DECATUR,45000445,65222,HC REMOVE FB CORNL W/ SLIT LAMP-LT,450,1 ,$397.00 ,$258.05 ,$104.41 ,$397.00 ,$266.85 ,$202.47 ,$218.35 ,$106.74 ,$111.16 ,$210.41 ,$106.74 ,$222.32 ,$106.74 ,$215.57 ,$215.57 ,$106.74 ,$215.57 ,$202.80 ,$277.90 ,$198.50 ,$317.60 ,$266.84 ,$106.74 ,$277.90 ,$106.74 ,$238.20 ,$106.74 ,$297.75 ,$219.14 ,$197.71 ,$219.14 ,$106.74 ,$219.14 ,$309.66 ,$309.66 ,$337.45 ,$266.84 ,$275.12 ,$106.74 ,$397.00 ,$218.35 ,$106.74 ,$104.41 ,$397.00 , N/A , N/A ,$112.08 ,$317.60 ,$215.57 ,$111.16 ,$357.30 ,$150.86 ,$325.00 ,$106.74 ,$190.56 
ST. MARY'S HOSPITAL - DECATUR,45000446,65222,HC REMOVE FB CORNL W/ SLIT LAMP-RT,450,1 ,$397.00 ,$258.05 ,$104.41 ,$397.00 ,$266.85 ,$202.47 ,$218.35 ,$106.74 ,$111.16 ,$210.41 ,$106.74 ,$222.32 ,$106.74 ,$215.57 ,$215.57 ,$106.74 ,$215.57 ,$202.80 ,$277.90 ,$198.50 ,$317.60 ,$266.84 ,$106.74 ,$277.90 ,$106.74 ,$238.20 ,$106.74 ,$297.75 ,$219.14 ,$197.71 ,$219.14 ,$106.74 ,$219.14 ,$309.66 ,$309.66 ,$337.45 ,$266.84 ,$275.12 ,$106.74 ,$397.00 ,$218.35 ,$106.74 ,$104.41 ,$397.00 , N/A , N/A ,$112.08 ,$317.60 ,$215.57 ,$111.16 ,$357.30 ,$150.86 ,$325.00 ,$106.74 ,$190.56 
ST. MARY'S HOSPITAL - DECATUR,45000451,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-LT,450,1 ,"$1,243.00 ",$807.95 ,$325.00 ,"$1,472.65 ","$1,472.65 ",$633.93 ,$683.65 ,$589.06 ,$348.04 ,$658.79 ,$589.06 ,$696.08 ,$589.06 ,$674.95 ,$674.95 ,$589.06 ,$674.95 ,"$1,119.21 ",$870.10 ,$621.50 ,$994.40 ,"$1,472.64 ",$589.06 ,$870.10 ,$589.06 ,$745.80 ,$589.06 ,$932.25 ,$686.14 ,$619.01 ,$686.14 ,$589.06 ,$686.14 ,$969.54 ,$969.54 ,"$1,056.55 ","$1,243.00 ",$861.40 ,$589.06 ,"$1,243.00 ",$683.65 ,$589.06 ,$326.91 ,"$1,243.00 ", N/A , N/A ,$618.51 ,$994.40 ,$674.95 ,$348.04 ,"$1,118.70 ",$472.34 ,$325.00 ,$589.06 ,$596.64 
ST. MARY'S HOSPITAL - DECATUR,45000452,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-RT,450,1 ,"$1,243.00 ",$807.95 ,$325.00 ,"$1,472.65 ","$1,472.65 ",$633.93 ,$683.65 ,$589.06 ,$348.04 ,$658.79 ,$589.06 ,$696.08 ,$589.06 ,$674.95 ,$674.95 ,$589.06 ,$674.95 ,"$1,119.21 ",$870.10 ,$621.50 ,$994.40 ,"$1,472.64 ",$589.06 ,$870.10 ,$589.06 ,$745.80 ,$589.06 ,$932.25 ,$686.14 ,$619.01 ,$686.14 ,$589.06 ,$686.14 ,$969.54 ,$969.54 ,"$1,056.55 ","$1,243.00 ",$861.40 ,$589.06 ,"$1,243.00 ",$683.65 ,$589.06 ,$326.91 ,"$1,243.00 ", N/A , N/A ,$618.51 ,$994.40 ,$674.95 ,$348.04 ,"$1,118.70 ",$472.34 ,$325.00 ,$589.06 ,$596.64 
ST. MARY'S HOSPITAL - DECATUR,45000453,69200,HC REM FOREIGN BODY CANAL AUD EXT-LT,450,1 ,$555.00 ,$360.75 ,$106.74 ,$555.00 ,$266.85 ,$283.05 ,$305.25 ,$106.74 ,$155.40 ,$294.15 ,$106.74 ,$310.80 ,$106.74 ,$301.37 ,$301.37 ,$106.74 ,$301.37 ,$202.80 ,$388.50 ,$277.50 ,$444.00 ,$266.84 ,$106.74 ,$388.50 ,$106.74 ,$333.00 ,$106.74 ,$416.25 ,$306.36 ,$276.39 ,$306.36 ,$106.74 ,$306.36 ,$432.90 ,$432.90 ,$471.75 ,$266.84 ,$384.62 ,$106.74 ,$555.00 ,$305.25 ,$106.74 ,$145.97 ,$555.00 , N/A , N/A ,$112.08 ,$444.00 ,$301.37 ,$155.40 ,$499.50 ,$210.90 ,$325.00 ,$106.74 ,$266.40 
ST. MARY'S HOSPITAL - DECATUR,45000454,69200,HC REM FOREIGN BODY CANAL AUD EXT-RT,450,1 ,$555.00 ,$360.75 ,$106.74 ,$555.00 ,$266.85 ,$283.05 ,$305.25 ,$106.74 ,$155.40 ,$294.15 ,$106.74 ,$310.80 ,$106.74 ,$301.37 ,$301.37 ,$106.74 ,$301.37 ,$202.80 ,$388.50 ,$277.50 ,$444.00 ,$266.84 ,$106.74 ,$388.50 ,$106.74 ,$333.00 ,$106.74 ,$416.25 ,$306.36 ,$276.39 ,$306.36 ,$106.74 ,$306.36 ,$432.90 ,$432.90 ,$471.75 ,$266.84 ,$384.62 ,$106.74 ,$555.00 ,$305.25 ,$106.74 ,$145.97 ,$555.00 , N/A , N/A ,$112.08 ,$444.00 ,$301.37 ,$155.40 ,$499.50 ,$210.90 ,$325.00 ,$106.74 ,$266.40 
ST. MARY'S HOSPITAL - DECATUR,45000455,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-LT,450,1 ,$357.00 ,$232.05 ,$52.69 ,$357.00 ,$131.73 ,$182.07 ,$196.35 ,$52.69 ,$99.96 ,$189.21 ,$52.69 ,$199.92 ,$52.69 ,$193.85 ,$193.85 ,$52.69 ,$193.85 ,$100.11 ,$249.90 ,$178.50 ,$285.60 ,$131.73 ,$52.69 ,$249.90 ,$52.69 ,$214.20 ,$52.69 ,$267.75 ,$197.06 ,$177.79 ,$197.06 ,$52.69 ,$197.06 ,$278.46 ,$278.46 ,$303.45 ,$131.73 ,$247.40 ,$52.69 ,$357.00 ,$196.35 ,$52.69 ,$93.89 ,$357.00 , N/A , N/A ,$55.32 ,$285.60 ,$193.85 ,$99.96 ,$321.30 ,$135.66 ,$325.00 ,$52.69 ,$171.36 
ST. MARY'S HOSPITAL - DECATUR,45000456,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-RT,450,1 ,$357.00 ,$232.05 ,$52.69 ,$357.00 ,$131.73 ,$182.07 ,$196.35 ,$52.69 ,$99.96 ,$189.21 ,$52.69 ,$199.92 ,$52.69 ,$193.85 ,$193.85 ,$52.69 ,$193.85 ,$100.11 ,$249.90 ,$178.50 ,$285.60 ,$131.73 ,$52.69 ,$249.90 ,$52.69 ,$214.20 ,$52.69 ,$267.75 ,$197.06 ,$177.79 ,$197.06 ,$52.69 ,$197.06 ,$278.46 ,$278.46 ,$303.45 ,$131.73 ,$247.40 ,$52.69 ,$357.00 ,$196.35 ,$52.69 ,$93.89 ,$357.00 , N/A , N/A ,$55.32 ,$285.60 ,$193.85 ,$99.96 ,$321.30 ,$135.66 ,$325.00 ,$52.69 ,$171.36 
ST. MARY'S HOSPITAL - DECATUR,45000460,29130,HC APPL SPLNT FINGER STATIC - LT,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45000461,29130,HC APPL SPLNT FINGER STATIC - RT,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45000464,30901,HC CNTRL NOSEBLEED ANT SMP- BIL,450,1 ,$935.00 ,$607.75 ,$106.74 ,$935.00 ,$266.85 ,$476.85 ,$514.25 ,$106.74 ,$261.80 ,$495.55 ,$106.74 ,$523.60 ,$106.74 ,$507.71 ,$507.71 ,$106.74 ,$507.71 ,$202.80 ,$654.50 ,$467.50 ,$748.00 ,$266.84 ,$106.74 ,$654.50 ,$106.74 ,$561.00 ,$106.74 ,$701.25 ,$516.12 ,$465.63 ,$516.12 ,$106.74 ,$516.12 ,$729.30 ,$729.30 ,$794.75 ,$266.84 ,$647.96 ,$106.74 ,$935.00 ,$514.25 ,$106.74 ,$245.91 ,$935.00 , N/A , N/A ,$112.08 ,$748.00 ,$507.71 ,$261.80 ,$841.50 ,$355.30 ,$325.00 ,$106.74 ,$448.80 
ST. MARY'S HOSPITAL - DECATUR,45000469,26010,HC DRAIN ABSC FINGER SIMPLE-F1,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000470,26010,HC DRAIN ABSC FINGER SIMPLE-F2,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000471,26010,HC DRAIN ABSC FINGER SIMPLE-F3,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000472,26010,HC DRAIN ABSC FINGER SIMPLE-F4,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000473,26010,HC DRAIN ABSC FINGER SIMPLE-F5,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000474,26010,HC DRAIN ABSC FINGER SIMPLE-F6,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000475,26010,HC DRAIN ABSC FINGER SIMPLE-F7,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000476,26010,HC DRAIN ABSC FINGER SIMPLE-F8,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000477,26010,HC DRAIN ABSC FINGER SIMPLE-F9,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000478,26010,HC DRAIN ABSC FINGER SIMPLE-FA,450,1 ,$749.00 ,$486.85 ,$169.99 ,$749.00 ,$424.98 ,$381.99 ,$411.95 ,$169.99 ,$209.72 ,$396.97 ,$169.99 ,$419.44 ,$169.99 ,$406.71 ,$406.71 ,$169.99 ,$406.71 ,$322.97 ,$524.30 ,$374.50 ,$599.20 ,$424.97 ,$169.99 ,$524.30 ,$169.99 ,$449.40 ,$169.99 ,$561.75 ,$413.45 ,$373.00 ,$413.45 ,$169.99 ,$413.45 ,$584.22 ,$584.22 ,$636.65 ,$424.97 ,$519.06 ,$169.99 ,$749.00 ,$411.95 ,$169.99 ,$196.99 ,$749.00 , N/A , N/A ,$178.49 ,$599.20 ,$406.71 ,$209.72 ,$674.10 ,$284.62 ,$325.00 ,$169.99 ,$359.52 
ST. MARY'S HOSPITAL - DECATUR,45000479,11740,HC EVAC HEMATOMA SUBUNGAL-F1,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000480,11740,HC EVAC HEMATOMA SUBUNGAL-F2,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000481,11740,HC EVAC HEMATOMA SUBUNGAL-F3,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000482,11740,HC EVAC HEMATOMA SUBUNGAL-F4,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000483,11740,HC EVAC HEMATOMA SUBUNGAL-F5,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000484,11740,HC EVAC HEMATOMA SUBUNGAL-F6,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000485,11740,HC EVAC HEMATOMA SUBUNGAL-F7,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000486,11740,HC EVAC HEMATOMA SUBUNGAL-F8,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000487,11740,HC EVAC HEMATOMA SUBUNGAL-F9,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000488,11740,HC EVAC HEMATOMA SUBUNGAL-FA,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000489,11740,HC EVAC HEMATOMA SUBUNGAL-T5,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000490,11740,HC EVAC HEMATOMA SUBUNGAL-TA,450,1 ,$324.00 ,$210.60 ,$85.21 ,$324.00 ,$266.85 ,$165.24 ,$178.20 ,$106.74 ,$90.72 ,$171.72 ,$106.74 ,$181.44 ,$106.74 ,$175.93 ,$175.93 ,$106.74 ,$175.93 ,$202.80 ,$226.80 ,$162.00 ,$259.20 ,$266.84 ,$106.74 ,$226.80 ,$106.74 ,$194.40 ,$106.74 ,$243.00 ,$178.85 ,$161.35 ,$178.85 ,$106.74 ,$178.85 ,$252.72 ,$252.72 ,$275.40 ,$266.84 ,$224.53 ,$106.74 ,$324.00 ,$178.20 ,$106.74 ,$85.21 ,$324.00 , N/A , N/A ,$112.08 ,$259.20 ,$175.93 ,$90.72 ,$291.60 ,$123.12 ,$324.00 ,$106.74 ,$155.52 
ST. MARY'S HOSPITAL - DECATUR,45000493,36600,HC ARTERIAL PUNCTURE,450,1 ,$233.00 ,$151.45 ,$61.28 ,$266.85 ,$266.85 ,$118.83 ,$128.15 ,$106.74 ,$65.24 ,$123.49 ,$106.74 ,$130.48 ,$106.74 ,$126.52 ,$126.52 ,$106.74 ,$126.52 ,$202.80 ,$163.10 ,$116.50 ,$186.40 ,$266.84 ,$106.74 ,$163.10 ,$106.74 ,$139.80 ,$106.74 ,$174.75 ,$128.62 ,$116.03 ,$128.62 ,$106.74 ,$128.62 ,$181.74 ,$181.74 ,$198.05 ,$233.00 ,$161.47 ,$106.74 ,$233.00 ,$128.15 ,$106.74 ,$61.28 ,$233.00 , N/A , N/A ,$112.08 ,$186.40 ,$126.52 ,$65.24 ,$209.70 ,$88.54 ,$233.00 ,$106.74 ,$111.84 
ST. MARY'S HOSPITAL - DECATUR,45000498,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-BIL,450,1 ,$357.00 ,$232.05 ,$52.69 ,$357.00 ,$131.73 ,$182.07 ,$196.35 ,$52.69 ,$99.96 ,$189.21 ,$52.69 ,$199.92 ,$52.69 ,$193.85 ,$193.85 ,$52.69 ,$193.85 ,$100.11 ,$249.90 ,$178.50 ,$285.60 ,$131.73 ,$52.69 ,$249.90 ,$52.69 ,$214.20 ,$52.69 ,$267.75 ,$197.06 ,$177.79 ,$197.06 ,$52.69 ,$197.06 ,$278.46 ,$278.46 ,$303.45 ,$131.73 ,$247.40 ,$52.69 ,$357.00 ,$196.35 ,$52.69 ,$93.89 ,$357.00 , N/A , N/A ,$55.32 ,$285.60 ,$193.85 ,$99.96 ,$321.30 ,$135.66 ,$325.00 ,$52.69 ,$171.36 
ST. MARY'S HOSPITAL - DECATUR,45000500,57200,HC REPAIR SUTURE VAGINA COLPORRHAPHY,450,1 ,"$3,089.00 ","$2,007.85 ",$325.00 ,"$6,208.95 ","$6,208.95 ","$1,575.39 ","$1,698.95 ","$2,483.58 ",$864.92 ,"$1,637.17 ","$2,483.58 ","$1,729.84 ","$2,483.58 ","$1,677.33 ","$1,677.33 ","$2,483.58 ","$1,677.33 ","$3,089.00 ","$2,162.30 ","$1,544.50 ","$2,471.20 ","$6,208.94 ","$2,483.58 ","$2,162.30 ","$2,483.58 ","$1,853.40 ","$2,483.58 ","$2,316.75 ","$1,566.00 ","$1,408.00 ","$1,566.00 ","$2,483.58 ","$1,566.00 ","$2,409.42 ","$2,409.42 ","$2,625.65 ","$3,089.00 ","$2,140.68 ","$2,483.58 ","$3,089.00 ","$1,698.95 ","$2,483.58 ",$812.41 ,"$3,089.00 ", N/A , N/A ,"$2,607.76 ","$2,471.20 ","$1,677.33 ",$864.92 ,"$2,780.10 ","$1,173.82 ",$325.00 ,"$2,483.58 ","$1,482.72 "
ST. MARY'S HOSPITAL - DECATUR,45000501,28208,HC REPAIR TENDON EXTENSOR FOOT-LT,450,1 ,"$5,023.00 ","$3,264.95 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$2,762.65 ","$2,680.74 ","$1,406.44 ","$2,662.19 ","$2,680.74 ","$2,812.88 ","$2,680.74 ","$2,727.49 ","$2,727.49 ","$2,680.74 ","$2,727.49 ","$5,023.00 ","$3,516.10 ","$2,511.50 ","$4,018.40 ","$6,701.85 ","$2,680.74 ","$3,516.10 ","$2,680.74 ","$3,013.80 ","$2,680.74 ","$3,767.25 ","$2,501.45 ","$2,250.30 ","$2,501.45 ","$2,680.74 ","$2,501.45 ","$3,786.00 ","$3,786.00 ","$4,269.55 ","$5,023.00 ","$3,480.94 ","$2,680.74 ","$5,023.00 ","$2,762.65 ","$2,680.74 ","$1,321.05 ","$5,023.00 ", N/A , N/A ,"$2,814.78 ","$4,018.40 ","$2,727.49 ","$1,406.44 ","$4,520.70 ","$1,908.74 ",$325.00 ,"$2,680.74 ","$2,411.04 "
ST. MARY'S HOSPITAL - DECATUR,45000502,28208,HC REPAIR TENDON EXTENSOR FOOT-RT,450,1 ,"$5,023.00 ","$3,264.95 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$2,762.65 ","$2,680.74 ","$1,406.44 ","$2,662.19 ","$2,680.74 ","$2,812.88 ","$2,680.74 ","$2,727.49 ","$2,727.49 ","$2,680.74 ","$2,727.49 ","$5,023.00 ","$3,516.10 ","$2,511.50 ","$4,018.40 ","$6,701.85 ","$2,680.74 ","$3,516.10 ","$2,680.74 ","$3,013.80 ","$2,680.74 ","$3,767.25 ","$2,501.45 ","$2,250.30 ","$2,501.45 ","$2,680.74 ","$2,501.45 ","$3,786.00 ","$3,786.00 ","$4,269.55 ","$5,023.00 ","$3,480.94 ","$2,680.74 ","$5,023.00 ","$2,762.65 ","$2,680.74 ","$1,321.05 ","$5,023.00 ", N/A , N/A ,"$2,814.78 ","$4,018.40 ","$2,727.49 ","$1,406.44 ","$4,520.70 ","$1,908.74 ",$325.00 ,"$2,680.74 ","$2,411.04 "
ST. MARY'S HOSPITAL - DECATUR,45000503,29550,HC STRAPPING TOES-T1,450,1 ,$533.00 ,$346.45 ,$52.69 ,$533.00 ,$131.73 ,$271.83 ,$293.15 ,$52.69 ,$149.24 ,$282.49 ,$52.69 ,$298.48 ,$52.69 ,$289.42 ,$289.42 ,$52.69 ,$289.42 ,$100.11 ,$373.10 ,$266.50 ,$426.40 ,$131.73 ,$52.69 ,$373.10 ,$52.69 ,$319.80 ,$52.69 ,$399.75 ,$294.22 ,$265.43 ,$294.22 ,$52.69 ,$294.22 ,$415.74 ,$415.74 ,$453.05 ,$131.73 ,$369.37 ,$52.69 ,$533.00 ,$293.15 ,$52.69 ,$140.18 ,$533.00 , N/A , N/A ,$55.32 ,$426.40 ,$289.42 ,$149.24 ,$479.70 ,$202.54 ,$325.00 ,$52.69 ,$255.84 
ST. MARY'S HOSPITAL - DECATUR,45000504,29550,HC STRAPPING TOES-T2,450,1 ,$532.00 ,$345.80 ,$52.69 ,$532.00 ,$131.73 ,$271.32 ,$292.60 ,$52.69 ,$148.96 ,$281.96 ,$52.69 ,$297.92 ,$52.69 ,$288.88 ,$288.88 ,$52.69 ,$288.88 ,$100.11 ,$372.40 ,$266.00 ,$425.60 ,$131.73 ,$52.69 ,$372.40 ,$52.69 ,$319.20 ,$52.69 ,$399.00 ,$293.66 ,$264.94 ,$293.66 ,$52.69 ,$293.66 ,$414.96 ,$414.96 ,$452.20 ,$131.73 ,$368.68 ,$52.69 ,$532.00 ,$292.60 ,$52.69 ,$139.92 ,$532.00 , N/A , N/A ,$55.32 ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$325.00 ,$52.69 ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,45000505,29550,HC STRAPPING TOES-T3,450,1 ,$532.00 ,$345.80 ,$52.69 ,$532.00 ,$131.73 ,$271.32 ,$292.60 ,$52.69 ,$148.96 ,$281.96 ,$52.69 ,$297.92 ,$52.69 ,$288.88 ,$288.88 ,$52.69 ,$288.88 ,$100.11 ,$372.40 ,$266.00 ,$425.60 ,$131.73 ,$52.69 ,$372.40 ,$52.69 ,$319.20 ,$52.69 ,$399.00 ,$293.66 ,$264.94 ,$293.66 ,$52.69 ,$293.66 ,$414.96 ,$414.96 ,$452.20 ,$131.73 ,$368.68 ,$52.69 ,$532.00 ,$292.60 ,$52.69 ,$139.92 ,$532.00 , N/A , N/A ,$55.32 ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$325.00 ,$52.69 ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,45000506,29550,HC STRAPPING TOES-T4,450,1 ,$533.00 ,$346.45 ,$52.69 ,$533.00 ,$131.73 ,$271.83 ,$293.15 ,$52.69 ,$149.24 ,$282.49 ,$52.69 ,$298.48 ,$52.69 ,$289.42 ,$289.42 ,$52.69 ,$289.42 ,$100.11 ,$373.10 ,$266.50 ,$426.40 ,$131.73 ,$52.69 ,$373.10 ,$52.69 ,$319.80 ,$52.69 ,$399.75 ,$294.22 ,$265.43 ,$294.22 ,$52.69 ,$294.22 ,$415.74 ,$415.74 ,$453.05 ,$131.73 ,$369.37 ,$52.69 ,$533.00 ,$293.15 ,$52.69 ,$140.18 ,$533.00 , N/A , N/A ,$55.32 ,$426.40 ,$289.42 ,$149.24 ,$479.70 ,$202.54 ,$325.00 ,$52.69 ,$255.84 
ST. MARY'S HOSPITAL - DECATUR,45000507,29550,HC STRAPPING TOES-T5,450,1 ,$532.00 ,$345.80 ,$52.69 ,$532.00 ,$131.73 ,$271.32 ,$292.60 ,$52.69 ,$148.96 ,$281.96 ,$52.69 ,$297.92 ,$52.69 ,$288.88 ,$288.88 ,$52.69 ,$288.88 ,$100.11 ,$372.40 ,$266.00 ,$425.60 ,$131.73 ,$52.69 ,$372.40 ,$52.69 ,$319.20 ,$52.69 ,$399.00 ,$293.66 ,$264.94 ,$293.66 ,$52.69 ,$293.66 ,$414.96 ,$414.96 ,$452.20 ,$131.73 ,$368.68 ,$52.69 ,$532.00 ,$292.60 ,$52.69 ,$139.92 ,$532.00 , N/A , N/A ,$55.32 ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$325.00 ,$52.69 ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,45000508,29550,HC STRAPPING TOES-T6,450,1 ,$533.00 ,$346.45 ,$52.69 ,$533.00 ,$131.73 ,$271.83 ,$293.15 ,$52.69 ,$149.24 ,$282.49 ,$52.69 ,$298.48 ,$52.69 ,$289.42 ,$289.42 ,$52.69 ,$289.42 ,$100.11 ,$373.10 ,$266.50 ,$426.40 ,$131.73 ,$52.69 ,$373.10 ,$52.69 ,$319.80 ,$52.69 ,$399.75 ,$294.22 ,$265.43 ,$294.22 ,$52.69 ,$294.22 ,$415.74 ,$415.74 ,$453.05 ,$131.73 ,$369.37 ,$52.69 ,$533.00 ,$293.15 ,$52.69 ,$140.18 ,$533.00 , N/A , N/A ,$55.32 ,$426.40 ,$289.42 ,$149.24 ,$479.70 ,$202.54 ,$325.00 ,$52.69 ,$255.84 
ST. MARY'S HOSPITAL - DECATUR,45000509,29550,HC STRAPPING TOES-T7,450,1 ,$532.00 ,$345.80 ,$52.69 ,$532.00 ,$131.73 ,$271.32 ,$292.60 ,$52.69 ,$148.96 ,$281.96 ,$52.69 ,$297.92 ,$52.69 ,$288.88 ,$288.88 ,$52.69 ,$288.88 ,$100.11 ,$372.40 ,$266.00 ,$425.60 ,$131.73 ,$52.69 ,$372.40 ,$52.69 ,$319.20 ,$52.69 ,$399.00 ,$293.66 ,$264.94 ,$293.66 ,$52.69 ,$293.66 ,$414.96 ,$414.96 ,$452.20 ,$131.73 ,$368.68 ,$52.69 ,$532.00 ,$292.60 ,$52.69 ,$139.92 ,$532.00 , N/A , N/A ,$55.32 ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$325.00 ,$52.69 ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,45000510,29550,HC STRAPPING TOES-T8,450,1 ,$459.00 ,$298.35 ,$52.69 ,$459.00 ,$131.73 ,$234.09 ,$252.45 ,$52.69 ,$128.52 ,$243.27 ,$52.69 ,$257.04 ,$52.69 ,$249.24 ,$249.24 ,$52.69 ,$249.24 ,$100.11 ,$321.30 ,$229.50 ,$367.20 ,$131.73 ,$52.69 ,$321.30 ,$52.69 ,$275.40 ,$52.69 ,$344.25 ,$253.37 ,$228.58 ,$253.37 ,$52.69 ,$253.37 ,$358.02 ,$358.02 ,$390.15 ,$131.73 ,$318.09 ,$52.69 ,$459.00 ,$252.45 ,$52.69 ,$120.72 ,$459.00 , N/A , N/A ,$55.32 ,$367.20 ,$249.24 ,$128.52 ,$413.10 ,$174.42 ,$325.00 ,$52.69 ,$220.32 
ST. MARY'S HOSPITAL - DECATUR,45000511,29550,HC STRAPPING TOES-T9,450,1 ,$532.00 ,$345.80 ,$52.69 ,$532.00 ,$131.73 ,$271.32 ,$292.60 ,$52.69 ,$148.96 ,$281.96 ,$52.69 ,$297.92 ,$52.69 ,$288.88 ,$288.88 ,$52.69 ,$288.88 ,$100.11 ,$372.40 ,$266.00 ,$425.60 ,$131.73 ,$52.69 ,$372.40 ,$52.69 ,$319.20 ,$52.69 ,$399.00 ,$293.66 ,$264.94 ,$293.66 ,$52.69 ,$293.66 ,$414.96 ,$414.96 ,$452.20 ,$131.73 ,$368.68 ,$52.69 ,$532.00 ,$292.60 ,$52.69 ,$139.92 ,$532.00 , N/A , N/A ,$55.32 ,$425.60 ,$288.88 ,$148.96 ,$478.80 ,$202.16 ,$325.00 ,$52.69 ,$255.36 
ST. MARY'S HOSPITAL - DECATUR,45000512,29550,HC STRAPPING TOES-TA,450,1 ,$533.00 ,$346.45 ,$52.69 ,$533.00 ,$131.73 ,$271.83 ,$293.15 ,$52.69 ,$149.24 ,$282.49 ,$52.69 ,$298.48 ,$52.69 ,$289.42 ,$289.42 ,$52.69 ,$289.42 ,$100.11 ,$373.10 ,$266.50 ,$426.40 ,$131.73 ,$52.69 ,$373.10 ,$52.69 ,$319.80 ,$52.69 ,$399.75 ,$294.22 ,$265.43 ,$294.22 ,$52.69 ,$294.22 ,$415.74 ,$415.74 ,$453.05 ,$131.73 ,$369.37 ,$52.69 ,$533.00 ,$293.15 ,$52.69 ,$140.18 ,$533.00 , N/A , N/A ,$55.32 ,$426.40 ,$289.42 ,$149.24 ,$479.70 ,$202.54 ,$325.00 ,$52.69 ,$255.84 
ST. MARY'S HOSPITAL - DECATUR,45000513,29580,HC APPLY UNNA BOOT-LT,450,1 ,$727.00 ,$472.55 ,$133.74 ,$727.00 ,$334.35 ,$370.77 ,$399.85 ,$133.74 ,$203.56 ,$385.31 ,$133.74 ,$407.12 ,$133.74 ,$394.76 ,$394.76 ,$133.74 ,$394.76 ,$254.10 ,$508.90 ,$363.50 ,$581.60 ,$334.34 ,$133.74 ,$508.90 ,$133.74 ,$436.20 ,$133.74 ,$545.25 ,$401.30 ,$362.05 ,$401.30 ,$133.74 ,$401.30 ,$567.06 ,$567.06 ,$617.95 ,$334.34 ,$503.81 ,$133.74 ,$727.00 ,$399.85 ,$133.74 ,$191.20 ,$727.00 , N/A , N/A ,$140.43 ,$581.60 ,$394.76 ,$203.56 ,$654.30 ,$276.26 ,$325.00 ,$133.74 ,$348.96 
ST. MARY'S HOSPITAL - DECATUR,45000514,29580,HC APPLY UNNA BOOT-RT,450,1 ,$727.00 ,$472.55 ,$133.74 ,$727.00 ,$334.35 ,$370.77 ,$399.85 ,$133.74 ,$203.56 ,$385.31 ,$133.74 ,$407.12 ,$133.74 ,$394.76 ,$394.76 ,$133.74 ,$394.76 ,$254.10 ,$508.90 ,$363.50 ,$581.60 ,$334.34 ,$133.74 ,$508.90 ,$133.74 ,$436.20 ,$133.74 ,$545.25 ,$401.30 ,$362.05 ,$401.30 ,$133.74 ,$401.30 ,$567.06 ,$567.06 ,$617.95 ,$334.34 ,$503.81 ,$133.74 ,$727.00 ,$399.85 ,$133.74 ,$191.20 ,$727.00 , N/A , N/A ,$140.43 ,$581.60 ,$394.76 ,$203.56 ,$654.30 ,$276.26 ,$325.00 ,$133.74 ,$348.96 
ST. MARY'S HOSPITAL - DECATUR,45000515,32551,HC TUBE THORACOSTOMY-BIL,450,1 ,"$2,583.00 ","$1,678.95 ",$325.00 ,"$6,774.50 ","$6,774.50 ","$1,317.33 ","$1,420.65 ","$2,709.80 ",$723.24 ,"$1,368.99 ","$2,709.80 ","$1,446.48 ","$2,583.00 ","$1,402.57 ","$1,402.57 ","$2,583.00 ","$1,402.57 ","$2,583.00 ","$1,808.10 ","$1,291.50 ","$2,066.40 ","$6,774.49 ","$2,709.80 ","$1,808.10 ","$2,709.80 ","$1,549.80 ","$2,709.80 ","$1,937.25 ","$1,425.82 ","$1,286.33 ","$1,425.82 ","$2,709.80 ","$1,425.82 ","$2,014.74 ","$2,014.74 ","$2,195.55 ","$2,583.00 ","$1,790.02 ","$2,709.80 ","$2,583.00 ","$1,420.65 ","$2,709.80 ",$679.33 ,"$2,583.00 ", N/A , N/A ,"$2,845.29 ","$2,066.40 ","$1,402.57 ",$723.24 ,"$2,324.70 ",$981.54 ,$325.00 ,"$2,709.80 ","$1,239.84 "
ST. MARY'S HOSPITAL - DECATUR,45000519,27502,HC TX FX FEMUR W/MAN W/W/O TRACTION-LT,450,1 ,"$1,212.00 ",$787.80 ,$318.76 ,"$3,296.18 ","$3,296.18 ",$618.12 ,$666.60 ,"$1,318.47 ",$339.36 ,$642.36 ,"$1,318.47 ",$678.72 ,"$1,212.00 ",$658.12 ,$658.12 ,"$1,212.00 ",$658.12 ,"$1,212.00 ",$848.40 ,$606.00 ,$969.60 ,"$3,296.17 ","$1,318.47 ",$848.40 ,"$1,318.47 ",$727.20 ,"$1,318.47 ",$909.00 ,$669.02 ,$603.58 ,$669.02 ,"$1,318.47 ",$669.02 ,$945.36 ,$945.36 ,"$1,030.20 ","$1,212.00 ",$839.92 ,"$1,318.47 ","$1,212.00 ",$666.60 ,"$1,318.47 ",$318.76 ,"$1,212.00 ", N/A , N/A ,"$1,384.39 ",$969.60 ,$658.12 ,$339.36 ,"$1,090.80 ",$460.56 ,$325.00 ,"$1,318.47 ",$581.76 
ST. MARY'S HOSPITAL - DECATUR,45000520,27502,HC TX FX FEMUR W/MAN W/W/O TRACTION-RT,450,1 ,"$1,212.00 ",$787.80 ,$318.76 ,"$3,296.18 ","$3,296.18 ",$618.12 ,$666.60 ,"$1,318.47 ",$339.36 ,$642.36 ,"$1,318.47 ",$678.72 ,"$1,212.00 ",$658.12 ,$658.12 ,"$1,212.00 ",$658.12 ,"$1,212.00 ",$848.40 ,$606.00 ,$969.60 ,"$3,296.17 ","$1,318.47 ",$848.40 ,"$1,318.47 ",$727.20 ,"$1,318.47 ",$909.00 ,$669.02 ,$603.58 ,$669.02 ,"$1,318.47 ",$669.02 ,$945.36 ,$945.36 ,"$1,030.20 ","$1,212.00 ",$839.92 ,"$1,318.47 ","$1,212.00 ",$666.60 ,"$1,318.47 ",$318.76 ,"$1,212.00 ", N/A , N/A ,"$1,384.39 ",$969.60 ,$658.12 ,$339.36 ,"$1,090.80 ",$460.56 ,$325.00 ,"$1,318.47 ",$581.76 
ST. MARY'S HOSPITAL - DECATUR,45000521,28405,HC TX FX CALCANEAL W/MANIP -LT,450,1 ,"$5,479.00 ","$3,561.35 ",$195.10 ,"$5,479.00 ",$487.75 ,"$2,200.00 ","$3,013.45 ",$195.10 ,"$1,534.12 ","$2,903.87 ",$195.10 ,"$3,068.24 ",$195.10 ,"$2,975.10 ","$2,975.10 ",$195.10 ,"$2,975.10 ",$370.70 ,"$3,835.30 ","$2,739.50 ","$4,383.20 ",$487.76 ,$195.10 ,"$3,835.30 ",$195.10 ,"$3,287.40 ",$195.10 ,"$4,109.25 ","$2,728.54 ","$2,454.59 ","$2,728.54 ",$195.10 ,"$2,728.54 ","$3,786.00 ","$3,786.00 ","$4,657.15 ",$487.76 ,"$3,796.95 ",$195.10 ,"$5,479.00 ","$3,013.45 ",$195.10 ,"$1,440.98 ","$5,479.00 ", N/A , N/A ,$204.86 ,"$4,383.20 ","$2,975.10 ","$1,534.12 ","$4,931.10 ","$2,082.02 ",$325.00 ,$195.10 ,"$2,629.92 "
ST. MARY'S HOSPITAL - DECATUR,45000522,28405,HC TX FX CALCANEAL W/MANIP -RT,450,1 ,"$5,479.00 ","$3,561.35 ",$195.10 ,"$5,479.00 ",$487.75 ,"$2,200.00 ","$3,013.45 ",$195.10 ,"$1,534.12 ","$2,903.87 ",$195.10 ,"$3,068.24 ",$195.10 ,"$2,975.10 ","$2,975.10 ",$195.10 ,"$2,975.10 ",$370.70 ,"$3,835.30 ","$2,739.50 ","$4,383.20 ",$487.76 ,$195.10 ,"$3,835.30 ",$195.10 ,"$3,287.40 ",$195.10 ,"$4,109.25 ","$2,728.54 ","$2,454.59 ","$2,728.54 ",$195.10 ,"$2,728.54 ","$3,786.00 ","$3,786.00 ","$4,657.15 ",$487.76 ,"$3,796.95 ",$195.10 ,"$5,479.00 ","$3,013.45 ",$195.10 ,"$1,440.98 ","$5,479.00 ", N/A , N/A ,$204.86 ,"$4,383.20 ","$2,975.10 ","$1,534.12 ","$4,931.10 ","$2,082.02 ",$325.00 ,$195.10 ,"$2,629.92 "
ST. MARY'S HOSPITAL - DECATUR,45000534,27825,HC TX FX TIBIA DISTAL W/MANIP W/W/O ANES-LT,450,1 ,"$3,090.00 ","$2,008.50 ",$325.00 ,"$3,296.18 ","$3,296.18 ","$1,575.90 ","$1,699.50 ","$1,318.47 ",$865.20 ,"$1,637.70 ","$1,318.47 ","$1,730.40 ","$1,318.47 ","$1,677.87 ","$1,677.87 ","$1,318.47 ","$1,677.87 ","$2,505.09 ","$2,163.00 ","$1,545.00 ","$2,472.00 ","$3,296.17 ","$1,318.47 ","$2,163.00 ","$1,318.47 ","$1,854.00 ","$1,318.47 ","$2,317.50 ","$1,566.00 ","$1,408.00 ","$1,566.00 ","$1,318.47 ","$1,566.00 ","$2,410.20 ","$2,410.20 ","$2,626.50 ","$3,090.00 ","$2,141.37 ","$1,318.47 ","$3,090.00 ","$1,699.50 ","$1,318.47 ",$812.67 ,"$3,090.00 ", N/A , N/A ,"$1,384.39 ","$2,472.00 ","$1,677.87 ",$865.20 ,"$2,781.00 ","$1,174.20 ",$325.00 ,"$1,318.47 ","$1,483.20 "
ST. MARY'S HOSPITAL - DECATUR,45000535,27825,HC TX FX TIBIA DISTAL W/MANIP W/W/O ANES-RT,450,1 ,"$3,090.00 ","$2,008.50 ",$325.00 ,"$3,296.18 ","$3,296.18 ","$1,575.90 ","$1,699.50 ","$1,318.47 ",$865.20 ,"$1,637.70 ","$1,318.47 ","$1,730.40 ","$1,318.47 ","$1,677.87 ","$1,677.87 ","$1,318.47 ","$1,677.87 ","$2,505.09 ","$2,163.00 ","$1,545.00 ","$2,472.00 ","$3,296.17 ","$1,318.47 ","$2,163.00 ","$1,318.47 ","$1,854.00 ","$1,318.47 ","$2,317.50 ","$1,566.00 ","$1,408.00 ","$1,566.00 ","$1,318.47 ","$1,566.00 ","$2,410.20 ","$2,410.20 ","$2,626.50 ","$3,090.00 ","$2,141.37 ","$1,318.47 ","$3,090.00 ","$1,699.50 ","$1,318.47 ",$812.67 ,"$3,090.00 ", N/A , N/A ,"$1,384.39 ","$2,472.00 ","$1,677.87 ",$865.20 ,"$2,781.00 ","$1,174.20 ",$325.00 ,"$1,318.47 ","$1,483.20 "
ST. MARY'S HOSPITAL - DECATUR,45000538,27530,HC TX FX TIBIAL W/O MANIP CLOSED,450,1 ,$656.00 ,$426.40 ,$172.53 ,$656.00 ,$487.75 ,$334.56 ,$360.80 ,$195.10 ,$183.68 ,$347.68 ,$195.10 ,$367.36 ,$195.10 ,$356.21 ,$356.21 ,$195.10 ,$356.21 ,$370.70 ,$459.20 ,$328.00 ,$524.80 ,$487.76 ,$195.10 ,$459.20 ,$195.10 ,$393.60 ,$195.10 ,$492.00 ,$362.11 ,$326.69 ,$362.11 ,$195.10 ,$362.11 ,$511.68 ,$511.68 ,$557.60 ,$487.76 ,$454.61 ,$195.10 ,$656.00 ,$360.80 ,$195.10 ,$172.53 ,$656.00 , N/A , N/A ,$204.86 ,$524.80 ,$356.21 ,$183.68 ,$590.40 ,$249.28 ,$325.00 ,$195.10 ,$314.88 
ST. MARY'S HOSPITAL - DECATUR,45000541,29075,HC APPL CAST ARM SHORT-LT,450,1 ,$316.00 ,$205.40 ,$83.11 ,$570.90 ,$570.90 ,$161.16 ,$173.80 ,$228.36 ,$88.48 ,$167.48 ,$228.36 ,$176.96 ,$228.36 ,$171.59 ,$171.59 ,$228.36 ,$171.59 ,$316.00 ,$221.20 ,$158.00 ,$252.80 ,$570.90 ,$228.36 ,$221.20 ,$228.36 ,$189.60 ,$228.36 ,$237.00 ,$174.43 ,$157.37 ,$174.43 ,$228.36 ,$174.43 ,$246.48 ,$246.48 ,$268.60 ,$316.00 ,$218.99 ,$228.36 ,$316.00 ,$173.80 ,$228.36 ,$83.11 ,$316.00 , N/A , N/A ,$239.78 ,$252.80 ,$171.59 ,$88.48 ,$284.40 ,$120.08 ,$316.00 ,$228.36 ,$151.68 
ST. MARY'S HOSPITAL - DECATUR,45000542,29075,HC APPL CAST ARM SHORT-RT,450,1 ,$316.00 ,$205.40 ,$83.11 ,$570.90 ,$570.90 ,$161.16 ,$173.80 ,$228.36 ,$88.48 ,$167.48 ,$228.36 ,$176.96 ,$228.36 ,$171.59 ,$171.59 ,$228.36 ,$171.59 ,$316.00 ,$221.20 ,$158.00 ,$252.80 ,$570.90 ,$228.36 ,$221.20 ,$228.36 ,$189.60 ,$228.36 ,$237.00 ,$174.43 ,$157.37 ,$174.43 ,$228.36 ,$174.43 ,$246.48 ,$246.48 ,$268.60 ,$316.00 ,$218.99 ,$228.36 ,$316.00 ,$173.80 ,$228.36 ,$83.11 ,$316.00 , N/A , N/A ,$239.78 ,$252.80 ,$171.59 ,$88.48 ,$284.40 ,$120.08 ,$316.00 ,$228.36 ,$151.68 
ST. MARY'S HOSPITAL - DECATUR,45000543,29085,HC APPL CAST HAND/FOREARM - LT,450,1 ,$419.00 ,$272.35 ,$110.20 ,$419.00 ,$334.35 ,$213.69 ,$230.45 ,$133.74 ,$117.32 ,$222.07 ,$133.74 ,$234.64 ,$133.74 ,$227.52 ,$227.52 ,$133.74 ,$227.52 ,$254.10 ,$293.30 ,$209.50 ,$335.20 ,$334.34 ,$133.74 ,$293.30 ,$133.74 ,$251.40 ,$133.74 ,$314.25 ,$231.29 ,$208.66 ,$231.29 ,$133.74 ,$231.29 ,$326.82 ,$326.82 ,$356.15 ,$334.34 ,$290.37 ,$133.74 ,$419.00 ,$230.45 ,$133.74 ,$110.20 ,$419.00 , N/A , N/A ,$140.43 ,$335.20 ,$227.52 ,$117.32 ,$377.10 ,$159.22 ,$325.00 ,$133.74 ,$201.12 
ST. MARY'S HOSPITAL - DECATUR,45000544,29085,HC APPL CAST HAND/FOREARM - RT,450,1 ,$419.00 ,$272.35 ,$110.20 ,$419.00 ,$334.35 ,$213.69 ,$230.45 ,$133.74 ,$117.32 ,$222.07 ,$133.74 ,$234.64 ,$133.74 ,$227.52 ,$227.52 ,$133.74 ,$227.52 ,$254.10 ,$293.30 ,$209.50 ,$335.20 ,$334.34 ,$133.74 ,$293.30 ,$133.74 ,$251.40 ,$133.74 ,$314.25 ,$231.29 ,$208.66 ,$231.29 ,$133.74 ,$231.29 ,$326.82 ,$326.82 ,$356.15 ,$334.34 ,$290.37 ,$133.74 ,$419.00 ,$230.45 ,$133.74 ,$110.20 ,$419.00 , N/A , N/A ,$140.43 ,$335.20 ,$227.52 ,$117.32 ,$377.10 ,$159.22 ,$325.00 ,$133.74 ,$201.12 
ST. MARY'S HOSPITAL - DECATUR,45000547,29125,HC APPL SHRT ARM SPLNT STAT-BIL,450,1 ,$743.00 ,$482.95 ,$106.74 ,$743.00 ,$266.85 ,$378.93 ,$408.65 ,$106.74 ,$208.04 ,$393.79 ,$106.74 ,$416.08 ,$106.74 ,$403.45 ,$403.45 ,$106.74 ,$403.45 ,$202.80 ,$520.10 ,$371.50 ,$594.40 ,$266.84 ,$106.74 ,$520.10 ,$106.74 ,$445.80 ,$106.74 ,$557.25 ,$410.14 ,$370.01 ,$410.14 ,$106.74 ,$410.14 ,$579.54 ,$579.54 ,$631.55 ,$266.84 ,$514.90 ,$106.74 ,$743.00 ,$408.65 ,$106.74 ,$195.41 ,$743.00 , N/A , N/A ,$112.08 ,$594.40 ,$403.45 ,$208.04 ,$668.70 ,$282.34 ,$325.00 ,$106.74 ,$356.64 
ST. MARY'S HOSPITAL - DECATUR,45000550,67700,HC BLEPHAROT EYELID DRAIN ABSC-E1,450,1 ,"$1,296.00 ",$842.40 ,$247.62 ,"$1,296.00 ",$619.05 ,$660.96 ,$712.80 ,$247.62 ,$362.88 ,$686.88 ,$247.62 ,$725.76 ,$247.62 ,$703.73 ,$703.73 ,$247.62 ,$703.73 ,$470.48 ,$907.20 ,$648.00 ,"$1,036.80 ",$619.05 ,$247.62 ,$907.20 ,$247.62 ,$777.60 ,$247.62 ,$972.00 ,$715.39 ,$645.41 ,$715.39 ,$247.62 ,$715.39 ,"$1,010.88 ","$1,010.88 ","$1,101.60 ",$619.05 ,$898.13 ,$247.62 ,"$1,296.00 ",$712.80 ,$247.62 ,$340.85 ,"$1,296.00 ", N/A , N/A ,$260.00 ,"$1,036.80 ",$703.73 ,$362.88 ,"$1,166.40 ",$492.48 ,$325.00 ,$247.62 ,$622.08 
ST. MARY'S HOSPITAL - DECATUR,45000551,67700,HC BLEPHAROT EYELID DRAIN ABSC-E2,450,1 ,"$1,296.00 ",$842.40 ,$247.62 ,"$1,296.00 ",$619.05 ,$660.96 ,$712.80 ,$247.62 ,$362.88 ,$686.88 ,$247.62 ,$725.76 ,$247.62 ,$703.73 ,$703.73 ,$247.62 ,$703.73 ,$470.48 ,$907.20 ,$648.00 ,"$1,036.80 ",$619.05 ,$247.62 ,$907.20 ,$247.62 ,$777.60 ,$247.62 ,$972.00 ,$715.39 ,$645.41 ,$715.39 ,$247.62 ,$715.39 ,"$1,010.88 ","$1,010.88 ","$1,101.60 ",$619.05 ,$898.13 ,$247.62 ,"$1,296.00 ",$712.80 ,$247.62 ,$340.85 ,"$1,296.00 ", N/A , N/A ,$260.00 ,"$1,036.80 ",$703.73 ,$362.88 ,"$1,166.40 ",$492.48 ,$325.00 ,$247.62 ,$622.08 
ST. MARY'S HOSPITAL - DECATUR,45000552,67700,HC BLEPHAROT EYELID DRAIN ABSC-E3,450,1 ,"$1,296.00 ",$842.40 ,$247.62 ,"$1,296.00 ",$619.05 ,$660.96 ,$712.80 ,$247.62 ,$362.88 ,$686.88 ,$247.62 ,$725.76 ,$247.62 ,$703.73 ,$703.73 ,$247.62 ,$703.73 ,$470.48 ,$907.20 ,$648.00 ,"$1,036.80 ",$619.05 ,$247.62 ,$907.20 ,$247.62 ,$777.60 ,$247.62 ,$972.00 ,$715.39 ,$645.41 ,$715.39 ,$247.62 ,$715.39 ,"$1,010.88 ","$1,010.88 ","$1,101.60 ",$619.05 ,$898.13 ,$247.62 ,"$1,296.00 ",$712.80 ,$247.62 ,$340.85 ,"$1,296.00 ", N/A , N/A ,$260.00 ,"$1,036.80 ",$703.73 ,$362.88 ,"$1,166.40 ",$492.48 ,$325.00 ,$247.62 ,$622.08 
ST. MARY'S HOSPITAL - DECATUR,45000553,67700,HC BLEPHAROT EYELID DRAIN ABSC-E4,450,1 ,"$1,296.00 ",$842.40 ,$247.62 ,"$1,296.00 ",$619.05 ,$660.96 ,$712.80 ,$247.62 ,$362.88 ,$686.88 ,$247.62 ,$725.76 ,$247.62 ,$703.73 ,$703.73 ,$247.62 ,$703.73 ,$470.48 ,$907.20 ,$648.00 ,"$1,036.80 ",$619.05 ,$247.62 ,$907.20 ,$247.62 ,$777.60 ,$247.62 ,$972.00 ,$715.39 ,$645.41 ,$715.39 ,$247.62 ,$715.39 ,"$1,010.88 ","$1,010.88 ","$1,101.60 ",$619.05 ,$898.13 ,$247.62 ,"$1,296.00 ",$712.80 ,$247.62 ,$340.85 ,"$1,296.00 ", N/A , N/A ,$260.00 ,"$1,036.80 ",$703.73 ,$362.88 ,"$1,166.40 ",$492.48 ,$325.00 ,$247.62 ,$622.08 
ST. MARY'S HOSPITAL - DECATUR,45000554,29581,HC APPLY MULTI COMP LOWER LEG-LT,450,1 ,$711.00 ,$462.15 ,$133.74 ,$711.00 ,$334.35 ,$362.61 ,$391.05 ,$133.74 ,$199.08 ,$376.83 ,$133.74 ,$398.16 ,$133.74 ,$386.07 ,$386.07 ,$133.74 ,$386.07 ,$254.10 ,$497.70 ,$355.50 ,$568.80 ,$334.34 ,$133.74 ,$497.70 ,$133.74 ,$426.60 ,$133.74 ,$533.25 ,$392.47 ,$354.08 ,$392.47 ,$133.74 ,$392.47 ,$554.58 ,$554.58 ,$604.35 ,$334.34 ,$492.72 ,$133.74 ,$711.00 ,$391.05 ,$133.74 ,$186.99 ,$711.00 , N/A , N/A ,$140.43 ,$568.80 ,$386.07 ,$199.08 ,$639.90 ,$270.18 ,$325.00 ,$133.74 ,$341.28 
ST. MARY'S HOSPITAL - DECATUR,45000555,29581,HC APPLY MULTI COMP LOWER LEG-RT,450,1 ,$711.00 ,$462.15 ,$133.74 ,$711.00 ,$334.35 ,$362.61 ,$391.05 ,$133.74 ,$199.08 ,$376.83 ,$133.74 ,$398.16 ,$133.74 ,$386.07 ,$386.07 ,$133.74 ,$386.07 ,$254.10 ,$497.70 ,$355.50 ,$568.80 ,$334.34 ,$133.74 ,$497.70 ,$133.74 ,$426.60 ,$133.74 ,$533.25 ,$392.47 ,$354.08 ,$392.47 ,$133.74 ,$392.47 ,$554.58 ,$554.58 ,$604.35 ,$334.34 ,$492.72 ,$133.74 ,$711.00 ,$391.05 ,$133.74 ,$186.99 ,$711.00 , N/A , N/A ,$140.43 ,$568.80 ,$386.07 ,$199.08 ,$639.90 ,$270.18 ,$325.00 ,$133.74 ,$341.28 
ST. MARY'S HOSPITAL - DECATUR,45000556,20103,HC EXPL PENTR WOUND EXTREMITY - LT,450,1 ,"$1,178.00 ",$765.70 ,$309.81 ,"$1,472.65 ","$1,472.65 ",$600.78 ,$647.90 ,$589.06 ,$329.84 ,$624.34 ,$589.06 ,$659.68 ,$589.06 ,$639.65 ,$639.65 ,$589.06 ,$639.65 ,"$1,119.21 ",$824.60 ,$589.00 ,$942.40 ,"$1,472.64 ",$589.06 ,$824.60 ,$589.06 ,$706.80 ,$589.06 ,$883.50 ,$650.26 ,$586.64 ,$650.26 ,$589.06 ,$650.26 ,$918.84 ,$918.84 ,"$1,001.30 ","$1,178.00 ",$816.35 ,$589.06 ,"$1,178.00 ",$647.90 ,$589.06 ,$309.81 ,"$1,178.00 ", N/A , N/A ,$618.51 ,$942.40 ,$639.65 ,$329.84 ,"$1,060.20 ",$447.64 ,$325.00 ,$589.06 ,$565.44 
ST. MARY'S HOSPITAL - DECATUR,45000557,20103,HC EXPL PENTR WOUND EXTREMITY - RT,450,1 ,"$1,178.00 ",$765.70 ,$309.81 ,"$1,472.65 ","$1,472.65 ",$600.78 ,$647.90 ,$589.06 ,$329.84 ,$624.34 ,$589.06 ,$659.68 ,$589.06 ,$639.65 ,$639.65 ,$589.06 ,$639.65 ,"$1,119.21 ",$824.60 ,$589.00 ,$942.40 ,"$1,472.64 ",$589.06 ,$824.60 ,$589.06 ,$706.80 ,$589.06 ,$883.50 ,$650.26 ,$586.64 ,$650.26 ,$589.06 ,$650.26 ,$918.84 ,$918.84 ,"$1,001.30 ","$1,178.00 ",$816.35 ,$589.06 ,"$1,178.00 ",$647.90 ,$589.06 ,$309.81 ,"$1,178.00 ", N/A , N/A ,$618.51 ,$942.40 ,$639.65 ,$329.84 ,"$1,060.20 ",$447.64 ,$325.00 ,$589.06 ,$565.44 
ST. MARY'S HOSPITAL - DECATUR,45000561,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$1,825.00 ","$1,186.25 ",$325.00 ,"$1,825.00 ","$1,472.65 ",$930.75 ,"$1,003.75 ",$589.06 ,$511.00 ,$967.25 ,$589.06 ,"$1,022.00 ",$589.06 ,$990.98 ,$990.98 ,$589.06 ,$990.98 ,"$1,119.21 ","$1,277.50 ",$912.50 ,"$1,460.00 ","$1,472.64 ",$589.06 ,"$1,277.50 ",$589.06 ,"$1,095.00 ",$589.06 ,"$1,368.75 ","$1,007.40 ",$908.85 ,"$1,007.40 ",$589.06 ,"$1,007.40 ","$1,423.50 ","$1,423.50 ","$1,551.25 ","$1,472.64 ","$1,264.73 ",$589.06 ,"$1,825.00 ","$1,003.75 ",$589.06 ,$479.98 ,"$1,825.00 ", N/A , N/A ,$618.51 ,"$1,460.00 ",$990.98 ,$511.00 ,"$1,642.50 ",$693.50 ,$325.00 ,$589.06 ,$876.00 
ST. MARY'S HOSPITAL - DECATUR,45000562,28190,HC REMOVE FB FOOT SUBCUT,450,1 ,"$1,825.00 ","$1,186.25 ",$325.00 ,"$1,825.00 ","$1,472.65 ",$930.75 ,"$1,003.75 ",$589.06 ,$511.00 ,$967.25 ,$589.06 ,"$1,022.00 ",$589.06 ,$990.98 ,$990.98 ,$589.06 ,$990.98 ,"$1,119.21 ","$1,277.50 ",$912.50 ,"$1,460.00 ","$1,472.64 ",$589.06 ,"$1,277.50 ",$589.06 ,"$1,095.00 ",$589.06 ,"$1,368.75 ","$1,007.40 ",$908.85 ,"$1,007.40 ",$589.06 ,"$1,007.40 ","$1,423.50 ","$1,423.50 ","$1,551.25 ","$1,472.64 ","$1,264.73 ",$589.06 ,"$1,825.00 ","$1,003.75 ",$589.06 ,$479.98 ,"$1,825.00 ", N/A , N/A ,$618.51 ,"$1,460.00 ",$990.98 ,$511.00 ,"$1,642.50 ",$693.50 ,$325.00 ,$589.06 ,$876.00 
ST. MARY'S HOSPITAL - DECATUR,45000563,25270,HC REPAIR TEND/MUSC/EXTENSOR FOREARM/WRIST PRIMARY-LT,450,1 ,"$6,129.00 ","$3,983.85 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$3,370.95 ","$2,680.74 ","$1,716.12 ","$3,248.37 ","$2,680.74 ","$3,432.24 ","$2,680.74 ","$3,100.00 ","$3,100.00 ","$2,680.74 ","$3,100.00 ","$5,093.40 ","$4,290.30 ","$3,064.50 ","$4,903.20 ","$6,701.85 ","$2,680.74 ","$4,290.30 ","$2,680.74 ","$3,677.40 ","$2,680.74 ","$4,596.75 ","$3,052.24 ","$2,745.79 ","$3,052.24 ","$2,680.74 ","$3,052.24 ","$3,786.00 ","$3,786.00 ","$5,209.65 ","$6,129.00 ","$4,247.40 ","$2,680.74 ","$6,129.00 ","$3,370.95 ","$2,680.74 ","$1,611.93 ","$6,129.00 ", N/A , N/A ,"$2,814.78 ","$4,903.20 ","$3,100.00 ","$1,716.12 ","$5,516.10 ","$2,329.02 ",$325.00 ,"$2,680.74 ","$2,941.92 "
ST. MARY'S HOSPITAL - DECATUR,45000564,25270,HC REPAIR TEND/MUSC/EXTENSOR FOREARM/WRIST PRIMARY-RT,450,1 ,"$6,129.00 ","$3,983.85 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$3,370.95 ","$2,680.74 ","$1,716.12 ","$3,248.37 ","$2,680.74 ","$3,432.24 ","$2,680.74 ","$3,100.00 ","$3,100.00 ","$2,680.74 ","$3,100.00 ","$5,093.40 ","$4,290.30 ","$3,064.50 ","$4,903.20 ","$6,701.85 ","$2,680.74 ","$4,290.30 ","$2,680.74 ","$3,677.40 ","$2,680.74 ","$4,596.75 ","$3,052.24 ","$2,745.79 ","$3,052.24 ","$2,680.74 ","$3,052.24 ","$3,786.00 ","$3,786.00 ","$5,209.65 ","$6,129.00 ","$4,247.40 ","$2,680.74 ","$6,129.00 ","$3,370.95 ","$2,680.74 ","$1,611.93 ","$6,129.00 ", N/A , N/A ,"$2,814.78 ","$4,903.20 ","$3,100.00 ","$1,716.12 ","$5,516.10 ","$2,329.02 ",$325.00 ,"$2,680.74 ","$2,941.92 "
ST. MARY'S HOSPITAL - DECATUR,45000565,25260,HC REPAIR TEND/MUSC/FLEXOR FOREARM/WRIST PRIMARY-LT,450,1 ,"$5,513.00 ","$3,583.45 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$3,032.15 ","$2,680.74 ","$1,543.64 ","$2,921.89 ","$2,680.74 ","$3,087.28 ","$2,680.74 ","$2,993.56 ","$2,993.56 ","$2,680.74 ","$2,993.56 ","$5,093.40 ","$3,859.10 ","$2,756.50 ","$4,410.40 ","$6,701.85 ","$2,680.74 ","$3,859.10 ","$2,680.74 ","$3,307.80 ","$2,680.74 ","$4,134.75 ","$2,745.47 ","$2,469.82 ","$2,745.47 ","$2,680.74 ","$2,745.47 ","$3,786.00 ","$3,786.00 ","$4,686.05 ","$5,513.00 ","$3,820.51 ","$2,680.74 ","$5,513.00 ","$3,032.15 ","$2,680.74 ","$1,449.92 ","$5,513.00 ", N/A , N/A ,"$2,814.78 ","$4,410.40 ","$2,993.56 ","$1,543.64 ","$4,961.70 ","$2,094.94 ",$325.00 ,"$2,680.74 ","$2,646.24 "
ST. MARY'S HOSPITAL - DECATUR,45000566,25260,HC REPAIR TEND/MUSC/FLEXOR FOREARM/WRIST PRIMARY-RT,450,1 ,"$5,513.00 ","$3,583.45 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$3,032.15 ","$2,680.74 ","$1,543.64 ","$2,921.89 ","$2,680.74 ","$3,087.28 ","$2,680.74 ","$2,993.56 ","$2,993.56 ","$2,680.74 ","$2,993.56 ","$5,093.40 ","$3,859.10 ","$2,756.50 ","$4,410.40 ","$6,701.85 ","$2,680.74 ","$3,859.10 ","$2,680.74 ","$3,307.80 ","$2,680.74 ","$4,134.75 ","$2,745.47 ","$2,469.82 ","$2,745.47 ","$2,680.74 ","$2,745.47 ","$3,786.00 ","$3,786.00 ","$4,686.05 ","$5,513.00 ","$3,820.51 ","$2,680.74 ","$5,513.00 ","$3,032.15 ","$2,680.74 ","$1,449.92 ","$5,513.00 ", N/A , N/A ,"$2,814.78 ","$4,410.40 ","$2,993.56 ","$1,543.64 ","$4,961.70 ","$2,094.94 ",$325.00 ,"$2,680.74 ","$2,646.24 "
ST. MARY'S HOSPITAL - DECATUR,45000567,26410,HC REPAIR TENDON HAND W/O GRAFT EA TENDON-LT,450,1 ,"$3,673.00 ","$2,387.45 ",$325.00 ,"$3,673.00 ","$3,296.18 ","$1,873.23 ","$2,020.15 ","$1,318.47 ","$1,028.44 ","$1,946.69 ","$1,318.47 ","$2,056.88 ","$1,318.47 ","$1,994.44 ","$1,994.44 ","$1,318.47 ","$1,994.44 ","$2,505.09 ","$2,571.10 ","$1,836.50 ","$2,938.40 ","$3,296.17 ","$1,318.47 ","$2,571.10 ","$1,318.47 ","$2,203.80 ","$1,318.47 ","$2,754.75 ","$1,829.15 ","$1,645.50 ","$1,829.15 ","$1,318.47 ","$1,829.15 ","$2,864.94 ","$2,864.94 ","$3,122.05 ","$3,296.17 ","$2,545.39 ","$1,318.47 ","$3,673.00 ","$2,020.15 ","$1,318.47 ",$966.00 ,"$3,673.00 ", N/A , N/A ,"$1,384.39 ","$2,938.40 ","$1,994.44 ","$1,028.44 ","$3,305.70 ","$1,395.74 ",$325.00 ,"$1,318.47 ","$1,763.04 "
ST. MARY'S HOSPITAL - DECATUR,45000568,26410,HC REPAIR TENDON HAND W/O GRAFT EA TENDON-RT,450,1 ,"$3,673.00 ","$2,387.45 ",$325.00 ,"$3,673.00 ","$3,296.18 ","$1,873.23 ","$2,020.15 ","$1,318.47 ","$1,028.44 ","$1,946.69 ","$1,318.47 ","$2,056.88 ","$1,318.47 ","$1,994.44 ","$1,994.44 ","$1,318.47 ","$1,994.44 ","$2,505.09 ","$2,571.10 ","$1,836.50 ","$2,938.40 ","$3,296.17 ","$1,318.47 ","$2,571.10 ","$1,318.47 ","$2,203.80 ","$1,318.47 ","$2,754.75 ","$1,829.15 ","$1,645.50 ","$1,829.15 ","$1,318.47 ","$1,829.15 ","$2,864.94 ","$2,864.94 ","$3,122.05 ","$3,296.17 ","$2,545.39 ","$1,318.47 ","$3,673.00 ","$2,020.15 ","$1,318.47 ",$966.00 ,"$3,673.00 ", N/A , N/A ,"$1,384.39 ","$2,938.40 ","$1,994.44 ","$1,028.44 ","$3,305.70 ","$1,395.74 ",$325.00 ,"$1,318.47 ","$1,763.04 "
ST. MARY'S HOSPITAL - DECATUR,45000570,24605,HC TX DISLOC ELBOW W/ANES CLOSED-LT,450,1 ,"$3,821.00 ","$2,483.65 ",$325.00 ,"$3,821.00 ","$3,296.18 ","$1,948.71 ","$2,101.55 ","$1,318.47 ","$1,069.88 ","$2,025.13 ","$1,318.47 ","$2,139.76 ","$1,318.47 ","$2,074.80 ","$2,074.80 ","$1,318.47 ","$2,074.80 ","$2,505.09 ","$2,674.70 ","$1,910.50 ","$3,056.80 ","$3,296.17 ","$1,318.47 ","$2,674.70 ","$1,318.47 ","$2,292.60 ","$1,318.47 ","$2,865.75 ","$1,902.86 ","$1,711.81 ","$1,902.86 ","$1,318.47 ","$1,902.86 ","$2,980.38 ","$2,980.38 ","$3,247.85 ","$3,296.17 ","$2,647.95 ","$1,318.47 ","$3,821.00 ","$2,101.55 ","$1,318.47 ","$1,004.92 ","$3,821.00 ", N/A , N/A ,"$1,384.39 ","$3,056.80 ","$2,074.80 ","$1,069.88 ","$3,438.90 ","$1,451.98 ",$325.00 ,"$1,318.47 ","$1,834.08 "
ST. MARY'S HOSPITAL - DECATUR,45000571,24605,HC TX DISLOC ELBOW W/ANES CLOSED-RT,450,1 ,"$3,821.00 ","$2,483.65 ",$325.00 ,"$3,821.00 ","$3,296.18 ","$1,948.71 ","$2,101.55 ","$1,318.47 ","$1,069.88 ","$2,025.13 ","$1,318.47 ","$2,139.76 ","$1,318.47 ","$2,074.80 ","$2,074.80 ","$1,318.47 ","$2,074.80 ","$2,505.09 ","$2,674.70 ","$1,910.50 ","$3,056.80 ","$3,296.17 ","$1,318.47 ","$2,674.70 ","$1,318.47 ","$2,292.60 ","$1,318.47 ","$2,865.75 ","$1,902.86 ","$1,711.81 ","$1,902.86 ","$1,318.47 ","$1,902.86 ","$2,980.38 ","$2,980.38 ","$3,247.85 ","$3,296.17 ","$2,647.95 ","$1,318.47 ","$3,821.00 ","$2,101.55 ","$1,318.47 ","$1,004.92 ","$3,821.00 ", N/A , N/A ,"$1,384.39 ","$3,056.80 ","$2,074.80 ","$1,069.88 ","$3,438.90 ","$1,451.98 ",$325.00 ,"$1,318.47 ","$1,834.08 "
ST. MARY'S HOSPITAL - DECATUR,45000575,27810,HC TX FX BIMALL ANKLE W/MANIP CLOSED-LT,450,1 ,$513.00 ,$333.45 ,$134.92 ,"$3,296.18 ","$3,296.18 ",$261.63 ,$282.15 ,"$1,318.47 ",$143.64 ,$271.89 ,"$1,318.47 ",$287.28 ,$513.00 ,$278.56 ,$278.56 ,$513.00 ,$278.56 ,$513.00 ,$359.10 ,$256.50 ,$410.40 ,"$3,296.17 ","$1,318.47 ",$359.10 ,"$1,318.47 ",$307.80 ,"$1,318.47 ",$384.75 ,$283.18 ,$255.47 ,$283.18 ,"$1,318.47 ",$283.18 ,$400.14 ,$400.14 ,$436.05 ,$513.00 ,$355.51 ,"$1,318.47 ",$513.00 ,$282.15 ,"$1,318.47 ",$134.92 ,$513.00 , N/A , N/A ,"$1,384.39 ",$410.40 ,$278.56 ,$143.64 ,$461.70 ,$194.94 ,$325.00 ,"$1,318.47 ",$246.24 
ST. MARY'S HOSPITAL - DECATUR,45000576,27810,HC TX FX BIMALL ANKLE W/MANIP CLOSED-RT,450,1 ,$513.00 ,$333.45 ,$134.92 ,"$3,296.18 ","$3,296.18 ",$261.63 ,$282.15 ,"$1,318.47 ",$143.64 ,$271.89 ,"$1,318.47 ",$287.28 ,$513.00 ,$278.56 ,$278.56 ,$513.00 ,$278.56 ,$513.00 ,$359.10 ,$256.50 ,$410.40 ,"$3,296.17 ","$1,318.47 ",$359.10 ,"$1,318.47 ",$307.80 ,"$1,318.47 ",$384.75 ,$283.18 ,$255.47 ,$283.18 ,"$1,318.47 ",$283.18 ,$400.14 ,$400.14 ,$436.05 ,$513.00 ,$355.51 ,"$1,318.47 ",$513.00 ,$282.15 ,"$1,318.47 ",$134.92 ,$513.00 , N/A , N/A ,"$1,384.39 ",$410.40 ,$278.56 ,$143.64 ,$461.70 ,$194.94 ,$325.00 ,"$1,318.47 ",$246.24 
ST. MARY'S HOSPITAL - DECATUR,45000577,27752,HC TX FX TIBIAL SHAFT W/MANIP CLOSED - LT,450,1 ,$279.00 ,$181.35 ,$73.38 ,"$3,296.18 ","$3,296.18 ",$142.29 ,$153.45 ,"$1,318.47 ",$78.12 ,$147.87 ,"$1,318.47 ",$156.24 ,$279.00 ,$151.50 ,$151.50 ,$279.00 ,$151.50 ,$279.00 ,$195.30 ,$139.50 ,$223.20 ,"$3,296.17 ","$1,318.47 ",$195.30 ,"$1,318.47 ",$167.40 ,"$1,318.47 ",$209.25 ,$154.01 ,$138.94 ,$154.01 ,"$1,318.47 ",$154.01 ,$217.62 ,$217.62 ,$237.15 ,$279.00 ,$193.35 ,"$1,318.47 ",$279.00 ,$153.45 ,"$1,318.47 ",$73.38 ,$279.00 , N/A , N/A ,"$1,384.39 ",$223.20 ,$151.50 ,$78.12 ,$251.10 ,$106.02 ,$279.00 ,"$1,318.47 ",$133.92 
ST. MARY'S HOSPITAL - DECATUR,45000578,27752,HC TX FX TIBIAL SHAFT W/MANIP CLOSED - RT,450,1 ,$279.00 ,$181.35 ,$73.38 ,"$3,296.18 ","$3,296.18 ",$142.29 ,$153.45 ,"$1,318.47 ",$78.12 ,$147.87 ,"$1,318.47 ",$156.24 ,$279.00 ,$151.50 ,$151.50 ,$279.00 ,$151.50 ,$279.00 ,$195.30 ,$139.50 ,$223.20 ,"$3,296.17 ","$1,318.47 ",$195.30 ,"$1,318.47 ",$167.40 ,"$1,318.47 ",$209.25 ,$154.01 ,$138.94 ,$154.01 ,"$1,318.47 ",$154.01 ,$217.62 ,$217.62 ,$237.15 ,$279.00 ,$193.35 ,"$1,318.47 ",$279.00 ,$153.45 ,"$1,318.47 ",$73.38 ,$279.00 , N/A , N/A ,"$1,384.39 ",$223.20 ,$151.50 ,$78.12 ,$251.10 ,$106.02 ,$279.00 ,"$1,318.47 ",$133.92 
ST. MARY'S HOSPITAL - DECATUR,45000579,25650,HC TX FX ULNAR STYLOID CLOSED - LT,450,1 ,$816.00 ,$530.40 ,$195.10 ,$816.00 ,$487.75 ,$416.16 ,$448.80 ,$195.10 ,$228.48 ,$432.48 ,$195.10 ,$456.96 ,$195.10 ,$443.09 ,$443.09 ,$195.10 ,$443.09 ,$370.70 ,$571.20 ,$408.00 ,$652.80 ,$487.76 ,$195.10 ,$571.20 ,$195.10 ,$489.60 ,$195.10 ,$612.00 ,$450.43 ,$406.37 ,$450.43 ,$195.10 ,$450.43 ,$636.48 ,$636.48 ,$693.60 ,$487.76 ,$565.49 ,$195.10 ,$816.00 ,$448.80 ,$195.10 ,$214.61 ,$816.00 , N/A , N/A ,$204.86 ,$652.80 ,$443.09 ,$228.48 ,$734.40 ,$310.08 ,$325.00 ,$195.10 ,$391.68 
ST. MARY'S HOSPITAL - DECATUR,45000580,25650,HC TX FX ULNAR STYLOID CLOSED - RT,450,1 ,$816.00 ,$530.40 ,$195.10 ,$816.00 ,$487.75 ,$416.16 ,$448.80 ,$195.10 ,$228.48 ,$432.48 ,$195.10 ,$456.96 ,$195.10 ,$443.09 ,$443.09 ,$195.10 ,$443.09 ,$370.70 ,$571.20 ,$408.00 ,$652.80 ,$487.76 ,$195.10 ,$571.20 ,$195.10 ,$489.60 ,$195.10 ,$612.00 ,$450.43 ,$406.37 ,$450.43 ,$195.10 ,$450.43 ,$636.48 ,$636.48 ,$693.60 ,$487.76 ,$565.49 ,$195.10 ,$816.00 ,$448.80 ,$195.10 ,$214.61 ,$816.00 , N/A , N/A ,$204.86 ,$652.80 ,$443.09 ,$228.48 ,$734.40 ,$310.08 ,$325.00 ,$195.10 ,$391.68 
ST. MARY'S HOSPITAL - DECATUR,45000640,11750,HC REMOVE NAIL BED-T5,450,1 ,"$2,519.00 ","$1,637.35 ",$325.00 ,"$2,519.00 ",$817.95 ,"$1,284.69 ","$1,385.45 ",$327.18 ,$705.32 ,"$1,335.07 ",$327.18 ,"$1,410.64 ",$327.18 ,"$1,367.82 ","$1,367.82 ",$327.18 ,"$1,367.82 ",$621.65 ,"$1,763.30 ","$1,259.50 ","$2,015.20 ",$817.95 ,$327.18 ,"$1,763.30 ",$327.18 ,"$1,511.40 ",$327.18 ,"$1,889.25 ","$1,390.49 ","$1,254.46 ","$1,390.49 ",$327.18 ,"$1,390.49 ","$1,964.82 ","$1,964.82 ","$2,141.15 ",$817.95 ,"$1,745.67 ",$327.18 ,"$2,519.00 ","$1,385.45 ",$327.18 ,$662.50 ,"$2,519.00 ", N/A , N/A ,$343.54 ,"$2,015.20 ","$1,367.82 ",$705.32 ,"$2,267.10 ",$957.22 ,$325.00 ,$327.18 ,"$1,209.12 "
ST. MARY'S HOSPITAL - DECATUR,45000645,11750,HC REMOVE NAIL BED-TA,450,1 ,"$2,519.00 ","$1,637.35 ",$325.00 ,"$2,519.00 ",$817.95 ,"$1,284.69 ","$1,385.45 ",$327.18 ,$705.32 ,"$1,335.07 ",$327.18 ,"$1,410.64 ",$327.18 ,"$1,367.82 ","$1,367.82 ",$327.18 ,"$1,367.82 ",$621.65 ,"$1,763.30 ","$1,259.50 ","$2,015.20 ",$817.95 ,$327.18 ,"$1,763.30 ",$327.18 ,"$1,511.40 ",$327.18 ,"$1,889.25 ","$1,390.49 ","$1,254.46 ","$1,390.49 ",$327.18 ,"$1,390.49 ","$1,964.82 ","$1,964.82 ","$2,141.15 ",$817.95 ,"$1,745.67 ",$327.18 ,"$2,519.00 ","$1,385.45 ",$327.18 ,$662.50 ,"$2,519.00 ", N/A , N/A ,$343.54 ,"$2,015.20 ","$1,367.82 ",$705.32 ,"$2,267.10 ",$957.22 ,$325.00 ,$327.18 ,"$1,209.12 "
ST. MARY'S HOSPITAL - DECATUR,45000646,11760,HC REPAIR NAIL BED-F1,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000647,11760,HC REPAIR NAIL BED-F2,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000648,11760,HC REPAIR NAIL BED-F3,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000649,11760,HC REPAIR NAIL BED-F4,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000650,11760,HC REPAIR NAIL BED-F5,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000651,11760,HC REPAIR NAIL BED-F6,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000652,11760,HC REPAIR NAIL BED-F7,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000653,11760,HC REPAIR NAIL BED-F8,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000654,11760,HC REPAIR NAIL BED-F9,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000655,11760,HC REPAIR NAIL BED-FA,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000660,11760,HC REPAIR NAIL BED-T5,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000665,11760,HC REPAIR NAIL BED-TA,450,1 ,$480.00 ,$312.00 ,$126.24 ,"$1,239.43 ","$1,239.43 ",$244.80 ,$264.00 ,$495.77 ,$134.40 ,$254.40 ,$495.77 ,$268.80 ,$480.00 ,$260.64 ,$260.64 ,$480.00 ,$260.64 ,$480.00 ,$336.00 ,$240.00 ,$384.00 ,"$1,239.42 ",$495.77 ,$336.00 ,$495.77 ,$288.00 ,$495.77 ,$360.00 ,$264.96 ,$239.04 ,$264.96 ,$495.77 ,$264.96 ,$374.40 ,$374.40 ,$408.00 ,$480.00 ,$332.64 ,$495.77 ,$480.00 ,$264.00 ,$495.77 ,$126.24 ,$480.00 , N/A , N/A ,$520.56 ,$384.00 ,$260.64 ,$134.40 ,$432.00 ,$182.40 ,$325.00 ,$495.77 ,$230.40 
ST. MARY'S HOSPITAL - DECATUR,45000700,11765,HC EXCISION WEDGE SKIN NAIL FOLD-T5,450,1 ,"$1,147.00 ",$745.55 ,$301.66 ,"$1,147.00 ",$817.95 ,$584.97 ,$630.85 ,$327.18 ,$321.16 ,$607.91 ,$327.18 ,$642.32 ,$327.18 ,$622.82 ,$622.82 ,$327.18 ,$622.82 ,$621.65 ,$802.90 ,$573.50 ,$917.60 ,$817.95 ,$327.18 ,$802.90 ,$327.18 ,$688.20 ,$327.18 ,$860.25 ,$633.14 ,$571.21 ,$633.14 ,$327.18 ,$633.14 ,$894.66 ,$894.66 ,$974.95 ,$817.95 ,$794.87 ,$327.18 ,"$1,147.00 ",$630.85 ,$327.18 ,$301.66 ,"$1,147.00 ", N/A , N/A ,$343.54 ,$917.60 ,$622.82 ,$321.16 ,"$1,032.30 ",$435.86 ,$325.00 ,$327.18 ,$550.56 
ST. MARY'S HOSPITAL - DECATUR,45000705,11765,HC EXCISION WEDGE SKIN NAIL FOLD-TA,450,1 ,"$1,147.00 ",$745.55 ,$301.66 ,"$1,147.00 ",$817.95 ,$584.97 ,$630.85 ,$327.18 ,$321.16 ,$607.91 ,$327.18 ,$642.32 ,$327.18 ,$622.82 ,$622.82 ,$327.18 ,$622.82 ,$621.65 ,$802.90 ,$573.50 ,$917.60 ,$817.95 ,$327.18 ,$802.90 ,$327.18 ,$688.20 ,$327.18 ,$860.25 ,$633.14 ,$571.21 ,$633.14 ,$327.18 ,$633.14 ,$894.66 ,$894.66 ,$974.95 ,$817.95 ,$794.87 ,$327.18 ,"$1,147.00 ",$630.85 ,$327.18 ,$301.66 ,"$1,147.00 ", N/A , N/A ,$343.54 ,$917.60 ,$622.82 ,$321.16 ,"$1,032.30 ",$435.86 ,$325.00 ,$327.18 ,$550.56 
ST. MARY'S HOSPITAL - DECATUR,45000751,24200,HC REMOVE FOREIGN BODY UPPER ARM/ELBOW SUBQ-LT,450,1 ,$979.00 ,$636.35 ,$257.48 ,"$3,329.73 ","$3,329.73 ",$499.29 ,$538.45 ,"$1,331.89 ",$274.12 ,$518.87 ,"$1,331.89 ",$548.24 ,$979.00 ,$531.60 ,$531.60 ,$979.00 ,$531.60 ,$979.00 ,$685.30 ,$489.50 ,$783.20 ,"$3,329.72 ","$1,331.89 ",$685.30 ,"$1,331.89 ",$587.40 ,"$1,331.89 ",$734.25 ,$540.41 ,$487.54 ,$540.41 ,"$1,331.89 ",$540.41 ,$763.62 ,$763.62 ,$832.15 ,$979.00 ,$678.45 ,"$1,331.89 ",$979.00 ,$538.45 ,"$1,331.89 ",$257.48 ,$979.00 , N/A , N/A ,"$1,398.48 ",$783.20 ,$531.60 ,$274.12 ,$881.10 ,$372.02 ,$325.00 ,"$1,331.89 ",$469.92 
ST. MARY'S HOSPITAL - DECATUR,45000752,24200,HC REMOVE FOREIGN BODY UPPER ARM/ELBOW SUBQ-RT,450,1 ,$979.00 ,$636.35 ,$257.48 ,"$3,329.73 ","$3,329.73 ",$499.29 ,$538.45 ,"$1,331.89 ",$274.12 ,$518.87 ,"$1,331.89 ",$548.24 ,$979.00 ,$531.60 ,$531.60 ,$979.00 ,$531.60 ,$979.00 ,$685.30 ,$489.50 ,$783.20 ,"$3,329.72 ","$1,331.89 ",$685.30 ,"$1,331.89 ",$587.40 ,"$1,331.89 ",$734.25 ,$540.41 ,$487.54 ,$540.41 ,"$1,331.89 ",$540.41 ,$763.62 ,$763.62 ,$832.15 ,$979.00 ,$678.45 ,"$1,331.89 ",$979.00 ,$538.45 ,"$1,331.89 ",$257.48 ,$979.00 , N/A , N/A ,"$1,398.48 ",$783.20 ,$531.60 ,$274.12 ,$881.10 ,$372.02 ,$325.00 ,"$1,331.89 ",$469.92 
ST. MARY'S HOSPITAL - DECATUR,45000779,25535,HC TX FX ULNAR CLOSED W/MANIP-LT,450,1 ,"$5,951.00 ","$3,868.15 ",$195.10 ,"$5,951.00 ",$487.75 ,"$2,200.00 ","$3,273.05 ",$195.10 ,"$1,666.28 ","$3,154.03 ",$195.10 ,"$3,332.56 ",$195.10 ,"$3,100.00 ","$3,100.00 ",$195.10 ,"$3,100.00 ",$370.70 ,"$4,165.70 ","$2,975.50 ","$4,760.80 ",$487.76 ,$195.10 ,"$4,165.70 ",$195.10 ,"$3,570.60 ",$195.10 ,"$4,463.25 ","$2,963.60 ","$2,666.05 ","$2,963.60 ",$195.10 ,"$2,963.60 ","$3,786.00 ","$3,786.00 ","$5,058.35 ",$487.76 ,"$4,124.04 ",$195.10 ,"$5,951.00 ","$3,273.05 ",$195.10 ,"$1,565.11 ","$5,951.00 ", N/A , N/A ,$204.86 ,"$4,760.80 ","$3,100.00 ","$1,666.28 ","$5,355.90 ","$2,261.38 ",$325.00 ,$195.10 ,"$2,856.48 "
ST. MARY'S HOSPITAL - DECATUR,45000780,25535,HC TX FX ULNAR CLOSED W/MANIP-RT,450,1 ,"$5,951.00 ","$3,868.15 ",$195.10 ,"$5,951.00 ",$487.75 ,"$2,200.00 ","$3,273.05 ",$195.10 ,"$1,666.28 ","$3,154.03 ",$195.10 ,"$3,332.56 ",$195.10 ,"$3,100.00 ","$3,100.00 ",$195.10 ,"$3,100.00 ",$370.70 ,"$4,165.70 ","$2,975.50 ","$4,760.80 ",$487.76 ,$195.10 ,"$4,165.70 ",$195.10 ,"$3,570.60 ",$195.10 ,"$4,463.25 ","$2,963.60 ","$2,666.05 ","$2,963.60 ",$195.10 ,"$2,963.60 ","$3,786.00 ","$3,786.00 ","$5,058.35 ",$487.76 ,"$4,124.04 ",$195.10 ,"$5,951.00 ","$3,273.05 ",$195.10 ,"$1,565.11 ","$5,951.00 ", N/A , N/A ,$204.86 ,"$4,760.80 ","$3,100.00 ","$1,666.28 ","$5,355.90 ","$2,261.38 ",$325.00 ,$195.10 ,"$2,856.48 "
ST. MARY'S HOSPITAL - DECATUR,45000788,25650,HC TX FX ULNAR STYLOID CLOSED - BIL,450,1 ,$816.00 ,$530.40 ,$214.61 ,$816.00 ,$731.65 ,$416.16 ,$448.80 ,$292.66 ,$228.48 ,$432.48 ,$292.66 ,$456.96 ,$292.66 ,$443.09 ,$443.09 ,$292.66 ,$443.09 ,$556.05 ,$571.20 ,$408.00 ,$652.80 ,$731.64 ,$292.66 ,$571.20 ,$292.66 ,$489.60 ,$292.66 ,$612.00 ,$450.43 ,$406.37 ,$450.43 ,$292.66 ,$450.43 ,$636.48 ,$636.48 ,$693.60 ,$731.64 ,$565.49 ,$292.66 ,$816.00 ,$448.80 ,$292.66 ,$214.61 ,$816.00 , N/A , N/A ,$307.29 ,$652.80 ,$443.09 ,$228.48 ,$734.40 ,$310.08 ,$325.00 ,$292.66 ,$391.68 
ST. MARY'S HOSPITAL - DECATUR,45000789,25675,HC CLOSED TX RADIO-ULNAR DISLOC W/MANIP-LT,450,1 ,"$1,003.00 ",$651.95 ,$195.10 ,"$1,003.00 ",$487.75 ,$511.53 ,$551.65 ,$195.10 ,$280.84 ,$531.59 ,$195.10 ,$561.68 ,$195.10 ,$544.63 ,$544.63 ,$195.10 ,$544.63 ,$370.70 ,$702.10 ,$501.50 ,$802.40 ,$487.76 ,$195.10 ,$702.10 ,$195.10 ,$601.80 ,$195.10 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$195.10 ,$553.66 ,$782.34 ,$782.34 ,$852.55 ,$487.76 ,$695.08 ,$195.10 ,"$1,003.00 ",$551.65 ,$195.10 ,$263.79 ,"$1,003.00 ", N/A , N/A ,$204.86 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$325.00 ,$195.10 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,45000790,25675,HC CLOSED TX RADIO-ULNAR DISLOC W/MANIP-RT,450,1 ,"$1,003.00 ",$651.95 ,$195.10 ,"$1,003.00 ",$487.75 ,$511.53 ,$551.65 ,$195.10 ,$280.84 ,$531.59 ,$195.10 ,$561.68 ,$195.10 ,$544.63 ,$544.63 ,$195.10 ,$544.63 ,$370.70 ,$702.10 ,$501.50 ,$802.40 ,$487.76 ,$195.10 ,$702.10 ,$195.10 ,$601.80 ,$195.10 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$195.10 ,$553.66 ,$782.34 ,$782.34 ,$852.55 ,$487.76 ,$695.08 ,$195.10 ,"$1,003.00 ",$551.65 ,$195.10 ,$263.79 ,"$1,003.00 ", N/A , N/A ,$204.86 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$325.00 ,$195.10 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,45000791,25680,HC TX FX CLOSED WRIST W/MANIP-LT,450,1 ,"$1,270.00 ",$825.50 ,$195.10 ,"$1,270.00 ",$487.75 ,$647.70 ,$698.50 ,$195.10 ,$355.60 ,$673.10 ,$195.10 ,$711.20 ,$195.10 ,$689.61 ,$689.61 ,$195.10 ,$689.61 ,$370.70 ,$889.00 ,$635.00 ,"$1,016.00 ",$487.76 ,$195.10 ,$889.00 ,$195.10 ,$762.00 ,$195.10 ,$952.50 ,$701.04 ,$632.46 ,$701.04 ,$195.10 ,$701.04 ,$990.60 ,$990.60 ,"$1,079.50 ",$487.76 ,$880.11 ,$195.10 ,"$1,270.00 ",$698.50 ,$195.10 ,$334.01 ,"$1,270.00 ", N/A , N/A ,$204.86 ,"$1,016.00 ",$689.61 ,$355.60 ,"$1,143.00 ",$482.60 ,$325.00 ,$195.10 ,$609.60 
ST. MARY'S HOSPITAL - DECATUR,45000792,25680,HC TX FX CLOSED WRIST W/MANIP-RT,450,1 ,"$1,270.00 ",$825.50 ,$195.10 ,"$1,270.00 ",$487.75 ,$647.70 ,$698.50 ,$195.10 ,$355.60 ,$673.10 ,$195.10 ,$711.20 ,$195.10 ,$689.61 ,$689.61 ,$195.10 ,$689.61 ,$370.70 ,$889.00 ,$635.00 ,"$1,016.00 ",$487.76 ,$195.10 ,$889.00 ,$195.10 ,$762.00 ,$195.10 ,$952.50 ,$701.04 ,$632.46 ,$701.04 ,$195.10 ,$701.04 ,$990.60 ,$990.60 ,"$1,079.50 ",$487.76 ,$880.11 ,$195.10 ,"$1,270.00 ",$698.50 ,$195.10 ,$334.01 ,"$1,270.00 ", N/A , N/A ,$204.86 ,"$1,016.00 ",$689.61 ,$355.60 ,"$1,143.00 ",$482.60 ,$325.00 ,$195.10 ,$609.60 
ST. MARY'S HOSPITAL - DECATUR,45000793,25690,HC TX CLOSED WRIST DISLOCATION-LT,450,1 ,"$6,096.00 ","$3,962.40 ",$325.00 ,"$6,096.00 ","$3,296.18 ","$2,200.00 ","$3,352.80 ","$1,318.47 ","$1,706.88 ","$3,230.88 ","$1,318.47 ","$3,413.76 ","$1,318.47 ","$3,100.00 ","$3,100.00 ","$1,318.47 ","$3,100.00 ","$2,505.09 ","$4,267.20 ","$3,048.00 ","$4,876.80 ","$3,296.17 ","$1,318.47 ","$4,267.20 ","$1,318.47 ","$3,657.60 ","$1,318.47 ","$4,572.00 ","$3,035.81 ","$2,731.01 ","$3,035.81 ","$1,318.47 ","$3,035.81 ","$3,786.00 ","$3,786.00 ","$5,181.60 ","$3,296.17 ","$4,224.53 ","$1,318.47 ","$6,096.00 ","$3,352.80 ","$1,318.47 ","$1,603.25 ","$6,096.00 ", N/A , N/A ,"$1,384.39 ","$4,876.80 ","$3,100.00 ","$1,706.88 ","$5,486.40 ","$2,316.48 ",$325.00 ,"$1,318.47 ","$2,926.08 "
ST. MARY'S HOSPITAL - DECATUR,45000794,25690,HC TX CLOSED WRIST DISLOCATION-RT,450,1 ,"$6,096.00 ","$3,962.40 ",$325.00 ,"$6,096.00 ","$3,296.18 ","$2,200.00 ","$3,352.80 ","$1,318.47 ","$1,706.88 ","$3,230.88 ","$1,318.47 ","$3,413.76 ","$1,318.47 ","$3,100.00 ","$3,100.00 ","$1,318.47 ","$3,100.00 ","$2,505.09 ","$4,267.20 ","$3,048.00 ","$4,876.80 ","$3,296.17 ","$1,318.47 ","$4,267.20 ","$1,318.47 ","$3,657.60 ","$1,318.47 ","$4,572.00 ","$3,035.81 ","$2,731.01 ","$3,035.81 ","$1,318.47 ","$3,035.81 ","$3,786.00 ","$3,786.00 ","$5,181.60 ","$3,296.17 ","$4,224.53 ","$1,318.47 ","$6,096.00 ","$3,352.80 ","$1,318.47 ","$1,603.25 ","$6,096.00 ", N/A , N/A ,"$1,384.39 ","$4,876.80 ","$3,100.00 ","$1,706.88 ","$5,486.40 ","$2,316.48 ",$325.00 ,"$1,318.47 ","$2,926.08 "
ST. MARY'S HOSPITAL - DECATUR,45000808,26356,HC REPAIR FLEXOR TENDON DIGIT ZONE 2,450,1 ,"$5,276.00 ","$3,429.40 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$2,901.80 ","$2,680.74 ","$1,477.28 ","$2,796.28 ","$2,680.74 ","$2,954.56 ","$2,680.74 ","$2,864.87 ","$2,864.87 ","$2,680.74 ","$2,864.87 ","$5,093.40 ","$3,693.20 ","$2,638.00 ","$4,220.80 ","$6,701.85 ","$2,680.74 ","$3,693.20 ","$2,680.74 ","$3,165.60 ","$2,680.74 ","$3,957.00 ","$2,627.45 ","$2,363.65 ","$2,627.45 ","$2,680.74 ","$2,627.45 ","$3,786.00 ","$3,786.00 ","$4,484.60 ","$5,276.00 ","$3,656.27 ","$2,680.74 ","$5,276.00 ","$2,901.80 ","$2,680.74 ","$1,387.59 ","$5,276.00 ", N/A , N/A ,"$2,814.78 ","$4,220.80 ","$2,864.87 ","$1,477.28 ","$4,748.40 ","$2,004.88 ",$325.00 ,"$2,680.74 ","$2,532.48 "
ST. MARY'S HOSPITAL - DECATUR,45000955,26770,HC TX DISL (I-P) HAND W/O ANES-F1,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000956,26770,HC TX DISL (I-P) HAND W/O ANES-F2,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000957,26770,HC TX DISL (I-P) HAND W/O ANES-F3,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000958,26770,HC TX DISL (I-P) HAND W/O ANES-F4,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000959,26770,HC TX DISL (I-P) HAND W/O ANES-F5,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000960,26770,HC TX DISL (I-P) HAND W/O ANES-F6,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000961,26770,HC TX DISL (I-P) HAND W/O ANES-F7,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000962,26770,HC TX DISL (I-P) HAND W/O ANES-F8,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000963,26770,HC TX DISL (I-P) HAND W/O ANES-F9,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45000964,26770,HC TX DISL (I-P) HAND W/O ANES-FA,450,1 ,$862.00 ,$560.30 ,$195.10 ,$862.00 ,$487.75 ,$439.62 ,$474.10 ,$195.10 ,$241.36 ,$456.86 ,$195.10 ,$482.72 ,$195.10 ,$468.07 ,$468.07 ,$195.10 ,$468.07 ,$370.70 ,$603.40 ,$431.00 ,$689.60 ,$487.76 ,$195.10 ,$603.40 ,$195.10 ,$517.20 ,$195.10 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$195.10 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$487.76 ,$597.37 ,$195.10 ,$862.00 ,$474.10 ,$195.10 ,$226.71 ,$862.00 , N/A , N/A ,$204.86 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$325.00 ,$195.10 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,45001000,27250,HC TX DISCL HIP CLOSED W/O ANES-RT,450,1 ,"$1,764.00 ","$1,146.60 ",$195.10 ,"$1,764.00 ",$487.75 ,$899.64 ,$970.20 ,$195.10 ,$493.92 ,$934.92 ,$195.10 ,$987.84 ,$195.10 ,$957.85 ,$957.85 ,$195.10 ,$957.85 ,$370.70 ,"$1,234.80 ",$882.00 ,"$1,411.20 ",$487.76 ,$195.10 ,"$1,234.80 ",$195.10 ,"$1,058.40 ",$195.10 ,"$1,323.00 ",$973.73 ,$878.47 ,$973.73 ,$195.10 ,$973.73 ,"$1,375.92 ","$1,375.92 ","$1,499.40 ",$487.76 ,"$1,222.45 ",$195.10 ,"$1,764.00 ",$970.20 ,$195.10 ,$463.93 ,"$1,764.00 ", N/A , N/A ,$204.86 ,"$1,411.20 ",$957.85 ,$493.92 ,"$1,587.60 ",$670.32 ,$325.00 ,$195.10 ,$846.72 
ST. MARY'S HOSPITAL - DECATUR,45001003,27500,HC TX FX CLOSED FEMUR W/O MANIP-LT,450,1 ,"$1,221.00 ",$793.65 ,$195.10 ,"$1,221.00 ",$487.75 ,$622.71 ,$671.55 ,$195.10 ,$341.88 ,$647.13 ,$195.10 ,$683.76 ,$195.10 ,$663.00 ,$663.00 ,$195.10 ,$663.00 ,$370.70 ,$854.70 ,$610.50 ,$976.80 ,$487.76 ,$195.10 ,$854.70 ,$195.10 ,$732.60 ,$195.10 ,$915.75 ,$673.99 ,$608.06 ,$673.99 ,$195.10 ,$673.99 ,$952.38 ,$952.38 ,"$1,037.85 ",$487.76 ,$846.15 ,$195.10 ,"$1,221.00 ",$671.55 ,$195.10 ,$321.12 ,"$1,221.00 ", N/A , N/A ,$204.86 ,$976.80 ,$663.00 ,$341.88 ,"$1,098.90 ",$463.98 ,$325.00 ,$195.10 ,$586.08 
ST. MARY'S HOSPITAL - DECATUR,45001004,27500,HC TX FX CLOSED FEMUR W/O MANIP-RT,450,1 ,"$1,221.00 ",$793.65 ,$195.10 ,"$1,221.00 ",$487.75 ,$622.71 ,$671.55 ,$195.10 ,$341.88 ,$647.13 ,$195.10 ,$683.76 ,$195.10 ,$663.00 ,$663.00 ,$195.10 ,$663.00 ,$370.70 ,$854.70 ,$610.50 ,$976.80 ,$487.76 ,$195.10 ,$854.70 ,$195.10 ,$732.60 ,$195.10 ,$915.75 ,$673.99 ,$608.06 ,$673.99 ,$195.10 ,$673.99 ,$952.38 ,$952.38 ,"$1,037.85 ",$487.76 ,$846.15 ,$195.10 ,"$1,221.00 ",$671.55 ,$195.10 ,$321.12 ,"$1,221.00 ", N/A , N/A ,$204.86 ,$976.80 ,$663.00 ,$341.88 ,"$1,098.90 ",$463.98 ,$325.00 ,$195.10 ,$586.08 
ST. MARY'S HOSPITAL - DECATUR,45001020,27760,HC CLSD TX FX MEDIAL MALLEOLUS W/O MANIP-LT,450,1 ,$773.00 ,$502.45 ,$195.10 ,$773.00 ,$487.75 ,$394.23 ,$425.15 ,$195.10 ,$216.44 ,$409.69 ,$195.10 ,$432.88 ,$195.10 ,$419.74 ,$419.74 ,$195.10 ,$419.74 ,$370.70 ,$541.10 ,$386.50 ,$618.40 ,$487.76 ,$195.10 ,$541.10 ,$195.10 ,$463.80 ,$195.10 ,$579.75 ,$426.70 ,$384.95 ,$426.70 ,$195.10 ,$426.70 ,$602.94 ,$602.94 ,$657.05 ,$487.76 ,$535.69 ,$195.10 ,$773.00 ,$425.15 ,$195.10 ,$203.30 ,$773.00 , N/A , N/A ,$204.86 ,$618.40 ,$419.74 ,$216.44 ,$695.70 ,$293.74 ,$325.00 ,$195.10 ,$371.04 
ST. MARY'S HOSPITAL - DECATUR,45001021,27760,HC CLSD TX FX MEDIAL MALLEOLUS W/O MANIP-RT,450,1 ,$773.00 ,$502.45 ,$195.10 ,$773.00 ,$487.75 ,$394.23 ,$425.15 ,$195.10 ,$216.44 ,$409.69 ,$195.10 ,$432.88 ,$195.10 ,$419.74 ,$419.74 ,$195.10 ,$419.74 ,$370.70 ,$541.10 ,$386.50 ,$618.40 ,$487.76 ,$195.10 ,$541.10 ,$195.10 ,$463.80 ,$195.10 ,$579.75 ,$426.70 ,$384.95 ,$426.70 ,$195.10 ,$426.70 ,$602.94 ,$602.94 ,$657.05 ,$487.76 ,$535.69 ,$195.10 ,$773.00 ,$425.15 ,$195.10 ,$203.30 ,$773.00 , N/A , N/A ,$204.86 ,$618.40 ,$419.74 ,$216.44 ,$695.70 ,$293.74 ,$325.00 ,$195.10 ,$371.04 
ST. MARY'S HOSPITAL - DECATUR,45001022,27762,HC CLSD TX FX MEDIAL MALLEOLUS W/MANIP-LT,450,1 ,"$3,883.00 ","$2,523.95 ",$325.00 ,"$3,883.00 ","$3,296.18 ","$1,980.33 ","$2,135.65 ","$1,318.47 ","$1,087.24 ","$2,057.99 ","$1,318.47 ","$2,174.48 ","$1,318.47 ","$2,108.47 ","$2,108.47 ","$1,318.47 ","$2,108.47 ","$2,505.09 ","$2,718.10 ","$1,941.50 ","$3,106.40 ","$3,296.17 ","$1,318.47 ","$2,718.10 ","$1,318.47 ","$2,329.80 ","$1,318.47 ","$2,912.25 ","$1,933.73 ","$1,739.58 ","$1,933.73 ","$1,318.47 ","$1,933.73 ","$3,028.74 ","$3,028.74 ","$3,300.55 ","$3,296.17 ","$2,690.92 ","$1,318.47 ","$3,883.00 ","$2,135.65 ","$1,318.47 ","$1,021.23 ","$3,883.00 ", N/A , N/A ,"$1,384.39 ","$3,106.40 ","$2,108.47 ","$1,087.24 ","$3,494.70 ","$1,475.54 ",$325.00 ,"$1,318.47 ","$1,863.84 "
ST. MARY'S HOSPITAL - DECATUR,45001023,27762,HC CLSD TX FX MEDIAL MALLEOLUS W/MANIP-RT,450,1 ,"$3,883.00 ","$2,523.95 ",$325.00 ,"$3,883.00 ","$3,296.18 ","$1,980.33 ","$2,135.65 ","$1,318.47 ","$1,087.24 ","$2,057.99 ","$1,318.47 ","$2,174.48 ","$1,318.47 ","$2,108.47 ","$2,108.47 ","$1,318.47 ","$2,108.47 ","$2,505.09 ","$2,718.10 ","$1,941.50 ","$3,106.40 ","$3,296.17 ","$1,318.47 ","$2,718.10 ","$1,318.47 ","$2,329.80 ","$1,318.47 ","$2,912.25 ","$1,933.73 ","$1,739.58 ","$1,933.73 ","$1,318.47 ","$1,933.73 ","$3,028.74 ","$3,028.74 ","$3,300.55 ","$3,296.17 ","$2,690.92 ","$1,318.47 ","$3,883.00 ","$2,135.65 ","$1,318.47 ","$1,021.23 ","$3,883.00 ", N/A , N/A ,"$1,384.39 ","$3,106.40 ","$2,108.47 ","$1,087.24 ","$3,494.70 ","$1,475.54 ",$325.00 ,"$1,318.47 ","$1,863.84 "
ST. MARY'S HOSPITAL - DECATUR,45001024,27768,HC CLSD TX POSTERIOR WITH MANIP,450,1 ,"$3,883.00 ","$2,523.95 ",$325.00 ,"$3,883.00 ","$3,296.18 ","$1,980.33 ","$2,135.65 ","$1,318.47 ","$1,087.24 ","$2,057.99 ","$1,318.47 ","$2,174.48 ","$1,318.47 ","$2,108.47 ","$2,108.47 ","$1,318.47 ","$2,108.47 ","$2,505.09 ","$2,718.10 ","$1,941.50 ","$3,106.40 ","$3,296.17 ","$1,318.47 ","$2,718.10 ","$1,318.47 ","$2,329.80 ","$1,318.47 ","$2,912.25 ","$1,933.73 ","$1,739.58 ","$1,933.73 ","$1,318.47 ","$1,933.73 ","$3,028.74 ","$3,028.74 ","$3,300.55 ","$3,296.17 ","$2,690.92 ","$1,318.47 ","$3,883.00 ","$2,135.65 ","$1,318.47 ","$1,021.23 ","$3,883.00 ", N/A , N/A ,"$1,384.39 ","$3,106.40 ","$2,108.47 ","$1,087.24 ","$3,494.70 ","$1,475.54 ",$325.00 ,"$1,318.47 ","$1,863.84 "
ST. MARY'S HOSPITAL - DECATUR,45001029,27786,HC TX FX CLOSED DISTAL FIBULAR  W/O MANIP-LT,450,1 ,$765.00 ,$497.25 ,$195.10 ,$765.00 ,$487.75 ,$390.15 ,$420.75 ,$195.10 ,$214.20 ,$405.45 ,$195.10 ,$428.40 ,$195.10 ,$415.40 ,$415.40 ,$195.10 ,$415.40 ,$370.70 ,$535.50 ,$382.50 ,$612.00 ,$487.76 ,$195.10 ,$535.50 ,$195.10 ,$459.00 ,$195.10 ,$573.75 ,$422.28 ,$380.97 ,$422.28 ,$195.10 ,$422.28 ,$596.70 ,$596.70 ,$650.25 ,$487.76 ,$530.15 ,$195.10 ,$765.00 ,$420.75 ,$195.10 ,$201.20 ,$765.00 , N/A , N/A ,$204.86 ,$612.00 ,$415.40 ,$214.20 ,$688.50 ,$290.70 ,$325.00 ,$195.10 ,$367.20 
ST. MARY'S HOSPITAL - DECATUR,45001030,27786,HC TX FX CLOSED DISTAL FIBULAR  W/O MANIP-RT,450,1 ,$765.00 ,$497.25 ,$195.10 ,$765.00 ,$487.75 ,$390.15 ,$420.75 ,$195.10 ,$214.20 ,$405.45 ,$195.10 ,$428.40 ,$195.10 ,$415.40 ,$415.40 ,$195.10 ,$415.40 ,$370.70 ,$535.50 ,$382.50 ,$612.00 ,$487.76 ,$195.10 ,$535.50 ,$195.10 ,$459.00 ,$195.10 ,$573.75 ,$422.28 ,$380.97 ,$422.28 ,$195.10 ,$422.28 ,$596.70 ,$596.70 ,$650.25 ,$487.76 ,$530.15 ,$195.10 ,$765.00 ,$420.75 ,$195.10 ,$201.20 ,$765.00 , N/A , N/A ,$204.86 ,$612.00 ,$415.40 ,$214.20 ,$688.50 ,$290.70 ,$325.00 ,$195.10 ,$367.20 
ST. MARY'S HOSPITAL - DECATUR,45001031,27788,HC TX FX CLOSED DISTAL FIBULAR W/MANIP-LT,450,1 ,$597.00 ,$388.05 ,$157.01 ,$597.00 ,$487.75 ,$304.47 ,$328.35 ,$195.10 ,$167.16 ,$316.41 ,$195.10 ,$334.32 ,$195.10 ,$324.17 ,$324.17 ,$195.10 ,$324.17 ,$370.70 ,$417.90 ,$298.50 ,$477.60 ,$487.76 ,$195.10 ,$417.90 ,$195.10 ,$358.20 ,$195.10 ,$447.75 ,$329.54 ,$297.31 ,$329.54 ,$195.10 ,$329.54 ,$465.66 ,$465.66 ,$507.45 ,$487.76 ,$413.72 ,$195.10 ,$597.00 ,$328.35 ,$195.10 ,$157.01 ,$597.00 , N/A , N/A ,$204.86 ,$477.60 ,$324.17 ,$167.16 ,$537.30 ,$226.86 ,$325.00 ,$195.10 ,$286.56 
ST. MARY'S HOSPITAL - DECATUR,45001032,27788,HC TX FX CLOSED DISTAL FIBULAR W/MANIP-RT,450,1 ,$597.00 ,$388.05 ,$157.01 ,$597.00 ,$487.75 ,$304.47 ,$328.35 ,$195.10 ,$167.16 ,$316.41 ,$195.10 ,$334.32 ,$195.10 ,$324.17 ,$324.17 ,$195.10 ,$324.17 ,$370.70 ,$417.90 ,$298.50 ,$477.60 ,$487.76 ,$195.10 ,$417.90 ,$195.10 ,$358.20 ,$195.10 ,$447.75 ,$329.54 ,$297.31 ,$329.54 ,$195.10 ,$329.54 ,$465.66 ,$465.66 ,$507.45 ,$487.76 ,$413.72 ,$195.10 ,$597.00 ,$328.35 ,$195.10 ,$157.01 ,$597.00 , N/A , N/A ,$204.86 ,$477.60 ,$324.17 ,$167.16 ,$537.30 ,$226.86 ,$325.00 ,$195.10 ,$286.56 
ST. MARY'S HOSPITAL - DECATUR,45001033,27810,HC TX FX BIMALL ANKLE W/MANIP CLOSED-BIL,450,1 ,$513.00 ,$333.45 ,$134.92 ,"$3,296.18 ","$3,296.18 ",$261.63 ,$282.15 ,"$1,318.47 ",$143.64 ,$271.89 ,"$1,318.47 ",$287.28 ,$513.00 ,$278.56 ,$278.56 ,$513.00 ,$278.56 ,$513.00 ,$359.10 ,$256.50 ,$410.40 ,"$3,296.17 ","$1,318.47 ",$359.10 ,"$1,318.47 ",$307.80 ,"$1,318.47 ",$384.75 ,$283.18 ,$255.47 ,$283.18 ,"$1,318.47 ",$283.18 ,$400.14 ,$400.14 ,$436.05 ,$513.00 ,$355.51 ,"$1,318.47 ",$513.00 ,$282.15 ,"$1,318.47 ",$134.92 ,$513.00 , N/A , N/A ,"$1,384.39 ",$410.40 ,$278.56 ,$143.64 ,$461.70 ,$194.94 ,$325.00 ,"$1,318.47 ",$246.24 
ST. MARY'S HOSPITAL - DECATUR,45001038,27840,HC TX DISL ANKE W/O ANES CLS-LT,450,1 ,$773.00 ,$502.45 ,$195.10 ,$773.00 ,$487.75 ,$394.23 ,$425.15 ,$195.10 ,$216.44 ,$409.69 ,$195.10 ,$432.88 ,$195.10 ,$419.74 ,$419.74 ,$195.10 ,$419.74 ,$370.70 ,$541.10 ,$386.50 ,$618.40 ,$487.76 ,$195.10 ,$541.10 ,$195.10 ,$463.80 ,$195.10 ,$579.75 ,$426.70 ,$384.95 ,$426.70 ,$195.10 ,$426.70 ,$602.94 ,$602.94 ,$657.05 ,$487.76 ,$535.69 ,$195.10 ,$773.00 ,$425.15 ,$195.10 ,$203.30 ,$773.00 , N/A , N/A ,$204.86 ,$618.40 ,$419.74 ,$216.44 ,$695.70 ,$293.74 ,$325.00 ,$195.10 ,$371.04 
ST. MARY'S HOSPITAL - DECATUR,45001039,27840,HC TX DISL ANKE W/O ANES CLS-RT,450,1 ,$773.00 ,$502.45 ,$195.10 ,$773.00 ,$487.75 ,$394.23 ,$425.15 ,$195.10 ,$216.44 ,$409.69 ,$195.10 ,$432.88 ,$195.10 ,$419.74 ,$419.74 ,$195.10 ,$419.74 ,$370.70 ,$541.10 ,$386.50 ,$618.40 ,$487.76 ,$195.10 ,$541.10 ,$195.10 ,$463.80 ,$195.10 ,$579.75 ,$426.70 ,$384.95 ,$426.70 ,$195.10 ,$426.70 ,$602.94 ,$602.94 ,$657.05 ,$487.76 ,$535.69 ,$195.10 ,$773.00 ,$425.15 ,$195.10 ,$203.30 ,$773.00 , N/A , N/A ,$204.86 ,$618.40 ,$419.74 ,$216.44 ,$695.70 ,$293.74 ,$325.00 ,$195.10 ,$371.04 
ST. MARY'S HOSPITAL - DECATUR,45001042,28192,HC REMOVE FOREIGN BODY FOOT DEEP-LT,450,1 ,"$6,989.00 ","$4,542.85 ",$325.00 ,"$6,989.00 ","$3,329.73 ","$2,200.00 ","$3,843.95 ","$1,331.89 ","$1,956.92 ","$3,704.17 ","$1,331.89 ","$3,913.84 ","$1,331.89 ","$3,100.00 ","$3,100.00 ","$1,331.89 ","$3,100.00 ","$2,530.59 ","$4,892.30 ","$3,494.50 ","$5,591.20 ","$3,329.72 ","$1,331.89 ","$4,892.30 ","$1,331.89 ","$4,193.40 ","$1,331.89 ","$5,241.75 ","$3,480.52 ","$3,131.07 ","$3,480.52 ","$1,331.89 ","$3,480.52 ","$3,786.00 ","$3,786.00 ","$5,940.65 ","$3,329.72 ","$4,843.38 ","$1,331.89 ","$6,989.00 ","$3,843.95 ","$1,331.89 ","$1,838.11 ","$6,989.00 ", N/A , N/A ,"$1,398.48 ","$5,591.20 ","$3,100.00 ","$1,956.92 ","$6,290.10 ","$2,655.82 ",$325.00 ,"$1,331.89 ","$3,354.72 "
ST. MARY'S HOSPITAL - DECATUR,45001043,28192,HC REMOVE FOREIGN BODY FOOT DEEP-RT,450,1 ,"$6,989.00 ","$4,542.85 ",$325.00 ,"$6,989.00 ","$3,329.73 ","$2,200.00 ","$3,843.95 ","$1,331.89 ","$1,956.92 ","$3,704.17 ","$1,331.89 ","$3,913.84 ","$1,331.89 ","$3,100.00 ","$3,100.00 ","$1,331.89 ","$3,100.00 ","$2,530.59 ","$4,892.30 ","$3,494.50 ","$5,591.20 ","$3,329.72 ","$1,331.89 ","$4,892.30 ","$1,331.89 ","$4,193.40 ","$1,331.89 ","$5,241.75 ","$3,480.52 ","$3,131.07 ","$3,480.52 ","$1,331.89 ","$3,480.52 ","$3,786.00 ","$3,786.00 ","$5,940.65 ","$3,329.72 ","$4,843.38 ","$1,331.89 ","$6,989.00 ","$3,843.95 ","$1,331.89 ","$1,838.11 ","$6,989.00 ", N/A , N/A ,"$1,398.48 ","$5,591.20 ","$3,100.00 ","$1,956.92 ","$6,290.10 ","$2,655.82 ",$325.00 ,"$1,331.89 ","$3,354.72 "
ST. MARY'S HOSPITAL - DECATUR,45001060,28515,HC TOE FX W/MANIP-T9,450,1 ,"$1,258.00 ",$817.70 ,$195.10 ,"$1,258.00 ",$487.75 ,$641.58 ,$691.90 ,$195.10 ,$352.24 ,$666.74 ,$195.10 ,$704.48 ,$195.10 ,$683.09 ,$683.09 ,$195.10 ,$683.09 ,$370.70 ,$880.60 ,$629.00 ,"$1,006.40 ",$487.76 ,$195.10 ,$880.60 ,$195.10 ,$754.80 ,$195.10 ,$943.50 ,$694.42 ,$626.48 ,$694.42 ,$195.10 ,$694.42 ,$981.24 ,$981.24 ,"$1,069.30 ",$487.76 ,$871.79 ,$195.10 ,"$1,258.00 ",$691.90 ,$195.10 ,$330.85 ,"$1,258.00 ", N/A , N/A ,$204.86 ,"$1,006.40 ",$683.09 ,$352.24 ,"$1,132.20 ",$478.04 ,$325.00 ,$195.10 ,$603.84 
ST. MARY'S HOSPITAL - DECATUR,45001070,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES-T6,450,1 ,$996.00 ,$647.40 ,$195.10 ,$996.00 ,$487.75 ,$507.96 ,$547.80 ,$195.10 ,$278.88 ,$527.88 ,$195.10 ,$557.76 ,$195.10 ,$540.83 ,$540.83 ,$195.10 ,$540.83 ,$370.70 ,$697.20 ,$498.00 ,$796.80 ,$487.76 ,$195.10 ,$697.20 ,$195.10 ,$597.60 ,$195.10 ,$747.00 ,$549.79 ,$496.01 ,$549.79 ,$195.10 ,$549.79 ,$776.88 ,$776.88 ,$846.60 ,$487.76 ,$690.23 ,$195.10 ,$996.00 ,$547.80 ,$195.10 ,$261.95 ,$996.00 , N/A , N/A ,$204.86 ,$796.80 ,$540.83 ,$278.88 ,$896.40 ,$378.48 ,$325.00 ,$195.10 ,$478.08 
ST. MARY'S HOSPITAL - DECATUR,45001087,29130,HC APPL SPLINT FINGER STATIC-F1,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001088,29130,HC APPL SPLINT FINGER STATIC-F2,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001089,29130,HC APPL SPLINT FINGER STATIC-F3,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001090,29130,HC APPL SPLINT FINGER STATIC-F4,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001091,29130,HC APPL SPLINT FINGER STATIC-F5,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001092,29130,HC APPL SPLINT FINGER STATIC-F6,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001093,29130,HC APPL SPLINT FINGER STATIC-F7,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001094,29130,HC APPL SPLINT FINGER STATIC-F8,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001095,29130,HC APPL SPLINT FINGER STATIC-F9,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001096,29130,HC APPL SPLINT FINGER STATIC-FA,450,1 ,$725.00 ,$471.25 ,$106.74 ,$725.00 ,$266.85 ,$369.75 ,$398.75 ,$106.74 ,$203.00 ,$384.25 ,$106.74 ,$406.00 ,$106.74 ,$393.68 ,$393.68 ,$106.74 ,$393.68 ,$202.80 ,$507.50 ,$362.50 ,$580.00 ,$266.84 ,$106.74 ,$507.50 ,$106.74 ,$435.00 ,$106.74 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$106.74 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$266.84 ,$502.43 ,$106.74 ,$725.00 ,$398.75 ,$106.74 ,$190.68 ,$725.00 , N/A , N/A ,$112.08 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$325.00 ,$106.74 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,45001097,29131,HC APPL SPLINT FINGER DYNAMIC-F1,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001098,29131,HC APPL SPLINT FINGER DYNAMIC-F2,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001099,29131,HC APPL SPLINT FINGER DYNAMIC-F3,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001100,29131,HC APPL SPLINT FINGER DYNAMIC-F4,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001101,29131,HC APPL SPLINT FINGER DYNAMIC-F5,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001102,29131,HC APPL SPLINT FINGER DYNAMIC-F6,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001103,29131,HC APPL SPLINT FINGER DYNAMIC-F7,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001104,29131,HC APPL SPLINT FINGER DYNAMIC-F8,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001105,29131,HC APPL SPLINT FINGER DYNAMIC-F9,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001106,29131,HC APPL SPLINT FINGER DYNAMIC-FA,450,1 ,$796.00 ,$517.40 ,$52.69 ,$796.00 ,$131.73 ,$405.96 ,$437.80 ,$52.69 ,$222.88 ,$421.88 ,$52.69 ,$445.76 ,$52.69 ,$432.23 ,$432.23 ,$52.69 ,$432.23 ,$100.11 ,$557.20 ,$398.00 ,$636.80 ,$131.73 ,$52.69 ,$557.20 ,$52.69 ,$477.60 ,$52.69 ,$597.00 ,$439.39 ,$396.41 ,$439.39 ,$52.69 ,$439.39 ,$620.88 ,$620.88 ,$676.60 ,$131.73 ,$551.63 ,$52.69 ,$796.00 ,$437.80 ,$52.69 ,$209.35 ,$796.00 , N/A , N/A ,$55.32 ,$636.80 ,$432.23 ,$222.88 ,$716.40 ,$302.48 ,$325.00 ,$52.69 ,$382.08 
ST. MARY'S HOSPITAL - DECATUR,45001107,29280,HC STRAPPING HAND/FINGER-LT,450,1 ,$558.00 ,$362.70 ,$52.69 ,$558.00 ,$131.73 ,$284.58 ,$306.90 ,$52.69 ,$156.24 ,$295.74 ,$52.69 ,$312.48 ,$52.69 ,$302.99 ,$302.99 ,$52.69 ,$302.99 ,$100.11 ,$390.60 ,$279.00 ,$446.40 ,$131.73 ,$52.69 ,$390.60 ,$52.69 ,$334.80 ,$52.69 ,$418.50 ,$308.02 ,$277.88 ,$308.02 ,$52.69 ,$308.02 ,$435.24 ,$435.24 ,$474.30 ,$131.73 ,$386.69 ,$52.69 ,$558.00 ,$306.90 ,$52.69 ,$146.75 ,$558.00 , N/A , N/A ,$55.32 ,$446.40 ,$302.99 ,$156.24 ,$502.20 ,$212.04 ,$325.00 ,$52.69 ,$267.84 
ST. MARY'S HOSPITAL - DECATUR,45001108,29280,HC STRAPPING HAND/FINGER-RT,450,1 ,$558.00 ,$362.70 ,$52.69 ,$558.00 ,$131.73 ,$284.58 ,$306.90 ,$52.69 ,$156.24 ,$295.74 ,$52.69 ,$312.48 ,$52.69 ,$302.99 ,$302.99 ,$52.69 ,$302.99 ,$100.11 ,$390.60 ,$279.00 ,$446.40 ,$131.73 ,$52.69 ,$390.60 ,$52.69 ,$334.80 ,$52.69 ,$418.50 ,$308.02 ,$277.88 ,$308.02 ,$52.69 ,$308.02 ,$435.24 ,$435.24 ,$474.30 ,$131.73 ,$386.69 ,$52.69 ,$558.00 ,$306.90 ,$52.69 ,$146.75 ,$558.00 , N/A , N/A ,$55.32 ,$446.40 ,$302.99 ,$156.24 ,$502.20 ,$212.04 ,$325.00 ,$52.69 ,$267.84 
ST. MARY'S HOSPITAL - DECATUR,45001112,29540,HC STRAPPING ANKLE/FOOT-LT,450,1 ,$413.00 ,$268.45 ,$108.62 ,$413.00 ,$334.35 ,$210.63 ,$227.15 ,$133.74 ,$115.64 ,$218.89 ,$133.74 ,$231.28 ,$133.74 ,$224.26 ,$224.26 ,$133.74 ,$224.26 ,$254.10 ,$289.10 ,$206.50 ,$330.40 ,$334.34 ,$133.74 ,$289.10 ,$133.74 ,$247.80 ,$133.74 ,$309.75 ,$227.98 ,$205.67 ,$227.98 ,$133.74 ,$227.98 ,$322.14 ,$322.14 ,$351.05 ,$334.34 ,$286.21 ,$133.74 ,$413.00 ,$227.15 ,$133.74 ,$108.62 ,$413.00 , N/A , N/A ,$140.43 ,$330.40 ,$224.26 ,$115.64 ,$371.70 ,$156.94 ,$325.00 ,$133.74 ,$198.24 
ST. MARY'S HOSPITAL - DECATUR,45001113,29540,HC STRAPPING ANKLE/FOOT-RT,450,1 ,$413.00 ,$268.45 ,$108.62 ,$413.00 ,$334.35 ,$210.63 ,$227.15 ,$133.74 ,$115.64 ,$218.89 ,$133.74 ,$231.28 ,$133.74 ,$224.26 ,$224.26 ,$133.74 ,$224.26 ,$254.10 ,$289.10 ,$206.50 ,$330.40 ,$334.34 ,$133.74 ,$289.10 ,$133.74 ,$247.80 ,$133.74 ,$309.75 ,$227.98 ,$205.67 ,$227.98 ,$133.74 ,$227.98 ,$322.14 ,$322.14 ,$351.05 ,$334.34 ,$286.21 ,$133.74 ,$413.00 ,$227.15 ,$133.74 ,$108.62 ,$413.00 , N/A , N/A ,$140.43 ,$330.40 ,$224.26 ,$115.64 ,$371.70 ,$156.94 ,$325.00 ,$133.74 ,$198.24 
ST. MARY'S HOSPITAL - DECATUR,45001114,29705,HC REM/BIV CAST ARM/LEG-LT,450,1 ,$513.00 ,$333.45 ,$134.92 ,$570.90 ,$570.90 ,$261.63 ,$282.15 ,$228.36 ,$143.64 ,$271.89 ,$228.36 ,$287.28 ,$228.36 ,$278.56 ,$278.56 ,$228.36 ,$278.56 ,$433.88 ,$359.10 ,$256.50 ,$410.40 ,$570.90 ,$228.36 ,$359.10 ,$228.36 ,$307.80 ,$228.36 ,$384.75 ,$283.18 ,$255.47 ,$283.18 ,$228.36 ,$283.18 ,$400.14 ,$400.14 ,$436.05 ,$513.00 ,$355.51 ,$228.36 ,$513.00 ,$282.15 ,$228.36 ,$134.92 ,$513.00 , N/A , N/A ,$239.78 ,$410.40 ,$278.56 ,$143.64 ,$461.70 ,$194.94 ,$325.00 ,$228.36 ,$246.24 
ST. MARY'S HOSPITAL - DECATUR,45001115,29705,HC REM/BIV CAST ARM/LEG-RT,450,1 ,$513.00 ,$333.45 ,$134.92 ,$570.90 ,$570.90 ,$261.63 ,$282.15 ,$228.36 ,$143.64 ,$271.89 ,$228.36 ,$287.28 ,$228.36 ,$278.56 ,$278.56 ,$228.36 ,$278.56 ,$433.88 ,$359.10 ,$256.50 ,$410.40 ,$570.90 ,$228.36 ,$359.10 ,$228.36 ,$307.80 ,$228.36 ,$384.75 ,$283.18 ,$255.47 ,$283.18 ,$228.36 ,$283.18 ,$400.14 ,$400.14 ,$436.05 ,$513.00 ,$355.51 ,$228.36 ,$513.00 ,$282.15 ,$228.36 ,$134.92 ,$513.00 , N/A , N/A ,$239.78 ,$410.40 ,$278.56 ,$143.64 ,$461.70 ,$194.94 ,$325.00 ,$228.36 ,$246.24 
ST. MARY'S HOSPITAL - DECATUR,45001120,30310,HC REMOVE NASAL FB W/ANESTH,450,1 ,"$5,948.00 ","$3,866.20 ",$325.00 ,"$6,474.08 ","$6,474.08 ","$2,200.00 ","$3,271.40 ","$2,589.63 ","$1,665.44 ","$3,152.44 ","$2,589.63 ","$3,330.88 ","$2,589.63 ","$3,100.00 ","$3,100.00 ","$2,589.63 ","$3,100.00 ","$4,920.29 ","$4,163.60 ","$2,974.00 ","$4,758.40 ","$6,474.07 ","$2,589.63 ","$4,163.60 ","$2,589.63 ","$3,568.80 ","$2,589.63 ","$4,461.00 ","$2,962.10 ","$2,664.70 ","$2,962.10 ","$2,589.63 ","$2,962.10 ","$3,786.00 ","$3,786.00 ","$5,055.80 ","$5,948.00 ","$4,121.96 ","$2,589.63 ","$5,948.00 ","$3,271.40 ","$2,589.63 ","$1,564.32 ","$5,948.00 ", N/A , N/A ,"$2,719.11 ","$4,758.40 ","$3,100.00 ","$1,665.44 ","$5,353.20 ","$2,260.24 ",$325.00 ,"$2,589.63 ","$2,855.04 "
ST. MARY'S HOSPITAL - DECATUR,45001122,30903,HC CNTRL NOSEBLEED ANT CPLX-BIL,450,1 ,$488.00 ,$317.20 ,$128.34 ,$488.00 ,$400.28 ,$248.88 ,$268.40 ,$160.11 ,$136.64 ,$258.64 ,$160.11 ,$273.28 ,$160.11 ,$264.98 ,$264.98 ,$160.11 ,$264.98 ,$304.20 ,$341.60 ,$244.00 ,$390.40 ,$400.26 ,$160.11 ,$341.60 ,$160.11 ,$292.80 ,$160.11 ,$366.00 ,$269.38 ,$243.02 ,$269.38 ,$160.11 ,$269.38 ,$380.64 ,$380.64 ,$414.80 ,$400.26 ,$338.18 ,$160.11 ,$488.00 ,$268.40 ,$160.11 ,$128.34 ,$488.00 , N/A , N/A ,$168.12 ,$390.40 ,$264.98 ,$136.64 ,$439.20 ,$185.44 ,$325.00 ,$160.11 ,$234.24 
ST. MARY'S HOSPITAL - DECATUR,45001127,32556,HC PLEURAL DRAINAGE W/O IMAGING -LT,450,1 ,"$2,546.00 ","$1,654.90 ",$325.00 ,"$3,843.71 ","$3,843.70 ","$1,298.46 ","$1,400.30 ","$1,537.48 ",$712.88 ,"$1,349.38 ","$1,537.48 ","$1,425.76 ","$1,537.48 ","$1,382.48 ","$1,382.48 ","$1,537.48 ","$1,382.48 ","$2,546.00 ","$1,782.20 ","$1,273.00 ","$2,036.80 ","$3,843.71 ","$1,537.48 ","$1,782.20 ","$1,537.48 ","$1,527.60 ","$1,537.48 ","$1,909.50 ","$1,405.39 ","$1,267.91 ","$1,405.39 ","$1,537.48 ","$1,405.39 ","$1,985.88 ","$1,985.88 ","$2,164.10 ","$2,546.00 ","$1,764.38 ","$1,537.48 ","$2,546.00 ","$1,400.30 ","$1,537.48 ",$669.60 ,"$2,546.00 ", N/A , N/A ,"$1,614.35 ","$2,036.80 ","$1,382.48 ",$712.88 ,"$2,291.40 ",$967.48 ,$325.00 ,"$1,537.48 ","$1,222.08 "
ST. MARY'S HOSPITAL - DECATUR,45001128,32556,HC PLEURAL DRAINAGE W/O IMAGING -RT,450,1 ,"$2,546.00 ","$1,654.90 ",$325.00 ,"$3,843.71 ","$3,843.70 ","$1,298.46 ","$1,400.30 ","$1,537.48 ",$712.88 ,"$1,349.38 ","$1,537.48 ","$1,425.76 ","$1,537.48 ","$1,382.48 ","$1,382.48 ","$1,537.48 ","$1,382.48 ","$2,546.00 ","$1,782.20 ","$1,273.00 ","$2,036.80 ","$3,843.71 ","$1,537.48 ","$1,782.20 ","$1,537.48 ","$1,527.60 ","$1,537.48 ","$1,909.50 ","$1,405.39 ","$1,267.91 ","$1,405.39 ","$1,537.48 ","$1,405.39 ","$1,985.88 ","$1,985.88 ","$2,164.10 ","$2,546.00 ","$1,764.38 ","$1,537.48 ","$2,546.00 ","$1,400.30 ","$1,537.48 ",$669.60 ,"$2,546.00 ", N/A , N/A ,"$1,614.35 ","$2,036.80 ","$1,382.48 ",$712.88 ,"$2,291.40 ",$967.48 ,$325.00 ,"$1,537.48 ","$1,222.08 "
ST. MARY'S HOSPITAL - DECATUR,45001129,35206,HC REPAIR BLOOD VESSEL UPPER EXTREMITY-LT,450,1 ,"$5,359.00 ","$3,483.35 ",$325.00 ,"$6,774.50 ","$6,774.50 ","$2,200.00 ","$2,947.45 ","$2,709.80 ","$1,500.52 ","$2,840.27 ","$2,709.80 ","$3,001.04 ","$2,709.80 ","$2,909.94 ","$2,909.94 ","$2,709.80 ","$2,909.94 ","$5,148.61 ","$3,751.30 ","$2,679.50 ","$4,287.20 ","$6,774.49 ","$2,709.80 ","$3,751.30 ","$2,709.80 ","$3,215.40 ","$2,709.80 ","$4,019.25 ","$2,668.78 ","$2,400.83 ","$2,668.78 ","$2,709.80 ","$2,668.78 ","$3,786.00 ","$3,786.00 ","$4,555.15 ","$5,359.00 ","$3,713.79 ","$2,709.80 ","$5,359.00 ","$2,947.45 ","$2,709.80 ","$1,409.42 ","$5,359.00 ", N/A , N/A ,"$2,845.29 ","$4,287.20 ","$2,909.94 ","$1,500.52 ","$4,823.10 ","$2,036.42 ",$325.00 ,"$2,709.80 ","$2,572.32 "
ST. MARY'S HOSPITAL - DECATUR,45001130,35206,HC REPAIR BLOOD VESSEL UPPER EXTREMITY-RT,450,1 ,"$5,359.00 ","$3,483.35 ",$325.00 ,"$6,774.50 ","$6,774.50 ","$2,200.00 ","$2,947.45 ","$2,709.80 ","$1,500.52 ","$2,840.27 ","$2,709.80 ","$3,001.04 ","$2,709.80 ","$2,909.94 ","$2,909.94 ","$2,709.80 ","$2,909.94 ","$5,148.61 ","$3,751.30 ","$2,679.50 ","$4,287.20 ","$6,774.49 ","$2,709.80 ","$3,751.30 ","$2,709.80 ","$3,215.40 ","$2,709.80 ","$4,019.25 ","$2,668.78 ","$2,400.83 ","$2,668.78 ","$2,709.80 ","$2,668.78 ","$3,786.00 ","$3,786.00 ","$4,555.15 ","$5,359.00 ","$3,713.79 ","$2,709.80 ","$5,359.00 ","$2,947.45 ","$2,709.80 ","$1,409.42 ","$5,359.00 ", N/A , N/A ,"$2,845.29 ","$4,287.20 ","$2,909.94 ","$1,500.52 ","$4,823.10 ","$2,036.42 ",$325.00 ,"$2,709.80 ","$2,572.32 "
ST. MARY'S HOSPITAL - DECATUR,45001142,35226,HC REPAIR BLOOD VESSEL LOWER EXTREMITY-RT,450,1 ,"$2,840.00 ","$1,846.00 ",$325.00 ,"$2,840.00 ","$1,472.65 ","$1,448.40 ","$1,562.00 ",$589.06 ,$795.20 ,"$1,505.20 ",$589.06 ,"$1,590.40 ",$589.06 ,"$1,542.12 ","$1,542.12 ",$589.06 ,"$1,542.12 ","$1,119.21 ","$1,988.00 ","$1,420.00 ","$2,272.00 ","$1,472.64 ",$589.06 ,"$1,988.00 ",$589.06 ,"$1,704.00 ",$589.06 ,"$2,130.00 ","$1,566.00 ","$1,408.00 ","$1,566.00 ",$589.06 ,"$1,566.00 ","$2,215.20 ","$2,215.20 ","$2,414.00 ","$1,472.64 ","$1,968.12 ",$589.06 ,"$2,840.00 ","$1,562.00 ",$589.06 ,$746.92 ,"$2,840.00 ", N/A , N/A ,$618.51 ,"$2,272.00 ","$1,542.12 ",$795.20 ,"$2,556.00 ","$1,079.20 ",$325.00 ,$589.06 ,"$1,363.20 "
ST. MARY'S HOSPITAL - DECATUR,45001156,42960,HC CONTROL HEMORRHAGE OROPHARYNGEAL SIMPLE,450,1 ,$619.00 ,$402.35 ,$162.80 ,"$1,070.30 ","$1,070.30 ",$315.69 ,$340.45 ,$428.12 ,$173.32 ,$328.07 ,$428.12 ,$346.64 ,$428.12 ,$336.12 ,$336.12 ,$428.12 ,$336.12 ,$619.00 ,$433.30 ,$309.50 ,$495.20 ,"$1,070.29 ",$428.12 ,$433.30 ,$428.12 ,$371.40 ,$428.12 ,$464.25 ,$341.69 ,$308.26 ,$341.69 ,$428.12 ,$341.69 ,$482.82 ,$482.82 ,$526.15 ,$619.00 ,$428.97 ,$428.12 ,$619.00 ,$340.45 ,$428.12 ,$162.80 ,$619.00 , N/A , N/A ,$449.53 ,$495.20 ,$336.12 ,$173.32 ,$557.10 ,$235.22 ,$325.00 ,$428.12 ,$297.12 
ST. MARY'S HOSPITAL - DECATUR,45001168,52281,HC CYSTOURETHROSCOPY W/CALIBRATION/DILATION,450,1 ,"$5,093.00 ","$3,310.45 ",$325.00 ,"$5,093.00 ","$4,237.25 ","$2,200.00 ","$2,801.15 ","$1,694.90 ","$1,426.04 ","$2,699.29 ","$1,694.90 ","$2,852.08 ","$1,694.90 ","$2,765.50 ","$2,765.50 ","$1,694.90 ","$2,765.50 ","$3,220.31 ","$3,565.10 ","$2,546.50 ","$4,074.40 ","$4,237.26 ","$1,694.90 ","$3,565.10 ","$1,694.90 ","$3,055.80 ","$1,694.90 ","$3,819.75 ","$2,536.31 ","$2,281.66 ","$2,536.31 ","$1,694.90 ","$2,536.31 ","$3,786.00 ","$3,786.00 ","$4,329.05 ","$4,237.26 ","$3,529.45 ","$1,694.90 ","$5,093.00 ","$2,801.15 ","$1,694.90 ","$1,339.46 ","$5,093.00 ", N/A , N/A ,"$1,779.65 ","$4,074.40 ","$2,765.50 ","$1,426.04 ","$4,583.70 ","$1,935.34 ",$325.00 ,"$1,694.90 ","$2,444.64 "
ST. MARY'S HOSPITAL - DECATUR,45001169,54235,HC INJ PENILE W/RX AGENT,450,1 ,$425.00 ,$276.25 ,$111.78 ,$629.73 ,$629.73 ,$216.75 ,$233.75 ,$251.89 ,$119.00 ,$225.25 ,$251.89 ,$238.00 ,$251.89 ,$230.78 ,$230.78 ,$251.89 ,$230.78 ,$425.00 ,$297.50 ,$212.50 ,$340.00 ,$629.73 ,$251.89 ,$297.50 ,$251.89 ,$255.00 ,$251.89 ,$318.75 ,$234.60 ,$211.65 ,$234.60 ,$251.89 ,$234.60 ,$331.50 ,$331.50 ,$361.25 ,$425.00 ,$294.53 ,$251.89 ,$425.00 ,$233.75 ,$251.89 ,$111.78 ,$425.00 , N/A , N/A ,$264.48 ,$340.00 ,$230.78 ,$119.00 ,$382.50 ,$161.50 ,$325.00 ,$251.89 ,$204.00 
ST. MARY'S HOSPITAL - DECATUR,45001198,65205,HC REM EYE FB CONJUCT SUPER-LT,450,1 ,"$1,003.00 ",$651.95 ,$106.74 ,"$1,003.00 ",$266.85 ,$511.53 ,$551.65 ,$106.74 ,$280.84 ,$531.59 ,$106.74 ,$561.68 ,$106.74 ,$544.63 ,$544.63 ,$106.74 ,$544.63 ,$202.80 ,$702.10 ,$501.50 ,$802.40 ,$266.84 ,$106.74 ,$702.10 ,$106.74 ,$601.80 ,$106.74 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$106.74 ,$553.66 ,$782.34 ,$782.34 ,$852.55 ,$266.84 ,$695.08 ,$106.74 ,"$1,003.00 ",$551.65 ,$106.74 ,$263.79 ,"$1,003.00 ", N/A , N/A ,$112.08 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$325.00 ,$106.74 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,45001199,65205,HC REM EYE FB CONJUCT SUPER-RT,450,1 ,"$1,003.00 ",$651.95 ,$106.74 ,"$1,003.00 ",$266.85 ,$511.53 ,$551.65 ,$106.74 ,$280.84 ,$531.59 ,$106.74 ,$561.68 ,$106.74 ,$544.63 ,$544.63 ,$106.74 ,$544.63 ,$202.80 ,$702.10 ,$501.50 ,$802.40 ,$266.84 ,$106.74 ,$702.10 ,$106.74 ,$601.80 ,$106.74 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$106.74 ,$553.66 ,$782.34 ,$782.34 ,$852.55 ,$266.84 ,$695.08 ,$106.74 ,"$1,003.00 ",$551.65 ,$106.74 ,$263.79 ,"$1,003.00 ", N/A , N/A ,$112.08 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$325.00 ,$106.74 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,45001207,69200,HC REM FOREIGN BODY CANAL AUD EXT-BIL,450,1 ,$555.00 ,$360.75 ,$106.74 ,$555.00 ,$266.85 ,$283.05 ,$305.25 ,$106.74 ,$155.40 ,$294.15 ,$106.74 ,$310.80 ,$106.74 ,$301.37 ,$301.37 ,$106.74 ,$301.37 ,$202.80 ,$388.50 ,$277.50 ,$444.00 ,$266.84 ,$106.74 ,$388.50 ,$106.74 ,$333.00 ,$106.74 ,$416.25 ,$306.36 ,$276.39 ,$306.36 ,$106.74 ,$306.36 ,$432.90 ,$432.90 ,$471.75 ,$266.84 ,$384.62 ,$106.74 ,$555.00 ,$305.25 ,$106.74 ,$145.97 ,$555.00 , N/A , N/A ,$112.08 ,$444.00 ,$301.37 ,$155.40 ,$499.50 ,$210.90 ,$325.00 ,$106.74 ,$266.40 
ST. MARY'S HOSPITAL - DECATUR,45001272,23665,HC TX FX DISLOC SHOULDER HUMERW/MANIP,450,1 ,"$2,831.00 ","$1,840.15 ",$325.00 ,"$3,296.18 ","$3,296.18 ","$1,443.81 ","$1,557.05 ","$1,318.47 ",$792.68 ,"$1,500.43 ","$1,318.47 ","$1,585.36 ","$1,318.47 ","$1,537.23 ","$1,537.23 ","$1,318.47 ","$1,537.23 ","$2,505.09 ","$1,981.70 ","$1,415.50 ","$2,264.80 ","$3,296.17 ","$1,318.47 ","$1,981.70 ","$1,318.47 ","$1,698.60 ","$1,318.47 ","$2,123.25 ","$1,562.71 ","$1,408.00 ","$1,562.71 ","$1,318.47 ","$1,562.71 ","$2,208.18 ","$2,208.18 ","$2,406.35 ","$2,831.00 ","$1,961.88 ","$1,318.47 ","$2,831.00 ","$1,557.05 ","$1,318.47 ",$744.55 ,"$2,831.00 ", N/A , N/A ,"$1,384.39 ","$2,264.80 ","$1,537.23 ",$792.68 ,"$2,547.90 ","$1,075.78 ",$325.00 ,"$1,318.47 ","$1,358.88 "
ST. MARY'S HOSPITAL - DECATUR,45001277,24577,HC TX FX HUMERUS CONDYLAR W/MANIP CLOSED,450,1 ,"$3,883.00 ","$2,523.95 ",$325.00 ,"$3,883.00 ","$3,296.18 ","$1,980.33 ","$2,135.65 ","$1,318.47 ","$1,087.24 ","$2,057.99 ","$1,318.47 ","$2,174.48 ","$1,318.47 ","$2,108.47 ","$2,108.47 ","$1,318.47 ","$2,108.47 ","$2,505.09 ","$2,718.10 ","$1,941.50 ","$3,106.40 ","$3,296.17 ","$1,318.47 ","$2,718.10 ","$1,318.47 ","$2,329.80 ","$1,318.47 ","$2,912.25 ","$1,933.73 ","$1,739.58 ","$1,933.73 ","$1,318.47 ","$1,933.73 ","$3,028.74 ","$3,028.74 ","$3,300.55 ","$3,296.17 ","$2,690.92 ","$1,318.47 ","$3,883.00 ","$2,135.65 ","$1,318.47 ","$1,021.23 ","$3,883.00 ", N/A , N/A ,"$1,384.39 ","$3,106.40 ","$2,108.47 ","$1,087.24 ","$3,494.70 ","$1,475.54 ",$325.00 ,"$1,318.47 ","$1,863.84 "
ST. MARY'S HOSPITAL - DECATUR,45001279,25260,HC REPAIR TEND/MUSC/FLEXOR FOREARM/WRIST PRIMARY,450,1 ,"$5,513.00 ","$3,583.45 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$3,032.15 ","$2,680.74 ","$1,543.64 ","$2,921.89 ","$2,680.74 ","$3,087.28 ","$2,680.74 ","$2,993.56 ","$2,993.56 ","$2,680.74 ","$2,993.56 ","$5,093.40 ","$3,859.10 ","$2,756.50 ","$4,410.40 ","$6,701.85 ","$2,680.74 ","$3,859.10 ","$2,680.74 ","$3,307.80 ","$2,680.74 ","$4,134.75 ","$2,745.47 ","$2,469.82 ","$2,745.47 ","$2,680.74 ","$2,745.47 ","$3,786.00 ","$3,786.00 ","$4,686.05 ","$5,513.00 ","$3,820.51 ","$2,680.74 ","$5,513.00 ","$3,032.15 ","$2,680.74 ","$1,449.92 ","$5,513.00 ", N/A , N/A ,"$2,814.78 ","$4,410.40 ","$2,993.56 ","$1,543.64 ","$4,961.70 ","$2,094.94 ",$325.00 ,"$2,680.74 ","$2,646.24 "
ST. MARY'S HOSPITAL - DECATUR,45001280,25270,HC REPAIR TEND/MUSC/EXTENSOR FOREARM/WRIST PRIMARY,450,1 ,"$6,129.00 ","$3,983.85 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$3,370.95 ","$2,680.74 ","$1,716.12 ","$3,248.37 ","$2,680.74 ","$3,432.24 ","$2,680.74 ","$3,100.00 ","$3,100.00 ","$2,680.74 ","$3,100.00 ","$5,093.40 ","$4,290.30 ","$3,064.50 ","$4,903.20 ","$6,701.85 ","$2,680.74 ","$4,290.30 ","$2,680.74 ","$3,677.40 ","$2,680.74 ","$4,596.75 ","$3,052.24 ","$2,745.79 ","$3,052.24 ","$2,680.74 ","$3,052.24 ","$3,786.00 ","$3,786.00 ","$5,209.65 ","$6,129.00 ","$4,247.40 ","$2,680.74 ","$6,129.00 ","$3,370.95 ","$2,680.74 ","$1,611.93 ","$6,129.00 ", N/A , N/A ,"$2,814.78 ","$4,903.20 ","$3,100.00 ","$1,716.12 ","$5,516.10 ","$2,329.02 ",$325.00 ,"$2,680.74 ","$2,941.92 "
ST. MARY'S HOSPITAL - DECATUR,45001281,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED,450,1 ,"$3,883.00 ","$2,523.95 ",$325.00 ,"$3,883.00 ","$3,296.18 ","$1,980.33 ","$2,135.65 ","$1,318.47 ","$1,087.24 ","$2,057.99 ","$1,318.47 ","$2,174.48 ","$1,318.47 ","$2,108.47 ","$2,108.47 ","$1,318.47 ","$2,108.47 ","$2,505.09 ","$2,718.10 ","$1,941.50 ","$3,106.40 ","$3,296.17 ","$1,318.47 ","$2,718.10 ","$1,318.47 ","$2,329.80 ","$1,318.47 ","$2,912.25 ","$1,933.73 ","$1,739.58 ","$1,933.73 ","$1,318.47 ","$1,933.73 ","$3,028.74 ","$3,028.74 ","$3,300.55 ","$3,296.17 ","$2,690.92 ","$1,318.47 ","$3,883.00 ","$2,135.65 ","$1,318.47 ","$1,021.23 ","$3,883.00 ", N/A , N/A ,"$1,384.39 ","$3,106.40 ","$2,108.47 ","$1,087.24 ","$3,494.70 ","$1,475.54 ",$325.00 ,"$1,318.47 ","$1,863.84 "
ST. MARY'S HOSPITAL - DECATUR,45001283,25675,HC CLOSED TX RADIO-ULNAR DISLOC W/MANIP,450,1 ,"$1,003.00 ",$651.95 ,$195.10 ,"$1,003.00 ",$487.75 ,$511.53 ,$551.65 ,$195.10 ,$280.84 ,$531.59 ,$195.10 ,$561.68 ,$195.10 ,$544.63 ,$544.63 ,$195.10 ,$544.63 ,$370.70 ,$702.10 ,$501.50 ,$802.40 ,$487.76 ,$195.10 ,$702.10 ,$195.10 ,$601.80 ,$195.10 ,$752.25 ,$553.66 ,$499.49 ,$553.66 ,$195.10 ,$553.66 ,$782.34 ,$782.34 ,$852.55 ,$487.76 ,$695.08 ,$195.10 ,"$1,003.00 ",$551.65 ,$195.10 ,$263.79 ,"$1,003.00 ", N/A , N/A ,$204.86 ,$802.40 ,$544.63 ,$280.84 ,$902.70 ,$381.14 ,$325.00 ,$195.10 ,$481.44 
ST. MARY'S HOSPITAL - DECATUR,45001290,27500,HC TX FX CLOSED FEMUR W/O MANIP,450,1 ,"$1,221.00 ",$793.65 ,$195.10 ,"$1,221.00 ",$487.75 ,$622.71 ,$671.55 ,$195.10 ,$341.88 ,$647.13 ,$195.10 ,$683.76 ,$195.10 ,$663.00 ,$663.00 ,$195.10 ,$663.00 ,$370.70 ,$854.70 ,$610.50 ,$976.80 ,$487.76 ,$195.10 ,$854.70 ,$195.10 ,$732.60 ,$195.10 ,$915.75 ,$673.99 ,$608.06 ,$673.99 ,$195.10 ,$673.99 ,$952.38 ,$952.38 ,"$1,037.85 ",$487.76 ,$846.15 ,$195.10 ,"$1,221.00 ",$671.55 ,$195.10 ,$321.12 ,"$1,221.00 ", N/A , N/A ,$204.86 ,$976.80 ,$663.00 ,$341.88 ,"$1,098.90 ",$463.98 ,$325.00 ,$195.10 ,$586.08 
ST. MARY'S HOSPITAL - DECATUR,45001291,27502,HC TX FX FEMUR W/MAN W/W/O TRACTION,450,1 ,"$1,212.00 ",$787.80 ,$318.76 ,"$3,296.18 ","$3,296.18 ",$618.12 ,$666.60 ,"$1,318.47 ",$339.36 ,$642.36 ,"$1,318.47 ",$678.72 ,"$1,212.00 ",$658.12 ,$658.12 ,"$1,212.00 ",$658.12 ,"$1,212.00 ",$848.40 ,$606.00 ,$969.60 ,"$3,296.17 ","$1,318.47 ",$848.40 ,"$1,318.47 ",$727.20 ,"$1,318.47 ",$909.00 ,$669.02 ,$603.58 ,$669.02 ,"$1,318.47 ",$669.02 ,$945.36 ,$945.36 ,"$1,030.20 ","$1,212.00 ",$839.92 ,"$1,318.47 ","$1,212.00 ",$666.60 ,"$1,318.47 ",$318.76 ,"$1,212.00 ", N/A , N/A ,"$1,384.39 ",$969.60 ,$658.12 ,$339.36 ,"$1,090.80 ",$460.56 ,$325.00 ,"$1,318.47 ",$581.76 
ST. MARY'S HOSPITAL - DECATUR,45001296,27762,HC TX FX CLOSED MEDIAL MALLEOLUS W/MANIP,450,1 ,"$3,883.00 ","$2,523.95 ",$325.00 ,"$3,883.00 ","$3,296.18 ","$1,980.33 ","$2,135.65 ","$1,318.47 ","$1,087.24 ","$2,057.99 ","$1,318.47 ","$2,174.48 ","$1,318.47 ","$2,108.47 ","$2,108.47 ","$1,318.47 ","$2,108.47 ","$2,505.09 ","$2,718.10 ","$1,941.50 ","$3,106.40 ","$3,296.17 ","$1,318.47 ","$2,718.10 ","$1,318.47 ","$2,329.80 ","$1,318.47 ","$2,912.25 ","$1,933.73 ","$1,739.58 ","$1,933.73 ","$1,318.47 ","$1,933.73 ","$3,028.74 ","$3,028.74 ","$3,300.55 ","$3,296.17 ","$2,690.92 ","$1,318.47 ","$3,883.00 ","$2,135.65 ","$1,318.47 ","$1,021.23 ","$3,883.00 ", N/A , N/A ,"$1,384.39 ","$3,106.40 ","$2,108.47 ","$1,087.24 ","$3,494.70 ","$1,475.54 ",$325.00 ,"$1,318.47 ","$1,863.84 "
ST. MARY'S HOSPITAL - DECATUR,45001298,27816,HC TX FX CLOSED TRIMALLEOLAR ANKLE W/O MANIP,450,1 ,$575.00 ,$373.75 ,$151.23 ,$575.00 ,$487.75 ,$293.25 ,$316.25 ,$195.10 ,$161.00 ,$304.75 ,$195.10 ,$322.00 ,$195.10 ,$312.23 ,$312.23 ,$195.10 ,$312.23 ,$370.70 ,$402.50 ,$287.50 ,$460.00 ,$487.76 ,$195.10 ,$402.50 ,$195.10 ,$345.00 ,$195.10 ,$431.25 ,$317.40 ,$286.35 ,$317.40 ,$195.10 ,$317.40 ,$448.50 ,$448.50 ,$488.75 ,$487.76 ,$398.48 ,$195.10 ,$575.00 ,$316.25 ,$195.10 ,$151.23 ,$575.00 , N/A , N/A ,$204.86 ,$460.00 ,$312.23 ,$161.00 ,$517.50 ,$218.50 ,$325.00 ,$195.10 ,$276.00 
ST. MARY'S HOSPITAL - DECATUR,45001303,28208,HC REPAIR TENDON EXTENSOR FOOT,450,1 ,"$5,023.00 ","$3,264.95 ",$325.00 ,"$6,701.85 ","$6,701.85 ","$2,200.00 ","$2,762.65 ","$2,680.74 ","$1,406.44 ","$2,662.19 ","$2,680.74 ","$2,812.88 ","$2,680.74 ","$2,727.49 ","$2,727.49 ","$2,680.74 ","$2,727.49 ","$5,023.00 ","$3,516.10 ","$2,511.50 ","$4,018.40 ","$6,701.85 ","$2,680.74 ","$3,516.10 ","$2,680.74 ","$3,013.80 ","$2,680.74 ","$3,767.25 ","$2,501.45 ","$2,250.30 ","$2,501.45 ","$2,680.74 ","$2,501.45 ","$3,786.00 ","$3,786.00 ","$4,269.55 ","$5,023.00 ","$3,480.94 ","$2,680.74 ","$5,023.00 ","$2,762.65 ","$2,680.74 ","$1,321.05 ","$5,023.00 ", N/A , N/A ,"$2,814.78 ","$4,018.40 ","$2,727.49 ","$1,406.44 ","$4,520.70 ","$1,908.74 ",$325.00 ,"$2,680.74 ","$2,411.04 "
ST. MARY'S HOSPITAL - DECATUR,45001304,28405,HC TX FX CALCANEAL W/MANIP,450,1 ,"$5,479.00 ","$3,561.35 ",$195.10 ,"$5,479.00 ",$487.75 ,"$2,200.00 ","$3,013.45 ",$195.10 ,"$1,534.12 ","$2,903.87 ",$195.10 ,"$3,068.24 ",$195.10 ,"$2,975.10 ","$2,975.10 ",$195.10 ,"$2,975.10 ",$370.70 ,"$3,835.30 ","$2,739.50 ","$4,383.20 ",$487.76 ,$195.10 ,"$3,835.30 ",$195.10 ,"$3,287.40 ",$195.10 ,"$4,109.25 ","$2,728.54 ","$2,454.59 ","$2,728.54 ",$195.10 ,"$2,728.54 ","$3,786.00 ","$3,786.00 ","$4,657.15 ",$487.76 ,"$3,796.95 ",$195.10 ,"$5,479.00 ","$3,013.45 ",$195.10 ,"$1,440.98 ","$5,479.00 ", N/A , N/A ,$204.86 ,"$4,383.20 ","$2,975.10 ","$1,534.12 ","$4,931.10 ","$2,082.02 ",$325.00 ,$195.10 ,"$2,629.92 "
ST. MARY'S HOSPITAL - DECATUR,45001315,67715,HC CANTHOTOMY INC EYELID FOLD,450,1 ,"$4,974.00 ","$3,233.10 ",$325.00 ,"$4,974.00 ","$4,735.55 ","$2,200.00 ","$2,735.70 ","$1,894.22 ","$1,392.72 ","$2,636.22 ","$1,894.22 ","$2,785.44 ","$1,894.22 ","$2,700.88 ","$2,700.88 ","$1,894.22 ","$2,700.88 ","$3,599.03 ","$3,481.80 ","$2,487.00 ","$3,979.20 ","$4,735.56 ","$1,894.22 ","$3,481.80 ","$1,894.22 ","$2,984.40 ","$1,894.22 ","$3,730.50 ","$2,477.05 ","$2,228.35 ","$2,477.05 ","$1,894.22 ","$2,477.05 ","$3,786.00 ","$3,786.00 ","$4,227.90 ","$4,735.56 ","$3,446.98 ","$1,894.22 ","$4,974.00 ","$2,735.70 ","$1,894.22 ","$1,308.16 ","$4,974.00 ", N/A , N/A ,"$1,988.93 ","$3,979.20 ","$2,700.88 ","$1,392.72 ","$4,476.60 ","$1,890.12 ",$325.00 ,"$1,894.22 ","$2,387.52 "
ST. MARY'S HOSPITAL - DECATUR,45001317,67935,HC REPAIR EYELID WOUND FULL THICKNESS,450,1 ,"$3,238.00 ","$2,104.70 ",$325.00 ,"$4,735.56 ","$4,735.55 ","$1,651.38 ","$1,780.90 ","$1,894.22 ",$906.64 ,"$1,716.14 ","$1,894.22 ","$1,813.28 ","$1,894.22 ","$1,758.23 ","$1,758.23 ","$1,894.22 ","$1,758.23 ","$3,238.00 ","$2,266.60 ","$1,619.00 ","$2,590.40 ","$4,735.56 ","$1,894.22 ","$2,266.60 ","$1,894.22 ","$1,942.80 ","$1,894.22 ","$2,428.50 ","$1,612.52 ","$1,450.62 ","$1,612.52 ","$1,894.22 ","$1,612.52 ","$2,525.64 ","$2,525.64 ","$2,752.30 ","$3,238.00 ","$2,243.93 ","$1,894.22 ","$3,238.00 ","$1,780.90 ","$1,894.22 ",$851.59 ,"$3,238.00 ", N/A , N/A ,"$1,988.93 ","$2,590.40 ","$1,758.23 ",$906.64 ,"$2,914.20 ","$1,230.44 ",$325.00 ,"$1,894.22 ","$1,554.24 "
ST. MARY'S HOSPITAL - DECATUR,45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,"$1,007.00 ",$654.55 ,$251.89 ,"$1,007.00 ",$629.73 ,$513.57 ,$553.85 ,$251.89 ,$281.96 ,$533.71 ,$251.89 ,$563.92 ,$251.89 ,$546.80 ,$546.80 ,$251.89 ,$546.80 ,$478.60 ,$704.90 ,$503.50 ,$805.60 ,$629.73 ,$251.89 ,$704.90 ,$251.89 ,$604.20 ,$251.89 ,$755.25 ,$555.86 ,$501.49 ,$555.86 ,$251.89 ,$555.86 ,$785.46 ,$785.46 ,$855.95 ,$629.73 ,$697.85 ,$251.89 ,"$1,007.00 ",$553.85 ,$251.89 ,$264.84 ,"$1,007.00 ", N/A , N/A ,$264.48 ,$805.60 ,$546.80 ,$281.96 ,$906.30 ,$382.66 ,$325.00 ,$251.89 ,$483.36 
ST. MARY'S HOSPITAL - DECATUR,45001332,43763,HC REPLACE GASTRO TUBE PERC W/REVISE TRACT,450,1 ,$975.00 ,$633.75 ,$251.89 ,$975.00 ,$629.73 ,$497.25 ,$536.25 ,$251.89 ,$273.00 ,$516.75 ,$251.89 ,$546.00 ,$251.89 ,$529.43 ,$529.43 ,$251.89 ,$529.43 ,$478.60 ,$682.50 ,$487.50 ,$780.00 ,$629.73 ,$251.89 ,$682.50 ,$251.89 ,$585.00 ,$251.89 ,$731.25 ,$538.20 ,$485.55 ,$538.20 ,$251.89 ,$538.20 ,$760.50 ,$760.50 ,$828.75 ,$629.73 ,$675.68 ,$251.89 ,$975.00 ,$536.25 ,$251.89 ,$256.43 ,$975.00 , N/A , N/A ,$264.48 ,$780.00 ,$529.43 ,$273.00 ,$877.50 ,$370.50 ,$325.00 ,$251.89 ,$468.00 
ST. MARY'S HOSPITAL - DECATUR,45001341,42720,HC I AND D ABSCESS PHARYNGEAL INTRAORAL APPROACH,450,1 ,"$7,631.00 ","$4,960.15 ",$325.00 ,"$7,631.00 ","$6,474.08 ","$2,200.00 ","$4,197.05 ","$2,589.63 ","$2,136.68 ","$4,044.43 ","$2,589.63 ","$4,273.36 ","$2,589.63 ","$3,100.00 ","$3,100.00 ","$2,589.63 ","$3,100.00 ","$4,920.29 ","$5,341.70 ","$3,815.50 ","$6,104.80 ","$6,474.07 ","$2,589.63 ","$5,341.70 ","$2,589.63 ","$4,578.60 ","$2,589.63 ","$5,723.25 ","$3,800.24 ","$3,418.69 ","$3,800.24 ","$2,589.63 ","$3,800.24 ","$3,786.00 ","$3,786.00 ","$6,486.35 ","$6,474.07 ","$5,288.28 ","$2,589.63 ","$7,631.00 ","$4,197.05 ","$2,589.63 ","$2,006.95 ","$7,631.00 ", N/A , N/A ,"$2,719.11 ","$6,104.80 ","$3,100.00 ","$2,136.68 ","$6,867.90 ","$2,899.78 ",$325.00 ,"$2,589.63 ","$3,662.88 "
ST. MARY'S HOSPITAL - DECATUR,45001343,37799,HC REPAIR/SUTURE MINOR VESSEL,450,1 ,"$1,860.00 ","$1,209.00 ",$325.00 ,"$1,860.00 ","$1,279.15 ",$948.60 ,"$1,023.00 ",$511.66 ,$520.80 ,$985.80 ,$511.66 ,"$1,041.60 ",$511.66 ,"$1,009.98 ","$1,009.98 ",$511.66 ,"$1,009.98 ",$972.16 ,"$1,302.00 ",$930.00 ,"$1,488.00 ","$1,279.16 ",$511.66 ,"$1,302.00 ",$511.66 ,"$1,116.00 ",$511.66 ,"$1,395.00 ","$1,026.72 ",$926.28 ,"$1,026.72 ",$511.66 ,"$1,026.72 ","$1,450.80 ","$1,450.80 ","$1,581.00 ","$1,279.16 ","$1,288.98 ",$511.66 ,"$1,860.00 ","$1,023.00 ",$511.66 ,$489.18 ,"$1,860.00 ", N/A , N/A ,$537.24 ,"$1,488.00 ","$1,009.98 ",$520.80 ,"$1,674.00 ",$706.80 ,$325.00 ,$511.66 ,$892.80 
ST. MARY'S HOSPITAL - DECATUR,45001354,42650,HC DILATION OF SALIVARY DUCT,450,1 ,"$3,733.00 ","$2,426.45 ",$325.00 ,"$3,733.00 ","$3,201.23 ","$1,903.83 ","$2,053.15 ","$1,280.49 ","$1,045.24 ","$1,978.49 ","$1,280.49 ","$2,090.48 ","$1,280.49 ","$2,027.02 ","$2,027.02 ","$1,280.49 ","$2,027.02 ","$2,432.94 ","$2,613.10 ","$1,866.50 ","$2,986.40 ","$3,201.24 ","$1,280.49 ","$2,613.10 ","$1,280.49 ","$2,239.80 ","$1,280.49 ","$2,799.75 ","$1,859.03 ","$1,672.38 ","$1,859.03 ","$1,280.49 ","$1,859.03 ","$2,911.74 ","$2,911.74 ","$3,173.05 ","$3,201.24 ","$2,586.97 ","$1,280.49 ","$3,733.00 ","$2,053.15 ","$1,280.49 ",$981.78 ,"$3,733.00 ", N/A , N/A ,"$1,344.51 ","$2,986.40 ","$2,027.02 ","$1,045.24 ","$3,359.70 ","$1,418.54 ",$325.00 ,"$1,280.49 ","$1,791.84 "
ST. MARY'S HOSPITAL - DECATUR,45001360,31577,HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),450,1 ,"$1,050.00 ",$682.50 ,$276.15 ,"$1,050.00 ",$889.50 ,$535.50 ,$577.50 ,$355.80 ,$294.00 ,$556.50 ,$355.80 ,$588.00 ,$355.80 ,$570.15 ,$570.15 ,$355.80 ,$570.15 ,$676.03 ,$735.00 ,$525.00 ,$840.00 ,$889.51 ,$355.80 ,$735.00 ,$355.80 ,$630.00 ,$355.80 ,$787.50 ,$579.60 ,$522.90 ,$579.60 ,$355.80 ,$579.60 ,$819.00 ,$819.00 ,$892.50 ,$889.51 ,$727.65 ,$355.80 ,"$1,050.00 ",$577.50 ,$355.80 ,$276.15 ,"$1,050.00 ", N/A , N/A ,$373.59 ,$840.00 ,$570.15 ,$294.00 ,$945.00 ,$399.00 ,$325.00 ,$355.80 ,$504.00 
ST. MARY'S HOSPITAL - DECATUR,45001361,27256,HC TX SPONT HIP DISC,450,1 ,$575.00 ,$373.75 ,$151.23 ,$575.00 ,$487.75 ,$293.25 ,$316.25 ,$195.10 ,$161.00 ,$304.75 ,$195.10 ,$322.00 ,$195.10 ,$312.23 ,$312.23 ,$195.10 ,$312.23 ,$370.70 ,$402.50 ,$287.50 ,$460.00 ,$487.76 ,$195.10 ,$402.50 ,$195.10 ,$345.00 ,$195.10 ,$431.25 ,$317.40 ,$286.35 ,$317.40 ,$195.10 ,$317.40 ,$448.50 ,$448.50 ,$488.75 ,$487.76 ,$398.48 ,$195.10 ,$575.00 ,$316.25 ,$195.10 ,$151.23 ,$575.00 , N/A , N/A ,$204.86 ,$460.00 ,$312.23 ,$161.00 ,$517.50 ,$218.50 ,$325.00 ,$195.10 ,$276.00 
ST. MARY'S HOSPITAL - DECATUR,45080002,42000,HC I AND D PALATE OR UVULA,450,1 ,$591.00 ,$384.15 ,$155.43 ,$591.00 ,$500.68 ,$301.41 ,$325.05 ,$200.27 ,$165.48 ,$313.23 ,$200.27 ,$330.96 ,$200.27 ,$320.91 ,$320.91 ,$200.27 ,$320.91 ,$380.51 ,$413.70 ,$295.50 ,$472.80 ,$500.67 ,$200.27 ,$413.70 ,$200.27 ,$354.60 ,$200.27 ,$443.25 ,$326.23 ,$294.32 ,$326.23 ,$200.27 ,$326.23 ,$460.98 ,$460.98 ,$502.35 ,$500.67 ,$409.56 ,$200.27 ,$591.00 ,$325.05 ,$200.27 ,$155.43 ,$591.00 , N/A , N/A ,$210.28 ,$472.80 ,$320.91 ,$165.48 ,$531.90 ,$224.58 ,$325.00 ,$200.27 ,$283.68 
ST. MARY'S HOSPITAL - DECATUR,46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$286.00 ,$185.90 ,$49.93 ,$330.40 ,$330.40 ,$145.86 ,$157.30 ,$132.16 ,$80.08 ,$140.14 ,$132.16 ,$167.31 ,$132.16 ,$155.30 ,$59.47 ,$132.16 ,$155.30 ,$251.11 ,$200.20 ,$143.00 ,$228.80 ,$330.40 ,$132.16 ,$200.20 ,$132.16 ,$171.60 ,$132.16 ,$214.50 ,$157.87 ,$142.43 ,$157.87 ,$132.16 ,$157.87 ,$223.08 ,$223.08 ,$243.10 ,$286.00 ,$198.20 ,$132.16 ,$286.00 ,$157.30 ,$132.16 ,$75.22 ,$286.00 ,$52.31 ,$49.93 ,$138.77 ,$228.80 ,$155.30 ,$80.08 ,$257.40 ,$108.68 ,$241.00 ,$132.16 ,$137.28 
ST. MARY'S HOSPITAL - DECATUR,46000004,94060,HC SPIROMETRY/PFT PRE  AND  POST,460,1 ,$882.00 ,$573.30 ,$49.93 ,$882.00 ,$626.30 ,$449.82 ,$485.10 ,$250.52 ,$246.96 ,$432.18 ,$250.52 ,$515.97 ,$250.52 ,$478.93 ,$102.33 ,$250.52 ,$478.93 ,$475.99 ,$617.40 ,$441.00 ,$705.60 ,$626.30 ,$250.52 ,$617.40 ,$250.52 ,$529.20 ,$250.52 ,$661.50 ,$486.86 ,$439.24 ,$486.86 ,$250.52 ,$486.86 ,$687.96 ,$687.96 ,$749.70 ,$626.30 ,$611.23 ,$250.52 ,$882.00 ,$485.10 ,$250.52 ,$231.97 ,$882.00 ,$52.31 ,$49.93 ,$263.05 ,$705.60 ,$478.93 ,$246.96 ,$793.80 ,$335.16 ,$241.00 ,$250.52 ,$423.36 
ST. MARY'S HOSPITAL - DECATUR,46000006,94070,HC SPIROMETRY/PFT CPLX,460,1 ,"$1,823.00 ","$1,184.95 ",$68.05 ,"$1,823.00 ",$626.30 ,$929.73 ,"$1,002.65 ",$250.52 ,$510.44 ,$475.58 ,$250.52 ,$475.58 ,$250.52 ,$989.89 ,$68.05 ,$250.52 ,$989.89 ,$475.99 ,"$1,276.10 ",$911.50 ,"$1,458.40 ",$626.30 ,$250.52 ,"$1,276.10 ",$250.52 ,"$1,093.80 ",$250.52 ,"$1,367.25 ","$1,006.30 ",$907.85 ,"$1,006.30 ",$250.52 ,"$1,006.30 ","$1,421.94 ","$1,421.94 ","$1,549.55 ",$626.30 ,"$1,263.34 ",$250.52 ,"$1,823.00 ","$1,002.65 ",$250.52 ,$479.45 ,"$1,823.00 ",$159.83 ,$152.57 ,$263.05 ,"$1,458.40 ",$989.89 ,$510.44 ,"$1,640.70 ",$692.74 ,$241.00 ,$250.52 ,$875.04 
ST. MARY'S HOSPITAL - DECATUR,46000007,94150,HC VITAL CAPACITY TOTAL,460,1 ,$189.00 ,$122.85 ,$47.78 ,$330.40 ,$330.40 ,$96.39 ,$103.95 ,$132.16 ,$52.92 ,$92.61 ,$132.16 ,$110.57 ,$132.16 ,$102.63 ,$47.78 ,$132.16 ,$102.63 ,$189.00 ,$132.30 ,$94.50 ,$151.20 ,$330.40 ,$132.16 ,$132.30 ,$132.16 ,$113.40 ,$132.16 ,$141.75 ,$104.33 ,$94.12 ,$104.33 ,$132.16 ,$104.33 ,$147.42 ,$147.42 ,$160.65 ,$189.00 ,$130.98 ,$132.16 ,$189.00 ,$103.95 ,$132.16 ,$49.71 ,$189.00 ,$52.31 ,$49.93 ,$138.77 ,$151.20 ,$102.63 ,$52.92 ,$170.10 ,$71.82 ,$189.00 ,$132.16 ,$90.72 
ST. MARY'S HOSPITAL - DECATUR,46000012,94728,HC AIRFLOW RESISTANCE,460,1 ,$119.00 ,$77.35 ,$31.30 ,$626.30 ,$626.30 ,$60.69 ,$65.45 ,$250.52 ,$33.32 ,$58.31 ,$250.52 ,$69.62 ,$119.00 ,$64.62 ,$61.81 ,$119.00 ,$64.62 ,$119.00 ,$83.30 ,$59.50 ,$95.20 ,$626.30 ,$250.52 ,$83.30 ,$250.52 ,$71.40 ,$250.52 ,$89.25 ,$65.69 ,$59.26 ,$65.69 ,$250.52 ,$65.69 ,$92.82 ,$92.82 ,$101.15 ,$119.00 ,$82.47 ,$250.52 ,$119.00 ,$65.45 ,$250.52 ,$31.30 ,$119.00 ,$52.31 ,$49.93 ,$263.05 ,$95.20 ,$64.62 ,$33.32 ,$107.10 ,$45.22 ,$119.00 ,$250.52 ,$57.12 
ST. MARY'S HOSPITAL - DECATUR,46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$463.00 ,$300.95 ,$49.93 ,$626.30 ,$626.30 ,$236.13 ,$254.65 ,$250.52 ,$129.64 ,$226.87 ,$250.52 ,$270.86 ,$250.52 ,$251.41 ,$91.42 ,$250.52 ,$251.41 ,$463.00 ,$324.10 ,$231.50 ,$370.40 ,$626.30 ,$250.52 ,$324.10 ,$250.52 ,$277.80 ,$250.52 ,$347.25 ,$255.58 ,$230.57 ,$255.58 ,$250.52 ,$255.58 ,$361.14 ,$361.14 ,$393.55 ,$463.00 ,$320.86 ,$250.52 ,$463.00 ,$254.65 ,$250.52 ,$121.77 ,$463.00 ,$52.31 ,$49.93 ,$263.05 ,$370.40 ,$251.41 ,$129.64 ,$416.70 ,$175.94 ,$241.00 ,$250.52 ,$222.24 
ST. MARY'S HOSPITAL - DECATUR,46000014,94618,HC WALK TEST 6 MIN,460,1 ,$272.00 ,$176.80 ,$24.40 ,$272.00 ,$266.85 ,$138.72 ,$149.60 ,$106.74 ,$76.16 ,$133.28 ,$106.74 ,$159.12 ,$106.74 ,$147.70 ,$24.40 ,$106.74 ,$147.70 ,$202.80 ,$190.40 ,$136.00 ,$217.60 ,$266.84 ,$106.74 ,$190.40 ,$106.74 ,$163.20 ,$106.74 ,$204.00 ,$150.14 ,$135.46 ,$150.14 ,$106.74 ,$150.14 ,$212.16 ,$212.16 ,$231.20 ,$266.84 ,$188.50 ,$106.74 ,$272.00 ,$149.60 ,$106.74 ,$71.54 ,$272.00 ,$159.83 ,$152.57 ,$112.08 ,$217.60 ,$147.70 ,$76.16 ,$244.80 ,$103.36 ,$241.00 ,$106.74 ,$130.56 
ST. MARY'S HOSPITAL - DECATUR,46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$475.00 ,$308.75 ,$49.93 ,$475.00 , N/A ,$242.25 ,$261.25 , N/A ,$133.00 ,$232.75 , N/A ,$277.88 , N/A ,$257.93 ,$101.56 , N/A ,$257.93 , N/A ,$332.50 ,$237.50 ,$380.00 , N/A , N/A ,$332.50 , N/A ,$285.00 , N/A ,$356.25 ,$262.20 ,$236.55 ,$262.20 , N/A ,$262.20 ,$370.50 ,$370.50 ,$403.75 , N/A ,$329.18 , N/A ,$475.00 ,$261.25 , N/A ,$124.93 ,$475.00 ,$52.31 ,$49.93 , N/A ,$380.00 ,$257.93 ,$133.00 ,$427.50 ,$180.50 ,$241.00 , N/A ,$228.00 
ST. MARY'S HOSPITAL - DECATUR,46000018,94762,HC OXIMETRY OVERNIGHT,460,1 ,$415.00 ,$269.75 ,$49.93 ,$415.00 ,$330.40 ,$211.65 ,$228.25 ,$132.16 ,$116.20 ,$203.35 ,$132.16 ,$242.78 ,$132.16 ,$225.35 ,$55.58 ,$132.16 ,$225.35 ,$251.11 ,$290.50 ,$207.50 ,$332.00 ,$330.40 ,$132.16 ,$290.50 ,$132.16 ,$249.00 ,$132.16 ,$311.25 ,$229.08 ,$206.67 ,$229.08 ,$132.16 ,$229.08 ,$323.70 ,$323.70 ,$352.75 ,$330.40 ,$287.60 ,$132.16 ,$415.00 ,$228.25 ,$132.16 ,$109.15 ,$415.00 ,$52.31 ,$49.93 ,$138.77 ,$332.00 ,$225.35 ,$116.20 ,$373.50 ,$157.70 ,$241.00 ,$132.16 ,$199.20 
ST. MARY'S HOSPITAL - DECATUR,46000021,94760,HC PULSE OX SINGLE,460,1 ,$120.00 ,$78.00 ,$5.70 ,$120.00 , N/A ,$61.20 ,$66.00 , N/A ,$33.60 ,$46.40 , N/A ,$46.40 , N/A ,$65.16 ,$5.70 , N/A ,$65.16 , N/A ,$84.00 ,$60.00 ,$96.00 , N/A , N/A ,$84.00 , N/A ,$72.00 , N/A ,$90.00 ,$66.24 ,$59.76 ,$66.24 , N/A ,$66.24 ,$93.60 ,$93.60 ,$102.00 , N/A ,$83.16 , N/A ,$120.00 ,$66.00 , N/A ,$31.56 ,$120.00 , N/A , N/A , N/A ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$120.00 , N/A ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,46000023,94761,HC PULSE OX MULTI DETERMIN,360,1 ,$205.00 ,$133.25 ,$53.92 ,$205.00 , N/A ,$104.55 ,$112.75 , N/A ,$57.40 ,$96.35 , N/A ,$110.70 , N/A ,$111.32 ,$111.32 , N/A ,$111.32 , N/A ,$143.50 ,$102.50 ,$164.00 , N/A , N/A ,$143.50 , N/A ,$123.00 , N/A ,$153.75 ,$113.16 ,$102.09 ,$113.16 , N/A ,$113.16 ,$159.90 ,$159.90 ,$174.25 , N/A ,$142.07 , N/A ,$205.00 ,$112.75 , N/A ,$53.92 ,$205.00 , N/A , N/A , N/A ,$164.00 ,$111.32 ,$57.40 ,$184.50 , N/A , N/A , N/A ,$98.40 
ST. MARY'S HOSPITAL - DECATUR,46000029,94375,HC FLOW VOLUME LOOP,460,1 ,$419.00 ,$272.35 ,$49.93 ,$626.30 ,$626.30 ,$213.69 ,$230.45 ,$250.52 ,$117.32 ,$205.31 ,$250.52 ,$245.12 ,$250.52 ,$227.52 ,$54.80 ,$250.52 ,$227.52 ,$419.00 ,$293.30 ,$209.50 ,$335.20 ,$626.30 ,$250.52 ,$293.30 ,$250.52 ,$251.40 ,$250.52 ,$314.25 ,$231.29 ,$208.66 ,$231.29 ,$250.52 ,$231.29 ,$326.82 ,$326.82 ,$356.15 ,$419.00 ,$290.37 ,$250.52 ,$419.00 ,$230.45 ,$250.52 ,$110.20 ,$419.00 ,$52.31 ,$49.93 ,$263.05 ,$335.20 ,$227.52 ,$117.32 ,$377.10 ,$159.22 ,$241.00 ,$250.52 ,$201.12 
ST. MARY'S HOSPITAL - DECATUR,46000030,94680,HC O2 UPTAKE EXPIRED GAS REST/EXERCISE,460,1 ,$205.00 ,$133.25 ,$49.93 ,$330.40 ,$330.40 ,$104.55 ,$112.75 ,$132.16 ,$57.40 ,$100.45 ,$132.16 ,$119.93 ,$132.16 ,$111.32 ,$94.54 ,$132.16 ,$111.32 ,$205.00 ,$143.50 ,$102.50 ,$164.00 ,$330.40 ,$132.16 ,$143.50 ,$132.16 ,$123.00 ,$132.16 ,$153.75 ,$113.16 ,$102.09 ,$113.16 ,$132.16 ,$113.16 ,$159.90 ,$159.90 ,$174.25 ,$205.00 ,$142.07 ,$132.16 ,$205.00 ,$112.75 ,$132.16 ,$53.92 ,$205.00 ,$52.31 ,$49.93 ,$138.77 ,$164.00 ,$111.32 ,$57.40 ,$184.50 ,$77.90 ,$205.00 ,$132.16 ,$98.40 
ST. MARY'S HOSPITAL - DECATUR,47000000,92585,HC AUDITORY EVOKED POTENT COMPR,470,1 ,"$1,265.00 ",$822.25 ,$143.95 ,"$1,265.00 ", N/A ,$645.15 ,$695.75 , N/A ,$354.20 ,$619.85 , N/A ,$740.03 , N/A ,$686.90 ,$143.95 , N/A ,$686.90 , N/A ,$885.50 ,$632.50 ,"$1,012.00 ", N/A , N/A ,$885.50 , N/A ,$759.00 , N/A ,$948.75 ,$698.28 ,$629.97 ,$698.28 , N/A ,$698.28 ,$986.70 ,$986.70 ,"$1,075.25 ", N/A ,$876.65 , N/A ,"$1,265.00 ",$695.75 , N/A ,$332.70 ,"$1,265.00 ", N/A , N/A , N/A ,"$1,012.00 ",$686.90 ,$354.20 ,"$1,138.50 ",$480.70 ,$300.00 , N/A ,$607.20 
ST. MARY'S HOSPITAL - DECATUR,47000001,92587,HC DISTORTION EVOKED POTENT LTD,470,1 ,$192.00 ,$124.80 ,$8.20 ,$626.30 ,$626.30 ,$97.92 ,$105.60 ,$250.52 ,$53.76 ,$43.35 ,$250.52 ,$43.35 ,$192.00 ,$104.26 ,$8.20 ,$192.00 ,$104.26 ,$192.00 ,$134.40 ,$96.00 ,$153.60 ,$626.30 ,$250.52 ,$134.40 ,$250.52 ,$115.20 ,$250.52 ,$144.00 ,$105.98 ,$95.62 ,$105.98 ,$250.52 ,$105.98 ,$149.76 ,$149.76 ,$163.20 ,$192.00 ,$133.06 ,$250.52 ,$192.00 ,$105.60 ,$250.52 ,$50.50 ,$192.00 ,$152.55 ,$145.61 ,$263.05 ,$153.60 ,$104.26 ,$53.76 ,$172.80 ,$72.96 ,$192.00 ,$250.52 ,$92.16 
ST. MARY'S HOSPITAL - DECATUR,47000091,92651,HC AEP HEARING STATUS DETER BB STIM I AND R,470,1 ,$767.00 ,$498.55 ,$92.17 ,$767.00 ,$330.40 ,$391.17 ,$421.85 ,$132.16 ,$214.76 ,$360.49 ,$132.16 ,$414.18 ,$132.16 ,$416.48 ,$306.80 ,$132.16 ,$416.48 ,$251.11 ,$536.90 ,$383.50 ,$613.60 ,$330.40 ,$132.16 ,$536.90 ,$132.16 ,$460.20 ,$132.16 ,$575.25 ,$423.38 ,$381.97 ,$423.38 ,$132.16 ,$423.38 ,$598.26 ,$598.26 ,$651.95 ,$330.40 ,$531.53 ,$132.16 ,$767.00 ,$421.85 ,$132.16 ,$201.72 ,$767.00 ,$96.56 ,$92.17 ,$138.77 ,$613.60 ,$416.48 ,$214.76 ,$690.30 ,$291.46 ,$300.00 ,$132.16 ,$368.16 
ST. MARY'S HOSPITAL - DECATUR,47000093,92653,HC NEURODIAGONSTIC I AND R,470,1 ,"$1,265.00 ",$822.25 ,$92.17 ,"$1,265.00 ",$626.30 ,$645.15 ,$695.75 ,$250.52 ,$354.20 ,$594.55 ,$250.52 ,$683.10 ,$250.52 ,$686.90 ,$506.00 ,$250.52 ,$686.90 ,$475.99 ,$885.50 ,$632.50 ,"$1,012.00 ",$626.30 ,$250.52 ,$885.50 ,$250.52 ,$759.00 ,$250.52 ,$948.75 ,$698.28 ,$629.97 ,$698.28 ,$250.52 ,$698.28 ,$986.70 ,$986.70 ,"$1,075.25 ",$626.30 ,$876.65 ,$250.52 ,"$1,265.00 ",$695.75 ,$250.52 ,$332.70 ,"$1,265.00 ",$96.56 ,$92.17 ,$263.05 ,"$1,012.00 ",$686.90 ,$354.20 ,"$1,138.50 ",$480.70 ,$300.00 ,$250.52 ,$607.20 
ST. MARY'S HOSPITAL - DECATUR,47100003,92567,HC TYMPANOMETRY IMPED TEST,471,1 ,$85.00 ,$55.25 ,$22.36 ,$92.17 ,$80.10 ,$43.35 ,$46.75 ,$32.04 ,$23.80 ,$41.65 ,$32.04 ,$49.73 ,$32.04 ,$46.16 ,$26.29 ,$32.04 ,$46.16 ,$60.88 ,$59.50 ,$42.50 ,$68.00 ,$80.10 ,$32.04 ,$59.50 ,$32.04 ,$51.00 ,$32.04 ,$63.75 ,$46.92 ,$42.33 ,$46.92 ,$32.04 ,$46.92 ,$66.30 ,$66.30 ,$72.25 ,$80.10 ,$58.91 ,$32.04 ,$85.00 ,$46.75 ,$32.04 ,$22.36 ,$85.00 ,$85.00 ,$92.17 ,$33.64 ,$68.00 ,$46.16 ,$23.80 ,$76.50 ,$32.30 ,$85.00 ,$32.04 ,$40.80 
ST. MARY'S HOSPITAL - DECATUR,47100005,92568,HC AUD ACOUSTIC REFLEX TESTING,471,1 ,$87.00 ,$56.55 ,$1.58 ,$87.00 ,$80.10 ,$44.37 ,$47.85 ,$32.04 ,$24.36 ,$42.63 ,$32.04 ,$50.90 ,$32.04 ,$47.24 ,$37.51 ,$32.04 ,$47.24 ,$60.88 ,$60.90 ,$43.50 ,$69.60 ,$80.10 ,$32.04 ,$60.90 ,$32.04 ,$52.20 ,$32.04 ,$65.25 ,$48.02 ,$43.33 ,$48.02 ,$32.04 ,$48.02 ,$67.86 ,$67.86 ,$73.95 ,$80.10 ,$60.29 ,$32.04 ,$87.00 ,$47.85 ,$32.04 ,$22.88 ,$87.00 ,$1.65 ,$1.58 ,$33.64 ,$69.60 ,$47.24 ,$24.36 ,$78.30 ,$33.06 ,$87.00 ,$32.04 ,$41.76 
ST. MARY'S HOSPITAL - DECATUR,47100006,92557,HC AUD COMPREHENSIVE AUDIO,471,1 ,$317.00 ,$206.05 ,$48.62 ,$330.40 ,$330.40 ,$161.67 ,$174.35 ,$132.16 ,$88.76 ,$155.33 ,$132.16 ,$185.45 ,$132.16 ,$172.13 ,$48.62 ,$132.16 ,$172.13 ,$251.11 ,$221.90 ,$158.50 ,$253.60 ,$330.40 ,$132.16 ,$221.90 ,$132.16 ,$190.20 ,$132.16 ,$237.75 ,$174.98 ,$157.87 ,$174.98 ,$132.16 ,$174.98 ,$247.26 ,$247.26 ,$269.45 ,$317.00 ,$219.68 ,$132.16 ,$317.00 ,$174.35 ,$132.16 ,$83.37 ,$317.00 ,$96.56 ,$92.17 ,$138.77 ,$253.60 ,$172.13 ,$88.76 ,$285.30 ,$120.46 ,$300.00 ,$132.16 ,$152.16 
ST. MARY'S HOSPITAL - DECATUR,47100007,92582,HC AUD CONDITION PLAY AUDIOMETRY,471,1 ,$192.00 ,$124.80 ,$50.50 ,$330.40 ,$330.40 ,$97.92 ,$105.60 ,$132.16 ,$53.76 ,$94.08 ,$132.16 ,$112.32 ,$132.16 ,$104.26 ,$97.32 ,$132.16 ,$104.26 ,$192.00 ,$134.40 ,$96.00 ,$153.60 ,$330.40 ,$132.16 ,$134.40 ,$132.16 ,$115.20 ,$132.16 ,$144.00 ,$105.98 ,$95.62 ,$105.98 ,$132.16 ,$105.98 ,$149.76 ,$149.76 ,$163.20 ,$192.00 ,$133.06 ,$132.16 ,$192.00 ,$105.60 ,$132.16 ,$50.50 ,$192.00 ,$83.53 ,$79.74 ,$138.77 ,$153.60 ,$104.26 ,$53.76 ,$172.80 ,$72.96 ,$192.00 ,$132.16 ,$92.16 
ST. MARY'S HOSPITAL - DECATUR,47100009,92558,HC AUD EVOKED OTOACOUS EMISSIONS SCREENING,471,1 ,$205.00 ,$133.25 ,$12.63 ,$205.00 , N/A ,$104.55 ,$112.75 , N/A ,$57.40 ,$96.35 , N/A ,$110.70 , N/A ,$111.32 ,$12.63 , N/A ,$111.32 , N/A ,$143.50 ,$102.50 ,$164.00 , N/A , N/A ,$143.50 , N/A ,$123.00 , N/A ,$153.75 ,$113.16 ,$102.09 ,$113.16 , N/A ,$113.16 ,$159.90 ,$159.90 ,$174.25 , N/A ,$142.07 , N/A ,$205.00 ,$112.75 , N/A ,$53.92 ,$205.00 ,$96.56 ,$92.17 , N/A ,$164.00 ,$111.32 ,$57.40 ,$184.50 ,$77.90 ,$205.00 , N/A ,$98.40 
ST. MARY'S HOSPITAL - DECATUR,47100010,92586,HC AUD EVOKED POTENTIAL LIMITED,471,1 ,$767.00 ,$498.55 ,$123.22 ,$767.00 , N/A ,$391.17 ,$421.85 , N/A ,$214.76 ,$375.83 , N/A ,$448.70 , N/A ,$416.48 ,$123.22 , N/A ,$416.48 , N/A ,$536.90 ,$383.50 ,$613.60 , N/A , N/A ,$536.90 , N/A ,$460.20 , N/A ,$575.25 ,$423.38 ,$381.97 ,$423.38 , N/A ,$423.38 ,$598.26 ,$598.26 ,$651.95 , N/A ,$531.53 , N/A ,$767.00 ,$421.85 , N/A ,$201.72 ,$767.00 , N/A , N/A , N/A ,$613.60 ,$416.48 ,$214.76 ,$690.30 ,$291.46 ,$300.00 , N/A ,$368.16 
ST. MARY'S HOSPITAL - DECATUR,47100011,92553,HC AUD PURE TONE AIR  AND  BONE,471,1 ,$183.00 ,$118.95 ,$48.13 ,$330.40 ,$330.40 ,$93.33 ,$100.65 ,$132.16 ,$51.24 ,$89.67 ,$132.16 ,$107.06 ,$132.16 ,$99.37 ,$53.08 ,$132.16 ,$99.37 ,$183.00 ,$128.10 ,$91.50 ,$146.40 ,$330.40 ,$132.16 ,$128.10 ,$132.16 ,$109.80 ,$132.16 ,$137.25 ,$101.02 ,$91.13 ,$101.02 ,$132.16 ,$101.02 ,$142.74 ,$142.74 ,$155.55 ,$183.00 ,$126.82 ,$132.16 ,$183.00 ,$100.65 ,$132.16 ,$48.13 ,$183.00 ,$96.56 ,$92.17 ,$138.77 ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$69.54 ,$183.00 ,$132.16 ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,47100013,92552,HC AUD PURE TONE AIR ONLY,471,1 ,$153.00 ,$99.45 ,$40.24 ,$266.85 ,$266.85 ,$78.03 ,$84.15 ,$106.74 ,$42.84 ,$74.97 ,$106.74 ,$89.51 ,$106.74 ,$83.08 ,$43.77 ,$106.74 ,$83.08 ,$153.00 ,$107.10 ,$76.50 ,$122.40 ,$266.84 ,$106.74 ,$107.10 ,$106.74 ,$91.80 ,$106.74 ,$114.75 ,$84.46 ,$76.19 ,$84.46 ,$106.74 ,$84.46 ,$119.34 ,$119.34 ,$130.05 ,$153.00 ,$106.03 ,$106.74 ,$153.00 ,$84.15 ,$106.74 ,$40.24 ,$153.00 ,$96.56 ,$92.17 ,$112.08 ,$122.40 ,$83.08 ,$42.84 ,$137.70 ,$58.14 ,$153.00 ,$106.74 ,$73.44 
ST. MARY'S HOSPITAL - DECATUR,47100015,92555,HC AUD SPEECH THRESHOLD,471,1 ,$96.00 ,$62.40 ,$25.25 ,$96.00 ,$80.10 ,$48.96 ,$52.80 ,$32.04 ,$26.88 ,$47.04 ,$32.04 ,$56.16 ,$32.04 ,$52.13 ,$33.47 ,$32.04 ,$52.13 ,$60.88 ,$67.20 ,$48.00 ,$76.80 ,$80.10 ,$32.04 ,$67.20 ,$32.04 ,$57.60 ,$32.04 ,$72.00 ,$52.99 ,$47.81 ,$52.99 ,$32.04 ,$52.99 ,$74.88 ,$74.88 ,$81.60 ,$80.10 ,$66.53 ,$32.04 ,$96.00 ,$52.80 ,$32.04 ,$25.25 ,$96.00 ,$96.00 ,$92.17 ,$33.64 ,$76.80 ,$52.13 ,$26.88 ,$86.40 ,$36.48 ,$96.00 ,$32.04 ,$46.08 
ST. MARY'S HOSPITAL - DECATUR,47100016,92556,HC AUD SPEECH THRESHOLD W/SPEECH RECOGNITION,471,1 ,$134.00 ,$87.10 ,$35.24 ,$134.00 ,$131.73 ,$68.34 ,$73.70 ,$52.69 ,$37.52 ,$65.66 ,$52.69 ,$78.39 ,$52.69 ,$72.76 ,$52.59 ,$52.69 ,$72.76 ,$100.11 ,$93.80 ,$67.00 ,$107.20 ,$131.73 ,$52.69 ,$93.80 ,$52.69 ,$80.40 ,$52.69 ,$100.50 ,$73.97 ,$66.73 ,$73.97 ,$52.69 ,$73.97 ,$104.52 ,$104.52 ,$113.90 ,$131.73 ,$92.86 ,$52.69 ,$134.00 ,$73.70 ,$52.69 ,$35.24 ,$134.00 ,$96.56 ,$92.17 ,$55.32 ,$107.20 ,$72.76 ,$37.52 ,$120.60 ,$50.92 ,$134.00 ,$52.69 ,$64.32 
ST. MARY'S HOSPITAL - DECATUR,47100017,92579,HC AUD VISUAL REINFORCEMENT AUDIOMETRY,471,1 ,$175.00 ,$113.75 ,$46.03 ,$330.40 ,$330.40 ,$89.25 ,$96.25 ,$132.16 ,$49.00 ,$85.75 ,$132.16 ,$102.38 ,$132.16 ,$95.03 ,$54.69 ,$132.16 ,$95.03 ,$175.00 ,$122.50 ,$87.50 ,$140.00 ,$330.40 ,$132.16 ,$122.50 ,$132.16 ,$105.00 ,$132.16 ,$131.25 ,$96.60 ,$87.15 ,$96.60 ,$132.16 ,$96.60 ,$136.50 ,$136.50 ,$148.75 ,$175.00 ,$121.28 ,$132.16 ,$175.00 ,$96.25 ,$132.16 ,$46.03 ,$175.00 ,$96.56 ,$92.17 ,$138.77 ,$140.00 ,$95.03 ,$49.00 ,$157.50 ,$66.50 ,$175.00 ,$132.16 ,$84.00 
ST. MARY'S HOSPITAL - DECATUR,47100019,92537,HC CALORIC VESTIBULAR TEST W/REC BILAT BITHERMAL,471,1 ,$567.00 ,$368.55 ,$18.34 ,$567.00 ,$330.40 ,$289.17 ,$311.85 ,$132.16 ,$158.76 ,$113.54 ,$132.16 ,$113.54 ,$132.16 ,$307.88 ,$18.34 ,$132.16 ,$307.88 ,$251.11 ,$396.90 ,$283.50 ,$453.60 ,$330.40 ,$132.16 ,$396.90 ,$132.16 ,$340.20 ,$132.16 ,$425.25 ,$312.98 ,$282.37 ,$312.98 ,$132.16 ,$312.98 ,$442.26 ,$442.26 ,$481.95 ,$330.40 ,$392.93 ,$132.16 ,$567.00 ,$311.85 ,$132.16 ,$149.12 ,$567.00 ,$152.55 ,$145.61 ,$138.77 ,$453.60 ,$307.88 ,$158.76 ,$510.30 ,$215.46 ,$300.00 ,$132.16 ,$272.16 
ST. MARY'S HOSPITAL - DECATUR,47100020,92538,HC CALORIC VESTIBULAR TEST W/REC BILAT MONOTHERMAL,471,1 ,$567.00 ,$368.55 ,$10.68 ,$567.00 ,$330.40 ,$289.17 ,$311.85 ,$132.16 ,$158.76 ,$65.27 ,$132.16 ,$65.27 ,$132.16 ,$307.88 ,$10.68 ,$132.16 ,$307.88 ,$251.11 ,$396.90 ,$283.50 ,$453.60 ,$330.40 ,$132.16 ,$396.90 ,$132.16 ,$340.20 ,$132.16 ,$425.25 ,$312.98 ,$282.37 ,$312.98 ,$132.16 ,$312.98 ,$442.26 ,$442.26 ,$481.95 ,$330.40 ,$392.93 ,$132.16 ,$567.00 ,$311.85 ,$132.16 ,$149.12 ,$567.00 ,$152.55 ,$145.61 ,$138.77 ,$453.60 ,$307.88 ,$158.76 ,$510.30 ,$215.46 ,$300.00 ,$132.16 ,$272.16 
ST. MARY'S HOSPITAL - DECATUR,47900001,V5264,HC EAR MOLD/INSERT NOT DISPOSABLE ANY TYPE (MISC TYPE IN),479,1 ,$48.00 ,$31.20 ,$12.62 ,$48.00 , N/A ,$24.48 ,$26.40 , N/A ,$13.44 ,$22.56 , N/A ,$25.92 , N/A ,$26.06 ,$48.00 , N/A ,$26.06 , N/A ,$33.60 ,$24.00 ,$38.40 , N/A , N/A ,$33.60 , N/A ,$28.80 , N/A ,$36.00 ,$26.50 ,$23.90 ,$26.50 , N/A ,$26.50 ,$37.44 ,$37.44 ,$40.80 , N/A ,$33.26 , N/A ,$48.00 ,$26.40 , N/A ,$12.62 ,$48.00 , N/A , N/A , N/A ,$38.40 ,$26.06 ,$13.44 ,$43.20 ,$18.24 ,$48.00 , N/A ,$23.04 
ST. MARY'S HOSPITAL - DECATUR,48000001,76825,HC US FETAL ECHO W/W/O M,480,1 ,"$1,882.00 ","$1,223.30 ",$256.68 ,"$1,882.00 ","$1,143.48 ",$256.68 ,"$1,035.10 ",$457.39 ,$526.96 ,$922.18 ,$457.39 ,"$1,100.97 ",$457.39 ,"$1,021.93 ",$396.21 ,$457.39 ,"$1,021.93 ",$869.04 ,"$1,317.40 ",$941.00 ,"$1,505.60 ","$1,143.47 ",$457.39 ,"$1,317.40 ",$457.39 ,"$1,129.20 ",$457.39 ,"$1,411.50 ","$1,038.86 ",$937.24 ,"$1,038.86 ",$457.39 ,"$1,038.86 ", N/A , N/A ,"$1,599.70 ","$1,143.47 ","$1,304.23 ",$457.39 ,"$1,882.00 ","$1,035.10 ",$457.39 ,$494.97 ,"$1,882.00 ", N/A , N/A ,$480.26 ,"$1,505.60 ","$1,021.93 ",$526.96 ,"$1,693.80 ",$715.16 ,"$1,025.00 ",$457.39 ,$903.36 
ST. MARY'S HOSPITAL - DECATUR,48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$3,802.00 ","$2,471.30 ",$229.38 ,"$3,802.00 ","$1,329.43 ","$1,939.02 ","$2,091.10 ",$531.77 ,"$1,064.56 ","$1,862.98 ",$531.77 ,"$2,008.07 ",$531.77 ,"$2,064.49 ",$229.38 ,$531.77 ,"$2,064.49 ","$1,010.36 ","$2,661.40 ","$1,901.00 ","$3,041.60 ","$1,329.42 ",$531.77 ,"$2,661.40 ",$531.77 ,"$2,281.20 ",$531.77 ,"$2,851.50 ","$2,098.70 ","$1,893.40 ","$2,098.70 ",$531.77 ,"$2,098.70 ","$2,965.56 ","$2,965.56 ","$3,231.70 ","$1,329.42 ","$2,634.79 ",$531.77 ,"$3,802.00 ","$2,091.10 ",$531.77 ,$999.93 ,"$3,802.00 ",$426.17 ,$406.80 ,$558.36 ,"$3,041.60 ","$2,064.49 ","$1,064.56 ","$3,421.80 ","$1,444.76 ","$1,025.00 ",$531.77 ,"$1,824.96 "
ST. MARY'S HOSPITAL - DECATUR,48000008,G0269,HC PLACE OCCLUSIVE DEVICE A/VV G0269,480,1 ,"$2,524.00 ","$1,640.60 ",$473.00 ,"$2,524.00 ", N/A ,"$2,524.00 ","$1,388.20 ", N/A ,$706.72 ,"$1,186.28 ", N/A ,"$1,362.96 ", N/A ,"$1,370.53 ",$473.00 , N/A ,"$1,370.53 ", N/A ,"$1,766.80 ","$1,262.00 ","$2,019.20 ", N/A , N/A ,"$1,766.80 ", N/A ,"$1,514.40 ", N/A ,"$1,893.00 ","$1,393.25 ","$1,256.95 ","$1,393.25 ", N/A ,"$1,393.25 ","$1,968.72 ","$1,968.72 ","$2,145.40 ", N/A ,"$1,749.13 ", N/A ,"$2,524.00 ","$1,388.20 ", N/A ,$663.81 ,"$2,524.00 ", N/A , N/A , N/A ,"$2,019.20 ","$1,370.53 ",$706.72 ,"$2,271.60 ",$959.12 ,"$1,025.00 ", N/A ,"$1,211.52 "
ST. MARY'S HOSPITAL - DECATUR,48000017,93640,HC EP EVAL CARDIO/DEFIB LEADS,480,1 ,"$3,975.00 ","$2,583.75 ",$169.13 ,"$3,975.00 ", N/A ,"$3,975.00 ","$2,186.25 ", N/A ,"$1,113.00 ","$1,947.75 ", N/A ,"$2,325.38 ", N/A ,"$2,158.43 ",$542.43 , N/A ,"$2,158.43 ", N/A ,"$2,782.50 ","$1,987.50 ","$3,180.00 ", N/A , N/A ,"$2,782.50 ", N/A ,"$2,385.00 ", N/A ,"$2,981.25 ","$2,194.20 ","$1,979.55 ","$2,194.20 ", N/A ,"$2,194.20 ","$3,100.50 ","$3,100.50 ","$3,378.75 ", N/A ,"$2,754.68 ", N/A ,"$3,975.00 ","$2,186.25 ", N/A ,"$1,045.43 ","$3,975.00 ",$177.19 ,$169.13 , N/A ,"$3,180.00 ","$2,158.43 ","$1,113.00 ","$3,577.50 ","$1,510.50 ","$1,025.00 ", N/A ,"$1,908.00 "
ST. MARY'S HOSPITAL - DECATUR,48000024,93668,HC PAD REHAB PER SESSION,480,1 ,$211.00 ,$137.15 ,$34.88 ,$211.00 ,$131.73 ,$107.61 ,$116.05 ,$52.69 ,$59.08 ,$103.39 ,$52.69 ,$123.44 ,$52.69 ,$114.57 ,$34.88 ,$52.69 ,$114.57 ,$100.11 ,$147.70 ,$105.50 ,$168.80 ,$131.73 ,$52.69 ,$147.70 ,$52.69 ,$126.60 ,$52.69 ,$158.25 ,$116.47 ,$105.08 ,$116.47 ,$52.69 ,$116.47 ,$164.58 ,$164.58 ,$179.35 ,$131.73 ,$146.22 ,$52.69 ,$211.00 ,$116.05 ,$52.69 ,$55.49 ,$211.00 ,$211.00 ,$203.82 ,$55.32 ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 ,$211.00 ,$52.69 ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,48100002,33206,HC INS/REPL PCMKR PERM ATRIAL 33206,481,1 ,"$9,356.00 ","$6,081.40 ","$2,460.63 ","$24,606.56 ","$24,606.55 ","$9,356.00 ","$5,145.80 ","$9,842.62 ","$2,619.68 ","$3,523.99 ","$9,842.62 ","$4,049.96 ","$9,356.00 ","$3,913.45 ","$3,913.45 ","$9,356.00 ","$3,913.45 ","$9,356.00 ","$3,500.00 ","$4,678.00 ","$7,484.80 ","$24,606.56 ","$9,842.62 ","$6,549.20 ","$9,842.62 ","$5,613.60 ","$9,842.62 ","$7,017.00 ","$5,164.51 ","$4,659.29 ","$5,164.51 ","$9,842.62 ","$5,164.51 ","$7,297.68 ","$7,297.68 ","$7,952.60 ","$9,356.00 ","$4,981.00 ","$9,842.62 ","$9,356.00 ","$5,145.80 ","$9,842.62 ","$2,460.63 ","$9,356.00 ","$5,626.94 ","$5,371.17 ","$10,334.75 ","$7,484.80 ","$3,913.45 ","$2,619.68 ","$8,420.40 ","$3,243.00 ","$9,356.00 ","$9,842.62 ","$4,490.88 "
ST. MARY'S HOSPITAL - DECATUR,48100003,33207,HC INS/REPL PACEMKR PERM VENTRIC 33207,481,1 ,"$10,387.00 ","$6,751.55 ","$2,731.78 ","$24,606.56 ","$24,606.55 ","$10,387.00 ","$5,712.85 ","$9,842.62 ","$2,908.36 ","$3,523.99 ","$9,842.62 ","$4,049.96 ","$9,842.62 ","$3,913.45 ","$3,913.45 ","$9,842.62 ","$3,913.45 ","$10,387.00 ","$3,500.00 ","$5,193.50 ","$8,309.60 ","$24,606.56 ","$9,842.62 ","$7,270.90 ","$9,842.62 ","$6,232.20 ","$9,842.62 ","$7,790.25 ","$5,733.62 ","$5,172.73 ","$5,733.62 ","$9,842.62 ","$5,733.62 ","$8,101.86 ","$8,101.86 ","$8,828.95 ","$10,387.00 ","$4,981.00 ","$9,842.62 ","$10,387.00 ","$5,712.85 ","$9,842.62 ","$2,731.78 ","$10,387.00 ","$5,626.94 ","$5,371.17 ","$10,334.75 ","$8,309.60 ","$3,913.45 ","$2,908.36 ","$9,348.30 ","$3,243.00 ","$10,387.00 ","$9,842.62 ","$4,985.76 "
ST. MARY'S HOSPITAL - DECATUR,48100004,33208,HC INS/REPL PACEMKR PERM A/V 33208,481,1 ,"$19,915.00 ","$12,944.75 ","$3,195.00 ","$24,606.56 ","$24,606.55 ","$12,000.00 ","$10,953.25 ","$9,842.62 ","$5,576.20 ","$3,523.99 ","$9,842.62 ","$4,049.96 ","$9,842.62 ","$3,913.45 ","$3,913.45 ","$9,842.62 ","$3,913.45 ","$18,700.98 ","$3,500.00 ","$9,957.50 ","$15,932.00 ","$24,606.56 ","$9,842.62 ","$13,940.50 ","$9,842.62 ","$11,949.00 ","$9,842.62 ","$14,936.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,842.62 ","$10,265.00 ","$15,533.70 ","$15,533.70 ","$16,927.75 ","$19,915.00 ","$4,981.00 ","$9,842.62 ","$19,915.00 ","$10,953.25 ","$9,842.62 ","$5,237.65 ","$19,915.00 ","$5,626.94 ","$5,371.17 ","$10,334.75 ","$15,932.00 ","$3,913.45 ","$5,576.20 ","$17,923.50 ","$3,195.00 ","$19,915.00 ","$9,842.62 ","$9,559.20 "
ST. MARY'S HOSPITAL - DECATUR,48100005,33210,HC INS/REPL TPM SGL ELEC/CATH 33210,481,1 ,"$5,003.00 ","$3,251.95 ","$1,315.79 ","$19,307.35 ","$19,307.35 ","$5,003.00 ","$2,751.65 ","$7,722.94 ","$1,400.84 ","$2,351.41 ","$7,722.94 ","$2,701.62 ","$5,003.00 ","$2,716.63 ","$2,716.63 ","$5,003.00 ","$2,716.63 ","$5,003.00 ","$3,500.00 ","$2,501.50 ","$4,002.40 ","$19,307.35 ","$7,722.94 ","$3,502.10 ","$7,722.94 ","$3,001.80 ","$7,722.94 ","$3,752.25 ","$2,761.66 ","$2,491.49 ","$2,761.66 ","$7,722.94 ","$2,761.66 ","$3,902.34 ","$3,902.34 ","$4,252.55 ","$5,003.00 ","$3,467.08 ","$7,722.94 ","$5,003.00 ","$2,751.65 ","$7,722.94 ","$1,315.79 ","$5,003.00 ","$2,179.58 ","$2,080.51 ","$8,109.09 ","$4,002.40 ","$2,716.63 ","$1,400.84 ","$4,502.70 ","$2,861.00 ","$5,003.00 ","$7,722.94 ","$2,401.44 "
ST. MARY'S HOSPITAL - DECATUR,48100006,33212,HC INS PULSE GEN SGL CHAMBER 33212,481,1 ,"$7,453.00 ","$4,844.45 ","$1,960.14 ","$19,307.35 ","$19,307.35 ","$5,500.00 ","$4,099.15 ","$7,722.94 ","$2,086.84 ","$3,502.91 ","$7,722.94 ","$4,024.62 ","$7,453.00 ","$3,913.45 ","$3,913.45 ","$7,453.00 ","$3,913.45 ","$7,453.00 ","$3,500.00 ","$3,726.50 ","$5,962.40 ","$19,307.35 ","$7,722.94 ","$5,217.10 ","$7,722.94 ","$4,471.80 ","$7,722.94 ","$5,589.75 ","$4,114.06 ","$3,711.59 ","$4,114.06 ","$7,722.94 ","$4,114.06 ","$5,813.34 ","$5,813.34 ","$6,335.05 ","$7,453.00 ","$4,981.00 ","$7,722.94 ","$7,453.00 ","$4,099.15 ","$7,722.94 ","$1,960.14 ","$7,453.00 ","$5,626.94 ","$5,371.17 ","$8,109.09 ","$5,962.40 ","$3,913.45 ","$2,086.84 ","$6,707.70 ","$3,243.00 ","$7,453.00 ","$7,722.94 ","$3,577.44 "
ST. MARY'S HOSPITAL - DECATUR,48100007,33213,HC INS PULSE GEN DUAL CHAMBER 33213,481,1 ,"$8,036.00 ","$5,223.40 ","$2,113.47 ","$24,606.56 ","$24,606.55 ","$5,500.00 ","$4,419.80 ","$9,842.62 ","$2,250.08 ","$3,523.99 ","$9,842.62 ","$4,049.96 ","$8,036.00 ","$3,913.45 ","$3,913.45 ","$8,036.00 ","$3,913.45 ","$8,036.00 ","$3,500.00 ","$4,018.00 ","$6,428.80 ","$24,606.56 ","$9,842.62 ","$5,625.20 ","$9,842.62 ","$4,821.60 ","$9,842.62 ","$6,027.00 ","$4,435.87 ","$4,001.93 ","$4,435.87 ","$9,842.62 ","$4,435.87 ","$6,268.08 ","$6,268.08 ","$6,830.60 ","$8,036.00 ","$4,981.00 ","$9,842.62 ","$8,036.00 ","$4,419.80 ","$9,842.62 ","$2,113.47 ","$8,036.00 ","$5,626.94 ","$5,371.17 ","$10,334.75 ","$6,428.80 ","$3,913.45 ","$2,250.08 ","$7,232.40 ","$3,243.00 ","$8,036.00 ","$9,842.62 ","$3,857.28 "
ST. MARY'S HOSPITAL - DECATUR,48100008,33214,HC UPGRADE PACEMAKER SYSTEM 33214,481,1 ,"$11,396.00 ","$7,407.40 ","$2,997.15 ","$24,606.56 ","$24,606.55 ","$11,396.00 ","$6,267.80 ","$9,842.62 ","$3,190.88 ","$3,523.99 ","$9,842.62 ","$4,049.96 ","$9,842.62 ","$3,913.45 ","$3,913.45 ","$9,842.62 ","$3,913.45 ","$11,396.00 ","$3,500.00 ","$5,698.00 ","$9,116.80 ","$24,606.56 ","$9,842.62 ","$7,977.20 ","$9,842.62 ","$6,837.60 ","$9,842.62 ","$8,547.00 ","$6,290.59 ","$5,675.21 ","$6,290.59 ","$9,842.62 ","$6,290.59 ","$8,888.88 ","$8,888.88 ","$9,686.60 ","$11,396.00 ","$4,981.00 ","$9,842.62 ","$11,396.00 ","$6,267.80 ","$9,842.62 ","$2,997.15 ","$11,396.00 ","$5,626.94 ","$5,371.17 ","$10,334.75 ","$9,116.80 ","$3,913.45 ","$3,190.88 ","$10,256.40 ","$3,195.00 ","$11,396.00 ","$9,842.62 ","$5,470.08 "
ST. MARY'S HOSPITAL - DECATUR,48100009,33215,HC REPOSITION PACE/DEFIB LEAD 33215,481,1 ,"$4,310.00 ","$2,801.50 ","$1,133.53 ","$6,774.50 ","$6,774.50 ","$4,310.00 ","$2,370.50 ","$2,709.80 ","$1,206.80 ","$2,025.70 ","$2,709.80 ","$2,327.40 ","$2,709.80 ","$2,340.33 ","$2,340.33 ","$2,709.80 ","$2,340.33 ","$4,310.00 ","$3,017.00 ","$2,155.00 ","$3,448.00 ","$6,774.49 ","$2,709.80 ","$3,017.00 ","$2,709.80 ","$2,586.00 ","$2,709.80 ","$3,232.50 ","$2,379.12 ","$2,146.38 ","$2,379.12 ","$2,709.80 ","$2,379.12 ","$3,361.80 ","$3,361.80 ","$3,663.50 ","$4,310.00 ","$2,986.83 ","$2,709.80 ","$4,310.00 ","$2,370.50 ","$2,709.80 ","$1,133.53 ","$4,310.00 ","$4,072.68 ","$3,887.56 ","$2,845.29 ","$3,448.00 ","$2,340.33 ","$1,206.80 ","$3,879.00 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$2,068.80 "
ST. MARY'S HOSPITAL - DECATUR,48100010,33216,HC INS ELECTRODE SGL CHAMBER 33216,481,1 ,"$6,156.00 ","$4,001.40 ","$1,619.03 ","$19,307.35 ","$19,307.35 ","$6,156.00 ","$3,385.80 ","$7,722.94 ","$1,723.68 ","$2,893.32 ","$7,722.94 ","$3,324.24 ","$6,156.00 ","$3,342.71 ","$3,342.71 ","$6,156.00 ","$3,342.71 ","$6,156.00 ","$3,500.00 ","$3,078.00 ","$4,924.80 ","$19,307.35 ","$7,722.94 ","$4,309.20 ","$7,722.94 ","$3,693.60 ","$7,722.94 ","$4,617.00 ","$3,398.11 ","$3,065.69 ","$3,398.11 ","$7,722.94 ","$3,398.11 ","$4,801.68 ","$4,801.68 ","$5,232.60 ","$6,156.00 ","$4,266.11 ","$7,722.94 ","$6,156.00 ","$3,385.80 ","$7,722.94 ","$1,619.03 ","$6,156.00 ","$2,179.58 ","$2,080.51 ","$8,109.09 ","$4,924.80 ","$3,342.71 ","$1,723.68 ","$5,540.40 ","$2,861.00 ","$5,100.00 ","$7,722.94 ","$2,954.88 "
ST. MARY'S HOSPITAL - DECATUR,48100011,33217,HC INS ELECTRODE DUAL CHAMBER 33217,481,1 ,"$6,328.00 ","$4,113.20 ","$1,664.26 ","$19,307.35 ","$19,307.35 ","$6,200.00 ","$3,480.40 ","$7,722.94 ","$1,771.84 ","$2,974.16 ","$7,722.94 ","$3,417.12 ","$6,328.00 ","$3,436.10 ","$3,436.10 ","$6,328.00 ","$3,436.10 ","$6,328.00 ","$3,500.00 ","$3,164.00 ","$5,062.40 ","$19,307.35 ","$7,722.94 ","$4,429.60 ","$7,722.94 ","$3,796.80 ","$7,722.94 ","$4,746.00 ","$3,493.06 ","$3,151.34 ","$3,493.06 ","$7,722.94 ","$3,493.06 ","$4,935.84 ","$4,935.84 ","$5,378.80 ","$6,328.00 ","$4,385.30 ","$7,722.94 ","$6,328.00 ","$3,480.40 ","$7,722.94 ","$1,664.26 ","$6,328.00 ","$2,179.58 ","$2,080.51 ","$8,109.09 ","$5,062.40 ","$3,436.10 ","$1,771.84 ","$5,695.20 ","$2,861.00 ","$5,100.00 ","$7,722.94 ","$3,037.44 "
ST. MARY'S HOSPITAL - DECATUR,48100012,33222,HC REVISE PACEMAKER POCKET 33222,481,1 ,"$3,649.00 ","$2,371.85 ",$959.69 ,"$4,053.30 ","$4,053.30 ","$3,500.00 ","$2,006.95 ","$1,621.32 ","$1,021.72 ","$1,715.03 ","$1,621.32 ","$1,970.46 ","$1,621.32 ","$1,981.41 ","$1,981.41 ","$1,621.32 ","$1,981.41 ","$3,080.51 ","$2,554.30 ","$1,824.50 ","$2,919.20 ","$4,053.30 ","$1,621.32 ","$2,554.30 ","$1,621.32 ","$2,189.40 ","$1,621.32 ","$2,736.75 ","$2,014.25 ","$1,817.20 ","$2,014.25 ","$1,621.32 ","$2,014.25 ","$2,846.22 ","$2,846.22 ","$3,101.65 ","$3,649.00 ","$2,528.76 ","$1,621.32 ","$3,649.00 ","$2,006.95 ","$1,621.32 ",$959.69 ,"$3,649.00 ","$1,225.99 ","$1,170.27 ","$1,702.39 ","$2,919.20 ","$1,981.41 ","$1,021.72 ","$3,284.10 ","$1,795.00 ","$2,100.00 ","$1,621.32 ","$1,751.52 "
ST. MARY'S HOSPITAL - DECATUR,48100013,33223,HC REVISE C-D POCKET 33223,481,1 ,"$3,656.00 ","$2,376.40 ",$961.53 ,"$4,053.30 ","$4,053.30 ","$3,500.00 ","$2,010.80 ","$1,621.32 ","$1,023.68 ","$1,718.32 ","$1,621.32 ","$1,974.24 ","$1,621.32 ","$1,985.21 ","$1,985.21 ","$1,621.32 ","$1,985.21 ","$3,080.51 ","$2,559.20 ","$1,828.00 ","$2,924.80 ","$4,053.30 ","$1,621.32 ","$2,559.20 ","$1,621.32 ","$2,193.60 ","$1,621.32 ","$2,742.00 ","$2,018.11 ","$1,820.69 ","$2,018.11 ","$1,621.32 ","$2,018.11 ","$2,851.68 ","$2,851.68 ","$3,107.60 ","$3,656.00 ","$2,533.61 ","$1,621.32 ","$3,656.00 ","$2,010.80 ","$1,621.32 ",$961.53 ,"$3,656.00 ","$1,225.99 ","$1,170.27 ","$1,702.39 ","$2,924.80 ","$1,985.21 ","$1,023.68 ","$3,290.40 ","$1,795.00 ","$2,100.00 ","$1,621.32 ","$1,754.88 "
ST. MARY'S HOSPITAL - DECATUR,48100014,33224,HC INSERT LV PACING ELECTRODE 33224,481,1 ,"$7,699.00 ","$5,004.35 ","$2,024.84 ","$24,606.56 ","$24,606.55 ","$5,500.00 ","$4,234.45 ","$9,842.62 ","$2,155.72 ","$3,523.99 ","$9,842.62 ","$4,049.96 ","$7,699.00 ","$3,913.45 ","$3,913.45 ","$7,699.00 ","$3,913.45 ","$7,699.00 ","$3,500.00 ","$3,849.50 ","$6,159.20 ","$24,606.56 ","$9,842.62 ","$5,389.30 ","$9,842.62 ","$4,619.40 ","$9,842.62 ","$5,774.25 ","$4,249.85 ","$3,834.10 ","$4,249.85 ","$9,842.62 ","$4,249.85 ","$6,005.22 ","$6,005.22 ","$6,544.15 ","$7,699.00 ","$4,981.00 ","$9,842.62 ","$7,699.00 ","$4,234.45 ","$9,842.62 ","$2,024.84 ","$7,699.00 ","$7,508.52 ","$7,167.23 ","$10,334.75 ","$6,159.20 ","$3,913.45 ","$2,155.72 ","$6,929.10 ","$3,195.00 ","$7,699.00 ","$9,842.62 ","$3,695.52 "
ST. MARY'S HOSPITAL - DECATUR,48100015,33225,HC INS LV PACING ELCT W/C-D/PACE 33225,481,1 ,"$6,400.00 ","$4,160.00 ","$1,683.20 ","$6,400.00 ", N/A ,"$6,200.00 ","$3,520.00 ", N/A ,"$1,792.00 ","$3,008.00 ", N/A ,"$3,456.00 ", N/A ,"$3,475.20 ","$3,475.20 ", N/A ,"$3,475.20 ", N/A ,"$3,500.00 ","$3,200.00 ","$5,120.00 ", N/A , N/A ,"$4,480.00 ", N/A ,"$3,840.00 ", N/A ,"$4,800.00 ","$3,532.80 ","$3,187.20 ","$3,532.80 ", N/A ,"$3,532.80 ","$4,992.00 ","$4,992.00 ","$5,440.00 ", N/A ,"$4,435.20 ", N/A ,"$6,400.00 ","$3,520.00 ", N/A ,"$1,683.20 ","$6,400.00 ", N/A , N/A , N/A ,"$5,120.00 ","$3,475.20 ","$1,792.00 ","$5,760.00 ","$3,195.00 ","$6,400.00 ", N/A ,"$3,072.00 "
ST. MARY'S HOSPITAL - DECATUR,48100016,33226,HC REPOSITION LV ELECTRODE 33226,481,1 ,"$4,304.00 ","$2,797.60 ","$1,131.95 ","$6,774.50 ","$6,774.50 ","$4,304.00 ","$2,367.20 ","$2,709.80 ","$1,205.12 ","$2,022.88 ","$2,709.80 ","$2,324.16 ","$2,709.80 ","$2,337.07 ","$2,337.07 ","$2,709.80 ","$2,337.07 ","$4,304.00 ","$3,012.80 ","$2,152.00 ","$3,443.20 ","$6,774.49 ","$2,709.80 ","$3,012.80 ","$2,709.80 ","$2,582.40 ","$2,709.80 ","$3,228.00 ","$2,375.81 ","$2,143.39 ","$2,375.81 ","$2,709.80 ","$2,375.81 ","$3,357.12 ","$3,357.12 ","$3,658.40 ","$4,304.00 ","$2,982.67 ","$2,709.80 ","$4,304.00 ","$2,367.20 ","$2,709.80 ","$1,131.95 ","$4,304.00 ","$4,072.68 ","$3,887.56 ","$2,845.29 ","$3,443.20 ","$2,337.07 ","$1,205.12 ","$3,873.60 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$2,065.92 "
ST. MARY'S HOSPITAL - DECATUR,48100017,33233,HC REMOVE PPM 33233,481,1 ,"$2,474.00 ","$1,608.10 ",$650.66 ,"$19,307.35 ","$19,307.35 ","$2,474.00 ","$1,360.70 ","$7,722.94 ",$692.72 ,"$1,162.78 ","$7,722.94 ","$1,335.96 ","$2,474.00 ","$1,343.38 ","$1,343.38 ","$2,474.00 ","$1,343.38 ","$2,474.00 ","$1,731.80 ","$1,237.00 ","$1,979.20 ","$19,307.35 ","$7,722.94 ","$1,731.80 ","$7,722.94 ","$1,484.40 ","$7,722.94 ","$1,855.50 ","$1,365.65 ","$1,232.05 ","$1,365.65 ","$7,722.94 ","$1,365.65 ","$1,929.72 ","$1,929.72 ","$2,102.90 ","$2,474.00 ","$1,714.48 ","$7,722.94 ","$2,474.00 ","$1,360.70 ","$7,722.94 ",$650.66 ,"$2,474.00 ","$2,474.00 ","$3,887.56 ","$8,109.09 ","$1,979.20 ","$1,343.38 ",$692.72 ,"$2,226.60 ","$2,474.00 ","$2,474.00 ","$7,722.94 ","$1,187.52 "
ST. MARY'S HOSPITAL - DECATUR,48100018,33234,HC REMOVE ELECTRODE SGL 33234,481,1 ,"$4,605.00 ","$2,993.25 ","$1,211.12 ","$8,149.00 ","$8,149.00 ","$4,605.00 ","$2,532.75 ","$3,259.60 ","$1,289.40 ","$2,164.35 ","$3,259.60 ","$2,486.70 ","$3,259.60 ","$2,500.52 ","$2,500.52 ","$3,259.60 ","$2,500.52 ","$4,605.00 ","$3,223.50 ","$2,302.50 ","$3,684.00 ","$8,149.00 ","$3,259.60 ","$3,223.50 ","$3,259.60 ","$2,763.00 ","$3,259.60 ","$3,453.75 ","$2,541.96 ","$2,293.29 ","$2,541.96 ","$3,259.60 ","$2,541.96 ","$3,591.90 ","$3,591.90 ","$3,914.25 ","$4,605.00 ","$3,191.27 ","$3,259.60 ","$4,605.00 ","$2,532.75 ","$3,259.60 ","$1,211.12 ","$4,605.00 ","$4,072.68 ","$3,887.56 ","$3,422.58 ","$3,684.00 ","$2,500.52 ","$1,289.40 ","$4,144.50 ","$2,641.00 ","$3,250.00 ","$3,259.60 ","$2,210.40 "
ST. MARY'S HOSPITAL - DECATUR,48100019,33235,HC REMOVE ELECTRODE DUAL 33235,481,1 ,"$2,722.00 ","$1,769.30 ",$715.89 ,"$8,149.00 ","$8,149.00 ","$2,722.00 ","$1,497.10 ","$3,259.60 ",$762.16 ,"$1,279.34 ","$3,259.60 ","$1,469.88 ","$2,722.00 ","$1,478.05 ","$1,478.05 ","$2,722.00 ","$1,478.05 ","$2,722.00 ","$1,905.40 ","$1,361.00 ","$2,177.60 ","$8,149.00 ","$3,259.60 ","$1,905.40 ","$3,259.60 ","$1,633.20 ","$3,259.60 ","$2,041.50 ","$1,502.54 ","$1,355.56 ","$1,502.54 ","$3,259.60 ","$1,502.54 ","$2,123.16 ","$2,123.16 ","$2,313.70 ","$2,722.00 ","$1,886.35 ","$3,259.60 ","$2,722.00 ","$1,497.10 ","$3,259.60 ",$715.89 ,"$2,722.00 ","$2,722.00 ","$3,887.56 ","$3,422.58 ","$2,177.60 ","$1,478.05 ",$762.16 ,"$2,449.80 ","$2,641.00 ","$2,722.00 ","$3,259.60 ","$1,306.56 "
ST. MARY'S HOSPITAL - DECATUR,48100020,33240,HC INSERT SGL/DUAL CHAMBER C-D 33240,481,1 ,"$1,901.00 ","$1,235.65 ",$499.96 ,"$54,570.85 ","$54,570.85 ","$1,901.00 ","$1,045.55 ","$21,828.34 ",$532.28 ,$893.47 ,"$21,828.34 ","$1,026.54 ","$1,901.00 ","$1,032.24 ","$1,032.24 ","$1,901.00 ","$1,032.24 ","$1,901.00 ","$1,330.70 ",$950.50 ,"$1,520.80 ","$54,570.85 ","$21,828.34 ","$1,330.70 ","$21,828.34 ","$1,140.60 ","$21,828.34 ","$1,425.75 ","$1,049.35 ",$946.70 ,"$1,049.35 ","$21,828.34 ","$1,049.35 ","$1,482.78 ","$1,482.78 ","$1,615.85 ","$1,901.00 ","$1,317.39 ","$21,828.34 ","$1,901.00 ","$1,045.55 ","$21,828.34 ",$499.96 ,"$1,901.00 ","$1,901.00 ","$15,407.01 ","$22,919.76 ","$1,520.80 ","$1,032.24 ",$532.28 ,"$1,710.90 ","$1,901.00 ","$1,901.00 ","$21,828.34 ",$912.48 
ST. MARY'S HOSPITAL - DECATUR,48100022,33241,HC REMOVE C-D PULSE GENERATOR 33241,481,1 ,"$3,765.00 ","$2,447.25 ",$990.20 ,"$8,149.00 ","$8,149.00 ","$3,765.00 ","$2,070.75 ","$3,259.60 ","$1,054.20 ","$1,769.55 ","$3,259.60 ","$2,033.10 ","$3,259.60 ","$2,044.40 ","$2,044.40 ","$3,259.60 ","$2,044.40 ","$3,765.00 ","$2,635.50 ","$1,882.50 ","$3,012.00 ","$8,149.00 ","$3,259.60 ","$2,635.50 ","$3,259.60 ","$2,259.00 ","$3,259.60 ","$2,823.75 ","$2,078.28 ","$1,874.97 ","$2,078.28 ","$3,259.60 ","$2,078.28 ","$2,936.70 ","$2,936.70 ","$3,200.25 ","$3,765.00 ","$2,609.15 ","$3,259.60 ","$3,765.00 ","$2,070.75 ","$3,259.60 ",$990.20 ,"$3,765.00 ","$3,765.00 ","$3,887.56 ","$3,422.58 ","$3,012.00 ","$2,044.40 ","$1,054.20 ","$3,388.50 ","$2,641.00 ","$3,250.00 ","$3,259.60 ","$1,807.20 "
ST. MARY'S HOSPITAL - DECATUR,48100023,33244,HC REMOVE C-D ELECTRODES 33244,481,1 ,"$3,305.00 ","$2,148.25 ",$869.22 ,"$8,149.00 ","$8,149.00 ","$3,305.00 ","$1,817.75 ","$3,259.60 ",$925.40 ,"$1,553.35 ","$3,259.60 ","$1,784.70 ","$3,259.60 ","$1,794.62 ","$1,794.62 ","$3,259.60 ","$1,794.62 ","$3,305.00 ","$2,313.50 ","$1,652.50 ","$2,644.00 ","$8,149.00 ","$3,259.60 ","$2,313.50 ","$3,259.60 ","$1,983.00 ","$3,259.60 ","$2,478.75 ","$1,824.36 ","$1,645.89 ","$1,824.36 ","$3,259.60 ","$1,824.36 ","$2,577.90 ","$2,577.90 ","$2,809.25 ","$3,305.00 ","$2,290.37 ","$3,259.60 ","$3,305.00 ","$1,817.75 ","$3,259.60 ",$869.22 ,"$3,305.00 ","$3,305.00 ","$3,887.56 ","$3,422.58 ","$2,644.00 ","$1,794.62 ",$925.40 ,"$2,974.50 ","$2,641.00 ","$3,250.00 ","$3,259.60 ","$1,586.40 "
ST. MARY'S HOSPITAL - DECATUR,48100024,33249,HC INS/REPOS DEFIB LEAD/GEN 33249,481,1 ,"$38,720.00 ","$25,168.00 ","$3,500.00 ","$77,733.50 ","$77,733.50 ","$12,000.00 ","$21,296.00 ","$31,093.40 ","$10,841.60 ","$3,523.99 ","$31,093.40 ","$4,049.96 ","$31,093.40 ","$3,913.45 ","$3,913.45 ","$31,093.40 ","$3,913.45 ","$38,720.00 ","$3,500.00 ","$19,360.00 ","$30,976.00 ","$77,733.50 ","$31,093.40 ","$27,104.00 ","$31,093.40 ","$23,232.00 ","$31,093.40 ","$29,040.00 ","$13,962.15 ","$13,966.19 ","$13,962.15 ","$31,093.40 ","$13,962.15 ","$30,201.60 ","$30,201.60 ","$32,912.00 ","$38,720.00 ","$4,981.00 ","$31,093.40 ","$38,720.00 ","$21,296.00 ","$31,093.40 ","$10,183.36 ","$38,720.00 ","$16,140.67 ","$15,407.01 ","$32,648.07 ","$30,976.00 ","$3,913.45 ","$10,841.60 ","$34,848.00 ","$4,611.00 ","$20,000.00 ","$31,093.40 ","$18,585.60 "
ST. MARY'S HOSPITAL - DECATUR,48100028,33285,HC IMPLANT CARDIAC EVENT RECORDER,481,1 ,"$5,815.00 ","$3,779.75 ","$1,529.35 ","$19,307.35 ","$19,307.35 ","$2,800.00 ","$3,198.25 ","$7,722.94 ","$1,628.20 ","$2,733.05 ","$7,722.94 ","$3,140.10 ","$5,815.00 ","$3,157.55 ","$3,157.55 ","$5,815.00 ","$3,157.55 ","$5,815.00 ","$3,500.00 ","$2,907.50 ","$4,652.00 ","$19,307.35 ","$7,722.94 ","$4,070.50 ","$7,722.94 ","$3,489.00 ","$7,722.94 ","$4,361.25 ","$3,209.88 ","$2,895.87 ","$3,209.88 ","$7,722.94 ","$3,209.88 ","$4,535.70 ","$4,535.70 ","$4,942.75 ","$5,815.00 ","$4,029.80 ","$7,722.94 ","$5,815.00 ","$3,198.25 ","$7,722.94 ","$1,529.35 ","$5,815.00 ","$2,784.85 ","$2,658.26 ","$8,109.09 ","$4,652.00 ","$3,157.55 ","$1,628.20 ","$5,233.50 ","$3,243.00 ","$5,815.00 ","$7,722.94 ","$2,791.20 "
ST. MARY'S HOSPITAL - DECATUR,48100029,33286,HC REMOVE CARDIAC EVENT RECORDER,481,1 ,"$2,688.00 ","$1,747.20 ",$430.28 ,"$2,688.00 ","$1,472.65 ","$2,688.00 ","$1,478.40 ",$589.06 ,$752.64 ,"$1,263.36 ",$589.06 ,"$1,451.52 ",$589.06 ,"$1,459.58 ","$1,459.58 ",$589.06 ,"$1,459.58 ","$1,119.21 ","$1,881.60 ","$1,344.00 ","$2,150.40 ","$1,472.64 ",$589.06 ,"$1,881.60 ",$589.06 ,"$1,612.80 ",$589.06 ,"$2,016.00 ","$1,483.78 ","$1,338.62 ","$1,483.78 ",$589.06 ,"$1,483.78 ","$2,096.64 ","$2,096.64 ","$2,284.80 ","$1,472.64 ","$1,862.78 ",$589.06 ,"$2,688.00 ","$1,478.40 ",$589.06 ,$706.94 ,"$2,688.00 ",$450.77 ,$430.28 ,$618.51 ,"$2,150.40 ","$1,459.58 ",$752.64 ,"$2,419.20 ","$1,483.00 ","$1,666.00 ",$589.06 ,"$1,290.24 "
ST. MARY'S HOSPITAL - DECATUR,48100030,33967,HC IABP INSERTION 33967,481,1 ,"$3,755.00 ","$2,440.75 ",$987.57 ,"$3,755.00 ", N/A ,"$3,755.00 ","$2,065.25 ", N/A ,"$1,051.40 ","$1,764.85 ", N/A ,"$2,027.70 ", N/A ,"$2,038.97 ","$2,038.97 ", N/A ,"$2,038.97 ", N/A ,"$2,628.50 ","$1,877.50 ","$3,004.00 ", N/A , N/A ,"$2,628.50 ", N/A ,"$2,253.00 ", N/A ,"$2,816.25 ","$2,072.76 ","$1,869.99 ","$2,072.76 ", N/A ,"$2,072.76 ","$2,928.90 ","$2,928.90 ","$3,191.75 ", N/A ,"$2,602.22 ", N/A ,"$3,755.00 ","$2,065.25 ", N/A ,$987.57 ,"$3,755.00 ", N/A , N/A , N/A ,"$3,004.00 ","$2,038.97 ","$1,051.40 ","$3,379.50 ","$3,755.00 ","$3,755.00 ", N/A ,"$1,802.40 "
ST. MARY'S HOSPITAL - DECATUR,48100034,35226,HC REPAIR BLOOD VESSEL,481,1 ,"$2,840.00 ","$1,846.00 ",$330.83 ,"$2,840.00 ","$1,472.65 ","$2,840.00 ","$1,562.00 ",$589.06 ,$795.20 ,"$1,334.80 ",$589.06 ,"$1,533.60 ",$589.06 ,"$1,542.12 ","$1,542.12 ",$589.06 ,"$1,542.12 ","$1,119.21 ","$1,988.00 ","$1,420.00 ","$2,272.00 ","$1,472.64 ",$589.06 ,"$1,988.00 ",$589.06 ,"$1,704.00 ",$589.06 ,"$2,130.00 ","$1,567.68 ","$1,414.32 ","$1,567.68 ",$589.06 ,"$1,567.68 ","$2,215.20 ","$2,215.20 ","$2,414.00 ","$1,472.64 ","$1,968.12 ",$589.06 ,"$2,840.00 ","$1,562.00 ",$589.06 ,$746.92 ,"$2,840.00 ",$346.59 ,$330.83 ,$618.51 ,"$2,272.00 ","$1,542.12 ",$795.20 ,"$2,556.00 ","$1,483.00 ","$1,666.00 ",$589.06 ,"$1,363.20 "
ST. MARY'S HOSPITAL - DECATUR,48100039,36010,HC INTRO CATH VENA CAVA SUP/IN,481,1 ,"$2,464.00 ","$1,601.60 ",$648.03 ,"$2,464.00 ", N/A ,"$2,464.00 ","$1,355.20 ", N/A ,$689.92 ,"$1,158.08 ", N/A ,"$1,330.56 ", N/A ,"$1,337.95 ","$1,337.95 ", N/A ,"$1,337.95 ", N/A ,"$1,724.80 ","$1,232.00 ","$1,971.20 ", N/A , N/A ,"$1,724.80 ", N/A ,"$1,478.40 ", N/A ,"$1,848.00 ","$1,360.13 ","$1,227.07 ","$1,360.13 ", N/A ,"$1,360.13 ","$1,921.92 ","$1,921.92 ","$2,094.40 ", N/A ,"$1,707.55 ", N/A ,"$2,464.00 ","$1,355.20 ", N/A ,$648.03 ,"$2,464.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$1,971.20 ","$1,337.95 ",$689.92 ,"$2,217.60 ",$737.00 ,$900.00 , N/A ,"$1,182.72 "
ST. MARY'S HOSPITAL - DECATUR,48100040,36011,"HC CATH PLCMT VENOUS, 1ST ORDER",481,1 ,"$1,515.00 ",$984.75 ,$398.45 ,"$1,786.63 ", N/A ,"$1,515.00 ",$833.25 , N/A ,$424.20 ,$712.05 , N/A ,$818.10 , N/A ,$822.65 ,$822.65 , N/A ,$822.65 , N/A ,"$1,060.50 ",$757.50 ,"$1,212.00 ", N/A , N/A ,"$1,060.50 ", N/A ,$909.00 , N/A ,"$1,136.25 ",$836.28 ,$754.47 ,$836.28 , N/A ,$836.28 ,"$1,181.70 ","$1,181.70 ","$1,287.75 ", N/A ,"$1,049.90 ", N/A ,"$1,515.00 ",$833.25 , N/A ,$398.45 ,"$1,515.00 ","$1,515.00 ","$1,786.63 ", N/A ,"$1,212.00 ",$822.65 ,$424.20 ,"$1,363.50 ",$737.00 ,$900.00 , N/A ,$727.20 
ST. MARY'S HOSPITAL - DECATUR,48100041,36012,"HC CATH PLCMT VENOUS, 2ND ORDER",481,1 ,"$1,566.00 ","$1,017.90 ",$411.86 ,"$1,786.63 ", N/A ,"$1,566.00 ",$861.30 , N/A ,$438.48 ,$736.02 , N/A ,$845.64 , N/A ,$850.34 ,$850.34 , N/A ,$850.34 , N/A ,"$1,096.20 ",$783.00 ,"$1,252.80 ", N/A , N/A ,"$1,096.20 ", N/A ,$939.60 , N/A ,"$1,174.50 ",$864.43 ,$779.87 ,$864.43 , N/A ,$864.43 ,"$1,221.48 ","$1,221.48 ","$1,331.10 ", N/A ,"$1,085.24 ", N/A ,"$1,566.00 ",$861.30 , N/A ,$411.86 ,"$1,566.00 ","$1,566.00 ","$1,786.63 ", N/A ,"$1,252.80 ",$850.34 ,$438.48 ,"$1,409.40 ",$737.00 ,$900.00 , N/A ,$751.68 
ST. MARY'S HOSPITAL - DECATUR,48100042,36013,HC INTRO CATH ARTERY HEART/PULM,481,1 ,$883.00 ,$573.95 ,$232.23 ,"$1,786.63 ", N/A ,$883.00 ,$485.65 , N/A ,$247.24 ,$415.01 , N/A ,$476.82 , N/A ,$479.47 ,$479.47 , N/A ,$479.47 , N/A ,$618.10 ,$441.50 ,$706.40 , N/A , N/A ,$618.10 , N/A ,$529.80 , N/A ,$662.25 ,$487.42 ,$439.73 ,$487.42 , N/A ,$487.42 ,$688.74 ,$688.74 ,$750.55 , N/A ,$611.92 , N/A ,$883.00 ,$485.65 , N/A ,$232.23 ,$883.00 ,$883.00 ,"$1,786.63 ", N/A ,$706.40 ,$479.47 ,$247.24 ,$794.70 ,$737.00 ,$883.00 , N/A ,$423.84 
ST. MARY'S HOSPITAL - DECATUR,48100047,36140,HC INTRO NDL/CATH ARTERY EXTREM 36140,481,1 ,"$2,576.00 ","$1,674.40 ",$677.49 ,"$2,576.00 ", N/A ,"$2,576.00 ","$1,416.80 ", N/A ,$721.28 ,"$1,210.72 ", N/A ,"$1,391.04 ", N/A ,"$1,398.77 ","$1,398.77 ", N/A ,"$1,398.77 ", N/A ,"$1,803.20 ","$1,288.00 ","$2,060.80 ", N/A , N/A ,"$1,803.20 ", N/A ,"$1,545.60 ", N/A ,"$1,932.00 ","$1,421.95 ","$1,282.85 ","$1,421.95 ", N/A ,"$1,421.95 ","$2,009.28 ","$2,009.28 ","$2,189.60 ", N/A ,"$1,785.17 ", N/A ,"$2,576.00 ","$1,416.80 ", N/A ,$677.49 ,"$2,576.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$2,060.80 ","$1,398.77 ",$721.28 ,"$2,318.40 ",$737.00 ,$900.00 , N/A ,"$1,236.48 "
ST. MARY'S HOSPITAL - DECATUR,48100051,36200,HC INTRO CATH AORTA 36200,481,1 ,"$6,267.00 ","$4,073.55 ",$737.00 ,"$6,267.00 ", N/A ,"$3,500.00 ","$3,446.85 ", N/A ,"$1,754.76 ","$2,945.49 ", N/A ,"$3,384.18 ", N/A ,"$3,402.98 ","$3,402.98 ", N/A ,"$3,402.98 ", N/A ,"$3,500.00 ","$3,133.50 ","$5,013.60 ", N/A , N/A ,"$4,386.90 ", N/A ,"$3,760.20 ", N/A ,"$4,700.25 ","$3,459.38 ","$3,120.97 ","$3,459.38 ", N/A ,"$3,459.38 ","$4,888.26 ","$4,888.26 ","$5,326.95 ", N/A ,"$4,343.03 ", N/A ,"$6,267.00 ","$3,446.85 ", N/A ,"$1,648.22 ","$6,267.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$5,013.60 ","$3,402.98 ","$1,754.76 ","$5,640.30 ",$737.00 ,$900.00 , N/A ,"$3,008.16 "
ST. MARY'S HOSPITAL - DECATUR,48100052,36215,HC PLACE CATH THOR/BRAC 1ST ORDER 36215,481,1 ,"$3,139.00 ","$2,040.35 ",$737.00 ,"$3,139.00 ", N/A ,"$3,139.00 ","$1,726.45 ", N/A ,$878.92 ,"$1,475.33 ", N/A ,"$1,695.06 ", N/A ,"$1,704.48 ","$1,704.48 ", N/A ,"$1,704.48 ", N/A ,"$2,197.30 ","$1,569.50 ","$2,511.20 ", N/A , N/A ,"$2,197.30 ", N/A ,"$1,883.40 ", N/A ,"$2,354.25 ","$1,732.73 ","$1,563.22 ","$1,732.73 ", N/A ,"$1,732.73 ","$2,448.42 ","$2,448.42 ","$2,668.15 ", N/A ,"$2,175.33 ", N/A ,"$3,139.00 ","$1,726.45 ", N/A ,$825.56 ,"$3,139.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$2,511.20 ","$1,704.48 ",$878.92 ,"$2,825.10 ",$737.00 ,$900.00 , N/A ,"$1,506.72 "
ST. MARY'S HOSPITAL - DECATUR,48100053,36216,HC PL CATH THOR/BRAC 2ND ORDER 36216,481,1 ,"$1,985.00 ","$1,290.25 ",$522.06 ,"$1,985.00 ", N/A ,"$1,985.00 ","$1,091.75 ", N/A ,$555.80 ,$932.95 , N/A ,"$1,071.90 ", N/A ,"$1,077.86 ","$1,077.86 ", N/A ,"$1,077.86 ", N/A ,"$1,389.50 ",$992.50 ,"$1,588.00 ", N/A , N/A ,"$1,389.50 ", N/A ,"$1,191.00 ", N/A ,"$1,488.75 ","$1,095.72 ",$988.53 ,"$1,095.72 ", N/A ,"$1,095.72 ","$1,548.30 ","$1,548.30 ","$1,687.25 ", N/A ,"$1,375.61 ", N/A ,"$1,985.00 ","$1,091.75 ", N/A ,$522.06 ,"$1,985.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$1,588.00 ","$1,077.86 ",$555.80 ,"$1,786.50 ",$737.00 ,$900.00 , N/A ,$952.80 
ST. MARY'S HOSPITAL - DECATUR,48100054,36217,HC PL CATH THOR/BRAC 3RD ORDER 36217,481,1 ,"$2,036.00 ","$1,323.40 ",$535.47 ,"$2,036.00 ", N/A ,"$2,036.00 ","$1,119.80 ", N/A ,$570.08 ,$956.92 , N/A ,"$1,099.44 ", N/A ,"$1,105.55 ","$1,105.55 ", N/A ,"$1,105.55 ", N/A ,"$1,425.20 ","$1,018.00 ","$1,628.80 ", N/A , N/A ,"$1,425.20 ", N/A ,"$1,221.60 ", N/A ,"$1,527.00 ","$1,123.87 ","$1,013.93 ","$1,123.87 ", N/A ,"$1,123.87 ","$1,588.08 ","$1,588.08 ","$1,730.60 ", N/A ,"$1,410.95 ", N/A ,"$2,036.00 ","$1,119.80 ", N/A ,$535.47 ,"$2,036.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$1,628.80 ","$1,105.55 ",$570.08 ,"$1,832.40 ",$737.00 ,$900.00 , N/A ,$977.28 
ST. MARY'S HOSPITAL - DECATUR,48100055,36218,HC PL CATH THOR/BRAC ADDL 36218,481,1 ,"$1,086.00 ",$705.90 ,$285.62 ,"$1,786.63 ", N/A ,"$1,086.00 ",$597.30 , N/A ,$304.08 ,$510.42 , N/A ,$586.44 , N/A ,$589.70 ,$589.70 , N/A ,$589.70 , N/A ,$760.20 ,$543.00 ,$868.80 , N/A , N/A ,$760.20 , N/A ,$651.60 , N/A ,$814.50 ,$599.47 ,$540.83 ,$599.47 , N/A ,$599.47 ,$847.08 ,$847.08 ,$923.10 , N/A ,$752.60 , N/A ,"$1,086.00 ",$597.30 , N/A ,$285.62 ,"$1,086.00 ","$1,086.00 ","$1,786.63 ", N/A ,$868.80 ,$589.70 ,$304.08 ,$977.40 ,$737.00 ,$900.00 , N/A ,$521.28 
ST. MARY'S HOSPITAL - DECATUR,48100056,36245,HC ABD 1ST ORDER 36245,481,1 ,"$3,031.00 ","$1,970.15 ",$737.00 ,"$3,031.00 ", N/A ,"$3,031.00 ","$1,667.05 ", N/A ,$848.68 ,"$1,424.57 ", N/A ,"$1,636.74 ", N/A ,"$1,645.83 ","$1,645.83 ", N/A ,"$1,645.83 ", N/A ,"$2,121.70 ","$1,515.50 ","$2,424.80 ", N/A , N/A ,"$2,121.70 ", N/A ,"$1,818.60 ", N/A ,"$2,273.25 ","$1,673.11 ","$1,509.44 ","$1,673.11 ", N/A ,"$1,673.11 ","$2,364.18 ","$2,364.18 ","$2,576.35 ", N/A ,"$2,100.48 ", N/A ,"$3,031.00 ","$1,667.05 ", N/A ,$797.15 ,"$3,031.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$2,424.80 ","$1,645.83 ",$848.68 ,"$2,727.90 ",$737.00 ,$900.00 , N/A ,"$1,454.88 "
ST. MARY'S HOSPITAL - DECATUR,48100057,36246,HC ABD INITIAL 2ND ORDER 36246,481,1 ,"$3,157.00 ","$2,052.05 ",$737.00 ,"$3,157.00 ", N/A ,"$3,157.00 ","$1,736.35 ", N/A ,$883.96 ,"$1,483.79 ", N/A ,"$1,704.78 ", N/A ,"$1,714.25 ","$1,714.25 ", N/A ,"$1,714.25 ", N/A ,"$2,209.90 ","$1,578.50 ","$2,525.60 ", N/A , N/A ,"$2,209.90 ", N/A ,"$1,894.20 ", N/A ,"$2,367.75 ","$1,742.66 ","$1,572.19 ","$1,742.66 ", N/A ,"$1,742.66 ","$2,462.46 ","$2,462.46 ","$2,683.45 ", N/A ,"$2,187.80 ", N/A ,"$3,157.00 ","$1,736.35 ", N/A ,$830.29 ,"$3,157.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$2,525.60 ","$1,714.25 ",$883.96 ,"$2,841.30 ",$737.00 ,$900.00 , N/A ,"$1,515.36 "
ST. MARY'S HOSPITAL - DECATUR,48100058,36247,HC ABD INT 3RD/PLUS ORDER 36247,481,1 ,"$2,223.00 ","$1,444.95 ",$584.65 ,"$2,223.00 ", N/A ,"$2,223.00 ","$1,222.65 ", N/A ,$622.44 ,"$1,044.81 ", N/A ,"$1,200.42 ", N/A ,"$1,207.09 ","$1,207.09 ", N/A ,"$1,207.09 ", N/A ,"$1,556.10 ","$1,111.50 ","$1,778.40 ", N/A , N/A ,"$1,556.10 ", N/A ,"$1,333.80 ", N/A ,"$1,667.25 ","$1,227.10 ","$1,107.05 ","$1,227.10 ", N/A ,"$1,227.10 ","$1,733.94 ","$1,733.94 ","$1,889.55 ", N/A ,"$1,540.54 ", N/A ,"$2,223.00 ","$1,222.65 ", N/A ,$584.65 ,"$2,223.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$1,778.40 ","$1,207.09 ",$622.44 ,"$2,000.70 ",$737.00 ,$900.00 , N/A ,"$1,067.04 "
ST. MARY'S HOSPITAL - DECATUR,48100059,36248,HC ABD ADDL 2ND/PLUS ORDER 36248,481,1 ,"$1,147.00 ",$745.55 ,$301.66 ,"$1,786.63 ", N/A ,"$1,147.00 ",$630.85 , N/A ,$321.16 ,$539.09 , N/A ,$619.38 , N/A ,$622.82 ,$622.82 , N/A ,$622.82 , N/A ,$802.90 ,$573.50 ,$917.60 , N/A , N/A ,$802.90 , N/A ,$688.20 , N/A ,$860.25 ,$633.14 ,$571.21 ,$633.14 , N/A ,$633.14 ,$894.66 ,$894.66 ,$974.95 , N/A ,$794.87 , N/A ,"$1,147.00 ",$630.85 , N/A ,$301.66 ,"$1,147.00 ","$1,147.00 ","$1,786.63 ", N/A ,$917.60 ,$622.82 ,$321.16 ,"$1,032.30 ",$737.00 ,$900.00 , N/A ,$550.56 
ST. MARY'S HOSPITAL - DECATUR,48100060,37184,HC PERIPH THROMBECK ONLY W/TPA 37184,481,1 ,"$8,017.00 ","$5,211.05 ","$2,080.51 ","$23,770.46 ","$23,770.45 ","$8,000.00 ","$4,409.35 ","$9,508.18 ","$2,244.76 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$8,017.00 ","$3,913.45 ","$3,913.45 ","$8,017.00 ","$3,913.45 ","$8,017.00 ","$3,500.00 ","$4,008.50 ","$6,413.60 ","$23,770.46 ","$9,508.18 ","$5,611.90 ","$9,508.18 ","$4,810.20 ","$9,508.18 ","$6,012.75 ","$4,425.38 ","$3,992.47 ","$4,425.38 ","$9,508.18 ","$4,425.38 ","$6,253.26 ","$6,253.26 ","$6,814.45 ","$8,017.00 ","$4,981.00 ","$9,508.18 ","$8,017.00 ","$4,409.35 ","$9,508.18 ","$2,108.47 ","$8,017.00 ","$2,179.58 ","$2,080.51 ","$9,983.59 ","$6,413.60 ","$3,913.45 ","$2,244.76 ","$7,215.30 ","$2,861.00 ","$5,100.00 ","$9,508.18 ","$3,848.16 "
ST. MARY'S HOSPITAL - DECATUR,48100061,37185,HC PRIM PERC THROMB EA ADDL 37185,481,1 ,"$3,605.00 ","$2,343.25 ",$737.00 ,"$3,605.00 ", N/A ,"$3,500.00 ","$1,982.75 ", N/A ,"$1,009.40 ","$1,694.35 ", N/A ,"$1,946.70 ", N/A ,"$1,957.52 ","$1,957.52 ", N/A ,"$1,957.52 ", N/A ,"$2,523.50 ","$1,802.50 ","$2,884.00 ", N/A , N/A ,"$2,523.50 ", N/A ,"$2,163.00 ", N/A ,"$2,703.75 ","$1,989.96 ","$1,795.29 ","$1,989.96 ", N/A ,"$1,989.96 ","$2,811.90 ","$2,811.90 ","$3,064.25 ", N/A ,"$2,498.27 ", N/A ,"$3,605.00 ","$1,982.75 ", N/A ,$948.12 ,"$3,605.00 ","$2,179.58 ","$2,080.51 ", N/A ,"$2,884.00 ","$1,957.52 ","$1,009.40 ","$3,244.50 ",$737.00 ,$900.00 , N/A ,"$1,730.40 "
ST. MARY'S HOSPITAL - DECATUR,48100062,37186,HC SEC PERC THROMB EA VESSEL ADDL 37186,481,1 ,"$4,068.00 ","$2,644.20 ",$737.00 ,"$4,068.00 ", N/A ,"$2,800.00 ","$2,237.40 ", N/A ,"$1,139.04 ","$1,911.96 ", N/A ,"$2,196.72 ", N/A ,"$2,208.92 ","$2,208.92 ", N/A ,"$2,208.92 ", N/A ,"$2,847.60 ","$2,034.00 ","$3,254.40 ", N/A , N/A ,"$2,847.60 ", N/A ,"$2,440.80 ", N/A ,"$3,051.00 ","$2,245.54 ","$2,025.86 ","$2,245.54 ", N/A ,"$2,245.54 ","$3,173.04 ","$3,173.04 ","$3,457.80 ", N/A ,"$2,819.12 ", N/A ,"$4,068.00 ","$2,237.40 ", N/A ,"$1,069.88 ","$4,068.00 ","$2,179.58 ","$2,080.51 ", N/A ,"$3,254.40 ","$2,208.92 ","$1,139.04 ","$3,661.20 ",$737.00 ,$900.00 , N/A ,"$1,952.64 "
ST. MARY'S HOSPITAL - DECATUR,48100063,37187,HC PRIMARY VENOUS THROMBECTOMY,481,1 ,"$6,604.00 ","$4,292.60 ","$1,736.85 ","$23,770.46 ","$23,770.45 ","$6,604.00 ","$3,632.20 ","$9,508.18 ","$1,849.12 ","$3,103.88 ","$9,508.18 ","$3,566.16 ","$6,604.00 ","$3,585.97 ","$3,585.97 ","$6,604.00 ","$3,585.97 ","$6,604.00 ","$3,500.00 ","$3,302.00 ","$5,283.20 ","$23,770.46 ","$9,508.18 ","$4,622.80 ","$9,508.18 ","$3,962.40 ","$9,508.18 ","$4,953.00 ","$3,645.41 ","$3,288.79 ","$3,645.41 ","$9,508.18 ","$3,645.41 ","$5,151.12 ","$5,151.12 ","$5,613.40 ","$6,604.00 ","$4,576.57 ","$9,508.18 ","$6,604.00 ","$3,632.20 ","$9,508.18 ","$1,736.85 ","$6,604.00 ","$2,179.58 ","$2,080.51 ","$9,983.59 ","$5,283.20 ","$3,585.97 ","$1,849.12 ","$5,943.60 ","$2,861.00 ","$5,100.00 ","$9,508.18 ","$3,169.92 "
ST. MARY'S HOSPITAL - DECATUR,48100064,37188,HC SUBSEQUENT VENOUS THROMBECTOMY,481,1 ,"$5,787.00 ","$3,761.55 ","$1,521.98 ","$6,774.50 ","$6,774.50 ","$5,787.00 ","$3,182.85 ","$2,709.80 ","$1,620.36 ","$2,719.89 ","$2,709.80 ","$3,124.98 ","$2,709.80 ","$3,142.34 ","$3,142.34 ","$2,709.80 ","$3,142.34 ","$5,148.61 ","$3,500.00 ","$2,893.50 ","$4,629.60 ","$6,774.49 ","$2,709.80 ","$4,050.90 ","$2,709.80 ","$3,472.20 ","$2,709.80 ","$4,340.25 ","$3,194.42 ","$2,881.93 ","$3,194.42 ","$2,709.80 ","$3,194.42 ","$4,513.86 ","$4,513.86 ","$4,918.95 ","$5,787.00 ","$4,010.39 ","$2,709.80 ","$5,787.00 ","$3,182.85 ","$2,709.80 ","$1,521.98 ","$5,787.00 ","$2,179.58 ","$2,080.51 ","$2,845.29 ","$4,629.60 ","$3,142.34 ","$1,620.36 ","$5,208.30 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$2,777.76 "
ST. MARY'S HOSPITAL - DECATUR,48100069,37241,HC OCCL/EMBOL TRANSCATH PERC 37241,481,1 ,"$12,549.00 ","$8,156.85 ","$3,243.00 ","$23,770.46 ","$23,770.45 ","$5,500.00 ","$6,901.95 ","$9,508.18 ","$3,513.72 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$12,549.00 ","$3,500.00 ","$6,274.50 ","$10,039.20 ","$23,770.46 ","$9,508.18 ","$8,784.30 ","$9,508.18 ","$7,529.40 ","$9,508.18 ","$9,411.75 ","$6,927.05 ","$6,249.40 ","$6,927.05 ","$9,508.18 ","$6,927.05 ","$9,788.22 ","$9,788.22 ","$10,666.65 ","$12,549.00 ","$4,981.00 ","$9,508.18 ","$12,549.00 ","$6,901.95 ","$9,508.18 ","$3,300.39 ","$12,549.00 ","$7,508.52 ","$7,167.23 ","$9,983.59 ","$10,039.20 ","$3,913.45 ","$3,513.72 ","$11,294.10 ","$3,243.00 ","$6,200.00 ","$9,508.18 ","$6,023.52 "
ST. MARY'S HOSPITAL - DECATUR,48100076,37215,HC PL STENT TRNSCATH CAROT ART W/ 37215,481,1 ,"$12,414.00 ","$8,069.10 ","$2,034.00 ","$12,414.00 ", N/A ,"$5,500.00 ","$6,827.70 ", N/A ,"$3,475.92 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$6,207.00 ","$9,931.20 ", N/A , N/A ,"$8,689.80 ", N/A ,"$7,448.40 ", N/A ,"$9,310.50 ","$6,852.53 ","$6,182.17 ","$6,852.53 ", N/A ,"$6,852.53 ","$9,682.92 ","$9,682.92 ","$10,551.90 ", N/A ,"$4,981.00 ", N/A ,"$12,414.00 ","$6,827.70 ", N/A ,"$3,264.88 ","$12,414.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$9,931.20 ","$3,913.45 ","$3,475.92 ","$11,172.60 ","$6,157.34 ","$2,034.00 ", N/A ,"$5,958.72 "
ST. MARY'S HOSPITAL - DECATUR,48100077,37220,HC RVC EN PRC ICA W/ANG INT VSL 37220,481,1 ,"$10,139.00 ","$6,590.35 ","$2,666.56 ","$11,729.16 ","$11,729.15 ","$6,200.00 ","$5,576.45 ","$4,691.66 ","$2,838.92 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,069.50 ","$8,111.20 ","$11,729.16 ","$4,691.66 ","$7,097.30 ","$4,691.66 ","$6,083.40 ","$4,691.66 ","$7,604.25 ","$5,596.73 ","$5,049.22 ","$5,596.73 ","$4,691.66 ","$5,596.73 ","$7,908.42 ","$7,908.42 ","$8,618.15 ","$10,139.00 ","$4,981.00 ","$4,691.66 ","$10,139.00 ","$5,576.45 ","$4,691.66 ","$2,666.56 ","$10,139.00 ","$3,461.35 ","$3,304.01 ","$4,926.24 ","$8,111.20 ","$3,913.45 ","$2,838.92 ","$9,125.10 ","$5,028.94 ","$5,100.00 ","$4,691.66 ","$4,866.72 "
ST. MARY'S HOSPITAL - DECATUR,48100078,37221,HC RVC EN PRC ICA W/TRN SNT INT V 37221,481,1 ,"$13,574.00 ","$8,823.10 ","$3,304.01 ","$23,770.46 ","$23,770.45 ","$6,200.00 ","$7,465.70 ","$9,508.18 ","$3,800.72 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$13,574.00 ","$3,500.00 ","$6,787.00 ","$10,859.20 ","$23,770.46 ","$9,508.18 ","$9,501.80 ","$9,508.18 ","$8,144.40 ","$9,508.18 ","$10,180.50 ","$7,492.85 ","$6,759.85 ","$7,492.85 ","$9,508.18 ","$7,492.85 ","$10,587.72 ","$10,587.72 ","$11,537.90 ","$13,574.00 ","$4,981.00 ","$9,508.18 ","$13,574.00 ","$7,465.70 ","$9,508.18 ","$3,569.96 ","$13,574.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$10,859.20 ","$3,913.45 ","$3,800.72 ","$12,216.60 ","$6,732.70 ","$6,200.00 ","$9,508.18 ","$6,515.52 "
ST. MARY'S HOSPITAL - DECATUR,48100079,37222,HC RVC EN PRC ICA W/ANG EA AD VS 37222,481,1 ,"$7,385.00 ","$4,800.25 ","$1,942.26 ","$7,385.00 ", N/A ,"$2,800.00 ","$4,061.75 ", N/A ,"$2,067.80 ","$3,470.95 ", N/A ,"$3,987.90 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,692.50 ","$5,908.00 ", N/A , N/A ,"$5,169.50 ", N/A ,"$4,431.00 ", N/A ,"$5,538.75 ","$4,076.52 ","$3,677.73 ","$4,076.52 ", N/A ,"$4,076.52 ","$5,760.30 ","$5,760.30 ","$6,277.25 ", N/A ,"$4,981.00 ", N/A ,"$7,385.00 ","$4,061.75 ", N/A ,"$1,942.26 ","$7,385.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$5,908.00 ","$3,913.45 ","$2,067.80 ","$6,646.50 ","$3,662.96 ","$5,100.00 ", N/A ,"$3,544.80 "
ST. MARY'S HOSPITAL - DECATUR,48100080,37223,HC RVC EN PRC ICA W/TRN ST AD VS 37223,481,1 ,"$12,599.00 ","$8,189.35 ","$2,800.00 ","$12,599.00 ", N/A ,"$2,800.00 ","$6,929.45 ", N/A ,"$3,527.72 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$6,299.50 ","$10,079.20 ", N/A , N/A ,"$8,819.30 ", N/A ,"$7,559.40 ", N/A ,"$9,449.25 ","$6,954.65 ","$6,274.30 ","$6,954.65 ", N/A ,"$6,954.65 ","$9,827.22 ","$9,827.22 ","$10,709.15 ", N/A ,"$4,981.00 ", N/A ,"$12,599.00 ","$6,929.45 ", N/A ,"$3,313.54 ","$12,599.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$10,079.20 ","$3,913.45 ","$3,527.72 ","$11,339.10 ","$6,249.10 ","$5,100.00 ", N/A ,"$6,047.52 "
ST. MARY'S HOSPITAL - DECATUR,48100081,37224,HC RVC EN PRC R/P W/ANG INT VSL 37224,481,1 ,"$10,924.00 ","$7,100.60 ","$2,873.01 ","$11,729.16 ","$11,729.15 ","$6,200.00 ","$6,008.20 ","$4,691.66 ","$3,058.72 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,462.00 ","$8,739.20 ","$11,729.16 ","$4,691.66 ","$7,646.80 ","$4,691.66 ","$6,554.40 ","$4,691.66 ","$8,193.00 ","$6,030.05 ","$5,440.15 ","$6,030.05 ","$4,691.66 ","$6,030.05 ","$8,520.72 ","$8,520.72 ","$9,285.40 ","$10,924.00 ","$4,981.00 ","$4,691.66 ","$10,924.00 ","$6,008.20 ","$4,691.66 ","$2,873.01 ","$10,924.00 ","$3,461.35 ","$3,304.01 ","$4,926.24 ","$8,739.20 ","$3,913.45 ","$3,058.72 ","$9,831.60 ","$5,418.30 ","$5,100.00 ","$4,691.66 ","$5,243.52 "
ST. MARY'S HOSPITAL - DECATUR,48100082,37225,HC RVC EN PRC F/P W/ANT INT VSL 37225,481,1 ,"$13,607.00 ","$8,844.55 ","$3,304.01 ","$23,770.46 ","$23,770.45 ","$6,200.00 ","$7,483.85 ","$9,508.18 ","$3,809.96 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$13,607.00 ","$3,500.00 ","$6,803.50 ","$10,885.60 ","$23,770.46 ","$9,508.18 ","$9,524.90 ","$9,508.18 ","$8,164.20 ","$9,508.18 ","$10,205.25 ","$7,511.06 ","$6,776.29 ","$7,511.06 ","$9,508.18 ","$7,511.06 ","$10,613.46 ","$10,613.46 ","$11,565.95 ","$13,607.00 ","$4,981.00 ","$9,508.18 ","$13,607.00 ","$7,483.85 ","$9,508.18 ","$3,578.64 ","$13,607.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$10,885.60 ","$3,913.45 ","$3,809.96 ","$12,246.30 ","$6,749.07 ","$6,200.00 ","$9,508.18 ","$6,531.36 "
ST. MARY'S HOSPITAL - DECATUR,48100083,37226,HC RVC EN PRC F/P W/TRN SNT IN VS 37226,481,1 ,"$13,472.00 ","$8,756.80 ","$3,304.01 ","$23,770.46 ","$23,770.45 ","$6,200.00 ","$7,409.60 ","$9,508.18 ","$3,772.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$13,472.00 ","$3,500.00 ","$6,736.00 ","$10,777.60 ","$23,770.46 ","$9,508.18 ","$9,430.40 ","$9,508.18 ","$8,083.20 ","$9,508.18 ","$10,104.00 ","$7,436.54 ","$6,709.06 ","$7,436.54 ","$9,508.18 ","$7,436.54 ","$10,508.16 ","$10,508.16 ","$11,451.20 ","$13,472.00 ","$4,981.00 ","$9,508.18 ","$13,472.00 ","$7,409.60 ","$9,508.18 ","$3,543.14 ","$13,472.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$10,777.60 ","$3,913.45 ","$3,772.16 ","$12,124.80 ","$6,682.11 ","$6,200.00 ","$9,508.18 ","$6,466.56 "
ST. MARY'S HOSPITAL - DECATUR,48100084,37227,HC RVC EN PRC F/P W/AN/TR ST INT 37227,481,1 ,"$25,284.00 ","$16,434.60 ","$3,304.01 ","$38,006.63 ","$38,006.63 ","$6,200.00 ","$13,906.20 ","$15,202.65 ","$7,079.52 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$25,284.00 ","$3,500.00 ","$12,642.00 ","$20,227.20 ","$38,006.61 ","$15,202.65 ","$17,698.80 ","$15,202.65 ","$15,170.40 ","$15,202.65 ","$18,963.00 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$15,202.65 ","$10,265.00 ","$19,721.52 ","$19,721.52 ","$21,491.40 ","$25,284.00 ","$4,981.00 ","$15,202.65 ","$25,284.00 ","$13,906.20 ","$15,202.65 ","$6,649.69 ","$25,284.00 ","$3,461.35 ","$3,304.01 ","$15,962.78 ","$20,227.20 ","$3,913.45 ","$7,079.52 ","$22,755.60 ","$12,540.86 ","$8,200.00 ","$15,202.65 ","$12,136.32 "
ST. MARY'S HOSPITAL - DECATUR,48100085,37228,HC RVC EN PRC T/P W/ANG INT VSL 37228,481,1 ,"$28,005.00 ","$18,203.25 ","$3,304.01 ","$28,005.00 ","$23,770.45 ","$6,200.00 ","$15,402.75 ","$9,508.18 ","$7,841.40 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$14,002.50 ","$22,404.00 ","$23,770.46 ","$9,508.18 ","$19,603.50 ","$9,508.18 ","$16,803.00 ","$9,508.18 ","$21,003.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$21,843.90 ","$21,843.90 ","$23,804.25 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$28,005.00 ","$15,402.75 ","$9,508.18 ","$7,365.32 ","$28,005.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$22,404.00 ","$3,913.45 ","$7,841.40 ","$25,204.50 ","$13,890.48 ","$5,100.00 ","$9,508.18 ","$13,442.40 "
ST. MARY'S HOSPITAL - DECATUR,48100086,37229,HC RVC EN PRC T/P W/ANT INT VSL 37229,481,1 ,"$12,778.00 ","$8,305.70 ","$3,304.01 ","$38,006.63 ","$38,006.63 ","$6,200.00 ","$7,027.90 ","$15,202.65 ","$3,577.84 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$12,778.00 ","$3,913.45 ","$3,913.45 ","$12,778.00 ","$3,913.45 ","$12,778.00 ","$3,500.00 ","$6,389.00 ","$10,222.40 ","$38,006.61 ","$15,202.65 ","$8,944.60 ","$15,202.65 ","$7,666.80 ","$15,202.65 ","$9,583.50 ","$7,053.46 ","$6,363.44 ","$7,053.46 ","$15,202.65 ","$7,053.46 ","$9,966.84 ","$9,966.84 ","$10,861.30 ","$12,778.00 ","$4,981.00 ","$15,202.65 ","$12,778.00 ","$7,027.90 ","$15,202.65 ","$3,360.61 ","$12,778.00 ","$3,461.35 ","$3,304.01 ","$15,962.78 ","$10,222.40 ","$3,913.45 ","$3,577.84 ","$11,500.20 ","$6,337.89 ","$6,200.00 ","$15,202.65 ","$6,133.44 "
ST. MARY'S HOSPITAL - DECATUR,48100087,37230,HC RVC EN PRC T/P W/TRN SNT IN VS 37230,481,1 ,"$13,471.00 ","$8,756.15 ","$3,304.01 ","$38,006.63 ","$38,006.63 ","$6,200.00 ","$7,409.05 ","$15,202.65 ","$3,771.88 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$13,471.00 ","$3,913.45 ","$3,913.45 ","$13,471.00 ","$3,913.45 ","$13,471.00 ","$3,500.00 ","$6,735.50 ","$10,776.80 ","$38,006.61 ","$15,202.65 ","$9,429.70 ","$15,202.65 ","$8,082.60 ","$15,202.65 ","$10,103.25 ","$7,435.99 ","$6,708.56 ","$7,435.99 ","$15,202.65 ","$7,435.99 ","$10,507.38 ","$10,507.38 ","$11,450.35 ","$13,471.00 ","$4,981.00 ","$15,202.65 ","$13,471.00 ","$7,409.05 ","$15,202.65 ","$3,542.87 ","$13,471.00 ","$3,461.35 ","$3,304.01 ","$15,962.78 ","$10,776.80 ","$3,913.45 ","$3,771.88 ","$12,123.90 ","$6,681.62 ","$6,200.00 ","$15,202.65 ","$6,466.08 "
ST. MARY'S HOSPITAL - DECATUR,48100088,37231,HC RVC EN PRC T/P W/AN/TR ST IN V 37231,481,1 ,"$35,303.00 ","$22,946.95 ","$3,304.01 ","$38,006.63 ","$38,006.63 ","$6,200.00 ","$19,416.65 ","$15,202.65 ","$9,884.84 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,651.50 ","$28,242.40 ","$38,006.61 ","$15,202.65 ","$24,712.10 ","$15,202.65 ","$21,181.80 ","$15,202.65 ","$26,477.25 ","$12,260.49 ","$12,435.38 ","$12,260.49 ","$15,202.65 ","$12,260.49 ","$27,536.34 ","$27,536.34 ","$30,007.55 ","$35,303.00 ","$4,981.00 ","$15,202.65 ","$35,303.00 ","$19,416.65 ","$15,202.65 ","$9,284.69 ","$35,303.00 ","$3,461.35 ","$3,304.01 ","$15,962.78 ","$28,242.40 ","$3,913.45 ","$9,884.84 ","$31,772.70 ","$17,510.29 ","$8,200.00 ","$15,202.65 ","$16,945.44 "
ST. MARY'S HOSPITAL - DECATUR,48100089,37232,HC RVC EN PRC T/P W/ANG EA AD VS 37232,481,1 ,"$9,188.00 ","$5,972.20 ","$2,416.44 ","$9,188.00 ", N/A ,"$2,800.00 ","$5,053.40 ", N/A ,"$2,572.64 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,594.00 ","$7,350.40 ", N/A , N/A ,"$6,431.60 ", N/A ,"$5,512.80 ", N/A ,"$6,891.00 ","$5,071.78 ","$4,575.62 ","$5,071.78 ", N/A ,"$5,071.78 ","$7,166.64 ","$7,166.64 ","$7,809.80 ", N/A ,"$4,981.00 ", N/A ,"$9,188.00 ","$5,053.40 ", N/A ,"$2,416.44 ","$9,188.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$7,350.40 ","$3,913.45 ","$2,572.64 ","$8,269.20 ","$4,557.25 ","$5,100.00 ", N/A ,"$4,410.24 "
ST. MARY'S HOSPITAL - DECATUR,48100090,37233,HC RVC EN PRC T/P W/ANT EA AD VS 37233,481,1 ,"$9,737.00 ","$6,329.05 ","$2,560.83 ","$9,737.00 ", N/A ,"$2,800.00 ","$5,355.35 ", N/A ,"$2,726.36 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,868.50 ","$7,789.60 ", N/A , N/A ,"$6,815.90 ", N/A ,"$5,842.20 ", N/A ,"$7,302.75 ","$5,374.82 ","$4,849.03 ","$5,374.82 ", N/A ,"$5,374.82 ","$7,594.86 ","$7,594.86 ","$8,276.45 ", N/A ,"$4,981.00 ", N/A ,"$9,737.00 ","$5,355.35 ", N/A ,"$2,560.83 ","$9,737.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$7,789.60 ","$3,913.45 ","$2,726.36 ","$8,763.30 ","$4,829.55 ","$6,200.00 ", N/A ,"$4,673.76 "
ST. MARY'S HOSPITAL - DECATUR,48100093,37252,HC US VASCULAR NON-CORONARY INIT 37252,481,1 ,"$5,916.00 ","$3,845.40 ",$101.56 ,"$5,916.00 ", N/A ,"$2,800.00 ","$3,253.80 ", N/A ,"$1,656.48 ","$2,780.52 ", N/A ,"$3,194.64 ", N/A ,"$3,212.39 ","$3,212.39 ", N/A ,"$3,212.39 ", N/A ,"$3,500.00 ","$2,958.00 ","$4,732.80 ", N/A , N/A ,"$4,141.20 ", N/A ,"$3,549.60 ", N/A ,"$4,437.00 ","$3,265.63 ","$2,946.17 ","$3,265.63 ", N/A ,"$3,265.63 ", N/A , N/A ,"$5,028.60 ", N/A ,"$4,099.79 ", N/A ,"$5,916.00 ","$3,253.80 ", N/A ,"$1,555.91 ","$5,916.00 ",$106.39 ,$101.56 , N/A ,"$4,732.80 ","$3,212.39 ","$1,656.48 ","$5,324.40 ",$737.00 ,$900.00 , N/A ,"$2,839.68 "
ST. MARY'S HOSPITAL - DECATUR,48100094,37253,HC US VASCULAR NON-CORON ADDL EA 37253,481,1 ,"$5,007.00 ","$3,254.55 ",$101.56 ,"$5,007.00 ", N/A ,"$2,800.00 ","$2,753.85 ", N/A ,"$1,401.96 ","$2,353.29 ", N/A ,"$2,703.78 ", N/A ,"$2,718.80 ","$2,718.80 ", N/A ,"$2,718.80 ", N/A ,"$3,500.00 ","$2,503.50 ","$4,005.60 ", N/A , N/A ,"$3,504.90 ", N/A ,"$3,004.20 ", N/A ,"$3,755.25 ","$2,763.86 ","$2,493.49 ","$2,763.86 ", N/A ,"$2,763.86 ", N/A , N/A ,"$4,255.95 ", N/A ,"$3,469.85 ", N/A ,"$5,007.00 ","$2,753.85 ", N/A ,"$1,316.84 ","$5,007.00 ",$106.39 ,$101.56 , N/A ,"$4,005.60 ","$2,718.80 ","$1,401.96 ","$4,506.30 ",$737.00 ,$900.00 , N/A ,"$2,403.36 "
ST. MARY'S HOSPITAL - DECATUR,48100095,37191,HC INTERRUPT VENA CAVA INFER,481,1 ,"$13,303.00 ","$8,646.95 ","$2,658.26 ","$13,303.00 ","$11,285.10 ","$5,500.00 ","$7,316.65 ","$4,514.04 ","$3,724.84 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$6,651.50 ","$10,642.40 ","$11,285.10 ","$4,514.04 ","$9,312.10 ","$4,514.04 ","$7,981.80 ","$4,514.04 ","$9,977.25 ","$7,343.26 ","$6,624.89 ","$7,343.26 ","$4,514.04 ","$7,343.26 ","$10,376.34 ","$10,376.34 ","$11,307.55 ","$11,285.10 ","$4,981.00 ","$4,514.04 ","$13,303.00 ","$7,316.65 ","$4,514.04 ","$3,498.69 ","$13,303.00 ","$2,784.85 ","$2,658.26 ","$4,739.74 ","$10,642.40 ","$3,913.45 ","$3,724.84 ","$11,972.70 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$6,385.44 "
ST. MARY'S HOSPITAL - DECATUR,48100107,93451,HC CATH RIGHT HEART 93451,481,1 ,"$9,398.00 ","$6,108.70 ","$1,626.71 ","$9,398.00 ","$6,862.28 ","$4,792.98 ","$5,168.90 ","$2,744.91 ","$2,631.44 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$4,699.00 ","$7,518.40 ","$6,862.29 ","$2,744.91 ","$6,578.60 ","$2,744.91 ","$5,638.80 ","$2,744.91 ","$7,048.50 ","$5,187.70 ","$4,680.20 ","$5,187.70 ","$2,744.91 ","$5,187.70 ","$7,330.44 ","$7,330.44 ","$7,988.30 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$9,398.00 ","$5,168.90 ","$2,744.91 ","$2,471.67 ","$9,398.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$7,518.40 ","$3,913.45 ","$2,631.44 ","$8,458.20 ","$4,661.41 ","$6,000.00 ","$2,744.91 ","$4,511.04 "
ST. MARY'S HOSPITAL - DECATUR,48100108,93452,HC LHC ONLY NO COROS 93452,481,1 ,"$12,371.00 ","$8,041.15 ","$1,626.71 ","$12,371.00 ","$6,862.28 ","$6,309.21 ","$6,804.05 ","$2,744.91 ","$3,463.88 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$6,185.50 ","$9,896.80 ","$6,862.29 ","$2,744.91 ","$8,659.70 ","$2,744.91 ","$7,422.60 ","$2,744.91 ","$9,278.25 ","$6,828.79 ","$6,160.76 ","$6,828.79 ","$2,744.91 ","$6,828.79 ","$9,649.38 ","$9,649.38 ","$10,515.35 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$12,371.00 ","$6,804.05 ","$2,744.91 ","$3,253.57 ","$12,371.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$9,896.80 ","$3,913.45 ","$3,463.88 ","$11,133.90 ","$6,136.02 ","$6,000.00 ","$2,744.91 ","$5,938.08 "
ST. MARY'S HOSPITAL - DECATUR,48100109,93453,HC RHC/LHC ONLY/NO CORS 93453,481,1 ,"$15,109.00 ","$9,820.85 ","$1,626.71 ","$15,109.00 ","$6,862.28 ","$7,705.59 ","$8,309.95 ","$2,744.91 ","$4,230.52 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$7,554.50 ","$12,087.20 ","$6,862.29 ","$2,744.91 ","$10,576.30 ","$2,744.91 ","$9,065.40 ","$2,744.91 ","$11,331.75 ","$8,340.17 ","$7,524.28 ","$8,340.17 ","$2,744.91 ","$8,340.17 ","$10,651.00 ","$10,651.00 ","$12,842.65 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$15,109.00 ","$8,309.95 ","$2,744.91 ","$3,973.67 ","$15,109.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$12,087.20 ","$3,913.45 ","$4,230.52 ","$13,598.10 ","$7,494.06 ","$6,000.00 ","$2,744.91 ","$7,252.32 "
ST. MARY'S HOSPITAL - DECATUR,48100110,93454,HC CORONARY ANGIO ONLY/NO LV 93454,481,1 ,"$10,872.00 ","$7,066.80 ","$1,626.71 ","$10,872.00 ","$6,862.28 ","$5,544.72 ","$5,979.60 ","$2,744.91 ","$3,044.16 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$5,436.00 ","$8,697.60 ","$6,862.29 ","$2,744.91 ","$7,610.40 ","$2,744.91 ","$6,523.20 ","$2,744.91 ","$8,154.00 ","$6,001.34 ","$5,414.26 ","$6,001.34 ","$2,744.91 ","$6,001.34 ","$8,480.16 ","$8,480.16 ","$9,241.20 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$10,872.00 ","$5,979.60 ","$2,744.91 ","$2,859.34 ","$10,872.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$8,697.60 ","$3,913.45 ","$3,044.16 ","$9,784.80 ","$5,392.51 ","$6,000.00 ","$2,744.91 ","$5,218.56 "
ST. MARY'S HOSPITAL - DECATUR,48100111,93455,HC CORO ANGIO  AND  GRAFTS ONLY NO LV 93455,481,1 ,"$10,466.00 ","$6,802.90 ","$1,626.71 ","$10,466.00 ","$6,862.28 ","$5,337.66 ","$5,756.30 ","$2,744.91 ","$2,930.48 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$5,233.00 ","$8,372.80 ","$6,862.29 ","$2,744.91 ","$7,326.20 ","$2,744.91 ","$6,279.60 ","$2,744.91 ","$7,849.50 ","$5,777.23 ","$5,212.07 ","$5,777.23 ","$2,744.91 ","$5,777.23 ","$8,163.48 ","$8,163.48 ","$8,896.10 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$10,466.00 ","$5,756.30 ","$2,744.91 ","$2,752.56 ","$10,466.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$8,372.80 ","$3,913.45 ","$2,930.48 ","$9,419.40 ","$5,191.14 ","$6,000.00 ","$2,744.91 ","$5,023.68 "
ST. MARY'S HOSPITAL - DECATUR,48100112,93456,HC RHC CORONARY ANGIO/NO LV 93456,481,1 ,"$13,597.00 ","$8,838.05 ","$1,626.71 ","$13,597.00 ","$6,862.28 ","$6,934.47 ","$7,478.35 ","$2,744.91 ","$3,807.16 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$6,798.50 ","$10,877.60 ","$6,862.29 ","$2,744.91 ","$9,517.90 ","$2,744.91 ","$8,158.20 ","$2,744.91 ","$10,197.75 ","$7,505.54 ","$6,771.31 ","$7,505.54 ","$2,744.91 ","$7,505.54 ","$10,605.66 ","$10,605.66 ","$11,557.45 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$13,597.00 ","$7,478.35 ","$2,744.91 ","$3,576.01 ","$13,597.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$10,877.60 ","$3,913.45 ","$3,807.16 ","$12,237.30 ","$6,744.11 ","$6,000.00 ","$2,744.91 ","$6,526.56 "
ST. MARY'S HOSPITAL - DECATUR,48100113,93457,HC RHC CORO ANGIO  AND  GRAFTS/NO LV 93457,481,1 ,"$15,171.00 ","$9,861.15 ","$1,626.71 ","$15,171.00 ","$6,862.28 ","$7,737.21 ","$8,344.05 ","$2,744.91 ","$4,247.88 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$7,585.50 ","$12,136.80 ","$6,862.29 ","$2,744.91 ","$10,619.70 ","$2,744.91 ","$9,102.60 ","$2,744.91 ","$11,378.25 ","$8,374.39 ","$7,555.16 ","$8,374.39 ","$2,744.91 ","$8,374.39 ","$10,651.00 ","$10,651.00 ","$12,895.35 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$15,171.00 ","$8,344.05 ","$2,744.91 ","$3,989.97 ","$15,171.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$12,136.80 ","$3,913.45 ","$4,247.88 ","$13,653.90 ","$7,524.82 ","$6,000.00 ","$2,744.91 ","$7,282.08 "
ST. MARY'S HOSPITAL - DECATUR,48100114,93458,HC CORONARY ANGIO WITH LV 93458,481,1 ,"$12,502.00 ","$8,126.30 ","$1,626.71 ","$12,502.00 ","$6,862.28 ","$6,376.02 ","$6,876.10 ","$2,744.91 ","$3,500.56 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$6,251.00 ","$10,001.60 ","$6,862.29 ","$2,744.91 ","$8,751.40 ","$2,744.91 ","$7,501.20 ","$2,744.91 ","$9,376.50 ","$6,901.10 ","$6,226.00 ","$6,901.10 ","$2,744.91 ","$6,901.10 ","$9,751.56 ","$9,751.56 ","$10,626.70 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$12,502.00 ","$6,876.10 ","$2,744.91 ","$3,288.03 ","$12,502.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$10,001.60 ","$3,913.45 ","$3,500.56 ","$11,251.80 ","$6,200.99 ","$6,000.00 ","$2,744.91 ","$6,000.96 "
ST. MARY'S HOSPITAL - DECATUR,48100115,93459,HC CORONARY ANGIO W GRAFTS AND LV 93459,481,1 ,"$13,624.00 ","$8,855.60 ","$1,626.71 ","$13,624.00 ","$6,862.28 ","$6,948.24 ","$7,493.20 ","$2,744.91 ","$3,814.72 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$6,812.00 ","$10,899.20 ","$6,862.29 ","$2,744.91 ","$9,536.80 ","$2,744.91 ","$8,174.40 ","$2,744.91 ","$10,218.00 ","$7,520.45 ","$6,784.75 ","$7,520.45 ","$2,744.91 ","$7,520.45 ","$10,626.72 ","$10,626.72 ","$11,580.40 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$13,624.00 ","$7,493.20 ","$2,744.91 ","$3,583.11 ","$13,624.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$10,899.20 ","$3,913.45 ","$3,814.72 ","$12,261.60 ","$6,757.50 ","$6,000.00 ","$2,744.91 ","$6,539.52 "
ST. MARY'S HOSPITAL - DECATUR,48100116,93460,HC RHC/LHC/CORONAY ANGIO AND LV 93460,481,1 ,"$15,995.00 ","$10,396.75 ","$1,626.71 ","$15,995.00 ","$6,862.28 ","$8,157.45 ","$8,797.25 ","$2,744.91 ","$4,478.60 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$7,997.50 ","$12,796.00 ","$6,862.29 ","$2,744.91 ","$11,196.50 ","$2,744.91 ","$9,597.00 ","$2,744.91 ","$11,996.25 ","$8,829.24 ","$7,965.51 ","$8,829.24 ","$2,744.91 ","$8,829.24 ","$10,651.00 ","$10,651.00 ","$13,595.75 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$15,995.00 ","$8,797.25 ","$2,744.91 ","$4,206.69 ","$15,995.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$12,796.00 ","$3,913.45 ","$4,478.60 ","$14,395.50 ","$2,810.00 ","$6,000.00 ","$2,744.91 ","$7,677.60 "
ST. MARY'S HOSPITAL - DECATUR,48100117,93461,HC RHC/LHC/CORON ANGIO GRAFTS  AND LV 93461,481,1 ,"$15,995.00 ","$10,396.75 ","$1,626.71 ","$15,995.00 ","$6,862.28 ","$8,157.45 ","$8,797.25 ","$2,744.91 ","$4,478.60 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$7,997.50 ","$12,796.00 ","$6,862.29 ","$2,744.91 ","$11,196.50 ","$2,744.91 ","$9,597.00 ","$2,744.91 ","$11,996.25 ","$8,829.24 ","$7,965.51 ","$8,829.24 ","$2,744.91 ","$8,829.24 ","$10,651.00 ","$10,651.00 ","$13,595.75 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$15,995.00 ","$8,797.25 ","$2,744.91 ","$4,206.69 ","$15,995.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$12,796.00 ","$3,913.45 ","$4,478.60 ","$14,395.50 ","$2,810.00 ","$6,000.00 ","$2,744.91 ","$7,677.60 "
ST. MARY'S HOSPITAL - DECATUR,48100118,93463,HC NITRIC OXIDE STUDY 93463,481,1 ,"$1,611.00 ","$1,047.15 ",$423.69 ,"$1,611.00 ", N/A ,$821.61 ,$886.05 , N/A ,$451.08 ,$757.17 , N/A ,$869.94 , N/A ,$874.77 ,$874.77 , N/A ,$874.77 , N/A ,"$1,127.70 ",$805.50 ,"$1,288.80 ", N/A , N/A ,"$1,127.70 ", N/A ,$966.60 , N/A ,"$1,208.25 ",$889.27 ,$802.28 ,$889.27 , N/A ,$889.27 ,"$1,256.58 ","$1,256.58 ","$1,369.35 ", N/A ,"$1,116.42 ", N/A ,"$1,611.00 ",$886.05 , N/A ,$423.69 ,"$1,611.00 ", N/A , N/A , N/A ,"$1,288.80 ",$874.77 ,$451.08 ,"$1,449.90 ",$737.00 ,$900.00 , N/A ,$773.28 
ST. MARY'S HOSPITAL - DECATUR,48100119,93567,HC AORTAGRAM 93567,481,1 ,"$1,300.00 ",$845.00 ,$341.90 ,"$1,300.00 ", N/A ,$663.00 ,$715.00 , N/A ,$364.00 ,$611.00 , N/A ,$702.00 , N/A ,$705.90 ,$705.90 , N/A ,$705.90 , N/A ,$910.00 ,$650.00 ,"$1,040.00 ", N/A , N/A ,$910.00 , N/A ,$780.00 , N/A ,$975.00 ,$717.60 ,$647.40 ,$717.60 , N/A ,$717.60 ,"$1,014.00 ","$1,014.00 ","$1,105.00 ", N/A ,$900.90 , N/A ,"$1,300.00 ",$715.00 , N/A ,$341.90 ,"$1,300.00 ", N/A , N/A , N/A ,"$1,040.00 ",$705.90 ,$364.00 ,"$1,170.00 ",$644.80 ,$900.00 , N/A ,$624.00 
ST. MARY'S HOSPITAL - DECATUR,48100120,93571,HC INTRAVASC DOPP COLOR FLOW INIT 93571,481,1 ,"$4,000.00 ","$2,600.00 ",$900.00 ,"$4,000.00 ", N/A ,"$2,040.00 ","$2,200.00 ", N/A ,"$1,120.00 ","$1,880.00 ", N/A ,"$2,160.00 ", N/A ,"$2,172.00 ","$2,172.00 ", N/A ,"$2,172.00 ", N/A ,"$2,800.00 ","$2,000.00 ","$3,200.00 ", N/A , N/A ,"$2,800.00 ", N/A ,"$2,400.00 ", N/A ,"$3,000.00 ","$2,208.00 ","$1,992.00 ","$2,208.00 ", N/A ,"$2,208.00 ","$3,120.00 ","$3,120.00 ","$3,400.00 ", N/A ,"$2,772.00 ", N/A ,"$4,000.00 ","$2,200.00 ", N/A ,"$1,052.00 ","$4,000.00 ", N/A , N/A , N/A ,"$3,200.00 ","$2,172.00 ","$1,120.00 ","$3,600.00 ","$1,984.00 ",$900.00 , N/A ,"$1,920.00 "
ST. MARY'S HOSPITAL - DECATUR,48100133,93641,HC EP EVAL CARDIO/DEFIB GENERATOR 93641,481,1 ,"$5,114.00 ","$3,324.10 ",$169.13 ,"$5,114.00 ", N/A ,"$5,114.00 ","$2,812.70 ", N/A ,"$1,431.92 ","$2,403.58 ", N/A ,"$2,761.56 ", N/A ,"$2,776.90 ","$2,776.90 ", N/A ,"$2,776.90 ", N/A ,"$3,500.00 ","$2,557.00 ","$4,091.20 ", N/A , N/A ,"$3,579.80 ", N/A ,"$3,068.40 ", N/A ,"$3,835.50 ","$2,822.93 ","$2,546.77 ","$2,822.93 ", N/A ,"$2,822.93 ","$3,988.92 ","$3,988.92 ","$4,346.90 ", N/A ,"$3,544.00 ", N/A ,"$5,114.00 ","$2,812.70 ", N/A ,"$1,344.98 ","$5,114.00 ",$177.19 ,$169.13 , N/A ,"$4,091.20 ","$2,776.90 ","$1,431.92 ","$4,602.60 ",$737.00 ,"$5,114.00 ", N/A ,"$2,454.72 "
ST. MARY'S HOSPITAL - DECATUR,48100135,93642,HC EP EVAL CARDIO/DEFIB SGL/DUAL 93642,481,1 ,"$6,322.00 ","$4,109.30 ",$169.13 ,"$6,322.00 ","$2,635.80 ","$6,322.00 ","$3,477.10 ","$1,054.32 ","$1,770.16 ","$2,971.34 ","$1,054.32 ","$3,413.88 ","$1,054.32 ","$3,432.85 ","$3,432.85 ","$1,054.32 ","$3,432.85 ","$2,003.21 ","$3,500.00 ","$3,161.00 ","$5,057.60 ","$2,635.80 ","$1,054.32 ","$4,425.40 ","$1,054.32 ","$3,793.20 ","$1,054.32 ","$4,741.50 ","$3,489.74 ","$3,148.36 ","$3,489.74 ","$1,054.32 ","$3,489.74 ","$4,931.16 ","$4,931.16 ","$5,373.70 ","$2,635.80 ","$4,381.15 ","$1,054.32 ","$6,322.00 ","$3,477.10 ","$1,054.32 ","$1,662.69 ","$6,322.00 ",$177.19 ,$169.13 ,"$1,107.04 ","$5,057.60 ","$3,432.85 ","$1,770.16 ","$5,689.80 ","$1,795.00 ","$6,322.00 ","$1,054.32 ","$3,034.56 "
ST. MARY'S HOSPITAL - DECATUR,48100139,93660,HC TILT TABLE EVALUATION 93660,481,1 ,"$4,464.00 ","$2,901.60 ",$94.70 ,"$4,464.00 ","$1,155.18 ","$2,276.64 ","$2,455.20 ",$462.07 ,"$1,249.92 ","$2,098.08 ",$462.07 ,"$2,410.56 ",$462.07 ,"$2,423.95 ","$2,423.95 ",$462.07 ,"$2,423.95 ",$877.93 ,"$3,124.80 ","$2,232.00 ","$3,571.20 ","$1,155.17 ",$462.07 ,"$3,124.80 ",$462.07 ,"$2,678.40 ",$462.07 ,"$3,348.00 ","$2,464.13 ","$2,223.07 ","$2,464.13 ",$462.07 ,"$2,464.13 ","$3,481.92 ","$3,481.92 ","$3,794.40 ","$1,155.17 ","$3,093.55 ",$462.07 ,"$4,464.00 ","$2,455.20 ",$462.07 ,"$1,174.03 ","$4,464.00 ",$99.21 ,$94.70 ,$485.17 ,"$3,571.20 ","$2,423.95 ","$1,249.92 ","$4,017.60 ",$737.00 ,$900.00 ,$462.07 ,"$2,142.72 "
ST. MARY'S HOSPITAL - DECATUR,48100150,93503,HC PLACEMENT SWANZ GAN CATH MONIT 93503,481,1 ,"$2,844.00 ","$1,848.60 ",$747.97 ,"$3,327.80 ","$3,327.80 ","$1,450.44 ","$1,564.20 ","$1,331.12 ",$796.32 ,"$1,336.68 ","$1,331.12 ","$1,535.76 ","$1,331.12 ","$1,544.29 ","$1,544.29 ","$1,331.12 ","$1,544.29 ","$2,529.13 ","$1,990.80 ","$1,422.00 ","$2,275.20 ","$3,327.80 ","$1,331.12 ","$1,990.80 ","$1,331.12 ","$1,706.40 ","$1,331.12 ","$2,133.00 ","$1,569.89 ","$1,416.31 ","$1,569.89 ","$1,331.12 ","$1,569.89 ","$2,218.32 ","$2,218.32 ","$2,417.40 ","$2,844.00 ","$1,970.89 ","$1,331.12 ","$2,844.00 ","$1,564.20 ","$1,331.12 ",$747.97 ,"$2,844.00 ","$1,190.62 ","$1,136.50 ","$1,397.68 ","$2,275.20 ","$1,544.29 ",$796.32 ,"$2,559.60 ","$1,410.62 ","$1,666.00 ","$1,331.12 ","$1,365.12 "
ST. MARY'S HOSPITAL - DECATUR,48100151,33227,HC REM/REPL PCMKR PUL GEN SGL 33227,481,1 ,"$17,300.00 ","$11,245.00 ","$3,243.00 ","$19,307.35 ","$19,307.35 ","$5,500.00 ","$9,515.00 ","$7,722.94 ","$4,844.00 ","$3,523.99 ","$7,722.94 ","$4,049.96 ","$7,722.94 ","$3,913.45 ","$3,913.45 ","$7,722.94 ","$3,913.45 ","$14,673.59 ","$3,500.00 ","$8,650.00 ","$13,840.00 ","$19,307.35 ","$7,722.94 ","$12,110.00 ","$7,722.94 ","$10,380.00 ","$7,722.94 ","$12,975.00 ","$9,549.60 ","$8,615.40 ","$9,549.60 ","$7,722.94 ","$9,549.60 ","$13,494.00 ","$13,494.00 ","$14,705.00 ","$17,300.00 ","$4,981.00 ","$7,722.94 ","$17,300.00 ","$9,515.00 ","$7,722.94 ","$4,549.90 ","$17,300.00 ","$5,626.94 ","$5,371.17 ","$8,109.09 ","$13,840.00 ","$3,913.45 ","$4,844.00 ","$15,570.00 ","$3,243.00 ","$17,300.00 ","$7,722.94 ","$8,304.00 "
ST. MARY'S HOSPITAL - DECATUR,48100152,33228,HC REM/REPL PCMKR PUL GEN DUAL 33228,481,1 ,"$18,177.00 ","$11,815.05 ","$3,243.00 ","$24,606.56 ","$24,606.55 ","$5,500.00 ","$9,997.35 ","$9,842.62 ","$5,089.56 ","$3,523.99 ","$9,842.62 ","$4,049.96 ","$9,842.62 ","$3,913.45 ","$3,913.45 ","$9,842.62 ","$3,913.45 ","$18,177.00 ","$3,500.00 ","$9,088.50 ","$14,541.60 ","$24,606.56 ","$9,842.62 ","$12,723.90 ","$9,842.62 ","$10,906.20 ","$9,842.62 ","$13,632.75 ","$10,033.70 ","$9,052.15 ","$10,033.70 ","$9,842.62 ","$10,033.70 ","$14,178.06 ","$14,178.06 ","$15,450.45 ","$18,177.00 ","$4,981.00 ","$9,842.62 ","$18,177.00 ","$9,997.35 ","$9,842.62 ","$4,780.55 ","$18,177.00 ","$5,626.94 ","$5,371.17 ","$10,334.75 ","$14,541.60 ","$3,913.45 ","$5,089.56 ","$16,359.30 ","$3,243.00 ","$18,177.00 ","$9,842.62 ","$8,724.96 "
ST. MARY'S HOSPITAL - DECATUR,48100153,33229,HC REM/REPL PCMKR PUL GEN MULT 33229,481,1 ,"$20,503.00 ","$13,326.95 ","$3,243.00 ","$44,074.03 ","$44,074.03 ","$5,500.00 ","$11,276.65 ","$17,629.61 ","$5,740.84 ","$3,523.99 ","$17,629.61 ","$4,049.96 ","$17,629.61 ","$3,913.45 ","$3,913.45 ","$17,629.61 ","$3,913.45 ","$20,503.00 ","$3,500.00 ","$10,251.50 ","$16,402.40 ","$44,074.02 ","$17,629.61 ","$14,352.10 ","$17,629.61 ","$12,301.80 ","$17,629.61 ","$15,377.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$17,629.61 ","$10,265.00 ","$15,992.34 ","$15,992.34 ","$17,427.55 ","$20,503.00 ","$4,981.00 ","$17,629.61 ","$20,503.00 ","$11,276.65 ","$17,629.61 ","$5,392.29 ","$20,503.00 ","$5,626.94 ","$5,371.17 ","$18,511.09 ","$16,402.40 ","$3,913.45 ","$5,740.84 ","$18,452.70 ","$3,243.00 ","$20,000.00 ","$17,629.61 ","$9,841.44 "
ST. MARY'S HOSPITAL - DECATUR,48100154,33262,HC REM/REPL DEFIB PUL GEN SGL 33262,481,1 ,"$33,068.00 ","$21,494.20 ","$3,500.00 ","$54,570.85 ","$54,570.85 ","$5,500.00 ","$18,187.40 ","$21,828.34 ","$9,259.04 ","$3,523.99 ","$21,828.34 ","$4,049.96 ","$21,828.34 ","$3,913.45 ","$3,913.45 ","$21,828.34 ","$3,913.45 ","$33,068.00 ","$3,500.00 ","$16,534.00 ","$26,454.40 ","$54,570.85 ","$21,828.34 ","$23,147.60 ","$21,828.34 ","$19,840.80 ","$21,828.34 ","$24,801.00 ","$11,147.46 ","$11,434.10 ","$11,147.46 ","$21,828.34 ","$11,147.46 ","$25,793.04 ","$25,793.04 ","$28,107.80 ","$33,068.00 ","$4,981.00 ","$21,828.34 ","$33,068.00 ","$18,187.40 ","$21,828.34 ","$8,696.88 ","$33,068.00 ","$16,140.67 ","$15,407.01 ","$22,919.76 ","$26,454.40 ","$3,913.45 ","$9,259.04 ","$29,761.20 ","$4,611.00 ","$20,000.00 ","$21,828.34 ","$15,872.64 "
ST. MARY'S HOSPITAL - DECATUR,48100155,33263,HC REM/REPL DEFIB PUL GEN DUAL 33263,481,1 ,"$33,068.00 ","$21,494.20 ","$3,500.00 ","$54,570.85 ","$54,570.85 ","$5,500.00 ","$18,187.40 ","$21,828.34 ","$9,259.04 ","$3,523.99 ","$21,828.34 ","$4,049.96 ","$21,828.34 ","$3,913.45 ","$3,913.45 ","$21,828.34 ","$3,913.45 ","$33,068.00 ","$3,500.00 ","$16,534.00 ","$26,454.40 ","$54,570.85 ","$21,828.34 ","$23,147.60 ","$21,828.34 ","$19,840.80 ","$21,828.34 ","$24,801.00 ","$11,147.46 ","$11,434.10 ","$11,147.46 ","$21,828.34 ","$11,147.46 ","$25,793.04 ","$25,793.04 ","$28,107.80 ","$33,068.00 ","$4,981.00 ","$21,828.34 ","$33,068.00 ","$18,187.40 ","$21,828.34 ","$8,696.88 ","$33,068.00 ","$16,140.67 ","$15,407.01 ","$22,919.76 ","$26,454.40 ","$3,913.45 ","$9,259.04 ","$29,761.20 ","$4,611.00 ","$20,000.00 ","$21,828.34 ","$15,872.64 "
ST. MARY'S HOSPITAL - DECATUR,48100156,33264,HC REM/REPL DEFIB PUL GEN MULT 33264,481,1 ,"$33,068.00 ","$21,494.20 ","$3,500.00 ","$77,733.50 ","$77,733.50 ","$5,500.00 ","$18,187.40 ","$31,093.40 ","$9,259.04 ","$3,523.99 ","$31,093.40 ","$4,049.96 ","$31,093.40 ","$3,913.45 ","$3,913.45 ","$31,093.40 ","$3,913.45 ","$33,068.00 ","$3,500.00 ","$16,534.00 ","$26,454.40 ","$77,733.50 ","$31,093.40 ","$23,147.60 ","$31,093.40 ","$19,840.80 ","$31,093.40 ","$24,801.00 ","$11,147.46 ","$11,434.10 ","$11,147.46 ","$31,093.40 ","$11,147.46 ","$25,793.04 ","$25,793.04 ","$28,107.80 ","$33,068.00 ","$4,981.00 ","$31,093.40 ","$33,068.00 ","$18,187.40 ","$31,093.40 ","$8,696.88 ","$33,068.00 ","$16,140.67 ","$15,407.01 ","$32,648.07 ","$26,454.40 ","$3,913.45 ","$9,259.04 ","$29,761.20 ","$4,611.00 ","$20,000.00 ","$31,093.40 ","$15,872.64 "
ST. MARY'S HOSPITAL - DECATUR,48100171,36253,HC PLC CATH RENAL ANGIO 1< UNI,481,1 ,"$13,581.00 ","$8,827.65 ","$1,786.63 ","$13,581.00 ","$11,285.10 ","$3,500.00 ","$7,469.55 ","$4,514.04 ","$3,802.68 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$6,790.50 ","$10,864.80 ","$11,285.10 ","$4,514.04 ","$9,506.70 ","$4,514.04 ","$8,148.60 ","$4,514.04 ","$10,185.75 ","$7,496.71 ","$6,763.34 ","$7,496.71 ","$4,514.04 ","$7,496.71 ","$10,593.18 ","$10,593.18 ","$11,543.85 ","$11,285.10 ","$4,981.00 ","$4,514.04 ","$13,581.00 ","$7,469.55 ","$4,514.04 ","$3,571.80 ","$13,581.00 ","$1,871.71 ","$1,786.63 ","$4,739.74 ","$10,864.80 ","$3,913.45 ","$3,802.68 ","$12,222.90 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$6,518.88 "
ST. MARY'S HOSPITAL - DECATUR,48100172,36254,HC PLC CATH RENAL ANGIO 1< BIL,481,1 ,"$7,980.00 ","$5,187.00 ","$1,786.63 ","$7,980.00 ","$6,774.50 ","$3,500.00 ","$4,389.00 ","$2,709.80 ","$2,234.40 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$3,990.00 ","$6,384.00 ","$6,774.49 ","$2,709.80 ","$5,586.00 ","$2,709.80 ","$4,788.00 ","$2,709.80 ","$5,985.00 ","$4,404.96 ","$3,974.04 ","$4,404.96 ","$2,709.80 ","$4,404.96 ","$6,224.40 ","$6,224.40 ","$6,783.00 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$7,980.00 ","$4,389.00 ","$2,709.80 ","$2,098.74 ","$7,980.00 ","$1,871.71 ","$1,786.63 ","$2,845.29 ","$6,384.00 ","$3,913.45 ","$2,234.40 ","$7,182.00 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$3,830.40 "
ST. MARY'S HOSPITAL - DECATUR,48100173,37193,HC FILTER REMOVAL,481,1 ,"$6,452.00 ","$4,193.80 ","$1,696.88 ","$6,774.50 ","$6,774.50 ","$5,500.00 ","$3,548.60 ","$2,709.80 ","$1,806.56 ","$3,032.44 ","$2,709.80 ","$3,484.08 ","$2,709.80 ","$3,503.44 ","$3,503.44 ","$2,709.80 ","$3,503.44 ","$5,148.61 ","$3,500.00 ","$3,226.00 ","$5,161.60 ","$6,774.49 ","$2,709.80 ","$4,516.40 ","$2,709.80 ","$3,871.20 ","$2,709.80 ","$4,839.00 ","$3,561.50 ","$3,213.10 ","$3,561.50 ","$2,709.80 ","$3,561.50 ","$5,032.56 ","$5,032.56 ","$5,484.20 ","$6,452.00 ","$4,471.24 ","$2,709.80 ","$6,452.00 ","$3,548.60 ","$2,709.80 ","$1,696.88 ","$6,452.00 ","$2,179.58 ","$2,080.51 ","$2,845.29 ","$5,161.60 ","$3,503.44 ","$1,806.56 ","$5,806.80 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$3,096.96 "
ST. MARY'S HOSPITAL - DECATUR,48100174,33230,HC INS DEFIB PULSE GEN W/EST DUAL,481,1 ,"$33,068.00 ","$21,494.20 ","$3,500.00 ","$54,570.85 ","$54,570.85 ","$5,500.00 ","$18,187.40 ","$21,828.34 ","$9,259.04 ","$3,523.99 ","$21,828.34 ","$4,049.96 ","$21,828.34 ","$3,913.45 ","$3,913.45 ","$21,828.34 ","$3,913.45 ","$33,068.00 ","$3,500.00 ","$16,534.00 ","$26,454.40 ","$54,570.85 ","$21,828.34 ","$23,147.60 ","$21,828.34 ","$19,840.80 ","$21,828.34 ","$24,801.00 ","$11,147.46 ","$11,434.10 ","$11,147.46 ","$21,828.34 ","$11,147.46 ","$25,793.04 ","$25,793.04 ","$28,107.80 ","$33,068.00 ","$4,981.00 ","$21,828.34 ","$33,068.00 ","$18,187.40 ","$21,828.34 ","$8,696.88 ","$33,068.00 ","$16,140.67 ","$15,407.01 ","$22,919.76 ","$26,454.40 ","$3,913.45 ","$9,259.04 ","$29,761.20 ","$4,611.00 ","$20,000.00 ","$21,828.34 ","$15,872.64 "
ST. MARY'S HOSPITAL - DECATUR,48100175,33231,HC INS DEFIB PULSE GEN W/EST MULT,481,1 ,"$33,068.00 ","$21,494.20 ","$3,500.00 ","$77,733.50 ","$77,733.50 ","$5,500.00 ","$18,187.40 ","$31,093.40 ","$9,259.04 ","$3,523.99 ","$31,093.40 ","$4,049.96 ","$31,093.40 ","$3,913.45 ","$3,913.45 ","$31,093.40 ","$3,913.45 ","$33,068.00 ","$3,500.00 ","$16,534.00 ","$26,454.40 ","$77,733.50 ","$31,093.40 ","$23,147.60 ","$31,093.40 ","$19,840.80 ","$31,093.40 ","$24,801.00 ","$11,147.46 ","$11,434.10 ","$11,147.46 ","$31,093.40 ","$11,147.46 ","$25,793.04 ","$25,793.04 ","$28,107.80 ","$33,068.00 ","$4,981.00 ","$31,093.40 ","$33,068.00 ","$18,187.40 ","$31,093.40 ","$8,696.88 ","$33,068.00 ","$16,140.67 ","$15,407.01 ","$32,648.07 ","$26,454.40 ","$3,913.45 ","$9,259.04 ","$29,761.20 ","$4,611.00 ","$20,000.00 ","$31,093.40 ","$15,872.64 "
ST. MARY'S HOSPITAL - DECATUR,48100176,37216,HC PL STENT TRNSCATH CAROT ART W/O,481,1 ,"$9,029.00 ","$5,868.85 ","$2,034.00 ","$9,029.00 ", N/A ,"$5,500.00 ","$4,965.95 ", N/A ,"$2,528.12 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,514.50 ","$7,223.20 ", N/A , N/A ,"$6,320.30 ", N/A ,"$5,417.40 ", N/A ,"$6,771.75 ","$4,984.01 ","$4,496.44 ","$4,984.01 ", N/A ,"$4,984.01 ","$7,042.62 ","$7,042.62 ","$7,674.65 ", N/A ,"$4,981.00 ", N/A ,"$9,029.00 ","$4,965.95 ", N/A ,"$2,374.63 ","$9,029.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$7,223.20 ","$3,913.45 ","$2,528.12 ","$8,126.10 ","$4,478.38 ","$2,034.00 ", N/A ,"$4,333.92 "
ST. MARY'S HOSPITAL - DECATUR,48100181,37212,HC VENOUS THROMBOLYSIS; INIT DAY 37212,481,1 ,"$7,008.00 ","$4,555.20 ","$1,843.10 ","$7,008.00 ","$6,774.50 ","$2,800.00 ","$3,854.40 ","$2,709.80 ","$1,962.24 ","$3,293.76 ","$2,709.80 ","$3,784.32 ","$2,709.80 ","$3,805.34 ","$3,805.34 ","$2,709.80 ","$3,805.34 ","$5,148.61 ","$3,500.00 ","$3,504.00 ","$5,606.40 ","$6,774.49 ","$2,709.80 ","$4,905.60 ","$2,709.80 ","$4,204.80 ","$2,709.80 ","$5,256.00 ","$3,868.42 ","$3,489.98 ","$3,868.42 ","$2,709.80 ","$3,868.42 ","$5,466.24 ","$5,466.24 ","$5,956.80 ","$6,774.49 ","$4,856.54 ","$2,709.80 ","$7,008.00 ","$3,854.40 ","$2,709.80 ","$1,843.10 ","$7,008.00 ","$2,179.58 ","$2,080.51 ","$2,845.29 ","$5,606.40 ","$3,805.34 ","$1,962.24 ","$6,307.20 ","$3,475.97 ","$3,250.00 ","$2,709.80 ","$3,363.84 "
ST. MARY'S HOSPITAL - DECATUR,48100182,37214,HC THROMBO CESS/CLOS; SUBSQ DAY 37214,481,1 ,"$8,296.00 ","$5,392.40 ","$1,666.00 ","$8,296.00 ","$6,774.50 ","$5,500.00 ","$4,562.80 ","$2,709.80 ","$2,322.88 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,148.00 ","$6,636.80 ","$6,774.49 ","$2,709.80 ","$5,807.20 ","$2,709.80 ","$4,977.60 ","$2,709.80 ","$6,222.00 ","$4,579.39 ","$4,131.41 ","$4,579.39 ","$2,709.80 ","$4,579.39 ","$6,470.88 ","$6,470.88 ","$7,051.60 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$8,296.00 ","$4,562.80 ","$2,709.80 ","$2,181.85 ","$8,296.00 ","$2,179.58 ","$2,080.51 ","$2,845.29 ","$6,636.80 ","$3,913.45 ","$2,322.88 ","$7,466.40 ","$4,114.82 ","$1,666.00 ","$2,709.80 ","$3,982.08 "
ST. MARY'S HOSPITAL - DECATUR,48100183,36225,HC CATH PLCMT SEL SUBCL/INOM VERTEB UNI 36225,481,1 ,"$9,725.00 ","$6,321.25 ","$1,786.63 ","$9,725.00 ","$6,774.50 ","$3,500.00 ","$5,348.75 ","$2,709.80 ","$2,723.00 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,862.50 ","$7,780.00 ","$6,774.49 ","$2,709.80 ","$6,807.50 ","$2,709.80 ","$5,835.00 ","$2,709.80 ","$7,293.75 ","$5,368.20 ","$4,843.05 ","$5,368.20 ","$2,709.80 ","$5,368.20 ","$7,585.50 ","$7,585.50 ","$8,266.25 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$9,725.00 ","$5,348.75 ","$2,709.80 ","$2,557.68 ","$9,725.00 ","$1,871.71 ","$1,786.63 ","$2,845.29 ","$7,780.00 ","$3,913.45 ","$2,723.00 ","$8,752.50 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$4,668.00 "
ST. MARY'S HOSPITAL - DECATUR,48100185,37211,HC ARTRL THROMBOLYSIS; INIT DAY 37211,481,1 ,"$7,008.00 ","$4,555.20 ","$1,843.10 ","$11,285.10 ","$11,285.10 ","$2,800.00 ","$3,854.40 ","$4,514.04 ","$1,962.24 ","$3,293.76 ","$4,514.04 ","$3,784.32 ","$4,514.04 ","$3,805.34 ","$3,805.34 ","$4,514.04 ","$3,805.34 ","$7,008.00 ","$3,500.00 ","$3,504.00 ","$5,606.40 ","$11,285.10 ","$4,514.04 ","$4,905.60 ","$4,514.04 ","$4,204.80 ","$4,514.04 ","$5,256.00 ","$3,868.42 ","$3,489.98 ","$3,868.42 ","$4,514.04 ","$3,868.42 ","$5,466.24 ","$5,466.24 ","$5,956.80 ","$7,008.00 ","$4,856.54 ","$4,514.04 ","$7,008.00 ","$3,854.40 ","$4,514.04 ","$1,843.10 ","$7,008.00 ","$2,179.58 ","$2,080.51 ","$4,739.74 ","$5,606.40 ","$3,805.34 ","$1,962.24 ","$6,307.20 ","$3,475.97 ","$5,100.00 ","$4,514.04 ","$3,363.84 "
ST. MARY'S HOSPITAL - DECATUR,48100186,37213,HC ARTRL/VENOUS THROMBOLYSIS; SUBSQ DAY 37213,481,1 ,"$9,496.00 ","$6,172.40 ","$1,666.00 ","$9,496.00 ","$6,774.50 ","$5,500.00 ","$5,222.80 ","$2,709.80 ","$2,658.88 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,748.00 ","$7,596.80 ","$6,774.49 ","$2,709.80 ","$6,647.20 ","$2,709.80 ","$5,697.60 ","$2,709.80 ","$7,122.00 ","$5,241.79 ","$4,729.01 ","$5,241.79 ","$2,709.80 ","$5,241.79 ","$7,406.88 ","$7,406.88 ","$8,071.60 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$9,496.00 ","$5,222.80 ","$2,709.80 ","$2,497.45 ","$9,496.00 ","$2,179.58 ","$2,080.51 ","$2,845.29 ","$7,596.80 ","$3,913.45 ","$2,658.88 ","$8,546.40 ","$4,710.02 ","$1,666.00 ","$2,709.80 ","$4,558.08 "
ST. MARY'S HOSPITAL - DECATUR,48100187,37197,HC TRANSCATH RETRVAL FOREIGN BODY 37197,481,1 ,"$3,890.00 ","$2,528.50 ","$1,023.07 ","$6,774.50 ","$6,774.50 ","$3,890.00 ","$2,139.50 ","$2,709.80 ","$1,089.20 ","$1,828.30 ","$2,709.80 ","$2,100.60 ","$2,709.80 ","$2,112.27 ","$2,112.27 ","$2,709.80 ","$2,112.27 ","$3,890.00 ","$2,723.00 ","$1,945.00 ","$3,112.00 ","$6,774.49 ","$2,709.80 ","$2,723.00 ","$2,709.80 ","$2,334.00 ","$2,709.80 ","$2,917.50 ","$2,147.28 ","$1,937.22 ","$2,147.28 ","$2,709.80 ","$2,147.28 ","$3,034.20 ","$3,034.20 ","$3,306.50 ","$3,890.00 ","$2,695.77 ","$2,709.80 ","$3,890.00 ","$2,139.50 ","$2,709.80 ","$1,023.07 ","$3,890.00 ","$3,461.35 ","$3,304.01 ","$2,845.29 ","$3,112.00 ","$2,112.27 ","$1,089.20 ","$3,501.00 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$1,867.20 "
ST. MARY'S HOSPITAL - DECATUR,48100188,36221,HC CATH PLCMT NON SEL THORAC AORTA 36221,481,1 ,"$8,700.00 ","$5,655.00 ","$1,786.63 ","$8,700.00 ","$6,774.50 ","$3,500.00 ","$4,785.00 ","$2,709.80 ","$2,436.00 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,350.00 ","$6,960.00 ","$6,774.49 ","$2,709.80 ","$6,090.00 ","$2,709.80 ","$5,220.00 ","$2,709.80 ","$6,525.00 ","$4,802.40 ","$4,332.60 ","$4,802.40 ","$2,709.80 ","$4,802.40 ","$6,786.00 ","$6,786.00 ","$7,395.00 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$8,700.00 ","$4,785.00 ","$2,709.80 ","$2,288.10 ","$8,700.00 ","$1,871.71 ","$1,786.63 ","$2,845.29 ","$6,960.00 ","$3,913.45 ","$2,436.00 ","$7,830.00 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$4,176.00 "
ST. MARY'S HOSPITAL - DECATUR,48100189,36222,HC CATH PLCMT SEL COM CAR/INOM EXTRACRN UNI 36222,481,1 ,"$9,865.00 ","$6,412.25 ","$1,786.63 ","$9,865.00 ","$6,774.50 ","$3,500.00 ","$5,425.75 ","$2,709.80 ","$2,762.20 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$4,932.50 ","$7,892.00 ","$6,774.49 ","$2,709.80 ","$6,905.50 ","$2,709.80 ","$5,919.00 ","$2,709.80 ","$7,398.75 ","$5,445.48 ","$4,912.77 ","$5,445.48 ","$2,709.80 ","$5,445.48 ","$7,694.70 ","$7,694.70 ","$8,385.25 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$9,865.00 ","$5,425.75 ","$2,709.80 ","$2,594.50 ","$9,865.00 ","$1,871.71 ","$1,786.63 ","$2,845.29 ","$7,892.00 ","$3,913.45 ","$2,762.20 ","$8,878.50 ","$2,641.00 ","$3,250.00 ","$2,709.80 ","$4,735.20 "
ST. MARY'S HOSPITAL - DECATUR,48100190,36223,HC CATH PLCMT SEL COM CAR/INOM INTRACRN UNI 36223,481,1 ,"$11,226.00 ","$7,296.90 ","$1,786.63 ","$11,285.10 ","$11,285.10 ","$3,500.00 ","$6,174.30 ","$4,514.04 ","$3,143.28 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$5,613.00 ","$8,980.80 ","$11,285.10 ","$4,514.04 ","$7,858.20 ","$4,514.04 ","$6,735.60 ","$4,514.04 ","$8,419.50 ","$6,196.75 ","$5,590.55 ","$6,196.75 ","$4,514.04 ","$6,196.75 ","$8,756.28 ","$8,756.28 ","$9,542.10 ","$11,226.00 ","$4,981.00 ","$4,514.04 ","$11,226.00 ","$6,174.30 ","$4,514.04 ","$2,952.44 ","$11,226.00 ","$1,871.71 ","$1,786.63 ","$4,739.74 ","$8,980.80 ","$3,913.45 ","$3,143.28 ","$10,103.40 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$5,388.48 "
ST. MARY'S HOSPITAL - DECATUR,48100191,36224,HC CATH PLCMT SEL INTERNAL CAR UNI 36224,481,1 ,"$14,648.00 ","$9,521.20 ","$1,786.63 ","$14,648.00 ","$11,285.10 ","$5,500.00 ","$8,056.40 ","$4,514.04 ","$4,101.44 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$7,324.00 ","$11,718.40 ","$11,285.10 ","$4,514.04 ","$10,253.60 ","$4,514.04 ","$8,788.80 ","$4,514.04 ","$10,986.00 ","$8,085.70 ","$7,294.70 ","$8,085.70 ","$4,514.04 ","$8,085.70 ","$11,425.44 ","$11,425.44 ","$12,450.80 ","$11,285.10 ","$4,981.00 ","$4,514.04 ","$14,648.00 ","$8,056.40 ","$4,514.04 ","$3,852.42 ","$14,648.00 ","$1,871.71 ","$1,786.63 ","$4,739.74 ","$11,718.40 ","$3,913.45 ","$4,101.44 ","$13,183.20 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$7,031.04 "
ST. MARY'S HOSPITAL - DECATUR,48100192,36226,HC CATH PLCMT SEL VERTEBRAL UNI 36226,481,1 ,"$11,330.00 ","$7,364.50 ","$1,786.63 ","$11,330.00 ","$11,285.10 ","$5,500.00 ","$6,231.50 ","$4,514.04 ","$3,172.40 ","$3,523.99 ","$4,514.04 ","$4,049.96 ","$4,514.04 ","$3,913.45 ","$3,913.45 ","$4,514.04 ","$3,913.45 ","$8,576.68 ","$3,500.00 ","$5,665.00 ","$9,064.00 ","$11,285.10 ","$4,514.04 ","$7,931.00 ","$4,514.04 ","$6,798.00 ","$4,514.04 ","$8,497.50 ","$6,254.16 ","$5,642.34 ","$6,254.16 ","$4,514.04 ","$6,254.16 ","$8,837.40 ","$8,837.40 ","$9,630.50 ","$11,285.10 ","$4,981.00 ","$4,514.04 ","$11,330.00 ","$6,231.50 ","$4,514.04 ","$2,979.79 ","$11,330.00 ","$1,871.71 ","$1,786.63 ","$4,739.74 ","$9,064.00 ","$3,913.45 ","$3,172.40 ","$10,197.00 ","$2,861.00 ","$5,100.00 ","$4,514.04 ","$5,438.40 "
ST. MARY'S HOSPITAL - DECATUR,48100200,92920,HC PTCA SINGL MAJ ART/BRANCH 92920,481,1 ,"$10,964.00 ","$7,126.60 ","$2,883.53 ","$11,729.16 ","$11,729.15 ","$7,500.00 ","$6,030.20 ","$4,691.66 ","$3,069.92 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,482.00 ","$8,771.20 ","$11,729.16 ","$4,691.66 ","$7,674.80 ","$4,691.66 ","$6,578.40 ","$4,691.66 ","$8,223.00 ","$6,052.13 ","$5,460.07 ","$6,052.13 ","$4,691.66 ","$6,052.13 ","$8,551.92 ","$8,551.92 ","$9,319.40 ","$10,964.00 ","$4,981.00 ","$4,691.66 ","$10,964.00 ","$6,030.20 ","$4,691.66 ","$2,883.53 ","$10,964.00 ","$6,014.54 ","$5,741.15 ","$4,926.24 ","$8,771.20 ","$3,913.45 ","$3,069.92 ","$9,867.60 ","$5,438.14 ","$10,964.00 ","$4,691.66 ","$5,262.72 "
ST. MARY'S HOSPITAL - DECATUR,48100201,92921,HC PTCA EA ADDL BRANCH MAJ ART 92921,481,1 ,"$7,834.00 ","$5,092.10 ","$2,060.34 ","$7,834.00 ", N/A ,"$7,500.00 ","$4,308.70 ", N/A ,"$2,193.52 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,917.00 ","$6,267.20 ", N/A , N/A ,"$5,483.80 ", N/A ,"$4,700.40 ", N/A ,"$5,875.50 ","$4,324.37 ","$3,901.33 ","$4,324.37 ", N/A ,"$4,324.37 ","$6,110.52 ","$6,110.52 ","$6,658.90 ", N/A ,"$4,981.00 ", N/A ,"$7,834.00 ","$4,308.70 ", N/A ,"$2,060.34 ","$7,834.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$6,267.20 ","$3,913.45 ","$2,193.52 ","$7,050.60 ","$3,885.66 ","$7,834.00 ", N/A ,"$3,760.32 "
ST. MARY'S HOSPITAL - DECATUR,48100202,92924,HC ROTOBLATOR SINGL MAJ ART/BRANCH 92924,481,1 ,"$18,258.00 ","$11,867.70 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$10,041.90 ","$9,508.18 ","$5,112.24 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$9,129.00 ","$14,606.40 ","$23,770.46 ","$9,508.18 ","$12,780.60 ","$9,508.18 ","$10,954.80 ","$9,508.18 ","$13,693.50 ","$10,078.42 ","$9,092.48 ","$10,078.42 ","$9,508.18 ","$10,078.42 ","$14,241.24 ","$14,241.24 ","$15,519.30 ","$18,258.00 ","$4,981.00 ","$9,508.18 ","$18,258.00 ","$10,041.90 ","$9,508.18 ","$4,801.85 ","$18,258.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$14,606.40 ","$3,913.45 ","$5,112.24 ","$16,432.20 ","$9,055.97 ","$18,258.00 ","$9,508.18 ","$8,763.84 "
ST. MARY'S HOSPITAL - DECATUR,48100203,92925,HC ROTOBLATOR EA ADDL BRANCH MAJ ART 92925,481,1 ,"$10,780.00 ","$7,007.00 ","$2,835.14 ","$10,780.00 ", N/A ,"$7,500.00 ","$5,929.00 ", N/A ,"$3,018.40 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,390.00 ","$8,624.00 ", N/A , N/A ,"$7,546.00 ", N/A ,"$6,468.00 ", N/A ,"$8,085.00 ","$5,950.56 ","$5,368.44 ","$5,950.56 ", N/A ,"$5,950.56 ","$8,408.40 ","$8,408.40 ","$9,163.00 ", N/A ,"$4,981.00 ", N/A ,"$10,780.00 ","$5,929.00 ", N/A ,"$2,835.14 ","$10,780.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,624.00 ","$3,913.45 ","$3,018.40 ","$9,702.00 ","$5,346.88 ","$10,780.00 ", N/A ,"$5,174.40 "
ST. MARY'S HOSPITAL - DECATUR,48100204,92928,HC BMS SINGL MAJ ART/BRANCH 92928,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100205,92929,HC BMS EA ADDL BRANCH MAJ ART 92929,481,1 ,"$9,672.00 ","$6,286.80 ","$2,543.74 ","$9,672.00 ", N/A ,"$7,500.00 ","$5,319.60 ", N/A ,"$2,708.16 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,836.00 ","$7,737.60 ", N/A , N/A ,"$6,770.40 ", N/A ,"$5,803.20 ", N/A ,"$7,254.00 ","$5,338.94 ","$4,816.66 ","$5,338.94 ", N/A ,"$5,338.94 ","$7,544.16 ","$7,544.16 ","$8,221.20 ", N/A ,"$4,981.00 ", N/A ,"$9,672.00 ","$5,319.60 ", N/A ,"$2,543.74 ","$9,672.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$7,737.60 ","$3,913.45 ","$2,708.16 ","$8,704.80 ","$4,797.31 ","$9,672.00 ", N/A ,"$4,642.56 "
ST. MARY'S HOSPITAL - DECATUR,48100206,92933,HC ROTOBLATOR/BMS SINGL MAJ ART/BRANCH 92933,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100207,92934,HC ROTOBLATOR/BMS EA ADDL BRANCH MAJ ART 92934,481,1 ,"$20,453.00 ","$13,294.45 ","$3,500.00 ","$20,453.00 ", N/A ,"$7,500.00 ","$11,249.15 ", N/A ,"$5,726.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$10,226.50 ","$16,362.40 ", N/A , N/A ,"$14,317.10 ", N/A ,"$12,271.80 ", N/A ,"$15,339.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,953.34 ","$15,953.34 ","$17,385.05 ", N/A ,"$4,981.00 ", N/A ,"$20,453.00 ","$11,249.15 ", N/A ,"$5,379.14 ","$20,453.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$16,362.40 ","$3,913.45 ","$5,726.84 ","$18,407.70 ","$10,144.69 ","$20,000.00 ", N/A ,"$9,817.44 "
ST. MARY'S HOSPITAL - DECATUR,48100208,92937,HC BYPASS GRAFT BMS SINGL MAJ ART/BRANCH 92937,481,1 ,"$25,691.00 ","$16,699.15 ","$3,500.00 ","$25,691.00 ","$23,770.45 ","$7,500.00 ","$14,130.05 ","$9,508.18 ","$7,193.48 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,845.50 ","$20,552.80 ","$23,770.46 ","$9,508.18 ","$17,983.70 ","$9,508.18 ","$15,414.60 ","$9,508.18 ","$19,268.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$20,038.98 ","$20,038.98 ","$21,837.35 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$25,691.00 ","$14,130.05 ","$9,508.18 ","$6,756.73 ","$25,691.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$20,552.80 ","$3,913.45 ","$7,193.48 ","$23,121.90 ","$12,742.74 ","$20,000.00 ","$9,508.18 ","$12,331.68 "
ST. MARY'S HOSPITAL - DECATUR,48100209,92938,HC BYPASS GRAFT BMS EA ADDL BRNCH MAJ ART 92938,481,1 ,"$18,063.00 ","$11,740.95 ","$3,500.00 ","$18,063.00 ", N/A ,"$7,500.00 ","$9,934.65 ", N/A ,"$5,057.64 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,031.50 ","$14,450.40 ", N/A , N/A ,"$12,644.10 ", N/A ,"$10,837.80 ", N/A ,"$13,547.25 ","$9,970.78 ","$8,995.37 ","$9,970.78 ", N/A ,"$9,970.78 ","$14,089.14 ","$14,089.14 ","$15,353.55 ", N/A ,"$4,981.00 ", N/A ,"$18,063.00 ","$9,934.65 ", N/A ,"$4,750.57 ","$18,063.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$14,450.40 ","$3,913.45 ","$5,057.64 ","$16,256.70 ","$8,959.25 ","$18,063.00 ", N/A ,"$8,670.24 "
ST. MARY'S HOSPITAL - DECATUR,48100210,92941,HC STEMI/NSTEMI BMS SING VESS 92941,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100211,92943,HC CTO BMS SING MAJ ART/BRNCH 92943,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$9,488.60 ","$9,508.18 ","$4,830.56 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$23,770.46 ","$9,508.18 ","$12,076.40 ","$9,508.18 ","$10,351.20 ","$9,508.18 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$9,508.18 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$9,508.18 ","$17,252.00 ","$9,488.60 ","$9,508.18 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$9,508.18 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100212,92944,HC CTO BMS EA ADD BNCH MAJ ART 92944,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100218,C9600,HC DES SING MAJ ART/BRNCH C9600,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100219,C9601,HC DES EA ADD BNCH MAJ ART C9601,481,1 ,"$11,419.00 ","$7,422.35 ","$3,003.20 ","$11,419.00 ", N/A ,"$7,500.00 ","$6,280.45 ", N/A ,"$3,197.32 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,709.50 ","$9,135.20 ", N/A , N/A ,"$7,993.30 ", N/A ,"$6,851.40 ", N/A ,"$8,564.25 ","$6,303.29 ","$5,686.66 ","$6,303.29 ", N/A ,"$6,303.29 ","$8,906.82 ","$8,906.82 ","$9,706.15 ", N/A ,"$4,981.00 ", N/A ,"$11,419.00 ","$6,280.45 ", N/A ,"$3,003.20 ","$11,419.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$9,135.20 ","$3,913.45 ","$3,197.32 ","$10,277.10 ","$5,663.82 ","$11,419.00 ", N/A ,"$5,481.12 "
ST. MARY'S HOSPITAL - DECATUR,48100221,C9603,HC ROTOBLAT/DES EA ADD BNCH MAJ ART C9603,481,1 ,"$22,200.00 ","$14,430.00 ","$3,500.00 ","$22,200.00 ", N/A ,"$7,500.00 ","$12,210.00 ", N/A ,"$6,216.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$11,100.00 ","$17,760.00 ", N/A , N/A ,"$15,540.00 ", N/A ,"$13,320.00 ", N/A ,"$16,650.00 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$17,316.00 ","$17,316.00 ","$18,870.00 ", N/A ,"$4,981.00 ", N/A ,"$22,200.00 ","$12,210.00 ", N/A ,"$5,838.60 ","$22,200.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$17,760.00 ","$3,913.45 ","$6,216.00 ","$19,980.00 ","$11,011.20 ","$20,000.00 ", N/A ,"$10,656.00 "
ST. MARY'S HOSPITAL - DECATUR,48100222,C9604,HC BYPASS GRAFT DES SING MAJ ART/BRNCH C9604,481,1 ,"$24,686.00 ","$16,045.90 ","$3,500.00 ","$24,686.00 ","$23,770.45 ","$7,500.00 ","$13,577.30 ","$9,508.18 ","$6,912.08 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,343.00 ","$19,748.80 ","$23,770.46 ","$9,508.18 ","$17,280.20 ","$9,508.18 ","$14,811.60 ","$9,508.18 ","$18,514.50 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$19,255.08 ","$19,255.08 ","$20,983.10 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$24,686.00 ","$13,577.30 ","$9,508.18 ","$6,492.42 ","$24,686.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$19,748.80 ","$3,913.45 ","$6,912.08 ","$22,217.40 ","$12,244.26 ","$20,000.00 ","$9,508.18 ","$11,849.28 "
ST. MARY'S HOSPITAL - DECATUR,48100223,C9605,HC BYPASS GRFT DES EA ADD BRNCH MAJ ART C9605,481,1 ,"$19,257.00 ","$12,517.05 ","$3,500.00 ","$19,257.00 ", N/A ,"$7,500.00 ","$10,591.35 ", N/A ,"$5,391.96 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,628.50 ","$15,405.60 ", N/A , N/A ,"$13,479.90 ", N/A ,"$11,554.20 ", N/A ,"$14,442.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,020.46 ","$15,020.46 ","$16,368.45 ", N/A ,"$4,981.00 ", N/A ,"$19,257.00 ","$10,591.35 ", N/A ,"$5,064.59 ","$19,257.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$15,405.60 ","$3,913.45 ","$5,391.96 ","$17,331.30 ","$9,551.47 ","$19,257.00 ", N/A ,"$9,243.36 "
ST. MARY'S HOSPITAL - DECATUR,48100224,C9607,HC CTO DES SING MAJ ART/BRNCH C9607,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$9,488.60 ","$15,202.65 ","$4,830.56 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$38,006.61 ","$15,202.65 ","$12,076.40 ","$15,202.65 ","$10,351.20 ","$15,202.65 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$15,202.65 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$15,202.65 ","$17,252.00 ","$9,488.60 ","$15,202.65 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$15,202.65 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100225,C9608,HC CTO DES EA ADD BRNCH MAJ ART C9608,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100226,C9606,HC STEMI/NSTEMI DES SINGL VESSEL C9606,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100230,37241,HC VENOUS EMBO FOR VEIN MALFORMATION 37241,481,1 ,"$12,549.00 ","$8,156.85 ","$3,243.00 ","$23,770.46 ","$23,770.45 ","$5,500.00 ","$6,901.95 ","$9,508.18 ","$3,513.72 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$12,549.00 ","$3,500.00 ","$6,274.50 ","$10,039.20 ","$23,770.46 ","$9,508.18 ","$8,784.30 ","$9,508.18 ","$7,529.40 ","$9,508.18 ","$9,411.75 ","$6,927.05 ","$6,249.40 ","$6,927.05 ","$9,508.18 ","$6,927.05 ","$9,788.22 ","$9,788.22 ","$10,666.65 ","$12,549.00 ","$4,981.00 ","$9,508.18 ","$12,549.00 ","$6,901.95 ","$9,508.18 ","$3,300.39 ","$12,549.00 ","$7,508.52 ","$7,167.23 ","$9,983.59 ","$10,039.20 ","$3,913.45 ","$3,513.72 ","$11,294.10 ","$3,243.00 ","$6,200.00 ","$9,508.18 ","$6,023.52 "
ST. MARY'S HOSPITAL - DECATUR,48100231,37242,HC ARTERIAL EMBO FOR AVM ANER PRE/PST AAA 37242,481,1 ,"$12,549.00 ","$8,156.85 ","$3,243.00 ","$23,770.46 ","$23,770.45 ","$5,500.00 ","$6,901.95 ","$9,508.18 ","$3,513.72 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$12,549.00 ","$3,500.00 ","$6,274.50 ","$10,039.20 ","$23,770.46 ","$9,508.18 ","$8,784.30 ","$9,508.18 ","$7,529.40 ","$9,508.18 ","$9,411.75 ","$6,927.05 ","$6,249.40 ","$6,927.05 ","$9,508.18 ","$6,927.05 ","$9,788.22 ","$9,788.22 ","$10,666.65 ","$12,549.00 ","$4,981.00 ","$9,508.18 ","$12,549.00 ","$6,901.95 ","$9,508.18 ","$3,300.39 ","$12,549.00 ","$7,508.52 ","$7,167.23 ","$9,983.59 ","$10,039.20 ","$3,913.45 ","$3,513.72 ","$11,294.10 ","$3,243.00 ","$6,200.00 ","$9,508.18 ","$6,023.52 "
ST. MARY'S HOSPITAL - DECATUR,48100232,37243,HC EMBOLIZATION OF TUMOR UFE CHEMO 37243,481,1 ,"$13,640.00 ","$8,866.00 ","$3,243.00 ","$23,770.46 ","$23,770.45 ","$5,500.00 ","$7,502.00 ","$9,508.18 ","$3,819.20 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$13,640.00 ","$3,500.00 ","$6,820.00 ","$10,912.00 ","$23,770.46 ","$9,508.18 ","$9,548.00 ","$9,508.18 ","$8,184.00 ","$9,508.18 ","$10,230.00 ","$7,529.28 ","$6,792.72 ","$7,529.28 ","$9,508.18 ","$7,529.28 ", N/A , N/A ,"$11,594.00 ","$13,640.00 ","$4,981.00 ","$9,508.18 ","$13,640.00 ","$7,502.00 ","$9,508.18 ","$3,587.32 ","$13,640.00 ","$7,508.52 ","$7,167.23 ","$9,983.59 ","$10,912.00 ","$3,913.45 ","$3,819.20 ","$12,276.00 ","$3,243.00 ","$6,200.00 ","$9,508.18 ","$6,547.20 "
ST. MARY'S HOSPITAL - DECATUR,48100233,37244,HC EMBOLIZATION FOR HEMORRAGE ART/VEN 37244,481,1 ,"$12,549.00 ","$8,156.85 ","$3,243.00 ","$23,770.46 ","$23,770.45 ","$5,500.00 ","$6,901.95 ","$9,508.18 ","$3,513.72 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$12,549.00 ","$3,500.00 ","$6,274.50 ","$10,039.20 ","$23,770.46 ","$9,508.18 ","$8,784.30 ","$9,508.18 ","$7,529.40 ","$9,508.18 ","$9,411.75 ","$6,927.05 ","$6,249.40 ","$6,927.05 ","$9,508.18 ","$6,927.05 ", N/A , N/A ,"$10,666.65 ","$12,549.00 ","$4,981.00 ","$9,508.18 ","$12,549.00 ","$6,901.95 ","$9,508.18 ","$3,300.39 ","$12,549.00 ","$7,508.52 ","$7,167.23 ","$9,983.59 ","$10,039.20 ","$3,913.45 ","$3,513.72 ","$11,294.10 ","$3,243.00 ","$6,200.00 ","$9,508.18 ","$6,023.52 "
ST. MARY'S HOSPITAL - DECATUR,48100234,37236,HC STENT INIT ARTERY UPPER EXT VISCERAL 37236,481,1 ,"$11,279.00 ","$7,331.35 ","$2,966.38 ","$23,770.46 ","$23,770.45 ","$5,500.00 ","$6,203.45 ","$9,508.18 ","$3,158.12 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$11,279.00 ","$3,500.00 ","$5,639.50 ","$9,023.20 ","$23,770.46 ","$9,508.18 ","$7,895.30 ","$9,508.18 ","$6,767.40 ","$9,508.18 ","$8,459.25 ","$6,226.01 ","$5,616.94 ","$6,226.01 ","$9,508.18 ","$6,226.01 ","$8,797.62 ","$8,797.62 ","$9,587.15 ","$11,279.00 ","$4,981.00 ","$9,508.18 ","$11,279.00 ","$6,203.45 ","$9,508.18 ","$2,966.38 ","$11,279.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$9,023.20 ","$3,913.45 ","$3,158.12 ","$10,151.10 ","$5,594.38 ","$6,200.00 ","$9,508.18 ","$5,413.92 "
ST. MARY'S HOSPITAL - DECATUR,48100235,37237,HC STENT ADDN ARTERY UPPER EXT VISERAL 37237,481,1 ,"$10,212.00 ","$6,637.80 ","$2,685.76 ","$10,212.00 ", N/A ,"$2,800.00 ","$5,616.60 ", N/A ,"$2,859.36 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,106.00 ","$8,169.60 ", N/A , N/A ,"$7,148.40 ", N/A ,"$6,127.20 ", N/A ,"$7,659.00 ","$5,637.02 ","$5,085.58 ","$5,637.02 ", N/A ,"$5,637.02 ","$7,965.36 ","$7,965.36 ","$8,680.20 ", N/A ,"$4,981.00 ", N/A ,"$10,212.00 ","$5,616.60 ", N/A ,"$2,685.76 ","$10,212.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$8,169.60 ","$3,913.45 ","$2,859.36 ","$9,190.80 ","$5,065.15 ","$5,100.00 ", N/A ,"$4,901.76 "
ST. MARY'S HOSPITAL - DECATUR,48100236,37238,HC STENT INIT VENOUS UPPER EXT VISERAL 37238,481,1 ,"$11,995.00 ","$7,796.75 ","$3,154.69 ","$23,770.46 ","$23,770.45 ","$5,500.00 ","$6,597.25 ","$9,508.18 ","$3,358.60 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$11,995.00 ","$3,500.00 ","$5,997.50 ","$9,596.00 ","$23,770.46 ","$9,508.18 ","$8,396.50 ","$9,508.18 ","$7,197.00 ","$9,508.18 ","$8,996.25 ","$6,621.24 ","$5,973.51 ","$6,621.24 ","$9,508.18 ","$6,621.24 ","$9,356.10 ","$9,356.10 ","$10,195.75 ","$11,995.00 ","$4,981.00 ","$9,508.18 ","$11,995.00 ","$6,597.25 ","$9,508.18 ","$3,154.69 ","$11,995.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$9,596.00 ","$3,913.45 ","$3,358.60 ","$10,795.50 ","$5,949.52 ","$6,200.00 ","$9,508.18 ","$5,757.60 "
ST. MARY'S HOSPITAL - DECATUR,48100237,37239,HC STENT ADDN VENOUS UPPER EXT VISERAL 37239,481,1 ,"$10,862.00 ","$7,060.30 ","$2,800.00 ","$10,862.00 ", N/A ,"$2,800.00 ","$5,974.10 ", N/A ,"$3,041.36 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,431.00 ","$8,689.60 ", N/A , N/A ,"$7,603.40 ", N/A ,"$6,517.20 ", N/A ,"$8,146.50 ","$5,995.82 ","$5,409.28 ","$5,995.82 ", N/A ,"$5,995.82 ","$8,472.36 ","$8,472.36 ","$9,232.70 ", N/A ,"$4,981.00 ", N/A ,"$10,862.00 ","$5,974.10 ", N/A ,"$2,856.71 ","$10,862.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$8,689.60 ","$3,913.45 ","$3,041.36 ","$9,775.80 ","$5,387.55 ","$5,100.00 ", N/A ,"$5,213.76 "
ST. MARY'S HOSPITAL - DECATUR,48100238,37217,HC STENT CAROTID OPEN 37217,481,1 ,"$10,857.00 ","$7,057.05 ","$2,034.00 ","$10,857.00 ", N/A ,"$5,500.00 ","$5,971.35 ", N/A ,"$3,039.96 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,428.50 ","$8,685.60 ", N/A , N/A ,"$7,599.90 ", N/A ,"$6,514.20 ", N/A ,"$8,142.75 ","$5,993.06 ","$5,406.79 ","$5,993.06 ", N/A ,"$5,993.06 ","$8,468.46 ","$8,468.46 ","$9,228.45 ", N/A ,"$4,981.00 ", N/A ,"$10,857.00 ","$5,971.35 ", N/A ,"$2,855.39 ","$10,857.00 ", N/A , N/A , N/A ,"$8,685.60 ","$3,913.45 ","$3,039.96 ","$9,771.30 ","$2,641.00 ","$2,034.00 ", N/A ,"$5,211.36 "
ST. MARY'S HOSPITAL - DECATUR,48100263,36902,HC INTRO CATH/CIRCUIT W/ANGIO 36902,481,1 ,"$7,347.00 ","$4,775.55 ","$1,932.26 ","$11,729.16 ","$11,729.15 ","$7,347.00 ","$4,040.85 ","$4,691.66 ","$2,057.16 ","$3,453.09 ","$4,691.66 ","$3,967.38 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$7,347.00 ","$3,500.00 ","$3,673.50 ","$5,877.60 ","$11,729.16 ","$4,691.66 ","$5,142.90 ","$4,691.66 ","$4,408.20 ","$4,691.66 ","$5,510.25 ","$4,055.54 ","$3,658.81 ","$4,055.54 ","$4,691.66 ","$4,055.54 ","$5,730.66 ","$5,730.66 ","$6,244.95 ","$7,347.00 ","$4,981.00 ","$4,691.66 ","$7,347.00 ","$4,040.85 ","$4,691.66 ","$1,932.26 ","$7,347.00 ","$3,461.35 ","$3,304.01 ","$4,926.24 ","$5,877.60 ","$3,913.45 ","$2,057.16 ","$6,612.30 ","$2,861.00 ","$5,100.00 ","$4,691.66 ","$3,526.56 "
ST. MARY'S HOSPITAL - DECATUR,48100264,36905,HC THROMBECTOMY/INFUS CIRCUIT W/ANGIO 36905,481,1 ,"$7,351.00 ","$4,778.15 ","$1,933.31 ","$23,770.46 ","$23,770.45 ","$7,351.00 ","$4,043.05 ","$9,508.18 ","$2,058.28 ","$3,454.97 ","$9,508.18 ","$3,969.54 ","$7,351.00 ","$3,913.45 ","$3,913.45 ","$7,351.00 ","$3,913.45 ","$7,351.00 ","$3,500.00 ","$3,675.50 ","$5,880.80 ","$23,770.46 ","$9,508.18 ","$5,145.70 ","$9,508.18 ","$4,410.60 ","$9,508.18 ","$5,513.25 ","$4,057.75 ","$3,660.80 ","$4,057.75 ","$9,508.18 ","$4,057.75 ","$5,733.78 ","$5,733.78 ","$6,248.35 ","$7,351.00 ","$4,981.00 ","$9,508.18 ","$7,351.00 ","$4,043.05 ","$9,508.18 ","$1,933.31 ","$7,351.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$5,880.80 ","$3,913.45 ","$2,058.28 ","$6,615.90 ","$3,243.00 ","$6,200.00 ","$9,508.18 ","$3,528.48 "
ST. MARY'S HOSPITAL - DECATUR,48100265,36907,HC ANGIOPLASTY CTR DIALYSIS SEGMENT 36907,481,1 ,"$7,347.00 ","$4,775.55 ",$737.00 ,"$7,347.00 ", N/A ,"$2,800.00 ","$4,040.85 ", N/A ,"$2,057.16 ","$3,453.09 ", N/A ,"$3,967.38 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,673.50 ","$5,877.60 ", N/A , N/A ,"$5,142.90 ", N/A ,"$4,408.20 ", N/A ,"$5,510.25 ","$4,055.54 ","$3,658.81 ","$4,055.54 ", N/A ,"$4,055.54 ","$5,730.66 ","$5,730.66 ","$6,244.95 ", N/A ,"$4,981.00 ", N/A ,"$7,347.00 ","$4,040.85 ", N/A ,"$1,932.26 ","$7,347.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$5,877.60 ","$3,913.45 ","$2,057.16 ","$6,612.30 ",$737.00 ,$900.00 , N/A ,"$3,526.56 "
ST. MARY'S HOSPITAL - DECATUR,48100266,37246,HC ANGIOPLASTY TRANLUM BALN INIT ARTERY 37246,481,1 ,"$4,427.00 ","$2,877.55 ","$1,164.30 ","$11,729.16 ","$11,729.15 ","$4,427.00 ","$2,434.85 ","$4,691.66 ","$1,239.56 ","$2,080.69 ","$4,691.66 ","$2,390.58 ","$4,427.00 ","$2,403.86 ","$2,403.86 ","$4,427.00 ","$2,403.86 ","$4,427.00 ","$3,098.90 ","$2,213.50 ","$3,541.60 ","$11,729.16 ","$4,691.66 ","$3,098.90 ","$4,691.66 ","$2,656.20 ","$4,691.66 ","$3,320.25 ","$2,443.70 ","$2,204.65 ","$2,443.70 ","$4,691.66 ","$2,443.70 ", N/A , N/A ,"$3,762.95 ","$4,427.00 ","$3,067.91 ","$4,691.66 ","$4,427.00 ","$2,434.85 ","$4,691.66 ","$1,164.30 ","$4,427.00 ","$3,461.35 ","$3,304.01 ","$4,926.24 ","$3,541.60 ","$2,403.86 ","$1,239.56 ","$3,984.30 ","$2,861.00 ","$4,427.00 ","$4,691.66 ","$2,124.96 "
ST. MARY'S HOSPITAL - DECATUR,48100267,37247,HC ANGIOPLASTY TRANLUM BALN ADDL ARTERY 37247,481,1 ,"$3,443.00 ","$2,237.95 ",$737.00 ,"$3,443.00 ", N/A ,"$2,800.00 ","$1,893.65 ", N/A ,$964.04 ,"$1,618.21 ", N/A ,"$1,859.22 ", N/A ,"$1,869.55 ","$1,869.55 ", N/A ,"$1,869.55 ", N/A ,"$2,410.10 ","$1,721.50 ","$2,754.40 ", N/A , N/A ,"$2,410.10 ", N/A ,"$2,065.80 ", N/A ,"$2,582.25 ","$1,900.54 ","$1,714.61 ","$1,900.54 ", N/A ,"$1,900.54 ", N/A , N/A ,"$2,926.55 ", N/A ,"$2,386.00 ", N/A ,"$3,443.00 ","$1,893.65 ", N/A ,$905.51 ,"$3,443.00 ","$3,443.00 ","$3,304.01 ", N/A ,"$2,754.40 ","$1,869.55 ",$964.04 ,"$3,098.70 ",$737.00 ,$900.00 , N/A ,"$1,652.64 "
ST. MARY'S HOSPITAL - DECATUR,48100268,37248,HC ANGIOPLASTY TRANLUM BALN INIT VEIN 37248,481,1 ,"$2,896.00 ","$1,882.40 ",$761.65 ,"$11,729.16 ","$11,729.15 ","$2,896.00 ","$1,592.80 ","$4,691.66 ",$810.88 ,"$1,361.12 ","$4,691.66 ","$1,563.84 ","$2,896.00 ","$1,572.53 ","$1,572.53 ","$2,896.00 ","$1,572.53 ","$2,896.00 ","$2,027.20 ","$1,448.00 ","$2,316.80 ","$11,729.16 ","$4,691.66 ","$2,027.20 ","$4,691.66 ","$1,737.60 ","$4,691.66 ","$2,172.00 ","$1,598.59 ","$1,442.21 ","$1,598.59 ","$4,691.66 ","$1,598.59 ", N/A , N/A ,"$2,461.60 ","$2,896.00 ","$2,006.93 ","$4,691.66 ","$2,896.00 ","$1,592.80 ","$4,691.66 ",$761.65 ,"$2,896.00 ","$2,896.00 ","$3,304.01 ","$4,926.24 ","$2,316.80 ","$1,572.53 ",$810.88 ,"$2,606.40 ","$2,861.00 ","$2,896.00 ","$4,691.66 ","$1,390.08 "
ST. MARY'S HOSPITAL - DECATUR,48100269,37249,HC ANGIOPLASTY TRANLUM BALN ADDL VEIN 37249,481,1 ,"$2,896.00 ","$1,882.40 ",$737.00 ,"$3,304.01 ", N/A ,"$2,800.00 ","$1,592.80 ", N/A ,$810.88 ,"$1,361.12 ", N/A ,"$1,563.84 ", N/A ,"$1,572.53 ","$1,572.53 ", N/A ,"$1,572.53 ", N/A ,"$2,027.20 ","$1,448.00 ","$2,316.80 ", N/A , N/A ,"$2,027.20 ", N/A ,"$1,737.60 ", N/A ,"$2,172.00 ","$1,598.59 ","$1,442.21 ","$1,598.59 ", N/A ,"$1,598.59 ", N/A , N/A ,"$2,461.60 ", N/A ,"$2,006.93 ", N/A ,"$2,896.00 ","$1,592.80 ", N/A ,$761.65 ,"$2,896.00 ","$2,896.00 ","$3,304.01 ", N/A ,"$2,316.80 ","$1,572.53 ",$810.88 ,"$2,606.40 ",$737.00 ,$900.00 , N/A ,"$1,390.08 "
ST. MARY'S HOSPITAL - DECATUR,48100270,36908,HC PLACE STENT CENTRAL DIAL SEGMENT 36908,481,1 ,"$14,546.00 ","$9,454.90 ",$737.00 ,"$14,546.00 ", N/A ,"$2,800.00 ","$8,000.30 ", N/A ,"$4,072.88 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$7,273.00 ","$11,636.80 ", N/A , N/A ,"$10,182.20 ", N/A ,"$8,727.60 ", N/A ,"$10,909.50 ","$8,029.39 ","$7,243.91 ","$8,029.39 ", N/A ,"$8,029.39 ","$11,345.88 ","$11,345.88 ","$12,364.10 ", N/A ,"$4,981.00 ", N/A ,"$14,546.00 ","$8,000.30 ", N/A ,"$3,825.60 ","$14,546.00 ","$3,461.35 ","$3,304.01 ", N/A ,"$11,636.80 ","$3,913.45 ","$4,072.88 ","$13,091.40 ",$737.00 ,$900.00 , N/A ,"$6,982.08 "
ST. MARY'S HOSPITAL - DECATUR,48100271,36909,HC DIAL CIRCUIT VASC EMBOL/OCCUL 36909,481,1 ,"$12,354.00 ","$8,030.10 ",$737.00 ,"$12,354.00 ", N/A ,"$2,800.00 ","$6,794.70 ", N/A ,"$3,459.12 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$6,177.00 ","$9,883.20 ", N/A , N/A ,"$8,647.80 ", N/A ,"$7,412.40 ", N/A ,"$9,265.50 ","$6,819.41 ","$6,152.29 ","$6,819.41 ", N/A ,"$6,819.41 ","$9,636.12 ","$9,636.12 ","$10,500.90 ", N/A ,"$4,981.00 ", N/A ,"$12,354.00 ","$6,794.70 ", N/A ,"$3,249.10 ","$12,354.00 ","$2,784.85 ","$2,658.26 ", N/A ,"$9,883.20 ","$3,913.45 ","$3,459.12 ","$11,118.60 ",$737.00 ,$900.00 , N/A ,"$5,929.92 "
ST. MARY'S HOSPITAL - DECATUR,48100272,36901,HC INTRO CATH DIALYSIS CIRCUIT 36901,481,1 ,"$2,908.00 ","$1,890.20 ",$764.80 ,"$3,327.80 ","$3,327.80 ","$2,800.00 ","$1,599.40 ","$1,331.12 ",$814.24 ,"$1,366.76 ","$1,331.12 ","$1,570.32 ","$1,331.12 ","$1,579.04 ","$1,579.04 ","$1,331.12 ","$1,579.04 ","$2,529.13 ","$2,035.60 ","$1,454.00 ","$2,326.40 ","$3,327.80 ","$1,331.12 ","$2,035.60 ","$1,331.12 ","$1,744.80 ","$1,331.12 ","$2,181.00 ","$1,605.22 ","$1,448.18 ","$1,605.22 ","$1,331.12 ","$1,605.22 ","$2,268.24 ","$2,268.24 ","$2,471.80 ","$2,908.00 ","$2,015.24 ","$1,331.12 ","$2,908.00 ","$1,599.40 ","$1,331.12 ",$764.80 ,"$2,908.00 ","$2,179.58 ","$2,080.51 ","$1,397.68 ","$2,326.40 ","$1,579.04 ",$814.24 ,"$2,617.20 ","$1,795.00 ","$2,100.00 ","$1,331.12 ","$1,395.84 "
ST. MARY'S HOSPITAL - DECATUR,48100273,36903,HC INTRO CATH/CIRCUIT W/STENT 36903,481,1 ,"$17,388.00 ","$11,302.20 ","$3,243.00 ","$23,770.46 ","$23,770.45 ","$12,000.00 ","$9,563.40 ","$9,508.18 ","$4,868.64 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$17,388.00 ","$3,500.00 ","$8,694.00 ","$13,910.40 ","$23,770.46 ","$9,508.18 ","$12,171.60 ","$9,508.18 ","$10,432.80 ","$9,508.18 ","$13,041.00 ","$9,598.18 ","$8,659.22 ","$9,598.18 ","$9,508.18 ","$9,598.18 ","$13,562.64 ","$13,562.64 ","$14,779.80 ","$17,388.00 ","$4,981.00 ","$9,508.18 ","$17,388.00 ","$9,563.40 ","$9,508.18 ","$4,573.04 ","$17,388.00 ","$3,461.35 ","$3,304.01 ","$9,983.59 ","$13,910.40 ","$3,913.45 ","$4,868.64 ","$15,649.20 ","$3,243.00 ","$6,200.00 ","$9,508.18 ","$8,346.24 "
ST. MARY'S HOSPITAL - DECATUR,48100274,36904,HC THROMBECTOMY/INFUS DIALYSIS CIRCUIT 36904,481,1 ,"$7,024.00 ","$4,565.60 ","$1,847.31 ","$11,729.16 ","$11,729.15 ","$7,024.00 ","$3,863.20 ","$4,691.66 ","$1,966.72 ","$3,301.28 ","$4,691.66 ","$3,792.96 ","$4,691.66 ","$3,814.03 ","$3,814.03 ","$4,691.66 ","$3,814.03 ","$7,024.00 ","$3,500.00 ","$3,512.00 ","$5,619.20 ","$11,729.16 ","$4,691.66 ","$4,916.80 ","$4,691.66 ","$4,214.40 ","$4,691.66 ","$5,268.00 ","$3,877.25 ","$3,497.95 ","$3,877.25 ","$4,691.66 ","$3,877.25 ","$5,478.72 ","$5,478.72 ","$5,970.40 ","$7,024.00 ","$4,867.63 ","$4,691.66 ","$7,024.00 ","$3,863.20 ","$4,691.66 ","$1,847.31 ","$7,024.00 ","$3,461.35 ","$3,304.01 ","$4,926.24 ","$5,619.20 ","$3,814.03 ","$1,966.72 ","$6,321.60 ","$2,861.00 ","$5,100.00 ","$4,691.66 ","$3,371.52 "
ST. MARY'S HOSPITAL - DECATUR,48100275,36906,HC THROMBECTOMY/INFUS CIRCUIT W/STENT 36906,481,1 ,"$12,152.00 ","$7,898.80 ","$3,195.98 ","$38,006.63 ","$38,006.63 ","$12,000.00 ","$6,683.60 ","$15,202.65 ","$3,402.56 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$12,152.00 ","$3,913.45 ","$3,913.45 ","$12,152.00 ","$3,913.45 ","$12,152.00 ","$3,500.00 ","$6,076.00 ","$9,721.60 ","$38,006.61 ","$15,202.65 ","$8,506.40 ","$15,202.65 ","$7,291.20 ","$15,202.65 ","$9,114.00 ","$6,707.90 ","$6,051.70 ","$6,707.90 ","$15,202.65 ","$6,707.90 ","$9,478.56 ","$9,478.56 ","$10,329.20 ","$12,152.00 ","$4,981.00 ","$15,202.65 ","$12,152.00 ","$6,683.60 ","$15,202.65 ","$3,195.98 ","$12,152.00 ","$3,461.35 ","$3,304.01 ","$15,962.78 ","$9,721.60 ","$3,913.45 ","$3,402.56 ","$10,936.80 ","$4,257.00 ","$8,200.00 ","$15,202.65 ","$5,832.96 "
ST. MARY'S HOSPITAL - DECATUR,48100277,93288,HC INTERROG DEVICE EVAL PACEMAKER SYSTEM,481,1 ,$288.00 ,$187.20 ,$28.23 ,$288.00 ,$88.13 ,$146.88 ,$158.40 ,$35.25 ,$80.64 ,$135.36 ,$35.25 ,$155.52 ,$35.25 ,$156.38 ,$156.38 ,$35.25 ,$156.38 ,$66.97 ,$201.60 ,$144.00 ,$230.40 ,$88.12 ,$35.25 ,$201.60 ,$35.25 ,$172.80 ,$35.25 ,$216.00 ,$158.98 ,$143.42 ,$158.98 ,$35.25 ,$158.98 ,$224.64 ,$224.64 ,$244.80 ,$88.12 ,$199.58 ,$35.25 ,$288.00 ,$158.40 ,$35.25 ,$75.74 ,$288.00 ,$29.58 ,$28.23 ,$37.01 ,$230.40 ,$156.38 ,$80.64 ,$259.20 , N/A , N/A ,$35.25 ,$138.24 
ST. MARY'S HOSPITAL - DECATUR,48100278,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-LC,480,1 ,"$4,400.00 ","$2,860.00 ",$289.34 ,"$4,400.00 ", N/A ,"$2,244.00 ","$2,420.00 ", N/A ,"$1,232.00 ","$2,156.00 ", N/A ,"$2,574.00 ", N/A ,"$2,389.20 ",$289.34 , N/A ,"$2,389.20 ", N/A ,"$3,080.00 ","$2,200.00 ","$3,520.00 ", N/A , N/A ,"$3,080.00 ", N/A ,"$2,640.00 ", N/A ,"$3,300.00 ","$2,428.80 ","$2,191.20 ","$2,428.80 ", N/A ,"$2,428.80 ","$3,432.00 ","$3,432.00 ","$3,740.00 ", N/A ,"$3,049.20 ", N/A ,"$4,400.00 ","$2,420.00 ", N/A ,"$1,157.20 ","$4,400.00 ", N/A , N/A , N/A ,"$3,520.00 ","$2,389.20 ","$1,232.00 ","$3,960.00 ","$1,672.00 ","$1,025.00 ", N/A ,"$2,112.00 "
ST. MARY'S HOSPITAL - DECATUR,48100279,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-LD,480,1 ,"$4,400.00 ","$2,860.00 ",$289.34 ,"$4,400.00 ", N/A ,"$2,244.00 ","$2,420.00 ", N/A ,"$1,232.00 ","$2,156.00 ", N/A ,"$2,574.00 ", N/A ,"$2,389.20 ",$289.34 , N/A ,"$2,389.20 ", N/A ,"$3,080.00 ","$2,200.00 ","$3,520.00 ", N/A , N/A ,"$3,080.00 ", N/A ,"$2,640.00 ", N/A ,"$3,300.00 ","$2,428.80 ","$2,191.20 ","$2,428.80 ", N/A ,"$2,428.80 ","$3,432.00 ","$3,432.00 ","$3,740.00 ", N/A ,"$3,049.20 ", N/A ,"$4,400.00 ","$2,420.00 ", N/A ,"$1,157.20 ","$4,400.00 ", N/A , N/A , N/A ,"$3,520.00 ","$2,389.20 ","$1,232.00 ","$3,960.00 ","$1,672.00 ","$1,025.00 ", N/A ,"$2,112.00 "
ST. MARY'S HOSPITAL - DECATUR,48100280,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-LM,480,1 ,"$4,400.00 ","$2,860.00 ",$289.34 ,"$4,400.00 ", N/A ,"$2,244.00 ","$2,420.00 ", N/A ,"$1,232.00 ","$2,156.00 ", N/A ,"$2,574.00 ", N/A ,"$2,389.20 ",$289.34 , N/A ,"$2,389.20 ", N/A ,"$3,080.00 ","$2,200.00 ","$3,520.00 ", N/A , N/A ,"$3,080.00 ", N/A ,"$2,640.00 ", N/A ,"$3,300.00 ","$2,428.80 ","$2,191.20 ","$2,428.80 ", N/A ,"$2,428.80 ","$3,432.00 ","$3,432.00 ","$3,740.00 ", N/A ,"$3,049.20 ", N/A ,"$4,400.00 ","$2,420.00 ", N/A ,"$1,157.20 ","$4,400.00 ", N/A , N/A , N/A ,"$3,520.00 ","$2,389.20 ","$1,232.00 ","$3,960.00 ","$1,672.00 ","$1,025.00 ", N/A ,"$2,112.00 "
ST. MARY'S HOSPITAL - DECATUR,48100281,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-RC,480,1 ,"$4,400.00 ","$2,860.00 ",$289.34 ,"$4,400.00 ", N/A ,"$2,244.00 ","$2,420.00 ", N/A ,"$1,232.00 ","$2,156.00 ", N/A ,"$2,574.00 ", N/A ,"$2,389.20 ",$289.34 , N/A ,"$2,389.20 ", N/A ,"$3,080.00 ","$2,200.00 ","$3,520.00 ", N/A , N/A ,"$3,080.00 ", N/A ,"$2,640.00 ", N/A ,"$3,300.00 ","$2,428.80 ","$2,191.20 ","$2,428.80 ", N/A ,"$2,428.80 ","$3,432.00 ","$3,432.00 ","$3,740.00 ", N/A ,"$3,049.20 ", N/A ,"$4,400.00 ","$2,420.00 ", N/A ,"$1,157.20 ","$4,400.00 ", N/A , N/A , N/A ,"$3,520.00 ","$2,389.20 ","$1,232.00 ","$3,960.00 ","$1,672.00 ","$1,025.00 ", N/A ,"$2,112.00 "
ST. MARY'S HOSPITAL - DECATUR,48100282,93571,HC INTRVASC DOPP COLOR FLOW INIT VSL-RI,480,1 ,"$4,400.00 ","$2,860.00 ",$289.34 ,"$4,400.00 ", N/A ,"$2,244.00 ","$2,420.00 ", N/A ,"$1,232.00 ","$2,156.00 ", N/A ,"$2,574.00 ", N/A ,"$2,389.20 ",$289.34 , N/A ,"$2,389.20 ", N/A ,"$3,080.00 ","$2,200.00 ","$3,520.00 ", N/A , N/A ,"$3,080.00 ", N/A ,"$2,640.00 ", N/A ,"$3,300.00 ","$2,428.80 ","$2,191.20 ","$2,428.80 ", N/A ,"$2,428.80 ","$3,432.00 ","$3,432.00 ","$3,740.00 ", N/A ,"$3,049.20 ", N/A ,"$4,400.00 ","$2,420.00 ", N/A ,"$1,157.20 ","$4,400.00 ", N/A , N/A , N/A ,"$3,520.00 ","$2,389.20 ","$1,232.00 ","$3,960.00 ","$1,672.00 ","$1,025.00 ", N/A ,"$2,112.00 "
ST. MARY'S HOSPITAL - DECATUR,48100283,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-LC,481,1 ,"$2,488.00 ","$1,617.20 ",$654.34 ,"$2,488.00 ", N/A ,"$1,268.88 ","$1,368.40 ", N/A ,$696.64 ,"$1,169.36 ", N/A ,"$1,343.52 ", N/A ,"$1,350.98 ","$1,350.98 ", N/A ,"$1,350.98 ", N/A ,"$1,741.60 ","$1,244.00 ","$1,990.40 ", N/A , N/A ,"$1,741.60 ", N/A ,"$1,492.80 ", N/A ,"$1,866.00 ","$1,373.38 ","$1,239.02 ","$1,373.38 ", N/A ,"$1,373.38 ","$1,940.64 ","$1,940.64 ","$2,114.80 ", N/A ,"$1,724.18 ", N/A ,"$2,488.00 ","$1,368.40 ", N/A ,$654.34 ,"$2,488.00 ", N/A , N/A , N/A ,"$1,990.40 ","$1,350.98 ",$696.64 ,"$2,239.20 ","$1,234.05 ",$900.00 , N/A ,"$1,194.24 "
ST. MARY'S HOSPITAL - DECATUR,48100284,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-LD,481,1 ,"$2,488.00 ","$1,617.20 ",$654.34 ,"$2,488.00 ", N/A ,"$1,268.88 ","$1,368.40 ", N/A ,$696.64 ,"$1,169.36 ", N/A ,"$1,343.52 ", N/A ,"$1,350.98 ","$1,350.98 ", N/A ,"$1,350.98 ", N/A ,"$1,741.60 ","$1,244.00 ","$1,990.40 ", N/A , N/A ,"$1,741.60 ", N/A ,"$1,492.80 ", N/A ,"$1,866.00 ","$1,373.38 ","$1,239.02 ","$1,373.38 ", N/A ,"$1,373.38 ","$1,940.64 ","$1,940.64 ","$2,114.80 ", N/A ,"$1,724.18 ", N/A ,"$2,488.00 ","$1,368.40 ", N/A ,$654.34 ,"$2,488.00 ", N/A , N/A , N/A ,"$1,990.40 ","$1,350.98 ",$696.64 ,"$2,239.20 ","$1,234.05 ",$900.00 , N/A ,"$1,194.24 "
ST. MARY'S HOSPITAL - DECATUR,48100285,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-LM,481,1 ,"$2,488.00 ","$1,617.20 ",$654.34 ,"$2,488.00 ", N/A ,"$1,268.88 ","$1,368.40 ", N/A ,$696.64 ,"$1,169.36 ", N/A ,"$1,343.52 ", N/A ,"$1,350.98 ","$1,350.98 ", N/A ,"$1,350.98 ", N/A ,"$1,741.60 ","$1,244.00 ","$1,990.40 ", N/A , N/A ,"$1,741.60 ", N/A ,"$1,492.80 ", N/A ,"$1,866.00 ","$1,373.38 ","$1,239.02 ","$1,373.38 ", N/A ,"$1,373.38 ","$1,940.64 ","$1,940.64 ","$2,114.80 ", N/A ,"$1,724.18 ", N/A ,"$2,488.00 ","$1,368.40 ", N/A ,$654.34 ,"$2,488.00 ", N/A , N/A , N/A ,"$1,990.40 ","$1,350.98 ",$696.64 ,"$2,239.20 ","$1,234.05 ",$900.00 , N/A ,"$1,194.24 "
ST. MARY'S HOSPITAL - DECATUR,48100286,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-RC,481,1 ,"$2,488.00 ","$1,617.20 ",$654.34 ,"$2,488.00 ", N/A ,"$1,268.88 ","$1,368.40 ", N/A ,$696.64 ,"$1,169.36 ", N/A ,"$1,343.52 ", N/A ,"$1,350.98 ","$1,350.98 ", N/A ,"$1,350.98 ", N/A ,"$1,741.60 ","$1,244.00 ","$1,990.40 ", N/A , N/A ,"$1,741.60 ", N/A ,"$1,492.80 ", N/A ,"$1,866.00 ","$1,373.38 ","$1,239.02 ","$1,373.38 ", N/A ,"$1,373.38 ","$1,940.64 ","$1,940.64 ","$2,114.80 ", N/A ,"$1,724.18 ", N/A ,"$2,488.00 ","$1,368.40 ", N/A ,$654.34 ,"$2,488.00 ", N/A , N/A , N/A ,"$1,990.40 ","$1,350.98 ",$696.64 ,"$2,239.20 ","$1,234.05 ",$900.00 , N/A ,"$1,194.24 "
ST. MARY'S HOSPITAL - DECATUR,48100287,93572,HC INTRVASC DOPP COLOR FLOW ADDL VSL-RI,481,1 ,"$2,488.00 ","$1,617.20 ",$654.34 ,"$2,488.00 ", N/A ,"$1,268.88 ","$1,368.40 ", N/A ,$696.64 ,"$1,169.36 ", N/A ,"$1,343.52 ", N/A ,"$1,350.98 ","$1,350.98 ", N/A ,"$1,350.98 ", N/A ,"$1,741.60 ","$1,244.00 ","$1,990.40 ", N/A , N/A ,"$1,741.60 ", N/A ,"$1,492.80 ", N/A ,"$1,866.00 ","$1,373.38 ","$1,239.02 ","$1,373.38 ", N/A ,"$1,373.38 ","$1,940.64 ","$1,940.64 ","$2,114.80 ", N/A ,"$1,724.18 ", N/A ,"$2,488.00 ","$1,368.40 ", N/A ,$654.34 ,"$2,488.00 ", N/A , N/A , N/A ,"$1,990.40 ","$1,350.98 ",$696.64 ,"$2,239.20 ","$1,234.05 ",$900.00 , N/A ,"$1,194.24 "
ST. MARY'S HOSPITAL - DECATUR,48100288,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-LC,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100289,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-LD,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100290,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-LM,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100291,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-RC,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100292,C9600,HC PLACE PERC COR STENT DRUG ELUT SINGLE-RI,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100293,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-LC,481,1 ,"$11,419.00 ","$7,422.35 ","$3,003.20 ","$11,419.00 ", N/A ,"$7,500.00 ","$6,280.45 ", N/A ,"$3,197.32 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,709.50 ","$9,135.20 ", N/A , N/A ,"$7,993.30 ", N/A ,"$6,851.40 ", N/A ,"$8,564.25 ","$6,303.29 ","$5,686.66 ","$6,303.29 ", N/A ,"$6,303.29 ","$8,906.82 ","$8,906.82 ","$9,706.15 ", N/A ,"$4,981.00 ", N/A ,"$11,419.00 ","$6,280.45 ", N/A ,"$3,003.20 ","$11,419.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$9,135.20 ","$3,913.45 ","$3,197.32 ","$10,277.10 ","$5,663.82 ","$11,419.00 ", N/A ,"$5,481.12 "
ST. MARY'S HOSPITAL - DECATUR,48100294,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-LD,481,1 ,"$11,419.00 ","$7,422.35 ","$3,003.20 ","$11,419.00 ", N/A ,"$7,500.00 ","$6,280.45 ", N/A ,"$3,197.32 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,709.50 ","$9,135.20 ", N/A , N/A ,"$7,993.30 ", N/A ,"$6,851.40 ", N/A ,"$8,564.25 ","$6,303.29 ","$5,686.66 ","$6,303.29 ", N/A ,"$6,303.29 ","$8,906.82 ","$8,906.82 ","$9,706.15 ", N/A ,"$4,981.00 ", N/A ,"$11,419.00 ","$6,280.45 ", N/A ,"$3,003.20 ","$11,419.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$9,135.20 ","$3,913.45 ","$3,197.32 ","$10,277.10 ","$5,663.82 ","$11,419.00 ", N/A ,"$5,481.12 "
ST. MARY'S HOSPITAL - DECATUR,48100295,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-LM,481,1 ,"$11,419.00 ","$7,422.35 ","$3,003.20 ","$11,419.00 ", N/A ,"$7,500.00 ","$6,280.45 ", N/A ,"$3,197.32 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,709.50 ","$9,135.20 ", N/A , N/A ,"$7,993.30 ", N/A ,"$6,851.40 ", N/A ,"$8,564.25 ","$6,303.29 ","$5,686.66 ","$6,303.29 ", N/A ,"$6,303.29 ","$8,906.82 ","$8,906.82 ","$9,706.15 ", N/A ,"$4,981.00 ", N/A ,"$11,419.00 ","$6,280.45 ", N/A ,"$3,003.20 ","$11,419.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$9,135.20 ","$3,913.45 ","$3,197.32 ","$10,277.10 ","$5,663.82 ","$11,419.00 ", N/A ,"$5,481.12 "
ST. MARY'S HOSPITAL - DECATUR,48100296,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-RC,481,1 ,"$11,419.00 ","$7,422.35 ","$3,003.20 ","$11,419.00 ", N/A ,"$7,500.00 ","$6,280.45 ", N/A ,"$3,197.32 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,709.50 ","$9,135.20 ", N/A , N/A ,"$7,993.30 ", N/A ,"$6,851.40 ", N/A ,"$8,564.25 ","$6,303.29 ","$5,686.66 ","$6,303.29 ", N/A ,"$6,303.29 ","$8,906.82 ","$8,906.82 ","$9,706.15 ", N/A ,"$4,981.00 ", N/A ,"$11,419.00 ","$6,280.45 ", N/A ,"$3,003.20 ","$11,419.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$9,135.20 ","$3,913.45 ","$3,197.32 ","$10,277.10 ","$5,663.82 ","$11,419.00 ", N/A ,"$5,481.12 "
ST. MARY'S HOSPITAL - DECATUR,48100297,C9601,HC PLACE PERC COR STENT DRUG ELUT EA ADDL-RI,481,1 ,"$11,419.00 ","$7,422.35 ","$3,003.20 ","$11,419.00 ", N/A ,"$7,500.00 ","$6,280.45 ", N/A ,"$3,197.32 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,709.50 ","$9,135.20 ", N/A , N/A ,"$7,993.30 ", N/A ,"$6,851.40 ", N/A ,"$8,564.25 ","$6,303.29 ","$5,686.66 ","$6,303.29 ", N/A ,"$6,303.29 ","$8,906.82 ","$8,906.82 ","$9,706.15 ", N/A ,"$4,981.00 ", N/A ,"$11,419.00 ","$6,280.45 ", N/A ,"$3,003.20 ","$11,419.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$9,135.20 ","$3,913.45 ","$3,197.32 ","$10,277.10 ","$5,663.82 ","$11,419.00 ", N/A ,"$5,481.12 "
ST. MARY'S HOSPITAL - DECATUR,48100298,92943,HC PERC TRANSL REVASC OCCL SGL VSL-LC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$9,488.60 ","$9,508.18 ","$4,830.56 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$23,770.46 ","$9,508.18 ","$12,076.40 ","$9,508.18 ","$10,351.20 ","$9,508.18 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$9,508.18 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$9,508.18 ","$17,252.00 ","$9,488.60 ","$9,508.18 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$9,508.18 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100299,92943,HC PERC TRANSL REVASC OCCL SGL VSL-LD,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$9,488.60 ","$9,508.18 ","$4,830.56 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$23,770.46 ","$9,508.18 ","$12,076.40 ","$9,508.18 ","$10,351.20 ","$9,508.18 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$9,508.18 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$9,508.18 ","$17,252.00 ","$9,488.60 ","$9,508.18 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$9,508.18 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100300,92943,HC PERC TRANSL REVASC OCCL SGL VSL-LM,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$9,488.60 ","$9,508.18 ","$4,830.56 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$23,770.46 ","$9,508.18 ","$12,076.40 ","$9,508.18 ","$10,351.20 ","$9,508.18 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$9,508.18 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$9,508.18 ","$17,252.00 ","$9,488.60 ","$9,508.18 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$9,508.18 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100301,92943,HC PERC TRANSL REVASC OCCL SGL VSL-RC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$9,488.60 ","$9,508.18 ","$4,830.56 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$23,770.46 ","$9,508.18 ","$12,076.40 ","$9,508.18 ","$10,351.20 ","$9,508.18 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$9,508.18 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$9,508.18 ","$17,252.00 ","$9,488.60 ","$9,508.18 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$9,508.18 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100302,92943,HC PERC TRANSL REVASC OCCL SGL VSL-RI,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$9,488.60 ","$9,508.18 ","$4,830.56 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$23,770.46 ","$9,508.18 ","$12,076.40 ","$9,508.18 ","$10,351.20 ","$9,508.18 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$9,508.18 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$9,508.18 ","$17,252.00 ","$9,488.60 ","$9,508.18 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$9,508.18 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100303,92944,HC PERC TRANSL REVASC OCCL EA ADL-LC,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100304,92944,HC PERC TRANSL REVASC OCCL EA ADL-LD,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100305,92944,HC PERC TRANSL REVASC OCCL EA ADL-LM,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100306,92944,HC PERC TRANSL REVASC OCCL EA ADL-RC,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100307,92944,HC PERC TRANSL REVASC OCCL EA ADL-RI,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100308,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-LC,481,1 ,"$25,691.00 ","$16,699.15 ","$3,500.00 ","$25,691.00 ","$23,770.45 ","$7,500.00 ","$14,130.05 ","$9,508.18 ","$7,193.48 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,845.50 ","$20,552.80 ","$23,770.46 ","$9,508.18 ","$17,983.70 ","$9,508.18 ","$15,414.60 ","$9,508.18 ","$19,268.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$20,038.98 ","$20,038.98 ","$21,837.35 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$25,691.00 ","$14,130.05 ","$9,508.18 ","$6,756.73 ","$25,691.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$20,552.80 ","$3,913.45 ","$7,193.48 ","$23,121.90 ","$12,742.74 ","$20,000.00 ","$9,508.18 ","$12,331.68 "
ST. MARY'S HOSPITAL - DECATUR,48100309,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-LD,481,1 ,"$25,691.00 ","$16,699.15 ","$3,500.00 ","$25,691.00 ","$23,770.45 ","$7,500.00 ","$14,130.05 ","$9,508.18 ","$7,193.48 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,845.50 ","$20,552.80 ","$23,770.46 ","$9,508.18 ","$17,983.70 ","$9,508.18 ","$15,414.60 ","$9,508.18 ","$19,268.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$20,038.98 ","$20,038.98 ","$21,837.35 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$25,691.00 ","$14,130.05 ","$9,508.18 ","$6,756.73 ","$25,691.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$20,552.80 ","$3,913.45 ","$7,193.48 ","$23,121.90 ","$12,742.74 ","$20,000.00 ","$9,508.18 ","$12,331.68 "
ST. MARY'S HOSPITAL - DECATUR,48100310,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-LM,481,1 ,"$25,691.00 ","$16,699.15 ","$3,500.00 ","$25,691.00 ","$23,770.45 ","$7,500.00 ","$14,130.05 ","$9,508.18 ","$7,193.48 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,845.50 ","$20,552.80 ","$23,770.46 ","$9,508.18 ","$17,983.70 ","$9,508.18 ","$15,414.60 ","$9,508.18 ","$19,268.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$20,038.98 ","$20,038.98 ","$21,837.35 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$25,691.00 ","$14,130.05 ","$9,508.18 ","$6,756.73 ","$25,691.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$20,552.80 ","$3,913.45 ","$7,193.48 ","$23,121.90 ","$12,742.74 ","$20,000.00 ","$9,508.18 ","$12,331.68 "
ST. MARY'S HOSPITAL - DECATUR,48100311,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-RC,481,1 ,"$25,691.00 ","$16,699.15 ","$3,500.00 ","$25,691.00 ","$23,770.45 ","$7,500.00 ","$14,130.05 ","$9,508.18 ","$7,193.48 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,845.50 ","$20,552.80 ","$23,770.46 ","$9,508.18 ","$17,983.70 ","$9,508.18 ","$15,414.60 ","$9,508.18 ","$19,268.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$20,038.98 ","$20,038.98 ","$21,837.35 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$25,691.00 ","$14,130.05 ","$9,508.18 ","$6,756.73 ","$25,691.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$20,552.80 ","$3,913.45 ","$7,193.48 ","$23,121.90 ","$12,742.74 ","$20,000.00 ","$9,508.18 ","$12,331.68 "
ST. MARY'S HOSPITAL - DECATUR,48100312,92937,HC PERC TRANSL REVASC GRAFT SGL VSL-RI,481,1 ,"$25,691.00 ","$16,699.15 ","$3,500.00 ","$25,691.00 ","$23,770.45 ","$7,500.00 ","$14,130.05 ","$9,508.18 ","$7,193.48 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,845.50 ","$20,552.80 ","$23,770.46 ","$9,508.18 ","$17,983.70 ","$9,508.18 ","$15,414.60 ","$9,508.18 ","$19,268.25 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$20,038.98 ","$20,038.98 ","$21,837.35 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$25,691.00 ","$14,130.05 ","$9,508.18 ","$6,756.73 ","$25,691.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$20,552.80 ","$3,913.45 ","$7,193.48 ","$23,121.90 ","$12,742.74 ","$20,000.00 ","$9,508.18 ","$12,331.68 "
ST. MARY'S HOSPITAL - DECATUR,48100313,92938,HC PERC TRANSL REVASC GRAFT EA AD-LC,481,1 ,"$18,063.00 ","$11,740.95 ","$3,500.00 ","$18,063.00 ", N/A ,"$7,500.00 ","$9,934.65 ", N/A ,"$5,057.64 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,031.50 ","$14,450.40 ", N/A , N/A ,"$12,644.10 ", N/A ,"$10,837.80 ", N/A ,"$13,547.25 ","$9,970.78 ","$8,995.37 ","$9,970.78 ", N/A ,"$9,970.78 ","$14,089.14 ","$14,089.14 ","$15,353.55 ", N/A ,"$4,981.00 ", N/A ,"$18,063.00 ","$9,934.65 ", N/A ,"$4,750.57 ","$18,063.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$14,450.40 ","$3,913.45 ","$5,057.64 ","$16,256.70 ","$8,959.25 ","$18,063.00 ", N/A ,"$8,670.24 "
ST. MARY'S HOSPITAL - DECATUR,48100314,92938,HC PERC TRANSL REVASC GRAFT EA AD-LD,481,1 ,"$18,063.00 ","$11,740.95 ","$3,500.00 ","$18,063.00 ", N/A ,"$7,500.00 ","$9,934.65 ", N/A ,"$5,057.64 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,031.50 ","$14,450.40 ", N/A , N/A ,"$12,644.10 ", N/A ,"$10,837.80 ", N/A ,"$13,547.25 ","$9,970.78 ","$8,995.37 ","$9,970.78 ", N/A ,"$9,970.78 ","$14,089.14 ","$14,089.14 ","$15,353.55 ", N/A ,"$4,981.00 ", N/A ,"$18,063.00 ","$9,934.65 ", N/A ,"$4,750.57 ","$18,063.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$14,450.40 ","$3,913.45 ","$5,057.64 ","$16,256.70 ","$8,959.25 ","$18,063.00 ", N/A ,"$8,670.24 "
ST. MARY'S HOSPITAL - DECATUR,48100315,92938,HC PERC TRANSL REVASC GRAFT EA AD-LM,481,1 ,"$18,063.00 ","$11,740.95 ","$3,500.00 ","$18,063.00 ", N/A ,"$7,500.00 ","$9,934.65 ", N/A ,"$5,057.64 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,031.50 ","$14,450.40 ", N/A , N/A ,"$12,644.10 ", N/A ,"$10,837.80 ", N/A ,"$13,547.25 ","$9,970.78 ","$8,995.37 ","$9,970.78 ", N/A ,"$9,970.78 ","$14,089.14 ","$14,089.14 ","$15,353.55 ", N/A ,"$4,981.00 ", N/A ,"$18,063.00 ","$9,934.65 ", N/A ,"$4,750.57 ","$18,063.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$14,450.40 ","$3,913.45 ","$5,057.64 ","$16,256.70 ","$8,959.25 ","$18,063.00 ", N/A ,"$8,670.24 "
ST. MARY'S HOSPITAL - DECATUR,48100316,92938,HC PERC TRANSL REVASC GRAFT EA AD-RC,481,1 ,"$18,063.00 ","$11,740.95 ","$3,500.00 ","$18,063.00 ", N/A ,"$7,500.00 ","$9,934.65 ", N/A ,"$5,057.64 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,031.50 ","$14,450.40 ", N/A , N/A ,"$12,644.10 ", N/A ,"$10,837.80 ", N/A ,"$13,547.25 ","$9,970.78 ","$8,995.37 ","$9,970.78 ", N/A ,"$9,970.78 ","$14,089.14 ","$14,089.14 ","$15,353.55 ", N/A ,"$4,981.00 ", N/A ,"$18,063.00 ","$9,934.65 ", N/A ,"$4,750.57 ","$18,063.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$14,450.40 ","$3,913.45 ","$5,057.64 ","$16,256.70 ","$8,959.25 ","$18,063.00 ", N/A ,"$8,670.24 "
ST. MARY'S HOSPITAL - DECATUR,48100317,92938,HC PERC TRANSL REVASC GRAFT EA AD-RI,481,1 ,"$18,063.00 ","$11,740.95 ","$3,500.00 ","$18,063.00 ", N/A ,"$7,500.00 ","$9,934.65 ", N/A ,"$5,057.64 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,031.50 ","$14,450.40 ", N/A , N/A ,"$12,644.10 ", N/A ,"$10,837.80 ", N/A ,"$13,547.25 ","$9,970.78 ","$8,995.37 ","$9,970.78 ", N/A ,"$9,970.78 ","$14,089.14 ","$14,089.14 ","$15,353.55 ", N/A ,"$4,981.00 ", N/A ,"$18,063.00 ","$9,934.65 ", N/A ,"$4,750.57 ","$18,063.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$14,450.40 ","$3,913.45 ","$5,057.64 ","$16,256.70 ","$8,959.25 ","$18,063.00 ", N/A ,"$8,670.24 "
ST. MARY'S HOSPITAL - DECATUR,48100318,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-LC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100319,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-LD,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100320,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-LM,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100321,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-RC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100322,92941,HC PERC TRANSL REVASC OCCL/INFARC SGL VSL-RI,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100324,36245,HC PLACE CATH ABD/PEL 1ST ORDER-LT,360,1 ,"$3,031.00 ","$1,970.15 ",$737.00 ,"$3,031.00 ", N/A ,"$3,031.00 ","$1,667.05 ", N/A ,$848.68 ,"$1,424.57 ", N/A ,"$1,636.74 ", N/A ,"$1,645.83 ","$1,645.83 ", N/A ,"$1,645.83 ", N/A ,"$2,121.70 ","$1,515.50 ","$2,424.80 ", N/A , N/A ,"$2,121.70 ", N/A ,"$1,818.60 ", N/A ,"$2,273.25 ","$1,673.11 ","$1,509.44 ","$1,673.11 ", N/A ,"$1,673.11 ","$2,364.18 ","$2,364.18 ","$2,576.35 ", N/A ,"$2,100.48 ", N/A ,"$3,031.00 ","$1,667.05 ", N/A ,$797.15 ,"$3,031.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$2,424.80 ","$1,645.83 ",$848.68 ,"$2,727.90 ",$737.00 ,$900.00 , N/A ,"$1,454.88 "
ST. MARY'S HOSPITAL - DECATUR,48100325,36245,HC PLACE CATH ABD/PEL 1ST ORDER-RT,360,1 ,"$3,031.00 ","$1,970.15 ",$737.00 ,"$3,031.00 ", N/A ,"$3,031.00 ","$1,667.05 ", N/A ,$848.68 ,"$1,424.57 ", N/A ,"$1,636.74 ", N/A ,"$1,645.83 ","$1,645.83 ", N/A ,"$1,645.83 ", N/A ,"$2,121.70 ","$1,515.50 ","$2,424.80 ", N/A , N/A ,"$2,121.70 ", N/A ,"$1,818.60 ", N/A ,"$2,273.25 ","$1,673.11 ","$1,509.44 ","$1,673.11 ", N/A ,"$1,673.11 ","$2,364.18 ","$2,364.18 ","$2,576.35 ", N/A ,"$2,100.48 ", N/A ,"$3,031.00 ","$1,667.05 ", N/A ,$797.15 ,"$3,031.00 ","$1,871.71 ","$1,786.63 ", N/A ,"$2,424.80 ","$1,645.83 ",$848.68 ,"$2,727.90 ",$737.00 ,$900.00 , N/A ,"$1,454.88 "
ST. MARY'S HOSPITAL - DECATUR,48100326,92928,HC PLACE PERC INTRACOR STENT SGL-LC,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100327,92928,HC PLACE PERC INTRACOR STENT SGL-LD,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100328,92928,HC PLACE PERC INTRACOR STENT SGL-LM,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100329,92928,HC PLACE PERC INTRACOR STENT SGL-RC,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100330,92928,HC PLACE PERC INTRACOR STENT SGL-RI,481,1 ,"$16,247.00 ","$10,560.55 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$8,935.85 ","$9,508.18 ","$4,549.16 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$16,247.00 ","$3,500.00 ","$8,123.50 ","$12,997.60 ","$23,770.46 ","$9,508.18 ","$11,372.90 ","$9,508.18 ","$9,748.20 ","$9,508.18 ","$12,185.25 ","$8,968.34 ","$8,091.01 ","$8,968.34 ","$9,508.18 ","$8,968.34 ","$12,672.66 ","$12,672.66 ","$13,809.95 ","$16,247.00 ","$4,981.00 ","$9,508.18 ","$16,247.00 ","$8,935.85 ","$9,508.18 ","$4,272.96 ","$16,247.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$12,997.60 ","$3,913.45 ","$4,549.16 ","$14,622.30 ","$8,058.51 ","$16,247.00 ","$9,508.18 ","$7,798.56 "
ST. MARY'S HOSPITAL - DECATUR,48100331,92929,HC PLACE PERC INTRACOR STENT EA AD-LC,481,1 ,"$9,672.00 ","$6,286.80 ","$2,543.74 ","$9,672.00 ", N/A ,"$7,500.00 ","$5,319.60 ", N/A ,"$2,708.16 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,836.00 ","$7,737.60 ", N/A , N/A ,"$6,770.40 ", N/A ,"$5,803.20 ", N/A ,"$7,254.00 ","$5,338.94 ","$4,816.66 ","$5,338.94 ", N/A ,"$5,338.94 ","$7,544.16 ","$7,544.16 ","$8,221.20 ", N/A ,"$4,981.00 ", N/A ,"$9,672.00 ","$5,319.60 ", N/A ,"$2,543.74 ","$9,672.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$7,737.60 ","$3,913.45 ","$2,708.16 ","$8,704.80 ","$4,797.31 ","$9,672.00 ", N/A ,"$4,642.56 "
ST. MARY'S HOSPITAL - DECATUR,48100332,92929,HC PLACE PERC INTRACOR STENT EA AD-LD,481,1 ,"$9,672.00 ","$6,286.80 ","$2,543.74 ","$9,672.00 ", N/A ,"$7,500.00 ","$5,319.60 ", N/A ,"$2,708.16 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,836.00 ","$7,737.60 ", N/A , N/A ,"$6,770.40 ", N/A ,"$5,803.20 ", N/A ,"$7,254.00 ","$5,338.94 ","$4,816.66 ","$5,338.94 ", N/A ,"$5,338.94 ","$7,544.16 ","$7,544.16 ","$8,221.20 ", N/A ,"$4,981.00 ", N/A ,"$9,672.00 ","$5,319.60 ", N/A ,"$2,543.74 ","$9,672.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$7,737.60 ","$3,913.45 ","$2,708.16 ","$8,704.80 ","$4,797.31 ","$9,672.00 ", N/A ,"$4,642.56 "
ST. MARY'S HOSPITAL - DECATUR,48100333,92929,HC PLACE PERC INTRACOR STENT EA AD-LM,481,1 ,"$9,672.00 ","$6,286.80 ","$2,543.74 ","$9,672.00 ", N/A ,"$7,500.00 ","$5,319.60 ", N/A ,"$2,708.16 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,836.00 ","$7,737.60 ", N/A , N/A ,"$6,770.40 ", N/A ,"$5,803.20 ", N/A ,"$7,254.00 ","$5,338.94 ","$4,816.66 ","$5,338.94 ", N/A ,"$5,338.94 ","$7,544.16 ","$7,544.16 ","$8,221.20 ", N/A ,"$4,981.00 ", N/A ,"$9,672.00 ","$5,319.60 ", N/A ,"$2,543.74 ","$9,672.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$7,737.60 ","$3,913.45 ","$2,708.16 ","$8,704.80 ","$4,797.31 ","$9,672.00 ", N/A ,"$4,642.56 "
ST. MARY'S HOSPITAL - DECATUR,48100334,92929,HC PLACE PERC INTRACOR STENT EA AD-RC,481,1 ,"$9,672.00 ","$6,286.80 ","$2,543.74 ","$9,672.00 ", N/A ,"$7,500.00 ","$5,319.60 ", N/A ,"$2,708.16 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,836.00 ","$7,737.60 ", N/A , N/A ,"$6,770.40 ", N/A ,"$5,803.20 ", N/A ,"$7,254.00 ","$5,338.94 ","$4,816.66 ","$5,338.94 ", N/A ,"$5,338.94 ","$7,544.16 ","$7,544.16 ","$8,221.20 ", N/A ,"$4,981.00 ", N/A ,"$9,672.00 ","$5,319.60 ", N/A ,"$2,543.74 ","$9,672.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$7,737.60 ","$3,913.45 ","$2,708.16 ","$8,704.80 ","$4,797.31 ","$9,672.00 ", N/A ,"$4,642.56 "
ST. MARY'S HOSPITAL - DECATUR,48100335,92929,HC PLACE PERC INTRACOR STENT EA AD-RI,481,1 ,"$9,672.00 ","$6,286.80 ","$2,543.74 ","$9,672.00 ", N/A ,"$7,500.00 ","$5,319.60 ", N/A ,"$2,708.16 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$4,836.00 ","$7,737.60 ", N/A , N/A ,"$6,770.40 ", N/A ,"$5,803.20 ", N/A ,"$7,254.00 ","$5,338.94 ","$4,816.66 ","$5,338.94 ", N/A ,"$5,338.94 ","$7,544.16 ","$7,544.16 ","$8,221.20 ", N/A ,"$4,981.00 ", N/A ,"$9,672.00 ","$5,319.60 ", N/A ,"$2,543.74 ","$9,672.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$7,737.60 ","$3,913.45 ","$2,708.16 ","$8,704.80 ","$4,797.31 ","$9,672.00 ", N/A ,"$4,642.56 "
ST. MARY'S HOSPITAL - DECATUR,48100336,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-LC,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100337,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-LD,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100338,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-LM,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100339,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-RC,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100340,C9602,HC PERC TRN ATHR DRUG ELUT STENT SGL-RI,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100341,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-LC,481,1 ,"$22,200.00 ","$14,430.00 ","$3,500.00 ","$22,200.00 ", N/A ,"$7,500.00 ","$12,210.00 ", N/A ,"$6,216.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$11,100.00 ","$17,760.00 ", N/A , N/A ,"$15,540.00 ", N/A ,"$13,320.00 ", N/A ,"$16,650.00 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$17,316.00 ","$17,316.00 ","$18,870.00 ", N/A ,"$4,981.00 ", N/A ,"$22,200.00 ","$12,210.00 ", N/A ,"$5,838.60 ","$22,200.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$17,760.00 ","$3,913.45 ","$6,216.00 ","$19,980.00 ","$11,011.20 ","$20,000.00 ", N/A ,"$10,656.00 "
ST. MARY'S HOSPITAL - DECATUR,48100342,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-LD,481,1 ,"$22,200.00 ","$14,430.00 ","$3,500.00 ","$22,200.00 ", N/A ,"$7,500.00 ","$12,210.00 ", N/A ,"$6,216.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$11,100.00 ","$17,760.00 ", N/A , N/A ,"$15,540.00 ", N/A ,"$13,320.00 ", N/A ,"$16,650.00 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$17,316.00 ","$17,316.00 ","$18,870.00 ", N/A ,"$4,981.00 ", N/A ,"$22,200.00 ","$12,210.00 ", N/A ,"$5,838.60 ","$22,200.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$17,760.00 ","$3,913.45 ","$6,216.00 ","$19,980.00 ","$11,011.20 ","$20,000.00 ", N/A ,"$10,656.00 "
ST. MARY'S HOSPITAL - DECATUR,48100343,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-LM,481,1 ,"$22,200.00 ","$14,430.00 ","$3,500.00 ","$22,200.00 ", N/A ,"$7,500.00 ","$12,210.00 ", N/A ,"$6,216.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$11,100.00 ","$17,760.00 ", N/A , N/A ,"$15,540.00 ", N/A ,"$13,320.00 ", N/A ,"$16,650.00 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$17,316.00 ","$17,316.00 ","$18,870.00 ", N/A ,"$4,981.00 ", N/A ,"$22,200.00 ","$12,210.00 ", N/A ,"$5,838.60 ","$22,200.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$17,760.00 ","$3,913.45 ","$6,216.00 ","$19,980.00 ","$11,011.20 ","$20,000.00 ", N/A ,"$10,656.00 "
ST. MARY'S HOSPITAL - DECATUR,48100344,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-RC,481,1 ,"$22,200.00 ","$14,430.00 ","$3,500.00 ","$22,200.00 ", N/A ,"$7,500.00 ","$12,210.00 ", N/A ,"$6,216.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$11,100.00 ","$17,760.00 ", N/A , N/A ,"$15,540.00 ", N/A ,"$13,320.00 ", N/A ,"$16,650.00 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$17,316.00 ","$17,316.00 ","$18,870.00 ", N/A ,"$4,981.00 ", N/A ,"$22,200.00 ","$12,210.00 ", N/A ,"$5,838.60 ","$22,200.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$17,760.00 ","$3,913.45 ","$6,216.00 ","$19,980.00 ","$11,011.20 ","$20,000.00 ", N/A ,"$10,656.00 "
ST. MARY'S HOSPITAL - DECATUR,48100345,C9603,HC PERC TRN ATHR DRUG ELUT STENT EA AD-RI,481,1 ,"$22,200.00 ","$14,430.00 ","$3,500.00 ","$22,200.00 ", N/A ,"$7,500.00 ","$12,210.00 ", N/A ,"$6,216.00 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$11,100.00 ","$17,760.00 ", N/A , N/A ,"$15,540.00 ", N/A ,"$13,320.00 ", N/A ,"$16,650.00 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$17,316.00 ","$17,316.00 ","$18,870.00 ", N/A ,"$4,981.00 ", N/A ,"$22,200.00 ","$12,210.00 ", N/A ,"$5,838.60 ","$22,200.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$17,760.00 ","$3,913.45 ","$6,216.00 ","$19,980.00 ","$11,011.20 ","$20,000.00 ", N/A ,"$10,656.00 "
ST. MARY'S HOSPITAL - DECATUR,48100346,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-LC,481,1 ,"$24,686.00 ","$16,045.90 ","$3,500.00 ","$24,686.00 ","$23,770.45 ","$7,500.00 ","$13,577.30 ","$9,508.18 ","$6,912.08 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,343.00 ","$19,748.80 ","$23,770.46 ","$9,508.18 ","$17,280.20 ","$9,508.18 ","$14,811.60 ","$9,508.18 ","$18,514.50 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$19,255.08 ","$19,255.08 ","$20,983.10 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$24,686.00 ","$13,577.30 ","$9,508.18 ","$6,492.42 ","$24,686.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$19,748.80 ","$3,913.45 ","$6,912.08 ","$22,217.40 ","$12,244.26 ","$20,000.00 ","$9,508.18 ","$11,849.28 "
ST. MARY'S HOSPITAL - DECATUR,48100347,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-LD,481,1 ,"$24,686.00 ","$16,045.90 ","$3,500.00 ","$24,686.00 ","$23,770.45 ","$7,500.00 ","$13,577.30 ","$9,508.18 ","$6,912.08 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,343.00 ","$19,748.80 ","$23,770.46 ","$9,508.18 ","$17,280.20 ","$9,508.18 ","$14,811.60 ","$9,508.18 ","$18,514.50 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$19,255.08 ","$19,255.08 ","$20,983.10 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$24,686.00 ","$13,577.30 ","$9,508.18 ","$6,492.42 ","$24,686.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$19,748.80 ","$3,913.45 ","$6,912.08 ","$22,217.40 ","$12,244.26 ","$20,000.00 ","$9,508.18 ","$11,849.28 "
ST. MARY'S HOSPITAL - DECATUR,48100348,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-LM,481,1 ,"$24,686.00 ","$16,045.90 ","$3,500.00 ","$24,686.00 ","$23,770.45 ","$7,500.00 ","$13,577.30 ","$9,508.18 ","$6,912.08 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,343.00 ","$19,748.80 ","$23,770.46 ","$9,508.18 ","$17,280.20 ","$9,508.18 ","$14,811.60 ","$9,508.18 ","$18,514.50 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$19,255.08 ","$19,255.08 ","$20,983.10 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$24,686.00 ","$13,577.30 ","$9,508.18 ","$6,492.42 ","$24,686.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$19,748.80 ","$3,913.45 ","$6,912.08 ","$22,217.40 ","$12,244.26 ","$20,000.00 ","$9,508.18 ","$11,849.28 "
ST. MARY'S HOSPITAL - DECATUR,48100349,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-RC,481,1 ,"$24,686.00 ","$16,045.90 ","$3,500.00 ","$24,686.00 ","$23,770.45 ","$7,500.00 ","$13,577.30 ","$9,508.18 ","$6,912.08 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,343.00 ","$19,748.80 ","$23,770.46 ","$9,508.18 ","$17,280.20 ","$9,508.18 ","$14,811.60 ","$9,508.18 ","$18,514.50 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$19,255.08 ","$19,255.08 ","$20,983.10 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$24,686.00 ","$13,577.30 ","$9,508.18 ","$6,492.42 ","$24,686.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$19,748.80 ","$3,913.45 ","$6,912.08 ","$22,217.40 ","$12,244.26 ","$20,000.00 ","$9,508.18 ","$11,849.28 "
ST. MARY'S HOSPITAL - DECATUR,48100350,C9604,HC PERC RVSC CABG COR GRFT STENT DRG ELUT SGL-RI,481,1 ,"$24,686.00 ","$16,045.90 ","$3,500.00 ","$24,686.00 ","$23,770.45 ","$7,500.00 ","$13,577.30 ","$9,508.18 ","$6,912.08 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$12,343.00 ","$19,748.80 ","$23,770.46 ","$9,508.18 ","$17,280.20 ","$9,508.18 ","$14,811.60 ","$9,508.18 ","$18,514.50 ","$10,265.00 ","$9,238.00 ","$10,265.00 ","$9,508.18 ","$10,265.00 ","$19,255.08 ","$19,255.08 ","$20,983.10 ","$23,770.46 ","$4,981.00 ","$9,508.18 ","$24,686.00 ","$13,577.30 ","$9,508.18 ","$6,492.42 ","$24,686.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$19,748.80 ","$3,913.45 ","$6,912.08 ","$22,217.40 ","$12,244.26 ","$20,000.00 ","$9,508.18 ","$11,849.28 "
ST. MARY'S HOSPITAL - DECATUR,48100351,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-LC,481,1 ,"$19,257.00 ","$12,517.05 ","$3,500.00 ","$19,257.00 ", N/A ,"$7,500.00 ","$10,591.35 ", N/A ,"$5,391.96 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,628.50 ","$15,405.60 ", N/A , N/A ,"$13,479.90 ", N/A ,"$11,554.20 ", N/A ,"$14,442.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,020.46 ","$15,020.46 ","$16,368.45 ", N/A ,"$4,981.00 ", N/A ,"$19,257.00 ","$10,591.35 ", N/A ,"$5,064.59 ","$19,257.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$15,405.60 ","$3,913.45 ","$5,391.96 ","$17,331.30 ","$9,551.47 ","$19,257.00 ", N/A ,"$9,243.36 "
ST. MARY'S HOSPITAL - DECATUR,48100352,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-LD,481,1 ,"$19,257.00 ","$12,517.05 ","$3,500.00 ","$19,257.00 ", N/A ,"$7,500.00 ","$10,591.35 ", N/A ,"$5,391.96 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,628.50 ","$15,405.60 ", N/A , N/A ,"$13,479.90 ", N/A ,"$11,554.20 ", N/A ,"$14,442.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,020.46 ","$15,020.46 ","$16,368.45 ", N/A ,"$4,981.00 ", N/A ,"$19,257.00 ","$10,591.35 ", N/A ,"$5,064.59 ","$19,257.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$15,405.60 ","$3,913.45 ","$5,391.96 ","$17,331.30 ","$9,551.47 ","$19,257.00 ", N/A ,"$9,243.36 "
ST. MARY'S HOSPITAL - DECATUR,48100353,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-LM,481,1 ,"$19,257.00 ","$12,517.05 ","$3,500.00 ","$19,257.00 ", N/A ,"$7,500.00 ","$10,591.35 ", N/A ,"$5,391.96 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,628.50 ","$15,405.60 ", N/A , N/A ,"$13,479.90 ", N/A ,"$11,554.20 ", N/A ,"$14,442.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,020.46 ","$15,020.46 ","$16,368.45 ", N/A ,"$4,981.00 ", N/A ,"$19,257.00 ","$10,591.35 ", N/A ,"$5,064.59 ","$19,257.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$15,405.60 ","$3,913.45 ","$5,391.96 ","$17,331.30 ","$9,551.47 ","$19,257.00 ", N/A ,"$9,243.36 "
ST. MARY'S HOSPITAL - DECATUR,48100354,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-RC,481,1 ,"$19,257.00 ","$12,517.05 ","$3,500.00 ","$19,257.00 ", N/A ,"$7,500.00 ","$10,591.35 ", N/A ,"$5,391.96 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,628.50 ","$15,405.60 ", N/A , N/A ,"$13,479.90 ", N/A ,"$11,554.20 ", N/A ,"$14,442.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,020.46 ","$15,020.46 ","$16,368.45 ", N/A ,"$4,981.00 ", N/A ,"$19,257.00 ","$10,591.35 ", N/A ,"$5,064.59 ","$19,257.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$15,405.60 ","$3,913.45 ","$5,391.96 ","$17,331.30 ","$9,551.47 ","$19,257.00 ", N/A ,"$9,243.36 "
ST. MARY'S HOSPITAL - DECATUR,48100355,C9605,HC PERC RVSC CABG COR GRFT STENT DRG ELUT EA ADL-RI,481,1 ,"$19,257.00 ","$12,517.05 ","$3,500.00 ","$19,257.00 ", N/A ,"$7,500.00 ","$10,591.35 ", N/A ,"$5,391.96 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$9,628.50 ","$15,405.60 ", N/A , N/A ,"$13,479.90 ", N/A ,"$11,554.20 ", N/A ,"$14,442.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,020.46 ","$15,020.46 ","$16,368.45 ", N/A ,"$4,981.00 ", N/A ,"$19,257.00 ","$10,591.35 ", N/A ,"$5,064.59 ","$19,257.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$15,405.60 ","$3,913.45 ","$5,391.96 ","$17,331.30 ","$9,551.47 ","$19,257.00 ", N/A ,"$9,243.36 "
ST. MARY'S HOSPITAL - DECATUR,48100356,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-LC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$9,488.60 ","$15,202.65 ","$4,830.56 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$38,006.61 ","$15,202.65 ","$12,076.40 ","$15,202.65 ","$10,351.20 ","$15,202.65 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$15,202.65 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$15,202.65 ","$17,252.00 ","$9,488.60 ","$15,202.65 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$15,202.65 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100357,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-LD,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$9,488.60 ","$15,202.65 ","$4,830.56 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$38,006.61 ","$15,202.65 ","$12,076.40 ","$15,202.65 ","$10,351.20 ","$15,202.65 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$15,202.65 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$15,202.65 ","$17,252.00 ","$9,488.60 ","$15,202.65 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$15,202.65 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100358,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-LM,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$9,488.60 ","$15,202.65 ","$4,830.56 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$38,006.61 ","$15,202.65 ","$12,076.40 ","$15,202.65 ","$10,351.20 ","$15,202.65 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$15,202.65 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$15,202.65 ","$17,252.00 ","$9,488.60 ","$15,202.65 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$15,202.65 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100359,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-RC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$9,488.60 ","$15,202.65 ","$4,830.56 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$38,006.61 ","$15,202.65 ","$12,076.40 ","$15,202.65 ","$10,351.20 ","$15,202.65 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$15,202.65 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$15,202.65 ","$17,252.00 ","$9,488.60 ","$15,202.65 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$15,202.65 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100360,C9607,HC PERC REVASC COR OCCL STENT DRG ELUT SGL-RI,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$9,488.60 ","$15,202.65 ","$4,830.56 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$17,252.00 ","$3,500.00 ","$8,626.00 ","$13,801.60 ","$38,006.61 ","$15,202.65 ","$12,076.40 ","$15,202.65 ","$10,351.20 ","$15,202.65 ","$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ","$15,202.65 ","$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ","$17,252.00 ","$4,981.00 ","$15,202.65 ","$17,252.00 ","$9,488.60 ","$15,202.65 ","$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ","$15,202.65 ","$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100361,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-LC,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100362,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-LD,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100363,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-LM,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100364,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-RC,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100365,C9608,HC PERC REVASC COR OCCL STENT DRG ELUT EA ADL-RI,481,1 ,"$10,226.00 ","$6,646.90 ","$2,689.44 ","$10,226.00 ", N/A ,"$7,500.00 ","$5,624.30 ", N/A ,"$2,863.28 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,113.00 ","$8,180.80 ", N/A , N/A ,"$7,158.20 ", N/A ,"$6,135.60 ", N/A ,"$7,669.50 ","$5,644.75 ","$5,092.55 ","$5,644.75 ", N/A ,"$5,644.75 ","$7,976.28 ","$7,976.28 ","$8,692.10 ", N/A ,"$4,981.00 ", N/A ,"$10,226.00 ","$5,624.30 ", N/A ,"$2,689.44 ","$10,226.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,180.80 ","$3,913.45 ","$2,863.28 ","$9,203.40 ","$5,072.10 ","$10,226.00 ", N/A ,"$4,908.48 "
ST. MARY'S HOSPITAL - DECATUR,48100366,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-LC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100367,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-LD,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100368,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-LM,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100369,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-RC,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100370,C9606,HC PERC REVASC COR STENT DRG ELUT W/AMI-RI,481,1 ,"$17,252.00 ","$11,213.80 ","$3,500.00 ","$17,252.00 ", N/A ,"$7,500.00 ","$9,488.60 ", N/A ,"$4,830.56 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$8,626.00 ","$13,801.60 ", N/A , N/A ,"$12,076.40 ", N/A ,"$10,351.20 ", N/A ,"$12,939.00 ","$9,523.10 ","$8,591.50 ","$9,523.10 ", N/A ,"$9,523.10 ","$13,456.56 ","$13,456.56 ","$14,664.20 ", N/A ,"$4,981.00 ", N/A ,"$17,252.00 ","$9,488.60 ", N/A ,"$4,537.28 ","$17,252.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$13,801.60 ","$3,913.45 ","$4,830.56 ","$15,526.80 ","$8,556.99 ","$17,252.00 ", N/A ,"$8,280.96 "
ST. MARY'S HOSPITAL - DECATUR,48100371,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-LC,481,1 ,"$18,258.00 ","$11,867.70 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$10,041.90 ","$9,508.18 ","$5,112.24 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$9,129.00 ","$14,606.40 ","$23,770.46 ","$9,508.18 ","$12,780.60 ","$9,508.18 ","$10,954.80 ","$9,508.18 ","$13,693.50 ","$10,078.42 ","$9,092.48 ","$10,078.42 ","$9,508.18 ","$10,078.42 ","$14,241.24 ","$14,241.24 ","$15,519.30 ","$18,258.00 ","$4,981.00 ","$9,508.18 ","$18,258.00 ","$10,041.90 ","$9,508.18 ","$4,801.85 ","$18,258.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$14,606.40 ","$3,913.45 ","$5,112.24 ","$16,432.20 ","$9,055.97 ","$18,258.00 ","$9,508.18 ","$8,763.84 "
ST. MARY'S HOSPITAL - DECATUR,48100372,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-LD,481,1 ,"$18,258.00 ","$11,867.70 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$10,041.90 ","$9,508.18 ","$5,112.24 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$9,129.00 ","$14,606.40 ","$23,770.46 ","$9,508.18 ","$12,780.60 ","$9,508.18 ","$10,954.80 ","$9,508.18 ","$13,693.50 ","$10,078.42 ","$9,092.48 ","$10,078.42 ","$9,508.18 ","$10,078.42 ","$14,241.24 ","$14,241.24 ","$15,519.30 ","$18,258.00 ","$4,981.00 ","$9,508.18 ","$18,258.00 ","$10,041.90 ","$9,508.18 ","$4,801.85 ","$18,258.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$14,606.40 ","$3,913.45 ","$5,112.24 ","$16,432.20 ","$9,055.97 ","$18,258.00 ","$9,508.18 ","$8,763.84 "
ST. MARY'S HOSPITAL - DECATUR,48100373,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-LM,481,1 ,"$18,258.00 ","$11,867.70 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$10,041.90 ","$9,508.18 ","$5,112.24 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$9,129.00 ","$14,606.40 ","$23,770.46 ","$9,508.18 ","$12,780.60 ","$9,508.18 ","$10,954.80 ","$9,508.18 ","$13,693.50 ","$10,078.42 ","$9,092.48 ","$10,078.42 ","$9,508.18 ","$10,078.42 ","$14,241.24 ","$14,241.24 ","$15,519.30 ","$18,258.00 ","$4,981.00 ","$9,508.18 ","$18,258.00 ","$10,041.90 ","$9,508.18 ","$4,801.85 ","$18,258.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$14,606.40 ","$3,913.45 ","$5,112.24 ","$16,432.20 ","$9,055.97 ","$18,258.00 ","$9,508.18 ","$8,763.84 "
ST. MARY'S HOSPITAL - DECATUR,48100374,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-RC,481,1 ,"$18,258.00 ","$11,867.70 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$10,041.90 ","$9,508.18 ","$5,112.24 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$9,129.00 ","$14,606.40 ","$23,770.46 ","$9,508.18 ","$12,780.60 ","$9,508.18 ","$10,954.80 ","$9,508.18 ","$13,693.50 ","$10,078.42 ","$9,092.48 ","$10,078.42 ","$9,508.18 ","$10,078.42 ","$14,241.24 ","$14,241.24 ","$15,519.30 ","$18,258.00 ","$4,981.00 ","$9,508.18 ","$18,258.00 ","$10,041.90 ","$9,508.18 ","$4,801.85 ","$18,258.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$14,606.40 ","$3,913.45 ","$5,112.24 ","$16,432.20 ","$9,055.97 ","$18,258.00 ","$9,508.18 ","$8,763.84 "
ST. MARY'S HOSPITAL - DECATUR,48100375,92924,HC PERC TRN ARTHR W/COR ANGIO SGL-RI,481,1 ,"$18,258.00 ","$11,867.70 ","$3,500.00 ","$23,770.46 ","$23,770.45 ","$7,500.00 ","$10,041.90 ","$9,508.18 ","$5,112.24 ","$3,523.99 ","$9,508.18 ","$4,049.96 ","$9,508.18 ","$3,913.45 ","$3,913.45 ","$9,508.18 ","$3,913.45 ","$18,065.55 ","$3,500.00 ","$9,129.00 ","$14,606.40 ","$23,770.46 ","$9,508.18 ","$12,780.60 ","$9,508.18 ","$10,954.80 ","$9,508.18 ","$13,693.50 ","$10,078.42 ","$9,092.48 ","$10,078.42 ","$9,508.18 ","$10,078.42 ","$14,241.24 ","$14,241.24 ","$15,519.30 ","$18,258.00 ","$4,981.00 ","$9,508.18 ","$18,258.00 ","$10,041.90 ","$9,508.18 ","$4,801.85 ","$18,258.00 ","$6,014.54 ","$5,741.15 ","$9,983.59 ","$14,606.40 ","$3,913.45 ","$5,112.24 ","$16,432.20 ","$9,055.97 ","$18,258.00 ","$9,508.18 ","$8,763.84 "
ST. MARY'S HOSPITAL - DECATUR,48100376,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-LC,481,1 ,"$10,780.00 ","$7,007.00 ","$2,835.14 ","$10,780.00 ", N/A ,"$7,500.00 ","$5,929.00 ", N/A ,"$3,018.40 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,390.00 ","$8,624.00 ", N/A , N/A ,"$7,546.00 ", N/A ,"$6,468.00 ", N/A ,"$8,085.00 ","$5,950.56 ","$5,368.44 ","$5,950.56 ", N/A ,"$5,950.56 ","$8,408.40 ","$8,408.40 ","$9,163.00 ", N/A ,"$4,981.00 ", N/A ,"$10,780.00 ","$5,929.00 ", N/A ,"$2,835.14 ","$10,780.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,624.00 ","$3,913.45 ","$3,018.40 ","$9,702.00 ","$5,346.88 ","$10,780.00 ", N/A ,"$5,174.40 "
ST. MARY'S HOSPITAL - DECATUR,48100377,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-LD,481,1 ,"$10,780.00 ","$7,007.00 ","$2,835.14 ","$10,780.00 ", N/A ,"$7,500.00 ","$5,929.00 ", N/A ,"$3,018.40 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,390.00 ","$8,624.00 ", N/A , N/A ,"$7,546.00 ", N/A ,"$6,468.00 ", N/A ,"$8,085.00 ","$5,950.56 ","$5,368.44 ","$5,950.56 ", N/A ,"$5,950.56 ","$8,408.40 ","$8,408.40 ","$9,163.00 ", N/A ,"$4,981.00 ", N/A ,"$10,780.00 ","$5,929.00 ", N/A ,"$2,835.14 ","$10,780.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,624.00 ","$3,913.45 ","$3,018.40 ","$9,702.00 ","$5,346.88 ","$10,780.00 ", N/A ,"$5,174.40 "
ST. MARY'S HOSPITAL - DECATUR,48100378,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-LM,481,1 ,"$10,780.00 ","$7,007.00 ","$2,835.14 ","$10,780.00 ", N/A ,"$7,500.00 ","$5,929.00 ", N/A ,"$3,018.40 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,390.00 ","$8,624.00 ", N/A , N/A ,"$7,546.00 ", N/A ,"$6,468.00 ", N/A ,"$8,085.00 ","$5,950.56 ","$5,368.44 ","$5,950.56 ", N/A ,"$5,950.56 ","$8,408.40 ","$8,408.40 ","$9,163.00 ", N/A ,"$4,981.00 ", N/A ,"$10,780.00 ","$5,929.00 ", N/A ,"$2,835.14 ","$10,780.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,624.00 ","$3,913.45 ","$3,018.40 ","$9,702.00 ","$5,346.88 ","$10,780.00 ", N/A ,"$5,174.40 "
ST. MARY'S HOSPITAL - DECATUR,48100379,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-RC,481,1 ,"$10,780.00 ","$7,007.00 ","$2,835.14 ","$10,780.00 ", N/A ,"$7,500.00 ","$5,929.00 ", N/A ,"$3,018.40 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,390.00 ","$8,624.00 ", N/A , N/A ,"$7,546.00 ", N/A ,"$6,468.00 ", N/A ,"$8,085.00 ","$5,950.56 ","$5,368.44 ","$5,950.56 ", N/A ,"$5,950.56 ","$8,408.40 ","$8,408.40 ","$9,163.00 ", N/A ,"$4,981.00 ", N/A ,"$10,780.00 ","$5,929.00 ", N/A ,"$2,835.14 ","$10,780.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,624.00 ","$3,913.45 ","$3,018.40 ","$9,702.00 ","$5,346.88 ","$10,780.00 ", N/A ,"$5,174.40 "
ST. MARY'S HOSPITAL - DECATUR,48100380,92925,HC PERC TRN ARTHR W/COR ANGIO EA ADL-RI,481,1 ,"$10,780.00 ","$7,007.00 ","$2,835.14 ","$10,780.00 ", N/A ,"$7,500.00 ","$5,929.00 ", N/A ,"$3,018.40 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$5,390.00 ","$8,624.00 ", N/A , N/A ,"$7,546.00 ", N/A ,"$6,468.00 ", N/A ,"$8,085.00 ","$5,950.56 ","$5,368.44 ","$5,950.56 ", N/A ,"$5,950.56 ","$8,408.40 ","$8,408.40 ","$9,163.00 ", N/A ,"$4,981.00 ", N/A ,"$10,780.00 ","$5,929.00 ", N/A ,"$2,835.14 ","$10,780.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$8,624.00 ","$3,913.45 ","$3,018.40 ","$9,702.00 ","$5,346.88 ","$10,780.00 ", N/A ,"$5,174.40 "
ST. MARY'S HOSPITAL - DECATUR,48100381,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-LC,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100382,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-LD,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100383,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-LM,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100384,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-RC,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100385,92933,HC PERC TRN ARTHR W/INTRA STENT ANGIO SGL-RI,481,1 ,"$34,504.00 ","$22,427.60 ","$3,500.00 ","$38,006.63 ","$38,006.63 ","$7,500.00 ","$18,977.20 ","$15,202.65 ","$9,661.12 ","$3,523.99 ","$15,202.65 ","$4,049.96 ","$15,202.65 ","$3,913.45 ","$3,913.45 ","$15,202.65 ","$3,913.45 ","$28,885.03 ","$3,500.00 ","$17,252.00 ","$27,603.20 ","$38,006.61 ","$15,202.65 ","$24,152.80 ","$15,202.65 ","$20,702.40 ","$15,202.65 ","$25,878.00 ","$11,862.58 ","$12,077.42 ","$11,862.58 ","$15,202.65 ","$11,862.58 ","$26,913.12 ","$26,913.12 ","$29,328.40 ","$34,504.00 ","$4,981.00 ","$15,202.65 ","$34,504.00 ","$18,977.20 ","$15,202.65 ","$9,074.55 ","$34,504.00 ","$6,014.54 ","$5,741.15 ","$15,962.78 ","$27,603.20 ","$3,913.45 ","$9,661.12 ","$31,053.60 ","$17,113.98 ","$20,000.00 ","$15,202.65 ","$16,561.92 "
ST. MARY'S HOSPITAL - DECATUR,48100386,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-LC,481,1 ,"$20,453.00 ","$13,294.45 ","$3,500.00 ","$20,453.00 ", N/A ,"$7,500.00 ","$11,249.15 ", N/A ,"$5,726.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$10,226.50 ","$16,362.40 ", N/A , N/A ,"$14,317.10 ", N/A ,"$12,271.80 ", N/A ,"$15,339.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,953.34 ","$15,953.34 ","$17,385.05 ", N/A ,"$4,981.00 ", N/A ,"$20,453.00 ","$11,249.15 ", N/A ,"$5,379.14 ","$20,453.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$16,362.40 ","$3,913.45 ","$5,726.84 ","$18,407.70 ","$10,144.69 ","$20,000.00 ", N/A ,"$9,817.44 "
ST. MARY'S HOSPITAL - DECATUR,48100387,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-LD,481,1 ,"$20,453.00 ","$13,294.45 ","$3,500.00 ","$20,453.00 ", N/A ,"$7,500.00 ","$11,249.15 ", N/A ,"$5,726.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$10,226.50 ","$16,362.40 ", N/A , N/A ,"$14,317.10 ", N/A ,"$12,271.80 ", N/A ,"$15,339.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,953.34 ","$15,953.34 ","$17,385.05 ", N/A ,"$4,981.00 ", N/A ,"$20,453.00 ","$11,249.15 ", N/A ,"$5,379.14 ","$20,453.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$16,362.40 ","$3,913.45 ","$5,726.84 ","$18,407.70 ","$10,144.69 ","$20,000.00 ", N/A ,"$9,817.44 "
ST. MARY'S HOSPITAL - DECATUR,48100388,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-LM,481,1 ,"$20,453.00 ","$13,294.45 ","$3,500.00 ","$20,453.00 ", N/A ,"$7,500.00 ","$11,249.15 ", N/A ,"$5,726.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$10,226.50 ","$16,362.40 ", N/A , N/A ,"$14,317.10 ", N/A ,"$12,271.80 ", N/A ,"$15,339.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,953.34 ","$15,953.34 ","$17,385.05 ", N/A ,"$4,981.00 ", N/A ,"$20,453.00 ","$11,249.15 ", N/A ,"$5,379.14 ","$20,453.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$16,362.40 ","$3,913.45 ","$5,726.84 ","$18,407.70 ","$10,144.69 ","$20,000.00 ", N/A ,"$9,817.44 "
ST. MARY'S HOSPITAL - DECATUR,48100389,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-RC,481,1 ,"$20,453.00 ","$13,294.45 ","$3,500.00 ","$20,453.00 ", N/A ,"$7,500.00 ","$11,249.15 ", N/A ,"$5,726.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$10,226.50 ","$16,362.40 ", N/A , N/A ,"$14,317.10 ", N/A ,"$12,271.80 ", N/A ,"$15,339.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,953.34 ","$15,953.34 ","$17,385.05 ", N/A ,"$4,981.00 ", N/A ,"$20,453.00 ","$11,249.15 ", N/A ,"$5,379.14 ","$20,453.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$16,362.40 ","$3,913.45 ","$5,726.84 ","$18,407.70 ","$10,144.69 ","$20,000.00 ", N/A ,"$9,817.44 "
ST. MARY'S HOSPITAL - DECATUR,48100390,92934,HC PERC TRN ARTHR W/INTRA STENT ANGIO EA ADL-RI,481,1 ,"$20,453.00 ","$13,294.45 ","$3,500.00 ","$20,453.00 ", N/A ,"$7,500.00 ","$11,249.15 ", N/A ,"$5,726.84 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$10,226.50 ","$16,362.40 ", N/A , N/A ,"$14,317.10 ", N/A ,"$12,271.80 ", N/A ,"$15,339.75 ","$10,265.00 ","$9,238.00 ","$10,265.00 ", N/A ,"$10,265.00 ","$15,953.34 ","$15,953.34 ","$17,385.05 ", N/A ,"$4,981.00 ", N/A ,"$20,453.00 ","$11,249.15 ", N/A ,"$5,379.14 ","$20,453.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$16,362.40 ","$3,913.45 ","$5,726.84 ","$18,407.70 ","$10,144.69 ","$20,000.00 ", N/A ,"$9,817.44 "
ST. MARY'S HOSPITAL - DECATUR,48100391,92973,HC PERC TRANSLUM THROMBECTOMY -LC,481,1 ,"$3,220.00 ","$2,093.00 ",$846.86 ,"$3,220.00 ", N/A ,"$1,642.20 ","$1,771.00 ", N/A ,$901.60 ,"$1,513.40 ", N/A ,"$1,738.80 ", N/A ,"$1,748.46 ","$1,748.46 ", N/A ,"$1,748.46 ", N/A ,"$2,254.00 ","$1,610.00 ","$2,576.00 ", N/A , N/A ,"$2,254.00 ", N/A ,"$1,932.00 ", N/A ,"$2,415.00 ","$1,777.44 ","$1,603.56 ","$1,777.44 ", N/A ,"$1,777.44 ","$2,511.60 ","$2,511.60 ","$2,737.00 ", N/A ,"$2,231.46 ", N/A ,"$3,220.00 ","$1,771.00 ", N/A ,$846.86 ,"$3,220.00 ", N/A , N/A , N/A ,"$2,576.00 ","$1,748.46 ",$901.60 ,"$2,898.00 ","$1,597.12 ",$900.00 , N/A ,"$1,545.60 "
ST. MARY'S HOSPITAL - DECATUR,48100392,92973,HC PERC TRANSLUM THROMBECTOMY -LD,481,1 ,"$3,220.00 ","$2,093.00 ",$846.86 ,"$3,220.00 ", N/A ,"$1,642.20 ","$1,771.00 ", N/A ,$901.60 ,"$1,513.40 ", N/A ,"$1,738.80 ", N/A ,"$1,748.46 ","$1,748.46 ", N/A ,"$1,748.46 ", N/A ,"$2,254.00 ","$1,610.00 ","$2,576.00 ", N/A , N/A ,"$2,254.00 ", N/A ,"$1,932.00 ", N/A ,"$2,415.00 ","$1,777.44 ","$1,603.56 ","$1,777.44 ", N/A ,"$1,777.44 ","$2,511.60 ","$2,511.60 ","$2,737.00 ", N/A ,"$2,231.46 ", N/A ,"$3,220.00 ","$1,771.00 ", N/A ,$846.86 ,"$3,220.00 ", N/A , N/A , N/A ,"$2,576.00 ","$1,748.46 ",$901.60 ,"$2,898.00 ","$1,597.12 ",$900.00 , N/A ,"$1,545.60 "
ST. MARY'S HOSPITAL - DECATUR,48100393,92973,HC PERC TRANSLUM THROMBECTOMY -LM,481,1 ,"$3,220.00 ","$2,093.00 ",$846.86 ,"$3,220.00 ", N/A ,"$1,642.20 ","$1,771.00 ", N/A ,$901.60 ,"$1,513.40 ", N/A ,"$1,738.80 ", N/A ,"$1,748.46 ","$1,748.46 ", N/A ,"$1,748.46 ", N/A ,"$2,254.00 ","$1,610.00 ","$2,576.00 ", N/A , N/A ,"$2,254.00 ", N/A ,"$1,932.00 ", N/A ,"$2,415.00 ","$1,777.44 ","$1,603.56 ","$1,777.44 ", N/A ,"$1,777.44 ","$2,511.60 ","$2,511.60 ","$2,737.00 ", N/A ,"$2,231.46 ", N/A ,"$3,220.00 ","$1,771.00 ", N/A ,$846.86 ,"$3,220.00 ", N/A , N/A , N/A ,"$2,576.00 ","$1,748.46 ",$901.60 ,"$2,898.00 ","$1,597.12 ",$900.00 , N/A ,"$1,545.60 "
ST. MARY'S HOSPITAL - DECATUR,48100394,92973,HC PERC TRANSLUM THROMBECTOMY -RC,481,1 ,"$3,220.00 ","$2,093.00 ",$846.86 ,"$3,220.00 ", N/A ,"$1,642.20 ","$1,771.00 ", N/A ,$901.60 ,"$1,513.40 ", N/A ,"$1,738.80 ", N/A ,"$1,748.46 ","$1,748.46 ", N/A ,"$1,748.46 ", N/A ,"$2,254.00 ","$1,610.00 ","$2,576.00 ", N/A , N/A ,"$2,254.00 ", N/A ,"$1,932.00 ", N/A ,"$2,415.00 ","$1,777.44 ","$1,603.56 ","$1,777.44 ", N/A ,"$1,777.44 ","$2,511.60 ","$2,511.60 ","$2,737.00 ", N/A ,"$2,231.46 ", N/A ,"$3,220.00 ","$1,771.00 ", N/A ,$846.86 ,"$3,220.00 ", N/A , N/A , N/A ,"$2,576.00 ","$1,748.46 ",$901.60 ,"$2,898.00 ","$1,597.12 ",$900.00 , N/A ,"$1,545.60 "
ST. MARY'S HOSPITAL - DECATUR,48100395,92973,HC PERC TRANSLUM THROMBECTOMY -RI,481,1 ,"$3,220.00 ","$2,093.00 ",$846.86 ,"$3,220.00 ", N/A ,"$1,642.20 ","$1,771.00 ", N/A ,$901.60 ,"$1,513.40 ", N/A ,"$1,738.80 ", N/A ,"$1,748.46 ","$1,748.46 ", N/A ,"$1,748.46 ", N/A ,"$2,254.00 ","$1,610.00 ","$2,576.00 ", N/A , N/A ,"$2,254.00 ", N/A ,"$1,932.00 ", N/A ,"$2,415.00 ","$1,777.44 ","$1,603.56 ","$1,777.44 ", N/A ,"$1,777.44 ","$2,511.60 ","$2,511.60 ","$2,737.00 ", N/A ,"$2,231.46 ", N/A ,"$3,220.00 ","$1,771.00 ", N/A ,$846.86 ,"$3,220.00 ", N/A , N/A , N/A ,"$2,576.00 ","$1,748.46 ",$901.60 ,"$2,898.00 ","$1,597.12 ",$900.00 , N/A ,"$1,545.60 "
ST. MARY'S HOSPITAL - DECATUR,48100396,92920,HC PERC TRANSLUM COR ANGIO SGL-LC,481,1 ,"$10,964.00 ","$7,126.60 ","$2,883.53 ","$11,729.16 ","$11,729.15 ","$7,500.00 ","$6,030.20 ","$4,691.66 ","$3,069.92 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,482.00 ","$8,771.20 ","$11,729.16 ","$4,691.66 ","$7,674.80 ","$4,691.66 ","$6,578.40 ","$4,691.66 ","$8,223.00 ","$6,052.13 ","$5,460.07 ","$6,052.13 ","$4,691.66 ","$6,052.13 ","$8,551.92 ","$8,551.92 ","$9,319.40 ","$10,964.00 ","$4,981.00 ","$4,691.66 ","$10,964.00 ","$6,030.20 ","$4,691.66 ","$2,883.53 ","$10,964.00 ","$6,014.54 ","$5,741.15 ","$4,926.24 ","$8,771.20 ","$3,913.45 ","$3,069.92 ","$9,867.60 ","$5,438.14 ","$10,964.00 ","$4,691.66 ","$5,262.72 "
ST. MARY'S HOSPITAL - DECATUR,48100397,92920,HC PERC TRANSLUM COR ANGIO SGL-LD,481,1 ,"$10,964.00 ","$7,126.60 ","$2,883.53 ","$11,729.16 ","$11,729.15 ","$7,500.00 ","$6,030.20 ","$4,691.66 ","$3,069.92 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,482.00 ","$8,771.20 ","$11,729.16 ","$4,691.66 ","$7,674.80 ","$4,691.66 ","$6,578.40 ","$4,691.66 ","$8,223.00 ","$6,052.13 ","$5,460.07 ","$6,052.13 ","$4,691.66 ","$6,052.13 ","$8,551.92 ","$8,551.92 ","$9,319.40 ","$10,964.00 ","$4,981.00 ","$4,691.66 ","$10,964.00 ","$6,030.20 ","$4,691.66 ","$2,883.53 ","$10,964.00 ","$6,014.54 ","$5,741.15 ","$4,926.24 ","$8,771.20 ","$3,913.45 ","$3,069.92 ","$9,867.60 ","$5,438.14 ","$10,964.00 ","$4,691.66 ","$5,262.72 "
ST. MARY'S HOSPITAL - DECATUR,48100398,92920,HC PERC TRANSLUM COR ANGIO SGL-LM,481,1 ,"$10,964.00 ","$7,126.60 ","$2,883.53 ","$11,729.16 ","$11,729.15 ","$7,500.00 ","$6,030.20 ","$4,691.66 ","$3,069.92 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,482.00 ","$8,771.20 ","$11,729.16 ","$4,691.66 ","$7,674.80 ","$4,691.66 ","$6,578.40 ","$4,691.66 ","$8,223.00 ","$6,052.13 ","$5,460.07 ","$6,052.13 ","$4,691.66 ","$6,052.13 ","$8,551.92 ","$8,551.92 ","$9,319.40 ","$10,964.00 ","$4,981.00 ","$4,691.66 ","$10,964.00 ","$6,030.20 ","$4,691.66 ","$2,883.53 ","$10,964.00 ","$6,014.54 ","$5,741.15 ","$4,926.24 ","$8,771.20 ","$3,913.45 ","$3,069.92 ","$9,867.60 ","$5,438.14 ","$10,964.00 ","$4,691.66 ","$5,262.72 "
ST. MARY'S HOSPITAL - DECATUR,48100399,92920,HC PERC TRANSLUM COR ANGIO SGL-RC,481,1 ,"$10,964.00 ","$7,126.60 ","$2,883.53 ","$11,729.16 ","$11,729.15 ","$7,500.00 ","$6,030.20 ","$4,691.66 ","$3,069.92 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,482.00 ","$8,771.20 ","$11,729.16 ","$4,691.66 ","$7,674.80 ","$4,691.66 ","$6,578.40 ","$4,691.66 ","$8,223.00 ","$6,052.13 ","$5,460.07 ","$6,052.13 ","$4,691.66 ","$6,052.13 ","$8,551.92 ","$8,551.92 ","$9,319.40 ","$10,964.00 ","$4,981.00 ","$4,691.66 ","$10,964.00 ","$6,030.20 ","$4,691.66 ","$2,883.53 ","$10,964.00 ","$6,014.54 ","$5,741.15 ","$4,926.24 ","$8,771.20 ","$3,913.45 ","$3,069.92 ","$9,867.60 ","$5,438.14 ","$10,964.00 ","$4,691.66 ","$5,262.72 "
ST. MARY'S HOSPITAL - DECATUR,48100400,92920,HC PERC TRANSLUM COR ANGIO SGL-RI,481,1 ,"$10,964.00 ","$7,126.60 ","$2,883.53 ","$11,729.16 ","$11,729.15 ","$7,500.00 ","$6,030.20 ","$4,691.66 ","$3,069.92 ","$3,523.99 ","$4,691.66 ","$4,049.96 ","$4,691.66 ","$3,913.45 ","$3,913.45 ","$4,691.66 ","$3,913.45 ","$8,914.16 ","$3,500.00 ","$5,482.00 ","$8,771.20 ","$11,729.16 ","$4,691.66 ","$7,674.80 ","$4,691.66 ","$6,578.40 ","$4,691.66 ","$8,223.00 ","$6,052.13 ","$5,460.07 ","$6,052.13 ","$4,691.66 ","$6,052.13 ","$8,551.92 ","$8,551.92 ","$9,319.40 ","$10,964.00 ","$4,981.00 ","$4,691.66 ","$10,964.00 ","$6,030.20 ","$4,691.66 ","$2,883.53 ","$10,964.00 ","$6,014.54 ","$5,741.15 ","$4,926.24 ","$8,771.20 ","$3,913.45 ","$3,069.92 ","$9,867.60 ","$5,438.14 ","$10,964.00 ","$4,691.66 ","$5,262.72 "
ST. MARY'S HOSPITAL - DECATUR,48100401,92921,HC PERC TRANSLUM COR ANGIO EA AD-LC,481,1 ,"$7,834.00 ","$5,092.10 ","$2,060.34 ","$7,834.00 ", N/A ,"$7,500.00 ","$4,308.70 ", N/A ,"$2,193.52 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,917.00 ","$6,267.20 ", N/A , N/A ,"$5,483.80 ", N/A ,"$4,700.40 ", N/A ,"$5,875.50 ","$4,324.37 ","$3,901.33 ","$4,324.37 ", N/A ,"$4,324.37 ","$6,110.52 ","$6,110.52 ","$6,658.90 ", N/A ,"$4,981.00 ", N/A ,"$7,834.00 ","$4,308.70 ", N/A ,"$2,060.34 ","$7,834.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$6,267.20 ","$3,913.45 ","$2,193.52 ","$7,050.60 ","$3,885.66 ","$7,834.00 ", N/A ,"$3,760.32 "
ST. MARY'S HOSPITAL - DECATUR,48100402,92921,HC PERC TRANSLUM COR ANGIO EA AD-LD,481,1 ,"$7,834.00 ","$5,092.10 ","$2,060.34 ","$7,834.00 ", N/A ,"$7,500.00 ","$4,308.70 ", N/A ,"$2,193.52 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,917.00 ","$6,267.20 ", N/A , N/A ,"$5,483.80 ", N/A ,"$4,700.40 ", N/A ,"$5,875.50 ","$4,324.37 ","$3,901.33 ","$4,324.37 ", N/A ,"$4,324.37 ","$6,110.52 ","$6,110.52 ","$6,658.90 ", N/A ,"$4,981.00 ", N/A ,"$7,834.00 ","$4,308.70 ", N/A ,"$2,060.34 ","$7,834.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$6,267.20 ","$3,913.45 ","$2,193.52 ","$7,050.60 ","$3,885.66 ","$7,834.00 ", N/A ,"$3,760.32 "
ST. MARY'S HOSPITAL - DECATUR,48100403,92921,HC PERC TRANSLUM COR ANGIO EA AD-LM,481,1 ,"$7,834.00 ","$5,092.10 ","$2,060.34 ","$7,834.00 ", N/A ,"$7,500.00 ","$4,308.70 ", N/A ,"$2,193.52 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,917.00 ","$6,267.20 ", N/A , N/A ,"$5,483.80 ", N/A ,"$4,700.40 ", N/A ,"$5,875.50 ","$4,324.37 ","$3,901.33 ","$4,324.37 ", N/A ,"$4,324.37 ","$6,110.52 ","$6,110.52 ","$6,658.90 ", N/A ,"$4,981.00 ", N/A ,"$7,834.00 ","$4,308.70 ", N/A ,"$2,060.34 ","$7,834.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$6,267.20 ","$3,913.45 ","$2,193.52 ","$7,050.60 ","$3,885.66 ","$7,834.00 ", N/A ,"$3,760.32 "
ST. MARY'S HOSPITAL - DECATUR,48100404,92921,HC PERC TRANSLUM COR ANGIO EA AD-RC,481,1 ,"$7,834.00 ","$5,092.10 ","$2,060.34 ","$7,834.00 ", N/A ,"$7,500.00 ","$4,308.70 ", N/A ,"$2,193.52 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,917.00 ","$6,267.20 ", N/A , N/A ,"$5,483.80 ", N/A ,"$4,700.40 ", N/A ,"$5,875.50 ","$4,324.37 ","$3,901.33 ","$4,324.37 ", N/A ,"$4,324.37 ","$6,110.52 ","$6,110.52 ","$6,658.90 ", N/A ,"$4,981.00 ", N/A ,"$7,834.00 ","$4,308.70 ", N/A ,"$2,060.34 ","$7,834.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$6,267.20 ","$3,913.45 ","$2,193.52 ","$7,050.60 ","$3,885.66 ","$7,834.00 ", N/A ,"$3,760.32 "
ST. MARY'S HOSPITAL - DECATUR,48100405,92921,HC PERC TRANSLUM COR ANGIO EA AD-RI,481,1 ,"$7,834.00 ","$5,092.10 ","$2,060.34 ","$7,834.00 ", N/A ,"$7,500.00 ","$4,308.70 ", N/A ,"$2,193.52 ","$3,523.99 ", N/A ,"$4,049.96 ", N/A ,"$3,913.45 ","$3,913.45 ", N/A ,"$3,913.45 ", N/A ,"$3,500.00 ","$3,917.00 ","$6,267.20 ", N/A , N/A ,"$5,483.80 ", N/A ,"$4,700.40 ", N/A ,"$5,875.50 ","$4,324.37 ","$3,901.33 ","$4,324.37 ", N/A ,"$4,324.37 ","$6,110.52 ","$6,110.52 ","$6,658.90 ", N/A ,"$4,981.00 ", N/A ,"$7,834.00 ","$4,308.70 ", N/A ,"$2,060.34 ","$7,834.00 ","$6,014.54 ","$5,741.15 ", N/A ,"$6,267.20 ","$3,913.45 ","$2,193.52 ","$7,050.60 ","$3,885.66 ","$7,834.00 ", N/A ,"$3,760.32 "
ST. MARY'S HOSPITAL - DECATUR,48100406,92978,HC US IVUS/OCT  S AND I INIT VESSEL-LC,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100407,92978,HC US IVUS/OCT S AND I INIT VESSEL-LD,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100408,92978,HC US IVUS/OCT S AND I INIT VESSEL-LM,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100409,92978,HC US IVUS/OCT S AND I INIT VESSEL-RC,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100410,92978,HC US IVUS/OCT S AND I INIT VESSEL-RI,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100411,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-LC,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100412,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-LD,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100413,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-LM,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100414,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-RC,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100415,92979,HC US IVUS/OCT S AND I VESSEL EA ADL-RI,481,1 ,"$5,445.00 ","$3,539.25 ",$900.00 ,"$5,445.00 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,524.60 ","$2,559.15 ", N/A ,"$2,940.30 ", N/A ,"$2,956.64 ","$2,956.64 ", N/A ,"$2,956.64 ", N/A ,"$3,500.00 ","$2,722.50 ","$4,356.00 ", N/A , N/A ,"$3,811.50 ", N/A ,"$3,267.00 ", N/A ,"$4,083.75 ","$3,005.64 ","$2,711.61 ","$3,005.64 ", N/A ,"$3,005.64 ","$4,247.10 ","$4,247.10 ","$4,628.25 ", N/A ,"$3,773.39 ", N/A ,"$5,445.00 ","$2,994.75 ", N/A ,"$1,432.04 ","$5,445.00 ", N/A , N/A , N/A ,"$4,356.00 ","$2,956.64 ","$1,524.60 ","$4,900.50 ","$2,700.72 ",$900.00 , N/A ,"$2,613.60 "
ST. MARY'S HOSPITAL - DECATUR,48100421,33211,HC INS/REPL TEMP ELECTRODE DUAL CHAMBER-33211,481,1 ,"$5,189.00 ","$3,372.85 ","$1,364.71 ","$19,307.35 ","$19,307.35 ","$5,189.00 ","$2,853.95 ","$7,722.94 ","$1,452.92 ","$2,438.83 ","$7,722.94 ","$2,802.06 ","$5,189.00 ","$2,817.63 ","$2,817.63 ","$5,189.00 ","$2,817.63 ","$5,189.00 ","$3,500.00 ","$2,594.50 ","$4,151.20 ","$19,307.35 ","$7,722.94 ","$3,632.30 ","$7,722.94 ","$3,113.40 ","$7,722.94 ","$3,891.75 ","$2,864.33 ","$2,584.12 ","$2,864.33 ","$7,722.94 ","$2,864.33 ","$4,047.42 ","$4,047.42 ","$4,410.65 ","$5,189.00 ","$3,595.98 ","$7,722.94 ","$5,189.00 ","$2,853.95 ","$7,722.94 ","$1,364.71 ","$5,189.00 ","$2,179.58 ","$2,080.51 ","$8,109.09 ","$4,151.20 ","$2,817.63 ","$1,452.92 ","$4,670.10 ","$2,861.00 ","$5,100.00 ","$7,722.94 ","$2,490.72 "
ST. MARY'S HOSPITAL - DECATUR,48100441,33999,HC CORONARY ASP THROMBECTOMY,481,1 ,"$1,224.00 ",$795.60 ,$321.91 ,"$1,279.16 ","$1,279.15 ","$1,224.00 ",$673.20 ,$511.66 ,$342.72 ,$575.28 ,$511.66 ,$660.96 ,$511.66 ,$664.63 ,$664.63 ,$511.66 ,$664.63 ,$972.16 ,$856.80 ,$612.00 ,$979.20 ,"$1,279.16 ",$511.66 ,$856.80 ,$511.66 ,$734.40 ,$511.66 ,$918.00 ,$675.65 ,$609.55 ,$675.65 ,$511.66 ,$675.65 ,$954.72 ,$954.72 ,"$1,040.40 ","$1,224.00 ",$848.23 ,$511.66 ,"$1,224.00 ",$673.20 ,$511.66 ,$321.91 ,"$1,224.00 ",$613.89 ,$585.98 ,$537.24 ,$979.20 ,$664.63 ,$342.72 ,"$1,101.60 ","$1,224.00 ","$1,224.00 ",$511.66 ,$587.52 
ST. MARY'S HOSPITAL - DECATUR,48100444,34812,HC EXPOSE FEMORAL ARTERY W/PROSTHESIS - BILATERAL,481,1 ,$476.00 ,$309.40 ,$125.19 ,$476.00 , N/A ,$476.00 ,$261.80 , N/A ,$133.28 ,$223.72 , N/A ,$257.04 , N/A ,$258.47 ,$258.47 , N/A ,$258.47 , N/A ,$333.20 ,$238.00 ,$380.80 , N/A , N/A ,$333.20 , N/A ,$285.60 , N/A ,$357.00 ,$262.75 ,$237.05 ,$262.75 , N/A ,$262.75 ,$371.28 ,$371.28 ,$404.60 , N/A ,$329.87 , N/A ,$476.00 ,$261.80 , N/A ,$125.19 ,$476.00 , N/A , N/A , N/A ,$380.80 ,$258.47 ,$133.28 ,$428.40 ,$476.00 ,$476.00 , N/A ,$228.48 
ST. MARY'S HOSPITAL - DECATUR,48100447,36222,HC CATH PLCMT SEL COM CAR/INOM EXTRACRN-BIL,481,1 ,"$14,798.00 ","$9,618.70 ","$2,679.95 ","$14,798.00 ","$6,774.50 ","$5,250.00 ","$8,138.90 ","$2,709.80 ","$4,143.44 ","$3,523.99 ","$2,709.80 ","$4,049.96 ","$2,709.80 ","$3,913.45 ","$3,913.45 ","$2,709.80 ","$3,913.45 ","$5,148.61 ","$3,500.00 ","$7,399.00 ","$11,838.40 ","$6,774.49 ","$2,709.80 ","$10,358.60 ","$2,709.80 ","$8,878.80 ","$2,709.80 ","$11,098.50 ","$8,168.50 ","$7,369.40 ","$8,168.50 ","$2,709.80 ","$8,168.50 ","$11,542.44 ","$11,542.44 ","$12,578.30 ","$6,774.49 ","$4,981.00 ","$2,709.80 ","$14,798.00 ","$8,138.90 ","$2,709.80 ","$3,891.87 ","$14,798.00 ","$2,807.56 ","$2,679.95 ","$2,845.29 ","$11,838.40 ","$3,913.45 ","$4,143.44 ","$13,318.20 ","$3,961.50 ","$4,875.00 ","$2,709.80 ","$7,103.04 "
ST. MARY'S HOSPITAL - DECATUR,48100452,36227,HC CATH PLCMT SEL EXTERNAL CARTOID-BIL,481,1 ,"$3,585.00 ","$2,330.25 ",$942.86 ,"$3,585.00 ", N/A ,"$3,585.00 ","$1,971.75 ", N/A ,"$1,003.80 ","$1,684.95 ", N/A ,"$1,935.90 ", N/A ,"$1,946.66 ","$1,946.66 ", N/A ,"$1,946.66 ", N/A ,"$2,509.50 ","$1,792.50 ","$2,868.00 ", N/A , N/A ,"$2,509.50 ", N/A ,"$2,151.00 ", N/A ,"$2,688.75 ","$1,978.92 ","$1,785.33 ","$1,978.92 ", N/A ,"$1,978.92 ","$2,796.30 ","$2,796.30 ","$3,047.25 ", N/A ,"$2,484.41 ", N/A ,"$3,585.00 ","$1,971.75 ", N/A ,$942.86 ,"$3,585.00 ","$2,807.56 ","$2,679.95 ", N/A ,"$2,868.00 ","$1,946.66 ","$1,003.80 ","$3,226.50 ","$1,105.50 ","$1,350.00 ", N/A ,"$1,720.80 "
ST. MARY'S HOSPITAL - DECATUR,48100456,75600,HC AORTOGRAM THORACIC W/O SERIALOGRAPHY,481,1 ,"$4,782.00 ","$3,108.30 ",$211.75 ,"$6,774.50 ","$6,774.50 ",$352.69 ,"$2,630.10 ","$2,709.80 ","$1,338.96 ","$2,247.54 ","$2,709.80 ","$2,582.28 ","$2,709.80 ","$2,596.63 ","$2,596.63 ","$2,709.80 ","$2,596.63 ","$4,782.00 ","$3,347.40 ","$2,391.00 ","$3,825.60 ","$6,774.49 ","$2,709.80 ","$3,347.40 ","$2,709.80 ","$2,869.20 ","$2,709.80 ","$3,586.50 ","$2,639.66 ","$2,381.44 ","$2,639.66 ","$2,709.80 ","$2,639.66 ", N/A , N/A ,"$4,064.70 ","$4,782.00 ","$3,313.93 ","$2,709.80 ","$4,782.00 ","$2,630.10 ","$2,709.80 ","$1,257.67 ","$4,782.00 ",$221.84 ,$211.75 ,"$2,845.29 ","$3,825.60 ","$2,596.63 ","$1,338.96 ","$4,303.80 ", N/A , N/A ,"$2,709.80 ","$2,295.36 "
ST. MARY'S HOSPITAL - DECATUR,48100460,93458,HC CORONARY ANGIO WITH LV,481,1 ,"$12,502.00 ","$8,126.30 ","$1,626.71 ","$12,502.00 ","$6,862.28 ","$6,376.02 ","$6,876.10 ","$2,744.91 ","$3,500.56 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$6,251.00 ","$10,001.60 ","$6,862.29 ","$2,744.91 ","$8,751.40 ","$2,744.91 ","$7,501.20 ","$2,744.91 ","$9,376.50 ","$6,901.10 ","$6,226.00 ","$6,901.10 ","$2,744.91 ","$6,901.10 ","$9,751.56 ","$9,751.56 ","$10,626.70 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$12,502.00 ","$6,876.10 ","$2,744.91 ","$3,288.03 ","$12,502.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$10,001.60 ","$3,913.45 ","$3,500.56 ","$11,251.80 ","$6,200.99 ","$6,000.00 ","$2,744.91 ","$6,000.96 "
ST. MARY'S HOSPITAL - DECATUR,48100461,93459,HC CORONARY ANGIO W GRAFTS AND LV,481,1 ,"$13,624.00 ","$8,855.60 ","$1,626.71 ","$13,624.00 ","$6,862.28 ","$6,948.24 ","$7,493.20 ","$2,744.91 ","$3,814.72 ","$3,523.99 ","$2,744.91 ","$4,049.96 ","$2,744.91 ","$3,913.45 ","$3,913.45 ","$2,744.91 ","$3,913.45 ","$5,215.34 ","$3,500.00 ","$6,812.00 ","$10,899.20 ","$6,862.29 ","$2,744.91 ","$9,536.80 ","$2,744.91 ","$8,174.40 ","$2,744.91 ","$10,218.00 ","$7,520.45 ","$6,784.75 ","$7,520.45 ","$2,744.91 ","$7,520.45 ","$10,626.72 ","$10,626.72 ","$11,580.40 ","$6,862.29 ","$4,981.00 ","$2,744.91 ","$13,624.00 ","$7,493.20 ","$2,744.91 ","$3,583.11 ","$13,624.00 ","$1,704.18 ","$1,626.71 ","$2,882.16 ","$10,899.20 ","$3,913.45 ","$3,814.72 ","$12,261.60 ","$6,757.50 ","$6,000.00 ","$2,744.91 ","$6,539.52 "
ST. MARY'S HOSPITAL - DECATUR,48100493,34713,HC PERQ ACCESS/CLOSURE FEM ARTY ENDOGRAFT UNI,481,1 ,$737.00 ,$479.05 ,$193.83 ,$737.00 , N/A ,$737.00 ,$405.35 , N/A ,$206.36 ,$346.39 , N/A ,$397.98 , N/A ,$400.19 ,$400.19 , N/A ,$400.19 , N/A ,$515.90 ,$368.50 ,$589.60 , N/A , N/A ,$515.90 , N/A ,$442.20 , N/A ,$552.75 ,$406.82 ,$367.03 ,$406.82 , N/A ,$406.82 ,$574.86 ,$574.86 ,$626.45 , N/A ,$510.74 , N/A ,$737.00 ,$405.35 , N/A ,$193.83 ,$737.00 , N/A , N/A , N/A ,$589.60 ,$400.19 ,$206.36 ,$663.30 ,$737.00 ,$737.00 , N/A ,$353.76 
ST. MARY'S HOSPITAL - DECATUR,48100532,93355,HC TRANSESOPHAGEAL ECHOCARDIOLOGY  (TEE),481,1 ,"$4,501.00 ","$2,925.65 ",$323.93 ,"$4,501.00 ", N/A ,"$2,295.51 ","$2,475.55 ", N/A ,"$1,260.28 ","$2,115.47 ", N/A ,"$2,430.54 ", N/A ,"$2,444.04 ","$2,444.04 ", N/A ,"$2,444.04 ", N/A ,"$3,150.70 ","$2,250.50 ","$3,600.80 ", N/A , N/A ,"$3,150.70 ", N/A ,"$2,700.60 ", N/A ,"$3,375.75 ","$2,484.55 ","$2,241.50 ","$2,484.55 ", N/A ,"$2,484.55 ","$3,510.78 ","$3,510.78 ","$3,825.85 ", N/A ,"$3,119.19 ", N/A ,"$4,501.00 ","$2,475.55 ", N/A ,"$1,183.76 ","$4,501.00 ",$339.35 ,$323.93 , N/A ,"$3,600.80 ","$2,444.04 ","$1,260.28 ","$4,050.90 ", N/A , N/A , N/A ,"$2,160.48 "
ST. MARY'S HOSPITAL - DECATUR,48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,684.00 ","$1,094.60 ",$65.94 ,"$1,684.00 ",$626.30 ,$858.84 ,$926.20 ,$250.52 ,$471.52 ,$571.91 ,$250.52 ,$571.91 ,$250.52 ,$914.41 ,$65.94 ,$250.52 ,$914.41 ,$475.99 ,"$1,178.80 ",$842.00 ,"$1,347.20 ",$626.30 ,$250.52 ,"$1,178.80 ",$250.52 ,"$1,010.40 ",$250.52 ,"$1,263.00 ",$929.57 ,$838.63 ,$929.57 ,$250.52 ,$929.57 ,"$1,313.52 ","$1,313.52 ","$1,431.40 ",$626.30 ,"$1,167.01 ",$250.52 ,"$1,684.00 ",$926.20 ,$250.52 ,$442.89 ,"$1,684.00 ",$213.52 ,$203.82 ,$263.05 ,"$1,347.20 ",$914.41 ,$471.52 ,"$1,515.60 ",$639.92 ,"$1,025.00 ",$250.52 ,$808.32 
ST. MARY'S HOSPITAL - DECATUR,48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$1,715.00 ","$1,114.75 ",$257.86 ,"$1,715.00 ","$1,143.48 ",$874.65 ,$943.25 ,$457.39 ,$480.20 ,$840.35 ,$457.39 ,"$1,003.28 ",$457.39 ,$931.25 ,$257.86 ,$457.39 ,$931.25 ,$869.04 ,"$1,200.50 ",$857.50 ,"$1,372.00 ","$1,143.47 ",$457.39 ,"$1,200.50 ",$457.39 ,"$1,029.00 ",$457.39 ,"$1,286.25 ",$946.68 ,$854.07 ,$946.68 ,$457.39 ,$946.68 ,"$1,337.70 ","$1,337.70 ","$1,457.75 ","$1,143.47 ","$1,188.50 ",$457.39 ,"$1,715.00 ",$943.25 ,$457.39 ,$451.05 ,"$1,715.00 ",$339.35 ,$323.93 ,$480.26 ,"$1,372.00 ",$931.25 ,$480.20 ,"$1,543.50 ",$651.70 ,"$1,000.00 ",$457.39 ,$823.20 
ST. MARY'S HOSPITAL - DECATUR,48300001,93307,HC ECHOCARDIOGRAM 2D W/O DOP,483,1 ,"$1,993.00 ","$1,295.45 ",$184.39 ,"$1,993.00 ",$544.53 ,"$1,016.43 ","$1,096.15 ",$217.81 ,$558.04 ,$976.57 ,$217.81 ,"$1,165.91 ",$217.81 ,"$1,082.20 ",$184.39 ,$217.81 ,"$1,082.20 ",$413.84 ,"$1,395.10 ",$996.50 ,"$1,594.40 ",$544.53 ,$217.81 ,"$1,395.10 ",$217.81 ,"$1,195.80 ",$217.81 ,"$1,494.75 ","$1,100.14 ",$992.51 ,"$1,100.14 ",$217.81 ,"$1,100.14 ","$1,554.54 ","$1,554.54 ","$1,694.05 ",$544.53 ,"$1,381.15 ",$217.81 ,"$1,993.00 ","$1,096.15 ",$217.81 ,$524.16 ,"$1,993.00 ",$339.35 ,$323.93 ,$228.70 ,"$1,594.40 ","$1,082.20 ",$558.04 ,"$1,793.70 ",$757.34 ,"$1,000.00 ",$217.81 ,$956.64 
ST. MARY'S HOSPITAL - DECATUR,48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$940.00 ,$611.00 ,$140.57 ,$940.00 ,$544.53 ,$479.40 ,$517.00 ,$217.81 ,$263.20 ,$460.60 ,$217.81 ,$549.90 ,$217.81 ,$510.42 ,$140.57 ,$217.81 ,$510.42 ,$413.84 ,$658.00 ,$470.00 ,$752.00 ,$544.53 ,$217.81 ,$658.00 ,$217.81 ,$564.00 ,$217.81 ,$705.00 ,$518.88 ,$468.12 ,$518.88 ,$217.81 ,$518.88 ,$733.20 ,$733.20 ,$799.00 ,$544.53 ,$651.42 ,$217.81 ,$940.00 ,$517.00 ,$217.81 ,$247.22 ,$940.00 ,$339.35 ,$323.93 ,$228.70 ,$752.00 ,$510.42 ,$263.20 ,$846.00 ,$357.20 ,$940.00 ,$217.81 ,$451.20 
ST. MARY'S HOSPITAL - DECATUR,48300003,93312,HC ECHO TEE CMPL W/PF,483,1 ,"$3,216.00 ","$2,090.40 ",$264.71 ,"$3,216.00 ","$1,143.48 ","$1,640.16 ","$1,768.80 ",$457.39 ,$900.48 ,"$1,575.84 ",$457.39 ,"$1,881.36 ",$457.39 ,"$1,746.29 ",$264.71 ,$457.39 ,"$1,746.29 ",$869.04 ,"$2,251.20 ","$1,608.00 ","$2,572.80 ","$1,143.47 ",$457.39 ,"$2,251.20 ",$457.39 ,"$1,929.60 ",$457.39 ,"$2,412.00 ","$1,775.23 ","$1,601.57 ","$1,775.23 ",$457.39 ,"$1,775.23 ","$2,508.48 ","$2,508.48 ","$2,733.60 ","$1,143.47 ","$2,228.69 ",$457.39 ,"$3,216.00 ","$1,768.80 ",$457.39 ,$845.81 ,"$3,216.00 ",$339.35 ,$323.93 ,$480.26 ,"$2,572.80 ","$1,746.29 ",$900.48 ,"$2,894.40 ","$1,222.08 ","$1,000.00 ",$457.39 ,"$1,543.68 "
ST. MARY'S HOSPITAL - DECATUR,48300005,93320,HC ECHO DOPPLER,483,1 ,$618.00 ,$401.70 ,$67.78 ,$618.00 , N/A ,$315.18 ,$339.90 , N/A ,$173.04 ,$302.82 , N/A ,$361.53 , N/A ,$335.57 ,$67.78 , N/A ,$335.57 , N/A ,$432.60 ,$309.00 ,$494.40 , N/A , N/A ,$432.60 , N/A ,$370.80 , N/A ,$463.50 ,$341.14 ,$307.76 ,$341.14 , N/A ,$341.14 ,$482.04 ,$482.04 ,$525.30 , N/A ,$428.27 , N/A ,$618.00 ,$339.90 , N/A ,$162.53 ,$618.00 ,$339.35 ,$323.93 , N/A ,$494.40 ,$335.57 ,$173.04 ,$556.20 ,$234.84 ,$618.00 , N/A ,$296.64 
ST. MARY'S HOSPITAL - DECATUR,48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,$706.00 ,$458.90 ,$42.45 ,$706.00 , N/A ,$360.06 ,$388.30 , N/A ,$197.68 ,$345.94 , N/A ,$374.03 , N/A ,$383.36 ,$42.45 , N/A ,$383.36 , N/A ,$494.20 ,$353.00 ,$564.80 , N/A , N/A ,$494.20 , N/A ,$423.60 , N/A ,$529.50 ,$389.71 ,$351.59 ,$389.71 , N/A ,$389.71 ,$550.68 ,$550.68 ,$600.10 , N/A ,$489.26 , N/A ,$706.00 ,$388.30 , N/A ,$185.68 ,$706.00 ,$339.35 ,$323.93 , N/A ,$564.80 ,$383.36 ,$197.68 ,$635.40 ,$268.28 ,$706.00 , N/A ,$338.88 
ST. MARY'S HOSPITAL - DECATUR,48300007,93350,HC ECHO REST  AND  STRESS W/PF,483,1 ,"$2,460.00 ","$1,599.00 ",$225.47 ,"$2,460.00 ","$1,143.48 ","$1,254.60 ","$1,353.00 ",$457.39 ,$688.80 ,"$1,205.40 ",$457.39 ,"$1,439.10 ",$457.39 ,"$1,335.78 ",$225.47 ,$457.39 ,"$1,335.78 ",$869.04 ,"$1,722.00 ","$1,230.00 ","$1,968.00 ","$1,143.47 ",$457.39 ,"$1,722.00 ",$457.39 ,"$1,476.00 ",$457.39 ,"$1,845.00 ","$1,357.92 ","$1,225.08 ","$1,357.92 ",$457.39 ,"$1,357.92 ","$1,918.80 ","$1,918.80 ","$2,091.00 ","$1,143.47 ","$1,704.78 ",$457.39 ,"$2,460.00 ","$1,353.00 ",$457.39 ,$646.98 ,"$2,460.00 ",$339.35 ,$323.93 ,$480.26 ,"$1,968.00 ","$1,335.78 ",$688.80 ,"$2,214.00 ",$934.80 ,"$1,000.00 ",$457.39 ,"$1,180.80 "
ST. MARY'S HOSPITAL - DECATUR,48300008,93303,HC ECHO PEDS CONGENITAL,483,1 ,$862.00 ,$560.30 ,$226.71 ,"$1,143.48 ","$1,143.48 ",$439.62 ,$474.10 ,$457.39 ,$241.36 ,$422.38 ,$457.39 ,$504.27 ,$457.39 ,$468.07 ,$331.80 ,$457.39 ,$468.07 ,$862.00 ,$603.40 ,$431.00 ,$689.60 ,"$1,143.47 ",$457.39 ,$603.40 ,$457.39 ,$517.20 ,$457.39 ,$646.50 ,$475.82 ,$429.28 ,$475.82 ,$457.39 ,$475.82 ,$672.36 ,$672.36 ,$732.70 ,$862.00 ,$597.37 ,$457.39 ,$862.00 ,$474.10 ,$457.39 ,$226.71 ,$862.00 ,$339.35 ,$323.93 ,$480.26 ,$689.60 ,$468.07 ,$241.36 ,$775.80 ,$327.56 ,$862.00 ,$457.39 ,$413.76 
ST. MARY'S HOSPITAL - DECATUR,48300009,93304,HC ECHO PEDS CONGENITAL LMTD,483,1 ,"$1,010.00 ",$656.50 ,$239.16 ,"$1,143.48 ","$1,143.48 ",$515.10 ,$555.50 ,$457.39 ,$282.80 ,$494.90 ,$457.39 ,$590.85 ,$457.39 ,$548.43 ,$239.16 ,$457.39 ,$548.43 ,$869.04 ,$707.00 ,$505.00 ,$808.00 ,"$1,143.47 ",$457.39 ,$707.00 ,$457.39 ,$606.00 ,$457.39 ,$757.50 ,$557.52 ,$502.98 ,$557.52 ,$457.39 ,$557.52 ,$787.80 ,$787.80 ,$858.50 ,"$1,010.00 ",$699.93 ,$457.39 ,"$1,010.00 ",$555.50 ,$457.39 ,$265.63 ,"$1,010.00 ",$339.35 ,$323.93 ,$480.26 ,$808.00 ,$548.43 ,$282.80 ,$909.00 ,$383.80 ,"$1,000.00 ",$457.39 ,$484.80 
ST. MARY'S HOSPITAL - DECATUR,48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,$557.00 ,$362.05 ,$37.66 ,$557.00 , N/A ,$284.07 ,$306.35 , N/A ,$155.96 ,$272.93 , N/A ,$325.85 , N/A ,$302.45 ,$37.66 , N/A ,$302.45 , N/A ,$389.90 ,$278.50 ,$445.60 , N/A , N/A ,$389.90 , N/A ,$334.20 , N/A ,$417.75 ,$307.46 ,$277.39 ,$307.46 , N/A ,$307.46 ,$434.46 ,$434.46 ,$473.45 , N/A ,$386.00 , N/A ,$557.00 ,$306.35 , N/A ,$146.49 ,$557.00 ,$339.35 ,$323.93 , N/A ,$445.60 ,$302.45 ,$155.96 ,$501.30 ,$211.66 ,$557.00 , N/A ,$267.36 
ST. MARY'S HOSPITAL - DECATUR,48300011,93351,HC ECHO 2D STRESS CONT MONITORING,483,1 ,"$2,822.00 ","$1,834.30 ",$284.56 ,"$2,822.00 ","$1,143.48 ","$1,439.22 ","$1,552.10 ",$457.39 ,$790.16 ,"$1,382.78 ",$457.39 ,"$1,650.87 ",$457.39 ,"$1,532.35 ",$284.56 ,$457.39 ,"$1,532.35 ",$869.04 ,"$1,975.40 ","$1,411.00 ","$2,257.60 ","$1,143.47 ",$457.39 ,"$1,975.40 ",$457.39 ,"$1,693.20 ",$457.39 ,"$2,116.50 ","$1,557.74 ","$1,405.36 ","$1,557.74 ",$457.39 ,"$1,557.74 ","$2,201.16 ","$2,201.16 ","$2,398.70 ","$1,143.47 ","$1,955.65 ",$457.39 ,"$2,822.00 ","$1,552.10 ",$457.39 ,$742.19 ,"$2,822.00 ",$339.35 ,$323.93 ,$480.26 ,"$2,257.60 ","$1,532.35 ",$790.16 ,"$2,539.80 ","$1,072.36 ","$1,000.00 ",$457.39 ,"$1,354.56 "
ST. MARY'S HOSPITAL - DECATUR,48300013,C8921,HC ECHO TTE CONGENTIAL W/W/O CONT  AND  W/CONT COMPL,483,1 ,"$2,119.00 ","$1,377.35 ",$323.93 ,"$2,119.00 ","$1,693.08 ","$1,080.69 ","$1,165.45 ",$677.23 ,$593.32 ,$995.93 ,$677.23 ,"$1,144.26 ",$677.23 ,"$1,150.62 ",$847.60 ,$677.23 ,"$1,150.62 ","$1,286.73 ","$1,483.30 ","$1,059.50 ","$1,695.20 ","$1,693.07 ",$677.23 ,"$1,483.30 ",$677.23 ,"$1,271.40 ",$677.23 ,"$1,589.25 ","$1,169.69 ","$1,055.26 ","$1,169.69 ",$677.23 ,"$1,169.69 ","$1,652.82 ","$1,652.82 ","$1,801.15 ","$1,693.07 ","$1,468.47 ",$677.23 ,"$2,119.00 ","$1,165.45 ",$677.23 ,$557.30 ,"$2,119.00 ",$339.35 ,$323.93 ,$711.09 ,"$1,695.20 ","$1,150.62 ",$593.32 ,"$1,907.10 ",$805.22 ,"$1,000.00 ",$677.23 ,"$1,017.12 "
ST. MARY'S HOSPITAL - DECATUR,48300016,C8924,HC ECHO TTE W/W/O CONT  AND  W/CONT LIMIT,483,1 ,"$1,229.00 ",$798.85 ,$323.23 ,"$1,229.00 ",$871.45 ,$626.79 ,$675.95 ,$348.58 ,$344.12 ,$577.63 ,$348.58 ,$663.66 ,$348.58 ,$667.35 ,$491.60 ,$348.58 ,$667.35 ,$662.31 ,$860.30 ,$614.50 ,$983.20 ,$871.46 ,$348.58 ,$860.30 ,$348.58 ,$737.40 ,$348.58 ,$921.75 ,$678.41 ,$612.04 ,$678.41 ,$348.58 ,$678.41 ,$958.62 ,$958.62 ,"$1,044.65 ",$871.46 ,$851.70 ,$348.58 ,"$1,229.00 ",$675.95 ,$348.58 ,$323.23 ,"$1,229.00 ",$339.35 ,$323.93 ,$366.01 ,$983.20 ,$667.35 ,$344.12 ,"$1,106.10 ",$467.02 ,"$1,000.00 ",$348.58 ,$589.92 
ST. MARY'S HOSPITAL - DECATUR,48300017,C8925,HC ECHO TEE 2D W/W/O CONT  AND  W/CONT W/PF,483,1 ,"$3,216.00 ","$2,090.40 ",$323.93 ,"$3,216.00 ","$1,693.08 ","$1,640.16 ","$1,768.80 ",$677.23 ,$900.48 ,"$1,511.52 ",$677.23 ,"$1,736.64 ",$677.23 ,"$1,746.29 ","$1,286.40 ",$677.23 ,"$1,746.29 ","$1,286.73 ","$2,251.20 ","$1,608.00 ","$2,572.80 ","$1,693.07 ",$677.23 ,"$2,251.20 ",$677.23 ,"$1,929.60 ",$677.23 ,"$2,412.00 ","$1,775.23 ","$1,601.57 ","$1,775.23 ",$677.23 ,"$1,775.23 ","$2,508.48 ","$2,508.48 ","$2,733.60 ","$1,693.07 ","$2,228.69 ",$677.23 ,"$3,216.00 ","$1,768.80 ",$677.23 ,$845.81 ,"$3,216.00 ",$339.35 ,$323.93 ,$711.09 ,"$2,572.80 ","$1,746.29 ",$900.48 ,"$2,894.40 ","$1,222.08 ","$1,000.00 ",$677.23 ,"$1,543.68 "
ST. MARY'S HOSPITAL - DECATUR,48300018,C8928,HC ECHO TTE 2D STRESS W/W/O CONT  AND  W/CONT W/PF,483,1 ,"$2,604.00 ","$1,692.60 ",$323.93 ,"$2,604.00 ","$1,693.08 ","$1,328.04 ","$1,432.20 ",$677.23 ,$729.12 ,"$1,223.88 ",$677.23 ,"$1,406.16 ",$677.23 ,"$1,413.97 ","$1,041.60 ",$677.23 ,"$1,413.97 ","$1,286.73 ","$1,822.80 ","$1,302.00 ","$2,083.20 ","$1,693.07 ",$677.23 ,"$1,822.80 ",$677.23 ,"$1,562.40 ",$677.23 ,"$1,953.00 ","$1,437.41 ","$1,296.79 ","$1,437.41 ",$677.23 ,"$1,437.41 ","$2,031.12 ","$2,031.12 ","$2,213.40 ","$1,693.07 ","$1,804.57 ",$677.23 ,"$2,604.00 ","$1,432.20 ",$677.23 ,$684.85 ,"$2,604.00 ",$339.35 ,$323.93 ,$711.09 ,"$2,083.20 ","$1,413.97 ",$729.12 ,"$2,343.60 ",$989.52 ,"$1,000.00 ",$677.23 ,"$1,249.92 "
ST. MARY'S HOSPITAL - DECATUR,48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT  AND  W/CONT,483,1 ,"$1,734.00 ","$1,127.10 ",$323.93 ,"$1,734.00 ","$1,693.08 ",$884.34 ,$953.70 ,$677.23 ,$485.52 ,$814.98 ,$677.23 ,$936.36 ,$677.23 ,$941.56 ,$693.60 ,$677.23 ,$941.56 ,"$1,286.73 ","$1,213.80 ",$867.00 ,"$1,387.20 ","$1,693.07 ",$677.23 ,"$1,213.80 ",$677.23 ,"$1,040.40 ",$677.23 ,"$1,300.50 ",$957.17 ,$863.53 ,$957.17 ,$677.23 ,$957.17 ,"$1,352.52 ","$1,352.52 ","$1,473.90 ","$1,693.07 ","$1,201.66 ",$677.23 ,"$1,734.00 ",$953.70 ,$677.23 ,$456.04 ,"$1,734.00 ",$339.35 ,$323.93 ,$711.09 ,"$1,387.20 ",$941.56 ,$485.52 ,"$1,560.60 ",$658.92 ,"$1,000.00 ",$677.23 ,$832.32 
ST. MARY'S HOSPITAL - DECATUR,48300020,C8930,HC ECHO TTE 2D REST/STRESS W/W/O CONT  AND  W/CONT W/PF,483,1 ,"$2,822.00 ","$1,834.30 ",$323.93 ,"$2,822.00 ","$1,693.08 ","$1,439.22 ","$1,552.10 ",$677.23 ,$790.16 ,"$1,326.34 ",$677.23 ,"$1,523.88 ",$677.23 ,"$1,532.35 ","$1,128.80 ",$677.23 ,"$1,532.35 ","$1,286.73 ","$1,975.40 ","$1,411.00 ","$2,257.60 ","$1,693.07 ",$677.23 ,"$1,975.40 ",$677.23 ,"$1,693.20 ",$677.23 ,"$2,116.50 ","$1,557.74 ","$1,405.36 ","$1,557.74 ",$677.23 ,"$1,557.74 ","$2,201.16 ","$2,201.16 ","$2,398.70 ","$1,693.07 ","$1,955.65 ",$677.23 ,"$2,822.00 ","$1,552.10 ",$677.23 ,$742.19 ,"$2,822.00 ",$339.35 ,$323.93 ,$711.09 ,"$2,257.60 ","$1,532.35 ",$790.16 ,"$2,539.80 ","$1,072.36 ","$1,000.00 ",$677.23 ,"$1,354.56 "
ST. MARY'S HOSPITAL - DECATUR,48300027,93356,HC MYOCARDIAL STRAIN IMAGING ADD ON,483,1 ,$184.00 ,$119.60 ,$24.89 ,$323.93 , N/A ,$93.84 ,$101.20 , N/A ,$51.52 ,$86.48 , N/A ,$99.36 , N/A ,$99.91 ,$24.89 , N/A ,$99.91 , N/A ,$128.80 ,$92.00 ,$147.20 , N/A , N/A ,$128.80 , N/A ,$110.40 , N/A ,$138.00 ,$101.57 ,$91.63 ,$101.57 , N/A ,$101.57 ,$143.52 ,$143.52 ,$156.40 , N/A ,$127.51 , N/A ,$184.00 ,$101.20 , N/A ,$48.39 ,$184.00 ,$184.00 ,$323.93 , N/A ,$147.20 ,$99.91 ,$51.52 ,$165.60 ,$69.92 ,$184.00 , N/A ,$88.32 
ST. MARY'S HOSPITAL - DECATUR,51000003,10180,HC I AND D WOUND POST OP COMPLEX,510,1 ,"$7,961.00 ","$5,174.65 ",$250.00 ,"$7,961.00 ","$5,611.10 ","$4,060.11 ","$4,378.55 ","$2,244.44 ","$2,229.08 ","$3,741.67 ","$2,244.44 ","$4,298.94 ","$2,244.44 ","$4,322.82 ",$303.40 ,"$2,244.44 ","$4,322.82 ","$4,264.43 ","$5,572.70 ","$3,980.50 ","$6,368.80 ","$5,611.09 ","$2,244.44 ","$5,572.70 ","$2,244.44 ","$4,776.60 ","$2,244.44 ","$5,970.75 ","$4,394.47 ","$3,964.58 ","$4,394.47 ","$2,244.44 ","$4,394.47 ","$6,209.58 ","$6,209.58 ","$6,766.85 ","$5,611.09 ","$5,516.97 ","$2,244.44 ","$7,961.00 ","$4,378.55 ","$2,244.44 ","$2,093.74 ","$7,961.00 ",$733.10 ,$699.77 ,"$2,356.66 ","$6,368.80 ","$4,322.82 ","$2,229.08 ","$7,164.90 ","$3,025.18 ",$250.00 ,"$2,244.44 ","$3,821.28 "
ST. MARY'S HOSPITAL - DECATUR,51000005,11042,HC DEBR SKIN/SUBQ TISS INIT 20CM FAC,510,1 ,"$1,300.00 ",$845.00 ,$104.90 ,"$1,300.00 ",$817.95 ,$663.00 ,$715.00 ,$327.18 ,$364.00 ,$611.00 ,$327.18 ,$702.00 ,$327.18 ,$705.90 ,$104.90 ,$327.18 ,$705.90 ,$621.65 ,$910.00 ,$650.00 ,"$1,040.00 ",$817.95 ,$327.18 ,$910.00 ,$327.18 ,$780.00 ,$327.18 ,$975.00 ,$717.60 ,$647.40 ,$717.60 ,$327.18 ,$717.60 ,"$1,014.00 ","$1,014.00 ","$1,105.00 ",$817.95 ,$900.90 ,$327.18 ,"$1,300.00 ",$715.00 ,$327.18 ,$341.90 ,"$1,300.00 ",$214.47 ,$204.72 ,$343.54 ,"$1,040.00 ",$705.90 ,$364.00 ,"$1,170.00 ",$494.00 ,$250.00 ,$327.18 ,$624.00 
ST. MARY'S HOSPITAL - DECATUR,51000006,11043,HC DEBR SKIN/SUBQ TISSUE/MUSCLE FAC,510,1 ,$627.00 ,$407.55 ,$164.90 ,"$1,239.43 ","$1,239.43 ",$319.77 ,$344.85 ,$495.77 ,$175.56 ,$294.69 ,$495.77 ,$338.58 ,$495.77 ,$340.46 ,$267.47 ,$495.77 ,$340.46 ,$627.00 ,$438.90 ,$313.50 ,$501.60 ,"$1,239.42 ",$495.77 ,$438.90 ,$495.77 ,$376.20 ,$495.77 ,$470.25 ,$346.10 ,$312.25 ,$346.10 ,$495.77 ,$346.10 ,$489.06 ,$489.06 ,$532.95 ,$627.00 ,$434.51 ,$495.77 ,$627.00 ,$344.85 ,$495.77 ,$164.90 ,$627.00 ,$583.48 ,$556.96 ,$520.56 ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$250.00 ,$495.77 ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,51000007,11044,HC DEBR SKIN/SUB TIS/MUS/BONE INT 20 FAC,510,1 ,"$3,891.00 ","$2,529.15 ",$250.00 ,"$3,891.00 ","$3,329.73 ","$1,984.41 ","$2,140.05 ","$1,331.89 ","$1,089.48 ","$1,828.77 ","$1,331.89 ","$2,101.14 ","$1,331.89 ","$2,112.81 ",$396.95 ,"$1,331.89 ","$2,112.81 ","$2,530.59 ","$2,723.70 ","$1,945.50 ","$3,112.80 ","$3,329.72 ","$1,331.89 ","$2,723.70 ","$1,331.89 ","$2,334.60 ","$1,331.89 ","$2,918.25 ","$2,147.83 ","$1,937.72 ","$2,147.83 ","$1,331.89 ","$2,147.83 ","$3,034.98 ","$3,034.98 ","$3,307.35 ","$3,329.72 ","$2,696.46 ","$1,331.89 ","$3,891.00 ","$2,140.05 ","$1,331.89 ","$1,023.33 ","$3,891.00 ",$837.54 ,$799.47 ,"$1,398.48 ","$3,112.80 ","$2,112.81 ","$1,089.48 ","$3,501.90 ","$1,478.58 ",$250.00 ,"$1,331.89 ","$1,867.68 "
ST. MARY'S HOSPITAL - DECATUR,51000009,11045,HC DEBR SKIN/SUBQ TIS EA ADL 20CM FAC,510,1 ,$627.00 ,$407.55 ,$46.10 ,$627.00 , N/A ,$319.77 ,$344.85 , N/A ,$175.56 ,$294.69 , N/A ,$338.58 , N/A ,$340.46 ,$46.10 , N/A ,$340.46 , N/A ,$438.90 ,$313.50 ,$501.60 , N/A , N/A ,$438.90 , N/A ,$376.20 , N/A ,$470.25 ,$346.10 ,$312.25 ,$346.10 , N/A ,$346.10 ,$489.06 ,$489.06 ,$532.95 , N/A ,$434.51 , N/A ,$627.00 ,$344.85 , N/A ,$164.90 ,$627.00 ,$583.48 ,$556.96 , N/A ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$250.00 , N/A ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,51000010,11046,HC DEBR SKIN/SUBQ MUS/FAS ADL 20C FAC,510,1 ,$627.00 ,$407.55 ,$97.71 ,$627.00 , N/A ,$319.77 ,$344.85 , N/A ,$175.56 ,$294.69 , N/A ,$338.58 , N/A ,$340.46 ,$97.71 , N/A ,$340.46 , N/A ,$438.90 ,$313.50 ,$501.60 , N/A , N/A ,$438.90 , N/A ,$376.20 , N/A ,$470.25 ,$346.10 ,$312.25 ,$346.10 , N/A ,$346.10 ,$489.06 ,$489.06 ,$532.95 , N/A ,$434.51 , N/A ,$627.00 ,$344.85 , N/A ,$164.90 ,$627.00 ,$583.48 ,$556.96 , N/A ,$501.60 ,$340.46 ,$175.56 ,$564.30 ,$238.26 ,$250.00 , N/A ,$300.96 
ST. MARY'S HOSPITAL - DECATUR,51000011,11047,HC DEBR SKIN/SUB TIS/MUS/BN ADL 20C FAC,510,1 ,"$3,891.00 ","$2,529.15 ",$173.22 ,"$3,891.00 ", N/A ,"$1,984.41 ","$2,140.05 ", N/A ,"$1,089.48 ","$1,828.77 ", N/A ,"$2,101.14 ", N/A ,"$2,112.81 ",$173.22 , N/A ,"$2,112.81 ", N/A ,"$2,723.70 ","$1,945.50 ","$3,112.80 ", N/A , N/A ,"$2,723.70 ", N/A ,"$2,334.60 ", N/A ,"$2,918.25 ","$2,147.83 ","$1,937.72 ","$2,147.83 ", N/A ,"$2,147.83 ","$3,034.98 ","$3,034.98 ","$3,307.35 ", N/A ,"$2,696.46 ", N/A ,"$3,891.00 ","$2,140.05 ", N/A ,"$1,023.33 ","$3,891.00 ",$837.54 ,$799.47 , N/A ,"$3,112.80 ","$2,112.81 ","$1,089.48 ","$3,501.90 ","$1,478.58 ",$250.00 , N/A ,"$1,867.68 "
ST. MARY'S HOSPITAL - DECATUR,51000012,11055,HC PARING LESN BENIGN 1 FAC,510,1 ,$325.00 ,$211.25 ,$27.64 ,$424.98 ,$424.98 ,$165.75 ,$178.75 ,$169.99 ,$91.00 ,$152.75 ,$169.99 ,$175.50 ,$169.99 ,$176.48 ,$27.64 ,$169.99 ,$176.48 ,$322.97 ,$227.50 ,$162.50 ,$260.00 ,$424.97 ,$169.99 ,$227.50 ,$169.99 ,$195.00 ,$169.99 ,$243.75 ,$179.40 ,$161.85 ,$179.40 ,$169.99 ,$179.40 ,$253.50 ,$253.50 ,$276.25 ,$325.00 ,$225.23 ,$169.99 ,$325.00 ,$178.75 ,$169.99 ,$85.48 ,$325.00 ,$214.47 ,$204.72 ,$178.49 ,$260.00 ,$176.48 ,$91.00 ,$292.50 ,$123.50 ,$250.00 ,$169.99 ,$156.00 
ST. MARY'S HOSPITAL - DECATUR,51000014,11056,HC PARING LESN BENIGN 2-4 FAC,510,1 ,$387.00 ,$251.55 ,$39.11 ,$424.98 ,$424.98 ,$197.37 ,$212.85 ,$169.99 ,$108.36 ,$181.89 ,$169.99 ,$208.98 ,$169.99 ,$210.14 ,$39.11 ,$169.99 ,$210.14 ,$322.97 ,$270.90 ,$193.50 ,$309.60 ,$424.97 ,$169.99 ,$270.90 ,$169.99 ,$232.20 ,$169.99 ,$290.25 ,$213.62 ,$192.73 ,$213.62 ,$169.99 ,$213.62 ,$301.86 ,$301.86 ,$328.95 ,$387.00 ,$268.19 ,$169.99 ,$387.00 ,$212.85 ,$169.99 ,$101.78 ,$387.00 ,$214.47 ,$204.72 ,$178.49 ,$309.60 ,$210.14 ,$108.36 ,$348.30 ,$147.06 ,$250.00 ,$169.99 ,$185.76 
ST. MARY'S HOSPITAL - DECATUR,51000021,11719,HC TRIM NAILS NONDYSTROPHIC FAC,510,1 ,$196.00 ,$127.40 ,$13.24 ,$196.00 ,$131.73 ,$99.96 ,$107.80 ,$52.69 ,$54.88 ,$92.12 ,$52.69 ,$105.84 ,$52.69 ,$106.43 ,$13.24 ,$52.69 ,$106.43 ,$100.11 ,$137.20 ,$98.00 ,$156.80 ,$131.73 ,$52.69 ,$137.20 ,$52.69 ,$117.60 ,$52.69 ,$147.00 ,$108.19 ,$97.61 ,$108.19 ,$52.69 ,$108.19 ,$152.88 ,$152.88 ,$166.60 ,$131.73 ,$135.83 ,$52.69 ,$196.00 ,$107.80 ,$52.69 ,$51.55 ,$196.00 ,$57.38 ,$54.77 ,$55.32 ,$156.80 ,$106.43 ,$54.88 ,$176.40 ,$74.48 ,$196.00 ,$52.69 ,$94.08 
ST. MARY'S HOSPITAL - DECATUR,51000023,11720,HC DEBR NAIL(S) UP TO 5,510,1 ,$239.00 ,$155.35 ,$25.27 ,$239.00 ,$131.73 ,$121.89 ,$131.45 ,$52.69 ,$66.92 ,$112.33 ,$52.69 ,$129.06 ,$52.69 ,$129.78 ,$25.27 ,$52.69 ,$129.78 ,$100.11 ,$167.30 ,$119.50 ,$191.20 ,$131.73 ,$52.69 ,$167.30 ,$52.69 ,$143.40 ,$52.69 ,$179.25 ,$131.93 ,$119.02 ,$131.93 ,$52.69 ,$131.93 ,$186.42 ,$186.42 ,$203.15 ,$131.73 ,$165.63 ,$52.69 ,$239.00 ,$131.45 ,$52.69 ,$62.86 ,$239.00 ,$57.38 ,$54.77 ,$55.32 ,$191.20 ,$129.78 ,$66.92 ,$215.10 ,$90.82 ,$239.00 ,$52.69 ,$114.72 
ST. MARY'S HOSPITAL - DECATUR,51000024,11721,HC DEBR NAIL(S) 6 OR MORE,510,1 ,$488.00 ,$317.20 ,$42.82 ,$488.00 ,$131.73 ,$248.88 ,$268.40 ,$52.69 ,$136.64 ,$229.36 ,$52.69 ,$263.52 ,$52.69 ,$264.98 ,$42.82 ,$52.69 ,$264.98 ,$100.11 ,$341.60 ,$244.00 ,$390.40 ,$131.73 ,$52.69 ,$341.60 ,$52.69 ,$292.80 ,$52.69 ,$366.00 ,$269.38 ,$243.02 ,$269.38 ,$52.69 ,$269.38 ,$380.64 ,$380.64 ,$414.80 ,$131.73 ,$338.18 ,$52.69 ,$488.00 ,$268.40 ,$52.69 ,$128.34 ,$488.00 ,$57.38 ,$54.77 ,$55.32 ,$390.40 ,$264.98 ,$136.64 ,$439.20 ,$185.44 ,$250.00 ,$52.69 ,$234.24 
ST. MARY'S HOSPITAL - DECATUR,51000025,11750,HC REMOVE NAIL BED FACIL,510,1 ,"$2,202.00 ","$1,431.30 ",$172.19 ,"$2,202.00 ",$817.95 ,"$1,123.02 ","$1,211.10 ",$327.18 ,$616.56 ,"$1,034.94 ",$327.18 ,"$1,189.08 ",$327.18 ,"$1,195.69 ",$172.19 ,$327.18 ,"$1,195.69 ",$621.65 ,"$1,541.40 ","$1,101.00 ","$1,761.60 ",$817.95 ,$327.18 ,"$1,541.40 ",$327.18 ,"$1,321.20 ",$327.18 ,"$1,651.50 ","$1,215.50 ","$1,096.60 ","$1,215.50 ",$327.18 ,"$1,215.50 ","$1,717.56 ","$1,717.56 ","$1,871.70 ",$817.95 ,"$1,525.99 ",$327.18 ,"$2,202.00 ","$1,211.10 ",$327.18 ,$579.13 ,"$2,202.00 ",$450.77 ,$430.28 ,$343.54 ,"$1,761.60 ","$1,195.69 ",$616.56 ,"$1,981.80 ",$836.76 ,$250.00 ,$327.18 ,"$1,056.96 "
ST. MARY'S HOSPITAL - DECATUR,51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,"$1,277.00 ",$830.05 ,$63.63 ,"$1,277.00 ",$754.55 ,$651.27 ,$702.35 ,$301.82 ,$357.56 ,$600.19 ,$301.82 ,$689.58 ,$301.82 ,$693.41 ,$63.63 ,$301.82 ,$693.41 ,$573.46 ,$893.90 ,$638.50 ,"$1,021.60 ",$754.56 ,$301.82 ,$893.90 ,$301.82 ,$766.20 ,$301.82 ,$957.75 ,$704.90 ,$635.95 ,$704.90 ,$301.82 ,$704.90 ,$996.06 ,$996.06 ,"$1,085.45 ",$754.56 ,$884.96 ,$301.82 ,"$1,277.00 ",$702.35 ,$301.82 ,$335.85 ,"$1,277.00 ",$83.53 ,$79.74 ,$316.91 ,"$1,021.60 ",$693.41 ,$357.56 ,"$1,149.30 ",$485.26 ,$250.00 ,$301.82 ,$612.96 
ST. MARY'S HOSPITAL - DECATUR,51000062,95991,HC REFILLING PUMP OR RESERVOIR,360,1 ,"$1,020.00 ",$663.00 ,$79.74 ,"$1,020.00 ",$618.28 ,"$1,020.00 ",$561.00 ,$247.31 ,$285.60 ,$479.40 ,$247.31 ,$550.80 ,$247.31 ,$553.86 ,$553.86 ,$247.31 ,$553.86 ,$469.90 ,$714.00 ,$510.00 ,$816.00 ,$618.29 ,$247.31 ,$714.00 ,$247.31 ,$612.00 ,$247.31 ,$765.00 ,$563.04 ,$507.96 ,$563.04 ,$247.31 ,$563.04 ,$795.60 ,$795.60 ,$867.00 ,$618.29 ,$706.86 ,$247.31 ,"$1,020.00 ",$561.00 ,$247.31 ,$268.26 ,"$1,020.00 ",$83.53 ,$79.74 ,$259.68 ,$816.00 ,$553.86 ,$285.60 ,$918.00 ,$737.00 ,$900.00 ,$247.31 ,$489.60 
ST. MARY'S HOSPITAL - DECATUR,51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$345.00 ,$224.25 ,$33.34 ,$345.00 ,$146.73 ,$175.95 ,$189.75 ,$58.69 ,$96.60 ,$169.05 ,$58.69 ,$201.83 ,$58.69 ,$187.34 ,$33.34 ,$58.69 ,$187.34 ,$111.51 ,$241.50 ,$172.50 ,$276.00 ,$146.72 ,$58.69 ,$241.50 ,$58.69 ,$207.00 ,$58.69 ,$258.75 ,$190.44 ,$171.81 ,$190.44 ,$58.69 ,$190.44 ,$269.10 ,$269.10 ,$293.25 ,$146.72 ,$239.09 ,$58.69 ,$345.00 ,$189.75 ,$58.69 ,$90.74 ,$345.00 , N/A , N/A ,$61.62 ,$276.00 ,$187.34 ,$96.60 ,$310.50 ,$131.10 ,$187.68 ,$58.69 ,$165.60 
ST. MARY'S HOSPITAL - DECATUR,51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$418.00 ,$271.70 ,$54.78 ,$484.13 ,$484.13 ,$213.18 ,$229.90 ,$193.65 ,$117.04 ,$204.82 ,$193.65 ,$244.53 ,$193.65 ,$226.97 ,$54.78 ,$193.65 ,$226.97 ,$367.93 ,$292.60 ,$209.00 ,$334.40 ,$484.12 ,$193.65 ,$292.60 ,$193.65 ,$250.80 ,$193.65 ,$313.50 ,$230.74 ,$208.16 ,$230.74 ,$193.65 ,$230.74 ,$326.04 ,$326.04 ,$355.30 ,$418.00 ,$289.67 ,$193.65 ,$418.00 ,$229.90 ,$193.65 ,$109.93 ,$418.00 , N/A , N/A ,$203.33 ,$334.40 ,$226.97 ,$117.04 ,$376.20 ,$158.84 ,$227.39 ,$193.65 ,$200.64 
ST. MARY'S HOSPITAL - DECATUR,51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$418.00 ,$271.70 ,$23.53 ,$418.00 ,$94.70 ,$213.18 ,$229.90 ,$37.88 ,$117.04 ,$204.82 ,$37.88 ,$244.53 ,$37.88 ,$226.97 ,$23.53 ,$37.88 ,$226.97 ,$71.97 ,$292.60 ,$209.00 ,$334.40 ,$94.70 ,$37.88 ,$292.60 ,$37.88 ,$250.80 ,$37.88 ,$313.50 ,$230.74 ,$208.16 ,$230.74 ,$37.88 ,$230.74 ,$326.04 ,$326.04 ,$355.30 ,$94.70 ,$289.67 ,$37.88 ,$418.00 ,$229.90 ,$37.88 ,$109.93 ,$418.00 , N/A , N/A ,$39.77 ,$334.40 ,$226.97 ,$117.04 ,$376.20 ,$158.84 ,$227.39 ,$37.88 ,$200.64 
ST. MARY'S HOSPITAL - DECATUR,51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$300.00 ,$195.00 ,$14.70 ,$300.00 , N/A ,$153.00 ,$165.00 , N/A ,$84.00 ,$147.00 , N/A ,$175.50 , N/A ,$162.90 ,$14.70 , N/A ,$162.90 , N/A ,$210.00 ,$150.00 ,$240.00 , N/A , N/A ,$210.00 , N/A ,$180.00 , N/A ,$225.00 ,$165.60 ,$149.40 ,$165.60 , N/A ,$165.60 ,$234.00 ,$234.00 ,$255.00 , N/A ,$207.90 , N/A ,$300.00 ,$165.00 , N/A ,$78.90 ,$300.00 , N/A , N/A , N/A ,$240.00 ,$162.90 ,$84.00 ,$270.00 ,$114.00 ,$163.20 , N/A ,$144.00 
ST. MARY'S HOSPITAL - DECATUR,51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$187.00 ,$121.55 ,$49.18 ,$187.00 ,$131.73 ,$95.37 ,$102.85 ,$52.69 ,$52.36 ,$91.63 ,$52.69 ,$109.40 ,$52.69 ,$101.54 ,$50.94 ,$52.69 ,$101.54 ,$100.11 ,$130.90 ,$93.50 ,$149.60 ,$131.73 ,$52.69 ,$130.90 ,$52.69 ,$112.20 ,$52.69 ,$140.25 ,$103.22 ,$93.13 ,$103.22 ,$52.69 ,$103.22 ,$145.86 ,$145.86 ,$158.95 ,$131.73 ,$129.59 ,$52.69 ,$187.00 ,$102.85 ,$52.69 ,$49.18 ,$187.00 ,$83.53 ,$79.74 ,$55.32 ,$149.60 ,$101.54 ,$52.36 ,$168.30 ,$71.06 ,$187.00 ,$52.69 ,$89.76 
ST. MARY'S HOSPITAL - DECATUR,51000072,97597,HC DEBR SKIN PART THICKNESS <20CM FAC,510,1 ,$745.00 ,$484.25 ,$29.13 ,$745.00 ,$424.98 ,$379.95 ,$409.75 ,$169.99 ,$208.60 ,$227.37 ,$169.99 ,$227.37 ,$169.99 ,$404.54 ,$29.13 ,$169.99 ,$404.54 ,$322.97 ,$521.50 ,$372.50 ,$596.00 ,$424.97 ,$169.99 ,$521.50 ,$169.99 ,$447.00 ,$169.99 ,$558.75 ,$411.24 ,$371.01 ,$411.24 ,$169.99 ,$411.24 ,$581.10 ,$581.10 ,$633.25 ,$424.97 ,$516.29 ,$169.99 ,$745.00 ,$409.75 ,$169.99 ,$195.94 ,$745.00 ,$83.53 ,$79.74 ,$178.49 ,$596.00 ,$404.54 ,$208.60 ,$670.50 ,$283.10 ,$250.00 ,$169.99 ,$357.60 
ST. MARY'S HOSPITAL - DECATUR,51000101,99202,HC CLINIC VISIT LIMITED NEW,510,1 ,$329.00 ,$213.85 ,$57.92 ,$329.00 , N/A ,$167.79 ,$180.95 , N/A ,$92.12 ,$161.21 , N/A ,$192.47 , N/A ,$178.65 ,$57.92 , N/A ,$178.65 , N/A ,$230.30 ,$164.50 ,$263.20 , N/A , N/A ,$230.30 , N/A ,$197.40 , N/A ,$246.75 ,$181.61 ,$163.84 ,$181.61 , N/A ,$181.61 ,$256.62 ,$256.62 ,$279.65 , N/A ,$228.00 , N/A ,$78.75 ,$180.95 , N/A ,$86.53 ,$329.00 ,$98.34 ,$93.87 , N/A ,$263.20 ,$178.65 ,$92.12 ,$296.10 ,$125.02 ,$250.00 , N/A ,$157.92 
ST. MARY'S HOSPITAL - DECATUR,51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$447.00 ,$290.55 ,$88.33 ,$447.00 , N/A ,$227.97 ,$245.85 , N/A ,$125.16 ,$219.03 , N/A ,$261.50 , N/A ,$242.72 ,$88.33 , N/A ,$242.72 , N/A ,$312.90 ,$223.50 ,$357.60 , N/A , N/A ,$312.90 , N/A ,$268.20 , N/A ,$335.25 ,$246.74 ,$222.61 ,$246.74 , N/A ,$246.74 ,$348.66 ,$348.66 ,$379.95 , N/A ,$309.77 , N/A ,$121.24 ,$245.85 , N/A ,$117.56 ,$447.00 ,$98.34 ,$93.87 , N/A ,$357.60 ,$242.72 ,$125.16 ,$402.30 ,$169.86 ,$250.00 , N/A ,$214.56 
ST. MARY'S HOSPITAL - DECATUR,51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$604.00 ,$392.60 ,$93.87 ,$604.00 , N/A ,$308.04 ,$332.20 , N/A ,$169.12 ,$295.96 , N/A ,$353.34 , N/A ,$327.97 ,$152.13 , N/A ,$327.97 , N/A ,$422.80 ,$302.00 ,$483.20 , N/A , N/A ,$422.80 , N/A ,$362.40 , N/A ,$453.00 ,$333.41 ,$300.79 ,$333.41 , N/A ,$333.41 ,$471.12 ,$471.12 ,$513.40 , N/A ,$418.57 , N/A ,$181.05 ,$332.20 , N/A ,$158.85 ,$604.00 ,$98.34 ,$93.87 , N/A ,$483.20 ,$327.97 ,$169.12 ,$543.60 ,$229.52 ,$250.00 , N/A ,$289.92 
ST. MARY'S HOSPITAL - DECATUR,51000113,99205,HC CLINIC VISIT COMPREH NEW,510,1 ,$746.00 ,$484.90 ,$93.87 ,$746.00 , N/A ,$380.46 ,$410.30 , N/A ,$208.88 ,$365.54 , N/A ,$436.41 , N/A ,$405.08 ,$198.23 , N/A ,$405.08 , N/A ,$522.20 ,$373.00 ,$596.80 , N/A , N/A ,$522.20 , N/A ,$447.60 , N/A ,$559.50 ,$411.79 ,$371.51 ,$411.79 , N/A ,$411.79 ,$581.88 ,$581.88 ,$634.10 , N/A ,$516.98 , N/A ,$239.15 ,$410.30 , N/A ,$196.20 ,$746.00 ,$98.34 ,$93.87 , N/A ,$596.80 ,$405.08 ,$208.88 ,$671.40 ,$283.48 ,$250.00 , N/A ,$358.08 
ST. MARY'S HOSPITAL - DECATUR,51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$281.00 ,$182.65 ,$11.48 ,$281.00 , N/A ,$143.31 ,$154.55 , N/A ,$78.68 ,$104.00 , N/A ,$104.00 , N/A ,$152.58 ,$11.48 , N/A ,$152.58 , N/A ,$196.70 ,$140.50 ,$224.80 , N/A , N/A ,$196.70 , N/A ,$168.60 , N/A ,$210.75 ,$155.11 ,$139.94 ,$155.11 , N/A ,$155.11 ,$219.18 ,$219.18 ,$238.85 , N/A ,$194.73 , N/A ,$281.00 ,$154.55 , N/A ,$73.90 ,$281.00 ,$98.34 ,$93.87 , N/A ,$224.80 ,$152.58 ,$78.68 ,$252.90 ,$106.78 ,$250.00 , N/A ,$134.88 
ST. MARY'S HOSPITAL - DECATUR,51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$327.00 ,$212.55 ,$28.92 ,$327.00 , N/A ,$166.77 ,$179.85 , N/A ,$91.56 ,$160.23 , N/A ,$191.30 , N/A ,$177.56 ,$28.92 , N/A ,$177.56 , N/A ,$228.90 ,$163.50 ,$261.60 , N/A , N/A ,$228.90 , N/A ,$196.20 , N/A ,$245.25 ,$180.50 ,$162.85 ,$180.50 , N/A ,$180.50 ,$255.06 ,$255.06 ,$277.95 , N/A ,$226.61 , N/A ,$60.02 ,$179.85 , N/A ,$86.00 ,$327.00 ,$98.34 ,$93.87 , N/A ,$261.60 ,$177.56 ,$91.56 ,$294.30 ,$124.26 ,$250.00 , N/A ,$156.96 
ST. MARY'S HOSPITAL - DECATUR,51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$395.00 ,$256.75 ,$53.74 ,$395.00 , N/A ,$201.45 ,$217.25 , N/A ,$110.60 ,$193.55 , N/A ,$231.08 , N/A ,$214.49 ,$53.74 , N/A ,$214.49 , N/A ,$276.50 ,$197.50 ,$316.00 , N/A , N/A ,$276.50 , N/A ,$237.00 , N/A ,$296.25 ,$218.04 ,$196.71 ,$218.04 , N/A ,$218.04 ,$308.10 ,$308.10 ,$335.75 , N/A ,$273.74 , N/A ,$97.92 ,$217.25 , N/A ,$103.89 ,$395.00 ,$98.34 ,$93.87 , N/A ,$316.00 ,$214.49 ,$110.60 ,$355.50 ,$150.10 ,$250.00 , N/A ,$189.60 
ST. MARY'S HOSPITAL - DECATUR,51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$577.00 ,$375.05 ,$84.31 ,$577.00 , N/A ,$294.27 ,$317.35 , N/A ,$161.56 ,$282.73 , N/A ,$337.55 , N/A ,$313.31 ,$84.31 , N/A ,$313.31 , N/A ,$403.90 ,$288.50 ,$461.60 , N/A , N/A ,$403.90 , N/A ,$346.20 , N/A ,$432.75 ,$318.50 ,$287.35 ,$318.50 , N/A ,$318.50 ,$450.06 ,$450.06 ,$490.45 , N/A ,$399.86 , N/A ,$577.00 ,$317.35 , N/A ,$151.75 ,$577.00 ,$98.34 ,$93.87 , N/A ,$461.60 ,$313.31 ,$161.56 ,$519.30 ,$219.26 ,$250.00 , N/A ,$276.96 
ST. MARY'S HOSPITAL - DECATUR,51000139,99215,HC CLINIC VISIT COMPRH EST,510,1 ,$625.00 ,$406.25 ,$93.87 ,$625.00 , N/A ,$318.75 ,$343.75 , N/A ,$175.00 ,$306.25 , N/A ,$365.63 , N/A ,$339.38 ,$129.78 , N/A ,$339.38 , N/A ,$437.50 ,$312.50 ,$500.00 , N/A , N/A ,$437.50 , N/A ,$375.00 , N/A ,$468.75 ,$345.00 ,$311.25 ,$345.00 , N/A ,$345.00 ,$487.50 ,$487.50 ,$531.25 , N/A ,$433.13 , N/A ,$625.00 ,$343.75 , N/A ,$164.38 ,$625.00 ,$98.34 ,$93.87 , N/A ,$500.00 ,$339.38 ,$175.00 ,$562.50 ,$237.50 ,$250.00 , N/A ,$300.00 
ST. MARY'S HOSPITAL - DECATUR,51000145,G0127,HC TRIM NAILS DYSTROPHIC FAC,510,1 ,$301.00 ,$195.65 ,$15.10 ,$301.00 ,$131.73 ,$153.51 ,$165.55 ,$52.69 ,$84.28 ,$141.47 ,$52.69 ,$162.54 ,$52.69 ,$163.44 ,$15.10 ,$52.69 ,$163.44 ,$100.11 ,$210.70 ,$150.50 ,$240.80 ,$131.73 ,$52.69 ,$210.70 ,$52.69 ,$180.60 ,$52.69 ,$225.75 ,$166.15 ,$149.90 ,$166.15 ,$52.69 ,$166.15 ,$234.78 ,$234.78 ,$255.85 ,$131.73 ,$208.59 ,$52.69 ,$301.00 ,$165.55 ,$52.69 ,$79.16 ,$301.00 ,$57.38 ,$54.77 ,$55.32 ,$240.80 ,$163.44 ,$84.28 ,$270.90 ,$114.38 ,$250.00 ,$52.69 ,$144.48 
ST. MARY'S HOSPITAL - DECATUR,51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$24.00 ,$15.60 ,$2.13 ,$24.00 ,$7.50 ,$12.24 ,$13.20 ,$3.00 ,$6.72 ,$11.76 ,$3.00 ,$14.04 ,$3.00 ,$13.03 ,$2.13 ,$3.00 ,$13.03 ,$5.70 ,$16.80 ,$12.00 ,$19.20 ,$7.50 ,$3.00 ,$16.80 ,$3.00 ,$14.40 ,$3.00 ,$18.00 ,$13.25 ,$11.95 ,$13.25 ,$3.00 ,$13.25 ,$3.90 ,$3.90 ,$20.40 ,$7.50 ,$16.63 ,$3.00 ,$24.00 ,$13.20 ,$3.00 ,$6.31 , N/A , N/A , N/A ,$3.15 ,$19.20 ,$13.03 ,$6.72 ,$21.60 ,$9.12 ,$6.00 ,$3.00 ,$11.52 
ST. MARY'S HOSPITAL - DECATUR,51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$301.00 ,$195.65 ,$66.23 ,$301.00 ,$266.85 ,$153.51 ,$165.55 ,$106.74 ,$84.28 ,$141.47 ,$106.74 ,$162.54 ,$106.74 ,$163.44 ,$66.23 ,$106.74 ,$163.44 ,$202.80 ,$210.70 ,$150.50 ,$240.80 ,$266.84 ,$106.74 ,$210.70 ,$106.74 ,$180.60 ,$106.74 ,$225.75 ,$166.15 ,$149.90 ,$166.15 ,$106.74 ,$166.15 ,$234.78 ,$234.78 ,$255.85 ,$266.84 ,$208.59 ,$106.74 ,$301.00 ,$165.55 ,$106.74 ,$79.16 ,$301.00 ,$83.53 ,$79.74 ,$112.08 ,$240.80 ,$163.44 ,$84.28 ,$270.90 ,$114.38 ,$250.00 ,$106.74 ,$144.48 
ST. MARY'S HOSPITAL - DECATUR,51000172,51702,HC CATH BLADDER SMP,510,1 ,$352.00 ,$228.80 ,$66.23 ,$352.00 ,$266.85 ,$179.52 ,$193.60 ,$106.74 ,$98.56 ,$165.44 ,$106.74 ,$190.08 ,$106.74 ,$191.14 ,$66.23 ,$106.74 ,$191.14 ,$202.80 ,$246.40 ,$176.00 ,$281.60 ,$266.84 ,$106.74 ,$246.40 ,$106.74 ,$211.20 ,$106.74 ,$264.00 ,$194.30 ,$175.30 ,$194.30 ,$106.74 ,$194.30 ,$274.56 ,$274.56 ,$299.20 ,$266.84 ,$243.94 ,$106.74 ,$352.00 ,$193.60 ,$106.74 ,$92.58 ,$352.00 ,$83.53 ,$79.74 ,$112.08 ,$281.60 ,$191.14 ,$98.56 ,$316.80 ,$133.76 ,$250.00 ,$106.74 ,$168.96 
ST. MARY'S HOSPITAL - DECATUR,51000175,94780,HC CARSEAT ANALYSIS FIRST 60MIN,510,1 ,$199.00 ,$129.35 ,$32.04 ,$199.00 ,$80.10 ,$101.49 ,$109.45 ,$32.04 ,$55.72 ,$93.53 ,$32.04 ,$107.46 ,$32.04 ,$108.06 ,$57.03 ,$32.04 ,$108.06 ,$60.88 ,$139.30 ,$99.50 ,$159.20 ,$80.10 ,$32.04 ,$139.30 ,$32.04 ,$119.40 ,$32.04 ,$149.25 ,$109.85 ,$99.10 ,$109.85 ,$32.04 ,$109.85 ,$155.22 ,$155.22 ,$169.15 ,$80.10 ,$137.91 ,$32.04 ,$199.00 ,$109.45 ,$32.04 ,$52.34 ,$199.00 ,$52.31 ,$49.93 ,$33.64 ,$159.20 ,$108.06 ,$55.72 ,$179.10 ,$75.62 ,$199.00 ,$32.04 ,$95.52 
ST. MARY'S HOSPITAL - DECATUR,51000207,52000,HC CYSTOURETHROSCOPY,510,1 ,"$7,870.00 ","$5,115.50 ",$212.02 ,"$7,870.00 ","$1,361.48 ","$4,013.70 ","$4,328.50 ",$544.59 ,"$2,203.60 ","$3,698.90 ",$544.59 ,"$4,249.80 ",$544.59 ,"$4,273.41 ",$212.02 ,$544.59 ,"$4,273.41 ","$1,034.71 ","$5,509.00 ","$3,935.00 ","$6,296.00 ","$1,361.46 ",$544.59 ,"$5,509.00 ",$544.59 ,"$4,722.00 ",$544.59 ,"$5,902.50 ","$4,344.24 ","$3,919.26 ","$4,344.24 ",$544.59 ,"$4,344.24 ","$6,138.60 ","$6,138.60 ","$6,689.50 ","$1,361.46 ","$5,453.91 ",$544.59 ,"$7,870.00 ","$4,328.50 ",$544.59 ,"$2,069.81 ","$7,870.00 ",$759.25 ,$724.74 ,$571.82 ,"$6,296.00 ","$4,273.41 ","$2,203.60 ","$7,083.00 ","$2,990.60 ",$250.00 ,$544.59 ,"$3,777.60 "
ST. MARY'S HOSPITAL - DECATUR,51000315,38222,HC BM ASPIRATION (BX/ASP SAME SITE),360,1 ,"$6,609.00 ","$4,295.85 ",$406.14 ,"$6,609.00 ","$5,611.10 ","$2,800.00 ","$3,634.95 ","$2,244.44 ","$1,850.52 ","$3,106.23 ","$2,244.44 ","$3,568.86 ","$2,244.44 ","$3,588.69 ","$3,588.69 ","$2,244.44 ","$3,588.69 ","$4,264.43 ","$3,500.00 ","$3,304.50 ","$5,287.20 ","$5,611.09 ","$2,244.44 ","$4,626.30 ","$2,244.44 ","$3,965.40 ","$2,244.44 ","$4,956.75 ","$3,648.17 ","$3,291.28 ","$3,648.17 ","$2,244.44 ","$3,648.17 ","$5,155.02 ","$5,155.02 ","$5,617.65 ","$5,611.09 ","$4,580.04 ","$2,244.44 ","$6,609.00 ","$3,634.95 ","$2,244.44 ","$1,738.17 ","$6,609.00 ",$425.48 ,$406.14 ,"$2,356.66 ","$5,287.20 ","$3,588.69 ","$1,850.52 ","$5,948.10 ","$1,795.00 ","$2,100.00 ","$2,244.44 ","$3,172.32 "
ST. MARY'S HOSPITAL - DECATUR,51000320,94781,HC CARSEAT ANALYSIS  EA ADDN 30MIN,510,1 ,$199.00 ,$129.35 ,$20.12 ,$199.00 , N/A ,$101.49 ,$109.45 , N/A ,$55.72 ,$93.53 , N/A ,$107.46 , N/A ,$108.06 ,$20.12 , N/A ,$108.06 , N/A ,$139.30 ,$99.50 ,$159.20 , N/A , N/A ,$139.30 , N/A ,$119.40 , N/A ,$149.25 ,$109.85 ,$99.10 ,$109.85 , N/A ,$109.85 ,$155.22 ,$155.22 ,$169.15 , N/A ,$137.91 , N/A ,$199.00 ,$109.45 , N/A ,$52.34 ,$199.00 ,$52.31 ,$49.93 , N/A ,$159.20 ,$108.06 ,$55.72 ,$179.10 ,$75.62 ,$199.00 , N/A ,$95.52 
ST. MARY'S HOSPITAL - DECATUR,51000325,15271,HC APL SKIN SUB TAL<100 INT 25CM,761,1 ,$498.00 ,$323.70 ,$130.97 ,"$4,053.30 ","$4,053.30 ",$253.98 ,$273.90 ,"$1,621.32 ",$139.44 ,$234.06 ,"$1,621.32 ",$268.92 ,$498.00 ,$270.41 ,$145.57 ,$498.00 ,$270.41 ,$498.00 ,$348.60 ,$249.00 ,$398.40 ,"$4,053.30 ","$1,621.32 ",$348.60 ,"$1,621.32 ",$298.80 ,"$1,621.32 ",$373.50 ,$274.90 ,$248.00 ,$274.90 ,"$1,621.32 ",$274.90 ,$388.44 ,$388.44 ,$423.30 ,$498.00 ,$345.11 ,"$1,621.32 ",$498.00 ,$273.90 ,"$1,621.32 ",$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ","$1,702.39 ",$398.40 ,$270.41 ,$139.44 ,$448.20 ,$189.24 ,$498.00 ,"$1,621.32 ",$239.04 
ST. MARY'S HOSPITAL - DECATUR,51000326,15272,HC APL SKIN SUB TAL<100 ADL 25CM,761,1 ,$183.00 ,$118.95 ,$30.29 ,"$1,057.63 ", N/A ,$93.33 ,$100.65 , N/A ,$51.24 ,$86.01 , N/A ,$98.82 , N/A ,$99.37 ,$30.29 , N/A ,$99.37 , N/A ,$128.10 ,$91.50 ,$146.40 , N/A , N/A ,$128.10 , N/A ,$109.80 , N/A ,$137.25 ,$101.02 ,$91.13 ,$101.02 , N/A ,$101.02 ,$142.74 ,$142.74 ,$155.55 , N/A ,$126.82 , N/A ,$183.00 ,$100.65 , N/A ,$48.13 ,$183.00 ,$183.00 ,"$1,057.63 ", N/A ,$146.40 ,$99.37 ,$51.24 ,$164.70 ,$69.54 ,$183.00 , N/A ,$87.84 
ST. MARY'S HOSPITAL - DECATUR,51000327,15273,HC APL SKIN SUB TAL>100 INT 100CM,761,1 ,$759.00 ,$493.35 ,$199.62 ,"$8,332.98 ","$8,332.98 ",$387.09 ,$417.45 ,"$3,333.19 ",$212.52 ,$356.73 ,"$3,333.19 ",$409.86 ,$759.00 ,$412.14 ,$352.87 ,$759.00 ,$412.14 ,$759.00 ,$531.30 ,$379.50 ,$607.20 ,"$8,332.98 ","$3,333.19 ",$531.30 ,"$3,333.19 ",$455.40 ,"$3,333.19 ",$569.25 ,$418.97 ,$377.98 ,$418.97 ,"$3,333.19 ",$418.97 ,$592.02 ,$592.02 ,$645.15 ,$759.00 ,$525.99 ,"$3,333.19 ",$759.00 ,$417.45 ,"$3,333.19 ",$199.62 ,$759.00 ,$759.00 ,"$1,057.63 ","$3,499.85 ",$607.20 ,$412.14 ,$212.52 ,$683.10 ,$288.42 ,$650.00 ,"$3,333.19 ",$364.32 
ST. MARY'S HOSPITAL - DECATUR,51000328,15274,HC APL SKIN SUB TAL>100 ADL 100CM,761,1 ,$498.00 ,$323.70 ,$80.84 ,"$1,057.63 ", N/A ,$253.98 ,$273.90 , N/A ,$139.44 ,$234.06 , N/A ,$268.92 , N/A ,$270.41 ,$80.84 , N/A ,$270.41 , N/A ,$348.60 ,$249.00 ,$398.40 , N/A , N/A ,$348.60 , N/A ,$298.80 , N/A ,$373.50 ,$274.90 ,$248.00 ,$274.90 , N/A ,$274.90 ,$388.44 ,$388.44 ,$423.30 , N/A ,$345.11 , N/A ,$498.00 ,$273.90 , N/A ,$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ", N/A ,$398.40 ,$270.41 ,$139.44 ,$448.20 ,$189.24 ,$498.00 , N/A ,$239.04 
ST. MARY'S HOSPITAL - DECATUR,51000329,15275,HC APL SKIN SUB OTH<100 INT 25CM,761,1 ,$498.00 ,$323.70 ,$130.97 ,"$4,053.30 ","$4,053.30 ",$253.98 ,$273.90 ,"$1,621.32 ",$139.44 ,$234.06 ,"$1,621.32 ",$268.92 ,$498.00 ,$270.41 ,$164.46 ,$498.00 ,$270.41 ,$498.00 ,$348.60 ,$249.00 ,$398.40 ,"$4,053.30 ","$1,621.32 ",$348.60 ,"$1,621.32 ",$298.80 ,"$1,621.32 ",$373.50 ,$274.90 ,$248.00 ,$274.90 ,"$1,621.32 ",$274.90 ,$388.44 ,$388.44 ,$423.30 ,$498.00 ,$345.11 ,"$1,621.32 ",$498.00 ,$273.90 ,"$1,621.32 ",$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ","$1,702.39 ",$398.40 ,$270.41 ,$139.44 ,$448.20 ,$189.24 ,$498.00 ,"$1,621.32 ",$239.04 
ST. MARY'S HOSPITAL - DECATUR,51000330,15276,HC APL SKIN SUB OTH<100 ADL 25CM,761,1 ,$366.00 ,$237.90 ,$44.09 ,"$1,057.63 ", N/A ,$186.66 ,$201.30 , N/A ,$102.48 ,$172.02 , N/A ,$197.64 , N/A ,$198.74 ,$44.09 , N/A ,$198.74 , N/A ,$256.20 ,$183.00 ,$292.80 , N/A , N/A ,$256.20 , N/A ,$219.60 , N/A ,$274.50 ,$202.03 ,$182.27 ,$202.03 , N/A ,$202.03 ,$285.48 ,$285.48 ,$311.10 , N/A ,$253.64 , N/A ,$366.00 ,$201.30 , N/A ,$96.26 ,$366.00 ,$366.00 ,"$1,057.63 ", N/A ,$292.80 ,$198.74 ,$102.48 ,$329.40 ,$139.08 ,$366.00 , N/A ,$175.68 
ST. MARY'S HOSPITAL - DECATUR,51000331,15277,HC APL SKIN SUB OTH>100 INT 100CM,761,1 ,$753.00 ,$489.45 ,$198.04 ,"$4,053.30 ","$4,053.30 ",$384.03 ,$414.15 ,"$1,621.32 ",$210.84 ,$353.91 ,"$1,621.32 ",$406.62 ,$753.00 ,$408.88 ,$398.62 ,$753.00 ,$408.88 ,$753.00 ,$527.10 ,$376.50 ,$602.40 ,"$4,053.30 ","$1,621.32 ",$527.10 ,"$1,621.32 ",$451.80 ,"$1,621.32 ",$564.75 ,$415.66 ,$374.99 ,$415.66 ,"$1,621.32 ",$415.66 ,$587.34 ,$587.34 ,$640.05 ,$753.00 ,$521.83 ,"$1,621.32 ",$753.00 ,$414.15 ,"$1,621.32 ",$198.04 ,$753.00 ,$753.00 ,"$1,057.63 ","$1,702.39 ",$602.40 ,$408.88 ,$210.84 ,$677.70 ,$286.14 ,$650.00 ,"$1,621.32 ",$361.44 
ST. MARY'S HOSPITAL - DECATUR,51000332,15278,HC APL SKIN SUB OTH>100 ADL 100CM,761,1 ,$498.00 ,$323.70 ,$100.69 ,"$1,057.63 ", N/A ,$253.98 ,$273.90 , N/A ,$139.44 ,$234.06 , N/A ,$268.92 , N/A ,$270.41 ,$100.69 , N/A ,$270.41 , N/A ,$348.60 ,$249.00 ,$398.40 , N/A , N/A ,$348.60 , N/A ,$298.80 , N/A ,$373.50 ,$274.90 ,$248.00 ,$274.90 , N/A ,$274.90 ,$388.44 ,$388.44 ,$423.30 , N/A ,$345.11 , N/A ,$498.00 ,$273.90 , N/A ,$130.97 ,$498.00 ,$498.00 ,"$1,057.63 ", N/A ,$398.40 ,$270.41 ,$139.44 ,$448.20 ,$189.24 ,$498.00 , N/A ,$239.04 
ST. MARY'S HOSPITAL - DECATUR,51000352,11057,HC PARING LESN BENIGN >4 FAC,510,1 ,$443.00 ,$287.95 ,$51.14 ,$443.00 ,$424.98 ,$225.93 ,$243.65 ,$169.99 ,$124.04 ,$208.21 ,$169.99 ,$239.22 ,$169.99 ,$240.55 ,$51.14 ,$169.99 ,$240.55 ,$322.97 ,$310.10 ,$221.50 ,$354.40 ,$424.97 ,$169.99 ,$310.10 ,$169.99 ,$265.80 ,$169.99 ,$332.25 ,$244.54 ,$220.61 ,$244.54 ,$169.99 ,$244.54 ,$345.54 ,$345.54 ,$376.55 ,$424.97 ,$307.00 ,$169.99 ,$443.00 ,$243.65 ,$169.99 ,$116.51 ,$443.00 ,$214.47 ,$204.72 ,$178.49 ,$354.40 ,$240.55 ,$124.04 ,$398.70 ,$168.34 ,$250.00 ,$169.99 ,$212.64 
ST. MARY'S HOSPITAL - DECATUR,51000400,29580,HC APPLY UNNA BOOT BILAT FAC,510,1 ,$727.00 ,$472.55 ,$63.38 ,$727.00 ,$501.50 ,$370.77 ,$399.85 ,$200.60 ,$203.56 ,$356.23 ,$200.60 ,$425.30 ,$200.60 ,$394.76 ,$63.38 ,$200.60 ,$394.76 ,$381.15 ,$508.90 ,$363.50 ,$581.60 ,$501.51 ,$200.60 ,$508.90 ,$200.60 ,$436.20 ,$200.60 ,$545.25 ,$401.30 ,$362.05 ,$401.30 ,$200.60 ,$401.30 ,$567.06 ,$567.06 ,$617.95 ,$501.51 ,$503.81 ,$200.60 ,$727.00 ,$399.85 ,$200.60 ,$191.20 ,$727.00 ,$264.42 ,$252.40 ,$210.63 ,$581.60 ,$394.76 ,$203.56 ,$654.30 ,$276.26 ,$250.00 ,$200.60 ,$348.96 
ST. MARY'S HOSPITAL - DECATUR,51000401,29581,HC APPLY MULTI COMP LWR LEG BIL FAC,510,1 ,$711.00 ,$462.15 ,$63.28 ,$711.00 ,$501.50 ,$362.61 ,$391.05 ,$200.60 ,$199.08 ,$334.17 ,$200.60 ,$383.94 ,$200.60 ,$386.07 ,$63.28 ,$200.60 ,$386.07 ,$381.15 ,$497.70 ,$355.50 ,$568.80 ,$501.51 ,$200.60 ,$497.70 ,$200.60 ,$426.60 ,$200.60 ,$533.25 ,$392.47 ,$354.08 ,$392.47 ,$200.60 ,$392.47 ,$554.58 ,$554.58 ,$604.35 ,$501.51 ,$492.72 ,$200.60 ,$711.00 ,$391.05 ,$200.60 ,$186.99 ,$711.00 ,$264.42 ,$252.40 ,$210.63 ,$568.80 ,$386.07 ,$199.08 ,$639.90 ,$270.18 ,$250.00 ,$200.60 ,$341.28 
ST. MARY'S HOSPITAL - DECATUR,51000407,11200,HC REMOVAL SKIN TAG LESIONS <=15 FAC,510,1 ,"$2,304.00 ","$1,497.60 ",$72.99 ,"$2,304.00 ",$424.98 ,"$1,175.04 ","$1,267.20 ",$169.99 ,$645.12 ,"$1,082.88 ",$169.99 ,"$1,244.16 ",$169.99 ,"$1,251.07 ",$72.99 ,$169.99 ,"$1,251.07 ",$322.97 ,"$1,612.80 ","$1,152.00 ","$1,843.20 ",$424.97 ,$169.99 ,"$1,612.80 ",$169.99 ,"$1,382.40 ",$169.99 ,"$1,728.00 ","$1,271.81 ","$1,147.39 ","$1,271.81 ",$169.99 ,"$1,271.81 ","$1,797.12 ","$1,797.12 ","$1,958.40 ",$424.97 ,"$1,596.67 ",$169.99 ,"$2,304.00 ","$1,267.20 ",$169.99 ,$605.95 ,"$2,304.00 ",$214.47 ,$204.72 ,$178.49 ,"$1,843.20 ","$1,251.07 ",$645.12 ,"$2,073.60 ",$875.52 ,$250.00 ,$169.99 ,"$1,105.92 "
ST. MARY'S HOSPITAL - DECATUR,51000425,15110,HC EPIDRM A-GRFT TRNK/ARM/LEG CM,510,1 ,"$4,734.00 ","$3,077.10 ",$250.00 ,"$4,734.00 ","$4,053.30 ","$2,414.34 ","$2,603.70 ","$1,621.32 ","$1,325.52 ","$2,224.98 ","$1,621.32 ","$2,556.36 ","$1,621.32 ","$2,570.56 ","$1,188.09 ","$1,621.32 ","$2,570.56 ","$3,080.51 ","$3,313.80 ","$2,367.00 ","$3,787.20 ","$4,053.30 ","$1,621.32 ","$3,313.80 ","$1,621.32 ","$2,840.40 ","$1,621.32 ","$3,550.50 ","$2,613.17 ","$2,357.53 ","$2,613.17 ","$1,621.32 ","$2,613.17 ","$3,692.52 ","$3,692.52 ","$4,023.90 ","$4,053.30 ","$3,280.66 ","$1,621.32 ","$4,734.00 ","$2,603.70 ","$1,621.32 ","$1,245.04 ","$4,734.00 ","$1,225.99 ","$1,170.27 ","$1,702.39 ","$3,787.20 ","$2,570.56 ","$1,325.52 ","$4,260.60 ","$1,798.92 ",$250.00 ,"$1,621.32 ","$2,272.32 "
ST. MARY'S HOSPITAL - DECATUR,51000428,15111,HC EPIDRM A-GRFT TRNK/ARM/LEG CM ADDN 100,510,1 ,"$2,637.00 ","$1,714.05 ",$183.21 ,"$2,637.00 ", N/A ,"$1,344.87 ","$1,450.35 ", N/A ,$738.36 ,"$1,239.39 ", N/A ,"$1,423.98 ", N/A ,"$1,431.89 ",$183.21 , N/A ,"$1,431.89 ", N/A ,"$1,845.90 ","$1,318.50 ","$2,109.60 ", N/A , N/A ,"$1,845.90 ", N/A ,"$1,582.20 ", N/A ,"$1,977.75 ","$1,455.62 ","$1,313.23 ","$1,455.62 ", N/A ,"$1,455.62 ","$2,056.86 ","$2,056.86 ","$2,241.45 ", N/A ,"$1,827.44 ", N/A ,"$2,637.00 ","$1,450.35 ", N/A ,$693.53 ,"$2,637.00 ","$1,225.99 ","$1,170.27 ", N/A ,"$2,109.60 ","$1,431.89 ",$738.36 ,"$2,373.30 ","$1,002.06 ",$250.00 , N/A ,"$1,265.76 "
ST. MARY'S HOSPITAL - DECATUR,51000429,15116,HC EPIDRM A-GRFT FACE/NCK/HF/G CM ADDN 100,510,1 ,"$2,120.00 ","$1,378.00 ",$250.00 ,"$2,120.00 ", N/A ,"$1,081.20 ","$1,166.00 ", N/A ,$593.60 ,$996.40 , N/A ,"$1,144.80 ", N/A ,"$1,151.16 ",$263.12 , N/A ,"$1,151.16 ", N/A ,"$1,484.00 ","$1,060.00 ","$1,696.00 ", N/A , N/A ,"$1,484.00 ", N/A ,"$1,272.00 ", N/A ,"$1,590.00 ","$1,170.24 ","$1,055.76 ","$1,170.24 ", N/A ,"$1,170.24 ","$1,653.60 ","$1,653.60 ","$1,802.00 ", N/A ,"$1,469.16 ", N/A ,"$2,120.00 ","$1,166.00 ", N/A ,$557.56 ,"$2,120.00 ","$1,108.00 ","$1,057.63 ", N/A ,"$1,696.00 ","$1,151.16 ",$593.60 ,"$1,908.00 ",$805.60 ,$250.00 , N/A ,"$1,017.60 "
ST. MARY'S HOSPITAL - DECATUR,51000431,15115,HC EPIDRM A-GRFT FACE SCLP HAND ETC FIRST 100CM W/PROC,510,1 ,"$4,239.00 ","$2,755.35 ",$250.00 ,"$4,239.00 ","$4,053.30 ","$2,161.89 ","$2,331.45 ","$1,621.32 ","$1,186.92 ","$1,992.33 ","$1,621.32 ","$2,289.06 ","$1,621.32 ","$2,301.78 ","$1,174.97 ","$1,621.32 ","$2,301.78 ","$3,080.51 ","$2,967.30 ","$2,119.50 ","$3,391.20 ","$4,053.30 ","$1,621.32 ","$2,967.30 ","$1,621.32 ","$2,543.40 ","$1,621.32 ","$3,179.25 ","$2,339.93 ","$2,111.02 ","$2,339.93 ","$1,621.32 ","$2,339.93 ","$3,306.42 ","$3,306.42 ","$3,603.15 ","$4,053.30 ","$2,937.63 ","$1,621.32 ","$4,239.00 ","$2,331.45 ","$1,621.32 ","$1,114.86 ","$4,239.00 ","$1,225.99 ","$1,170.27 ","$1,702.39 ","$3,391.20 ","$2,301.78 ","$1,186.92 ","$3,815.10 ","$1,610.82 ",$250.00 ,"$1,621.32 ","$2,034.72 "
ST. MARY'S HOSPITAL - DECATUR,51000465,99203,HC CLINIC VISIT INTERM NEW -25,510,1 ,$447.00 ,$290.55 ,$88.33 ,$447.00 , N/A ,$227.97 ,$245.85 , N/A ,$125.16 ,$219.03 , N/A ,$261.50 , N/A ,$242.72 ,$88.33 , N/A ,$242.72 , N/A ,$312.90 ,$223.50 ,$357.60 , N/A , N/A ,$312.90 , N/A ,$268.20 , N/A ,$335.25 ,$246.74 ,$222.61 ,$246.74 , N/A ,$246.74 ,$348.66 ,$348.66 ,$379.95 , N/A ,$309.77 , N/A ,$121.24 ,$245.85 , N/A ,$117.56 ,$447.00 ,$98.34 ,$93.87 , N/A ,$357.60 ,$242.72 ,$125.16 ,$402.30 ,$169.86 ,$250.00 , N/A ,$214.56 
ST. MARY'S HOSPITAL - DECATUR,51000466,99204,HC CLINIC VISIT COMPLEX NEW -25,510,1 ,$604.00 ,$392.60 ,$93.87 ,$604.00 , N/A ,$308.04 ,$332.20 , N/A ,$169.12 ,$295.96 , N/A ,$353.34 , N/A ,$327.97 ,$152.13 , N/A ,$327.97 , N/A ,$422.80 ,$302.00 ,$483.20 , N/A , N/A ,$422.80 , N/A ,$362.40 , N/A ,$453.00 ,$333.41 ,$300.79 ,$333.41 , N/A ,$333.41 ,$471.12 ,$471.12 ,$513.40 , N/A ,$418.57 , N/A ,$181.05 ,$332.20 , N/A ,$158.85 ,$604.00 ,$98.34 ,$93.87 , N/A ,$483.20 ,$327.97 ,$169.12 ,$543.60 ,$229.52 ,$250.00 , N/A ,$289.92 
ST. MARY'S HOSPITAL - DECATUR,51000467,99205,HC CLINIC VISIT COMPREH NEW -25,510,1 ,$746.00 ,$484.90 ,$93.87 ,$746.00 , N/A ,$380.46 ,$410.30 , N/A ,$208.88 ,$365.54 , N/A ,$436.41 , N/A ,$405.08 ,$198.23 , N/A ,$405.08 , N/A ,$522.20 ,$373.00 ,$596.80 , N/A , N/A ,$522.20 , N/A ,$447.60 , N/A ,$559.50 ,$411.79 ,$371.51 ,$411.79 , N/A ,$411.79 ,$581.88 ,$581.88 ,$634.10 , N/A ,$516.98 , N/A ,$239.15 ,$410.30 , N/A ,$196.20 ,$746.00 ,$98.34 ,$93.87 , N/A ,$596.80 ,$405.08 ,$208.88 ,$671.40 ,$283.48 ,$250.00 , N/A ,$358.08 
ST. MARY'S HOSPITAL - DECATUR,51000468,99211,HC CLINIC VISIT BRIEF ESTAB -25,510,1 ,$281.00 ,$182.65 ,$11.48 ,$281.00 , N/A ,$143.31 ,$154.55 , N/A ,$78.68 ,$104.00 , N/A ,$104.00 , N/A ,$152.58 ,$11.48 , N/A ,$152.58 , N/A ,$196.70 ,$140.50 ,$224.80 , N/A , N/A ,$196.70 , N/A ,$168.60 , N/A ,$210.75 ,$155.11 ,$139.94 ,$155.11 , N/A ,$155.11 ,$219.18 ,$219.18 ,$238.85 , N/A ,$194.73 , N/A ,$281.00 ,$154.55 , N/A ,$73.90 ,$281.00 ,$98.34 ,$93.87 , N/A ,$224.80 ,$152.58 ,$78.68 ,$252.90 ,$106.78 ,$250.00 , N/A ,$134.88 
ST. MARY'S HOSPITAL - DECATUR,51000469,99212,HC CLINIC VISIT LIMITED ESTAB -25,510,1 ,$327.00 ,$212.55 ,$28.92 ,$327.00 , N/A ,$166.77 ,$179.85 , N/A ,$91.56 ,$160.23 , N/A ,$191.30 , N/A ,$177.56 ,$28.92 , N/A ,$177.56 , N/A ,$228.90 ,$163.50 ,$261.60 , N/A , N/A ,$228.90 , N/A ,$196.20 , N/A ,$245.25 ,$180.50 ,$162.85 ,$180.50 , N/A ,$180.50 ,$255.06 ,$255.06 ,$277.95 , N/A ,$226.61 , N/A ,$60.02 ,$179.85 , N/A ,$86.00 ,$327.00 ,$98.34 ,$93.87 , N/A ,$261.60 ,$177.56 ,$91.56 ,$294.30 ,$124.26 ,$250.00 , N/A ,$156.96 
ST. MARY'S HOSPITAL - DECATUR,51000470,99213,HC CLINIC VISIT INTERM EST -25,510,1 ,$395.00 ,$256.75 ,$53.74 ,$395.00 , N/A ,$201.45 ,$217.25 , N/A ,$110.60 ,$193.55 , N/A ,$231.08 , N/A ,$214.49 ,$53.74 , N/A ,$214.49 , N/A ,$276.50 ,$197.50 ,$316.00 , N/A , N/A ,$276.50 , N/A ,$237.00 , N/A ,$296.25 ,$218.04 ,$196.71 ,$218.04 , N/A ,$218.04 ,$308.10 ,$308.10 ,$335.75 , N/A ,$273.74 , N/A ,$97.92 ,$217.25 , N/A ,$103.89 ,$395.00 ,$98.34 ,$93.87 , N/A ,$316.00 ,$214.49 ,$110.60 ,$355.50 ,$150.10 ,$250.00 , N/A ,$189.60 
ST. MARY'S HOSPITAL - DECATUR,51000471,99214,HC CLINIC VISIT COMPLEX EST -25,510,1 ,$577.00 ,$375.05 ,$84.31 ,$577.00 , N/A ,$294.27 ,$317.35 , N/A ,$161.56 ,$282.73 , N/A ,$337.55 , N/A ,$313.31 ,$84.31 , N/A ,$313.31 , N/A ,$403.90 ,$288.50 ,$461.60 , N/A , N/A ,$403.90 , N/A ,$346.20 , N/A ,$432.75 ,$318.50 ,$287.35 ,$318.50 , N/A ,$318.50 ,$450.06 ,$450.06 ,$490.45 , N/A ,$399.86 , N/A ,$577.00 ,$317.35 , N/A ,$151.75 ,$577.00 ,$98.34 ,$93.87 , N/A ,$461.60 ,$313.31 ,$161.56 ,$519.30 ,$219.26 ,$250.00 , N/A ,$276.96 
ST. MARY'S HOSPITAL - DECATUR,51000472,99215,HC CLINIC VISIT COMPREH EST -25,510,1 ,$625.00 ,$406.25 ,$93.87 ,$625.00 , N/A ,$318.75 ,$343.75 , N/A ,$175.00 ,$306.25 , N/A ,$365.63 , N/A ,$339.38 ,$129.78 , N/A ,$339.38 , N/A ,$437.50 ,$312.50 ,$500.00 , N/A , N/A ,$437.50 , N/A ,$375.00 , N/A ,$468.75 ,$345.00 ,$311.25 ,$345.00 , N/A ,$345.00 ,$487.50 ,$487.50 ,$531.25 , N/A ,$433.13 , N/A ,$625.00 ,$343.75 , N/A ,$164.38 ,$625.00 ,$98.34 ,$93.87 , N/A ,$500.00 ,$339.38 ,$175.00 ,$562.50 ,$237.50 ,$250.00 , N/A ,$300.00 
ST. MARY'S HOSPITAL - DECATUR,51001009,99213,HC CLINIC VISIT - MEMORY FOLLOWUP,510,1 ,$395.00 ,$256.75 ,$53.74 ,$395.00 , N/A ,$201.45 ,$217.25 , N/A ,$110.60 ,$193.55 , N/A ,$231.08 , N/A ,$214.49 ,$53.74 , N/A ,$214.49 , N/A ,$276.50 ,$197.50 ,$316.00 , N/A , N/A ,$276.50 , N/A ,$237.00 , N/A ,$296.25 ,$218.04 ,$196.71 ,$218.04 , N/A ,$218.04 ,$308.10 ,$308.10 ,$335.75 , N/A ,$273.74 , N/A ,$97.92 ,$217.25 , N/A ,$103.89 ,$395.00 ,$98.34 ,$93.87 , N/A ,$316.00 ,$214.49 ,$110.60 ,$355.50 ,$150.10 ,$250.00 , N/A ,$189.60 
ST. MARY'S HOSPITAL - DECATUR,51001010,99215,HC CLINIC VISIT - MEMORY INITIAL,510,1 ,$625.00 ,$406.25 ,$93.87 ,$625.00 , N/A ,$318.75 ,$343.75 , N/A ,$175.00 ,$306.25 , N/A ,$365.63 , N/A ,$339.38 ,$129.78 , N/A ,$339.38 , N/A ,$437.50 ,$312.50 ,$500.00 , N/A , N/A ,$437.50 , N/A ,$375.00 , N/A ,$468.75 ,$345.00 ,$311.25 ,$345.00 , N/A ,$345.00 ,$487.50 ,$487.50 ,$531.25 , N/A ,$433.13 , N/A ,$625.00 ,$343.75 , N/A ,$164.38 ,$625.00 ,$98.34 ,$93.87 , N/A ,$500.00 ,$339.38 ,$175.00 ,$562.50 ,$237.50 ,$250.00 , N/A ,$300.00 
ST. MARY'S HOSPITAL - DECATUR,51100000,62370,HC ELEC ANLYS REPRGRMING/REFILL SPINAL INF PUMP PHYSICIAN,511,1 ,$750.00 ,$487.50 ,$93.57 ,$750.00 ,$646.15 ,$382.50 ,$412.50 ,$258.46 ,$210.00 ,$352.50 ,$258.46 ,$405.00 ,$258.46 ,$407.25 ,$93.57 ,$258.46 ,$407.25 ,$491.08 ,$525.00 ,$375.00 ,$600.00 ,$646.16 ,$258.46 ,$525.00 ,$258.46 ,$450.00 ,$258.46 ,$562.50 ,$414.00 ,$373.50 ,$414.00 ,$258.46 ,$414.00 ,$585.00 ,$585.00 ,$637.50 ,$646.16 ,$519.75 ,$258.46 ,$750.00 ,$412.50 ,$258.46 ,$197.25 ,$750.00 ,$177.19 ,$169.13 ,$271.38 ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$250.00 ,$258.46 ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$6,577.00 ","$4,275.05 ",$231.30 ,"$6,577.00 ",$871.45 ,"$1,100.00 ","$3,617.35 ",$348.58 ,"$1,841.56 ","$3,222.73 ",$348.58 ,"$3,847.55 ",$348.58 ,"$3,571.31 ",$595.19 ,$348.58 ,"$3,571.31 ",$662.31 ,"$4,603.90 ","$3,288.50 ","$5,261.60 ",$871.46 ,$348.58 ,"$4,603.90 ",$348.58 ,"$3,946.20 ",$348.58 ,"$4,932.75 ","$3,630.50 ","$3,275.35 ","$3,630.50 ",$348.58 ,"$3,630.50 ",$404.21 ,$404.21 ,"$5,590.45 ",$871.46 ,"$4,557.86 ",$348.58 ,"$6,577.00 ","$3,617.35 ",$348.58 ,"$1,729.75 ","$6,577.00 ",$242.32 ,$231.30 ,$366.01 ,"$5,261.60 ","$3,571.31 ","$1,841.56 ","$5,919.30 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,156.96 "
ST. MARY'S HOSPITAL - DECATUR,61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$4,906.00 ","$3,188.90 ",$217.81 ,"$4,906.00 ",$544.53 ,"$1,100.00 ","$2,698.30 ",$217.81 ,"$1,373.68 ","$2,403.94 ",$217.81 ,"$2,870.01 ",$217.81 ,"$2,663.96 ",$448.88 ,$217.81 ,"$2,663.96 ",$413.84 ,"$3,434.20 ","$2,453.00 ","$3,924.80 ",$544.53 ,$217.81 ,"$3,434.20 ",$217.81 ,"$2,943.60 ",$217.81 ,"$3,679.50 ","$2,708.11 ","$2,443.19 ","$2,708.11 ",$217.81 ,"$2,708.11 ",$304.85 ,$304.85 ,"$4,170.10 ",$544.53 ,"$3,399.86 ",$217.81 ,"$4,906.00 ","$2,698.30 ",$217.81 ,"$1,290.28 ","$4,906.00 ",$296.66 ,$283.17 ,$228.70 ,"$3,924.80 ","$2,663.96 ","$1,373.68 ","$4,415.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,354.88 "
ST. MARY'S HOSPITAL - DECATUR,61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$4,906.00 ","$3,188.90 ",$283.17 ,"$4,906.00 ",$871.45 ,"$1,100.00 ","$2,698.30 ",$348.58 ,"$1,373.68 ","$2,403.94 ",$348.58 ,"$2,870.01 ",$348.58 ,"$2,663.96 ",$444.50 ,$348.58 ,"$2,663.96 ",$662.31 ,"$3,434.20 ","$2,453.00 ","$3,924.80 ",$871.46 ,$348.58 ,"$3,434.20 ",$348.58 ,"$2,943.60 ",$348.58 ,"$3,679.50 ","$2,708.11 ","$2,443.19 ","$2,708.11 ",$348.58 ,"$2,708.11 ",$301.88 ,$301.88 ,"$4,170.10 ",$871.46 ,"$3,399.86 ",$348.58 ,"$4,906.00 ","$2,698.30 ",$348.58 ,"$1,290.28 ","$4,906.00 ",$296.66 ,$283.17 ,$366.01 ,"$3,924.80 ","$2,663.96 ","$1,373.68 ","$4,415.40 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,354.88 "
ST. MARY'S HOSPITAL - DECATUR,61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$6,577.00 ","$4,275.05 ",$283.17 ,"$6,577.00 ",$871.45 ,"$1,100.00 ","$3,617.35 ",$348.58 ,"$1,841.56 ","$3,222.73 ",$348.58 ,"$3,847.55 ",$348.58 ,"$3,571.31 ",$688.32 ,$348.58 ,"$3,571.31 ",$662.31 ,"$4,603.90 ","$3,288.50 ","$5,261.60 ",$871.46 ,$348.58 ,"$4,603.90 ",$348.58 ,"$3,946.20 ",$348.58 ,"$4,932.75 ","$3,630.50 ","$3,275.35 ","$3,630.50 ",$348.58 ,"$3,630.50 ",$467.46 ,$467.46 ,"$5,590.45 ",$871.46 ,"$4,557.86 ",$348.58 ,"$6,577.00 ","$3,617.35 ",$348.58 ,"$1,729.75 ","$6,577.00 ",$296.66 ,$283.17 ,$366.01 ,"$5,261.60 ","$3,571.31 ","$1,841.56 ","$5,919.30 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,156.96 "
ST. MARY'S HOSPITAL - DECATUR,61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$4,906.00 ","$3,188.90 ",$217.81 ,"$4,906.00 ",$544.53 ,"$1,100.00 ","$2,698.30 ",$217.81 ,"$1,373.68 ","$2,403.94 ",$217.81 ,"$2,870.01 ",$217.81 ,"$2,663.96 ",$451.08 ,$217.81 ,"$2,663.96 ",$413.84 ,"$3,434.20 ","$2,453.00 ","$3,924.80 ",$544.53 ,$217.81 ,"$3,434.20 ",$217.81 ,"$2,943.60 ",$217.81 ,"$3,679.50 ","$2,708.11 ","$2,443.19 ","$2,708.11 ",$217.81 ,"$2,708.11 ",$306.35 ,$306.35 ,"$4,170.10 ",$544.53 ,"$3,399.86 ",$217.81 ,"$4,906.00 ","$2,698.30 ",$217.81 ,"$1,290.28 ","$4,906.00 ",$296.66 ,$283.17 ,$228.70 ,"$3,924.80 ","$2,663.96 ","$1,373.68 ","$4,415.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,354.88 "
ST. MARY'S HOSPITAL - DECATUR,61000006,70548,HC MRA NECK W/CONTRAST,610,1 ,"$4,906.00 ","$3,188.90 ",$283.17 ,"$4,906.00 ",$871.45 ,"$1,100.00 ","$2,698.30 ",$348.58 ,"$1,373.68 ","$2,403.94 ",$348.58 ,"$2,870.01 ",$348.58 ,"$2,663.96 ",$477.41 ,$348.58 ,"$2,663.96 ",$662.31 ,"$3,434.20 ","$2,453.00 ","$3,924.80 ",$871.46 ,$348.58 ,"$3,434.20 ",$348.58 ,"$2,943.60 ",$348.58 ,"$3,679.50 ","$2,708.11 ","$2,443.19 ","$2,708.11 ",$348.58 ,"$2,708.11 ",$324.23 ,$324.23 ,"$4,170.10 ",$871.46 ,"$3,399.86 ",$348.58 ,"$4,906.00 ","$2,698.30 ",$348.58 ,"$1,290.28 ","$4,906.00 ",$296.66 ,$283.17 ,$366.01 ,"$3,924.80 ","$2,663.96 ","$1,373.68 ","$4,415.40 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,354.88 "
ST. MARY'S HOSPITAL - DECATUR,61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$6,871.00 ","$4,466.15 ",$283.17 ,"$6,871.00 ",$871.45 ,"$1,100.00 ","$3,779.05 ",$348.58 ,"$1,923.88 ","$3,366.79 ",$348.58 ,"$4,019.54 ",$348.58 ,"$3,730.95 ",$692.71 ,$348.58 ,"$3,730.95 ",$662.31 ,"$4,809.70 ","$3,435.50 ","$5,496.80 ",$871.46 ,$348.58 ,"$4,809.70 ",$348.58 ,"$4,122.60 ",$348.58 ,"$5,153.25 ","$3,792.79 ","$3,421.76 ","$3,792.79 ",$348.58 ,"$3,792.79 ",$470.45 ,$470.45 ,"$5,840.35 ",$871.46 ,"$4,761.60 ",$348.58 ,"$6,871.00 ","$3,779.05 ",$348.58 ,"$1,807.07 ","$6,871.00 ",$296.66 ,$283.17 ,$366.01 ,"$5,496.80 ","$3,730.95 ","$1,923.88 ","$6,183.90 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,298.08 "
ST. MARY'S HOSPITAL - DECATUR,61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$5,227.00 ","$3,397.55 ",$212.30 ,"$5,227.00 ",$544.53 ,"$1,100.00 ","$2,874.85 ",$217.81 ,"$1,463.56 ","$2,561.23 ",$217.81 ,"$3,057.80 ",$217.81 ,"$2,838.26 ",$685.13 ,$217.81 ,"$2,838.26 ",$413.84 ,"$3,658.90 ","$2,613.50 ","$4,181.60 ",$544.53 ,$217.81 ,"$3,658.90 ",$217.81 ,"$3,136.20 ",$217.81 ,"$3,920.25 ","$2,885.30 ","$2,603.05 ","$2,885.30 ",$217.81 ,"$2,885.30 ",$212.30 ,$212.30 ,"$4,442.95 ",$544.53 ,"$3,622.31 ",$217.81 ,"$5,227.00 ","$2,874.85 ",$217.81 ,"$1,374.70 ","$5,227.00 ",$271.50 ,$259.16 ,$228.70 ,"$4,181.60 ","$2,838.26 ","$1,463.56 ","$4,704.30 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,508.96 "
ST. MARY'S HOSPITAL - DECATUR,61000009,70552,HC MRI BRAIN W/CON,610,1 ,"$5,598.00 ","$3,638.70 ",$259.16 ,"$5,598.00 ",$871.45 ,"$1,100.00 ","$3,078.90 ",$348.58 ,"$1,567.44 ","$2,743.02 ",$348.58 ,"$3,255.79 ",$348.58 ,"$3,039.71 ",$462.78 ,$348.58 ,"$3,039.71 ",$662.31 ,"$3,918.60 ","$2,799.00 ","$4,478.40 ",$871.46 ,$348.58 ,"$3,918.60 ",$348.58 ,"$3,358.80 ",$348.58 ,"$4,198.50 ","$3,090.10 ","$2,787.80 ","$3,090.10 ",$348.58 ,"$3,090.10 ",$314.30 ,$314.30 ,"$4,758.30 ",$871.46 ,"$3,879.41 ",$348.58 ,"$5,598.00 ","$3,078.90 ",$348.58 ,"$1,472.27 ","$5,598.00 ",$271.50 ,$259.16 ,$366.01 ,"$4,478.40 ","$3,039.71 ","$1,567.44 ","$5,038.20 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,687.04 "
ST. MARY'S HOSPITAL - DECATUR,61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$8,162.00 ","$5,305.30 ",$259.16 ,"$8,162.00 ",$871.45 ,"$1,100.00 ","$4,489.10 ",$348.58 ,"$2,285.36 ","$3,999.38 ",$348.58 ,"$4,774.77 ",$348.58 ,"$4,431.97 ",$860.14 ,$348.58 ,"$4,431.97 ",$662.31 ,"$5,713.40 ","$4,081.00 ","$6,529.60 ",$871.46 ,$348.58 ,"$5,713.40 ",$348.58 ,"$4,897.20 ",$348.58 ,"$6,121.50 ","$4,505.42 ","$4,064.68 ","$4,505.42 ",$348.58 ,"$4,505.42 ",$358.01 ,$358.01 ,"$6,937.70 ",$871.46 ,"$5,656.27 ",$348.58 ,"$8,162.00 ","$4,489.10 ",$348.58 ,"$2,146.61 ","$8,162.00 ",$271.50 ,$259.16 ,$366.01 ,"$6,529.60 ","$4,431.97 ","$2,285.36 ","$7,345.80 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,917.76 "
ST. MARY'S HOSPITAL - DECATUR,61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$4,656.00 ","$3,026.40 ",$186.91 ,"$4,656.00 ",$544.53 ,"$1,100.00 ","$2,560.80 ",$217.81 ,"$1,303.68 ","$2,281.44 ",$217.81 ,"$2,723.76 ",$217.81 ,"$2,528.21 ",$589.42 ,$217.81 ,"$2,528.21 ",$413.84 ,"$3,259.20 ","$2,328.00 ","$3,724.80 ",$544.53 ,$217.81 ,"$3,259.20 ",$217.81 ,"$2,793.60 ",$217.81 ,"$3,492.00 ","$2,570.11 ","$2,318.69 ","$2,570.11 ",$217.81 ,"$2,570.11 ",$203.85 ,$203.85 ,"$3,957.60 ",$544.53 ,"$3,226.61 ",$217.81 ,"$4,656.00 ","$2,560.80 ",$217.81 ,"$1,224.53 ","$4,656.00 ",$195.81 ,$186.91 ,$228.70 ,"$3,724.80 ","$2,528.21 ","$1,303.68 ","$4,190.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,234.88 "
ST. MARY'S HOSPITAL - DECATUR,61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$5,405.00 ","$3,513.25 ",$186.91 ,"$5,405.00 ",$871.45 ,"$1,100.00 ","$2,972.75 ",$348.58 ,"$1,513.40 ","$2,648.45 ",$348.58 ,"$3,161.93 ",$348.58 ,"$2,934.92 ",$474.49 ,$348.58 ,"$2,934.92 ",$662.31 ,"$3,783.50 ","$2,702.50 ","$4,324.00 ",$871.46 ,$348.58 ,"$3,783.50 ",$348.58 ,"$3,243.00 ",$348.58 ,"$4,053.75 ","$2,983.56 ","$2,691.69 ","$2,983.56 ",$348.58 ,"$2,983.56 ",$322.25 ,$322.25 ,"$4,594.25 ",$871.46 ,"$3,745.67 ",$348.58 ,"$5,405.00 ","$2,972.75 ",$348.58 ,"$1,421.52 ","$5,405.00 ",$195.81 ,$186.91 ,$366.01 ,"$4,324.00 ","$2,934.92 ","$1,513.40 ","$4,864.50 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,594.40 "
ST. MARY'S HOSPITAL - DECATUR,61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$4,554.00 ","$2,960.10 ",$186.91 ,"$4,554.00 ",$544.53 ,"$1,100.00 ","$2,504.70 ",$217.81 ,"$1,275.12 ","$2,231.46 ",$217.81 ,"$2,664.09 ",$217.81 ,"$2,472.82 ",$300.89 ,$217.81 ,"$2,472.82 ",$413.84 ,"$3,187.80 ","$2,277.00 ","$3,643.20 ",$544.53 ,$217.81 ,"$3,187.80 ",$217.81 ,"$2,732.40 ",$217.81 ,"$3,415.50 ","$2,513.81 ","$2,267.89 ","$2,513.81 ",$217.81 ,"$2,513.81 ",$204.35 ,$204.35 ,"$3,870.90 ",$544.53 ,"$3,155.92 ",$217.81 ,"$4,554.00 ","$2,504.70 ",$217.81 ,"$1,197.70 ","$4,554.00 ",$195.81 ,$186.91 ,$228.70 ,"$3,643.20 ","$2,472.82 ","$1,275.12 ","$4,098.60 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,185.92 "
ST. MARY'S HOSPITAL - DECATUR,61000014,72147,HC MRI T-SPINE W/CON,610,1 ,"$4,864.00 ","$3,161.60 ",$186.91 ,"$4,864.00 ",$871.45 ,"$1,100.00 ","$2,675.20 ",$348.58 ,"$1,361.92 ","$2,383.36 ",$348.58 ,"$2,845.44 ",$348.58 ,"$2,641.15 ",$471.56 ,$348.58 ,"$2,641.15 ",$662.31 ,"$3,404.80 ","$2,432.00 ","$3,891.20 ",$871.46 ,$348.58 ,"$3,404.80 ",$348.58 ,"$2,918.40 ",$348.58 ,"$3,648.00 ","$2,684.93 ","$2,422.27 ","$2,684.93 ",$348.58 ,"$2,684.93 ",$320.25 ,$320.25 ,"$4,134.40 ",$871.46 ,"$3,370.75 ",$348.58 ,"$4,864.00 ","$2,675.20 ",$348.58 ,"$1,279.23 ","$4,864.00 ",$195.81 ,$186.91 ,$366.01 ,"$3,891.20 ","$2,641.15 ","$1,361.92 ","$4,377.60 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,334.72 "
ST. MARY'S HOSPITAL - DECATUR,61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$4,854.00 ","$3,155.10 ",$186.91 ,"$4,854.00 ",$544.53 ,"$1,100.00 ","$2,669.70 ",$217.81 ,"$1,359.12 ","$2,378.46 ",$217.81 ,"$2,839.59 ",$217.81 ,"$2,635.72 ",$300.89 ,$217.81 ,"$2,635.72 ",$413.84 ,"$3,397.80 ","$2,427.00 ","$3,883.20 ",$544.53 ,$217.81 ,"$3,397.80 ",$217.81 ,"$2,912.40 ",$217.81 ,"$3,640.50 ","$2,679.41 ","$2,417.29 ","$2,679.41 ",$217.81 ,"$2,679.41 ",$204.35 ,$204.35 ,"$4,125.90 ",$544.53 ,"$3,363.82 ",$217.81 ,"$4,854.00 ","$2,669.70 ",$217.81 ,"$1,276.60 ","$4,854.00 ",$195.81 ,$186.91 ,$228.70 ,"$3,883.20 ","$2,635.72 ","$1,359.12 ","$4,368.60 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,329.92 "
ST. MARY'S HOSPITAL - DECATUR,61000017,72149,HC MRI L-SPINE W/CON,610,1 ,"$4,957.00 ","$3,222.05 ",$186.91 ,"$4,957.00 ",$871.45 ,"$1,100.00 ","$2,726.35 ",$348.58 ,"$1,387.96 ","$2,428.93 ",$348.58 ,"$2,899.85 ",$348.58 ,"$2,691.65 ",$466.44 ,$348.58 ,"$2,691.65 ",$662.31 ,"$3,469.90 ","$2,478.50 ","$3,965.60 ",$871.46 ,$348.58 ,"$3,469.90 ",$348.58 ,"$2,974.20 ",$348.58 ,"$3,717.75 ","$2,736.26 ","$2,468.59 ","$2,736.26 ",$348.58 ,"$2,736.26 ",$316.77 ,$316.77 ,"$4,213.45 ",$871.46 ,"$3,435.20 ",$348.58 ,"$4,957.00 ","$2,726.35 ",$348.58 ,"$1,303.69 ","$4,957.00 ",$195.81 ,$186.91 ,$366.01 ,"$3,965.60 ","$2,691.65 ","$1,387.96 ","$4,461.30 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,379.36 "
ST. MARY'S HOSPITAL - DECATUR,61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$7,786.00 ","$5,060.90 ",$186.91 ,"$7,786.00 ",$871.45 ,"$1,100.00 ","$4,282.30 ",$348.58 ,"$2,180.08 ","$3,815.14 ",$348.58 ,"$4,554.81 ",$348.58 ,"$4,227.80 ",$532.28 ,$348.58 ,"$4,227.80 ",$662.31 ,"$5,450.20 ","$3,893.00 ","$6,228.80 ",$871.46 ,$348.58 ,"$5,450.20 ",$348.58 ,"$4,671.60 ",$348.58 ,"$5,839.50 ","$4,297.87 ","$3,877.43 ","$4,297.87 ",$348.58 ,"$4,297.87 ",$361.49 ,$361.49 ,"$6,618.10 ",$871.46 ,"$5,395.70 ",$348.58 ,"$7,786.00 ","$4,282.30 ",$348.58 ,"$2,047.72 ","$7,786.00 ",$195.81 ,$186.91 ,$366.01 ,"$6,228.80 ","$4,227.80 ","$2,180.08 ","$7,007.40 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,737.28 "
ST. MARY'S HOSPITAL - DECATUR,61000019,72157,HC MRI T-SPINE W AND W/O CON,610,1 ,"$7,366.00 ","$4,787.90 ",$186.91 ,"$7,366.00 ",$871.45 ,"$1,100.00 ","$4,051.30 ",$348.58 ,"$2,062.48 ","$3,609.34 ",$348.58 ,"$3,752.31 ",$348.58 ,"$3,999.74 ",$534.47 ,$348.58 ,"$3,999.74 ",$662.31 ,"$5,156.20 ","$3,683.00 ","$5,892.80 ",$871.46 ,$348.58 ,"$5,156.20 ",$348.58 ,"$4,419.60 ",$348.58 ,"$5,524.50 ","$4,066.03 ","$3,668.27 ","$4,066.03 ",$348.58 ,"$4,066.03 ",$362.97 ,$362.97 ,"$6,261.10 ",$871.46 ,"$5,104.64 ",$348.58 ,"$7,366.00 ","$4,051.30 ",$348.58 ,"$1,937.26 ","$7,366.00 ",$195.81 ,$186.91 ,$366.01 ,"$5,892.80 ","$3,999.74 ","$2,062.48 ","$6,629.40 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,535.68 "
ST. MARY'S HOSPITAL - DECATUR,61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$7,158.00 ","$4,652.70 ",$186.91 ,"$7,158.00 ",$871.45 ,"$1,100.00 ","$3,936.90 ",$348.58 ,"$2,004.24 ","$3,507.42 ",$348.58 ,"$4,187.43 ",$348.58 ,"$3,886.79 ",$530.81 ,$348.58 ,"$3,886.79 ",$662.31 ,"$5,010.60 ","$3,579.00 ","$5,726.40 ",$871.46 ,$348.58 ,"$5,010.60 ",$348.58 ,"$4,294.80 ",$348.58 ,"$5,368.50 ","$3,951.22 ","$3,564.68 ","$3,951.22 ",$348.58 ,"$3,951.22 ",$360.50 ,$360.50 ,"$6,084.30 ",$871.46 ,"$4,960.49 ",$348.58 ,"$7,158.00 ","$3,936.90 ",$348.58 ,"$1,882.55 ","$7,158.00 ",$195.81 ,$186.91 ,$366.01 ,"$5,726.40 ","$3,886.79 ","$2,004.24 ","$6,442.20 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,435.84 "
ST. MARY'S HOSPITAL - DECATUR,61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$4,256.00 ","$2,766.40 ",$217.81 ,"$4,256.00 ",$544.53 ,"$1,100.00 ","$2,340.80 ",$217.81 ,"$1,191.68 ","$2,085.44 ",$217.81 ,"$2,489.76 ",$217.81 ,"$2,311.01 ",$405.49 ,$217.81 ,"$2,311.01 ",$413.84 ,"$2,979.20 ","$2,128.00 ","$3,404.80 ",$544.53 ,$217.81 ,"$2,979.20 ",$217.81 ,"$2,553.60 ",$217.81 ,"$3,192.00 ","$2,349.31 ","$2,119.49 ","$2,349.31 ",$217.81 ,"$2,349.31 ",$275.39 ,$275.39 ,"$3,617.60 ",$544.53 ,"$2,949.41 ",$217.81 ,"$4,256.00 ","$2,340.80 ",$217.81 ,"$1,119.33 ","$4,256.00 ",$242.32 ,$231.30 ,$228.70 ,"$3,404.80 ","$2,311.01 ","$1,191.68 ","$3,830.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,042.88 "
ST. MARY'S HOSPITAL - DECATUR,61000022,72196,HC MRI PELVIS W/CON,610,1 ,"$4,309.00 ","$2,800.85 ",$231.30 ,"$4,309.00 ",$871.45 ,"$1,100.00 ","$2,369.95 ",$348.58 ,"$1,206.52 ","$2,111.41 ",$348.58 ,"$2,520.77 ",$348.58 ,"$2,339.79 ",$470.83 ,$348.58 ,"$2,339.79 ",$662.31 ,"$3,016.30 ","$2,154.50 ","$3,447.20 ",$871.46 ,$348.58 ,"$3,016.30 ",$348.58 ,"$2,585.40 ",$348.58 ,"$3,231.75 ","$2,378.57 ","$2,145.88 ","$2,378.57 ",$348.58 ,"$2,378.57 ",$319.76 ,$319.76 ,"$3,662.65 ",$871.46 ,"$2,986.14 ",$348.58 ,"$4,309.00 ","$2,369.95 ",$348.58 ,"$1,133.27 ","$4,309.00 ",$242.32 ,$231.30 ,$366.01 ,"$3,447.20 ","$2,339.79 ","$1,206.52 ","$3,878.10 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,068.32 "
ST. MARY'S HOSPITAL - DECATUR,61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$5,960.00 ","$3,874.00 ",$231.30 ,"$5,960.00 ",$871.45 ,"$1,100.00 ","$3,278.00 ",$348.58 ,"$1,668.80 ","$2,920.40 ",$348.58 ,"$3,486.60 ",$348.58 ,"$3,236.28 ",$593.73 ,$348.58 ,"$3,236.28 ",$662.31 ,"$4,172.00 ","$2,980.00 ","$4,768.00 ",$871.46 ,$348.58 ,"$4,172.00 ",$348.58 ,"$3,576.00 ",$348.58 ,"$4,470.00 ","$3,289.92 ","$2,968.08 ","$3,289.92 ",$348.58 ,"$3,289.92 ",$403.22 ,$403.22 ,"$5,066.00 ",$871.46 ,"$4,130.28 ",$348.58 ,"$5,960.00 ","$3,278.00 ",$348.58 ,"$1,567.48 ","$5,960.00 ",$242.32 ,$231.30 ,$366.01 ,"$4,768.00 ","$3,236.28 ","$1,668.80 ","$5,364.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,860.80 "
ST. MARY'S HOSPITAL - DECATUR,61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$4,256.00 ","$2,766.40 ",$217.81 ,"$4,256.00 ",$544.53 ,"$1,100.00 ","$2,340.80 ",$217.81 ,"$1,191.68 ","$2,085.44 ",$217.81 ,"$2,489.76 ",$217.81 ,"$2,311.01 ",$599.58 ,$217.81 ,"$2,311.01 ",$413.84 ,"$2,979.20 ","$2,128.00 ","$3,404.80 ",$544.53 ,$217.81 ,"$2,979.20 ",$217.81 ,"$2,553.60 ",$217.81 ,"$3,192.00 ","$2,349.31 ","$2,119.49 ","$2,349.31 ",$217.81 ,"$2,349.31 ",$318.27 ,$318.27 ,"$3,617.60 ",$544.53 ,"$2,949.41 ",$217.81 ,"$4,256.00 ","$2,340.80 ",$217.81 ,"$1,119.33 ","$4,256.00 ",$242.32 ,$231.30 ,$228.70 ,"$3,404.80 ","$2,311.01 ","$1,191.68 ","$3,830.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,042.88 "
ST. MARY'S HOSPITAL - DECATUR,61000025,73219,HC MRI UPPR EXT NONJOINT W/CONTRAST,610,1 ,"$4,690.00 ","$3,048.50 ",$231.30 ,"$4,690.00 ",$871.45 ,"$1,100.00 ","$2,579.50 ",$348.58 ,"$1,313.20 ","$2,298.10 ",$348.58 ,"$2,743.65 ",$348.58 ,"$2,546.67 ",$644.20 ,$348.58 ,"$2,546.67 ",$662.31 ,"$3,283.00 ","$2,345.00 ","$3,752.00 ",$871.46 ,$348.58 ,"$3,283.00 ",$348.58 ,"$2,814.00 ",$348.58 ,"$3,517.50 ","$2,588.88 ","$2,335.62 ","$2,588.88 ",$348.58 ,"$2,588.88 ",$437.49 ,$437.49 ,"$3,986.50 ",$871.46 ,"$3,250.17 ",$348.58 ,"$4,690.00 ","$2,579.50 ",$348.58 ,"$1,233.47 ","$4,690.00 ",$242.32 ,$231.30 ,$366.01 ,"$3,752.00 ","$2,546.67 ","$1,313.20 ","$4,221.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,251.20 "
ST. MARY'S HOSPITAL - DECATUR,61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$5,960.00 ","$3,874.00 ",$231.30 ,"$5,960.00 ",$871.45 ,"$1,100.00 ","$3,278.00 ",$348.58 ,"$1,668.80 ","$2,920.40 ",$348.58 ,"$3,486.60 ",$348.58 ,"$3,236.28 ",$783.19 ,$348.58 ,"$3,236.28 ",$662.31 ,"$4,172.00 ","$2,980.00 ","$4,768.00 ",$871.46 ,$348.58 ,"$4,172.00 ",$348.58 ,"$3,576.00 ",$348.58 ,"$4,470.00 ","$3,289.92 ","$2,968.08 ","$3,289.92 ",$348.58 ,"$3,289.92 ",$531.89 ,$531.89 ,"$5,066.00 ",$871.46 ,"$4,130.28 ",$348.58 ,"$5,960.00 ","$3,278.00 ",$348.58 ,"$1,567.48 ","$5,960.00 ",$242.32 ,$231.30 ,$366.01 ,"$4,768.00 ","$3,236.28 ","$1,668.80 ","$5,364.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,860.80 "
ST. MARY'S HOSPITAL - DECATUR,61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$4,256.00 ","$2,766.40 ",$156.11 ,"$4,256.00 ",$544.53 ,"$1,100.00 ","$2,340.80 ",$217.81 ,"$1,191.68 ","$2,085.44 ",$217.81 ,"$2,489.76 ",$217.81 ,"$2,311.01 ",$339.16 ,$217.81 ,"$2,311.01 ",$413.84 ,"$2,979.20 ","$2,128.00 ","$3,404.80 ",$544.53 ,$217.81 ,"$2,979.20 ",$217.81 ,"$2,553.60 ",$217.81 ,"$3,192.00 ","$2,349.31 ","$2,119.49 ","$2,349.31 ",$217.81 ,"$2,349.31 ",$230.33 ,$230.33 ,"$3,617.60 ",$544.53 ,"$2,949.41 ",$217.81 ,"$4,256.00 ","$2,340.80 ",$217.81 ,"$1,119.33 ","$4,256.00 ",$163.55 ,$156.11 ,$228.70 ,"$3,404.80 ","$2,311.01 ","$1,191.68 ","$3,830.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,042.88 "
ST. MARY'S HOSPITAL - DECATUR,61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$4,479.00 ","$2,911.35 ",$156.11 ,"$4,479.00 ","$1,693.08 ","$1,100.00 ","$2,463.45 ",$677.23 ,"$1,254.12 ","$2,194.71 ",$677.23 ,"$2,620.22 ",$677.23 ,"$2,432.10 ",$596.65 ,$677.23 ,"$2,432.10 ","$1,286.73 ","$3,135.30 ","$2,239.50 ","$3,583.20 ","$1,693.07 ",$677.23 ,"$3,135.30 ",$677.23 ,"$2,687.40 ",$677.23 ,"$3,359.25 ","$2,472.41 ","$2,230.54 ","$2,472.41 ",$677.23 ,"$2,472.41 ",$405.21 ,$405.21 ,"$3,807.15 ","$1,693.07 ","$3,103.95 ",$677.23 ,"$4,479.00 ","$2,463.45 ",$677.23 ,"$1,177.98 ","$4,479.00 ",$163.55 ,$156.11 ,$711.09 ,"$3,583.20 ","$2,432.10 ","$1,254.12 ","$4,031.10 ",$788.00 ,"$1,350.00 ",$677.23 ,"$2,149.92 "
ST. MARY'S HOSPITAL - DECATUR,61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$5,960.00 ","$3,874.00 ",$156.11 ,"$5,960.00 ",$871.45 ,"$1,100.00 ","$3,278.00 ",$348.58 ,"$1,668.80 ","$2,920.40 ",$348.58 ,"$3,486.60 ",$348.58 ,"$3,236.28 ",$726.86 ,$348.58 ,"$3,236.28 ",$662.31 ,"$4,172.00 ","$2,980.00 ","$4,768.00 ",$871.46 ,$348.58 ,"$4,172.00 ",$348.58 ,"$3,576.00 ",$348.58 ,"$4,470.00 ","$3,289.92 ","$2,968.08 ","$3,289.92 ",$348.58 ,"$3,289.92 ",$493.64 ,$493.64 ,"$5,066.00 ",$871.46 ,"$4,130.28 ",$348.58 ,"$5,960.00 ","$3,278.00 ",$348.58 ,"$1,567.48 ","$5,960.00 ",$163.55 ,$156.11 ,$366.01 ,"$4,768.00 ","$3,236.28 ","$1,668.80 ","$5,364.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,860.80 "
ST. MARY'S HOSPITAL - DECATUR,61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$4,456.00 ","$2,896.40 ",$217.81 ,"$4,456.00 ",$544.53 ,"$1,100.00 ","$2,450.80 ",$217.81 ,"$1,247.68 ","$2,183.44 ",$217.81 ,"$2,606.76 ",$217.81 ,"$2,419.61 ",$400.37 ,$217.81 ,"$2,419.61 ",$413.84 ,"$3,119.20 ","$2,228.00 ","$3,564.80 ",$544.53 ,$217.81 ,"$3,119.20 ",$217.81 ,"$2,673.60 ",$217.81 ,"$3,342.00 ","$2,459.71 ","$2,219.09 ","$2,459.71 ",$217.81 ,"$2,459.71 ",$271.91 ,$271.91 ,"$3,787.60 ",$544.53 ,"$3,088.01 ",$217.81 ,"$4,456.00 ","$2,450.80 ",$217.81 ,"$1,171.93 ","$4,456.00 ",$242.32 ,$231.30 ,$228.70 ,"$3,564.80 ","$2,419.61 ","$1,247.68 ","$4,010.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,138.88 "
ST. MARY'S HOSPITAL - DECATUR,61000032,73719,HC MRI LE NONJOINT W/ CONTRAST,610,1 ,"$4,682.00 ","$3,043.30 ",$231.30 ,"$4,682.00 ",$871.45 ,"$1,100.00 ","$2,575.10 ",$348.58 ,"$1,310.96 ","$2,294.18 ",$348.58 ,"$2,738.97 ",$348.58 ,"$2,542.33 ",$470.83 ,$348.58 ,"$2,542.33 ",$662.31 ,"$3,277.40 ","$2,341.00 ","$3,745.60 ",$871.46 ,$348.58 ,"$3,277.40 ",$348.58 ,"$2,809.20 ",$348.58 ,"$3,511.50 ","$2,584.46 ","$2,331.64 ","$2,584.46 ",$348.58 ,"$2,584.46 ",$319.76 ,$319.76 ,"$3,979.70 ",$871.46 ,"$3,244.63 ",$348.58 ,"$4,682.00 ","$2,575.10 ",$348.58 ,"$1,231.37 ","$4,682.00 ",$242.32 ,$231.30 ,$366.01 ,"$3,745.60 ","$2,542.33 ","$1,310.96 ","$4,213.80 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,247.36 "
ST. MARY'S HOSPITAL - DECATUR,61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$5,960.00 ","$3,874.00 ",$231.30 ,"$5,960.00 ",$871.45 ,"$1,100.00 ","$3,278.00 ",$348.58 ,"$1,668.80 ","$2,920.40 ",$348.58 ,"$3,486.60 ",$348.58 ,"$3,236.28 ",$597.38 ,$348.58 ,"$3,236.28 ",$662.31 ,"$4,172.00 ","$2,980.00 ","$4,768.00 ",$871.46 ,$348.58 ,"$4,172.00 ",$348.58 ,"$3,576.00 ",$348.58 ,"$4,470.00 ","$3,289.92 ","$2,968.08 ","$3,289.92 ",$348.58 ,"$3,289.92 ",$405.71 ,$405.71 ,"$5,066.00 ",$871.46 ,"$4,130.28 ",$348.58 ,"$5,960.00 ","$3,278.00 ",$348.58 ,"$1,567.48 ","$5,960.00 ",$242.32 ,$231.30 ,$366.01 ,"$4,768.00 ","$3,236.28 ","$1,668.80 ","$5,364.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,860.80 "
ST. MARY'S HOSPITAL - DECATUR,61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$4,256.00 ","$2,766.40 ",$156.11 ,"$4,256.00 ",$544.53 ,"$1,100.00 ","$2,340.80 ",$217.81 ,"$1,191.68 ","$2,085.44 ",$217.81 ,"$2,489.76 ",$217.81 ,"$2,311.01 ",$339.16 ,$217.81 ,"$2,311.01 ",$413.84 ,"$2,979.20 ","$2,128.00 ","$3,404.80 ",$544.53 ,$217.81 ,"$2,979.20 ",$217.81 ,"$2,553.60 ",$217.81 ,"$3,192.00 ","$2,349.31 ","$2,119.49 ","$2,349.31 ",$217.81 ,"$2,349.31 ",$230.33 ,$230.33 ,"$3,617.60 ",$544.53 ,"$2,949.41 ",$217.81 ,"$4,256.00 ","$2,340.80 ",$217.81 ,"$1,119.33 ","$4,256.00 ",$163.55 ,$156.11 ,$228.70 ,"$3,404.80 ","$2,311.01 ","$1,191.68 ","$3,830.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,042.88 "
ST. MARY'S HOSPITAL - DECATUR,61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$4,378.00 ","$2,845.70 ",$156.11 ,"$4,378.00 ","$1,693.08 ","$1,100.00 ","$2,407.90 ",$677.23 ,"$1,225.84 ","$2,145.22 ",$677.23 ,"$2,561.13 ",$677.23 ,"$2,377.25 ",$600.31 ,$677.23 ,"$2,377.25 ","$1,286.73 ","$3,064.60 ","$2,189.00 ","$3,502.40 ","$1,693.07 ",$677.23 ,"$3,064.60 ",$677.23 ,"$2,626.80 ",$677.23 ,"$3,283.50 ","$2,416.66 ","$2,180.24 ","$2,416.66 ",$677.23 ,"$2,416.66 ",$407.69 ,$407.69 ,"$3,721.30 ","$1,693.07 ","$3,033.95 ",$677.23 ,"$4,378.00 ","$2,407.90 ",$677.23 ,"$1,151.41 ","$4,378.00 ",$163.55 ,$156.11 ,$711.09 ,"$3,502.40 ","$2,377.25 ","$1,225.84 ","$3,940.20 ",$788.00 ,"$1,350.00 ",$677.23 ,"$2,101.44 "
ST. MARY'S HOSPITAL - DECATUR,61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$5,902.00 ","$3,836.30 ",$156.11 ,"$5,902.00 ",$871.45 ,"$1,100.00 ","$3,246.10 ",$348.58 ,"$1,652.56 ","$2,891.98 ",$348.58 ,"$3,452.67 ",$348.58 ,"$3,204.79 ",$725.40 ,$348.58 ,"$3,204.79 ",$662.31 ,"$4,131.40 ","$2,951.00 ","$4,721.60 ",$871.46 ,$348.58 ,"$4,131.40 ",$348.58 ,"$3,541.20 ",$348.58 ,"$4,426.50 ","$3,257.90 ","$2,939.20 ","$3,257.90 ",$348.58 ,"$3,257.90 ",$492.65 ,$492.65 ,"$5,016.70 ",$871.46 ,"$4,090.09 ",$348.58 ,"$5,902.00 ","$3,246.10 ",$348.58 ,"$1,552.23 ","$5,902.00 ",$163.55 ,$156.11 ,$366.01 ,"$4,721.60 ","$3,204.79 ","$1,652.56 ","$5,311.80 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,832.96 "
ST. MARY'S HOSPITAL - DECATUR,61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$4,256.00 ","$2,766.40 ",$217.81 ,"$4,256.00 ",$544.53 ,"$1,100.00 ","$2,340.80 ",$217.81 ,"$1,191.68 ","$2,085.44 ",$217.81 ,"$2,489.76 ",$217.81 ,"$2,311.01 ",$351.36 ,$217.81 ,"$2,311.01 ",$413.84 ,"$2,979.20 ","$2,128.00 ","$3,404.80 ",$544.53 ,$217.81 ,"$2,979.20 ",$217.81 ,"$2,553.60 ",$217.81 ,"$3,192.00 ","$2,349.31 ","$2,119.49 ","$2,349.31 ",$217.81 ,"$2,349.31 ",$238.62 ,$238.62 ,"$3,617.60 ",$544.53 ,"$2,949.41 ",$217.81 ,"$4,256.00 ","$2,340.80 ",$217.81 ,"$1,119.33 ","$4,256.00 ",$290.42 ,$277.22 ,$228.70 ,"$3,404.80 ","$2,311.01 ","$1,191.68 ","$3,830.40 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,042.88 "
ST. MARY'S HOSPITAL - DECATUR,61000039,74182,HC MRI ABDOMEN W/CON,610,1 ,"$4,580.00 ","$2,977.00 ",$277.22 ,"$4,580.00 ",$871.45 ,"$1,100.00 ","$2,519.00 ",$348.58 ,"$1,282.40 ","$2,244.20 ",$348.58 ,"$2,679.30 ",$348.58 ,"$2,486.94 ",$559.34 ,$348.58 ,"$2,486.94 ",$662.31 ,"$3,206.00 ","$2,290.00 ","$3,664.00 ",$871.46 ,$348.58 ,"$3,206.00 ",$348.58 ,"$2,748.00 ",$348.58 ,"$3,435.00 ","$2,528.16 ","$2,280.84 ","$2,528.16 ",$348.58 ,"$2,528.16 ",$379.86 ,$379.86 ,"$3,893.00 ",$871.46 ,"$3,173.94 ",$348.58 ,"$4,580.00 ","$2,519.00 ",$348.58 ,"$1,204.54 ","$4,580.00 ",$290.42 ,$277.22 ,$366.01 ,"$3,664.00 ","$2,486.94 ","$1,282.40 ","$4,122.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,198.40 "
ST. MARY'S HOSPITAL - DECATUR,61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$5,960.00 ","$3,874.00 ",$277.22 ,"$5,960.00 ",$871.45 ,"$1,100.00 ","$3,278.00 ",$348.58 ,"$1,668.80 ","$2,920.40 ",$348.58 ,"$3,486.60 ",$348.58 ,"$3,236.28 ",$594.46 ,$348.58 ,"$3,236.28 ",$662.31 ,"$4,172.00 ","$2,980.00 ","$4,768.00 ",$871.46 ,$348.58 ,"$4,172.00 ",$348.58 ,"$3,576.00 ",$348.58 ,"$4,470.00 ","$3,289.92 ","$2,968.08 ","$3,289.92 ",$348.58 ,"$3,289.92 ",$403.71 ,$403.71 ,"$5,066.00 ",$871.46 ,"$4,130.28 ",$348.58 ,"$5,960.00 ","$3,278.00 ",$348.58 ,"$1,567.48 ","$5,960.00 ",$290.42 ,$277.22 ,$366.01 ,"$4,768.00 ","$3,236.28 ","$1,668.80 ","$5,364.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,860.80 "
ST. MARY'S HOSPITAL - DECATUR,61000050,C8937,HC MRI BREAST CAD,610,1 ,$164.00 ,$106.60 ,$43.13 ,$164.00 , N/A ,$83.64 ,$90.20 , N/A ,$45.92 ,$77.08 , N/A ,$88.56 , N/A ,$89.05 ,$65.60 , N/A ,$89.05 , N/A ,$114.80 ,$82.00 ,$131.20 , N/A , N/A ,$114.80 , N/A ,$98.40 , N/A ,$123.00 ,$90.53 ,$81.67 ,$90.53 , N/A ,$90.53 ,$114.80 ,$114.80 ,$139.40 , N/A ,$113.65 , N/A ,$164.00 ,$90.20 , N/A ,$43.13 ,$164.00 , N/A , N/A , N/A ,$131.20 ,$89.05 ,$45.92 ,$147.60 ,$164.00 ,$164.00 , N/A ,$78.72 
ST. MARY'S HOSPITAL - DECATUR,61000052,C8901,HC MRA ABDOMEN W/O CONTRAST,610,1 ,$642.00 ,$417.30 ,$168.85 ,$642.00 ,$544.53 ,$642.00 ,$353.10 ,$217.81 ,$179.76 ,$301.74 ,$217.81 ,$346.68 ,$217.81 ,$348.61 ,$256.80 ,$217.81 ,$348.61 ,$413.84 ,$449.40 ,$321.00 ,$513.60 ,$544.53 ,$217.81 ,$449.40 ,$217.81 ,$385.20 ,$217.81 ,$481.50 ,$354.38 ,$319.72 ,$354.38 ,$217.81 ,$354.38 ,$449.40 ,$449.40 ,$545.70 ,$544.53 ,$444.91 ,$217.81 ,$642.00 ,$353.10 ,$217.81 ,$168.85 ,$642.00 ,$313.34 ,$299.09 ,$228.70 ,$513.60 ,$348.61 ,$179.76 ,$577.80 ,$642.00 ,$642.00 ,$217.81 ,$308.16 
ST. MARY'S HOSPITAL - DECATUR,61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$4,854.00 ","$3,155.10 ",$299.09 ,"$4,854.00 ",$871.45 ,"$1,100.00 ","$2,669.70 ",$348.58 ,"$1,359.12 ","$2,281.38 ",$348.58 ,"$2,621.16 ",$348.58 ,"$2,635.72 ","$1,941.60 ",$348.58 ,"$2,635.72 ",$662.31 ,"$3,397.80 ","$2,427.00 ","$3,883.20 ",$871.46 ,$348.58 ,"$3,397.80 ",$348.58 ,"$2,912.40 ",$348.58 ,"$3,640.50 ","$2,679.41 ","$2,417.29 ","$2,679.41 ",$348.58 ,"$2,679.41 ","$3,397.80 ","$3,397.80 ","$4,125.90 ",$871.46 ,"$3,363.82 ",$348.58 ,"$4,854.00 ","$2,669.70 ",$348.58 ,"$1,276.60 ","$4,854.00 ",$313.34 ,$299.09 ,$366.01 ,"$3,883.20 ","$2,635.72 ","$1,359.12 ","$4,368.60 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,329.92 "
ST. MARY'S HOSPITAL - DECATUR,61000058,77047,HC MRI BREAST BI W/O CON,610,1 ,"$4,399.00 ","$2,859.35 ",$179.80 ,"$4,399.00 ",$544.53 ,"$1,100.00 ","$2,419.45 ",$217.81 ,"$1,231.72 ","$2,067.53 ",$217.81 ,"$2,375.46 ",$217.81 ,"$2,388.66 ",$360.87 ,$217.81 ,"$2,388.66 ",$413.84 ,"$3,079.30 ","$2,199.50 ","$3,519.20 ",$544.53 ,$217.81 ,"$3,079.30 ",$217.81 ,"$2,639.40 ",$217.81 ,"$3,299.25 ","$2,428.25 ","$2,190.70 ","$2,428.25 ",$217.81 ,"$2,428.25 ",$245.09 ,$245.09 ,"$3,739.15 ",$544.53 ,"$3,048.51 ",$217.81 ,$179.80 ,"$2,419.45 ",$217.81 ,"$1,156.94 ","$4,399.00 ",$242.32 ,$231.30 ,$228.70 ,"$3,519.20 ","$2,388.66 ","$1,231.72 ","$3,959.10 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,111.52 "
ST. MARY'S HOSPITAL - DECATUR,61000059,C8908,HC MRI BREAST BI W AND W/O CON,610,1 ,"$5,320.00 ","$3,458.00 ",$231.30 ,"$5,320.00 ",$871.45 ,"$1,100.00 ","$2,926.00 ",$348.58 ,"$1,489.60 ","$2,500.40 ",$348.58 ,"$2,872.80 ",$348.58 ,"$2,888.76 ","$2,128.00 ",$348.58 ,"$2,888.76 ",$662.31 ,"$3,724.00 ","$2,660.00 ","$4,256.00 ",$871.46 ,$348.58 ,"$3,724.00 ",$348.58 ,"$3,192.00 ",$348.58 ,"$3,990.00 ","$2,936.64 ","$2,649.36 ","$2,936.64 ",$348.58 ,"$2,936.64 ","$3,724.00 ","$3,724.00 ","$4,522.00 ",$871.46 ,"$3,686.76 ",$348.58 ,"$5,320.00 ","$2,926.00 ",$348.58 ,"$1,399.16 ","$5,320.00 ",$242.32 ,$231.30 ,$366.01 ,"$4,256.00 ","$2,888.76 ","$1,489.60 ","$4,788.00 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,553.60 "
ST. MARY'S HOSPITAL - DECATUR,61000060,C8909,HC MRA CHEST W/CONTRAST,610,1 ,"$4,327.00 ","$2,812.55 ",$263.09 ,"$4,327.00 ",$871.45 ,"$1,100.00 ","$2,379.85 ",$348.58 ,"$1,211.56 ","$2,033.69 ",$348.58 ,"$2,336.58 ",$348.58 ,"$2,349.56 ","$1,730.80 ",$348.58 ,"$2,349.56 ",$662.31 ,"$3,028.90 ","$2,163.50 ","$3,461.60 ",$871.46 ,$348.58 ,"$3,028.90 ",$348.58 ,"$2,596.20 ",$348.58 ,"$3,245.25 ","$2,388.50 ","$2,154.85 ","$2,388.50 ",$348.58 ,"$2,388.50 ","$3,028.90 ","$3,028.90 ","$3,677.95 ",$871.46 ,"$2,998.61 ",$348.58 ,"$4,327.00 ","$2,379.85 ",$348.58 ,"$1,138.00 ","$4,327.00 ",$275.62 ,$263.09 ,$366.01 ,"$3,461.60 ","$2,349.56 ","$1,211.56 ","$3,894.30 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,076.96 "
ST. MARY'S HOSPITAL - DECATUR,61000061,C8910,HC MRA CHEST W/O CONTRAST,610,1 ,"$4,327.00 ","$2,812.55 ",$217.81 ,"$4,327.00 ",$544.53 ,"$1,100.00 ","$2,379.85 ",$217.81 ,"$1,211.56 ","$2,033.69 ",$217.81 ,"$2,336.58 ",$217.81 ,"$2,349.56 ","$1,730.80 ",$217.81 ,"$2,349.56 ",$413.84 ,"$3,028.90 ","$2,163.50 ","$3,461.60 ",$544.53 ,$217.81 ,"$3,028.90 ",$217.81 ,"$2,596.20 ",$217.81 ,"$3,245.25 ","$2,388.50 ","$2,154.85 ","$2,388.50 ",$217.81 ,"$2,388.50 ","$3,028.90 ","$3,028.90 ","$3,677.95 ",$544.53 ,"$2,998.61 ",$217.81 ,"$4,327.00 ","$2,379.85 ",$217.81 ,"$1,138.00 ","$4,327.00 ",$275.62 ,$263.09 ,$228.70 ,"$3,461.60 ","$2,349.56 ","$1,211.56 ","$3,894.30 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,076.96 "
ST. MARY'S HOSPITAL - DECATUR,61000062,C8911,HC MRA CHEST W AND W/O CONTRAST,610,1 ,"$4,604.00 ","$2,992.60 ",$263.09 ,"$4,604.00 ",$871.45 ,"$1,100.00 ","$2,532.20 ",$348.58 ,"$1,289.12 ","$2,163.88 ",$348.58 ,"$2,486.16 ",$348.58 ,"$2,499.97 ","$1,841.60 ",$348.58 ,"$2,499.97 ",$662.31 ,"$3,222.80 ","$2,302.00 ","$3,683.20 ",$871.46 ,$348.58 ,"$3,222.80 ",$348.58 ,"$2,762.40 ",$348.58 ,"$3,453.00 ","$2,541.41 ","$2,292.79 ","$2,541.41 ",$348.58 ,"$2,541.41 ","$3,222.80 ","$3,222.80 ","$3,913.40 ",$871.46 ,"$3,190.57 ",$348.58 ,"$4,604.00 ","$2,532.20 ",$348.58 ,"$1,210.85 ","$4,604.00 ",$275.62 ,$263.09 ,$366.01 ,"$3,683.20 ","$2,499.97 ","$1,289.12 ","$4,143.60 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,209.92 "
ST. MARY'S HOSPITAL - DECATUR,61000063,C8912,HC MRA LWR EXT W/CON,610,1 ,"$4,738.00 ","$3,079.70 ",$299.09 ,"$4,738.00 ",$871.45 ,"$1,100.00 ","$2,605.90 ",$348.58 ,"$1,326.64 ","$2,226.86 ",$348.58 ,"$2,558.52 ",$348.58 ,"$2,572.73 ","$1,895.20 ",$348.58 ,"$2,572.73 ",$662.31 ,"$3,316.60 ","$2,369.00 ","$3,790.40 ",$871.46 ,$348.58 ,"$3,316.60 ",$348.58 ,"$2,842.80 ",$348.58 ,"$3,553.50 ","$2,615.38 ","$2,359.52 ","$2,615.38 ",$348.58 ,"$2,615.38 ","$3,316.60 ","$3,316.60 ","$4,027.30 ",$871.46 ,"$3,283.43 ",$348.58 ,"$4,738.00 ","$2,605.90 ",$348.58 ,"$1,246.09 ","$4,738.00 ",$313.34 ,$299.09 ,$366.01 ,"$3,790.40 ","$2,572.73 ","$1,326.64 ","$4,264.20 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,274.24 "
ST. MARY'S HOSPITAL - DECATUR,61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$4,238.00 ","$2,754.70 ",$217.81 ,"$4,238.00 ",$544.53 ,"$1,100.00 ","$2,330.90 ",$217.81 ,"$1,186.64 ","$1,991.86 ",$217.81 ,"$2,288.52 ",$217.81 ,"$2,301.23 ","$1,695.20 ",$217.81 ,"$2,301.23 ",$413.84 ,"$2,966.60 ","$2,119.00 ","$3,390.40 ",$544.53 ,$217.81 ,"$2,966.60 ",$217.81 ,"$2,542.80 ",$217.81 ,"$3,178.50 ","$2,339.38 ","$2,110.52 ","$2,339.38 ",$217.81 ,"$2,339.38 ","$2,966.60 ","$2,966.60 ","$3,602.30 ",$544.53 ,"$2,936.93 ",$217.81 ,"$4,238.00 ","$2,330.90 ",$217.81 ,"$1,114.59 ","$4,238.00 ",$313.34 ,$299.09 ,$228.70 ,"$3,390.40 ","$2,301.23 ","$1,186.64 ","$3,814.20 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,034.24 "
ST. MARY'S HOSPITAL - DECATUR,61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$7,437.00 ","$4,834.05 ",$299.09 ,"$7,437.00 ",$871.45 ,"$1,100.00 ","$4,090.35 ",$348.58 ,"$2,082.36 ","$3,495.39 ",$348.58 ,"$4,015.98 ",$348.58 ,"$4,038.29 ","$2,974.80 ",$348.58 ,"$4,038.29 ",$662.31 ,"$5,205.90 ","$3,718.50 ","$5,949.60 ",$871.46 ,$348.58 ,"$5,205.90 ",$348.58 ,"$4,462.20 ",$348.58 ,"$5,577.75 ","$4,105.22 ","$3,703.63 ","$4,105.22 ",$348.58 ,"$4,105.22 ","$5,205.90 ","$5,205.90 ","$6,321.45 ",$871.46 ,"$5,153.84 ",$348.58 ,"$7,437.00 ","$4,090.35 ",$348.58 ,"$1,955.93 ","$7,437.00 ",$313.34 ,$299.09 ,$366.01 ,"$5,949.60 ","$4,038.29 ","$2,082.36 ","$6,693.30 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,569.76 "
ST. MARY'S HOSPITAL - DECATUR,61000068,C8918,HC MRA PELVIS W/CON,610,1 ,"$4,327.00 ","$2,812.55 ",$299.09 ,"$4,327.00 ",$871.45 ,"$1,100.00 ","$2,379.85 ",$348.58 ,"$1,211.56 ","$2,033.69 ",$348.58 ,"$2,336.58 ",$348.58 ,"$2,349.56 ","$1,730.80 ",$348.58 ,"$2,349.56 ",$662.31 ,"$3,028.90 ","$2,163.50 ","$3,461.60 ",$871.46 ,$348.58 ,"$3,028.90 ",$348.58 ,"$2,596.20 ",$348.58 ,"$3,245.25 ","$2,388.50 ","$2,154.85 ","$2,388.50 ",$348.58 ,"$2,388.50 ","$3,028.90 ","$3,028.90 ","$3,677.95 ",$871.46 ,"$2,998.61 ",$348.58 ,"$4,327.00 ","$2,379.85 ",$348.58 ,"$1,138.00 ","$4,327.00 ",$313.34 ,$299.09 ,$366.01 ,"$3,461.60 ","$2,349.56 ","$1,211.56 ","$3,894.30 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,076.96 "
ST. MARY'S HOSPITAL - DECATUR,61000069,C8919,HC MRA PELVIS W/O CON,610,1 ,"$4,327.00 ","$2,812.55 ",$217.81 ,"$4,327.00 ",$544.53 ,"$1,100.00 ","$2,379.85 ",$217.81 ,"$1,211.56 ","$2,033.69 ",$217.81 ,"$2,336.58 ",$217.81 ,"$2,349.56 ","$1,730.80 ",$217.81 ,"$2,349.56 ",$413.84 ,"$3,028.90 ","$2,163.50 ","$3,461.60 ",$544.53 ,$217.81 ,"$3,028.90 ",$217.81 ,"$2,596.20 ",$217.81 ,"$3,245.25 ","$2,388.50 ","$2,154.85 ","$2,388.50 ",$217.81 ,"$2,388.50 ","$3,028.90 ","$3,028.90 ","$3,677.95 ",$544.53 ,"$2,998.61 ",$217.81 ,"$4,327.00 ","$2,379.85 ",$217.81 ,"$1,138.00 ","$4,327.00 ",$313.34 ,$299.09 ,$228.70 ,"$3,461.60 ","$2,349.56 ","$1,211.56 ","$3,894.30 ",$788.00 ,"$1,350.00 ",$217.81 ,"$2,076.96 "
ST. MARY'S HOSPITAL - DECATUR,61000070,C8920,HC MRA PELVIS W AND W/O CONTRAST,610,1 ,"$4,488.00 ","$2,917.20 ",$299.09 ,"$4,488.00 ",$871.45 ,"$1,100.00 ","$2,468.40 ",$348.58 ,"$1,256.64 ","$2,109.36 ",$348.58 ,"$2,423.52 ",$348.58 ,"$2,436.98 ","$1,795.20 ",$348.58 ,"$2,436.98 ",$662.31 ,"$3,141.60 ","$2,244.00 ","$3,590.40 ",$871.46 ,$348.58 ,"$3,141.60 ",$348.58 ,"$2,692.80 ",$348.58 ,"$3,366.00 ","$2,477.38 ","$2,235.02 ","$2,477.38 ",$348.58 ,"$2,477.38 ","$3,141.60 ","$3,141.60 ","$3,814.80 ",$871.46 ,"$3,110.18 ",$348.58 ,"$4,488.00 ","$2,468.40 ",$348.58 ,"$1,180.34 ","$4,488.00 ",$313.34 ,$299.09 ,$366.01 ,"$3,590.40 ","$2,436.98 ","$1,256.64 ","$4,039.20 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,154.24 "
ST. MARY'S HOSPITAL - DECATUR,61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$8,162.00 ","$5,305.30 ",$259.16 ,"$8,162.00 ",$871.45 ,"$1,100.00 ","$4,489.10 ",$348.58 ,"$2,285.36 ","$3,999.38 ",$348.58 ,"$4,774.77 ",$348.58 ,"$4,431.97 ",$860.14 ,$348.58 ,"$4,431.97 ",$662.31 ,"$5,713.40 ","$4,081.00 ","$6,529.60 ",$871.46 ,$348.58 ,"$5,713.40 ",$348.58 ,"$4,897.20 ",$348.58 ,"$6,121.50 ","$4,505.42 ","$4,064.68 ","$4,505.42 ",$348.58 ,"$4,505.42 ",$358.01 ,$358.01 ,"$6,937.70 ",$871.46 ,"$5,656.27 ",$348.58 ,"$8,162.00 ","$4,489.10 ",$348.58 ,"$2,146.61 ","$8,162.00 ",$271.50 ,$259.16 ,$366.01 ,"$6,529.60 ","$4,431.97 ","$2,285.36 ","$7,345.80 ",$788.00 ,"$1,350.00 ",$348.58 ,"$3,917.76 "
ST. MARY'S HOSPITAL - DECATUR,61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$4,906.00 ","$3,188.90 ",$231.30 ,"$4,906.00 ",$871.45 ,"$1,100.00 ","$2,698.30 ",$348.58 ,"$1,373.68 ","$2,403.94 ",$348.58 ,"$2,870.01 ",$348.58 ,"$2,663.96 ",$481.80 ,$348.58 ,"$2,663.96 ",$662.31 ,"$3,434.20 ","$2,453.00 ","$3,924.80 ",$871.46 ,$348.58 ,"$3,434.20 ",$348.58 ,"$2,943.60 ",$348.58 ,"$3,679.50 ","$2,708.11 ","$2,443.19 ","$2,708.11 ",$348.58 ,"$2,708.11 ",$327.21 ,$327.21 ,"$4,170.10 ",$871.46 ,"$3,399.86 ",$348.58 ,"$4,906.00 ","$2,698.30 ",$348.58 ,"$1,290.28 ","$4,906.00 ",$242.32 ,$231.30 ,$366.01 ,"$3,924.80 ","$2,663.96 ","$1,373.68 ","$4,415.40 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,354.88 "
ST. MARY'S HOSPITAL - DECATUR,61800004,C8935,HC MRA UPPR EXT W/O CONTRAST,618,1 ,"$3,544.00 ","$2,303.60 ",$217.81 ,"$3,544.00 ",$544.53 ,"$1,100.00 ","$1,949.20 ",$217.81 ,$992.32 ,"$1,665.68 ",$217.81 ,"$1,913.76 ",$217.81 ,"$1,924.39 ","$1,417.60 ",$217.81 ,"$1,924.39 ",$413.84 ,"$2,480.80 ","$1,772.00 ","$2,835.20 ",$544.53 ,$217.81 ,"$2,480.80 ",$217.81 ,"$2,126.40 ",$217.81 ,"$2,658.00 ","$1,956.29 ","$1,764.91 ","$1,956.29 ",$217.81 ,"$1,956.29 ","$2,764.32 ","$2,764.32 ","$3,012.40 ",$544.53 ,"$2,455.99 ",$217.81 ,"$3,544.00 ","$1,949.20 ",$217.81 ,$932.07 ,"$3,544.00 ",$313.34 ,$299.09 ,$228.70 ,"$2,835.20 ","$1,924.39 ",$992.32 ,"$3,189.60 ",$788.00 ,"$1,350.00 ",$217.81 ,"$1,701.12 "
ST. MARY'S HOSPITAL - DECATUR,61800005,C8936,HC MRA UPPR EXT W/  AND  W/O CONTRAST,618,1 ,"$4,256.00 ","$2,766.40 ",$299.09 ,"$4,256.00 ",$871.45 ,"$1,100.00 ","$2,340.80 ",$348.58 ,"$1,191.68 ","$2,000.32 ",$348.58 ,"$2,298.24 ",$348.58 ,"$2,311.01 ","$1,702.40 ",$348.58 ,"$2,311.01 ",$662.31 ,"$2,979.20 ","$2,128.00 ","$3,404.80 ",$871.46 ,$348.58 ,"$2,979.20 ",$348.58 ,"$2,553.60 ",$348.58 ,"$3,192.00 ","$2,349.31 ","$2,119.49 ","$2,349.31 ",$348.58 ,"$2,349.31 ","$3,319.68 ","$3,319.68 ","$3,617.60 ",$871.46 ,"$2,949.41 ",$348.58 ,"$4,256.00 ","$2,340.80 ",$348.58 ,"$1,119.33 ","$4,256.00 ",$313.34 ,$299.09 ,$366.01 ,"$3,404.80 ","$2,311.01 ","$1,191.68 ","$3,830.40 ",$788.00 ,"$1,350.00 ",$348.58 ,"$2,042.88 "
ST. MARY'S HOSPITAL - DECATUR,63600003,Q4102,HC OASIS PER SQ CENTIMETER,636,1 ,$33.00 ,$21.45 ,$8.68 ,$308.51 , N/A ,$16.83 ,$18.15 , N/A ,$9.24 ,$16.17 , N/A ,$17.82 , N/A ,$17.92 ,$13.20 , N/A ,$17.92 , N/A ,$23.10 ,$16.50 ,$26.40 , N/A , N/A ,$23.10 , N/A ,$19.80 , N/A ,$24.75 ,$18.22 ,$16.43 ,$18.22 , N/A ,$18.22 ,$25.74 ,$25.74 ,$28.05 , N/A ,$22.87 , N/A ,$33.00 ,$18.15 , N/A ,$8.68 ,$33.00 ,$33.00 ,$308.51 , N/A ,$26.40 ,$17.92 ,$9.24 ,$29.70 ,$12.54 ,$16.17 , N/A ,$15.84 
ST. MARY'S HOSPITAL - DECATUR,63600009,Q4186,HC EPIFIX PER SQ CM,636,1 ,$207.00 ,$134.55 ,$54.44 ,$308.51 , N/A ,$105.57 ,$113.85 , N/A ,$57.96 ,$97.29 , N/A ,$111.78 , N/A ,$112.40 ,$181.79 , N/A ,$112.40 , N/A ,$144.90 ,$103.50 ,$165.60 , N/A , N/A ,$144.90 , N/A ,$124.20 , N/A ,$155.25 ,$114.26 ,$103.09 ,$114.26 , N/A ,$114.26 ,$161.46 ,$161.46 ,$175.95 , N/A ,$143.45 , N/A ,$207.00 ,$113.85 , N/A ,$54.44 ,$207.00 ,$207.00 ,$308.51 , N/A ,$165.60 ,$112.40 ,$57.96 ,$186.30 ,$78.66 ,$207.00 , N/A ,$99.36 
ST. MARY'S HOSPITAL - DECATUR,63600019,M1145,"HC MFN DRUG ADD-ON, PER DOSE",636,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,63600183,Q4196,HC PURAPLY ANTIMICROBIAL PER SQ CENTIMETER USED - JC,636,1 ,$582.00 ,$378.30 ,$92.82 ,$582.00 , N/A ,$296.82 ,$320.10 , N/A ,$162.96 ,$273.54 , N/A ,$314.28 , N/A ,$316.03 ,$92.82 , N/A ,$316.03 , N/A ,$407.40 ,$291.00 ,$465.60 , N/A , N/A ,$407.40 , N/A ,$349.20 , N/A ,$436.50 ,$321.26 ,$289.84 ,$321.26 , N/A ,$321.26 ,$453.96 ,$453.96 ,$494.70 , N/A ,$403.33 , N/A ,$582.00 ,$320.10 , N/A ,$153.07 ,$582.00 ,$323.20 ,$308.51 , N/A ,$465.60 ,$316.03 ,$162.96 ,$523.80 ,$221.16 ,$182.57 , N/A ,$279.36 
ST. MARY'S HOSPITAL - DECATUR,63600184,Q4196,HC PURAPLY ANTIMICROBIAL PER SQ CENTIMETER WASTED - JW,636,1 ,$582.00 ,$378.30 ,$92.82 ,$582.00 , N/A ,$296.82 ,$320.10 , N/A ,$162.96 ,$273.54 , N/A ,$314.28 , N/A ,$316.03 ,$92.82 , N/A ,$316.03 , N/A ,$407.40 ,$291.00 ,$465.60 , N/A , N/A ,$407.40 , N/A ,$349.20 , N/A ,$436.50 ,$321.26 ,$289.84 ,$321.26 , N/A ,$321.26 ,$453.96 ,$453.96 ,$494.70 , N/A ,$403.33 , N/A ,$582.00 ,$320.10 , N/A ,$153.07 ,$582.00 ,$323.20 ,$308.51 , N/A ,$465.60 ,$316.03 ,$162.96 ,$523.80 ,$221.16 ,$182.57 , N/A ,$279.36 
ST. MARY'S HOSPITAL - DECATUR,63600185,Q4101,HC APLIGRAF PER SQ CM USED -JC,636,1 ,$121.00 ,$78.65 ,$31.82 ,$308.51 , N/A ,$61.71 ,$66.55 , N/A ,$33.88 ,$59.29 , N/A ,$65.34 , N/A ,$65.70 ,$48.40 , N/A ,$65.70 , N/A ,$84.70 ,$60.50 ,$96.80 , N/A , N/A ,$84.70 , N/A ,$72.60 , N/A ,$90.75 ,$66.79 ,$60.26 ,$66.79 , N/A ,$66.79 ,$94.38 ,$94.38 ,$102.85 , N/A ,$83.85 , N/A ,$121.00 ,$66.55 , N/A ,$31.82 ,$121.00 ,$121.00 ,$308.51 , N/A ,$96.80 ,$65.70 ,$33.88 ,$108.90 ,$45.98 ,$50.23 , N/A ,$58.08 
ST. MARY'S HOSPITAL - DECATUR,63600186,Q4101,HC APLIGRAF PER SQ CM WASTED - JW,636,1 ,$123.00 ,$79.95 ,$32.35 ,$308.51 , N/A ,$62.73 ,$67.65 , N/A ,$34.44 ,$60.27 , N/A ,$66.42 , N/A ,$66.79 ,$49.20 , N/A ,$66.79 , N/A ,$86.10 ,$61.50 ,$98.40 , N/A , N/A ,$86.10 , N/A ,$73.80 , N/A ,$92.25 ,$67.90 ,$61.25 ,$67.90 , N/A ,$67.90 ,$95.94 ,$95.94 ,$104.55 , N/A ,$85.24 , N/A ,$123.00 ,$67.65 , N/A ,$32.35 ,$123.00 ,$123.00 ,$308.51 , N/A ,$98.40 ,$66.79 ,$34.44 ,$110.70 ,$46.74 ,$50.23 , N/A ,$59.04 
ST. MARY'S HOSPITAL - DECATUR,63600187,Q4106,HC DERMAGRAFT PER SQ CM USED -JC,636,1 ,$120.00 ,$78.00 ,$31.56 ,$308.51 , N/A ,$61.20 ,$66.00 , N/A ,$33.60 ,$58.80 , N/A ,$64.80 , N/A ,$65.16 ,$48.00 , N/A ,$65.16 , N/A ,$84.00 ,$60.00 ,$96.00 , N/A , N/A ,$84.00 , N/A ,$72.00 , N/A ,$90.00 ,$66.24 ,$59.76 ,$66.24 , N/A ,$66.24 ,$93.60 ,$93.60 ,$102.00 , N/A ,$83.16 , N/A ,$120.00 ,$66.00 , N/A ,$31.56 ,$120.00 ,$120.00 ,$308.51 , N/A ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$52.75 , N/A ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,63600188,Q4106,HC DERMAGRAFT PER SQ CM WASTED -JW,636,1 ,$120.00 ,$78.00 ,$31.56 ,$308.51 , N/A ,$61.20 ,$66.00 , N/A ,$33.60 ,$58.80 , N/A ,$64.80 , N/A ,$65.16 ,$48.00 , N/A ,$65.16 , N/A ,$84.00 ,$60.00 ,$96.00 , N/A , N/A ,$84.00 , N/A ,$72.00 , N/A ,$90.00 ,$66.24 ,$59.76 ,$66.24 , N/A ,$66.24 ,$93.60 ,$93.60 ,$102.00 , N/A ,$83.16 , N/A ,$120.00 ,$66.00 , N/A ,$31.56 ,$120.00 ,$120.00 ,$308.51 , N/A ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$52.75 , N/A ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,63600190,Q4160,HC NUSHIELD PER SQ CM,636,1 ,"$1,305.00 ",$848.25 ,$158.30 ,"$1,305.00 ", N/A ,$665.55 ,$717.75 , N/A ,$365.40 ,$613.35 , N/A ,$704.70 , N/A ,$708.62 ,$215.21 , N/A ,$708.62 , N/A ,$913.50 ,$652.50 ,"$1,044.00 ", N/A , N/A ,$913.50 , N/A ,$783.00 , N/A ,$978.75 ,$720.36 ,$649.89 ,$720.36 , N/A ,$720.36 ,"$1,017.90 ","$1,017.90 ","$1,109.25 ", N/A ,$904.37 , N/A ,"$1,305.00 ",$717.75 , N/A ,$343.22 ,"$1,305.00 ",$323.20 ,$308.51 , N/A ,"$1,044.00 ",$708.62 ,$365.40 ,"$1,174.50 ",$495.90 ,$158.30 , N/A ,$626.40 
ST. MARY'S HOSPITAL - DECATUR,71000223,N/A,HC C-SECTION RECOVERY 1 HR,710,1 ,"$1,984.00 ","$1,289.60 ",$521.79 ,"$1,984.00 ", N/A ,"$1,011.84 ","$1,091.20 ", N/A ,$555.52 ,$932.48 , N/A ,"$1,071.36 ", N/A ,"$1,077.31 ", N/A , N/A ,"$1,077.31 ", N/A ,"$1,388.80 ",$992.00 ,"$1,587.20 ", N/A , N/A ,"$1,388.80 ", N/A ,"$1,190.40 ", N/A ,"$1,488.00 ","$1,095.17 ",$988.03 ,"$1,095.17 ", N/A ,"$1,095.17 ","$1,547.52 ","$1,547.52 ","$1,686.40 ", N/A ,"$1,374.91 ", N/A ,"$1,984.00 ","$1,091.20 ", N/A ,$521.79 ,"$1,984.00 ", N/A , N/A , N/A ,"$1,587.20 ","$1,077.31 ",$555.52 ,"$1,785.60 ",$753.92 ,"$1,289.60 ", N/A ,$952.32 
ST. MARY'S HOSPITAL - DECATUR,71000237,N/A,HC RECOVERY CLASS 1 INIT 15MIN,710,1 ,$903.00 ,$586.95 ,$237.49 ,$903.00 , N/A ,$460.53 ,$496.65 , N/A ,$252.84 ,$424.41 , N/A ,$487.62 , N/A ,$490.33 , N/A , N/A ,$490.33 , N/A ,$632.10 ,$451.50 ,$722.40 , N/A , N/A ,$632.10 , N/A ,$541.80 , N/A ,$677.25 ,$498.46 ,$449.69 ,$498.46 , N/A ,$498.46 ,$704.34 ,$704.34 ,$767.55 , N/A ,$625.78 , N/A ,$903.00 ,$496.65 , N/A ,$237.49 ,$903.00 , N/A , N/A , N/A ,$722.40 ,$490.33 ,$252.84 ,$812.70 ,$343.14 ,$586.95 , N/A ,$433.44 
ST. MARY'S HOSPITAL - DECATUR,71000238,N/A,HC RECOVERY CLASS 1 ADDL 15MIN,710,1 ,$132.00 ,$85.80 ,$34.72 ,$132.00 , N/A ,$67.32 ,$72.60 , N/A ,$36.96 ,$62.04 , N/A ,$71.28 , N/A ,$71.68 , N/A , N/A ,$71.68 , N/A ,$92.40 ,$66.00 ,$105.60 , N/A , N/A ,$92.40 , N/A ,$79.20 , N/A ,$99.00 ,$72.86 ,$65.74 ,$72.86 , N/A ,$72.86 ,$102.96 ,$102.96 ,$112.20 , N/A ,$91.48 , N/A ,$132.00 ,$72.60 , N/A ,$34.72 ,$132.00 , N/A , N/A , N/A ,$105.60 ,$71.68 ,$36.96 ,$118.80 ,$50.16 ,$85.80 , N/A ,$63.36 
ST. MARY'S HOSPITAL - DECATUR,71000239,N/A,HC RECOVERY CLASS 2 INIT 15MIN,710,1 ,"$1,013.00 ",$658.45 ,$266.42 ,"$1,013.00 ", N/A ,$516.63 ,$557.15 , N/A ,$283.64 ,$476.11 , N/A ,$547.02 , N/A ,$550.06 , N/A , N/A ,$550.06 , N/A ,$709.10 ,$506.50 ,$810.40 , N/A , N/A ,$709.10 , N/A ,$607.80 , N/A ,$759.75 ,$559.18 ,$504.47 ,$559.18 , N/A ,$559.18 ,$790.14 ,$790.14 ,$861.05 , N/A ,$702.01 , N/A ,"$1,013.00 ",$557.15 , N/A ,$266.42 ,"$1,013.00 ", N/A , N/A , N/A ,$810.40 ,$550.06 ,$283.64 ,$911.70 ,$384.94 ,$658.45 , N/A ,$486.24 
ST. MARY'S HOSPITAL - DECATUR,71000240,N/A,HC RECOVERY CLASS 2 ADDL 15MIN,710,1 ,$165.00 ,$107.25 ,$43.40 ,$165.00 , N/A ,$84.15 ,$90.75 , N/A ,$46.20 ,$77.55 , N/A ,$89.10 , N/A ,$89.60 , N/A , N/A ,$89.60 , N/A ,$115.50 ,$82.50 ,$132.00 , N/A , N/A ,$115.50 , N/A ,$99.00 , N/A ,$123.75 ,$91.08 ,$82.17 ,$91.08 , N/A ,$91.08 ,$128.70 ,$128.70 ,$140.25 , N/A ,$114.35 , N/A ,$165.00 ,$90.75 , N/A ,$43.40 ,$165.00 , N/A , N/A , N/A ,$132.00 ,$89.60 ,$46.20 ,$148.50 ,$62.70 ,$107.25 , N/A ,$79.20 
ST. MARY'S HOSPITAL - DECATUR,71000241,N/A,HC RECOVERY CLASS 3 INIT 15MIN,710,1 ,"$1,125.00 ",$731.25 ,$295.88 ,"$1,125.00 ", N/A ,$573.75 ,$618.75 , N/A ,$315.00 ,$528.75 , N/A ,$607.50 , N/A ,$610.88 , N/A , N/A ,$610.88 , N/A ,$787.50 ,$562.50 ,$900.00 , N/A , N/A ,$787.50 , N/A ,$675.00 , N/A ,$843.75 ,$621.00 ,$560.25 ,$621.00 , N/A ,$621.00 ,$877.50 ,$877.50 ,$956.25 , N/A ,$779.63 , N/A ,"$1,125.00 ",$618.75 , N/A ,$295.88 ,"$1,125.00 ", N/A , N/A , N/A ,$900.00 ,$610.88 ,$315.00 ,"$1,012.50 ",$427.50 ,$731.25 , N/A ,$540.00 
ST. MARY'S HOSPITAL - DECATUR,71000242,N/A,HC RECOVERY CLASS 3 ADDL 15MIN,710,1 ,$202.00 ,$131.30 ,$53.13 ,$202.00 , N/A ,$103.02 ,$111.10 , N/A ,$56.56 ,$94.94 , N/A ,$109.08 , N/A ,$109.69 , N/A , N/A ,$109.69 , N/A ,$141.40 ,$101.00 ,$161.60 , N/A , N/A ,$141.40 , N/A ,$121.20 , N/A ,$151.50 ,$111.50 ,$100.60 ,$111.50 , N/A ,$111.50 ,$157.56 ,$157.56 ,$171.70 , N/A ,$139.99 , N/A ,$202.00 ,$111.10 , N/A ,$53.13 ,$202.00 , N/A , N/A , N/A ,$161.60 ,$109.69 ,$56.56 ,$181.80 ,$76.76 ,$131.30 , N/A ,$96.96 
ST. MARY'S HOSPITAL - DECATUR,71000249,N/A,HC C-SECTION RECOVERY ADDL 30MIN,710,1 ,$165.00 ,$107.25 ,$43.40 ,$165.00 , N/A ,$84.15 ,$90.75 , N/A ,$46.20 ,$77.55 , N/A ,$89.10 , N/A ,$89.60 , N/A , N/A ,$89.60 , N/A ,$115.50 ,$82.50 ,$132.00 , N/A , N/A ,$115.50 , N/A ,$99.00 , N/A ,$123.75 ,$91.08 ,$82.17 ,$91.08 , N/A ,$91.08 ,$128.70 ,$128.70 ,$140.25 , N/A ,$114.35 , N/A ,$165.00 ,$90.75 , N/A ,$43.40 ,$165.00 , N/A , N/A , N/A ,$132.00 ,$89.60 ,$46.20 ,$148.50 ,$62.70 ,$107.25 , N/A ,$79.20 
ST. MARY'S HOSPITAL - DECATUR,71000250,N/A,HC PHASE II RECOVERY INIT 15MIN,710,1 ,$177.00 ,$115.05 ,$46.55 ,$177.00 , N/A ,$90.27 ,$97.35 , N/A ,$49.56 ,$83.19 , N/A ,$95.58 , N/A ,$96.11 , N/A , N/A ,$96.11 , N/A ,$123.90 ,$88.50 ,$141.60 , N/A , N/A ,$123.90 , N/A ,$106.20 , N/A ,$132.75 ,$97.70 ,$88.15 ,$97.70 , N/A ,$97.70 ,$138.06 ,$138.06 ,$150.45 , N/A ,$122.66 , N/A ,$177.00 ,$97.35 , N/A ,$46.55 ,$177.00 , N/A , N/A , N/A ,$141.60 ,$96.11 ,$49.56 ,$159.30 ,$67.26 ,$115.05 , N/A ,$84.96 
ST. MARY'S HOSPITAL - DECATUR,71000251,N/A,HC PHASE II RECOVERY ADDL 15MIN,710,1 ,$89.00 ,$57.85 ,$23.41 ,$89.00 , N/A ,$45.39 ,$48.95 , N/A ,$24.92 ,$41.83 , N/A ,$48.06 , N/A ,$48.33 , N/A , N/A ,$48.33 , N/A ,$62.30 ,$44.50 ,$71.20 , N/A , N/A ,$62.30 , N/A ,$53.40 , N/A ,$66.75 ,$49.13 ,$44.32 ,$49.13 , N/A ,$49.13 ,$69.42 ,$69.42 ,$75.65 , N/A ,$61.68 , N/A ,$89.00 ,$48.95 , N/A ,$23.41 ,$89.00 , N/A , N/A , N/A ,$71.20 ,$48.33 ,$24.92 ,$80.10 ,$33.82 ,$57.85 , N/A ,$42.72 
ST. MARY'S HOSPITAL - DECATUR,72000008,59412,HC EXTERNAL CEPHALIC VERSION,720,1 ,"$4,704.00 ","$3,057.60 ",$175.28 ,"$6,208.95 ","$6,208.95 ","$2,399.04 ","$2,587.20 ","$2,483.58 ","$1,317.12 ","$2,210.88 ","$2,483.58 ","$2,540.16 ","$2,483.58 ","$2,554.27 ",$175.28 ,"$2,483.58 ","$2,554.27 ","$4,704.00 ","$3,292.80 ","$2,352.00 ","$3,763.20 ","$6,208.94 ","$2,483.58 ","$3,292.80 ","$2,483.58 ","$2,822.40 ","$2,483.58 ","$3,528.00 ","$2,596.61 ","$2,342.59 ","$2,596.61 ","$2,483.58 ","$2,596.61 ","$3,669.12 ","$3,669.12 ","$3,998.40 ","$4,704.00 ","$3,259.87 ","$2,483.58 ","$4,704.00 ","$2,587.20 ","$2,483.58 ","$1,237.15 ","$4,704.00 ", N/A , N/A ,"$2,607.76 ","$3,763.20 ","$2,554.27 ","$1,317.12 ","$4,233.60 ","$1,787.52 ",$800.00 ,"$2,483.58 ","$2,257.92 "
ST. MARY'S HOSPITAL - DECATUR,72000010,99465,HC DELIV/BIRTH ROOM RESUSCITATION,720,1 ,$854.00 ,$555.10 ,$224.60 ,"$1,329.43 ","$1,329.43 ",$435.54 ,$469.70 ,$531.77 ,$239.12 ,$418.46 ,$531.77 ,$499.59 ,$531.77 ,$463.72 ,$254.54 ,$531.77 ,$463.72 ,$854.00 ,$597.80 ,$427.00 ,$683.20 ,"$1,329.42 ",$531.77 ,$597.80 ,$531.77 ,$512.40 ,$531.77 ,$640.50 ,$471.41 ,$425.29 ,$471.41 ,$531.77 ,$471.41 ,$666.12 ,$666.12 ,$725.90 ,$854.00 ,$591.82 ,$531.77 ,$854.00 ,$469.70 ,$531.77 ,$224.60 ,$854.00 ,$472.46 ,$450.99 ,$558.36 ,$683.20 ,$463.72 ,$239.12 ,$768.60 ,$324.52 ,$800.00 ,$531.77 ,$409.92 
ST. MARY'S HOSPITAL - DECATUR,72000011,N/A,HC EPIDURAL PER HR,720,1 ,$140.00 ,$91.00 ,$36.82 ,$140.00 , N/A ,$71.40 ,$77.00 , N/A ,$39.20 ,$65.80 , N/A ,$75.60 , N/A ,$76.02 ,$56.00 , N/A ,$76.02 , N/A ,$98.00 ,$70.00 ,$112.00 , N/A , N/A ,$98.00 , N/A ,$84.00 , N/A ,$105.00 ,$77.28 ,$69.72 ,$77.28 , N/A ,$77.28 ,$109.20 ,$109.20 ,$119.00 , N/A ,$97.02 , N/A ,$140.00 ,$77.00 , N/A ,$36.82 ,$140.00 , N/A , N/A , N/A ,$112.00 ,$76.02 ,$39.20 ,$126.00 ,$53.20 ,$140.00 , N/A ,$67.20 
ST. MARY'S HOSPITAL - DECATUR,72000024,59410,HC VAGINAL DELIVERY ONLY INCLUDES POSTPARTUM CARE,720,1 ,"$2,652.00 ","$1,723.80 ",$697.48 ,"$2,652.00 ", N/A ,"$1,352.52 ","$1,458.60 ", N/A ,$742.56 ,"$1,246.44 ", N/A ,"$1,432.08 ", N/A ,"$1,440.04 ","$1,780.44 ", N/A ,"$1,440.04 ", N/A ,"$1,856.40 ","$1,326.00 ","$2,121.60 ", N/A , N/A ,"$1,856.40 ", N/A ,"$1,591.20 ", N/A ,"$1,989.00 ","$1,463.90 ","$1,320.70 ","$1,463.90 ", N/A ,"$1,463.90 ","$2,068.56 ","$2,068.56 ","$2,254.20 ", N/A ,"$1,837.84 ", N/A ,"$2,652.00 ","$1,458.60 ", N/A ,$697.48 ,"$2,652.00 ","$1,318.88 ","$1,258.93 ", N/A ,"$2,121.60 ","$1,440.04 ",$742.56 ,"$2,386.80 ","$1,007.76 ",$800.00 , N/A ,"$1,272.96 "
ST. MARY'S HOSPITAL - DECATUR,72000025,N/A,HC C-SECTION SINGLE ADDL 30 MIN,720,1 ,$736.00 ,$478.40 ,$193.57 ,$736.00 , N/A ,$375.36 ,$404.80 , N/A ,$206.08 ,$345.92 , N/A ,$397.44 , N/A ,$399.65 ,$294.40 , N/A ,$399.65 , N/A ,$515.20 ,$368.00 ,$588.80 , N/A , N/A ,$515.20 , N/A ,$441.60 , N/A ,$552.00 ,$406.27 ,$366.53 ,$406.27 , N/A ,$406.27 ,$574.08 ,$574.08 ,$625.60 , N/A ,$510.05 , N/A ,$736.00 ,$404.80 , N/A ,$193.57 ,$736.00 , N/A , N/A , N/A ,$588.80 ,$399.65 ,$206.08 ,$662.40 ,$279.68 ,$736.00 , N/A ,$353.28 
ST. MARY'S HOSPITAL - DECATUR,72000026,N/A,HC C-SECTION TWIN ADDL 30 MIN,720,1 ,$652.00 ,$423.80 ,$171.48 ,$652.00 , N/A ,$332.52 ,$358.60 , N/A ,$182.56 ,$306.44 , N/A ,$352.08 , N/A ,$354.04 ,$260.80 , N/A ,$354.04 , N/A ,$456.40 ,$326.00 ,$521.60 , N/A , N/A ,$456.40 , N/A ,$391.20 , N/A ,$489.00 ,$359.90 ,$324.70 ,$359.90 , N/A ,$359.90 ,$508.56 ,$508.56 ,$554.20 , N/A ,$451.84 , N/A ,$652.00 ,$358.60 , N/A ,$171.48 ,$652.00 , N/A , N/A , N/A ,$521.60 ,$354.04 ,$182.56 ,$586.80 ,$247.76 ,$652.00 , N/A ,$312.96 
ST. MARY'S HOSPITAL - DECATUR,72100004,N/A,HC LABOR INDUCTION PER HR,721,1 ,$140.00 ,$91.00 ,$36.82 ,$140.00 , N/A ,$71.40 ,$77.00 , N/A ,$39.20 ,$65.80 , N/A ,$75.60 , N/A ,$76.02 ,$56.00 , N/A ,$76.02 , N/A ,$98.00 ,$70.00 ,$112.00 , N/A , N/A ,$98.00 , N/A ,$84.00 , N/A ,$105.00 ,$77.28 ,$69.72 ,$77.28 , N/A ,$77.28 ,$109.20 ,$109.20 ,$119.00 , N/A ,$97.02 , N/A ,$140.00 ,$77.00 , N/A ,$36.82 ,$140.00 , N/A , N/A , N/A ,$112.00 ,$76.02 ,$39.20 ,$126.00 ,$53.20 ,$140.00 , N/A ,$67.20 
ST. MARY'S HOSPITAL - DECATUR,72100005,N/A,HC LABOR PER HR,721,1 ,$140.00 ,$91.00 ,$36.82 ,$140.00 , N/A ,$71.40 ,$77.00 , N/A ,$39.20 ,$65.80 , N/A ,$75.60 , N/A ,$76.02 ,$56.00 , N/A ,$76.02 , N/A ,$98.00 ,$70.00 ,$112.00 , N/A , N/A ,$98.00 , N/A ,$84.00 , N/A ,$105.00 ,$77.28 ,$69.72 ,$77.28 , N/A ,$77.28 ,$109.20 ,$109.20 ,$119.00 , N/A ,$97.02 , N/A ,$140.00 ,$77.00 , N/A ,$36.82 ,$140.00 , N/A , N/A , N/A ,$112.00 ,$76.02 ,$39.20 ,$126.00 ,$53.20 ,$140.00 , N/A ,$67.20 
ST. MARY'S HOSPITAL - DECATUR,72200005,N/A,HC C-SECT INIT 1 HR SINGLE,722,1 ,"$4,933.00 ","$3,206.45 ",$800.00 ,"$4,933.00 ", N/A ,"$2,515.83 ","$2,713.15 ", N/A ,"$1,381.24 ","$2,318.51 ", N/A ,"$2,663.82 ", N/A ,"$2,678.62 ","$1,973.20 ", N/A ,"$2,678.62 ", N/A ,"$3,453.10 ","$2,466.50 ","$3,946.40 ", N/A , N/A ,"$3,453.10 ", N/A ,"$2,959.80 ", N/A ,"$3,699.75 ","$2,723.02 ","$2,456.63 ","$2,723.02 ", N/A ,"$2,723.02 ","$3,847.74 ","$3,847.74 ","$4,193.05 ", N/A ,"$3,418.57 ", N/A ,"$4,933.00 ","$2,713.15 ", N/A ,"$1,297.38 ","$4,933.00 ", N/A , N/A , N/A ,"$3,946.40 ","$2,678.62 ","$1,381.24 ","$4,439.70 ","$1,874.54 ",$800.00 , N/A ,"$2,367.84 "
ST. MARY'S HOSPITAL - DECATUR,72200007,N/A,HC C-SECT INIT 1 HR TWIN,722,1 ,"$4,366.00 ","$2,837.90 ",$800.00 ,"$4,366.00 ", N/A ,"$2,226.66 ","$2,401.30 ", N/A ,"$1,222.48 ","$2,052.02 ", N/A ,"$2,357.64 ", N/A ,"$2,370.74 ","$1,746.40 ", N/A ,"$2,370.74 ", N/A ,"$3,056.20 ","$2,183.00 ","$3,492.80 ", N/A , N/A ,"$3,056.20 ", N/A ,"$2,619.60 ", N/A ,"$3,274.50 ","$2,410.03 ","$2,174.27 ","$2,410.03 ", N/A ,"$2,410.03 ","$3,405.48 ","$3,405.48 ","$3,711.10 ", N/A ,"$3,025.64 ", N/A ,"$4,366.00 ","$2,401.30 ", N/A ,"$1,148.26 ","$4,366.00 ", N/A , N/A , N/A ,"$3,492.80 ","$2,370.74 ","$1,222.48 ","$3,929.40 ","$1,659.08 ",$800.00 , N/A ,"$2,095.68 "
ST. MARY'S HOSPITAL - DECATUR,73000002,93005,HC EKG,730,1 ,$426.00 ,$276.90 ,$16.80 ,$426.00 ,$131.73 ,$217.26 ,$234.30 ,$52.69 ,$119.28 ,$145.29 ,$52.69 ,$145.29 ,$52.69 ,$231.32 ,$16.80 ,$52.69 ,$231.32 ,$100.11 ,$298.20 ,$213.00 ,$340.80 ,$131.73 ,$52.69 ,$298.20 ,$52.69 ,$255.60 ,$52.69 ,$319.50 ,$235.15 ,$212.15 ,$235.15 ,$52.69 ,$235.15 ,$332.28 ,$332.28 ,$362.10 ,$131.73 ,$295.22 ,$52.69 ,$426.00 ,$234.30 ,$52.69 ,$112.04 ,$426.00 ,$18.02 ,$17.20 ,$55.32 ,$340.80 ,$231.32 ,$119.28 ,$383.40 ,$161.88 ,$426.00 ,$52.69 ,$204.48 
ST. MARY'S HOSPITAL - DECATUR,73000003,93041,HC EKG RHYTHM STRIP TRACING,730,1 ,$273.00 ,$177.45 ,$11.17 ,$273.00 ,$131.73 ,$139.23 ,$150.15 ,$52.69 ,$76.44 ,$128.31 ,$52.69 ,$147.42 ,$52.69 ,$148.24 ,$11.17 ,$52.69 ,$148.24 ,$100.11 ,$191.10 ,$136.50 ,$218.40 ,$131.73 ,$52.69 ,$191.10 ,$52.69 ,$163.80 ,$52.69 ,$204.75 ,$150.70 ,$135.95 ,$150.70 ,$52.69 ,$150.70 ,$212.94 ,$212.94 ,$232.05 ,$131.73 ,$189.19 ,$52.69 ,$273.00 ,$150.15 ,$52.69 ,$71.80 ,$273.00 ,$18.02 ,$17.20 ,$55.32 ,$218.40 ,$148.24 ,$76.44 ,$245.70 ,$103.74 ,$273.00 ,$52.69 ,$131.04 
ST. MARY'S HOSPITAL - DECATUR,73100000,93225,HC HOLTER MONITOR RECORDING,731,1 ,$945.00 ,$614.25 ,$46.13 ,$945.00 ,$266.85 ,$481.95 ,$519.75 ,$106.74 ,$264.60 ,$443.33 ,$106.74 ,$443.33 ,$106.74 ,$513.14 ,$50.20 ,$106.74 ,$513.14 ,$202.80 ,$661.50 ,$472.50 ,$756.00 ,$266.84 ,$106.74 ,$661.50 ,$106.74 ,$567.00 ,$106.74 ,$708.75 ,$521.64 ,$470.61 ,$521.64 ,$106.74 ,$521.64 ,$737.10 ,$737.10 ,$803.25 ,$266.84 ,$654.89 ,$106.74 ,$945.00 ,$519.75 ,$106.74 ,$248.54 ,$945.00 ,$48.32 ,$46.13 ,$112.08 ,$756.00 ,$513.14 ,$264.60 ,$850.50 ,$359.10 ,$835.00 ,$106.74 ,$453.60 
ST. MARY'S HOSPITAL - DECATUR,73100002,93226,HC HOLTER SCAN  AND  REPORT 48 HR,731,1 ,"$1,101.00 ",$715.65 ,$46.13 ,"$1,101.00 ",$266.85 ,$561.51 ,$605.55 ,$106.74 ,$308.28 ,$539.49 ,$106.74 ,$630.40 ,$106.74 ,$597.84 ,$70.73 ,$106.74 ,$597.84 ,$202.80 ,$770.70 ,$550.50 ,$880.80 ,$266.84 ,$106.74 ,$770.70 ,$106.74 ,$660.60 ,$106.74 ,$825.75 ,$607.75 ,$548.30 ,$607.75 ,$106.74 ,$607.75 ,$858.78 ,$858.78 ,$935.85 ,$266.84 ,$762.99 ,$106.74 ,"$1,101.00 ",$605.55 ,$106.74 ,$289.56 ,"$1,101.00 ",$48.32 ,$46.13 ,$112.08 ,$880.80 ,$597.84 ,$308.28 ,$990.90 ,$418.38 ,$835.00 ,$106.74 ,$528.48 
ST. MARY'S HOSPITAL - DECATUR,73100004,93270,HC CARDIAC EVENT RECORDER,731,1 ,$597.00 ,$388.05 ,$18.02 ,$597.00 ,$88.13 ,$304.47 ,$328.35 ,$35.25 ,$167.16 ,$156.99 ,$35.25 ,$156.99 ,$35.25 ,$324.17 ,$18.02 ,$35.25 ,$324.17 ,$66.97 ,$417.90 ,$298.50 ,$477.60 ,$88.12 ,$35.25 ,$417.90 ,$35.25 ,$358.20 ,$35.25 ,$447.75 ,$329.54 ,$297.31 ,$329.54 ,$35.25 ,$329.54 ,$465.66 ,$465.66 ,$507.45 ,$88.12 ,$413.72 ,$35.25 ,$597.00 ,$328.35 ,$35.25 ,$157.01 ,$597.00 ,$48.32 ,$46.13 ,$37.01 ,$477.60 ,$324.17 ,$167.16 ,$537.30 ,$226.86 ,$597.00 ,$35.25 ,$286.56 
ST. MARY'S HOSPITAL - DECATUR,73100005,93271,HC CARDIAC EVENT MONITOR,731,1 ,"$2,048.00 ","$1,331.20 ",$94.70 ,"$2,048.00 ",$237.58 ,"$1,044.48 ","$1,126.40 ",$95.03 ,$573.44 ,"$1,003.52 ",$95.03 ,"$1,198.08 ",$95.03 ,"$1,112.06 ",$323.37 ,$95.03 ,"$1,112.06 ",$180.56 ,"$1,433.60 ","$1,024.00 ","$1,638.40 ",$237.58 ,$95.03 ,"$1,433.60 ",$95.03 ,"$1,228.80 ",$95.03 ,"$1,536.00 ","$1,130.50 ","$1,019.90 ","$1,130.50 ",$95.03 ,"$1,130.50 ","$1,597.44 ","$1,597.44 ","$1,740.80 ",$237.58 ,"$1,419.26 ",$95.03 ,"$2,048.00 ","$1,126.40 ",$95.03 ,$538.62 ,"$2,048.00 ",$99.21 ,$94.70 ,$99.78 ,"$1,638.40 ","$1,112.06 ",$573.44 ,"$1,843.20 ",$778.24 ,$835.00 ,$95.03 ,$983.04 
ST. MARY'S HOSPITAL - DECATUR,74000001,95803,HC ACTIGRAPHY TESTING 72HR TO 14 DAYS,740,1 ,$358.00 ,$232.70 ,$52.69 ,$358.00 ,$131.73 ,$182.58 ,$196.90 ,$52.69 ,$100.24 ,$168.26 ,$52.69 ,$193.32 ,$52.69 ,$194.39 ,$144.13 ,$52.69 ,$194.39 ,$100.11 ,$250.60 ,$179.00 ,$286.40 ,$131.73 ,$52.69 ,$250.60 ,$52.69 ,$214.80 ,$52.69 ,$268.50 ,$197.62 ,$178.28 ,$197.62 ,$52.69 ,$197.62 ,$279.24 ,$279.24 ,$304.30 ,$131.73 ,$248.09 ,$52.69 ,$358.00 ,$196.90 ,$52.69 ,$94.15 ,$358.00 ,$83.53 ,$79.74 ,$55.32 ,$286.40 ,$194.39 ,$100.24 ,$322.20 ,$136.04 ,$358.00 ,$52.69 ,$171.84 
ST. MARY'S HOSPITAL - DECATUR,74000002,95805,HC MULTIPLE SLEEP LATENCY,740,1 ,"$2,650.00 ","$1,722.50 ",$462.07 ,"$2,650.00 ","$1,155.18 ","$1,351.50 ","$1,457.50 ",$462.07 ,$742.00 ,"$1,298.50 ",$462.07 ,"$1,550.25 ",$462.07 ,"$1,438.95 ",$523.20 ,$462.07 ,"$1,438.95 ",$877.93 ,"$1,855.00 ","$1,325.00 ","$2,120.00 ","$1,155.17 ",$462.07 ,"$1,855.00 ",$462.07 ,"$1,590.00 ",$462.07 ,"$1,987.50 ","$1,462.80 ","$1,319.70 ","$1,462.80 ",$462.07 ,"$1,462.80 ","$2,067.00 ","$2,067.00 ","$2,252.50 ","$1,155.17 ","$1,836.45 ",$462.07 ,"$2,650.00 ","$1,457.50 ",$462.07 ,$696.95 ,"$2,650.00 ",$536.72 ,$512.33 ,$485.17 ,"$2,120.00 ","$1,438.95 ",$742.00 ,"$2,385.00 ","$1,007.00 ","$2,650.00 ",$462.07 ,"$1,272.00 "
ST. MARY'S HOSPITAL - DECATUR,74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,$873.00 ,$567.45 ,$127.73 ,$873.00 ,$330.40 ,$445.23 ,$480.15 ,$132.16 ,$244.44 ,$427.77 ,$132.16 ,$510.71 ,$132.16 ,$474.04 ,$127.73 ,$132.16 ,$474.04 ,$251.11 ,$611.10 ,$436.50 ,$698.40 ,$330.40 ,$132.16 ,$611.10 ,$132.16 ,$523.80 ,$132.16 ,$654.75 ,$481.90 ,$434.75 ,$481.90 ,$132.16 ,$481.90 ,$680.94 ,$680.94 ,$742.05 ,$330.40 ,$604.99 ,$132.16 ,$873.00 ,$480.15 ,$132.16 ,$229.60 ,$873.00 ,$536.72 ,$512.33 ,$138.77 ,$698.40 ,$474.04 ,$244.44 ,$785.70 ,$331.74 ,$873.00 ,$132.16 ,$419.04 
ST. MARY'S HOSPITAL - DECATUR,74000006,95810,HC SLEEP STUDY,740,1 ,"$6,584.00 ","$4,279.60 ",$512.33 ,"$6,584.00 ","$2,177.23 ","$3,357.84 ","$3,621.20 ",$870.89 ,"$1,843.52 ","$3,226.16 ",$870.89 ,"$3,851.64 ",$870.89 ,"$3,575.11 ","$1,070.73 ",$870.89 ,"$3,575.11 ","$1,654.69 ","$4,608.80 ","$3,292.00 ","$5,267.20 ","$2,177.22 ",$870.89 ,"$4,608.80 ",$870.89 ,"$3,950.40 ",$870.89 ,"$4,938.00 ","$3,634.37 ","$3,278.83 ","$3,634.37 ",$870.89 ,"$3,634.37 ","$5,135.52 ","$5,135.52 ","$5,596.40 ","$2,177.22 ","$4,562.71 ",$870.89 ,"$6,584.00 ","$3,621.20 ",$870.89 ,"$1,731.59 ","$6,584.00 ",$536.72 ,$512.33 ,$914.43 ,"$5,267.20 ","$3,575.11 ","$1,843.52 ","$5,925.60 ","$2,501.92 ","$3,250.00 ",$870.89 ,"$3,160.32 "
ST. MARY'S HOSPITAL - DECATUR,74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$6,584.00 ","$4,279.60 ",$512.33 ,"$6,584.00 ","$2,177.23 ","$3,357.84 ","$3,621.20 ",$870.89 ,"$1,843.52 ","$3,226.16 ",$870.89 ,"$3,851.64 ",$870.89 ,"$3,575.11 ","$1,125.55 ",$870.89 ,"$3,575.11 ","$1,654.69 ","$4,608.80 ","$3,292.00 ","$5,267.20 ","$2,177.22 ",$870.89 ,"$4,608.80 ",$870.89 ,"$3,950.40 ",$870.89 ,"$4,938.00 ","$3,634.37 ","$3,278.83 ","$3,634.37 ",$870.89 ,"$3,634.37 ","$5,135.52 ","$5,135.52 ","$5,596.40 ","$2,177.22 ","$4,562.71 ",$870.89 ,"$6,584.00 ","$3,621.20 ",$870.89 ,"$1,731.59 ","$6,584.00 ",$536.72 ,$512.33 ,$914.43 ,"$5,267.20 ","$3,575.11 ","$1,843.52 ","$5,925.60 ","$2,501.92 ","$3,250.00 ",$870.89 ,"$3,160.32 "
ST. MARY'S HOSPITAL - DECATUR,74000013,95813,HC EEG MONITOR > 1 HR,740,1 ,"$1,878.00 ","$1,220.70 ",$250.52 ,"$1,878.00 ",$626.30 ,$957.78 ,"$1,032.90 ",$250.52 ,$525.84 ,$920.22 ,$250.52 ,"$1,098.63 ",$250.52 ,"$1,019.75 ",$458.52 ,$250.52 ,"$1,019.75 ",$475.99 ,"$1,314.60 ",$939.00 ,"$1,502.40 ",$626.30 ,$250.52 ,"$1,314.60 ",$250.52 ,"$1,126.80 ",$250.52 ,"$1,408.50 ","$1,036.66 ",$935.24 ,"$1,036.66 ",$250.52 ,"$1,036.66 ","$1,464.84 ","$1,464.84 ","$1,596.30 ",$626.30 ,"$1,301.45 ",$250.52 ,"$1,878.00 ","$1,032.90 ",$250.52 ,$493.91 ,"$1,878.00 ",$320.78 ,$306.20 ,$263.05 ,"$1,502.40 ","$1,019.75 ",$525.84 ,"$1,690.20 ",$713.64 ,$540.00 ,$250.52 ,$901.44 
ST. MARY'S HOSPITAL - DECATUR,74000014,95816,HC EEG AWAKE/DROWSY,740,1 ,$788.00 ,$512.20 ,$172.89 ,$788.00 ,$626.30 ,$401.88 ,$433.40 ,$250.52 ,$220.64 ,$386.12 ,$250.52 ,$460.98 ,$250.52 ,$427.88 ,$442.12 ,$250.52 ,$427.88 ,$475.99 ,$551.60 ,$394.00 ,$630.40 ,$626.30 ,$250.52 ,$551.60 ,$250.52 ,$472.80 ,$250.52 ,$591.00 ,$434.98 ,$392.42 ,$434.98 ,$250.52 ,$434.98 ,$614.64 ,$614.64 ,$669.80 ,$626.30 ,$546.08 ,$250.52 ,$788.00 ,$433.40 ,$250.52 ,$207.24 ,$788.00 ,$181.13 ,$172.89 ,$263.05 ,$630.40 ,$427.88 ,$220.64 ,$709.20 ,$299.44 ,$540.00 ,$250.52 ,$378.24 
ST. MARY'S HOSPITAL - DECATUR,74000016,95819,HC EEG AWAKE/ASLEEP,740,1 ,"$1,169.00 ",$759.85 ,$172.89 ,"$1,169.00 ",$626.30 ,$596.19 ,$642.95 ,$250.52 ,$327.32 ,$572.81 ,$250.52 ,$683.87 ,$250.52 ,$634.77 ,$535.02 ,$250.52 ,$634.77 ,$475.99 ,$818.30 ,$584.50 ,$935.20 ,$626.30 ,$250.52 ,$818.30 ,$250.52 ,$701.40 ,$250.52 ,$876.75 ,$645.29 ,$582.16 ,$645.29 ,$250.52 ,$645.29 ,$911.82 ,$911.82 ,$993.65 ,$626.30 ,$810.12 ,$250.52 ,"$1,169.00 ",$642.95 ,$250.52 ,$307.45 ,"$1,169.00 ",$181.13 ,$172.89 ,$263.05 ,$935.20 ,$634.77 ,$327.32 ,"$1,052.10 ",$444.22 ,$540.00 ,$250.52 ,$561.12 
ST. MARY'S HOSPITAL - DECATUR,74000018,95822,HC EEG COMA OR SLEEP ONLY,740,1 ,"$1,622.00 ","$1,054.30 ",$172.89 ,"$1,622.00 ",$626.30 ,$827.22 ,$892.10 ,$250.52 ,$454.16 ,$794.78 ,$250.52 ,$948.87 ,$250.52 ,$880.75 ,$473.89 ,$250.52 ,$880.75 ,$475.99 ,"$1,135.40 ",$811.00 ,"$1,297.60 ",$626.30 ,$250.52 ,"$1,135.40 ",$250.52 ,$973.20 ,$250.52 ,"$1,216.50 ",$895.34 ,$807.76 ,$895.34 ,$250.52 ,$895.34 ,"$1,265.16 ","$1,265.16 ","$1,378.70 ",$626.30 ,"$1,124.05 ",$250.52 ,"$1,622.00 ",$892.10 ,$250.52 ,$426.59 ,"$1,622.00 ",$181.13 ,$172.89 ,$263.05 ,"$1,297.60 ",$880.75 ,$454.16 ,"$1,459.80 ",$616.36 ,$540.00 ,$250.52 ,$778.56 
ST. MARY'S HOSPITAL - DECATUR,74000020,95824,HC EEG CEREBRAL DEATH EVAL,740,1 ,$788.00 ,$512.20 ,$92.13 ,"$1,155.18 ","$1,155.18 ",$401.88 ,$433.40 ,$462.07 ,$220.64 ,$386.12 ,$462.07 ,$460.98 ,$462.07 ,$427.88 ,$92.13 ,$462.07 ,$427.88 ,$788.00 ,$551.60 ,$394.00 ,$630.40 ,"$1,155.17 ",$462.07 ,$551.60 ,$462.07 ,$472.80 ,$462.07 ,$591.00 ,$434.98 ,$392.42 ,$434.98 ,$462.07 ,$434.98 ,$614.64 ,$614.64 ,$669.80 ,$788.00 ,$546.08 ,$462.07 ,$788.00 ,$433.40 ,$462.07 ,$207.24 ,$788.00 ,$181.13 ,$172.89 ,$485.17 ,$630.40 ,$427.88 ,$220.64 ,$709.20 ,$299.44 ,$540.00 ,$462.07 ,$378.24 
ST. MARY'S HOSPITAL - DECATUR,74000023,95928,HC TCMEP UPPER LIMBS,740,1 ,"$1,221.00 ",$793.65 ,$201.51 ,"$2,177.23 ","$2,177.23 ",$622.71 ,$671.55 ,$870.89 ,$341.88 ,$598.29 ,$870.89 ,$714.29 ,$870.89 ,$663.00 ,$201.51 ,$870.89 ,$663.00 ,"$1,221.00 ",$854.70 ,$610.50 ,$976.80 ,"$2,177.22 ",$870.89 ,$854.70 ,$870.89 ,$732.60 ,$870.89 ,$915.75 ,$673.99 ,$608.06 ,$673.99 ,$870.89 ,$673.99 ,$952.38 ,$952.38 ,"$1,037.85 ","$1,221.00 ",$846.15 ,$870.89 ,"$1,221.00 ",$671.55 ,$870.89 ,$321.12 ,"$1,221.00 ",$229.67 ,$219.23 ,$914.43 ,$976.80 ,$663.00 ,$341.88 ,"$1,098.90 ",$463.98 ,$540.00 ,$870.89 ,$586.08 
ST. MARY'S HOSPITAL - DECATUR,74000024,95929,HC TCMEP LWR LIMBS,740,1 ,"$1,355.00 ",$880.75 ,$208.68 ,"$1,355.00 ","$1,155.18 ",$691.05 ,$745.25 ,$462.07 ,$379.40 ,$663.95 ,$462.07 ,$792.68 ,$462.07 ,$735.77 ,$208.68 ,$462.07 ,$735.77 ,$877.93 ,$948.50 ,$677.50 ,"$1,084.00 ","$1,155.17 ",$462.07 ,$948.50 ,$462.07 ,$813.00 ,$462.07 ,"$1,016.25 ",$747.96 ,$674.79 ,$747.96 ,$462.07 ,$747.96 ,"$1,056.90 ","$1,056.90 ","$1,151.75 ","$1,155.17 ",$939.02 ,$462.07 ,"$1,355.00 ",$745.25 ,$462.07 ,$356.37 ,"$1,355.00 ",$229.67 ,$219.23 ,$485.17 ,"$1,084.00 ",$735.77 ,$379.40 ,"$1,219.50 ",$514.90 ,$540.00 ,$462.07 ,$650.40 
ST. MARY'S HOSPITAL - DECATUR,74000025,95937,HC NEUROMUSCULAR JUNCTION TEST,740,1 ,$478.00 ,$310.70 ,$77.01 ,$478.00 ,$330.40 ,$243.78 ,$262.90 ,$132.16 ,$133.84 ,$234.22 ,$132.16 ,$279.63 ,$132.16 ,$259.55 ,$77.01 ,$132.16 ,$259.55 ,$251.11 ,$334.60 ,$239.00 ,$382.40 ,$330.40 ,$132.16 ,$334.60 ,$132.16 ,$286.80 ,$132.16 ,$358.50 ,$263.86 ,$238.04 ,$263.86 ,$132.16 ,$263.86 ,$372.84 ,$372.84 ,$406.30 ,$330.40 ,$331.25 ,$132.16 ,$478.00 ,$262.90 ,$132.16 ,$125.71 ,$478.00 ,$229.67 ,$219.23 ,$138.77 ,$382.40 ,$259.55 ,$133.84 ,$430.20 ,$181.64 ,$478.00 ,$132.16 ,$229.44 
ST. MARY'S HOSPITAL - DECATUR,74000029,95955,HC EEG INTRAOP,740,1 ,"$1,877.00 ","$1,220.05 ",$172.89 ,"$1,877.00 ", N/A ,$957.27 ,"$1,032.35 ", N/A ,$525.56 ,$919.73 , N/A ,"$1,098.05 ", N/A ,"$1,019.21 ",$225.59 , N/A ,"$1,019.21 ", N/A ,"$1,313.90 ",$938.50 ,"$1,501.60 ", N/A , N/A ,"$1,313.90 ", N/A ,"$1,126.20 ", N/A ,"$1,407.75 ","$1,036.10 ",$934.75 ,"$1,036.10 ", N/A ,"$1,036.10 ","$1,464.06 ","$1,464.06 ","$1,595.45 ", N/A ,"$1,300.76 ", N/A ,"$1,877.00 ","$1,032.35 ", N/A ,$493.65 ,"$1,877.00 ",$181.13 ,$172.89 , N/A ,"$1,501.60 ","$1,019.21 ",$525.56 ,"$1,689.30 ",$713.26 ,$540.00 , N/A ,$900.96 
ST. MARY'S HOSPITAL - DECATUR,74000033,95939,HC TCMEP UPPER AND LOWER,740,1 ,$770.00 ,$500.50 ,$202.51 ,"$2,177.23 ","$2,177.23 ",$392.70 ,$423.50 ,$870.89 ,$215.60 ,$361.90 ,$870.89 ,$415.80 ,$770.00 ,$418.11 ,$570.88 ,$770.00 ,$418.11 ,$770.00 ,$539.00 ,$385.00 ,$616.00 ,"$2,177.22 ",$870.89 ,$539.00 ,$870.89 ,$462.00 ,$870.89 ,$577.50 ,$425.04 ,$383.46 ,$425.04 ,$870.89 ,$425.04 ,$600.60 ,$600.60 ,$654.50 ,$770.00 ,$533.61 ,$870.89 ,$770.00 ,$423.50 ,$870.89 ,$202.51 ,$770.00 ,$229.67 ,$219.23 ,$914.43 ,$616.00 ,$418.11 ,$215.60 ,$693.00 ,$292.60 ,$540.00 ,$870.89 ,$369.60 
ST. MARY'S HOSPITAL - DECATUR,74000041,95782,HC SLEEP STUDY ONE ON ONE <6 YRS,740,1 ,"$4,211.00 ","$2,737.15 ",$870.89 ,"$4,211.00 ","$2,177.23 ","$2,147.61 ","$2,316.05 ",$870.89 ,"$1,179.08 ","$2,063.39 ",$870.89 ,"$2,463.44 ",$870.89 ,"$2,286.57 ","$1,258.52 ",$870.89 ,"$2,286.57 ","$1,654.69 ","$2,947.70 ","$2,105.50 ","$3,368.80 ","$2,177.22 ",$870.89 ,"$2,947.70 ",$870.89 ,"$2,526.60 ",$870.89 ,"$3,158.25 ","$2,324.47 ","$2,097.08 ","$2,324.47 ",$870.89 ,"$2,324.47 ","$3,284.58 ","$3,284.58 ","$3,579.35 ","$2,177.22 ","$2,918.22 ",$870.89 ,"$4,211.00 ","$2,316.05 ",$870.89 ,"$1,107.49 ","$4,211.00 ", N/A , N/A ,$914.43 ,"$3,368.80 ","$2,286.57 ","$1,179.08 ","$3,789.90 ","$1,600.18 ","$3,250.00 ",$870.89 ,"$2,021.28 "
ST. MARY'S HOSPITAL - DECATUR,74000043,95940,HC NEURO TEST INTRAOPER PER 15MIN,740,1 ,$210.00 ,$136.50 ,$51.00 ,$210.00 , N/A ,$107.10 ,$115.50 , N/A ,$58.80 ,$98.70 , N/A ,$113.40 , N/A ,$114.03 ,$51.00 , N/A ,$114.03 , N/A ,$147.00 ,$105.00 ,$168.00 , N/A , N/A ,$147.00 , N/A ,$126.00 , N/A ,$157.50 ,$115.92 ,$104.58 ,$115.92 , N/A ,$115.92 ,$163.80 ,$163.80 ,$178.50 , N/A ,$145.53 , N/A ,$210.00 ,$115.50 , N/A ,$55.23 ,$210.00 , N/A , N/A , N/A ,$168.00 ,$114.03 ,$58.80 ,$189.00 ,$79.80 ,$210.00 , N/A ,$100.80 
ST. MARY'S HOSPITAL - DECATUR,74000044,95941,HC NEURO TEST INTRAOPER REMOTE/> 1 OR PER HR,740,1 ,$371.00 ,$241.15 ,$97.57 ,$371.00 , N/A ,$189.21 ,$204.05 , N/A ,$103.88 ,$174.37 , N/A ,$200.34 , N/A ,$201.45 ,$289.45 , N/A ,$201.45 , N/A ,$259.70 ,$185.50 ,$296.80 , N/A , N/A ,$259.70 , N/A ,$222.60 , N/A ,$278.25 ,$204.79 ,$184.76 ,$204.79 , N/A ,$204.79 ,$289.38 ,$289.38 ,$315.35 , N/A ,$257.10 , N/A ,$371.00 ,$204.05 , N/A ,$97.57 ,$371.00 , N/A , N/A , N/A ,$296.80 ,$201.45 ,$103.88 ,$333.90 ,$140.98 ,$371.00 , N/A ,$178.08 
ST. MARY'S HOSPITAL - DECATUR,74000045,95810,HC SLEEP STUDY PSG 4+ PARAMETERS >6YRS -52,740,1 ,"$6,584.00 ","$4,279.60 ",$256.16 ,"$6,584.00 ","$1,088.60 ","$3,357.84 ","$3,621.20 ",$435.44 ,"$1,843.52 ","$3,226.16 ",$435.44 ,"$3,851.64 ",$435.44 ,"$3,575.11 ","$1,070.73 ",$435.44 ,"$3,575.11 ",$827.34 ,"$4,608.80 ","$3,292.00 ","$5,267.20 ","$1,088.61 ",$435.44 ,"$4,608.80 ",$435.44 ,"$3,950.40 ",$435.44 ,"$4,938.00 ","$3,634.37 ","$3,278.83 ","$3,634.37 ",$435.44 ,"$3,634.37 ","$5,135.52 ","$5,135.52 ","$5,596.40 ","$1,088.61 ","$4,562.71 ",$435.44 ,"$6,584.00 ","$3,621.20 ",$435.44 ,"$1,731.59 ","$6,584.00 ",$268.36 ,$256.16 ,$457.21 ,"$5,267.20 ","$3,575.11 ","$1,843.52 ","$5,925.60 ","$2,501.92 ","$3,250.00 ",$435.44 ,"$3,160.32 "
ST. MARY'S HOSPITAL - DECATUR,74000046,95811,HC SLEEP STUDY PSG 4+ PARAMTRS W/CPAP >6YR-52,740,1 ,"$6,584.00 ","$4,279.60 ",$256.16 ,"$6,584.00 ","$1,088.60 ","$3,357.84 ","$3,621.20 ",$435.44 ,"$1,843.52 ","$3,226.16 ",$435.44 ,"$3,851.64 ",$435.44 ,"$3,575.11 ","$1,125.55 ",$435.44 ,"$3,575.11 ",$827.34 ,"$4,608.80 ","$3,292.00 ","$5,267.20 ","$1,088.61 ",$435.44 ,"$4,608.80 ",$435.44 ,"$3,950.40 ",$435.44 ,"$4,938.00 ","$3,634.37 ","$3,278.83 ","$3,634.37 ",$435.44 ,"$3,634.37 ","$5,135.52 ","$5,135.52 ","$5,596.40 ","$1,088.61 ","$4,562.71 ",$435.44 ,"$6,584.00 ","$3,621.20 ",$435.44 ,"$1,731.59 ","$6,584.00 ",$268.36 ,$256.16 ,$457.21 ,"$5,267.20 ","$3,575.11 ","$1,843.52 ","$5,925.60 ","$2,501.92 ","$3,250.00 ",$435.44 ,"$3,160.32 "
ST. MARY'S HOSPITAL - DECATUR,74000090,95712,HC VEEG W/VIDEO BY TECH 2-12 HOURS W/INTERMITTENT MONITORING,740,1 ,"$2,729.00 ","$1,773.85 ",$172.89 ,"$2,729.00 ",$626.30 ,"$1,391.79 ","$1,500.95 ",$250.52 ,$764.12 ,"$1,282.63 ",$250.52 ,"$1,473.66 ",$250.52 ,"$1,481.85 ","$1,091.60 ",$250.52 ,"$1,481.85 ",$475.99 ,"$1,910.30 ","$1,364.50 ","$2,183.20 ",$626.30 ,$250.52 ,"$1,910.30 ",$250.52 ,"$1,637.40 ",$250.52 ,"$2,046.75 ","$1,506.41 ","$1,359.04 ","$1,506.41 ",$250.52 ,"$1,506.41 ","$2,128.62 ","$2,128.62 ","$2,319.65 ",$626.30 ,"$1,891.20 ",$250.52 ,"$2,729.00 ","$1,500.95 ",$250.52 ,$717.73 ,"$2,729.00 ",$181.13 ,$172.89 ,$263.05 ,"$2,183.20 ","$1,481.85 ",$764.12 ,"$2,456.10 ","$1,037.02 ",$540.00 ,$250.52 ,"$1,309.92 "
ST. MARY'S HOSPITAL - DECATUR,74000093,95715,HC VEEG W/VIDEO BY TECH 12-26 HOURS EACH INCREMENT W/INTERMITTENT MONITORING,740,1 ,"$5,458.00 ","$3,547.70 ",$306.20 ,"$5,458.00 ","$1,155.18 ","$2,783.58 ","$3,001.90 ",$462.07 ,"$1,528.24 ","$2,565.26 ",$462.07 ,"$2,947.32 ",$462.07 ,"$2,963.69 ","$2,183.20 ",$462.07 ,"$2,963.69 ",$877.93 ,"$3,820.60 ","$2,729.00 ","$4,366.40 ","$1,155.17 ",$462.07 ,"$3,820.60 ",$462.07 ,"$3,274.80 ",$462.07 ,"$4,093.50 ","$3,012.82 ","$2,718.08 ","$3,012.82 ",$462.07 ,"$3,012.82 ","$4,257.24 ","$4,257.24 ","$4,639.30 ","$1,155.17 ","$3,782.39 ",$462.07 ,"$5,458.00 ","$3,001.90 ",$462.07 ,"$1,435.45 ","$5,458.00 ",$320.78 ,$306.20 ,$485.17 ,"$4,366.40 ","$2,963.69 ","$1,528.24 ","$4,912.20 ","$2,074.04 ",$540.00 ,$462.07 ,"$2,619.84 "
ST. MARY'S HOSPITAL - DECATUR,75000095,78267,HC UREA BREATH TEST C-14 ISOTO,300,1 ,$489.00 ,$317.85 ,$7.52 ,$489.00 ,$27.65 ,$19.82 ,$268.95 ,$11.06 ,$136.92 ,$229.83 ,$11.06 ,$264.06 ,$11.06 ,$265.53 ,$7.85 ,$11.06 ,$265.53 ,$21.01 ,$342.30 ,$244.50 ,$391.20 ,$27.65 ,$11.06 ,$342.30 ,$11.06 ,$293.40 ,$11.06 ,$366.75 ,$269.93 ,$243.52 ,$269.93 ,$11.06 ,$269.93 ,$14.38 ,$14.38 ,$415.65 ,$27.65 ,$338.88 ,$11.06 ,$489.00 ,$268.95 ,$11.06 ,$128.61 , N/A ,$7.88 ,$7.52 ,$11.61 ,$391.20 ,$265.53 ,$136.92 ,$440.10 ,$185.82 , N/A ,$11.06 ,$234.72 
ST. MARY'S HOSPITAL - DECATUR,75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,"$2,719.00 ","$1,767.35 ",$461.90 ,"$2,719.00 ","$1,914.88 ","$2,719.00 ","$1,495.45 ",$765.95 ,$761.32 ,"$1,277.93 ",$765.95 ,"$1,468.26 ",$765.95 ,"$1,476.42 ","$1,476.42 ",$765.95 ,"$1,476.42 ","$1,455.30 ","$1,903.30 ","$1,359.50 ","$2,175.20 ","$1,914.87 ",$765.95 ,"$1,903.30 ",$765.95 ,"$1,631.40 ",$765.95 ,"$2,039.25 ","$1,500.89 ","$1,354.06 ","$1,500.89 ",$765.95 ,"$1,500.89 ","$2,120.82 ","$2,120.82 ","$2,311.15 ","$1,914.87 ","$1,884.27 ",$765.95 ,"$2,719.00 ","$1,495.45 ",$765.95 ,$715.10 ,"$2,719.00 ",$483.89 ,$461.90 ,$804.25 ,"$2,175.20 ","$1,476.42 ",$761.32 ,"$2,447.10 ","$1,795.00 ","$2,100.00 ",$765.95 ,"$1,305.12 "
ST. MARY'S HOSPITAL - DECATUR,75000510,49082,HC PARACENTESIS W/O IMAGING,750,1 ,"$2,042.00 ","$1,327.30 ",$461.90 ,"$2,042.00 ","$1,914.88 ","$2,042.00 ","$1,123.10 ",$765.95 ,$571.76 ,$959.74 ,$765.95 ,"$1,102.68 ",$765.95 ,"$1,108.81 ","$1,108.81 ",$765.95 ,"$1,108.81 ","$1,455.30 ","$1,429.40 ","$1,021.00 ","$1,633.60 ","$1,914.87 ",$765.95 ,"$1,429.40 ",$765.95 ,"$1,225.20 ",$765.95 ,"$1,531.50 ","$1,127.18 ","$1,016.92 ","$1,127.18 ",$765.95 ,"$1,127.18 ","$1,592.76 ","$1,592.76 ","$1,735.70 ","$1,914.87 ","$1,415.11 ",$765.95 ,"$2,042.00 ","$1,123.10 ",$765.95 ,$537.05 ,"$2,042.00 ",$483.89 ,$461.90 ,$804.25 ,"$1,633.60 ","$1,108.81 ",$571.76 ,"$1,837.80 ","$1,795.00 ","$2,042.00 ",$765.95 ,$980.16 
ST. MARY'S HOSPITAL - DECATUR,75001053,N/A,HC ENDOSCOPY NASAL DIAGNOSTIC - 31231,750,1 ,"$1,777.00 ","$1,155.05 ",$467.35 ,"$1,777.00 ", N/A ,$906.27 ,$977.35 , N/A ,$497.56 ,$835.19 , N/A ,$959.58 , N/A ,$964.91 ,$964.91 , N/A ,$964.91 , N/A ,"$1,243.90 ",$888.50 ,"$1,421.60 ", N/A , N/A ,"$1,243.90 ", N/A ,"$1,066.20 ", N/A ,"$1,332.75 ",$980.90 ,$884.95 ,$980.90 , N/A ,$980.90 ,"$1,386.06 ","$1,386.06 ","$1,510.45 ", N/A ,"$1,231.46 ", N/A ,"$1,777.00 ",$977.35 , N/A ,$467.35 ,"$1,777.00 ", N/A , N/A , N/A ,"$1,421.60 ",$964.91 ,$497.56 ,"$1,599.30 ", N/A , N/A , N/A ,$852.96 
ST. MARY'S HOSPITAL - DECATUR,75001055,N/A,HC BRONCHOSCOPY DX W/WASHING -31622,750,1 ,"$2,190.00 ","$1,423.50 ",$575.97 ,"$2,190.00 ", N/A ,"$1,116.90 ","$1,204.50 ", N/A ,$613.20 ,"$1,029.30 ", N/A ,"$1,182.60 ", N/A ,"$1,189.17 ","$1,189.17 ", N/A ,"$1,189.17 ", N/A ,"$1,533.00 ","$1,095.00 ","$1,752.00 ", N/A , N/A ,"$1,533.00 ", N/A ,"$1,314.00 ", N/A ,"$1,642.50 ","$1,208.88 ","$1,090.62 ","$1,208.88 ", N/A ,"$1,208.88 ","$1,708.20 ","$1,708.20 ","$1,861.50 ", N/A ,"$1,517.67 ", N/A ,"$2,190.00 ","$1,204.50 ", N/A ,$575.97 ,"$2,190.00 ", N/A , N/A , N/A ,"$1,752.00 ","$1,189.17 ",$613.20 ,"$1,971.00 ", N/A , N/A , N/A ,"$1,051.20 "
ST. MARY'S HOSPITAL - DECATUR,75001057,N/A,HC BRONCHOSCOPY W/ALVEOLAR LAVAGE -31624,750,1 ,"$4,025.00 ","$2,616.25 ","$1,058.58 ","$4,025.00 ", N/A ,"$2,052.75 ","$2,213.75 ", N/A ,"$1,127.00 ","$1,891.75 ", N/A ,"$2,173.50 ", N/A ,"$2,185.58 ","$2,185.58 ", N/A ,"$2,185.58 ", N/A ,"$2,817.50 ","$2,012.50 ","$3,220.00 ", N/A , N/A ,"$2,817.50 ", N/A ,"$2,415.00 ", N/A ,"$3,018.75 ","$2,221.80 ","$2,004.45 ","$2,221.80 ", N/A ,"$2,221.80 ","$3,139.50 ","$3,139.50 ","$3,421.25 ", N/A ,"$2,789.33 ", N/A ,"$4,025.00 ","$2,213.75 ", N/A ,"$1,058.58 ","$4,025.00 ", N/A , N/A , N/A ,"$3,220.00 ","$2,185.58 ","$1,127.00 ","$3,622.50 ", N/A , N/A , N/A ,"$1,932.00 "
ST. MARY'S HOSPITAL - DECATUR,75001058,N/A,HC BRONCHOSCOPY W/BIOPSY - 31625,750,1 ,"$4,552.00 ","$2,958.80 ","$1,197.18 ","$4,552.00 ", N/A ,"$2,321.52 ","$2,503.60 ", N/A ,"$1,274.56 ","$2,139.44 ", N/A ,"$2,458.08 ", N/A ,"$2,471.74 ","$2,471.74 ", N/A ,"$2,471.74 ", N/A ,"$3,186.40 ","$2,276.00 ","$3,641.60 ", N/A , N/A ,"$3,186.40 ", N/A ,"$2,731.20 ", N/A ,"$3,414.00 ","$2,512.70 ","$2,266.90 ","$2,512.70 ", N/A ,"$2,512.70 ","$3,550.56 ","$3,550.56 ","$3,869.20 ", N/A ,"$3,154.54 ", N/A ,"$4,552.00 ","$2,503.60 ", N/A ,"$1,197.18 ","$4,552.00 ", N/A , N/A , N/A ,"$3,641.60 ","$2,471.74 ","$1,274.56 ","$4,096.80 ", N/A , N/A , N/A ,"$2,184.96 "
ST. MARY'S HOSPITAL - DECATUR,75001059,N/A,HC BRONCHOSCOPY W/LUNG BIOPSY SGL - 31628,750,1 ,"$8,639.00 ","$5,615.35 ","$2,272.06 ","$8,639.00 ", N/A ,"$4,405.89 ","$4,751.45 ", N/A ,"$2,418.92 ","$4,060.33 ", N/A ,"$4,665.06 ", N/A ,"$4,690.98 ","$4,690.98 ", N/A ,"$4,690.98 ", N/A ,"$3,500.00 ","$4,319.50 ","$6,911.20 ", N/A , N/A ,"$6,047.30 ", N/A ,"$5,183.40 ", N/A ,"$6,479.25 ","$4,057.00 ","$3,651.00 ","$4,057.00 ", N/A ,"$4,057.00 ","$6,738.42 ","$6,738.42 ","$7,343.15 ", N/A ,"$4,981.00 ", N/A ,"$8,639.00 ","$4,751.45 ", N/A ,"$2,272.06 ","$8,639.00 ", N/A , N/A , N/A ,"$6,911.20 ","$4,690.98 ","$2,418.92 ","$7,775.10 ", N/A , N/A , N/A ,"$4,146.72 "
ST. MARY'S HOSPITAL - DECATUR,75001063,N/A,HC ESOPHAGOSCOPY RIGID W/BIOPSY - 43193,750,1 ,"$2,391.00 ","$1,554.15 ",$628.83 ,"$2,391.00 ", N/A ,"$1,219.41 ","$1,315.05 ", N/A ,$669.48 ,"$1,123.77 ", N/A ,"$1,291.14 ", N/A ,"$1,298.31 ","$1,298.31 ", N/A ,"$1,298.31 ", N/A ,"$1,673.70 ","$1,195.50 ","$1,912.80 ", N/A , N/A ,"$1,673.70 ", N/A ,"$1,434.60 ", N/A ,"$1,793.25 ","$1,319.83 ","$1,190.72 ","$1,319.83 ", N/A ,"$1,319.83 ","$1,864.98 ","$1,864.98 ","$2,032.35 ", N/A ,"$1,656.96 ", N/A ,"$2,391.00 ","$1,315.05 ", N/A ,$628.83 ,"$2,391.00 ", N/A , N/A , N/A ,"$1,912.80 ","$1,298.31 ",$669.48 ,"$2,151.90 ", N/A , N/A , N/A ,"$1,147.68 "
ST. MARY'S HOSPITAL - DECATUR,75001066,N/A,HC ESOPHAGOSCOPY FLEXIBLE DX W/BRUSH/WASH -43200,750,1 ,"$2,258.00 ","$1,467.70 ",$593.85 ,"$2,258.00 ", N/A ,"$1,151.58 ","$1,241.90 ", N/A ,$632.24 ,"$1,061.26 ", N/A ,"$1,219.32 ", N/A ,"$1,226.09 ","$1,226.09 ", N/A ,"$1,226.09 ", N/A ,"$1,580.60 ","$1,129.00 ","$1,806.40 ", N/A , N/A ,"$1,580.60 ", N/A ,"$1,354.80 ", N/A ,"$1,693.50 ","$1,246.42 ","$1,124.48 ","$1,246.42 ", N/A ,"$1,246.42 ","$1,761.24 ","$1,761.24 ","$1,919.30 ", N/A ,"$1,564.79 ", N/A ,"$2,258.00 ","$1,241.90 ", N/A ,$593.85 ,"$2,258.00 ", N/A , N/A , N/A ,"$1,806.40 ","$1,226.09 ",$632.24 ,"$2,032.20 ", N/A , N/A , N/A ,"$1,083.84 "
ST. MARY'S HOSPITAL - DECATUR,75001070,N/A,HC ESOPHAGOSCOPY FLEXIBLE W/ENDO US EXAM - 43231,750,1 ,"$5,546.00 ","$3,604.90 ","$1,458.60 ","$5,546.00 ", N/A ,"$2,828.46 ","$3,050.30 ", N/A ,"$1,552.88 ","$2,606.62 ", N/A ,"$2,994.84 ", N/A ,"$3,011.48 ","$3,011.48 ", N/A ,"$3,011.48 ", N/A ,"$3,500.00 ","$2,773.00 ","$4,436.80 ", N/A , N/A ,"$3,882.20 ", N/A ,"$3,327.60 ", N/A ,"$4,159.50 ","$3,061.39 ","$2,761.91 ","$3,061.39 ", N/A ,"$3,061.39 ","$4,325.88 ","$4,325.88 ","$4,714.10 ", N/A ,"$3,843.38 ", N/A ,"$5,546.00 ","$3,050.30 ", N/A ,"$1,458.60 ","$5,546.00 ", N/A , N/A , N/A ,"$4,436.80 ","$3,011.48 ","$1,552.88 ","$4,991.40 ", N/A , N/A , N/A ,"$2,662.08 "
ST. MARY'S HOSPITAL - DECATUR,75001071,N/A,HC EGD W/BALLOON DILAT >30MM - 43233,750,1 ,"$1,947.00 ","$1,265.55 ",$512.06 ,"$1,947.00 ", N/A ,$992.97 ,"$1,070.85 ", N/A ,$545.16 ,$915.09 , N/A ,"$1,051.38 ", N/A ,"$1,057.22 ","$1,057.22 ", N/A ,"$1,057.22 ", N/A ,"$1,362.90 ",$973.50 ,"$1,557.60 ", N/A , N/A ,"$1,362.90 ", N/A ,"$1,168.20 ", N/A ,"$1,460.25 ","$1,074.74 ",$969.61 ,"$1,074.74 ", N/A ,"$1,074.74 ","$1,518.66 ","$1,518.66 ","$1,654.95 ", N/A ,"$1,349.27 ", N/A ,"$1,947.00 ","$1,070.85 ", N/A ,$512.06 ,"$1,947.00 ", N/A , N/A , N/A ,"$1,557.60 ","$1,057.22 ",$545.16 ,"$1,752.30 ", N/A , N/A , N/A ,$934.56 
ST. MARY'S HOSPITAL - DECATUR,75001072,N/A,HC EGD W/BRUSH/WASH - 43235,750,1 ,"$1,177.00 ",$765.05 ,$309.55 ,"$1,177.00 ", N/A ,$600.27 ,$647.35 , N/A ,$329.56 ,$553.19 , N/A ,$635.58 , N/A ,$639.11 ,$639.11 , N/A ,$639.11 , N/A ,$823.90 ,$588.50 ,$941.60 , N/A , N/A ,$823.90 , N/A ,$706.20 , N/A ,$882.75 ,$649.70 ,$586.15 ,$649.70 , N/A ,$649.70 ,$918.06 ,$918.06 ,"$1,000.45 ", N/A ,$815.66 , N/A ,"$1,177.00 ",$647.35 , N/A ,$309.55 ,"$1,177.00 ", N/A , N/A , N/A ,$941.60 ,$639.11 ,$329.56 ,"$1,059.30 ", N/A , N/A , N/A ,$564.96 
ST. MARY'S HOSPITAL - DECATUR,75001073,N/A,HC EGD W/SUBMUCOSAL INJ - 43236,750,1 ,"$1,156.00 ",$751.40 ,$304.03 ,"$1,156.00 ", N/A ,$589.56 ,$635.80 , N/A ,$323.68 ,$543.32 , N/A ,$624.24 , N/A ,$627.71 ,$627.71 , N/A ,$627.71 , N/A ,$809.20 ,$578.00 ,$924.80 , N/A , N/A ,$809.20 , N/A ,$693.60 , N/A ,$867.00 ,$638.11 ,$575.69 ,$638.11 , N/A ,$638.11 ,$901.68 ,$901.68 ,$982.60 , N/A ,$801.11 , N/A ,"$1,156.00 ",$635.80 , N/A ,$304.03 ,"$1,156.00 ", N/A , N/A , N/A ,$924.80 ,$627.71 ,$323.68 ,"$1,040.40 ", N/A , N/A , N/A ,$554.88 
ST. MARY'S HOSPITAL - DECATUR,75001074,N/A,HC EGD W/ENDO US EXAM LIMITED - 43237,750,1 ,"$5,425.00 ","$3,526.25 ","$1,426.78 ","$5,425.00 ", N/A ,"$2,766.75 ","$2,983.75 ", N/A ,"$1,519.00 ","$2,549.75 ", N/A ,"$2,929.50 ", N/A ,"$2,945.78 ","$2,945.78 ", N/A ,"$2,945.78 ", N/A ,"$3,500.00 ","$2,712.50 ","$4,340.00 ", N/A , N/A ,"$3,797.50 ", N/A ,"$3,255.00 ", N/A ,"$4,068.75 ","$2,994.60 ","$2,701.65 ","$2,994.60 ", N/A ,"$2,994.60 ","$4,231.50 ","$4,231.50 ","$4,611.25 ", N/A ,"$3,759.53 ", N/A ,"$5,425.00 ","$2,983.75 ", N/A ,"$1,426.78 ","$5,425.00 ", N/A , N/A , N/A ,"$4,340.00 ","$2,945.78 ","$1,519.00 ","$4,882.50 ", N/A , N/A , N/A ,"$2,604.00 "
ST. MARY'S HOSPITAL - DECATUR,75001076,N/A,HC EGD W/BIOPSY SGL/MULT - 43239,750,1 ,"$2,223.00 ","$1,444.95 ",$584.65 ,"$2,223.00 ", N/A ,"$1,133.73 ","$1,222.65 ", N/A ,$622.44 ,"$1,044.81 ", N/A ,"$1,200.42 ", N/A ,"$1,207.09 ","$1,207.09 ", N/A ,"$1,207.09 ", N/A ,"$1,556.10 ","$1,111.50 ","$1,778.40 ", N/A , N/A ,"$1,556.10 ", N/A ,"$1,333.80 ", N/A ,"$1,667.25 ","$1,227.10 ","$1,107.05 ","$1,227.10 ", N/A ,"$1,227.10 ","$1,733.94 ","$1,733.94 ","$1,889.55 ", N/A ,"$1,540.54 ", N/A ,"$2,223.00 ","$1,222.65 ", N/A ,$584.65 ,"$2,223.00 ", N/A , N/A , N/A ,"$1,778.40 ","$1,207.09 ",$622.44 ,"$2,000.70 ", N/A , N/A , N/A ,"$1,067.04 "
ST. MARY'S HOSPITAL - DECATUR,75001080,N/A,HC EGD W/BAND LIGATION - 43244,750,1 ,"$2,145.00 ","$1,394.25 ",$564.14 ,"$2,145.00 ", N/A ,"$1,093.95 ","$1,179.75 ", N/A ,$600.60 ,"$1,008.15 ", N/A ,"$1,158.30 ", N/A ,"$1,164.74 ","$1,164.74 ", N/A ,"$1,164.74 ", N/A ,"$1,501.50 ","$1,072.50 ","$1,716.00 ", N/A , N/A ,"$1,501.50 ", N/A ,"$1,287.00 ", N/A ,"$1,608.75 ","$1,184.04 ","$1,068.21 ","$1,184.04 ", N/A ,"$1,184.04 ","$1,673.10 ","$1,673.10 ","$1,823.25 ", N/A ,"$1,486.49 ", N/A ,"$2,145.00 ","$1,179.75 ", N/A ,$564.14 ,"$2,145.00 ", N/A , N/A , N/A ,"$1,716.00 ","$1,164.74 ",$600.60 ,"$1,930.50 ", N/A , N/A , N/A ,"$1,029.60 "
ST. MARY'S HOSPITAL - DECATUR,75001081,N/A,HC EGD W/DILAT STRICTURE - 43245,750,1 ,"$4,236.00 ","$2,753.40 ","$1,114.07 ","$4,236.00 ", N/A ,"$2,160.36 ","$2,329.80 ", N/A ,"$1,186.08 ","$1,990.92 ", N/A ,"$2,287.44 ", N/A ,"$2,300.15 ","$2,300.15 ", N/A ,"$2,300.15 ", N/A ,"$2,965.20 ","$2,118.00 ","$3,388.80 ", N/A , N/A ,"$2,965.20 ", N/A ,"$2,541.60 ", N/A ,"$3,177.00 ","$2,338.27 ","$2,109.53 ","$2,338.27 ", N/A ,"$2,338.27 ","$3,304.08 ","$3,304.08 ","$3,600.60 ", N/A ,"$2,935.55 ", N/A ,"$4,236.00 ","$2,329.80 ", N/A ,"$1,114.07 ","$4,236.00 ", N/A , N/A , N/A ,"$3,388.80 ","$2,300.15 ","$1,186.08 ","$3,812.40 ", N/A , N/A , N/A ,"$2,033.28 "
ST. MARY'S HOSPITAL - DECATUR,75001082,N/A,HC EGD W/PLACEMENT G-TUBE - 43246,750,1 ,"$3,146.00 ","$2,044.90 ",$827.40 ,"$3,146.00 ", N/A ,"$1,604.46 ","$1,730.30 ", N/A ,$880.88 ,"$1,478.62 ", N/A ,"$1,698.84 ", N/A ,"$1,708.28 ","$1,708.28 ", N/A ,"$1,708.28 ", N/A ,"$2,202.20 ","$1,573.00 ","$2,516.80 ", N/A , N/A ,"$2,202.20 ", N/A ,"$1,887.60 ", N/A ,"$2,359.50 ","$1,736.59 ","$1,566.71 ","$1,736.59 ", N/A ,"$1,736.59 ","$2,453.88 ","$2,453.88 ","$2,674.10 ", N/A ,"$2,180.18 ", N/A ,"$3,146.00 ","$1,730.30 ", N/A ,$827.40 ,"$3,146.00 ", N/A , N/A , N/A ,"$2,516.80 ","$1,708.28 ",$880.88 ,"$2,831.40 ", N/A , N/A , N/A ,"$1,510.08 "
ST. MARY'S HOSPITAL - DECATUR,75001083,N/A,HC EGD W/FB REMOVAL - 43247,750,1 ,"$2,455.00 ","$1,595.75 ",$645.67 ,"$2,455.00 ", N/A ,"$1,252.05 ","$1,350.25 ", N/A ,$687.40 ,"$1,153.85 ", N/A ,"$1,325.70 ", N/A ,"$1,333.07 ","$1,333.07 ", N/A ,"$1,333.07 ", N/A ,"$1,718.50 ","$1,227.50 ","$1,964.00 ", N/A , N/A ,"$1,718.50 ", N/A ,"$1,473.00 ", N/A ,"$1,841.25 ","$1,355.16 ","$1,222.59 ","$1,355.16 ", N/A ,"$1,355.16 ","$1,914.90 ","$1,914.90 ","$2,086.75 ", N/A ,"$1,701.32 ", N/A ,"$2,455.00 ","$1,350.25 ", N/A ,$645.67 ,"$2,455.00 ", N/A , N/A , N/A ,"$1,964.00 ","$1,333.07 ",$687.40 ,"$2,209.50 ", N/A , N/A , N/A ,"$1,178.40 "
ST. MARY'S HOSPITAL - DECATUR,75001085,N/A,HC EGD W/BALLOON DILAT <30MM - 43249,750,1 ,"$2,391.00 ","$1,554.15 ",$628.83 ,"$2,391.00 ", N/A ,"$1,219.41 ","$1,315.05 ", N/A ,$669.48 ,"$1,123.77 ", N/A ,"$1,291.14 ", N/A ,"$1,298.31 ","$1,298.31 ", N/A ,"$1,298.31 ", N/A ,"$1,673.70 ","$1,195.50 ","$1,912.80 ", N/A , N/A ,"$1,673.70 ", N/A ,"$1,434.60 ", N/A ,"$1,793.25 ","$1,319.83 ","$1,190.72 ","$1,319.83 ", N/A ,"$1,319.83 ","$1,864.98 ","$1,864.98 ","$2,032.35 ", N/A ,"$1,656.96 ", N/A ,"$2,391.00 ","$1,315.05 ", N/A ,$628.83 ,"$2,391.00 ", N/A , N/A , N/A ,"$1,912.80 ","$1,298.31 ",$669.48 ,"$2,151.90 ", N/A , N/A , N/A ,"$1,147.68 "
ST. MARY'S HOSPITAL - DECATUR,75001086,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN HOT BIOPSY - 43250,750,1 ,"$4,017.00 ","$2,611.05 ","$1,056.47 ","$4,017.00 ", N/A ,"$2,048.67 ","$2,209.35 ", N/A ,"$1,124.76 ","$1,887.99 ", N/A ,"$2,169.18 ", N/A ,"$2,181.23 ","$2,181.23 ", N/A ,"$2,181.23 ", N/A ,"$2,811.90 ","$2,008.50 ","$3,213.60 ", N/A , N/A ,"$2,811.90 ", N/A ,"$2,410.20 ", N/A ,"$3,012.75 ","$2,217.38 ","$2,000.47 ","$2,217.38 ", N/A ,"$2,217.38 ","$3,133.26 ","$3,133.26 ","$3,414.45 ", N/A ,"$2,783.78 ", N/A ,"$4,017.00 ","$2,209.35 ", N/A ,"$1,056.47 ","$4,017.00 ", N/A , N/A , N/A ,"$3,213.60 ","$2,181.23 ","$1,124.76 ","$3,615.30 ", N/A , N/A , N/A ,"$1,928.16 "
ST. MARY'S HOSPITAL - DECATUR,75001087,N/A,HC EGD W/REMOVAL TUMOR/POLYP/LESN SNARE TECH - 43251,750,1 ,"$2,488.00 ","$1,617.20 ",$654.34 ,"$2,488.00 ", N/A ,"$1,268.88 ","$1,368.40 ", N/A ,$696.64 ,"$1,169.36 ", N/A ,"$1,343.52 ", N/A ,"$1,350.98 ","$1,350.98 ", N/A ,"$1,350.98 ", N/A ,"$1,741.60 ","$1,244.00 ","$1,990.40 ", N/A , N/A ,"$1,741.60 ", N/A ,"$1,492.80 ", N/A ,"$1,866.00 ","$1,373.38 ","$1,239.02 ","$1,373.38 ", N/A ,"$1,373.38 ","$1,940.64 ","$1,940.64 ","$2,114.80 ", N/A ,"$1,724.18 ", N/A ,"$2,488.00 ","$1,368.40 ", N/A ,$654.34 ,"$2,488.00 ", N/A , N/A , N/A ,"$1,990.40 ","$1,350.98 ",$696.64 ,"$2,239.20 ", N/A , N/A , N/A ,"$1,194.24 "
ST. MARY'S HOSPITAL - DECATUR,75001089,N/A,HC EGD W/ENDO MUCOSAL RESECTION - 43254,750,1 ,"$5,727.00 ","$3,722.55 ","$1,506.20 ","$5,727.00 ", N/A ,"$2,920.77 ","$3,149.85 ", N/A ,"$1,603.56 ","$2,691.69 ", N/A ,"$3,092.58 ", N/A ,"$3,109.76 ","$3,109.76 ", N/A ,"$3,109.76 ", N/A ,"$3,500.00 ","$2,863.50 ","$4,581.60 ", N/A , N/A ,"$4,008.90 ", N/A ,"$3,436.20 ", N/A ,"$4,295.25 ","$3,161.30 ","$2,852.05 ","$3,161.30 ", N/A ,"$3,161.30 ","$4,467.06 ","$4,467.06 ","$4,867.95 ", N/A ,"$3,968.81 ", N/A ,"$5,727.00 ","$3,149.85 ", N/A ,"$1,506.20 ","$5,727.00 ", N/A , N/A , N/A ,"$4,581.60 ","$3,109.76 ","$1,603.56 ","$5,154.30 ", N/A , N/A , N/A ,"$2,748.96 "
ST. MARY'S HOSPITAL - DECATUR,75001090,N/A,HC EGD W/CONTROL BLEEDING - 43255,750,1 ,"$2,267.00 ","$1,473.55 ",$596.22 ,"$2,267.00 ", N/A ,"$1,156.17 ","$1,246.85 ", N/A ,$634.76 ,"$1,065.49 ", N/A ,"$1,224.18 ", N/A ,"$1,230.98 ","$1,230.98 ", N/A ,"$1,230.98 ", N/A ,"$1,586.90 ","$1,133.50 ","$1,813.60 ", N/A , N/A ,"$1,586.90 ", N/A ,"$1,360.20 ", N/A ,"$1,700.25 ","$1,251.38 ","$1,128.97 ","$1,251.38 ", N/A ,"$1,251.38 ","$1,768.26 ","$1,768.26 ","$1,926.95 ", N/A ,"$1,571.03 ", N/A ,"$2,267.00 ","$1,246.85 ", N/A ,$596.22 ,"$2,267.00 ", N/A , N/A , N/A ,"$1,813.60 ","$1,230.98 ",$634.76 ,"$2,040.30 ", N/A , N/A , N/A ,"$1,088.16 "
ST. MARY'S HOSPITAL - DECATUR,75001093,N/A,HC EGD W/TUMOR ABLATION - 43270,750,1 ,"$5,605.00 ","$3,643.25 ","$1,474.12 ","$5,605.00 ", N/A ,"$2,858.55 ","$3,082.75 ", N/A ,"$1,569.40 ","$2,634.35 ", N/A ,"$3,026.70 ", N/A ,"$3,043.52 ","$3,043.52 ", N/A ,"$3,043.52 ", N/A ,"$3,500.00 ","$2,802.50 ","$4,484.00 ", N/A , N/A ,"$3,923.50 ", N/A ,"$3,363.00 ", N/A ,"$4,203.75 ","$3,093.96 ","$2,791.29 ","$3,093.96 ", N/A ,"$3,093.96 ","$4,371.90 ","$4,371.90 ","$4,764.25 ", N/A ,"$3,884.27 ", N/A ,"$5,605.00 ","$3,082.75 ", N/A ,"$1,474.12 ","$5,605.00 ", N/A , N/A , N/A ,"$4,484.00 ","$3,043.52 ","$1,569.40 ","$5,044.50 ", N/A , N/A , N/A ,"$2,690.40 "
ST. MARY'S HOSPITAL - DECATUR,75001096,N/A,HC ERCP W/SPHINCTEROTOMY - 43262,750,1 ,"$5,762.00 ","$3,745.30 ","$1,515.41 ","$5,762.00 ", N/A ,"$2,938.62 ","$3,169.10 ", N/A ,"$1,613.36 ","$2,708.14 ", N/A ,"$3,111.48 ", N/A ,"$3,128.77 ","$3,128.77 ", N/A ,"$3,128.77 ", N/A ,"$3,500.00 ","$2,881.00 ","$4,609.60 ", N/A , N/A ,"$4,033.40 ", N/A ,"$3,457.20 ", N/A ,"$4,321.50 ","$3,180.62 ","$2,869.48 ","$3,180.62 ", N/A ,"$3,180.62 ","$4,494.36 ","$4,494.36 ","$4,897.70 ", N/A ,"$3,993.07 ", N/A ,"$5,762.00 ","$3,169.10 ", N/A ,"$1,515.41 ","$5,762.00 ", N/A , N/A , N/A ,"$4,609.60 ","$3,128.77 ","$1,613.36 ","$5,185.80 ", N/A , N/A , N/A ,"$2,765.76 "
ST. MARY'S HOSPITAL - DECATUR,75001101,N/A,HC ERCP W/FB OR STENT REMOVAL DUCT - 43275,750,1 ,"$5,893.00 ","$3,830.45 ","$1,549.86 ","$5,893.00 ", N/A ,"$3,005.43 ","$3,241.15 ", N/A ,"$1,650.04 ","$2,769.71 ", N/A ,"$3,182.22 ", N/A ,"$3,199.90 ","$3,199.90 ", N/A ,"$3,199.90 ", N/A ,"$3,500.00 ","$2,946.50 ","$4,714.40 ", N/A , N/A ,"$4,125.10 ", N/A ,"$3,535.80 ", N/A ,"$4,419.75 ","$3,252.94 ","$2,934.71 ","$3,252.94 ", N/A ,"$3,252.94 ","$4,596.54 ","$4,596.54 ","$5,009.05 ", N/A ,"$4,083.85 ", N/A ,"$5,893.00 ","$3,241.15 ", N/A ,"$1,549.86 ","$5,893.00 ", N/A , N/A , N/A ,"$4,714.40 ","$3,199.90 ","$1,650.04 ","$5,303.70 ", N/A , N/A , N/A ,"$2,828.64 "
ST. MARY'S HOSPITAL - DECATUR,75001111,N/A,HC ENTEROSCOPY UPPER SMALL BOWEL - 44360,750,1 ,"$1,034.00 ",$672.10 ,$271.94 ,"$1,034.00 ", N/A ,$527.34 ,$568.70 , N/A ,$289.52 ,$485.98 , N/A ,$558.36 , N/A ,$561.46 ,$561.46 , N/A ,$561.46 , N/A ,$723.80 ,$517.00 ,$827.20 , N/A , N/A ,$723.80 , N/A ,$620.40 , N/A ,$775.50 ,$570.77 ,$514.93 ,$570.77 , N/A ,$570.77 ,$806.52 ,$806.52 ,$878.90 , N/A ,$716.56 , N/A ,"$1,034.00 ",$568.70 , N/A ,$271.94 ,"$1,034.00 ", N/A , N/A , N/A ,$827.20 ,$561.46 ,$289.52 ,$930.60 , N/A , N/A , N/A ,$496.32 
ST. MARY'S HOSPITAL - DECATUR,75001112,N/A,HC ENTEROSCOPY UPR SM BOWEL W/BIOPSY - 44361,750,1 ,"$2,391.00 ","$1,554.15 ",$628.83 ,"$2,391.00 ", N/A ,"$1,219.41 ","$1,315.05 ", N/A ,$669.48 ,"$1,123.77 ", N/A ,"$1,291.14 ", N/A ,"$1,298.31 ","$1,298.31 ", N/A ,"$1,298.31 ", N/A ,"$1,673.70 ","$1,195.50 ","$1,912.80 ", N/A , N/A ,"$1,673.70 ", N/A ,"$1,434.60 ", N/A ,"$1,793.25 ","$1,319.83 ","$1,190.72 ","$1,319.83 ", N/A ,"$1,319.83 ","$1,864.98 ","$1,864.98 ","$2,032.35 ", N/A ,"$1,656.96 ", N/A ,"$2,391.00 ","$1,315.05 ", N/A ,$628.83 ,"$2,391.00 ", N/A , N/A , N/A ,"$1,912.80 ","$1,298.31 ",$669.48 ,"$2,151.90 ", N/A , N/A , N/A ,"$1,147.68 "
ST. MARY'S HOSPITAL - DECATUR,75001115,N/A,HC ENTEROSCOPY W/CONTROL BLEEDING - 44366,750,1 ,"$4,950.00 ","$3,217.50 ","$1,301.85 ","$4,950.00 ", N/A ,"$2,524.50 ","$2,722.50 ", N/A ,"$1,386.00 ","$2,326.50 ", N/A ,"$2,673.00 ", N/A ,"$2,687.85 ","$2,687.85 ", N/A ,"$2,687.85 ", N/A ,"$3,465.00 ","$2,475.00 ","$3,960.00 ", N/A , N/A ,"$3,465.00 ", N/A ,"$2,970.00 ", N/A ,"$3,712.50 ","$2,732.40 ","$2,465.10 ","$2,732.40 ", N/A ,"$2,732.40 ","$3,861.00 ","$3,861.00 ","$4,207.50 ", N/A ,"$3,430.35 ", N/A ,"$4,950.00 ","$2,722.50 ", N/A ,"$1,301.85 ","$4,950.00 ", N/A , N/A , N/A ,"$3,960.00 ","$2,687.85 ","$1,386.00 ","$4,455.00 ", N/A , N/A , N/A ,"$2,376.00 "
ST. MARY'S HOSPITAL - DECATUR,75001116,N/A,HC ENTEROSCOPY W/ABLATION - 44369,750,1 ,"$6,397.00 ","$4,158.05 ","$1,682.41 ","$6,397.00 ", N/A ,"$3,262.47 ","$3,518.35 ", N/A ,"$1,791.16 ","$3,006.59 ", N/A ,"$3,454.38 ", N/A ,"$3,473.57 ","$3,473.57 ", N/A ,"$3,473.57 ", N/A ,"$3,500.00 ","$3,198.50 ","$5,117.60 ", N/A , N/A ,"$4,477.90 ", N/A ,"$3,838.20 ", N/A ,"$4,797.75 ","$3,531.14 ","$3,185.71 ","$3,531.14 ", N/A ,"$3,531.14 ","$4,989.66 ","$4,989.66 ","$5,437.45 ", N/A ,"$4,433.12 ", N/A ,"$6,397.00 ","$3,518.35 ", N/A ,"$1,682.41 ","$6,397.00 ", N/A , N/A , N/A ,"$5,117.60 ","$3,473.57 ","$1,791.16 ","$5,757.30 ", N/A , N/A , N/A ,"$3,070.56 "
ST. MARY'S HOSPITAL - DECATUR,75001123,N/A,HC ENDOSCOPY POUCH DX W/BRUSH/WASH - 44385,750,1 ,"$2,241.00 ","$1,456.65 ",$589.38 ,"$2,241.00 ", N/A ,"$1,142.91 ","$1,232.55 ", N/A ,$627.48 ,"$1,053.27 ", N/A ,"$1,210.14 ", N/A ,"$1,216.86 ","$1,216.86 ", N/A ,"$1,216.86 ", N/A ,"$1,568.70 ","$1,120.50 ","$1,792.80 ", N/A , N/A ,"$1,568.70 ", N/A ,"$1,344.60 ", N/A ,"$1,680.75 ","$1,237.03 ","$1,116.02 ","$1,237.03 ", N/A ,"$1,237.03 ","$1,747.98 ","$1,747.98 ","$1,904.85 ", N/A ,"$1,553.01 ", N/A ,"$2,241.00 ","$1,232.55 ", N/A ,$589.38 ,"$2,241.00 ", N/A , N/A , N/A ,"$1,792.80 ","$1,216.86 ",$627.48 ,"$2,016.90 ", N/A , N/A , N/A ,"$1,075.68 "
ST. MARY'S HOSPITAL - DECATUR,75001124,N/A,HC ENDOSCOPY POUCH W/BIOPSY SGL/MULT - 44386,750,1 ,"$1,287.00 ",$836.55 ,$338.48 ,"$1,287.00 ", N/A ,$656.37 ,$707.85 , N/A ,$360.36 ,$604.89 , N/A ,$694.98 , N/A ,$698.84 ,$698.84 , N/A ,$698.84 , N/A ,$900.90 ,$643.50 ,"$1,029.60 ", N/A , N/A ,$900.90 , N/A ,$772.20 , N/A ,$965.25 ,$710.42 ,$640.93 ,$710.42 , N/A ,$710.42 ,"$1,003.86 ","$1,003.86 ","$1,093.95 ", N/A ,$891.89 , N/A ,"$1,287.00 ",$707.85 , N/A ,$338.48 ,"$1,287.00 ", N/A , N/A , N/A ,"$1,029.60 ",$698.84 ,$360.36 ,"$1,158.30 ", N/A , N/A , N/A ,$617.76 
ST. MARY'S HOSPITAL - DECATUR,75001125,N/A,HC COLONOSCOPY STOMA DX W/BRUSH/WASH - 44388,750,1 ,"$2,391.00 ","$1,554.15 ",$628.83 ,"$2,391.00 ", N/A ,"$1,219.41 ","$1,315.05 ", N/A ,$669.48 ,"$1,123.77 ", N/A ,"$1,291.14 ", N/A ,"$1,298.31 ","$1,298.31 ", N/A ,"$1,298.31 ", N/A ,"$1,673.70 ","$1,195.50 ","$1,912.80 ", N/A , N/A ,"$1,673.70 ", N/A ,"$1,434.60 ", N/A ,"$1,793.25 ","$1,319.83 ","$1,190.72 ","$1,319.83 ", N/A ,"$1,319.83 ","$1,864.98 ","$1,864.98 ","$2,032.35 ", N/A ,"$1,656.96 ", N/A ,"$2,391.00 ","$1,315.05 ", N/A ,$628.83 ,"$2,391.00 ", N/A , N/A , N/A ,"$1,912.80 ","$1,298.31 ",$669.48 ,"$2,151.90 ", N/A , N/A , N/A ,"$1,147.68 "
ST. MARY'S HOSPITAL - DECATUR,75001126,N/A,HC COLONOSCOPY STOMA W/BX SGL/MULT - 44389,750,1 ,"$3,378.00 ","$2,195.70 ",$888.41 ,"$3,378.00 ", N/A ,"$1,722.78 ","$1,857.90 ", N/A ,$945.84 ,"$1,587.66 ", N/A ,"$1,824.12 ", N/A ,"$1,834.25 ","$1,834.25 ", N/A ,"$1,834.25 ", N/A ,"$2,364.60 ","$1,689.00 ","$2,702.40 ", N/A , N/A ,"$2,364.60 ", N/A ,"$2,026.80 ", N/A ,"$2,533.50 ","$1,864.66 ","$1,682.24 ","$1,864.66 ", N/A ,"$1,864.66 ","$2,634.84 ","$2,634.84 ","$2,871.30 ", N/A ,"$2,340.95 ", N/A ,"$3,378.00 ","$1,857.90 ", N/A ,$888.41 ,"$3,378.00 ", N/A , N/A , N/A ,"$2,702.40 ","$1,834.25 ",$945.84 ,"$3,040.20 ", N/A , N/A , N/A ,"$1,621.44 "
ST. MARY'S HOSPITAL - DECATUR,75001130,N/A,HC COLONOSCOPY STOMA W/REM TUMOR SNARE TECH - 44394,750,1 ,"$2,892.00 ","$1,879.80 ",$760.60 ,"$2,892.00 ", N/A ,"$1,474.92 ","$1,590.60 ", N/A ,$809.76 ,"$1,359.24 ", N/A ,"$1,561.68 ", N/A ,"$1,570.36 ","$1,570.36 ", N/A ,"$1,570.36 ", N/A ,"$2,024.40 ","$1,446.00 ","$2,313.60 ", N/A , N/A ,"$2,024.40 ", N/A ,"$1,735.20 ", N/A ,"$2,169.00 ","$1,596.38 ","$1,440.22 ","$1,596.38 ", N/A ,"$1,596.38 ","$2,255.76 ","$2,255.76 ","$2,458.20 ", N/A ,"$2,004.16 ", N/A ,"$2,892.00 ","$1,590.60 ", N/A ,$760.60 ,"$2,892.00 ", N/A , N/A , N/A ,"$2,313.60 ","$1,570.36 ",$809.76 ,"$2,602.80 ", N/A , N/A , N/A ,"$1,388.16 "
ST. MARY'S HOSPITAL - DECATUR,75001139,N/A,HC PROCTOSIGMOIDOSCOPY RIGID DX W/W/O SPECIMEN - 45300,750,1 ,"$5,163.00 ","$3,355.95 ","$1,357.87 ","$5,163.00 ", N/A ,"$2,633.13 ","$2,839.65 ", N/A ,"$1,445.64 ","$2,426.61 ", N/A ,"$2,788.02 ", N/A ,"$2,803.51 ","$2,803.51 ", N/A ,"$2,803.51 ", N/A ,"$3,500.00 ","$2,581.50 ","$4,130.40 ", N/A , N/A ,"$3,614.10 ", N/A ,"$3,097.80 ", N/A ,"$3,872.25 ","$2,849.98 ","$2,571.17 ","$2,849.98 ", N/A ,"$2,849.98 ","$4,027.14 ","$4,027.14 ","$4,388.55 ", N/A ,"$3,577.96 ", N/A ,"$5,163.00 ","$2,839.65 ", N/A ,"$1,357.87 ","$5,163.00 ", N/A , N/A , N/A ,"$4,130.40 ","$2,803.51 ","$1,445.64 ","$4,646.70 ", N/A , N/A , N/A ,"$2,478.24 "
ST. MARY'S HOSPITAL - DECATUR,75001142,N/A,HC SIGMOIDOSCOPY DX W/BRUSH/WASH - 45330,750,1 ,"$1,421.00 ",$923.65 ,$373.72 ,"$1,421.00 ", N/A ,$724.71 ,$781.55 , N/A ,$397.88 ,$667.87 , N/A ,$767.34 , N/A ,$771.60 ,$771.60 , N/A ,$771.60 , N/A ,$994.70 ,$710.50 ,"$1,136.80 ", N/A , N/A ,$994.70 , N/A ,$852.60 , N/A ,"$1,065.75 ",$784.39 ,$707.66 ,$784.39 , N/A ,$784.39 ,"$1,108.38 ","$1,108.38 ","$1,207.85 ", N/A ,$984.75 , N/A ,"$1,421.00 ",$781.55 , N/A ,$373.72 ,"$1,421.00 ", N/A , N/A , N/A ,"$1,136.80 ",$771.60 ,$397.88 ,"$1,278.90 ", N/A , N/A , N/A ,$682.08 
ST. MARY'S HOSPITAL - DECATUR,75001143,N/A,HC SIGMOIDOSCOPY W/BIOPSY SGL/MULT -45331,750,1 ,"$3,004.00 ","$1,952.60 ",$790.05 ,"$3,004.00 ", N/A ,"$1,532.04 ","$1,652.20 ", N/A ,$841.12 ,"$1,411.88 ", N/A ,"$1,622.16 ", N/A ,"$1,631.17 ","$1,631.17 ", N/A ,"$1,631.17 ", N/A ,"$2,102.80 ","$1,502.00 ","$2,403.20 ", N/A , N/A ,"$2,102.80 ", N/A ,"$1,802.40 ", N/A ,"$2,253.00 ","$1,658.21 ","$1,495.99 ","$1,658.21 ", N/A ,"$1,658.21 ","$2,343.12 ","$2,343.12 ","$2,553.40 ", N/A ,"$2,081.77 ", N/A ,"$3,004.00 ","$1,652.20 ", N/A ,$790.05 ,"$3,004.00 ", N/A , N/A , N/A ,"$2,403.20 ","$1,631.17 ",$841.12 ,"$2,703.60 ", N/A , N/A , N/A ,"$1,441.92 "
ST. MARY'S HOSPITAL - DECATUR,75001146,N/A,HC SIGMOIDOSCOPY W/CONTROL BLEEDING - 45334,750,1 ,"$2,391.00 ","$1,554.15 ",$628.83 ,"$2,391.00 ", N/A ,"$1,219.41 ","$1,315.05 ", N/A ,$669.48 ,"$1,123.77 ", N/A ,"$1,291.14 ", N/A ,"$1,298.31 ","$1,298.31 ", N/A ,"$1,298.31 ", N/A ,"$1,673.70 ","$1,195.50 ","$1,912.80 ", N/A , N/A ,"$1,673.70 ", N/A ,"$1,434.60 ", N/A ,"$1,793.25 ","$1,319.83 ","$1,190.72 ","$1,319.83 ", N/A ,"$1,319.83 ","$1,864.98 ","$1,864.98 ","$2,032.35 ", N/A ,"$1,656.96 ", N/A ,"$2,391.00 ","$1,315.05 ", N/A ,$628.83 ,"$2,391.00 ", N/A , N/A , N/A ,"$1,912.80 ","$1,298.31 ",$669.48 ,"$2,151.90 ", N/A , N/A , N/A ,"$1,147.68 "
ST. MARY'S HOSPITAL - DECATUR,75001147,N/A,HC SIGMOIDOSCOPY W/SUBMUCOSAL INJ - 45335,750,1 ,"$2,241.00 ","$1,456.65 ",$589.38 ,"$2,241.00 ", N/A ,"$1,142.91 ","$1,232.55 ", N/A ,$627.48 ,"$1,053.27 ", N/A ,"$1,210.14 ", N/A ,"$1,216.86 ","$1,216.86 ", N/A ,"$1,216.86 ", N/A ,"$1,568.70 ","$1,120.50 ","$1,792.80 ", N/A , N/A ,"$1,568.70 ", N/A ,"$1,344.60 ", N/A ,"$1,680.75 ","$1,237.03 ","$1,116.02 ","$1,237.03 ", N/A ,"$1,237.03 ","$1,747.98 ","$1,747.98 ","$1,904.85 ", N/A ,"$1,553.01 ", N/A ,"$2,241.00 ","$1,232.55 ", N/A ,$589.38 ,"$2,241.00 ", N/A , N/A , N/A ,"$1,792.80 ","$1,216.86 ",$627.48 ,"$2,016.90 ", N/A , N/A , N/A ,"$1,075.68 "
ST. MARY'S HOSPITAL - DECATUR,75001148,N/A,HC SIGMOIDOSCOPY W/DECOMPRESSION -45337,750,1 ,"$4,720.00 ","$3,068.00 ","$1,241.36 ","$4,720.00 ", N/A ,"$2,407.20 ","$2,596.00 ", N/A ,"$1,321.60 ","$2,218.40 ", N/A ,"$2,548.80 ", N/A ,"$2,562.96 ","$2,562.96 ", N/A ,"$2,562.96 ", N/A ,"$3,304.00 ","$2,360.00 ","$3,776.00 ", N/A , N/A ,"$3,304.00 ", N/A ,"$2,832.00 ", N/A ,"$3,540.00 ","$2,605.44 ","$2,350.56 ","$2,605.44 ", N/A ,"$2,605.44 ","$3,681.60 ","$3,681.60 ","$4,012.00 ", N/A ,"$3,270.96 ", N/A ,"$4,720.00 ","$2,596.00 ", N/A ,"$1,241.36 ","$4,720.00 ", N/A , N/A , N/A ,"$3,776.00 ","$2,562.96 ","$1,321.60 ","$4,248.00 ", N/A , N/A , N/A ,"$2,265.60 "
ST. MARY'S HOSPITAL - DECATUR,75001149,N/A,HC SIGMOIDOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45338,750,1 ,"$2,629.00 ","$1,708.85 ",$691.43 ,"$2,629.00 ", N/A ,"$1,340.79 ","$1,445.95 ", N/A ,$736.12 ,"$1,235.63 ", N/A ,"$1,419.66 ", N/A ,"$1,427.55 ","$1,427.55 ", N/A ,"$1,427.55 ", N/A ,"$1,840.30 ","$1,314.50 ","$2,103.20 ", N/A , N/A ,"$1,840.30 ", N/A ,"$1,577.40 ", N/A ,"$1,971.75 ","$1,451.21 ","$1,309.24 ","$1,451.21 ", N/A ,"$1,451.21 ","$2,050.62 ","$2,050.62 ","$2,234.65 ", N/A ,"$1,821.90 ", N/A ,"$2,629.00 ","$1,445.95 ", N/A ,$691.43 ,"$2,629.00 ", N/A , N/A , N/A ,"$2,103.20 ","$1,427.55 ",$736.12 ,"$2,366.10 ", N/A , N/A , N/A ,"$1,261.92 "
ST. MARY'S HOSPITAL - DECATUR,75001150,N/A,HC SIGMOIDOSCOPY W/DILATION - 45340,750,1 ,"$2,142.00 ","$1,392.30 ",$563.35 ,"$2,142.00 ", N/A ,"$1,092.42 ","$1,178.10 ", N/A ,$599.76 ,"$1,006.74 ", N/A ,"$1,156.68 ", N/A ,"$1,163.11 ","$1,163.11 ", N/A ,"$1,163.11 ", N/A ,"$1,499.40 ","$1,071.00 ","$1,713.60 ", N/A , N/A ,"$1,499.40 ", N/A ,"$1,285.20 ", N/A ,"$1,606.50 ","$1,182.38 ","$1,066.72 ","$1,182.38 ", N/A ,"$1,182.38 ","$1,670.76 ","$1,670.76 ","$1,820.70 ", N/A ,"$1,484.41 ", N/A ,"$2,142.00 ","$1,178.10 ", N/A ,$563.35 ,"$2,142.00 ", N/A , N/A , N/A ,"$1,713.60 ","$1,163.11 ",$599.76 ,"$1,927.80 ", N/A , N/A , N/A ,"$1,028.16 "
ST. MARY'S HOSPITAL - DECATUR,75001153,N/A,HC SIGMOIDOSCOPY W/ABLATION TUMOR - 45346,750,1 ,"$3,111.00 ","$2,022.15 ",$818.19 ,"$3,111.00 ", N/A ,"$1,586.61 ","$1,711.05 ", N/A ,$871.08 ,"$1,462.17 ", N/A ,"$1,679.94 ", N/A ,"$1,689.27 ","$1,689.27 ", N/A ,"$1,689.27 ", N/A ,"$2,177.70 ","$1,555.50 ","$2,488.80 ", N/A , N/A ,"$2,177.70 ", N/A ,"$1,866.60 ", N/A ,"$2,333.25 ","$1,717.27 ","$1,549.28 ","$1,717.27 ", N/A ,"$1,717.27 ","$2,426.58 ","$2,426.58 ","$2,644.35 ", N/A ,"$2,155.92 ", N/A ,"$3,111.00 ","$1,711.05 ", N/A ,$818.19 ,"$3,111.00 ", N/A , N/A , N/A ,"$2,488.80 ","$1,689.27 ",$871.08 ,"$2,799.90 ", N/A , N/A , N/A ,"$1,493.28 "
ST. MARY'S HOSPITAL - DECATUR,75001155,N/A,HC SIGMOIDOSCOPY W/ENDO MUCOSAL RESECTION - 45349,750,1 ,"$6,814.00 ","$4,429.10 ","$1,792.08 ","$6,814.00 ", N/A ,"$3,475.14 ","$3,747.70 ", N/A ,"$1,907.92 ","$3,202.58 ", N/A ,"$3,679.56 ", N/A ,"$3,700.00 ","$3,700.00 ", N/A ,"$3,700.00 ", N/A ,"$3,500.00 ","$3,407.00 ","$5,451.20 ", N/A , N/A ,"$4,769.80 ", N/A ,"$4,088.40 ", N/A ,"$5,110.50 ","$3,761.33 ","$3,393.37 ","$3,761.33 ", N/A ,"$3,761.33 ","$5,314.92 ","$5,314.92 ","$5,791.90 ", N/A ,"$4,722.10 ", N/A ,"$6,814.00 ","$3,747.70 ", N/A ,"$1,792.08 ","$6,814.00 ", N/A , N/A , N/A ,"$5,451.20 ","$3,700.00 ","$1,907.92 ","$6,132.60 ", N/A , N/A , N/A ,"$3,270.72 "
ST. MARY'S HOSPITAL - DECATUR,75001156,N/A,HC SIGMOIDOSCOPY W/BAND LIGATION - 45350,750,1 ,"$2,145.00 ","$1,394.25 ",$564.14 ,"$2,145.00 ", N/A ,"$1,093.95 ","$1,179.75 ", N/A ,$600.60 ,"$1,008.15 ", N/A ,"$1,158.30 ", N/A ,"$1,164.74 ","$1,164.74 ", N/A ,"$1,164.74 ", N/A ,"$1,501.50 ","$1,072.50 ","$1,716.00 ", N/A , N/A ,"$1,501.50 ", N/A ,"$1,287.00 ", N/A ,"$1,608.75 ","$1,184.04 ","$1,068.21 ","$1,184.04 ", N/A ,"$1,184.04 ","$1,673.10 ","$1,673.10 ","$1,823.25 ", N/A ,"$1,486.49 ", N/A ,"$2,145.00 ","$1,179.75 ", N/A ,$564.14 ,"$2,145.00 ", N/A , N/A , N/A ,"$1,716.00 ","$1,164.74 ",$600.60 ,"$1,930.50 ", N/A , N/A , N/A ,"$1,029.60 "
ST. MARY'S HOSPITAL - DECATUR,75001157,N/A,HC COLONOSCOPY DX W/SPECIMEN BRUSH/WASH - 45378,750,1 ,"$2,293.00 ","$1,490.45 ",$603.06 ,"$2,293.00 ", N/A ,"$1,169.43 ","$1,261.15 ", N/A ,$642.04 ,"$1,077.71 ", N/A ,"$1,238.22 ", N/A ,"$1,245.10 ","$1,245.10 ", N/A ,"$1,245.10 ", N/A ,"$1,605.10 ","$1,146.50 ","$1,834.40 ", N/A , N/A ,"$1,605.10 ", N/A ,"$1,375.80 ", N/A ,"$1,719.75 ","$1,265.74 ","$1,141.91 ","$1,265.74 ", N/A ,"$1,265.74 ","$1,788.54 ","$1,788.54 ","$1,949.05 ", N/A ,"$1,589.05 ", N/A ,"$2,293.00 ","$1,261.15 ", N/A ,$603.06 ,"$2,293.00 ", N/A , N/A , N/A ,"$1,834.40 ","$1,245.10 ",$642.04 ,"$2,063.70 ", N/A , N/A , N/A ,"$1,100.64 "
ST. MARY'S HOSPITAL - DECATUR,75001159,N/A,HC COLONOSCOPY W/BIOPSY SGL/MULT - 45380,750,1 ,"$3,315.00 ","$2,154.75 ",$871.85 ,"$3,315.00 ", N/A ,"$1,690.65 ","$1,823.25 ", N/A ,$928.20 ,"$1,558.05 ", N/A ,"$1,790.10 ", N/A ,"$1,800.05 ","$1,800.05 ", N/A ,"$1,800.05 ", N/A ,"$2,320.50 ","$1,657.50 ","$2,652.00 ", N/A , N/A ,"$2,320.50 ", N/A ,"$1,989.00 ", N/A ,"$2,486.25 ","$1,829.88 ","$1,650.87 ","$1,829.88 ", N/A ,"$1,829.88 ","$2,585.70 ","$2,585.70 ","$2,817.75 ", N/A ,"$2,297.30 ", N/A ,"$3,315.00 ","$1,823.25 ", N/A ,$871.85 ,"$3,315.00 ", N/A , N/A , N/A ,"$2,652.00 ","$1,800.05 ",$928.20 ,"$2,983.50 ", N/A , N/A , N/A ,"$1,591.20 "
ST. MARY'S HOSPITAL - DECATUR,75001160,N/A,HC COLONOSCOPY W/SUBMUCOSAL INJ - 45381,750,1 ,"$3,032.00 ","$1,970.80 ",$797.42 ,"$3,032.00 ", N/A ,"$1,546.32 ","$1,667.60 ", N/A ,$848.96 ,"$1,425.04 ", N/A ,"$1,637.28 ", N/A ,"$1,646.38 ","$1,646.38 ", N/A ,"$1,646.38 ", N/A ,"$2,122.40 ","$1,516.00 ","$2,425.60 ", N/A , N/A ,"$2,122.40 ", N/A ,"$1,819.20 ", N/A ,"$2,274.00 ","$1,673.66 ","$1,509.94 ","$1,673.66 ", N/A ,"$1,673.66 ","$2,364.96 ","$2,364.96 ","$2,577.20 ", N/A ,"$2,101.18 ", N/A ,"$3,032.00 ","$1,667.60 ", N/A ,$797.42 ,"$3,032.00 ", N/A , N/A , N/A ,"$2,425.60 ","$1,646.38 ",$848.96 ,"$2,728.80 ", N/A , N/A , N/A ,"$1,455.36 "
ST. MARY'S HOSPITAL - DECATUR,75001161,N/A,HC COLONOSCOPY W/CONTROL BLEEDING - 45382,750,1 ,"$3,376.00 ","$2,194.40 ",$887.89 ,"$3,376.00 ", N/A ,"$1,721.76 ","$1,856.80 ", N/A ,$945.28 ,"$1,586.72 ", N/A ,"$1,823.04 ", N/A ,"$1,833.17 ","$1,833.17 ", N/A ,"$1,833.17 ", N/A ,"$2,363.20 ","$1,688.00 ","$2,700.80 ", N/A , N/A ,"$2,363.20 ", N/A ,"$2,025.60 ", N/A ,"$2,532.00 ","$1,863.55 ","$1,681.25 ","$1,863.55 ", N/A ,"$1,863.55 ","$2,633.28 ","$2,633.28 ","$2,869.60 ", N/A ,"$2,339.57 ", N/A ,"$3,376.00 ","$1,856.80 ", N/A ,$887.89 ,"$3,376.00 ", N/A , N/A , N/A ,"$2,700.80 ","$1,833.17 ",$945.28 ,"$3,038.40 ", N/A , N/A , N/A ,"$1,620.48 "
ST. MARY'S HOSPITAL - DECATUR,75001162,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN HOT BIOPSY - 45384,750,1 ,"$4,169.00 ","$2,709.85 ","$1,096.45 ","$4,169.00 ", N/A ,"$2,126.19 ","$2,292.95 ", N/A ,"$1,167.32 ","$1,959.43 ", N/A ,"$2,251.26 ", N/A ,"$2,263.77 ","$2,263.77 ", N/A ,"$2,263.77 ", N/A ,"$2,918.30 ","$2,084.50 ","$3,335.20 ", N/A , N/A ,"$2,918.30 ", N/A ,"$2,501.40 ", N/A ,"$3,126.75 ","$2,301.29 ","$2,076.16 ","$2,301.29 ", N/A ,"$2,301.29 ","$3,251.82 ","$3,251.82 ","$3,543.65 ", N/A ,"$2,889.12 ", N/A ,"$4,169.00 ","$2,292.95 ", N/A ,"$1,096.45 ","$4,169.00 ", N/A , N/A , N/A ,"$3,335.20 ","$2,263.77 ","$1,167.32 ","$3,752.10 ", N/A , N/A , N/A ,"$2,001.12 "
ST. MARY'S HOSPITAL - DECATUR,75001163,N/A,HC COLONOSCOPY W/REM TUMOR/POLYP/LESN SNARE TECH - 45385,750,1 ,"$3,411.00 ","$2,217.15 ",$897.09 ,"$3,411.00 ", N/A ,"$1,739.61 ","$1,876.05 ", N/A ,$955.08 ,"$1,603.17 ", N/A ,"$1,841.94 ", N/A ,"$1,852.17 ","$1,852.17 ", N/A ,"$1,852.17 ", N/A ,"$2,387.70 ","$1,705.50 ","$2,728.80 ", N/A , N/A ,"$2,387.70 ", N/A ,"$2,046.60 ", N/A ,"$2,558.25 ","$1,882.87 ","$1,698.68 ","$1,882.87 ", N/A ,"$1,882.87 ","$2,660.58 ","$2,660.58 ","$2,899.35 ", N/A ,"$2,363.82 ", N/A ,"$3,411.00 ","$1,876.05 ", N/A ,$897.09 ,"$3,411.00 ", N/A , N/A , N/A ,"$2,728.80 ","$1,852.17 ",$955.08 ,"$3,069.90 ", N/A , N/A , N/A ,"$1,637.28 "
ST. MARY'S HOSPITAL - DECATUR,75001165,N/A,HC COLONOSCOPY W/ABLATION TUMOR - 45388,750,1 ,"$4,185.00 ","$2,720.25 ","$1,100.66 ","$4,185.00 ", N/A ,"$2,134.35 ","$2,301.75 ", N/A ,"$1,171.80 ","$1,966.95 ", N/A ,"$2,259.90 ", N/A ,"$2,272.46 ","$2,272.46 ", N/A ,"$2,272.46 ", N/A ,"$2,929.50 ","$2,092.50 ","$3,348.00 ", N/A , N/A ,"$2,929.50 ", N/A ,"$2,511.00 ", N/A ,"$3,138.75 ","$2,310.12 ","$2,084.13 ","$2,310.12 ", N/A ,"$2,310.12 ","$3,264.30 ","$3,264.30 ","$3,557.25 ", N/A ,"$2,900.21 ", N/A ,"$4,185.00 ","$2,301.75 ", N/A ,"$1,100.66 ","$4,185.00 ", N/A , N/A , N/A ,"$3,348.00 ","$2,272.46 ","$1,171.80 ","$3,766.50 ", N/A , N/A , N/A ,"$2,008.80 "
ST. MARY'S HOSPITAL - DECATUR,75001167,N/A,HC COLONOSCOPY W/MUCOSAL RESECTION - 45390,750,1 ,"$5,001.00 ","$3,250.65 ","$1,315.26 ","$5,001.00 ", N/A ,"$2,550.51 ","$2,750.55 ", N/A ,"$1,400.28 ","$2,350.47 ", N/A ,"$2,700.54 ", N/A ,"$2,715.54 ","$2,715.54 ", N/A ,"$2,715.54 ", N/A ,"$3,500.00 ","$2,500.50 ","$4,000.80 ", N/A , N/A ,"$3,500.70 ", N/A ,"$3,000.60 ", N/A ,"$3,750.75 ","$2,760.55 ","$2,490.50 ","$2,760.55 ", N/A ,"$2,760.55 ","$3,900.78 ","$3,900.78 ","$4,250.85 ", N/A ,"$3,465.69 ", N/A ,"$5,001.00 ","$2,750.55 ", N/A ,"$1,315.26 ","$5,001.00 ", N/A , N/A , N/A ,"$4,000.80 ","$2,715.54 ","$1,400.28 ","$4,500.90 ", N/A , N/A , N/A ,"$2,400.48 "
ST. MARY'S HOSPITAL - DECATUR,75001171,N/A,HC COLONOSCOPY W/BAND LIGATION - 45398,750,1 ,"$3,378.00 ","$2,195.70 ",$888.41 ,"$3,378.00 ", N/A ,"$1,722.78 ","$1,857.90 ", N/A ,$945.84 ,"$1,587.66 ", N/A ,"$1,824.12 ", N/A ,"$1,834.25 ","$1,834.25 ", N/A ,"$1,834.25 ", N/A ,"$2,364.60 ","$1,689.00 ","$2,702.40 ", N/A , N/A ,"$2,364.60 ", N/A ,"$2,026.80 ", N/A ,"$2,533.50 ","$1,864.66 ","$1,682.24 ","$1,864.66 ", N/A ,"$1,864.66 ","$2,634.84 ","$2,634.84 ","$2,871.30 ", N/A ,"$2,340.95 ", N/A ,"$3,378.00 ","$1,857.90 ", N/A ,$888.41 ,"$3,378.00 ", N/A , N/A , N/A ,"$2,702.40 ","$1,834.25 ",$945.84 ,"$3,040.20 ", N/A , N/A , N/A ,"$1,621.44 "
ST. MARY'S HOSPITAL - DECATUR,75001173,N/A,HC HERMORRHOIDECTOMY INTERNAL W/LIGATION - 46221,750,1 ,"$3,912.00 ","$2,542.80 ","$1,028.86 ","$3,912.00 ", N/A ,"$1,995.12 ","$2,151.60 ", N/A ,"$1,095.36 ","$1,838.64 ", N/A ,"$2,112.48 ", N/A ,"$2,124.22 ","$2,124.22 ", N/A ,"$2,124.22 ", N/A ,"$2,738.40 ","$1,956.00 ","$3,129.60 ", N/A , N/A ,"$2,738.40 ", N/A ,"$2,347.20 ", N/A ,"$2,934.00 ","$2,159.42 ","$1,948.18 ","$2,159.42 ", N/A ,"$2,159.42 ","$3,051.36 ","$3,051.36 ","$3,325.20 ", N/A ,"$2,711.02 ", N/A ,"$3,912.00 ","$2,151.60 ", N/A ,"$1,028.86 ","$3,912.00 ", N/A , N/A , N/A ,"$3,129.60 ","$2,124.22 ","$1,095.36 ","$3,520.80 ", N/A , N/A , N/A ,"$1,877.76 "
ST. MARY'S HOSPITAL - DECATUR,75001180,N/A,HC PLACE GASTROSTOMY TUBE PERC W/GUID - 49440,750,1 ,"$3,378.00 ","$2,195.70 ",$888.41 ,"$3,378.00 ", N/A ,"$1,722.78 ","$1,857.90 ", N/A ,$945.84 ,"$1,587.66 ", N/A ,"$1,824.12 ", N/A ,"$1,834.25 ","$1,834.25 ", N/A ,"$1,834.25 ", N/A ,"$2,364.60 ","$1,689.00 ","$2,702.40 ", N/A , N/A ,"$2,364.60 ", N/A ,"$2,026.80 ", N/A ,"$2,533.50 ","$1,864.66 ","$1,682.24 ","$1,864.66 ", N/A ,"$1,864.66 ","$2,634.84 ","$2,634.84 ","$2,871.30 ", N/A ,"$2,340.95 ", N/A ,"$3,378.00 ","$1,857.90 ", N/A ,$888.41 ,"$3,378.00 ", N/A , N/A , N/A ,"$2,702.40 ","$1,834.25 ",$945.84 ,"$3,040.20 ", N/A , N/A , N/A ,"$1,621.44 "
ST. MARY'S HOSPITAL - DECATUR,75001196,91110,HC IMAGE GI TRACT ESPOH THRU ILIEM W/REPORT- 91110,750,1 ,"$3,925.00 ","$2,551.25 ",$765.95 ,"$3,925.00 ","$1,914.88 ","$2,001.75 ","$2,158.75 ",$765.95 ,"$1,099.00 ","$1,923.25 ",$765.95 ,"$2,296.13 ",$765.95 ,"$2,131.28 ","$2,131.28 ",$765.95 ,"$2,131.28 ","$1,455.30 ","$2,747.50 ","$1,962.50 ","$3,140.00 ","$1,914.87 ",$765.95 ,"$2,747.50 ",$765.95 ,"$2,355.00 ",$765.95 ,"$2,943.75 ","$2,166.60 ","$1,954.65 ","$2,166.60 ",$765.95 ,"$2,166.60 ","$3,061.50 ","$3,061.50 ","$3,336.25 ","$1,914.87 ","$2,720.03 ",$765.95 ,"$3,925.00 ","$2,158.75 ",$765.95 ,"$1,032.28 ","$3,925.00 ","$1,597.96 ","$1,525.32 ",$804.25 ,"$3,140.00 ","$2,131.28 ","$1,099.00 ","$3,532.50 ","$1,795.00 ","$2,100.00 ",$765.95 ,"$1,884.00 "
ST. MARY'S HOSPITAL - DECATUR,75001200,G0104,HC COLONOSCOPY SCREEN W/FLEX SIGMOID - G0104,750,1 ,"$3,560.00 ","$2,314.00 ",$437.97 ,"$3,560.00 ","$1,878.00 ","$2,800.00 ","$1,958.00 ",$751.20 ,$996.80 ,$931.79 ,$751.20 ,$931.79 ,$751.20 ,"$1,933.08 ","$1,933.08 ",$751.20 ,"$1,933.08 ","$1,427.28 ","$2,492.00 ","$1,780.00 ","$2,848.00 ","$1,878.00 ",$751.20 ,"$2,492.00 ",$751.20 ,"$2,136.00 ",$751.20 ,"$2,670.00 ","$1,965.12 ","$1,772.88 ","$1,965.12 ",$751.20 ,"$1,965.12 ","$2,776.80 ","$2,776.80 ","$3,026.00 ","$1,878.00 ","$2,467.08 ",$751.20 ,"$3,560.00 ","$1,958.00 ",$751.20 ,$936.28 ,"$3,560.00 ",$458.82 ,$437.97 ,$788.76 ,"$2,848.00 ","$1,933.08 ",$996.80 ,"$3,204.00 ","$1,483.00 ","$1,666.00 ",$751.20 ,"$1,708.80 "
ST. MARY'S HOSPITAL - DECATUR,75001213,G0455,HC FECAL MICROBIOTA PREP INSTIL- G0455,750,1 ,"$2,429.00 ","$1,578.85 ",$638.83 ,"$2,429.00 ","$1,914.88 ","$2,429.00 ","$1,335.95 ",$765.95 ,$680.12 ,"$1,141.63 ",$765.95 ,"$1,311.66 ",$765.95 ,"$1,318.95 ","$1,318.95 ",$765.95 ,"$1,318.95 ","$1,455.30 ","$1,700.30 ","$1,214.50 ","$1,943.20 ","$1,914.87 ",$765.95 ,"$1,700.30 ",$765.95 ,"$1,457.40 ",$765.95 ,"$1,821.75 ","$1,340.81 ","$1,209.64 ","$1,340.81 ",$765.95 ,"$1,340.81 ","$1,894.62 ","$1,894.62 ","$2,064.65 ","$1,914.87 ","$1,683.30 ",$765.95 ,"$2,429.00 ","$1,335.95 ",$765.95 ,$638.83 ,"$2,429.00 ", N/A , N/A ,$804.25 ,"$1,943.20 ","$1,318.95 ",$680.12 ,"$2,186.10 ", N/A , N/A ,$765.95 ,"$1,165.92 "
ST. MARY'S HOSPITAL - DECATUR,75001223,N/A,HC SMALL BOWEL ENDOSCOPY- 44378,750,1 ,"$5,069.00 ","$3,294.85 ","$1,333.15 ","$5,069.00 ", N/A ,"$2,585.19 ","$2,787.95 ", N/A ,"$1,419.32 ","$2,382.43 ", N/A ,"$2,737.26 ", N/A ,"$2,752.47 ","$2,752.47 ", N/A ,"$2,752.47 ", N/A ,"$3,500.00 ","$2,534.50 ","$4,055.20 ", N/A , N/A ,"$3,548.30 ", N/A ,"$3,041.40 ", N/A ,"$3,801.75 ","$2,798.09 ","$2,524.36 ","$2,798.09 ", N/A ,"$2,798.09 ","$3,953.82 ","$3,953.82 ","$4,308.65 ", N/A ,"$3,512.82 ", N/A ,"$5,069.00 ","$2,787.95 ", N/A ,"$1,333.15 ","$5,069.00 ", N/A , N/A , N/A ,"$4,055.20 ","$2,752.47 ","$1,419.32 ","$4,562.10 ", N/A , N/A , N/A ,"$2,433.12 "
ST. MARY'S HOSPITAL - DECATUR,76000012,36514,HC PLASMAPHERESIS THERAPY,361,1 ,"$6,955.00 ","$4,520.75 ","$1,291.13 ","$6,955.00 ","$3,227.83 ","$3,500.00 ","$3,825.25 ","$1,291.13 ","$1,947.40 ","$3,268.85 ","$1,291.13 ","$3,755.70 ","$1,291.13 ","$3,776.57 ","$3,776.57 ","$1,291.13 ","$3,776.57 ","$2,453.16 ","$3,500.00 ","$3,477.50 ","$5,564.00 ","$3,227.84 ","$1,291.13 ","$4,868.50 ","$1,291.13 ","$4,173.00 ","$1,291.13 ","$5,216.25 ","$3,839.16 ","$3,463.59 ","$3,839.16 ","$1,291.13 ","$3,839.16 ","$5,424.90 ","$5,424.90 ","$5,911.75 ","$3,227.84 ","$4,819.82 ","$1,291.13 ","$6,955.00 ","$3,825.25 ","$1,291.13 ","$1,829.17 ","$6,955.00 ","$1,808.87 ","$1,726.65 ","$1,355.69 ","$5,564.00 ","$3,776.57 ","$1,947.40 ","$6,259.50 ","$1,795.00 ","$2,100.00 ","$1,291.13 ","$3,338.40 "
ST. MARY'S HOSPITAL - DECATUR,76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$1,551.00 ","$1,008.15 ",$407.91 ,"$1,551.00 ","$1,502.73 ",$791.01 ,$853.05 ,$601.09 ,$434.28 ,$728.97 ,$601.09 ,$837.54 ,$601.09 ,$842.19 ,$842.19 ,$601.09 ,$842.19 ,"$1,142.07 ","$1,085.70 ",$775.50 ,"$1,240.80 ","$1,502.72 ",$601.09 ,"$1,085.70 ",$601.09 ,$930.60 ,$601.09 ,"$1,163.25 ",$856.15 ,$772.40 ,$856.15 ,$601.09 ,$856.15 ,"$1,209.78 ","$1,209.78 ","$1,318.35 ","$1,502.72 ","$1,074.84 ",$601.09 ,"$1,551.00 ",$853.05 ,$601.09 ,$407.91 ,"$1,551.00 ",$557.90 ,$532.54 ,$631.14 ,"$1,240.80 ",$842.19 ,$434.28 ,"$1,395.90 ",$589.38 ,"$1,008.15 ",$601.09 ,$744.48 
ST. MARY'S HOSPITAL - DECATUR,76100006,64447,HC INJ ANES NERVE FEMORAL SINGLE-BI,761,1 ,"$2,368.00 ","$1,539.20 ",$135.68 ,"$2,368.00 ","$2,254.08 ","$1,207.68 ","$1,302.40 ",$901.63 ,$663.04 ,"$1,112.96 ",$901.63 ,"$1,278.72 ",$901.63 ,"$1,285.82 ",$135.68 ,$901.63 ,"$1,285.82 ","$1,713.10 ","$1,657.60 ","$1,184.00 ","$1,894.40 ","$2,254.08 ",$901.63 ,"$1,657.60 ",$901.63 ,"$1,420.80 ",$901.63 ,"$1,776.00 ","$1,307.14 ","$1,179.26 ","$1,307.14 ",$901.63 ,"$1,307.14 ","$1,847.04 ","$1,847.04 ","$2,012.80 ","$2,254.08 ","$1,641.02 ",$901.63 ,"$2,368.00 ","$1,302.40 ",$901.63 ,$622.78 ,"$2,368.00 ",$461.42 ,$440.44 ,$946.71 ,"$1,894.40 ","$1,285.82 ",$663.04 ,"$2,131.20 ",$899.84 ,$650.00 ,$901.63 ,"$1,136.64 "
ST. MARY'S HOSPITAL - DECATUR,76100007,64447,HC INJ ANES NERVE FEMORAL SINGLE-LT,761,1 ,"$2,368.00 ","$1,539.20 ",$135.68 ,"$2,368.00 ","$1,502.73 ","$1,207.68 ","$1,302.40 ",$601.09 ,$663.04 ,"$1,112.96 ",$601.09 ,"$1,278.72 ",$601.09 ,"$1,285.82 ",$135.68 ,$601.09 ,"$1,285.82 ","$1,142.07 ","$1,657.60 ","$1,184.00 ","$1,894.40 ","$1,502.72 ",$601.09 ,"$1,657.60 ",$601.09 ,"$1,420.80 ",$601.09 ,"$1,776.00 ","$1,307.14 ","$1,179.26 ","$1,307.14 ",$601.09 ,"$1,307.14 ","$1,847.04 ","$1,847.04 ","$2,012.80 ","$1,502.72 ","$1,641.02 ",$601.09 ,"$2,368.00 ","$1,302.40 ",$601.09 ,$622.78 ,"$2,368.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,894.40 ","$1,285.82 ",$663.04 ,"$2,131.20 ",$899.84 ,$650.00 ,$601.09 ,"$1,136.64 "
ST. MARY'S HOSPITAL - DECATUR,76100008,64447,HC INJ ANES NERVE FEMORAL SINGLE-RT,761,1 ,"$2,368.00 ","$1,539.20 ",$135.68 ,"$2,368.00 ","$1,502.73 ","$1,207.68 ","$1,302.40 ",$601.09 ,$663.04 ,"$1,112.96 ",$601.09 ,"$1,278.72 ",$601.09 ,"$1,285.82 ",$135.68 ,$601.09 ,"$1,285.82 ","$1,142.07 ","$1,657.60 ","$1,184.00 ","$1,894.40 ","$1,502.72 ",$601.09 ,"$1,657.60 ",$601.09 ,"$1,420.80 ",$601.09 ,"$1,776.00 ","$1,307.14 ","$1,179.26 ","$1,307.14 ",$601.09 ,"$1,307.14 ","$1,847.04 ","$1,847.04 ","$2,012.80 ","$1,502.72 ","$1,641.02 ",$601.09 ,"$2,368.00 ","$1,302.40 ",$601.09 ,$622.78 ,"$2,368.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,894.40 ","$1,285.82 ",$663.04 ,"$2,131.20 ",$899.84 ,$650.00 ,$601.09 ,"$1,136.64 "
ST. MARY'S HOSPITAL - DECATUR,76100009,64425,HC INJ ANES NERVE ILIOINGUINAL-LT,761,1 ,"$2,245.00 ","$1,459.25 ",$190.98 ,"$2,245.00 ","$1,502.73 ","$1,144.95 ","$1,234.75 ",$601.09 ,$628.60 ,"$1,055.15 ",$601.09 ,"$1,212.30 ",$601.09 ,"$1,219.04 ",$190.98 ,$601.09 ,"$1,219.04 ","$1,142.07 ","$1,571.50 ","$1,122.50 ","$1,796.00 ","$1,502.72 ",$601.09 ,"$1,571.50 ",$601.09 ,"$1,347.00 ",$601.09 ,"$1,683.75 ","$1,239.24 ","$1,118.01 ","$1,239.24 ",$601.09 ,"$1,239.24 ","$1,751.10 ","$1,751.10 ","$1,908.25 ","$1,502.72 ","$1,555.79 ",$601.09 ,"$2,245.00 ","$1,234.75 ",$601.09 ,$590.44 ,"$2,245.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,796.00 ","$1,219.04 ",$628.60 ,"$2,020.50 ",$853.10 ,$650.00 ,$601.09 ,"$1,077.60 "
ST. MARY'S HOSPITAL - DECATUR,76100010,64425,HC INJ ANES NERVE ILIOINGUINAL-RT,761,1 ,"$2,245.00 ","$1,459.25 ",$190.98 ,"$2,245.00 ","$1,502.73 ","$1,144.95 ","$1,234.75 ",$601.09 ,$628.60 ,"$1,055.15 ",$601.09 ,"$1,212.30 ",$601.09 ,"$1,219.04 ",$190.98 ,$601.09 ,"$1,219.04 ","$1,142.07 ","$1,571.50 ","$1,122.50 ","$1,796.00 ","$1,502.72 ",$601.09 ,"$1,571.50 ",$601.09 ,"$1,347.00 ",$601.09 ,"$1,683.75 ","$1,239.24 ","$1,118.01 ","$1,239.24 ",$601.09 ,"$1,239.24 ","$1,751.10 ","$1,751.10 ","$1,908.25 ","$1,502.72 ","$1,555.79 ",$601.09 ,"$2,245.00 ","$1,234.75 ",$601.09 ,$590.44 ,"$2,245.00 ",$307.62 ,$293.63 ,$631.14 ,"$1,796.00 ","$1,219.04 ",$628.60 ,"$2,020.50 ",$853.10 ,$650.00 ,$601.09 ,"$1,077.60 "
ST. MARY'S HOSPITAL - DECATUR,76100011,64450,HC INJ ANES NERVE PERIPHERAL-BI,761,1 ,"$1,890.00 ","$1,228.50 ",$127.30 ,"$2,254.08 ","$2,254.08 ",$963.90 ,"$1,039.50 ",$901.63 ,$529.20 ,$888.30 ,$901.63 ,"$1,020.60 ",$901.63 ,"$1,026.27 ",$127.30 ,$901.63 ,"$1,026.27 ","$1,713.10 ","$1,323.00 ",$945.00 ,"$1,512.00 ","$2,254.08 ",$901.63 ,"$1,323.00 ",$901.63 ,"$1,134.00 ",$901.63 ,"$1,417.50 ","$1,043.28 ",$941.22 ,"$1,043.28 ",$901.63 ,"$1,043.28 ","$1,474.20 ","$1,474.20 ","$1,606.50 ","$1,890.00 ","$1,309.77 ",$901.63 ,"$1,890.00 ","$1,039.50 ",$901.63 ,$497.07 ,"$1,890.00 ",$461.42 ,$440.44 ,$946.71 ,"$1,512.00 ","$1,026.27 ",$529.20 ,"$1,701.00 ",$718.20 ,$650.00 ,$901.63 ,$907.20 
ST. MARY'S HOSPITAL - DECATUR,76100015,64405,HC INJ ANES NERVE GREAT OCCIPITAL-BI,761,1 ,"$4,530.00 ","$2,944.50 ",$109.96 ,"$4,530.00 ",$927.43 ,"$2,310.30 ","$2,491.50 ",$370.97 ,"$1,268.40 ","$2,129.10 ",$370.97 ,"$2,446.20 ",$370.97 ,"$2,459.79 ",$109.96 ,$370.97 ,"$2,459.79 ",$704.85 ,"$3,171.00 ","$2,265.00 ","$3,624.00 ",$927.43 ,$370.97 ,"$3,171.00 ",$370.97 ,"$2,718.00 ",$370.97 ,"$3,397.50 ","$2,500.56 ","$2,255.94 ","$2,500.56 ",$370.97 ,"$2,500.56 ","$3,533.40 ","$3,533.40 ","$3,850.50 ",$927.43 ,"$3,139.29 ",$370.97 ,"$4,530.00 ","$2,491.50 ",$370.97 ,"$1,191.39 ","$4,530.00 ",$461.42 ,$440.44 ,$389.52 ,"$3,624.00 ","$2,459.79 ","$1,268.40 ","$4,077.00 ","$1,721.40 ",$650.00 ,$370.97 ,"$2,174.40 "
ST. MARY'S HOSPITAL - DECATUR,76100016,64405,HC INJ ANES NERVE GREAT OCCIPITAL-LT,761,1 ,"$4,530.00 ","$2,944.50 ",$109.96 ,"$4,530.00 ",$618.28 ,"$2,310.30 ","$2,491.50 ",$247.31 ,"$1,268.40 ","$2,129.10 ",$247.31 ,"$2,446.20 ",$247.31 ,"$2,459.79 ",$109.96 ,$247.31 ,"$2,459.79 ",$469.90 ,"$3,171.00 ","$2,265.00 ","$3,624.00 ",$618.29 ,$247.31 ,"$3,171.00 ",$247.31 ,"$2,718.00 ",$247.31 ,"$3,397.50 ","$2,500.56 ","$2,255.94 ","$2,500.56 ",$247.31 ,"$2,500.56 ","$3,533.40 ","$3,533.40 ","$3,850.50 ",$618.29 ,"$3,139.29 ",$247.31 ,"$4,530.00 ","$2,491.50 ",$247.31 ,"$1,191.39 ","$4,530.00 ",$307.62 ,$293.63 ,$259.68 ,"$3,624.00 ","$2,459.79 ","$1,268.40 ","$4,077.00 ","$1,721.40 ",$650.00 ,$247.31 ,"$2,174.40 "
ST. MARY'S HOSPITAL - DECATUR,76100017,64405,HC INJ ANES NERVE GREAT OCCIPITAL-RT,761,1 ,"$4,530.00 ","$2,944.50 ",$109.96 ,"$4,530.00 ",$618.28 ,"$2,310.30 ","$2,491.50 ",$247.31 ,"$1,268.40 ","$2,129.10 ",$247.31 ,"$2,446.20 ",$247.31 ,"$2,459.79 ",$109.96 ,$247.31 ,"$2,459.79 ",$469.90 ,"$3,171.00 ","$2,265.00 ","$3,624.00 ",$618.29 ,$247.31 ,"$3,171.00 ",$247.31 ,"$2,718.00 ",$247.31 ,"$3,397.50 ","$2,500.56 ","$2,255.94 ","$2,500.56 ",$247.31 ,"$2,500.56 ","$3,533.40 ","$3,533.40 ","$3,850.50 ",$618.29 ,"$3,139.29 ",$247.31 ,"$4,530.00 ","$2,491.50 ",$247.31 ,"$1,191.39 ","$4,530.00 ",$307.62 ,$293.63 ,$259.68 ,"$3,624.00 ","$2,459.79 ","$1,268.40 ","$4,077.00 ","$1,721.40 ",$650.00 ,$247.31 ,"$2,174.40 "
ST. MARY'S HOSPITAL - DECATUR,76100018,G0260,HC INJ ARTHROGRAM SACROILIAC-BI,761,1 ,"$8,066.00 ","$5,242.90 ",$216.13 ,"$8,066.00 ","$1,502.73 ","$4,113.66 ","$4,436.30 ",$601.09 ,"$2,258.48 ","$3,791.02 ",$601.09 ,"$4,355.64 ",$601.09 ,"$4,379.84 ","$3,226.40 ",$601.09 ,"$4,379.84 ","$1,142.07 ","$5,646.20 ","$4,033.00 ","$6,452.80 ","$1,502.72 ",$601.09 ,"$5,646.20 ",$601.09 ,"$4,839.60 ",$601.09 ,"$6,049.50 ","$2,754.00 ","$2,478.00 ","$2,754.00 ",$601.09 ,"$2,754.00 ","$6,291.48 ","$6,291.48 ","$6,856.10 ","$1,502.72 ","$5,589.74 ",$601.09 ,"$8,066.00 ","$4,436.30 ",$601.09 ,"$2,121.36 ","$8,066.00 ",$226.42 ,$216.13 ,$631.14 ,"$6,452.80 ","$4,379.84 ","$2,258.48 ","$7,259.40 ","$3,065.08 ",$650.00 ,$601.09 ,"$3,871.68 "
ST. MARY'S HOSPITAL - DECATUR,76100019,G0260,HC INJ ARTHROGRAM SACROILIAC-LT,761,1 ,"$5,377.00 ","$3,495.05 ",$216.13 ,"$5,377.00 ","$1,502.73 ","$2,742.27 ","$2,957.35 ",$601.09 ,"$1,505.56 ","$2,527.19 ",$601.09 ,"$2,903.58 ",$601.09 ,"$2,919.71 ","$2,150.80 ",$601.09 ,"$2,919.71 ","$1,142.07 ","$3,763.90 ","$2,688.50 ","$4,301.60 ","$1,502.72 ",$601.09 ,"$3,763.90 ",$601.09 ,"$3,226.20 ",$601.09 ,"$4,032.75 ","$2,754.00 ","$2,478.00 ","$2,754.00 ",$601.09 ,"$2,754.00 ","$4,194.06 ","$4,194.06 ","$4,570.45 ","$1,502.72 ","$3,726.26 ",$601.09 ,"$5,377.00 ","$2,957.35 ",$601.09 ,"$1,414.15 ","$5,377.00 ",$226.42 ,$216.13 ,$631.14 ,"$4,301.60 ","$2,919.71 ","$1,505.56 ","$4,839.30 ","$2,043.26 ",$650.00 ,$601.09 ,"$2,580.96 "
ST. MARY'S HOSPITAL - DECATUR,76100020,G0260,HC INJ ARTHROGRAM SACROILIAC-RT,761,1 ,"$5,377.00 ","$3,495.05 ",$216.13 ,"$5,377.00 ","$1,502.73 ","$2,742.27 ","$2,957.35 ",$601.09 ,"$1,505.56 ","$2,527.19 ",$601.09 ,"$2,903.58 ",$601.09 ,"$2,919.71 ","$2,150.80 ",$601.09 ,"$2,919.71 ","$1,142.07 ","$3,763.90 ","$2,688.50 ","$4,301.60 ","$1,502.72 ",$601.09 ,"$3,763.90 ",$601.09 ,"$3,226.20 ",$601.09 ,"$4,032.75 ","$2,754.00 ","$2,478.00 ","$2,754.00 ",$601.09 ,"$2,754.00 ","$4,194.06 ","$4,194.06 ","$4,570.45 ","$1,502.72 ","$3,726.26 ",$601.09 ,"$5,377.00 ","$2,957.35 ",$601.09 ,"$1,414.15 ","$5,377.00 ",$226.42 ,$216.13 ,$631.14 ,"$4,301.60 ","$2,919.71 ","$1,505.56 ","$4,839.30 ","$2,043.26 ",$650.00 ,$601.09 ,"$2,580.96 "
ST. MARY'S HOSPITAL - DECATUR,76100021,64484,HC INJ EPID LUMBAR/SACRAL ADDL,761,1 ,"$2,331.00 ","$1,515.15 ",$104.58 ,"$2,331.00 ", N/A ,"$1,188.81 ","$1,282.05 ", N/A ,$652.68 ,"$1,095.57 ", N/A ,"$1,258.74 ", N/A ,"$1,265.73 ",$104.58 , N/A ,"$1,265.73 ", N/A ,"$1,631.70 ","$1,165.50 ","$1,864.80 ", N/A , N/A ,"$1,631.70 ", N/A ,"$1,398.60 ", N/A ,"$1,748.25 ","$1,286.71 ","$1,160.84 ","$1,286.71 ", N/A ,"$1,286.71 ","$1,818.18 ","$1,818.18 ","$1,981.35 ", N/A ,"$1,615.38 ", N/A ,"$2,331.00 ","$1,282.05 ", N/A ,$613.05 ,"$2,331.00 ",$557.90 ,$532.54 , N/A ,"$1,864.80 ","$1,265.73 ",$652.68 ,"$2,097.90 ",$885.78 ,$650.00 , N/A ,"$1,118.88 "
ST. MARY'S HOSPITAL - DECATUR,76100022,64484,HC INJ EPID LUMBAR/SACRAL ADDL-LT,761,1 ,"$2,331.00 ","$1,515.15 ",$104.58 ,"$2,331.00 ", N/A ,"$1,188.81 ","$1,282.05 ", N/A ,$652.68 ,"$1,095.57 ", N/A ,"$1,258.74 ", N/A ,"$1,265.73 ",$104.58 , N/A ,"$1,265.73 ", N/A ,"$1,631.70 ","$1,165.50 ","$1,864.80 ", N/A , N/A ,"$1,631.70 ", N/A ,"$1,398.60 ", N/A ,"$1,748.25 ","$1,286.71 ","$1,160.84 ","$1,286.71 ", N/A ,"$1,286.71 ","$1,818.18 ","$1,818.18 ","$1,981.35 ", N/A ,"$1,615.38 ", N/A ,"$2,331.00 ","$1,282.05 ", N/A ,$613.05 ,"$2,331.00 ",$557.90 ,$532.54 , N/A ,"$1,864.80 ","$1,265.73 ",$652.68 ,"$2,097.90 ",$885.78 ,$650.00 , N/A ,"$1,118.88 "
ST. MARY'S HOSPITAL - DECATUR,76100023,64484,HC INJ EPID LUMBAR/SACRAL ADDL-RT,761,1 ,"$2,331.00 ","$1,515.15 ",$104.58 ,"$2,331.00 ", N/A ,"$1,188.81 ","$1,282.05 ", N/A ,$652.68 ,"$1,095.57 ", N/A ,"$1,258.74 ", N/A ,"$1,265.73 ",$104.58 , N/A ,"$1,265.73 ", N/A ,"$1,631.70 ","$1,165.50 ","$1,864.80 ", N/A , N/A ,"$1,631.70 ", N/A ,"$1,398.60 ", N/A ,"$1,748.25 ","$1,286.71 ","$1,160.84 ","$1,286.71 ", N/A ,"$1,286.71 ","$1,818.18 ","$1,818.18 ","$1,981.35 ", N/A ,"$1,615.38 ", N/A ,"$2,331.00 ","$1,282.05 ", N/A ,$613.05 ,"$2,331.00 ",$557.90 ,$532.54 , N/A ,"$1,864.80 ","$1,265.73 ",$652.68 ,"$2,097.90 ",$885.78 ,$650.00 , N/A ,"$1,118.88 "
ST. MARY'S HOSPITAL - DECATUR,76100024,64483,HC INJ EPID LUMBAR/SACRAL SGL-BI,761,1 ,"$3,453.00 ","$2,244.45 ",$222.15 ,"$3,453.00 ","$2,922.15 ","$1,761.03 ","$1,899.15 ","$1,168.86 ",$966.84 ,"$1,622.91 ","$1,168.86 ","$1,864.62 ","$1,168.86 ","$1,874.98 ",$222.15 ,"$1,168.86 ","$1,874.98 ","$2,220.83 ","$2,417.10 ","$1,726.50 ","$2,762.40 ","$2,922.15 ","$1,168.86 ","$2,417.10 ","$1,168.86 ","$2,071.80 ","$1,168.86 ","$2,589.75 ","$1,906.06 ","$1,719.59 ","$1,906.06 ","$1,168.86 ","$1,906.06 ","$2,693.34 ","$2,693.34 ","$2,935.05 ","$2,922.15 ","$2,392.93 ","$1,168.86 ","$3,453.00 ","$1,899.15 ","$1,168.86 ",$908.14 ,"$3,453.00 ",$836.85 ,$798.81 ,"$1,227.30 ","$2,762.40 ","$1,874.98 ",$966.84 ,"$3,107.70 ","$1,312.14 ",$650.00 ,"$1,168.86 ","$1,657.44 "
ST. MARY'S HOSPITAL - DECATUR,76100025,64483,HC INJ EPID LUMBAR/SACRAL SGL-LT,761,1 ,"$3,453.00 ","$2,244.45 ",$222.15 ,"$3,453.00 ","$1,948.10 ","$1,761.03 ","$1,899.15 ",$779.24 ,$966.84 ,"$1,622.91 ",$779.24 ,"$1,864.62 ",$779.24 ,"$1,874.98 ",$222.15 ,$779.24 ,"$1,874.98 ","$1,480.55 ","$2,417.10 ","$1,726.50 ","$2,762.40 ","$1,948.10 ",$779.24 ,"$2,417.10 ",$779.24 ,"$2,071.80 ",$779.24 ,"$2,589.75 ","$1,906.06 ","$1,719.59 ","$1,906.06 ",$779.24 ,"$1,906.06 ","$2,693.34 ","$2,693.34 ","$2,935.05 ","$1,948.10 ","$2,392.93 ",$779.24 ,"$3,453.00 ","$1,899.15 ",$779.24 ,$908.14 ,"$3,453.00 ",$557.90 ,$532.54 ,$818.20 ,"$2,762.40 ","$1,874.98 ",$966.84 ,"$3,107.70 ","$1,312.14 ",$650.00 ,$779.24 ,"$1,657.44 "
ST. MARY'S HOSPITAL - DECATUR,76100026,64483,HC INJ EPID LUMBAR/SACRAL SGL-RT,761,1 ,"$3,453.00 ","$2,244.45 ",$222.15 ,"$3,453.00 ","$1,948.10 ","$1,761.03 ","$1,899.15 ",$779.24 ,$966.84 ,"$1,622.91 ",$779.24 ,"$1,864.62 ",$779.24 ,"$1,874.98 ",$222.15 ,$779.24 ,"$1,874.98 ","$1,480.55 ","$2,417.10 ","$1,726.50 ","$2,762.40 ","$1,948.10 ",$779.24 ,"$2,417.10 ",$779.24 ,"$2,071.80 ",$779.24 ,"$2,589.75 ","$1,906.06 ","$1,719.59 ","$1,906.06 ",$779.24 ,"$1,906.06 ","$2,693.34 ","$2,693.34 ","$2,935.05 ","$1,948.10 ","$2,392.93 ",$779.24 ,"$3,453.00 ","$1,899.15 ",$779.24 ,$908.14 ,"$3,453.00 ",$557.90 ,$532.54 ,$818.20 ,"$2,762.40 ","$1,874.98 ",$966.84 ,"$3,107.70 ","$1,312.14 ",$650.00 ,$779.24 ,"$1,657.44 "
ST. MARY'S HOSPITAL - DECATUR,76100027,64479,HC INJ EPIDURAL CREV/THOR SGL-BI,761,1 ,"$5,265.00 ","$3,422.25 ",$262.54 ,"$5,265.00 ","$2,922.15 ","$2,685.15 ","$2,895.75 ","$1,168.86 ","$1,474.20 ","$2,474.55 ","$1,168.86 ","$2,843.10 ","$1,168.86 ","$2,858.90 ",$262.54 ,"$1,168.86 ","$2,858.90 ","$2,220.83 ","$3,685.50 ","$2,632.50 ","$4,212.00 ","$2,922.15 ","$1,168.86 ","$3,685.50 ","$1,168.86 ","$3,159.00 ","$1,168.86 ","$3,948.75 ","$2,754.00 ","$2,478.00 ","$2,754.00 ","$1,168.86 ","$2,754.00 ","$4,106.70 ","$4,106.70 ","$4,475.25 ","$2,922.15 ","$3,648.65 ","$1,168.86 ","$5,265.00 ","$2,895.75 ","$1,168.86 ","$1,384.70 ","$5,265.00 ",$836.85 ,$798.81 ,"$1,227.30 ","$4,212.00 ","$2,858.90 ","$1,474.20 ","$4,738.50 ","$2,000.70 ",$650.00 ,"$1,168.86 ","$2,527.20 "
ST. MARY'S HOSPITAL - DECATUR,76100028,64479,HC INJ EPIDURAL CREV/THOR SGL-LT,761,1 ,"$5,265.00 ","$3,422.25 ",$262.54 ,"$5,265.00 ","$1,948.10 ","$2,685.15 ","$2,895.75 ",$779.24 ,"$1,474.20 ","$2,474.55 ",$779.24 ,"$2,843.10 ",$779.24 ,"$2,858.90 ",$262.54 ,$779.24 ,"$2,858.90 ","$1,480.55 ","$3,685.50 ","$2,632.50 ","$4,212.00 ","$1,948.10 ",$779.24 ,"$3,685.50 ",$779.24 ,"$3,159.00 ",$779.24 ,"$3,948.75 ","$2,754.00 ","$2,478.00 ","$2,754.00 ",$779.24 ,"$2,754.00 ","$4,106.70 ","$4,106.70 ","$4,475.25 ","$1,948.10 ","$3,648.65 ",$779.24 ,"$5,265.00 ","$2,895.75 ",$779.24 ,"$1,384.70 ","$5,265.00 ",$557.90 ,$532.54 ,$818.20 ,"$4,212.00 ","$2,858.90 ","$1,474.20 ","$4,738.50 ","$2,000.70 ",$650.00 ,$779.24 ,"$2,527.20 "
ST. MARY'S HOSPITAL - DECATUR,76100029,64479,HC INJ EPIDURAL CREV/THOR SGL-RT,761,1 ,"$5,265.00 ","$3,422.25 ",$262.54 ,"$5,265.00 ","$1,948.10 ","$2,685.15 ","$2,895.75 ",$779.24 ,"$1,474.20 ","$2,474.55 ",$779.24 ,"$2,843.10 ",$779.24 ,"$2,858.90 ",$262.54 ,$779.24 ,"$2,858.90 ","$1,480.55 ","$3,685.50 ","$2,632.50 ","$4,212.00 ","$1,948.10 ",$779.24 ,"$3,685.50 ",$779.24 ,"$3,159.00 ",$779.24 ,"$3,948.75 ","$2,754.00 ","$2,478.00 ","$2,754.00 ",$779.24 ,"$2,754.00 ","$4,106.70 ","$4,106.70 ","$4,475.25 ","$1,948.10 ","$3,648.65 ",$779.24 ,"$5,265.00 ","$2,895.75 ",$779.24 ,"$1,384.70 ","$5,265.00 ",$557.90 ,$532.54 ,$818.20 ,"$4,212.00 ","$2,858.90 ","$1,474.20 ","$4,738.50 ","$2,000.70 ",$650.00 ,$779.24 ,"$2,527.20 "
ST. MARY'S HOSPITAL - DECATUR,76100030,64490,HC INJ PARAVERT F JNT C/T 1 LV-BI,761,1 ,"$2,434.00 ","$1,582.10 ",$211.39 ,"$2,922.15 ","$2,922.15 ","$1,241.34 ","$1,338.70 ","$1,168.86 ",$681.52 ,"$1,143.98 ","$1,168.86 ","$1,314.36 ","$1,168.86 ","$1,321.66 ",$211.39 ,"$1,168.86 ","$1,321.66 ","$2,220.83 ","$1,703.80 ","$1,217.00 ","$1,947.20 ","$2,922.15 ","$1,168.86 ","$1,703.80 ","$1,168.86 ","$1,460.40 ","$1,168.86 ","$1,825.50 ","$1,343.57 ","$1,212.13 ","$1,343.57 ","$1,168.86 ","$1,343.57 ","$1,898.52 ","$1,898.52 ","$2,068.90 ","$2,434.00 ","$1,686.76 ","$1,168.86 ","$2,434.00 ","$1,338.70 ","$1,168.86 ",$640.14 ,"$2,434.00 ",$836.85 ,$798.81 ,"$1,227.30 ","$1,947.20 ","$1,321.66 ",$681.52 ,"$2,190.60 ",$924.92 ,$650.00 ,"$1,168.86 ","$1,168.32 "
ST. MARY'S HOSPITAL - DECATUR,76100031,64490,HC INJ PARAVERT F JNT C/T 1 LV-LT,761,1 ,"$2,434.00 ","$1,582.10 ",$211.39 ,"$2,434.00 ","$1,948.10 ","$1,241.34 ","$1,338.70 ",$779.24 ,$681.52 ,"$1,143.98 ",$779.24 ,"$1,314.36 ",$779.24 ,"$1,321.66 ",$211.39 ,$779.24 ,"$1,321.66 ","$1,480.55 ","$1,703.80 ","$1,217.00 ","$1,947.20 ","$1,948.10 ",$779.24 ,"$1,703.80 ",$779.24 ,"$1,460.40 ",$779.24 ,"$1,825.50 ","$1,343.57 ","$1,212.13 ","$1,343.57 ",$779.24 ,"$1,343.57 ","$1,898.52 ","$1,898.52 ","$2,068.90 ","$1,948.10 ","$1,686.76 ",$779.24 ,"$2,434.00 ","$1,338.70 ",$779.24 ,$640.14 ,"$2,434.00 ",$557.90 ,$532.54 ,$818.20 ,"$1,947.20 ","$1,321.66 ",$681.52 ,"$2,190.60 ",$924.92 ,$650.00 ,$779.24 ,"$1,168.32 "
ST. MARY'S HOSPITAL - DECATUR,76100032,64490,HC INJ PARAVERT F JNT C/T 1 LV-RT,761,1 ,"$2,434.00 ","$1,582.10 ",$211.39 ,"$2,434.00 ","$1,948.10 ","$1,241.34 ","$1,338.70 ",$779.24 ,$681.52 ,"$1,143.98 ",$779.24 ,"$1,314.36 ",$779.24 ,"$1,321.66 ",$211.39 ,$779.24 ,"$1,321.66 ","$1,480.55 ","$1,703.80 ","$1,217.00 ","$1,947.20 ","$1,948.10 ",$779.24 ,"$1,703.80 ",$779.24 ,"$1,460.40 ",$779.24 ,"$1,825.50 ","$1,343.57 ","$1,212.13 ","$1,343.57 ",$779.24 ,"$1,343.57 ","$1,898.52 ","$1,898.52 ","$2,068.90 ","$1,948.10 ","$1,686.76 ",$779.24 ,"$2,434.00 ","$1,338.70 ",$779.24 ,$640.14 ,"$2,434.00 ",$557.90 ,$532.54 ,$818.20 ,"$1,947.20 ","$1,321.66 ",$681.52 ,"$2,190.60 ",$924.92 ,$650.00 ,$779.24 ,"$1,168.32 "
ST. MARY'S HOSPITAL - DECATUR,76100033,64491,HC INJ PARAVERT F JNT C/T 2 LV,761,1 ,"$2,164.00 ","$1,406.60 ",$120.92 ,"$2,164.00 ", N/A ,"$1,103.64 ","$1,190.20 ", N/A ,$605.92 ,"$1,017.08 ", N/A ,"$1,168.56 ", N/A ,"$1,175.05 ",$120.92 , N/A ,"$1,175.05 ", N/A ,"$1,514.80 ","$1,082.00 ","$1,731.20 ", N/A , N/A ,"$1,514.80 ", N/A ,"$1,298.40 ", N/A ,"$1,623.00 ","$1,194.53 ","$1,077.67 ","$1,194.53 ", N/A ,"$1,194.53 ","$1,687.92 ","$1,687.92 ","$1,839.40 ", N/A ,"$1,499.65 ", N/A ,"$2,164.00 ","$1,190.20 ", N/A ,$569.13 ,"$2,164.00 ",$557.90 ,$532.54 , N/A ,"$1,731.20 ","$1,175.05 ",$605.92 ,"$1,947.60 ",$822.32 ,$650.00 , N/A ,"$1,038.72 "
ST. MARY'S HOSPITAL - DECATUR,76100034,64491,HC INJ PARAVERT F JNT C/T 2 LV-LT,761,1 ,"$2,164.00 ","$1,406.60 ",$120.92 ,"$2,164.00 ", N/A ,"$1,103.64 ","$1,190.20 ", N/A ,$605.92 ,"$1,017.08 ", N/A ,"$1,168.56 ", N/A ,"$1,175.05 ",$120.92 , N/A ,"$1,175.05 ", N/A ,"$1,514.80 ","$1,082.00 ","$1,731.20 ", N/A , N/A ,"$1,514.80 ", N/A ,"$1,298.40 ", N/A ,"$1,623.00 ","$1,194.53 ","$1,077.67 ","$1,194.53 ", N/A ,"$1,194.53 ","$1,687.92 ","$1,687.92 ","$1,839.40 ", N/A ,"$1,499.65 ", N/A ,"$2,164.00 ","$1,190.20 ", N/A ,$569.13 ,"$2,164.00 ",$557.90 ,$532.54 , N/A ,"$1,731.20 ","$1,175.05 ",$605.92 ,"$1,947.60 ",$822.32 ,$650.00 , N/A ,"$1,038.72 "
ST. MARY'S HOSPITAL - DECATUR,76100035,64491,HC INJ PARAVERT F JNT C/T 2 LV-RT,761,1 ,"$2,164.00 ","$1,406.60 ",$120.92 ,"$2,164.00 ", N/A ,"$1,103.64 ","$1,190.20 ", N/A ,$605.92 ,"$1,017.08 ", N/A ,"$1,168.56 ", N/A ,"$1,175.05 ",$120.92 , N/A ,"$1,175.05 ", N/A ,"$1,514.80 ","$1,082.00 ","$1,731.20 ", N/A , N/A ,"$1,514.80 ", N/A ,"$1,298.40 ", N/A ,"$1,623.00 ","$1,194.53 ","$1,077.67 ","$1,194.53 ", N/A ,"$1,194.53 ","$1,687.92 ","$1,687.92 ","$1,839.40 ", N/A ,"$1,499.65 ", N/A ,"$2,164.00 ","$1,190.20 ", N/A ,$569.13 ,"$2,164.00 ",$557.90 ,$532.54 , N/A ,"$1,731.20 ","$1,175.05 ",$605.92 ,"$1,947.60 ",$822.32 ,$650.00 , N/A ,"$1,038.72 "
ST. MARY'S HOSPITAL - DECATUR,76100036,64492,HC INJ PARAVERT F JNT C/T 3 LV,761,1 ,"$1,232.00 ",$800.80 ,$122.22 ,"$1,232.00 ", N/A ,$628.32 ,$677.60 , N/A ,$344.96 ,$579.04 , N/A ,$665.28 , N/A ,$668.98 ,$122.22 , N/A ,$668.98 , N/A ,$862.40 ,$616.00 ,$985.60 , N/A , N/A ,$862.40 , N/A ,$739.20 , N/A ,$924.00 ,$680.06 ,$613.54 ,$680.06 , N/A ,$680.06 ,$960.96 ,$960.96 ,"$1,047.20 ", N/A ,$853.78 , N/A ,"$1,232.00 ",$677.60 , N/A ,$324.02 ,"$1,232.00 ",$557.90 ,$532.54 , N/A ,$985.60 ,$668.98 ,$344.96 ,"$1,108.80 ",$468.16 ,$650.00 , N/A ,$591.36 
ST. MARY'S HOSPITAL - DECATUR,76100037,64492,HC INJ PARAVERT F JNT C/T 3 LV-LT,761,1 ,"$1,232.00 ",$800.80 ,$122.22 ,"$1,232.00 ", N/A ,$628.32 ,$677.60 , N/A ,$344.96 ,$579.04 , N/A ,$665.28 , N/A ,$668.98 ,$122.22 , N/A ,$668.98 , N/A ,$862.40 ,$616.00 ,$985.60 , N/A , N/A ,$862.40 , N/A ,$739.20 , N/A ,$924.00 ,$680.06 ,$613.54 ,$680.06 , N/A ,$680.06 ,$960.96 ,$960.96 ,"$1,047.20 ", N/A ,$853.78 , N/A ,"$1,232.00 ",$677.60 , N/A ,$324.02 ,"$1,232.00 ",$557.90 ,$532.54 , N/A ,$985.60 ,$668.98 ,$344.96 ,"$1,108.80 ",$468.16 ,$650.00 , N/A ,$591.36 
ST. MARY'S HOSPITAL - DECATUR,76100038,64492,HC INJ PARAVERT F JNT C/T 3 LV-RT,761,1 ,"$1,232.00 ",$800.80 ,$122.22 ,"$1,232.00 ", N/A ,$628.32 ,$677.60 , N/A ,$344.96 ,$579.04 , N/A ,$665.28 , N/A ,$668.98 ,$122.22 , N/A ,$668.98 , N/A ,$862.40 ,$616.00 ,$985.60 , N/A , N/A ,$862.40 , N/A ,$739.20 , N/A ,$924.00 ,$680.06 ,$613.54 ,$680.06 , N/A ,$680.06 ,$960.96 ,$960.96 ,"$1,047.20 ", N/A ,$853.78 , N/A ,"$1,232.00 ",$677.60 , N/A ,$324.02 ,"$1,232.00 ",$557.90 ,$532.54 , N/A ,$985.60 ,$668.98 ,$344.96 ,"$1,108.80 ",$468.16 ,$650.00 , N/A ,$591.36 
ST. MARY'S HOSPITAL - DECATUR,76100039,64493,HC INJ PARAVERT F JNT L/S 1 LV-BI,761,1 ,"$2,313.00 ","$1,503.45 ",$179.70 ,"$2,922.15 ","$2,922.15 ","$1,179.63 ","$1,272.15 ","$1,168.86 ",$647.64 ,"$1,087.11 ","$1,168.86 ","$1,249.02 ","$1,168.86 ","$1,255.96 ",$179.70 ,"$1,168.86 ","$1,255.96 ","$2,220.83 ","$1,619.10 ","$1,156.50 ","$1,850.40 ","$2,922.15 ","$1,168.86 ","$1,619.10 ","$1,168.86 ","$1,387.80 ","$1,168.86 ","$1,734.75 ","$1,276.78 ","$1,151.87 ","$1,276.78 ","$1,168.86 ","$1,276.78 ","$1,804.14 ","$1,804.14 ","$1,966.05 ","$2,313.00 ","$1,602.91 ","$1,168.86 ","$2,313.00 ","$1,272.15 ","$1,168.86 ",$608.32 ,"$2,313.00 ",$836.85 ,$798.81 ,"$1,227.30 ","$1,850.40 ","$1,255.96 ",$647.64 ,"$2,081.70 ",$878.94 ,$650.00 ,"$1,168.86 ","$1,110.24 "
ST. MARY'S HOSPITAL - DECATUR,76100040,64493,HC INJ PARAVERT F JNT L/S 1 LV-LT,761,1 ,"$2,313.00 ","$1,503.45 ",$179.70 ,"$2,313.00 ","$1,948.10 ","$1,179.63 ","$1,272.15 ",$779.24 ,$647.64 ,"$1,087.11 ",$779.24 ,"$1,249.02 ",$779.24 ,"$1,255.96 ",$179.70 ,$779.24 ,"$1,255.96 ","$1,480.55 ","$1,619.10 ","$1,156.50 ","$1,850.40 ","$1,948.10 ",$779.24 ,"$1,619.10 ",$779.24 ,"$1,387.80 ",$779.24 ,"$1,734.75 ","$1,276.78 ","$1,151.87 ","$1,276.78 ",$779.24 ,"$1,276.78 ","$1,804.14 ","$1,804.14 ","$1,966.05 ","$1,948.10 ","$1,602.91 ",$779.24 ,"$2,313.00 ","$1,272.15 ",$779.24 ,$608.32 ,"$2,313.00 ",$557.90 ,$532.54 ,$818.20 ,"$1,850.40 ","$1,255.96 ",$647.64 ,"$2,081.70 ",$878.94 ,$650.00 ,$779.24 ,"$1,110.24 "
ST. MARY'S HOSPITAL - DECATUR,76100041,64493,HC INJ PARAVERT F JNT L/S 1 LV-RT,761,1 ,"$2,313.00 ","$1,503.45 ",$179.70 ,"$2,313.00 ","$1,948.10 ","$1,179.63 ","$1,272.15 ",$779.24 ,$647.64 ,"$1,087.11 ",$779.24 ,"$1,249.02 ",$779.24 ,"$1,255.96 ",$179.70 ,$779.24 ,"$1,255.96 ","$1,480.55 ","$1,619.10 ","$1,156.50 ","$1,850.40 ","$1,948.10 ",$779.24 ,"$1,619.10 ",$779.24 ,"$1,387.80 ",$779.24 ,"$1,734.75 ","$1,276.78 ","$1,151.87 ","$1,276.78 ",$779.24 ,"$1,276.78 ","$1,804.14 ","$1,804.14 ","$1,966.05 ","$1,948.10 ","$1,602.91 ",$779.24 ,"$2,313.00 ","$1,272.15 ",$779.24 ,$608.32 ,"$2,313.00 ",$557.90 ,$532.54 ,$818.20 ,"$1,850.40 ","$1,255.96 ",$647.64 ,"$2,081.70 ",$878.94 ,$650.00 ,$779.24 ,"$1,110.24 "
ST. MARY'S HOSPITAL - DECATUR,76100042,64494,HC INJ PARAVERT F JNT L/S 2 LV,761,1 ,"$1,596.00 ","$1,037.40 ",$104.79 ,"$1,596.00 ", N/A ,$813.96 ,$877.80 , N/A ,$446.88 ,$750.12 , N/A ,$861.84 , N/A ,$866.63 ,$104.79 , N/A ,$866.63 , N/A ,"$1,117.20 ",$798.00 ,"$1,276.80 ", N/A , N/A ,"$1,117.20 ", N/A ,$957.60 , N/A ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 , N/A ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ", N/A ,"$1,106.03 ", N/A ,"$1,596.00 ",$877.80 , N/A ,$419.75 ,"$1,596.00 ",$557.90 ,$532.54 , N/A ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$606.48 ,$650.00 , N/A ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,76100043,64494,HC INJ PARAVERT F JNT L/S 2 LV-LT,761,1 ,"$1,596.00 ","$1,037.40 ",$104.79 ,"$1,596.00 ", N/A ,$813.96 ,$877.80 , N/A ,$446.88 ,$750.12 , N/A ,$861.84 , N/A ,$866.63 ,$104.79 , N/A ,$866.63 , N/A ,"$1,117.20 ",$798.00 ,"$1,276.80 ", N/A , N/A ,"$1,117.20 ", N/A ,$957.60 , N/A ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 , N/A ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ", N/A ,"$1,106.03 ", N/A ,"$1,596.00 ",$877.80 , N/A ,$419.75 ,"$1,596.00 ",$557.90 ,$532.54 , N/A ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$606.48 ,$650.00 , N/A ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,76100044,64494,HC INJ PARAVERT F JNT L/S 2 LV-RT,761,1 ,"$1,596.00 ","$1,037.40 ",$104.79 ,"$1,596.00 ", N/A ,$813.96 ,$877.80 , N/A ,$446.88 ,$750.12 , N/A ,$861.84 , N/A ,$866.63 ,$104.79 , N/A ,$866.63 , N/A ,"$1,117.20 ",$798.00 ,"$1,276.80 ", N/A , N/A ,"$1,117.20 ", N/A ,$957.60 , N/A ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 , N/A ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ", N/A ,"$1,106.03 ", N/A ,"$1,596.00 ",$877.80 , N/A ,$419.75 ,"$1,596.00 ",$557.90 ,$532.54 , N/A ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$606.48 ,$650.00 , N/A ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,76100045,64495,HC INJ PARAVRT F JNT L/S 3+ LV,761,1 ,"$1,596.00 ","$1,037.40 ",$106.09 ,"$1,596.00 ", N/A ,$813.96 ,$877.80 , N/A ,$446.88 ,$750.12 , N/A ,$861.84 , N/A ,$866.63 ,$106.09 , N/A ,$866.63 , N/A ,"$1,117.20 ",$798.00 ,"$1,276.80 ", N/A , N/A ,"$1,117.20 ", N/A ,$957.60 , N/A ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 , N/A ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ", N/A ,"$1,106.03 ", N/A ,"$1,596.00 ",$877.80 , N/A ,$419.75 ,"$1,596.00 ",$557.90 ,$532.54 , N/A ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$606.48 ,$650.00 , N/A ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,76100046,64495,HC INJ PARAVRT F JNT L/S 3+ LV-LT,761,1 ,"$1,596.00 ","$1,037.40 ",$106.09 ,"$1,596.00 ", N/A ,$813.96 ,$877.80 , N/A ,$446.88 ,$750.12 , N/A ,$861.84 , N/A ,$866.63 ,$106.09 , N/A ,$866.63 , N/A ,"$1,117.20 ",$798.00 ,"$1,276.80 ", N/A , N/A ,"$1,117.20 ", N/A ,$957.60 , N/A ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 , N/A ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ", N/A ,"$1,106.03 ", N/A ,"$1,596.00 ",$877.80 , N/A ,$419.75 ,"$1,596.00 ",$557.90 ,$532.54 , N/A ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$606.48 ,$650.00 , N/A ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,76100047,64495,HC INJ PARAVRT F JNT L/S 3+ LV-RT,761,1 ,"$1,596.00 ","$1,037.40 ",$106.09 ,"$1,596.00 ", N/A ,$813.96 ,$877.80 , N/A ,$446.88 ,$750.12 , N/A ,$861.84 , N/A ,$866.63 ,$106.09 , N/A ,$866.63 , N/A ,"$1,117.20 ",$798.00 ,"$1,276.80 ", N/A , N/A ,"$1,117.20 ", N/A ,$957.60 , N/A ,"$1,197.00 ",$880.99 ,$794.81 ,$880.99 , N/A ,$880.99 ,"$1,244.88 ","$1,244.88 ","$1,356.60 ", N/A ,"$1,106.03 ", N/A ,"$1,596.00 ",$877.80 , N/A ,$419.75 ,"$1,596.00 ",$557.90 ,$532.54 , N/A ,"$1,276.80 ",$866.63 ,$446.88 ,"$1,436.40 ",$606.48 ,$650.00 , N/A ,$766.08 
ST. MARY'S HOSPITAL - DECATUR,76100048,97607,HC NEG PRESS WOUND THERAPY WO DME<50CM,761,1 ,"$1,303.00 ",$846.95 ,$192.08 ,"$1,303.00 ",$817.95 ,$664.53 ,$716.65 ,$327.18 ,$364.84 ,$612.41 ,$327.18 ,$703.62 ,$327.18 ,$707.53 ,$521.20 ,$327.18 ,$707.53 ,$621.65 ,$912.10 ,$651.50 ,"$1,042.40 ",$817.95 ,$327.18 ,$912.10 ,$327.18 ,$781.80 ,$327.18 ,$977.25 ,$719.26 ,$648.89 ,$719.26 ,$327.18 ,$719.26 ,"$1,016.34 ","$1,016.34 ","$1,107.55 ",$817.95 ,$902.98 ,$327.18 ,"$1,303.00 ",$716.65 ,$327.18 ,$342.69 ,"$1,303.00 ",$201.22 ,$192.08 ,$343.54 ,"$1,042.40 ",$707.53 ,$364.84 ,"$1,172.70 ",$495.14 ,$650.00 ,$327.18 ,$625.44 
ST. MARY'S HOSPITAL - DECATUR,76100050,62367,HC ANALYSIS ELECT PUMP W/O REPROGRAMMING,761,1 ,"$1,188.00 ",$772.20 ,$50.75 ,"$1,188.00 ",$646.15 ,$605.88 ,$653.40 ,$258.46 ,$332.64 ,$558.36 ,$258.46 ,$641.52 ,$258.46 ,$645.08 ,$50.75 ,$258.46 ,$645.08 ,$491.08 ,$831.60 ,$594.00 ,$950.40 ,$646.16 ,$258.46 ,$831.60 ,$258.46 ,$712.80 ,$258.46 ,$891.00 ,$655.78 ,$591.62 ,$655.78 ,$258.46 ,$655.78 ,$926.64 ,$926.64 ,"$1,009.80 ",$646.16 ,$823.28 ,$258.46 ,"$1,188.00 ",$653.40 ,$258.46 ,$312.44 ,"$1,188.00 ",$177.19 ,$169.13 ,$271.38 ,$950.40 ,$645.08 ,$332.64 ,"$1,069.20 ",$451.44 ,$650.00 ,$258.46 ,$570.24 
ST. MARY'S HOSPITAL - DECATUR,76100051,62368,HC ANALYSIS ELECT PUMP W/REPROGRAMMING,761,1 ,$558.00 ,$362.70 ,$71.17 ,$646.16 ,$646.15 ,$284.58 ,$306.90 ,$258.46 ,$156.24 ,$262.26 ,$258.46 ,$301.32 ,$258.46 ,$302.99 ,$71.17 ,$258.46 ,$302.99 ,$491.08 ,$390.60 ,$279.00 ,$446.40 ,$646.16 ,$258.46 ,$390.60 ,$258.46 ,$334.80 ,$258.46 ,$418.50 ,$308.02 ,$277.88 ,$308.02 ,$258.46 ,$308.02 ,$435.24 ,$435.24 ,$474.30 ,$558.00 ,$386.69 ,$258.46 ,$558.00 ,$306.90 ,$258.46 ,$146.75 ,$558.00 ,$177.19 ,$169.13 ,$271.38 ,$446.40 ,$302.99 ,$156.24 ,$502.20 ,$212.04 ,$558.00 ,$258.46 ,$267.84 
ST. MARY'S HOSPITAL - DECATUR,76100052,95990,HC PUMP MAINT SPINAL/BRAIN,761,1 ,"$1,493.00 ",$970.45 ,$79.74 ,"$1,493.00 ",$754.55 ,$761.43 ,$821.15 ,$301.82 ,$418.04 ,$731.57 ,$301.82 ,$873.41 ,$301.82 ,$810.70 ,$134.72 ,$301.82 ,$810.70 ,$573.46 ,"$1,045.10 ",$746.50 ,"$1,194.40 ",$754.56 ,$301.82 ,"$1,045.10 ",$301.82 ,$895.80 ,$301.82 ,"$1,119.75 ",$824.14 ,$743.51 ,$824.14 ,$301.82 ,$824.14 ,"$1,164.54 ","$1,164.54 ","$1,269.05 ",$754.56 ,"$1,034.65 ",$301.82 ,"$1,493.00 ",$821.15 ,$301.82 ,$392.66 ,"$1,493.00 ",$83.53 ,$79.74 ,$316.91 ,"$1,194.40 ",$810.70 ,$418.04 ,"$1,343.70 ",$567.34 ,$650.00 ,$301.82 ,$716.64 
ST. MARY'S HOSPITAL - DECATUR,76100053,62369,HC ANALYSIS ELECT PUMP W/REPROGRAMMING  AND  REFILL,761,1 ,"$1,044.00 ",$678.60 ,$71.17 ,"$1,044.00 ",$646.15 ,$532.44 ,$574.20 ,$258.46 ,$292.32 ,$490.68 ,$258.46 ,$563.76 ,$258.46 ,$566.89 ,$71.17 ,$258.46 ,$566.89 ,$491.08 ,$730.80 ,$522.00 ,$835.20 ,$646.16 ,$258.46 ,$730.80 ,$258.46 ,$626.40 ,$258.46 ,$783.00 ,$576.29 ,$519.91 ,$576.29 ,$258.46 ,$576.29 ,$814.32 ,$814.32 ,$887.40 ,$646.16 ,$723.49 ,$258.46 ,"$1,044.00 ",$574.20 ,$258.46 ,$274.57 ,"$1,044.00 ",$177.19 ,$169.13 ,$271.38 ,$835.20 ,$566.89 ,$292.32 ,$939.60 ,$396.72 ,$650.00 ,$258.46 ,$501.12 
ST. MARY'S HOSPITAL - DECATUR,76100054,64999,HC GANGLION IMPAR BLOCK,761,1 ,$833.00 ,$541.45 ,$219.08 ,$833.00 ,$618.28 ,$424.83 ,$458.15 ,$247.31 ,$233.24 ,$391.51 ,$247.31 ,$449.82 ,$247.31 ,$452.32 ,$333.20 ,$247.31 ,$452.32 ,$469.90 ,$583.10 ,$416.50 ,$666.40 ,$618.29 ,$247.31 ,$583.10 ,$247.31 ,$499.80 ,$247.31 ,$624.75 ,$459.82 ,$414.83 ,$459.82 ,$247.31 ,$459.82 ,$649.74 ,$649.74 ,$708.05 ,$618.29 ,$577.27 ,$247.31 ,$833.00 ,$458.15 ,$247.31 ,$219.08 ,$833.00 ,$307.62 ,$293.63 ,$259.68 ,$666.40 ,$452.32 ,$233.24 ,$749.70 ,$316.54 ,$650.00 ,$247.31 ,$399.84 
ST. MARY'S HOSPITAL - DECATUR,76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$401.00 ,$260.65 ,$105.46 ,$401.00 , N/A ,$204.51 ,$220.55 , N/A ,$112.28 ,$188.47 , N/A ,$216.54 , N/A ,$217.74 ,$217.74 , N/A ,$217.74 , N/A ,$280.70 ,$200.50 ,$320.80 , N/A , N/A ,$280.70 , N/A ,$240.60 , N/A ,$300.75 ,$221.35 ,$199.70 ,$221.35 , N/A ,$221.35 ,$312.78 ,$312.78 ,$340.85 , N/A ,$277.89 , N/A ,$401.00 ,$220.55 , N/A ,$105.46 ,$401.00 , N/A , N/A , N/A ,$320.80 ,$217.74 ,$112.28 ,$360.90 ,$152.38 ,$401.00 , N/A ,$192.48 
ST. MARY'S HOSPITAL - DECATUR,76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$69.00 ,$44.85 ,$18.15 ,$69.00 , N/A ,$35.19 ,$37.95 , N/A ,$19.32 ,$32.43 , N/A ,$37.26 , N/A ,$37.47 ,$37.47 , N/A ,$37.47 , N/A ,$48.30 ,$34.50 ,$55.20 , N/A , N/A ,$48.30 , N/A ,$41.40 , N/A ,$51.75 ,$38.09 ,$34.36 ,$38.09 , N/A ,$38.09 ,$53.82 ,$53.82 ,$58.65 , N/A ,$47.82 , N/A ,$69.00 ,$37.95 , N/A ,$18.15 ,$69.00 , N/A , N/A , N/A ,$55.20 ,$37.47 ,$19.32 ,$62.10 ,$26.22 ,$69.00 , N/A ,$33.12 
ST. MARY'S HOSPITAL - DECATUR,77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$62.00 ,$40.30 ,$15.00 ,$146.73 ,$146.73 ,$31.62 ,$34.10 ,$58.69 ,$17.36 ,$30.38 ,$58.69 ,$36.27 ,$58.69 ,$33.67 ,$15.00 ,$58.69 ,$33.67 ,$62.00 ,$43.40 ,$31.00 ,$49.60 ,$146.72 ,$58.69 ,$43.40 ,$58.69 ,$37.20 ,$58.69 ,$46.50 ,$34.22 ,$30.88 ,$34.22 ,$58.69 ,$34.22 ,$48.36 ,$48.36 ,$52.70 ,$62.00 ,$42.97 ,$58.69 ,$62.00 ,$34.10 ,$58.69 ,$16.31 ,$62.00 , N/A , N/A ,$61.62 ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$50.00 ,$58.69 ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,77100002,90472,HC IMMUN ADMIN EA ADD VACC,771,1 ,$62.00 ,$40.30 ,$8.00 ,$62.00 , N/A ,$31.62 ,$34.10 , N/A ,$17.36 ,$30.38 , N/A ,$36.27 , N/A ,$33.67 ,$8.00 , N/A ,$33.67 , N/A ,$43.40 ,$31.00 ,$49.60 , N/A , N/A ,$43.40 , N/A ,$37.20 , N/A ,$46.50 ,$34.22 ,$30.88 ,$34.22 , N/A ,$34.22 ,$48.36 ,$48.36 ,$52.70 , N/A ,$42.97 , N/A ,$62.00 ,$34.10 , N/A ,$16.31 ,$62.00 , N/A , N/A , N/A ,$49.60 ,$33.67 ,$17.36 ,$55.80 ,$23.56 ,$50.00 , N/A ,$29.76 
ST. MARY'S HOSPITAL - DECATUR,77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$94.00 ,$61.10 ,$15.00 ,$94.70 ,$94.70 ,$47.94 ,$51.70 ,$37.88 ,$26.32 ,$46.06 ,$37.88 ,$54.99 ,$37.88 ,$51.04 ,$15.00 ,$37.88 ,$51.04 ,$71.97 ,$65.80 ,$47.00 ,$75.20 ,$94.70 ,$37.88 ,$65.80 ,$37.88 ,$56.40 ,$37.88 ,$70.50 ,$51.89 ,$46.81 ,$51.89 ,$37.88 ,$51.89 ,$73.32 ,$73.32 ,$79.90 ,$94.00 ,$65.14 ,$37.88 ,$94.00 ,$51.70 ,$37.88 ,$24.72 ,$94.00 , N/A , N/A ,$39.77 ,$75.20 ,$51.04 ,$26.32 ,$84.60 ,$35.72 ,$50.00 ,$37.88 ,$45.12 
ST. MARY'S HOSPITAL - DECATUR,77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$94.00 ,$61.10 ,$15.00 ,$94.70 ,$94.70 ,$47.94 ,$51.70 ,$37.88 ,$26.32 ,$46.06 ,$37.88 ,$54.99 ,$37.88 ,$51.04 ,$15.00 ,$37.88 ,$51.04 ,$71.97 ,$65.80 ,$47.00 ,$75.20 ,$94.70 ,$37.88 ,$65.80 ,$37.88 ,$56.40 ,$37.88 ,$70.50 ,$51.89 ,$46.81 ,$51.89 ,$37.88 ,$51.89 ,$73.32 ,$73.32 ,$79.90 ,$94.00 ,$65.14 ,$37.88 ,$94.00 ,$51.70 ,$37.88 ,$24.72 ,$94.00 , N/A , N/A ,$39.77 ,$75.20 ,$51.04 ,$26.32 ,$84.60 ,$35.72 ,$50.00 ,$37.88 ,$45.12 
ST. MARY'S HOSPITAL - DECATUR,77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$94.00 ,$61.10 ,$15.00 ,$94.70 ,$94.70 ,$47.94 ,$51.70 ,$37.88 ,$26.32 ,$46.06 ,$37.88 ,$54.99 ,$37.88 ,$51.04 ,$15.00 ,$37.88 ,$51.04 ,$71.97 ,$65.80 ,$47.00 ,$75.20 ,$94.70 ,$37.88 ,$65.80 ,$37.88 ,$56.40 ,$37.88 ,$70.50 ,$51.89 ,$46.81 ,$51.89 ,$37.88 ,$51.89 ,$73.32 ,$73.32 ,$79.90 ,$94.00 ,$65.14 ,$37.88 ,$94.00 ,$51.70 ,$37.88 ,$24.72 ,$94.00 , N/A , N/A ,$39.77 ,$75.20 ,$51.04 ,$26.32 ,$84.60 ,$35.72 ,$50.00 ,$37.88 ,$45.12 
ST. MARY'S HOSPITAL - DECATUR,77100009,0001A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 ,$92.68 ,$61.20 ,$66.00 ,$37.07 ,$33.60 ,$56.40 ,$37.07 ,$64.80 ,$37.07 ,$65.16 ,$48.00 ,$37.07 ,$65.16 ,$70.44 ,$84.00 ,$60.00 ,$96.00 ,$92.69 ,$37.07 ,$84.00 ,$37.07 ,$72.00 ,$37.07 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$37.07 ,$66.24 ,$93.60 ,$93.60 ,$102.00 ,$92.69 ,$83.16 ,$37.07 ,$120.00 ,$66.00 ,$37.07 ,$31.56 ,$120.00 , N/A , N/A ,$38.92 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 ,$37.07 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100010,0002A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 ,$92.68 ,$61.20 ,$66.00 ,$37.07 ,$33.60 ,$56.40 ,$37.07 ,$64.80 ,$37.07 ,$65.16 ,$48.00 ,$37.07 ,$65.16 ,$70.44 ,$84.00 ,$60.00 ,$96.00 ,$92.69 ,$37.07 ,$84.00 ,$37.07 ,$72.00 ,$37.07 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$37.07 ,$66.24 ,$93.60 ,$93.60 ,$102.00 ,$92.69 ,$83.16 ,$37.07 ,$120.00 ,$66.00 ,$37.07 ,$31.56 ,$120.00 , N/A , N/A ,$38.92 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 ,$37.07 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100011,0011A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 ,$92.68 ,$61.20 ,$66.00 ,$37.07 ,$33.60 ,$56.40 ,$37.07 ,$64.80 ,$37.07 ,$65.16 ,$48.00 ,$37.07 ,$65.16 ,$70.44 ,$84.00 ,$60.00 ,$96.00 ,$92.69 ,$37.07 ,$84.00 ,$37.07 ,$72.00 ,$37.07 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$37.07 ,$66.24 ,$93.60 ,$93.60 ,$102.00 ,$92.69 ,$83.16 ,$37.07 ,$120.00 ,$66.00 ,$37.07 ,$31.56 ,$120.00 , N/A , N/A ,$38.92 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 ,$37.07 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100012,0012A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5M SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 ,$92.68 ,$61.20 ,$66.00 ,$37.07 ,$33.60 ,$56.40 ,$37.07 ,$64.80 ,$37.07 ,$65.16 ,$48.00 ,$37.07 ,$65.16 ,$70.44 ,$84.00 ,$60.00 ,$96.00 ,$92.69 ,$37.07 ,$84.00 ,$37.07 ,$72.00 ,$37.07 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$37.07 ,$66.24 ,$93.60 ,$93.60 ,$102.00 ,$92.69 ,$83.16 ,$37.07 ,$120.00 ,$66.00 ,$37.07 ,$31.56 ,$120.00 , N/A , N/A ,$38.92 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 ,$37.07 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100013,0021A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 , N/A ,$80.00 ,$66.00 , N/A ,$33.60 ,$56.40 , N/A ,$64.80 , N/A ,$65.16 ,$48.00 , N/A ,$65.16 , N/A ,$84.00 ,$60.00 ,$96.00 , N/A , N/A ,$84.00 , N/A ,$72.00 , N/A ,$90.00 ,$66.24 ,$59.76 ,$66.24 , N/A ,$66.24 ,$93.60 ,$93.60 ,$102.00 , N/A ,$83.16 , N/A ,$120.00 ,$66.00 , N/A ,$31.56 ,$120.00 , N/A , N/A , N/A ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 , N/A ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100014,0022A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 , N/A ,$80.00 ,$66.00 , N/A ,$33.60 ,$56.40 , N/A ,$64.80 , N/A ,$65.16 ,$48.00 , N/A ,$65.16 , N/A ,$84.00 ,$60.00 ,$96.00 , N/A , N/A ,$84.00 , N/A ,$72.00 , N/A ,$90.00 ,$66.24 ,$59.76 ,$66.24 , N/A ,$66.24 ,$93.60 ,$93.60 ,$102.00 , N/A ,$83.16 , N/A ,$120.00 ,$66.00 , N/A ,$31.56 ,$120.00 , N/A , N/A , N/A ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 , N/A ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100015,0031A,HC ADMINISTRATION SARS-COV-2 VACCINE AD26 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 ,$92.68 ,$80.00 ,$66.00 ,$37.07 ,$33.60 ,$56.40 ,$37.07 ,$64.80 ,$37.07 ,$65.16 ,$48.00 ,$37.07 ,$65.16 ,$70.44 ,$84.00 ,$60.00 ,$96.00 ,$92.69 ,$37.07 ,$84.00 ,$37.07 ,$72.00 ,$37.07 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$37.07 ,$66.24 ,$93.60 ,$93.60 ,$102.00 ,$92.69 ,$83.16 ,$37.07 ,$120.00 ,$66.00 ,$37.07 ,$31.56 ,$120.00 , N/A , N/A ,$38.92 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 ,$37.07 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100016,0041A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML FIRST DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 , N/A ,$80.00 ,$66.00 , N/A ,$33.60 ,$56.40 , N/A ,$64.80 , N/A ,$65.16 ,$48.00 , N/A ,$65.16 , N/A ,$84.00 ,$60.00 ,$96.00 , N/A , N/A ,$84.00 , N/A ,$72.00 , N/A ,$90.00 ,$66.24 ,$59.76 ,$66.24 , N/A ,$66.24 ,$93.60 ,$93.60 ,$102.00 , N/A ,$83.16 , N/A ,$120.00 ,$66.00 , N/A ,$31.56 ,$120.00 , N/A , N/A , N/A ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 , N/A ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100017,0042A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML SECOND DOSE,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 , N/A ,$80.00 ,$66.00 , N/A ,$33.60 ,$56.40 , N/A ,$64.80 , N/A ,$65.16 ,$48.00 , N/A ,$65.16 , N/A ,$84.00 ,$60.00 ,$96.00 , N/A , N/A ,$84.00 , N/A ,$72.00 , N/A ,$90.00 ,$66.24 ,$59.76 ,$66.24 , N/A ,$66.24 ,$93.60 ,$93.60 ,$102.00 , N/A ,$83.16 , N/A ,$120.00 ,$66.00 , N/A ,$31.56 ,$120.00 , N/A , N/A , N/A ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 , N/A ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100019,0013A,HC ADM SARSCOV2 100MCG/0.5ML 3RD - MODERNA,771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 ,$92.68 ,$61.20 ,$66.00 ,$37.07 ,$33.60 ,$56.40 ,$37.07 ,$64.80 ,$37.07 ,$65.16 ,$48.00 ,$37.07 ,$65.16 ,$70.44 ,$84.00 ,$60.00 ,$96.00 ,$92.69 ,$37.07 ,$84.00 ,$37.07 ,$72.00 ,$37.07 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$37.07 ,$66.24 ,$93.60 ,$93.60 ,$102.00 ,$92.69 ,$83.16 ,$37.07 ,$120.00 ,$66.00 ,$37.07 ,$31.56 ,$120.00 , N/A , N/A ,$38.92 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 ,$37.07 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,77100025,0064A,"HC ADMIN SARS-COV-2 VACCINE 50MCG/0.25ML, BOOSTER DOSE",771,1 ,$120.00 ,$78.00 ,$31.56 ,$120.00 ,$92.68 ,$80.00 ,$66.00 ,$37.07 ,$33.60 ,$56.40 ,$37.07 ,$64.80 ,$37.07 ,$65.16 ,$48.00 ,$37.07 ,$65.16 ,$70.44 ,$84.00 ,$60.00 ,$96.00 ,$92.69 ,$37.07 ,$84.00 ,$37.07 ,$72.00 ,$37.07 ,$90.00 ,$66.24 ,$59.76 ,$66.24 ,$37.07 ,$66.24 ,$93.60 ,$93.60 ,$102.00 ,$92.69 ,$83.16 ,$37.07 ,$120.00 ,$66.00 ,$37.07 ,$31.56 ,$120.00 , N/A , N/A ,$38.92 ,$96.00 ,$65.16 ,$33.60 ,$108.00 ,$45.60 ,$50.00 ,$37.07 ,$57.60 
ST. MARY'S HOSPITAL - DECATUR,80100010,90945,HC DIALYSIS PROC OTHER THAN HEMO,801,1 ,$518.00 ,$336.70 ,$136.23 ,$860.88 ,$860.88 ,$264.18 ,$284.90 ,$344.35 ,$145.04 ,$253.82 ,$344.35 ,$303.03 ,$344.35 ,$281.27 ,$281.27 ,$344.35 ,$281.27 ,$518.00 ,$362.60 ,$259.00 ,$414.40 ,$860.87 ,$344.35 ,$362.60 ,$344.35 ,$310.80 ,$344.35 ,$388.50 ,$285.94 ,$257.96 ,$285.94 ,$344.35 ,$285.94 ,$404.04 ,$404.04 ,$440.30 ,$518.00 ,$358.97 ,$344.35 ,$518.00 ,$284.90 ,$344.35 ,$136.23 ,$518.00 ,$518.00 ,$629.13 ,$361.57 ,$414.40 ,$281.27 ,$145.04 ,$466.20 ,$196.84 ,$336.70 ,$344.35 ,$248.64 
ST. MARY'S HOSPITAL - DECATUR,80100011,G0257,HC HEMODIALYSIS INPATIENT,801,1 ,"$1,948.00 ","$1,266.20 ",$512.32 ,"$1,948.00 ","$1,549.98 ",$993.48 ,"$1,071.40 ",$619.99 ,$545.44 ,$915.56 ,$619.99 ,"$1,051.92 ",$619.99 ,"$1,057.76 ","$1,057.76 ",$619.99 ,"$1,057.76 ","$1,177.97 ","$1,363.60 ",$974.00 ,"$1,558.40 ","$1,549.96 ",$619.99 ,"$1,363.60 ",$619.99 ,"$1,168.80 ",$619.99 ,"$1,461.00 ","$1,075.30 ",$970.10 ,"$1,075.30 ",$619.99 ,"$1,075.30 ","$1,519.44 ","$1,519.44 ","$1,655.80 ","$1,549.96 ","$1,349.96 ",$619.99 ,"$1,948.00 ","$1,071.40 ",$619.99 ,$512.32 ,"$1,948.00 ",$663.55 ,$633.39 ,$650.99 ,"$1,558.40 ","$1,057.76 ",$545.44 ,"$1,753.20 ",$740.24 ,"$1,266.20 ",$619.99 ,$935.04 
ST. MARY'S HOSPITAL - DECATUR,80300001,N/A,HC CAPD INPATIENT,803,1 ,$286.00 ,$185.90 ,$75.22 ,$286.00 , N/A ,$145.86 ,$157.30 , N/A ,$80.08 ,$134.42 , N/A ,$154.44 , N/A ,$155.30 ,$155.30 , N/A ,$155.30 , N/A ,$200.20 ,$143.00 ,$228.80 , N/A , N/A ,$200.20 , N/A ,$171.60 , N/A ,$214.50 ,$157.87 ,$142.43 ,$157.87 , N/A ,$157.87 ,$223.08 ,$223.08 ,$243.10 , N/A ,$198.20 , N/A ,$286.00 ,$157.30 , N/A ,$75.22 ,$286.00 , N/A , N/A , N/A ,$228.80 ,$155.30 ,$80.08 ,$257.40 ,$108.68 ,$185.90 , N/A ,$137.28 
ST. MARY'S HOSPITAL - DECATUR,80400001,N/A,HC CCPD INPATIENT,804,1 ,"$1,144.00 ",$743.60 ,$300.87 ,"$1,144.00 ", N/A ,$583.44 ,$629.20 , N/A ,$320.32 ,$537.68 , N/A ,$617.76 , N/A ,$621.19 ,$621.19 , N/A ,$621.19 , N/A ,$800.80 ,$572.00 ,$915.20 , N/A , N/A ,$800.80 , N/A ,$686.40 , N/A ,$858.00 ,$631.49 ,$569.71 ,$631.49 , N/A ,$631.49 ,$892.32 ,$892.32 ,$972.40 , N/A ,$792.79 , N/A ,"$1,144.00 ",$629.20 , N/A ,$300.87 ,"$1,144.00 ", N/A , N/A , N/A ,$915.20 ,$621.19 ,$320.32 ,"$1,029.60 ",$434.72 ,$743.60 , N/A ,$549.12 
ST. MARY'S HOSPITAL - DECATUR,82900001,G0257,HC HEMODIALYSIS OUTPATIENT,829,1 ,"$1,948.00 ","$1,266.20 ",$512.32 ,"$1,948.00 ","$1,549.98 ",$993.48 ,"$1,071.40 ",$619.99 ,$545.44 ,$915.56 ,$619.99 ,"$1,051.92 ",$619.99 ,"$1,057.76 ","$1,057.76 ",$619.99 ,"$1,057.76 ","$1,177.97 ","$1,363.60 ",$974.00 ,"$1,558.40 ","$1,549.96 ",$619.99 ,"$1,363.60 ",$619.99 ,"$1,168.80 ",$619.99 ,"$1,461.00 ","$1,075.30 ",$970.10 ,"$1,075.30 ",$619.99 ,"$1,075.30 ","$1,519.44 ","$1,519.44 ","$1,655.80 ","$1,549.96 ","$1,349.96 ",$619.99 ,"$1,948.00 ","$1,071.40 ",$619.99 ,$512.32 ,"$1,948.00 ",$663.55 ,$633.39 ,$650.99 ,"$1,558.40 ","$1,057.76 ",$545.44 ,"$1,753.20 ",$740.24 ,$750.00 ,$619.99 ,$935.04 
ST. MARY'S HOSPITAL - DECATUR,90000001,90785,HC PSYCH THERAPY COMPLEX INTERACTIVE,900,1 ,$151.00 ,$98.15 ,$23.97 ,$151.00 , N/A ,$77.01 ,$83.05 , N/A ,$42.28 ,$73.99 , N/A ,$88.34 , N/A ,$81.99 ,$23.97 , N/A ,$81.99 , N/A ,$105.70 ,$75.50 ,$120.80 , N/A , N/A ,$135.90 , N/A ,$90.60 , N/A ,$113.25 ,$83.35 ,$75.20 ,$83.35 , N/A ,$83.35 ,$117.78 ,$117.78 ,$128.35 , N/A ,$104.64 , N/A ,$151.00 ,$83.05 , N/A ,$39.71 ,$151.00 , N/A , N/A , N/A ,$120.80 ,$81.99 ,$42.28 ,$135.90 ,$57.38 ,$151.00 , N/A ,$72.48 
ST. MARY'S HOSPITAL - DECATUR,90000002,90791,HC EVAL PSYCH DIAG,900,1 ,$395.00 ,$256.75 ,$103.89 ,$395.00 ,$316.65 ,$201.45 ,$217.25 ,$126.66 ,$110.60 ,$193.55 ,$126.66 ,$231.08 ,$126.66 ,$214.49 ,$222.01 ,$126.66 ,$214.49 ,$240.65 ,$276.50 ,$197.50 ,$316.00 ,$316.64 ,$126.66 ,$355.50 ,$126.66 ,$237.00 ,$126.66 ,$296.25 ,$218.04 ,$196.71 ,$218.04 ,$126.66 ,$218.04 ,$308.10 ,$308.10 ,$335.75 ,$316.64 ,$273.74 ,$126.66 ,$395.00 ,$217.25 ,$126.66 ,$103.89 ,$395.00 ,$192.43 ,$183.69 ,$132.99 ,$316.00 ,$214.49 ,$110.60 ,$355.50 ,$150.10 ,$359.00 ,$126.66 ,$189.60 
ST. MARY'S HOSPITAL - DECATUR,90100001,90870,HC ELECTROCONVULSIVE THERAPY,901,1 ,"$1,250.00 ",$812.50 ,$323.68 ,"$1,250.00 ","$1,155.18 ",$637.50 ,$687.50 ,$462.07 ,$350.00 ,$612.50 ,$462.07 ,$731.25 ,$462.07 ,$678.75 ,$678.75 ,$462.07 ,$678.75 ,$877.93 ,$812.50 ,$625.00 ,"$1,000.00 ","$1,155.17 ",$462.07 ,"$1,125.00 ",$462.07 ,$750.00 ,$462.07 ,$937.50 ,$690.00 ,$622.50 ,$690.00 ,$462.07 ,$690.00 ,$975.00 ,$975.00 ,"$1,062.50 ","$1,155.17 ",$812.50 ,$462.07 ,"$1,250.00 ",$687.50 ,$462.07 ,$328.75 ,$596.00 ,$339.10 ,$323.68 ,$485.17 ,"$1,000.00 ",$678.75 ,$350.00 ,"$1,125.00 ",$475.00 , N/A ,$462.07 ,$600.00 
ST. MARY'S HOSPITAL - DECATUR,91400004,90832,HC THERAPY INDIVIDUAL PSYCH 30MIN,914,1 ,$173.00 ,$112.45 ,$45.50 ,$316.65 ,$316.65 ,$88.23 ,$95.15 ,$126.66 ,$48.44 ,$84.77 ,$126.66 ,$101.21 ,$126.66 ,$93.94 ,$108.54 ,$126.66 ,$93.94 ,$173.00 ,$112.45 ,$86.50 ,$138.40 ,$316.64 ,$126.66 ,$155.70 ,$126.66 ,$103.80 ,$126.66 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$126.66 ,$95.50 ,$134.94 ,$134.94 ,$147.05 ,$173.00 ,$112.45 ,$126.66 ,$173.00 ,$95.15 ,$126.66 ,$45.50 ,$103.80 ,$103.53 ,$98.83 ,$132.99 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 , N/A ,$126.66 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,91400007,90834,HC THERAPY INDIVIDUAL PSYCH 45MIN,914,1 ,$220.00 ,$143.00 ,$57.86 ,$316.65 ,$316.65 ,$112.20 ,$121.00 ,$126.66 ,$61.60 ,$107.80 ,$126.66 ,$128.70 ,$126.66 ,$119.46 ,$144.60 ,$126.66 ,$119.46 ,$220.00 ,$143.00 ,$110.00 ,$176.00 ,$316.64 ,$126.66 ,$198.00 ,$126.66 ,$132.00 ,$126.66 ,$165.00 ,$121.44 ,$109.56 ,$121.44 ,$126.66 ,$121.44 ,$171.60 ,$171.60 ,$187.00 ,$220.00 ,$143.00 ,$126.66 ,$220.00 ,$121.00 ,$126.66 ,$57.86 ,$132.00 ,$103.71 ,$98.99 ,$132.99 ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 , N/A ,$126.66 ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,91400012,90837,HC THERAPY INDIVIDUAL PSYCH 60MIN,914,1 ,$489.00 ,$317.85 ,$98.99 ,$489.00 ,$316.65 ,$249.39 ,$268.95 ,$126.66 ,$136.92 ,$239.61 ,$126.66 ,$286.07 ,$126.66 ,$265.53 ,$217.24 ,$126.66 ,$265.53 ,$240.65 ,$317.85 ,$244.50 ,$391.20 ,$316.64 ,$126.66 ,$440.10 ,$126.66 ,$293.40 ,$126.66 ,$366.75 ,$269.93 ,$243.52 ,$269.93 ,$126.66 ,$269.93 ,$381.42 ,$381.42 ,$415.65 ,$316.64 ,$317.85 ,$126.66 ,$489.00 ,$268.95 ,$126.66 ,$128.61 ,$293.40 ,$103.71 ,$98.99 ,$132.99 ,$391.20 ,$265.53 ,$136.92 ,$440.10 ,$185.82 , N/A ,$126.66 ,$234.72 
ST. MARY'S HOSPITAL - DECATUR,91600001,90846,HC THERAPY FAMILY PSYCH W/O PATIENT MASTERS,916,1 ,$298.00 ,$193.70 ,$78.37 ,$316.65 ,$316.65 ,$151.98 ,$163.90 ,$126.66 ,$83.44 ,$146.02 ,$126.66 ,$174.33 ,$126.66 ,$161.81 ,$188.41 ,$126.66 ,$161.81 ,$240.65 ,$193.70 ,$149.00 ,$238.40 ,$316.64 ,$126.66 ,$268.20 ,$126.66 ,$178.80 ,$126.66 ,$223.50 ,$164.50 ,$148.40 ,$164.50 ,$126.66 ,$164.50 ,$232.44 ,$232.44 ,$253.30 ,$298.00 ,$193.70 ,$126.66 ,$298.00 ,$163.90 ,$126.66 ,$78.37 ,$178.80 ,$109.34 ,$104.37 ,$132.99 ,$238.40 ,$161.81 ,$83.44 ,$268.20 ,$113.24 , N/A ,$126.66 ,$143.04 
ST. MARY'S HOSPITAL - DECATUR,91600003,90847,HC THERAPY FAMILY PSYCH W/PATIENT MASTERS,916,1 ,$323.00 ,$209.95 ,$84.95 ,$323.00 ,$316.65 ,$164.73 ,$177.65 ,$126.66 ,$90.44 ,$158.27 ,$126.66 ,$188.96 ,$126.66 ,$175.39 ,$195.77 ,$126.66 ,$175.39 ,$240.65 ,$209.95 ,$161.50 ,$258.40 ,$316.64 ,$126.66 ,$290.70 ,$126.66 ,$193.80 ,$126.66 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$126.66 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$316.64 ,$209.95 ,$126.66 ,$323.00 ,$177.65 ,$126.66 ,$84.95 ,$193.80 ,$109.34 ,$104.37 ,$132.99 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$126.66 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,91600005,90846,HC THERAPY FAMILY PSYCH W/O PATIENT 50 MIN,916,1 ,$298.00 ,$193.70 ,$78.37 ,$316.65 ,$316.65 ,$151.98 ,$163.90 ,$126.66 ,$83.44 ,$146.02 ,$126.66 ,$174.33 ,$126.66 ,$161.81 ,$188.41 ,$126.66 ,$161.81 ,$240.65 ,$193.70 ,$149.00 ,$238.40 ,$316.64 ,$126.66 ,$268.20 ,$126.66 ,$178.80 ,$126.66 ,$223.50 ,$164.50 ,$148.40 ,$164.50 ,$126.66 ,$164.50 ,$232.44 ,$232.44 ,$253.30 ,$298.00 ,$193.70 ,$126.66 ,$298.00 ,$163.90 ,$126.66 ,$78.37 ,$178.80 ,$109.34 ,$104.37 ,$132.99 ,$238.40 ,$161.81 ,$83.44 ,$268.20 ,$113.24 , N/A ,$126.66 ,$143.04 
ST. MARY'S HOSPITAL - DECATUR,91600006,90847,HC THERAPY FAMILY PSYCH W/PATIENT 50 MIN,916,1 ,$323.00 ,$209.95 ,$84.95 ,$323.00 ,$316.65 ,$164.73 ,$177.65 ,$126.66 ,$90.44 ,$158.27 ,$126.66 ,$188.96 ,$126.66 ,$175.39 ,$195.77 ,$126.66 ,$175.39 ,$240.65 ,$209.95 ,$161.50 ,$258.40 ,$316.64 ,$126.66 ,$290.70 ,$126.66 ,$193.80 ,$126.66 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$126.66 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$316.64 ,$209.95 ,$126.66 ,$323.00 ,$177.65 ,$126.66 ,$84.95 ,$193.80 ,$109.34 ,$104.37 ,$132.99 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$126.66 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,91600007,90853,HC THERAPY GROUP PSYCH,916,1 ,$323.00 ,$209.95 ,$54.52 ,$323.00 ,$177.08 ,$164.73 ,$177.65 ,$70.83 ,$90.44 ,$158.27 ,$70.83 ,$188.96 ,$70.83 ,$175.39 ,$54.52 ,$70.83 ,$175.39 ,$134.58 ,$209.95 ,$161.50 ,$258.40 ,$177.08 ,$70.83 ,$290.70 ,$70.83 ,$193.80 ,$70.83 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$70.83 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$177.08 ,$209.95 ,$70.83 ,$323.00 ,$177.65 ,$70.83 ,$84.95 ,$193.80 ,$147.05 ,$140.36 ,$74.37 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$70.83 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,91800008,96112,HC DEVELOPMENT TEST ADMIN MD/QHCP INIT HOUR,918,1 ,$683.00 ,$443.95 ,$179.63 ,$683.00 ,$616.30 ,$348.33 ,$375.65 ,$246.52 ,$191.24 ,$321.01 ,$246.52 ,$368.82 ,$246.52 ,$370.87 ,$295.93 ,$246.52 ,$370.87 ,$468.38 ,$478.10 ,$341.50 ,$546.40 ,$616.29 ,$246.52 ,$614.70 ,$246.52 ,$409.80 ,$246.52 ,$512.25 ,$377.02 ,$340.13 ,$377.02 ,$246.52 ,$377.02 ,$532.74 ,$532.74 ,$580.55 ,$616.29 ,$473.32 ,$246.52 ,$683.00 ,$375.65 ,$246.52 ,$179.63 ,$409.80 ,$562.06 ,$536.51 ,$258.85 ,$546.40 ,$370.87 ,$191.24 ,$614.70 ,$259.54 ,$359.00 ,$246.52 ,$327.84 
ST. MARY'S HOSPITAL - DECATUR,91800009,96113,HC DEVELOPMENT TEST ADMIN MD/QHCP ADDL HOUR,918,1 ,$683.00 ,$443.95 ,$135.33 ,$683.00 , N/A ,$348.33 ,$375.65 , N/A ,$191.24 ,$321.01 , N/A ,$368.82 , N/A ,$370.87 ,$135.33 , N/A ,$370.87 , N/A ,$478.10 ,$341.50 ,$546.40 , N/A , N/A ,$614.70 , N/A ,$409.80 , N/A ,$512.25 ,$377.02 ,$340.13 ,$377.02 , N/A ,$377.02 ,$532.74 ,$532.74 ,$580.55 , N/A ,$473.32 , N/A ,$683.00 ,$375.65 , N/A ,$179.63 ,$409.80 ,$562.06 ,$536.51 , N/A ,$546.40 ,$370.87 ,$191.24 ,$614.70 ,$259.54 ,$359.00 , N/A ,$327.84 
ST. MARY'S HOSPITAL - DECATUR,91800010,96130,HC PSYCH TESTING EVAL MD/QHCP INIT HOUR,918,1 ,$422.00 ,$274.30 ,$110.99 ,$616.30 ,$616.30 ,$215.22 ,$232.10 ,$246.52 ,$118.16 ,$198.34 ,$246.52 ,$227.88 ,$246.52 ,$229.15 ,$256.07 ,$246.52 ,$229.15 ,$422.00 ,$295.40 ,$211.00 ,$337.60 ,$616.29 ,$246.52 ,$379.80 ,$246.52 ,$253.20 ,$246.52 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$246.52 ,$232.94 ,$329.16 ,$329.16 ,$358.70 ,$422.00 ,$292.45 ,$246.52 ,$422.00 ,$232.10 ,$246.52 ,$110.99 ,$253.20 ,$422.00 ,$536.51 ,$258.85 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$359.00 ,$246.52 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,91800011,96131,HC PSYCH TESTING EVAL MD/QHCP ADDL HOUR,918,1 ,$211.00 ,$137.15 ,$55.49 ,$536.51 , N/A ,$107.61 ,$116.05 , N/A ,$59.08 ,$99.17 , N/A ,$113.94 , N/A ,$114.57 ,$194.87 , N/A ,$114.57 , N/A ,$147.70 ,$105.50 ,$168.80 , N/A , N/A ,$189.90 , N/A ,$126.60 , N/A ,$158.25 ,$116.47 ,$105.08 ,$116.47 , N/A ,$116.47 ,$164.58 ,$164.58 ,$179.35 , N/A ,$146.22 , N/A ,$211.00 ,$116.05 , N/A ,$55.49 ,$126.60 ,$211.00 ,$536.51 , N/A ,$168.80 ,$114.57 ,$59.08 ,$189.90 ,$80.18 ,$211.00 , N/A ,$101.28 
ST. MARY'S HOSPITAL - DECATUR,91800012,96146,HC PSYCH TESTING EVAL SINGLE AUTO EVAL,918,1 ,$422.00 ,$274.30 ,$4.82 ,$536.51 ,$58.45 ,$215.22 ,$232.10 ,$23.38 ,$118.16 ,$198.34 ,$23.38 ,$227.88 ,$23.38 ,$229.15 ,$4.82 ,$23.38 ,$229.15 ,$44.43 ,$295.40 ,$211.00 ,$337.60 ,$58.46 ,$23.38 ,$379.80 ,$23.38 ,$253.20 ,$23.38 ,$316.50 ,$232.94 ,$210.16 ,$232.94 ,$23.38 ,$232.94 ,$329.16 ,$329.16 ,$358.70 ,$58.46 ,$292.45 ,$23.38 ,$422.00 ,$232.10 ,$23.38 ,$110.99 ,$253.20 ,$422.00 ,$536.51 ,$24.55 ,$337.60 ,$229.15 ,$118.16 ,$379.80 ,$160.36 ,$359.00 ,$23.38 ,$202.56 
ST. MARY'S HOSPITAL - DECATUR,92000002,59025,HC TEST NON STRESS FETAL,920,1 ,"$1,225.00 ",$796.25 ,$31.73 ,"$1,225.00 ",$403.15 ,$624.75 ,$673.75 ,$161.26 ,$343.00 ,$575.75 ,$161.26 ,$661.50 ,$161.26 ,$665.18 ,$31.73 ,$161.26 ,$665.18 ,$306.40 ,$857.50 ,$612.50 ,$980.00 ,$403.16 ,$161.26 ,$857.50 ,$161.26 ,$735.00 ,$161.26 ,$918.75 ,$676.20 ,$610.05 ,$676.20 ,$161.26 ,$676.20 ,$955.50 ,$955.50 ,"$1,041.25 ",$403.16 ,$848.93 ,$161.26 ,"$1,225.00 ",$673.75 ,$161.26 ,$322.18 ,"$1,225.00 ", N/A , N/A ,$169.32 ,$980.00 ,$665.18 ,$343.00 ,"$1,102.50 ",$465.50 ,$215.00 ,$161.26 ,$588.00 
ST. MARY'S HOSPITAL - DECATUR,92000003,93786,HC AMBUL BLOOD PRESS MONITR,920,1 ,$606.00 ,$393.90 ,$46.13 ,$606.00 ,$266.85 ,$309.06 ,$333.30 ,$106.74 ,$169.68 ,$296.94 ,$106.74 ,$354.51 ,$106.74 ,$329.06 ,$57.04 ,$106.74 ,$329.06 ,$202.80 ,$424.20 ,$303.00 ,$484.80 ,$266.84 ,$106.74 ,$424.20 ,$106.74 ,$363.60 ,$106.74 ,$454.50 ,$334.51 ,$301.79 ,$334.51 ,$106.74 ,$334.51 ,$472.68 ,$472.68 ,$515.10 ,$266.84 ,$419.96 ,$106.74 ,$606.00 ,$333.30 ,$106.74 ,$159.38 ,$606.00 ,$48.32 ,$46.13 ,$112.08 ,$484.80 ,$329.06 ,$169.68 ,$545.40 ,$230.28 ,$215.00 ,$106.74 ,$290.88 
ST. MARY'S HOSPITAL - DECATUR,92000016,95970,HC ANALYZE NEUROSTIM W/O PROGRAMMING,920,1 ,$736.00 ,$478.40 ,$28.23 ,$736.00 ,$266.85 ,$375.36 ,$404.80 ,$106.74 ,$206.08 ,$318.98 ,$106.74 ,$318.98 ,$106.74 ,$399.65 ,$29.22 ,$106.74 ,$399.65 ,$202.80 ,$515.20 ,$368.00 ,$588.80 ,$266.84 ,$106.74 ,$515.20 ,$106.74 ,$441.60 ,$106.74 ,$552.00 ,$406.27 ,$366.53 ,$406.27 ,$106.74 ,$406.27 ,$574.08 ,$574.08 ,$625.60 ,$266.84 ,$510.05 ,$106.74 ,$736.00 ,$404.80 ,$106.74 ,$193.57 ,$736.00 ,$29.58 ,$28.23 ,$112.08 ,$588.80 ,$399.65 ,$206.08 ,$662.40 ,$279.68 ,$215.00 ,$106.74 ,$353.28 
ST. MARY'S HOSPITAL - DECATUR,92000017,N/A,HC ADULT DAYCARE 15 MIN,920,1 ,$2.25 ,$1.46 ,$0.59 ,$2.25 , N/A ,$1.15 ,$1.24 , N/A ,$0.63 ,$1.06 , N/A ,$1.22 , N/A ,$1.22 ,$0.90 , N/A ,$1.22 , N/A ,$1.58 ,$1.13 ,$1.80 , N/A , N/A ,$1.58 , N/A ,$1.35 , N/A ,$1.69 ,$1.24 ,$1.12 ,$1.24 , N/A ,$1.24 ,$1.76 ,$1.76 ,$1.91 , N/A ,$1.56 , N/A ,$2.25 ,$1.24 , N/A ,$0.59 ,$2.25 , N/A , N/A , N/A ,$1.80 ,$1.22 ,$0.63 ,$2.03 ,$0.86 ,$2.25 , N/A ,$1.08 
ST. MARY'S HOSPITAL - DECATUR,92000018,N/A,HC ADULT DAYCARE NON IDOA FULL DAY,920,1 ,$78.00 ,$50.70 ,$20.51 ,$78.00 , N/A ,$39.78 ,$42.90 , N/A ,$21.84 ,$36.66 , N/A ,$42.12 , N/A ,$42.35 ,$31.20 , N/A ,$42.35 , N/A ,$54.60 ,$39.00 ,$62.40 , N/A , N/A ,$54.60 , N/A ,$46.80 , N/A ,$58.50 ,$43.06 ,$38.84 ,$43.06 , N/A ,$43.06 ,$60.84 ,$60.84 ,$66.30 , N/A ,$54.05 , N/A ,$78.00 ,$42.90 , N/A ,$20.51 ,$78.00 , N/A , N/A , N/A ,$62.40 ,$42.35 ,$21.84 ,$70.20 ,$29.64 ,$78.00 , N/A ,$37.44 
ST. MARY'S HOSPITAL - DECATUR,92000019,N/A,HC ADULT DAYCARE NON IDOA HALF DAY,920,1 ,$39.00 ,$25.35 ,$10.26 ,$39.00 , N/A ,$19.89 ,$21.45 , N/A ,$10.92 ,$18.33 , N/A ,$21.06 , N/A ,$21.18 ,$15.60 , N/A ,$21.18 , N/A ,$27.30 ,$19.50 ,$31.20 , N/A , N/A ,$27.30 , N/A ,$23.40 , N/A ,$29.25 ,$21.53 ,$19.42 ,$21.53 , N/A ,$21.53 ,$30.42 ,$30.42 ,$33.15 , N/A ,$27.03 , N/A ,$39.00 ,$21.45 , N/A ,$10.26 ,$39.00 , N/A , N/A , N/A ,$31.20 ,$21.18 ,$10.92 ,$35.10 ,$14.82 ,$39.00 , N/A ,$18.72 
ST. MARY'S HOSPITAL - DECATUR,92000020,N/A,HC ADULT DAYCARE TRANSPORTATION ONE WAY,920,1 ,$16.00 ,$10.40 ,$4.21 ,$16.00 , N/A ,$8.16 ,$8.80 , N/A ,$4.48 ,$7.52 , N/A ,$8.64 , N/A ,$8.69 ,$6.40 , N/A ,$8.69 , N/A ,$11.20 ,$8.00 ,$12.80 , N/A , N/A ,$11.20 , N/A ,$9.60 , N/A ,$12.00 ,$8.83 ,$7.97 ,$8.83 , N/A ,$8.83 ,$12.48 ,$12.48 ,$13.60 , N/A ,$11.09 , N/A ,$16.00 ,$8.80 , N/A ,$4.21 ,$16.00 , N/A , N/A , N/A ,$12.80 ,$8.69 ,$4.48 ,$14.40 ,$6.08 ,$16.00 , N/A ,$7.68 
ST. MARY'S HOSPITAL - DECATUR,92000021,N/A,HC ADULT DAYCARE TRANSPORTATION ROUND TRIP,920,1 ,$32.00 ,$20.80 ,$8.42 ,$32.00 , N/A ,$16.32 ,$17.60 , N/A ,$8.96 ,$15.04 , N/A ,$17.28 , N/A ,$17.38 ,$12.80 , N/A ,$17.38 , N/A ,$22.40 ,$16.00 ,$25.60 , N/A , N/A ,$22.40 , N/A ,$19.20 , N/A ,$24.00 ,$17.66 ,$15.94 ,$17.66 , N/A ,$17.66 ,$24.96 ,$24.96 ,$27.20 , N/A ,$22.18 , N/A ,$32.00 ,$17.60 , N/A ,$8.42 ,$32.00 , N/A , N/A , N/A ,$25.60 ,$17.38 ,$8.96 ,$28.80 ,$12.16 ,$32.00 , N/A ,$15.36 
ST. MARY'S HOSPITAL - DECATUR,92000029,N/A,HC ADULT DAYCARE AFTER HOURS EA 15 MIN,920,1 ,$13.00 ,$8.45 ,$3.42 ,$13.00 , N/A ,$6.63 ,$7.15 , N/A ,$3.64 ,$6.11 , N/A ,$7.02 , N/A ,$7.06 ,$5.20 , N/A ,$7.06 , N/A ,$9.10 ,$6.50 ,$10.40 , N/A , N/A ,$9.10 , N/A ,$7.80 , N/A ,$9.75 ,$7.18 ,$6.47 ,$7.18 , N/A ,$7.18 ,$10.14 ,$10.14 ,$11.05 , N/A ,$9.01 , N/A ,$13.00 ,$7.15 , N/A ,$3.42 ,$13.00 , N/A , N/A , N/A ,$10.40 ,$7.06 ,$3.64 ,$11.70 ,$4.94 ,$13.00 , N/A ,$6.24 
ST. MARY'S HOSPITAL - DECATUR,92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,468.00 ",$954.20 ,$101.56 ,"$1,468.00 ",$544.53 ,$748.68 ,$807.40 ,$217.81 ,$411.04 ,$719.32 ,$217.81 ,$858.78 ,$217.81 ,$797.12 ,$301.09 ,$217.81 ,$797.12 ,$413.84 ,"$1,027.60 ",$734.00 ,"$1,174.40 ",$544.53 ,$217.81 ,"$1,027.60 ",$217.81 ,$880.80 ,$217.81 ,"$1,101.00 ",$810.34 ,$731.06 ,$810.34 ,$217.81 ,$810.34 ,"$1,145.04 ","$1,145.04 ","$1,247.80 ",$544.53 ,"$1,017.32 ",$217.81 ,"$1,468.00 ",$807.40 ,$217.81 ,$386.08 ,"$1,468.00 ",$106.39 ,$101.56 ,$228.70 ,"$1,174.40 ",$797.12 ,$411.04 ,"$1,321.20 ",$557.84 ,$798.59 ,$217.81 ,$704.64 
ST. MARY'S HOSPITAL - DECATUR,92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,$725.00 ,$471.25 ,$101.56 ,$725.00 ,$257.65 ,$369.75 ,$398.75 ,$103.06 ,$203.00 ,$355.25 ,$103.06 ,$424.13 ,$103.06 ,$393.68 ,$193.41 ,$103.06 ,$393.68 ,$195.81 ,$507.50 ,$362.50 ,$580.00 ,$257.64 ,$103.06 ,$507.50 ,$103.06 ,$435.00 ,$103.06 ,$543.75 ,$400.20 ,$361.05 ,$400.20 ,$103.06 ,$400.20 ,$565.50 ,$565.50 ,$616.25 ,$257.64 ,$502.43 ,$103.06 ,$725.00 ,$398.75 ,$103.06 ,$190.68 ,$725.00 ,$106.39 ,$101.56 ,$108.21 ,$580.00 ,$393.68 ,$203.00 ,$652.50 ,$275.50 ,$394.40 ,$103.06 ,$348.00 
ST. MARY'S HOSPITAL - DECATUR,92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,"$1,351.00 ",$878.15 ,$94.70 ,"$1,351.00 ",$266.85 ,$689.01 ,$743.05 ,$106.74 ,$378.28 ,$661.99 ,$106.74 ,$790.34 ,$106.74 ,$733.59 ,$142.78 ,$106.74 ,$733.59 ,$202.80 ,$945.70 ,$675.50 ,"$1,080.80 ",$266.84 ,$106.74 ,$945.70 ,$106.74 ,$810.60 ,$106.74 ,"$1,013.25 ",$745.75 ,$672.80 ,$745.75 ,$106.74 ,$745.75 ,"$1,053.78 ","$1,053.78 ","$1,148.35 ",$266.84 ,$936.24 ,$106.74 ,"$1,351.00 ",$743.05 ,$106.74 ,$355.31 ,"$1,351.00 ",$99.21 ,$94.70 ,$112.08 ,"$1,080.80 ",$733.59 ,$378.28 ,"$1,215.90 ",$513.38 ,$734.94 ,$106.74 ,$648.48 
ST. MARY'S HOSPITAL - DECATUR,92100023,93923,HC TCPO2/ABI/PPG MULT LEVELS,921,1 ,"$1,386.00 ",$900.90 ,$94.70 ,"$1,386.00 ",$330.40 ,$706.86 ,$762.30 ,$132.16 ,$388.08 ,$679.14 ,$132.16 ,$810.81 ,$132.16 ,$752.60 ,$216.33 ,$132.16 ,$752.60 ,$251.11 ,$970.20 ,$693.00 ,"$1,108.80 ",$330.40 ,$132.16 ,$970.20 ,$132.16 ,$831.60 ,$132.16 ,"$1,039.50 ",$765.07 ,$690.23 ,$765.07 ,$132.16 ,$765.07 ,"$1,081.08 ","$1,081.08 ","$1,178.10 ",$330.40 ,$960.50 ,$132.16 ,"$1,386.00 ",$762.30 ,$132.16 ,$364.52 ,"$1,386.00 ",$99.21 ,$94.70 ,$138.77 ,"$1,108.80 ",$752.60 ,$388.08 ,"$1,247.40 ",$526.68 ,$753.98 ,$132.16 ,$665.28 
ST. MARY'S HOSPITAL - DECATUR,92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,"$1,386.00 ",$900.90 ,$94.70 ,"$1,386.00 ",$330.40 ,$706.86 ,$762.30 ,$132.16 ,$388.08 ,$679.14 ,$132.16 ,$810.81 ,$132.16 ,$752.60 ,$216.33 ,$132.16 ,$752.60 ,$251.11 ,$970.20 ,$693.00 ,"$1,108.80 ",$330.40 ,$132.16 ,$970.20 ,$132.16 ,$831.60 ,$132.16 ,"$1,039.50 ",$765.07 ,$690.23 ,$765.07 ,$132.16 ,$765.07 ,"$1,081.08 ","$1,081.08 ","$1,178.10 ",$330.40 ,$960.50 ,$132.16 ,"$1,386.00 ",$762.30 ,$132.16 ,$364.52 ,"$1,386.00 ",$99.21 ,$94.70 ,$138.77 ,"$1,108.80 ",$752.60 ,$388.08 ,"$1,247.40 ",$526.68 ,$753.98 ,$132.16 ,$665.28 
ST. MARY'S HOSPITAL - DECATUR,92100031,93923,HC RESTING ARTERIAL UPPER BILATERAL,921,1 ,"$1,386.00 ",$900.90 ,$94.70 ,"$1,386.00 ",$330.40 ,$706.86 ,$762.30 ,$132.16 ,$388.08 ,$679.14 ,$132.16 ,$810.81 ,$132.16 ,$752.60 ,$216.33 ,$132.16 ,$752.60 ,$251.11 ,$970.20 ,$693.00 ,"$1,108.80 ",$330.40 ,$132.16 ,$970.20 ,$132.16 ,$831.60 ,$132.16 ,"$1,039.50 ",$765.07 ,$690.23 ,$765.07 ,$132.16 ,$765.07 ,"$1,081.08 ","$1,081.08 ","$1,178.10 ",$330.40 ,$960.50 ,$132.16 ,"$1,386.00 ",$762.30 ,$132.16 ,$364.52 ,"$1,386.00 ",$99.21 ,$94.70 ,$138.77 ,"$1,108.80 ",$752.60 ,$388.08 ,"$1,247.40 ",$526.68 ,$753.98 ,$132.16 ,$665.28 
ST. MARY'S HOSPITAL - DECATUR,92100032,93924,HC DOPPLER ARTERY LWR EXT STRESS,921,1 ,"$1,690.00 ","$1,098.50 ",$94.70 ,"$1,690.00 ",$626.30 ,$861.90 ,$929.50 ,$250.52 ,$473.20 ,$828.10 ,$250.52 ,$988.65 ,$250.52 ,$917.67 ,$272.53 ,$250.52 ,$917.67 ,$475.99 ,"$1,183.00 ",$845.00 ,"$1,352.00 ",$626.30 ,$250.52 ,"$1,183.00 ",$250.52 ,"$1,014.00 ",$250.52 ,"$1,267.50 ",$932.88 ,$841.62 ,$932.88 ,$250.52 ,$932.88 ,"$1,318.20 ","$1,318.20 ","$1,436.50 ",$626.30 ,"$1,171.17 ",$250.52 ,"$1,690.00 ",$929.50 ,$250.52 ,$444.47 ,"$1,690.00 ",$99.21 ,$94.70 ,$263.05 ,"$1,352.00 ",$917.67 ,$473.20 ,"$1,521.00 ",$642.20 ,$919.36 ,$250.52 ,$811.20 
ST. MARY'S HOSPITAL - DECATUR,92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$1,757.00 ","$1,142.05 ",$133.68 ,"$1,757.00 ",$544.53 ,$896.07 ,$966.35 ,$217.81 ,$491.96 ,$860.93 ,$217.81 ,"$1,027.85 ",$217.81 ,$954.05 ,$420.79 ,$217.81 ,$954.05 ,$413.84 ,"$1,229.90 ",$878.50 ,"$1,405.60 ",$544.53 ,$217.81 ,"$1,229.90 ",$217.81 ,"$1,054.20 ",$217.81 ,"$1,317.75 ",$969.86 ,$874.99 ,$969.86 ,$217.81 ,$969.86 ,"$1,370.46 ","$1,370.46 ","$1,493.45 ",$544.53 ,"$1,217.60 ",$217.81 ,"$1,757.00 ",$966.35 ,$217.81 ,$462.09 ,"$1,757.00 ",$140.04 ,$133.68 ,$228.70 ,"$1,405.60 ",$954.05 ,$491.96 ,"$1,581.30 ",$667.66 ,$955.81 ,$217.81 ,$843.36 
ST. MARY'S HOSPITAL - DECATUR,92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,"$1,291.00 ",$839.15 ,$103.06 ,"$1,291.00 ",$257.65 ,$658.41 ,$710.05 ,$103.06 ,$361.48 ,$632.59 ,$103.06 ,$755.24 ,$103.06 ,$701.01 ,$245.12 ,$103.06 ,$701.01 ,$195.81 ,$903.70 ,$645.50 ,"$1,032.80 ",$257.64 ,$103.06 ,$903.70 ,$103.06 ,$774.60 ,$103.06 ,$968.25 ,$712.63 ,$642.92 ,$712.63 ,$103.06 ,$712.63 ,"$1,006.98 ","$1,006.98 ","$1,097.35 ",$257.64 ,$894.66 ,$103.06 ,"$1,291.00 ",$710.05 ,$103.06 ,$339.53 ,"$1,291.00 ",$140.04 ,$133.68 ,$108.21 ,"$1,032.80 ",$701.01 ,$361.48 ,"$1,161.90 ",$490.58 ,$702.30 ,$103.06 ,$619.68 
ST. MARY'S HOSPITAL - DECATUR,92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,900.00 ","$1,235.00 ",$101.56 ,"$1,900.00 ",$544.53 ,$969.00 ,"$1,045.00 ",$217.81 ,$532.00 ,$931.00 ,$217.81 ,"$1,111.50 ",$217.81 ,"$1,031.70 ",$321.88 ,$217.81 ,"$1,031.70 ",$413.84 ,"$1,330.00 ",$950.00 ,"$1,520.00 ",$544.53 ,$217.81 ,"$1,330.00 ",$217.81 ,"$1,140.00 ",$217.81 ,"$1,425.00 ","$1,048.80 ",$946.20 ,"$1,048.80 ",$217.81 ,"$1,048.80 ","$1,482.00 ","$1,482.00 ","$1,615.00 ",$544.53 ,"$1,316.70 ",$217.81 ,"$1,900.00 ","$1,045.00 ",$217.81 ,$499.70 ,"$1,900.00 ",$106.39 ,$101.56 ,$228.70 ,"$1,520.00 ","$1,031.70 ",$532.00 ,"$1,710.00 ",$722.00 ,"$1,033.60 ",$217.81 ,$912.00 
ST. MARY'S HOSPITAL - DECATUR,92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,"$1,339.00 ",$870.35 ,$101.56 ,"$1,339.00 ",$257.65 ,$682.89 ,$736.45 ,$103.06 ,$374.92 ,$656.11 ,$103.06 ,$783.32 ,$103.06 ,$727.08 ,$201.03 ,$103.06 ,$727.08 ,$195.81 ,$937.30 ,$669.50 ,"$1,071.20 ",$257.64 ,$103.06 ,$937.30 ,$103.06 ,$803.40 ,$103.06 ,"$1,004.25 ",$739.13 ,$666.82 ,$739.13 ,$103.06 ,$739.13 ,"$1,044.42 ","$1,044.42 ","$1,138.15 ",$257.64 ,$927.93 ,$103.06 ,"$1,339.00 ",$736.45 ,$103.06 ,$352.16 ,"$1,339.00 ",$106.39 ,$101.56 ,$108.21 ,"$1,071.20 ",$727.08 ,$374.92 ,"$1,205.10 ",$508.82 ,$728.42 ,$103.06 ,$642.72 
ST. MARY'S HOSPITAL - DECATUR,92100039,93931,HC DUPLEX ARTRL UPR EXT PSEUD ONLY,921,1 ,"$1,117.00 ",$726.05 ,$101.56 ,"$1,117.00 ",$257.65 ,$569.67 ,$614.35 ,$103.06 ,$312.76 ,$547.33 ,$103.06 ,$653.45 ,$103.06 ,$606.53 ,$201.03 ,$103.06 ,$606.53 ,$195.81 ,$781.90 ,$558.50 ,$893.60 ,$257.64 ,$103.06 ,$781.90 ,$103.06 ,$670.20 ,$103.06 ,$837.75 ,$616.58 ,$556.27 ,$616.58 ,$103.06 ,$616.58 ,$871.26 ,$871.26 ,$949.45 ,$257.64 ,$774.08 ,$103.06 ,"$1,117.00 ",$614.35 ,$103.06 ,$293.77 ,"$1,117.00 ",$106.39 ,$101.56 ,$108.21 ,$893.60 ,$606.53 ,$312.76 ,"$1,005.30 ",$424.46 ,$607.65 ,$103.06 ,$536.16 
ST. MARY'S HOSPITAL - DECATUR,92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$1,784.00 ","$1,159.60 ",$133.68 ,"$1,784.00 ",$544.53 ,$909.84 ,$981.20 ,$217.81 ,$499.52 ,$874.16 ,$217.81 ,"$1,043.64 ",$217.81 ,$968.71 ,$311.60 ,$217.81 ,$968.71 ,$413.84 ,"$1,248.80 ",$892.00 ,"$1,427.20 ",$544.53 ,$217.81 ,"$1,248.80 ",$217.81 ,"$1,070.40 ",$217.81 ,"$1,338.00 ",$984.77 ,$888.43 ,$984.77 ,$217.81 ,$984.77 ,"$1,391.52 ","$1,391.52 ","$1,516.40 ",$544.53 ,"$1,236.31 ",$217.81 ,"$1,784.00 ",$981.20 ,$217.81 ,$469.19 ,"$1,784.00 ",$140.04 ,$133.68 ,$228.70 ,"$1,427.20 ",$968.71 ,$499.52 ,"$1,605.60 ",$677.92 ,$970.50 ,$217.81 ,$856.32 
ST. MARY'S HOSPITAL - DECATUR,92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,"$1,458.00 ",$947.70 ,$103.06 ,"$1,458.00 ",$257.65 ,$743.58 ,$801.90 ,$103.06 ,$408.24 ,$714.42 ,$103.06 ,$852.93 ,$103.06 ,$791.69 ,$190.75 ,$103.06 ,$791.69 ,$195.81 ,"$1,020.60 ",$729.00 ,"$1,166.40 ",$257.64 ,$103.06 ,"$1,020.60 ",$103.06 ,$874.80 ,$103.06 ,"$1,093.50 ",$804.82 ,$726.08 ,$804.82 ,$103.06 ,$804.82 ,"$1,137.24 ","$1,137.24 ","$1,239.30 ",$257.64 ,"$1,010.39 ",$103.06 ,"$1,458.00 ",$801.90 ,$103.06 ,$383.45 ,"$1,458.00 ",$140.04 ,$133.68 ,$108.21 ,"$1,166.40 ",$791.69 ,$408.24 ,"$1,312.20 ",$554.04 ,$793.15 ,$103.06 ,$699.84 
ST. MARY'S HOSPITAL - DECATUR,92100046,93990,HC DUPLEX HEMODIALYSIS ACCESS,921,1 ,$700.00 ,$455.00 ,$101.56 ,$700.00 ,$257.65 ,$357.00 ,$385.00 ,$103.06 ,$196.00 ,$343.00 ,$103.06 ,$409.50 ,$103.06 ,$380.10 ,$245.71 ,$103.06 ,$380.10 ,$195.81 ,$490.00 ,$350.00 ,$560.00 ,$257.64 ,$103.06 ,$490.00 ,$103.06 ,$420.00 ,$103.06 ,$525.00 ,$386.40 ,$348.60 ,$386.40 ,$103.06 ,$386.40 ,$546.00 ,$546.00 ,$595.00 ,$257.64 ,$485.10 ,$103.06 ,$700.00 ,$385.00 ,$103.06 ,$184.10 ,$700.00 ,$106.39 ,$101.56 ,$108.21 ,$560.00 ,$380.10 ,$196.00 ,$630.00 ,$266.00 ,$380.80 ,$103.06 ,$336.00 
ST. MARY'S HOSPITAL - DECATUR,92100047,93980,HC DUPLEX PENILE VESSELS COMPLETE,921,1 ,"$1,388.00 ",$902.20 ,$101.56 ,"$1,388.00 ",$257.65 ,$707.88 ,$763.40 ,$103.06 ,$388.64 ,$680.12 ,$103.06 ,$811.98 ,$103.06 ,$753.68 ,$116.92 ,$103.06 ,$753.68 ,$195.81 ,$971.60 ,$694.00 ,"$1,110.40 ",$257.64 ,$103.06 ,$971.60 ,$103.06 ,$832.80 ,$103.06 ,"$1,041.00 ",$766.18 ,$691.22 ,$766.18 ,$103.06 ,$766.18 ,"$1,082.64 ","$1,082.64 ","$1,179.80 ",$257.64 ,$961.88 ,$103.06 ,"$1,388.00 ",$763.40 ,$103.06 ,$365.04 ,"$1,388.00 ",$106.39 ,$101.56 ,$108.21 ,"$1,110.40 ",$753.68 ,$388.64 ,"$1,249.20 ",$527.44 ,$755.07 ,$103.06 ,$666.24 
ST. MARY'S HOSPITAL - DECATUR,92100050,93293,HC ANALYSIS PACEMAKER TELEPHONIC,921,1 ,$230.00 ,$149.50 ,$28.23 ,$230.00 ,$88.13 ,$117.30 ,$126.50 ,$35.25 ,$64.40 ,$112.70 ,$35.25 ,$134.55 ,$35.25 ,$124.89 ,$72.10 ,$35.25 ,$124.89 ,$66.97 ,$161.00 ,$115.00 ,$184.00 ,$88.12 ,$35.25 ,$161.00 ,$35.25 ,$138.00 ,$35.25 ,$172.50 ,$126.96 ,$114.54 ,$126.96 ,$35.25 ,$126.96 ,$179.40 ,$179.40 ,$195.50 ,$88.12 ,$159.39 ,$35.25 ,$230.00 ,$126.50 ,$35.25 ,$60.49 ,$230.00 ,$29.58 ,$28.23 ,$37.01 ,$184.00 ,$124.89 ,$64.40 ,$207.00 ,$87.40 ,$125.12 ,$35.25 ,$110.40 
ST. MARY'S HOSPITAL - DECATUR,92100053,93985,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL BILATERAL STUDY,921,1 ,"$1,403.00 ",$911.95 ,$101.56 ,"$1,403.00 ",$544.53 ,$715.53 ,$771.65 ,$217.81 ,$392.84 ,$659.41 ,$217.81 ,$757.62 ,$217.81 ,$761.83 ,$423.20 ,$217.81 ,$761.83 ,$413.84 ,$982.10 ,$701.50 ,"$1,122.40 ",$544.53 ,$217.81 ,$982.10 ,$217.81 ,$841.80 ,$217.81 ,"$1,052.25 ",$774.46 ,$698.69 ,$774.46 ,$217.81 ,$774.46 ,"$1,094.34 ","$1,094.34 ","$1,192.55 ",$544.53 ,$972.28 ,$217.81 ,"$1,403.00 ",$771.65 ,$217.81 ,$368.99 ,"$1,403.00 ",$106.39 ,$101.56 ,$228.70 ,"$1,122.40 ",$761.83 ,$392.84 ,"$1,262.70 ",$533.14 ,$763.23 ,$217.81 ,$673.44 
ST. MARY'S HOSPITAL - DECATUR,92100054,93986,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL UNILATERAL STUDY,921,1 ,$750.00 ,$487.50 ,$101.56 ,$750.00 ,$257.65 ,$382.50 ,$412.50 ,$103.06 ,$210.00 ,$352.50 ,$103.06 ,$405.00 ,$103.06 ,$407.25 ,$240.95 ,$103.06 ,$407.25 ,$195.81 ,$525.00 ,$375.00 ,$600.00 ,$257.64 ,$103.06 ,$525.00 ,$103.06 ,$450.00 ,$103.06 ,$562.50 ,$414.00 ,$373.50 ,$414.00 ,$103.06 ,$414.00 ,$585.00 ,$585.00 ,$637.50 ,$257.64 ,$519.75 ,$103.06 ,$750.00 ,$412.50 ,$103.06 ,$197.25 ,$750.00 ,$106.39 ,$101.56 ,$108.21 ,$600.00 ,$407.25 ,$210.00 ,$675.00 ,$285.00 ,$408.00 ,$103.06 ,$360.00 
ST. MARY'S HOSPITAL - DECATUR,92200000,95860,HC EMG ONE EXTREMITY,922,1 ,"$1,074.00 ",$698.10 ,$100.58 ,"$1,074.00 ",$266.85 ,$547.74 ,$590.70 ,$106.74 ,$300.72 ,$526.26 ,$106.74 ,$628.29 ,$106.74 ,$583.18 ,$100.58 ,$106.74 ,$583.18 ,$202.80 ,$751.80 ,$537.00 ,$859.20 ,$266.84 ,$106.74 ,$751.80 ,$106.74 ,$644.40 ,$106.74 ,$805.50 ,$592.85 ,$534.85 ,$592.85 ,$106.74 ,$592.85 ,$837.72 ,$837.72 ,$912.90 ,$266.84 ,$744.28 ,$106.74 ,"$1,074.00 ",$590.70 ,$106.74 ,$282.46 ,"$1,074.00 ",$229.67 ,$219.23 ,$112.08 ,$859.20 ,$583.18 ,$300.72 ,$966.60 ,$408.12 ,$584.26 ,$106.74 ,$515.52 
ST. MARY'S HOSPITAL - DECATUR,92200001,95861,HC EMG TWO EXTREMITIES,922,1 ,"$1,132.00 ",$735.80 ,$106.74 ,"$1,132.00 ",$266.85 ,$577.32 ,$622.60 ,$106.74 ,$316.96 ,$554.68 ,$106.74 ,$662.22 ,$106.74 ,$614.68 ,$130.30 ,$106.74 ,$614.68 ,$202.80 ,$792.40 ,$566.00 ,$905.60 ,$266.84 ,$106.74 ,$792.40 ,$106.74 ,$679.20 ,$106.74 ,$849.00 ,$624.86 ,$563.74 ,$624.86 ,$106.74 ,$624.86 ,$882.96 ,$882.96 ,$962.20 ,$266.84 ,$784.48 ,$106.74 ,"$1,132.00 ",$622.60 ,$106.74 ,$297.72 ,"$1,132.00 ",$229.67 ,$219.23 ,$112.08 ,$905.60 ,$614.68 ,$316.96 ,"$1,018.80 ",$430.16 ,$615.81 ,$106.74 ,$543.36 
ST. MARY'S HOSPITAL - DECATUR,92200003,95867,HC EMG CRANIAL NERVE UNI,922,1 ,"$1,006.00 ",$653.90 ,$91.87 ,"$1,006.00 ",$626.30 ,$513.06 ,$553.30 ,$250.52 ,$281.68 ,$492.94 ,$250.52 ,$588.51 ,$250.52 ,$546.26 ,$91.87 ,$250.52 ,$546.26 ,$475.99 ,$704.20 ,$503.00 ,$804.80 ,$626.30 ,$250.52 ,$704.20 ,$250.52 ,$603.60 ,$250.52 ,$754.50 ,$555.31 ,$500.99 ,$555.31 ,$250.52 ,$555.31 ,$784.68 ,$784.68 ,$855.10 ,$626.30 ,$697.16 ,$250.52 ,"$1,006.00 ",$553.30 ,$250.52 ,$264.58 ,"$1,006.00 ",$229.67 ,$219.23 ,$263.05 ,$804.80 ,$546.26 ,$281.68 ,$905.40 ,$382.28 ,$547.26 ,$250.52 ,$482.88 
ST. MARY'S HOSPITAL - DECATUR,92200008,95925,HC SSEP UPPER LIMBS,922,1 ,"$1,708.00 ","$1,110.20 ",$150.95 ,"$1,708.00 ",$626.30 ,$871.08 ,$939.40 ,$250.52 ,$478.24 ,$836.92 ,$250.52 ,$999.18 ,$250.52 ,$927.44 ,$150.95 ,$250.52 ,$927.44 ,$475.99 ,"$1,195.60 ",$854.00 ,"$1,366.40 ",$626.30 ,$250.52 ,"$1,195.60 ",$250.52 ,"$1,024.80 ",$250.52 ,"$1,281.00 ",$942.82 ,$850.58 ,$942.82 ,$250.52 ,$942.82 ,"$1,332.24 ","$1,332.24 ","$1,451.80 ",$626.30 ,"$1,183.64 ",$250.52 ,"$1,708.00 ",$939.40 ,$250.52 ,$449.20 ,"$1,708.00 ",$229.67 ,$219.23 ,$263.05 ,"$1,366.40 ",$927.44 ,$478.24 ,"$1,537.20 ",$649.04 ,$929.15 ,$250.52 ,$819.84 
ST. MARY'S HOSPITAL - DECATUR,92200009,95926,HC SSEP LOWER LIMBS,922,1 ,"$1,708.00 ","$1,110.20 ",$145.32 ,"$1,708.00 ",$626.30 ,$871.08 ,$939.40 ,$250.52 ,$478.24 ,$836.92 ,$250.52 ,$999.18 ,$250.52 ,$927.44 ,$145.32 ,$250.52 ,$927.44 ,$475.99 ,"$1,195.60 ",$854.00 ,"$1,366.40 ",$626.30 ,$250.52 ,"$1,195.60 ",$250.52 ,"$1,024.80 ",$250.52 ,"$1,281.00 ",$942.82 ,$850.58 ,$942.82 ,$250.52 ,$942.82 ,"$1,332.24 ","$1,332.24 ","$1,451.80 ",$626.30 ,"$1,183.64 ",$250.52 ,"$1,708.00 ",$939.40 ,$250.52 ,$449.20 ,"$1,708.00 ",$229.67 ,$219.23 ,$263.05 ,"$1,366.40 ",$927.44 ,$478.24 ,"$1,537.20 ",$649.04 ,$929.15 ,$250.52 ,$819.84 
ST. MARY'S HOSPITAL - DECATUR,92200010,95930,HC EVOKED POTENTIAL VISUAL,922,1 ,"$1,234.00 ",$802.10 ,$71.89 ,"$1,234.00 ",$626.30 ,$629.34 ,$678.70 ,$250.52 ,$345.52 ,$604.66 ,$250.52 ,$647.90 ,$250.52 ,$670.06 ,$71.89 ,$250.52 ,$670.06 ,$475.99 ,$863.80 ,$617.00 ,$987.20 ,$626.30 ,$250.52 ,$863.80 ,$250.52 ,$740.40 ,$250.52 ,$925.50 ,$681.17 ,$614.53 ,$681.17 ,$250.52 ,$681.17 ,$962.52 ,$962.52 ,"$1,048.90 ",$626.30 ,$855.16 ,$250.52 ,"$1,234.00 ",$678.70 ,$250.52 ,$324.54 ,"$1,234.00 ",$229.67 ,$219.23 ,$263.05 ,$987.20 ,$670.06 ,$345.52 ,"$1,110.60 ",$468.92 ,$671.30 ,$250.52 ,$592.32 
ST. MARY'S HOSPITAL - DECATUR,92200011,95886,HC EMG ADD ON >5 MUSCLES,922,1 ,$336.00 ,$218.40 ,$69.68 ,$336.00 , N/A ,$171.36 ,$184.80 , N/A ,$94.08 ,$157.92 , N/A ,$181.44 , N/A ,$182.45 ,$69.68 , N/A ,$182.45 , N/A ,$235.20 ,$168.00 ,$268.80 , N/A , N/A ,$235.20 , N/A ,$201.60 , N/A ,$252.00 ,$185.47 ,$167.33 ,$185.47 , N/A ,$185.47 ,$262.08 ,$262.08 ,$285.60 , N/A ,$232.85 , N/A ,$336.00 ,$184.80 , N/A ,$88.37 ,$336.00 ,$229.67 ,$219.23 , N/A ,$268.80 ,$182.45 ,$94.08 ,$302.40 ,$127.68 ,$182.78 , N/A ,$161.28 
ST. MARY'S HOSPITAL - DECATUR,92200015,95938,HC SSEP UPPER AND LOWER,922,1 ,"$1,467.00 ",$953.55 ,$219.23 ,"$1,467.00 ","$1,155.18 ",$748.17 ,$806.85 ,$462.07 ,$410.76 ,$689.49 ,$462.07 ,$792.18 ,$462.07 ,$796.58 ,$434.44 ,$462.07 ,$796.58 ,$877.93 ,"$1,026.90 ",$733.50 ,"$1,173.60 ","$1,155.17 ",$462.07 ,"$1,026.90 ",$462.07 ,$880.20 ,$462.07 ,"$1,100.25 ",$809.78 ,$730.57 ,$809.78 ,$462.07 ,$809.78 ,"$1,144.26 ","$1,144.26 ","$1,246.95 ","$1,155.17 ","$1,016.63 ",$462.07 ,"$1,467.00 ",$806.85 ,$462.07 ,$385.82 ,"$1,467.00 ",$229.67 ,$219.23 ,$485.17 ,"$1,173.60 ",$796.58 ,$410.76 ,"$1,320.30 ",$557.46 ,$798.05 ,$462.07 ,$704.16 
ST. MARY'S HOSPITAL - DECATUR,92200016,95885,HC EMG ADD ON <5 MUSCLES,922,1 ,$170.00 ,$110.50 ,$44.71 ,$219.23 , N/A ,$86.70 ,$93.50 , N/A ,$47.60 ,$79.90 , N/A ,$91.80 , N/A ,$92.31 ,$60.97 , N/A ,$92.31 , N/A ,$119.00 ,$85.00 ,$136.00 , N/A , N/A ,$119.00 , N/A ,$102.00 , N/A ,$127.50 ,$93.84 ,$84.66 ,$93.84 , N/A ,$93.84 ,$132.60 ,$132.60 ,$144.50 , N/A ,$117.81 , N/A ,$170.00 ,$93.50 , N/A ,$44.71 ,$170.00 ,$170.00 ,$219.23 , N/A ,$136.00 ,$92.31 ,$47.60 ,$153.00 ,$64.60 ,$92.48 , N/A ,$81.60 
ST. MARY'S HOSPITAL - DECATUR,92200017,95887,HC EMG ADD ON CRANIAL,922,1 ,$90.00 ,$58.50 ,$23.67 ,$219.23 , N/A ,$45.90 ,$49.50 , N/A ,$25.20 ,$42.30 , N/A ,$48.60 , N/A ,$48.87 ,$64.04 , N/A ,$48.87 , N/A ,$63.00 ,$45.00 ,$72.00 , N/A , N/A ,$63.00 , N/A ,$54.00 , N/A ,$67.50 ,$49.68 ,$44.82 ,$49.68 , N/A ,$49.68 ,$70.20 ,$70.20 ,$76.50 , N/A ,$62.37 , N/A ,$90.00 ,$49.50 , N/A ,$23.67 ,$90.00 ,$90.00 ,$219.23 , N/A ,$72.00 ,$48.87 ,$25.20 ,$81.00 ,$34.20 ,$48.96 , N/A ,$43.20 
ST. MARY'S HOSPITAL - DECATUR,92200021,95907,HC NVR CNDJ TST 1-2 STUDIES,922,1 ,$828.00 ,$538.20 ,$61.13 ,$828.00 ,$330.40 ,$422.28 ,$455.40 ,$132.16 ,$231.84 ,$389.16 ,$132.16 ,$447.12 ,$132.16 ,$449.60 ,$61.13 ,$132.16 ,$449.60 ,$251.11 ,$579.60 ,$414.00 ,$662.40 ,$330.40 ,$132.16 ,$579.60 ,$132.16 ,$496.80 ,$132.16 ,$621.00 ,$457.06 ,$412.34 ,$457.06 ,$132.16 ,$457.06 ,$645.84 ,$645.84 ,$703.80 ,$330.40 ,$573.80 ,$132.16 ,$828.00 ,$455.40 ,$132.16 ,$217.76 ,$828.00 ,$229.67 ,$219.23 ,$138.77 ,$662.40 ,$449.60 ,$231.84 ,$745.20 ,$314.64 ,$450.43 ,$132.16 ,$397.44 
ST. MARY'S HOSPITAL - DECATUR,92200022,95908,HC NVR CNDJ TST 3-4 STUDIES,922,1 ,"$1,659.00 ","$1,078.35 ",$81.62 ,"$1,659.00 ",$626.30 ,$846.09 ,$912.45 ,$250.52 ,$464.52 ,$779.73 ,$250.52 ,$895.86 ,$250.52 ,$900.84 ,$81.62 ,$250.52 ,$900.84 ,$475.99 ,"$1,161.30 ",$829.50 ,"$1,327.20 ",$626.30 ,$250.52 ,"$1,161.30 ",$250.52 ,$995.40 ,$250.52 ,"$1,244.25 ",$915.77 ,$826.18 ,$915.77 ,$250.52 ,$915.77 ,"$1,294.02 ","$1,294.02 ","$1,410.15 ",$626.30 ,"$1,149.69 ",$250.52 ,"$1,659.00 ",$912.45 ,$250.52 ,$436.32 ,"$1,659.00 ",$229.67 ,$219.23 ,$263.05 ,"$1,327.20 ",$900.84 ,$464.52 ,"$1,493.10 ",$630.42 ,$902.50 ,$250.52 ,$796.32 
ST. MARY'S HOSPITAL - DECATUR,92200023,95909,HC NVR CNDJ TST 5-6 STUDIES,922,1 ,"$2,488.00 ","$1,617.20 ",$97.51 ,"$2,488.00 ",$626.30 ,"$1,268.88 ","$1,368.40 ",$250.52 ,$696.64 ,"$1,169.36 ",$250.52 ,"$1,343.52 ",$250.52 ,"$1,350.98 ",$97.51 ,$250.52 ,"$1,350.98 ",$475.99 ,"$1,741.60 ","$1,244.00 ","$1,990.40 ",$626.30 ,$250.52 ,"$1,741.60 ",$250.52 ,"$1,492.80 ",$250.52 ,"$1,866.00 ","$1,373.38 ","$1,239.02 ","$1,373.38 ",$250.52 ,"$1,373.38 ","$1,940.64 ","$1,940.64 ","$2,114.80 ",$626.30 ,"$1,724.18 ",$250.52 ,"$2,488.00 ","$1,368.40 ",$250.52 ,$654.34 ,"$2,488.00 ",$229.67 ,$219.23 ,$263.05 ,"$1,990.40 ","$1,350.98 ",$696.64 ,"$2,239.20 ",$945.44 ,"$1,353.47 ",$250.52 ,"$1,194.24 "
ST. MARY'S HOSPITAL - DECATUR,92200024,95910,HC NVR CNDJ TST 7-8 STUDIES,922,1 ,"$3,318.00 ","$2,156.70 ",$125.17 ,"$3,318.00 ",$626.30 ,"$1,692.18 ","$1,824.90 ",$250.52 ,$929.04 ,"$1,559.46 ",$250.52 ,"$1,791.72 ",$250.52 ,"$1,801.67 ",$125.17 ,$250.52 ,"$1,801.67 ",$475.99 ,"$2,322.60 ","$1,659.00 ","$2,654.40 ",$626.30 ,$250.52 ,"$2,322.60 ",$250.52 ,"$1,990.80 ",$250.52 ,"$2,488.50 ","$1,831.54 ","$1,652.36 ","$1,831.54 ",$250.52 ,"$1,831.54 ","$2,588.04 ","$2,588.04 ","$2,820.30 ",$626.30 ,"$2,299.37 ",$250.52 ,"$3,318.00 ","$1,824.90 ",$250.52 ,$872.63 ,"$3,318.00 ",$229.67 ,$219.23 ,$263.05 ,"$2,654.40 ","$1,801.67 ",$929.04 ,"$2,986.20 ","$1,260.84 ","$1,804.99 ",$250.52 ,"$1,592.64 "
ST. MARY'S HOSPITAL - DECATUR,92200025,95911,HC NVR CNDJ TST 9-10 STUDIES,922,1 ,"$4,147.00 ","$2,695.55 ",$143.10 ,"$4,147.00 ","$1,155.18 ","$2,114.97 ","$2,280.85 ",$462.07 ,"$1,161.16 ","$1,949.09 ",$462.07 ,"$2,239.38 ",$462.07 ,"$2,251.82 ",$143.10 ,$462.07 ,"$2,251.82 ",$877.93 ,"$2,902.90 ","$2,073.50 ","$3,317.60 ","$1,155.17 ",$462.07 ,"$2,902.90 ",$462.07 ,"$2,488.20 ",$462.07 ,"$3,110.25 ","$2,289.14 ","$2,065.21 ","$2,289.14 ",$462.07 ,"$2,289.14 ","$3,234.66 ","$3,234.66 ","$3,524.95 ","$1,155.17 ","$2,873.87 ",$462.07 ,"$4,147.00 ","$2,280.85 ",$462.07 ,"$1,090.66 ","$4,147.00 ",$229.67 ,$219.23 ,$485.17 ,"$3,317.60 ","$2,251.82 ","$1,161.16 ","$3,732.30 ","$1,575.86 ","$2,255.97 ",$462.07 ,"$1,990.56 "
ST. MARY'S HOSPITAL - DECATUR,92200026,95912,HC NVR CNDJ TST 11-12 STUDIES,922,1 ,"$4,975.00 ","$3,233.75 ",$147.72 ,"$4,975.00 ","$1,155.18 ","$2,537.25 ","$2,736.25 ",$462.07 ,"$1,393.00 ","$2,338.25 ",$462.07 ,"$2,686.50 ",$462.07 ,"$2,701.43 ",$147.72 ,$462.07 ,"$2,701.43 ",$877.93 ,"$3,482.50 ","$2,487.50 ","$3,980.00 ","$1,155.17 ",$462.07 ,"$3,482.50 ",$462.07 ,"$2,985.00 ",$462.07 ,"$3,731.25 ","$2,746.20 ","$2,477.55 ","$2,746.20 ",$462.07 ,"$2,746.20 ","$3,880.50 ","$3,880.50 ","$4,228.75 ","$1,155.17 ","$3,447.68 ",$462.07 ,"$4,975.00 ","$2,736.25 ",$462.07 ,"$1,308.43 ","$4,975.00 ",$229.67 ,$219.23 ,$485.17 ,"$3,980.00 ","$2,701.43 ","$1,393.00 ","$4,477.50 ","$1,890.50 ","$2,706.40 ",$462.07 ,"$2,388.00 "
ST. MARY'S HOSPITAL - DECATUR,92200027,95913,HC NVR CNDJ TST 13 AND > STUDIES,922,1 ,"$8,293.00 ","$5,390.45 ",$163.60 ,"$8,293.00 ","$1,155.18 ","$4,229.43 ","$4,561.15 ",$462.07 ,"$2,322.04 ","$3,897.71 ",$462.07 ,"$4,478.22 ",$462.07 ,"$4,503.10 ",$163.60 ,$462.07 ,"$4,503.10 ",$877.93 ,"$5,805.10 ","$4,146.50 ","$6,634.40 ","$1,155.17 ",$462.07 ,"$5,805.10 ",$462.07 ,"$4,975.80 ",$462.07 ,"$6,219.75 ","$4,577.74 ","$4,129.91 ","$4,577.74 ",$462.07 ,"$4,577.74 ","$6,468.54 ","$6,468.54 ","$7,049.05 ","$1,155.17 ","$5,747.05 ",$462.07 ,"$8,293.00 ","$4,561.15 ",$462.07 ,"$2,181.06 ","$8,293.00 ",$229.67 ,$219.23 ,$485.17 ,"$6,634.40 ","$4,503.10 ","$2,322.04 ","$7,463.70 ","$3,151.34 ","$4,511.39 ",$462.07 ,"$3,980.64 "
ST. MARY'S HOSPITAL - DECATUR,92200029,95870,HC EMG NON LIMB,922,1 ,$543.00 ,$352.95 ,$103.14 ,$543.00 ,$266.85 ,$276.93 ,$298.65 ,$106.74 ,$152.04 ,$266.07 ,$106.74 ,$317.66 ,$106.74 ,$294.85 ,$103.14 ,$106.74 ,$294.85 ,$202.80 ,$380.10 ,$271.50 ,$434.40 ,$266.84 ,$106.74 ,$380.10 ,$106.74 ,$325.80 ,$106.74 ,$407.25 ,$299.74 ,$270.41 ,$299.74 ,$106.74 ,$299.74 ,$423.54 ,$423.54 ,$461.55 ,$266.84 ,$376.30 ,$106.74 ,$543.00 ,$298.65 ,$106.74 ,$142.81 ,$543.00 ,$229.67 ,$219.23 ,$112.08 ,$434.40 ,$294.85 ,$152.04 ,$488.70 ,$206.34 ,$295.39 ,$106.74 ,$260.64 
ST. MARY'S HOSPITAL - DECATUR,92200030,95865,HC EMG LARYNX,922,1 ,$690.00 ,$448.50 ,$95.97 ,$690.00 ,$266.85 ,$351.90 ,$379.50 ,$106.74 ,$193.20 ,$338.10 ,$106.74 ,$403.65 ,$106.74 ,$374.67 ,$95.97 ,$106.74 ,$374.67 ,$202.80 ,$483.00 ,$345.00 ,$552.00 ,$266.84 ,$106.74 ,$483.00 ,$106.74 ,$414.00 ,$106.74 ,$517.50 ,$380.88 ,$343.62 ,$380.88 ,$106.74 ,$380.88 ,$538.20 ,$538.20 ,$586.50 ,$266.84 ,$478.17 ,$106.74 ,$690.00 ,$379.50 ,$106.74 ,$181.47 ,$690.00 ,$229.67 ,$219.23 ,$112.08 ,$552.00 ,$374.67 ,$193.20 ,$621.00 ,$262.20 ,$375.36 ,$106.74 ,$331.20 
ST. MARY'S HOSPITAL - DECATUR,92200031,95927,HC SSEP TRUNK/HEAD,922,1 ,"$1,708.00 ","$1,110.20 ",$152.14 ,"$1,708.00 ",$626.30 ,$871.08 ,$939.40 ,$250.52 ,$478.24 ,$836.92 ,$250.52 ,$999.18 ,$250.52 ,$927.44 ,$152.14 ,$250.52 ,$927.44 ,$475.99 ,"$1,195.60 ",$854.00 ,"$1,366.40 ",$626.30 ,$250.52 ,"$1,195.60 ",$250.52 ,"$1,024.80 ",$250.52 ,"$1,281.00 ",$942.82 ,$850.58 ,$942.82 ,$250.52 ,$942.82 ,"$1,332.24 ","$1,332.24 ","$1,451.80 ",$626.30 ,"$1,183.64 ",$250.52 ,"$1,708.00 ",$939.40 ,$250.52 ,$449.20 ,"$1,708.00 ",$229.67 ,$219.23 ,$263.05 ,"$1,366.40 ",$927.44 ,$478.24 ,"$1,537.20 ",$649.04 ,$929.15 ,$250.52 ,$819.84 
ST. MARY'S HOSPITAL - DECATUR,92200032,95869,HC EMG THORACIC PARASPINAL,922,1 ,$535.00 ,$347.75 ,$107.75 ,$535.00 ,$330.40 ,$272.85 ,$294.25 ,$132.16 ,$149.80 ,$262.15 ,$132.16 ,$312.98 ,$132.16 ,$290.51 ,$107.75 ,$132.16 ,$290.51 ,$251.11 ,$374.50 ,$267.50 ,$428.00 ,$330.40 ,$132.16 ,$374.50 ,$132.16 ,$321.00 ,$132.16 ,$401.25 ,$295.32 ,$266.43 ,$295.32 ,$132.16 ,$295.32 ,$417.30 ,$417.30 ,$454.75 ,$330.40 ,$370.76 ,$132.16 ,$535.00 ,$294.25 ,$132.16 ,$140.71 ,$535.00 ,$229.67 ,$219.23 ,$138.77 ,$428.00 ,$290.51 ,$149.80 ,$481.50 ,$203.30 ,$291.04 ,$132.16 ,$256.80 
ST. MARY'S HOSPITAL - DECATUR,94000101,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$382.00 ,$248.30 ,$59.15 ,$382.00 ,$266.85 ,$194.82 ,$210.10 ,$106.74 ,$106.96 ,$187.18 ,$106.74 ,$223.47 ,$106.74 ,$207.43 ,$136.76 ,$106.74 ,$207.43 ,$202.80 ,$267.40 ,$191.00 ,$305.60 ,$266.84 ,$106.74 ,$267.40 ,$106.74 ,$229.20 ,$106.74 ,$286.50 ,$210.86 ,$190.24 ,$210.86 ,$106.74 ,$210.86 ,$297.96 ,$297.96 ,$324.70 ,$266.84 ,$264.73 ,$106.74 ,$382.00 ,$210.10 ,$106.74 ,$100.47 ,$382.00 ,$61.96 ,$59.15 ,$112.08 ,$305.60 ,$207.43 ,$106.96 ,$343.80 ,$145.16 ,$207.81 ,$106.74 ,$183.36 
ST. MARY'S HOSPITAL - DECATUR,94000104,96372,HC INJECTION IM/SUBQ,940,1 ,$345.00 ,$224.25 ,$33.34 ,$345.00 ,$146.73 ,$175.95 ,$189.75 ,$58.69 ,$96.60 ,$169.05 ,$58.69 ,$201.83 ,$58.69 ,$187.34 ,$33.34 ,$58.69 ,$187.34 ,$111.51 ,$241.50 ,$172.50 ,$276.00 ,$146.72 ,$58.69 ,$241.50 ,$58.69 ,$207.00 ,$58.69 ,$258.75 ,$190.44 ,$171.81 ,$190.44 ,$58.69 ,$190.44 ,$269.10 ,$269.10 ,$293.25 ,$146.72 ,$239.09 ,$58.69 ,$345.00 ,$189.75 ,$58.69 ,$90.74 ,$345.00 , N/A , N/A ,$61.62 ,$276.00 ,$187.34 ,$96.60 ,$310.50 ,$131.10 ,$187.68 ,$58.69 ,$165.60 
ST. MARY'S HOSPITAL - DECATUR,94000105,96374,HC INJ IV PUSH SINGL/INITIAL,940,1 ,$418.00 ,$271.70 ,$54.78 ,$484.13 ,$484.13 ,$213.18 ,$229.90 ,$193.65 ,$117.04 ,$204.82 ,$193.65 ,$244.53 ,$193.65 ,$226.97 ,$54.78 ,$193.65 ,$226.97 ,$367.93 ,$292.60 ,$209.00 ,$334.40 ,$484.12 ,$193.65 ,$292.60 ,$193.65 ,$250.80 ,$193.65 ,$313.50 ,$230.74 ,$208.16 ,$230.74 ,$193.65 ,$230.74 ,$326.04 ,$326.04 ,$355.30 ,$418.00 ,$289.67 ,$193.65 ,$418.00 ,$229.90 ,$193.65 ,$109.93 ,$418.00 , N/A , N/A ,$203.33 ,$334.40 ,$226.97 ,$117.04 ,$376.20 ,$158.84 ,$227.39 ,$193.65 ,$200.64 
ST. MARY'S HOSPITAL - DECATUR,94000111,96373,HC INJ TX/PROPH/DIAG INTRA-ARTERIAL,940,1 ,$342.00 ,$222.30 ,$26.76 ,$484.13 ,$484.13 ,$174.42 ,$188.10 ,$193.65 ,$95.76 ,$160.74 ,$193.65 ,$184.68 ,$193.65 ,$185.71 ,$26.76 ,$193.65 ,$185.71 ,$342.00 ,$239.40 ,$171.00 ,$273.60 ,$484.12 ,$193.65 ,$239.40 ,$193.65 ,$205.20 ,$193.65 ,$256.50 ,$188.78 ,$170.32 ,$188.78 ,$193.65 ,$188.78 ,$266.76 ,$266.76 ,$290.70 ,$342.00 ,$237.01 ,$193.65 ,$342.00 ,$188.10 ,$193.65 ,$89.95 ,$342.00 , N/A , N/A ,$203.33 ,$273.60 ,$185.71 ,$95.76 ,$307.80 ,$129.96 ,$186.05 ,$193.65 ,$164.16 
ST. MARY'S HOSPITAL - DECATUR,94000112,E0202,HC PHOTO THERAPY PER HOUR,940,1 ,$14.00 ,$9.10 ,$2.80 ,$14.00 ,$7.00 ,$7.14 ,$7.70 ,$2.80 ,$3.92 ,$6.58 ,$2.80 ,$7.56 ,$2.80 ,$7.60 ,$14.00 ,$2.80 ,$7.60 ,$5.32 ,$9.80 ,$7.00 ,$11.20 ,$7.00 ,$2.80 ,$9.80 ,$2.80 ,$8.40 ,$2.80 ,$10.50 ,$7.73 ,$6.97 ,$7.73 ,$2.80 ,$7.73 ,$10.92 ,$10.92 ,$11.90 ,$7.00 ,$9.70 ,$2.80 ,$14.00 ,$7.70 ,$2.80 ,$3.68 ,$14.00 , N/A , N/A ,$2.94 ,$11.20 ,$7.60 ,$3.92 ,$12.60 ,$5.32 ,$7.62 ,$2.80 ,$6.72 
ST. MARY'S HOSPITAL - DECATUR,94000114,20560,HC NEEDLE INSERTION W/O INJECTION 1-2 MUSCLES,940,1 ,$254.00 ,$165.10 ,$18.44 ,$254.00 ,$58.45 ,$129.54 ,$139.70 ,$23.38 ,$71.12 ,$119.38 ,$23.38 ,$137.16 ,$23.38 ,$137.92 ,$56.82 ,$23.38 ,$137.92 ,$44.43 ,$177.80 ,$127.00 ,$203.20 ,$58.46 ,$23.38 ,$177.80 ,$23.38 ,$152.40 ,$23.38 ,$190.50 ,$140.21 ,$126.49 ,$140.21 ,$23.38 ,$140.21 ,$198.12 ,$198.12 ,$215.90 ,$58.46 ,$176.02 ,$23.38 ,$254.00 ,$139.70 ,$23.38 ,$66.80 ,$254.00 ,$19.32 ,$18.44 ,$24.55 ,$203.20 ,$137.92 ,$71.12 ,$228.60 ,$96.52 ,$138.18 ,$23.38 ,$121.92 
ST. MARY'S HOSPITAL - DECATUR,94000115,20561,HC NEEDLE INSERTION W/O INJECTION 3+ MUSCLES,940,1 ,$254.00 ,$165.10 ,$18.44 ,$254.00 ,$58.45 ,$129.54 ,$139.70 ,$23.38 ,$71.12 ,$119.38 ,$23.38 ,$137.16 ,$23.38 ,$137.92 ,$84.61 ,$23.38 ,$137.92 ,$44.43 ,$177.80 ,$127.00 ,$203.20 ,$58.46 ,$23.38 ,$177.80 ,$23.38 ,$152.40 ,$23.38 ,$190.50 ,$140.21 ,$126.49 ,$140.21 ,$23.38 ,$140.21 ,$198.12 ,$198.12 ,$215.90 ,$58.46 ,$176.02 ,$23.38 ,$254.00 ,$139.70 ,$23.38 ,$66.80 ,$254.00 ,$19.32 ,$18.44 ,$24.55 ,$203.20 ,$137.92 ,$71.12 ,$228.60 ,$96.52 ,$138.18 ,$23.38 ,$121.92 
ST. MARY'S HOSPITAL - DECATUR,94200005,97802,HC NUTRITION THRPY EVAL 15 MIN,942,1 ,$75.00 ,$48.75 ,$19.73 ,$89.73 ,$76.28 ,$38.25 ,$41.25 ,$30.51 ,$21.00 ,$36.75 ,$30.51 ,$43.88 ,$30.51 ,$40.73 ,$45.10 ,$30.51 ,$40.73 ,$68.19 ,$52.50 ,$37.50 ,$60.00 ,$89.73 ,$30.51 ,$52.50 ,$30.51 ,$45.00 ,$30.51 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$30.51 ,$41.40 ,$58.50 ,$58.50 ,$63.75 ,$30.51 ,$51.98 ,$30.51 ,$75.00 ,$41.25 ,$30.51 ,$19.73 ,$75.00 , N/A , N/A ,$32.04 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$75.00 ,$30.51 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,94200006,97803,HC NUTRITION THRPY RE-EVAL 15 MIN,942,1 ,$75.00 ,$48.75 ,$19.73 ,$78.05 ,$66.35 ,$38.25 ,$41.25 ,$26.54 ,$21.00 ,$36.75 ,$26.54 ,$43.88 ,$26.54 ,$40.73 ,$38.56 ,$26.54 ,$40.73 ,$59.32 ,$52.50 ,$37.50 ,$60.00 ,$78.05 ,$26.54 ,$52.50 ,$26.54 ,$45.00 ,$26.54 ,$56.25 ,$41.40 ,$37.35 ,$41.40 ,$26.54 ,$41.40 ,$58.50 ,$58.50 ,$63.75 ,$26.54 ,$51.98 ,$26.54 ,$75.00 ,$41.25 ,$26.54 ,$19.73 ,$75.00 , N/A , N/A ,$27.87 ,$60.00 ,$40.73 ,$21.00 ,$67.50 ,$28.50 ,$75.00 ,$26.54 ,$36.00 
ST. MARY'S HOSPITAL - DECATUR,94200007,97804,HC MNT GROUP INIT 30 MIN,942,1 ,$21.00 ,$13.65 ,$5.52 ,$41.60 ,$35.35 ,$10.71 ,$11.55 ,$14.14 ,$5.88 ,$10.29 ,$14.14 ,$12.29 ,$14.14 ,$11.40 ,$21.00 ,$14.14 ,$11.40 ,$21.00 ,$14.70 ,$10.50 ,$16.80 ,$41.60 ,$14.14 ,$14.70 ,$14.14 ,$12.60 ,$14.14 ,$15.75 ,$11.59 ,$10.46 ,$11.59 ,$14.14 ,$11.59 ,$16.38 ,$16.38 ,$17.85 ,$14.14 ,$14.55 ,$14.14 ,$21.00 ,$11.55 ,$14.14 ,$5.52 ,$21.00 , N/A , N/A ,$14.85 ,$16.80 ,$11.40 ,$5.88 ,$18.90 ,$7.98 ,$21.00 ,$14.14 ,$10.08 
ST. MARY'S HOSPITAL - DECATUR,94200019,N/A,HC LACTATION CONSULT 30 MIN,942,1 ,$217.00 ,$141.05 ,$57.07 ,$217.00 , N/A ,$110.67 ,$119.35 , N/A ,$60.76 ,$101.99 , N/A ,$117.18 , N/A ,$117.83 ,$86.80 , N/A ,$117.83 , N/A ,$151.90 ,$108.50 ,$173.60 , N/A , N/A ,$151.90 , N/A ,$130.20 , N/A ,$162.75 ,$119.78 ,$108.07 ,$119.78 , N/A ,$119.78 ,$169.26 ,$169.26 ,$184.45 , N/A ,$150.38 , N/A ,$217.00 ,$119.35 , N/A ,$57.07 ,$217.00 , N/A , N/A , N/A ,$173.60 ,$117.83 ,$60.76 ,$195.30 ,$82.46 ,$162.00 , N/A ,$104.16 
ST. MARY'S HOSPITAL - DECATUR,94200020,N/A,HC LACTATION CONSULT 45 MIN,942,1 ,$275.00 ,$178.75 ,$72.33 ,$275.00 , N/A ,$140.25 ,$151.25 , N/A ,$77.00 ,$129.25 , N/A ,$148.50 , N/A ,$149.33 ,$110.00 , N/A ,$149.33 , N/A ,$192.50 ,$137.50 ,$220.00 , N/A , N/A ,$192.50 , N/A ,$165.00 , N/A ,$206.25 ,$151.80 ,$136.95 ,$151.80 , N/A ,$151.80 ,$214.50 ,$214.50 ,$233.75 , N/A ,$190.58 , N/A ,$275.00 ,$151.25 , N/A ,$72.33 ,$275.00 , N/A , N/A , N/A ,$220.00 ,$149.33 ,$77.00 ,$247.50 ,$104.50 ,$162.00 , N/A ,$132.00 
ST. MARY'S HOSPITAL - DECATUR,94200021,N/A,HC LACTATION CONSULT 60 MIN,942,1 ,$325.00 ,$211.25 ,$85.48 ,$325.00 , N/A ,$165.75 ,$178.75 , N/A ,$91.00 ,$152.75 , N/A ,$175.50 , N/A ,$176.48 ,$130.00 , N/A ,$176.48 , N/A ,$227.50 ,$162.50 ,$260.00 , N/A , N/A ,$227.50 , N/A ,$195.00 , N/A ,$243.75 ,$179.40 ,$161.85 ,$179.40 , N/A ,$179.40 ,$253.50 ,$253.50 ,$276.25 , N/A ,$225.23 , N/A ,$325.00 ,$178.75 , N/A ,$85.48 ,$325.00 , N/A , N/A , N/A ,$260.00 ,$176.48 ,$91.00 ,$292.50 ,$123.50 ,$162.00 , N/A ,$156.00 
ST. MARY'S HOSPITAL - DECATUR,94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$276.00 ,$179.40 ,$29.51 ,$276.00 ,$274.70 ,$140.76 ,$151.80 ,$109.88 ,$77.28 ,$135.24 ,$109.88 ,$161.46 ,$109.88 ,$149.87 ,$29.51 ,$109.88 ,$149.87 ,$208.77 ,$193.20 ,$138.00 ,$220.80 ,$274.70 ,$109.88 ,$193.20 ,$109.88 ,$165.60 ,$109.88 ,$207.00 ,$152.35 ,$137.45 ,$152.35 ,$109.88 ,$152.35 ,$215.28 ,$215.28 ,$234.60 ,$274.70 ,$191.27 ,$109.88 ,$276.00 ,$151.80 ,$109.88 ,$72.59 ,$276.00 , N/A , N/A ,$115.37 ,$220.80 ,$149.87 ,$77.28 ,$248.40 ,$104.88 ,$250.00 ,$109.88 ,$132.48 
ST. MARY'S HOSPITAL - DECATUR,94300019,N/A,HC CARDIAC REHAB PHASE 3 FULL MONTH,943,1 ,$49.00 ,$31.85 ,$12.89 ,$49.00 , N/A ,$24.99 ,$26.95 , N/A ,$13.72 ,$23.03 , N/A ,$26.46 , N/A ,$26.61 ,$19.60 , N/A ,$26.61 , N/A ,$34.30 ,$24.50 ,$39.20 , N/A , N/A ,$34.30 , N/A ,$29.40 , N/A ,$36.75 ,$27.05 ,$24.40 ,$27.05 , N/A ,$27.05 ,$38.22 ,$38.22 ,$41.65 , N/A ,$33.96 , N/A ,$49.00 ,$26.95 , N/A ,$12.89 ,$49.00 , N/A , N/A , N/A ,$39.20 ,$26.61 ,$13.72 ,$44.10 ,$18.62 ,$49.00 , N/A ,$23.52 
ST. MARY'S HOSPITAL - DECATUR,94300020,N/A,HC CARDIAC REHAB PHASE 3 HALF MONTH,943,1 ,$46.00 ,$29.90 ,$12.10 ,$46.00 , N/A ,$23.46 ,$25.30 , N/A ,$12.88 ,$21.62 , N/A ,$24.84 , N/A ,$24.98 ,$18.40 , N/A ,$24.98 , N/A ,$32.20 ,$23.00 ,$36.80 , N/A , N/A ,$32.20 , N/A ,$27.60 , N/A ,$34.50 ,$25.39 ,$22.91 ,$25.39 , N/A ,$25.39 ,$35.88 ,$35.88 ,$39.10 , N/A ,$31.88 , N/A ,$46.00 ,$25.30 , N/A ,$12.10 ,$46.00 , N/A , N/A , N/A ,$36.80 ,$24.98 ,$12.88 ,$41.40 ,$17.48 ,$46.00 , N/A ,$22.08 
ST. MARY'S HOSPITAL - DECATUR,94300024,N/A,HC CARDIAC REHAB PHASE 3 - 8 SESSIONS,943,1 ,$32.00 ,$20.80 ,$8.42 ,$32.00 , N/A ,$16.32 ,$17.60 , N/A ,$8.96 ,$15.04 , N/A ,$17.28 , N/A ,$17.38 ,$12.80 , N/A ,$17.38 , N/A ,$22.40 ,$16.00 ,$25.60 , N/A , N/A ,$22.40 , N/A ,$19.20 , N/A ,$24.00 ,$17.66 ,$15.94 ,$17.66 , N/A ,$17.66 ,$24.96 ,$24.96 ,$27.20 , N/A ,$22.18 , N/A ,$32.00 ,$17.60 , N/A ,$8.42 ,$32.00 , N/A , N/A , N/A ,$25.60 ,$17.38 ,$8.96 ,$28.80 ,$12.16 ,$32.00 , N/A ,$15.36 
ST. MARY'S HOSPITAL - DECATUR,94400008,90791,HC DRUG EVAL PSYCH DIAG ADOL,944,1 ,$395.00 ,$256.75 ,$103.89 ,$395.00 ,$316.65 ,$201.45 ,$217.25 ,$126.66 ,$110.60 ,$193.55 ,$126.66 ,$231.08 ,$126.66 ,$214.49 ,$214.49 ,$126.66 ,$214.49 ,$240.65 ,$276.50 ,$197.50 ,$335.75 ,$316.64 ,$126.66 ,$276.50 ,$126.66 ,$237.00 ,$126.66 ,$296.25 ,$218.04 ,$196.71 ,$218.04 ,$126.66 ,$218.04 ,$308.10 ,$308.10 ,$335.75 ,$316.64 ,$273.74 ,$126.66 ,$395.00 ,$217.25 ,$126.66 ,$103.89 ,$395.00 ,$192.43 ,$183.69 ,$132.99 ,$316.00 ,$214.49 ,$110.60 ,$355.50 ,$150.10 , N/A ,$126.66 ,$189.60 
ST. MARY'S HOSPITAL - DECATUR,94400009,90791,HC DRUG EVAL PSYCH DIAG ADULT,944,1 ,$395.00 ,$256.75 ,$103.89 ,$395.00 ,$316.65 ,$201.45 ,$217.25 ,$126.66 ,$110.60 ,$193.55 ,$126.66 ,$231.08 ,$126.66 ,$214.49 ,$214.49 ,$126.66 ,$214.49 ,$240.65 ,$276.50 ,$197.50 ,$335.75 ,$316.64 ,$126.66 ,$276.50 ,$126.66 ,$237.00 ,$126.66 ,$296.25 ,$218.04 ,$196.71 ,$218.04 ,$126.66 ,$218.04 ,$308.10 ,$308.10 ,$335.75 ,$316.64 ,$273.74 ,$126.66 ,$395.00 ,$217.25 ,$126.66 ,$103.89 ,$395.00 ,$192.43 ,$183.69 ,$132.99 ,$316.00 ,$214.49 ,$110.60 ,$355.50 ,$150.10 , N/A ,$126.66 ,$189.60 
ST. MARY'S HOSPITAL - DECATUR,94400013,90832,HC DRUG THERAPY INDIVIDUAL 30MIN,944,1 ,$173.00 ,$112.45 ,$45.50 ,$316.65 ,$316.65 ,$88.23 ,$95.15 ,$126.66 ,$48.44 ,$84.77 ,$126.66 ,$101.21 ,$126.66 ,$93.94 ,$93.94 ,$126.66 ,$93.94 ,$173.00 ,$121.10 ,$86.50 ,$147.05 ,$316.64 ,$126.66 ,$121.10 ,$126.66 ,$103.80 ,$126.66 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$126.66 ,$95.50 ,$134.94 ,$134.94 ,$147.05 ,$173.00 ,$119.89 ,$126.66 ,$173.00 ,$95.15 ,$126.66 ,$45.50 ,$173.00 ,$103.53 ,$98.83 ,$132.99 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 , N/A ,$126.66 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,94400014,90834,HC DRUG THERAPY INDIVIDUAL 45MIN,944,1 ,$220.00 ,$143.00 ,$57.86 ,$316.65 ,$316.65 ,$112.20 ,$121.00 ,$126.66 ,$61.60 ,$107.80 ,$126.66 ,$128.70 ,$126.66 ,$119.46 ,$119.46 ,$126.66 ,$119.46 ,$220.00 ,$154.00 ,$110.00 ,$187.00 ,$316.64 ,$126.66 ,$154.00 ,$126.66 ,$132.00 ,$126.66 ,$165.00 ,$121.44 ,$109.56 ,$121.44 ,$126.66 ,$121.44 ,$171.60 ,$171.60 ,$187.00 ,$220.00 ,$152.46 ,$126.66 ,$220.00 ,$121.00 ,$126.66 ,$57.86 ,$220.00 ,$103.71 ,$98.99 ,$132.99 ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 , N/A ,$126.66 ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,94400016,90853,HC DRUG THERAPY GROUP 60 MIN,944,1 ,$323.00 ,$209.95 ,$70.83 ,$323.00 ,$177.08 ,$164.73 ,$177.65 ,$70.83 ,$90.44 ,$158.27 ,$70.83 ,$188.96 ,$70.83 ,$175.39 ,$175.39 ,$70.83 ,$175.39 ,$134.58 ,$226.10 ,$161.50 ,$274.55 ,$177.08 ,$70.83 ,$226.10 ,$70.83 ,$193.80 ,$70.83 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$70.83 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$177.08 ,$223.84 ,$70.83 ,$323.00 ,$177.65 ,$70.83 ,$84.95 ,$323.00 ,$147.05 ,$140.36 ,$74.37 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$70.83 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,94400017,90853,HC DRUG THERAPY GROUP 90 MIN,944,1 ,$323.00 ,$209.95 ,$70.83 ,$323.00 ,$177.08 ,$164.73 ,$177.65 ,$70.83 ,$90.44 ,$158.27 ,$70.83 ,$188.96 ,$70.83 ,$175.39 ,$175.39 ,$70.83 ,$175.39 ,$134.58 ,$226.10 ,$161.50 ,$274.55 ,$177.08 ,$70.83 ,$226.10 ,$70.83 ,$193.80 ,$70.83 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$70.83 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$177.08 ,$223.84 ,$70.83 ,$323.00 ,$177.65 ,$70.83 ,$84.95 ,$323.00 ,$147.05 ,$140.36 ,$74.37 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$70.83 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,94400019,90853,HC DRUG GROUP THERAPY 120 MIN,944,1 ,$323.00 ,$209.95 ,$70.83 ,$323.00 ,$177.08 ,$164.73 ,$177.65 ,$70.83 ,$90.44 ,$158.27 ,$70.83 ,$188.96 ,$70.83 ,$175.39 ,$175.39 ,$70.83 ,$175.39 ,$134.58 ,$226.10 ,$161.50 ,$274.55 ,$177.08 ,$70.83 ,$226.10 ,$70.83 ,$193.80 ,$70.83 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$70.83 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$177.08 ,$223.84 ,$70.83 ,$323.00 ,$177.65 ,$70.83 ,$84.95 ,$323.00 ,$147.05 ,$140.36 ,$74.37 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$70.83 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,94400020,99408,HC DRUG ABUSE SCREEN W/INTERV 15-30MIN,944,1 ,$50.00 ,$32.50 ,$13.15 ,$98.83 , N/A ,$25.50 ,$27.50 , N/A ,$14.00 ,$24.50 , N/A ,$29.25 , N/A ,$27.15 ,$27.15 , N/A ,$27.15 , N/A ,$35.00 ,$25.00 ,$42.50 , N/A , N/A ,$35.00 , N/A ,$30.00 , N/A ,$37.50 ,$27.60 ,$24.90 ,$27.60 , N/A ,$27.60 ,$39.00 ,$39.00 ,$42.50 , N/A ,$34.65 , N/A ,$50.00 ,$27.50 , N/A ,$13.15 ,$50.00 ,$50.00 ,$98.83 , N/A ,$40.00 ,$27.15 ,$14.00 ,$45.00 ,$19.00 , N/A , N/A ,$24.00 
ST. MARY'S HOSPITAL - DECATUR,94400021,99409,HC DRUG ABUSE SCREEN W/INTERV > 30MIN,944,1 ,$50.00 ,$32.50 ,$13.15 ,$98.99 , N/A ,$25.50 ,$27.50 , N/A ,$14.00 ,$24.50 , N/A ,$29.25 , N/A ,$27.15 ,$27.15 , N/A ,$27.15 , N/A ,$35.00 ,$25.00 ,$42.50 , N/A , N/A ,$35.00 , N/A ,$30.00 , N/A ,$37.50 ,$27.60 ,$24.90 ,$27.60 , N/A ,$27.60 ,$39.00 ,$39.00 ,$42.50 , N/A ,$34.65 , N/A ,$50.00 ,$27.50 , N/A ,$13.15 ,$50.00 ,$50.00 ,$98.99 , N/A ,$40.00 ,$27.15 ,$14.00 ,$45.00 ,$19.00 , N/A , N/A ,$24.00 
ST. MARY'S HOSPITAL - DECATUR,94400022,90832,HC DRUG THERAPY INDIVIDUAL W/IOP 30MIN,944,1 ,$173.00 ,$112.45 ,$45.50 ,$316.65 ,$316.65 ,$88.23 ,$95.15 ,$126.66 ,$48.44 ,$84.77 ,$126.66 ,$101.21 ,$126.66 ,$93.94 ,$93.94 ,$126.66 ,$93.94 ,$173.00 ,$121.10 ,$86.50 ,$147.05 ,$316.64 ,$126.66 ,$121.10 ,$126.66 ,$103.80 ,$126.66 ,$129.75 ,$95.50 ,$86.15 ,$95.50 ,$126.66 ,$95.50 ,$134.94 ,$134.94 ,$147.05 ,$173.00 ,$119.89 ,$126.66 ,$173.00 ,$95.15 ,$126.66 ,$45.50 ,$173.00 ,$103.53 ,$98.83 ,$132.99 ,$138.40 ,$93.94 ,$48.44 ,$155.70 ,$65.74 , N/A ,$126.66 ,$83.04 
ST. MARY'S HOSPITAL - DECATUR,94400023,90834,HC DRUG THERAPY INIDIVIDUAL W/IOP 60MIN,944,1 ,$220.00 ,$143.00 ,$57.86 ,$316.65 ,$316.65 ,$112.20 ,$121.00 ,$126.66 ,$61.60 ,$107.80 ,$126.66 ,$128.70 ,$126.66 ,$119.46 ,$119.46 ,$126.66 ,$119.46 ,$220.00 ,$154.00 ,$110.00 ,$187.00 ,$316.64 ,$126.66 ,$154.00 ,$126.66 ,$132.00 ,$126.66 ,$165.00 ,$121.44 ,$109.56 ,$121.44 ,$126.66 ,$121.44 ,$171.60 ,$171.60 ,$187.00 ,$220.00 ,$152.46 ,$126.66 ,$220.00 ,$121.00 ,$126.66 ,$57.86 ,$220.00 ,$103.71 ,$98.99 ,$132.99 ,$176.00 ,$119.46 ,$61.60 ,$198.00 ,$83.60 , N/A ,$126.66 ,$105.60 
ST. MARY'S HOSPITAL - DECATUR,94400024,90853,HC GROUP THERAPY W/IOP 90MIN,944,1 ,$323.00 ,$209.95 ,$70.83 ,$323.00 ,$177.08 ,$164.73 ,$177.65 ,$70.83 ,$90.44 ,$158.27 ,$70.83 ,$188.96 ,$70.83 ,$175.39 ,$175.39 ,$70.83 ,$175.39 ,$134.58 ,$226.10 ,$161.50 ,$274.55 ,$177.08 ,$70.83 ,$226.10 ,$70.83 ,$193.80 ,$70.83 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$70.83 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$177.08 ,$223.84 ,$70.83 ,$323.00 ,$177.65 ,$70.83 ,$84.95 ,$323.00 ,$147.05 ,$140.36 ,$74.37 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$70.83 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,94400025,90853,HC GROUP THERAPY W/IOP 120MIN,944,1 ,$323.00 ,$209.95 ,$70.83 ,$323.00 ,$177.08 ,$164.73 ,$177.65 ,$70.83 ,$90.44 ,$158.27 ,$70.83 ,$188.96 ,$70.83 ,$175.39 ,$175.39 ,$70.83 ,$175.39 ,$134.58 ,$226.10 ,$161.50 ,$274.55 ,$177.08 ,$70.83 ,$226.10 ,$70.83 ,$193.80 ,$70.83 ,$242.25 ,$178.30 ,$160.85 ,$178.30 ,$70.83 ,$178.30 ,$251.94 ,$251.94 ,$274.55 ,$177.08 ,$223.84 ,$70.83 ,$323.00 ,$177.65 ,$70.83 ,$84.95 ,$323.00 ,$147.05 ,$140.36 ,$74.37 ,$258.40 ,$175.39 ,$90.44 ,$290.70 ,$122.74 , N/A ,$70.83 ,$155.04 
ST. MARY'S HOSPITAL - DECATUR,96000044,G2061,PC NON PHYSICIAN EST PT 5-10 MIN,960,1 ,$38.00 ,$24.70 ,$10.64 ,$38.00 , N/A ,$19.38 ,$20.90 , N/A ,$10.64 ,$17.86 , N/A ,$20.52 , N/A ,$20.63 ,$17.64 , N/A ,$20.63 , N/A ,$26.60 ,$19.00 ,$30.40 , N/A , N/A ,$26.60 , N/A ,$22.80 , N/A ,$28.50 ,$20.98 ,$18.92 ,$20.98 , N/A ,$20.98 ,$29.64 ,$29.64 ,$32.30 , N/A ,$26.33 , N/A ,$38.00 ,$20.90 , N/A ,$15.49 ,$38.00 , N/A , N/A , N/A ,$30.40 ,$20.63 ,$10.64 ,$34.20 ,$14.44 , N/A , N/A ,$18.24 
ST. MARY'S HOSPITAL - DECATUR,96000045,G2062,PC NON PHYSICIAN EST PT 11-20 MIN,960,1 ,$38.00 ,$24.70 ,$10.64 ,$38.00 , N/A ,$19.38 ,$20.90 , N/A ,$10.64 ,$17.86 , N/A ,$20.52 , N/A ,$20.63 ,$31.16 , N/A ,$20.63 , N/A ,$26.60 ,$19.00 ,$30.40 , N/A , N/A ,$26.60 , N/A ,$22.80 , N/A ,$28.50 ,$20.98 ,$18.92 ,$20.98 , N/A ,$20.98 ,$29.64 ,$29.64 ,$32.30 , N/A ,$26.33 , N/A ,$38.00 ,$20.90 , N/A ,$27.35 ,$38.00 , N/A , N/A , N/A ,$30.40 ,$20.63 ,$10.64 ,$34.20 ,$14.44 , N/A , N/A ,$18.24 
ST. MARY'S HOSPITAL - DECATUR,96000046,G2063,PC NON PHYSICIAN EST PT > 21 MIN,960,1 ,$38.00 ,$24.70 ,$10.64 ,$38.00 , N/A ,$19.38 ,$20.90 , N/A ,$10.64 ,$17.86 , N/A ,$20.52 , N/A ,$20.63 ,$38.00 , N/A ,$20.63 , N/A ,$26.60 ,$19.00 ,$30.40 , N/A , N/A ,$26.60 , N/A ,$22.80 , N/A ,$28.50 ,$20.98 ,$18.92 ,$20.98 , N/A ,$20.98 ,$29.64 ,$29.64 ,$32.30 , N/A ,$26.33 , N/A ,$38.00 ,$20.90 , N/A ,$38.00 ,$38.00 , N/A , N/A , N/A ,$30.40 ,$20.63 ,$10.64 ,$34.20 ,$14.44 , N/A , N/A ,$18.24 
ST. MARY'S HOSPITAL - DECATUR,96400027,215,PC ANESTH SKULL REPAIR/FRACT,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400286,100,PC ANESTH SALIVARY GLAND W/BX-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400287,120,PC ANESTH EXT/MID/INR EAR W/BX NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400288,140,PC ANESTH EYE NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400290,160,PC ANESTH NOSE/SINUS NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400292,170,PC ANESTH MOUTH W/BIOPSY NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400293,190,PC ANESTH FACE BONE/SKULL NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400294,300,PC ANESTH HEAD/NECK/TRUNK NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400295,320,PC ANESTH NECK ORGANS >1YR NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400296,400,PC ANESTH INTEG EXTRM/TRUNK NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400297,404,PC ANESTH BREAST RADICAL/MOD RAD-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400298,406,PC ANESTH BREAST/RAD/MOD RAD W/DISSECTION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400299,410,PC ANESTH ELEC CONV ARRHYTHMIAS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400300,450,PC ANESTH CLAVICLE/SCAPULA NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400301,520,PC ANESTH CHEST CLOSED NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400302,635,PC ANESTH LUMBAR PUNCTURE DIAG/THERAP-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400303,700,PC ANESTH ABD WALL/UPPER ANTR NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400304,730,PC ANESTH ABD WALL/UPPER POSTR NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400306,750,PC ANESTH RPR HERNIA UPPER ABD NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400307,752,PC ANESTH RPR HERNIA LUMB/VENTR WND DEH-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400308,790,PC ANESTH UPPER ABD W/LAP NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400310,800,PC ANESTH ABD WALL LOW ANTR NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400312,820,PC ANESTH ABD WALL LOWER POSTR-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400313,830,PC ANESTH RPR HERNIA LOW ABD NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400314,832,PC ANESTH RPR HERNIA VENTRAL/INCISONAL-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400315,840,PC ANESTH LOWER ABD W/LAP NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400316,844,PC ANESTH ABDOMINOPERINEAL RESECTION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400317,846,PC ANESTH HYSTERECTOMY RADICAL-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400320,862,PC ANESTH RENAL PROC/DONOR NEPHRECTOMY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400322,865,PC ANESTH PROSTATECTOMY RADICAL-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400324,873,PC ANESTH LITHOTRIPSY W/O WATER BATH-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400325,902,PC ANESTH ANORECTAL PROC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400327,908,PC ANESTH PERINEAL PROSTATECTOMY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400328,910,PC ANESTH TRANSURETHRAL PROC NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400329,912,PC ANESTH TRANSURETHRAL RESECT BLADDER TUMR-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400330,914,PC ANESTH TRANSURETRAL RESECT PROSTATE-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400332,920,PC ANESTH GENITALIA MALE NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400339,940,PC ANESTH VAGINAL PROCS W/BX NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400340,942,PC ANESTH VAGINAL COLPECT/VAG/COLPRHY PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400341,944,PC ANESTH VAGINAL HYSTERECTOMY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400342,948,PC ANESTH CERVICAL CERCLAGE-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400344,952,PC ANESTH HYSTEROSCOPY/HYSTERGRAPH-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400345,1200,PC ANESTH HIP JOINT CLOSED PROC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400346,1232,PC ANESTH FEMUR AMPUTATION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400347,1250,PC ANESTH UPPER LEG PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400349,1320,PC ANESTH KNEE/POPLITEAL PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400350,1340,PC ANESTH FEMUR CLOSED PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400351,1360,PC ANESTH FEMUR OPEN PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400352,1380,PC ANESTH KNEE JOINT CLOSED-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400353,1382,PC ANESTH KNEE ARTHROSCOPIC DIAG PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400354,1390,PC ANESTH KNEE CLOSED PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400355,1392,PC ANESTH KNEE OPEN PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400356,1400,PC ANESTH KNEE ARTHROSOPIC OPEN PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400358,1462,PC ANESTH LWR LEG/ANKLE/FOOT CLOSED-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400359,1464,PC ANESTH ANKLE/FOOT ARTHROSCOPIC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400360,1470,PC ANESTH LWR LEG NERV/MUSC/TEND NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400361,1472,PC ANESTH RPR ACHILLES TENDN W/OR W/O GRAFT-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400362,1480,PC ANESTH LWR LEG/ANKLE/FOOT OPEN NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400363,1482,PC ANESTH LWR LEG RADICAL RESECTION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400366,1610,PC ANESTH SHLDR NERV/MUSC/TEND-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400367,1620,PC ANESTH SHLDR CLOSED PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400368,1630,PC ANESTH SHLDR ARTHROSCOPIC NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400369,1710,PC ANESTH UPPR ARM/ELBW NERV/MUSC/TEND NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400370,1730,PC ANESTH HUMERUS/ELBOW CLOSED PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400371,1740,PC ANESTH ELBOW ARTHROSCOPIC PROC NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400372,1770,PC ANESTH UPPR ARM/ELBOW NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400373,1780,PC ANESTH VEINS UPPR ARM/ELBOW NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400374,1810,PC ANESTH LOWR ARM NERV/MUSC/TEND PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400375,1820,PC ANESTH LOWER ARM CLOSED PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400376,1830,PC ANESTH LOWER ARM ARTHRO/ENDOSC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400377,1840,PC ANESTH LOWER ARM ARTERIES PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400378,1850,PC ANESTH VEINS LOWER ARM NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400379,1922,PC ANESTH NO-INVAS IMAGE OR RAD THPY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400380,1961,PC ANESTH CESAREAN DELIVERY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400382,1967,PC ANESTH VAGINAL DELIVERY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400383,1968,PC ANESTH CESAREAN DELIVERY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400384,1999,PC ANESTH UNLISTED PROC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400388,126,PC ANESTH TYMPANOTOMY -QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400403,N/A,PC CRNA PER MINUTE,964,1 ,$25.00 ,$16.25 ,$3.50 ,$25.00 ,$8.75 ,$12.75 ,$13.75 ,$3.50 ,$7.00 ,$11.75 ,$3.50 ,$13.50 ,$3.50 ,$13.58 ,$10.00 ,$3.50 ,$13.58 ,$6.65 ,$17.50 ,$12.50 ,$20.00 ,$8.75 ,$3.50 ,$17.50 ,$3.50 ,$15.00 ,$3.50 ,$18.75 ,$13.80 ,$12.45 ,$13.80 ,$3.50 ,$13.80 ,$19.50 ,$19.50 ,$21.25 ,$8.75 ,$17.33 ,$3.50 ,$25.00 ,$13.75 ,$3.50 ,$17.50 ,$25.00 , N/A , N/A ,$3.68 ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A ,$3.50 ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400404,1996,PC DAILY MGMT CONTIN DRUG ADMIN,964,1 ,$158.00 ,$102.70 ,$44.24 ,$158.00 , N/A ,$80.58 ,$86.90 , N/A ,$44.24 ,$74.26 , N/A ,$85.32 , N/A ,$85.79 ,$63.20 , N/A ,$85.79 , N/A ,$110.60 ,$79.00 ,$126.40 , N/A , N/A ,$110.60 , N/A ,$94.80 , N/A ,$118.50 ,$87.22 ,$78.68 ,$87.22 , N/A ,$87.22 ,$123.24 ,$123.24 ,$134.30 , N/A ,$109.49 , N/A ,$158.00 ,$86.90 , N/A ,$110.60 ,$158.00 , N/A , N/A , N/A ,$126.40 ,$85.79 ,$44.24 ,$142.20 ,$60.04 , N/A , N/A ,$75.84 
ST. MARY'S HOSPITAL - DECATUR,96400405,62326,PC INJ W/CATH PLACE LUMBAR/SACRAL W/O GUIDANCE,964,1 ,"$2,827.00 ","$1,837.55 ",$154.45 ,"$2,827.00 ","$1,948.10 ","$1,441.77 ","$1,554.85 ",$779.24 ,$791.56 ,"$1,328.69 ",$779.24 ,"$1,526.58 ",$779.24 ,"$1,535.06 ",$884.00 ,$779.24 ,"$1,535.06 ","$1,480.55 ","$1,978.90 ","$1,413.50 ","$2,261.60 ","$1,948.10 ",$779.24 ,"$1,978.90 ",$779.24 ,"$1,696.20 ",$779.24 ,"$2,120.25 ","$1,560.50 ","$1,407.85 ","$1,560.50 ",$779.24 ,"$1,560.50 ","$2,205.06 ","$2,205.06 ","$2,402.95 ","$1,948.10 ","$1,959.11 ",$779.24 ,"$2,827.00 ","$1,554.85 ",$779.24 ,$154.45 ,"$2,827.00 ",$557.90 ,$532.54 ,$818.20 ,"$2,261.60 ","$1,535.06 ",$791.56 ,"$2,544.30 ","$1,074.26 ", N/A ,$779.24 ,"$1,356.96 "
ST. MARY'S HOSPITAL - DECATUR,96400408,103,PC ANESTH EYELID BLEPHAROPLASTY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400409,104,PC ANESTH ELECTROCONVULSIVE THERAPY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400410,124,PC ANESTH EAR PROC W/BX OTOSCOPY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400411,210,PC ANESTH INTRACRANIAL PROCS NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400412,211,PC ANESTH INTRACRANIAL PROC HEMATOMA-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400413,214,PC ANESTH INTRACRANIAL PROC BURR HOLES W/VENTRICULOGRAPHY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400414,216,PC ANESTH INTRACRANIAL PROCS VASCULAR-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400415,218,PC ANESTH INTRACRANIAL PROCS SITTING POSITION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400416,220,PC ANESTH INTRACRANIAL SHUNTING PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400417,350,PC ANESTH NECK VESSEL NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400418,352,PC ANESTH NECK VESSEL SIMPLE LIGATION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400419,402,PC ANESTH BREAST RECONSTRUCT PROC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400420,500,PC ANESTH ESOPHAGEAL PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400421,522,PC ANESTH CHEST BIOPSY PLEURA-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400422,528,PC ANESTH CHEST MEDIAST/DX THORASC W/LUNG VENTIL-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400423,530,PC ANESTH PACEMAKER INSERTION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400424,532,PC ANESTH VASCULAR ACCESS CENTRAL VENOUS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400425,534,PC ANESTH INSERT CARDIOVERTER/DEFIBRILLATOR-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400426,541,PC ANESTH THORACOTOMY VENTILATION SINGLE LUNG-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400427,560,PC ANESTH HEART PROC W/O PUMP OXYGENATOR-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400428,600,PC ANESTH CERVICAL SPINE/CORD NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400429,620,PC ANESTH THORACIC SPINE/CORD NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400430,625,PC ANESTH THORACIC SPINE W/O LUNG VENTILATION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400431,630,PC ANESTH LUMBAR PROCS NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400432,640,PC ANESTH SPINE MANIPULATION/CLOSED PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400433,670,PC ANESTH EXTENSIVE SPINE/CORD PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400434,702,PC ANESTH LIVER BIOPSY PERC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400435,731,PC ANESTH UPPER GI ENDO PROC NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400436,732,PC ANESTH UPPER GI ERCP-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400437,754,PC ANESTH HERNIA UPPR ABDOMEN OMPHALOCELE-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400438,811,PC ANESTH LOWER ENDO PROCS NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400439,812,PC ANESTH SCREENING COLONOSCOPY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400440,813,PC ANESTH UPPER/LOWER GI ENDO PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400441,872,PC ANESTH LITHO EXTRACORPOREAL SHOCK WAVE W/BATH-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400442,918,PC ANESTH TRANSURETHRAL STONE REMOVAL-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400443,1112,PC ANESTH BONE MARROW ASPIRATION/BIOPSY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400444,1120,PC ANESTH BONY PELVIS PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400445,1202,PC ANESTH ARTHROSCOPY HIP-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400446,1210,PC ANESTH OPEN HIP JOINT NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400447,1214,PC ANESTH HIP ARTHROPLASTY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400448,1215,PC ANESTH OPEN REVISE TOTAL HIP ARTHROPLASTY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400449,1220,PC ANESTH CLOSED PROCS FEMUR-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400450,1230,PC ANESTH OPEN FEMUR PROCS NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400451,1270,PC ANESTH ARTERIES UPPER LEG W/GRAFT NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400452,1274,PC ANESTH FEMORAL ARTERY EMBOLECTOMY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400453,1402,PC ANESTH TOTAL KNEE ARTHROPLASTY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400454,1440,PC ANESTH KNEE/POPLITEAL ARTERIES NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400455,1474,PC ANESTH GASTROCNEMIUS RECESSION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400456,1484,PC ANESTH LOWER LEG PROCS OSTEOTOMY/OSTEOPLASTY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400457,1502,PC ANESTH LOWER LEG ARTERY EMBOLECTOMY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400458,1622,PC ANESTH SHOULDER ARTHROSCOPY DX-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400459,1638,PC ANESTH TOTAL SHOULDER REPLACMENT-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400460,1670,PC ANESTH SHOULDER/AXILLA VEIN PROCS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400461,1712,PC ANESTH TENOTOMY UPPER ARM OPEN-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400462,1716,PC ANESTH BICEPS TENDON REPAIR-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400463,1772,PC ANESTH EMBOLECTOMY UPPER ARM/ELBOW-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400464,1844,PC ANESTH VASCULAR SHUNT OR REVISION-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400465,1916,PC ANESTH ARTERIOGRAPHY/VENOGRAPHY DX-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400466,1920,PC ANESTH HEART CATH W/ANGIOGRAPHY/VENTRICULOGRAPHY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400467,1924,PC ANESTH ARTERIAL INTERVEN RAD PROCS THERAPEUTIC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400468,1925,PC ANESTH ARTERIAL INTERVEN RAD PROCS CAROTID/CORONARY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400469,1926,PC ANESTH ARTERIAL INTERVEN RAD PROCS INTRACRANIAL/CARDIAC/AORTIC-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400470,1930,PC ANESTH VENOUS/LYMPHATIC SYSTEM THERAP NOS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400471,1935,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS DX-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400472,1936,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS THERAP-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400473,1960,PC ANESTH VAGINAL DELIVERY-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400474,1965,PC ANESTH ABORTION IMCOMPLETE/MISSED-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400475,1966,PC ANESTH ABORTION INDUCED-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400476,1991,PC ANESTH NERVE BLOCK/INJ DX/THER NON PRONE DIFF PHYS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400477,1992,PC ANESTH NERVE BLOCK/INJ DX/THER PRONE DIFF PHYS-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400483,N/A,PC ANESTH SALIVARY GLAND W/BX-QX,964,1 ,$25.00 ,$8.13 ,$1.75 ,$12.50 ,$4.38 ,$6.38 ,$6.88 ,$1.75 ,$3.50 ,$5.88 ,$1.75 ,$6.75 ,$1.75 ,$6.79 ,$5.00 ,$1.75 ,$6.79 ,$3.33 ,$8.75 ,$12.50 ,$10.00 ,$4.38 ,$1.75 ,$8.75 ,$1.75 ,$7.50 ,$1.75 ,$9.38 ,$6.90 ,$6.23 ,$6.90 ,$1.75 ,$6.90 ,$9.75 ,$9.75 ,$10.63 ,$4.38 ,$8.67 ,$1.75 ,$12.50 ,$6.88 ,$1.75 ,$8.75 ,$12.50 , N/A , N/A ,$1.84 ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A ,$1.75 ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400484,120,PC ANESTH EXT/MID/INR EAR W/BX NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400485,140,PC ANESTH EYE NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400486,160,PC ANESTH NOSE/SINUS NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400487,170,PC ANESTH MOUTH W/BIOPSY NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400488,190,PC ANESTH FACE BONE/SKULL NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400489,300,PC ANESTH HEAD/NECK/TRUNK NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400490,320,PC ANESTH NECK ORGANS >1YR NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400491,400,PC ANESTH INTEG EXTRM/TRUNK NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400492,404,PC ANESTH BREAST RADICAL/MOD RAD-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400493,406,PC ANESTH BREAST/RAD/MOD RAD W/DISSECTION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400494,410,PC ANESTH ELEC CONV ARRHYTHMIAS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400495,450,PC ANESTH CLAVICLE/SCAPULA NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400496,520,PC ANESTH CHEST CLOSED NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400497,635,PC ANESTH LUMBAR PUNCTURE DIAG/THERAP-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400498,700,PC ANESTH ABD WALL/UPPER ANTR NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400499,730,PC ANESTH ABD WALL/UPPER POSTR NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400500,750,PC ANESTH RPR HERNIA UPPER ABD NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400501,752,PC ANESTH RPR HERNIA LUMB/VENTR WND DEH-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400502,790,PC ANESTH UPPER ABD W/LAP NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400503,800,PC ANESTH ABD WALL LOW ANTR NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400504,820,PC ANESTH ABD WALL LOWER POSTR-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400505,830,PC ANESTH RPR HERNIA LOW ABD NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400506,832,PC ANESTH RPR HERNIA VENTRAL/INCISONAL-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400507,840,PC ANESTH LOWER ABD W/LAP NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400508,844,PC ANESTH ABDOMINOPERINEAL RESECTION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400509,846,PC ANESTH HYSTERECTOMY RADICAL-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400510,860,PC ANESTH LOWER ABD EXTRAPERIT NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400511,862,PC ANESTH RENAL PROC/DONOR NEPHRECTOMY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400512,865,PC ANESTH PROSTATECTOMY RADICAL-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400513,873,PC ANESTH LITHOTRIPSY W/O WATER BATH-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400514,902,PC ANESTH ANORECTAL PROC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400515,908,PC ANESTH PERINEAL PROSTATECTOMY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400516,910,PC ANESTH TRANSURETHRAL PROC NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400517,912,PC ANESTH TRANSURETHRAL RESECT BLADDER TUMR-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400518,914,PC ANESTH TRANSURETRAL RESECT PROSTATE-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400519,920,PC ANESTH GENITALIA MALE NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400520,940,PC ANESTH VAGINAL PROCS W/BX NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400521,942,PC ANESTH VAGINAL COLPECT/VAG/COLPRHY PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400522,944,PC ANESTH VAGINAL HYSTERECTOMY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400523,948,PC ANESTH CERVICAL CERCLAGE-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400524,952,PC ANESTH HYSTEROSCOPY/HYSTERGRAPH-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400525,1200,PC ANESTH HIP JOINT CLOSED PROC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400526,1232,PC ANESTH FEMUR AMPUTATION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400527,1250,PC ANESTH UPPER LEG PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400528,1320,PC ANESTH KNEE/POPLITEAL PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400529,1340,PC ANESTH FEMUR CLOSED PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400530,1360,PC ANESTH FEMUR OPEN PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400531,1380,PC ANESTH KNEE JOINT CLOSED-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400532,1382,PC ANESTH KNEE ARTHROSCOPIC DIAG PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400533,1390,PC ANESTH KNEE CLOSED PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400534,1392,PC ANESTH KNEE OPEN PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400535,1400,PC ANESTH KNEE ARTHROSOPIC OPEN PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400536,1462,PC ANESTH LWR LEG/ANKLE/FOOT CLOSED-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400537,1464,PC ANESTH ANKLE/FOOT ARTHROSCOPIC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400538,1470,PC ANESTH LWR LEG NERV/MUSC/TEND NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400539,1472,PC ANESTH RPR ACHILLES TENDN W/OR W/O GRAFT-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400540,1480,PC ANESTH LWR LEG/ANKLE/FOOT OPEN NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400541,1482,PC ANESTH LWR LEG RADICAL RESECTION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400542,1610,PC ANESTH SHLDR NERV/MUSC/TEND-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400543,1620,PC ANESTH SHLDR CLOSED PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400544,1630,PC ANESTH SHLDR ARTHROSCOPIC NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400545,1710,PC ANESTH UPPR ARM/ELBW NERV/MUSC/TEND NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400546,1730,PC ANESTH HUMERUS/ELBOW CLOSED PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400547,1740,PC ANESTH ELBOW ARTHROSCOPIC PROC NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400548,1770,PC ANESTH UPPR ARM/ELBOW NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400549,1780,PC ANESTH VEINS UPPR ARM/ELBOW NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400550,1810,PC ANESTH LOWR ARM NERV/MUSC/TEND PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400551,1820,PC ANESTH LOWER ARM CLOSED PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400552,1830,PC ANESTH LOWER ARM ARTHRO/ENDOSC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400553,1840,PC ANESTH LOWER ARM ARTERIES PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400554,1850,PC ANESTH VEINS LOWER ARM NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400555,1922,PC ANESTH NO-INVAS IMAGE OR RAD THPY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400556,1961,PC ANESTH CESAREAN DELIVERY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400557,1967,PC ANESTH VAGINAL DELIVERY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400558,1968,PC ANESTH CESAREAN DELIVERY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400559,1999,PC ANESTH UNLISTED PROC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400560,126,PC ANESTH TYMPANOTOMY -QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400561,103,PC ANESTH EYELID BLEPHAROPLASTY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400562,104,PC ANESTH ELECTROCONVULSIVE THERAPY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400563,124,PC ANESTH EAR PROC W/BX OTOSCOPY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400564,210,PC ANESTH INTRACRANIAL PROCS NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400565,211,PC ANESTH INTRACRANIAL PROC HEMATOMA-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400566,214,PC ANESTH INTRACRANIAL PROC BURR HOLES W/VENTRICULOGRAPHY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400567,216,PC ANESTH INTRACRANIAL PROCS VASCULAR-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400568,218,PC ANESTH INTRACRANIAL PROCS SITTING POSITION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400569,220,PC ANESTH INTRACRANIAL SHUNTING PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400570,350,PC ANESTH NECK VESSEL NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400571,352,PC ANESTH NECK VESSEL SIMPLE LIGATION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400572,402,PC ANESTH BREAST RECONSTRUCT PROC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400573,500,PC ANESTH ESOPHAGEAL PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400574,522,PC ANESTH CHEST BIOPSY PLEURA-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400575,528,PC ANESTH CHEST MEDIAST/DX THORASC W/LUNG VENTIL-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400576,530,PC ANESTH PACEMAKER INSERTION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400577,532,PC ANESTH VASCULAR ACCESS CENTRAL VENOUS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400578,534,PC ANESTH INSERT CARDIOVERTER/DEFIBRILLATOR-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400579,541,PC ANESTH THORACOTOMY VENTILATION SINGLE LUNG-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400580,560,PC ANESTH HEART PROC W/O PUMP OXYGENATOR-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400581,600,PC ANESTH CERVICAL SPINE/CORD NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400582,620,PC ANESTH THORACIC SPINE/CORD NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400583,625,PC ANESTH THORACIC SPINE W/O LUNG VENTILATION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400584,630,PC ANESTH LUMBAR PROCS NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400585,640,PC ANESTH SPINE MANIPULATION/CLOSED PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400586,670,PC ANESTH EXTENSIVE SPINE/CORD PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400587,702,PC ANESTH LIVER BIOPSY PERC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400588,731,PC ANESTH UPPER GI ENDO PROC NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400589,732,PC ANESTH UPPER GI ERCP-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400590,754,PC ANESTH HERNIA UPPR ABDOMEN OMPHALOCELE-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400591,811,PC ANESTH LOWER ENDO PROCS NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400592,812,PC ANESTH SCREENING COLONOSCOPY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400593,813,PC ANESTH UPPER/LOWER GI ENDO PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400594,872,PC ANESTH LITHO EXTRACORPOREAL SHOCK WAVE W/BATH-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400595,918,PC ANESTH TRANSURETHRAL STONE REMOVAL-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400596,1112,PC ANESTH BONE MARROW ASPIRATION/BIOPSY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400597,1120,PC ANESTH BONY PELVIS PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400598,1202,PC ANESTH ARTHROSCOPY HIP-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400599,1210,PC ANESTH OPEN HIP JOINT NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400600,1214,PC ANESTH HIP ARTHROPLASTY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400601,1215,PC ANESTH OPEN REVISE TOTAL HIP ARTHROPLASTY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400602,1220,PC ANESTH CLOSED PROCS FEMUR-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400603,1230,PC ANESTH OPEN FEMUR PROCS NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400604,1270,PC ANESTH ARTERIES UPPER LEG W/GRAFT NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400605,1274,PC ANESTH FEMORAL ARTERY EMBOLECTOMY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400606,1402,PC ANESTH TOTAL KNEE ARTHROPLASTY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400607,1440,PC ANESTH KNEE/POPLITEAL ARTERIES NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400608,1474,PC ANESTH GASTROCNEMIUS RECESSION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400609,1484,PC ANESTH LOWER LEG PROCS OSTEOTOMY/OSTEOPLASTY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400610,1502,PC ANESTH LOWER LEG ARTERY EMBOLECTOMY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400611,1622,PC ANESTH SHOULDER ARTHROSCOPY DX-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400612,1638,PC ANESTH TOTAL SHOULDER REPLACMENT-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400613,1670,PC ANESTH SHOULDER/AXILLA VEIN PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400614,1712,PC ANESTH TENOTOMY UPPER ARM OPEN-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400615,1716,PC ANESTH BICEPS TENDON REPAIR-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400616,1772,PC ANESTH EMBOLECTOMY UPPER ARM/ELBOW-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400617,1844,PC ANESTH VASCULAR SHUNT OR REVISION-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400618,1916,PC ANESTH ARTERIOGRAPHY/VENOGRAPHY DX-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400619,1920,PC ANESTH HEART CATH W/ANGIOGRAPHY/VENTRICULOGRAPHY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400620,1924,PC ANESTH ARTERIAL INTERVEN RAD PROCS THERAPEUTIC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400621,1925,PC ANESTH ARTERIAL INTERVEN RAD PROCS CAROTID/CORONARY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400622,1926,PC ANESTH ARTERIAL INTERVEN RAD PROCS INTRACRANIAL/CARDIAC/AORTIC-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400623,1930,PC ANESTH VENOUS/LYMPHATIC SYSTEM THERAP NOS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400624,1935,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS DX-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400625,1936,PC ANESTH SPINE/SPINAL CORD PERC IMAGE GUIDED PROCS THERAP-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400626,1960,PC ANESTH VAGINAL DELIVERY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400627,1965,PC ANESTH ABORTION IMCOMPLETE/MISSED-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400628,1966,PC ANESTH ABORTION INDUCED-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400629,1991,PC ANESTH NERVE BLOCK/INJ DX/THER NON PRONE DIFF PHYS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400630,1992,PC ANESTH NERVE BLOCK/INJ DX/THER PRONE DIFF PHYS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400631,1990,PC ANESTH ORGAN HARVEST-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400636,100,PC ANESTH SALIVARY GLAND W/BX-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400637,1744,PC ANESTH REPAIR HUMERUS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400647,906,PC ANESTH REMOVAL OF VULVA-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400648,906,PC ANESTH REMOVAL OF VULVA-QZ,964,1 ,$25.00 ,$16.25 ,$7.00 ,$25.00 , N/A ,$12.75 ,$13.75 , N/A ,$7.00 ,$11.75 , N/A ,$13.50 , N/A ,$13.58 ,$10.00 , N/A ,$13.58 , N/A ,$17.50 ,$12.50 ,$20.00 , N/A , N/A ,$17.50 , N/A ,$15.00 , N/A ,$18.75 ,$13.80 ,$12.45 ,$13.80 , N/A ,$13.80 ,$19.50 ,$19.50 ,$21.25 , N/A ,$17.33 , N/A ,$25.00 ,$13.75 , N/A ,$17.50 ,$25.00 , N/A , N/A , N/A ,$20.00 ,$13.58 ,$7.00 ,$22.50 ,$9.50 , N/A , N/A ,$12.00 
ST. MARY'S HOSPITAL - DECATUR,96400649,1260,PC ANESTH VEINS UPPER LEG PROCS-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,96400650,1170,PC ANESTH PELVIS SURGERY-QX,964,1 ,$25.00 ,$8.13 ,$3.50 ,$12.50 , N/A ,$6.38 ,$6.88 , N/A ,$3.50 ,$5.88 , N/A ,$6.75 , N/A ,$6.79 ,$5.00 , N/A ,$6.79 , N/A ,$8.75 ,$12.50 ,$10.00 , N/A , N/A ,$8.75 , N/A ,$7.50 , N/A ,$9.38 ,$6.90 ,$6.23 ,$6.90 , N/A ,$6.90 ,$9.75 ,$9.75 ,$10.63 , N/A ,$8.67 , N/A ,$12.50 ,$6.88 , N/A ,$8.75 ,$12.50 , N/A , N/A , N/A ,$10.00 ,$6.79 ,$3.50 ,$11.25 ,$4.75 , N/A , N/A ,$6.00 
ST. MARY'S HOSPITAL - DECATUR,98180942,69200,PC REM FOREIGN BODY CANAL AUD EXT-LT,981,1 ,$430.00 ,$279.50 ,$79.74 ,$430.00 ,$266.85 ,$219.30 ,$236.50 ,$106.74 ,$120.40 ,$202.10 ,$106.74 ,$232.20 ,$106.74 ,$233.49 ,$86.57 ,$106.74 ,$233.49 ,$202.80 ,$301.00 ,$215.00 ,$344.00 ,$266.84 ,$106.74 ,$301.00 ,$106.74 ,$258.00 ,$106.74 ,$322.50 ,$237.36 ,$214.14 ,$237.36 ,$106.74 ,$237.36 ,$335.40 ,$335.40 ,$365.50 ,$266.84 ,$297.99 ,$106.74 ,$430.00 ,$236.50 ,$106.74 ,$82.30 ,$430.00 ,$83.53 ,$79.74 ,$112.08 ,$344.00 ,$233.49 ,$120.40 ,$387.00 ,$163.40 , N/A ,$106.74 ,$206.40 
ST. MARY'S HOSPITAL - DECATUR,98500000,93010,PC EKG INTER AND REPORT PRO,985,1 ,$54.00 ,$35.10 ,$15.12 ,$54.00 , N/A ,$27.54 ,$29.70 , N/A ,$15.12 ,$26.46 , N/A ,$31.59 , N/A ,$29.32 ,$17.84 , N/A ,$29.32 , N/A ,$37.80 ,$27.00 ,$43.20 , N/A , N/A ,$37.80 , N/A ,$32.40 , N/A ,$40.50 ,$29.81 ,$26.89 ,$29.81 , N/A ,$29.81 ,$42.12 ,$42.12 ,$45.90 , N/A ,$37.42 , N/A ,$54.00 ,$29.70 , N/A ,$15.74 ,$54.00 ,$18.02 ,$17.20 , N/A ,$43.20 ,$29.32 ,$15.12 ,$48.60 ,$20.52 , N/A , N/A ,$25.92 
ST. MARY'S HOSPITAL - DECATUR,99000002,N/A,HC BOOKS AND PAMPHLETS ALL TYPES,990,1 ,$16.00 ,$10.40 ,$4.21 ,$16.00 , N/A ,$8.16 ,$8.80 , N/A ,$4.48 ,$7.52 , N/A ,$8.64 , N/A ,$8.69 , N/A , N/A ,$8.69 , N/A ,$11.20 ,$8.00 ,$12.80 , N/A , N/A ,$11.20 , N/A ,$9.60 , N/A ,$12.00 ,$8.83 ,$7.97 ,$8.83 , N/A ,$8.83 ,$12.48 ,$12.48 ,$13.60 , N/A ,$11.09 , N/A ,$16.00 ,$8.80 , N/A ,$4.21 ,$16.00 , N/A , N/A , N/A ,$12.80 ,$8.69 ,$4.48 ,$14.40 ,$6.08 , N/A , N/A ,$7.68 
ST. MARY'S HOSPITAL - DECATUR,99980035,N/A,HC ER NO CHARGE,999,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A 
ST. MARY'S HOSPITAL - DECATUR,99980044,N/A,HC CLINIC NO CHARGE,999,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 , N/A ,$0.01 , N/A , N/A , N/A , N/A