SACRED HEART HOSPITAL - Price Transparency,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Site,Svc_Cd,HCPC/Cpt_Cd,CDM_Svc_Descr,Rev_Cd, Quantity/Units , Hopsital_Cdm_Chg , Self_Pay_Chg , Minimum_Negotiated_Chg , Maximum_Negotiated_Chg , AETNA HSHS , AETNA MEDICARE , AMISH COMMUNITY DISCOUNT , ANTEHM MEDICAID , ANTHEM , ANTHEM BC MEDICAID , ANTHEM BLUE PRIORITY , ANTHEM WISCONSIN INDEMNITY , CENPATICO , CHOICE CARE , CIGNA , CONTINUUS MEDICAID MANAGED , FAMILY HEALTH CENTER , FIRST HEALTH NETWORK , GOVERNMENT EMPLOYEE HEALTH ASSOCIATION , GROUP HEALTH COOP , GROUP HEALTH MEDICAID , GROUP HEALTH MEDICAID HMO , GUNDERSON HEALTH PLAN MEDICAID , HEALTH CARE ALLIANCE , HEALTH PARTNERS MEDICARE , HEALTHEOS ," HEALTHPARTNERS, INC. ", HUMANA , HUMANA MEDICARE ADVANTAGE , IMMERGRUN INC , INTERPLAN HEALTH GROUP , MANAGED MEDICARE NO SEQUESTRATION , MEDICA , MEDICA MEDICARE ADVANTAGE , MULTIPLAN , NAPHCARE , NCHA , NETWORK HEALTH MEDICAID , PREFERRED ONE , PREFERRED ONE   ST CROIX , PREVEA 360 EMPLOYEES , PREVEA HEALTH NETWORK , QUARTZ , SECURITY HEALTH PLAN , SECURITY HEALTH PLAN NARROW NETWORK , SECURITY HEALTH PLAN OF WISCONSIN , SECURITY HEATLH MEDICAID , SELECT CARE ," UCARE WISCONSIN, INC ", UHC MEDICAID , UNITED HEALTH ALL PAYOR , UNITED HEALTH CARE MEDICARE , UNITED HEALTHCARE BEHAVIORAL HEALTH , VESTICA , WEA INSURANCE CORPORATION , WEA INSURANCE CORPORATION                         1 , WEA INSURANCE CORPORATION                         2 , WEA NORTHWEST , WEA NORTHWEST CHIP , WPS PREFERRED ADV PLUS STATE WIDE , WPS PREFERRED HEALTH PLAN , WPS_INDEMNITY 
SACRED HEART HOSPITAL (ACU),N/A,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,120,1 ,"$60,517.70 ","$45,388.28 ","$3,765.45 ","$72,756.56 ","$38,973.40 ","$69,735.51 ","$36,310.62 ","$3,765.45 ","$60,517.70 ","$3,937.47 ","$60,517.70 ","$57,491.82 ","$3,822.79 ","$48,414.16 ","$55,676.28 ","$3,765.45 ", N/A ,"$57,491.82 ","$53,255.58 ","$47,203.81 ","$3,765.45 ","$3,822.79 ","$3,822.79 ","$44,177.92 ","$33,284.74 ","$55,071.11 ","$55,071.11 ","$48,414.16 ","$71,827.57 ","$33,284.74 ","$54,465.93 ","$69,735.51 ","$54,465.93 ","$32,679.56 ","$56,886.64 ","$60,517.70 ","$55,676.28 ","$4,052.16 ","$55,071.11 ","$69,735.51 ","$60,517.70 ","$60,517.70 ","$54,465.93 ","$54,465.93 ","$54,465.93 ","$72,756.56 ","$3,822.79 ","$57,491.82 ","$71,112.56 ","$3,822.79 ","$52,650.40 ","$69,735.51 ","$54,465.93 ","$69,735.51 ","$54,465.93 ","$54,465.93 ","$54,465.93 ","$58,702.17 ","$49,019.34 ","$56,281.46 ","$52,045.22 ","$58,702.17 "
SACRED HEART HOSPITAL (ACU),N/A,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,120,1 ,"$15,305.70 ","$11,479.28 ","$3,765.45 ","$18,966.63 ","$9,856.87 ","$18,185.10 ","$10,713.99 ","$3,765.45 ","$15,305.70 ","$3,937.47 ","$15,305.70 ","$14,540.42 ","$3,822.79 ","$12,244.56 ","$14,081.24 ","$3,765.45 ", N/A ,"$14,540.42 ","$13,469.02 ","$11,938.45 ","$3,765.45 ","$3,822.79 ","$3,822.79 ","$11,173.16 ","$8,418.14 ","$13,928.19 ","$13,928.19 ","$12,244.56 ","$18,730.65 ","$8,418.14 ","$13,775.13 ","$18,185.10 ","$13,775.13 ","$8,265.08 ","$14,387.36 ","$15,305.70 ","$14,081.24 ","$4,052.16 ","$13,928.19 ","$18,185.10 ","$15,305.70 ","$15,305.70 ","$13,775.13 ","$13,775.13 ","$13,775.13 ","$18,966.63 ","$3,822.79 ","$14,540.42 ","$18,549.91 ","$3,822.79 ","$13,315.96 ","$18,185.10 ","$13,775.13 ","$18,185.10 ","$13,775.13 ","$13,775.13 ","$13,775.13 ","$14,846.53 ","$12,397.62 ","$14,234.30 ","$13,162.90 ","$14,846.53 "
SACRED HEART HOSPITAL (ACU),N/A,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,120,1 ,"$11,455.16 ","$8,591.37 ","$3,765.45 ","$14,259.62 ","$7,377.12 ","$13,674.06 ","$8,018.61 ","$3,765.45 ","$11,455.16 ","$3,937.47 ","$11,455.16 ","$10,882.40 ","$3,822.79 ","$9,164.13 ","$10,538.75 ","$3,765.45 ", N/A ,"$10,882.40 ","$10,080.54 ","$8,935.02 ","$3,765.45 ","$3,822.79 ","$3,822.79 ","$8,362.27 ","$6,300.34 ","$10,424.20 ","$10,424.20 ","$9,164.13 ","$14,084.28 ","$6,300.34 ","$10,309.64 ","$13,674.06 ","$10,309.64 ","$6,185.79 ","$10,767.85 ","$11,455.16 ","$10,538.75 ","$4,052.16 ","$10,424.20 ","$13,674.06 ","$11,455.16 ","$11,455.16 ","$10,309.64 ","$10,309.64 ","$10,309.64 ","$14,259.62 ","$3,822.79 ","$10,882.40 ","$13,950.27 ","$3,822.79 ","$9,965.99 ","$13,674.06 ","$10,309.64 ","$13,674.06 ","$10,309.64 ","$10,309.64 ","$10,309.64 ","$11,111.51 ","$9,278.68 ","$10,653.30 ","$9,851.44 ","$11,111.51 "
SACRED HEART HOSPITAL (ACU),N/A,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,120,1 ,"$23,694.57 ","$17,770.93 ","$3,765.45 ","$28,638.53 ","$15,259.30 ","$27,454.19 ","$16,586.20 ","$3,765.45 ","$23,694.57 ","$3,937.47 ","$23,694.57 ","$22,509.84 ","$3,822.79 ","$18,955.66 ","$21,799.00 ","$3,765.45 ", N/A ,"$22,509.84 ","$20,851.22 ","$18,481.76 ","$3,765.45 ","$3,822.79 ","$3,822.79 ","$17,297.04 ","$13,032.01 ","$21,562.06 ","$21,562.06 ","$18,955.66 ","$28,277.81 ","$13,032.01 ","$21,325.11 ","$27,454.19 ","$21,325.11 ","$12,795.07 ","$22,272.90 ","$23,694.57 ","$21,799.00 ","$4,052.16 ","$21,562.06 ","$27,454.19 ","$23,694.57 ","$23,694.57 ","$21,325.11 ","$21,325.11 ","$21,325.11 ","$28,638.53 ","$3,822.79 ","$22,509.84 ","$28,000.88 ","$3,822.79 ","$20,614.28 ","$27,454.19 ","$21,325.11 ","$27,454.19 ","$21,325.11 ","$21,325.11 ","$21,325.11 ","$22,983.73 ","$19,192.60 ","$22,035.95 ","$20,377.33 ","$22,983.73 "
SACRED HEART HOSPITAL (ACU),N/A,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,120,1 ,"$6,828.61 ","$5,121.46 ","$3,687.45 ","$8,603.38 ","$4,397.62 ","$8,253.30 ","$4,780.03 ","$3,765.45 ","$6,828.61 ","$3,937.47 ","$6,828.61 ","$6,487.18 ","$3,822.79 ","$5,462.89 ","$6,282.32 ","$3,765.45 ", N/A ,"$6,487.18 ","$6,009.18 ","$5,326.32 ","$3,765.45 ","$3,822.79 ","$3,822.79 ","$4,984.89 ","$3,755.74 ","$6,214.04 ","$6,214.04 ","$5,462.89 ","$8,500.90 ","$3,755.74 ","$6,145.75 ","$8,253.30 ","$6,145.75 ","$3,687.45 ","$6,418.89 ","$6,828.61 ","$6,282.32 ","$4,052.16 ","$6,214.04 ","$8,253.30 ","$6,828.61 ","$6,828.61 ","$6,145.75 ","$6,145.75 ","$6,145.75 ","$8,603.38 ","$3,822.79 ","$6,487.18 ","$8,423.06 ","$3,822.79 ","$5,940.89 ","$8,253.30 ","$6,145.75 ","$8,253.30 ","$6,145.75 ","$6,145.75 ","$6,145.75 ","$6,623.75 ","$5,531.17 ","$6,350.61 ","$5,872.60 ","$6,623.75 "
SACRED HEART HOSPITAL (ACU),12000001,N/A,HC DAILY SERVICE GENERAL,120,1 ,"$1,114.00 ",$835.50 ,$601.56 ,"$1,114.00 ",$717.42 , Inpatient Medicare ,$779.80 , Inpatient Medicaid ,"$20,474.00 ", Inpatient Medicaid +3% ,"$16,380.00 ","$1,058.30 ", Inpatient Medicaid ,$891.20 ,"$1,024.88 ", Inpatient Medicaid , N/A ,"$1,058.30 ",$980.32 ,$868.92 , Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,$813.22 ,$612.70 ,"$1,013.74 ","$1,013.74 ",$891.20 , Inpatient Medicare +3% ,$612.70 ,"$1,002.60 ", Inpatient Medicare ,"$1,002.60 ",$601.56 ,"$1,058.30 ", Inpatient Medicare +100% ,"$1,024.88 ", Inpatient Medicaid +6% ,"$1,013.74 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$1,002.60 ","$1,002.60 ","$15,809.74 ", Inpatient Medicaid , Inpatient Medicaid ,"$1,002.60 ", Inpatient Medicare +5% , Inpatient Medicaid ,$969.18 , Inpatient Medicare ,"$1,002.60 ", Inpatient Medicare ,"$1,002.60 ","$1,002.60 ","$1,002.60 ","$1,080.58 ",$902.34 ,"$1,036.02 ",$958.04 ,"$1,080.58 "
SACRED HEART HOSPITAL (ACU),12200001,N/A,HC DAILY SERVICE OBSTETRICS,122,1 ,"$1,114.00 ",$835.50 ,$601.56 ,"$1,114.00 ",$717.42 , Inpatient Medicare ,$779.80 , Inpatient Medicaid ,"$20,474.00 ", Inpatient Medicaid +3% ,"$16,380.00 ","$1,058.30 ", Inpatient Medicaid ,$891.20 ,"$1,024.88 ", Inpatient Medicaid , N/A ,"$1,058.30 ",$980.32 ,$868.92 , Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,$813.22 ,$612.70 ,"$1,013.74 ","$1,013.74 ",$891.20 , Inpatient Medicare +3% ,$612.70 ,"$1,002.60 ", Inpatient Medicare ,"$1,002.60 ",$601.56 ,"$1,058.30 ", Inpatient Medicare +100% ,"$1,024.88 ", Inpatient Medicaid +6% ,"$1,013.74 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$1,002.60 ","$1,002.60 ","$15,809.74 ", Inpatient Medicaid , Inpatient Medicaid ,"$1,002.60 ", Inpatient Medicare +5% , Inpatient Medicaid ,$969.18 , Inpatient Medicare , N/A , Inpatient Medicare ,"$1,002.60 ","$1,002.60 ","$1,002.60 ","$1,080.58 ",$902.34 ,"$1,036.02 ",$958.04 ,"$1,080.58 "
SACRED HEART HOSPITAL (ACU),12400002,N/A,HC DAILY SERVICE PSYCH ADULT,124,1 ,"$1,414.00 ","$1,060.50 ",$763.56 ,"$1,414.00 ",$910.62 , Inpatient Medicare ,$989.80 , Inpatient Medicaid ,"$2,143.00 ", Inpatient Medicaid +3% ,"$1,715.00 ","$1,343.30 ", Inpatient Medicaid ,"$1,131.20 ","$1,300.88 ", Inpatient Medicaid , N/A ,"$1,343.30 ","$1,244.32 ","$1,102.92 ", Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,"$1,032.22 ",$777.70 ,"$1,286.74 ","$1,286.74 ","$1,131.20 ", Inpatient Medicare +3% ,$777.70 ,"$1,272.60 ", Inpatient Medicare ,"$1,272.60 ",$763.56 ,"$1,343.30 ", Inpatient Medicare +100% ,"$1,300.88 ", Inpatient Medicaid +6% ,"$1,286.74 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$1,272.60 ","$1,272.60 ","$2,036.51 ", Inpatient Medicaid , Inpatient Medicaid ,"$1,272.60 ", Inpatient Medicare +5% , Inpatient Medicaid ,"$1,230.18 ", Inpatient Medicare ,"$1,272.60 ", Inpatient Medicare ,"$1,272.60 ","$1,272.60 ","$1,272.60 ","$1,371.58 ","$1,145.34 ","$1,315.02 ","$1,216.04 ","$1,371.58 "
SACRED HEART HOSPITAL (ACU),12400003,N/A,HC DAILY SERVICE PSYCH ADOLESCENT,124,1 ,"$1,727.00 ","$1,295.25 ",$932.58 ,"$1,727.00 ","$1,112.19 ", Inpatient Medicare ,"$1,208.90 ", Inpatient Medicaid ,"$2,143.00 ", Inpatient Medicaid +3% ,"$1,715.00 ","$1,640.65 ", Inpatient Medicaid ,"$1,381.60 ","$1,588.84 ", Inpatient Medicaid , N/A ,"$1,640.65 ","$1,519.76 ","$1,347.06 ", Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,"$1,260.71 ",$949.85 ,"$1,571.57 ","$1,571.57 ","$1,381.60 ", Inpatient Medicare +3% ,$949.85 ,"$1,554.30 ", Inpatient Medicare ,"$1,554.30 ",$932.58 ,"$1,640.65 ", Inpatient Medicare +100% ,"$1,588.84 ", Inpatient Medicaid +6% ,"$1,571.57 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$1,554.30 ","$1,554.30 ","$2,036.51 ", Inpatient Medicaid , Inpatient Medicaid ,"$1,554.30 ", Inpatient Medicare +5% , Inpatient Medicaid ,"$1,502.49 ", Inpatient Medicare ,"$1,554.30 ", Inpatient Medicare ,"$1,554.30 ","$1,554.30 ","$1,554.30 ","$1,675.19 ","$1,398.87 ","$1,606.11 ","$1,485.22 ","$1,675.19 "
SACRED HEART HOSPITAL (ACU),12800001,N/A,HC DAILY REHAB SERVICE,128,1 ,"$1,596.00 ","$1,197.00 ",$861.84 ,"$1,596.00 ","$1,027.82 ", Inpatient Medicare ,"$1,117.20 ", Inpatient Medicaid ,"$2,841.00 ", Inpatient Medicaid +3% ,"$2,273.00 ","$1,516.20 ", Inpatient Medicaid ,"$1,276.80 ","$1,468.32 ", Inpatient Medicaid , N/A ,"$1,516.20 ","$1,404.48 ","$1,244.88 ", Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,"$1,165.08 ",$877.80 ,"$1,452.36 ","$1,452.36 ","$1,276.80 ", Inpatient Medicare +3% ,$877.80 ,"$1,436.40 ", Inpatient Medicare ,"$1,436.40 ",$861.84 ,"$1,516.20 ", Inpatient Medicare +100% ,"$1,468.32 ", Inpatient Medicaid +6% ,"$1,452.36 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$1,436.40 ","$1,436.40 ","$2,036.51 ", Inpatient Medicaid , Inpatient Medicaid ,"$1,436.40 ", Inpatient Medicare +5% , Inpatient Medicaid ,"$1,388.52 ", Inpatient Medicare ,"$1,436.40 ", Inpatient Medicare ,"$1,436.40 ","$1,436.40 ","$1,436.40 ","$1,548.12 ","$1,292.76 ","$1,484.28 ","$1,372.56 ","$1,548.12 "
SACRED HEART HOSPITAL (ACU),16900000,N/A,HC DAILY SERVICE PROLONGED STAY,169,1 ,$466.00 ,$349.50 ,$251.64 ,$466.00 ,$300.10 , Inpatient Medicare ,$326.20 , Inpatient Medicaid ,"$20,474.00 ", Inpatient Medicaid +3% ,"$16,380.00 ",$442.70 , Inpatient Medicaid ,$372.80 ,$428.72 , Inpatient Medicaid , N/A ,$442.70 ,$410.08 ,$363.48 , Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,$340.18 ,$256.30 ,$424.06 ,$424.06 ,$372.80 , Inpatient Medicare +3% ,$256.30 ,$419.40 , Inpatient Medicare ,$419.40 ,$251.64 ,$442.70 , Inpatient Medicare +100% ,$428.72 , Inpatient Medicaid +6% ,$424.06 , Inpatient Medicare ,"$13,265.10 ","$13,265.10 ",$419.40 ,$419.40 ,"$15,809.74 ", Inpatient Medicaid , Inpatient Medicaid ,$419.40 , Inpatient Medicare +5% , Inpatient Medicaid ,$405.42 , Inpatient Medicare , N/A , Inpatient Medicare ,$419.40 ,$419.40 ,$419.40 ,$452.02 ,$377.46 ,$433.38 ,$400.76 ,$452.02 
SACRED HEART HOSPITAL (ACU),20000001,N/A,HC DAILY SERVICE ICU,200,1 ,"$3,012.00 ","$2,259.00 ","$1,626.48 ","$3,012.00 ","$1,939.73 ", Inpatient Medicare ,"$2,108.40 ", Inpatient Medicaid ,"$20,474.00 ", Inpatient Medicaid +3% ,"$16,380.00 ","$2,861.40 ", Inpatient Medicaid ,"$2,409.60 ","$2,771.04 ", Inpatient Medicaid , N/A ,"$2,861.40 ","$2,650.56 ","$2,349.36 ", Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,"$2,198.76 ","$1,656.60 ","$2,740.92 ","$2,740.92 ","$2,409.60 ", Inpatient Medicare +3% ,"$1,656.60 ","$2,710.80 ", Inpatient Medicare ,"$2,710.80 ","$1,626.48 ","$2,861.40 ", Inpatient Medicare +100% ,"$2,771.04 ", Inpatient Medicaid +6% ,"$2,740.92 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$2,710.80 ","$2,710.80 ","$15,809.74 ", Inpatient Medicaid , Inpatient Medicaid ,"$2,710.80 ", Inpatient Medicare +5% , Inpatient Medicaid ,"$2,620.44 ", Inpatient Medicare ,"$2,710.80 ", Inpatient Medicare ,"$2,710.80 ","$2,710.80 ","$2,710.80 ","$2,921.64 ","$2,439.72 ","$2,801.16 ","$2,590.32 ","$2,921.64 "
SACRED HEART HOSPITAL (ACU),20600002,N/A,HC DAILY SERVICE IMCU,206,1 ,"$2,454.00 ","$1,840.50 ","$1,325.16 ","$2,454.00 ","$1,580.38 ", Inpatient Medicare ,"$1,717.80 ", Inpatient Medicaid ,"$20,474.00 ", Inpatient Medicaid +3% ,"$16,380.00 ","$2,331.30 ", Inpatient Medicaid ,"$1,963.20 ","$2,257.68 ", Inpatient Medicaid , N/A ,"$2,331.30 ","$2,159.52 ","$1,914.12 ", Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,"$1,791.42 ","$1,349.70 ","$2,233.14 ","$2,233.14 ","$1,963.20 ", Inpatient Medicare +3% ,"$1,349.70 ","$2,208.60 ", Inpatient Medicare ,"$2,208.60 ","$1,325.16 ","$2,331.30 ", Inpatient Medicare +100% ,"$2,257.68 ", Inpatient Medicaid +6% ,"$2,233.14 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$2,208.60 ","$2,208.60 ","$15,809.74 ", Inpatient Medicaid , Inpatient Medicaid ,"$2,208.60 ", Inpatient Medicare +5% , Inpatient Medicaid ,"$2,134.98 ", Inpatient Medicare , N/A , Inpatient Medicare ,"$2,208.60 ","$2,208.60 ","$2,208.60 ","$2,380.38 ","$1,987.74 ","$2,282.22 ","$2,110.44 ","$2,380.38 "
SACRED HEART HOSPITAL (ACU),21000001,N/A,HC DAILY SERVICE W/TELEMETRY,210,1 ,"$1,908.00 ","$1,431.00 ","$1,030.32 ","$1,908.00 ","$1,228.75 ", Inpatient Medicare ,"$1,335.60 ", Inpatient Medicaid ,"$20,474.00 ", Inpatient Medicaid +3% ,"$16,380.00 ","$1,812.60 ", Inpatient Medicaid ,"$1,526.40 ","$1,755.36 ", Inpatient Medicaid , N/A ,"$1,812.60 ","$1,679.04 ","$1,488.24 ", Inpatient Medicaid , Inpatient Medicaid , Inpatient Medicaid ,"$1,392.84 ","$1,049.40 ","$1,736.28 ","$1,736.28 ","$1,526.40 ", Inpatient Medicare +3% ,"$1,049.40 ","$1,717.20 ", Inpatient Medicare ,"$1,717.20 ","$1,030.32 ","$1,812.60 ", Inpatient Medicare +100% ,"$1,755.36 ", Inpatient Medicaid +6% ,"$1,736.28 ", Inpatient Medicare ,"$13,265.10 ","$13,265.10 ","$1,717.20 ","$1,717.20 ","$15,809.74 ", Inpatient Medicaid , Inpatient Medicaid ,"$1,717.20 ", Inpatient Medicare +5% , Inpatient Medicaid ,"$1,659.96 ", Inpatient Medicare ,"$1,717.20 ", Inpatient Medicare ,"$1,717.20 ","$1,717.20 ","$1,717.20 ","$1,850.76 ","$1,545.48 ","$1,774.44 ","$1,640.88 ","$1,850.76 "
SACRED HEART HOSPITAL (ACU),23100002,N/A,HC CARDIAC/RESP MONITOR,231,1 ,$347.00 ,$260.25 ,$187.38 ,$347.00 ,$223.47 , N/A ,$242.90 , N/A ,$288.01 , N/A ,$229.02 ,$329.65 , N/A ,$277.60 ,$319.24 , N/A ,$294.95 ,$329.65 ,$305.36 ,$263.72 , N/A , N/A , N/A ,$253.31 ,$190.85 ,$315.77 ,$315.77 ,$277.60 , N/A ,$190.85 ,$312.30 , N/A ,$312.30 ,$187.38 ,$326.18 , N/A ,$319.24 , N/A ,$315.77 , N/A ,$213.54 ,$213.54 ,$312.30 ,$258.97 ,$241.69 , N/A , N/A ,$329.65 , N/A , N/A ,$301.89 , N/A ,$312.30 , N/A ,$312.30 ,$312.30 ,$312.30 ,$336.59 ,$281.07 ,$322.71 ,$298.42 ,$336.59 
SACRED HEART HOSPITAL (ACU),26000000,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$464.87 ,$348.65 ,$98.38 ,$486.82 ,$299.38 ,$216.36 ,$325.41 ,$98.38 ,$385.84 ,$101.33 ,$306.81 ,$441.63 ,$98.38 ,$371.90 ,$427.68 ,$98.38 ,$395.14 ,$441.63 ,$409.09 ,$353.30 ,$98.38 ,$98.38 ,$98.38 ,$339.36 ,$255.68 ,$423.03 ,$423.03 ,$371.90 ,$222.85 ,$255.68 ,$418.38 ,$216.36 ,$418.38 ,$251.03 ,$436.98 ,$486.82 ,$427.68 ,$104.28 ,$423.03 ,$216.36 ,$286.08 ,$286.08 ,$418.38 ,$346.93 ,$323.78 ,$218.53 ,$98.38 ,$441.63 ,$227.18 ,$98.38 ,$404.44 ,$216.36 ,$418.38 ,$216.36 ,$418.38 ,$418.38 ,$418.38 ,$450.92 ,$376.54 ,$432.33 ,$399.79 ,$450.92 
SACRED HEART HOSPITAL (ACU),26000001,96361,HC HYDRATION THERAPY EA ADDL HR,260,1 ,$229.98 ,$172.49 ,$42.32 ,$229.98 ,$148.11 ,$42.32 ,$160.99 ,$166.51 ,$190.88 ,$171.51 ,$151.79 ,$218.48 ,$166.51 ,$183.98 ,$211.58 ,$166.51 ,$195.48 ,$218.48 ,$202.38 ,$174.78 ,$166.51 ,$166.51 ,$166.51 ,$167.89 ,$126.49 ,$209.28 ,$209.28 ,$183.98 ,$43.59 ,$126.49 ,$206.98 ,$42.32 ,$206.98 ,$124.19 ,$216.18 ,$95.23 ,$211.58 ,$176.50 ,$209.28 ,$42.32 ,$141.53 ,$141.53 ,$206.98 ,$171.63 ,$160.18 ,$42.75 ,$166.51 ,$218.48 ,$44.44 ,$166.51 ,$200.08 ,$42.32 ,$206.98 ,$42.32 ,$206.98 ,$206.98 ,$206.98 ,$223.08 ,$186.28 ,$213.88 ,$197.78 ,$223.08 
SACRED HEART HOSPITAL (ACU),26000002,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$475.02 ,$356.27 ,$98.38 ,$486.82 ,$305.91 ,$216.36 ,$332.51 ,$98.38 ,$394.27 ,$101.33 ,$313.51 ,$451.27 ,$98.38 ,$380.02 ,$437.02 ,$98.38 ,$403.77 ,$451.27 ,$418.02 ,$361.02 ,$98.38 ,$98.38 ,$98.38 ,$346.76 ,$261.26 ,$432.27 ,$432.27 ,$380.02 ,$222.85 ,$261.26 ,$427.52 ,$216.36 ,$427.52 ,$256.51 ,$446.52 ,$486.82 ,$437.02 ,$104.28 ,$432.27 ,$216.36 ,$292.33 ,$292.33 ,$427.52 ,$354.51 ,$330.85 ,$218.53 ,$98.38 ,$451.27 ,$227.18 ,$98.38 ,$413.27 ,$216.36 ,$427.52 ,$216.36 ,$427.52 ,$427.52 ,$427.52 ,$460.77 ,$384.77 ,$441.77 ,$408.52 ,$460.77 
SACRED HEART HOSPITAL (ACU),26000003,96366,HC INFUSION THERAPY EA ADDL HR,260,1 ,$232.24 ,$174.18 ,$42.32 ,$232.24 ,$149.56 ,$42.32 ,$162.57 ,$166.51 ,$192.76 ,$171.51 ,$153.28 ,$220.63 ,$166.51 ,$185.79 ,$213.66 ,$166.51 ,$197.40 ,$220.63 ,$204.37 ,$176.50 ,$166.51 ,$166.51 ,$166.51 ,$169.54 ,$127.73 ,$211.34 ,$211.34 ,$185.79 ,$43.59 ,$127.73 ,$209.02 ,$42.32 ,$209.02 ,$125.41 ,$218.31 ,$95.23 ,$213.66 ,$176.50 ,$211.34 ,$42.32 ,$142.92 ,$142.92 ,$209.02 ,$173.32 ,$161.76 ,$42.75 ,$166.51 ,$220.63 ,$44.44 ,$166.51 ,$202.05 ,$42.32 ,$209.02 ,$42.32 ,$209.02 ,$209.02 ,$209.02 ,$225.27 ,$188.11 ,$215.98 ,$199.73 ,$225.27 
SACRED HEART HOSPITAL (ACU),26000004,96367,HC IV INF ADDL SEQ INIT HR,260,1 ,$232.24 ,$174.18 ,$65.57 ,$232.24 ,$149.56 ,$65.57 ,$162.57 ,$98.38 ,$192.76 ,$101.33 ,$153.28 ,$220.63 ,$98.38 ,$185.79 ,$213.66 ,$98.38 ,$197.40 ,$220.63 ,$204.37 ,$176.50 ,$98.38 ,$98.38 ,$98.38 ,$169.54 ,$127.73 ,$211.34 ,$211.34 ,$185.79 ,$67.54 ,$127.73 ,$209.02 ,$65.57 ,$209.02 ,$125.41 ,$218.31 ,$147.54 ,$213.66 ,$104.28 ,$211.34 ,$65.57 ,$142.92 ,$142.92 ,$209.02 ,$173.32 ,$161.76 ,$66.23 ,$98.38 ,$220.63 ,$68.85 ,$98.38 ,$202.05 ,$65.57 ,$209.02 ,$65.57 ,$209.02 ,$209.02 ,$209.02 ,$225.27 ,$188.11 ,$215.98 ,$199.73 ,$225.27 
SACRED HEART HOSPITAL (ACU),26000005,96368,HC INFUS CONCURRENT,260,1 ,$232.24 ,$174.18 ,$98.38 ,$232.24 ,$149.56 , N/A ,$162.57 ,$98.38 ,$192.76 ,$101.33 ,$153.28 ,$220.63 ,$98.38 ,$185.79 ,$213.66 ,$98.38 ,$197.40 ,$220.63 ,$204.37 ,$176.50 ,$98.38 ,$98.38 ,$98.38 ,$169.54 ,$127.73 ,$211.34 ,$211.34 ,$185.79 , N/A ,$127.73 ,$209.02 , N/A ,$209.02 ,$125.41 ,$218.31 , N/A ,$213.66 ,$104.28 ,$211.34 , N/A ,$142.92 ,$142.92 ,$209.02 ,$173.32 ,$161.76 , N/A ,$98.38 ,$220.63 , N/A ,$98.38 ,$202.05 , N/A ,$209.02 , N/A ,$209.02 ,$209.02 ,$209.02 ,$225.27 ,$188.11 ,$215.98 ,$199.73 ,$225.27 
SACRED HEART HOSPITAL (ACU),26000006,96360,HC HYDRATION THERAPY 1ST HOUR,260,1 ,$464.87 ,$348.65 ,$98.38 ,$486.82 ,$299.38 ,$216.36 ,$325.41 ,$98.38 ,$385.84 ,$101.33 ,$306.81 ,$441.63 ,$98.38 ,$371.90 ,$427.68 ,$98.38 ,$395.14 ,$441.63 ,$409.09 ,$353.30 ,$98.38 ,$98.38 ,$98.38 ,$339.36 ,$255.68 ,$423.03 ,$423.03 ,$371.90 ,$222.85 ,$255.68 ,$418.38 ,$216.36 ,$418.38 ,$251.03 ,$436.98 ,$486.82 ,$427.68 ,$104.28 ,$423.03 ,$216.36 ,$286.08 ,$286.08 ,$418.38 ,$346.93 ,$323.78 ,$218.53 ,$98.38 ,$441.63 ,$227.18 ,$98.38 ,$404.44 ,$216.36 ,$418.38 ,$216.36 ,$418.38 ,$418.38 ,$418.38 ,$450.92 ,$376.54 ,$432.33 ,$399.79 ,$450.92 
SACRED HEART HOSPITAL (ACU),26000007,96365,HC INFUSION THERAPY 1ST HOUR,260,1 ,$475.02 ,$356.27 ,$98.38 ,$486.82 ,$305.91 ,$216.36 ,$332.51 ,$98.38 ,$394.27 ,$101.33 ,$313.51 ,$451.27 ,$98.38 ,$380.02 ,$437.02 ,$98.38 ,$403.77 ,$451.27 ,$418.02 ,$361.02 ,$98.38 ,$98.38 ,$98.38 ,$346.76 ,$261.26 ,$432.27 ,$432.27 ,$380.02 ,$222.85 ,$261.26 ,$427.52 ,$216.36 ,$427.52 ,$256.51 ,$446.52 ,$486.82 ,$437.02 ,$104.28 ,$432.27 ,$216.36 ,$292.33 ,$292.33 ,$427.52 ,$354.51 ,$330.85 ,$218.53 ,$98.38 ,$451.27 ,$227.18 ,$98.38 ,$413.27 ,$216.36 ,$427.52 ,$216.36 ,$427.52 ,$427.52 ,$427.52 ,$460.77 ,$384.77 ,$441.77 ,$408.52 ,$460.77 
SACRED HEART HOSPITAL (ACU),26000008,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$201.78 ,$151.34 ,$14.35 ,$201.78 ,$129.95 ,$42.32 ,$141.25 ,$14.35 ,$167.48 ,$14.78 ,$133.17 ,$191.69 ,$14.35 ,$161.42 ,$185.64 ,$14.35 ,$171.51 ,$191.69 ,$177.57 ,$153.35 ,$14.35 ,$14.35 ,$14.35 ,$147.30 ,$110.98 ,$183.62 ,$183.62 ,$161.42 ,$43.59 ,$110.98 ,$181.60 ,$42.32 ,$181.60 ,$108.96 ,$189.67 ,$95.23 ,$185.64 ,$15.21 ,$183.62 ,$42.32 ,$124.18 ,$124.18 ,$181.60 ,$150.59 ,$140.54 ,$42.75 ,$14.35 ,$191.69 ,$44.44 ,$14.35 ,$175.55 ,$42.32 ,$181.60 ,$42.32 ,$181.60 ,$181.60 ,$181.60 ,$195.73 ,$163.44 ,$187.66 ,$173.53 ,$195.73 
SACRED HEART HOSPITAL (ACU),26000009,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$163.20 ,$122.40 ,$14.35 ,$163.20 ,$105.10 , N/A ,$114.24 ,$14.35 ,$135.46 ,$14.78 ,$107.71 ,$155.04 ,$14.35 ,$130.56 ,$150.14 ,$14.35 ,$138.72 ,$155.04 ,$143.62 ,$124.03 ,$14.35 ,$14.35 ,$14.35 ,$119.14 ,$89.76 ,$148.51 ,$148.51 ,$130.56 , N/A ,$89.76 ,$146.88 , N/A ,$146.88 ,$88.13 ,$153.41 , N/A ,$150.14 ,$15.21 ,$148.51 , N/A ,$100.43 ,$100.43 ,$146.88 ,$121.80 ,$113.67 , N/A ,$14.35 ,$155.04 , N/A ,$14.35 ,$141.98 , N/A ,$146.88 , N/A ,$146.88 ,$146.88 ,$146.88 ,$158.30 ,$132.19 ,$151.78 ,$140.35 ,$158.30 
SACRED HEART HOSPITAL (ACU),26000013,C8957,HC IV INFUSION THERAPY/DX >8 HRS W/IMPLANT PUMP,260,1 ,$972.00 ,$729.00 ,$166.51 ,$972.00 ,$625.97 ,$337.23 ,$680.40 ,$166.51 ,$806.76 ,$171.51 ,$641.52 ,$923.40 ,$166.51 ,$777.60 ,$894.24 ,$166.51 ,$826.20 ,$923.40 ,$855.36 ,$738.72 ,$166.51 ,$166.51 ,$166.51 ,$709.56 ,$534.60 ,$884.52 ,$884.52 ,$777.60 ,$347.35 ,$534.60 ,$874.80 ,$337.23 ,$874.80 ,$524.88 ,$913.68 ,$758.76 ,$894.24 ,$176.50 ,$884.52 ,$337.23 ,$598.17 ,$598.17 ,$874.80 ,$725.40 ,$677.00 ,$340.60 ,$166.51 ,$923.40 ,$354.09 ,$166.51 ,$845.64 ,$337.23 ,$874.80 ,$337.23 ,$874.80 ,$874.80 ,$874.80 ,$942.84 ,$787.32 ,$903.96 ,$835.92 ,$942.84 
SACRED HEART HOSPITAL (ACU),26000014,M0239,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB",260,1 ,$697.00 ,$522.75 ,$309.60 ,$697.00 ,$448.87 , N/A ,$487.90 ,$309.60 ,$578.51 ,$318.89 ,$460.02 ,$662.15 ,$309.60 ,$557.60 ,$641.24 ,$309.60 ,$592.45 ,$662.15 ,$613.36 ,$529.72 ,$309.60 ,$309.60 ,$309.60 ,$508.81 ,$383.35 ,$634.27 ,$634.27 ,$557.60 , N/A ,$383.35 ,$627.30 , N/A ,$627.30 ,$376.38 ,$655.18 , N/A ,$641.24 ,$328.18 ,$634.27 , N/A ,$428.93 ,$428.93 ,$627.30 ,$520.17 ,$485.46 , N/A ,$309.60 ,$662.15 , N/A ,$309.60 ,$606.39 , N/A ,$627.30 , N/A ,$627.30 ,$627.30 ,$627.30 ,$676.09 ,$564.57 ,$648.21 ,$599.42 ,$676.09 
SACRED HEART HOSPITAL (ACU),26000015,M0243,"HC INTRAVENOUS INFUSION, CASIRIVIMAB AND IMDEVIMAB ADMINISTRATION",260,1 ,$969.00 ,$726.75 ,$450.00 ,"$1,049.69 ",$624.04 ,$466.53 ,$678.30 ,$450.00 ,$804.27 ,$463.50 ,$639.54 ,$920.55 ,$450.00 ,$775.20 ,$891.48 ,$450.00 ,$823.65 ,$920.55 ,$852.72 ,$736.44 ,$450.00 ,$450.00 ,$450.00 ,$707.37 ,$532.95 ,$881.79 ,$881.79 ,$775.20 ,$480.53 ,$532.95 ,$872.10 ,$466.53 ,$872.10 ,$523.26 ,$910.86 ,"$1,049.69 ",$891.48 ,$477.00 ,$881.79 ,$466.53 ,$596.32 ,$596.32 ,$872.10 ,$723.16 ,$674.91 ,$471.19 ,$450.00 ,$920.55 ,$489.86 ,$450.00 ,$843.03 ,$466.53 ,$872.10 ,$466.53 ,$872.10 ,$872.10 ,$872.10 ,$939.93 ,$784.89 ,$901.17 ,$833.34 ,$939.93 
SACRED HEART HOSPITAL (ACU),26000016,M0245,"HC INTRAVENOUS INFUSION, BAMLANIVIMAB AND ETESEVIMAB ADMINISTRATION",260,1 ,$780.00 ,$585.00 ,$421.20 ,"$1,049.69 ",$502.32 ,$466.53 ,$546.00 ,$450.00 ,$647.40 ,$463.50 ,$514.80 ,$741.00 ,$450.00 ,$624.00 ,$717.60 ,$450.00 ,$663.00 ,$741.00 ,$686.40 ,$592.80 ,$450.00 ,$450.00 ,$450.00 ,$569.40 ,$429.00 ,$709.80 ,$709.80 ,$624.00 ,$480.53 ,$429.00 ,$702.00 ,$466.53 ,$702.00 ,$421.20 ,$733.20 ,"$1,049.69 ",$717.60 ,$477.00 ,$709.80 ,$466.53 ,$480.01 ,$480.01 ,$702.00 ,$582.11 ,$543.27 ,$471.19 ,$450.00 ,$741.00 ,$489.86 ,$450.00 ,$678.60 ,$466.53 ,$702.00 ,$466.53 ,$702.00 ,$702.00 ,$702.00 ,$756.60 ,$631.80 ,$725.40 ,$670.80 ,$756.60 
SACRED HEART HOSPITAL (ACU),26000017,M0247,"HC INTRAVENOUS INFUSION, SOTROVIMAB ADMINISTRATION",260,1 ,"$1,125.00 ",$843.75 ,$450.00 ,"$1,125.00 ",$724.50 ,$466.53 ,$787.50 ,$450.00 ,$933.75 ,$463.50 ,$742.50 ,"$1,068.75 ",$450.00 ,$900.00 ,"$1,035.00 ",$450.00 ,$956.25 ,"$1,068.75 ",$990.00 ,$855.00 ,$450.00 ,$450.00 ,$450.00 ,$821.25 ,$618.75 ,"$1,023.75 ","$1,023.75 ",$900.00 ,$480.53 ,$618.75 ,"$1,012.50 ",$466.53 ,"$1,012.50 ",$607.50 ,"$1,057.50 ","$1,049.69 ","$1,035.00 ",$477.00 ,"$1,023.75 ",$466.53 ,$692.33 ,$692.33 ,"$1,012.50 ",$839.59 ,$783.56 ,$471.19 ,$450.00 ,"$1,068.75 ",$489.86 ,$450.00 ,$978.75 ,$466.53 ,"$1,012.50 ",$466.53 ,"$1,012.50 ","$1,012.50 ","$1,012.50 ","$1,091.25 ",$911.25 ,"$1,046.25 ",$967.50 ,"$1,091.25 "
SACRED HEART HOSPITAL (ACU),27000001,N/A,HC HELMET PROTECTIVE,270,1 ,$438.00 ,$328.50 ,$236.52 ,$438.00 ,$282.07 , N/A ,$306.60 , N/A ,$363.54 , N/A ,$289.08 ,$416.10 , N/A ,$350.40 ,$402.96 , N/A ,$372.30 ,$416.10 ,$385.44 ,$332.88 , N/A , N/A , N/A ,$319.74 ,$240.90 ,$398.58 ,$398.58 ,$350.40 , N/A ,$240.90 ,$394.20 , N/A ,$394.20 ,$236.52 ,$411.72 , N/A ,$402.96 , N/A ,$398.58 , N/A ,$269.55 ,$269.55 ,$394.20 ,$326.88 ,$305.07 , N/A , N/A ,$416.10 , N/A , N/A ,$381.06 , N/A ,$394.20 , N/A ,$394.20 ,$394.20 ,$394.20 ,$424.86 ,$354.78 ,$407.34 ,$376.68 ,$424.86 
SACRED HEART HOSPITAL (ACU),27000003,N/A,HC KIT SET-UP COOL GUARD,270,1 ,"$1,056.00 ",$792.00 ,$570.24 ,"$1,056.00 ",$680.06 , N/A ,$739.20 , N/A ,$876.48 , N/A ,$696.96 ,"$1,003.20 ", N/A ,$844.80 ,$971.52 , N/A ,$897.60 ,"$1,003.20 ",$929.28 ,$802.56 , N/A , N/A , N/A ,$770.88 ,$580.80 ,$960.96 ,$960.96 ,$844.80 , N/A ,$580.80 ,$950.40 , N/A ,$950.40 ,$570.24 ,$992.64 , N/A ,$971.52 , N/A ,$960.96 , N/A ,$649.86 ,$649.86 ,$950.40 ,$788.09 ,$735.50 , N/A , N/A ,"$1,003.20 ", N/A , N/A ,$918.72 , N/A ,$950.40 , N/A ,$950.40 ,$950.40 ,$950.40 ,"$1,024.32 ",$855.36 ,$982.08 ,$908.16 ,"$1,024.32 "
SACRED HEART HOSPITAL (ACU),27000004,N/A,HC KIT PACEMAKER/ICD,270,1 ,$560.00 ,$420.00 ,$302.40 ,$560.00 ,$360.64 , N/A ,$392.00 , N/A ,$464.80 , N/A ,$369.60 ,$532.00 , N/A ,$448.00 ,$515.20 , N/A ,$476.00 ,$532.00 ,$492.80 ,$425.60 , N/A , N/A , N/A ,$408.80 ,$308.00 ,$509.60 ,$509.60 ,$448.00 , N/A ,$308.00 ,$504.00 , N/A ,$504.00 ,$302.40 ,$526.40 , N/A ,$515.20 , N/A ,$509.60 , N/A ,$344.62 ,$344.62 ,$504.00 ,$417.93 ,$390.04 , N/A , N/A ,$532.00 , N/A , N/A ,$487.20 , N/A ,$504.00 , N/A ,$504.00 ,$504.00 ,$504.00 ,$543.20 ,$453.60 ,$520.80 ,$481.60 ,$543.20 
SACRED HEART HOSPITAL (ACU),27000006,N/A,HC FEMOSTOP COMPRESSION DEVICE,270,1 ,$371.00 ,$278.25 ,$200.34 ,$371.00 ,$238.92 , N/A ,$259.70 , N/A ,$307.93 , N/A ,$244.86 ,$352.45 , N/A ,$296.80 ,$341.32 , N/A ,$315.35 ,$352.45 ,$326.48 ,$281.96 , N/A , N/A , N/A ,$270.83 ,$204.05 ,$337.61 ,$337.61 ,$296.80 , N/A ,$204.05 ,$333.90 , N/A ,$333.90 ,$200.34 ,$348.74 , N/A ,$341.32 , N/A ,$337.61 , N/A ,$228.31 ,$228.31 ,$333.90 ,$276.88 ,$258.40 , N/A , N/A ,$352.45 , N/A , N/A ,$322.77 , N/A ,$333.90 , N/A ,$333.90 ,$333.90 ,$333.90 ,$359.87 ,$300.51 ,$345.03 ,$319.06 ,$359.87 
SACRED HEART HOSPITAL (ACU),27000013,N/A,HC PUMP BREAST,270,1 ,$29.00 ,$21.75 ,$15.66 ,$29.00 ,$18.68 , N/A ,$20.30 , N/A ,$24.07 , N/A ,$19.14 ,$27.55 , N/A ,$23.20 ,$26.68 , N/A ,$24.65 ,$27.55 ,$25.52 ,$22.04 , N/A , N/A , N/A ,$21.17 ,$15.95 ,$26.39 ,$26.39 ,$23.20 , N/A ,$15.95 ,$26.10 , N/A ,$26.10 ,$15.66 ,$27.26 , N/A ,$26.68 , N/A ,$26.39 , N/A ,$17.85 ,$17.85 ,$26.10 ,$21.64 ,$20.20 , N/A , N/A ,$27.55 , N/A , N/A ,$25.23 , N/A ,$26.10 , N/A ,$26.10 ,$26.10 ,$26.10 ,$28.13 ,$23.49 ,$26.97 ,$24.94 ,$28.13 
SACRED HEART HOSPITAL (ACU),27000021,N/A,HC TRAY ARTHROGRAM,270,1 ,$64.00 ,$48.00 ,$34.56 ,$64.00 ,$41.22 , N/A ,$44.80 , N/A ,$53.12 , N/A ,$42.24 ,$60.80 , N/A ,$51.20 ,$58.88 , N/A ,$54.40 ,$60.80 ,$56.32 ,$48.64 , N/A , N/A , N/A ,$46.72 ,$35.20 ,$58.24 ,$58.24 ,$51.20 , N/A ,$35.20 ,$57.60 , N/A ,$57.60 ,$34.56 ,$60.16 , N/A ,$58.88 , N/A ,$58.24 , N/A ,$39.39 ,$39.39 ,$57.60 ,$47.76 ,$44.58 , N/A , N/A ,$60.80 , N/A , N/A ,$55.68 , N/A ,$57.60 , N/A ,$57.60 ,$57.60 ,$57.60 ,$62.08 ,$51.84 ,$59.52 ,$55.04 ,$62.08 
SACRED HEART HOSPITAL (ACU),27000022,N/A,HC TRAY BIOPSY,270,1 ,$52.00 ,$39.00 ,$28.08 ,$52.00 ,$33.49 , N/A ,$36.40 , N/A ,$43.16 , N/A ,$34.32 ,$49.40 , N/A ,$41.60 ,$47.84 , N/A ,$44.20 ,$49.40 ,$45.76 ,$39.52 , N/A , N/A , N/A ,$37.96 ,$28.60 ,$47.32 ,$47.32 ,$41.60 , N/A ,$28.60 ,$46.80 , N/A ,$46.80 ,$28.08 ,$48.88 , N/A ,$47.84 , N/A ,$47.32 , N/A ,$32.00 ,$32.00 ,$46.80 ,$38.81 ,$36.22 , N/A , N/A ,$49.40 , N/A , N/A ,$45.24 , N/A ,$46.80 , N/A ,$46.80 ,$46.80 ,$46.80 ,$50.44 ,$42.12 ,$48.36 ,$44.72 ,$50.44 
SACRED HEART HOSPITAL (ACU),27000028,N/A,HC ELECTRODE TIER 1,270,1 ,"$1,933.00 ","$1,449.75 ","$1,043.82 ","$1,933.00 ","$1,244.85 ", N/A ,"$1,353.10 ", N/A ,"$1,604.39 ", N/A ,"$1,275.78 ","$1,836.35 ", N/A ,"$1,546.40 ","$1,778.36 ", N/A ,"$1,643.05 ","$1,836.35 ","$1,701.04 ","$1,469.08 ", N/A , N/A , N/A ,"$1,411.09 ","$1,063.15 ","$1,759.03 ","$1,759.03 ","$1,546.40 ", N/A ,"$1,063.15 ","$1,739.70 ", N/A ,"$1,739.70 ","$1,043.82 ","$1,817.02 ", N/A ,"$1,778.36 ", N/A ,"$1,759.03 ", N/A ,"$1,189.57 ","$1,189.57 ","$1,739.70 ","$1,442.60 ","$1,346.33 ", N/A , N/A ,"$1,836.35 ", N/A , N/A ,"$1,681.71 ", N/A ,"$1,739.70 ", N/A ,"$1,739.70 ","$1,739.70 ","$1,739.70 ","$1,875.01 ","$1,565.73 ","$1,797.69 ","$1,662.38 ","$1,875.01 "
SACRED HEART HOSPITAL (ACU),27000029,N/A,HC SET ACCESS INTRODUCER,270,1 ,$324.00 ,$243.00 ,$174.96 ,$324.00 ,$208.66 , N/A ,$226.80 , N/A ,$268.92 , N/A ,$213.84 ,$307.80 , N/A ,$259.20 ,$298.08 , N/A ,$275.40 ,$307.80 ,$285.12 ,$246.24 , N/A , N/A , N/A ,$236.52 ,$178.20 ,$294.84 ,$294.84 ,$259.20 , N/A ,$178.20 ,$291.60 , N/A ,$291.60 ,$174.96 ,$304.56 , N/A ,$298.08 , N/A ,$294.84 , N/A ,$199.39 ,$199.39 ,$291.60 ,$241.80 ,$225.67 , N/A , N/A ,$307.80 , N/A , N/A ,$281.88 , N/A ,$291.60 , N/A ,$291.60 ,$291.60 ,$291.60 ,$314.28 ,$262.44 ,$301.32 ,$278.64 ,$314.28 
SACRED HEART HOSPITAL (ACU),27000030,N/A,HC ELECTRODE RFA TIER 1,270,1 ,"$2,523.00 ","$1,892.25 ","$1,362.42 ","$2,523.00 ","$1,624.81 ", N/A ,"$1,766.10 ", N/A ,"$2,094.09 ", N/A ,"$1,665.18 ","$2,396.85 ", N/A ,"$2,018.40 ","$2,321.16 ", N/A ,"$2,144.55 ","$2,396.85 ","$2,220.24 ","$1,917.48 ", N/A , N/A , N/A ,"$1,841.79 ","$1,387.65 ","$2,295.93 ","$2,295.93 ","$2,018.40 ", N/A ,"$1,387.65 ","$2,270.70 ", N/A ,"$2,270.70 ","$1,362.42 ","$2,371.62 ", N/A ,"$2,321.16 ", N/A ,"$2,295.93 ", N/A ,"$1,552.65 ","$1,552.65 ","$2,270.70 ","$1,882.91 ","$1,757.27 ", N/A , N/A ,"$2,396.85 ", N/A , N/A ,"$2,195.01 ", N/A ,"$2,270.70 ", N/A ,"$2,270.70 ","$2,270.70 ","$2,270.70 ","$2,447.31 ","$2,043.63 ","$2,346.39 ","$2,169.78 ","$2,447.31 "
SACRED HEART HOSPITAL (ACU),27000031,N/A,HC ELECTRODE RFA TIER 2,270,1 ,"$3,519.00 ","$2,639.25 ","$1,900.26 ","$3,519.00 ","$2,266.24 ", N/A ,"$2,463.30 ", N/A ,"$2,920.77 ", N/A ,"$2,322.54 ","$3,343.05 ", N/A ,"$2,815.20 ","$3,237.48 ", N/A ,"$2,991.15 ","$3,343.05 ","$3,096.72 ","$2,674.44 ", N/A , N/A , N/A ,"$2,568.87 ","$1,935.45 ","$3,202.29 ","$3,202.29 ","$2,815.20 ", N/A ,"$1,935.45 ","$3,167.10 ", N/A ,"$3,167.10 ","$1,900.26 ","$3,307.86 ", N/A ,"$3,237.48 ", N/A ,"$3,202.29 ", N/A ,"$2,165.59 ","$2,165.59 ","$3,167.10 ","$2,626.23 ","$2,450.98 ", N/A , N/A ,"$3,343.05 ", N/A , N/A ,"$3,061.53 ", N/A ,"$3,167.10 ", N/A ,"$3,167.10 ","$3,167.10 ","$3,167.10 ","$3,413.43 ","$2,850.39 ","$3,272.67 ","$3,026.34 ","$3,413.43 "
SACRED HEART HOSPITAL (ACU),27000032,N/A,HC ELECTRODE TIER 2,270,1 ,"$1,638.00 ","$1,228.50 ",$884.52 ,"$1,638.00 ","$1,054.87 ", N/A ,"$1,146.60 ", N/A ,"$1,359.54 ", N/A ,"$1,081.08 ","$1,556.10 ", N/A ,"$1,310.40 ","$1,506.96 ", N/A ,"$1,392.30 ","$1,556.10 ","$1,441.44 ","$1,244.88 ", N/A , N/A , N/A ,"$1,195.74 ",$900.90 ,"$1,490.58 ","$1,490.58 ","$1,310.40 ", N/A ,$900.90 ,"$1,474.20 ", N/A ,"$1,474.20 ",$884.52 ,"$1,539.72 ", N/A ,"$1,506.96 ", N/A ,"$1,490.58 ", N/A ,"$1,008.03 ","$1,008.03 ","$1,474.20 ","$1,222.44 ","$1,140.87 ", N/A , N/A ,"$1,556.10 ", N/A , N/A ,"$1,425.06 ", N/A ,"$1,474.20 ", N/A ,"$1,474.20 ","$1,474.20 ","$1,474.20 ","$1,588.86 ","$1,326.78 ","$1,523.34 ","$1,408.68 ","$1,588.86 "
SACRED HEART HOSPITAL (ACU),27000033,N/A,HC ELECTRODE TIER 3,270,1 ,"$2,548.00 ","$1,911.00 ","$1,375.92 ","$2,548.00 ","$1,640.91 ", N/A ,"$1,783.60 ", N/A ,"$2,114.84 ", N/A ,"$1,681.68 ","$2,420.60 ", N/A ,"$2,038.40 ","$2,344.16 ", N/A ,"$2,165.80 ","$2,420.60 ","$2,242.24 ","$1,936.48 ", N/A , N/A , N/A ,"$1,860.04 ","$1,401.40 ","$2,318.68 ","$2,318.68 ","$2,038.40 ", N/A ,"$1,401.40 ","$2,293.20 ", N/A ,"$2,293.20 ","$1,375.92 ","$2,395.12 ", N/A ,"$2,344.16 ", N/A ,"$2,318.68 ", N/A ,"$1,568.04 ","$1,568.04 ","$2,293.20 ","$1,901.57 ","$1,774.68 ", N/A , N/A ,"$2,420.60 ", N/A , N/A ,"$2,216.76 ", N/A ,"$2,293.20 ", N/A ,"$2,293.20 ","$2,293.20 ","$2,293.20 ","$2,471.56 ","$2,063.88 ","$2,369.64 ","$2,191.28 ","$2,471.56 "
SACRED HEART HOSPITAL (ACU),27000034,N/A,HC ELECTRODE SOLOIST,270,1 ,"$1,604.00 ","$1,203.00 ",$866.16 ,"$1,604.00 ","$1,032.98 ", N/A ,"$1,122.80 ", N/A ,"$1,331.32 ", N/A ,"$1,058.64 ","$1,523.80 ", N/A ,"$1,283.20 ","$1,475.68 ", N/A ,"$1,363.40 ","$1,523.80 ","$1,411.52 ","$1,219.04 ", N/A , N/A , N/A ,"$1,170.92 ",$882.20 ,"$1,459.64 ","$1,459.64 ","$1,283.20 ", N/A ,$882.20 ,"$1,443.60 ", N/A ,"$1,443.60 ",$866.16 ,"$1,507.76 ", N/A ,"$1,475.68 ", N/A ,"$1,459.64 ", N/A ,$987.10 ,$987.10 ,"$1,443.60 ","$1,197.07 ","$1,117.19 ", N/A , N/A ,"$1,523.80 ", N/A , N/A ,"$1,395.48 ", N/A ,"$1,443.60 ", N/A ,"$1,443.60 ","$1,443.60 ","$1,443.60 ","$1,555.88 ","$1,299.24 ","$1,491.72 ","$1,379.44 ","$1,555.88 "
SACRED HEART HOSPITAL (ACU),27000035,N/A,HC MEPILEX TRANSFER SKIN CARE,270,1 ,$272.00 ,$204.00 ,$146.88 ,$272.00 ,$175.17 , N/A ,$190.40 , N/A ,$225.76 , N/A ,$179.52 ,$258.40 , N/A ,$217.60 ,$250.24 , N/A ,$231.20 ,$258.40 ,$239.36 ,$206.72 , N/A , N/A , N/A ,$198.56 ,$149.60 ,$247.52 ,$247.52 ,$217.60 , N/A ,$149.60 ,$244.80 , N/A ,$244.80 ,$146.88 ,$255.68 , N/A ,$250.24 , N/A ,$247.52 , N/A ,$167.39 ,$167.39 ,$244.80 ,$202.99 ,$189.45 , N/A , N/A ,$258.40 , N/A , N/A ,$236.64 , N/A ,$244.80 , N/A ,$244.80 ,$244.80 ,$244.80 ,$263.84 ,$220.32 ,$252.96 ,$233.92 ,$263.84 
SACRED HEART HOSPITAL (ACU),27000036,N/A,HC TIP BALL PROBE STIMULATING,270,1 ,$195.00 ,$146.25 ,$105.30 ,$195.00 ,$125.58 , N/A ,$136.50 , N/A ,$161.85 , N/A ,$128.70 ,$185.25 , N/A ,$156.00 ,$179.40 , N/A ,$165.75 ,$185.25 ,$171.60 ,$148.20 , N/A , N/A , N/A ,$142.35 ,$107.25 ,$177.45 ,$177.45 ,$156.00 , N/A ,$107.25 ,$175.50 , N/A ,$175.50 ,$105.30 ,$183.30 , N/A ,$179.40 , N/A ,$177.45 , N/A ,$120.00 ,$120.00 ,$175.50 ,$145.53 ,$135.82 , N/A , N/A ,$185.25 , N/A , N/A ,$169.65 , N/A ,$175.50 , N/A ,$175.50 ,$175.50 ,$175.50 ,$189.15 ,$157.95 ,$181.35 ,$167.70 ,$189.15 
SACRED HEART HOSPITAL (ACU),27000037,N/A,HC DEVICE RADIAL COMPRESSION,270,1 ,$164.00 ,$123.00 ,$88.56 ,$164.00 ,$105.62 , N/A ,$114.80 , N/A ,$136.12 , N/A ,$108.24 ,$155.80 , N/A ,$131.20 ,$150.88 , N/A ,$139.40 ,$155.80 ,$144.32 ,$124.64 , N/A , N/A , N/A ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 , N/A ,$90.20 ,$147.60 , N/A ,$147.60 ,$88.56 ,$154.16 , N/A ,$150.88 , N/A ,$149.24 , N/A ,$100.93 ,$100.93 ,$147.60 ,$122.39 ,$114.23 , N/A , N/A ,$155.80 , N/A , N/A ,$142.68 , N/A ,$147.60 , N/A ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),27000038,N/A,HC LUBRICANT ROTAGLIDE,272,1 ,$208.00 ,$156.00 ,$112.32 ,$208.00 ,$133.95 , N/A ,$145.60 , N/A ,$172.64 , N/A ,$137.28 ,$197.60 , N/A ,$166.40 ,$191.36 , N/A ,$176.80 ,$197.60 ,$183.04 ,$158.08 , N/A , N/A , N/A ,$151.84 ,$114.40 ,$189.28 ,$189.28 ,$166.40 , N/A ,$114.40 ,$187.20 , N/A ,$187.20 ,$112.32 ,$195.52 , N/A ,$191.36 , N/A ,$189.28 , N/A ,$128.00 ,$128.00 ,$187.20 ,$155.23 ,$144.87 , N/A , N/A ,$197.60 , N/A , N/A ,$180.96 , N/A ,$187.20 , N/A ,$187.20 ,$187.20 ,$187.20 ,$201.76 ,$168.48 ,$193.44 ,$178.88 ,$201.76 
SACRED HEART HOSPITAL (ACU),27000039,N/A,HC COVER CAP,270,1 ,$79.00 ,$59.25 ,$42.66 ,$79.00 ,$50.88 , N/A ,$55.30 , N/A ,$65.57 , N/A ,$52.14 ,$75.05 , N/A ,$63.20 ,$72.68 , N/A ,$67.15 ,$75.05 ,$69.52 ,$60.04 , N/A , N/A , N/A ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 , N/A ,$43.45 ,$71.10 , N/A ,$71.10 ,$42.66 ,$74.26 , N/A ,$72.68 , N/A ,$71.89 , N/A ,$48.62 ,$48.62 ,$71.10 ,$58.96 ,$55.02 , N/A , N/A ,$75.05 , N/A , N/A ,$68.73 , N/A ,$71.10 , N/A ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),27000040,N/A,HC SYSTEM CLOSED FLUSH BLOOD DRAW,270,1 ,$95.00 ,$71.25 ,$51.30 ,$95.00 ,$61.18 , N/A ,$66.50 , N/A ,$78.85 , N/A ,$62.70 ,$90.25 , N/A ,$76.00 ,$87.40 , N/A ,$80.75 ,$90.25 ,$83.60 ,$72.20 , N/A , N/A , N/A ,$69.35 ,$52.25 ,$86.45 ,$86.45 ,$76.00 , N/A ,$52.25 ,$85.50 , N/A ,$85.50 ,$51.30 ,$89.30 , N/A ,$87.40 , N/A ,$86.45 , N/A ,$58.46 ,$58.46 ,$85.50 ,$70.90 ,$66.17 , N/A , N/A ,$90.25 , N/A , N/A ,$82.65 , N/A ,$85.50 , N/A ,$85.50 ,$85.50 ,$85.50 ,$92.15 ,$76.95 ,$88.35 ,$81.70 ,$92.15 
SACRED HEART HOSPITAL (ACU),27000051,N/A,HC DIALYSATE BAG 5 LITERS,270,1 ,$133.00 ,$99.75 ,$71.82 ,$133.00 ,$85.65 , N/A ,$93.10 , N/A ,$110.39 , N/A ,$87.78 ,$126.35 , N/A ,$106.40 ,$122.36 , N/A ,$113.05 ,$126.35 ,$117.04 ,$101.08 , N/A , N/A , N/A ,$97.09 ,$73.15 ,$121.03 ,$121.03 ,$106.40 , N/A ,$73.15 ,$119.70 , N/A ,$119.70 ,$71.82 ,$125.02 , N/A ,$122.36 , N/A ,$121.03 , N/A ,$81.85 ,$81.85 ,$119.70 ,$99.26 ,$92.63 , N/A , N/A ,$126.35 , N/A , N/A ,$115.71 , N/A ,$119.70 , N/A ,$119.70 ,$119.70 ,$119.70 ,$129.01 ,$107.73 ,$123.69 ,$114.38 ,$129.01 
SACRED HEART HOSPITAL (ACU),27000125,A7036,HC CPAP CHIN STRAP,270,1 ,$107.00 ,$80.25 ,$31.54 ,$107.00 ,$68.91 ,$31.54 ,$74.90 , N/A ,$88.81 , N/A ,$70.62 ,$101.65 , N/A ,$85.60 ,$98.44 , N/A ,$90.95 ,$101.65 ,$94.16 ,$81.32 , N/A , N/A , N/A ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 ,$32.49 ,$58.85 ,$96.30 ,$31.54 ,$96.30 ,$57.78 ,$100.58 ,$70.97 ,$98.44 , N/A ,$97.37 ,$31.54 ,$65.85 ,$65.85 ,$96.30 ,$79.85 ,$74.53 ,$31.86 , N/A ,$101.65 ,$33.12 , N/A ,$93.09 ,$31.54 ,$96.30 ,$31.54 ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),27100038,N/A,HC CPAP MASK,271,1 ,$65.00 ,$48.75 ,$35.10 ,$65.00 ,$41.86 , N/A ,$45.50 , N/A ,$53.95 , N/A ,$42.90 ,$61.75 , N/A ,$52.00 ,$59.80 , N/A ,$55.25 ,$61.75 ,$57.20 ,$49.40 , N/A , N/A , N/A ,$47.45 ,$35.75 ,$59.15 ,$59.15 ,$52.00 , N/A ,$35.75 ,$58.50 , N/A ,$58.50 ,$35.10 ,$61.10 , N/A ,$59.80 , N/A ,$59.15 , N/A ,$40.00 ,$40.00 ,$58.50 ,$48.51 ,$45.27 , N/A , N/A ,$61.75 , N/A , N/A ,$56.55 , N/A ,$58.50 , N/A ,$58.50 ,$58.50 ,$58.50 ,$63.05 ,$52.65 ,$60.45 ,$55.90 ,$63.05 
SACRED HEART HOSPITAL (ACU),27100053,N/A,HC FLUID WARMER,271,1 ,$63.00 ,$47.25 ,$34.02 ,$63.00 ,$40.57 , N/A ,$44.10 , N/A ,$52.29 , N/A ,$41.58 ,$59.85 , N/A ,$50.40 ,$57.96 , N/A ,$53.55 ,$59.85 ,$55.44 ,$47.88 , N/A , N/A , N/A ,$45.99 ,$34.65 ,$57.33 ,$57.33 ,$50.40 , N/A ,$34.65 ,$56.70 , N/A ,$56.70 ,$34.02 ,$59.22 , N/A ,$57.96 , N/A ,$57.33 , N/A ,$38.77 ,$38.77 ,$56.70 ,$47.02 ,$43.88 , N/A , N/A ,$59.85 , N/A , N/A ,$54.81 , N/A ,$56.70 , N/A ,$56.70 ,$56.70 ,$56.70 ,$61.11 ,$51.03 ,$58.59 ,$54.18 ,$61.11 
SACRED HEART HOSPITAL (ACU),27100106,N/A,HC OXYGEN DAILY,271,1 ,$157.00 ,$117.75 ,$84.78 ,$157.00 ,$101.11 , N/A ,$109.90 , N/A ,$130.31 , N/A ,$103.62 ,$149.15 , N/A ,$125.60 ,$144.44 , N/A ,$133.45 ,$149.15 ,$138.16 ,$119.32 , N/A , N/A , N/A ,$114.61 ,$86.35 ,$142.87 ,$142.87 ,$125.60 , N/A ,$86.35 ,$141.30 , N/A ,$141.30 ,$84.78 ,$147.58 , N/A ,$144.44 , N/A ,$142.87 , N/A ,$96.62 ,$96.62 ,$141.30 ,$117.17 ,$109.35 , N/A , N/A ,$149.15 , N/A , N/A ,$136.59 , N/A ,$141.30 , N/A ,$141.30 ,$141.30 ,$141.30 ,$152.29 ,$127.17 ,$146.01 ,$135.02 ,$152.29 
SACRED HEART HOSPITAL (ACU),27100108,N/A,HC OXYGEN HOOD DAILY,271,1 ,$176.00 ,$132.00 ,$95.04 ,$176.00 ,$113.34 , N/A ,$123.20 , N/A ,$146.08 , N/A ,$116.16 ,$167.20 , N/A ,$140.80 ,$161.92 , N/A ,$149.60 ,$167.20 ,$154.88 ,$133.76 , N/A , N/A , N/A ,$128.48 ,$96.80 ,$160.16 ,$160.16 ,$140.80 , N/A ,$96.80 ,$158.40 , N/A ,$158.40 ,$95.04 ,$165.44 , N/A ,$161.92 , N/A ,$160.16 , N/A ,$108.31 ,$108.31 ,$158.40 ,$131.35 ,$122.58 , N/A , N/A ,$167.20 , N/A , N/A ,$153.12 , N/A ,$158.40 , N/A ,$158.40 ,$158.40 ,$158.40 ,$170.72 ,$142.56 ,$163.68 ,$151.36 ,$170.72 
SACRED HEART HOSPITAL (ACU),27100114,N/A,HC PEAK FLOWMETER,271,1 ,$76.00 ,$57.00 ,$41.04 ,$76.00 ,$48.94 , N/A ,$53.20 , N/A ,$63.08 , N/A ,$50.16 ,$72.20 , N/A ,$60.80 ,$69.92 , N/A ,$64.60 ,$72.20 ,$66.88 ,$57.76 , N/A , N/A , N/A ,$55.48 ,$41.80 ,$69.16 ,$69.16 ,$60.80 , N/A ,$41.80 ,$68.40 , N/A ,$68.40 ,$41.04 ,$71.44 , N/A ,$69.92 , N/A ,$69.16 , N/A ,$46.77 ,$46.77 ,$68.40 ,$56.72 ,$52.93 , N/A , N/A ,$72.20 , N/A , N/A ,$66.12 , N/A ,$68.40 , N/A ,$68.40 ,$68.40 ,$68.40 ,$73.72 ,$61.56 ,$70.68 ,$65.36 ,$73.72 
SACRED HEART HOSPITAL (ACU),27100184,N/A,HC HELIOX DAILY,271,1 ,$138.00 ,$103.50 ,$74.52 ,$138.00 ,$88.87 , N/A ,$96.60 , N/A ,$114.54 , N/A ,$91.08 ,$131.10 , N/A ,$110.40 ,$126.96 , N/A ,$117.30 ,$131.10 ,$121.44 ,$104.88 , N/A , N/A , N/A ,$100.74 ,$75.90 ,$125.58 ,$125.58 ,$110.40 , N/A ,$75.90 ,$124.20 , N/A ,$124.20 ,$74.52 ,$129.72 , N/A ,$126.96 , N/A ,$125.58 , N/A ,$84.93 ,$84.93 ,$124.20 ,$102.99 ,$96.12 , N/A , N/A ,$131.10 , N/A , N/A ,$120.06 , N/A ,$124.20 , N/A ,$124.20 ,$124.20 ,$124.20 ,$133.86 ,$111.78 ,$128.34 ,$118.68 ,$133.86 
SACRED HEART HOSPITAL (ACU),27100185,N/A,HC CANNULA NASAL OXIMIZER,271,1 ,$106.00 ,$79.50 ,$57.24 ,$106.00 ,$68.26 , N/A ,$74.20 , N/A ,$87.98 , N/A ,$69.96 ,$100.70 , N/A ,$84.80 ,$97.52 , N/A ,$90.10 ,$100.70 ,$93.28 ,$80.56 , N/A , N/A , N/A ,$77.38 ,$58.30 ,$96.46 ,$96.46 ,$84.80 , N/A ,$58.30 ,$95.40 , N/A ,$95.40 ,$57.24 ,$99.64 , N/A ,$97.52 , N/A ,$96.46 , N/A ,$65.23 ,$65.23 ,$95.40 ,$79.11 ,$73.83 , N/A , N/A ,$100.70 , N/A , N/A ,$92.22 , N/A ,$95.40 , N/A ,$95.40 ,$95.40 ,$95.40 ,$102.82 ,$85.86 ,$98.58 ,$91.16 ,$102.82 
SACRED HEART HOSPITAL (ACU),27100186,L3260,HC BOOT/SHOE SURGICAL,274,1 ,$240.00 ,$180.00 ,$129.60 ,$240.00 ,$154.56 , N/A ,$168.00 , N/A ,$199.20 , N/A ,$158.40 ,$228.00 , N/A ,$192.00 ,$220.80 , N/A ,$204.00 ,$228.00 ,$211.20 ,$182.40 , N/A , N/A , N/A ,$175.20 ,$132.00 ,$218.40 ,$218.40 ,$192.00 , N/A ,$132.00 ,$216.00 , N/A ,$216.00 ,$129.60 ,$225.60 , N/A ,$220.80 , N/A ,$218.40 , N/A ,$147.70 ,$147.70 ,$216.00 ,$179.11 , N/A , N/A , N/A ,$228.00 , N/A , N/A ,$208.80 , N/A ,$216.00 , N/A ,$216.00 ,$216.00 ,$216.00 ,$232.80 ,$194.40 ,$223.20 ,$206.40 ,$232.80 
SACRED HEART HOSPITAL (ACU),27100187,N/A,HC BAG DRAINAGE,271,1 ,$109.00 ,$81.75 ,$58.86 ,$109.00 ,$70.20 , N/A ,$76.30 , N/A ,$90.47 , N/A ,$71.94 ,$103.55 , N/A ,$87.20 ,$100.28 , N/A ,$92.65 ,$103.55 ,$95.92 ,$82.84 , N/A , N/A , N/A ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 , N/A ,$59.95 ,$98.10 , N/A ,$98.10 ,$58.86 ,$102.46 , N/A ,$100.28 , N/A ,$99.19 , N/A ,$67.08 ,$67.08 ,$98.10 ,$81.35 ,$75.92 , N/A , N/A ,$103.55 , N/A , N/A ,$94.83 , N/A ,$98.10 , N/A ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),27100196,N/A,HC SENSOR BIS,271,1 ,$70.00 ,$52.50 ,$37.80 ,$70.00 ,$45.08 , N/A ,$49.00 , N/A ,$58.10 , N/A ,$46.20 ,$66.50 , N/A ,$56.00 ,$64.40 , N/A ,$59.50 ,$66.50 ,$61.60 ,$53.20 , N/A , N/A , N/A ,$51.10 ,$38.50 ,$63.70 ,$63.70 ,$56.00 , N/A ,$38.50 ,$63.00 , N/A ,$63.00 ,$37.80 ,$65.80 , N/A ,$64.40 , N/A ,$63.70 , N/A ,$43.08 ,$43.08 ,$63.00 ,$52.24 ,$48.76 , N/A , N/A ,$66.50 , N/A , N/A ,$60.90 , N/A ,$63.00 , N/A ,$63.00 ,$63.00 ,$63.00 ,$67.90 ,$56.70 ,$65.10 ,$60.20 ,$67.90 
SACRED HEART HOSPITAL (ACU),27100240,N/A,HC CAUTERY GROUNDING PAD,271,1 ,$25.00 ,$18.75 ,$13.50 ,$25.00 ,$16.10 , N/A ,$17.50 , N/A ,$20.75 , N/A ,$16.50 ,$23.75 , N/A ,$20.00 ,$23.00 , N/A ,$21.25 ,$23.75 ,$22.00 ,$19.00 , N/A , N/A , N/A ,$18.25 ,$13.75 ,$22.75 ,$22.75 ,$20.00 , N/A ,$13.75 ,$22.50 , N/A ,$22.50 ,$13.50 ,$23.50 , N/A ,$23.00 , N/A ,$22.75 , N/A ,$15.39 ,$15.39 ,$22.50 ,$18.66 ,$17.41 , N/A , N/A ,$23.75 , N/A , N/A ,$21.75 , N/A ,$22.50 , N/A ,$22.50 ,$22.50 ,$22.50 ,$24.25 ,$20.25 ,$23.25 ,$21.50 ,$24.25 
SACRED HEART HOSPITAL (ACU),27200006,C1715,HC BRACHYTHERAPY NEEDLE,272,1 ,$17.00 ,$12.75 ,$9.18 ,$17.00 ,$10.95 , N/A ,$11.90 , N/A ,$14.11 , N/A ,$11.22 ,$16.15 , N/A ,$13.60 ,$15.64 , N/A ,$14.45 ,$16.15 ,$14.96 ,$12.92 , N/A , N/A , N/A ,$12.41 ,$9.35 ,$15.47 ,$15.47 ,$13.60 , N/A ,$9.35 ,$15.30 , N/A ,$15.30 ,$9.18 ,$15.98 , N/A ,$15.64 , N/A ,$15.47 , N/A ,$10.46 ,$10.46 ,$15.30 ,$12.69 ,$11.84 , N/A , N/A ,$16.15 , N/A , N/A ,$14.79 , N/A ,$15.30 , N/A ,$15.30 ,$15.30 ,$15.30 ,$16.49 ,$13.77 ,$15.81 ,$14.62 ,$16.49 
SACRED HEART HOSPITAL (ACU),27200009,C1724,HC ROTABLATOR BURR,272,1 ,"$1,655.00 ","$1,241.25 ",$893.70 ,"$1,655.00 ","$1,065.82 ", N/A ,"$1,158.50 ", N/A ,"$1,373.65 ", N/A ,"$1,092.30 ","$1,572.25 ", N/A ,"$1,324.00 ","$1,522.60 ", N/A ,"$1,406.75 ","$1,572.25 ","$1,456.40 ","$1,257.80 ", N/A , N/A , N/A ,"$1,208.15 ",$910.25 ,"$1,506.05 ","$1,506.05 ","$1,324.00 ", N/A ,$910.25 ,"$1,489.50 ", N/A ,"$1,489.50 ",$893.70 ,"$1,555.70 ", N/A ,"$1,522.60 ", N/A ,"$1,506.05 ", N/A ,"$1,018.49 ","$1,018.49 ","$1,489.50 ","$1,235.13 ","$1,152.71 ", N/A , N/A ,"$1,572.25 ", N/A , N/A ,"$1,439.85 ", N/A ,"$1,489.50 ", N/A ,"$1,489.50 ","$1,489.50 ","$1,489.50 ","$1,605.35 ","$1,340.55 ","$1,539.15 ","$1,423.30 ","$1,605.35 "
SACRED HEART HOSPITAL (ACU),27200034,C1729,HC CATHETER DRAINAGE,272,1 ,$554.00 ,$415.50 ,$299.16 ,$554.00 ,$356.78 , N/A ,$387.80 , N/A ,$459.82 , N/A ,$365.64 ,$526.30 , N/A ,$443.20 ,$509.68 , N/A ,$470.90 ,$526.30 ,$487.52 ,$421.04 , N/A , N/A , N/A ,$404.42 ,$304.70 ,$504.14 ,$504.14 ,$443.20 , N/A ,$304.70 ,$498.60 , N/A ,$498.60 ,$299.16 ,$520.76 , N/A ,$509.68 , N/A ,$504.14 , N/A ,$340.93 ,$340.93 ,$498.60 ,$413.45 ,$385.86 , N/A , N/A ,$526.30 , N/A , N/A ,$481.98 , N/A ,$498.60 , N/A ,$498.60 ,$498.60 ,$498.60 ,$537.38 ,$448.74 ,$515.22 ,$476.44 ,$537.38 
SACRED HEART HOSPITAL (ACU),27200056,C1757,HC ANGIOJET CATHETER,272,1 ,"$3,354.00 ","$2,515.50 ","$1,811.16 ","$3,354.00 ","$2,159.98 ", N/A ,"$2,347.80 ", N/A ,"$2,783.82 ", N/A ,"$2,213.64 ","$3,186.30 ", N/A ,"$2,683.20 ","$3,085.68 ", N/A ,"$2,850.90 ","$3,186.30 ","$2,951.52 ","$2,549.04 ", N/A , N/A , N/A ,"$2,448.42 ","$1,844.70 ","$3,052.14 ","$3,052.14 ","$2,683.20 ", N/A ,"$1,844.70 ","$3,018.60 ", N/A ,"$3,018.60 ","$1,811.16 ","$3,152.76 ", N/A ,"$3,085.68 ", N/A ,"$3,052.14 ", N/A ,"$2,064.05 ","$2,064.05 ","$3,018.60 ","$2,503.09 ","$2,336.06 ", N/A , N/A ,"$3,186.30 ", N/A , N/A ,"$2,917.98 ", N/A ,"$3,018.60 ", N/A ,"$3,018.60 ","$3,018.60 ","$3,018.60 ","$3,253.38 ","$2,716.74 ","$3,119.22 ","$2,884.44 ","$3,253.38 "
SACRED HEART HOSPITAL (ACU),27200059,C1757,HC ANGIOJET ZELANTE CATHETER,272,1 ,"$4,414.00 ","$3,310.50 ","$2,383.56 ","$4,414.00 ","$2,842.62 ", N/A ,"$3,089.80 ", N/A ,"$3,663.62 ", N/A ,"$2,913.24 ","$4,193.30 ", N/A ,"$3,531.20 ","$4,060.88 ", N/A ,"$3,751.90 ","$4,193.30 ","$3,884.32 ","$3,354.64 ", N/A , N/A , N/A ,"$3,222.22 ","$2,427.70 ","$4,016.74 ","$4,016.74 ","$3,531.20 ", N/A ,"$2,427.70 ","$3,972.60 ", N/A ,"$3,972.60 ","$2,383.56 ","$4,149.16 ", N/A ,"$4,060.88 ", N/A ,"$4,016.74 ", N/A ,"$2,716.38 ","$2,716.38 ","$3,972.60 ","$3,294.17 ","$3,074.35 ", N/A , N/A ,"$4,193.30 ", N/A , N/A ,"$3,840.18 ", N/A ,"$3,972.60 ", N/A ,"$3,972.60 ","$3,972.60 ","$3,972.60 ","$4,281.58 ","$3,575.34 ","$4,105.02 ","$3,796.04 ","$4,281.58 "
SACRED HEART HOSPITAL (ACU),27200070,C1757,HC CATH THROMBECTOMY,272,1 ,"$1,339.00 ","$1,004.25 ",$723.06 ,"$1,339.00 ",$862.32 , N/A ,$937.30 , N/A ,"$1,111.37 ", N/A ,$883.74 ,"$1,272.05 ", N/A ,"$1,071.20 ","$1,231.88 ", N/A ,"$1,138.15 ","$1,272.05 ","$1,178.32 ","$1,017.64 ", N/A , N/A , N/A ,$977.47 ,$736.45 ,"$1,218.49 ","$1,218.49 ","$1,071.20 ", N/A ,$736.45 ,"$1,205.10 ", N/A ,"$1,205.10 ",$723.06 ,"$1,258.66 ", N/A ,"$1,231.88 ", N/A ,"$1,218.49 ", N/A ,$824.02 ,$824.02 ,"$1,205.10 ",$999.30 ,$932.61 , N/A , N/A ,"$1,272.05 ", N/A , N/A ,"$1,164.93 ", N/A ,"$1,205.10 ", N/A ,"$1,205.10 ","$1,205.10 ","$1,205.10 ","$1,298.83 ","$1,084.59 ","$1,245.27 ","$1,151.54 ","$1,298.83 "
SACRED HEART HOSPITAL (ACU),27200077,C1764,HC REVEAL LOOP RECORDER,278,1 ,"$7,597.00 ","$5,697.75 ","$4,102.38 ","$7,597.00 ","$4,892.47 ", N/A ,"$5,317.90 ", N/A ,"$6,305.51 ", N/A ,"$5,014.02 ","$7,217.15 ", N/A ,"$6,077.60 ","$6,989.24 ", N/A ,"$6,457.45 ","$7,217.15 ","$6,685.36 ","$5,773.72 ", N/A , N/A , N/A ,"$5,545.81 ","$4,178.35 ","$6,913.27 ","$6,913.27 ","$6,077.60 ", N/A ,"$4,178.35 ","$6,837.30 ", N/A ,"$6,837.30 ","$4,102.38 ","$7,141.18 ", N/A ,"$6,989.24 ", N/A ,"$6,913.27 ", N/A ,"$4,675.19 ","$4,675.19 ","$6,837.30 ","$5,669.64 ", N/A , N/A , N/A ,"$7,217.15 ", N/A , N/A ,"$6,609.39 ", N/A ,"$6,837.30 ", N/A ,"$6,837.30 ","$6,837.30 ","$6,837.30 ","$7,369.09 ","$6,153.57 ","$7,065.21 ","$6,533.42 ","$7,369.09 "
SACRED HEART HOSPITAL (ACU),27200138,C1773,HC SNARE RETRIEVAL DEVICE,272,1 ,"$6,777.00 ","$5,082.75 ","$3,659.58 ","$6,777.00 ","$4,364.39 ", N/A ,"$4,743.90 ", N/A ,"$5,624.91 ", N/A ,"$4,472.82 ","$6,438.15 ", N/A ,"$5,421.60 ","$6,234.84 ", N/A ,"$5,760.45 ","$6,438.15 ","$5,963.76 ","$5,150.52 ", N/A , N/A , N/A ,"$4,947.21 ","$3,727.35 ","$6,167.07 ","$6,167.07 ","$5,421.60 ", N/A ,"$3,727.35 ","$6,099.30 ", N/A ,"$6,099.30 ","$3,659.58 ","$6,370.38 ", N/A ,"$6,234.84 ", N/A ,"$6,167.07 ", N/A ,"$4,170.57 ","$4,170.57 ","$6,099.30 ","$5,057.68 ","$4,720.18 ", N/A , N/A ,"$6,438.15 ", N/A , N/A ,"$5,895.99 ", N/A ,"$6,099.30 ", N/A ,"$6,099.30 ","$6,099.30 ","$6,099.30 ","$6,573.69 ","$5,489.37 ","$6,302.61 ","$5,828.22 ","$6,573.69 "
SACRED HEART HOSPITAL (ACU),27200176,C2618,HC CRYO ABLATION SYSTEM,272,1 ,"$2,818.00 ","$2,113.50 ","$1,521.72 ","$2,818.00 ","$1,814.79 ", N/A ,"$1,972.60 ", N/A ,"$2,338.94 ", N/A ,"$1,859.88 ","$2,677.10 ", N/A ,"$2,254.40 ","$2,592.56 ", N/A ,"$2,395.30 ","$2,677.10 ","$2,479.84 ","$2,141.68 ", N/A , N/A , N/A ,"$2,057.14 ","$1,549.90 ","$2,564.38 ","$2,564.38 ","$2,254.40 ", N/A ,"$1,549.90 ","$2,536.20 ", N/A ,"$2,536.20 ","$1,521.72 ","$2,648.92 ", N/A ,"$2,592.56 ", N/A ,"$2,564.38 ", N/A ,"$1,734.20 ","$1,734.20 ","$2,536.20 ","$2,103.07 ","$1,962.74 ", N/A , N/A ,"$2,677.10 ", N/A , N/A ,"$2,451.66 ", N/A ,"$2,536.20 ", N/A ,"$2,536.20 ","$2,536.20 ","$2,536.20 ","$2,733.46 ","$2,282.58 ","$2,620.74 ","$2,423.48 ","$2,733.46 "
SACRED HEART HOSPITAL (ACU),27200247,N/A,HC ANGIOJET PUMPSET,272,1 ,"$1,330.00 ",$997.50 ,$718.20 ,"$1,330.00 ",$856.52 , N/A ,$931.00 , N/A ,"$1,103.90 ", N/A ,$877.80 ,"$1,263.50 ", N/A ,"$1,064.00 ","$1,223.60 ", N/A ,"$1,130.50 ","$1,263.50 ","$1,170.40 ","$1,010.80 ", N/A , N/A , N/A ,$970.90 ,$731.50 ,"$1,210.30 ","$1,210.30 ","$1,064.00 ", N/A ,$731.50 ,"$1,197.00 ", N/A ,"$1,197.00 ",$718.20 ,"$1,250.20 ", N/A ,"$1,223.60 ", N/A ,"$1,210.30 ", N/A ,$818.48 ,$818.48 ,"$1,197.00 ",$992.58 ,$926.35 , N/A , N/A ,"$1,263.50 ", N/A , N/A ,"$1,157.10 ", N/A ,"$1,197.00 ", N/A ,"$1,197.00 ","$1,197.00 ","$1,197.00 ","$1,290.10 ","$1,077.30 ","$1,236.90 ","$1,143.80 ","$1,290.10 "
SACRED HEART HOSPITAL (ACU),27200338,N/A,HC BIOPSY DEVICE NEEDLE CORE,272,1 ,$110.00 ,$82.50 ,$59.40 ,$110.00 ,$70.84 , N/A ,$77.00 , N/A ,$91.30 , N/A ,$72.60 ,$104.50 , N/A ,$88.00 ,$101.20 , N/A ,$93.50 ,$104.50 ,$96.80 ,$83.60 , N/A , N/A , N/A ,$80.30 ,$60.50 ,$100.10 ,$100.10 ,$88.00 , N/A ,$60.50 ,$99.00 , N/A ,$99.00 ,$59.40 ,$103.40 , N/A ,$101.20 , N/A ,$100.10 , N/A ,$67.69 ,$67.69 ,$99.00 ,$82.09 ,$76.62 , N/A , N/A ,$104.50 , N/A , N/A ,$95.70 , N/A ,$99.00 , N/A ,$99.00 ,$99.00 ,$99.00 ,$106.70 ,$89.10 ,$102.30 ,$94.60 ,$106.70 
SACRED HEART HOSPITAL (ACU),27200507,N/A,HC BLADE STERNUM,272,1 ,$84.00 ,$63.00 ,$45.36 ,$84.00 ,$54.10 , N/A ,$58.80 , N/A ,$69.72 , N/A ,$55.44 ,$79.80 , N/A ,$67.20 ,$77.28 , N/A ,$71.40 ,$79.80 ,$73.92 ,$63.84 , N/A , N/A , N/A ,$61.32 ,$46.20 ,$76.44 ,$76.44 ,$67.20 , N/A ,$46.20 ,$75.60 , N/A ,$75.60 ,$45.36 ,$78.96 , N/A ,$77.28 , N/A ,$76.44 , N/A ,$51.69 ,$51.69 ,$75.60 ,$62.69 ,$58.51 , N/A , N/A ,$79.80 , N/A , N/A ,$73.08 , N/A ,$75.60 , N/A ,$75.60 ,$75.60 ,$75.60 ,$81.48 ,$68.04 ,$78.12 ,$72.24 ,$81.48 
SACRED HEART HOSPITAL (ACU),27200744,N/A,HC CATH ANGIOGRAPHIC SLIP,272,1 ,$113.00 ,$84.75 ,$61.02 ,$113.00 ,$72.77 , N/A ,$79.10 , N/A ,$93.79 , N/A ,$74.58 ,$107.35 , N/A ,$90.40 ,$103.96 , N/A ,$96.05 ,$107.35 ,$99.44 ,$85.88 , N/A , N/A , N/A ,$82.49 ,$62.15 ,$102.83 ,$102.83 ,$90.40 , N/A ,$62.15 ,$101.70 , N/A ,$101.70 ,$61.02 ,$106.22 , N/A ,$103.96 , N/A ,$102.83 , N/A ,$69.54 ,$69.54 ,$101.70 ,$84.33 ,$78.70 , N/A , N/A ,$107.35 , N/A , N/A ,$98.31 , N/A ,$101.70 , N/A ,$101.70 ,$101.70 ,$101.70 ,$109.61 ,$91.53 ,$105.09 ,$97.18 ,$109.61 
SACRED HEART HOSPITAL (ACU),27200801,N/A,HC CATH LEG BAG (ALL SIZES),272,1 ,$34.00 ,$25.50 ,$18.36 ,$34.00 ,$21.90 , N/A ,$23.80 , N/A ,$28.22 , N/A ,$22.44 ,$32.30 , N/A ,$27.20 ,$31.28 , N/A ,$28.90 ,$32.30 ,$29.92 ,$25.84 , N/A , N/A , N/A ,$24.82 ,$18.70 ,$30.94 ,$30.94 ,$27.20 , N/A ,$18.70 ,$30.60 , N/A ,$30.60 ,$18.36 ,$31.96 , N/A ,$31.28 , N/A ,$30.94 , N/A ,$20.92 ,$20.92 ,$30.60 ,$25.37 ,$23.68 , N/A , N/A ,$32.30 , N/A , N/A ,$29.58 , N/A ,$30.60 , N/A ,$30.60 ,$30.60 ,$30.60 ,$32.98 ,$27.54 ,$31.62 ,$29.24 ,$32.98 
SACRED HEART HOSPITAL (ACU),27200846,N/A,HC CATHETER,272,1 ,$246.00 ,$184.50 ,$132.84 ,$246.00 ,$158.42 , N/A ,$172.20 , N/A ,$204.18 , N/A ,$162.36 ,$233.70 , N/A ,$196.80 ,$226.32 , N/A ,$209.10 ,$233.70 ,$216.48 ,$186.96 , N/A , N/A , N/A ,$179.58 ,$135.30 ,$223.86 ,$223.86 ,$196.80 , N/A ,$135.30 ,$221.40 , N/A ,$221.40 ,$132.84 ,$231.24 , N/A ,$226.32 , N/A ,$223.86 , N/A ,$151.39 ,$151.39 ,$221.40 ,$183.59 ,$171.34 , N/A , N/A ,$233.70 , N/A , N/A ,$214.02 , N/A ,$221.40 , N/A ,$221.40 ,$221.40 ,$221.40 ,$238.62 ,$199.26 ,$228.78 ,$211.56 ,$238.62 
SACRED HEART HOSPITAL (ACU),27201086,C1769,HC GUIDEWIRE,272,1 ,$242.00 ,$181.50 ,$130.68 ,$242.00 ,$155.85 , N/A ,$169.40 , N/A ,$200.86 , N/A ,$159.72 ,$229.90 , N/A ,$193.60 ,$222.64 , N/A ,$205.70 ,$229.90 ,$212.96 ,$183.92 , N/A , N/A , N/A ,$176.66 ,$133.10 ,$220.22 ,$220.22 ,$193.60 , N/A ,$133.10 ,$217.80 , N/A ,$217.80 ,$130.68 ,$227.48 , N/A ,$222.64 , N/A ,$220.22 , N/A ,$148.93 ,$148.93 ,$217.80 ,$180.60 ,$168.55 , N/A , N/A ,$229.90 , N/A , N/A ,$210.54 , N/A ,$217.80 , N/A ,$217.80 ,$217.80 ,$217.80 ,$234.74 ,$196.02 ,$225.06 ,$208.12 ,$234.74 
SACRED HEART HOSPITAL (ACU),27201247,N/A,HC ENDOTRACH TUBE HOLDER,272,1 ,$68.00 ,$51.00 ,$36.72 ,$68.00 ,$43.79 , N/A ,$47.60 , N/A ,$56.44 , N/A ,$44.88 ,$64.60 , N/A ,$54.40 ,$62.56 , N/A ,$57.80 ,$64.60 ,$59.84 ,$51.68 , N/A , N/A , N/A ,$49.64 ,$37.40 ,$61.88 ,$61.88 ,$54.40 , N/A ,$37.40 ,$61.20 , N/A ,$61.20 ,$36.72 ,$63.92 , N/A ,$62.56 , N/A ,$61.88 , N/A ,$41.85 ,$41.85 ,$61.20 ,$50.75 ,$47.36 , N/A , N/A ,$64.60 , N/A , N/A ,$59.16 , N/A ,$61.20 , N/A ,$61.20 ,$61.20 ,$61.20 ,$65.96 ,$55.08 ,$63.24 ,$58.48 ,$65.96 
SACRED HEART HOSPITAL (ACU),27201319,N/A,HC FOLEY CATH W/URINE METER,272,1 ,$46.00 ,$34.50 ,$24.84 ,$46.00 ,$29.62 , N/A ,$32.20 , N/A ,$38.18 , N/A ,$30.36 ,$43.70 , N/A ,$36.80 ,$42.32 , N/A ,$39.10 ,$43.70 ,$40.48 ,$34.96 , N/A , N/A , N/A ,$33.58 ,$25.30 ,$41.86 ,$41.86 ,$36.80 , N/A ,$25.30 ,$41.40 , N/A ,$41.40 ,$24.84 ,$43.24 , N/A ,$42.32 , N/A ,$41.86 , N/A ,$28.31 ,$28.31 ,$41.40 ,$34.33 ,$32.04 , N/A , N/A ,$43.70 , N/A , N/A ,$40.02 , N/A ,$41.40 , N/A ,$41.40 ,$41.40 ,$41.40 ,$44.62 ,$37.26 ,$42.78 ,$39.56 ,$44.62 
SACRED HEART HOSPITAL (ACU),27201327,N/A,HC FRONTRUNNER XP CTO CATHETER,272,1 ,"$1,587.00 ","$1,190.25 ",$856.98 ,"$1,587.00 ","$1,022.03 ", N/A ,"$1,110.90 ", N/A ,"$1,317.21 ", N/A ,"$1,047.42 ","$1,507.65 ", N/A ,"$1,269.60 ","$1,460.04 ", N/A ,"$1,348.95 ","$1,507.65 ","$1,396.56 ","$1,206.12 ", N/A , N/A , N/A ,"$1,158.51 ",$872.85 ,"$1,444.17 ","$1,444.17 ","$1,269.60 ", N/A ,$872.85 ,"$1,428.30 ", N/A ,"$1,428.30 ",$856.98 ,"$1,491.78 ", N/A ,"$1,460.04 ", N/A ,"$1,444.17 ", N/A ,$976.64 ,$976.64 ,"$1,428.30 ","$1,184.38 ","$1,105.35 ", N/A , N/A ,"$1,507.65 ", N/A , N/A ,"$1,380.69 ", N/A ,"$1,428.30 ", N/A ,"$1,428.30 ","$1,428.30 ","$1,428.30 ","$1,539.39 ","$1,285.47 ","$1,475.91 ","$1,364.82 ","$1,539.39 "
SACRED HEART HOSPITAL (ACU),27201417,N/A,HC HOLMIUM LASER FIBER,272,1 ,$209.00 ,$156.75 ,$112.86 ,$209.00 ,$134.60 , N/A ,$146.30 , N/A ,$173.47 , N/A ,$137.94 ,$198.55 , N/A ,$167.20 ,$192.28 , N/A ,$177.65 ,$198.55 ,$183.92 ,$158.84 , N/A , N/A , N/A ,$152.57 ,$114.95 ,$190.19 ,$190.19 ,$167.20 , N/A ,$114.95 ,$188.10 , N/A ,$188.10 ,$112.86 ,$196.46 , N/A ,$192.28 , N/A ,$190.19 , N/A ,$128.62 ,$128.62 ,$188.10 ,$155.98 ,$145.57 , N/A , N/A ,$198.55 , N/A , N/A ,$181.83 , N/A ,$188.10 , N/A ,$188.10 ,$188.10 ,$188.10 ,$202.73 ,$169.29 ,$194.37 ,$179.74 ,$202.73 
SACRED HEART HOSPITAL (ACU),27201423,N/A,HC HYSTEROSALPINGEOGRAM CATH,272,1 ,$94.00 ,$70.50 ,$50.76 ,$94.00 ,$60.54 , N/A ,$65.80 , N/A ,$78.02 , N/A ,$62.04 ,$89.30 , N/A ,$75.20 ,$86.48 , N/A ,$79.90 ,$89.30 ,$82.72 ,$71.44 , N/A , N/A , N/A ,$68.62 ,$51.70 ,$85.54 ,$85.54 ,$75.20 , N/A ,$51.70 ,$84.60 , N/A ,$84.60 ,$50.76 ,$88.36 , N/A ,$86.48 , N/A ,$85.54 , N/A ,$57.85 ,$57.85 ,$84.60 ,$70.15 ,$65.47 , N/A , N/A ,$89.30 , N/A , N/A ,$81.78 , N/A ,$84.60 , N/A ,$84.60 ,$84.60 ,$84.60 ,$91.18 ,$76.14 ,$87.42 ,$80.84 ,$91.18 
SACRED HEART HOSPITAL (ACU),27201424,N/A,HC IABP BALLOON,272,1 ,"$2,544.00 ","$1,908.00 ","$1,373.76 ","$2,544.00 ","$1,638.34 ", N/A ,"$1,780.80 ", N/A ,"$2,111.52 ", N/A ,"$1,679.04 ","$2,416.80 ", N/A ,"$2,035.20 ","$2,340.48 ", N/A ,"$2,162.40 ","$2,416.80 ","$2,238.72 ","$1,933.44 ", N/A , N/A , N/A ,"$1,857.12 ","$1,399.20 ","$2,315.04 ","$2,315.04 ","$2,035.20 ", N/A ,"$1,399.20 ","$2,289.60 ", N/A ,"$2,289.60 ","$1,373.76 ","$2,391.36 ", N/A ,"$2,340.48 ", N/A ,"$2,315.04 ", N/A ,"$1,565.58 ","$1,565.58 ","$2,289.60 ","$1,898.59 ","$1,771.90 ", N/A , N/A ,"$2,416.80 ", N/A , N/A ,"$2,213.28 ", N/A ,"$2,289.60 ", N/A ,"$2,289.60 ","$2,289.60 ","$2,289.60 ","$2,467.68 ","$2,060.64 ","$2,365.92 ","$2,187.84 ","$2,467.68 "
SACRED HEART HOSPITAL (ACU),27201427,N/A,HC ICY CATH KIT,272,1 ,"$1,852.00 ","$1,389.00 ","$1,000.08 ","$1,852.00 ","$1,192.69 ", N/A ,"$1,296.40 ", N/A ,"$1,537.16 ", N/A ,"$1,222.32 ","$1,759.40 ", N/A ,"$1,481.60 ","$1,703.84 ", N/A ,"$1,574.20 ","$1,759.40 ","$1,629.76 ","$1,407.52 ", N/A , N/A , N/A ,"$1,351.96 ","$1,018.60 ","$1,685.32 ","$1,685.32 ","$1,481.60 ", N/A ,"$1,018.60 ","$1,666.80 ", N/A ,"$1,666.80 ","$1,000.08 ","$1,740.88 ", N/A ,"$1,703.84 ", N/A ,"$1,685.32 ", N/A ,"$1,139.72 ","$1,139.72 ","$1,666.80 ","$1,382.15 ","$1,289.92 ", N/A , N/A ,"$1,759.40 ", N/A , N/A ,"$1,611.24 ", N/A ,"$1,666.80 ", N/A ,"$1,666.80 ","$1,666.80 ","$1,666.80 ","$1,796.44 ","$1,500.12 ","$1,722.36 ","$1,592.72 ","$1,796.44 "
SACRED HEART HOSPITAL (ACU),27201431,N/A,HC INFLATION DEVICE,272,1 ,$434.00 ,$325.50 ,$234.36 ,$434.00 ,$279.50 , N/A ,$303.80 , N/A ,$360.22 , N/A ,$286.44 ,$412.30 , N/A ,$347.20 ,$399.28 , N/A ,$368.90 ,$412.30 ,$381.92 ,$329.84 , N/A , N/A , N/A ,$316.82 ,$238.70 ,$394.94 ,$394.94 ,$347.20 , N/A ,$238.70 ,$390.60 , N/A ,$390.60 ,$234.36 ,$407.96 , N/A ,$399.28 , N/A ,$394.94 , N/A ,$267.08 ,$267.08 ,$390.60 ,$323.89 ,$302.28 , N/A , N/A ,$412.30 , N/A , N/A ,$377.58 , N/A ,$390.60 , N/A ,$390.60 ,$390.60 ,$390.60 ,$420.98 ,$351.54 ,$403.62 ,$373.24 ,$420.98 
SACRED HEART HOSPITAL (ACU),27201469,N/A,HC IV EXT SET W/T CONNECTOR,272,1 ,$449.00 ,$336.75 ,$242.46 ,$449.00 ,$289.16 , N/A ,$314.30 , N/A ,$372.67 , N/A ,$296.34 ,$426.55 , N/A ,$359.20 ,$413.08 , N/A ,$381.65 ,$426.55 ,$395.12 ,$341.24 , N/A , N/A , N/A ,$327.77 ,$246.95 ,$408.59 ,$408.59 ,$359.20 , N/A ,$246.95 ,$404.10 , N/A ,$404.10 ,$242.46 ,$422.06 , N/A ,$413.08 , N/A ,$408.59 , N/A ,$276.31 ,$276.31 ,$404.10 ,$335.09 ,$312.73 , N/A , N/A ,$426.55 , N/A , N/A ,$390.63 , N/A ,$404.10 , N/A ,$404.10 ,$404.10 ,$404.10 ,$435.53 ,$363.69 ,$417.57 ,$386.14 ,$435.53 
SACRED HEART HOSPITAL (ACU),27201487,N/A,HC KIT ARROW 9 MAC TWO LUMEN,272,1 ,$446.00 ,$334.50 ,$240.84 ,$446.00 ,$287.22 , N/A ,$312.20 , N/A ,$370.18 , N/A ,$294.36 ,$423.70 , N/A ,$356.80 ,$410.32 , N/A ,$379.10 ,$423.70 ,$392.48 ,$338.96 , N/A , N/A , N/A ,$325.58 ,$245.30 ,$405.86 ,$405.86 ,$356.80 , N/A ,$245.30 ,$401.40 , N/A ,$401.40 ,$240.84 ,$419.24 , N/A ,$410.32 , N/A ,$405.86 , N/A ,$274.47 ,$274.47 ,$401.40 ,$332.85 ,$310.64 , N/A , N/A ,$423.70 , N/A , N/A ,$388.02 , N/A ,$401.40 , N/A ,$401.40 ,$401.40 ,$401.40 ,$432.62 ,$361.26 ,$414.78 ,$383.56 ,$432.62 
SACRED HEART HOSPITAL (ACU),27201521,N/A,HC KIT INTRODUCER,272,1 ,$218.00 ,$163.50 ,$117.72 ,$218.00 ,$140.39 , N/A ,$152.60 , N/A ,$180.94 , N/A ,$143.88 ,$207.10 , N/A ,$174.40 ,$200.56 , N/A ,$185.30 ,$207.10 ,$191.84 ,$165.68 , N/A , N/A , N/A ,$159.14 ,$119.90 ,$198.38 ,$198.38 ,$174.40 , N/A ,$119.90 ,$196.20 , N/A ,$196.20 ,$117.72 ,$204.92 , N/A ,$200.56 , N/A ,$198.38 , N/A ,$134.16 ,$134.16 ,$196.20 ,$162.69 ,$151.84 , N/A , N/A ,$207.10 , N/A , N/A ,$189.66 , N/A ,$196.20 , N/A ,$196.20 ,$196.20 ,$196.20 ,$211.46 ,$176.58 ,$202.74 ,$187.48 ,$211.46 
SACRED HEART HOSPITAL (ACU),27201637,N/A,HC MAMMOTOME PROBE,272,1 ,$632.00 ,$474.00 ,$341.28 ,$632.00 ,$407.01 , N/A ,$442.40 , N/A ,$524.56 , N/A ,$417.12 ,$600.40 , N/A ,$505.60 ,$581.44 , N/A ,$537.20 ,$600.40 ,$556.16 ,$480.32 , N/A , N/A , N/A ,$461.36 ,$347.60 ,$575.12 ,$575.12 ,$505.60 , N/A ,$347.60 ,$568.80 , N/A ,$568.80 ,$341.28 ,$594.08 , N/A ,$581.44 , N/A ,$575.12 , N/A ,$388.93 ,$388.93 ,$568.80 ,$471.66 ,$440.19 , N/A , N/A ,$600.40 , N/A , N/A ,$549.84 , N/A ,$568.80 , N/A ,$568.80 ,$568.80 ,$568.80 ,$613.04 ,$511.92 ,$587.76 ,$543.52 ,$613.04 
SACRED HEART HOSPITAL (ACU),27201713,N/A,HC NEEDLE SPINAL,272,1 ,$39.00 ,$29.25 ,$21.06 ,$39.00 ,$25.12 , N/A ,$27.30 , N/A ,$32.37 , N/A ,$25.74 ,$37.05 , N/A ,$31.20 ,$35.88 , N/A ,$33.15 ,$37.05 ,$34.32 ,$29.64 , N/A , N/A , N/A ,$28.47 ,$21.45 ,$35.49 ,$35.49 ,$31.20 , N/A ,$21.45 ,$35.10 , N/A ,$35.10 ,$21.06 ,$36.66 , N/A ,$35.88 , N/A ,$35.49 , N/A ,$24.00 ,$24.00 ,$35.10 ,$29.11 ,$27.16 , N/A , N/A ,$37.05 , N/A , N/A ,$33.93 , N/A ,$35.10 , N/A ,$35.10 ,$35.10 ,$35.10 ,$37.83 ,$31.59 ,$36.27 ,$33.54 ,$37.83 
SACRED HEART HOSPITAL (ACU),27201768,N/A,HC OUTBACK LTD CATHETER,272,1 ,"$3,068.00 ","$2,301.00 ","$1,656.72 ","$3,068.00 ","$1,975.79 ", N/A ,"$2,147.60 ", N/A ,"$2,546.44 ", N/A ,"$2,024.88 ","$2,914.60 ", N/A ,"$2,454.40 ","$2,822.56 ", N/A ,"$2,607.80 ","$2,914.60 ","$2,699.84 ","$2,331.68 ", N/A , N/A , N/A ,"$2,239.64 ","$1,687.40 ","$2,791.88 ","$2,791.88 ","$2,454.40 ", N/A ,"$1,687.40 ","$2,761.20 ", N/A ,"$2,761.20 ","$1,656.72 ","$2,883.92 ", N/A ,"$2,822.56 ", N/A ,"$2,791.88 ", N/A ,"$1,888.05 ","$1,888.05 ","$2,761.20 ","$2,289.65 ","$2,136.86 ", N/A , N/A ,"$2,914.60 ", N/A , N/A ,"$2,669.16 ", N/A ,"$2,761.20 ", N/A ,"$2,761.20 ","$2,761.20 ","$2,761.20 ","$2,975.96 ","$2,485.08 ","$2,853.24 ","$2,638.48 ","$2,975.96 "
SACRED HEART HOSPITAL (ACU),27201911,N/A,HC PROBE LASER FIBER,272,1 ,"$1,375.00 ","$1,031.25 ",$742.50 ,"$1,375.00 ",$885.50 , N/A ,$962.50 , N/A ,"$1,141.25 ", N/A ,$907.50 ,"$1,306.25 ", N/A ,"$1,100.00 ","$1,265.00 ", N/A ,"$1,168.75 ","$1,306.25 ","$1,210.00 ","$1,045.00 ", N/A , N/A , N/A ,"$1,003.75 ",$756.25 ,"$1,251.25 ","$1,251.25 ","$1,100.00 ", N/A ,$756.25 ,"$1,237.50 ", N/A ,"$1,237.50 ",$742.50 ,"$1,292.50 ", N/A ,"$1,265.00 ", N/A ,"$1,251.25 ", N/A ,$846.18 ,$846.18 ,"$1,237.50 ","$1,026.16 ",$957.69 , N/A , N/A ,"$1,306.25 ", N/A , N/A ,"$1,196.25 ", N/A ,"$1,237.50 ", N/A ,"$1,237.50 ","$1,237.50 ","$1,237.50 ","$1,333.75 ","$1,113.75 ","$1,278.75 ","$1,182.50 ","$1,333.75 "
SACRED HEART HOSPITAL (ACU),27201970,N/A,HC RESOLUTION CLIP,272,1 ,$618.00 ,$463.50 ,$333.72 ,$618.00 ,$397.99 , N/A ,$432.60 , N/A ,$512.94 , N/A ,$407.88 ,$587.10 , N/A ,$494.40 ,$568.56 , N/A ,$525.30 ,$587.10 ,$543.84 ,$469.68 , N/A , N/A , N/A ,$451.14 ,$339.90 ,$562.38 ,$562.38 ,$494.40 , N/A ,$339.90 ,$556.20 , N/A ,$556.20 ,$333.72 ,$580.92 , N/A ,$568.56 , N/A ,$562.38 , N/A ,$380.32 ,$380.32 ,$556.20 ,$461.21 ,$430.44 , N/A , N/A ,$587.10 , N/A , N/A ,$537.66 , N/A ,$556.20 , N/A ,$556.20 ,$556.20 ,$556.20 ,$599.46 ,$500.58 ,$574.74 ,$531.48 ,$599.46 
SACRED HEART HOSPITAL (ACU),27202167,N/A,HC STYLET VNUS RFS 6F 12CM,272,1 ,"$1,721.00 ","$1,290.75 ",$929.34 ,"$1,721.00 ","$1,108.32 ", N/A ,"$1,204.70 ", N/A ,"$1,428.43 ", N/A ,"$1,135.86 ","$1,634.95 ", N/A ,"$1,376.80 ","$1,583.32 ", N/A ,"$1,462.85 ","$1,634.95 ","$1,514.48 ","$1,307.96 ", N/A , N/A , N/A ,"$1,256.33 ",$946.55 ,"$1,566.11 ","$1,566.11 ","$1,376.80 ", N/A ,$946.55 ,"$1,548.90 ", N/A ,"$1,548.90 ",$929.34 ,"$1,617.74 ", N/A ,"$1,583.32 ", N/A ,"$1,566.11 ", N/A ,"$1,059.10 ","$1,059.10 ","$1,548.90 ","$1,284.38 ","$1,198.68 ", N/A , N/A ,"$1,634.95 ", N/A , N/A ,"$1,497.27 ", N/A ,"$1,548.90 ", N/A ,"$1,548.90 ","$1,548.90 ","$1,548.90 ","$1,669.37 ","$1,394.01 ","$1,600.53 ","$1,480.06 ","$1,669.37 "
SACRED HEART HOSPITAL (ACU),27202658,N/A,HC TEMP PACEMAKER,272,1 ,$334.00 ,$250.50 ,$180.36 ,$334.00 ,$215.10 , N/A ,$233.80 , N/A ,$277.22 , N/A ,$220.44 ,$317.30 , N/A ,$267.20 ,$307.28 , N/A ,$283.90 ,$317.30 ,$293.92 ,$253.84 , N/A , N/A , N/A ,$243.82 ,$183.70 ,$303.94 ,$303.94 ,$267.20 , N/A ,$183.70 ,$300.60 , N/A ,$300.60 ,$180.36 ,$313.96 , N/A ,$307.28 , N/A ,$303.94 , N/A ,$205.54 ,$205.54 ,$300.60 ,$249.26 ,$232.63 , N/A , N/A ,$317.30 , N/A , N/A ,$290.58 , N/A ,$300.60 , N/A ,$300.60 ,$300.60 ,$300.60 ,$323.98 ,$270.54 ,$310.62 ,$287.24 ,$323.98 
SACRED HEART HOSPITAL (ACU),27202720,N/A,HC TRACHEOSTOMY TUBE,272,1 ,$782.00 ,$586.50 ,$422.28 ,$782.00 ,$503.61 , N/A ,$547.40 , N/A ,$649.06 , N/A ,$516.12 ,$742.90 , N/A ,$625.60 ,$719.44 , N/A ,$664.70 ,$742.90 ,$688.16 ,$594.32 , N/A , N/A , N/A ,$570.86 ,$430.10 ,$711.62 ,$711.62 ,$625.60 , N/A ,$430.10 ,$703.80 , N/A ,$703.80 ,$422.28 ,$735.08 , N/A ,$719.44 , N/A ,$711.62 , N/A ,$481.24 ,$481.24 ,$703.80 ,$583.61 ,$544.66 , N/A , N/A ,$742.90 , N/A , N/A ,$680.34 , N/A ,$703.80 , N/A ,$703.80 ,$703.80 ,$703.80 ,$758.54 ,$633.42 ,$727.26 ,$672.52 ,$758.54 
SACRED HEART HOSPITAL (ACU),27202836,N/A,HC TRAY URETHRAL CATHETER,272,1 ,$43.00 ,$32.25 ,$23.22 ,$43.00 ,$27.69 , N/A ,$30.10 , N/A ,$35.69 , N/A ,$28.38 ,$40.85 , N/A ,$34.40 ,$39.56 , N/A ,$36.55 ,$40.85 ,$37.84 ,$32.68 , N/A , N/A , N/A ,$31.39 ,$23.65 ,$39.13 ,$39.13 ,$34.40 , N/A ,$23.65 ,$38.70 , N/A ,$38.70 ,$23.22 ,$40.42 , N/A ,$39.56 , N/A ,$39.13 , N/A ,$26.46 ,$26.46 ,$38.70 ,$32.09 ,$29.95 , N/A , N/A ,$40.85 , N/A , N/A ,$37.41 , N/A ,$38.70 , N/A ,$38.70 ,$38.70 ,$38.70 ,$41.71 ,$34.83 ,$39.99 ,$36.98 ,$41.71 
SACRED HEART HOSPITAL (ACU),27202901,N/A,HC TUBES TRACH,278,1 ,$355.00 ,$266.25 ,$191.70 ,$355.00 ,$228.62 , N/A ,$248.50 , N/A ,$294.65 , N/A ,$234.30 ,$337.25 , N/A ,$284.00 ,$326.60 , N/A ,$301.75 ,$337.25 ,$312.40 ,$269.80 , N/A , N/A , N/A ,$259.15 ,$195.25 ,$323.05 ,$323.05 ,$284.00 , N/A ,$195.25 ,$319.50 , N/A ,$319.50 ,$191.70 ,$333.70 , N/A ,$326.60 , N/A ,$323.05 , N/A ,$218.47 ,$218.47 ,$319.50 ,$264.94 , N/A , N/A , N/A ,$337.25 , N/A , N/A ,$308.85 , N/A ,$319.50 , N/A ,$319.50 ,$319.50 ,$319.50 ,$344.35 ,$287.55 ,$330.15 ,$305.30 ,$344.35 
SACRED HEART HOSPITAL (ACU),27203002,N/A,HC WIRE GUIDE LUNDERQUIST,272,1 ,$349.00 ,$261.75 ,$188.46 ,$349.00 ,$224.76 , N/A ,$244.30 , N/A ,$289.67 , N/A ,$230.34 ,$331.55 , N/A ,$279.20 ,$321.08 , N/A ,$296.65 ,$331.55 ,$307.12 ,$265.24 , N/A , N/A , N/A ,$254.77 ,$191.95 ,$317.59 ,$317.59 ,$279.20 , N/A ,$191.95 ,$314.10 , N/A ,$314.10 ,$188.46 ,$328.06 , N/A ,$321.08 , N/A ,$317.59 , N/A ,$214.77 ,$214.77 ,$314.10 ,$260.46 ,$243.08 , N/A , N/A ,$331.55 , N/A , N/A ,$303.63 , N/A ,$314.10 , N/A ,$314.10 ,$314.10 ,$314.10 ,$338.53 ,$282.69 ,$324.57 ,$300.14 ,$338.53 
SACRED HEART HOSPITAL (ACU),27203025,N/A,HC EMBOLIZATION COIL,272,1 ,$380.00 ,$285.00 ,$205.20 ,$380.00 ,$244.72 , N/A ,$266.00 , N/A ,$315.40 , N/A ,$250.80 ,$361.00 , N/A ,$304.00 ,$349.60 , N/A ,$323.00 ,$361.00 ,$334.40 ,$288.80 , N/A , N/A , N/A ,$277.40 ,$209.00 ,$345.80 ,$345.80 ,$304.00 , N/A ,$209.00 ,$342.00 , N/A ,$342.00 ,$205.20 ,$357.20 , N/A ,$349.60 , N/A ,$345.80 , N/A ,$233.85 ,$233.85 ,$342.00 ,$283.59 ,$264.67 , N/A , N/A ,$361.00 , N/A , N/A ,$330.60 , N/A ,$342.00 , N/A ,$342.00 ,$342.00 ,$342.00 ,$368.60 ,$307.80 ,$353.40 ,$326.80 ,$368.60 
SACRED HEART HOSPITAL (ACU),27203066,N/A,HC SINGLE TRANDUCER,272,1 ,$72.00 ,$54.00 ,$38.88 ,$72.00 ,$46.37 , N/A ,$50.40 , N/A ,$59.76 , N/A ,$47.52 ,$68.40 , N/A ,$57.60 ,$66.24 , N/A ,$61.20 ,$68.40 ,$63.36 ,$54.72 , N/A , N/A , N/A ,$52.56 ,$39.60 ,$65.52 ,$65.52 ,$57.60 , N/A ,$39.60 ,$64.80 , N/A ,$64.80 ,$38.88 ,$67.68 , N/A ,$66.24 , N/A ,$65.52 , N/A ,$44.31 ,$44.31 ,$64.80 ,$53.73 ,$50.15 , N/A , N/A ,$68.40 , N/A , N/A ,$62.64 , N/A ,$64.80 , N/A ,$64.80 ,$64.80 ,$64.80 ,$69.84 ,$58.32 ,$66.96 ,$61.92 ,$69.84 
SACRED HEART HOSPITAL (ACU),27203119,C1894,HC SHEATH RAABE/ANSEL/SHUTTLE/DESTINATION,272,1 ,$151.00 ,$113.25 ,$81.54 ,$151.00 ,$97.24 , N/A ,$105.70 , N/A ,$125.33 , N/A ,$99.66 ,$143.45 , N/A ,$120.80 ,$138.92 , N/A ,$128.35 ,$143.45 ,$132.88 ,$114.76 , N/A , N/A , N/A ,$110.23 ,$83.05 ,$137.41 ,$137.41 ,$120.80 , N/A ,$83.05 ,$135.90 , N/A ,$135.90 ,$81.54 ,$141.94 , N/A ,$138.92 , N/A ,$137.41 , N/A ,$92.93 ,$92.93 ,$135.90 ,$112.69 ,$105.17 , N/A , N/A ,$143.45 , N/A , N/A ,$131.37 , N/A ,$135.90 , N/A ,$135.90 ,$135.90 ,$135.90 ,$146.47 ,$122.31 ,$140.43 ,$129.86 ,$146.47 
SACRED HEART HOSPITAL (ACU),27203224,N/A,HC SNARE GOOSENECK,272,1 ,$878.00 ,$658.50 ,$474.12 ,$878.00 ,$565.43 , N/A ,$614.60 , N/A ,$728.74 , N/A ,$579.48 ,$834.10 , N/A ,$702.40 ,$807.76 , N/A ,$746.30 ,$834.10 ,$772.64 ,$667.28 , N/A , N/A , N/A ,$640.94 ,$482.90 ,$798.98 ,$798.98 ,$702.40 , N/A ,$482.90 ,$790.20 , N/A ,$790.20 ,$474.12 ,$825.32 , N/A ,$807.76 , N/A ,$798.98 , N/A ,$540.32 ,$540.32 ,$790.20 ,$655.25 ,$611.53 , N/A , N/A ,$834.10 , N/A , N/A ,$763.86 , N/A ,$790.20 , N/A ,$790.20 ,$790.20 ,$790.20 ,$851.66 ,$711.18 ,$816.54 ,$755.08 ,$851.66 
SACRED HEART HOSPITAL (ACU),27203227,N/A,HC CATH PIGTAIL 14FR X 25CM,272,1 ,$229.00 ,$171.75 ,$123.66 ,$229.00 ,$147.48 , N/A ,$160.30 , N/A ,$190.07 , N/A ,$151.14 ,$217.55 , N/A ,$183.20 ,$210.68 , N/A ,$194.65 ,$217.55 ,$201.52 ,$174.04 , N/A , N/A , N/A ,$167.17 ,$125.95 ,$208.39 ,$208.39 ,$183.20 , N/A ,$125.95 ,$206.10 , N/A ,$206.10 ,$123.66 ,$215.26 , N/A ,$210.68 , N/A ,$208.39 , N/A ,$140.93 ,$140.93 ,$206.10 ,$170.90 ,$159.50 , N/A , N/A ,$217.55 , N/A , N/A ,$199.23 , N/A ,$206.10 , N/A ,$206.10 ,$206.10 ,$206.10 ,$222.13 ,$185.49 ,$212.97 ,$196.94 ,$222.13 
SACRED HEART HOSPITAL (ACU),27203400,C1725,HC BALLOON TIER 1,272,1 ,$224.00 ,$168.00 ,$120.96 ,$224.00 ,$144.26 , N/A ,$156.80 , N/A ,$185.92 , N/A ,$147.84 ,$212.80 , N/A ,$179.20 ,$206.08 , N/A ,$190.40 ,$212.80 ,$197.12 ,$170.24 , N/A , N/A , N/A ,$163.52 ,$123.20 ,$203.84 ,$203.84 ,$179.20 , N/A ,$123.20 ,$201.60 , N/A ,$201.60 ,$120.96 ,$210.56 , N/A ,$206.08 , N/A ,$203.84 , N/A ,$137.85 ,$137.85 ,$201.60 ,$167.17 ,$156.02 , N/A , N/A ,$212.80 , N/A , N/A ,$194.88 , N/A ,$201.60 , N/A ,$201.60 ,$201.60 ,$201.60 ,$217.28 ,$181.44 ,$208.32 ,$192.64 ,$217.28 
SACRED HEART HOSPITAL (ACU),27203410,C1894,HC DIAGNOSTIC SHEATH TIER 1,272,1 ,$123.00 ,$92.25 ,$66.42 ,$123.00 ,$79.21 , N/A ,$86.10 , N/A ,$102.09 , N/A ,$81.18 ,$116.85 , N/A ,$98.40 ,$113.16 , N/A ,$104.55 ,$116.85 ,$108.24 ,$93.48 , N/A , N/A , N/A ,$89.79 ,$67.65 ,$111.93 ,$111.93 ,$98.40 , N/A ,$67.65 ,$110.70 , N/A ,$110.70 ,$66.42 ,$115.62 , N/A ,$113.16 , N/A ,$111.93 , N/A ,$75.69 ,$75.69 ,$110.70 ,$91.79 ,$85.67 , N/A , N/A ,$116.85 , N/A , N/A ,$107.01 , N/A ,$110.70 , N/A ,$110.70 ,$110.70 ,$110.70 ,$119.31 ,$99.63 ,$114.39 ,$105.78 ,$119.31 
SACRED HEART HOSPITAL (ACU),27203503,N/A,HC CANNULA NASAL HEATED HI FLOW,272,1 ,$149.00 ,$111.75 ,$80.46 ,$149.00 ,$95.96 , N/A ,$104.30 , N/A ,$123.67 , N/A ,$98.34 ,$141.55 , N/A ,$119.20 ,$137.08 , N/A ,$126.65 ,$141.55 ,$131.12 ,$113.24 , N/A , N/A , N/A ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 , N/A ,$81.95 ,$134.10 , N/A ,$134.10 ,$80.46 ,$140.06 , N/A ,$137.08 , N/A ,$135.59 , N/A ,$91.69 ,$91.69 ,$134.10 ,$111.20 ,$103.78 , N/A , N/A ,$141.55 , N/A , N/A ,$129.63 , N/A ,$134.10 , N/A ,$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),27203531,C1751,HC CATHETER CV TRIPLE-LUMEN,272,1 ,"$1,498.00 ","$1,123.50 ",$808.92 ,"$1,498.00 ",$964.71 , N/A ,"$1,048.60 ", N/A ,"$1,243.34 ", N/A ,$988.68 ,"$1,423.10 ", N/A ,"$1,198.40 ","$1,378.16 ", N/A ,"$1,273.30 ","$1,423.10 ","$1,318.24 ","$1,138.48 ", N/A , N/A , N/A ,"$1,093.54 ",$823.90 ,"$1,363.18 ","$1,363.18 ","$1,198.40 ", N/A ,$823.90 ,"$1,348.20 ", N/A ,"$1,348.20 ",$808.92 ,"$1,408.12 ", N/A ,"$1,378.16 ", N/A ,"$1,363.18 ", N/A ,$921.87 ,$921.87 ,"$1,348.20 ","$1,117.96 ","$1,043.36 ", N/A , N/A ,"$1,423.10 ", N/A , N/A ,"$1,303.26 ", N/A ,"$1,348.20 ", N/A ,"$1,348.20 ","$1,348.20 ","$1,348.20 ","$1,453.06 ","$1,213.38 ","$1,393.14 ","$1,288.28 ","$1,453.06 "
SACRED HEART HOSPITAL (ACU),27203532,C1751,HC CATHETER CV DUAL-LUMEN,272,1 ,$68.00 ,$51.00 ,$36.72 ,$68.00 ,$43.79 , N/A ,$47.60 , N/A ,$56.44 , N/A ,$44.88 ,$64.60 , N/A ,$54.40 ,$62.56 , N/A ,$57.80 ,$64.60 ,$59.84 ,$51.68 , N/A , N/A , N/A ,$49.64 ,$37.40 ,$61.88 ,$61.88 ,$54.40 , N/A ,$37.40 ,$61.20 , N/A ,$61.20 ,$36.72 ,$63.92 , N/A ,$62.56 , N/A ,$61.88 , N/A ,$41.85 ,$41.85 ,$61.20 ,$50.75 ,$47.36 , N/A , N/A ,$64.60 , N/A , N/A ,$59.16 , N/A ,$61.20 , N/A ,$61.20 ,$61.20 ,$61.20 ,$65.96 ,$55.08 ,$63.24 ,$58.48 ,$65.96 
SACRED HEART HOSPITAL (ACU),27203535,N/A,HC TRAY LUMBAR PUNCTURE,272,1 ,$32.00 ,$24.00 ,$17.28 ,$32.00 ,$20.61 , N/A ,$22.40 , N/A ,$26.56 , N/A ,$21.12 ,$30.40 , N/A ,$25.60 ,$29.44 , N/A ,$27.20 ,$30.40 ,$28.16 ,$24.32 , N/A , N/A , N/A ,$23.36 ,$17.60 ,$29.12 ,$29.12 ,$25.60 , N/A ,$17.60 ,$28.80 , N/A ,$28.80 ,$17.28 ,$30.08 , N/A ,$29.44 , N/A ,$29.12 , N/A ,$19.69 ,$19.69 ,$28.80 ,$23.88 ,$22.29 , N/A , N/A ,$30.40 , N/A , N/A ,$27.84 , N/A ,$28.80 , N/A ,$28.80 ,$28.80 ,$28.80 ,$31.04 ,$25.92 ,$29.76 ,$27.52 ,$31.04 
SACRED HEART HOSPITAL (ACU),27203536,N/A,HC KIT LUMBAR DRAIN,272,1 ,$30.00 ,$22.50 ,$16.20 ,$30.00 ,$19.32 , N/A ,$21.00 , N/A ,$24.90 , N/A ,$19.80 ,$28.50 , N/A ,$24.00 ,$27.60 , N/A ,$25.50 ,$28.50 ,$26.40 ,$22.80 , N/A , N/A , N/A ,$21.90 ,$16.50 ,$27.30 ,$27.30 ,$24.00 , N/A ,$16.50 ,$27.00 , N/A ,$27.00 ,$16.20 ,$28.20 , N/A ,$27.60 , N/A ,$27.30 , N/A ,$18.46 ,$18.46 ,$27.00 ,$22.39 ,$20.90 , N/A , N/A ,$28.50 , N/A , N/A ,$26.10 , N/A ,$27.00 , N/A ,$27.00 ,$27.00 ,$27.00 ,$29.10 ,$24.30 ,$27.90 ,$25.80 ,$29.10 
SACRED HEART HOSPITAL (ACU),27203537,N/A,HC CATHETER RADIAL ARTERY,272,1 ,$46.00 ,$34.50 ,$24.84 ,$46.00 ,$29.62 , N/A ,$32.20 , N/A ,$38.18 , N/A ,$30.36 ,$43.70 , N/A ,$36.80 ,$42.32 , N/A ,$39.10 ,$43.70 ,$40.48 ,$34.96 , N/A , N/A , N/A ,$33.58 ,$25.30 ,$41.86 ,$41.86 ,$36.80 , N/A ,$25.30 ,$41.40 , N/A ,$41.40 ,$24.84 ,$43.24 , N/A ,$42.32 , N/A ,$41.86 , N/A ,$28.31 ,$28.31 ,$41.40 ,$34.33 ,$32.04 , N/A , N/A ,$43.70 , N/A , N/A ,$40.02 , N/A ,$41.40 , N/A ,$41.40 ,$41.40 ,$41.40 ,$44.62 ,$37.26 ,$42.78 ,$39.56 ,$44.62 
SACRED HEART HOSPITAL (ACU),27203538,N/A,HC KIT ARTERIAL LINE,272,1 ,$53.00 ,$39.75 ,$28.62 ,$53.00 ,$34.13 , N/A ,$37.10 , N/A ,$43.99 , N/A ,$34.98 ,$50.35 , N/A ,$42.40 ,$48.76 , N/A ,$45.05 ,$50.35 ,$46.64 ,$40.28 , N/A , N/A , N/A ,$38.69 ,$29.15 ,$48.23 ,$48.23 ,$42.40 , N/A ,$29.15 ,$47.70 , N/A ,$47.70 ,$28.62 ,$49.82 , N/A ,$48.76 , N/A ,$48.23 , N/A ,$32.62 ,$32.62 ,$47.70 ,$39.55 ,$36.91 , N/A , N/A ,$50.35 , N/A , N/A ,$46.11 , N/A ,$47.70 , N/A ,$47.70 ,$47.70 ,$47.70 ,$51.41 ,$42.93 ,$49.29 ,$45.58 ,$51.41 
SACRED HEART HOSPITAL (ACU),27203539,N/A,HC TRANSDUCER,272,1 ,$124.00 ,$93.00 ,$66.96 ,$124.00 ,$79.86 , N/A ,$86.80 , N/A ,$102.92 , N/A ,$81.84 ,$117.80 , N/A ,$99.20 ,$114.08 , N/A ,$105.40 ,$117.80 ,$109.12 ,$94.24 , N/A , N/A , N/A ,$90.52 ,$68.20 ,$112.84 ,$112.84 ,$99.20 , N/A ,$68.20 ,$111.60 , N/A ,$111.60 ,$66.96 ,$116.56 , N/A ,$114.08 , N/A ,$112.84 , N/A ,$76.31 ,$76.31 ,$111.60 ,$92.54 ,$86.37 , N/A , N/A ,$117.80 , N/A , N/A ,$107.88 , N/A ,$111.60 , N/A ,$111.60 ,$111.60 ,$111.60 ,$120.28 ,$100.44 ,$115.32 ,$106.64 ,$120.28 
SACRED HEART HOSPITAL (ACU),27203540,N/A,HC CATHETER FEMOSTOP,272,1 ,$351.00 ,$263.25 ,$189.54 ,$351.00 ,$226.04 , N/A ,$245.70 , N/A ,$291.33 , N/A ,$231.66 ,$333.45 , N/A ,$280.80 ,$322.92 , N/A ,$298.35 ,$333.45 ,$308.88 ,$266.76 , N/A , N/A , N/A ,$256.23 ,$193.05 ,$319.41 ,$319.41 ,$280.80 , N/A ,$193.05 ,$315.90 , N/A ,$315.90 ,$189.54 ,$329.94 , N/A ,$322.92 , N/A ,$319.41 , N/A ,$216.01 ,$216.01 ,$315.90 ,$261.95 ,$244.47 , N/A , N/A ,$333.45 , N/A , N/A ,$305.37 , N/A ,$315.90 , N/A ,$315.90 ,$315.90 ,$315.90 ,$340.47 ,$284.31 ,$326.43 ,$301.86 ,$340.47 
SACRED HEART HOSPITAL (ACU),27203541,N/A,HC KIT PERCUTANEOUS SHEATH,272,1 ,$254.00 ,$190.50 ,$137.16 ,$254.00 ,$163.58 , N/A ,$177.80 , N/A ,$210.82 , N/A ,$167.64 ,$241.30 , N/A ,$203.20 ,$233.68 , N/A ,$215.90 ,$241.30 ,$223.52 ,$193.04 , N/A , N/A , N/A ,$185.42 ,$139.70 ,$231.14 ,$231.14 ,$203.20 , N/A ,$139.70 ,$228.60 , N/A ,$228.60 ,$137.16 ,$238.76 , N/A ,$233.68 , N/A ,$231.14 , N/A ,$156.31 ,$156.31 ,$228.60 ,$189.56 ,$176.91 , N/A , N/A ,$241.30 , N/A , N/A ,$220.98 , N/A ,$228.60 , N/A ,$228.60 ,$228.60 ,$228.60 ,$246.38 ,$205.74 ,$236.22 ,$218.44 ,$246.38 
SACRED HEART HOSPITAL (ACU),27203542,N/A,HC D-STAT DRY PAD,272,1 ,$272.00 ,$204.00 ,$146.88 ,$272.00 ,$175.17 , N/A ,$190.40 , N/A ,$225.76 , N/A ,$179.52 ,$258.40 , N/A ,$217.60 ,$250.24 , N/A ,$231.20 ,$258.40 ,$239.36 ,$206.72 , N/A , N/A , N/A ,$198.56 ,$149.60 ,$247.52 ,$247.52 ,$217.60 , N/A ,$149.60 ,$244.80 , N/A ,$244.80 ,$146.88 ,$255.68 , N/A ,$250.24 , N/A ,$247.52 , N/A ,$167.39 ,$167.39 ,$244.80 ,$202.99 ,$189.45 , N/A , N/A ,$258.40 , N/A , N/A ,$236.64 , N/A ,$244.80 , N/A ,$244.80 ,$244.80 ,$244.80 ,$263.84 ,$220.32 ,$252.96 ,$233.92 ,$263.84 
SACRED HEART HOSPITAL (ACU),27203543,N/A,HC CATHETER THERMODILUTION,272,1 ,$191.00 ,$143.25 ,$103.14 ,$191.00 ,$123.00 , N/A ,$133.70 , N/A ,$158.53 , N/A ,$126.06 ,$181.45 , N/A ,$152.80 ,$175.72 , N/A ,$162.35 ,$181.45 ,$168.08 ,$145.16 , N/A , N/A , N/A ,$139.43 ,$105.05 ,$173.81 ,$173.81 ,$152.80 , N/A ,$105.05 ,$171.90 , N/A ,$171.90 ,$103.14 ,$179.54 , N/A ,$175.72 , N/A ,$173.81 , N/A ,$117.54 ,$117.54 ,$171.90 ,$142.54 ,$133.03 , N/A , N/A ,$181.45 , N/A , N/A ,$166.17 , N/A ,$171.90 , N/A ,$171.90 ,$171.90 ,$171.90 ,$185.27 ,$154.71 ,$177.63 ,$164.26 ,$185.27 
SACRED HEART HOSPITAL (ACU),27203544,N/A,HC CATHETER FEMORAL ARTERY,272,1 ,$53.00 ,$39.75 ,$28.62 ,$53.00 ,$34.13 , N/A ,$37.10 , N/A ,$43.99 , N/A ,$34.98 ,$50.35 , N/A ,$42.40 ,$48.76 , N/A ,$45.05 ,$50.35 ,$46.64 ,$40.28 , N/A , N/A , N/A ,$38.69 ,$29.15 ,$48.23 ,$48.23 ,$42.40 , N/A ,$29.15 ,$47.70 , N/A ,$47.70 ,$28.62 ,$49.82 , N/A ,$48.76 , N/A ,$48.23 , N/A ,$32.62 ,$32.62 ,$47.70 ,$39.55 ,$36.91 , N/A , N/A ,$50.35 , N/A , N/A ,$46.11 , N/A ,$47.70 , N/A ,$47.70 ,$47.70 ,$47.70 ,$51.41 ,$42.93 ,$49.29 ,$45.58 ,$51.41 
SACRED HEART HOSPITAL (ACU),27203545,N/A,HC TRAY HEMODIALYSIS CATHETER,272,1 ,$349.00 ,$261.75 ,$188.46 ,$349.00 ,$224.76 , N/A ,$244.30 , N/A ,$289.67 , N/A ,$230.34 ,$331.55 , N/A ,$279.20 ,$321.08 , N/A ,$296.65 ,$331.55 ,$307.12 ,$265.24 , N/A , N/A , N/A ,$254.77 ,$191.95 ,$317.59 ,$317.59 ,$279.20 , N/A ,$191.95 ,$314.10 , N/A ,$314.10 ,$188.46 ,$328.06 , N/A ,$321.08 , N/A ,$317.59 , N/A ,$214.77 ,$214.77 ,$314.10 ,$260.46 ,$243.08 , N/A , N/A ,$331.55 , N/A , N/A ,$303.63 , N/A ,$314.10 , N/A ,$314.10 ,$314.10 ,$314.10 ,$338.53 ,$282.69 ,$324.57 ,$300.14 ,$338.53 
SACRED HEART HOSPITAL (ACU),27203546,N/A,HC KIT CATHETER COOL LINE,272,1 ,"$1,440.00 ","$1,080.00 ",$777.60 ,"$1,440.00 ",$927.36 , N/A ,"$1,008.00 ", N/A ,"$1,195.20 ", N/A ,$950.40 ,"$1,368.00 ", N/A ,"$1,152.00 ","$1,324.80 ", N/A ,"$1,224.00 ","$1,368.00 ","$1,267.20 ","$1,094.40 ", N/A , N/A , N/A ,"$1,051.20 ",$792.00 ,"$1,310.40 ","$1,310.40 ","$1,152.00 ", N/A ,$792.00 ,"$1,296.00 ", N/A ,"$1,296.00 ",$777.60 ,"$1,353.60 ", N/A ,"$1,324.80 ", N/A ,"$1,310.40 ", N/A ,$886.18 ,$886.18 ,"$1,296.00 ","$1,074.67 ","$1,002.96 ", N/A , N/A ,"$1,368.00 ", N/A , N/A ,"$1,252.80 ", N/A ,"$1,296.00 ", N/A ,"$1,296.00 ","$1,296.00 ","$1,296.00 ","$1,396.80 ","$1,166.40 ","$1,339.20 ","$1,238.40 ","$1,396.80 "
SACRED HEART HOSPITAL (ACU),27203547,N/A,HC VENOUS/ARTERIAL MANAGEMENT SYSTEM,272,1 ,$185.00 ,$138.75 ,$99.90 ,$185.00 ,$119.14 , N/A ,$129.50 , N/A ,$153.55 , N/A ,$122.10 ,$175.75 , N/A ,$148.00 ,$170.20 , N/A ,$157.25 ,$175.75 ,$162.80 ,$140.60 , N/A , N/A , N/A ,$135.05 ,$101.75 ,$168.35 ,$168.35 ,$148.00 , N/A ,$101.75 ,$166.50 , N/A ,$166.50 ,$99.90 ,$173.90 , N/A ,$170.20 , N/A ,$168.35 , N/A ,$113.85 ,$113.85 ,$166.50 ,$138.07 ,$128.85 , N/A , N/A ,$175.75 , N/A , N/A ,$160.95 , N/A ,$166.50 , N/A ,$166.50 ,$166.50 ,$166.50 ,$179.45 ,$149.85 ,$172.05 ,$159.10 ,$179.45 
SACRED HEART HOSPITAL (ACU),27203548,N/A,HC PERCUTANEOUS CATH INTRODUCER,272,1 ,$102.00 ,$76.50 ,$55.08 ,$102.00 ,$65.69 , N/A ,$71.40 , N/A ,$84.66 , N/A ,$67.32 ,$96.90 , N/A ,$81.60 ,$93.84 , N/A ,$86.70 ,$96.90 ,$89.76 ,$77.52 , N/A , N/A , N/A ,$74.46 ,$56.10 ,$92.82 ,$92.82 ,$81.60 , N/A ,$56.10 ,$91.80 , N/A ,$91.80 ,$55.08 ,$95.88 , N/A ,$93.84 , N/A ,$92.82 , N/A ,$62.77 ,$62.77 ,$91.80 ,$76.12 ,$71.04 , N/A , N/A ,$96.90 , N/A , N/A ,$88.74 , N/A ,$91.80 , N/A ,$91.80 ,$91.80 ,$91.80 ,$98.94 ,$82.62 ,$94.86 ,$87.72 ,$98.94 
SACRED HEART HOSPITAL (ACU),27203549,N/A,HC TRANSDUCER TUBING,272,1 ,"$1,016.00 ",$762.00 ,$548.64 ,"$1,016.00 ",$654.30 , N/A ,$711.20 , N/A ,$843.28 , N/A ,$670.56 ,$965.20 , N/A ,$812.80 ,$934.72 , N/A ,$863.60 ,$965.20 ,$894.08 ,$772.16 , N/A , N/A , N/A ,$741.68 ,$558.80 ,$924.56 ,$924.56 ,$812.80 , N/A ,$558.80 ,$914.40 , N/A ,$914.40 ,$548.64 ,$955.04 , N/A ,$934.72 , N/A ,$924.56 , N/A ,$625.25 ,$625.25 ,$914.40 ,$758.24 ,$707.64 , N/A , N/A ,$965.20 , N/A , N/A ,$883.92 , N/A ,$914.40 , N/A ,$914.40 ,$914.40 ,$914.40 ,$985.52 ,$822.96 ,$944.88 ,$873.76 ,$985.52 
SACRED HEART HOSPITAL (ACU),27203550,N/A,HC CATHETER VENOUS,272,1 ,"$1,432.00 ","$1,074.00 ",$773.28 ,"$1,432.00 ",$922.21 , N/A ,"$1,002.40 ", N/A ,"$1,188.56 ", N/A ,$945.12 ,"$1,360.40 ", N/A ,"$1,145.60 ","$1,317.44 ", N/A ,"$1,217.20 ","$1,360.40 ","$1,260.16 ","$1,088.32 ", N/A , N/A , N/A ,"$1,045.36 ",$787.60 ,"$1,303.12 ","$1,303.12 ","$1,145.60 ", N/A ,$787.60 ,"$1,288.80 ", N/A ,"$1,288.80 ",$773.28 ,"$1,346.08 ", N/A ,"$1,317.44 ", N/A ,"$1,303.12 ", N/A ,$881.25 ,$881.25 ,"$1,288.80 ","$1,068.70 ",$997.39 , N/A , N/A ,"$1,360.40 ", N/A , N/A ,"$1,245.84 ", N/A ,"$1,288.80 ", N/A ,"$1,288.80 ","$1,288.80 ","$1,288.80 ","$1,389.04 ","$1,159.92 ","$1,331.76 ","$1,231.52 ","$1,389.04 "
SACRED HEART HOSPITAL (ACU),27203551,N/A,HC TRIPLE LUMEN CENTRAL LINE,272,1 ,"$1,422.00 ","$1,066.50 ",$767.88 ,"$1,422.00 ",$915.77 , N/A ,$995.40 , N/A ,"$1,180.26 ", N/A ,$938.52 ,"$1,350.90 ", N/A ,"$1,137.60 ","$1,308.24 ", N/A ,"$1,208.70 ","$1,350.90 ","$1,251.36 ","$1,080.72 ", N/A , N/A , N/A ,"$1,038.06 ",$782.10 ,"$1,294.02 ","$1,294.02 ","$1,137.60 ", N/A ,$782.10 ,"$1,279.80 ", N/A ,"$1,279.80 ",$767.88 ,"$1,336.68 ", N/A ,"$1,308.24 ", N/A ,"$1,294.02 ", N/A ,$875.10 ,$875.10 ,"$1,279.80 ","$1,061.24 ",$990.42 , N/A , N/A ,"$1,350.90 ", N/A , N/A ,"$1,237.14 ", N/A ,"$1,279.80 ", N/A ,"$1,279.80 ","$1,279.80 ","$1,279.80 ","$1,379.34 ","$1,151.82 ","$1,322.46 ","$1,222.92 ","$1,379.34 "
SACRED HEART HOSPITAL (ACU),27203552,N/A,HC PACEMAKER WIRE,278,1 ,$262.00 ,$196.50 ,$141.48 ,$262.00 ,$168.73 , N/A ,$183.40 , N/A ,$217.46 , N/A ,$172.92 ,$248.90 , N/A ,$209.60 ,$241.04 , N/A ,$222.70 ,$248.90 ,$230.56 ,$199.12 , N/A , N/A , N/A ,$191.26 ,$144.10 ,$238.42 ,$238.42 ,$209.60 , N/A ,$144.10 ,$235.80 , N/A ,$235.80 ,$141.48 ,$246.28 , N/A ,$241.04 , N/A ,$238.42 , N/A ,$161.23 ,$161.23 ,$235.80 ,$195.53 , N/A , N/A , N/A ,$248.90 , N/A , N/A ,$227.94 , N/A ,$235.80 , N/A ,$235.80 ,$235.80 ,$235.80 ,$254.14 ,$212.22 ,$243.66 ,$225.32 ,$254.14 
SACRED HEART HOSPITAL (ACU),27203553,N/A,HC TRANSDUCER DISPOSABLE,272,1 ,$124.00 ,$93.00 ,$66.96 ,$124.00 ,$79.86 , N/A ,$86.80 , N/A ,$102.92 , N/A ,$81.84 ,$117.80 , N/A ,$99.20 ,$114.08 , N/A ,$105.40 ,$117.80 ,$109.12 ,$94.24 , N/A , N/A , N/A ,$90.52 ,$68.20 ,$112.84 ,$112.84 ,$99.20 , N/A ,$68.20 ,$111.60 , N/A ,$111.60 ,$66.96 ,$116.56 , N/A ,$114.08 , N/A ,$112.84 , N/A ,$76.31 ,$76.31 ,$111.60 ,$92.54 ,$86.37 , N/A , N/A ,$117.80 , N/A , N/A ,$107.88 , N/A ,$111.60 , N/A ,$111.60 ,$111.60 ,$111.60 ,$120.28 ,$100.44 ,$115.32 ,$106.64 ,$120.28 
SACRED HEART HOSPITAL (ACU),27203554,N/A,HC KIT ICP PRESSURE MONITOR,272,1 ,$896.00 ,$672.00 ,$483.84 ,$896.00 ,$577.02 , N/A ,$627.20 , N/A ,$743.68 , N/A ,$591.36 ,$851.20 , N/A ,$716.80 ,$824.32 , N/A ,$761.60 ,$851.20 ,$788.48 ,$680.96 , N/A , N/A , N/A ,$654.08 ,$492.80 ,$815.36 ,$815.36 ,$716.80 , N/A ,$492.80 ,$806.40 , N/A ,$806.40 ,$483.84 ,$842.24 , N/A ,$824.32 , N/A ,$815.36 , N/A ,$551.40 ,$551.40 ,$806.40 ,$668.68 ,$624.06 , N/A , N/A ,$851.20 , N/A , N/A ,$779.52 , N/A ,$806.40 , N/A ,$806.40 ,$806.40 ,$806.40 ,$869.12 ,$725.76 ,$833.28 ,$770.56 ,$869.12 
SACRED HEART HOSPITAL (ACU),27203593,N/A,HC TRAY PERICARDIOCENTESIS DISP,272,1 ,$462.00 ,$346.50 ,$249.48 ,$462.00 ,$297.53 , N/A ,$323.40 , N/A ,$383.46 , N/A ,$304.92 ,$438.90 , N/A ,$369.60 ,$425.04 , N/A ,$392.70 ,$438.90 ,$406.56 ,$351.12 , N/A , N/A , N/A ,$337.26 ,$254.10 ,$420.42 ,$420.42 ,$369.60 , N/A ,$254.10 ,$415.80 , N/A ,$415.80 ,$249.48 ,$434.28 , N/A ,$425.04 , N/A ,$420.42 , N/A ,$284.31 ,$284.31 ,$415.80 ,$344.79 ,$321.78 , N/A , N/A ,$438.90 , N/A , N/A ,$401.94 , N/A ,$415.80 , N/A ,$415.80 ,$415.80 ,$415.80 ,$448.14 ,$374.22 ,$429.66 ,$397.32 ,$448.14 
SACRED HEART HOSPITAL (ACU),27203599,N/A,HC TUBE TRACH PEDIATRIC,272,1 ,$152.00 ,$114.00 ,$82.08 ,$152.00 ,$97.89 , N/A ,$106.40 , N/A ,$126.16 , N/A ,$100.32 ,$144.40 , N/A ,$121.60 ,$139.84 , N/A ,$129.20 ,$144.40 ,$133.76 ,$115.52 , N/A , N/A , N/A ,$110.96 ,$83.60 ,$138.32 ,$138.32 ,$121.60 , N/A ,$83.60 ,$136.80 , N/A ,$136.80 ,$82.08 ,$142.88 , N/A ,$139.84 , N/A ,$138.32 , N/A ,$93.54 ,$93.54 ,$136.80 ,$113.44 ,$105.87 , N/A , N/A ,$144.40 , N/A , N/A ,$132.24 , N/A ,$136.80 , N/A ,$136.80 ,$136.80 ,$136.80 ,$147.44 ,$123.12 ,$141.36 ,$130.72 ,$147.44 
SACRED HEART HOSPITAL (ACU),27203600,N/A,HC SUCTION WET PACK TRACH CARE,272,1 ,$8.00 ,$6.00 ,$4.32 ,$8.00 ,$5.15 , N/A ,$5.60 , N/A ,$6.64 , N/A ,$5.28 ,$7.60 , N/A ,$6.40 ,$7.36 , N/A ,$6.80 ,$7.60 ,$7.04 ,$6.08 , N/A , N/A , N/A ,$5.84 ,$4.40 ,$7.28 ,$7.28 ,$6.40 , N/A ,$4.40 ,$7.20 , N/A ,$7.20 ,$4.32 ,$7.52 , N/A ,$7.36 , N/A ,$7.28 , N/A ,$4.92 ,$4.92 ,$7.20 ,$5.97 ,$5.57 , N/A , N/A ,$7.60 , N/A , N/A ,$6.96 , N/A ,$7.20 , N/A ,$7.20 ,$7.20 ,$7.20 ,$7.76 ,$6.48 ,$7.44 ,$6.88 ,$7.76 
SACRED HEART HOSPITAL (ACU),27203614,N/A,HC NEEDLE LOCALIZATION,272,1 ,$136.00 ,$102.00 ,$73.44 ,$136.00 ,$87.58 , N/A ,$95.20 , N/A ,$112.88 , N/A ,$89.76 ,$129.20 , N/A ,$108.80 ,$125.12 , N/A ,$115.60 ,$129.20 ,$119.68 ,$103.36 , N/A , N/A , N/A ,$99.28 ,$74.80 ,$123.76 ,$123.76 ,$108.80 , N/A ,$74.80 ,$122.40 , N/A ,$122.40 ,$73.44 ,$127.84 , N/A ,$125.12 , N/A ,$123.76 , N/A ,$83.69 ,$83.69 ,$122.40 ,$101.50 ,$94.72 , N/A , N/A ,$129.20 , N/A , N/A ,$118.32 , N/A ,$122.40 , N/A ,$122.40 ,$122.40 ,$122.40 ,$131.92 ,$110.16 ,$126.48 ,$116.96 ,$131.92 
SACRED HEART HOSPITAL (ACU),27203634,N/A,HC CATHETER SIALOGRAM,272,1 ,$100.00 ,$75.00 ,$54.00 ,$100.00 ,$64.40 , N/A ,$70.00 , N/A ,$83.00 , N/A ,$66.00 ,$95.00 , N/A ,$80.00 ,$92.00 , N/A ,$85.00 ,$95.00 ,$88.00 ,$76.00 , N/A , N/A , N/A ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 , N/A ,$55.00 ,$90.00 , N/A ,$90.00 ,$54.00 ,$94.00 , N/A ,$92.00 , N/A ,$91.00 , N/A ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 , N/A , N/A ,$95.00 , N/A , N/A ,$87.00 , N/A ,$90.00 , N/A ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),27203636,N/A,HC TRAY MYELOGRAM,272,1 ,$220.00 ,$165.00 ,$118.80 ,$220.00 ,$141.68 , N/A ,$154.00 , N/A ,$182.60 , N/A ,$145.20 ,$209.00 , N/A ,$176.00 ,$202.40 , N/A ,$187.00 ,$209.00 ,$193.60 ,$167.20 , N/A , N/A , N/A ,$160.60 ,$121.00 ,$200.20 ,$200.20 ,$176.00 , N/A ,$121.00 ,$198.00 , N/A ,$198.00 ,$118.80 ,$206.80 , N/A ,$202.40 , N/A ,$200.20 , N/A ,$135.39 ,$135.39 ,$198.00 ,$164.19 ,$153.23 , N/A , N/A ,$209.00 , N/A , N/A ,$191.40 , N/A ,$198.00 , N/A ,$198.00 ,$198.00 ,$198.00 ,$213.40 ,$178.20 ,$204.60 ,$189.20 ,$213.40 
SACRED HEART HOSPITAL (ACU),27203638,N/A,HC TUBE ENTEROCLYSIS,272,1 ,$835.00 ,$626.25 ,$450.90 ,$835.00 ,$537.74 , N/A ,$584.50 , N/A ,$693.05 , N/A ,$551.10 ,$793.25 , N/A ,$668.00 ,$768.20 , N/A ,$709.75 ,$793.25 ,$734.80 ,$634.60 , N/A , N/A , N/A ,$609.55 ,$459.25 ,$759.85 ,$759.85 ,$668.00 , N/A ,$459.25 ,$751.50 , N/A ,$751.50 ,$450.90 ,$784.90 , N/A ,$768.20 , N/A ,$759.85 , N/A ,$513.86 ,$513.86 ,$751.50 ,$623.16 ,$581.58 , N/A , N/A ,$793.25 , N/A , N/A ,$726.45 , N/A ,$751.50 , N/A ,$751.50 ,$751.50 ,$751.50 ,$809.95 ,$676.35 ,$776.55 ,$718.10 ,$809.95 
SACRED HEART HOSPITAL (ACU),27203641,N/A,HC NEEDLE BIOPSY,272,1 ,$103.00 ,$77.25 ,$55.62 ,$103.00 ,$66.33 , N/A ,$72.10 , N/A ,$85.49 , N/A ,$67.98 ,$97.85 , N/A ,$82.40 ,$94.76 , N/A ,$87.55 ,$97.85 ,$90.64 ,$78.28 , N/A , N/A , N/A ,$75.19 ,$56.65 ,$93.73 ,$93.73 ,$82.40 , N/A ,$56.65 ,$92.70 , N/A ,$92.70 ,$55.62 ,$96.82 , N/A ,$94.76 , N/A ,$93.73 , N/A ,$63.39 ,$63.39 ,$92.70 ,$76.87 ,$71.74 , N/A , N/A ,$97.85 , N/A , N/A ,$89.61 , N/A ,$92.70 , N/A ,$92.70 ,$92.70 ,$92.70 ,$99.91 ,$83.43 ,$95.79 ,$88.58 ,$99.91 
SACRED HEART HOSPITAL (ACU),27203642,N/A,HC PROBE RADIOFREQUENCY,272,1 ,"$2,226.00 ","$1,669.50 ","$1,202.04 ","$2,226.00 ","$1,433.54 ", N/A ,"$1,558.20 ", N/A ,"$1,847.58 ", N/A ,"$1,469.16 ","$2,114.70 ", N/A ,"$1,780.80 ","$2,047.92 ", N/A ,"$1,892.10 ","$2,114.70 ","$1,958.88 ","$1,691.76 ", N/A , N/A , N/A ,"$1,624.98 ","$1,224.30 ","$2,025.66 ","$2,025.66 ","$1,780.80 ", N/A ,"$1,224.30 ","$2,003.40 ", N/A ,"$2,003.40 ","$1,202.04 ","$2,092.44 ", N/A ,"$2,047.92 ", N/A ,"$2,025.66 ", N/A ,"$1,369.88 ","$1,369.88 ","$2,003.40 ","$1,661.26 ","$1,550.41 ", N/A , N/A ,"$2,114.70 ", N/A , N/A ,"$1,936.62 ", N/A ,"$2,003.40 ", N/A ,"$2,003.40 ","$2,003.40 ","$2,003.40 ","$2,159.22 ","$1,803.06 ","$2,070.18 ","$1,914.36 ","$2,159.22 "
SACRED HEART HOSPITAL (ACU),27203643,N/A,HC ELECTRODE ENDO,272,1 ,$224.00 ,$168.00 ,$120.96 ,$224.00 ,$144.26 , N/A ,$156.80 , N/A ,$185.92 , N/A ,$147.84 ,$212.80 , N/A ,$179.20 ,$206.08 , N/A ,$190.40 ,$212.80 ,$197.12 ,$170.24 , N/A , N/A , N/A ,$163.52 ,$123.20 ,$203.84 ,$203.84 ,$179.20 , N/A ,$123.20 ,$201.60 , N/A ,$201.60 ,$120.96 ,$210.56 , N/A ,$206.08 , N/A ,$203.84 , N/A ,$137.85 ,$137.85 ,$201.60 ,$167.17 ,$156.02 , N/A , N/A ,$212.80 , N/A , N/A ,$194.88 , N/A ,$201.60 , N/A ,$201.60 ,$201.60 ,$201.60 ,$217.28 ,$181.44 ,$208.32 ,$192.64 ,$217.28 
SACRED HEART HOSPITAL (ACU),27203644,N/A,HC PROBE STIMULATOR PRASS,272,1 ,$479.00 ,$359.25 ,$258.66 ,$479.00 ,$308.48 , N/A ,$335.30 , N/A ,$397.57 , N/A ,$316.14 ,$455.05 , N/A ,$383.20 ,$440.68 , N/A ,$407.15 ,$455.05 ,$421.52 ,$364.04 , N/A , N/A , N/A ,$349.67 ,$263.45 ,$435.89 ,$435.89 ,$383.20 , N/A ,$263.45 ,$431.10 , N/A ,$431.10 ,$258.66 ,$450.26 , N/A ,$440.68 , N/A ,$435.89 , N/A ,$294.78 ,$294.78 ,$431.10 ,$357.48 ,$333.62 , N/A , N/A ,$455.05 , N/A , N/A ,$416.73 , N/A ,$431.10 , N/A ,$431.10 ,$431.10 ,$431.10 ,$464.63 ,$387.99 ,$445.47 ,$411.94 ,$464.63 
SACRED HEART HOSPITAL (ACU),27203646,C1769,HC GUIDEWIRE FRACTIONAL FLOW RESERVE (FFR),272,1 ,"$3,301.00 ","$2,475.75 ","$1,782.54 ","$3,301.00 ","$2,125.84 ", N/A ,"$2,310.70 ", N/A ,"$2,739.83 ", N/A ,"$2,178.66 ","$3,135.95 ", N/A ,"$2,640.80 ","$3,036.92 ", N/A ,"$2,805.85 ","$3,135.95 ","$2,904.88 ","$2,508.76 ", N/A , N/A , N/A ,"$2,409.73 ","$1,815.55 ","$3,003.91 ","$3,003.91 ","$2,640.80 ", N/A ,"$1,815.55 ","$2,970.90 ", N/A ,"$2,970.90 ","$1,782.54 ","$3,102.94 ", N/A ,"$3,036.92 ", N/A ,"$3,003.91 ", N/A ,"$2,031.44 ","$2,031.44 ","$2,970.90 ","$2,463.54 ","$2,299.15 ", N/A , N/A ,"$3,135.95 ", N/A , N/A ,"$2,871.87 ", N/A ,"$2,970.90 ", N/A ,"$2,970.90 ","$2,970.90 ","$2,970.90 ","$3,201.97 ","$2,673.81 ","$3,069.93 ","$2,838.86 ","$3,201.97 "
SACRED HEART HOSPITAL (ACU),27203647,N/A,HC CATHETER AORTIC BALLOON PUMP,272,1 ,"$2,544.00 ","$1,908.00 ","$1,373.76 ","$2,544.00 ","$1,638.34 ", N/A ,"$1,780.80 ", N/A ,"$2,111.52 ", N/A ,"$1,679.04 ","$2,416.80 ", N/A ,"$2,035.20 ","$2,340.48 ", N/A ,"$2,162.40 ","$2,416.80 ","$2,238.72 ","$1,933.44 ", N/A , N/A , N/A ,"$1,857.12 ","$1,399.20 ","$2,315.04 ","$2,315.04 ","$2,035.20 ", N/A ,"$1,399.20 ","$2,289.60 ", N/A ,"$2,289.60 ","$1,373.76 ","$2,391.36 ", N/A ,"$2,340.48 ", N/A ,"$2,315.04 ", N/A ,"$1,565.58 ","$1,565.58 ","$2,289.60 ","$1,898.59 ","$1,771.90 ", N/A , N/A ,"$2,416.80 ", N/A , N/A ,"$2,213.28 ", N/A ,"$2,289.60 ", N/A ,"$2,289.60 ","$2,289.60 ","$2,289.60 ","$2,467.68 ","$2,060.64 ","$2,365.92 ","$2,187.84 ","$2,467.68 "
SACRED HEART HOSPITAL (ACU),27203648,N/A,HC CATHETER DIAGNOSTIC,272,1 ,$115.00 ,$86.25 ,$62.10 ,$115.00 ,$74.06 , N/A ,$80.50 , N/A ,$95.45 , N/A ,$75.90 ,$109.25 , N/A ,$92.00 ,$105.80 , N/A ,$97.75 ,$109.25 ,$101.20 ,$87.40 , N/A , N/A , N/A ,$83.95 ,$63.25 ,$104.65 ,$104.65 ,$92.00 , N/A ,$63.25 ,$103.50 , N/A ,$103.50 ,$62.10 ,$108.10 , N/A ,$105.80 , N/A ,$104.65 , N/A ,$70.77 ,$70.77 ,$103.50 ,$85.82 ,$80.10 , N/A , N/A ,$109.25 , N/A , N/A ,$100.05 , N/A ,$103.50 , N/A ,$103.50 ,$103.50 ,$103.50 ,$111.55 ,$93.15 ,$106.95 ,$98.90 ,$111.55 
SACRED HEART HOSPITAL (ACU),27203649,C1725,HC BALLOON CATHETER,272,1 ,"$1,676.00 ","$1,257.00 ",$905.04 ,"$1,676.00 ","$1,079.34 ", N/A ,"$1,173.20 ", N/A ,"$1,391.08 ", N/A ,"$1,106.16 ","$1,592.20 ", N/A ,"$1,340.80 ","$1,541.92 ", N/A ,"$1,424.60 ","$1,592.20 ","$1,474.88 ","$1,273.76 ", N/A , N/A , N/A ,"$1,223.48 ",$921.80 ,"$1,525.16 ","$1,525.16 ","$1,340.80 ", N/A ,$921.80 ,"$1,508.40 ", N/A ,"$1,508.40 ",$905.04 ,"$1,575.44 ", N/A ,"$1,541.92 ", N/A ,"$1,525.16 ", N/A ,"$1,031.41 ","$1,031.41 ","$1,508.40 ","$1,250.80 ","$1,167.33 ", N/A , N/A ,"$1,592.20 ", N/A , N/A ,"$1,458.12 ", N/A ,"$1,508.40 ", N/A ,"$1,508.40 ","$1,508.40 ","$1,508.40 ","$1,625.72 ","$1,357.56 ","$1,558.68 ","$1,441.36 ","$1,625.72 "
SACRED HEART HOSPITAL (ACU),27203650,N/A,HC CATHETER ASPIRATION EXPORT,272,1 ,"$2,519.00 ","$1,889.25 ","$1,360.26 ","$2,519.00 ","$1,622.24 ", N/A ,"$1,763.30 ", N/A ,"$2,090.77 ", N/A ,"$1,662.54 ","$2,393.05 ", N/A ,"$2,015.20 ","$2,317.48 ", N/A ,"$2,141.15 ","$2,393.05 ","$2,216.72 ","$1,914.44 ", N/A , N/A , N/A ,"$1,838.87 ","$1,385.45 ","$2,292.29 ","$2,292.29 ","$2,015.20 ", N/A ,"$1,385.45 ","$2,267.10 ", N/A ,"$2,267.10 ","$1,360.26 ","$2,367.86 ", N/A ,"$2,317.48 ", N/A ,"$2,292.29 ", N/A ,"$1,550.19 ","$1,550.19 ","$2,267.10 ","$1,879.93 ","$1,754.48 ", N/A , N/A ,"$2,393.05 ", N/A , N/A ,"$2,191.53 ", N/A ,"$2,267.10 ", N/A ,"$2,267.10 ","$2,267.10 ","$2,267.10 ","$2,443.43 ","$2,040.39 ","$2,342.67 ","$2,166.34 ","$2,443.43 "
SACRED HEART HOSPITAL (ACU),27203651,N/A,HC FEMOSTOP COMPRESSION DEVICE,272,1 ,$351.00 ,$263.25 ,$189.54 ,$351.00 ,$226.04 , N/A ,$245.70 , N/A ,$291.33 , N/A ,$231.66 ,$333.45 , N/A ,$280.80 ,$322.92 , N/A ,$298.35 ,$333.45 ,$308.88 ,$266.76 , N/A , N/A , N/A ,$256.23 ,$193.05 ,$319.41 ,$319.41 ,$280.80 , N/A ,$193.05 ,$315.90 , N/A ,$315.90 ,$189.54 ,$329.94 , N/A ,$322.92 , N/A ,$319.41 , N/A ,$216.01 ,$216.01 ,$315.90 ,$261.95 ,$244.47 , N/A , N/A ,$333.45 , N/A , N/A ,$305.37 , N/A ,$315.90 , N/A ,$315.90 ,$315.90 ,$315.90 ,$340.47 ,$284.31 ,$326.43 ,$301.86 ,$340.47 
SACRED HEART HOSPITAL (ACU),27203652,C1887,HC CATHETER CARDIAC CATH-GUIDE,272,1 ,$342.00 ,$256.50 ,$184.68 ,$342.00 ,$220.25 , N/A ,$239.40 , N/A ,$283.86 , N/A ,$225.72 ,$324.90 , N/A ,$273.60 ,$314.64 , N/A ,$290.70 ,$324.90 ,$300.96 ,$259.92 , N/A , N/A , N/A ,$249.66 ,$188.10 ,$311.22 ,$311.22 ,$273.60 , N/A ,$188.10 ,$307.80 , N/A ,$307.80 ,$184.68 ,$321.48 , N/A ,$314.64 , N/A ,$311.22 , N/A ,$210.47 ,$210.47 ,$307.80 ,$255.23 ,$238.20 , N/A , N/A ,$324.90 , N/A , N/A ,$297.54 , N/A ,$307.80 , N/A ,$307.80 ,$307.80 ,$307.80 ,$331.74 ,$277.02 ,$318.06 ,$294.12 ,$331.74 
SACRED HEART HOSPITAL (ACU),27203653,N/A,HC CATHETER PIGTAIL DUAL LUMEN,272,1 ,$542.00 ,$406.50 ,$292.68 ,$542.00 ,$349.05 , N/A ,$379.40 , N/A ,$449.86 , N/A ,$357.72 ,$514.90 , N/A ,$433.60 ,$498.64 , N/A ,$460.70 ,$514.90 ,$476.96 ,$411.92 , N/A , N/A , N/A ,$395.66 ,$298.10 ,$493.22 ,$493.22 ,$433.60 , N/A ,$298.10 ,$487.80 , N/A ,$487.80 ,$292.68 ,$509.48 , N/A ,$498.64 , N/A ,$493.22 , N/A ,$333.55 ,$333.55 ,$487.80 ,$404.49 ,$377.50 , N/A , N/A ,$514.90 , N/A , N/A ,$471.54 , N/A ,$487.80 , N/A ,$487.80 ,$487.80 ,$487.80 ,$525.74 ,$439.02 ,$504.06 ,$466.12 ,$525.74 
SACRED HEART HOSPITAL (ACU),27203654,N/A,HC CATHETER SWAN GANZ,272,1 ,$449.00 ,$336.75 ,$242.46 ,$449.00 ,$289.16 , N/A ,$314.30 , N/A ,$372.67 , N/A ,$296.34 ,$426.55 , N/A ,$359.20 ,$413.08 , N/A ,$381.65 ,$426.55 ,$395.12 ,$341.24 , N/A , N/A , N/A ,$327.77 ,$246.95 ,$408.59 ,$408.59 ,$359.20 , N/A ,$246.95 ,$404.10 , N/A ,$404.10 ,$242.46 ,$422.06 , N/A ,$413.08 , N/A ,$408.59 , N/A ,$276.31 ,$276.31 ,$404.10 ,$335.09 ,$312.73 , N/A , N/A ,$426.55 , N/A , N/A ,$390.63 , N/A ,$404.10 , N/A ,$404.10 ,$404.10 ,$404.10 ,$435.53 ,$363.69 ,$417.57 ,$386.14 ,$435.53 
SACRED HEART HOSPITAL (ACU),27203655,N/A,HC CATHETER SWAN GANZ THERMODIULTION,272,1 ,$197.00 ,$147.75 ,$106.38 ,$197.00 ,$126.87 , N/A ,$137.90 , N/A ,$163.51 , N/A ,$130.02 ,$187.15 , N/A ,$157.60 ,$181.24 , N/A ,$167.45 ,$187.15 ,$173.36 ,$149.72 , N/A , N/A , N/A ,$143.81 ,$108.35 ,$179.27 ,$179.27 ,$157.60 , N/A ,$108.35 ,$177.30 , N/A ,$177.30 ,$106.38 ,$185.18 , N/A ,$181.24 , N/A ,$179.27 , N/A ,$121.23 ,$121.23 ,$177.30 ,$147.02 ,$137.21 , N/A , N/A ,$187.15 , N/A , N/A ,$171.39 , N/A ,$177.30 , N/A ,$177.30 ,$177.30 ,$177.30 ,$191.09 ,$159.57 ,$183.21 ,$169.42 ,$191.09 
SACRED HEART HOSPITAL (ACU),27203656,C1725,HC BALLOON CUTTING DEVICE,272,1 ,"$1,932.00 ","$1,449.00 ","$1,043.28 ","$1,932.00 ","$1,244.21 ", N/A ,"$1,352.40 ", N/A ,"$1,603.56 ", N/A ,"$1,275.12 ","$1,835.40 ", N/A ,"$1,545.60 ","$1,777.44 ", N/A ,"$1,642.20 ","$1,835.40 ","$1,700.16 ","$1,468.32 ", N/A , N/A , N/A ,"$1,410.36 ","$1,062.60 ","$1,758.12 ","$1,758.12 ","$1,545.60 ", N/A ,"$1,062.60 ","$1,738.80 ", N/A ,"$1,738.80 ","$1,043.28 ","$1,816.08 ", N/A ,"$1,777.44 ", N/A ,"$1,758.12 ", N/A ,"$1,188.95 ","$1,188.95 ","$1,738.80 ","$1,441.85 ","$1,345.64 ", N/A , N/A ,"$1,835.40 ", N/A , N/A ,"$1,680.84 ", N/A ,"$1,738.80 ", N/A ,"$1,738.80 ","$1,738.80 ","$1,738.80 ","$1,874.04 ","$1,564.92 ","$1,796.76 ","$1,661.52 ","$1,874.04 "
SACRED HEART HOSPITAL (ACU),27203657,C1769,HC GUIDEWIRE,272,1 ,$63.00 ,$47.25 ,$34.02 ,$63.00 ,$40.57 , N/A ,$44.10 , N/A ,$52.29 , N/A ,$41.58 ,$59.85 , N/A ,$50.40 ,$57.96 , N/A ,$53.55 ,$59.85 ,$55.44 ,$47.88 , N/A , N/A , N/A ,$45.99 ,$34.65 ,$57.33 ,$57.33 ,$50.40 , N/A ,$34.65 ,$56.70 , N/A ,$56.70 ,$34.02 ,$59.22 , N/A ,$57.96 , N/A ,$57.33 , N/A ,$38.77 ,$38.77 ,$56.70 ,$47.02 ,$43.88 , N/A , N/A ,$59.85 , N/A , N/A ,$54.81 , N/A ,$56.70 , N/A ,$56.70 ,$56.70 ,$56.70 ,$61.11 ,$51.03 ,$58.59 ,$54.18 ,$61.11 
SACRED HEART HOSPITAL (ACU),27203658,C1769,HC GUIDEWIRE GLIDEWIRE,272,1 ,$141.00 ,$105.75 ,$76.14 ,$141.00 ,$90.80 , N/A ,$98.70 , N/A ,$117.03 , N/A ,$93.06 ,$133.95 , N/A ,$112.80 ,$129.72 , N/A ,$119.85 ,$133.95 ,$124.08 ,$107.16 , N/A , N/A , N/A ,$102.93 ,$77.55 ,$128.31 ,$128.31 ,$112.80 , N/A ,$77.55 ,$126.90 , N/A ,$126.90 ,$76.14 ,$132.54 , N/A ,$129.72 , N/A ,$128.31 , N/A ,$86.77 ,$86.77 ,$126.90 ,$105.23 ,$98.21 , N/A , N/A ,$133.95 , N/A , N/A ,$122.67 , N/A ,$126.90 , N/A ,$126.90 ,$126.90 ,$126.90 ,$136.77 ,$114.21 ,$131.13 ,$121.26 ,$136.77 
SACRED HEART HOSPITAL (ACU),27203660,C1894,HC INTRODUCER SHEATH PACEMAKER,272,1 ,$296.00 ,$222.00 ,$159.84 ,$296.00 ,$190.62 , N/A ,$207.20 , N/A ,$245.68 , N/A ,$195.36 ,$281.20 , N/A ,$236.80 ,$272.32 , N/A ,$251.60 ,$281.20 ,$260.48 ,$224.96 , N/A , N/A , N/A ,$216.08 ,$162.80 ,$269.36 ,$269.36 ,$236.80 , N/A ,$162.80 ,$266.40 , N/A ,$266.40 ,$159.84 ,$278.24 , N/A ,$272.32 , N/A ,$269.36 , N/A ,$182.16 ,$182.16 ,$266.40 ,$220.90 ,$206.16 , N/A , N/A ,$281.20 , N/A , N/A ,$257.52 , N/A ,$266.40 , N/A ,$266.40 ,$266.40 ,$266.40 ,$287.12 ,$239.76 ,$275.28 ,$254.56 ,$287.12 
SACRED HEART HOSPITAL (ACU),27203661,N/A,HC SUTURE,272,1 ,$93.00 ,$69.75 ,$50.22 ,$93.00 ,$59.89 , N/A ,$65.10 , N/A ,$77.19 , N/A ,$61.38 ,$88.35 , N/A ,$74.40 ,$85.56 , N/A ,$79.05 ,$88.35 ,$81.84 ,$70.68 , N/A , N/A , N/A ,$67.89 ,$51.15 ,$84.63 ,$84.63 ,$74.40 , N/A ,$51.15 ,$83.70 , N/A ,$83.70 ,$50.22 ,$87.42 , N/A ,$85.56 , N/A ,$84.63 , N/A ,$57.23 ,$57.23 ,$83.70 ,$69.41 ,$64.77 , N/A , N/A ,$88.35 , N/A , N/A ,$80.91 , N/A ,$83.70 , N/A ,$83.70 ,$83.70 ,$83.70 ,$90.21 ,$75.33 ,$86.49 ,$79.98 ,$90.21 
SACRED HEART HOSPITAL (ACU),27203662,N/A,HC SUTURE MULTIPACK,272,1 ,$271.00 ,$203.25 ,$146.34 ,$271.00 ,$174.52 , N/A ,$189.70 , N/A ,$224.93 , N/A ,$178.86 ,$257.45 , N/A ,$216.80 ,$249.32 , N/A ,$230.35 ,$257.45 ,$238.48 ,$205.96 , N/A , N/A , N/A ,$197.83 ,$149.05 ,$246.61 ,$246.61 ,$216.80 , N/A ,$149.05 ,$243.90 , N/A ,$243.90 ,$146.34 ,$254.74 , N/A ,$249.32 , N/A ,$246.61 , N/A ,$166.77 ,$166.77 ,$243.90 ,$202.25 ,$188.75 , N/A , N/A ,$257.45 , N/A , N/A ,$235.77 , N/A ,$243.90 , N/A ,$243.90 ,$243.90 ,$243.90 ,$262.87 ,$219.51 ,$252.03 ,$233.06 ,$262.87 
SACRED HEART HOSPITAL (ACU),27203663,C1884,HC FILTER WIRE,272,1 ,"$2,957.00 ","$2,217.75 ","$1,596.78 ","$2,957.00 ","$1,904.31 ", N/A ,"$2,069.90 ", N/A ,"$2,454.31 ", N/A ,"$1,951.62 ","$2,809.15 ", N/A ,"$2,365.60 ","$2,720.44 ", N/A ,"$2,513.45 ","$2,809.15 ","$2,602.16 ","$2,247.32 ", N/A , N/A , N/A ,"$2,158.61 ","$1,626.35 ","$2,690.87 ","$2,690.87 ","$2,365.60 ", N/A ,"$1,626.35 ","$2,661.30 ", N/A ,"$2,661.30 ","$1,596.78 ","$2,779.58 ", N/A ,"$2,720.44 ", N/A ,"$2,690.87 ", N/A ,"$1,819.74 ","$1,819.74 ","$2,661.30 ","$2,206.81 ","$2,059.55 ", N/A , N/A ,"$2,809.15 ", N/A , N/A ,"$2,572.59 ", N/A ,"$2,661.30 ", N/A ,"$2,661.30 ","$2,661.30 ","$2,661.30 ","$2,868.29 ","$2,395.17 ","$2,750.01 ","$2,543.02 ","$2,868.29 "
SACRED HEART HOSPITAL (ACU),27203664,N/A,HC WIRE PACEMAKER,278,1 ,"$1,076.00 ",$807.00 ,$581.04 ,"$1,076.00 ",$692.94 , N/A ,$753.20 , N/A ,$893.08 , N/A ,$710.16 ,"$1,022.20 ", N/A ,$860.80 ,$989.92 , N/A ,$914.60 ,"$1,022.20 ",$946.88 ,$817.76 , N/A , N/A , N/A ,$785.48 ,$591.80 ,$979.16 ,$979.16 ,$860.80 , N/A ,$591.80 ,$968.40 , N/A ,$968.40 ,$581.04 ,"$1,011.44 ", N/A ,$989.92 , N/A ,$979.16 , N/A ,$662.17 ,$662.17 ,$968.40 ,$803.02 , N/A , N/A , N/A ,"$1,022.20 ", N/A , N/A ,$936.12 , N/A ,$968.40 , N/A ,$968.40 ,$968.40 ,$968.40 ,"$1,043.72 ",$871.56 ,"$1,000.68 ",$925.36 ,"$1,043.72 "
SACRED HEART HOSPITAL (ACU),27203665,C1724,HC ROTATIONAL ADVANCER ATHERECTOMY,272,1 ,"$3,253.00 ","$2,439.75 ","$1,756.62 ","$3,253.00 ","$2,094.93 ", N/A ,"$2,277.10 ", N/A ,"$2,699.99 ", N/A ,"$2,146.98 ","$3,090.35 ", N/A ,"$2,602.40 ","$2,992.76 ", N/A ,"$2,765.05 ","$3,090.35 ","$2,862.64 ","$2,472.28 ", N/A , N/A , N/A ,"$2,374.69 ","$1,789.15 ","$2,960.23 ","$2,960.23 ","$2,602.40 ", N/A ,"$1,789.15 ","$2,927.70 ", N/A ,"$2,927.70 ","$1,756.62 ","$3,057.82 ", N/A ,"$2,992.76 ", N/A ,"$2,960.23 ", N/A ,"$2,001.90 ","$2,001.90 ","$2,927.70 ","$2,427.71 ","$2,265.71 ", N/A , N/A ,"$3,090.35 ", N/A , N/A ,"$2,830.11 ", N/A ,"$2,927.70 ", N/A ,"$2,927.70 ","$2,927.70 ","$2,927.70 ","$3,155.41 ","$2,634.93 ","$3,025.29 ","$2,797.58 ","$3,155.41 "
SACRED HEART HOSPITAL (ACU),27203666,C1753,HC CATHETER IVUS,272,1 ,"$2,120.00 ","$1,590.00 ","$1,144.80 ","$2,120.00 ","$1,365.28 ", N/A ,"$1,484.00 ", N/A ,"$1,759.60 ", N/A ,"$1,399.20 ","$2,014.00 ", N/A ,"$1,696.00 ","$1,950.40 ", N/A ,"$1,802.00 ","$2,014.00 ","$1,865.60 ","$1,611.20 ", N/A , N/A , N/A ,"$1,547.60 ","$1,166.00 ","$1,929.20 ","$1,929.20 ","$1,696.00 ", N/A ,"$1,166.00 ","$1,908.00 ", N/A ,"$1,908.00 ","$1,144.80 ","$1,992.80 ", N/A ,"$1,950.40 ", N/A ,"$1,929.20 ", N/A ,"$1,304.65 ","$1,304.65 ","$1,908.00 ","$1,582.16 ","$1,476.58 ", N/A , N/A ,"$2,014.00 ", N/A , N/A ,"$1,844.40 ", N/A ,"$1,908.00 ", N/A ,"$1,908.00 ","$1,908.00 ","$1,908.00 ","$2,056.40 ","$1,717.20 ","$1,971.60 ","$1,823.20 ","$2,056.40 "
SACRED HEART HOSPITAL (ACU),27203667,C1725,HC CATHETER BALLOON CORONARY,272,1 ,"$1,402.00 ","$1,051.50 ",$757.08 ,"$1,402.00 ",$902.89 , N/A ,$981.40 , N/A ,"$1,163.66 ", N/A ,$925.32 ,"$1,331.90 ", N/A ,"$1,121.60 ","$1,289.84 ", N/A ,"$1,191.70 ","$1,331.90 ","$1,233.76 ","$1,065.52 ", N/A , N/A , N/A ,"$1,023.46 ",$771.10 ,"$1,275.82 ","$1,275.82 ","$1,121.60 ", N/A ,$771.10 ,"$1,261.80 ", N/A ,"$1,261.80 ",$757.08 ,"$1,317.88 ", N/A ,"$1,289.84 ", N/A ,"$1,275.82 ", N/A ,$862.79 ,$862.79 ,"$1,261.80 ","$1,046.31 ",$976.49 , N/A , N/A ,"$1,331.90 ", N/A , N/A ,"$1,219.74 ", N/A ,"$1,261.80 ", N/A ,"$1,261.80 ","$1,261.80 ","$1,261.80 ","$1,359.94 ","$1,135.62 ","$1,303.86 ","$1,205.72 ","$1,359.94 "
SACRED HEART HOSPITAL (ACU),27203668,C1725,HC CATHETER BALLOON PERIPHERAL,272,1 ,$970.00 ,$727.50 ,$523.80 ,$970.00 ,$624.68 , N/A ,$679.00 , N/A ,$805.10 , N/A ,$640.20 ,$921.50 , N/A ,$776.00 ,$892.40 , N/A ,$824.50 ,$921.50 ,$853.60 ,$737.20 , N/A , N/A , N/A ,$708.10 ,$533.50 ,$882.70 ,$882.70 ,$776.00 , N/A ,$533.50 ,$873.00 , N/A ,$873.00 ,$523.80 ,$911.80 , N/A ,$892.40 , N/A ,$882.70 , N/A ,$596.94 ,$596.94 ,$873.00 ,$723.91 ,$675.61 , N/A , N/A ,$921.50 , N/A , N/A ,$843.90 , N/A ,$873.00 , N/A ,$873.00 ,$873.00 ,$873.00 ,$940.90 ,$785.70 ,$902.10 ,$834.20 ,$940.90 
SACRED HEART HOSPITAL (ACU),27203669,N/A,HC BALLOON CUTTING PERIPHERAL,272,1 ,"$1,928.00 ","$1,446.00 ","$1,041.12 ","$1,928.00 ","$1,241.63 ", N/A ,"$1,349.60 ", N/A ,"$1,600.24 ", N/A ,"$1,272.48 ","$1,831.60 ", N/A ,"$1,542.40 ","$1,773.76 ", N/A ,"$1,638.80 ","$1,831.60 ","$1,696.64 ","$1,465.28 ", N/A , N/A , N/A ,"$1,407.44 ","$1,060.40 ","$1,754.48 ","$1,754.48 ","$1,542.40 ", N/A ,"$1,060.40 ","$1,735.20 ", N/A ,"$1,735.20 ","$1,041.12 ","$1,812.32 ", N/A ,"$1,773.76 ", N/A ,"$1,754.48 ", N/A ,"$1,186.49 ","$1,186.49 ","$1,735.20 ","$1,438.87 ","$1,342.85 ", N/A , N/A ,"$1,831.60 ", N/A , N/A ,"$1,677.36 ", N/A ,"$1,735.20 ", N/A ,"$1,735.20 ","$1,735.20 ","$1,735.20 ","$1,870.16 ","$1,561.68 ","$1,793.04 ","$1,658.08 ","$1,870.16 "
SACRED HEART HOSPITAL (ACU),27203670,N/A,HC GUIDEWIRE ROTATIONAL ATHERECTOMY,272,1 ,$527.00 ,$395.25 ,$284.58 ,$527.00 ,$339.39 , N/A ,$368.90 , N/A ,$437.41 , N/A ,$347.82 ,$500.65 , N/A ,$421.60 ,$484.84 , N/A ,$447.95 ,$500.65 ,$463.76 ,$400.52 , N/A , N/A , N/A ,$384.71 ,$289.85 ,$479.57 ,$479.57 ,$421.60 , N/A ,$289.85 ,$474.30 , N/A ,$474.30 ,$284.58 ,$495.38 , N/A ,$484.84 , N/A ,$479.57 , N/A ,$324.32 ,$324.32 ,$474.30 ,$393.30 ,$367.06 , N/A , N/A ,$500.65 , N/A , N/A ,$458.49 , N/A ,$474.30 , N/A ,$474.30 ,$474.30 ,$474.30 ,$511.19 ,$426.87 ,$490.11 ,$453.22 ,$511.19 
SACRED HEART HOSPITAL (ACU),27203671,N/A,HC LEAD CRT,272,1 ,"$3,757.00 ","$2,817.75 ","$2,028.78 ","$3,757.00 ","$2,419.51 ", N/A ,"$2,629.90 ", N/A ,"$3,118.31 ", N/A ,"$2,479.62 ","$3,569.15 ", N/A ,"$3,005.60 ","$3,456.44 ", N/A ,"$3,193.45 ","$3,569.15 ","$3,306.16 ","$2,855.32 ", N/A , N/A , N/A ,"$2,742.61 ","$2,066.35 ","$3,418.87 ","$3,418.87 ","$3,005.60 ", N/A ,"$2,066.35 ","$3,381.30 ", N/A ,"$3,381.30 ","$2,028.78 ","$3,531.58 ", N/A ,"$3,456.44 ", N/A ,"$3,418.87 ", N/A ,"$2,312.06 ","$2,312.06 ","$3,381.30 ","$2,803.85 ","$2,616.75 ", N/A , N/A ,"$3,569.15 ", N/A , N/A ,"$3,268.59 ", N/A ,"$3,381.30 ", N/A ,"$3,381.30 ","$3,381.30 ","$3,381.30 ","$3,644.29 ","$3,043.17 ","$3,494.01 ","$3,231.02 ","$3,644.29 "
SACRED HEART HOSPITAL (ACU),27203672,N/A,HC ARTHERECTOMY DEVICE PERIPHERAL,272,1 ,"$6,694.00 ","$5,020.50 ","$3,614.76 ","$6,694.00 ","$4,310.94 ", N/A ,"$4,685.80 ", N/A ,"$5,556.02 ", N/A ,"$4,418.04 ","$6,359.30 ", N/A ,"$5,355.20 ","$6,158.48 ", N/A ,"$5,689.90 ","$6,359.30 ","$5,890.72 ","$5,087.44 ", N/A , N/A , N/A ,"$4,886.62 ","$3,681.70 ","$6,091.54 ","$6,091.54 ","$5,355.20 ", N/A ,"$3,681.70 ","$6,024.60 ", N/A ,"$6,024.60 ","$3,614.76 ","$6,292.36 ", N/A ,"$6,158.48 ", N/A ,"$6,091.54 ", N/A ,"$4,119.49 ","$4,119.49 ","$6,024.60 ","$4,995.73 ","$4,662.37 ", N/A , N/A ,"$6,359.30 ", N/A , N/A ,"$5,823.78 ", N/A ,"$6,024.60 ", N/A ,"$6,024.60 ","$6,024.60 ","$6,024.60 ","$6,493.18 ","$5,422.14 ","$6,225.42 ","$5,756.84 ","$6,493.18 "
SACRED HEART HOSPITAL (ACU),27203673,C1887,HC CATHETER GUIDELINER,272,1 ,"$1,385.00 ","$1,038.75 ",$747.90 ,"$1,385.00 ",$891.94 , N/A ,$969.50 , N/A ,"$1,149.55 ", N/A ,$914.10 ,"$1,315.75 ", N/A ,"$1,108.00 ","$1,274.20 ", N/A ,"$1,177.25 ","$1,315.75 ","$1,218.80 ","$1,052.60 ", N/A , N/A , N/A ,"$1,011.05 ",$761.75 ,"$1,260.35 ","$1,260.35 ","$1,108.00 ", N/A ,$761.75 ,"$1,246.50 ", N/A ,"$1,246.50 ",$747.90 ,"$1,301.90 ", N/A ,"$1,274.20 ", N/A ,"$1,260.35 ", N/A ,$852.33 ,$852.33 ,"$1,246.50 ","$1,033.63 ",$964.65 , N/A , N/A ,"$1,315.75 ", N/A , N/A ,"$1,204.95 ", N/A ,"$1,246.50 ", N/A ,"$1,246.50 ","$1,246.50 ","$1,246.50 ","$1,343.45 ","$1,121.85 ","$1,288.05 ","$1,191.10 ","$1,343.45 "
SACRED HEART HOSPITAL (ACU),27203674,N/A,HC GUIDEWIRE-EXCHANGE WIRE,272,1 ,$156.00 ,$117.00 ,$84.24 ,$156.00 ,$100.46 , N/A ,$109.20 , N/A ,$129.48 , N/A ,$102.96 ,$148.20 , N/A ,$124.80 ,$143.52 , N/A ,$132.60 ,$148.20 ,$137.28 ,$118.56 , N/A , N/A , N/A ,$113.88 ,$85.80 ,$141.96 ,$141.96 ,$124.80 , N/A ,$85.80 ,$140.40 , N/A ,$140.40 ,$84.24 ,$146.64 , N/A ,$143.52 , N/A ,$141.96 , N/A ,$96.00 ,$96.00 ,$140.40 ,$116.42 ,$108.65 , N/A , N/A ,$148.20 , N/A , N/A ,$135.72 , N/A ,$140.40 , N/A ,$140.40 ,$140.40 ,$140.40 ,$151.32 ,$126.36 ,$145.08 ,$134.16 ,$151.32 
SACRED HEART HOSPITAL (ACU),27203679,C1751,HC CATHETER INFUSION,272,1 ,$574.00 ,$430.50 ,$309.96 ,$574.00 ,$369.66 , N/A ,$401.80 , N/A ,$476.42 , N/A ,$378.84 ,$545.30 , N/A ,$459.20 ,$528.08 , N/A ,$487.90 ,$545.30 ,$505.12 ,$436.24 , N/A , N/A , N/A ,$419.02 ,$315.70 ,$522.34 ,$522.34 ,$459.20 , N/A ,$315.70 ,$516.60 , N/A ,$516.60 ,$309.96 ,$539.56 , N/A ,$528.08 , N/A ,$522.34 , N/A ,$353.24 ,$353.24 ,$516.60 ,$428.38 ,$399.79 , N/A , N/A ,$545.30 , N/A , N/A ,$499.38 , N/A ,$516.60 , N/A ,$516.60 ,$516.60 ,$516.60 ,$556.78 ,$464.94 ,$533.82 ,$493.64 ,$556.78 
SACRED HEART HOSPITAL (ACU),27203680,N/A,HC SET NEEDLE ACCESS,272,1 ,$771.00 ,$578.25 ,$416.34 ,$771.00 ,$496.52 , N/A ,$539.70 , N/A ,$639.93 , N/A ,$508.86 ,$732.45 , N/A ,$616.80 ,$709.32 , N/A ,$655.35 ,$732.45 ,$678.48 ,$585.96 , N/A , N/A , N/A ,$562.83 ,$424.05 ,$701.61 ,$701.61 ,$616.80 , N/A ,$424.05 ,$693.90 , N/A ,$693.90 ,$416.34 ,$724.74 , N/A ,$709.32 , N/A ,$701.61 , N/A ,$474.47 ,$474.47 ,$693.90 ,$575.40 ,$537.00 , N/A , N/A ,$732.45 , N/A , N/A ,$670.77 , N/A ,$693.90 , N/A ,$693.90 ,$693.90 ,$693.90 ,$747.87 ,$624.51 ,$717.03 ,$663.06 ,$747.87 
SACRED HEART HOSPITAL (ACU),27203681,N/A,HC NEEDLE BIOPSY COAXIAL BONE,272,1 ,$404.00 ,$303.00 ,$218.16 ,$404.00 ,$260.18 , N/A ,$282.80 , N/A ,$335.32 , N/A ,$266.64 ,$383.80 , N/A ,$323.20 ,$371.68 , N/A ,$343.40 ,$383.80 ,$355.52 ,$307.04 , N/A , N/A , N/A ,$294.92 ,$222.20 ,$367.64 ,$367.64 ,$323.20 , N/A ,$222.20 ,$363.60 , N/A ,$363.60 ,$218.16 ,$379.76 , N/A ,$371.68 , N/A ,$367.64 , N/A ,$248.62 ,$248.62 ,$363.60 ,$301.51 ,$281.39 , N/A , N/A ,$383.80 , N/A , N/A ,$351.48 , N/A ,$363.60 , N/A ,$363.60 ,$363.60 ,$363.60 ,$391.88 ,$327.24 ,$375.72 ,$347.44 ,$391.88 
SACRED HEART HOSPITAL (ACU),27203682,N/A,HC CATHETER REPERFUSION MAX,272,1 ,"$2,624.00 ","$1,968.00 ","$1,416.96 ","$2,624.00 ","$1,689.86 ", N/A ,"$1,836.80 ", N/A ,"$2,177.92 ", N/A ,"$1,731.84 ","$2,492.80 ", N/A ,"$2,099.20 ","$2,414.08 ", N/A ,"$2,230.40 ","$2,492.80 ","$2,309.12 ","$1,994.24 ", N/A , N/A , N/A ,"$1,915.52 ","$1,443.20 ","$2,387.84 ","$2,387.84 ","$2,099.20 ", N/A ,"$1,443.20 ","$2,361.60 ", N/A ,"$2,361.60 ","$1,416.96 ","$2,466.56 ", N/A ,"$2,414.08 ", N/A ,"$2,387.84 ", N/A ,"$1,614.81 ","$1,614.81 ","$2,361.60 ","$1,958.29 ","$1,827.62 ", N/A , N/A ,"$2,492.80 ", N/A , N/A ,"$2,282.88 ", N/A ,"$2,361.60 ", N/A ,"$2,361.60 ","$2,361.60 ","$2,361.60 ","$2,545.28 ","$2,125.44 ","$2,440.32 ","$2,256.64 ","$2,545.28 "
SACRED HEART HOSPITAL (ACU),27203683,N/A,HC CATHETER REPERFUSION ACE,272,1 ,"$3,904.00 ","$2,928.00 ","$2,108.16 ","$3,904.00 ","$2,514.18 ", N/A ,"$2,732.80 ", N/A ,"$3,240.32 ", N/A ,"$2,576.64 ","$3,708.80 ", N/A ,"$3,123.20 ","$3,591.68 ", N/A ,"$3,318.40 ","$3,708.80 ","$3,435.52 ","$2,967.04 ", N/A , N/A , N/A ,"$2,849.92 ","$2,147.20 ","$3,552.64 ","$3,552.64 ","$3,123.20 ", N/A ,"$2,147.20 ","$3,513.60 ", N/A ,"$3,513.60 ","$2,108.16 ","$3,669.76 ", N/A ,"$3,591.68 ", N/A ,"$3,552.64 ", N/A ,"$2,402.52 ","$2,402.52 ","$3,513.60 ","$2,913.56 ","$2,719.14 ", N/A , N/A ,"$3,708.80 ", N/A , N/A ,"$3,396.48 ", N/A ,"$3,513.60 ", N/A ,"$3,513.60 ","$3,513.60 ","$3,513.60 ","$3,786.88 ","$3,162.24 ","$3,630.72 ","$3,357.44 ","$3,786.88 "
SACRED HEART HOSPITAL (ACU),27203685,C1725,HC CATHETER BALLOON ANGIO,272,1 ,"$1,835.00 ","$1,376.25 ",$990.90 ,"$1,835.00 ","$1,181.74 ", N/A ,"$1,284.50 ", N/A ,"$1,523.05 ", N/A ,"$1,211.10 ","$1,743.25 ", N/A ,"$1,468.00 ","$1,688.20 ", N/A ,"$1,559.75 ","$1,743.25 ","$1,614.80 ","$1,394.60 ", N/A , N/A , N/A ,"$1,339.55 ","$1,009.25 ","$1,669.85 ","$1,669.85 ","$1,468.00 ", N/A ,"$1,009.25 ","$1,651.50 ", N/A ,"$1,651.50 ",$990.90 ,"$1,724.90 ", N/A ,"$1,688.20 ", N/A ,"$1,669.85 ", N/A ,"$1,129.26 ","$1,129.26 ","$1,651.50 ","$1,369.46 ","$1,278.08 ", N/A , N/A ,"$1,743.25 ", N/A , N/A ,"$1,596.45 ", N/A ,"$1,651.50 ", N/A ,"$1,651.50 ","$1,651.50 ","$1,651.50 ","$1,779.95 ","$1,486.35 ","$1,706.55 ","$1,578.10 ","$1,779.95 "
SACRED HEART HOSPITAL (ACU),27203686,N/A,HC CATHETER GLIDECATH,272,1 ,$329.00 ,$246.75 ,$177.66 ,$329.00 ,$211.88 , N/A ,$230.30 , N/A ,$273.07 , N/A ,$217.14 ,$312.55 , N/A ,$263.20 ,$302.68 , N/A ,$279.65 ,$312.55 ,$289.52 ,$250.04 , N/A , N/A , N/A ,$240.17 ,$180.95 ,$299.39 ,$299.39 ,$263.20 , N/A ,$180.95 ,$296.10 , N/A ,$296.10 ,$177.66 ,$309.26 , N/A ,$302.68 , N/A ,$299.39 , N/A ,$202.47 ,$202.47 ,$296.10 ,$245.53 ,$229.15 , N/A , N/A ,$312.55 , N/A , N/A ,$286.23 , N/A ,$296.10 , N/A ,$296.10 ,$296.10 ,$296.10 ,$319.13 ,$266.49 ,$305.97 ,$282.94 ,$319.13 
SACRED HEART HOSPITAL (ACU),27203687,N/A,HC CATHETER BILIARY,272,1 ,$686.00 ,$514.50 ,$370.44 ,$686.00 ,$441.78 , N/A ,$480.20 , N/A ,$569.38 , N/A ,$452.76 ,$651.70 , N/A ,$548.80 ,$631.12 , N/A ,$583.10 ,$651.70 ,$603.68 ,$521.36 , N/A , N/A , N/A ,$500.78 ,$377.30 ,$624.26 ,$624.26 ,$548.80 , N/A ,$377.30 ,$617.40 , N/A ,$617.40 ,$370.44 ,$644.84 , N/A ,$631.12 , N/A ,$624.26 , N/A ,$422.16 ,$422.16 ,$617.40 ,$511.96 ,$477.80 , N/A , N/A ,$651.70 , N/A , N/A ,$596.82 , N/A ,$617.40 , N/A ,$617.40 ,$617.40 ,$617.40 ,$665.42 ,$555.66 ,$637.98 ,$589.96 ,$665.42 
SACRED HEART HOSPITAL (ACU),27203688,N/A,HC COIL PUSHER,272,1 ,"$1,167.00 ",$875.25 ,$630.18 ,"$1,167.00 ",$751.55 , N/A ,$816.90 , N/A ,$968.61 , N/A ,$770.22 ,"$1,108.65 ", N/A ,$933.60 ,"$1,073.64 ", N/A ,$991.95 ,"$1,108.65 ","$1,026.96 ",$886.92 , N/A , N/A , N/A ,$851.91 ,$641.85 ,"$1,061.97 ","$1,061.97 ",$933.60 , N/A ,$641.85 ,"$1,050.30 ", N/A ,"$1,050.30 ",$630.18 ,"$1,096.98 ", N/A ,"$1,073.64 ", N/A ,"$1,061.97 ", N/A ,$718.17 ,$718.17 ,"$1,050.30 ",$870.93 ,$812.82 , N/A , N/A ,"$1,108.65 ", N/A , N/A ,"$1,015.29 ", N/A ,"$1,050.30 ", N/A ,"$1,050.30 ","$1,050.30 ","$1,050.30 ","$1,131.99 ",$945.27 ,"$1,085.31 ","$1,003.62 ","$1,131.99 "
SACRED HEART HOSPITAL (ACU),27203689,N/A,HC COVER PROBE,272,1 ,$79.00 ,$59.25 ,$42.66 ,$79.00 ,$50.88 , N/A ,$55.30 , N/A ,$65.57 , N/A ,$52.14 ,$75.05 , N/A ,$63.20 ,$72.68 , N/A ,$67.15 ,$75.05 ,$69.52 ,$60.04 , N/A , N/A , N/A ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 , N/A ,$43.45 ,$71.10 , N/A ,$71.10 ,$42.66 ,$74.26 , N/A ,$72.68 , N/A ,$71.89 , N/A ,$48.62 ,$48.62 ,$71.10 ,$58.96 ,$55.02 , N/A , N/A ,$75.05 , N/A , N/A ,$68.73 , N/A ,$71.10 , N/A ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),27203691,N/A,HC TUBE GASTROSTOMY,272,1 ,$206.00 ,$154.50 ,$111.24 ,$206.00 ,$132.66 , N/A ,$144.20 , N/A ,$170.98 , N/A ,$135.96 ,$195.70 , N/A ,$164.80 ,$189.52 , N/A ,$175.10 ,$195.70 ,$181.28 ,$156.56 , N/A , N/A , N/A ,$150.38 ,$113.30 ,$187.46 ,$187.46 ,$164.80 , N/A ,$113.30 ,$185.40 , N/A ,$185.40 ,$111.24 ,$193.64 , N/A ,$189.52 , N/A ,$187.46 , N/A ,$126.77 ,$126.77 ,$185.40 ,$153.74 ,$143.48 , N/A , N/A ,$195.70 , N/A , N/A ,$179.22 , N/A ,$185.40 , N/A ,$185.40 ,$185.40 ,$185.40 ,$199.82 ,$166.86 ,$191.58 ,$177.16 ,$199.82 
SACRED HEART HOSPITAL (ACU),27203695,C1887,HC MICROCATHETER PROGREAT,272,1 ,"$1,091.00 ",$818.25 ,$589.14 ,"$1,091.00 ",$702.60 , N/A ,$763.70 , N/A ,$905.53 , N/A ,$720.06 ,"$1,036.45 ", N/A ,$872.80 ,"$1,003.72 ", N/A ,$927.35 ,"$1,036.45 ",$960.08 ,$829.16 , N/A , N/A , N/A ,$796.43 ,$600.05 ,$992.81 ,$992.81 ,$872.80 , N/A ,$600.05 ,$981.90 , N/A ,$981.90 ,$589.14 ,"$1,025.54 ", N/A ,"$1,003.72 ", N/A ,$992.81 , N/A ,$671.40 ,$671.40 ,$981.90 ,$814.21 ,$759.88 , N/A , N/A ,"$1,036.45 ", N/A , N/A ,$949.17 , N/A ,$981.90 , N/A ,$981.90 ,$981.90 ,$981.90 ,"$1,058.27 ",$883.71 ,"$1,014.63 ",$938.26 ,"$1,058.27 "
SACRED HEART HOSPITAL (ACU),27203696,N/A,HC TRAY ANGIOGRAPHY,272,1 ,$559.00 ,$419.25 ,$301.86 ,$559.00 ,$360.00 , N/A ,$391.30 , N/A ,$463.97 , N/A ,$368.94 ,$531.05 , N/A ,$447.20 ,$514.28 , N/A ,$475.15 ,$531.05 ,$491.92 ,$424.84 , N/A , N/A , N/A ,$408.07 ,$307.45 ,$508.69 ,$508.69 ,$447.20 , N/A ,$307.45 ,$503.10 , N/A ,$503.10 ,$301.86 ,$525.46 , N/A ,$514.28 , N/A ,$508.69 , N/A ,$344.01 ,$344.01 ,$503.10 ,$417.18 ,$389.34 , N/A , N/A ,$531.05 , N/A , N/A ,$486.33 , N/A ,$503.10 , N/A ,$503.10 ,$503.10 ,$503.10 ,$542.23 ,$452.79 ,$519.87 ,$480.74 ,$542.23 
SACRED HEART HOSPITAL (ACU),27203697,C1887,HC CATHETER FAS TRACKER W/TIP,272,1 ,"$1,736.00 ","$1,302.00 ",$937.44 ,"$1,736.00 ","$1,117.98 ", N/A ,"$1,215.20 ", N/A ,"$1,440.88 ", N/A ,"$1,145.76 ","$1,649.20 ", N/A ,"$1,388.80 ","$1,597.12 ", N/A ,"$1,475.60 ","$1,649.20 ","$1,527.68 ","$1,319.36 ", N/A , N/A , N/A ,"$1,267.28 ",$954.80 ,"$1,579.76 ","$1,579.76 ","$1,388.80 ", N/A ,$954.80 ,"$1,562.40 ", N/A ,"$1,562.40 ",$937.44 ,"$1,631.84 ", N/A ,"$1,597.12 ", N/A ,"$1,579.76 ", N/A ,"$1,068.33 ","$1,068.33 ","$1,562.40 ","$1,295.58 ","$1,209.12 ", N/A , N/A ,"$1,649.20 ", N/A , N/A ,"$1,510.32 ", N/A ,"$1,562.40 ", N/A ,"$1,562.40 ","$1,562.40 ","$1,562.40 ","$1,683.92 ","$1,406.16 ","$1,614.48 ","$1,492.96 ","$1,683.92 "
SACRED HEART HOSPITAL (ACU),27203698,C1769,HC GUIDEWIRE STEERABLE FATHOM,272,1 ,$756.00 ,$567.00 ,$408.24 ,$756.00 ,$486.86 , N/A ,$529.20 , N/A ,$627.48 , N/A ,$498.96 ,$718.20 , N/A ,$604.80 ,$695.52 , N/A ,$642.60 ,$718.20 ,$665.28 ,$574.56 , N/A , N/A , N/A ,$551.88 ,$415.80 ,$687.96 ,$687.96 ,$604.80 , N/A ,$415.80 ,$680.40 , N/A ,$680.40 ,$408.24 ,$710.64 , N/A ,$695.52 , N/A ,$687.96 , N/A ,$465.24 ,$465.24 ,$680.40 ,$564.20 ,$526.55 , N/A , N/A ,$718.20 , N/A , N/A ,$657.72 , N/A ,$680.40 , N/A ,$680.40 ,$680.40 ,$680.40 ,$733.32 ,$612.36 ,$703.08 ,$650.16 ,$733.32 
SACRED HEART HOSPITAL (ACU),27203699,C1769,HC GUIDEWIRE STIFF LUNDERQUIST,272,1 ,$410.00 ,$307.50 ,$221.40 ,$410.00 ,$264.04 , N/A ,$287.00 , N/A ,$340.30 , N/A ,$270.60 ,$389.50 , N/A ,$328.00 ,$377.20 , N/A ,$348.50 ,$389.50 ,$360.80 ,$311.60 , N/A , N/A , N/A ,$299.30 ,$225.50 ,$373.10 ,$373.10 ,$328.00 , N/A ,$225.50 ,$369.00 , N/A ,$369.00 ,$221.40 ,$385.40 , N/A ,$377.20 , N/A ,$373.10 , N/A ,$252.31 ,$252.31 ,$369.00 ,$305.98 ,$285.57 , N/A , N/A ,$389.50 , N/A , N/A ,$356.70 , N/A ,$369.00 , N/A ,$369.00 ,$369.00 ,$369.00 ,$397.70 ,$332.10 ,$381.30 ,$352.60 ,$397.70 
SACRED HEART HOSPITAL (ACU),27203701,C1729,HC CATHETER NEPHROSTOMY,272,1 ,$543.00 ,$407.25 ,$293.22 ,$543.00 ,$349.69 , N/A ,$380.10 , N/A ,$450.69 , N/A ,$358.38 ,$515.85 , N/A ,$434.40 ,$499.56 , N/A ,$461.55 ,$515.85 ,$477.84 ,$412.68 , N/A , N/A , N/A ,$396.39 ,$298.65 ,$494.13 ,$494.13 ,$434.40 , N/A ,$298.65 ,$488.70 , N/A ,$488.70 ,$293.22 ,$510.42 , N/A ,$499.56 , N/A ,$494.13 , N/A ,$334.16 ,$334.16 ,$488.70 ,$405.24 ,$378.20 , N/A , N/A ,$515.85 , N/A , N/A ,$472.41 , N/A ,$488.70 , N/A ,$488.70 ,$488.70 ,$488.70 ,$526.71 ,$439.83 ,$504.99 ,$466.98 ,$526.71 
SACRED HEART HOSPITAL (ACU),27203702,N/A,HC TRAY CATHETER PICC,272,1 ,$175.00 ,$131.25 ,$94.50 ,$175.00 ,$112.70 , N/A ,$122.50 , N/A ,$145.25 , N/A ,$115.50 ,$166.25 , N/A ,$140.00 ,$161.00 , N/A ,$148.75 ,$166.25 ,$154.00 ,$133.00 , N/A , N/A , N/A ,$127.75 ,$96.25 ,$159.25 ,$159.25 ,$140.00 , N/A ,$96.25 ,$157.50 , N/A ,$157.50 ,$94.50 ,$164.50 , N/A ,$161.00 , N/A ,$159.25 , N/A ,$107.70 ,$107.70 ,$157.50 ,$130.60 ,$121.89 , N/A , N/A ,$166.25 , N/A , N/A ,$152.25 , N/A ,$157.50 , N/A ,$157.50 ,$157.50 ,$157.50 ,$169.75 ,$141.75 ,$162.75 ,$150.50 ,$169.75 
SACRED HEART HOSPITAL (ACU),27203703,C1751,HC CATHETER PICC,272,1 ,$642.00 ,$481.50 ,$346.68 ,$642.00 ,$413.45 , N/A ,$449.40 , N/A ,$532.86 , N/A ,$423.72 ,$609.90 , N/A ,$513.60 ,$590.64 , N/A ,$545.70 ,$609.90 ,$564.96 ,$487.92 , N/A , N/A , N/A ,$468.66 ,$353.10 ,$584.22 ,$584.22 ,$513.60 , N/A ,$353.10 ,$577.80 , N/A ,$577.80 ,$346.68 ,$603.48 , N/A ,$590.64 , N/A ,$584.22 , N/A ,$395.09 ,$395.09 ,$577.80 ,$479.12 ,$447.15 , N/A , N/A ,$609.90 , N/A , N/A ,$558.54 , N/A ,$577.80 , N/A ,$577.80 ,$577.80 ,$577.80 ,$622.74 ,$520.02 ,$597.06 ,$552.12 ,$622.74 
SACRED HEART HOSPITAL (ACU),27203705,C1751,HC CATHETER PULSE SPRAY,272,1 ,$508.00 ,$381.00 ,$274.32 ,$508.00 ,$327.15 , N/A ,$355.60 , N/A ,$421.64 , N/A ,$335.28 ,$482.60 , N/A ,$406.40 ,$467.36 , N/A ,$431.80 ,$482.60 ,$447.04 ,$386.08 , N/A , N/A , N/A ,$370.84 ,$279.40 ,$462.28 ,$462.28 ,$406.40 , N/A ,$279.40 ,$457.20 , N/A ,$457.20 ,$274.32 ,$477.52 , N/A ,$467.36 , N/A ,$462.28 , N/A ,$312.62 ,$312.62 ,$457.20 ,$379.12 ,$353.82 , N/A , N/A ,$482.60 , N/A , N/A ,$441.96 , N/A ,$457.20 , N/A ,$457.20 ,$457.20 ,$457.20 ,$492.76 ,$411.48 ,$472.44 ,$436.88 ,$492.76 
SACRED HEART HOSPITAL (ACU),27203708,C1894,HC SHEATH PINNACLE,272,1 ,$371.00 ,$278.25 ,$200.34 ,$371.00 ,$238.92 , N/A ,$259.70 , N/A ,$307.93 , N/A ,$244.86 ,$352.45 , N/A ,$296.80 ,$341.32 , N/A ,$315.35 ,$352.45 ,$326.48 ,$281.96 , N/A , N/A , N/A ,$270.83 ,$204.05 ,$337.61 ,$337.61 ,$296.80 , N/A ,$204.05 ,$333.90 , N/A ,$333.90 ,$200.34 ,$348.74 , N/A ,$341.32 , N/A ,$337.61 , N/A ,$228.31 ,$228.31 ,$333.90 ,$276.88 ,$258.40 , N/A , N/A ,$352.45 , N/A , N/A ,$322.77 , N/A ,$333.90 , N/A ,$333.90 ,$333.90 ,$333.90 ,$359.87 ,$300.51 ,$345.03 ,$319.06 ,$359.87 
SACRED HEART HOSPITAL (ACU),27203709,C1894,HC SHEATH/INTRODUCER BRITE TIP,272,1 ,$237.00 ,$177.75 ,$127.98 ,$237.00 ,$152.63 , N/A ,$165.90 , N/A ,$196.71 , N/A ,$156.42 ,$225.15 , N/A ,$189.60 ,$218.04 , N/A ,$201.45 ,$225.15 ,$208.56 ,$180.12 , N/A , N/A , N/A ,$173.01 ,$130.35 ,$215.67 ,$215.67 ,$189.60 , N/A ,$130.35 ,$213.30 , N/A ,$213.30 ,$127.98 ,$222.78 , N/A ,$218.04 , N/A ,$215.67 , N/A ,$145.85 ,$145.85 ,$213.30 ,$176.87 ,$165.07 , N/A , N/A ,$225.15 , N/A , N/A ,$206.19 , N/A ,$213.30 , N/A ,$213.30 ,$213.30 ,$213.30 ,$229.89 ,$191.97 ,$220.41 ,$203.82 ,$229.89 
SACRED HEART HOSPITAL (ACU),27203710,C1894,HC SHEATH INTRODUCER 11,272,1 ,$119.00 ,$89.25 ,$64.26 ,$119.00 ,$76.64 , N/A ,$83.30 , N/A ,$98.77 , N/A ,$78.54 ,$113.05 , N/A ,$95.20 ,$109.48 , N/A ,$101.15 ,$113.05 ,$104.72 ,$90.44 , N/A , N/A , N/A ,$86.87 ,$65.45 ,$108.29 ,$108.29 ,$95.20 , N/A ,$65.45 ,$107.10 , N/A ,$107.10 ,$64.26 ,$111.86 , N/A ,$109.48 , N/A ,$108.29 , N/A ,$73.23 ,$73.23 ,$107.10 ,$88.81 ,$82.88 , N/A , N/A ,$113.05 , N/A , N/A ,$103.53 , N/A ,$107.10 , N/A ,$107.10 ,$107.10 ,$107.10 ,$115.43 ,$96.39 ,$110.67 ,$102.34 ,$115.43 
SACRED HEART HOSPITAL (ACU),27203712,C1894,HC SHEATH GUIDING DIAL EASE,272,1 ,$55.00 ,$41.25 ,$29.70 ,$55.00 ,$35.42 , N/A ,$38.50 , N/A ,$45.65 , N/A ,$36.30 ,$52.25 , N/A ,$44.00 ,$50.60 , N/A ,$46.75 ,$52.25 ,$48.40 ,$41.80 , N/A , N/A , N/A ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 , N/A ,$30.25 ,$49.50 , N/A ,$49.50 ,$29.70 ,$51.70 , N/A ,$50.60 , N/A ,$50.05 , N/A ,$33.85 ,$33.85 ,$49.50 ,$41.05 ,$38.31 , N/A , N/A ,$52.25 , N/A , N/A ,$47.85 , N/A ,$49.50 , N/A ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),27203713,C1893,HC SHEATH PEEL AWAY,272,1 ,$244.00 ,$183.00 ,$131.76 ,$244.00 ,$157.14 , N/A ,$170.80 , N/A ,$202.52 , N/A ,$161.04 ,$231.80 , N/A ,$195.20 ,$224.48 , N/A ,$207.40 ,$231.80 ,$214.72 ,$185.44 , N/A , N/A , N/A ,$178.12 ,$134.20 ,$222.04 ,$222.04 ,$195.20 , N/A ,$134.20 ,$219.60 , N/A ,$219.60 ,$131.76 ,$229.36 , N/A ,$224.48 , N/A ,$222.04 , N/A ,$150.16 ,$150.16 ,$219.60 ,$182.10 ,$169.95 , N/A , N/A ,$231.80 , N/A , N/A ,$212.28 , N/A ,$219.60 , N/A ,$219.60 ,$219.60 ,$219.60 ,$236.68 ,$197.64 ,$226.92 ,$209.84 ,$236.68 
SACRED HEART HOSPITAL (ACU),27203714,N/A,HC SYSTEM DELIVERY VERTEBROPLASTY,272,1 ,"$2,531.00 ","$1,898.25 ","$1,366.74 ","$2,531.00 ","$1,629.96 ", N/A ,"$1,771.70 ", N/A ,"$2,100.73 ", N/A ,"$1,670.46 ","$2,404.45 ", N/A ,"$2,024.80 ","$2,328.52 ", N/A ,"$2,151.35 ","$2,404.45 ","$2,227.28 ","$1,923.56 ", N/A , N/A , N/A ,"$1,847.63 ","$1,392.05 ","$2,303.21 ","$2,303.21 ","$2,024.80 ", N/A ,"$1,392.05 ","$2,277.90 ", N/A ,"$2,277.90 ","$1,366.74 ","$2,379.14 ", N/A ,"$2,328.52 ", N/A ,"$2,303.21 ", N/A ,"$1,557.58 ","$1,557.58 ","$2,277.90 ","$1,888.89 ","$1,762.84 ", N/A , N/A ,"$2,404.45 ", N/A , N/A ,"$2,201.97 ", N/A ,"$2,277.90 ", N/A ,"$2,277.90 ","$2,277.90 ","$2,277.90 ","$2,455.07 ","$2,050.11 ","$2,353.83 ","$2,176.66 ","$2,455.07 "
SACRED HEART HOSPITAL (ACU),27203715,N/A,HC DILATOR NYLON,272,1 ,$98.00 ,$73.50 ,$52.92 ,$98.00 ,$63.11 , N/A ,$68.60 , N/A ,$81.34 , N/A ,$64.68 ,$93.10 , N/A ,$78.40 ,$90.16 , N/A ,$83.30 ,$93.10 ,$86.24 ,$74.48 , N/A , N/A , N/A ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 , N/A ,$53.90 ,$88.20 , N/A ,$88.20 ,$52.92 ,$92.12 , N/A ,$90.16 , N/A ,$89.18 , N/A ,$60.31 ,$60.31 ,$88.20 ,$73.14 ,$68.26 , N/A , N/A ,$93.10 , N/A , N/A ,$85.26 , N/A ,$88.20 , N/A ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),27203716,N/A,HC SET BLOOD COMPONENT,272,1 ,$38.00 ,$28.50 ,$20.52 ,$38.00 ,$24.47 , N/A ,$26.60 , N/A ,$31.54 , N/A ,$25.08 ,$36.10 , N/A ,$30.40 ,$34.96 , N/A ,$32.30 ,$36.10 ,$33.44 ,$28.88 , N/A , N/A , N/A ,$27.74 ,$20.90 ,$34.58 ,$34.58 ,$30.40 , N/A ,$20.90 ,$34.20 , N/A ,$34.20 ,$20.52 ,$35.72 , N/A ,$34.96 , N/A ,$34.58 , N/A ,$23.39 ,$23.39 ,$34.20 ,$28.36 ,$26.47 , N/A , N/A ,$36.10 , N/A , N/A ,$33.06 , N/A ,$34.20 , N/A ,$34.20 ,$34.20 ,$34.20 ,$36.86 ,$30.78 ,$35.34 ,$32.68 ,$36.86 
SACRED HEART HOSPITAL (ACU),27203717,N/A,HC KIT COOL GUARD DAILY,272,1 ,$338.00 ,$253.50 ,$182.52 ,$338.00 ,$217.67 , N/A ,$236.60 , N/A ,$280.54 , N/A ,$223.08 ,$321.10 , N/A ,$270.40 ,$310.96 , N/A ,$287.30 ,$321.10 ,$297.44 ,$256.88 , N/A , N/A , N/A ,$246.74 ,$185.90 ,$307.58 ,$307.58 ,$270.40 , N/A ,$185.90 ,$304.20 , N/A ,$304.20 ,$182.52 ,$317.72 , N/A ,$310.96 , N/A ,$307.58 , N/A ,$208.01 ,$208.01 ,$304.20 ,$252.25 ,$235.42 , N/A , N/A ,$321.10 , N/A , N/A ,$294.06 , N/A ,$304.20 , N/A ,$304.20 ,$304.20 ,$304.20 ,$327.86 ,$273.78 ,$314.34 ,$290.68 ,$327.86 
SACRED HEART HOSPITAL (ACU),27203718,N/A,HC TRAY CENTESIS PROCEDURE,272,1 ,$79.00 ,$59.25 ,$42.66 ,$79.00 ,$50.88 , N/A ,$55.30 , N/A ,$65.57 , N/A ,$52.14 ,$75.05 , N/A ,$63.20 ,$72.68 , N/A ,$67.15 ,$75.05 ,$69.52 ,$60.04 , N/A , N/A , N/A ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 , N/A ,$43.45 ,$71.10 , N/A ,$71.10 ,$42.66 ,$74.26 , N/A ,$72.68 , N/A ,$71.89 , N/A ,$48.62 ,$48.62 ,$71.10 ,$58.96 ,$55.02 , N/A , N/A ,$75.05 , N/A , N/A ,$68.73 , N/A ,$71.10 , N/A ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),27203719,C1729,HC CATHETER CENTESIS ONE STEP,272,1 ,$61.00 ,$45.75 ,$32.94 ,$61.00 ,$39.28 , N/A ,$42.70 , N/A ,$50.63 , N/A ,$40.26 ,$57.95 , N/A ,$48.80 ,$56.12 , N/A ,$51.85 ,$57.95 ,$53.68 ,$46.36 , N/A , N/A , N/A ,$44.53 ,$33.55 ,$55.51 ,$55.51 ,$48.80 , N/A ,$33.55 ,$54.90 , N/A ,$54.90 ,$32.94 ,$57.34 , N/A ,$56.12 , N/A ,$55.51 , N/A ,$37.54 ,$37.54 ,$54.90 ,$45.52 ,$42.49 , N/A , N/A ,$57.95 , N/A , N/A ,$53.07 , N/A ,$54.90 , N/A ,$54.90 ,$54.90 ,$54.90 ,$59.17 ,$49.41 ,$56.73 ,$52.46 ,$59.17 
SACRED HEART HOSPITAL (ACU),27203720,N/A,HC MARKER BREAST CORE MARK,272,1 ,$197.00 ,$147.75 ,$106.38 ,$197.00 ,$126.87 , N/A ,$137.90 , N/A ,$163.51 , N/A ,$130.02 ,$187.15 , N/A ,$157.60 ,$181.24 , N/A ,$167.45 ,$187.15 ,$173.36 ,$149.72 , N/A , N/A , N/A ,$143.81 ,$108.35 ,$179.27 ,$179.27 ,$157.60 , N/A ,$108.35 ,$177.30 , N/A ,$177.30 ,$106.38 ,$185.18 , N/A ,$181.24 , N/A ,$179.27 , N/A ,$121.23 ,$121.23 ,$177.30 ,$147.02 ,$137.21 , N/A , N/A ,$187.15 , N/A , N/A ,$171.39 , N/A ,$177.30 , N/A ,$177.30 ,$177.30 ,$177.30 ,$191.09 ,$159.57 ,$183.21 ,$169.42 ,$191.09 
SACRED HEART HOSPITAL (ACU),27203722,N/A,HC CONTAINER TRANSPORT NEEDLE SPECIMEN,272,1 ,$68.00 ,$51.00 ,$36.72 ,$68.00 ,$43.79 , N/A ,$47.60 , N/A ,$56.44 , N/A ,$44.88 ,$64.60 , N/A ,$54.40 ,$62.56 , N/A ,$57.80 ,$64.60 ,$59.84 ,$51.68 , N/A , N/A , N/A ,$49.64 ,$37.40 ,$61.88 ,$61.88 ,$54.40 , N/A ,$37.40 ,$61.20 , N/A ,$61.20 ,$36.72 ,$63.92 , N/A ,$62.56 , N/A ,$61.88 , N/A ,$41.85 ,$41.85 ,$61.20 ,$50.75 ,$47.36 , N/A , N/A ,$64.60 , N/A , N/A ,$59.16 , N/A ,$61.20 , N/A ,$61.20 ,$61.20 ,$61.20 ,$65.96 ,$55.08 ,$63.24 ,$58.48 ,$65.96 
SACRED HEART HOSPITAL (ACU),27203723,N/A,HC CUP BIOPSY ADDITIONAL,272,1 ,$168.00 ,$126.00 ,$90.72 ,$168.00 ,$108.19 , N/A ,$117.60 , N/A ,$139.44 , N/A ,$110.88 ,$159.60 , N/A ,$134.40 ,$154.56 , N/A ,$142.80 ,$159.60 ,$147.84 ,$127.68 , N/A , N/A , N/A ,$122.64 ,$92.40 ,$152.88 ,$152.88 ,$134.40 , N/A ,$92.40 ,$151.20 , N/A ,$151.20 ,$90.72 ,$157.92 , N/A ,$154.56 , N/A ,$152.88 , N/A ,$103.39 ,$103.39 ,$151.20 ,$125.38 ,$117.01 , N/A , N/A ,$159.60 , N/A , N/A ,$146.16 , N/A ,$151.20 , N/A ,$151.20 ,$151.20 ,$151.20 ,$162.96 ,$136.08 ,$156.24 ,$144.48 ,$162.96 
SACRED HEART HOSPITAL (ACU),27203724,N/A,HC NEEDLE ELECTRODE COACCESS,272,1 ,"$2,517.00 ","$1,887.75 ","$1,359.18 ","$2,517.00 ","$1,620.95 ", N/A ,"$1,761.90 ", N/A ,"$2,089.11 ", N/A ,"$1,661.22 ","$2,391.15 ", N/A ,"$2,013.60 ","$2,315.64 ", N/A ,"$2,139.45 ","$2,391.15 ","$2,214.96 ","$1,912.92 ", N/A , N/A , N/A ,"$1,837.41 ","$1,384.35 ","$2,290.47 ","$2,290.47 ","$2,013.60 ", N/A ,"$1,384.35 ","$2,265.30 ", N/A ,"$2,265.30 ","$1,359.18 ","$2,365.98 ", N/A ,"$2,315.64 ", N/A ,"$2,290.47 ", N/A ,"$1,548.96 ","$1,548.96 ","$2,265.30 ","$1,878.44 ","$1,753.09 ", N/A , N/A ,"$2,391.15 ", N/A , N/A ,"$2,189.79 ", N/A ,"$2,265.30 ", N/A ,"$2,265.30 ","$2,265.30 ","$2,265.30 ","$2,441.49 ","$2,038.77 ","$2,340.81 ","$2,164.62 ","$2,441.49 "
SACRED HEART HOSPITAL (ACU),27203725,N/A,HC NEEDLE ELECTRODE NON COACCESS,272,1 ,"$1,462.00 ","$1,096.50 ",$789.48 ,"$1,462.00 ",$941.53 , N/A ,"$1,023.40 ", N/A ,"$1,213.46 ", N/A ,$964.92 ,"$1,388.90 ", N/A ,"$1,169.60 ","$1,345.04 ", N/A ,"$1,242.70 ","$1,388.90 ","$1,286.56 ","$1,111.12 ", N/A , N/A , N/A ,"$1,067.26 ",$804.10 ,"$1,330.42 ","$1,330.42 ","$1,169.60 ", N/A ,$804.10 ,"$1,315.80 ", N/A ,"$1,315.80 ",$789.48 ,"$1,374.28 ", N/A ,"$1,345.04 ", N/A ,"$1,330.42 ", N/A ,$899.71 ,$899.71 ,"$1,315.80 ","$1,091.09 ","$1,018.28 ", N/A , N/A ,"$1,388.90 ", N/A , N/A ,"$1,271.94 ", N/A ,"$1,315.80 ", N/A ,"$1,315.80 ","$1,315.80 ","$1,315.80 ","$1,418.14 ","$1,184.22 ","$1,359.66 ","$1,257.32 ","$1,418.14 "
SACRED HEART HOSPITAL (ACU),27203726,N/A,HC CATHETER SUPPORT,272,1 ,$517.00 ,$387.75 ,$279.18 ,$517.00 ,$332.95 , N/A ,$361.90 , N/A ,$429.11 , N/A ,$341.22 ,$491.15 , N/A ,$413.60 ,$475.64 , N/A ,$439.45 ,$491.15 ,$454.96 ,$392.92 , N/A , N/A , N/A ,$377.41 ,$284.35 ,$470.47 ,$470.47 ,$413.60 , N/A ,$284.35 ,$465.30 , N/A ,$465.30 ,$279.18 ,$485.98 , N/A ,$475.64 , N/A ,$470.47 , N/A ,$318.16 ,$318.16 ,$465.30 ,$385.84 ,$360.09 , N/A , N/A ,$491.15 , N/A , N/A ,$449.79 , N/A ,$465.30 , N/A ,$465.30 ,$465.30 ,$465.30 ,$501.49 ,$418.77 ,$480.81 ,$444.62 ,$501.49 
SACRED HEART HOSPITAL (ACU),27203727,N/A,HC GUIDEWIRE MAKNV,272,1 ,$91.00 ,$68.25 ,$49.14 ,$91.00 ,$58.60 , N/A ,$63.70 , N/A ,$75.53 , N/A ,$60.06 ,$86.45 , N/A ,$72.80 ,$83.72 , N/A ,$77.35 ,$86.45 ,$80.08 ,$69.16 , N/A , N/A , N/A ,$66.43 ,$50.05 ,$82.81 ,$82.81 ,$72.80 , N/A ,$50.05 ,$81.90 , N/A ,$81.90 ,$49.14 ,$85.54 , N/A ,$83.72 , N/A ,$82.81 , N/A ,$56.00 ,$56.00 ,$81.90 ,$67.91 ,$63.38 , N/A , N/A ,$86.45 , N/A , N/A ,$79.17 , N/A ,$81.90 , N/A ,$81.90 ,$81.90 ,$81.90 ,$88.27 ,$73.71 ,$84.63 ,$78.26 ,$88.27 
SACRED HEART HOSPITAL (ACU),27203728,N/A,HC FRONTRUNNER GUIDE CATHETER,272,1 ,$784.00 ,$588.00 ,$423.36 ,$784.00 ,$504.90 , N/A ,$548.80 , N/A ,$650.72 , N/A ,$517.44 ,$744.80 , N/A ,$627.20 ,$721.28 , N/A ,$666.40 ,$744.80 ,$689.92 ,$595.84 , N/A , N/A , N/A ,$572.32 ,$431.20 ,$713.44 ,$713.44 ,$627.20 , N/A ,$431.20 ,$705.60 , N/A ,$705.60 ,$423.36 ,$736.96 , N/A ,$721.28 , N/A ,$713.44 , N/A ,$482.47 ,$482.47 ,$705.60 ,$585.10 ,$546.06 , N/A , N/A ,$744.80 , N/A , N/A ,$682.08 , N/A ,$705.60 , N/A ,$705.60 ,$705.60 ,$705.60 ,$760.48 ,$635.04 ,$729.12 ,$674.24 ,$760.48 
SACRED HEART HOSPITAL (ACU),27203729,N/A,HC SNARE MICRO,272,1 ,"$1,555.00 ","$1,166.25 ",$839.70 ,"$1,555.00 ","$1,001.42 ", N/A ,"$1,088.50 ", N/A ,"$1,290.65 ", N/A ,"$1,026.30 ","$1,477.25 ", N/A ,"$1,244.00 ","$1,430.60 ", N/A ,"$1,321.75 ","$1,477.25 ","$1,368.40 ","$1,181.80 ", N/A , N/A , N/A ,"$1,135.15 ",$855.25 ,"$1,415.05 ","$1,415.05 ","$1,244.00 ", N/A ,$855.25 ,"$1,399.50 ", N/A ,"$1,399.50 ",$839.70 ,"$1,461.70 ", N/A ,"$1,430.60 ", N/A ,"$1,415.05 ", N/A ,$956.95 ,$956.95 ,"$1,399.50 ","$1,160.50 ","$1,083.06 ", N/A , N/A ,"$1,477.25 ", N/A , N/A ,"$1,352.85 ", N/A ,"$1,399.50 ", N/A ,"$1,399.50 ","$1,399.50 ","$1,399.50 ","$1,508.35 ","$1,259.55 ","$1,446.15 ","$1,337.30 ","$1,508.35 "
SACRED HEART HOSPITAL (ACU),27203730,N/A,HC KIT POWER PULSE SPRAY,272,1 ,$107.00 ,$80.25 ,$57.78 ,$107.00 ,$68.91 , N/A ,$74.90 , N/A ,$88.81 , N/A ,$70.62 ,$101.65 , N/A ,$85.60 ,$98.44 , N/A ,$90.95 ,$101.65 ,$94.16 ,$81.32 , N/A , N/A , N/A ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 , N/A ,$58.85 ,$96.30 , N/A ,$96.30 ,$57.78 ,$100.58 , N/A ,$98.44 , N/A ,$97.37 , N/A ,$65.85 ,$65.85 ,$96.30 ,$79.85 ,$74.53 , N/A , N/A ,$101.65 , N/A , N/A ,$93.09 , N/A ,$96.30 , N/A ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),27203731,N/A,HC SYRINGE UTERINE EMBOSPHERE,272,1 ,$784.00 ,$588.00 ,$423.36 ,$784.00 ,$504.90 , N/A ,$548.80 , N/A ,$650.72 , N/A ,$517.44 ,$744.80 , N/A ,$627.20 ,$721.28 , N/A ,$666.40 ,$744.80 ,$689.92 ,$595.84 , N/A , N/A , N/A ,$572.32 ,$431.20 ,$713.44 ,$713.44 ,$627.20 , N/A ,$431.20 ,$705.60 , N/A ,$705.60 ,$423.36 ,$736.96 , N/A ,$721.28 , N/A ,$713.44 , N/A ,$482.47 ,$482.47 ,$705.60 ,$585.10 ,$546.06 , N/A , N/A ,$744.80 , N/A , N/A ,$682.08 , N/A ,$705.60 , N/A ,$705.60 ,$705.60 ,$705.60 ,$760.48 ,$635.04 ,$729.12 ,$674.24 ,$760.48 
SACRED HEART HOSPITAL (ACU),27203732,C1757,HC CATHETER INFUSION UNI-FUS,272,1 ,$517.00 ,$387.75 ,$279.18 ,$517.00 ,$332.95 , N/A ,$361.90 , N/A ,$429.11 , N/A ,$341.22 ,$491.15 , N/A ,$413.60 ,$475.64 , N/A ,$439.45 ,$491.15 ,$454.96 ,$392.92 , N/A , N/A , N/A ,$377.41 ,$284.35 ,$470.47 ,$470.47 ,$413.60 , N/A ,$284.35 ,$465.30 , N/A ,$465.30 ,$279.18 ,$485.98 , N/A ,$475.64 , N/A ,$470.47 , N/A ,$318.16 ,$318.16 ,$465.30 ,$385.84 ,$360.09 , N/A , N/A ,$491.15 , N/A , N/A ,$449.79 , N/A ,$465.30 , N/A ,$465.30 ,$465.30 ,$465.30 ,$501.49 ,$418.77 ,$480.81 ,$444.62 ,$501.49 
SACRED HEART HOSPITAL (ACU),27203733,C1757,HC ANGIOJET AVX CATHETER,272,1 ,"$1,307.00 ",$980.25 ,$705.78 ,"$1,307.00 ",$841.71 , N/A ,$914.90 , N/A ,"$1,084.81 ", N/A ,$862.62 ,"$1,241.65 ", N/A ,"$1,045.60 ","$1,202.44 ", N/A ,"$1,110.95 ","$1,241.65 ","$1,150.16 ",$993.32 , N/A , N/A , N/A ,$954.11 ,$718.85 ,"$1,189.37 ","$1,189.37 ","$1,045.60 ", N/A ,$718.85 ,"$1,176.30 ", N/A ,"$1,176.30 ",$705.78 ,"$1,228.58 ", N/A ,"$1,202.44 ", N/A ,"$1,189.37 ", N/A ,$804.33 ,$804.33 ,"$1,176.30 ",$975.41 ,$910.33 , N/A , N/A ,"$1,241.65 ", N/A , N/A ,"$1,137.09 ", N/A ,"$1,176.30 ", N/A ,"$1,176.30 ","$1,176.30 ","$1,176.30 ","$1,267.79 ","$1,058.67 ","$1,215.51 ","$1,124.02 ","$1,267.79 "
SACRED HEART HOSPITAL (ACU),27203734,C1757,HC CATHETER ANGIOJET SOLENT,272,1 ,"$3,018.00 ","$2,263.50 ","$1,629.72 ","$3,018.00 ","$1,943.59 ", N/A ,"$2,112.60 ", N/A ,"$2,504.94 ", N/A ,"$1,991.88 ","$2,867.10 ", N/A ,"$2,414.40 ","$2,776.56 ", N/A ,"$2,565.30 ","$2,867.10 ","$2,655.84 ","$2,293.68 ", N/A , N/A , N/A ,"$2,203.14 ","$1,659.90 ","$2,746.38 ","$2,746.38 ","$2,414.40 ", N/A ,"$1,659.90 ","$2,716.20 ", N/A ,"$2,716.20 ","$1,629.72 ","$2,836.92 ", N/A ,"$2,776.56 ", N/A ,"$2,746.38 ", N/A ,"$1,857.28 ","$1,857.28 ","$2,716.20 ","$2,252.33 ","$2,102.04 ", N/A , N/A ,"$2,867.10 ", N/A , N/A ,"$2,625.66 ", N/A ,"$2,716.20 ", N/A ,"$2,716.20 ","$2,716.20 ","$2,716.20 ","$2,927.46 ","$2,444.58 ","$2,806.74 ","$2,595.48 ","$2,927.46 "
SACRED HEART HOSPITAL (ACU),27203735,N/A,HC SYSTEM ENDOVASCULAR SNARE,272,1 ,$878.00 ,$658.50 ,$474.12 ,$878.00 ,$565.43 , N/A ,$614.60 , N/A ,$728.74 , N/A ,$579.48 ,$834.10 , N/A ,$702.40 ,$807.76 , N/A ,$746.30 ,$834.10 ,$772.64 ,$667.28 , N/A , N/A , N/A ,$640.94 ,$482.90 ,$798.98 ,$798.98 ,$702.40 , N/A ,$482.90 ,$790.20 , N/A ,$790.20 ,$474.12 ,$825.32 , N/A ,$807.76 , N/A ,$798.98 , N/A ,$540.32 ,$540.32 ,$790.20 ,$655.25 ,$611.53 , N/A , N/A ,$834.10 , N/A , N/A ,$763.86 , N/A ,$790.20 , N/A ,$790.20 ,$790.20 ,$790.20 ,$851.66 ,$711.18 ,$816.54 ,$755.08 ,$851.66 
SACRED HEART HOSPITAL (ACU),27203736,N/A,HC CATHETER BALLOON RELIANT,272,1 ,"$1,163.00 ",$872.25 ,$628.02 ,"$1,163.00 ",$748.97 , N/A ,$814.10 , N/A ,$965.29 , N/A ,$767.58 ,"$1,104.85 ", N/A ,$930.40 ,"$1,069.96 ", N/A ,$988.55 ,"$1,104.85 ","$1,023.44 ",$883.88 , N/A , N/A , N/A ,$848.99 ,$639.65 ,"$1,058.33 ","$1,058.33 ",$930.40 , N/A ,$639.65 ,"$1,046.70 ", N/A ,"$1,046.70 ",$628.02 ,"$1,093.22 ", N/A ,"$1,069.96 ", N/A ,"$1,058.33 ", N/A ,$715.71 ,$715.71 ,"$1,046.70 ",$867.95 ,$810.03 , N/A , N/A ,"$1,104.85 ", N/A , N/A ,"$1,011.81 ", N/A ,"$1,046.70 ", N/A ,"$1,046.70 ","$1,046.70 ","$1,046.70 ","$1,128.11 ",$942.03 ,"$1,081.59 ","$1,000.18 ","$1,128.11 "
SACRED HEART HOSPITAL (ACU),27203737,N/A,HC TUBE GASTROSTOMY/JEJUNOSTOMY,272,1 ,$686.00 ,$514.50 ,$370.44 ,$686.00 ,$441.78 , N/A ,$480.20 , N/A ,$569.38 , N/A ,$452.76 ,$651.70 , N/A ,$548.80 ,$631.12 , N/A ,$583.10 ,$651.70 ,$603.68 ,$521.36 , N/A , N/A , N/A ,$500.78 ,$377.30 ,$624.26 ,$624.26 ,$548.80 , N/A ,$377.30 ,$617.40 , N/A ,$617.40 ,$370.44 ,$644.84 , N/A ,$631.12 , N/A ,$624.26 , N/A ,$422.16 ,$422.16 ,$617.40 ,$511.96 ,$477.80 , N/A , N/A ,$651.70 , N/A , N/A ,$596.82 , N/A ,$617.40 , N/A ,$617.40 ,$617.40 ,$617.40 ,$665.42 ,$555.66 ,$637.98 ,$589.96 ,$665.42 
SACRED HEART HOSPITAL (ACU),27203738,N/A,HC TUBE JEJUNOSTOMY,272,1 ,$524.00 ,$393.00 ,$282.96 ,$524.00 ,$337.46 , N/A ,$366.80 , N/A ,$434.92 , N/A ,$345.84 ,$497.80 , N/A ,$419.20 ,$482.08 , N/A ,$445.40 ,$497.80 ,$461.12 ,$398.24 , N/A , N/A , N/A ,$382.52 ,$288.20 ,$476.84 ,$476.84 ,$419.20 , N/A ,$288.20 ,$471.60 , N/A ,$471.60 ,$282.96 ,$492.56 , N/A ,$482.08 , N/A ,$476.84 , N/A ,$322.47 ,$322.47 ,$471.60 ,$391.06 ,$364.97 , N/A , N/A ,$497.80 , N/A , N/A ,$455.88 , N/A ,$471.60 , N/A ,$471.60 ,$471.60 ,$471.60 ,$508.28 ,$424.44 ,$487.32 ,$450.64 ,$508.28 
SACRED HEART HOSPITAL (ACU),27203739,N/A,HC GLIDEWIRE,272,1 ,$124.00 ,$93.00 ,$66.96 ,$124.00 ,$79.86 , N/A ,$86.80 , N/A ,$102.92 , N/A ,$81.84 ,$117.80 , N/A ,$99.20 ,$114.08 , N/A ,$105.40 ,$117.80 ,$109.12 ,$94.24 , N/A , N/A , N/A ,$90.52 ,$68.20 ,$112.84 ,$112.84 ,$99.20 , N/A ,$68.20 ,$111.60 , N/A ,$111.60 ,$66.96 ,$116.56 , N/A ,$114.08 , N/A ,$112.84 , N/A ,$76.31 ,$76.31 ,$111.60 ,$92.54 ,$86.37 , N/A , N/A ,$117.80 , N/A , N/A ,$107.88 , N/A ,$111.60 , N/A ,$111.60 ,$111.60 ,$111.60 ,$120.28 ,$100.44 ,$115.32 ,$106.64 ,$120.28 
SACRED HEART HOSPITAL (ACU),27203740,N/A,HC NEEDLE VERTEBROPLASTY BIOPSY,272,1 ,$175.00 ,$131.25 ,$94.50 ,$175.00 ,$112.70 , N/A ,$122.50 , N/A ,$145.25 , N/A ,$115.50 ,$166.25 , N/A ,$140.00 ,$161.00 , N/A ,$148.75 ,$166.25 ,$154.00 ,$133.00 , N/A , N/A , N/A ,$127.75 ,$96.25 ,$159.25 ,$159.25 ,$140.00 , N/A ,$96.25 ,$157.50 , N/A ,$157.50 ,$94.50 ,$164.50 , N/A ,$161.00 , N/A ,$159.25 , N/A ,$107.70 ,$107.70 ,$157.50 ,$130.60 ,$121.89 , N/A , N/A ,$166.25 , N/A , N/A ,$152.25 , N/A ,$157.50 , N/A ,$157.50 ,$157.50 ,$157.50 ,$169.75 ,$141.75 ,$162.75 ,$150.50 ,$169.75 
SACRED HEART HOSPITAL (ACU),27203741,N/A,HC CATHETER BALLOON PERIPHERAL VIATRAC,272,1 ,$753.00 ,$564.75 ,$406.62 ,$753.00 ,$484.93 , N/A ,$527.10 , N/A ,$624.99 , N/A ,$496.98 ,$715.35 , N/A ,$602.40 ,$692.76 , N/A ,$640.05 ,$715.35 ,$662.64 ,$572.28 , N/A , N/A , N/A ,$549.69 ,$414.15 ,$685.23 ,$685.23 ,$602.40 , N/A ,$414.15 ,$677.70 , N/A ,$677.70 ,$406.62 ,$707.82 , N/A ,$692.76 , N/A ,$685.23 , N/A ,$463.40 ,$463.40 ,$677.70 ,$561.96 ,$524.46 , N/A , N/A ,$715.35 , N/A , N/A ,$655.11 , N/A ,$677.70 , N/A ,$677.70 ,$677.70 ,$677.70 ,$730.41 ,$609.93 ,$700.29 ,$647.58 ,$730.41 
SACRED HEART HOSPITAL (ACU),27203742,N/A,HC STENT XACT STENT EXCHANGE,278,1 ,"$3,371.00 ","$2,528.25 ","$1,820.34 ","$3,371.00 ","$2,170.92 ", N/A ,"$2,359.70 ", N/A ,"$2,797.93 ", N/A ,"$2,224.86 ","$3,202.45 ", N/A ,"$2,696.80 ","$3,101.32 ", N/A ,"$2,865.35 ","$3,202.45 ","$2,966.48 ","$2,561.96 ", N/A , N/A , N/A ,"$2,460.83 ","$1,854.05 ","$3,067.61 ","$3,067.61 ","$2,696.80 ", N/A ,"$1,854.05 ","$3,033.90 ", N/A ,"$3,033.90 ","$1,820.34 ","$3,168.74 ", N/A ,"$3,101.32 ", N/A ,"$3,067.61 ", N/A ,"$2,074.51 ","$2,074.51 ","$3,033.90 ","$2,515.78 ", N/A , N/A , N/A ,"$3,202.45 ", N/A , N/A ,"$2,932.77 ", N/A ,"$3,033.90 ", N/A ,"$3,033.90 ","$3,033.90 ","$3,033.90 ","$3,269.87 ","$2,730.51 ","$3,135.03 ","$2,899.06 ","$3,269.87 "
SACRED HEART HOSPITAL (ACU),27203743,N/A,HC CATHETER REPERFUSION PENUMBRA,272,1 ,"$2,650.00 ","$1,987.50 ","$1,431.00 ","$2,650.00 ","$1,706.60 ", N/A ,"$1,855.00 ", N/A ,"$2,199.50 ", N/A ,"$1,749.00 ","$2,517.50 ", N/A ,"$2,120.00 ","$2,438.00 ", N/A ,"$2,252.50 ","$2,517.50 ","$2,332.00 ","$2,014.00 ", N/A , N/A , N/A ,"$1,934.50 ","$1,457.50 ","$2,411.50 ","$2,411.50 ","$2,120.00 ", N/A ,"$1,457.50 ","$2,385.00 ", N/A ,"$2,385.00 ","$1,431.00 ","$2,491.00 ", N/A ,"$2,438.00 ", N/A ,"$2,411.50 ", N/A ,"$1,630.81 ","$1,630.81 ","$2,385.00 ","$1,977.70 ","$1,845.73 ", N/A , N/A ,"$2,517.50 ", N/A , N/A ,"$2,305.50 ", N/A ,"$2,385.00 ", N/A ,"$2,385.00 ","$2,385.00 ","$2,385.00 ","$2,570.50 ","$2,146.50 ","$2,464.50 ","$2,279.00 ","$2,570.50 "
SACRED HEART HOSPITAL (ACU),27203744,N/A,HC SEPARATOR PENUMBRA,272,1 ,"$4,688.00 ","$3,516.00 ","$2,531.52 ","$4,688.00 ","$3,019.07 ", N/A ,"$3,281.60 ", N/A ,"$3,891.04 ", N/A ,"$3,094.08 ","$4,453.60 ", N/A ,"$3,750.40 ","$4,312.96 ", N/A ,"$3,984.80 ","$4,453.60 ","$4,125.44 ","$3,562.88 ", N/A , N/A , N/A ,"$3,422.24 ","$2,578.40 ","$4,266.08 ","$4,266.08 ","$3,750.40 ", N/A ,"$2,578.40 ","$4,219.20 ", N/A ,"$4,219.20 ","$2,531.52 ","$4,406.72 ", N/A ,"$4,312.96 ", N/A ,"$4,266.08 ", N/A ,"$2,885.00 ","$2,885.00 ","$4,219.20 ","$3,498.65 ","$3,265.19 ", N/A , N/A ,"$4,453.60 ", N/A , N/A ,"$4,078.56 ", N/A ,"$4,219.20 ", N/A ,"$4,219.20 ","$4,219.20 ","$4,219.20 ","$4,547.36 ","$3,797.28 ","$4,359.84 ","$4,031.68 ","$4,547.36 "
SACRED HEART HOSPITAL (ACU),27203745,N/A,HC TUBING ASPIRATION,272,1 ,"$1,160.00 ",$870.00 ,$626.40 ,"$1,160.00 ",$747.04 , N/A ,$812.00 , N/A ,$962.80 , N/A ,$765.60 ,"$1,102.00 ", N/A ,$928.00 ,"$1,067.20 ", N/A ,$986.00 ,"$1,102.00 ","$1,020.80 ",$881.60 , N/A , N/A , N/A ,$846.80 ,$638.00 ,"$1,055.60 ","$1,055.60 ",$928.00 , N/A ,$638.00 ,"$1,044.00 ", N/A ,"$1,044.00 ",$626.40 ,"$1,090.40 ", N/A ,"$1,067.20 ", N/A ,"$1,055.60 ", N/A ,$713.86 ,$713.86 ,"$1,044.00 ",$865.71 ,$807.94 , N/A , N/A ,"$1,102.00 ", N/A , N/A ,"$1,009.20 ", N/A ,"$1,044.00 ", N/A ,"$1,044.00 ","$1,044.00 ","$1,044.00 ","$1,125.20 ",$939.60 ,"$1,078.80 ",$997.60 ,"$1,125.20 "
SACRED HEART HOSPITAL (ACU),27203746,N/A,HC CATHETER BALLOON SLEEK,272,1 ,$897.00 ,$672.75 ,$484.38 ,$897.00 ,$577.67 , N/A ,$627.90 , N/A ,$744.51 , N/A ,$592.02 ,$852.15 , N/A ,$717.60 ,$825.24 , N/A ,$762.45 ,$852.15 ,$789.36 ,$681.72 , N/A , N/A , N/A ,$654.81 ,$493.35 ,$816.27 ,$816.27 ,$717.60 , N/A ,$493.35 ,$807.30 , N/A ,$807.30 ,$484.38 ,$843.18 , N/A ,$825.24 , N/A ,$816.27 , N/A ,$552.01 ,$552.01 ,$807.30 ,$669.43 ,$624.76 , N/A , N/A ,$852.15 , N/A , N/A ,$780.39 , N/A ,$807.30 , N/A ,$807.30 ,$807.30 ,$807.30 ,$870.09 ,$726.57 ,$834.21 ,$771.42 ,$870.09 
SACRED HEART HOSPITAL (ACU),27203747,N/A,HC CATHETER BALLOON POWERFLEX,272,1 ,$423.00 ,$317.25 ,$228.42 ,$423.00 ,$272.41 , N/A ,$296.10 , N/A ,$351.09 , N/A ,$279.18 ,$401.85 , N/A ,$338.40 ,$389.16 , N/A ,$359.55 ,$401.85 ,$372.24 ,$321.48 , N/A , N/A , N/A ,$308.79 ,$232.65 ,$384.93 ,$384.93 ,$338.40 , N/A ,$232.65 ,$380.70 , N/A ,$380.70 ,$228.42 ,$397.62 , N/A ,$389.16 , N/A ,$384.93 , N/A ,$260.31 ,$260.31 ,$380.70 ,$315.68 ,$294.62 , N/A , N/A ,$401.85 , N/A , N/A ,$368.01 , N/A ,$380.70 , N/A ,$380.70 ,$380.70 ,$380.70 ,$410.31 ,$342.63 ,$393.39 ,$363.78 ,$410.31 
SACRED HEART HOSPITAL (ACU),27203748,N/A,HC CATHETER BALLOON SABER,272,1 ,$925.00 ,$693.75 ,$499.50 ,$925.00 ,$595.70 , N/A ,$647.50 , N/A ,$767.75 , N/A ,$610.50 ,$878.75 , N/A ,$740.00 ,$851.00 , N/A ,$786.25 ,$878.75 ,$814.00 ,$703.00 , N/A , N/A , N/A ,$675.25 ,$508.75 ,$841.75 ,$841.75 ,$740.00 , N/A ,$508.75 ,$832.50 , N/A ,$832.50 ,$499.50 ,$869.50 , N/A ,$851.00 , N/A ,$841.75 , N/A ,$569.25 ,$569.25 ,$832.50 ,$690.33 ,$644.26 , N/A , N/A ,$878.75 , N/A , N/A ,$804.75 , N/A ,$832.50 , N/A ,$832.50 ,$832.50 ,$832.50 ,$897.25 ,$749.25 ,$860.25 ,$795.50 ,$897.25 
SACRED HEART HOSPITAL (ACU),27203749,C1725,HC CATHETER BALLOON PERIPHERAL CONQUEST,272,1 ,$643.00 ,$482.25 ,$347.22 ,$643.00 ,$414.09 , N/A ,$450.10 , N/A ,$533.69 , N/A ,$424.38 ,$610.85 , N/A ,$514.40 ,$591.56 , N/A ,$546.55 ,$610.85 ,$565.84 ,$488.68 , N/A , N/A , N/A ,$469.39 ,$353.65 ,$585.13 ,$585.13 ,$514.40 , N/A ,$353.65 ,$578.70 , N/A ,$578.70 ,$347.22 ,$604.42 , N/A ,$591.56 , N/A ,$585.13 , N/A ,$395.70 ,$395.70 ,$578.70 ,$479.87 ,$447.85 , N/A , N/A ,$610.85 , N/A , N/A ,$559.41 , N/A ,$578.70 , N/A ,$578.70 ,$578.70 ,$578.70 ,$623.71 ,$520.83 ,$597.99 ,$552.98 ,$623.71 
SACRED HEART HOSPITAL (ACU),27203750,C2628,HC CATHETER BALLOON OCCLUSION,272,1 ,$715.00 ,$536.25 ,$386.10 ,$715.00 ,$460.46 , N/A ,$500.50 , N/A ,$593.45 , N/A ,$471.90 ,$679.25 , N/A ,$572.00 ,$657.80 , N/A ,$607.75 ,$679.25 ,$629.20 ,$543.40 , N/A , N/A , N/A ,$521.95 ,$393.25 ,$650.65 ,$650.65 ,$572.00 , N/A ,$393.25 ,$643.50 , N/A ,$643.50 ,$386.10 ,$672.10 , N/A ,$657.80 , N/A ,$650.65 , N/A ,$440.01 ,$440.01 ,$643.50 ,$533.60 ,$498.00 , N/A , N/A ,$679.25 , N/A , N/A ,$622.05 , N/A ,$643.50 , N/A ,$643.50 ,$643.50 ,$643.50 ,$693.55 ,$579.15 ,$664.95 ,$614.90 ,$693.55 
SACRED HEART HOSPITAL (ACU),27203751,N/A,HC CATHETER BALLOON INPACT,272,1 ,"$2,211.00 ","$1,658.25 ","$1,193.94 ","$2,211.00 ","$1,423.88 ", N/A ,"$1,547.70 ", N/A ,"$1,835.13 ", N/A ,"$1,459.26 ","$2,100.45 ", N/A ,"$1,768.80 ","$2,034.12 ", N/A ,"$1,879.35 ","$2,100.45 ","$1,945.68 ","$1,680.36 ", N/A , N/A , N/A ,"$1,614.03 ","$1,216.05 ","$2,012.01 ","$2,012.01 ","$1,768.80 ", N/A ,"$1,216.05 ","$1,989.90 ", N/A ,"$1,989.90 ","$1,193.94 ","$2,078.34 ", N/A ,"$2,034.12 ", N/A ,"$2,012.01 ", N/A ,"$1,360.65 ","$1,360.65 ","$1,989.90 ","$1,650.07 ","$1,539.96 ", N/A , N/A ,"$2,100.45 ", N/A , N/A ,"$1,923.57 ", N/A ,"$1,989.90 ", N/A ,"$1,989.90 ","$1,989.90 ","$1,989.90 ","$2,144.67 ","$1,790.91 ","$2,056.23 ","$1,901.46 ","$2,144.67 "
SACRED HEART HOSPITAL (ACU),27203752,N/A,HC CATHETER BALLOON CHOCOLATE,272,1 ,"$1,427.00 ","$1,070.25 ",$770.58 ,"$1,427.00 ",$918.99 , N/A ,$998.90 , N/A ,"$1,184.41 ", N/A ,$941.82 ,"$1,355.65 ", N/A ,"$1,141.60 ","$1,312.84 ", N/A ,"$1,212.95 ","$1,355.65 ","$1,255.76 ","$1,084.52 ", N/A , N/A , N/A ,"$1,041.71 ",$784.85 ,"$1,298.57 ","$1,298.57 ","$1,141.60 ", N/A ,$784.85 ,"$1,284.30 ", N/A ,"$1,284.30 ",$770.58 ,"$1,341.38 ", N/A ,"$1,312.84 ", N/A ,"$1,298.57 ", N/A ,$878.18 ,$878.18 ,"$1,284.30 ","$1,064.97 ",$993.91 , N/A , N/A ,"$1,355.65 ", N/A , N/A ,"$1,241.49 ", N/A ,"$1,284.30 ", N/A ,"$1,284.30 ","$1,284.30 ","$1,284.30 ","$1,384.19 ","$1,155.87 ","$1,327.11 ","$1,227.22 ","$1,384.19 "
SACRED HEART HOSPITAL (ACU),27203753,N/A,HC CATHETER BALLOON MAXI,272,1 ,$922.00 ,$691.50 ,$497.88 ,$922.00 ,$593.77 , N/A ,$645.40 , N/A ,$765.26 , N/A ,$608.52 ,$875.90 , N/A ,$737.60 ,$848.24 , N/A ,$783.70 ,$875.90 ,$811.36 ,$700.72 , N/A , N/A , N/A ,$673.06 ,$507.10 ,$839.02 ,$839.02 ,$737.60 , N/A ,$507.10 ,$829.80 , N/A ,$829.80 ,$497.88 ,$866.68 , N/A ,$848.24 , N/A ,$839.02 , N/A ,$567.40 ,$567.40 ,$829.80 ,$688.09 ,$642.17 , N/A , N/A ,$875.90 , N/A , N/A ,$802.14 , N/A ,$829.80 , N/A ,$829.80 ,$829.80 ,$829.80 ,$894.34 ,$746.82 ,$857.46 ,$792.92 ,$894.34 
SACRED HEART HOSPITAL (ACU),27203754,N/A,HC STENT GENESIS,278,1 ,"$1,411.00 ","$1,058.25 ",$761.94 ,"$1,411.00 ",$908.68 , N/A ,$987.70 , N/A ,"$1,171.13 ", N/A ,$931.26 ,"$1,340.45 ", N/A ,"$1,128.80 ","$1,298.12 ", N/A ,"$1,199.35 ","$1,340.45 ","$1,241.68 ","$1,072.36 ", N/A , N/A , N/A ,"$1,030.03 ",$776.05 ,"$1,284.01 ","$1,284.01 ","$1,128.80 ", N/A ,$776.05 ,"$1,269.90 ", N/A ,"$1,269.90 ",$761.94 ,"$1,326.34 ", N/A ,"$1,298.12 ", N/A ,"$1,284.01 ", N/A ,$868.33 ,$868.33 ,"$1,269.90 ","$1,053.03 ", N/A , N/A , N/A ,"$1,340.45 ", N/A , N/A ,"$1,227.57 ", N/A ,"$1,269.90 ", N/A ,"$1,269.90 ","$1,269.90 ","$1,269.90 ","$1,368.67 ","$1,142.91 ","$1,312.23 ","$1,213.46 ","$1,368.67 "
SACRED HEART HOSPITAL (ACU),27203755,N/A,HC STENT VASCULAR,278,1 ,"$1,356.00 ","$1,017.00 ",$732.24 ,"$1,356.00 ",$873.26 , N/A ,$949.20 , N/A ,"$1,125.48 ", N/A ,$894.96 ,"$1,288.20 ", N/A ,"$1,084.80 ","$1,247.52 ", N/A ,"$1,152.60 ","$1,288.20 ","$1,193.28 ","$1,030.56 ", N/A , N/A , N/A ,$989.88 ,$745.80 ,"$1,233.96 ","$1,233.96 ","$1,084.80 ", N/A ,$745.80 ,"$1,220.40 ", N/A ,"$1,220.40 ",$732.24 ,"$1,274.64 ", N/A ,"$1,247.52 ", N/A ,"$1,233.96 ", N/A ,$834.48 ,$834.48 ,"$1,220.40 ","$1,011.98 ", N/A , N/A , N/A ,"$1,288.20 ", N/A , N/A ,"$1,179.72 ", N/A ,"$1,220.40 ", N/A ,"$1,220.40 ","$1,220.40 ","$1,220.40 ","$1,315.32 ","$1,098.36 ","$1,261.08 ","$1,166.16 ","$1,315.32 "
SACRED HEART HOSPITAL (ACU),27203756,C1877,HC STENT PALMAZ,278,1 ,"$1,835.00 ","$1,376.25 ",$990.90 ,"$1,835.00 ","$1,181.74 ", N/A ,"$1,284.50 ", N/A ,"$1,523.05 ", N/A ,"$1,211.10 ","$1,743.25 ", N/A ,"$1,468.00 ","$1,688.20 ", N/A ,"$1,559.75 ","$1,743.25 ","$1,614.80 ","$1,394.60 ", N/A , N/A , N/A ,"$1,339.55 ","$1,009.25 ","$1,669.85 ","$1,669.85 ","$1,468.00 ", N/A ,"$1,009.25 ","$1,651.50 ", N/A ,"$1,651.50 ",$990.90 ,"$1,724.90 ", N/A ,"$1,688.20 ", N/A ,"$1,669.85 ", N/A ,"$1,129.26 ","$1,129.26 ","$1,651.50 ","$1,369.46 ", N/A , N/A , N/A ,"$1,743.25 ", N/A , N/A ,"$1,596.45 ", N/A ,"$1,651.50 ", N/A ,"$1,651.50 ","$1,651.50 ","$1,651.50 ","$1,779.95 ","$1,486.35 ","$1,706.55 ","$1,578.10 ","$1,779.95 "
SACRED HEART HOSPITAL (ACU),27203757,N/A,HC KIT ASPIRATION ACE 68,272,1 ,"$4,485.00 ","$3,363.75 ","$2,421.90 ","$4,485.00 ","$2,888.34 ", N/A ,"$3,139.50 ", N/A ,"$3,722.55 ", N/A ,"$2,960.10 ","$4,260.75 ", N/A ,"$3,588.00 ","$4,126.20 ", N/A ,"$3,812.25 ","$4,260.75 ","$3,946.80 ","$3,408.60 ", N/A , N/A , N/A ,"$3,274.05 ","$2,466.75 ","$4,081.35 ","$4,081.35 ","$3,588.00 ", N/A ,"$2,466.75 ","$4,036.50 ", N/A ,"$4,036.50 ","$2,421.90 ","$4,215.90 ", N/A ,"$4,126.20 ", N/A ,"$4,081.35 ", N/A ,"$2,760.07 ","$2,760.07 ","$4,036.50 ","$3,347.16 ","$3,123.80 ", N/A , N/A ,"$4,260.75 ", N/A , N/A ,"$3,901.95 ", N/A ,"$4,036.50 ", N/A ,"$4,036.50 ","$4,036.50 ","$4,036.50 ","$4,350.45 ","$3,632.85 ","$4,171.05 ","$3,857.10 ","$4,350.45 "
SACRED HEART HOSPITAL (ACU),27203758,N/A,HC SHEATH NEURON,272,1 ,"$1,294.00 ",$970.50 ,$698.76 ,"$1,294.00 ",$833.34 , N/A ,$905.80 , N/A ,"$1,074.02 ", N/A ,$854.04 ,"$1,229.30 ", N/A ,"$1,035.20 ","$1,190.48 ", N/A ,"$1,099.90 ","$1,229.30 ","$1,138.72 ",$983.44 , N/A , N/A , N/A ,$944.62 ,$711.70 ,"$1,177.54 ","$1,177.54 ","$1,035.20 ", N/A ,$711.70 ,"$1,164.60 ", N/A ,"$1,164.60 ",$698.76 ,"$1,216.36 ", N/A ,"$1,190.48 ", N/A ,"$1,177.54 ", N/A ,$796.33 ,$796.33 ,"$1,164.60 ",$965.71 ,$901.27 , N/A , N/A ,"$1,229.30 ", N/A , N/A ,"$1,125.78 ", N/A ,"$1,164.60 ", N/A ,"$1,164.60 ","$1,164.60 ","$1,164.60 ","$1,255.18 ","$1,048.14 ","$1,203.42 ","$1,112.84 ","$1,255.18 "
SACRED HEART HOSPITAL (ACU),27203759,N/A,HC CANISTER PERIPHERAL,272,1 ,"$1,160.00 ",$870.00 ,$626.40 ,"$1,160.00 ",$747.04 , N/A ,$812.00 , N/A ,$962.80 , N/A ,$765.60 ,"$1,102.00 ", N/A ,$928.00 ,"$1,067.20 ", N/A ,$986.00 ,"$1,102.00 ","$1,020.80 ",$881.60 , N/A , N/A , N/A ,$846.80 ,$638.00 ,"$1,055.60 ","$1,055.60 ",$928.00 , N/A ,$638.00 ,"$1,044.00 ", N/A ,"$1,044.00 ",$626.40 ,"$1,090.40 ", N/A ,"$1,067.20 ", N/A ,"$1,055.60 ", N/A ,$713.86 ,$713.86 ,"$1,044.00 ",$865.71 ,$807.94 , N/A , N/A ,"$1,102.00 ", N/A , N/A ,"$1,009.20 ", N/A ,"$1,044.00 ", N/A ,"$1,044.00 ","$1,044.00 ","$1,044.00 ","$1,125.20 ",$939.60 ,"$1,078.80 ",$997.60 ,"$1,125.20 "
SACRED HEART HOSPITAL (ACU),27203760,N/A,HC CATHETER SEPARATOR INDIGO 3,272,1 ,"$1,811.00 ","$1,358.25 ",$977.94 ,"$1,811.00 ","$1,166.28 ", N/A ,"$1,267.70 ", N/A ,"$1,503.13 ", N/A ,"$1,195.26 ","$1,720.45 ", N/A ,"$1,448.80 ","$1,666.12 ", N/A ,"$1,539.35 ","$1,720.45 ","$1,593.68 ","$1,376.36 ", N/A , N/A , N/A ,"$1,322.03 ",$996.05 ,"$1,648.01 ","$1,648.01 ","$1,448.80 ", N/A ,$996.05 ,"$1,629.90 ", N/A ,"$1,629.90 ",$977.94 ,"$1,702.34 ", N/A ,"$1,666.12 ", N/A ,"$1,648.01 ", N/A ,"$1,114.49 ","$1,114.49 ","$1,629.90 ","$1,351.55 ","$1,261.36 ", N/A , N/A ,"$1,720.45 ", N/A , N/A ,"$1,575.57 ", N/A ,"$1,629.90 ", N/A ,"$1,629.90 ","$1,629.90 ","$1,629.90 ","$1,756.67 ","$1,466.91 ","$1,684.23 ","$1,557.46 ","$1,756.67 "
SACRED HEART HOSPITAL (ACU),27203761,N/A,HC CATHETER SEPARATOR INDIGO 6,272,1 ,"$1,811.00 ","$1,358.25 ",$977.94 ,"$1,811.00 ","$1,166.28 ", N/A ,"$1,267.70 ", N/A ,"$1,503.13 ", N/A ,"$1,195.26 ","$1,720.45 ", N/A ,"$1,448.80 ","$1,666.12 ", N/A ,"$1,539.35 ","$1,720.45 ","$1,593.68 ","$1,376.36 ", N/A , N/A , N/A ,"$1,322.03 ",$996.05 ,"$1,648.01 ","$1,648.01 ","$1,448.80 ", N/A ,$996.05 ,"$1,629.90 ", N/A ,"$1,629.90 ",$977.94 ,"$1,702.34 ", N/A ,"$1,666.12 ", N/A ,"$1,648.01 ", N/A ,"$1,114.49 ","$1,114.49 ","$1,629.90 ","$1,351.55 ","$1,261.36 ", N/A , N/A ,"$1,720.45 ", N/A , N/A ,"$1,575.57 ", N/A ,"$1,629.90 ", N/A ,"$1,629.90 ","$1,629.90 ","$1,629.90 ","$1,756.67 ","$1,466.91 ","$1,684.23 ","$1,557.46 ","$1,756.67 "
SACRED HEART HOSPITAL (ACU),27203762,N/A,HC CATHETER SEPARATOR INDIGO 8,272,1 ,"$3,065.00 ","$2,298.75 ","$1,655.10 ","$3,065.00 ","$1,973.86 ", N/A ,"$2,145.50 ", N/A ,"$2,543.95 ", N/A ,"$2,022.90 ","$2,911.75 ", N/A ,"$2,452.00 ","$2,819.80 ", N/A ,"$2,605.25 ","$2,911.75 ","$2,697.20 ","$2,329.40 ", N/A , N/A , N/A ,"$2,237.45 ","$1,685.75 ","$2,789.15 ","$2,789.15 ","$2,452.00 ", N/A ,"$1,685.75 ","$2,758.50 ", N/A ,"$2,758.50 ","$1,655.10 ","$2,881.10 ", N/A ,"$2,819.80 ", N/A ,"$2,789.15 ", N/A ,"$1,886.20 ","$1,886.20 ","$2,758.50 ","$2,287.41 ","$2,134.77 ", N/A , N/A ,"$2,911.75 ", N/A , N/A ,"$2,666.55 ", N/A ,"$2,758.50 ", N/A ,"$2,758.50 ","$2,758.50 ","$2,758.50 ","$2,973.05 ","$2,482.65 ","$2,850.45 ","$2,635.90 ","$2,973.05 "
SACRED HEART HOSPITAL (ACU),27203763,N/A,HC CATHETER ASPIRATION INDIGO 3,272,1 ,"$1,952.00 ","$1,464.00 ","$1,054.08 ","$1,952.00 ","$1,257.09 ", N/A ,"$1,366.40 ", N/A ,"$1,620.16 ", N/A ,"$1,288.32 ","$1,854.40 ", N/A ,"$1,561.60 ","$1,795.84 ", N/A ,"$1,659.20 ","$1,854.40 ","$1,717.76 ","$1,483.52 ", N/A , N/A , N/A ,"$1,424.96 ","$1,073.60 ","$1,776.32 ","$1,776.32 ","$1,561.60 ", N/A ,"$1,073.60 ","$1,756.80 ", N/A ,"$1,756.80 ","$1,054.08 ","$1,834.88 ", N/A ,"$1,795.84 ", N/A ,"$1,776.32 ", N/A ,"$1,201.26 ","$1,201.26 ","$1,756.80 ","$1,456.78 ","$1,359.57 ", N/A , N/A ,"$1,854.40 ", N/A , N/A ,"$1,698.24 ", N/A ,"$1,756.80 ", N/A ,"$1,756.80 ","$1,756.80 ","$1,756.80 ","$1,893.44 ","$1,581.12 ","$1,815.36 ","$1,678.72 ","$1,893.44 "
SACRED HEART HOSPITAL (ACU),27203764,N/A,HC CATHETER ASPIRATION INDIGO 6,272,1 ,"$3,058.00 ","$2,293.50 ","$1,651.32 ","$3,058.00 ","$1,969.35 ", N/A ,"$2,140.60 ", N/A ,"$2,538.14 ", N/A ,"$2,018.28 ","$2,905.10 ", N/A ,"$2,446.40 ","$2,813.36 ", N/A ,"$2,599.30 ","$2,905.10 ","$2,691.04 ","$2,324.08 ", N/A , N/A , N/A ,"$2,232.34 ","$1,681.90 ","$2,782.78 ","$2,782.78 ","$2,446.40 ", N/A ,"$1,681.90 ","$2,752.20 ", N/A ,"$2,752.20 ","$1,651.32 ","$2,874.52 ", N/A ,"$2,813.36 ", N/A ,"$2,782.78 ", N/A ,"$1,881.89 ","$1,881.89 ","$2,752.20 ","$2,282.19 ","$2,129.90 ", N/A , N/A ,"$2,905.10 ", N/A , N/A ,"$2,660.46 ", N/A ,"$2,752.20 ", N/A ,"$2,752.20 ","$2,752.20 ","$2,752.20 ","$2,966.26 ","$2,476.98 ","$2,843.94 ","$2,629.88 ","$2,966.26 "
SACRED HEART HOSPITAL (ACU),27203765,N/A,HC CATHETER ASPIRATION INDIGO 8,272,1 ,"$4,626.00 ","$3,469.50 ","$2,498.04 ","$4,626.00 ","$2,979.14 ", N/A ,"$3,238.20 ", N/A ,"$3,839.58 ", N/A ,"$3,053.16 ","$4,394.70 ", N/A ,"$3,700.80 ","$4,255.92 ", N/A ,"$3,932.10 ","$4,394.70 ","$4,070.88 ","$3,515.76 ", N/A , N/A , N/A ,"$3,376.98 ","$2,544.30 ","$4,209.66 ","$4,209.66 ","$3,700.80 ", N/A ,"$2,544.30 ","$4,163.40 ", N/A ,"$4,163.40 ","$2,498.04 ","$4,348.44 ", N/A ,"$4,255.92 ", N/A ,"$4,209.66 ", N/A ,"$2,846.84 ","$2,846.84 ","$4,163.40 ","$3,452.38 ","$3,222.01 ", N/A , N/A ,"$4,394.70 ", N/A , N/A ,"$4,024.62 ", N/A ,"$4,163.40 ", N/A ,"$4,163.40 ","$4,163.40 ","$4,163.40 ","$4,487.22 ","$3,747.06 ","$4,302.18 ","$3,978.36 ","$4,487.22 "
SACRED HEART HOSPITAL (ACU),27203766,N/A,HC CATHETER SELECT,272,1 ,$392.00 ,$294.00 ,$211.68 ,$392.00 ,$252.45 , N/A ,$274.40 , N/A ,$325.36 , N/A ,$258.72 ,$372.40 , N/A ,$313.60 ,$360.64 , N/A ,$333.20 ,$372.40 ,$344.96 ,$297.92 , N/A , N/A , N/A ,$286.16 ,$215.60 ,$356.72 ,$356.72 ,$313.60 , N/A ,$215.60 ,$352.80 , N/A ,$352.80 ,$211.68 ,$368.48 , N/A ,$360.64 , N/A ,$356.72 , N/A ,$241.24 ,$241.24 ,$352.80 ,$292.55 ,$273.03 , N/A , N/A ,$372.40 , N/A , N/A ,$341.04 , N/A ,$352.80 , N/A ,$352.80 ,$352.80 ,$352.80 ,$380.24 ,$317.52 ,$364.56 ,$337.12 ,$380.24 
SACRED HEART HOSPITAL (ACU),27203767,N/A,HC CATHETER GLIDE,272,1 ,$161.00 ,$120.75 ,$86.94 ,$161.00 ,$103.68 , N/A ,$112.70 , N/A ,$133.63 , N/A ,$106.26 ,$152.95 , N/A ,$128.80 ,$148.12 , N/A ,$136.85 ,$152.95 ,$141.68 ,$122.36 , N/A , N/A , N/A ,$117.53 ,$88.55 ,$146.51 ,$146.51 ,$128.80 , N/A ,$88.55 ,$144.90 , N/A ,$144.90 ,$86.94 ,$151.34 , N/A ,$148.12 , N/A ,$146.51 , N/A ,$99.08 ,$99.08 ,$144.90 ,$120.15 ,$112.14 , N/A , N/A ,$152.95 , N/A , N/A ,$140.07 , N/A ,$144.90 , N/A ,$144.90 ,$144.90 ,$144.90 ,$156.17 ,$130.41 ,$149.73 ,$138.46 ,$156.17 
SACRED HEART HOSPITAL (ACU),27203768,N/A,HC KIT ANCHOR SUTURE,272,1 ,$338.00 ,$253.50 ,$182.52 ,$338.00 ,$217.67 , N/A ,$236.60 , N/A ,$280.54 , N/A ,$223.08 ,$321.10 , N/A ,$270.40 ,$310.96 , N/A ,$287.30 ,$321.10 ,$297.44 ,$256.88 , N/A , N/A , N/A ,$246.74 ,$185.90 ,$307.58 ,$307.58 ,$270.40 , N/A ,$185.90 ,$304.20 , N/A ,$304.20 ,$182.52 ,$317.72 , N/A ,$310.96 , N/A ,$307.58 , N/A ,$208.01 ,$208.01 ,$304.20 ,$252.25 ,$235.42 , N/A , N/A ,$321.10 , N/A , N/A ,$294.06 , N/A ,$304.20 , N/A ,$304.20 ,$304.20 ,$304.20 ,$327.86 ,$273.78 ,$314.34 ,$290.68 ,$327.86 
SACRED HEART HOSPITAL (ACU),27203770,N/A,HC STENT NEPHROURETERAL,278,1 ,$363.00 ,$272.25 ,$196.02 ,$363.00 ,$233.77 , N/A ,$254.10 , N/A ,$301.29 , N/A ,$239.58 ,$344.85 , N/A ,$290.40 ,$333.96 , N/A ,$308.55 ,$344.85 ,$319.44 ,$275.88 , N/A , N/A , N/A ,$264.99 ,$199.65 ,$330.33 ,$330.33 ,$290.40 , N/A ,$199.65 ,$326.70 , N/A ,$326.70 ,$196.02 ,$341.22 , N/A ,$333.96 , N/A ,$330.33 , N/A ,$223.39 ,$223.39 ,$326.70 ,$270.91 , N/A , N/A , N/A ,$344.85 , N/A , N/A ,$315.81 , N/A ,$326.70 , N/A ,$326.70 ,$326.70 ,$326.70 ,$352.11 ,$294.03 ,$337.59 ,$312.18 ,$352.11 
SACRED HEART HOSPITAL (ACU),27203771,N/A,HC KIT PARACENTESIS,272,1 ,"$1,297.00 ",$972.75 ,$700.38 ,"$1,297.00 ",$835.27 , N/A ,$907.90 , N/A ,"$1,076.51 ", N/A ,$856.02 ,"$1,232.15 ", N/A ,"$1,037.60 ","$1,193.24 ", N/A ,"$1,102.45 ","$1,232.15 ","$1,141.36 ",$985.72 , N/A , N/A , N/A ,$946.81 ,$713.35 ,"$1,180.27 ","$1,180.27 ","$1,037.60 ", N/A ,$713.35 ,"$1,167.30 ", N/A ,"$1,167.30 ",$700.38 ,"$1,219.18 ", N/A ,"$1,193.24 ", N/A ,"$1,180.27 ", N/A ,$798.17 ,$798.17 ,"$1,167.30 ",$967.95 ,$903.36 , N/A , N/A ,"$1,232.15 ", N/A , N/A ,"$1,128.39 ", N/A ,"$1,167.30 ", N/A ,"$1,167.30 ","$1,167.30 ","$1,167.30 ","$1,258.09 ","$1,050.57 ","$1,206.21 ","$1,115.42 ","$1,258.09 "
SACRED HEART HOSPITAL (ACU),27203772,C1769,HC GUIDEWIRE TAD,272,1 ,$433.00 ,$324.75 ,$233.82 ,$433.00 ,$278.85 , N/A ,$303.10 , N/A ,$359.39 , N/A ,$285.78 ,$411.35 , N/A ,$346.40 ,$398.36 , N/A ,$368.05 ,$411.35 ,$381.04 ,$329.08 , N/A , N/A , N/A ,$316.09 ,$238.15 ,$394.03 ,$394.03 ,$346.40 , N/A ,$238.15 ,$389.70 , N/A ,$389.70 ,$233.82 ,$407.02 , N/A ,$398.36 , N/A ,$394.03 , N/A ,$266.47 ,$266.47 ,$389.70 ,$323.15 ,$301.58 , N/A , N/A ,$411.35 , N/A , N/A ,$376.71 , N/A ,$389.70 , N/A ,$389.70 ,$389.70 ,$389.70 ,$420.01 ,$350.73 ,$402.69 ,$372.38 ,$420.01 
SACRED HEART HOSPITAL (ACU),27203773,C1769,HC GUIDEWIRE ANGIOPLASTY,272,1 ,$392.00 ,$294.00 ,$211.68 ,$392.00 ,$252.45 , N/A ,$274.40 , N/A ,$325.36 , N/A ,$258.72 ,$372.40 , N/A ,$313.60 ,$360.64 , N/A ,$333.20 ,$372.40 ,$344.96 ,$297.92 , N/A , N/A , N/A ,$286.16 ,$215.60 ,$356.72 ,$356.72 ,$313.60 , N/A ,$215.60 ,$352.80 , N/A ,$352.80 ,$211.68 ,$368.48 , N/A ,$360.64 , N/A ,$356.72 , N/A ,$241.24 ,$241.24 ,$352.80 ,$292.55 ,$273.03 , N/A , N/A ,$372.40 , N/A , N/A ,$341.04 , N/A ,$352.80 , N/A ,$352.80 ,$352.80 ,$352.80 ,$380.24 ,$317.52 ,$364.56 ,$337.12 ,$380.24 
SACRED HEART HOSPITAL (ACU),27203774,N/A,HC MARKER PIGTAIL,272,1 ,$602.00 ,$451.50 ,$325.08 ,$602.00 ,$387.69 , N/A ,$421.40 , N/A ,$499.66 , N/A ,$397.32 ,$571.90 , N/A ,$481.60 ,$553.84 , N/A ,$511.70 ,$571.90 ,$529.76 ,$457.52 , N/A , N/A , N/A ,$439.46 ,$331.10 ,$547.82 ,$547.82 ,$481.60 , N/A ,$331.10 ,$541.80 , N/A ,$541.80 ,$325.08 ,$565.88 , N/A ,$553.84 , N/A ,$547.82 , N/A ,$370.47 ,$370.47 ,$541.80 ,$449.27 ,$419.29 , N/A , N/A ,$571.90 , N/A , N/A ,$523.74 , N/A ,$541.80 , N/A ,$541.80 ,$541.80 ,$541.80 ,$583.94 ,$487.62 ,$559.86 ,$517.72 ,$583.94 
SACRED HEART HOSPITAL (ACU),27203775,N/A,HC STENT VASCULAR CONTROL 40-100MM LENGTH,278,1 ,"$1,422.00 ","$1,066.50 ",$767.88 ,"$1,422.00 ",$915.77 , N/A ,$995.40 , N/A ,"$1,180.26 ", N/A ,$938.52 ,"$1,350.90 ", N/A ,"$1,137.60 ","$1,308.24 ", N/A ,"$1,208.70 ","$1,350.90 ","$1,251.36 ","$1,080.72 ", N/A , N/A , N/A ,"$1,038.06 ",$782.10 ,"$1,294.02 ","$1,294.02 ","$1,137.60 ", N/A ,$782.10 ,"$1,279.80 ", N/A ,"$1,279.80 ",$767.88 ,"$1,336.68 ", N/A ,"$1,308.24 ", N/A ,"$1,294.02 ", N/A ,$875.10 ,$875.10 ,"$1,279.80 ","$1,061.24 ", N/A , N/A , N/A ,"$1,350.90 ", N/A , N/A ,"$1,237.14 ", N/A ,"$1,279.80 ", N/A ,"$1,279.80 ","$1,279.80 ","$1,279.80 ","$1,379.34 ","$1,151.82 ","$1,322.46 ","$1,222.92 ","$1,379.34 "
SACRED HEART HOSPITAL (ACU),27203776,N/A,HC STENT VASCULAR CONTROL 120-150MM LENGTH,278,1 ,"$1,811.00 ","$1,358.25 ",$977.94 ,"$1,811.00 ","$1,166.28 ", N/A ,"$1,267.70 ", N/A ,"$1,503.13 ", N/A ,"$1,195.26 ","$1,720.45 ", N/A ,"$1,448.80 ","$1,666.12 ", N/A ,"$1,539.35 ","$1,720.45 ","$1,593.68 ","$1,376.36 ", N/A , N/A , N/A ,"$1,322.03 ",$996.05 ,"$1,648.01 ","$1,648.01 ","$1,448.80 ", N/A ,$996.05 ,"$1,629.90 ", N/A ,"$1,629.90 ",$977.94 ,"$1,702.34 ", N/A ,"$1,666.12 ", N/A ,"$1,648.01 ", N/A ,"$1,114.49 ","$1,114.49 ","$1,629.90 ","$1,351.55 ", N/A , N/A , N/A ,"$1,720.45 ", N/A , N/A ,"$1,575.57 ", N/A ,"$1,629.90 ", N/A ,"$1,629.90 ","$1,629.90 ","$1,629.90 ","$1,756.67 ","$1,466.91 ","$1,684.23 ","$1,557.46 ","$1,756.67 "
SACRED HEART HOSPITAL (ACU),27203777,N/A,HC STENT VASCULAR CONTROL 12-14MM,278,1 ,"$1,356.00 ","$1,017.00 ",$732.24 ,"$1,356.00 ",$873.26 , N/A ,$949.20 , N/A ,"$1,125.48 ", N/A ,$894.96 ,"$1,288.20 ", N/A ,"$1,084.80 ","$1,247.52 ", N/A ,"$1,152.60 ","$1,288.20 ","$1,193.28 ","$1,030.56 ", N/A , N/A , N/A ,$989.88 ,$745.80 ,"$1,233.96 ","$1,233.96 ","$1,084.80 ", N/A ,$745.80 ,"$1,220.40 ", N/A ,"$1,220.40 ",$732.24 ,"$1,274.64 ", N/A ,"$1,247.52 ", N/A ,"$1,233.96 ", N/A ,$834.48 ,$834.48 ,"$1,220.40 ","$1,011.98 ", N/A , N/A , N/A ,"$1,288.20 ", N/A , N/A ,"$1,179.72 ", N/A ,"$1,220.40 ", N/A ,"$1,220.40 ","$1,220.40 ","$1,220.40 ","$1,315.32 ","$1,098.36 ","$1,261.08 ","$1,166.16 ","$1,315.32 "
SACRED HEART HOSPITAL (ACU),27203790,N/A,HC BLADE CAUTERY PEAK PLASMA,272,1 ,$813.00 ,$609.75 ,$439.02 ,$813.00 ,$523.57 , N/A ,$569.10 , N/A ,$674.79 , N/A ,$536.58 ,$772.35 , N/A ,$650.40 ,$747.96 , N/A ,$691.05 ,$772.35 ,$715.44 ,$617.88 , N/A , N/A , N/A ,$593.49 ,$447.15 ,$739.83 ,$739.83 ,$650.40 , N/A ,$447.15 ,$731.70 , N/A ,$731.70 ,$439.02 ,$764.22 , N/A ,$747.96 , N/A ,$739.83 , N/A ,$500.32 ,$500.32 ,$731.70 ,$606.74 ,$566.25 , N/A , N/A ,$772.35 , N/A , N/A ,$707.31 , N/A ,$731.70 , N/A ,$731.70 ,$731.70 ,$731.70 ,$788.61 ,$658.53 ,$756.09 ,$699.18 ,$788.61 
SACRED HEART HOSPITAL (ACU),27203825,C1769,HC GUIDEWIRE VIPER WIRE,272,1 ,$605.00 ,$453.75 ,$326.70 ,$605.00 ,$389.62 , N/A ,$423.50 , N/A ,$502.15 , N/A ,$399.30 ,$574.75 , N/A ,$484.00 ,$556.60 , N/A ,$514.25 ,$574.75 ,$532.40 ,$459.80 , N/A , N/A , N/A ,$441.65 ,$332.75 ,$550.55 ,$550.55 ,$484.00 , N/A ,$332.75 ,$544.50 , N/A ,$544.50 ,$326.70 ,$568.70 , N/A ,$556.60 , N/A ,$550.55 , N/A ,$372.32 ,$372.32 ,$544.50 ,$451.51 ,$421.38 , N/A , N/A ,$574.75 , N/A , N/A ,$526.35 , N/A ,$544.50 , N/A ,$544.50 ,$544.50 ,$544.50 ,$586.85 ,$490.05 ,$562.65 ,$520.30 ,$586.85 
SACRED HEART HOSPITAL (ACU),27203911,C1724,HC CATHETER TRANSLUMINAL ATHERECTOMY ROTATIONAL T1,272,1 ,"$5,892.00 ","$4,419.00 ","$3,181.68 ","$5,892.00 ","$3,794.45 ", N/A ,"$4,124.40 ", N/A ,"$4,890.36 ", N/A ,"$3,888.72 ","$5,597.40 ", N/A ,"$4,713.60 ","$5,420.64 ", N/A ,"$5,008.20 ","$5,597.40 ","$5,184.96 ","$4,477.92 ", N/A , N/A , N/A ,"$4,301.16 ","$3,240.60 ","$5,361.72 ","$5,361.72 ","$4,713.60 ", N/A ,"$3,240.60 ","$5,302.80 ", N/A ,"$5,302.80 ","$3,181.68 ","$5,538.48 ", N/A ,"$5,420.64 ", N/A ,"$5,361.72 ", N/A ,"$3,625.94 ","$3,625.94 ","$5,302.80 ","$4,397.20 ","$4,103.78 ", N/A , N/A ,"$5,597.40 ", N/A , N/A ,"$5,126.04 ", N/A ,"$5,302.80 ", N/A ,"$5,302.80 ","$5,302.80 ","$5,302.80 ","$5,715.24 ","$4,772.52 ","$5,479.56 ","$5,067.12 ","$5,715.24 "
SACRED HEART HOSPITAL (ACU),27203948,C1725,HC CATHETER TRANSLUMINAL ANGIOPLASTY NON-LASER T6,272,1 ,$248.00 ,$186.00 ,$133.92 ,$248.00 ,$159.71 , N/A ,$173.60 , N/A ,$205.84 , N/A ,$163.68 ,$235.60 , N/A ,$198.40 ,$228.16 , N/A ,$210.80 ,$235.60 ,$218.24 ,$188.48 , N/A , N/A , N/A ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 , N/A ,$136.40 ,$223.20 , N/A ,$223.20 ,$133.92 ,$233.12 , N/A ,$228.16 , N/A ,$225.68 , N/A ,$152.62 ,$152.62 ,$223.20 ,$185.08 ,$172.73 , N/A , N/A ,$235.60 , N/A , N/A ,$215.76 , N/A ,$223.20 , N/A ,$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),27204073,C1751,HC CATHETER INFUSION PICC/CV/MIDLINE T1,272,1 ,$458.00 ,$343.50 ,$247.32 ,$458.00 ,$294.95 , N/A ,$320.60 , N/A ,$380.14 , N/A ,$302.28 ,$435.10 , N/A ,$366.40 ,$421.36 , N/A ,$389.30 ,$435.10 ,$403.04 ,$348.08 , N/A , N/A , N/A ,$334.34 ,$251.90 ,$416.78 ,$416.78 ,$366.40 , N/A ,$251.90 ,$412.20 , N/A ,$412.20 ,$247.32 ,$430.52 , N/A ,$421.36 , N/A ,$416.78 , N/A ,$281.85 ,$281.85 ,$412.20 ,$341.81 ,$319.00 , N/A , N/A ,$435.10 , N/A , N/A ,$398.46 , N/A ,$412.20 , N/A ,$412.20 ,$412.20 ,$412.20 ,$444.26 ,$370.98 ,$425.94 ,$393.88 ,$444.26 
SACRED HEART HOSPITAL (ACU),27204128,C1757,HC CATHETER THROMBECTOMY/EMBOLECTOMY T28,272,1 ,"$8,678.00 ","$6,508.50 ","$4,686.12 ","$8,678.00 ","$5,588.63 ", N/A ,"$6,074.60 ", N/A ,"$7,202.74 ", N/A ,"$5,727.48 ","$8,244.10 ", N/A ,"$6,942.40 ","$7,983.76 ", N/A ,"$7,376.30 ","$8,244.10 ","$7,636.64 ","$6,595.28 ", N/A , N/A , N/A ,"$6,334.94 ","$4,772.90 ","$7,896.98 ","$7,896.98 ","$6,942.40 ", N/A ,"$4,772.90 ","$7,810.20 ", N/A ,"$7,810.20 ","$4,686.12 ","$8,157.32 ", N/A ,"$7,983.76 ", N/A ,"$7,896.98 ", N/A ,"$5,340.44 ","$5,340.44 ","$7,810.20 ","$6,476.39 ","$6,044.23 ", N/A , N/A ,"$8,244.10 ", N/A , N/A ,"$7,549.86 ", N/A ,"$7,810.20 ", N/A ,"$7,810.20 ","$7,810.20 ","$7,810.20 ","$8,417.66 ","$7,029.18 ","$8,070.54 ","$7,463.08 ","$8,417.66 "
SACRED HEART HOSPITAL (ACU),27204334,C1887,HC CATHETER GUIDING T10,272,1 ,$543.00 ,$407.25 ,$293.22 ,$543.00 ,$349.69 , N/A ,$380.10 , N/A ,$450.69 , N/A ,$358.38 ,$515.85 , N/A ,$434.40 ,$499.56 , N/A ,$461.55 ,$515.85 ,$477.84 ,$412.68 , N/A , N/A , N/A ,$396.39 ,$298.65 ,$494.13 ,$494.13 ,$434.40 , N/A ,$298.65 ,$488.70 , N/A ,$488.70 ,$293.22 ,$510.42 , N/A ,$499.56 , N/A ,$494.13 , N/A ,$334.16 ,$334.16 ,$488.70 ,$405.24 ,$378.20 , N/A , N/A ,$515.85 , N/A , N/A ,$472.41 , N/A ,$488.70 , N/A ,$488.70 ,$488.70 ,$488.70 ,$526.71 ,$439.83 ,$504.99 ,$466.98 ,$526.71 
SACRED HEART HOSPITAL (ACU),27204557,C1729,HC CATHETER DRAINAGE T1,272,1 ,$54.00 ,$40.50 ,$29.16 ,$54.00 ,$34.78 , N/A ,$37.80 , N/A ,$44.82 , N/A ,$35.64 ,$51.30 , N/A ,$43.20 ,$49.68 , N/A ,$45.90 ,$51.30 ,$47.52 ,$41.04 , N/A , N/A , N/A ,$39.42 ,$29.70 ,$49.14 ,$49.14 ,$43.20 , N/A ,$29.70 ,$48.60 , N/A ,$48.60 ,$29.16 ,$50.76 , N/A ,$49.68 , N/A ,$49.14 , N/A ,$33.23 ,$33.23 ,$48.60 ,$40.30 ,$37.61 , N/A , N/A ,$51.30 , N/A , N/A ,$46.98 , N/A ,$48.60 , N/A ,$48.60 ,$48.60 ,$48.60 ,$52.38 ,$43.74 ,$50.22 ,$46.44 ,$52.38 
SACRED HEART HOSPITAL (ACU),27204630,N/A,HC HANDLE DETACHMENT RUBY,272,1 ,$699.00 ,$524.25 ,$377.46 ,$699.00 ,$450.16 , N/A ,$489.30 , N/A ,$580.17 , N/A ,$461.34 ,$664.05 , N/A ,$559.20 ,$643.08 , N/A ,$594.15 ,$664.05 ,$615.12 ,$531.24 , N/A , N/A , N/A ,$510.27 ,$384.45 ,$636.09 ,$636.09 ,$559.20 , N/A ,$384.45 ,$629.10 , N/A ,$629.10 ,$377.46 ,$657.06 , N/A ,$643.08 , N/A ,$636.09 , N/A ,$430.16 ,$430.16 ,$629.10 ,$521.66 ,$486.85 , N/A , N/A ,$664.05 , N/A , N/A ,$608.13 , N/A ,$629.10 , N/A ,$629.10 ,$629.10 ,$629.10 ,$678.03 ,$566.19 ,$650.07 ,$601.14 ,$678.03 
SACRED HEART HOSPITAL (ACU),27204631,N/A,HC SEPARATOR 3D,272,1 ,"$8,678.00 ","$6,508.50 ","$4,686.12 ","$8,678.00 ","$5,588.63 ", N/A ,"$6,074.60 ", N/A ,"$7,202.74 ", N/A ,"$5,727.48 ","$8,244.10 ", N/A ,"$6,942.40 ","$7,983.76 ", N/A ,"$7,376.30 ","$8,244.10 ","$7,636.64 ","$6,595.28 ", N/A , N/A , N/A ,"$6,334.94 ","$4,772.90 ","$7,896.98 ","$7,896.98 ","$6,942.40 ", N/A ,"$4,772.90 ","$7,810.20 ", N/A ,"$7,810.20 ","$4,686.12 ","$8,157.32 ", N/A ,"$7,983.76 ", N/A ,"$7,896.98 ", N/A ,"$5,340.44 ","$5,340.44 ","$7,810.20 ","$6,476.39 ","$6,044.23 ", N/A , N/A ,"$8,244.10 ", N/A , N/A ,"$7,549.86 ", N/A ,"$7,810.20 ", N/A ,"$7,810.20 ","$7,810.20 ","$7,810.20 ","$8,417.66 ","$7,029.18 ","$8,070.54 ","$7,463.08 ","$8,417.66 "
SACRED HEART HOSPITAL (ACU),27204632,N/A,HC MICROCATHETER PX SLIM,272,1 ,"$1,351.00 ","$1,013.25 ",$729.54 ,"$1,351.00 ",$870.04 , N/A ,$945.70 , N/A ,"$1,121.33 ", N/A ,$891.66 ,"$1,283.45 ", N/A ,"$1,080.80 ","$1,242.92 ", N/A ,"$1,148.35 ","$1,283.45 ","$1,188.88 ","$1,026.76 ", N/A , N/A , N/A ,$986.23 ,$743.05 ,"$1,229.41 ","$1,229.41 ","$1,080.80 ", N/A ,$743.05 ,"$1,215.90 ", N/A ,"$1,215.90 ",$729.54 ,"$1,269.94 ", N/A ,"$1,242.92 ", N/A ,"$1,229.41 ", N/A ,$831.41 ,$831.41 ,"$1,215.90 ","$1,008.25 ",$940.97 , N/A , N/A ,"$1,283.45 ", N/A , N/A ,"$1,175.37 ", N/A ,"$1,215.90 ", N/A ,"$1,215.90 ","$1,215.90 ","$1,215.90 ","$1,310.47 ","$1,094.31 ","$1,256.43 ","$1,161.86 ","$1,310.47 "
SACRED HEART HOSPITAL (ACU),27204633,N/A,HC QUICK CLOT HEMOSTATIS,272,1 ,$102.00 ,$76.50 ,$55.08 ,$102.00 ,$65.69 , N/A ,$71.40 , N/A ,$84.66 , N/A ,$67.32 ,$96.90 , N/A ,$81.60 ,$93.84 , N/A ,$86.70 ,$96.90 ,$89.76 ,$77.52 , N/A , N/A , N/A ,$74.46 ,$56.10 ,$92.82 ,$92.82 ,$81.60 , N/A ,$56.10 ,$91.80 , N/A ,$91.80 ,$55.08 ,$95.88 , N/A ,$93.84 , N/A ,$92.82 , N/A ,$62.77 ,$62.77 ,$91.80 ,$76.12 ,$71.04 , N/A , N/A ,$96.90 , N/A , N/A ,$88.74 , N/A ,$91.80 , N/A ,$91.80 ,$91.80 ,$91.80 ,$98.94 ,$82.62 ,$94.86 ,$87.72 ,$98.94 
SACRED HEART HOSPITAL (ACU),27204634,C1757,HC ASPIRATION CATHETER CATD,272,1 ,"$4,331.00 ","$3,248.25 ","$2,338.74 ","$4,331.00 ","$2,789.16 ", N/A ,"$3,031.70 ", N/A ,"$3,594.73 ", N/A ,"$2,858.46 ","$4,114.45 ", N/A ,"$3,464.80 ","$3,984.52 ", N/A ,"$3,681.35 ","$4,114.45 ","$3,811.28 ","$3,291.56 ", N/A , N/A , N/A ,"$3,161.63 ","$2,382.05 ","$3,941.21 ","$3,941.21 ","$3,464.80 ", N/A ,"$2,382.05 ","$3,897.90 ", N/A ,"$3,897.90 ","$2,338.74 ","$4,071.14 ", N/A ,"$3,984.52 ", N/A ,"$3,941.21 ", N/A ,"$2,665.30 ","$2,665.30 ","$3,897.90 ","$3,232.23 ","$3,016.54 ", N/A , N/A ,"$4,114.45 ", N/A , N/A ,"$3,767.97 ", N/A ,"$3,897.90 ", N/A ,"$3,897.90 ","$3,897.90 ","$3,897.90 ","$4,201.07 ","$3,508.11 ","$4,027.83 ","$3,724.66 ","$4,201.07 "
SACRED HEART HOSPITAL (ACU),27204635,N/A,HC SEPARATOR CATD,272,1 ,"$2,787.00 ","$2,090.25 ","$1,504.98 ","$2,787.00 ","$1,794.83 ", N/A ,"$1,950.90 ", N/A ,"$2,313.21 ", N/A ,"$1,839.42 ","$2,647.65 ", N/A ,"$2,229.60 ","$2,564.04 ", N/A ,"$2,368.95 ","$2,647.65 ","$2,452.56 ","$2,118.12 ", N/A , N/A , N/A ,"$2,034.51 ","$1,532.85 ","$2,536.17 ","$2,536.17 ","$2,229.60 ", N/A ,"$1,532.85 ","$2,508.30 ", N/A ,"$2,508.30 ","$1,504.98 ","$2,619.78 ", N/A ,"$2,564.04 ", N/A ,"$2,536.17 ", N/A ,"$1,715.12 ","$1,715.12 ","$2,508.30 ","$2,079.94 ","$1,941.15 ", N/A , N/A ,"$2,647.65 ", N/A , N/A ,"$2,424.69 ", N/A ,"$2,508.30 ", N/A ,"$2,508.30 ","$2,508.30 ","$2,508.30 ","$2,703.39 ","$2,257.47 ","$2,591.91 ","$2,396.82 ","$2,703.39 "
SACRED HEART HOSPITAL (ACU),27204636,N/A,HC GLIDEWIRE ADVANTAGE,272,1 ,$528.00 ,$396.00 ,$285.12 ,$528.00 ,$340.03 , N/A ,$369.60 , N/A ,$438.24 , N/A ,$348.48 ,$501.60 , N/A ,$422.40 ,$485.76 , N/A ,$448.80 ,$501.60 ,$464.64 ,$401.28 , N/A , N/A , N/A ,$385.44 ,$290.40 ,$480.48 ,$480.48 ,$422.40 , N/A ,$290.40 ,$475.20 , N/A ,$475.20 ,$285.12 ,$496.32 , N/A ,$485.76 , N/A ,$480.48 , N/A ,$324.93 ,$324.93 ,$475.20 ,$394.05 ,$367.75 , N/A , N/A ,$501.60 , N/A , N/A ,$459.36 , N/A ,$475.20 , N/A ,$475.20 ,$475.20 ,$475.20 ,$512.16 ,$427.68 ,$491.04 ,$454.08 ,$512.16 
SACRED HEART HOSPITAL (ACU),27204637,N/A,HC GLIDEWIRE GOLD TIP,272,1 ,$900.00 ,$675.00 ,$486.00 ,$900.00 ,$579.60 , N/A ,$630.00 , N/A ,$747.00 , N/A ,$594.00 ,$855.00 , N/A ,$720.00 ,$828.00 , N/A ,$765.00 ,$855.00 ,$792.00 ,$684.00 , N/A , N/A , N/A ,$657.00 ,$495.00 ,$819.00 ,$819.00 ,$720.00 , N/A ,$495.00 ,$810.00 , N/A ,$810.00 ,$486.00 ,$846.00 , N/A ,$828.00 , N/A ,$819.00 , N/A ,$553.86 ,$553.86 ,$810.00 ,$671.67 ,$626.85 , N/A , N/A ,$855.00 , N/A , N/A ,$783.00 , N/A ,$810.00 , N/A ,$810.00 ,$810.00 ,$810.00 ,$873.00 ,$729.00 ,$837.00 ,$774.00 ,$873.00 
SACRED HEART HOSPITAL (ACU),27205022,N/A,HC SITZ MARKER,272,1 ,$207.00 ,$155.25 ,$111.78 ,$207.00 ,$133.31 , N/A ,$144.90 , N/A ,$171.81 , N/A ,$136.62 ,$196.65 , N/A ,$165.60 ,$190.44 , N/A ,$175.95 ,$196.65 ,$182.16 ,$157.32 , N/A , N/A , N/A ,$151.11 ,$113.85 ,$188.37 ,$188.37 ,$165.60 , N/A ,$113.85 ,$186.30 , N/A ,$186.30 ,$111.78 ,$194.58 , N/A ,$190.44 , N/A ,$188.37 , N/A ,$127.39 ,$127.39 ,$186.30 ,$154.48 ,$144.18 , N/A , N/A ,$196.65 , N/A , N/A ,$180.09 , N/A ,$186.30 , N/A ,$186.30 ,$186.30 ,$186.30 ,$200.79 ,$167.67 ,$192.51 ,$178.02 ,$200.79 
SACRED HEART HOSPITAL (ACU),27205345,N/A,HC DRESSING GAUZE STRETCH,272,1 ,$22.00 ,$16.50 ,$11.88 ,$22.00 ,$14.17 , N/A ,$15.40 , N/A ,$18.26 , N/A ,$14.52 ,$20.90 , N/A ,$17.60 ,$20.24 , N/A ,$18.70 ,$20.90 ,$19.36 ,$16.72 , N/A , N/A , N/A ,$16.06 ,$12.10 ,$20.02 ,$20.02 ,$17.60 , N/A ,$12.10 ,$19.80 , N/A ,$19.80 ,$11.88 ,$20.68 , N/A ,$20.24 , N/A ,$20.02 , N/A ,$13.54 ,$13.54 ,$19.80 ,$16.42 ,$15.32 , N/A , N/A ,$20.90 , N/A , N/A ,$19.14 , N/A ,$19.80 , N/A ,$19.80 ,$19.80 ,$19.80 ,$21.34 ,$17.82 ,$20.46 ,$18.92 ,$21.34 
SACRED HEART HOSPITAL (ACU),27205348,N/A,HC CATHETER ANGIOGRAPHIC TIP,272,1 ,$78.00 ,$58.50 ,$42.12 ,$78.00 ,$50.23 , N/A ,$54.60 , N/A ,$64.74 , N/A ,$51.48 ,$74.10 , N/A ,$62.40 ,$71.76 , N/A ,$66.30 ,$74.10 ,$68.64 ,$59.28 , N/A , N/A , N/A ,$56.94 ,$42.90 ,$70.98 ,$70.98 ,$62.40 , N/A ,$42.90 ,$70.20 , N/A ,$70.20 ,$42.12 ,$73.32 , N/A ,$71.76 , N/A ,$70.98 , N/A ,$48.00 ,$48.00 ,$70.20 ,$58.21 ,$54.33 , N/A , N/A ,$74.10 , N/A , N/A ,$67.86 , N/A ,$70.20 , N/A ,$70.20 ,$70.20 ,$70.20 ,$75.66 ,$63.18 ,$72.54 ,$67.08 ,$75.66 
SACRED HEART HOSPITAL (ACU),27205412,C1769,HC WIRE TAVR SAFARI 2,272,1 ,$618.00 ,$463.50 ,$333.72 ,$618.00 ,$397.99 , N/A ,$432.60 , N/A ,$512.94 , N/A ,$407.88 ,$587.10 , N/A ,$494.40 ,$568.56 , N/A ,$525.30 ,$587.10 ,$543.84 ,$469.68 , N/A , N/A , N/A ,$451.14 ,$339.90 ,$562.38 ,$562.38 ,$494.40 , N/A ,$339.90 ,$556.20 , N/A ,$556.20 ,$333.72 ,$580.92 , N/A ,$568.56 , N/A ,$562.38 , N/A ,$380.32 ,$380.32 ,$556.20 ,$461.21 ,$430.44 , N/A , N/A ,$587.10 , N/A , N/A ,$537.66 , N/A ,$556.20 , N/A ,$556.20 ,$556.20 ,$556.20 ,$599.46 ,$500.58 ,$574.74 ,$531.48 ,$599.46 
SACRED HEART HOSPITAL (ACU),27205413,C1894,HC INTRODUCER/SHEATH LEADLESS PACEMKR,272,1 ,"$1,553.00 ","$1,164.75 ",$838.62 ,"$1,553.00 ","$1,000.13 ", N/A ,"$1,087.10 ", N/A ,"$1,288.99 ", N/A ,"$1,024.98 ","$1,475.35 ", N/A ,"$1,242.40 ","$1,428.76 ", N/A ,"$1,320.05 ","$1,475.35 ","$1,366.64 ","$1,180.28 ", N/A , N/A , N/A ,"$1,133.69 ",$854.15 ,"$1,413.23 ","$1,413.23 ","$1,242.40 ", N/A ,$854.15 ,"$1,397.70 ", N/A ,"$1,397.70 ",$838.62 ,"$1,459.82 ", N/A ,"$1,428.76 ", N/A ,"$1,413.23 ", N/A ,$955.72 ,$955.72 ,"$1,397.70 ","$1,159.00 ","$1,081.66 ", N/A , N/A ,"$1,475.35 ", N/A , N/A ,"$1,351.11 ", N/A ,"$1,397.70 ", N/A ,"$1,397.70 ","$1,397.70 ","$1,397.70 ","$1,506.41 ","$1,257.93 ","$1,444.29 ","$1,335.58 ","$1,506.41 "
SACRED HEART HOSPITAL (ACU),27205415,N/A,HC PACK TAVR,272,1 ,$320.00 ,$240.00 ,$172.80 ,$320.00 ,$206.08 , N/A ,$224.00 , N/A ,$265.60 , N/A ,$211.20 ,$304.00 , N/A ,$256.00 ,$294.40 , N/A ,$272.00 ,$304.00 ,$281.60 ,$243.20 , N/A , N/A , N/A ,$233.60 ,$176.00 ,$291.20 ,$291.20 ,$256.00 , N/A ,$176.00 ,$288.00 , N/A ,$288.00 ,$172.80 ,$300.80 , N/A ,$294.40 , N/A ,$291.20 , N/A ,$196.93 ,$196.93 ,$288.00 ,$238.82 ,$222.88 , N/A , N/A ,$304.00 , N/A , N/A ,$278.40 , N/A ,$288.00 , N/A ,$288.00 ,$288.00 ,$288.00 ,$310.40 ,$259.20 ,$297.60 ,$275.20 ,$310.40 
SACRED HEART HOSPITAL (ACU),27205416,N/A,HC TRAY ACCESS ARTERIAL,272,1 ,$102.00 ,$76.50 ,$55.08 ,$102.00 ,$65.69 , N/A ,$71.40 , N/A ,$84.66 , N/A ,$67.32 ,$96.90 , N/A ,$81.60 ,$93.84 , N/A ,$86.70 ,$96.90 ,$89.76 ,$77.52 , N/A , N/A , N/A ,$74.46 ,$56.10 ,$92.82 ,$92.82 ,$81.60 , N/A ,$56.10 ,$91.80 , N/A ,$91.80 ,$55.08 ,$95.88 , N/A ,$93.84 , N/A ,$92.82 , N/A ,$62.77 ,$62.77 ,$91.80 ,$76.12 ,$71.04 , N/A , N/A ,$96.90 , N/A , N/A ,$88.74 , N/A ,$91.80 , N/A ,$91.80 ,$91.80 ,$91.80 ,$98.94 ,$82.62 ,$94.86 ,$87.72 ,$98.94 
SACRED HEART HOSPITAL (ACU),27205447,C1725,HC CATHETER BALLOON DIL,272,1 ,"$2,406.00 ","$1,804.50 ","$1,299.24 ","$2,406.00 ","$1,549.46 ", N/A ,"$1,684.20 ", N/A ,"$1,996.98 ", N/A ,"$1,587.96 ","$2,285.70 ", N/A ,"$1,924.80 ","$2,213.52 ", N/A ,"$2,045.10 ","$2,285.70 ","$2,117.28 ","$1,828.56 ", N/A , N/A , N/A ,"$1,756.38 ","$1,323.30 ","$2,189.46 ","$2,189.46 ","$1,924.80 ", N/A ,"$1,323.30 ","$2,165.40 ", N/A ,"$2,165.40 ","$1,299.24 ","$2,261.64 ", N/A ,"$2,213.52 ", N/A ,"$2,189.46 ", N/A ,"$1,480.65 ","$1,480.65 ","$2,165.40 ","$1,795.60 ","$1,675.78 ", N/A , N/A ,"$2,285.70 ", N/A , N/A ,"$2,093.22 ", N/A ,"$2,165.40 ", N/A ,"$2,165.40 ","$2,165.40 ","$2,165.40 ","$2,333.82 ","$1,948.86 ","$2,237.58 ","$2,069.16 ","$2,333.82 "
SACRED HEART HOSPITAL (ACU),27205467,N/A,HC PRESSURE GUIDEWIRE,272,1 ,"$2,003.00 ","$1,502.25 ","$1,081.62 ","$2,003.00 ","$1,289.93 ", N/A ,"$1,402.10 ", N/A ,"$1,662.49 ", N/A ,"$1,321.98 ","$1,902.85 ", N/A ,"$1,602.40 ","$1,842.76 ", N/A ,"$1,702.55 ","$1,902.85 ","$1,762.64 ","$1,522.28 ", N/A , N/A , N/A ,"$1,462.19 ","$1,101.65 ","$1,822.73 ","$1,822.73 ","$1,602.40 ", N/A ,"$1,101.65 ","$1,802.70 ", N/A ,"$1,802.70 ","$1,081.62 ","$1,882.82 ", N/A ,"$1,842.76 ", N/A ,"$1,822.73 ", N/A ,"$1,232.65 ","$1,232.65 ","$1,802.70 ","$1,494.84 ","$1,395.09 ", N/A , N/A ,"$1,902.85 ", N/A , N/A ,"$1,742.61 ", N/A ,"$1,802.70 ", N/A ,"$1,802.70 ","$1,802.70 ","$1,802.70 ","$1,942.91 ","$1,622.43 ","$1,862.79 ","$1,722.58 ","$1,942.91 "
SACRED HEART HOSPITAL (ACU),27205487,N/A,HC BOTTLE DRAINAGE SAFETY VAC,272,1 ,$49.00 ,$36.75 ,$26.46 ,$49.00 ,$31.56 , N/A ,$34.30 , N/A ,$40.67 , N/A ,$32.34 ,$46.55 , N/A ,$39.20 ,$45.08 , N/A ,$41.65 ,$46.55 ,$43.12 ,$37.24 , N/A , N/A , N/A ,$35.77 ,$26.95 ,$44.59 ,$44.59 ,$39.20 , N/A ,$26.95 ,$44.10 , N/A ,$44.10 ,$26.46 ,$46.06 , N/A ,$45.08 , N/A ,$44.59 , N/A ,$30.15 ,$30.15 ,$44.10 ,$36.57 ,$34.13 , N/A , N/A ,$46.55 , N/A , N/A ,$42.63 , N/A ,$44.10 , N/A ,$44.10 ,$44.10 ,$44.10 ,$47.53 ,$39.69 ,$45.57 ,$42.14 ,$47.53 
SACRED HEART HOSPITAL (ACU),27205492,N/A,HC PERCUTANEOUS TENOTOMY SUPPLY KIT,272,1 ,"$2,500.00 ","$1,875.00 ","$1,350.00 ","$2,500.00 ","$1,610.00 ", N/A ,"$1,750.00 ", N/A ,"$2,075.00 ", N/A ,"$1,650.00 ","$2,375.00 ", N/A ,"$2,000.00 ","$2,300.00 ", N/A ,"$2,125.00 ","$2,375.00 ","$2,200.00 ","$1,900.00 ", N/A , N/A , N/A ,"$1,825.00 ","$1,375.00 ","$2,275.00 ","$2,275.00 ","$2,000.00 ", N/A ,"$1,375.00 ","$2,250.00 ", N/A ,"$2,250.00 ","$1,350.00 ","$2,350.00 ", N/A ,"$2,300.00 ", N/A ,"$2,275.00 ", N/A ,"$1,538.50 ","$1,538.50 ","$2,250.00 ","$1,865.75 ","$1,741.25 ", N/A , N/A ,"$2,375.00 ", N/A , N/A ,"$2,175.00 ", N/A ,"$2,250.00 ", N/A ,"$2,250.00 ","$2,250.00 ","$2,250.00 ","$2,425.00 ","$2,025.00 ","$2,325.00 ","$2,150.00 ","$2,425.00 "
SACRED HEART HOSPITAL (ACU),27271729,C1729,HC CATHETER DRAINAGE,272,1 ,$189.00 ,$141.75 ,$102.06 ,$189.00 ,$121.72 , N/A ,$132.30 , N/A ,$156.87 , N/A ,$124.74 ,$179.55 , N/A ,$151.20 ,$173.88 , N/A ,$160.65 ,$179.55 ,$166.32 ,$143.64 , N/A , N/A , N/A ,$137.97 ,$103.95 ,$171.99 ,$171.99 ,$151.20 , N/A ,$103.95 ,$170.10 , N/A ,$170.10 ,$102.06 ,$177.66 , N/A ,$173.88 , N/A ,$171.99 , N/A ,$116.31 ,$116.31 ,$170.10 ,$141.05 ,$131.64 , N/A , N/A ,$179.55 , N/A , N/A ,$164.43 , N/A ,$170.10 , N/A ,$170.10 ,$170.10 ,$170.10 ,$183.33 ,$153.09 ,$175.77 ,$162.54 ,$183.33 
SACRED HEART HOSPITAL (ACU),27271752,C1752,HC CATHETER HEMODIALYSIS/PERITONEAL SHORT-TERM,272,1 ,$231.00 ,$173.25 ,$124.74 ,$231.00 ,$148.76 , N/A ,$161.70 , N/A ,$191.73 , N/A ,$152.46 ,$219.45 , N/A ,$184.80 ,$212.52 , N/A ,$196.35 ,$219.45 ,$203.28 ,$175.56 , N/A , N/A , N/A ,$168.63 ,$127.05 ,$210.21 ,$210.21 ,$184.80 , N/A ,$127.05 ,$207.90 , N/A ,$207.90 ,$124.74 ,$217.14 , N/A ,$212.52 , N/A ,$210.21 , N/A ,$142.16 ,$142.16 ,$207.90 ,$172.40 ,$160.89 , N/A , N/A ,$219.45 , N/A , N/A ,$200.97 , N/A ,$207.90 , N/A ,$207.90 ,$207.90 ,$207.90 ,$224.07 ,$187.11 ,$214.83 ,$198.66 ,$224.07 
SACRED HEART HOSPITAL (ACU),27282046,N/A,HC PROBE STRGHT 2.3MM 220CM,272,1 ,$613.00 ,$459.75 ,$331.02 ,$613.00 ,$394.77 , N/A ,$429.10 , N/A ,$508.79 , N/A ,$404.58 ,$582.35 , N/A ,$490.40 ,$563.96 , N/A ,$521.05 ,$582.35 ,$539.44 ,$465.88 , N/A , N/A , N/A ,$447.49 ,$337.15 ,$557.83 ,$557.83 ,$490.40 , N/A ,$337.15 ,$551.70 , N/A ,$551.70 ,$331.02 ,$576.22 , N/A ,$563.96 , N/A ,$557.83 , N/A ,$377.24 ,$377.24 ,$551.70 ,$457.48 ,$426.95 , N/A , N/A ,$582.35 , N/A , N/A ,$533.31 , N/A ,$551.70 , N/A ,$551.70 ,$551.70 ,$551.70 ,$594.61 ,$496.53 ,$570.09 ,$527.18 ,$594.61 
SACRED HEART HOSPITAL (ACU),27282047,N/A,HC ARG PROBE CONNECTOR,272,1 ,$50.00 ,$37.50 ,$27.00 ,$50.00 ,$32.20 , N/A ,$35.00 , N/A ,$41.50 , N/A ,$33.00 ,$47.50 , N/A ,$40.00 ,$46.00 , N/A ,$42.50 ,$47.50 ,$44.00 ,$38.00 , N/A , N/A , N/A ,$36.50 ,$27.50 ,$45.50 ,$45.50 ,$40.00 , N/A ,$27.50 ,$45.00 , N/A ,$45.00 ,$27.00 ,$47.00 , N/A ,$46.00 , N/A ,$45.50 , N/A ,$30.77 ,$30.77 ,$45.00 ,$37.32 ,$34.83 , N/A , N/A ,$47.50 , N/A , N/A ,$43.50 , N/A ,$45.00 , N/A ,$45.00 ,$45.00 ,$45.00 ,$48.50 ,$40.50 ,$46.50 ,$43.00 ,$48.50 
SACRED HEART HOSPITAL (ACU),27282051,N/A,HC FETAL PILLOW,272,1 ,"$1,863.00 ","$1,397.25 ","$1,006.02 ","$1,863.00 ","$1,199.77 ", N/A ,"$1,304.10 ", N/A ,"$1,546.29 ", N/A ,"$1,229.58 ","$1,769.85 ", N/A ,"$1,490.40 ","$1,713.96 ", N/A ,"$1,583.55 ","$1,769.85 ","$1,639.44 ","$1,415.88 ", N/A , N/A , N/A ,"$1,359.99 ","$1,024.65 ","$1,695.33 ","$1,695.33 ","$1,490.40 ", N/A ,"$1,024.65 ","$1,676.70 ", N/A ,"$1,676.70 ","$1,006.02 ","$1,751.22 ", N/A ,"$1,713.96 ", N/A ,"$1,695.33 ", N/A ,"$1,146.49 ","$1,146.49 ","$1,676.70 ","$1,390.36 ","$1,297.58 ", N/A , N/A ,"$1,769.85 ", N/A , N/A ,"$1,620.81 ", N/A ,"$1,676.70 ", N/A ,"$1,676.70 ","$1,676.70 ","$1,676.70 ","$1,807.11 ","$1,509.03 ","$1,732.59 ","$1,602.18 ","$1,807.11 "
SACRED HEART HOSPITAL (ACU),27282052,N/A,HC DEVICE CLOSURE PADLOCK CLIP,272,1 ,"$1,708.00 ","$1,281.00 ",$922.32 ,"$1,708.00 ","$1,099.95 ", N/A ,"$1,195.60 ", N/A ,"$1,417.64 ", N/A ,"$1,127.28 ","$1,622.60 ", N/A ,"$1,366.40 ","$1,571.36 ", N/A ,"$1,451.80 ","$1,622.60 ","$1,503.04 ","$1,298.08 ", N/A , N/A , N/A ,"$1,246.84 ",$939.40 ,"$1,554.28 ","$1,554.28 ","$1,366.40 ", N/A ,$939.40 ,"$1,537.20 ", N/A ,"$1,537.20 ",$922.32 ,"$1,605.52 ", N/A ,"$1,571.36 ", N/A ,"$1,554.28 ", N/A ,"$1,051.10 ","$1,051.10 ","$1,537.20 ","$1,274.68 ","$1,189.62 ", N/A , N/A ,"$1,622.60 ", N/A , N/A ,"$1,485.96 ", N/A ,"$1,537.20 ", N/A ,"$1,537.20 ","$1,537.20 ","$1,537.20 ","$1,656.76 ","$1,383.48 ","$1,588.44 ","$1,468.88 ","$1,656.76 "
SACRED HEART HOSPITAL (ACU),27282053,N/A,HC ATHERECT ADV DEVICE BURR CATH,272,1 ,"$6,505.00 ","$4,878.75 ","$3,512.70 ","$6,505.00 ","$4,189.22 ", N/A ,"$4,553.50 ", N/A ,"$5,399.15 ", N/A ,"$4,293.30 ","$6,179.75 ", N/A ,"$5,204.00 ","$5,984.60 ", N/A ,"$5,529.25 ","$6,179.75 ","$5,724.40 ","$4,943.80 ", N/A , N/A , N/A ,"$4,748.65 ","$3,577.75 ","$5,919.55 ","$5,919.55 ","$5,204.00 ", N/A ,"$3,577.75 ","$5,854.50 ", N/A ,"$5,854.50 ","$3,512.70 ","$6,114.70 ", N/A ,"$5,984.60 ", N/A ,"$5,919.55 ", N/A ,"$4,003.18 ","$4,003.18 ","$5,854.50 ","$4,854.68 ","$4,530.73 ", N/A , N/A ,"$6,179.75 ", N/A , N/A ,"$5,659.35 ", N/A ,"$5,854.50 ", N/A ,"$5,854.50 ","$5,854.50 ","$5,854.50 ","$6,309.85 ","$5,269.05 ","$6,049.65 ","$5,594.30 ","$6,309.85 "
SACRED HEART HOSPITAL (ACU),27282054,C1887,HC CATH GUIDE MACH1,272,1 ,$151.00 ,$113.25 ,$81.54 ,$151.00 ,$97.24 , N/A ,$105.70 , N/A ,$125.33 , N/A ,$99.66 ,$143.45 , N/A ,$120.80 ,$138.92 , N/A ,$128.35 ,$143.45 ,$132.88 ,$114.76 , N/A , N/A , N/A ,$110.23 ,$83.05 ,$137.41 ,$137.41 ,$120.80 , N/A ,$83.05 ,$135.90 , N/A ,$135.90 ,$81.54 ,$141.94 , N/A ,$138.92 , N/A ,$137.41 , N/A ,$92.93 ,$92.93 ,$135.90 ,$112.69 ,$105.17 , N/A , N/A ,$143.45 , N/A , N/A ,$131.37 , N/A ,$135.90 , N/A ,$135.90 ,$135.90 ,$135.90 ,$146.47 ,$122.31 ,$140.43 ,$129.86 ,$146.47 
SACRED HEART HOSPITAL (ACU),27400012,L0450,HC HEART HUGGER SUPPORT HARNESS,274,1 ,$264.00 ,$198.00 ,$142.56 ,$353.14 ,$170.02 ,$156.95 ,$184.80 , N/A ,$219.12 , N/A ,$174.24 ,$250.80 , N/A ,$211.20 ,$242.88 , N/A ,$224.40 ,$250.80 ,$232.32 ,$200.64 , N/A , N/A , N/A ,$192.72 ,$145.20 ,$240.24 ,$240.24 ,$211.20 ,$161.66 ,$145.20 ,$237.60 ,$156.95 ,$237.60 ,$142.56 ,$248.16 ,$353.14 ,$242.88 , N/A ,$240.24 ,$156.95 ,$162.47 ,$162.47 ,$237.60 ,$197.02 , N/A ,$158.52 , N/A ,$250.80 ,$164.80 , N/A ,$229.68 ,$156.95 ,$237.60 ,$156.95 ,$237.60 ,$237.60 ,$237.60 ,$256.08 ,$213.84 ,$245.52 ,$227.04 ,$256.08 
SACRED HEART HOSPITAL (ACU),27400018,L1830,HC KNEE BRACE - HINGED,274,1 ,$105.00 ,$78.75 ,$56.70 ,$177.03 ,$67.62 ,$78.68 ,$73.50 , N/A ,$87.15 , N/A ,$69.30 ,$99.75 , N/A ,$84.00 ,$96.60 , N/A ,$89.25 ,$99.75 ,$92.40 ,$79.80 , N/A , N/A , N/A ,$76.65 ,$57.75 ,$95.55 ,$95.55 ,$84.00 ,$81.04 ,$57.75 ,$94.50 ,$78.68 ,$94.50 ,$56.70 ,$98.70 ,$177.03 ,$96.60 , N/A ,$95.55 ,$78.68 ,$64.62 ,$64.62 ,$94.50 ,$78.36 , N/A ,$79.47 , N/A ,$99.75 ,$82.61 , N/A ,$91.35 ,$78.68 ,$94.50 ,$78.68 ,$94.50 ,$94.50 ,$94.50 ,$101.85 ,$85.05 ,$97.65 ,$90.30 ,$101.85 
SACRED HEART HOSPITAL (ACU),27400077,L8509,HC VOICE PROST KIT REPLC LEVEL 1,274,1 ,$773.00 ,$579.75 ,$246.96 ,$773.00 ,$497.81 ,$246.96 ,$541.10 , N/A ,$641.59 , N/A ,$510.18 ,$734.35 , N/A ,$618.40 ,$711.16 , N/A ,$657.05 ,$734.35 ,$680.24 ,$587.48 , N/A , N/A , N/A ,$564.29 ,$425.15 ,$703.43 ,$703.43 ,$618.40 ,$254.37 ,$425.15 ,$695.70 ,$246.96 ,$695.70 ,$417.42 ,$726.62 ,$555.66 ,$711.16 , N/A ,$703.43 ,$246.96 ,$475.70 ,$475.70 ,$695.70 ,$576.89 , N/A ,$249.43 , N/A ,$734.35 ,$259.31 , N/A ,$672.51 ,$246.96 ,$695.70 ,$246.96 ,$695.70 ,$695.70 ,$695.70 ,$749.81 ,$626.13 ,$718.89 ,$664.78 ,$749.81 
SACRED HEART HOSPITAL (ACU),27400093,L8501,HC VALVE TRACH,274,1 ,$288.00 ,$216.00 ,$155.52 ,$358.13 ,$185.47 ,$159.17 ,$201.60 , N/A ,$239.04 , N/A ,$190.08 ,$273.60 , N/A ,$230.40 ,$264.96 , N/A ,$244.80 ,$273.60 ,$253.44 ,$218.88 , N/A , N/A , N/A ,$210.24 ,$158.40 ,$262.08 ,$262.08 ,$230.40 ,$163.95 ,$158.40 ,$259.20 ,$159.17 ,$259.20 ,$155.52 ,$270.72 ,$358.13 ,$264.96 , N/A ,$262.08 ,$159.17 ,$177.24 ,$177.24 ,$259.20 ,$214.93 , N/A ,$160.76 , N/A ,$273.60 ,$167.13 , N/A ,$250.56 ,$159.17 ,$259.20 ,$159.17 ,$259.20 ,$259.20 ,$259.20 ,$279.36 ,$233.28 ,$267.84 ,$247.68 ,$279.36 
SACRED HEART HOSPITAL (ACU),27400094,L0172,HC COLLAR CERVICAL FOAM PREFAB,274,1 ,$427.00 ,$320.25 ,$204.94 ,$461.11 ,$274.99 ,$204.94 ,$298.90 , N/A ,$354.41 , N/A ,$281.82 ,$405.65 , N/A ,$341.60 ,$392.84 , N/A ,$362.95 ,$405.65 ,$375.76 ,$324.52 , N/A , N/A , N/A ,$311.71 ,$234.85 ,$388.57 ,$388.57 ,$341.60 ,$211.09 ,$234.85 ,$384.30 ,$204.94 ,$384.30 ,$230.58 ,$401.38 ,$461.11 ,$392.84 , N/A ,$388.57 ,$204.94 ,$262.78 ,$262.78 ,$384.30 ,$318.67 , N/A ,$206.99 , N/A ,$405.65 ,$215.18 , N/A ,$371.49 ,$204.94 ,$384.30 ,$204.94 ,$384.30 ,$384.30 ,$384.30 ,$414.19 ,$345.87 ,$397.11 ,$367.22 ,$414.19 
SACRED HEART HOSPITAL (ACU),27400095,L0472,HC BRACE BACK JEWITT,274,1 ,"$1,240.00 ",$930.00 ,$589.71 ,"$1,326.85 ",$798.56 ,$589.71 ,$868.00 , N/A ,"$1,029.20 ", N/A ,$818.40 ,"$1,178.00 ", N/A ,$992.00 ,"$1,140.80 ", N/A ,"$1,054.00 ","$1,178.00 ","$1,091.20 ",$942.40 , N/A , N/A , N/A ,$905.20 ,$682.00 ,"$1,128.40 ","$1,128.40 ",$992.00 ,$607.40 ,$682.00 ,"$1,116.00 ",$589.71 ,"$1,116.00 ",$669.60 ,"$1,165.60 ","$1,326.85 ","$1,140.80 ", N/A ,"$1,128.40 ",$589.71 ,$763.10 ,$763.10 ,"$1,116.00 ",$925.41 , N/A ,$595.61 , N/A ,"$1,178.00 ",$619.20 , N/A ,"$1,078.80 ",$589.71 ,"$1,116.00 ",$589.71 ,"$1,116.00 ","$1,116.00 ","$1,116.00 ","$1,202.80 ","$1,004.40 ","$1,153.20 ","$1,066.40 ","$1,202.80 "
SACRED HEART HOSPITAL (ACU),27400096,L0484,HC TLSO TRIPLANAR CONTROL CUSTOM,274,1 ,"$2,837.00 ","$2,127.75 ","$1,531.98 ","$4,736.86 ","$1,827.03 ","$2,105.27 ","$1,985.90 ", N/A ,"$2,354.71 ", N/A ,"$1,872.42 ","$2,695.15 ", N/A ,"$2,269.60 ","$2,610.04 ", N/A ,"$2,411.45 ","$2,695.15 ","$2,496.56 ","$2,156.12 ", N/A , N/A , N/A ,"$2,071.01 ","$1,560.35 ","$2,581.67 ","$2,581.67 ","$2,269.60 ","$2,168.43 ","$1,560.35 ","$2,553.30 ","$2,105.27 ","$2,553.30 ","$1,531.98 ","$2,666.78 ","$4,736.86 ","$2,610.04 ", N/A ,"$2,581.67 ","$2,105.27 ","$1,745.89 ","$1,745.89 ","$2,553.30 ","$2,117.25 ", N/A ,"$2,126.32 ", N/A ,"$2,695.15 ","$2,210.54 ", N/A ,"$2,468.19 ","$2,105.27 ","$2,553.30 ","$2,105.27 ","$2,553.30 ","$2,553.30 ","$2,553.30 ","$2,751.89 ","$2,297.97 ","$2,638.41 ","$2,439.82 ","$2,751.89 "
SACRED HEART HOSPITAL (ACU),27400097,L0627,HC ORTHOSIS LUMBAR SAGITTAL PREFAB,274,1 ,"$1,258.00 ",$943.50 ,$598.50 ,"$1,346.63 ",$810.15 ,$598.50 ,$880.60 , N/A ,"$1,044.14 ", N/A ,$830.28 ,"$1,195.10 ", N/A ,"$1,006.40 ","$1,157.36 ", N/A ,"$1,069.30 ","$1,195.10 ","$1,107.04 ",$956.08 , N/A , N/A , N/A ,$918.34 ,$691.90 ,"$1,144.78 ","$1,144.78 ","$1,006.40 ",$616.46 ,$691.90 ,"$1,132.20 ",$598.50 ,"$1,132.20 ",$679.32 ,"$1,182.52 ","$1,346.63 ","$1,157.36 ", N/A ,"$1,144.78 ",$598.50 ,$774.17 ,$774.17 ,"$1,132.20 ",$938.85 , N/A ,$604.49 , N/A ,"$1,195.10 ",$628.43 , N/A ,"$1,094.46 ",$598.50 ,"$1,132.20 ",$598.50 ,"$1,132.20 ","$1,132.20 ","$1,132.20 ","$1,220.26 ","$1,018.98 ","$1,169.94 ","$1,081.88 ","$1,220.26 "
SACRED HEART HOSPITAL (ACU),27400098,L0637,HC ORTHOSIS L/S CUSTOM,274,1 ,"$1,983.00 ","$1,487.25 ","$1,070.82 ","$3,352.57 ","$1,277.05 ","$1,490.03 ","$1,388.10 ", N/A ,"$1,645.89 ", N/A ,"$1,308.78 ","$1,883.85 ", N/A ,"$1,586.40 ","$1,824.36 ", N/A ,"$1,685.55 ","$1,883.85 ","$1,745.04 ","$1,507.08 ", N/A , N/A , N/A ,"$1,447.59 ","$1,090.65 ","$1,804.53 ","$1,804.53 ","$1,586.40 ","$1,534.73 ","$1,090.65 ","$1,784.70 ","$1,490.03 ","$1,784.70 ","$1,070.82 ","$1,864.02 ","$3,352.57 ","$1,824.36 ", N/A ,"$1,804.53 ","$1,490.03 ","$1,220.34 ","$1,220.34 ","$1,784.70 ","$1,479.91 ", N/A ,"$1,504.93 ", N/A ,"$1,883.85 ","$1,564.53 ", N/A ,"$1,725.21 ","$1,490.03 ","$1,784.70 ","$1,490.03 ","$1,784.70 ","$1,784.70 ","$1,784.70 ","$1,923.51 ","$1,606.23 ","$1,844.19 ","$1,705.38 ","$1,923.51 "
SACRED HEART HOSPITAL (ACU),27400099,L0650,HC ORTHOSIS L/S PREFAB,274,1 ,"$1,983.00 ","$1,487.25 ","$1,070.82 ","$2,507.08 ","$1,277.05 ","$1,114.26 ","$1,388.10 ", N/A ,"$1,645.89 ", N/A ,"$1,308.78 ","$1,883.85 ", N/A ,"$1,586.40 ","$1,824.36 ", N/A ,"$1,685.55 ","$1,883.85 ","$1,745.04 ","$1,507.08 ", N/A , N/A , N/A ,"$1,447.59 ","$1,090.65 ","$1,804.53 ","$1,804.53 ","$1,586.40 ","$1,147.69 ","$1,090.65 ","$1,784.70 ","$1,114.26 ","$1,784.70 ","$1,070.82 ","$1,864.02 ","$2,507.08 ","$1,824.36 ", N/A ,"$1,804.53 ","$1,114.26 ","$1,220.34 ","$1,220.34 ","$1,784.70 ","$1,479.91 ", N/A ,"$1,125.40 ", N/A ,"$1,883.85 ","$1,169.97 ", N/A ,"$1,725.21 ","$1,114.26 ","$1,784.70 ","$1,114.26 ","$1,784.70 ","$1,784.70 ","$1,784.70 ","$1,923.51 ","$1,606.23 ","$1,844.19 ","$1,705.38 ","$1,923.51 "
SACRED HEART HOSPITAL (ACU),27400100,L0810,HC HALO VEST,274,1 ,"$4,031.00 ","$3,023.25 ","$2,176.74 ","$6,889.91 ","$2,595.96 ","$3,062.18 ","$2,821.70 ", N/A ,"$3,345.73 ", N/A ,"$2,660.46 ","$3,829.45 ", N/A ,"$3,224.80 ","$3,708.52 ", N/A ,"$3,426.35 ","$3,829.45 ","$3,547.28 ","$3,063.56 ", N/A , N/A , N/A ,"$2,942.63 ","$2,217.05 ","$3,668.21 ","$3,668.21 ","$3,224.80 ","$3,154.05 ","$2,217.05 ","$3,627.90 ","$3,062.18 ","$3,627.90 ","$2,176.74 ","$3,789.14 ","$6,889.91 ","$3,708.52 ", N/A ,"$3,668.21 ","$3,062.18 ","$2,480.68 ","$2,480.68 ","$3,627.90 ","$3,008.34 ", N/A ,"$3,092.81 ", N/A ,"$3,829.45 ","$3,215.29 ", N/A ,"$3,506.97 ","$3,062.18 ","$3,627.90 ","$3,062.18 ","$3,627.90 ","$3,627.90 ","$3,627.90 ","$3,910.07 ","$3,265.11 ","$3,748.83 ","$3,466.66 ","$3,910.07 "
SACRED HEART HOSPITAL (ACU),27400101,L0859,HC HALO MRI COMPATIBLE SYSTEM,274,1 ,"$1,718.00 ","$1,288.50 ",$927.72 ,"$2,936.27 ","$1,106.39 ","$1,305.01 ","$1,202.60 ", N/A ,"$1,425.94 ", N/A ,"$1,133.88 ","$1,632.10 ", N/A ,"$1,374.40 ","$1,580.56 ", N/A ,"$1,460.30 ","$1,632.10 ","$1,511.84 ","$1,305.68 ", N/A , N/A , N/A ,"$1,254.14 ",$944.90 ,"$1,563.38 ","$1,563.38 ","$1,374.40 ","$1,344.16 ",$944.90 ,"$1,546.20 ","$1,305.01 ","$1,546.20 ",$927.72 ,"$1,614.92 ","$2,936.27 ","$1,580.56 ", N/A ,"$1,563.38 ","$1,305.01 ","$1,057.26 ","$1,057.26 ","$1,546.20 ","$1,282.14 ", N/A ,"$1,318.06 ", N/A ,"$1,632.10 ","$1,370.26 ", N/A ,"$1,494.66 ","$1,305.01 ","$1,546.20 ","$1,305.01 ","$1,546.20 ","$1,546.20 ","$1,546.20 ","$1,666.46 ","$1,391.58 ","$1,597.74 ","$1,477.48 ","$1,666.46 "
SACRED HEART HOSPITAL (ACU),27400102,L1686,HC ORTHOSIS HIP ABDUCTION CONTROL,274,1 ,"$1,434.00 ","$1,075.50 ",$774.36 ,"$2,424.73 ",$923.50 ,"$1,077.66 ","$1,003.80 ", N/A ,"$1,190.22 ", N/A ,$946.44 ,"$1,362.30 ", N/A ,"$1,147.20 ","$1,319.28 ", N/A ,"$1,218.90 ","$1,362.30 ","$1,261.92 ","$1,089.84 ", N/A , N/A , N/A ,"$1,046.82 ",$788.70 ,"$1,304.94 ","$1,304.94 ","$1,147.20 ","$1,109.99 ",$788.70 ,"$1,290.60 ","$1,077.66 ","$1,290.60 ",$774.36 ,"$1,347.96 ","$2,424.73 ","$1,319.28 ", N/A ,"$1,304.94 ","$1,077.66 ",$882.48 ,$882.48 ,"$1,290.60 ","$1,070.19 ", N/A ,"$1,088.43 ", N/A ,"$1,362.30 ","$1,131.54 ", N/A ,"$1,247.58 ","$1,077.66 ","$1,290.60 ","$1,077.66 ","$1,290.60 ","$1,290.60 ","$1,290.60 ","$1,390.98 ","$1,161.54 ","$1,333.62 ","$1,233.24 ","$1,390.98 "
SACRED HEART HOSPITAL (ACU),27400103,L1820,HC ORTHOSIS KNEE PREFAB,274,1 ,$429.00 ,$321.75 ,$205.75 ,$462.94 ,$276.28 ,$205.75 ,$300.30 , N/A ,$356.07 , N/A ,$283.14 ,$407.55 , N/A ,$343.20 ,$394.68 , N/A ,$364.65 ,$407.55 ,$377.52 ,$326.04 , N/A , N/A , N/A ,$313.17 ,$235.95 ,$390.39 ,$390.39 ,$343.20 ,$211.92 ,$235.95 ,$386.10 ,$205.75 ,$386.10 ,$231.66 ,$403.26 ,$462.94 ,$394.68 , N/A ,$390.39 ,$205.75 ,$264.01 ,$264.01 ,$386.10 ,$320.16 , N/A ,$207.81 , N/A ,$407.55 ,$216.04 , N/A ,$373.23 ,$205.75 ,$386.10 ,$205.75 ,$386.10 ,$386.10 ,$386.10 ,$416.13 ,$347.49 ,$398.97 ,$368.94 ,$416.13 
SACRED HEART HOSPITAL (ACU),27400104,L1830,HC KNEE IMMOBILIZER,274,1 ,$183.00 ,$137.25 ,$94.28 ,$212.13 ,$117.85 ,$94.28 ,$128.10 , N/A ,$151.89 , N/A ,$120.78 ,$173.85 , N/A ,$146.40 ,$168.36 , N/A ,$155.55 ,$173.85 ,$161.04 ,$139.08 , N/A , N/A , N/A ,$133.59 ,$100.65 ,$166.53 ,$166.53 ,$146.40 ,$97.11 ,$100.65 ,$164.70 ,$94.28 ,$164.70 ,$98.82 ,$172.02 ,$212.13 ,$168.36 , N/A ,$166.53 ,$94.28 ,$112.62 ,$112.62 ,$164.70 ,$136.57 , N/A ,$95.22 , N/A ,$173.85 ,$98.99 , N/A ,$159.21 ,$94.28 ,$164.70 ,$94.28 ,$164.70 ,$164.70 ,$164.70 ,$177.51 ,$148.23 ,$170.19 ,$157.38 ,$177.51 
SACRED HEART HOSPITAL (ACU),27400105,L1831,HC ORTHOSIS KNEE LOCKING PREFAB,274,1 ,$888.00 ,$666.00 ,$426.01 ,$958.52 ,$571.87 ,$426.01 ,$621.60 , N/A ,$737.04 , N/A ,$586.08 ,$843.60 , N/A ,$710.40 ,$816.96 , N/A ,$754.80 ,$843.60 ,$781.44 ,$674.88 , N/A , N/A , N/A ,$648.24 ,$488.40 ,$808.08 ,$808.08 ,$710.40 ,$438.79 ,$488.40 ,$799.20 ,$426.01 ,$799.20 ,$479.52 ,$834.72 ,$958.52 ,$816.96 , N/A ,$808.08 ,$426.01 ,$546.48 ,$546.48 ,$799.20 ,$662.71 , N/A ,$430.27 , N/A ,$843.60 ,$447.31 , N/A ,$772.56 ,$426.01 ,$799.20 ,$426.01 ,$799.20 ,$799.20 ,$799.20 ,$861.36 ,$719.28 ,$825.84 ,$763.68 ,$861.36 
SACRED HEART HOSPITAL (ACU),27400106,L1832,HC ORTHOSIS KNEE PREFAB,274,1 ,"$1,406.00 ","$1,054.50 ",$759.24 ,"$1,940.76 ",$905.46 ,$862.56 ,$984.20 , N/A ,"$1,166.98 ", N/A ,$927.96 ,"$1,335.70 ", N/A ,"$1,124.80 ","$1,293.52 ", N/A ,"$1,195.10 ","$1,335.70 ","$1,237.28 ","$1,068.56 ", N/A , N/A , N/A ,"$1,026.38 ",$773.30 ,"$1,279.46 ","$1,279.46 ","$1,124.80 ",$888.44 ,$773.30 ,"$1,265.40 ",$862.56 ,"$1,265.40 ",$759.24 ,"$1,321.64 ","$1,940.76 ","$1,293.52 ", N/A ,"$1,279.46 ",$862.56 ,$865.25 ,$865.25 ,"$1,265.40 ","$1,049.30 ", N/A ,$871.19 , N/A ,"$1,335.70 ",$905.69 , N/A ,"$1,223.22 ",$862.56 ,"$1,265.40 ",$862.56 ,"$1,265.40 ","$1,265.40 ","$1,265.40 ","$1,363.82 ","$1,138.86 ","$1,307.58 ","$1,209.16 ","$1,363.82 "
SACRED HEART HOSPITAL (ACU),27400107,L1845,HC ORTHOSIS KNEE/THIGH/CALF PREFAB,274,1 ,"$1,685.00 ","$1,263.75 ",$909.90 ,"$2,349.02 ","$1,085.14 ","$1,044.01 ","$1,179.50 ", N/A ,"$1,398.55 ", N/A ,"$1,112.10 ","$1,600.75 ", N/A ,"$1,348.00 ","$1,550.20 ", N/A ,"$1,432.25 ","$1,600.75 ","$1,482.80 ","$1,280.60 ", N/A , N/A , N/A ,"$1,230.05 ",$926.75 ,"$1,533.35 ","$1,533.35 ","$1,348.00 ","$1,075.33 ",$926.75 ,"$1,516.50 ","$1,044.01 ","$1,516.50 ",$909.90 ,"$1,583.90 ","$2,349.02 ","$1,550.20 ", N/A ,"$1,533.35 ","$1,044.01 ","$1,036.95 ","$1,036.95 ","$1,516.50 ","$1,257.52 ", N/A ,"$1,054.45 ", N/A ,"$1,600.75 ","$1,096.21 ", N/A ,"$1,465.95 ","$1,044.01 ","$1,516.50 ","$1,044.01 ","$1,516.50 ","$1,516.50 ","$1,516.50 ","$1,634.45 ","$1,364.85 ","$1,567.05 ","$1,449.10 ","$1,634.45 "
SACRED HEART HOSPITAL (ACU),27400108,L2620,HC PELVIC CONTROL HIP,274,1 ,$766.00 ,$574.50 ,$364.21 ,$819.47 ,$493.30 ,$364.21 ,$536.20 , N/A ,$635.78 , N/A ,$505.56 ,$727.70 , N/A ,$612.80 ,$704.72 , N/A ,$651.10 ,$727.70 ,$674.08 ,$582.16 , N/A , N/A , N/A ,$559.18 ,$421.30 ,$697.06 ,$697.06 ,$612.80 ,$375.14 ,$421.30 ,$689.40 ,$364.21 ,$689.40 ,$413.64 ,$720.04 ,$819.47 ,$704.72 , N/A ,$697.06 ,$364.21 ,$471.40 ,$471.40 ,$689.40 ,$571.67 , N/A ,$367.85 , N/A ,$727.70 ,$382.42 , N/A ,$666.42 ,$364.21 ,$689.40 ,$364.21 ,$689.40 ,$689.40 ,$689.40 ,$743.02 ,$620.46 ,$712.38 ,$658.76 ,$743.02 
SACRED HEART HOSPITAL (ACU),27400109,L3702,HC ORTHOSIS ELBOW W/O JOINTS CUSTOM,274,1 ,$670.00 ,$502.50 ,$355.81 ,$800.57 ,$431.48 ,$355.81 ,$469.00 , N/A ,$556.10 , N/A ,$442.20 ,$636.50 , N/A ,$536.00 ,$616.40 , N/A ,$569.50 ,$636.50 ,$589.60 ,$509.20 , N/A , N/A , N/A ,$489.10 ,$368.50 ,$609.70 ,$609.70 ,$536.00 ,$366.48 ,$368.50 ,$603.00 ,$355.81 ,$603.00 ,$361.80 ,$629.80 ,$800.57 ,$616.40 , N/A ,$609.70 ,$355.81 ,$412.32 ,$412.32 ,$603.00 ,$500.02 , N/A ,$359.37 , N/A ,$636.50 ,$373.60 , N/A ,$582.90 ,$355.81 ,$603.00 ,$355.81 ,$603.00 ,$603.00 ,$603.00 ,$649.90 ,$542.70 ,$623.10 ,$576.20 ,$649.90 
SACRED HEART HOSPITAL (ACU),27400110,L3808,HC ORTHOSIS WHFO RIGID W/O JOINTS,274,1 ,$536.00 ,$402.00 ,$289.44 ,$856.85 ,$345.18 ,$380.82 ,$375.20 , N/A ,$444.88 , N/A ,$353.76 ,$509.20 , N/A ,$428.80 ,$493.12 , N/A ,$455.60 ,$509.20 ,$471.68 ,$407.36 , N/A , N/A , N/A ,$391.28 ,$294.80 ,$487.76 ,$487.76 ,$428.80 ,$392.24 ,$294.80 ,$482.40 ,$380.82 ,$482.40 ,$289.44 ,$503.84 ,$856.85 ,$493.12 , N/A ,$487.76 ,$380.82 ,$329.85 ,$329.85 ,$482.40 ,$400.02 , N/A ,$384.63 , N/A ,$509.20 ,$399.87 , N/A ,$466.32 ,$380.82 ,$482.40 ,$380.82 ,$482.40 ,$482.40 ,$482.40 ,$519.92 ,$434.16 ,$498.48 ,$460.96 ,$519.92 
SACRED HEART HOSPITAL (ACU),27400111,L3905,HC ORTHOSIS WHO W/NONTORSION JOINTS CUSTOM,274,1 ,$754.00 ,$565.50 ,$407.16 ,"$2,053.21 ",$485.58 ,$912.54 ,$527.80 , N/A ,$625.82 , N/A ,$497.64 ,$716.30 , N/A ,$603.20 ,$693.68 , N/A ,$640.90 ,$716.30 ,$663.52 ,$573.04 , N/A , N/A , N/A ,$550.42 ,$414.70 ,$686.14 ,$686.14 ,$603.20 ,$939.92 ,$414.70 ,$678.60 ,$912.54 ,$678.60 ,$407.16 ,$708.76 ,"$2,053.21 ",$693.68 , N/A ,$686.14 ,$912.54 ,$464.01 ,$464.01 ,$678.60 ,$562.71 , N/A ,$921.66 , N/A ,$716.30 ,$958.16 , N/A ,$655.98 ,$912.54 ,$678.60 ,$912.54 ,$678.60 ,$678.60 ,$678.60 ,$731.38 ,$610.74 ,$701.22 ,$648.44 ,$731.38 
SACRED HEART HOSPITAL (ACU),27400112,L3906,HC ORTHOSIS WHO GAUNTLET MOLDED CUSTOM,274,1 ,$504.00 ,$378.00 ,$272.16 ,"$1,102.64 ",$324.58 ,$490.06 ,$352.80 , N/A ,$418.32 , N/A ,$332.64 ,$478.80 , N/A ,$403.20 ,$463.68 , N/A ,$428.40 ,$478.80 ,$443.52 ,$383.04 , N/A , N/A , N/A ,$367.92 ,$277.20 ,$458.64 ,$458.64 ,$403.20 ,$504.76 ,$277.20 ,$453.60 ,$490.06 ,$453.60 ,$272.16 ,$473.76 ,"$1,102.64 ",$463.68 , N/A ,$458.64 ,$490.06 ,$310.16 ,$310.16 ,$453.60 ,$376.14 , N/A ,$494.96 , N/A ,$478.80 ,$514.57 , N/A ,$438.48 ,$490.06 ,$453.60 ,$490.06 ,$453.60 ,$453.60 ,$453.60 ,$488.88 ,$408.24 ,$468.72 ,$433.44 ,$488.88 
SACRED HEART HOSPITAL (ACU),27400113,L3908,HC ORTHOSIS WHO SPLINT WRIST EXT CONTROL COCK-UP,274,1 ,$343.00 ,$257.25 ,$124.92 ,$343.00 ,$220.89 ,$124.92 ,$240.10 , N/A ,$284.69 , N/A ,$226.38 ,$325.85 , N/A ,$274.40 ,$315.56 , N/A ,$291.55 ,$325.85 ,$301.84 ,$260.68 , N/A , N/A , N/A ,$250.39 ,$188.65 ,$312.13 ,$312.13 ,$274.40 ,$128.67 ,$188.65 ,$308.70 ,$124.92 ,$308.70 ,$185.22 ,$322.42 ,$281.07 ,$315.56 , N/A ,$312.13 ,$124.92 ,$211.08 ,$211.08 ,$308.70 ,$255.98 , N/A ,$126.17 , N/A ,$325.85 ,$131.17 , N/A ,$298.41 ,$124.92 ,$308.70 ,$124.92 ,$308.70 ,$308.70 ,$308.70 ,$332.71 ,$277.83 ,$318.99 ,$294.98 ,$332.71 
SACRED HEART HOSPITAL (ACU),27400114,L3913,HC ORTHOSIS HFO KNUCKLE BENDER W/OUTRG CUSTOM,274,1 ,$504.00 ,$378.00 ,$272.16 ,$694.85 ,$324.58 ,$308.82 ,$352.80 , N/A ,$418.32 , N/A ,$332.64 ,$478.80 , N/A ,$403.20 ,$463.68 , N/A ,$428.40 ,$478.80 ,$443.52 ,$383.04 , N/A , N/A , N/A ,$367.92 ,$277.20 ,$458.64 ,$458.64 ,$403.20 ,$318.08 ,$277.20 ,$453.60 ,$308.82 ,$453.60 ,$272.16 ,$473.76 ,$694.85 ,$463.68 , N/A ,$458.64 ,$308.82 ,$310.16 ,$310.16 ,$453.60 ,$376.14 , N/A ,$311.91 , N/A ,$478.80 ,$324.27 , N/A ,$438.48 ,$308.82 ,$453.60 ,$308.82 ,$453.60 ,$453.60 ,$453.60 ,$488.88 ,$408.24 ,$468.72 ,$433.44 ,$488.88 
SACRED HEART HOSPITAL (ACU),27400115,L3980,HC ORTHOSIS HUMERAL FRACTURE,274,1 ,"$1,078.00 ",$808.50 ,$512.76 ,"$1,153.71 ",$694.23 ,$512.76 ,$754.60 , N/A ,$894.74 , N/A ,$711.48 ,"$1,024.10 ", N/A ,$862.40 ,$991.76 , N/A ,$916.30 ,"$1,024.10 ",$948.64 ,$819.28 , N/A , N/A , N/A ,$786.94 ,$592.90 ,$980.98 ,$980.98 ,$862.40 ,$528.14 ,$592.90 ,$970.20 ,$512.76 ,$970.20 ,$582.12 ,"$1,013.32 ","$1,153.71 ",$991.76 , N/A ,$980.98 ,$512.76 ,$663.40 ,$663.40 ,$970.20 ,$804.51 , N/A ,$517.89 , N/A ,"$1,024.10 ",$538.40 , N/A ,$937.86 ,$512.76 ,$970.20 ,$512.76 ,$970.20 ,$970.20 ,$970.20 ,"$1,045.66 ",$873.18 ,"$1,002.54 ",$927.08 ,"$1,045.66 "
SACRED HEART HOSPITAL (ACU),27400116,L4210,HC PADS COLLAR CERVICAL,274,1 ,$214.00 ,$160.50 ,$115.56 ,$214.00 ,$137.82 , N/A ,$149.80 , N/A ,$177.62 , N/A ,$141.24 ,$203.30 , N/A ,$171.20 ,$196.88 , N/A ,$181.90 ,$203.30 ,$188.32 ,$162.64 , N/A , N/A , N/A ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 , N/A ,$117.70 ,$192.60 , N/A ,$192.60 ,$115.56 ,$201.16 , N/A ,$196.88 , N/A ,$194.74 , N/A ,$131.70 ,$131.70 ,$192.60 ,$159.71 , N/A , N/A , N/A ,$203.30 , N/A , N/A ,$186.18 , N/A ,$192.60 , N/A ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),27400117,L8460,HC PROSTHETIC SHRINKER ABOVE KNEE,274,1 ,$203.00 ,$152.25 ,$96.64 ,$217.44 ,$130.73 ,$96.64 ,$142.10 , N/A ,$168.49 , N/A ,$133.98 ,$192.85 , N/A ,$162.40 ,$186.76 , N/A ,$172.55 ,$192.85 ,$178.64 ,$154.28 , N/A , N/A , N/A ,$148.19 ,$111.65 ,$184.73 ,$184.73 ,$162.40 ,$99.54 ,$111.65 ,$182.70 ,$96.64 ,$182.70 ,$109.62 ,$190.82 ,$217.44 ,$186.76 , N/A ,$184.73 ,$96.64 ,$124.93 ,$124.93 ,$182.70 ,$151.50 , N/A ,$97.61 , N/A ,$192.85 ,$101.47 , N/A ,$176.61 ,$96.64 ,$182.70 ,$96.64 ,$182.70 ,$182.70 ,$182.70 ,$196.91 ,$164.43 ,$188.79 ,$174.58 ,$196.91 
SACRED HEART HOSPITAL (ACU),27500020,C1898,HC MSB PACEMAKER LEAD,275,1 ,"$1,054.00 ",$790.50 ,$569.16 ,"$1,054.00 ",$678.78 , N/A ,$737.80 , N/A ,$874.82 , N/A ,$695.64 ,"$1,001.30 ", N/A ,$843.20 ,$969.68 , N/A ,$895.90 ,"$1,001.30 ",$927.52 ,$801.04 , N/A , N/A , N/A ,$769.42 ,$579.70 ,$959.14 ,$959.14 ,$843.20 , N/A ,$579.70 ,$948.60 , N/A ,$948.60 ,$569.16 ,$990.76 , N/A ,$969.68 , N/A ,$959.14 , N/A ,$648.63 ,$648.63 ,$948.60 ,$786.60 , N/A , N/A , N/A ,"$1,001.30 ", N/A , N/A ,$916.98 , N/A ,$948.60 , N/A ,$948.60 ,$948.60 ,$948.60 ,"$1,022.38 ",$853.74 ,$980.22 ,$906.44 ,"$1,022.38 "
SACRED HEART HOSPITAL (ACU),27500022,C1900,HC MSB LEAD FOR CS,275,1 ,"$2,718.00 ","$2,038.50 ","$1,467.72 ","$2,718.00 ","$1,750.39 ", N/A ,"$1,902.60 ", N/A ,"$2,255.94 ", N/A ,"$1,793.88 ","$2,582.10 ", N/A ,"$2,174.40 ","$2,500.56 ", N/A ,"$2,310.30 ","$2,582.10 ","$2,391.84 ","$2,065.68 ", N/A , N/A , N/A ,"$1,984.14 ","$1,494.90 ","$2,473.38 ","$2,473.38 ","$2,174.40 ", N/A ,"$1,494.90 ","$2,446.20 ", N/A ,"$2,446.20 ","$1,467.72 ","$2,554.92 ", N/A ,"$2,500.56 ", N/A ,"$2,473.38 ", N/A ,"$1,672.66 ","$1,672.66 ","$2,446.20 ","$2,028.44 ", N/A , N/A , N/A ,"$2,582.10 ", N/A , N/A ,"$2,364.66 ", N/A ,"$2,446.20 ", N/A ,"$2,446.20 ","$2,446.20 ","$2,446.20 ","$2,636.46 ","$2,201.58 ","$2,527.74 ","$2,337.48 ","$2,636.46 "
SACRED HEART HOSPITAL (ACU),27500023,C1786,HC MSB PACER SINGLE,275,1 ,"$4,311.00 ","$3,233.25 ","$2,327.94 ","$4,311.00 ","$2,776.28 ", N/A ,"$3,017.70 ", N/A ,"$3,578.13 ", N/A ,"$2,845.26 ","$4,095.45 ", N/A ,"$3,448.80 ","$3,966.12 ", N/A ,"$3,664.35 ","$4,095.45 ","$3,793.68 ","$3,276.36 ", N/A , N/A , N/A ,"$3,147.03 ","$2,371.05 ","$3,923.01 ","$3,923.01 ","$3,448.80 ", N/A ,"$2,371.05 ","$3,879.90 ", N/A ,"$3,879.90 ","$2,327.94 ","$4,052.34 ", N/A ,"$3,966.12 ", N/A ,"$3,923.01 ", N/A ,"$2,652.99 ","$2,652.99 ","$3,879.90 ","$3,217.30 ", N/A , N/A , N/A ,"$4,095.45 ", N/A , N/A ,"$3,750.57 ", N/A ,"$3,879.90 ", N/A ,"$3,879.90 ","$3,879.90 ","$3,879.90 ","$4,181.67 ","$3,491.91 ","$4,009.23 ","$3,707.46 ","$4,181.67 "
SACRED HEART HOSPITAL (ACU),27500024,C1785,HC MSB PACER DUAL,275,1 ,"$5,571.00 ","$4,178.25 ","$3,008.34 ","$5,571.00 ","$3,587.72 ", N/A ,"$3,899.70 ", N/A ,"$4,623.93 ", N/A ,"$3,676.86 ","$5,292.45 ", N/A ,"$4,456.80 ","$5,125.32 ", N/A ,"$4,735.35 ","$5,292.45 ","$4,902.48 ","$4,233.96 ", N/A , N/A , N/A ,"$4,066.83 ","$3,064.05 ","$5,069.61 ","$5,069.61 ","$4,456.80 ", N/A ,"$3,064.05 ","$5,013.90 ", N/A ,"$5,013.90 ","$3,008.34 ","$5,236.74 ", N/A ,"$5,125.32 ", N/A ,"$5,069.61 ", N/A ,"$3,428.39 ","$3,428.39 ","$5,013.90 ","$4,157.64 ", N/A , N/A , N/A ,"$5,292.45 ", N/A , N/A ,"$4,846.77 ", N/A ,"$5,013.90 ", N/A ,"$5,013.90 ","$5,013.90 ","$5,013.90 ","$5,403.87 ","$4,512.51 ","$5,181.03 ","$4,791.06 ","$5,403.87 "
SACRED HEART HOSPITAL (ACU),27500025,C2621,HC MSB PACER BI-V,275,1 ,"$9,111.00 ","$6,833.25 ","$4,919.94 ","$9,111.00 ","$5,867.48 ", N/A ,"$6,377.70 ", N/A ,"$7,562.13 ", N/A ,"$6,013.26 ","$8,655.45 ", N/A ,"$7,288.80 ","$8,382.12 ", N/A ,"$7,744.35 ","$8,655.45 ","$8,017.68 ","$6,924.36 ", N/A , N/A , N/A ,"$6,651.03 ","$5,011.05 ","$8,291.01 ","$8,291.01 ","$7,288.80 ", N/A ,"$5,011.05 ","$8,199.90 ", N/A ,"$8,199.90 ","$4,919.94 ","$8,564.34 ", N/A ,"$8,382.12 ", N/A ,"$8,291.01 ", N/A ,"$5,606.91 ","$5,606.91 ","$8,199.90 ","$6,799.54 ", N/A , N/A , N/A ,"$8,655.45 ", N/A , N/A ,"$7,926.57 ", N/A ,"$8,199.90 ", N/A ,"$8,199.90 ","$8,199.90 ","$8,199.90 ","$8,837.67 ","$7,379.91 ","$8,473.23 ","$7,835.46 ","$8,837.67 "
SACRED HEART HOSPITAL (ACU),27500026,C1722,HC MSB ICD SINGLE,275,1 ,"$18,586.00 ","$13,939.50 ","$10,036.44 ","$18,586.00 ","$11,969.38 ", N/A ,"$13,010.20 ", N/A ,"$15,426.38 ", N/A ,"$12,266.76 ","$17,656.70 ", N/A ,"$14,868.80 ","$17,099.12 ", N/A ,"$15,798.10 ","$17,656.70 ","$16,355.68 ","$14,125.36 ", N/A , N/A , N/A ,"$13,567.78 ","$10,222.30 ","$16,913.26 ","$16,913.26 ","$14,868.80 ", N/A ,"$10,222.30 ","$16,727.40 ", N/A ,"$16,727.40 ","$10,036.44 ","$17,470.84 ", N/A ,"$17,099.12 ", N/A ,"$16,913.26 ", N/A ,"$11,437.82 ","$11,437.82 ","$16,727.40 ","$13,870.73 ", N/A , N/A , N/A ,"$17,656.70 ", N/A , N/A ,"$16,169.82 ", N/A ,"$16,727.40 ", N/A ,"$16,727.40 ","$16,727.40 ","$16,727.40 ","$18,028.42 ","$15,054.66 ","$17,284.98 ","$15,983.96 ","$18,028.42 "
SACRED HEART HOSPITAL (ACU),27500027,C1721,HC MSB ICD DUAL,275,1 ,"$20,327.00 ","$15,245.25 ","$10,976.58 ","$20,327.00 ","$13,090.59 ", N/A ,"$14,228.90 ", N/A ,"$16,871.41 ", N/A ,"$13,415.82 ","$19,310.65 ", N/A ,"$16,261.60 ","$18,700.84 ", N/A ,"$17,277.95 ","$19,310.65 ","$17,887.76 ","$15,448.52 ", N/A , N/A , N/A ,"$14,838.71 ","$11,179.85 ","$18,497.57 ","$18,497.57 ","$16,261.60 ", N/A ,"$11,179.85 ","$18,294.30 ", N/A ,"$18,294.30 ","$10,976.58 ","$19,107.38 ", N/A ,"$18,700.84 ", N/A ,"$18,497.57 ", N/A ,"$12,509.24 ","$12,509.24 ","$18,294.30 ","$15,170.04 ", N/A , N/A , N/A ,"$19,310.65 ", N/A , N/A ,"$17,684.49 ", N/A ,"$18,294.30 ", N/A ,"$18,294.30 ","$18,294.30 ","$18,294.30 ","$19,717.19 ","$16,464.87 ","$18,904.11 ","$17,481.22 ","$19,717.19 "
SACRED HEART HOSPITAL (ACU),27500028,C1882,HC MSB ICD BI-V,275,1 ,"$26,121.00 ","$19,590.75 ","$14,105.34 ","$26,121.00 ","$16,821.92 ", N/A ,"$18,284.70 ", N/A ,"$21,680.43 ", N/A ,"$17,239.86 ","$24,814.95 ", N/A ,"$20,896.80 ","$24,031.32 ", N/A ,"$22,202.85 ","$24,814.95 ","$22,986.48 ","$19,851.96 ", N/A , N/A , N/A ,"$19,068.33 ","$14,366.55 ","$23,770.11 ","$23,770.11 ","$20,896.80 ", N/A ,"$14,366.55 ","$23,508.90 ", N/A ,"$23,508.90 ","$14,105.34 ","$24,553.74 ", N/A ,"$24,031.32 ", N/A ,"$23,770.11 ", N/A ,"$16,074.86 ","$16,074.86 ","$23,508.90 ","$19,494.10 ", N/A , N/A , N/A ,"$24,814.95 ", N/A , N/A ,"$22,725.27 ", N/A ,"$23,508.90 ", N/A ,"$23,508.90 ","$23,508.90 ","$23,508.90 ","$25,337.37 ","$21,158.01 ","$24,292.53 ","$22,464.06 ","$25,337.37 "
SACRED HEART HOSPITAL (ACU),27500031,C1896,HC MSB ICD LEAD NON ENDO SGL OR DUAL,275,1 ,"$6,272.00 ","$4,704.00 ","$3,386.88 ","$6,272.00 ","$4,039.17 ", N/A ,"$4,390.40 ", N/A ,"$5,205.76 ", N/A ,"$4,139.52 ","$5,958.40 ", N/A ,"$5,017.60 ","$5,770.24 ", N/A ,"$5,331.20 ","$5,958.40 ","$5,519.36 ","$4,766.72 ", N/A , N/A , N/A ,"$4,578.56 ","$3,449.60 ","$5,707.52 ","$5,707.52 ","$5,017.60 ", N/A ,"$3,449.60 ","$5,644.80 ", N/A ,"$5,644.80 ","$3,386.88 ","$5,895.68 ", N/A ,"$5,770.24 ", N/A ,"$5,707.52 ", N/A ,"$3,859.79 ","$3,859.79 ","$5,644.80 ","$4,680.79 ", N/A , N/A , N/A ,"$5,958.40 ", N/A , N/A ,"$5,456.64 ", N/A ,"$5,644.80 ", N/A ,"$5,644.80 ","$5,644.80 ","$5,644.80 ","$6,083.84 ","$5,080.32 ","$5,832.96 ","$5,393.92 ","$6,083.84 "
SACRED HEART HOSPITAL (ACU),27500032,C1777,HC ICD LEAD ENDO SINGLE,275,1 ,"$4,965.00 ","$3,723.75 ","$2,681.10 ","$4,965.00 ","$3,197.46 ", N/A ,"$3,475.50 ", N/A ,"$4,120.95 ", N/A ,"$3,276.90 ","$4,716.75 ", N/A ,"$3,972.00 ","$4,567.80 ", N/A ,"$4,220.25 ","$4,716.75 ","$4,369.20 ","$3,773.40 ", N/A , N/A , N/A ,"$3,624.45 ","$2,730.75 ","$4,518.15 ","$4,518.15 ","$3,972.00 ", N/A ,"$2,730.75 ","$4,468.50 ", N/A ,"$4,468.50 ","$2,681.10 ","$4,667.10 ", N/A ,"$4,567.80 ", N/A ,"$4,518.15 ", N/A ,"$3,055.46 ","$3,055.46 ","$4,468.50 ","$3,705.38 ", N/A , N/A , N/A ,"$4,716.75 ", N/A , N/A ,"$4,319.55 ", N/A ,"$4,468.50 ", N/A ,"$4,468.50 ","$4,468.50 ","$4,468.50 ","$4,816.05 ","$4,021.65 ","$4,617.45 ","$4,269.90 ","$4,816.05 "
SACRED HEART HOSPITAL (ACU),27500040,N/A,HC WIRE PACEMAKER,275,1 ,$262.00 ,$196.50 ,$141.48 ,$262.00 ,$168.73 , N/A ,$183.40 , N/A ,$217.46 , N/A ,$172.92 ,$248.90 , N/A ,$209.60 ,$241.04 , N/A ,$222.70 ,$248.90 ,$230.56 ,$199.12 , N/A , N/A , N/A ,$191.26 ,$144.10 ,$238.42 ,$238.42 ,$209.60 , N/A ,$144.10 ,$235.80 , N/A ,$235.80 ,$141.48 ,$246.28 , N/A ,$241.04 , N/A ,$238.42 , N/A ,$161.23 ,$161.23 ,$235.80 ,$195.53 , N/A , N/A , N/A ,$248.90 , N/A , N/A ,$227.94 , N/A ,$235.80 , N/A ,$235.80 ,$235.80 ,$235.80 ,$254.14 ,$212.22 ,$243.66 ,$225.32 ,$254.14 
SACRED HEART HOSPITAL (ACU),27500041,N/A,HC PACEMAKER CATH W INTRODUCER,275,1 ,$560.00 ,$420.00 ,$302.40 ,$560.00 ,$360.64 , N/A ,$392.00 , N/A ,$464.80 , N/A ,$369.60 ,$532.00 , N/A ,$448.00 ,$515.20 , N/A ,$476.00 ,$532.00 ,$492.80 ,$425.60 , N/A , N/A , N/A ,$408.80 ,$308.00 ,$509.60 ,$509.60 ,$448.00 , N/A ,$308.00 ,$504.00 , N/A ,$504.00 ,$302.40 ,$526.40 , N/A ,$515.20 , N/A ,$509.60 , N/A ,$344.62 ,$344.62 ,$504.00 ,$417.93 , N/A , N/A , N/A ,$532.00 , N/A , N/A ,$487.20 , N/A ,$504.00 , N/A ,$504.00 ,$504.00 ,$504.00 ,$543.20 ,$453.60 ,$520.80 ,$481.60 ,$543.20 
SACRED HEART HOSPITAL (ACU),27500202,C1786,HC PACEMAKER SINGLE MICRA C1786,275,1 ,"$15,137.00 ","$11,352.75 ","$8,173.98 ","$15,137.00 ","$9,748.23 ", N/A ,"$10,595.90 ", N/A ,"$12,563.71 ", N/A ,"$9,990.42 ","$14,380.15 ", N/A ,"$12,109.60 ","$13,926.04 ", N/A ,"$12,866.45 ","$14,380.15 ","$13,320.56 ","$11,504.12 ", N/A , N/A , N/A ,"$11,050.01 ","$8,325.35 ","$13,774.67 ","$13,774.67 ","$12,109.60 ", N/A ,"$8,325.35 ","$13,623.30 ", N/A ,"$13,623.30 ","$8,173.98 ","$14,228.78 ", N/A ,"$13,926.04 ", N/A ,"$13,774.67 ", N/A ,"$9,315.31 ","$9,315.31 ","$13,623.30 ","$11,296.74 ", N/A , N/A , N/A ,"$14,380.15 ", N/A , N/A ,"$13,169.19 ", N/A ,"$13,623.30 ", N/A ,"$13,623.30 ","$13,623.30 ","$13,623.30 ","$14,682.89 ","$12,260.97 ","$14,077.41 ","$13,017.82 ","$14,682.89 "
SACRED HEART HOSPITAL (ACU),27800123,C1724,HC DIAMONDBACK BURR  AND  LUBRICANT,278,1 ,$261.00 ,$195.75 ,$140.94 ,$261.00 ,$168.08 , N/A ,$182.70 , N/A ,$216.63 , N/A ,$172.26 ,$247.95 , N/A ,$208.80 ,$240.12 , N/A ,$221.85 ,$247.95 ,$229.68 ,$198.36 , N/A , N/A , N/A ,$190.53 ,$143.55 ,$237.51 ,$237.51 ,$208.80 , N/A ,$143.55 ,$234.90 , N/A ,$234.90 ,$140.94 ,$245.34 , N/A ,$240.12 , N/A ,$237.51 , N/A ,$160.62 ,$160.62 ,$234.90 ,$194.78 , N/A , N/A , N/A ,$247.95 , N/A , N/A ,$227.07 , N/A ,$234.90 , N/A ,$234.90 ,$234.90 ,$234.90 ,$253.17 ,$211.41 ,$242.73 ,$224.46 ,$253.17 
SACRED HEART HOSPITAL (ACU),27800133,C1751,HC HICKMAN,278,1 ,"$1,035.00 ",$776.25 ,$558.90 ,"$1,035.00 ",$666.54 , N/A ,$724.50 , N/A ,$859.05 , N/A ,$683.10 ,$983.25 , N/A ,$828.00 ,$952.20 , N/A ,$879.75 ,$983.25 ,$910.80 ,$786.60 , N/A , N/A , N/A ,$755.55 ,$569.25 ,$941.85 ,$941.85 ,$828.00 , N/A ,$569.25 ,$931.50 , N/A ,$931.50 ,$558.90 ,$972.90 , N/A ,$952.20 , N/A ,$941.85 , N/A ,$636.94 ,$636.94 ,$931.50 ,$772.42 , N/A , N/A , N/A ,$983.25 , N/A , N/A ,$900.45 , N/A ,$931.50 , N/A ,$931.50 ,$931.50 ,$931.50 ,"$1,003.95 ",$838.35 ,$962.55 ,$890.10 ,"$1,003.95 "
SACRED HEART HOSPITAL (ACU),27800166,C1760,HC DEVICE VASCULAR CLOSURE,278,1 ,$943.00 ,$707.25 ,$509.22 ,$943.00 ,$607.29 , N/A ,$660.10 , N/A ,$782.69 , N/A ,$622.38 ,$895.85 , N/A ,$754.40 ,$867.56 , N/A ,$801.55 ,$895.85 ,$829.84 ,$716.68 , N/A , N/A , N/A ,$688.39 ,$518.65 ,$858.13 ,$858.13 ,$754.40 , N/A ,$518.65 ,$848.70 , N/A ,$848.70 ,$509.22 ,$886.42 , N/A ,$867.56 , N/A ,$858.13 , N/A ,$580.32 ,$580.32 ,$848.70 ,$703.76 , N/A , N/A , N/A ,$895.85 , N/A , N/A ,$820.41 , N/A ,$848.70 , N/A ,$848.70 ,$848.70 ,$848.70 ,$914.71 ,$763.83 ,$876.99 ,$810.98 ,$914.71 
SACRED HEART HOSPITAL (ACU),27800170,C1760,HC PERCLOSE,278,1 ,$699.00 ,$524.25 ,$377.46 ,$699.00 ,$450.16 , N/A ,$489.30 , N/A ,$580.17 , N/A ,$461.34 ,$664.05 , N/A ,$559.20 ,$643.08 , N/A ,$594.15 ,$664.05 ,$615.12 ,$531.24 , N/A , N/A , N/A ,$510.27 ,$384.45 ,$636.09 ,$636.09 ,$559.20 , N/A ,$384.45 ,$629.10 , N/A ,$629.10 ,$377.46 ,$657.06 , N/A ,$643.08 , N/A ,$636.09 , N/A ,$430.16 ,$430.16 ,$629.10 ,$521.66 , N/A , N/A , N/A ,$664.05 , N/A , N/A ,$608.13 , N/A ,$629.10 , N/A ,$629.10 ,$629.10 ,$629.10 ,$678.03 ,$566.19 ,$650.07 ,$601.14 ,$678.03 
SACRED HEART HOSPITAL (ACU),27800493,C1788,HC PORT,278,1 ,"$1,827.00 ","$1,370.25 ",$986.58 ,"$1,827.00 ","$1,176.59 ", N/A ,"$1,278.90 ", N/A ,"$1,516.41 ", N/A ,"$1,205.82 ","$1,735.65 ", N/A ,"$1,461.60 ","$1,680.84 ", N/A ,"$1,552.95 ","$1,735.65 ","$1,607.76 ","$1,388.52 ", N/A , N/A , N/A ,"$1,333.71 ","$1,004.85 ","$1,662.57 ","$1,662.57 ","$1,461.60 ", N/A ,"$1,004.85 ","$1,644.30 ", N/A ,"$1,644.30 ",$986.58 ,"$1,717.38 ", N/A ,"$1,680.84 ", N/A ,"$1,662.57 ", N/A ,"$1,124.34 ","$1,124.34 ","$1,644.30 ","$1,363.49 ", N/A , N/A , N/A ,"$1,735.65 ", N/A , N/A ,"$1,589.49 ", N/A ,"$1,644.30 ", N/A ,"$1,644.30 ","$1,644.30 ","$1,644.30 ","$1,772.19 ","$1,479.87 ","$1,699.11 ","$1,571.22 ","$1,772.19 "
SACRED HEART HOSPITAL (ACU),27800506,C1874,HC DRUG ELUTING STENT,278,1 ,"$6,782.00 ","$5,086.50 ","$3,662.28 ","$6,782.00 ","$4,367.61 ", N/A ,"$4,747.40 ", N/A ,"$5,629.06 ", N/A ,"$4,476.12 ","$6,442.90 ", N/A ,"$5,425.60 ","$6,239.44 ", N/A ,"$5,764.70 ","$6,442.90 ","$5,968.16 ","$5,154.32 ", N/A , N/A , N/A ,"$4,950.86 ","$3,730.10 ","$6,171.62 ","$6,171.62 ","$5,425.60 ", N/A ,"$3,730.10 ","$6,103.80 ", N/A ,"$6,103.80 ","$3,662.28 ","$6,375.08 ", N/A ,"$6,239.44 ", N/A ,"$6,171.62 ", N/A ,"$4,173.64 ","$4,173.64 ","$6,103.80 ","$5,061.41 ", N/A , N/A , N/A ,"$6,442.90 ", N/A , N/A ,"$5,900.34 ", N/A ,"$6,103.80 ", N/A ,"$6,103.80 ","$6,103.80 ","$6,103.80 ","$6,578.54 ","$5,493.42 ","$6,307.26 ","$5,832.52 ","$6,578.54 "
SACRED HEART HOSPITAL (ACU),27800535,C1876,HC STENT BARE METAL,278,1 ,"$2,457.00 ","$1,842.75 ","$1,326.78 ","$2,457.00 ","$1,582.31 ", N/A ,"$1,719.90 ", N/A ,"$2,039.31 ", N/A ,"$1,621.62 ","$2,334.15 ", N/A ,"$1,965.60 ","$2,260.44 ", N/A ,"$2,088.45 ","$2,334.15 ","$2,162.16 ","$1,867.32 ", N/A , N/A , N/A ,"$1,793.61 ","$1,351.35 ","$2,235.87 ","$2,235.87 ","$1,965.60 ", N/A ,"$1,351.35 ","$2,211.30 ", N/A ,"$2,211.30 ","$1,326.78 ","$2,309.58 ", N/A ,"$2,260.44 ", N/A ,"$2,235.87 ", N/A ,"$1,512.04 ","$1,512.04 ","$2,211.30 ","$1,833.66 ", N/A , N/A , N/A ,"$2,334.15 ", N/A , N/A ,"$2,137.59 ", N/A ,"$2,211.30 ", N/A ,"$2,211.30 ","$2,211.30 ","$2,211.30 ","$2,383.29 ","$1,990.17 ","$2,285.01 ","$2,113.02 ","$2,383.29 "
SACRED HEART HOSPITAL (ACU),27800557,C1880,HC IVC FILTER,278,1 ,"$3,387.00 ","$2,540.25 ","$1,828.98 ","$3,387.00 ","$2,181.23 ", N/A ,"$2,370.90 ", N/A ,"$2,811.21 ", N/A ,"$2,235.42 ","$3,217.65 ", N/A ,"$2,709.60 ","$3,116.04 ", N/A ,"$2,878.95 ","$3,217.65 ","$2,980.56 ","$2,574.12 ", N/A , N/A , N/A ,"$2,472.51 ","$1,862.85 ","$3,082.17 ","$3,082.17 ","$2,709.60 ", N/A ,"$1,862.85 ","$3,048.30 ", N/A ,"$3,048.30 ","$1,828.98 ","$3,183.78 ", N/A ,"$3,116.04 ", N/A ,"$3,082.17 ", N/A ,"$2,084.36 ","$2,084.36 ","$3,048.30 ","$2,527.72 ", N/A , N/A , N/A ,"$3,217.65 ", N/A , N/A ,"$2,946.69 ", N/A ,"$3,048.30 ", N/A ,"$3,048.30 ","$3,048.30 ","$3,048.30 ","$3,285.39 ","$2,743.47 ","$3,149.91 ","$2,912.82 ","$3,285.39 "
SACRED HEART HOSPITAL (ACU),27801312,N/A,HC VALVE MASTER AORTIC 21 MM TO 29MM,278,1 ,"$50,456.00 ","$37,842.00 ","$27,246.24 ","$50,456.00 ","$32,493.66 ", N/A ,"$30,273.60 ", N/A ,"$41,878.48 ", N/A ,"$33,300.96 ","$47,933.20 ", N/A ,"$40,364.80 ","$46,419.52 ", N/A ,"$42,887.60 ","$47,933.20 ","$44,401.28 ","$38,346.56 ", N/A , N/A , N/A ,"$36,832.88 ","$27,750.80 ","$45,914.96 ","$45,914.96 ","$40,364.80 ", N/A ,"$27,750.80 ","$45,410.40 ", N/A ,"$45,410.40 ","$27,246.24 ","$47,428.64 ", N/A ,"$46,419.52 ", N/A ,"$45,914.96 ", N/A ,"$31,050.62 ","$31,050.62 ","$45,410.40 ","$37,655.31 ", N/A , N/A , N/A ,"$47,933.20 ", N/A , N/A ,"$43,896.72 ", N/A ,"$45,410.40 ", N/A ,"$45,410.40 ","$45,410.40 ","$45,410.40 ","$48,942.32 ","$40,869.36 ","$46,924.08 ","$43,392.16 ","$48,942.32 "
SACRED HEART HOSPITAL (ACU),27801362,C1874,HC VIABAHN 5 CM COVERED STENTS,278,1 ,"$5,135.00 ","$3,851.25 ","$2,772.90 ","$5,135.00 ","$3,306.94 ", N/A ,"$3,594.50 ", N/A ,"$4,262.05 ", N/A ,"$3,389.10 ","$4,878.25 ", N/A ,"$4,108.00 ","$4,724.20 ", N/A ,"$4,364.75 ","$4,878.25 ","$4,518.80 ","$3,902.60 ", N/A , N/A , N/A ,"$3,748.55 ","$2,824.25 ","$4,672.85 ","$4,672.85 ","$4,108.00 ", N/A ,"$2,824.25 ","$4,621.50 ", N/A ,"$4,621.50 ","$2,772.90 ","$4,826.90 ", N/A ,"$4,724.20 ", N/A ,"$4,672.85 ", N/A ,"$3,160.08 ","$3,160.08 ","$4,621.50 ","$3,832.25 ", N/A , N/A , N/A ,"$4,878.25 ", N/A , N/A ,"$4,467.45 ", N/A ,"$4,621.50 ", N/A ,"$4,621.50 ","$4,621.50 ","$4,621.50 ","$4,980.95 ","$4,159.35 ","$4,775.55 ","$4,416.10 ","$4,980.95 "
SACRED HEART HOSPITAL (ACU),27801363,C1874,HC VIABAHN 10-15 CM COVERED STENTS,278,1 ,"$5,614.00 ","$4,210.50 ","$3,031.56 ","$5,614.00 ","$3,615.42 ", N/A ,"$3,929.80 ", N/A ,"$4,659.62 ", N/A ,"$3,705.24 ","$5,333.30 ", N/A ,"$4,491.20 ","$5,164.88 ", N/A ,"$4,771.90 ","$5,333.30 ","$4,940.32 ","$4,266.64 ", N/A , N/A , N/A ,"$4,098.22 ","$3,087.70 ","$5,108.74 ","$5,108.74 ","$4,491.20 ", N/A ,"$3,087.70 ","$5,052.60 ", N/A ,"$5,052.60 ","$3,031.56 ","$5,277.16 ", N/A ,"$5,164.88 ", N/A ,"$5,108.74 ", N/A ,"$3,454.86 ","$3,454.86 ","$5,052.60 ","$4,189.73 ", N/A , N/A , N/A ,"$5,333.30 ", N/A , N/A ,"$4,884.18 ", N/A ,"$5,052.60 ", N/A ,"$5,052.60 ","$5,052.60 ","$5,052.60 ","$5,445.58 ","$4,547.34 ","$5,221.02 ","$4,828.04 ","$5,445.58 "
SACRED HEART HOSPITAL (ACU),27801430,C2623,HC CATH TRANSLUMINAL DRUG COATED C2623,278,1 ,"$2,211.00 ","$1,658.25 ","$1,193.94 ","$2,211.00 ","$1,423.88 ", N/A ,"$1,547.70 ", N/A ,"$1,835.13 ", N/A ,"$1,459.26 ","$2,100.45 ", N/A ,"$1,768.80 ","$2,034.12 ", N/A ,"$1,879.35 ","$2,100.45 ","$1,945.68 ","$1,680.36 ", N/A , N/A , N/A ,"$1,614.03 ","$1,216.05 ","$2,012.01 ","$2,012.01 ","$1,768.80 ", N/A ,"$1,216.05 ","$1,989.90 ", N/A ,"$1,989.90 ","$1,193.94 ","$2,078.34 ", N/A ,"$2,034.12 ", N/A ,"$2,012.01 ", N/A ,"$1,360.65 ","$1,360.65 ","$1,989.90 ","$1,650.07 ", N/A , N/A , N/A ,"$2,100.45 ", N/A , N/A ,"$1,923.57 ", N/A ,"$1,989.90 ", N/A ,"$1,989.90 ","$1,989.90 ","$1,989.90 ","$2,144.67 ","$1,790.91 ","$2,056.23 ","$1,901.46 ","$2,144.67 "
SACRED HEART HOSPITAL (ACU),27801450,C1751,HC PICC,278,1 ,$642.00 ,$481.50 ,$346.68 ,$642.00 ,$413.45 , N/A ,$449.40 , N/A ,$532.86 , N/A ,$423.72 ,$609.90 , N/A ,$513.60 ,$590.64 , N/A ,$545.70 ,$609.90 ,$564.96 ,$487.92 , N/A , N/A , N/A ,$468.66 ,$353.10 ,$584.22 ,$584.22 ,$513.60 , N/A ,$353.10 ,$577.80 , N/A ,$577.80 ,$346.68 ,$603.48 , N/A ,$590.64 , N/A ,$584.22 , N/A ,$395.09 ,$395.09 ,$577.80 ,$479.12 , N/A , N/A , N/A ,$609.90 , N/A , N/A ,$558.54 , N/A ,$577.80 , N/A ,$577.80 ,$577.80 ,$577.80 ,$622.74 ,$520.02 ,$597.06 ,$552.12 ,$622.74 
SACRED HEART HOSPITAL (ACU),27801471,C1713,HC ANCHOR SUTURE,278,1 ,$316.00 ,$237.00 ,$170.64 ,$316.00 ,$203.50 , N/A ,$221.20 , N/A ,$262.28 , N/A ,$208.56 ,$300.20 , N/A ,$252.80 ,$290.72 , N/A ,$268.60 ,$300.20 ,$278.08 ,$240.16 , N/A , N/A , N/A ,$230.68 ,$173.80 ,$287.56 ,$287.56 ,$252.80 , N/A ,$173.80 ,$284.40 , N/A ,$284.40 ,$170.64 ,$297.04 , N/A ,$290.72 , N/A ,$287.56 , N/A ,$194.47 ,$194.47 ,$284.40 ,$235.83 , N/A , N/A , N/A ,$300.20 , N/A , N/A ,$274.92 , N/A ,$284.40 , N/A ,$284.40 ,$284.40 ,$284.40 ,$306.52 ,$255.96 ,$293.88 ,$271.76 ,$306.52 
SACRED HEART HOSPITAL (ACU),27801479,C1894,HC INTRODUCER CATH,278,1 ,$63.00 ,$47.25 ,$34.02 ,$63.00 ,$40.57 , N/A ,$44.10 , N/A ,$52.29 , N/A ,$41.58 ,$59.85 , N/A ,$50.40 ,$57.96 , N/A ,$53.55 ,$59.85 ,$55.44 ,$47.88 , N/A , N/A , N/A ,$45.99 ,$34.65 ,$57.33 ,$57.33 ,$50.40 , N/A ,$34.65 ,$56.70 , N/A ,$56.70 ,$34.02 ,$59.22 , N/A ,$57.96 , N/A ,$57.33 , N/A ,$38.77 ,$38.77 ,$56.70 ,$47.02 , N/A , N/A , N/A ,$59.85 , N/A , N/A ,$54.81 , N/A ,$56.70 , N/A ,$56.70 ,$56.70 ,$56.70 ,$61.11 ,$51.03 ,$58.59 ,$54.18 ,$61.11 
SACRED HEART HOSPITAL (ACU),27801480,C2639,HC BRACHY NON-STRANDED  I-125 PER SOURCE,278,1 ,$70.00 ,$52.50 ,$34.82 ,$144.21 ,$45.08 ,$34.82 ,$49.00 ,$70.00 ,$58.10 ,$140.13 ,$46.20 ,$66.50 ,$136.05 ,$56.00 ,$64.40 ,$70.00 ,$59.50 ,$66.50 ,$61.60 ,$53.20 ,$70.00 ,$70.00 ,$136.05 ,$51.10 ,$38.50 ,$63.70 ,$63.70 ,$56.00 ,$35.86 ,$38.50 ,$63.00 ,$34.82 ,$63.00 ,$37.80 ,$65.80 ,$78.35 ,$64.40 ,$144.21 ,$63.70 ,$34.82 ,$43.08 ,$43.08 ,$63.00 ,$52.24 , N/A ,$35.17 ,$70.00 ,$66.50 ,$36.56 ,$70.00 ,$60.90 ,$34.82 ,$63.00 ,$34.82 ,$63.00 ,$63.00 ,$63.00 ,$67.90 ,$56.70 ,$65.10 ,$60.20 ,$67.90 
SACRED HEART HOSPITAL (ACU),27801481,N/A,HC TUBE FEEDING,278,1 ,$9.00 ,$6.75 ,$4.86 ,$9.00 ,$5.80 , N/A ,$6.30 , N/A ,$7.47 , N/A ,$5.94 ,$8.55 , N/A ,$7.20 ,$8.28 , N/A ,$7.65 ,$8.55 ,$7.92 ,$6.84 , N/A , N/A , N/A ,$6.57 ,$4.95 ,$8.19 ,$8.19 ,$7.20 , N/A ,$4.95 ,$8.10 , N/A ,$8.10 ,$4.86 ,$8.46 , N/A ,$8.28 , N/A ,$8.19 , N/A ,$5.54 ,$5.54 ,$8.10 ,$6.72 , N/A , N/A , N/A ,$8.55 , N/A , N/A ,$7.83 , N/A ,$8.10 , N/A ,$8.10 ,$8.10 ,$8.10 ,$8.73 ,$7.29 ,$8.37 ,$7.74 ,$8.73 
SACRED HEART HOSPITAL (ACU),27801483,N/A,HC CATHETER CROSSING SUPPORT,278,1 ,$473.00 ,$354.75 ,$255.42 ,$473.00 ,$304.61 , N/A ,$331.10 , N/A ,$392.59 , N/A ,$312.18 ,$449.35 , N/A ,$378.40 ,$435.16 , N/A ,$402.05 ,$449.35 ,$416.24 ,$359.48 , N/A , N/A , N/A ,$345.29 ,$260.15 ,$430.43 ,$430.43 ,$378.40 , N/A ,$260.15 ,$425.70 , N/A ,$425.70 ,$255.42 ,$444.62 , N/A ,$435.16 , N/A ,$430.43 , N/A ,$291.08 ,$291.08 ,$425.70 ,$353.00 , N/A , N/A , N/A ,$449.35 , N/A , N/A ,$411.51 , N/A ,$425.70 , N/A ,$425.70 ,$425.70 ,$425.70 ,$458.81 ,$383.13 ,$439.89 ,$406.78 ,$458.81 
SACRED HEART HOSPITAL (ACU),27801484,C1894,HC INTRODUCER MICROPUNCTURE SET,278,1 ,$251.00 ,$188.25 ,$135.54 ,$251.00 ,$161.64 , N/A ,$175.70 , N/A ,$208.33 , N/A ,$165.66 ,$238.45 , N/A ,$200.80 ,$230.92 , N/A ,$213.35 ,$238.45 ,$220.88 ,$190.76 , N/A , N/A , N/A ,$183.23 ,$138.05 ,$228.41 ,$228.41 ,$200.80 , N/A ,$138.05 ,$225.90 , N/A ,$225.90 ,$135.54 ,$235.94 , N/A ,$230.92 , N/A ,$228.41 , N/A ,$154.47 ,$154.47 ,$225.90 ,$187.32 , N/A , N/A , N/A ,$238.45 , N/A , N/A ,$218.37 , N/A ,$225.90 , N/A ,$225.90 ,$225.90 ,$225.90 ,$243.47 ,$203.31 ,$233.43 ,$215.86 ,$243.47 
SACRED HEART HOSPITAL (ACU),27801485,C1779,HC LEAD PACEMAKER VENTRICULAR,278,1 ,"$2,212.00 ","$1,659.00 ","$1,194.48 ","$2,212.00 ","$1,424.53 ", N/A ,"$1,548.40 ", N/A ,"$1,835.96 ", N/A ,"$1,459.92 ","$2,101.40 ", N/A ,"$1,769.60 ","$2,035.04 ", N/A ,"$1,880.20 ","$2,101.40 ","$1,946.56 ","$1,681.12 ", N/A , N/A , N/A ,"$1,614.76 ","$1,216.60 ","$2,012.92 ","$2,012.92 ","$1,769.60 ", N/A ,"$1,216.60 ","$1,990.80 ", N/A ,"$1,990.80 ","$1,194.48 ","$2,079.28 ", N/A ,"$2,035.04 ", N/A ,"$2,012.92 ", N/A ,"$1,361.26 ","$1,361.26 ","$1,990.80 ","$1,650.82 ", N/A , N/A , N/A ,"$2,101.40 ", N/A , N/A ,"$1,924.44 ", N/A ,"$1,990.80 ", N/A ,"$1,990.80 ","$1,990.80 ","$1,990.80 ","$2,145.64 ","$1,791.72 ","$2,057.16 ","$1,902.32 ","$2,145.64 "
SACRED HEART HOSPITAL (ACU),27801486,C2617,HC STENT RENAL,278,1 ,"$1,872.00 ","$1,404.00 ","$1,010.88 ","$1,872.00 ","$1,205.57 ", N/A ,"$1,310.40 ", N/A ,"$1,553.76 ", N/A ,"$1,235.52 ","$1,778.40 ", N/A ,"$1,497.60 ","$1,722.24 ", N/A ,"$1,591.20 ","$1,778.40 ","$1,647.36 ","$1,422.72 ", N/A , N/A , N/A ,"$1,366.56 ","$1,029.60 ","$1,703.52 ","$1,703.52 ","$1,497.60 ", N/A ,"$1,029.60 ","$1,684.80 ", N/A ,"$1,684.80 ","$1,010.88 ","$1,759.68 ", N/A ,"$1,722.24 ", N/A ,"$1,703.52 ", N/A ,"$1,152.03 ","$1,152.03 ","$1,684.80 ","$1,397.07 ", N/A , N/A , N/A ,"$1,778.40 ", N/A , N/A ,"$1,628.64 ", N/A ,"$1,684.80 ", N/A ,"$1,684.80 ","$1,684.80 ","$1,684.80 ","$1,815.84 ","$1,516.32 ","$1,740.96 ","$1,609.92 ","$1,815.84 "
SACRED HEART HOSPITAL (ACU),27801487,C1898,HC LEAD PACEMAKER ATRIAL,278,1 ,"$2,091.00 ","$1,568.25 ","$1,129.14 ","$2,091.00 ","$1,346.60 ", N/A ,"$1,463.70 ", N/A ,"$1,735.53 ", N/A ,"$1,380.06 ","$1,986.45 ", N/A ,"$1,672.80 ","$1,923.72 ", N/A ,"$1,777.35 ","$1,986.45 ","$1,840.08 ","$1,589.16 ", N/A , N/A , N/A ,"$1,526.43 ","$1,150.05 ","$1,902.81 ","$1,902.81 ","$1,672.80 ", N/A ,"$1,150.05 ","$1,881.90 ", N/A ,"$1,881.90 ","$1,129.14 ","$1,965.54 ", N/A ,"$1,923.72 ", N/A ,"$1,902.81 ", N/A ,"$1,286.80 ","$1,286.80 ","$1,881.90 ","$1,560.51 ", N/A , N/A , N/A ,"$1,986.45 ", N/A , N/A ,"$1,819.17 ", N/A ,"$1,881.90 ", N/A ,"$1,881.90 ","$1,881.90 ","$1,881.90 ","$2,028.27 ","$1,693.71 ","$1,944.63 ","$1,798.26 ","$2,028.27 "
SACRED HEART HOSPITAL (ACU),27801489,C1750,HC CATHETER DIALYSIS ASH SPLIT,278,1 ,"$1,207.00 ",$905.25 ,$651.78 ,"$1,207.00 ",$777.31 , N/A ,$844.90 , N/A ,"$1,001.81 ", N/A ,$796.62 ,"$1,146.65 ", N/A ,$965.60 ,"$1,110.44 ", N/A ,"$1,025.95 ","$1,146.65 ","$1,062.16 ",$917.32 , N/A , N/A , N/A ,$881.11 ,$663.85 ,"$1,098.37 ","$1,098.37 ",$965.60 , N/A ,$663.85 ,"$1,086.30 ", N/A ,"$1,086.30 ",$651.78 ,"$1,134.58 ", N/A ,"$1,110.44 ", N/A ,"$1,098.37 ", N/A ,$742.79 ,$742.79 ,"$1,086.30 ",$900.78 , N/A , N/A , N/A ,"$1,146.65 ", N/A , N/A ,"$1,050.09 ", N/A ,"$1,086.30 ", N/A ,"$1,086.30 ","$1,086.30 ","$1,086.30 ","$1,170.79 ",$977.67 ,"$1,122.51 ","$1,038.02 ","$1,170.79 "
SACRED HEART HOSPITAL (ACU),27801490,C1750,HC CATHETER DIALYSIS PERMANENT,278,1 ,$645.00 ,$483.75 ,$348.30 ,$645.00 ,$415.38 , N/A ,$451.50 , N/A ,$535.35 , N/A ,$425.70 ,$612.75 , N/A ,$516.00 ,$593.40 , N/A ,$548.25 ,$612.75 ,$567.60 ,$490.20 , N/A , N/A , N/A ,$470.85 ,$354.75 ,$586.95 ,$586.95 ,$516.00 , N/A ,$354.75 ,$580.50 , N/A ,$580.50 ,$348.30 ,$606.30 , N/A ,$593.40 , N/A ,$586.95 , N/A ,$396.93 ,$396.93 ,$580.50 ,$481.36 , N/A , N/A , N/A ,$612.75 , N/A , N/A ,$561.15 , N/A ,$580.50 , N/A ,$580.50 ,$580.50 ,$580.50 ,$625.65 ,$522.45 ,$599.85 ,$554.70 ,$625.65 
SACRED HEART HOSPITAL (ACU),27801493,C1713,HC ADHESIVE BIOGLUE,278,1 ,"$1,273.00 ",$954.75 ,$687.42 ,"$1,273.00 ",$819.81 , N/A ,$891.10 , N/A ,"$1,056.59 ", N/A ,$840.18 ,"$1,209.35 ", N/A ,"$1,018.40 ","$1,171.16 ", N/A ,"$1,082.05 ","$1,209.35 ","$1,120.24 ",$967.48 , N/A , N/A , N/A ,$929.29 ,$700.15 ,"$1,158.43 ","$1,158.43 ","$1,018.40 ", N/A ,$700.15 ,"$1,145.70 ", N/A ,"$1,145.70 ",$687.42 ,"$1,196.62 ", N/A ,"$1,171.16 ", N/A ,"$1,158.43 ", N/A ,$783.40 ,$783.40 ,"$1,145.70 ",$950.04 , N/A , N/A , N/A ,"$1,209.35 ", N/A , N/A ,"$1,107.51 ", N/A ,"$1,145.70 ", N/A ,"$1,145.70 ","$1,145.70 ","$1,145.70 ","$1,234.81 ","$1,031.13 ","$1,183.89 ","$1,094.78 ","$1,234.81 "
SACRED HEART HOSPITAL (ACU),27801494,Q4116,HC MATRIX ALLODERM PER SQ CM,278,1 ,$51.00 ,$38.25 ,$27.54 ,$51.00 ,$32.84 , N/A ,$35.70 , N/A ,$42.33 , N/A ,$33.66 ,$48.45 , N/A ,$40.80 ,$46.92 , N/A ,$43.35 ,$48.45 ,$44.88 ,$38.76 , N/A , N/A , N/A ,$37.23 ,$28.05 ,$46.41 ,$46.41 ,$40.80 , N/A ,$28.05 ,$45.90 , N/A ,$45.90 ,$27.54 ,$47.94 , N/A ,$46.92 , N/A ,$46.41 , N/A ,$31.39 ,$31.39 ,$45.90 ,$38.06 , N/A , N/A , N/A ,$48.45 , N/A , N/A ,$44.37 , N/A ,$45.90 , N/A ,$45.90 ,$45.90 ,$45.90 ,$49.47 ,$41.31 ,$47.43 ,$43.86 ,$49.47 
SACRED HEART HOSPITAL (ACU),27801495,C1768,HC GRAFT VASCULAR FEMORAL ARTERY TIER 1,278,1 ,"$12,479.00 ","$9,359.25 ","$6,738.66 ","$12,479.00 ","$8,036.48 ", N/A ,"$8,735.30 ", N/A ,"$10,357.57 ", N/A ,"$8,236.14 ","$11,855.05 ", N/A ,"$9,983.20 ","$11,480.68 ", N/A ,"$10,607.15 ","$11,855.05 ","$10,981.52 ","$9,484.04 ", N/A , N/A , N/A ,"$9,109.67 ","$6,863.45 ","$11,355.89 ","$11,355.89 ","$9,983.20 ", N/A ,"$6,863.45 ","$11,231.10 ", N/A ,"$11,231.10 ","$6,738.66 ","$11,730.26 ", N/A ,"$11,480.68 ", N/A ,"$11,355.89 ", N/A ,"$7,679.58 ","$7,679.58 ","$11,231.10 ","$9,313.08 ", N/A , N/A , N/A ,"$11,855.05 ", N/A , N/A ,"$10,856.73 ", N/A ,"$11,231.10 ", N/A ,"$11,231.10 ","$11,231.10 ","$11,231.10 ","$12,104.63 ","$10,107.99 ","$11,605.47 ","$10,731.94 ","$12,104.63 "
SACRED HEART HOSPITAL (ACU),27801496,C1768,HC GRAFT VASCULAR FEMORAL ARTERY TIER 2,278,1 ,"$13,869.00 ","$10,401.75 ","$7,489.26 ","$13,869.00 ","$8,931.64 ", N/A ,"$9,708.30 ", N/A ,"$11,511.27 ", N/A ,"$9,153.54 ","$13,175.55 ", N/A ,"$11,095.20 ","$12,759.48 ", N/A ,"$11,788.65 ","$13,175.55 ","$12,204.72 ","$10,540.44 ", N/A , N/A , N/A ,"$10,124.37 ","$7,627.95 ","$12,620.79 ","$12,620.79 ","$11,095.20 ", N/A ,"$7,627.95 ","$12,482.10 ", N/A ,"$12,482.10 ","$7,489.26 ","$13,036.86 ", N/A ,"$12,759.48 ", N/A ,"$12,620.79 ", N/A ,"$8,534.98 ","$8,534.98 ","$12,482.10 ","$10,350.43 ", N/A , N/A , N/A ,"$13,175.55 ", N/A , N/A ,"$12,066.03 ", N/A ,"$12,482.10 ", N/A ,"$12,482.10 ","$12,482.10 ","$12,482.10 ","$13,452.93 ","$11,233.89 ","$12,898.17 ","$11,927.34 ","$13,452.93 "
SACRED HEART HOSPITAL (ACU),27801497,C1768,HC GRAFT VASCULAR FEMORAL ARTERY TIER 3,278,1 ,"$16,374.00 ","$12,280.50 ","$8,841.96 ","$16,374.00 ","$10,544.86 ", N/A ,"$11,461.80 ", N/A ,"$13,590.42 ", N/A ,"$10,806.84 ","$15,555.30 ", N/A ,"$13,099.20 ","$15,064.08 ", N/A ,"$13,917.90 ","$15,555.30 ","$14,409.12 ","$12,444.24 ", N/A , N/A , N/A ,"$11,953.02 ","$9,005.70 ","$14,900.34 ","$14,900.34 ","$13,099.20 ", N/A ,"$9,005.70 ","$14,736.60 ", N/A ,"$14,736.60 ","$8,841.96 ","$15,391.56 ", N/A ,"$15,064.08 ", N/A ,"$14,900.34 ", N/A ,"$10,076.56 ","$10,076.56 ","$14,736.60 ","$12,219.92 ", N/A , N/A , N/A ,"$15,555.30 ", N/A , N/A ,"$14,245.38 ", N/A ,"$14,736.60 ", N/A ,"$14,736.60 ","$14,736.60 ","$14,736.60 ","$15,882.78 ","$13,262.94 ","$15,227.82 ","$14,081.64 ","$15,882.78 "
SACRED HEART HOSPITAL (ACU),27801498,C1713,HC BONE CANCELLOUS CHIPS TIER 1,278,1 ,"$1,043.00 ",$782.25 ,$563.22 ,"$1,043.00 ",$671.69 , N/A ,$730.10 , N/A ,$865.69 , N/A ,$688.38 ,$990.85 , N/A ,$834.40 ,$959.56 , N/A ,$886.55 ,$990.85 ,$917.84 ,$792.68 , N/A , N/A , N/A ,$761.39 ,$573.65 ,$949.13 ,$949.13 ,$834.40 , N/A ,$573.65 ,$938.70 , N/A ,$938.70 ,$563.22 ,$980.42 , N/A ,$959.56 , N/A ,$949.13 , N/A ,$641.86 ,$641.86 ,$938.70 ,$778.39 , N/A , N/A , N/A ,$990.85 , N/A , N/A ,$907.41 , N/A ,$938.70 , N/A ,$938.70 ,$938.70 ,$938.70 ,"$1,011.71 ",$844.83 ,$969.99 ,$896.98 ,"$1,011.71 "
SACRED HEART HOSPITAL (ACU),27801499,C1713,HC BONE CANCELLOUS CHIPS TIER 2,278,1 ,"$1,845.00 ","$1,383.75 ",$996.30 ,"$1,845.00 ","$1,188.18 ", N/A ,"$1,291.50 ", N/A ,"$1,531.35 ", N/A ,"$1,217.70 ","$1,752.75 ", N/A ,"$1,476.00 ","$1,697.40 ", N/A ,"$1,568.25 ","$1,752.75 ","$1,623.60 ","$1,402.20 ", N/A , N/A , N/A ,"$1,346.85 ","$1,014.75 ","$1,678.95 ","$1,678.95 ","$1,476.00 ", N/A ,"$1,014.75 ","$1,660.50 ", N/A ,"$1,660.50 ",$996.30 ,"$1,734.30 ", N/A ,"$1,697.40 ", N/A ,"$1,678.95 ", N/A ,"$1,135.41 ","$1,135.41 ","$1,660.50 ","$1,376.92 ", N/A , N/A , N/A ,"$1,752.75 ", N/A , N/A ,"$1,605.15 ", N/A ,"$1,660.50 ", N/A ,"$1,660.50 ","$1,660.50 ","$1,660.50 ","$1,789.65 ","$1,494.45 ","$1,715.85 ","$1,586.70 ","$1,789.65 "
SACRED HEART HOSPITAL (ACU),27801500,C1713,HC BONE CRANIAL FLAP,278,1 ,"$1,504.00 ","$1,128.00 ",$812.16 ,"$1,504.00 ",$968.58 , N/A ,"$1,052.80 ", N/A ,"$1,248.32 ", N/A ,$992.64 ,"$1,428.80 ", N/A ,"$1,203.20 ","$1,383.68 ", N/A ,"$1,278.40 ","$1,428.80 ","$1,323.52 ","$1,143.04 ", N/A , N/A , N/A ,"$1,097.92 ",$827.20 ,"$1,368.64 ","$1,368.64 ","$1,203.20 ", N/A ,$827.20 ,"$1,353.60 ", N/A ,"$1,353.60 ",$812.16 ,"$1,413.76 ", N/A ,"$1,383.68 ", N/A ,"$1,368.64 ", N/A ,$925.56 ,$925.56 ,"$1,353.60 ","$1,122.44 ", N/A , N/A , N/A ,"$1,428.80 ", N/A , N/A ,"$1,308.48 ", N/A ,"$1,353.60 ", N/A ,"$1,353.60 ","$1,353.60 ","$1,353.60 ","$1,458.88 ","$1,218.24 ","$1,398.72 ","$1,293.44 ","$1,458.88 "
SACRED HEART HOSPITAL (ACU),27801501,C1713,HC BONE DOWEL FACET,278,1 ,"$6,042.00 ","$4,531.50 ","$3,262.68 ","$6,042.00 ","$3,891.05 ", N/A ,"$4,229.40 ", N/A ,"$5,014.86 ", N/A ,"$3,987.72 ","$5,739.90 ", N/A ,"$4,833.60 ","$5,558.64 ", N/A ,"$5,135.70 ","$5,739.90 ","$5,316.96 ","$4,591.92 ", N/A , N/A , N/A ,"$4,410.66 ","$3,323.10 ","$5,498.22 ","$5,498.22 ","$4,833.60 ", N/A ,"$3,323.10 ","$5,437.80 ", N/A ,"$5,437.80 ","$3,262.68 ","$5,679.48 ", N/A ,"$5,558.64 ", N/A ,"$5,498.22 ", N/A ,"$3,718.25 ","$3,718.25 ","$5,437.80 ","$4,509.14 ", N/A , N/A , N/A ,"$5,739.90 ", N/A , N/A ,"$5,256.54 ", N/A ,"$5,437.80 ", N/A ,"$5,437.80 ","$5,437.80 ","$5,437.80 ","$5,860.74 ","$4,894.02 ","$5,619.06 ","$5,196.12 ","$5,860.74 "
SACRED HEART HOSPITAL (ACU),27801502,C1713,HC BONE FRAGMENT FEMUR HEAD,278,1 ,"$5,831.00 ","$4,373.25 ","$3,148.74 ","$5,831.00 ","$3,755.16 ", N/A ,"$4,081.70 ", N/A ,"$4,839.73 ", N/A ,"$3,848.46 ","$5,539.45 ", N/A ,"$4,664.80 ","$5,364.52 ", N/A ,"$4,956.35 ","$5,539.45 ","$5,131.28 ","$4,431.56 ", N/A , N/A , N/A ,"$4,256.63 ","$3,207.05 ","$5,306.21 ","$5,306.21 ","$4,664.80 ", N/A ,"$3,207.05 ","$5,247.90 ", N/A ,"$5,247.90 ","$3,148.74 ","$5,481.14 ", N/A ,"$5,364.52 ", N/A ,"$5,306.21 ", N/A ,"$3,588.40 ","$3,588.40 ","$5,247.90 ","$4,351.68 ", N/A , N/A , N/A ,"$5,539.45 ", N/A , N/A ,"$5,072.97 ", N/A ,"$5,247.90 ", N/A ,"$5,247.90 ","$5,247.90 ","$5,247.90 ","$5,656.07 ","$4,723.11 ","$5,422.83 ","$5,014.66 ","$5,656.07 "
SACRED HEART HOSPITAL (ACU),27801503,C1713,HC BONE FRAGMENT FIBULA,278,1 ,"$3,616.00 ","$2,712.00 ","$1,952.64 ","$3,616.00 ","$2,328.70 ", N/A ,"$2,531.20 ", N/A ,"$3,001.28 ", N/A ,"$2,386.56 ","$3,435.20 ", N/A ,"$2,892.80 ","$3,326.72 ", N/A ,"$3,073.60 ","$3,435.20 ","$3,182.08 ","$2,748.16 ", N/A , N/A , N/A ,"$2,639.68 ","$1,988.80 ","$3,290.56 ","$3,290.56 ","$2,892.80 ", N/A ,"$1,988.80 ","$3,254.40 ", N/A ,"$3,254.40 ","$1,952.64 ","$3,399.04 ", N/A ,"$3,326.72 ", N/A ,"$3,290.56 ", N/A ,"$2,225.29 ","$2,225.29 ","$3,254.40 ","$2,698.62 ", N/A , N/A , N/A ,"$3,435.20 ", N/A , N/A ,"$3,145.92 ", N/A ,"$3,254.40 ", N/A ,"$3,254.40 ","$3,254.40 ","$3,254.40 ","$3,507.52 ","$2,928.96 ","$3,362.88 ","$3,109.76 ","$3,507.52 "
SACRED HEART HOSPITAL (ACU),27801504,C1713,HC BONE FRAGMENT FEMUR CORTICAL,278,1 ,"$2,821.00 ","$2,115.75 ","$1,523.34 ","$2,821.00 ","$1,816.72 ", N/A ,"$1,974.70 ", N/A ,"$2,341.43 ", N/A ,"$1,861.86 ","$2,679.95 ", N/A ,"$2,256.80 ","$2,595.32 ", N/A ,"$2,397.85 ","$2,679.95 ","$2,482.48 ","$2,143.96 ", N/A , N/A , N/A ,"$2,059.33 ","$1,551.55 ","$2,567.11 ","$2,567.11 ","$2,256.80 ", N/A ,"$1,551.55 ","$2,538.90 ", N/A ,"$2,538.90 ","$1,523.34 ","$2,651.74 ", N/A ,"$2,595.32 ", N/A ,"$2,567.11 ", N/A ,"$1,736.04 ","$1,736.04 ","$2,538.90 ","$2,105.31 ", N/A , N/A , N/A ,"$2,679.95 ", N/A , N/A ,"$2,454.27 ", N/A ,"$2,538.90 ", N/A ,"$2,538.90 ","$2,538.90 ","$2,538.90 ","$2,736.37 ","$2,285.01 ","$2,623.53 ","$2,426.06 ","$2,736.37 "
SACRED HEART HOSPITAL (ACU),27801505,C1713,HC GRAFT BONE MAGNIFUSE TIER 1,278,1 ,"$5,410.00 ","$4,057.50 ","$2,921.40 ","$5,410.00 ","$3,484.04 ", N/A ,"$3,787.00 ", N/A ,"$4,490.30 ", N/A ,"$3,570.60 ","$5,139.50 ", N/A ,"$4,328.00 ","$4,977.20 ", N/A ,"$4,598.50 ","$5,139.50 ","$4,760.80 ","$4,111.60 ", N/A , N/A , N/A ,"$3,949.30 ","$2,975.50 ","$4,923.10 ","$4,923.10 ","$4,328.00 ", N/A ,"$2,975.50 ","$4,869.00 ", N/A ,"$4,869.00 ","$2,921.40 ","$5,085.40 ", N/A ,"$4,977.20 ", N/A ,"$4,923.10 ", N/A ,"$3,329.31 ","$3,329.31 ","$4,869.00 ","$4,037.48 ", N/A , N/A , N/A ,"$5,139.50 ", N/A , N/A ,"$4,706.70 ", N/A ,"$4,869.00 ", N/A ,"$4,869.00 ","$4,869.00 ","$4,869.00 ","$5,247.70 ","$4,382.10 ","$5,031.30 ","$4,652.60 ","$5,247.70 "
SACRED HEART HOSPITAL (ACU),27801506,C1713,HC GRAFT BONE MAGNIFUSE TIER 2,278,1 ,"$7,869.00 ","$5,901.75 ","$4,249.26 ","$7,869.00 ","$5,067.64 ", N/A ,"$5,508.30 ", N/A ,"$6,531.27 ", N/A ,"$5,193.54 ","$7,475.55 ", N/A ,"$6,295.20 ","$7,239.48 ", N/A ,"$6,688.65 ","$7,475.55 ","$6,924.72 ","$5,980.44 ", N/A , N/A , N/A ,"$5,744.37 ","$4,327.95 ","$7,160.79 ","$7,160.79 ","$6,295.20 ", N/A ,"$4,327.95 ","$7,082.10 ", N/A ,"$7,082.10 ","$4,249.26 ","$7,396.86 ", N/A ,"$7,239.48 ", N/A ,"$7,160.79 ", N/A ,"$4,842.58 ","$4,842.58 ","$7,082.10 ","$5,872.63 ", N/A , N/A , N/A ,"$7,475.55 ", N/A , N/A ,"$6,846.03 ", N/A ,"$7,082.10 ", N/A ,"$7,082.10 ","$7,082.10 ","$7,082.10 ","$7,632.93 ","$6,373.89 ","$7,318.17 ","$6,767.34 ","$7,632.93 "
SACRED HEART HOSPITAL (ACU),27801507,C1713,HC GRAFT BONE MAGNIFUSE TIER 3,278,1 ,"$3,097.00 ","$2,322.75 ","$1,672.38 ","$3,097.00 ","$1,994.47 ", N/A ,"$2,167.90 ", N/A ,"$2,570.51 ", N/A ,"$2,044.02 ","$2,942.15 ", N/A ,"$2,477.60 ","$2,849.24 ", N/A ,"$2,632.45 ","$2,942.15 ","$2,725.36 ","$2,353.72 ", N/A , N/A , N/A ,"$2,260.81 ","$1,703.35 ","$2,818.27 ","$2,818.27 ","$2,477.60 ", N/A ,"$1,703.35 ","$2,787.30 ", N/A ,"$2,787.30 ","$1,672.38 ","$2,911.18 ", N/A ,"$2,849.24 ", N/A ,"$2,818.27 ", N/A ,"$1,905.89 ","$1,905.89 ","$2,787.30 ","$2,311.29 ", N/A , N/A , N/A ,"$2,942.15 ", N/A , N/A ,"$2,694.39 ", N/A ,"$2,787.30 ", N/A ,"$2,787.30 ","$2,787.30 ","$2,787.30 ","$3,004.09 ","$2,508.57 ","$2,880.21 ","$2,663.42 ","$3,004.09 "
SACRED HEART HOSPITAL (ACU),27801508,C1713,HC GRAFT BONE INFUSE X-SMALL,278,1 ,"$1,818.00 ","$1,363.50 ",$981.72 ,"$1,818.00 ","$1,170.79 ", N/A ,"$1,272.60 ", N/A ,"$1,508.94 ", N/A ,"$1,199.88 ","$1,727.10 ", N/A ,"$1,454.40 ","$1,672.56 ", N/A ,"$1,545.30 ","$1,727.10 ","$1,599.84 ","$1,381.68 ", N/A , N/A , N/A ,"$1,327.14 ",$999.90 ,"$1,654.38 ","$1,654.38 ","$1,454.40 ", N/A ,$999.90 ,"$1,636.20 ", N/A ,"$1,636.20 ",$981.72 ,"$1,708.92 ", N/A ,"$1,672.56 ", N/A ,"$1,654.38 ", N/A ,"$1,118.80 ","$1,118.80 ","$1,636.20 ","$1,356.77 ", N/A , N/A , N/A ,"$1,727.10 ", N/A , N/A ,"$1,581.66 ", N/A ,"$1,636.20 ", N/A ,"$1,636.20 ","$1,636.20 ","$1,636.20 ","$1,763.46 ","$1,472.58 ","$1,690.74 ","$1,563.48 ","$1,763.46 "
SACRED HEART HOSPITAL (ACU),27801509,C1713,HC GRAFT BONE INFUSE XX-SMALL,278,1 ,"$3,582.00 ","$2,686.50 ","$1,934.28 ","$3,582.00 ","$2,306.81 ", N/A ,"$2,507.40 ", N/A ,"$2,973.06 ", N/A ,"$2,364.12 ","$3,402.90 ", N/A ,"$2,865.60 ","$3,295.44 ", N/A ,"$3,044.70 ","$3,402.90 ","$3,152.16 ","$2,722.32 ", N/A , N/A , N/A ,"$2,614.86 ","$1,970.10 ","$3,259.62 ","$3,259.62 ","$2,865.60 ", N/A ,"$1,970.10 ","$3,223.80 ", N/A ,"$3,223.80 ","$1,934.28 ","$3,367.08 ", N/A ,"$3,295.44 ", N/A ,"$3,259.62 ", N/A ,"$2,204.36 ","$2,204.36 ","$3,223.80 ","$2,673.25 ", N/A , N/A , N/A ,"$3,402.90 ", N/A , N/A ,"$3,116.34 ", N/A ,"$3,223.80 ", N/A ,"$3,223.80 ","$3,223.80 ","$3,223.80 ","$3,474.54 ","$2,901.42 ","$3,331.26 ","$3,080.52 ","$3,474.54 "
SACRED HEART HOSPITAL (ACU),27801510,C1713,HC BONE MATRIX ALPHAGRAFT 2.5CC,278,1 ,$838.00 ,$628.50 ,$452.52 ,$838.00 ,$539.67 , N/A ,$586.60 , N/A ,$695.54 , N/A ,$553.08 ,$796.10 , N/A ,$670.40 ,$770.96 , N/A ,$712.30 ,$796.10 ,$737.44 ,$636.88 , N/A , N/A , N/A ,$611.74 ,$460.90 ,$762.58 ,$762.58 ,$670.40 , N/A ,$460.90 ,$754.20 , N/A ,$754.20 ,$452.52 ,$787.72 , N/A ,$770.96 , N/A ,$762.58 , N/A ,$515.71 ,$515.71 ,$754.20 ,$625.40 , N/A , N/A , N/A ,$796.10 , N/A , N/A ,$729.06 , N/A ,$754.20 , N/A ,$754.20 ,$754.20 ,$754.20 ,$812.86 ,$678.78 ,$779.34 ,$720.68 ,$812.86 
SACRED HEART HOSPITAL (ACU),27801511,C1713,HC BONE MATRIX ALPHAGRAFT 5CC,278,1 ,"$1,183.00 ",$887.25 ,$638.82 ,"$1,183.00 ",$761.85 , N/A ,$828.10 , N/A ,$981.89 , N/A ,$780.78 ,"$1,123.85 ", N/A ,$946.40 ,"$1,088.36 ", N/A ,"$1,005.55 ","$1,123.85 ","$1,041.04 ",$899.08 , N/A , N/A , N/A ,$863.59 ,$650.65 ,"$1,076.53 ","$1,076.53 ",$946.40 , N/A ,$650.65 ,"$1,064.70 ", N/A ,"$1,064.70 ",$638.82 ,"$1,112.02 ", N/A ,"$1,088.36 ", N/A ,"$1,076.53 ", N/A ,$728.02 ,$728.02 ,"$1,064.70 ",$882.87 , N/A , N/A , N/A ,"$1,123.85 ", N/A , N/A ,"$1,029.21 ", N/A ,"$1,064.70 ", N/A ,"$1,064.70 ","$1,064.70 ","$1,064.70 ","$1,147.51 ",$958.23 ,"$1,100.19 ","$1,017.38 ","$1,147.51 "
SACRED HEART HOSPITAL (ACU),27801512,C1713,HC BONE MATRIX ALPHAGRAFT 10CC,278,1 ,"$1,679.00 ","$1,259.25 ",$906.66 ,"$1,679.00 ","$1,081.28 ", N/A ,"$1,175.30 ", N/A ,"$1,393.57 ", N/A ,"$1,108.14 ","$1,595.05 ", N/A ,"$1,343.20 ","$1,544.68 ", N/A ,"$1,427.15 ","$1,595.05 ","$1,477.52 ","$1,276.04 ", N/A , N/A , N/A ,"$1,225.67 ",$923.45 ,"$1,527.89 ","$1,527.89 ","$1,343.20 ", N/A ,$923.45 ,"$1,511.10 ", N/A ,"$1,511.10 ",$906.66 ,"$1,578.26 ", N/A ,"$1,544.68 ", N/A ,"$1,527.89 ", N/A ,"$1,033.26 ","$1,033.26 ","$1,511.10 ","$1,253.04 ", N/A , N/A , N/A ,"$1,595.05 ", N/A , N/A ,"$1,460.73 ", N/A ,"$1,511.10 ", N/A ,"$1,511.10 ","$1,511.10 ","$1,511.10 ","$1,628.63 ","$1,359.99 ","$1,561.47 ","$1,443.94 ","$1,628.63 "
SACRED HEART HOSPITAL (ACU),27801513,C1763,HC TISSUE MATRIX DURAGEN TIER 1,278,1 ,$901.00 ,$675.75 ,$486.54 ,$901.00 ,$580.24 , N/A ,$630.70 , N/A ,$747.83 , N/A ,$594.66 ,$855.95 , N/A ,$720.80 ,$828.92 , N/A ,$765.85 ,$855.95 ,$792.88 ,$684.76 , N/A , N/A , N/A ,$657.73 ,$495.55 ,$819.91 ,$819.91 ,$720.80 , N/A ,$495.55 ,$810.90 , N/A ,$810.90 ,$486.54 ,$846.94 , N/A ,$828.92 , N/A ,$819.91 , N/A ,$554.48 ,$554.48 ,$810.90 ,$672.42 , N/A , N/A , N/A ,$855.95 , N/A , N/A ,$783.87 , N/A ,$810.90 , N/A ,$810.90 ,$810.90 ,$810.90 ,$873.97 ,$729.81 ,$837.93 ,$774.86 ,$873.97 
SACRED HEART HOSPITAL (ACU),27801514,C1763,HC TISSUE MATRIX DURAGEN TIER 2,278,1 ,"$1,530.00 ","$1,147.50 ",$826.20 ,"$1,530.00 ",$985.32 , N/A ,"$1,071.00 ", N/A ,"$1,269.90 ", N/A ,"$1,009.80 ","$1,453.50 ", N/A ,"$1,224.00 ","$1,407.60 ", N/A ,"$1,300.50 ","$1,453.50 ","$1,346.40 ","$1,162.80 ", N/A , N/A , N/A ,"$1,116.90 ",$841.50 ,"$1,392.30 ","$1,392.30 ","$1,224.00 ", N/A ,$841.50 ,"$1,377.00 ", N/A ,"$1,377.00 ",$826.20 ,"$1,438.20 ", N/A ,"$1,407.60 ", N/A ,"$1,392.30 ", N/A ,$941.56 ,$941.56 ,"$1,377.00 ","$1,141.84 ", N/A , N/A , N/A ,"$1,453.50 ", N/A , N/A ,"$1,331.10 ", N/A ,"$1,377.00 ", N/A ,"$1,377.00 ","$1,377.00 ","$1,377.00 ","$1,484.10 ","$1,239.30 ","$1,422.90 ","$1,315.80 ","$1,484.10 "
SACRED HEART HOSPITAL (ACU),27801515,C1763,HC TISSUE MATRIX DURAGEN TIER 3,278,1 ,"$2,628.00 ","$1,971.00 ","$1,419.12 ","$2,628.00 ","$1,692.43 ", N/A ,"$1,839.60 ", N/A ,"$2,181.24 ", N/A ,"$1,734.48 ","$2,496.60 ", N/A ,"$2,102.40 ","$2,417.76 ", N/A ,"$2,233.80 ","$2,496.60 ","$2,312.64 ","$1,997.28 ", N/A , N/A , N/A ,"$1,918.44 ","$1,445.40 ","$2,391.48 ","$2,391.48 ","$2,102.40 ", N/A ,"$1,445.40 ","$2,365.20 ", N/A ,"$2,365.20 ","$1,419.12 ","$2,470.32 ", N/A ,"$2,417.76 ", N/A ,"$2,391.48 ", N/A ,"$1,617.27 ","$1,617.27 ","$2,365.20 ","$1,961.28 ", N/A , N/A , N/A ,"$2,496.60 ", N/A , N/A ,"$2,286.36 ", N/A ,"$2,365.20 ", N/A ,"$2,365.20 ","$2,365.20 ","$2,365.20 ","$2,549.16 ","$2,128.68 ","$2,444.04 ","$2,260.08 ","$2,549.16 "
SACRED HEART HOSPITAL (ACU),27801516,C1763,HC TISSUE MATRIX DURAGEN TIER 4,278,1 ,"$4,762.00 ","$3,571.50 ","$2,571.48 ","$4,762.00 ","$3,066.73 ", N/A ,"$3,333.40 ", N/A ,"$3,952.46 ", N/A ,"$3,142.92 ","$4,523.90 ", N/A ,"$3,809.60 ","$4,381.04 ", N/A ,"$4,047.70 ","$4,523.90 ","$4,190.56 ","$3,619.12 ", N/A , N/A , N/A ,"$3,476.26 ","$2,619.10 ","$4,333.42 ","$4,333.42 ","$3,809.60 ", N/A ,"$2,619.10 ","$4,285.80 ", N/A ,"$4,285.80 ","$2,571.48 ","$4,476.28 ", N/A ,"$4,381.04 ", N/A ,"$4,333.42 ", N/A ,"$2,930.53 ","$2,930.53 ","$4,285.80 ","$3,553.88 ", N/A , N/A , N/A ,"$4,523.90 ", N/A , N/A ,"$4,142.94 ", N/A ,"$4,285.80 ", N/A ,"$4,285.80 ","$4,285.80 ","$4,285.80 ","$4,619.14 ","$3,857.22 ","$4,428.66 ","$4,095.32 ","$4,619.14 "
SACRED HEART HOSPITAL (ACU),27801517,N/A,HC GRAFT STRUT FEMORAL CORTICAL,278,1 ,$911.00 ,$683.25 ,$491.94 ,$911.00 ,$586.68 , N/A ,$637.70 , N/A ,$756.13 , N/A ,$601.26 ,$865.45 , N/A ,$728.80 ,$838.12 , N/A ,$774.35 ,$865.45 ,$801.68 ,$692.36 , N/A , N/A , N/A ,$665.03 ,$501.05 ,$829.01 ,$829.01 ,$728.80 , N/A ,$501.05 ,$819.90 , N/A ,$819.90 ,$491.94 ,$856.34 , N/A ,$838.12 , N/A ,$829.01 , N/A ,$560.63 ,$560.63 ,$819.90 ,$679.88 , N/A , N/A , N/A ,$865.45 , N/A , N/A ,$792.57 , N/A ,$819.90 , N/A ,$819.90 ,$819.90 ,$819.90 ,$883.67 ,$737.91 ,$847.23 ,$783.46 ,$883.67 
SACRED HEART HOSPITAL (ACU),27801518,C1713,HC GRAFT BONE FIBULA,278,1 ,"$2,533.00 ","$1,899.75 ","$1,367.82 ","$2,533.00 ","$1,631.25 ", N/A ,"$1,773.10 ", N/A ,"$2,102.39 ", N/A ,"$1,671.78 ","$2,406.35 ", N/A ,"$2,026.40 ","$2,330.36 ", N/A ,"$2,153.05 ","$2,406.35 ","$2,229.04 ","$1,925.08 ", N/A , N/A , N/A ,"$1,849.09 ","$1,393.15 ","$2,305.03 ","$2,305.03 ","$2,026.40 ", N/A ,"$1,393.15 ","$2,279.70 ", N/A ,"$2,279.70 ","$1,367.82 ","$2,381.02 ", N/A ,"$2,330.36 ", N/A ,"$2,305.03 ", N/A ,"$1,558.81 ","$1,558.81 ","$2,279.70 ","$1,890.38 ", N/A , N/A , N/A ,"$2,406.35 ", N/A , N/A ,"$2,203.71 ", N/A ,"$2,279.70 ", N/A ,"$2,279.70 ","$2,279.70 ","$2,279.70 ","$2,457.01 ","$2,051.73 ","$2,355.69 ","$2,178.38 ","$2,457.01 "
SACRED HEART HOSPITAL (ACU),27801519,N/A,HC GRAFT TISSUE ILIAC CREST,278,1 ,"$3,368.00 ","$2,526.00 ","$1,818.72 ","$3,368.00 ","$2,168.99 ", N/A ,"$2,357.60 ", N/A ,"$2,795.44 ", N/A ,"$2,222.88 ","$3,199.60 ", N/A ,"$2,694.40 ","$3,098.56 ", N/A ,"$2,862.80 ","$3,199.60 ","$2,963.84 ","$2,559.68 ", N/A , N/A , N/A ,"$2,458.64 ","$1,852.40 ","$3,064.88 ","$3,064.88 ","$2,694.40 ", N/A ,"$1,852.40 ","$3,031.20 ", N/A ,"$3,031.20 ","$1,818.72 ","$3,165.92 ", N/A ,"$3,098.56 ", N/A ,"$3,064.88 ", N/A ,"$2,072.67 ","$2,072.67 ","$3,031.20 ","$2,513.54 ", N/A , N/A , N/A ,"$3,199.60 ", N/A , N/A ,"$2,930.16 ", N/A ,"$3,031.20 ", N/A ,"$3,031.20 ","$3,031.20 ","$3,031.20 ","$3,266.96 ","$2,728.08 ","$3,132.24 ","$2,896.48 ","$3,266.96 "
SACRED HEART HOSPITAL (ACU),27801520,C1713,HC GRAFT BONE ILIUM TRICORTICAL,278,1 ,"$2,744.00 ","$2,058.00 ","$1,481.76 ","$2,744.00 ","$1,767.14 ", N/A ,"$1,920.80 ", N/A ,"$2,277.52 ", N/A ,"$1,811.04 ","$2,606.80 ", N/A ,"$2,195.20 ","$2,524.48 ", N/A ,"$2,332.40 ","$2,606.80 ","$2,414.72 ","$2,085.44 ", N/A , N/A , N/A ,"$2,003.12 ","$1,509.20 ","$2,497.04 ","$2,497.04 ","$2,195.20 ", N/A ,"$1,509.20 ","$2,469.60 ", N/A ,"$2,469.60 ","$1,481.76 ","$2,579.36 ", N/A ,"$2,524.48 ", N/A ,"$2,497.04 ", N/A ,"$1,688.66 ","$1,688.66 ","$2,469.60 ","$2,047.85 ", N/A , N/A , N/A ,"$2,606.80 ", N/A , N/A ,"$2,387.28 ", N/A ,"$2,469.60 ", N/A ,"$2,469.60 ","$2,469.60 ","$2,469.60 ","$2,661.68 ","$2,222.64 ","$2,551.92 ","$2,359.84 ","$2,661.68 "
SACRED HEART HOSPITAL (ACU),27801521,N/A,HC TISSUE MATRIX HEMOSTATIC W/THROMBIN,278,1 ,$379.00 ,$284.25 ,$204.66 ,$379.00 ,$244.08 , N/A ,$265.30 , N/A ,$314.57 , N/A ,$250.14 ,$360.05 , N/A ,$303.20 ,$348.68 , N/A ,$322.15 ,$360.05 ,$333.52 ,$288.04 , N/A , N/A , N/A ,$276.67 ,$208.45 ,$344.89 ,$344.89 ,$303.20 , N/A ,$208.45 ,$341.10 , N/A ,$341.10 ,$204.66 ,$356.26 , N/A ,$348.68 , N/A ,$344.89 , N/A ,$233.24 ,$233.24 ,$341.10 ,$282.85 , N/A , N/A , N/A ,$360.05 , N/A , N/A ,$329.73 , N/A ,$341.10 , N/A ,$341.10 ,$341.10 ,$341.10 ,$367.63 ,$306.99 ,$352.47 ,$325.94 ,$367.63 
SACRED HEART HOSPITAL (ACU),27801522,C1713,HC GRAFT MATRIX PUTTY .5CC,278,1 ,$442.00 ,$331.50 ,$238.68 ,$442.00 ,$284.65 , N/A ,$309.40 , N/A ,$366.86 , N/A ,$291.72 ,$419.90 , N/A ,$353.60 ,$406.64 , N/A ,$375.70 ,$419.90 ,$388.96 ,$335.92 , N/A , N/A , N/A ,$322.66 ,$243.10 ,$402.22 ,$402.22 ,$353.60 , N/A ,$243.10 ,$397.80 , N/A ,$397.80 ,$238.68 ,$415.48 , N/A ,$406.64 , N/A ,$402.22 , N/A ,$272.01 ,$272.01 ,$397.80 ,$329.86 , N/A , N/A , N/A ,$419.90 , N/A , N/A ,$384.54 , N/A ,$397.80 , N/A ,$397.80 ,$397.80 ,$397.80 ,$428.74 ,$358.02 ,$411.06 ,$380.12 ,$428.74 
SACRED HEART HOSPITAL (ACU),27801523,C1713,HC GRAFT MATRIX PUTTY 1CC,278,1 ,$813.00 ,$609.75 ,$439.02 ,$813.00 ,$523.57 , N/A ,$569.10 , N/A ,$674.79 , N/A ,$536.58 ,$772.35 , N/A ,$650.40 ,$747.96 , N/A ,$691.05 ,$772.35 ,$715.44 ,$617.88 , N/A , N/A , N/A ,$593.49 ,$447.15 ,$739.83 ,$739.83 ,$650.40 , N/A ,$447.15 ,$731.70 , N/A ,$731.70 ,$439.02 ,$764.22 , N/A ,$747.96 , N/A ,$739.83 , N/A ,$500.32 ,$500.32 ,$731.70 ,$606.74 , N/A , N/A , N/A ,$772.35 , N/A , N/A ,$707.31 , N/A ,$731.70 , N/A ,$731.70 ,$731.70 ,$731.70 ,$788.61 ,$658.53 ,$756.09 ,$699.18 ,$788.61 
SACRED HEART HOSPITAL (ACU),27801524,C1713,HC GRAFT MATRIX PUTTY 5CC,278,1 ,"$3,175.00 ","$2,381.25 ","$1,714.50 ","$3,175.00 ","$2,044.70 ", N/A ,"$2,222.50 ", N/A ,"$2,635.25 ", N/A ,"$2,095.50 ","$3,016.25 ", N/A ,"$2,540.00 ","$2,921.00 ", N/A ,"$2,698.75 ","$3,016.25 ","$2,794.00 ","$2,413.00 ", N/A , N/A , N/A ,"$2,317.75 ","$1,746.25 ","$2,889.25 ","$2,889.25 ","$2,540.00 ", N/A ,"$1,746.25 ","$2,857.50 ", N/A ,"$2,857.50 ","$1,714.50 ","$2,984.50 ", N/A ,"$2,921.00 ", N/A ,"$2,889.25 ", N/A ,"$1,953.90 ","$1,953.90 ","$2,857.50 ","$2,369.50 ", N/A , N/A , N/A ,"$3,016.25 ", N/A , N/A ,"$2,762.25 ", N/A ,"$2,857.50 ", N/A ,"$2,857.50 ","$2,857.50 ","$2,857.50 ","$3,079.75 ","$2,571.75 ","$2,952.75 ","$2,730.50 ","$3,079.75 "
SACRED HEART HOSPITAL (ACU),27801525,C1713,HC GRAFT MATRIX PUTTY 10CC,278,1 ,"$4,533.00 ","$3,399.75 ","$2,447.82 ","$4,533.00 ","$2,919.25 ", N/A ,"$3,173.10 ", N/A ,"$3,762.39 ", N/A ,"$2,991.78 ","$4,306.35 ", N/A ,"$3,626.40 ","$4,170.36 ", N/A ,"$3,853.05 ","$4,306.35 ","$3,989.04 ","$3,445.08 ", N/A , N/A , N/A ,"$3,309.09 ","$2,493.15 ","$4,125.03 ","$4,125.03 ","$3,626.40 ", N/A ,"$2,493.15 ","$4,079.70 ", N/A ,"$4,079.70 ","$2,447.82 ","$4,261.02 ", N/A ,"$4,170.36 ", N/A ,"$4,125.03 ", N/A ,"$2,789.61 ","$2,789.61 ","$4,079.70 ","$3,382.98 ", N/A , N/A , N/A ,"$4,306.35 ", N/A , N/A ,"$3,943.71 ", N/A ,"$4,079.70 ", N/A ,"$4,079.70 ","$4,079.70 ","$4,079.70 ","$4,397.01 ","$3,671.73 ","$4,215.69 ","$3,898.38 ","$4,397.01 "
SACRED HEART HOSPITAL (ACU),27801526,C1713,HC BONE MATRIX DEMINERALIZED .5CC,278,1 ,$453.00 ,$339.75 ,$244.62 ,$453.00 ,$291.73 , N/A ,$317.10 , N/A ,$375.99 , N/A ,$298.98 ,$430.35 , N/A ,$362.40 ,$416.76 , N/A ,$385.05 ,$430.35 ,$398.64 ,$344.28 , N/A , N/A , N/A ,$330.69 ,$249.15 ,$412.23 ,$412.23 ,$362.40 , N/A ,$249.15 ,$407.70 , N/A ,$407.70 ,$244.62 ,$425.82 , N/A ,$416.76 , N/A ,$412.23 , N/A ,$278.78 ,$278.78 ,$407.70 ,$338.07 , N/A , N/A , N/A ,$430.35 , N/A , N/A ,$394.11 , N/A ,$407.70 , N/A ,$407.70 ,$407.70 ,$407.70 ,$439.41 ,$366.93 ,$421.29 ,$389.58 ,$439.41 
SACRED HEART HOSPITAL (ACU),27801527,C1713,HC BONE MATRIX DEMINERALIZED 1CC,278,1 ,$733.00 ,$549.75 ,$395.82 ,$733.00 ,$472.05 , N/A ,$513.10 , N/A ,$608.39 , N/A ,$483.78 ,$696.35 , N/A ,$586.40 ,$674.36 , N/A ,$623.05 ,$696.35 ,$645.04 ,$557.08 , N/A , N/A , N/A ,$535.09 ,$403.15 ,$667.03 ,$667.03 ,$586.40 , N/A ,$403.15 ,$659.70 , N/A ,$659.70 ,$395.82 ,$689.02 , N/A ,$674.36 , N/A ,$667.03 , N/A ,$451.09 ,$451.09 ,$659.70 ,$547.04 , N/A , N/A , N/A ,$696.35 , N/A , N/A ,$637.71 , N/A ,$659.70 , N/A ,$659.70 ,$659.70 ,$659.70 ,$711.01 ,$593.73 ,$681.69 ,$630.38 ,$711.01 
SACRED HEART HOSPITAL (ACU),27801528,C1713,HC BONE MATRIX DEMINERALIZED 5CC,278,1 ,"$4,213.00 ","$3,159.75 ","$2,275.02 ","$4,213.00 ","$2,713.17 ", N/A ,"$2,949.10 ", N/A ,"$3,496.79 ", N/A ,"$2,780.58 ","$4,002.35 ", N/A ,"$3,370.40 ","$3,875.96 ", N/A ,"$3,581.05 ","$4,002.35 ","$3,707.44 ","$3,201.88 ", N/A , N/A , N/A ,"$3,075.49 ","$2,317.15 ","$3,833.83 ","$3,833.83 ","$3,370.40 ", N/A ,"$2,317.15 ","$3,791.70 ", N/A ,"$3,791.70 ","$2,275.02 ","$3,960.22 ", N/A ,"$3,875.96 ", N/A ,"$3,833.83 ", N/A ,"$2,592.68 ","$2,592.68 ","$3,791.70 ","$3,144.16 ", N/A , N/A , N/A ,"$4,002.35 ", N/A , N/A ,"$3,665.31 ", N/A ,"$3,791.70 ", N/A ,"$3,791.70 ","$3,791.70 ","$3,791.70 ","$4,086.61 ","$3,412.53 ","$3,918.09 ","$3,623.18 ","$4,086.61 "
SACRED HEART HOSPITAL (ACU),27801529,C1713,HC BONE MATRIX DEMINERALIZED 10CC,278,1 ,"$4,609.00 ","$3,456.75 ","$2,488.86 ","$4,609.00 ","$2,968.20 ", N/A ,"$3,226.30 ", N/A ,"$3,825.47 ", N/A ,"$3,041.94 ","$4,378.55 ", N/A ,"$3,687.20 ","$4,240.28 ", N/A ,"$3,917.65 ","$4,378.55 ","$4,055.92 ","$3,502.84 ", N/A , N/A , N/A ,"$3,364.57 ","$2,534.95 ","$4,194.19 ","$4,194.19 ","$3,687.20 ", N/A ,"$2,534.95 ","$4,148.10 ", N/A ,"$4,148.10 ","$2,488.86 ","$4,332.46 ", N/A ,"$4,240.28 ", N/A ,"$4,194.19 ", N/A ,"$2,836.38 ","$2,836.38 ","$4,148.10 ","$3,439.70 ", N/A , N/A , N/A ,"$4,378.55 ", N/A , N/A ,"$4,009.83 ", N/A ,"$4,148.10 ", N/A ,"$4,148.10 ","$4,148.10 ","$4,148.10 ","$4,470.73 ","$3,733.29 ","$4,286.37 ","$3,963.74 ","$4,470.73 "
SACRED HEART HOSPITAL (ACU),27801531,N/A,HC MATRIX DUREPAIR TIER 1,278,1 ,$556.00 ,$417.00 ,$300.24 ,$556.00 ,$358.06 , N/A ,$389.20 , N/A ,$461.48 , N/A ,$366.96 ,$528.20 , N/A ,$444.80 ,$511.52 , N/A ,$472.60 ,$528.20 ,$489.28 ,$422.56 , N/A , N/A , N/A ,$405.88 ,$305.80 ,$505.96 ,$505.96 ,$444.80 , N/A ,$305.80 ,$500.40 , N/A ,$500.40 ,$300.24 ,$522.64 , N/A ,$511.52 , N/A ,$505.96 , N/A ,$342.16 ,$342.16 ,$500.40 ,$414.94 , N/A , N/A , N/A ,$528.20 , N/A , N/A ,$483.72 , N/A ,$500.40 , N/A ,$500.40 ,$500.40 ,$500.40 ,$539.32 ,$450.36 ,$517.08 ,$478.16 ,$539.32 
SACRED HEART HOSPITAL (ACU),27801532,N/A,HC MATRIX DUREPAIR TIER 2,278,1 ,"$1,129.00 ",$846.75 ,$609.66 ,"$1,129.00 ",$727.08 , N/A ,$790.30 , N/A ,$937.07 , N/A ,$745.14 ,"$1,072.55 ", N/A ,$903.20 ,"$1,038.68 ", N/A ,$959.65 ,"$1,072.55 ",$993.52 ,$858.04 , N/A , N/A , N/A ,$824.17 ,$620.95 ,"$1,027.39 ","$1,027.39 ",$903.20 , N/A ,$620.95 ,"$1,016.10 ", N/A ,"$1,016.10 ",$609.66 ,"$1,061.26 ", N/A ,"$1,038.68 ", N/A ,"$1,027.39 ", N/A ,$694.79 ,$694.79 ,"$1,016.10 ",$842.57 , N/A , N/A , N/A ,"$1,072.55 ", N/A , N/A ,$982.23 , N/A ,"$1,016.10 ", N/A ,"$1,016.10 ","$1,016.10 ","$1,016.10 ","$1,095.13 ",$914.49 ,"$1,049.97 ",$970.94 ,"$1,095.13 "
SACRED HEART HOSPITAL (ACU),27801533,N/A,HC MATRIX DUREPAIR TIER 3,278,1 ,"$2,509.00 ","$1,881.75 ","$1,354.86 ","$2,509.00 ","$1,615.80 ", N/A ,"$1,756.30 ", N/A ,"$2,082.47 ", N/A ,"$1,655.94 ","$2,383.55 ", N/A ,"$2,007.20 ","$2,308.28 ", N/A ,"$2,132.65 ","$2,383.55 ","$2,207.92 ","$1,906.84 ", N/A , N/A , N/A ,"$1,831.57 ","$1,379.95 ","$2,283.19 ","$2,283.19 ","$2,007.20 ", N/A ,"$1,379.95 ","$2,258.10 ", N/A ,"$2,258.10 ","$1,354.86 ","$2,358.46 ", N/A ,"$2,308.28 ", N/A ,"$2,283.19 ", N/A ,"$1,544.04 ","$1,544.04 ","$2,258.10 ","$1,872.47 ", N/A , N/A , N/A ,"$2,383.55 ", N/A , N/A ,"$2,182.83 ", N/A ,"$2,258.10 ", N/A ,"$2,258.10 ","$2,258.10 ","$2,258.10 ","$2,433.73 ","$2,032.29 ","$2,333.37 ","$2,157.74 ","$2,433.73 "
SACRED HEART HOSPITAL (ACU),27801534,N/A,HC MATRIX DUREPAIR TIER 4,278,1 ,"$4,709.00 ","$3,531.75 ","$2,542.86 ","$4,709.00 ","$3,032.60 ", N/A ,"$3,296.30 ", N/A ,"$3,908.47 ", N/A ,"$3,107.94 ","$4,473.55 ", N/A ,"$3,767.20 ","$4,332.28 ", N/A ,"$4,002.65 ","$4,473.55 ","$4,143.92 ","$3,578.84 ", N/A , N/A , N/A ,"$3,437.57 ","$2,589.95 ","$4,285.19 ","$4,285.19 ","$3,767.20 ", N/A ,"$2,589.95 ","$4,238.10 ", N/A ,"$4,238.10 ","$2,542.86 ","$4,426.46 ", N/A ,"$4,332.28 ", N/A ,"$4,285.19 ", N/A ,"$2,897.92 ","$2,897.92 ","$4,238.10 ","$3,514.33 ", N/A , N/A , N/A ,"$4,473.55 ", N/A , N/A ,"$4,096.83 ", N/A ,"$4,238.10 ", N/A ,"$4,238.10 ","$4,238.10 ","$4,238.10 ","$4,567.73 ","$3,814.29 ","$4,379.37 ","$4,049.74 ","$4,567.73 "
SACRED HEART HOSPITAL (ACU),27801535,C1781,HC MESH SYNTHETIC TIER 1,278,1 ,"$1,321.00 ",$990.75 ,$713.34 ,"$1,321.00 ",$850.72 , N/A ,$924.70 , N/A ,"$1,096.43 ", N/A ,$871.86 ,"$1,254.95 ", N/A ,"$1,056.80 ","$1,215.32 ", N/A ,"$1,122.85 ","$1,254.95 ","$1,162.48 ","$1,003.96 ", N/A , N/A , N/A ,$964.33 ,$726.55 ,"$1,202.11 ","$1,202.11 ","$1,056.80 ", N/A ,$726.55 ,"$1,188.90 ", N/A ,"$1,188.90 ",$713.34 ,"$1,241.74 ", N/A ,"$1,215.32 ", N/A ,"$1,202.11 ", N/A ,$812.94 ,$812.94 ,"$1,188.90 ",$985.86 , N/A , N/A , N/A ,"$1,254.95 ", N/A , N/A ,"$1,149.27 ", N/A ,"$1,188.90 ", N/A ,"$1,188.90 ","$1,188.90 ","$1,188.90 ","$1,281.37 ","$1,070.01 ","$1,228.53 ","$1,136.06 ","$1,281.37 "
SACRED HEART HOSPITAL (ACU),27801536,C1781,HC MESH SYNTHETIC TIER 2,278,1 ,"$1,701.00 ","$1,275.75 ",$918.54 ,"$1,701.00 ","$1,095.44 ", N/A ,"$1,190.70 ", N/A ,"$1,411.83 ", N/A ,"$1,122.66 ","$1,615.95 ", N/A ,"$1,360.80 ","$1,564.92 ", N/A ,"$1,445.85 ","$1,615.95 ","$1,496.88 ","$1,292.76 ", N/A , N/A , N/A ,"$1,241.73 ",$935.55 ,"$1,547.91 ","$1,547.91 ","$1,360.80 ", N/A ,$935.55 ,"$1,530.90 ", N/A ,"$1,530.90 ",$918.54 ,"$1,598.94 ", N/A ,"$1,564.92 ", N/A ,"$1,547.91 ", N/A ,"$1,046.80 ","$1,046.80 ","$1,530.90 ","$1,269.46 ", N/A , N/A , N/A ,"$1,615.95 ", N/A , N/A ,"$1,479.87 ", N/A ,"$1,530.90 ", N/A ,"$1,530.90 ","$1,530.90 ","$1,530.90 ","$1,649.97 ","$1,377.81 ","$1,581.93 ","$1,462.86 ","$1,649.97 "
SACRED HEART HOSPITAL (ACU),27801537,C1713,HC GRAFT BONE INFUSE TIER 1,278,1 ,"$4,441.00 ","$3,330.75 ","$2,398.14 ","$4,441.00 ","$2,860.00 ", N/A ,"$3,108.70 ", N/A ,"$3,686.03 ", N/A ,"$2,931.06 ","$4,218.95 ", N/A ,"$3,552.80 ","$4,085.72 ", N/A ,"$3,774.85 ","$4,218.95 ","$3,908.08 ","$3,375.16 ", N/A , N/A , N/A ,"$3,241.93 ","$2,442.55 ","$4,041.31 ","$4,041.31 ","$3,552.80 ", N/A ,"$2,442.55 ","$3,996.90 ", N/A ,"$3,996.90 ","$2,398.14 ","$4,174.54 ", N/A ,"$4,085.72 ", N/A ,"$4,041.31 ", N/A ,"$2,732.99 ","$2,732.99 ","$3,996.90 ","$3,314.32 ", N/A , N/A , N/A ,"$4,218.95 ", N/A , N/A ,"$3,863.67 ", N/A ,"$3,996.90 ", N/A ,"$3,996.90 ","$3,996.90 ","$3,996.90 ","$4,307.77 ","$3,597.21 ","$4,130.13 ","$3,819.26 ","$4,307.77 "
SACRED HEART HOSPITAL (ACU),27801538,C1713,HC GRAFT BONE INFUSE TIER 2,278,1 ,"$8,977.00 ","$6,732.75 ","$4,847.58 ","$8,977.00 ","$5,781.19 ", N/A ,"$6,283.90 ", N/A ,"$7,450.91 ", N/A ,"$5,924.82 ","$8,528.15 ", N/A ,"$7,181.60 ","$8,258.84 ", N/A ,"$7,630.45 ","$8,528.15 ","$7,899.76 ","$6,822.52 ", N/A , N/A , N/A ,"$6,553.21 ","$4,937.35 ","$8,169.07 ","$8,169.07 ","$7,181.60 ", N/A ,"$4,937.35 ","$8,079.30 ", N/A ,"$8,079.30 ","$4,847.58 ","$8,438.38 ", N/A ,"$8,258.84 ", N/A ,"$8,169.07 ", N/A ,"$5,524.45 ","$5,524.45 ","$8,079.30 ","$6,699.54 ", N/A , N/A , N/A ,"$8,528.15 ", N/A , N/A ,"$7,809.99 ", N/A ,"$8,079.30 ", N/A ,"$8,079.30 ","$8,079.30 ","$8,079.30 ","$8,707.69 ","$7,271.37 ","$8,348.61 ","$7,720.22 ","$8,707.69 "
SACRED HEART HOSPITAL (ACU),27801539,N/A,HC SEALANT PLEURAL LEAK PROGEL TIER 1,278,1 ,"$2,096.00 ","$1,572.00 ","$1,131.84 ","$2,096.00 ","$1,349.82 ", N/A ,"$1,467.20 ", N/A ,"$1,739.68 ", N/A ,"$1,383.36 ","$1,991.20 ", N/A ,"$1,676.80 ","$1,928.32 ", N/A ,"$1,781.60 ","$1,991.20 ","$1,844.48 ","$1,592.96 ", N/A , N/A , N/A ,"$1,530.08 ","$1,152.80 ","$1,907.36 ","$1,907.36 ","$1,676.80 ", N/A ,"$1,152.80 ","$1,886.40 ", N/A ,"$1,886.40 ","$1,131.84 ","$1,970.24 ", N/A ,"$1,928.32 ", N/A ,"$1,907.36 ", N/A ,"$1,289.88 ","$1,289.88 ","$1,886.40 ","$1,564.24 ", N/A , N/A , N/A ,"$1,991.20 ", N/A , N/A ,"$1,823.52 ", N/A ,"$1,886.40 ", N/A ,"$1,886.40 ","$1,886.40 ","$1,886.40 ","$2,033.12 ","$1,697.76 ","$1,949.28 ","$1,802.56 ","$2,033.12 "
SACRED HEART HOSPITAL (ACU),27801540,N/A,HC SEALANT PLEURAL LEAK PROGEL TIER 2,278,1 ,"$2,035.00 ","$1,526.25 ","$1,098.90 ","$2,035.00 ","$1,310.54 ", N/A ,"$1,424.50 ", N/A ,"$1,689.05 ", N/A ,"$1,343.10 ","$1,933.25 ", N/A ,"$1,628.00 ","$1,872.20 ", N/A ,"$1,729.75 ","$1,933.25 ","$1,790.80 ","$1,546.60 ", N/A , N/A , N/A ,"$1,485.55 ","$1,119.25 ","$1,851.85 ","$1,851.85 ","$1,628.00 ", N/A ,"$1,119.25 ","$1,831.50 ", N/A ,"$1,831.50 ","$1,098.90 ","$1,912.90 ", N/A ,"$1,872.20 ", N/A ,"$1,851.85 ", N/A ,"$1,252.34 ","$1,252.34 ","$1,831.50 ","$1,518.72 ", N/A , N/A , N/A ,"$1,933.25 ", N/A , N/A ,"$1,770.45 ", N/A ,"$1,831.50 ", N/A ,"$1,831.50 ","$1,831.50 ","$1,831.50 ","$1,973.95 ","$1,648.35 ","$1,892.55 ","$1,750.10 ","$1,973.95 "
SACRED HEART HOSPITAL (ACU),27801541,N/A,HC SEALANT FIBRIN EVICEL/VISTASEAL TIER 1,278,1 ,"$1,235.00 ",$926.25 ,$666.90 ,"$1,235.00 ",$795.34 , N/A ,$864.50 , N/A ,"$1,025.05 ", N/A ,$815.10 ,"$1,173.25 ", N/A ,$988.00 ,"$1,136.20 ", N/A ,"$1,049.75 ","$1,173.25 ","$1,086.80 ",$938.60 , N/A , N/A , N/A ,$901.55 ,$679.25 ,"$1,123.85 ","$1,123.85 ",$988.00 , N/A ,$679.25 ,"$1,111.50 ", N/A ,"$1,111.50 ",$666.90 ,"$1,160.90 ", N/A ,"$1,136.20 ", N/A ,"$1,123.85 ", N/A ,$760.02 ,$760.02 ,"$1,111.50 ",$921.68 , N/A , N/A , N/A ,"$1,173.25 ", N/A , N/A ,"$1,074.45 ", N/A ,"$1,111.50 ", N/A ,"$1,111.50 ","$1,111.50 ","$1,111.50 ","$1,197.95 ","$1,000.35 ","$1,148.55 ","$1,062.10 ","$1,197.95 "
SACRED HEART HOSPITAL (ACU),27801542,N/A,HC SEALANT FIBRIN EVICEL/VISTASEAL TIER 2,278,1 ,"$1,859.00 ","$1,394.25 ","$1,003.86 ","$1,859.00 ","$1,197.20 ", N/A ,"$1,301.30 ", N/A ,"$1,542.97 ", N/A ,"$1,226.94 ","$1,766.05 ", N/A ,"$1,487.20 ","$1,710.28 ", N/A ,"$1,580.15 ","$1,766.05 ","$1,635.92 ","$1,412.84 ", N/A , N/A , N/A ,"$1,357.07 ","$1,022.45 ","$1,691.69 ","$1,691.69 ","$1,487.20 ", N/A ,"$1,022.45 ","$1,673.10 ", N/A ,"$1,673.10 ","$1,003.86 ","$1,747.46 ", N/A ,"$1,710.28 ", N/A ,"$1,691.69 ", N/A ,"$1,144.03 ","$1,144.03 ","$1,673.10 ","$1,387.37 ", N/A , N/A , N/A ,"$1,766.05 ", N/A , N/A ,"$1,617.33 ", N/A ,"$1,673.10 ", N/A ,"$1,673.10 ","$1,673.10 ","$1,673.10 ","$1,803.23 ","$1,505.79 ","$1,728.87 ","$1,598.74 ","$1,803.23 "
SACRED HEART HOSPITAL (ACU),27801543,N/A,HC SEALANT DURASEAL,278,1 ,"$11,375.00 ","$8,531.25 ","$6,142.50 ","$11,375.00 ","$7,325.50 ", N/A ,"$7,962.50 ", N/A ,"$9,441.25 ", N/A ,"$7,507.50 ","$10,806.25 ", N/A ,"$9,100.00 ","$10,465.00 ", N/A ,"$9,668.75 ","$10,806.25 ","$10,010.00 ","$8,645.00 ", N/A , N/A , N/A ,"$8,303.75 ","$6,256.25 ","$10,351.25 ","$10,351.25 ","$9,100.00 ", N/A ,"$6,256.25 ","$10,237.50 ", N/A ,"$10,237.50 ","$6,142.50 ","$10,692.50 ", N/A ,"$10,465.00 ", N/A ,"$10,351.25 ", N/A ,"$7,000.18 ","$7,000.18 ","$10,237.50 ","$8,489.16 ", N/A , N/A , N/A ,"$10,806.25 ", N/A , N/A ,"$9,896.25 ", N/A ,"$10,237.50 ", N/A ,"$10,237.50 ","$10,237.50 ","$10,237.50 ","$11,033.75 ","$9,213.75 ","$10,578.75 ","$9,782.50 ","$11,033.75 "
SACRED HEART HOSPITAL (ACU),27801544,N/A,HC SEALANT FLOSEAL TIER 1,278,1 ,"$1,156.00 ",$867.00 ,$624.24 ,"$1,156.00 ",$744.46 , N/A ,$809.20 , N/A ,$959.48 , N/A ,$762.96 ,"$1,098.20 ", N/A ,$924.80 ,"$1,063.52 ", N/A ,$982.60 ,"$1,098.20 ","$1,017.28 ",$878.56 , N/A , N/A , N/A ,$843.88 ,$635.80 ,"$1,051.96 ","$1,051.96 ",$924.80 , N/A ,$635.80 ,"$1,040.40 ", N/A ,"$1,040.40 ",$624.24 ,"$1,086.64 ", N/A ,"$1,063.52 ", N/A ,"$1,051.96 ", N/A ,$711.40 ,$711.40 ,"$1,040.40 ",$862.72 , N/A , N/A , N/A ,"$1,098.20 ", N/A , N/A ,"$1,005.72 ", N/A ,"$1,040.40 ", N/A ,"$1,040.40 ","$1,040.40 ","$1,040.40 ","$1,121.32 ",$936.36 ,"$1,075.08 ",$994.16 ,"$1,121.32 "
SACRED HEART HOSPITAL (ACU),27801545,N/A,HC SEALANT FLOSEAL TIER 2,278,1 ,$686.00 ,$514.50 ,$370.44 ,$686.00 ,$441.78 , N/A ,$480.20 , N/A ,$569.38 , N/A ,$452.76 ,$651.70 , N/A ,$548.80 ,$631.12 , N/A ,$583.10 ,$651.70 ,$603.68 ,$521.36 , N/A , N/A , N/A ,$500.78 ,$377.30 ,$624.26 ,$624.26 ,$548.80 , N/A ,$377.30 ,$617.40 , N/A ,$617.40 ,$370.44 ,$644.84 , N/A ,$631.12 , N/A ,$624.26 , N/A ,$422.16 ,$422.16 ,$617.40 ,$511.96 , N/A , N/A , N/A ,$651.70 , N/A , N/A ,$596.82 , N/A ,$617.40 , N/A ,$617.40 ,$617.40 ,$617.40 ,$665.42 ,$555.66 ,$637.98 ,$589.96 ,$665.42 
SACRED HEART HOSPITAL (ACU),27801546,C1713,HC SPACER FRA,278,1 ,"$12,570.00 ","$9,427.50 ","$6,787.80 ","$12,570.00 ","$8,095.08 ", N/A ,"$8,799.00 ", N/A ,"$10,433.10 ", N/A ,"$8,296.20 ","$11,941.50 ", N/A ,"$10,056.00 ","$11,564.40 ", N/A ,"$10,684.50 ","$11,941.50 ","$11,061.60 ","$9,553.20 ", N/A , N/A , N/A ,"$9,176.10 ","$6,913.50 ","$11,438.70 ","$11,438.70 ","$10,056.00 ", N/A ,"$6,913.50 ","$11,313.00 ", N/A ,"$11,313.00 ","$6,787.80 ","$11,815.80 ", N/A ,"$11,564.40 ", N/A ,"$11,438.70 ", N/A ,"$7,735.58 ","$7,735.58 ","$11,313.00 ","$9,380.99 ", N/A , N/A , N/A ,"$11,941.50 ", N/A , N/A ,"$10,935.90 ", N/A ,"$11,313.00 ", N/A ,"$11,313.00 ","$11,313.00 ","$11,313.00 ","$12,192.90 ","$10,181.70 ","$11,690.10 ","$10,810.20 ","$12,192.90 "
SACRED HEART HOSPITAL (ACU),27801547,C1713,HC SPACER ACF,278,1 ,"$5,167.00 ","$3,875.25 ","$2,790.18 ","$5,167.00 ","$3,327.55 ", N/A ,"$3,616.90 ", N/A ,"$4,288.61 ", N/A ,"$3,410.22 ","$4,908.65 ", N/A ,"$4,133.60 ","$4,753.64 ", N/A ,"$4,391.95 ","$4,908.65 ","$4,546.96 ","$3,926.92 ", N/A , N/A , N/A ,"$3,771.91 ","$2,841.85 ","$4,701.97 ","$4,701.97 ","$4,133.60 ", N/A ,"$2,841.85 ","$4,650.30 ", N/A ,"$4,650.30 ","$2,790.18 ","$4,856.98 ", N/A ,"$4,753.64 ", N/A ,"$4,701.97 ", N/A ,"$3,179.77 ","$3,179.77 ","$4,650.30 ","$3,856.13 ", N/A , N/A , N/A ,"$4,908.65 ", N/A , N/A ,"$4,495.29 ", N/A ,"$4,650.30 ", N/A ,"$4,650.30 ","$4,650.30 ","$4,650.30 ","$5,011.99 ","$4,185.27 ","$4,805.31 ","$4,443.62 ","$5,011.99 "
SACRED HEART HOSPITAL (ACU),27801548,C1762,HC GRAFT STEM CELLS NUCEL,278,1 ,"$11,891.00 ","$8,918.25 ","$6,421.14 ","$11,891.00 ","$7,657.80 ", N/A ,"$8,323.70 ", N/A ,"$9,869.53 ", N/A ,"$7,848.06 ","$11,296.45 ", N/A ,"$9,512.80 ","$10,939.72 ", N/A ,"$10,107.35 ","$11,296.45 ","$10,464.08 ","$9,037.16 ", N/A , N/A , N/A ,"$8,680.43 ","$6,540.05 ","$10,820.81 ","$10,820.81 ","$9,512.80 ", N/A ,"$6,540.05 ","$10,701.90 ", N/A ,"$10,701.90 ","$6,421.14 ","$11,177.54 ", N/A ,"$10,939.72 ", N/A ,"$10,820.81 ", N/A ,"$7,317.72 ","$7,317.72 ","$10,701.90 ","$8,874.25 ", N/A , N/A , N/A ,"$11,296.45 ", N/A , N/A ,"$10,345.17 ", N/A ,"$10,701.90 ", N/A ,"$10,701.90 ","$10,701.90 ","$10,701.90 ","$11,534.27 ","$9,631.71 ","$11,058.63 ","$10,226.26 ","$11,534.27 "
SACRED HEART HOSPITAL (ACU),27801549,C1713,HC TENDON PATELLAR,278,1 ,"$1,091.00 ",$818.25 ,$589.14 ,"$1,091.00 ",$702.60 , N/A ,$763.70 , N/A ,$905.53 , N/A ,$720.06 ,"$1,036.45 ", N/A ,$872.80 ,"$1,003.72 ", N/A ,$927.35 ,"$1,036.45 ",$960.08 ,$829.16 , N/A , N/A , N/A ,$796.43 ,$600.05 ,$992.81 ,$992.81 ,$872.80 , N/A ,$600.05 ,$981.90 , N/A ,$981.90 ,$589.14 ,"$1,025.54 ", N/A ,"$1,003.72 ", N/A ,$992.81 , N/A ,$671.40 ,$671.40 ,$981.90 ,$814.21 , N/A , N/A , N/A ,"$1,036.45 ", N/A , N/A ,$949.17 , N/A ,$981.90 , N/A ,$981.90 ,$981.90 ,$981.90 ,"$1,058.27 ",$883.71 ,"$1,014.63 ",$938.26 ,"$1,058.27 "
SACRED HEART HOSPITAL (ACU),27801550,C1713,HC TENDON ACHILLES W/CALCANEOUS BLOCK,278,1 ,"$4,825.00 ","$3,618.75 ","$2,605.50 ","$4,825.00 ","$3,107.30 ", N/A ,"$3,377.50 ", N/A ,"$4,004.75 ", N/A ,"$3,184.50 ","$4,583.75 ", N/A ,"$3,860.00 ","$4,439.00 ", N/A ,"$4,101.25 ","$4,583.75 ","$4,246.00 ","$3,667.00 ", N/A , N/A , N/A ,"$3,522.25 ","$2,653.75 ","$4,390.75 ","$4,390.75 ","$3,860.00 ", N/A ,"$2,653.75 ","$4,342.50 ", N/A ,"$4,342.50 ","$2,605.50 ","$4,535.50 ", N/A ,"$4,439.00 ", N/A ,"$4,390.75 ", N/A ,"$2,969.31 ","$2,969.31 ","$4,342.50 ","$3,600.90 ", N/A , N/A , N/A ,"$4,583.75 ", N/A , N/A ,"$4,197.75 ", N/A ,"$4,342.50 ", N/A ,"$4,342.50 ","$4,342.50 ","$4,342.50 ","$4,680.25 ","$3,908.25 ","$4,487.25 ","$4,149.50 ","$4,680.25 "
SACRED HEART HOSPITAL (ACU),27801551,C1713,HC TENDON ACHILLES,278,1 ,"$5,075.00 ","$3,806.25 ","$2,740.50 ","$5,075.00 ","$3,268.30 ", N/A ,"$3,552.50 ", N/A ,"$4,212.25 ", N/A ,"$3,349.50 ","$4,821.25 ", N/A ,"$4,060.00 ","$4,669.00 ", N/A ,"$4,313.75 ","$4,821.25 ","$4,466.00 ","$3,857.00 ", N/A , N/A , N/A ,"$3,704.75 ","$2,791.25 ","$4,618.25 ","$4,618.25 ","$4,060.00 ", N/A ,"$2,791.25 ","$4,567.50 ", N/A ,"$4,567.50 ","$2,740.50 ","$4,770.50 ", N/A ,"$4,669.00 ", N/A ,"$4,618.25 ", N/A ,"$3,123.16 ","$3,123.16 ","$4,567.50 ","$3,787.47 ", N/A , N/A , N/A ,"$4,821.25 ", N/A , N/A ,"$4,415.25 ", N/A ,"$4,567.50 ", N/A ,"$4,567.50 ","$4,567.50 ","$4,567.50 ","$4,922.75 ","$4,110.75 ","$4,719.75 ","$4,364.50 ","$4,922.75 "
SACRED HEART HOSPITAL (ACU),27801552,C1713,HC TENDON RADIUS ULNA SHAFT,278,1 ,"$3,893.00 ","$2,919.75 ","$2,102.22 ","$3,893.00 ","$2,507.09 ", N/A ,"$2,725.10 ", N/A ,"$3,231.19 ", N/A ,"$2,569.38 ","$3,698.35 ", N/A ,"$3,114.40 ","$3,581.56 ", N/A ,"$3,309.05 ","$3,698.35 ","$3,425.84 ","$2,958.68 ", N/A , N/A , N/A ,"$2,841.89 ","$2,141.15 ","$3,542.63 ","$3,542.63 ","$3,114.40 ", N/A ,"$2,141.15 ","$3,503.70 ", N/A ,"$3,503.70 ","$2,102.22 ","$3,659.42 ", N/A ,"$3,581.56 ", N/A ,"$3,542.63 ", N/A ,"$2,395.75 ","$2,395.75 ","$3,503.70 ","$2,905.35 ", N/A , N/A , N/A ,"$3,698.35 ", N/A , N/A ,"$3,386.91 ", N/A ,"$3,503.70 ", N/A ,"$3,503.70 ","$3,503.70 ","$3,503.70 ","$3,776.21 ","$3,153.33 ","$3,620.49 ","$3,347.98 ","$3,776.21 "
SACRED HEART HOSPITAL (ACU),27801553,C1768,HC GRAFT VASCULAR FEMORAL VEIN TIER 1,278,1 ,"$12,399.00 ","$9,299.25 ","$6,695.46 ","$12,399.00 ","$7,984.96 ", N/A ,"$8,679.30 ", N/A ,"$10,291.17 ", N/A ,"$8,183.34 ","$11,779.05 ", N/A ,"$9,919.20 ","$11,407.08 ", N/A ,"$10,539.15 ","$11,779.05 ","$10,911.12 ","$9,423.24 ", N/A , N/A , N/A ,"$9,051.27 ","$6,819.45 ","$11,283.09 ","$11,283.09 ","$9,919.20 ", N/A ,"$6,819.45 ","$11,159.10 ", N/A ,"$11,159.10 ","$6,695.46 ","$11,655.06 ", N/A ,"$11,407.08 ", N/A ,"$11,283.09 ", N/A ,"$7,630.34 ","$7,630.34 ","$11,159.10 ","$9,253.37 ", N/A , N/A , N/A ,"$11,779.05 ", N/A , N/A ,"$10,787.13 ", N/A ,"$11,159.10 ", N/A ,"$11,159.10 ","$11,159.10 ","$11,159.10 ","$12,027.03 ","$10,043.19 ","$11,531.07 ","$10,663.14 ","$12,027.03 "
SACRED HEART HOSPITAL (ACU),27801554,C1768,HC GRAFT VASCULAR FEMORAL VEIN TIER 2,278,1 ,"$14,519.00 ","$10,889.25 ","$7,840.26 ","$14,519.00 ","$9,350.24 ", N/A ,"$10,163.30 ", N/A ,"$12,050.77 ", N/A ,"$9,582.54 ","$13,793.05 ", N/A ,"$11,615.20 ","$13,357.48 ", N/A ,"$12,341.15 ","$13,793.05 ","$12,776.72 ","$11,034.44 ", N/A , N/A , N/A ,"$10,598.87 ","$7,985.45 ","$13,212.29 ","$13,212.29 ","$11,615.20 ", N/A ,"$7,985.45 ","$13,067.10 ", N/A ,"$13,067.10 ","$7,840.26 ","$13,647.86 ", N/A ,"$13,357.48 ", N/A ,"$13,212.29 ", N/A ,"$8,934.99 ","$8,934.99 ","$13,067.10 ","$10,835.53 ", N/A , N/A , N/A ,"$13,793.05 ", N/A , N/A ,"$12,631.53 ", N/A ,"$13,067.10 ", N/A ,"$13,067.10 ","$13,067.10 ","$13,067.10 ","$14,083.43 ","$11,760.39 ","$13,502.67 ","$12,486.34 ","$14,083.43 "
SACRED HEART HOSPITAL (ACU),27801555,C1768,HC GRAFT VASCULAR FEMORAL VEIN TIER 3,278,1 ,"$16,735.00 ","$12,551.25 ","$9,036.90 ","$16,735.00 ","$10,777.34 ", N/A ,"$11,714.50 ", N/A ,"$13,890.05 ", N/A ,"$11,045.10 ","$15,898.25 ", N/A ,"$13,388.00 ","$15,396.20 ", N/A ,"$14,224.75 ","$15,898.25 ","$14,726.80 ","$12,718.60 ", N/A , N/A , N/A ,"$12,216.55 ","$9,204.25 ","$15,228.85 ","$15,228.85 ","$13,388.00 ", N/A ,"$9,204.25 ","$15,061.50 ", N/A ,"$15,061.50 ","$9,036.90 ","$15,730.90 ", N/A ,"$15,396.20 ", N/A ,"$15,228.85 ", N/A ,"$10,298.72 ","$10,298.72 ","$15,061.50 ","$12,489.33 ", N/A , N/A , N/A ,"$15,898.25 ", N/A , N/A ,"$14,559.45 ", N/A ,"$15,061.50 ", N/A ,"$15,061.50 ","$15,061.50 ","$15,061.50 ","$16,232.95 ","$13,555.35 ","$15,563.55 ","$14,392.10 ","$16,232.95 "
SACRED HEART HOSPITAL (ACU),27801556,C1768,HC GRAFT VASCULAR SAPHENOUS VEIN TIER 1,278,1 ,"$9,310.00 ","$6,982.50 ","$5,027.40 ","$9,310.00 ","$5,995.64 ", N/A ,"$6,517.00 ", N/A ,"$7,727.30 ", N/A ,"$6,144.60 ","$8,844.50 ", N/A ,"$7,448.00 ","$8,565.20 ", N/A ,"$7,913.50 ","$8,844.50 ","$8,192.80 ","$7,075.60 ", N/A , N/A , N/A ,"$6,796.30 ","$5,120.50 ","$8,472.10 ","$8,472.10 ","$7,448.00 ", N/A ,"$5,120.50 ","$8,379.00 ", N/A ,"$8,379.00 ","$5,027.40 ","$8,751.40 ", N/A ,"$8,565.20 ", N/A ,"$8,472.10 ", N/A ,"$5,729.37 ","$5,729.37 ","$8,379.00 ","$6,948.05 ", N/A , N/A , N/A ,"$8,844.50 ", N/A , N/A ,"$8,099.70 ", N/A ,"$8,379.00 ", N/A ,"$8,379.00 ","$8,379.00 ","$8,379.00 ","$9,030.70 ","$7,541.10 ","$8,658.30 ","$8,006.60 ","$9,030.70 "
SACRED HEART HOSPITAL (ACU),27801557,C1768,HC GRAFT VASCULAR SAPHENOUS VEIN TIER 2,278,1 ,"$12,879.00 ","$9,659.25 ","$6,954.66 ","$12,879.00 ","$8,294.08 ", N/A ,"$9,015.30 ", N/A ,"$10,689.57 ", N/A ,"$8,500.14 ","$12,235.05 ", N/A ,"$10,303.20 ","$11,848.68 ", N/A ,"$10,947.15 ","$12,235.05 ","$11,333.52 ","$9,788.04 ", N/A , N/A , N/A ,"$9,401.67 ","$7,083.45 ","$11,719.89 ","$11,719.89 ","$10,303.20 ", N/A ,"$7,083.45 ","$11,591.10 ", N/A ,"$11,591.10 ","$6,954.66 ","$12,106.26 ", N/A ,"$11,848.68 ", N/A ,"$11,719.89 ", N/A ,"$7,925.74 ","$7,925.74 ","$11,591.10 ","$9,611.60 ", N/A , N/A , N/A ,"$12,235.05 ", N/A , N/A ,"$11,204.73 ", N/A ,"$11,591.10 ", N/A ,"$11,591.10 ","$11,591.10 ","$11,591.10 ","$12,492.63 ","$10,431.99 ","$11,977.47 ","$11,075.94 ","$12,492.63 "
SACRED HEART HOSPITAL (ACU),27801558,C1768,HC GRAFT VASCULAR SAPHENOUS VEIN TIER 3,278,1 ,"$14,265.00 ","$10,698.75 ","$7,703.10 ","$14,265.00 ","$9,186.66 ", N/A ,"$9,985.50 ", N/A ,"$11,839.95 ", N/A ,"$9,414.90 ","$13,551.75 ", N/A ,"$11,412.00 ","$13,123.80 ", N/A ,"$12,125.25 ","$13,551.75 ","$12,553.20 ","$10,841.40 ", N/A , N/A , N/A ,"$10,413.45 ","$7,845.75 ","$12,981.15 ","$12,981.15 ","$11,412.00 ", N/A ,"$7,845.75 ","$12,838.50 ", N/A ,"$12,838.50 ","$7,703.10 ","$13,409.10 ", N/A ,"$13,123.80 ", N/A ,"$12,981.15 ", N/A ,"$8,778.68 ","$8,778.68 ","$12,838.50 ","$10,645.97 ", N/A , N/A , N/A ,"$13,551.75 ", N/A , N/A ,"$12,410.55 ", N/A ,"$12,838.50 ", N/A ,"$12,838.50 ","$12,838.50 ","$12,838.50 ","$13,837.05 ","$11,554.65 ","$13,266.45 ","$12,267.90 ","$13,837.05 "
SACRED HEART HOSPITAL (ACU),27801559,C1768,HC GRAFT VASCULAR SAPHENOUS VEIN TIER 4,278,1 ,"$18,540.00 ","$13,905.00 ","$10,011.60 ","$18,540.00 ","$11,939.76 ", N/A ,"$12,978.00 ", N/A ,"$15,388.20 ", N/A ,"$12,236.40 ","$17,613.00 ", N/A ,"$14,832.00 ","$17,056.80 ", N/A ,"$15,759.00 ","$17,613.00 ","$16,315.20 ","$14,090.40 ", N/A , N/A , N/A ,"$13,534.20 ","$10,197.00 ","$16,871.40 ","$16,871.40 ","$14,832.00 ", N/A ,"$10,197.00 ","$16,686.00 ", N/A ,"$16,686.00 ","$10,011.60 ","$17,427.60 ", N/A ,"$17,056.80 ", N/A ,"$16,871.40 ", N/A ,"$11,409.52 ","$11,409.52 ","$16,686.00 ","$13,836.40 ", N/A , N/A , N/A ,"$17,613.00 ", N/A , N/A ,"$16,129.80 ", N/A ,"$16,686.00 ", N/A ,"$16,686.00 ","$16,686.00 ","$16,686.00 ","$17,983.80 ","$15,017.40 ","$17,242.20 ","$15,944.40 ","$17,983.80 "
SACRED HEART HOSPITAL (ACU),27801560,C1768,HC GRAFT VASCULAR SAPHENOUS VEIN TIER 5,278,1 ,"$19,820.00 ","$14,865.00 ","$10,702.80 ","$19,820.00 ","$12,764.08 ", N/A ,"$13,874.00 ", N/A ,"$16,450.60 ", N/A ,"$13,081.20 ","$18,829.00 ", N/A ,"$15,856.00 ","$18,234.40 ", N/A ,"$16,847.00 ","$18,829.00 ","$17,441.60 ","$15,063.20 ", N/A , N/A , N/A ,"$14,468.60 ","$10,901.00 ","$18,036.20 ","$18,036.20 ","$15,856.00 ", N/A ,"$10,901.00 ","$17,838.00 ", N/A ,"$17,838.00 ","$10,702.80 ","$18,630.80 ", N/A ,"$18,234.40 ", N/A ,"$18,036.20 ", N/A ,"$12,197.23 ","$12,197.23 ","$17,838.00 ","$14,791.67 ", N/A , N/A , N/A ,"$18,829.00 ", N/A , N/A ,"$17,243.40 ", N/A ,"$17,838.00 ", N/A ,"$17,838.00 ","$17,838.00 ","$17,838.00 ","$19,225.40 ","$16,054.20 ","$18,432.60 ","$17,045.20 ","$19,225.40 "
SACRED HEART HOSPITAL (ACU),27801561,C1788,HC PAS PORT DELTEC,278,1 ,"$1,447.00 ","$1,085.25 ",$781.38 ,"$1,447.00 ",$931.87 , N/A ,"$1,012.90 ", N/A ,"$1,201.01 ", N/A ,$955.02 ,"$1,374.65 ", N/A ,"$1,157.60 ","$1,331.24 ", N/A ,"$1,229.95 ","$1,374.65 ","$1,273.36 ","$1,099.72 ", N/A , N/A , N/A ,"$1,056.31 ",$795.85 ,"$1,316.77 ","$1,316.77 ","$1,157.60 ", N/A ,$795.85 ,"$1,302.30 ", N/A ,"$1,302.30 ",$781.38 ,"$1,360.18 ", N/A ,"$1,331.24 ", N/A ,"$1,316.77 ", N/A ,$890.48 ,$890.48 ,"$1,302.30 ","$1,079.90 ", N/A , N/A , N/A ,"$1,374.65 ", N/A , N/A ,"$1,258.89 ", N/A ,"$1,302.30 ", N/A ,"$1,302.30 ","$1,302.30 ","$1,302.30 ","$1,403.59 ","$1,172.07 ","$1,345.71 ","$1,244.42 ","$1,403.59 "
SACRED HEART HOSPITAL (ACU),27801562,C1788,HC PAS PORT ANGIODYNAMICS,278,1 ,"$1,131.00 ",$848.25 ,$610.74 ,"$1,131.00 ",$728.36 , N/A ,$791.70 , N/A ,$938.73 , N/A ,$746.46 ,"$1,074.45 ", N/A ,$904.80 ,"$1,040.52 ", N/A ,$961.35 ,"$1,074.45 ",$995.28 ,$859.56 , N/A , N/A , N/A ,$825.63 ,$622.05 ,"$1,029.21 ","$1,029.21 ",$904.80 , N/A ,$622.05 ,"$1,017.90 ", N/A ,"$1,017.90 ",$610.74 ,"$1,063.14 ", N/A ,"$1,040.52 ", N/A ,"$1,029.21 ", N/A ,$696.02 ,$696.02 ,"$1,017.90 ",$844.07 , N/A , N/A , N/A ,"$1,074.45 ", N/A , N/A ,$983.97 , N/A ,"$1,017.90 ", N/A ,"$1,017.90 ","$1,017.90 ","$1,017.90 ","$1,097.07 ",$916.11 ,"$1,051.83 ",$972.66 ,"$1,097.07 "
SACRED HEART HOSPITAL (ACU),27801669,C1874,HC STENT COATED/COVERED W/DEL SYSTEM T5,278,1 ,"$1,941.00 ","$1,455.75 ","$1,048.14 ","$1,941.00 ","$1,250.00 ", N/A ,"$1,358.70 ", N/A ,"$1,611.03 ", N/A ,"$1,281.06 ","$1,843.95 ", N/A ,"$1,552.80 ","$1,785.72 ", N/A ,"$1,649.85 ","$1,843.95 ","$1,708.08 ","$1,475.16 ", N/A , N/A , N/A ,"$1,416.93 ","$1,067.55 ","$1,766.31 ","$1,766.31 ","$1,552.80 ", N/A ,"$1,067.55 ","$1,746.90 ", N/A ,"$1,746.90 ","$1,048.14 ","$1,824.54 ", N/A ,"$1,785.72 ", N/A ,"$1,766.31 ", N/A ,"$1,194.49 ","$1,194.49 ","$1,746.90 ","$1,448.57 ", N/A , N/A , N/A ,"$1,843.95 ", N/A , N/A ,"$1,688.67 ", N/A ,"$1,746.90 ", N/A ,"$1,746.90 ","$1,746.90 ","$1,746.90 ","$1,882.77 ","$1,572.21 ","$1,805.13 ","$1,669.26 ","$1,882.77 "
SACRED HEART HOSPITAL (ACU),27801705,C1876,HC STENT NON-COATED/NON-COVERED W/DEL SYSTEM T2,278,1 ,$932.00 ,$699.00 ,$503.28 ,$932.00 ,$600.21 , N/A ,$652.40 , N/A ,$773.56 , N/A ,$615.12 ,$885.40 , N/A ,$745.60 ,$857.44 , N/A ,$792.20 ,$885.40 ,$820.16 ,$708.32 , N/A , N/A , N/A ,$680.36 ,$512.60 ,$848.12 ,$848.12 ,$745.60 , N/A ,$512.60 ,$838.80 , N/A ,$838.80 ,$503.28 ,$876.08 , N/A ,$857.44 , N/A ,$848.12 , N/A ,$573.55 ,$573.55 ,$838.80 ,$695.55 , N/A , N/A , N/A ,$885.40 , N/A , N/A ,$810.84 , N/A ,$838.80 , N/A ,$838.80 ,$838.80 ,$838.80 ,$904.04 ,$754.92 ,$866.76 ,$801.52 ,$904.04 
SACRED HEART HOSPITAL (ACU),27802133,N/A,HC DEVICE HEART ASSIST IMPELLA,278,1 ,"$38,813.00 ","$29,109.75 ","$20,959.02 ","$38,813.00 ","$24,995.57 ", N/A ,"$27,169.10 ", N/A ,"$32,214.79 ", N/A ,"$25,616.58 ","$36,872.35 ", N/A ,"$31,050.40 ","$35,707.96 ", N/A ,"$32,991.05 ","$36,872.35 ","$34,155.44 ","$29,497.88 ", N/A , N/A , N/A ,"$28,333.49 ","$21,347.15 ","$35,319.83 ","$35,319.83 ","$31,050.40 ", N/A ,"$21,347.15 ","$34,931.70 ", N/A ,"$34,931.70 ","$20,959.02 ","$36,484.22 ", N/A ,"$35,707.96 ", N/A ,"$35,319.83 ", N/A ,"$23,885.52 ","$23,885.52 ","$34,931.70 ","$28,966.14 ", N/A , N/A , N/A ,"$36,872.35 ", N/A , N/A ,"$33,767.31 ", N/A ,"$34,931.70 ", N/A ,"$34,931.70 ","$34,931.70 ","$34,931.70 ","$37,648.61 ","$31,438.53 ","$36,096.09 ","$33,379.18 ","$37,648.61 "
SACRED HEART HOSPITAL (ACU),27802137,N/A,HC SYSTEM HEART VALVE TRANSCATH SAPIEN 3,278,1 ,"$50,456.00 ","$37,842.00 ","$27,246.24 ","$50,456.00 ","$32,493.66 ", N/A ,"$30,273.60 ", N/A ,"$41,878.48 ", N/A ,"$33,300.96 ","$47,933.20 ", N/A ,"$40,364.80 ","$46,419.52 ", N/A ,"$42,887.60 ","$47,933.20 ","$44,401.28 ","$38,346.56 ", N/A , N/A , N/A ,"$36,832.88 ","$27,750.80 ","$45,914.96 ","$45,914.96 ","$40,364.80 ", N/A ,"$27,750.80 ","$45,410.40 ", N/A ,"$45,410.40 ","$27,246.24 ","$47,428.64 ", N/A ,"$46,419.52 ", N/A ,"$45,914.96 ", N/A ,"$31,050.62 ","$31,050.62 ","$45,410.40 ","$37,655.31 ", N/A , N/A , N/A ,"$47,933.20 ", N/A , N/A ,"$43,896.72 ", N/A ,"$45,410.40 ", N/A ,"$45,410.40 ","$45,410.40 ","$45,410.40 ","$48,942.32 ","$40,869.36 ","$46,924.08 ","$43,392.16 ","$48,942.32 "
SACRED HEART HOSPITAL (ACU),27802138,N/A,HC SYSTEM HEART VALVE TRANSCATH SAPIEN XT,278,1 ,"$50,456.00 ","$37,842.00 ","$27,246.24 ","$50,456.00 ","$32,493.66 ", N/A ,"$30,273.60 ", N/A ,"$41,878.48 ", N/A ,"$33,300.96 ","$47,933.20 ", N/A ,"$40,364.80 ","$46,419.52 ", N/A ,"$42,887.60 ","$47,933.20 ","$44,401.28 ","$38,346.56 ", N/A , N/A , N/A ,"$36,832.88 ","$27,750.80 ","$45,914.96 ","$45,914.96 ","$40,364.80 ", N/A ,"$27,750.80 ","$45,410.40 ", N/A ,"$45,410.40 ","$27,246.24 ","$47,428.64 ", N/A ,"$46,419.52 ", N/A ,"$45,914.96 ", N/A ,"$31,050.62 ","$31,050.62 ","$45,410.40 ","$37,655.31 ", N/A , N/A , N/A ,"$47,933.20 ", N/A , N/A ,"$43,896.72 ", N/A ,"$45,410.40 ", N/A ,"$45,410.40 ","$45,410.40 ","$45,410.40 ","$48,942.32 ","$40,869.36 ","$46,924.08 ","$43,392.16 ","$48,942.32 "
SACRED HEART HOSPITAL (ACU),27802148,N/A,HC MICROCATHETER LANTERN,278,1 ,"$1,527.00 ","$1,145.25 ",$824.58 ,"$1,527.00 ",$983.39 , N/A ,"$1,068.90 ", N/A ,"$1,267.41 ", N/A ,"$1,007.82 ","$1,450.65 ", N/A ,"$1,221.60 ","$1,404.84 ", N/A ,"$1,297.95 ","$1,450.65 ","$1,343.76 ","$1,160.52 ", N/A , N/A , N/A ,"$1,114.71 ",$839.85 ,"$1,389.57 ","$1,389.57 ","$1,221.60 ", N/A ,$839.85 ,"$1,374.30 ", N/A ,"$1,374.30 ",$824.58 ,"$1,435.38 ", N/A ,"$1,404.84 ", N/A ,"$1,389.57 ", N/A ,$939.72 ,$939.72 ,"$1,374.30 ","$1,139.60 ", N/A , N/A , N/A ,"$1,450.65 ", N/A , N/A ,"$1,328.49 ", N/A ,"$1,374.30 ", N/A ,"$1,374.30 ","$1,374.30 ","$1,374.30 ","$1,481.19 ","$1,236.87 ","$1,420.11 ","$1,313.22 ","$1,481.19 "
SACRED HEART HOSPITAL (ACU),27802149,C1889,HC EMBOLIZATION COIL RUBY 5-25CM,278,1 ,"$1,521.00 ","$1,140.75 ",$821.34 ,"$1,521.00 ",$979.52 , N/A ,"$1,064.70 ", N/A ,"$1,262.43 ", N/A ,"$1,003.86 ","$1,444.95 ", N/A ,"$1,216.80 ","$1,399.32 ", N/A ,"$1,292.85 ","$1,444.95 ","$1,338.48 ","$1,155.96 ", N/A , N/A , N/A ,"$1,110.33 ",$836.55 ,"$1,384.11 ","$1,384.11 ","$1,216.80 ", N/A ,$836.55 ,"$1,368.90 ", N/A ,"$1,368.90 ",$821.34 ,"$1,429.74 ", N/A ,"$1,399.32 ", N/A ,"$1,384.11 ", N/A ,$936.02 ,$936.02 ,"$1,368.90 ","$1,135.12 ", N/A , N/A , N/A ,"$1,444.95 ", N/A , N/A ,"$1,323.27 ", N/A ,"$1,368.90 ", N/A ,"$1,368.90 ","$1,368.90 ","$1,368.90 ","$1,475.37 ","$1,232.01 ","$1,414.53 ","$1,308.06 ","$1,475.37 "
SACRED HEART HOSPITAL (ACU),27802150,C1889,HC EMBOLIZATION COIL RUBY 26-60CM,278,1 ,"$1,987.00 ","$1,490.25 ","$1,072.98 ","$1,987.00 ","$1,279.63 ", N/A ,"$1,390.90 ", N/A ,"$1,649.21 ", N/A ,"$1,311.42 ","$1,887.65 ", N/A ,"$1,589.60 ","$1,828.04 ", N/A ,"$1,688.95 ","$1,887.65 ","$1,748.56 ","$1,510.12 ", N/A , N/A , N/A ,"$1,450.51 ","$1,092.85 ","$1,808.17 ","$1,808.17 ","$1,589.60 ", N/A ,"$1,092.85 ","$1,788.30 ", N/A ,"$1,788.30 ","$1,072.98 ","$1,867.78 ", N/A ,"$1,828.04 ", N/A ,"$1,808.17 ", N/A ,"$1,222.80 ","$1,222.80 ","$1,788.30 ","$1,482.90 ", N/A , N/A , N/A ,"$1,887.65 ", N/A , N/A ,"$1,728.69 ", N/A ,"$1,788.30 ", N/A ,"$1,788.30 ","$1,788.30 ","$1,788.30 ","$1,927.39 ","$1,609.47 ","$1,847.91 ","$1,708.82 ","$1,927.39 "
SACRED HEART HOSPITAL (ACU),27802178,N/A,HC SYSTEM HEART VALVE CERTITUDE,278,1 ,"$50,456.00 ","$37,842.00 ","$27,246.24 ","$50,456.00 ","$32,493.66 ", N/A ,"$30,273.60 ", N/A ,"$41,878.48 ", N/A ,"$33,300.96 ","$47,933.20 ", N/A ,"$40,364.80 ","$46,419.52 ", N/A ,"$42,887.60 ","$47,933.20 ","$44,401.28 ","$38,346.56 ", N/A , N/A , N/A ,"$36,832.88 ","$27,750.80 ","$45,914.96 ","$45,914.96 ","$40,364.80 ", N/A ,"$27,750.80 ","$45,410.40 ", N/A ,"$45,410.40 ","$27,246.24 ","$47,428.64 ", N/A ,"$46,419.52 ", N/A ,"$45,914.96 ", N/A ,"$31,050.62 ","$31,050.62 ","$45,410.40 ","$37,655.31 ", N/A , N/A , N/A ,"$47,933.20 ", N/A , N/A ,"$43,896.72 ", N/A ,"$45,410.40 ", N/A ,"$45,410.40 ","$45,410.40 ","$45,410.40 ","$48,942.32 ","$40,869.36 ","$46,924.08 ","$43,392.16 ","$48,942.32 "
SACRED HEART HOSPITAL (ACU),27802180,C1889,"HC CATH SIL DRAIN 15FR, BALLOON DEFLATED",278,1 ,$337.00 ,$252.75 ,$181.98 ,$337.00 ,$217.03 , N/A ,$235.90 , N/A ,$279.71 , N/A ,$222.42 ,$320.15 , N/A ,$269.60 ,$310.04 , N/A ,$286.45 ,$320.15 ,$296.56 ,$256.12 , N/A , N/A , N/A ,$246.01 ,$185.35 ,$306.67 ,$306.67 ,$269.60 , N/A ,$185.35 ,$303.30 , N/A ,$303.30 ,$181.98 ,$316.78 , N/A ,$310.04 , N/A ,$306.67 , N/A ,$207.39 ,$207.39 ,$303.30 ,$251.50 , N/A , N/A , N/A ,$320.15 , N/A , N/A ,$293.19 , N/A ,$303.30 , N/A ,$303.30 ,$303.30 ,$303.30 ,$326.89 ,$272.97 ,$313.41 ,$289.82 ,$326.89 
SACRED HEART HOSPITAL (ACU),27878699,L8699,HC PROSTHETIC IMPLANTS NOS,278,1 ,"$1,526.25 ","$1,144.69 ",$824.18 ,"$1,526.25 ",$982.91 , N/A ,"$1,068.38 ", N/A ,"$1,266.79 ", N/A ,"$1,007.33 ","$1,449.94 ", N/A ,"$1,221.00 ","$1,404.15 ", N/A ,"$1,297.31 ","$1,449.94 ","$1,343.10 ","$1,159.95 ", N/A , N/A , N/A ,"$1,114.16 ",$839.44 ,"$1,388.89 ","$1,388.89 ","$1,221.00 ", N/A ,$839.44 ,"$1,373.63 ", N/A ,"$1,373.63 ",$824.18 ,"$1,434.68 ", N/A ,"$1,404.15 ", N/A ,"$1,388.89 ", N/A ,$939.25 ,$939.25 ,"$1,373.63 ","$1,139.04 ", N/A , N/A , N/A ,"$1,449.94 ", N/A , N/A ,"$1,327.84 ", N/A ,"$1,373.63 ", N/A ,"$1,373.63 ","$1,373.63 ","$1,373.63 ","$1,480.46 ","$1,236.26 ","$1,419.41 ","$1,312.58 ","$1,480.46 "
SACRED HEART HOSPITAL (ACU),28000001,G0498,HC CHEMO IV W/PUMP EXTENDED,280,1 ,$969.00 ,$726.75 ,$166.51 ,$969.00 ,$624.04 ,$337.23 ,$678.30 ,$166.51 ,$804.27 ,$171.51 ,$639.54 ,$920.55 ,$166.51 ,$775.20 ,$891.48 ,$166.51 ,$823.65 ,$920.55 ,$852.72 ,$736.44 ,$166.51 ,$166.51 ,$166.51 ,$707.37 ,$532.95 ,$881.79 ,$881.79 ,$775.20 ,$347.35 ,$532.95 ,$872.10 ,$337.23 ,$872.10 ,$523.26 ,$910.86 ,$758.76 ,$891.48 ,$176.50 ,$881.79 ,$337.23 ,$596.32 ,$596.32 ,$872.10 ,$723.16 ,$674.91 ,$340.60 ,$166.51 ,$920.55 ,$354.09 ,$166.51 ,$843.03 ,$337.23 ,$872.10 ,$337.23 ,$872.10 ,$872.10 ,$872.10 ,$939.93 ,$784.89 ,$901.17 ,$833.34 ,$939.93 
SACRED HEART HOSPITAL (ACU),30000004,N/A,HC POC GLUCOSE,300,1 ,$32.00 ,$24.00 ,$17.28 ,$32.00 ,$20.61 , N/A ,$22.40 , N/A ,$26.56 , N/A ,$21.12 ,$30.40 , N/A ,$25.60 ,$29.44 , N/A ,$27.20 ,$30.40 ,$28.16 ,$24.32 , N/A , N/A , N/A ,$23.36 ,$17.60 ,$29.12 ,$29.12 ,$25.60 , N/A ,$17.60 ,$28.80 , N/A ,$28.80 ,$17.28 ,$30.08 , N/A ,$29.44 , N/A ,$29.12 , N/A ,$19.69 ,$19.69 ,$28.80 ,$23.88 ,$22.29 , N/A , N/A ,$30.40 , N/A , N/A ,$27.84 , N/A ,$28.80 , N/A ,$28.80 ,$28.80 ,$28.80 ,$31.04 ,$25.92 ,$29.76 ,$27.52 ,$31.04 
SACRED HEART HOSPITAL (ACU),30000009,36416,HC CAPILLARY COLLECTION,300,1 ,$37.82 ,$28.37 ,$0.76 ,$37.82 ,$24.36 , N/A ,$26.47 ,$0.76 ,$31.39 ,$0.78 ,$24.96 ,$35.93 ,$0.76 ,$30.26 ,$34.79 ,$0.76 ,$32.15 ,$35.93 ,$33.28 ,$28.74 ,$0.76 ,$0.76 ,$0.76 ,$27.61 ,$20.80 ,$34.42 ,$34.42 ,$30.26 , N/A ,$20.80 ,$34.04 , N/A ,$34.04 ,$20.42 ,$35.55 , N/A ,$34.79 ,$0.81 ,$34.42 , N/A ,$23.27 ,$23.27 ,$34.04 ,$28.23 ,$26.34 , N/A ,$0.76 ,$35.93 , N/A ,$0.76 ,$32.90 , N/A ,$34.04 , N/A ,$34.04 ,$34.04 ,$34.04 ,$36.69 ,$30.63 ,$35.17 ,$32.53 ,$36.69 
SACRED HEART HOSPITAL (ACU),30000010,36415,HC VENIPUNCTURE,300,1 ,$39.10 ,$29.33 ,$0.76 ,$39.10 ,$25.18 ,$3.00 ,$27.37 ,$0.76 ,$32.45 ,$0.78 ,$25.81 ,$37.15 ,$0.76 ,$31.28 ,$35.97 ,$0.76 ,$33.24 ,$37.15 ,$34.41 ,$29.72 ,$0.76 ,$0.76 ,$0.76 ,$28.54 ,$21.51 ,$35.58 ,$35.58 ,$31.28 ,$3.09 ,$21.51 ,$35.19 ,$3.00 ,$35.19 ,$21.11 ,$36.75 ,$6.75 ,$35.97 ,$0.81 ,$35.58 ,$3.00 ,$24.06 ,$24.06 ,$24.83 ,$29.18 ,$15.27 ,$3.03 ,$0.76 ,$37.15 ,$3.15 ,$0.76 ,$34.02 ,$3.00 ,$35.19 ,$3.00 ,$35.19 ,$35.19 ,$35.19 ,$37.93 ,$31.67 ,$36.36 ,$33.63 ,$37.93 
SACRED HEART HOSPITAL (ACU),30000013,36415,HC VENIPUNCTURE (DRAW FEE),300,1 ,$39.10 ,$29.33 ,$0.76 ,$39.10 ,$25.18 ,$3.00 ,$27.37 ,$0.76 ,$32.45 ,$0.78 ,$25.81 ,$37.15 ,$0.76 ,$31.28 ,$35.97 ,$0.76 ,$33.24 ,$37.15 ,$34.41 ,$29.72 ,$0.76 ,$0.76 ,$0.76 ,$28.54 ,$21.51 ,$35.58 ,$35.58 ,$31.28 ,$3.09 ,$21.51 ,$35.19 ,$3.00 ,$35.19 ,$21.11 ,$36.75 ,$6.75 ,$35.97 ,$0.81 ,$35.58 ,$3.00 ,$24.06 ,$24.06 ,$24.83 ,$29.18 ,$15.27 ,$3.03 ,$0.76 ,$37.15 ,$3.15 ,$0.76 ,$34.02 ,$3.00 ,$35.19 ,$3.00 ,$35.19 ,$35.19 ,$35.19 ,$37.93 ,$31.67 ,$36.36 ,$33.63 ,$37.93 
SACRED HEART HOSPITAL (ACU),30000015,36600,HC ARTERIAL PUNCTURE,300,1 ,$284.00 ,$213.00 ,$19.05 ,$284.00 ,$182.90 ,$119.26 ,$198.80 ,$19.05 ,$235.72 ,$19.62 ,$187.44 ,$269.80 ,$19.05 ,$227.20 ,$261.28 ,$19.05 ,$241.40 ,$269.80 ,$249.92 ,$215.84 ,$19.05 ,$19.05 ,$19.05 ,$207.32 ,$156.20 ,$258.44 ,$258.44 ,$227.20 ,$122.84 ,$156.20 ,$255.60 ,$119.26 ,$255.60 ,$153.36 ,$266.96 ,$268.33 ,$261.28 ,$20.19 ,$258.44 ,$119.26 ,$174.77 ,$174.77 ,$255.60 ,$211.95 ,$76.28 ,$120.45 ,$19.05 ,$269.80 ,$125.22 ,$19.05 ,$247.08 ,$119.26 ,$255.60 ,$119.26 ,$255.60 ,$255.60 ,$255.60 ,$275.48 ,$230.04 ,$264.12 ,$244.24 ,$275.48 
SACRED HEART HOSPITAL (ACU),30000016,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$361.00 ,$270.75 ,$19.05 ,$361.00 ,$232.48 ,$119.26 ,$252.70 ,$19.05 ,$299.63 ,$19.62 ,$238.26 ,$342.95 ,$19.05 ,$288.80 ,$332.12 ,$19.05 ,$306.85 ,$342.95 ,$317.68 ,$274.36 ,$19.05 ,$19.05 ,$19.05 ,$263.53 ,$198.55 ,$328.51 ,$328.51 ,$288.80 ,$122.84 ,$198.55 ,$324.90 ,$119.26 ,$324.90 ,$194.94 ,$339.34 ,$268.33 ,$332.12 ,$20.19 ,$328.51 ,$119.26 ,$222.16 ,$222.16 ,$324.90 ,$269.41 ,$251.44 ,$120.45 ,$19.05 ,$342.95 ,$125.22 ,$19.05 ,$314.07 ,$119.26 ,$324.90 ,$119.26 ,$324.90 ,$324.90 ,$324.90 ,$350.17 ,$292.41 ,$335.73 ,$310.46 ,$350.17 
SACRED HEART HOSPITAL (ACU),30000035,43752,HC PLACE TUBE NASOGASTRIC,300,1 ,$277.00 ,$207.75 ,$149.58 ,$645.84 ,$178.39 ,$287.04 ,$193.90 ,$218.32 ,$229.91 ,$224.87 ,$182.82 ,$263.15 ,$218.32 ,$221.60 ,$254.84 ,$218.32 ,$235.45 ,$263.15 ,$243.76 ,$210.52 ,$218.32 ,$218.32 ,$218.32 ,$202.21 ,$152.35 ,$252.07 ,$252.07 ,$221.60 ,$295.65 ,$152.35 ,$249.30 ,$287.04 ,$249.30 ,$149.58 ,$260.38 ,$645.84 ,$254.84 ,$231.42 ,$252.07 ,$287.04 ,$170.47 ,$170.47 ,$249.30 ,$206.73 ,$192.93 ,$289.91 ,$218.32 ,$263.15 ,$301.39 ,$218.32 ,$240.99 ,$287.04 ,$249.30 ,$287.04 ,$249.30 ,$249.30 ,$249.30 ,$268.69 ,$224.37 ,$257.61 ,$238.22 ,$268.69 
SACRED HEART HOSPITAL (ACU),30000105,89060,HC CRYSTAL ID LIGHT MICRO,300,1 ,$94.93 ,$71.20 ,$7.33 ,$94.93 ,$61.13 ,$7.33 ,$66.45 ,$7.57 ,$17.17 ,$7.80 ,$13.73 ,$90.18 ,$7.57 ,$75.94 ,$87.34 ,$7.57 ,$80.69 ,$90.18 ,$83.54 ,$72.15 ,$7.57 ,$7.57 ,$7.57 ,$69.30 ,$52.21 ,$86.39 ,$86.39 ,$75.94 ,$7.55 ,$52.21 ,$85.44 ,$7.33 ,$85.44 ,$51.26 ,$89.23 ,$16.49 ,$87.34 ,$8.02 ,$86.39 ,$7.33 ,$58.42 ,$58.42 ,$87.89 ,$70.85 ,$44.96 ,$7.40 ,$7.57 ,$90.18 ,$7.70 ,$7.57 ,$82.59 ,$7.33 ,$85.44 ,$7.33 ,$85.44 ,$85.44 ,$85.44 ,$92.08 ,$76.89 ,$88.28 ,$81.64 ,$92.08 
SACRED HEART HOSPITAL (ACU),30000109,89230,HC SWEAT COLLECTION,300,1 ,$434.09 ,$325.57 ,$5.52 ,$434.09 ,$279.55 ,$52.56 ,$303.86 ,$9.37 ,$6.90 ,$9.65 ,$5.52 ,$412.39 ,$9.37 ,$347.27 ,$399.36 ,$9.37 ,$368.98 ,$412.39 ,$382.00 ,$329.91 ,$9.37 ,$9.37 ,$9.37 ,$316.89 ,$238.75 ,$395.02 ,$395.02 ,$347.27 ,$54.14 ,$238.75 ,$390.68 ,$52.56 ,$390.68 ,$234.41 ,$408.04 ,$118.25 ,$399.36 ,$9.93 ,$395.02 ,$52.56 ,$267.14 ,$267.14 ,$128.82 ,$323.96 ,$16.45 ,$53.08 ,$9.37 ,$412.39 ,$55.18 ,$9.37 ,$377.66 ,$52.56 ,$390.68 ,$52.56 ,$390.68 ,$390.68 ,$390.68 ,$421.07 ,$351.61 ,$403.70 ,$373.32 ,$421.07 
SACRED HEART HOSPITAL (ACU),30000115,99001,HC SPECIMEN HAND/CONVEY OTHER,300,1 ,$35.07 ,$26.30 ,$3.92 ,$35.07 ,$22.59 , N/A ,$24.55 ,$3.92 ,$29.11 ,$4.04 ,$23.15 ,$33.32 ,$3.92 ,$28.06 ,$32.26 ,$3.92 ,$29.81 ,$33.32 ,$30.86 ,$26.65 ,$3.92 ,$3.92 ,$3.92 ,$25.60 ,$19.29 ,$31.91 ,$31.91 ,$28.06 , N/A ,$19.29 ,$31.56 , N/A ,$31.56 ,$18.94 ,$32.97 , N/A ,$32.26 ,$4.16 ,$31.91 , N/A ,$21.58 ,$21.58 ,$25.50 ,$26.17 ,$24.43 , N/A ,$3.92 ,$33.32 , N/A ,$3.92 ,$30.51 , N/A ,$31.56 , N/A ,$31.56 ,$31.56 ,$31.56 ,$34.02 ,$28.41 ,$32.62 ,$30.16 ,$34.02 
SACRED HEART HOSPITAL (ACU),30000121,80306,HC DRUG SCREEN SGL CLASS PRESUMPTIVE INSTRMNT,300,1 ,$153.00 ,$114.75 ,$17.14 ,$153.00 ,$98.53 ,$17.14 ,$107.10 ,$17.71 ,$34.91 ,$18.24 ,$27.93 ,$145.35 ,$17.71 ,$122.40 ,$140.76 ,$17.71 ,$130.05 ,$145.35 ,$134.64 ,$116.28 ,$17.71 ,$17.71 ,$17.71 ,$111.69 ,$84.15 ,$139.23 ,$139.23 ,$122.40 ,$17.65 ,$84.15 ,$137.70 ,$17.14 ,$137.70 ,$82.62 ,$143.82 ,$38.57 ,$140.76 ,$18.77 ,$139.23 ,$17.14 ,$94.16 ,$94.16 ,$38.33 ,$114.18 ,$85.97 ,$17.31 ,$17.71 ,$145.35 ,$18.00 ,$17.71 ,$133.11 ,$17.14 ,$137.70 ,$17.14 ,$137.70 ,$137.70 ,$137.70 ,$148.41 ,$123.93 ,$142.29 ,$131.58 ,$148.41 
SACRED HEART HOSPITAL (ACU),30000201,86332,HC IMMUNE COMPLEX ASSAY,300,1 ,$191.53 ,$143.65 ,$24.37 ,$191.53 ,$123.35 ,$24.37 ,$134.07 ,$25.18 ,$58.50 ,$25.94 ,$46.80 ,$181.95 ,$25.18 ,$153.22 ,$176.21 ,$25.18 ,$162.80 ,$181.95 ,$168.55 ,$145.56 ,$25.18 ,$25.18 ,$25.18 ,$139.82 ,$105.34 ,$174.29 ,$174.29 ,$153.22 ,$25.10 ,$105.34 ,$172.38 ,$24.37 ,$172.38 ,$103.43 ,$180.04 ,$54.83 ,$176.21 ,$26.69 ,$174.29 ,$24.37 ,$117.87 ,$117.87 ,$191.53 ,$142.94 ,$153.21 ,$24.61 ,$25.18 ,$181.95 ,$25.59 ,$25.18 ,$166.63 ,$24.37 ,$172.38 ,$24.37 ,$172.38 ,$172.38 ,$172.38 ,$185.78 ,$155.14 ,$178.12 ,$164.72 ,$185.78 
SACRED HEART HOSPITAL (ACU),30000213,36591,HC COLLECT BLOOD PORT/ACCESS DVC,300,1 ,$104.00 ,$78.00 ,$19.05 ,$268.33 ,$66.98 ,$119.26 ,$72.80 ,$19.05 ,$86.32 ,$19.62 ,$68.64 ,$98.80 ,$19.05 ,$83.20 ,$95.68 ,$19.05 ,$88.40 ,$98.80 ,$91.52 ,$79.04 ,$19.05 ,$19.05 ,$19.05 ,$75.92 ,$57.20 ,$94.64 ,$94.64 ,$83.20 ,$122.84 ,$57.20 ,$93.60 ,$119.26 ,$93.60 ,$56.16 ,$97.76 ,$268.33 ,$95.68 ,$20.19 ,$94.64 ,$119.26 ,$64.00 ,$64.00 ,$93.60 ,$77.62 ,$72.44 ,$120.45 ,$19.05 ,$98.80 ,$125.22 ,$19.05 ,$90.48 ,$119.26 ,$93.60 ,$119.26 ,$93.60 ,$93.60 ,$93.60 ,$100.88 ,$84.24 ,$96.72 ,$89.44 ,$100.88 
SACRED HEART HOSPITAL (ACU),30000214,36592,HC COLLECT BLD CENTRL/PERPH CATH,300,1 ,$104.00 ,$78.00 ,$19.05 ,$268.33 ,$66.98 ,$119.26 ,$72.80 ,$19.05 ,$86.32 ,$19.62 ,$68.64 ,$98.80 ,$19.05 ,$83.20 ,$95.68 ,$19.05 ,$88.40 ,$98.80 ,$91.52 ,$79.04 ,$19.05 ,$19.05 ,$19.05 ,$75.92 ,$57.20 ,$94.64 ,$94.64 ,$83.20 ,$122.84 ,$57.20 ,$93.60 ,$119.26 ,$93.60 ,$56.16 ,$97.76 ,$268.33 ,$95.68 ,$20.19 ,$94.64 ,$119.26 ,$64.00 ,$64.00 ,$93.60 ,$77.62 ,$72.44 ,$120.45 ,$19.05 ,$98.80 ,$125.22 ,$19.05 ,$90.48 ,$119.26 ,$93.60 ,$119.26 ,$93.60 ,$93.60 ,$93.60 ,$100.88 ,$84.24 ,$96.72 ,$89.44 ,$100.88 
SACRED HEART HOSPITAL (ACU),30000215,81510,HC FETAL CONG ABNORMAL AFP/UE3/HCG,300,1 ,$138.85 ,$104.14 ,$44.43 ,$138.85 ,$89.42 ,$55.54 ,$97.20 ,$44.43 ,$138.85 ,$45.76 ,$138.85 ,$131.91 ,$44.43 ,$111.08 ,$127.74 ,$44.43 ,$118.02 ,$131.91 ,$122.19 ,$105.53 ,$44.43 ,$44.43 ,$44.43 ,$101.36 ,$76.37 ,$126.35 ,$126.35 ,$111.08 ,$57.21 ,$76.37 ,$124.97 ,$55.54 ,$124.97 ,$74.98 ,$130.52 ,$124.97 ,$127.74 ,$47.10 ,$126.35 ,$55.54 ,$85.45 ,$85.45 ,$105.41 ,$103.62 ,$124.97 ,$56.10 ,$44.43 ,$131.91 ,$58.32 ,$44.43 ,$120.80 ,$55.54 ,$124.97 ,$55.54 ,$124.97 ,$124.97 ,$124.97 ,$134.68 ,$112.47 ,$129.13 ,$119.41 ,$134.68 
SACRED HEART HOSPITAL (ACU),30000216,81511,HC FETAL CONG ABNORMAL AFP/UE3/HCG/DIA,300,1 ,$383.75 ,$287.81 ,$122.80 ,$383.75 ,$247.14 ,$153.50 ,$268.63 ,$122.80 ,$383.75 ,$126.48 ,$383.75 ,$364.56 ,$122.80 ,$307.00 ,$353.05 ,$122.80 ,$326.19 ,$364.56 ,$337.70 ,$291.65 ,$122.80 ,$122.80 ,$122.80 ,$280.14 ,$211.06 ,$349.21 ,$349.21 ,$307.00 ,$158.11 ,$211.06 ,$345.38 ,$153.50 ,$345.38 ,$207.23 ,$360.73 ,$345.38 ,$353.05 ,$130.17 ,$349.21 ,$153.50 ,$236.16 ,$236.16 ,$291.60 ,$286.39 ,$345.38 ,$155.04 ,$122.80 ,$364.56 ,$161.18 ,$122.80 ,$333.86 ,$153.50 ,$345.38 ,$153.50 ,$345.38 ,$345.38 ,$345.38 ,$372.24 ,$310.84 ,$356.89 ,$330.03 ,$372.24 
SACRED HEART HOSPITAL (ACU),30000217,86005,HC RAST ALLERGEN MULTI QL,300,1 ,$134.84 ,$101.13 ,$7.97 ,$134.84 ,$86.84 ,$7.97 ,$94.39 ,$8.24 ,$19.13 ,$8.49 ,$15.30 ,$128.10 ,$8.24 ,$107.87 ,$124.05 ,$8.24 ,$114.61 ,$128.10 ,$118.66 ,$102.48 ,$8.24 ,$8.24 ,$8.24 ,$98.43 ,$74.16 ,$122.70 ,$122.70 ,$107.87 ,$8.21 ,$74.16 ,$121.36 ,$7.97 ,$121.36 ,$72.81 ,$126.75 ,$17.93 ,$124.05 ,$8.73 ,$122.70 ,$7.97 ,$82.98 ,$82.98 ,$34.07 ,$100.63 ,$50.10 ,$8.05 ,$8.24 ,$128.10 ,$8.37 ,$8.24 ,$117.31 ,$7.97 ,$121.36 ,$7.97 ,$121.36 ,$121.36 ,$121.36 ,$130.79 ,$109.22 ,$125.40 ,$115.96 ,$130.79 
SACRED HEART HOSPITAL (ACU),30000219,86970,HC RBC PRETREAT CHEM,300,1 ,$95.38 ,$71.54 ,$8.64 ,$95.38 ,$61.42 ,$35.80 ,$66.77 ,$8.64 ,$48.04 ,$8.90 ,$38.43 ,$90.61 ,$8.64 ,$76.30 ,$87.75 ,$8.64 ,$81.07 ,$90.61 ,$83.93 ,$72.49 ,$8.64 ,$8.64 ,$8.64 ,$69.63 ,$52.46 ,$86.80 ,$86.80 ,$76.30 ,$36.87 ,$52.46 ,$85.84 ,$35.80 ,$85.84 ,$51.51 ,$89.66 ,$80.55 ,$87.75 ,$9.16 ,$86.80 ,$35.80 ,$58.70 ,$58.70 ,$60.39 ,$71.18 ,$66.43 ,$36.16 ,$8.64 ,$90.61 ,$37.59 ,$8.64 ,$82.98 ,$35.80 ,$85.84 ,$35.80 ,$85.84 ,$85.84 ,$85.84 ,$92.52 ,$77.26 ,$88.70 ,$82.03 ,$92.52 
SACRED HEART HOSPITAL (ACU),30000220,86971,HC RBC PRETREAT ENZYME,300,1 ,$538.58 ,$403.94 ,$8.64 ,$693.07 ,$346.85 ,$308.03 ,$377.01 ,$8.64 ,$38.43 ,$8.90 ,$30.74 ,$511.65 ,$8.64 ,$430.86 ,$495.49 ,$8.64 ,$457.79 ,$511.65 ,$473.95 ,$409.32 ,$8.64 ,$8.64 ,$8.64 ,$393.16 ,$296.22 ,$490.11 ,$490.11 ,$430.86 ,$317.27 ,$296.22 ,$484.72 ,$308.03 ,$484.72 ,$290.83 ,$506.27 ,$693.07 ,$495.49 ,$9.16 ,$490.11 ,$308.03 ,$331.44 ,$331.44 ,$40.85 ,$401.94 ,$375.12 ,$311.11 ,$8.64 ,$511.65 ,$323.43 ,$8.64 ,$468.56 ,$308.03 ,$484.72 ,$308.03 ,$484.72 ,$484.72 ,$484.72 ,$522.42 ,$436.25 ,$500.88 ,$463.18 ,$522.42 
SACRED HEART HOSPITAL (ACU),30000223,89051,HC CELL CT BODY FLUID W/DIFF,300,1 ,$114.60 ,$85.95 ,$5.60 ,$114.60 ,$73.80 ,$5.60 ,$80.22 ,$5.79 ,$13.21 ,$5.96 ,$10.57 ,$108.87 ,$5.79 ,$91.68 ,$105.43 ,$5.79 ,$97.41 ,$108.87 ,$100.85 ,$87.10 ,$5.79 ,$5.79 ,$5.79 ,$83.66 ,$63.03 ,$104.29 ,$104.29 ,$91.68 ,$5.77 ,$63.03 ,$103.14 ,$5.60 ,$103.14 ,$61.88 ,$107.72 ,$12.60 ,$105.43 ,$6.14 ,$104.29 ,$5.60 ,$70.52 ,$70.52 ,$87.89 ,$85.53 ,$34.62 ,$5.66 ,$5.79 ,$108.87 ,$5.88 ,$5.79 ,$99.70 ,$5.60 ,$103.14 ,$5.60 ,$103.14 ,$103.14 ,$103.14 ,$111.16 ,$92.83 ,$106.58 ,$98.56 ,$111.16 
SACRED HEART HOSPITAL (ACU),30000225,89190,HC SMEAR NASAL EOSINOPHILS,300,1 ,$74.29 ,$55.72 ,$5.79 ,$74.29 ,$47.84 ,$5.79 ,$52.00 ,$5.98 ,$11.39 ,$6.16 ,$9.11 ,$70.58 ,$5.98 ,$59.43 ,$68.35 ,$5.98 ,$63.15 ,$70.58 ,$65.38 ,$56.46 ,$5.98 ,$5.98 ,$5.98 ,$54.23 ,$40.86 ,$67.60 ,$67.60 ,$59.43 ,$5.96 ,$40.86 ,$66.86 ,$5.79 ,$66.86 ,$40.12 ,$69.83 ,$13.03 ,$68.35 ,$6.34 ,$67.60 ,$5.79 ,$45.72 ,$45.72 ,$32.94 ,$55.44 ,$29.84 ,$5.85 ,$5.98 ,$70.58 ,$6.08 ,$5.98 ,$64.63 ,$5.79 ,$66.86 ,$5.79 ,$66.86 ,$66.86 ,$66.86 ,$72.06 ,$60.17 ,$69.09 ,$63.89 ,$72.06 
SACRED HEART HOSPITAL (ACU),30000226,89320,HC SEMEN ANALYSIS COMPLETE,300,1 ,$438.45 ,$328.84 ,$12.31 ,$438.45 ,$282.36 ,$12.31 ,$306.92 ,$12.72 ,$28.93 ,$13.10 ,$23.14 ,$416.53 ,$12.72 ,$350.76 ,$403.37 ,$12.72 ,$372.68 ,$416.53 ,$385.84 ,$333.22 ,$12.72 ,$12.72 ,$12.72 ,$320.07 ,$241.15 ,$398.99 ,$398.99 ,$350.76 ,$12.68 ,$241.15 ,$394.61 ,$12.31 ,$394.61 ,$236.76 ,$412.14 ,$27.70 ,$403.37 ,$13.48 ,$398.99 ,$12.31 ,$269.82 ,$269.82 ,$114.22 ,$327.22 ,$62.68 ,$12.43 ,$12.72 ,$416.53 ,$12.93 ,$12.72 ,$381.45 ,$12.31 ,$394.61 ,$12.31 ,$394.61 ,$394.61 ,$394.61 ,$425.30 ,$355.14 ,$407.76 ,$377.07 ,$425.30 
SACRED HEART HOSPITAL (ACU),30000227,89321,HC SEMEN PRESENCE/MOTILITY,300,1 ,$200.24 ,$150.18 ,$12.05 ,$200.24 ,$128.95 ,$12.05 ,$140.17 ,$12.45 ,$28.93 ,$12.82 ,$23.14 ,$190.23 ,$12.45 ,$160.19 ,$184.22 ,$12.45 ,$170.20 ,$190.23 ,$176.21 ,$152.18 ,$12.45 ,$12.45 ,$12.45 ,$146.18 ,$110.13 ,$182.22 ,$182.22 ,$160.19 ,$12.41 ,$110.13 ,$180.22 ,$12.05 ,$180.22 ,$108.13 ,$188.23 ,$27.11 ,$184.22 ,$13.20 ,$182.22 ,$12.05 ,$123.23 ,$123.23 ,$32.86 ,$149.44 ,$139.47 ,$12.17 ,$12.45 ,$190.23 ,$12.65 ,$12.45 ,$174.21 ,$12.05 ,$180.22 ,$12.05 ,$180.22 ,$180.22 ,$180.22 ,$194.23 ,$162.19 ,$186.22 ,$172.21 ,$194.23 
SACRED HEART HOSPITAL (ACU),30000228,86078,HC INVESTIGATE TRANSFSN REACTION,300,1 ,$322.95 ,$242.21 ,$8.64 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$8.64 ,$97.09 ,$8.90 ,$77.67 ,$306.80 ,$8.64 ,$258.36 ,$297.11 ,$8.64 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$8.64 ,$8.64 ,$8.64 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$9.16 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$147.57 ,$241.02 ,$263.18 ,$159.32 ,$8.64 ,$306.80 ,$165.63 ,$8.64 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),30000232,N/A,HC UA DRUG COLLECTION FEE LEVEL 2,300,1 ,$34.00 ,$25.50 ,$18.36 ,$34.00 ,$21.90 , N/A ,$23.80 , N/A ,$28.22 , N/A ,$22.44 ,$32.30 , N/A ,$27.20 ,$31.28 , N/A ,$28.90 ,$32.30 ,$29.92 ,$25.84 , N/A , N/A , N/A ,$24.82 ,$18.70 ,$30.94 ,$30.94 ,$27.20 , N/A ,$18.70 ,$30.60 , N/A ,$30.60 ,$18.36 ,$31.96 , N/A ,$31.28 , N/A ,$30.94 , N/A ,$20.92 ,$20.92 ,$30.60 ,$25.37 ,$23.68 , N/A , N/A ,$32.30 , N/A , N/A ,$29.58 , N/A ,$30.60 , N/A ,$30.60 ,$30.60 ,$30.60 ,$32.98 ,$27.54 ,$31.62 ,$29.24 ,$32.98 
SACRED HEART HOSPITAL (ACU),30000233,N/A,HC UA DRUG COLLECTION FEE LEVEL 3,300,1 ,$46.00 ,$34.50 ,$24.84 ,$46.00 ,$29.62 , N/A ,$32.20 , N/A ,$38.18 , N/A ,$30.36 ,$43.70 , N/A ,$36.80 ,$42.32 , N/A ,$39.10 ,$43.70 ,$40.48 ,$34.96 , N/A , N/A , N/A ,$33.58 ,$25.30 ,$41.86 ,$41.86 ,$36.80 , N/A ,$25.30 ,$41.40 , N/A ,$41.40 ,$24.84 ,$43.24 , N/A ,$42.32 , N/A ,$41.86 , N/A ,$28.31 ,$28.31 ,$41.40 ,$34.33 ,$32.04 , N/A , N/A ,$43.70 , N/A , N/A ,$40.02 , N/A ,$41.40 , N/A ,$41.40 ,$41.40 ,$41.40 ,$44.62 ,$37.26 ,$42.78 ,$39.56 ,$44.62 
SACRED HEART HOSPITAL (ACU),30000234,N/A,HC KIT RAPID DRUG TEST 10 PANEL,300,1 ,$69.00 ,$51.75 ,$37.26 ,$69.00 ,$44.44 , N/A ,$48.30 , N/A ,$57.27 , N/A ,$45.54 ,$65.55 , N/A ,$55.20 ,$63.48 , N/A ,$58.65 ,$65.55 ,$60.72 ,$52.44 , N/A , N/A , N/A ,$50.37 ,$37.95 ,$62.79 ,$62.79 ,$55.20 , N/A ,$37.95 ,$62.10 , N/A ,$62.10 ,$37.26 ,$64.86 , N/A ,$63.48 , N/A ,$62.79 , N/A ,$42.46 ,$42.46 ,$62.10 ,$51.49 ,$48.06 , N/A , N/A ,$65.55 , N/A , N/A ,$60.03 , N/A ,$62.10 , N/A ,$62.10 ,$62.10 ,$62.10 ,$66.93 ,$55.89 ,$64.17 ,$59.34 ,$66.93 
SACRED HEART HOSPITAL (ACU),30000235,N/A,HC KIT RAPID DRUG TEST MRO,300,1 ,$69.00 ,$51.75 ,$37.26 ,$69.00 ,$44.44 , N/A ,$48.30 , N/A ,$57.27 , N/A ,$45.54 ,$65.55 , N/A ,$55.20 ,$63.48 , N/A ,$58.65 ,$65.55 ,$60.72 ,$52.44 , N/A , N/A , N/A ,$50.37 ,$37.95 ,$62.79 ,$62.79 ,$55.20 , N/A ,$37.95 ,$62.10 , N/A ,$62.10 ,$37.26 ,$64.86 , N/A ,$63.48 , N/A ,$62.79 , N/A ,$42.46 ,$42.46 ,$62.10 ,$51.49 ,$48.06 , N/A , N/A ,$65.55 , N/A , N/A ,$60.03 , N/A ,$62.10 , N/A ,$62.10 ,$62.10 ,$62.10 ,$66.93 ,$55.89 ,$64.17 ,$59.34 ,$66.93 
SACRED HEART HOSPITAL (ACU),30002037,87631,"HC RESP VIRUS, 3-5 TARGETS",300,1 ,$478.00 ,$358.50 ,$140.78 ,$478.00 ,$307.83 ,$142.63 ,$334.60 ,$140.78 ,$307.97 ,$145.00 ,$246.37 ,$454.10 ,$140.78 ,$382.40 ,$439.76 ,$140.78 ,$406.30 ,$454.10 ,$420.64 ,$363.28 ,$140.78 ,$140.78 ,$140.78 ,$348.94 ,$262.90 ,$434.98 ,$434.98 ,$382.40 ,$146.91 ,$262.90 ,$430.20 ,$142.63 ,$430.20 ,$258.12 ,$449.32 ,$320.92 ,$439.76 ,$149.23 ,$434.98 ,$142.63 ,$294.16 ,$294.16 ,$354.57 ,$356.73 ,$430.20 ,$144.06 ,$140.78 ,$454.10 ,$149.76 ,$140.78 ,$415.86 ,$142.63 ,$430.20 ,$142.63 ,$430.20 ,$430.20 ,$430.20 ,$463.66 ,$387.18 ,$444.54 ,$411.08 ,$463.66 
SACRED HEART HOSPITAL (ACU),30100101,80048,HC BASIC METABOLIC PANEL,301,1 ,$228.72 ,$171.54 ,$8.46 ,$228.72 ,$147.30 ,$8.46 ,$160.10 ,$8.74 ,$20.30 ,$9.00 ,$16.24 ,$217.28 ,$8.74 ,$182.98 ,$210.42 ,$8.74 ,$194.41 ,$217.28 ,$201.27 ,$173.83 ,$8.74 ,$8.74 ,$8.74 ,$166.97 ,$125.80 ,$208.14 ,$208.14 ,$182.98 ,$8.71 ,$125.80 ,$205.85 ,$8.46 ,$205.85 ,$123.51 ,$215.00 ,$19.04 ,$210.42 ,$9.26 ,$208.14 ,$8.46 ,$140.75 ,$140.75 ,$32.65 ,$170.69 ,$53.16 ,$8.54 ,$8.74 ,$217.28 ,$8.88 ,$8.74 ,$198.99 ,$8.46 ,$205.85 ,$8.46 ,$205.85 ,$205.85 ,$205.85 ,$221.86 ,$185.26 ,$212.71 ,$196.70 ,$221.86 
SACRED HEART HOSPITAL (ACU),30100103,80051,HC ELECTROLYTE PANEL,301,1 ,$204.24 ,$153.18 ,$7.01 ,$204.24 ,$131.53 ,$7.01 ,$142.97 ,$7.24 ,$16.84 ,$7.46 ,$13.47 ,$194.03 ,$7.24 ,$163.39 ,$187.90 ,$7.24 ,$173.60 ,$194.03 ,$179.73 ,$155.22 ,$7.24 ,$7.24 ,$7.24 ,$149.10 ,$112.33 ,$185.86 ,$185.86 ,$163.39 ,$7.22 ,$112.33 ,$183.82 ,$7.01 ,$183.82 ,$110.29 ,$191.99 ,$15.77 ,$187.90 ,$7.67 ,$185.86 ,$7.01 ,$125.69 ,$125.69 ,$51.87 ,$152.42 ,$44.09 ,$7.08 ,$7.24 ,$194.03 ,$7.36 ,$7.24 ,$177.69 ,$7.01 ,$183.82 ,$7.01 ,$183.82 ,$183.82 ,$183.82 ,$198.11 ,$165.43 ,$189.94 ,$175.65 ,$198.11 
SACRED HEART HOSPITAL (ACU),30100104,80053,HC COMPREHENSIVE METABOL PANEL,301,1 ,$315.54 ,$236.66 ,$10.56 ,$315.54 ,$203.21 ,$10.56 ,$220.88 ,$10.91 ,$25.36 ,$11.24 ,$20.29 ,$299.76 ,$10.91 ,$252.43 ,$290.30 ,$10.91 ,$268.21 ,$299.76 ,$277.68 ,$239.81 ,$10.91 ,$10.91 ,$10.91 ,$230.34 ,$173.55 ,$287.14 ,$287.14 ,$252.43 ,$10.88 ,$173.55 ,$283.99 ,$10.56 ,$283.99 ,$170.39 ,$296.61 ,$23.76 ,$290.30 ,$11.56 ,$287.14 ,$10.56 ,$194.18 ,$194.18 ,$40.83 ,$235.49 ,$66.39 ,$10.67 ,$10.91 ,$299.76 ,$11.09 ,$10.91 ,$274.52 ,$10.56 ,$283.99 ,$10.56 ,$283.99 ,$283.99 ,$283.99 ,$306.07 ,$255.59 ,$293.45 ,$271.36 ,$306.07 
SACRED HEART HOSPITAL (ACU),30100107,80061,HC LIPID PANEL,301,1 ,$248.79 ,$186.59 ,$13.39 ,$248.79 ,$160.22 ,$13.39 ,$174.15 ,$13.84 ,$32.15 ,$14.26 ,$25.72 ,$236.35 ,$13.84 ,$199.03 ,$228.89 ,$13.84 ,$211.47 ,$236.35 ,$218.94 ,$189.08 ,$13.84 ,$13.84 ,$13.84 ,$181.62 ,$136.83 ,$226.40 ,$226.40 ,$199.03 ,$13.79 ,$136.83 ,$223.91 ,$13.39 ,$223.91 ,$134.35 ,$233.86 ,$30.13 ,$228.89 ,$14.67 ,$226.40 ,$13.39 ,$153.11 ,$153.11 ,$74.23 ,$185.67 ,$84.16 ,$13.52 ,$13.84 ,$236.35 ,$14.06 ,$13.84 ,$216.45 ,$13.39 ,$223.91 ,$13.39 ,$223.91 ,$223.91 ,$223.91 ,$241.33 ,$201.52 ,$231.37 ,$213.96 ,$241.33 
SACRED HEART HOSPITAL (ACU),30100110,80076,HC LIVER (HEPATIC) PANEL,301,1 ,$196.52 ,$147.39 ,$8.17 ,$196.52 ,$126.56 ,$8.17 ,$137.56 ,$8.44 ,$19.62 ,$8.69 ,$15.69 ,$186.69 ,$8.44 ,$157.22 ,$180.80 ,$8.44 ,$167.04 ,$186.69 ,$172.94 ,$149.36 ,$8.44 ,$8.44 ,$8.44 ,$143.46 ,$108.09 ,$178.83 ,$178.83 ,$157.22 ,$8.42 ,$108.09 ,$176.87 ,$8.17 ,$176.87 ,$106.12 ,$184.73 ,$18.38 ,$180.80 ,$8.95 ,$178.83 ,$8.17 ,$120.94 ,$120.94 ,$31.65 ,$146.66 ,$51.37 ,$8.25 ,$8.44 ,$186.69 ,$8.58 ,$8.44 ,$170.97 ,$8.17 ,$176.87 ,$8.17 ,$176.87 ,$176.87 ,$176.87 ,$190.62 ,$159.18 ,$182.76 ,$169.01 ,$190.62 
SACRED HEART HOSPITAL (ACU),30100115,80346,HC BENZODIAZEPINE GC/MS,301,1 ,$72.00 ,$54.00 ,$3.94 ,$72.00 ,$46.37 , N/A ,$50.40 ,$3.94 ,$41.42 ,$4.06 ,$33.14 ,$68.40 ,$3.94 ,$57.60 ,$66.24 ,$3.94 ,$61.20 ,$68.40 ,$63.36 ,$54.72 ,$3.94 ,$3.94 ,$3.94 ,$52.56 ,$39.60 ,$65.52 ,$65.52 ,$57.60 , N/A ,$39.60 ,$64.80 , N/A ,$64.80 ,$38.88 ,$67.68 , N/A ,$66.24 ,$4.18 ,$65.52 , N/A ,$44.31 ,$44.31 ,$47.23 ,$53.73 ,$50.15 , N/A ,$3.94 ,$68.40 , N/A ,$3.94 ,$62.64 , N/A ,$64.80 , N/A ,$64.80 ,$64.80 ,$64.80 ,$69.84 ,$58.32 ,$66.96 ,$61.92 ,$69.84 
SACRED HEART HOSPITAL (ACU),30100116,80156,HC CARBAMAZEPINE TOTAL,301,1 ,$165.16 ,$123.87 ,$14.57 ,$165.16 ,$106.36 ,$14.57 ,$115.61 ,$15.06 ,$34.97 ,$15.51 ,$27.97 ,$156.90 ,$15.06 ,$132.13 ,$151.95 ,$15.06 ,$140.39 ,$156.90 ,$145.34 ,$125.52 ,$15.06 ,$15.06 ,$15.06 ,$120.57 ,$90.84 ,$150.30 ,$150.30 ,$132.13 ,$15.01 ,$90.84 ,$148.64 ,$14.57 ,$148.64 ,$89.19 ,$155.25 ,$32.78 ,$151.95 ,$15.96 ,$150.30 ,$14.57 ,$101.64 ,$101.64 ,$88.52 ,$123.26 ,$91.55 ,$14.72 ,$15.06 ,$156.90 ,$15.30 ,$15.06 ,$143.69 ,$14.57 ,$148.64 ,$14.57 ,$148.64 ,$148.64 ,$148.64 ,$160.21 ,$133.78 ,$153.60 ,$142.04 ,$160.21 
SACRED HEART HOSPITAL (ACU),30100117,80157,HC CARBAMAZEPINE FREE,301,1 ,$72.20 ,$54.15 ,$13.25 ,$72.20 ,$46.50 ,$13.25 ,$50.54 ,$13.69 ,$31.82 ,$14.10 ,$25.45 ,$68.59 ,$13.69 ,$57.76 ,$66.42 ,$13.69 ,$61.37 ,$68.59 ,$63.54 ,$54.87 ,$13.69 ,$13.69 ,$13.69 ,$52.71 ,$39.71 ,$65.70 ,$65.70 ,$57.76 ,$13.65 ,$39.71 ,$64.98 ,$13.25 ,$64.98 ,$38.99 ,$67.87 ,$29.81 ,$66.42 ,$14.51 ,$65.70 ,$13.25 ,$44.43 ,$44.43 ,$50.27 ,$53.88 ,$64.98 ,$13.38 ,$13.69 ,$68.59 ,$13.91 ,$13.69 ,$62.81 ,$13.25 ,$64.98 ,$13.25 ,$64.98 ,$64.98 ,$64.98 ,$70.03 ,$58.48 ,$67.15 ,$62.09 ,$70.03 
SACRED HEART HOSPITAL (ACU),30100118,80158,HC CYCLOSPORINE,301,1 ,$129.00 ,$96.75 ,$18.05 ,$129.00 ,$83.08 ,$18.05 ,$90.30 ,$18.65 ,$43.33 ,$19.21 ,$34.66 ,$122.55 ,$18.65 ,$103.20 ,$118.68 ,$18.65 ,$109.65 ,$122.55 ,$113.52 ,$98.04 ,$18.65 ,$18.65 ,$18.65 ,$94.17 ,$70.95 ,$117.39 ,$117.39 ,$103.20 ,$18.59 ,$70.95 ,$116.10 ,$18.05 ,$116.10 ,$69.66 ,$121.26 ,$40.61 ,$118.68 ,$19.77 ,$117.39 ,$18.05 ,$79.39 ,$79.39 ,$96.21 ,$96.27 ,$113.44 ,$18.23 ,$18.65 ,$122.55 ,$18.95 ,$18.65 ,$112.23 ,$18.05 ,$116.10 ,$18.05 ,$116.10 ,$116.10 ,$116.10 ,$125.13 ,$104.49 ,$119.97 ,$110.94 ,$125.13 
SACRED HEART HOSPITAL (ACU),30100120,80162,HC DIGOXIN LEVELS,301,1 ,$192.95 ,$144.71 ,$13.28 ,$192.95 ,$124.26 ,$13.28 ,$135.07 ,$13.72 ,$31.87 ,$14.13 ,$25.49 ,$183.30 ,$13.72 ,$154.36 ,$177.51 ,$13.72 ,$164.01 ,$183.30 ,$169.80 ,$146.64 ,$13.72 ,$13.72 ,$13.72 ,$140.85 ,$106.12 ,$175.58 ,$175.58 ,$154.36 ,$13.68 ,$106.12 ,$173.66 ,$13.28 ,$173.66 ,$104.19 ,$181.37 ,$29.88 ,$177.51 ,$14.54 ,$175.58 ,$13.28 ,$118.74 ,$118.74 ,$82.56 ,$144.00 ,$83.45 ,$13.41 ,$13.72 ,$183.30 ,$13.94 ,$13.72 ,$167.87 ,$13.28 ,$173.66 ,$13.28 ,$173.66 ,$173.66 ,$173.66 ,$187.16 ,$156.29 ,$179.44 ,$165.94 ,$187.16 
SACRED HEART HOSPITAL (ACU),30100121,80164,HC VALPROIC ACID,301,1 ,$74.46 ,$55.85 ,$13.54 ,$74.46 ,$47.95 ,$13.54 ,$52.12 ,$13.99 ,$32.52 ,$14.41 ,$26.01 ,$70.74 ,$13.99 ,$59.57 ,$68.50 ,$13.99 ,$63.29 ,$70.74 ,$65.52 ,$56.59 ,$13.99 ,$13.99 ,$13.99 ,$54.36 ,$40.95 ,$67.76 ,$67.76 ,$59.57 ,$13.95 ,$40.95 ,$67.01 ,$13.54 ,$67.01 ,$40.21 ,$69.99 ,$30.47 ,$68.50 ,$14.83 ,$67.76 ,$13.54 ,$45.82 ,$45.82 ,$74.46 ,$55.57 ,$67.01 ,$13.68 ,$13.99 ,$70.74 ,$14.22 ,$13.99 ,$64.78 ,$13.54 ,$67.01 ,$13.54 ,$67.01 ,$67.01 ,$67.01 ,$72.23 ,$60.31 ,$69.25 ,$64.04 ,$72.23 
SACRED HEART HOSPITAL (ACU),30100124,80170,HC GENTAMICIN,301,1 ,$198.65 ,$148.99 ,$16.38 ,$198.65 ,$127.93 ,$16.38 ,$139.06 ,$16.93 ,$39.32 ,$17.44 ,$31.46 ,$188.72 ,$16.93 ,$158.92 ,$182.76 ,$16.93 ,$168.85 ,$188.72 ,$174.81 ,$150.97 ,$16.93 ,$16.93 ,$16.93 ,$145.01 ,$109.26 ,$180.77 ,$180.77 ,$158.92 ,$16.87 ,$109.26 ,$178.79 ,$16.38 ,$178.79 ,$107.27 ,$186.73 ,$36.86 ,$182.76 ,$17.95 ,$180.77 ,$16.38 ,$122.25 ,$122.25 ,$112.00 ,$148.25 ,$102.95 ,$16.54 ,$16.93 ,$188.72 ,$17.20 ,$16.93 ,$172.83 ,$16.38 ,$178.79 ,$16.38 ,$178.79 ,$178.79 ,$178.79 ,$192.69 ,$160.91 ,$184.74 ,$170.84 ,$192.69 
SACRED HEART HOSPITAL (ACU),30100126,80176,HC LIDOCAINE,301,1 ,$177.89 ,$133.42 ,$14.69 ,$177.89 ,$114.56 ,$14.69 ,$124.52 ,$15.18 ,$35.26 ,$15.64 ,$28.21 ,$169.00 ,$15.18 ,$142.31 ,$163.66 ,$15.18 ,$151.21 ,$169.00 ,$156.54 ,$135.20 ,$15.18 ,$15.18 ,$15.18 ,$129.86 ,$97.84 ,$161.88 ,$161.88 ,$142.31 ,$15.13 ,$97.84 ,$160.10 ,$14.69 ,$160.10 ,$96.06 ,$167.22 ,$33.05 ,$163.66 ,$16.09 ,$161.88 ,$14.69 ,$109.47 ,$109.47 ,$88.52 ,$132.76 ,$92.36 ,$14.84 ,$15.18 ,$169.00 ,$15.42 ,$15.18 ,$154.76 ,$14.69 ,$160.10 ,$14.69 ,$160.10 ,$160.10 ,$160.10 ,$172.55 ,$144.09 ,$165.44 ,$152.99 ,$172.55 
SACRED HEART HOSPITAL (ACU),30100127,80178,HC LITHIUM,301,1 ,$72.56 ,$54.42 ,$6.61 ,$72.56 ,$46.73 ,$6.61 ,$50.79 ,$6.83 ,$15.87 ,$7.03 ,$12.70 ,$68.93 ,$6.83 ,$58.05 ,$66.76 ,$6.83 ,$61.68 ,$68.93 ,$63.85 ,$55.15 ,$6.83 ,$6.83 ,$6.83 ,$52.97 ,$39.91 ,$66.03 ,$66.03 ,$58.05 ,$6.81 ,$39.91 ,$65.30 ,$6.61 ,$65.30 ,$39.18 ,$68.21 ,$14.87 ,$66.76 ,$7.24 ,$66.03 ,$6.61 ,$44.65 ,$44.65 ,$44.14 ,$54.15 ,$41.55 ,$6.68 ,$6.83 ,$68.93 ,$6.94 ,$6.83 ,$63.13 ,$6.61 ,$65.30 ,$6.61 ,$65.30 ,$65.30 ,$65.30 ,$70.38 ,$58.77 ,$67.48 ,$62.40 ,$70.38 
SACRED HEART HOSPITAL (ACU),30100129,80184,HC PHENOBARBITAL,301,1 ,$86.92 ,$65.19 ,$15.30 ,$86.92 ,$55.98 ,$15.30 ,$60.84 ,$15.81 ,$27.49 ,$16.28 ,$21.99 ,$82.57 ,$15.81 ,$69.54 ,$79.97 ,$15.81 ,$73.88 ,$82.57 ,$76.49 ,$66.06 ,$15.81 ,$15.81 ,$15.81 ,$63.45 ,$47.81 ,$79.10 ,$79.10 ,$69.54 ,$15.76 ,$47.81 ,$78.23 ,$15.30 ,$78.23 ,$46.94 ,$81.70 ,$34.43 ,$79.97 ,$16.76 ,$79.10 ,$15.30 ,$53.49 ,$53.49 ,$86.92 ,$64.87 ,$77.90 ,$15.45 ,$15.81 ,$82.57 ,$16.07 ,$15.81 ,$75.62 ,$15.30 ,$78.23 ,$15.30 ,$78.23 ,$78.23 ,$78.23 ,$84.31 ,$70.41 ,$80.84 ,$74.75 ,$84.31 
SACRED HEART HOSPITAL (ACU),30100130,80185,HC PHENYTOIN TOTAL,301,1 ,$145.22 ,$108.92 ,$13.25 ,$145.22 ,$93.52 ,$13.25 ,$101.65 ,$13.69 ,$31.82 ,$14.10 ,$25.45 ,$137.96 ,$13.69 ,$116.18 ,$133.60 ,$13.69 ,$123.44 ,$137.96 ,$127.79 ,$110.37 ,$13.69 ,$13.69 ,$13.69 ,$106.01 ,$79.87 ,$132.15 ,$132.15 ,$116.18 ,$13.65 ,$79.87 ,$130.70 ,$13.25 ,$130.70 ,$78.42 ,$136.51 ,$29.81 ,$133.60 ,$14.51 ,$132.15 ,$13.25 ,$89.37 ,$89.37 ,$91.14 ,$108.38 ,$83.30 ,$13.38 ,$13.69 ,$137.96 ,$13.91 ,$13.69 ,$126.34 ,$13.25 ,$130.70 ,$13.25 ,$130.70 ,$130.70 ,$130.70 ,$140.86 ,$117.63 ,$135.05 ,$124.89 ,$140.86 
SACRED HEART HOSPITAL (ACU),30100131,80186,HC PHENYTOIN FREE,301,1 ,$42.48 ,$31.86 ,$13.76 ,$42.48 ,$27.36 ,$13.76 ,$29.74 ,$14.22 ,$28.18 ,$14.65 ,$22.54 ,$40.36 ,$14.22 ,$33.98 ,$39.08 ,$14.22 ,$36.11 ,$40.36 ,$37.38 ,$32.28 ,$14.22 ,$14.22 ,$14.22 ,$31.01 ,$23.36 ,$38.66 ,$38.66 ,$33.98 ,$14.17 ,$23.36 ,$38.23 ,$13.76 ,$38.23 ,$22.94 ,$39.93 ,$30.96 ,$39.08 ,$15.07 ,$38.66 ,$13.76 ,$26.14 ,$26.14 ,$42.48 ,$31.70 ,$38.23 ,$13.90 ,$14.22 ,$40.36 ,$14.45 ,$14.22 ,$36.96 ,$13.76 ,$38.23 ,$13.76 ,$38.23 ,$38.23 ,$38.23 ,$41.21 ,$34.41 ,$39.51 ,$36.53 ,$41.21 
SACRED HEART HOSPITAL (ACU),30100132,80188,HC PRIMIDONE,301,1 ,$51.20 ,$38.40 ,$16.59 ,$51.20 ,$32.97 ,$16.59 ,$35.84 ,$17.14 ,$39.83 ,$17.65 ,$31.86 ,$48.64 ,$17.14 ,$40.96 ,$47.10 ,$17.14 ,$43.52 ,$48.64 ,$45.06 ,$38.91 ,$17.14 ,$17.14 ,$17.14 ,$37.38 ,$28.16 ,$46.59 ,$46.59 ,$40.96 ,$17.09 ,$28.16 ,$46.08 ,$16.59 ,$46.08 ,$27.65 ,$48.13 ,$37.33 ,$47.10 ,$18.17 ,$46.59 ,$16.59 ,$31.51 ,$31.51 ,$51.20 ,$38.21 ,$46.08 ,$16.76 ,$17.14 ,$48.64 ,$17.42 ,$17.14 ,$44.54 ,$16.59 ,$46.08 ,$16.59 ,$46.08 ,$46.08 ,$46.08 ,$49.66 ,$41.47 ,$47.62 ,$44.03 ,$49.66 
SACRED HEART HOSPITAL (ACU),30100133,80192,HC PROCAINEAMIDE,301,1 ,$95.85 ,$71.89 ,$16.75 ,$95.85 ,$61.73 ,$16.75 ,$67.10 ,$17.31 ,$40.22 ,$17.83 ,$32.17 ,$91.06 ,$17.31 ,$76.68 ,$88.18 ,$17.31 ,$81.47 ,$91.06 ,$84.35 ,$72.85 ,$17.31 ,$17.31 ,$17.31 ,$69.97 ,$52.72 ,$87.22 ,$87.22 ,$76.68 ,$17.25 ,$52.72 ,$86.27 ,$16.75 ,$86.27 ,$51.76 ,$90.10 ,$37.69 ,$88.18 ,$18.35 ,$87.22 ,$16.75 ,$58.99 ,$58.99 ,$81.28 ,$71.53 ,$86.27 ,$16.92 ,$17.31 ,$91.06 ,$17.59 ,$17.31 ,$83.39 ,$16.75 ,$86.27 ,$16.75 ,$86.27 ,$86.27 ,$86.27 ,$92.97 ,$77.64 ,$89.14 ,$82.43 ,$92.97 
SACRED HEART HOSPITAL (ACU),30100134,80194,HC QUINIDINE,301,1 ,$94.50 ,$70.88 ,$14.60 ,$94.50 ,$60.86 ,$14.60 ,$66.15 ,$15.09 ,$35.05 ,$15.54 ,$28.04 ,$89.78 ,$15.09 ,$75.60 ,$86.94 ,$15.09 ,$80.33 ,$89.78 ,$83.16 ,$71.82 ,$15.09 ,$15.09 ,$15.09 ,$68.99 ,$51.98 ,$86.00 ,$86.00 ,$75.60 ,$15.04 ,$51.98 ,$85.05 ,$14.60 ,$85.05 ,$51.03 ,$88.83 ,$32.85 ,$86.94 ,$16.00 ,$86.00 ,$14.60 ,$58.16 ,$58.16 ,$82.56 ,$70.53 ,$85.05 ,$14.75 ,$15.09 ,$89.78 ,$15.33 ,$15.09 ,$82.22 ,$14.60 ,$85.05 ,$14.60 ,$85.05 ,$85.05 ,$85.05 ,$91.67 ,$76.55 ,$87.89 ,$81.27 ,$91.67 
SACRED HEART HOSPITAL (ACU),30100135,80195,HC RAPAMYCIN (SIROLIMUS),301,1 ,$65.55 ,$49.16 ,$13.73 ,$65.55 ,$42.21 ,$13.73 ,$45.89 ,$14.19 ,$32.97 ,$14.62 ,$26.38 ,$62.27 ,$14.19 ,$52.44 ,$60.31 ,$14.19 ,$55.72 ,$62.27 ,$57.68 ,$49.82 ,$14.19 ,$14.19 ,$14.19 ,$47.85 ,$36.05 ,$59.65 ,$59.65 ,$52.44 ,$14.14 ,$36.05 ,$59.00 ,$13.73 ,$59.00 ,$35.40 ,$61.62 ,$30.89 ,$60.31 ,$15.04 ,$59.65 ,$13.73 ,$40.34 ,$40.34 ,$40.81 ,$48.92 ,$59.00 ,$13.87 ,$14.19 ,$62.27 ,$14.42 ,$14.19 ,$57.03 ,$13.73 ,$59.00 ,$13.73 ,$59.00 ,$59.00 ,$59.00 ,$63.58 ,$53.10 ,$60.96 ,$56.37 ,$63.58 
SACRED HEART HOSPITAL (ACU),30100137,80197,HC TACROLIMUS,301,1 ,$47.83 ,$35.87 ,$13.73 ,$47.83 ,$30.80 ,$13.73 ,$33.48 ,$14.19 ,$32.97 ,$14.62 ,$26.38 ,$45.44 ,$14.19 ,$38.26 ,$44.00 ,$14.19 ,$40.66 ,$45.44 ,$42.09 ,$36.35 ,$14.19 ,$14.19 ,$14.19 ,$34.92 ,$26.31 ,$43.53 ,$43.53 ,$38.26 ,$14.14 ,$26.31 ,$43.05 ,$13.73 ,$43.05 ,$25.83 ,$44.96 ,$30.89 ,$44.00 ,$15.04 ,$43.53 ,$13.73 ,$29.43 ,$29.43 ,$47.83 ,$35.70 ,$43.05 ,$13.87 ,$14.19 ,$45.44 ,$14.42 ,$14.19 ,$41.61 ,$13.73 ,$43.05 ,$13.73 ,$43.05 ,$43.05 ,$43.05 ,$46.40 ,$38.74 ,$44.48 ,$41.13 ,$46.40 
SACRED HEART HOSPITAL (ACU),30100138,80198,HC THEOPHYLLINE,301,1 ,$165.16 ,$123.87 ,$14.14 ,$165.16 ,$106.36 ,$14.14 ,$115.61 ,$14.61 ,$33.95 ,$15.05 ,$27.16 ,$156.90 ,$14.61 ,$132.13 ,$151.95 ,$14.61 ,$140.39 ,$156.90 ,$145.34 ,$125.52 ,$14.61 ,$14.61 ,$14.61 ,$120.57 ,$90.84 ,$150.30 ,$150.30 ,$132.13 ,$14.56 ,$90.84 ,$148.64 ,$14.14 ,$148.64 ,$89.19 ,$155.25 ,$31.82 ,$151.95 ,$15.49 ,$150.30 ,$14.14 ,$101.64 ,$101.64 ,$68.96 ,$123.26 ,$88.90 ,$14.28 ,$14.61 ,$156.90 ,$14.85 ,$14.61 ,$143.69 ,$14.14 ,$148.64 ,$14.14 ,$148.64 ,$148.64 ,$148.64 ,$160.21 ,$133.78 ,$153.60 ,$142.04 ,$160.21 
SACRED HEART HOSPITAL (ACU),30100139,80200,HC TOBRAMYCIN,301,1 ,$199.63 ,$149.72 ,$16.13 ,$199.63 ,$128.56 ,$16.13 ,$139.74 ,$16.67 ,$38.71 ,$17.17 ,$30.97 ,$189.65 ,$16.67 ,$159.70 ,$183.66 ,$16.67 ,$169.69 ,$189.65 ,$175.67 ,$151.72 ,$16.67 ,$16.67 ,$16.67 ,$145.73 ,$109.80 ,$181.66 ,$181.66 ,$159.70 ,$16.61 ,$109.80 ,$179.67 ,$16.13 ,$179.67 ,$107.80 ,$187.65 ,$36.29 ,$183.66 ,$17.67 ,$181.66 ,$16.13 ,$122.85 ,$122.85 ,$106.54 ,$148.98 ,$101.37 ,$16.29 ,$16.67 ,$189.65 ,$16.94 ,$16.67 ,$173.68 ,$16.13 ,$179.67 ,$16.13 ,$179.67 ,$179.67 ,$179.67 ,$193.64 ,$161.70 ,$185.66 ,$171.68 ,$193.64 
SACRED HEART HOSPITAL (ACU),30100140,80201,HC TOPIRAMATE,301,1 ,$72.11 ,$54.08 ,$11.92 ,$72.11 ,$46.44 ,$11.92 ,$50.48 ,$12.32 ,$28.61 ,$12.69 ,$22.89 ,$68.50 ,$12.32 ,$57.69 ,$66.34 ,$12.32 ,$61.29 ,$68.50 ,$63.46 ,$54.80 ,$12.32 ,$12.32 ,$12.32 ,$52.64 ,$39.66 ,$65.62 ,$65.62 ,$57.69 ,$12.28 ,$39.66 ,$64.90 ,$11.92 ,$64.90 ,$38.94 ,$67.78 ,$26.82 ,$66.34 ,$13.06 ,$65.62 ,$11.92 ,$44.38 ,$44.38 ,$72.11 ,$53.82 ,$64.90 ,$12.04 ,$12.32 ,$68.50 ,$12.52 ,$12.32 ,$62.74 ,$11.92 ,$64.90 ,$11.92 ,$64.90 ,$64.90 ,$64.90 ,$69.95 ,$58.41 ,$67.06 ,$62.01 ,$69.95 
SACRED HEART HOSPITAL (ACU),30100141,80202,HC VANCOMYCIN,301,1 ,$190.34 ,$142.76 ,$13.54 ,$190.34 ,$122.58 ,$13.54 ,$133.24 ,$13.99 ,$32.52 ,$14.41 ,$26.01 ,$180.82 ,$13.99 ,$152.27 ,$175.11 ,$13.99 ,$161.79 ,$180.82 ,$167.50 ,$144.66 ,$13.99 ,$13.99 ,$13.99 ,$138.95 ,$104.69 ,$173.21 ,$173.21 ,$152.27 ,$13.95 ,$104.69 ,$171.31 ,$13.54 ,$171.31 ,$102.78 ,$178.92 ,$30.47 ,$175.11 ,$14.83 ,$173.21 ,$13.54 ,$117.14 ,$117.14 ,$134.62 ,$142.05 ,$85.13 ,$13.68 ,$13.99 ,$180.82 ,$14.22 ,$13.99 ,$165.60 ,$13.54 ,$171.31 ,$13.54 ,$171.31 ,$171.31 ,$171.31 ,$184.63 ,$154.18 ,$177.02 ,$163.69 ,$184.63 
SACRED HEART HOSPITAL (ACU),30100146,80171,HC GABAPENTIN PLASMA,301,1 ,$109.00 ,$81.75 ,$14.48 ,$109.00 ,$70.20 ,$21.67 ,$76.30 ,$14.48 ,$31.82 ,$14.91 ,$25.45 ,$103.55 ,$14.48 ,$87.20 ,$100.28 ,$14.48 ,$92.65 ,$103.55 ,$95.92 ,$82.84 ,$14.48 ,$14.48 ,$14.48 ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 ,$22.32 ,$59.95 ,$98.10 ,$21.67 ,$98.10 ,$58.86 ,$102.46 ,$48.76 ,$100.28 ,$15.35 ,$99.19 ,$21.67 ,$67.08 ,$67.08 ,$34.23 ,$81.35 ,$98.10 ,$21.89 ,$14.48 ,$103.55 ,$22.75 ,$14.48 ,$94.83 ,$21.67 ,$98.10 ,$21.67 ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),30100147,80175,HC LAMOTRIGINE,301,1 ,$54.00 ,$40.50 ,$13.25 ,$54.00 ,$34.78 ,$13.25 ,$37.80 ,$13.69 ,$31.82 ,$14.10 ,$25.45 ,$51.30 ,$13.69 ,$43.20 ,$49.68 ,$13.69 ,$45.90 ,$51.30 ,$47.52 ,$41.04 ,$13.69 ,$13.69 ,$13.69 ,$39.42 ,$29.70 ,$49.14 ,$49.14 ,$43.20 ,$13.65 ,$29.70 ,$48.60 ,$13.25 ,$48.60 ,$29.16 ,$50.76 ,$29.81 ,$49.68 ,$14.51 ,$49.14 ,$13.25 ,$33.23 ,$33.23 ,$34.23 ,$40.30 ,$48.60 ,$13.38 ,$13.69 ,$51.30 ,$13.91 ,$13.69 ,$46.98 ,$13.25 ,$48.60 ,$13.25 ,$48.60 ,$48.60 ,$48.60 ,$52.38 ,$43.74 ,$50.22 ,$46.44 ,$52.38 
SACRED HEART HOSPITAL (ACU),30100149,80177,HC KEPPRA,301,1 ,$67.00 ,$50.25 ,$13.25 ,$67.00 ,$43.15 ,$13.25 ,$46.90 ,$13.69 ,$31.82 ,$14.10 ,$25.45 ,$63.65 ,$13.69 ,$53.60 ,$61.64 ,$13.69 ,$56.95 ,$63.65 ,$58.96 ,$50.92 ,$13.69 ,$13.69 ,$13.69 ,$48.91 ,$36.85 ,$60.97 ,$60.97 ,$53.60 ,$13.65 ,$36.85 ,$60.30 ,$13.25 ,$60.30 ,$36.18 ,$62.98 ,$29.81 ,$61.64 ,$14.51 ,$60.97 ,$13.25 ,$41.23 ,$41.23 ,$34.23 ,$50.00 ,$60.30 ,$13.38 ,$13.69 ,$63.65 ,$13.91 ,$13.69 ,$58.29 ,$13.25 ,$60.30 ,$13.25 ,$60.30 ,$60.30 ,$60.30 ,$64.99 ,$54.27 ,$62.31 ,$57.62 ,$64.99 
SACRED HEART HOSPITAL (ACU),30100150,80203,HC ZONISAMIDE,301,1 ,$128.00 ,$96.00 ,$13.25 ,$128.00 ,$82.43 ,$13.25 ,$89.60 ,$13.69 ,$31.82 ,$14.10 ,$25.45 ,$121.60 ,$13.69 ,$102.40 ,$117.76 ,$13.69 ,$108.80 ,$121.60 ,$112.64 ,$97.28 ,$13.69 ,$13.69 ,$13.69 ,$93.44 ,$70.40 ,$116.48 ,$116.48 ,$102.40 ,$13.65 ,$70.40 ,$115.20 ,$13.25 ,$115.20 ,$69.12 ,$120.32 ,$29.81 ,$117.76 ,$14.51 ,$116.48 ,$13.25 ,$78.77 ,$78.77 ,$34.23 ,$95.53 ,$83.30 ,$13.38 ,$13.69 ,$121.60 ,$13.91 ,$13.69 ,$111.36 ,$13.25 ,$115.20 ,$13.25 ,$115.20 ,$115.20 ,$115.20 ,$124.16 ,$103.68 ,$119.04 ,$110.08 ,$124.16 
SACRED HEART HOSPITAL (ACU),30100157,82009,HC ACETONE SERUM,301,1 ,$99.00 ,$74.25 ,$4.52 ,$99.00 ,$63.76 ,$4.52 ,$69.30 ,$4.67 ,$10.85 ,$4.81 ,$8.68 ,$94.05 ,$4.67 ,$79.20 ,$91.08 ,$4.67 ,$84.15 ,$94.05 ,$87.12 ,$75.24 ,$4.67 ,$4.67 ,$4.67 ,$72.27 ,$54.45 ,$90.09 ,$90.09 ,$79.20 ,$4.66 ,$54.45 ,$89.10 ,$4.52 ,$89.10 ,$53.46 ,$93.06 ,$10.17 ,$91.08 ,$4.95 ,$90.09 ,$4.52 ,$60.92 ,$60.92 ,$27.69 ,$73.88 ,$28.41 ,$4.57 ,$4.67 ,$94.05 ,$4.75 ,$4.67 ,$86.13 ,$4.52 ,$89.10 ,$4.52 ,$89.10 ,$89.10 ,$89.10 ,$96.03 ,$80.19 ,$92.07 ,$85.14 ,$96.03 
SACRED HEART HOSPITAL (ACU),30100158,82010,HC ACETONE KETONES SERUM QN,301,1 ,$43.00 ,$32.25 ,$8.17 ,$43.00 ,$27.69 ,$8.17 ,$30.10 ,$8.44 ,$19.62 ,$8.69 ,$15.69 ,$40.85 ,$8.44 ,$34.40 ,$39.56 ,$8.44 ,$36.55 ,$40.85 ,$37.84 ,$32.68 ,$8.44 ,$8.44 ,$8.44 ,$31.39 ,$23.65 ,$39.13 ,$39.13 ,$34.40 ,$8.42 ,$23.65 ,$38.70 ,$8.17 ,$38.70 ,$23.22 ,$40.42 ,$18.38 ,$39.56 ,$8.95 ,$39.13 ,$8.17 ,$26.46 ,$26.46 ,$43.00 ,$32.09 ,$38.70 ,$8.25 ,$8.44 ,$40.85 ,$8.58 ,$8.44 ,$37.41 ,$8.17 ,$38.70 ,$8.17 ,$38.70 ,$38.70 ,$38.70 ,$41.71 ,$34.83 ,$39.99 ,$36.98 ,$41.71 
SACRED HEART HOSPITAL (ACU),30100163,82024,HC ACTH,301,1 ,$126.00 ,$94.50 ,$38.62 ,$126.00 ,$81.14 ,$38.62 ,$88.20 ,$39.91 ,$92.72 ,$41.11 ,$74.17 ,$119.70 ,$39.91 ,$100.80 ,$115.92 ,$39.91 ,$107.10 ,$119.70 ,$110.88 ,$95.76 ,$39.91 ,$39.91 ,$39.91 ,$91.98 ,$69.30 ,$114.66 ,$114.66 ,$100.80 ,$39.78 ,$69.30 ,$113.40 ,$38.62 ,$113.40 ,$68.04 ,$118.44 ,$86.90 ,$115.92 ,$42.30 ,$114.66 ,$38.62 ,$77.54 ,$77.54 ,$126.00 ,$94.03 ,$113.40 ,$39.01 ,$39.91 ,$119.70 ,$40.55 ,$39.91 ,$109.62 ,$38.62 ,$113.40 ,$38.62 ,$113.40 ,$113.40 ,$113.40 ,$122.22 ,$102.06 ,$117.18 ,$108.36 ,$122.22 
SACRED HEART HOSPITAL (ACU),30100164,82040,HC ALBUMIN,301,1 ,$92.00 ,$69.00 ,$4.95 ,$92.00 ,$59.25 ,$4.95 ,$64.40 ,$5.11 ,$11.88 ,$5.26 ,$9.51 ,$87.40 ,$5.11 ,$73.60 ,$84.64 ,$5.11 ,$78.20 ,$87.40 ,$80.96 ,$69.92 ,$5.11 ,$5.11 ,$5.11 ,$67.16 ,$50.60 ,$83.72 ,$83.72 ,$73.60 ,$5.10 ,$50.60 ,$82.80 ,$4.95 ,$82.80 ,$49.68 ,$86.48 ,$11.14 ,$84.64 ,$5.42 ,$83.72 ,$4.95 ,$56.62 ,$56.62 ,$54.24 ,$68.66 ,$31.11 ,$5.00 ,$5.11 ,$87.40 ,$5.20 ,$5.11 ,$80.04 ,$4.95 ,$82.80 ,$4.95 ,$82.80 ,$82.80 ,$82.80 ,$89.24 ,$74.52 ,$85.56 ,$79.12 ,$89.24 
SACRED HEART HOSPITAL (ACU),30100166,82042,HC ALBUMIN BODY FLUID,301,1 ,$53.00 ,$39.75 ,$7.27 ,$53.00 ,$34.13 ,$7.78 ,$37.10 ,$7.27 ,$12.43 ,$7.49 ,$9.94 ,$50.35 ,$7.27 ,$42.40 ,$48.76 ,$7.27 ,$45.05 ,$50.35 ,$46.64 ,$40.28 ,$7.27 ,$7.27 ,$7.27 ,$38.69 ,$29.15 ,$48.23 ,$48.23 ,$42.40 ,$8.01 ,$29.15 ,$47.70 ,$7.78 ,$47.70 ,$28.62 ,$49.82 ,$17.51 ,$48.76 ,$7.71 ,$48.23 ,$7.78 ,$32.62 ,$32.62 ,$44.56 ,$39.55 ,$39.61 ,$7.86 ,$7.27 ,$50.35 ,$8.17 ,$7.27 ,$46.11 ,$7.78 ,$47.70 ,$7.78 ,$47.70 ,$47.70 ,$47.70 ,$51.41 ,$42.93 ,$49.29 ,$45.58 ,$51.41 
SACRED HEART HOSPITAL (ACU),30100168,82043,HC MICROALBUMIN URINE QN,301,1 ,$89.00 ,$66.75 ,$5.78 ,$89.00 ,$57.32 ,$5.78 ,$62.30 ,$5.97 ,$13.88 ,$6.15 ,$11.10 ,$84.55 ,$5.97 ,$71.20 ,$81.88 ,$5.97 ,$75.65 ,$84.55 ,$78.32 ,$67.64 ,$5.97 ,$5.97 ,$5.97 ,$64.97 ,$48.95 ,$80.99 ,$80.99 ,$71.20 ,$5.95 ,$48.95 ,$80.10 ,$5.78 ,$80.10 ,$48.06 ,$83.66 ,$13.01 ,$81.88 ,$6.33 ,$80.99 ,$5.78 ,$54.77 ,$54.77 ,$89.00 ,$66.42 ,$36.35 ,$5.84 ,$5.97 ,$84.55 ,$6.07 ,$5.97 ,$77.43 ,$5.78 ,$80.10 ,$5.78 ,$80.10 ,$80.10 ,$80.10 ,$86.33 ,$72.09 ,$82.77 ,$76.54 ,$86.33 
SACRED HEART HOSPITAL (ACU),30100170,82085,HC ALDOLASE,301,1 ,$75.00 ,$56.25 ,$9.71 ,$75.00 ,$48.30 ,$9.71 ,$52.50 ,$10.03 ,$23.31 ,$10.33 ,$18.65 ,$71.25 ,$10.03 ,$60.00 ,$69.00 ,$10.03 ,$63.75 ,$71.25 ,$66.00 ,$57.00 ,$10.03 ,$10.03 ,$10.03 ,$54.75 ,$41.25 ,$68.25 ,$68.25 ,$60.00 ,$10.00 ,$41.25 ,$67.50 ,$9.71 ,$67.50 ,$40.50 ,$70.50 ,$21.85 ,$69.00 ,$10.63 ,$68.25 ,$9.71 ,$46.16 ,$46.16 ,$71.82 ,$55.97 ,$61.05 ,$9.81 ,$10.03 ,$71.25 ,$10.20 ,$10.03 ,$65.25 ,$9.71 ,$67.50 ,$9.71 ,$67.50 ,$67.50 ,$67.50 ,$72.75 ,$60.75 ,$69.75 ,$64.50 ,$72.75 
SACRED HEART HOSPITAL (ACU),30100171,82088,HC ALDOSTERONE,301,1 ,$132.00 ,$99.00 ,$40.75 ,$132.00 ,$85.01 ,$40.75 ,$92.40 ,$42.11 ,$97.83 ,$43.37 ,$78.26 ,$125.40 ,$42.11 ,$105.60 ,$121.44 ,$42.11 ,$112.20 ,$125.40 ,$116.16 ,$100.32 ,$42.11 ,$42.11 ,$42.11 ,$96.36 ,$72.60 ,$120.12 ,$120.12 ,$105.60 ,$41.97 ,$72.60 ,$118.80 ,$40.75 ,$118.80 ,$71.28 ,$124.08 ,$91.69 ,$121.44 ,$44.64 ,$120.12 ,$40.75 ,$81.23 ,$81.23 ,$132.00 ,$98.51 ,$118.80 ,$41.16 ,$42.11 ,$125.40 ,$42.79 ,$42.11 ,$114.84 ,$40.75 ,$118.80 ,$40.75 ,$118.80 ,$118.80 ,$118.80 ,$128.04 ,$106.92 ,$122.76 ,$113.52 ,$128.04 
SACRED HEART HOSPITAL (ACU),30100172,82103,HC ALPHA-1 ANTITRYPSIN TOTAL,301,1 ,$67.00 ,$50.25 ,$13.44 ,$67.00 ,$43.15 ,$13.44 ,$46.90 ,$13.89 ,$32.25 ,$14.31 ,$25.80 ,$63.65 ,$13.89 ,$53.60 ,$61.64 ,$13.89 ,$56.95 ,$63.65 ,$58.96 ,$50.92 ,$13.89 ,$13.89 ,$13.89 ,$48.91 ,$36.85 ,$60.97 ,$60.97 ,$53.60 ,$13.84 ,$36.85 ,$60.30 ,$13.44 ,$60.30 ,$36.18 ,$62.98 ,$30.24 ,$61.64 ,$14.72 ,$60.97 ,$13.44 ,$41.23 ,$41.23 ,$67.00 ,$50.00 ,$60.30 ,$13.57 ,$13.89 ,$63.65 ,$14.11 ,$13.89 ,$58.29 ,$13.44 ,$60.30 ,$13.44 ,$60.30 ,$60.30 ,$60.30 ,$64.99 ,$54.27 ,$62.31 ,$57.62 ,$64.99 
SACRED HEART HOSPITAL (ACU),30100175,82105,HC ALPHA FETOPROTEIN SERUM,301,1 ,$56.00 ,$42.00 ,$16.77 ,$56.00 ,$36.06 ,$16.77 ,$39.20 ,$17.33 ,$40.27 ,$17.85 ,$32.21 ,$53.20 ,$17.33 ,$44.80 ,$51.52 ,$17.33 ,$47.60 ,$53.20 ,$49.28 ,$42.56 ,$17.33 ,$17.33 ,$17.33 ,$40.88 ,$30.80 ,$50.96 ,$50.96 ,$44.80 ,$17.27 ,$30.80 ,$50.40 ,$16.77 ,$50.40 ,$30.24 ,$52.64 ,$37.73 ,$51.52 ,$18.37 ,$50.96 ,$16.77 ,$34.46 ,$34.46 ,$56.00 ,$41.79 ,$50.40 ,$16.94 ,$17.33 ,$53.20 ,$17.61 ,$17.33 ,$48.72 ,$16.77 ,$50.40 ,$16.77 ,$50.40 ,$50.40 ,$50.40 ,$54.32 ,$45.36 ,$52.08 ,$48.16 ,$54.32 
SACRED HEART HOSPITAL (ACU),30100179,82108,HC ALUMINUM,301,1 ,$83.00 ,$62.25 ,$25.48 ,$83.00 ,$53.45 ,$25.48 ,$58.10 ,$26.33 ,$61.16 ,$27.12 ,$48.93 ,$78.85 ,$26.33 ,$66.40 ,$76.36 ,$26.33 ,$70.55 ,$78.85 ,$73.04 ,$63.08 ,$26.33 ,$26.33 ,$26.33 ,$60.59 ,$45.65 ,$75.53 ,$75.53 ,$66.40 ,$26.24 ,$45.65 ,$74.70 ,$25.48 ,$74.70 ,$44.82 ,$78.02 ,$57.33 ,$76.36 ,$27.91 ,$75.53 ,$25.48 ,$51.08 ,$51.08 ,$83.00 ,$61.94 ,$74.70 ,$25.73 ,$26.33 ,$78.85 ,$26.75 ,$26.33 ,$72.21 ,$25.48 ,$74.70 ,$25.48 ,$74.70 ,$74.70 ,$74.70 ,$80.51 ,$67.23 ,$77.19 ,$71.38 ,$80.51 
SACRED HEART HOSPITAL (ACU),30100182,82139,HC AMINO ACID 6+ QN PLASMA,301,1 ,$164.00 ,$123.00 ,$16.87 ,$164.00 ,$105.62 ,$16.87 ,$114.80 ,$17.43 ,$34.60 ,$17.95 ,$27.68 ,$155.80 ,$17.43 ,$131.20 ,$150.88 ,$17.43 ,$139.40 ,$155.80 ,$144.32 ,$124.64 ,$17.43 ,$17.43 ,$17.43 ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 ,$17.38 ,$90.20 ,$147.60 ,$16.87 ,$147.60 ,$88.56 ,$154.16 ,$37.96 ,$150.88 ,$18.48 ,$149.24 ,$16.87 ,$100.93 ,$100.93 ,$71.40 ,$122.39 ,$106.06 ,$17.04 ,$17.43 ,$155.80 ,$17.71 ,$17.43 ,$142.68 ,$16.87 ,$147.60 ,$16.87 ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),30100186,82140,HC AMMONIA,301,1 ,$211.00 ,$158.25 ,$14.57 ,$211.00 ,$135.88 ,$14.57 ,$147.70 ,$15.06 ,$34.98 ,$15.51 ,$27.99 ,$200.45 ,$15.06 ,$168.80 ,$194.12 ,$15.06 ,$179.35 ,$200.45 ,$185.68 ,$160.36 ,$15.06 ,$15.06 ,$15.06 ,$154.03 ,$116.05 ,$192.01 ,$192.01 ,$168.80 ,$15.01 ,$116.05 ,$189.90 ,$14.57 ,$189.90 ,$113.94 ,$198.34 ,$32.78 ,$194.12 ,$15.96 ,$192.01 ,$14.57 ,$129.85 ,$129.85 ,$118.58 ,$157.47 ,$91.60 ,$14.72 ,$15.06 ,$200.45 ,$15.30 ,$15.06 ,$183.57 ,$14.57 ,$189.90 ,$14.57 ,$189.90 ,$189.90 ,$189.90 ,$204.67 ,$170.91 ,$196.23 ,$181.46 ,$204.67 
SACRED HEART HOSPITAL (ACU),30100187,80324,HC AMPHETAMINE,301,1 ,$71.00 ,$53.25 ,$3.94 ,$71.00 ,$45.72 , N/A ,$49.70 ,$3.94 ,$41.42 ,$4.06 ,$33.14 ,$67.45 ,$3.94 ,$56.80 ,$65.32 ,$3.94 ,$60.35 ,$67.45 ,$62.48 ,$53.96 ,$3.94 ,$3.94 ,$3.94 ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 , N/A ,$39.05 ,$63.90 , N/A ,$63.90 ,$38.34 ,$66.74 , N/A ,$65.32 ,$4.18 ,$64.61 , N/A ,$43.69 ,$43.69 ,$47.23 ,$52.99 ,$49.45 , N/A ,$3.94 ,$67.45 , N/A ,$3.94 ,$61.77 , N/A ,$63.90 , N/A ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),30100188,82150,HC AMYLASE,301,1 ,$160.00 ,$120.00 ,$6.48 ,$160.00 ,$103.04 ,$6.48 ,$112.00 ,$6.70 ,$15.56 ,$6.90 ,$12.45 ,$152.00 ,$6.70 ,$128.00 ,$147.20 ,$6.70 ,$136.00 ,$152.00 ,$140.80 ,$121.60 ,$6.70 ,$6.70 ,$6.70 ,$116.80 ,$88.00 ,$145.60 ,$145.60 ,$128.00 ,$6.67 ,$88.00 ,$144.00 ,$6.48 ,$144.00 ,$86.40 ,$150.40 ,$14.58 ,$147.20 ,$7.10 ,$145.60 ,$6.48 ,$98.46 ,$98.46 ,$59.25 ,$119.41 ,$40.73 ,$6.54 ,$6.70 ,$152.00 ,$6.80 ,$6.70 ,$139.20 ,$6.48 ,$144.00 ,$6.48 ,$144.00 ,$144.00 ,$144.00 ,$155.20 ,$129.60 ,$148.80 ,$137.60 ,$155.20 
SACRED HEART HOSPITAL (ACU),30100189,82157,HC ANDROSTENEDIONE,301,1 ,$227.00 ,$170.25 ,$29.28 ,$227.00 ,$146.19 ,$29.28 ,$158.90 ,$30.26 ,$70.28 ,$31.17 ,$56.22 ,$215.65 ,$30.26 ,$181.60 ,$208.84 ,$30.26 ,$192.95 ,$215.65 ,$199.76 ,$172.52 ,$30.26 ,$30.26 ,$30.26 ,$165.71 ,$124.85 ,$206.57 ,$206.57 ,$181.60 ,$30.16 ,$124.85 ,$204.30 ,$29.28 ,$204.30 ,$122.58 ,$213.38 ,$65.88 ,$208.84 ,$32.08 ,$206.57 ,$29.28 ,$139.70 ,$139.70 ,$227.00 ,$169.41 ,$184.01 ,$29.57 ,$30.26 ,$215.65 ,$30.74 ,$30.26 ,$197.49 ,$29.28 ,$204.30 ,$29.28 ,$204.30 ,$204.30 ,$204.30 ,$220.19 ,$183.87 ,$211.11 ,$195.22 ,$220.19 
SACRED HEART HOSPITAL (ACU),30100191,82164,HC ANGIOTENSIN 1 ENZYME (ACE),301,1 ,$67.00 ,$50.25 ,$14.60 ,$67.00 ,$43.15 ,$14.60 ,$46.90 ,$15.09 ,$35.05 ,$15.54 ,$28.04 ,$63.65 ,$15.09 ,$53.60 ,$61.64 ,$15.09 ,$56.95 ,$63.65 ,$58.96 ,$50.92 ,$15.09 ,$15.09 ,$15.09 ,$48.91 ,$36.85 ,$60.97 ,$60.97 ,$53.60 ,$15.04 ,$36.85 ,$60.30 ,$14.60 ,$60.30 ,$36.18 ,$62.98 ,$32.85 ,$61.64 ,$16.00 ,$60.97 ,$14.60 ,$41.23 ,$41.23 ,$67.00 ,$50.00 ,$60.30 ,$14.75 ,$15.09 ,$63.65 ,$15.33 ,$15.09 ,$58.29 ,$14.60 ,$60.30 ,$14.60 ,$60.30 ,$60.30 ,$60.30 ,$64.99 ,$54.27 ,$62.31 ,$57.62 ,$64.99 
SACRED HEART HOSPITAL (ACU),30100192,82172,HC APOLIPOPROTEIN SERUM,301,1 ,$56.00 ,$42.00 ,$21.09 ,$56.00 ,$36.06 ,$21.09 ,$39.20 ,$21.79 ,$37.21 ,$22.44 ,$29.76 ,$53.20 ,$21.79 ,$44.80 ,$51.52 ,$21.79 ,$47.60 ,$53.20 ,$49.28 ,$42.56 ,$21.79 ,$21.79 ,$21.79 ,$40.88 ,$30.80 ,$50.96 ,$50.96 ,$44.80 ,$21.72 ,$30.80 ,$50.40 ,$21.09 ,$50.40 ,$30.24 ,$52.64 ,$47.45 ,$51.52 ,$23.10 ,$50.96 ,$21.09 ,$34.46 ,$34.46 ,$56.00 ,$41.79 ,$50.40 ,$21.30 ,$21.79 ,$53.20 ,$22.14 ,$21.79 ,$48.72 ,$21.09 ,$50.40 ,$21.09 ,$50.40 ,$50.40 ,$50.40 ,$54.32 ,$45.36 ,$52.08 ,$48.16 ,$54.32 
SACRED HEART HOSPITAL (ACU),30100193,82175,HC ARSENIC,301,1 ,$62.00 ,$46.50 ,$18.97 ,$62.00 ,$39.93 ,$18.97 ,$43.40 ,$19.60 ,$45.54 ,$20.19 ,$36.43 ,$58.90 ,$19.60 ,$49.60 ,$57.04 ,$19.60 ,$52.70 ,$58.90 ,$54.56 ,$47.12 ,$19.60 ,$19.60 ,$19.60 ,$45.26 ,$34.10 ,$56.42 ,$56.42 ,$49.60 ,$19.54 ,$34.10 ,$55.80 ,$18.97 ,$55.80 ,$33.48 ,$58.28 ,$42.68 ,$57.04 ,$20.78 ,$56.42 ,$18.97 ,$38.15 ,$38.15 ,$62.00 ,$46.27 ,$55.80 ,$19.16 ,$19.60 ,$58.90 ,$19.92 ,$19.60 ,$53.94 ,$18.97 ,$55.80 ,$18.97 ,$55.80 ,$55.80 ,$55.80 ,$60.14 ,$50.22 ,$57.66 ,$53.32 ,$60.14 
SACRED HEART HOSPITAL (ACU),30100197,82180,HC VITAMIN C (ASCORBIC ACID),301,1 ,$225.00 ,$168.75 ,$9.89 ,$225.00 ,$144.90 ,$9.89 ,$157.50 ,$10.22 ,$23.73 ,$10.53 ,$18.98 ,$213.75 ,$10.22 ,$180.00 ,$207.00 ,$10.22 ,$191.25 ,$213.75 ,$198.00 ,$171.00 ,$10.22 ,$10.22 ,$10.22 ,$164.25 ,$123.75 ,$204.75 ,$204.75 ,$180.00 ,$10.19 ,$123.75 ,$202.50 ,$9.89 ,$202.50 ,$121.50 ,$211.50 ,$22.25 ,$207.00 ,$10.83 ,$204.75 ,$9.89 ,$138.47 ,$138.47 ,$122.98 ,$167.92 ,$62.12 ,$9.99 ,$10.22 ,$213.75 ,$10.38 ,$10.22 ,$195.75 ,$9.89 ,$202.50 ,$9.89 ,$202.50 ,$202.50 ,$202.50 ,$218.25 ,$182.25 ,$209.25 ,$193.50 ,$218.25 
SACRED HEART HOSPITAL (ACU),30100201,82232,HC BETA 2 MICROGLOBULIN,301,1 ,$65.00 ,$48.75 ,$16.18 ,$65.00 ,$41.86 ,$16.18 ,$45.50 ,$16.72 ,$38.83 ,$17.22 ,$31.07 ,$61.75 ,$16.72 ,$52.00 ,$59.80 ,$16.72 ,$55.25 ,$61.75 ,$57.20 ,$49.40 ,$16.72 ,$16.72 ,$16.72 ,$47.45 ,$35.75 ,$59.15 ,$59.15 ,$52.00 ,$16.67 ,$35.75 ,$58.50 ,$16.18 ,$58.50 ,$35.10 ,$61.10 ,$36.41 ,$59.80 ,$17.72 ,$59.15 ,$16.18 ,$40.00 ,$40.00 ,$61.49 ,$48.51 ,$58.50 ,$16.34 ,$16.72 ,$61.75 ,$16.99 ,$16.72 ,$56.55 ,$16.18 ,$58.50 ,$16.18 ,$58.50 ,$58.50 ,$58.50 ,$63.05 ,$52.65 ,$60.45 ,$55.90 ,$63.05 
SACRED HEART HOSPITAL (ACU),30100202,82247,HC BILIRUBIN TOTAL,301,1 ,$105.00 ,$78.75 ,$4.24 ,$105.00 ,$67.62 ,$5.02 ,$73.50 ,$4.24 ,$12.04 ,$4.37 ,$9.63 ,$99.75 ,$4.24 ,$84.00 ,$96.60 ,$4.24 ,$89.25 ,$99.75 ,$92.40 ,$79.80 ,$4.24 ,$4.24 ,$4.24 ,$76.65 ,$57.75 ,$95.55 ,$95.55 ,$84.00 ,$5.17 ,$57.75 ,$94.50 ,$5.02 ,$94.50 ,$56.70 ,$98.70 ,$11.30 ,$96.60 ,$4.49 ,$95.55 ,$5.02 ,$64.62 ,$64.62 ,$21.33 ,$78.36 ,$31.52 ,$5.07 ,$4.24 ,$99.75 ,$5.27 ,$4.24 ,$91.35 ,$5.02 ,$94.50 ,$5.02 ,$94.50 ,$94.50 ,$94.50 ,$101.85 ,$85.05 ,$97.65 ,$90.30 ,$101.85 
SACRED HEART HOSPITAL (ACU),30100203,82248,HC BILIRUBIN DIRECT,301,1 ,$105.00 ,$78.75 ,$4.70 ,$105.00 ,$67.62 ,$5.02 ,$73.50 ,$4.70 ,$12.04 ,$4.84 ,$9.63 ,$99.75 ,$4.70 ,$84.00 ,$96.60 ,$4.70 ,$89.25 ,$99.75 ,$92.40 ,$79.80 ,$4.70 ,$4.70 ,$4.70 ,$76.65 ,$57.75 ,$95.55 ,$95.55 ,$84.00 ,$5.17 ,$57.75 ,$94.50 ,$5.02 ,$94.50 ,$56.70 ,$98.70 ,$11.30 ,$96.60 ,$4.98 ,$95.55 ,$5.02 ,$64.62 ,$64.62 ,$21.33 ,$78.36 ,$31.52 ,$5.07 ,$4.70 ,$99.75 ,$5.27 ,$4.70 ,$91.35 ,$5.02 ,$94.50 ,$5.02 ,$94.50 ,$94.50 ,$94.50 ,$101.85 ,$85.05 ,$97.65 ,$90.30 ,$101.85 
SACRED HEART HOSPITAL (ACU),30100205,82270,HC OCCULT BLOOD FECAL SCRN,301,1 ,$57.00 ,$42.75 ,$3.66 ,$57.00 ,$36.71 ,$4.38 ,$39.90 ,$3.66 ,$7.81 ,$3.77 ,$6.24 ,$54.15 ,$3.66 ,$45.60 ,$52.44 ,$3.66 ,$48.45 ,$54.15 ,$50.16 ,$43.32 ,$3.66 ,$3.66 ,$3.66 ,$41.61 ,$31.35 ,$51.87 ,$51.87 ,$45.60 ,$4.51 ,$31.35 ,$51.30 ,$4.38 ,$51.30 ,$30.78 ,$53.58 ,$9.86 ,$52.44 ,$3.88 ,$51.87 ,$4.38 ,$35.08 ,$35.08 ,$43.91 ,$42.54 ,$22.30 ,$4.42 ,$3.66 ,$54.15 ,$4.60 ,$3.66 ,$49.59 ,$4.38 ,$51.30 ,$4.38 ,$51.30 ,$51.30 ,$51.30 ,$55.29 ,$46.17 ,$53.01 ,$49.02 ,$55.29 
SACRED HEART HOSPITAL (ACU),30100206,82271,HC OCCULT BLOOD GASTRIC,301,1 ,$58.00 ,$43.50 ,$4.26 ,$58.00 ,$37.35 ,$5.32 ,$40.60 ,$4.26 ,$7.81 ,$4.39 ,$6.24 ,$55.10 ,$4.26 ,$46.40 ,$53.36 ,$4.26 ,$49.30 ,$55.10 ,$51.04 ,$44.08 ,$4.26 ,$4.26 ,$4.26 ,$42.34 ,$31.90 ,$52.78 ,$52.78 ,$46.40 ,$5.48 ,$31.90 ,$52.20 ,$5.32 ,$52.20 ,$31.32 ,$54.52 ,$11.97 ,$53.36 ,$4.52 ,$52.78 ,$5.32 ,$35.69 ,$35.69 ,$10.01 ,$43.29 ,$27.09 ,$5.37 ,$4.26 ,$55.10 ,$5.59 ,$4.26 ,$50.46 ,$5.32 ,$52.20 ,$5.32 ,$52.20 ,$52.20 ,$52.20 ,$56.26 ,$46.98 ,$53.94 ,$49.88 ,$56.26 
SACRED HEART HOSPITAL (ACU),30100207,82272,HC OCCULT BLOOD FECAL DIAG,301,1 ,$57.00 ,$42.75 ,$4.23 ,$57.00 ,$36.71 ,$4.23 ,$39.90 ,$4.26 ,$7.81 ,$4.39 ,$6.24 ,$54.15 ,$4.26 ,$45.60 ,$52.44 ,$4.26 ,$48.45 ,$54.15 ,$50.16 ,$43.32 ,$4.26 ,$4.26 ,$4.26 ,$41.61 ,$31.35 ,$51.87 ,$51.87 ,$45.60 ,$4.36 ,$31.35 ,$51.30 ,$4.23 ,$51.30 ,$30.78 ,$53.58 ,$9.52 ,$52.44 ,$4.52 ,$51.87 ,$4.23 ,$35.08 ,$35.08 ,$10.01 ,$42.54 ,$21.54 ,$4.27 ,$4.26 ,$54.15 ,$4.44 ,$4.26 ,$49.59 ,$4.23 ,$51.30 ,$4.23 ,$51.30 ,$51.30 ,$51.30 ,$55.29 ,$46.17 ,$53.01 ,$49.02 ,$55.29 
SACRED HEART HOSPITAL (ACU),30100212,82306,HC VITAMIN D 25 OH,301,1 ,$99.00 ,$74.25 ,$29.60 ,$99.00 ,$63.76 ,$29.60 ,$69.30 ,$30.59 ,$71.07 ,$31.51 ,$56.85 ,$94.05 ,$30.59 ,$79.20 ,$91.08 ,$30.59 ,$84.15 ,$94.05 ,$87.12 ,$75.24 ,$30.59 ,$30.59 ,$30.59 ,$72.27 ,$54.45 ,$90.09 ,$90.09 ,$79.20 ,$30.49 ,$54.45 ,$89.10 ,$29.60 ,$89.10 ,$53.46 ,$93.06 ,$66.60 ,$91.08 ,$32.43 ,$90.09 ,$29.60 ,$60.92 ,$60.92 ,$57.99 ,$73.88 ,$89.10 ,$29.90 ,$30.59 ,$94.05 ,$31.08 ,$30.59 ,$86.13 ,$29.60 ,$89.10 ,$29.60 ,$89.10 ,$89.10 ,$89.10 ,$96.03 ,$80.19 ,$92.07 ,$85.14 ,$96.03 
SACRED HEART HOSPITAL (ACU),30100213,82308,HC CALCITONIN,301,1 ,$87.00 ,$65.25 ,$26.79 ,$87.00 ,$56.03 ,$26.79 ,$60.90 ,$27.68 ,$64.31 ,$28.51 ,$51.45 ,$82.65 ,$27.68 ,$69.60 ,$80.04 ,$27.68 ,$73.95 ,$82.65 ,$76.56 ,$66.12 ,$27.68 ,$27.68 ,$27.68 ,$63.51 ,$47.85 ,$79.17 ,$79.17 ,$69.60 ,$27.59 ,$47.85 ,$78.30 ,$26.79 ,$78.30 ,$46.98 ,$81.78 ,$60.28 ,$80.04 ,$29.34 ,$79.17 ,$26.79 ,$53.54 ,$53.54 ,$87.00 ,$64.93 ,$78.30 ,$27.06 ,$27.68 ,$82.65 ,$28.13 ,$27.68 ,$75.69 ,$26.79 ,$78.30 ,$26.79 ,$78.30 ,$78.30 ,$78.30 ,$84.39 ,$70.47 ,$80.91 ,$74.82 ,$84.39 
SACRED HEART HOSPITAL (ACU),30100214,82310,HC CALCIUM,301,1 ,$105.00 ,$78.75 ,$5.16 ,$105.00 ,$67.62 ,$5.16 ,$73.50 ,$5.33 ,$12.39 ,$5.49 ,$9.91 ,$99.75 ,$5.33 ,$84.00 ,$96.60 ,$5.33 ,$89.25 ,$99.75 ,$92.40 ,$79.80 ,$5.33 ,$5.33 ,$5.33 ,$76.65 ,$57.75 ,$95.55 ,$95.55 ,$84.00 ,$5.31 ,$57.75 ,$94.50 ,$5.16 ,$94.50 ,$56.70 ,$98.70 ,$11.61 ,$96.60 ,$5.65 ,$95.55 ,$5.16 ,$64.62 ,$64.62 ,$49.41 ,$78.36 ,$32.43 ,$5.21 ,$5.33 ,$99.75 ,$5.42 ,$5.33 ,$91.35 ,$5.16 ,$94.50 ,$5.16 ,$94.50 ,$94.50 ,$94.50 ,$101.85 ,$85.05 ,$97.65 ,$90.30 ,$101.85 
SACRED HEART HOSPITAL (ACU),30100215,82330,HC CALCIUM IONIZED,301,1 ,$123.00 ,$92.25 ,$13.68 ,$123.00 ,$79.21 ,$13.68 ,$86.10 ,$14.14 ,$32.83 ,$14.56 ,$26.26 ,$116.85 ,$14.14 ,$98.40 ,$113.16 ,$14.14 ,$104.55 ,$116.85 ,$108.24 ,$93.48 ,$14.14 ,$14.14 ,$14.14 ,$89.79 ,$67.65 ,$111.93 ,$111.93 ,$98.40 ,$14.09 ,$67.65 ,$110.70 ,$13.68 ,$110.70 ,$66.42 ,$115.62 ,$30.78 ,$113.16 ,$14.99 ,$111.93 ,$13.68 ,$75.69 ,$75.69 ,$87.89 ,$91.79 ,$85.95 ,$13.82 ,$14.14 ,$116.85 ,$14.36 ,$14.14 ,$107.01 ,$13.68 ,$110.70 ,$13.68 ,$110.70 ,$110.70 ,$110.70 ,$119.31 ,$99.63 ,$114.39 ,$105.78 ,$119.31 
SACRED HEART HOSPITAL (ACU),30100216,82340,HC CALCIUM URINE QN TIMED,301,1 ,$112.00 ,$84.00 ,$6.03 ,$112.00 ,$72.13 ,$6.03 ,$78.40 ,$6.23 ,$14.47 ,$6.42 ,$11.58 ,$106.40 ,$6.23 ,$89.60 ,$103.04 ,$6.23 ,$95.20 ,$106.40 ,$98.56 ,$85.12 ,$6.23 ,$6.23 ,$6.23 ,$81.76 ,$61.60 ,$101.92 ,$101.92 ,$89.60 ,$6.21 ,$61.60 ,$100.80 ,$6.03 ,$100.80 ,$60.48 ,$105.28 ,$13.57 ,$103.04 ,$6.60 ,$101.92 ,$6.03 ,$68.92 ,$68.92 ,$49.41 ,$83.59 ,$37.88 ,$6.09 ,$6.23 ,$106.40 ,$6.33 ,$6.23 ,$97.44 ,$6.03 ,$100.80 ,$6.03 ,$100.80 ,$100.80 ,$100.80 ,$108.64 ,$90.72 ,$104.16 ,$96.32 ,$108.64 
SACRED HEART HOSPITAL (ACU),30100222,82374,HC BICARBONATE,301,1 ,$94.00 ,$70.50 ,$4.88 ,$94.00 ,$60.54 ,$4.88 ,$65.80 ,$5.04 ,$11.73 ,$5.19 ,$9.38 ,$89.30 ,$5.04 ,$75.20 ,$86.48 ,$5.04 ,$79.90 ,$89.30 ,$82.72 ,$71.44 ,$5.04 ,$5.04 ,$5.04 ,$68.62 ,$51.70 ,$85.54 ,$85.54 ,$75.20 ,$5.03 ,$51.70 ,$84.60 ,$4.88 ,$84.60 ,$50.76 ,$88.36 ,$10.98 ,$86.48 ,$5.34 ,$85.54 ,$4.88 ,$57.85 ,$57.85 ,$49.41 ,$70.15 ,$30.70 ,$4.93 ,$5.04 ,$89.30 ,$5.12 ,$5.04 ,$81.78 ,$4.88 ,$84.60 ,$4.88 ,$84.60 ,$84.60 ,$84.60 ,$91.18 ,$76.14 ,$87.42 ,$80.84 ,$91.18 
SACRED HEART HOSPITAL (ACU),30100224,82375,HC CARBON MONOXIDE,301,1 ,$149.00 ,$111.75 ,$12.32 ,$149.00 ,$95.96 ,$12.32 ,$104.30 ,$12.73 ,$29.58 ,$13.11 ,$23.66 ,$141.55 ,$12.73 ,$119.20 ,$137.08 ,$12.73 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$12.73 ,$12.73 ,$12.73 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,$12.69 ,$81.95 ,$134.10 ,$12.32 ,$134.10 ,$80.46 ,$140.06 ,$27.72 ,$137.08 ,$13.49 ,$135.59 ,$12.32 ,$91.69 ,$91.69 ,$59.95 ,$111.20 ,$77.44 ,$12.44 ,$12.73 ,$141.55 ,$12.94 ,$12.73 ,$129.63 ,$12.32 ,$134.10 ,$12.32 ,$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),30100226,82378,HC CARBINOEMBRYONIC AG (CEA),301,1 ,$93.00 ,$69.75 ,$18.96 ,$93.00 ,$59.89 ,$18.96 ,$65.10 ,$19.59 ,$45.52 ,$20.18 ,$36.41 ,$88.35 ,$19.59 ,$74.40 ,$85.56 ,$19.59 ,$79.05 ,$88.35 ,$81.84 ,$70.68 ,$19.59 ,$19.59 ,$19.59 ,$67.89 ,$51.15 ,$84.63 ,$84.63 ,$74.40 ,$19.53 ,$51.15 ,$83.70 ,$18.96 ,$83.70 ,$50.22 ,$87.42 ,$42.66 ,$85.56 ,$20.77 ,$84.63 ,$18.96 ,$57.23 ,$57.23 ,$93.00 ,$69.41 ,$83.70 ,$19.15 ,$19.59 ,$88.35 ,$19.91 ,$19.59 ,$80.91 ,$18.96 ,$83.70 ,$18.96 ,$83.70 ,$83.70 ,$83.70 ,$90.21 ,$75.33 ,$86.49 ,$79.98 ,$90.21 
SACRED HEART HOSPITAL (ACU),30100231,82380,HC CAROTENE,301,1 ,$39.00 ,$29.25 ,$9.22 ,$39.00 ,$25.12 ,$9.22 ,$27.30 ,$9.53 ,$22.14 ,$9.82 ,$17.71 ,$37.05 ,$9.53 ,$31.20 ,$35.88 ,$9.53 ,$33.15 ,$37.05 ,$34.32 ,$29.64 ,$9.53 ,$9.53 ,$9.53 ,$28.47 ,$21.45 ,$35.49 ,$35.49 ,$31.20 ,$9.50 ,$21.45 ,$35.10 ,$9.22 ,$35.10 ,$21.06 ,$36.66 ,$20.75 ,$35.88 ,$10.10 ,$35.49 ,$9.22 ,$24.00 ,$24.00 ,$39.00 ,$29.11 ,$35.10 ,$9.31 ,$9.53 ,$37.05 ,$9.68 ,$9.53 ,$33.93 ,$9.22 ,$35.10 ,$9.22 ,$35.10 ,$35.10 ,$35.10 ,$37.83 ,$31.59 ,$36.27 ,$33.54 ,$37.83 
SACRED HEART HOSPITAL (ACU),30100232,82384,HC CATECHOLAMINE FRACTION,301,1 ,$143.00 ,$107.25 ,$25.25 ,$143.00 ,$92.09 ,$25.25 ,$100.10 ,$26.09 ,$60.62 ,$26.87 ,$48.50 ,$135.85 ,$26.09 ,$114.40 ,$131.56 ,$26.09 ,$121.55 ,$135.85 ,$125.84 ,$108.68 ,$26.09 ,$26.09 ,$26.09 ,$104.39 ,$78.65 ,$130.13 ,$130.13 ,$114.40 ,$26.01 ,$78.65 ,$128.70 ,$25.25 ,$128.70 ,$77.22 ,$134.42 ,$56.81 ,$131.56 ,$27.66 ,$130.13 ,$25.25 ,$88.00 ,$88.00 ,$143.00 ,$106.72 ,$128.70 ,$25.50 ,$26.09 ,$135.85 ,$26.51 ,$26.09 ,$124.41 ,$25.25 ,$128.70 ,$25.25 ,$128.70 ,$128.70 ,$128.70 ,$138.71 ,$115.83 ,$132.99 ,$122.98 ,$138.71 
SACRED HEART HOSPITAL (ACU),30100235,82390,HC CERULOPLASMIN,301,1 ,$63.00 ,$47.25 ,$10.74 ,$63.00 ,$40.57 ,$10.74 ,$44.10 ,$11.10 ,$25.78 ,$11.43 ,$20.62 ,$59.85 ,$11.10 ,$50.40 ,$57.96 ,$11.10 ,$53.55 ,$59.85 ,$55.44 ,$47.88 ,$11.10 ,$11.10 ,$11.10 ,$45.99 ,$34.65 ,$57.33 ,$57.33 ,$50.40 ,$11.06 ,$34.65 ,$56.70 ,$10.74 ,$56.70 ,$34.02 ,$59.22 ,$24.17 ,$57.96 ,$11.77 ,$57.33 ,$10.74 ,$38.77 ,$38.77 ,$63.00 ,$47.02 ,$56.70 ,$10.85 ,$11.10 ,$59.85 ,$11.28 ,$11.10 ,$54.81 ,$10.74 ,$56.70 ,$10.74 ,$56.70 ,$56.70 ,$56.70 ,$61.11 ,$51.03 ,$58.59 ,$54.18 ,$61.11 
SACRED HEART HOSPITAL (ACU),30100236,82397,HC CHEMILUMINESCENT ASSAY,301,1 ,$46.00 ,$34.50 ,$14.12 ,$46.00 ,$29.62 ,$14.12 ,$32.20 ,$14.59 ,$33.90 ,$15.03 ,$27.12 ,$43.70 ,$14.59 ,$36.80 ,$42.32 ,$14.59 ,$39.10 ,$43.70 ,$40.48 ,$34.96 ,$14.59 ,$14.59 ,$14.59 ,$33.58 ,$25.30 ,$41.86 ,$41.86 ,$36.80 ,$14.54 ,$25.30 ,$41.40 ,$14.12 ,$41.40 ,$24.84 ,$43.24 ,$31.77 ,$42.32 ,$15.47 ,$41.86 ,$14.12 ,$28.31 ,$28.31 ,$46.00 ,$34.33 ,$41.40 ,$14.26 ,$14.59 ,$43.70 ,$14.83 ,$14.59 ,$40.02 ,$14.12 ,$41.40 ,$14.12 ,$41.40 ,$41.40 ,$41.40 ,$44.62 ,$37.26 ,$42.78 ,$39.56 ,$44.62 
SACRED HEART HOSPITAL (ACU),30100237,82435,HC CHLORIDE,301,1 ,$87.00 ,$65.25 ,$4.60 ,$87.00 ,$56.03 ,$4.60 ,$60.90 ,$4.75 ,$11.04 ,$4.89 ,$8.83 ,$82.65 ,$4.75 ,$69.60 ,$80.04 ,$4.75 ,$73.95 ,$82.65 ,$76.56 ,$66.12 ,$4.75 ,$4.75 ,$4.75 ,$63.51 ,$47.85 ,$79.17 ,$79.17 ,$69.60 ,$4.74 ,$47.85 ,$78.30 ,$4.60 ,$78.30 ,$46.98 ,$81.78 ,$10.35 ,$80.04 ,$5.04 ,$79.17 ,$4.60 ,$53.54 ,$53.54 ,$49.41 ,$64.93 ,$28.92 ,$4.65 ,$4.75 ,$82.65 ,$4.83 ,$4.75 ,$75.69 ,$4.60 ,$78.30 ,$4.60 ,$78.30 ,$78.30 ,$78.30 ,$84.39 ,$70.47 ,$80.91 ,$74.82 ,$84.39 
SACRED HEART HOSPITAL (ACU),30100238,82436,HC CHLORIDE URINE,301,1 ,$93.00 ,$69.75 ,$5.75 ,$93.00 ,$59.89 ,$5.75 ,$65.10 ,$5.94 ,$12.08 ,$6.12 ,$9.66 ,$88.35 ,$5.94 ,$74.40 ,$85.56 ,$5.94 ,$79.05 ,$88.35 ,$81.84 ,$70.68 ,$5.94 ,$5.94 ,$5.94 ,$67.89 ,$51.15 ,$84.63 ,$84.63 ,$74.40 ,$5.92 ,$51.15 ,$83.70 ,$5.75 ,$83.70 ,$50.22 ,$87.42 ,$12.94 ,$85.56 ,$6.30 ,$84.63 ,$5.75 ,$57.23 ,$57.23 ,$36.04 ,$69.41 ,$31.62 ,$5.81 ,$5.94 ,$88.35 ,$6.04 ,$5.94 ,$80.91 ,$5.75 ,$83.70 ,$5.75 ,$83.70 ,$83.70 ,$83.70 ,$90.21 ,$75.33 ,$86.49 ,$79.98 ,$90.21 
SACRED HEART HOSPITAL (ACU),30100240,82438,HC CHLORIDE OTHER SOURCE,301,1 ,$90.00 ,$67.50 ,$5.00 ,$90.00 ,$57.96 ,$5.00 ,$63.00 ,$5.17 ,$11.73 ,$5.33 ,$9.38 ,$85.50 ,$5.17 ,$72.00 ,$82.80 ,$5.17 ,$76.50 ,$85.50 ,$79.20 ,$68.40 ,$5.17 ,$5.17 ,$5.17 ,$65.70 ,$49.50 ,$81.90 ,$81.90 ,$72.00 ,$5.15 ,$49.50 ,$81.00 ,$5.00 ,$81.00 ,$48.60 ,$84.60 ,$11.25 ,$82.80 ,$5.48 ,$81.90 ,$5.00 ,$55.39 ,$55.39 ,$53.78 ,$67.17 ,$30.70 ,$5.05 ,$5.17 ,$85.50 ,$5.25 ,$5.17 ,$78.30 ,$5.00 ,$81.00 ,$5.00 ,$81.00 ,$81.00 ,$81.00 ,$87.30 ,$72.90 ,$83.70 ,$77.40 ,$87.30 
SACRED HEART HOSPITAL (ACU),30100241,82465,HC CHOLESTEROL,301,1 ,$98.00 ,$73.50 ,$4.35 ,$98.00 ,$63.11 ,$4.35 ,$68.60 ,$4.49 ,$10.45 ,$4.62 ,$8.36 ,$93.10 ,$4.49 ,$78.40 ,$90.16 ,$4.49 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$4.49 ,$4.49 ,$4.49 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$4.48 ,$53.90 ,$88.20 ,$4.35 ,$88.20 ,$52.92 ,$92.12 ,$9.79 ,$90.16 ,$4.76 ,$89.18 ,$4.35 ,$60.31 ,$60.31 ,$50.50 ,$73.14 ,$27.34 ,$4.39 ,$4.49 ,$93.10 ,$4.57 ,$4.49 ,$85.26 ,$4.35 ,$88.20 ,$4.35 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),30100242,82542,HC CHROMATO QN SGL COLUMN,301,1 ,$145.00 ,$108.75 ,$24.09 ,$145.00 ,$93.38 ,$24.09 ,$101.50 ,$24.89 ,$43.35 ,$25.64 ,$34.68 ,$137.75 ,$24.89 ,$116.00 ,$133.40 ,$24.89 ,$123.25 ,$137.75 ,$127.60 ,$110.20 ,$24.89 ,$24.89 ,$24.89 ,$105.85 ,$79.75 ,$131.95 ,$131.95 ,$116.00 ,$24.81 ,$79.75 ,$130.50 ,$24.09 ,$130.50 ,$78.30 ,$136.30 ,$54.20 ,$133.40 ,$26.38 ,$131.95 ,$24.09 ,$89.23 ,$89.23 ,$76.74 ,$108.21 ,$122.66 ,$24.33 ,$24.89 ,$137.75 ,$25.29 ,$24.89 ,$126.15 ,$24.09 ,$130.50 ,$24.09 ,$130.50 ,$130.50 ,$130.50 ,$140.65 ,$117.45 ,$134.85 ,$124.70 ,$140.65 
SACRED HEART HOSPITAL (ACU),30100243,80299,HC CHROMATO QN MLT COLUMN,301,1 ,$86.19 ,$64.64 ,$18.64 ,$86.19 ,$55.51 ,$18.64 ,$60.33 ,$19.26 ,$32.88 ,$19.84 ,$26.31 ,$81.88 ,$19.26 ,$68.95 ,$79.29 ,$19.26 ,$73.26 ,$81.88 ,$75.85 ,$65.50 ,$19.26 ,$19.26 ,$19.26 ,$62.92 ,$47.40 ,$78.43 ,$78.43 ,$68.95 ,$19.20 ,$47.40 ,$77.57 ,$18.64 ,$77.57 ,$46.54 ,$81.02 ,$41.94 ,$79.29 ,$20.42 ,$78.43 ,$18.64 ,$53.04 ,$53.04 ,$86.19 ,$64.32 ,$77.57 ,$18.83 ,$19.26 ,$81.88 ,$19.57 ,$19.26 ,$74.99 ,$18.64 ,$77.57 ,$18.64 ,$77.57 ,$77.57 ,$77.57 ,$83.60 ,$69.81 ,$80.16 ,$74.12 ,$83.60 
SACRED HEART HOSPITAL (ACU),30100245,82495,HC CHROMIUM SERUM,301,1 ,$69.00 ,$51.75 ,$10.23 ,$69.00 ,$44.44 ,$20.28 ,$48.30 ,$10.23 ,$17.47 ,$10.54 ,$13.97 ,$65.55 ,$10.23 ,$55.20 ,$63.48 ,$10.23 ,$58.65 ,$65.55 ,$60.72 ,$52.44 ,$10.23 ,$10.23 ,$10.23 ,$50.37 ,$37.95 ,$62.79 ,$62.79 ,$55.20 ,$20.89 ,$37.95 ,$62.10 ,$20.28 ,$62.10 ,$37.26 ,$64.86 ,$45.63 ,$63.48 ,$10.84 ,$62.79 ,$20.28 ,$42.46 ,$42.46 ,$46.55 ,$51.49 ,$62.10 ,$20.48 ,$10.23 ,$65.55 ,$21.29 ,$10.23 ,$60.03 ,$20.28 ,$62.10 ,$20.28 ,$62.10 ,$62.10 ,$62.10 ,$66.93 ,$55.89 ,$64.17 ,$59.34 ,$66.93 
SACRED HEART HOSPITAL (ACU),30100246,82507,HC CITRATE,301,1 ,$115.00 ,$86.25 ,$27.80 ,$115.00 ,$74.06 ,$27.80 ,$80.50 ,$28.73 ,$66.75 ,$29.59 ,$53.40 ,$109.25 ,$28.73 ,$92.00 ,$105.80 ,$28.73 ,$97.75 ,$109.25 ,$101.20 ,$87.40 ,$28.73 ,$28.73 ,$28.73 ,$83.95 ,$63.25 ,$104.65 ,$104.65 ,$92.00 ,$28.63 ,$63.25 ,$103.50 ,$27.80 ,$103.50 ,$62.10 ,$108.10 ,$62.55 ,$105.80 ,$30.45 ,$104.65 ,$27.80 ,$70.77 ,$70.77 ,$115.00 ,$85.82 ,$103.50 ,$28.08 ,$28.73 ,$109.25 ,$29.19 ,$28.73 ,$100.05 ,$27.80 ,$103.50 ,$27.80 ,$103.50 ,$103.50 ,$103.50 ,$111.55 ,$93.15 ,$106.95 ,$98.90 ,$111.55 
SACRED HEART HOSPITAL (ACU),30100252,82525,HC COPPER,301,1 ,$91.00 ,$68.25 ,$12.41 ,$91.00 ,$58.60 ,$12.41 ,$63.70 ,$12.82 ,$24.64 ,$13.20 ,$19.71 ,$86.45 ,$12.82 ,$72.80 ,$83.72 ,$12.82 ,$77.35 ,$86.45 ,$80.08 ,$69.16 ,$12.82 ,$12.82 ,$12.82 ,$66.43 ,$50.05 ,$82.81 ,$82.81 ,$72.80 ,$12.78 ,$50.05 ,$81.90 ,$12.41 ,$81.90 ,$49.14 ,$85.54 ,$27.92 ,$83.72 ,$13.59 ,$82.81 ,$12.41 ,$56.00 ,$56.00 ,$91.00 ,$67.91 ,$78.00 ,$12.53 ,$12.82 ,$86.45 ,$13.03 ,$12.82 ,$79.17 ,$12.41 ,$81.90 ,$12.41 ,$81.90 ,$81.90 ,$81.90 ,$88.27 ,$73.71 ,$84.63 ,$78.26 ,$88.27 
SACRED HEART HOSPITAL (ACU),30100253,82530,HC CORTISOL FREE,301,1 ,$196.00 ,$147.00 ,$16.71 ,$196.00 ,$126.22 ,$16.71 ,$137.20 ,$17.27 ,$40.11 ,$17.79 ,$32.09 ,$186.20 ,$17.27 ,$156.80 ,$180.32 ,$17.27 ,$166.60 ,$186.20 ,$172.48 ,$148.96 ,$17.27 ,$17.27 ,$17.27 ,$143.08 ,$107.80 ,$178.36 ,$178.36 ,$156.80 ,$17.21 ,$107.80 ,$176.40 ,$16.71 ,$176.40 ,$105.84 ,$184.24 ,$37.60 ,$180.32 ,$18.31 ,$178.36 ,$16.71 ,$120.62 ,$120.62 ,$162.51 ,$146.27 ,$105.04 ,$16.88 ,$17.27 ,$186.20 ,$17.55 ,$17.27 ,$170.52 ,$16.71 ,$176.40 ,$16.71 ,$176.40 ,$176.40 ,$176.40 ,$190.12 ,$158.76 ,$182.28 ,$168.56 ,$190.12 
SACRED HEART HOSPITAL (ACU),30100254,82533,HC CORTISOL TOTAL,301,1 ,$222.00 ,$166.50 ,$16.30 ,$222.00 ,$142.97 ,$16.30 ,$155.40 ,$16.84 ,$39.13 ,$17.35 ,$31.30 ,$210.90 ,$16.84 ,$177.60 ,$204.24 ,$16.84 ,$188.70 ,$210.90 ,$195.36 ,$168.72 ,$16.84 ,$16.84 ,$16.84 ,$162.06 ,$122.10 ,$202.02 ,$202.02 ,$177.60 ,$16.79 ,$122.10 ,$199.80 ,$16.30 ,$199.80 ,$119.88 ,$208.68 ,$36.68 ,$204.24 ,$17.85 ,$202.02 ,$16.30 ,$136.62 ,$136.62 ,$125.17 ,$165.68 ,$102.44 ,$16.46 ,$16.84 ,$210.90 ,$17.12 ,$16.84 ,$193.14 ,$16.30 ,$199.80 ,$16.30 ,$199.80 ,$199.80 ,$199.80 ,$215.34 ,$179.82 ,$206.46 ,$190.92 ,$215.34 
SACRED HEART HOSPITAL (ACU),30100259,82550,HC CREATINE KINASE (CPK) TOTAL,301,1 ,$150.00 ,$112.50 ,$6.51 ,$150.00 ,$96.60 ,$6.51 ,$105.00 ,$6.73 ,$15.63 ,$6.93 ,$12.50 ,$142.50 ,$6.73 ,$120.00 ,$138.00 ,$6.73 ,$127.50 ,$142.50 ,$132.00 ,$114.00 ,$6.73 ,$6.73 ,$6.73 ,$109.50 ,$82.50 ,$136.50 ,$136.50 ,$120.00 ,$6.71 ,$82.50 ,$135.00 ,$6.51 ,$135.00 ,$81.00 ,$141.00 ,$14.65 ,$138.00 ,$7.13 ,$136.50 ,$6.51 ,$92.31 ,$92.31 ,$92.26 ,$111.95 ,$40.94 ,$6.58 ,$6.73 ,$142.50 ,$6.84 ,$6.73 ,$130.50 ,$6.51 ,$135.00 ,$6.51 ,$135.00 ,$135.00 ,$135.00 ,$145.50 ,$121.50 ,$139.50 ,$129.00 ,$145.50 
SACRED HEART HOSPITAL (ACU),30100261,82553,HC CREATINE KINASE MB FRAC,301,1 ,$258.00 ,$193.50 ,$8.66 ,$258.00 ,$166.15 ,$11.55 ,$180.60 ,$8.66 ,$14.79 ,$8.92 ,$11.83 ,$245.10 ,$8.66 ,$206.40 ,$237.36 ,$8.66 ,$219.30 ,$245.10 ,$227.04 ,$196.08 ,$8.66 ,$8.66 ,$8.66 ,$188.34 ,$141.90 ,$234.78 ,$234.78 ,$206.40 ,$11.90 ,$141.90 ,$232.20 ,$11.55 ,$232.20 ,$139.32 ,$242.52 ,$25.99 ,$237.36 ,$9.18 ,$234.78 ,$11.55 ,$158.77 ,$158.77 ,$48.30 ,$192.55 ,$72.61 ,$11.67 ,$8.66 ,$245.10 ,$12.13 ,$8.66 ,$224.46 ,$11.55 ,$232.20 ,$11.55 ,$232.20 ,$232.20 ,$232.20 ,$250.26 ,$208.98 ,$239.94 ,$221.88 ,$250.26 
SACRED HEART HOSPITAL (ACU),30100262,82565,HC CREATININE,301,1 ,$94.00 ,$70.50 ,$5.12 ,$94.00 ,$60.54 ,$5.12 ,$65.80 ,$5.29 ,$12.30 ,$5.45 ,$9.84 ,$89.30 ,$5.29 ,$75.20 ,$86.48 ,$5.29 ,$79.90 ,$89.30 ,$82.72 ,$71.44 ,$5.29 ,$5.29 ,$5.29 ,$68.62 ,$51.70 ,$85.54 ,$85.54 ,$75.20 ,$5.27 ,$51.70 ,$84.60 ,$5.12 ,$84.60 ,$50.76 ,$88.36 ,$11.52 ,$86.48 ,$5.61 ,$85.54 ,$5.12 ,$57.85 ,$57.85 ,$65.89 ,$70.15 ,$32.23 ,$5.17 ,$5.29 ,$89.30 ,$5.38 ,$5.29 ,$81.78 ,$5.12 ,$84.60 ,$5.12 ,$84.60 ,$84.60 ,$84.60 ,$91.18 ,$76.14 ,$87.42 ,$80.84 ,$91.18 
SACRED HEART HOSPITAL (ACU),30100263,82570,HC CREATININE BODY FLUID,301,1 ,$92.00 ,$69.00 ,$5.18 ,$92.00 ,$59.25 ,$5.18 ,$64.40 ,$5.35 ,$12.43 ,$5.51 ,$9.94 ,$87.40 ,$5.35 ,$73.60 ,$84.64 ,$5.35 ,$78.20 ,$87.40 ,$80.96 ,$69.92 ,$5.35 ,$5.35 ,$5.35 ,$67.16 ,$50.60 ,$83.72 ,$83.72 ,$73.60 ,$5.34 ,$50.60 ,$82.80 ,$5.18 ,$82.80 ,$49.68 ,$86.48 ,$11.66 ,$84.64 ,$5.67 ,$83.72 ,$5.18 ,$56.62 ,$56.62 ,$63.68 ,$68.66 ,$32.54 ,$5.23 ,$5.35 ,$87.40 ,$5.44 ,$5.35 ,$80.04 ,$5.18 ,$82.80 ,$5.18 ,$82.80 ,$82.80 ,$82.80 ,$89.24 ,$74.52 ,$85.56 ,$79.12 ,$89.24 
SACRED HEART HOSPITAL (ACU),30100266,82575,HC CREATININE CLEARANCE,301,1 ,$167.00 ,$125.25 ,$9.46 ,$167.00 ,$107.55 ,$9.46 ,$116.90 ,$9.78 ,$22.70 ,$10.07 ,$18.16 ,$158.65 ,$9.78 ,$133.60 ,$153.64 ,$9.78 ,$141.95 ,$158.65 ,$146.96 ,$126.92 ,$9.78 ,$9.78 ,$9.78 ,$121.91 ,$91.85 ,$151.97 ,$151.97 ,$133.60 ,$9.74 ,$91.85 ,$150.30 ,$9.46 ,$150.30 ,$90.18 ,$156.98 ,$21.29 ,$153.64 ,$10.37 ,$151.97 ,$9.46 ,$102.77 ,$102.77 ,$74.67 ,$124.63 ,$59.42 ,$9.55 ,$9.78 ,$158.65 ,$9.93 ,$9.78 ,$145.29 ,$9.46 ,$150.30 ,$9.46 ,$150.30 ,$150.30 ,$150.30 ,$161.99 ,$135.27 ,$155.31 ,$143.62 ,$161.99 
SACRED HEART HOSPITAL (ACU),30100267,82585,HC CRYOFIBRINOGEN,301,1 ,$45.00 ,$33.75 ,$9.02 ,$45.00 ,$28.98 ,$14.14 ,$31.50 ,$9.02 ,$15.40 ,$9.29 ,$12.32 ,$42.75 ,$9.02 ,$36.00 ,$41.40 ,$9.02 ,$38.25 ,$42.75 ,$39.60 ,$34.20 ,$9.02 ,$9.02 ,$9.02 ,$32.85 ,$24.75 ,$40.95 ,$40.95 ,$36.00 ,$14.56 ,$24.75 ,$40.50 ,$14.14 ,$40.50 ,$24.30 ,$42.30 ,$31.82 ,$41.40 ,$9.56 ,$40.95 ,$14.14 ,$27.69 ,$27.69 ,$45.00 ,$33.58 ,$40.50 ,$14.28 ,$9.02 ,$42.75 ,$14.85 ,$9.02 ,$39.15 ,$14.14 ,$40.50 ,$14.14 ,$40.50 ,$40.50 ,$40.50 ,$43.65 ,$36.45 ,$41.85 ,$38.70 ,$43.65 
SACRED HEART HOSPITAL (ACU),30100268,82595,HC CRYOGLOBULIN,301,1 ,$61.00 ,$45.75 ,$6.47 ,$61.00 ,$39.28 ,$6.47 ,$42.70 ,$6.69 ,$15.52 ,$6.89 ,$12.42 ,$57.95 ,$6.69 ,$48.80 ,$56.12 ,$6.69 ,$51.85 ,$57.95 ,$53.68 ,$46.36 ,$6.69 ,$6.69 ,$6.69 ,$44.53 ,$33.55 ,$55.51 ,$55.51 ,$48.80 ,$6.66 ,$33.55 ,$54.90 ,$6.47 ,$54.90 ,$32.94 ,$57.34 ,$14.56 ,$56.12 ,$7.09 ,$55.51 ,$6.47 ,$37.54 ,$37.54 ,$46.12 ,$45.52 ,$40.63 ,$6.53 ,$6.69 ,$57.95 ,$6.79 ,$6.69 ,$53.07 ,$6.47 ,$54.90 ,$6.47 ,$54.90 ,$54.90 ,$54.90 ,$59.17 ,$49.41 ,$56.73 ,$52.46 ,$59.17 
SACRED HEART HOSPITAL (ACU),30100269,82607,HC VITAMIN B12,301,1 ,$86.00 ,$64.50 ,$15.08 ,$86.00 ,$55.38 ,$15.08 ,$60.20 ,$15.58 ,$36.19 ,$16.05 ,$28.95 ,$81.70 ,$15.58 ,$68.80 ,$79.12 ,$15.58 ,$73.10 ,$81.70 ,$75.68 ,$65.36 ,$15.58 ,$15.58 ,$15.58 ,$62.78 ,$47.30 ,$78.26 ,$78.26 ,$68.80 ,$15.53 ,$47.30 ,$77.40 ,$15.08 ,$77.40 ,$46.44 ,$80.84 ,$33.93 ,$79.12 ,$16.51 ,$78.26 ,$15.08 ,$52.92 ,$52.92 ,$86.00 ,$64.18 ,$77.40 ,$15.23 ,$15.58 ,$81.70 ,$15.83 ,$15.58 ,$74.82 ,$15.08 ,$77.40 ,$15.08 ,$77.40 ,$77.40 ,$77.40 ,$83.42 ,$69.66 ,$79.98 ,$73.96 ,$83.42 
SACRED HEART HOSPITAL (ACU),30100271,82627,HC DHEA SULFATE,301,1 ,$72.00 ,$54.00 ,$22.23 ,$72.00 ,$46.37 ,$22.23 ,$50.40 ,$22.97 ,$53.38 ,$23.66 ,$42.70 ,$68.40 ,$22.97 ,$57.60 ,$66.24 ,$22.97 ,$61.20 ,$68.40 ,$63.36 ,$54.72 ,$22.97 ,$22.97 ,$22.97 ,$52.56 ,$39.60 ,$65.52 ,$65.52 ,$57.60 ,$22.90 ,$39.60 ,$64.80 ,$22.23 ,$64.80 ,$38.88 ,$67.68 ,$50.02 ,$66.24 ,$24.35 ,$65.52 ,$22.23 ,$44.31 ,$44.31 ,$72.00 ,$53.73 ,$64.80 ,$22.45 ,$22.97 ,$68.40 ,$23.34 ,$22.97 ,$62.64 ,$22.23 ,$64.80 ,$22.23 ,$64.80 ,$64.80 ,$64.80 ,$69.84 ,$58.32 ,$66.96 ,$61.92 ,$69.84 
SACRED HEART HOSPITAL (ACU),30100272,82652,HC VITAMIN D (1 25 DIHYDROXY),301,1 ,$217.00 ,$162.75 ,$38.50 ,$217.00 ,$139.75 ,$38.50 ,$151.90 ,$39.78 ,$92.42 ,$40.97 ,$73.93 ,$206.15 ,$39.78 ,$173.60 ,$199.64 ,$39.78 ,$184.45 ,$206.15 ,$190.96 ,$164.92 ,$39.78 ,$39.78 ,$39.78 ,$158.41 ,$119.35 ,$197.47 ,$197.47 ,$173.60 ,$39.66 ,$119.35 ,$195.30 ,$38.50 ,$195.30 ,$117.18 ,$203.98 ,$86.63 ,$199.64 ,$42.17 ,$197.47 ,$38.50 ,$133.54 ,$133.54 ,$186.68 ,$161.95 ,$195.30 ,$38.89 ,$39.78 ,$206.15 ,$40.43 ,$39.78 ,$188.79 ,$38.50 ,$195.30 ,$38.50 ,$195.30 ,$195.30 ,$195.30 ,$210.49 ,$175.77 ,$201.81 ,$186.62 ,$210.49 
SACRED HEART HOSPITAL (ACU),30100273,82657,HC ENZYME ACT NONRAD SUBS,301,1 ,$97.00 ,$72.75 ,$22.17 ,$97.00 ,$62.47 ,$22.17 ,$67.90 ,$22.91 ,$43.35 ,$23.60 ,$34.68 ,$92.15 ,$22.91 ,$77.60 ,$89.24 ,$22.91 ,$82.45 ,$92.15 ,$85.36 ,$73.72 ,$22.91 ,$22.91 ,$22.91 ,$70.81 ,$53.35 ,$88.27 ,$88.27 ,$77.60 ,$22.84 ,$53.35 ,$87.30 ,$22.17 ,$87.30 ,$52.38 ,$91.18 ,$49.88 ,$89.24 ,$24.28 ,$88.27 ,$22.17 ,$59.69 ,$59.69 ,$76.74 ,$72.39 ,$87.30 ,$22.39 ,$22.91 ,$92.15 ,$23.28 ,$22.91 ,$84.39 ,$22.17 ,$87.30 ,$22.17 ,$87.30 ,$87.30 ,$87.30 ,$94.09 ,$78.57 ,$90.21 ,$83.42 ,$94.09 
SACRED HEART HOSPITAL (ACU),30100275,82668,HC ERYTHROPOIETIN,301,1 ,$90.00 ,$67.50 ,$18.79 ,$90.00 ,$57.96 ,$18.79 ,$63.00 ,$19.42 ,$45.12 ,$20.00 ,$36.09 ,$85.50 ,$19.42 ,$72.00 ,$82.80 ,$19.42 ,$76.50 ,$85.50 ,$79.20 ,$68.40 ,$19.42 ,$19.42 ,$19.42 ,$65.70 ,$49.50 ,$81.90 ,$81.90 ,$72.00 ,$19.35 ,$49.50 ,$81.00 ,$18.79 ,$81.00 ,$48.60 ,$84.60 ,$42.28 ,$82.80 ,$20.59 ,$81.90 ,$18.79 ,$55.39 ,$55.39 ,$65.89 ,$67.17 ,$81.00 ,$18.98 ,$19.42 ,$85.50 ,$19.73 ,$19.42 ,$78.30 ,$18.79 ,$81.00 ,$18.79 ,$81.00 ,$81.00 ,$81.00 ,$87.30 ,$72.90 ,$83.70 ,$77.40 ,$87.30 
SACRED HEART HOSPITAL (ACU),30100276,82670,HC ESTRADIOL,301,1 ,$177.00 ,$132.75 ,$27.94 ,$177.00 ,$113.99 ,$27.94 ,$123.90 ,$28.87 ,$67.06 ,$29.74 ,$53.65 ,$168.15 ,$28.87 ,$141.60 ,$162.84 ,$28.87 ,$150.45 ,$168.15 ,$155.76 ,$134.52 ,$28.87 ,$28.87 ,$28.87 ,$129.21 ,$97.35 ,$161.07 ,$161.07 ,$141.60 ,$28.78 ,$97.35 ,$159.30 ,$27.94 ,$159.30 ,$95.58 ,$166.38 ,$62.87 ,$162.84 ,$30.60 ,$161.07 ,$27.94 ,$108.93 ,$108.93 ,$177.00 ,$132.10 ,$159.30 ,$28.22 ,$28.87 ,$168.15 ,$29.34 ,$28.87 ,$153.99 ,$27.94 ,$159.30 ,$27.94 ,$159.30 ,$159.30 ,$159.30 ,$171.69 ,$143.37 ,$164.61 ,$152.22 ,$171.69 
SACRED HEART HOSPITAL (ACU),30100278,82672,HC ESTROGEN TOTAL,301,1 ,$135.00 ,$101.25 ,$21.70 ,$135.00 ,$86.94 ,$21.70 ,$94.50 ,$22.42 ,$52.08 ,$23.09 ,$41.66 ,$128.25 ,$22.42 ,$108.00 ,$124.20 ,$22.42 ,$114.75 ,$128.25 ,$118.80 ,$102.60 ,$22.42 ,$22.42 ,$22.42 ,$98.55 ,$74.25 ,$122.85 ,$122.85 ,$108.00 ,$22.35 ,$74.25 ,$121.50 ,$21.70 ,$121.50 ,$72.90 ,$126.90 ,$48.83 ,$124.20 ,$23.77 ,$122.85 ,$21.70 ,$83.08 ,$83.08 ,$135.00 ,$100.75 ,$121.50 ,$21.92 ,$22.42 ,$128.25 ,$22.79 ,$22.42 ,$117.45 ,$21.70 ,$121.50 ,$21.70 ,$121.50 ,$121.50 ,$121.50 ,$130.95 ,$109.35 ,$125.55 ,$116.10 ,$130.95 
SACRED HEART HOSPITAL (ACU),30100280,82677,HC ESTRIOL,301,1 ,$79.00 ,$59.25 ,$24.18 ,$79.00 ,$50.88 ,$24.18 ,$55.30 ,$24.99 ,$58.05 ,$25.74 ,$46.44 ,$75.05 ,$24.99 ,$63.20 ,$72.68 ,$24.99 ,$67.15 ,$75.05 ,$69.52 ,$60.04 ,$24.99 ,$24.99 ,$24.99 ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 ,$24.91 ,$43.45 ,$71.10 ,$24.18 ,$71.10 ,$42.66 ,$74.26 ,$54.41 ,$72.68 ,$26.49 ,$71.89 ,$24.18 ,$48.62 ,$48.62 ,$79.00 ,$58.96 ,$71.10 ,$24.42 ,$24.99 ,$75.05 ,$25.39 ,$24.99 ,$68.73 ,$24.18 ,$71.10 ,$24.18 ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),30100287,82710,HC FECAL FAT QN,301,1 ,$68.00 ,$51.00 ,$16.80 ,$68.00 ,$43.79 ,$16.80 ,$47.60 ,$17.36 ,$40.34 ,$17.88 ,$32.27 ,$64.60 ,$17.36 ,$54.40 ,$62.56 ,$17.36 ,$57.80 ,$64.60 ,$59.84 ,$51.68 ,$17.36 ,$17.36 ,$17.36 ,$49.64 ,$37.40 ,$61.88 ,$61.88 ,$54.40 ,$17.30 ,$37.40 ,$61.20 ,$16.80 ,$61.20 ,$36.72 ,$63.92 ,$37.80 ,$62.56 ,$18.40 ,$61.88 ,$16.80 ,$41.85 ,$41.85 ,$68.00 ,$50.75 ,$61.20 ,$16.97 ,$17.36 ,$64.60 ,$17.64 ,$17.36 ,$59.16 ,$16.80 ,$61.20 ,$16.80 ,$61.20 ,$61.20 ,$61.20 ,$65.96 ,$55.08 ,$63.24 ,$58.48 ,$65.96 
SACRED HEART HOSPITAL (ACU),30100290,82728,HC FERRITIN,301,1 ,$180.00 ,$135.00 ,$13.63 ,$180.00 ,$115.92 ,$13.63 ,$126.00 ,$14.08 ,$32.73 ,$14.50 ,$26.18 ,$171.00 ,$14.08 ,$144.00 ,$165.60 ,$14.08 ,$153.00 ,$171.00 ,$158.40 ,$136.80 ,$14.08 ,$14.08 ,$14.08 ,$131.40 ,$99.00 ,$163.80 ,$163.80 ,$144.00 ,$14.04 ,$99.00 ,$162.00 ,$13.63 ,$162.00 ,$97.20 ,$169.20 ,$30.67 ,$165.60 ,$14.92 ,$163.80 ,$13.63 ,$110.77 ,$110.77 ,$107.64 ,$134.33 ,$85.69 ,$13.77 ,$14.08 ,$171.00 ,$14.31 ,$14.08 ,$156.60 ,$13.63 ,$162.00 ,$13.63 ,$162.00 ,$162.00 ,$162.00 ,$174.60 ,$145.80 ,$167.40 ,$154.80 ,$174.60 
SACRED HEART HOSPITAL (ACU),30100291,82731,HC FETAL FIBRONECTIN,301,1 ,$269.00 ,$201.75 ,$63.97 ,$269.00 ,$173.24 ,$64.41 ,$188.30 ,$66.55 ,$154.63 ,$68.55 ,$123.70 ,$255.55 ,$66.55 ,$215.20 ,$247.48 ,$66.55 ,$228.65 ,$255.55 ,$236.72 ,$204.44 ,$66.55 ,$66.55 ,$66.55 ,$196.37 ,$147.95 ,$244.79 ,$244.79 ,$215.20 ,$66.34 ,$147.95 ,$242.10 ,$64.41 ,$242.10 ,$145.26 ,$252.86 ,$144.92 ,$247.48 ,$70.54 ,$244.79 ,$64.41 ,$165.54 ,$165.54 ,$63.97 ,$200.75 ,$242.10 ,$65.05 ,$66.55 ,$255.55 ,$67.63 ,$66.55 ,$234.03 ,$64.41 ,$242.10 ,$64.41 ,$242.10 ,$242.10 ,$242.10 ,$260.93 ,$217.89 ,$250.17 ,$231.34 ,$260.93 
SACRED HEART HOSPITAL (ACU),30100292,82746,HC FOLIC ACID SERUM,301,1 ,$156.00 ,$117.00 ,$14.70 ,$156.00 ,$100.46 ,$14.70 ,$109.20 ,$15.19 ,$35.30 ,$15.65 ,$28.24 ,$148.20 ,$15.19 ,$124.80 ,$143.52 ,$15.19 ,$132.60 ,$148.20 ,$137.28 ,$118.56 ,$15.19 ,$15.19 ,$15.19 ,$113.88 ,$85.80 ,$141.96 ,$141.96 ,$124.80 ,$15.14 ,$85.80 ,$140.40 ,$14.70 ,$140.40 ,$84.24 ,$146.64 ,$33.08 ,$143.52 ,$16.10 ,$141.96 ,$14.70 ,$96.00 ,$96.00 ,$127.39 ,$116.42 ,$92.41 ,$14.85 ,$15.19 ,$148.20 ,$15.44 ,$15.19 ,$135.72 ,$14.70 ,$140.40 ,$14.70 ,$140.40 ,$140.40 ,$140.40 ,$151.32 ,$126.36 ,$145.08 ,$134.16 ,$151.32 
SACRED HEART HOSPITAL (ACU),30100293,82747,HC FOLIC ACID RBC,301,1 ,$56.00 ,$42.00 ,$16.37 ,$56.00 ,$36.06 ,$17.65 ,$39.20 ,$16.37 ,$27.95 ,$16.86 ,$22.36 ,$53.20 ,$16.37 ,$44.80 ,$51.52 ,$16.37 ,$47.60 ,$53.20 ,$49.28 ,$42.56 ,$16.37 ,$16.37 ,$16.37 ,$40.88 ,$30.80 ,$50.96 ,$50.96 ,$44.80 ,$18.18 ,$30.80 ,$50.40 ,$17.65 ,$50.40 ,$30.24 ,$52.64 ,$39.71 ,$51.52 ,$17.35 ,$50.96 ,$17.65 ,$34.46 ,$34.46 ,$56.00 ,$41.79 ,$50.40 ,$17.83 ,$16.37 ,$53.20 ,$18.53 ,$16.37 ,$48.72 ,$17.65 ,$50.40 ,$17.65 ,$50.40 ,$50.40 ,$50.40 ,$54.32 ,$45.36 ,$52.08 ,$48.16 ,$54.32 
SACRED HEART HOSPITAL (ACU),30100295,82784,HC GAMMAGLOBULIN,301,1 ,$47.00 ,$35.25 ,$9.30 ,$47.00 ,$30.27 ,$9.30 ,$32.90 ,$9.61 ,$22.33 ,$9.90 ,$17.86 ,$44.65 ,$9.61 ,$37.60 ,$43.24 ,$9.61 ,$39.95 ,$44.65 ,$41.36 ,$35.72 ,$9.61 ,$9.61 ,$9.61 ,$34.31 ,$25.85 ,$42.77 ,$42.77 ,$37.60 ,$9.58 ,$25.85 ,$42.30 ,$9.30 ,$42.30 ,$25.38 ,$44.18 ,$20.93 ,$43.24 ,$10.19 ,$42.77 ,$9.30 ,$28.92 ,$28.92 ,$47.00 ,$35.08 ,$42.30 ,$9.39 ,$9.61 ,$44.65 ,$9.77 ,$9.61 ,$40.89 ,$9.30 ,$42.30 ,$9.30 ,$42.30 ,$42.30 ,$42.30 ,$45.59 ,$38.07 ,$43.71 ,$40.42 ,$45.59 
SACRED HEART HOSPITAL (ACU),30100298,82784,HC GAMMAGLOBULIN TOTAL,301,1 ,$63.00 ,$47.25 ,$9.30 ,$63.00 ,$40.57 ,$9.30 ,$44.10 ,$9.61 ,$22.33 ,$9.90 ,$17.86 ,$59.85 ,$9.61 ,$50.40 ,$57.96 ,$9.61 ,$53.55 ,$59.85 ,$55.44 ,$47.88 ,$9.61 ,$9.61 ,$9.61 ,$45.99 ,$34.65 ,$57.33 ,$57.33 ,$50.40 ,$9.58 ,$34.65 ,$56.70 ,$9.30 ,$56.70 ,$34.02 ,$59.22 ,$20.93 ,$57.96 ,$10.19 ,$57.33 ,$9.30 ,$38.77 ,$38.77 ,$63.00 ,$47.02 ,$56.70 ,$9.39 ,$9.61 ,$59.85 ,$9.77 ,$9.61 ,$54.81 ,$9.30 ,$56.70 ,$9.30 ,$56.70 ,$56.70 ,$56.70 ,$61.11 ,$51.03 ,$58.59 ,$54.18 ,$61.11 
SACRED HEART HOSPITAL (ACU),30100302,82785,HC GAMMAGLOBULIN IGE,301,1 ,$86.00 ,$64.50 ,$16.46 ,$86.00 ,$55.38 ,$16.46 ,$60.20 ,$17.01 ,$39.52 ,$17.52 ,$31.61 ,$81.70 ,$17.01 ,$68.80 ,$79.12 ,$17.01 ,$73.10 ,$81.70 ,$75.68 ,$65.36 ,$17.01 ,$17.01 ,$17.01 ,$62.78 ,$47.30 ,$78.26 ,$78.26 ,$68.80 ,$16.95 ,$47.30 ,$77.40 ,$16.46 ,$77.40 ,$46.44 ,$80.84 ,$37.04 ,$79.12 ,$18.03 ,$78.26 ,$16.46 ,$52.92 ,$52.92 ,$86.00 ,$64.18 ,$77.40 ,$16.62 ,$17.01 ,$81.70 ,$17.28 ,$17.01 ,$74.82 ,$16.46 ,$77.40 ,$16.46 ,$77.40 ,$77.40 ,$77.40 ,$83.42 ,$69.66 ,$79.98 ,$73.96 ,$83.42 
SACRED HEART HOSPITAL (ACU),30100305,82800,HC BLOOD GAS PH,301,1 ,$76.00 ,$57.00 ,$11.00 ,$76.00 ,$48.94 ,$11.00 ,$53.20 ,$11.37 ,$20.32 ,$11.71 ,$16.25 ,$72.20 ,$11.37 ,$60.80 ,$69.92 ,$11.37 ,$64.60 ,$72.20 ,$66.88 ,$57.76 ,$11.37 ,$11.37 ,$11.37 ,$55.48 ,$41.80 ,$69.16 ,$69.16 ,$60.80 ,$11.33 ,$41.80 ,$68.40 ,$11.00 ,$68.40 ,$41.04 ,$71.44 ,$24.75 ,$69.92 ,$12.05 ,$69.16 ,$11.00 ,$46.77 ,$46.77 ,$70.29 ,$56.72 ,$56.01 ,$11.11 ,$11.37 ,$72.20 ,$11.55 ,$11.37 ,$66.12 ,$11.00 ,$68.40 ,$11.00 ,$68.40 ,$68.40 ,$68.40 ,$73.72 ,$61.56 ,$70.68 ,$65.36 ,$73.72 
SACRED HEART HOSPITAL (ACU),30100306,82803,HC BLOOD GAS PH PO2  AND /OR PCO2,301,1 ,$358.00 ,$268.50 ,$26.07 ,$358.00 ,$230.55 ,$26.07 ,$250.60 ,$26.94 ,$46.45 ,$27.75 ,$37.16 ,$340.10 ,$26.94 ,$286.40 ,$329.36 ,$26.94 ,$304.30 ,$340.10 ,$315.04 ,$272.08 ,$26.94 ,$26.94 ,$26.94 ,$261.34 ,$196.90 ,$325.78 ,$325.78 ,$286.40 ,$26.85 ,$196.90 ,$322.20 ,$26.07 ,$322.20 ,$193.32 ,$336.52 ,$58.66 ,$329.36 ,$28.56 ,$325.78 ,$26.07 ,$220.31 ,$220.31 ,$107.64 ,$267.18 ,$132.74 ,$26.33 ,$26.94 ,$340.10 ,$27.37 ,$26.94 ,$311.46 ,$26.07 ,$322.20 ,$26.07 ,$322.20 ,$322.20 ,$322.20 ,$347.26 ,$289.98 ,$332.94 ,$307.88 ,$347.26 
SACRED HEART HOSPITAL (ACU),30100309,82941,HC GASTRIN,301,1 ,$104.00 ,$78.00 ,$17.63 ,$104.00 ,$66.98 ,$17.63 ,$72.80 ,$18.22 ,$42.33 ,$18.77 ,$33.87 ,$98.80 ,$18.22 ,$83.20 ,$95.68 ,$18.22 ,$88.40 ,$98.80 ,$91.52 ,$79.04 ,$18.22 ,$18.22 ,$18.22 ,$75.92 ,$57.20 ,$94.64 ,$94.64 ,$83.20 ,$18.16 ,$57.20 ,$93.60 ,$17.63 ,$93.60 ,$56.16 ,$97.76 ,$39.67 ,$95.68 ,$19.31 ,$94.64 ,$17.63 ,$64.00 ,$64.00 ,$54.90 ,$77.62 ,$93.60 ,$17.81 ,$18.22 ,$98.80 ,$18.51 ,$18.22 ,$90.48 ,$17.63 ,$93.60 ,$17.63 ,$93.60 ,$93.60 ,$93.60 ,$100.88 ,$84.24 ,$96.72 ,$89.44 ,$100.88 
SACRED HEART HOSPITAL (ACU),30100311,82945,HC GLUCOSE BODY FLUID,301,1 ,$107.00 ,$80.25 ,$3.93 ,$107.00 ,$68.91 ,$3.93 ,$74.90 ,$4.06 ,$9.43 ,$4.18 ,$7.55 ,$101.65 ,$4.06 ,$85.60 ,$98.44 ,$4.06 ,$90.95 ,$101.65 ,$94.16 ,$81.32 ,$4.06 ,$4.06 ,$4.06 ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 ,$4.05 ,$58.85 ,$96.30 ,$3.93 ,$96.30 ,$57.78 ,$100.58 ,$8.84 ,$98.44 ,$4.30 ,$97.37 ,$3.93 ,$65.85 ,$65.85 ,$53.15 ,$79.85 ,$24.69 ,$3.97 ,$4.06 ,$101.65 ,$4.13 ,$4.06 ,$93.09 ,$3.93 ,$96.30 ,$3.93 ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),30100312,82947,HC GLUCOSE,301,1 ,$79.00 ,$59.25 ,$3.93 ,$79.00 ,$50.88 ,$3.93 ,$55.30 ,$4.06 ,$9.43 ,$4.18 ,$7.55 ,$75.05 ,$4.06 ,$63.20 ,$72.68 ,$4.06 ,$67.15 ,$75.05 ,$69.52 ,$60.04 ,$4.06 ,$4.06 ,$4.06 ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 ,$4.05 ,$43.45 ,$71.10 ,$3.93 ,$71.10 ,$42.66 ,$74.26 ,$8.84 ,$72.68 ,$4.30 ,$71.89 ,$3.93 ,$48.62 ,$48.62 ,$54.90 ,$58.96 ,$24.69 ,$3.97 ,$4.06 ,$75.05 ,$4.13 ,$4.06 ,$68.73 ,$3.93 ,$71.10 ,$3.93 ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),30100314,82951,HC GLUCOSE TOLERANCE,301,1 ,$170.00 ,$127.50 ,$12.87 ,$170.00 ,$109.48 ,$12.87 ,$119.00 ,$13.30 ,$30.91 ,$13.70 ,$24.72 ,$161.50 ,$13.30 ,$136.00 ,$156.40 ,$13.30 ,$144.50 ,$161.50 ,$149.60 ,$129.20 ,$13.30 ,$13.30 ,$13.30 ,$124.10 ,$93.50 ,$154.70 ,$154.70 ,$136.00 ,$13.26 ,$93.50 ,$153.00 ,$12.87 ,$153.00 ,$91.80 ,$159.80 ,$28.96 ,$156.40 ,$14.10 ,$154.70 ,$12.87 ,$104.62 ,$104.62 ,$139.47 ,$126.87 ,$80.91 ,$13.00 ,$13.30 ,$161.50 ,$13.51 ,$13.30 ,$147.90 ,$12.87 ,$153.00 ,$12.87 ,$153.00 ,$153.00 ,$153.00 ,$164.90 ,$137.70 ,$158.10 ,$146.20 ,$164.90 
SACRED HEART HOSPITAL (ACU),30100315,82952,HC GLUCOSE TOLERANCE ADDL SPEC,301,1 ,$100.00 ,$75.00 ,$3.92 ,$100.00 ,$64.40 ,$3.92 ,$70.00 ,$4.05 ,$9.42 ,$4.17 ,$7.53 ,$95.00 ,$4.05 ,$80.00 ,$92.00 ,$4.05 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$4.05 ,$4.05 ,$4.05 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$4.04 ,$55.00 ,$90.00 ,$3.92 ,$90.00 ,$54.00 ,$94.00 ,$8.82 ,$92.00 ,$4.29 ,$91.00 ,$3.92 ,$61.54 ,$61.54 ,$57.09 ,$74.63 ,$24.64 ,$3.96 ,$4.05 ,$95.00 ,$4.12 ,$4.05 ,$87.00 ,$3.92 ,$90.00 ,$3.92 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),30100316,82955,HC G6PD ENZYME QN,301,1 ,$87.00 ,$65.25 ,$9.70 ,$87.00 ,$56.03 ,$9.70 ,$60.90 ,$10.02 ,$23.28 ,$10.32 ,$18.62 ,$82.65 ,$10.02 ,$69.60 ,$80.04 ,$10.02 ,$73.95 ,$82.65 ,$76.56 ,$66.12 ,$10.02 ,$10.02 ,$10.02 ,$63.51 ,$47.85 ,$79.17 ,$79.17 ,$69.60 ,$9.99 ,$47.85 ,$78.30 ,$9.70 ,$78.30 ,$46.98 ,$81.78 ,$21.83 ,$80.04 ,$10.62 ,$79.17 ,$9.70 ,$53.54 ,$53.54 ,$87.00 ,$64.93 ,$60.95 ,$9.80 ,$10.02 ,$82.65 ,$10.19 ,$10.02 ,$75.69 ,$9.70 ,$78.30 ,$9.70 ,$78.30 ,$78.30 ,$78.30 ,$84.39 ,$70.47 ,$80.91 ,$74.82 ,$84.39 
SACRED HEART HOSPITAL (ACU),30100319,82977,HC GGT/GGTP,301,1 ,$159.00 ,$119.25 ,$7.20 ,$159.00 ,$102.40 ,$7.20 ,$111.30 ,$7.44 ,$17.29 ,$7.66 ,$13.83 ,$151.05 ,$7.44 ,$127.20 ,$146.28 ,$7.44 ,$135.15 ,$151.05 ,$139.92 ,$120.84 ,$7.44 ,$7.44 ,$7.44 ,$116.07 ,$87.45 ,$144.69 ,$144.69 ,$127.20 ,$7.42 ,$87.45 ,$143.10 ,$7.20 ,$143.10 ,$85.86 ,$149.46 ,$16.20 ,$146.28 ,$7.89 ,$144.69 ,$7.20 ,$97.85 ,$97.85 ,$69.62 ,$118.66 ,$45.26 ,$7.27 ,$7.44 ,$151.05 ,$7.56 ,$7.44 ,$138.33 ,$7.20 ,$143.10 ,$7.20 ,$143.10 ,$143.10 ,$143.10 ,$154.23 ,$128.79 ,$147.87 ,$136.74 ,$154.23 
SACRED HEART HOSPITAL (ACU),30100321,82985,HC FRUCTOSAMINE,301,1 ,$49.00 ,$36.75 ,$16.62 ,$49.00 ,$31.56 ,$16.76 ,$34.30 ,$16.62 ,$28.37 ,$17.12 ,$22.69 ,$46.55 ,$16.62 ,$39.20 ,$45.08 ,$16.62 ,$41.65 ,$46.55 ,$43.12 ,$37.24 ,$16.62 ,$16.62 ,$16.62 ,$35.77 ,$26.95 ,$44.59 ,$44.59 ,$39.20 ,$17.26 ,$26.95 ,$44.10 ,$16.76 ,$44.10 ,$26.46 ,$46.06 ,$37.71 ,$45.08 ,$17.62 ,$44.59 ,$16.76 ,$30.15 ,$30.15 ,$49.00 ,$36.57 ,$44.10 ,$16.93 ,$16.62 ,$46.55 ,$17.60 ,$16.62 ,$42.63 ,$16.76 ,$44.10 ,$16.76 ,$44.10 ,$44.10 ,$44.10 ,$47.53 ,$39.69 ,$45.57 ,$42.14 ,$47.53 
SACRED HEART HOSPITAL (ACU),30100322,83001,HC FSH,301,1 ,$153.00 ,$114.75 ,$18.58 ,$153.00 ,$98.53 ,$18.58 ,$107.10 ,$19.20 ,$44.61 ,$19.78 ,$35.69 ,$145.35 ,$19.20 ,$122.40 ,$140.76 ,$19.20 ,$130.05 ,$145.35 ,$134.64 ,$116.28 ,$19.20 ,$19.20 ,$19.20 ,$111.69 ,$84.15 ,$139.23 ,$139.23 ,$122.40 ,$19.14 ,$84.15 ,$137.70 ,$18.58 ,$137.70 ,$82.62 ,$143.82 ,$41.81 ,$140.76 ,$20.35 ,$139.23 ,$18.58 ,$94.16 ,$94.16 ,$153.00 ,$114.18 ,$116.80 ,$18.77 ,$19.20 ,$145.35 ,$19.51 ,$19.20 ,$133.11 ,$18.58 ,$137.70 ,$18.58 ,$137.70 ,$137.70 ,$137.70 ,$148.41 ,$123.93 ,$142.29 ,$131.58 ,$148.41 
SACRED HEART HOSPITAL (ACU),30100325,83002,HC LUTEINIZING HORMONE (LH),301,1 ,$150.00 ,$112.50 ,$18.52 ,$150.00 ,$96.60 ,$18.52 ,$105.00 ,$19.14 ,$44.45 ,$19.71 ,$35.56 ,$142.50 ,$19.14 ,$120.00 ,$138.00 ,$19.14 ,$127.50 ,$142.50 ,$132.00 ,$114.00 ,$19.14 ,$19.14 ,$19.14 ,$109.50 ,$82.50 ,$136.50 ,$136.50 ,$120.00 ,$19.08 ,$82.50 ,$135.00 ,$18.52 ,$135.00 ,$81.00 ,$141.00 ,$41.67 ,$138.00 ,$20.29 ,$136.50 ,$18.52 ,$92.31 ,$92.31 ,$150.00 ,$111.95 ,$116.39 ,$18.71 ,$19.14 ,$142.50 ,$19.45 ,$19.14 ,$130.50 ,$18.52 ,$135.00 ,$18.52 ,$135.00 ,$135.00 ,$135.00 ,$145.50 ,$121.50 ,$139.50 ,$129.00 ,$145.50 
SACRED HEART HOSPITAL (ACU),30100326,83003,HC GROWTH HORMONE,301,1 ,$82.00 ,$61.50 ,$16.67 ,$82.00 ,$52.81 ,$16.67 ,$57.40 ,$17.23 ,$40.02 ,$17.75 ,$32.02 ,$77.90 ,$17.23 ,$65.60 ,$75.44 ,$17.23 ,$69.70 ,$77.90 ,$72.16 ,$62.32 ,$17.23 ,$17.23 ,$17.23 ,$59.86 ,$45.10 ,$74.62 ,$74.62 ,$65.60 ,$17.17 ,$45.10 ,$73.80 ,$16.67 ,$73.80 ,$44.28 ,$77.08 ,$37.51 ,$75.44 ,$18.26 ,$74.62 ,$16.67 ,$50.46 ,$50.46 ,$82.00 ,$61.20 ,$73.80 ,$16.84 ,$17.23 ,$77.90 ,$17.50 ,$17.23 ,$71.34 ,$16.67 ,$73.80 ,$16.67 ,$73.80 ,$73.80 ,$73.80 ,$79.54 ,$66.42 ,$76.26 ,$70.52 ,$79.54 
SACRED HEART HOSPITAL (ACU),30100327,83010,HC HAPTOGLOBIN,301,1 ,$109.00 ,$81.75 ,$12.58 ,$109.00 ,$70.20 ,$12.58 ,$76.30 ,$13.00 ,$30.19 ,$13.39 ,$24.15 ,$103.55 ,$13.00 ,$87.20 ,$100.28 ,$13.00 ,$92.65 ,$103.55 ,$95.92 ,$82.84 ,$13.00 ,$13.00 ,$13.00 ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 ,$12.96 ,$59.95 ,$98.10 ,$12.58 ,$98.10 ,$58.86 ,$102.46 ,$28.31 ,$100.28 ,$13.78 ,$99.19 ,$12.58 ,$67.08 ,$67.08 ,$109.00 ,$81.35 ,$79.07 ,$12.71 ,$13.00 ,$103.55 ,$13.21 ,$13.00 ,$94.83 ,$12.58 ,$98.10 ,$12.58 ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),30100328,83018,HC HEAVY METAL EACH,301,1 ,$81.00 ,$60.75 ,$21.96 ,$81.00 ,$52.16 ,$21.96 ,$56.70 ,$22.69 ,$52.73 ,$23.37 ,$42.18 ,$76.95 ,$22.69 ,$64.80 ,$74.52 ,$22.69 ,$68.85 ,$76.95 ,$71.28 ,$61.56 ,$22.69 ,$22.69 ,$22.69 ,$59.13 ,$44.55 ,$73.71 ,$73.71 ,$64.80 ,$22.62 ,$44.55 ,$72.90 ,$21.96 ,$72.90 ,$43.74 ,$76.14 ,$49.41 ,$74.52 ,$24.05 ,$73.71 ,$21.96 ,$49.85 ,$49.85 ,$81.00 ,$60.45 ,$72.90 ,$22.18 ,$22.69 ,$76.95 ,$23.06 ,$22.69 ,$70.47 ,$21.96 ,$72.90 ,$21.96 ,$72.90 ,$72.90 ,$72.90 ,$78.57 ,$65.61 ,$75.33 ,$69.66 ,$78.57 
SACRED HEART HOSPITAL (ACU),30100333,83021,HC HEMOGLOBIN FRACT QN,301,1 ,$59.00 ,$44.25 ,$18.06 ,$59.00 ,$38.00 ,$18.06 ,$41.30 ,$18.66 ,$43.35 ,$19.22 ,$34.68 ,$56.05 ,$18.66 ,$47.20 ,$54.28 ,$18.66 ,$50.15 ,$56.05 ,$51.92 ,$44.84 ,$18.66 ,$18.66 ,$18.66 ,$43.07 ,$32.45 ,$53.69 ,$53.69 ,$47.20 ,$18.60 ,$32.45 ,$53.10 ,$18.06 ,$53.10 ,$31.86 ,$55.46 ,$40.64 ,$54.28 ,$19.78 ,$53.69 ,$18.06 ,$36.31 ,$36.31 ,$59.00 ,$44.03 ,$53.10 ,$18.24 ,$18.66 ,$56.05 ,$18.96 ,$18.66 ,$51.33 ,$18.06 ,$53.10 ,$18.06 ,$53.10 ,$53.10 ,$53.10 ,$57.23 ,$47.79 ,$54.87 ,$50.74 ,$57.23 
SACRED HEART HOSPITAL (ACU),30100337,83036,HC GLYCOSYLATED HGB,301,1 ,$61.00 ,$45.75 ,$9.71 ,$61.00 ,$39.28 ,$9.71 ,$42.70 ,$10.03 ,$23.31 ,$10.33 ,$18.65 ,$57.95 ,$10.03 ,$48.80 ,$56.12 ,$10.03 ,$51.85 ,$57.95 ,$53.68 ,$46.36 ,$10.03 ,$10.03 ,$10.03 ,$44.53 ,$33.55 ,$55.51 ,$55.51 ,$48.80 ,$10.00 ,$33.55 ,$54.90 ,$9.71 ,$54.90 ,$32.94 ,$57.34 ,$21.85 ,$56.12 ,$10.63 ,$55.51 ,$9.71 ,$37.54 ,$37.54 ,$61.00 ,$45.52 ,$54.90 ,$9.81 ,$10.03 ,$57.95 ,$10.20 ,$10.03 ,$53.07 ,$9.71 ,$54.90 ,$9.71 ,$54.90 ,$54.90 ,$54.90 ,$59.17 ,$49.41 ,$56.73 ,$52.46 ,$59.17 
SACRED HEART HOSPITAL (ACU),30100338,83050,HC METHEMOGLOBIN,301,1 ,$116.00 ,$87.00 ,$4.12 ,$116.00 ,$74.70 ,$8.20 ,$81.20 ,$4.12 ,$7.04 ,$4.24 ,$5.63 ,$110.20 ,$4.12 ,$92.80 ,$106.72 ,$4.12 ,$98.60 ,$110.20 ,$102.08 ,$88.16 ,$4.12 ,$4.12 ,$4.12 ,$84.68 ,$63.80 ,$105.56 ,$105.56 ,$92.80 ,$8.45 ,$63.80 ,$104.40 ,$8.20 ,$104.40 ,$62.64 ,$109.04 ,$18.45 ,$106.72 ,$4.37 ,$105.56 ,$8.20 ,$71.39 ,$71.39 ,$74.67 ,$86.57 ,$46.08 ,$8.28 ,$4.12 ,$110.20 ,$8.61 ,$4.12 ,$100.92 ,$8.20 ,$104.40 ,$8.20 ,$104.40 ,$104.40 ,$104.40 ,$112.52 ,$93.96 ,$107.88 ,$99.76 ,$112.52 
SACRED HEART HOSPITAL (ACU),30100339,83051,HC HEMOGLOBIN PLASMA,301,1 ,$75.00 ,$56.25 ,$4.90 ,$75.00 ,$48.30 ,$7.31 ,$52.50 ,$4.90 ,$8.35 ,$5.05 ,$6.68 ,$71.25 ,$4.90 ,$60.00 ,$69.00 ,$4.90 ,$63.75 ,$71.25 ,$66.00 ,$57.00 ,$4.90 ,$4.90 ,$4.90 ,$54.75 ,$41.25 ,$68.25 ,$68.25 ,$60.00 ,$7.53 ,$41.25 ,$67.50 ,$7.31 ,$67.50 ,$40.50 ,$70.50 ,$16.45 ,$69.00 ,$5.19 ,$68.25 ,$7.31 ,$46.16 ,$46.16 ,$24.36 ,$55.97 ,$45.98 ,$7.38 ,$4.90 ,$71.25 ,$7.68 ,$4.90 ,$65.25 ,$7.31 ,$67.50 ,$7.31 ,$67.50 ,$67.50 ,$67.50 ,$72.75 ,$60.75 ,$69.75 ,$64.50 ,$72.75 
SACRED HEART HOSPITAL (ACU),30100344,83070,HC HEMOSIDERIN,301,1 ,$98.00 ,$73.50 ,$4.75 ,$98.00 ,$63.11 ,$4.75 ,$68.60 ,$4.91 ,$11.39 ,$5.06 ,$9.11 ,$93.10 ,$4.91 ,$78.40 ,$90.16 ,$4.91 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$4.91 ,$4.91 ,$4.91 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$4.89 ,$53.90 ,$88.20 ,$4.75 ,$88.20 ,$52.92 ,$92.12 ,$10.69 ,$90.16 ,$5.20 ,$89.18 ,$4.75 ,$60.31 ,$60.31 ,$74.67 ,$73.14 ,$29.84 ,$4.80 ,$4.91 ,$93.10 ,$4.99 ,$4.91 ,$85.26 ,$4.75 ,$88.20 ,$4.75 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),30100346,83090,HC HOMOCYSTEINE,301,1 ,$72.00 ,$54.00 ,$17.92 ,$72.00 ,$46.37 ,$17.92 ,$50.40 ,$18.52 ,$40.50 ,$19.08 ,$32.40 ,$68.40 ,$18.52 ,$57.60 ,$66.24 ,$18.52 ,$61.20 ,$68.40 ,$63.36 ,$54.72 ,$18.52 ,$18.52 ,$18.52 ,$52.56 ,$39.60 ,$65.52 ,$65.52 ,$57.60 ,$18.46 ,$39.60 ,$64.80 ,$17.92 ,$64.80 ,$38.88 ,$67.68 ,$40.32 ,$66.24 ,$19.63 ,$65.52 ,$17.92 ,$44.31 ,$44.31 ,$35.74 ,$53.73 ,$64.80 ,$18.10 ,$18.52 ,$68.40 ,$18.82 ,$18.52 ,$62.64 ,$17.92 ,$64.80 ,$17.92 ,$64.80 ,$64.80 ,$64.80 ,$69.84 ,$58.32 ,$66.96 ,$61.92 ,$69.84 
SACRED HEART HOSPITAL (ACU),30100350,83497,HC HYDROXYINDOLACET 5 (HIAA),301,1 ,$88.00 ,$66.00 ,$12.90 ,$88.00 ,$56.67 ,$12.90 ,$61.60 ,$13.33 ,$30.96 ,$13.73 ,$24.77 ,$83.60 ,$13.33 ,$70.40 ,$80.96 ,$13.33 ,$74.80 ,$83.60 ,$77.44 ,$66.88 ,$13.33 ,$13.33 ,$13.33 ,$64.24 ,$48.40 ,$80.08 ,$80.08 ,$70.40 ,$13.29 ,$48.40 ,$79.20 ,$12.90 ,$79.20 ,$47.52 ,$82.72 ,$29.03 ,$80.96 ,$14.13 ,$80.08 ,$12.90 ,$54.16 ,$54.16 ,$88.00 ,$65.67 ,$79.20 ,$13.03 ,$13.33 ,$83.60 ,$13.55 ,$13.33 ,$76.56 ,$12.90 ,$79.20 ,$12.90 ,$79.20 ,$79.20 ,$79.20 ,$85.36 ,$71.28 ,$81.84 ,$75.68 ,$85.36 
SACRED HEART HOSPITAL (ACU),30100352,83498,HC HYDROXYPROGESTERONE 17D,301,1 ,$91.00 ,$68.25 ,$27.17 ,$91.00 ,$58.60 ,$27.17 ,$63.70 ,$28.07 ,$65.22 ,$28.91 ,$52.18 ,$86.45 ,$28.07 ,$72.80 ,$83.72 ,$28.07 ,$77.35 ,$86.45 ,$80.08 ,$69.16 ,$28.07 ,$28.07 ,$28.07 ,$66.43 ,$50.05 ,$82.81 ,$82.81 ,$72.80 ,$27.99 ,$50.05 ,$81.90 ,$27.17 ,$81.90 ,$49.14 ,$85.54 ,$61.13 ,$83.72 ,$29.75 ,$82.81 ,$27.17 ,$56.00 ,$56.00 ,$91.00 ,$67.91 ,$81.90 ,$27.44 ,$28.07 ,$86.45 ,$28.53 ,$28.07 ,$79.17 ,$27.17 ,$81.90 ,$27.17 ,$81.90 ,$81.90 ,$81.90 ,$88.27 ,$73.71 ,$84.63 ,$78.26 ,$88.27 
SACRED HEART HOSPITAL (ACU),30100355,83516,HC IMMUNO QL/SQ MLT,301,1 ,$58.00 ,$43.50 ,$11.53 ,$58.00 ,$37.35 ,$11.53 ,$40.60 ,$11.91 ,$27.69 ,$12.27 ,$22.15 ,$55.10 ,$11.91 ,$46.40 ,$53.36 ,$11.91 ,$49.30 ,$55.10 ,$51.04 ,$44.08 ,$11.91 ,$11.91 ,$11.91 ,$42.34 ,$31.90 ,$52.78 ,$52.78 ,$46.40 ,$11.88 ,$31.90 ,$52.20 ,$11.53 ,$52.20 ,$31.32 ,$54.52 ,$25.94 ,$53.36 ,$12.62 ,$52.78 ,$11.53 ,$35.69 ,$35.69 ,$48.30 ,$43.29 ,$52.20 ,$11.65 ,$11.91 ,$55.10 ,$12.11 ,$11.91 ,$50.46 ,$11.53 ,$52.20 ,$11.53 ,$52.20 ,$52.20 ,$52.20 ,$56.26 ,$46.98 ,$53.94 ,$49.88 ,$56.26 
SACRED HEART HOSPITAL (ACU),30100363,83519,HC ACETYLCHOLINE RECEPTR AB,301,1 ,$59.00 ,$44.25 ,$18.40 ,$59.00 ,$38.00 ,$18.40 ,$41.30 ,$19.00 ,$32.43 ,$19.57 ,$25.94 ,$56.05 ,$19.00 ,$47.20 ,$54.28 ,$19.00 ,$50.15 ,$56.05 ,$51.92 ,$44.84 ,$19.00 ,$19.00 ,$19.00 ,$43.07 ,$32.45 ,$53.69 ,$53.69 ,$47.20 ,$18.95 ,$32.45 ,$53.10 ,$18.40 ,$53.10 ,$31.86 ,$55.46 ,$41.40 ,$54.28 ,$20.14 ,$53.69 ,$18.40 ,$36.31 ,$36.31 ,$59.00 ,$44.03 ,$53.10 ,$18.58 ,$19.00 ,$56.05 ,$19.32 ,$19.00 ,$51.33 ,$18.40 ,$53.10 ,$18.40 ,$53.10 ,$53.10 ,$53.10 ,$57.23 ,$47.79 ,$54.87 ,$50.74 ,$57.23 
SACRED HEART HOSPITAL (ACU),30100366,86341,HC ISLET CELL AUTO AB,301,1 ,$61.08 ,$45.81 ,$19.88 ,$61.08 ,$39.34 ,$23.57 ,$42.76 ,$19.88 ,$33.93 ,$20.48 ,$27.15 ,$58.03 ,$19.88 ,$48.86 ,$56.19 ,$19.88 ,$51.92 ,$58.03 ,$53.75 ,$46.42 ,$19.88 ,$19.88 ,$19.88 ,$44.59 ,$33.59 ,$55.58 ,$55.58 ,$48.86 ,$24.28 ,$33.59 ,$54.97 ,$23.57 ,$54.97 ,$32.98 ,$57.42 ,$53.03 ,$56.19 ,$21.07 ,$55.58 ,$23.57 ,$37.59 ,$37.59 ,$61.08 ,$45.58 ,$54.97 ,$23.81 ,$19.88 ,$58.03 ,$24.75 ,$19.88 ,$53.14 ,$23.57 ,$54.97 ,$23.57 ,$54.97 ,$54.97 ,$54.97 ,$59.25 ,$49.47 ,$56.80 ,$52.53 ,$59.25 
SACRED HEART HOSPITAL (ACU),30100392,83525,HC INSULIN TOTAL,301,1 ,$90.00 ,$67.50 ,$11.43 ,$90.00 ,$57.96 ,$11.43 ,$63.00 ,$11.81 ,$27.44 ,$12.16 ,$21.95 ,$85.50 ,$11.81 ,$72.00 ,$82.80 ,$11.81 ,$76.50 ,$85.50 ,$79.20 ,$68.40 ,$11.81 ,$11.81 ,$11.81 ,$65.70 ,$49.50 ,$81.90 ,$81.90 ,$72.00 ,$11.77 ,$49.50 ,$81.00 ,$11.43 ,$81.00 ,$48.60 ,$84.60 ,$25.72 ,$82.80 ,$12.52 ,$81.90 ,$11.43 ,$55.39 ,$55.39 ,$90.00 ,$67.17 ,$71.84 ,$11.54 ,$11.81 ,$85.50 ,$12.00 ,$11.81 ,$78.30 ,$11.43 ,$81.00 ,$11.43 ,$81.00 ,$81.00 ,$81.00 ,$87.30 ,$72.90 ,$83.70 ,$77.40 ,$87.30 
SACRED HEART HOSPITAL (ACU),30100393,83540,HC IRON TOTAL,301,1 ,$65.00 ,$48.75 ,$6.47 ,$65.00 ,$41.86 ,$6.47 ,$45.50 ,$6.69 ,$15.54 ,$6.89 ,$12.43 ,$61.75 ,$6.69 ,$52.00 ,$59.80 ,$6.69 ,$55.25 ,$61.75 ,$57.20 ,$49.40 ,$6.69 ,$6.69 ,$6.69 ,$47.45 ,$35.75 ,$59.15 ,$59.15 ,$52.00 ,$6.66 ,$35.75 ,$58.50 ,$6.47 ,$58.50 ,$35.10 ,$61.10 ,$14.56 ,$59.80 ,$7.09 ,$59.15 ,$6.47 ,$40.00 ,$40.00 ,$65.00 ,$48.51 ,$40.68 ,$6.53 ,$6.69 ,$61.75 ,$6.79 ,$6.69 ,$56.55 ,$6.47 ,$58.50 ,$6.47 ,$58.50 ,$58.50 ,$58.50 ,$63.05 ,$52.65 ,$60.45 ,$55.90 ,$63.05 
SACRED HEART HOSPITAL (ACU),30100394,83550,HC IRON BINDING CAPACITY,301,1 ,$28.00 ,$21.00 ,$8.74 ,$28.00 ,$18.03 ,$8.74 ,$19.60 ,$9.03 ,$20.98 ,$9.30 ,$16.79 ,$26.60 ,$9.03 ,$22.40 ,$25.76 ,$9.03 ,$23.80 ,$26.60 ,$24.64 ,$21.28 ,$9.03 ,$9.03 ,$9.03 ,$20.44 ,$15.40 ,$25.48 ,$25.48 ,$22.40 ,$9.00 ,$15.40 ,$25.20 ,$8.74 ,$25.20 ,$15.12 ,$26.32 ,$19.67 ,$25.76 ,$9.57 ,$25.48 ,$8.74 ,$17.23 ,$17.23 ,$28.00 ,$20.90 ,$25.20 ,$8.83 ,$9.03 ,$26.60 ,$9.18 ,$9.03 ,$24.36 ,$8.74 ,$25.20 ,$8.74 ,$25.20 ,$25.20 ,$25.20 ,$27.16 ,$22.68 ,$26.04 ,$24.08 ,$27.16 
SACRED HEART HOSPITAL (ACU),30100396,83605,HC LACTATE/LACTIC ACID,301,1 ,$105.00 ,$78.75 ,$11.57 ,$105.00 ,$67.62 ,$11.57 ,$73.50 ,$11.96 ,$25.64 ,$12.32 ,$20.51 ,$99.75 ,$11.96 ,$84.00 ,$96.60 ,$11.96 ,$89.25 ,$99.75 ,$92.40 ,$79.80 ,$11.96 ,$11.96 ,$11.96 ,$76.65 ,$57.75 ,$95.55 ,$95.55 ,$84.00 ,$11.92 ,$57.75 ,$94.50 ,$11.57 ,$94.50 ,$56.70 ,$98.70 ,$26.03 ,$96.60 ,$12.68 ,$95.55 ,$11.57 ,$64.62 ,$64.62 ,$39.99 ,$78.36 ,$67.16 ,$11.69 ,$11.96 ,$99.75 ,$12.15 ,$11.96 ,$91.35 ,$11.57 ,$94.50 ,$11.57 ,$94.50 ,$94.50 ,$94.50 ,$101.85 ,$85.05 ,$97.65 ,$90.30 ,$101.85 
SACRED HEART HOSPITAL (ACU),30100397,83615,HC LACTATE DEHYDRO (LDH),301,1 ,$112.00 ,$84.00 ,$6.04 ,$112.00 ,$72.13 ,$6.04 ,$78.40 ,$6.24 ,$14.49 ,$6.43 ,$11.59 ,$106.40 ,$6.24 ,$89.60 ,$103.04 ,$6.24 ,$95.20 ,$106.40 ,$98.56 ,$85.12 ,$6.24 ,$6.24 ,$6.24 ,$81.76 ,$61.60 ,$101.92 ,$101.92 ,$89.60 ,$6.22 ,$61.60 ,$100.80 ,$6.04 ,$100.80 ,$60.48 ,$105.28 ,$13.59 ,$103.04 ,$6.61 ,$101.92 ,$6.04 ,$68.92 ,$68.92 ,$65.89 ,$83.59 ,$37.93 ,$6.10 ,$6.24 ,$106.40 ,$6.34 ,$6.24 ,$97.44 ,$6.04 ,$100.80 ,$6.04 ,$100.80 ,$100.80 ,$100.80 ,$108.64 ,$90.72 ,$104.16 ,$96.32 ,$108.64 
SACRED HEART HOSPITAL (ACU),30100401,83655,HC LEAD,301,1 ,$44.00 ,$33.00 ,$12.11 ,$44.00 ,$28.34 ,$12.11 ,$30.80 ,$12.51 ,$29.07 ,$12.89 ,$23.25 ,$41.80 ,$12.51 ,$35.20 ,$40.48 ,$12.51 ,$37.40 ,$41.80 ,$38.72 ,$33.44 ,$12.51 ,$12.51 ,$12.51 ,$32.12 ,$24.20 ,$40.04 ,$40.04 ,$35.20 ,$12.47 ,$24.20 ,$39.60 ,$12.11 ,$39.60 ,$23.76 ,$41.36 ,$27.25 ,$40.48 ,$13.26 ,$40.04 ,$12.11 ,$27.08 ,$27.08 ,$44.00 ,$32.84 ,$39.60 ,$12.23 ,$12.51 ,$41.80 ,$12.72 ,$12.51 ,$38.28 ,$12.11 ,$39.60 ,$12.11 ,$39.60 ,$39.60 ,$39.60 ,$42.68 ,$35.64 ,$40.92 ,$37.84 ,$42.68 
SACRED HEART HOSPITAL (ACU),30100408,83663,HC FETAL LUNG MATURITY,301,1 ,$174.00 ,$130.50 ,$13.65 ,$174.00 ,$112.06 ,$18.91 ,$121.80 ,$13.65 ,$45.40 ,$14.06 ,$36.32 ,$165.30 ,$13.65 ,$139.20 ,$160.08 ,$13.65 ,$147.90 ,$165.30 ,$153.12 ,$132.24 ,$13.65 ,$13.65 ,$13.65 ,$127.02 ,$95.70 ,$158.34 ,$158.34 ,$139.20 ,$19.48 ,$95.70 ,$156.60 ,$18.91 ,$156.60 ,$93.96 ,$163.56 ,$42.55 ,$160.08 ,$14.47 ,$158.34 ,$18.91 ,$107.08 ,$107.08 ,$30.93 ,$129.86 ,$118.89 ,$19.10 ,$13.65 ,$165.30 ,$19.86 ,$13.65 ,$151.38 ,$18.91 ,$156.60 ,$18.91 ,$156.60 ,$156.60 ,$156.60 ,$168.78 ,$140.94 ,$161.82 ,$149.64 ,$168.78 
SACRED HEART HOSPITAL (ACU),30100409,83690,HC LIPASE,301,1 ,$166.00 ,$124.50 ,$6.89 ,$166.00 ,$106.90 ,$6.89 ,$116.20 ,$7.12 ,$16.54 ,$7.33 ,$13.23 ,$157.70 ,$7.12 ,$132.80 ,$152.72 ,$7.12 ,$141.10 ,$157.70 ,$146.08 ,$126.16 ,$7.12 ,$7.12 ,$7.12 ,$121.18 ,$91.30 ,$151.06 ,$151.06 ,$132.80 ,$7.10 ,$91.30 ,$149.40 ,$6.89 ,$149.40 ,$89.64 ,$156.04 ,$15.50 ,$152.72 ,$7.55 ,$151.06 ,$6.89 ,$102.16 ,$102.16 ,$59.25 ,$123.89 ,$43.33 ,$6.96 ,$7.12 ,$157.70 ,$7.23 ,$7.12 ,$144.42 ,$6.89 ,$149.40 ,$6.89 ,$149.40 ,$149.40 ,$149.40 ,$161.02 ,$134.46 ,$154.38 ,$142.76 ,$161.02 
SACRED HEART HOSPITAL (ACU),30100413,83704,HC LP FRACTN ION MOBILITY,301,1 ,$193.00 ,$144.75 ,$34.19 ,$193.00 ,$124.29 ,$34.19 ,$135.10 ,$35.33 ,$75.74 ,$36.39 ,$60.59 ,$183.35 ,$35.33 ,$154.40 ,$177.56 ,$35.33 ,$164.05 ,$183.35 ,$169.84 ,$146.68 ,$35.33 ,$35.33 ,$35.33 ,$140.89 ,$106.15 ,$175.63 ,$175.63 ,$154.40 ,$35.22 ,$106.15 ,$173.70 ,$34.19 ,$173.70 ,$104.22 ,$181.42 ,$76.93 ,$177.56 ,$37.45 ,$175.63 ,$34.19 ,$118.77 ,$118.77 ,$93.92 ,$144.04 ,$173.70 ,$34.53 ,$35.33 ,$183.35 ,$35.90 ,$35.33 ,$167.91 ,$34.19 ,$173.70 ,$34.19 ,$173.70 ,$173.70 ,$173.70 ,$187.21 ,$156.33 ,$179.49 ,$165.98 ,$187.21 
SACRED HEART HOSPITAL (ACU),30100415,83718,HC CHOLESTEROL HDL,301,1 ,$130.00 ,$97.50 ,$8.19 ,$130.00 ,$83.72 ,$8.19 ,$91.00 ,$8.46 ,$19.67 ,$8.71 ,$15.74 ,$123.50 ,$8.46 ,$104.00 ,$119.60 ,$8.46 ,$110.50 ,$123.50 ,$114.40 ,$98.80 ,$8.46 ,$8.46 ,$8.46 ,$94.90 ,$71.50 ,$118.30 ,$118.30 ,$104.00 ,$8.44 ,$71.50 ,$117.00 ,$8.19 ,$117.00 ,$70.20 ,$122.20 ,$18.43 ,$119.60 ,$8.97 ,$118.30 ,$8.19 ,$80.00 ,$80.00 ,$72.48 ,$97.02 ,$51.53 ,$8.27 ,$8.46 ,$123.50 ,$8.60 ,$8.46 ,$113.10 ,$8.19 ,$117.00 ,$8.19 ,$117.00 ,$117.00 ,$117.00 ,$126.10 ,$105.30 ,$120.90 ,$111.80 ,$126.10 
SACRED HEART HOSPITAL (ACU),30100416,83721,HC CHOLESTEROL LDL,301,1 ,$102.00 ,$76.50 ,$10.50 ,$102.00 ,$65.69 ,$10.50 ,$71.40 ,$10.85 ,$22.91 ,$11.18 ,$18.33 ,$96.90 ,$10.85 ,$81.60 ,$93.84 ,$10.85 ,$86.70 ,$96.90 ,$89.76 ,$77.52 ,$10.85 ,$10.85 ,$10.85 ,$74.46 ,$56.10 ,$92.82 ,$92.82 ,$81.60 ,$10.82 ,$56.10 ,$91.80 ,$10.50 ,$91.80 ,$55.08 ,$95.88 ,$23.63 ,$93.84 ,$11.50 ,$92.82 ,$10.50 ,$62.77 ,$62.77 ,$79.07 ,$76.12 ,$59.98 ,$10.61 ,$10.85 ,$96.90 ,$11.03 ,$10.85 ,$88.74 ,$10.50 ,$91.80 ,$10.50 ,$91.80 ,$91.80 ,$91.80 ,$98.94 ,$82.62 ,$94.86 ,$87.72 ,$98.94 
SACRED HEART HOSPITAL (ACU),30100417,83735,HC MAGNESIUM,301,1 ,$137.00 ,$102.75 ,$6.70 ,$137.00 ,$88.23 ,$6.70 ,$95.90 ,$6.92 ,$16.08 ,$7.13 ,$12.87 ,$130.15 ,$6.92 ,$109.60 ,$126.04 ,$6.92 ,$116.45 ,$130.15 ,$120.56 ,$104.12 ,$6.92 ,$6.92 ,$6.92 ,$100.01 ,$75.35 ,$124.67 ,$124.67 ,$109.60 ,$6.90 ,$75.35 ,$123.30 ,$6.70 ,$123.30 ,$73.98 ,$128.78 ,$15.08 ,$126.04 ,$7.34 ,$124.67 ,$6.70 ,$84.31 ,$84.31 ,$59.25 ,$102.24 ,$42.11 ,$6.77 ,$6.92 ,$130.15 ,$7.04 ,$6.92 ,$119.19 ,$6.70 ,$123.30 ,$6.70 ,$123.30 ,$123.30 ,$123.30 ,$132.89 ,$110.97 ,$127.41 ,$117.82 ,$132.89 
SACRED HEART HOSPITAL (ACU),30100421,82542,HC BILE ACIDS,301,1 ,$42.00 ,$31.50 ,$22.68 ,$54.20 ,$27.05 ,$24.09 ,$29.40 ,$24.89 ,$42.00 ,$25.64 ,$34.68 ,$39.90 ,$24.89 ,$33.60 ,$38.64 ,$24.89 ,$35.70 ,$39.90 ,$36.96 ,$31.92 ,$24.89 ,$24.89 ,$24.89 ,$30.66 ,$23.10 ,$38.22 ,$38.22 ,$33.60 ,$24.81 ,$23.10 ,$37.80 ,$24.09 ,$37.80 ,$22.68 ,$39.48 ,$54.20 ,$38.64 ,$26.38 ,$38.22 ,$24.09 ,$25.85 ,$25.85 ,$42.00 ,$31.34 ,$37.80 ,$24.33 ,$24.89 ,$39.90 ,$25.29 ,$24.89 ,$36.54 ,$24.09 ,$37.80 ,$24.09 ,$37.80 ,$37.80 ,$37.80 ,$40.74 ,$34.02 ,$39.06 ,$36.12 ,$40.74 
SACRED HEART HOSPITAL (ACU),30100424,80183,HC TRILEPTAL,301,1 ,$79.00 ,$59.25 ,$13.25 ,$79.00 ,$50.88 ,$13.25 ,$55.30 ,$13.69 ,$31.82 ,$14.10 ,$25.45 ,$75.05 ,$13.69 ,$63.20 ,$72.68 ,$13.69 ,$67.15 ,$75.05 ,$69.52 ,$60.04 ,$13.69 ,$13.69 ,$13.69 ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 ,$13.65 ,$43.45 ,$71.10 ,$13.25 ,$71.10 ,$42.66 ,$74.26 ,$29.81 ,$72.68 ,$14.51 ,$71.89 ,$13.25 ,$48.62 ,$48.62 ,$34.23 ,$58.96 ,$71.10 ,$13.38 ,$13.69 ,$75.05 ,$13.91 ,$13.69 ,$68.73 ,$13.25 ,$71.10 ,$13.25 ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),30100426,83825,HC MERCURY,301,1 ,$53.00 ,$39.75 ,$16.26 ,$53.00 ,$34.13 ,$16.26 ,$37.10 ,$16.80 ,$39.03 ,$17.30 ,$31.22 ,$50.35 ,$16.80 ,$42.40 ,$48.76 ,$16.80 ,$45.05 ,$50.35 ,$46.64 ,$40.28 ,$16.80 ,$16.80 ,$16.80 ,$38.69 ,$29.15 ,$48.23 ,$48.23 ,$42.40 ,$16.75 ,$29.15 ,$47.70 ,$16.26 ,$47.70 ,$28.62 ,$49.82 ,$36.59 ,$48.76 ,$17.81 ,$48.23 ,$16.26 ,$32.62 ,$32.62 ,$53.00 ,$39.55 ,$47.70 ,$16.42 ,$16.80 ,$50.35 ,$17.07 ,$16.80 ,$46.11 ,$16.26 ,$47.70 ,$16.26 ,$47.70 ,$47.70 ,$47.70 ,$51.41 ,$42.93 ,$49.29 ,$45.58 ,$51.41 
SACRED HEART HOSPITAL (ACU),30100430,83835,HC METANEPHRINES,301,1 ,$122.00 ,$91.50 ,$16.94 ,$122.00 ,$78.57 ,$16.94 ,$85.40 ,$17.50 ,$40.67 ,$18.03 ,$32.54 ,$115.90 ,$17.50 ,$97.60 ,$112.24 ,$17.50 ,$103.70 ,$115.90 ,$107.36 ,$92.72 ,$17.50 ,$17.50 ,$17.50 ,$89.06 ,$67.10 ,$111.02 ,$111.02 ,$97.60 ,$17.45 ,$67.10 ,$109.80 ,$16.94 ,$109.80 ,$65.88 ,$114.68 ,$38.12 ,$112.24 ,$18.55 ,$111.02 ,$16.94 ,$75.08 ,$75.08 ,$122.00 ,$91.05 ,$106.52 ,$17.11 ,$17.50 ,$115.90 ,$17.79 ,$17.50 ,$106.14 ,$16.94 ,$109.80 ,$16.94 ,$109.80 ,$109.80 ,$109.80 ,$118.34 ,$98.82 ,$113.46 ,$104.92 ,$118.34 
SACRED HEART HOSPITAL (ACU),30100433,80358,HC METHADONE,301,1 ,$139.00 ,$104.25 ,$1.58 ,$139.00 ,$89.52 , N/A ,$97.30 ,$1.58 ,$41.42 ,$1.63 ,$33.14 ,$132.05 ,$1.58 ,$111.20 ,$127.88 ,$1.58 ,$118.15 ,$132.05 ,$122.32 ,$105.64 ,$1.58 ,$1.58 ,$1.58 ,$101.47 ,$76.45 ,$126.49 ,$126.49 ,$111.20 , N/A ,$76.45 ,$125.10 , N/A ,$125.10 ,$75.06 ,$130.66 , N/A ,$127.88 ,$1.67 ,$126.49 , N/A ,$85.54 ,$85.54 ,$47.23 ,$103.74 ,$96.81 , N/A ,$1.58 ,$132.05 , N/A ,$1.58 ,$120.93 , N/A ,$125.10 , N/A ,$125.10 ,$125.10 ,$125.10 ,$134.83 ,$112.59 ,$129.27 ,$119.54 ,$134.83 
SACRED HEART HOSPITAL (ACU),30100434,83873,HC MYELIN BASIC PROTEIN,301,1 ,$144.00 ,$108.00 ,$17.20 ,$144.00 ,$92.74 ,$17.20 ,$100.80 ,$17.77 ,$41.30 ,$18.30 ,$33.04 ,$136.80 ,$17.77 ,$115.20 ,$132.48 ,$17.77 ,$122.40 ,$136.80 ,$126.72 ,$109.44 ,$17.77 ,$17.77 ,$17.77 ,$105.12 ,$79.20 ,$131.04 ,$131.04 ,$115.20 ,$17.72 ,$79.20 ,$129.60 ,$17.20 ,$129.60 ,$77.76 ,$135.36 ,$38.70 ,$132.48 ,$18.84 ,$131.04 ,$17.20 ,$88.62 ,$88.62 ,$128.72 ,$107.47 ,$108.15 ,$17.37 ,$17.77 ,$136.80 ,$18.06 ,$17.77 ,$125.28 ,$17.20 ,$129.60 ,$17.20 ,$129.60 ,$129.60 ,$129.60 ,$139.68 ,$116.64 ,$133.92 ,$123.84 ,$139.68 
SACRED HEART HOSPITAL (ACU),30100435,83874,HC MYOGLOBIN,301,1 ,$107.00 ,$80.25 ,$12.92 ,$107.00 ,$68.91 ,$12.92 ,$74.90 ,$13.35 ,$31.01 ,$13.75 ,$24.81 ,$101.65 ,$13.35 ,$85.60 ,$98.44 ,$13.35 ,$90.95 ,$101.65 ,$94.16 ,$81.32 ,$13.35 ,$13.35 ,$13.35 ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 ,$13.31 ,$58.85 ,$96.30 ,$12.92 ,$96.30 ,$57.78 ,$100.58 ,$29.07 ,$98.44 ,$14.15 ,$97.37 ,$12.92 ,$65.85 ,$65.85 ,$105.84 ,$79.85 ,$81.21 ,$13.05 ,$13.35 ,$101.65 ,$13.57 ,$13.35 ,$93.09 ,$12.92 ,$96.30 ,$12.92 ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),30100438,83880,HC BNP NATRIURETIC PEPTIDE,301,1 ,$248.00 ,$186.00 ,$39.26 ,$248.00 ,$159.71 ,$39.26 ,$173.60 ,$40.57 ,$81.48 ,$41.79 ,$65.18 ,$235.60 ,$40.57 ,$198.40 ,$228.16 ,$40.57 ,$210.80 ,$235.60 ,$218.24 ,$188.48 ,$40.57 ,$40.57 ,$40.57 ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 ,$40.44 ,$136.40 ,$223.20 ,$39.26 ,$223.20 ,$133.92 ,$233.12 ,$88.34 ,$228.16 ,$43.00 ,$225.68 ,$39.26 ,$152.62 ,$152.62 ,$113.82 ,$185.08 ,$213.34 ,$39.65 ,$40.57 ,$235.60 ,$41.22 ,$40.57 ,$215.76 ,$39.26 ,$223.20 ,$39.26 ,$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),30100439,83883,HC NEPHELOMETRY EA ANALYTE,301,1 ,$146.00 ,$109.50 ,$13.60 ,$146.00 ,$94.02 ,$13.60 ,$102.20 ,$14.05 ,$32.64 ,$14.47 ,$26.11 ,$138.70 ,$14.05 ,$116.80 ,$134.32 ,$14.05 ,$124.10 ,$138.70 ,$128.48 ,$110.96 ,$14.05 ,$14.05 ,$14.05 ,$106.58 ,$80.30 ,$132.86 ,$132.86 ,$116.80 ,$14.01 ,$80.30 ,$131.40 ,$13.60 ,$131.40 ,$78.84 ,$137.24 ,$30.60 ,$134.32 ,$14.89 ,$132.86 ,$13.60 ,$89.85 ,$89.85 ,$21.56 ,$108.96 ,$85.49 ,$13.74 ,$14.05 ,$138.70 ,$14.28 ,$14.05 ,$127.02 ,$13.60 ,$131.40 ,$13.60 ,$131.40 ,$131.40 ,$131.40 ,$141.62 ,$118.26 ,$135.78 ,$125.56 ,$141.62 
SACRED HEART HOSPITAL (ACU),30100441,86160,HC C1 ESTERASE INHIB PRO QU,301,1 ,$224.10 ,$168.08 ,$12.00 ,$224.10 ,$144.32 ,$12.00 ,$156.87 ,$12.40 ,$28.81 ,$12.77 ,$23.04 ,$212.90 ,$12.40 ,$179.28 ,$206.17 ,$12.40 ,$190.49 ,$212.90 ,$197.21 ,$170.32 ,$12.40 ,$12.40 ,$12.40 ,$163.59 ,$123.26 ,$203.93 ,$203.93 ,$179.28 ,$12.36 ,$123.26 ,$201.69 ,$12.00 ,$201.69 ,$121.01 ,$210.65 ,$27.00 ,$206.17 ,$13.14 ,$203.93 ,$12.00 ,$137.91 ,$137.91 ,$109.82 ,$167.25 ,$75.41 ,$12.12 ,$12.40 ,$212.90 ,$12.60 ,$12.40 ,$194.97 ,$12.00 ,$201.69 ,$12.00 ,$201.69 ,$201.69 ,$201.69 ,$217.38 ,$181.52 ,$208.41 ,$192.73 ,$217.38 
SACRED HEART HOSPITAL (ACU),30100445,G0480,HC NICOTINE W/METABOLITE,301,1 ,$378.00 ,$283.50 ,$63.95 ,$378.00 ,$243.43 ,$114.43 ,$264.60 ,$63.95 ,$205.89 ,$65.87 ,$164.71 ,$359.10 ,$63.95 ,$302.40 ,$347.76 ,$63.95 ,$321.30 ,$359.10 ,$332.64 ,$287.28 ,$63.95 ,$63.95 ,$63.95 ,$275.94 ,$207.90 ,$343.98 ,$343.98 ,$302.40 ,$117.86 ,$207.90 ,$340.20 ,$114.43 ,$340.20 ,$204.12 ,$355.32 ,$257.47 ,$347.76 ,$67.79 ,$343.98 ,$114.43 ,$232.62 ,$232.62 ,$340.20 ,$282.10 ,$340.20 ,$115.57 ,$63.95 ,$359.10 ,$120.15 ,$63.95 ,$328.86 ,$114.43 ,$340.20 ,$114.43 ,$340.20 ,$340.20 ,$340.20 ,$366.66 ,$306.18 ,$351.54 ,$325.08 ,$366.66 
SACRED HEART HOSPITAL (ACU),30100637,83921,HC ORGANIC ACID SNG QN(METHYL),301,1 ,$175.00 ,$131.25 ,$21.21 ,$175.00 ,$112.70 ,$21.21 ,$122.50 ,$21.92 ,$39.50 ,$22.58 ,$31.60 ,$166.25 ,$21.92 ,$140.00 ,$161.00 ,$21.92 ,$148.75 ,$166.25 ,$154.00 ,$133.00 ,$21.92 ,$21.92 ,$21.92 ,$127.75 ,$96.25 ,$159.25 ,$159.25 ,$140.00 ,$21.85 ,$96.25 ,$157.50 ,$21.21 ,$157.50 ,$94.50 ,$164.50 ,$47.72 ,$161.00 ,$23.24 ,$159.25 ,$21.21 ,$107.70 ,$107.70 ,$62.83 ,$130.60 ,$107.99 ,$21.42 ,$21.92 ,$166.25 ,$22.27 ,$21.92 ,$152.25 ,$21.21 ,$157.50 ,$21.21 ,$157.50 ,$157.50 ,$157.50 ,$169.75 ,$141.75 ,$162.75 ,$150.50 ,$169.75 
SACRED HEART HOSPITAL (ACU),30100660,83915,HC NUCLEOTIDASE,301,1 ,$74.00 ,$55.50 ,$11.15 ,$74.00 ,$47.66 ,$11.15 ,$51.80 ,$11.52 ,$26.78 ,$11.87 ,$21.42 ,$70.30 ,$11.52 ,$59.20 ,$68.08 ,$11.52 ,$62.90 ,$70.30 ,$65.12 ,$56.24 ,$11.52 ,$11.52 ,$11.52 ,$54.02 ,$40.70 ,$67.34 ,$67.34 ,$59.20 ,$11.48 ,$40.70 ,$66.60 ,$11.15 ,$66.60 ,$39.96 ,$69.56 ,$25.09 ,$68.08 ,$12.21 ,$67.34 ,$11.15 ,$45.54 ,$45.54 ,$74.00 ,$55.23 ,$66.60 ,$11.26 ,$11.52 ,$70.30 ,$11.71 ,$11.52 ,$64.38 ,$11.15 ,$66.60 ,$11.15 ,$66.60 ,$66.60 ,$66.60 ,$71.78 ,$59.94 ,$68.82 ,$63.64 ,$71.78 
SACRED HEART HOSPITAL (ACU),30100661,83916,HC OLIGOCLONAL BANDS,301,1 ,$94.00 ,$70.50 ,$27.39 ,$94.00 ,$60.54 ,$27.39 ,$65.80 ,$28.28 ,$48.28 ,$29.13 ,$38.63 ,$89.30 ,$28.28 ,$75.20 ,$86.48 ,$28.28 ,$79.90 ,$89.30 ,$82.72 ,$71.44 ,$28.28 ,$28.28 ,$28.28 ,$68.62 ,$51.70 ,$85.54 ,$85.54 ,$75.20 ,$28.21 ,$51.70 ,$84.60 ,$27.39 ,$84.60 ,$50.76 ,$88.36 ,$61.63 ,$86.48 ,$29.98 ,$85.54 ,$27.39 ,$57.85 ,$57.85 ,$94.00 ,$70.15 ,$84.60 ,$27.66 ,$28.28 ,$89.30 ,$28.76 ,$28.28 ,$81.78 ,$27.39 ,$84.60 ,$27.39 ,$84.60 ,$84.60 ,$84.60 ,$91.18 ,$76.14 ,$87.42 ,$80.84 ,$91.18 
SACRED HEART HOSPITAL (ACU),30100668,83930,HC OSMOLALITY BLOOD,301,1 ,$120.00 ,$90.00 ,$6.61 ,$120.00 ,$77.28 ,$6.61 ,$84.00 ,$6.83 ,$15.87 ,$7.03 ,$12.70 ,$114.00 ,$6.83 ,$96.00 ,$110.40 ,$6.83 ,$102.00 ,$114.00 ,$105.60 ,$91.20 ,$6.83 ,$6.83 ,$6.83 ,$87.60 ,$66.00 ,$109.20 ,$109.20 ,$96.00 ,$6.81 ,$66.00 ,$108.00 ,$6.61 ,$108.00 ,$64.80 ,$112.80 ,$14.87 ,$110.40 ,$7.24 ,$109.20 ,$6.61 ,$73.85 ,$73.85 ,$103.23 ,$89.56 ,$41.55 ,$6.68 ,$6.83 ,$114.00 ,$6.94 ,$6.83 ,$104.40 ,$6.61 ,$108.00 ,$6.61 ,$108.00 ,$108.00 ,$108.00 ,$116.40 ,$97.20 ,$111.60 ,$103.20 ,$116.40 
SACRED HEART HOSPITAL (ACU),30100669,83935,HC OSMOLALITY URINE,301,1 ,$120.00 ,$90.00 ,$6.82 ,$120.00 ,$77.28 ,$6.82 ,$84.00 ,$7.05 ,$16.36 ,$7.26 ,$13.09 ,$114.00 ,$7.05 ,$96.00 ,$110.40 ,$7.05 ,$102.00 ,$114.00 ,$105.60 ,$91.20 ,$7.05 ,$7.05 ,$7.05 ,$87.60 ,$66.00 ,$109.20 ,$109.20 ,$96.00 ,$7.02 ,$66.00 ,$108.00 ,$6.82 ,$108.00 ,$64.80 ,$112.80 ,$15.35 ,$110.40 ,$7.47 ,$109.20 ,$6.82 ,$73.85 ,$73.85 ,$81.28 ,$89.56 ,$42.87 ,$6.89 ,$7.05 ,$114.00 ,$7.16 ,$7.05 ,$104.40 ,$6.82 ,$108.00 ,$6.82 ,$108.00 ,$108.00 ,$108.00 ,$116.40 ,$97.20 ,$111.60 ,$103.20 ,$116.40 
SACRED HEART HOSPITAL (ACU),30100670,83945,HC OXALATE,301,1 ,$92.00 ,$69.00 ,$14.45 ,$92.00 ,$59.25 ,$14.45 ,$64.40 ,$14.93 ,$30.91 ,$15.38 ,$24.72 ,$87.40 ,$14.93 ,$73.60 ,$84.64 ,$14.93 ,$78.20 ,$87.40 ,$80.96 ,$69.92 ,$14.93 ,$14.93 ,$14.93 ,$67.16 ,$50.60 ,$83.72 ,$83.72 ,$73.60 ,$14.88 ,$50.60 ,$82.80 ,$14.45 ,$82.80 ,$49.68 ,$86.48 ,$32.51 ,$84.64 ,$15.83 ,$83.72 ,$14.45 ,$56.62 ,$56.62 ,$92.00 ,$68.66 ,$80.91 ,$14.59 ,$14.93 ,$87.40 ,$15.17 ,$14.93 ,$80.04 ,$14.45 ,$82.80 ,$14.45 ,$82.80 ,$82.80 ,$82.80 ,$89.24 ,$74.52 ,$85.56 ,$79.12 ,$89.24 
SACRED HEART HOSPITAL (ACU),30100672,83970,HC PARATHYROID HORMONE (PTH),301,1 ,$274.00 ,$205.50 ,$41.28 ,$274.00 ,$176.46 ,$41.28 ,$191.80 ,$42.65 ,$99.09 ,$43.93 ,$79.27 ,$260.30 ,$42.65 ,$219.20 ,$252.08 ,$42.65 ,$232.90 ,$260.30 ,$241.12 ,$208.24 ,$42.65 ,$42.65 ,$42.65 ,$200.02 ,$150.70 ,$249.34 ,$249.34 ,$219.20 ,$42.52 ,$150.70 ,$246.60 ,$41.28 ,$246.60 ,$147.96 ,$257.56 ,$92.88 ,$252.08 ,$45.21 ,$249.34 ,$41.28 ,$168.62 ,$168.62 ,$274.00 ,$204.49 ,$246.60 ,$41.69 ,$42.65 ,$260.30 ,$43.34 ,$42.65 ,$238.38 ,$41.28 ,$246.60 ,$41.28 ,$246.60 ,$246.60 ,$246.60 ,$265.78 ,$221.94 ,$254.82 ,$235.64 ,$265.78 
SACRED HEART HOSPITAL (ACU),30100673,83986,HC PH BODY FLUID,301,1 ,$116.00 ,$87.00 ,$3.58 ,$116.00 ,$74.70 ,$3.58 ,$81.20 ,$3.70 ,$8.59 ,$3.81 ,$6.87 ,$110.20 ,$3.70 ,$92.80 ,$106.72 ,$3.70 ,$98.60 ,$110.20 ,$102.08 ,$88.16 ,$3.70 ,$3.70 ,$3.70 ,$84.68 ,$63.80 ,$105.56 ,$105.56 ,$92.80 ,$3.69 ,$63.80 ,$104.40 ,$3.58 ,$104.40 ,$62.64 ,$109.04 ,$8.06 ,$106.72 ,$3.92 ,$105.56 ,$3.58 ,$71.39 ,$71.39 ,$70.29 ,$86.57 ,$22.50 ,$3.62 ,$3.70 ,$110.20 ,$3.76 ,$3.70 ,$100.92 ,$3.58 ,$104.40 ,$3.58 ,$104.40 ,$104.40 ,$104.40 ,$112.52 ,$93.96 ,$107.88 ,$99.76 ,$112.52 
SACRED HEART HOSPITAL (ACU),30100676,84030,HC NEWBORN SCREEN PKU,301,1 ,$154.00 ,$115.50 ,$5.50 ,$154.00 ,$99.18 ,$5.50 ,$107.80 ,$5.68 ,$13.20 ,$5.85 ,$10.56 ,$146.30 ,$5.68 ,$123.20 ,$141.68 ,$5.68 ,$130.90 ,$146.30 ,$135.52 ,$117.04 ,$5.68 ,$5.68 ,$5.68 ,$112.42 ,$84.70 ,$140.14 ,$140.14 ,$123.20 ,$5.67 ,$84.70 ,$138.60 ,$5.50 ,$138.60 ,$83.16 ,$144.76 ,$12.38 ,$141.68 ,$6.02 ,$140.14 ,$5.50 ,$94.77 ,$94.77 ,$76.87 ,$114.93 ,$34.57 ,$5.56 ,$5.68 ,$146.30 ,$5.78 ,$5.68 ,$133.98 ,$5.50 ,$138.60 ,$5.50 ,$138.60 ,$138.60 ,$138.60 ,$149.38 ,$124.74 ,$143.22 ,$132.44 ,$149.38 
SACRED HEART HOSPITAL (ACU),30100679,84075,HC ALKALINE PHOSPHATASE,301,1 ,$112.00 ,$84.00 ,$5.18 ,$112.00 ,$72.13 ,$5.18 ,$78.40 ,$5.35 ,$12.43 ,$5.51 ,$9.94 ,$106.40 ,$5.35 ,$89.60 ,$103.04 ,$5.35 ,$95.20 ,$106.40 ,$98.56 ,$85.12 ,$5.35 ,$5.35 ,$5.35 ,$81.76 ,$61.60 ,$101.92 ,$101.92 ,$89.60 ,$5.34 ,$61.60 ,$100.80 ,$5.18 ,$100.80 ,$60.48 ,$105.28 ,$11.66 ,$103.04 ,$5.67 ,$101.92 ,$5.18 ,$68.92 ,$68.92 ,$65.89 ,$83.59 ,$32.54 ,$5.23 ,$5.35 ,$106.40 ,$5.44 ,$5.35 ,$97.44 ,$5.18 ,$100.80 ,$5.18 ,$100.80 ,$100.80 ,$100.80 ,$108.64 ,$90.72 ,$104.16 ,$96.32 ,$108.64 
SACRED HEART HOSPITAL (ACU),30100681,84080,HC ALK PHOS ISOENZ,301,1 ,$66.00 ,$49.50 ,$14.78 ,$66.00 ,$42.50 ,$14.78 ,$46.20 ,$15.27 ,$35.49 ,$15.73 ,$28.39 ,$62.70 ,$15.27 ,$52.80 ,$60.72 ,$15.27 ,$56.10 ,$62.70 ,$58.08 ,$50.16 ,$15.27 ,$15.27 ,$15.27 ,$48.18 ,$36.30 ,$60.06 ,$60.06 ,$52.80 ,$15.22 ,$36.30 ,$59.40 ,$14.78 ,$59.40 ,$35.64 ,$62.04 ,$33.26 ,$60.72 ,$16.19 ,$60.06 ,$14.78 ,$40.62 ,$40.62 ,$66.00 ,$49.26 ,$59.40 ,$14.93 ,$15.27 ,$62.70 ,$15.52 ,$15.27 ,$57.42 ,$14.78 ,$59.40 ,$14.78 ,$59.40 ,$59.40 ,$59.40 ,$64.02 ,$53.46 ,$61.38 ,$56.76 ,$64.02 
SACRED HEART HOSPITAL (ACU),30100682,84081,HC PHOSPHATIDYLYCEROL (PG),301,1 ,$140.00 ,$105.00 ,$16.52 ,$140.00 ,$90.16 ,$16.52 ,$98.00 ,$17.07 ,$39.66 ,$17.58 ,$31.72 ,$133.00 ,$17.07 ,$112.00 ,$128.80 ,$17.07 ,$119.00 ,$133.00 ,$123.20 ,$106.40 ,$17.07 ,$17.07 ,$17.07 ,$102.20 ,$77.00 ,$127.40 ,$127.40 ,$112.00 ,$17.02 ,$77.00 ,$126.00 ,$16.52 ,$126.00 ,$75.60 ,$131.60 ,$37.17 ,$128.80 ,$18.09 ,$127.40 ,$16.52 ,$86.16 ,$86.16 ,$140.00 ,$104.48 ,$103.82 ,$16.69 ,$17.07 ,$133.00 ,$17.35 ,$17.07 ,$121.80 ,$16.52 ,$126.00 ,$16.52 ,$126.00 ,$126.00 ,$126.00 ,$135.80 ,$113.40 ,$130.20 ,$120.40 ,$135.80 
SACRED HEART HOSPITAL (ACU),30100684,84100,HC PHOSPHORUS,301,1 ,$99.00 ,$74.25 ,$4.74 ,$99.00 ,$63.76 ,$4.74 ,$69.30 ,$4.90 ,$11.38 ,$5.05 ,$9.10 ,$94.05 ,$4.90 ,$79.20 ,$91.08 ,$4.90 ,$84.15 ,$94.05 ,$87.12 ,$75.24 ,$4.90 ,$4.90 ,$4.90 ,$72.27 ,$54.45 ,$90.09 ,$90.09 ,$79.20 ,$4.88 ,$54.45 ,$89.10 ,$4.74 ,$89.10 ,$53.46 ,$93.06 ,$10.67 ,$91.08 ,$5.19 ,$90.09 ,$4.74 ,$60.92 ,$60.92 ,$61.49 ,$73.88 ,$29.79 ,$4.79 ,$4.90 ,$94.05 ,$4.98 ,$4.90 ,$86.13 ,$4.74 ,$89.10 ,$4.74 ,$89.10 ,$89.10 ,$89.10 ,$96.03 ,$80.19 ,$92.07 ,$85.14 ,$96.03 
SACRED HEART HOSPITAL (ACU),30100685,84105,HC PHOSPHORUS URINE,301,1 ,$109.00 ,$81.75 ,$5.78 ,$109.00 ,$70.20 ,$5.78 ,$76.30 ,$5.97 ,$12.43 ,$6.15 ,$9.94 ,$103.55 ,$5.97 ,$87.20 ,$100.28 ,$5.97 ,$92.65 ,$103.55 ,$95.92 ,$82.84 ,$5.97 ,$5.97 ,$5.97 ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 ,$5.95 ,$59.95 ,$98.10 ,$5.78 ,$98.10 ,$58.86 ,$102.46 ,$13.01 ,$100.28 ,$6.33 ,$99.19 ,$5.78 ,$67.08 ,$67.08 ,$61.49 ,$81.35 ,$32.54 ,$5.84 ,$5.97 ,$103.55 ,$6.07 ,$5.97 ,$94.83 ,$5.78 ,$98.10 ,$5.78 ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),30100686,84110,HC PORPHOBILINOGEN QN,301,1 ,$39.00 ,$29.25 ,$8.44 ,$39.00 ,$25.12 ,$8.44 ,$27.30 ,$8.72 ,$20.27 ,$8.98 ,$16.21 ,$37.05 ,$8.72 ,$31.20 ,$35.88 ,$8.72 ,$33.15 ,$37.05 ,$34.32 ,$29.64 ,$8.72 ,$8.72 ,$8.72 ,$28.47 ,$21.45 ,$35.49 ,$35.49 ,$31.20 ,$8.69 ,$21.45 ,$35.10 ,$8.44 ,$35.10 ,$21.06 ,$36.66 ,$18.99 ,$35.88 ,$9.24 ,$35.49 ,$8.44 ,$24.00 ,$24.00 ,$39.00 ,$29.11 ,$35.10 ,$8.52 ,$8.72 ,$37.05 ,$8.86 ,$8.72 ,$33.93 ,$8.44 ,$35.10 ,$8.44 ,$35.10 ,$35.10 ,$35.10 ,$37.83 ,$31.59 ,$36.27 ,$33.54 ,$37.83 
SACRED HEART HOSPITAL (ACU),30100688,84112,HC PLACENTAL ALPHA MICROGLOBULIN,301,1 ,$258.00 ,$193.50 ,$90.57 ,$258.00 ,$166.15 ,$98.11 ,$180.60 ,$90.57 ,$154.63 ,$93.29 ,$123.70 ,$245.10 ,$90.57 ,$206.40 ,$237.36 ,$90.57 ,$219.30 ,$245.10 ,$227.04 ,$196.08 ,$90.57 ,$90.57 ,$90.57 ,$188.34 ,$141.90 ,$234.78 ,$234.78 ,$206.40 ,$101.05 ,$141.90 ,$232.20 ,$98.11 ,$232.20 ,$139.32 ,$242.52 ,$220.75 ,$237.36 ,$96.00 ,$234.78 ,$98.11 ,$158.77 ,$158.77 ,$182.76 ,$192.55 ,$232.20 ,$99.09 ,$90.57 ,$245.10 ,$103.02 ,$90.57 ,$224.46 ,$98.11 ,$232.20 ,$98.11 ,$232.20 ,$232.20 ,$232.20 ,$250.26 ,$208.98 ,$239.94 ,$221.88 ,$250.26 
SACRED HEART HOSPITAL (ACU),30100689,84120,HC PORPHYRINS QN FRACT,301,1 ,$92.00 ,$69.00 ,$14.71 ,$92.00 ,$59.25 ,$14.71 ,$64.40 ,$15.20 ,$35.32 ,$15.66 ,$28.25 ,$87.40 ,$15.20 ,$73.60 ,$84.64 ,$15.20 ,$78.20 ,$87.40 ,$80.96 ,$69.92 ,$15.20 ,$15.20 ,$15.20 ,$67.16 ,$50.60 ,$83.72 ,$83.72 ,$73.60 ,$15.15 ,$50.60 ,$82.80 ,$14.71 ,$82.80 ,$49.68 ,$86.48 ,$33.10 ,$84.64 ,$16.11 ,$83.72 ,$14.71 ,$56.62 ,$56.62 ,$92.00 ,$68.66 ,$82.80 ,$14.86 ,$15.20 ,$87.40 ,$15.45 ,$15.20 ,$80.04 ,$14.71 ,$82.80 ,$14.71 ,$82.80 ,$82.80 ,$82.80 ,$89.24 ,$74.52 ,$85.56 ,$79.12 ,$89.24 
SACRED HEART HOSPITAL (ACU),30100691,84132,HC POTASSIUM,301,1 ,$98.00 ,$73.50 ,$4.76 ,$98.00 ,$63.11 ,$4.76 ,$68.60 ,$4.92 ,$11.04 ,$5.07 ,$8.83 ,$93.10 ,$4.92 ,$78.40 ,$90.16 ,$4.92 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$4.92 ,$4.92 ,$4.92 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$4.90 ,$53.90 ,$88.20 ,$4.76 ,$88.20 ,$52.92 ,$92.12 ,$10.71 ,$90.16 ,$5.22 ,$89.18 ,$4.76 ,$60.31 ,$60.31 ,$39.53 ,$73.14 ,$28.92 ,$4.81 ,$4.92 ,$93.10 ,$5.00 ,$4.92 ,$85.26 ,$4.76 ,$88.20 ,$4.76 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),30100694,84133,HC POTASSIUM URINE,301,1 ,$98.00 ,$73.50 ,$4.73 ,$98.00 ,$63.11 ,$4.73 ,$68.60 ,$4.89 ,$10.34 ,$5.04 ,$8.27 ,$93.10 ,$4.89 ,$78.40 ,$90.16 ,$4.89 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$4.89 ,$4.89 ,$4.89 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$4.87 ,$53.90 ,$88.20 ,$4.73 ,$88.20 ,$52.92 ,$92.12 ,$10.64 ,$90.16 ,$5.18 ,$89.18 ,$4.73 ,$60.31 ,$60.31 ,$39.53 ,$73.14 ,$27.09 ,$4.78 ,$4.89 ,$93.10 ,$4.97 ,$4.89 ,$85.26 ,$4.73 ,$88.20 ,$4.73 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),30100695,84134,HC PREALBUMIN,301,1 ,$62.00 ,$46.50 ,$7.85 ,$62.00 ,$39.93 ,$14.59 ,$43.40 ,$7.85 ,$13.41 ,$8.09 ,$10.72 ,$58.90 ,$7.85 ,$49.60 ,$57.04 ,$7.85 ,$52.70 ,$58.90 ,$54.56 ,$47.12 ,$7.85 ,$7.85 ,$7.85 ,$45.26 ,$34.10 ,$56.42 ,$56.42 ,$49.60 ,$15.03 ,$34.10 ,$55.80 ,$14.59 ,$55.80 ,$33.48 ,$58.28 ,$32.83 ,$57.04 ,$8.32 ,$56.42 ,$14.59 ,$38.15 ,$38.15 ,$62.00 ,$46.27 ,$55.80 ,$14.74 ,$7.85 ,$58.90 ,$15.32 ,$7.85 ,$53.94 ,$14.59 ,$55.80 ,$14.59 ,$55.80 ,$55.80 ,$55.80 ,$60.14 ,$50.22 ,$57.66 ,$53.32 ,$60.14 
SACRED HEART HOSPITAL (ACU),30100696,84144,HC PROGESTERONE,301,1 ,$137.00 ,$102.75 ,$20.86 ,$137.00 ,$88.23 ,$20.86 ,$95.90 ,$21.55 ,$44.68 ,$22.20 ,$35.74 ,$130.15 ,$21.55 ,$109.60 ,$126.04 ,$21.55 ,$116.45 ,$130.15 ,$120.56 ,$104.12 ,$21.55 ,$21.55 ,$21.55 ,$100.01 ,$75.35 ,$124.67 ,$124.67 ,$109.60 ,$21.49 ,$75.35 ,$123.30 ,$20.86 ,$123.30 ,$73.98 ,$128.78 ,$46.94 ,$126.04 ,$22.84 ,$124.67 ,$20.86 ,$84.31 ,$84.31 ,$137.00 ,$102.24 ,$123.30 ,$21.07 ,$21.55 ,$130.15 ,$21.90 ,$21.55 ,$119.19 ,$20.86 ,$123.30 ,$20.86 ,$123.30 ,$123.30 ,$123.30 ,$132.89 ,$110.97 ,$127.41 ,$117.82 ,$132.89 
SACRED HEART HOSPITAL (ACU),30100697,84146,HC PROLACTIN,301,1 ,$94.00 ,$70.50 ,$19.38 ,$94.00 ,$60.54 ,$19.38 ,$65.80 ,$20.03 ,$46.52 ,$20.63 ,$37.21 ,$89.30 ,$20.03 ,$75.20 ,$86.48 ,$20.03 ,$79.90 ,$89.30 ,$82.72 ,$71.44 ,$20.03 ,$20.03 ,$20.03 ,$68.62 ,$51.70 ,$85.54 ,$85.54 ,$75.20 ,$19.96 ,$51.70 ,$84.60 ,$19.38 ,$84.60 ,$50.76 ,$88.36 ,$43.61 ,$86.48 ,$21.23 ,$85.54 ,$19.38 ,$57.85 ,$57.85 ,$94.00 ,$70.15 ,$84.60 ,$19.57 ,$20.03 ,$89.30 ,$20.35 ,$20.03 ,$81.78 ,$19.38 ,$84.60 ,$19.38 ,$84.60 ,$84.60 ,$84.60 ,$91.18 ,$76.14 ,$87.42 ,$80.84 ,$91.18 
SACRED HEART HOSPITAL (ACU),30100698,84153,HC PSA TOTAL,301,1 ,$210.00 ,$157.50 ,$18.39 ,$210.00 ,$135.24 ,$18.39 ,$147.00 ,$19.00 ,$44.15 ,$19.57 ,$35.32 ,$199.50 ,$19.00 ,$168.00 ,$193.20 ,$19.00 ,$178.50 ,$199.50 ,$184.80 ,$159.60 ,$19.00 ,$19.00 ,$19.00 ,$153.30 ,$115.50 ,$191.10 ,$191.10 ,$168.00 ,$18.94 ,$115.50 ,$189.00 ,$18.39 ,$189.00 ,$113.40 ,$197.40 ,$41.38 ,$193.20 ,$20.14 ,$191.10 ,$18.39 ,$129.23 ,$129.23 ,$139.47 ,$156.72 ,$115.63 ,$18.57 ,$19.00 ,$199.50 ,$19.31 ,$19.00 ,$182.70 ,$18.39 ,$189.00 ,$18.39 ,$189.00 ,$189.00 ,$189.00 ,$203.70 ,$170.10 ,$195.30 ,$180.60 ,$203.70 
SACRED HEART HOSPITAL (ACU),30100699,84154,HC PSA FREE,301,1 ,$60.00 ,$45.00 ,$18.39 ,$60.00 ,$38.64 ,$18.39 ,$42.00 ,$19.00 ,$44.15 ,$19.57 ,$35.32 ,$57.00 ,$19.00 ,$48.00 ,$55.20 ,$19.00 ,$51.00 ,$57.00 ,$52.80 ,$45.60 ,$19.00 ,$19.00 ,$19.00 ,$43.80 ,$33.00 ,$54.60 ,$54.60 ,$48.00 ,$18.94 ,$33.00 ,$54.00 ,$18.39 ,$54.00 ,$32.40 ,$56.40 ,$41.38 ,$55.20 ,$20.14 ,$54.60 ,$18.39 ,$36.92 ,$36.92 ,$60.00 ,$44.78 ,$54.00 ,$18.57 ,$19.00 ,$57.00 ,$19.31 ,$19.00 ,$52.20 ,$18.39 ,$54.00 ,$18.39 ,$54.00 ,$54.00 ,$54.00 ,$58.20 ,$48.60 ,$55.80 ,$51.60 ,$58.20 
SACRED HEART HOSPITAL (ACU),30100700,84155,HC PROTEIN TOTAL,301,1 ,$91.00 ,$68.25 ,$3.67 ,$91.00 ,$58.60 ,$3.67 ,$63.70 ,$3.79 ,$8.80 ,$3.90 ,$7.04 ,$86.45 ,$3.79 ,$72.80 ,$83.72 ,$3.79 ,$77.35 ,$86.45 ,$80.08 ,$69.16 ,$3.79 ,$3.79 ,$3.79 ,$66.43 ,$50.05 ,$82.81 ,$82.81 ,$72.80 ,$3.78 ,$50.05 ,$81.90 ,$3.67 ,$81.90 ,$49.14 ,$85.54 ,$8.26 ,$83.72 ,$4.02 ,$82.81 ,$3.67 ,$56.00 ,$56.00 ,$43.91 ,$67.91 ,$23.06 ,$3.71 ,$3.79 ,$86.45 ,$3.85 ,$3.79 ,$79.17 ,$3.67 ,$81.90 ,$3.67 ,$81.90 ,$81.90 ,$81.90 ,$88.27 ,$73.71 ,$84.63 ,$78.26 ,$88.27 
SACRED HEART HOSPITAL (ACU),30100701,84156,HC PROTEIN TOTAL URINE,301,1 ,$118.00 ,$88.50 ,$3.67 ,$118.00 ,$75.99 ,$3.67 ,$82.60 ,$3.79 ,$8.80 ,$3.90 ,$7.04 ,$112.10 ,$3.79 ,$94.40 ,$108.56 ,$3.79 ,$100.30 ,$112.10 ,$103.84 ,$89.68 ,$3.79 ,$3.79 ,$3.79 ,$86.14 ,$64.90 ,$107.38 ,$107.38 ,$94.40 ,$3.78 ,$64.90 ,$106.20 ,$3.67 ,$106.20 ,$63.72 ,$110.92 ,$8.26 ,$108.56 ,$4.02 ,$107.38 ,$3.67 ,$72.62 ,$72.62 ,$11.26 ,$88.06 ,$23.06 ,$3.71 ,$3.79 ,$112.10 ,$3.85 ,$3.79 ,$102.66 ,$3.67 ,$106.20 ,$3.67 ,$106.20 ,$106.20 ,$106.20 ,$114.46 ,$95.58 ,$109.74 ,$101.48 ,$114.46 
SACRED HEART HOSPITAL (ACU),30100703,84157,HC PROTEIN TOTAL OTH SRC,301,1 ,$118.00 ,$88.50 ,$4.00 ,$118.00 ,$75.99 ,$4.00 ,$82.60 ,$4.13 ,$8.80 ,$4.25 ,$7.04 ,$112.10 ,$4.13 ,$94.40 ,$108.56 ,$4.13 ,$100.30 ,$112.10 ,$103.84 ,$89.68 ,$4.13 ,$4.13 ,$4.13 ,$86.14 ,$64.90 ,$107.38 ,$107.38 ,$94.40 ,$4.12 ,$64.90 ,$106.20 ,$4.00 ,$106.20 ,$63.72 ,$110.92 ,$9.00 ,$108.56 ,$4.38 ,$107.38 ,$4.00 ,$72.62 ,$72.62 ,$11.26 ,$88.06 ,$23.06 ,$4.04 ,$4.13 ,$112.10 ,$4.20 ,$4.13 ,$102.66 ,$4.00 ,$106.20 ,$4.00 ,$106.20 ,$106.20 ,$106.20 ,$114.46 ,$95.58 ,$109.74 ,$101.48 ,$114.46 
SACRED HEART HOSPITAL (ACU),30100705,84165,HC PROTEIN ELECTROPHORESIS,301,1 ,$42.00 ,$31.50 ,$10.74 ,$42.00 ,$27.05 ,$10.74 ,$29.40 ,$11.10 ,$25.78 ,$11.43 ,$20.62 ,$39.90 ,$11.10 ,$33.60 ,$38.64 ,$11.10 ,$35.70 ,$39.90 ,$36.96 ,$31.92 ,$11.10 ,$11.10 ,$11.10 ,$30.66 ,$23.10 ,$38.22 ,$38.22 ,$33.60 ,$11.06 ,$23.10 ,$37.80 ,$10.74 ,$37.80 ,$22.68 ,$39.48 ,$24.17 ,$38.64 ,$11.77 ,$38.22 ,$10.74 ,$25.85 ,$25.85 ,$42.00 ,$31.34 ,$37.80 ,$10.85 ,$11.10 ,$39.90 ,$11.28 ,$11.10 ,$36.54 ,$10.74 ,$37.80 ,$10.74 ,$37.80 ,$37.80 ,$37.80 ,$40.74 ,$34.02 ,$39.06 ,$36.12 ,$40.74 
SACRED HEART HOSPITAL (ACU),30100706,84166,HC PROTEIN EP OTH FLUID,301,1 ,$56.00 ,$42.00 ,$17.83 ,$56.00 ,$36.06 ,$17.83 ,$39.20 ,$18.42 ,$42.81 ,$18.97 ,$34.24 ,$53.20 ,$18.42 ,$44.80 ,$51.52 ,$18.42 ,$47.60 ,$53.20 ,$49.28 ,$42.56 ,$18.42 ,$18.42 ,$18.42 ,$40.88 ,$30.80 ,$50.96 ,$50.96 ,$44.80 ,$18.36 ,$30.80 ,$50.40 ,$17.83 ,$50.40 ,$30.24 ,$52.64 ,$40.12 ,$51.52 ,$19.53 ,$50.96 ,$17.83 ,$34.46 ,$34.46 ,$51.79 ,$41.79 ,$50.40 ,$18.01 ,$18.42 ,$53.20 ,$18.72 ,$18.42 ,$48.72 ,$17.83 ,$50.40 ,$17.83 ,$50.40 ,$50.40 ,$50.40 ,$54.32 ,$45.36 ,$52.08 ,$48.16 ,$54.32 
SACRED HEART HOSPITAL (ACU),30100708,84181,HC PROTEIN WESTERN BLOT,301,1 ,$55.00 ,$41.25 ,$17.03 ,$55.00 ,$35.42 ,$17.03 ,$38.50 ,$17.60 ,$40.88 ,$18.13 ,$32.70 ,$52.25 ,$17.60 ,$44.00 ,$50.60 ,$17.60 ,$46.75 ,$52.25 ,$48.40 ,$41.80 ,$17.60 ,$17.60 ,$17.60 ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 ,$17.54 ,$30.25 ,$49.50 ,$17.03 ,$49.50 ,$29.70 ,$51.70 ,$38.32 ,$50.60 ,$18.66 ,$50.05 ,$17.03 ,$33.85 ,$33.85 ,$55.00 ,$41.05 ,$49.50 ,$17.20 ,$17.60 ,$52.25 ,$17.88 ,$17.60 ,$47.85 ,$17.03 ,$49.50 ,$17.03 ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),30100709,84202,HC PROTOPORPHYRIN,301,1 ,$84.00 ,$63.00 ,$14.35 ,$84.00 ,$54.10 ,$14.35 ,$58.80 ,$14.83 ,$34.44 ,$15.27 ,$27.55 ,$79.80 ,$14.83 ,$67.20 ,$77.28 ,$14.83 ,$71.40 ,$79.80 ,$73.92 ,$63.84 ,$14.83 ,$14.83 ,$14.83 ,$61.32 ,$46.20 ,$76.44 ,$76.44 ,$67.20 ,$14.78 ,$46.20 ,$75.60 ,$14.35 ,$75.60 ,$45.36 ,$78.96 ,$32.29 ,$77.28 ,$15.72 ,$76.44 ,$14.35 ,$51.69 ,$51.69 ,$84.00 ,$62.69 ,$75.60 ,$14.49 ,$14.83 ,$79.80 ,$15.07 ,$14.83 ,$73.08 ,$14.35 ,$75.60 ,$14.35 ,$75.60 ,$75.60 ,$75.60 ,$81.48 ,$68.04 ,$78.12 ,$72.24 ,$81.48 
SACRED HEART HOSPITAL (ACU),30100712,84210,HC PYRUVATE,301,1 ,$100.00 ,$75.00 ,$14.48 ,$100.00 ,$64.40 ,$14.48 ,$70.00 ,$14.96 ,$26.06 ,$15.41 ,$20.85 ,$95.00 ,$14.96 ,$80.00 ,$92.00 ,$14.96 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$14.96 ,$14.96 ,$14.96 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$14.91 ,$55.00 ,$90.00 ,$14.48 ,$90.00 ,$54.00 ,$94.00 ,$32.58 ,$92.00 ,$15.86 ,$91.00 ,$14.48 ,$61.54 ,$61.54 ,$100.00 ,$74.63 ,$73.73 ,$14.62 ,$14.96 ,$95.00 ,$15.20 ,$14.96 ,$87.00 ,$14.48 ,$90.00 ,$14.48 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),30100714,84238,HC RECEPTOR ASSAY NON ENDO,301,1 ,$119.00 ,$89.25 ,$36.57 ,$119.00 ,$76.64 ,$36.57 ,$83.30 ,$37.79 ,$87.78 ,$38.92 ,$70.22 ,$113.05 ,$37.79 ,$95.20 ,$109.48 ,$37.79 ,$101.15 ,$113.05 ,$104.72 ,$90.44 ,$37.79 ,$37.79 ,$37.79 ,$86.87 ,$65.45 ,$108.29 ,$108.29 ,$95.20 ,$37.67 ,$65.45 ,$107.10 ,$36.57 ,$107.10 ,$64.26 ,$111.86 ,$82.28 ,$109.48 ,$40.06 ,$108.29 ,$36.57 ,$73.23 ,$73.23 ,$119.00 ,$88.81 ,$107.10 ,$36.94 ,$37.79 ,$113.05 ,$38.40 ,$37.79 ,$103.53 ,$36.57 ,$107.10 ,$36.57 ,$107.10 ,$107.10 ,$107.10 ,$115.43 ,$96.39 ,$110.67 ,$102.34 ,$115.43 
SACRED HEART HOSPITAL (ACU),30100715,84244,HC RENIN,301,1 ,$71.00 ,$53.25 ,$21.99 ,$71.00 ,$45.72 ,$21.99 ,$49.70 ,$22.72 ,$52.80 ,$23.40 ,$42.24 ,$67.45 ,$22.72 ,$56.80 ,$65.32 ,$22.72 ,$60.35 ,$67.45 ,$62.48 ,$53.96 ,$22.72 ,$22.72 ,$22.72 ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 ,$22.65 ,$39.05 ,$63.90 ,$21.99 ,$63.90 ,$38.34 ,$66.74 ,$49.48 ,$65.32 ,$24.08 ,$64.61 ,$21.99 ,$43.69 ,$43.69 ,$71.00 ,$52.99 ,$63.90 ,$22.21 ,$22.72 ,$67.45 ,$23.09 ,$22.72 ,$61.77 ,$21.99 ,$63.90 ,$21.99 ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),30100718,84260,HC SEROTONIN,301,1 ,$107.00 ,$80.25 ,$30.98 ,$107.00 ,$68.91 ,$30.98 ,$74.90 ,$32.01 ,$74.38 ,$32.97 ,$59.50 ,$101.65 ,$32.01 ,$85.60 ,$98.44 ,$32.01 ,$90.95 ,$101.65 ,$94.16 ,$81.32 ,$32.01 ,$32.01 ,$32.01 ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 ,$31.91 ,$58.85 ,$96.30 ,$30.98 ,$96.30 ,$57.78 ,$100.58 ,$69.71 ,$98.44 ,$33.93 ,$97.37 ,$30.98 ,$65.85 ,$65.85 ,$107.00 ,$79.85 ,$96.30 ,$31.29 ,$32.01 ,$101.65 ,$32.53 ,$32.01 ,$93.09 ,$30.98 ,$96.30 ,$30.98 ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),30100720,84270,HC SEX HORMONE BIND GLOB,301,1 ,$73.00 ,$54.75 ,$21.73 ,$73.00 ,$47.01 ,$21.73 ,$51.10 ,$22.45 ,$52.17 ,$23.12 ,$41.73 ,$69.35 ,$22.45 ,$58.40 ,$67.16 ,$22.45 ,$62.05 ,$69.35 ,$64.24 ,$55.48 ,$22.45 ,$22.45 ,$22.45 ,$53.29 ,$40.15 ,$66.43 ,$66.43 ,$58.40 ,$22.38 ,$40.15 ,$65.70 ,$21.73 ,$65.70 ,$39.42 ,$68.62 ,$48.89 ,$67.16 ,$23.80 ,$66.43 ,$21.73 ,$44.92 ,$44.92 ,$73.00 ,$54.48 ,$65.70 ,$21.95 ,$22.45 ,$69.35 ,$22.82 ,$22.45 ,$63.51 ,$21.73 ,$65.70 ,$21.73 ,$65.70 ,$65.70 ,$65.70 ,$70.81 ,$59.13 ,$67.89 ,$62.78 ,$70.81 
SACRED HEART HOSPITAL (ACU),30100721,84295,HC SODIUM,301,1 ,$98.00 ,$73.50 ,$4.81 ,$98.00 ,$63.11 ,$4.81 ,$68.60 ,$4.97 ,$11.55 ,$5.12 ,$9.24 ,$93.10 ,$4.97 ,$78.40 ,$90.16 ,$4.97 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$4.97 ,$4.97 ,$4.97 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$4.95 ,$53.90 ,$88.20 ,$4.81 ,$88.20 ,$52.92 ,$92.12 ,$10.82 ,$90.16 ,$5.27 ,$89.18 ,$4.81 ,$60.31 ,$60.31 ,$41.75 ,$73.14 ,$30.24 ,$4.86 ,$4.97 ,$93.10 ,$5.05 ,$4.97 ,$85.26 ,$4.81 ,$88.20 ,$4.81 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),30100724,84300,HC SODIUM URINE,301,1 ,$98.00 ,$73.50 ,$5.06 ,$98.00 ,$63.11 ,$5.06 ,$68.60 ,$5.23 ,$11.67 ,$5.39 ,$9.34 ,$93.10 ,$5.23 ,$78.40 ,$90.16 ,$5.23 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$5.23 ,$5.23 ,$5.23 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$5.21 ,$53.90 ,$88.20 ,$5.06 ,$88.20 ,$52.92 ,$92.12 ,$11.39 ,$90.16 ,$5.54 ,$89.18 ,$5.06 ,$60.31 ,$60.31 ,$41.75 ,$73.14 ,$30.55 ,$5.11 ,$5.23 ,$93.10 ,$5.31 ,$5.23 ,$85.26 ,$5.06 ,$88.20 ,$5.06 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),30100725,84302,HC SODIUM OTHER FLUID,301,1 ,$35.00 ,$26.25 ,$4.86 ,$35.00 ,$22.54 ,$4.86 ,$24.50 ,$5.02 ,$11.67 ,$5.17 ,$9.34 ,$33.25 ,$5.02 ,$28.00 ,$32.20 ,$5.02 ,$29.75 ,$33.25 ,$30.80 ,$26.60 ,$5.02 ,$5.02 ,$5.02 ,$25.55 ,$19.25 ,$31.85 ,$31.85 ,$28.00 ,$5.01 ,$19.25 ,$31.50 ,$4.86 ,$31.50 ,$18.90 ,$32.90 ,$10.94 ,$32.20 ,$5.32 ,$31.85 ,$4.86 ,$21.54 ,$21.54 ,$16.60 ,$26.12 ,$30.55 ,$4.91 ,$5.02 ,$33.25 ,$5.10 ,$5.02 ,$30.45 ,$4.86 ,$31.50 ,$4.86 ,$31.50 ,$31.50 ,$31.50 ,$33.95 ,$28.35 ,$32.55 ,$30.10 ,$33.95 
SACRED HEART HOSPITAL (ACU),30100726,84305,HC SOMATOMEDINC,301,1 ,$122.00 ,$91.50 ,$21.26 ,$122.00 ,$78.57 ,$21.26 ,$85.40 ,$21.97 ,$51.05 ,$22.63 ,$40.84 ,$115.90 ,$21.97 ,$97.60 ,$112.24 ,$21.97 ,$103.70 ,$115.90 ,$107.36 ,$92.72 ,$21.97 ,$21.97 ,$21.97 ,$89.06 ,$67.10 ,$111.02 ,$111.02 ,$97.60 ,$21.90 ,$67.10 ,$109.80 ,$21.26 ,$109.80 ,$65.88 ,$114.68 ,$47.84 ,$112.24 ,$23.29 ,$111.02 ,$21.26 ,$75.08 ,$75.08 ,$122.00 ,$91.05 ,$109.80 ,$21.47 ,$21.97 ,$115.90 ,$22.32 ,$21.97 ,$106.14 ,$21.26 ,$109.80 ,$21.26 ,$109.80 ,$109.80 ,$109.80 ,$118.34 ,$98.82 ,$113.46 ,$104.92 ,$118.34 
SACRED HEART HOSPITAL (ACU),30100727,84311,HC SPECTROPHOTOMETRY,301,1 ,$46.00 ,$34.50 ,$8.10 ,$46.00 ,$29.62 ,$8.10 ,$32.20 ,$8.37 ,$16.78 ,$8.62 ,$13.43 ,$43.70 ,$8.37 ,$36.80 ,$42.32 ,$8.37 ,$39.10 ,$43.70 ,$40.48 ,$34.96 ,$8.37 ,$8.37 ,$8.37 ,$33.58 ,$25.30 ,$41.86 ,$41.86 ,$36.80 ,$8.34 ,$25.30 ,$41.40 ,$8.10 ,$41.40 ,$24.84 ,$43.24 ,$18.23 ,$42.32 ,$8.87 ,$41.86 ,$8.10 ,$28.31 ,$28.31 ,$34.07 ,$34.33 ,$41.40 ,$8.18 ,$8.37 ,$43.70 ,$8.51 ,$8.37 ,$40.02 ,$8.10 ,$41.40 ,$8.10 ,$41.40 ,$41.40 ,$41.40 ,$44.62 ,$37.26 ,$42.78 ,$39.56 ,$44.62 
SACRED HEART HOSPITAL (ACU),30100728,84376,HC SUGARS SINGLE QL,301,1 ,$52.00 ,$39.00 ,$5.50 ,$52.00 ,$33.49 ,$5.50 ,$36.40 ,$5.68 ,$13.20 ,$5.85 ,$10.56 ,$49.40 ,$5.68 ,$41.60 ,$47.84 ,$5.68 ,$44.20 ,$49.40 ,$45.76 ,$39.52 ,$5.68 ,$5.68 ,$5.68 ,$37.96 ,$28.60 ,$47.32 ,$47.32 ,$41.60 ,$5.67 ,$28.60 ,$46.80 ,$5.50 ,$46.80 ,$28.08 ,$48.88 ,$12.38 ,$47.84 ,$6.02 ,$47.32 ,$5.50 ,$32.00 ,$32.00 ,$23.44 ,$38.81 ,$34.57 ,$5.56 ,$5.68 ,$49.40 ,$5.78 ,$5.68 ,$45.24 ,$5.50 ,$46.80 ,$5.50 ,$46.80 ,$46.80 ,$46.80 ,$50.44 ,$42.12 ,$48.36 ,$44.72 ,$50.44 
SACRED HEART HOSPITAL (ACU),30100732,84402,HC TESTOSTERONE FREE,301,1 ,$83.00 ,$62.25 ,$25.47 ,$83.00 ,$53.45 ,$25.47 ,$58.10 ,$26.32 ,$61.15 ,$27.11 ,$48.92 ,$78.85 ,$26.32 ,$66.40 ,$76.36 ,$26.32 ,$70.55 ,$78.85 ,$73.04 ,$63.08 ,$26.32 ,$26.32 ,$26.32 ,$60.59 ,$45.65 ,$75.53 ,$75.53 ,$66.40 ,$26.23 ,$45.65 ,$74.70 ,$25.47 ,$74.70 ,$44.82 ,$78.02 ,$57.31 ,$76.36 ,$27.90 ,$75.53 ,$25.47 ,$51.08 ,$51.08 ,$83.00 ,$61.94 ,$74.70 ,$25.72 ,$26.32 ,$78.85 ,$26.74 ,$26.32 ,$72.21 ,$25.47 ,$74.70 ,$25.47 ,$74.70 ,$74.70 ,$74.70 ,$80.51 ,$67.23 ,$77.19 ,$71.38 ,$80.51 
SACRED HEART HOSPITAL (ACU),30100733,84403,HC TESTOSTERONE TOTAL,301,1 ,$84.00 ,$63.00 ,$25.81 ,$84.00 ,$54.10 ,$25.81 ,$58.80 ,$26.67 ,$60.50 ,$27.47 ,$48.40 ,$79.80 ,$26.67 ,$67.20 ,$77.28 ,$26.67 ,$71.40 ,$79.80 ,$73.92 ,$63.84 ,$26.67 ,$26.67 ,$26.67 ,$61.32 ,$46.20 ,$76.44 ,$76.44 ,$67.20 ,$26.58 ,$46.20 ,$75.60 ,$25.81 ,$75.60 ,$45.36 ,$78.96 ,$58.07 ,$77.28 ,$28.27 ,$76.44 ,$25.81 ,$51.69 ,$51.69 ,$84.00 ,$62.69 ,$75.60 ,$26.07 ,$26.67 ,$79.80 ,$27.10 ,$26.67 ,$73.08 ,$25.81 ,$75.60 ,$25.81 ,$75.60 ,$75.60 ,$75.60 ,$81.48 ,$68.04 ,$78.12 ,$72.24 ,$81.48 
SACRED HEART HOSPITAL (ACU),30100735,84425,HC VITAMIN B1,301,1 ,$134.00 ,$100.50 ,$21.23 ,$134.00 ,$86.30 ,$21.23 ,$93.80 ,$21.94 ,$50.96 ,$22.60 ,$40.77 ,$127.30 ,$21.94 ,$107.20 ,$123.28 ,$21.94 ,$113.90 ,$127.30 ,$117.92 ,$101.84 ,$21.94 ,$21.94 ,$21.94 ,$97.82 ,$73.70 ,$121.94 ,$121.94 ,$107.20 ,$21.87 ,$73.70 ,$120.60 ,$21.23 ,$120.60 ,$72.36 ,$125.96 ,$47.77 ,$123.28 ,$23.26 ,$121.94 ,$21.23 ,$82.46 ,$82.46 ,$134.00 ,$100.00 ,$120.60 ,$21.44 ,$21.94 ,$127.30 ,$22.29 ,$21.94 ,$116.58 ,$21.23 ,$120.60 ,$21.23 ,$120.60 ,$120.60 ,$120.60 ,$129.98 ,$108.54 ,$124.62 ,$115.24 ,$129.98 
SACRED HEART HOSPITAL (ACU),30100737,84432,HC THYROGLOBULIN,301,1 ,$52.00 ,$39.00 ,$16.06 ,$52.00 ,$33.49 ,$16.06 ,$36.40 ,$16.59 ,$38.55 ,$17.09 ,$30.84 ,$49.40 ,$16.59 ,$41.60 ,$47.84 ,$16.59 ,$44.20 ,$49.40 ,$45.76 ,$39.52 ,$16.59 ,$16.59 ,$16.59 ,$37.96 ,$28.60 ,$47.32 ,$47.32 ,$41.60 ,$16.54 ,$28.60 ,$46.80 ,$16.06 ,$46.80 ,$28.08 ,$48.88 ,$36.14 ,$47.84 ,$17.59 ,$47.32 ,$16.06 ,$32.00 ,$32.00 ,$43.91 ,$38.81 ,$46.80 ,$16.22 ,$16.59 ,$49.40 ,$16.86 ,$16.59 ,$45.24 ,$16.06 ,$46.80 ,$16.06 ,$46.80 ,$46.80 ,$46.80 ,$50.44 ,$42.12 ,$48.36 ,$44.72 ,$50.44 
SACRED HEART HOSPITAL (ACU),30100739,84436,HC THYROXINE (T-4) TOTAL,301,1 ,$35.00 ,$26.25 ,$6.87 ,$35.00 ,$22.54 ,$6.87 ,$24.50 ,$7.10 ,$16.49 ,$7.31 ,$13.19 ,$33.25 ,$7.10 ,$28.00 ,$32.20 ,$7.10 ,$29.75 ,$33.25 ,$30.80 ,$26.60 ,$7.10 ,$7.10 ,$7.10 ,$25.55 ,$19.25 ,$31.85 ,$31.85 ,$28.00 ,$7.08 ,$19.25 ,$31.50 ,$6.87 ,$31.50 ,$18.90 ,$32.90 ,$15.46 ,$32.20 ,$7.53 ,$31.85 ,$6.87 ,$21.54 ,$21.54 ,$35.00 ,$26.12 ,$31.50 ,$6.94 ,$7.10 ,$33.25 ,$7.21 ,$7.10 ,$30.45 ,$6.87 ,$31.50 ,$6.87 ,$31.50 ,$31.50 ,$31.50 ,$33.95 ,$28.35 ,$32.55 ,$30.10 ,$33.95 
SACRED HEART HOSPITAL (ACU),30100740,84439,HC T4 FREE,301,1 ,$115.00 ,$86.25 ,$9.02 ,$115.00 ,$74.06 ,$9.02 ,$80.50 ,$9.32 ,$21.65 ,$9.60 ,$17.32 ,$109.25 ,$9.32 ,$92.00 ,$105.80 ,$9.32 ,$97.75 ,$109.25 ,$101.20 ,$87.40 ,$9.32 ,$9.32 ,$9.32 ,$83.95 ,$63.25 ,$104.65 ,$104.65 ,$92.00 ,$9.29 ,$63.25 ,$103.50 ,$9.02 ,$103.50 ,$62.10 ,$108.10 ,$20.30 ,$105.80 ,$9.88 ,$104.65 ,$9.02 ,$70.77 ,$70.77 ,$92.26 ,$85.82 ,$56.67 ,$9.11 ,$9.32 ,$109.25 ,$9.47 ,$9.32 ,$100.05 ,$9.02 ,$103.50 ,$9.02 ,$103.50 ,$103.50 ,$103.50 ,$111.55 ,$93.15 ,$106.95 ,$98.90 ,$111.55 
SACRED HEART HOSPITAL (ACU),30100743,84443,HC THYROID STIMULATING HORM,301,1 ,$202.00 ,$151.50 ,$16.80 ,$202.00 ,$130.09 ,$16.80 ,$141.40 ,$17.36 ,$40.34 ,$17.88 ,$32.27 ,$191.90 ,$17.36 ,$161.60 ,$185.84 ,$17.36 ,$171.70 ,$191.90 ,$177.76 ,$153.52 ,$17.36 ,$17.36 ,$17.36 ,$147.46 ,$111.10 ,$183.82 ,$183.82 ,$161.60 ,$17.30 ,$111.10 ,$181.80 ,$16.80 ,$181.80 ,$109.08 ,$189.88 ,$37.80 ,$185.84 ,$18.40 ,$183.82 ,$16.80 ,$124.31 ,$124.31 ,$127.39 ,$150.75 ,$105.65 ,$16.97 ,$17.36 ,$191.90 ,$17.64 ,$17.36 ,$175.74 ,$16.80 ,$181.80 ,$16.80 ,$181.80 ,$181.80 ,$181.80 ,$195.94 ,$163.62 ,$187.86 ,$173.72 ,$195.94 
SACRED HEART HOSPITAL (ACU),30100744,84445,HC THYROID STIM IMMUNO GLOB,301,1 ,$183.00 ,$137.25 ,$32.70 ,$183.00 ,$117.85 ,$50.86 ,$128.10 ,$32.70 ,$55.83 ,$33.68 ,$44.66 ,$173.85 ,$32.70 ,$146.40 ,$168.36 ,$32.70 ,$155.55 ,$173.85 ,$161.04 ,$139.08 ,$32.70 ,$32.70 ,$32.70 ,$133.59 ,$100.65 ,$166.53 ,$166.53 ,$146.40 ,$52.39 ,$100.65 ,$164.70 ,$50.86 ,$164.70 ,$98.82 ,$172.02 ,$114.44 ,$168.36 ,$34.66 ,$166.53 ,$50.86 ,$112.62 ,$112.62 ,$127.39 ,$136.57 ,$164.70 ,$51.37 ,$32.70 ,$173.85 ,$53.40 ,$32.70 ,$159.21 ,$50.86 ,$164.70 ,$50.86 ,$164.70 ,$164.70 ,$164.70 ,$177.51 ,$148.23 ,$170.19 ,$157.38 ,$177.51 
SACRED HEART HOSPITAL (ACU),30100745,84446,HC VITAMIN E,301,1 ,$82.00 ,$61.50 ,$14.18 ,$82.00 ,$52.81 ,$14.18 ,$57.40 ,$14.65 ,$34.04 ,$15.09 ,$27.23 ,$77.90 ,$14.65 ,$65.60 ,$75.44 ,$14.65 ,$69.70 ,$77.90 ,$72.16 ,$62.32 ,$14.65 ,$14.65 ,$14.65 ,$59.86 ,$45.10 ,$74.62 ,$74.62 ,$65.60 ,$14.61 ,$45.10 ,$73.80 ,$14.18 ,$73.80 ,$44.28 ,$77.08 ,$31.91 ,$75.44 ,$15.53 ,$74.62 ,$14.18 ,$50.46 ,$50.46 ,$46.12 ,$61.20 ,$73.80 ,$14.32 ,$14.65 ,$77.90 ,$14.89 ,$14.65 ,$71.34 ,$14.18 ,$73.80 ,$14.18 ,$73.80 ,$73.80 ,$73.80 ,$79.54 ,$66.42 ,$76.26 ,$70.52 ,$79.54 
SACRED HEART HOSPITAL (ACU),30100746,84450,HC AST,301,1 ,$112.00 ,$84.00 ,$5.18 ,$112.00 ,$72.13 ,$5.18 ,$78.40 ,$5.35 ,$12.43 ,$5.51 ,$9.94 ,$106.40 ,$5.35 ,$89.60 ,$103.04 ,$5.35 ,$95.20 ,$106.40 ,$98.56 ,$85.12 ,$5.35 ,$5.35 ,$5.35 ,$81.76 ,$61.60 ,$101.92 ,$101.92 ,$89.60 ,$5.34 ,$61.60 ,$100.80 ,$5.18 ,$100.80 ,$60.48 ,$105.28 ,$11.66 ,$103.04 ,$5.67 ,$101.92 ,$5.18 ,$68.92 ,$68.92 ,$48.30 ,$83.59 ,$32.54 ,$5.23 ,$5.35 ,$106.40 ,$5.44 ,$5.35 ,$97.44 ,$5.18 ,$100.80 ,$5.18 ,$100.80 ,$100.80 ,$100.80 ,$108.64 ,$90.72 ,$104.16 ,$96.32 ,$108.64 
SACRED HEART HOSPITAL (ACU),30100747,84460,HC ALT,301,1 ,$128.00 ,$96.00 ,$5.30 ,$128.00 ,$82.43 ,$5.30 ,$89.60 ,$5.48 ,$12.72 ,$5.64 ,$10.18 ,$121.60 ,$5.48 ,$102.40 ,$117.76 ,$5.48 ,$108.80 ,$121.60 ,$112.64 ,$97.28 ,$5.48 ,$5.48 ,$5.48 ,$93.44 ,$70.40 ,$116.48 ,$116.48 ,$102.40 ,$5.46 ,$70.40 ,$115.20 ,$5.30 ,$115.20 ,$69.12 ,$120.32 ,$11.93 ,$117.76 ,$5.81 ,$116.48 ,$5.30 ,$78.77 ,$78.77 ,$52.72 ,$95.53 ,$33.30 ,$5.35 ,$5.48 ,$121.60 ,$5.57 ,$5.48 ,$111.36 ,$5.30 ,$115.20 ,$5.30 ,$115.20 ,$115.20 ,$115.20 ,$124.16 ,$103.68 ,$119.04 ,$110.08 ,$124.16 
SACRED HEART HOSPITAL (ACU),30100748,84466,HC TRANSFERRIN,301,1 ,$140.00 ,$105.00 ,$12.76 ,$140.00 ,$90.16 ,$12.76 ,$98.00 ,$13.18 ,$30.64 ,$13.58 ,$24.51 ,$133.00 ,$13.18 ,$112.00 ,$128.80 ,$13.18 ,$119.00 ,$133.00 ,$123.20 ,$106.40 ,$13.18 ,$13.18 ,$13.18 ,$102.20 ,$77.00 ,$127.40 ,$127.40 ,$112.00 ,$13.14 ,$77.00 ,$126.00 ,$12.76 ,$126.00 ,$75.60 ,$131.60 ,$28.71 ,$128.80 ,$13.97 ,$127.40 ,$12.76 ,$86.16 ,$86.16 ,$109.82 ,$104.48 ,$80.24 ,$12.89 ,$13.18 ,$133.00 ,$13.40 ,$13.18 ,$121.80 ,$12.76 ,$126.00 ,$12.76 ,$126.00 ,$126.00 ,$126.00 ,$135.80 ,$113.40 ,$130.20 ,$120.40 ,$135.80 
SACRED HEART HOSPITAL (ACU),30100750,84478,HC TRIGLYCERIDES,301,1 ,$150.00 ,$112.50 ,$5.74 ,$150.00 ,$96.60 ,$5.74 ,$105.00 ,$5.93 ,$13.79 ,$6.11 ,$11.03 ,$142.50 ,$5.93 ,$120.00 ,$138.00 ,$5.93 ,$127.50 ,$142.50 ,$132.00 ,$114.00 ,$5.93 ,$5.93 ,$5.93 ,$109.50 ,$82.50 ,$136.50 ,$136.50 ,$120.00 ,$5.91 ,$82.50 ,$135.00 ,$5.74 ,$135.00 ,$81.00 ,$141.00 ,$12.92 ,$138.00 ,$6.29 ,$136.50 ,$5.74 ,$92.31 ,$92.31 ,$54.90 ,$111.95 ,$36.10 ,$5.80 ,$5.93 ,$142.50 ,$6.03 ,$5.93 ,$130.50 ,$5.74 ,$135.00 ,$5.74 ,$135.00 ,$135.00 ,$135.00 ,$145.50 ,$121.50 ,$139.50 ,$129.00 ,$145.50 
SACRED HEART HOSPITAL (ACU),30100753,84479,HC T3 UPTAKE,301,1 ,$60.00 ,$45.00 ,$6.47 ,$60.00 ,$38.64 ,$6.47 ,$42.00 ,$6.69 ,$15.52 ,$6.89 ,$12.42 ,$57.00 ,$6.69 ,$48.00 ,$55.20 ,$6.69 ,$51.00 ,$57.00 ,$52.80 ,$45.60 ,$6.69 ,$6.69 ,$6.69 ,$43.80 ,$33.00 ,$54.60 ,$54.60 ,$48.00 ,$6.66 ,$33.00 ,$54.00 ,$6.47 ,$54.00 ,$32.40 ,$56.40 ,$14.56 ,$55.20 ,$7.09 ,$54.60 ,$6.47 ,$36.92 ,$36.92 ,$60.00 ,$44.78 ,$40.63 ,$6.53 ,$6.69 ,$57.00 ,$6.79 ,$6.69 ,$52.20 ,$6.47 ,$54.00 ,$6.47 ,$54.00 ,$54.00 ,$54.00 ,$58.20 ,$48.60 ,$55.80 ,$51.60 ,$58.20 
SACRED HEART HOSPITAL (ACU),30100754,84480,HC T3 TOTAL,301,1 ,$150.00 ,$112.50 ,$14.18 ,$150.00 ,$96.60 ,$14.18 ,$105.00 ,$14.65 ,$34.04 ,$15.09 ,$27.23 ,$142.50 ,$14.65 ,$120.00 ,$138.00 ,$14.65 ,$127.50 ,$142.50 ,$132.00 ,$114.00 ,$14.65 ,$14.65 ,$14.65 ,$109.50 ,$82.50 ,$136.50 ,$136.50 ,$120.00 ,$14.61 ,$82.50 ,$135.00 ,$14.18 ,$135.00 ,$81.00 ,$141.00 ,$31.91 ,$138.00 ,$15.53 ,$136.50 ,$14.18 ,$92.31 ,$92.31 ,$92.26 ,$111.95 ,$89.15 ,$14.32 ,$14.65 ,$142.50 ,$14.89 ,$14.65 ,$130.50 ,$14.18 ,$135.00 ,$14.18 ,$135.00 ,$135.00 ,$135.00 ,$145.50 ,$121.50 ,$139.50 ,$129.00 ,$145.50 
SACRED HEART HOSPITAL (ACU),30100755,84481,HC T3 FREE,301,1 ,$55.00 ,$41.25 ,$16.62 ,$55.00 ,$35.42 ,$16.94 ,$38.50 ,$16.62 ,$28.37 ,$17.12 ,$22.69 ,$52.25 ,$16.62 ,$44.00 ,$50.60 ,$16.62 ,$46.75 ,$52.25 ,$48.40 ,$41.80 ,$16.62 ,$16.62 ,$16.62 ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 ,$17.45 ,$30.25 ,$49.50 ,$16.94 ,$49.50 ,$29.70 ,$51.70 ,$38.12 ,$50.60 ,$17.62 ,$50.05 ,$16.94 ,$33.85 ,$33.85 ,$55.00 ,$41.05 ,$49.50 ,$17.11 ,$16.62 ,$52.25 ,$17.79 ,$16.62 ,$47.85 ,$16.94 ,$49.50 ,$16.94 ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),30100757,84482,HC T3 REVERSE,301,1 ,$103.00 ,$77.25 ,$10.82 ,$103.00 ,$66.33 ,$15.76 ,$72.10 ,$10.82 ,$18.46 ,$11.14 ,$14.77 ,$97.85 ,$10.82 ,$82.40 ,$94.76 ,$10.82 ,$87.55 ,$97.85 ,$90.64 ,$78.28 ,$10.82 ,$10.82 ,$10.82 ,$75.19 ,$56.65 ,$93.73 ,$93.73 ,$82.40 ,$16.23 ,$56.65 ,$92.70 ,$15.76 ,$92.70 ,$55.62 ,$96.82 ,$35.46 ,$94.76 ,$11.47 ,$93.73 ,$15.76 ,$63.39 ,$63.39 ,$103.00 ,$76.87 ,$92.70 ,$15.92 ,$10.82 ,$97.85 ,$16.55 ,$10.82 ,$89.61 ,$15.76 ,$92.70 ,$15.76 ,$92.70 ,$92.70 ,$92.70 ,$99.91 ,$83.43 ,$95.79 ,$88.58 ,$99.91 
SACRED HEART HOSPITAL (ACU),30100758,84484,HC TROPONIN QN,301,1 ,$270.00 ,$202.50 ,$12.47 ,$270.00 ,$173.88 ,$12.47 ,$189.00 ,$12.89 ,$23.63 ,$13.28 ,$18.90 ,$256.50 ,$12.89 ,$216.00 ,$248.40 ,$12.89 ,$229.50 ,$256.50 ,$237.60 ,$205.20 ,$12.89 ,$12.89 ,$12.89 ,$197.10 ,$148.50 ,$245.70 ,$245.70 ,$216.00 ,$12.84 ,$148.50 ,$243.00 ,$12.47 ,$243.00 ,$145.80 ,$253.80 ,$28.06 ,$248.40 ,$13.66 ,$245.70 ,$12.47 ,$166.16 ,$166.16 ,$34.79 ,$201.50 ,$63.49 ,$12.59 ,$12.89 ,$256.50 ,$13.09 ,$12.89 ,$234.90 ,$12.47 ,$243.00 ,$12.47 ,$243.00 ,$243.00 ,$243.00 ,$261.90 ,$218.70 ,$251.10 ,$232.20 ,$261.90 
SACRED HEART HOSPITAL (ACU),30100761,84520,HC BUN,301,1 ,$91.00 ,$68.25 ,$3.95 ,$91.00 ,$58.60 ,$3.95 ,$63.70 ,$4.08 ,$9.49 ,$4.20 ,$7.59 ,$86.45 ,$4.08 ,$72.80 ,$83.72 ,$4.08 ,$77.35 ,$86.45 ,$80.08 ,$69.16 ,$4.08 ,$4.08 ,$4.08 ,$66.43 ,$50.05 ,$82.81 ,$82.81 ,$72.80 ,$4.07 ,$50.05 ,$81.90 ,$3.95 ,$81.90 ,$49.14 ,$85.54 ,$8.89 ,$83.72 ,$4.32 ,$82.81 ,$3.95 ,$56.00 ,$56.00 ,$46.12 ,$67.91 ,$24.85 ,$3.99 ,$4.08 ,$86.45 ,$4.15 ,$4.08 ,$79.17 ,$3.95 ,$81.90 ,$3.95 ,$81.90 ,$81.90 ,$81.90 ,$88.27 ,$73.71 ,$84.63 ,$78.26 ,$88.27 
SACRED HEART HOSPITAL (ACU),30100764,84540,HC UREA URINE,301,1 ,$78.00 ,$58.50 ,$5.56 ,$78.00 ,$50.23 ,$5.56 ,$54.60 ,$5.75 ,$11.39 ,$5.92 ,$9.11 ,$74.10 ,$5.75 ,$62.40 ,$71.76 ,$5.75 ,$66.30 ,$74.10 ,$68.64 ,$59.28 ,$5.75 ,$5.75 ,$5.75 ,$56.94 ,$42.90 ,$70.98 ,$70.98 ,$62.40 ,$5.73 ,$42.90 ,$70.20 ,$5.56 ,$70.20 ,$42.12 ,$73.32 ,$12.51 ,$71.76 ,$6.10 ,$70.98 ,$5.56 ,$48.00 ,$48.00 ,$46.12 ,$58.21 ,$29.84 ,$5.62 ,$5.75 ,$74.10 ,$5.84 ,$5.75 ,$67.86 ,$5.56 ,$70.20 ,$5.56 ,$70.20 ,$70.20 ,$70.20 ,$75.66 ,$63.18 ,$72.54 ,$67.08 ,$75.66 
SACRED HEART HOSPITAL (ACU),30100765,84550,HC URIC ACID,301,1 ,$158.00 ,$118.50 ,$4.52 ,$158.00 ,$101.75 ,$4.52 ,$110.60 ,$4.67 ,$10.85 ,$4.81 ,$8.68 ,$150.10 ,$4.67 ,$126.40 ,$145.36 ,$4.67 ,$134.30 ,$150.10 ,$139.04 ,$120.08 ,$4.67 ,$4.67 ,$4.67 ,$115.34 ,$86.90 ,$143.78 ,$143.78 ,$126.40 ,$4.66 ,$86.90 ,$142.20 ,$4.52 ,$142.20 ,$85.32 ,$148.52 ,$10.17 ,$145.36 ,$4.95 ,$143.78 ,$4.52 ,$97.23 ,$97.23 ,$63.68 ,$117.92 ,$28.41 ,$4.57 ,$4.67 ,$150.10 ,$4.75 ,$4.67 ,$137.46 ,$4.52 ,$142.20 ,$4.52 ,$142.20 ,$142.20 ,$142.20 ,$153.26 ,$127.98 ,$146.94 ,$135.88 ,$153.26 
SACRED HEART HOSPITAL (ACU),30100766,84560,HC URIC ACID OTH SRC,301,1 ,$159.00 ,$119.25 ,$5.08 ,$159.00 ,$102.40 ,$5.08 ,$111.30 ,$5.25 ,$11.39 ,$5.41 ,$9.11 ,$151.05 ,$5.25 ,$127.20 ,$146.28 ,$5.25 ,$135.15 ,$151.05 ,$139.92 ,$120.84 ,$5.25 ,$5.25 ,$5.25 ,$116.07 ,$87.45 ,$144.69 ,$144.69 ,$127.20 ,$5.23 ,$87.45 ,$143.10 ,$5.08 ,$143.10 ,$85.86 ,$149.46 ,$11.43 ,$146.28 ,$5.57 ,$144.69 ,$5.08 ,$97.85 ,$97.85 ,$48.30 ,$118.66 ,$29.84 ,$5.13 ,$5.25 ,$151.05 ,$5.33 ,$5.25 ,$138.33 ,$5.08 ,$143.10 ,$5.08 ,$143.10 ,$143.10 ,$143.10 ,$154.23 ,$128.79 ,$147.87 ,$136.74 ,$154.23 
SACRED HEART HOSPITAL (ACU),30100768,84585,HC VANILLYLMAND AC (VMA),301,1 ,$90.00 ,$67.50 ,$15.50 ,$90.00 ,$57.96 ,$15.50 ,$63.00 ,$16.02 ,$37.21 ,$16.50 ,$29.76 ,$85.50 ,$16.02 ,$72.00 ,$82.80 ,$16.02 ,$76.50 ,$85.50 ,$79.20 ,$68.40 ,$16.02 ,$16.02 ,$16.02 ,$65.70 ,$49.50 ,$81.90 ,$81.90 ,$72.00 ,$15.97 ,$49.50 ,$81.00 ,$15.50 ,$81.00 ,$48.60 ,$84.60 ,$34.88 ,$82.80 ,$16.98 ,$81.90 ,$15.50 ,$55.39 ,$55.39 ,$90.00 ,$67.17 ,$81.00 ,$15.66 ,$16.02 ,$85.50 ,$16.28 ,$16.02 ,$78.30 ,$15.50 ,$81.00 ,$15.50 ,$81.00 ,$81.00 ,$81.00 ,$87.30 ,$72.90 ,$83.70 ,$77.40 ,$87.30 
SACRED HEART HOSPITAL (ACU),30100769,84586,HC VASOACTIVE INTEST PEPTIDE,301,1 ,$185.00 ,$138.75 ,$17.93 ,$185.00 ,$119.14 ,$35.33 ,$129.50 ,$17.93 ,$30.61 ,$18.47 ,$24.49 ,$175.75 ,$17.93 ,$148.00 ,$170.20 ,$17.93 ,$157.25 ,$175.75 ,$162.80 ,$140.60 ,$17.93 ,$17.93 ,$17.93 ,$135.05 ,$101.75 ,$168.35 ,$168.35 ,$148.00 ,$36.39 ,$101.75 ,$166.50 ,$35.33 ,$166.50 ,$99.90 ,$173.90 ,$79.49 ,$170.20 ,$19.01 ,$168.35 ,$35.33 ,$113.85 ,$113.85 ,$98.75 ,$138.07 ,$166.50 ,$35.68 ,$17.93 ,$175.75 ,$37.10 ,$17.93 ,$160.95 ,$35.33 ,$166.50 ,$35.33 ,$166.50 ,$166.50 ,$166.50 ,$179.45 ,$149.85 ,$172.05 ,$159.10 ,$179.45 
SACRED HEART HOSPITAL (ACU),30100771,84590,HC VITAMIN A,301,1 ,$76.00 ,$57.00 ,$11.61 ,$76.00 ,$48.94 ,$11.61 ,$53.20 ,$12.00 ,$27.86 ,$12.36 ,$22.29 ,$72.20 ,$12.00 ,$60.80 ,$69.92 ,$12.00 ,$64.60 ,$72.20 ,$66.88 ,$57.76 ,$12.00 ,$12.00 ,$12.00 ,$55.48 ,$41.80 ,$69.16 ,$69.16 ,$60.80 ,$11.96 ,$41.80 ,$68.40 ,$11.61 ,$68.40 ,$41.04 ,$71.44 ,$26.12 ,$69.92 ,$12.72 ,$69.16 ,$11.61 ,$46.77 ,$46.77 ,$76.00 ,$56.72 ,$68.40 ,$11.73 ,$12.00 ,$72.20 ,$12.19 ,$12.00 ,$66.12 ,$11.61 ,$68.40 ,$11.61 ,$68.40 ,$68.40 ,$68.40 ,$73.72 ,$61.56 ,$70.68 ,$65.36 ,$73.72 
SACRED HEART HOSPITAL (ACU),30100773,80320,HC VOLATILES,301,1 ,$298.00 ,$223.50 ,$3.94 ,$298.00 ,$191.91 , N/A ,$208.60 ,$3.94 ,$41.42 ,$4.06 ,$33.14 ,$283.10 ,$3.94 ,$238.40 ,$274.16 ,$3.94 ,$253.30 ,$283.10 ,$262.24 ,$226.48 ,$3.94 ,$3.94 ,$3.94 ,$217.54 ,$163.90 ,$271.18 ,$271.18 ,$238.40 , N/A ,$163.90 ,$268.20 , N/A ,$268.20 ,$160.92 ,$280.12 , N/A ,$274.16 ,$4.18 ,$271.18 , N/A ,$183.39 ,$183.39 ,$47.23 ,$222.40 ,$207.56 , N/A ,$3.94 ,$283.10 , N/A ,$3.94 ,$259.26 , N/A ,$268.20 , N/A ,$268.20 ,$268.20 ,$268.20 ,$289.06 ,$241.38 ,$277.14 ,$256.28 ,$289.06 
SACRED HEART HOSPITAL (ACU),30100776,84630,HC ZINC,301,1 ,$109.00 ,$81.75 ,$11.39 ,$109.00 ,$70.20 ,$11.39 ,$76.30 ,$11.77 ,$24.87 ,$12.12 ,$19.89 ,$103.55 ,$11.77 ,$87.20 ,$100.28 ,$11.77 ,$92.65 ,$103.55 ,$95.92 ,$82.84 ,$11.77 ,$11.77 ,$11.77 ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 ,$11.73 ,$59.95 ,$98.10 ,$11.39 ,$98.10 ,$58.86 ,$102.46 ,$25.63 ,$100.28 ,$12.48 ,$99.19 ,$11.39 ,$67.08 ,$67.08 ,$48.73 ,$81.35 ,$71.59 ,$11.50 ,$11.77 ,$103.55 ,$11.96 ,$11.77 ,$94.83 ,$11.39 ,$98.10 ,$11.39 ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),30100801,84681,HC C PEPTIDE,301,1 ,$77.00 ,$57.75 ,$7.34 ,$77.00 ,$49.59 ,$20.81 ,$53.90 ,$7.34 ,$12.53 ,$7.56 ,$10.02 ,$73.15 ,$7.34 ,$61.60 ,$70.84 ,$7.34 ,$65.45 ,$73.15 ,$67.76 ,$58.52 ,$7.34 ,$7.34 ,$7.34 ,$56.21 ,$42.35 ,$70.07 ,$70.07 ,$61.60 ,$21.43 ,$42.35 ,$69.30 ,$20.81 ,$69.30 ,$41.58 ,$72.38 ,$46.82 ,$70.84 ,$7.78 ,$70.07 ,$20.81 ,$47.39 ,$47.39 ,$36.22 ,$57.47 ,$69.30 ,$21.02 ,$7.34 ,$73.15 ,$21.85 ,$7.34 ,$66.99 ,$20.81 ,$69.30 ,$20.81 ,$69.30 ,$69.30 ,$69.30 ,$74.69 ,$62.37 ,$71.61 ,$66.22 ,$74.69 
SACRED HEART HOSPITAL (ACU),30100802,84702,HC HCG QN,301,1 ,$245.00 ,$183.75 ,$15.05 ,$245.00 ,$157.78 ,$15.05 ,$171.50 ,$15.55 ,$36.14 ,$16.02 ,$28.91 ,$232.75 ,$15.55 ,$196.00 ,$225.40 ,$15.55 ,$208.25 ,$232.75 ,$215.60 ,$186.20 ,$15.55 ,$15.55 ,$15.55 ,$178.85 ,$134.75 ,$222.95 ,$222.95 ,$196.00 ,$15.50 ,$134.75 ,$220.50 ,$15.05 ,$220.50 ,$132.30 ,$230.30 ,$33.86 ,$225.40 ,$16.48 ,$222.95 ,$15.05 ,$150.77 ,$150.77 ,$65.02 ,$182.84 ,$94.65 ,$15.20 ,$15.55 ,$232.75 ,$15.80 ,$15.55 ,$213.15 ,$15.05 ,$220.50 ,$15.05 ,$220.50 ,$220.50 ,$220.50 ,$237.65 ,$198.45 ,$227.85 ,$210.70 ,$237.65 
SACRED HEART HOSPITAL (ACU),30100808,84703,HC HCG QL,301,1 ,$207.00 ,$155.25 ,$7.52 ,$207.00 ,$133.31 ,$7.52 ,$144.90 ,$7.77 ,$18.06 ,$8.00 ,$14.45 ,$196.65 ,$7.77 ,$165.60 ,$190.44 ,$7.77 ,$175.95 ,$196.65 ,$182.16 ,$157.32 ,$7.77 ,$7.77 ,$7.77 ,$151.11 ,$113.85 ,$188.37 ,$188.37 ,$165.60 ,$7.75 ,$113.85 ,$186.30 ,$7.52 ,$186.30 ,$111.78 ,$194.58 ,$16.92 ,$190.44 ,$8.24 ,$188.37 ,$7.52 ,$127.39 ,$127.39 ,$67.41 ,$154.48 ,$47.30 ,$7.60 ,$7.77 ,$196.65 ,$7.90 ,$7.77 ,$180.09 ,$7.52 ,$186.30 ,$7.52 ,$186.30 ,$186.30 ,$186.30 ,$200.79 ,$167.67 ,$192.51 ,$178.02 ,$200.79 
SACRED HEART HOSPITAL (ACU),30100809,84999,HC CHEMISTRY UNLISTED,301,1 ,$80.00 ,$60.00 ,$3.94 ,$80.00 ,$51.52 , N/A ,$56.00 ,$3.94 ,$66.40 ,$4.06 ,$52.80 ,$76.00 ,$3.94 ,$64.00 ,$73.60 ,$3.94 ,$68.00 ,$76.00 ,$70.40 ,$60.80 ,$3.94 ,$3.94 ,$3.94 ,$58.40 ,$44.00 ,$72.80 ,$72.80 ,$64.00 , N/A ,$44.00 ,$72.00 , N/A ,$72.00 ,$43.20 ,$75.20 ,$48.00 ,$73.60 ,$4.18 ,$72.80 , N/A ,$49.23 ,$49.23 ,$72.00 ,$59.70 ,$55.72 ,$65.60 ,$3.94 ,$76.00 , N/A ,$3.94 ,$69.60 , N/A ,$72.00 , N/A ,$72.00 ,$72.00 ,$72.00 ,$77.60 ,$64.80 ,$74.40 ,$68.80 ,$77.60 
SACRED HEART HOSPITAL (ACU),30100810,88720,HC BILICHECK TEST,301,1 ,$106.00 ,$79.50 ,$3.63 ,$106.00 ,$68.26 ,$5.02 ,$74.20 ,$3.63 ,$12.04 ,$3.74 ,$9.63 ,$100.70 ,$3.63 ,$84.80 ,$97.52 ,$3.63 ,$90.10 ,$100.70 ,$93.28 ,$80.56 ,$3.63 ,$3.63 ,$3.63 ,$77.38 ,$58.30 ,$96.46 ,$96.46 ,$84.80 ,$5.17 ,$58.30 ,$95.40 ,$5.02 ,$95.40 ,$57.24 ,$99.64 ,$11.30 ,$97.52 ,$3.85 ,$96.46 ,$5.02 ,$65.23 ,$65.23 ,$30.80 ,$79.11 ,$31.52 ,$5.07 ,$3.63 ,$100.70 ,$5.27 ,$3.63 ,$92.22 ,$5.02 ,$95.40 ,$5.02 ,$95.40 ,$95.40 ,$95.40 ,$102.82 ,$85.86 ,$98.58 ,$91.16 ,$102.82 
SACRED HEART HOSPITAL (ACU),30100815,G0123,HC PAP SMEAR THIN PREP SCREEN,311,1 ,$118.50 ,$88.88 ,$20.26 ,$118.50 ,$76.31 ,$20.26 ,$82.95 ,$20.93 ,$48.63 ,$21.56 ,$38.91 ,$112.58 ,$20.93 ,$94.80 ,$109.02 ,$20.93 ,$100.73 ,$112.58 ,$104.28 ,$90.06 ,$20.93 ,$20.93 ,$20.93 ,$86.51 ,$65.18 ,$107.84 ,$107.84 ,$94.80 ,$20.87 ,$65.18 ,$106.65 ,$20.26 ,$106.65 ,$63.99 ,$111.39 ,$45.59 ,$109.02 ,$22.19 ,$107.84 ,$20.26 ,$72.92 ,$72.92 ,$106.65 ,$88.44 ,$106.65 ,$20.46 ,$20.93 ,$112.58 ,$21.27 ,$20.93 ,$103.10 ,$20.26 ,$106.65 ,$20.26 ,$106.65 ,$106.65 ,$106.65 ,$114.95 ,$95.99 ,$110.21 ,$101.91 ,$114.95 
SACRED HEART HOSPITAL (ACU),30100818,84182,HC PROTEIN WEST BLOT BAND ID,301,1 ,$293.00 ,$219.75 ,$25.31 ,$293.00 ,$188.69 ,$29.21 ,$205.10 ,$25.31 ,$43.21 ,$26.07 ,$34.57 ,$278.35 ,$25.31 ,$234.40 ,$269.56 ,$25.31 ,$249.05 ,$278.35 ,$257.84 ,$222.68 ,$25.31 ,$25.31 ,$25.31 ,$213.89 ,$161.15 ,$266.63 ,$266.63 ,$234.40 ,$30.09 ,$161.15 ,$263.70 ,$29.21 ,$263.70 ,$158.22 ,$275.42 ,$65.72 ,$269.56 ,$26.83 ,$266.63 ,$29.21 ,$180.31 ,$180.31 ,$99.52 ,$218.67 ,$148.73 ,$29.50 ,$25.31 ,$278.35 ,$30.67 ,$25.31 ,$254.91 ,$29.21 ,$263.70 ,$29.21 ,$263.70 ,$263.70 ,$263.70 ,$284.21 ,$237.33 ,$272.49 ,$251.98 ,$284.21 
SACRED HEART HOSPITAL (ACU),30100820,83664,HC LAMELLAR BODY CT,301,1 ,$74.00 ,$55.50 ,$6.82 ,$74.00 ,$47.66 ,$19.32 ,$51.80 ,$6.82 ,$45.40 ,$7.02 ,$36.32 ,$70.30 ,$6.82 ,$59.20 ,$68.08 ,$6.82 ,$62.90 ,$70.30 ,$65.12 ,$56.24 ,$6.82 ,$6.82 ,$6.82 ,$54.02 ,$40.70 ,$67.34 ,$67.34 ,$59.20 ,$19.90 ,$40.70 ,$66.60 ,$19.32 ,$66.60 ,$39.96 ,$69.56 ,$43.47 ,$68.08 ,$7.23 ,$67.34 ,$19.32 ,$45.54 ,$45.54 ,$30.93 ,$55.23 ,$66.60 ,$19.51 ,$6.82 ,$70.30 ,$20.29 ,$6.82 ,$64.38 ,$19.32 ,$66.60 ,$19.32 ,$66.60 ,$66.60 ,$66.60 ,$71.78 ,$59.94 ,$68.82 ,$63.64 ,$71.78 
SACRED HEART HOSPITAL (ACU),30100821,80159,HC CLOZAPINE,301,1 ,$75.00 ,$56.25 ,$20.15 ,$75.00 ,$48.30 ,$20.15 ,$52.50 ,$20.18 ,$44.40 ,$20.79 ,$35.52 ,$71.25 ,$20.18 ,$60.00 ,$69.00 ,$20.18 ,$63.75 ,$71.25 ,$66.00 ,$57.00 ,$20.18 ,$20.18 ,$20.18 ,$54.75 ,$41.25 ,$68.25 ,$68.25 ,$60.00 ,$20.75 ,$41.25 ,$67.50 ,$20.15 ,$67.50 ,$40.50 ,$70.50 ,$45.34 ,$69.00 ,$21.39 ,$68.25 ,$20.15 ,$46.16 ,$46.16 ,$47.92 ,$55.97 ,$67.50 ,$20.35 ,$20.18 ,$71.25 ,$21.16 ,$20.18 ,$65.25 ,$20.15 ,$67.50 ,$20.15 ,$67.50 ,$67.50 ,$67.50 ,$72.75 ,$60.75 ,$69.75 ,$64.50 ,$72.75 
SACRED HEART HOSPITAL (ACU),30100845,82948,HC GLUCOSE BLOOD REAGENT STRIP,301,1 ,$26.00 ,$19.50 ,$4.45 ,$26.00 ,$16.74 ,$5.04 ,$18.20 ,$4.45 ,$7.61 ,$4.58 ,$6.09 ,$24.70 ,$4.45 ,$20.80 ,$23.92 ,$4.45 ,$22.10 ,$24.70 ,$22.88 ,$19.76 ,$4.45 ,$4.45 ,$4.45 ,$18.98 ,$14.30 ,$23.66 ,$23.66 ,$20.80 ,$5.19 ,$14.30 ,$23.40 ,$5.04 ,$23.40 ,$14.04 ,$24.44 ,$11.34 ,$23.92 ,$4.72 ,$23.66 ,$5.04 ,$16.00 ,$16.00 ,$21.96 ,$19.40 ,$23.40 ,$5.09 ,$4.45 ,$24.70 ,$5.29 ,$4.45 ,$22.62 ,$5.04 ,$23.40 ,$5.04 ,$23.40 ,$23.40 ,$23.40 ,$25.22 ,$21.06 ,$24.18 ,$22.36 ,$25.22 
SACRED HEART HOSPITAL (ACU),30100860,84145,HC PROCALCITONIN,301,1 ,$167.00 ,$125.25 ,$27.22 ,$167.00 ,$107.55 ,$27.22 ,$116.90 ,$28.13 ,$64.31 ,$28.97 ,$51.45 ,$158.65 ,$28.13 ,$133.60 ,$153.64 ,$28.13 ,$141.95 ,$158.65 ,$146.96 ,$126.92 ,$28.13 ,$28.13 ,$28.13 ,$121.91 ,$91.85 ,$151.97 ,$151.97 ,$133.60 ,$28.04 ,$91.85 ,$150.30 ,$27.22 ,$150.30 ,$90.18 ,$156.98 ,$61.25 ,$153.64 ,$29.82 ,$151.97 ,$27.22 ,$102.77 ,$102.77 ,$75.98 ,$124.63 ,$150.30 ,$27.49 ,$28.13 ,$158.65 ,$28.58 ,$28.13 ,$145.29 ,$27.22 ,$150.30 ,$27.22 ,$150.30 ,$150.30 ,$150.30 ,$161.99 ,$135.27 ,$155.31 ,$143.62 ,$161.99 
SACRED HEART HOSPITAL (ACU),30100961,83993,HC CALPROTECTIN STOOL,301,1 ,$200.00 ,$150.00 ,$19.63 ,$200.00 ,$128.80 ,$19.63 ,$140.00 ,$20.28 ,$47.13 ,$20.89 ,$37.70 ,$190.00 ,$20.28 ,$160.00 ,$184.00 ,$20.28 ,$170.00 ,$190.00 ,$176.00 ,$152.00 ,$20.28 ,$20.28 ,$20.28 ,$146.00 ,$110.00 ,$182.00 ,$182.00 ,$160.00 ,$20.22 ,$110.00 ,$180.00 ,$19.63 ,$180.00 ,$108.00 ,$188.00 ,$44.17 ,$184.00 ,$21.50 ,$182.00 ,$19.63 ,$123.08 ,$123.08 ,$57.25 ,$149.26 ,$123.42 ,$19.83 ,$20.28 ,$190.00 ,$20.61 ,$20.28 ,$174.00 ,$19.63 ,$180.00 ,$19.63 ,$180.00 ,$180.00 ,$180.00 ,$194.00 ,$162.00 ,$186.00 ,$172.00 ,$194.00 
SACRED HEART HOSPITAL (ACU),30100969,82705,HC FECAL FAT QUALITATIVE,301,1 ,$61.00 ,$45.75 ,$5.10 ,$61.00 ,$39.28 ,$5.10 ,$42.70 ,$5.27 ,$12.23 ,$5.43 ,$9.79 ,$57.95 ,$5.27 ,$48.80 ,$56.12 ,$5.27 ,$51.85 ,$57.95 ,$53.68 ,$46.36 ,$5.27 ,$5.27 ,$5.27 ,$44.53 ,$33.55 ,$55.51 ,$55.51 ,$48.80 ,$5.25 ,$33.55 ,$54.90 ,$5.10 ,$54.90 ,$32.94 ,$57.34 ,$11.48 ,$56.12 ,$5.59 ,$55.51 ,$5.10 ,$37.54 ,$37.54 ,$61.00 ,$45.52 ,$32.03 ,$5.15 ,$5.27 ,$57.95 ,$5.36 ,$5.27 ,$53.07 ,$5.10 ,$54.90 ,$5.10 ,$54.90 ,$54.90 ,$54.90 ,$59.17 ,$49.41 ,$56.73 ,$52.46 ,$59.17 
SACRED HEART HOSPITAL (ACU),30100970,80180,HC MYCOPHENOLIC ACID,301,1 ,$101.00 ,$75.75 ,$18.05 ,$101.00 ,$65.04 ,$18.05 ,$70.70 ,$18.65 ,$43.33 ,$19.21 ,$34.66 ,$95.95 ,$18.65 ,$80.80 ,$92.92 ,$18.65 ,$85.85 ,$95.95 ,$88.88 ,$76.76 ,$18.65 ,$18.65 ,$18.65 ,$73.73 ,$55.55 ,$91.91 ,$91.91 ,$80.80 ,$18.59 ,$55.55 ,$90.90 ,$18.05 ,$90.90 ,$54.54 ,$94.94 ,$40.61 ,$92.92 ,$19.77 ,$91.91 ,$18.05 ,$62.16 ,$62.16 ,$47.23 ,$75.38 ,$90.90 ,$18.23 ,$18.65 ,$95.95 ,$18.95 ,$18.65 ,$87.87 ,$18.05 ,$90.90 ,$18.05 ,$90.90 ,$90.90 ,$90.90 ,$97.97 ,$81.81 ,$93.93 ,$86.86 ,$97.97 
SACRED HEART HOSPITAL (ACU),30100993,80055,HC PRENATAL PANEL,301,1 ,$147.55 ,$110.66 ,$18.84 ,$147.55 ,$95.02 ,$47.81 ,$103.29 ,$18.84 ,$114.77 ,$19.41 ,$91.81 ,$140.17 ,$18.84 ,$118.04 ,$135.75 ,$18.84 ,$125.42 ,$140.17 ,$129.84 ,$112.14 ,$18.84 ,$18.84 ,$18.84 ,$107.71 ,$81.15 ,$134.27 ,$134.27 ,$118.04 ,$49.24 ,$81.15 ,$132.80 ,$47.81 ,$132.80 ,$79.68 ,$138.70 ,$107.57 ,$135.75 ,$19.97 ,$134.27 ,$47.81 ,$90.80 ,$90.80 ,$108.94 ,$110.12 ,$132.80 ,$48.29 ,$18.84 ,$140.17 ,$50.20 ,$18.84 ,$128.37 ,$47.81 ,$132.80 ,$47.81 ,$132.80 ,$132.80 ,$132.80 ,$143.12 ,$119.52 ,$137.22 ,$126.89 ,$143.12 
SACRED HEART HOSPITAL (ACU),30100994,81479,HC IDH GENE MUTATION ASSAY,301,1 ,$76.00 ,$57.00 ,$14.07 ,$76.00 ,$48.94 , N/A ,$53.20 ,$14.07 ,$63.08 ,$14.49 ,$50.16 ,$72.20 ,$14.07 ,$60.80 ,$69.92 ,$14.07 ,$64.60 ,$72.20 ,$66.88 ,$57.76 ,$14.07 ,$14.07 ,$14.07 ,$55.48 ,$41.80 ,$69.16 ,$69.16 ,$60.80 , N/A ,$41.80 ,$68.40 , N/A ,$68.40 ,$41.04 ,$71.44 ,$45.60 ,$69.92 ,$14.91 ,$69.16 , N/A ,$46.77 ,$46.77 ,$68.40 ,$56.72 ,$52.93 ,$62.32 ,$14.07 ,$72.20 , N/A ,$14.07 ,$66.12 , N/A ,$68.40 , N/A ,$68.40 ,$68.40 ,$68.40 ,$73.72 ,$61.56 ,$70.68 ,$65.36 ,$73.72 
SACRED HEART HOSPITAL (ACU),30100995,82017,HC ACYLCARNITINES QN EA SPEC,301,1 ,$55.00 ,$41.25 ,$16.87 ,$55.00 ,$35.42 ,$16.87 ,$38.50 ,$17.43 ,$34.60 ,$17.95 ,$27.68 ,$52.25 ,$17.43 ,$44.00 ,$50.60 ,$17.43 ,$46.75 ,$52.25 ,$48.40 ,$41.80 ,$17.43 ,$17.43 ,$17.43 ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 ,$17.38 ,$30.25 ,$49.50 ,$16.87 ,$49.50 ,$29.70 ,$51.70 ,$37.96 ,$50.60 ,$18.48 ,$50.05 ,$16.87 ,$33.85 ,$33.85 ,$55.00 ,$41.05 ,$49.50 ,$17.04 ,$17.43 ,$52.25 ,$17.71 ,$17.43 ,$47.85 ,$16.87 ,$49.50 ,$16.87 ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),30100996,82075,HC ALCOHOL BREATH,301,1 ,$79.00 ,$59.25 ,$16.95 ,$79.00 ,$50.88 ,$30.00 ,$55.30 ,$16.95 ,$28.93 ,$17.46 ,$23.14 ,$75.05 ,$16.95 ,$63.20 ,$72.68 ,$16.95 ,$67.15 ,$75.05 ,$69.52 ,$60.04 ,$16.95 ,$16.95 ,$16.95 ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 ,$30.90 ,$43.45 ,$71.10 ,$30.00 ,$71.10 ,$42.66 ,$74.26 ,$67.50 ,$72.68 ,$17.97 ,$71.89 ,$30.00 ,$48.62 ,$48.62 ,$79.00 ,$58.96 ,$71.10 ,$30.30 ,$16.95 ,$75.05 ,$31.50 ,$16.95 ,$68.73 ,$30.00 ,$71.10 ,$30.00 ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),30100997,82106,HC ALPHA FETOPROTEIN AMNIOTIC FLUID,301,1 ,$240.00 ,$180.00 ,$17.00 ,$240.00 ,$154.56 ,$17.00 ,$168.00 ,$17.57 ,$40.27 ,$18.10 ,$32.21 ,$228.00 ,$17.57 ,$192.00 ,$220.80 ,$17.57 ,$204.00 ,$228.00 ,$211.20 ,$182.40 ,$17.57 ,$17.57 ,$17.57 ,$175.20 ,$132.00 ,$218.40 ,$218.40 ,$192.00 ,$17.51 ,$132.00 ,$216.00 ,$17.00 ,$216.00 ,$129.60 ,$225.60 ,$38.25 ,$220.80 ,$18.62 ,$218.40 ,$17.00 ,$147.70 ,$147.70 ,$104.52 ,$179.11 ,$105.45 ,$17.17 ,$17.57 ,$228.00 ,$17.85 ,$17.57 ,$208.80 ,$17.00 ,$216.00 ,$17.00 ,$216.00 ,$216.00 ,$216.00 ,$232.80 ,$194.40 ,$223.20 ,$206.40 ,$232.80 
SACRED HEART HOSPITAL (ACU),30100998,82128,HC AMINO ACIDS MULT QL EA SPECIMEN,301,1 ,$196.00 ,$147.00 ,$13.87 ,$196.00 ,$126.22 ,$13.87 ,$137.20 ,$14.33 ,$33.30 ,$14.76 ,$26.64 ,$186.20 ,$14.33 ,$156.80 ,$180.32 ,$14.33 ,$166.60 ,$186.20 ,$172.48 ,$148.96 ,$14.33 ,$14.33 ,$14.33 ,$143.08 ,$107.80 ,$178.36 ,$178.36 ,$156.80 ,$14.29 ,$107.80 ,$176.40 ,$13.87 ,$176.40 ,$105.84 ,$184.24 ,$31.21 ,$180.32 ,$15.19 ,$178.36 ,$13.87 ,$120.62 ,$120.62 ,$65.89 ,$146.27 ,$87.22 ,$14.01 ,$14.33 ,$186.20 ,$14.56 ,$14.33 ,$170.52 ,$13.87 ,$176.40 ,$13.87 ,$176.40 ,$176.40 ,$176.40 ,$190.12 ,$158.76 ,$182.28 ,$168.56 ,$190.12 
SACRED HEART HOSPITAL (ACU),30100999,82190,HC ATOMIC ABSORPTION SPEC EA ANALYTE,301,1 ,$189.00 ,$141.75 ,$15.90 ,$189.00 ,$121.72 ,$15.90 ,$132.30 ,$16.43 ,$29.35 ,$16.92 ,$23.48 ,$179.55 ,$16.43 ,$151.20 ,$173.88 ,$16.43 ,$160.65 ,$179.55 ,$166.32 ,$143.64 ,$16.43 ,$16.43 ,$16.43 ,$137.97 ,$103.95 ,$171.99 ,$171.99 ,$151.20 ,$16.38 ,$103.95 ,$170.10 ,$15.90 ,$170.10 ,$102.06 ,$177.66 ,$35.78 ,$173.88 ,$17.42 ,$171.99 ,$15.90 ,$116.31 ,$116.31 ,$92.26 ,$141.05 ,$93.74 ,$16.06 ,$16.43 ,$179.55 ,$16.70 ,$16.43 ,$164.43 ,$15.90 ,$170.10 ,$15.90 ,$170.10 ,$170.10 ,$170.10 ,$183.33 ,$153.09 ,$175.77 ,$162.54 ,$183.33 
SACRED HEART HOSPITAL (ACU),30101000,82261,HC BIOTINIDASE,301,1 ,$55.00 ,$41.25 ,$16.87 ,$55.00 ,$35.42 ,$16.87 ,$38.50 ,$17.43 ,$34.60 ,$17.95 ,$27.68 ,$52.25 ,$17.43 ,$44.00 ,$50.60 ,$17.43 ,$46.75 ,$52.25 ,$48.40 ,$41.80 ,$17.43 ,$17.43 ,$17.43 ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 ,$17.38 ,$30.25 ,$49.50 ,$16.87 ,$49.50 ,$29.70 ,$51.70 ,$37.96 ,$50.60 ,$18.48 ,$50.05 ,$16.87 ,$33.85 ,$33.85 ,$55.00 ,$41.05 ,$49.50 ,$17.04 ,$17.43 ,$52.25 ,$17.71 ,$17.43 ,$47.85 ,$16.87 ,$49.50 ,$16.87 ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),30101001,82355,HC CALCULUS ANALYSIS QL,301,1 ,$90.00 ,$67.50 ,$11.58 ,$90.00 ,$57.96 ,$11.58 ,$63.00 ,$11.97 ,$27.79 ,$12.33 ,$22.23 ,$85.50 ,$11.97 ,$72.00 ,$82.80 ,$11.97 ,$76.50 ,$85.50 ,$79.20 ,$68.40 ,$11.97 ,$11.97 ,$11.97 ,$65.70 ,$49.50 ,$81.90 ,$81.90 ,$72.00 ,$11.93 ,$49.50 ,$81.00 ,$11.58 ,$81.00 ,$48.60 ,$84.60 ,$26.06 ,$82.80 ,$12.69 ,$81.90 ,$11.58 ,$55.39 ,$55.39 ,$90.00 ,$67.17 ,$72.76 ,$11.70 ,$11.97 ,$85.50 ,$12.16 ,$11.97 ,$78.30 ,$11.58 ,$81.00 ,$11.58 ,$81.00 ,$81.00 ,$81.00 ,$87.30 ,$72.90 ,$83.70 ,$77.40 ,$87.30 
SACRED HEART HOSPITAL (ACU),30101003,82523,HC COLLAGEN CROSS LINKS ANY METHOD,301,1 ,$86.00 ,$64.50 ,$14.65 ,$86.00 ,$55.38 ,$18.68 ,$60.20 ,$14.65 ,$25.01 ,$15.09 ,$20.01 ,$81.70 ,$14.65 ,$68.80 ,$79.12 ,$14.65 ,$73.10 ,$81.70 ,$75.68 ,$65.36 ,$14.65 ,$14.65 ,$14.65 ,$62.78 ,$47.30 ,$78.26 ,$78.26 ,$68.80 ,$19.24 ,$47.30 ,$77.40 ,$18.68 ,$77.40 ,$46.44 ,$80.84 ,$42.03 ,$79.12 ,$15.53 ,$78.26 ,$18.68 ,$52.92 ,$52.92 ,$65.70 ,$64.18 ,$77.40 ,$18.87 ,$14.65 ,$81.70 ,$19.61 ,$14.65 ,$74.82 ,$18.68 ,$77.40 ,$18.68 ,$77.40 ,$77.40 ,$77.40 ,$83.42 ,$69.66 ,$79.98 ,$73.96 ,$83.42 
SACRED HEART HOSPITAL (ACU),30101004,82608,HC CYANOCOBALAMIN (B12) UNSAT BINDING CAPACITY,301,1 ,$205.00 ,$153.75 ,$14.32 ,$205.00 ,$132.02 ,$14.32 ,$143.50 ,$14.80 ,$34.37 ,$15.24 ,$27.50 ,$194.75 ,$14.80 ,$164.00 ,$188.60 ,$14.80 ,$174.25 ,$194.75 ,$180.40 ,$155.80 ,$14.80 ,$14.80 ,$14.80 ,$149.65 ,$112.75 ,$186.55 ,$186.55 ,$164.00 ,$14.75 ,$112.75 ,$184.50 ,$14.32 ,$184.50 ,$110.70 ,$192.70 ,$32.22 ,$188.60 ,$15.69 ,$186.55 ,$14.32 ,$126.16 ,$126.16 ,$116.40 ,$152.99 ,$90.02 ,$14.46 ,$14.80 ,$194.75 ,$15.04 ,$14.80 ,$178.35 ,$14.32 ,$184.50 ,$14.32 ,$184.50 ,$184.50 ,$184.50 ,$198.85 ,$166.05 ,$190.65 ,$176.30 ,$198.85 
SACRED HEART HOSPITAL (ACU),30101005,82760,HC GLACTOSE,301,1 ,$36.00 ,$27.00 ,$11.20 ,$36.00 ,$23.18 ,$11.20 ,$25.20 ,$11.57 ,$26.88 ,$11.92 ,$21.50 ,$34.20 ,$11.57 ,$28.80 ,$33.12 ,$11.57 ,$30.60 ,$34.20 ,$31.68 ,$27.36 ,$11.57 ,$11.57 ,$11.57 ,$26.28 ,$19.80 ,$32.76 ,$32.76 ,$28.80 ,$11.54 ,$19.80 ,$32.40 ,$11.20 ,$32.40 ,$19.44 ,$33.84 ,$25.20 ,$33.12 ,$12.26 ,$32.76 ,$11.20 ,$22.15 ,$22.15 ,$36.00 ,$26.87 ,$32.40 ,$11.31 ,$11.57 ,$34.20 ,$11.76 ,$11.57 ,$31.32 ,$11.20 ,$32.40 ,$11.20 ,$32.40 ,$32.40 ,$32.40 ,$34.92 ,$29.16 ,$33.48 ,$30.96 ,$34.92 
SACRED HEART HOSPITAL (ACU),30101006,82787,HC IMMUNOGLOBULIN SUBCLASSES,301,1 ,$54.00 ,$40.50 ,$5.90 ,$54.00 ,$34.78 ,$8.02 ,$37.80 ,$5.90 ,$10.08 ,$6.08 ,$8.06 ,$51.30 ,$5.90 ,$43.20 ,$49.68 ,$5.90 ,$45.90 ,$51.30 ,$47.52 ,$41.04 ,$5.90 ,$5.90 ,$5.90 ,$39.42 ,$29.70 ,$49.14 ,$49.14 ,$43.20 ,$8.26 ,$29.70 ,$48.60 ,$8.02 ,$48.60 ,$29.16 ,$50.76 ,$18.05 ,$49.68 ,$6.25 ,$49.14 ,$8.02 ,$33.23 ,$33.23 ,$54.00 ,$40.30 ,$48.60 ,$8.10 ,$5.90 ,$51.30 ,$8.42 ,$5.90 ,$46.98 ,$8.02 ,$48.60 ,$8.02 ,$48.60 ,$48.60 ,$48.60 ,$52.38 ,$43.74 ,$50.22 ,$46.44 ,$52.38 
SACRED HEART HOSPITAL (ACU),30101008,83020,HC HGB ELECTROPHORESIS,301,1 ,$42.00 ,$31.50 ,$6.41 ,$42.00 ,$27.05 ,$12.87 ,$29.40 ,$6.41 ,$10.94 ,$6.60 ,$8.75 ,$39.90 ,$6.41 ,$33.60 ,$38.64 ,$6.41 ,$35.70 ,$39.90 ,$36.96 ,$31.92 ,$6.41 ,$6.41 ,$6.41 ,$30.66 ,$23.10 ,$38.22 ,$38.22 ,$33.60 ,$13.26 ,$23.10 ,$37.80 ,$12.87 ,$37.80 ,$22.68 ,$39.48 ,$28.96 ,$38.64 ,$6.79 ,$38.22 ,$12.87 ,$25.85 ,$25.85 ,$32.94 ,$31.34 ,$37.80 ,$13.00 ,$6.41 ,$39.90 ,$13.51 ,$6.41 ,$36.54 ,$12.87 ,$37.80 ,$12.87 ,$37.80 ,$37.80 ,$37.80 ,$40.74 ,$34.02 ,$39.06 ,$36.12 ,$40.74 
SACRED HEART HOSPITAL (ACU),30101010,83520,HC IMMUNOASSAY QN OTHER,301,1 ,$45.00 ,$33.75 ,$17.27 ,$45.00 ,$28.98 ,$17.27 ,$31.50 ,$17.85 ,$31.08 ,$18.39 ,$24.86 ,$42.75 ,$17.85 ,$36.00 ,$41.40 ,$17.85 ,$38.25 ,$42.75 ,$39.60 ,$34.20 ,$17.85 ,$17.85 ,$17.85 ,$32.85 ,$24.75 ,$40.95 ,$40.95 ,$36.00 ,$17.79 ,$24.75 ,$40.50 ,$17.27 ,$40.50 ,$24.30 ,$42.30 ,$38.86 ,$41.40 ,$18.92 ,$40.95 ,$17.27 ,$27.69 ,$27.69 ,$45.00 ,$33.58 ,$40.50 ,$17.44 ,$17.85 ,$42.75 ,$18.13 ,$17.85 ,$39.15 ,$17.27 ,$40.50 ,$17.27 ,$40.50 ,$40.50 ,$40.50 ,$43.65 ,$36.45 ,$41.85 ,$38.70 ,$43.65 
SACRED HEART HOSPITAL (ACU),30101011,83630,HC LACTOFERRIN FECAL QL,301,1 ,$196.00 ,$147.00 ,$16.82 ,$196.00 ,$126.22 ,$19.70 ,$137.20 ,$16.82 ,$47.13 ,$17.32 ,$37.70 ,$186.20 ,$16.82 ,$156.80 ,$180.32 ,$16.82 ,$166.60 ,$186.20 ,$172.48 ,$148.96 ,$16.82 ,$16.82 ,$16.82 ,$143.08 ,$107.80 ,$178.36 ,$178.36 ,$156.80 ,$20.29 ,$107.80 ,$176.40 ,$19.70 ,$176.40 ,$105.84 ,$184.24 ,$44.33 ,$180.32 ,$17.83 ,$178.36 ,$19.70 ,$120.62 ,$120.62 ,$58.51 ,$146.27 ,$123.42 ,$19.90 ,$16.82 ,$186.20 ,$20.69 ,$16.82 ,$170.52 ,$19.70 ,$176.40 ,$19.70 ,$176.40 ,$176.40 ,$176.40 ,$190.12 ,$158.76 ,$182.28 ,$168.56 ,$190.12 
SACRED HEART HOSPITAL (ACU),30101012,83661,HC FETAL LUNG MATURITY L/S RATIO,301,1 ,$71.00 ,$53.25 ,$21.99 ,$71.00 ,$45.72 ,$21.99 ,$49.70 ,$22.72 ,$52.78 ,$23.40 ,$42.22 ,$67.45 ,$22.72 ,$56.80 ,$65.32 ,$22.72 ,$60.35 ,$67.45 ,$62.48 ,$53.96 ,$22.72 ,$22.72 ,$22.72 ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 ,$22.65 ,$39.05 ,$63.90 ,$21.99 ,$63.90 ,$38.34 ,$66.74 ,$49.48 ,$65.32 ,$24.08 ,$64.61 ,$21.99 ,$43.69 ,$43.69 ,$71.00 ,$52.99 ,$63.90 ,$22.21 ,$22.72 ,$67.45 ,$23.09 ,$22.72 ,$61.77 ,$21.99 ,$63.90 ,$21.99 ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),30101013,83698,HC LIPOPROTEIN ASSOC PHOSPHOLIPASE A2,301,1 ,$149.00 ,$111.75 ,$46.31 ,$149.00 ,$95.96 ,$46.31 ,$104.30 ,$47.73 ,$81.48 ,$49.16 ,$65.18 ,$141.55 ,$47.73 ,$119.20 ,$137.08 ,$47.73 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$47.73 ,$47.73 ,$47.73 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,$47.70 ,$81.95 ,$134.10 ,$46.31 ,$134.10 ,$80.46 ,$140.06 ,$104.20 ,$137.08 ,$50.59 ,$135.59 ,$46.31 ,$91.69 ,$91.69 ,$91.55 ,$111.20 ,$134.10 ,$46.77 ,$47.73 ,$141.55 ,$48.63 ,$47.73 ,$129.63 ,$46.31 ,$134.10 ,$46.31 ,$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),30101014,83789,HC MASS SPEC QL,301,1 ,$144.00 ,$108.00 ,$24.11 ,$144.00 ,$92.74 ,$24.11 ,$100.80 ,$24.91 ,$43.35 ,$25.66 ,$34.68 ,$136.80 ,$24.91 ,$115.20 ,$132.48 ,$24.91 ,$122.40 ,$136.80 ,$126.72 ,$109.44 ,$24.91 ,$24.91 ,$24.91 ,$105.12 ,$79.20 ,$131.04 ,$131.04 ,$115.20 ,$24.83 ,$79.20 ,$129.60 ,$24.11 ,$129.60 ,$77.76 ,$135.36 ,$54.25 ,$132.48 ,$26.40 ,$131.04 ,$24.11 ,$88.62 ,$88.62 ,$76.74 ,$107.47 ,$122.76 ,$24.35 ,$24.91 ,$136.80 ,$25.32 ,$24.91 ,$125.28 ,$24.11 ,$129.60 ,$24.11 ,$129.60 ,$129.60 ,$129.60 ,$139.68 ,$116.64 ,$133.92 ,$123.84 ,$139.68 
SACRED HEART HOSPITAL (ACU),30101015,83872,HC MUCIN SYNOVIAL FLUID (ROPES TEST),301,1 ,$37.00 ,$27.75 ,$5.86 ,$37.00 ,$23.83 ,$5.86 ,$25.90 ,$6.06 ,$14.07 ,$6.24 ,$11.26 ,$35.15 ,$6.06 ,$29.60 ,$34.04 ,$6.06 ,$31.45 ,$35.15 ,$32.56 ,$28.12 ,$6.06 ,$6.06 ,$6.06 ,$27.01 ,$20.35 ,$33.67 ,$33.67 ,$29.60 ,$6.04 ,$20.35 ,$33.30 ,$5.86 ,$33.30 ,$19.98 ,$34.78 ,$13.19 ,$34.04 ,$6.42 ,$33.67 ,$5.86 ,$22.77 ,$22.77 ,$37.00 ,$27.61 ,$33.30 ,$5.92 ,$6.06 ,$35.15 ,$6.15 ,$6.06 ,$32.19 ,$5.86 ,$33.30 ,$5.86 ,$33.30 ,$33.30 ,$33.30 ,$35.89 ,$29.97 ,$34.41 ,$31.82 ,$35.89 
SACRED HEART HOSPITAL (ACU),30101016,83919,HC ORGANIC ACIDS QL EA SPECIMEN,301,1 ,$184.00 ,$138.00 ,$16.45 ,$184.00 ,$118.50 ,$16.45 ,$128.80 ,$17.00 ,$39.50 ,$17.51 ,$31.60 ,$174.80 ,$17.00 ,$147.20 ,$169.28 ,$17.00 ,$156.40 ,$174.80 ,$161.92 ,$139.84 ,$17.00 ,$17.00 ,$17.00 ,$134.32 ,$101.20 ,$167.44 ,$167.44 ,$147.20 ,$16.94 ,$101.20 ,$165.60 ,$16.45 ,$165.60 ,$99.36 ,$172.96 ,$37.01 ,$169.28 ,$18.02 ,$167.44 ,$16.45 ,$113.23 ,$113.23 ,$70.34 ,$137.32 ,$103.41 ,$16.61 ,$17.00 ,$174.80 ,$17.27 ,$17.00 ,$160.08 ,$16.45 ,$165.60 ,$16.45 ,$165.60 ,$165.60 ,$165.60 ,$178.48 ,$149.04 ,$171.12 ,$158.24 ,$178.48 
SACRED HEART HOSPITAL (ACU),30101017,84030,HC NEWBORN SCREENING (PKU),301,1 ,$18.00 ,$13.50 ,$5.50 ,$18.00 ,$11.59 ,$5.50 ,$12.60 ,$5.68 ,$13.20 ,$5.85 ,$10.56 ,$17.10 ,$5.68 ,$14.40 ,$16.56 ,$5.68 ,$15.30 ,$17.10 ,$15.84 ,$13.68 ,$5.68 ,$5.68 ,$5.68 ,$13.14 ,$9.90 ,$16.38 ,$16.38 ,$14.40 ,$5.67 ,$9.90 ,$16.20 ,$5.50 ,$16.20 ,$9.72 ,$16.92 ,$12.38 ,$16.56 ,$6.02 ,$16.38 ,$5.50 ,$11.08 ,$11.08 ,$18.00 ,$13.43 ,$16.20 ,$5.56 ,$5.68 ,$17.10 ,$5.78 ,$5.68 ,$15.66 ,$5.50 ,$16.20 ,$5.50 ,$16.20 ,$16.20 ,$16.20 ,$17.46 ,$14.58 ,$16.74 ,$15.48 ,$17.46 
SACRED HEART HOSPITAL (ACU),30101020,84510,HC TYROSINE,301,1 ,$34.00 ,$25.50 ,$10.63 ,$34.00 ,$21.90 ,$10.63 ,$23.80 ,$10.98 ,$24.97 ,$11.31 ,$19.98 ,$32.30 ,$10.98 ,$27.20 ,$31.28 ,$10.98 ,$28.90 ,$32.30 ,$29.92 ,$25.84 ,$10.98 ,$10.98 ,$10.98 ,$24.82 ,$18.70 ,$30.94 ,$30.94 ,$27.20 ,$10.95 ,$18.70 ,$30.60 ,$10.63 ,$30.60 ,$18.36 ,$31.96 ,$23.92 ,$31.28 ,$11.64 ,$30.94 ,$10.63 ,$20.92 ,$20.92 ,$34.00 ,$25.37 ,$30.60 ,$10.74 ,$10.98 ,$32.30 ,$11.16 ,$10.98 ,$29.58 ,$10.63 ,$30.60 ,$10.63 ,$30.60 ,$30.60 ,$30.60 ,$32.98 ,$27.54 ,$31.62 ,$29.24 ,$32.98 
SACRED HEART HOSPITAL (ACU),30101021,84520,HC BUN TRANSFUSION REACTION,301,1 ,$91.00 ,$68.25 ,$3.95 ,$91.00 ,$58.60 ,$3.95 ,$63.70 ,$4.08 ,$9.49 ,$4.20 ,$7.59 ,$86.45 ,$4.08 ,$72.80 ,$83.72 ,$4.08 ,$77.35 ,$86.45 ,$80.08 ,$69.16 ,$4.08 ,$4.08 ,$4.08 ,$66.43 ,$50.05 ,$82.81 ,$82.81 ,$72.80 ,$4.07 ,$50.05 ,$81.90 ,$3.95 ,$81.90 ,$49.14 ,$85.54 ,$8.89 ,$83.72 ,$4.32 ,$82.81 ,$3.95 ,$56.00 ,$56.00 ,$46.12 ,$67.91 ,$24.85 ,$3.99 ,$4.08 ,$86.45 ,$4.15 ,$4.08 ,$79.17 ,$3.95 ,$81.90 ,$3.95 ,$81.90 ,$81.90 ,$81.90 ,$88.27 ,$73.71 ,$84.63 ,$78.26 ,$88.27 
SACRED HEART HOSPITAL (ACU),30101023,G0103,HC PSA ANNUAL SCREENING,301,1 ,$307.00 ,$230.25 ,$19.31 ,$307.00 ,$197.71 ,$19.31 ,$214.90 ,$19.95 ,$44.15 ,$20.55 ,$35.32 ,$291.65 ,$19.95 ,$245.60 ,$282.44 ,$19.95 ,$260.95 ,$291.65 ,$270.16 ,$233.32 ,$19.95 ,$19.95 ,$19.95 ,$224.11 ,$168.85 ,$279.37 ,$279.37 ,$245.60 ,$19.89 ,$168.85 ,$276.30 ,$19.31 ,$276.30 ,$165.78 ,$288.58 ,$43.45 ,$282.44 ,$21.15 ,$279.37 ,$19.31 ,$188.93 ,$188.93 ,$276.30 ,$229.11 ,$115.63 ,$19.50 ,$19.95 ,$291.65 ,$20.28 ,$19.95 ,$267.09 ,$19.31 ,$276.30 ,$19.31 ,$276.30 ,$276.30 ,$276.30 ,$297.79 ,$248.67 ,$285.51 ,$264.02 ,$297.79 
SACRED HEART HOSPITAL (ACU),30101024,G0480,HC DRUG CONFIRMATION EA PROC 1-7 CLASSES,301,1 ,$378.00 ,$283.50 ,$63.95 ,$378.00 ,$243.43 ,$114.43 ,$264.60 ,$63.95 ,$205.89 ,$65.87 ,$164.71 ,$359.10 ,$63.95 ,$302.40 ,$347.76 ,$63.95 ,$321.30 ,$359.10 ,$332.64 ,$287.28 ,$63.95 ,$63.95 ,$63.95 ,$275.94 ,$207.90 ,$343.98 ,$343.98 ,$302.40 ,$117.86 ,$207.90 ,$340.20 ,$114.43 ,$340.20 ,$204.12 ,$355.32 ,$257.47 ,$347.76 ,$67.79 ,$343.98 ,$114.43 ,$232.62 ,$232.62 ,$340.20 ,$282.10 ,$340.20 ,$115.57 ,$63.95 ,$359.10 ,$120.15 ,$63.95 ,$328.86 ,$114.43 ,$340.20 ,$114.43 ,$340.20 ,$340.20 ,$340.20 ,$366.66 ,$306.18 ,$351.54 ,$325.08 ,$366.66 
SACRED HEART HOSPITAL (ACU),30101027,82803,HC I-STAT G3  AND  PANEL-XS,301,1 ,$356.00 ,$267.00 ,$26.07 ,$356.00 ,$229.26 ,$26.07 ,$249.20 ,$26.94 ,$46.45 ,$27.75 ,$37.16 ,$338.20 ,$26.94 ,$284.80 ,$327.52 ,$26.94 ,$302.60 ,$338.20 ,$313.28 ,$270.56 ,$26.94 ,$26.94 ,$26.94 ,$259.88 ,$195.80 ,$323.96 ,$323.96 ,$284.80 ,$26.85 ,$195.80 ,$320.40 ,$26.07 ,$320.40 ,$192.24 ,$334.64 ,$58.66 ,$327.52 ,$28.56 ,$323.96 ,$26.07 ,$219.08 ,$219.08 ,$107.64 ,$265.68 ,$132.74 ,$26.33 ,$26.94 ,$338.20 ,$27.37 ,$26.94 ,$309.72 ,$26.07 ,$320.40 ,$26.07 ,$320.40 ,$320.40 ,$320.40 ,$345.32 ,$288.36 ,$331.08 ,$306.16 ,$345.32 
SACRED HEART HOSPITAL (ACU),30101050,82610,HC CYSTATIN C,301,1 ,$113.00 ,$84.75 ,$18.52 ,$113.00 ,$72.77 ,$18.52 ,$79.10 ,$19.00 ,$32.64 ,$19.57 ,$26.11 ,$107.35 ,$19.00 ,$90.40 ,$103.96 ,$19.00 ,$96.05 ,$107.35 ,$99.44 ,$85.88 ,$19.00 ,$19.00 ,$19.00 ,$82.49 ,$62.15 ,$102.83 ,$102.83 ,$90.40 ,$19.08 ,$62.15 ,$101.70 ,$18.52 ,$101.70 ,$61.02 ,$106.22 ,$41.67 ,$103.96 ,$20.14 ,$102.83 ,$18.52 ,$69.54 ,$69.54 ,$40.08 ,$84.33 ,$94.30 ,$18.71 ,$19.00 ,$107.35 ,$19.45 ,$19.00 ,$98.31 ,$18.52 ,$101.70 ,$18.52 ,$101.70 ,$101.70 ,$101.70 ,$109.61 ,$91.53 ,$105.09 ,$97.18 ,$109.61 
SACRED HEART HOSPITAL (ACU),30101072,80365,HC OXYCODONE,301,1 ,$31.00 ,$23.25 ,$1.58 ,$31.00 ,$19.96 , N/A ,$21.70 ,$1.58 ,$31.00 ,$1.63 ,$31.00 ,$29.45 ,$1.58 ,$24.80 ,$28.52 ,$1.58 ,$26.35 ,$29.45 ,$27.28 ,$23.56 ,$1.58 ,$1.58 ,$1.58 ,$22.63 ,$17.05 ,$28.21 ,$28.21 ,$24.80 , N/A ,$17.05 ,$27.90 , N/A ,$27.90 ,$16.74 ,$29.14 , N/A ,$28.52 ,$1.67 ,$28.21 , N/A ,$19.08 ,$19.08 ,$31.00 ,$23.14 ,$21.59 , N/A ,$1.58 ,$29.45 , N/A ,$1.58 ,$26.97 , N/A ,$27.90 , N/A ,$27.90 ,$27.90 ,$27.90 ,$30.07 ,$25.11 ,$28.83 ,$26.66 ,$30.07 
SACRED HEART HOSPITAL (ACU),30101089,80150,HC AMIKACIN - 90,301,1 ,$54.00 ,$40.50 ,$15.08 ,$54.00 ,$34.78 ,$15.08 ,$37.80 ,$15.58 ,$36.19 ,$16.05 ,$28.95 ,$51.30 ,$15.58 ,$43.20 ,$49.68 ,$15.58 ,$45.90 ,$51.30 ,$47.52 ,$41.04 ,$15.58 ,$15.58 ,$15.58 ,$39.42 ,$29.70 ,$49.14 ,$49.14 ,$43.20 ,$15.53 ,$29.70 ,$48.60 ,$15.08 ,$48.60 ,$29.16 ,$50.76 ,$33.93 ,$49.68 ,$16.51 ,$49.14 ,$15.08 ,$33.23 ,$33.23 ,$54.00 ,$40.30 ,$48.60 ,$15.23 ,$15.58 ,$51.30 ,$15.83 ,$15.58 ,$46.98 ,$15.08 ,$48.60 ,$15.08 ,$48.60 ,$48.60 ,$48.60 ,$52.38 ,$43.74 ,$50.22 ,$46.44 ,$52.38 
SACRED HEART HOSPITAL (ACU),30101139,80307,HC DRUG SCREEN PRESUMPTIVE INSTRUMENT,301,1 ,$122.00 ,$91.50 ,$62.14 ,$139.82 ,$78.57 ,$62.14 ,$85.40 ,$63.40 ,$122.00 ,$65.30 ,$111.73 ,$115.90 ,$63.40 ,$97.60 ,$112.24 ,$63.40 ,$103.70 ,$115.90 ,$107.36 ,$92.72 ,$63.40 ,$63.40 ,$63.40 ,$89.06 ,$67.10 ,$111.02 ,$111.02 ,$97.60 ,$64.00 ,$67.10 ,$109.80 ,$62.14 ,$109.80 ,$65.88 ,$114.68 ,$139.82 ,$112.24 ,$67.20 ,$111.02 ,$62.14 ,$75.08 ,$75.08 ,$122.00 ,$91.05 ,$84.97 ,$62.76 ,$63.40 ,$115.90 ,$65.25 ,$63.40 ,$106.14 ,$62.14 ,$109.80 ,$62.14 ,$109.80 ,$109.80 ,$109.80 ,$118.34 ,$98.82 ,$113.46 ,$104.92 ,$118.34 
SACRED HEART HOSPITAL (ACU),30101654,82642,HC DIHYDROTESTOSTERONE,301,1 ,$71.00 ,$53.25 ,$29.28 ,$71.00 ,$45.72 ,$29.28 ,$49.70 ,$30.26 ,$56.93 ,$31.17 ,$45.54 ,$67.45 ,$30.26 ,$56.80 ,$65.32 ,$30.26 ,$60.35 ,$67.45 ,$62.48 ,$53.96 ,$30.26 ,$30.26 ,$30.26 ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 ,$30.16 ,$39.05 ,$63.90 ,$29.28 ,$63.90 ,$38.34 ,$66.74 ,$65.88 ,$65.32 ,$32.08 ,$64.61 ,$29.28 ,$43.69 ,$43.69 ,$63.90 ,$52.99 ,$63.90 ,$29.57 ,$30.26 ,$67.45 ,$30.74 ,$30.26 ,$61.77 ,$29.28 ,$63.90 ,$29.28 ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),30101664,80307,HC DRUG SCREEN UMBILICAL CORD-90,301,1 ,$252.00 ,$189.00 ,$62.14 ,$252.00 ,$162.29 ,$62.14 ,$176.40 ,$63.40 ,$139.67 ,$65.30 ,$111.73 ,$239.40 ,$63.40 ,$201.60 ,$231.84 ,$63.40 ,$214.20 ,$239.40 ,$221.76 ,$191.52 ,$63.40 ,$63.40 ,$63.40 ,$183.96 ,$138.60 ,$229.32 ,$229.32 ,$201.60 ,$64.00 ,$138.60 ,$226.80 ,$62.14 ,$226.80 ,$136.08 ,$236.88 ,$139.82 ,$231.84 ,$67.20 ,$229.32 ,$62.14 ,$155.08 ,$155.08 ,$151.96 ,$188.07 ,$175.52 ,$62.76 ,$63.40 ,$239.40 ,$65.25 ,$63.40 ,$219.24 ,$62.14 ,$226.80 ,$62.14 ,$226.80 ,$226.80 ,$226.80 ,$244.44 ,$204.12 ,$234.36 ,$216.72 ,$244.44 
SACRED HEART HOSPITAL (ACU),30101673,80353,HC COCAINE QN,301,1 ,$67.00 ,$50.25 ,$1.58 ,$67.00 ,$43.15 , N/A ,$46.90 ,$1.58 ,$41.42 ,$1.63 ,$33.14 ,$63.65 ,$1.58 ,$53.60 ,$61.64 ,$1.58 ,$56.95 ,$63.65 ,$58.96 ,$50.92 ,$1.58 ,$1.58 ,$1.58 ,$48.91 ,$36.85 ,$60.97 ,$60.97 ,$53.60 , N/A ,$36.85 ,$60.30 , N/A ,$60.30 ,$36.18 ,$62.98 , N/A ,$61.64 ,$1.67 ,$60.97 , N/A ,$41.23 ,$41.23 ,$47.23 ,$50.00 ,$46.67 , N/A ,$1.58 ,$63.65 , N/A ,$1.58 ,$58.29 , N/A ,$60.30 , N/A ,$60.30 ,$60.30 ,$60.30 ,$64.99 ,$54.27 ,$62.31 ,$57.62 ,$64.99 
SACRED HEART HOSPITAL (ACU),30101687,80353,HC COCAINE,301,1 ,$67.00 ,$50.25 ,$1.58 ,$67.00 ,$43.15 , N/A ,$46.90 ,$1.58 ,$41.42 ,$1.63 ,$33.14 ,$63.65 ,$1.58 ,$53.60 ,$61.64 ,$1.58 ,$56.95 ,$63.65 ,$58.96 ,$50.92 ,$1.58 ,$1.58 ,$1.58 ,$48.91 ,$36.85 ,$60.97 ,$60.97 ,$53.60 , N/A ,$36.85 ,$60.30 , N/A ,$60.30 ,$36.18 ,$62.98 , N/A ,$61.64 ,$1.67 ,$60.97 , N/A ,$41.23 ,$41.23 ,$47.23 ,$50.00 ,$46.67 , N/A ,$1.58 ,$63.65 , N/A ,$1.58 ,$58.29 , N/A ,$60.30 , N/A ,$60.30 ,$60.30 ,$60.30 ,$64.99 ,$54.27 ,$62.31 ,$57.62 ,$64.99 
SACRED HEART HOSPITAL (ACU),30101737,82784,HC IMMUNOGLOBIN G,301,1 ,$217.00 ,$162.75 ,$9.30 ,$217.00 ,$139.75 ,$9.30 ,$151.90 ,$9.61 ,$22.33 ,$9.90 ,$17.86 ,$206.15 ,$9.61 ,$173.60 ,$199.64 ,$9.61 ,$184.45 ,$206.15 ,$190.96 ,$164.92 ,$9.61 ,$9.61 ,$9.61 ,$158.41 ,$119.35 ,$197.47 ,$197.47 ,$173.60 ,$9.58 ,$119.35 ,$195.30 ,$9.30 ,$195.30 ,$117.18 ,$203.98 ,$20.93 ,$199.64 ,$10.19 ,$197.47 ,$9.30 ,$133.54 ,$133.54 ,$139.47 ,$161.95 ,$58.45 ,$9.39 ,$9.61 ,$206.15 ,$9.77 ,$9.61 ,$188.79 ,$9.30 ,$195.30 ,$9.30 ,$195.30 ,$195.30 ,$195.30 ,$210.49 ,$175.77 ,$201.81 ,$186.62 ,$210.49 
SACRED HEART HOSPITAL (ACU),30101761,83520,HC PHOSPHOLIPASE A2 RECPT ANTIBODY,301,1 ,$270.00 ,$202.50 ,$17.27 ,$270.00 ,$173.88 ,$17.27 ,$189.00 ,$17.85 ,$31.08 ,$18.39 ,$24.86 ,$256.50 ,$17.85 ,$216.00 ,$248.40 ,$17.85 ,$229.50 ,$256.50 ,$237.60 ,$205.20 ,$17.85 ,$17.85 ,$17.85 ,$197.10 ,$148.50 ,$245.70 ,$245.70 ,$216.00 ,$17.79 ,$148.50 ,$243.00 ,$17.27 ,$243.00 ,$145.80 ,$253.80 ,$38.86 ,$248.40 ,$18.92 ,$245.70 ,$17.27 ,$166.16 ,$166.16 ,$109.82 ,$201.50 ,$87.93 ,$17.44 ,$17.85 ,$256.50 ,$18.13 ,$17.85 ,$234.90 ,$17.27 ,$243.00 ,$17.27 ,$243.00 ,$243.00 ,$243.00 ,$261.90 ,$218.70 ,$251.10 ,$232.20 ,$261.90 
SACRED HEART HOSPITAL (ACU),30101764,80358,HC METHADONE QUANT SERUM- REF,301,1 ,$55.00 ,$41.25 ,$1.58 ,$55.00 ,$35.42 , N/A ,$38.50 ,$1.58 ,$41.42 ,$1.63 ,$33.14 ,$52.25 ,$1.58 ,$44.00 ,$50.60 ,$1.58 ,$46.75 ,$52.25 ,$48.40 ,$41.80 ,$1.58 ,$1.58 ,$1.58 ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 , N/A ,$30.25 ,$49.50 , N/A ,$49.50 ,$29.70 ,$51.70 , N/A ,$50.60 ,$1.67 ,$50.05 , N/A ,$33.85 ,$33.85 ,$47.23 ,$41.05 ,$38.31 , N/A ,$1.58 ,$52.25 , N/A ,$1.58 ,$47.85 , N/A ,$49.50 , N/A ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),30101772,83521,HC IMMUNO LIGHT CHAINS FREE EA,301,1 ,$146.00 ,$109.50 ,$3.94 ,$146.00 ,$94.02 ,$17.27 ,$102.20 ,$3.94 ,$30.22 ,$4.06 ,$96.36 ,$138.70 ,$3.94 ,$116.80 ,$134.32 ,$3.94 ,$124.10 ,$138.70 ,$128.48 ,$110.96 ,$3.94 ,$3.94 ,$3.94 ,$106.58 ,$80.30 ,$132.86 ,$132.86 ,$116.80 ,$17.79 ,$80.30 ,$131.40 ,$17.27 ,$131.40 ,$78.84 ,$137.24 ,$38.86 ,$134.32 ,$4.18 ,$132.86 ,$17.27 ,$89.85 ,$89.85 ,$131.40 ,$108.96 ,$101.69 ,$17.44 ,$3.94 ,$138.70 ,$18.13 ,$3.94 ,$127.02 ,$17.27 ,$131.40 ,$17.27 ,$131.40 ,$131.40 ,$131.40 ,$141.62 ,$118.26 ,$135.78 ,$125.56 ,$141.62 
SACRED HEART HOSPITAL (ACU),30101773,83529,HC INTERLEUKIN- 6,301,1 ,$45.00 ,$33.75 ,$3.94 ,$45.00 ,$28.98 ,$17.27 ,$31.50 ,$3.94 ,$30.22 ,$4.06 ,$29.70 ,$42.75 ,$3.94 ,$36.00 ,$41.40 ,$3.94 ,$38.25 ,$42.75 ,$39.60 ,$34.20 ,$3.94 ,$3.94 ,$3.94 ,$32.85 ,$24.75 ,$40.95 ,$40.95 ,$36.00 ,$17.79 ,$24.75 ,$40.50 ,$17.27 ,$40.50 ,$24.30 ,$42.30 ,$38.86 ,$41.40 ,$4.18 ,$40.95 ,$17.27 ,$27.69 ,$27.69 ,$40.50 ,$33.58 ,$31.34 ,$17.44 ,$3.94 ,$42.75 ,$18.13 ,$3.94 ,$39.15 ,$17.27 ,$40.50 ,$17.27 ,$40.50 ,$40.50 ,$40.50 ,$43.65 ,$36.45 ,$41.85 ,$38.70 ,$43.65 
SACRED HEART HOSPITAL (ACU),30140189,82157,HC ANDROSTENEDIONE-REF,301,1 ,$95.00 ,$71.25 ,$29.28 ,$95.00 ,$61.18 ,$29.28 ,$66.50 ,$30.26 ,$70.28 ,$31.17 ,$56.22 ,$90.25 ,$30.26 ,$76.00 ,$87.40 ,$30.26 ,$80.75 ,$90.25 ,$83.60 ,$72.20 ,$30.26 ,$30.26 ,$30.26 ,$69.35 ,$52.25 ,$86.45 ,$86.45 ,$76.00 ,$30.16 ,$52.25 ,$85.50 ,$29.28 ,$85.50 ,$51.30 ,$89.30 ,$65.88 ,$87.40 ,$32.08 ,$86.45 ,$29.28 ,$58.46 ,$58.46 ,$95.00 ,$70.90 ,$85.50 ,$29.57 ,$30.26 ,$90.25 ,$30.74 ,$30.26 ,$82.65 ,$29.28 ,$85.50 ,$29.28 ,$85.50 ,$85.50 ,$85.50 ,$92.15 ,$76.95 ,$88.35 ,$81.70 ,$92.15 
SACRED HEART HOSPITAL (ACU),30140302,82785,HC GAMMAGLOBULIN IGE-REF,301,1 ,$47.00 ,$35.25 ,$16.46 ,$47.00 ,$30.27 ,$16.46 ,$32.90 ,$17.01 ,$39.52 ,$17.52 ,$31.61 ,$44.65 ,$17.01 ,$37.60 ,$43.24 ,$17.01 ,$39.95 ,$44.65 ,$41.36 ,$35.72 ,$17.01 ,$17.01 ,$17.01 ,$34.31 ,$25.85 ,$42.77 ,$42.77 ,$37.60 ,$16.95 ,$25.85 ,$42.30 ,$16.46 ,$42.30 ,$25.38 ,$44.18 ,$37.04 ,$43.24 ,$18.03 ,$42.77 ,$16.46 ,$28.92 ,$28.92 ,$47.00 ,$35.08 ,$42.30 ,$16.62 ,$17.01 ,$44.65 ,$17.28 ,$17.01 ,$40.89 ,$16.46 ,$42.30 ,$16.46 ,$42.30 ,$42.30 ,$42.30 ,$45.59 ,$38.07 ,$43.71 ,$40.42 ,$45.59 
SACRED HEART HOSPITAL (ACU),30140424,80183,HC TRILEPTAL-REF,301,1 ,$79.00 ,$59.25 ,$13.25 ,$79.00 ,$50.88 ,$13.25 ,$55.30 ,$13.69 ,$31.82 ,$14.10 ,$25.45 ,$75.05 ,$13.69 ,$63.20 ,$72.68 ,$13.69 ,$67.15 ,$75.05 ,$69.52 ,$60.04 ,$13.69 ,$13.69 ,$13.69 ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 ,$13.65 ,$43.45 ,$71.10 ,$13.25 ,$71.10 ,$42.66 ,$74.26 ,$29.81 ,$72.68 ,$14.51 ,$71.89 ,$13.25 ,$48.62 ,$48.62 ,$34.23 ,$58.96 ,$71.10 ,$13.38 ,$13.69 ,$75.05 ,$13.91 ,$13.69 ,$68.73 ,$13.25 ,$71.10 ,$13.25 ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),30140670,83945,HC OXALATE-REF,301,1 ,$92.00 ,$69.00 ,$14.45 ,$92.00 ,$59.25 ,$14.45 ,$64.40 ,$14.93 ,$30.91 ,$15.38 ,$24.72 ,$87.40 ,$14.93 ,$73.60 ,$84.64 ,$14.93 ,$78.20 ,$87.40 ,$80.96 ,$69.92 ,$14.93 ,$14.93 ,$14.93 ,$67.16 ,$50.60 ,$83.72 ,$83.72 ,$73.60 ,$14.88 ,$50.60 ,$82.80 ,$14.45 ,$82.80 ,$49.68 ,$86.48 ,$32.51 ,$84.64 ,$15.83 ,$83.72 ,$14.45 ,$56.62 ,$56.62 ,$92.00 ,$68.66 ,$80.91 ,$14.59 ,$14.93 ,$87.40 ,$15.17 ,$14.93 ,$80.04 ,$14.45 ,$82.80 ,$14.45 ,$82.80 ,$82.80 ,$82.80 ,$89.24 ,$74.52 ,$85.56 ,$79.12 ,$89.24 
SACRED HEART HOSPITAL (ACU),30200102,86003,HC ALLERGEN IGE QN EA,302,1 ,$68.69 ,$51.52 ,$4.57 ,$68.69 ,$44.24 ,$5.22 ,$48.08 ,$4.57 ,$7.79 ,$4.71 ,$6.23 ,$65.26 ,$4.57 ,$54.95 ,$63.19 ,$4.57 ,$58.39 ,$65.26 ,$60.45 ,$52.20 ,$4.57 ,$4.57 ,$4.57 ,$50.14 ,$37.78 ,$62.51 ,$62.51 ,$54.95 ,$5.38 ,$37.78 ,$61.82 ,$5.22 ,$61.82 ,$37.09 ,$64.57 ,$11.75 ,$63.19 ,$4.84 ,$62.51 ,$5.22 ,$42.27 ,$42.27 ,$68.69 ,$51.26 ,$32.79 ,$5.27 ,$4.57 ,$65.26 ,$5.48 ,$4.57 ,$59.76 ,$5.22 ,$61.82 ,$5.22 ,$61.82 ,$61.82 ,$61.82 ,$66.63 ,$55.64 ,$63.88 ,$59.07 ,$66.63 
SACRED HEART HOSPITAL (ACU),30200103,86021,HC LEUKO AB ID,302,1 ,$138.65 ,$103.99 ,$15.05 ,$138.65 ,$89.29 ,$15.05 ,$97.06 ,$15.55 ,$36.14 ,$16.02 ,$28.91 ,$131.72 ,$15.55 ,$110.92 ,$127.56 ,$15.55 ,$117.85 ,$131.72 ,$122.01 ,$105.37 ,$15.55 ,$15.55 ,$15.55 ,$101.21 ,$76.26 ,$126.17 ,$126.17 ,$110.92 ,$15.50 ,$76.26 ,$124.79 ,$15.05 ,$124.79 ,$74.87 ,$130.33 ,$33.86 ,$127.56 ,$16.48 ,$126.17 ,$15.05 ,$85.33 ,$85.33 ,$138.65 ,$103.47 ,$94.65 ,$15.20 ,$15.55 ,$131.72 ,$15.80 ,$15.55 ,$120.63 ,$15.05 ,$124.79 ,$15.05 ,$124.79 ,$124.79 ,$124.79 ,$134.49 ,$112.31 ,$128.94 ,$119.24 ,$134.49 
SACRED HEART HOSPITAL (ACU),30200108,86022,HC PLATELET AB ID (HIT),302,1 ,$228.70 ,$171.53 ,$18.37 ,$228.70 ,$147.28 ,$18.37 ,$160.09 ,$18.98 ,$44.10 ,$19.55 ,$35.28 ,$217.27 ,$18.98 ,$182.96 ,$210.40 ,$18.98 ,$194.40 ,$217.27 ,$201.26 ,$173.81 ,$18.98 ,$18.98 ,$18.98 ,$166.95 ,$125.79 ,$208.12 ,$208.12 ,$182.96 ,$18.92 ,$125.79 ,$205.83 ,$18.37 ,$205.83 ,$123.50 ,$214.98 ,$41.33 ,$210.40 ,$20.12 ,$208.12 ,$18.37 ,$140.74 ,$140.74 ,$228.70 ,$170.68 ,$115.48 ,$18.55 ,$18.98 ,$217.27 ,$19.29 ,$18.98 ,$198.97 ,$18.37 ,$205.83 ,$18.37 ,$205.83 ,$205.83 ,$205.83 ,$221.84 ,$185.25 ,$212.69 ,$196.68 ,$221.84 
SACRED HEART HOSPITAL (ACU),30200119,86038,HC ANA SCREEN,302,1 ,$41.93 ,$31.45 ,$12.09 ,$41.93 ,$27.00 ,$12.09 ,$29.35 ,$12.49 ,$25.01 ,$12.86 ,$20.01 ,$39.83 ,$12.49 ,$33.54 ,$38.58 ,$12.49 ,$35.64 ,$39.83 ,$36.90 ,$31.87 ,$12.49 ,$12.49 ,$12.49 ,$30.61 ,$23.06 ,$38.16 ,$38.16 ,$33.54 ,$12.45 ,$23.06 ,$37.74 ,$12.09 ,$37.74 ,$22.64 ,$39.41 ,$27.20 ,$38.58 ,$13.24 ,$38.16 ,$12.09 ,$25.80 ,$25.80 ,$41.93 ,$31.29 ,$37.74 ,$12.21 ,$12.49 ,$39.83 ,$12.69 ,$12.49 ,$36.48 ,$12.09 ,$37.74 ,$12.09 ,$37.74 ,$37.74 ,$37.74 ,$40.67 ,$33.96 ,$38.99 ,$36.06 ,$40.67 
SACRED HEART HOSPITAL (ACU),30200120,86039,HC ANA TITER,302,1 ,$41.93 ,$31.45 ,$11.16 ,$41.93 ,$27.00 ,$11.16 ,$29.35 ,$11.53 ,$26.79 ,$11.88 ,$21.43 ,$39.83 ,$11.53 ,$33.54 ,$38.58 ,$11.53 ,$35.64 ,$39.83 ,$36.90 ,$31.87 ,$11.53 ,$11.53 ,$11.53 ,$30.61 ,$23.06 ,$38.16 ,$38.16 ,$33.54 ,$11.49 ,$23.06 ,$37.74 ,$11.16 ,$37.74 ,$22.64 ,$39.41 ,$25.11 ,$38.58 ,$12.22 ,$38.16 ,$11.16 ,$25.80 ,$25.80 ,$41.93 ,$31.29 ,$37.74 ,$11.27 ,$11.53 ,$39.83 ,$11.72 ,$11.53 ,$36.48 ,$11.16 ,$37.74 ,$11.16 ,$37.74 ,$37.74 ,$37.74 ,$40.67 ,$33.96 ,$38.99 ,$36.06 ,$40.67 
SACRED HEART HOSPITAL (ACU),30200123,86140,HC C-REACTIVE PROTEIN,302,1 ,$109.70 ,$82.28 ,$5.18 ,$109.70 ,$70.65 ,$5.18 ,$76.79 ,$5.35 ,$12.43 ,$5.51 ,$9.94 ,$104.22 ,$5.35 ,$87.76 ,$100.92 ,$5.35 ,$93.25 ,$104.22 ,$96.54 ,$83.37 ,$5.35 ,$5.35 ,$5.35 ,$80.08 ,$60.34 ,$99.83 ,$99.83 ,$87.76 ,$5.34 ,$60.34 ,$98.73 ,$5.18 ,$98.73 ,$59.24 ,$103.12 ,$11.66 ,$100.92 ,$5.67 ,$99.83 ,$5.18 ,$67.51 ,$67.51 ,$65.89 ,$81.87 ,$32.54 ,$5.23 ,$5.35 ,$104.22 ,$5.44 ,$5.35 ,$95.44 ,$5.18 ,$98.73 ,$5.18 ,$98.73 ,$98.73 ,$98.73 ,$106.41 ,$88.86 ,$102.02 ,$94.34 ,$106.41 
SACRED HEART HOSPITAL (ACU),30200124,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$205.95 ,$154.46 ,$12.95 ,$205.95 ,$132.63 ,$12.95 ,$144.17 ,$13.38 ,$31.08 ,$13.78 ,$24.86 ,$195.65 ,$13.38 ,$164.76 ,$189.47 ,$13.38 ,$175.06 ,$195.65 ,$181.24 ,$156.52 ,$13.38 ,$13.38 ,$13.38 ,$150.34 ,$113.27 ,$187.41 ,$187.41 ,$164.76 ,$13.34 ,$113.27 ,$185.36 ,$12.95 ,$185.36 ,$111.21 ,$193.59 ,$29.14 ,$189.47 ,$14.18 ,$187.41 ,$12.95 ,$126.74 ,$126.74 ,$35.26 ,$153.70 ,$81.36 ,$13.08 ,$13.38 ,$195.65 ,$13.60 ,$13.38 ,$179.18 ,$12.95 ,$185.36 ,$12.95 ,$185.36 ,$185.36 ,$185.36 ,$199.77 ,$166.82 ,$191.53 ,$177.12 ,$199.77 
SACRED HEART HOSPITAL (ACU),30200125,86146,HC BETA 2 GLYCO AB,302,1 ,$78.55 ,$58.91 ,$8.17 ,$78.55 ,$50.59 ,$25.45 ,$54.99 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$74.62 ,$8.17 ,$62.84 ,$72.27 ,$8.17 ,$66.77 ,$74.62 ,$69.12 ,$59.70 ,$8.17 ,$8.17 ,$8.17 ,$57.34 ,$43.20 ,$71.48 ,$71.48 ,$62.84 ,$26.21 ,$43.20 ,$70.70 ,$25.45 ,$70.70 ,$42.42 ,$73.84 ,$57.26 ,$72.27 ,$8.66 ,$71.48 ,$25.45 ,$48.34 ,$48.34 ,$78.55 ,$58.62 ,$70.70 ,$25.70 ,$8.17 ,$74.62 ,$26.72 ,$8.17 ,$68.34 ,$25.45 ,$70.70 ,$25.45 ,$70.70 ,$70.70 ,$70.70 ,$76.19 ,$63.63 ,$73.05 ,$67.55 ,$76.19 
SACRED HEART HOSPITAL (ACU),30200126,86147,HC CARDIOLIPIN AB EA,302,1 ,$78.55 ,$58.91 ,$8.17 ,$78.55 ,$50.59 ,$25.45 ,$54.99 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$74.62 ,$8.17 ,$62.84 ,$72.27 ,$8.17 ,$66.77 ,$74.62 ,$69.12 ,$59.70 ,$8.17 ,$8.17 ,$8.17 ,$57.34 ,$43.20 ,$71.48 ,$71.48 ,$62.84 ,$26.21 ,$43.20 ,$70.70 ,$25.45 ,$70.70 ,$42.42 ,$73.84 ,$57.26 ,$72.27 ,$8.66 ,$71.48 ,$25.45 ,$48.34 ,$48.34 ,$78.55 ,$58.62 ,$70.70 ,$25.70 ,$8.17 ,$74.62 ,$26.72 ,$8.17 ,$68.34 ,$25.45 ,$70.70 ,$25.45 ,$70.70 ,$70.70 ,$70.70 ,$76.19 ,$63.63 ,$73.05 ,$67.55 ,$76.19 
SACRED HEART HOSPITAL (ACU),30200129,86157,HC COLD AGGLUTININ TITER,302,1 ,$187.70 ,$140.78 ,$8.06 ,$187.70 ,$120.88 ,$8.06 ,$131.39 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$178.32 ,$8.17 ,$150.16 ,$172.68 ,$8.17 ,$159.55 ,$178.32 ,$165.18 ,$142.65 ,$8.17 ,$8.17 ,$8.17 ,$137.02 ,$103.24 ,$170.81 ,$170.81 ,$150.16 ,$8.30 ,$103.24 ,$168.93 ,$8.06 ,$168.93 ,$101.36 ,$176.44 ,$18.14 ,$172.68 ,$8.66 ,$170.81 ,$8.06 ,$115.51 ,$115.51 ,$57.09 ,$140.08 ,$50.66 ,$8.14 ,$8.17 ,$178.32 ,$8.46 ,$8.17 ,$163.30 ,$8.06 ,$168.93 ,$8.06 ,$168.93 ,$168.93 ,$168.93 ,$182.07 ,$152.04 ,$174.56 ,$161.42 ,$182.07 
SACRED HEART HOSPITAL (ACU),30200133,86161,HC C1 ESTERASE INHIBITOR,302,1 ,$216.98 ,$162.74 ,$12.00 ,$216.98 ,$139.74 ,$12.00 ,$151.89 ,$12.40 ,$28.81 ,$12.77 ,$23.04 ,$206.13 ,$12.40 ,$173.58 ,$199.62 ,$12.40 ,$184.43 ,$206.13 ,$190.94 ,$164.90 ,$12.40 ,$12.40 ,$12.40 ,$158.40 ,$119.34 ,$197.45 ,$197.45 ,$173.58 ,$12.36 ,$119.34 ,$195.28 ,$12.00 ,$195.28 ,$117.17 ,$203.96 ,$27.00 ,$199.62 ,$13.14 ,$197.45 ,$12.00 ,$133.53 ,$133.53 ,$109.82 ,$161.93 ,$75.41 ,$12.12 ,$12.40 ,$206.13 ,$12.60 ,$12.40 ,$188.77 ,$12.00 ,$195.28 ,$12.00 ,$195.28 ,$195.28 ,$195.28 ,$210.47 ,$175.75 ,$201.79 ,$186.60 ,$210.47 
SACRED HEART HOSPITAL (ACU),30200137,86225,HC DNA DOUBLE STRAND AB,302,1 ,$42.43 ,$31.82 ,$13.74 ,$42.43 ,$27.32 ,$13.74 ,$29.70 ,$14.20 ,$32.99 ,$14.63 ,$26.39 ,$40.31 ,$14.20 ,$33.94 ,$39.04 ,$14.20 ,$36.07 ,$40.31 ,$37.34 ,$32.25 ,$14.20 ,$14.20 ,$14.20 ,$30.97 ,$23.34 ,$38.61 ,$38.61 ,$33.94 ,$14.15 ,$23.34 ,$38.19 ,$13.74 ,$38.19 ,$22.91 ,$39.88 ,$30.92 ,$39.04 ,$15.05 ,$38.61 ,$13.74 ,$26.11 ,$26.11 ,$42.43 ,$31.67 ,$38.19 ,$13.88 ,$14.20 ,$40.31 ,$14.43 ,$14.20 ,$36.91 ,$13.74 ,$38.19 ,$13.74 ,$38.19 ,$38.19 ,$38.19 ,$41.16 ,$34.37 ,$39.46 ,$36.49 ,$41.16 
SACRED HEART HOSPITAL (ACU),30200138,86235,HC ENA AB,302,1 ,$78.00 ,$58.50 ,$17.93 ,$78.00 ,$50.23 ,$17.93 ,$54.60 ,$18.53 ,$43.05 ,$19.09 ,$34.44 ,$74.10 ,$18.53 ,$62.40 ,$71.76 ,$18.53 ,$66.30 ,$74.10 ,$68.64 ,$59.28 ,$18.53 ,$18.53 ,$18.53 ,$56.94 ,$42.90 ,$70.98 ,$70.98 ,$62.40 ,$18.47 ,$42.90 ,$70.20 ,$17.93 ,$70.20 ,$42.12 ,$73.32 ,$40.34 ,$71.76 ,$19.64 ,$70.98 ,$17.93 ,$48.00 ,$48.00 ,$78.00 ,$58.21 ,$70.20 ,$18.11 ,$18.53 ,$74.10 ,$18.83 ,$18.53 ,$67.86 ,$17.93 ,$70.20 ,$17.93 ,$70.20 ,$70.20 ,$70.20 ,$75.66 ,$63.18 ,$72.54 ,$67.08 ,$75.66 
SACRED HEART HOSPITAL (ACU),30200158,86300,HC TUMOR AG CA 15-3 (27.29),302,1 ,$38.69 ,$29.02 ,$20.81 ,$46.82 ,$24.92 ,$20.81 ,$27.08 ,$21.50 ,$38.69 ,$22.15 ,$38.69 ,$36.76 ,$21.50 ,$30.95 ,$35.59 ,$21.50 ,$32.89 ,$36.76 ,$34.05 ,$29.40 ,$21.50 ,$21.50 ,$21.50 ,$28.24 ,$21.28 ,$35.21 ,$35.21 ,$30.95 ,$21.43 ,$21.28 ,$34.82 ,$20.81 ,$34.82 ,$20.89 ,$36.37 ,$46.82 ,$35.59 ,$22.79 ,$35.21 ,$20.81 ,$23.81 ,$23.81 ,$38.69 ,$28.87 ,$34.82 ,$21.02 ,$21.50 ,$36.76 ,$21.85 ,$21.50 ,$33.66 ,$20.81 ,$34.82 ,$20.81 ,$34.82 ,$34.82 ,$34.82 ,$37.53 ,$31.34 ,$35.98 ,$33.27 ,$37.53 
SACRED HEART HOSPITAL (ACU),30200160,86301,HC TUMOR AG CA 19-9,302,1 ,$202.16 ,$151.62 ,$20.81 ,$202.16 ,$130.19 ,$20.81 ,$141.51 ,$21.50 ,$49.96 ,$22.15 ,$39.97 ,$192.05 ,$21.50 ,$161.73 ,$185.99 ,$21.50 ,$171.84 ,$192.05 ,$177.90 ,$153.64 ,$21.50 ,$21.50 ,$21.50 ,$147.58 ,$111.19 ,$183.97 ,$183.97 ,$161.73 ,$21.43 ,$111.19 ,$181.94 ,$20.81 ,$181.94 ,$109.17 ,$190.03 ,$46.82 ,$185.99 ,$22.79 ,$183.97 ,$20.81 ,$124.41 ,$124.41 ,$73.45 ,$150.87 ,$130.85 ,$21.02 ,$21.50 ,$192.05 ,$21.85 ,$21.50 ,$175.88 ,$20.81 ,$181.94 ,$20.81 ,$181.94 ,$181.94 ,$181.94 ,$196.10 ,$163.75 ,$188.01 ,$173.86 ,$196.10 
SACRED HEART HOSPITAL (ACU),30200162,86304,HC TUMOR AG CA 125,302,1 ,$179.77 ,$134.83 ,$20.81 ,$179.77 ,$115.77 ,$20.81 ,$125.84 ,$21.50 ,$49.96 ,$22.15 ,$39.97 ,$170.78 ,$21.50 ,$143.82 ,$165.39 ,$21.50 ,$152.80 ,$170.78 ,$158.20 ,$136.63 ,$21.50 ,$21.50 ,$21.50 ,$131.23 ,$98.87 ,$163.59 ,$163.59 ,$143.82 ,$21.43 ,$98.87 ,$161.79 ,$20.81 ,$161.79 ,$97.08 ,$168.98 ,$46.82 ,$165.39 ,$22.79 ,$163.59 ,$20.81 ,$110.63 ,$110.63 ,$73.45 ,$134.16 ,$130.85 ,$21.02 ,$21.50 ,$170.78 ,$21.85 ,$21.50 ,$156.40 ,$20.81 ,$161.79 ,$20.81 ,$161.79 ,$161.79 ,$161.79 ,$174.38 ,$145.61 ,$167.19 ,$154.60 ,$174.38 
SACRED HEART HOSPITAL (ACU),30200163,86308,HC HETEROPHILE SCR MONO,302,1 ,$142.89 ,$107.17 ,$5.18 ,$142.89 ,$92.02 ,$5.18 ,$100.02 ,$5.35 ,$12.43 ,$5.51 ,$9.94 ,$135.75 ,$5.35 ,$114.31 ,$131.46 ,$5.35 ,$121.46 ,$135.75 ,$125.74 ,$108.60 ,$5.35 ,$5.35 ,$5.35 ,$104.31 ,$78.59 ,$130.03 ,$130.03 ,$114.31 ,$5.34 ,$78.59 ,$128.60 ,$5.18 ,$128.60 ,$77.16 ,$134.32 ,$11.66 ,$131.46 ,$5.67 ,$130.03 ,$5.18 ,$87.93 ,$87.93 ,$51.17 ,$106.64 ,$32.54 ,$5.23 ,$5.35 ,$135.75 ,$5.44 ,$5.35 ,$124.31 ,$5.18 ,$128.60 ,$5.18 ,$128.60 ,$128.60 ,$128.60 ,$138.60 ,$115.74 ,$132.89 ,$122.89 ,$138.60 
SACRED HEART HOSPITAL (ACU),30200167,86331,HC IMMUNODIFF EL EA AG AB QL,302,1 ,$43.41 ,$32.56 ,$11.98 ,$43.41 ,$27.96 ,$11.98 ,$30.39 ,$12.38 ,$28.75 ,$12.75 ,$23.00 ,$41.24 ,$12.38 ,$34.73 ,$39.94 ,$12.38 ,$36.90 ,$41.24 ,$38.20 ,$32.99 ,$12.38 ,$12.38 ,$12.38 ,$31.69 ,$23.88 ,$39.50 ,$39.50 ,$34.73 ,$12.34 ,$23.88 ,$39.07 ,$11.98 ,$39.07 ,$23.44 ,$40.81 ,$26.96 ,$39.94 ,$13.12 ,$39.50 ,$11.98 ,$26.71 ,$26.71 ,$43.41 ,$32.40 ,$39.07 ,$12.10 ,$12.38 ,$41.24 ,$12.58 ,$12.38 ,$37.77 ,$11.98 ,$39.07 ,$11.98 ,$39.07 ,$39.07 ,$39.07 ,$42.11 ,$35.16 ,$40.37 ,$37.33 ,$42.11 
SACRED HEART HOSPITAL (ACU),30200169,86334,HC IMMUNOFIX ELECTRO SERUM,302,1 ,$68.98 ,$51.74 ,$22.34 ,$68.98 ,$44.42 ,$22.34 ,$48.29 ,$23.08 ,$53.64 ,$23.77 ,$42.91 ,$65.53 ,$23.08 ,$55.18 ,$63.46 ,$23.08 ,$58.63 ,$65.53 ,$60.70 ,$52.42 ,$23.08 ,$23.08 ,$23.08 ,$50.36 ,$37.94 ,$62.77 ,$62.77 ,$55.18 ,$23.01 ,$37.94 ,$62.08 ,$22.34 ,$62.08 ,$37.25 ,$64.84 ,$50.27 ,$63.46 ,$24.46 ,$62.77 ,$22.34 ,$42.45 ,$42.45 ,$68.98 ,$51.48 ,$62.08 ,$22.56 ,$23.08 ,$65.53 ,$23.46 ,$23.08 ,$60.01 ,$22.34 ,$62.08 ,$22.34 ,$62.08 ,$62.08 ,$62.08 ,$66.91 ,$55.87 ,$64.15 ,$59.32 ,$66.91 
SACRED HEART HOSPITAL (ACU),30200171,86335,HC IMMUNOFIX ELECTRO OTH,302,1 ,$90.58 ,$67.94 ,$29.35 ,$90.58 ,$58.33 ,$29.35 ,$63.41 ,$30.33 ,$70.46 ,$31.24 ,$56.36 ,$86.05 ,$30.33 ,$72.46 ,$83.33 ,$30.33 ,$76.99 ,$86.05 ,$79.71 ,$68.84 ,$30.33 ,$30.33 ,$30.33 ,$66.12 ,$49.82 ,$82.43 ,$82.43 ,$72.46 ,$30.23 ,$49.82 ,$81.52 ,$29.35 ,$81.52 ,$48.91 ,$85.15 ,$66.04 ,$83.33 ,$32.15 ,$82.43 ,$29.35 ,$55.74 ,$55.74 ,$84.76 ,$67.60 ,$81.52 ,$29.64 ,$30.33 ,$86.05 ,$30.82 ,$30.33 ,$78.80 ,$29.35 ,$81.52 ,$29.35 ,$81.52 ,$81.52 ,$81.52 ,$87.86 ,$73.37 ,$84.24 ,$77.90 ,$87.86 
SACRED HEART HOSPITAL (ACU),30200173,86336,HC INHIBIN A,302,1 ,$48.10 ,$36.08 ,$15.59 ,$48.10 ,$30.98 ,$15.59 ,$33.67 ,$16.11 ,$37.42 ,$16.59 ,$29.93 ,$45.70 ,$16.11 ,$38.48 ,$44.25 ,$16.11 ,$40.89 ,$45.70 ,$42.33 ,$36.56 ,$16.11 ,$16.11 ,$16.11 ,$35.11 ,$26.46 ,$43.77 ,$43.77 ,$38.48 ,$16.06 ,$26.46 ,$43.29 ,$15.59 ,$43.29 ,$25.97 ,$45.21 ,$35.08 ,$44.25 ,$17.08 ,$43.77 ,$15.59 ,$29.60 ,$29.60 ,$48.10 ,$35.90 ,$43.29 ,$15.75 ,$16.11 ,$45.70 ,$16.37 ,$16.11 ,$41.85 ,$15.59 ,$43.29 ,$15.59 ,$43.29 ,$43.29 ,$43.29 ,$46.66 ,$38.96 ,$44.73 ,$41.37 ,$46.66 
SACRED HEART HOSPITAL (ACU),30200176,86337,HC INSULIN AB,302,1 ,$221.00 ,$165.75 ,$21.41 ,$221.00 ,$142.32 ,$21.41 ,$154.70 ,$22.12 ,$51.40 ,$22.78 ,$41.12 ,$209.95 ,$22.12 ,$176.80 ,$203.32 ,$22.12 ,$187.85 ,$209.95 ,$194.48 ,$167.96 ,$22.12 ,$22.12 ,$22.12 ,$161.33 ,$121.55 ,$201.11 ,$201.11 ,$176.80 ,$22.05 ,$121.55 ,$198.90 ,$21.41 ,$198.90 ,$119.34 ,$207.74 ,$48.17 ,$203.32 ,$23.45 ,$201.11 ,$21.41 ,$136.00 ,$136.00 ,$107.82 ,$164.93 ,$134.57 ,$21.62 ,$22.12 ,$209.95 ,$22.48 ,$22.12 ,$192.27 ,$21.41 ,$198.90 ,$21.41 ,$198.90 ,$198.90 ,$198.90 ,$214.37 ,$179.01 ,$205.53 ,$190.06 ,$214.37 
SACRED HEART HOSPITAL (ACU),30200181,86355,HC B CELLS TOTAL COUNT,302,1 ,$116.45 ,$87.34 ,$37.73 ,$116.45 ,$74.99 ,$37.73 ,$81.52 ,$38.99 ,$90.56 ,$40.16 ,$72.45 ,$110.63 ,$38.99 ,$93.16 ,$107.13 ,$38.99 ,$98.98 ,$110.63 ,$102.48 ,$88.50 ,$38.99 ,$38.99 ,$38.99 ,$85.01 ,$64.05 ,$105.97 ,$105.97 ,$93.16 ,$38.86 ,$64.05 ,$104.81 ,$37.73 ,$104.81 ,$62.88 ,$109.46 ,$84.89 ,$107.13 ,$41.33 ,$105.97 ,$37.73 ,$71.66 ,$71.66 ,$112.40 ,$86.91 ,$104.81 ,$38.11 ,$38.99 ,$110.63 ,$39.62 ,$38.99 ,$101.31 ,$37.73 ,$104.81 ,$37.73 ,$104.81 ,$104.81 ,$104.81 ,$112.96 ,$94.32 ,$108.30 ,$100.15 ,$112.96 
SACRED HEART HOSPITAL (ACU),30200184,86360,HC ABS T CELLS CD4 CD8 RATIO,302,1 ,$220.08 ,$165.06 ,$46.98 ,$220.08 ,$141.73 ,$46.98 ,$154.06 ,$48.54 ,$112.79 ,$50.00 ,$90.23 ,$209.08 ,$48.54 ,$176.06 ,$202.47 ,$48.54 ,$187.07 ,$209.08 ,$193.67 ,$167.26 ,$48.54 ,$48.54 ,$48.54 ,$160.66 ,$121.04 ,$200.27 ,$200.27 ,$176.06 ,$48.39 ,$121.04 ,$198.07 ,$46.98 ,$198.07 ,$118.84 ,$206.88 ,$105.71 ,$202.47 ,$51.45 ,$200.27 ,$46.98 ,$135.44 ,$135.44 ,$220.08 ,$164.25 ,$198.07 ,$47.45 ,$48.54 ,$209.08 ,$49.33 ,$48.54 ,$191.47 ,$46.98 ,$198.07 ,$46.98 ,$198.07 ,$198.07 ,$198.07 ,$213.48 ,$178.26 ,$204.67 ,$189.27 ,$213.48 
SACRED HEART HOSPITAL (ACU),30200189,86376,HC MICROSOMAL AB,302,1 ,$86.96 ,$65.22 ,$14.55 ,$86.96 ,$56.00 ,$14.55 ,$60.87 ,$15.03 ,$34.93 ,$15.48 ,$27.94 ,$82.61 ,$15.03 ,$69.57 ,$80.00 ,$15.03 ,$73.92 ,$82.61 ,$76.52 ,$66.09 ,$15.03 ,$15.03 ,$15.03 ,$63.48 ,$47.83 ,$79.13 ,$79.13 ,$69.57 ,$14.99 ,$47.83 ,$78.26 ,$14.55 ,$78.26 ,$46.96 ,$81.74 ,$32.74 ,$80.00 ,$15.93 ,$79.13 ,$14.55 ,$53.52 ,$53.52 ,$86.96 ,$64.90 ,$78.26 ,$14.70 ,$15.03 ,$82.61 ,$15.28 ,$15.03 ,$75.66 ,$14.55 ,$78.26 ,$14.55 ,$78.26 ,$78.26 ,$78.26 ,$84.35 ,$70.44 ,$80.87 ,$74.79 ,$84.35 
SACRED HEART HOSPITAL (ACU),30200191,86403,HC PARTICLE AGG SCREEN,302,1 ,$125.66 ,$94.25 ,$11.54 ,$125.66 ,$80.93 ,$11.54 ,$87.96 ,$11.92 ,$24.47 ,$12.28 ,$19.57 ,$119.38 ,$11.92 ,$100.53 ,$115.61 ,$11.92 ,$106.81 ,$119.38 ,$110.58 ,$95.50 ,$11.92 ,$11.92 ,$11.92 ,$91.73 ,$69.11 ,$114.35 ,$114.35 ,$100.53 ,$11.89 ,$69.11 ,$113.09 ,$11.54 ,$113.09 ,$67.86 ,$118.12 ,$25.97 ,$115.61 ,$12.64 ,$114.35 ,$11.54 ,$77.33 ,$77.33 ,$51.58 ,$93.78 ,$64.05 ,$11.66 ,$11.92 ,$119.38 ,$12.12 ,$11.92 ,$109.32 ,$11.54 ,$113.09 ,$11.54 ,$113.09 ,$113.09 ,$113.09 ,$121.89 ,$101.78 ,$116.86 ,$108.07 ,$121.89 
SACRED HEART HOSPITAL (ACU),30200197,86430,HC RHEUMATOID FACTOR,302,1 ,$231.46 ,$173.60 ,$6.14 ,$231.46 ,$149.06 ,$6.14 ,$162.02 ,$6.34 ,$13.62 ,$6.53 ,$10.89 ,$219.89 ,$6.34 ,$185.17 ,$212.94 ,$6.34 ,$196.74 ,$219.89 ,$203.68 ,$175.91 ,$6.34 ,$6.34 ,$6.34 ,$168.97 ,$127.30 ,$210.63 ,$210.63 ,$185.17 ,$6.32 ,$127.30 ,$208.31 ,$6.14 ,$208.31 ,$124.99 ,$217.57 ,$13.82 ,$212.94 ,$6.72 ,$210.63 ,$6.14 ,$142.44 ,$142.44 ,$57.09 ,$172.74 ,$35.64 ,$6.20 ,$6.34 ,$219.89 ,$6.45 ,$6.34 ,$201.37 ,$6.14 ,$208.31 ,$6.14 ,$208.31 ,$208.31 ,$208.31 ,$224.52 ,$187.48 ,$215.26 ,$199.06 ,$224.52 
SACRED HEART HOSPITAL (ACU),30200198,86431,HC RHEUMATOID FACTOR QN,302,1 ,$235.59 ,$176.69 ,$5.67 ,$235.59 ,$151.72 ,$5.67 ,$164.91 ,$5.86 ,$13.62 ,$6.04 ,$10.89 ,$223.81 ,$5.86 ,$188.47 ,$216.74 ,$5.86 ,$200.25 ,$223.81 ,$207.32 ,$179.05 ,$5.86 ,$5.86 ,$5.86 ,$171.98 ,$129.57 ,$214.39 ,$214.39 ,$188.47 ,$5.84 ,$129.57 ,$212.03 ,$5.67 ,$212.03 ,$127.22 ,$221.45 ,$12.76 ,$216.74 ,$6.21 ,$214.39 ,$5.67 ,$144.98 ,$144.98 ,$74.23 ,$175.82 ,$35.64 ,$5.73 ,$5.86 ,$223.81 ,$5.95 ,$5.86 ,$204.96 ,$5.67 ,$212.03 ,$5.67 ,$212.03 ,$212.03 ,$212.03 ,$228.52 ,$190.83 ,$219.10 ,$202.61 ,$228.52 
SACRED HEART HOSPITAL (ACU),30200199,86480,HC TB QUANTIFERON GOLD,302,1 ,$99.00 ,$74.25 ,$53.46 ,$139.46 ,$63.76 ,$61.98 ,$69.30 ,$64.04 ,$99.00 ,$65.96 ,$99.00 ,$94.05 ,$64.04 ,$79.20 ,$91.08 ,$64.04 ,$84.15 ,$94.05 ,$87.12 ,$75.24 ,$64.04 ,$64.04 ,$64.04 ,$72.27 ,$54.45 ,$90.09 ,$90.09 ,$79.20 ,$63.84 ,$54.45 ,$89.10 ,$61.98 ,$89.10 ,$53.46 ,$93.06 ,$139.46 ,$91.08 ,$67.88 ,$90.09 ,$61.98 ,$60.92 ,$60.92 ,$99.00 ,$73.88 ,$89.10 ,$62.60 ,$64.04 ,$94.05 ,$65.08 ,$64.04 ,$86.13 ,$61.98 ,$89.10 ,$61.98 ,$89.10 ,$89.10 ,$89.10 ,$96.03 ,$80.19 ,$92.07 ,$85.14 ,$96.03 
SACRED HEART HOSPITAL (ACU),30200201,86592,HC SYPHILIS VDRL RPR QL,302,1 ,$57.43 ,$43.07 ,$4.27 ,$57.43 ,$36.98 ,$4.27 ,$40.20 ,$4.41 ,$10.26 ,$4.54 ,$8.20 ,$54.56 ,$4.41 ,$45.94 ,$52.84 ,$4.41 ,$48.82 ,$54.56 ,$50.54 ,$43.65 ,$4.41 ,$4.41 ,$4.41 ,$41.92 ,$31.59 ,$52.26 ,$52.26 ,$45.94 ,$4.40 ,$31.59 ,$51.69 ,$4.27 ,$51.69 ,$31.01 ,$53.98 ,$9.61 ,$52.84 ,$4.67 ,$52.26 ,$4.27 ,$35.34 ,$35.34 ,$43.91 ,$42.86 ,$26.83 ,$4.31 ,$4.41 ,$54.56 ,$4.48 ,$4.41 ,$49.96 ,$4.27 ,$51.69 ,$4.27 ,$51.69 ,$51.69 ,$51.69 ,$55.71 ,$46.52 ,$53.41 ,$49.39 ,$55.71 
SACRED HEART HOSPITAL (ACU),30200207,86606,HC ASPERGILLUS AB,302,1 ,$46.48 ,$34.86 ,$8.17 ,$46.48 ,$29.93 ,$15.05 ,$32.54 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$44.16 ,$8.17 ,$37.18 ,$42.76 ,$8.17 ,$39.51 ,$44.16 ,$40.90 ,$35.32 ,$8.17 ,$8.17 ,$8.17 ,$33.93 ,$25.56 ,$42.30 ,$42.30 ,$37.18 ,$15.50 ,$25.56 ,$41.83 ,$15.05 ,$41.83 ,$25.10 ,$43.69 ,$33.86 ,$42.76 ,$8.66 ,$42.30 ,$15.05 ,$28.60 ,$28.60 ,$46.48 ,$34.69 ,$41.83 ,$15.20 ,$8.17 ,$44.16 ,$15.80 ,$8.17 ,$40.44 ,$15.05 ,$41.83 ,$15.05 ,$41.83 ,$41.83 ,$41.83 ,$45.09 ,$37.65 ,$43.23 ,$39.97 ,$45.09 
SACRED HEART HOSPITAL (ACU),30200211,86609,HC BACTERIUM AB NOS,302,1 ,$39.75 ,$29.81 ,$8.17 ,$39.75 ,$25.60 ,$12.88 ,$27.83 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$37.76 ,$8.17 ,$31.80 ,$36.57 ,$8.17 ,$33.79 ,$37.76 ,$34.98 ,$30.21 ,$8.17 ,$8.17 ,$8.17 ,$29.02 ,$21.86 ,$36.17 ,$36.17 ,$31.80 ,$13.27 ,$21.86 ,$35.78 ,$12.88 ,$35.78 ,$21.47 ,$37.37 ,$28.98 ,$36.57 ,$8.66 ,$36.17 ,$12.88 ,$24.46 ,$24.46 ,$39.75 ,$29.67 ,$35.78 ,$13.01 ,$8.17 ,$37.76 ,$13.52 ,$8.17 ,$34.58 ,$12.88 ,$35.78 ,$12.88 ,$35.78 ,$35.78 ,$35.78 ,$38.56 ,$32.20 ,$36.97 ,$34.19 ,$38.56 
SACRED HEART HOSPITAL (ACU),30200212,86611,HC BARTONELLA SCREEN AB,302,1 ,$47.09 ,$35.32 ,$8.17 ,$47.09 ,$30.33 ,$10.18 ,$32.96 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$44.74 ,$8.17 ,$37.67 ,$43.32 ,$8.17 ,$40.03 ,$44.74 ,$41.44 ,$35.79 ,$8.17 ,$8.17 ,$8.17 ,$34.38 ,$25.90 ,$42.85 ,$42.85 ,$37.67 ,$10.49 ,$25.90 ,$42.38 ,$10.18 ,$42.38 ,$25.43 ,$44.26 ,$22.91 ,$43.32 ,$8.66 ,$42.85 ,$10.18 ,$28.98 ,$28.98 ,$47.09 ,$35.14 ,$42.38 ,$10.28 ,$8.17 ,$44.74 ,$10.69 ,$8.17 ,$40.97 ,$10.18 ,$42.38 ,$10.18 ,$42.38 ,$42.38 ,$42.38 ,$45.68 ,$38.14 ,$43.79 ,$40.50 ,$45.68 
SACRED HEART HOSPITAL (ACU),30200213,86612,HC BLASTOMYCES AB,302,1 ,$84.54 ,$63.41 ,$8.17 ,$84.54 ,$54.44 ,$12.90 ,$59.18 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$80.31 ,$8.17 ,$67.63 ,$77.78 ,$8.17 ,$71.86 ,$80.31 ,$74.40 ,$64.25 ,$8.17 ,$8.17 ,$8.17 ,$61.71 ,$46.50 ,$76.93 ,$76.93 ,$67.63 ,$13.29 ,$46.50 ,$76.09 ,$12.90 ,$76.09 ,$45.65 ,$79.47 ,$29.03 ,$77.78 ,$8.66 ,$76.93 ,$12.90 ,$52.03 ,$52.03 ,$43.91 ,$63.09 ,$76.09 ,$13.03 ,$8.17 ,$80.31 ,$13.55 ,$8.17 ,$73.55 ,$12.90 ,$76.09 ,$12.90 ,$76.09 ,$76.09 ,$76.09 ,$82.00 ,$68.48 ,$78.62 ,$72.70 ,$82.00 
SACRED HEART HOSPITAL (ACU),30200217,86617,HC LYME DISEASE AB CONFIRM (IGG),302,1 ,$104.10 ,$78.08 ,$15.49 ,$104.10 ,$67.04 ,$15.49 ,$72.87 ,$16.01 ,$37.19 ,$16.49 ,$29.75 ,$98.90 ,$16.01 ,$83.28 ,$95.77 ,$16.01 ,$88.49 ,$98.90 ,$91.61 ,$79.12 ,$16.01 ,$16.01 ,$16.01 ,$75.99 ,$57.26 ,$94.73 ,$94.73 ,$83.28 ,$15.95 ,$57.26 ,$93.69 ,$15.49 ,$93.69 ,$56.21 ,$97.85 ,$34.85 ,$95.77 ,$16.97 ,$94.73 ,$15.49 ,$64.06 ,$64.06 ,$104.10 ,$77.69 ,$93.69 ,$15.64 ,$16.01 ,$98.90 ,$16.26 ,$16.01 ,$90.57 ,$15.49 ,$93.69 ,$15.49 ,$93.69 ,$93.69 ,$93.69 ,$100.98 ,$84.32 ,$96.81 ,$89.53 ,$100.98 
SACRED HEART HOSPITAL (ACU),30200219,86618,HC LYME AB,302,1 ,$47.00 ,$35.25 ,$17.03 ,$47.00 ,$30.27 ,$17.03 ,$32.90 ,$17.60 ,$40.88 ,$18.13 ,$32.70 ,$44.65 ,$17.60 ,$37.60 ,$43.24 ,$17.60 ,$39.95 ,$44.65 ,$41.36 ,$35.72 ,$17.60 ,$17.60 ,$17.60 ,$34.31 ,$25.85 ,$42.77 ,$42.77 ,$37.60 ,$17.54 ,$25.85 ,$42.30 ,$17.03 ,$42.30 ,$25.38 ,$44.18 ,$38.32 ,$43.24 ,$18.66 ,$42.77 ,$17.03 ,$28.92 ,$28.92 ,$47.00 ,$35.08 ,$42.30 ,$17.20 ,$17.60 ,$44.65 ,$17.88 ,$17.60 ,$40.89 ,$17.03 ,$42.30 ,$17.03 ,$42.30 ,$42.30 ,$42.30 ,$45.59 ,$38.07 ,$43.71 ,$40.42 ,$45.59 
SACRED HEART HOSPITAL (ACU),30200222,86628,HC CANDIDA AB,302,1 ,$37.05 ,$27.79 ,$8.17 ,$37.05 ,$23.86 ,$12.01 ,$25.94 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$35.20 ,$8.17 ,$29.64 ,$34.09 ,$8.17 ,$31.49 ,$35.20 ,$32.60 ,$28.16 ,$8.17 ,$8.17 ,$8.17 ,$27.05 ,$20.38 ,$33.72 ,$33.72 ,$29.64 ,$12.37 ,$20.38 ,$33.35 ,$12.01 ,$33.35 ,$20.01 ,$34.83 ,$27.02 ,$34.09 ,$8.66 ,$33.72 ,$12.01 ,$22.80 ,$22.80 ,$37.05 ,$27.65 ,$33.35 ,$12.13 ,$8.17 ,$35.20 ,$12.61 ,$8.17 ,$32.23 ,$12.01 ,$33.35 ,$12.01 ,$33.35 ,$33.35 ,$33.35 ,$35.94 ,$30.01 ,$34.46 ,$31.86 ,$35.94 
SACRED HEART HOSPITAL (ACU),30200223,86631,HC CHLAMYDIA AB,302,1 ,$105.10 ,$78.83 ,$8.17 ,$105.10 ,$67.68 ,$11.82 ,$73.57 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$99.85 ,$8.17 ,$84.08 ,$96.69 ,$8.17 ,$89.34 ,$99.85 ,$92.49 ,$79.88 ,$8.17 ,$8.17 ,$8.17 ,$76.72 ,$57.81 ,$95.64 ,$95.64 ,$84.08 ,$12.17 ,$57.81 ,$94.59 ,$11.82 ,$94.59 ,$56.75 ,$98.79 ,$26.60 ,$96.69 ,$8.66 ,$95.64 ,$11.82 ,$64.68 ,$64.68 ,$56.01 ,$78.44 ,$74.34 ,$11.94 ,$8.17 ,$99.85 ,$12.41 ,$8.17 ,$91.44 ,$11.82 ,$94.59 ,$11.82 ,$94.59 ,$94.59 ,$94.59 ,$101.95 ,$85.13 ,$97.74 ,$90.39 ,$101.95 
SACRED HEART HOSPITAL (ACU),30200230,86632,HC CHLAMYDIA AB IGM,302,1 ,$39.15 ,$29.36 ,$8.17 ,$39.15 ,$25.21 ,$12.68 ,$27.41 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$37.19 ,$8.17 ,$31.32 ,$36.02 ,$8.17 ,$33.28 ,$37.19 ,$34.45 ,$29.75 ,$8.17 ,$8.17 ,$8.17 ,$28.58 ,$21.53 ,$35.63 ,$35.63 ,$31.32 ,$13.06 ,$21.53 ,$35.24 ,$12.68 ,$35.24 ,$21.14 ,$36.80 ,$28.53 ,$36.02 ,$8.66 ,$35.63 ,$12.68 ,$24.09 ,$24.09 ,$39.15 ,$29.22 ,$35.24 ,$12.81 ,$8.17 ,$37.19 ,$13.31 ,$8.17 ,$34.06 ,$12.68 ,$35.24 ,$12.68 ,$35.24 ,$35.24 ,$35.24 ,$37.98 ,$31.71 ,$36.41 ,$33.67 ,$37.98 
SACRED HEART HOSPITAL (ACU),30200231,86635,HC COCCIDIOIDES AB,302,1 ,$84.54 ,$63.41 ,$8.17 ,$84.54 ,$54.44 ,$11.47 ,$59.18 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$80.31 ,$8.17 ,$67.63 ,$77.78 ,$8.17 ,$71.86 ,$80.31 ,$74.40 ,$64.25 ,$8.17 ,$8.17 ,$8.17 ,$61.71 ,$46.50 ,$76.93 ,$76.93 ,$67.63 ,$11.81 ,$46.50 ,$76.09 ,$11.47 ,$76.09 ,$45.65 ,$79.47 ,$25.81 ,$77.78 ,$8.66 ,$76.93 ,$11.47 ,$52.03 ,$52.03 ,$35.16 ,$63.09 ,$72.15 ,$11.58 ,$8.17 ,$80.31 ,$12.04 ,$8.17 ,$73.55 ,$11.47 ,$76.09 ,$11.47 ,$76.09 ,$76.09 ,$76.09 ,$82.00 ,$68.48 ,$78.62 ,$72.70 ,$82.00 
SACRED HEART HOSPITAL (ACU),30200247,86666,HC EHRICHIA AB,302,1 ,$114.75 ,$86.06 ,$8.17 ,$114.75 ,$73.90 ,$10.18 ,$80.33 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$109.01 ,$8.17 ,$91.80 ,$105.57 ,$8.17 ,$97.54 ,$109.01 ,$100.98 ,$87.21 ,$8.17 ,$8.17 ,$8.17 ,$83.77 ,$63.11 ,$104.42 ,$104.42 ,$91.80 ,$10.49 ,$63.11 ,$103.28 ,$10.18 ,$103.28 ,$61.97 ,$107.87 ,$22.91 ,$105.57 ,$8.66 ,$104.42 ,$10.18 ,$70.62 ,$70.62 ,$63.79 ,$85.64 ,$63.95 ,$10.28 ,$8.17 ,$109.01 ,$10.69 ,$8.17 ,$99.83 ,$10.18 ,$103.28 ,$10.18 ,$103.28 ,$103.28 ,$103.28 ,$111.31 ,$92.95 ,$106.72 ,$98.69 ,$111.31 
SACRED HEART HOSPITAL (ACU),30200250,86671,HC FUNGUS AB NOS,302,1 ,$137.27 ,$102.95 ,$7.15 ,$137.27 ,$88.40 ,$12.25 ,$96.09 ,$7.15 ,$12.22 ,$7.36 ,$9.77 ,$130.41 ,$7.15 ,$109.82 ,$126.29 ,$7.15 ,$116.68 ,$130.41 ,$120.80 ,$104.33 ,$7.15 ,$7.15 ,$7.15 ,$100.21 ,$75.50 ,$124.92 ,$124.92 ,$109.82 ,$12.62 ,$75.50 ,$123.54 ,$12.25 ,$123.54 ,$74.13 ,$129.03 ,$27.56 ,$126.29 ,$7.58 ,$124.92 ,$12.25 ,$84.48 ,$84.48 ,$54.90 ,$102.44 ,$77.04 ,$12.37 ,$7.15 ,$130.41 ,$12.86 ,$7.15 ,$119.42 ,$12.25 ,$123.54 ,$12.25 ,$123.54 ,$123.54 ,$123.54 ,$133.15 ,$111.19 ,$127.66 ,$118.05 ,$133.15 
SACRED HEART HOSPITAL (ACU),30200251,86677,HC H PYLORI AB,302,1 ,$134.51 ,$100.88 ,$8.17 ,$134.51 ,$86.62 ,$16.85 ,$94.16 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$127.78 ,$8.17 ,$107.61 ,$123.75 ,$8.17 ,$114.33 ,$127.78 ,$118.37 ,$102.23 ,$8.17 ,$8.17 ,$8.17 ,$98.19 ,$73.98 ,$122.40 ,$122.40 ,$107.61 ,$17.36 ,$73.98 ,$121.06 ,$16.85 ,$121.06 ,$72.64 ,$126.44 ,$37.91 ,$123.75 ,$8.66 ,$122.40 ,$16.85 ,$82.78 ,$82.78 ,$134.51 ,$100.38 ,$91.19 ,$17.02 ,$8.17 ,$127.78 ,$17.69 ,$8.17 ,$117.02 ,$16.85 ,$121.06 ,$16.85 ,$121.06 ,$121.06 ,$121.06 ,$130.47 ,$108.95 ,$125.09 ,$115.68 ,$130.47 
SACRED HEART HOSPITAL (ACU),30200253,86689,HC HIV WESTERN BLOT,302,1 ,$144.72 ,$108.54 ,$19.35 ,$144.72 ,$93.20 ,$19.35 ,$101.30 ,$19.99 ,$46.46 ,$20.59 ,$37.17 ,$137.48 ,$19.99 ,$115.78 ,$133.14 ,$19.99 ,$123.01 ,$137.48 ,$127.35 ,$109.99 ,$19.99 ,$19.99 ,$19.99 ,$105.65 ,$79.60 ,$131.70 ,$131.70 ,$115.78 ,$19.93 ,$79.60 ,$130.25 ,$19.35 ,$130.25 ,$78.15 ,$136.04 ,$43.54 ,$133.14 ,$21.19 ,$131.70 ,$19.35 ,$89.06 ,$89.06 ,$65.02 ,$108.00 ,$121.69 ,$19.54 ,$19.99 ,$137.48 ,$20.32 ,$19.99 ,$125.91 ,$19.35 ,$130.25 ,$19.35 ,$130.25 ,$130.25 ,$130.25 ,$140.38 ,$117.22 ,$134.59 ,$124.46 ,$140.38 
SACRED HEART HOSPITAL (ACU),30200259,86694,HC HERPES SIMPLEX AB,302,1 ,$54.90 ,$41.18 ,$14.39 ,$54.90 ,$35.36 ,$14.39 ,$38.43 ,$14.87 ,$34.55 ,$15.32 ,$27.64 ,$52.16 ,$14.87 ,$43.92 ,$50.51 ,$14.87 ,$46.67 ,$52.16 ,$48.31 ,$41.72 ,$14.87 ,$14.87 ,$14.87 ,$40.08 ,$30.20 ,$49.96 ,$49.96 ,$43.92 ,$14.82 ,$30.20 ,$49.41 ,$14.39 ,$49.41 ,$29.65 ,$51.61 ,$32.38 ,$50.51 ,$15.76 ,$49.96 ,$14.39 ,$33.79 ,$33.79 ,$54.90 ,$40.97 ,$49.41 ,$14.53 ,$14.87 ,$52.16 ,$15.11 ,$14.87 ,$47.76 ,$14.39 ,$49.41 ,$14.39 ,$49.41 ,$49.41 ,$49.41 ,$53.25 ,$44.47 ,$51.06 ,$47.21 ,$53.25 
SACRED HEART HOSPITAL (ACU),30200261,86695,HC HERPES SIMPLEX AB I,302,1 ,$81.22 ,$60.92 ,$13.19 ,$81.22 ,$52.31 ,$13.19 ,$56.85 ,$13.63 ,$31.66 ,$14.04 ,$25.33 ,$77.16 ,$13.63 ,$64.98 ,$74.72 ,$13.63 ,$69.04 ,$77.16 ,$71.47 ,$61.73 ,$13.63 ,$13.63 ,$13.63 ,$59.29 ,$44.67 ,$73.91 ,$73.91 ,$64.98 ,$13.59 ,$44.67 ,$73.10 ,$13.19 ,$73.10 ,$43.86 ,$76.35 ,$29.68 ,$74.72 ,$14.45 ,$73.91 ,$13.19 ,$49.98 ,$49.98 ,$76.87 ,$60.61 ,$73.10 ,$13.32 ,$13.63 ,$77.16 ,$13.85 ,$13.63 ,$70.66 ,$13.19 ,$73.10 ,$13.19 ,$73.10 ,$73.10 ,$73.10 ,$78.78 ,$65.79 ,$75.53 ,$69.85 ,$78.78 
SACRED HEART HOSPITAL (ACU),30200263,86696,HC HERPES SIMPLEX AB II,302,1 ,$115.90 ,$86.93 ,$19.35 ,$115.90 ,$74.64 ,$19.35 ,$81.13 ,$19.99 ,$46.46 ,$20.59 ,$37.17 ,$110.11 ,$19.99 ,$92.72 ,$106.63 ,$19.99 ,$98.52 ,$110.11 ,$101.99 ,$88.08 ,$19.99 ,$19.99 ,$19.99 ,$84.61 ,$63.75 ,$105.47 ,$105.47 ,$92.72 ,$19.93 ,$63.75 ,$104.31 ,$19.35 ,$104.31 ,$62.59 ,$108.95 ,$43.54 ,$106.63 ,$21.19 ,$105.47 ,$19.35 ,$71.32 ,$71.32 ,$62.83 ,$86.50 ,$104.31 ,$19.54 ,$19.99 ,$110.11 ,$20.32 ,$19.99 ,$100.83 ,$19.35 ,$104.31 ,$19.35 ,$104.31 ,$104.31 ,$104.31 ,$112.42 ,$93.88 ,$107.79 ,$99.67 ,$112.42 
SACRED HEART HOSPITAL (ACU),30200265,86698,HC HISTOPLASMA AB,302,1 ,$41.24 ,$30.93 ,$13.79 ,$41.24 ,$26.56 ,$13.79 ,$28.87 ,$14.25 ,$26.95 ,$14.68 ,$21.56 ,$39.18 ,$14.25 ,$32.99 ,$37.94 ,$14.25 ,$35.05 ,$39.18 ,$36.29 ,$31.34 ,$14.25 ,$14.25 ,$14.25 ,$30.11 ,$22.68 ,$37.53 ,$37.53 ,$32.99 ,$14.20 ,$22.68 ,$37.12 ,$13.79 ,$37.12 ,$22.27 ,$38.77 ,$31.03 ,$37.94 ,$15.11 ,$37.53 ,$13.79 ,$25.38 ,$25.38 ,$41.24 ,$30.78 ,$37.12 ,$13.93 ,$14.25 ,$39.18 ,$14.48 ,$14.25 ,$35.88 ,$13.79 ,$37.12 ,$13.79 ,$37.12 ,$37.12 ,$37.12 ,$40.00 ,$33.40 ,$38.35 ,$35.47 ,$40.00 
SACRED HEART HOSPITAL (ACU),30200270,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$90.11 ,$67.58 ,$13.71 ,$90.11 ,$58.03 ,$13.71 ,$63.08 ,$14.17 ,$32.90 ,$14.60 ,$26.32 ,$85.60 ,$14.17 ,$72.09 ,$82.90 ,$14.17 ,$76.59 ,$85.60 ,$79.30 ,$68.48 ,$14.17 ,$14.17 ,$14.17 ,$65.78 ,$49.56 ,$82.00 ,$82.00 ,$72.09 ,$14.12 ,$49.56 ,$81.10 ,$13.71 ,$81.10 ,$48.66 ,$84.70 ,$30.85 ,$82.90 ,$15.02 ,$82.00 ,$13.71 ,$55.45 ,$55.45 ,$79.07 ,$67.25 ,$81.10 ,$13.85 ,$14.17 ,$85.60 ,$14.40 ,$14.17 ,$78.40 ,$13.71 ,$81.10 ,$13.71 ,$81.10 ,$81.10 ,$81.10 ,$87.41 ,$72.99 ,$83.80 ,$77.49 ,$87.41 
SACRED HEART HOSPITAL (ACU),30200271,86704,HC HEP CORE AB,302,1 ,$83.00 ,$62.25 ,$12.05 ,$83.00 ,$53.45 ,$12.05 ,$58.10 ,$12.45 ,$28.93 ,$12.82 ,$23.14 ,$78.85 ,$12.45 ,$66.40 ,$76.36 ,$12.45 ,$70.55 ,$78.85 ,$73.04 ,$63.08 ,$12.45 ,$12.45 ,$12.45 ,$60.59 ,$45.65 ,$75.53 ,$75.53 ,$66.40 ,$12.41 ,$45.65 ,$74.70 ,$12.05 ,$74.70 ,$44.82 ,$78.02 ,$27.11 ,$76.36 ,$13.20 ,$75.53 ,$12.05 ,$51.08 ,$51.08 ,$62.90 ,$61.94 ,$74.70 ,$12.17 ,$12.45 ,$78.85 ,$12.65 ,$12.45 ,$72.21 ,$12.05 ,$74.70 ,$12.05 ,$74.70 ,$74.70 ,$74.70 ,$80.51 ,$67.23 ,$77.19 ,$71.38 ,$80.51 
SACRED HEART HOSPITAL (ACU),30200282,86735,HC MUMPS AB,302,1 ,$106.02 ,$79.52 ,$13.05 ,$106.02 ,$68.28 ,$13.05 ,$74.21 ,$13.48 ,$31.33 ,$13.88 ,$25.06 ,$100.72 ,$13.48 ,$84.82 ,$97.54 ,$13.48 ,$90.12 ,$100.72 ,$93.30 ,$80.58 ,$13.48 ,$13.48 ,$13.48 ,$77.39 ,$58.31 ,$96.48 ,$96.48 ,$84.82 ,$13.44 ,$58.31 ,$95.42 ,$13.05 ,$95.42 ,$57.25 ,$99.66 ,$29.36 ,$97.54 ,$14.29 ,$96.48 ,$13.05 ,$65.24 ,$65.24 ,$65.02 ,$79.12 ,$82.03 ,$13.18 ,$13.48 ,$100.72 ,$13.70 ,$13.48 ,$92.24 ,$13.05 ,$95.42 ,$13.05 ,$95.42 ,$95.42 ,$95.42 ,$102.84 ,$85.88 ,$98.60 ,$91.18 ,$102.84 
SACRED HEART HOSPITAL (ACU),30200285,86744,HC NOCARDIA AB,302,1 ,$40.70 ,$30.53 ,$8.17 ,$40.70 ,$26.21 ,$15.99 ,$28.49 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$38.67 ,$8.17 ,$32.56 ,$37.44 ,$8.17 ,$34.60 ,$38.67 ,$35.82 ,$30.93 ,$8.17 ,$8.17 ,$8.17 ,$29.71 ,$22.39 ,$37.04 ,$37.04 ,$32.56 ,$16.47 ,$22.39 ,$36.63 ,$15.99 ,$36.63 ,$21.98 ,$38.26 ,$35.98 ,$37.44 ,$8.66 ,$37.04 ,$15.99 ,$25.05 ,$25.05 ,$40.70 ,$30.37 ,$36.63 ,$16.15 ,$8.17 ,$38.67 ,$16.79 ,$8.17 ,$35.41 ,$15.99 ,$36.63 ,$15.99 ,$36.63 ,$36.63 ,$36.63 ,$39.48 ,$32.97 ,$37.85 ,$35.00 ,$39.48 
SACRED HEART HOSPITAL (ACU),30200288,86762,HC RUBELLA AB,302,1 ,$162.58 ,$121.94 ,$14.39 ,$162.58 ,$104.70 ,$14.39 ,$113.81 ,$14.87 ,$34.55 ,$15.32 ,$27.64 ,$154.45 ,$14.87 ,$130.06 ,$149.57 ,$14.87 ,$138.19 ,$154.45 ,$143.07 ,$123.56 ,$14.87 ,$14.87 ,$14.87 ,$118.68 ,$89.42 ,$147.95 ,$147.95 ,$130.06 ,$14.82 ,$89.42 ,$146.32 ,$14.39 ,$146.32 ,$87.79 ,$152.83 ,$32.38 ,$149.57 ,$15.76 ,$147.95 ,$14.39 ,$100.05 ,$100.05 ,$60.62 ,$121.33 ,$72.18 ,$14.53 ,$14.87 ,$154.45 ,$15.11 ,$14.87 ,$141.44 ,$14.39 ,$146.32 ,$14.39 ,$146.32 ,$146.32 ,$146.32 ,$157.70 ,$131.69 ,$151.20 ,$139.82 ,$157.70 
SACRED HEART HOSPITAL (ACU),30200291,86765,HC RUBEOLA AB,302,1 ,$79.38 ,$59.54 ,$12.88 ,$79.38 ,$51.12 ,$12.88 ,$55.57 ,$13.31 ,$30.92 ,$13.71 ,$24.74 ,$75.41 ,$13.31 ,$63.50 ,$73.03 ,$13.31 ,$67.47 ,$75.41 ,$69.85 ,$60.33 ,$13.31 ,$13.31 ,$13.31 ,$57.95 ,$43.66 ,$72.24 ,$72.24 ,$63.50 ,$13.27 ,$43.66 ,$71.44 ,$12.88 ,$71.44 ,$42.87 ,$74.62 ,$28.98 ,$73.03 ,$14.11 ,$72.24 ,$12.88 ,$48.85 ,$48.85 ,$57.99 ,$59.24 ,$71.44 ,$13.01 ,$13.31 ,$75.41 ,$13.52 ,$13.31 ,$69.06 ,$12.88 ,$71.44 ,$12.88 ,$71.44 ,$71.44 ,$71.44 ,$77.00 ,$64.30 ,$73.82 ,$68.27 ,$77.00 
SACRED HEART HOSPITAL (ACU),30200298,86780,HC TREPONEMA P AB CONFIRM,302,1 ,$105.68 ,$79.26 ,$11.13 ,$105.68 ,$68.06 ,$13.24 ,$73.98 ,$11.13 ,$19.01 ,$11.46 ,$15.20 ,$100.40 ,$11.13 ,$84.54 ,$97.23 ,$11.13 ,$89.83 ,$100.40 ,$93.00 ,$80.32 ,$11.13 ,$11.13 ,$11.13 ,$77.15 ,$58.12 ,$96.17 ,$96.17 ,$84.54 ,$13.64 ,$58.12 ,$95.11 ,$13.24 ,$95.11 ,$57.07 ,$99.34 ,$29.79 ,$97.23 ,$11.80 ,$96.17 ,$13.24 ,$65.04 ,$65.04 ,$49.28 ,$78.87 ,$83.20 ,$13.37 ,$11.13 ,$100.40 ,$13.90 ,$11.13 ,$91.94 ,$13.24 ,$95.11 ,$13.24 ,$95.11 ,$95.11 ,$95.11 ,$102.51 ,$85.60 ,$98.28 ,$90.88 ,$102.51 
SACRED HEART HOSPITAL (ACU),30200299,86787,HC VARICELLA ZOSTER ATB,302,1 ,$108.89 ,$81.67 ,$8.17 ,$108.89 ,$70.13 ,$12.88 ,$76.22 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$103.45 ,$8.17 ,$87.11 ,$100.18 ,$8.17 ,$92.56 ,$103.45 ,$95.82 ,$82.76 ,$8.17 ,$8.17 ,$8.17 ,$79.49 ,$59.89 ,$99.09 ,$99.09 ,$87.11 ,$13.27 ,$59.89 ,$98.00 ,$12.88 ,$98.00 ,$58.80 ,$102.36 ,$28.98 ,$100.18 ,$8.66 ,$99.09 ,$12.88 ,$67.01 ,$67.01 ,$43.91 ,$81.26 ,$80.96 ,$13.01 ,$8.17 ,$103.45 ,$13.52 ,$8.17 ,$94.73 ,$12.88 ,$98.00 ,$12.88 ,$98.00 ,$98.00 ,$98.00 ,$105.62 ,$88.20 ,$101.27 ,$93.65 ,$105.62 
SACRED HEART HOSPITAL (ACU),30200303,86788,HC WEST NILE VIRUS AB IGM,302,1 ,$52.00 ,$39.00 ,$8.17 ,$52.00 ,$33.49 ,$16.85 ,$36.40 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$49.40 ,$8.17 ,$41.60 ,$47.84 ,$8.17 ,$44.20 ,$49.40 ,$45.76 ,$39.52 ,$8.17 ,$8.17 ,$8.17 ,$37.96 ,$28.60 ,$47.32 ,$47.32 ,$41.60 ,$17.36 ,$28.60 ,$46.80 ,$16.85 ,$46.80 ,$28.08 ,$48.88 ,$37.91 ,$47.84 ,$8.66 ,$47.32 ,$16.85 ,$32.00 ,$32.00 ,$45.41 ,$38.81 ,$46.80 ,$17.02 ,$8.17 ,$49.40 ,$17.69 ,$8.17 ,$45.24 ,$16.85 ,$46.80 ,$16.85 ,$46.80 ,$46.80 ,$46.80 ,$50.44 ,$42.12 ,$48.36 ,$44.72 ,$50.44 
SACRED HEART HOSPITAL (ACU),30200304,86789,HC WEST NILE AB,302,1 ,$100.52 ,$75.39 ,$14.39 ,$100.52 ,$64.73 ,$14.39 ,$70.36 ,$14.87 ,$34.55 ,$15.32 ,$27.64 ,$95.49 ,$14.87 ,$80.42 ,$92.48 ,$14.87 ,$85.44 ,$95.49 ,$88.46 ,$76.40 ,$14.87 ,$14.87 ,$14.87 ,$73.38 ,$55.29 ,$91.47 ,$91.47 ,$80.42 ,$14.82 ,$55.29 ,$90.47 ,$14.39 ,$90.47 ,$54.28 ,$94.49 ,$32.38 ,$92.48 ,$15.76 ,$91.47 ,$14.39 ,$61.86 ,$61.86 ,$38.81 ,$75.02 ,$90.47 ,$14.53 ,$14.87 ,$95.49 ,$15.11 ,$14.87 ,$87.45 ,$14.39 ,$90.47 ,$14.39 ,$90.47 ,$90.47 ,$90.47 ,$97.50 ,$81.42 ,$93.48 ,$86.45 ,$97.50 
SACRED HEART HOSPITAL (ACU),30200312,86800,HC THYROGLOBULIN AB,302,1 ,$86.84 ,$65.13 ,$15.91 ,$86.84 ,$55.93 ,$15.91 ,$60.79 ,$16.44 ,$38.19 ,$16.93 ,$30.55 ,$82.50 ,$16.44 ,$69.47 ,$79.89 ,$16.44 ,$73.81 ,$82.50 ,$76.42 ,$66.00 ,$16.44 ,$16.44 ,$16.44 ,$63.39 ,$47.76 ,$79.02 ,$79.02 ,$69.47 ,$16.39 ,$47.76 ,$78.16 ,$15.91 ,$78.16 ,$46.89 ,$81.63 ,$35.80 ,$79.89 ,$17.43 ,$79.02 ,$15.91 ,$53.44 ,$53.44 ,$86.84 ,$64.81 ,$78.16 ,$16.07 ,$16.44 ,$82.50 ,$16.71 ,$16.44 ,$75.55 ,$15.91 ,$78.16 ,$15.91 ,$78.16 ,$78.16 ,$78.16 ,$84.23 ,$70.34 ,$80.76 ,$74.68 ,$84.23 
SACRED HEART HOSPITAL (ACU),30200314,86803,HC HEP C AB,302,1 ,$152.89 ,$114.67 ,$14.27 ,$152.89 ,$98.46 ,$14.27 ,$107.02 ,$14.75 ,$34.25 ,$15.19 ,$27.40 ,$145.25 ,$14.75 ,$122.31 ,$140.66 ,$14.75 ,$129.96 ,$145.25 ,$134.54 ,$116.20 ,$14.75 ,$14.75 ,$14.75 ,$111.61 ,$84.09 ,$139.13 ,$139.13 ,$122.31 ,$14.70 ,$84.09 ,$137.60 ,$14.27 ,$137.60 ,$82.56 ,$143.72 ,$32.11 ,$140.66 ,$15.64 ,$139.13 ,$14.27 ,$94.09 ,$94.09 ,$71.73 ,$114.10 ,$89.66 ,$14.41 ,$14.75 ,$145.25 ,$14.98 ,$14.75 ,$133.01 ,$14.27 ,$137.60 ,$14.27 ,$137.60 ,$137.60 ,$137.60 ,$148.30 ,$123.84 ,$142.19 ,$131.49 ,$148.30 
SACRED HEART HOSPITAL (ACU),30200502,87272,HC CRYPTOSPORIDIUM,302,1 ,$43.00 ,$32.25 ,$11.98 ,$43.00 ,$27.69 ,$11.98 ,$30.10 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$40.85 ,$12.38 ,$34.40 ,$39.56 ,$12.38 ,$36.55 ,$40.85 ,$37.84 ,$32.68 ,$12.38 ,$12.38 ,$12.38 ,$31.39 ,$23.65 ,$39.13 ,$39.13 ,$34.40 ,$12.34 ,$23.65 ,$38.70 ,$11.98 ,$38.70 ,$23.22 ,$40.42 ,$26.96 ,$39.56 ,$13.12 ,$39.13 ,$11.98 ,$26.46 ,$26.46 ,$43.00 ,$32.09 ,$38.70 ,$12.10 ,$12.38 ,$40.85 ,$12.58 ,$12.38 ,$37.41 ,$11.98 ,$38.70 ,$11.98 ,$38.70 ,$38.70 ,$38.70 ,$41.71 ,$34.83 ,$39.99 ,$36.98 ,$41.71 
SACRED HEART HOSPITAL (ACU),30200503,86022,HC PLATELET AB ID (HIT),302,1 ,$411.33 ,$308.50 ,$18.37 ,$411.33 ,$264.90 ,$18.37 ,$287.93 ,$18.98 ,$44.10 ,$19.55 ,$35.28 ,$390.76 ,$18.98 ,$329.06 ,$378.42 ,$18.98 ,$349.63 ,$390.76 ,$361.97 ,$312.61 ,$18.98 ,$18.98 ,$18.98 ,$300.27 ,$226.23 ,$374.31 ,$374.31 ,$329.06 ,$18.92 ,$226.23 ,$370.20 ,$18.37 ,$370.20 ,$222.12 ,$386.65 ,$41.33 ,$378.42 ,$20.12 ,$374.31 ,$18.37 ,$253.13 ,$253.13 ,$230.61 ,$306.98 ,$115.48 ,$18.55 ,$18.98 ,$390.76 ,$19.29 ,$18.98 ,$357.86 ,$18.37 ,$370.20 ,$18.37 ,$370.20 ,$370.20 ,$370.20 ,$398.99 ,$333.18 ,$382.54 ,$353.74 ,$398.99 
SACRED HEART HOSPITAL (ACU),30200504,86023,HC PLATELET ASSOC AB ID IGG,302,1 ,$149.90 ,$112.43 ,$12.46 ,$149.90 ,$96.54 ,$12.46 ,$104.93 ,$12.87 ,$29.91 ,$13.26 ,$23.93 ,$142.41 ,$12.87 ,$119.92 ,$137.91 ,$12.87 ,$127.42 ,$142.41 ,$131.91 ,$113.92 ,$12.87 ,$12.87 ,$12.87 ,$109.43 ,$82.45 ,$136.41 ,$136.41 ,$119.92 ,$12.83 ,$82.45 ,$134.91 ,$12.46 ,$134.91 ,$80.95 ,$140.91 ,$28.04 ,$137.91 ,$13.64 ,$136.41 ,$12.46 ,$92.25 ,$92.25 ,$56.76 ,$111.87 ,$78.31 ,$12.58 ,$12.87 ,$142.41 ,$13.08 ,$12.87 ,$130.41 ,$12.46 ,$134.91 ,$12.46 ,$134.91 ,$134.91 ,$134.91 ,$145.40 ,$121.42 ,$139.41 ,$128.91 ,$145.40 
SACRED HEART HOSPITAL (ACU),30200506,86060,HC ASO,302,1 ,$120.50 ,$90.38 ,$7.30 ,$120.50 ,$77.60 ,$7.30 ,$84.35 ,$7.54 ,$17.52 ,$7.77 ,$14.01 ,$114.48 ,$7.54 ,$96.40 ,$110.86 ,$7.54 ,$102.43 ,$114.48 ,$106.04 ,$91.58 ,$7.54 ,$7.54 ,$7.54 ,$87.97 ,$66.28 ,$109.66 ,$109.66 ,$96.40 ,$7.52 ,$66.28 ,$108.45 ,$7.30 ,$108.45 ,$65.07 ,$113.27 ,$16.43 ,$110.86 ,$7.99 ,$109.66 ,$7.30 ,$74.16 ,$74.16 ,$69.19 ,$89.93 ,$45.88 ,$7.37 ,$7.54 ,$114.48 ,$7.67 ,$7.54 ,$104.84 ,$7.30 ,$108.45 ,$7.30 ,$108.45 ,$108.45 ,$108.45 ,$116.89 ,$97.61 ,$112.07 ,$103.63 ,$116.89 
SACRED HEART HOSPITAL (ACU),30200507,86141,HC C-REACTIVE PROTEIN (HS),302,1 ,$205.95 ,$154.46 ,$12.95 ,$205.95 ,$132.63 ,$12.95 ,$144.17 ,$13.38 ,$31.08 ,$13.78 ,$24.86 ,$195.65 ,$13.38 ,$164.76 ,$189.47 ,$13.38 ,$175.06 ,$195.65 ,$181.24 ,$156.52 ,$13.38 ,$13.38 ,$13.38 ,$150.34 ,$113.27 ,$187.41 ,$187.41 ,$164.76 ,$13.34 ,$113.27 ,$185.36 ,$12.95 ,$185.36 ,$111.21 ,$193.59 ,$29.14 ,$189.47 ,$14.18 ,$187.41 ,$12.95 ,$126.74 ,$126.74 ,$35.26 ,$153.70 ,$81.36 ,$13.08 ,$13.38 ,$195.65 ,$13.60 ,$13.38 ,$179.18 ,$12.95 ,$185.36 ,$12.95 ,$185.36 ,$185.36 ,$185.36 ,$199.77 ,$166.82 ,$191.53 ,$177.12 ,$199.77 
SACRED HEART HOSPITAL (ACU),30200508,86162,HC COMPLEMENT TOTAL,302,1 ,$112.45 ,$84.34 ,$20.32 ,$112.45 ,$72.42 ,$20.32 ,$78.72 ,$21.00 ,$45.43 ,$21.63 ,$36.34 ,$106.83 ,$21.00 ,$89.96 ,$103.45 ,$21.00 ,$95.58 ,$106.83 ,$98.96 ,$85.46 ,$21.00 ,$21.00 ,$21.00 ,$82.09 ,$61.85 ,$102.33 ,$102.33 ,$89.96 ,$20.93 ,$61.85 ,$101.21 ,$20.32 ,$101.21 ,$60.72 ,$105.70 ,$45.72 ,$103.45 ,$22.26 ,$102.33 ,$20.32 ,$69.20 ,$69.20 ,$112.45 ,$83.92 ,$101.21 ,$20.52 ,$21.00 ,$106.83 ,$21.34 ,$21.00 ,$97.83 ,$20.32 ,$101.21 ,$20.32 ,$101.21 ,$101.21 ,$101.21 ,$109.08 ,$91.08 ,$104.58 ,$96.71 ,$109.08 
SACRED HEART HOSPITAL (ACU),30200510,86200,HC CCP AB,302,1 ,$107.97 ,$80.98 ,$12.95 ,$107.97 ,$69.53 ,$12.95 ,$75.58 ,$13.38 ,$31.08 ,$13.78 ,$24.86 ,$102.57 ,$13.38 ,$86.38 ,$99.33 ,$13.38 ,$91.77 ,$102.57 ,$95.01 ,$82.06 ,$13.38 ,$13.38 ,$13.38 ,$78.82 ,$59.38 ,$98.25 ,$98.25 ,$86.38 ,$13.34 ,$59.38 ,$97.17 ,$12.95 ,$97.17 ,$58.30 ,$101.49 ,$29.14 ,$99.33 ,$14.18 ,$98.25 ,$12.95 ,$66.44 ,$66.44 ,$38.50 ,$80.58 ,$81.36 ,$13.08 ,$13.38 ,$102.57 ,$13.60 ,$13.38 ,$93.93 ,$12.95 ,$97.17 ,$12.95 ,$97.17 ,$97.17 ,$97.17 ,$104.73 ,$87.46 ,$100.41 ,$92.85 ,$104.73 
SACRED HEART HOSPITAL (ACU),30200511,86226,HC DNA SINGLE STRAND AB,302,1 ,$96.26 ,$72.20 ,$12.11 ,$96.26 ,$61.99 ,$12.11 ,$67.38 ,$12.51 ,$29.07 ,$12.89 ,$23.25 ,$91.45 ,$12.51 ,$77.01 ,$88.56 ,$12.51 ,$81.82 ,$91.45 ,$84.71 ,$73.16 ,$12.51 ,$12.51 ,$12.51 ,$70.27 ,$52.94 ,$87.60 ,$87.60 ,$77.01 ,$12.47 ,$52.94 ,$86.63 ,$12.11 ,$86.63 ,$51.98 ,$90.48 ,$27.25 ,$88.56 ,$13.26 ,$87.60 ,$12.11 ,$59.24 ,$59.24 ,$96.26 ,$71.84 ,$76.12 ,$12.23 ,$12.51 ,$91.45 ,$12.72 ,$12.51 ,$83.75 ,$12.11 ,$86.63 ,$12.11 ,$86.63 ,$86.63 ,$86.63 ,$93.37 ,$77.97 ,$89.52 ,$82.78 ,$93.37 
SACRED HEART HOSPITAL (ACU),30200512,86255,HC FLUOR AB SCR,302,1 ,$120.80 ,$90.60 ,$12.05 ,$120.80 ,$77.80 ,$12.05 ,$84.56 ,$12.45 ,$28.93 ,$12.82 ,$23.14 ,$114.76 ,$12.45 ,$96.64 ,$111.14 ,$12.45 ,$102.68 ,$114.76 ,$106.30 ,$91.81 ,$12.45 ,$12.45 ,$12.45 ,$88.18 ,$66.44 ,$109.93 ,$109.93 ,$96.64 ,$12.41 ,$66.44 ,$108.72 ,$12.05 ,$108.72 ,$65.23 ,$113.55 ,$27.11 ,$111.14 ,$13.20 ,$109.93 ,$12.05 ,$74.34 ,$74.34 ,$114.22 ,$90.15 ,$75.76 ,$12.17 ,$12.45 ,$114.76 ,$12.65 ,$12.45 ,$105.10 ,$12.05 ,$108.72 ,$12.05 ,$108.72 ,$108.72 ,$108.72 ,$117.18 ,$97.85 ,$112.34 ,$103.89 ,$117.18 
SACRED HEART HOSPITAL (ACU),30200513,86256,HC FLUOR AB TITER,302,1 ,$75.24 ,$56.43 ,$12.05 ,$75.24 ,$48.45 ,$12.05 ,$52.67 ,$12.45 ,$28.93 ,$12.82 ,$23.14 ,$71.48 ,$12.45 ,$60.19 ,$69.22 ,$12.45 ,$63.95 ,$71.48 ,$66.21 ,$57.18 ,$12.45 ,$12.45 ,$12.45 ,$54.93 ,$41.38 ,$68.47 ,$68.47 ,$60.19 ,$12.41 ,$41.38 ,$67.72 ,$12.05 ,$67.72 ,$40.63 ,$70.73 ,$27.11 ,$69.22 ,$13.20 ,$68.47 ,$12.05 ,$46.30 ,$46.30 ,$75.24 ,$56.15 ,$67.72 ,$12.17 ,$12.45 ,$71.48 ,$12.65 ,$12.45 ,$65.46 ,$12.05 ,$67.72 ,$12.05 ,$67.72 ,$67.72 ,$67.72 ,$72.98 ,$60.94 ,$69.97 ,$64.71 ,$72.98 
SACRED HEART HOSPITAL (ACU),30200515,86304,HC TUMOR AG CA 125,302,1 ,$179.77 ,$134.83 ,$20.81 ,$179.77 ,$115.77 ,$20.81 ,$125.84 ,$21.50 ,$49.96 ,$22.15 ,$39.97 ,$170.78 ,$21.50 ,$143.82 ,$165.39 ,$21.50 ,$152.80 ,$170.78 ,$158.20 ,$136.63 ,$21.50 ,$21.50 ,$21.50 ,$131.23 ,$98.87 ,$163.59 ,$163.59 ,$143.82 ,$21.43 ,$98.87 ,$161.79 ,$20.81 ,$161.79 ,$97.08 ,$168.98 ,$46.82 ,$165.39 ,$22.79 ,$163.59 ,$20.81 ,$110.63 ,$110.63 ,$73.45 ,$134.16 ,$130.85 ,$21.02 ,$21.50 ,$170.78 ,$21.85 ,$21.50 ,$156.40 ,$20.81 ,$161.79 ,$20.81 ,$161.79 ,$161.79 ,$161.79 ,$174.38 ,$145.61 ,$167.19 ,$154.60 ,$174.38 
SACRED HEART HOSPITAL (ACU),30200517,86316,HC TUMOR AG OTHER AG QN,302,1 ,$171.04 ,$128.28 ,$20.81 ,$171.04 ,$110.15 ,$20.81 ,$119.73 ,$21.50 ,$49.96 ,$22.15 ,$39.97 ,$162.49 ,$21.50 ,$136.83 ,$157.36 ,$21.50 ,$145.38 ,$162.49 ,$150.52 ,$129.99 ,$21.50 ,$21.50 ,$21.50 ,$124.86 ,$94.07 ,$155.65 ,$155.65 ,$136.83 ,$21.43 ,$94.07 ,$153.94 ,$20.81 ,$153.94 ,$92.36 ,$160.78 ,$46.82 ,$157.36 ,$22.79 ,$155.65 ,$20.81 ,$105.26 ,$105.26 ,$162.51 ,$127.65 ,$130.85 ,$21.02 ,$21.50 ,$162.49 ,$21.85 ,$21.50 ,$148.80 ,$20.81 ,$153.94 ,$20.81 ,$153.94 ,$153.94 ,$153.94 ,$165.91 ,$138.54 ,$159.07 ,$147.09 ,$165.91 
SACRED HEART HOSPITAL (ACU),30200520,86340,HC INTRINSIC FACTOR AB,302,1 ,$88.22 ,$66.17 ,$14.28 ,$88.22 ,$56.81 ,$15.08 ,$61.75 ,$14.28 ,$24.38 ,$14.71 ,$19.50 ,$83.81 ,$14.28 ,$70.58 ,$81.16 ,$14.28 ,$74.99 ,$83.81 ,$77.63 ,$67.05 ,$14.28 ,$14.28 ,$14.28 ,$64.40 ,$48.52 ,$80.28 ,$80.28 ,$70.58 ,$15.53 ,$48.52 ,$79.40 ,$15.08 ,$79.40 ,$47.64 ,$82.93 ,$33.93 ,$81.16 ,$15.14 ,$80.28 ,$15.08 ,$54.29 ,$54.29 ,$88.22 ,$65.84 ,$79.40 ,$15.23 ,$14.28 ,$83.81 ,$15.83 ,$14.28 ,$76.75 ,$15.08 ,$79.40 ,$15.08 ,$79.40 ,$79.40 ,$79.40 ,$85.57 ,$71.46 ,$82.04 ,$75.87 ,$85.57 
SACRED HEART HOSPITAL (ACU),30200521,86357,HC CD8 TOTAL COUNT,302,1 ,$116.45 ,$87.34 ,$37.73 ,$116.45 ,$74.99 ,$37.73 ,$81.52 ,$38.99 ,$90.56 ,$40.16 ,$72.45 ,$110.63 ,$38.99 ,$93.16 ,$107.13 ,$38.99 ,$98.98 ,$110.63 ,$102.48 ,$88.50 ,$38.99 ,$38.99 ,$38.99 ,$85.01 ,$64.05 ,$105.97 ,$105.97 ,$93.16 ,$38.86 ,$64.05 ,$104.81 ,$37.73 ,$104.81 ,$62.88 ,$109.46 ,$84.89 ,$107.13 ,$41.33 ,$105.97 ,$37.73 ,$71.66 ,$71.66 ,$112.40 ,$86.91 ,$104.81 ,$38.11 ,$38.99 ,$110.63 ,$39.62 ,$38.99 ,$101.31 ,$37.73 ,$104.81 ,$37.73 ,$104.81 ,$104.81 ,$104.81 ,$112.96 ,$94.32 ,$108.30 ,$100.15 ,$112.96 
SACRED HEART HOSPITAL (ACU),30200522,86359,HC T CELLS TOTAL COUNT,302,1 ,$116.45 ,$87.34 ,$37.73 ,$116.45 ,$74.99 ,$37.73 ,$81.52 ,$38.99 ,$90.56 ,$40.16 ,$72.45 ,$110.63 ,$38.99 ,$93.16 ,$107.13 ,$38.99 ,$98.98 ,$110.63 ,$102.48 ,$88.50 ,$38.99 ,$38.99 ,$38.99 ,$85.01 ,$64.05 ,$105.97 ,$105.97 ,$93.16 ,$38.86 ,$64.05 ,$104.81 ,$37.73 ,$104.81 ,$62.88 ,$109.46 ,$84.89 ,$107.13 ,$41.33 ,$105.97 ,$37.73 ,$71.66 ,$71.66 ,$116.45 ,$86.91 ,$104.81 ,$38.11 ,$38.99 ,$110.63 ,$39.62 ,$38.99 ,$101.31 ,$37.73 ,$104.81 ,$37.73 ,$104.81 ,$104.81 ,$104.81 ,$112.96 ,$94.32 ,$108.30 ,$100.15 ,$112.96 
SACRED HEART HOSPITAL (ACU),30200523,86431,HC RHEUMATOID FACTOR QN,302,1 ,$235.59 ,$176.69 ,$5.67 ,$235.59 ,$151.72 ,$5.67 ,$164.91 ,$5.86 ,$13.62 ,$6.04 ,$10.89 ,$223.81 ,$5.86 ,$188.47 ,$216.74 ,$5.86 ,$200.25 ,$223.81 ,$207.32 ,$179.05 ,$5.86 ,$5.86 ,$5.86 ,$171.98 ,$129.57 ,$214.39 ,$214.39 ,$188.47 ,$5.84 ,$129.57 ,$212.03 ,$5.67 ,$212.03 ,$127.22 ,$221.45 ,$12.76 ,$216.74 ,$6.21 ,$214.39 ,$5.67 ,$144.98 ,$144.98 ,$74.23 ,$175.82 ,$35.64 ,$5.73 ,$5.86 ,$223.81 ,$5.95 ,$5.86 ,$204.96 ,$5.67 ,$212.03 ,$5.67 ,$212.03 ,$212.03 ,$212.03 ,$228.52 ,$190.83 ,$219.10 ,$202.61 ,$228.52 
SACRED HEART HOSPITAL (ACU),30200524,86480,HC TB CELL IMMUNITY MEAS GAMMA INTERF,302,1 ,$191.30 ,$143.48 ,$61.98 ,$191.30 ,$123.20 ,$61.98 ,$133.91 ,$64.04 ,$148.79 ,$65.96 ,$119.03 ,$181.74 ,$64.04 ,$153.04 ,$176.00 ,$64.04 ,$162.61 ,$181.74 ,$168.34 ,$145.39 ,$64.04 ,$64.04 ,$64.04 ,$139.65 ,$105.22 ,$174.08 ,$174.08 ,$153.04 ,$63.84 ,$105.22 ,$172.17 ,$61.98 ,$172.17 ,$103.30 ,$179.82 ,$139.46 ,$176.00 ,$67.88 ,$174.08 ,$61.98 ,$117.73 ,$117.73 ,$184.01 ,$142.77 ,$172.17 ,$62.60 ,$64.04 ,$181.74 ,$65.08 ,$64.04 ,$166.43 ,$61.98 ,$172.17 ,$61.98 ,$172.17 ,$172.17 ,$172.17 ,$185.56 ,$154.95 ,$177.91 ,$164.52 ,$185.56 
SACRED HEART HOSPITAL (ACU),30200525,86485,HC SKIN TEST CANDIDA,302,1 ,$103.10 ,$77.33 ,$9.83 ,$103.10 ,$66.40 ,$26.13 ,$72.17 ,$9.83 ,$33.02 ,$10.12 ,$26.42 ,$97.95 ,$9.83 ,$82.48 ,$94.85 ,$9.83 ,$87.64 ,$97.95 ,$90.73 ,$78.36 ,$9.83 ,$9.83 ,$9.83 ,$75.26 ,$56.71 ,$93.82 ,$93.82 ,$82.48 ,$26.91 ,$56.71 ,$92.79 ,$26.13 ,$92.79 ,$55.67 ,$96.91 ,$58.79 ,$94.85 ,$10.42 ,$93.82 ,$26.13 ,$63.45 ,$63.45 ,$38.59 ,$76.94 ,$71.81 ,$26.39 ,$9.83 ,$97.95 ,$27.43 ,$9.83 ,$89.70 ,$26.13 ,$92.79 ,$26.13 ,$92.79 ,$92.79 ,$92.79 ,$100.01 ,$83.51 ,$95.88 ,$88.67 ,$100.01 
SACRED HEART HOSPITAL (ACU),30200527,86580,HC SKIN TEST TB INTRADERMAL,302,1 ,$104.41 ,$78.31 ,$3.39 ,$104.41 ,$67.24 ,$26.13 ,$73.09 ,$3.39 ,$13.49 ,$3.49 ,$10.79 ,$99.19 ,$3.39 ,$83.53 ,$96.06 ,$3.39 ,$88.75 ,$99.19 ,$91.88 ,$79.35 ,$3.39 ,$3.39 ,$3.39 ,$76.22 ,$57.43 ,$95.01 ,$95.01 ,$83.53 ,$26.91 ,$57.43 ,$93.97 ,$26.13 ,$93.97 ,$56.38 ,$98.15 ,$58.79 ,$96.06 ,$3.59 ,$95.01 ,$26.13 ,$64.25 ,$64.25 ,$32.50 ,$77.92 ,$39.21 ,$26.39 ,$3.39 ,$99.19 ,$27.43 ,$3.39 ,$90.84 ,$26.13 ,$93.97 ,$26.13 ,$93.97 ,$93.97 ,$93.97 ,$101.28 ,$84.57 ,$97.10 ,$89.79 ,$101.28 
SACRED HEART HOSPITAL (ACU),30200528,86615,HC BORDETELLA AB,302,1 ,$78.69 ,$59.02 ,$8.17 ,$78.69 ,$50.68 ,$13.19 ,$55.08 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$74.76 ,$8.17 ,$62.95 ,$72.39 ,$8.17 ,$66.89 ,$74.76 ,$69.25 ,$59.80 ,$8.17 ,$8.17 ,$8.17 ,$57.44 ,$43.28 ,$71.61 ,$71.61 ,$62.95 ,$13.59 ,$43.28 ,$70.82 ,$13.19 ,$70.82 ,$42.49 ,$73.97 ,$29.68 ,$72.39 ,$8.66 ,$71.61 ,$13.19 ,$48.43 ,$48.43 ,$64.67 ,$58.73 ,$70.82 ,$13.32 ,$8.17 ,$74.76 ,$13.85 ,$8.17 ,$68.46 ,$13.19 ,$70.82 ,$13.19 ,$70.82 ,$70.82 ,$70.82 ,$76.33 ,$63.74 ,$73.18 ,$67.67 ,$76.33 
SACRED HEART HOSPITAL (ACU),30200529,86617,HC LYME DISEASE AB CONFIRM,302,1 ,$47.83 ,$35.87 ,$15.49 ,$47.83 ,$30.80 ,$15.49 ,$33.48 ,$16.01 ,$37.19 ,$16.49 ,$29.75 ,$45.44 ,$16.01 ,$38.26 ,$44.00 ,$16.01 ,$40.66 ,$45.44 ,$42.09 ,$36.35 ,$16.01 ,$16.01 ,$16.01 ,$34.92 ,$26.31 ,$43.53 ,$43.53 ,$38.26 ,$15.95 ,$26.31 ,$43.05 ,$15.49 ,$43.05 ,$25.83 ,$44.96 ,$34.85 ,$44.00 ,$16.97 ,$43.53 ,$15.49 ,$29.43 ,$29.43 ,$47.83 ,$35.70 ,$43.05 ,$15.64 ,$16.01 ,$45.44 ,$16.26 ,$16.01 ,$41.61 ,$15.49 ,$43.05 ,$15.49 ,$43.05 ,$43.05 ,$43.05 ,$46.40 ,$38.74 ,$44.48 ,$41.13 ,$46.40 
SACRED HEART HOSPITAL (ACU),30200530,86645,HC CMV AB IGM,302,1 ,$52.00 ,$39.00 ,$8.17 ,$52.00 ,$33.49 ,$16.85 ,$36.40 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$49.40 ,$8.17 ,$41.60 ,$47.84 ,$8.17 ,$44.20 ,$49.40 ,$45.76 ,$39.52 ,$8.17 ,$8.17 ,$8.17 ,$37.96 ,$28.60 ,$47.32 ,$47.32 ,$41.60 ,$17.36 ,$28.60 ,$46.80 ,$16.85 ,$46.80 ,$28.08 ,$48.88 ,$37.91 ,$47.84 ,$8.66 ,$47.32 ,$16.85 ,$32.00 ,$32.00 ,$52.00 ,$38.81 ,$46.80 ,$17.02 ,$8.17 ,$49.40 ,$17.69 ,$8.17 ,$45.24 ,$16.85 ,$46.80 ,$16.85 ,$46.80 ,$46.80 ,$46.80 ,$50.44 ,$42.12 ,$48.36 ,$44.72 ,$50.44 
SACRED HEART HOSPITAL (ACU),30200531,86651,HC ENCEPHALITIS CALIFORNIA AB,302,1 ,$75.12 ,$56.34 ,$8.17 ,$75.12 ,$48.38 ,$13.19 ,$52.58 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$71.36 ,$8.17 ,$60.10 ,$69.11 ,$8.17 ,$63.85 ,$71.36 ,$66.11 ,$57.09 ,$8.17 ,$8.17 ,$8.17 ,$54.84 ,$41.32 ,$68.36 ,$68.36 ,$60.10 ,$13.59 ,$41.32 ,$67.61 ,$13.19 ,$67.61 ,$40.56 ,$70.61 ,$29.68 ,$69.11 ,$8.66 ,$68.36 ,$13.19 ,$46.23 ,$46.23 ,$64.67 ,$56.06 ,$67.61 ,$13.32 ,$8.17 ,$71.36 ,$13.85 ,$8.17 ,$65.35 ,$13.19 ,$67.61 ,$13.19 ,$67.61 ,$67.61 ,$67.61 ,$72.87 ,$60.85 ,$69.86 ,$64.60 ,$72.87 
SACRED HEART HOSPITAL (ACU),30200532,86652,HC ENCEPHALITIS EQUINE AB,302,1 ,$75.12 ,$56.34 ,$8.17 ,$75.12 ,$48.38 ,$13.19 ,$52.58 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$71.36 ,$8.17 ,$60.10 ,$69.11 ,$8.17 ,$63.85 ,$71.36 ,$66.11 ,$57.09 ,$8.17 ,$8.17 ,$8.17 ,$54.84 ,$41.32 ,$68.36 ,$68.36 ,$60.10 ,$13.59 ,$41.32 ,$67.61 ,$13.19 ,$67.61 ,$40.56 ,$70.61 ,$29.68 ,$69.11 ,$8.66 ,$68.36 ,$13.19 ,$46.23 ,$46.23 ,$64.67 ,$56.06 ,$67.61 ,$13.32 ,$8.17 ,$71.36 ,$13.85 ,$8.17 ,$65.35 ,$13.19 ,$67.61 ,$13.19 ,$67.61 ,$67.61 ,$67.61 ,$72.87 ,$60.85 ,$69.86 ,$64.60 ,$72.87 
SACRED HEART HOSPITAL (ACU),30200533,86653,HC ENCEPHALITIS ST LOUIS AB,302,1 ,$75.12 ,$56.34 ,$8.17 ,$75.12 ,$48.38 ,$13.19 ,$52.58 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$71.36 ,$8.17 ,$60.10 ,$69.11 ,$8.17 ,$63.85 ,$71.36 ,$66.11 ,$57.09 ,$8.17 ,$8.17 ,$8.17 ,$54.84 ,$41.32 ,$68.36 ,$68.36 ,$60.10 ,$13.59 ,$41.32 ,$67.61 ,$13.19 ,$67.61 ,$40.56 ,$70.61 ,$29.68 ,$69.11 ,$8.66 ,$68.36 ,$13.19 ,$46.23 ,$46.23 ,$64.67 ,$56.06 ,$67.61 ,$13.32 ,$8.17 ,$71.36 ,$13.85 ,$8.17 ,$65.35 ,$13.19 ,$67.61 ,$13.19 ,$67.61 ,$67.61 ,$67.61 ,$72.87 ,$60.85 ,$69.86 ,$64.60 ,$72.87 
SACRED HEART HOSPITAL (ACU),30200534,86654,HC ENCEPHALITIS WEST EQUINE AB,302,1 ,$75.12 ,$56.34 ,$8.17 ,$75.12 ,$48.38 ,$13.19 ,$52.58 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$71.36 ,$8.17 ,$60.10 ,$69.11 ,$8.17 ,$63.85 ,$71.36 ,$66.11 ,$57.09 ,$8.17 ,$8.17 ,$8.17 ,$54.84 ,$41.32 ,$68.36 ,$68.36 ,$60.10 ,$13.59 ,$41.32 ,$67.61 ,$13.19 ,$67.61 ,$40.56 ,$70.61 ,$29.68 ,$69.11 ,$8.66 ,$68.36 ,$13.19 ,$46.23 ,$46.23 ,$64.67 ,$56.06 ,$67.61 ,$13.32 ,$8.17 ,$71.36 ,$13.85 ,$8.17 ,$65.35 ,$13.19 ,$67.61 ,$13.19 ,$67.61 ,$67.61 ,$67.61 ,$72.87 ,$60.85 ,$69.86 ,$64.60 ,$72.87 
SACRED HEART HOSPITAL (ACU),30200535,86658,HC ENTEROVIRUS A,302,1 ,$64.22 ,$48.17 ,$8.17 ,$64.22 ,$41.36 ,$13.03 ,$44.95 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$61.01 ,$8.17 ,$51.38 ,$59.08 ,$8.17 ,$54.59 ,$61.01 ,$56.51 ,$48.81 ,$8.17 ,$8.17 ,$8.17 ,$46.88 ,$35.32 ,$58.44 ,$58.44 ,$51.38 ,$13.42 ,$35.32 ,$57.80 ,$13.03 ,$57.80 ,$34.68 ,$60.37 ,$29.32 ,$59.08 ,$8.66 ,$58.44 ,$13.03 ,$39.52 ,$39.52 ,$64.22 ,$47.93 ,$57.80 ,$13.16 ,$8.17 ,$61.01 ,$13.68 ,$8.17 ,$55.87 ,$13.03 ,$57.80 ,$13.03 ,$57.80 ,$57.80 ,$57.80 ,$62.29 ,$52.02 ,$59.72 ,$55.23 ,$62.29 
SACRED HEART HOSPITAL (ACU),30200536,86663,HC EBV EARLY AG,302,1 ,$76.73 ,$57.55 ,$13.12 ,$76.73 ,$49.41 ,$13.12 ,$53.71 ,$13.56 ,$31.50 ,$13.97 ,$25.20 ,$72.89 ,$13.56 ,$61.38 ,$70.59 ,$13.56 ,$65.22 ,$72.89 ,$67.52 ,$58.31 ,$13.56 ,$13.56 ,$13.56 ,$56.01 ,$42.20 ,$69.82 ,$69.82 ,$61.38 ,$13.51 ,$42.20 ,$69.06 ,$13.12 ,$69.06 ,$41.43 ,$72.13 ,$29.52 ,$70.59 ,$14.37 ,$69.82 ,$13.12 ,$47.22 ,$47.22 ,$64.67 ,$57.26 ,$69.06 ,$13.25 ,$13.56 ,$72.89 ,$13.78 ,$13.56 ,$66.76 ,$13.12 ,$69.06 ,$13.12 ,$69.06 ,$69.06 ,$69.06 ,$74.43 ,$62.15 ,$71.36 ,$65.99 ,$74.43 
SACRED HEART HOSPITAL (ACU),30200537,86664,HC EBV NUCLEAR AG,302,1 ,$47.20 ,$35.40 ,$15.29 ,$47.20 ,$30.40 ,$15.29 ,$33.04 ,$15.80 ,$36.72 ,$16.27 ,$29.37 ,$44.84 ,$15.80 ,$37.76 ,$43.42 ,$15.80 ,$40.12 ,$44.84 ,$41.54 ,$35.87 ,$15.80 ,$15.80 ,$15.80 ,$34.46 ,$25.96 ,$42.95 ,$42.95 ,$37.76 ,$15.75 ,$25.96 ,$42.48 ,$15.29 ,$42.48 ,$25.49 ,$44.37 ,$34.40 ,$43.42 ,$16.75 ,$42.95 ,$15.29 ,$29.05 ,$29.05 ,$47.20 ,$35.23 ,$42.48 ,$15.44 ,$15.80 ,$44.84 ,$16.05 ,$15.80 ,$41.06 ,$15.29 ,$42.48 ,$15.29 ,$42.48 ,$42.48 ,$42.48 ,$45.78 ,$38.23 ,$43.90 ,$40.59 ,$45.78 
SACRED HEART HOSPITAL (ACU),30200538,86665,HC EBV VIRAL CAP,302,1 ,$60.64 ,$45.48 ,$18.14 ,$60.64 ,$39.05 ,$18.14 ,$42.45 ,$18.74 ,$43.56 ,$19.30 ,$34.85 ,$57.61 ,$18.74 ,$48.51 ,$55.79 ,$18.74 ,$51.54 ,$57.61 ,$53.36 ,$46.09 ,$18.74 ,$18.74 ,$18.74 ,$44.27 ,$33.35 ,$55.18 ,$55.18 ,$48.51 ,$18.68 ,$33.35 ,$54.58 ,$18.14 ,$54.58 ,$32.75 ,$57.00 ,$40.82 ,$55.79 ,$19.86 ,$55.18 ,$18.14 ,$37.32 ,$37.32 ,$55.76 ,$45.26 ,$54.58 ,$18.32 ,$18.74 ,$57.61 ,$19.05 ,$18.74 ,$52.76 ,$18.14 ,$54.58 ,$18.14 ,$54.58 ,$54.58 ,$54.58 ,$58.82 ,$49.12 ,$56.40 ,$52.15 ,$58.82 
SACRED HEART HOSPITAL (ACU),30200541,86702,HC HIV-2 AB,302,1 ,$240.98 ,$180.74 ,$13.52 ,$240.98 ,$155.19 ,$13.52 ,$168.69 ,$13.97 ,$32.45 ,$14.39 ,$25.96 ,$228.93 ,$13.97 ,$192.78 ,$221.70 ,$13.97 ,$204.83 ,$228.93 ,$212.06 ,$183.14 ,$13.97 ,$13.97 ,$13.97 ,$175.92 ,$132.54 ,$219.29 ,$219.29 ,$192.78 ,$13.93 ,$132.54 ,$216.88 ,$13.52 ,$216.88 ,$130.13 ,$226.52 ,$30.42 ,$221.70 ,$14.81 ,$219.29 ,$13.52 ,$148.30 ,$148.30 ,$83.70 ,$179.84 ,$84.98 ,$13.66 ,$13.97 ,$228.93 ,$14.20 ,$13.97 ,$209.65 ,$13.52 ,$216.88 ,$13.52 ,$216.88 ,$216.88 ,$216.88 ,$233.75 ,$195.19 ,$224.11 ,$207.24 ,$233.75 
SACRED HEART HOSPITAL (ACU),30200542,86703,HC HIV 1 HIV 2 AB SGL ASSAY,302,1 ,$90.11 ,$67.58 ,$13.71 ,$90.11 ,$58.03 ,$13.71 ,$63.08 ,$14.17 ,$32.90 ,$14.60 ,$26.32 ,$85.60 ,$14.17 ,$72.09 ,$82.90 ,$14.17 ,$76.59 ,$85.60 ,$79.30 ,$68.48 ,$14.17 ,$14.17 ,$14.17 ,$65.78 ,$49.56 ,$82.00 ,$82.00 ,$72.09 ,$14.12 ,$49.56 ,$81.10 ,$13.71 ,$81.10 ,$48.66 ,$84.70 ,$30.85 ,$82.90 ,$15.02 ,$82.00 ,$13.71 ,$55.45 ,$55.45 ,$79.07 ,$67.25 ,$81.10 ,$13.85 ,$14.17 ,$85.60 ,$14.40 ,$14.17 ,$78.40 ,$13.71 ,$81.10 ,$13.71 ,$81.10 ,$81.10 ,$81.10 ,$87.41 ,$72.99 ,$83.80 ,$77.49 ,$87.41 
SACRED HEART HOSPITAL (ACU),30200543,86704,HC HEP CORE AB,302,1 ,$189.41 ,$142.06 ,$12.05 ,$189.41 ,$121.98 ,$12.05 ,$132.59 ,$12.45 ,$28.93 ,$12.82 ,$23.14 ,$179.94 ,$12.45 ,$151.53 ,$174.26 ,$12.45 ,$161.00 ,$179.94 ,$166.68 ,$143.95 ,$12.45 ,$12.45 ,$12.45 ,$138.27 ,$104.18 ,$172.36 ,$172.36 ,$151.53 ,$12.41 ,$104.18 ,$170.47 ,$12.05 ,$170.47 ,$102.28 ,$178.05 ,$27.11 ,$174.26 ,$13.20 ,$172.36 ,$12.05 ,$116.56 ,$116.56 ,$62.90 ,$141.36 ,$75.76 ,$12.17 ,$12.45 ,$179.94 ,$12.65 ,$12.45 ,$164.79 ,$12.05 ,$170.47 ,$12.05 ,$170.47 ,$170.47 ,$170.47 ,$183.73 ,$153.42 ,$176.15 ,$162.89 ,$183.73 
SACRED HEART HOSPITAL (ACU),30200544,86705,HC HEP B CORE IGM,302,1 ,$55.72 ,$41.79 ,$11.77 ,$55.72 ,$35.88 ,$11.77 ,$39.00 ,$12.16 ,$28.26 ,$12.52 ,$22.61 ,$52.93 ,$12.16 ,$44.58 ,$51.26 ,$12.16 ,$47.36 ,$52.93 ,$49.03 ,$42.35 ,$12.16 ,$12.16 ,$12.16 ,$40.68 ,$30.65 ,$50.71 ,$50.71 ,$44.58 ,$12.12 ,$30.65 ,$50.15 ,$11.77 ,$50.15 ,$30.09 ,$52.38 ,$26.48 ,$51.26 ,$12.89 ,$50.71 ,$11.77 ,$34.29 ,$34.29 ,$55.72 ,$41.58 ,$50.15 ,$11.89 ,$12.16 ,$52.93 ,$12.36 ,$12.16 ,$48.48 ,$11.77 ,$50.15 ,$11.77 ,$50.15 ,$50.15 ,$50.15 ,$54.05 ,$45.13 ,$51.82 ,$47.92 ,$54.05 
SACRED HEART HOSPITAL (ACU),30200545,86706,HC HEP B SURFACE AB,302,1 ,$176.10 ,$132.08 ,$10.74 ,$176.10 ,$113.41 ,$10.74 ,$123.27 ,$11.10 ,$25.78 ,$11.43 ,$20.62 ,$167.30 ,$11.10 ,$140.88 ,$162.01 ,$11.10 ,$149.69 ,$167.30 ,$154.97 ,$133.84 ,$11.10 ,$11.10 ,$11.10 ,$128.55 ,$96.86 ,$160.25 ,$160.25 ,$140.88 ,$11.06 ,$96.86 ,$158.49 ,$10.74 ,$158.49 ,$95.09 ,$165.53 ,$24.17 ,$162.01 ,$11.77 ,$160.25 ,$10.74 ,$108.37 ,$108.37 ,$48.56 ,$131.42 ,$67.51 ,$10.85 ,$11.10 ,$167.30 ,$11.28 ,$11.10 ,$153.21 ,$10.74 ,$158.49 ,$10.74 ,$158.49 ,$158.49 ,$158.49 ,$170.82 ,$142.64 ,$163.77 ,$151.45 ,$170.82 
SACRED HEART HOSPITAL (ACU),30200546,86707,HC HEP B E AB,302,1 ,$81.45 ,$61.09 ,$11.57 ,$81.45 ,$52.45 ,$11.57 ,$57.02 ,$11.96 ,$27.77 ,$12.32 ,$22.22 ,$77.38 ,$11.96 ,$65.16 ,$74.93 ,$11.96 ,$69.23 ,$77.38 ,$71.68 ,$61.90 ,$11.96 ,$11.96 ,$11.96 ,$59.46 ,$44.80 ,$74.12 ,$74.12 ,$65.16 ,$11.92 ,$44.80 ,$73.31 ,$11.57 ,$73.31 ,$43.98 ,$76.56 ,$26.03 ,$74.93 ,$12.68 ,$74.12 ,$11.57 ,$50.12 ,$50.12 ,$52.97 ,$60.79 ,$72.71 ,$11.69 ,$11.96 ,$77.38 ,$12.15 ,$11.96 ,$70.86 ,$11.57 ,$73.31 ,$11.57 ,$73.31 ,$73.31 ,$73.31 ,$79.01 ,$65.97 ,$75.75 ,$70.05 ,$79.01 
SACRED HEART HOSPITAL (ACU),30200547,86708,HC HEP A AB TOTAL,302,1 ,$62.38 ,$46.79 ,$12.39 ,$62.38 ,$40.17 ,$12.39 ,$43.67 ,$12.80 ,$29.73 ,$13.18 ,$23.79 ,$59.26 ,$12.80 ,$49.90 ,$57.39 ,$12.80 ,$53.02 ,$59.26 ,$54.89 ,$47.41 ,$12.80 ,$12.80 ,$12.80 ,$45.54 ,$34.31 ,$56.77 ,$56.77 ,$49.90 ,$12.76 ,$34.31 ,$56.14 ,$12.39 ,$56.14 ,$33.69 ,$58.64 ,$27.88 ,$57.39 ,$13.57 ,$56.77 ,$12.39 ,$38.39 ,$38.39 ,$60.69 ,$46.55 ,$56.14 ,$12.51 ,$12.80 ,$59.26 ,$13.01 ,$12.80 ,$54.27 ,$12.39 ,$56.14 ,$12.39 ,$56.14 ,$56.14 ,$56.14 ,$60.51 ,$50.53 ,$58.01 ,$53.65 ,$60.51 
SACRED HEART HOSPITAL (ACU),30200548,86709,HC HEP A AB IGM,302,1 ,$202.39 ,$151.79 ,$11.26 ,$202.39 ,$130.34 ,$11.26 ,$141.67 ,$11.63 ,$27.02 ,$11.98 ,$21.62 ,$192.27 ,$11.63 ,$161.91 ,$186.20 ,$11.63 ,$172.03 ,$192.27 ,$178.10 ,$153.82 ,$11.63 ,$11.63 ,$11.63 ,$147.74 ,$111.31 ,$184.17 ,$184.17 ,$161.91 ,$11.60 ,$111.31 ,$182.15 ,$11.26 ,$182.15 ,$109.29 ,$190.25 ,$25.34 ,$186.20 ,$12.33 ,$184.17 ,$11.26 ,$124.55 ,$124.55 ,$56.28 ,$151.04 ,$70.77 ,$11.37 ,$11.63 ,$192.27 ,$11.82 ,$11.63 ,$176.08 ,$11.26 ,$182.15 ,$11.26 ,$182.15 ,$182.15 ,$182.15 ,$196.32 ,$163.94 ,$188.22 ,$174.06 ,$196.32 
SACRED HEART HOSPITAL (ACU),30200549,86713,HC LEGIONELLA AB,302,1 ,$202.16 ,$151.62 ,$15.30 ,$202.16 ,$130.19 ,$15.30 ,$141.51 ,$15.81 ,$36.73 ,$16.28 ,$29.39 ,$192.05 ,$15.81 ,$161.73 ,$185.99 ,$15.81 ,$171.84 ,$192.05 ,$177.90 ,$153.64 ,$15.81 ,$15.81 ,$15.81 ,$147.58 ,$111.19 ,$183.97 ,$183.97 ,$161.73 ,$15.76 ,$111.19 ,$181.94 ,$15.30 ,$181.94 ,$109.17 ,$190.03 ,$34.43 ,$185.99 ,$16.76 ,$183.97 ,$15.30 ,$124.41 ,$124.41 ,$92.92 ,$150.87 ,$96.18 ,$15.45 ,$15.81 ,$192.05 ,$16.07 ,$15.81 ,$175.88 ,$15.30 ,$181.94 ,$15.30 ,$181.94 ,$181.94 ,$181.94 ,$196.10 ,$163.75 ,$188.01 ,$173.86 ,$196.10 
SACRED HEART HOSPITAL (ACU),30200550,86727,HC LYMPH CHORIOMENINGITIS AB,302,1 ,$39.73 ,$29.80 ,$8.17 ,$39.73 ,$25.59 ,$12.87 ,$27.81 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$37.74 ,$8.17 ,$31.78 ,$36.55 ,$8.17 ,$33.77 ,$37.74 ,$34.96 ,$30.19 ,$8.17 ,$8.17 ,$8.17 ,$29.00 ,$21.85 ,$36.15 ,$36.15 ,$31.78 ,$13.26 ,$21.85 ,$35.76 ,$12.87 ,$35.76 ,$21.45 ,$37.35 ,$28.96 ,$36.55 ,$8.66 ,$36.15 ,$12.87 ,$24.45 ,$24.45 ,$39.73 ,$29.65 ,$35.76 ,$13.00 ,$8.17 ,$37.74 ,$13.51 ,$8.17 ,$34.57 ,$12.87 ,$35.76 ,$12.87 ,$35.76 ,$35.76 ,$35.76 ,$38.54 ,$32.18 ,$36.95 ,$34.17 ,$38.54 
SACRED HEART HOSPITAL (ACU),30200551,86738,HC MYCOPLASMA AB,302,1 ,$67.77 ,$50.83 ,$13.24 ,$67.77 ,$43.64 ,$13.24 ,$47.44 ,$13.68 ,$31.78 ,$14.09 ,$25.42 ,$64.38 ,$13.68 ,$54.22 ,$62.35 ,$13.68 ,$57.60 ,$64.38 ,$59.64 ,$51.51 ,$13.68 ,$13.68 ,$13.68 ,$49.47 ,$37.27 ,$61.67 ,$61.67 ,$54.22 ,$13.64 ,$37.27 ,$60.99 ,$13.24 ,$60.99 ,$36.60 ,$63.70 ,$29.79 ,$62.35 ,$14.50 ,$61.67 ,$13.24 ,$41.71 ,$41.71 ,$67.77 ,$50.58 ,$60.99 ,$13.37 ,$13.68 ,$64.38 ,$13.90 ,$13.68 ,$58.96 ,$13.24 ,$60.99 ,$13.24 ,$60.99 ,$60.99 ,$60.99 ,$65.74 ,$54.89 ,$63.03 ,$58.28 ,$65.74 
SACRED HEART HOSPITAL (ACU),30200552,86747,HC PARVOVIRUS AB,302,1 ,$104.30 ,$78.23 ,$15.03 ,$104.30 ,$67.17 ,$15.03 ,$73.01 ,$15.53 ,$36.09 ,$16.00 ,$28.87 ,$99.09 ,$15.53 ,$83.44 ,$95.96 ,$15.53 ,$88.66 ,$99.09 ,$91.78 ,$79.27 ,$15.53 ,$15.53 ,$15.53 ,$76.14 ,$57.37 ,$94.91 ,$94.91 ,$83.44 ,$15.48 ,$57.37 ,$93.87 ,$15.03 ,$93.87 ,$56.32 ,$98.04 ,$33.82 ,$95.96 ,$16.46 ,$94.91 ,$15.03 ,$64.19 ,$64.19 ,$87.89 ,$77.84 ,$93.87 ,$15.18 ,$15.53 ,$99.09 ,$15.78 ,$15.53 ,$90.74 ,$15.03 ,$93.87 ,$15.03 ,$93.87 ,$93.87 ,$93.87 ,$101.17 ,$84.48 ,$97.00 ,$89.70 ,$101.17 
SACRED HEART HOSPITAL (ACU),30200553,86753,HC PROTOZOA AB NOS,302,1 ,$68.46 ,$51.35 ,$8.17 ,$68.46 ,$44.09 ,$12.39 ,$47.92 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$65.04 ,$8.17 ,$54.77 ,$62.98 ,$8.17 ,$58.19 ,$65.04 ,$60.24 ,$52.03 ,$8.17 ,$8.17 ,$8.17 ,$49.98 ,$37.65 ,$62.30 ,$62.30 ,$54.77 ,$12.76 ,$37.65 ,$61.61 ,$12.39 ,$61.61 ,$36.97 ,$64.35 ,$27.88 ,$62.98 ,$8.66 ,$62.30 ,$12.39 ,$42.13 ,$42.13 ,$60.17 ,$51.09 ,$61.61 ,$12.51 ,$8.17 ,$65.04 ,$13.01 ,$8.17 ,$59.56 ,$12.39 ,$61.61 ,$12.39 ,$61.61 ,$61.61 ,$61.61 ,$66.41 ,$55.45 ,$63.67 ,$58.88 ,$66.41 
SACRED HEART HOSPITAL (ACU),30200554,86777,HC TOXOPLASMA AB,302,1 ,$46.98 ,$35.24 ,$14.39 ,$46.98 ,$30.26 ,$14.39 ,$32.89 ,$14.87 ,$34.55 ,$15.32 ,$27.64 ,$44.63 ,$14.87 ,$37.58 ,$43.22 ,$14.87 ,$39.93 ,$44.63 ,$41.34 ,$35.70 ,$14.87 ,$14.87 ,$14.87 ,$34.30 ,$25.84 ,$42.75 ,$42.75 ,$37.58 ,$14.82 ,$25.84 ,$42.28 ,$14.39 ,$42.28 ,$25.37 ,$44.16 ,$32.38 ,$43.22 ,$15.76 ,$42.75 ,$14.39 ,$28.91 ,$28.91 ,$46.55 ,$35.06 ,$42.28 ,$14.53 ,$14.87 ,$44.63 ,$15.11 ,$14.87 ,$40.87 ,$14.39 ,$42.28 ,$14.39 ,$42.28 ,$42.28 ,$42.28 ,$45.57 ,$38.05 ,$43.69 ,$40.40 ,$45.57 
SACRED HEART HOSPITAL (ACU),30200555,86778,HC TOXOPLASMA AB IGM,302,1 ,$46.98 ,$35.24 ,$14.41 ,$46.98 ,$30.26 ,$14.41 ,$32.89 ,$14.89 ,$30.68 ,$15.34 ,$24.54 ,$44.63 ,$14.89 ,$37.58 ,$43.22 ,$14.89 ,$39.93 ,$44.63 ,$41.34 ,$35.70 ,$14.89 ,$14.89 ,$14.89 ,$34.30 ,$25.84 ,$42.75 ,$42.75 ,$37.58 ,$14.84 ,$25.84 ,$42.28 ,$14.41 ,$42.28 ,$25.37 ,$44.16 ,$32.42 ,$43.22 ,$15.78 ,$42.75 ,$14.41 ,$28.91 ,$28.91 ,$46.55 ,$35.06 ,$42.28 ,$14.55 ,$14.89 ,$44.63 ,$15.13 ,$14.89 ,$40.87 ,$14.41 ,$42.28 ,$14.41 ,$42.28 ,$42.28 ,$42.28 ,$45.57 ,$38.05 ,$43.69 ,$40.40 ,$45.57 
SACRED HEART HOSPITAL (ACU),30200556,86790,HC VIRUS AB NOT SPECIFIED,302,1 ,$152.54 ,$114.41 ,$3.39 ,$152.54 ,$98.24 ,$12.88 ,$106.78 ,$3.39 ,$13.97 ,$3.49 ,$11.17 ,$144.91 ,$3.39 ,$122.03 ,$140.34 ,$3.39 ,$129.66 ,$144.91 ,$134.24 ,$115.93 ,$3.39 ,$3.39 ,$3.39 ,$111.35 ,$83.90 ,$138.81 ,$138.81 ,$122.03 ,$13.27 ,$83.90 ,$137.29 ,$12.88 ,$137.29 ,$82.37 ,$143.39 ,$28.98 ,$140.34 ,$3.59 ,$138.81 ,$12.88 ,$93.87 ,$93.87 ,$64.67 ,$113.84 ,$80.96 ,$13.01 ,$3.39 ,$144.91 ,$13.52 ,$3.39 ,$132.71 ,$12.88 ,$137.29 ,$12.88 ,$137.29 ,$137.29 ,$137.29 ,$147.96 ,$123.56 ,$141.86 ,$131.18 ,$147.96 
SACRED HEART HOSPITAL (ACU),30200557,86804,HC HEP C AB CONFIRM,302,1 ,$145.64 ,$109.23 ,$15.49 ,$145.64 ,$93.79 ,$15.49 ,$101.95 ,$16.01 ,$37.19 ,$16.49 ,$29.75 ,$138.36 ,$16.01 ,$116.51 ,$133.99 ,$16.01 ,$123.79 ,$138.36 ,$128.16 ,$110.69 ,$16.01 ,$16.01 ,$16.01 ,$106.32 ,$80.10 ,$132.53 ,$132.53 ,$116.51 ,$15.95 ,$80.10 ,$131.08 ,$15.49 ,$131.08 ,$78.65 ,$136.90 ,$34.85 ,$133.99 ,$16.97 ,$132.53 ,$15.49 ,$89.63 ,$89.63 ,$79.43 ,$108.69 ,$97.40 ,$15.64 ,$16.01 ,$138.36 ,$16.26 ,$16.01 ,$126.71 ,$15.49 ,$131.08 ,$15.49 ,$131.08 ,$131.08 ,$131.08 ,$141.27 ,$117.97 ,$135.45 ,$125.25 ,$141.27 
SACRED HEART HOSPITAL (ACU),30200558,86812,HC HLA TYPING SINGLE A/B/C,302,1 ,$149.55 ,$112.16 ,$25.81 ,$149.55 ,$96.31 ,$25.81 ,$104.69 ,$26.67 ,$61.95 ,$27.47 ,$49.56 ,$142.07 ,$26.67 ,$119.64 ,$137.59 ,$26.67 ,$127.12 ,$142.07 ,$131.60 ,$113.66 ,$26.67 ,$26.67 ,$26.67 ,$109.17 ,$82.25 ,$136.09 ,$136.09 ,$119.64 ,$26.58 ,$82.25 ,$134.60 ,$25.81 ,$134.60 ,$80.76 ,$140.58 ,$58.07 ,$137.59 ,$28.27 ,$136.09 ,$25.81 ,$92.03 ,$92.03 ,$149.55 ,$111.61 ,$134.60 ,$26.07 ,$26.67 ,$142.07 ,$27.10 ,$26.67 ,$130.11 ,$25.81 ,$134.60 ,$25.81 ,$134.60 ,$134.60 ,$134.60 ,$145.06 ,$121.14 ,$139.08 ,$128.61 ,$145.06 
SACRED HEART HOSPITAL (ACU),30200559,86850,HC AB SCREEN,302,1 ,$263.53 ,$197.65 ,$5.38 ,$263.53 ,$169.71 ,$52.56 ,$184.47 ,$5.38 ,$9.19 ,$5.54 ,$7.35 ,$250.35 ,$5.38 ,$210.82 ,$242.45 ,$5.38 ,$224.00 ,$250.35 ,$231.91 ,$200.28 ,$5.38 ,$5.38 ,$5.38 ,$192.38 ,$144.94 ,$239.81 ,$239.81 ,$210.82 ,$54.14 ,$144.94 ,$237.18 ,$52.56 ,$237.18 ,$142.31 ,$247.72 ,$118.25 ,$242.45 ,$5.70 ,$239.81 ,$52.56 ,$162.18 ,$162.18 ,$67.41 ,$196.67 ,$49.74 ,$53.08 ,$5.38 ,$250.35 ,$55.18 ,$5.38 ,$229.27 ,$52.56 ,$237.18 ,$52.56 ,$237.18 ,$237.18 ,$237.18 ,$255.62 ,$213.46 ,$245.08 ,$226.64 ,$255.62 
SACRED HEART HOSPITAL (ACU),30200560,86860,HC ELUTION,302,1 ,$322.95 ,$242.21 ,$8.51 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$8.51 ,$52.24 ,$8.77 ,$41.79 ,$306.80 ,$8.51 ,$258.36 ,$297.11 ,$8.51 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$8.51 ,$8.51 ,$8.51 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$9.02 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$197.64 ,$241.02 ,$224.93 ,$159.32 ,$8.51 ,$306.80 ,$165.63 ,$8.51 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),30200561,86870,HC RBC AB ID PANEL,302,1 ,$538.58 ,$403.94 ,$8.51 ,$693.07 ,$346.85 ,$308.03 ,$377.01 ,$8.51 ,$71.45 ,$8.77 ,$57.16 ,$511.65 ,$8.51 ,$430.86 ,$495.49 ,$8.51 ,$457.79 ,$511.65 ,$473.95 ,$409.32 ,$8.51 ,$8.51 ,$8.51 ,$393.16 ,$296.22 ,$490.11 ,$490.11 ,$430.86 ,$317.27 ,$296.22 ,$484.72 ,$308.03 ,$484.72 ,$290.83 ,$506.27 ,$693.07 ,$495.49 ,$9.02 ,$490.11 ,$308.03 ,$331.44 ,$331.44 ,$197.64 ,$401.94 ,$375.12 ,$311.11 ,$8.51 ,$511.65 ,$323.43 ,$8.51 ,$468.56 ,$308.03 ,$484.72 ,$308.03 ,$484.72 ,$484.72 ,$484.72 ,$522.42 ,$436.25 ,$500.88 ,$463.18 ,$522.42 
SACRED HEART HOSPITAL (ACU),30200562,86880,HC COOMBS DIRECT,302,1 ,$110.39 ,$82.79 ,$5.57 ,$132.46 ,$71.09 ,$58.87 ,$77.27 ,$5.57 ,$10.33 ,$5.74 ,$8.26 ,$104.87 ,$5.57 ,$88.31 ,$101.56 ,$5.57 ,$93.83 ,$104.87 ,$97.14 ,$83.90 ,$5.57 ,$5.57 ,$5.57 ,$80.58 ,$60.71 ,$100.45 ,$100.45 ,$88.31 ,$60.64 ,$60.71 ,$99.35 ,$58.87 ,$99.35 ,$59.61 ,$103.77 ,$132.46 ,$101.56 ,$5.90 ,$100.45 ,$58.87 ,$67.93 ,$67.93 ,$32.94 ,$82.38 ,$33.86 ,$59.46 ,$5.57 ,$104.87 ,$61.82 ,$5.57 ,$96.04 ,$58.87 ,$99.35 ,$58.87 ,$99.35 ,$99.35 ,$99.35 ,$107.08 ,$89.42 ,$102.66 ,$94.94 ,$107.08 
SACRED HEART HOSPITAL (ACU),30200563,86885,HC INDIRECT COOMBS,302,1 ,$132.91 ,$99.68 ,$5.91 ,$354.91 ,$85.59 ,$157.74 ,$93.04 ,$5.91 ,$13.74 ,$6.09 ,$10.99 ,$126.26 ,$5.91 ,$106.33 ,$122.28 ,$5.91 ,$112.97 ,$126.26 ,$116.96 ,$101.01 ,$5.91 ,$5.91 ,$5.91 ,$97.02 ,$73.10 ,$120.95 ,$120.95 ,$106.33 ,$162.47 ,$73.10 ,$119.62 ,$157.74 ,$119.62 ,$71.77 ,$124.94 ,$354.91 ,$122.28 ,$6.26 ,$120.95 ,$157.74 ,$81.79 ,$81.79 ,$47.68 ,$99.19 ,$36.00 ,$159.32 ,$5.91 ,$126.26 ,$165.63 ,$5.91 ,$115.63 ,$157.74 ,$119.62 ,$157.74 ,$119.62 ,$119.62 ,$119.62 ,$128.92 ,$107.66 ,$123.61 ,$114.30 ,$128.92 
SACRED HEART HOSPITAL (ACU),30200564,86890,HC AUTOLOGOUS PROCESSING FEE,302,1 ,$538.58 ,$403.94 ,$8.64 ,$538.58 ,$346.85 ,$157.74 ,$377.01 ,$8.64 ,$163.92 ,$8.90 ,$131.14 ,$511.65 ,$8.64 ,$430.86 ,$495.49 ,$8.64 ,$457.79 ,$511.65 ,$473.95 ,$409.32 ,$8.64 ,$8.64 ,$8.64 ,$393.16 ,$296.22 ,$490.11 ,$490.11 ,$430.86 ,$162.47 ,$296.22 ,$484.72 ,$157.74 ,$484.72 ,$290.83 ,$506.27 ,$354.91 ,$495.49 ,$9.16 ,$490.11 ,$157.74 ,$331.44 ,$331.44 ,$184.48 ,$401.94 ,$375.12 ,$159.32 ,$8.64 ,$511.65 ,$165.63 ,$8.64 ,$468.56 ,$157.74 ,$484.72 ,$157.74 ,$484.72 ,$484.72 ,$484.72 ,$522.42 ,$436.25 ,$500.88 ,$463.18 ,$522.42 
SACRED HEART HOSPITAL (ACU),30200565,86900,HC BLOOD TYPING ABO,302,1 ,$61.94 ,$46.46 ,$3.09 ,$268.33 ,$39.89 ,$119.26 ,$43.36 ,$3.09 ,$6.58 ,$3.18 ,$5.26 ,$58.84 ,$3.09 ,$49.55 ,$56.98 ,$3.09 ,$52.65 ,$58.84 ,$54.51 ,$47.07 ,$3.09 ,$3.09 ,$3.09 ,$45.22 ,$34.07 ,$56.37 ,$56.37 ,$49.55 ,$122.84 ,$34.07 ,$55.75 ,$119.26 ,$55.75 ,$33.45 ,$58.22 ,$268.33 ,$56.98 ,$3.28 ,$56.37 ,$119.26 ,$38.12 ,$38.12 ,$50.50 ,$46.23 ,$18.79 ,$120.45 ,$3.09 ,$58.84 ,$125.22 ,$3.09 ,$53.89 ,$119.26 ,$55.75 ,$119.26 ,$55.75 ,$55.75 ,$55.75 ,$60.08 ,$50.17 ,$57.60 ,$53.27 ,$60.08 
SACRED HEART HOSPITAL (ACU),30200566,86901,HC BLOOD TYPING RH,302,1 ,$78.00 ,$58.50 ,$3.09 ,$80.55 ,$50.23 ,$35.80 ,$54.60 ,$3.09 ,$6.58 ,$3.18 ,$5.26 ,$74.10 ,$3.09 ,$62.40 ,$71.76 ,$3.09 ,$66.30 ,$74.10 ,$68.64 ,$59.28 ,$3.09 ,$3.09 ,$3.09 ,$56.94 ,$42.90 ,$70.98 ,$70.98 ,$62.40 ,$36.87 ,$42.90 ,$70.20 ,$35.80 ,$70.20 ,$42.12 ,$73.32 ,$80.55 ,$71.76 ,$3.28 ,$70.98 ,$35.80 ,$48.00 ,$48.00 ,$50.50 ,$58.21 ,$18.79 ,$36.16 ,$3.09 ,$74.10 ,$37.59 ,$3.09 ,$67.86 ,$35.80 ,$70.20 ,$35.80 ,$70.20 ,$70.20 ,$70.20 ,$75.66 ,$63.18 ,$72.54 ,$67.08 ,$75.66 
SACRED HEART HOSPITAL (ACU),30200567,86902,HC RBC AG SCR RGT SERUM,302,1 ,$146.78 ,$110.09 ,$5.37 ,$693.07 ,$94.53 ,$308.03 ,$102.75 ,$5.37 ,$9.19 ,$5.53 ,$7.35 ,$139.44 ,$5.37 ,$117.42 ,$135.04 ,$5.37 ,$124.76 ,$139.44 ,$129.17 ,$111.55 ,$5.37 ,$5.37 ,$5.37 ,$107.15 ,$80.73 ,$133.57 ,$133.57 ,$117.42 ,$317.27 ,$80.73 ,$132.10 ,$308.03 ,$132.10 ,$79.26 ,$137.97 ,$693.07 ,$135.04 ,$5.69 ,$133.57 ,$308.03 ,$90.33 ,$90.33 ,$10.95 ,$109.54 ,$32.33 ,$311.11 ,$5.37 ,$139.44 ,$323.43 ,$5.37 ,$127.70 ,$308.03 ,$132.10 ,$308.03 ,$132.10 ,$132.10 ,$132.10 ,$142.38 ,$118.89 ,$136.51 ,$126.23 ,$142.38 
SACRED HEART HOSPITAL (ACU),30200568,86905,HC RBC ANTIGEN OTHER THAN ABO OR RH(D) EACH,302,1 ,$206.06 ,$154.55 ,$3.96 ,$693.07 ,$132.70 ,$308.03 ,$144.24 ,$3.96 ,$9.19 ,$4.08 ,$7.35 ,$195.76 ,$3.96 ,$164.85 ,$189.58 ,$3.96 ,$175.15 ,$195.76 ,$181.33 ,$156.61 ,$3.96 ,$3.96 ,$3.96 ,$150.42 ,$113.33 ,$187.51 ,$187.51 ,$164.85 ,$317.27 ,$113.33 ,$185.45 ,$308.03 ,$185.45 ,$111.27 ,$193.70 ,$693.07 ,$189.58 ,$4.20 ,$187.51 ,$308.03 ,$126.81 ,$126.81 ,$57.09 ,$153.78 ,$24.08 ,$311.11 ,$3.96 ,$195.76 ,$323.43 ,$3.96 ,$179.27 ,$308.03 ,$185.45 ,$308.03 ,$185.45 ,$185.45 ,$185.45 ,$199.88 ,$166.91 ,$191.64 ,$177.21 ,$199.88 
SACRED HEART HOSPITAL (ACU),30200569,86920,HC CROSSMATCH IMMEDIATE SPIN,302,1 ,$322.95 ,$242.21 ,$7.15 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$7.15 ,$57.65 ,$7.36 ,$46.12 ,$306.80 ,$7.15 ,$258.36 ,$297.11 ,$7.15 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$7.15 ,$7.15 ,$7.15 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$7.58 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$30.75 ,$241.02 ,$224.93 ,$159.32 ,$7.15 ,$306.80 ,$165.63 ,$7.15 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),30200570,86921,HC CROSSMATCH INCUBATION,302,1 ,$322.95 ,$242.21 ,$8.51 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$8.51 ,$52.24 ,$8.77 ,$41.79 ,$306.80 ,$8.51 ,$258.36 ,$297.11 ,$8.51 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$8.51 ,$8.51 ,$8.51 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$9.02 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$47.68 ,$241.02 ,$224.93 ,$159.32 ,$8.51 ,$306.80 ,$165.63 ,$8.51 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),30200571,86922,HC CROSSMATCH AHG,302,1 ,$322.95 ,$242.21 ,$8.51 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$8.51 ,$61.85 ,$8.77 ,$49.48 ,$306.80 ,$8.51 ,$258.36 ,$297.11 ,$8.51 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$8.51 ,$8.51 ,$8.51 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$9.02 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$90.47 ,$241.02 ,$224.93 ,$159.32 ,$8.51 ,$306.80 ,$165.63 ,$8.51 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),30200572,86923,HC CROSSMATCH ELECTRONIC,302,1 ,$322.95 ,$242.21 ,$8.51 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$8.51 ,$46.24 ,$8.77 ,$36.99 ,$306.80 ,$8.51 ,$258.36 ,$297.11 ,$8.51 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$8.51 ,$8.51 ,$8.51 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$9.02 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$44.66 ,$241.02 ,$224.93 ,$159.32 ,$8.51 ,$306.80 ,$165.63 ,$8.51 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),30200575,87801,HC INFECT MLT  ORG AMP,302,1 ,$444.00 ,$333.00 ,$50.62 ,$444.00 ,$285.94 ,$70.20 ,$310.80 ,$50.62 ,$168.51 ,$52.14 ,$134.81 ,$421.80 ,$50.62 ,$355.20 ,$408.48 ,$50.62 ,$377.40 ,$421.80 ,$390.72 ,$337.44 ,$50.62 ,$50.62 ,$50.62 ,$324.12 ,$244.20 ,$404.04 ,$404.04 ,$355.20 ,$72.31 ,$244.20 ,$399.60 ,$70.20 ,$399.60 ,$239.76 ,$417.36 ,$157.95 ,$408.48 ,$53.66 ,$404.04 ,$70.20 ,$273.24 ,$273.24 ,$122.72 ,$331.36 ,$399.60 ,$70.90 ,$50.62 ,$421.80 ,$73.71 ,$50.62 ,$386.28 ,$70.20 ,$399.60 ,$70.20 ,$399.60 ,$399.60 ,$399.60 ,$430.68 ,$359.64 ,$412.92 ,$381.84 ,$430.68 
SACRED HEART HOSPITAL (ACU),30200576,87804,HC INFLUENZA ASSAY W/OPTIC,302,1 ,$156.00 ,$117.00 ,$16.55 ,$156.00 ,$100.46 ,$16.55 ,$109.20 ,$16.86 ,$28.77 ,$17.37 ,$23.02 ,$148.20 ,$16.86 ,$124.80 ,$143.52 ,$16.86 ,$132.60 ,$148.20 ,$137.28 ,$118.56 ,$16.86 ,$16.86 ,$16.86 ,$113.88 ,$85.80 ,$141.96 ,$141.96 ,$124.80 ,$17.05 ,$85.80 ,$140.40 ,$16.55 ,$140.40 ,$84.24 ,$146.64 ,$37.24 ,$143.52 ,$17.87 ,$141.96 ,$16.55 ,$96.00 ,$96.00 ,$65.98 ,$116.42 ,$84.27 ,$16.72 ,$16.86 ,$148.20 ,$17.38 ,$16.86 ,$135.72 ,$16.55 ,$140.40 ,$16.55 ,$140.40 ,$140.40 ,$140.40 ,$151.32 ,$126.36 ,$145.08 ,$134.16 ,$151.32 
SACRED HEART HOSPITAL (ACU),30200577,86481,HC TB ANTIGEN RESPONSE GAMMA INTER T-CELL SUSP,302,1 ,$250.00 ,$187.50 ,$90.12 ,$250.00 ,$161.00 ,$100.00 ,$175.00 ,$90.12 ,$179.88 ,$92.82 ,$143.91 ,$237.50 ,$90.12 ,$200.00 ,$230.00 ,$90.12 ,$212.50 ,$237.50 ,$220.00 ,$190.00 ,$90.12 ,$90.12 ,$90.12 ,$182.50 ,$137.50 ,$227.50 ,$227.50 ,$200.00 ,$103.00 ,$137.50 ,$225.00 ,$100.00 ,$225.00 ,$135.00 ,$235.00 ,$225.00 ,$230.00 ,$95.53 ,$227.50 ,$100.00 ,$153.85 ,$153.85 ,$175.92 ,$186.58 ,$225.00 ,$101.00 ,$90.12 ,$237.50 ,$105.00 ,$90.12 ,$217.50 ,$100.00 ,$225.00 ,$100.00 ,$225.00 ,$225.00 ,$225.00 ,$242.50 ,$202.50 ,$232.50 ,$215.00 ,$242.50 
SACRED HEART HOSPITAL (ACU),30200581,87801,HC INFECT MLT  ORG AMP -52,302,1 ,$377.00 ,$282.75 ,$50.62 ,$377.00 ,$242.79 ,$70.20 ,$263.90 ,$50.62 ,$168.51 ,$52.14 ,$134.81 ,$358.15 ,$50.62 ,$301.60 ,$346.84 ,$50.62 ,$320.45 ,$358.15 ,$331.76 ,$286.52 ,$50.62 ,$50.62 ,$50.62 ,$275.21 ,$207.35 ,$343.07 ,$343.07 ,$301.60 ,$72.31 ,$207.35 ,$339.30 ,$70.20 ,$339.30 ,$203.58 ,$354.38 ,$157.95 ,$346.84 ,$53.66 ,$343.07 ,$70.20 ,$232.01 ,$232.01 ,$122.72 ,$281.36 ,$339.30 ,$70.90 ,$50.62 ,$358.15 ,$73.71 ,$50.62 ,$327.99 ,$70.20 ,$339.30 ,$70.20 ,$339.30 ,$339.30 ,$339.30 ,$365.69 ,$305.37 ,$350.61 ,$324.22 ,$365.69 
SACRED HEART HOSPITAL (ACU),30200824,86644,HC CMV AB,302,1 ,$44.43 ,$33.32 ,$14.39 ,$44.43 ,$28.61 ,$14.39 ,$31.10 ,$14.87 ,$34.55 ,$15.32 ,$27.64 ,$42.21 ,$14.87 ,$35.54 ,$40.88 ,$14.87 ,$37.77 ,$42.21 ,$39.10 ,$33.77 ,$14.87 ,$14.87 ,$14.87 ,$32.43 ,$24.44 ,$40.43 ,$40.43 ,$35.54 ,$14.82 ,$24.44 ,$39.99 ,$14.39 ,$39.99 ,$23.99 ,$41.76 ,$32.38 ,$40.88 ,$15.76 ,$40.43 ,$14.39 ,$27.34 ,$27.34 ,$44.43 ,$33.16 ,$39.99 ,$14.53 ,$14.87 ,$42.21 ,$15.11 ,$14.87 ,$38.65 ,$14.39 ,$39.99 ,$14.39 ,$39.99 ,$39.99 ,$39.99 ,$43.10 ,$35.99 ,$41.32 ,$38.21 ,$43.10 
SACRED HEART HOSPITAL (ACU),30201083,86353,HC LYMPHOCYTE TRANFORM MITOGENS,302,1 ,$55.00 ,$41.25 ,$29.70 ,$110.32 ,$35.42 ,$49.03 ,$38.50 ,$50.66 ,$55.00 ,$52.18 ,$55.00 ,$52.25 ,$50.66 ,$44.00 ,$50.60 ,$50.66 ,$46.75 ,$52.25 ,$48.40 ,$41.80 ,$50.66 ,$50.66 ,$50.66 ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 ,$50.50 ,$30.25 ,$49.50 ,$49.03 ,$49.50 ,$29.70 ,$51.70 ,$110.32 ,$50.60 ,$53.70 ,$50.05 ,$49.03 ,$33.85 ,$33.85 ,$55.00 ,$41.05 ,$49.50 ,$49.52 ,$50.66 ,$52.25 ,$51.48 ,$50.66 ,$47.85 ,$49.03 ,$49.50 ,$49.03 ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),30201087,86317,HC INFECTIOUS STREPTOCOCCUS PNEUMONIAE EA AB,302,1 ,$136.00 ,$102.00 ,$14.99 ,$136.00 ,$87.58 ,$14.99 ,$95.20 ,$15.49 ,$35.98 ,$15.95 ,$28.78 ,$129.20 ,$15.49 ,$108.80 ,$125.12 ,$15.49 ,$115.60 ,$129.20 ,$119.68 ,$103.36 ,$15.49 ,$15.49 ,$15.49 ,$99.28 ,$74.80 ,$123.76 ,$123.76 ,$108.80 ,$15.44 ,$74.80 ,$122.40 ,$14.99 ,$122.40 ,$73.44 ,$127.84 ,$33.73 ,$125.12 ,$16.42 ,$123.76 ,$14.99 ,$83.69 ,$83.69 ,$81.28 ,$101.50 ,$94.19 ,$15.14 ,$15.49 ,$129.20 ,$15.74 ,$15.49 ,$118.32 ,$14.99 ,$122.40 ,$14.99 ,$122.40 ,$122.40 ,$122.40 ,$131.92 ,$110.16 ,$126.48 ,$116.96 ,$131.92 
SACRED HEART HOSPITAL (ACU),30201179,86255,HC PHOSPHOLIPASE A2 RECPT ANTIBODY,302,1 ,$270.00 ,$202.50 ,$12.05 ,$270.00 ,$173.88 ,$12.05 ,$189.00 ,$12.45 ,$28.93 ,$12.82 ,$23.14 ,$256.50 ,$12.45 ,$216.00 ,$248.40 ,$12.45 ,$229.50 ,$256.50 ,$237.60 ,$205.20 ,$12.45 ,$12.45 ,$12.45 ,$197.10 ,$148.50 ,$245.70 ,$245.70 ,$216.00 ,$12.41 ,$148.50 ,$243.00 ,$12.05 ,$243.00 ,$145.80 ,$253.80 ,$27.11 ,$248.40 ,$13.20 ,$245.70 ,$12.05 ,$166.16 ,$166.16 ,$114.22 ,$201.50 ,$75.76 ,$12.17 ,$12.45 ,$256.50 ,$12.65 ,$12.45 ,$234.90 ,$12.05 ,$243.00 ,$12.05 ,$243.00 ,$243.00 ,$243.00 ,$261.90 ,$218.70 ,$251.10 ,$232.20 ,$261.90 
SACRED HEART HOSPITAL (ACU),30201196,86015,HC ACTIN ANTIBODY,302,1 ,$58.00 ,$43.50 ,$3.39 ,$58.00 ,$37.35 ,$11.53 ,$40.60 ,$3.39 ,$20.18 ,$3.49 ,$38.28 ,$55.10 ,$3.39 ,$46.40 ,$53.36 ,$3.39 ,$49.30 ,$55.10 ,$51.04 ,$44.08 ,$3.39 ,$3.39 ,$3.39 ,$42.34 ,$31.90 ,$52.78 ,$52.78 ,$46.40 ,$11.88 ,$31.90 ,$52.20 ,$11.53 ,$52.20 ,$31.32 ,$54.52 ,$25.94 ,$53.36 ,$3.59 ,$52.78 ,$11.53 ,$35.69 ,$35.69 ,$52.20 ,$43.29 ,$40.40 ,$11.65 ,$3.39 ,$55.10 ,$12.11 ,$3.39 ,$50.46 ,$11.53 ,$52.20 ,$11.53 ,$52.20 ,$52.20 ,$52.20 ,$56.26 ,$46.98 ,$53.94 ,$49.88 ,$56.26 
SACRED HEART HOSPITAL (ACU),30201197,86015,HC EMA ANTIBODY EA IGG,302,1 ,$121.00 ,$90.75 ,$3.39 ,$121.00 ,$77.92 ,$11.53 ,$84.70 ,$3.39 ,$20.18 ,$3.49 ,$79.86 ,$114.95 ,$3.39 ,$96.80 ,$111.32 ,$3.39 ,$102.85 ,$114.95 ,$106.48 ,$91.96 ,$3.39 ,$3.39 ,$3.39 ,$88.33 ,$66.55 ,$110.11 ,$110.11 ,$96.80 ,$11.88 ,$66.55 ,$108.90 ,$11.53 ,$108.90 ,$65.34 ,$113.74 ,$25.94 ,$111.32 ,$3.59 ,$110.11 ,$11.53 ,$74.46 ,$74.46 ,$108.90 ,$90.30 ,$84.28 ,$11.65 ,$3.39 ,$114.95 ,$12.11 ,$3.39 ,$105.27 ,$11.53 ,$108.90 ,$11.53 ,$108.90 ,$108.90 ,$108.90 ,$117.37 ,$98.01 ,$112.53 ,$104.06 ,$117.37 
SACRED HEART HOSPITAL (ACU),30201198,86258,HC GLIADIN AB IGG IGA,302,1 ,$58.00 ,$43.50 ,$3.39 ,$58.00 ,$37.35 ,$11.53 ,$40.60 ,$3.39 ,$20.18 ,$3.49 ,$38.28 ,$55.10 ,$3.39 ,$46.40 ,$53.36 ,$3.39 ,$49.30 ,$55.10 ,$51.04 ,$44.08 ,$3.39 ,$3.39 ,$3.39 ,$42.34 ,$31.90 ,$52.78 ,$52.78 ,$46.40 ,$11.88 ,$31.90 ,$52.20 ,$11.53 ,$52.20 ,$31.32 ,$54.52 ,$25.94 ,$53.36 ,$3.59 ,$52.78 ,$11.53 ,$35.69 ,$35.69 ,$52.20 ,$43.29 ,$40.40 ,$11.65 ,$3.39 ,$55.10 ,$12.11 ,$3.39 ,$50.46 ,$11.53 ,$52.20 ,$11.53 ,$52.20 ,$52.20 ,$52.20 ,$56.26 ,$46.98 ,$53.94 ,$49.88 ,$56.26 
SACRED HEART HOSPITAL (ACU),30201199,83516,HC TTG AB IGG IGA,302,1 ,$58.00 ,$43.50 ,$11.53 ,$58.00 ,$37.35 ,$11.53 ,$40.60 ,$11.91 ,$27.69 ,$12.27 ,$22.15 ,$55.10 ,$11.91 ,$46.40 ,$53.36 ,$11.91 ,$49.30 ,$55.10 ,$51.04 ,$44.08 ,$11.91 ,$11.91 ,$11.91 ,$42.34 ,$31.90 ,$52.78 ,$52.78 ,$46.40 ,$11.88 ,$31.90 ,$52.20 ,$11.53 ,$52.20 ,$31.32 ,$54.52 ,$25.94 ,$53.36 ,$12.62 ,$52.78 ,$11.53 ,$35.69 ,$35.69 ,$48.30 ,$43.29 ,$52.20 ,$11.65 ,$11.91 ,$55.10 ,$12.11 ,$11.91 ,$50.46 ,$11.53 ,$52.20 ,$11.53 ,$52.20 ,$52.20 ,$52.20 ,$56.26 ,$46.98 ,$53.94 ,$49.88 ,$56.26 
SACRED HEART HOSPITAL (ACU),30240102,86003,HC ALLERGEN IGE QN EA-REF,302,1 ,$69.89 ,$52.42 ,$4.57 ,$69.89 ,$45.01 ,$5.22 ,$48.92 ,$4.57 ,$7.79 ,$4.71 ,$6.23 ,$66.40 ,$4.57 ,$55.91 ,$64.30 ,$4.57 ,$59.41 ,$66.40 ,$61.50 ,$53.12 ,$4.57 ,$4.57 ,$4.57 ,$51.02 ,$38.44 ,$63.60 ,$63.60 ,$55.91 ,$5.38 ,$38.44 ,$62.90 ,$5.22 ,$62.90 ,$37.74 ,$65.70 ,$11.75 ,$64.30 ,$4.84 ,$63.60 ,$5.22 ,$43.01 ,$43.01 ,$69.89 ,$52.16 ,$32.79 ,$5.27 ,$4.57 ,$66.40 ,$5.48 ,$4.57 ,$60.80 ,$5.22 ,$62.90 ,$5.22 ,$62.90 ,$62.90 ,$62.90 ,$67.79 ,$56.61 ,$65.00 ,$60.11 ,$67.79 
SACRED HEART HOSPITAL (ACU),30500103,85007,HC BLOOD COUNT MAN DIFF WBC,305,1 ,$76.27 ,$57.20 ,$3.80 ,$76.27 ,$49.12 ,$3.80 ,$53.39 ,$3.93 ,$8.24 ,$4.05 ,$6.59 ,$72.46 ,$3.93 ,$61.02 ,$70.17 ,$3.93 ,$64.83 ,$72.46 ,$67.12 ,$57.97 ,$3.93 ,$3.93 ,$3.93 ,$55.68 ,$41.95 ,$69.41 ,$69.41 ,$61.02 ,$3.91 ,$41.95 ,$68.64 ,$3.80 ,$68.64 ,$41.19 ,$71.69 ,$8.55 ,$70.17 ,$4.17 ,$69.41 ,$3.80 ,$46.94 ,$46.94 ,$43.91 ,$56.92 ,$21.59 ,$3.84 ,$3.93 ,$72.46 ,$3.99 ,$3.93 ,$66.35 ,$3.80 ,$68.64 ,$3.80 ,$68.64 ,$68.64 ,$68.64 ,$73.98 ,$61.78 ,$70.93 ,$65.59 ,$73.98 
SACRED HEART HOSPITAL (ACU),30500104,85014,HC HEMATOCRIT,305,1 ,$31.41 ,$23.56 ,$2.37 ,$31.41 ,$20.23 ,$2.37 ,$21.99 ,$2.45 ,$5.69 ,$2.52 ,$4.55 ,$29.84 ,$2.45 ,$25.13 ,$28.90 ,$2.45 ,$26.70 ,$29.84 ,$27.64 ,$23.87 ,$2.45 ,$2.45 ,$2.45 ,$22.93 ,$17.28 ,$28.58 ,$28.58 ,$25.13 ,$2.44 ,$17.28 ,$28.27 ,$2.37 ,$28.27 ,$16.96 ,$29.53 ,$5.33 ,$28.90 ,$2.60 ,$28.58 ,$2.37 ,$19.33 ,$19.33 ,$29.66 ,$23.44 ,$14.92 ,$2.39 ,$2.45 ,$29.84 ,$2.49 ,$2.45 ,$27.33 ,$2.37 ,$28.27 ,$2.37 ,$28.27 ,$28.27 ,$28.27 ,$30.47 ,$25.44 ,$29.21 ,$27.01 ,$30.47 
SACRED HEART HOSPITAL (ACU),30500106,85018,HC HGB,305,1 ,$32.36 ,$24.27 ,$2.37 ,$32.36 ,$20.84 ,$2.37 ,$22.65 ,$2.45 ,$5.69 ,$2.52 ,$4.55 ,$30.74 ,$2.45 ,$25.89 ,$29.77 ,$2.45 ,$27.51 ,$30.74 ,$28.48 ,$24.59 ,$2.45 ,$2.45 ,$2.45 ,$23.62 ,$17.80 ,$29.45 ,$29.45 ,$25.89 ,$2.44 ,$17.80 ,$29.12 ,$2.37 ,$29.12 ,$17.47 ,$30.42 ,$5.33 ,$29.77 ,$2.60 ,$29.45 ,$2.37 ,$19.91 ,$19.91 ,$32.36 ,$24.15 ,$14.92 ,$2.39 ,$2.45 ,$30.74 ,$2.49 ,$2.45 ,$28.15 ,$2.37 ,$29.12 ,$2.37 ,$29.12 ,$29.12 ,$29.12 ,$31.39 ,$26.21 ,$30.09 ,$27.83 ,$31.39 
SACRED HEART HOSPITAL (ACU),30500107,85025,HC CBC AUTO W/AUTO DIFF,305,1 ,$145.46 ,$109.10 ,$7.77 ,$145.46 ,$93.68 ,$7.77 ,$101.82 ,$8.03 ,$18.66 ,$8.27 ,$14.92 ,$138.19 ,$8.03 ,$116.37 ,$133.82 ,$8.03 ,$123.64 ,$138.19 ,$128.00 ,$110.55 ,$8.03 ,$8.03 ,$8.03 ,$106.19 ,$80.00 ,$132.37 ,$132.37 ,$116.37 ,$8.00 ,$80.00 ,$130.91 ,$7.77 ,$130.91 ,$78.55 ,$136.73 ,$17.48 ,$133.82 ,$8.51 ,$132.37 ,$7.77 ,$89.52 ,$89.52 ,$76.87 ,$108.56 ,$48.83 ,$7.85 ,$8.03 ,$138.19 ,$8.16 ,$8.03 ,$126.55 ,$7.77 ,$130.91 ,$7.77 ,$130.91 ,$130.91 ,$130.91 ,$141.10 ,$117.82 ,$135.28 ,$125.10 ,$141.10 
SACRED HEART HOSPITAL (ACU),30500108,85027,HC CBC W/O DIFF,305,1 ,$93.83 ,$70.37 ,$6.47 ,$93.83 ,$60.43 ,$6.47 ,$65.68 ,$6.69 ,$15.52 ,$6.89 ,$12.42 ,$89.14 ,$6.69 ,$75.06 ,$86.32 ,$6.69 ,$79.76 ,$89.14 ,$82.57 ,$71.31 ,$6.69 ,$6.69 ,$6.69 ,$68.50 ,$51.61 ,$85.39 ,$85.39 ,$75.06 ,$6.66 ,$51.61 ,$84.45 ,$6.47 ,$84.45 ,$50.67 ,$88.20 ,$14.56 ,$86.32 ,$7.09 ,$85.39 ,$6.47 ,$57.74 ,$57.74 ,$76.87 ,$70.03 ,$40.63 ,$6.53 ,$6.69 ,$89.14 ,$6.79 ,$6.69 ,$81.63 ,$6.47 ,$84.45 ,$6.47 ,$84.45 ,$84.45 ,$84.45 ,$91.02 ,$76.00 ,$87.26 ,$80.69 ,$91.02 
SACRED HEART HOSPITAL (ACU),30500111,85045,HC RETIC COUNT AUTO,305,1 ,$92.50 ,$69.38 ,$3.99 ,$92.50 ,$59.57 ,$3.99 ,$64.75 ,$4.12 ,$9.59 ,$4.24 ,$7.67 ,$87.88 ,$4.12 ,$74.00 ,$85.10 ,$4.12 ,$78.63 ,$87.88 ,$81.40 ,$70.30 ,$4.12 ,$4.12 ,$4.12 ,$67.53 ,$50.88 ,$84.18 ,$84.18 ,$74.00 ,$4.11 ,$50.88 ,$83.25 ,$3.99 ,$83.25 ,$49.95 ,$86.95 ,$8.98 ,$85.10 ,$4.37 ,$84.18 ,$3.99 ,$56.92 ,$56.92 ,$79.07 ,$69.03 ,$25.10 ,$4.03 ,$4.12 ,$87.88 ,$4.19 ,$4.12 ,$80.48 ,$3.99 ,$83.25 ,$3.99 ,$83.25 ,$83.25 ,$83.25 ,$89.73 ,$74.93 ,$86.03 ,$79.55 ,$89.73 
SACRED HEART HOSPITAL (ACU),30500112,85048,HC BLOOD COUNT LEUKO AUTO,305,1 ,$36.08 ,$27.06 ,$2.54 ,$36.08 ,$23.24 ,$2.54 ,$25.26 ,$2.62 ,$6.09 ,$2.70 ,$4.87 ,$34.28 ,$2.62 ,$28.86 ,$33.19 ,$2.62 ,$30.67 ,$34.28 ,$31.75 ,$27.42 ,$2.62 ,$2.62 ,$2.62 ,$26.34 ,$19.84 ,$32.83 ,$32.83 ,$28.86 ,$2.62 ,$19.84 ,$32.47 ,$2.54 ,$32.47 ,$19.48 ,$33.92 ,$5.72 ,$33.19 ,$2.78 ,$32.83 ,$2.54 ,$22.20 ,$22.20 ,$30.75 ,$26.93 ,$15.94 ,$2.57 ,$2.62 ,$34.28 ,$2.67 ,$2.62 ,$31.39 ,$2.54 ,$32.47 ,$2.54 ,$32.47 ,$32.47 ,$32.47 ,$35.00 ,$29.22 ,$33.55 ,$31.03 ,$35.00 
SACRED HEART HOSPITAL (ACU),30500113,85049,HC PLATELET COUNT AUTO,305,1 ,$76.74 ,$57.56 ,$4.48 ,$76.74 ,$49.42 ,$4.48 ,$53.72 ,$4.63 ,$10.75 ,$4.77 ,$8.60 ,$72.90 ,$4.63 ,$61.39 ,$70.60 ,$4.63 ,$65.23 ,$72.90 ,$67.53 ,$58.32 ,$4.63 ,$4.63 ,$4.63 ,$56.02 ,$42.21 ,$69.83 ,$69.83 ,$61.39 ,$4.61 ,$42.21 ,$69.07 ,$4.48 ,$69.07 ,$41.44 ,$72.14 ,$10.08 ,$70.60 ,$4.91 ,$69.83 ,$4.48 ,$47.23 ,$47.23 ,$14.95 ,$57.27 ,$28.16 ,$4.52 ,$4.63 ,$72.90 ,$4.70 ,$4.63 ,$66.76 ,$4.48 ,$69.07 ,$4.48 ,$69.07 ,$69.07 ,$69.07 ,$74.44 ,$62.16 ,$71.37 ,$66.00 ,$74.44 
SACRED HEART HOSPITAL (ACU),30500115,85060,HC BLOOD SMEAR INTERP,305,1 ,$61.78 ,$46.34 ,$3.93 ,$61.78 ,$39.79 , N/A ,$43.25 ,$3.93 ,$43.24 ,$4.05 ,$34.59 ,$58.69 ,$3.93 ,$49.42 ,$56.84 ,$3.93 ,$52.51 ,$58.69 ,$54.37 ,$46.95 ,$3.93 ,$3.93 ,$3.93 ,$45.10 ,$33.98 ,$56.22 ,$56.22 ,$49.42 , N/A ,$33.98 ,$55.60 , N/A ,$55.60 ,$33.36 ,$58.07 , N/A ,$56.84 ,$4.17 ,$56.22 , N/A ,$38.02 ,$38.02 ,$61.78 ,$46.11 ,$55.60 , N/A ,$3.93 ,$58.69 , N/A ,$3.93 ,$53.75 , N/A ,$55.60 , N/A ,$55.60 ,$55.60 ,$55.60 ,$59.93 ,$50.04 ,$57.46 ,$53.13 ,$59.93 
SACRED HEART HOSPITAL (ACU),30500121,85210,HC FACTOR II,305,1 ,$105.48 ,$79.11 ,$8.17 ,$105.48 ,$67.93 ,$12.98 ,$73.84 ,$8.17 ,$13.97 ,$8.42 ,$11.17 ,$100.21 ,$8.17 ,$84.38 ,$97.04 ,$8.17 ,$89.66 ,$100.21 ,$92.82 ,$80.16 ,$8.17 ,$8.17 ,$8.17 ,$77.00 ,$58.01 ,$95.99 ,$95.99 ,$84.38 ,$13.37 ,$58.01 ,$94.93 ,$12.98 ,$94.93 ,$56.96 ,$99.15 ,$29.21 ,$97.04 ,$8.66 ,$95.99 ,$12.98 ,$64.91 ,$64.91 ,$105.48 ,$78.72 ,$81.62 ,$13.11 ,$8.17 ,$100.21 ,$13.63 ,$8.17 ,$91.77 ,$12.98 ,$94.93 ,$12.98 ,$94.93 ,$94.93 ,$94.93 ,$102.32 ,$85.44 ,$98.10 ,$90.71 ,$102.32 
SACRED HEART HOSPITAL (ACU),30500123,85220,HC FACTOR V,305,1 ,$120.37 ,$90.28 ,$17.65 ,$120.37 ,$77.52 ,$17.65 ,$84.26 ,$18.24 ,$42.37 ,$18.79 ,$33.89 ,$114.35 ,$18.24 ,$96.30 ,$110.74 ,$18.24 ,$102.31 ,$114.35 ,$105.93 ,$91.48 ,$18.24 ,$18.24 ,$18.24 ,$87.87 ,$66.20 ,$109.54 ,$109.54 ,$96.30 ,$18.18 ,$66.20 ,$108.33 ,$17.65 ,$108.33 ,$65.00 ,$113.15 ,$39.71 ,$110.74 ,$19.33 ,$109.54 ,$17.65 ,$74.08 ,$74.08 ,$120.37 ,$89.83 ,$108.33 ,$17.83 ,$18.24 ,$114.35 ,$18.53 ,$18.24 ,$104.72 ,$17.65 ,$108.33 ,$17.65 ,$108.33 ,$108.33 ,$108.33 ,$116.76 ,$97.50 ,$111.94 ,$103.52 ,$116.76 
SACRED HEART HOSPITAL (ACU),30500125,85230,HC FACTOR VII,305,1 ,$116.45 ,$87.34 ,$17.90 ,$116.45 ,$74.99 ,$17.90 ,$81.52 ,$18.50 ,$42.98 ,$19.06 ,$34.38 ,$110.63 ,$18.50 ,$93.16 ,$107.13 ,$18.50 ,$98.98 ,$110.63 ,$102.48 ,$88.50 ,$18.50 ,$18.50 ,$18.50 ,$85.01 ,$64.05 ,$105.97 ,$105.97 ,$93.16 ,$18.44 ,$64.05 ,$104.81 ,$17.90 ,$104.81 ,$62.88 ,$109.46 ,$40.28 ,$107.13 ,$19.61 ,$105.97 ,$17.90 ,$71.66 ,$71.66 ,$116.45 ,$86.91 ,$104.81 ,$18.08 ,$18.50 ,$110.63 ,$18.80 ,$18.50 ,$101.31 ,$17.90 ,$104.81 ,$17.90 ,$104.81 ,$104.81 ,$104.81 ,$112.96 ,$94.32 ,$108.30 ,$100.15 ,$112.96 
SACRED HEART HOSPITAL (ACU),30500126,85240,HC FACTOR VIII AHG,305,1 ,$120.37 ,$90.28 ,$9.84 ,$120.37 ,$77.52 ,$17.90 ,$84.26 ,$9.84 ,$16.80 ,$10.14 ,$13.44 ,$114.35 ,$9.84 ,$96.30 ,$110.74 ,$9.84 ,$102.31 ,$114.35 ,$105.93 ,$91.48 ,$9.84 ,$9.84 ,$9.84 ,$87.87 ,$66.20 ,$109.54 ,$109.54 ,$96.30 ,$18.44 ,$66.20 ,$108.33 ,$17.90 ,$108.33 ,$65.00 ,$113.15 ,$40.28 ,$110.74 ,$10.43 ,$109.54 ,$17.90 ,$74.08 ,$74.08 ,$120.37 ,$89.83 ,$108.33 ,$18.08 ,$9.84 ,$114.35 ,$18.80 ,$9.84 ,$104.72 ,$17.90 ,$108.33 ,$17.90 ,$108.33 ,$108.33 ,$108.33 ,$116.76 ,$97.50 ,$111.94 ,$103.52 ,$116.76 
SACRED HEART HOSPITAL (ACU),30500130,85245,HC FACTOR VIII VW RISTO,305,1 ,$181.45 ,$136.09 ,$22.94 ,$181.45 ,$116.85 ,$22.94 ,$127.02 ,$23.70 ,$55.07 ,$24.41 ,$44.06 ,$172.38 ,$23.70 ,$145.16 ,$166.93 ,$23.70 ,$154.23 ,$172.38 ,$159.68 ,$137.90 ,$23.70 ,$23.70 ,$23.70 ,$132.46 ,$99.80 ,$165.12 ,$165.12 ,$145.16 ,$23.63 ,$99.80 ,$163.31 ,$22.94 ,$163.31 ,$97.98 ,$170.56 ,$51.62 ,$166.93 ,$25.12 ,$165.12 ,$22.94 ,$111.66 ,$111.66 ,$181.45 ,$135.42 ,$144.19 ,$23.17 ,$23.70 ,$172.38 ,$24.09 ,$23.70 ,$157.86 ,$22.94 ,$163.31 ,$22.94 ,$163.31 ,$163.31 ,$163.31 ,$176.01 ,$146.97 ,$168.75 ,$156.05 ,$176.01 
SACRED HEART HOSPITAL (ACU),30500132,85246,HC FACTOR VIII VW AG,305,1 ,$157.02 ,$117.77 ,$22.94 ,$157.02 ,$101.12 ,$22.94 ,$109.91 ,$23.70 ,$55.07 ,$24.41 ,$44.06 ,$149.17 ,$23.70 ,$125.62 ,$144.46 ,$23.70 ,$133.47 ,$149.17 ,$138.18 ,$119.34 ,$23.70 ,$23.70 ,$23.70 ,$114.62 ,$86.36 ,$142.89 ,$142.89 ,$125.62 ,$23.63 ,$86.36 ,$141.32 ,$22.94 ,$141.32 ,$84.79 ,$147.60 ,$51.62 ,$144.46 ,$25.12 ,$142.89 ,$22.94 ,$96.63 ,$96.63 ,$157.02 ,$117.18 ,$141.32 ,$23.17 ,$23.70 ,$149.17 ,$24.09 ,$23.70 ,$136.61 ,$22.94 ,$141.32 ,$22.94 ,$141.32 ,$141.32 ,$141.32 ,$152.31 ,$127.19 ,$146.03 ,$135.04 ,$152.31 
SACRED HEART HOSPITAL (ACU),30500136,85247,HC FACTOR VW MULTIM ANALY,305,1 ,$269.27 ,$201.95 ,$22.94 ,$269.27 ,$173.41 ,$22.94 ,$188.49 ,$23.70 ,$55.07 ,$24.41 ,$44.06 ,$255.81 ,$23.70 ,$215.42 ,$247.73 ,$23.70 ,$228.88 ,$255.81 ,$236.96 ,$204.65 ,$23.70 ,$23.70 ,$23.70 ,$196.57 ,$148.10 ,$245.04 ,$245.04 ,$215.42 ,$23.63 ,$148.10 ,$242.34 ,$22.94 ,$242.34 ,$145.41 ,$253.11 ,$51.62 ,$247.73 ,$25.12 ,$245.04 ,$22.94 ,$165.71 ,$165.71 ,$269.27 ,$200.96 ,$144.19 ,$23.17 ,$23.70 ,$255.81 ,$24.09 ,$23.70 ,$234.26 ,$22.94 ,$242.34 ,$22.94 ,$242.34 ,$242.34 ,$242.34 ,$261.19 ,$218.11 ,$250.42 ,$231.57 ,$261.19 
SACRED HEART HOSPITAL (ACU),30500138,85250,HC FACTOR IX,305,1 ,$116.45 ,$87.34 ,$19.04 ,$116.45 ,$74.99 ,$19.04 ,$81.52 ,$19.67 ,$45.71 ,$20.26 ,$36.57 ,$110.63 ,$19.67 ,$93.16 ,$107.13 ,$19.67 ,$98.98 ,$110.63 ,$102.48 ,$88.50 ,$19.67 ,$19.67 ,$19.67 ,$85.01 ,$64.05 ,$105.97 ,$105.97 ,$93.16 ,$19.61 ,$64.05 ,$104.81 ,$19.04 ,$104.81 ,$62.88 ,$109.46 ,$42.84 ,$107.13 ,$20.85 ,$105.97 ,$19.04 ,$71.66 ,$71.66 ,$116.45 ,$86.91 ,$104.81 ,$19.23 ,$19.67 ,$110.63 ,$19.99 ,$19.67 ,$101.31 ,$19.04 ,$104.81 ,$19.04 ,$104.81 ,$104.81 ,$104.81 ,$112.96 ,$94.32 ,$108.30 ,$100.15 ,$112.96 
SACRED HEART HOSPITAL (ACU),30500142,85260,HC FACTOR X,305,1 ,$120.37 ,$90.28 ,$17.90 ,$120.37 ,$77.52 ,$17.90 ,$84.26 ,$18.50 ,$42.98 ,$19.06 ,$34.38 ,$114.35 ,$18.50 ,$96.30 ,$110.74 ,$18.50 ,$102.31 ,$114.35 ,$105.93 ,$91.48 ,$18.50 ,$18.50 ,$18.50 ,$87.87 ,$66.20 ,$109.54 ,$109.54 ,$96.30 ,$18.44 ,$66.20 ,$108.33 ,$17.90 ,$108.33 ,$65.00 ,$113.15 ,$40.28 ,$110.74 ,$19.61 ,$109.54 ,$17.90 ,$74.08 ,$74.08 ,$120.37 ,$89.83 ,$108.33 ,$18.08 ,$18.50 ,$114.35 ,$18.80 ,$18.50 ,$104.72 ,$17.90 ,$108.33 ,$17.90 ,$108.33 ,$108.33 ,$108.33 ,$116.76 ,$97.50 ,$111.94 ,$103.52 ,$116.76 
SACRED HEART HOSPITAL (ACU),30500144,85270,HC FACTOR XI,305,1 ,$113.01 ,$84.76 ,$17.90 ,$113.01 ,$72.78 ,$17.90 ,$79.11 ,$18.50 ,$42.98 ,$19.06 ,$34.38 ,$107.36 ,$18.50 ,$90.41 ,$103.97 ,$18.50 ,$96.06 ,$107.36 ,$99.45 ,$85.89 ,$18.50 ,$18.50 ,$18.50 ,$82.50 ,$62.16 ,$102.84 ,$102.84 ,$90.41 ,$18.44 ,$62.16 ,$101.71 ,$17.90 ,$101.71 ,$61.03 ,$106.23 ,$40.28 ,$103.97 ,$19.61 ,$102.84 ,$17.90 ,$69.55 ,$69.55 ,$113.01 ,$84.34 ,$101.71 ,$18.08 ,$18.50 ,$107.36 ,$18.80 ,$18.50 ,$98.32 ,$17.90 ,$101.71 ,$17.90 ,$101.71 ,$101.71 ,$101.71 ,$109.62 ,$91.54 ,$105.10 ,$97.19 ,$109.62 
SACRED HEART HOSPITAL (ACU),30500149,85300,HC ANTITHROMBIN III ACT,305,1 ,$88.49 ,$66.37 ,$11.85 ,$88.49 ,$56.99 ,$11.85 ,$61.94 ,$12.24 ,$28.46 ,$12.61 ,$22.76 ,$84.07 ,$12.24 ,$70.79 ,$81.41 ,$12.24 ,$75.22 ,$84.07 ,$77.87 ,$67.25 ,$12.24 ,$12.24 ,$12.24 ,$64.60 ,$48.67 ,$80.53 ,$80.53 ,$70.79 ,$12.21 ,$48.67 ,$79.64 ,$11.85 ,$79.64 ,$47.78 ,$83.18 ,$26.66 ,$81.41 ,$12.97 ,$80.53 ,$11.85 ,$54.46 ,$54.46 ,$88.49 ,$66.04 ,$74.49 ,$11.97 ,$12.24 ,$84.07 ,$12.44 ,$12.24 ,$76.99 ,$11.85 ,$79.64 ,$11.85 ,$79.64 ,$79.64 ,$79.64 ,$85.84 ,$71.68 ,$82.30 ,$76.10 ,$85.84 
SACRED HEART HOSPITAL (ACU),30500153,85302,HC PROTEIN C AG,305,1 ,$45.73 ,$34.30 ,$12.01 ,$45.73 ,$29.45 ,$12.01 ,$32.01 ,$12.41 ,$28.84 ,$12.78 ,$23.07 ,$43.44 ,$12.41 ,$36.58 ,$42.07 ,$12.41 ,$38.87 ,$43.44 ,$40.24 ,$34.75 ,$12.41 ,$12.41 ,$12.41 ,$33.38 ,$25.15 ,$41.61 ,$41.61 ,$36.58 ,$12.37 ,$25.15 ,$41.16 ,$12.01 ,$41.16 ,$24.69 ,$42.99 ,$27.02 ,$42.07 ,$13.15 ,$41.61 ,$12.01 ,$28.14 ,$28.14 ,$45.73 ,$34.13 ,$41.16 ,$12.13 ,$12.41 ,$43.44 ,$12.61 ,$12.41 ,$39.79 ,$12.01 ,$41.16 ,$12.01 ,$41.16 ,$41.16 ,$41.16 ,$44.36 ,$37.04 ,$42.53 ,$39.33 ,$44.36 
SACRED HEART HOSPITAL (ACU),30500154,85303,HC PROTEIN C ACTIVITY,305,1 ,$42.70 ,$32.03 ,$13.84 ,$42.70 ,$27.50 ,$13.84 ,$29.89 ,$14.30 ,$33.22 ,$14.73 ,$26.57 ,$40.57 ,$14.30 ,$34.16 ,$39.28 ,$14.30 ,$36.30 ,$40.57 ,$37.58 ,$32.45 ,$14.30 ,$14.30 ,$14.30 ,$31.17 ,$23.49 ,$38.86 ,$38.86 ,$34.16 ,$14.26 ,$23.49 ,$38.43 ,$13.84 ,$38.43 ,$23.06 ,$40.14 ,$31.14 ,$39.28 ,$15.16 ,$38.86 ,$13.84 ,$26.28 ,$26.28 ,$42.70 ,$31.87 ,$38.43 ,$13.98 ,$14.30 ,$40.57 ,$14.53 ,$14.30 ,$37.15 ,$13.84 ,$38.43 ,$13.84 ,$38.43 ,$38.43 ,$38.43 ,$41.42 ,$34.59 ,$39.71 ,$36.72 ,$41.42 
SACRED HEART HOSPITAL (ACU),30500156,85305,HC PROTEIN S TOTAL,305,1 ,$45.73 ,$34.30 ,$11.61 ,$45.73 ,$29.45 ,$11.61 ,$32.01 ,$12.00 ,$27.86 ,$12.36 ,$22.29 ,$43.44 ,$12.00 ,$36.58 ,$42.07 ,$12.00 ,$38.87 ,$43.44 ,$40.24 ,$34.75 ,$12.00 ,$12.00 ,$12.00 ,$33.38 ,$25.15 ,$41.61 ,$41.61 ,$36.58 ,$11.96 ,$25.15 ,$41.16 ,$11.61 ,$41.16 ,$24.69 ,$42.99 ,$26.12 ,$42.07 ,$12.72 ,$41.61 ,$11.61 ,$28.14 ,$28.14 ,$45.73 ,$34.13 ,$41.16 ,$11.73 ,$12.00 ,$43.44 ,$12.19 ,$12.00 ,$39.79 ,$11.61 ,$41.16 ,$11.61 ,$41.16 ,$41.16 ,$41.16 ,$44.36 ,$37.04 ,$42.53 ,$39.33 ,$44.36 
SACRED HEART HOSPITAL (ACU),30500159,85306,HC PROTEIN S FREE,305,1 ,$47.30 ,$35.48 ,$15.32 ,$47.30 ,$30.46 ,$15.32 ,$33.11 ,$15.83 ,$34.30 ,$16.30 ,$27.44 ,$44.94 ,$15.83 ,$37.84 ,$43.52 ,$15.83 ,$40.21 ,$44.94 ,$41.62 ,$35.95 ,$15.83 ,$15.83 ,$15.83 ,$34.53 ,$26.02 ,$43.04 ,$43.04 ,$37.84 ,$15.78 ,$26.02 ,$42.57 ,$15.32 ,$42.57 ,$25.54 ,$44.46 ,$34.47 ,$43.52 ,$16.78 ,$43.04 ,$15.32 ,$29.11 ,$29.11 ,$47.30 ,$35.30 ,$42.57 ,$15.47 ,$15.83 ,$44.94 ,$16.09 ,$15.83 ,$41.15 ,$15.32 ,$42.57 ,$15.32 ,$42.57 ,$42.57 ,$42.57 ,$45.88 ,$38.31 ,$43.99 ,$40.68 ,$45.88 
SACRED HEART HOSPITAL (ACU),30500168,85347,HC ACTIVATED CLOTTING TIME,305,1 ,$88.30 ,$66.23 ,$4.28 ,$88.30 ,$56.87 ,$4.28 ,$61.81 ,$4.42 ,$10.22 ,$4.55 ,$8.18 ,$83.89 ,$4.42 ,$70.64 ,$81.24 ,$4.42 ,$75.06 ,$83.89 ,$77.70 ,$67.11 ,$4.42 ,$4.42 ,$4.42 ,$64.46 ,$48.57 ,$80.35 ,$80.35 ,$70.64 ,$4.41 ,$48.57 ,$79.47 ,$4.28 ,$79.47 ,$47.68 ,$83.00 ,$9.63 ,$81.24 ,$4.69 ,$80.35 ,$4.28 ,$54.34 ,$54.34 ,$34.73 ,$65.90 ,$26.78 ,$4.32 ,$4.42 ,$83.89 ,$4.49 ,$4.42 ,$76.82 ,$4.28 ,$79.47 ,$4.28 ,$79.47 ,$79.47 ,$79.47 ,$85.65 ,$71.52 ,$82.12 ,$75.94 ,$85.65 
SACRED HEART HOSPITAL (ACU),30500172,85347,HC ACTIVATED CLOTTING TIME (HRACT),305,1 ,$91.81 ,$68.86 ,$4.28 ,$91.81 ,$59.13 ,$4.28 ,$64.27 ,$4.42 ,$10.22 ,$4.55 ,$8.18 ,$87.22 ,$4.42 ,$73.45 ,$84.47 ,$4.42 ,$78.04 ,$87.22 ,$80.79 ,$69.78 ,$4.42 ,$4.42 ,$4.42 ,$67.02 ,$50.50 ,$83.55 ,$83.55 ,$73.45 ,$4.41 ,$50.50 ,$82.63 ,$4.28 ,$82.63 ,$49.58 ,$86.30 ,$9.63 ,$84.47 ,$4.69 ,$83.55 ,$4.28 ,$56.50 ,$56.50 ,$34.73 ,$68.52 ,$26.78 ,$4.32 ,$4.42 ,$87.22 ,$4.49 ,$4.42 ,$79.87 ,$4.28 ,$82.63 ,$4.28 ,$82.63 ,$82.63 ,$82.63 ,$89.06 ,$74.37 ,$85.38 ,$78.96 ,$89.06 
SACRED HEART HOSPITAL (ACU),30500175,85379,HC D DIMER QN,305,1 ,$179.16 ,$134.37 ,$10.18 ,$179.16 ,$115.38 ,$10.18 ,$125.41 ,$10.52 ,$19.46 ,$10.84 ,$15.57 ,$170.20 ,$10.52 ,$143.33 ,$164.83 ,$10.52 ,$152.29 ,$170.20 ,$157.66 ,$136.16 ,$10.52 ,$10.52 ,$10.52 ,$130.79 ,$98.54 ,$163.04 ,$163.04 ,$143.33 ,$10.49 ,$98.54 ,$161.24 ,$10.18 ,$161.24 ,$96.75 ,$168.41 ,$22.91 ,$164.83 ,$11.15 ,$163.04 ,$10.18 ,$110.26 ,$110.26 ,$55.63 ,$133.71 ,$63.95 ,$10.28 ,$10.52 ,$170.20 ,$10.69 ,$10.52 ,$155.87 ,$10.18 ,$161.24 ,$10.18 ,$161.24 ,$161.24 ,$161.24 ,$173.79 ,$145.12 ,$166.62 ,$154.08 ,$173.79 
SACRED HEART HOSPITAL (ACU),30500176,85384,HC FIBRINOGEN,305,1 ,$199.97 ,$149.98 ,$9.72 ,$199.97 ,$128.78 ,$9.72 ,$139.98 ,$10.04 ,$20.39 ,$10.34 ,$16.31 ,$189.97 ,$10.04 ,$159.98 ,$183.97 ,$10.04 ,$169.97 ,$189.97 ,$175.97 ,$151.98 ,$10.04 ,$10.04 ,$10.04 ,$145.98 ,$109.98 ,$181.97 ,$181.97 ,$159.98 ,$10.01 ,$109.98 ,$179.97 ,$9.72 ,$179.97 ,$107.98 ,$187.97 ,$21.87 ,$183.97 ,$10.64 ,$181.97 ,$9.72 ,$123.06 ,$123.06 ,$55.76 ,$149.24 ,$53.41 ,$9.82 ,$10.04 ,$189.97 ,$10.21 ,$10.04 ,$173.97 ,$9.72 ,$179.97 ,$9.72 ,$179.97 ,$179.97 ,$179.97 ,$193.97 ,$161.98 ,$185.97 ,$171.97 ,$193.97 
SACRED HEART HOSPITAL (ACU),30500179,85385,HC FIBRINOGEN AG,305,1 ,$79.41 ,$59.56 ,$11.94 ,$79.41 ,$51.14 ,$14.46 ,$55.59 ,$11.94 ,$20.39 ,$12.30 ,$16.31 ,$75.44 ,$11.94 ,$63.53 ,$73.06 ,$11.94 ,$67.50 ,$75.44 ,$69.88 ,$60.35 ,$11.94 ,$11.94 ,$11.94 ,$57.97 ,$43.68 ,$72.26 ,$72.26 ,$63.53 ,$14.89 ,$43.68 ,$71.47 ,$14.46 ,$71.47 ,$42.88 ,$74.65 ,$32.54 ,$73.06 ,$12.66 ,$72.26 ,$14.46 ,$48.87 ,$48.87 ,$55.76 ,$59.26 ,$71.47 ,$14.60 ,$11.94 ,$75.44 ,$15.18 ,$11.94 ,$69.09 ,$14.46 ,$71.47 ,$14.46 ,$71.47 ,$71.47 ,$71.47 ,$77.03 ,$64.32 ,$73.85 ,$68.29 ,$77.03 
SACRED HEART HOSPITAL (ACU),30500180,85397,HC MBC ADAMTS13 ACTIVITY,305,1 ,$172.10 ,$129.08 ,$30.86 ,$172.10 ,$110.83 ,$30.86 ,$120.47 ,$31.89 ,$55.07 ,$32.85 ,$44.06 ,$163.50 ,$31.89 ,$137.68 ,$158.33 ,$31.89 ,$146.29 ,$163.50 ,$151.45 ,$130.80 ,$31.89 ,$31.89 ,$31.89 ,$125.63 ,$94.66 ,$156.61 ,$156.61 ,$137.68 ,$31.79 ,$94.66 ,$154.89 ,$30.86 ,$154.89 ,$92.93 ,$161.77 ,$69.44 ,$158.33 ,$33.80 ,$156.61 ,$30.86 ,$105.91 ,$105.91 ,$63.66 ,$128.44 ,$154.89 ,$31.17 ,$31.89 ,$163.50 ,$32.40 ,$31.89 ,$149.73 ,$30.86 ,$154.89 ,$30.86 ,$154.89 ,$154.89 ,$154.89 ,$166.94 ,$139.40 ,$160.05 ,$148.01 ,$166.94 
SACRED HEART HOSPITAL (ACU),30500184,85420,HC PLASMINOGEN ACTIVITY,305,1 ,$76.84 ,$57.63 ,$6.53 ,$76.84 ,$49.49 ,$6.53 ,$53.79 ,$6.75 ,$15.68 ,$6.95 ,$12.54 ,$73.00 ,$6.75 ,$61.47 ,$70.69 ,$6.75 ,$65.31 ,$73.00 ,$67.62 ,$58.40 ,$6.75 ,$6.75 ,$6.75 ,$56.09 ,$42.26 ,$69.92 ,$69.92 ,$61.47 ,$6.73 ,$42.26 ,$69.16 ,$6.53 ,$69.16 ,$41.49 ,$72.23 ,$14.69 ,$70.69 ,$7.16 ,$69.92 ,$6.53 ,$47.29 ,$47.29 ,$49.41 ,$57.35 ,$41.04 ,$6.60 ,$6.75 ,$73.00 ,$6.86 ,$6.75 ,$66.85 ,$6.53 ,$69.16 ,$6.53 ,$69.16 ,$69.16 ,$69.16 ,$74.53 ,$62.24 ,$71.46 ,$66.08 ,$74.53 
SACRED HEART HOSPITAL (ACU),30500185,85460,HC FETAL HGB KLEIHAUER BETKE,305,1 ,$62.04 ,$46.53 ,$7.73 ,$62.04 ,$39.95 ,$7.73 ,$43.43 ,$7.99 ,$18.57 ,$8.23 ,$14.85 ,$58.94 ,$7.99 ,$49.63 ,$57.08 ,$7.99 ,$52.73 ,$58.94 ,$54.60 ,$47.15 ,$7.99 ,$7.99 ,$7.99 ,$45.29 ,$34.12 ,$56.46 ,$56.46 ,$49.63 ,$7.96 ,$34.12 ,$55.84 ,$7.73 ,$55.84 ,$33.50 ,$58.32 ,$17.39 ,$57.08 ,$8.47 ,$56.46 ,$7.73 ,$38.18 ,$38.18 ,$57.09 ,$46.30 ,$48.62 ,$7.81 ,$7.99 ,$58.94 ,$8.12 ,$7.99 ,$53.97 ,$7.73 ,$55.84 ,$7.73 ,$55.84 ,$55.84 ,$55.84 ,$60.18 ,$50.25 ,$57.70 ,$53.35 ,$60.18 
SACRED HEART HOSPITAL (ACU),30500186,85461,HC FETAL HGB ROSETTE,305,1 ,$156.83 ,$117.62 ,$9.33 ,$156.83 ,$101.00 ,$9.36 ,$109.78 ,$9.33 ,$15.93 ,$9.61 ,$12.74 ,$148.99 ,$9.33 ,$125.46 ,$144.28 ,$9.33 ,$133.31 ,$148.99 ,$138.01 ,$119.19 ,$9.33 ,$9.33 ,$9.33 ,$114.49 ,$86.26 ,$142.72 ,$142.72 ,$125.46 ,$9.64 ,$86.26 ,$141.15 ,$9.36 ,$141.15 ,$84.69 ,$147.42 ,$21.06 ,$144.28 ,$9.89 ,$142.72 ,$9.36 ,$96.51 ,$96.51 ,$34.07 ,$117.04 ,$47.66 ,$9.45 ,$9.33 ,$148.99 ,$9.83 ,$9.33 ,$136.44 ,$9.36 ,$141.15 ,$9.36 ,$141.15 ,$141.15 ,$141.15 ,$152.13 ,$127.03 ,$145.85 ,$134.87 ,$152.13 
SACRED HEART HOSPITAL (ACU),30500187,85520,HC HEPARIN ASSAY,305,1 ,$157.49 ,$118.12 ,$13.09 ,$157.49 ,$101.42 ,$13.09 ,$110.24 ,$13.53 ,$26.83 ,$13.94 ,$21.46 ,$149.62 ,$13.53 ,$125.99 ,$144.89 ,$13.53 ,$133.87 ,$149.62 ,$138.59 ,$119.69 ,$13.53 ,$13.53 ,$13.53 ,$114.97 ,$86.62 ,$143.32 ,$143.32 ,$125.99 ,$13.48 ,$86.62 ,$141.74 ,$13.09 ,$141.74 ,$85.04 ,$148.04 ,$29.45 ,$144.89 ,$14.34 ,$143.32 ,$13.09 ,$96.92 ,$96.92 ,$84.12 ,$117.53 ,$82.28 ,$13.22 ,$13.53 ,$149.62 ,$13.74 ,$13.53 ,$137.02 ,$13.09 ,$141.74 ,$13.09 ,$141.74 ,$141.74 ,$141.74 ,$152.77 ,$127.57 ,$146.47 ,$135.44 ,$152.77 
SACRED HEART HOSPITAL (ACU),30500190,85540,HC LEUKOCYTE ALK PHOS,305,1 ,$93.92 ,$70.44 ,$8.60 ,$93.92 ,$60.48 ,$8.60 ,$65.74 ,$8.89 ,$20.65 ,$9.16 ,$16.52 ,$89.22 ,$8.89 ,$75.14 ,$86.41 ,$8.89 ,$79.83 ,$89.22 ,$82.65 ,$71.38 ,$8.89 ,$8.89 ,$8.89 ,$68.56 ,$51.66 ,$85.47 ,$85.47 ,$75.14 ,$8.86 ,$51.66 ,$84.53 ,$8.60 ,$84.53 ,$50.72 ,$88.28 ,$19.35 ,$86.41 ,$9.42 ,$85.47 ,$8.60 ,$57.80 ,$57.80 ,$93.92 ,$70.09 ,$54.07 ,$8.69 ,$8.89 ,$89.22 ,$9.03 ,$8.89 ,$81.71 ,$8.60 ,$84.53 ,$8.60 ,$84.53 ,$84.53 ,$84.53 ,$91.10 ,$76.08 ,$87.35 ,$80.77 ,$91.10 
SACRED HEART HOSPITAL (ACU),30500191,85557,HC OSMOTIC FRAG RBC INCUB,305,1 ,$43.91 ,$32.93 ,$13.36 ,$43.91 ,$28.28 ,$13.36 ,$30.74 ,$13.80 ,$32.06 ,$14.21 ,$25.65 ,$41.71 ,$13.80 ,$35.13 ,$40.40 ,$13.80 ,$37.32 ,$41.71 ,$38.64 ,$33.37 ,$13.80 ,$13.80 ,$13.80 ,$32.05 ,$24.15 ,$39.96 ,$39.96 ,$35.13 ,$13.76 ,$24.15 ,$39.52 ,$13.36 ,$39.52 ,$23.71 ,$41.28 ,$30.06 ,$40.40 ,$14.63 ,$39.96 ,$13.36 ,$27.02 ,$27.02 ,$43.91 ,$32.77 ,$39.52 ,$13.49 ,$13.80 ,$41.71 ,$14.03 ,$13.80 ,$38.20 ,$13.36 ,$39.52 ,$13.36 ,$39.52 ,$39.52 ,$39.52 ,$42.59 ,$35.57 ,$40.84 ,$37.76 ,$42.59 
SACRED HEART HOSPITAL (ACU),30500192,85576,HC PLATELET AGGREGATION EA,305,1 ,$251.80 ,$188.85 ,$24.91 ,$251.80 ,$162.16 ,$24.91 ,$176.26 ,$25.74 ,$51.57 ,$26.51 ,$41.26 ,$239.21 ,$25.74 ,$201.44 ,$231.66 ,$25.74 ,$214.03 ,$239.21 ,$221.58 ,$191.37 ,$25.74 ,$25.74 ,$25.74 ,$183.81 ,$138.49 ,$229.14 ,$229.14 ,$201.44 ,$25.66 ,$138.49 ,$226.62 ,$24.91 ,$226.62 ,$135.97 ,$236.69 ,$56.05 ,$231.66 ,$27.28 ,$229.14 ,$24.91 ,$154.96 ,$154.96 ,$65.70 ,$187.92 ,$135.03 ,$25.16 ,$25.74 ,$239.21 ,$26.16 ,$25.74 ,$219.07 ,$24.91 ,$226.62 ,$24.91 ,$226.62 ,$226.62 ,$226.62 ,$244.25 ,$203.96 ,$234.17 ,$216.55 ,$244.25 
SACRED HEART HOSPITAL (ACU),30500196,85610,HC PROTHROMBIN TIME (PT),305,1 ,$76.46 ,$57.35 ,$4.29 ,$76.46 ,$49.24 ,$4.29 ,$53.52 ,$4.43 ,$9.43 ,$4.56 ,$7.55 ,$72.64 ,$4.43 ,$61.17 ,$70.34 ,$4.43 ,$64.99 ,$72.64 ,$67.28 ,$58.11 ,$4.43 ,$4.43 ,$4.43 ,$55.82 ,$42.05 ,$69.58 ,$69.58 ,$61.17 ,$4.42 ,$42.05 ,$68.81 ,$4.29 ,$68.81 ,$41.29 ,$71.87 ,$9.65 ,$70.34 ,$4.70 ,$69.58 ,$4.29 ,$47.05 ,$47.05 ,$47.68 ,$57.06 ,$24.69 ,$4.33 ,$4.43 ,$72.64 ,$4.50 ,$4.43 ,$66.52 ,$4.29 ,$68.81 ,$4.29 ,$68.81 ,$68.81 ,$68.81 ,$74.17 ,$61.93 ,$71.11 ,$65.76 ,$74.17 
SACRED HEART HOSPITAL (ACU),30500202,85613,HC RUSSELL VIPER VENOM DIL,305,1 ,$69.78 ,$52.34 ,$9.58 ,$69.78 ,$44.94 ,$9.58 ,$48.85 ,$9.90 ,$23.00 ,$10.20 ,$18.40 ,$66.29 ,$9.90 ,$55.82 ,$64.20 ,$9.90 ,$59.31 ,$66.29 ,$61.41 ,$53.03 ,$9.90 ,$9.90 ,$9.90 ,$50.94 ,$38.38 ,$63.50 ,$63.50 ,$55.82 ,$9.87 ,$38.38 ,$62.80 ,$9.58 ,$62.80 ,$37.68 ,$65.59 ,$21.56 ,$64.20 ,$10.49 ,$63.50 ,$9.58 ,$42.94 ,$42.94 ,$47.68 ,$52.08 ,$60.23 ,$9.68 ,$9.90 ,$66.29 ,$10.06 ,$9.90 ,$60.71 ,$9.58 ,$62.80 ,$9.58 ,$62.80 ,$62.80 ,$62.80 ,$67.69 ,$56.52 ,$64.90 ,$60.01 ,$67.69 
SACRED HEART HOSPITAL (ACU),30500205,85652,HC SED RATE AUTO,305,1 ,$60.71 ,$45.53 ,$2.70 ,$60.71 ,$39.10 ,$2.70 ,$42.50 ,$2.79 ,$6.48 ,$2.87 ,$5.18 ,$57.67 ,$2.79 ,$48.57 ,$55.85 ,$2.79 ,$51.60 ,$57.67 ,$53.42 ,$46.14 ,$2.79 ,$2.79 ,$2.79 ,$44.32 ,$33.39 ,$55.25 ,$55.25 ,$48.57 ,$2.78 ,$33.39 ,$54.64 ,$2.70 ,$54.64 ,$32.78 ,$57.07 ,$6.08 ,$55.85 ,$2.96 ,$55.25 ,$2.70 ,$37.36 ,$37.36 ,$25.24 ,$45.31 ,$16.96 ,$2.73 ,$2.79 ,$57.67 ,$2.84 ,$2.79 ,$52.82 ,$2.70 ,$54.64 ,$2.70 ,$54.64 ,$54.64 ,$54.64 ,$58.89 ,$49.18 ,$56.46 ,$52.21 ,$58.89 
SACRED HEART HOSPITAL (ACU),30500206,85660,HC SICKLE CELL RBC,305,1 ,$54.32 ,$40.74 ,$5.51 ,$54.32 ,$34.98 ,$5.51 ,$38.02 ,$5.69 ,$13.23 ,$5.86 ,$10.58 ,$51.60 ,$5.69 ,$43.46 ,$49.97 ,$5.69 ,$46.17 ,$51.60 ,$47.80 ,$41.28 ,$5.69 ,$5.69 ,$5.69 ,$39.65 ,$29.88 ,$49.43 ,$49.43 ,$43.46 ,$5.68 ,$29.88 ,$48.89 ,$5.51 ,$48.89 ,$29.33 ,$51.06 ,$12.40 ,$49.97 ,$6.03 ,$49.43 ,$5.51 ,$33.43 ,$33.43 ,$43.91 ,$40.54 ,$34.62 ,$5.57 ,$5.69 ,$51.60 ,$5.79 ,$5.69 ,$47.26 ,$5.51 ,$48.89 ,$5.51 ,$48.89 ,$48.89 ,$48.89 ,$52.69 ,$44.00 ,$50.52 ,$46.72 ,$52.69 
SACRED HEART HOSPITAL (ACU),30500207,85670,HC THROMBIN TIME PLASMA,305,1 ,$33.12 ,$24.84 ,$1.20 ,$33.12 ,$21.33 ,$5.77 ,$23.18 ,$1.20 ,$13.84 ,$1.24 ,$11.07 ,$31.46 ,$1.20 ,$26.50 ,$30.47 ,$1.20 ,$28.15 ,$31.46 ,$29.15 ,$25.17 ,$1.20 ,$1.20 ,$1.20 ,$24.18 ,$18.22 ,$30.14 ,$30.14 ,$26.50 ,$5.94 ,$18.22 ,$29.81 ,$5.77 ,$29.81 ,$17.88 ,$31.13 ,$12.98 ,$30.47 ,$1.27 ,$30.14 ,$5.77 ,$20.38 ,$20.38 ,$33.12 ,$24.72 ,$29.81 ,$5.83 ,$1.20 ,$31.46 ,$6.06 ,$1.20 ,$28.81 ,$5.77 ,$29.81 ,$5.77 ,$29.81 ,$29.81 ,$29.81 ,$32.13 ,$26.83 ,$30.80 ,$28.48 ,$32.13 
SACRED HEART HOSPITAL (ACU),30500211,85730,HC PTT,305,1 ,$116.93 ,$87.70 ,$6.01 ,$116.93 ,$75.30 ,$6.01 ,$81.85 ,$6.21 ,$14.42 ,$6.40 ,$11.54 ,$111.08 ,$6.21 ,$93.54 ,$107.58 ,$6.21 ,$99.39 ,$111.08 ,$102.90 ,$88.87 ,$6.21 ,$6.21 ,$6.21 ,$85.36 ,$64.31 ,$106.41 ,$106.41 ,$93.54 ,$6.19 ,$64.31 ,$105.24 ,$6.01 ,$105.24 ,$63.14 ,$109.91 ,$13.52 ,$107.58 ,$6.58 ,$106.41 ,$6.01 ,$71.96 ,$71.96 ,$49.41 ,$87.26 ,$37.78 ,$6.07 ,$6.21 ,$111.08 ,$6.31 ,$6.21 ,$101.73 ,$6.01 ,$105.24 ,$6.01 ,$105.24 ,$105.24 ,$105.24 ,$113.42 ,$94.71 ,$108.74 ,$100.56 ,$113.42 
SACRED HEART HOSPITAL (ACU),30500213,85732,HC PTT MIXING STUDY,305,1 ,$88.49 ,$66.37 ,$6.47 ,$88.49 ,$56.99 ,$6.47 ,$61.94 ,$6.69 ,$15.52 ,$6.89 ,$12.42 ,$84.07 ,$6.69 ,$70.79 ,$81.41 ,$6.69 ,$75.22 ,$84.07 ,$77.87 ,$67.25 ,$6.69 ,$6.69 ,$6.69 ,$64.60 ,$48.67 ,$80.53 ,$80.53 ,$70.79 ,$6.66 ,$48.67 ,$79.64 ,$6.47 ,$79.64 ,$47.78 ,$83.18 ,$14.56 ,$81.41 ,$7.09 ,$80.53 ,$6.47 ,$54.46 ,$54.46 ,$69.19 ,$66.04 ,$40.63 ,$6.53 ,$6.69 ,$84.07 ,$6.79 ,$6.69 ,$76.99 ,$6.47 ,$79.64 ,$6.47 ,$79.64 ,$79.64 ,$79.64 ,$85.84 ,$71.68 ,$82.30 ,$76.10 ,$85.84 
SACRED HEART HOSPITAL (ACU),30500324,85009,HC BLOOD COUNT MAN DIFF WBC BUFFY COAT,305,1 ,$62.77 ,$47.08 ,$5.07 ,$62.77 ,$40.42 ,$5.07 ,$43.94 ,$5.23 ,$8.94 ,$5.39 ,$7.15 ,$59.63 ,$5.23 ,$50.22 ,$57.75 ,$5.23 ,$53.35 ,$59.63 ,$55.24 ,$47.71 ,$5.23 ,$5.23 ,$5.23 ,$45.82 ,$34.52 ,$57.12 ,$57.12 ,$50.22 ,$5.22 ,$34.52 ,$56.49 ,$5.07 ,$56.49 ,$33.90 ,$59.00 ,$11.41 ,$57.75 ,$5.54 ,$57.12 ,$5.07 ,$38.63 ,$38.63 ,$38.66 ,$46.85 ,$25.81 ,$5.12 ,$5.23 ,$59.63 ,$5.32 ,$5.23 ,$54.61 ,$5.07 ,$56.49 ,$5.07 ,$56.49 ,$56.49 ,$56.49 ,$60.89 ,$50.84 ,$58.38 ,$53.98 ,$60.89 
SACRED HEART HOSPITAL (ACU),30500325,85013,HC BLOOD COUNT SPUN MICROHEMATOCRIT,305,1 ,$40.76 ,$30.57 ,$3.34 ,$40.76 ,$26.25 ,$7.00 ,$28.53 ,$3.34 ,$5.69 ,$3.44 ,$4.55 ,$38.72 ,$3.34 ,$32.61 ,$37.50 ,$3.34 ,$34.65 ,$38.72 ,$35.87 ,$30.98 ,$3.34 ,$3.34 ,$3.34 ,$29.75 ,$22.42 ,$37.09 ,$37.09 ,$32.61 ,$7.21 ,$22.42 ,$36.68 ,$7.00 ,$36.68 ,$22.01 ,$38.31 ,$15.75 ,$37.50 ,$3.54 ,$37.09 ,$7.00 ,$25.08 ,$25.08 ,$32.94 ,$30.42 ,$35.64 ,$7.07 ,$3.34 ,$38.72 ,$7.35 ,$3.34 ,$35.46 ,$7.00 ,$36.68 ,$7.00 ,$36.68 ,$36.68 ,$36.68 ,$39.54 ,$33.02 ,$37.91 ,$35.05 ,$39.54 
SACRED HEART HOSPITAL (ACU),30500326,85014,HC HEMATOCRIT,305,1 ,$31.41 ,$23.56 ,$2.37 ,$31.41 ,$20.23 ,$2.37 ,$21.99 ,$2.45 ,$5.69 ,$2.52 ,$4.55 ,$29.84 ,$2.45 ,$25.13 ,$28.90 ,$2.45 ,$26.70 ,$29.84 ,$27.64 ,$23.87 ,$2.45 ,$2.45 ,$2.45 ,$22.93 ,$17.28 ,$28.58 ,$28.58 ,$25.13 ,$2.44 ,$17.28 ,$28.27 ,$2.37 ,$28.27 ,$16.96 ,$29.53 ,$5.33 ,$28.90 ,$2.60 ,$28.58 ,$2.37 ,$19.33 ,$19.33 ,$29.66 ,$23.44 ,$14.92 ,$2.39 ,$2.45 ,$29.84 ,$2.49 ,$2.45 ,$27.33 ,$2.37 ,$28.27 ,$2.37 ,$28.27 ,$28.27 ,$28.27 ,$30.47 ,$25.44 ,$29.21 ,$27.01 ,$30.47 
SACRED HEART HOSPITAL (ACU),30500327,85041,HC BLOOD COUNT RBS AUTO,305,1 ,$18.81 ,$14.11 ,$3.02 ,$18.81 ,$12.11 ,$3.02 ,$13.17 ,$3.12 ,$7.25 ,$3.21 ,$5.80 ,$17.87 ,$3.12 ,$15.05 ,$17.31 ,$3.12 ,$15.99 ,$17.87 ,$16.55 ,$14.30 ,$3.12 ,$3.12 ,$3.12 ,$13.73 ,$10.35 ,$17.12 ,$17.12 ,$15.05 ,$3.11 ,$10.35 ,$16.93 ,$3.02 ,$16.93 ,$10.16 ,$17.68 ,$6.80 ,$17.31 ,$3.31 ,$17.12 ,$3.02 ,$11.58 ,$11.58 ,$18.81 ,$14.04 ,$16.93 ,$3.05 ,$3.12 ,$17.87 ,$3.17 ,$3.12 ,$16.36 ,$3.02 ,$16.93 ,$3.02 ,$16.93 ,$16.93 ,$16.93 ,$18.25 ,$15.24 ,$17.49 ,$16.18 ,$18.25 
SACRED HEART HOSPITAL (ACU),30500328,85307,HC ACTIV PROTEIN C RESIST,305,1 ,$126.48 ,$94.86 ,$15.32 ,$126.48 ,$81.45 ,$15.32 ,$88.54 ,$15.83 ,$34.30 ,$16.30 ,$27.44 ,$120.16 ,$15.83 ,$101.18 ,$116.36 ,$15.83 ,$107.51 ,$120.16 ,$111.30 ,$96.12 ,$15.83 ,$15.83 ,$15.83 ,$92.33 ,$69.56 ,$115.10 ,$115.10 ,$101.18 ,$15.78 ,$69.56 ,$113.83 ,$15.32 ,$113.83 ,$68.30 ,$118.89 ,$34.47 ,$116.36 ,$16.78 ,$115.10 ,$15.32 ,$77.84 ,$77.84 ,$71.53 ,$94.39 ,$96.33 ,$15.47 ,$15.83 ,$120.16 ,$16.09 ,$15.83 ,$110.04 ,$15.32 ,$113.83 ,$15.32 ,$113.83 ,$113.83 ,$113.83 ,$122.69 ,$102.45 ,$117.63 ,$108.77 ,$122.69 
SACRED HEART HOSPITAL (ACU),30500330,85347,HC ACTIVATED CLOTTING TIME,305,1 ,$88.30 ,$66.23 ,$4.28 ,$88.30 ,$56.87 ,$4.28 ,$61.81 ,$4.42 ,$10.22 ,$4.55 ,$8.18 ,$83.89 ,$4.42 ,$70.64 ,$81.24 ,$4.42 ,$75.06 ,$83.89 ,$77.70 ,$67.11 ,$4.42 ,$4.42 ,$4.42 ,$64.46 ,$48.57 ,$80.35 ,$80.35 ,$70.64 ,$4.41 ,$48.57 ,$79.47 ,$4.28 ,$79.47 ,$47.68 ,$83.00 ,$9.63 ,$81.24 ,$4.69 ,$80.35 ,$4.28 ,$54.34 ,$54.34 ,$34.73 ,$65.90 ,$26.78 ,$4.32 ,$4.42 ,$83.89 ,$4.49 ,$4.42 ,$76.82 ,$4.28 ,$79.47 ,$4.28 ,$79.47 ,$79.47 ,$79.47 ,$85.65 ,$71.52 ,$82.12 ,$75.94 ,$85.65 
SACRED HEART HOSPITAL (ACU),30500332,85520,HC HEPARIN ASSAY,305,1 ,$157.49 ,$118.12 ,$13.09 ,$157.49 ,$101.42 ,$13.09 ,$110.24 ,$13.53 ,$26.83 ,$13.94 ,$21.46 ,$149.62 ,$13.53 ,$125.99 ,$144.89 ,$13.53 ,$133.87 ,$149.62 ,$138.59 ,$119.69 ,$13.53 ,$13.53 ,$13.53 ,$114.97 ,$86.62 ,$143.32 ,$143.32 ,$125.99 ,$13.48 ,$86.62 ,$141.74 ,$13.09 ,$141.74 ,$85.04 ,$148.04 ,$29.45 ,$144.89 ,$14.34 ,$143.32 ,$13.09 ,$96.92 ,$96.92 ,$84.12 ,$117.53 ,$82.28 ,$13.22 ,$13.53 ,$149.62 ,$13.74 ,$13.53 ,$137.02 ,$13.09 ,$141.74 ,$13.09 ,$141.74 ,$141.74 ,$141.74 ,$152.77 ,$127.57 ,$146.47 ,$135.44 ,$152.77 
SACRED HEART HOSPITAL (ACU),30500333,85555,HC OSMOTIC FAGILITY RBC INCUB,305,1 ,$43.91 ,$32.93 ,$7.47 ,$43.91 ,$28.28 ,$7.47 ,$30.74 ,$7.72 ,$16.05 ,$7.95 ,$12.84 ,$41.71 ,$7.72 ,$35.13 ,$40.40 ,$7.72 ,$37.32 ,$41.71 ,$38.64 ,$33.37 ,$7.72 ,$7.72 ,$7.72 ,$32.05 ,$24.15 ,$39.96 ,$39.96 ,$35.13 ,$7.69 ,$24.15 ,$39.52 ,$7.47 ,$39.52 ,$23.71 ,$41.28 ,$16.81 ,$40.40 ,$8.18 ,$39.96 ,$7.47 ,$27.02 ,$27.02 ,$43.91 ,$32.77 ,$39.52 ,$7.54 ,$7.72 ,$41.71 ,$7.84 ,$7.72 ,$38.20 ,$7.47 ,$39.52 ,$7.47 ,$39.52 ,$39.52 ,$39.52 ,$42.59 ,$35.57 ,$40.84 ,$37.76 ,$42.59 
SACRED HEART HOSPITAL (ACU),30500334,85635,HC REPTILASE TEST,305,1 ,$94.69 ,$71.02 ,$9.85 ,$94.69 ,$60.98 ,$9.85 ,$66.28 ,$10.18 ,$23.64 ,$10.49 ,$18.91 ,$89.96 ,$10.18 ,$75.75 ,$87.11 ,$10.18 ,$80.49 ,$89.96 ,$83.33 ,$71.96 ,$10.18 ,$10.18 ,$10.18 ,$69.12 ,$52.08 ,$86.17 ,$86.17 ,$75.75 ,$10.15 ,$52.08 ,$85.22 ,$9.85 ,$85.22 ,$51.13 ,$89.01 ,$22.16 ,$87.11 ,$10.79 ,$86.17 ,$9.85 ,$58.27 ,$58.27 ,$94.69 ,$70.67 ,$61.91 ,$9.95 ,$10.18 ,$89.96 ,$10.34 ,$10.18 ,$82.38 ,$9.85 ,$85.22 ,$9.85 ,$85.22 ,$85.22 ,$85.22 ,$91.85 ,$76.70 ,$88.06 ,$81.43 ,$91.85 
SACRED HEART HOSPITAL (ACU),30500335,85670,HC THROMBIN TIME PLASMA,305,1 ,$151.87 ,$113.90 ,$1.20 ,$151.87 ,$97.80 ,$5.77 ,$106.31 ,$1.20 ,$13.84 ,$1.24 ,$11.07 ,$144.28 ,$1.20 ,$121.50 ,$139.72 ,$1.20 ,$129.09 ,$144.28 ,$133.65 ,$115.42 ,$1.20 ,$1.20 ,$1.20 ,$110.87 ,$83.53 ,$138.20 ,$138.20 ,$121.50 ,$5.94 ,$83.53 ,$136.68 ,$5.77 ,$136.68 ,$82.01 ,$142.76 ,$12.98 ,$139.72 ,$1.27 ,$138.20 ,$5.77 ,$93.46 ,$93.46 ,$52.72 ,$113.34 ,$36.25 ,$5.83 ,$1.20 ,$144.28 ,$6.06 ,$1.20 ,$132.13 ,$5.77 ,$136.68 ,$5.77 ,$136.68 ,$136.68 ,$136.68 ,$147.31 ,$123.01 ,$141.24 ,$130.61 ,$147.31 
SACRED HEART HOSPITAL (ACU),30500336,85810,HC VISCOSITY,305,1 ,$77.50 ,$58.13 ,$11.67 ,$77.50 ,$49.91 ,$11.67 ,$54.25 ,$12.06 ,$28.02 ,$12.42 ,$22.41 ,$73.63 ,$12.06 ,$62.00 ,$71.30 ,$12.06 ,$65.88 ,$73.63 ,$68.20 ,$58.90 ,$12.06 ,$12.06 ,$12.06 ,$56.58 ,$42.63 ,$70.53 ,$70.53 ,$62.00 ,$12.02 ,$42.63 ,$69.75 ,$11.67 ,$69.75 ,$41.85 ,$72.85 ,$26.26 ,$71.30 ,$12.78 ,$70.53 ,$11.67 ,$47.69 ,$47.69 ,$69.42 ,$57.84 ,$69.75 ,$11.79 ,$12.06 ,$73.63 ,$12.25 ,$12.06 ,$67.43 ,$11.67 ,$69.75 ,$11.67 ,$69.75 ,$69.75 ,$69.75 ,$75.18 ,$62.78 ,$72.08 ,$66.65 ,$75.18 
SACRED HEART HOSPITAL (ACU),30500337,85999,HC HEPARIN DOSE RESPONSE,305,1 ,$84.00 ,$63.00 ,$1.83 ,$84.00 ,$54.10 , N/A ,$58.80 ,$1.83 ,$69.72 ,$1.88 ,$55.44 ,$79.80 ,$1.83 ,$67.20 ,$77.28 ,$1.83 ,$71.40 ,$79.80 ,$73.92 ,$63.84 ,$1.83 ,$1.83 ,$1.83 ,$61.32 ,$46.20 ,$76.44 ,$76.44 ,$67.20 , N/A ,$46.20 ,$75.60 , N/A ,$75.60 ,$45.36 ,$78.96 ,$50.40 ,$77.28 ,$1.94 ,$76.44 , N/A ,$51.69 ,$51.69 ,$75.60 ,$62.69 ,$58.51 ,$68.88 ,$1.83 ,$79.80 , N/A ,$1.83 ,$73.08 , N/A ,$75.60 , N/A ,$75.60 ,$75.60 ,$75.60 ,$81.48 ,$68.04 ,$78.12 ,$72.24 ,$81.48 
SACRED HEART HOSPITAL (ACU),30500338,85999,HC PLATELET MAPPING,305,1 ,$679.22 ,$509.42 ,$1.83 ,$679.22 ,$437.42 , N/A ,$475.45 ,$1.83 ,$563.75 ,$1.88 ,$448.29 ,$645.26 ,$1.83 ,$543.38 ,$624.88 ,$1.83 ,$577.34 ,$645.26 ,$597.71 ,$516.21 ,$1.83 ,$1.83 ,$1.83 ,$495.83 ,$373.57 ,$618.09 ,$618.09 ,$543.38 , N/A ,$373.57 ,$611.30 , N/A ,$611.30 ,$366.78 ,$638.47 ,$407.53 ,$624.88 ,$1.94 ,$618.09 , N/A ,$417.99 ,$417.99 ,$611.30 ,$506.90 ,$473.08 ,$556.96 ,$1.83 ,$645.26 , N/A ,$1.83 ,$590.92 , N/A ,$611.30 , N/A ,$611.30 ,$611.30 ,$611.30 ,$658.84 ,$550.17 ,$631.67 ,$584.13 ,$658.84 
SACRED HEART HOSPITAL (ACU),30500339,85999,HC THROMBOELASTOGRAPHY,305,1 ,$264.69 ,$198.52 ,$1.83 ,$264.69 ,$170.46 , N/A ,$185.28 ,$1.83 ,$219.69 ,$1.88 ,$174.70 ,$251.46 ,$1.83 ,$211.75 ,$243.51 ,$1.83 ,$224.99 ,$251.46 ,$232.93 ,$201.16 ,$1.83 ,$1.83 ,$1.83 ,$193.22 ,$145.58 ,$240.87 ,$240.87 ,$211.75 , N/A ,$145.58 ,$238.22 , N/A ,$238.22 ,$142.93 ,$248.81 ,$158.81 ,$243.51 ,$1.94 ,$240.87 , N/A ,$162.89 ,$162.89 ,$238.22 ,$197.54 ,$184.36 ,$217.05 ,$1.83 ,$251.46 , N/A ,$1.83 ,$230.28 , N/A ,$238.22 , N/A ,$238.22 ,$238.22 ,$238.22 ,$256.75 ,$214.40 ,$246.16 ,$227.63 ,$256.75 
SACRED HEART HOSPITAL (ACU),30500340,85018,HC HEMOGLOBIN  - QW,305,1 ,$29.12 ,$21.84 ,$2.37 ,$29.12 ,$18.75 ,$2.37 ,$20.38 ,$2.45 ,$5.69 ,$2.52 ,$4.55 ,$27.66 ,$2.45 ,$23.30 ,$26.79 ,$2.45 ,$24.75 ,$27.66 ,$25.63 ,$22.13 ,$2.45 ,$2.45 ,$2.45 ,$21.26 ,$16.02 ,$26.50 ,$26.50 ,$23.30 ,$2.44 ,$16.02 ,$26.21 ,$2.37 ,$26.21 ,$15.72 ,$27.37 ,$5.33 ,$26.79 ,$2.60 ,$26.50 ,$2.37 ,$17.92 ,$17.92 ,$29.12 ,$21.73 ,$14.92 ,$2.39 ,$2.45 ,$27.66 ,$2.49 ,$2.45 ,$25.33 ,$2.37 ,$26.21 ,$2.37 ,$26.21 ,$26.21 ,$26.21 ,$28.25 ,$23.59 ,$27.08 ,$25.04 ,$28.25 
SACRED HEART HOSPITAL (ACU),30500342,85597,HC PLATELET NEUTRALIZATION,305,1 ,$55.48 ,$41.61 ,$17.98 ,$55.48 ,$35.73 ,$17.98 ,$38.84 ,$18.58 ,$43.16 ,$19.14 ,$34.52 ,$52.71 ,$18.58 ,$44.38 ,$51.04 ,$18.58 ,$47.16 ,$52.71 ,$48.82 ,$42.16 ,$18.58 ,$18.58 ,$18.58 ,$40.50 ,$30.51 ,$50.49 ,$50.49 ,$44.38 ,$18.52 ,$30.51 ,$49.93 ,$17.98 ,$49.93 ,$29.96 ,$52.15 ,$40.46 ,$51.04 ,$19.69 ,$50.49 ,$17.98 ,$34.14 ,$34.14 ,$55.48 ,$41.40 ,$49.93 ,$18.16 ,$18.58 ,$52.71 ,$18.88 ,$18.58 ,$48.27 ,$17.98 ,$49.93 ,$17.98 ,$49.93 ,$49.93 ,$49.93 ,$53.82 ,$44.94 ,$51.60 ,$47.71 ,$53.82 
SACRED HEART HOSPITAL (ACU),30600101,87015,HC CONCENTRATION INFECTIOUS AGENT,306,1 ,$55.00 ,$41.25 ,$5.25 ,$55.00 ,$35.42 ,$6.68 ,$38.50 ,$5.25 ,$8.98 ,$5.41 ,$7.18 ,$52.25 ,$5.25 ,$44.00 ,$50.60 ,$5.25 ,$46.75 ,$52.25 ,$48.40 ,$41.80 ,$5.25 ,$5.25 ,$5.25 ,$40.15 ,$30.25 ,$50.05 ,$50.05 ,$44.00 ,$6.88 ,$30.25 ,$49.50 ,$6.68 ,$49.50 ,$29.70 ,$51.70 ,$15.03 ,$50.60 ,$5.57 ,$50.05 ,$6.68 ,$33.85 ,$33.85 ,$55.00 ,$41.05 ,$41.95 ,$6.75 ,$5.25 ,$52.25 ,$7.01 ,$5.25 ,$47.85 ,$6.68 ,$49.50 ,$6.68 ,$49.50 ,$49.50 ,$49.50 ,$53.35 ,$44.55 ,$51.15 ,$47.30 ,$53.35 
SACRED HEART HOSPITAL (ACU),30600102,87040,HC BLOOD CULTURE,306,1 ,$291.00 ,$218.25 ,$10.32 ,$291.00 ,$187.40 ,$10.32 ,$203.70 ,$10.66 ,$24.78 ,$10.98 ,$19.82 ,$276.45 ,$10.66 ,$232.80 ,$267.72 ,$10.66 ,$247.35 ,$276.45 ,$256.08 ,$221.16 ,$10.66 ,$10.66 ,$10.66 ,$212.43 ,$160.05 ,$264.81 ,$264.81 ,$232.80 ,$10.63 ,$160.05 ,$261.90 ,$10.32 ,$261.90 ,$157.14 ,$273.54 ,$23.22 ,$267.72 ,$11.30 ,$264.81 ,$10.32 ,$179.08 ,$179.08 ,$81.28 ,$217.17 ,$64.87 ,$10.42 ,$10.66 ,$276.45 ,$10.84 ,$10.66 ,$253.17 ,$10.32 ,$261.90 ,$10.32 ,$261.90 ,$261.90 ,$261.90 ,$282.27 ,$235.71 ,$270.63 ,$250.26 ,$282.27 
SACRED HEART HOSPITAL (ACU),30600103,87045,HC STOOL CULTURE,306,1 ,$150.00 ,$112.50 ,$9.44 ,$150.00 ,$96.60 ,$9.44 ,$105.00 ,$9.75 ,$22.66 ,$10.04 ,$18.13 ,$142.50 ,$9.75 ,$120.00 ,$138.00 ,$9.75 ,$127.50 ,$142.50 ,$132.00 ,$114.00 ,$9.75 ,$9.75 ,$9.75 ,$109.50 ,$82.50 ,$136.50 ,$136.50 ,$120.00 ,$9.72 ,$82.50 ,$135.00 ,$9.44 ,$135.00 ,$81.00 ,$141.00 ,$21.24 ,$138.00 ,$10.34 ,$136.50 ,$9.44 ,$92.31 ,$92.31 ,$92.92 ,$111.95 ,$59.37 ,$9.53 ,$9.75 ,$142.50 ,$9.91 ,$9.75 ,$130.50 ,$9.44 ,$135.00 ,$9.44 ,$135.00 ,$135.00 ,$135.00 ,$145.50 ,$121.50 ,$139.50 ,$129.00 ,$145.50 
SACRED HEART HOSPITAL (ACU),30600104,87046,HC STOOL CULTURE ADD ISO,306,1 ,$119.00 ,$89.25 ,$3.40 ,$119.00 ,$76.64 ,$9.44 ,$83.30 ,$3.40 ,$22.66 ,$3.50 ,$18.13 ,$113.05 ,$3.40 ,$95.20 ,$109.48 ,$3.40 ,$101.15 ,$113.05 ,$104.72 ,$90.44 ,$3.40 ,$3.40 ,$3.40 ,$86.87 ,$65.45 ,$108.29 ,$108.29 ,$95.20 ,$9.72 ,$65.45 ,$107.10 ,$9.44 ,$107.10 ,$64.26 ,$111.86 ,$21.24 ,$109.48 ,$3.60 ,$108.29 ,$9.44 ,$73.23 ,$73.23 ,$36.72 ,$88.81 ,$59.37 ,$9.53 ,$3.40 ,$113.05 ,$9.91 ,$3.40 ,$103.53 ,$9.44 ,$107.10 ,$9.44 ,$107.10 ,$107.10 ,$107.10 ,$115.43 ,$96.39 ,$110.67 ,$102.34 ,$115.43 
SACRED HEART HOSPITAL (ACU),30600109,87070,HC BODY FLUID CULTURE,306,1 ,$211.00 ,$158.25 ,$8.62 ,$211.00 ,$135.88 ,$8.62 ,$147.70 ,$8.91 ,$20.69 ,$9.18 ,$16.55 ,$200.45 ,$8.91 ,$168.80 ,$194.12 ,$8.91 ,$179.35 ,$200.45 ,$185.68 ,$160.36 ,$8.91 ,$8.91 ,$8.91 ,$154.03 ,$116.05 ,$192.01 ,$192.01 ,$168.80 ,$8.88 ,$116.05 ,$189.90 ,$8.62 ,$189.90 ,$113.94 ,$198.34 ,$19.40 ,$194.12 ,$9.44 ,$192.01 ,$8.62 ,$129.85 ,$129.85 ,$90.06 ,$157.47 ,$54.17 ,$8.71 ,$8.91 ,$200.45 ,$9.05 ,$8.91 ,$183.57 ,$8.62 ,$189.90 ,$8.62 ,$189.90 ,$189.90 ,$189.90 ,$204.67 ,$170.91 ,$196.23 ,$181.46 ,$204.67 
SACRED HEART HOSPITAL (ACU),30600119,87075,HC CULTURE ANAEROBIC,306,1 ,$230.00 ,$172.50 ,$9.47 ,$230.00 ,$148.12 ,$9.47 ,$161.00 ,$9.79 ,$22.73 ,$10.08 ,$18.19 ,$218.50 ,$9.79 ,$184.00 ,$211.60 ,$9.79 ,$195.50 ,$218.50 ,$202.40 ,$174.80 ,$9.79 ,$9.79 ,$9.79 ,$167.90 ,$126.50 ,$209.30 ,$209.30 ,$184.00 ,$9.75 ,$126.50 ,$207.00 ,$9.47 ,$207.00 ,$124.20 ,$216.20 ,$21.31 ,$211.60 ,$10.38 ,$209.30 ,$9.47 ,$141.54 ,$141.54 ,$87.89 ,$171.65 ,$59.52 ,$9.56 ,$9.79 ,$218.50 ,$9.94 ,$9.79 ,$200.10 ,$9.47 ,$207.00 ,$9.47 ,$207.00 ,$207.00 ,$207.00 ,$223.10 ,$186.30 ,$213.90 ,$197.80 ,$223.10 
SACRED HEART HOSPITAL (ACU),30600121,87076,HC CULTURE ANAEROBIC ID,306,1 ,$168.00 ,$126.00 ,$8.08 ,$168.00 ,$108.19 ,$8.08 ,$117.60 ,$8.35 ,$19.39 ,$8.60 ,$15.51 ,$159.60 ,$8.35 ,$134.40 ,$154.56 ,$8.35 ,$142.80 ,$159.60 ,$147.84 ,$127.68 ,$8.35 ,$8.35 ,$8.35 ,$122.64 ,$92.40 ,$152.88 ,$152.88 ,$134.40 ,$8.32 ,$92.40 ,$151.20 ,$8.08 ,$151.20 ,$90.72 ,$157.92 ,$18.18 ,$154.56 ,$8.85 ,$152.88 ,$8.08 ,$103.39 ,$103.39 ,$92.26 ,$125.38 ,$50.76 ,$8.16 ,$8.35 ,$159.60 ,$8.48 ,$8.35 ,$146.16 ,$8.08 ,$151.20 ,$8.08 ,$151.20 ,$151.20 ,$151.20 ,$162.96 ,$136.08 ,$156.24 ,$144.48 ,$162.96 
SACRED HEART HOSPITAL (ACU),30600123,87077,HC CULTURE AEROBIC ID ADDL,306,1 ,$88.00 ,$66.00 ,$8.08 ,$88.00 ,$56.67 ,$8.08 ,$61.60 ,$8.35 ,$19.39 ,$8.60 ,$15.51 ,$83.60 ,$8.35 ,$70.40 ,$80.96 ,$8.35 ,$74.80 ,$83.60 ,$77.44 ,$66.88 ,$8.35 ,$8.35 ,$8.35 ,$64.24 ,$48.40 ,$80.08 ,$80.08 ,$70.40 ,$8.32 ,$48.40 ,$79.20 ,$8.08 ,$79.20 ,$47.52 ,$82.72 ,$18.18 ,$80.96 ,$8.85 ,$80.08 ,$8.08 ,$54.16 ,$54.16 ,$40.59 ,$65.67 ,$50.76 ,$8.16 ,$8.35 ,$83.60 ,$8.48 ,$8.35 ,$76.56 ,$8.08 ,$79.20 ,$8.08 ,$79.20 ,$79.20 ,$79.20 ,$85.36 ,$71.28 ,$81.84 ,$75.68 ,$85.36 
SACRED HEART HOSPITAL (ACU),30600134,87086,HC CULTURE URINE W/COLONY CT,306,1 ,$144.00 ,$108.00 ,$8.07 ,$144.00 ,$92.74 ,$8.07 ,$100.80 ,$8.34 ,$19.37 ,$8.59 ,$15.50 ,$136.80 ,$8.34 ,$115.20 ,$132.48 ,$8.34 ,$122.40 ,$136.80 ,$126.72 ,$109.44 ,$8.34 ,$8.34 ,$8.34 ,$105.12 ,$79.20 ,$131.04 ,$131.04 ,$115.20 ,$8.31 ,$79.20 ,$129.60 ,$8.07 ,$129.60 ,$77.76 ,$135.36 ,$18.16 ,$132.48 ,$8.84 ,$131.04 ,$8.07 ,$88.62 ,$88.62 ,$70.29 ,$107.47 ,$50.71 ,$8.15 ,$8.34 ,$136.80 ,$8.47 ,$8.34 ,$125.28 ,$8.07 ,$129.60 ,$8.07 ,$129.60 ,$129.60 ,$129.60 ,$139.68 ,$116.64 ,$133.92 ,$123.84 ,$139.68 
SACRED HEART HOSPITAL (ACU),30600135,87088,HC CULTURE URINE ID EA ISOL,306,1 ,$151.00 ,$113.25 ,$8.09 ,$151.00 ,$97.24 ,$8.09 ,$105.70 ,$8.36 ,$19.43 ,$8.61 ,$15.54 ,$143.45 ,$8.36 ,$120.80 ,$138.92 ,$8.36 ,$128.35 ,$143.45 ,$132.88 ,$114.76 ,$8.36 ,$8.36 ,$8.36 ,$110.23 ,$83.05 ,$137.41 ,$137.41 ,$120.80 ,$8.33 ,$83.05 ,$135.90 ,$8.09 ,$135.90 ,$81.54 ,$141.94 ,$18.20 ,$138.92 ,$8.86 ,$137.41 ,$8.09 ,$92.93 ,$92.93 ,$57.99 ,$112.69 ,$50.87 ,$8.17 ,$8.36 ,$143.45 ,$8.49 ,$8.36 ,$131.37 ,$8.09 ,$135.90 ,$8.09 ,$135.90 ,$135.90 ,$135.90 ,$146.47 ,$122.31 ,$140.43 ,$129.86 ,$146.47 
SACRED HEART HOSPITAL (ACU),30600136,87101,HC CULTURE FUNGUS SKIN/HAIR/NAIL,306,1 ,$133.00 ,$99.75 ,$7.71 ,$133.00 ,$85.65 ,$7.71 ,$93.10 ,$7.97 ,$18.50 ,$8.21 ,$14.80 ,$126.35 ,$7.97 ,$106.40 ,$122.36 ,$7.97 ,$113.05 ,$126.35 ,$117.04 ,$101.08 ,$7.97 ,$7.97 ,$7.97 ,$97.09 ,$73.15 ,$121.03 ,$121.03 ,$106.40 ,$7.94 ,$73.15 ,$119.70 ,$7.71 ,$119.70 ,$71.82 ,$125.02 ,$17.35 ,$122.36 ,$8.45 ,$121.03 ,$7.71 ,$81.85 ,$81.85 ,$74.04 ,$99.26 ,$48.42 ,$7.79 ,$7.97 ,$126.35 ,$8.10 ,$7.97 ,$115.71 ,$7.71 ,$119.70 ,$7.71 ,$119.70 ,$119.70 ,$119.70 ,$129.01 ,$107.73 ,$123.69 ,$114.38 ,$129.01 
SACRED HEART HOSPITAL (ACU),30600138,87102,HC CULTURE FUNGUS OTHER,306,1 ,$142.00 ,$106.50 ,$8.41 ,$142.00 ,$91.45 ,$8.41 ,$99.40 ,$8.69 ,$20.18 ,$8.95 ,$16.14 ,$134.90 ,$8.69 ,$113.60 ,$130.64 ,$8.69 ,$120.70 ,$134.90 ,$124.96 ,$107.92 ,$8.69 ,$8.69 ,$8.69 ,$103.66 ,$78.10 ,$129.22 ,$129.22 ,$113.60 ,$8.66 ,$78.10 ,$127.80 ,$8.41 ,$127.80 ,$76.68 ,$133.48 ,$18.92 ,$130.64 ,$9.21 ,$129.22 ,$8.41 ,$87.39 ,$87.39 ,$74.04 ,$105.97 ,$52.85 ,$8.49 ,$8.69 ,$134.90 ,$8.83 ,$8.69 ,$123.54 ,$8.41 ,$127.80 ,$8.41 ,$127.80 ,$127.80 ,$127.80 ,$137.74 ,$115.02 ,$132.06 ,$122.12 ,$137.74 
SACRED HEART HOSPITAL (ACU),30600140,87103,HC CULTURE FUNGUS BLOOD,306,1 ,$208.00 ,$156.00 ,$12.68 ,$208.00 ,$133.95 ,$20.46 ,$145.60 ,$12.68 ,$21.65 ,$13.06 ,$17.32 ,$197.60 ,$12.68 ,$166.40 ,$191.36 ,$12.68 ,$176.80 ,$197.60 ,$183.04 ,$158.08 ,$12.68 ,$12.68 ,$12.68 ,$151.84 ,$114.40 ,$189.28 ,$189.28 ,$166.40 ,$21.07 ,$114.40 ,$187.20 ,$20.46 ,$187.20 ,$112.32 ,$195.52 ,$46.04 ,$191.36 ,$13.44 ,$189.28 ,$20.46 ,$128.00 ,$128.00 ,$46.55 ,$155.23 ,$104.17 ,$20.66 ,$12.68 ,$197.60 ,$21.48 ,$12.68 ,$180.96 ,$20.46 ,$187.20 ,$20.46 ,$187.20 ,$187.20 ,$187.20 ,$201.76 ,$168.48 ,$193.44 ,$178.88 ,$201.76 
SACRED HEART HOSPITAL (ACU),30600141,87106,HC CULTURE FUNGUS ID (ORGANISM),306,1 ,$115.00 ,$86.25 ,$10.32 ,$115.00 ,$74.06 ,$10.32 ,$80.50 ,$10.66 ,$24.78 ,$10.98 ,$19.82 ,$109.25 ,$10.66 ,$92.00 ,$105.80 ,$10.66 ,$97.75 ,$109.25 ,$101.20 ,$87.40 ,$10.66 ,$10.66 ,$10.66 ,$83.95 ,$63.25 ,$104.65 ,$104.65 ,$92.00 ,$10.63 ,$63.25 ,$103.50 ,$10.32 ,$103.50 ,$62.10 ,$108.10 ,$23.22 ,$105.80 ,$11.30 ,$104.65 ,$10.32 ,$70.77 ,$70.77 ,$98.81 ,$85.82 ,$64.87 ,$10.42 ,$10.66 ,$109.25 ,$10.84 ,$10.66 ,$100.05 ,$10.32 ,$103.50 ,$10.32 ,$103.50 ,$103.50 ,$103.50 ,$111.55 ,$93.15 ,$106.95 ,$98.90 ,$111.55 
SACRED HEART HOSPITAL (ACU),30600145,87107,HC CULTURE FUNGUS ID MOLD,306,1 ,$142.00 ,$106.50 ,$10.32 ,$142.00 ,$91.45 ,$10.32 ,$99.40 ,$10.66 ,$24.78 ,$10.98 ,$19.82 ,$134.90 ,$10.66 ,$113.60 ,$130.64 ,$10.66 ,$120.70 ,$134.90 ,$124.96 ,$107.92 ,$10.66 ,$10.66 ,$10.66 ,$103.66 ,$78.10 ,$129.22 ,$129.22 ,$113.60 ,$10.63 ,$78.10 ,$127.80 ,$10.32 ,$127.80 ,$76.68 ,$133.48 ,$23.22 ,$130.64 ,$11.30 ,$129.22 ,$10.32 ,$87.39 ,$87.39 ,$35.74 ,$105.97 ,$64.87 ,$10.42 ,$10.66 ,$134.90 ,$10.84 ,$10.66 ,$123.54 ,$10.32 ,$127.80 ,$10.32 ,$127.80 ,$127.80 ,$127.80 ,$137.74 ,$115.02 ,$132.06 ,$122.12 ,$137.74 
SACRED HEART HOSPITAL (ACU),30600146,87109,HC CULTURE MYCOPLASMA,306,1 ,$215.00 ,$161.25 ,$14.01 ,$215.00 ,$138.46 ,$15.39 ,$150.50 ,$14.01 ,$23.91 ,$14.43 ,$19.12 ,$204.25 ,$14.01 ,$172.00 ,$197.80 ,$14.01 ,$182.75 ,$204.25 ,$189.20 ,$163.40 ,$14.01 ,$14.01 ,$14.01 ,$156.95 ,$118.25 ,$195.65 ,$195.65 ,$172.00 ,$15.85 ,$118.25 ,$193.50 ,$15.39 ,$193.50 ,$116.10 ,$202.10 ,$34.63 ,$197.80 ,$14.85 ,$195.65 ,$15.39 ,$132.31 ,$132.31 ,$83.44 ,$160.45 ,$96.74 ,$15.54 ,$14.01 ,$204.25 ,$16.16 ,$14.01 ,$187.05 ,$15.39 ,$193.50 ,$15.39 ,$193.50 ,$193.50 ,$193.50 ,$208.55 ,$174.15 ,$199.95 ,$184.90 ,$208.55 
SACRED HEART HOSPITAL (ACU),30600147,87110,HC CULTURE CHLAMYDIA,306,1 ,$195.00 ,$146.25 ,$19.60 ,$195.00 ,$125.58 ,$19.60 ,$136.50 ,$20.25 ,$47.04 ,$20.86 ,$37.63 ,$185.25 ,$20.25 ,$156.00 ,$179.40 ,$20.25 ,$165.75 ,$185.25 ,$171.60 ,$148.20 ,$20.25 ,$20.25 ,$20.25 ,$142.35 ,$107.25 ,$177.45 ,$177.45 ,$156.00 ,$20.19 ,$107.25 ,$175.50 ,$19.60 ,$175.50 ,$105.30 ,$183.30 ,$44.10 ,$179.40 ,$21.47 ,$177.45 ,$19.60 ,$120.00 ,$120.00 ,$98.81 ,$145.53 ,$123.17 ,$19.80 ,$20.25 ,$185.25 ,$20.58 ,$20.25 ,$169.65 ,$19.60 ,$175.50 ,$19.60 ,$175.50 ,$175.50 ,$175.50 ,$189.15 ,$157.95 ,$181.35 ,$167.70 ,$189.15 
SACRED HEART HOSPITAL (ACU),30600148,87116,HC CULTURE AFB/TB/MYCOBACT,306,1 ,$281.00 ,$210.75 ,$10.80 ,$281.00 ,$180.96 ,$10.80 ,$196.70 ,$11.16 ,$25.94 ,$11.49 ,$20.75 ,$266.95 ,$11.16 ,$224.80 ,$258.52 ,$11.16 ,$238.85 ,$266.95 ,$247.28 ,$213.56 ,$11.16 ,$11.16 ,$11.16 ,$205.13 ,$154.55 ,$255.71 ,$255.71 ,$224.80 ,$11.12 ,$154.55 ,$252.90 ,$10.80 ,$252.90 ,$151.74 ,$264.14 ,$24.30 ,$258.52 ,$11.83 ,$255.71 ,$10.80 ,$172.93 ,$172.93 ,$76.87 ,$209.71 ,$67.92 ,$10.91 ,$11.16 ,$266.95 ,$11.34 ,$11.16 ,$244.47 ,$10.80 ,$252.90 ,$10.80 ,$252.90 ,$252.90 ,$252.90 ,$272.57 ,$227.61 ,$261.33 ,$241.66 ,$272.57 
SACRED HEART HOSPITAL (ACU),30600159,87147,HC CULTURE TYPE SEROLOGIC,306,1 ,$41.00 ,$30.75 ,$5.18 ,$41.00 ,$26.40 ,$5.18 ,$28.70 ,$5.35 ,$12.43 ,$5.51 ,$9.94 ,$38.95 ,$5.35 ,$32.80 ,$37.72 ,$5.35 ,$34.85 ,$38.95 ,$36.08 ,$31.16 ,$5.35 ,$5.35 ,$5.35 ,$29.93 ,$22.55 ,$37.31 ,$37.31 ,$32.80 ,$5.34 ,$22.55 ,$36.90 ,$5.18 ,$36.90 ,$22.14 ,$38.54 ,$11.66 ,$37.72 ,$5.67 ,$37.31 ,$5.18 ,$25.23 ,$25.23 ,$41.00 ,$30.60 ,$32.54 ,$5.23 ,$5.35 ,$38.95 ,$5.44 ,$5.35 ,$35.67 ,$5.18 ,$36.90 ,$5.18 ,$36.90 ,$36.90 ,$36.90 ,$39.77 ,$33.21 ,$38.13 ,$35.26 ,$39.77 
SACRED HEART HOSPITAL (ACU),30600160,87150,HC ID NUCLEAR ACID PROBE,306,1 ,$157.00 ,$117.75 ,$35.09 ,$157.00 ,$101.11 ,$35.09 ,$109.90 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$149.15 ,$36.26 ,$125.60 ,$144.44 ,$36.26 ,$133.45 ,$149.15 ,$138.16 ,$119.32 ,$36.26 ,$36.26 ,$36.26 ,$114.61 ,$86.35 ,$142.87 ,$142.87 ,$125.60 ,$36.14 ,$86.35 ,$141.30 ,$35.09 ,$141.30 ,$84.78 ,$147.58 ,$78.95 ,$144.44 ,$38.44 ,$142.87 ,$35.09 ,$96.62 ,$96.62 ,$57.50 ,$117.17 ,$141.30 ,$35.44 ,$36.26 ,$149.15 ,$36.84 ,$36.26 ,$136.59 ,$35.09 ,$141.30 ,$35.09 ,$141.30 ,$141.30 ,$141.30 ,$152.29 ,$127.17 ,$146.01 ,$135.02 ,$152.29 
SACRED HEART HOSPITAL (ACU),30600161,87168,HC EXAM ARTHROPOD,306,1 ,$71.00 ,$53.25 ,$4.27 ,$71.00 ,$45.72 ,$4.27 ,$49.70 ,$4.41 ,$10.26 ,$4.54 ,$8.20 ,$67.45 ,$4.41 ,$56.80 ,$65.32 ,$4.41 ,$60.35 ,$67.45 ,$62.48 ,$53.96 ,$4.41 ,$4.41 ,$4.41 ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 ,$4.40 ,$39.05 ,$63.90 ,$4.27 ,$63.90 ,$38.34 ,$66.74 ,$9.61 ,$65.32 ,$4.67 ,$64.61 ,$4.27 ,$43.69 ,$43.69 ,$10.63 ,$52.99 ,$26.83 ,$4.31 ,$4.41 ,$67.45 ,$4.48 ,$4.41 ,$61.77 ,$4.27 ,$63.90 ,$4.27 ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),30600162,87169,HC PARASITE ID,306,1 ,$71.00 ,$53.25 ,$4.31 ,$71.00 ,$45.72 ,$4.31 ,$49.70 ,$4.45 ,$10.26 ,$4.58 ,$8.20 ,$67.45 ,$4.45 ,$56.80 ,$65.32 ,$4.45 ,$60.35 ,$67.45 ,$62.48 ,$53.96 ,$4.45 ,$4.45 ,$4.45 ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 ,$4.44 ,$39.05 ,$63.90 ,$4.31 ,$63.90 ,$38.34 ,$66.74 ,$9.70 ,$65.32 ,$4.72 ,$64.61 ,$4.31 ,$43.69 ,$43.69 ,$10.63 ,$52.99 ,$26.83 ,$4.35 ,$4.45 ,$67.45 ,$4.53 ,$4.45 ,$61.77 ,$4.31 ,$63.90 ,$4.31 ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),30600163,87172,HC PINWORM EXAM,306,1 ,$89.00 ,$66.75 ,$4.27 ,$89.00 ,$57.32 ,$4.27 ,$62.30 ,$4.41 ,$10.26 ,$4.54 ,$8.20 ,$84.55 ,$4.41 ,$71.20 ,$81.88 ,$4.41 ,$75.65 ,$84.55 ,$78.32 ,$67.64 ,$4.41 ,$4.41 ,$4.41 ,$64.97 ,$48.95 ,$80.99 ,$80.99 ,$71.20 ,$4.40 ,$48.95 ,$80.10 ,$4.27 ,$80.10 ,$48.06 ,$83.66 ,$9.61 ,$81.88 ,$4.67 ,$80.99 ,$4.27 ,$54.77 ,$54.77 ,$10.63 ,$66.42 ,$26.83 ,$4.31 ,$4.41 ,$84.55 ,$4.48 ,$4.41 ,$77.43 ,$4.27 ,$80.10 ,$4.27 ,$80.10 ,$80.10 ,$80.10 ,$86.33 ,$72.09 ,$82.77 ,$76.54 ,$86.33 
SACRED HEART HOSPITAL (ACU),30600164,87177,HC SMEAR OVA PARASITE CONC/ID,306,1 ,$156.00 ,$117.00 ,$8.90 ,$156.00 ,$100.46 ,$8.90 ,$109.20 ,$9.20 ,$21.37 ,$9.48 ,$17.09 ,$148.20 ,$9.20 ,$124.80 ,$143.52 ,$9.20 ,$132.60 ,$148.20 ,$137.28 ,$118.56 ,$9.20 ,$9.20 ,$9.20 ,$113.88 ,$85.80 ,$141.96 ,$141.96 ,$124.80 ,$9.17 ,$85.80 ,$140.40 ,$8.90 ,$140.40 ,$84.24 ,$146.64 ,$20.03 ,$143.52 ,$9.75 ,$141.96 ,$8.90 ,$96.00 ,$96.00 ,$83.44 ,$116.42 ,$55.96 ,$8.99 ,$9.20 ,$148.20 ,$9.35 ,$9.20 ,$135.72 ,$8.90 ,$140.40 ,$8.90 ,$140.40 ,$140.40 ,$140.40 ,$151.32 ,$126.36 ,$145.08 ,$134.16 ,$151.32 
SACRED HEART HOSPITAL (ACU),30600166,87181,HC SENSITIVITY STUDY AGAR,306,1 ,$90.00 ,$67.50 ,$4.75 ,$90.00 ,$57.96 ,$4.75 ,$63.00 ,$4.91 ,$11.39 ,$5.06 ,$9.11 ,$85.50 ,$4.91 ,$72.00 ,$82.80 ,$4.91 ,$76.50 ,$85.50 ,$79.20 ,$68.40 ,$4.91 ,$4.91 ,$4.91 ,$65.70 ,$49.50 ,$81.90 ,$81.90 ,$72.00 ,$4.89 ,$49.50 ,$81.00 ,$4.75 ,$81.00 ,$48.60 ,$84.60 ,$10.69 ,$82.80 ,$5.20 ,$81.90 ,$4.75 ,$55.39 ,$55.39 ,$49.41 ,$67.17 ,$29.84 ,$4.80 ,$4.91 ,$85.50 ,$4.99 ,$4.91 ,$78.30 ,$4.75 ,$81.00 ,$4.75 ,$81.00 ,$81.00 ,$81.00 ,$87.30 ,$72.90 ,$83.70 ,$77.40 ,$87.30 
SACRED HEART HOSPITAL (ACU),30600169,87184,HC SENSITIVITY DISK KB,306,1 ,$125.00 ,$93.75 ,$7.48 ,$125.00 ,$80.50 ,$7.48 ,$87.50 ,$7.73 ,$16.56 ,$7.96 ,$13.24 ,$118.75 ,$7.73 ,$100.00 ,$115.00 ,$7.73 ,$106.25 ,$118.75 ,$110.00 ,$95.00 ,$7.73 ,$7.73 ,$7.73 ,$91.25 ,$68.75 ,$113.75 ,$113.75 ,$100.00 ,$7.70 ,$68.75 ,$112.50 ,$7.48 ,$112.50 ,$67.50 ,$117.50 ,$16.83 ,$115.00 ,$8.19 ,$113.75 ,$7.48 ,$76.93 ,$76.93 ,$57.99 ,$93.29 ,$43.33 ,$7.55 ,$7.73 ,$118.75 ,$7.85 ,$7.73 ,$108.75 ,$7.48 ,$112.50 ,$7.48 ,$112.50 ,$112.50 ,$112.50 ,$121.25 ,$101.25 ,$116.25 ,$107.50 ,$121.25 
SACRED HEART HOSPITAL (ACU),30600171,87185,HC BETA LACTAMASE,306,1 ,$92.00 ,$69.00 ,$4.75 ,$92.00 ,$59.25 ,$4.75 ,$64.40 ,$4.91 ,$11.39 ,$5.06 ,$9.11 ,$87.40 ,$4.91 ,$73.60 ,$84.64 ,$4.91 ,$78.20 ,$87.40 ,$80.96 ,$69.92 ,$4.91 ,$4.91 ,$4.91 ,$67.16 ,$50.60 ,$83.72 ,$83.72 ,$73.60 ,$4.89 ,$50.60 ,$82.80 ,$4.75 ,$82.80 ,$49.68 ,$86.48 ,$10.69 ,$84.64 ,$5.20 ,$83.72 ,$4.75 ,$56.62 ,$56.62 ,$26.09 ,$68.66 ,$29.84 ,$4.80 ,$4.91 ,$87.40 ,$4.99 ,$4.91 ,$80.04 ,$4.75 ,$82.80 ,$4.75 ,$82.80 ,$82.80 ,$82.80 ,$89.24 ,$74.52 ,$85.56 ,$79.12 ,$89.24 
SACRED HEART HOSPITAL (ACU),30600172,87186,HC SENSITIVITY MIC,306,1 ,$166.00 ,$124.50 ,$8.65 ,$166.00 ,$106.90 ,$8.65 ,$116.20 ,$8.94 ,$20.76 ,$9.21 ,$16.60 ,$157.70 ,$8.94 ,$132.80 ,$152.72 ,$8.94 ,$141.10 ,$157.70 ,$146.08 ,$126.16 ,$8.94 ,$8.94 ,$8.94 ,$121.18 ,$91.30 ,$151.06 ,$151.06 ,$132.80 ,$8.91 ,$91.30 ,$149.40 ,$8.65 ,$149.40 ,$89.64 ,$156.04 ,$19.46 ,$152.72 ,$9.48 ,$151.06 ,$8.65 ,$102.16 ,$102.16 ,$79.70 ,$123.89 ,$54.33 ,$8.74 ,$8.94 ,$157.70 ,$9.08 ,$8.94 ,$144.42 ,$8.65 ,$149.40 ,$8.65 ,$149.40 ,$149.40 ,$149.40 ,$161.02 ,$134.46 ,$154.38 ,$142.76 ,$161.02 
SACRED HEART HOSPITAL (ACU),30600174,87205,HC SMEAR GRAM/GIEMSA,306,1 ,$115.00 ,$86.25 ,$4.27 ,$115.00 ,$74.06 ,$4.27 ,$80.50 ,$4.41 ,$10.26 ,$4.54 ,$8.20 ,$109.25 ,$4.41 ,$92.00 ,$105.80 ,$4.41 ,$97.75 ,$109.25 ,$101.20 ,$87.40 ,$4.41 ,$4.41 ,$4.41 ,$83.95 ,$63.25 ,$104.65 ,$104.65 ,$92.00 ,$4.40 ,$63.25 ,$103.50 ,$4.27 ,$103.50 ,$62.10 ,$108.10 ,$9.61 ,$105.80 ,$4.67 ,$104.65 ,$4.27 ,$70.77 ,$70.77 ,$36.04 ,$85.82 ,$26.83 ,$4.31 ,$4.41 ,$109.25 ,$4.48 ,$4.41 ,$100.05 ,$4.27 ,$103.50 ,$4.27 ,$103.50 ,$103.50 ,$103.50 ,$111.55 ,$93.15 ,$106.95 ,$98.90 ,$111.55 
SACRED HEART HOSPITAL (ACU),30600176,87206,HC SMEAR ACID FAST/FLUOR,306,1 ,$76.00 ,$57.00 ,$5.39 ,$76.00 ,$48.94 ,$5.39 ,$53.20 ,$5.57 ,$12.93 ,$5.74 ,$10.35 ,$72.20 ,$5.57 ,$60.80 ,$69.92 ,$5.57 ,$64.60 ,$72.20 ,$66.88 ,$57.76 ,$5.57 ,$5.57 ,$5.57 ,$55.48 ,$41.80 ,$69.16 ,$69.16 ,$60.80 ,$5.55 ,$41.80 ,$68.40 ,$5.39 ,$68.40 ,$41.04 ,$71.44 ,$12.13 ,$69.92 ,$5.90 ,$69.16 ,$5.39 ,$46.77 ,$46.77 ,$62.87 ,$56.72 ,$33.86 ,$5.44 ,$5.57 ,$72.20 ,$5.66 ,$5.57 ,$66.12 ,$5.39 ,$68.40 ,$5.39 ,$68.40 ,$68.40 ,$68.40 ,$73.72 ,$61.56 ,$70.68 ,$65.36 ,$73.72 
SACRED HEART HOSPITAL (ACU),30600182,87209,HC OVA  AND  PARASITE W/STAIN,306,1 ,$64.00 ,$48.00 ,$17.98 ,$64.00 ,$41.22 ,$17.98 ,$44.80 ,$18.58 ,$43.16 ,$19.14 ,$34.52 ,$60.80 ,$18.58 ,$51.20 ,$58.88 ,$18.58 ,$54.40 ,$60.80 ,$56.32 ,$48.64 ,$18.58 ,$18.58 ,$18.58 ,$46.72 ,$35.20 ,$58.24 ,$58.24 ,$51.20 ,$18.52 ,$35.20 ,$57.60 ,$17.98 ,$57.60 ,$34.56 ,$60.16 ,$40.46 ,$58.88 ,$19.69 ,$58.24 ,$17.98 ,$39.39 ,$39.39 ,$53.13 ,$47.76 ,$57.60 ,$18.16 ,$18.58 ,$60.80 ,$18.88 ,$18.58 ,$55.68 ,$17.98 ,$57.60 ,$17.98 ,$57.60 ,$57.60 ,$57.60 ,$62.08 ,$51.84 ,$59.52 ,$55.04 ,$62.08 
SACRED HEART HOSPITAL (ACU),30600183,87210,HC SMEAR WET MOUNT,306,1 ,$105.00 ,$78.75 ,$5.82 ,$105.00 ,$67.62 ,$5.82 ,$73.50 ,$6.00 ,$10.26 ,$6.18 ,$8.20 ,$99.75 ,$6.00 ,$84.00 ,$96.60 ,$6.00 ,$89.25 ,$99.75 ,$92.40 ,$79.80 ,$6.00 ,$6.00 ,$6.00 ,$76.65 ,$57.75 ,$95.55 ,$95.55 ,$84.00 ,$5.99 ,$57.75 ,$94.50 ,$5.82 ,$94.50 ,$56.70 ,$98.70 ,$13.10 ,$96.60 ,$6.36 ,$95.55 ,$5.82 ,$64.62 ,$64.62 ,$48.30 ,$78.36 ,$29.63 ,$5.88 ,$6.00 ,$99.75 ,$6.11 ,$6.00 ,$91.35 ,$5.82 ,$94.50 ,$5.82 ,$94.50 ,$94.50 ,$94.50 ,$101.85 ,$85.05 ,$97.65 ,$90.30 ,$101.85 
SACRED HEART HOSPITAL (ACU),30600185,87220,HC TISSUE KOH PREP,306,1 ,$140.00 ,$105.00 ,$4.27 ,$140.00 ,$90.16 ,$4.27 ,$98.00 ,$4.41 ,$10.26 ,$4.54 ,$8.20 ,$133.00 ,$4.41 ,$112.00 ,$128.80 ,$4.41 ,$119.00 ,$133.00 ,$123.20 ,$106.40 ,$4.41 ,$4.41 ,$4.41 ,$102.20 ,$77.00 ,$127.40 ,$127.40 ,$112.00 ,$4.40 ,$77.00 ,$126.00 ,$4.27 ,$126.00 ,$75.60 ,$131.60 ,$9.61 ,$128.80 ,$4.67 ,$127.40 ,$4.27 ,$86.16 ,$86.16 ,$34.07 ,$104.48 ,$26.83 ,$4.31 ,$4.41 ,$133.00 ,$4.48 ,$4.41 ,$121.80 ,$4.27 ,$126.00 ,$4.27 ,$126.00 ,$126.00 ,$126.00 ,$135.80 ,$113.40 ,$130.20 ,$120.40 ,$135.80 
SACRED HEART HOSPITAL (ACU),30600213,87324,HC EIA QL CLOS DIFF TOXIN AG,306,1 ,$66.00 ,$49.50 ,$11.98 ,$66.00 ,$42.50 ,$11.98 ,$46.20 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$62.70 ,$12.38 ,$52.80 ,$60.72 ,$12.38 ,$56.10 ,$62.70 ,$58.08 ,$50.16 ,$12.38 ,$12.38 ,$12.38 ,$48.18 ,$36.30 ,$60.06 ,$60.06 ,$52.80 ,$12.34 ,$36.30 ,$59.40 ,$11.98 ,$59.40 ,$35.64 ,$62.04 ,$26.96 ,$60.72 ,$13.12 ,$60.06 ,$11.98 ,$40.62 ,$40.62 ,$51.16 ,$49.26 ,$59.40 ,$12.10 ,$12.38 ,$62.70 ,$12.58 ,$12.38 ,$57.42 ,$11.98 ,$59.40 ,$11.98 ,$59.40 ,$59.40 ,$59.40 ,$64.02 ,$53.46 ,$61.38 ,$56.76 ,$64.02 
SACRED HEART HOSPITAL (ACU),30600215,87328,HC EIA QL CRYPTOSPORIDIUM AG,306,1 ,$233.00 ,$174.75 ,$13.82 ,$233.00 ,$150.05 ,$13.82 ,$163.10 ,$14.28 ,$28.77 ,$14.71 ,$23.02 ,$221.35 ,$14.28 ,$186.40 ,$214.36 ,$14.28 ,$198.05 ,$221.35 ,$205.04 ,$177.08 ,$14.28 ,$14.28 ,$14.28 ,$170.09 ,$128.15 ,$212.03 ,$212.03 ,$186.40 ,$14.23 ,$128.15 ,$209.70 ,$13.82 ,$209.70 ,$125.82 ,$219.02 ,$31.10 ,$214.36 ,$15.14 ,$212.03 ,$13.82 ,$143.39 ,$143.39 ,$51.16 ,$173.89 ,$75.36 ,$13.96 ,$14.28 ,$221.35 ,$14.51 ,$14.28 ,$202.71 ,$13.82 ,$209.70 ,$13.82 ,$209.70 ,$209.70 ,$209.70 ,$226.01 ,$188.73 ,$216.69 ,$200.38 ,$226.01 
SACRED HEART HOSPITAL (ACU),30600216,87329,HC EIA QL GIARDIA AG,306,1 ,$218.00 ,$163.50 ,$11.98 ,$218.00 ,$140.39 ,$11.98 ,$152.60 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$207.10 ,$12.38 ,$174.40 ,$200.56 ,$12.38 ,$185.30 ,$207.10 ,$191.84 ,$165.68 ,$12.38 ,$12.38 ,$12.38 ,$159.14 ,$119.90 ,$198.38 ,$198.38 ,$174.40 ,$12.34 ,$119.90 ,$196.20 ,$11.98 ,$196.20 ,$117.72 ,$204.92 ,$26.96 ,$200.56 ,$13.12 ,$198.38 ,$11.98 ,$134.16 ,$134.16 ,$36.23 ,$162.69 ,$75.36 ,$12.10 ,$12.38 ,$207.10 ,$12.58 ,$12.38 ,$189.66 ,$11.98 ,$196.20 ,$11.98 ,$196.20 ,$196.20 ,$196.20 ,$211.46 ,$176.58 ,$202.74 ,$187.48 ,$211.46 
SACRED HEART HOSPITAL (ACU),30600217,87338,HC EIA QL H PYLORI AG STOOL,306,1 ,$518.00 ,$388.50 ,$14.38 ,$518.00 ,$333.59 ,$14.38 ,$362.60 ,$14.86 ,$34.53 ,$15.31 ,$27.62 ,$492.10 ,$14.86 ,$414.40 ,$476.56 ,$14.86 ,$440.30 ,$492.10 ,$455.84 ,$393.68 ,$14.86 ,$14.86 ,$14.86 ,$378.14 ,$284.90 ,$471.38 ,$471.38 ,$414.40 ,$14.81 ,$284.90 ,$466.20 ,$14.38 ,$466.20 ,$279.72 ,$486.92 ,$32.36 ,$476.56 ,$15.75 ,$471.38 ,$14.38 ,$318.78 ,$318.78 ,$49.72 ,$386.58 ,$90.43 ,$14.52 ,$14.86 ,$492.10 ,$15.10 ,$14.86 ,$450.66 ,$14.38 ,$466.20 ,$14.38 ,$466.20 ,$466.20 ,$466.20 ,$502.46 ,$419.58 ,$481.74 ,$445.48 ,$502.46 
SACRED HEART HOSPITAL (ACU),30600222,87385,HC EIA QL HISTOPLASMA AG,306,1 ,$209.00 ,$156.75 ,$13.25 ,$209.00 ,$134.60 ,$13.25 ,$146.30 ,$13.69 ,$28.77 ,$14.10 ,$23.02 ,$198.55 ,$13.69 ,$167.20 ,$192.28 ,$13.69 ,$177.65 ,$198.55 ,$183.92 ,$158.84 ,$13.69 ,$13.69 ,$13.69 ,$152.57 ,$114.95 ,$190.19 ,$190.19 ,$167.20 ,$13.65 ,$114.95 ,$188.10 ,$13.25 ,$188.10 ,$112.86 ,$196.46 ,$29.81 ,$192.28 ,$14.51 ,$190.19 ,$13.25 ,$128.62 ,$128.62 ,$51.16 ,$155.98 ,$75.36 ,$13.38 ,$13.69 ,$198.55 ,$13.91 ,$13.69 ,$181.83 ,$13.25 ,$188.10 ,$13.25 ,$188.10 ,$188.10 ,$188.10 ,$202.73 ,$169.29 ,$194.37 ,$179.74 ,$202.73 
SACRED HEART HOSPITAL (ACU),30600225,87400,HC EIA QL INFLUENZA A/B AG,306,1 ,$227.00 ,$170.25 ,$8.66 ,$227.00 ,$146.19 ,$14.13 ,$158.90 ,$8.66 ,$28.77 ,$8.92 ,$23.02 ,$215.65 ,$8.66 ,$181.60 ,$208.84 ,$8.66 ,$192.95 ,$215.65 ,$199.76 ,$172.52 ,$8.66 ,$8.66 ,$8.66 ,$165.71 ,$124.85 ,$206.57 ,$206.57 ,$181.60 ,$14.55 ,$124.85 ,$204.30 ,$14.13 ,$204.30 ,$122.58 ,$213.38 ,$31.79 ,$208.84 ,$9.18 ,$206.57 ,$14.13 ,$139.70 ,$139.70 ,$28.98 ,$169.41 ,$75.36 ,$14.27 ,$8.66 ,$215.65 ,$14.84 ,$8.66 ,$197.49 ,$14.13 ,$204.30 ,$14.13 ,$204.30 ,$204.30 ,$204.30 ,$220.19 ,$183.87 ,$211.11 ,$195.22 ,$220.19 
SACRED HEART HOSPITAL (ACU),30600226,87420,HC RSV AG QL,306,1 ,$299.00 ,$224.25 ,$13.91 ,$299.00 ,$192.56 ,$13.91 ,$209.30 ,$14.37 ,$28.77 ,$14.80 ,$23.02 ,$284.05 ,$14.37 ,$239.20 ,$275.08 ,$14.37 ,$254.15 ,$284.05 ,$263.12 ,$227.24 ,$14.37 ,$14.37 ,$14.37 ,$218.27 ,$164.45 ,$272.09 ,$272.09 ,$239.20 ,$14.33 ,$164.45 ,$269.10 ,$13.91 ,$269.10 ,$161.46 ,$281.06 ,$31.30 ,$275.08 ,$15.23 ,$272.09 ,$13.91 ,$184.00 ,$184.00 ,$51.16 ,$223.14 ,$75.36 ,$14.05 ,$14.37 ,$284.05 ,$14.61 ,$14.37 ,$260.13 ,$13.91 ,$269.10 ,$13.91 ,$269.10 ,$269.10 ,$269.10 ,$290.03 ,$242.19 ,$278.07 ,$257.14 ,$290.03 
SACRED HEART HOSPITAL (ACU),30600227,87425,HC EIA QL ROTAVIRUS AG,306,1 ,$298.00 ,$223.50 ,$11.98 ,$298.00 ,$191.91 ,$11.98 ,$208.60 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$283.10 ,$12.38 ,$238.40 ,$274.16 ,$12.38 ,$253.30 ,$283.10 ,$262.24 ,$226.48 ,$12.38 ,$12.38 ,$12.38 ,$217.54 ,$163.90 ,$271.18 ,$271.18 ,$238.40 ,$12.34 ,$163.90 ,$268.20 ,$11.98 ,$268.20 ,$160.92 ,$280.12 ,$26.96 ,$274.16 ,$13.12 ,$271.18 ,$11.98 ,$183.39 ,$183.39 ,$51.16 ,$222.40 ,$75.36 ,$12.10 ,$12.38 ,$283.10 ,$12.58 ,$12.38 ,$259.26 ,$11.98 ,$268.20 ,$11.98 ,$268.20 ,$268.20 ,$268.20 ,$289.06 ,$241.38 ,$277.14 ,$256.28 ,$289.06 
SACRED HEART HOSPITAL (ACU),30600228,87430,HC RAPID STREP,306,1 ,$71.00 ,$53.25 ,$16.81 ,$71.00 ,$45.72 ,$16.81 ,$49.70 ,$16.86 ,$28.77 ,$17.37 ,$23.02 ,$67.45 ,$16.86 ,$56.80 ,$65.32 ,$16.86 ,$60.35 ,$67.45 ,$62.48 ,$53.96 ,$16.86 ,$16.86 ,$16.86 ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 ,$17.31 ,$39.05 ,$63.90 ,$16.81 ,$63.90 ,$38.34 ,$66.74 ,$37.82 ,$65.32 ,$17.87 ,$64.61 ,$16.81 ,$43.69 ,$43.69 ,$24.36 ,$52.99 ,$63.90 ,$16.98 ,$16.86 ,$67.45 ,$17.65 ,$16.86 ,$61.77 ,$16.81 ,$63.90 ,$16.81 ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),30600236,87491,HC CHLAMYDIA TRACH AMP,306,1 ,$231.00 ,$173.25 ,$35.09 ,$231.00 ,$148.76 ,$35.09 ,$161.70 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$219.45 ,$36.26 ,$184.80 ,$212.52 ,$36.26 ,$196.35 ,$219.45 ,$203.28 ,$175.56 ,$36.26 ,$36.26 ,$36.26 ,$168.63 ,$127.05 ,$210.21 ,$210.21 ,$184.80 ,$36.14 ,$127.05 ,$207.90 ,$35.09 ,$207.90 ,$124.74 ,$217.14 ,$78.95 ,$212.52 ,$38.44 ,$210.21 ,$35.09 ,$142.16 ,$142.16 ,$149.23 ,$172.40 ,$207.90 ,$35.44 ,$36.26 ,$219.45 ,$36.84 ,$36.26 ,$200.97 ,$35.09 ,$207.90 ,$35.09 ,$207.90 ,$207.90 ,$207.90 ,$224.07 ,$187.11 ,$214.83 ,$198.66 ,$224.07 
SACRED HEART HOSPITAL (ACU),30600237,87493,HC CLOSTRIDUM DIFFICILE,306,1 ,$149.00 ,$111.75 ,$37.27 ,$149.00 ,$95.96 ,$37.27 ,$104.30 ,$38.51 ,$84.25 ,$39.67 ,$67.40 ,$141.55 ,$38.51 ,$119.20 ,$137.08 ,$38.51 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$38.51 ,$38.51 ,$38.51 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,$38.39 ,$81.95 ,$134.10 ,$37.27 ,$134.10 ,$80.46 ,$140.06 ,$83.86 ,$137.08 ,$40.82 ,$135.59 ,$37.27 ,$91.69 ,$91.69 ,$104.04 ,$111.20 ,$134.10 ,$37.64 ,$38.51 ,$141.55 ,$39.13 ,$38.51 ,$129.63 ,$37.27 ,$134.10 ,$37.27 ,$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),30600238,87497,HC CMV QN,306,1 ,$399.00 ,$299.25 ,$42.84 ,$399.00 ,$256.96 ,$42.84 ,$279.30 ,$44.27 ,$102.83 ,$45.60 ,$82.26 ,$379.05 ,$44.27 ,$319.20 ,$367.08 ,$44.27 ,$339.15 ,$379.05 ,$351.12 ,$303.24 ,$44.27 ,$44.27 ,$44.27 ,$291.27 ,$219.45 ,$363.09 ,$363.09 ,$319.20 ,$44.13 ,$219.45 ,$359.10 ,$42.84 ,$359.10 ,$215.46 ,$375.06 ,$96.39 ,$367.08 ,$46.93 ,$363.09 ,$42.84 ,$245.54 ,$245.54 ,$181.23 ,$297.77 ,$269.24 ,$43.27 ,$44.27 ,$379.05 ,$44.98 ,$44.27 ,$347.13 ,$42.84 ,$359.10 ,$42.84 ,$359.10 ,$359.10 ,$359.10 ,$387.03 ,$323.19 ,$371.07 ,$343.14 ,$387.03 
SACRED HEART HOSPITAL (ACU),30600244,87529,HC HERPES SIMPLEX AMP,306,1 ,$56.00 ,$42.00 ,$30.24 ,$78.95 ,$36.06 ,$35.09 ,$39.20 ,$36.26 ,$56.00 ,$37.35 ,$56.00 ,$53.20 ,$36.26 ,$44.80 ,$51.52 ,$36.26 ,$47.60 ,$53.20 ,$49.28 ,$42.56 ,$36.26 ,$36.26 ,$36.26 ,$40.88 ,$30.80 ,$50.96 ,$50.96 ,$44.80 ,$36.14 ,$30.80 ,$50.40 ,$35.09 ,$50.40 ,$30.24 ,$52.64 ,$78.95 ,$51.52 ,$38.44 ,$50.96 ,$35.09 ,$34.46 ,$34.46 ,$56.00 ,$41.79 ,$50.40 ,$35.44 ,$36.26 ,$53.20 ,$36.84 ,$36.26 ,$48.72 ,$35.09 ,$50.40 ,$35.09 ,$50.40 ,$50.40 ,$50.40 ,$54.32 ,$45.36 ,$52.08 ,$48.16 ,$54.32 
SACRED HEART HOSPITAL (ACU),30600249,87591,HC NEISSERIA AMP,306,1 ,$231.00 ,$173.25 ,$35.09 ,$231.00 ,$148.76 ,$35.09 ,$161.70 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$219.45 ,$36.26 ,$184.80 ,$212.52 ,$36.26 ,$196.35 ,$219.45 ,$203.28 ,$175.56 ,$36.26 ,$36.26 ,$36.26 ,$168.63 ,$127.05 ,$210.21 ,$210.21 ,$184.80 ,$36.14 ,$127.05 ,$207.90 ,$35.09 ,$207.90 ,$124.74 ,$217.14 ,$78.95 ,$212.52 ,$38.44 ,$210.21 ,$35.09 ,$142.16 ,$142.16 ,$149.23 ,$172.40 ,$207.90 ,$35.44 ,$36.26 ,$219.45 ,$36.84 ,$36.26 ,$200.97 ,$35.09 ,$207.90 ,$35.09 ,$207.90 ,$207.90 ,$207.90 ,$224.07 ,$187.11 ,$214.83 ,$198.66 ,$224.07 
SACRED HEART HOSPITAL (ACU),30600252,87624,HC HPV AMP,306,1 ,$157.00 ,$117.75 ,$35.09 ,$157.00 ,$101.11 ,$35.09 ,$109.90 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$149.15 ,$36.26 ,$125.60 ,$144.44 ,$36.26 ,$133.45 ,$149.15 ,$138.16 ,$119.32 ,$36.26 ,$36.26 ,$36.26 ,$114.61 ,$86.35 ,$142.87 ,$142.87 ,$125.60 ,$36.14 ,$86.35 ,$141.30 ,$35.09 ,$141.30 ,$84.78 ,$147.58 ,$78.95 ,$144.44 ,$38.44 ,$142.87 ,$35.09 ,$96.62 ,$96.62 ,$91.72 ,$117.17 ,$141.30 ,$35.44 ,$36.26 ,$149.15 ,$36.84 ,$36.26 ,$136.59 ,$35.09 ,$141.30 ,$35.09 ,$141.30 ,$141.30 ,$141.30 ,$152.29 ,$127.17 ,$146.01 ,$135.02 ,$152.29 
SACRED HEART HOSPITAL (ACU),30600255,87641,HC MRSA AMP,306,1 ,$425.00 ,$318.75 ,$35.09 ,$425.00 ,$273.70 ,$35.09 ,$297.50 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$403.75 ,$36.26 ,$340.00 ,$391.00 ,$36.26 ,$361.25 ,$403.75 ,$374.00 ,$323.00 ,$36.26 ,$36.26 ,$36.26 ,$310.25 ,$233.75 ,$386.75 ,$386.75 ,$340.00 ,$36.14 ,$233.75 ,$382.50 ,$35.09 ,$382.50 ,$229.50 ,$399.50 ,$78.95 ,$391.00 ,$38.44 ,$386.75 ,$35.09 ,$261.55 ,$261.55 ,$94.47 ,$317.18 ,$220.62 ,$35.44 ,$36.26 ,$403.75 ,$36.84 ,$36.26 ,$369.75 ,$35.09 ,$382.50 ,$35.09 ,$382.50 ,$382.50 ,$382.50 ,$412.25 ,$344.25 ,$395.25 ,$365.50 ,$412.25 
SACRED HEART HOSPITAL (ACU),30600256,87798,HC INFECT AMP (BORDETELLA),306,1 ,$335.00 ,$251.25 ,$35.09 ,$335.00 ,$215.74 ,$35.09 ,$234.50 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$318.25 ,$36.26 ,$268.00 ,$308.20 ,$36.26 ,$284.75 ,$318.25 ,$294.80 ,$254.60 ,$36.26 ,$36.26 ,$36.26 ,$244.55 ,$184.25 ,$304.85 ,$304.85 ,$268.00 ,$36.14 ,$184.25 ,$301.50 ,$35.09 ,$301.50 ,$180.90 ,$314.90 ,$78.95 ,$308.20 ,$38.44 ,$304.85 ,$35.09 ,$206.16 ,$206.16 ,$149.23 ,$250.01 ,$220.62 ,$35.44 ,$36.26 ,$318.25 ,$36.84 ,$36.26 ,$291.45 ,$35.09 ,$301.50 ,$35.09 ,$301.50 ,$301.50 ,$301.50 ,$324.95 ,$271.35 ,$311.55 ,$288.10 ,$324.95 
SACRED HEART HOSPITAL (ACU),30600257,87653,HC INFECT AMP (GRP B STREP),306,1 ,$176.00 ,$132.00 ,$35.09 ,$176.00 ,$113.34 ,$35.09 ,$123.20 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$167.20 ,$36.26 ,$140.80 ,$161.92 ,$36.26 ,$149.60 ,$167.20 ,$154.88 ,$133.76 ,$36.26 ,$36.26 ,$36.26 ,$128.48 ,$96.80 ,$160.16 ,$160.16 ,$140.80 ,$36.14 ,$96.80 ,$158.40 ,$35.09 ,$158.40 ,$95.04 ,$165.44 ,$78.95 ,$161.92 ,$38.44 ,$160.16 ,$35.09 ,$108.31 ,$108.31 ,$94.47 ,$131.35 ,$158.40 ,$35.44 ,$36.26 ,$167.20 ,$36.84 ,$36.26 ,$153.12 ,$35.09 ,$158.40 ,$35.09 ,$158.40 ,$158.40 ,$158.40 ,$170.72 ,$142.56 ,$163.68 ,$151.36 ,$170.72 
SACRED HEART HOSPITAL (ACU),30600258,87798,HC INFECT AMP (PNEUMO),306,1 ,$220.00 ,$165.00 ,$35.09 ,$220.00 ,$141.68 ,$35.09 ,$154.00 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$209.00 ,$36.26 ,$176.00 ,$202.40 ,$36.26 ,$187.00 ,$209.00 ,$193.60 ,$167.20 ,$36.26 ,$36.26 ,$36.26 ,$160.60 ,$121.00 ,$200.20 ,$200.20 ,$176.00 ,$36.14 ,$121.00 ,$198.00 ,$35.09 ,$198.00 ,$118.80 ,$206.80 ,$78.95 ,$202.40 ,$38.44 ,$200.20 ,$35.09 ,$135.39 ,$135.39 ,$149.23 ,$164.19 ,$198.00 ,$35.44 ,$36.26 ,$209.00 ,$36.84 ,$36.26 ,$191.40 ,$35.09 ,$198.00 ,$35.09 ,$198.00 ,$198.00 ,$198.00 ,$213.40 ,$178.20 ,$204.60 ,$189.20 ,$213.40 
SACRED HEART HOSPITAL (ACU),30600259,87798,HC INFECT AMP (WEST NILE),306,1 ,$298.00 ,$223.50 ,$35.09 ,$298.00 ,$191.91 ,$35.09 ,$208.60 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$283.10 ,$36.26 ,$238.40 ,$274.16 ,$36.26 ,$253.30 ,$283.10 ,$262.24 ,$226.48 ,$36.26 ,$36.26 ,$36.26 ,$217.54 ,$163.90 ,$271.18 ,$271.18 ,$238.40 ,$36.14 ,$163.90 ,$268.20 ,$35.09 ,$268.20 ,$160.92 ,$280.12 ,$78.95 ,$274.16 ,$38.44 ,$271.18 ,$35.09 ,$183.39 ,$183.39 ,$149.23 ,$222.40 ,$220.62 ,$35.44 ,$36.26 ,$283.10 ,$36.84 ,$36.26 ,$259.26 ,$35.09 ,$268.20 ,$35.09 ,$268.20 ,$268.20 ,$268.20 ,$289.06 ,$241.38 ,$277.14 ,$256.28 ,$289.06 
SACRED HEART HOSPITAL (ACU),30600266,87798,HC INFECT AMP,306,1 ,$125.00 ,$93.75 ,$35.09 ,$125.00 ,$80.50 ,$35.09 ,$87.50 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$118.75 ,$36.26 ,$100.00 ,$115.00 ,$36.26 ,$106.25 ,$118.75 ,$110.00 ,$95.00 ,$36.26 ,$36.26 ,$36.26 ,$91.25 ,$68.75 ,$113.75 ,$113.75 ,$100.00 ,$36.14 ,$68.75 ,$112.50 ,$35.09 ,$112.50 ,$67.50 ,$117.50 ,$78.95 ,$115.00 ,$38.44 ,$113.75 ,$35.09 ,$76.93 ,$76.93 ,$125.00 ,$93.29 ,$112.50 ,$35.44 ,$36.26 ,$118.75 ,$36.84 ,$36.26 ,$108.75 ,$35.09 ,$112.50 ,$35.09 ,$112.50 ,$112.50 ,$112.50 ,$121.25 ,$101.25 ,$116.25 ,$107.50 ,$121.25 
SACRED HEART HOSPITAL (ACU),30600267,87799,HC INFECT AGENT QN,306,1 ,$443.00 ,$332.25 ,$42.84 ,$443.00 ,$285.29 ,$42.84 ,$310.10 ,$44.27 ,$102.83 ,$45.60 ,$82.26 ,$420.85 ,$44.27 ,$354.40 ,$407.56 ,$44.27 ,$376.55 ,$420.85 ,$389.84 ,$336.68 ,$44.27 ,$44.27 ,$44.27 ,$323.39 ,$243.65 ,$403.13 ,$403.13 ,$354.40 ,$44.13 ,$243.65 ,$398.70 ,$42.84 ,$398.70 ,$239.22 ,$416.42 ,$96.39 ,$407.56 ,$46.93 ,$403.13 ,$42.84 ,$272.62 ,$272.62 ,$181.23 ,$330.61 ,$269.24 ,$43.27 ,$44.27 ,$420.85 ,$44.98 ,$44.27 ,$385.41 ,$42.84 ,$398.70 ,$42.84 ,$398.70 ,$398.70 ,$398.70 ,$429.71 ,$358.83 ,$411.99 ,$380.98 ,$429.71 
SACRED HEART HOSPITAL (ACU),30600268,87802,HC OPTICAL STREP B,306,1 ,$567.00 ,$425.25 ,$12.73 ,$567.00 ,$365.15 ,$12.73 ,$396.90 ,$13.15 ,$28.77 ,$13.54 ,$23.02 ,$538.65 ,$13.15 ,$453.60 ,$521.64 ,$13.15 ,$481.95 ,$538.65 ,$498.96 ,$430.92 ,$13.15 ,$13.15 ,$13.15 ,$413.91 ,$311.85 ,$515.97 ,$515.97 ,$453.60 ,$13.11 ,$311.85 ,$510.30 ,$12.73 ,$510.30 ,$306.18 ,$532.98 ,$28.64 ,$521.64 ,$13.94 ,$515.97 ,$12.73 ,$348.93 ,$348.93 ,$65.98 ,$423.15 ,$75.36 ,$12.86 ,$13.15 ,$538.65 ,$13.37 ,$13.15 ,$493.29 ,$12.73 ,$510.30 ,$12.73 ,$510.30 ,$510.30 ,$510.30 ,$549.99 ,$459.27 ,$527.31 ,$487.62 ,$549.99 
SACRED HEART HOSPITAL (ACU),30600269,87807,HC QL RSV,306,1 ,$141.00 ,$105.75 ,$13.10 ,$141.00 ,$90.80 ,$13.10 ,$98.70 ,$13.54 ,$28.77 ,$13.95 ,$23.02 ,$133.95 ,$13.54 ,$112.80 ,$129.72 ,$13.54 ,$119.85 ,$133.95 ,$124.08 ,$107.16 ,$13.54 ,$13.54 ,$13.54 ,$102.93 ,$77.55 ,$128.31 ,$128.31 ,$112.80 ,$13.49 ,$77.55 ,$126.90 ,$13.10 ,$126.90 ,$76.14 ,$132.54 ,$29.48 ,$129.72 ,$14.35 ,$128.31 ,$13.10 ,$86.77 ,$86.77 ,$53.13 ,$105.23 ,$75.36 ,$13.23 ,$13.54 ,$133.95 ,$13.76 ,$13.54 ,$122.67 ,$13.10 ,$126.90 ,$13.10 ,$126.90 ,$126.90 ,$126.90 ,$136.77 ,$114.21 ,$131.13 ,$121.26 ,$136.77 
SACRED HEART HOSPITAL (ACU),30600271,87899,HC INFECT AGENT DETECT OPTICAL,306,1 ,$105.00 ,$78.75 ,$16.07 ,$105.00 ,$67.62 ,$16.07 ,$73.50 ,$16.61 ,$28.77 ,$17.11 ,$23.02 ,$99.75 ,$16.61 ,$84.00 ,$96.60 ,$16.61 ,$89.25 ,$99.75 ,$92.40 ,$79.80 ,$16.61 ,$16.61 ,$16.61 ,$76.65 ,$57.75 ,$95.55 ,$95.55 ,$84.00 ,$16.55 ,$57.75 ,$94.50 ,$16.07 ,$94.50 ,$56.70 ,$98.70 ,$36.16 ,$96.60 ,$17.61 ,$95.55 ,$16.07 ,$64.62 ,$64.62 ,$51.16 ,$78.36 ,$81.82 ,$16.23 ,$16.61 ,$99.75 ,$16.87 ,$16.61 ,$91.35 ,$16.07 ,$94.50 ,$16.07 ,$94.50 ,$94.50 ,$94.50 ,$101.85 ,$85.05 ,$97.65 ,$90.30 ,$101.85 
SACRED HEART HOSPITAL (ACU),30600275,87153,HC MYCOBACTERIA ID BY DNA SEQUENCING,306,1 ,$215.00 ,$161.25 ,$60.92 ,$259.56 ,$138.46 ,$115.36 ,$150.50 ,$119.20 ,$215.00 ,$122.78 ,$215.00 ,$204.25 ,$119.20 ,$172.00 ,$197.80 ,$119.20 ,$182.75 ,$204.25 ,$189.20 ,$163.40 ,$119.20 ,$119.20 ,$119.20 ,$156.95 ,$118.25 ,$195.65 ,$195.65 ,$172.00 ,$118.82 ,$118.25 ,$193.50 ,$115.36 ,$193.50 ,$116.10 ,$202.10 ,$259.56 ,$197.80 ,$126.35 ,$195.65 ,$115.36 ,$132.31 ,$132.31 ,$60.92 ,$160.45 ,$193.50 ,$116.51 ,$119.20 ,$204.25 ,$121.13 ,$119.20 ,$187.05 ,$115.36 ,$193.50 ,$115.36 ,$193.50 ,$193.50 ,$193.50 ,$208.55 ,$174.15 ,$199.95 ,$184.90 ,$208.55 
SACRED HEART HOSPITAL (ACU),30600286,87625,HC HPV GENOTYPE 16 18/45,306,1 ,$157.00 ,$117.75 ,$38.30 ,$157.00 ,$101.11 ,$40.55 ,$109.90 ,$38.30 ,$84.25 ,$39.45 ,$67.40 ,$149.15 ,$38.30 ,$125.60 ,$144.44 ,$38.30 ,$133.45 ,$149.15 ,$138.16 ,$119.32 ,$38.30 ,$38.30 ,$38.30 ,$114.61 ,$86.35 ,$142.87 ,$142.87 ,$125.60 ,$41.77 ,$86.35 ,$141.30 ,$40.55 ,$141.30 ,$84.78 ,$147.58 ,$91.24 ,$144.44 ,$40.60 ,$142.87 ,$40.55 ,$96.62 ,$96.62 ,$91.72 ,$117.17 ,$141.30 ,$40.96 ,$38.30 ,$149.15 ,$42.58 ,$38.30 ,$136.59 ,$40.55 ,$141.30 ,$40.55 ,$141.30 ,$141.30 ,$141.30 ,$152.29 ,$127.17 ,$146.01 ,$135.02 ,$152.29 
SACRED HEART HOSPITAL (ACU),30600300,87081,HC CULTURE SCR PRESUMP PATHOGENS,306,1 ,$157.00 ,$117.75 ,$6.63 ,$157.00 ,$101.11 ,$6.63 ,$109.90 ,$6.85 ,$15.91 ,$7.06 ,$12.73 ,$149.15 ,$6.85 ,$125.60 ,$144.44 ,$6.85 ,$133.45 ,$149.15 ,$138.16 ,$119.32 ,$6.85 ,$6.85 ,$6.85 ,$114.61 ,$86.35 ,$142.87 ,$142.87 ,$125.60 ,$6.83 ,$86.35 ,$141.30 ,$6.63 ,$141.30 ,$84.78 ,$147.58 ,$14.92 ,$144.44 ,$7.26 ,$142.87 ,$6.63 ,$96.62 ,$96.62 ,$53.35 ,$117.17 ,$41.65 ,$6.70 ,$6.85 ,$149.15 ,$6.96 ,$6.85 ,$136.59 ,$6.63 ,$141.30 ,$6.63 ,$141.30 ,$141.30 ,$141.30 ,$152.29 ,$127.17 ,$146.01 ,$135.02 ,$152.29 
SACRED HEART HOSPITAL (ACU),30600301,87118,HC CULTURE MYCOBACTERIA ID,306,1 ,$286.00 ,$214.50 ,$14.61 ,$286.00 ,$184.18 ,$14.61 ,$200.20 ,$15.10 ,$26.27 ,$15.55 ,$21.01 ,$271.70 ,$15.10 ,$228.80 ,$263.12 ,$15.10 ,$243.10 ,$271.70 ,$251.68 ,$217.36 ,$15.10 ,$15.10 ,$15.10 ,$208.78 ,$157.30 ,$260.26 ,$260.26 ,$228.80 ,$15.05 ,$157.30 ,$257.40 ,$14.61 ,$257.40 ,$154.44 ,$268.84 ,$32.87 ,$263.12 ,$16.01 ,$260.26 ,$14.61 ,$176.00 ,$176.00 ,$98.81 ,$213.44 ,$74.39 ,$14.76 ,$15.10 ,$271.70 ,$15.34 ,$15.10 ,$248.82 ,$14.61 ,$257.40 ,$14.61 ,$257.40 ,$257.40 ,$257.40 ,$277.42 ,$231.66 ,$265.98 ,$245.96 ,$277.42 
SACRED HEART HOSPITAL (ACU),30600302,87149,HC CULTURE TYPING ID NUCLEIC ACID,306,1 ,$150.00 ,$112.50 ,$20.05 ,$150.00 ,$96.60 ,$20.05 ,$105.00 ,$20.72 ,$48.14 ,$21.34 ,$38.51 ,$142.50 ,$20.72 ,$120.00 ,$138.00 ,$20.72 ,$127.50 ,$142.50 ,$132.00 ,$114.00 ,$20.72 ,$20.72 ,$20.72 ,$109.50 ,$82.50 ,$136.50 ,$136.50 ,$120.00 ,$20.65 ,$82.50 ,$135.00 ,$20.05 ,$135.00 ,$81.00 ,$141.00 ,$45.11 ,$138.00 ,$21.96 ,$136.50 ,$20.05 ,$92.31 ,$92.31 ,$52.19 ,$111.95 ,$126.07 ,$20.25 ,$20.72 ,$142.50 ,$21.05 ,$20.72 ,$130.50 ,$20.05 ,$135.00 ,$20.05 ,$135.00 ,$135.00 ,$135.00 ,$145.50 ,$121.50 ,$139.50 ,$129.00 ,$145.50 
SACRED HEART HOSPITAL (ACU),30600303,87176,HC HOMOGENIZATION TISSUE,306,1 ,$56.00 ,$42.00 ,$5.88 ,$56.00 ,$36.06 ,$5.88 ,$39.20 ,$6.08 ,$14.12 ,$6.26 ,$11.30 ,$53.20 ,$6.08 ,$44.80 ,$51.52 ,$6.08 ,$47.60 ,$53.20 ,$49.28 ,$42.56 ,$6.08 ,$6.08 ,$6.08 ,$40.88 ,$30.80 ,$50.96 ,$50.96 ,$44.80 ,$6.06 ,$30.80 ,$50.40 ,$5.88 ,$50.40 ,$30.24 ,$52.64 ,$13.23 ,$51.52 ,$6.44 ,$50.96 ,$5.88 ,$34.46 ,$34.46 ,$56.00 ,$41.79 ,$36.97 ,$5.94 ,$6.08 ,$53.20 ,$6.17 ,$6.08 ,$48.72 ,$5.88 ,$50.40 ,$5.88 ,$50.40 ,$50.40 ,$50.40 ,$54.32 ,$45.36 ,$52.08 ,$48.16 ,$54.32 
SACRED HEART HOSPITAL (ACU),30600306,87207,HC SPECIAL STAIN INCL BODIES/PARASITES,306,1 ,$127.00 ,$95.25 ,$5.99 ,$127.00 ,$81.79 ,$5.99 ,$88.90 ,$6.19 ,$14.39 ,$6.38 ,$11.51 ,$120.65 ,$6.19 ,$101.60 ,$116.84 ,$6.19 ,$107.95 ,$120.65 ,$111.76 ,$96.52 ,$6.19 ,$6.19 ,$6.19 ,$92.71 ,$69.85 ,$115.57 ,$115.57 ,$101.60 ,$6.17 ,$69.85 ,$114.30 ,$5.99 ,$114.30 ,$68.58 ,$119.38 ,$13.48 ,$116.84 ,$6.56 ,$115.57 ,$5.99 ,$78.16 ,$78.16 ,$52.72 ,$94.78 ,$37.68 ,$6.05 ,$6.19 ,$120.65 ,$6.29 ,$6.19 ,$110.49 ,$5.99 ,$114.30 ,$5.99 ,$114.30 ,$114.30 ,$114.30 ,$123.19 ,$102.87 ,$118.11 ,$109.22 ,$123.19 
SACRED HEART HOSPITAL (ACU),30600308,87252,HC CULTURE VIRUS ID TISSUE,306,1 ,$229.00 ,$171.75 ,$26.07 ,$229.00 ,$147.48 ,$26.07 ,$160.30 ,$26.94 ,$62.58 ,$27.75 ,$50.06 ,$217.55 ,$26.94 ,$183.20 ,$210.68 ,$26.94 ,$194.65 ,$217.55 ,$201.52 ,$174.04 ,$26.94 ,$26.94 ,$26.94 ,$167.17 ,$125.95 ,$208.39 ,$208.39 ,$183.20 ,$26.85 ,$125.95 ,$206.10 ,$26.07 ,$206.10 ,$123.66 ,$215.26 ,$58.66 ,$210.68 ,$28.56 ,$208.39 ,$26.07 ,$140.93 ,$140.93 ,$149.34 ,$170.90 ,$163.85 ,$26.33 ,$26.94 ,$217.55 ,$27.37 ,$26.94 ,$199.23 ,$26.07 ,$206.10 ,$26.07 ,$206.10 ,$206.10 ,$206.10 ,$222.13 ,$185.49 ,$212.97 ,$196.94 ,$222.13 
SACRED HEART HOSPITAL (ACU),30600310,87273,HC IF HERPES SIMPLEX 2 AG,306,1 ,$59.00 ,$44.25 ,$11.98 ,$59.00 ,$38.00 ,$11.98 ,$41.30 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$56.05 ,$12.38 ,$47.20 ,$54.28 ,$12.38 ,$50.15 ,$56.05 ,$51.92 ,$44.84 ,$12.38 ,$12.38 ,$12.38 ,$43.07 ,$32.45 ,$53.69 ,$53.69 ,$47.20 ,$12.34 ,$32.45 ,$53.10 ,$11.98 ,$53.10 ,$31.86 ,$55.46 ,$26.96 ,$54.28 ,$13.12 ,$53.69 ,$11.98 ,$36.31 ,$36.31 ,$52.19 ,$44.03 ,$53.10 ,$12.10 ,$12.38 ,$56.05 ,$12.58 ,$12.38 ,$51.33 ,$11.98 ,$53.10 ,$11.98 ,$53.10 ,$53.10 ,$53.10 ,$57.23 ,$47.79 ,$54.87 ,$50.74 ,$57.23 
SACRED HEART HOSPITAL (ACU),30600311,87274,HC IF HERPES SIMPLEX 1 AG,306,1 ,$59.00 ,$44.25 ,$11.98 ,$59.00 ,$38.00 ,$11.98 ,$41.30 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$56.05 ,$12.38 ,$47.20 ,$54.28 ,$12.38 ,$50.15 ,$56.05 ,$51.92 ,$44.84 ,$12.38 ,$12.38 ,$12.38 ,$43.07 ,$32.45 ,$53.69 ,$53.69 ,$47.20 ,$12.34 ,$32.45 ,$53.10 ,$11.98 ,$53.10 ,$31.86 ,$55.46 ,$26.96 ,$54.28 ,$13.12 ,$53.69 ,$11.98 ,$36.31 ,$36.31 ,$51.16 ,$44.03 ,$53.10 ,$12.10 ,$12.38 ,$56.05 ,$12.58 ,$12.38 ,$51.33 ,$11.98 ,$53.10 ,$11.98 ,$53.10 ,$53.10 ,$53.10 ,$57.23 ,$47.79 ,$54.87 ,$50.74 ,$57.23 
SACRED HEART HOSPITAL (ACU),30600312,87290,HC IF VARICELLA ZOETER AG,306,1 ,$109.00 ,$81.75 ,$13.42 ,$109.00 ,$70.20 ,$13.42 ,$76.30 ,$13.87 ,$28.77 ,$14.29 ,$23.02 ,$103.55 ,$13.87 ,$87.20 ,$100.28 ,$13.87 ,$92.65 ,$103.55 ,$95.92 ,$82.84 ,$13.87 ,$13.87 ,$13.87 ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 ,$13.82 ,$59.95 ,$98.10 ,$13.42 ,$98.10 ,$58.86 ,$102.46 ,$30.20 ,$100.28 ,$14.70 ,$99.19 ,$13.42 ,$67.08 ,$67.08 ,$51.16 ,$81.35 ,$75.36 ,$13.55 ,$13.87 ,$103.55 ,$14.09 ,$13.87 ,$94.83 ,$13.42 ,$98.10 ,$13.42 ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),30600313,87305,HC EIA QL ASPERGILLUS AG,306,1 ,$301.00 ,$225.75 ,$11.98 ,$301.00 ,$193.84 ,$11.98 ,$210.70 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$285.95 ,$12.38 ,$240.80 ,$276.92 ,$12.38 ,$255.85 ,$285.95 ,$264.88 ,$228.76 ,$12.38 ,$12.38 ,$12.38 ,$219.73 ,$165.55 ,$273.91 ,$273.91 ,$240.80 ,$12.34 ,$165.55 ,$270.90 ,$11.98 ,$270.90 ,$162.54 ,$282.94 ,$26.96 ,$276.92 ,$13.12 ,$273.91 ,$11.98 ,$185.24 ,$185.24 ,$32.23 ,$224.64 ,$75.36 ,$12.10 ,$12.38 ,$285.95 ,$12.58 ,$12.38 ,$261.87 ,$11.98 ,$270.90 ,$11.98 ,$270.90 ,$270.90 ,$270.90 ,$291.97 ,$243.81 ,$279.93 ,$258.86 ,$291.97 
SACRED HEART HOSPITAL (ACU),30600314,87340,HC EIA QL HEPATITIS B AG,306,1 ,$124.00 ,$93.00 ,$10.33 ,$124.00 ,$79.86 ,$10.33 ,$86.80 ,$10.67 ,$24.80 ,$10.99 ,$19.84 ,$117.80 ,$10.67 ,$99.20 ,$114.08 ,$10.67 ,$105.40 ,$117.80 ,$109.12 ,$94.24 ,$10.67 ,$10.67 ,$10.67 ,$90.52 ,$68.20 ,$112.84 ,$112.84 ,$99.20 ,$10.64 ,$68.20 ,$111.60 ,$10.33 ,$111.60 ,$66.96 ,$116.56 ,$23.24 ,$114.08 ,$11.31 ,$112.84 ,$10.33 ,$76.31 ,$76.31 ,$43.72 ,$92.54 ,$64.92 ,$10.43 ,$10.67 ,$117.80 ,$10.85 ,$10.67 ,$107.88 ,$10.33 ,$111.60 ,$10.33 ,$111.60 ,$111.60 ,$111.60 ,$120.28 ,$100.44 ,$115.32 ,$106.64 ,$120.28 
SACRED HEART HOSPITAL (ACU),30600315,87350,HC HEPATITIS BE AG QL,306,1 ,$92.00 ,$69.00 ,$11.53 ,$92.00 ,$59.25 ,$11.53 ,$64.40 ,$11.91 ,$27.67 ,$12.27 ,$22.13 ,$87.40 ,$11.91 ,$73.60 ,$84.64 ,$11.91 ,$78.20 ,$87.40 ,$80.96 ,$69.92 ,$11.91 ,$11.91 ,$11.91 ,$67.16 ,$50.60 ,$83.72 ,$83.72 ,$73.60 ,$11.88 ,$50.60 ,$82.80 ,$11.53 ,$82.80 ,$49.68 ,$86.48 ,$25.94 ,$84.64 ,$12.62 ,$83.72 ,$11.53 ,$56.62 ,$56.62 ,$49.02 ,$68.66 ,$72.45 ,$11.65 ,$11.91 ,$87.40 ,$12.11 ,$11.91 ,$80.04 ,$11.53 ,$82.80 ,$11.53 ,$82.80 ,$82.80 ,$82.80 ,$89.24 ,$74.52 ,$85.56 ,$79.12 ,$89.24 
SACRED HEART HOSPITAL (ACU),30600316,87389,HC HIV-1 AG W/HIV-1  AND  HIV-2 AB,306,1 ,$85.00 ,$63.75 ,$24.08 ,$85.00 ,$54.74 ,$24.08 ,$59.50 ,$24.88 ,$57.80 ,$25.63 ,$46.24 ,$80.75 ,$24.88 ,$68.00 ,$78.20 ,$24.88 ,$72.25 ,$80.75 ,$74.80 ,$64.60 ,$24.88 ,$24.88 ,$24.88 ,$62.05 ,$46.75 ,$77.35 ,$77.35 ,$68.00 ,$24.80 ,$46.75 ,$76.50 ,$24.08 ,$76.50 ,$45.90 ,$79.90 ,$54.18 ,$78.20 ,$26.37 ,$77.35 ,$24.08 ,$52.31 ,$52.31 ,$68.45 ,$63.44 ,$76.50 ,$24.32 ,$24.88 ,$80.75 ,$25.28 ,$24.88 ,$73.95 ,$24.08 ,$76.50 ,$24.08 ,$76.50 ,$76.50 ,$76.50 ,$82.45 ,$68.85 ,$79.05 ,$73.10 ,$82.45 
SACRED HEART HOSPITAL (ACU),30600317,87427,HC SHIGELLA LIKE TOXIN AG,306,1 ,$218.00 ,$163.50 ,$11.98 ,$218.00 ,$140.39 ,$11.98 ,$152.60 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$207.10 ,$12.38 ,$174.40 ,$200.56 ,$12.38 ,$185.30 ,$207.10 ,$191.84 ,$165.68 ,$12.38 ,$12.38 ,$12.38 ,$159.14 ,$119.90 ,$198.38 ,$198.38 ,$174.40 ,$12.34 ,$119.90 ,$196.20 ,$11.98 ,$196.20 ,$117.72 ,$204.92 ,$26.96 ,$200.56 ,$13.12 ,$198.38 ,$11.98 ,$134.16 ,$134.16 ,$28.98 ,$162.69 ,$75.36 ,$12.10 ,$12.38 ,$207.10 ,$12.58 ,$12.38 ,$189.66 ,$11.98 ,$196.20 ,$11.98 ,$196.20 ,$196.20 ,$196.20 ,$211.46 ,$176.58 ,$202.74 ,$187.48 ,$211.46 
SACRED HEART HOSPITAL (ACU),30600318,87449,HC EIA QL MLT AG INF,306,1 ,$66.00 ,$49.50 ,$11.98 ,$66.00 ,$42.50 ,$11.98 ,$46.20 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$62.70 ,$12.38 ,$52.80 ,$60.72 ,$12.38 ,$56.10 ,$62.70 ,$58.08 ,$50.16 ,$12.38 ,$12.38 ,$12.38 ,$48.18 ,$36.30 ,$60.06 ,$60.06 ,$52.80 ,$12.34 ,$36.30 ,$59.40 ,$11.98 ,$59.40 ,$35.64 ,$62.04 ,$26.96 ,$60.72 ,$13.12 ,$60.06 ,$11.98 ,$40.62 ,$40.62 ,$51.16 ,$49.26 ,$59.40 ,$12.10 ,$12.38 ,$62.70 ,$12.58 ,$12.38 ,$57.42 ,$11.98 ,$59.40 ,$11.98 ,$59.40 ,$59.40 ,$59.40 ,$64.02 ,$53.46 ,$61.38 ,$56.76 ,$64.02 
SACRED HEART HOSPITAL (ACU),30600319,87450,HC EIA QL SGL AG,306,1 ,$65.00 ,$48.75 ,$9.91 ,$65.00 ,$41.86 , N/A ,$45.50 ,$9.91 ,$23.03 ,$10.21 ,$18.42 ,$61.75 ,$9.91 ,$52.00 ,$59.80 ,$9.91 ,$55.25 ,$61.75 ,$57.20 ,$49.40 ,$9.91 ,$9.91 ,$9.91 ,$47.45 ,$35.75 ,$59.15 ,$59.15 ,$52.00 , N/A ,$35.75 ,$58.50 , N/A ,$58.50 ,$35.10 ,$61.10 , N/A ,$59.80 ,$10.50 ,$59.15 , N/A ,$40.00 ,$40.00 ,$40.52 ,$48.51 ,$58.50 , N/A ,$9.91 ,$61.75 , N/A ,$9.91 ,$56.55 , N/A ,$58.50 , N/A ,$58.50 ,$58.50 ,$58.50 ,$63.05 ,$52.65 ,$60.45 ,$55.90 ,$63.05 
SACRED HEART HOSPITAL (ACU),30600320,87476,HC LYMES DNA DETECT PCR,306,1 ,$357.00 ,$267.75 ,$35.09 ,$357.00 ,$229.91 ,$35.09 ,$249.90 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$339.15 ,$36.26 ,$285.60 ,$328.44 ,$36.26 ,$303.45 ,$339.15 ,$314.16 ,$271.32 ,$36.26 ,$36.26 ,$36.26 ,$260.61 ,$196.35 ,$324.87 ,$324.87 ,$285.60 ,$36.14 ,$196.35 ,$321.30 ,$35.09 ,$321.30 ,$192.78 ,$335.58 ,$78.95 ,$328.44 ,$38.44 ,$324.87 ,$35.09 ,$219.70 ,$219.70 ,$149.23 ,$266.43 ,$220.62 ,$35.44 ,$36.26 ,$339.15 ,$36.84 ,$36.26 ,$310.59 ,$35.09 ,$321.30 ,$35.09 ,$321.30 ,$321.30 ,$321.30 ,$346.29 ,$289.17 ,$332.01 ,$307.02 ,$346.29 
SACRED HEART HOSPITAL (ACU),30600321,87502,HC INFLUENZA VIRUS MULTIPLE DNA/RNA,306,1 ,$483.00 ,$362.25 ,$95.80 ,$483.00 ,$311.05 ,$95.80 ,$338.10 ,$98.99 ,$204.28 ,$101.96 ,$163.42 ,$458.85 ,$98.99 ,$386.40 ,$444.36 ,$98.99 ,$410.55 ,$458.85 ,$425.04 ,$367.08 ,$98.99 ,$98.99 ,$98.99 ,$352.59 ,$265.65 ,$439.53 ,$439.53 ,$386.40 ,$98.67 ,$265.65 ,$434.70 ,$95.80 ,$434.70 ,$260.82 ,$454.02 ,$215.55 ,$444.36 ,$104.93 ,$439.53 ,$95.80 ,$297.24 ,$297.24 ,$240.94 ,$360.46 ,$434.70 ,$96.76 ,$98.99 ,$458.85 ,$100.59 ,$98.99 ,$420.21 ,$95.80 ,$434.70 ,$95.80 ,$434.70 ,$434.70 ,$434.70 ,$468.51 ,$391.23 ,$449.19 ,$415.38 ,$468.51 
SACRED HEART HOSPITAL (ACU),30600322,87502,HC INFLUENZA VIRUS MULTIPLE DNA/RNA,306,1 ,$483.00 ,$362.25 ,$95.80 ,$483.00 ,$311.05 ,$95.80 ,$338.10 ,$98.99 ,$204.28 ,$101.96 ,$163.42 ,$458.85 ,$98.99 ,$386.40 ,$444.36 ,$98.99 ,$410.55 ,$458.85 ,$425.04 ,$367.08 ,$98.99 ,$98.99 ,$98.99 ,$352.59 ,$265.65 ,$439.53 ,$439.53 ,$386.40 ,$98.67 ,$265.65 ,$434.70 ,$95.80 ,$434.70 ,$260.82 ,$454.02 ,$215.55 ,$444.36 ,$104.93 ,$439.53 ,$95.80 ,$297.24 ,$297.24 ,$240.94 ,$360.46 ,$434.70 ,$96.76 ,$98.99 ,$458.85 ,$100.59 ,$98.99 ,$420.21 ,$95.80 ,$434.70 ,$95.80 ,$434.70 ,$434.70 ,$434.70 ,$468.51 ,$391.23 ,$449.19 ,$415.38 ,$468.51 
SACRED HEART HOSPITAL (ACU),30600323,87503,HC INFLUENZA VIRUS MULT DNA/RNA >2 EA ADDL,306,1 ,$111.00 ,$83.25 ,$29.20 ,$111.00 ,$71.48 ,$29.22 ,$77.70 ,$29.20 ,$49.86 ,$30.08 ,$39.89 ,$105.45 ,$29.20 ,$88.80 ,$102.12 ,$29.20 ,$94.35 ,$105.45 ,$97.68 ,$84.36 ,$29.20 ,$29.20 ,$29.20 ,$81.03 ,$61.05 ,$101.01 ,$101.01 ,$88.80 ,$30.10 ,$61.05 ,$99.90 ,$29.22 ,$99.90 ,$59.94 ,$104.34 ,$65.75 ,$102.12 ,$30.95 ,$101.01 ,$29.22 ,$68.31 ,$68.31 ,$58.87 ,$82.84 ,$99.90 ,$29.51 ,$29.20 ,$105.45 ,$30.68 ,$29.20 ,$96.57 ,$29.22 ,$99.90 ,$29.22 ,$99.90 ,$99.90 ,$99.90 ,$107.67 ,$89.91 ,$103.23 ,$95.46 ,$107.67 
SACRED HEART HOSPITAL (ACU),30600324,87517,HC HEPATITIS B QN,306,1 ,$317.00 ,$237.75 ,$42.84 ,$317.00 ,$204.15 ,$42.84 ,$221.90 ,$44.27 ,$102.83 ,$45.60 ,$82.26 ,$301.15 ,$44.27 ,$253.60 ,$291.64 ,$44.27 ,$269.45 ,$301.15 ,$278.96 ,$240.92 ,$44.27 ,$44.27 ,$44.27 ,$231.41 ,$174.35 ,$288.47 ,$288.47 ,$253.60 ,$44.13 ,$174.35 ,$285.30 ,$42.84 ,$285.30 ,$171.18 ,$297.98 ,$96.39 ,$291.64 ,$46.93 ,$288.47 ,$42.84 ,$195.08 ,$195.08 ,$181.23 ,$236.58 ,$269.24 ,$43.27 ,$44.27 ,$301.15 ,$44.98 ,$44.27 ,$275.79 ,$42.84 ,$285.30 ,$42.84 ,$285.30 ,$285.30 ,$285.30 ,$307.49 ,$256.77 ,$294.81 ,$272.62 ,$307.49 
SACRED HEART HOSPITAL (ACU),30600325,87521,HC HEPATITIS C PROBE AND RVRS TRNSC,306,1 ,$407.00 ,$305.25 ,$35.09 ,$407.00 ,$262.11 ,$35.09 ,$284.90 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$386.65 ,$36.26 ,$325.60 ,$374.44 ,$36.26 ,$345.95 ,$386.65 ,$358.16 ,$309.32 ,$36.26 ,$36.26 ,$36.26 ,$297.11 ,$223.85 ,$370.37 ,$370.37 ,$325.60 ,$36.14 ,$223.85 ,$366.30 ,$35.09 ,$366.30 ,$219.78 ,$382.58 ,$78.95 ,$374.44 ,$38.44 ,$370.37 ,$35.09 ,$250.47 ,$250.47 ,$149.23 ,$303.74 ,$220.62 ,$35.44 ,$36.26 ,$386.65 ,$36.84 ,$36.26 ,$354.09 ,$35.09 ,$366.30 ,$35.09 ,$366.30 ,$366.30 ,$366.30 ,$394.79 ,$329.67 ,$378.51 ,$350.02 ,$394.79 
SACRED HEART HOSPITAL (ACU),30600326,87522,HC HEPATITIS C QN,306,1 ,$554.00 ,$415.50 ,$42.84 ,$554.00 ,$356.78 ,$42.84 ,$387.80 ,$44.27 ,$102.83 ,$45.60 ,$82.26 ,$526.30 ,$44.27 ,$443.20 ,$509.68 ,$44.27 ,$470.90 ,$526.30 ,$487.52 ,$421.04 ,$44.27 ,$44.27 ,$44.27 ,$404.42 ,$304.70 ,$504.14 ,$504.14 ,$443.20 ,$44.13 ,$304.70 ,$498.60 ,$42.84 ,$498.60 ,$299.16 ,$520.76 ,$96.39 ,$509.68 ,$46.93 ,$504.14 ,$42.84 ,$340.93 ,$340.93 ,$181.23 ,$413.45 ,$269.24 ,$43.27 ,$44.27 ,$526.30 ,$44.98 ,$44.27 ,$481.98 ,$42.84 ,$498.60 ,$42.84 ,$498.60 ,$498.60 ,$498.60 ,$537.38 ,$448.74 ,$515.22 ,$476.44 ,$537.38 
SACRED HEART HOSPITAL (ACU),30600327,87529,HC HERPES SIMPLEX AMP,306,1 ,$275.00 ,$206.25 ,$35.09 ,$275.00 ,$177.10 ,$35.09 ,$192.50 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$261.25 ,$36.26 ,$220.00 ,$253.00 ,$36.26 ,$233.75 ,$261.25 ,$242.00 ,$209.00 ,$36.26 ,$36.26 ,$36.26 ,$200.75 ,$151.25 ,$250.25 ,$250.25 ,$220.00 ,$36.14 ,$151.25 ,$247.50 ,$35.09 ,$247.50 ,$148.50 ,$258.50 ,$78.95 ,$253.00 ,$38.44 ,$250.25 ,$35.09 ,$169.24 ,$169.24 ,$149.23 ,$205.23 ,$220.62 ,$35.44 ,$36.26 ,$261.25 ,$36.84 ,$36.26 ,$239.25 ,$35.09 ,$247.50 ,$35.09 ,$247.50 ,$247.50 ,$247.50 ,$266.75 ,$222.75 ,$255.75 ,$236.50 ,$266.75 
SACRED HEART HOSPITAL (ACU),30600328,87530,HC HSV QUANT,306,1 ,$281.00 ,$210.75 ,$42.84 ,$281.00 ,$180.96 ,$42.84 ,$196.70 ,$44.27 ,$102.83 ,$45.60 ,$82.26 ,$266.95 ,$44.27 ,$224.80 ,$258.52 ,$44.27 ,$238.85 ,$266.95 ,$247.28 ,$213.56 ,$44.27 ,$44.27 ,$44.27 ,$205.13 ,$154.55 ,$255.71 ,$255.71 ,$224.80 ,$44.13 ,$154.55 ,$252.90 ,$42.84 ,$252.90 ,$151.74 ,$264.14 ,$96.39 ,$258.52 ,$46.93 ,$255.71 ,$42.84 ,$172.93 ,$172.93 ,$181.23 ,$209.71 ,$252.90 ,$43.27 ,$44.27 ,$266.95 ,$44.98 ,$44.27 ,$244.47 ,$42.84 ,$252.90 ,$42.84 ,$252.90 ,$252.90 ,$252.90 ,$272.57 ,$227.61 ,$261.33 ,$241.66 ,$272.57 
SACRED HEART HOSPITAL (ACU),30600329,87535,HC PROBE HIV-1 AMP,306,1 ,$541.00 ,$405.75 ,$35.09 ,$541.00 ,$348.40 ,$35.09 ,$378.70 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$513.95 ,$36.26 ,$432.80 ,$497.72 ,$36.26 ,$459.85 ,$513.95 ,$476.08 ,$411.16 ,$36.26 ,$36.26 ,$36.26 ,$394.93 ,$297.55 ,$492.31 ,$492.31 ,$432.80 ,$36.14 ,$297.55 ,$486.90 ,$35.09 ,$486.90 ,$292.14 ,$508.54 ,$78.95 ,$497.72 ,$38.44 ,$492.31 ,$35.09 ,$332.93 ,$332.93 ,$149.23 ,$403.75 ,$220.62 ,$35.44 ,$36.26 ,$513.95 ,$36.84 ,$36.26 ,$470.67 ,$35.09 ,$486.90 ,$35.09 ,$486.90 ,$486.90 ,$486.90 ,$524.77 ,$438.21 ,$503.13 ,$465.26 ,$524.77 
SACRED HEART HOSPITAL (ACU),30600330,87536,HC HIV-1 QN,306,1 ,$302.00 ,$226.50 ,$85.10 ,$302.00 ,$194.49 ,$85.10 ,$211.40 ,$87.93 ,$204.28 ,$90.57 ,$163.42 ,$286.90 ,$87.93 ,$241.60 ,$277.84 ,$87.93 ,$256.70 ,$286.90 ,$265.76 ,$229.52 ,$87.93 ,$87.93 ,$87.93 ,$220.46 ,$166.10 ,$274.82 ,$274.82 ,$241.60 ,$87.65 ,$166.10 ,$271.80 ,$85.10 ,$271.80 ,$163.08 ,$283.88 ,$191.48 ,$277.84 ,$93.21 ,$274.82 ,$85.10 ,$185.85 ,$185.85 ,$157.75 ,$225.38 ,$271.80 ,$85.95 ,$87.93 ,$286.90 ,$89.36 ,$87.93 ,$262.74 ,$85.10 ,$271.80 ,$85.10 ,$271.80 ,$271.80 ,$271.80 ,$292.94 ,$244.62 ,$280.86 ,$259.72 ,$292.94 
SACRED HEART HOSPITAL (ACU),30600331,87540,HC LEGIONELLA DIRECT PROBE,306,1 ,$620.00 ,$465.00 ,$20.05 ,$620.00 ,$399.28 ,$20.05 ,$434.00 ,$20.72 ,$48.14 ,$21.34 ,$38.51 ,$589.00 ,$20.72 ,$496.00 ,$570.40 ,$20.72 ,$527.00 ,$589.00 ,$545.60 ,$471.20 ,$20.72 ,$20.72 ,$20.72 ,$452.60 ,$341.00 ,$564.20 ,$564.20 ,$496.00 ,$20.65 ,$341.00 ,$558.00 ,$20.05 ,$558.00 ,$334.80 ,$582.80 ,$45.11 ,$570.40 ,$21.96 ,$564.20 ,$20.05 ,$381.55 ,$381.55 ,$85.27 ,$462.71 ,$126.07 ,$20.25 ,$20.72 ,$589.00 ,$21.05 ,$20.72 ,$539.40 ,$20.05 ,$558.00 ,$20.05 ,$558.00 ,$558.00 ,$558.00 ,$601.40 ,$502.20 ,$576.60 ,$533.20 ,$601.40 
SACRED HEART HOSPITAL (ACU),30600332,87651,HC INFECT AMP (GRP A STREP),306,1 ,$162.00 ,$121.50 ,$35.09 ,$162.00 ,$104.33 ,$35.09 ,$113.40 ,$36.26 ,$84.25 ,$37.35 ,$67.40 ,$153.90 ,$36.26 ,$129.60 ,$149.04 ,$36.26 ,$137.70 ,$153.90 ,$142.56 ,$123.12 ,$36.26 ,$36.26 ,$36.26 ,$118.26 ,$89.10 ,$147.42 ,$147.42 ,$129.60 ,$36.14 ,$89.10 ,$145.80 ,$35.09 ,$145.80 ,$87.48 ,$152.28 ,$78.95 ,$149.04 ,$38.44 ,$147.42 ,$35.09 ,$99.69 ,$99.69 ,$149.23 ,$120.90 ,$145.80 ,$35.44 ,$36.26 ,$153.90 ,$36.84 ,$36.26 ,$140.94 ,$35.09 ,$145.80 ,$35.09 ,$145.80 ,$145.80 ,$145.80 ,$157.14 ,$131.22 ,$150.66 ,$139.32 ,$157.14 
SACRED HEART HOSPITAL (ACU),30600333,87808,HC TRICHOMONAS VAGINITIS OPTICAL,306,1 ,$44.00 ,$33.00 ,$15.29 ,$44.00 ,$28.34 ,$15.29 ,$30.80 ,$15.80 ,$28.77 ,$16.27 ,$23.02 ,$41.80 ,$15.80 ,$35.20 ,$40.48 ,$15.80 ,$37.40 ,$41.80 ,$38.72 ,$33.44 ,$15.80 ,$15.80 ,$15.80 ,$32.12 ,$24.20 ,$40.04 ,$40.04 ,$35.20 ,$15.75 ,$24.20 ,$39.60 ,$15.29 ,$39.60 ,$23.76 ,$41.36 ,$34.40 ,$40.48 ,$16.75 ,$40.04 ,$15.29 ,$27.08 ,$27.08 ,$32.23 ,$32.84 ,$39.60 ,$15.44 ,$15.80 ,$41.80 ,$16.05 ,$15.80 ,$38.28 ,$15.29 ,$39.60 ,$15.29 ,$39.60 ,$39.60 ,$39.60 ,$42.68 ,$35.64 ,$40.92 ,$37.84 ,$42.68 
SACRED HEART HOSPITAL (ACU),30600334,87902,HC GENTOYPE HEP C,306,1 ,$913.00 ,$684.75 ,$257.45 ,$913.00 ,$587.97 ,$257.45 ,$639.10 ,$266.02 ,$618.01 ,$274.00 ,$494.41 ,$867.35 ,$266.02 ,$730.40 ,$839.96 ,$266.02 ,$776.05 ,$867.35 ,$803.44 ,$693.88 ,$266.02 ,$266.02 ,$266.02 ,$666.49 ,$502.15 ,$830.83 ,$830.83 ,$730.40 ,$265.17 ,$502.15 ,$821.70 ,$257.45 ,$821.70 ,$493.02 ,$858.22 ,$579.26 ,$839.96 ,$281.98 ,$830.83 ,$257.45 ,$561.86 ,$561.86 ,$888.60 ,$681.37 ,$821.70 ,$260.02 ,$266.02 ,$867.35 ,$270.32 ,$266.02 ,$794.31 ,$257.45 ,$821.70 ,$257.45 ,$821.70 ,$821.70 ,$821.70 ,$885.61 ,$739.53 ,$849.09 ,$785.18 ,$885.61 
SACRED HEART HOSPITAL (ACU),30600336,87507,HC IF AG DNA/RNA PROBE TQ 12-25 TARGETS,306,1 ,"$1,035.00 ",$776.25 ,$416.78 ,"$1,035.00 ",$666.54 ,$416.78 ,$724.50 ,$430.66 ,"$1,000.51 ",$443.58 ,$800.41 ,$983.25 ,$430.66 ,$828.00 ,$952.20 ,$430.66 ,$879.75 ,$983.25 ,$910.80 ,$786.60 ,$430.66 ,$430.66 ,$430.66 ,$755.55 ,$569.25 ,$941.85 ,$941.85 ,$828.00 ,$429.28 ,$569.25 ,$931.50 ,$416.78 ,$931.50 ,$558.90 ,$972.90 ,$937.76 ,$952.20 ,$456.50 ,$941.85 ,$416.78 ,$636.94 ,$636.94 ,"$1,035.00 ",$772.42 ,$931.50 ,$420.95 ,$430.66 ,$983.25 ,$437.62 ,$430.66 ,$900.45 ,$416.78 ,$931.50 ,$416.78 ,$931.50 ,$931.50 ,$931.50 ,"$1,003.95 ",$838.35 ,$962.55 ,$890.10 ,"$1,003.95 "
SACRED HEART HOSPITAL (ACU),30600348,87483,HC INFECT AMP CNS DNA/RNA 14 TARGETS,306,1 ,"$1,479.00 ","$1,109.25 ",$333.42 ,"$1,479.00 ",$952.48 ,$416.78 ,"$1,035.30 ",$333.42 ,"$1,000.51 ",$343.42 ,$800.41 ,"$1,405.05 ",$333.42 ,"$1,183.20 ","$1,360.68 ",$333.42 ,"$1,257.15 ","$1,405.05 ","$1,301.52 ","$1,124.04 ",$333.42 ,$333.42 ,$333.42 ,"$1,079.67 ",$813.45 ,"$1,345.89 ","$1,345.89 ","$1,183.20 ",$429.28 ,$813.45 ,"$1,331.10 ",$416.78 ,"$1,331.10 ",$798.66 ,"$1,390.26 ",$937.76 ,"$1,360.68 ",$353.43 ,"$1,345.89 ",$416.78 ,$910.18 ,$910.18 ,"$1,090.41 ","$1,103.78 ","$1,030.12 ",$420.95 ,$333.42 ,"$1,405.05 ",$437.62 ,$333.42 ,"$1,286.73 ",$416.78 ,"$1,331.10 ",$416.78 ,"$1,331.10 ","$1,331.10 ","$1,331.10 ","$1,434.63 ","$1,197.99 ","$1,375.47 ","$1,271.94 ","$1,434.63 "
SACRED HEART HOSPITAL (ACU),30600500,87254,HC VIRUS ISOL SHELL RESP RAPID CULTURE W/REFLEX,306,1 ,$126.00 ,$94.50 ,$7.06 ,$126.00 ,$81.14 ,$19.56 ,$88.20 ,$7.06 ,$46.95 ,$7.27 ,$37.56 ,$119.70 ,$7.06 ,$100.80 ,$115.92 ,$7.06 ,$107.10 ,$119.70 ,$110.88 ,$95.76 ,$7.06 ,$7.06 ,$7.06 ,$91.98 ,$69.30 ,$114.66 ,$114.66 ,$100.80 ,$20.15 ,$69.30 ,$113.40 ,$19.56 ,$113.40 ,$68.04 ,$118.44 ,$44.01 ,$115.92 ,$7.48 ,$114.66 ,$19.56 ,$77.54 ,$77.54 ,$65.70 ,$94.03 ,$113.40 ,$19.76 ,$7.06 ,$119.70 ,$20.54 ,$7.06 ,$109.62 ,$19.56 ,$113.40 ,$19.56 ,$113.40 ,$113.40 ,$113.40 ,$122.22 ,$102.06 ,$117.18 ,$108.36 ,$122.22 
SACRED HEART HOSPITAL (ACU),30600635,87637,HC 4PLEX COVID/RSV/FLU PCR,306,1 ,$268.00 ,$201.00 ,$142.63 ,$320.92 ,$172.59 ,$142.63 ,$187.60 ,$142.63 ,$249.60 ,$146.91 ,$214.94 ,$254.60 ,$142.63 ,$214.40 ,$246.56 ,$142.63 ,$227.80 ,$254.60 ,$235.84 ,$203.68 ,$142.63 ,$142.63 ,$142.63 ,$195.64 ,$147.40 ,$243.88 ,$243.88 ,$214.40 ,$146.91 ,$147.40 ,$241.20 ,$142.63 ,$241.20 ,$144.72 ,$251.92 ,$320.92 ,$246.56 ,$151.19 ,$243.88 ,$142.63 ,$164.93 ,$164.93 ,$241.20 ,$200.01 ,$186.66 ,$144.06 ,$142.63 ,$254.60 ,$149.76 ,$142.63 ,$233.16 ,$142.63 ,$241.20 ,$142.63 ,$241.20 ,$241.20 ,$241.20 ,$259.96 ,$217.08 ,$249.24 ,$230.48 ,$259.96 
SACRED HEART HOSPITAL (ACU),30600636,87811,HC COVID ANTIGEN TEST,306,1 ,$104.00 ,$78.00 ,$41.38 ,$104.00 ,$66.98 ,$41.38 ,$72.80 ,$41.38 ,$78.16 ,$42.62 ,$62.52 ,$98.80 ,$41.38 ,$83.20 ,$95.68 ,$41.38 ,$88.40 ,$98.80 ,$91.52 ,$79.04 ,$41.38 ,$41.38 ,$41.38 ,$75.92 ,$57.20 ,$94.64 ,$94.64 ,$83.20 ,$42.62 ,$57.20 ,$93.60 ,$41.38 ,$93.60 ,$56.16 ,$97.76 ,$93.11 ,$95.68 ,$43.86 ,$94.64 ,$41.38 ,$64.00 ,$64.00 ,$93.60 ,$77.62 ,$72.44 ,$41.79 ,$41.38 ,$98.80 ,$43.45 ,$41.38 ,$90.48 ,$41.38 ,$93.60 ,$41.38 ,$93.60 ,$93.60 ,$93.60 ,$100.88 ,$84.24 ,$96.72 ,$89.44 ,$100.88 
SACRED HEART HOSPITAL (ACU),30600637,87635,HC COVID-19 LAB PCR TEST,306,1 ,$164.00 ,$123.00 ,$51.31 ,$164.00 ,$105.62 ,$51.31 ,$114.80 ,$51.31 ,$89.79 ,$52.85 ,$77.18 ,$155.80 ,$51.31 ,$131.20 ,$150.88 ,$51.31 ,$139.40 ,$155.80 ,$144.32 ,$124.64 ,$51.31 ,$51.31 ,$51.31 ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 ,$52.85 ,$90.20 ,$147.60 ,$51.31 ,$147.60 ,$88.56 ,$154.16 ,$115.45 ,$150.88 ,$54.39 ,$149.24 ,$51.31 ,$100.93 ,$100.93 ,$147.60 ,$122.39 ,$114.23 ,$51.82 ,$51.31 ,$155.80 ,$53.88 ,$51.31 ,$142.68 ,$51.31 ,$147.60 ,$51.31 ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),30600646,0241U,HC SARS-COV-2/FLU/RSV,306,1 ,$268.00 ,$201.00 ,$35.91 ,$320.92 ,$172.59 ,$142.63 ,$187.60 ,$35.91 ,$249.60 ,$36.99 ,$176.88 ,$254.60 ,$35.91 ,$214.40 ,$246.56 ,$35.91 ,$227.80 ,$254.60 ,$235.84 ,$203.68 ,$35.91 ,$35.91 ,$35.91 ,$195.64 ,$147.40 ,$243.88 ,$243.88 ,$214.40 ,$146.91 ,$147.40 ,$241.20 ,$142.63 ,$241.20 ,$144.72 ,$251.92 ,$320.92 ,$246.56 ,$38.06 ,$243.88 ,$142.63 ,$164.93 ,$164.93 ,$241.20 ,$200.01 ,$186.66 ,$144.06 ,$35.91 ,$254.60 ,$149.76 ,$35.91 ,$233.16 ,$142.63 ,$241.20 ,$142.63 ,$241.20 ,$241.20 ,$241.20 ,$259.96 ,$217.08 ,$249.24 ,$230.48 ,$259.96 
SACRED HEART HOSPITAL (ACU),30640227,87425,HC EIA QL ROTAVIRUS AG-REF,306,1 ,$190.00 ,$142.50 ,$11.98 ,$190.00 ,$122.36 ,$11.98 ,$133.00 ,$12.38 ,$28.77 ,$12.75 ,$23.02 ,$180.50 ,$12.38 ,$152.00 ,$174.80 ,$12.38 ,$161.50 ,$180.50 ,$167.20 ,$144.40 ,$12.38 ,$12.38 ,$12.38 ,$138.70 ,$104.50 ,$172.90 ,$172.90 ,$152.00 ,$12.34 ,$104.50 ,$171.00 ,$11.98 ,$171.00 ,$102.60 ,$178.60 ,$26.96 ,$174.80 ,$13.12 ,$172.90 ,$11.98 ,$116.93 ,$116.93 ,$51.16 ,$141.80 ,$75.36 ,$12.10 ,$12.38 ,$180.50 ,$12.58 ,$12.38 ,$165.30 ,$11.98 ,$171.00 ,$11.98 ,$171.00 ,$171.00 ,$171.00 ,$184.30 ,$153.90 ,$176.70 ,$163.40 ,$184.30 
SACRED HEART HOSPITAL (ACU),30682011,87635,HC COVID-19 LAB TEST NON-CDC,306,1 ,$164.00 ,$123.00 ,$51.31 ,$164.00 ,$105.62 ,$51.31 ,$114.80 ,$51.31 ,$89.79 ,$52.85 ,$77.18 ,$155.80 ,$51.31 ,$131.20 ,$150.88 ,$51.31 ,$139.40 ,$155.80 ,$144.32 ,$124.64 ,$51.31 ,$51.31 ,$51.31 ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 ,$52.85 ,$90.20 ,$147.60 ,$51.31 ,$147.60 ,$88.56 ,$154.16 ,$115.45 ,$150.88 ,$54.39 ,$149.24 ,$51.31 ,$100.93 ,$100.93 ,$147.60 ,$122.39 ,$114.23 ,$51.82 ,$51.31 ,$155.80 ,$53.88 ,$51.31 ,$142.68 ,$51.31 ,$147.60 ,$51.31 ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),30682013,87635,HC COVID-19 LAB TEST,306,1 ,$164.00 ,$123.00 ,$51.31 ,$164.00 ,$105.62 ,$51.31 ,$114.80 ,$51.31 ,$89.79 ,$52.85 ,$77.18 ,$155.80 ,$51.31 ,$131.20 ,$150.88 ,$51.31 ,$139.40 ,$155.80 ,$144.32 ,$124.64 ,$51.31 ,$51.31 ,$51.31 ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 ,$52.85 ,$90.20 ,$147.60 ,$51.31 ,$147.60 ,$88.56 ,$154.16 ,$115.45 ,$150.88 ,$54.39 ,$149.24 ,$51.31 ,$100.93 ,$100.93 ,$147.60 ,$122.39 ,$114.23 ,$51.82 ,$51.31 ,$155.80 ,$53.88 ,$51.31 ,$142.68 ,$51.31 ,$147.60 ,$51.31 ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),30682014,86769,HC SARS-COV-2 COVID-19 ANTIBODY,306,1 ,$104.00 ,$78.00 ,$42.13 ,$104.00 ,$66.98 ,$42.13 ,$72.80 ,$42.13 ,$73.73 ,$43.39 ,$63.50 ,$98.80 ,$42.13 ,$83.20 ,$95.68 ,$42.13 ,$88.40 ,$98.80 ,$91.52 ,$79.04 ,$42.13 ,$42.13 ,$42.13 ,$75.92 ,$57.20 ,$94.64 ,$94.64 ,$83.20 ,$43.39 ,$57.20 ,$93.60 ,$42.13 ,$93.60 ,$56.16 ,$97.76 ,$94.79 ,$95.68 ,$44.66 ,$94.64 ,$42.13 ,$64.00 ,$64.00 ,$93.60 ,$77.62 ,$72.44 ,$42.55 ,$42.13 ,$98.80 ,$44.24 ,$42.13 ,$90.48 ,$42.13 ,$93.60 ,$42.13 ,$93.60 ,$93.60 ,$93.60 ,$100.88 ,$84.24 ,$96.72 ,$89.44 ,$100.88 
SACRED HEART HOSPITAL (ACU),30682021,86769,HC SARS-COV-2 COVID-19 ANTIBODY IN-HOUSE,306,1 ,$78.00 ,$58.50 ,$42.12 ,$94.79 ,$50.23 ,$42.13 ,$54.60 ,$42.13 ,$73.73 ,$43.39 ,$63.50 ,$74.10 ,$42.13 ,$62.40 ,$71.76 ,$42.13 ,$66.30 ,$74.10 ,$68.64 ,$59.28 ,$42.13 ,$42.13 ,$42.13 ,$56.94 ,$42.90 ,$70.98 ,$70.98 ,$62.40 ,$43.39 ,$42.90 ,$70.20 ,$42.13 ,$70.20 ,$42.12 ,$73.32 ,$94.79 ,$71.76 ,$44.66 ,$70.98 ,$42.13 ,$48.00 ,$48.00 ,$70.20 ,$58.21 ,$54.33 ,$42.55 ,$42.13 ,$74.10 ,$44.24 ,$42.13 ,$67.86 ,$42.13 ,$70.20 ,$42.13 ,$70.20 ,$70.20 ,$70.20 ,$75.66 ,$63.18 ,$72.54 ,$67.08 ,$75.66 
SACRED HEART HOSPITAL (ACU),30682023,87426,HC SARS COVID ANTIGEN TEST,306,1 ,$75.00 ,$56.25 ,$35.33 ,$79.49 ,$48.30 ,$35.33 ,$52.50 ,$35.33 ,$75.00 ,$36.39 ,$68.39 ,$71.25 ,$35.33 ,$60.00 ,$69.00 ,$35.33 ,$63.75 ,$71.25 ,$66.00 ,$57.00 ,$35.33 ,$35.33 ,$35.33 ,$54.75 ,$41.25 ,$68.25 ,$68.25 ,$60.00 ,$36.39 ,$41.25 ,$67.50 ,$35.33 ,$67.50 ,$40.50 ,$70.50 ,$79.49 ,$69.00 ,$37.45 ,$68.25 ,$35.33 ,$46.16 ,$46.16 ,$67.50 ,$55.97 ,$52.24 ,$35.68 ,$35.33 ,$71.25 ,$37.10 ,$35.33 ,$65.25 ,$35.33 ,$67.50 ,$35.33 ,$67.50 ,$67.50 ,$67.50 ,$72.75 ,$60.75 ,$69.75 ,$64.50 ,$72.75 
SACRED HEART HOSPITAL (ACU),30682024,87635,HC SARS-COV-2 COVID-19 TEST,306,1 ,$121.00 ,$90.75 ,$51.31 ,$121.00 ,$77.92 ,$51.31 ,$84.70 ,$51.31 ,$89.79 ,$52.85 ,$77.18 ,$114.95 ,$51.31 ,$96.80 ,$111.32 ,$51.31 ,$102.85 ,$114.95 ,$106.48 ,$91.96 ,$51.31 ,$51.31 ,$51.31 ,$88.33 ,$66.55 ,$110.11 ,$110.11 ,$96.80 ,$52.85 ,$66.55 ,$108.90 ,$51.31 ,$108.90 ,$65.34 ,$113.74 ,$115.45 ,$111.32 ,$54.39 ,$110.11 ,$51.31 ,$74.46 ,$74.46 ,$108.90 ,$90.30 ,$84.28 ,$51.82 ,$51.31 ,$114.95 ,$53.88 ,$51.31 ,$105.27 ,$51.31 ,$108.90 ,$51.31 ,$108.90 ,$108.90 ,$108.90 ,$117.37 ,$98.01 ,$112.53 ,$104.06 ,$117.37 
SACRED HEART HOSPITAL (ACU),30700101,81001,HC URINALYSIS AUTO W/MICRO,307,1 ,$100.04 ,$75.03 ,$3.17 ,$100.04 ,$64.43 ,$3.17 ,$70.03 ,$3.28 ,$7.61 ,$3.38 ,$6.09 ,$95.04 ,$3.28 ,$80.03 ,$92.04 ,$3.28 ,$85.03 ,$95.04 ,$88.04 ,$76.03 ,$3.28 ,$3.28 ,$3.28 ,$73.03 ,$55.02 ,$91.04 ,$91.04 ,$80.03 ,$3.27 ,$55.02 ,$90.04 ,$3.17 ,$90.04 ,$54.02 ,$94.04 ,$7.13 ,$92.04 ,$3.48 ,$91.04 ,$3.17 ,$61.56 ,$61.56 ,$19.77 ,$74.66 ,$19.96 ,$3.20 ,$3.28 ,$95.04 ,$3.33 ,$3.28 ,$87.03 ,$3.17 ,$90.04 ,$3.17 ,$90.04 ,$90.04 ,$90.04 ,$97.04 ,$81.03 ,$93.04 ,$86.03 ,$97.04 
SACRED HEART HOSPITAL (ACU),30700104,81003,HC URINALYSIS AUTO W/O MICRO,307,1 ,$42.60 ,$31.95 ,$2.25 ,$42.60 ,$27.43 ,$2.25 ,$29.82 ,$2.32 ,$5.39 ,$2.39 ,$4.31 ,$40.47 ,$2.32 ,$34.08 ,$39.19 ,$2.32 ,$36.21 ,$40.47 ,$37.49 ,$32.38 ,$2.32 ,$2.32 ,$2.32 ,$31.10 ,$23.43 ,$38.77 ,$38.77 ,$34.08 ,$2.32 ,$23.43 ,$38.34 ,$2.25 ,$38.34 ,$23.00 ,$40.04 ,$5.06 ,$39.19 ,$2.46 ,$38.77 ,$2.25 ,$26.22 ,$26.22 ,$41.31 ,$31.79 ,$14.10 ,$2.27 ,$2.32 ,$40.47 ,$2.36 ,$2.32 ,$37.06 ,$2.25 ,$38.34 ,$2.25 ,$38.34 ,$38.34 ,$38.34 ,$41.32 ,$34.51 ,$39.62 ,$36.64 ,$41.32 
SACRED HEART HOSPITAL (ACU),30700116,81025,HC URINE PREGNANCY TEST,307,1 ,$126.50 ,$94.88 ,$8.61 ,$126.50 ,$81.47 ,$8.61 ,$88.55 ,$8.90 ,$15.17 ,$9.17 ,$12.14 ,$120.18 ,$8.90 ,$101.20 ,$116.38 ,$8.90 ,$107.53 ,$120.18 ,$111.32 ,$96.14 ,$8.90 ,$8.90 ,$8.90 ,$92.35 ,$69.58 ,$115.12 ,$115.12 ,$101.20 ,$8.87 ,$69.58 ,$113.85 ,$8.61 ,$113.85 ,$68.31 ,$118.91 ,$19.37 ,$116.38 ,$9.43 ,$115.12 ,$8.61 ,$77.85 ,$77.85 ,$39.09 ,$94.41 ,$43.84 ,$8.70 ,$8.90 ,$120.18 ,$9.04 ,$8.90 ,$110.06 ,$8.61 ,$113.85 ,$8.61 ,$113.85 ,$113.85 ,$113.85 ,$122.71 ,$102.47 ,$117.65 ,$108.79 ,$122.71 
SACRED HEART HOSPITAL (ACU),30700120,81002,HC URANALYSIS NON AUTO W/O MICRO,307,1 ,$42.60 ,$31.95 ,$3.48 ,$42.60 ,$27.43 ,$3.48 ,$29.82 ,$3.60 ,$6.13 ,$3.71 ,$4.90 ,$40.47 ,$3.60 ,$34.08 ,$39.19 ,$3.60 ,$36.21 ,$40.47 ,$37.49 ,$32.38 ,$3.60 ,$3.60 ,$3.60 ,$31.10 ,$23.43 ,$38.77 ,$38.77 ,$34.08 ,$3.58 ,$23.43 ,$38.34 ,$3.48 ,$38.34 ,$23.00 ,$40.04 ,$7.83 ,$39.19 ,$3.82 ,$38.77 ,$3.48 ,$26.22 ,$26.22 ,$24.57 ,$31.79 ,$17.72 ,$3.51 ,$3.60 ,$40.47 ,$3.65 ,$3.60 ,$37.06 ,$3.48 ,$38.34 ,$3.48 ,$38.34 ,$38.34 ,$38.34 ,$41.32 ,$34.51 ,$39.62 ,$36.64 ,$41.32 
SACRED HEART HOSPITAL (ACU),31000021,81275,HC KRAS GENE,310,1 ,$922.00 ,$691.50 ,$157.98 ,$922.00 ,$593.77 ,$193.25 ,$645.40 ,$157.98 ,$347.50 ,$162.72 ,$278.00 ,$875.90 ,$157.98 ,$737.60 ,$848.24 ,$157.98 ,$783.70 ,$875.90 ,$811.36 ,$700.72 ,$157.98 ,$157.98 ,$157.98 ,$673.06 ,$507.10 ,$839.02 ,$839.02 ,$737.60 ,$199.05 ,$507.10 ,$829.80 ,$193.25 ,$829.80 ,$497.88 ,$866.68 ,$434.81 ,$848.24 ,$167.46 ,$839.02 ,$193.25 ,$567.40 ,$567.40 ,$377.16 ,$688.09 ,$829.80 ,$195.18 ,$157.98 ,$875.90 ,$202.91 ,$157.98 ,$802.14 ,$193.25 ,$829.80 ,$193.25 ,$829.80 ,$829.80 ,$829.80 ,$894.34 ,$746.82 ,$857.46 ,$792.92 ,$894.34 
SACRED HEART HOSPITAL (ACU),31000022,81291,HC MTHFR ISOLATION,310,1 ,$527.00 ,$395.25 ,$14.07 ,$527.00 ,$339.39 ,$65.34 ,$368.90 ,$14.07 ,$104.79 ,$14.49 ,$83.83 ,$500.65 ,$14.07 ,$421.60 ,$484.84 ,$14.07 ,$447.95 ,$500.65 ,$463.76 ,$400.52 ,$14.07 ,$14.07 ,$14.07 ,$384.71 ,$289.85 ,$479.57 ,$479.57 ,$421.60 ,$67.30 ,$289.85 ,$474.30 ,$65.34 ,$474.30 ,$284.58 ,$495.38 ,$147.02 ,$484.84 ,$14.91 ,$479.57 ,$65.34 ,$324.32 ,$324.32 ,$113.63 ,$393.30 ,$332.69 ,$65.99 ,$14.07 ,$500.65 ,$68.61 ,$14.07 ,$458.49 ,$65.34 ,$474.30 ,$65.34 ,$474.30 ,$474.30 ,$474.30 ,$511.19 ,$426.87 ,$490.11 ,$453.22 ,$511.19 
SACRED HEART HOSPITAL (ACU),31000031,81401,HC HUNT MOPATH PROCEDURE L2,310,1 ,$453.00 ,$339.75 ,$109.60 ,$453.00 ,$291.73 , N/A ,$317.10 ,$109.60 ,$453.00 ,$112.89 ,$453.00 ,$430.35 ,$109.60 ,$362.40 ,$416.76 ,$109.60 ,$385.05 ,$430.35 ,$398.64 ,$344.28 ,$109.60 ,$109.60 ,$109.60 ,$330.69 ,$249.15 ,$412.23 ,$412.23 ,$362.40 , N/A ,$249.15 ,$407.70 , N/A ,$407.70 ,$244.62 ,$425.82 ,$271.80 ,$416.76 ,$116.18 ,$412.23 , N/A ,$278.78 ,$278.78 ,$260.79 ,$338.07 ,$407.70 ,$371.46 ,$109.60 ,$430.35 , N/A ,$109.60 ,$394.11 , N/A ,$407.70 , N/A ,$407.70 ,$407.70 ,$407.70 ,$439.41 ,$366.93 ,$421.29 ,$389.58 ,$439.41 
SACRED HEART HOSPITAL (ACU),31000057,81206,HC BCR/ABL1 GENE MAJOR BP QL/QN,310,1 ,$669.00 ,$501.75 ,$163.96 ,$669.00 ,$430.84 ,$163.96 ,$468.30 ,$169.42 ,$393.59 ,$174.50 ,$314.87 ,$635.55 ,$169.42 ,$535.20 ,$615.48 ,$169.42 ,$568.65 ,$635.55 ,$588.72 ,$508.44 ,$169.42 ,$169.42 ,$169.42 ,$488.37 ,$367.95 ,$608.79 ,$608.79 ,$535.20 ,$168.88 ,$367.95 ,$602.10 ,$163.96 ,$602.10 ,$361.26 ,$628.86 ,$368.91 ,$615.48 ,$179.59 ,$608.79 ,$163.96 ,$411.70 ,$411.70 ,$427.13 ,$499.27 ,$602.10 ,$165.60 ,$169.42 ,$635.55 ,$172.16 ,$169.42 ,$582.03 ,$163.96 ,$602.10 ,$163.96 ,$602.10 ,$602.10 ,$602.10 ,$648.93 ,$541.89 ,$622.17 ,$575.34 ,$648.93 
SACRED HEART HOSPITAL (ACU),31000058,81220,HC CFTR GENE ANALYSIS,310,1 ,"$1,840.00 ","$1,380.00 ",$210.00 ,"$1,840.00 ","$1,184.96 ",$556.60 ,"$1,288.00 ",$210.00 ,"$1,840.00 ",$216.30 ,"$1,840.00 ","$1,748.00 ",$210.00 ,"$1,472.00 ","$1,692.80 ",$210.00 ,"$1,564.00 ","$1,748.00 ","$1,619.20 ","$1,398.40 ",$210.00 ,$210.00 ,$210.00 ,"$1,343.20 ","$1,012.00 ","$1,674.40 ","$1,674.40 ","$1,472.00 ",$573.30 ,"$1,012.00 ","$1,656.00 ",$556.60 ,"$1,656.00 ",$993.60 ,"$1,729.60 ","$1,252.35 ","$1,692.80 ",$222.60 ,"$1,674.40 ",$556.60 ,"$1,132.34 ","$1,132.34 ","$1,058.24 ","$1,373.19 ","$1,656.00 ",$562.17 ,$210.00 ,"$1,748.00 ",$584.43 ,$210.00 ,"$1,600.80 ",$556.60 ,"$1,656.00 ",$556.60 ,"$1,656.00 ","$1,656.00 ","$1,656.00 ","$1,784.80 ","$1,490.40 ","$1,711.20 ","$1,582.40 ","$1,784.80 "
SACRED HEART HOSPITAL (ACU),31000059,81240,HC F2 GENE ANAL 20210G A VAR,310,1 ,$469.00 ,$351.75 ,$53.70 ,$469.00 ,$302.04 ,$65.69 ,$328.30 ,$53.70 ,$118.13 ,$55.31 ,$94.50 ,$445.55 ,$53.70 ,$375.20 ,$431.48 ,$53.70 ,$398.65 ,$445.55 ,$412.72 ,$356.44 ,$53.70 ,$53.70 ,$53.70 ,$342.37 ,$257.95 ,$426.79 ,$426.79 ,$375.20 ,$67.66 ,$257.95 ,$422.10 ,$65.69 ,$422.10 ,$253.26 ,$440.86 ,$147.80 ,$431.48 ,$56.92 ,$426.79 ,$65.69 ,$288.62 ,$288.62 ,$128.00 ,$350.01 ,$334.47 ,$66.35 ,$53.70 ,$445.55 ,$68.97 ,$53.70 ,$408.03 ,$65.69 ,$422.10 ,$65.69 ,$422.10 ,$422.10 ,$422.10 ,$454.93 ,$379.89 ,$436.17 ,$403.34 ,$454.93 
SACRED HEART HOSPITAL (ACU),31000060,81241,HC F5 GENE ANAL LEIDEN VAR,310,1 ,$279.00 ,$209.25 ,$66.70 ,$279.00 ,$179.68 ,$73.37 ,$195.30 ,$66.70 ,$146.69 ,$68.70 ,$117.35 ,$265.05 ,$66.70 ,$223.20 ,$256.68 ,$66.70 ,$237.15 ,$265.05 ,$245.52 ,$212.04 ,$66.70 ,$66.70 ,$66.70 ,$203.67 ,$153.45 ,$253.89 ,$253.89 ,$223.20 ,$75.57 ,$153.45 ,$251.10 ,$73.37 ,$251.10 ,$150.66 ,$262.26 ,$165.08 ,$256.68 ,$70.70 ,$253.89 ,$73.37 ,$171.70 ,$171.70 ,$159.49 ,$208.22 ,$251.10 ,$74.10 ,$66.70 ,$265.05 ,$77.04 ,$66.70 ,$242.73 ,$73.37 ,$251.10 ,$73.37 ,$251.10 ,$251.10 ,$251.10 ,$270.63 ,$225.99 ,$259.47 ,$239.94 ,$270.63 
SACRED HEART HOSPITAL (ACU),31000061,81256,HC HFE GENE ANALYSIS,310,1 ,$350.00 ,$262.50 ,$65.36 ,$350.00 ,$225.40 ,$65.36 ,$245.00 ,$67.54 ,$156.91 ,$69.57 ,$125.52 ,$332.50 ,$67.54 ,$280.00 ,$322.00 ,$67.54 ,$297.50 ,$332.50 ,$308.00 ,$266.00 ,$67.54 ,$67.54 ,$67.54 ,$255.50 ,$192.50 ,$318.50 ,$318.50 ,$280.00 ,$67.32 ,$192.50 ,$315.00 ,$65.36 ,$315.00 ,$189.00 ,$329.00 ,$147.06 ,$322.00 ,$71.59 ,$318.50 ,$65.36 ,$215.39 ,$215.39 ,$170.44 ,$261.21 ,$315.00 ,$66.01 ,$67.54 ,$332.50 ,$68.63 ,$67.54 ,$304.50 ,$65.36 ,$315.00 ,$65.36 ,$315.00 ,$315.00 ,$315.00 ,$339.50 ,$283.50 ,$325.50 ,$301.00 ,$339.50 
SACRED HEART HOSPITAL (ACU),31000062,81270,HC JAK2 GENE ANALYSIS,310,1 ,$514.00 ,$385.50 ,$91.66 ,$514.00 ,$331.02 ,$91.66 ,$359.80 ,$94.71 ,$220.05 ,$97.55 ,$176.04 ,$488.30 ,$94.71 ,$411.20 ,$472.88 ,$94.71 ,$436.90 ,$488.30 ,$452.32 ,$390.64 ,$94.71 ,$94.71 ,$94.71 ,$375.22 ,$282.70 ,$467.74 ,$467.74 ,$411.20 ,$94.41 ,$282.70 ,$462.60 ,$91.66 ,$462.60 ,$277.56 ,$483.16 ,$206.24 ,$472.88 ,$100.39 ,$467.74 ,$91.66 ,$316.32 ,$316.32 ,$238.89 ,$383.60 ,$462.60 ,$92.58 ,$94.71 ,$488.30 ,$96.24 ,$94.71 ,$447.18 ,$91.66 ,$462.60 ,$91.66 ,$462.60 ,$462.60 ,$462.60 ,$498.58 ,$416.34 ,$478.02 ,$442.04 ,$498.58 
SACRED HEART HOSPITAL (ACU),31000063,81315,HC PML/RARAL COM BRKPNTS,310,1 ,"$1,208.00 ",$906.00 ,$207.31 ,"$1,208.00 ",$777.95 ,$207.31 ,$845.60 ,$214.21 ,$497.67 ,$220.64 ,$398.13 ,"$1,147.60 ",$214.21 ,$966.40 ,"$1,111.36 ",$214.21 ,"$1,026.80 ","$1,147.60 ","$1,063.04 ",$918.08 ,$214.21 ,$214.21 ,$214.21 ,$881.84 ,$664.40 ,"$1,099.28 ","$1,099.28 ",$966.40 ,$213.53 ,$664.40 ,"$1,087.20 ",$207.31 ,"$1,087.20 ",$652.32 ,"$1,135.52 ",$466.45 ,"$1,111.36 ",$227.06 ,"$1,099.28 ",$207.31 ,$743.40 ,$743.40 ,$540.07 ,$901.53 ,"$1,087.20 ",$209.38 ,$214.21 ,"$1,147.60 ",$217.68 ,$214.21 ,"$1,050.96 ",$207.31 ,"$1,087.20 ",$207.31 ,"$1,087.20 ","$1,087.20 ","$1,087.20 ","$1,171.76 ",$978.48 ,"$1,123.44 ","$1,038.88 ","$1,171.76 "
SACRED HEART HOSPITAL (ACU),31000064,81370,HC HLA CLASS 1 AND 2 LOW RESOLUTION,310,1 ,"$1,641.00 ","$1,230.75 ",$402.12 ,"$1,641.00 ","$1,056.80 ",$402.12 ,"$1,148.70 ",$415.51 ,$965.32 ,$427.98 ,$772.25 ,"$1,558.95 ",$415.51 ,"$1,312.80 ","$1,509.72 ",$415.51 ,"$1,394.85 ","$1,558.95 ","$1,444.08 ","$1,247.16 ",$415.51 ,$415.51 ,$415.51 ,"$1,197.93 ",$902.55 ,"$1,493.31 ","$1,493.31 ","$1,312.80 ",$414.18 ,$902.55 ,"$1,476.90 ",$402.12 ,"$1,476.90 ",$886.14 ,"$1,542.54 ",$904.77 ,"$1,509.72 ",$440.44 ,"$1,493.31 ",$402.12 ,"$1,009.87 ","$1,009.87 ","$1,047.97 ","$1,224.68 ","$1,476.90 ",$406.14 ,$415.51 ,"$1,558.95 ",$422.23 ,$415.51 ,"$1,427.67 ",$402.12 ,"$1,476.90 ",$402.12 ,"$1,476.90 ","$1,476.90 ","$1,476.90 ","$1,591.77 ","$1,329.21 ","$1,526.13 ","$1,411.26 ","$1,591.77 "
SACRED HEART HOSPITAL (ACU),31000065,81372,HC CLASS 1 TYPING COMPLETE LOW RESOLUTION,310,1 ,"$1,334.00 ","$1,000.50 ",$241.09 ,"$1,334.00 ",$859.10 ,$403.59 ,$933.80 ,$241.09 ,$530.29 ,$248.32 ,$424.23 ,"$1,267.30 ",$241.09 ,"$1,067.20 ","$1,227.28 ",$241.09 ,"$1,133.90 ","$1,267.30 ","$1,173.92 ","$1,013.84 ",$241.09 ,$241.09 ,$241.09 ,$973.82 ,$733.70 ,"$1,213.94 ","$1,213.94 ","$1,067.20 ",$415.70 ,$733.70 ,"$1,200.60 ",$403.59 ,"$1,200.60 ",$720.36 ,"$1,253.96 ",$908.08 ,"$1,227.28 ",$255.56 ,"$1,213.94 ",$403.59 ,$820.94 ,$820.94 ,$575.66 ,$995.56 ,"$1,200.60 ",$407.63 ,$241.09 ,"$1,267.30 ",$423.77 ,$241.09 ,"$1,160.58 ",$403.59 ,"$1,200.60 ",$403.59 ,"$1,200.60 ","$1,200.60 ","$1,200.60 ","$1,293.98 ","$1,080.54 ","$1,240.62 ","$1,147.24 ","$1,293.98 "
SACRED HEART HOSPITAL (ACU),31000066,81406,HC MOLECULAR PATH PROC LEVEL 7,310,1 ,"$4,420.00 ","$3,315.00 ",$226.30 ,"$4,420.00 ","$2,846.48 ", N/A ,"$3,094.00 ",$226.30 ,"$1,237.60 ",$233.09 ,$990.08 ,"$4,199.00 ",$226.30 ,"$3,536.00 ","$4,066.40 ",$226.30 ,"$3,757.00 ","$4,199.00 ","$3,889.60 ","$3,359.20 ",$226.30 ,$226.30 ,$226.30 ,"$3,226.60 ","$2,431.00 ","$4,022.20 ","$4,022.20 ","$3,536.00 ", N/A ,"$2,431.00 ","$3,978.00 ", N/A ,"$3,978.00 ","$2,386.80 ","$4,154.80 ","$2,652.00 ","$4,066.40 ",$239.88 ,"$4,022.20 ", N/A ,"$2,720.07 ","$2,720.07 ",$538.02 ,"$3,298.65 ","$1,440.31 ","$3,624.40 ",$226.30 ,"$4,199.00 ", N/A ,$226.30 ,"$3,845.40 ", N/A ,"$3,978.00 ", N/A ,"$3,978.00 ","$3,978.00 ","$3,978.00 ","$4,287.40 ","$3,580.20 ","$4,110.60 ","$3,801.20 ","$4,287.40 "
SACRED HEART HOSPITAL (ACU),31000067,88341,HC IMMUNOHISTOCHEM AB EACH ADDL,310,1 ,$289.49 ,$217.12 ,$13.13 ,$289.49 ,$186.43 , N/A ,$202.64 ,$13.13 ,$104.48 ,$13.52 ,$83.58 ,$275.02 ,$13.13 ,$231.59 ,$266.33 ,$13.13 ,$246.07 ,$275.02 ,$254.75 ,$220.01 ,$13.13 ,$13.13 ,$13.13 ,$211.33 ,$159.22 ,$263.44 ,$263.44 ,$231.59 , N/A ,$159.22 ,$260.54 , N/A ,$260.54 ,$156.32 ,$272.12 , N/A ,$266.33 ,$13.92 ,$263.44 , N/A ,$178.15 ,$178.15 ,$129.37 ,$216.05 ,$260.54 , N/A ,$13.13 ,$275.02 , N/A ,$13.13 ,$251.86 , N/A ,$260.54 , N/A ,$260.54 ,$260.54 ,$260.54 ,$280.81 ,$234.49 ,$269.23 ,$248.96 ,$280.81 
SACRED HEART HOSPITAL (ACU),31000068,88341,HC IMMUNOHISTOCHEM AB EA ADDL REPEAT,310,1 ,$289.49 ,$217.12 ,$13.13 ,$289.49 ,$186.43 , N/A ,$202.64 ,$13.13 ,$104.48 ,$13.52 ,$83.58 ,$275.02 ,$13.13 ,$231.59 ,$266.33 ,$13.13 ,$246.07 ,$275.02 ,$254.75 ,$220.01 ,$13.13 ,$13.13 ,$13.13 ,$211.33 ,$159.22 ,$263.44 ,$263.44 ,$231.59 , N/A ,$159.22 ,$260.54 , N/A ,$260.54 ,$156.32 ,$272.12 , N/A ,$266.33 ,$13.92 ,$263.44 , N/A ,$178.15 ,$178.15 ,$129.37 ,$216.05 ,$260.54 , N/A ,$13.13 ,$275.02 , N/A ,$13.13 ,$251.86 , N/A ,$260.54 , N/A ,$260.54 ,$260.54 ,$260.54 ,$280.81 ,$234.49 ,$269.23 ,$248.96 ,$280.81 
SACRED HEART HOSPITAL (ACU),31000069,88342,HC IMMUNOHISTOCHEM AB-INITIAL,310,1 ,$570.22 ,$427.67 ,$13.13 ,$570.22 ,$367.22 ,$157.74 ,$399.15 ,$13.13 ,$118.56 ,$13.52 ,$94.85 ,$541.71 ,$13.13 ,$456.18 ,$524.60 ,$13.13 ,$484.69 ,$541.71 ,$501.79 ,$433.37 ,$13.13 ,$13.13 ,$13.13 ,$416.26 ,$313.62 ,$518.90 ,$518.90 ,$456.18 ,$162.47 ,$313.62 ,$513.20 ,$157.74 ,$513.20 ,$307.92 ,$536.01 ,$354.91 ,$524.60 ,$13.92 ,$518.90 ,$157.74 ,$350.91 ,$350.91 ,$87.89 ,$425.56 ,$360.23 ,$159.32 ,$13.13 ,$541.71 ,$165.63 ,$13.13 ,$496.09 ,$157.74 ,$513.20 ,$157.74 ,$513.20 ,$513.20 ,$513.20 ,$553.11 ,$461.88 ,$530.30 ,$490.39 ,$553.11 
SACRED HEART HOSPITAL (ACU),31000070,88367,HC FISH HER-2NEU,310,1 ,$570.22 ,$427.67 ,$13.13 ,$693.07 ,$367.22 ,$308.03 ,$399.15 ,$13.13 ,$118.56 ,$13.52 ,$94.85 ,$541.71 ,$13.13 ,$456.18 ,$524.60 ,$13.13 ,$484.69 ,$541.71 ,$501.79 ,$433.37 ,$13.13 ,$13.13 ,$13.13 ,$416.26 ,$313.62 ,$518.90 ,$518.90 ,$456.18 ,$317.27 ,$313.62 ,$513.20 ,$308.03 ,$513.20 ,$307.92 ,$536.01 ,$693.07 ,$524.60 ,$13.92 ,$518.90 ,$308.03 ,$350.91 ,$350.91 ,$284.89 ,$425.56 ,$354.99 ,$311.11 ,$13.13 ,$541.71 ,$323.43 ,$13.13 ,$496.09 ,$308.03 ,$513.20 ,$308.03 ,$513.20 ,$513.20 ,$513.20 ,$553.11 ,$461.88 ,$530.30 ,$490.39 ,$553.11 
SACRED HEART HOSPITAL (ACU),31000071,88367,HC MORPHO ANALYSIS INSITU HYBRID,310,1 ,$570.22 ,$427.67 ,$13.13 ,$693.07 ,$367.22 ,$308.03 ,$399.15 ,$13.13 ,$118.56 ,$13.52 ,$94.85 ,$541.71 ,$13.13 ,$456.18 ,$524.60 ,$13.13 ,$484.69 ,$541.71 ,$501.79 ,$433.37 ,$13.13 ,$13.13 ,$13.13 ,$416.26 ,$313.62 ,$518.90 ,$518.90 ,$456.18 ,$317.27 ,$313.62 ,$513.20 ,$308.03 ,$513.20 ,$307.92 ,$536.01 ,$693.07 ,$524.60 ,$13.92 ,$518.90 ,$308.03 ,$350.91 ,$350.91 ,$284.89 ,$425.56 ,$354.99 ,$311.11 ,$13.13 ,$541.71 ,$323.43 ,$13.13 ,$496.09 ,$308.03 ,$513.20 ,$308.03 ,$513.20 ,$513.20 ,$513.20 ,$553.11 ,$461.88 ,$530.30 ,$490.39 ,$553.11 
SACRED HEART HOSPITAL (ACU),31000072,88285,HC CHROMOSOME ADDL CELLS COUNTED EA STUDY,310,1 ,$67.28 ,$50.46 ,$26.72 ,$67.28 ,$43.33 ,$26.91 ,$47.10 ,$26.72 ,$45.61 ,$27.52 ,$36.48 ,$63.92 ,$26.72 ,$53.82 ,$61.90 ,$26.72 ,$57.19 ,$63.92 ,$59.21 ,$51.13 ,$26.72 ,$26.72 ,$26.72 ,$49.11 ,$37.00 ,$61.22 ,$61.22 ,$53.82 ,$27.72 ,$37.00 ,$60.55 ,$26.91 ,$60.55 ,$36.33 ,$63.24 ,$60.55 ,$61.90 ,$28.32 ,$61.22 ,$26.91 ,$41.40 ,$41.40 ,$49.41 ,$50.21 ,$60.55 ,$27.18 ,$26.72 ,$63.92 ,$28.26 ,$26.72 ,$58.53 ,$26.91 ,$60.55 ,$26.91 ,$60.55 ,$60.55 ,$60.55 ,$65.26 ,$54.50 ,$62.57 ,$57.86 ,$65.26 
SACRED HEART HOSPITAL (ACU),31100101,88104,HC CYTOPATH FLD SMEAR,311,1 ,$140.05 ,$105.04 ,$3.12 ,$140.05 ,$90.19 ,$35.80 ,$98.04 ,$3.12 ,$75.34 ,$3.21 ,$60.27 ,$133.05 ,$3.12 ,$112.04 ,$128.85 ,$3.12 ,$119.04 ,$133.05 ,$123.24 ,$106.44 ,$3.12 ,$3.12 ,$3.12 ,$102.24 ,$77.03 ,$127.45 ,$127.45 ,$112.04 ,$36.87 ,$77.03 ,$126.05 ,$35.80 ,$126.05 ,$75.63 ,$131.65 ,$80.55 ,$128.85 ,$3.31 ,$127.45 ,$35.80 ,$86.19 ,$86.19 ,$126.59 ,$104.52 ,$126.05 ,$36.16 ,$3.12 ,$133.05 ,$37.59 ,$3.12 ,$121.84 ,$35.80 ,$126.05 ,$35.80 ,$126.05 ,$126.05 ,$126.05 ,$135.85 ,$113.44 ,$130.25 ,$120.44 ,$135.85 
SACRED HEART HOSPITAL (ACU),31100102,88108,HC CYTOPATH CONCENTRATION,311,1 ,$223.69 ,$167.77 ,$3.12 ,$223.69 ,$144.06 ,$35.80 ,$156.58 ,$3.12 ,$66.33 ,$3.21 ,$53.06 ,$212.51 ,$3.12 ,$178.95 ,$205.79 ,$3.12 ,$190.14 ,$212.51 ,$196.85 ,$170.00 ,$3.12 ,$3.12 ,$3.12 ,$163.29 ,$123.03 ,$203.56 ,$203.56 ,$178.95 ,$36.87 ,$123.03 ,$201.32 ,$35.80 ,$201.32 ,$120.79 ,$210.27 ,$80.55 ,$205.79 ,$3.31 ,$203.56 ,$35.80 ,$137.66 ,$137.66 ,$131.77 ,$166.94 ,$186.56 ,$36.16 ,$3.12 ,$212.51 ,$37.59 ,$3.12 ,$194.61 ,$35.80 ,$201.32 ,$35.80 ,$201.32 ,$201.32 ,$201.32 ,$216.98 ,$181.19 ,$208.03 ,$192.37 ,$216.98 
SACRED HEART HOSPITAL (ACU),31100104,88112,HC CYTOPATH CELL ENHANCE,311,1 ,$141.13 ,$105.85 ,$9.37 ,$141.13 ,$90.89 ,$52.56 ,$98.79 ,$9.37 ,$66.33 ,$9.65 ,$53.06 ,$134.07 ,$9.37 ,$112.90 ,$129.84 ,$9.37 ,$119.96 ,$134.07 ,$124.19 ,$107.26 ,$9.37 ,$9.37 ,$9.37 ,$103.02 ,$77.62 ,$128.43 ,$128.43 ,$112.90 ,$54.14 ,$77.62 ,$127.02 ,$52.56 ,$127.02 ,$76.21 ,$132.66 ,$118.25 ,$129.84 ,$9.93 ,$128.43 ,$52.56 ,$86.85 ,$86.85 ,$140.92 ,$105.33 ,$127.02 ,$53.08 ,$9.37 ,$134.07 ,$55.18 ,$9.37 ,$122.78 ,$52.56 ,$127.02 ,$52.56 ,$127.02 ,$127.02 ,$127.02 ,$136.90 ,$114.32 ,$131.25 ,$121.37 ,$136.90 
SACRED HEART HOSPITAL (ACU),31100107,88142,HC THINPREP PAP,311,1 ,$192.24 ,$144.18 ,$20.26 ,$192.24 ,$123.80 ,$20.26 ,$134.57 ,$20.93 ,$48.63 ,$21.56 ,$38.91 ,$182.63 ,$20.93 ,$153.79 ,$176.86 ,$20.93 ,$163.40 ,$182.63 ,$169.17 ,$146.10 ,$20.93 ,$20.93 ,$20.93 ,$140.34 ,$105.73 ,$174.94 ,$174.94 ,$153.79 ,$20.87 ,$105.73 ,$173.02 ,$20.26 ,$173.02 ,$103.81 ,$180.71 ,$45.59 ,$176.86 ,$22.19 ,$174.94 ,$20.26 ,$118.30 ,$118.30 ,$51.87 ,$143.47 ,$127.34 ,$20.46 ,$20.93 ,$182.63 ,$21.27 ,$20.93 ,$167.25 ,$20.26 ,$173.02 ,$20.26 ,$173.02 ,$173.02 ,$173.02 ,$186.47 ,$155.71 ,$178.78 ,$165.33 ,$186.47 
SACRED HEART HOSPITAL (ACU),31100110,88160,HC CYTOPATH SMEAR NON GYN,311,1 ,$107.39 ,$80.54 ,$3.12 ,$107.39 ,$69.16 ,$26.13 ,$75.17 ,$3.12 ,$77.14 ,$3.21 ,$61.71 ,$102.02 ,$3.12 ,$85.91 ,$98.80 ,$3.12 ,$91.28 ,$102.02 ,$94.50 ,$81.62 ,$3.12 ,$3.12 ,$3.12 ,$78.39 ,$59.06 ,$97.72 ,$97.72 ,$85.91 ,$26.91 ,$59.06 ,$96.65 ,$26.13 ,$96.65 ,$57.99 ,$100.95 ,$58.79 ,$98.80 ,$3.31 ,$97.72 ,$26.13 ,$66.09 ,$66.09 ,$104.33 ,$80.15 ,$96.65 ,$26.39 ,$3.12 ,$102.02 ,$27.43 ,$3.12 ,$93.43 ,$26.13 ,$96.65 ,$26.13 ,$96.65 ,$96.65 ,$96.65 ,$104.17 ,$86.99 ,$99.87 ,$92.36 ,$104.17 
SACRED HEART HOSPITAL (ACU),31100113,88164,HC CYTOPATH SCR BETHESDA,311,1 ,$93.51 ,$70.13 ,$14.86 ,$93.51 ,$60.22 ,$15.92 ,$65.46 ,$14.86 ,$25.36 ,$15.31 ,$20.29 ,$88.83 ,$14.86 ,$74.81 ,$86.03 ,$14.86 ,$79.48 ,$88.83 ,$82.29 ,$71.07 ,$14.86 ,$14.86 ,$14.86 ,$68.26 ,$51.43 ,$85.09 ,$85.09 ,$74.81 ,$16.40 ,$51.43 ,$84.16 ,$15.92 ,$84.16 ,$50.50 ,$87.90 ,$35.82 ,$86.03 ,$15.75 ,$85.09 ,$15.92 ,$57.55 ,$57.55 ,$22.38 ,$69.79 ,$74.59 ,$16.08 ,$14.86 ,$88.83 ,$16.72 ,$14.86 ,$81.35 ,$15.92 ,$84.16 ,$15.92 ,$84.16 ,$84.16 ,$84.16 ,$90.70 ,$75.74 ,$86.96 ,$80.42 ,$90.70 
SACRED HEART HOSPITAL (ACU),31100114,88172,HC FINE NEEDLE EVAL,311,1 ,$341.92 ,$256.44 ,$12.88 ,$354.91 ,$220.20 ,$157.74 ,$239.34 ,$12.88 ,$33.30 ,$13.27 ,$26.64 ,$324.82 ,$12.88 ,$273.54 ,$314.57 ,$12.88 ,$290.63 ,$324.82 ,$300.89 ,$259.86 ,$12.88 ,$12.88 ,$12.88 ,$249.60 ,$188.06 ,$311.15 ,$311.15 ,$273.54 ,$162.47 ,$188.06 ,$307.73 ,$157.74 ,$307.73 ,$184.64 ,$321.40 ,$354.91 ,$314.57 ,$13.65 ,$311.15 ,$157.74 ,$210.42 ,$210.42 ,$186.68 ,$255.17 ,$100.61 ,$159.32 ,$12.88 ,$324.82 ,$165.63 ,$12.88 ,$297.47 ,$157.74 ,$307.73 ,$157.74 ,$307.73 ,$307.73 ,$307.73 ,$331.66 ,$276.96 ,$317.99 ,$294.05 ,$331.66 
SACRED HEART HOSPITAL (ACU),31100115,88173,HC FINE NEEDLE INTERP,311,1 ,$245.86 ,$184.40 ,$11.96 ,$245.86 ,$158.33 ,$52.56 ,$172.10 ,$11.96 ,$135.66 ,$12.32 ,$108.53 ,$233.57 ,$11.96 ,$196.69 ,$226.19 ,$11.96 ,$208.98 ,$233.57 ,$216.36 ,$186.85 ,$11.96 ,$11.96 ,$11.96 ,$179.48 ,$135.22 ,$223.73 ,$223.73 ,$196.69 ,$54.14 ,$135.22 ,$221.27 ,$52.56 ,$221.27 ,$132.76 ,$231.11 ,$118.25 ,$226.19 ,$12.68 ,$223.73 ,$52.56 ,$151.30 ,$151.30 ,$197.64 ,$183.49 ,$221.27 ,$53.08 ,$11.96 ,$233.57 ,$55.18 ,$11.96 ,$213.90 ,$52.56 ,$221.27 ,$52.56 ,$221.27 ,$221.27 ,$221.27 ,$238.48 ,$199.15 ,$228.65 ,$211.44 ,$238.48 
SACRED HEART HOSPITAL (ACU),31100121,88184,HC FLOW CYTO 1ST MARKER,311,1 ,$570.22 ,$427.67 ,$9.37 ,$693.07 ,$367.22 ,$308.03 ,$399.15 ,$9.37 ,$102.95 ,$9.65 ,$82.36 ,$541.71 ,$9.37 ,$456.18 ,$524.60 ,$9.37 ,$484.69 ,$541.71 ,$501.79 ,$433.37 ,$9.37 ,$9.37 ,$9.37 ,$416.26 ,$313.62 ,$518.90 ,$518.90 ,$456.18 ,$317.27 ,$313.62 ,$513.20 ,$308.03 ,$513.20 ,$307.92 ,$536.01 ,$693.07 ,$524.60 ,$9.93 ,$518.90 ,$308.03 ,$350.91 ,$350.91 ,$103.17 ,$425.56 ,$329.27 ,$311.11 ,$9.37 ,$541.71 ,$323.43 ,$9.37 ,$496.09 ,$308.03 ,$513.20 ,$308.03 ,$513.20 ,$513.20 ,$513.20 ,$553.11 ,$461.88 ,$530.30 ,$490.39 ,$553.11 
SACRED HEART HOSPITAL (ACU),31100126,88185,HC FLOW CYTO EA ADD MARKER,311,1 ,$56.89 ,$42.67 ,$12.88 ,$56.89 ,$36.64 , N/A ,$39.82 ,$12.88 ,$56.89 ,$13.27 ,$50.44 ,$54.05 ,$12.88 ,$45.51 ,$52.34 ,$12.88 ,$48.36 ,$54.05 ,$50.06 ,$43.24 ,$12.88 ,$12.88 ,$12.88 ,$41.53 ,$31.29 ,$51.77 ,$51.77 ,$45.51 , N/A ,$31.29 ,$51.20 , N/A ,$51.20 ,$30.72 ,$53.48 , N/A ,$52.34 ,$13.65 ,$51.77 , N/A ,$35.01 ,$35.01 ,$50.82 ,$42.46 ,$51.20 , N/A ,$12.88 ,$54.05 , N/A ,$12.88 ,$49.49 , N/A ,$51.20 , N/A ,$51.20 ,$51.20 ,$51.20 ,$55.18 ,$46.08 ,$52.91 ,$48.93 ,$55.18 
SACRED HEART HOSPITAL (ACU),31100137,88233,HC TISSUE CULT SKIN/OTH SOLID,311,1 ,$434.35 ,$325.76 ,$70.04 ,$434.35 ,$279.72 ,$140.73 ,$304.05 ,$70.04 ,$119.56 ,$72.14 ,$95.65 ,$412.63 ,$70.04 ,$347.48 ,$399.60 ,$70.04 ,$369.20 ,$412.63 ,$382.23 ,$330.11 ,$70.04 ,$70.04 ,$70.04 ,$317.08 ,$238.89 ,$395.26 ,$395.26 ,$347.48 ,$144.95 ,$238.89 ,$390.92 ,$140.73 ,$390.92 ,$234.55 ,$408.29 ,$316.64 ,$399.60 ,$74.24 ,$395.26 ,$140.73 ,$267.30 ,$267.30 ,$175.71 ,$324.16 ,$390.92 ,$142.14 ,$70.04 ,$412.63 ,$147.77 ,$70.04 ,$377.88 ,$140.73 ,$390.92 ,$140.73 ,$390.92 ,$390.92 ,$390.92 ,$421.32 ,$351.82 ,$403.95 ,$373.54 ,$421.32 
SACRED HEART HOSPITAL (ACU),31100143,88237,HC TISSUE CULT BONE/BLD (CHROMO),311,1 ,$389.83 ,$292.37 ,$70.04 ,$389.83 ,$251.05 ,$143.75 ,$272.88 ,$70.04 ,$119.56 ,$72.14 ,$95.65 ,$370.34 ,$70.04 ,$311.86 ,$358.64 ,$70.04 ,$331.36 ,$370.34 ,$343.05 ,$296.27 ,$70.04 ,$70.04 ,$70.04 ,$284.58 ,$214.41 ,$354.75 ,$354.75 ,$311.86 ,$148.06 ,$214.41 ,$350.85 ,$143.75 ,$350.85 ,$210.51 ,$366.44 ,$323.44 ,$358.64 ,$74.24 ,$354.75 ,$143.75 ,$239.90 ,$239.90 ,$98.81 ,$290.93 ,$350.85 ,$145.19 ,$70.04 ,$370.34 ,$150.94 ,$70.04 ,$339.15 ,$143.75 ,$350.85 ,$143.75 ,$350.85 ,$350.85 ,$350.85 ,$378.14 ,$315.76 ,$362.54 ,$335.25 ,$378.14 
SACRED HEART HOSPITAL (ACU),31100144,88237,HC TISSUE CULT BONE/BLD,311,1 ,$394.38 ,$295.79 ,$70.04 ,$394.38 ,$253.98 ,$143.75 ,$276.07 ,$70.04 ,$119.56 ,$72.14 ,$95.65 ,$374.66 ,$70.04 ,$315.50 ,$362.83 ,$70.04 ,$335.22 ,$374.66 ,$347.05 ,$299.73 ,$70.04 ,$70.04 ,$70.04 ,$287.90 ,$216.91 ,$358.89 ,$358.89 ,$315.50 ,$148.06 ,$216.91 ,$354.94 ,$143.75 ,$354.94 ,$212.97 ,$370.72 ,$323.44 ,$362.83 ,$74.24 ,$358.89 ,$143.75 ,$242.70 ,$242.70 ,$98.81 ,$294.33 ,$354.94 ,$145.19 ,$70.04 ,$374.66 ,$150.94 ,$70.04 ,$343.11 ,$143.75 ,$354.94 ,$143.75 ,$354.94 ,$354.94 ,$354.94 ,$382.55 ,$319.45 ,$366.77 ,$339.17 ,$382.55 
SACRED HEART HOSPITAL (ACU),31100145,88237,HC TISSUE CULT BONE/BLD (CHROMO 1),311,1 ,$873.00 ,$654.75 ,$70.04 ,$873.00 ,$562.21 ,$143.75 ,$611.10 ,$70.04 ,$119.56 ,$72.14 ,$95.65 ,$829.35 ,$70.04 ,$698.40 ,$803.16 ,$70.04 ,$742.05 ,$829.35 ,$768.24 ,$663.48 ,$70.04 ,$70.04 ,$70.04 ,$637.29 ,$480.15 ,$794.43 ,$794.43 ,$698.40 ,$148.06 ,$480.15 ,$785.70 ,$143.75 ,$785.70 ,$471.42 ,$820.62 ,$323.44 ,$803.16 ,$74.24 ,$794.43 ,$143.75 ,$537.24 ,$537.24 ,$98.81 ,$651.52 ,$785.70 ,$145.19 ,$70.04 ,$829.35 ,$150.94 ,$70.04 ,$759.51 ,$143.75 ,$785.70 ,$143.75 ,$785.70 ,$785.70 ,$785.70 ,$846.81 ,$707.13 ,$811.89 ,$750.78 ,$846.81 
SACRED HEART HOSPITAL (ACU),31100148,88239,HC TISSUE CULT TUMOR,311,1 ,$525.48 ,$394.11 ,$70.04 ,$525.48 ,$338.41 ,$147.52 ,$367.84 ,$70.04 ,$119.56 ,$72.14 ,$95.65 ,$499.21 ,$70.04 ,$420.38 ,$483.44 ,$70.04 ,$446.66 ,$499.21 ,$462.42 ,$399.36 ,$70.04 ,$70.04 ,$70.04 ,$383.60 ,$289.01 ,$478.19 ,$478.19 ,$420.38 ,$151.95 ,$289.01 ,$472.93 ,$147.52 ,$472.93 ,$283.76 ,$493.95 ,$331.92 ,$483.44 ,$74.24 ,$478.19 ,$147.52 ,$323.38 ,$323.38 ,$490.32 ,$392.17 ,$472.93 ,$149.00 ,$70.04 ,$499.21 ,$154.90 ,$70.04 ,$457.17 ,$147.52 ,$472.93 ,$147.52 ,$472.93 ,$472.93 ,$472.93 ,$509.72 ,$425.64 ,$488.70 ,$451.91 ,$509.72 
SACRED HEART HOSPITAL (ACU),31100151,88240,HC CRYOPRESERVATION,311,1 ,$32.68 ,$24.51 ,$9.83 ,$32.68 ,$21.05 ,$13.07 ,$22.88 ,$9.83 ,$16.78 ,$10.12 ,$13.43 ,$31.05 ,$9.83 ,$26.14 ,$30.07 ,$9.83 ,$27.78 ,$31.05 ,$28.76 ,$24.84 ,$9.83 ,$9.83 ,$9.83 ,$23.86 ,$17.97 ,$29.74 ,$29.74 ,$26.14 ,$13.46 ,$17.97 ,$29.41 ,$13.07 ,$29.41 ,$17.65 ,$30.72 ,$29.41 ,$30.07 ,$10.42 ,$29.74 ,$13.07 ,$20.11 ,$20.11 ,$32.68 ,$24.39 ,$29.41 ,$13.20 ,$9.83 ,$31.05 ,$13.72 ,$9.83 ,$28.43 ,$13.07 ,$29.41 ,$13.07 ,$29.41 ,$29.41 ,$29.41 ,$31.70 ,$26.47 ,$30.39 ,$28.10 ,$31.70 
SACRED HEART HOSPITAL (ACU),31100161,88262,HC CHROM COUNT 15-20/2,311,1 ,$565.91 ,$424.43 ,$125.49 ,$565.91 ,$364.45 ,$125.49 ,$396.14 ,$129.67 ,$299.22 ,$133.56 ,$239.37 ,$537.61 ,$129.67 ,$452.73 ,$520.64 ,$129.67 ,$481.02 ,$537.61 ,$498.00 ,$430.09 ,$129.67 ,$129.67 ,$129.67 ,$413.11 ,$311.25 ,$514.98 ,$514.98 ,$452.73 ,$129.25 ,$311.25 ,$509.32 ,$125.49 ,$509.32 ,$305.59 ,$531.96 ,$282.35 ,$520.64 ,$137.45 ,$514.98 ,$125.49 ,$348.26 ,$348.26 ,$565.91 ,$422.34 ,$509.32 ,$126.74 ,$129.67 ,$537.61 ,$131.76 ,$129.67 ,$492.34 ,$125.49 ,$509.32 ,$125.49 ,$509.32 ,$509.32 ,$509.32 ,$548.93 ,$458.39 ,$526.30 ,$486.68 ,$548.93 
SACRED HEART HOSPITAL (ACU),31100166,88264,HC CHROM ANLYS ANALYZE 20,311,1 ,$568.00 ,$426.00 ,$144.61 ,$568.00 ,$365.79 ,$144.61 ,$397.60 ,$149.43 ,$299.22 ,$153.91 ,$239.37 ,$539.60 ,$149.43 ,$454.40 ,$522.56 ,$149.43 ,$482.80 ,$539.60 ,$499.84 ,$431.68 ,$149.43 ,$149.43 ,$149.43 ,$414.64 ,$312.40 ,$516.88 ,$516.88 ,$454.40 ,$148.95 ,$312.40 ,$511.20 ,$144.61 ,$511.20 ,$306.72 ,$533.92 ,$325.37 ,$522.56 ,$158.40 ,$516.88 ,$144.61 ,$349.55 ,$349.55 ,$528.72 ,$423.90 ,$511.20 ,$146.06 ,$149.43 ,$539.60 ,$151.84 ,$149.43 ,$494.16 ,$144.61 ,$511.20 ,$144.61 ,$511.20 ,$511.20 ,$511.20 ,$550.96 ,$460.08 ,$528.24 ,$488.48 ,$550.96 
SACRED HEART HOSPITAL (ACU),31100171,88269,HC CHROM CT AMNIOTIC INSITU,311,1 ,$732.06 ,$549.05 ,$173.66 ,$732.06 ,$471.45 ,$173.66 ,$512.44 ,$179.44 ,$399.28 ,$184.82 ,$319.42 ,$695.46 ,$179.44 ,$585.65 ,$673.50 ,$179.44 ,$622.25 ,$695.46 ,$644.21 ,$556.37 ,$179.44 ,$179.44 ,$179.44 ,$534.40 ,$402.63 ,$666.17 ,$666.17 ,$585.65 ,$178.87 ,$402.63 ,$658.85 ,$173.66 ,$658.85 ,$395.31 ,$688.14 ,$390.74 ,$673.50 ,$190.21 ,$666.17 ,$173.66 ,$450.51 ,$450.51 ,$327.27 ,$546.34 ,$658.85 ,$175.40 ,$179.44 ,$695.46 ,$182.34 ,$179.44 ,$636.89 ,$173.66 ,$658.85 ,$173.66 ,$658.85 ,$658.85 ,$658.85 ,$710.10 ,$592.97 ,$680.82 ,$629.57 ,$710.10 
SACRED HEART HOSPITAL (ACU),31100183,88271,HC MCG DNA PROBE (EACH),311,1 ,$66.10 ,$49.58 ,$20.36 ,$66.10 ,$42.57 ,$21.42 ,$46.27 ,$20.36 ,$34.76 ,$20.97 ,$27.80 ,$62.80 ,$20.36 ,$52.88 ,$60.81 ,$20.36 ,$56.19 ,$62.80 ,$58.17 ,$50.24 ,$20.36 ,$20.36 ,$20.36 ,$48.25 ,$36.36 ,$60.15 ,$60.15 ,$52.88 ,$22.06 ,$36.36 ,$59.49 ,$21.42 ,$59.49 ,$35.69 ,$62.13 ,$48.20 ,$60.81 ,$21.58 ,$60.15 ,$21.42 ,$40.68 ,$40.68 ,$66.10 ,$49.33 ,$59.49 ,$21.63 ,$20.36 ,$62.80 ,$22.49 ,$20.36 ,$57.51 ,$21.42 ,$59.49 ,$21.42 ,$59.49 ,$59.49 ,$59.49 ,$64.12 ,$53.54 ,$61.47 ,$56.85 ,$64.12 
SACRED HEART HOSPITAL (ACU),31100193,88274,HC MCG INTERPHASE INSITU 25 (HER2),311,1 ,$436.00 ,$327.00 ,$42.38 ,$436.00 ,$280.78 ,$42.38 ,$305.20 ,$43.79 ,$83.56 ,$45.10 ,$66.85 ,$414.20 ,$43.79 ,$348.80 ,$401.12 ,$43.79 ,$370.60 ,$414.20 ,$383.68 ,$331.36 ,$43.79 ,$43.79 ,$43.79 ,$318.28 ,$239.80 ,$396.76 ,$396.76 ,$348.80 ,$43.65 ,$239.80 ,$392.40 ,$42.38 ,$392.40 ,$235.44 ,$409.84 ,$95.36 ,$401.12 ,$46.42 ,$396.76 ,$42.38 ,$268.31 ,$268.31 ,$133.68 ,$325.39 ,$218.84 ,$42.80 ,$43.79 ,$414.20 ,$44.50 ,$43.79 ,$379.32 ,$42.38 ,$392.40 ,$42.38 ,$392.40 ,$392.40 ,$392.40 ,$422.92 ,$353.16 ,$405.48 ,$374.96 ,$422.92 
SACRED HEART HOSPITAL (ACU),31100197,88275,HC MCG INTERPH INSITU 100 ADDITIONAL,311,1 ,$322.18 ,$241.64 ,$51.19 ,$322.18 ,$207.48 ,$51.19 ,$225.53 ,$52.89 ,$96.41 ,$54.48 ,$77.13 ,$306.07 ,$52.89 ,$257.74 ,$296.41 ,$52.89 ,$273.85 ,$306.07 ,$283.52 ,$244.86 ,$52.89 ,$52.89 ,$52.89 ,$235.19 ,$177.20 ,$293.18 ,$293.18 ,$257.74 ,$52.73 ,$177.20 ,$289.96 ,$51.19 ,$289.96 ,$173.98 ,$302.85 ,$115.18 ,$296.41 ,$56.06 ,$293.18 ,$51.19 ,$198.27 ,$198.27 ,$155.11 ,$240.44 ,$260.64 ,$51.70 ,$52.89 ,$306.07 ,$53.75 ,$52.89 ,$280.30 ,$51.19 ,$289.96 ,$51.19 ,$289.96 ,$289.96 ,$289.96 ,$312.51 ,$260.97 ,$299.63 ,$277.07 ,$312.51 
SACRED HEART HOSPITAL (ACU),31100211,88280,HC CHROM ADDL KARYO,311,1 ,$110.58 ,$82.94 ,$33.47 ,$110.58 ,$71.21 ,$33.47 ,$77.41 ,$34.58 ,$60.24 ,$35.62 ,$48.19 ,$105.05 ,$34.58 ,$88.46 ,$101.73 ,$34.58 ,$93.99 ,$105.05 ,$97.31 ,$84.04 ,$34.58 ,$34.58 ,$34.58 ,$80.72 ,$60.82 ,$100.63 ,$100.63 ,$88.46 ,$34.47 ,$60.82 ,$99.52 ,$33.47 ,$99.52 ,$59.71 ,$103.95 ,$75.31 ,$101.73 ,$36.65 ,$100.63 ,$33.47 ,$68.05 ,$68.05 ,$110.58 ,$82.53 ,$99.52 ,$33.80 ,$34.58 ,$105.05 ,$35.14 ,$34.58 ,$96.20 ,$33.47 ,$99.52 ,$33.47 ,$99.52 ,$99.52 ,$99.52 ,$107.26 ,$89.57 ,$102.84 ,$95.10 ,$107.26 
SACRED HEART HOSPITAL (ACU),31100216,88291,HC INTERPRETATION,311,1 ,$133.41 ,$100.06 ,$14.07 ,$133.41 ,$85.92 , N/A ,$93.39 ,$14.07 ,$56.05 ,$14.49 ,$44.84 ,$126.74 ,$14.07 ,$106.73 ,$122.74 ,$14.07 ,$113.40 ,$126.74 ,$117.40 ,$101.39 ,$14.07 ,$14.07 ,$14.07 ,$97.39 ,$73.38 ,$121.40 ,$121.40 ,$106.73 , N/A ,$73.38 ,$120.07 , N/A ,$120.07 ,$72.04 ,$125.41 , N/A ,$122.74 ,$14.91 ,$121.40 , N/A ,$82.10 ,$82.10 ,$78.89 ,$99.56 ,$120.07 , N/A ,$14.07 ,$126.74 , N/A ,$14.07 ,$116.07 , N/A ,$120.07 , N/A ,$120.07 ,$120.07 ,$120.07 ,$129.41 ,$108.06 ,$124.07 ,$114.73 ,$129.41 
SACRED HEART HOSPITAL (ACU),31100225,88187,HC FLOW CYTO INT 2-8 MARKERS,311,1 ,$249.48 ,$187.11 ,$9.37 ,$249.48 ,$160.67 , N/A ,$174.64 ,$9.37 ,$99.86 ,$9.65 ,$79.88 ,$237.01 ,$9.37 ,$199.58 ,$229.52 ,$9.37 ,$212.06 ,$237.01 ,$219.54 ,$189.60 ,$9.37 ,$9.37 ,$9.37 ,$182.12 ,$137.21 ,$227.03 ,$227.03 ,$199.58 , N/A ,$137.21 ,$224.53 , N/A ,$224.53 ,$134.72 ,$234.51 , N/A ,$229.52 ,$9.93 ,$227.03 , N/A ,$153.53 ,$153.53 ,$140.12 ,$186.19 ,$224.53 , N/A ,$9.37 ,$237.01 , N/A ,$9.37 ,$217.05 , N/A ,$224.53 , N/A ,$224.53 ,$224.53 ,$224.53 ,$242.00 ,$202.08 ,$232.02 ,$214.55 ,$242.00 
SACRED HEART HOSPITAL (ACU),31100226,88188,HC FLOW CYTO INT 9-15 MARKERS,311,1 ,$314.81 ,$236.11 ,$9.37 ,$314.81 ,$202.74 , N/A ,$220.37 ,$9.37 ,$127.52 ,$9.65 ,$102.02 ,$299.07 ,$9.37 ,$251.85 ,$289.63 ,$9.37 ,$267.59 ,$299.07 ,$277.03 ,$239.26 ,$9.37 ,$9.37 ,$9.37 ,$229.81 ,$173.15 ,$286.48 ,$286.48 ,$251.85 , N/A ,$173.15 ,$283.33 , N/A ,$283.33 ,$170.00 ,$295.92 , N/A ,$289.63 ,$9.93 ,$286.48 , N/A ,$193.73 ,$193.73 ,$174.76 ,$234.94 ,$283.33 , N/A ,$9.37 ,$299.07 , N/A ,$9.37 ,$273.88 , N/A ,$283.33 , N/A ,$283.33 ,$283.33 ,$283.33 ,$305.37 ,$255.00 ,$292.77 ,$270.74 ,$305.37 
SACRED HEART HOSPITAL (ACU),31100227,88189,HC FLOW CYTO INT >16 MARKERS,311,1 ,$416.88 ,$312.66 ,$9.37 ,$416.88 ,$268.47 , N/A ,$291.82 ,$9.37 ,$157.10 ,$9.65 ,$125.68 ,$396.04 ,$9.37 ,$333.50 ,$383.53 ,$9.37 ,$354.35 ,$396.04 ,$366.85 ,$316.83 ,$9.37 ,$9.37 ,$9.37 ,$304.32 ,$229.28 ,$379.36 ,$379.36 ,$333.50 , N/A ,$229.28 ,$375.19 , N/A ,$375.19 ,$225.12 ,$391.87 , N/A ,$383.53 ,$9.93 ,$379.36 , N/A ,$256.55 ,$256.55 ,$230.20 ,$311.12 ,$375.19 , N/A ,$9.37 ,$396.04 , N/A ,$9.37 ,$362.69 , N/A ,$375.19 , N/A ,$375.19 ,$375.19 ,$375.19 ,$404.37 ,$337.67 ,$387.70 ,$358.52 ,$404.37 
SACRED HEART HOSPITAL (ACU),31100228,88199,HC UNLISTED CYTOPATH PROCEDURE,311,1 ,$187.05 ,$140.29 ,$3.12 ,$187.05 ,$120.46 ,$52.56 ,$130.94 ,$3.12 ,$155.25 ,$3.21 ,$123.45 ,$177.70 ,$3.12 ,$149.64 ,$172.09 ,$3.12 ,$158.99 ,$177.70 ,$164.60 ,$142.16 ,$3.12 ,$3.12 ,$3.12 ,$136.55 ,$102.88 ,$170.22 ,$170.22 ,$149.64 ,$54.14 ,$102.88 ,$168.35 ,$52.56 ,$168.35 ,$101.01 ,$175.83 ,$118.25 ,$172.09 ,$3.31 ,$170.22 ,$52.56 ,$115.11 ,$115.11 ,$168.35 ,$139.60 ,$130.28 ,$53.08 ,$3.12 ,$177.70 ,$55.18 ,$3.12 ,$162.73 ,$52.56 ,$168.35 ,$52.56 ,$168.35 ,$168.35 ,$168.35 ,$181.44 ,$151.51 ,$173.96 ,$160.86 ,$181.44 
SACRED HEART HOSPITAL (ACU),31100229,88230,HC TISSUE CULT NONNEO LYMPHOCYTE,311,1 ,$359.55 ,$269.66 ,$70.04 ,$359.55 ,$231.55 ,$116.49 ,$251.69 ,$70.04 ,$119.56 ,$72.14 ,$95.65 ,$341.57 ,$70.04 ,$287.64 ,$330.79 ,$70.04 ,$305.62 ,$341.57 ,$316.40 ,$273.26 ,$70.04 ,$70.04 ,$70.04 ,$262.47 ,$197.75 ,$327.19 ,$327.19 ,$287.64 ,$119.98 ,$197.75 ,$323.60 ,$116.49 ,$323.60 ,$194.16 ,$337.98 ,$262.10 ,$330.79 ,$74.24 ,$327.19 ,$116.49 ,$221.27 ,$221.27 ,$175.71 ,$268.33 ,$323.60 ,$117.65 ,$70.04 ,$341.57 ,$122.31 ,$70.04 ,$312.81 ,$116.49 ,$323.60 ,$116.49 ,$323.60 ,$323.60 ,$323.60 ,$348.76 ,$291.24 ,$334.38 ,$309.21 ,$348.76 
SACRED HEART HOSPITAL (ACU),31100230,88235,HC TISSUE CULT AMNIO/CHORION,311,1 ,$454.53 ,$340.90 ,$70.04 ,$454.53 ,$292.72 ,$150.30 ,$318.17 ,$70.04 ,$119.56 ,$72.14 ,$95.65 ,$431.80 ,$70.04 ,$363.62 ,$418.17 ,$70.04 ,$386.35 ,$431.80 ,$399.99 ,$345.44 ,$70.04 ,$70.04 ,$70.04 ,$331.81 ,$249.99 ,$413.62 ,$413.62 ,$363.62 ,$154.81 ,$249.99 ,$409.08 ,$150.30 ,$409.08 ,$245.45 ,$427.26 ,$338.18 ,$418.17 ,$74.24 ,$413.62 ,$150.30 ,$279.72 ,$279.72 ,$162.51 ,$339.22 ,$409.08 ,$151.80 ,$70.04 ,$431.80 ,$157.82 ,$70.04 ,$395.44 ,$150.30 ,$409.08 ,$150.30 ,$409.08 ,$409.08 ,$409.08 ,$440.89 ,$368.17 ,$422.71 ,$390.90 ,$440.89 
SACRED HEART HOSPITAL (ACU),31100231,P3000,HC PAP SMEAR SCREEN (UP TO 3),311,1 ,$77.00 ,$57.75 ,$14.86 ,$77.00 ,$49.59 ,$15.92 ,$53.90 ,$14.86 ,$25.36 ,$15.31 ,$20.29 ,$73.15 ,$14.86 ,$61.60 ,$70.84 ,$14.86 ,$65.45 ,$73.15 ,$67.76 ,$58.52 ,$14.86 ,$14.86 ,$14.86 ,$56.21 ,$42.35 ,$70.07 ,$70.07 ,$61.60 ,$16.40 ,$42.35 ,$69.30 ,$15.92 ,$69.30 ,$41.58 ,$72.38 ,$35.82 ,$70.84 ,$15.75 ,$70.07 ,$15.92 ,$47.39 ,$47.39 ,$69.30 ,$57.47 ,$69.30 ,$16.08 ,$14.86 ,$73.15 ,$16.72 ,$14.86 ,$66.99 ,$15.92 ,$69.30 ,$15.92 ,$69.30 ,$69.30 ,$69.30 ,$74.69 ,$62.37 ,$71.61 ,$66.22 ,$74.69 
SACRED HEART HOSPITAL (ACU),31200101,88300,HC GROSS ONLY LEVEL I,312,1 ,$91.96 ,$68.97 ,$7.18 ,$91.96 ,$59.22 ,$26.13 ,$64.37 ,$7.18 ,$19.50 ,$7.40 ,$15.60 ,$87.36 ,$7.18 ,$73.57 ,$84.60 ,$7.18 ,$78.17 ,$87.36 ,$80.92 ,$69.89 ,$7.18 ,$7.18 ,$7.18 ,$67.13 ,$50.58 ,$83.68 ,$83.68 ,$73.57 ,$26.91 ,$50.58 ,$82.76 ,$26.13 ,$82.76 ,$49.66 ,$86.44 ,$58.79 ,$84.60 ,$7.61 ,$83.68 ,$26.13 ,$56.59 ,$56.59 ,$91.96 ,$68.63 ,$58.50 ,$26.39 ,$7.18 ,$87.36 ,$27.43 ,$7.18 ,$80.01 ,$26.13 ,$82.76 ,$26.13 ,$82.76 ,$82.76 ,$82.76 ,$89.20 ,$74.49 ,$85.52 ,$79.09 ,$89.20 
SACRED HEART HOSPITAL (ACU),31200102,88302,HC GROSS  AND  MICRO LEVEL II,312,1 ,$238.40 ,$178.80 ,$7.18 ,$238.40 ,$153.53 ,$26.13 ,$166.88 ,$7.18 ,$39.32 ,$7.40 ,$31.46 ,$226.48 ,$7.18 ,$190.72 ,$219.33 ,$7.18 ,$202.64 ,$226.48 ,$209.79 ,$181.18 ,$7.18 ,$7.18 ,$7.18 ,$174.03 ,$131.12 ,$216.94 ,$216.94 ,$190.72 ,$26.91 ,$131.12 ,$214.56 ,$26.13 ,$214.56 ,$128.74 ,$224.10 ,$58.79 ,$219.33 ,$7.61 ,$216.94 ,$26.13 ,$146.71 ,$146.71 ,$208.67 ,$177.92 ,$116.39 ,$26.39 ,$7.18 ,$226.48 ,$27.43 ,$7.18 ,$207.41 ,$26.13 ,$214.56 ,$26.13 ,$214.56 ,$214.56 ,$214.56 ,$231.25 ,$193.10 ,$221.71 ,$205.02 ,$231.25 
SACRED HEART HOSPITAL (ACU),31200103,88304,HC GROSS  AND  MICRO LEVEL III,312,1 ,$249.84 ,$187.38 ,$7.18 ,$249.84 ,$160.90 ,$52.56 ,$174.89 ,$7.18 ,$48.91 ,$7.40 ,$39.13 ,$237.35 ,$7.18 ,$199.87 ,$229.85 ,$7.18 ,$212.36 ,$237.35 ,$219.86 ,$189.88 ,$7.18 ,$7.18 ,$7.18 ,$182.38 ,$137.41 ,$227.35 ,$227.35 ,$199.87 ,$54.14 ,$137.41 ,$224.86 ,$52.56 ,$224.86 ,$134.91 ,$234.85 ,$118.25 ,$229.85 ,$7.61 ,$227.35 ,$52.56 ,$153.75 ,$153.75 ,$219.64 ,$186.46 ,$142.72 ,$53.08 ,$7.18 ,$237.35 ,$55.18 ,$7.18 ,$217.36 ,$52.56 ,$224.86 ,$52.56 ,$224.86 ,$224.86 ,$224.86 ,$242.34 ,$202.37 ,$232.35 ,$214.86 ,$242.34 
SACRED HEART HOSPITAL (ACU),31200105,88305,HC CELLIENT CELL BLOCK,312,1 ,$343.03 ,$257.27 ,$13.13 ,$343.03 ,$220.91 ,$52.56 ,$240.12 ,$13.13 ,$49.53 ,$13.52 ,$39.62 ,$325.88 ,$13.13 ,$274.42 ,$315.59 ,$13.13 ,$291.58 ,$325.88 ,$301.87 ,$260.70 ,$13.13 ,$13.13 ,$13.13 ,$250.41 ,$188.67 ,$312.16 ,$312.16 ,$274.42 ,$54.14 ,$188.67 ,$308.73 ,$52.56 ,$308.73 ,$185.24 ,$322.45 ,$118.25 ,$315.59 ,$13.92 ,$312.16 ,$52.56 ,$211.10 ,$211.10 ,$296.47 ,$256.00 ,$146.23 ,$53.08 ,$13.13 ,$325.88 ,$55.18 ,$13.13 ,$298.44 ,$52.56 ,$308.73 ,$52.56 ,$308.73 ,$308.73 ,$308.73 ,$332.74 ,$277.85 ,$319.02 ,$295.01 ,$332.74 
SACRED HEART HOSPITAL (ACU),31200108,88305,HC GROSS  AND  MICRO LEVEL IV,312,1 ,$343.00 ,$257.25 ,$13.13 ,$343.00 ,$220.89 ,$52.56 ,$240.10 ,$13.13 ,$49.53 ,$13.52 ,$39.62 ,$325.85 ,$13.13 ,$274.40 ,$315.56 ,$13.13 ,$291.55 ,$325.85 ,$301.84 ,$260.68 ,$13.13 ,$13.13 ,$13.13 ,$250.39 ,$188.65 ,$312.13 ,$312.13 ,$274.40 ,$54.14 ,$188.65 ,$308.70 ,$52.56 ,$308.70 ,$185.22 ,$322.42 ,$118.25 ,$315.56 ,$13.92 ,$312.13 ,$52.56 ,$211.08 ,$211.08 ,$296.47 ,$255.98 ,$146.23 ,$53.08 ,$13.13 ,$325.85 ,$55.18 ,$13.13 ,$298.41 ,$52.56 ,$308.70 ,$52.56 ,$308.70 ,$308.70 ,$308.70 ,$332.71 ,$277.83 ,$318.99 ,$294.98 ,$332.71 
SACRED HEART HOSPITAL (ACU),31200110,88307,HC GROSS  AND  MICRO LEVEL V,312,1 ,$570.22 ,$427.67 ,$13.13 ,$693.07 ,$367.22 ,$308.03 ,$399.15 ,$13.13 ,$303.78 ,$13.52 ,$243.03 ,$541.71 ,$13.13 ,$456.18 ,$524.60 ,$13.13 ,$484.69 ,$541.71 ,$501.79 ,$433.37 ,$13.13 ,$13.13 ,$13.13 ,$416.26 ,$313.62 ,$518.90 ,$518.90 ,$456.18 ,$317.27 ,$313.62 ,$513.20 ,$308.03 ,$513.20 ,$307.92 ,$536.01 ,$693.07 ,$524.60 ,$13.92 ,$518.90 ,$308.03 ,$350.91 ,$350.91 ,$461.20 ,$425.56 ,$513.20 ,$311.11 ,$13.13 ,$541.71 ,$323.43 ,$13.13 ,$496.09 ,$308.03 ,$513.20 ,$308.03 ,$513.20 ,$513.20 ,$513.20 ,$553.11 ,$461.88 ,$530.30 ,$490.39 ,$553.11 
SACRED HEART HOSPITAL (ACU),31200113,88309,HC GROSS  AND  MICRO LEVEL VI,312,1 ,"$1,431.86 ","$1,073.90 ",$13.13 ,"$1,559.48 ",$922.12 ,$693.10 ,"$1,002.30 ",$13.13 ,$431.36 ,$13.52 ,$345.09 ,"$1,360.27 ",$13.13 ,"$1,145.49 ","$1,317.31 ",$13.13 ,"$1,217.08 ","$1,360.27 ","$1,260.04 ","$1,088.21 ",$13.13 ,$13.13 ,$13.13 ,"$1,045.26 ",$787.52 ,"$1,302.99 ","$1,302.99 ","$1,145.49 ",$713.89 ,$787.52 ,"$1,288.67 ",$693.10 ,"$1,288.67 ",$773.20 ,"$1,345.95 ","$1,559.48 ","$1,317.31 ",$13.92 ,"$1,302.99 ",$693.10 ,$881.17 ,$881.17 ,$603.96 ,"$1,068.60 ","$1,235.07 ",$700.03 ,$13.13 ,"$1,360.27 ",$727.76 ,$13.13 ,"$1,245.72 ",$693.10 ,"$1,288.67 ",$693.10 ,"$1,288.67 ","$1,288.67 ","$1,288.67 ","$1,388.90 ","$1,159.81 ","$1,331.63 ","$1,231.40 ","$1,388.90 "
SACRED HEART HOSPITAL (ACU),31200116,88311,HC DECALCIFICATION,312,1 ,$78.09 ,$58.57 ,$12.24 ,$78.09 ,$50.29 , N/A ,$54.66 ,$13.13 ,$15.30 ,$13.52 ,$12.24 ,$74.19 ,$13.13 ,$62.47 ,$71.84 ,$13.13 ,$66.38 ,$74.19 ,$68.72 ,$59.35 ,$13.13 ,$13.13 ,$13.13 ,$57.01 ,$42.95 ,$71.06 ,$71.06 ,$62.47 , N/A ,$42.95 ,$70.28 , N/A ,$70.28 ,$42.17 ,$73.40 , N/A ,$71.84 ,$13.92 ,$71.06 , N/A ,$48.06 ,$48.06 ,$49.41 ,$58.28 ,$44.50 , N/A ,$13.13 ,$74.19 , N/A ,$13.13 ,$67.94 , N/A ,$70.28 , N/A ,$70.28 ,$70.28 ,$70.28 ,$75.75 ,$63.25 ,$72.62 ,$67.16 ,$75.75 
SACRED HEART HOSPITAL (ACU),31200173,88331,HC CONSULT PATH SURG W/FROZEN,312,1 ,$354.10 ,$265.58 ,$11.96 ,$354.91 ,$228.04 ,$157.74 ,$247.87 ,$11.96 ,$54.32 ,$12.32 ,$43.46 ,$336.40 ,$11.96 ,$283.28 ,$325.77 ,$11.96 ,$300.99 ,$336.40 ,$311.61 ,$269.12 ,$11.96 ,$11.96 ,$11.96 ,$258.49 ,$194.76 ,$322.23 ,$322.23 ,$283.28 ,$162.47 ,$194.76 ,$318.69 ,$157.74 ,$318.69 ,$191.21 ,$332.85 ,$354.91 ,$325.77 ,$12.68 ,$322.23 ,$157.74 ,$217.91 ,$217.91 ,$209.55 ,$264.26 ,$160.28 ,$159.32 ,$11.96 ,$336.40 ,$165.63 ,$11.96 ,$308.07 ,$157.74 ,$318.69 ,$157.74 ,$318.69 ,$318.69 ,$318.69 ,$343.48 ,$286.82 ,$329.31 ,$304.53 ,$343.48 
SACRED HEART HOSPITAL (ACU),31200174,88332,HC CONSULT PATH SURG ADDL FROZEN,312,1 ,$141.85 ,$106.39 ,$11.96 ,$141.85 ,$91.35 , N/A ,$99.30 ,$11.96 ,$34.51 ,$12.32 ,$27.61 ,$134.76 ,$11.96 ,$113.48 ,$130.50 ,$11.96 ,$120.57 ,$134.76 ,$124.83 ,$107.81 ,$11.96 ,$11.96 ,$11.96 ,$103.55 ,$78.02 ,$129.08 ,$129.08 ,$113.48 , N/A ,$78.02 ,$127.67 , N/A ,$127.67 ,$76.60 ,$133.34 , N/A ,$130.50 ,$12.68 ,$129.08 , N/A ,$87.29 ,$87.29 ,$87.89 ,$105.86 ,$104.12 , N/A ,$11.96 ,$134.76 , N/A ,$11.96 ,$123.41 , N/A ,$127.67 , N/A ,$127.67 ,$127.67 ,$127.67 ,$137.59 ,$114.90 ,$131.92 ,$121.99 ,$137.59 
SACRED HEART HOSPITAL (ACU),31200175,88333,HC CONSULT PATH SURG CYTO INIT,312,1 ,"$1,431.86 ","$1,073.90 ",$11.96 ,"$1,559.48 ",$922.12 ,$693.10 ,"$1,002.30 ",$11.96 ,$48.32 ,$12.32 ,$38.65 ,"$1,360.27 ",$11.96 ,"$1,145.49 ","$1,317.31 ",$11.96 ,"$1,217.08 ","$1,360.27 ","$1,260.04 ","$1,088.21 ",$11.96 ,$11.96 ,$11.96 ,"$1,045.26 ",$787.52 ,"$1,302.99 ","$1,302.99 ","$1,145.49 ",$713.89 ,$787.52 ,"$1,288.67 ",$693.10 ,"$1,288.67 ",$773.20 ,"$1,345.95 ","$1,559.48 ","$1,317.31 ",$12.68 ,"$1,302.99 ",$693.10 ,$881.17 ,$881.17 ,$45.42 ,"$1,068.60 ",$121.69 ,$700.03 ,$11.96 ,"$1,360.27 ",$727.76 ,$11.96 ,"$1,245.72 ",$693.10 ,"$1,288.67 ",$693.10 ,"$1,288.67 ","$1,288.67 ","$1,288.67 ","$1,388.90 ","$1,159.81 ","$1,331.63 ","$1,231.40 ","$1,388.90 "
SACRED HEART HOSPITAL (ACU),31200176,88334,HC CONSULT PATH SURG EA ADDL,312,1 ,$74.48 ,$55.86 ,$11.96 ,$74.48 ,$47.97 , N/A ,$52.14 ,$11.96 ,$32.71 ,$12.32 ,$26.17 ,$70.76 ,$11.96 ,$59.58 ,$68.52 ,$11.96 ,$63.31 ,$70.76 ,$65.54 ,$56.60 ,$11.96 ,$11.96 ,$11.96 ,$54.37 ,$40.96 ,$67.78 ,$67.78 ,$59.58 , N/A ,$40.96 ,$67.03 , N/A ,$67.03 ,$40.22 ,$70.01 , N/A ,$68.52 ,$12.68 ,$67.78 , N/A ,$45.84 ,$45.84 ,$27.72 ,$55.58 ,$67.03 , N/A ,$11.96 ,$70.76 , N/A ,$11.96 ,$64.80 , N/A ,$67.03 , N/A ,$67.03 ,$67.03 ,$67.03 ,$72.25 ,$60.33 ,$69.27 ,$64.05 ,$72.25 
SACRED HEART HOSPITAL (ACU),31200186,88346,HC IF DIRECT,312,1 ,$570.22 ,$427.67 ,$13.13 ,$693.07 ,$367.22 ,$308.03 ,$399.15 ,$13.13 ,$96.36 ,$13.52 ,$77.08 ,$541.71 ,$13.13 ,$456.18 ,$524.60 ,$13.13 ,$484.69 ,$541.71 ,$501.79 ,$433.37 ,$13.13 ,$13.13 ,$13.13 ,$416.26 ,$313.62 ,$518.90 ,$518.90 ,$456.18 ,$317.27 ,$313.62 ,$513.20 ,$308.03 ,$513.20 ,$307.92 ,$536.01 ,$693.07 ,$524.60 ,$13.92 ,$518.90 ,$308.03 ,$350.91 ,$350.91 ,$87.89 ,$425.56 ,$281.31 ,$311.11 ,$13.13 ,$541.71 ,$323.43 ,$13.13 ,$496.09 ,$308.03 ,$513.20 ,$308.03 ,$513.20 ,$513.20 ,$513.20 ,$553.11 ,$461.88 ,$530.30 ,$490.39 ,$553.11 
SACRED HEART HOSPITAL (ACU),31200194,88360,HC MORPHO ANLYS TUMOR MAN (HER2),312,1 ,$360.00 ,$270.00 ,$13.13 ,$360.00 ,$231.84 ,$157.74 ,$252.00 ,$13.13 ,$141.38 ,$13.52 ,$113.11 ,$342.00 ,$13.13 ,$288.00 ,$331.20 ,$13.13 ,$306.00 ,$342.00 ,$316.80 ,$273.60 ,$13.13 ,$13.13 ,$13.13 ,$262.80 ,$198.00 ,$327.60 ,$327.60 ,$288.00 ,$162.47 ,$198.00 ,$324.00 ,$157.74 ,$324.00 ,$194.40 ,$338.40 ,$354.91 ,$331.20 ,$13.92 ,$327.60 ,$157.74 ,$221.54 ,$221.54 ,$100.46 ,$268.67 ,$324.00 ,$159.32 ,$13.13 ,$342.00 ,$165.63 ,$13.13 ,$313.20 ,$157.74 ,$324.00 ,$157.74 ,$324.00 ,$324.00 ,$324.00 ,$349.20 ,$291.60 ,$334.80 ,$309.60 ,$349.20 
SACRED HEART HOSPITAL (ACU),31200204,88365,HC IN SITU HYBRID (FISH),312,1 ,$341.92 ,$256.44 ,$13.13 ,$354.91 ,$220.20 ,$157.74 ,$239.34 ,$13.13 ,$223.04 ,$13.52 ,$178.43 ,$324.82 ,$13.13 ,$273.54 ,$314.57 ,$13.13 ,$290.63 ,$324.82 ,$300.89 ,$259.86 ,$13.13 ,$13.13 ,$13.13 ,$249.60 ,$188.06 ,$311.15 ,$311.15 ,$273.54 ,$162.47 ,$188.06 ,$307.73 ,$157.74 ,$307.73 ,$184.64 ,$321.40 ,$354.91 ,$314.57 ,$13.92 ,$311.15 ,$157.74 ,$210.42 ,$210.42 ,$196.33 ,$255.17 ,$307.73 ,$159.32 ,$13.13 ,$324.82 ,$165.63 ,$13.13 ,$297.47 ,$157.74 ,$307.73 ,$157.74 ,$307.73 ,$307.73 ,$307.73 ,$331.66 ,$276.96 ,$317.99 ,$294.05 ,$331.66 
SACRED HEART HOSPITAL (ACU),31200239,88368,HC HER2 DUAL ISH,312,1 ,$800.00 ,$600.00 ,$13.13 ,$800.00 ,$515.20 ,$308.03 ,$560.00 ,$13.13 ,$126.98 ,$13.52 ,$101.58 ,$760.00 ,$13.13 ,$640.00 ,$736.00 ,$13.13 ,$680.00 ,$760.00 ,$704.00 ,$608.00 ,$13.13 ,$13.13 ,$13.13 ,$584.00 ,$440.00 ,$728.00 ,$728.00 ,$640.00 ,$317.27 ,$440.00 ,$720.00 ,$308.03 ,$720.00 ,$432.00 ,$752.00 ,$693.07 ,$736.00 ,$13.92 ,$728.00 ,$308.03 ,$492.32 ,$492.32 ,$232.30 ,$597.04 ,$388.29 ,$311.11 ,$13.13 ,$760.00 ,$323.43 ,$13.13 ,$696.00 ,$308.03 ,$720.00 ,$308.03 ,$720.00 ,$720.00 ,$720.00 ,$776.00 ,$648.00 ,$744.00 ,$688.00 ,$776.00 
SACRED HEART HOSPITAL (ACU),31200245,88350,HC IMMUNOFLUOR PER SPEC EA ADDN SINGLE STAIN,312,1 ,$34.52 ,$25.89 ,$13.13 ,$34.52 ,$22.23 , N/A ,$24.16 ,$13.13 ,$34.52 ,$13.52 ,$34.52 ,$32.79 ,$13.13 ,$27.62 ,$31.76 ,$13.13 ,$29.34 ,$32.79 ,$30.38 ,$26.24 ,$13.13 ,$13.13 ,$13.13 ,$25.20 ,$18.99 ,$31.41 ,$31.41 ,$27.62 , N/A ,$18.99 ,$31.07 , N/A ,$31.07 ,$18.64 ,$32.45 , N/A ,$31.76 ,$13.92 ,$31.41 , N/A ,$21.24 ,$21.24 ,$34.52 ,$25.76 ,$31.07 , N/A ,$13.13 ,$32.79 , N/A ,$13.13 ,$30.03 , N/A ,$31.07 , N/A ,$31.07 ,$31.07 ,$31.07 ,$33.48 ,$27.96 ,$32.10 ,$29.69 ,$33.48 
SACRED HEART HOSPITAL (ACU),31200246,88312,HC SPECIAL STAIN I,312,1 ,$134.02 ,$100.52 ,$7.18 ,$134.02 ,$86.31 ,$52.56 ,$93.81 ,$7.18 ,$119.18 ,$7.40 ,$95.34 ,$127.32 ,$7.18 ,$107.22 ,$123.30 ,$7.18 ,$113.92 ,$127.32 ,$117.94 ,$101.86 ,$7.18 ,$7.18 ,$7.18 ,$97.83 ,$73.71 ,$121.96 ,$121.96 ,$107.22 ,$54.14 ,$73.71 ,$120.62 ,$52.56 ,$120.62 ,$72.37 ,$125.98 ,$118.25 ,$123.30 ,$7.61 ,$121.96 ,$52.56 ,$82.48 ,$82.48 ,$87.89 ,$100.02 ,$120.62 ,$53.08 ,$7.18 ,$127.32 ,$55.18 ,$7.18 ,$116.60 ,$52.56 ,$120.62 ,$52.56 ,$120.62 ,$120.62 ,$120.62 ,$130.00 ,$108.56 ,$124.64 ,$115.26 ,$130.00 
SACRED HEART HOSPITAL (ACU),31200247,88313,HC SPECIAL STAIN II,312,1 ,$84.49 ,$63.37 ,$7.18 ,$84.49 ,$54.41 ,$35.80 ,$59.14 ,$7.18 ,$84.49 ,$7.40 ,$77.56 ,$80.27 ,$7.18 ,$67.59 ,$77.73 ,$7.18 ,$71.82 ,$80.27 ,$74.35 ,$64.21 ,$7.18 ,$7.18 ,$7.18 ,$61.68 ,$46.47 ,$76.89 ,$76.89 ,$67.59 ,$36.87 ,$46.47 ,$76.04 ,$35.80 ,$76.04 ,$45.62 ,$79.42 ,$80.55 ,$77.73 ,$7.61 ,$76.89 ,$35.80 ,$52.00 ,$52.00 ,$74.67 ,$63.05 ,$76.04 ,$36.16 ,$7.18 ,$80.27 ,$37.59 ,$7.18 ,$73.51 ,$35.80 ,$76.04 ,$35.80 ,$76.04 ,$76.04 ,$76.04 ,$81.96 ,$68.44 ,$78.58 ,$72.66 ,$81.96 
SACRED HEART HOSPITAL (ACU),31200248,88360,HC MORPHO ANALYSIS TUMOR MANUAL,312,1 ,$570.22 ,$427.67 ,$13.13 ,$570.22 ,$367.22 ,$157.74 ,$399.15 ,$13.13 ,$141.38 ,$13.52 ,$113.11 ,$541.71 ,$13.13 ,$456.18 ,$524.60 ,$13.13 ,$484.69 ,$541.71 ,$501.79 ,$433.37 ,$13.13 ,$13.13 ,$13.13 ,$416.26 ,$313.62 ,$518.90 ,$518.90 ,$456.18 ,$162.47 ,$313.62 ,$513.20 ,$157.74 ,$513.20 ,$307.92 ,$536.01 ,$354.91 ,$524.60 ,$13.92 ,$518.90 ,$157.74 ,$350.91 ,$350.91 ,$100.46 ,$425.56 ,$435.64 ,$159.32 ,$13.13 ,$541.71 ,$165.63 ,$13.13 ,$496.09 ,$157.74 ,$513.20 ,$157.74 ,$513.20 ,$513.20 ,$513.20 ,$553.11 ,$461.88 ,$530.30 ,$490.39 ,$553.11 
SACRED HEART HOSPITAL (ACU),31200292,88377,HC MORPH ANLZ INST HYB EA MTPL,312,1 ,$261.78 ,$196.34 ,$13.13 ,$354.91 ,$168.59 ,$157.74 ,$183.25 ,$13.13 ,$261.78 ,$13.52 ,$261.78 ,$248.69 ,$13.13 ,$209.42 ,$240.84 ,$13.13 ,$222.51 ,$248.69 ,$230.37 ,$198.95 ,$13.13 ,$13.13 ,$13.13 ,$191.10 ,$143.98 ,$238.22 ,$238.22 ,$209.42 ,$162.47 ,$143.98 ,$235.60 ,$157.74 ,$235.60 ,$141.36 ,$246.07 ,$354.91 ,$240.84 ,$13.92 ,$238.22 ,$157.74 ,$161.10 ,$161.10 ,$261.78 ,$195.37 ,$235.60 ,$159.32 ,$13.13 ,$248.69 ,$165.63 ,$13.13 ,$227.75 ,$157.74 ,$235.60 ,$157.74 ,$235.60 ,$235.60 ,$235.60 ,$253.93 ,$212.04 ,$243.46 ,$225.13 ,$253.93 
SACRED HEART HOSPITAL (ACU),31200321,88377,HC MORPH ANLZ INST HYB EA PROBE MNL,312,1 ,$800.00 ,$600.00 ,$13.13 ,$800.00 ,$515.20 ,$157.74 ,$560.00 ,$13.13 ,$573.97 ,$13.52 ,$459.17 ,$760.00 ,$13.13 ,$640.00 ,$736.00 ,$13.13 ,$680.00 ,$760.00 ,$704.00 ,$608.00 ,$13.13 ,$13.13 ,$13.13 ,$584.00 ,$440.00 ,$728.00 ,$728.00 ,$640.00 ,$162.47 ,$440.00 ,$720.00 ,$157.74 ,$720.00 ,$432.00 ,$752.00 ,$354.91 ,$736.00 ,$13.92 ,$728.00 ,$157.74 ,$492.32 ,$492.32 ,$409.33 ,$597.04 ,$720.00 ,$159.32 ,$13.13 ,$760.00 ,$165.63 ,$13.13 ,$696.00 ,$157.74 ,$720.00 ,$157.74 ,$720.00 ,$720.00 ,$720.00 ,$776.00 ,$648.00 ,$744.00 ,$688.00 ,$776.00 
SACRED HEART HOSPITAL (ACU),31200322,88377,HC M/PHM TRC ALYS ISHQUANT/ SEMIQ,312,1 ,$862.00 ,$646.50 ,$13.13 ,$862.00 ,$555.13 ,$157.74 ,$603.40 ,$13.13 ,$573.97 ,$13.52 ,$459.17 ,$818.90 ,$13.13 ,$689.60 ,$793.04 ,$13.13 ,$732.70 ,$818.90 ,$758.56 ,$655.12 ,$13.13 ,$13.13 ,$13.13 ,$629.26 ,$474.10 ,$784.42 ,$784.42 ,$689.60 ,$162.47 ,$474.10 ,$775.80 ,$157.74 ,$775.80 ,$465.48 ,$810.28 ,$354.91 ,$793.04 ,$13.92 ,$784.42 ,$157.74 ,$530.47 ,$530.47 ,$409.33 ,$643.31 ,$775.80 ,$159.32 ,$13.13 ,$818.90 ,$165.63 ,$13.13 ,$749.94 ,$157.74 ,$775.80 ,$157.74 ,$775.80 ,$775.80 ,$775.80 ,$836.14 ,$698.22 ,$801.66 ,$741.32 ,$836.14 
SACRED HEART HOSPITAL (ACU),32000003,22510,HC VERTEBROPLASTY INJ PERC THOR,320,1 ,"$7,215.93 ","$5,411.95 ","$1,511.00 ","$7,215.93 ","$4,647.06 ","$2,995.19 ","$5,051.15 ","$1,511.00 ","$5,989.22 ","$1,556.33 ","$4,762.51 ","$6,855.13 ","$1,511.00 ","$5,772.74 ","$6,638.66 ","$1,511.00 ","$6,133.54 ","$6,855.13 ","$6,350.02 ","$5,484.11 ","$1,511.00 ","$1,511.00 ","$1,511.00 ","$5,267.63 ","$3,968.76 ","$6,566.50 ","$6,566.50 ","$5,772.74 ","$3,085.05 ","$3,968.76 ","$6,494.34 ","$2,995.19 ","$6,494.34 ","$3,896.60 ","$6,782.97 ","$6,739.17 ","$6,638.66 ","$1,601.66 ","$6,566.50 ","$2,995.19 ","$4,440.68 ","$4,440.68 ","$6,494.34 ","$5,385.25 ","$5,025.90 ","$3,025.14 ","$1,511.00 ","$6,855.13 ","$3,144.95 ","$1,511.00 ","$6,277.86 ","$2,995.19 ","$6,494.34 ","$2,995.19 ","$6,494.34 ","$6,494.34 ","$6,494.34 ","$6,999.45 ","$5,844.90 ","$6,710.81 ","$6,205.70 ","$6,999.45 "
SACRED HEART HOSPITAL (ACU),32000004,22511,HC VERTEBROPLASTY INJ PERC LUMBAR,320,1 ,"$7,052.73 ","$5,289.55 ","$1,511.00 ","$7,052.73 ","$4,541.96 ","$2,995.19 ","$4,936.91 ","$1,511.00 ","$5,853.77 ","$1,556.33 ","$4,654.80 ","$6,700.09 ","$1,511.00 ","$5,642.18 ","$6,488.51 ","$1,511.00 ","$5,994.82 ","$6,700.09 ","$6,206.40 ","$5,360.07 ","$1,511.00 ","$1,511.00 ","$1,511.00 ","$5,148.49 ","$3,879.00 ","$6,417.98 ","$6,417.98 ","$5,642.18 ","$3,085.05 ","$3,879.00 ","$6,347.46 ","$2,995.19 ","$6,347.46 ","$3,808.47 ","$6,629.57 ","$6,739.17 ","$6,488.51 ","$1,601.66 ","$6,417.98 ","$2,995.19 ","$4,340.25 ","$4,340.25 ","$6,347.46 ","$5,263.45 ","$4,912.23 ","$3,025.14 ","$1,511.00 ","$6,700.09 ","$3,144.95 ","$1,511.00 ","$6,135.88 ","$2,995.19 ","$6,347.46 ","$2,995.19 ","$6,347.46 ","$6,347.46 ","$6,347.46 ","$6,841.15 ","$5,712.71 ","$6,559.04 ","$6,065.35 ","$6,841.15 "
SACRED HEART HOSPITAL (ACU),32000005,22512,HC VERTEBROPLASTY INJ PERC ADDL,320,1 ,"$3,384.04 ","$2,538.03 ","$1,511.00 ","$3,384.04 ","$2,179.32 ", N/A ,"$2,368.83 ","$1,511.00 ","$2,808.75 ","$1,556.33 ","$2,233.47 ","$3,214.84 ","$1,511.00 ","$2,707.23 ","$3,113.32 ","$1,511.00 ","$2,876.43 ","$3,214.84 ","$2,977.96 ","$2,571.87 ","$1,511.00 ","$1,511.00 ","$1,511.00 ","$2,470.35 ","$1,861.22 ","$3,079.48 ","$3,079.48 ","$2,707.23 ", N/A ,"$1,861.22 ","$3,045.64 ", N/A ,"$3,045.64 ","$1,827.38 ","$3,181.00 ", N/A ,"$3,113.32 ","$1,601.66 ","$3,079.48 ", N/A ,"$2,082.54 ","$2,082.54 ","$3,045.64 ","$2,525.51 ","$2,356.98 ", N/A ,"$1,511.00 ","$3,214.84 ", N/A ,"$1,511.00 ","$2,944.11 ", N/A ,"$3,045.64 ", N/A ,"$3,045.64 ","$3,045.64 ","$3,045.64 ","$3,282.52 ","$2,741.07 ","$3,147.16 ","$2,910.27 ","$3,282.52 "
SACRED HEART HOSPITAL (ACU),32000009,23350,HC ARTHROGRAM INJ SHOULDER,320,1 ,$537.00 ,$402.75 ,$98.34 ,$537.00 ,$345.83 , N/A ,$375.90 ,$98.34 ,$445.71 ,$101.29 ,$354.42 ,$510.15 ,$98.34 ,$429.60 ,$494.04 ,$98.34 ,$456.45 ,$510.15 ,$472.56 ,$408.12 ,$98.34 ,$98.34 ,$98.34 ,$392.01 ,$295.35 ,$488.67 ,$488.67 ,$429.60 , N/A ,$295.35 ,$483.30 , N/A ,$483.30 ,$289.98 ,$504.78 , N/A ,$494.04 ,$104.24 ,$488.67 , N/A ,$330.47 ,$330.47 ,$483.30 ,$400.76 ,$374.02 , N/A ,$98.34 ,$510.15 , N/A ,$98.34 ,$467.19 , N/A ,$483.30 , N/A ,$483.30 ,$483.30 ,$483.30 ,$520.89 ,$434.97 ,$499.41 ,$461.82 ,$520.89 
SACRED HEART HOSPITAL (ACU),32000010,24220,HC ARTHROGRAM INJ ELBOW,320,1 ,$380.00 ,$285.00 ,$98.34 ,$380.00 ,$244.72 , N/A ,$266.00 ,$98.34 ,$315.40 ,$101.29 ,$250.80 ,$361.00 ,$98.34 ,$304.00 ,$349.60 ,$98.34 ,$323.00 ,$361.00 ,$334.40 ,$288.80 ,$98.34 ,$98.34 ,$98.34 ,$277.40 ,$209.00 ,$345.80 ,$345.80 ,$304.00 , N/A ,$209.00 ,$342.00 , N/A ,$342.00 ,$205.20 ,$357.20 , N/A ,$349.60 ,$104.24 ,$345.80 , N/A ,$233.85 ,$233.85 ,$342.00 ,$283.59 ,$264.67 , N/A ,$98.34 ,$361.00 , N/A ,$98.34 ,$330.60 , N/A ,$342.00 , N/A ,$342.00 ,$342.00 ,$342.00 ,$368.60 ,$307.80 ,$353.40 ,$326.80 ,$368.60 
SACRED HEART HOSPITAL (ACU),32000011,25246,HC ARTHROGRAM INJ WRIST,320,1 ,$619.00 ,$464.25 ,$98.34 ,$619.00 ,$398.64 , N/A ,$433.30 ,$98.34 ,$513.77 ,$101.29 ,$408.54 ,$588.05 ,$98.34 ,$495.20 ,$569.48 ,$98.34 ,$526.15 ,$588.05 ,$544.72 ,$470.44 ,$98.34 ,$98.34 ,$98.34 ,$451.87 ,$340.45 ,$563.29 ,$563.29 ,$495.20 , N/A ,$340.45 ,$557.10 , N/A ,$557.10 ,$334.26 ,$581.86 , N/A ,$569.48 ,$104.24 ,$563.29 , N/A ,$380.93 ,$380.93 ,$557.10 ,$461.96 ,$431.13 , N/A ,$98.34 ,$588.05 , N/A ,$98.34 ,$538.53 , N/A ,$557.10 , N/A ,$557.10 ,$557.10 ,$557.10 ,$600.43 ,$501.39 ,$575.67 ,$532.34 ,$600.43 
SACRED HEART HOSPITAL (ACU),32000012,27093,HC INJ ARTHROGRAM HIP W/O,320,1 ,$526.00 ,$394.50 ,$98.34 ,$526.00 ,$338.74 , N/A ,$368.20 ,$98.34 ,$436.58 ,$101.29 ,$347.16 ,$499.70 ,$98.34 ,$420.80 ,$483.92 ,$98.34 ,$447.10 ,$499.70 ,$462.88 ,$399.76 ,$98.34 ,$98.34 ,$98.34 ,$383.98 ,$289.30 ,$478.66 ,$478.66 ,$420.80 , N/A ,$289.30 ,$473.40 , N/A ,$473.40 ,$284.04 ,$494.44 , N/A ,$483.92 ,$104.24 ,$478.66 , N/A ,$323.70 ,$323.70 ,$473.40 ,$392.55 ,$366.36 , N/A ,$98.34 ,$499.70 , N/A ,$98.34 ,$457.62 , N/A ,$473.40 , N/A ,$473.40 ,$473.40 ,$473.40 ,$510.22 ,$426.06 ,$489.18 ,$452.36 ,$510.22 
SACRED HEART HOSPITAL (ACU),32000015,27369,HC ARTHROGRAM INJ KNEE,320,1 ,$655.00 ,$491.25 ,$98.34 ,$655.00 ,$421.82 , N/A ,$458.50 ,$98.34 ,$543.65 ,$101.29 ,$432.30 ,$622.25 ,$98.34 ,$524.00 ,$602.60 ,$98.34 ,$556.75 ,$622.25 ,$576.40 ,$497.80 ,$98.34 ,$98.34 ,$98.34 ,$478.15 ,$360.25 ,$596.05 ,$596.05 ,$524.00 , N/A ,$360.25 ,$589.50 , N/A ,$589.50 ,$353.70 ,$615.70 , N/A ,$602.60 ,$104.24 ,$596.05 , N/A ,$403.09 ,$403.09 ,$589.50 ,$488.83 ,$456.21 , N/A ,$98.34 ,$622.25 , N/A ,$98.34 ,$569.85 , N/A ,$589.50 , N/A ,$589.50 ,$589.50 ,$589.50 ,$635.35 ,$530.55 ,$609.15 ,$563.30 ,$635.35 
SACRED HEART HOSPITAL (ACU),32000016,27648,HC ARTHROGRAM INJ ANKLE,320,1 ,$319.00 ,$239.25 ,$98.34 ,$319.00 ,$205.44 , N/A ,$223.30 ,$98.34 ,$264.77 ,$101.29 ,$210.54 ,$303.05 ,$98.34 ,$255.20 ,$293.48 ,$98.34 ,$271.15 ,$303.05 ,$280.72 ,$242.44 ,$98.34 ,$98.34 ,$98.34 ,$232.87 ,$175.45 ,$290.29 ,$290.29 ,$255.20 , N/A ,$175.45 ,$287.10 , N/A ,$287.10 ,$172.26 ,$299.86 , N/A ,$293.48 ,$104.24 ,$290.29 , N/A ,$196.31 ,$196.31 ,$287.10 ,$238.07 ,$222.18 , N/A ,$98.34 ,$303.05 , N/A ,$98.34 ,$277.53 , N/A ,$287.10 , N/A ,$287.10 ,$287.10 ,$287.10 ,$309.43 ,$258.39 ,$296.67 ,$274.34 ,$309.43 
SACRED HEART HOSPITAL (ACU),32000018,32550,HC INSERT CATH PLEURAL INDWELL W/,320,1 ,"$6,165.00 ","$4,623.75 ",$309.29 ,"$7,571.16 ","$3,970.26 ","$3,364.96 ","$4,315.50 ",$309.29 ,"$5,116.95 ",$318.57 ,"$4,068.90 ","$5,856.75 ",$309.29 ,"$4,932.00 ","$5,671.80 ",$309.29 ,"$5,240.25 ","$5,856.75 ","$5,425.20 ","$4,685.40 ",$309.29 ,$309.29 ,$309.29 ,"$4,500.45 ","$3,390.75 ","$5,610.15 ","$5,610.15 ","$4,932.00 ","$3,465.91 ","$3,390.75 ","$5,548.50 ","$3,364.96 ","$5,548.50 ","$3,329.10 ","$5,795.10 ","$7,571.16 ","$5,671.80 ",$327.85 ,"$5,610.15 ","$3,364.96 ","$3,793.94 ","$3,793.94 ","$5,548.50 ","$4,600.94 ","$4,293.92 ","$3,398.61 ",$309.29 ,"$5,856.75 ","$3,533.21 ",$309.29 ,"$5,363.55 ","$3,364.96 ","$5,548.50 ","$3,364.96 ","$5,548.50 ","$5,548.50 ","$5,548.50 ","$5,980.05 ","$4,993.65 ","$5,733.45 ","$5,301.90 ","$5,980.05 "
SACRED HEART HOSPITAL (ACU),32000019,32551,HC CHEST TUBE INSERTION 32551,320,1 ,$791.00 ,$593.25 ,$309.29 ,"$3,346.33 ",$509.40 ,"$1,487.26 ",$553.70 ,$309.29 ,$656.53 ,$318.57 ,$522.06 ,$751.45 ,$309.29 ,$632.80 ,$727.72 ,$309.29 ,$672.35 ,$751.45 ,$696.08 ,$601.16 ,$309.29 ,$309.29 ,$309.29 ,$577.43 ,$435.05 ,$719.81 ,$719.81 ,$632.80 ,"$1,531.88 ",$435.05 ,$711.90 ,"$1,487.26 ",$711.90 ,$427.14 ,$743.54 ,"$3,346.33 ",$727.72 ,$327.85 ,$719.81 ,"$1,487.26 ",$486.78 ,$486.78 ,$711.90 ,$590.32 ,$550.93 ,"$1,502.13 ",$309.29 ,$751.45 ,"$1,561.62 ",$309.29 ,$688.17 ,"$1,487.26 ",$711.90 ,"$1,487.26 ",$711.90 ,$711.90 ,$711.90 ,$767.27 ,$640.71 ,$735.63 ,$680.26 ,$767.27 
SACRED HEART HOSPITAL (ACU),32000020,32552,HC REMOVAL TUNNELED PLEURAL CATH,320,1 ,"$2,268.00 ","$1,701.00 ",$309.29 ,"$2,268.00 ","$1,460.59 ",$571.68 ,"$1,587.60 ",$309.29 ,"$1,882.44 ",$318.57 ,"$1,496.88 ","$2,154.60 ",$309.29 ,"$1,814.40 ","$2,086.56 ",$309.29 ,"$1,927.80 ","$2,154.60 ","$1,995.84 ","$1,723.68 ",$309.29 ,$309.29 ,$309.29 ,"$1,655.64 ","$1,247.40 ","$2,063.88 ","$2,063.88 ","$1,814.40 ",$588.83 ,"$1,247.40 ","$2,041.20 ",$571.68 ,"$2,041.20 ","$1,224.72 ","$2,131.92 ","$1,286.28 ","$2,086.56 ",$327.85 ,"$2,063.88 ",$571.68 ,"$1,395.73 ","$1,395.73 ","$2,041.20 ","$1,692.61 ","$1,579.66 ",$577.40 ,$309.29 ,"$2,154.60 ",$600.27 ,$309.29 ,"$1,973.16 ",$571.68 ,"$2,041.20 ",$571.68 ,"$2,041.20 ","$2,041.20 ","$2,041.20 ","$2,199.96 ","$1,837.08 ","$2,109.24 ","$1,950.48 ","$2,199.96 "
SACRED HEART HOSPITAL (ACU),32000027,36002,HC INJ PSEUDOANEURYSM (THROMBIN),320,1 ,"$1,206.00 ",$904.50 ,$273.54 ,"$1,286.28 ",$776.66 ,$571.68 ,$844.20 ,$273.54 ,"$1,000.98 ",$281.75 ,$795.96 ,"$1,145.70 ",$273.54 ,$964.80 ,"$1,109.52 ",$273.54 ,"$1,025.10 ","$1,145.70 ","$1,061.28 ",$916.56 ,$273.54 ,$273.54 ,$273.54 ,$880.38 ,$663.30 ,"$1,097.46 ","$1,097.46 ",$964.80 ,$588.83 ,$663.30 ,"$1,085.40 ",$571.68 ,"$1,085.40 ",$651.24 ,"$1,133.64 ","$1,286.28 ","$1,109.52 ",$289.95 ,"$1,097.46 ",$571.68 ,$742.17 ,$742.17 ,"$1,085.40 ",$900.04 ,$839.98 ,$577.40 ,$273.54 ,"$1,145.70 ",$600.27 ,$273.54 ,"$1,049.22 ",$571.68 ,"$1,085.40 ",$571.68 ,"$1,085.40 ","$1,085.40 ","$1,085.40 ","$1,169.82 ",$976.86 ,"$1,121.58 ","$1,037.16 ","$1,169.82 "
SACRED HEART HOSPITAL (ACU),32000028,36005,HC VENOGRAM INJECTION 36005,320,1 ,$720.00 ,$540.00 ,$206.34 ,$720.00 ,$463.68 , N/A ,$504.00 ,$206.34 ,$597.60 ,$212.53 ,$475.20 ,$684.00 ,$206.34 ,$576.00 ,$662.40 ,$206.34 ,$612.00 ,$684.00 ,$633.60 ,$547.20 ,$206.34 ,$206.34 ,$206.34 ,$525.60 ,$396.00 ,$655.20 ,$655.20 ,$576.00 , N/A ,$396.00 ,$648.00 , N/A ,$648.00 ,$388.80 ,$676.80 , N/A ,$662.40 ,$218.72 ,$655.20 , N/A ,$443.09 ,$443.09 ,$648.00 ,$537.34 ,$501.48 , N/A ,$206.34 ,$684.00 , N/A ,$206.34 ,$626.40 , N/A ,$648.00 , N/A ,$648.00 ,$648.00 ,$648.00 ,$698.40 ,$583.20 ,$669.60 ,$619.20 ,$698.40 
SACRED HEART HOSPITAL (ACU),32000030,36598,HC CONTRAST INJ CV CATH W/FLUORO,320,1 ,$286.00 ,$214.50 ,$98.34 ,$486.82 ,$184.18 ,$216.36 ,$200.20 ,$98.34 ,$237.38 ,$101.29 ,$188.76 ,$271.70 ,$98.34 ,$228.80 ,$263.12 ,$98.34 ,$243.10 ,$271.70 ,$251.68 ,$217.36 ,$98.34 ,$98.34 ,$98.34 ,$208.78 ,$157.30 ,$260.26 ,$260.26 ,$228.80 ,$222.85 ,$157.30 ,$257.40 ,$216.36 ,$257.40 ,$154.44 ,$268.84 ,$486.82 ,$263.12 ,$104.24 ,$260.26 ,$216.36 ,$176.00 ,$176.00 ,$257.40 ,$213.44 ,$199.20 ,$218.53 ,$98.34 ,$271.70 ,$227.18 ,$98.34 ,$248.82 ,$216.36 ,$257.40 ,$216.36 ,$257.40 ,$257.40 ,$257.40 ,$277.42 ,$231.66 ,$265.98 ,$245.96 ,$277.42 
SACRED HEART HOSPITAL (ACU),32000032,42400,HC BX GLAND SALIVARY NEEDLE,320,1 ,"$1,079.00 ",$809.25 ,$298.28 ,"$1,480.84 ",$694.88 ,$658.15 ,$755.30 ,$298.28 ,$895.57 ,$307.23 ,$712.14 ,"$1,025.05 ",$298.28 ,$863.20 ,$992.68 ,$298.28 ,$917.15 ,"$1,025.05 ",$949.52 ,$820.04 ,$298.28 ,$298.28 ,$298.28 ,$787.67 ,$593.45 ,$981.89 ,$981.89 ,$863.20 ,$677.89 ,$593.45 ,$971.10 ,$658.15 ,$971.10 ,$582.66 ,"$1,014.26 ","$1,480.84 ",$992.68 ,$316.18 ,$981.89 ,$658.15 ,$664.02 ,$664.02 ,$971.10 ,$805.26 ,$751.52 ,$664.73 ,$298.28 ,"$1,025.05 ",$691.06 ,$298.28 ,$938.73 ,$658.15 ,$971.10 ,$658.15 ,$971.10 ,$971.10 ,$971.10 ,"$1,046.63 ",$873.99 ,"$1,003.47 ",$927.94 ,"$1,046.63 "
SACRED HEART HOSPITAL (ACU),32000033,42550,HC SIALOGRAM INJECTION,320,1 ,$497.00 ,$372.75 ,$98.34 ,$497.00 ,$320.07 , N/A ,$347.90 ,$98.34 ,$412.51 ,$101.29 ,$328.02 ,$472.15 ,$98.34 ,$397.60 ,$457.24 ,$98.34 ,$422.45 ,$472.15 ,$437.36 ,$377.72 ,$98.34 ,$98.34 ,$98.34 ,$362.81 ,$273.35 ,$452.27 ,$452.27 ,$397.60 , N/A ,$273.35 ,$447.30 , N/A ,$447.30 ,$268.38 ,$467.18 , N/A ,$457.24 ,$104.24 ,$452.27 , N/A ,$305.85 ,$305.85 ,$447.30 ,$370.91 ,$346.16 , N/A ,$98.34 ,$472.15 , N/A ,$98.34 ,$432.39 , N/A ,$447.30 , N/A ,$447.30 ,$447.30 ,$447.30 ,$482.09 ,$402.57 ,$462.21 ,$427.42 ,$482.09 
SACRED HEART HOSPITAL (ACU),32000035,43752,HC PLACE TUBE NASOGASTRIC,320,1 ,$528.00 ,$396.00 ,$218.32 ,$645.84 ,$340.03 ,$287.04 ,$369.60 ,$218.32 ,$438.24 ,$224.87 ,$348.48 ,$501.60 ,$218.32 ,$422.40 ,$485.76 ,$218.32 ,$448.80 ,$501.60 ,$464.64 ,$401.28 ,$218.32 ,$218.32 ,$218.32 ,$385.44 ,$290.40 ,$480.48 ,$480.48 ,$422.40 ,$295.65 ,$290.40 ,$475.20 ,$287.04 ,$475.20 ,$285.12 ,$496.32 ,$645.84 ,$485.76 ,$231.42 ,$480.48 ,$287.04 ,$324.93 ,$324.93 ,$475.20 ,$394.05 ,$367.75 ,$289.91 ,$218.32 ,$501.60 ,$301.39 ,$218.32 ,$459.36 ,$287.04 ,$475.20 ,$287.04 ,$475.20 ,$475.20 ,$475.20 ,$512.16 ,$427.68 ,$491.04 ,$454.08 ,$512.16 
SACRED HEART HOSPITAL (ACU),32000036,43761,HC REPOSITION G-TUBE,320,1 ,$723.00 ,$542.25 ,$64.85 ,$723.00 ,$465.61 ,$281.44 ,$506.10 ,$64.85 ,$600.09 ,$66.80 ,$477.18 ,$686.85 ,$64.85 ,$578.40 ,$665.16 ,$64.85 ,$614.55 ,$686.85 ,$636.24 ,$549.48 ,$64.85 ,$64.85 ,$64.85 ,$527.79 ,$397.65 ,$657.93 ,$657.93 ,$578.40 ,$289.88 ,$397.65 ,$650.70 ,$281.44 ,$650.70 ,$390.42 ,$679.62 ,$633.24 ,$665.16 ,$68.74 ,$657.93 ,$281.44 ,$444.93 ,$444.93 ,$650.70 ,$539.57 ,$503.57 ,$284.25 ,$64.85 ,$686.85 ,$295.51 ,$64.85 ,$629.01 ,$281.44 ,$650.70 ,$281.44 ,$650.70 ,$650.70 ,$650.70 ,$701.31 ,$585.63 ,$672.39 ,$621.78 ,$701.31 
SACRED HEART HOSPITAL (ACU),32000038,44500,HC INTRO TUBE GI LONG,320,1 ,$565.00 ,$423.75 ,$218.32 ,"$1,925.53 ",$363.86 ,$855.79 ,$395.50 ,$218.32 ,$468.95 ,$224.87 ,$372.90 ,$536.75 ,$218.32 ,$452.00 ,$519.80 ,$218.32 ,$480.25 ,$536.75 ,$497.20 ,$429.40 ,$218.32 ,$218.32 ,$218.32 ,$412.45 ,$310.75 ,$514.15 ,$514.15 ,$452.00 ,$881.46 ,$310.75 ,$508.50 ,$855.79 ,$508.50 ,$305.10 ,$531.10 ,"$1,925.53 ",$519.80 ,$231.42 ,$514.15 ,$855.79 ,$347.70 ,$347.70 ,$508.50 ,$421.66 ,$393.52 ,$864.35 ,$218.32 ,$536.75 ,$898.58 ,$218.32 ,$491.55 ,$855.79 ,$508.50 ,$855.79 ,$508.50 ,$508.50 ,$508.50 ,$548.05 ,$457.65 ,$525.45 ,$485.90 ,$548.05 
SACRED HEART HOSPITAL (ACU),32000043,47536,HC CHG PERC BIL DRAIN CATH,320,1 ,"$4,252.78 ","$3,189.59 ",$817.89 ,"$7,571.16 ","$2,738.79 ","$3,364.96 ","$2,976.95 ",$817.89 ,"$3,529.81 ",$842.43 ,"$2,806.83 ","$4,040.14 ",$817.89 ,"$3,402.22 ","$3,912.56 ",$817.89 ,"$3,614.86 ","$4,040.14 ","$3,742.45 ","$3,232.11 ",$817.89 ,$817.89 ,$817.89 ,"$3,104.53 ","$2,339.03 ","$3,870.03 ","$3,870.03 ","$3,402.22 ","$3,465.91 ","$2,339.03 ","$3,827.50 ","$3,364.96 ","$3,827.50 ","$2,296.50 ","$3,997.61 ","$7,571.16 ","$3,912.56 ",$866.96 ,"$3,870.03 ","$3,364.96 ","$2,617.16 ","$2,617.16 ","$3,827.50 ","$3,173.85 ","$2,962.06 ","$3,398.61 ",$817.89 ,"$4,040.14 ","$3,533.21 ",$817.89 ,"$3,699.92 ","$3,364.96 ","$3,827.50 ","$3,364.96 ","$3,827.50 ","$3,827.50 ","$3,827.50 ","$4,125.20 ","$3,444.75 ","$3,955.09 ","$3,657.39 ","$4,125.20 "
SACRED HEART HOSPITAL (ACU),32000044,47535,HC REVISE/REINSERT TUBE TRNSHEPAT,320,1 ,"$4,252.78 ","$3,189.59 ",$817.89 ,"$7,571.16 ","$2,738.79 ","$3,364.96 ","$2,976.95 ",$817.89 ,"$3,529.81 ",$842.43 ,"$2,806.83 ","$4,040.14 ",$817.89 ,"$3,402.22 ","$3,912.56 ",$817.89 ,"$3,614.86 ","$4,040.14 ","$3,742.45 ","$3,232.11 ",$817.89 ,$817.89 ,$817.89 ,"$3,104.53 ","$2,339.03 ","$3,870.03 ","$3,870.03 ","$3,402.22 ","$3,465.91 ","$2,339.03 ","$3,827.50 ","$3,364.96 ","$3,827.50 ","$2,296.50 ","$3,997.61 ","$7,571.16 ","$3,912.56 ",$866.96 ,"$3,870.03 ","$3,364.96 ","$2,617.16 ","$2,617.16 ","$3,827.50 ","$3,173.85 ","$2,962.06 ","$3,398.61 ",$817.89 ,"$4,040.14 ","$3,533.21 ",$817.89 ,"$3,699.92 ","$3,364.96 ","$3,827.50 ","$3,364.96 ","$3,827.50 ","$3,827.50 ","$3,827.50 ","$4,125.20 ","$3,444.75 ","$3,955.09 ","$3,657.39 ","$4,125.20 "
SACRED HEART HOSPITAL (ACU),32000045,47542,HC ENDO BILIARY W/DIL BILI DUCT,320,1 ,"$2,157.74 ","$1,618.31 ",$817.89 ,"$2,157.74 ","$1,389.58 ", N/A ,"$1,510.42 ",$817.89 ,"$1,790.92 ",$842.43 ,"$1,424.11 ","$2,049.85 ",$817.89 ,"$1,726.19 ","$1,985.12 ",$817.89 ,"$1,834.08 ","$2,049.85 ","$1,898.81 ","$1,639.88 ",$817.89 ,$817.89 ,$817.89 ,"$1,575.15 ","$1,186.76 ","$1,963.54 ","$1,963.54 ","$1,726.19 ", N/A ,"$1,186.76 ","$1,941.97 ", N/A ,"$1,941.97 ","$1,165.18 ","$2,028.28 ", N/A ,"$1,985.12 ",$866.96 ,"$1,963.54 ", N/A ,"$1,327.87 ","$1,327.87 ","$1,941.97 ","$1,610.32 ","$1,502.87 ", N/A ,$817.89 ,"$2,049.85 ", N/A ,$817.89 ,"$1,877.23 ", N/A ,"$1,941.97 ", N/A ,"$1,941.97 ","$1,941.97 ","$1,941.97 ","$2,093.01 ","$1,747.77 ","$2,006.70 ","$1,855.66 ","$2,093.01 "
SACRED HEART HOSPITAL (ACU),32000046,47539,HC ENDO BILIARY DIL DUCT W/STENT,320,1 ,"$4,252.78 ","$3,189.59 ",$817.89 ,"$12,041.00 ","$2,738.79 ","$5,351.56 ","$2,976.95 ",$817.89 ,"$3,529.81 ",$842.43 ,"$2,806.83 ","$4,040.14 ",$817.89 ,"$3,402.22 ","$3,912.56 ",$817.89 ,"$3,614.86 ","$4,040.14 ","$3,742.45 ","$3,232.11 ",$817.89 ,$817.89 ,$817.89 ,"$3,104.53 ","$2,339.03 ","$3,870.03 ","$3,870.03 ","$3,402.22 ","$5,512.11 ","$2,339.03 ","$3,827.50 ","$5,351.56 ","$3,827.50 ","$2,296.50 ","$3,997.61 ","$12,041.00 ","$3,912.56 ",$866.96 ,"$3,870.03 ","$5,351.56 ","$2,617.16 ","$2,617.16 ","$3,827.50 ","$3,173.85 ","$2,962.06 ","$5,405.07 ",$817.89 ,"$4,040.14 ","$5,619.13 ",$817.89 ,"$3,699.92 ","$5,351.56 ","$3,827.50 ","$5,351.56 ","$3,827.50 ","$3,827.50 ","$3,827.50 ","$4,125.20 ","$3,444.75 ","$3,955.09 ","$3,657.39 ","$4,125.20 "
SACRED HEART HOSPITAL (ACU),32000051,49406,HC DRN ABSC RETROPERITONEAL PERC,320,1 ,"$2,728.51 ","$2,046.38 ",$239.96 ,"$3,348.27 ","$1,757.16 ","$1,488.12 ","$1,909.96 ",$239.96 ,"$2,264.66 ",$247.16 ,"$1,800.82 ","$2,592.08 ",$239.96 ,"$2,182.81 ","$2,510.23 ",$239.96 ,"$2,319.23 ","$2,592.08 ","$2,401.09 ","$2,073.67 ",$239.96 ,$239.96 ,$239.96 ,"$1,991.81 ","$1,500.68 ","$2,482.94 ","$2,482.94 ","$2,182.81 ","$1,532.76 ","$1,500.68 ","$2,455.66 ","$1,488.12 ","$2,455.66 ","$1,473.40 ","$2,564.80 ","$3,348.27 ","$2,510.23 ",$254.36 ,"$2,482.94 ","$1,488.12 ","$1,679.13 ","$1,679.13 ","$2,455.66 ","$2,036.29 ","$1,900.41 ","$1,503.00 ",$239.96 ,"$2,592.08 ","$1,562.52 ",$239.96 ,"$2,373.80 ","$1,488.12 ","$2,455.66 ","$1,488.12 ","$2,455.66 ","$2,455.66 ","$2,455.66 ","$2,646.65 ","$2,210.09 ","$2,537.51 ","$2,346.52 ","$2,646.65 "
SACRED HEART HOSPITAL (ACU),32000053,49423,HC EXCHG CATH ABSC/CYST DRAIN,320,1 ,$666.41 ,$499.81 ,$239.96 ,"$3,865.12 ",$429.17 ,"$1,717.83 ",$466.49 ,$239.96 ,$553.12 ,$247.16 ,$439.83 ,$633.09 ,$239.96 ,$533.13 ,$613.10 ,$239.96 ,$566.45 ,$633.09 ,$586.44 ,$506.47 ,$239.96 ,$239.96 ,$239.96 ,$486.48 ,$366.53 ,$606.43 ,$606.43 ,$533.13 ,"$1,769.36 ",$366.53 ,$599.77 ,"$1,717.83 ",$599.77 ,$359.86 ,$626.43 ,"$3,865.12 ",$613.10 ,$254.36 ,$606.43 ,"$1,717.83 ",$410.11 ,$410.11 ,$599.77 ,$497.34 ,$464.15 ,"$1,735.01 ",$239.96 ,$633.09 ,"$1,803.72 ",$239.96 ,$579.78 ,"$1,717.83 ",$599.77 ,"$1,717.83 ",$599.77 ,$599.77 ,$599.77 ,$646.42 ,$539.79 ,$619.76 ,$573.11 ,$646.42 
SACRED HEART HOSPITAL (ACU),32000054,49424,HC INJ CONTRAST ABSC/CYST,320,1 ,$474.27 ,$355.70 ,$98.34 ,$474.27 ,$305.43 , N/A ,$331.99 ,$98.34 ,$393.64 ,$101.29 ,$313.02 ,$450.56 ,$98.34 ,$379.42 ,$436.33 ,$98.34 ,$403.13 ,$450.56 ,$417.36 ,$360.45 ,$98.34 ,$98.34 ,$98.34 ,$346.22 ,$260.85 ,$431.59 ,$431.59 ,$379.42 , N/A ,$260.85 ,$426.84 , N/A ,$426.84 ,$256.11 ,$445.81 , N/A ,$436.33 ,$104.24 ,$431.59 , N/A ,$291.87 ,$291.87 ,$426.84 ,$353.95 ,$330.33 , N/A ,$98.34 ,$450.56 , N/A ,$98.34 ,$412.61 , N/A ,$426.84 , N/A ,$426.84 ,$426.84 ,$426.84 ,$460.04 ,$384.16 ,$441.07 ,$407.87 ,$460.04 
SACRED HEART HOSPITAL (ACU),32000056,49440,HC INSERT GASTRO TUBE FLUORO,320,1 ,"$2,019.00 ","$1,514.25 ",$218.32 ,"$3,865.12 ","$1,300.24 ","$1,717.83 ","$1,413.30 ",$218.32 ,"$1,675.77 ",$224.87 ,"$1,332.54 ","$1,918.05 ",$218.32 ,"$1,615.20 ","$1,857.48 ",$218.32 ,"$1,716.15 ","$1,918.05 ","$1,776.72 ","$1,534.44 ",$218.32 ,$218.32 ,$218.32 ,"$1,473.87 ","$1,110.45 ","$1,837.29 ","$1,837.29 ","$1,615.20 ","$1,769.36 ","$1,110.45 ","$1,817.10 ","$1,717.83 ","$1,817.10 ","$1,090.26 ","$1,897.86 ","$3,865.12 ","$1,857.48 ",$231.42 ,"$1,837.29 ","$1,717.83 ","$1,242.49 ","$1,242.49 ","$1,817.10 ","$1,506.78 ","$1,406.23 ","$1,735.01 ",$218.32 ,"$1,918.05 ","$1,803.72 ",$218.32 ,"$1,756.53 ","$1,717.83 ","$1,817.10 ","$1,717.83 ","$1,817.10 ","$1,817.10 ","$1,817.10 ","$1,958.43 ","$1,635.39 ","$1,877.67 ","$1,736.34 ","$1,958.43 "
SACRED HEART HOSPITAL (ACU),32000057,49441,HC INSERT DUODEN/JEJUN TBE FLUORO,320,1 ,"$1,324.00 ",$993.00 ,$218.32 ,"$3,865.12 ",$852.66 ,"$1,717.83 ",$926.80 ,$218.32 ,"$1,098.92 ",$224.87 ,$873.84 ,"$1,257.80 ",$218.32 ,"$1,059.20 ","$1,218.08 ",$218.32 ,"$1,125.40 ","$1,257.80 ","$1,165.12 ","$1,006.24 ",$218.32 ,$218.32 ,$218.32 ,$966.52 ,$728.20 ,"$1,204.84 ","$1,204.84 ","$1,059.20 ","$1,769.36 ",$728.20 ,"$1,191.60 ","$1,717.83 ","$1,191.60 ",$714.96 ,"$1,244.56 ","$3,865.12 ","$1,218.08 ",$231.42 ,"$1,204.84 ","$1,717.83 ",$814.79 ,$814.79 ,"$1,191.60 ",$988.10 ,$922.17 ,"$1,735.01 ",$218.32 ,"$1,257.80 ","$1,803.72 ",$218.32 ,"$1,151.88 ","$1,717.83 ","$1,191.60 ","$1,717.83 ","$1,191.60 ","$1,191.60 ","$1,191.60 ","$1,284.28 ","$1,072.44 ","$1,231.32 ","$1,138.64 ","$1,284.28 "
SACRED HEART HOSPITAL (ACU),32000059,49446,HC CHG G-TB TO GJ-TB PERC FLUORO,320,1 ,"$1,541.00 ","$1,155.75 ",$218.32 ,"$3,865.12 ",$992.40 ,"$1,717.83 ","$1,078.70 ",$218.32 ,"$1,279.03 ",$224.87 ,"$1,017.06 ","$1,463.95 ",$218.32 ,"$1,232.80 ","$1,417.72 ",$218.32 ,"$1,309.85 ","$1,463.95 ","$1,356.08 ","$1,171.16 ",$218.32 ,$218.32 ,$218.32 ,"$1,124.93 ",$847.55 ,"$1,402.31 ","$1,402.31 ","$1,232.80 ","$1,769.36 ",$847.55 ,"$1,386.90 ","$1,717.83 ","$1,386.90 ",$832.14 ,"$1,448.54 ","$3,865.12 ","$1,417.72 ",$231.42 ,"$1,402.31 ","$1,717.83 ",$948.33 ,$948.33 ,"$1,386.90 ","$1,150.05 ","$1,073.31 ","$1,735.01 ",$218.32 ,"$1,463.95 ","$1,803.72 ",$218.32 ,"$1,340.67 ","$1,717.83 ","$1,386.90 ","$1,717.83 ","$1,386.90 ","$1,386.90 ","$1,386.90 ","$1,494.77 ","$1,248.21 ","$1,433.13 ","$1,325.26 ","$1,494.77 "
SACRED HEART HOSPITAL (ACU),32000060,49450,HC RPLC G/CEC/OTH TB UNDER FLUORO,320,1 ,$961.00 ,$720.75 ,$218.32 ,"$1,925.53 ",$618.88 ,$855.79 ,$672.70 ,$218.32 ,$797.63 ,$224.87 ,$634.26 ,$912.95 ,$218.32 ,$768.80 ,$884.12 ,$218.32 ,$816.85 ,$912.95 ,$845.68 ,$730.36 ,$218.32 ,$218.32 ,$218.32 ,$701.53 ,$528.55 ,$874.51 ,$874.51 ,$768.80 ,$881.46 ,$528.55 ,$864.90 ,$855.79 ,$864.90 ,$518.94 ,$903.34 ,"$1,925.53 ",$884.12 ,$231.42 ,$874.51 ,$855.79 ,$591.40 ,$591.40 ,$864.90 ,$717.19 ,$669.34 ,$864.35 ,$218.32 ,$912.95 ,$898.58 ,$218.32 ,$836.07 ,$855.79 ,$864.90 ,$855.79 ,$864.90 ,$864.90 ,$864.90 ,$932.17 ,$778.41 ,$893.73 ,$826.46 ,$932.17 
SACRED HEART HOSPITAL (ACU),32000061,49451,HC RPLC DUODEN/JEJUN TB FLUORO,320,1 ,"$1,603.00 ","$1,202.25 ",$218.32 ,"$1,925.53 ","$1,032.33 ",$855.79 ,"$1,122.10 ",$218.32 ,"$1,330.49 ",$224.87 ,"$1,057.98 ","$1,522.85 ",$218.32 ,"$1,282.40 ","$1,474.76 ",$218.32 ,"$1,362.55 ","$1,522.85 ","$1,410.64 ","$1,218.28 ",$218.32 ,$218.32 ,$218.32 ,"$1,170.19 ",$881.65 ,"$1,458.73 ","$1,458.73 ","$1,282.40 ",$881.46 ,$881.65 ,"$1,442.70 ",$855.79 ,"$1,442.70 ",$865.62 ,"$1,506.82 ","$1,925.53 ","$1,474.76 ",$231.42 ,"$1,458.73 ",$855.79 ,$986.49 ,$986.49 ,"$1,442.70 ","$1,196.32 ","$1,116.49 ",$864.35 ,$218.32 ,"$1,522.85 ",$898.58 ,$218.32 ,"$1,394.61 ",$855.79 ,"$1,442.70 ",$855.79 ,"$1,442.70 ","$1,442.70 ","$1,442.70 ","$1,554.91 ","$1,298.43 ","$1,490.79 ","$1,378.58 ","$1,554.91 "
SACRED HEART HOSPITAL (ACU),32000062,49452,HC RPLC GASTRO-JEJUN TB FLUORO,361,1 ,"$1,204.00 ",$903.00 ,$218.32 ,"$1,925.53 ",$775.38 ,$855.79 ,$842.80 ,$218.32 ,"$1,204.00 ",$224.87 ,"$1,204.00 ","$1,143.80 ",$218.32 ,$963.20 ,"$1,107.68 ",$218.32 , N/A ,"$1,143.80 ","$1,059.52 ",$915.04 ,$218.32 ,$218.32 ,$218.32 ,$878.92 ,$662.20 ,"$1,095.64 ","$1,095.64 ",$963.20 ,$881.46 ,$662.20 ,"$1,083.60 ",$855.79 ,"$1,083.60 ",$650.16 ,"$1,131.76 ","$1,925.53 ","$1,107.68 ",$231.42 ,"$1,095.64 ",$855.79 ,$740.94 ,$740.94 ,"$1,083.60 ",$898.55 ,"$1,083.60 ",$864.35 ,$218.32 ,"$1,143.80 ",$898.58 ,$218.32 ,"$1,047.48 ",$855.79 ,"$1,083.60 ",$855.79 ,"$1,083.60 ","$1,083.60 ","$1,083.60 ","$1,167.88 ",$975.24 ,"$1,119.72 ","$1,035.44 ","$1,167.88 "
SACRED HEART HOSPITAL (ACU),32000063,49465,HC INJ CNTR W/FLUOR EVAL G/D/J TB,320,1 ,$327.00 ,$245.25 ,$39.20 ,$547.56 ,$210.59 ,$243.36 ,$228.90 ,$39.20 ,$271.41 ,$40.38 ,$215.82 ,$310.65 ,$39.20 ,$261.60 ,$300.84 ,$39.20 ,$277.95 ,$310.65 ,$287.76 ,$248.52 ,$39.20 ,$39.20 ,$39.20 ,$238.71 ,$179.85 ,$297.57 ,$297.57 ,$261.60 ,$250.66 ,$179.85 ,$294.30 ,$243.36 ,$294.30 ,$176.58 ,$307.38 ,$547.56 ,$300.84 ,$41.55 ,$297.57 ,$243.36 ,$201.24 ,$201.24 ,$294.30 ,$244.04 ,$227.76 ,$245.79 ,$39.20 ,$310.65 ,$255.53 ,$39.20 ,$284.49 ,$243.36 ,$294.30 ,$243.36 ,$294.30 ,$294.30 ,$294.30 ,$317.19 ,$264.87 ,$304.11 ,$281.22 ,$317.19 
SACRED HEART HOSPITAL (ACU),32000066,49405,HC DRN ABSC PERIRENAL  PERC,320,1 ,"$2,242.48 ","$1,681.86 ",$239.96 ,"$3,348.27 ","$1,444.16 ","$1,488.12 ","$1,569.74 ",$239.96 ,"$1,861.26 ",$247.16 ,"$1,480.04 ","$2,130.36 ",$239.96 ,"$1,793.98 ","$2,063.08 ",$239.96 ,"$1,906.11 ","$2,130.36 ","$1,973.38 ","$1,704.28 ",$239.96 ,$239.96 ,$239.96 ,"$1,637.01 ","$1,233.36 ","$2,040.66 ","$2,040.66 ","$1,793.98 ","$1,532.76 ","$1,233.36 ","$2,018.23 ","$1,488.12 ","$2,018.23 ","$1,210.94 ","$2,107.93 ","$3,348.27 ","$2,063.08 ",$254.36 ,"$2,040.66 ","$1,488.12 ","$1,380.02 ","$1,380.02 ","$2,018.23 ","$1,673.56 ","$1,561.89 ","$1,503.00 ",$239.96 ,"$2,130.36 ","$1,562.52 ",$239.96 ,"$1,950.96 ","$1,488.12 ","$2,018.23 ","$1,488.12 ","$2,018.23 ","$2,018.23 ","$2,018.23 ","$2,175.21 ","$1,816.41 ","$2,085.51 ","$1,928.53 ","$2,175.21 "
SACRED HEART HOSPITAL (ACU),32000067,50382,HC CHANGE URETERAL STENT PERCU,320,1 ,"$2,837.00 ","$2,127.75 ",$490.07 ,"$4,260.86 ","$1,827.03 ","$1,893.71 ","$1,985.90 ",$490.07 ,"$2,354.71 ",$504.77 ,"$1,872.42 ","$2,695.15 ",$490.07 ,"$2,269.60 ","$2,610.04 ",$490.07 ,"$2,411.45 ","$2,695.15 ","$2,496.56 ","$2,156.12 ",$490.07 ,$490.07 ,$490.07 ,"$2,071.01 ","$1,560.35 ","$2,581.67 ","$2,581.67 ","$2,269.60 ","$1,950.52 ","$1,560.35 ","$2,553.30 ","$1,893.71 ","$2,553.30 ","$1,531.98 ","$2,666.78 ","$4,260.86 ","$2,610.04 ",$519.47 ,"$2,581.67 ","$1,893.71 ","$1,745.89 ","$1,745.89 ","$2,553.30 ","$2,117.25 ","$1,975.97 ","$1,912.65 ",$490.07 ,"$2,695.15 ","$1,988.40 ",$490.07 ,"$2,468.19 ","$1,893.71 ","$2,553.30 ","$1,893.71 ","$2,553.30 ","$2,553.30 ","$2,553.30 ","$2,751.89 ","$2,297.97 ","$2,638.41 ","$2,439.82 ","$2,751.89 "
SACRED HEART HOSPITAL (ACU),32000068,50384,HC REM URETERAL STENT PERCU,320,1 ,"$2,553.00 ","$1,914.75 ",$490.07 ,"$4,260.86 ","$1,644.13 ","$1,893.71 ","$1,787.10 ",$490.07 ,"$2,118.99 ",$504.77 ,"$1,684.98 ","$2,425.35 ",$490.07 ,"$2,042.40 ","$2,348.76 ",$490.07 ,"$2,170.05 ","$2,425.35 ","$2,246.64 ","$1,940.28 ",$490.07 ,$490.07 ,$490.07 ,"$1,863.69 ","$1,404.15 ","$2,323.23 ","$2,323.23 ","$2,042.40 ","$1,950.52 ","$1,404.15 ","$2,297.70 ","$1,893.71 ","$2,297.70 ","$1,378.62 ","$2,399.82 ","$4,260.86 ","$2,348.76 ",$519.47 ,"$2,323.23 ","$1,893.71 ","$1,571.12 ","$1,571.12 ","$2,297.70 ","$1,905.30 ","$1,778.16 ","$1,912.65 ",$490.07 ,"$2,425.35 ","$1,988.40 ",$490.07 ,"$2,221.11 ","$1,893.71 ","$2,297.70 ","$1,893.71 ","$2,297.70 ","$2,297.70 ","$2,297.70 ","$2,476.41 ","$2,067.93 ","$2,374.29 ","$2,195.58 ","$2,476.41 "
SACRED HEART HOSPITAL (ACU),32000071,50387,HC CHANGE EXT/INT URET STENT,320,1 ,"$1,887.00 ","$1,415.25 ",$490.07 ,"$4,260.86 ","$1,215.23 ","$1,893.71 ","$1,320.90 ",$490.07 ,"$1,566.21 ",$504.77 ,"$1,245.42 ","$1,792.65 ",$490.07 ,"$1,509.60 ","$1,736.04 ",$490.07 ,"$1,603.95 ","$1,792.65 ","$1,660.56 ","$1,434.12 ",$490.07 ,$490.07 ,$490.07 ,"$1,377.51 ","$1,037.85 ","$1,717.17 ","$1,717.17 ","$1,509.60 ","$1,950.52 ","$1,037.85 ","$1,698.30 ","$1,893.71 ","$1,698.30 ","$1,018.98 ","$1,773.78 ","$4,260.86 ","$1,736.04 ",$519.47 ,"$1,717.17 ","$1,893.71 ","$1,161.26 ","$1,161.26 ","$1,698.30 ","$1,408.27 ","$1,314.30 ","$1,912.65 ",$490.07 ,"$1,792.65 ","$1,988.40 ",$490.07 ,"$1,641.69 ","$1,893.71 ","$1,698.30 ","$1,893.71 ","$1,698.30 ","$1,698.30 ","$1,698.30 ","$1,830.39 ","$1,528.47 ","$1,754.91 ","$1,622.82 ","$1,830.39 "
SACRED HEART HOSPITAL (ACU),32000072,50389,HC REM NEPHRO TUBE FLUORO,320,1 ,"$1,939.98 ","$1,454.99 ",$123.38 ,"$1,939.98 ","$1,249.35 ",$608.47 ,"$1,357.99 ",$123.38 ,"$1,610.18 ",$127.08 ,"$1,280.39 ","$1,842.98 ",$123.38 ,"$1,551.98 ","$1,784.78 ",$123.38 ,"$1,648.98 ","$1,842.98 ","$1,707.18 ","$1,474.38 ",$123.38 ,$123.38 ,$123.38 ,"$1,416.19 ","$1,066.99 ","$1,765.38 ","$1,765.38 ","$1,551.98 ",$626.72 ,"$1,066.99 ","$1,745.98 ",$608.47 ,"$1,745.98 ","$1,047.59 ","$1,823.58 ","$1,369.05 ","$1,784.78 ",$130.78 ,"$1,765.38 ",$608.47 ,"$1,193.86 ","$1,193.86 ","$1,745.98 ","$1,447.81 ","$1,351.20 ",$614.55 ,$123.38 ,"$1,842.98 ",$638.89 ,$123.38 ,"$1,687.78 ",$608.47 ,"$1,745.98 ",$608.47 ,"$1,745.98 ","$1,745.98 ","$1,745.98 ","$1,881.78 ","$1,571.38 ","$1,804.18 ","$1,668.38 ","$1,881.78 "
SACRED HEART HOSPITAL (ACU),32000077,50693,HC INTRO GUIDE RENAL PELVIS URET DIL,320,1 ,"$2,268.00 ","$1,701.00 ",$955.28 ,"$7,316.47 ","$1,460.59 ","$3,251.76 ","$1,587.60 ",$955.28 ,"$1,882.44 ",$983.94 ,"$1,496.88 ","$2,154.60 ",$955.28 ,"$1,814.40 ","$2,086.56 ",$955.28 ,"$1,927.80 ","$2,154.60 ","$1,995.84 ","$1,723.68 ",$955.28 ,$955.28 ,$955.28 ,"$1,655.64 ","$1,247.40 ","$2,063.88 ","$2,063.88 ","$1,814.40 ","$3,349.31 ","$1,247.40 ","$2,041.20 ","$3,251.76 ","$2,041.20 ","$1,224.72 ","$2,131.92 ","$7,316.47 ","$2,086.56 ","$1,012.60 ","$2,063.88 ","$3,251.76 ","$1,395.73 ","$1,395.73 ","$2,041.20 ","$1,692.61 ","$1,579.66 ","$3,284.28 ",$955.28 ,"$2,154.60 ","$3,414.35 ",$955.28 ,"$1,973.16 ","$3,251.76 ","$2,041.20 ","$3,251.76 ","$2,041.20 ","$2,041.20 ","$2,041.20 ","$2,199.96 ","$1,837.08 ","$2,109.24 ","$1,950.48 ","$2,199.96 "
SACRED HEART HOSPITAL (ACU),32000079,50435,HC CHANGE NEPHROSTOMY TUBE,320,1 ,"$3,925.00 ","$2,943.75 ",$490.07 ,"$4,260.86 ","$2,527.70 ","$1,893.71 ","$2,747.50 ",$490.07 ,"$3,257.75 ",$504.77 ,"$2,590.50 ","$3,728.75 ",$490.07 ,"$3,140.00 ","$3,611.00 ",$490.07 ,"$3,336.25 ","$3,728.75 ","$3,454.00 ","$2,983.00 ",$490.07 ,$490.07 ,$490.07 ,"$2,865.25 ","$2,158.75 ","$3,571.75 ","$3,571.75 ","$3,140.00 ","$1,950.52 ","$2,158.75 ","$3,532.50 ","$1,893.71 ","$3,532.50 ","$2,119.50 ","$3,689.50 ","$4,260.86 ","$3,611.00 ",$519.47 ,"$3,571.75 ","$1,893.71 ","$2,415.45 ","$2,415.45 ","$3,532.50 ","$2,929.23 ","$2,733.76 ","$1,912.65 ",$490.07 ,"$3,728.75 ","$1,988.40 ",$490.07 ,"$3,414.75 ","$1,893.71 ","$3,532.50 ","$1,893.71 ","$3,532.50 ","$3,532.50 ","$3,532.50 ","$3,807.25 ","$3,179.25 ","$3,650.25 ","$3,375.50 ","$3,807.25 "
SACRED HEART HOSPITAL (ACU),32000081,50684,HC INJ URETEROGRAPHY,320,1 ,$827.00 ,$620.25 ,$98.34 ,$827.00 ,$532.59 , N/A ,$578.90 ,$98.34 ,$686.41 ,$101.29 ,$545.82 ,$785.65 ,$98.34 ,$661.60 ,$760.84 ,$98.34 ,$702.95 ,$785.65 ,$727.76 ,$628.52 ,$98.34 ,$98.34 ,$98.34 ,$603.71 ,$454.85 ,$752.57 ,$752.57 ,$661.60 , N/A ,$454.85 ,$744.30 , N/A ,$744.30 ,$446.58 ,$777.38 , N/A ,$760.84 ,$104.24 ,$752.57 , N/A ,$508.94 ,$508.94 ,$744.30 ,$617.19 ,$576.01 , N/A ,$98.34 ,$785.65 , N/A ,$98.34 ,$719.49 , N/A ,$744.30 , N/A ,$744.30 ,$744.30 ,$744.30 ,$802.19 ,$669.87 ,$769.11 ,$711.22 ,$802.19 
SACRED HEART HOSPITAL (ACU),32000082,50688,HC CHG TUBE URETEROSTOMY,320,1 ,$547.00 ,$410.25 ,$295.38 ,"$4,260.86 ",$352.27 ,"$1,893.71 ",$382.90 ,$490.07 ,$454.01 ,$504.77 ,$361.02 ,$519.65 ,$490.07 ,$437.60 ,$503.24 ,$490.07 ,$464.95 ,$519.65 ,$481.36 ,$415.72 ,$490.07 ,$490.07 ,$490.07 ,$399.31 ,$300.85 ,$497.77 ,$497.77 ,$437.60 ,"$1,950.52 ",$300.85 ,$492.30 ,"$1,893.71 ",$492.30 ,$295.38 ,$514.18 ,"$4,260.86 ",$503.24 ,$519.47 ,$497.77 ,"$1,893.71 ",$336.62 ,$336.62 ,$492.30 ,$408.23 ,$380.99 ,"$1,912.65 ",$490.07 ,$519.65 ,"$1,988.40 ",$490.07 ,$475.89 ,"$1,893.71 ",$492.30 ,"$1,893.71 ",$492.30 ,$492.30 ,$492.30 ,$530.59 ,$443.07 ,$508.71 ,$470.42 ,$530.59 
SACRED HEART HOSPITAL (ACU),32000083,50690,HC INJ ILEAL CONDUIT,320,1 ,$294.00 ,$220.50 ,$98.34 ,$294.00 ,$189.34 , N/A ,$205.80 ,$98.34 ,$244.02 ,$101.29 ,$194.04 ,$279.30 ,$98.34 ,$235.20 ,$270.48 ,$98.34 ,$249.90 ,$279.30 ,$258.72 ,$223.44 ,$98.34 ,$98.34 ,$98.34 ,$214.62 ,$161.70 ,$267.54 ,$267.54 ,$235.20 , N/A ,$161.70 ,$264.60 , N/A ,$264.60 ,$158.76 ,$276.36 , N/A ,$270.48 ,$104.24 ,$267.54 , N/A ,$180.93 ,$180.93 ,$264.60 ,$219.41 ,$204.77 , N/A ,$98.34 ,$279.30 , N/A ,$98.34 ,$255.78 , N/A ,$264.60 , N/A ,$264.60 ,$264.60 ,$264.60 ,$285.18 ,$238.14 ,$273.42 ,$252.84 ,$285.18 
SACRED HEART HOSPITAL (ACU),32000085,51600,HC INJ CYSTOGRAM,320,1 ,$245.00 ,$183.75 ,$98.34 ,$245.00 ,$157.78 , N/A ,$171.50 ,$98.34 ,$203.35 ,$101.29 ,$161.70 ,$232.75 ,$98.34 ,$196.00 ,$225.40 ,$98.34 ,$208.25 ,$232.75 ,$215.60 ,$186.20 ,$98.34 ,$98.34 ,$98.34 ,$178.85 ,$134.75 ,$222.95 ,$222.95 ,$196.00 , N/A ,$134.75 ,$220.50 , N/A ,$220.50 ,$132.30 ,$230.30 , N/A ,$225.40 ,$104.24 ,$222.95 , N/A ,$150.77 ,$150.77 ,$220.50 ,$182.84 ,$170.64 , N/A ,$98.34 ,$232.75 , N/A ,$98.34 ,$213.15 , N/A ,$220.50 , N/A ,$220.50 ,$220.50 ,$220.50 ,$237.65 ,$198.45 ,$227.85 ,$210.70 ,$237.65 
SACRED HEART HOSPITAL (ACU),32000086,51610,HC INJ URETHROCYSTOGRAM RETRO,320,1 ,$381.00 ,$285.75 ,$98.34 ,$381.00 ,$245.36 , N/A ,$266.70 ,$98.34 ,$316.23 ,$101.29 ,$251.46 ,$361.95 ,$98.34 ,$304.80 ,$350.52 ,$98.34 ,$323.85 ,$361.95 ,$335.28 ,$289.56 ,$98.34 ,$98.34 ,$98.34 ,$278.13 ,$209.55 ,$346.71 ,$346.71 ,$304.80 , N/A ,$209.55 ,$342.90 , N/A ,$342.90 ,$205.74 ,$358.14 , N/A ,$350.52 ,$104.24 ,$346.71 , N/A ,$234.47 ,$234.47 ,$342.90 ,$284.34 ,$265.37 , N/A ,$98.34 ,$361.95 , N/A ,$98.34 ,$331.47 , N/A ,$342.90 , N/A ,$342.90 ,$342.90 ,$342.90 ,$369.57 ,$308.61 ,$354.33 ,$327.66 ,$369.57 
SACRED HEART HOSPITAL (ACU),32000087,58340,HC CATH/INTRO SALINE/CONTRAST SIS,320,1 ,$514.00 ,$385.50 ,$98.34 ,$514.00 ,$331.02 , N/A ,$359.80 ,$98.34 ,$426.62 ,$101.29 ,$339.24 ,$488.30 ,$98.34 ,$411.20 ,$472.88 ,$98.34 ,$436.90 ,$488.30 ,$452.32 ,$390.64 ,$98.34 ,$98.34 ,$98.34 ,$375.22 ,$282.70 ,$467.74 ,$467.74 ,$411.20 , N/A ,$282.70 ,$462.60 , N/A ,$462.60 ,$277.56 ,$483.16 , N/A ,$472.88 ,$104.24 ,$467.74 , N/A ,$316.32 ,$316.32 ,$462.60 ,$383.60 ,$358.00 , N/A ,$98.34 ,$488.30 , N/A ,$98.34 ,$447.18 , N/A ,$462.60 , N/A ,$462.60 ,$462.60 ,$462.60 ,$498.58 ,$416.34 ,$478.02 ,$442.04 ,$498.58 
SACRED HEART HOSPITAL (ACU),32000089,61070,HC PUNCT ASP/INJ SHUNT TUBE,320,1 ,$856.00 ,$642.00 ,$141.34 ,"$1,511.09 ",$551.26 ,$671.59 ,$599.20 ,$141.34 ,$710.48 ,$145.58 ,$564.96 ,$813.20 ,$141.34 ,$684.80 ,$787.52 ,$141.34 ,$727.60 ,$813.20 ,$753.28 ,$650.56 ,$141.34 ,$141.34 ,$141.34 ,$624.88 ,$470.80 ,$778.96 ,$778.96 ,$684.80 ,$691.74 ,$470.80 ,$770.40 ,$671.59 ,$770.40 ,$462.24 ,$804.64 ,"$1,511.09 ",$787.52 ,$149.82 ,$778.96 ,$671.59 ,$526.78 ,$526.78 ,$770.40 ,$638.83 ,$596.20 ,$678.31 ,$141.34 ,$813.20 ,$705.17 ,$141.34 ,$744.72 ,$671.59 ,$770.40 ,$671.59 ,$770.40 ,$770.40 ,$770.40 ,$830.32 ,$693.36 ,$796.08 ,$736.16 ,$830.32 
SACRED HEART HOSPITAL (ACU),32000090,62272,HC LUMBAR PUNCTURE DRAIN,320,1 ,$390.00 ,$292.50 ,$210.60 ,"$1,511.09 ",$251.16 ,$671.59 ,$273.00 ,$277.73 ,$323.70 ,$286.06 ,$257.40 ,$370.50 ,$277.73 ,$312.00 ,$358.80 ,$277.73 ,$331.50 ,$370.50 ,$343.20 ,$296.40 ,$277.73 ,$277.73 ,$277.73 ,$284.70 ,$214.50 ,$354.90 ,$354.90 ,$312.00 ,$691.74 ,$214.50 ,$351.00 ,$671.59 ,$351.00 ,$210.60 ,$366.60 ,"$1,511.09 ",$358.80 ,$294.39 ,$354.90 ,$671.59 ,$240.01 ,$240.01 ,$351.00 ,$291.06 ,$271.64 ,$678.31 ,$277.73 ,$370.50 ,$705.17 ,$277.73 ,$339.30 ,$671.59 ,$351.00 ,$671.59 ,$351.00 ,$351.00 ,$351.00 ,$378.30 ,$315.90 ,$362.70 ,$335.40 ,$378.30 
SACRED HEART HOSPITAL (ACU),32000091,62284,HC INJ MYELOGRAM,320,1 ,$577.00 ,$432.75 ,$98.34 ,$577.00 ,$371.59 , N/A ,$403.90 ,$98.34 ,$478.91 ,$101.29 ,$380.82 ,$548.15 ,$98.34 ,$461.60 ,$530.84 ,$98.34 ,$490.45 ,$548.15 ,$507.76 ,$438.52 ,$98.34 ,$98.34 ,$98.34 ,$421.21 ,$317.35 ,$525.07 ,$525.07 ,$461.60 , N/A ,$317.35 ,$519.30 , N/A ,$519.30 ,$311.58 ,$542.38 , N/A ,$530.84 ,$104.24 ,$525.07 , N/A ,$355.09 ,$355.09 ,$519.30 ,$430.62 ,$401.88 , N/A ,$98.34 ,$548.15 , N/A ,$98.34 ,$501.99 , N/A ,$519.30 , N/A ,$519.30 ,$519.30 ,$519.30 ,$559.69 ,$467.37 ,$536.61 ,$496.22 ,$559.69 
SACRED HEART HOSPITAL (ACU),32000092,62287,HC DECOMP DISC LUMBAR PERC,320,1 ,"$4,316.00 ","$3,237.00 ","$1,511.00 ","$4,316.00 ","$2,779.50 ","$1,857.12 ","$3,021.20 ","$1,511.00 ","$3,582.28 ","$1,556.33 ","$2,848.56 ","$4,100.20 ","$1,511.00 ","$3,452.80 ","$3,970.72 ","$1,511.00 ","$3,668.60 ","$4,100.20 ","$3,798.08 ","$3,280.16 ","$1,511.00 ","$1,511.00 ","$1,511.00 ","$3,150.68 ","$2,373.80 ","$3,927.56 ","$3,927.56 ","$3,452.80 ","$1,912.83 ","$2,373.80 ","$3,884.40 ","$1,857.12 ","$3,884.40 ","$2,330.64 ","$4,057.04 ","$4,178.51 ","$3,970.72 ","$1,601.66 ","$3,927.56 ","$1,857.12 ","$2,656.07 ","$2,656.07 ","$3,884.40 ","$3,221.03 ","$3,006.09 ","$1,875.69 ","$1,511.00 ","$4,100.20 ","$1,949.97 ","$1,511.00 ","$3,754.92 ","$1,857.12 ","$3,884.40 ","$1,857.12 ","$3,884.40 ","$3,884.40 ","$3,884.40 ","$4,186.52 ","$3,495.96 ","$4,013.88 ","$3,711.76 ","$4,186.52 "
SACRED HEART HOSPITAL (ACU),32000093,62290,HC INJ DISKOGRAM LUMBAR EA LEVEL,320,1 ,"$1,319.00 ",$989.25 ,$98.34 ,"$1,319.00 ",$849.44 , N/A ,$923.30 ,$98.34 ,"$1,094.77 ",$101.29 ,$870.54 ,"$1,253.05 ",$98.34 ,"$1,055.20 ","$1,213.48 ",$98.34 ,"$1,121.15 ","$1,253.05 ","$1,160.72 ","$1,002.44 ",$98.34 ,$98.34 ,$98.34 ,$962.87 ,$725.45 ,"$1,200.29 ","$1,200.29 ","$1,055.20 ", N/A ,$725.45 ,"$1,187.10 ", N/A ,"$1,187.10 ",$712.26 ,"$1,239.86 ", N/A ,"$1,213.48 ",$104.24 ,"$1,200.29 ", N/A ,$811.71 ,$811.71 ,"$1,187.10 ",$984.37 ,$918.68 , N/A ,$98.34 ,"$1,253.05 ", N/A ,$98.34 ,"$1,147.53 ", N/A ,"$1,187.10 ", N/A ,"$1,187.10 ","$1,187.10 ","$1,187.10 ","$1,279.43 ","$1,068.39 ","$1,226.67 ","$1,134.34 ","$1,279.43 "
SACRED HEART HOSPITAL (ACU),32000094,62291,HC INJ DISKOGRAM CERVICAL EA LVL,320,1 ,"$1,583.00 ","$1,187.25 ",$98.34 ,"$1,583.00 ","$1,019.45 ", N/A ,"$1,108.10 ",$98.34 ,"$1,313.89 ",$101.29 ,"$1,044.78 ","$1,503.85 ",$98.34 ,"$1,266.40 ","$1,456.36 ",$98.34 ,"$1,345.55 ","$1,503.85 ","$1,393.04 ","$1,203.08 ",$98.34 ,$98.34 ,$98.34 ,"$1,155.59 ",$870.65 ,"$1,440.53 ","$1,440.53 ","$1,266.40 ", N/A ,$870.65 ,"$1,424.70 ", N/A ,"$1,424.70 ",$854.82 ,"$1,488.02 ", N/A ,"$1,456.36 ",$104.24 ,"$1,440.53 ", N/A ,$974.18 ,$974.18 ,"$1,424.70 ","$1,181.39 ","$1,102.56 ", N/A ,$98.34 ,"$1,503.85 ", N/A ,$98.34 ,"$1,377.21 ", N/A ,"$1,424.70 ", N/A ,"$1,424.70 ","$1,424.70 ","$1,424.70 ","$1,535.51 ","$1,282.23 ","$1,472.19 ","$1,361.38 ","$1,535.51 "
SACRED HEART HOSPITAL (ACU),32000097,62350,HC IMPLANT/REVISE SPINAL CATHETER,320,1 ,"$8,069.00 ","$6,051.75 ","$1,511.00 ","$13,570.12 ","$5,196.44 ","$6,031.17 ","$5,648.30 ","$1,511.00 ","$6,697.27 ","$1,556.33 ","$5,325.54 ","$7,665.55 ","$1,511.00 ","$6,455.20 ","$7,423.48 ","$1,511.00 ","$6,858.65 ","$7,665.55 ","$7,100.72 ","$6,132.44 ","$1,511.00 ","$1,511.00 ","$1,511.00 ","$5,890.37 ","$4,437.95 ","$7,342.79 ","$7,342.79 ","$6,455.20 ","$6,212.11 ","$4,437.95 ","$7,262.10 ","$6,031.17 ","$7,262.10 ","$4,357.26 ","$7,584.86 ","$13,570.12 ","$7,423.48 ","$1,601.66 ","$7,342.79 ","$6,031.17 ","$4,965.66 ","$4,965.66 ","$7,262.10 ","$6,021.89 ","$5,620.06 ","$6,091.48 ","$1,511.00 ","$7,665.55 ","$6,332.72 ","$1,511.00 ","$7,020.03 ","$6,031.17 ","$7,262.10 ","$6,031.17 ","$7,262.10 ","$7,262.10 ","$7,262.10 ","$7,826.93 ","$6,535.89 ","$7,504.17 ","$6,939.34 ","$7,826.93 "
SACRED HEART HOSPITAL (ACU),32000100,70110,HC MANDIBLE MIN 4 VIEWS,320,1 ,$385.00 ,$288.75 ,$18.59 ,$385.00 ,$247.94 ,$115.15 ,$269.50 ,$18.59 ,$42.32 ,$19.15 ,$33.85 ,$365.75 ,$18.59 ,$308.00 ,$354.20 ,$18.59 ,$327.25 ,$365.75 ,$338.80 ,$292.60 ,$18.59 ,$18.59 ,$18.59 ,$281.05 ,$211.75 ,$350.35 ,$350.35 ,$308.00 ,$118.60 ,$211.75 ,$346.50 ,$115.15 ,$346.50 ,$207.90 ,$361.90 ,$259.08 ,$354.20 ,$19.71 ,$350.35 ,$115.15 ,$236.93 ,$236.93 ,$196.00 ,$287.33 ,$170.17 ,$116.30 ,$18.59 ,$365.75 ,$120.90 ,$18.59 ,$334.95 ,$115.15 ,$346.50 ,$115.15 ,$346.50 ,$346.50 ,$346.50 ,$373.45 ,$311.85 ,$358.05 ,$331.10 ,$373.45 
SACRED HEART HOSPITAL (ACU),32000103,70140,HC FACIAL BONES < 3 VIEWS,320,1 ,$322.00 ,$241.50 ,$18.59 ,$322.00 ,$207.37 ,$85.55 ,$225.40 ,$18.59 ,$32.11 ,$19.15 ,$25.69 ,$305.90 ,$18.59 ,$257.60 ,$296.24 ,$18.59 ,$273.70 ,$305.90 ,$283.36 ,$244.72 ,$18.59 ,$18.59 ,$18.59 ,$235.06 ,$177.10 ,$293.02 ,$293.02 ,$257.60 ,$88.12 ,$177.10 ,$289.80 ,$85.55 ,$289.80 ,$173.88 ,$302.68 ,$192.49 ,$296.24 ,$19.71 ,$293.02 ,$85.55 ,$198.16 ,$198.16 ,$120.46 ,$240.31 ,$129.03 ,$86.40 ,$18.59 ,$305.90 ,$89.83 ,$18.59 ,$280.14 ,$85.55 ,$289.80 ,$85.55 ,$289.80 ,$289.80 ,$289.80 ,$312.34 ,$260.82 ,$299.46 ,$276.92 ,$312.34 
SACRED HEART HOSPITAL (ACU),32000104,70150,HC FACIAL BONES MIN 3 VIEWS,320,1 ,$369.00 ,$276.75 ,$18.59 ,$369.00 ,$237.64 ,$115.15 ,$258.30 ,$18.59 ,$47.13 ,$19.15 ,$37.70 ,$350.55 ,$18.59 ,$295.20 ,$339.48 ,$18.59 ,$313.65 ,$350.55 ,$324.72 ,$280.44 ,$18.59 ,$18.59 ,$18.59 ,$269.37 ,$202.95 ,$335.79 ,$335.79 ,$295.20 ,$118.60 ,$202.95 ,$332.10 ,$115.15 ,$332.10 ,$199.26 ,$346.86 ,$259.08 ,$339.48 ,$19.71 ,$335.79 ,$115.15 ,$227.08 ,$227.08 ,$211.73 ,$275.38 ,$189.55 ,$116.30 ,$18.59 ,$350.55 ,$120.90 ,$18.59 ,$321.03 ,$115.15 ,$332.10 ,$115.15 ,$332.10 ,$332.10 ,$332.10 ,$357.93 ,$298.89 ,$343.17 ,$317.34 ,$357.93 
SACRED HEART HOSPITAL (ACU),32000105,70160,HC NASAL BONES MIN 3 VIEWS,320,1 ,$230.00 ,$172.50 ,$18.59 ,$230.00 ,$148.12 ,$85.55 ,$161.00 ,$18.59 ,$39.92 ,$19.15 ,$31.93 ,$218.50 ,$18.59 ,$184.00 ,$211.60 ,$18.59 ,$195.50 ,$218.50 ,$202.40 ,$174.80 ,$18.59 ,$18.59 ,$18.59 ,$167.90 ,$126.50 ,$209.30 ,$209.30 ,$184.00 ,$88.12 ,$126.50 ,$207.00 ,$85.55 ,$207.00 ,$124.20 ,$216.20 ,$192.49 ,$211.60 ,$19.71 ,$209.30 ,$85.55 ,$141.54 ,$141.54 ,$136.43 ,$171.65 ,$162.94 ,$86.40 ,$18.59 ,$218.50 ,$89.83 ,$18.59 ,$200.10 ,$85.55 ,$207.00 ,$85.55 ,$207.00 ,$207.00 ,$207.00 ,$223.10 ,$186.30 ,$213.90 ,$197.80 ,$223.10 
SACRED HEART HOSPITAL (ACU),32000106,70200,HC XRAY ORBITS (EYE) (MIN 4 V),320,1 ,$196.00 ,$147.00 ,$18.59 ,$259.08 ,$126.22 ,$115.15 ,$137.20 ,$18.59 ,$47.13 ,$19.15 ,$37.70 ,$186.20 ,$18.59 ,$156.80 ,$180.32 ,$18.59 ,$166.60 ,$186.20 ,$172.48 ,$148.96 ,$18.59 ,$18.59 ,$18.59 ,$143.08 ,$107.80 ,$178.36 ,$178.36 ,$156.80 ,$118.60 ,$107.80 ,$176.40 ,$115.15 ,$176.40 ,$105.84 ,$184.24 ,$259.08 ,$180.32 ,$19.71 ,$178.36 ,$115.15 ,$120.62 ,$120.62 ,$168.14 ,$146.27 ,$176.40 ,$116.30 ,$18.59 ,$186.20 ,$120.90 ,$18.59 ,$170.52 ,$115.15 ,$176.40 ,$115.15 ,$176.40 ,$176.40 ,$176.40 ,$190.12 ,$158.76 ,$182.28 ,$168.56 ,$190.12 
SACRED HEART HOSPITAL (ACU),32000107,70210,HC XRAY SINUS WATERS VIEW,320,1 ,$221.00 ,$165.75 ,$18.59 ,$221.00 ,$142.32 ,$85.55 ,$154.70 ,$18.59 ,$35.11 ,$19.15 ,$28.08 ,$209.95 ,$18.59 ,$176.80 ,$203.32 ,$18.59 ,$187.85 ,$209.95 ,$194.48 ,$167.96 ,$18.59 ,$18.59 ,$18.59 ,$161.33 ,$121.55 ,$201.11 ,$201.11 ,$176.80 ,$88.12 ,$121.55 ,$198.90 ,$85.55 ,$198.90 ,$119.34 ,$207.74 ,$192.49 ,$203.32 ,$19.71 ,$201.11 ,$85.55 ,$136.00 ,$136.00 ,$108.82 ,$164.93 ,$141.18 ,$86.40 ,$18.59 ,$209.95 ,$89.83 ,$18.59 ,$192.27 ,$85.55 ,$198.90 ,$85.55 ,$198.90 ,$198.90 ,$198.90 ,$214.37 ,$179.01 ,$205.53 ,$190.06 ,$214.37 
SACRED HEART HOSPITAL (ACU),32000108,70220,HC SINUSES MIN 3 VIEWS,320,1 ,$358.00 ,$268.50 ,$18.59 ,$358.00 ,$230.55 ,$85.55 ,$250.60 ,$18.59 ,$41.72 ,$19.15 ,$33.38 ,$340.10 ,$18.59 ,$286.40 ,$329.36 ,$18.59 ,$304.30 ,$340.10 ,$315.04 ,$272.08 ,$18.59 ,$18.59 ,$18.59 ,$261.34 ,$196.90 ,$325.78 ,$325.78 ,$286.40 ,$88.12 ,$196.90 ,$322.20 ,$85.55 ,$322.20 ,$193.32 ,$336.52 ,$192.49 ,$329.36 ,$19.71 ,$325.78 ,$85.55 ,$220.31 ,$220.31 ,$163.88 ,$267.18 ,$167.79 ,$86.40 ,$18.59 ,$340.10 ,$89.83 ,$18.59 ,$311.46 ,$85.55 ,$322.20 ,$85.55 ,$322.20 ,$322.20 ,$322.20 ,$347.26 ,$289.98 ,$332.94 ,$307.88 ,$347.26 
SACRED HEART HOSPITAL (ACU),32000110,70250,HC SKULL LESS THAN 4 VIEWS,320,1 ,$219.00 ,$164.25 ,$18.59 ,$259.08 ,$141.04 ,$115.15 ,$153.30 ,$18.59 ,$39.32 ,$19.15 ,$31.46 ,$208.05 ,$18.59 ,$175.20 ,$201.48 ,$18.59 ,$186.15 ,$208.05 ,$192.72 ,$166.44 ,$18.59 ,$18.59 ,$18.59 ,$159.87 ,$120.45 ,$199.29 ,$199.29 ,$175.20 ,$118.60 ,$120.45 ,$197.10 ,$115.15 ,$197.10 ,$118.26 ,$205.86 ,$259.08 ,$201.48 ,$19.71 ,$199.29 ,$115.15 ,$134.77 ,$134.77 ,$121.17 ,$163.44 ,$160.48 ,$116.30 ,$18.59 ,$208.05 ,$120.90 ,$18.59 ,$190.53 ,$115.15 ,$197.10 ,$115.15 ,$197.10 ,$197.10 ,$197.10 ,$212.43 ,$177.39 ,$203.67 ,$188.34 ,$212.43 
SACRED HEART HOSPITAL (ACU),32000112,70260,HC SKULL MIN 4 VIEWS,320,1 ,$317.00 ,$237.75 ,$18.59 ,$317.00 ,$204.15 ,$115.15 ,$221.90 ,$18.59 ,$47.13 ,$19.15 ,$37.70 ,$301.15 ,$18.59 ,$253.60 ,$291.64 ,$18.59 ,$269.45 ,$301.15 ,$278.96 ,$240.92 ,$18.59 ,$18.59 ,$18.59 ,$231.41 ,$174.35 ,$288.47 ,$288.47 ,$253.60 ,$118.60 ,$174.35 ,$285.30 ,$115.15 ,$285.30 ,$171.18 ,$297.98 ,$259.08 ,$291.64 ,$19.71 ,$288.47 ,$115.15 ,$195.08 ,$195.08 ,$261.76 ,$236.58 ,$189.55 ,$116.30 ,$18.59 ,$301.15 ,$120.90 ,$18.59 ,$275.79 ,$115.15 ,$285.30 ,$115.15 ,$285.30 ,$285.30 ,$285.30 ,$307.49 ,$256.77 ,$294.81 ,$272.62 ,$307.49 
SACRED HEART HOSPITAL (ACU),32000114,70336,HC MRI TMJ,320,1 ,"$3,534.00 ","$2,650.50 ",$82.68 ,"$3,534.00 ","$2,275.90 ",$243.36 ,"$2,473.80 ",$82.68 ,$418.46 ,$85.16 ,$334.77 ,"$3,357.30 ",$82.68 ,"$2,827.20 ","$3,251.28 ",$82.68 ,"$3,003.90 ","$3,357.30 ","$3,109.92 ","$2,685.84 ",$82.68 ,$82.68 ,$82.68 ,"$2,579.82 ","$1,943.70 ","$3,215.94 ","$3,215.94 ","$2,827.20 ",$250.66 ,"$1,943.70 ","$3,180.60 ",$243.36 ,"$3,180.60 ","$1,908.36 ","$3,321.96 ",$547.56 ,"$3,251.28 ",$87.64 ,"$3,215.94 ",$243.36 ,"$2,174.82 ","$2,174.82 ","$1,236.87 ","$2,637.42 ","$1,697.23 ",$245.79 ,$82.68 ,"$3,357.30 ",$255.53 ,$82.68 ,"$3,074.58 ",$243.36 ,"$3,180.60 ",$243.36 ,"$3,180.60 ","$3,180.60 ","$3,180.60 ","$3,427.98 ","$2,862.54 ","$3,286.62 ","$3,039.24 ","$3,427.98 "
SACRED HEART HOSPITAL (ACU),32000115,70355,HC XRAY PAN MANDIBLE/MAXLA,320,1 ,$212.00 ,$159.00 ,$12.71 ,$212.00 ,$136.53 ,$85.55 ,$148.40 ,$18.59 ,$15.89 ,$19.15 ,$12.71 ,$201.40 ,$18.59 ,$169.60 ,$195.04 ,$18.59 ,$180.20 ,$201.40 ,$186.56 ,$161.12 ,$18.59 ,$18.59 ,$18.59 ,$154.76 ,$116.60 ,$192.92 ,$192.92 ,$169.60 ,$88.12 ,$116.60 ,$190.80 ,$85.55 ,$190.80 ,$114.48 ,$199.28 ,$192.49 ,$195.04 ,$19.71 ,$192.92 ,$85.55 ,$130.46 ,$130.46 ,$199.48 ,$158.22 ,$63.74 ,$86.40 ,$18.59 ,$201.40 ,$89.83 ,$18.59 ,$184.44 ,$85.55 ,$190.80 ,$85.55 ,$190.80 ,$190.80 ,$190.80 ,$205.64 ,$171.72 ,$197.16 ,$182.32 ,$205.64 
SACRED HEART HOSPITAL (ACU),32000116,70360,HC XRAY NECK SOFT TISSUE,320,1 ,$219.90 ,$164.93 ,$18.59 ,$219.90 ,$141.62 ,$85.55 ,$153.93 ,$18.59 ,$32.71 ,$19.15 ,$26.17 ,$208.91 ,$18.59 ,$175.92 ,$202.31 ,$18.59 ,$186.92 ,$208.91 ,$193.51 ,$167.12 ,$18.59 ,$18.59 ,$18.59 ,$160.53 ,$120.95 ,$200.11 ,$200.11 ,$175.92 ,$88.12 ,$120.95 ,$197.91 ,$85.55 ,$197.91 ,$118.75 ,$206.71 ,$192.49 ,$202.31 ,$19.71 ,$200.11 ,$85.55 ,$135.33 ,$135.33 ,$118.95 ,$164.11 ,$133.88 ,$86.40 ,$18.59 ,$208.91 ,$89.83 ,$18.59 ,$191.31 ,$85.55 ,$197.91 ,$85.55 ,$197.91 ,$197.91 ,$197.91 ,$213.30 ,$178.12 ,$204.51 ,$189.11 ,$213.30 
SACRED HEART HOSPITAL (ACU),32000121,71045,HC XR CHEST 1V,320,1 ,$271.52 ,$203.64 ,$14.13 ,$271.52 ,$174.86 ,$85.55 ,$190.06 ,$18.59 ,$17.66 ,$19.15 ,$14.13 ,$257.94 ,$18.59 ,$217.22 ,$249.80 ,$18.59 ,$230.79 ,$257.94 ,$238.94 ,$206.36 ,$18.59 ,$18.59 ,$18.59 ,$198.21 ,$149.34 ,$247.08 ,$247.08 ,$217.22 ,$88.12 ,$149.34 ,$244.37 ,$85.55 ,$244.37 ,$146.62 ,$255.23 ,$192.49 ,$249.80 ,$19.71 ,$247.08 ,$85.55 ,$167.09 ,$167.09 ,$38.33 ,$202.64 ,$172.28 ,$86.40 ,$18.59 ,$257.94 ,$89.83 ,$18.59 ,$236.22 ,$85.55 ,$244.37 ,$85.55 ,$244.37 ,$244.37 ,$244.37 ,$263.37 ,$219.93 ,$252.51 ,$233.51 ,$263.37 
SACRED HEART HOSPITAL (ACU),32000127,71046,HC XR CHEST 2V,320,1 ,$302.70 ,$227.03 ,$18.59 ,$302.70 ,$194.94 ,$85.55 ,$211.89 ,$18.59 ,$32.67 ,$19.15 ,$26.14 ,$287.57 ,$18.59 ,$242.16 ,$278.48 ,$18.59 ,$257.30 ,$287.57 ,$266.38 ,$230.05 ,$18.59 ,$18.59 ,$18.59 ,$220.97 ,$166.49 ,$275.46 ,$275.46 ,$242.16 ,$88.12 ,$166.49 ,$272.43 ,$85.55 ,$272.43 ,$163.46 ,$284.54 ,$192.49 ,$278.48 ,$19.71 ,$275.46 ,$85.55 ,$186.28 ,$186.28 ,$58.87 ,$225.91 ,$211.63 ,$86.40 ,$18.59 ,$287.57 ,$89.83 ,$18.59 ,$263.35 ,$85.55 ,$272.43 ,$85.55 ,$272.43 ,$272.43 ,$272.43 ,$293.62 ,$245.19 ,$281.51 ,$260.32 ,$293.62 
SACRED HEART HOSPITAL (ACU),32000130,71047,HC XR CHEST 2V W/LORDOTIC,320,1 ,$310.25 ,$232.69 ,$18.59 ,$310.25 ,$199.80 ,$85.55 ,$217.18 ,$18.59 ,$41.69 ,$19.15 ,$33.35 ,$294.74 ,$18.59 ,$248.20 ,$285.43 ,$18.59 ,$263.71 ,$294.74 ,$273.02 ,$235.79 ,$18.59 ,$18.59 ,$18.59 ,$226.48 ,$170.64 ,$282.33 ,$282.33 ,$248.20 ,$88.12 ,$170.64 ,$279.23 ,$85.55 ,$279.23 ,$167.54 ,$291.64 ,$192.49 ,$285.43 ,$19.71 ,$282.33 ,$85.55 ,$190.93 ,$190.93 ,$75.30 ,$231.54 ,$216.09 ,$86.40 ,$18.59 ,$294.74 ,$89.83 ,$18.59 ,$269.92 ,$85.55 ,$279.23 ,$85.55 ,$279.23 ,$279.23 ,$279.23 ,$300.94 ,$251.30 ,$288.53 ,$266.82 ,$300.94 
SACRED HEART HOSPITAL (ACU),32000131,71048,HC XR CHEST PA/LAT W/OBLIQUES,320,1 ,$315.72 ,$236.79 ,$18.59 ,$315.72 ,$203.32 ,$115.15 ,$221.00 ,$18.59 ,$42.89 ,$19.15 ,$34.31 ,$299.93 ,$18.59 ,$252.58 ,$290.46 ,$18.59 ,$268.36 ,$299.93 ,$277.83 ,$239.95 ,$18.59 ,$18.59 ,$18.59 ,$230.48 ,$173.65 ,$287.31 ,$287.31 ,$252.58 ,$118.60 ,$173.65 ,$284.15 ,$115.15 ,$284.15 ,$170.49 ,$296.78 ,$259.08 ,$290.46 ,$19.71 ,$287.31 ,$115.15 ,$194.29 ,$194.29 ,$80.77 ,$235.62 ,$219.90 ,$116.30 ,$18.59 ,$299.93 ,$120.90 ,$18.59 ,$274.68 ,$115.15 ,$284.15 ,$115.15 ,$284.15 ,$284.15 ,$284.15 ,$306.25 ,$255.73 ,$293.62 ,$271.52 ,$306.25 
SACRED HEART HOSPITAL (ACU),32000135,71046,HC XR CHEST SPECIAL VIEWS,320,1 ,$295.26 ,$221.45 ,$18.59 ,$295.26 ,$190.15 ,$85.55 ,$206.68 ,$18.59 ,$32.67 ,$19.15 ,$26.14 ,$280.50 ,$18.59 ,$236.21 ,$271.64 ,$18.59 ,$250.97 ,$280.50 ,$259.83 ,$224.40 ,$18.59 ,$18.59 ,$18.59 ,$215.54 ,$162.39 ,$268.69 ,$268.69 ,$236.21 ,$88.12 ,$162.39 ,$265.73 ,$85.55 ,$265.73 ,$159.44 ,$277.54 ,$192.49 ,$271.64 ,$19.71 ,$268.69 ,$85.55 ,$181.70 ,$181.70 ,$58.87 ,$220.35 ,$211.63 ,$86.40 ,$18.59 ,$280.50 ,$89.83 ,$18.59 ,$256.88 ,$85.55 ,$265.73 ,$85.55 ,$265.73 ,$265.73 ,$265.73 ,$286.40 ,$239.16 ,$274.59 ,$253.92 ,$286.40 
SACRED HEART HOSPITAL (ACU),32000137,71100,HC XR RIBS 2V UNI,320,1 ,$227.00 ,$170.25 ,$18.59 ,$227.00 ,$146.19 ,$85.55 ,$158.90 ,$18.59 ,$36.31 ,$19.15 ,$29.05 ,$215.65 ,$18.59 ,$181.60 ,$208.84 ,$18.59 ,$192.95 ,$215.65 ,$199.76 ,$172.52 ,$18.59 ,$18.59 ,$18.59 ,$165.71 ,$124.85 ,$206.57 ,$206.57 ,$181.60 ,$88.12 ,$124.85 ,$204.30 ,$85.55 ,$204.30 ,$122.58 ,$213.38 ,$192.49 ,$208.84 ,$19.71 ,$206.57 ,$85.55 ,$139.70 ,$139.70 ,$176.68 ,$169.41 ,$148.41 ,$86.40 ,$18.59 ,$215.65 ,$89.83 ,$18.59 ,$197.49 ,$85.55 ,$204.30 ,$85.55 ,$204.30 ,$204.30 ,$204.30 ,$220.19 ,$183.87 ,$211.11 ,$195.22 ,$220.19 
SACRED HEART HOSPITAL (ACU),32000138,71101,HC XR RIBS W/CXR 3+V UNI,320,1 ,$262.00 ,$196.50 ,$18.59 ,$262.00 ,$168.73 ,$115.15 ,$183.40 ,$18.59 ,$38.12 ,$19.15 ,$30.49 ,$248.90 ,$18.59 ,$209.60 ,$241.04 ,$18.59 ,$222.70 ,$248.90 ,$230.56 ,$199.12 ,$18.59 ,$18.59 ,$18.59 ,$191.26 ,$144.10 ,$238.42 ,$238.42 ,$209.60 ,$118.60 ,$144.10 ,$235.80 ,$115.15 ,$235.80 ,$141.48 ,$246.28 ,$259.08 ,$241.04 ,$19.71 ,$238.42 ,$115.15 ,$161.23 ,$161.23 ,$163.46 ,$195.53 ,$165.33 ,$116.30 ,$18.59 ,$248.90 ,$120.90 ,$18.59 ,$227.94 ,$115.15 ,$235.80 ,$115.15 ,$235.80 ,$235.80 ,$235.80 ,$254.14 ,$212.22 ,$243.66 ,$225.32 ,$254.14 
SACRED HEART HOSPITAL (ACU),32000139,71110,HC XR RIBS 3 V BIL,320,1 ,$314.00 ,$235.50 ,$18.59 ,$314.00 ,$202.22 ,$115.15 ,$219.80 ,$18.59 ,$39.92 ,$19.15 ,$31.93 ,$298.30 ,$18.59 ,$251.20 ,$288.88 ,$18.59 ,$266.90 ,$298.30 ,$276.32 ,$238.64 ,$18.59 ,$18.59 ,$18.59 ,$229.22 ,$172.70 ,$285.74 ,$285.74 ,$251.20 ,$118.60 ,$172.70 ,$282.60 ,$115.15 ,$282.60 ,$169.56 ,$295.16 ,$259.08 ,$288.88 ,$19.71 ,$285.74 ,$115.15 ,$193.24 ,$193.24 ,$186.20 ,$234.34 ,$170.17 ,$116.30 ,$18.59 ,$298.30 ,$120.90 ,$18.59 ,$273.18 ,$115.15 ,$282.60 ,$115.15 ,$282.60 ,$282.60 ,$282.60 ,$304.58 ,$254.34 ,$292.02 ,$270.04 ,$304.58 
SACRED HEART HOSPITAL (ACU),32000140,71111,HC XR RIBS W/CXR 4+V BI,320,1 ,$444.00 ,$333.00 ,$18.59 ,$444.00 ,$285.94 ,$115.15 ,$310.80 ,$18.59 ,$53.13 ,$19.15 ,$42.50 ,$421.80 ,$18.59 ,$355.20 ,$408.48 ,$18.59 ,$377.40 ,$421.80 ,$390.72 ,$337.44 ,$18.59 ,$18.59 ,$18.59 ,$324.12 ,$244.20 ,$404.04 ,$404.04 ,$355.20 ,$118.60 ,$244.20 ,$399.60 ,$115.15 ,$399.60 ,$239.76 ,$417.36 ,$259.08 ,$408.48 ,$19.71 ,$404.04 ,$115.15 ,$273.24 ,$273.24 ,$180.86 ,$331.36 ,$206.47 ,$116.30 ,$18.59 ,$421.80 ,$120.90 ,$18.59 ,$386.28 ,$115.15 ,$399.60 ,$115.15 ,$399.60 ,$399.60 ,$399.60 ,$430.68 ,$359.64 ,$412.92 ,$381.84 ,$430.68 
SACRED HEART HOSPITAL (ACU),32000141,71120,HC XR STERNUM 2+V,320,1 ,$263.00 ,$197.25 ,$18.59 ,$263.00 ,$169.37 ,$85.55 ,$184.10 ,$18.59 ,$32.11 ,$19.15 ,$25.69 ,$249.85 ,$18.59 ,$210.40 ,$241.96 ,$18.59 ,$223.55 ,$249.85 ,$231.44 ,$199.88 ,$18.59 ,$18.59 ,$18.59 ,$191.99 ,$144.65 ,$239.33 ,$239.33 ,$210.40 ,$88.12 ,$144.65 ,$236.70 ,$85.55 ,$236.70 ,$142.02 ,$247.22 ,$192.49 ,$241.96 ,$19.71 ,$239.33 ,$85.55 ,$161.85 ,$161.85 ,$129.23 ,$196.28 ,$131.49 ,$86.40 ,$18.59 ,$249.85 ,$89.83 ,$18.59 ,$228.81 ,$85.55 ,$236.70 ,$85.55 ,$236.70 ,$236.70 ,$236.70 ,$255.11 ,$213.03 ,$244.59 ,$226.18 ,$255.11 
SACRED HEART HOSPITAL (ACU),32000142,71130,HC XR STERNOCLAVIC JT 3+V,320,1 ,$341.00 ,$255.75 ,$18.59 ,$341.00 ,$219.60 ,$85.55 ,$238.70 ,$18.59 ,$41.11 ,$19.15 ,$32.89 ,$323.95 ,$18.59 ,$272.80 ,$313.72 ,$18.59 ,$289.85 ,$323.95 ,$300.08 ,$259.16 ,$18.59 ,$18.59 ,$18.59 ,$248.93 ,$187.55 ,$310.31 ,$310.31 ,$272.80 ,$88.12 ,$187.55 ,$306.90 ,$85.55 ,$306.90 ,$184.14 ,$320.54 ,$192.49 ,$313.72 ,$19.71 ,$310.31 ,$85.55 ,$209.85 ,$209.85 ,$118.29 ,$254.49 ,$167.79 ,$86.40 ,$18.59 ,$323.95 ,$89.83 ,$18.59 ,$296.67 ,$85.55 ,$306.90 ,$85.55 ,$306.90 ,$306.90 ,$306.90 ,$330.77 ,$276.21 ,$317.13 ,$293.26 ,$330.77 
SACRED HEART HOSPITAL (ACU),32000144,71250,HC CT CHEST W/O CONTRAST,350,1 ,"$1,764.28 ","$1,323.21 ",$37.88 ,"$1,764.28 ","$1,136.20 ",$115.15 ,"$1,235.00 ",$37.88 ,"$1,764.28 ",$39.02 ,"$1,764.28 ","$1,676.07 ",$37.88 ,"$1,411.42 ","$1,623.14 ",$37.88 ,"$1,499.64 ","$1,676.07 ","$1,552.57 ","$1,340.85 ",$37.88 ,$37.88 ,$37.88 ,"$1,287.92 ",$970.35 ,"$1,605.49 ","$1,605.49 ","$1,411.42 ",$118.60 ,$970.35 ,"$1,587.85 ",$115.15 ,"$1,587.85 ",$952.71 ,"$1,658.42 ",$259.08 ,"$1,623.14 ",$40.15 ,"$1,605.49 ",$115.15 ,"$1,085.74 ","$1,085.74 ",$960.34 ,"$1,316.68 ","$1,587.85 ",$116.30 ,$37.88 ,"$1,676.07 ",$120.90 ,$37.88 ,"$1,534.92 ",$115.15 ,"$1,587.85 ",$115.15 ,"$1,587.85 ","$1,587.85 ","$1,587.85 ","$1,711.35 ","$1,429.07 ","$1,640.78 ","$1,517.28 ","$1,711.35 "
SACRED HEART HOSPITAL (ACU),32000146,71260,HC CT CHEST W/CONTRAST,350,1 ,"$2,285.38 ","$1,714.04 ",$102.60 ,"$2,285.38 ","$1,471.78 ",$188.92 ,"$1,599.77 ",$102.60 ,"$2,285.38 ",$105.68 ,"$1,929.00 ","$2,171.11 ",$102.60 ,"$1,828.30 ","$2,102.55 ",$102.60 ,"$1,942.57 ","$2,171.11 ","$2,011.13 ","$1,736.89 ",$102.60 ,$102.60 ,$102.60 ,"$1,668.33 ","$1,256.96 ","$2,079.70 ","$2,079.70 ","$1,828.30 ",$194.59 ,"$1,256.96 ","$2,056.84 ",$188.92 ,"$2,056.84 ","$1,234.11 ","$2,148.26 ",$425.07 ,"$2,102.55 ",$108.76 ,"$2,079.70 ",$188.92 ,"$1,406.42 ","$1,406.42 ","$1,117.16 ","$1,705.58 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,171.11 ",$198.37 ,$102.60 ,"$1,988.28 ",$188.92 ,"$2,056.84 ",$188.92 ,"$2,056.84 ","$2,056.84 ","$2,056.84 ","$2,216.82 ","$1,851.16 ","$2,125.40 ","$1,965.43 ","$2,216.82 "
SACRED HEART HOSPITAL (ACU),32000148,71270,HC CT CHEST W AND W/O CONTRAST,350,1 ,"$2,339.64 ","$1,754.73 ",$102.60 ,"$2,339.64 ","$1,506.73 ",$188.92 ,"$1,637.75 ",$102.60 ,"$2,339.64 ",$105.68 ,"$1,929.00 ","$2,222.66 ",$102.60 ,"$1,871.71 ","$2,152.47 ",$102.60 ,"$1,988.69 ","$2,222.66 ","$2,058.88 ","$1,778.13 ",$102.60 ,$102.60 ,$102.60 ,"$1,707.94 ","$1,286.80 ","$2,129.07 ","$2,129.07 ","$1,871.71 ",$194.59 ,"$1,286.80 ","$2,105.68 ",$188.92 ,"$2,105.68 ","$1,263.41 ","$2,199.26 ",$425.07 ,"$2,152.47 ",$108.76 ,"$2,129.07 ",$188.92 ,"$1,439.81 ","$1,439.81 ","$1,376.12 ","$1,746.07 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,222.66 ",$198.37 ,$102.60 ,"$2,035.49 ",$188.92 ,"$2,105.68 ",$188.92 ,"$2,105.68 ","$2,105.68 ","$2,105.68 ","$2,269.45 ","$1,895.11 ","$2,175.87 ","$2,012.09 ","$2,269.45 "
SACRED HEART HOSPITAL (ACU),32000150,71275,HC CTA CHEST W AND W/O CONTRAST,350,1 ,"$4,746.70 ","$3,560.03 ",$125.62 ,"$4,746.70 ","$3,056.87 ",$188.92 ,"$3,322.69 ",$125.62 ,"$2,412.00 ",$129.39 ,"$1,929.00 ","$4,509.37 ",$125.62 ,"$3,797.36 ","$4,366.96 ",$125.62 ,"$4,034.70 ","$4,509.37 ","$4,177.10 ","$3,607.49 ",$125.62 ,$125.62 ,$125.62 ,"$3,465.09 ","$2,610.69 ","$4,319.50 ","$4,319.50 ","$3,797.36 ",$194.59 ,"$2,610.69 ","$4,272.03 ",$188.92 ,"$4,272.03 ","$2,563.22 ","$4,461.90 ",$425.07 ,"$4,366.96 ",$133.16 ,"$4,319.50 ",$188.92 ,"$2,921.12 ","$2,921.12 ",$879.36 ,"$3,542.46 ","$1,929.32 ",$190.81 ,$125.62 ,"$4,509.37 ",$198.37 ,$125.62 ,"$4,129.63 ",$188.92 ,"$4,272.03 ",$188.92 ,"$4,272.03 ","$4,272.03 ","$4,272.03 ","$4,604.30 ","$3,844.83 ","$4,414.43 ","$4,082.16 ","$4,604.30 "
SACRED HEART HOSPITAL (ACU),32000151,71550,HC MRI CHEST W/O CON,610,1 ,"$3,888.00 ","$2,916.00 ",$82.68 ,"$3,888.00 ","$2,503.87 ",$243.36 ,"$2,721.60 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$3,693.60 ",$82.68 ,"$3,110.40 ","$3,576.96 ",$82.68 ,"$3,304.80 ","$3,693.60 ","$3,421.44 ","$2,954.88 ",$82.68 ,$82.68 ,$82.68 ,"$2,838.24 ","$2,138.40 ","$3,538.08 ","$3,538.08 ","$3,110.40 ",$250.66 ,"$2,138.40 ","$3,499.20 ",$243.36 ,"$3,499.20 ","$2,099.52 ","$3,654.72 ",$547.56 ,"$3,576.96 ",$87.64 ,"$3,538.08 ",$243.36 ,"$2,392.68 ","$2,392.68 ","$2,080.29 ","$2,901.61 ","$2,143.69 ",$245.79 ,$82.68 ,"$3,693.60 ",$255.53 ,$82.68 ,"$3,382.56 ",$243.36 ,"$3,499.20 ",$243.36 ,"$3,499.20 ","$3,499.20 ","$3,499.20 ","$3,771.36 ","$3,149.28 ","$3,615.84 ","$3,343.68 ","$3,771.36 "
SACRED HEART HOSPITAL (ACU),32000153,71552,HC MRI CHEST W AND W/O CONTRAST,610,1 ,"$4,367.00 ","$3,275.25 ",$144.87 ,"$4,367.00 ","$2,812.35 ",$389.47 ,"$3,056.90 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,148.65 ",$144.87 ,"$3,493.60 ","$4,017.64 ",$144.87 ,"$3,711.95 ","$4,148.65 ","$3,842.96 ","$3,318.92 ",$144.87 ,$144.87 ,$144.87 ,"$3,187.91 ","$2,401.85 ","$3,973.97 ","$3,973.97 ","$3,493.60 ",$401.15 ,"$2,401.85 ","$3,930.30 ",$389.47 ,"$3,930.30 ","$2,358.18 ","$4,104.98 ",$876.31 ,"$4,017.64 ",$153.56 ,"$3,973.97 ",$389.47 ,"$2,687.45 ","$2,687.45 ","$2,441.93 ","$3,259.09 ","$2,143.69 ",$393.37 ,$144.87 ,"$4,148.65 ",$408.94 ,$144.87 ,"$3,799.29 ",$389.47 ,"$3,930.30 ",$389.47 ,"$3,930.30 ","$3,930.30 ","$3,930.30 ","$4,235.99 ","$3,537.27 ","$4,061.31 ","$3,755.62 ","$4,235.99 "
SACRED HEART HOSPITAL (ACU),32000155,72020,HC XR SPINE 1V ANY LEVEL,320,1 ,$401.00 ,$300.75 ,$18.59 ,$401.00 ,$258.24 ,$85.55 ,$280.70 ,$18.59 ,$23.70 ,$19.15 ,$18.96 ,$380.95 ,$18.59 ,$320.80 ,$368.92 ,$18.59 ,$340.85 ,$380.95 ,$352.88 ,$304.76 ,$18.59 ,$18.59 ,$18.59 ,$292.73 ,$220.55 ,$364.91 ,$364.91 ,$320.80 ,$88.12 ,$220.55 ,$360.90 ,$85.55 ,$360.90 ,$216.54 ,$376.94 ,$192.49 ,$368.92 ,$19.71 ,$364.91 ,$85.55 ,$246.78 ,$246.78 ,$106.75 ,$299.27 ,$97.65 ,$86.40 ,$18.59 ,$380.95 ,$89.83 ,$18.59 ,$348.87 ,$85.55 ,$360.90 ,$85.55 ,$360.90 ,$360.90 ,$360.90 ,$388.97 ,$324.81 ,$372.93 ,$344.86 ,$388.97 
SACRED HEART HOSPITAL (ACU),32000164,72040,HC XR C-SPINE 2-3V,320,1 ,$369.00 ,$276.75 ,$18.59 ,$369.00 ,$237.64 ,$85.55 ,$258.30 ,$18.59 ,$36.31 ,$19.15 ,$29.05 ,$350.55 ,$18.59 ,$295.20 ,$339.48 ,$18.59 ,$313.65 ,$350.55 ,$324.72 ,$280.44 ,$18.59 ,$18.59 ,$18.59 ,$269.37 ,$202.95 ,$335.79 ,$335.79 ,$295.20 ,$88.12 ,$202.95 ,$332.10 ,$85.55 ,$332.10 ,$199.26 ,$346.86 ,$192.49 ,$339.48 ,$19.71 ,$335.79 ,$85.55 ,$227.08 ,$227.08 ,$197.66 ,$275.38 ,$148.41 ,$86.40 ,$18.59 ,$350.55 ,$89.83 ,$18.59 ,$321.03 ,$85.55 ,$332.10 ,$85.55 ,$332.10 ,$332.10 ,$332.10 ,$357.93 ,$298.89 ,$343.17 ,$317.34 ,$357.93 
SACRED HEART HOSPITAL (ACU),32000168,72050,HC XR C-SPINE 4-5 VIEW,320,1 ,$433.00 ,$324.75 ,$18.59 ,$433.00 ,$278.85 ,$115.15 ,$303.10 ,$18.59 ,$49.53 ,$19.15 ,$39.62 ,$411.35 ,$18.59 ,$346.40 ,$398.36 ,$18.59 ,$368.05 ,$411.35 ,$381.04 ,$329.08 ,$18.59 ,$18.59 ,$18.59 ,$316.09 ,$238.15 ,$394.03 ,$394.03 ,$346.40 ,$118.60 ,$238.15 ,$389.70 ,$115.15 ,$389.70 ,$233.82 ,$407.02 ,$259.08 ,$398.36 ,$19.71 ,$394.03 ,$115.15 ,$266.47 ,$266.47 ,$198.42 ,$323.15 ,$199.24 ,$116.30 ,$18.59 ,$411.35 ,$120.90 ,$18.59 ,$376.71 ,$115.15 ,$389.70 ,$115.15 ,$389.70 ,$389.70 ,$389.70 ,$420.01 ,$350.73 ,$402.69 ,$372.38 ,$420.01 
SACRED HEART HOSPITAL (ACU),32000170,72052,HC XR C-SPINE 6+ VIEWS,320,1 ,$607.00 ,$455.25 ,$18.59 ,$607.00 ,$390.91 ,$115.15 ,$424.90 ,$18.59 ,$63.33 ,$19.15 ,$50.67 ,$576.65 ,$18.59 ,$485.60 ,$558.44 ,$18.59 ,$515.95 ,$576.65 ,$534.16 ,$461.32 ,$18.59 ,$18.59 ,$18.59 ,$443.11 ,$333.85 ,$552.37 ,$552.37 ,$485.60 ,$118.60 ,$333.85 ,$546.30 ,$115.15 ,$546.30 ,$327.78 ,$570.58 ,$259.08 ,$558.44 ,$19.71 ,$552.37 ,$115.15 ,$373.55 ,$373.55 ,$211.40 ,$453.00 ,$254.84 ,$116.30 ,$18.59 ,$576.65 ,$120.90 ,$18.59 ,$528.09 ,$115.15 ,$546.30 ,$115.15 ,$546.30 ,$546.30 ,$546.30 ,$588.79 ,$491.67 ,$564.51 ,$522.02 ,$588.79 
SACRED HEART HOSPITAL (ACU),32000172,72070,HC XR T-SPINE 2V,320,1 ,$206.00 ,$154.50 ,$18.59 ,$259.08 ,$132.66 ,$115.15 ,$144.20 ,$18.59 ,$38.12 ,$19.15 ,$30.49 ,$195.70 ,$18.59 ,$164.80 ,$189.52 ,$18.59 ,$175.10 ,$195.70 ,$181.28 ,$156.56 ,$18.59 ,$18.59 ,$18.59 ,$150.38 ,$113.30 ,$187.46 ,$187.46 ,$164.80 ,$118.60 ,$113.30 ,$185.40 ,$115.15 ,$185.40 ,$111.24 ,$193.64 ,$259.08 ,$189.52 ,$19.71 ,$187.46 ,$115.15 ,$126.77 ,$126.77 ,$206.00 ,$153.74 ,$153.25 ,$116.30 ,$18.59 ,$195.70 ,$120.90 ,$18.59 ,$179.22 ,$115.15 ,$185.40 ,$115.15 ,$185.40 ,$185.40 ,$185.40 ,$199.82 ,$166.86 ,$191.58 ,$177.16 ,$199.82 
SACRED HEART HOSPITAL (ACU),32000174,72072,HC XR T-SPINE 3V,320,1 ,$313.00 ,$234.75 ,$18.59 ,$313.00 ,$201.57 ,$115.15 ,$219.10 ,$18.59 ,$39.32 ,$19.15 ,$31.46 ,$297.35 ,$18.59 ,$250.40 ,$287.96 ,$18.59 ,$266.05 ,$297.35 ,$275.44 ,$237.88 ,$18.59 ,$18.59 ,$18.59 ,$228.49 ,$172.15 ,$284.83 ,$284.83 ,$250.40 ,$118.60 ,$172.15 ,$281.70 ,$115.15 ,$281.70 ,$169.02 ,$294.22 ,$259.08 ,$287.96 ,$19.71 ,$284.83 ,$115.15 ,$192.62 ,$192.62 ,$169.75 ,$233.59 ,$160.48 ,$116.30 ,$18.59 ,$297.35 ,$120.90 ,$18.59 ,$272.31 ,$115.15 ,$281.70 ,$115.15 ,$281.70 ,$281.70 ,$281.70 ,$303.61 ,$253.53 ,$291.09 ,$269.18 ,$303.61 
SACRED HEART HOSPITAL (ACU),32000178,72100,HC XR L-SPINE 2-3V,320,1 ,$261.00 ,$195.75 ,$18.59 ,$261.00 ,$168.08 ,$115.15 ,$182.70 ,$18.59 ,$39.92 ,$19.15 ,$31.93 ,$247.95 ,$18.59 ,$208.80 ,$240.12 ,$18.59 ,$221.85 ,$247.95 ,$229.68 ,$198.36 ,$18.59 ,$18.59 ,$18.59 ,$190.53 ,$143.55 ,$237.51 ,$237.51 ,$208.80 ,$118.60 ,$143.55 ,$234.90 ,$115.15 ,$234.90 ,$140.94 ,$245.34 ,$259.08 ,$240.12 ,$19.71 ,$237.51 ,$115.15 ,$160.62 ,$160.62 ,$198.89 ,$194.78 ,$160.48 ,$116.30 ,$18.59 ,$247.95 ,$120.90 ,$18.59 ,$227.07 ,$115.15 ,$234.90 ,$115.15 ,$234.90 ,$234.90 ,$234.90 ,$253.17 ,$211.41 ,$242.73 ,$224.46 ,$253.17 
SACRED HEART HOSPITAL (ACU),32000181,72110,HC XR L-SPINE 4+V,320,1 ,$380.00 ,$285.00 ,$18.59 ,$380.00 ,$244.72 ,$115.15 ,$266.00 ,$18.59 ,$55.53 ,$19.15 ,$44.42 ,$361.00 ,$18.59 ,$304.00 ,$349.60 ,$18.59 ,$323.00 ,$361.00 ,$334.40 ,$288.80 ,$18.59 ,$18.59 ,$18.59 ,$277.40 ,$209.00 ,$345.80 ,$345.80 ,$304.00 ,$118.60 ,$209.00 ,$342.00 ,$115.15 ,$342.00 ,$205.20 ,$357.20 ,$259.08 ,$349.60 ,$19.71 ,$345.80 ,$115.15 ,$233.85 ,$233.85 ,$230.21 ,$283.59 ,$223.39 ,$116.30 ,$18.59 ,$361.00 ,$120.90 ,$18.59 ,$330.60 ,$115.15 ,$342.00 ,$115.15 ,$342.00 ,$342.00 ,$342.00 ,$368.60 ,$307.80 ,$353.40 ,$326.80 ,$368.60 
SACRED HEART HOSPITAL (ACU),32000184,72114,HC XR L-SPINE CMPL W/BEND MIN 6 VIEW,320,1 ,$460.00 ,$345.00 ,$18.59 ,$460.00 ,$296.24 ,$115.15 ,$322.00 ,$18.59 ,$76.55 ,$19.15 ,$61.24 ,$437.00 ,$18.59 ,$368.00 ,$423.20 ,$18.59 ,$391.00 ,$437.00 ,$404.80 ,$349.60 ,$18.59 ,$18.59 ,$18.59 ,$335.80 ,$253.00 ,$418.60 ,$418.60 ,$368.00 ,$118.60 ,$253.00 ,$414.00 ,$115.15 ,$414.00 ,$248.40 ,$432.40 ,$259.08 ,$423.20 ,$19.71 ,$418.60 ,$115.15 ,$283.08 ,$283.08 ,$256.15 ,$343.30 ,$305.59 ,$116.30 ,$18.59 ,$437.00 ,$120.90 ,$18.59 ,$400.20 ,$115.15 ,$414.00 ,$115.15 ,$414.00 ,$414.00 ,$414.00 ,$446.20 ,$372.60 ,$427.80 ,$395.60 ,$446.20 
SACRED HEART HOSPITAL (ACU),32000186,72170,HC XR PELVIS 1-2V,320,1 ,$266.00 ,$199.50 ,$18.59 ,$266.00 ,$171.30 ,$115.15 ,$186.20 ,$18.59 ,$38.71 ,$19.15 ,$30.97 ,$252.70 ,$18.59 ,$212.80 ,$244.72 ,$18.59 ,$226.10 ,$252.70 ,$234.08 ,$202.16 ,$18.59 ,$18.59 ,$18.59 ,$194.18 ,$146.30 ,$242.06 ,$242.06 ,$212.80 ,$118.60 ,$146.30 ,$239.40 ,$115.15 ,$239.40 ,$143.64 ,$250.04 ,$259.08 ,$244.72 ,$19.71 ,$242.06 ,$115.15 ,$163.70 ,$163.70 ,$132.52 ,$198.52 ,$155.64 ,$116.30 ,$18.59 ,$252.70 ,$120.90 ,$18.59 ,$231.42 ,$115.15 ,$239.40 ,$115.15 ,$239.40 ,$239.40 ,$239.40 ,$258.02 ,$215.46 ,$247.38 ,$228.76 ,$258.02 
SACRED HEART HOSPITAL (ACU),32000189,72190,HC XR PELVIS CMPL 3+V,320,1 ,$295.00 ,$221.25 ,$18.59 ,$295.00 ,$189.98 ,$115.15 ,$206.50 ,$18.59 ,$45.33 ,$19.15 ,$36.26 ,$280.25 ,$18.59 ,$236.00 ,$271.40 ,$18.59 ,$250.75 ,$280.25 ,$259.60 ,$224.20 ,$18.59 ,$18.59 ,$18.59 ,$215.35 ,$162.25 ,$268.45 ,$268.45 ,$236.00 ,$118.60 ,$162.25 ,$265.50 ,$115.15 ,$265.50 ,$159.30 ,$277.30 ,$259.08 ,$271.40 ,$19.71 ,$268.45 ,$115.15 ,$181.54 ,$181.54 ,$189.95 ,$220.16 ,$182.25 ,$116.30 ,$18.59 ,$280.25 ,$120.90 ,$18.59 ,$256.65 ,$115.15 ,$265.50 ,$115.15 ,$265.50 ,$265.50 ,$265.50 ,$286.15 ,$238.95 ,$274.35 ,$253.70 ,$286.15 
SACRED HEART HOSPITAL (ACU),32000190,72202,HC XR SACROILI JT 3+V,320,1 ,$257.00 ,$192.75 ,$18.59 ,$259.08 ,$165.51 ,$115.15 ,$179.90 ,$18.59 ,$39.32 ,$19.15 ,$31.46 ,$244.15 ,$18.59 ,$205.60 ,$236.44 ,$18.59 ,$218.45 ,$244.15 ,$226.16 ,$195.32 ,$18.59 ,$18.59 ,$18.59 ,$187.61 ,$141.35 ,$233.87 ,$233.87 ,$205.60 ,$118.60 ,$141.35 ,$231.30 ,$115.15 ,$231.30 ,$138.78 ,$241.58 ,$259.08 ,$236.44 ,$19.71 ,$233.87 ,$115.15 ,$158.16 ,$158.16 ,$139.72 ,$191.80 ,$158.10 ,$116.30 ,$18.59 ,$244.15 ,$120.90 ,$18.59 ,$223.59 ,$115.15 ,$231.30 ,$115.15 ,$231.30 ,$231.30 ,$231.30 ,$249.29 ,$208.17 ,$239.01 ,$221.02 ,$249.29 
SACRED HEART HOSPITAL (ACU),32000191,72220,HC XR SACRUM/COCCYX 2+V,320,1 ,$293.00 ,$219.75 ,$18.59 ,$293.00 ,$188.69 ,$85.55 ,$205.10 ,$18.59 ,$32.11 ,$19.15 ,$25.69 ,$278.35 ,$18.59 ,$234.40 ,$269.56 ,$18.59 ,$249.05 ,$278.35 ,$257.84 ,$222.68 ,$18.59 ,$18.59 ,$18.59 ,$213.89 ,$161.15 ,$266.63 ,$266.63 ,$234.40 ,$88.12 ,$161.15 ,$263.70 ,$85.55 ,$263.70 ,$158.22 ,$275.42 ,$192.49 ,$269.56 ,$19.71 ,$266.63 ,$85.55 ,$180.31 ,$180.31 ,$121.03 ,$218.67 ,$131.49 ,$86.40 ,$18.59 ,$278.35 ,$89.83 ,$18.59 ,$254.91 ,$85.55 ,$263.70 ,$85.55 ,$263.70 ,$263.70 ,$263.70 ,$284.21 ,$237.33 ,$272.49 ,$251.98 ,$284.21 
SACRED HEART HOSPITAL (ACU),32000194,62302,HC XR MYELOGRAM C-SPINE,320,1 ,"$2,510.00 ","$1,882.50 ",$190.36 ,"$2,510.00 ","$1,616.44 ",$756.67 ,"$1,757.00 ",$190.36 ,"$2,083.30 ",$196.07 ,"$1,656.60 ","$2,384.50 ",$190.36 ,"$2,008.00 ","$2,309.20 ",$190.36 ,"$2,133.50 ","$2,384.50 ","$2,208.80 ","$1,907.60 ",$190.36 ,$190.36 ,$190.36 ,"$1,832.30 ","$1,380.50 ","$2,284.10 ","$2,284.10 ","$2,008.00 ",$779.37 ,"$1,380.50 ","$2,259.00 ",$756.67 ,"$2,259.00 ","$1,355.40 ","$2,359.40 ","$1,702.50 ","$2,309.20 ",$201.78 ,"$2,284.10 ",$756.67 ,"$1,544.65 ","$1,544.65 ","$2,259.00 ","$1,873.21 ","$1,748.22 ",$764.23 ,$190.36 ,"$2,384.50 ",$794.50 ,$190.36 ,"$2,183.70 ",$756.67 ,"$2,259.00 ",$756.67 ,"$2,259.00 ","$2,259.00 ","$2,259.00 ","$2,434.70 ","$2,033.10 ","$2,334.30 ","$2,158.60 ","$2,434.70 "
SACRED HEART HOSPITAL (ACU),32000195,62303,HC XR MYELOGRAM T-SPINE,320,1 ,"$2,510.00 ","$1,882.50 ",$190.36 ,"$2,510.00 ","$1,616.44 ",$756.67 ,"$1,757.00 ",$190.36 ,"$2,083.30 ",$196.07 ,"$1,656.60 ","$2,384.50 ",$190.36 ,"$2,008.00 ","$2,309.20 ",$190.36 ,"$2,133.50 ","$2,384.50 ","$2,208.80 ","$1,907.60 ",$190.36 ,$190.36 ,$190.36 ,"$1,832.30 ","$1,380.50 ","$2,284.10 ","$2,284.10 ","$2,008.00 ",$779.37 ,"$1,380.50 ","$2,259.00 ",$756.67 ,"$2,259.00 ","$1,355.40 ","$2,359.40 ","$1,702.50 ","$2,309.20 ",$201.78 ,"$2,284.10 ",$756.67 ,"$1,544.65 ","$1,544.65 ","$2,259.00 ","$1,873.21 ","$1,748.22 ",$764.23 ,$190.36 ,"$2,384.50 ",$794.50 ,$190.36 ,"$2,183.70 ",$756.67 ,"$2,259.00 ",$756.67 ,"$2,259.00 ","$2,259.00 ","$2,259.00 ","$2,434.70 ","$2,033.10 ","$2,334.30 ","$2,158.60 ","$2,434.70 "
SACRED HEART HOSPITAL (ACU),32000196,62304,HC XR MYELOGRAM L-SPINE,320,1 ,"$2,510.00 ","$1,882.50 ",$190.36 ,"$2,510.00 ","$1,616.44 ",$756.67 ,"$1,757.00 ",$190.36 ,"$2,083.30 ",$196.07 ,"$1,656.60 ","$2,384.50 ",$190.36 ,"$2,008.00 ","$2,309.20 ",$190.36 ,"$2,133.50 ","$2,384.50 ","$2,208.80 ","$1,907.60 ",$190.36 ,$190.36 ,$190.36 ,"$1,832.30 ","$1,380.50 ","$2,284.10 ","$2,284.10 ","$2,008.00 ",$779.37 ,"$1,380.50 ","$2,259.00 ",$756.67 ,"$2,259.00 ","$1,355.40 ","$2,359.40 ","$1,702.50 ","$2,309.20 ",$201.78 ,"$2,284.10 ",$756.67 ,"$1,544.65 ","$1,544.65 ","$2,259.00 ","$1,873.21 ","$1,748.22 ",$764.23 ,$190.36 ,"$2,384.50 ",$794.50 ,$190.36 ,"$2,183.70 ",$756.67 ,"$2,259.00 ",$756.67 ,"$2,259.00 ","$2,259.00 ","$2,259.00 ","$2,434.70 ","$2,033.10 ","$2,334.30 ","$2,158.60 ","$2,434.70 "
SACRED HEART HOSPITAL (ACU),32000197,62305,HC XR MYELOGRAM >2 REGIONS,320,1 ,"$2,510.00 ","$1,882.50 ",$190.36 ,"$2,510.00 ","$1,616.44 ",$756.67 ,"$1,757.00 ",$190.36 ,"$2,083.30 ",$196.07 ,"$1,656.60 ","$2,384.50 ",$190.36 ,"$2,008.00 ","$2,309.20 ",$190.36 ,"$2,133.50 ","$2,384.50 ","$2,208.80 ","$1,907.60 ",$190.36 ,$190.36 ,$190.36 ,"$1,832.30 ","$1,380.50 ","$2,284.10 ","$2,284.10 ","$2,008.00 ",$779.37 ,"$1,380.50 ","$2,259.00 ",$756.67 ,"$2,259.00 ","$1,355.40 ","$2,359.40 ","$1,702.50 ","$2,309.20 ",$201.78 ,"$2,284.10 ",$756.67 ,"$1,544.65 ","$1,544.65 ","$2,259.00 ","$1,873.21 ","$1,748.22 ",$764.23 ,$190.36 ,"$2,384.50 ",$794.50 ,$190.36 ,"$2,183.70 ",$756.67 ,"$2,259.00 ",$756.67 ,"$2,259.00 ","$2,259.00 ","$2,259.00 ","$2,434.70 ","$2,033.10 ","$2,334.30 ","$2,158.60 ","$2,434.70 "
SACRED HEART HOSPITAL (ACU),32000198,72285,HC XR DISKOGRAM C- OR T-SPINE,320,1 ,$980.00 ,$735.00 ,$70.36 ,"$4,178.51 ",$631.12 ,"$1,857.12 ",$686.00 ,$190.36 ,$87.96 ,$196.07 ,$70.36 ,$931.00 ,$190.36 ,$784.00 ,$901.60 ,$190.36 ,$833.00 ,$931.00 ,$862.40 ,$744.80 ,$190.36 ,$190.36 ,$190.36 ,$715.40 ,$539.00 ,$891.80 ,$891.80 ,$784.00 ,"$1,912.83 ",$539.00 ,$882.00 ,"$1,857.12 ",$882.00 ,$529.20 ,$921.20 ,"$4,178.51 ",$901.60 ,$201.78 ,$891.80 ,"$1,857.12 ",$603.09 ,$603.09 ,$980.00 ,$731.37 ,$353.96 ,"$1,875.69 ",$190.36 ,$931.00 ,"$1,949.97 ",$190.36 ,$852.60 ,"$1,857.12 ",$882.00 ,"$1,857.12 ",$882.00 ,$882.00 ,$882.00 ,$950.60 ,$793.80 ,$911.40 ,$842.80 ,$950.60 
SACRED HEART HOSPITAL (ACU),32000200,72295,HC XR DISKOGRAM L-SPINE,320,1 ,"$1,917.00 ","$1,437.75 ",$73.23 ,"$4,178.51 ","$1,234.55 ","$1,857.12 ","$1,341.90 ",$190.36 ,$91.54 ,$196.07 ,$73.23 ,"$1,821.15 ",$190.36 ,"$1,533.60 ","$1,763.64 ",$190.36 ,"$1,629.45 ","$1,821.15 ","$1,686.96 ","$1,456.92 ",$190.36 ,$190.36 ,$190.36 ,"$1,399.41 ","$1,054.35 ","$1,744.47 ","$1,744.47 ","$1,533.60 ","$1,912.83 ","$1,054.35 ","$1,725.30 ","$1,857.12 ","$1,725.30 ","$1,035.18 ","$1,801.98 ","$4,178.51 ","$1,763.64 ",$201.78 ,"$1,744.47 ","$1,857.12 ","$1,179.72 ","$1,179.72 ","$1,519.70 ","$1,430.66 ",$366.11 ,"$1,875.69 ",$190.36 ,"$1,821.15 ","$1,949.97 ",$190.36 ,"$1,667.79 ","$1,857.12 ","$1,725.30 ","$1,857.12 ","$1,725.30 ","$1,725.30 ","$1,725.30 ","$1,859.49 ","$1,552.77 ","$1,782.81 ","$1,648.62 ","$1,859.49 "
SACRED HEART HOSPITAL (ACU),32000201,73000,HC XRAY CLAVICLE,320,1 ,$258.00 ,$193.50 ,$18.59 ,$258.00 ,$166.15 ,$85.55 ,$180.60 ,$18.59 ,$32.11 ,$19.15 ,$25.69 ,$245.10 ,$18.59 ,$206.40 ,$237.36 ,$18.59 ,$219.30 ,$245.10 ,$227.04 ,$196.08 ,$18.59 ,$18.59 ,$18.59 ,$188.34 ,$141.90 ,$234.78 ,$234.78 ,$206.40 ,$88.12 ,$141.90 ,$232.20 ,$85.55 ,$232.20 ,$139.32 ,$242.52 ,$192.49 ,$237.36 ,$19.71 ,$234.78 ,$85.55 ,$158.77 ,$158.77 ,$113.22 ,$192.55 ,$131.49 ,$86.40 ,$18.59 ,$245.10 ,$89.83 ,$18.59 ,$224.46 ,$85.55 ,$232.20 ,$85.55 ,$232.20 ,$232.20 ,$232.20 ,$250.26 ,$208.98 ,$239.94 ,$221.88 ,$250.26 
SACRED HEART HOSPITAL (ACU),32000204,73010,HC XRAY SCAPULA,320,1 ,$258.00 ,$193.50 ,$18.59 ,$259.08 ,$166.15 ,$115.15 ,$180.60 ,$18.59 ,$35.11 ,$19.15 ,$28.08 ,$245.10 ,$18.59 ,$206.40 ,$237.36 ,$18.59 ,$219.30 ,$245.10 ,$227.04 ,$196.08 ,$18.59 ,$18.59 ,$18.59 ,$188.34 ,$141.90 ,$234.78 ,$234.78 ,$206.40 ,$118.60 ,$141.90 ,$232.20 ,$115.15 ,$232.20 ,$139.32 ,$242.52 ,$259.08 ,$237.36 ,$19.71 ,$234.78 ,$115.15 ,$158.77 ,$158.77 ,$137.31 ,$192.55 ,$143.57 ,$116.30 ,$18.59 ,$245.10 ,$120.90 ,$18.59 ,$224.46 ,$115.15 ,$232.20 ,$115.15 ,$232.20 ,$232.20 ,$232.20 ,$250.26 ,$208.98 ,$239.94 ,$221.88 ,$250.26 
SACRED HEART HOSPITAL (ACU),32000205,73020,HC XRAY SHOULDER (1 V),320,1 ,$221.00 ,$165.75 ,$18.59 ,$221.00 ,$142.32 ,$85.55 ,$154.70 ,$18.59 ,$24.90 ,$19.15 ,$19.92 ,$209.95 ,$18.59 ,$176.80 ,$203.32 ,$18.59 ,$187.85 ,$209.95 ,$194.48 ,$167.96 ,$18.59 ,$18.59 ,$18.59 ,$161.33 ,$121.55 ,$201.11 ,$201.11 ,$176.80 ,$88.12 ,$121.55 ,$198.90 ,$85.55 ,$198.90 ,$119.34 ,$207.74 ,$192.49 ,$203.32 ,$19.71 ,$201.11 ,$85.55 ,$136.00 ,$136.00 ,$92.22 ,$164.93 ,$100.04 ,$86.40 ,$18.59 ,$209.95 ,$89.83 ,$18.59 ,$192.27 ,$85.55 ,$198.90 ,$85.55 ,$198.90 ,$198.90 ,$198.90 ,$214.37 ,$179.01 ,$205.53 ,$190.06 ,$214.37 
SACRED HEART HOSPITAL (ACU),32000208,73030,HC XRAY SHOULDER (MIN 2 V),320,1 ,$263.00 ,$197.25 ,$18.59 ,$263.00 ,$169.37 ,$85.55 ,$184.10 ,$18.59 ,$32.71 ,$19.15 ,$26.17 ,$249.85 ,$18.59 ,$210.40 ,$241.96 ,$18.59 ,$223.55 ,$249.85 ,$231.44 ,$199.88 ,$18.59 ,$18.59 ,$18.59 ,$191.99 ,$144.65 ,$239.33 ,$239.33 ,$210.40 ,$88.12 ,$144.65 ,$236.70 ,$85.55 ,$236.70 ,$142.02 ,$247.22 ,$192.49 ,$241.96 ,$19.71 ,$239.33 ,$85.55 ,$161.85 ,$161.85 ,$137.87 ,$196.28 ,$133.88 ,$86.40 ,$18.59 ,$249.85 ,$89.83 ,$18.59 ,$228.81 ,$85.55 ,$236.70 ,$85.55 ,$236.70 ,$236.70 ,$236.70 ,$255.11 ,$213.03 ,$244.59 ,$226.18 ,$255.11 
SACRED HEART HOSPITAL (ACU),32000212,73040,HC XRAY SHOULDER ARTHRO,320,1 ,$843.00 ,$632.25 ,$39.20 ,$876.31 ,$542.89 ,$389.47 ,$590.10 ,$39.20 ,$122.17 ,$40.38 ,$97.73 ,$800.85 ,$39.20 ,$674.40 ,$775.56 ,$39.20 ,$716.55 ,$800.85 ,$741.84 ,$640.68 ,$39.20 ,$39.20 ,$39.20 ,$615.39 ,$463.65 ,$767.13 ,$767.13 ,$674.40 ,$401.15 ,$463.65 ,$758.70 ,$389.47 ,$758.70 ,$455.22 ,$792.42 ,$876.31 ,$775.56 ,$41.55 ,$767.13 ,$389.47 ,$518.78 ,$518.78 ,$388.94 ,$629.13 ,$501.53 ,$393.37 ,$39.20 ,$800.85 ,$408.94 ,$39.20 ,$733.41 ,$389.47 ,$758.70 ,$389.47 ,$758.70 ,$758.70 ,$758.70 ,$817.71 ,$682.83 ,$783.99 ,$724.98 ,$817.71 
SACRED HEART HOSPITAL (ACU),32000213,73050,HC XR AC JOINTS BI W/W/O WTS,320,1 ,$358.00 ,$268.50 ,$18.59 ,$358.00 ,$230.55 ,$85.55 ,$250.60 ,$18.59 ,$41.72 ,$19.15 ,$33.38 ,$340.10 ,$18.59 ,$286.40 ,$329.36 ,$18.59 ,$304.30 ,$340.10 ,$315.04 ,$272.08 ,$18.59 ,$18.59 ,$18.59 ,$261.34 ,$196.90 ,$325.78 ,$325.78 ,$286.40 ,$88.12 ,$196.90 ,$322.20 ,$85.55 ,$322.20 ,$193.32 ,$336.52 ,$192.49 ,$329.36 ,$19.71 ,$325.78 ,$85.55 ,$220.31 ,$220.31 ,$128.79 ,$267.18 ,$170.17 ,$86.40 ,$18.59 ,$340.10 ,$89.83 ,$18.59 ,$311.46 ,$85.55 ,$322.20 ,$85.55 ,$322.20 ,$322.20 ,$322.20 ,$347.26 ,$289.98 ,$332.94 ,$307.88 ,$347.26 
SACRED HEART HOSPITAL (ACU),32000214,73060,HC XRAY HUMERUS (2 V),320,1 ,$237.00 ,$177.75 ,$18.59 ,$237.00 ,$152.63 ,$85.55 ,$165.90 ,$18.59 ,$34.51 ,$19.15 ,$27.61 ,$225.15 ,$18.59 ,$189.60 ,$218.04 ,$18.59 ,$201.45 ,$225.15 ,$208.56 ,$180.12 ,$18.59 ,$18.59 ,$18.59 ,$173.01 ,$130.35 ,$215.67 ,$215.67 ,$189.60 ,$88.12 ,$130.35 ,$213.30 ,$85.55 ,$213.30 ,$127.98 ,$222.78 ,$192.49 ,$218.04 ,$19.71 ,$215.67 ,$85.55 ,$145.85 ,$145.85 ,$129.80 ,$176.87 ,$138.72 ,$86.40 ,$18.59 ,$225.15 ,$89.83 ,$18.59 ,$206.19 ,$85.55 ,$213.30 ,$85.55 ,$213.30 ,$213.30 ,$213.30 ,$229.89 ,$191.97 ,$220.41 ,$203.82 ,$229.89 
SACRED HEART HOSPITAL (ACU),32000217,73070,HC XRAY ELBOW (2 V),320,1 ,$214.00 ,$160.50 ,$18.59 ,$214.00 ,$137.82 ,$85.55 ,$149.80 ,$18.59 ,$32.11 ,$19.15 ,$25.69 ,$203.30 ,$18.59 ,$171.20 ,$196.88 ,$18.59 ,$181.90 ,$203.30 ,$188.32 ,$162.64 ,$18.59 ,$18.59 ,$18.59 ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 ,$88.12 ,$117.70 ,$192.60 ,$85.55 ,$192.60 ,$115.56 ,$201.16 ,$192.49 ,$196.88 ,$19.71 ,$194.74 ,$85.55 ,$131.70 ,$131.70 ,$93.90 ,$159.71 ,$129.03 ,$86.40 ,$18.59 ,$203.30 ,$89.83 ,$18.59 ,$186.18 ,$85.55 ,$192.60 ,$85.55 ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),32000220,73080,HC XRAY ELBOW (MIN 3 V),320,1 ,$235.00 ,$176.25 ,$18.59 ,$235.00 ,$151.34 ,$85.55 ,$164.50 ,$18.59 ,$37.52 ,$19.15 ,$30.02 ,$223.25 ,$18.59 ,$188.00 ,$216.20 ,$18.59 ,$199.75 ,$223.25 ,$206.80 ,$178.60 ,$18.59 ,$18.59 ,$18.59 ,$171.55 ,$129.25 ,$213.85 ,$213.85 ,$188.00 ,$88.12 ,$129.25 ,$211.50 ,$85.55 ,$211.50 ,$126.90 ,$220.90 ,$192.49 ,$216.20 ,$19.71 ,$213.85 ,$85.55 ,$144.62 ,$144.62 ,$120.08 ,$175.38 ,$153.25 ,$86.40 ,$18.59 ,$223.25 ,$89.83 ,$18.59 ,$204.45 ,$85.55 ,$211.50 ,$85.55 ,$211.50 ,$211.50 ,$211.50 ,$227.95 ,$190.35 ,$218.55 ,$202.10 ,$227.95 
SACRED HEART HOSPITAL (ACU),32000222,73085,HC XRAY ELBOW ARTHRO,320,1 ,$343.00 ,$257.25 ,$39.20 ,$876.31 ,$220.89 ,$389.47 ,$240.10 ,$39.20 ,$112.56 ,$40.38 ,$90.05 ,$325.85 ,$39.20 ,$274.40 ,$315.56 ,$39.20 ,$291.55 ,$325.85 ,$301.84 ,$260.68 ,$39.20 ,$39.20 ,$39.20 ,$250.39 ,$188.65 ,$312.13 ,$312.13 ,$274.40 ,$401.15 ,$188.65 ,$308.70 ,$389.47 ,$308.70 ,$185.22 ,$322.42 ,$876.31 ,$315.56 ,$41.55 ,$312.13 ,$389.47 ,$211.08 ,$211.08 ,$312.92 ,$255.98 ,$308.70 ,$393.37 ,$39.20 ,$325.85 ,$408.94 ,$39.20 ,$298.41 ,$389.47 ,$308.70 ,$389.47 ,$308.70 ,$308.70 ,$308.70 ,$332.71 ,$277.83 ,$318.99 ,$294.98 ,$332.71 
SACRED HEART HOSPITAL (ACU),32000223,73090,HC XRAY FOREARM (2 V),320,1 ,$214.00 ,$160.50 ,$18.59 ,$214.00 ,$137.82 ,$85.55 ,$149.80 ,$18.59 ,$29.10 ,$19.15 ,$23.28 ,$203.30 ,$18.59 ,$171.20 ,$196.88 ,$18.59 ,$181.90 ,$203.30 ,$188.32 ,$162.64 ,$18.59 ,$18.59 ,$18.59 ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 ,$88.12 ,$117.70 ,$192.60 ,$85.55 ,$192.60 ,$115.56 ,$201.16 ,$192.49 ,$196.88 ,$19.71 ,$194.74 ,$85.55 ,$131.70 ,$131.70 ,$114.13 ,$159.71 ,$116.96 ,$86.40 ,$18.59 ,$203.30 ,$89.83 ,$18.59 ,$186.18 ,$85.55 ,$192.60 ,$85.55 ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),32000226,73092,HC XRAY INFANT UP EXTRM MIN 2V,320,1 ,$274.00 ,$205.50 ,$18.59 ,$274.00 ,$176.46 ,$115.15 ,$191.80 ,$18.59 ,$32.71 ,$19.15 ,$26.17 ,$260.30 ,$18.59 ,$219.20 ,$252.08 ,$18.59 ,$232.90 ,$260.30 ,$241.12 ,$208.24 ,$18.59 ,$18.59 ,$18.59 ,$200.02 ,$150.70 ,$249.34 ,$249.34 ,$219.20 ,$118.60 ,$150.70 ,$246.60 ,$115.15 ,$246.60 ,$147.96 ,$257.56 ,$259.08 ,$252.08 ,$19.71 ,$249.34 ,$115.15 ,$168.62 ,$168.62 ,$107.95 ,$204.49 ,$129.03 ,$116.30 ,$18.59 ,$260.30 ,$120.90 ,$18.59 ,$238.38 ,$115.15 ,$246.60 ,$115.15 ,$246.60 ,$246.60 ,$246.60 ,$265.78 ,$221.94 ,$254.82 ,$235.64 ,$265.78 
SACRED HEART HOSPITAL (ACU),32000229,73100,HC XRAY WRIST 2 VIEWS,320,1 ,$161.00 ,$120.75 ,$18.59 ,$192.49 ,$103.68 ,$85.55 ,$112.70 ,$18.59 ,$34.51 ,$19.15 ,$27.61 ,$152.95 ,$18.59 ,$128.80 ,$148.12 ,$18.59 ,$136.85 ,$152.95 ,$141.68 ,$122.36 ,$18.59 ,$18.59 ,$18.59 ,$117.53 ,$88.55 ,$146.51 ,$146.51 ,$128.80 ,$88.12 ,$88.55 ,$144.90 ,$85.55 ,$144.90 ,$86.94 ,$151.34 ,$192.49 ,$148.12 ,$19.71 ,$146.51 ,$85.55 ,$99.08 ,$99.08 ,$87.40 ,$120.15 ,$144.90 ,$86.40 ,$18.59 ,$152.95 ,$89.83 ,$18.59 ,$140.07 ,$85.55 ,$144.90 ,$85.55 ,$144.90 ,$144.90 ,$144.90 ,$156.17 ,$130.41 ,$149.73 ,$138.46 ,$156.17 
SACRED HEART HOSPITAL (ACU),32000233,73110,HC XRAY WRIST COMP MIN 3 V,320,1 ,$214.00 ,$160.50 ,$18.59 ,$214.00 ,$137.82 ,$85.55 ,$149.80 ,$18.59 ,$44.71 ,$19.15 ,$35.77 ,$203.30 ,$18.59 ,$171.20 ,$196.88 ,$18.59 ,$181.90 ,$203.30 ,$188.32 ,$162.64 ,$18.59 ,$18.59 ,$18.59 ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 ,$88.12 ,$117.70 ,$192.60 ,$85.55 ,$192.60 ,$115.56 ,$201.16 ,$192.49 ,$196.88 ,$19.71 ,$194.74 ,$85.55 ,$131.70 ,$131.70 ,$122.57 ,$159.71 ,$177.40 ,$86.40 ,$18.59 ,$203.30 ,$89.83 ,$18.59 ,$186.18 ,$85.55 ,$192.60 ,$85.55 ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),32000236,73115,HC XRAY WRIST ARTHRO,320,1 ,$851.00 ,$638.25 ,$39.20 ,$876.31 ,$548.04 ,$389.47 ,$595.70 ,$39.20 ,$131.18 ,$40.38 ,$104.94 ,$808.45 ,$39.20 ,$680.80 ,$782.92 ,$39.20 ,$723.35 ,$808.45 ,$748.88 ,$646.76 ,$39.20 ,$39.20 ,$39.20 ,$621.23 ,$468.05 ,$774.41 ,$774.41 ,$680.80 ,$401.15 ,$468.05 ,$765.90 ,$389.47 ,$765.90 ,$459.54 ,$799.94 ,$876.31 ,$782.92 ,$41.55 ,$774.41 ,$389.47 ,$523.71 ,$523.71 ,$236.70 ,$635.10 ,$532.98 ,$393.37 ,$39.20 ,$808.45 ,$408.94 ,$39.20 ,$740.37 ,$389.47 ,$765.90 ,$389.47 ,$765.90 ,$765.90 ,$765.90 ,$825.47 ,$689.31 ,$791.43 ,$731.86 ,$825.47 
SACRED HEART HOSPITAL (ACU),32000237,73120,HC XRAY HAND 2 VIEW,320,1 ,$133.00 ,$99.75 ,$18.59 ,$259.08 ,$85.65 ,$115.15 ,$93.10 ,$18.59 ,$29.72 ,$19.15 ,$23.77 ,$126.35 ,$18.59 ,$106.40 ,$122.36 ,$18.59 ,$113.05 ,$126.35 ,$117.04 ,$101.08 ,$18.59 ,$18.59 ,$18.59 ,$97.09 ,$73.15 ,$121.03 ,$121.03 ,$106.40 ,$118.60 ,$73.15 ,$119.70 ,$115.15 ,$119.70 ,$71.82 ,$125.02 ,$259.08 ,$122.36 ,$19.71 ,$121.03 ,$115.15 ,$81.85 ,$81.85 ,$79.37 ,$99.26 ,$119.70 ,$116.30 ,$18.59 ,$126.35 ,$120.90 ,$18.59 ,$115.71 ,$115.15 ,$119.70 ,$115.15 ,$119.70 ,$119.70 ,$119.70 ,$129.01 ,$107.73 ,$123.69 ,$114.38 ,$129.01 
SACRED HEART HOSPITAL (ACU),32000239,73130,HC XRAY HAND MIN 3 VIEW,320,1 ,$214.00 ,$160.50 ,$18.59 ,$214.00 ,$137.82 ,$85.55 ,$149.80 ,$18.59 ,$36.91 ,$19.15 ,$29.53 ,$203.30 ,$18.59 ,$171.20 ,$196.88 ,$18.59 ,$181.90 ,$203.30 ,$188.32 ,$162.64 ,$18.59 ,$18.59 ,$18.59 ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 ,$88.12 ,$117.70 ,$192.60 ,$85.55 ,$192.60 ,$115.56 ,$201.16 ,$192.49 ,$196.88 ,$19.71 ,$194.74 ,$85.55 ,$131.70 ,$131.70 ,$124.65 ,$159.71 ,$155.64 ,$86.40 ,$18.59 ,$203.30 ,$89.83 ,$18.59 ,$186.18 ,$85.55 ,$192.60 ,$85.55 ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),32000241,73140,HC XRAY FINGER MIN 2 VIEWS,320,1 ,$214.00 ,$160.50 ,$18.59 ,$214.00 ,$137.82 ,$85.55 ,$149.80 ,$18.59 ,$41.11 ,$19.15 ,$32.89 ,$203.30 ,$18.59 ,$171.20 ,$196.88 ,$18.59 ,$181.90 ,$203.30 ,$188.32 ,$162.64 ,$18.59 ,$18.59 ,$18.59 ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 ,$88.12 ,$117.70 ,$192.60 ,$85.55 ,$192.60 ,$115.56 ,$201.16 ,$192.49 ,$196.88 ,$19.71 ,$194.74 ,$85.55 ,$131.70 ,$131.70 ,$97.88 ,$159.71 ,$170.17 ,$86.40 ,$18.59 ,$203.30 ,$89.83 ,$18.59 ,$186.18 ,$85.55 ,$192.60 ,$85.55 ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),32000243,73140,HC XRAY FINGER MIN 2 VIEWS MULTI,320,1 ,$214.00 ,$160.50 ,$18.59 ,$214.00 ,$137.82 ,$85.55 ,$149.80 ,$18.59 ,$41.11 ,$19.15 ,$32.89 ,$203.30 ,$18.59 ,$171.20 ,$196.88 ,$18.59 ,$181.90 ,$203.30 ,$188.32 ,$162.64 ,$18.59 ,$18.59 ,$18.59 ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 ,$88.12 ,$117.70 ,$192.60 ,$85.55 ,$192.60 ,$115.56 ,$201.16 ,$192.49 ,$196.88 ,$19.71 ,$194.74 ,$85.55 ,$131.70 ,$131.70 ,$97.88 ,$159.71 ,$170.17 ,$86.40 ,$18.59 ,$203.30 ,$89.83 ,$18.59 ,$186.18 ,$85.55 ,$192.60 ,$85.55 ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),32000252,73525,HC XRAY HIP ARTHRGRPHY,320,1 ,$396.00 ,$297.00 ,$39.20 ,$876.31 ,$255.02 ,$389.47 ,$277.20 ,$39.20 ,$122.78 ,$40.38 ,$98.22 ,$376.20 ,$39.20 ,$316.80 ,$364.32 ,$39.20 ,$336.60 ,$376.20 ,$348.48 ,$300.96 ,$39.20 ,$39.20 ,$39.20 ,$289.08 ,$217.80 ,$360.36 ,$360.36 ,$316.80 ,$401.15 ,$217.80 ,$356.40 ,$389.47 ,$356.40 ,$213.84 ,$372.24 ,$876.31 ,$364.32 ,$41.55 ,$360.36 ,$389.47 ,$243.70 ,$243.70 ,$323.03 ,$295.53 ,$356.40 ,$393.37 ,$39.20 ,$376.20 ,$408.94 ,$39.20 ,$344.52 ,$389.47 ,$356.40 ,$389.47 ,$356.40 ,$356.40 ,$356.40 ,$384.12 ,$320.76 ,$368.28 ,$340.56 ,$384.12 
SACRED HEART HOSPITAL (ACU),32000260,73560,HC XRAY KNEE (1 OR 2 V),320,1 ,$194.00 ,$145.50 ,$18.59 ,$194.00 ,$124.94 ,$85.55 ,$135.80 ,$18.59 ,$37.52 ,$19.15 ,$30.02 ,$184.30 ,$18.59 ,$155.20 ,$178.48 ,$18.59 ,$164.90 ,$184.30 ,$170.72 ,$147.44 ,$18.59 ,$18.59 ,$18.59 ,$141.62 ,$106.70 ,$176.54 ,$176.54 ,$155.20 ,$88.12 ,$106.70 ,$174.60 ,$85.55 ,$174.60 ,$104.76 ,$182.36 ,$192.49 ,$178.48 ,$19.71 ,$176.54 ,$85.55 ,$119.39 ,$119.39 ,$111.79 ,$144.78 ,$153.25 ,$86.40 ,$18.59 ,$184.30 ,$89.83 ,$18.59 ,$168.78 ,$85.55 ,$174.60 ,$85.55 ,$174.60 ,$174.60 ,$174.60 ,$188.18 ,$157.14 ,$180.42 ,$166.84 ,$188.18 
SACRED HEART HOSPITAL (ACU),32000263,73562,HC XRAY KNEE (3 V),320,1 ,$226.00 ,$169.50 ,$18.59 ,$226.00 ,$145.54 ,$85.55 ,$158.20 ,$18.59 ,$44.12 ,$19.15 ,$35.29 ,$214.70 ,$18.59 ,$180.80 ,$207.92 ,$18.59 ,$192.10 ,$214.70 ,$198.88 ,$171.76 ,$18.59 ,$18.59 ,$18.59 ,$164.98 ,$124.30 ,$205.66 ,$205.66 ,$180.80 ,$88.12 ,$124.30 ,$203.40 ,$85.55 ,$203.40 ,$122.04 ,$212.44 ,$192.49 ,$207.92 ,$19.71 ,$205.66 ,$85.55 ,$139.08 ,$139.08 ,$120.15 ,$168.66 ,$177.40 ,$86.40 ,$18.59 ,$214.70 ,$89.83 ,$18.59 ,$196.62 ,$85.55 ,$203.40 ,$85.55 ,$203.40 ,$203.40 ,$203.40 ,$219.22 ,$183.06 ,$210.18 ,$194.36 ,$219.22 
SACRED HEART HOSPITAL (ACU),32000265,73564,HC XRAY KNEE (MIN 4 V),320,1 ,$284.00 ,$213.00 ,$18.59 ,$284.00 ,$182.90 ,$115.15 ,$198.80 ,$18.59 ,$47.72 ,$19.15 ,$38.18 ,$269.80 ,$18.59 ,$227.20 ,$261.28 ,$18.59 ,$241.40 ,$269.80 ,$249.92 ,$215.84 ,$18.59 ,$18.59 ,$18.59 ,$207.32 ,$156.20 ,$258.44 ,$258.44 ,$227.20 ,$118.60 ,$156.20 ,$255.60 ,$115.15 ,$255.60 ,$153.36 ,$266.96 ,$259.08 ,$261.28 ,$19.71 ,$258.44 ,$115.15 ,$174.77 ,$174.77 ,$127.08 ,$211.95 ,$191.94 ,$116.30 ,$18.59 ,$269.80 ,$120.90 ,$18.59 ,$247.08 ,$115.15 ,$255.60 ,$115.15 ,$255.60 ,$255.60 ,$255.60 ,$275.48 ,$230.04 ,$264.12 ,$244.24 ,$275.48 
SACRED HEART HOSPITAL (ACU),32000267,73565,HC XR KNEE STAND,320,1 ,$186.00 ,$139.50 ,$18.59 ,$192.49 ,$119.78 ,$85.55 ,$130.20 ,$18.59 ,$45.33 ,$19.15 ,$36.26 ,$176.70 ,$18.59 ,$148.80 ,$171.12 ,$18.59 ,$158.10 ,$176.70 ,$163.68 ,$141.36 ,$18.59 ,$18.59 ,$18.59 ,$135.78 ,$102.30 ,$169.26 ,$169.26 ,$148.80 ,$88.12 ,$102.30 ,$167.40 ,$85.55 ,$167.40 ,$100.44 ,$174.84 ,$192.49 ,$171.12 ,$19.71 ,$169.26 ,$85.55 ,$114.46 ,$114.46 ,$140.99 ,$138.81 ,$167.40 ,$86.40 ,$18.59 ,$176.70 ,$89.83 ,$18.59 ,$161.82 ,$85.55 ,$167.40 ,$85.55 ,$167.40 ,$167.40 ,$167.40 ,$180.42 ,$150.66 ,$172.98 ,$159.96 ,$180.42 
SACRED HEART HOSPITAL (ACU),32000268,73580,HC XRAY KNEE ARTHRO,320,1 ,$937.00 ,$702.75 ,$39.20 ,$937.00 ,$603.43 ,$389.47 ,$655.90 ,$39.20 ,$144.39 ,$40.38 ,$115.51 ,$890.15 ,$39.20 ,$749.60 ,$862.04 ,$39.20 ,$796.45 ,$890.15 ,$824.56 ,$712.12 ,$39.20 ,$39.20 ,$39.20 ,$684.01 ,$515.35 ,$852.67 ,$852.67 ,$749.60 ,$401.15 ,$515.35 ,$843.30 ,$389.47 ,$843.30 ,$505.98 ,$880.78 ,$876.31 ,$862.04 ,$41.55 ,$852.67 ,$389.47 ,$576.63 ,$576.63 ,$394.40 ,$699.28 ,$600.66 ,$393.37 ,$39.20 ,$890.15 ,$408.94 ,$39.20 ,$815.19 ,$389.47 ,$843.30 ,$389.47 ,$843.30 ,$843.30 ,$843.30 ,$908.89 ,$758.97 ,$871.41 ,$805.82 ,$908.89 
SACRED HEART HOSPITAL (ACU),32000269,73590,HC XRAY TIBIA/FIBULA 2 VIEW,320,1 ,$211.00 ,$158.25 ,$18.59 ,$211.00 ,$135.88 ,$85.55 ,$147.70 ,$18.59 ,$33.92 ,$19.15 ,$27.13 ,$200.45 ,$18.59 ,$168.80 ,$194.12 ,$18.59 ,$179.35 ,$200.45 ,$185.68 ,$160.36 ,$18.59 ,$18.59 ,$18.59 ,$154.03 ,$116.05 ,$192.01 ,$192.01 ,$168.80 ,$88.12 ,$116.05 ,$189.90 ,$85.55 ,$189.90 ,$113.94 ,$198.34 ,$192.49 ,$194.12 ,$19.71 ,$192.01 ,$85.55 ,$129.85 ,$129.85 ,$117.61 ,$157.47 ,$136.33 ,$86.40 ,$18.59 ,$200.45 ,$89.83 ,$18.59 ,$183.57 ,$85.55 ,$189.90 ,$85.55 ,$189.90 ,$189.90 ,$189.90 ,$204.67 ,$170.91 ,$196.23 ,$181.46 ,$204.67 
SACRED HEART HOSPITAL (ACU),32000272,73592,HC XRAY INFANT LO EXTRM MIN 2V,320,1 ,$404.00 ,$303.00 ,$18.59 ,$404.00 ,$260.18 ,$85.55 ,$282.80 ,$18.59 ,$32.71 ,$19.15 ,$26.17 ,$383.80 ,$18.59 ,$323.20 ,$371.68 ,$18.59 ,$343.40 ,$383.80 ,$355.52 ,$307.04 ,$18.59 ,$18.59 ,$18.59 ,$294.92 ,$222.20 ,$367.64 ,$367.64 ,$323.20 ,$88.12 ,$222.20 ,$363.60 ,$85.55 ,$363.60 ,$218.16 ,$379.76 ,$192.49 ,$371.68 ,$19.71 ,$367.64 ,$85.55 ,$248.62 ,$248.62 ,$116.95 ,$301.51 ,$129.03 ,$86.40 ,$18.59 ,$383.80 ,$89.83 ,$18.59 ,$351.48 ,$85.55 ,$363.60 ,$85.55 ,$363.60 ,$363.60 ,$363.60 ,$391.88 ,$327.24 ,$375.72 ,$347.44 ,$391.88 
SACRED HEART HOSPITAL (ACU),32000274,73600,HC XRAY ANKLE (2 V),320,1 ,$286.00 ,$214.50 ,$18.59 ,$286.00 ,$184.18 ,$85.55 ,$200.20 ,$18.59 ,$35.72 ,$19.15 ,$28.57 ,$271.70 ,$18.59 ,$228.80 ,$263.12 ,$18.59 ,$243.10 ,$271.70 ,$251.68 ,$217.36 ,$18.59 ,$18.59 ,$18.59 ,$208.78 ,$157.30 ,$260.26 ,$260.26 ,$228.80 ,$88.12 ,$157.30 ,$257.40 ,$85.55 ,$257.40 ,$154.44 ,$268.84 ,$192.49 ,$263.12 ,$19.71 ,$260.26 ,$85.55 ,$176.00 ,$176.00 ,$90.50 ,$213.44 ,$143.57 ,$86.40 ,$18.59 ,$271.70 ,$89.83 ,$18.59 ,$248.82 ,$85.55 ,$257.40 ,$85.55 ,$257.40 ,$257.40 ,$257.40 ,$277.42 ,$231.66 ,$265.98 ,$245.96 ,$277.42 
SACRED HEART HOSPITAL (ACU),32000276,73610,HC XRAY ANKLE (MIN 3 V),320,1 ,$276.00 ,$207.00 ,$18.59 ,$276.00 ,$177.74 ,$85.55 ,$193.20 ,$18.59 ,$38.12 ,$19.15 ,$30.49 ,$262.20 ,$18.59 ,$220.80 ,$253.92 ,$18.59 ,$234.60 ,$262.20 ,$242.88 ,$209.76 ,$18.59 ,$18.59 ,$18.59 ,$201.48 ,$151.80 ,$251.16 ,$251.16 ,$220.80 ,$88.12 ,$151.80 ,$248.40 ,$85.55 ,$248.40 ,$149.04 ,$259.44 ,$192.49 ,$253.92 ,$19.71 ,$251.16 ,$85.55 ,$169.85 ,$169.85 ,$116.80 ,$205.98 ,$153.25 ,$86.40 ,$18.59 ,$262.20 ,$89.83 ,$18.59 ,$240.12 ,$85.55 ,$248.40 ,$85.55 ,$248.40 ,$248.40 ,$248.40 ,$267.72 ,$223.56 ,$256.68 ,$237.36 ,$267.72 
SACRED HEART HOSPITAL (ACU),32000278,73615,HC XRAY ARTHRO ANKLE,320,1 ,$400.00 ,$300.00 ,$39.20 ,$876.31 ,$257.60 ,$389.47 ,$280.00 ,$39.20 ,$129.38 ,$40.38 ,$103.50 ,$380.00 ,$39.20 ,$320.00 ,$368.00 ,$39.20 ,$340.00 ,$380.00 ,$352.00 ,$304.00 ,$39.20 ,$39.20 ,$39.20 ,$292.00 ,$220.00 ,$364.00 ,$364.00 ,$320.00 ,$401.15 ,$220.00 ,$360.00 ,$389.47 ,$360.00 ,$216.00 ,$376.00 ,$876.31 ,$368.00 ,$41.55 ,$364.00 ,$389.47 ,$246.16 ,$246.16 ,$321.31 ,$298.52 ,$360.00 ,$393.37 ,$39.20 ,$380.00 ,$408.94 ,$39.20 ,$348.00 ,$389.47 ,$360.00 ,$389.47 ,$360.00 ,$360.00 ,$360.00 ,$388.00 ,$324.00 ,$372.00 ,$344.00 ,$388.00 
SACRED HEART HOSPITAL (ACU),32000279,73620,HC XRAY FOOT (2 V),320,1 ,$154.00 ,$115.50 ,$18.59 ,$192.49 ,$99.18 ,$85.55 ,$107.80 ,$18.59 ,$30.31 ,$19.15 ,$24.25 ,$146.30 ,$18.59 ,$123.20 ,$141.68 ,$18.59 ,$130.90 ,$146.30 ,$135.52 ,$117.04 ,$18.59 ,$18.59 ,$18.59 ,$112.42 ,$84.70 ,$140.14 ,$140.14 ,$123.20 ,$88.12 ,$84.70 ,$138.60 ,$85.55 ,$138.60 ,$83.16 ,$144.76 ,$192.49 ,$141.68 ,$19.71 ,$140.14 ,$85.55 ,$94.77 ,$94.77 ,$91.12 ,$114.93 ,$124.26 ,$86.40 ,$18.59 ,$146.30 ,$89.83 ,$18.59 ,$133.98 ,$85.55 ,$138.60 ,$85.55 ,$138.60 ,$138.60 ,$138.60 ,$149.38 ,$124.74 ,$143.22 ,$132.44 ,$149.38 
SACRED HEART HOSPITAL (ACU),32000281,73630,HC XRAY FOOT (MIN 3 V),320,1 ,$263.00 ,$197.25 ,$18.59 ,$263.00 ,$169.37 ,$85.55 ,$184.10 ,$18.59 ,$34.51 ,$19.15 ,$27.61 ,$249.85 ,$18.59 ,$210.40 ,$241.96 ,$18.59 ,$223.55 ,$249.85 ,$231.44 ,$199.88 ,$18.59 ,$18.59 ,$18.59 ,$191.99 ,$144.65 ,$239.33 ,$239.33 ,$210.40 ,$88.12 ,$144.65 ,$236.70 ,$85.55 ,$236.70 ,$142.02 ,$247.22 ,$192.49 ,$241.96 ,$19.71 ,$239.33 ,$85.55 ,$161.85 ,$161.85 ,$116.54 ,$196.28 ,$141.18 ,$86.40 ,$18.59 ,$249.85 ,$89.83 ,$18.59 ,$228.81 ,$85.55 ,$236.70 ,$85.55 ,$236.70 ,$236.70 ,$236.70 ,$255.11 ,$213.03 ,$244.59 ,$226.18 ,$255.11 
SACRED HEART HOSPITAL (ACU),32000283,73650,HC XRAY OS CALCIS HEEL,320,1 ,$309.00 ,$231.75 ,$18.59 ,$309.00 ,$199.00 ,$85.55 ,$216.30 ,$18.59 ,$31.52 ,$19.15 ,$25.21 ,$293.55 ,$18.59 ,$247.20 ,$284.28 ,$18.59 ,$262.65 ,$293.55 ,$271.92 ,$234.84 ,$18.59 ,$18.59 ,$18.59 ,$225.57 ,$169.95 ,$281.19 ,$281.19 ,$247.20 ,$88.12 ,$169.95 ,$278.10 ,$85.55 ,$278.10 ,$166.86 ,$290.46 ,$192.49 ,$284.28 ,$19.71 ,$281.19 ,$85.55 ,$190.16 ,$190.16 ,$115.08 ,$230.61 ,$129.03 ,$86.40 ,$18.59 ,$293.55 ,$89.83 ,$18.59 ,$268.83 ,$85.55 ,$278.10 ,$85.55 ,$278.10 ,$278.10 ,$278.10 ,$299.73 ,$250.29 ,$287.37 ,$265.74 ,$299.73 
SACRED HEART HOSPITAL (ACU),32000286,73660,HC XRAY TOE MIN 2 VIEW,320,1 ,$235.00 ,$176.25 ,$18.59 ,$235.00 ,$151.34 ,$85.55 ,$164.50 ,$18.59 ,$35.72 ,$19.15 ,$28.57 ,$223.25 ,$18.59 ,$188.00 ,$216.20 ,$18.59 ,$199.75 ,$223.25 ,$206.80 ,$178.60 ,$18.59 ,$18.59 ,$18.59 ,$171.55 ,$129.25 ,$213.85 ,$213.85 ,$188.00 ,$88.12 ,$129.25 ,$211.50 ,$85.55 ,$211.50 ,$126.90 ,$220.90 ,$192.49 ,$216.20 ,$19.71 ,$213.85 ,$85.55 ,$144.62 ,$144.62 ,$107.80 ,$175.38 ,$146.02 ,$86.40 ,$18.59 ,$223.25 ,$89.83 ,$18.59 ,$204.45 ,$85.55 ,$211.50 ,$85.55 ,$211.50 ,$211.50 ,$211.50 ,$227.95 ,$190.35 ,$218.55 ,$202.10 ,$227.95 
SACRED HEART HOSPITAL (ACU),32000289,74018,HC XRAY ABDOMEN 1V,320,1 ,$269.24 ,$201.93 ,$18.59 ,$269.24 ,$173.39 ,$85.55 ,$188.47 ,$18.59 ,$30.28 ,$19.15 ,$24.22 ,$255.78 ,$18.59 ,$215.39 ,$247.70 ,$18.59 ,$228.85 ,$255.78 ,$236.93 ,$204.62 ,$18.59 ,$18.59 ,$18.59 ,$196.55 ,$148.08 ,$245.01 ,$245.01 ,$215.39 ,$88.12 ,$148.08 ,$242.32 ,$85.55 ,$242.32 ,$145.39 ,$253.09 ,$192.49 ,$247.70 ,$19.71 ,$245.01 ,$85.55 ,$165.69 ,$165.69 ,$52.71 ,$200.93 ,$189.73 ,$86.40 ,$18.59 ,$255.78 ,$89.83 ,$18.59 ,$234.24 ,$85.55 ,$242.32 ,$85.55 ,$242.32 ,$242.32 ,$242.32 ,$261.16 ,$218.08 ,$250.39 ,$231.55 ,$261.16 
SACRED HEART HOSPITAL (ACU),32000294,74019,HC XRAY ABDOMEN AP  AND  LAT (2 V OR 3 V),320,1 ,$443.46 ,$332.60 ,$18.59 ,$443.46 ,$285.59 ,$115.15 ,$310.42 ,$18.59 ,$36.28 ,$19.15 ,$29.02 ,$421.29 ,$18.59 ,$354.77 ,$407.98 ,$18.59 ,$376.94 ,$421.29 ,$390.24 ,$337.03 ,$18.59 ,$18.59 ,$18.59 ,$323.73 ,$243.90 ,$403.55 ,$403.55 ,$354.77 ,$118.60 ,$243.90 ,$399.11 ,$115.15 ,$399.11 ,$239.47 ,$416.85 ,$259.08 ,$407.98 ,$19.71 ,$403.55 ,$115.15 ,$272.91 ,$272.91 ,$64.34 ,$330.95 ,$308.87 ,$116.30 ,$18.59 ,$421.29 ,$120.90 ,$18.59 ,$385.81 ,$115.15 ,$399.11 ,$115.15 ,$399.11 ,$399.11 ,$399.11 ,$430.16 ,$359.20 ,$412.42 ,$381.38 ,$430.16 
SACRED HEART HOSPITAL (ACU),32000298,74022,HC XRAY ABDOMEN AP/DECUB/ERECT/CXR,320,1 ,$467.82 ,$350.87 ,$18.59 ,$467.82 ,$301.28 ,$115.15 ,$327.47 ,$18.59 ,$47.72 ,$19.15 ,$38.18 ,$444.43 ,$18.59 ,$374.26 ,$430.39 ,$18.59 ,$397.65 ,$444.43 ,$411.68 ,$355.54 ,$18.59 ,$18.59 ,$18.59 ,$341.51 ,$257.30 ,$425.72 ,$425.72 ,$374.26 ,$118.60 ,$257.30 ,$421.04 ,$115.15 ,$421.04 ,$252.62 ,$439.75 ,$259.08 ,$430.39 ,$19.71 ,$425.72 ,$115.15 ,$287.90 ,$287.90 ,$179.07 ,$349.13 ,$191.94 ,$116.30 ,$18.59 ,$444.43 ,$120.90 ,$18.59 ,$407.00 ,$115.15 ,$421.04 ,$115.15 ,$421.04 ,$421.04 ,$421.04 ,$453.79 ,$378.93 ,$435.07 ,$402.33 ,$453.79 
SACRED HEART HOSPITAL (ACU),32000300,74220,HC XRAY ESOPHAGUS,320,1 ,$448.97 ,$336.73 ,$18.59 ,$448.97 ,$289.14 ,$188.92 ,$314.28 ,$18.59 ,$109.57 ,$19.15 ,$87.65 ,$426.52 ,$18.59 ,$359.18 ,$413.05 ,$18.59 ,$381.62 ,$426.52 ,$395.09 ,$341.22 ,$18.59 ,$18.59 ,$18.59 ,$327.75 ,$246.93 ,$408.56 ,$408.56 ,$359.18 ,$194.59 ,$246.93 ,$404.07 ,$188.92 ,$404.07 ,$242.44 ,$422.03 ,$425.07 ,$413.05 ,$19.71 ,$408.56 ,$188.92 ,$276.30 ,$276.30 ,$195.85 ,$335.07 ,$404.07 ,$190.81 ,$18.59 ,$426.52 ,$198.37 ,$18.59 ,$390.60 ,$188.92 ,$404.07 ,$188.92 ,$404.07 ,$404.07 ,$404.07 ,$435.50 ,$363.67 ,$417.54 ,$386.11 ,$435.50 
SACRED HEART HOSPITAL (ACU),32000301,74230,HC VIDEO FLUORO SWALLOWING,320,1 ,$393.87 ,$295.40 ,$39.20 ,$425.07 ,$253.65 ,$188.92 ,$275.71 ,$39.20 ,$170.80 ,$40.38 ,$136.64 ,$374.18 ,$39.20 ,$315.10 ,$362.36 ,$39.20 ,$334.79 ,$374.18 ,$346.61 ,$299.34 ,$39.20 ,$39.20 ,$39.20 ,$287.53 ,$216.63 ,$358.42 ,$358.42 ,$315.10 ,$194.59 ,$216.63 ,$354.48 ,$188.92 ,$354.48 ,$212.69 ,$370.24 ,$425.07 ,$362.36 ,$41.55 ,$358.42 ,$188.92 ,$242.39 ,$242.39 ,$226.07 ,$293.95 ,$354.48 ,$190.81 ,$39.20 ,$374.18 ,$198.37 ,$39.20 ,$342.67 ,$188.92 ,$354.48 ,$188.92 ,$354.48 ,$354.48 ,$354.48 ,$382.05 ,$319.03 ,$366.30 ,$338.73 ,$382.05 
SACRED HEART HOSPITAL (ACU),32000302,74240,HC XRAY UPPER GI TRACT,320,1 ,$697.76 ,$523.32 ,$39.20 ,$697.76 ,$449.36 ,$188.92 ,$488.43 ,$39.20 ,$131.18 ,$40.38 ,$104.94 ,$662.87 ,$39.20 ,$558.21 ,$641.94 ,$39.20 ,$593.10 ,$662.87 ,$614.03 ,$530.30 ,$39.20 ,$39.20 ,$39.20 ,$509.36 ,$383.77 ,$634.96 ,$634.96 ,$558.21 ,$194.59 ,$383.77 ,$627.98 ,$188.92 ,$627.98 ,$376.79 ,$655.89 ,$425.07 ,$641.94 ,$41.55 ,$634.96 ,$188.92 ,$429.40 ,$429.40 ,$239.70 ,$520.74 ,$530.52 ,$190.81 ,$39.20 ,$662.87 ,$198.37 ,$39.20 ,$607.05 ,$188.92 ,$627.98 ,$188.92 ,$627.98 ,$627.98 ,$627.98 ,$676.83 ,$565.19 ,$648.92 ,$600.07 ,$676.83 
SACRED HEART HOSPITAL (ACU),32000306,74246,HC UPPER GI TRACT - NO KUB,320,1 ,$800.96 ,$600.72 ,$39.20 ,$800.96 ,$515.82 ,$188.92 ,$560.67 ,$39.20 ,$155.19 ,$40.38 ,$124.15 ,$760.91 ,$39.20 ,$640.77 ,$736.88 ,$39.20 ,$680.82 ,$760.91 ,$704.84 ,$608.73 ,$39.20 ,$39.20 ,$39.20 ,$584.70 ,$440.53 ,$728.87 ,$728.87 ,$640.77 ,$194.59 ,$440.53 ,$720.86 ,$188.92 ,$720.86 ,$432.52 ,$752.90 ,$425.07 ,$736.88 ,$41.55 ,$728.87 ,$188.92 ,$492.91 ,$492.91 ,$324.84 ,$597.76 ,$624.88 ,$190.81 ,$39.20 ,$760.91 ,$198.37 ,$39.20 ,$696.84 ,$188.92 ,$720.86 ,$188.92 ,$720.86 ,$720.86 ,$720.86 ,$776.93 ,$648.78 ,$744.89 ,$688.83 ,$776.93 
SACRED HEART HOSPITAL (ACU),32000307,74246,HC XRAY ESOPHAGUS/UGI W AIR,320,1 ,$800.96 ,$600.72 ,$39.20 ,$800.96 ,$515.82 ,$188.92 ,$560.67 ,$39.20 ,$155.19 ,$40.38 ,$124.15 ,$760.91 ,$39.20 ,$640.77 ,$736.88 ,$39.20 ,$680.82 ,$760.91 ,$704.84 ,$608.73 ,$39.20 ,$39.20 ,$39.20 ,$584.70 ,$440.53 ,$728.87 ,$728.87 ,$640.77 ,$194.59 ,$440.53 ,$720.86 ,$188.92 ,$720.86 ,$432.52 ,$752.90 ,$425.07 ,$736.88 ,$41.55 ,$728.87 ,$188.92 ,$492.91 ,$492.91 ,$324.84 ,$597.76 ,$624.88 ,$190.81 ,$39.20 ,$760.91 ,$198.37 ,$39.20 ,$696.84 ,$188.92 ,$720.86 ,$188.92 ,$720.86 ,$720.86 ,$720.86 ,$776.93 ,$648.78 ,$744.89 ,$688.83 ,$776.93 
SACRED HEART HOSPITAL (ACU),32000311,74250,HC XRAY SMALL BOWEL,320,1 ,$448.97 ,$336.73 ,$39.20 ,$448.97 ,$289.14 ,$188.92 ,$314.28 ,$39.20 ,$134.79 ,$40.38 ,$107.83 ,$426.52 ,$39.20 ,$359.18 ,$413.05 ,$39.20 ,$381.62 ,$426.52 ,$395.09 ,$341.22 ,$39.20 ,$39.20 ,$39.20 ,$327.75 ,$246.93 ,$408.56 ,$408.56 ,$359.18 ,$194.59 ,$246.93 ,$404.07 ,$188.92 ,$404.07 ,$242.44 ,$422.03 ,$425.07 ,$413.05 ,$41.55 ,$408.56 ,$188.92 ,$276.30 ,$276.30 ,$327.04 ,$335.07 ,$404.07 ,$190.81 ,$39.20 ,$426.52 ,$198.37 ,$39.20 ,$390.60 ,$188.92 ,$404.07 ,$188.92 ,$404.07 ,$404.07 ,$404.07 ,$435.50 ,$363.67 ,$417.54 ,$386.11 ,$435.50 
SACRED HEART HOSPITAL (ACU),32000312,74018,HC SITZ MARKER STUDY,320,1 ,$448.97 ,$336.73 ,$18.59 ,$448.97 ,$289.14 ,$85.55 ,$314.28 ,$18.59 ,$30.28 ,$19.15 ,$24.22 ,$426.52 ,$18.59 ,$359.18 ,$413.05 ,$18.59 ,$381.62 ,$426.52 ,$395.09 ,$341.22 ,$18.59 ,$18.59 ,$18.59 ,$327.75 ,$246.93 ,$408.56 ,$408.56 ,$359.18 ,$88.12 ,$246.93 ,$404.07 ,$85.55 ,$404.07 ,$242.44 ,$422.03 ,$192.49 ,$413.05 ,$19.71 ,$408.56 ,$85.55 ,$276.30 ,$276.30 ,$52.71 ,$335.07 ,$189.73 ,$86.40 ,$18.59 ,$426.52 ,$89.83 ,$18.59 ,$390.60 ,$85.55 ,$404.07 ,$85.55 ,$404.07 ,$404.07 ,$404.07 ,$435.50 ,$363.67 ,$417.54 ,$386.11 ,$435.50 
SACRED HEART HOSPITAL (ACU),32000314,74251,HC SMALL BOWEL VIA ENTEROCLY TUBE,320,1 ,$520.94 ,$390.71 ,$39.20 ,$520.94 ,$335.49 ,$188.92 ,$364.66 ,$39.20 ,$520.94 ,$40.38 ,$520.44 ,$494.89 ,$39.20 ,$416.75 ,$479.26 ,$39.20 ,$442.80 ,$494.89 ,$458.43 ,$395.91 ,$39.20 ,$39.20 ,$39.20 ,$380.29 ,$286.52 ,$474.06 ,$474.06 ,$416.75 ,$194.59 ,$286.52 ,$468.85 ,$188.92 ,$468.85 ,$281.31 ,$489.68 ,$425.07 ,$479.26 ,$41.55 ,$474.06 ,$188.92 ,$320.59 ,$320.59 ,$149.82 ,$388.78 ,$468.85 ,$190.81 ,$39.20 ,$494.89 ,$198.37 ,$39.20 ,$453.22 ,$188.92 ,$468.85 ,$188.92 ,$468.85 ,$468.85 ,$468.85 ,$505.31 ,$421.96 ,$484.47 ,$448.01 ,$505.31 
SACRED HEART HOSPITAL (ACU),32000315,74270,HC XRAY COLON BARIUM,320,1 ,$632.13 ,$474.10 ,$39.20 ,$632.13 ,$407.09 ,$188.92 ,$442.49 ,$39.20 ,$194.22 ,$40.38 ,$155.37 ,$600.52 ,$39.20 ,$505.70 ,$581.56 ,$39.20 ,$537.31 ,$600.52 ,$556.27 ,$480.42 ,$39.20 ,$39.20 ,$39.20 ,$461.45 ,$347.67 ,$575.24 ,$575.24 ,$505.70 ,$194.59 ,$347.67 ,$568.92 ,$188.92 ,$568.92 ,$341.35 ,$594.20 ,$425.07 ,$581.56 ,$41.55 ,$575.24 ,$188.92 ,$389.01 ,$389.01 ,$364.16 ,$471.76 ,$568.92 ,$190.81 ,$39.20 ,$600.52 ,$198.37 ,$39.20 ,$549.95 ,$188.92 ,$568.92 ,$188.92 ,$568.92 ,$568.92 ,$568.92 ,$613.17 ,$512.03 ,$587.88 ,$543.63 ,$613.17 
SACRED HEART HOSPITAL (ACU),32000319,74270,HC XRAY BARM ENEMA WATER SOL,320,1 ,$632.13 ,$474.10 ,$39.20 ,$632.13 ,$407.09 ,$188.92 ,$442.49 ,$39.20 ,$194.22 ,$40.38 ,$155.37 ,$600.52 ,$39.20 ,$505.70 ,$581.56 ,$39.20 ,$537.31 ,$600.52 ,$556.27 ,$480.42 ,$39.20 ,$39.20 ,$39.20 ,$461.45 ,$347.67 ,$575.24 ,$575.24 ,$505.70 ,$194.59 ,$347.67 ,$568.92 ,$188.92 ,$568.92 ,$341.35 ,$594.20 ,$425.07 ,$581.56 ,$41.55 ,$575.24 ,$188.92 ,$389.01 ,$389.01 ,$364.16 ,$471.76 ,$568.92 ,$190.81 ,$39.20 ,$600.52 ,$198.37 ,$39.20 ,$549.95 ,$188.92 ,$568.92 ,$188.92 ,$568.92 ,$568.92 ,$568.92 ,$613.17 ,$512.03 ,$587.88 ,$543.63 ,$613.17 
SACRED HEART HOSPITAL (ACU),32000320,74280,HC XRAY COLON BARIUM AIR CONTRAST,320,1 ,$769.62 ,$577.22 ,$39.20 ,$769.62 ,$495.64 ,$188.92 ,$538.73 ,$39.20 ,$275.89 ,$40.38 ,$220.71 ,$731.14 ,$39.20 ,$615.70 ,$708.05 ,$39.20 ,$654.18 ,$731.14 ,$677.27 ,$584.91 ,$39.20 ,$39.20 ,$39.20 ,$561.82 ,$423.29 ,$700.35 ,$700.35 ,$615.70 ,$194.59 ,$423.29 ,$692.66 ,$188.92 ,$692.66 ,$415.59 ,$723.44 ,$425.07 ,$708.05 ,$41.55 ,$700.35 ,$188.92 ,$473.62 ,$473.62 ,$440.63 ,$574.37 ,$692.66 ,$190.81 ,$39.20 ,$731.14 ,$198.37 ,$39.20 ,$669.57 ,$188.92 ,$692.66 ,$188.92 ,$692.66 ,$692.66 ,$692.66 ,$746.53 ,$623.39 ,$715.75 ,$661.87 ,$746.53 
SACRED HEART HOSPITAL (ACU),32000322,74283,HC THERAPEUTIC COLON,320,1 ,$303.00 ,$227.25 ,$39.20 ,$425.07 ,$195.13 ,$188.92 ,$212.10 ,$39.20 ,$177.42 ,$40.38 ,$141.93 ,$287.85 ,$39.20 ,$242.40 ,$278.76 ,$39.20 ,$257.55 ,$287.85 ,$266.64 ,$230.28 ,$39.20 ,$39.20 ,$39.20 ,$221.19 ,$166.65 ,$275.73 ,$275.73 ,$242.40 ,$194.59 ,$166.65 ,$272.70 ,$188.92 ,$272.70 ,$163.62 ,$284.82 ,$425.07 ,$278.76 ,$41.55 ,$275.73 ,$188.92 ,$186.47 ,$186.47 ,$233.17 ,$226.13 ,$272.70 ,$190.81 ,$39.20 ,$287.85 ,$198.37 ,$39.20 ,$263.61 ,$188.92 ,$272.70 ,$188.92 ,$272.70 ,$272.70 ,$272.70 ,$293.91 ,$245.43 ,$281.79 ,$260.58 ,$293.91 
SACRED HEART HOSPITAL (ACU),32000323,74300,HC CHOLANGIOGRAPHY OPERATIVE,320,1 ,$484.34 ,$363.26 ,$45.33 ,$484.34 ,$311.92 , N/A ,$339.04 ,$58.37 ,$56.67 ,$60.12 ,$45.33 ,$460.12 ,$58.37 ,$387.47 ,$445.59 ,$58.37 ,$411.69 ,$460.12 ,$426.22 ,$368.10 ,$58.37 ,$58.37 ,$58.37 ,$353.57 ,$266.39 ,$440.75 ,$440.75 ,$387.47 , N/A ,$266.39 ,$435.91 , N/A ,$435.91 ,$261.54 ,$455.28 , N/A ,$445.59 ,$61.87 ,$440.75 , N/A ,$298.06 ,$298.06 ,$137.45 ,$361.46 ,$125.03 , N/A ,$58.37 ,$460.12 , N/A ,$58.37 ,$421.38 , N/A ,$435.91 , N/A ,$435.91 ,$435.91 ,$435.91 ,$469.81 ,$392.32 ,$450.44 ,$416.53 ,$469.81 
SACRED HEART HOSPITAL (ACU),32000325,47531,HC XRAY CHOLANGIOGRAM THRU CATH,320,1 ,$380.00 ,$285.00 ,$205.20 ,"$7,571.16 ",$244.72 ,"$3,364.96 ",$266.00 ,$380.00 ,$315.40 ,$610.71 ,$250.80 ,$361.00 ,$592.92 ,$304.00 ,$349.60 ,$380.00 ,$323.00 ,$361.00 ,$334.40 ,$288.80 ,$380.00 ,$380.00 ,$592.92 ,$277.40 ,$209.00 ,$345.80 ,$345.80 ,$304.00 ,"$3,465.91 ",$209.00 ,$342.00 ,"$3,364.96 ",$342.00 ,$205.20 ,$357.20 ,"$7,571.16 ",$349.60 ,$628.50 ,$345.80 ,"$3,364.96 ",$233.85 ,$233.85 ,$342.00 ,$283.59 ,$264.67 ,"$3,398.61 ",$380.00 ,$361.00 ,"$3,533.21 ",$380.00 ,$330.60 ,"$3,364.96 ",$342.00 ,"$3,364.96 ",$342.00 ,$342.00 ,$342.00 ,$368.60 ,$307.80 ,$353.40 ,$326.80 ,$368.60 
SACRED HEART HOSPITAL (ACU),32000326,47532,HC PERCUTAN CHOLANGIOGRAM,320,1 ,"$1,715.00 ","$1,286.25 ",$592.92 ,"$7,571.16 ","$1,104.46 ","$3,364.96 ","$1,200.50 ",$592.92 ,"$1,423.45 ",$610.71 ,"$1,131.90 ","$1,629.25 ",$592.92 ,"$1,372.00 ","$1,577.80 ",$592.92 ,"$1,457.75 ","$1,629.25 ","$1,509.20 ","$1,303.40 ",$592.92 ,$592.92 ,$592.92 ,"$1,251.95 ",$943.25 ,"$1,560.65 ","$1,560.65 ","$1,372.00 ","$3,465.91 ",$943.25 ,"$1,543.50 ","$3,364.96 ","$1,543.50 ",$926.10 ,"$1,612.10 ","$7,571.16 ","$1,577.80 ",$628.50 ,"$1,560.65 ","$3,364.96 ","$1,055.41 ","$1,055.41 ","$1,543.50 ","$1,279.90 ","$1,194.50 ","$3,398.61 ",$592.92 ,"$1,629.25 ","$3,533.21 ",$592.92 ,"$1,492.05 ","$3,364.96 ","$1,543.50 ","$3,364.96 ","$1,543.50 ","$1,543.50 ","$1,543.50 ","$1,663.55 ","$1,389.15 ","$1,594.95 ","$1,474.90 ","$1,663.55 "
SACRED HEART HOSPITAL (ACU),32000327,47544,HC XRAY REM BILE DUCT STONE,320,1 ,"$2,858.00 ","$2,143.50 ",$817.89 ,"$2,858.00 ","$1,840.55 ", N/A ,"$2,000.60 ",$817.89 ,"$2,372.14 ",$842.43 ,"$1,886.28 ","$2,715.10 ",$817.89 ,"$2,286.40 ","$2,629.36 ",$817.89 ,"$2,429.30 ","$2,715.10 ","$2,515.04 ","$2,172.08 ",$817.89 ,$817.89 ,$817.89 ,"$2,086.34 ","$1,571.90 ","$2,600.78 ","$2,600.78 ","$2,286.40 ", N/A ,"$1,571.90 ","$2,572.20 ", N/A ,"$2,572.20 ","$1,543.32 ","$2,686.52 ", N/A ,"$2,629.36 ",$866.96 ,"$2,600.78 ", N/A ,"$1,758.81 ","$1,758.81 ","$2,572.20 ","$2,132.93 ","$1,990.60 ", N/A ,$817.89 ,"$2,715.10 ", N/A ,$817.89 ,"$2,486.46 ", N/A ,"$2,572.20 ", N/A ,"$2,572.20 ","$2,572.20 ","$2,572.20 ","$2,772.26 ","$2,314.98 ","$2,657.94 ","$2,457.88 ","$2,772.26 "
SACRED HEART HOSPITAL (ACU),32000328,74328,HC XRAY ERCP BILIARY ONLY,320,1 ,"$1,028.09 ",$771.07 ,$58.37 ,"$1,028.09 ",$662.09 , N/A ,$719.66 ,$58.37 ,$139.14 ,$60.12 ,$111.31 ,$976.69 ,$58.37 ,$822.47 ,$945.84 ,$58.37 ,$873.88 ,$976.69 ,$904.72 ,$781.35 ,$58.37 ,$58.37 ,$58.37 ,$750.51 ,$565.45 ,$935.56 ,$935.56 ,$822.47 , N/A ,$565.45 ,$925.28 , N/A ,$925.28 ,$555.17 ,$966.40 , N/A ,$945.84 ,$61.87 ,$935.56 , N/A ,$632.69 ,$632.69 ,$468.03 ,$767.26 ,$245.71 , N/A ,$58.37 ,$976.69 , N/A ,$58.37 ,$894.44 , N/A ,$925.28 , N/A ,$925.28 ,$925.28 ,$925.28 ,$997.25 ,$832.75 ,$956.12 ,$884.16 ,$997.25 
SACRED HEART HOSPITAL (ACU),32000329,74329,HC ERCP PANCREATIC,320,1 ,$851.65 ,$638.74 ,$58.37 ,$851.65 ,$548.46 , N/A ,$596.16 ,$58.37 ,$110.65 ,$60.12 ,$88.52 ,$809.07 ,$58.37 ,$681.32 ,$783.52 ,$58.37 ,$723.90 ,$809.07 ,$749.45 ,$647.25 ,$58.37 ,$58.37 ,$58.37 ,$621.70 ,$468.41 ,$775.00 ,$775.00 ,$681.32 , N/A ,$468.41 ,$766.49 , N/A ,$766.49 ,$459.89 ,$800.55 , N/A ,$783.52 ,$61.87 ,$775.00 , N/A ,$524.11 ,$524.11 ,$468.03 ,$635.59 ,$248.17 , N/A ,$58.37 ,$809.07 , N/A ,$58.37 ,$740.94 , N/A ,$766.49 , N/A ,$766.49 ,$766.49 ,$766.49 ,$826.10 ,$689.84 ,$792.03 ,$732.42 ,$826.10 
SACRED HEART HOSPITAL (ACU),32000330,74330,HC XRAY ERCP CATH BILIARY AND PANCREAS,320,1 ,"$1,029.06 ",$771.80 ,$58.37 ,"$1,029.06 ",$662.71 , N/A ,$720.34 ,$58.37 ,$205.10 ,$60.12 ,$164.08 ,$977.61 ,$58.37 ,$823.25 ,$946.74 ,$58.37 ,$874.70 ,$977.61 ,$905.57 ,$782.09 ,$58.37 ,$58.37 ,$58.37 ,$751.21 ,$565.98 ,$936.44 ,$936.44 ,$823.25 , N/A ,$565.98 ,$926.15 , N/A ,$926.15 ,$555.69 ,$967.32 , N/A ,$946.74 ,$61.87 ,$936.44 , N/A ,$633.28 ,$633.28 ,$447.07 ,$767.99 ,$316.48 , N/A ,$58.37 ,$977.61 , N/A ,$58.37 ,$895.28 , N/A ,$926.15 , N/A ,$926.15 ,$926.15 ,$926.15 ,$998.19 ,$833.54 ,$957.03 ,$884.99 ,$998.19 
SACRED HEART HOSPITAL (ACU),32000331,74340,HC INTRODUCTION LONG GI TUBE,320,1 ,"$1,418.76 ","$1,064.07 ",$58.37 ,"$1,418.76 ",$913.68 , N/A ,$993.13 ,$58.37 ,$134.94 ,$60.12 ,$107.95 ,"$1,347.82 ",$58.37 ,"$1,135.01 ","$1,305.26 ",$58.37 ,"$1,205.95 ","$1,347.82 ","$1,248.51 ","$1,078.26 ",$58.37 ,$58.37 ,$58.37 ,"$1,035.69 ",$780.32 ,"$1,291.07 ","$1,291.07 ","$1,135.01 ", N/A ,$780.32 ,"$1,276.88 ", N/A ,"$1,276.88 ",$766.13 ,"$1,333.63 ", N/A ,"$1,305.26 ",$61.87 ,"$1,291.07 ", N/A ,$873.10 ,$873.10 ,$342.29 ,"$1,058.82 ",$187.44 , N/A ,$58.37 ,"$1,347.82 ", N/A ,$58.37 ,"$1,234.32 ", N/A ,"$1,276.88 ", N/A ,"$1,276.88 ","$1,276.88 ","$1,276.88 ","$1,376.20 ","$1,149.20 ","$1,319.45 ","$1,220.13 ","$1,376.20 "
SACRED HEART HOSPITAL (ACU),32000333,74363,HC BILIARY DILITAT W OR W/O STENT,320,1 ,"$1,299.65 ",$974.74 ,$58.37 ,"$1,299.65 ",$836.97 , N/A ,$909.76 ,$58.37 ,$132.84 ,$60.12 ,$106.27 ,"$1,234.67 ",$58.37 ,"$1,039.72 ","$1,195.68 ",$58.37 ,"$1,104.70 ","$1,234.67 ","$1,143.69 ",$987.73 ,$58.37 ,$58.37 ,$58.37 ,$948.74 ,$714.81 ,"$1,182.68 ","$1,182.68 ","$1,039.72 ", N/A ,$714.81 ,"$1,169.69 ", N/A ,"$1,169.69 ",$701.81 ,"$1,221.67 ", N/A ,"$1,195.68 ",$61.87 ,"$1,182.68 ", N/A ,$799.80 ,$799.80 ,$701.39 ,$969.93 ,$294.50 , N/A ,$58.37 ,"$1,234.67 ", N/A ,$58.37 ,"$1,130.70 ", N/A ,"$1,169.69 ", N/A ,"$1,169.69 ","$1,169.69 ","$1,169.69 ","$1,260.66 ","$1,052.72 ","$1,208.67 ","$1,117.70 ","$1,260.66 "
SACRED HEART HOSPITAL (ACU),32000335,74400,HC XRAY IVP W OR W/O TOMO,320,1 ,"$1,032.10 ",$774.08 ,$39.20 ,"$1,032.10 ",$664.67 ,$188.92 ,$722.47 ,$39.20 ,$144.39 ,$40.38 ,$115.51 ,$980.50 ,$39.20 ,$825.68 ,$949.53 ,$39.20 ,$877.29 ,$980.50 ,$908.25 ,$784.40 ,$39.20 ,$39.20 ,$39.20 ,$753.43 ,$567.66 ,$939.21 ,$939.21 ,$825.68 ,$194.59 ,$567.66 ,$928.89 ,$188.92 ,$928.89 ,$557.33 ,$970.17 ,$425.07 ,$949.53 ,$41.55 ,$939.21 ,$188.92 ,$635.15 ,$635.15 ,$400.08 ,$770.26 ,$578.89 ,$190.81 ,$39.20 ,$980.50 ,$198.37 ,$39.20 ,$897.93 ,$188.92 ,$928.89 ,$188.92 ,$928.89 ,$928.89 ,$928.89 ,"$1,001.14 ",$836.00 ,$959.85 ,$887.61 ,"$1,001.14 "
SACRED HEART HOSPITAL (ACU),32000339,74420,HC XRAY UROGRAM RETROGRADE,320,1 ,$615.23 ,$461.42 ,$39.20 ,$876.31 ,$396.21 ,$389.47 ,$430.66 ,$39.20 ,$615.23 ,$40.38 ,$601.13 ,$584.47 ,$39.20 ,$492.18 ,$566.01 ,$39.20 ,$522.95 ,$584.47 ,$541.40 ,$467.57 ,$39.20 ,$39.20 ,$39.20 ,$449.12 ,$338.38 ,$559.86 ,$559.86 ,$492.18 ,$401.15 ,$338.38 ,$553.71 ,$389.47 ,$553.71 ,$332.22 ,$578.32 ,$876.31 ,$566.01 ,$41.55 ,$559.86 ,$389.47 ,$378.61 ,$378.61 ,$367.38 ,$459.15 ,$123.28 ,$393.37 ,$39.20 ,$584.47 ,$408.94 ,$39.20 ,$535.25 ,$389.47 ,$553.71 ,$389.47 ,$553.71 ,$553.71 ,$553.71 ,$596.77 ,$498.34 ,$572.16 ,$529.10 ,$596.77 
SACRED HEART HOSPITAL (ACU),32000340,74425,HC XRAY UROGRAM ANTEGRADE,320,1 ,"$1,542.06 ","$1,156.55 ",$39.20 ,"$1,542.06 ",$993.09 ,$389.47 ,"$1,079.44 ",$39.20 ,$751.42 ,$40.38 ,$601.13 ,"$1,464.96 ",$39.20 ,"$1,233.65 ","$1,418.70 ",$39.20 ,"$1,310.75 ","$1,464.96 ","$1,357.01 ","$1,171.97 ",$39.20 ,$39.20 ,$39.20 ,"$1,125.70 ",$848.13 ,"$1,403.27 ","$1,403.27 ","$1,233.65 ",$401.15 ,$848.13 ,"$1,387.85 ",$389.47 ,"$1,387.85 ",$832.71 ,"$1,449.54 ",$876.31 ,"$1,418.70 ",$41.55 ,"$1,403.27 ",$389.47 ,$948.98 ,$948.98 ,$224.91 ,"$1,150.84 ",$121.73 ,$393.37 ,$39.20 ,"$1,464.96 ",$408.94 ,$39.20 ,"$1,341.59 ",$389.47 ,"$1,387.85 ",$389.47 ,"$1,387.85 ","$1,387.85 ","$1,387.85 ","$1,495.80 ","$1,249.07 ","$1,434.12 ","$1,326.17 ","$1,495.80 "
SACRED HEART HOSPITAL (ACU),32000341,50431,HC ANGIO NEPHROSTGRAM,320,1 ,"$2,374.00 ","$1,780.50 ",$123.38 ,"$2,374.00 ","$1,528.86 ",$608.47 ,"$1,661.80 ",$123.38 ,"$1,970.42 ",$127.08 ,"$1,566.84 ","$2,255.30 ",$123.38 ,"$1,899.20 ","$2,184.08 ",$123.38 ,"$2,017.90 ","$2,255.30 ","$2,089.12 ","$1,804.24 ",$123.38 ,$123.38 ,$123.38 ,"$1,733.02 ","$1,305.70 ","$2,160.34 ","$2,160.34 ","$1,899.20 ",$626.72 ,"$1,305.70 ","$2,136.60 ",$608.47 ,"$2,136.60 ","$1,281.96 ","$2,231.56 ","$1,369.05 ","$2,184.08 ",$130.78 ,"$2,160.34 ",$608.47 ,"$1,460.96 ","$1,460.96 ","$2,136.60 ","$1,771.72 ","$1,653.49 ",$614.55 ,$123.38 ,"$2,255.30 ",$638.89 ,$123.38 ,"$2,065.38 ",$608.47 ,"$2,136.60 ",$608.47 ,"$2,136.60 ","$2,136.60 ","$2,136.60 ","$2,302.78 ","$1,922.94 ","$2,207.82 ","$2,041.64 ","$2,302.78 "
SACRED HEART HOSPITAL (ACU),32000342,74425,HC XR UROGRAM ANTE (LOOPOGRAM SVG),320,1 ,"$1,542.06 ","$1,156.55 ",$39.20 ,"$1,542.06 ",$993.09 ,$389.47 ,"$1,079.44 ",$39.20 ,$751.42 ,$40.38 ,$601.13 ,"$1,464.96 ",$39.20 ,"$1,233.65 ","$1,418.70 ",$39.20 ,"$1,310.75 ","$1,464.96 ","$1,357.01 ","$1,171.97 ",$39.20 ,$39.20 ,$39.20 ,"$1,125.70 ",$848.13 ,"$1,403.27 ","$1,403.27 ","$1,233.65 ",$401.15 ,$848.13 ,"$1,387.85 ",$389.47 ,"$1,387.85 ",$832.71 ,"$1,449.54 ",$876.31 ,"$1,418.70 ",$41.55 ,"$1,403.27 ",$389.47 ,$948.98 ,$948.98 ,$224.91 ,"$1,150.84 ",$121.73 ,$393.37 ,$39.20 ,"$1,464.96 ",$408.94 ,$39.20 ,"$1,341.59 ",$389.47 ,"$1,387.85 ",$389.47 ,"$1,387.85 ","$1,387.85 ","$1,387.85 ","$1,495.80 ","$1,249.07 ","$1,434.12 ","$1,326.17 ","$1,495.80 "
SACRED HEART HOSPITAL (ACU),32000343,74430,HC CYSTOGRAM 3+ VIEWS,320,1 ,$615.23 ,$461.42 ,$29.05 ,$876.31 ,$396.21 ,$389.47 ,$430.66 ,$39.20 ,$36.31 ,$40.38 ,$29.05 ,$584.47 ,$39.20 ,$492.18 ,$566.01 ,$39.20 ,$522.95 ,$584.47 ,$541.40 ,$467.57 ,$39.20 ,$39.20 ,$39.20 ,$449.12 ,$338.38 ,$559.86 ,$559.86 ,$492.18 ,$401.15 ,$338.38 ,$553.71 ,$389.47 ,$553.71 ,$332.22 ,$578.32 ,$876.31 ,$566.01 ,$41.55 ,$559.86 ,$389.47 ,$378.61 ,$378.61 ,$177.32 ,$459.15 ,$148.41 ,$393.37 ,$39.20 ,$584.47 ,$408.94 ,$39.20 ,$535.25 ,$389.47 ,$553.71 ,$389.47 ,$553.71 ,$553.71 ,$553.71 ,$596.77 ,$498.34 ,$572.16 ,$529.10 ,$596.77 
SACRED HEART HOSPITAL (ACU),32000344,74450,HC CYSTOURETHROGRAM RETROGRADE,320,1 ,$692.37 ,$519.28 ,$39.20 ,$692.37 ,$445.89 ,$243.36 ,$484.66 ,$39.20 ,$87.87 ,$40.38 ,$301.88 ,$657.75 ,$39.20 ,$553.90 ,$636.98 ,$39.20 ,$588.51 ,$657.75 ,$609.29 ,$526.20 ,$39.20 ,$39.20 ,$39.20 ,$505.43 ,$380.80 ,$630.06 ,$630.06 ,$553.90 ,$250.66 ,$380.80 ,$623.13 ,$243.36 ,$623.13 ,$373.88 ,$650.83 ,$547.56 ,$636.98 ,$41.55 ,$630.06 ,$243.36 ,$426.08 ,$426.08 ,$217.86 ,$516.72 ,$114.15 ,$245.79 ,$39.20 ,$657.75 ,$255.53 ,$39.20 ,$602.36 ,$243.36 ,$623.13 ,$243.36 ,$623.13 ,$623.13 ,$623.13 ,$671.60 ,$560.82 ,$643.90 ,$595.44 ,$671.60 
SACRED HEART HOSPITAL (ACU),32000346,74455,HC XRAY VOID CYSTOURETHGRAM,320,1 ,$709.39 ,$532.04 ,$39.20 ,$709.39 ,$456.85 ,$243.36 ,$496.57 ,$39.20 ,$110.16 ,$40.38 ,$88.13 ,$673.92 ,$39.20 ,$567.51 ,$652.64 ,$39.20 ,$602.98 ,$673.92 ,$624.26 ,$539.14 ,$39.20 ,$39.20 ,$39.20 ,$517.85 ,$390.16 ,$645.54 ,$645.54 ,$567.51 ,$250.66 ,$390.16 ,$638.45 ,$243.36 ,$638.45 ,$383.07 ,$666.83 ,$547.56 ,$652.64 ,$41.55 ,$645.54 ,$243.36 ,$436.56 ,$436.56 ,$243.48 ,$529.42 ,$448.32 ,$245.79 ,$39.20 ,$673.92 ,$255.53 ,$39.20 ,$617.17 ,$243.36 ,$638.45 ,$243.36 ,$638.45 ,$638.45 ,$638.45 ,$688.11 ,$574.61 ,$659.73 ,$610.08 ,$688.11 
SACRED HEART HOSPITAL (ACU),32000348,74470,HC RENAL CYST STUDY S AND I,320,1 ,$648.41 ,$486.31 ,$39.20 ,"$1,149.84 ",$417.58 ,$511.04 ,$453.89 ,$39.20 ,$75.25 ,$40.38 ,$301.88 ,$615.99 ,$39.20 ,$518.73 ,$596.54 ,$39.20 ,$551.15 ,$615.99 ,$570.60 ,$492.79 ,$39.20 ,$39.20 ,$39.20 ,$473.34 ,$356.63 ,$590.05 ,$590.05 ,$518.73 ,$526.37 ,$356.63 ,$583.57 ,$511.04 ,$583.57 ,$350.14 ,$609.51 ,"$1,149.84 ",$596.54 ,$41.55 ,$590.05 ,$511.04 ,$399.03 ,$399.03 ,$255.13 ,$483.91 ,$182.67 ,$516.15 ,$39.20 ,$615.99 ,$536.59 ,$39.20 ,$564.12 ,$511.04 ,$583.57 ,$511.04 ,$583.57 ,$583.57 ,$583.57 ,$628.96 ,$525.21 ,$603.02 ,$557.63 ,$628.96 
SACRED HEART HOSPITAL (ACU),32000349,50432,HC PERCUTANEOUS NEPHRO CATH PLCMT,320,1 ,"$4,168.46 ","$3,126.35 ",$490.07 ,"$4,260.86 ","$2,684.49 ","$1,893.71 ","$2,917.92 ",$490.07 ,"$3,459.82 ",$504.77 ,"$2,751.18 ","$3,960.04 ",$490.07 ,"$3,334.77 ","$3,834.98 ",$490.07 ,"$3,543.19 ","$3,960.04 ","$3,668.24 ","$3,168.03 ",$490.07 ,$490.07 ,$490.07 ,"$3,042.98 ","$2,292.65 ","$3,793.30 ","$3,793.30 ","$3,334.77 ","$1,950.52 ","$2,292.65 ","$3,751.61 ","$1,893.71 ","$3,751.61 ","$2,250.97 ","$3,918.35 ","$4,260.86 ","$3,834.98 ",$519.47 ,"$3,793.30 ","$1,893.71 ","$2,565.27 ","$2,565.27 ","$3,751.61 ","$3,110.92 ","$2,903.33 ","$1,912.65 ",$490.07 ,"$3,960.04 ","$1,988.40 ",$490.07 ,"$3,626.56 ","$1,893.71 ","$3,751.61 ","$1,893.71 ","$3,751.61 ","$3,751.61 ","$3,751.61 ","$4,043.41 ","$3,376.45 ","$3,876.67 ","$3,584.88 ","$4,043.41 "
SACRED HEART HOSPITAL (ACU),32000352,74485,"HC DILITATN NEPHRO,URETER,URETHRA",320,1 ,"$1,801.49 ","$1,351.12 ",$58.37 ,"$4,260.86 ","$1,160.16 ","$1,893.71 ","$1,261.04 ",$58.37 ,$110.76 ,$60.12 ,$88.61 ,"$1,711.42 ",$58.37 ,"$1,441.19 ","$1,657.37 ",$58.37 ,"$1,531.27 ","$1,711.42 ","$1,585.31 ","$1,369.13 ",$58.37 ,$58.37 ,$58.37 ,"$1,315.09 ",$990.82 ,"$1,639.36 ","$1,639.36 ","$1,441.19 ","$1,950.52 ",$990.82 ,"$1,621.34 ","$1,893.71 ","$1,621.34 ",$972.80 ,"$1,693.40 ","$4,260.86 ","$1,657.37 ",$61.87 ,"$1,639.36 ","$1,893.71 ","$1,108.64 ","$1,108.64 ",$469.86 ,"$1,344.45 ",$453.16 ,"$1,912.65 ",$58.37 ,"$1,711.42 ","$1,988.40 ",$58.37 ,"$1,567.30 ","$1,893.71 ","$1,621.34 ","$1,893.71 ","$1,621.34 ","$1,621.34 ","$1,621.34 ","$1,747.45 ","$1,459.21 ","$1,675.39 ","$1,549.28 ","$1,747.45 "
SACRED HEART HOSPITAL (ACU),32000354,74740,HC XRAY HYSTEROSALPINGOGRAP,320,1 ,"$1,349.35 ","$1,012.01 ",$39.20 ,"$1,349.35 ",$868.98 ,$243.36 ,$944.55 ,$39.20 ,$93.96 ,$40.38 ,$75.17 ,"$1,281.88 ",$39.20 ,"$1,079.48 ","$1,241.40 ",$39.20 ,"$1,146.95 ","$1,281.88 ","$1,187.43 ","$1,025.51 ",$39.20 ,$39.20 ,$39.20 ,$985.03 ,$742.14 ,"$1,227.91 ","$1,227.91 ","$1,079.48 ",$250.66 ,$742.14 ,"$1,214.42 ",$243.36 ,"$1,214.42 ",$728.65 ,"$1,268.39 ",$547.56 ,"$1,241.40 ",$41.55 ,"$1,227.91 ",$243.36 ,$830.39 ,$830.39 ,$277.54 ,"$1,007.02 ",$378.18 ,$245.79 ,$39.20 ,"$1,281.88 ",$255.53 ,$39.20 ,"$1,173.93 ",$243.36 ,"$1,214.42 ",$243.36 ,"$1,214.42 ","$1,214.42 ","$1,214.42 ","$1,308.87 ","$1,092.97 ","$1,254.90 ","$1,160.44 ","$1,308.87 "
SACRED HEART HOSPITAL (ACU),32000355,75605,HC THORACIC AORTA,320,1 ,$819.00 ,$614.25 ,$110.71 ,"$11,347.95 ",$527.44 ,"$5,043.53 ",$573.30 ,$819.00 ,$138.39 ,"$1,376.81 ",$110.71 ,$778.05 ,"$1,336.71 ",$655.20 ,$753.48 ,$819.00 ,$696.15 ,$778.05 ,$720.72 ,$622.44 ,$819.00 ,$819.00 ,"$1,336.71 ",$597.87 ,$450.45 ,$745.29 ,$745.29 ,$655.20 ,"$5,194.84 ",$450.45 ,$737.10 ,"$5,043.53 ",$737.10 ,$442.26 ,$769.86 ,"$11,347.95 ",$753.48 ,"$1,416.91 ",$745.29 ,"$5,043.53 ",$504.01 ,$504.01 ,$596.51 ,$611.22 ,$559.59 ,"$5,093.97 ",$819.00 ,$778.05 ,"$5,295.71 ",$819.00 ,$712.53 ,"$5,043.53 ",$737.10 ,"$5,043.53 ",$737.10 ,$737.10 ,$737.10 ,$794.43 ,$663.39 ,$761.67 ,$704.34 ,$794.43 
SACRED HEART HOSPITAL (ACU),32000356,75625,HC ABDOMINAL AORTAGRAM 75625,320,1 ,"$4,029.00 ","$3,021.75 ",$109.75 ,"$6,812.22 ","$2,594.68 ","$3,027.65 ","$2,820.30 ",$592.92 ,$137.18 ,$610.71 ,$109.75 ,"$3,827.55 ",$592.92 ,"$3,223.20 ","$3,706.68 ",$592.92 ,"$3,424.65 ","$3,827.55 ","$3,545.52 ","$3,062.04 ",$592.92 ,$592.92 ,$592.92 ,"$2,941.17 ","$2,215.95 ","$3,666.39 ","$3,666.39 ","$3,223.20 ","$3,118.48 ","$2,215.95 ","$3,626.10 ","$3,027.65 ","$3,626.10 ","$2,175.66 ","$3,787.26 ","$6,812.22 ","$3,706.68 ",$628.50 ,"$3,666.39 ","$3,027.65 ","$2,479.45 ","$2,479.45 ",$828.31 ,"$3,006.84 ",$552.29 ,"$3,057.93 ",$592.92 ,"$3,827.55 ","$3,179.04 ",$592.92 ,"$3,505.23 ","$3,027.65 ","$3,626.10 ","$3,027.65 ","$3,626.10 ","$3,626.10 ","$3,626.10 ","$3,908.13 ","$3,263.49 ","$3,746.97 ","$3,464.94 ","$3,908.13 "
SACRED HEART HOSPITAL (ACU),32000357,75630,HC AORTA WITH RUNOFF 75630,320,1 ,"$2,303.00 ","$1,727.25 ",$110.71 ,"$6,812.22 ","$1,483.13 ","$3,027.65 ","$1,612.10 ",$592.92 ,$138.39 ,$610.71 ,$110.71 ,"$2,187.85 ",$592.92 ,"$1,842.40 ","$2,118.76 ",$592.92 ,"$1,957.55 ","$2,187.85 ","$2,026.64 ","$1,750.28 ",$592.92 ,$592.92 ,$592.92 ,"$1,681.19 ","$1,266.65 ","$2,095.73 ","$2,095.73 ","$1,842.40 ","$3,118.48 ","$1,266.65 ","$2,072.70 ","$3,027.65 ","$2,072.70 ","$1,243.62 ","$2,164.82 ","$6,812.22 ","$2,118.76 ",$628.50 ,"$2,095.73 ","$3,027.65 ","$1,417.27 ","$1,417.27 ","$1,189.90 ","$1,718.73 ",$559.59 ,"$3,057.93 ",$592.92 ,"$2,187.85 ","$3,179.04 ",$592.92 ,"$2,003.61 ","$3,027.65 ","$2,072.70 ","$3,027.65 ","$2,072.70 ","$2,072.70 ","$2,072.70 ","$2,233.91 ","$1,865.43 ","$2,141.79 ","$1,980.58 ","$2,233.91 "
SACRED HEART HOSPITAL (ACU),32000370,75705,HC ANGIO SPINAL,320,1 ,"$2,377.00 ","$1,782.75 ",$178.18 ,"$11,347.95 ","$1,530.79 ","$5,043.53 ","$1,663.90 ","$1,336.71 ",$222.72 ,"$1,376.81 ",$178.18 ,"$2,258.15 ","$1,336.71 ","$1,901.60 ","$2,186.84 ","$1,336.71 ","$2,020.45 ","$2,258.15 ","$2,091.76 ","$1,806.52 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$1,735.21 ","$1,307.35 ","$2,163.07 ","$2,163.07 ","$1,901.60 ","$5,194.84 ","$1,307.35 ","$2,139.30 ","$5,043.53 ","$2,139.30 ","$1,283.58 ","$2,234.38 ","$11,347.95 ","$2,186.84 ","$1,416.91 ","$2,163.07 ","$5,043.53 ","$1,462.81 ","$1,462.81 ","$1,324.83 ","$1,773.96 ",$937.77 ,"$5,093.97 ","$1,336.71 ","$2,258.15 ","$5,295.71 ","$1,336.71 ","$2,067.99 ","$5,043.53 ","$2,139.30 ","$5,043.53 ","$2,139.30 ","$2,139.30 ","$2,139.30 ","$2,305.69 ","$1,925.37 ","$2,210.61 ","$2,044.22 ","$2,305.69 "
SACRED HEART HOSPITAL (ACU),32000371,75710,HC ANGIO EXTREMITY UNI 75710,320,1 ,"$3,074.00 ","$2,305.50 ",$142.63 ,"$6,812.22 ","$1,979.66 ","$3,027.65 ","$2,151.80 ",$592.92 ,$178.29 ,$610.71 ,$142.63 ,"$2,920.30 ",$592.92 ,"$2,459.20 ","$2,828.08 ",$592.92 ,"$2,612.90 ","$2,920.30 ","$2,705.12 ","$2,336.24 ",$592.92 ,$592.92 ,$592.92 ,"$2,244.02 ","$1,690.70 ","$2,797.34 ","$2,797.34 ","$2,459.20 ","$3,118.48 ","$1,690.70 ","$2,766.60 ","$3,027.65 ","$2,766.60 ","$1,659.96 ","$2,889.56 ","$6,812.22 ","$2,828.08 ",$628.50 ,"$2,797.34 ","$3,027.65 ","$1,891.74 ","$1,891.74 ",$869.77 ,"$2,294.13 ",$583.74 ,"$3,057.93 ",$592.92 ,"$2,920.30 ","$3,179.04 ",$592.92 ,"$2,674.38 ","$3,027.65 ","$2,766.60 ","$3,027.65 ","$2,766.60 ","$2,766.60 ","$2,766.60 ","$2,981.78 ","$2,489.94 ","$2,858.82 ","$2,643.64 ","$2,981.78 "
SACRED HEART HOSPITAL (ACU),32000372,75710,HC ANGIO EXTREMITY UNI OR,320,1 ,"$4,540.00 ","$3,405.00 ",$142.63 ,"$6,812.22 ","$2,923.76 ","$3,027.65 ","$3,178.00 ",$592.92 ,$178.29 ,$610.71 ,$142.63 ,"$4,313.00 ",$592.92 ,"$3,632.00 ","$4,176.80 ",$592.92 ,"$3,859.00 ","$4,313.00 ","$3,995.20 ","$3,450.40 ",$592.92 ,$592.92 ,$592.92 ,"$3,314.20 ","$2,497.00 ","$4,131.40 ","$4,131.40 ","$3,632.00 ","$3,118.48 ","$2,497.00 ","$4,086.00 ","$3,027.65 ","$4,086.00 ","$2,451.60 ","$4,267.60 ","$6,812.22 ","$4,176.80 ",$628.50 ,"$4,131.40 ","$3,027.65 ","$2,793.92 ","$2,793.92 ",$869.77 ,"$3,388.20 ",$583.74 ,"$3,057.93 ",$592.92 ,"$4,313.00 ","$3,179.04 ",$592.92 ,"$3,949.80 ","$3,027.65 ","$4,086.00 ","$3,027.65 ","$4,086.00 ","$4,086.00 ","$4,086.00 ","$4,403.80 ","$3,677.40 ","$4,222.20 ","$3,904.40 ","$4,403.80 "
SACRED HEART HOSPITAL (ACU),32000373,75716,HC ANGIO EXTREMITY BILAT 75716,320,1 ,"$3,322.00 ","$2,491.50 ",$164.96 ,"$6,812.22 ","$2,139.37 ","$3,027.65 ","$2,325.40 ",$592.92 ,$206.20 ,$610.71 ,$164.96 ,"$3,155.90 ",$592.92 ,"$2,657.60 ","$3,056.24 ",$592.92 ,"$2,823.70 ","$3,155.90 ","$2,923.36 ","$2,524.72 ",$592.92 ,$592.92 ,$592.92 ,"$2,425.06 ","$1,827.10 ","$3,023.02 ","$3,023.02 ","$2,657.60 ","$3,118.48 ","$1,827.10 ","$2,989.80 ","$3,027.65 ","$2,989.80 ","$1,793.88 ","$3,122.68 ","$6,812.22 ","$3,056.24 ",$628.50 ,"$3,023.02 ","$3,027.65 ","$2,044.36 ","$2,044.36 ","$1,220.58 ","$2,479.21 ",$673.25 ,"$3,057.93 ",$592.92 ,"$3,155.90 ","$3,179.04 ",$592.92 ,"$2,890.14 ","$3,027.65 ","$2,989.80 ","$3,027.65 ","$2,989.80 ","$2,989.80 ","$2,989.80 ","$3,222.34 ","$2,690.82 ","$3,089.46 ","$2,856.92 ","$3,222.34 "
SACRED HEART HOSPITAL (ACU),32000375,36251,HC ANGIO SEL RENAL UNILA 36251,320,1 ,"$6,763.00 ","$5,072.25 ","$1,336.71 ","$6,812.22 ","$4,355.37 ","$3,027.65 ","$4,734.10 ","$1,336.71 ","$5,613.29 ","$1,376.81 ","$4,463.58 ","$6,424.85 ","$1,336.71 ","$5,410.40 ","$6,221.96 ","$1,336.71 ","$5,748.55 ","$6,424.85 ","$5,951.44 ","$5,139.88 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$4,936.99 ","$3,719.65 ","$6,154.33 ","$6,154.33 ","$5,410.40 ","$3,118.48 ","$3,719.65 ","$6,086.70 ","$3,027.65 ","$6,086.70 ","$3,652.02 ","$6,357.22 ","$6,812.22 ","$6,221.96 ","$1,416.91 ","$6,154.33 ","$3,027.65 ","$4,161.95 ","$4,161.95 ","$6,086.70 ","$5,047.23 ","$4,710.43 ","$3,057.93 ","$1,336.71 ","$6,424.85 ","$3,179.04 ","$1,336.71 ","$5,883.81 ","$3,027.65 ","$6,086.70 ","$3,027.65 ","$6,086.70 ","$6,086.70 ","$6,086.70 ","$6,560.11 ","$5,478.03 ","$6,289.59 ","$5,816.18 ","$6,560.11 "
SACRED HEART HOSPITAL (ACU),32000376,36252,HC ANGIO SEL RENAL BILAT 36252,320,1 ,"$7,582.00 ","$5,686.50 ","$1,336.71 ","$7,582.00 ","$4,882.81 ","$3,027.65 ","$5,307.40 ","$1,336.71 ","$6,293.06 ","$1,376.81 ","$5,004.12 ","$7,202.90 ","$1,336.71 ","$6,065.60 ","$6,975.44 ","$1,336.71 ","$6,444.70 ","$7,202.90 ","$6,672.16 ","$5,762.32 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$5,534.86 ","$4,170.10 ","$6,899.62 ","$6,899.62 ","$6,065.60 ","$3,118.48 ","$4,170.10 ","$6,823.80 ","$3,027.65 ","$6,823.80 ","$4,094.28 ","$7,127.08 ","$6,812.22 ","$6,975.44 ","$1,416.91 ","$6,899.62 ","$3,027.65 ","$4,665.96 ","$4,665.96 ","$6,823.80 ","$5,658.45 ","$5,280.86 ","$3,057.93 ","$1,336.71 ","$7,202.90 ","$3,179.04 ","$1,336.71 ","$6,596.34 ","$3,027.65 ","$6,823.80 ","$3,027.65 ","$6,823.80 ","$6,823.80 ","$6,823.80 ","$7,354.54 ","$6,141.42 ","$7,051.26 ","$6,520.52 ","$7,354.54 "
SACRED HEART HOSPITAL (ACU),32000378,75726,"HC ANGIO VISERAL, SEL, OR SUPRASEL 75726",320,1 ,"$3,547.00 ","$2,660.25 ",$126.56 ,"$11,347.95 ","$2,284.27 ","$5,043.53 ","$2,482.90 ","$1,336.71 ",$158.20 ,"$1,376.81 ",$126.56 ,"$3,369.65 ","$1,336.71 ","$2,837.60 ","$3,263.24 ","$1,336.71 ","$3,014.95 ","$3,369.65 ","$3,121.36 ","$2,695.72 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$2,589.31 ","$1,950.85 ","$3,227.77 ","$3,227.77 ","$2,837.60 ","$5,194.84 ","$1,950.85 ","$3,192.30 ","$5,043.53 ","$3,192.30 ","$1,915.38 ","$3,334.18 ","$11,347.95 ","$3,263.24 ","$1,416.91 ","$3,227.77 ","$5,043.53 ","$2,182.82 ","$2,182.82 ","$1,294.35 ","$2,647.13 ",$639.41 ,"$5,093.97 ","$1,336.71 ","$3,369.65 ","$5,295.71 ","$1,336.71 ","$3,085.89 ","$5,043.53 ","$3,192.30 ","$5,043.53 ","$3,192.30 ","$3,192.30 ","$3,192.30 ","$3,440.59 ","$2,873.07 ","$3,298.71 ","$3,050.42 ","$3,440.59 "
SACRED HEART HOSPITAL (ACU),32000382,75731,HC ANGIO ADRENAL UNILATERAL,320,1 ,"$1,151.00 ",$863.25 ,$154.17 ,"$6,812.22 ",$741.24 ,"$3,027.65 ",$805.70 ,$592.92 ,$192.71 ,$610.71 ,$154.17 ,"$1,093.45 ",$592.92 ,$920.80 ,"$1,058.92 ",$592.92 ,$978.35 ,"$1,093.45 ","$1,012.88 ",$874.76 ,$592.92 ,$592.92 ,$592.92 ,$840.23 ,$633.05 ,"$1,047.41 ","$1,047.41 ",$920.80 ,"$3,118.48 ",$633.05 ,"$1,035.90 ","$3,027.65 ","$1,035.90 ",$621.54 ,"$1,081.94 ","$6,812.22 ","$1,058.92 ",$628.50 ,"$1,047.41 ","$3,027.65 ",$708.33 ,$708.33 ,"$1,151.00 ",$858.99 ,$780.52 ,"$3,057.93 ",$592.92 ,"$1,093.45 ","$3,179.04 ",$592.92 ,"$1,001.37 ","$3,027.65 ","$1,035.90 ","$3,027.65 ","$1,035.90 ","$1,035.90 ","$1,035.90 ","$1,116.47 ",$932.31 ,"$1,070.43 ",$989.86 ,"$1,116.47 "
SACRED HEART HOSPITAL (ACU),32000383,75733,HC ANGIO ADRENAL BILATERAL,320,1 ,"$1,218.00 ",$913.50 ,$164.49 ,"$6,812.22 ",$784.39 ,"$3,027.65 ",$852.60 ,$592.92 ,$205.61 ,$610.71 ,$164.49 ,"$1,157.10 ",$592.92 ,$974.40 ,"$1,120.56 ",$592.92 ,"$1,035.30 ","$1,157.10 ","$1,071.84 ",$925.68 ,$592.92 ,$592.92 ,$592.92 ,$889.14 ,$669.90 ,"$1,108.38 ","$1,108.38 ",$974.40 ,"$3,118.48 ",$669.90 ,"$1,096.20 ","$3,027.65 ","$1,096.20 ",$657.72 ,"$1,144.92 ","$6,812.22 ","$1,120.56 ",$628.50 ,"$1,108.38 ","$3,027.65 ",$749.56 ,$749.56 ,"$1,218.00 ",$908.99 ,$822.57 ,"$3,057.93 ",$592.92 ,"$1,157.10 ","$3,179.04 ",$592.92 ,"$1,059.66 ","$3,027.65 ","$1,096.20 ","$3,027.65 ","$1,096.20 ","$1,096.20 ","$1,096.20 ","$1,181.46 ",$986.58 ,"$1,132.74 ","$1,047.48 ","$1,181.46 "
SACRED HEART HOSPITAL (ACU),32000384,75736,HC ANGIO PELVIC SELECT,320,1 ,"$2,664.00 ","$1,998.00 ",$141.20 ,"$11,347.95 ","$1,715.62 ","$5,043.53 ","$1,864.80 ","$1,336.71 ",$176.51 ,"$1,376.81 ",$141.20 ,"$2,530.80 ","$1,336.71 ","$2,131.20 ","$2,450.88 ","$1,336.71 ","$2,264.40 ","$2,530.80 ","$2,344.32 ","$2,024.64 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$1,944.72 ","$1,465.20 ","$2,424.24 ","$2,424.24 ","$2,131.20 ","$5,194.84 ","$1,465.20 ","$2,397.60 ","$5,043.53 ","$2,397.60 ","$1,438.56 ","$2,504.16 ","$11,347.95 ","$2,450.88 ","$1,416.91 ","$2,424.24 ","$5,043.53 ","$1,639.43 ","$1,639.43 ","$1,294.35 ","$1,988.14 ",$712.84 ,"$5,093.97 ","$1,336.71 ","$2,530.80 ","$5,295.71 ","$1,336.71 ","$2,317.68 ","$5,043.53 ","$2,397.60 ","$5,043.53 ","$2,397.60 ","$2,397.60 ","$2,397.60 ","$2,584.08 ","$2,157.84 ","$2,477.52 ","$2,291.04 ","$2,584.08 "
SACRED HEART HOSPITAL (ACU),32000385,75741,HC ANGIO PULMONARY UNILAT,320,1 ,"$2,127.00 ","$1,595.25 ",$117.43 ,"$6,812.22 ","$1,369.79 ","$3,027.65 ","$1,488.90 ",$592.92 ,$146.79 ,$610.71 ,$117.43 ,"$2,020.65 ",$592.92 ,"$1,701.60 ","$1,956.84 ",$592.92 ,"$1,807.95 ","$2,020.65 ","$1,871.76 ","$1,616.52 ",$592.92 ,$592.92 ,$592.92 ,"$1,552.71 ","$1,169.85 ","$1,935.57 ","$1,935.57 ","$1,701.60 ","$3,118.48 ","$1,169.85 ","$1,914.30 ","$3,027.65 ","$1,914.30 ","$1,148.58 ","$1,999.38 ","$6,812.22 ","$1,956.84 ",$628.50 ,"$1,935.57 ","$3,027.65 ","$1,308.96 ","$1,308.96 ","$1,139.22 ","$1,587.38 ",$591.04 ,"$3,057.93 ",$592.92 ,"$2,020.65 ","$3,179.04 ",$592.92 ,"$1,850.49 ","$3,027.65 ","$1,914.30 ","$3,027.65 ","$1,914.30 ","$1,914.30 ","$1,914.30 ","$2,063.19 ","$1,722.87 ","$1,978.11 ","$1,829.22 ","$2,063.19 "
SACRED HEART HOSPITAL (ACU),32000386,75743,HC ANGIO PULMONARY BILAT,320,1 ,"$2,293.00 ","$1,719.75 ",$118.87 ,"$6,812.22 ","$1,476.69 ","$3,027.65 ","$1,605.10 ",$592.92 ,$148.59 ,$610.71 ,$118.87 ,"$2,178.35 ",$592.92 ,"$1,834.40 ","$2,109.56 ",$592.92 ,"$1,949.05 ","$2,178.35 ","$2,017.84 ","$1,742.68 ",$592.92 ,$592.92 ,$592.92 ,"$1,673.89 ","$1,261.15 ","$2,086.63 ","$2,086.63 ","$1,834.40 ","$3,118.48 ","$1,261.15 ","$2,063.70 ","$3,027.65 ","$2,063.70 ","$1,238.22 ","$2,155.42 ","$6,812.22 ","$2,109.56 ",$628.50 ,"$2,086.63 ","$3,027.65 ","$1,411.11 ","$1,411.11 ","$1,335.32 ","$1,711.27 ",$598.27 ,"$3,057.93 ",$592.92 ,"$2,178.35 ","$3,179.04 ",$592.92 ,"$1,994.91 ","$3,027.65 ","$2,063.70 ","$3,027.65 ","$2,063.70 ","$2,063.70 ","$2,063.70 ","$2,224.21 ","$1,857.33 ","$2,132.49 ","$1,971.98 ","$2,224.21 "
SACRED HEART HOSPITAL (ACU),32000387,75746,HC ANGIO PULMONARY NONSELECT,320,1 ,"$1,548.00 ","$1,161.00 ",$130.89 ,"$6,812.22 ",$996.91 ,"$3,027.65 ","$1,083.60 ",$592.92 ,$163.61 ,$610.71 ,$130.89 ,"$1,470.60 ",$592.92 ,"$1,238.40 ","$1,424.16 ",$592.92 ,"$1,315.80 ","$1,470.60 ","$1,362.24 ","$1,176.48 ",$592.92 ,$592.92 ,$592.92 ,"$1,130.04 ",$851.40 ,"$1,408.68 ","$1,408.68 ","$1,238.40 ","$3,118.48 ",$851.40 ,"$1,393.20 ","$3,027.65 ","$1,393.20 ",$835.92 ,"$1,455.12 ","$6,812.22 ","$1,424.16 ",$628.50 ,"$1,408.68 ","$3,027.65 ",$952.64 ,$952.64 ,$828.31 ,"$1,155.27 ",$652.33 ,"$3,057.93 ",$592.92 ,"$1,470.60 ","$3,179.04 ",$592.92 ,"$1,346.76 ","$3,027.65 ","$1,393.20 ","$3,027.65 ","$1,393.20 ","$1,393.20 ","$1,393.20 ","$1,501.56 ","$1,253.88 ","$1,439.64 ","$1,331.28 ","$1,501.56 "
SACRED HEART HOSPITAL (ACU),32000389,75774,HC ANGIO EA VESSEL ADDL 75774,320,1 ,"$1,999.00 ","$1,499.25 ",$92.93 ,"$1,999.00 ","$1,287.36 ", N/A ,"$1,399.30 ","$1,336.71 ",$116.17 ,"$1,376.81 ",$92.93 ,"$1,899.05 ","$1,336.71 ","$1,599.20 ","$1,839.08 ","$1,336.71 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ", N/A ,"$1,099.45 ","$1,799.10 ", N/A ,"$1,799.10 ","$1,079.46 ","$1,879.06 ", N/A ,"$1,839.08 ","$1,416.91 ","$1,819.09 ", N/A ,"$1,230.18 ","$1,230.18 ",$518.56 ,"$1,491.85 ",$472.54 , N/A ,"$1,336.71 ","$1,899.05 ", N/A ,"$1,336.71 ","$1,739.13 ", N/A ,"$1,799.10 ", N/A ,"$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),32000394,75810,HC SPLENOPORTOGRAPHY,320,1 ,$634.00 ,$475.50 ,$273.54 ,"$6,812.22 ",$408.30 ,"$3,027.65 ",$443.80 ,$273.54 ,$634.00 ,$281.75 ,$634.00 ,$602.30 ,$273.54 ,$507.20 ,$583.28 ,$273.54 ,$538.90 ,$602.30 ,$557.92 ,$481.84 ,$273.54 ,$273.54 ,$273.54 ,$462.82 ,$348.70 ,$576.94 ,$576.94 ,$507.20 ,"$3,118.48 ",$348.70 ,$570.60 ,"$3,027.65 ",$570.60 ,$342.36 ,$595.96 ,"$6,812.22 ",$583.28 ,$289.95 ,$576.94 ,"$3,027.65 ",$390.16 ,$390.16 ,$634.00 ,$473.15 ,$376.50 ,"$3,057.93 ",$273.54 ,$602.30 ,"$3,179.04 ",$273.54 ,$551.58 ,"$3,027.65 ",$570.60 ,"$3,027.65 ",$570.60 ,$570.60 ,$570.60 ,$614.98 ,$513.54 ,$589.62 ,$545.24 ,$614.98 
SACRED HEART HOSPITAL (ACU),32000395,75820,HC VENOGRAM EXTREMITY UNI 75820,320,1 ,$957.00 ,$717.75 ,$108.78 ,"$3,346.33 ",$616.31 ,"$1,487.26 ",$669.90 ,$273.54 ,$135.98 ,$281.75 ,$108.78 ,$909.15 ,$273.54 ,$765.60 ,$880.44 ,$273.54 ,$813.45 ,$909.15 ,$842.16 ,$727.32 ,$273.54 ,$273.54 ,$273.54 ,$698.61 ,$526.35 ,$870.87 ,$870.87 ,$765.60 ,"$1,531.88 ",$526.35 ,$861.30 ,"$1,487.26 ",$861.30 ,$516.78 ,$899.58 ,"$3,346.33 ",$880.44 ,$289.95 ,$870.87 ,"$1,487.26 ",$588.94 ,$588.94 ,$300.06 ,$714.21 ,$549.90 ,"$1,502.13 ",$273.54 ,$909.15 ,"$1,561.62 ",$273.54 ,$832.59 ,"$1,487.26 ",$861.30 ,"$1,487.26 ",$861.30 ,$861.30 ,$861.30 ,$928.29 ,$775.17 ,$890.01 ,$823.02 ,$928.29 
SACRED HEART HOSPITAL (ACU),32000397,75822,HC VENOGRAM EXTREMITY BILAT,320,1 ,"$1,498.00 ","$1,123.50 ",$114.07 ,"$3,346.33 ",$964.71 ,"$1,487.26 ","$1,048.60 ",$273.54 ,$142.59 ,$281.75 ,$114.07 ,"$1,423.10 ",$273.54 ,"$1,198.40 ","$1,378.16 ",$273.54 ,"$1,273.30 ","$1,423.10 ","$1,318.24 ","$1,138.48 ",$273.54 ,$273.54 ,$273.54 ,"$1,093.54 ",$823.90 ,"$1,363.18 ","$1,363.18 ","$1,198.40 ","$1,531.88 ",$823.90 ,"$1,348.20 ","$1,487.26 ","$1,348.20 ",$808.92 ,"$1,408.12 ","$3,346.33 ","$1,378.16 ",$289.95 ,"$1,363.18 ","$1,487.26 ",$921.87 ,$921.87 ,$454.83 ,"$1,117.96 ",$569.28 ,"$1,502.13 ",$273.54 ,"$1,423.10 ","$1,561.62 ",$273.54 ,"$1,303.26 ","$1,487.26 ","$1,348.20 ","$1,487.26 ","$1,348.20 ","$1,348.20 ","$1,348.20 ","$1,453.06 ","$1,213.38 ","$1,393.14 ","$1,288.28 ","$1,453.06 "
SACRED HEART HOSPITAL (ACU),32000398,75825,HC VENOGRAPHY CAVAL INFERIOR,320,1 ,"$3,469.00 ","$2,601.75 ",$106.86 ,"$6,812.22 ","$2,234.04 ","$3,027.65 ","$2,428.30 ",$592.92 ,$133.58 ,$610.71 ,$106.86 ,"$3,295.55 ",$592.92 ,"$2,775.20 ","$3,191.48 ",$592.92 ,"$2,948.65 ","$3,295.55 ","$3,052.72 ","$2,636.44 ",$592.92 ,$592.92 ,$592.92 ,"$2,532.37 ","$1,907.95 ","$3,156.79 ","$3,156.79 ","$2,775.20 ","$3,118.48 ","$1,907.95 ","$3,122.10 ","$3,027.65 ","$3,122.10 ","$1,873.26 ","$3,260.86 ","$6,812.22 ","$3,191.48 ",$628.50 ,"$3,156.79 ","$3,027.65 ","$2,134.82 ","$2,134.82 ",$880.19 ,"$2,588.91 ",$535.37 ,"$3,057.93 ",$592.92 ,"$3,295.55 ","$3,179.04 ",$592.92 ,"$3,018.03 ","$3,027.65 ","$3,122.10 ","$3,027.65 ","$3,122.10 ","$3,122.10 ","$3,122.10 ","$3,364.93 ","$2,809.89 ","$3,226.17 ","$2,983.34 ","$3,364.93 "
SACRED HEART HOSPITAL (ACU),32000399,75827,HC VENOGRAPHY CAVAL SUPERIOR,320,1 ,"$2,438.00 ","$1,828.50 ",$110.71 ,"$3,346.33 ","$1,570.07 ","$1,487.26 ","$1,706.60 ",$273.54 ,$138.39 ,$281.75 ,$110.71 ,"$2,316.10 ",$273.54 ,"$1,950.40 ","$2,242.96 ",$273.54 ,"$2,072.30 ","$2,316.10 ","$2,145.44 ","$1,852.88 ",$273.54 ,$273.54 ,$273.54 ,"$1,779.74 ","$1,340.90 ","$2,218.58 ","$2,218.58 ","$1,950.40 ","$1,531.88 ","$1,340.90 ","$2,194.20 ","$1,487.26 ","$2,194.20 ","$1,316.52 ","$2,291.72 ","$3,346.33 ","$2,242.96 ",$289.95 ,"$2,218.58 ","$1,487.26 ","$1,500.35 ","$1,500.35 ",$880.19 ,"$1,819.48 ",$561.98 ,"$1,502.13 ",$273.54 ,"$2,316.10 ","$1,561.62 ",$273.54 ,"$2,121.06 ","$1,487.26 ","$2,194.20 ","$1,487.26 ","$2,194.20 ","$2,194.20 ","$2,194.20 ","$2,364.86 ","$1,974.78 ","$2,267.34 ","$2,096.68 ","$2,364.86 "
SACRED HEART HOSPITAL (ACU),32000400,75831,HC VENOGRAM RENAL UNILAT,320,1 ,"$1,792.00 ","$1,344.00 ",$114.55 ,"$6,812.22 ","$1,154.05 ","$3,027.65 ","$1,254.40 ",$592.92 ,$143.19 ,$610.71 ,$114.55 ,"$1,702.40 ",$592.92 ,"$1,433.60 ","$1,648.64 ",$592.92 ,"$1,523.20 ","$1,702.40 ","$1,576.96 ","$1,361.92 ",$592.92 ,$592.92 ,$592.92 ,"$1,308.16 ",$985.60 ,"$1,630.72 ","$1,630.72 ","$1,433.60 ","$3,118.48 ",$985.60 ,"$1,612.80 ","$3,027.65 ","$1,612.80 ",$967.68 ,"$1,684.48 ","$6,812.22 ","$1,648.64 ",$628.50 ,"$1,630.72 ","$3,027.65 ","$1,102.80 ","$1,102.80 ",$851.02 ,"$1,337.37 ",$578.89 ,"$3,057.93 ",$592.92 ,"$1,702.40 ","$3,179.04 ",$592.92 ,"$1,559.04 ","$3,027.65 ","$1,612.80 ","$3,027.65 ","$1,612.80 ","$1,612.80 ","$1,612.80 ","$1,738.24 ","$1,451.52 ","$1,666.56 ","$1,541.12 ","$1,738.24 "
SACRED HEART HOSPITAL (ACU),32000401,75833,HC VENOGRAM RENAL BILAT,320,1 ,"$2,110.00 ","$1,582.50 ",$124.39 ,"$6,812.22 ","$1,358.84 ","$3,027.65 ","$1,477.00 ",$592.92 ,$155.49 ,$610.71 ,$124.39 ,"$2,004.50 ",$592.92 ,"$1,688.00 ","$1,941.20 ",$592.92 ,"$1,793.50 ","$2,004.50 ","$1,856.80 ","$1,603.60 ",$592.92 ,$592.92 ,$592.92 ,"$1,540.30 ","$1,160.50 ","$1,920.10 ","$1,920.10 ","$1,688.00 ","$3,118.48 ","$1,160.50 ","$1,899.00 ","$3,027.65 ","$1,899.00 ","$1,139.40 ","$1,983.40 ","$6,812.22 ","$1,941.20 ",$628.50 ,"$1,920.10 ","$3,027.65 ","$1,298.49 ","$1,298.49 ",$984.86 ,"$1,574.69 ",$633.02 ,"$3,057.93 ",$592.92 ,"$2,004.50 ","$3,179.04 ",$592.92 ,"$1,835.70 ","$3,027.65 ","$1,899.00 ","$3,027.65 ","$1,899.00 ","$1,899.00 ","$1,899.00 ","$2,046.70 ","$1,709.10 ","$1,962.30 ","$1,814.60 ","$2,046.70 "
SACRED HEART HOSPITAL (ACU),32000402,75840,HC VENOGRAM ADRENAL UNILAT,320,1 ,$950.00 ,$712.50 ,$123.68 ,"$6,812.22 ",$611.80 ,"$3,027.65 ",$665.00 ,$592.92 ,$154.60 ,$610.71 ,$123.68 ,$902.50 ,$592.92 ,$760.00 ,$874.00 ,$592.92 ,$807.50 ,$902.50 ,$836.00 ,$722.00 ,$592.92 ,$592.92 ,$592.92 ,$693.50 ,$522.50 ,$864.50 ,$864.50 ,$760.00 ,"$3,118.48 ",$522.50 ,$855.00 ,"$3,027.65 ",$855.00 ,$513.00 ,$893.00 ,"$6,812.22 ",$874.00 ,$628.50 ,$864.50 ,"$3,027.65 ",$584.63 ,$584.63 ,$880.19 ,$708.99 ,$620.03 ,"$3,057.93 ",$592.92 ,$902.50 ,"$3,179.04 ",$592.92 ,$826.50 ,"$3,027.65 ",$855.00 ,"$3,027.65 ",$855.00 ,$855.00 ,$855.00 ,$921.50 ,$769.50 ,$883.50 ,$817.00 ,$921.50 
SACRED HEART HOSPITAL (ACU),32000403,75842,HC VENOGRAM ADRENAL BILAT,320,1 ,$950.00 ,$712.50 ,$143.12 ,"$11,347.95 ",$611.80 ,"$5,043.53 ",$665.00 ,$950.00 ,$178.90 ,"$1,376.81 ",$143.12 ,$902.50 ,"$1,336.71 ",$760.00 ,$874.00 ,$950.00 ,$807.50 ,$902.50 ,$836.00 ,$722.00 ,$950.00 ,$950.00 ,"$1,336.71 ",$693.50 ,$522.50 ,$864.50 ,$864.50 ,$760.00 ,"$5,194.84 ",$522.50 ,$855.00 ,"$5,043.53 ",$855.00 ,$513.00 ,$893.00 ,"$11,347.95 ",$874.00 ,"$1,416.91 ",$864.50 ,"$5,043.53 ",$584.63 ,$584.63 ,$950.00 ,$708.99 ,$698.31 ,"$5,093.97 ",$950.00 ,$902.50 ,"$5,295.71 ",$950.00 ,$826.50 ,"$5,043.53 ",$855.00 ,"$5,043.53 ",$855.00 ,$855.00 ,$855.00 ,$921.50 ,$769.50 ,$883.50 ,$817.00 ,$921.50 
SACRED HEART HOSPITAL (ACU),32000404,75860,HC VENOGRAPHY SINUS/ JUGULAR,320,1 ,$950.00 ,$712.50 ,$118.40 ,"$6,812.22 ",$611.80 ,"$3,027.65 ",$665.00 ,$592.92 ,$148.00 ,$610.71 ,$118.40 ,$902.50 ,$592.92 ,$760.00 ,$874.00 ,$592.92 ,$807.50 ,$902.50 ,$836.00 ,$722.00 ,$592.92 ,$592.92 ,$592.92 ,$693.50 ,$522.50 ,$864.50 ,$864.50 ,$760.00 ,"$3,118.48 ",$522.50 ,$855.00 ,"$3,027.65 ",$855.00 ,$513.00 ,$893.00 ,"$6,812.22 ",$874.00 ,$628.50 ,$864.50 ,"$3,027.65 ",$584.63 ,$584.63 ,$880.19 ,$708.99 ,$600.66 ,"$3,057.93 ",$592.92 ,$902.50 ,"$3,179.04 ",$592.92 ,$826.50 ,"$3,027.65 ",$855.00 ,"$3,027.65 ",$855.00 ,$855.00 ,$855.00 ,$921.50 ,$769.50 ,$883.50 ,$817.00 ,$921.50 
SACRED HEART HOSPITAL (ACU),32000406,75870,HC VENOGRAM SUPERIOR SAGITTAL,320,1 ,$820.00 ,$615.00 ,$123.68 ,"$6,812.22 ",$528.08 ,"$3,027.65 ",$574.00 ,$273.54 ,$154.60 ,$281.75 ,$123.68 ,$779.00 ,$273.54 ,$656.00 ,$754.40 ,$273.54 ,$697.00 ,$779.00 ,$721.60 ,$623.20 ,$273.54 ,$273.54 ,$273.54 ,$598.60 ,$451.00 ,$746.20 ,$746.20 ,$656.00 ,"$3,118.48 ",$451.00 ,$738.00 ,"$3,027.65 ",$738.00 ,$442.80 ,$770.80 ,"$6,812.22 ",$754.40 ,$289.95 ,$746.20 ,"$3,027.65 ",$504.63 ,$504.63 ,$820.00 ,$611.97 ,$620.03 ,"$3,057.93 ",$273.54 ,$779.00 ,"$3,179.04 ",$273.54 ,$713.40 ,"$3,027.65 ",$738.00 ,"$3,027.65 ",$738.00 ,$738.00 ,$738.00 ,$795.40 ,$664.20 ,$762.60 ,$705.20 ,$795.40 
SACRED HEART HOSPITAL (ACU),32000409,75885,HC TRANSHEPATIC PORTOGRAPHY W/ HEMO,320,1 ,$819.00 ,$614.25 ,$118.87 ,"$6,812.22 ",$527.44 ,"$3,027.65 ",$573.30 ,$592.92 ,$148.59 ,$610.71 ,$118.87 ,$778.05 ,$592.92 ,$655.20 ,$753.48 ,$592.92 ,$696.15 ,$778.05 ,$720.72 ,$622.44 ,$592.92 ,$592.92 ,$592.92 ,$597.87 ,$450.45 ,$745.29 ,$745.29 ,$655.20 ,"$3,118.48 ",$450.45 ,$737.10 ,"$3,027.65 ",$737.10 ,$442.26 ,$769.86 ,"$6,812.22 ",$753.48 ,$628.50 ,$745.29 ,"$3,027.65 ",$504.01 ,$504.01 ,$819.00 ,$611.22 ,$600.66 ,"$3,057.93 ",$592.92 ,$778.05 ,"$3,179.04 ",$592.92 ,$712.53 ,"$3,027.65 ",$737.10 ,"$3,027.65 ",$737.10 ,$737.10 ,$737.10 ,$794.43 ,$663.39 ,$761.67 ,$704.34 ,$794.43 
SACRED HEART HOSPITAL (ACU),32000411,75889,HC VENOGRAM HEPATIC W/HEMO,320,1 ,$820.00 ,$615.00 ,$119.83 ,"$6,812.22 ",$528.08 ,"$3,027.65 ",$574.00 ,$592.92 ,$149.78 ,$610.71 ,$119.83 ,$779.00 ,$592.92 ,$656.00 ,$754.40 ,$592.92 ,$697.00 ,$779.00 ,$721.60 ,$623.20 ,$592.92 ,$592.92 ,$592.92 ,$598.60 ,$451.00 ,$746.20 ,$746.20 ,$656.00 ,"$3,118.48 ",$451.00 ,$738.00 ,"$3,027.65 ",$738.00 ,$442.80 ,$770.80 ,"$6,812.22 ",$754.40 ,$628.50 ,$746.20 ,"$3,027.65 ",$504.63 ,$504.63 ,$820.00 ,$611.97 ,$605.50 ,"$3,057.93 ",$592.92 ,$779.00 ,"$3,179.04 ",$592.92 ,$713.40 ,"$3,027.65 ",$738.00 ,"$3,027.65 ",$738.00 ,$738.00 ,$738.00 ,$795.40 ,$664.20 ,$762.60 ,$705.20 ,$795.40 
SACRED HEART HOSPITAL (ACU),32000412,75891,HC VENOGRAM HEPATIC W/O HEMO,320,1 ,$852.00 ,$639.00 ,$120.79 ,"$6,812.22 ",$548.69 ,"$3,027.65 ",$596.40 ,$592.92 ,$150.99 ,$610.71 ,$120.79 ,$809.40 ,$592.92 ,$681.60 ,$783.84 ,$592.92 ,$724.20 ,$809.40 ,$749.76 ,$647.52 ,$592.92 ,$592.92 ,$592.92 ,$621.96 ,$468.60 ,$775.32 ,$775.32 ,$681.60 ,"$3,118.48 ",$468.60 ,$766.80 ,"$3,027.65 ",$766.80 ,$460.08 ,$800.88 ,"$6,812.22 ",$783.84 ,$628.50 ,$775.32 ,"$3,027.65 ",$524.32 ,$524.32 ,$852.00 ,$635.85 ,$607.96 ,"$3,057.93 ",$592.92 ,$809.40 ,"$3,179.04 ",$592.92 ,$741.24 ,"$3,027.65 ",$766.80 ,"$3,027.65 ",$766.80 ,$766.80 ,$766.80 ,$826.44 ,$690.12 ,$792.36 ,$732.72 ,$826.44 
SACRED HEART HOSPITAL (ACU),32000413,75893,HC VENOGRAM SAMPLING CATH,320,1 ,"$1,569.00 ","$1,176.75 ",$124.15 ,"$11,347.95 ","$1,010.44 ","$5,043.53 ","$1,098.30 ","$1,336.71 ",$155.19 ,"$1,376.81 ",$124.15 ,"$1,490.55 ","$1,336.71 ","$1,255.20 ","$1,443.48 ","$1,336.71 ","$1,333.65 ","$1,490.55 ","$1,380.72 ","$1,192.44 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$1,145.37 ",$862.95 ,"$1,427.79 ","$1,427.79 ","$1,255.20 ","$5,194.84 ",$862.95 ,"$1,412.10 ","$5,043.53 ","$1,412.10 ",$847.26 ,"$1,474.86 ","$11,347.95 ","$1,443.48 ","$1,416.91 ","$1,427.79 ","$5,043.53 ",$965.56 ,$965.56 ,"$1,544.48 ","$1,170.94 ",$634.56 ,"$5,093.97 ","$1,336.71 ","$1,490.55 ","$5,295.71 ","$1,336.71 ","$1,365.03 ","$5,043.53 ","$1,412.10 ","$5,043.53 ","$1,412.10 ","$1,412.10 ","$1,412.10 ","$1,521.93 ","$1,270.89 ","$1,459.17 ","$1,349.34 ","$1,521.93 "
SACRED HEART HOSPITAL (ACU),32000414,75894,HC TRANSCATH EMBOLIZATION 75894,320,1 ,"$1,963.72 ","$1,472.79 ",$58.37 ,"$1,963.72 ","$1,264.64 ", N/A ,"$1,374.60 ",$58.37 ,"$1,506.86 ",$60.12 ,"$1,205.48 ","$1,865.53 ",$58.37 ,"$1,570.98 ","$1,806.62 ",$58.37 ,"$1,669.16 ","$1,865.53 ","$1,728.07 ","$1,492.43 ",$58.37 ,$58.37 ,$58.37 ,"$1,433.52 ","$1,080.05 ","$1,786.99 ","$1,786.99 ","$1,570.98 ", N/A ,"$1,080.05 ","$1,767.35 ", N/A ,"$1,767.35 ","$1,060.41 ","$1,845.90 ", N/A ,"$1,806.62 ",$61.87 ,"$1,786.99 ", N/A ,"$1,208.47 ","$1,208.47 ","$1,478.22 ","$1,465.52 ",$473.03 , N/A ,$58.37 ,"$1,865.53 ", N/A ,$58.37 ,"$1,708.44 ", N/A ,"$1,767.35 ", N/A ,"$1,767.35 ","$1,767.35 ","$1,767.35 ","$1,904.81 ","$1,590.61 ","$1,826.26 ","$1,688.80 ","$1,904.81 "
SACRED HEART HOSPITAL (ACU),32000417,75898,HC TRANSCATH ANGIO EXIST 75898,320,1 ,$855.00 ,$641.25 ,$73.89 ,"$6,812.22 ",$550.62 ,"$3,027.65 ",$598.50 ,$273.54 ,$73.89 ,$281.75 ,$855.00 ,$812.25 ,$273.54 ,$684.00 ,$786.60 ,$273.54 ,$726.75 ,$812.25 ,$752.40 ,$649.80 ,$273.54 ,$273.54 ,$273.54 ,$624.15 ,$470.25 ,$778.05 ,$778.05 ,$684.00 ,"$3,118.48 ",$470.25 ,$769.50 ,"$3,027.65 ",$769.50 ,$461.70 ,$803.70 ,"$6,812.22 ",$786.60 ,$289.95 ,$778.05 ,"$3,027.65 ",$526.17 ,$526.17 ,$239.48 ,$638.09 ,$592.37 ,"$3,057.93 ",$273.54 ,$812.25 ,"$3,179.04 ",$273.54 ,$743.85 ,"$3,027.65 ",$769.50 ,"$3,027.65 ",$769.50 ,$769.50 ,$769.50 ,$829.35 ,$692.55 ,$795.15 ,$735.30 ,$829.35 
SACRED HEART HOSPITAL (ACU),32000421,75901,HC REMOVE PERICATH OBST CV CATH,320,1 ,"$1,075.00 ",$806.25 ,$58.37 ,"$1,075.00 ",$692.30 , N/A ,$752.50 ,$58.37 ,$259.67 ,$60.12 ,$207.73 ,"$1,021.25 ",$58.37 ,$860.00 ,$989.00 ,$58.37 ,$913.75 ,"$1,021.25 ",$946.00 ,$817.00 ,$58.37 ,$58.37 ,$58.37 ,$784.75 ,$591.25 ,$978.25 ,$978.25 ,$860.00 , N/A ,$591.25 ,$967.50 , N/A ,$967.50 ,$580.50 ,"$1,010.50 ", N/A ,$989.00 ,$61.87 ,$978.25 , N/A ,$661.56 ,$661.56 ,$172.29 ,$802.27 ,$967.50 , N/A ,$58.37 ,"$1,021.25 ", N/A ,$58.37 ,$935.25 , N/A ,$967.50 , N/A ,$967.50 ,$967.50 ,$967.50 ,"$1,042.75 ",$870.75 ,$999.75 ,$924.50 ,"$1,042.75 "
SACRED HEART HOSPITAL (ACU),32000422,75902,HC REMOVE INTRALUMN OBST CV CATH,320,1 ,$568.00 ,$426.00 ,$58.37 ,$568.00 ,$365.79 , N/A ,$397.60 ,$58.37 ,$89.76 ,$60.12 ,$71.81 ,$539.60 ,$58.37 ,$454.40 ,$522.56 ,$58.37 ,$482.80 ,$539.60 ,$499.84 ,$431.68 ,$58.37 ,$58.37 ,$58.37 ,$414.64 ,$312.40 ,$516.88 ,$516.88 ,$454.40 , N/A ,$312.40 ,$511.20 , N/A ,$511.20 ,$306.72 ,$533.92 , N/A ,$522.56 ,$61.87 ,$516.88 , N/A ,$349.55 ,$349.55 ,$172.29 ,$423.90 ,$361.26 , N/A ,$58.37 ,$539.60 , N/A ,$58.37 ,$494.16 , N/A ,$511.20 , N/A ,$511.20 ,$511.20 ,$511.20 ,$550.96 ,$460.08 ,$528.24 ,$488.48 ,$550.96 
SACRED HEART HOSPITAL (ACU),32000423,37191,HC IVC FILTER PLACEMENT 37191,320,1 ,"$3,588.73 ","$2,691.55 ","$1,161.13 ","$11,347.95 ","$2,311.14 ","$5,043.53 ","$2,512.11 ","$1,161.13 ","$2,978.65 ","$1,195.96 ","$2,368.56 ","$3,409.29 ","$1,161.13 ","$2,870.98 ","$3,301.63 ","$1,161.13 ","$3,050.42 ","$3,409.29 ","$3,158.08 ","$2,727.43 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$2,619.77 ","$1,973.80 ","$3,265.74 ","$3,265.74 ","$2,870.98 ","$5,194.84 ","$1,973.80 ","$3,229.86 ","$5,043.53 ","$3,229.86 ","$1,937.91 ","$3,373.41 ","$11,347.95 ","$3,301.63 ","$1,230.80 ","$3,265.74 ","$5,043.53 ","$2,208.50 ","$2,208.50 ","$3,229.86 ","$2,678.27 ","$2,499.55 ","$5,093.97 ","$1,161.13 ","$3,409.29 ","$5,295.71 ","$1,161.13 ","$3,122.20 ","$5,043.53 ","$3,229.86 ","$5,043.53 ","$3,229.86 ","$3,229.86 ","$3,229.86 ","$3,481.07 ","$2,906.87 ","$3,337.52 ","$3,086.31 ","$3,481.07 "
SACRED HEART HOSPITAL (ACU),32000435,75970,HC TRANSCATH BX,320,1 ,"$1,783.74 ","$1,337.81 ",$58.37 ,"$1,783.74 ","$1,148.73 ", N/A ,"$1,248.62 ",$58.37 ,$674.10 ,$60.12 ,$539.28 ,"$1,694.55 ",$58.37 ,"$1,426.99 ","$1,641.04 ",$58.37 ,"$1,516.18 ","$1,694.55 ","$1,569.69 ","$1,355.64 ",$58.37 ,$58.37 ,$58.37 ,"$1,302.13 ",$981.06 ,"$1,623.20 ","$1,623.20 ","$1,426.99 ", N/A ,$981.06 ,"$1,605.37 ", N/A ,"$1,605.37 ",$963.22 ,"$1,676.72 ", N/A ,"$1,641.04 ",$61.87 ,"$1,623.20 ", N/A ,"$1,097.71 ","$1,097.71 ",$720.70 ,"$1,331.21 ",$274.63 , N/A ,$58.37 ,"$1,694.55 ", N/A ,$58.37 ,"$1,551.85 ", N/A ,"$1,605.37 ", N/A ,"$1,605.37 ","$1,605.37 ","$1,605.37 ","$1,730.23 ","$1,444.83 ","$1,658.88 ","$1,534.02 ","$1,730.23 "
SACRED HEART HOSPITAL (ACU),32000438,47533,HC TRANSHEPATIC DRAINAGE,320,1 ,"$4,404.00 ","$3,303.00 ",$817.89 ,"$7,571.16 ","$2,836.18 ","$3,364.96 ","$3,082.80 ",$817.89 ,"$3,655.32 ",$842.43 ,"$2,906.64 ","$4,183.80 ",$817.89 ,"$3,523.20 ","$4,051.68 ",$817.89 ,"$3,743.40 ","$4,183.80 ","$3,875.52 ","$3,347.04 ",$817.89 ,$817.89 ,$817.89 ,"$3,214.92 ","$2,422.20 ","$4,007.64 ","$4,007.64 ","$3,523.20 ","$3,465.91 ","$2,422.20 ","$3,963.60 ","$3,364.96 ","$3,963.60 ","$2,378.16 ","$4,139.76 ","$7,571.16 ","$4,051.68 ",$866.96 ,"$4,007.64 ","$3,364.96 ","$2,710.22 ","$2,710.22 ","$3,963.60 ","$3,286.71 ","$3,067.39 ","$3,398.61 ",$817.89 ,"$4,183.80 ","$3,533.21 ",$817.89 ,"$3,831.48 ","$3,364.96 ","$3,963.60 ","$3,364.96 ","$3,963.60 ","$3,963.60 ","$3,963.60 ","$4,271.88 ","$3,567.24 ","$4,095.72 ","$3,787.44 ","$4,271.88 "
SACRED HEART HOSPITAL (ACU),32000439,47534,HC PLACE BILIARY DRAINAGE CATH,320,1 ,"$4,404.00 ","$3,303.00 ",$817.89 ,"$7,571.16 ","$2,836.18 ","$3,364.96 ","$3,082.80 ",$817.89 ,"$3,655.32 ",$842.43 ,"$2,906.64 ","$4,183.80 ",$817.89 ,"$3,523.20 ","$4,051.68 ",$817.89 ,"$3,743.40 ","$4,183.80 ","$3,875.52 ","$3,347.04 ",$817.89 ,$817.89 ,$817.89 ,"$3,214.92 ","$2,422.20 ","$4,007.64 ","$4,007.64 ","$3,523.20 ","$3,465.91 ","$2,422.20 ","$3,963.60 ","$3,364.96 ","$3,963.60 ","$2,378.16 ","$4,139.76 ","$7,571.16 ","$4,051.68 ",$866.96 ,"$4,007.64 ","$3,364.96 ","$2,710.22 ","$2,710.22 ","$3,963.60 ","$3,286.71 ","$3,067.39 ","$3,398.61 ",$817.89 ,"$4,183.80 ","$3,533.21 ",$817.89 ,"$3,831.48 ","$3,364.96 ","$3,963.60 ","$3,364.96 ","$3,963.60 ","$3,963.60 ","$3,963.60 ","$4,271.88 ","$3,567.24 ","$4,095.72 ","$3,787.44 ","$4,271.88 "
SACRED HEART HOSPITAL (ACU),32000440,75984,HC CHANGE PERC DRAINAGE TUBE OR CATH,320,1 ,"$2,239.31 ","$1,679.48 ",$58.37 ,"$2,239.31 ","$1,442.12 ", N/A ,"$1,567.52 ",$58.37 ,$119.77 ,$60.12 ,$95.82 ,"$2,127.34 ",$58.37 ,"$1,791.45 ","$2,060.17 ",$58.37 ,"$1,903.41 ","$2,127.34 ","$1,970.59 ","$1,701.88 ",$58.37 ,$58.37 ,$58.37 ,"$1,634.70 ","$1,231.62 ","$2,037.77 ","$2,037.77 ","$1,791.45 ", N/A ,"$1,231.62 ","$2,015.38 ", N/A ,"$2,015.38 ","$1,209.23 ","$2,104.95 ", N/A ,"$2,060.17 ",$61.87 ,"$2,037.77 ", N/A ,"$1,378.07 ","$1,378.07 ",$302.16 ,"$1,671.20 ",$484.61 , N/A ,$58.37 ,"$2,127.34 ", N/A ,$58.37 ,"$1,948.20 ", N/A ,"$2,015.38 ", N/A ,"$2,015.38 ","$2,015.38 ","$2,015.38 ","$2,172.13 ","$1,813.84 ","$2,082.56 ","$1,925.81 ","$2,172.13 "
SACRED HEART HOSPITAL (ACU),32000444,49406,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER,320,1 ,"$2,728.51 ","$2,046.38 ",$239.96 ,"$3,348.27 ","$1,757.16 ","$1,488.12 ","$1,909.96 ",$239.96 ,"$2,264.66 ",$247.16 ,"$1,800.82 ","$2,592.08 ",$239.96 ,"$2,182.81 ","$2,510.23 ",$239.96 ,"$2,319.23 ","$2,592.08 ","$2,401.09 ","$2,073.67 ",$239.96 ,$239.96 ,$239.96 ,"$1,991.81 ","$1,500.68 ","$2,482.94 ","$2,482.94 ","$2,182.81 ","$1,532.76 ","$1,500.68 ","$2,455.66 ","$1,488.12 ","$2,455.66 ","$1,473.40 ","$2,564.80 ","$3,348.27 ","$2,510.23 ",$254.36 ,"$2,482.94 ","$1,488.12 ","$1,679.13 ","$1,679.13 ","$2,455.66 ","$2,036.29 ","$1,900.41 ","$1,503.00 ",$239.96 ,"$2,592.08 ","$1,562.52 ",$239.96 ,"$2,373.80 ","$1,488.12 ","$2,455.66 ","$1,488.12 ","$2,455.66 ","$2,455.66 ","$2,455.66 ","$2,646.65 ","$2,210.09 ","$2,537.51 ","$2,346.52 ","$2,646.65 "
SACRED HEART HOSPITAL (ACU),32000445,75989,HC GUID FOR PERC DRAIN ABSCESS,320,1 ,$887.64 ,$665.73 ,$58.37 ,$887.64 ,$571.64 , N/A ,$621.35 ,$58.37 ,$105.37 ,$60.12 ,$84.29 ,$843.26 ,$58.37 ,$710.11 ,$816.63 ,$58.37 ,$754.49 ,$843.26 ,$781.12 ,$674.61 ,$58.37 ,$58.37 ,$58.37 ,$647.98 ,$488.20 ,$807.75 ,$807.75 ,$710.11 , N/A ,$488.20 ,$798.88 , N/A ,$798.88 ,$479.33 ,$834.38 , N/A ,$816.63 ,$61.87 ,$807.75 , N/A ,$546.25 ,$546.25 ,$632.22 ,$662.45 ,$428.94 , N/A ,$58.37 ,$843.26 , N/A ,$58.37 ,$772.25 , N/A ,$798.88 , N/A ,$798.88 ,$798.88 ,$798.88 ,$861.01 ,$718.99 ,$825.51 ,$763.37 ,$861.01 
SACRED HEART HOSPITAL (ACU),32000447,76000,HC FLUOROSCOPY UP TO 1 HR 76000,320,1 ,$532.00 ,$399.00 ,$39.20 ,$547.56 ,$342.61 ,$243.36 ,$372.40 ,$39.20 ,$65.14 ,$40.38 ,$52.11 ,$505.40 ,$39.20 ,$425.60 ,$489.44 ,$39.20 ,$452.20 ,$505.40 ,$468.16 ,$404.32 ,$39.20 ,$39.20 ,$39.20 ,$388.36 ,$292.60 ,$484.12 ,$484.12 ,$425.60 ,$250.66 ,$292.60 ,$478.80 ,$243.36 ,$478.80 ,$287.28 ,$500.08 ,$547.56 ,$489.44 ,$41.55 ,$484.12 ,$243.36 ,$327.39 ,$327.39 ,$245.01 ,$397.03 ,$264.52 ,$245.79 ,$39.20 ,$505.40 ,$255.53 ,$39.20 ,$462.84 ,$243.36 ,$478.80 ,$243.36 ,$478.80 ,$478.80 ,$478.80 ,$516.04 ,$430.92 ,$494.76 ,$457.52 ,$516.04 
SACRED HEART HOSPITAL (ACU),32000450,76000,HC FLUORO CARM < 1 HR,320,1 ,$532.00 ,$399.00 ,$39.20 ,$547.56 ,$342.61 ,$243.36 ,$372.40 ,$39.20 ,$65.14 ,$40.38 ,$52.11 ,$505.40 ,$39.20 ,$425.60 ,$489.44 ,$39.20 ,$452.20 ,$505.40 ,$468.16 ,$404.32 ,$39.20 ,$39.20 ,$39.20 ,$388.36 ,$292.60 ,$484.12 ,$484.12 ,$425.60 ,$250.66 ,$292.60 ,$478.80 ,$243.36 ,$478.80 ,$287.28 ,$500.08 ,$547.56 ,$489.44 ,$41.55 ,$484.12 ,$243.36 ,$327.39 ,$327.39 ,$245.01 ,$397.03 ,$264.52 ,$245.79 ,$39.20 ,$505.40 ,$255.53 ,$39.20 ,$462.84 ,$243.36 ,$478.80 ,$243.36 ,$478.80 ,$478.80 ,$478.80 ,$516.04 ,$430.92 ,$494.76 ,$457.52 ,$516.04 
SACRED HEART HOSPITAL (ACU),32000465,76080,HC ABSCESS FISTULA OR SINUS TRACT,320,1 ,$778.67 ,$584.00 ,$38.65 ,"$1,149.84 ",$501.46 ,$511.04 ,$545.07 ,$39.20 ,$48.32 ,$40.38 ,$38.65 ,$739.74 ,$39.20 ,$622.94 ,$716.38 ,$39.20 ,$661.87 ,$739.74 ,$685.23 ,$591.79 ,$39.20 ,$39.20 ,$39.20 ,$568.43 ,$428.27 ,$708.59 ,$708.59 ,$622.94 ,$526.37 ,$428.27 ,$700.80 ,$511.04 ,$700.80 ,$420.48 ,$731.95 ,"$1,149.84 ",$716.38 ,$41.55 ,$708.59 ,$511.04 ,$479.19 ,$479.19 ,$191.94 ,$581.12 ,$194.39 ,$516.15 ,$39.20 ,$739.74 ,$536.59 ,$39.20 ,$677.44 ,$511.04 ,$700.80 ,$511.04 ,$700.80 ,$700.80 ,$700.80 ,$755.31 ,$630.72 ,$724.16 ,$669.66 ,$755.31 
SACRED HEART HOSPITAL (ACU),32000467,76098,HC RADIOLOGICAL EXAM SURG SPEC,320,1 ,$97.21 ,$72.91 ,$11.28 ,"$1,149.84 ",$62.60 ,$511.04 ,$68.05 ,$39.20 ,$14.11 ,$40.38 ,$11.28 ,$92.35 ,$39.20 ,$77.77 ,$89.43 ,$39.20 ,$82.63 ,$92.35 ,$85.54 ,$73.88 ,$39.20 ,$39.20 ,$39.20 ,$70.96 ,$53.47 ,$88.46 ,$88.46 ,$77.77 ,$526.37 ,$53.47 ,$87.49 ,$511.04 ,$87.49 ,$52.49 ,$91.38 ,"$1,149.84 ",$89.43 ,$41.55 ,$88.46 ,$511.04 ,$59.82 ,$59.82 ,$95.01 ,$72.55 ,$58.90 ,$516.15 ,$39.20 ,$92.35 ,$536.59 ,$39.20 ,$84.57 ,$511.04 ,$87.49 ,$511.04 ,$87.49 ,$87.49 ,$87.49 ,$94.29 ,$78.74 ,$90.41 ,$83.60 ,$94.29 
SACRED HEART HOSPITAL (ACU),32000468,76100,HC RADIOLOGICAL EXAM TOMOGRAPHY SINGL,320,1 ,$767.29 ,$575.47 ,$18.59 ,$767.29 ,$494.13 ,$115.15 ,$537.10 ,$18.59 ,$101.15 ,$19.15 ,$80.92 ,$728.93 ,$18.59 ,$613.83 ,$705.91 ,$18.59 ,$652.20 ,$728.93 ,$675.22 ,$583.14 ,$18.59 ,$18.59 ,$18.59 ,$560.12 ,$422.01 ,$698.23 ,$698.23 ,$613.83 ,$118.60 ,$422.01 ,$690.56 ,$115.15 ,$690.56 ,$414.34 ,$721.25 ,$259.08 ,$705.91 ,$19.71 ,$698.23 ,$115.15 ,$472.19 ,$472.19 ,$197.54 ,$572.63 ,$407.18 ,$116.30 ,$18.59 ,$728.93 ,$120.90 ,$18.59 ,$667.54 ,$115.15 ,$690.56 ,$115.15 ,$690.56 ,$690.56 ,$690.56 ,$744.27 ,$621.50 ,$713.58 ,$659.87 ,$744.27 
SACRED HEART HOSPITAL (ACU),32000475,77001,HC FLUORO CV ACCESS PLACEMENT,320,1 ,"$1,396.00 ","$1,047.00 ",$58.37 ,"$1,396.00 ",$899.02 , N/A ,$977.20 ,$58.37 ,$110.16 ,$60.12 ,$88.13 ,"$1,326.20 ",$58.37 ,"$1,116.80 ","$1,284.32 ",$58.37 ,"$1,186.60 ","$1,326.20 ","$1,228.48 ","$1,060.96 ",$58.37 ,$58.37 ,$58.37 ,"$1,019.08 ",$767.80 ,"$1,270.36 ","$1,270.36 ","$1,116.80 ", N/A ,$767.80 ,"$1,256.40 ", N/A ,"$1,256.40 ",$753.84 ,"$1,312.24 ", N/A ,"$1,284.32 ",$61.87 ,"$1,270.36 ", N/A ,$859.10 ,$859.10 ,$124.51 ,"$1,041.83 ",$445.93 , N/A ,$58.37 ,"$1,326.20 ", N/A ,$58.37 ,"$1,214.52 ", N/A ,"$1,256.40 ", N/A ,"$1,256.40 ","$1,256.40 ","$1,256.40 ","$1,354.12 ","$1,130.76 ","$1,298.28 ","$1,200.56 ","$1,354.12 "
SACRED HEART HOSPITAL (ACU),32000476,77002,HC FLUORO NEEDLE PLACEMENT,320,1 ,$365.00 ,$273.75 ,$58.37 ,$365.00 ,$235.06 , N/A ,$255.50 ,$58.37 ,$109.57 ,$60.12 ,$87.65 ,$346.75 ,$58.37 ,$292.00 ,$335.80 ,$58.37 ,$310.25 ,$346.75 ,$321.20 ,$277.40 ,$58.37 ,$58.37 ,$58.37 ,$266.45 ,$200.75 ,$332.15 ,$332.15 ,$292.00 , N/A ,$200.75 ,$328.50 , N/A ,$328.50 ,$197.10 ,$343.10 , N/A ,$335.80 ,$61.87 ,$332.15 , N/A ,$224.62 ,$224.62 ,$95.93 ,$272.40 ,$328.50 , N/A ,$58.37 ,$346.75 , N/A ,$58.37 ,$317.55 , N/A ,$328.50 , N/A ,$328.50 ,$328.50 ,$328.50 ,$354.05 ,$295.65 ,$339.45 ,$313.90 ,$354.05 
SACRED HEART HOSPITAL (ACU),32000481,77003,HC FLUORO NEEDLE LOCALIZATION,320,1 ,$340.00 ,$255.00 ,$58.37 ,$340.00 ,$218.96 , N/A ,$238.00 ,$58.37 ,$108.36 ,$60.12 ,$86.69 ,$323.00 ,$58.37 ,$272.00 ,$312.80 ,$58.37 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$58.37 ,$58.37 ,$58.37 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 , N/A ,$187.00 ,$306.00 , N/A ,$306.00 ,$183.60 ,$319.60 , N/A ,$312.80 ,$61.87 ,$309.40 , N/A ,$209.24 ,$209.24 ,$87.88 ,$253.74 ,$306.00 , N/A ,$58.37 ,$323.00 , N/A ,$58.37 ,$295.80 , N/A ,$306.00 , N/A ,$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),32000487,19081,HC MAMM STER GUIDE BRST MAMMT STEREO CORE,320,1 ,"$2,726.73 ","$2,045.05 ",$454.28 ,"$3,348.27 ","$1,756.01 ","$1,488.12 ","$1,908.71 ",$454.28 ,"$2,263.19 ",$467.91 ,"$1,799.64 ","$2,590.39 ",$454.28 ,"$2,181.38 ","$2,508.59 ",$454.28 ,"$2,317.72 ","$2,590.39 ","$2,399.52 ","$2,072.31 ",$454.28 ,$454.28 ,$454.28 ,"$1,990.51 ","$1,499.70 ","$2,481.32 ","$2,481.32 ","$2,181.38 ","$1,532.76 ","$1,499.70 ","$2,454.06 ","$1,488.12 ","$2,454.06 ","$1,472.43 ","$2,563.13 ","$3,348.27 ","$2,508.59 ",$481.54 ,"$2,481.32 ","$1,488.12 ","$1,678.03 ","$1,678.03 ","$2,454.06 ","$2,034.96 ","$1,125.42 ","$1,503.00 ",$454.28 ,"$2,590.39 ","$1,562.52 ",$454.28 ,"$2,372.26 ","$1,488.12 ","$2,454.06 ","$1,488.12 ","$2,454.06 ","$2,454.06 ","$2,454.06 ","$2,644.93 ","$2,208.65 ","$2,535.86 ","$2,344.99 ","$2,644.93 "
SACRED HEART HOSPITAL (ACU),32000489,19281,HC MAMM GUIDE NDL PLACEMENT,320,1 ,"$1,717.16 ","$1,287.87 ",$266.73 ,"$1,717.16 ","$1,105.85 ",$658.15 ,"$1,202.01 ",$266.73 ,"$1,425.24 ",$274.73 ,"$1,133.33 ","$1,631.30 ",$266.73 ,"$1,373.73 ","$1,579.79 ",$266.73 ,"$1,459.59 ","$1,631.30 ","$1,511.10 ","$1,305.04 ",$266.73 ,$266.73 ,$266.73 ,"$1,253.53 ",$944.44 ,"$1,562.62 ","$1,562.62 ","$1,373.73 ",$677.89 ,$944.44 ,"$1,545.44 ",$658.15 ,"$1,545.44 ",$927.27 ,"$1,614.13 ","$1,480.84 ","$1,579.79 ",$282.73 ,"$1,562.62 ",$658.15 ,"$1,056.74 ","$1,056.74 ","$1,545.44 ","$1,281.52 ","$1,196.00 ",$664.73 ,$266.73 ,"$1,631.30 ",$691.06 ,$266.73 ,"$1,493.93 ",$658.15 ,"$1,545.44 ",$658.15 ,"$1,545.44 ","$1,545.44 ","$1,545.44 ","$1,665.65 ","$1,390.90 ","$1,596.96 ","$1,476.76 ","$1,665.65 "
SACRED HEART HOSPITAL (ACU),32000492,77073,HC BONE LENGTH STUDIES,320,1 ,$246.00 ,$184.50 ,$18.59 ,$259.08 ,$158.42 ,$115.15 ,$172.20 ,$18.59 ,$35.72 ,$19.15 ,$28.57 ,$233.70 ,$18.59 ,$196.80 ,$226.32 ,$18.59 ,$209.10 ,$233.70 ,$216.48 ,$186.96 ,$18.59 ,$18.59 ,$18.59 ,$179.58 ,$135.30 ,$223.86 ,$223.86 ,$196.80 ,$118.60 ,$135.30 ,$221.40 ,$115.15 ,$221.40 ,$132.84 ,$231.24 ,$259.08 ,$226.32 ,$19.71 ,$223.86 ,$115.15 ,$151.39 ,$151.39 ,$56.39 ,$183.59 ,$146.02 ,$116.30 ,$18.59 ,$233.70 ,$120.90 ,$18.59 ,$214.02 ,$115.15 ,$221.40 ,$115.15 ,$221.40 ,$221.40 ,$221.40 ,$238.62 ,$199.26 ,$228.78 ,$211.56 ,$238.62 
SACRED HEART HOSPITAL (ACU),32000494,77075,HC BONE SURVEY COMPLETE,320,1 ,$958.00 ,$718.50 ,$39.20 ,$958.00 ,$616.95 ,$115.15 ,$670.60 ,$39.20 ,$101.15 ,$40.38 ,$80.92 ,$910.10 ,$39.20 ,$766.40 ,$881.36 ,$39.20 ,$814.30 ,$910.10 ,$843.04 ,$728.08 ,$39.20 ,$39.20 ,$39.20 ,$699.34 ,$526.90 ,$871.78 ,$871.78 ,$766.40 ,$118.60 ,$526.90 ,$862.20 ,$115.15 ,$862.20 ,$517.32 ,$900.52 ,$259.08 ,$881.36 ,$41.55 ,$871.78 ,$115.15 ,$589.55 ,$589.55 ,$121.57 ,$714.96 ,$409.63 ,$116.30 ,$39.20 ,$910.10 ,$120.90 ,$39.20 ,$833.46 ,$115.15 ,$862.20 ,$115.15 ,$862.20 ,$862.20 ,$862.20 ,$929.26 ,$775.98 ,$890.94 ,$823.88 ,$929.26 
SACRED HEART HOSPITAL (ACU),32000495,77076,HC OSSEOUS SURVEY INFANT,320,1 ,$224.00 ,$168.00 ,$18.59 ,$259.08 ,$144.26 ,$115.15 ,$156.80 ,$18.59 ,$103.57 ,$19.15 ,$82.85 ,$212.80 ,$18.59 ,$179.20 ,$206.08 ,$18.59 ,$190.40 ,$212.80 ,$197.12 ,$170.24 ,$18.59 ,$18.59 ,$18.59 ,$163.52 ,$123.20 ,$203.84 ,$203.84 ,$179.20 ,$118.60 ,$123.20 ,$201.60 ,$115.15 ,$201.60 ,$120.96 ,$210.56 ,$259.08 ,$206.08 ,$19.71 ,$203.84 ,$115.15 ,$137.85 ,$137.85 ,$75.43 ,$167.17 ,$201.60 ,$116.30 ,$18.59 ,$212.80 ,$120.90 ,$18.59 ,$194.88 ,$115.15 ,$201.60 ,$115.15 ,$201.60 ,$201.60 ,$201.60 ,$217.28 ,$181.44 ,$208.32 ,$192.64 ,$217.28 
SACRED HEART HOSPITAL (ACU),32000496,77080,HC BONE DENSITY DXA,320,1 ,$510.00 ,$382.50 ,$25.77 ,$510.00 ,$328.44 ,$115.15 ,$357.00 ,$25.77 ,$51.92 ,$26.54 ,$41.54 ,$484.50 ,$25.77 ,$408.00 ,$469.20 ,$25.77 ,$433.50 ,$484.50 ,$448.80 ,$387.60 ,$25.77 ,$25.77 ,$25.77 ,$372.30 ,$280.50 ,$464.10 ,$464.10 ,$408.00 ,$118.60 ,$280.50 ,$459.00 ,$115.15 ,$459.00 ,$275.40 ,$479.40 ,$259.08 ,$469.20 ,$27.32 ,$464.10 ,$115.15 ,$313.85 ,$313.85 ,$195.54 ,$380.61 ,$216.16 ,$116.30 ,$25.77 ,$484.50 ,$120.90 ,$25.77 ,$443.70 ,$115.15 ,$459.00 ,$115.15 ,$459.00 ,$459.00 ,$459.00 ,$494.70 ,$413.10 ,$474.30 ,$438.60 ,$494.70 
SACRED HEART HOSPITAL (ACU),32000500,76000,HC FLUOROSCOPY UP TO 1 HR SNIFF DIAPHRM,320,1 ,$423.00 ,$317.25 ,$39.20 ,$547.56 ,$272.41 ,$243.36 ,$296.10 ,$39.20 ,$65.14 ,$40.38 ,$52.11 ,$401.85 ,$39.20 ,$338.40 ,$389.16 ,$39.20 ,$359.55 ,$401.85 ,$372.24 ,$321.48 ,$39.20 ,$39.20 ,$39.20 ,$308.79 ,$232.65 ,$384.93 ,$384.93 ,$338.40 ,$250.66 ,$232.65 ,$380.70 ,$243.36 ,$380.70 ,$228.42 ,$397.62 ,$547.56 ,$389.16 ,$41.55 ,$384.93 ,$243.36 ,$260.31 ,$260.31 ,$245.01 ,$315.68 ,$264.52 ,$245.79 ,$39.20 ,$401.85 ,$255.53 ,$39.20 ,$368.01 ,$243.36 ,$380.70 ,$243.36 ,$380.70 ,$380.70 ,$380.70 ,$410.31 ,$342.63 ,$393.39 ,$363.78 ,$410.31 
SACRED HEART HOSPITAL (ACU),32000503,20501,HC INJ TRACT SINOGRAM DIAG,320,1 ,$554.00 ,$415.50 ,$98.34 ,$554.00 ,$356.78 , N/A ,$387.80 ,$98.34 ,$459.82 ,$101.29 ,$365.64 ,$526.30 ,$98.34 ,$443.20 ,$509.68 ,$98.34 ,$470.90 ,$526.30 ,$487.52 ,$421.04 ,$98.34 ,$98.34 ,$98.34 ,$404.42 ,$304.70 ,$504.14 ,$504.14 ,$443.20 , N/A ,$304.70 ,$498.60 , N/A ,$498.60 ,$299.16 ,$520.76 , N/A ,$509.68 ,$104.24 ,$504.14 , N/A ,$340.93 ,$340.93 ,$498.60 ,$413.45 ,$385.86 , N/A ,$98.34 ,$526.30 , N/A ,$98.34 ,$481.98 , N/A ,$498.60 , N/A ,$498.60 ,$498.60 ,$498.60 ,$537.38 ,$448.74 ,$515.22 ,$476.44 ,$537.38 
SACRED HEART HOSPITAL (ACU),32000504,20550,HC INJ SINGLE TENDON/LIGAMENT,320,1 ,$406.00 ,$304.50 ,$78.10 ,$621.73 ,$261.46 ,$276.32 ,$284.20 ,$78.10 ,$336.98 ,$80.44 ,$267.96 ,$385.70 ,$78.10 ,$324.80 ,$373.52 ,$78.10 ,$345.10 ,$385.70 ,$357.28 ,$308.56 ,$78.10 ,$78.10 ,$78.10 ,$296.38 ,$223.30 ,$369.46 ,$369.46 ,$324.80 ,$284.61 ,$223.30 ,$365.40 ,$276.32 ,$365.40 ,$219.24 ,$381.64 ,$621.73 ,$373.52 ,$82.79 ,$369.46 ,$276.32 ,$249.85 ,$249.85 ,$365.40 ,$303.00 ,$282.78 ,$279.09 ,$78.10 ,$385.70 ,$290.14 ,$78.10 ,$353.22 ,$276.32 ,$365.40 ,$276.32 ,$365.40 ,$365.40 ,$365.40 ,$393.82 ,$328.86 ,$377.58 ,$349.16 ,$393.82 
SACRED HEART HOSPITAL (ACU),32000505,20552,HC INJ TRIGGER PT 1-2 MUSCLE(S),320,1 ,$672.00 ,$504.00 ,$78.10 ,$672.00 ,$432.77 ,$276.32 ,$470.40 ,$78.10 ,$557.76 ,$80.44 ,$443.52 ,$638.40 ,$78.10 ,$537.60 ,$618.24 ,$78.10 ,$571.20 ,$638.40 ,$591.36 ,$510.72 ,$78.10 ,$78.10 ,$78.10 ,$490.56 ,$369.60 ,$611.52 ,$611.52 ,$537.60 ,$284.61 ,$369.60 ,$604.80 ,$276.32 ,$604.80 ,$362.88 ,$631.68 ,$621.73 ,$618.24 ,$82.79 ,$611.52 ,$276.32 ,$413.55 ,$413.55 ,$604.80 ,$501.51 ,$468.05 ,$279.09 ,$78.10 ,$638.40 ,$290.14 ,$78.10 ,$584.64 ,$276.32 ,$604.80 ,$276.32 ,$604.80 ,$604.80 ,$604.80 ,$651.84 ,$544.32 ,$624.96 ,$577.92 ,$651.84 
SACRED HEART HOSPITAL (ACU),32000506,20553,HC INJ TRIGGER PT 3+ MUSC GROUP,320,1 ,$412.00 ,$309.00 ,$78.10 ,$621.73 ,$265.33 ,$276.32 ,$288.40 ,$78.10 ,$341.96 ,$80.44 ,$271.92 ,$391.40 ,$78.10 ,$329.60 ,$379.04 ,$78.10 ,$350.20 ,$391.40 ,$362.56 ,$313.12 ,$78.10 ,$78.10 ,$78.10 ,$300.76 ,$226.60 ,$374.92 ,$374.92 ,$329.60 ,$284.61 ,$226.60 ,$370.80 ,$276.32 ,$370.80 ,$222.48 ,$387.28 ,$621.73 ,$379.04 ,$82.79 ,$374.92 ,$276.32 ,$253.54 ,$253.54 ,$370.80 ,$307.48 ,$286.96 ,$279.09 ,$78.10 ,$391.40 ,$290.14 ,$78.10 ,$358.44 ,$276.32 ,$370.80 ,$276.32 ,$370.80 ,$370.80 ,$370.80 ,$399.64 ,$333.72 ,$383.16 ,$354.32 ,$399.64 
SACRED HEART HOSPITAL (ACU),32000509,77072,HC BONE AGE STUDIES,320,1 ,$337.00 ,$252.75 ,$18.00 ,$337.00 ,$217.03 ,$115.15 ,$235.90 ,$18.59 ,$22.51 ,$19.15 ,$18.00 ,$320.15 ,$18.59 ,$269.60 ,$310.04 ,$18.59 ,$286.45 ,$320.15 ,$296.56 ,$256.12 ,$18.59 ,$18.59 ,$18.59 ,$246.01 ,$185.35 ,$306.67 ,$306.67 ,$269.60 ,$118.60 ,$185.35 ,$303.30 ,$115.15 ,$303.30 ,$181.98 ,$316.78 ,$259.08 ,$310.04 ,$19.71 ,$306.67 ,$115.15 ,$207.39 ,$207.39 ,$26.37 ,$251.50 ,$90.35 ,$116.30 ,$18.59 ,$320.15 ,$120.90 ,$18.59 ,$293.19 ,$115.15 ,$303.30 ,$115.15 ,$303.30 ,$303.30 ,$303.30 ,$326.89 ,$272.97 ,$313.41 ,$289.82 ,$326.89 
SACRED HEART HOSPITAL (ACU),32000523,72020,HC XR SPINE 1V (C SPINE CLEAR LAT),320,1 ,$401.00 ,$300.75 ,$18.59 ,$401.00 ,$258.24 ,$85.55 ,$280.70 ,$18.59 ,$23.70 ,$19.15 ,$18.96 ,$380.95 ,$18.59 ,$320.80 ,$368.92 ,$18.59 ,$340.85 ,$380.95 ,$352.88 ,$304.76 ,$18.59 ,$18.59 ,$18.59 ,$292.73 ,$220.55 ,$364.91 ,$364.91 ,$320.80 ,$88.12 ,$220.55 ,$360.90 ,$85.55 ,$360.90 ,$216.54 ,$376.94 ,$192.49 ,$368.92 ,$19.71 ,$364.91 ,$85.55 ,$246.78 ,$246.78 ,$106.75 ,$299.27 ,$97.65 ,$86.40 ,$18.59 ,$380.95 ,$89.83 ,$18.59 ,$348.87 ,$85.55 ,$360.90 ,$85.55 ,$360.90 ,$360.90 ,$360.90 ,$388.97 ,$324.81 ,$372.93 ,$344.86 ,$388.97 
SACRED HEART HOSPITAL (ACU),32000528,47543,HC ENDO BILIARY PERC DX WITH SPECIMEN,320,1 ,"$5,165.00 ","$3,873.75 ",$817.89 ,"$5,165.00 ","$3,326.26 ", N/A ,"$3,615.50 ",$817.89 ,"$4,286.95 ",$842.43 ,"$3,408.90 ","$4,906.75 ",$817.89 ,"$4,132.00 ","$4,751.80 ",$817.89 ,"$4,390.25 ","$4,906.75 ","$4,545.20 ","$3,925.40 ",$817.89 ,$817.89 ,$817.89 ,"$3,770.45 ","$2,840.75 ","$4,700.15 ","$4,700.15 ","$4,132.00 ", N/A ,"$2,840.75 ","$4,648.50 ", N/A ,"$4,648.50 ","$2,789.10 ","$4,855.10 ", N/A ,"$4,751.80 ",$866.96 ,"$4,700.15 ", N/A ,"$3,178.54 ","$3,178.54 ","$4,648.50 ","$3,854.64 ","$3,597.42 ", N/A ,$817.89 ,"$4,906.75 ", N/A ,$817.89 ,"$4,493.55 ", N/A ,"$4,648.50 ", N/A ,"$4,648.50 ","$4,648.50 ","$4,648.50 ","$5,010.05 ","$4,183.65 ","$4,803.45 ","$4,441.90 ","$5,010.05 "
SACRED HEART HOSPITAL (ACU),32000530,32554,HC THORACENTESIS W/O IMAGING 32554,320,1 ,"$1,432.00 ","$1,074.00 ",$309.29 ,"$1,432.00 ",$922.21 ,$571.68 ,"$1,002.40 ",$309.29 ,"$1,188.56 ",$318.57 ,$945.12 ,"$1,360.40 ",$309.29 ,"$1,145.60 ","$1,317.44 ",$309.29 ,"$1,217.20 ","$1,360.40 ","$1,260.16 ","$1,088.32 ",$309.29 ,$309.29 ,$309.29 ,"$1,045.36 ",$787.60 ,"$1,303.12 ","$1,303.12 ","$1,145.60 ",$588.83 ,$787.60 ,"$1,288.80 ",$571.68 ,"$1,288.80 ",$773.28 ,"$1,346.08 ","$1,286.28 ","$1,317.44 ",$327.85 ,"$1,303.12 ",$571.68 ,$881.25 ,$881.25 ,"$1,288.80 ","$1,068.70 ",$997.39 ,$577.40 ,$309.29 ,"$1,360.40 ",$600.27 ,$309.29 ,"$1,245.84 ",$571.68 ,"$1,288.80 ",$571.68 ,"$1,288.80 ","$1,288.80 ","$1,288.80 ","$1,389.04 ","$1,159.92 ","$1,331.76 ","$1,231.52 ","$1,389.04 "
SACRED HEART HOSPITAL (ACU),32000531,32555,HC THORACENTESIS W IMAGING 32555,320,1 ,"$2,246.00 ","$1,684.50 ",$309.29 ,"$2,246.00 ","$1,446.42 ",$571.68 ,"$1,572.20 ",$309.29 ,"$1,864.18 ",$318.57 ,"$1,482.36 ","$2,133.70 ",$309.29 ,"$1,796.80 ","$2,066.32 ",$309.29 ,"$1,909.10 ","$2,133.70 ","$1,976.48 ","$1,706.96 ",$309.29 ,$309.29 ,$309.29 ,"$1,639.58 ","$1,235.30 ","$2,043.86 ","$2,043.86 ","$1,796.80 ",$588.83 ,"$1,235.30 ","$2,021.40 ",$571.68 ,"$2,021.40 ","$1,212.84 ","$2,111.24 ","$1,286.28 ","$2,066.32 ",$327.85 ,"$2,043.86 ",$571.68 ,"$1,382.19 ","$1,382.19 ","$2,021.40 ","$1,676.19 ","$1,564.34 ",$577.40 ,$309.29 ,"$2,133.70 ",$600.27 ,$309.29 ,"$1,954.02 ",$571.68 ,"$2,021.40 ",$571.68 ,"$2,021.40 ","$2,021.40 ","$2,021.40 ","$2,178.62 ","$1,819.26 ","$2,088.78 ","$1,931.56 ","$2,178.62 "
SACRED HEART HOSPITAL (ACU),32000533,32557,HC PLEURAL DRAINAGE W/IMAGING 32557,320,1 ,"$1,683.00 ","$1,262.25 ",$309.29 ,"$3,346.33 ","$1,083.85 ","$1,487.26 ","$1,178.10 ",$309.29 ,"$1,396.89 ",$318.57 ,"$1,110.78 ","$1,598.85 ",$309.29 ,"$1,346.40 ","$1,548.36 ",$309.29 ,"$1,430.55 ","$1,598.85 ","$1,481.04 ","$1,279.08 ",$309.29 ,$309.29 ,$309.29 ,"$1,228.59 ",$925.65 ,"$1,531.53 ","$1,531.53 ","$1,346.40 ","$1,531.88 ",$925.65 ,"$1,514.70 ","$1,487.26 ","$1,514.70 ",$908.82 ,"$1,582.02 ","$3,346.33 ","$1,548.36 ",$327.85 ,"$1,531.53 ","$1,487.26 ","$1,035.72 ","$1,035.72 ","$1,514.70 ","$1,256.02 ","$1,172.21 ","$1,502.13 ",$309.29 ,"$1,598.85 ","$1,561.62 ",$309.29 ,"$1,464.21 ","$1,487.26 ","$1,514.70 ","$1,487.26 ","$1,514.70 ","$1,514.70 ","$1,514.70 ","$1,632.51 ","$1,363.23 ","$1,565.19 ","$1,447.38 ","$1,632.51 "
SACRED HEART HOSPITAL (ACU),32000543,72074,HC XR T-SPINE 4 + VIEWS,320,1 ,$315.00 ,$236.25 ,$18.59 ,$315.00 ,$202.86 ,$115.15 ,$220.50 ,$18.59 ,$47.13 ,$19.15 ,$37.70 ,$299.25 ,$18.59 ,$252.00 ,$289.80 ,$18.59 ,$267.75 ,$299.25 ,$277.20 ,$239.40 ,$18.59 ,$18.59 ,$18.59 ,$229.95 ,$173.25 ,$286.65 ,$286.65 ,$252.00 ,$118.60 ,$173.25 ,$283.50 ,$115.15 ,$283.50 ,$170.10 ,$296.10 ,$259.08 ,$289.80 ,$19.71 ,$286.65 ,$115.15 ,$193.85 ,$193.85 ,$211.37 ,$235.08 ,$189.55 ,$116.30 ,$18.59 ,$299.25 ,$120.90 ,$18.59 ,$274.05 ,$115.15 ,$283.50 ,$115.15 ,$283.50 ,$283.50 ,$283.50 ,$305.55 ,$255.15 ,$292.95 ,$270.90 ,$305.55 
SACRED HEART HOSPITAL (ACU),32000551,77077,HC XR JOINT SRVY SINGLE 2 JOINTS,320,1 ,$164.00 ,$123.00 ,$18.59 ,$259.08 ,$105.62 ,$115.15 ,$114.80 ,$18.59 ,$35.11 ,$19.15 ,$28.08 ,$155.80 ,$18.59 ,$131.20 ,$150.88 ,$18.59 ,$139.40 ,$155.80 ,$144.32 ,$124.64 ,$18.59 ,$18.59 ,$18.59 ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 ,$118.60 ,$90.20 ,$147.60 ,$115.15 ,$147.60 ,$88.56 ,$154.16 ,$259.08 ,$150.88 ,$19.71 ,$149.24 ,$115.15 ,$100.93 ,$100.93 ,$75.43 ,$122.39 ,$141.18 ,$116.30 ,$18.59 ,$155.80 ,$120.90 ,$18.59 ,$142.68 ,$115.15 ,$147.60 ,$115.15 ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),32000560,49460,HC MECHAN REMOVAL OF OBSTRUCT MATERIAL FROM G/J/D TUBE FLUOR/CONT,320,1 ,"$1,155.04 ",$866.28 ,$218.32 ,"$1,925.53 ",$743.85 ,$855.79 ,$808.53 ,$218.32 ,$958.68 ,$224.87 ,$762.33 ,"$1,097.29 ",$218.32 ,$924.03 ,"$1,062.64 ",$218.32 ,$981.78 ,"$1,097.29 ","$1,016.44 ",$877.83 ,$218.32 ,$218.32 ,$218.32 ,$843.18 ,$635.27 ,"$1,051.09 ","$1,051.09 ",$924.03 ,$881.46 ,$635.27 ,"$1,039.54 ",$855.79 ,"$1,039.54 ",$623.72 ,"$1,085.74 ","$1,925.53 ","$1,062.64 ",$231.42 ,"$1,051.09 ",$855.79 ,$710.81 ,$710.81 ,"$1,039.54 ",$862.01 ,$804.49 ,$864.35 ,$218.32 ,"$1,097.29 ",$898.58 ,$218.32 ,"$1,004.88 ",$855.79 ,"$1,039.54 ",$855.79 ,"$1,039.54 ","$1,039.54 ","$1,039.54 ","$1,120.39 ",$935.58 ,"$1,074.19 ",$993.33 ,"$1,120.39 "
SACRED HEART HOSPITAL (ACU),32000561,49405,HC ABSCESS DRAIN KIDN/LIV/SPLN/LUNG VISERAL 49405,320,1 ,"$2,242.48 ","$1,681.86 ",$239.96 ,"$3,348.27 ","$1,444.16 ","$1,488.12 ","$1,569.74 ",$239.96 ,"$1,861.26 ",$247.16 ,"$1,480.04 ","$2,130.36 ",$239.96 ,"$1,793.98 ","$2,063.08 ",$239.96 ,"$1,906.11 ","$2,130.36 ","$1,973.38 ","$1,704.28 ",$239.96 ,$239.96 ,$239.96 ,"$1,637.01 ","$1,233.36 ","$2,040.66 ","$2,040.66 ","$1,793.98 ","$1,532.76 ","$1,233.36 ","$2,018.23 ","$1,488.12 ","$2,018.23 ","$1,210.94 ","$2,107.93 ","$3,348.27 ","$2,063.08 ",$254.36 ,"$2,040.66 ","$1,488.12 ","$1,380.02 ","$1,380.02 ","$2,018.23 ","$1,673.56 ","$1,561.89 ","$1,503.00 ",$239.96 ,"$2,130.36 ","$1,562.52 ",$239.96 ,"$1,950.96 ","$1,488.12 ","$2,018.23 ","$1,488.12 ","$2,018.23 ","$2,018.23 ","$2,018.23 ","$2,175.21 ","$1,816.41 ","$2,085.51 ","$1,928.53 ","$2,175.21 "
SACRED HEART HOSPITAL (ACU),32000562,49406,HC ABSCESS DRAIN PERI/ RETROPER PERC 49406,320,1 ,"$2,728.51 ","$2,046.38 ",$239.96 ,"$3,348.27 ","$1,757.16 ","$1,488.12 ","$1,909.96 ",$239.96 ,"$2,264.66 ",$247.16 ,"$1,800.82 ","$2,592.08 ",$239.96 ,"$2,182.81 ","$2,510.23 ",$239.96 ,"$2,319.23 ","$2,592.08 ","$2,401.09 ","$2,073.67 ",$239.96 ,$239.96 ,$239.96 ,"$1,991.81 ","$1,500.68 ","$2,482.94 ","$2,482.94 ","$2,182.81 ","$1,532.76 ","$1,500.68 ","$2,455.66 ","$1,488.12 ","$2,455.66 ","$1,473.40 ","$2,564.80 ","$3,348.27 ","$2,510.23 ",$254.36 ,"$2,482.94 ","$1,488.12 ","$1,679.13 ","$1,679.13 ","$2,455.66 ","$2,036.29 ","$1,900.41 ","$1,503.00 ",$239.96 ,"$2,592.08 ","$1,562.52 ",$239.96 ,"$2,373.80 ","$1,488.12 ","$2,455.66 ","$1,488.12 ","$2,455.66 ","$2,455.66 ","$2,455.66 ","$2,646.65 ","$2,210.09 ","$2,537.51 ","$2,346.52 ","$2,646.65 "
SACRED HEART HOSPITAL (ACU),32000563,49407,HC PERC DRN ABSC/HEM/CYST PERIT/RETROPER TV OR TR,320,1 ,"$2,202.11 ","$1,651.58 ",$239.96 ,"$3,348.27 ","$1,418.16 ","$1,488.12 ","$1,541.48 ",$239.96 ,"$1,827.75 ",$247.16 ,"$1,453.39 ","$2,092.00 ",$239.96 ,"$1,761.69 ","$2,025.94 ",$239.96 ,"$1,871.79 ","$2,092.00 ","$1,937.86 ","$1,673.60 ",$239.96 ,$239.96 ,$239.96 ,"$1,607.54 ","$1,211.16 ","$2,003.92 ","$2,003.92 ","$1,761.69 ","$1,532.76 ","$1,211.16 ","$1,981.90 ","$1,488.12 ","$1,981.90 ","$1,189.14 ","$2,069.98 ","$3,348.27 ","$2,025.94 ",$254.36 ,"$2,003.92 ","$1,488.12 ","$1,355.18 ","$1,355.18 ","$1,981.90 ","$1,643.43 ","$1,533.77 ","$1,503.00 ",$239.96 ,"$2,092.00 ","$1,562.52 ",$239.96 ,"$1,915.84 ","$1,488.12 ","$1,981.90 ","$1,488.12 ","$1,981.90 ","$1,981.90 ","$1,981.90 ","$2,136.05 ","$1,783.71 ","$2,047.96 ","$1,893.81 ","$2,136.05 "
SACRED HEART HOSPITAL (ACU),32000564,0075T,HC STENT VERTEBRAL EXTRACRANIAL 0075T,320,1 ,"$1,354.00 ","$1,015.50 ",$731.16 ,"$2,028.50 ",$871.98 , N/A ,$947.80 ,"$1,354.00 ","$1,123.82 ","$1,971.09 ",$893.64 ,"$1,286.30 ","$1,913.68 ","$1,083.20 ","$1,245.68 ","$1,354.00 ","$1,150.90 ","$1,286.30 ","$1,191.52 ","$1,029.04 ","$1,354.00 ","$1,354.00 ","$1,913.68 ",$988.42 ,$744.70 ,"$1,232.14 ","$1,232.14 ","$1,083.20 ", N/A ,$744.70 ,"$1,218.60 ", N/A ,"$1,218.60 ",$731.16 ,"$1,272.76 ", N/A ,"$1,245.68 ","$2,028.50 ","$1,232.14 ", N/A ,$833.25 ,$833.25 ,"$1,218.60 ","$1,010.49 ",$943.06 , N/A ,"$1,354.00 ","$1,286.30 ", N/A ,"$1,354.00 ","$1,177.98 ", N/A ,"$1,218.60 ", N/A ,"$1,218.60 ","$1,218.60 ","$1,218.60 ","$1,313.38 ","$1,096.74 ","$1,259.22 ","$1,164.44 ","$1,313.38 "
SACRED HEART HOSPITAL (ACU),32000565,37218,HC STENT CAROTID INTRATHORACIC 37218,320,1 ,"$2,567.00 ","$1,925.25 ","$1,386.18 ","$3,867.78 ","$1,653.15 ", N/A ,"$1,796.90 ","$2,567.00 ","$2,130.61 ","$3,758.32 ","$1,694.22 ","$2,438.65 ","$3,648.85 ","$2,053.60 ","$2,361.64 ","$2,567.00 ","$2,181.95 ","$2,438.65 ","$2,258.96 ","$1,950.92 ","$2,567.00 ","$2,567.00 ","$3,648.85 ","$1,873.91 ","$1,411.85 ","$2,335.97 ","$2,335.97 ","$2,053.60 ", N/A ,"$1,411.85 ","$2,310.30 ", N/A ,"$2,310.30 ","$1,386.18 ","$2,412.98 ", N/A ,"$2,361.64 ","$3,867.78 ","$2,335.97 ", N/A ,"$1,579.73 ","$1,579.73 ","$2,310.30 ","$1,915.75 ","$1,787.92 ", N/A ,"$2,567.00 ","$2,438.65 ", N/A ,"$2,567.00 ","$2,233.29 ", N/A ,"$2,310.30 ", N/A ,"$2,310.30 ","$2,310.30 ","$2,310.30 ","$2,489.99 ","$2,079.27 ","$2,387.31 ","$2,207.62 ","$2,489.99 "
SACRED HEART HOSPITAL (ACU),32000567,70100,HC XR MANDIBLE 1-3 VIEW,320,1 ,$264.00 ,$198.00 ,$18.59 ,$264.00 ,$170.02 ,$85.55 ,$184.80 ,$18.59 ,$39.92 ,$19.15 ,$31.93 ,$250.80 ,$18.59 ,$211.20 ,$242.88 ,$18.59 ,$224.40 ,$250.80 ,$232.32 ,$200.64 ,$18.59 ,$18.59 ,$18.59 ,$192.72 ,$145.20 ,$240.24 ,$240.24 ,$211.20 ,$88.12 ,$145.20 ,$237.60 ,$85.55 ,$237.60 ,$142.56 ,$248.16 ,$192.49 ,$242.88 ,$19.71 ,$240.24 ,$85.55 ,$162.47 ,$162.47 ,$127.61 ,$197.02 ,$160.48 ,$86.40 ,$18.59 ,$250.80 ,$89.83 ,$18.59 ,$229.68 ,$85.55 ,$237.60 ,$85.55 ,$237.60 ,$237.60 ,$237.60 ,$256.08 ,$213.84 ,$245.52 ,$227.04 ,$256.08 
SACRED HEART HOSPITAL (ACU),32000570,72081,HC XR SPINE/CERV SCOLIOSIS 1 VW,320,1 ,$266.00 ,$199.50 ,$18.59 ,$266.00 ,$171.30 ,$85.55 ,$186.20 ,$18.59 ,$42.91 ,$19.15 ,$34.33 ,$252.70 ,$18.59 ,$212.80 ,$244.72 ,$18.59 ,$226.10 ,$252.70 ,$234.08 ,$202.16 ,$18.59 ,$18.59 ,$18.59 ,$194.18 ,$146.30 ,$242.06 ,$242.06 ,$212.80 ,$88.12 ,$146.30 ,$239.40 ,$85.55 ,$239.40 ,$143.64 ,$250.04 ,$192.49 ,$244.72 ,$19.71 ,$242.06 ,$85.55 ,$163.70 ,$163.70 ,$48.60 ,$198.52 ,$170.17 ,$86.40 ,$18.59 ,$252.70 ,$89.83 ,$18.59 ,$231.42 ,$85.55 ,$239.40 ,$85.55 ,$239.40 ,$239.40 ,$239.40 ,$258.02 ,$215.46 ,$247.38 ,$228.76 ,$258.02 
SACRED HEART HOSPITAL (ACU),32000571,72082,HC XR SPINE/CERV SCOLIOSIS 2-3VW,320,1 ,$418.00 ,$313.50 ,$18.59 ,$418.00 ,$269.19 ,$115.15 ,$292.60 ,$18.59 ,$77.74 ,$19.15 ,$62.19 ,$397.10 ,$18.59 ,$334.40 ,$384.56 ,$18.59 ,$355.30 ,$397.10 ,$367.84 ,$317.68 ,$18.59 ,$18.59 ,$18.59 ,$305.14 ,$229.90 ,$380.38 ,$380.38 ,$334.40 ,$118.60 ,$229.90 ,$376.20 ,$115.15 ,$376.20 ,$225.72 ,$392.92 ,$259.08 ,$384.56 ,$19.71 ,$380.38 ,$115.15 ,$257.24 ,$257.24 ,$88.30 ,$311.95 ,$312.89 ,$116.30 ,$18.59 ,$397.10 ,$120.90 ,$18.59 ,$363.66 ,$115.15 ,$376.20 ,$115.15 ,$376.20 ,$376.20 ,$376.20 ,$405.46 ,$338.58 ,$388.74 ,$359.48 ,$405.46 
SACRED HEART HOSPITAL (ACU),32000574,73501,HC XR HIP W/PELVIS UNI 1VIEW,320,1 ,$204.00 ,$153.00 ,$18.59 ,$204.00 ,$131.38 ,$85.55 ,$142.80 ,$18.59 ,$33.92 ,$19.15 ,$27.13 ,$193.80 ,$18.59 ,$163.20 ,$187.68 ,$18.59 ,$173.40 ,$193.80 ,$179.52 ,$155.04 ,$18.59 ,$18.59 ,$18.59 ,$148.92 ,$112.20 ,$185.64 ,$185.64 ,$163.20 ,$88.12 ,$112.20 ,$183.60 ,$85.55 ,$183.60 ,$110.16 ,$191.76 ,$192.49 ,$187.68 ,$19.71 ,$185.64 ,$85.55 ,$125.54 ,$125.54 ,$38.33 ,$152.25 ,$138.72 ,$86.40 ,$18.59 ,$193.80 ,$89.83 ,$18.59 ,$177.48 ,$85.55 ,$183.60 ,$85.55 ,$183.60 ,$183.60 ,$183.60 ,$197.88 ,$165.24 ,$189.72 ,$175.44 ,$197.88 
SACRED HEART HOSPITAL (ACU),32000575,73502,HC XR HIP W/PELVIS UNI 2-3VWS,320,1 ,$274.00 ,$205.50 ,$18.59 ,$274.00 ,$176.46 ,$85.55 ,$191.80 ,$18.59 ,$50.72 ,$19.15 ,$40.57 ,$260.30 ,$18.59 ,$219.20 ,$252.08 ,$18.59 ,$232.90 ,$260.30 ,$241.12 ,$208.24 ,$18.59 ,$18.59 ,$18.59 ,$200.02 ,$150.70 ,$249.34 ,$249.34 ,$219.20 ,$88.12 ,$150.70 ,$246.60 ,$85.55 ,$246.60 ,$147.96 ,$257.56 ,$192.49 ,$252.08 ,$19.71 ,$249.34 ,$85.55 ,$168.62 ,$168.62 ,$57.50 ,$204.49 ,$204.01 ,$86.40 ,$18.59 ,$260.30 ,$89.83 ,$18.59 ,$238.38 ,$85.55 ,$246.60 ,$85.55 ,$246.60 ,$246.60 ,$246.60 ,$265.78 ,$221.94 ,$254.82 ,$235.64 ,$265.78 
SACRED HEART HOSPITAL (ACU),32000577,73521,HC XR HIP W/PELVIS BIL 2 VIEWS,320,1 ,$274.00 ,$205.50 ,$18.59 ,$274.00 ,$176.46 ,$115.15 ,$191.80 ,$18.59 ,$47.13 ,$19.15 ,$37.70 ,$260.30 ,$18.59 ,$219.20 ,$252.08 ,$18.59 ,$232.90 ,$260.30 ,$241.12 ,$208.24 ,$18.59 ,$18.59 ,$18.59 ,$200.02 ,$150.70 ,$249.34 ,$249.34 ,$219.20 ,$118.60 ,$150.70 ,$246.60 ,$115.15 ,$246.60 ,$147.96 ,$257.56 ,$259.08 ,$252.08 ,$19.71 ,$249.34 ,$115.15 ,$168.62 ,$168.62 ,$53.39 ,$204.49 ,$177.40 ,$116.30 ,$18.59 ,$260.30 ,$120.90 ,$18.59 ,$238.38 ,$115.15 ,$246.60 ,$115.15 ,$246.60 ,$246.60 ,$246.60 ,$265.78 ,$221.94 ,$254.82 ,$235.64 ,$265.78 
SACRED HEART HOSPITAL (ACU),32000578,73522,HC XR HIP W/PELVIS BIL 3-4VIEWS,320,1 ,$323.00 ,$242.25 ,$18.59 ,$323.00 ,$208.01 ,$115.15 ,$226.10 ,$18.59 ,$56.74 ,$19.15 ,$45.39 ,$306.85 ,$18.59 ,$258.40 ,$297.16 ,$18.59 ,$274.55 ,$306.85 ,$284.24 ,$245.48 ,$18.59 ,$18.59 ,$18.59 ,$235.79 ,$177.65 ,$293.93 ,$293.93 ,$258.40 ,$118.60 ,$177.65 ,$290.70 ,$115.15 ,$290.70 ,$174.42 ,$303.62 ,$259.08 ,$297.16 ,$19.71 ,$293.93 ,$115.15 ,$198.77 ,$198.77 ,$64.34 ,$241.05 ,$228.23 ,$116.30 ,$18.59 ,$306.85 ,$120.90 ,$18.59 ,$281.01 ,$115.15 ,$290.70 ,$115.15 ,$290.70 ,$290.70 ,$290.70 ,$313.31 ,$261.63 ,$300.39 ,$277.78 ,$313.31 
SACRED HEART HOSPITAL (ACU),32000579,73523,HC XR HIP W/PELVIS BIL 5+VIEWS,320,1 ,$323.00 ,$242.25 ,$18.59 ,$323.00 ,$208.01 ,$115.15 ,$226.10 ,$18.59 ,$68.13 ,$19.15 ,$54.50 ,$306.85 ,$18.59 ,$258.40 ,$297.16 ,$18.59 ,$274.55 ,$306.85 ,$284.24 ,$245.48 ,$18.59 ,$18.59 ,$18.59 ,$235.79 ,$177.65 ,$293.93 ,$293.93 ,$258.40 ,$118.60 ,$177.65 ,$290.70 ,$115.15 ,$290.70 ,$174.42 ,$303.62 ,$259.08 ,$297.16 ,$19.71 ,$293.93 ,$115.15 ,$198.77 ,$198.77 ,$77.35 ,$241.05 ,$274.21 ,$116.30 ,$18.59 ,$306.85 ,$120.90 ,$18.59 ,$281.01 ,$115.15 ,$290.70 ,$115.15 ,$290.70 ,$290.70 ,$290.70 ,$313.31 ,$261.63 ,$300.39 ,$277.78 ,$313.31 
SACRED HEART HOSPITAL (ACU),32000581,73552,HC XR FEMUR 2+VIEWS,320,1 ,$244.00 ,$183.00 ,$18.59 ,$244.00 ,$157.14 ,$85.55 ,$170.80 ,$18.59 ,$38.71 ,$19.15 ,$30.97 ,$231.80 ,$18.59 ,$195.20 ,$224.48 ,$18.59 ,$207.40 ,$231.80 ,$214.72 ,$185.44 ,$18.59 ,$18.59 ,$18.59 ,$178.12 ,$134.20 ,$222.04 ,$222.04 ,$195.20 ,$88.12 ,$134.20 ,$219.60 ,$85.55 ,$219.60 ,$131.76 ,$229.36 ,$192.49 ,$224.48 ,$19.71 ,$222.04 ,$85.55 ,$150.16 ,$150.16 ,$43.81 ,$182.10 ,$158.10 ,$86.40 ,$18.59 ,$231.80 ,$89.83 ,$18.59 ,$212.28 ,$85.55 ,$219.60 ,$85.55 ,$219.60 ,$219.60 ,$219.60 ,$236.68 ,$197.64 ,$226.92 ,$209.84 ,$236.68 
SACRED HEART HOSPITAL (ACU),32000586,72265,HC XR MYELOGRAPHY L-SPINE,320,1 ,"$1,068.00 ",$801.00 ,$68.43 ,"$1,702.50 ",$687.79 ,$756.67 ,$747.60 ,$190.36 ,$85.54 ,$196.07 ,$68.43 ,"$1,014.60 ",$190.36 ,$854.40 ,$982.56 ,$190.36 ,$907.80 ,"$1,014.60 ",$939.84 ,$811.68 ,$190.36 ,$190.36 ,$190.36 ,$779.64 ,$587.40 ,$971.88 ,$971.88 ,$854.40 ,$779.37 ,$587.40 ,$961.20 ,$756.67 ,$961.20 ,$576.72 ,"$1,003.92 ","$1,702.50 ",$982.56 ,$201.78 ,$971.88 ,$756.67 ,$657.25 ,$657.25 ,$871.76 ,$797.05 ,$344.35 ,$764.23 ,$190.36 ,"$1,014.60 ",$794.50 ,$190.36 ,$929.16 ,$756.67 ,$961.20 ,$756.67 ,$961.20 ,$961.20 ,$961.20 ,"$1,035.96 ",$865.08 ,$993.24 ,$918.48 ,"$1,035.96 "
SACRED HEART HOSPITAL (ACU),32000588,72275,HC XR EPIDUROGRAPHY,320,1 ,$248.00 ,$186.00 ,$103.03 ,$248.00 ,$159.71 , N/A ,$173.60 , N/A ,$128.78 , N/A ,$103.03 ,$235.60 , N/A ,$198.40 ,$228.16 , N/A ,$210.80 ,$235.60 ,$218.24 ,$188.48 , N/A , N/A , N/A ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 , N/A ,$136.40 ,$223.20 , N/A ,$223.20 ,$133.92 ,$233.12 , N/A ,$228.16 , N/A ,$225.68 , N/A ,$152.62 ,$152.62 ,$234.69 ,$185.08 ,$223.20 , N/A , N/A ,$235.60 , N/A , N/A ,$215.76 , N/A ,$223.20 , N/A ,$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),32000589,74019,HC XR ABDOMEN 2V,320,1 ,$337.07 ,$252.80 ,$18.59 ,$337.07 ,$217.07 ,$115.15 ,$235.95 ,$18.59 ,$36.28 ,$19.15 ,$29.02 ,$320.22 ,$18.59 ,$269.66 ,$310.10 ,$18.59 ,$286.51 ,$320.22 ,$296.62 ,$256.17 ,$18.59 ,$18.59 ,$18.59 ,$246.06 ,$185.39 ,$306.73 ,$306.73 ,$269.66 ,$118.60 ,$185.39 ,$303.36 ,$115.15 ,$303.36 ,$182.02 ,$316.85 ,$259.08 ,$310.10 ,$19.71 ,$306.73 ,$115.15 ,$207.43 ,$207.43 ,$64.34 ,$251.56 ,$234.77 ,$116.30 ,$18.59 ,$320.22 ,$120.90 ,$18.59 ,$293.25 ,$115.15 ,$303.36 ,$115.15 ,$303.36 ,$303.36 ,$303.36 ,$326.96 ,$273.03 ,$313.48 ,$289.88 ,$326.96 
SACRED HEART HOSPITAL (ACU),32000590,74360,HC XR ESOPHAGEAL DILATION INTRALUMINAL,320,1 ,"$1,302.94 ",$977.21 ,$58.37 ,"$1,302.94 ",$839.09 , N/A ,$912.06 ,$58.37 ,$147.84 ,$60.12 ,$118.27 ,"$1,237.79 ",$58.37 ,"$1,042.35 ","$1,198.70 ",$58.37 ,"$1,107.50 ","$1,237.79 ","$1,146.59 ",$990.23 ,$58.37 ,$58.37 ,$58.37 ,$951.15 ,$716.62 ,"$1,185.68 ","$1,185.68 ","$1,042.35 ", N/A ,$716.62 ,"$1,172.65 ", N/A ,"$1,172.65 ",$703.59 ,"$1,224.76 ", N/A ,"$1,198.70 ",$61.87 ,"$1,185.68 ", N/A ,$801.83 ,$801.83 ,$362.03 ,$972.38 ,$191.65 , N/A ,$58.37 ,"$1,237.79 ", N/A ,$58.37 ,"$1,133.56 ", N/A ,"$1,172.65 ", N/A ,"$1,172.65 ","$1,172.65 ","$1,172.65 ","$1,263.85 ","$1,055.38 ","$1,211.73 ","$1,120.53 ","$1,263.85 "
SACRED HEART HOSPITAL (ACU),32000591,75956,HC ENDOVASC REPR THOR AORTA W/SUBCL S AND I,320,1 ,"$3,301.00 ","$2,475.75 ",$58.37 ,"$3,301.00 ","$2,125.84 ", N/A ,"$2,310.70 ",$58.37 ,$575.19 ,$60.12 ,$460.15 ,"$3,135.95 ",$58.37 ,"$2,640.80 ","$3,036.92 ",$58.37 ,"$2,805.85 ","$3,135.95 ","$2,904.88 ","$2,508.76 ",$58.37 ,$58.37 ,$58.37 ,"$2,409.73 ","$1,815.55 ","$3,003.91 ","$3,003.91 ","$2,640.80 ", N/A ,"$1,815.55 ","$2,970.90 ", N/A ,"$2,970.90 ","$1,782.54 ","$3,102.94 ", N/A ,"$3,036.92 ",$61.87 ,"$3,003.91 ", N/A ,"$2,031.44 ","$2,031.44 ",$800.67 ,"$2,463.54 ","$2,267.42 ", N/A ,$58.37 ,"$3,135.95 ", N/A ,$58.37 ,"$2,871.87 ", N/A ,"$2,970.90 ", N/A ,"$2,970.90 ","$2,970.90 ","$2,970.90 ","$3,201.97 ","$2,673.81 ","$3,069.93 ","$2,838.86 ","$3,201.97 "
SACRED HEART HOSPITAL (ACU),32000592,75957,HC ENDOVASC REPR THOR AORTA W/O SUBCL S AND I,320,1 ,"$1,540.00 ","$1,155.00 ",$58.37 ,"$1,540.00 ",$991.76 , N/A ,"$1,078.00 ",$58.37 ,$493.69 ,$60.12 ,$394.95 ,"$1,463.00 ",$58.37 ,"$1,232.00 ","$1,416.80 ",$58.37 ,"$1,309.00 ","$1,463.00 ","$1,355.20 ","$1,170.40 ",$58.37 ,$58.37 ,$58.37 ,"$1,124.20 ",$847.00 ,"$1,401.40 ","$1,401.40 ","$1,232.00 ", N/A ,$847.00 ,"$1,386.00 ", N/A ,"$1,386.00 ",$831.60 ,"$1,447.60 ", N/A ,"$1,416.80 ",$61.87 ,"$1,401.40 ", N/A ,$947.72 ,$947.72 ,$685.97 ,"$1,149.30 ","$1,386.00 ", N/A ,$58.37 ,"$1,463.00 ", N/A ,$58.37 ,"$1,339.80 ", N/A ,"$1,386.00 ", N/A ,"$1,386.00 ","$1,386.00 ","$1,386.00 ","$1,493.80 ","$1,247.40 ","$1,432.20 ","$1,324.40 ","$1,493.80 "
SACRED HEART HOSPITAL (ACU),32000594,75959,HC PLACE DISTAL EXT PROSTH POST RPR THOR AORTA S AND I,320,1 ,"$1,964.00 ","$1,473.00 ",$58.37 ,"$1,964.00 ","$1,264.82 ", N/A ,"$1,374.80 ",$58.37 ,$278.65 ,$60.12 ,$222.92 ,"$1,865.80 ",$58.37 ,"$1,571.20 ","$1,806.88 ",$58.37 ,"$1,669.40 ","$1,865.80 ","$1,728.32 ","$1,492.64 ",$58.37 ,$58.37 ,$58.37 ,"$1,433.72 ","$1,080.20 ","$1,787.24 ","$1,787.24 ","$1,571.20 ", N/A ,"$1,080.20 ","$1,767.60 ", N/A ,"$1,767.60 ","$1,060.56 ","$1,846.16 ", N/A ,"$1,806.88 ",$61.87 ,"$1,787.24 ", N/A ,"$1,208.65 ","$1,208.65 ",$400.34 ,"$1,465.73 ","$1,134.13 ", N/A ,$58.37 ,"$1,865.80 ", N/A ,$58.37 ,"$1,708.68 ", N/A ,"$1,767.60 ", N/A ,"$1,767.60 ","$1,767.60 ","$1,767.60 ","$1,905.08 ","$1,590.84 ","$1,826.52 ","$1,689.04 ","$1,905.08 "
SACRED HEART HOSPITAL (ACU),32000600,77061,HC DIGITAL BREAST TOMOSYNTHESIS UNI,320,1 ,$40.00 ,$30.00 ,$16.44 ,$40.00 ,$25.76 , N/A ,$28.00 ,$16.44 ,$40.00 ,$16.93 ,$40.00 ,$38.00 ,$16.44 ,$32.00 ,$36.80 ,$16.44 ,$34.00 ,$38.00 ,$35.20 ,$30.40 ,$16.44 ,$16.44 ,$16.44 ,$29.20 ,$22.00 ,$36.40 ,$36.40 ,$32.00 , N/A ,$22.00 ,$36.00 , N/A ,$36.00 ,$21.60 ,$37.60 , N/A ,$36.80 ,$17.43 ,$36.40 , N/A ,$24.62 ,$24.62 ,$40.00 ,$29.85 ,$27.86 , N/A ,$16.44 ,$38.00 , N/A ,$16.44 ,$34.80 , N/A ,$36.00 , N/A ,$36.00 ,$36.00 ,$36.00 ,$38.80 ,$32.40 ,$37.20 ,$34.40 ,$38.80 
SACRED HEART HOSPITAL (ACU),32000601,77062,HC DIGITAL BREAST TOMOSYNTHESIS BIL,320,1 ,$40.00 ,$30.00 ,$16.44 ,$40.00 ,$25.76 , N/A ,$28.00 ,$16.44 ,$40.00 ,$16.93 ,$40.00 ,$38.00 ,$16.44 ,$32.00 ,$36.80 ,$16.44 ,$34.00 ,$38.00 ,$35.20 ,$30.40 ,$16.44 ,$16.44 ,$16.44 ,$29.20 ,$22.00 ,$36.40 ,$36.40 ,$32.00 , N/A ,$22.00 ,$36.00 , N/A ,$36.00 ,$21.60 ,$37.60 , N/A ,$36.80 ,$17.43 ,$36.40 , N/A ,$24.62 ,$24.62 ,$40.00 ,$29.85 ,$27.86 , N/A ,$16.44 ,$38.00 , N/A ,$16.44 ,$34.80 , N/A ,$36.00 , N/A ,$36.00 ,$36.00 ,$36.00 ,$38.80 ,$32.40 ,$37.20 ,$34.40 ,$38.80 
SACRED HEART HOSPITAL (ACU),32000611,G1004,HC RAD AUC CDSM NATL DECISION SUPPORT COMPANY,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000612,74248,HC XRAY SMALL INTESTINE FOLLOW THRU STUDY,320,1 ,$774.41 ,$580.81 ,$39.20 ,$774.41 ,$498.72 , N/A ,$542.09 ,$39.20 ,$79.29 ,$40.38 ,$63.43 ,$735.69 ,$39.20 ,$619.53 ,$712.46 ,$39.20 ,$658.25 ,$735.69 ,$681.48 ,$588.55 ,$39.20 ,$39.20 ,$39.20 ,$565.32 ,$425.93 ,$704.71 ,$704.71 ,$619.53 , N/A ,$425.93 ,$696.97 , N/A ,$696.97 ,$418.18 ,$727.95 , N/A ,$712.46 ,$41.55 ,$704.71 , N/A ,$476.57 ,$476.57 ,$696.97 ,$577.94 ,$552.03 , N/A ,$39.20 ,$735.69 , N/A ,$39.20 ,$673.74 , N/A ,$696.97 , N/A ,$696.97 ,$696.97 ,$696.97 ,$751.18 ,$627.27 ,$720.20 ,$665.99 ,$751.18 
SACRED HEART HOSPITAL (ACU),32000613,G1002,HC RAD AUC CDSM MEDCURRENT,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000614,G1003,HC RAD AUC CDSM MEDICALIS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000615,G1005,HC RAD AUC CDSM NATIONAL IMAGING ASSOCIATES,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000616,G1006,HC RAD AUC CDSM TEST APPROPRIATE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000617,G1007,HC RAD AUC CDSM AIM SPECIALTY HEALTH,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000618,G1008,HC RAD AUC CDSM CRANBERRY PEAK,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000619,G1009,HC RAD AUC CDSM SAGE HEALTH MGMT SOLUTIONS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000620,G1010,HC RAD AUC CDSM STANSON,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000621,G1011,HC RAD AUC CDSM QUALIFIED TOOL NOS,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),32000623,G1001,HC RAD AUC CDSM EVICORE,320,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),33100003,96420,HC CHEMO IV INTRA ART PUSH TECH,331,1 ,"$2,248.00 ","$1,686.00 ",$14.35 ,"$2,248.00 ","$1,447.71 ",$337.23 ,"$1,573.60 ",$14.35 ,"$1,865.84 ",$14.78 ,"$1,483.68 ","$2,135.60 ",$14.35 ,"$1,798.40 ","$2,068.16 ",$14.35 ,"$1,910.80 ","$2,135.60 ","$1,978.24 ","$1,708.48 ",$14.35 ,$14.35 ,$14.35 ,"$1,641.04 ","$1,236.40 ","$2,045.68 ","$2,045.68 ","$1,798.40 ",$347.35 ,"$1,236.40 ","$2,023.20 ",$337.23 ,"$2,023.20 ","$1,213.92 ","$2,113.12 ",$758.76 ,"$2,068.16 ",$15.21 ,"$2,045.68 ",$337.23 ,"$1,383.42 ","$1,383.42 ","$2,023.20 ","$1,677.68 ","$1,565.73 ",$340.60 ,$14.35 ,"$2,135.60 ",$354.09 ,$14.35 ,"$1,955.76 ",$337.23 ,"$2,023.20 ",$337.23 ,"$2,023.20 ","$2,023.20 ","$2,023.20 ","$2,180.56 ","$1,820.88 ","$2,090.64 ","$1,933.28 ","$2,180.56 "
SACRED HEART HOSPITAL (ACU),33300009,77285,HC SIMULATION INTERMED,333,1 ,"$1,532.00 ","$1,149.00 ",$62.18 ,"$1,532.00 ",$986.61 ,$358.16 ,"$1,072.40 ",$62.18 ,$649.93 ,$64.05 ,$519.95 ,"$1,455.40 ",$62.18 ,"$1,225.60 ","$1,409.44 ",$62.18 ,"$1,302.20 ","$1,455.40 ","$1,348.16 ","$1,164.32 ",$62.18 ,$62.18 ,$62.18 ,"$1,118.36 ",$842.60 ,"$1,394.12 ","$1,394.12 ","$1,225.60 ",$368.90 ,$842.60 ,"$1,378.80 ",$358.16 ,"$1,378.80 ",$827.28 ,"$1,440.08 ",$805.85 ,"$1,409.44 ",$65.91 ,"$1,394.12 ",$358.16 ,$942.79 ,$942.79 ,$679.02 ,"$1,143.33 ","$1,378.80 ",$361.74 ,$62.18 ,"$1,455.40 ",$376.06 ,$62.18 ,"$1,332.84 ",$358.16 ,"$1,378.80 ",$358.16 ,"$1,378.80 ","$1,378.80 ","$1,378.80 ","$1,486.04 ","$1,240.92 ","$1,424.76 ","$1,317.52 ","$1,486.04 "
SACRED HEART HOSPITAL (ACU),33300010,77290,HC SIMULATION COMPLEX,333,1 ,"$3,883.00 ","$2,912.25 ",$62.18 ,"$3,883.00 ","$2,500.65 ",$358.16 ,"$2,718.10 ",$62.18 ,$740.60 ,$64.05 ,$592.48 ,"$3,688.85 ",$62.18 ,"$3,106.40 ","$3,572.36 ",$62.18 ,"$3,300.55 ","$3,688.85 ","$3,417.04 ","$2,951.08 ",$62.18 ,$62.18 ,$62.18 ,"$2,834.59 ","$2,135.65 ","$3,533.53 ","$3,533.53 ","$3,106.40 ",$368.90 ,"$2,135.65 ","$3,494.70 ",$358.16 ,"$3,494.70 ","$2,096.82 ","$3,650.02 ",$805.85 ,"$3,572.36 ",$65.91 ,"$3,533.53 ",$358.16 ,"$2,389.60 ","$2,389.60 ",$817.35 ,"$2,897.88 ",$567.31 ,$361.74 ,$62.18 ,"$3,688.85 ",$376.06 ,$62.18 ,"$3,378.21 ",$358.16 ,"$3,494.70 ",$358.16 ,"$3,494.70 ","$3,494.70 ","$3,494.70 ","$3,766.51 ","$3,145.23 ","$3,611.19 ","$3,339.38 ","$3,766.51 "
SACRED HEART HOSPITAL (ACU),33300011,77295,HC SIMULATION 3-D,333,1 ,"$7,247.00 ","$5,435.25 ",$357.63 ,"$7,247.00 ","$4,667.07 ","$1,335.56 ","$5,072.90 ",$357.63 ,$456.56 ,$368.36 ,$365.25 ,"$6,884.65 ",$357.63 ,"$5,797.60 ","$6,667.24 ",$357.63 ,"$6,159.95 ","$6,884.65 ","$6,377.36 ","$5,507.72 ",$357.63 ,$357.63 ,$357.63 ,"$5,290.31 ","$3,985.85 ","$6,594.77 ","$6,594.77 ","$5,797.60 ","$1,375.63 ","$3,985.85 ","$6,522.30 ","$1,335.56 ","$6,522.30 ","$3,913.38 ","$6,812.18 ","$3,005.00 ","$6,667.24 ",$379.09 ,"$6,594.77 ","$1,335.56 ","$4,459.80 ","$4,459.80 ","$3,214.13 ","$5,408.44 ","$1,876.39 ","$1,348.91 ",$357.63 ,"$6,884.65 ","$1,402.33 ",$357.63 ,"$6,304.89 ","$1,335.56 ","$6,522.30 ","$1,335.56 ","$6,522.30 ","$6,522.30 ","$6,522.30 ","$7,029.59 ","$5,870.07 ","$6,739.71 ","$6,232.42 ","$7,029.59 "
SACRED HEART HOSPITAL (ACU),33300016,77300,HC DOSIMETRY CALCULATION,333,1 ,$592.00 ,$444.00 ,$46.34 ,$592.00 ,$381.25 ,$134.20 ,$414.40 ,$62.18 ,$57.93 ,$64.05 ,$46.34 ,$562.40 ,$62.18 ,$473.60 ,$544.64 ,$62.18 ,$503.20 ,$562.40 ,$520.96 ,$449.92 ,$62.18 ,$62.18 ,$62.18 ,$432.16 ,$325.60 ,$538.72 ,$538.72 ,$473.60 ,$138.23 ,$325.60 ,$532.80 ,$134.20 ,$532.80 ,$319.68 ,$556.48 ,$301.95 ,$544.64 ,$65.91 ,$538.72 ,$134.20 ,$364.32 ,$364.32 ,$218.17 ,$441.81 ,$237.92 ,$135.54 ,$62.18 ,$562.40 ,$140.91 ,$62.18 ,$515.04 ,$134.20 ,$532.80 ,$134.20 ,$532.80 ,$532.80 ,$532.80 ,$574.24 ,$479.52 ,$550.56 ,$509.12 ,$574.24 
SACRED HEART HOSPITAL (ACU),33300017,77301,HC IMRT TX PLAN,333,1 ,"$10,953.00 ","$8,214.75 ",$357.63 ,"$10,953.00 ","$7,053.73 ","$1,335.56 ","$7,667.10 ",$357.63 ,"$2,616.90 ",$368.36 ,"$2,093.52 ","$10,405.35 ",$357.63 ,"$8,762.40 ","$10,076.76 ",$357.63 ,"$9,310.05 ","$10,405.35 ","$9,638.64 ","$8,324.28 ",$357.63 ,$357.63 ,$357.63 ,"$7,995.69 ","$6,024.15 ","$9,967.23 ","$9,967.23 ","$8,762.40 ","$1,375.63 ","$6,024.15 ","$9,857.70 ","$1,335.56 ","$9,857.70 ","$5,914.62 ","$10,295.82 ","$3,005.00 ","$10,076.76 ",$379.09 ,"$9,967.23 ","$1,335.56 ","$6,740.48 ","$6,740.48 ","$2,509.39 ","$8,174.22 ","$9,857.70 ","$1,348.91 ",$357.63 ,"$10,405.35 ","$1,402.33 ",$357.63 ,"$9,529.11 ","$1,335.56 ","$9,857.70 ","$1,335.56 ","$9,857.70 ","$9,857.70 ","$9,857.70 ","$10,624.41 ","$8,871.93 ","$10,186.29 ","$9,419.58 ","$10,624.41 "
SACRED HEART HOSPITAL (ACU),33300018,77306,HC ISODOSE PLAN SIMPLE,333,1 ,$623.00 ,$467.25 ,$38.15 ,$805.85 ,$401.21 ,$358.16 ,$436.10 ,$38.15 ,$130.27 ,$39.29 ,$104.22 ,$591.85 ,$38.15 ,$498.40 ,$573.16 ,$38.15 ,$529.55 ,$591.85 ,$548.24 ,$473.48 ,$38.15 ,$38.15 ,$38.15 ,$454.79 ,$342.65 ,$566.93 ,$566.93 ,$498.40 ,$368.90 ,$342.65 ,$560.70 ,$358.16 ,$560.70 ,$336.42 ,$585.62 ,$805.85 ,$573.16 ,$40.44 ,$566.93 ,$358.16 ,$383.39 ,$383.39 ,$278.59 ,$464.94 ,$536.28 ,$361.74 ,$38.15 ,$591.85 ,$376.06 ,$38.15 ,$542.01 ,$358.16 ,$560.70 ,$358.16 ,$560.70 ,$560.70 ,$560.70 ,$604.31 ,$504.63 ,$579.39 ,$535.78 ,$604.31 
SACRED HEART HOSPITAL (ACU),33300022,77307,HC ISODOSE PLAN COMPLEX,333,1 ,"$2,098.00 ","$1,573.50 ",$62.18 ,"$2,098.00 ","$1,351.11 ",$358.16 ,"$1,468.60 ",$62.18 ,$235.62 ,$64.05 ,$188.50 ,"$1,993.10 ",$62.18 ,"$1,678.40 ","$1,930.16 ",$62.18 ,"$1,783.30 ","$1,993.10 ","$1,846.24 ","$1,594.48 ",$62.18 ,$62.18 ,$62.18 ,"$1,531.54 ","$1,153.90 ","$1,909.18 ","$1,909.18 ","$1,678.40 ",$368.90 ,"$1,153.90 ","$1,888.20 ",$358.16 ,"$1,888.20 ","$1,132.92 ","$1,972.12 ",$805.85 ,"$1,930.16 ",$65.91 ,"$1,909.18 ",$358.16 ,"$1,291.11 ","$1,291.11 ",$545.55 ,"$1,565.74 ",$970.07 ,$361.74 ,$62.18 ,"$1,993.10 ",$376.06 ,$62.18 ,"$1,825.26 ",$358.16 ,"$1,888.20 ",$358.16 ,"$1,888.20 ","$1,888.20 ","$1,888.20 ","$2,035.06 ","$1,699.38 ","$1,951.14 ","$1,804.28 ","$2,035.06 "
SACRED HEART HOSPITAL (ACU),33300024,77321,HC PORT PLAN SPECIAL,333,1 ,"$1,240.00 ",$930.00 ,$59.30 ,"$1,240.00 ",$798.56 ,$358.16 ,$868.00 ,$62.18 ,$74.13 ,$64.05 ,$59.30 ,"$1,178.00 ",$62.18 ,$992.00 ,"$1,140.80 ",$62.18 ,"$1,054.00 ","$1,178.00 ","$1,091.20 ",$942.40 ,$62.18 ,$62.18 ,$62.18 ,$905.20 ,$682.00 ,"$1,128.40 ","$1,128.40 ",$992.00 ,$368.90 ,$682.00 ,"$1,116.00 ",$358.16 ,"$1,116.00 ",$669.60 ,"$1,165.60 ",$805.85 ,"$1,140.80 ",$65.91 ,"$1,128.40 ",$358.16 ,$763.10 ,$763.10 ,$629.43 ,$925.41 ,$305.59 ,$361.74 ,$62.18 ,"$1,178.00 ",$376.06 ,$62.18 ,"$1,078.80 ",$358.16 ,"$1,116.00 ",$358.16 ,"$1,116.00 ","$1,116.00 ","$1,116.00 ","$1,202.80 ","$1,004.40 ","$1,153.20 ","$1,066.40 ","$1,202.80 "
SACRED HEART HOSPITAL (ACU),33300027,77318,HC BRACHY ISODOSE PLAN COMPLEX,333,1 ,"$1,539.00 ","$1,154.25 ",$62.18 ,"$1,539.00 ",$991.12 ,$358.16 ,"$1,077.30 ",$62.18 ,$346.96 ,$64.05 ,$277.56 ,"$1,462.05 ",$62.18 ,"$1,231.20 ","$1,415.88 ",$62.18 ,"$1,308.15 ","$1,462.05 ","$1,354.32 ","$1,169.64 ",$62.18 ,$62.18 ,$62.18 ,"$1,123.47 ",$846.45 ,"$1,400.49 ","$1,400.49 ","$1,231.20 ",$368.90 ,$846.45 ,"$1,385.10 ",$358.16 ,"$1,385.10 ",$831.06 ,"$1,446.66 ",$805.85 ,"$1,415.88 ",$65.91 ,"$1,400.49 ",$358.16 ,$947.10 ,$947.10 ,$675.60 ,"$1,148.56 ","$1,385.10 ",$361.74 ,$62.18 ,"$1,462.05 ",$376.06 ,$62.18 ,"$1,338.93 ",$358.16 ,"$1,385.10 ",$358.16 ,"$1,385.10 ","$1,385.10 ","$1,385.10 ","$1,492.83 ","$1,246.59 ","$1,431.27 ","$1,323.54 ","$1,492.83 "
SACRED HEART HOSPITAL (ACU),33300029,77331,HC DOSIMETRY CALCULATION SPECIAL,333,1 ,$696.00 ,$522.00 ,$25.69 ,$696.00 ,$448.22 ,$134.20 ,$487.20 ,$38.15 ,$32.11 ,$39.29 ,$25.69 ,$661.20 ,$38.15 ,$556.80 ,$640.32 ,$38.15 ,$591.60 ,$661.20 ,$612.48 ,$528.96 ,$38.15 ,$38.15 ,$38.15 ,$508.08 ,$382.80 ,$633.36 ,$633.36 ,$556.80 ,$138.23 ,$382.80 ,$626.40 ,$134.20 ,$626.40 ,$375.84 ,$654.24 ,$301.95 ,$640.32 ,$40.44 ,$633.36 ,$134.20 ,$428.32 ,$428.32 ,$94.85 ,$519.42 ,$131.49 ,$135.54 ,$38.15 ,$661.20 ,$140.91 ,$38.15 ,$605.52 ,$134.20 ,$626.40 ,$134.20 ,$626.40 ,$626.40 ,$626.40 ,$675.12 ,$563.76 ,$647.28 ,$598.56 ,$675.12 
SACRED HEART HOSPITAL (ACU),33300030,77332,HC TREATMENT DEVICE SIMPLE,333,1 ,$446.00 ,$334.50 ,$38.15 ,$446.00 ,$287.22 ,$134.20 ,$312.20 ,$38.15 ,$74.13 ,$39.29 ,$59.30 ,$423.70 ,$38.15 ,$356.80 ,$410.32 ,$38.15 ,$379.10 ,$423.70 ,$392.48 ,$338.96 ,$38.15 ,$38.15 ,$38.15 ,$325.58 ,$245.30 ,$405.86 ,$405.86 ,$356.80 ,$138.23 ,$245.30 ,$401.40 ,$134.20 ,$401.40 ,$240.84 ,$419.24 ,$301.95 ,$410.32 ,$40.44 ,$405.86 ,$134.20 ,$274.47 ,$274.47 ,$224.35 ,$332.85 ,$240.30 ,$135.54 ,$38.15 ,$423.70 ,$140.91 ,$38.15 ,$388.02 ,$134.20 ,$401.40 ,$134.20 ,$401.40 ,$401.40 ,$401.40 ,$432.62 ,$361.26 ,$414.78 ,$383.56 ,$432.62 
SACRED HEART HOSPITAL (ACU),33300031,77333,HC TREATMENT DEVICE INTERM,333,1 ,$459.00 ,$344.25 ,$38.15 ,$459.00 ,$295.60 ,$134.20 ,$321.30 ,$38.15 ,$98.16 ,$39.29 ,$78.53 ,$436.05 ,$38.15 ,$367.20 ,$422.28 ,$38.15 ,$390.15 ,$436.05 ,$403.92 ,$348.84 ,$38.15 ,$38.15 ,$38.15 ,$335.07 ,$252.45 ,$417.69 ,$417.69 ,$367.20 ,$138.23 ,$252.45 ,$413.10 ,$134.20 ,$413.10 ,$247.86 ,$431.46 ,$301.95 ,$422.28 ,$40.44 ,$417.69 ,$134.20 ,$282.47 ,$282.47 ,$313.61 ,$342.55 ,$404.79 ,$135.54 ,$38.15 ,$436.05 ,$140.91 ,$38.15 ,$399.33 ,$134.20 ,$413.10 ,$134.20 ,$413.10 ,$413.10 ,$413.10 ,$445.23 ,$371.79 ,$426.87 ,$394.74 ,$445.23 
SACRED HEART HOSPITAL (ACU),33300032,77334,HC TREATMENT DEVICE COMPLEX,333,1 ,"$1,460.00 ","$1,095.00 ",$62.18 ,"$1,460.00 ",$940.24 ,$358.16 ,"$1,022.00 ",$62.18 ,$120.98 ,$64.05 ,$96.78 ,"$1,387.00 ",$62.18 ,"$1,168.00 ","$1,343.20 ",$62.18 ,"$1,241.00 ","$1,387.00 ","$1,284.80 ","$1,109.60 ",$62.18 ,$62.18 ,$62.18 ,"$1,065.80 ",$803.00 ,"$1,328.60 ","$1,328.60 ","$1,168.00 ",$368.90 ,$803.00 ,"$1,314.00 ",$358.16 ,"$1,314.00 ",$788.40 ,"$1,372.40 ",$805.85 ,"$1,343.20 ",$65.91 ,"$1,328.60 ",$358.16 ,$898.48 ,$898.48 ,$543.69 ,"$1,089.60 ",$477.31 ,$361.74 ,$62.18 ,"$1,387.00 ",$376.06 ,$62.18 ,"$1,270.20 ",$358.16 ,"$1,314.00 ",$358.16 ,"$1,314.00 ","$1,314.00 ","$1,314.00 ","$1,416.20 ","$1,182.60 ","$1,357.80 ","$1,255.60 ","$1,416.20 "
SACRED HEART HOSPITAL (ACU),33300033,77336,HC MEDICAL PHYSICS CONTINUING,333,1 ,$945.00 ,$708.75 ,$38.15 ,$945.00 ,$608.58 ,$134.20 ,$661.50 ,$38.15 ,$132.90 ,$39.29 ,$106.32 ,$897.75 ,$38.15 ,$756.00 ,$869.40 ,$38.15 ,$803.25 ,$897.75 ,$831.60 ,$718.20 ,$38.15 ,$38.15 ,$38.15 ,$689.85 ,$519.75 ,$859.95 ,$859.95 ,$756.00 ,$138.23 ,$519.75 ,$850.50 ,$134.20 ,$850.50 ,$510.30 ,$888.30 ,$301.95 ,$869.40 ,$40.44 ,$859.95 ,$134.20 ,$581.55 ,$581.55 ,$208.67 ,$705.25 ,$545.48 ,$135.54 ,$38.15 ,$897.75 ,$140.91 ,$38.15 ,$822.15 ,$134.20 ,$850.50 ,$134.20 ,$850.50 ,$850.50 ,$850.50 ,$916.65 ,$765.45 ,$878.85 ,$812.70 ,$916.65 
SACRED HEART HOSPITAL (ACU),33300034,77338,HC MLC DEVICE FOR IMRT,333,1 ,"$3,625.00 ","$2,718.75 ",$62.18 ,"$3,625.00 ","$2,334.50 ",$358.16 ,"$2,537.50 ",$62.18 ,$485.07 ,$64.05 ,$388.05 ,"$3,443.75 ",$62.18 ,"$2,900.00 ","$3,335.00 ",$62.18 ,"$3,081.25 ","$3,443.75 ","$3,190.00 ","$2,755.00 ",$62.18 ,$62.18 ,$62.18 ,"$2,646.25 ","$1,993.75 ","$3,298.75 ","$3,298.75 ","$2,900.00 ",$368.90 ,"$1,993.75 ","$3,262.50 ",$358.16 ,"$3,262.50 ","$1,957.50 ","$3,407.50 ",$805.85 ,"$3,335.00 ",$65.91 ,"$3,298.75 ",$358.16 ,"$2,230.83 ","$2,230.83 ",$478.47 ,"$2,705.34 ","$1,998.19 ",$361.74 ,$62.18 ,"$3,443.75 ",$376.06 ,$62.18 ,"$3,153.75 ",$358.16 ,"$3,262.50 ",$358.16 ,"$3,262.50 ","$3,262.50 ","$3,262.50 ","$3,516.25 ","$2,936.25 ","$3,371.25 ","$3,117.50 ","$3,516.25 "
SACRED HEART HOSPITAL (ACU),33300036,77370,HC SPECIAL MED PHYSICS CONSULT,333,1 ,$874.00 ,$655.50 ,$38.15 ,$874.00 ,$562.86 ,$134.20 ,$611.80 ,$38.15 ,$203.98 ,$39.29 ,$163.18 ,$830.30 ,$38.15 ,$699.20 ,$804.08 ,$38.15 ,$742.90 ,$830.30 ,$769.12 ,$664.24 ,$38.15 ,$38.15 ,$38.15 ,$638.02 ,$480.70 ,$795.34 ,$795.34 ,$699.20 ,$138.23 ,$480.70 ,$786.60 ,$134.20 ,$786.60 ,$471.96 ,$821.56 ,$301.95 ,$804.08 ,$40.44 ,$795.34 ,$134.20 ,$537.86 ,$537.86 ,$417.26 ,$652.27 ,$786.60 ,$135.54 ,$38.15 ,$830.30 ,$140.91 ,$38.15 ,$760.38 ,$134.20 ,$786.60 ,$134.20 ,$786.60 ,$786.60 ,$786.60 ,$847.78 ,$707.94 ,$812.82 ,$751.64 ,$847.78 
SACRED HEART HOSPITAL (ACU),33300037,77402,HC RAD THRPY SIMPLE >1MEV,333,1 ,$523.00 ,$392.25 ,$59.42 ,$523.00 ,$336.81 ,$126.69 ,$366.10 ,$59.42 ,$244.65 ,$61.20 ,$195.72 ,$496.85 ,$59.42 ,$418.40 ,$481.16 ,$59.42 ,$444.55 ,$496.85 ,$460.24 ,$397.48 ,$59.42 ,$59.42 ,$59.42 ,$381.79 ,$287.65 ,$475.93 ,$475.93 ,$418.40 ,$130.49 ,$287.65 ,$470.70 ,$126.69 ,$470.70 ,$282.42 ,$491.62 ,$285.06 ,$481.16 ,$62.99 ,$475.93 ,$126.69 ,$321.85 ,$321.85 ,$285.49 ,$390.31 ,$364.27 ,$127.96 ,$59.42 ,$496.85 ,$133.03 ,$59.42 ,$455.01 ,$126.69 ,$470.70 ,$126.69 ,$470.70 ,$470.70 ,$470.70 ,$507.31 ,$423.63 ,$486.39 ,$449.78 ,$507.31 
SACRED HEART HOSPITAL (ACU),33300041,77407,HC RAD THRPY INTERMEDIATE,333,1 ,$566.00 ,$424.50 ,$59.42 ,$575.22 ,$364.50 ,$255.65 ,$396.20 ,$59.42 ,$336.53 ,$61.20 ,$269.22 ,$537.70 ,$59.42 ,$452.80 ,$520.72 ,$59.42 ,$481.10 ,$537.70 ,$498.08 ,$430.16 ,$59.42 ,$59.42 ,$59.42 ,$413.18 ,$311.30 ,$515.06 ,$515.06 ,$452.80 ,$263.32 ,$311.30 ,$509.40 ,$255.65 ,$509.40 ,$305.64 ,$532.04 ,$575.22 ,$520.72 ,$62.99 ,$515.06 ,$255.65 ,$348.32 ,$348.32 ,$465.59 ,$422.41 ,$394.22 ,$258.21 ,$59.42 ,$537.70 ,$268.44 ,$59.42 ,$492.42 ,$255.65 ,$509.40 ,$255.65 ,$509.40 ,$509.40 ,$509.40 ,$549.02 ,$458.46 ,$526.38 ,$486.76 ,$549.02 
SACRED HEART HOSPITAL (ACU),33300045,77412,HC RAD THRPY COMPLEX,333,1 ,"$1,156.00 ",$867.00 ,$59.42 ,"$1,156.00 ",$744.46 ,$255.65 ,$809.20 ,$59.42 ,$458.41 ,$61.20 ,$366.73 ,"$1,098.20 ",$59.42 ,$924.80 ,"$1,063.52 ",$59.42 ,$982.60 ,"$1,098.20 ","$1,017.28 ",$878.56 ,$59.42 ,$59.42 ,$59.42 ,$843.88 ,$635.80 ,"$1,051.96 ","$1,051.96 ",$924.80 ,$263.32 ,$635.80 ,"$1,040.40 ",$255.65 ,"$1,040.40 ",$624.24 ,"$1,086.64 ",$575.22 ,"$1,063.52 ",$62.99 ,"$1,051.96 ",$255.65 ,$711.40 ,$711.40 ,$523.79 ,$862.72 ,$805.15 ,$258.21 ,$59.42 ,"$1,098.20 ",$268.44 ,$59.42 ,"$1,005.72 ",$255.65 ,"$1,040.40 ",$255.65 ,"$1,040.40 ","$1,040.40 ","$1,040.40 ","$1,121.32 ",$936.36 ,"$1,075.08 ",$994.16 ,"$1,121.32 "
SACRED HEART HOSPITAL (ACU),33300051,77386,HC IMRT TREATMENT COMPLEX,333,1 ,"$2,749.00 ","$2,061.75 ",$158.09 ,"$2,749.00 ","$1,770.36 ",$573.84 ,"$1,924.30 ",$158.09 ,$584.15 ,$162.83 ,$467.32 ,"$2,611.55 ",$158.09 ,"$2,199.20 ","$2,529.08 ",$158.09 ,"$2,336.65 ","$2,611.55 ","$2,419.12 ","$2,089.24 ",$158.09 ,$158.09 ,$158.09 ,"$2,006.77 ","$1,511.95 ","$2,501.59 ","$2,501.59 ","$2,199.20 ",$591.06 ,"$1,511.95 ","$2,474.10 ",$573.84 ,"$2,474.10 ","$1,484.46 ","$2,584.06 ","$1,291.13 ","$2,529.08 ",$167.58 ,"$2,501.59 ",$573.84 ,"$1,691.73 ","$1,691.73 ",$765.96 ,"$2,051.58 ","$1,914.68 ",$579.57 ,$158.09 ,"$2,611.55 ",$602.53 ,$158.09 ,"$2,391.63 ",$573.84 ,"$2,474.10 ",$573.84 ,"$2,474.10 ","$2,474.10 ","$2,474.10 ","$2,666.53 ","$2,226.69 ","$2,556.57 ","$2,364.14 ","$2,666.53 "
SACRED HEART HOSPITAL (ACU),33300052,77417,HC PORT FILMS,333,1 ,$301.00 ,$225.75 ,$14.64 ,$301.00 ,$193.84 , N/A ,$210.70 ,$18.59 ,$18.31 ,$19.15 ,$14.64 ,$285.95 ,$18.59 ,$240.80 ,$276.92 ,$18.59 ,$255.85 ,$285.95 ,$264.88 ,$228.76 ,$18.59 ,$18.59 ,$18.59 ,$219.73 ,$165.55 ,$273.91 ,$273.91 ,$240.80 , N/A ,$165.55 ,$270.90 , N/A ,$270.90 ,$162.54 ,$282.94 , N/A ,$276.92 ,$19.71 ,$273.91 , N/A ,$185.24 ,$185.24 ,$118.58 ,$224.64 ,$75.82 , N/A ,$18.59 ,$285.95 , N/A ,$18.59 ,$261.87 , N/A ,$270.90 , N/A ,$270.90 ,$270.90 ,$270.90 ,$291.97 ,$243.81 ,$279.93 ,$258.86 ,$291.97 
SACRED HEART HOSPITAL (ACU),33300054,77385,HC IMRT TREATMENT SIMPLE,333,1 ,"$2,749.00 ","$2,061.75 ",$158.09 ,"$2,749.00 ","$1,770.36 ",$573.84 ,"$1,924.30 ",$158.09 ,$583.29 ,$162.83 ,$466.63 ,"$2,611.55 ",$158.09 ,"$2,199.20 ","$2,529.08 ",$158.09 ,"$2,336.65 ","$2,611.55 ","$2,419.12 ","$2,089.24 ",$158.09 ,$158.09 ,$158.09 ,"$2,006.77 ","$1,511.95 ","$2,501.59 ","$2,501.59 ","$2,199.20 ",$591.06 ,"$1,511.95 ","$2,474.10 ",$573.84 ,"$2,474.10 ","$1,484.46 ","$2,584.06 ","$1,291.13 ","$2,529.08 ",$167.58 ,"$2,501.59 ",$573.84 ,"$1,691.73 ","$1,691.73 ",$763.90 ,"$2,051.58 ","$1,914.68 ",$579.57 ,$158.09 ,"$2,611.55 ",$602.53 ,$158.09 ,"$2,391.63 ",$573.84 ,"$2,474.10 ",$573.84 ,"$2,474.10 ","$2,474.10 ","$2,474.10 ","$2,666.53 ","$2,226.69 ","$2,556.57 ","$2,364.14 ","$2,666.53 "
SACRED HEART HOSPITAL (ACU),33300055,77387,HC STEREOSCOPIC X RAY GUIDANCE,333,1 ,$262.00 ,$196.50 ,$38.15 ,$262.00 ,$168.73 , N/A ,$183.40 ,$38.15 ,$109.69 ,$39.29 ,$87.75 ,$248.90 ,$38.15 ,$209.60 ,$241.04 ,$38.15 ,$222.70 ,$248.90 ,$230.56 ,$199.12 ,$38.15 ,$38.15 ,$38.15 ,$191.26 ,$144.10 ,$238.42 ,$238.42 ,$209.60 , N/A ,$144.10 ,$235.80 , N/A ,$235.80 ,$141.48 ,$246.28 , N/A ,$241.04 ,$40.44 ,$238.42 , N/A ,$161.23 ,$161.23 ,$121.16 ,$195.53 ,$182.48 , N/A ,$38.15 ,$248.90 , N/A ,$38.15 ,$227.94 , N/A ,$235.80 , N/A ,$235.80 ,$235.80 ,$235.80 ,$254.14 ,$212.22 ,$243.66 ,$225.32 ,$254.14 
SACRED HEART HOSPITAL (ACU),33300057,77470,HC SPECIAL TREATMENT PROCEDURE,333,1 ,"$2,398.00 ","$1,798.50 ",$52.58 ,"$2,398.00 ","$1,544.31 ",$573.84 ,"$1,678.60 ",$158.09 ,$65.73 ,$162.83 ,$52.58 ,"$2,278.10 ",$158.09 ,"$1,918.40 ","$2,206.16 ",$158.09 ,"$2,038.30 ","$2,278.10 ","$2,110.24 ","$1,822.48 ",$158.09 ,$158.09 ,$158.09 ,"$1,750.54 ","$1,318.90 ","$2,182.18 ","$2,182.18 ","$1,918.40 ",$591.06 ,"$1,318.90 ","$2,158.20 ",$573.84 ,"$2,158.20 ","$1,294.92 ","$2,254.12 ","$1,291.13 ","$2,206.16 ",$167.58 ,"$2,182.18 ",$573.84 ,"$1,475.73 ","$1,475.73 ","$1,280.20 ","$1,789.63 ",$213.70 ,$579.57 ,$158.09 ,"$2,278.10 ",$602.53 ,$158.09 ,"$2,086.26 ",$573.84 ,"$2,158.20 ",$573.84 ,"$2,158.20 ","$2,158.20 ","$2,158.20 ","$2,326.06 ","$1,942.38 ","$2,230.14 ","$2,062.28 ","$2,326.06 "
SACRED HEART HOSPITAL (ACU),33300065,77778,HC INTERSTITIAL APPL-COMPLE,333,1 ,"$4,178.00 ","$3,133.50 ",$468.16 ,"$4,178.00 ","$2,690.63 ",$750.28 ,"$2,924.60 ",$468.16 ,$624.00 ,$482.20 ,$499.20 ,"$3,969.10 ",$468.16 ,"$3,342.40 ","$3,843.76 ",$468.16 ,"$3,551.30 ","$3,969.10 ","$3,676.64 ","$3,175.28 ",$468.16 ,$468.16 ,$468.16 ,"$3,049.94 ","$2,297.90 ","$3,801.98 ","$3,801.98 ","$3,342.40 ",$772.79 ,"$2,297.90 ","$3,760.20 ",$750.28 ,"$3,760.20 ","$2,256.12 ","$3,927.32 ","$1,688.12 ","$3,843.76 ",$496.25 ,"$3,801.98 ",$750.28 ,"$2,571.14 ","$2,571.14 ",$570.36 ,"$3,118.04 ","$2,564.59 ",$757.78 ,$468.16 ,"$3,969.10 ",$787.79 ,$468.16 ,"$3,634.86 ",$750.28 ,"$3,760.20 ",$750.28 ,"$3,760.20 ","$3,760.20 ","$3,760.20 ","$4,052.66 ","$3,384.18 ","$3,885.54 ","$3,593.08 ","$4,052.66 "
SACRED HEART HOSPITAL (ACU),33300070,C9728,HC PLCMNT FIDUCIAL MARKERS OTHER,333,1 ,"$1,060.00 ",$795.00 ,$357.63 ,"$3,005.00 ",$682.64 ,"$1,335.56 ",$742.00 ,$357.63 ,$879.80 ,$368.36 ,$699.60 ,"$1,007.00 ",$357.63 ,$848.00 ,$975.20 ,$357.63 ,$901.00 ,"$1,007.00 ",$932.80 ,$805.60 ,$357.63 ,$357.63 ,$357.63 ,$773.80 ,$583.00 ,$964.60 ,$964.60 ,$848.00 ,"$1,375.63 ",$583.00 ,$954.00 ,"$1,335.56 ",$954.00 ,$572.40 ,$996.40 ,"$3,005.00 ",$975.20 ,$379.09 ,$964.60 ,"$1,335.56 ",$652.32 ,$652.32 ,$954.00 ,$791.08 ,$738.29 ,"$1,348.91 ",$357.63 ,"$1,007.00 ","$1,402.33 ",$357.63 ,$922.20 ,"$1,335.56 ",$954.00 ,"$1,335.56 ",$954.00 ,$954.00 ,$954.00 ,"$1,028.20 ",$858.60 ,$985.80 ,$911.60 ,"$1,028.20 "
SACRED HEART HOSPITAL (ACU),33300071,77372,HC SRS TREATMENT,333,1 ,"$15,812.00 ","$11,859.00 ","$1,458.60 ","$18,507.58 ","$10,182.93 ","$8,225.59 ","$11,068.40 ","$1,934.34 ","$1,823.26 ","$1,992.37 ","$1,458.60 ","$15,021.40 ","$1,934.34 ","$12,649.60 ","$14,547.04 ","$1,934.34 ","$13,440.20 ","$15,021.40 ","$13,914.56 ","$12,017.12 ","$1,934.34 ","$1,934.34 ","$1,934.34 ","$11,542.76 ","$8,696.60 ","$14,388.92 ","$14,388.92 ","$12,649.60 ","$8,472.36 ","$8,696.60 ","$14,230.80 ","$8,225.59 ","$14,230.80 ","$8,538.48 ","$14,863.28 ","$18,507.58 ","$14,547.04 ","$2,050.40 ","$14,388.92 ","$8,225.59 ","$9,730.70 ","$9,730.70 ","$1,688.81 ","$11,800.50 ","$7,489.96 ","$8,307.85 ","$1,934.34 ","$15,021.40 ","$8,636.87 ","$1,934.34 ","$13,756.44 ","$8,225.59 ","$14,230.80 ","$8,225.59 ","$14,230.80 ","$14,230.80 ","$14,230.80 ","$15,337.64 ","$12,807.72 ","$14,705.16 ","$13,598.32 ","$15,337.64 "
SACRED HEART HOSPITAL (ACU),33300072,77373,HC SRT TREATMENT,333,1 ,"$6,453.00 ","$4,839.75 ",$468.16 ,"$6,453.00 ","$4,155.73 ","$1,834.30 ","$4,517.10 ",$468.16 ,"$2,314.34 ",$482.20 ,"$1,851.47 ","$6,130.35 ",$468.16 ,"$5,162.40 ","$5,936.76 ",$468.16 ,"$5,485.05 ","$6,130.35 ","$5,678.64 ","$4,904.28 ",$468.16 ,$468.16 ,$468.16 ,"$4,710.69 ","$3,549.15 ","$5,872.23 ","$5,872.23 ","$5,162.40 ","$1,889.33 ","$3,549.15 ","$5,807.70 ","$1,834.30 ","$5,807.70 ","$3,484.62 ","$6,065.82 ","$4,127.18 ","$5,936.76 ",$496.25 ,"$5,872.23 ","$1,834.30 ","$3,971.18 ","$3,971.18 ","$3,149.14 ","$4,815.87 ","$5,807.70 ","$1,852.65 ",$468.16 ,"$6,130.35 ","$1,926.02 ",$468.16 ,"$5,614.11 ","$1,834.30 ","$5,807.70 ","$1,834.30 ","$5,807.70 ","$5,807.70 ","$5,807.70 ","$6,259.41 ","$5,226.93 ","$6,001.29 ","$5,549.58 ","$6,259.41 "
SACRED HEART HOSPITAL (ACU),33300084,77293,HC RESPIRATORY MOTION MGMT SIM,333,1 ,$443.23 ,$332.42 ,$38.15 ,$443.23 ,$285.44 , N/A ,$310.26 ,$38.15 ,$443.23 ,$39.29 ,$443.23 ,$421.07 ,$38.15 ,$354.58 ,$407.77 ,$38.15 ,$376.75 ,$421.07 ,$390.04 ,$336.85 ,$38.15 ,$38.15 ,$38.15 ,$323.56 ,$243.78 ,$403.34 ,$403.34 ,$354.58 , N/A ,$243.78 ,$398.91 , N/A ,$398.91 ,$239.34 ,$416.64 , N/A ,$407.77 ,$40.44 ,$403.34 , N/A ,$272.76 ,$272.76 ,$443.23 ,$330.78 ,$398.91 , N/A ,$38.15 ,$421.07 , N/A ,$38.15 ,$385.61 , N/A ,$398.91 , N/A ,$398.91 ,$398.91 ,$398.91 ,$429.93 ,$359.02 ,$412.20 ,$381.18 ,$429.93 
SACRED HEART HOSPITAL (ACU),33300085,C2638,HC IODINE 125 PER SOURCE STRANDED,333,1 ,$62.00 ,$46.50 ,$33.48 ,$144.21 ,$39.93 ,$38.19 ,$43.40 ,$62.00 ,$51.46 ,$140.13 ,$40.92 ,$58.90 ,$136.05 ,$49.60 ,$57.04 ,$62.00 ,$52.70 ,$58.90 ,$54.56 ,$47.12 ,$62.00 ,$62.00 ,$136.05 ,$45.26 ,$34.10 ,$56.42 ,$56.42 ,$49.60 ,$39.34 ,$34.10 ,$55.80 ,$38.19 ,$55.80 ,$33.48 ,$58.28 ,$85.93 ,$57.04 ,$144.21 ,$56.42 ,$38.19 ,$38.15 ,$38.15 ,$55.80 ,$46.27 ,$43.18 ,$38.57 ,$62.00 ,$58.90 ,$40.10 ,$62.00 ,$53.94 ,$38.19 ,$55.80 ,$38.19 ,$55.80 ,$55.80 ,$55.80 ,$60.14 ,$50.22 ,$57.66 ,$53.32 ,$60.14 
SACRED HEART HOSPITAL (ACU),33301005,77280,HC SIMULATION SMP,333,1 ,"$1,262.00 ",$946.50 ,$38.15 ,"$1,262.00 ",$812.73 ,$134.20 ,$883.40 ,$38.15 ,$404.37 ,$39.29 ,$323.50 ,"$1,198.90 ",$38.15 ,"$1,009.60 ","$1,161.04 ",$38.15 ,"$1,072.70 ","$1,198.90 ","$1,110.56 ",$959.12 ,$38.15 ,$38.15 ,$38.15 ,$921.26 ,$694.10 ,"$1,148.42 ","$1,148.42 ","$1,009.60 ",$138.23 ,$694.10 ,"$1,135.80 ",$134.20 ,"$1,135.80 ",$681.48 ,"$1,186.28 ",$301.95 ,"$1,161.04 ",$40.44 ,"$1,148.42 ",$134.20 ,$776.63 ,$776.63 ,$434.53 ,$941.83 ,"$1,135.80 ",$135.54 ,$38.15 ,"$1,198.90 ",$140.91 ,$38.15 ,"$1,097.94 ",$134.20 ,"$1,135.80 ",$134.20 ,"$1,135.80 ","$1,135.80 ","$1,135.80 ","$1,224.14 ","$1,022.22 ","$1,173.66 ","$1,085.32 ","$1,224.14 "
SACRED HEART HOSPITAL (ACU),33301006,77401,HC RAD THERAPY SUPER/ORTHOVOLT PER DAY,333,1 ,$399.00 ,$299.25 ,$33.38 ,$399.00 ,$256.96 ,$126.69 ,$279.30 ,$59.42 ,$41.72 ,$61.20 ,$33.38 ,$379.05 ,$59.42 ,$319.20 ,$367.08 ,$59.42 ,$339.15 ,$379.05 ,$351.12 ,$303.24 ,$59.42 ,$59.42 ,$59.42 ,$291.27 ,$219.45 ,$363.09 ,$363.09 ,$319.20 ,$130.49 ,$219.45 ,$359.10 ,$126.69 ,$359.10 ,$215.46 ,$375.06 ,$285.06 ,$367.08 ,$62.99 ,$363.09 ,$126.69 ,$245.54 ,$245.54 ,$285.49 ,$297.77 ,$170.17 ,$127.96 ,$59.42 ,$379.05 ,$133.03 ,$59.42 ,$347.13 ,$126.69 ,$359.10 ,$126.69 ,$359.10 ,$359.10 ,$359.10 ,$387.03 ,$323.19 ,$371.07 ,$343.14 ,$387.03 
SACRED HEART HOSPITAL (ACU),33301007,77790,HC RADIOELEMENT HANDLING/LOADING,333,1 ,$564.00 ,$423.00 ,$19.92 ,$564.00 ,$363.22 , N/A ,$394.80 ,$38.15 ,$24.90 ,$39.29 ,$19.92 ,$535.80 ,$38.15 ,$451.20 ,$518.88 ,$38.15 ,$479.40 ,$535.80 ,$496.32 ,$428.64 ,$38.15 ,$38.15 ,$38.15 ,$411.72 ,$310.20 ,$513.24 ,$513.24 ,$451.20 , N/A ,$310.20 ,$507.60 , N/A ,$507.60 ,$304.56 ,$530.16 , N/A ,$518.88 ,$40.44 ,$513.24 , N/A ,$347.09 ,$347.09 ,$57.88 ,$420.91 ,$102.43 , N/A ,$38.15 ,$535.80 , N/A ,$38.15 ,$490.68 , N/A ,$507.60 , N/A ,$507.60 ,$507.60 ,$507.60 ,$547.08 ,$456.84 ,$524.52 ,$485.04 ,$547.08 
SACRED HEART HOSPITAL (ACU),33500002,96401,HC CHEMO SQ/IM NON ANTI-NEOPLAST,335,1 ,$287.00 ,$215.25 ,$14.35 ,$287.00 ,$184.83 ,$65.57 ,$200.90 ,$14.35 ,$238.21 ,$14.78 ,$189.42 ,$272.65 ,$14.35 ,$229.60 ,$264.04 ,$14.35 ,$243.95 ,$272.65 ,$252.56 ,$218.12 ,$14.35 ,$14.35 ,$14.35 ,$209.51 ,$157.85 ,$261.17 ,$261.17 ,$229.60 ,$67.54 ,$157.85 ,$258.30 ,$65.57 ,$258.30 ,$154.98 ,$269.78 ,$147.54 ,$264.04 ,$15.21 ,$261.17 ,$65.57 ,$176.62 ,$176.62 ,$258.30 ,$214.19 ,$199.90 ,$66.23 ,$14.35 ,$272.65 ,$68.85 ,$14.35 ,$249.69 ,$65.57 ,$258.30 ,$65.57 ,$258.30 ,$258.30 ,$258.30 ,$278.39 ,$232.47 ,$266.91 ,$246.82 ,$278.39 
SACRED HEART HOSPITAL (ACU),33500003,96409,HC CHEMO IV PUSH SINGLE/INIT,335,1 ,$378.00 ,$283.50 ,$14.35 ,$486.82 ,$243.43 ,$216.36 ,$264.60 ,$14.35 ,$313.74 ,$14.78 ,$249.48 ,$359.10 ,$14.35 ,$302.40 ,$347.76 ,$14.35 ,$321.30 ,$359.10 ,$332.64 ,$287.28 ,$14.35 ,$14.35 ,$14.35 ,$275.94 ,$207.90 ,$343.98 ,$343.98 ,$302.40 ,$222.85 ,$207.90 ,$340.20 ,$216.36 ,$340.20 ,$204.12 ,$355.32 ,$486.82 ,$347.76 ,$15.21 ,$343.98 ,$216.36 ,$232.62 ,$232.62 ,$340.20 ,$282.10 ,$263.28 ,$218.53 ,$14.35 ,$359.10 ,$227.18 ,$14.35 ,$328.86 ,$216.36 ,$340.20 ,$216.36 ,$340.20 ,$340.20 ,$340.20 ,$366.66 ,$306.18 ,$351.54 ,$325.08 ,$366.66 
SACRED HEART HOSPITAL (ACU),33500004,96411,HC CHEMO IV PUSH ADDL DRUG,335,1 ,$217.00 ,$162.75 ,$14.35 ,$217.00 ,$139.75 ,$65.57 ,$151.90 ,$14.35 ,$180.11 ,$14.78 ,$143.22 ,$206.15 ,$14.35 ,$173.60 ,$199.64 ,$14.35 ,$184.45 ,$206.15 ,$190.96 ,$164.92 ,$14.35 ,$14.35 ,$14.35 ,$158.41 ,$119.35 ,$197.47 ,$197.47 ,$173.60 ,$67.54 ,$119.35 ,$195.30 ,$65.57 ,$195.30 ,$117.18 ,$203.98 ,$147.54 ,$199.64 ,$15.21 ,$197.47 ,$65.57 ,$133.54 ,$133.54 ,$195.30 ,$161.95 ,$151.14 ,$66.23 ,$14.35 ,$206.15 ,$68.85 ,$14.35 ,$188.79 ,$65.57 ,$195.30 ,$65.57 ,$195.30 ,$195.30 ,$195.30 ,$210.49 ,$175.77 ,$201.81 ,$186.62 ,$210.49 
SACRED HEART HOSPITAL (ACU),33500005,96413,HC CHEMO IV INFUSION SGL/INIT<1H,335,1 ,$725.00 ,$543.75 ,$98.38 ,$758.76 ,$466.90 ,$337.23 ,$507.50 ,$98.38 ,$601.75 ,$101.33 ,$478.50 ,$688.75 ,$98.38 ,$580.00 ,$667.00 ,$98.38 ,$616.25 ,$688.75 ,$638.00 ,$551.00 ,$98.38 ,$98.38 ,$98.38 ,$529.25 ,$398.75 ,$659.75 ,$659.75 ,$580.00 ,$347.35 ,$398.75 ,$652.50 ,$337.23 ,$652.50 ,$391.50 ,$681.50 ,$758.76 ,$667.00 ,$104.28 ,$659.75 ,$337.23 ,$446.17 ,$446.17 ,$652.50 ,$541.07 ,$504.96 ,$340.60 ,$98.38 ,$688.75 ,$354.09 ,$98.38 ,$630.75 ,$337.23 ,$652.50 ,$337.23 ,$652.50 ,$652.50 ,$652.50 ,$703.25 ,$587.25 ,$674.25 ,$623.50 ,$703.25 
SACRED HEART HOSPITAL (ACU),33500006,96415,HC CHEMO IV INFUSION ADDL HR,335,1 ,$249.00 ,$186.75 ,$65.57 ,$249.00 ,$160.36 ,$65.57 ,$174.30 ,$166.51 ,$206.67 ,$171.51 ,$164.34 ,$236.55 ,$166.51 ,$199.20 ,$229.08 ,$166.51 ,$211.65 ,$236.55 ,$219.12 ,$189.24 ,$166.51 ,$166.51 ,$166.51 ,$181.77 ,$136.95 ,$226.59 ,$226.59 ,$199.20 ,$67.54 ,$136.95 ,$224.10 ,$65.57 ,$224.10 ,$134.46 ,$234.06 ,$147.54 ,$229.08 ,$176.50 ,$226.59 ,$65.57 ,$153.23 ,$153.23 ,$224.10 ,$185.83 ,$173.43 ,$66.23 ,$166.51 ,$236.55 ,$68.85 ,$166.51 ,$216.63 ,$65.57 ,$224.10 ,$65.57 ,$224.10 ,$224.10 ,$224.10 ,$241.53 ,$201.69 ,$231.57 ,$214.14 ,$241.53 
SACRED HEART HOSPITAL (ACU),33500007,96416,HC CHEMO ADMIN INTRAV INFUS >8HR,335,1 ,$525.00 ,$393.75 ,$166.51 ,$758.76 ,$338.10 ,$337.23 ,$367.50 ,$166.51 ,$435.75 ,$171.51 ,$346.50 ,$498.75 ,$166.51 ,$420.00 ,$483.00 ,$166.51 ,$446.25 ,$498.75 ,$462.00 ,$399.00 ,$166.51 ,$166.51 ,$166.51 ,$383.25 ,$288.75 ,$477.75 ,$477.75 ,$420.00 ,$347.35 ,$288.75 ,$472.50 ,$337.23 ,$472.50 ,$283.50 ,$493.50 ,$758.76 ,$483.00 ,$176.50 ,$477.75 ,$337.23 ,$323.09 ,$323.09 ,$472.50 ,$391.81 ,$365.66 ,$340.60 ,$166.51 ,$498.75 ,$354.09 ,$166.51 ,$456.75 ,$337.23 ,$472.50 ,$337.23 ,$472.50 ,$472.50 ,$472.50 ,$509.25 ,$425.25 ,$488.25 ,$451.50 ,$509.25 
SACRED HEART HOSPITAL (ACU),33500008,96417,HC CHEMO IV INFUSION EA ADDL <1H,335,1 ,$249.00 ,$186.75 ,$65.57 ,$249.00 ,$160.36 ,$65.57 ,$174.30 ,$98.38 ,$206.67 ,$101.33 ,$164.34 ,$236.55 ,$98.38 ,$199.20 ,$229.08 ,$98.38 ,$211.65 ,$236.55 ,$219.12 ,$189.24 ,$98.38 ,$98.38 ,$98.38 ,$181.77 ,$136.95 ,$226.59 ,$226.59 ,$199.20 ,$67.54 ,$136.95 ,$224.10 ,$65.57 ,$224.10 ,$134.46 ,$234.06 ,$147.54 ,$229.08 ,$104.28 ,$226.59 ,$65.57 ,$153.23 ,$153.23 ,$224.10 ,$185.83 ,$173.43 ,$66.23 ,$98.38 ,$236.55 ,$68.85 ,$98.38 ,$216.63 ,$65.57 ,$224.10 ,$65.57 ,$224.10 ,$224.10 ,$224.10 ,$241.53 ,$201.69 ,$231.57 ,$214.14 ,$241.53 
SACRED HEART HOSPITAL (ACU),33500012,96450,HC CHEMO CNS,335,1 ,$636.00 ,$477.00 ,$166.51 ,$758.76 ,$409.58 ,$337.23 ,$445.20 ,$166.51 ,$527.88 ,$171.51 ,$419.76 ,$604.20 ,$166.51 ,$508.80 ,$585.12 ,$166.51 ,$540.60 ,$604.20 ,$559.68 ,$483.36 ,$166.51 ,$166.51 ,$166.51 ,$464.28 ,$349.80 ,$578.76 ,$578.76 ,$508.80 ,$347.35 ,$349.80 ,$572.40 ,$337.23 ,$572.40 ,$343.44 ,$597.84 ,$758.76 ,$585.12 ,$176.50 ,$578.76 ,$337.23 ,$391.39 ,$391.39 ,$572.40 ,$474.65 ,$442.97 ,$340.60 ,$166.51 ,$604.20 ,$354.09 ,$166.51 ,$553.32 ,$337.23 ,$572.40 ,$337.23 ,$572.40 ,$572.40 ,$572.40 ,$616.92 ,$515.16 ,$591.48 ,$546.96 ,$616.92 
SACRED HEART HOSPITAL (ACU),33500013,96402,HC CHEMOTHERAPY INJECTION-HORMONAL ANTI-NEO,335,1 ,$287.00 ,$215.25 ,$14.35 ,$287.00 ,$184.83 ,$65.57 ,$200.90 ,$14.35 ,$238.21 ,$14.78 ,$189.42 ,$272.65 ,$14.35 ,$229.60 ,$264.04 ,$14.35 ,$243.95 ,$272.65 ,$252.56 ,$218.12 ,$14.35 ,$14.35 ,$14.35 ,$209.51 ,$157.85 ,$261.17 ,$261.17 ,$229.60 ,$67.54 ,$157.85 ,$258.30 ,$65.57 ,$258.30 ,$154.98 ,$269.78 ,$147.54 ,$264.04 ,$15.21 ,$261.17 ,$65.57 ,$176.62 ,$176.62 ,$258.30 ,$214.19 ,$199.90 ,$66.23 ,$14.35 ,$272.65 ,$68.85 ,$14.35 ,$249.69 ,$65.57 ,$258.30 ,$65.57 ,$258.30 ,$258.30 ,$258.30 ,$278.39 ,$232.47 ,$266.91 ,$246.82 ,$278.39 
SACRED HEART HOSPITAL (ACU),33500014,96521,HC REFILLING/MAINTENANCE PORTABLE PUMP,335,1 ,$657.00 ,$492.75 ,$14.35 ,$657.00 ,$423.11 ,$216.36 ,$459.90 ,$14.35 ,$545.31 ,$14.78 ,$433.62 ,$624.15 ,$14.35 ,$525.60 ,$604.44 ,$14.35 ,$558.45 ,$624.15 ,$578.16 ,$499.32 ,$14.35 ,$14.35 ,$14.35 ,$479.61 ,$361.35 ,$597.87 ,$597.87 ,$525.60 ,$222.85 ,$361.35 ,$591.30 ,$216.36 ,$591.30 ,$354.78 ,$617.58 ,$486.82 ,$604.44 ,$15.21 ,$597.87 ,$216.36 ,$404.32 ,$404.32 ,$591.30 ,$490.32 ,$457.60 ,$218.53 ,$14.35 ,$624.15 ,$227.18 ,$14.35 ,$571.59 ,$216.36 ,$591.30 ,$216.36 ,$591.30 ,$591.30 ,$591.30 ,$637.29 ,$532.17 ,$611.01 ,$565.02 ,$637.29 
SACRED HEART HOSPITAL (ACU),33500026,96549,HC CHEMO ADMIN PROLONGED WITH PUMP,335,1 ,$810.00 ,$607.50 ,$42.32 ,$810.00 ,$521.64 ,$42.32 ,$567.00 ,$98.38 ,$672.30 ,$101.33 ,$534.60 ,$769.50 ,$98.38 ,$648.00 ,$745.20 ,$98.38 ,$688.50 ,$769.50 ,$712.80 ,$615.60 ,$98.38 ,$98.38 ,$98.38 ,$591.30 ,$445.50 ,$737.10 ,$737.10 ,$648.00 ,$43.59 ,$445.50 ,$729.00 ,$42.32 ,$729.00 ,$437.40 ,$761.40 ,$95.23 ,$745.20 ,$104.28 ,$737.10 ,$42.32 ,$498.47 ,$498.47 ,$729.00 ,$604.50 ,$564.17 ,$42.75 ,$98.38 ,$769.50 ,$44.44 ,$98.38 ,$704.70 ,$42.32 ,$729.00 ,$42.32 ,$729.00 ,$729.00 ,$729.00 ,$785.70 ,$656.10 ,$753.30 ,$696.60 ,$785.70 
SACRED HEART HOSPITAL (ACU),34000004,78014,HC NM THYROID IMAGING SGL OR MULT UPTAKE 78014,340,1 ,"$1,412.00 ","$1,059.00 ",$124.60 ,"$1,412.00 ",$909.33 ,$398.69 ,$988.40 ,$124.60 ,$380.92 ,$128.34 ,$304.74 ,"$1,341.40 ",$124.60 ,"$1,129.60 ","$1,299.04 ",$124.60 ,"$1,200.20 ","$1,341.40 ","$1,242.56 ","$1,073.12 ",$124.60 ,$124.60 ,$124.60 ,"$1,030.76 ",$776.60 ,"$1,284.92 ","$1,284.92 ","$1,129.60 ",$410.65 ,$776.60 ,"$1,270.80 ",$398.69 ,"$1,270.80 ",$762.48 ,"$1,327.28 ",$897.05 ,"$1,299.04 ",$132.08 ,"$1,284.92 ",$398.69 ,$868.94 ,$868.94 ,$440.13 ,"$1,053.78 ","$1,270.80 ",$402.67 ,$124.60 ,"$1,341.40 ",$418.62 ,$124.60 ,"$1,228.44 ",$398.69 ,"$1,270.80 ",$398.69 ,"$1,270.80 ","$1,270.80 ","$1,270.80 ","$1,369.64 ","$1,143.72 ","$1,313.16 ","$1,214.32 ","$1,369.64 "
SACRED HEART HOSPITAL (ACU),34000006,78013,HC NM THYROID SCAN,340,1 ,$833.00 ,$624.75 ,$124.60 ,$897.05 ,$536.45 ,$398.69 ,$583.10 ,$124.60 ,$303.47 ,$128.34 ,$242.77 ,$791.35 ,$124.60 ,$666.40 ,$766.36 ,$124.60 ,$708.05 ,$791.35 ,$733.04 ,$633.08 ,$124.60 ,$124.60 ,$124.60 ,$608.09 ,$458.15 ,$758.03 ,$758.03 ,$666.40 ,$410.65 ,$458.15 ,$749.70 ,$398.69 ,$749.70 ,$449.82 ,$783.02 ,$897.05 ,$766.36 ,$132.08 ,$758.03 ,$398.69 ,$512.63 ,$512.63 ,$386.74 ,$621.67 ,$749.70 ,$402.67 ,$124.60 ,$791.35 ,$418.62 ,$124.60 ,$724.71 ,$398.69 ,$749.70 ,$398.69 ,$749.70 ,$749.70 ,$749.70 ,$808.01 ,$674.73 ,$774.69 ,$716.38 ,$808.01 
SACRED HEART HOSPITAL (ACU),34000007,78018,HC NM THYROID CA METS WHOLE BODY,340,1 ,"$1,820.00 ","$1,365.00 ",$124.60 ,"$1,820.00 ","$1,172.08 ",$517.56 ,"$1,274.00 ",$124.60 ,$477.87 ,$128.34 ,$382.30 ,"$1,729.00 ",$124.60 ,"$1,456.00 ","$1,674.40 ",$124.60 ,"$1,547.00 ","$1,729.00 ","$1,601.60 ","$1,383.20 ",$124.60 ,$124.60 ,$124.60 ,"$1,328.60 ","$1,001.00 ","$1,656.20 ","$1,656.20 ","$1,456.00 ",$533.09 ,"$1,001.00 ","$1,638.00 ",$517.56 ,"$1,638.00 ",$982.80 ,"$1,710.80 ","$1,164.51 ","$1,674.40 ",$132.08 ,"$1,656.20 ",$517.56 ,"$1,120.03 ","$1,120.03 ","$1,543.70 ","$1,358.27 ","$1,638.00 ",$522.74 ,$124.60 ,"$1,729.00 ",$543.44 ,$124.60 ,"$1,583.40 ",$517.56 ,"$1,638.00 ",$517.56 ,"$1,638.00 ","$1,638.00 ","$1,638.00 ","$1,765.40 ","$1,474.20 ","$1,692.60 ","$1,565.20 ","$1,765.40 "
SACRED HEART HOSPITAL (ACU),34000009,78070,HC PARATHRYOID IMAGING 78070,340,1 ,"$1,389.00 ","$1,041.75 ",$313.08 ,"$1,389.00 ",$894.52 ,$398.69 ,$972.30 ,$313.08 ,$458.97 ,$322.47 ,$367.18 ,"$1,319.55 ",$313.08 ,"$1,111.20 ","$1,277.88 ",$313.08 ,"$1,180.65 ","$1,319.55 ","$1,222.32 ","$1,055.64 ",$313.08 ,$313.08 ,$313.08 ,"$1,013.97 ",$763.95 ,"$1,263.99 ","$1,263.99 ","$1,111.20 ",$410.65 ,$763.95 ,"$1,250.10 ",$398.69 ,"$1,250.10 ",$750.06 ,"$1,305.66 ",$897.05 ,"$1,277.88 ",$331.86 ,"$1,263.99 ",$398.69 ,$854.79 ,$854.79 ,$472.24 ,"$1,036.61 ","$1,250.10 ",$402.67 ,$313.08 ,"$1,319.55 ",$418.62 ,$313.08 ,"$1,208.43 ",$398.69 ,"$1,250.10 ",$398.69 ,"$1,250.10 ","$1,250.10 ","$1,250.10 ","$1,347.33 ","$1,125.09 ","$1,291.77 ","$1,194.54 ","$1,347.33 "
SACRED HEART HOSPITAL (ACU),34000014,78195,HC LYMPH NODE IMAGING,340,1 ,"$1,727.00 ","$1,295.25 ",$313.08 ,"$1,727.00 ","$1,112.19 ",$517.56 ,"$1,208.90 ",$313.08 ,$523.51 ,$322.47 ,$418.81 ,"$1,640.65 ",$313.08 ,"$1,381.60 ","$1,588.84 ",$313.08 ,"$1,467.95 ","$1,640.65 ","$1,519.76 ","$1,312.52 ",$313.08 ,$313.08 ,$313.08 ,"$1,260.71 ",$949.85 ,"$1,571.57 ","$1,571.57 ","$1,381.60 ",$533.09 ,$949.85 ,"$1,554.30 ",$517.56 ,"$1,554.30 ",$932.58 ,"$1,623.38 ","$1,164.51 ","$1,588.84 ",$331.86 ,"$1,571.57 ",$517.56 ,"$1,062.80 ","$1,062.80 ",$549.48 ,"$1,288.86 ","$1,554.30 ",$522.74 ,$313.08 ,"$1,640.65 ",$543.44 ,$313.08 ,"$1,502.49 ",$517.56 ,"$1,554.30 ",$517.56 ,"$1,554.30 ","$1,554.30 ","$1,554.30 ","$1,675.19 ","$1,398.87 ","$1,606.11 ","$1,485.22 ","$1,675.19 "
SACRED HEART HOSPITAL (ACU),34000021,78216,HC RBC LIVER SCAN,340,1 ,"$1,366.00 ","$1,024.50 ",$139.51 ,"$1,366.00 ",$879.70 ,$398.69 ,$956.20 ,$313.08 ,$174.39 ,$322.47 ,$139.51 ,"$1,297.70 ",$313.08 ,"$1,092.80 ","$1,256.72 ",$313.08 ,"$1,161.10 ","$1,297.70 ","$1,202.08 ","$1,038.16 ",$313.08 ,$313.08 ,$313.08 ,$997.18 ,$751.30 ,"$1,243.06 ","$1,243.06 ","$1,092.80 ",$410.65 ,$751.30 ,"$1,229.40 ",$398.69 ,"$1,229.40 ",$737.64 ,"$1,284.04 ",$897.05 ,"$1,256.72 ",$331.86 ,"$1,243.06 ",$398.69 ,$840.64 ,$840.64 ,$607.70 ,"$1,019.45 ",$701.61 ,$402.67 ,$313.08 ,"$1,297.70 ",$418.62 ,$313.08 ,"$1,188.42 ",$398.69 ,"$1,229.40 ",$398.69 ,"$1,229.40 ","$1,229.40 ","$1,229.40 ","$1,325.02 ","$1,106.46 ","$1,270.38 ","$1,174.76 ","$1,325.02 "
SACRED HEART HOSPITAL (ACU),34000022,78226,HC HEPATOBILIARY SCAN,340,1 ,"$1,144.00 ",$858.00 ,$124.60 ,"$1,144.00 ",$736.74 ,$398.69 ,$800.80 ,$124.60 ,$517.51 ,$128.34 ,$414.01 ,"$1,086.80 ",$124.60 ,$915.20 ,"$1,052.48 ",$124.60 ,$972.40 ,"$1,086.80 ","$1,006.72 ",$869.44 ,$124.60 ,$124.60 ,$124.60 ,$835.12 ,$629.20 ,"$1,041.04 ","$1,041.04 ",$915.20 ,$410.65 ,$629.20 ,"$1,029.60 ",$398.69 ,"$1,029.60 ",$617.76 ,"$1,075.36 ",$897.05 ,"$1,052.48 ",$132.08 ,"$1,041.04 ",$398.69 ,$704.02 ,$704.02 ,$590.04 ,$853.77 ,"$1,029.60 ",$402.67 ,$124.60 ,"$1,086.80 ",$418.62 ,$124.60 ,$995.28 ,$398.69 ,"$1,029.60 ",$398.69 ,"$1,029.60 ","$1,029.60 ","$1,029.60 ","$1,109.68 ",$926.64 ,"$1,063.92 ",$983.84 ,"$1,109.68 "
SACRED HEART HOSPITAL (ACU),34000026,78264,HC GASTRIC EMPTYING STUDY,340,1 ,"$1,738.00 ","$1,303.50 ",$124.60 ,"$1,738.00 ","$1,119.27 ",$398.69 ,"$1,216.60 ",$124.60 ,$522.92 ,$128.34 ,$418.33 ,"$1,651.10 ",$124.60 ,"$1,390.40 ","$1,598.96 ",$124.60 ,"$1,477.30 ","$1,651.10 ","$1,529.44 ","$1,320.88 ",$124.60 ,$124.60 ,$124.60 ,"$1,268.74 ",$955.90 ,"$1,581.58 ","$1,581.58 ","$1,390.40 ",$410.65 ,$955.90 ,"$1,564.20 ",$398.69 ,"$1,564.20 ",$938.52 ,"$1,633.72 ",$897.05 ,"$1,598.96 ",$132.08 ,"$1,581.58 ",$398.69 ,"$1,069.57 ","$1,069.57 ",$428.76 ,"$1,297.07 ","$1,564.20 ",$402.67 ,$124.60 ,"$1,651.10 ",$418.62 ,$124.60 ,"$1,512.06 ",$398.69 ,"$1,564.20 ",$398.69 ,"$1,564.20 ","$1,564.20 ","$1,564.20 ","$1,685.86 ","$1,407.78 ","$1,616.34 ","$1,494.68 ","$1,685.86 "
SACRED HEART HOSPITAL (ACU),34000027,78278,HC GI BLEED SCAN,340,1 ,"$2,597.00 ","$1,947.75 ",$313.08 ,"$2,597.00 ","$1,672.47 ",$398.69 ,"$1,817.90 ",$313.08 ,$527.12 ,$322.47 ,$421.69 ,"$2,467.15 ",$313.08 ,"$2,077.60 ","$2,389.24 ",$313.08 ,"$2,207.45 ","$2,467.15 ","$2,285.36 ","$1,973.72 ",$313.08 ,$313.08 ,$313.08 ,"$1,895.81 ","$1,428.35 ","$2,363.27 ","$2,363.27 ","$2,077.60 ",$410.65 ,"$1,428.35 ","$2,337.30 ",$398.69 ,"$2,337.30 ","$1,402.38 ","$2,441.18 ",$897.05 ,"$2,389.24 ",$331.86 ,"$2,363.27 ",$398.69 ,"$1,598.19 ","$1,598.19 ",$684.61 ,"$1,938.14 ","$2,131.85 ",$402.67 ,$313.08 ,"$2,467.15 ",$418.62 ,$313.08 ,"$2,259.39 ",$398.69 ,"$2,337.30 ",$398.69 ,"$2,337.30 ","$2,337.30 ","$2,337.30 ","$2,519.09 ","$2,103.57 ","$2,415.21 ","$2,233.42 ","$2,519.09 "
SACRED HEART HOSPITAL (ACU),34000028,78290,HC SM BOWEL MECKEL'S SCAN,340,1 ,"$1,648.00 ","$1,236.00 ",$124.60 ,"$1,648.00 ","$1,061.31 ",$398.69 ,"$1,153.60 ",$124.60 ,$524.11 ,$128.34 ,$419.29 ,"$1,565.60 ",$124.60 ,"$1,318.40 ","$1,516.16 ",$124.60 ,"$1,400.80 ","$1,565.60 ","$1,450.24 ","$1,252.48 ",$124.60 ,$124.60 ,$124.60 ,"$1,203.04 ",$906.40 ,"$1,499.68 ","$1,499.68 ","$1,318.40 ",$410.65 ,$906.40 ,"$1,483.20 ",$398.69 ,"$1,483.20 ",$889.92 ,"$1,549.12 ",$897.05 ,"$1,516.16 ",$132.08 ,"$1,499.68 ",$398.69 ,"$1,014.18 ","$1,014.18 ",$448.91 ,"$1,229.90 ","$1,483.20 ",$402.67 ,$124.60 ,"$1,565.60 ",$418.62 ,$124.60 ,"$1,433.76 ",$398.69 ,"$1,483.20 ",$398.69 ,"$1,483.20 ","$1,483.20 ","$1,483.20 ","$1,598.56 ","$1,334.88 ","$1,532.64 ","$1,417.28 ","$1,598.56 "
SACRED HEART HOSPITAL (ACU),34000029,78300,HC BONE SCAN LIMITED,340,1 ,"$1,212.00 ",$909.00 ,$124.60 ,"$1,212.00 ",$780.53 ,$398.69 ,$848.40 ,$124.60 ,$263.85 ,$128.34 ,$211.08 ,"$1,151.40 ",$124.60 ,$969.60 ,"$1,115.04 ",$124.60 ,"$1,030.20 ","$1,151.40 ","$1,066.56 ",$921.12 ,$124.60 ,$124.60 ,$124.60 ,$884.76 ,$666.60 ,"$1,102.92 ","$1,102.92 ",$969.60 ,$410.65 ,$666.60 ,"$1,090.80 ",$398.69 ,"$1,090.80 ",$654.48 ,"$1,139.28 ",$897.05 ,"$1,115.04 ",$132.08 ,"$1,102.92 ",$398.69 ,$745.86 ,$745.86 ,$454.90 ,$904.52 ,"$1,090.80 ",$402.67 ,$124.60 ,"$1,151.40 ",$418.62 ,$124.60 ,"$1,054.44 ",$398.69 ,"$1,090.80 ",$398.69 ,"$1,090.80 ","$1,090.80 ","$1,090.80 ","$1,175.64 ",$981.72 ,"$1,127.16 ","$1,042.32 ","$1,175.64 "
SACRED HEART HOSPITAL (ACU),34000030,78305,HC BONE SCAN MULTIPLE,340,1 ,"$1,417.00 ","$1,062.75 ",$124.60 ,"$1,417.00 ",$912.55 ,$398.69 ,$991.90 ,$124.60 ,$335.30 ,$128.34 ,$268.24 ,"$1,346.15 ",$124.60 ,"$1,133.60 ","$1,303.64 ",$124.60 ,"$1,204.45 ","$1,346.15 ","$1,246.96 ","$1,076.92 ",$124.60 ,$124.60 ,$124.60 ,"$1,034.41 ",$779.35 ,"$1,289.47 ","$1,289.47 ","$1,133.60 ",$410.65 ,$779.35 ,"$1,275.30 ",$398.69 ,"$1,275.30 ",$765.18 ,"$1,331.98 ",$897.05 ,"$1,303.64 ",$132.08 ,"$1,289.47 ",$398.69 ,$872.02 ,$872.02 ,$611.45 ,"$1,057.51 ","$1,275.30 ",$402.67 ,$124.60 ,"$1,346.15 ",$418.62 ,$124.60 ,"$1,232.79 ",$398.69 ,"$1,275.30 ",$398.69 ,"$1,275.30 ","$1,275.30 ","$1,275.30 ","$1,374.49 ","$1,147.77 ","$1,317.81 ","$1,218.62 ","$1,374.49 "
SACRED HEART HOSPITAL (ACU),34000031,78306,HC BONE SCAN WHOLE BODY,340,1 ,"$1,799.00 ","$1,349.25 ",$124.60 ,"$1,799.00 ","$1,158.56 ",$398.69 ,"$1,259.30 ",$124.60 ,$368.32 ,$128.34 ,$294.66 ,"$1,709.05 ",$124.60 ,"$1,439.20 ","$1,655.08 ",$124.60 ,"$1,529.15 ","$1,709.05 ","$1,583.12 ","$1,367.24 ",$124.60 ,$124.60 ,$124.60 ,"$1,313.27 ",$989.45 ,"$1,637.09 ","$1,637.09 ","$1,439.20 ",$410.65 ,$989.45 ,"$1,619.10 ",$398.69 ,"$1,619.10 ",$971.46 ,"$1,691.06 ",$897.05 ,"$1,655.08 ",$132.08 ,"$1,637.09 ",$398.69 ,"$1,107.10 ","$1,107.10 ",$756.75 ,"$1,342.59 ","$1,619.10 ",$402.67 ,$124.60 ,"$1,709.05 ",$418.62 ,$124.60 ,"$1,565.13 ",$398.69 ,"$1,619.10 ",$398.69 ,"$1,619.10 ","$1,619.10 ","$1,619.10 ","$1,745.03 ","$1,457.19 ","$1,673.07 ","$1,547.14 ","$1,745.03 "
SACRED HEART HOSPITAL (ACU),34000033,78315,HC BONE SCAN/3 PHASE,340,1 ,"$2,253.00 ","$1,689.75 ",$124.60 ,"$2,253.00 ","$1,450.93 ",$398.69 ,"$1,577.10 ",$124.60 ,$520.50 ,$128.34 ,$416.40 ,"$2,140.35 ",$124.60 ,"$1,802.40 ","$2,072.76 ",$124.60 ,"$1,915.05 ","$2,140.35 ","$1,982.64 ","$1,712.28 ",$124.60 ,$124.60 ,$124.60 ,"$1,644.69 ","$1,239.15 ","$2,050.23 ","$2,050.23 ","$1,802.40 ",$410.65 ,"$1,239.15 ","$2,027.70 ",$398.69 ,"$2,027.70 ","$1,216.62 ","$2,117.82 ",$897.05 ,"$2,072.76 ",$132.08 ,"$2,050.23 ",$398.69 ,"$1,386.50 ","$1,386.50 ",$689.08 ,"$1,681.41 ","$2,027.70 ",$402.67 ,$124.60 ,"$2,140.35 ",$418.62 ,$124.60 ,"$1,960.11 ",$398.69 ,"$2,027.70 ",$398.69 ,"$2,027.70 ","$2,027.70 ","$2,027.70 ","$2,185.41 ","$1,824.93 ","$2,095.29 ","$1,937.58 ","$2,185.41 "
SACRED HEART HOSPITAL (ACU),34000035,78451,HC HT MUSCLE IMAGE SPECT SINGLE,340,1 ,"$2,815.00 ","$2,111.25 ",$295.02 ,"$3,109.74 ","$1,812.86 ","$1,382.11 ","$1,970.50 ",$313.08 ,$479.68 ,$322.47 ,$383.74 ,"$2,674.25 ",$313.08 ,"$2,252.00 ","$2,589.80 ",$313.08 ,"$2,392.75 ","$2,674.25 ","$2,477.20 ","$2,139.40 ",$313.08 ,$313.08 ,$313.08 ,"$2,054.95 ","$1,548.25 ","$2,561.65 ","$2,561.65 ","$2,252.00 ","$1,423.57 ","$1,548.25 ","$2,533.50 ","$1,382.11 ","$2,533.50 ","$1,520.10 ","$2,646.10 ","$3,109.74 ","$2,589.80 ",$331.86 ,"$2,561.65 ","$1,382.11 ","$1,732.35 ","$1,732.35 ",$295.02 ,"$2,100.83 ","$1,945.68 ","$1,395.93 ",$313.08 ,"$2,674.25 ","$1,451.21 ",$313.08 ,"$2,449.05 ","$1,382.11 ","$2,533.50 ","$1,382.11 ","$2,533.50 ","$2,533.50 ","$2,533.50 ","$2,730.55 ","$2,280.15 ","$2,617.95 ","$2,420.90 ","$2,730.55 "
SACRED HEART HOSPITAL (ACU),34000037,78452,HC HT MUSCLE IMAGE SPECT MULTI,340,1 ,"$7,239.00 ","$5,429.25 ",$313.08 ,"$7,239.00 ","$4,661.92 ","$1,382.11 ","$5,067.30 ",$313.08 ,$691.01 ,$322.47 ,$552.80 ,"$6,877.05 ",$313.08 ,"$5,791.20 ","$6,659.88 ",$313.08 ,"$6,153.15 ","$6,877.05 ","$6,370.32 ","$5,501.64 ",$313.08 ,$313.08 ,$313.08 ,"$5,284.47 ","$3,981.45 ","$6,587.49 ","$6,587.49 ","$5,791.20 ","$1,423.57 ","$3,981.45 ","$6,515.10 ","$1,382.11 ","$6,515.10 ","$3,909.06 ","$6,804.66 ","$3,109.74 ","$6,659.88 ",$331.86 ,"$6,587.49 ","$1,382.11 ","$4,454.88 ","$4,454.88 ",$570.19 ,"$5,402.47 ","$2,808.40 ","$1,395.93 ",$313.08 ,"$6,877.05 ","$1,451.21 ",$313.08 ,"$6,297.93 ","$1,382.11 ","$6,515.10 ","$1,382.11 ","$6,515.10 ","$6,515.10 ","$6,515.10 ","$7,021.83 ","$5,863.59 ","$6,732.27 ","$6,225.54 ","$7,021.83 "
SACRED HEART HOSPITAL (ACU),34000043,78466,HC CARDIAC SCAN,340,1 ,$917.00 ,$687.75 ,$124.60 ,$917.00 ,$590.55 ,$398.69 ,$641.90 ,$124.60 ,$281.86 ,$128.34 ,$225.48 ,$871.15 ,$124.60 ,$733.60 ,$843.64 ,$124.60 ,$779.45 ,$871.15 ,$806.96 ,$696.92 ,$124.60 ,$124.60 ,$124.60 ,$669.41 ,$504.35 ,$834.47 ,$834.47 ,$733.60 ,$410.65 ,$504.35 ,$825.30 ,$398.69 ,$825.30 ,$495.18 ,$861.98 ,$897.05 ,$843.64 ,$132.08 ,$834.47 ,$398.69 ,$564.32 ,$564.32 ,$397.74 ,$684.36 ,$825.30 ,$402.67 ,$124.60 ,$871.15 ,$418.62 ,$124.60 ,$797.79 ,$398.69 ,$825.30 ,$398.69 ,$825.30 ,$825.30 ,$825.30 ,$889.49 ,$742.77 ,$852.81 ,$788.62 ,$889.49 
SACRED HEART HOSPITAL (ACU),34000044,78472,HC MUGA RESTING SGL,340,1 ,"$2,606.00 ","$1,954.50 ",$124.60 ,"$2,606.00 ","$1,678.26 ",$398.69 ,"$1,824.20 ",$124.60 ,$317.89 ,$128.34 ,$254.31 ,"$2,475.70 ",$124.60 ,"$2,084.80 ","$2,397.52 ",$124.60 ,"$2,215.10 ","$2,475.70 ","$2,293.28 ","$1,980.56 ",$124.60 ,$124.60 ,$124.60 ,"$1,902.38 ","$1,433.30 ","$2,371.46 ","$2,371.46 ","$2,084.80 ",$410.65 ,"$1,433.30 ","$2,345.40 ",$398.69 ,"$2,345.40 ","$1,407.24 ","$2,449.64 ",$897.05 ,"$2,397.52 ",$132.08 ,"$2,371.46 ",$398.69 ,"$1,603.73 ","$1,603.73 ",$816.43 ,"$1,944.86 ","$1,286.89 ",$402.67 ,$124.60 ,"$2,475.70 ",$418.62 ,$124.60 ,"$2,267.22 ",$398.69 ,"$2,345.40 ",$398.69 ,"$2,345.40 ","$2,345.40 ","$2,345.40 ","$2,527.82 ","$2,110.86 ","$2,423.58 ","$2,241.16 ","$2,527.82 "
SACRED HEART HOSPITAL (ACU),34000047,78580,HC LUNG PERFUS,340,1 ,"$1,937.00 ","$1,452.75 ",$285.04 ,"$1,937.00 ","$1,247.43 ",$398.69 ,"$1,355.90 ",$313.08 ,$356.30 ,$322.47 ,$285.04 ,"$1,840.15 ",$313.08 ,"$1,549.60 ","$1,782.04 ",$313.08 ,"$1,646.45 ","$1,840.15 ","$1,704.56 ","$1,472.12 ",$313.08 ,$313.08 ,$313.08 ,"$1,414.01 ","$1,065.35 ","$1,762.67 ","$1,762.67 ","$1,549.60 ",$410.65 ,"$1,065.35 ","$1,743.30 ",$398.69 ,"$1,743.30 ","$1,045.98 ","$1,820.78 ",$897.05 ,"$1,782.04 ",$331.86 ,"$1,762.67 ",$398.69 ,"$1,192.03 ","$1,192.03 ",$595.26 ,"$1,445.58 ","$1,436.84 ",$402.67 ,$313.08 ,"$1,840.15 ",$418.62 ,$313.08 ,"$1,685.19 ",$398.69 ,"$1,743.30 ",$398.69 ,"$1,743.30 ","$1,743.30 ","$1,743.30 ","$1,878.89 ","$1,568.97 ","$1,801.41 ","$1,665.82 ","$1,878.89 "
SACRED HEART HOSPITAL (ACU),34000048,78582,HC LUNG SCAN-VENT/PERF,340,1 ,"$2,679.00 ","$2,009.25 ",$313.08 ,"$2,679.00 ","$1,725.28 ",$517.56 ,"$1,875.30 ",$313.08 ,$495.90 ,$322.47 ,$396.72 ,"$2,545.05 ",$313.08 ,"$2,143.20 ","$2,464.68 ",$313.08 ,"$2,277.15 ","$2,545.05 ","$2,357.52 ","$2,036.04 ",$313.08 ,$313.08 ,$313.08 ,"$1,955.67 ","$1,473.45 ","$2,437.89 ","$2,437.89 ","$2,143.20 ",$533.09 ,"$1,473.45 ","$2,411.10 ",$517.56 ,"$2,411.10 ","$1,446.66 ","$2,518.26 ","$1,164.51 ","$2,464.68 ",$331.86 ,"$2,437.89 ",$517.56 ,"$1,648.66 ","$1,648.66 ",$546.92 ,"$1,999.34 ","$2,001.28 ",$522.74 ,$313.08 ,"$2,545.05 ",$543.44 ,$313.08 ,"$2,330.73 ",$517.56 ,"$2,411.10 ",$517.56 ,"$2,411.10 ","$2,411.10 ","$2,411.10 ","$2,598.63 ","$2,169.99 ","$2,491.47 ","$2,303.94 ","$2,598.63 "
SACRED HEART HOSPITAL (ACU),34000053,78601,HC BRAIN W/FLOW < 4 VIEWS STAT,340,1 ,"$1,217.00 ",$912.75 ,$124.60 ,"$1,217.00 ",$783.75 ,$398.69 ,$851.90 ,$124.60 ,$333.50 ,$128.34 ,$266.80 ,"$1,156.15 ",$124.60 ,$973.60 ,"$1,119.64 ",$124.60 ,"$1,034.45 ","$1,156.15 ","$1,070.96 ",$924.92 ,$124.60 ,$124.60 ,$124.60 ,$888.41 ,$669.35 ,"$1,107.47 ","$1,107.47 ",$973.60 ,$410.65 ,$669.35 ,"$1,095.30 ",$398.69 ,"$1,095.30 ",$657.18 ,"$1,143.98 ",$897.05 ,"$1,119.64 ",$132.08 ,"$1,107.47 ",$398.69 ,$748.94 ,$748.94 ,$502.95 ,$908.25 ,"$1,095.30 ",$402.67 ,$124.60 ,"$1,156.15 ",$418.62 ,$124.60 ,"$1,058.79 ",$398.69 ,"$1,095.30 ",$398.69 ,"$1,095.30 ","$1,095.30 ","$1,095.30 ","$1,180.49 ",$985.77 ,"$1,131.81 ","$1,046.62 ","$1,180.49 "
SACRED HEART HOSPITAL (ACU),34000054,78606,HC BRAIN SC W/VASCULAR FLOW > 4 VIEWS,340,1 ,"$1,018.00 ",$763.50 ,$124.60 ,"$1,164.51 ",$655.59 ,$517.56 ,$712.60 ,$124.60 ,$524.72 ,$128.34 ,$419.78 ,$967.10 ,$124.60 ,$814.40 ,$936.56 ,$124.60 ,$865.30 ,$967.10 ,$895.84 ,$773.68 ,$124.60 ,$124.60 ,$124.60 ,$743.14 ,$559.90 ,$926.38 ,$926.38 ,$814.40 ,$533.09 ,$559.90 ,$916.20 ,$517.56 ,$916.20 ,$549.72 ,$956.92 ,"$1,164.51 ",$936.56 ,$132.08 ,$926.38 ,$517.56 ,$626.48 ,$626.48 ,$581.02 ,$759.73 ,$916.20 ,$522.74 ,$124.60 ,$967.10 ,$543.44 ,$124.60 ,$885.66 ,$517.56 ,$916.20 ,$517.56 ,$916.20 ,$916.20 ,$916.20 ,$987.46 ,$824.58 ,$946.74 ,$875.48 ,$987.46 
SACRED HEART HOSPITAL (ACU),34000056,78630,HC CISTERNOGRAPHY,340,1 ,"$1,127.00 ",$845.25 ,$313.08 ,"$1,164.51 ",$725.79 ,$517.56 ,$788.90 ,$313.08 ,$536.11 ,$322.47 ,$428.89 ,"$1,070.65 ",$313.08 ,$901.60 ,"$1,036.84 ",$313.08 ,$957.95 ,"$1,070.65 ",$991.76 ,$856.52 ,$313.08 ,$313.08 ,$313.08 ,$822.71 ,$619.85 ,"$1,025.57 ","$1,025.57 ",$901.60 ,$533.09 ,$619.85 ,"$1,014.30 ",$517.56 ,"$1,014.30 ",$608.58 ,"$1,059.38 ","$1,164.51 ","$1,036.84 ",$331.86 ,"$1,025.57 ",$517.56 ,$693.56 ,$693.56 ,$754.75 ,$841.08 ,"$1,014.30 ",$522.74 ,$313.08 ,"$1,070.65 ",$543.44 ,$313.08 ,$980.49 ,$517.56 ,"$1,014.30 ",$517.56 ,"$1,014.30 ","$1,014.30 ","$1,014.30 ","$1,093.19 ",$912.87 ,"$1,048.11 ",$969.22 ,"$1,093.19 "
SACRED HEART HOSPITAL (ACU),34000057,78645,HC CSF SHUNT EVALUATION,340,1 ,$845.00 ,$633.75 ,$313.08 ,"$1,164.51 ",$544.18 ,$517.56 ,$591.50 ,$313.08 ,$521.12 ,$322.47 ,$416.89 ,$802.75 ,$313.08 ,$676.00 ,$777.40 ,$313.08 ,$718.25 ,$802.75 ,$743.60 ,$642.20 ,$313.08 ,$313.08 ,$313.08 ,$616.85 ,$464.75 ,$768.95 ,$768.95 ,$676.00 ,$533.09 ,$464.75 ,$760.50 ,$517.56 ,$760.50 ,$456.30 ,$794.30 ,"$1,164.51 ",$777.40 ,$331.86 ,$768.95 ,$517.56 ,$520.01 ,$520.01 ,$514.09 ,$630.62 ,$760.50 ,$522.74 ,$313.08 ,$802.75 ,$543.44 ,$313.08 ,$735.15 ,$517.56 ,$760.50 ,$517.56 ,$760.50 ,$760.50 ,$760.50 ,$819.65 ,$684.45 ,$785.85 ,$726.70 ,$819.65 
SACRED HEART HOSPITAL (ACU),34000062,78707,HC KIDNEY SCAN W/FLOW AND FUNCTION,340,1 ,"$1,751.00 ","$1,313.25 ",$124.60 ,"$1,751.00 ","$1,127.64 ",$517.56 ,"$1,225.70 ",$124.60 ,$327.50 ,$128.34 ,$262.00 ,"$1,663.45 ",$124.60 ,"$1,400.80 ","$1,610.92 ",$124.60 ,"$1,488.35 ","$1,663.45 ","$1,540.88 ","$1,330.76 ",$124.60 ,$124.60 ,$124.60 ,"$1,278.23 ",$963.05 ,"$1,593.41 ","$1,593.41 ","$1,400.80 ",$533.09 ,$963.05 ,"$1,575.90 ",$517.56 ,"$1,575.90 ",$945.54 ,"$1,645.94 ","$1,164.51 ","$1,610.92 ",$132.08 ,"$1,593.41 ",$517.56 ,"$1,077.57 ","$1,077.57 ",$678.27 ,"$1,306.77 ","$1,323.19 ",$522.74 ,$124.60 ,"$1,663.45 ",$543.44 ,$124.60 ,"$1,523.37 ",$517.56 ,"$1,575.90 ",$517.56 ,"$1,575.90 ","$1,575.90 ","$1,575.90 ","$1,698.47 ","$1,418.31 ","$1,628.43 ","$1,505.86 ","$1,698.47 "
SACRED HEART HOSPITAL (ACU),34000063,78708,HC KIDNEY W/PHARMACLGCL INTER,340,1 ,"$1,584.00 ","$1,188.00 ",$124.60 ,"$1,584.00 ","$1,020.10 ",$517.56 ,"$1,108.80 ",$124.60 ,$205.29 ,$128.34 ,$164.23 ,"$1,504.80 ",$124.60 ,"$1,267.20 ","$1,457.28 ",$124.60 ,"$1,346.40 ","$1,504.80 ","$1,393.92 ","$1,203.84 ",$124.60 ,$124.60 ,$124.60 ,"$1,156.32 ",$871.20 ,"$1,441.44 ","$1,441.44 ","$1,267.20 ",$533.09 ,$871.20 ,"$1,425.60 ",$517.56 ,"$1,425.60 ",$855.36 ,"$1,488.96 ","$1,164.51 ","$1,457.28 ",$132.08 ,"$1,441.44 ",$517.56 ,$974.79 ,$974.79 ,$500.97 ,"$1,182.14 ",$828.25 ,$522.74 ,$124.60 ,"$1,504.80 ",$543.44 ,$124.60 ,"$1,378.08 ",$517.56 ,"$1,425.60 ",$517.56 ,"$1,425.60 ","$1,425.60 ","$1,425.60 ","$1,536.48 ","$1,283.04 ","$1,473.12 ","$1,362.24 ","$1,536.48 "
SACRED HEART HOSPITAL (ACU),34000066,78740,HC URETERAL REFLUX STUDY,340,1 ,$924.00 ,$693.00 ,$124.60 ,$924.00 ,$595.06 ,$398.69 ,$646.80 ,$124.60 ,$336.49 ,$128.34 ,$269.19 ,$877.80 ,$124.60 ,$739.20 ,$850.08 ,$124.60 ,$785.40 ,$877.80 ,$813.12 ,$702.24 ,$124.60 ,$124.60 ,$124.60 ,$674.52 ,$508.20 ,$840.84 ,$840.84 ,$739.20 ,$410.65 ,$508.20 ,$831.60 ,$398.69 ,$831.60 ,$498.96 ,$868.56 ,$897.05 ,$850.08 ,$132.08 ,$840.84 ,$398.69 ,$568.63 ,$568.63 ,$352.71 ,$689.58 ,$831.60 ,$402.67 ,$124.60 ,$877.80 ,$418.62 ,$124.60 ,$803.88 ,$398.69 ,$831.60 ,$398.69 ,$831.60 ,$831.60 ,$831.60 ,$896.28 ,$748.44 ,$859.32 ,$794.64 ,$896.28 
SACRED HEART HOSPITAL (ACU),34000068,78800,HC TUMOR LOCAL LIMITED,340,1 ,$996.00 ,$747.00 ,$223.57 ,$996.00 ,$641.42 ,$398.69 ,$697.20 ,$313.08 ,$279.46 ,$322.47 ,$223.57 ,$946.20 ,$313.08 ,$796.80 ,$916.32 ,$313.08 ,$846.60 ,$946.20 ,$876.48 ,$756.96 ,$313.08 ,$313.08 ,$313.08 ,$727.08 ,$547.80 ,$906.36 ,$906.36 ,$796.80 ,$410.65 ,$547.80 ,$896.40 ,$398.69 ,$896.40 ,$537.84 ,$936.24 ,$897.05 ,$916.32 ,$331.86 ,$906.36 ,$398.69 ,$612.94 ,$612.94 ,$484.04 ,$743.31 ,$896.40 ,$402.67 ,$313.08 ,$946.20 ,$418.62 ,$313.08 ,$866.52 ,$398.69 ,$896.40 ,$398.69 ,$896.40 ,$896.40 ,$896.40 ,$966.12 ,$806.76 ,$926.28 ,$856.56 ,$966.12 
SACRED HEART HOSPITAL (ACU),34000069,78801,HC TUMOR LOCAL MULTIPLE,340,1 ,"$2,649.00 ","$1,986.75 ",$313.08 ,"$2,649.00 ","$1,705.96 ",$398.69 ,"$1,854.30 ",$313.08 ,$391.74 ,$322.47 ,$313.39 ,"$2,516.55 ",$313.08 ,"$2,119.20 ","$2,437.08 ",$313.08 ,"$2,251.65 ","$2,516.55 ","$2,331.12 ","$2,013.24 ",$313.08 ,$313.08 ,$313.08 ,"$1,933.77 ","$1,456.95 ","$2,410.59 ","$2,410.59 ","$2,119.20 ",$410.65 ,"$1,456.95 ","$2,384.10 ",$398.69 ,"$2,384.10 ","$1,430.46 ","$2,490.06 ",$897.05 ,"$2,437.08 ",$331.86 ,"$2,410.59 ",$398.69 ,"$1,630.19 ","$1,630.19 ",$597.09 ,"$1,976.95 ","$1,565.04 ",$402.67 ,$313.08 ,"$2,516.55 ",$418.62 ,$313.08 ,"$2,304.63 ",$398.69 ,"$2,384.10 ",$398.69 ,"$2,384.10 ","$2,384.10 ","$2,384.10 ","$2,569.53 ","$2,145.69 ","$2,463.57 ","$2,278.14 ","$2,569.53 "
SACRED HEART HOSPITAL (ACU),34000070,78802,HC TUMOR IMAGE-WHOLE BODY-1 DAY,340,1 ,"$2,649.00 ","$1,986.75 ",$313.08 ,"$3,109.74 ","$1,705.96 ","$1,382.11 ","$1,854.30 ",$313.08 ,$495.90 ,$322.47 ,$396.72 ,"$2,516.55 ",$313.08 ,"$2,119.20 ","$2,437.08 ",$313.08 ,"$2,251.65 ","$2,516.55 ","$2,331.12 ","$2,013.24 ",$313.08 ,$313.08 ,$313.08 ,"$1,933.77 ","$1,456.95 ","$2,410.59 ","$2,410.59 ","$2,119.20 ","$1,423.57 ","$1,456.95 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$1,430.46 ","$2,490.06 ","$3,109.74 ","$2,437.08 ",$331.86 ,"$2,410.59 ","$1,382.11 ","$1,630.19 ","$1,630.19 ",$822.57 ,"$1,976.95 ","$2,003.66 ","$1,395.93 ",$313.08 ,"$2,516.55 ","$1,451.21 ",$313.08 ,"$2,304.63 ","$1,382.11 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$2,384.10 ","$2,384.10 ","$2,569.53 ","$2,145.69 ","$2,463.57 ","$2,278.14 ","$2,569.53 "
SACRED HEART HOSPITAL (ACU),34000071,78803,HC TUMOR IMAGING (SPECT),340,1 ,"$2,649.00 ","$1,986.75 ",$313.08 ,"$3,109.74 ","$1,705.96 ","$1,382.11 ","$1,854.30 ",$313.08 ,$509.71 ,$322.47 ,$407.76 ,"$2,516.55 ",$313.08 ,"$2,119.20 ","$2,437.08 ",$313.08 ,"$2,251.65 ","$2,516.55 ","$2,331.12 ","$2,013.24 ",$313.08 ,$313.08 ,$313.08 ,"$1,933.77 ","$1,456.95 ","$2,410.59 ","$2,410.59 ","$2,119.20 ","$1,423.57 ","$1,456.95 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$1,430.46 ","$2,490.06 ","$3,109.74 ","$2,437.08 ",$331.86 ,"$2,410.59 ","$1,382.11 ","$1,630.19 ","$1,630.19 ",$972.54 ,"$1,976.95 ","$2,066.57 ","$1,395.93 ",$313.08 ,"$2,516.55 ","$1,451.21 ",$313.08 ,"$2,304.63 ","$1,382.11 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$2,384.10 ","$2,384.10 ","$2,569.53 ","$2,145.69 ","$2,463.57 ","$2,278.14 ","$2,569.53 "
SACRED HEART HOSPITAL (ACU),34000073,78803,HC TUMOR IMAGING (SPECT) GALLIUM,340,1 ,"$2,649.00 ","$1,986.75 ",$313.08 ,"$3,109.74 ","$1,705.96 ","$1,382.11 ","$1,854.30 ",$313.08 ,$509.71 ,$322.47 ,$407.76 ,"$2,516.55 ",$313.08 ,"$2,119.20 ","$2,437.08 ",$313.08 ,"$2,251.65 ","$2,516.55 ","$2,331.12 ","$2,013.24 ",$313.08 ,$313.08 ,$313.08 ,"$1,933.77 ","$1,456.95 ","$2,410.59 ","$2,410.59 ","$2,119.20 ","$1,423.57 ","$1,456.95 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$1,430.46 ","$2,490.06 ","$3,109.74 ","$2,437.08 ",$331.86 ,"$2,410.59 ","$1,382.11 ","$1,630.19 ","$1,630.19 ",$972.54 ,"$1,976.95 ","$2,066.57 ","$1,395.93 ",$313.08 ,"$2,516.55 ","$1,451.21 ",$313.08 ,"$2,304.63 ","$1,382.11 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$2,384.10 ","$2,384.10 ","$2,569.53 ","$2,145.69 ","$2,463.57 ","$2,278.14 ","$2,569.53 "
SACRED HEART HOSPITAL (ACU),34000075,78803,HC TUMOR IMAGING (SPECT) OCTREO,340,1 ,"$2,649.00 ","$1,986.75 ",$313.08 ,"$3,109.74 ","$1,705.96 ","$1,382.11 ","$1,854.30 ",$313.08 ,$509.71 ,$322.47 ,$407.76 ,"$2,516.55 ",$313.08 ,"$2,119.20 ","$2,437.08 ",$313.08 ,"$2,251.65 ","$2,516.55 ","$2,331.12 ","$2,013.24 ",$313.08 ,$313.08 ,$313.08 ,"$1,933.77 ","$1,456.95 ","$2,410.59 ","$2,410.59 ","$2,119.20 ","$1,423.57 ","$1,456.95 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$1,430.46 ","$2,490.06 ","$3,109.74 ","$2,437.08 ",$331.86 ,"$2,410.59 ","$1,382.11 ","$1,630.19 ","$1,630.19 ",$972.54 ,"$1,976.95 ","$2,066.57 ","$1,395.93 ",$313.08 ,"$2,516.55 ","$1,451.21 ",$313.08 ,"$2,304.63 ","$1,382.11 ","$2,384.10 ","$1,382.11 ","$2,384.10 ","$2,384.10 ","$2,384.10 ","$2,569.53 ","$2,145.69 ","$2,463.57 ","$2,278.14 ","$2,569.53 "
SACRED HEART HOSPITAL (ACU),34000077,78804,HC TUMOR/INF-WHOLE BODY-MULT DAY,340,1 ,"$1,228.00 ",$921.00 ,$313.08 ,"$3,109.74 ",$790.83 ,"$1,382.11 ",$859.60 ,$313.08 ,$903.25 ,$322.47 ,$722.60 ,"$1,166.60 ",$313.08 ,$982.40 ,"$1,129.76 ",$313.08 ,"$1,043.80 ","$1,166.60 ","$1,080.64 ",$933.28 ,$313.08 ,$313.08 ,$313.08 ,$896.44 ,$675.40 ,"$1,117.48 ","$1,117.48 ",$982.40 ,"$1,423.57 ",$675.40 ,"$1,105.20 ","$1,382.11 ","$1,105.20 ",$663.12 ,"$1,154.32 ","$3,109.74 ","$1,129.76 ",$331.86 ,"$1,117.48 ","$1,382.11 ",$755.71 ,$755.71 ,$369.56 ,$916.46 ,"$1,105.20 ","$1,395.93 ",$313.08 ,"$1,166.60 ","$1,451.21 ",$313.08 ,"$1,068.36 ","$1,382.11 ","$1,105.20 ","$1,382.11 ","$1,105.20 ","$1,105.20 ","$1,105.20 ","$1,191.16 ",$994.68 ,"$1,142.04 ","$1,056.08 ","$1,191.16 "
SACRED HEART HOSPITAL (ACU),34000081,79005,HC NM RADIOPAHARM THRPY ORAL,340,1 ,"$1,942.00 ","$1,456.50 ",$66.75 ,"$1,942.00 ","$1,250.65 ",$267.61 ,"$1,359.40 ",$101.42 ,$83.44 ,$104.46 ,$66.75 ,"$1,844.90 ",$101.42 ,"$1,553.60 ","$1,786.64 ",$101.42 ,"$1,650.70 ","$1,844.90 ","$1,708.96 ","$1,475.92 ",$101.42 ,$101.42 ,$101.42 ,"$1,417.66 ","$1,068.10 ","$1,767.22 ","$1,767.22 ","$1,553.60 ",$275.64 ,"$1,068.10 ","$1,747.80 ",$267.61 ,"$1,747.80 ","$1,048.68 ","$1,825.48 ",$602.13 ,"$1,786.64 ",$107.51 ,"$1,767.22 ",$267.61 ,"$1,195.11 ","$1,195.11 ",$216.61 ,"$1,449.31 ",$335.50 ,$270.29 ,$101.42 ,"$1,844.90 ",$281.00 ,$101.42 ,"$1,689.54 ",$267.61 ,"$1,747.80 ",$267.61 ,"$1,747.80 ","$1,747.80 ","$1,747.80 ","$1,883.74 ","$1,573.02 ","$1,806.06 ","$1,670.12 ","$1,883.74 "
SACRED HEART HOSPITAL (ACU),34000083,79101,HC NM RADIOPAHARM THRPY IV,340,1 ,$864.00 ,$648.00 ,$65.07 ,$864.00 ,$556.42 ,$267.61 ,$604.80 ,$101.42 ,$81.34 ,$104.46 ,$65.07 ,$820.80 ,$101.42 ,$691.20 ,$794.88 ,$101.42 ,$734.40 ,$820.80 ,$760.32 ,$656.64 ,$101.42 ,$101.42 ,$101.42 ,$630.72 ,$475.20 ,$786.24 ,$786.24 ,$691.20 ,$275.64 ,$475.20 ,$777.60 ,$267.61 ,$777.60 ,$466.56 ,$812.16 ,$602.13 ,$794.88 ,$107.51 ,$786.24 ,$267.61 ,$531.71 ,$531.71 ,$216.61 ,$644.80 ,$332.20 ,$270.29 ,$101.42 ,$820.80 ,$281.00 ,$101.42 ,$751.68 ,$267.61 ,$777.60 ,$267.61 ,$777.60 ,$777.60 ,$777.60 ,$838.08 ,$699.84 ,$803.52 ,$743.04 ,$838.08 
SACRED HEART HOSPITAL (ACU),34000090,78597,HC PULM PERF DIFF W/IMG,340,1 ,$971.00 ,$728.25 ,$234.39 ,$971.00 ,$625.32 ,$398.69 ,$679.70 ,$313.08 ,$292.99 ,$322.47 ,$234.39 ,$922.45 ,$313.08 ,$776.80 ,$893.32 ,$313.08 ,$825.35 ,$922.45 ,$854.48 ,$737.96 ,$313.08 ,$313.08 ,$313.08 ,$708.83 ,$534.05 ,$883.61 ,$883.61 ,$776.80 ,$410.65 ,$534.05 ,$873.90 ,$398.69 ,$873.90 ,$524.34 ,$912.74 ,$897.05 ,$893.32 ,$331.86 ,$883.61 ,$398.69 ,$597.55 ,$597.55 ,$326.51 ,$724.66 ,$873.90 ,$402.67 ,$313.08 ,$922.45 ,$418.62 ,$313.08 ,$844.77 ,$398.69 ,$873.90 ,$398.69 ,$873.90 ,$873.90 ,$873.90 ,$941.87 ,$786.51 ,$903.03 ,$835.06 ,$941.87 
SACRED HEART HOSPITAL (ACU),34000092,78227,HC NM HEPATOBILIARY DUCTS W/PHARM,340,1 ,$974.00 ,$730.50 ,$124.60 ,"$1,164.51 ",$627.26 ,$517.56 ,$681.80 ,$124.60 ,$710.54 ,$128.34 ,$568.43 ,$925.30 ,$124.60 ,$779.20 ,$896.08 ,$124.60 ,$827.90 ,$925.30 ,$857.12 ,$740.24 ,$124.60 ,$124.60 ,$124.60 ,$711.02 ,$535.70 ,$886.34 ,$886.34 ,$779.20 ,$533.09 ,$535.70 ,$876.60 ,$517.56 ,$876.60 ,$525.96 ,$915.56 ,"$1,164.51 ",$896.08 ,$132.08 ,$886.34 ,$517.56 ,$599.40 ,$599.40 ,$819.35 ,$726.90 ,$876.60 ,$522.74 ,$124.60 ,$925.30 ,$543.44 ,$124.60 ,$847.38 ,$517.56 ,$876.60 ,$517.56 ,$876.60 ,$876.60 ,$876.60 ,$944.78 ,$788.94 ,$905.82 ,$837.64 ,$944.78 
SACRED HEART HOSPITAL (ACU),34000093,78071,HC PARATHYROID IMG W/SPECT 78071,340,1 ,"$2,152.00 ","$1,614.00 ",$124.60 ,"$2,152.00 ","$1,385.89 ",$398.69 ,"$1,506.40 ",$124.60 ,$525.91 ,$128.34 ,$420.73 ,"$2,044.40 ",$124.60 ,"$1,721.60 ","$1,979.84 ",$124.60 ,"$1,829.20 ","$2,044.40 ","$1,893.76 ","$1,635.52 ",$124.60 ,$124.60 ,$124.60 ,"$1,570.96 ","$1,183.60 ","$1,958.32 ","$1,958.32 ","$1,721.60 ",$410.65 ,"$1,183.60 ","$1,936.80 ",$398.69 ,"$1,936.80 ","$1,162.08 ","$2,022.88 ",$897.05 ,"$1,979.84 ",$132.08 ,"$1,958.32 ",$398.69 ,"$1,324.34 ","$1,324.34 ",$614.00 ,"$1,606.04 ","$1,936.80 ",$402.67 ,$124.60 ,"$2,044.40 ",$418.62 ,$124.60 ,"$1,872.24 ",$398.69 ,"$1,936.80 ",$398.69 ,"$1,936.80 ","$1,936.80 ","$1,936.80 ","$2,087.44 ","$1,743.12 ","$2,001.36 ","$1,850.72 ","$2,087.44 "
SACRED HEART HOSPITAL (ACU),34000094,78072,HC PARATHYROID IMG W/SPECT AND CT 78072,340,1 ,"$2,152.00 ","$1,614.00 ",$124.60 ,"$2,152.00 ","$1,385.89 ",$517.56 ,"$1,506.40 ",$124.60 ,$591.36 ,$128.34 ,$473.09 ,"$2,044.40 ",$124.60 ,"$1,721.60 ","$1,979.84 ",$124.60 ,"$1,829.20 ","$2,044.40 ","$1,893.76 ","$1,635.52 ",$124.60 ,$124.60 ,$124.60 ,"$1,570.96 ","$1,183.60 ","$1,958.32 ","$1,958.32 ","$1,721.60 ",$533.09 ,"$1,183.60 ","$1,936.80 ",$517.56 ,"$1,936.80 ","$1,162.08 ","$2,022.88 ","$1,164.51 ","$1,979.84 ",$132.08 ,"$1,958.32 ",$517.56 ,"$1,324.34 ","$1,324.34 ",$157.44 ,"$1,606.04 ","$1,936.80 ",$522.74 ,$124.60 ,"$2,044.40 ",$543.44 ,$124.60 ,"$1,872.24 ",$517.56 ,"$1,936.80 ",$517.56 ,"$1,936.80 ","$1,936.80 ","$1,936.80 ","$2,087.44 ","$1,743.12 ","$2,001.36 ","$1,850.72 ","$2,087.44 "
SACRED HEART HOSPITAL (ACU),34100001,78015,HC NM THYROID CA METAST;LTD,341,1 ,$928.00 ,$696.00 ,$124.60 ,$928.00 ,$597.63 ,$398.69 ,$649.60 ,$124.60 ,$332.29 ,$128.34 ,$265.83 ,$881.60 ,$124.60 ,$742.40 ,$853.76 ,$124.60 ,$788.80 ,$881.60 ,$816.64 ,$705.28 ,$124.60 ,$124.60 ,$124.60 ,$677.44 ,$510.40 ,$844.48 ,$844.48 ,$742.40 ,$410.65 ,$510.40 ,$835.20 ,$398.69 ,$835.20 ,$501.12 ,$872.32 ,$897.05 ,$853.76 ,$132.08 ,$844.48 ,$398.69 ,$571.09 ,$571.09 ,$401.89 ,$692.57 ,$835.20 ,$402.67 ,$124.60 ,$881.60 ,$418.62 ,$124.60 ,$807.36 ,$398.69 ,$835.20 ,$398.69 ,$835.20 ,$835.20 ,$835.20 ,$900.16 ,$751.68 ,$863.04 ,$798.08 ,$900.16 
SACRED HEART HOSPITAL (ACU),34100007,A9538,HC NM PYROPHOSPHATE 99M VIAL,343,1 ,$376.00 ,$282.00 ,$203.04 ,$376.00 ,$242.14 , N/A ,$263.20 , N/A ,$312.08 , N/A ,$248.16 ,$357.20 , N/A ,$300.80 ,$345.92 , N/A ,$319.60 ,$357.20 ,$330.88 ,$285.76 , N/A , N/A , N/A ,$274.48 ,$206.80 ,$342.16 ,$342.16 ,$300.80 , N/A ,$206.80 ,$338.40 , N/A ,$338.40 ,$203.04 ,$353.44 , N/A ,$345.92 , N/A ,$342.16 , N/A ,$231.39 ,$231.39 ,$338.40 ,$280.61 ,$261.88 , N/A , N/A ,$357.20 , N/A , N/A ,$327.12 , N/A ,$338.40 , N/A ,$338.40 ,$338.40 ,$338.40 ,$364.72 ,$304.56 ,$349.68 ,$323.36 ,$364.72 
SACRED HEART HOSPITAL (ACU),34100010,78445,HC NM NON CARDIAC VASCULAR W/FLOW,341,1 ,$582.00 ,$436.50 ,$124.60 ,$897.05 ,$374.81 ,$398.69 ,$407.40 ,$124.60 ,$276.45 ,$128.34 ,$221.16 ,$552.90 ,$124.60 ,$465.60 ,$535.44 ,$124.60 ,$494.70 ,$552.90 ,$512.16 ,$442.32 ,$124.60 ,$124.60 ,$124.60 ,$424.86 ,$320.10 ,$529.62 ,$529.62 ,$465.60 ,$410.65 ,$320.10 ,$523.80 ,$398.69 ,$523.80 ,$314.28 ,$547.08 ,$897.05 ,$535.44 ,$132.08 ,$529.62 ,$398.69 ,$358.16 ,$358.16 ,$333.72 ,$434.35 ,$523.80 ,$402.67 ,$124.60 ,$552.90 ,$418.62 ,$124.60 ,$506.34 ,$398.69 ,$523.80 ,$398.69 ,$523.80 ,$523.80 ,$523.80 ,$564.54 ,$471.42 ,$541.26 ,$500.52 ,$564.54 
SACRED HEART HOSPITAL (ACU),34100017,A9567,HC NM TECH 99 DTPA VENT,341,1 ,$297.00 ,$222.75 ,$160.38 ,$297.00 ,$191.27 , N/A ,$207.90 , N/A ,$246.51 , N/A ,$196.02 ,$282.15 , N/A ,$237.60 ,$273.24 , N/A ,$252.45 ,$282.15 ,$261.36 ,$225.72 , N/A , N/A , N/A ,$216.81 ,$163.35 ,$270.27 ,$270.27 ,$237.60 , N/A ,$163.35 ,$267.30 , N/A ,$267.30 ,$160.38 ,$279.18 , N/A ,$273.24 , N/A ,$270.27 , N/A ,$182.77 ,$182.77 ,$267.30 ,$221.65 ,$206.86 , N/A , N/A ,$282.15 , N/A , N/A ,$258.39 , N/A ,$267.30 , N/A ,$267.30 ,$267.30 ,$267.30 ,$288.09 ,$240.57 ,$276.21 ,$255.42 ,$288.09 
SACRED HEART HOSPITAL (ACU),34100020,0042T,HC CT CEREBRAL PERFUSION W/BLOOD FLOW,351,1 ,"$1,276.51 ",$957.38 ,$102.60 ,"$1,276.51 ",$822.07 , N/A ,$893.56 ,$102.60 ,"$1,276.51 ",$105.68 ,"$1,276.51 ","$1,212.68 ",$102.60 ,"$1,021.21 ","$1,174.39 ",$102.60 ,"$1,085.03 ","$1,212.68 ","$1,123.33 ",$970.15 ,$102.60 ,$102.60 ,$102.60 ,$931.85 ,$702.08 ,"$1,161.62 ","$1,161.62 ","$1,021.21 ", N/A ,$702.08 ,"$1,148.86 ", N/A ,"$1,148.86 ",$689.32 ,"$1,199.92 ", N/A ,"$1,174.39 ",$108.76 ,"$1,161.62 ", N/A ,$785.56 ,$785.56 ,"$1,148.86 ",$952.66 ,"$1,148.86 ", N/A ,$102.60 ,"$1,212.68 ", N/A ,$102.60 ,"$1,110.56 ", N/A ,"$1,148.86 ", N/A ,"$1,148.86 ","$1,148.86 ","$1,148.86 ","$1,238.21 ","$1,033.97 ","$1,187.15 ","$1,097.80 ","$1,238.21 "
SACRED HEART HOSPITAL (ACU),34100025,78232,HC NM SALIVARY GLAND FUNCTION,341,1 ,$662.00 ,$496.50 ,$112.60 ,$897.05 ,$426.33 ,$398.69 ,$463.40 ,$124.60 ,$140.75 ,$128.34 ,$112.60 ,$628.90 ,$124.60 ,$529.60 ,$609.04 ,$124.60 ,$562.70 ,$628.90 ,$582.56 ,$503.12 ,$124.60 ,$124.60 ,$124.60 ,$483.26 ,$364.10 ,$602.42 ,$602.42 ,$529.60 ,$410.65 ,$364.10 ,$595.80 ,$398.69 ,$595.80 ,$357.48 ,$622.28 ,$897.05 ,$609.04 ,$132.08 ,$602.42 ,$398.69 ,$407.39 ,$407.39 ,$406.32 ,$494.05 ,$568.57 ,$402.67 ,$124.60 ,$628.90 ,$418.62 ,$124.60 ,$575.94 ,$398.69 ,$595.80 ,$398.69 ,$595.80 ,$595.80 ,$595.80 ,$642.14 ,$536.22 ,$615.66 ,$569.32 ,$642.14 
SACRED HEART HOSPITAL (ACU),34100026,78453,HC HT MUSCLE IMAGE PLANAR SINGLE,341,1 ,"$3,357.00 ","$2,517.75 ",$275.17 ,"$3,357.00 ","$2,161.91 ","$1,382.11 ","$2,349.90 ",$313.08 ,$446.65 ,$322.47 ,$357.32 ,"$3,189.15 ",$313.08 ,"$2,685.60 ","$3,088.44 ",$313.08 ,"$2,853.45 ","$3,189.15 ","$2,954.16 ","$2,551.32 ",$313.08 ,$313.08 ,$313.08 ,"$2,450.61 ","$1,846.35 ","$3,054.87 ","$3,054.87 ","$2,685.60 ","$1,423.57 ","$1,846.35 ","$3,021.30 ","$1,382.11 ","$3,021.30 ","$1,812.78 ","$3,155.58 ","$3,109.74 ","$3,088.44 ",$331.86 ,"$3,054.87 ","$1,382.11 ","$2,065.90 ","$2,065.90 ",$275.17 ,"$2,505.33 ","$1,810.18 ","$1,395.93 ",$313.08 ,"$3,189.15 ","$1,451.21 ",$313.08 ,"$2,920.59 ","$1,382.11 ","$3,021.30 ","$1,382.11 ","$3,021.30 ","$3,021.30 ","$3,021.30 ","$3,256.29 ","$2,719.17 ","$3,122.01 ","$2,887.02 ","$3,256.29 "
SACRED HEART HOSPITAL (ACU),34100033,78831,HC TUMOR LOCAL SPECT MULT AREA 1 DAY OR SGL AREA W/MULT DAYS,341,1 ,"$3,514.00 ","$2,635.50 ",$313.08 ,"$3,514.00 ","$2,263.02 ","$1,382.11 ","$2,459.80 ",$313.08 ,"$1,061.34 ",$322.47 ,$849.07 ,"$3,338.30 ",$313.08 ,"$2,811.20 ","$3,232.88 ",$313.08 ,"$2,986.90 ","$3,338.30 ","$3,092.32 ","$2,670.64 ",$313.08 ,$313.08 ,$313.08 ,"$2,565.22 ","$1,932.70 ","$3,197.74 ","$3,197.74 ","$2,811.20 ","$1,423.57 ","$1,932.70 ","$3,162.60 ","$1,382.11 ","$3,162.60 ","$1,897.56 ","$3,303.16 ","$3,109.74 ","$3,232.88 ",$331.86 ,"$3,197.74 ","$1,382.11 ","$2,162.52 ","$2,162.52 ","$3,162.60 ","$2,622.50 ","$3,162.60 ","$1,395.93 ",$313.08 ,"$3,338.30 ","$1,451.21 ",$313.08 ,"$3,057.18 ","$1,382.11 ","$3,162.60 ","$1,382.11 ","$3,162.60 ","$3,162.60 ","$3,162.60 ","$3,408.58 ","$2,846.34 ","$3,268.02 ","$3,022.04 ","$3,408.58 "
SACRED HEART HOSPITAL (ACU),34100034,78830,HC TUMOR IMAGING SPECT W/CT SGL AREA 1 DAY,341,1 ,"$2,818.00 ","$2,113.50 ",$313.08 ,"$3,109.74 ","$1,814.79 ","$1,382.11 ","$1,972.60 ",$313.08 ,$715.30 ,$322.47 ,$572.24 ,"$2,677.10 ",$313.08 ,"$2,254.40 ","$2,592.56 ",$313.08 ,"$2,395.30 ","$2,677.10 ","$2,479.84 ","$2,141.68 ",$313.08 ,$313.08 ,$313.08 ,"$2,057.14 ","$1,549.90 ","$2,564.38 ","$2,564.38 ","$2,254.40 ","$1,423.57 ","$1,549.90 ","$2,536.20 ","$1,382.11 ","$2,536.20 ","$1,521.72 ","$2,648.92 ","$3,109.74 ","$2,592.56 ",$331.86 ,"$2,564.38 ","$1,382.11 ","$1,734.20 ","$1,734.20 ","$2,536.20 ","$2,103.07 ","$2,536.20 ","$1,395.93 ",$313.08 ,"$2,677.10 ","$1,451.21 ",$313.08 ,"$2,451.66 ","$1,382.11 ","$2,536.20 ","$1,382.11 ","$2,536.20 ","$2,536.20 ","$2,536.20 ","$2,733.46 ","$2,282.58 ","$2,620.74 ","$2,423.48 ","$2,733.46 "
SACRED HEART HOSPITAL (ACU),34100035,78832,HC TUMOR LOCAL SPECT W/CT MULT AREA 1 DAY OR SGL AREA W/MULT DAYS,341,1 ,"$5,258.00 ","$3,943.50 ",$313.08 ,"$5,258.00 ","$3,386.15 ","$1,565.34 ","$3,680.60 ",$313.08 ,"$1,402.38 ",$322.47 ,"$1,121.90 ","$4,995.10 ",$313.08 ,"$4,206.40 ","$4,837.36 ",$313.08 ,"$4,469.30 ","$4,995.10 ","$4,627.04 ","$3,996.08 ",$313.08 ,$313.08 ,$313.08 ,"$3,838.34 ","$2,891.90 ","$4,784.78 ","$4,784.78 ","$4,206.40 ","$1,612.30 ","$2,891.90 ","$4,732.20 ","$1,565.34 ","$4,732.20 ","$2,839.32 ","$4,942.52 ","$3,522.02 ","$4,837.36 ",$331.86 ,"$4,784.78 ","$1,565.34 ","$3,235.77 ","$3,235.77 ","$4,732.20 ","$3,924.05 ","$4,732.20 ","$1,580.99 ",$313.08 ,"$4,995.10 ","$1,643.61 ",$313.08 ,"$4,574.46 ","$1,565.34 ","$4,732.20 ","$1,565.34 ","$4,732.20 ","$4,732.20 ","$4,732.20 ","$5,100.26 ","$4,258.98 ","$4,889.94 ","$4,521.88 ","$5,100.26 "
SACRED HEART HOSPITAL (ACU),34300002,A9500,HC DIAGNUCLIDE CARDIO UP TO 40MCI,343,1 ,"$1,251.00 ",$938.25 ,$675.54 ,"$1,251.00 ",$805.64 , N/A ,$875.70 , N/A ,"$1,038.33 ", N/A ,$825.66 ,"$1,188.45 ", N/A ,"$1,000.80 ","$1,150.92 ", N/A ,"$1,063.35 ","$1,188.45 ","$1,100.88 ",$950.76 , N/A , N/A , N/A ,$913.23 ,$688.05 ,"$1,138.41 ","$1,138.41 ","$1,000.80 ", N/A ,$688.05 ,"$1,125.90 ", N/A ,"$1,125.90 ",$675.54 ,"$1,175.94 ", N/A ,"$1,150.92 ", N/A ,"$1,138.41 ", N/A ,$769.87 ,$769.87 ,"$1,125.90 ",$933.62 ,$685.67 , N/A , N/A ,"$1,188.45 ", N/A , N/A ,"$1,088.37 ", N/A ,"$1,125.90 ", N/A ,"$1,125.90 ","$1,125.90 ","$1,125.90 ","$1,213.47 ","$1,013.31 ","$1,163.43 ","$1,075.86 ","$1,213.47 "
SACRED HEART HOSPITAL (ACU),34300004,A9503,HC DIAGNUCLIDE MDP UP TO 30MCI,343,1 ,$385.00 ,$288.75 ,$207.90 ,$385.00 ,$247.94 , N/A ,$269.50 , N/A ,$319.55 , N/A ,$254.10 ,$365.75 , N/A ,$308.00 ,$354.20 , N/A ,$327.25 ,$365.75 ,$338.80 ,$292.60 , N/A , N/A , N/A ,$281.05 ,$211.75 ,$350.35 ,$350.35 ,$308.00 , N/A ,$211.75 ,$346.50 , N/A ,$346.50 ,$207.90 ,$361.90 , N/A ,$354.20 , N/A ,$350.35 , N/A ,$236.93 ,$236.93 ,$346.50 ,$287.33 ,$211.16 , N/A , N/A ,$365.75 , N/A , N/A ,$334.95 , N/A ,$346.50 , N/A ,$346.50 ,$346.50 ,$346.50 ,$373.45 ,$311.85 ,$358.05 ,$331.10 ,$373.45 
SACRED HEART HOSPITAL (ACU),34300006,A9505,HC DIAGNUCLIDE THALL 201 PER MCI,343,1 ,$231.00 ,$173.25 ,$124.74 ,$231.00 ,$148.76 , N/A ,$161.70 , N/A ,$191.73 , N/A ,$152.46 ,$219.45 , N/A ,$184.80 ,$212.52 , N/A ,$196.35 ,$219.45 ,$203.28 ,$175.56 , N/A , N/A , N/A ,$168.63 ,$127.05 ,$210.21 ,$210.21 ,$184.80 , N/A ,$127.05 ,$207.90 , N/A ,$207.90 ,$124.74 ,$217.14 , N/A ,$212.52 , N/A ,$210.21 , N/A ,$142.16 ,$142.16 ,$207.90 ,$172.40 ,$160.89 , N/A , N/A ,$219.45 , N/A , N/A ,$200.97 , N/A ,$207.90 , N/A ,$207.90 ,$207.90 ,$207.90 ,$224.07 ,$187.11 ,$214.83 ,$198.66 ,$224.07 
SACRED HEART HOSPITAL (ACU),34300007,A9507,HC DIAGNUCLIDE PROSTASCINT,343,1 ,"$7,340.00 ","$5,505.00 ","$3,963.60 ","$7,340.00 ","$4,726.96 ", N/A ,"$5,138.00 ", N/A ,"$6,092.20 ", N/A ,"$4,844.40 ","$6,973.00 ", N/A ,"$5,872.00 ","$6,752.80 ", N/A ,"$6,239.00 ","$6,973.00 ","$6,459.20 ","$5,578.40 ", N/A , N/A , N/A ,"$5,358.20 ","$4,037.00 ","$6,679.40 ","$6,679.40 ","$5,872.00 ", N/A ,"$4,037.00 ","$6,606.00 ", N/A ,"$6,606.00 ","$3,963.60 ","$6,899.60 ", N/A ,"$6,752.80 ", N/A ,"$6,679.40 ", N/A ,"$4,517.04 ","$4,517.04 ","$6,606.00 ","$5,477.84 ","$5,112.31 ", N/A , N/A ,"$6,973.00 ", N/A , N/A ,"$6,385.80 ", N/A ,"$6,606.00 ", N/A ,"$6,606.00 ","$6,606.00 ","$6,606.00 ","$7,119.80 ","$5,945.40 ","$6,826.20 ","$6,312.40 ","$7,119.80 "
SACRED HEART HOSPITAL (ACU),34300008,A9508,HC DIAGNUCLIDE I131 PER .5 MCI,343,1 ,"$7,550.00 ","$5,662.50 ","$4,077.00 ","$7,550.00 ","$4,862.20 ", N/A ,"$5,285.00 ", N/A ,"$6,266.50 ", N/A ,"$4,983.00 ","$7,172.50 ", N/A ,"$6,040.00 ","$6,946.00 ", N/A ,"$6,417.50 ","$7,172.50 ","$6,644.00 ","$5,738.00 ", N/A , N/A , N/A ,"$5,511.50 ","$4,152.50 ","$6,870.50 ","$6,870.50 ","$6,040.00 ", N/A ,"$4,152.50 ","$6,795.00 ", N/A ,"$6,795.00 ","$4,077.00 ","$7,097.00 ", N/A ,"$6,946.00 ", N/A ,"$6,870.50 ", N/A ,"$4,646.27 ","$4,646.27 ","$6,795.00 ","$5,634.57 ","$5,258.58 ", N/A , N/A ,"$7,172.50 ", N/A , N/A ,"$6,568.50 ", N/A ,"$6,795.00 ", N/A ,"$6,795.00 ","$6,795.00 ","$6,795.00 ","$7,323.50 ","$6,115.50 ","$7,021.50 ","$6,493.00 ","$7,323.50 "
SACRED HEART HOSPITAL (ACU),34300009,A9512,HC TECHNETIUM TC99 PERTECH PER MCI,343,1 ,$33.00 ,$24.75 ,$17.82 ,$33.00 ,$21.25 , N/A ,$23.10 , N/A ,$27.39 , N/A ,$21.78 ,$31.35 , N/A ,$26.40 ,$30.36 , N/A ,$28.05 ,$31.35 ,$29.04 ,$25.08 , N/A , N/A , N/A ,$24.09 ,$18.15 ,$30.03 ,$30.03 ,$26.40 , N/A ,$18.15 ,$29.70 , N/A ,$29.70 ,$17.82 ,$31.02 , N/A ,$30.36 , N/A ,$30.03 , N/A ,$20.31 ,$20.31 ,$29.70 ,$24.63 ,$22.98 , N/A , N/A ,$31.35 , N/A , N/A ,$28.71 , N/A ,$29.70 , N/A ,$29.70 ,$29.70 ,$29.70 ,$32.01 ,$26.73 ,$30.69 ,$28.38 ,$32.01 
SACRED HEART HOSPITAL (ACU),34300010,A9516,HC DIAGNUCLIDE I123 CAPS 100 MICR,343,1 ,$109.00 ,$81.75 ,$58.86 ,$109.00 ,$70.20 , N/A ,$76.30 , N/A ,$90.47 , N/A ,$71.94 ,$103.55 , N/A ,$87.20 ,$100.28 , N/A ,$92.65 ,$103.55 ,$95.92 ,$82.84 , N/A , N/A , N/A ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 , N/A ,$59.95 ,$98.10 , N/A ,$98.10 ,$58.86 ,$102.46 , N/A ,$100.28 , N/A ,$99.19 , N/A ,$67.08 ,$67.08 ,$98.10 ,$81.35 ,$98.10 , N/A , N/A ,$103.55 , N/A , N/A ,$94.83 , N/A ,$98.10 , N/A ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),34300011,A9517,HC DIAGNUCLIDE I131 CAPS PER MCI,343,1 ,$22.00 ,$16.50 ,$11.88 ,$155.94 ,$14.17 ,$20.12 ,$15.40 ,$22.00 ,$18.26 ,$151.52 ,$14.52 ,$20.90 ,$147.11 ,$17.60 ,$20.24 ,$22.00 ,$18.70 ,$20.90 ,$19.36 ,$16.72 ,$22.00 ,$22.00 ,$147.11 ,$16.06 ,$12.10 ,$20.02 ,$20.02 ,$17.60 ,$20.72 ,$12.10 ,$19.80 ,$20.12 ,$19.80 ,$11.88 ,$20.68 ,$45.27 ,$20.24 ,$155.94 ,$20.02 ,$20.12 ,$13.54 ,$13.54 ,$19.80 ,$16.42 ,$15.32 ,$20.32 ,$22.00 ,$20.90 ,$21.13 ,$22.00 ,$19.14 ,$20.12 ,$19.80 ,$20.12 ,$19.80 ,$19.80 ,$19.80 ,$21.34 ,$17.82 ,$20.46 ,$18.92 ,$21.34 
SACRED HEART HOSPITAL (ACU),34300012,A9521,HC DIAGNUCLIDE CERETEC,343,1 ,"$1,317.00 ",$987.75 ,$711.18 ,"$1,317.00 ",$848.15 , N/A ,$921.90 , N/A ,"$1,093.11 ", N/A ,$869.22 ,"$1,251.15 ", N/A ,"$1,053.60 ","$1,211.64 ", N/A ,"$1,119.45 ","$1,251.15 ","$1,158.96 ","$1,000.92 ", N/A , N/A , N/A ,$961.41 ,$724.35 ,"$1,198.47 ","$1,198.47 ","$1,053.60 ", N/A ,$724.35 ,"$1,185.30 ", N/A ,"$1,185.30 ",$711.18 ,"$1,237.98 ", N/A ,"$1,211.64 ", N/A ,"$1,198.47 ", N/A ,$810.48 ,$810.48 ,"$1,185.30 ",$982.88 ,$917.29 , N/A , N/A ,"$1,251.15 ", N/A , N/A ,"$1,145.79 ", N/A ,"$1,185.30 ", N/A ,"$1,185.30 ","$1,185.30 ","$1,185.30 ","$1,277.49 ","$1,066.77 ","$1,224.81 ","$1,132.62 ","$1,277.49 "
SACRED HEART HOSPITAL (ACU),34300014,A9528,HC DIAGNUCLIDE I131 NECK/CHST,343,1 ,$142.00 ,$106.50 ,$76.68 ,$142.00 ,$91.45 , N/A ,$99.40 , N/A ,$117.86 , N/A ,$93.72 ,$134.90 , N/A ,$113.60 ,$130.64 , N/A ,$120.70 ,$134.90 ,$124.96 ,$107.92 , N/A , N/A , N/A ,$103.66 ,$78.10 ,$129.22 ,$129.22 ,$113.60 , N/A ,$78.10 ,$127.80 , N/A ,$127.80 ,$76.68 ,$133.48 , N/A ,$130.64 , N/A ,$129.22 , N/A ,$87.39 ,$87.39 ,$127.80 ,$105.97 ,$98.90 , N/A , N/A ,$134.90 , N/A , N/A ,$123.54 , N/A ,$127.80 , N/A ,$127.80 ,$127.80 ,$127.80 ,$137.74 ,$115.02 ,$132.06 ,$122.12 ,$137.74 
SACRED HEART HOSPITAL (ACU),34300016,A9537,HC DIAGNUCLIDE CHOLETEC HEPAT PER DOSE,343,1 ,$436.00 ,$327.00 ,$235.44 ,$436.00 ,$280.78 , N/A ,$305.20 , N/A ,$361.88 , N/A ,$287.76 ,$414.20 , N/A ,$348.80 ,$401.12 , N/A ,$370.60 ,$414.20 ,$383.68 ,$331.36 , N/A , N/A , N/A ,$318.28 ,$239.80 ,$396.76 ,$396.76 ,$348.80 , N/A ,$239.80 ,$392.40 , N/A ,$392.40 ,$235.44 ,$409.84 , N/A ,$401.12 , N/A ,$396.76 , N/A ,$268.31 ,$268.31 ,$392.40 ,$325.39 ,$238.79 , N/A , N/A ,$414.20 , N/A , N/A ,$379.32 , N/A ,$392.40 , N/A ,$392.40 ,$392.40 ,$392.40 ,$422.92 ,$353.16 ,$405.48 ,$374.96 ,$422.92 
SACRED HEART HOSPITAL (ACU),34300017,A9539,HC DIAGNUCLIDE DTPA KIDNEY PER DOSE,343,1 ,$223.00 ,$167.25 ,$120.42 ,$223.00 ,$143.61 , N/A ,$156.10 , N/A ,$185.09 , N/A ,$147.18 ,$211.85 , N/A ,$178.40 ,$205.16 , N/A ,$189.55 ,$211.85 ,$196.24 ,$169.48 , N/A , N/A , N/A ,$162.79 ,$122.65 ,$202.93 ,$202.93 ,$178.40 , N/A ,$122.65 ,$200.70 , N/A ,$200.70 ,$120.42 ,$209.62 , N/A ,$205.16 , N/A ,$202.93 , N/A ,$137.23 ,$137.23 ,$200.70 ,$166.42 ,$155.32 , N/A , N/A ,$211.85 , N/A , N/A ,$194.01 , N/A ,$200.70 , N/A ,$200.70 ,$200.70 ,$200.70 ,$216.31 ,$180.63 ,$207.39 ,$191.78 ,$216.31 
SACRED HEART HOSPITAL (ACU),34300019,A9540,HC DIAGNUCLIDE MAA LUNG SCAN PER DOSE<10MCI,343,1 ,$342.00 ,$256.50 ,$184.68 ,$342.00 ,$220.25 , N/A ,$239.40 , N/A ,$283.86 , N/A ,$225.72 ,$324.90 , N/A ,$273.60 ,$314.64 , N/A ,$290.70 ,$324.90 ,$300.96 ,$259.92 , N/A , N/A , N/A ,$249.66 ,$188.10 ,$311.22 ,$311.22 ,$273.60 , N/A ,$188.10 ,$307.80 , N/A ,$307.80 ,$184.68 ,$321.48 , N/A ,$314.64 , N/A ,$311.22 , N/A ,$210.47 ,$210.47 ,$307.80 ,$255.23 ,$238.20 , N/A , N/A ,$324.90 , N/A , N/A ,$297.54 , N/A ,$307.80 , N/A ,$307.80 ,$307.80 ,$307.80 ,$331.74 ,$277.02 ,$318.06 ,$294.12 ,$331.74 
SACRED HEART HOSPITAL (ACU),34300020,A9541,HC DIAGNUCLIDE SULFUR COLLOID UP TO 20MCI,343,1 ,$165.00 ,$123.75 ,$89.10 ,$165.00 ,$106.26 , N/A ,$115.50 , N/A ,$136.95 , N/A ,$108.90 ,$156.75 , N/A ,$132.00 ,$151.80 , N/A ,$140.25 ,$156.75 ,$145.20 ,$125.40 , N/A , N/A , N/A ,$120.45 ,$90.75 ,$150.15 ,$150.15 ,$132.00 , N/A ,$90.75 ,$148.50 , N/A ,$148.50 ,$89.10 ,$155.10 , N/A ,$151.80 , N/A ,$150.15 , N/A ,$101.54 ,$101.54 ,$148.50 ,$123.14 ,$90.45 , N/A , N/A ,$156.75 , N/A , N/A ,$143.55 , N/A ,$148.50 , N/A ,$148.50 ,$148.50 ,$148.50 ,$160.05 ,$133.65 ,$153.45 ,$141.90 ,$160.05 
SACRED HEART HOSPITAL (ACU),34300022,A9543,HC Y90 ZEVALIN THERAPEUTIC 40 MCI,343,1 ,"$4,072.00 ","$3,054.00 ","$2,198.88 ","$134,536.16 ","$2,622.37 ","$59,793.85 ","$2,850.40 ","$4,072.00 ","$3,379.76 ","$13,316.64 ","$2,687.52 ","$3,868.40 ","$12,928.78 ","$3,257.60 ","$3,746.24 ","$4,072.00 ","$3,461.20 ","$3,868.40 ","$3,583.36 ","$3,094.72 ","$4,072.00 ","$4,072.00 ","$12,928.78 ","$2,972.56 ","$2,239.60 ","$3,705.52 ","$3,705.52 ","$3,257.60 ","$61,587.67 ","$2,239.60 ","$3,664.80 ","$59,793.85 ","$3,664.80 ","$2,198.88 ","$3,827.68 ","$134,536.16 ","$3,746.24 ","$13,704.51 ","$3,705.52 ","$59,793.85 ","$2,505.91 ","$2,505.91 ","$3,664.80 ","$3,038.93 ","$2,836.15 ","$60,391.79 ","$4,072.00 ","$3,868.40 ","$62,783.54 ","$4,072.00 ","$3,542.64 ","$59,793.85 ","$3,664.80 ","$59,793.85 ","$3,664.80 ","$3,664.80 ","$3,664.80 ","$3,949.84 ","$3,298.32 ","$3,786.96 ","$3,501.92 ","$3,949.84 "
SACRED HEART HOSPITAL (ACU),34300023,N/A,HC NON HODGKINS LYMPH SCAN 1ST,272,1 ,"$2,868.00 ","$2,151.00 ","$1,548.72 ","$2,868.00 ","$1,846.99 ", N/A ,"$2,007.60 ", N/A ,"$2,380.44 ", N/A ,"$1,892.88 ","$2,724.60 ", N/A ,"$2,294.40 ","$2,638.56 ", N/A ,"$2,437.80 ","$2,724.60 ","$2,523.84 ","$2,179.68 ", N/A , N/A , N/A ,"$2,093.64 ","$1,577.40 ","$2,609.88 ","$2,609.88 ","$2,294.40 ", N/A ,"$1,577.40 ","$2,581.20 ", N/A ,"$2,581.20 ","$1,548.72 ","$2,695.92 ", N/A ,"$2,638.56 ", N/A ,"$2,609.88 ", N/A ,"$1,764.97 ","$1,764.97 ","$2,581.20 ","$2,140.39 ","$1,997.56 ", N/A , N/A ,"$2,724.60 ", N/A , N/A ,"$2,495.16 ", N/A ,"$2,581.20 ", N/A ,"$2,581.20 ","$2,581.20 ","$2,581.20 ","$2,781.96 ","$2,323.08 ","$2,667.24 ","$2,466.48 ","$2,781.96 "
SACRED HEART HOSPITAL (ACU),34300024,A9547,HC DIAGNUCLIDE IN OXINE .5 MCI,343,1 ,"$1,353.00 ","$1,014.75 ",$730.62 ,"$1,353.00 ",$871.33 , N/A ,$947.10 , N/A ,"$1,122.99 ", N/A ,$892.98 ,"$1,285.35 ", N/A ,"$1,082.40 ","$1,244.76 ", N/A ,"$1,150.05 ","$1,285.35 ","$1,190.64 ","$1,028.28 ", N/A , N/A , N/A ,$987.69 ,$744.15 ,"$1,231.23 ","$1,231.23 ","$1,082.40 ", N/A ,$744.15 ,"$1,217.70 ", N/A ,"$1,217.70 ",$730.62 ,"$1,271.82 ", N/A ,"$1,244.76 ", N/A ,"$1,231.23 ", N/A ,$832.64 ,$832.64 ,"$1,217.70 ","$1,009.74 ",$942.36 , N/A , N/A ,"$1,285.35 ", N/A , N/A ,"$1,177.11 ", N/A ,"$1,217.70 ", N/A ,"$1,217.70 ","$1,217.70 ","$1,217.70 ","$1,312.41 ","$1,095.93 ","$1,258.29 ","$1,163.58 ","$1,312.41 "
SACRED HEART HOSPITAL (ACU),34300026,A9548,HC DIAGNUCLIDE IN-111 DTPA,343,1 ,"$1,091.00 ",$818.25 ,$589.14 ,"$1,091.00 ",$702.60 , N/A ,$763.70 , N/A ,$905.53 , N/A ,$720.06 ,"$1,036.45 ", N/A ,$872.80 ,"$1,003.72 ", N/A ,$927.35 ,"$1,036.45 ",$960.08 ,$829.16 , N/A , N/A , N/A ,$796.43 ,$600.05 ,$992.81 ,$992.81 ,$872.80 , N/A ,$600.05 ,$981.90 , N/A ,$981.90 ,$589.14 ,"$1,025.54 ", N/A ,"$1,003.72 ", N/A ,$992.81 , N/A ,$671.40 ,$671.40 ,$981.90 ,$814.21 ,$759.88 , N/A , N/A ,"$1,036.45 ", N/A , N/A ,$949.17 , N/A ,$981.90 , N/A ,$981.90 ,$981.90 ,$981.90 ,"$1,058.27 ",$883.71 ,"$1,014.63 ",$938.26 ,"$1,058.27 "
SACRED HEART HOSPITAL (ACU),34300028,A9551,HC DIAGNUCLIDE DMSA,343,1 ,$541.00 ,$405.75 ,$292.14 ,$541.00 ,$348.40 , N/A ,$378.70 , N/A ,$449.03 , N/A ,$357.06 ,$513.95 , N/A ,$432.80 ,$497.72 , N/A ,$459.85 ,$513.95 ,$476.08 ,$411.16 , N/A , N/A , N/A ,$394.93 ,$297.55 ,$492.31 ,$492.31 ,$432.80 , N/A ,$297.55 ,$486.90 , N/A ,$486.90 ,$292.14 ,$508.54 , N/A ,$497.72 , N/A ,$492.31 , N/A ,$332.93 ,$332.93 ,$486.90 ,$403.75 ,$376.81 , N/A , N/A ,$513.95 , N/A , N/A ,$470.67 , N/A ,$486.90 , N/A ,$486.90 ,$486.90 ,$486.90 ,$524.77 ,$438.21 ,$503.13 ,$465.26 ,$524.77 
SACRED HEART HOSPITAL (ACU),34300029,A9552,HC DIAGNUCLIDE 18FDG,343,1 ,"$2,852.00 ","$2,139.00 ","$1,540.08 ","$2,852.00 ","$1,836.69 ", N/A ,"$1,996.40 ", N/A ,"$2,367.16 ", N/A ,"$1,882.32 ","$2,709.40 ", N/A ,"$2,281.60 ","$2,623.84 ", N/A ,"$2,424.20 ","$2,709.40 ","$2,509.76 ","$2,167.52 ", N/A , N/A , N/A ,"$2,081.96 ","$1,568.60 ","$2,595.32 ","$2,595.32 ","$2,281.60 ", N/A ,"$1,568.60 ","$2,566.80 ", N/A ,"$2,566.80 ","$1,540.08 ","$2,680.88 ", N/A ,"$2,623.84 ", N/A ,"$2,595.32 ", N/A ,"$1,755.12 ","$1,755.12 ","$2,566.80 ","$2,128.45 ","$2,166.70 ", N/A , N/A ,"$2,709.40 ", N/A , N/A ,"$2,481.24 ", N/A ,"$2,566.80 ", N/A ,"$2,566.80 ","$2,566.80 ","$2,566.80 ","$2,766.44 ","$2,310.12 ","$2,652.36 ","$2,452.72 ","$2,766.44 "
SACRED HEART HOSPITAL (ACU),34300031,A9556,HC DIAGNUCLIDE GA67 PER MCI,343,1 ,$240.00 ,$180.00 ,$129.60 ,$240.00 ,$154.56 , N/A ,$168.00 , N/A ,$199.20 , N/A ,$158.40 ,$228.00 , N/A ,$192.00 ,$220.80 , N/A ,$204.00 ,$228.00 ,$211.20 ,$182.40 , N/A , N/A , N/A ,$175.20 ,$132.00 ,$218.40 ,$218.40 ,$192.00 , N/A ,$132.00 ,$216.00 , N/A ,$216.00 ,$129.60 ,$225.60 , N/A ,$220.80 , N/A ,$218.40 , N/A ,$147.70 ,$147.70 ,$216.00 ,$179.11 ,$167.16 , N/A , N/A ,$228.00 , N/A , N/A ,$208.80 , N/A ,$216.00 , N/A ,$216.00 ,$216.00 ,$216.00 ,$232.80 ,$194.40 ,$223.20 ,$206.40 ,$232.80 
SACRED HEART HOSPITAL (ACU),34300035,A9560,HC TC99M GI BLD MUGA UP TO 30MCI,343,1 ,$242.00 ,$181.50 ,$130.68 ,$242.00 ,$155.85 , N/A ,$169.40 , N/A ,$200.86 , N/A ,$159.72 ,$229.90 , N/A ,$193.60 ,$222.64 , N/A ,$205.70 ,$229.90 ,$212.96 ,$183.92 , N/A , N/A , N/A ,$176.66 ,$133.10 ,$220.22 ,$220.22 ,$193.60 , N/A ,$133.10 ,$217.80 , N/A ,$217.80 ,$130.68 ,$227.48 , N/A ,$222.64 , N/A ,$220.22 , N/A ,$148.93 ,$148.93 ,$217.80 ,$180.60 ,$168.55 , N/A , N/A ,$229.90 , N/A , N/A ,$210.54 , N/A ,$217.80 , N/A ,$217.80 ,$217.80 ,$217.80 ,$234.74 ,$196.02 ,$225.06 ,$208.12 ,$234.74 
SACRED HEART HOSPITAL (ACU),34300036,A9560,HC RBC TAG KIT WITH TC99,343,1 ,$769.00 ,$576.75 ,$415.26 ,$769.00 ,$495.24 , N/A ,$538.30 , N/A ,$638.27 , N/A ,$507.54 ,$730.55 , N/A ,$615.20 ,$707.48 , N/A ,$653.65 ,$730.55 ,$676.72 ,$584.44 , N/A , N/A , N/A ,$561.37 ,$422.95 ,$699.79 ,$699.79 ,$615.20 , N/A ,$422.95 ,$692.10 , N/A ,$692.10 ,$415.26 ,$722.86 , N/A ,$707.48 , N/A ,$699.79 , N/A ,$473.24 ,$473.24 ,$692.10 ,$573.90 ,$535.61 , N/A , N/A ,$730.55 , N/A , N/A ,$669.03 , N/A ,$692.10 , N/A ,$692.10 ,$692.10 ,$692.10 ,$745.93 ,$622.89 ,$715.17 ,$661.34 ,$745.93 
SACRED HEART HOSPITAL (ACU),34300037,A9562,HC DIAG NUCLDE MAG 3 PER DOSE,343,1 ,$960.00 ,$720.00 ,$518.40 ,$960.00 ,$618.24 , N/A ,$672.00 , N/A ,$796.80 , N/A ,$633.60 ,$912.00 , N/A ,$768.00 ,$883.20 , N/A ,$816.00 ,$912.00 ,$844.80 ,$729.60 , N/A , N/A , N/A ,$700.80 ,$528.00 ,$873.60 ,$873.60 ,$768.00 , N/A ,$528.00 ,$864.00 , N/A ,$864.00 ,$518.40 ,$902.40 , N/A ,$883.20 , N/A ,$873.60 , N/A ,$590.78 ,$590.78 ,$864.00 ,$716.45 ,$668.64 , N/A , N/A ,$912.00 , N/A , N/A ,$835.20 , N/A ,$864.00 , N/A ,$864.00 ,$864.00 ,$864.00 ,$931.20 ,$777.60 ,$892.80 ,$825.60 ,$931.20 
SACRED HEART HOSPITAL (ACU),34300038,A9572,HC DIAGNUCLIDE OCTREOTIDE PER DOSE UP TO 6MCI,343,1 ,"$3,172.00 ","$2,379.00 ","$1,712.88 ","$3,172.00 ","$2,042.77 ", N/A ,"$2,220.40 ", N/A ,"$2,632.76 ", N/A ,"$2,093.52 ","$3,013.40 ", N/A ,"$2,537.60 ","$2,918.24 ", N/A ,"$2,696.20 ","$3,013.40 ","$2,791.36 ","$2,410.72 ", N/A , N/A , N/A ,"$2,315.56 ","$1,744.60 ","$2,886.52 ","$2,886.52 ","$2,537.60 ", N/A ,"$1,744.60 ","$2,854.80 ", N/A ,"$2,854.80 ","$1,712.88 ","$2,981.68 ", N/A ,"$2,918.24 ", N/A ,"$2,886.52 ", N/A ,"$1,952.05 ","$1,952.05 ","$2,854.80 ","$2,367.26 ","$2,209.30 ", N/A , N/A ,"$3,013.40 ", N/A , N/A ,"$2,759.64 ", N/A ,"$2,854.80 ", N/A ,"$2,854.80 ","$2,854.80 ","$2,854.80 ","$3,076.84 ","$2,569.32 ","$2,949.96 ","$2,727.92 ","$3,076.84 "
SACRED HEART HOSPITAL (ACU),34300040,A9604,HC THER ISOTOP SAMARIUM 153 UP TO 150MCI,343,1 ,"$4,291.00 ","$3,218.25 ","$2,317.14 ","$38,834.67 ","$2,763.40 ","$17,259.85 ","$3,003.70 ","$4,291.00 ","$3,561.53 ","$4,427.01 ","$2,832.06 ","$4,076.45 ","$4,298.07 ","$3,432.80 ","$3,947.72 ","$4,291.00 ","$3,647.35 ","$4,076.45 ","$3,776.08 ","$3,261.16 ","$4,291.00 ","$4,291.00 ","$4,298.07 ","$3,132.43 ","$2,360.05 ","$3,904.81 ","$3,904.81 ","$3,432.80 ","$17,777.65 ","$2,360.05 ","$3,861.90 ","$17,259.85 ","$3,861.90 ","$2,317.14 ","$4,033.54 ","$38,834.67 ","$3,947.72 ","$4,555.95 ","$3,904.81 ","$17,259.85 ","$2,640.68 ","$2,640.68 ","$3,861.90 ","$3,202.37 ","$2,988.68 ","$17,432.45 ","$4,291.00 ","$4,076.45 ","$18,122.85 ","$4,291.00 ","$3,733.17 ","$17,259.85 ","$3,861.90 ","$17,259.85 ","$3,861.90 ","$3,861.90 ","$3,861.90 ","$4,162.27 ","$3,475.71 ","$3,990.63 ","$3,690.26 ","$4,162.27 "
SACRED HEART HOSPITAL (ACU),34300041,J2805,HC DIAGNUCLIDE CCK,636,1 ,$109.00 ,$81.75 ,$27.18 ,$109.00 ,$70.20 , N/A ,$76.30 ,$27.18 ,$109.00 ,$28.00 ,$109.00 ,$103.55 ,$27.18 ,$87.20 ,$100.28 ,$27.18 ,$92.65 ,$103.55 ,$95.92 ,$82.84 ,$27.18 ,$27.18 ,$27.18 ,$79.57 ,$59.95 ,$99.19 ,$99.19 ,$87.20 , N/A ,$59.95 ,$98.10 , N/A ,$98.10 ,$58.86 ,$102.46 , N/A ,$100.28 ,$28.81 ,$99.19 , N/A ,$67.08 ,$67.08 ,$98.10 ,$81.35 ,$98.10 , N/A ,$27.18 ,$103.55 , N/A ,$27.18 ,$94.83 , N/A ,$98.10 , N/A ,$98.10 ,$98.10 ,$98.10 ,$105.73 ,$88.29 ,$101.37 ,$93.74 ,$105.73 
SACRED HEART HOSPITAL (ACU),34300049,A9509,HC DIAGNUCLIDE I123 CAP PER MILLICURIE,343,1 ,"$1,406.00 ","$1,054.50 ",$759.24 ,"$1,406.00 ",$905.46 , N/A ,$984.20 , N/A ,"$1,166.98 ", N/A ,$927.96 ,"$1,335.70 ", N/A ,"$1,124.80 ","$1,293.52 ", N/A ,"$1,195.10 ","$1,335.70 ","$1,237.28 ","$1,068.56 ", N/A , N/A , N/A ,"$1,026.38 ",$773.30 ,"$1,279.46 ","$1,279.46 ","$1,124.80 ", N/A ,$773.30 ,"$1,265.40 ", N/A ,"$1,265.40 ",$759.24 ,"$1,321.64 ", N/A ,"$1,293.52 ", N/A ,"$1,279.46 ", N/A ,$865.25 ,$865.25 ,"$1,265.40 ","$1,049.30 ",$979.28 , N/A , N/A ,"$1,335.70 ", N/A , N/A ,"$1,223.22 ", N/A ,"$1,265.40 ", N/A ,"$1,265.40 ","$1,265.40 ","$1,265.40 ","$1,363.82 ","$1,138.86 ","$1,307.58 ","$1,209.16 ","$1,363.82 "
SACRED HEART HOSPITAL (ACU),34300050,A9510,HC DIAGNUCLIDE TECHN TC-99 PER STUDY DOSE/15 MCI,343,1 ,$429.00 ,$321.75 ,$231.66 ,$429.00 ,$276.28 , N/A ,$300.30 , N/A ,$356.07 , N/A ,$283.14 ,$407.55 , N/A ,$343.20 ,$394.68 , N/A ,$364.65 ,$407.55 ,$377.52 ,$326.04 , N/A , N/A , N/A ,$313.17 ,$235.95 ,$390.39 ,$390.39 ,$343.20 , N/A ,$235.95 ,$386.10 , N/A ,$386.10 ,$231.66 ,$403.26 , N/A ,$394.68 , N/A ,$390.39 , N/A ,$264.01 ,$264.01 ,$386.10 ,$320.16 ,$298.80 , N/A , N/A ,$407.55 , N/A , N/A ,$373.23 , N/A ,$386.10 , N/A ,$386.10 ,$386.10 ,$386.10 ,$416.13 ,$347.49 ,$398.97 ,$368.94 ,$416.13 
SACRED HEART HOSPITAL (ACU),34300052,A9539,HC DIAGNUCLIDE DTPA AEROSOL,343,1 ,$223.00 ,$167.25 ,$120.42 ,$223.00 ,$143.61 , N/A ,$156.10 , N/A ,$185.09 , N/A ,$147.18 ,$211.85 , N/A ,$178.40 ,$205.16 , N/A ,$189.55 ,$211.85 ,$196.24 ,$169.48 , N/A , N/A , N/A ,$162.79 ,$122.65 ,$202.93 ,$202.93 ,$178.40 , N/A ,$122.65 ,$200.70 , N/A ,$200.70 ,$120.42 ,$209.62 , N/A ,$205.16 , N/A ,$202.93 , N/A ,$137.23 ,$137.23 ,$200.70 ,$166.42 ,$155.32 , N/A , N/A ,$211.85 , N/A , N/A ,$194.01 , N/A ,$200.70 , N/A ,$200.70 ,$200.70 ,$200.70 ,$216.31 ,$180.63 ,$207.39 ,$191.78 ,$216.31 
SACRED HEART HOSPITAL (ACU),34300053,A9606,HC NUCLIDE XOFIGO PER MICROCURIE,636,1 ,$218.00 ,$163.50 ,$117.72 ,"$4,555.95 ",$140.39 ,$148.93 ,$152.60 ,$218.00 , N/A ,"$4,427.01 ", N/A ,$207.10 ,"$4,298.07 ",$174.40 ,$200.56 ,$218.00 ,$185.30 ,$207.10 ,$191.84 ,$165.68 ,$218.00 ,$218.00 ,"$4,298.07 ",$159.14 ,$119.90 ,$198.38 ,$198.38 ,$174.40 ,$153.40 ,$119.90 ,$196.20 ,$148.93 ,$196.20 ,$117.72 ,$204.92 ,$335.08 ,$200.56 ,"$4,555.95 ",$198.38 ,$148.93 ,$134.16 ,$134.16 ,$196.20 ,$162.69 , N/A ,$150.41 ,$218.00 ,$207.10 ,$156.37 ,$218.00 ,$189.66 ,$148.93 ,$196.20 ,$148.93 ,$196.20 ,$196.20 ,$196.20 ,$211.46 ,$176.58 ,$202.74 ,$187.48 ,$211.46 
SACRED HEART HOSPITAL (ACU),34300071,A9592,HC COPPER CU-64 DOTATATE DIAGNOSTIC 1 MILLICURIE,343,1 ,"$2,850.00 ","$2,137.50 ",$918.52 ,"$2,850.00 ","$1,835.40 ",$918.52 ,"$1,995.00 ", N/A ,"$2,365.50 ", N/A ,"$1,881.00 ","$2,707.50 ", N/A ,"$2,280.00 ","$2,622.00 ", N/A ,"$2,422.50 ","$2,707.50 ","$2,508.00 ","$2,166.00 ", N/A , N/A , N/A ,"$2,080.50 ","$1,567.50 ","$2,593.50 ","$2,593.50 ","$2,280.00 ",$946.08 ,"$1,567.50 ","$2,565.00 ",$918.52 ,"$2,565.00 ","$1,539.00 ","$2,679.00 ","$2,066.68 ","$2,622.00 ", N/A ,"$2,593.50 ",$918.52 ,"$1,753.89 ","$1,753.89 ","$2,565.00 ","$2,126.96 ","$1,985.03 ",$927.71 , N/A ,"$2,707.50 ",$964.45 , N/A ,"$2,479.50 ",$918.52 ,"$2,565.00 ",$918.52 ,"$2,565.00 ","$2,565.00 ","$2,565.00 ","$2,764.50 ","$2,308.50 ","$2,650.50 ","$2,451.00 ","$2,764.50 "
SACRED HEART HOSPITAL (ACU),35000005,21501,HC I AND D ABSC NECK/THORAX,350,1 ,"$2,061.00 ","$1,545.75 ",$728.22 ,"$5,642.34 ","$1,327.28 ","$2,507.71 ","$1,442.70 ",$728.22 ,"$2,061.00 ",$750.07 ,"$1,929.00 ","$1,957.95 ",$728.22 ,"$1,648.80 ","$1,896.12 ",$728.22 ,"$1,751.85 ","$1,957.95 ","$1,813.68 ","$1,566.36 ",$728.22 ,$728.22 ,$728.22 ,"$1,504.53 ","$1,133.55 ","$1,875.51 ","$1,875.51 ","$1,648.80 ","$2,582.94 ","$1,133.55 ","$1,854.90 ","$2,507.71 ","$1,854.90 ","$1,112.94 ","$1,937.34 ","$5,642.34 ","$1,896.12 ",$771.91 ,"$1,875.51 ","$2,507.71 ","$1,268.34 ","$1,268.34 ","$1,854.90 ","$1,538.12 ","$1,854.90 ","$2,532.79 ",$728.22 ,"$1,957.95 ","$2,633.09 ",$728.22 ,"$1,793.07 ","$2,507.71 ","$1,854.90 ","$2,507.71 ","$1,854.90 ","$1,854.90 ","$1,854.90 ","$1,999.17 ","$1,669.41 ","$1,916.73 ","$1,772.46 ","$1,999.17 "
SACRED HEART HOSPITAL (ACU),35000006,21550,HC BX TISSUE NECK/THORAX,350,1 ,"$1,230.00 ",$922.50 ,$664.20 ,"$3,348.27 ",$792.12 ,"$1,488.12 ",$861.00 ,$728.22 ,"$1,230.00 ",$750.07 ,"$1,230.00 ","$1,168.50 ",$728.22 ,$984.00 ,"$1,131.60 ",$728.22 ,"$1,045.50 ","$1,168.50 ","$1,082.40 ",$934.80 ,$728.22 ,$728.22 ,$728.22 ,$897.90 ,$676.50 ,"$1,119.30 ","$1,119.30 ",$984.00 ,"$1,532.76 ",$676.50 ,"$1,107.00 ","$1,488.12 ","$1,107.00 ",$664.20 ,"$1,156.20 ","$3,348.27 ","$1,131.60 ",$771.91 ,"$1,119.30 ","$1,488.12 ",$756.94 ,$756.94 ,"$1,107.00 ",$917.95 ,"$1,107.00 ","$1,503.00 ",$728.22 ,"$1,168.50 ","$1,562.52 ",$728.22 ,"$1,070.10 ","$1,488.12 ","$1,107.00 ","$1,488.12 ","$1,107.00 ","$1,107.00 ","$1,107.00 ","$1,193.10 ",$996.30 ,"$1,143.90 ","$1,057.80 ","$1,193.10 "
SACRED HEART HOSPITAL (ACU),35000013,32400,HC BX PLEURA NEEDLE PERC,350,1 ,"$1,843.55 ","$1,382.66 ",$309.29 ,"$3,348.27 ","$1,187.25 ","$1,488.12 ","$1,290.49 ",$309.29 ,"$1,843.55 ",$318.57 ,"$1,843.55 ","$1,751.37 ",$309.29 ,"$1,474.84 ","$1,696.07 ",$309.29 ,"$1,567.02 ","$1,751.37 ","$1,622.32 ","$1,401.10 ",$309.29 ,$309.29 ,$309.29 ,"$1,345.79 ","$1,013.95 ","$1,677.63 ","$1,677.63 ","$1,474.84 ","$1,532.76 ","$1,013.95 ","$1,659.20 ","$1,488.12 ","$1,659.20 ",$995.52 ,"$1,732.94 ","$3,348.27 ","$1,696.07 ",$327.85 ,"$1,677.63 ","$1,488.12 ","$1,134.52 ","$1,134.52 ","$1,659.20 ","$1,375.84 ","$1,659.20 ","$1,503.00 ",$309.29 ,"$1,751.37 ","$1,562.52 ",$309.29 ,"$1,603.89 ","$1,488.12 ","$1,659.20 ","$1,488.12 ","$1,659.20 ","$1,659.20 ","$1,659.20 ","$1,788.24 ","$1,493.28 ","$1,714.50 ","$1,585.45 ","$1,788.24 "
SACRED HEART HOSPITAL (ACU),35000018,47000,HC BX LIVER NEEDLE PERC,350,1 ,"$1,704.00 ","$1,278.00 ",$239.96 ,"$3,348.27 ","$1,097.38 ","$1,488.12 ","$1,192.80 ",$239.96 ,"$1,704.00 ",$247.16 ,"$1,704.00 ","$1,618.80 ",$239.96 ,"$1,363.20 ","$1,567.68 ",$239.96 ,"$1,448.40 ","$1,618.80 ","$1,499.52 ","$1,295.04 ",$239.96 ,$239.96 ,$239.96 ,"$1,243.92 ",$937.20 ,"$1,550.64 ","$1,550.64 ","$1,363.20 ","$1,532.76 ",$937.20 ,"$1,533.60 ","$1,488.12 ","$1,533.60 ",$920.16 ,"$1,601.76 ","$3,348.27 ","$1,567.68 ",$254.36 ,"$1,550.64 ","$1,488.12 ","$1,048.64 ","$1,048.64 ","$1,533.60 ","$1,271.70 ","$1,533.60 ","$1,503.00 ",$239.96 ,"$1,618.80 ","$1,562.52 ",$239.96 ,"$1,482.48 ","$1,488.12 ","$1,533.60 ","$1,488.12 ","$1,533.60 ","$1,533.60 ","$1,533.60 ","$1,652.88 ","$1,380.24 ","$1,584.72 ","$1,465.44 ","$1,652.88 "
SACRED HEART HOSPITAL (ACU),35000019,47001,HC BIOPSY LIVER OTHER PROC,350,1 ,"$1,804.53 ","$1,353.40 ",$239.96 ,"$1,804.53 ","$1,162.12 ", N/A ,"$1,263.17 ",$239.96 ,"$1,804.53 ",$247.16 ,"$1,804.53 ","$1,714.30 ",$239.96 ,"$1,443.62 ","$1,660.17 ",$239.96 ,"$1,533.85 ","$1,714.30 ","$1,587.99 ","$1,371.44 ",$239.96 ,$239.96 ,$239.96 ,"$1,317.31 ",$992.49 ,"$1,642.12 ","$1,642.12 ","$1,443.62 ", N/A ,$992.49 ,"$1,624.08 ", N/A ,"$1,624.08 ",$974.45 ,"$1,696.26 ", N/A ,"$1,660.17 ",$254.36 ,"$1,642.12 ", N/A ,"$1,110.51 ","$1,110.51 ","$1,624.08 ","$1,346.72 ","$1,624.08 ", N/A ,$239.96 ,"$1,714.30 ", N/A ,$239.96 ,"$1,569.94 ", N/A ,"$1,624.08 ", N/A ,"$1,624.08 ","$1,624.08 ","$1,624.08 ","$1,750.39 ","$1,461.67 ","$1,678.21 ","$1,551.90 ","$1,750.39 "
SACRED HEART HOSPITAL (ACU),35000020,49405,HC PERC DRN ABSC/HEM/CYST VISCERAL,350,1 ,"$2,242.48 ","$1,681.86 ",$239.96 ,"$3,348.27 ","$1,444.16 ","$1,488.12 ","$1,569.74 ",$239.96 ,"$2,242.48 ",$247.16 ,"$1,929.00 ","$2,130.36 ",$239.96 ,"$1,793.98 ","$2,063.08 ",$239.96 ,"$1,906.11 ","$2,130.36 ","$1,973.38 ","$1,704.28 ",$239.96 ,$239.96 ,$239.96 ,"$1,637.01 ","$1,233.36 ","$2,040.66 ","$2,040.66 ","$1,793.98 ","$1,532.76 ","$1,233.36 ","$2,018.23 ","$1,488.12 ","$2,018.23 ","$1,210.94 ","$2,107.93 ","$3,348.27 ","$2,063.08 ",$254.36 ,"$2,040.66 ","$1,488.12 ","$1,380.02 ","$1,380.02 ","$2,018.23 ","$1,673.56 ","$1,929.32 ","$1,503.00 ",$239.96 ,"$2,130.36 ","$1,562.52 ",$239.96 ,"$1,950.96 ","$1,488.12 ","$2,018.23 ","$1,488.12 ","$2,018.23 ","$2,018.23 ","$2,018.23 ","$2,175.21 ","$1,816.41 ","$2,085.51 ","$1,928.53 ","$2,175.21 "
SACRED HEART HOSPITAL (ACU),35000021,47382,HC ABLATION TUMR LIVER RADIO PERC,350,1 ,$944.58 ,$708.44 ,$510.07 ,"$12,041.00 ",$608.31 ,"$5,351.56 ",$661.21 ,$944.58 ,$944.58 ,"$2,134.17 ",$944.58 ,$897.35 ,"$2,072.01 ",$755.66 ,$869.01 ,$944.58 ,$802.89 ,$897.35 ,$831.23 ,$717.88 ,$944.58 ,$944.58 ,"$2,072.01 ",$689.54 ,$519.52 ,$859.57 ,$859.57 ,$755.66 ,"$5,512.11 ",$519.52 ,$850.12 ,"$5,351.56 ",$850.12 ,$510.07 ,$887.91 ,"$12,041.00 ",$869.01 ,"$2,196.33 ",$859.57 ,"$5,351.56 ",$581.29 ,$581.29 ,$850.12 ,$704.94 ,$850.12 ,"$5,405.07 ",$944.58 ,$897.35 ,"$5,619.13 ",$944.58 ,$821.78 ,"$5,351.56 ",$850.12 ,"$5,351.56 ",$850.12 ,$850.12 ,$850.12 ,$916.24 ,$765.11 ,$878.46 ,$812.34 ,$916.24 
SACRED HEART HOSPITAL (ACU),35000023,48102,HC BX PANCREAS NEEDLE PERC,350,1 ,"$1,354.09 ","$1,015.57 ",$239.96 ,"$3,348.27 ",$872.03 ,"$1,488.12 ",$947.86 ,$239.96 ,"$1,354.09 ",$247.16 ,"$1,354.09 ","$1,286.39 ",$239.96 ,"$1,083.27 ","$1,245.76 ",$239.96 ,"$1,150.98 ","$1,286.39 ","$1,191.60 ","$1,029.11 ",$239.96 ,$239.96 ,$239.96 ,$988.49 ,$744.75 ,"$1,232.22 ","$1,232.22 ","$1,083.27 ","$1,532.76 ",$744.75 ,"$1,218.68 ","$1,488.12 ","$1,218.68 ",$731.21 ,"$1,272.84 ","$3,348.27 ","$1,245.76 ",$254.36 ,"$1,232.22 ","$1,488.12 ",$833.31 ,$833.31 ,"$1,218.68 ","$1,010.56 ","$1,218.68 ","$1,503.00 ",$239.96 ,"$1,286.39 ","$1,562.52 ",$239.96 ,"$1,178.06 ","$1,488.12 ","$1,218.68 ","$1,488.12 ","$1,218.68 ","$1,218.68 ","$1,218.68 ","$1,313.47 ","$1,096.81 ","$1,259.30 ","$1,164.52 ","$1,313.47 "
SACRED HEART HOSPITAL (ACU),35000025,49180,HC ABDOM/RETRO/MASS BIOP,350,1 ,"$1,379.00 ","$1,034.25 ",$239.96 ,"$3,348.27 ",$888.08 ,"$1,488.12 ",$965.30 ,$239.96 ,"$1,379.00 ",$247.16 ,"$1,379.00 ","$1,310.05 ",$239.96 ,"$1,103.20 ","$1,268.68 ",$239.96 ,"$1,172.15 ","$1,310.05 ","$1,213.52 ","$1,048.04 ",$239.96 ,$239.96 ,$239.96 ,"$1,006.67 ",$758.45 ,"$1,254.89 ","$1,254.89 ","$1,103.20 ","$1,532.76 ",$758.45 ,"$1,241.10 ","$1,488.12 ","$1,241.10 ",$744.66 ,"$1,296.26 ","$3,348.27 ","$1,268.68 ",$254.36 ,"$1,254.89 ","$1,488.12 ",$848.64 ,$848.64 ,"$1,241.10 ","$1,029.15 ","$1,241.10 ","$1,503.00 ",$239.96 ,"$1,310.05 ","$1,562.52 ",$239.96 ,"$1,199.73 ","$1,488.12 ","$1,241.10 ","$1,488.12 ","$1,241.10 ","$1,241.10 ","$1,241.10 ","$1,337.63 ","$1,116.99 ","$1,282.47 ","$1,185.94 ","$1,337.63 "
SACRED HEART HOSPITAL (ACU),35000026,50200,"HC PERC BIOPSY/KIDNEY, NEEDLE",350,1 ,"$1,341.00 ","$1,005.75 ",$490.07 ,"$3,348.27 ",$863.60 ,"$1,488.12 ",$938.70 ,$490.07 ,"$1,341.00 ",$504.77 ,"$1,341.00 ","$1,273.95 ",$490.07 ,"$1,072.80 ","$1,233.72 ",$490.07 ,"$1,139.85 ","$1,273.95 ","$1,180.08 ","$1,019.16 ",$490.07 ,$490.07 ,$490.07 ,$978.93 ,$737.55 ,"$1,220.31 ","$1,220.31 ","$1,072.80 ","$1,532.76 ",$737.55 ,"$1,206.90 ","$1,488.12 ","$1,206.90 ",$724.14 ,"$1,260.54 ","$3,348.27 ","$1,233.72 ",$519.47 ,"$1,220.31 ","$1,488.12 ",$825.25 ,$825.25 ,"$1,206.90 ","$1,000.79 ","$1,206.90 ","$1,503.00 ",$490.07 ,"$1,273.95 ","$1,562.52 ",$490.07 ,"$1,166.67 ","$1,488.12 ","$1,206.90 ","$1,488.12 ","$1,206.90 ","$1,206.90 ","$1,206.90 ","$1,300.77 ","$1,086.21 ","$1,247.13 ","$1,153.26 ","$1,300.77 "
SACRED HEART HOSPITAL (ACU),35000027,50390,HC RENAL CYST/PELVIS ASP/INJ,350,1 ,"$1,142.00 ",$856.50 ,$123.38 ,"$1,480.84 ",$735.45 ,$658.15 ,$799.40 ,$123.38 ,"$1,142.00 ",$127.08 ,"$1,142.00 ","$1,084.90 ",$123.38 ,$913.60 ,"$1,050.64 ",$123.38 ,$970.70 ,"$1,084.90 ","$1,004.96 ",$867.92 ,$123.38 ,$123.38 ,$123.38 ,$833.66 ,$628.10 ,"$1,039.22 ","$1,039.22 ",$913.60 ,$677.89 ,$628.10 ,"$1,027.80 ",$658.15 ,"$1,027.80 ",$616.68 ,"$1,073.48 ","$1,480.84 ","$1,050.64 ",$130.78 ,"$1,039.22 ",$658.15 ,$702.79 ,$702.79 ,"$1,027.80 ",$852.27 ,"$1,027.80 ",$664.73 ,$123.38 ,"$1,084.90 ",$691.06 ,$123.38 ,$993.54 ,$658.15 ,"$1,027.80 ",$658.15 ,"$1,027.80 ","$1,027.80 ","$1,027.80 ","$1,107.74 ",$925.02 ,"$1,062.06 ",$982.12 ,"$1,107.74 "
SACRED HEART HOSPITAL (ACU),35000028,60100,HC BX THYROID NEEDLE PERC,350,1 ,$876.00 ,$657.00 ,$298.28 ,"$1,480.84 ",$564.14 ,$658.15 ,$613.20 ,$298.28 ,$876.00 ,$307.23 ,$876.00 ,$832.20 ,$298.28 ,$700.80 ,$805.92 ,$298.28 ,$744.60 ,$832.20 ,$770.88 ,$665.76 ,$298.28 ,$298.28 ,$298.28 ,$639.48 ,$481.80 ,$797.16 ,$797.16 ,$700.80 ,$677.89 ,$481.80 ,$788.40 ,$658.15 ,$788.40 ,$473.04 ,$823.44 ,"$1,480.84 ",$805.92 ,$316.18 ,$797.16 ,$658.15 ,$539.09 ,$539.09 ,$788.40 ,$653.76 ,$788.40 ,$664.73 ,$298.28 ,$832.20 ,$691.06 ,$298.28 ,$762.12 ,$658.15 ,$788.40 ,$658.15 ,$788.40 ,$788.40 ,$788.40 ,$849.72 ,$709.56 ,$814.68 ,$753.36 ,$849.72 
SACRED HEART HOSPITAL (ACU),35000029,60699,HC UNLISTED PROCEDURE ENDOCRINE SYSTEM,350,1 ,"$1,770.62 ","$1,327.97 ",$938.49 ,"$12,041.00 ","$1,140.28 ","$5,351.56 ","$1,239.43 ",$938.49 ,"$1,770.62 ",$966.64 ,"$1,770.62 ","$1,682.09 ",$938.49 ,"$1,416.50 ","$1,628.97 ",$938.49 ,"$1,505.03 ","$1,682.09 ","$1,558.15 ","$1,345.67 ",$938.49 ,$938.49 ,$938.49 ,"$1,292.55 ",$973.84 ,"$1,611.26 ","$1,611.26 ","$1,416.50 ","$5,512.11 ",$973.84 ,"$1,593.56 ","$5,351.56 ","$1,593.56 ",$956.13 ,"$1,664.38 ","$12,041.00 ","$1,628.97 ",$994.80 ,"$1,611.26 ","$5,351.56 ","$1,089.64 ","$1,089.64 ","$1,593.56 ","$1,321.41 ","$1,593.56 ","$5,405.07 ",$938.49 ,"$1,682.09 ","$5,619.13 ",$938.49 ,"$1,540.44 ","$5,351.56 ","$1,593.56 ","$5,351.56 ","$1,593.56 ","$1,593.56 ","$1,593.56 ","$1,717.50 ","$1,434.20 ","$1,646.68 ","$1,522.73 ","$1,717.50 "
SACRED HEART HOSPITAL (ACU),35000031,64425,HC INJ ANESTH; ILIOINGUINAL NERVE,350,1 ,"$1,697.00 ","$1,272.75 ",$141.34 ,"$1,697.00 ","$1,092.87 ",$671.59 ,"$1,187.90 ",$141.34 ,"$1,697.00 ",$145.58 ,"$1,697.00 ","$1,612.15 ",$141.34 ,"$1,357.60 ","$1,561.24 ",$141.34 ,"$1,442.45 ","$1,612.15 ","$1,493.36 ","$1,289.72 ",$141.34 ,$141.34 ,$141.34 ,"$1,238.81 ",$933.35 ,"$1,544.27 ","$1,544.27 ","$1,357.60 ",$691.74 ,$933.35 ,"$1,527.30 ",$671.59 ,"$1,527.30 ",$916.38 ,"$1,595.18 ","$1,511.09 ","$1,561.24 ",$149.82 ,"$1,544.27 ",$671.59 ,"$1,044.33 ","$1,044.33 ","$1,527.30 ","$1,266.47 ","$1,527.30 ",$678.31 ,$141.34 ,"$1,612.15 ",$705.17 ,$141.34 ,"$1,476.39 ",$671.59 ,"$1,527.30 ",$671.59 ,"$1,527.30 ","$1,527.30 ","$1,527.30 ","$1,646.09 ","$1,374.57 ","$1,578.21 ","$1,459.42 ","$1,646.09 "
SACRED HEART HOSPITAL (ACU),35000034,64530,HC INJ CELIAC PLEXUS BLOCK,350,1 ,"$2,907.00 ","$2,180.25 ",$376.63 ,"$2,907.00 ","$1,872.11 ",$870.64 ,"$2,034.90 ",$376.63 ,"$2,412.00 ",$387.93 ,"$1,929.00 ","$2,761.65 ",$376.63 ,"$2,325.60 ","$2,674.44 ",$376.63 ,"$2,470.95 ","$2,761.65 ","$2,558.16 ","$2,209.32 ",$376.63 ,$376.63 ,$376.63 ,"$2,122.11 ","$1,598.85 ","$2,645.37 ","$2,645.37 ","$2,325.60 ",$896.76 ,"$1,598.85 ","$2,616.30 ",$870.64 ,"$2,616.30 ","$1,569.78 ","$2,732.58 ","$1,958.95 ","$2,674.44 ",$399.23 ,"$2,645.37 ",$870.64 ,"$1,788.97 ","$1,788.97 ","$2,616.30 ","$2,169.49 ","$1,929.32 ",$879.35 ,$376.63 ,"$2,761.65 ",$914.18 ,$376.63 ,"$2,529.09 ",$870.64 ,"$2,616.30 ",$870.64 ,"$2,616.30 ","$2,616.30 ","$2,616.30 ","$2,819.79 ","$2,354.67 ","$2,703.51 ","$2,500.02 ","$2,819.79 "
SACRED HEART HOSPITAL (ACU),35000035,64680,HC DEST NERVE CELIAC PLEXUS,350,1 ,"$4,062.00 ","$3,046.50 ",$376.63 ,"$4,062.00 ","$2,615.93 ",$870.64 ,"$2,843.40 ",$376.63 ,"$2,412.00 ",$387.93 ,"$1,929.00 ","$3,858.90 ",$376.63 ,"$3,249.60 ","$3,737.04 ",$376.63 ,"$3,452.70 ","$3,858.90 ","$3,574.56 ","$3,087.12 ",$376.63 ,$376.63 ,$376.63 ,"$2,965.26 ","$2,234.10 ","$3,696.42 ","$3,696.42 ","$3,249.60 ",$896.76 ,"$2,234.10 ","$3,655.80 ",$870.64 ,"$3,655.80 ","$2,193.48 ","$3,818.28 ","$1,958.95 ","$3,737.04 ",$399.23 ,"$3,696.42 ",$870.64 ,"$2,499.75 ","$2,499.75 ","$3,655.80 ","$3,031.47 ","$1,929.32 ",$879.35 ,$376.63 ,"$3,858.90 ",$914.18 ,$376.63 ,"$3,533.94 ",$870.64 ,"$3,655.80 ",$870.64 ,"$3,655.80 ","$3,655.80 ","$3,655.80 ","$3,940.14 ","$3,290.22 ","$3,777.66 ","$3,493.32 ","$3,940.14 "
SACRED HEART HOSPITAL (ACU),35000036,70450,HC CT HEAD/BRAIN W/O CONTRAST,350,1 ,"$1,812.48 ","$1,359.36 ",$102.60 ,"$1,812.48 ","$1,167.24 ",$115.15 ,"$1,268.74 ",$102.60 ,"$1,812.48 ",$105.68 ,"$1,812.48 ","$1,721.86 ",$102.60 ,"$1,449.98 ","$1,667.48 ",$102.60 ,"$1,540.61 ","$1,721.86 ","$1,594.98 ","$1,377.48 ",$102.60 ,$102.60 ,$102.60 ,"$1,323.11 ",$996.86 ,"$1,649.36 ","$1,649.36 ","$1,449.98 ",$118.60 ,$996.86 ,"$1,631.23 ",$115.15 ,"$1,631.23 ",$978.74 ,"$1,703.73 ",$259.08 ,"$1,667.48 ",$108.76 ,"$1,649.36 ",$115.15 ,"$1,115.40 ","$1,115.40 ",$810.12 ,"$1,352.65 ","$1,631.23 ",$116.30 ,$102.60 ,"$1,721.86 ",$120.90 ,$102.60 ,"$1,576.86 ",$115.15 ,"$1,631.23 ",$115.15 ,"$1,631.23 ","$1,631.23 ","$1,631.23 ","$1,758.11 ","$1,468.11 ","$1,685.61 ","$1,558.73 ","$1,758.11 "
SACRED HEART HOSPITAL (ACU),35000037,70460,HC CT HEAD/BRAIN W/CONTRAST,350,1 ,"$1,837.36 ","$1,378.02 ",$102.60 ,"$1,837.36 ","$1,183.26 ",$188.92 ,"$1,286.15 ",$102.60 ,"$1,837.36 ",$105.68 ,"$1,837.36 ","$1,745.49 ",$102.60 ,"$1,469.89 ","$1,690.37 ",$102.60 ,"$1,561.76 ","$1,745.49 ","$1,616.88 ","$1,396.39 ",$102.60 ,$102.60 ,$102.60 ,"$1,341.27 ","$1,010.55 ","$1,672.00 ","$1,672.00 ","$1,469.89 ",$194.59 ,"$1,010.55 ","$1,653.62 ",$188.92 ,"$1,653.62 ",$992.17 ,"$1,727.12 ",$425.07 ,"$1,690.37 ",$108.76 ,"$1,672.00 ",$188.92 ,"$1,130.71 ","$1,130.71 ","$1,045.74 ","$1,371.22 ","$1,653.62 ",$190.81 ,$102.60 ,"$1,745.49 ",$198.37 ,$102.60 ,"$1,598.50 ",$188.92 ,"$1,653.62 ",$188.92 ,"$1,653.62 ","$1,653.62 ","$1,653.62 ","$1,782.24 ","$1,488.26 ","$1,708.74 ","$1,580.13 ","$1,782.24 "
SACRED HEART HOSPITAL (ACU),35000038,70470,HC CT HEAD/BRAIN W AND W/O CONTRAST,350,1 ,"$2,446.15 ","$1,834.61 ",$102.60 ,"$2,446.15 ","$1,575.32 ",$188.92 ,"$1,712.31 ",$102.60 ,"$2,412.00 ",$105.68 ,"$1,929.00 ","$2,323.84 ",$102.60 ,"$1,956.92 ","$2,250.46 ",$102.60 ,"$2,079.23 ","$2,323.84 ","$2,152.61 ","$1,859.07 ",$102.60 ,$102.60 ,$102.60 ,"$1,785.69 ","$1,345.38 ","$2,226.00 ","$2,226.00 ","$1,956.92 ",$194.59 ,"$1,345.38 ","$2,201.54 ",$188.92 ,"$2,201.54 ","$1,320.92 ","$2,299.38 ",$425.07 ,"$2,250.46 ",$108.76 ,"$2,226.00 ",$188.92 ,"$1,505.36 ","$1,505.36 ","$1,166.02 ","$1,825.56 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,323.84 ",$198.37 ,$102.60 ,"$2,128.15 ",$188.92 ,"$2,201.54 ",$188.92 ,"$2,201.54 ","$2,201.54 ","$2,201.54 ","$2,372.77 ","$1,981.38 ","$2,274.92 ","$2,103.69 ","$2,372.77 "
SACRED HEART HOSPITAL (ACU),35000039,70480,HC CT ORBIT/IAC/EAR W/O CONTRAST,350,1 ,"$1,807.17 ","$1,355.38 ",$37.88 ,"$1,807.17 ","$1,163.82 ",$115.15 ,"$1,265.02 ",$37.88 ,"$1,807.17 ",$39.02 ,"$1,807.17 ","$1,716.81 ",$37.88 ,"$1,445.74 ","$1,662.60 ",$37.88 ,"$1,536.09 ","$1,716.81 ","$1,590.31 ","$1,373.45 ",$37.88 ,$37.88 ,$37.88 ,"$1,319.23 ",$993.94 ,"$1,644.52 ","$1,644.52 ","$1,445.74 ",$118.60 ,$993.94 ,"$1,626.45 ",$115.15 ,"$1,626.45 ",$975.87 ,"$1,698.74 ",$259.08 ,"$1,662.60 ",$40.15 ,"$1,644.52 ",$115.15 ,"$1,112.13 ","$1,112.13 ",$701.71 ,"$1,348.69 ","$1,626.45 ",$116.30 ,$37.88 ,"$1,716.81 ",$120.90 ,$37.88 ,"$1,572.24 ",$115.15 ,"$1,626.45 ",$115.15 ,"$1,626.45 ","$1,626.45 ","$1,626.45 ","$1,752.95 ","$1,463.81 ","$1,680.67 ","$1,554.17 ","$1,752.95 "
SACRED HEART HOSPITAL (ACU),35000041,70481,HC CT ORBIT/IAC/EAR W/CONTRAST,350,1 ,"$1,542.85 ","$1,157.14 ",$102.60 ,"$1,542.85 ",$993.60 ,$188.92 ,"$1,080.00 ",$102.60 ,"$1,542.85 ",$105.68 ,"$1,542.85 ","$1,465.71 ",$102.60 ,"$1,234.28 ","$1,419.42 ",$102.60 ,"$1,311.42 ","$1,465.71 ","$1,357.71 ","$1,172.57 ",$102.60 ,$102.60 ,$102.60 ,"$1,126.28 ",$848.57 ,"$1,403.99 ","$1,403.99 ","$1,234.28 ",$194.59 ,$848.57 ,"$1,388.57 ",$188.92 ,"$1,388.57 ",$833.14 ,"$1,450.28 ",$425.07 ,"$1,419.42 ",$108.76 ,"$1,403.99 ",$188.92 ,$949.47 ,$949.47 ,"$1,052.17 ","$1,151.43 ","$1,388.57 ",$190.81 ,$102.60 ,"$1,465.71 ",$198.37 ,$102.60 ,"$1,342.28 ",$188.92 ,"$1,388.57 ",$188.92 ,"$1,388.57 ","$1,388.57 ","$1,388.57 ","$1,496.56 ","$1,249.71 ","$1,434.85 ","$1,326.85 ","$1,496.56 "
SACRED HEART HOSPITAL (ACU),35000042,70482,HC CT ORBIT/IAC/EAR W AND W/O CONTRAST,350,1 ,"$1,902.76 ","$1,427.07 ",$102.60 ,"$1,902.76 ","$1,225.38 ",$188.92 ,"$1,331.93 ",$102.60 ,"$1,902.76 ",$105.68 ,"$1,902.76 ","$1,807.62 ",$102.60 ,"$1,522.21 ","$1,750.54 ",$102.60 ,"$1,617.35 ","$1,807.62 ","$1,674.43 ","$1,446.10 ",$102.60 ,$102.60 ,$102.60 ,"$1,389.01 ","$1,046.52 ","$1,731.51 ","$1,731.51 ","$1,522.21 ",$194.59 ,"$1,046.52 ","$1,712.48 ",$188.92 ,"$1,712.48 ","$1,027.49 ","$1,788.59 ",$425.07 ,"$1,750.54 ",$108.76 ,"$1,731.51 ",$188.92 ,"$1,170.96 ","$1,170.96 ","$1,134.09 ","$1,420.03 ","$1,712.48 ",$190.81 ,$102.60 ,"$1,807.62 ",$198.37 ,$102.60 ,"$1,655.40 ",$188.92 ,"$1,712.48 ",$188.92 ,"$1,712.48 ","$1,712.48 ","$1,712.48 ","$1,845.68 ","$1,541.24 ","$1,769.57 ","$1,636.37 ","$1,845.68 "
SACRED HEART HOSPITAL (ACU),35000043,70486,HC CT MAX/FACIAL W/O CONTRAST,350,1 ,"$1,855.01 ","$1,391.26 ",$37.88 ,"$1,855.01 ","$1,194.63 ",$115.15 ,"$1,298.51 ",$37.88 ,"$1,855.01 ",$39.02 ,"$1,855.01 ","$1,762.26 ",$37.88 ,"$1,484.01 ","$1,706.61 ",$37.88 ,"$1,576.76 ","$1,762.26 ","$1,632.41 ","$1,409.81 ",$37.88 ,$37.88 ,$37.88 ,"$1,354.16 ","$1,020.26 ","$1,688.06 ","$1,688.06 ","$1,484.01 ",$118.60 ,"$1,020.26 ","$1,669.51 ",$115.15 ,"$1,669.51 ","$1,001.71 ","$1,743.71 ",$259.08 ,"$1,706.61 ",$40.15 ,"$1,688.06 ",$115.15 ,"$1,141.57 ","$1,141.57 ",$725.40 ,"$1,384.39 ","$1,669.51 ",$116.30 ,$37.88 ,"$1,762.26 ",$120.90 ,$37.88 ,"$1,613.86 ",$115.15 ,"$1,669.51 ",$115.15 ,"$1,669.51 ","$1,669.51 ","$1,669.51 ","$1,799.36 ","$1,502.56 ","$1,725.16 ","$1,595.31 ","$1,799.36 "
SACRED HEART HOSPITAL (ACU),35000045,70487,HC CT MAX/FACIAL W/CONTRAST,350,1 ,"$1,868.32 ","$1,401.24 ",$102.60 ,"$1,868.32 ","$1,203.20 ",$188.92 ,"$1,307.82 ",$102.60 ,"$1,868.32 ",$105.68 ,"$1,868.32 ","$1,774.90 ",$102.60 ,"$1,494.66 ","$1,718.85 ",$102.60 ,"$1,588.07 ","$1,774.90 ","$1,644.12 ","$1,419.92 ",$102.60 ,$102.60 ,$102.60 ,"$1,363.87 ","$1,027.58 ","$1,700.17 ","$1,700.17 ","$1,494.66 ",$194.59 ,"$1,027.58 ","$1,681.49 ",$188.92 ,"$1,681.49 ","$1,008.89 ","$1,756.22 ",$425.07 ,"$1,718.85 ",$108.76 ,"$1,700.17 ",$188.92 ,"$1,149.76 ","$1,149.76 ",$993.30 ,"$1,394.33 ","$1,681.49 ",$190.81 ,$102.60 ,"$1,774.90 ",$198.37 ,$102.60 ,"$1,625.44 ",$188.92 ,"$1,681.49 ",$188.92 ,"$1,681.49 ","$1,681.49 ","$1,681.49 ","$1,812.27 ","$1,513.34 ","$1,737.54 ","$1,606.76 ","$1,812.27 "
SACRED HEART HOSPITAL (ACU),35000046,70488,HC CT MAX/FACIAL W AND W/O CONTRAST,350,1 ,"$2,030.91 ","$1,523.18 ",$102.60 ,"$2,030.91 ","$1,307.91 ",$188.92 ,"$1,421.64 ",$102.60 ,"$2,030.91 ",$105.68 ,"$1,929.00 ","$1,929.36 ",$102.60 ,"$1,624.73 ","$1,868.44 ",$102.60 ,"$1,726.27 ","$1,929.36 ","$1,787.20 ","$1,543.49 ",$102.60 ,$102.60 ,$102.60 ,"$1,482.56 ","$1,117.00 ","$1,848.13 ","$1,848.13 ","$1,624.73 ",$194.59 ,"$1,117.00 ","$1,827.82 ",$188.92 ,"$1,827.82 ","$1,096.69 ","$1,909.06 ",$425.07 ,"$1,868.44 ",$108.76 ,"$1,848.13 ",$188.92 ,"$1,249.82 ","$1,249.82 ","$1,135.21 ","$1,515.67 ","$1,827.82 ",$190.81 ,$102.60 ,"$1,929.36 ",$198.37 ,$102.60 ,"$1,766.89 ",$188.92 ,"$1,827.82 ",$188.92 ,"$1,827.82 ","$1,827.82 ","$1,827.82 ","$1,969.98 ","$1,645.04 ","$1,888.75 ","$1,746.58 ","$1,969.98 "
SACRED HEART HOSPITAL (ACU),35000047,70490,HC CT NECK SFT TISS W/O CONTRAST,350,1 ,"$1,362.27 ","$1,021.70 ",$37.88 ,"$1,362.27 ",$877.30 ,$115.15 ,$953.59 ,$37.88 ,"$1,362.27 ",$39.02 ,"$1,362.27 ","$1,294.16 ",$37.88 ,"$1,089.82 ","$1,253.29 ",$37.88 ,"$1,157.93 ","$1,294.16 ","$1,198.80 ","$1,035.33 ",$37.88 ,$37.88 ,$37.88 ,$994.46 ,$749.25 ,"$1,239.67 ","$1,239.67 ","$1,089.82 ",$118.60 ,$749.25 ,"$1,226.04 ",$115.15 ,"$1,226.04 ",$735.63 ,"$1,280.53 ",$259.08 ,"$1,253.29 ",$40.15 ,"$1,239.67 ",$115.15 ,$838.34 ,$838.34 ,$721.87 ,"$1,016.66 ","$1,226.04 ",$116.30 ,$37.88 ,"$1,294.16 ",$120.90 ,$37.88 ,"$1,185.17 ",$115.15 ,"$1,226.04 ",$115.15 ,"$1,226.04 ","$1,226.04 ","$1,226.04 ","$1,321.40 ","$1,103.44 ","$1,266.91 ","$1,171.55 ","$1,321.40 "
SACRED HEART HOSPITAL (ACU),35000048,70491,HC CT NECK SFT TISS W/CONTRAST,350,1 ,"$2,171.61 ","$1,628.71 ",$102.60 ,"$2,171.61 ","$1,398.52 ",$188.92 ,"$1,520.13 ",$102.60 ,"$2,171.61 ",$105.68 ,"$1,929.00 ","$2,063.03 ",$102.60 ,"$1,737.29 ","$1,997.88 ",$102.60 ,"$1,845.87 ","$2,063.03 ","$1,911.02 ","$1,650.42 ",$102.60 ,$102.60 ,$102.60 ,"$1,585.28 ","$1,194.39 ","$1,976.17 ","$1,976.17 ","$1,737.29 ",$194.59 ,"$1,194.39 ","$1,954.45 ",$188.92 ,"$1,954.45 ","$1,172.67 ","$2,041.31 ",$425.07 ,"$1,997.88 ",$108.76 ,"$1,976.17 ",$188.92 ,"$1,336.41 ","$1,336.41 ",$955.63 ,"$1,620.67 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,063.03 ",$198.37 ,$102.60 ,"$1,889.30 ",$188.92 ,"$1,954.45 ",$188.92 ,"$1,954.45 ","$1,954.45 ","$1,954.45 ","$2,106.46 ","$1,759.00 ","$2,019.60 ","$1,867.58 ","$2,106.46 "
SACRED HEART HOSPITAL (ACU),35000049,70492,HC CT NECK SFT TISS W AND WO CONTRAST,350,1 ,"$2,199.39 ","$1,649.54 ",$102.60 ,"$2,199.39 ","$1,416.41 ",$188.92 ,"$1,539.57 ",$102.60 ,"$2,199.39 ",$105.68 ,"$1,929.00 ","$2,089.42 ",$102.60 ,"$1,759.51 ","$2,023.44 ",$102.60 ,"$1,869.48 ","$2,089.42 ","$1,935.46 ","$1,671.54 ",$102.60 ,$102.60 ,$102.60 ,"$1,605.55 ","$1,209.66 ","$2,001.44 ","$2,001.44 ","$1,759.51 ",$194.59 ,"$1,209.66 ","$1,979.45 ",$188.92 ,"$1,979.45 ","$1,187.67 ","$2,067.43 ",$425.07 ,"$2,023.44 ",$108.76 ,"$2,001.44 ",$188.92 ,"$1,353.50 ","$1,353.50 ","$1,167.24 ","$1,641.40 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,089.42 ",$198.37 ,$102.60 ,"$1,913.47 ",$188.92 ,"$1,979.45 ",$188.92 ,"$1,979.45 ","$1,979.45 ","$1,979.45 ","$2,133.41 ","$1,781.51 ","$2,045.43 ","$1,891.48 ","$2,133.41 "
SACRED HEART HOSPITAL (ACU),35000050,70496,HC CT ANGIO HEAD W/WO,350,1 ,"$2,766.40 ","$2,074.80 ",$125.62 ,"$2,766.40 ","$1,781.56 ",$188.92 ,"$1,936.48 ",$125.62 ,"$2,412.00 ",$129.39 ,"$1,929.00 ","$2,628.08 ",$125.62 ,"$2,213.12 ","$2,545.09 ",$125.62 ,"$2,351.44 ","$2,628.08 ","$2,434.43 ","$2,102.46 ",$125.62 ,$125.62 ,$125.62 ,"$2,019.47 ","$1,521.52 ","$2,517.42 ","$2,517.42 ","$2,213.12 ",$194.59 ,"$1,521.52 ","$2,489.76 ",$188.92 ,"$2,489.76 ","$1,493.86 ","$2,600.42 ",$425.07 ,"$2,545.09 ",$133.16 ,"$2,517.42 ",$188.92 ,"$1,702.44 ","$1,702.44 ",$723.79 ,"$2,064.56 ","$1,929.32 ",$190.81 ,$125.62 ,"$2,628.08 ",$198.37 ,$125.62 ,"$2,406.77 ",$188.92 ,"$2,489.76 ",$188.92 ,"$2,489.76 ","$2,489.76 ","$2,489.76 ","$2,683.41 ","$2,240.78 ","$2,572.75 ","$2,379.10 ","$2,683.41 "
SACRED HEART HOSPITAL (ACU),35000051,70498,HC CT ANGIO NECK W/WO CONTRAST,350,1 ,"$2,766.40 ","$2,074.80 ",$125.62 ,"$2,766.40 ","$1,781.56 ",$188.92 ,"$1,936.48 ",$125.62 ,"$2,412.00 ",$129.39 ,"$1,929.00 ","$2,628.08 ",$125.62 ,"$2,213.12 ","$2,545.09 ",$125.62 ,"$2,351.44 ","$2,628.08 ","$2,434.43 ","$2,102.46 ",$125.62 ,$125.62 ,$125.62 ,"$2,019.47 ","$1,521.52 ","$2,517.42 ","$2,517.42 ","$2,213.12 ",$194.59 ,"$1,521.52 ","$2,489.76 ",$188.92 ,"$2,489.76 ","$1,493.86 ","$2,600.42 ",$425.07 ,"$2,545.09 ",$133.16 ,"$2,517.42 ",$188.92 ,"$1,702.44 ","$1,702.44 ",$723.79 ,"$2,064.56 ","$1,929.32 ",$190.81 ,$125.62 ,"$2,628.08 ",$198.37 ,$125.62 ,"$2,406.77 ",$188.92 ,"$2,489.76 ",$188.92 ,"$2,489.76 ","$2,489.76 ","$2,489.76 ","$2,683.41 ","$2,240.78 ","$2,572.75 ","$2,379.10 ","$2,683.41 "
SACRED HEART HOSPITAL (ACU),35000052,70540,HC MRI ORBIT/FACE/NECK W/O CON,610,1 ,"$3,790.00 ","$2,842.50 ",$82.68 ,"$3,790.00 ","$2,440.76 ",$243.36 ,"$2,653.00 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$3,600.50 ",$82.68 ,"$3,032.00 ","$3,486.80 ",$82.68 ,"$3,221.50 ","$3,600.50 ","$3,335.20 ","$2,880.40 ",$82.68 ,$82.68 ,$82.68 ,"$2,766.70 ","$2,084.50 ","$3,448.90 ","$3,448.90 ","$3,032.00 ",$250.66 ,"$2,084.50 ","$3,411.00 ",$243.36 ,"$3,411.00 ","$2,046.60 ","$3,562.60 ",$547.56 ,"$3,486.80 ",$87.64 ,"$3,448.90 ",$243.36 ,"$2,332.37 ","$2,332.37 ","$2,000.62 ","$2,828.48 ","$2,143.69 ",$245.79 ,$82.68 ,"$3,600.50 ",$255.53 ,$82.68 ,"$3,297.30 ",$243.36 ,"$3,411.00 ",$243.36 ,"$3,411.00 ","$3,411.00 ","$3,411.00 ","$3,676.30 ","$3,069.90 ","$3,524.70 ","$3,259.40 ","$3,676.30 "
SACRED HEART HOSPITAL (ACU),35000053,72125,HC CT C-SPINE W/O CONTRAST,350,1 ,"$2,274.10 ","$1,705.58 ",$37.88 ,"$2,274.10 ","$1,464.52 ",$115.15 ,"$1,591.87 ",$37.88 ,"$2,274.10 ",$39.02 ,"$1,929.00 ","$2,160.40 ",$37.88 ,"$1,819.28 ","$2,092.17 ",$37.88 ,"$1,932.99 ","$2,160.40 ","$2,001.21 ","$1,728.32 ",$37.88 ,$37.88 ,$37.88 ,"$1,660.09 ","$1,250.76 ","$2,069.43 ","$2,069.43 ","$1,819.28 ",$118.60 ,"$1,250.76 ","$2,046.69 ",$115.15 ,"$2,046.69 ","$1,228.01 ","$2,137.65 ",$259.08 ,"$2,092.17 ",$40.15 ,"$2,069.43 ",$115.15 ,"$1,399.48 ","$1,399.48 ","$1,003.67 ","$1,697.16 ","$1,929.32 ",$116.30 ,$37.88 ,"$2,160.40 ",$120.90 ,$37.88 ,"$1,978.47 ",$115.15 ,"$2,046.69 ",$115.15 ,"$2,046.69 ","$2,046.69 ","$2,046.69 ","$2,205.88 ","$1,842.02 ","$2,114.91 ","$1,955.73 ","$2,205.88 "
SACRED HEART HOSPITAL (ACU),35000055,72126,HC CT C-SPINE W/CONTRAST,350,1 ,"$2,330.86 ","$1,748.15 ",$102.60 ,"$2,330.86 ","$1,501.07 ",$389.47 ,"$1,631.60 ",$102.60 ,"$2,330.86 ",$105.68 ,"$1,929.00 ","$2,214.32 ",$102.60 ,"$1,864.69 ","$2,144.39 ",$102.60 ,"$1,981.23 ","$2,214.32 ","$2,051.16 ","$1,771.45 ",$102.60 ,$102.60 ,$102.60 ,"$1,701.53 ","$1,281.97 ","$2,121.08 ","$2,121.08 ","$1,864.69 ",$401.15 ,"$1,281.97 ","$2,097.77 ",$389.47 ,"$2,097.77 ","$1,258.66 ","$2,191.01 ",$876.31 ,"$2,144.39 ",$108.76 ,"$2,121.08 ",$389.47 ,"$1,434.41 ","$1,434.41 ","$1,029.70 ","$1,739.52 ","$1,929.32 ",$393.37 ,$102.60 ,"$2,214.32 ",$408.94 ,$102.60 ,"$2,027.85 ",$389.47 ,"$2,097.77 ",$389.47 ,"$2,097.77 ","$2,097.77 ","$2,097.77 ","$2,260.93 ","$1,888.00 ","$2,167.70 ","$2,004.54 ","$2,260.93 "
SACRED HEART HOSPITAL (ACU),35000056,72127,HC CT C-SPINE W AND W/O CONTRAST,350,1 ,"$2,360.28 ","$1,770.21 ",$102.60 ,"$2,360.28 ","$1,520.02 ",$188.92 ,"$1,652.20 ",$102.60 ,"$2,360.28 ",$105.68 ,"$1,929.00 ","$2,242.27 ",$102.60 ,"$1,888.22 ","$2,171.46 ",$102.60 ,"$2,006.24 ","$2,242.27 ","$2,077.05 ","$1,793.81 ",$102.60 ,$102.60 ,$102.60 ,"$1,723.00 ","$1,298.15 ","$2,147.85 ","$2,147.85 ","$1,888.22 ",$194.59 ,"$1,298.15 ","$2,124.25 ",$188.92 ,"$2,124.25 ","$1,274.55 ","$2,218.66 ",$425.07 ,"$2,171.46 ",$108.76 ,"$2,147.85 ",$188.92 ,"$1,452.52 ","$1,452.52 ","$1,142.33 ","$1,761.48 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,242.27 ",$198.37 ,$102.60 ,"$2,053.44 ",$188.92 ,"$2,124.25 ",$188.92 ,"$2,124.25 ","$2,124.25 ","$2,124.25 ","$2,289.47 ","$1,911.83 ","$2,195.06 ","$2,029.84 ","$2,289.47 "
SACRED HEART HOSPITAL (ACU),35000057,72128,HC CT T-SPINE W/O CONTRAST,350,1 ,"$1,647.78 ","$1,235.84 ",$37.88 ,"$1,647.78 ","$1,061.17 ",$115.15 ,"$1,153.45 ",$37.88 ,"$1,647.78 ",$39.02 ,"$1,647.78 ","$1,565.39 ",$37.88 ,"$1,318.22 ","$1,515.96 ",$37.88 ,"$1,400.61 ","$1,565.39 ","$1,450.05 ","$1,252.31 ",$37.88 ,$37.88 ,$37.88 ,"$1,202.88 ",$906.28 ,"$1,499.48 ","$1,499.48 ","$1,318.22 ",$118.60 ,$906.28 ,"$1,483.00 ",$115.15 ,"$1,483.00 ",$889.80 ,"$1,548.91 ",$259.08 ,"$1,515.96 ",$40.15 ,"$1,499.48 ",$115.15 ,"$1,014.04 ","$1,014.04 ",$943.82 ,"$1,229.74 ","$1,483.00 ",$116.30 ,$37.88 ,"$1,565.39 ",$120.90 ,$37.88 ,"$1,433.57 ",$115.15 ,"$1,483.00 ",$115.15 ,"$1,483.00 ","$1,483.00 ","$1,483.00 ","$1,598.35 ","$1,334.70 ","$1,532.44 ","$1,417.09 ","$1,598.35 "
SACRED HEART HOSPITAL (ACU),35000059,72129,HC CT T-SPINE W/CONTRAST,350,1 ,"$2,058.64 ","$1,543.98 ",$102.60 ,"$2,058.64 ","$1,325.76 ",$188.92 ,"$1,441.05 ",$102.60 ,"$2,058.64 ",$105.68 ,"$1,929.00 ","$1,955.71 ",$102.60 ,"$1,646.91 ","$1,893.95 ",$102.60 ,"$1,749.84 ","$1,955.71 ","$1,811.60 ","$1,564.57 ",$102.60 ,$102.60 ,$102.60 ,"$1,502.81 ","$1,132.25 ","$1,873.36 ","$1,873.36 ","$1,646.91 ",$194.59 ,"$1,132.25 ","$1,852.78 ",$188.92 ,"$1,852.78 ","$1,111.67 ","$1,935.12 ",$425.07 ,"$1,893.95 ",$108.76 ,"$1,873.36 ",$188.92 ,"$1,266.89 ","$1,266.89 ","$1,029.70 ","$1,536.36 ","$1,852.78 ",$190.81 ,$102.60 ,"$1,955.71 ",$198.37 ,$102.60 ,"$1,791.02 ",$188.92 ,"$1,852.78 ",$188.92 ,"$1,852.78 ","$1,852.78 ","$1,852.78 ","$1,996.88 ","$1,667.50 ","$1,914.54 ","$1,770.43 ","$1,996.88 "
SACRED HEART HOSPITAL (ACU),35000061,72131,HC CT L-SPINE W/O CONTRAST,350,1 ,"$1,719.69 ","$1,289.77 ",$37.88 ,"$1,719.69 ","$1,107.48 ",$115.15 ,"$1,203.78 ",$37.88 ,"$1,719.69 ",$39.02 ,"$1,719.69 ","$1,633.71 ",$37.88 ,"$1,375.75 ","$1,582.11 ",$37.88 ,"$1,461.74 ","$1,633.71 ","$1,513.33 ","$1,306.96 ",$37.88 ,$37.88 ,$37.88 ,"$1,255.37 ",$945.83 ,"$1,564.92 ","$1,564.92 ","$1,375.75 ",$118.60 ,$945.83 ,"$1,547.72 ",$115.15 ,"$1,547.72 ",$928.63 ,"$1,616.51 ",$259.08 ,"$1,582.11 ",$40.15 ,"$1,564.92 ",$115.15 ,"$1,058.30 ","$1,058.30 ","$1,003.67 ","$1,283.40 ","$1,547.72 ",$116.30 ,$37.88 ,"$1,633.71 ",$120.90 ,$37.88 ,"$1,496.13 ",$115.15 ,"$1,547.72 ",$115.15 ,"$1,547.72 ","$1,547.72 ","$1,547.72 ","$1,668.10 ","$1,392.95 ","$1,599.31 ","$1,478.93 ","$1,668.10 "
SACRED HEART HOSPITAL (ACU),35000062,72132,HC CT L-SPINE W/CONTRAST,350,1 ,"$1,725.78 ","$1,294.34 ",$102.60 ,"$1,725.78 ","$1,111.40 ",$389.47 ,"$1,208.05 ",$102.60 ,"$1,725.78 ",$105.68 ,"$1,725.78 ","$1,639.49 ",$102.60 ,"$1,380.62 ","$1,587.72 ",$102.60 ,"$1,466.91 ","$1,639.49 ","$1,518.69 ","$1,311.59 ",$102.60 ,$102.60 ,$102.60 ,"$1,259.82 ",$949.18 ,"$1,570.46 ","$1,570.46 ","$1,380.62 ",$401.15 ,$949.18 ,"$1,553.20 ",$389.47 ,"$1,553.20 ",$931.92 ,"$1,622.23 ",$876.31 ,"$1,587.72 ",$108.76 ,"$1,570.46 ",$389.47 ,"$1,062.05 ","$1,062.05 ","$1,132.41 ","$1,287.95 ","$1,553.20 ",$393.37 ,$102.60 ,"$1,639.49 ",$408.94 ,$102.60 ,"$1,501.43 ",$389.47 ,"$1,553.20 ",$389.47 ,"$1,553.20 ","$1,553.20 ","$1,553.20 ","$1,674.01 ","$1,397.88 ","$1,604.98 ","$1,484.17 ","$1,674.01 "
SACRED HEART HOSPITAL (ACU),35000063,72133,HC CT L-SPINE W AND W/O CONTRAST,350,1 ,"$1,509.12 ","$1,131.84 ",$102.60 ,"$1,509.12 ",$971.87 ,$188.92 ,"$1,056.38 ",$102.60 ,"$1,509.12 ",$105.68 ,"$1,509.12 ","$1,433.66 ",$102.60 ,"$1,207.30 ","$1,388.39 ",$102.60 ,"$1,282.75 ","$1,433.66 ","$1,328.03 ","$1,146.93 ",$102.60 ,$102.60 ,$102.60 ,"$1,101.66 ",$830.02 ,"$1,373.30 ","$1,373.30 ","$1,207.30 ",$194.59 ,$830.02 ,"$1,358.21 ",$188.92 ,"$1,358.21 ",$814.92 ,"$1,418.57 ",$425.07 ,"$1,388.39 ",$108.76 ,"$1,373.30 ",$188.92 ,$928.71 ,$928.71 ,"$1,141.59 ","$1,126.26 ","$1,358.21 ",$190.81 ,$102.60 ,"$1,433.66 ",$198.37 ,$102.60 ,"$1,312.93 ",$188.92 ,"$1,358.21 ",$188.92 ,"$1,358.21 ","$1,358.21 ","$1,358.21 ","$1,463.85 ","$1,222.39 ","$1,403.48 ","$1,297.84 ","$1,463.85 "
SACRED HEART HOSPITAL (ACU),35000064,72191,HC CTA PELVIS W AND W/O CONTRAST,350,1 ,"$3,823.82 ","$2,867.87 ",$125.62 ,"$3,823.82 ","$2,462.54 ",$188.92 ,"$2,676.67 ",$125.62 ,"$2,412.00 ",$129.39 ,"$1,929.00 ","$3,632.63 ",$125.62 ,"$3,059.06 ","$3,517.91 ",$125.62 ,"$3,250.25 ","$3,632.63 ","$3,364.96 ","$2,906.10 ",$125.62 ,$125.62 ,$125.62 ,"$2,791.39 ","$2,103.10 ","$3,479.68 ","$3,479.68 ","$3,059.06 ",$194.59 ,"$2,103.10 ","$3,441.44 ",$188.92 ,"$3,441.44 ","$2,064.86 ","$3,594.39 ",$425.07 ,"$3,517.91 ",$133.16 ,"$3,479.68 ",$188.92 ,"$2,353.18 ","$2,353.18 ",$845.54 ,"$2,853.72 ","$1,929.32 ",$190.81 ,$125.62 ,"$3,632.63 ",$198.37 ,$125.62 ,"$3,326.72 ",$188.92 ,"$3,441.44 ",$188.92 ,"$3,441.44 ","$3,441.44 ","$3,441.44 ","$3,709.11 ","$3,097.29 ","$3,556.15 ","$3,288.49 ","$3,709.11 "
SACRED HEART HOSPITAL (ACU),35000065,72192,HC CT PELVIS W/O CONTRAST,350,1 ,"$1,875.01 ","$1,406.26 ",$37.88 ,"$1,875.01 ","$1,207.51 ",$115.15 ,"$1,312.51 ",$37.88 ,"$1,875.01 ",$39.02 ,"$1,875.01 ","$1,781.26 ",$37.88 ,"$1,500.01 ","$1,725.01 ",$37.88 ,"$1,593.76 ","$1,781.26 ","$1,650.01 ","$1,425.01 ",$37.88 ,$37.88 ,$37.88 ,"$1,368.76 ","$1,031.26 ","$1,706.26 ","$1,706.26 ","$1,500.01 ",$118.60 ,"$1,031.26 ","$1,687.51 ",$115.15 ,"$1,687.51 ","$1,012.51 ","$1,762.51 ",$259.08 ,"$1,725.01 ",$40.15 ,"$1,706.26 ",$115.15 ,"$1,153.88 ","$1,153.88 ",$856.07 ,"$1,399.32 ","$1,687.51 ",$116.30 ,$37.88 ,"$1,781.26 ",$120.90 ,$37.88 ,"$1,631.26 ",$115.15 ,"$1,687.51 ",$115.15 ,"$1,687.51 ","$1,687.51 ","$1,687.51 ","$1,818.76 ","$1,518.76 ","$1,743.76 ","$1,612.51 ","$1,818.76 "
SACRED HEART HOSPITAL (ACU),35000066,72193,HC CT PELVIS W/CONTRAST,350,1 ,"$2,147.02 ","$1,610.27 ",$102.60 ,"$2,147.02 ","$1,382.68 ",$188.92 ,"$1,502.91 ",$102.60 ,"$2,147.02 ",$105.68 ,"$1,929.00 ","$2,039.67 ",$102.60 ,"$1,717.62 ","$1,975.26 ",$102.60 ,"$1,824.97 ","$2,039.67 ","$1,889.38 ","$1,631.74 ",$102.60 ,$102.60 ,$102.60 ,"$1,567.32 ","$1,180.86 ","$1,953.79 ","$1,953.79 ","$1,717.62 ",$194.59 ,"$1,180.86 ","$1,932.32 ",$188.92 ,"$1,932.32 ","$1,159.39 ","$2,018.20 ",$425.07 ,"$1,975.26 ",$108.76 ,"$1,953.79 ",$188.92 ,"$1,321.28 ","$1,321.28 ","$1,116.43 ","$1,602.32 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,039.67 ",$198.37 ,$102.60 ,"$1,867.91 ",$188.92 ,"$1,932.32 ",$188.92 ,"$1,932.32 ","$1,932.32 ","$1,932.32 ","$2,082.61 ","$1,739.09 ","$1,996.73 ","$1,846.44 ","$2,082.61 "
SACRED HEART HOSPITAL (ACU),35000067,72194,HC CT PELVIS W AND W/O CONTRAST,350,1 ,"$2,327.64 ","$1,745.73 ",$102.60 ,"$2,327.64 ","$1,499.00 ",$188.92 ,"$1,629.35 ",$102.60 ,"$2,327.64 ",$105.68 ,"$1,929.00 ","$2,211.26 ",$102.60 ,"$1,862.11 ","$2,141.43 ",$102.60 ,"$1,978.49 ","$2,211.26 ","$2,048.32 ","$1,769.01 ",$102.60 ,$102.60 ,$102.60 ,"$1,699.18 ","$1,280.20 ","$2,118.15 ","$2,118.15 ","$1,862.11 ",$194.59 ,"$1,280.20 ","$2,094.88 ",$188.92 ,"$2,094.88 ","$1,256.93 ","$2,187.98 ",$425.07 ,"$2,141.43 ",$108.76 ,"$2,118.15 ",$188.92 ,"$1,432.43 ","$1,432.43 ","$1,217.41 ","$1,737.12 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,211.26 ",$198.37 ,$102.60 ,"$2,025.05 ",$188.92 ,"$2,094.88 ",$188.92 ,"$2,094.88 ","$2,094.88 ","$2,094.88 ","$2,257.81 ","$1,885.39 ","$2,164.71 ","$2,001.77 ","$2,257.81 "
SACRED HEART HOSPITAL (ACU),35000069,73200,HC CT UPPER EXTRM WO CONT,350,1 ,"$1,461.64 ","$1,096.23 ",$37.88 ,"$1,461.64 ",$941.30 ,$115.15 ,"$1,023.15 ",$37.88 ,"$1,461.64 ",$39.02 ,"$1,461.64 ","$1,388.56 ",$37.88 ,"$1,169.31 ","$1,344.71 ",$37.88 ,"$1,242.39 ","$1,388.56 ","$1,286.24 ","$1,110.85 ",$37.88 ,$37.88 ,$37.88 ,"$1,067.00 ",$803.90 ,"$1,330.09 ","$1,330.09 ","$1,169.31 ",$118.60 ,$803.90 ,"$1,315.48 ",$115.15 ,"$1,315.48 ",$789.29 ,"$1,373.94 ",$259.08 ,"$1,344.71 ",$40.15 ,"$1,330.09 ",$115.15 ,$899.49 ,$899.49 ,$771.29 ,"$1,090.82 ","$1,315.48 ",$116.30 ,$37.88 ,"$1,388.56 ",$120.90 ,$37.88 ,"$1,271.63 ",$115.15 ,"$1,315.48 ",$115.15 ,"$1,315.48 ","$1,315.48 ","$1,315.48 ","$1,417.79 ","$1,183.93 ","$1,359.33 ","$1,257.01 ","$1,417.79 "
SACRED HEART HOSPITAL (ACU),35000071,73201,HC CT UPPER EXTRM W CONT,350,1 ,"$1,272.81 ",$954.61 ,$102.60 ,"$1,272.81 ",$819.69 ,$389.47 ,$890.97 ,$102.60 ,"$1,272.81 ",$105.68 ,"$1,272.81 ","$1,209.17 ",$102.60 ,"$1,018.25 ","$1,170.99 ",$102.60 ,"$1,081.89 ","$1,209.17 ","$1,120.07 ",$967.34 ,$102.60 ,$102.60 ,$102.60 ,$929.15 ,$700.05 ,"$1,158.26 ","$1,158.26 ","$1,018.25 ",$401.15 ,$700.05 ,"$1,145.53 ",$389.47 ,"$1,145.53 ",$687.32 ,"$1,196.44 ",$876.31 ,"$1,170.99 ",$108.76 ,"$1,158.26 ",$389.47 ,$783.29 ,$783.29 ,"$1,036.30 ",$949.90 ,"$1,145.53 ",$393.37 ,$102.60 ,"$1,209.17 ",$408.94 ,$102.60 ,"$1,107.34 ",$389.47 ,"$1,145.53 ",$389.47 ,"$1,145.53 ","$1,145.53 ","$1,145.53 ","$1,234.63 ","$1,030.98 ","$1,183.71 ","$1,094.62 ","$1,234.63 "
SACRED HEART HOSPITAL (ACU),35000072,73202,HC CT UPPER EXTR W/WO CONTR,350,1 ,"$1,345.43 ","$1,009.07 ",$102.60 ,"$1,345.43 ",$866.46 ,$188.92 ,$941.80 ,$102.60 ,"$1,345.43 ",$105.68 ,"$1,345.43 ","$1,278.16 ",$102.60 ,"$1,076.34 ","$1,237.80 ",$102.60 ,"$1,143.62 ","$1,278.16 ","$1,183.98 ","$1,022.53 ",$102.60 ,$102.60 ,$102.60 ,$982.16 ,$739.99 ,"$1,224.34 ","$1,224.34 ","$1,076.34 ",$194.59 ,$739.99 ,"$1,210.89 ",$188.92 ,"$1,210.89 ",$726.53 ,"$1,264.70 ",$425.07 ,"$1,237.80 ",$108.76 ,"$1,224.34 ",$188.92 ,$827.98 ,$827.98 ,"$1,162.75 ","$1,004.09 ","$1,210.89 ",$190.81 ,$102.60 ,"$1,278.16 ",$198.37 ,$102.60 ,"$1,170.52 ",$188.92 ,"$1,210.89 ",$188.92 ,"$1,210.89 ","$1,210.89 ","$1,210.89 ","$1,305.07 ","$1,089.80 ","$1,251.25 ","$1,157.07 ","$1,305.07 "
SACRED HEART HOSPITAL (ACU),35000073,73206,HC CT ANGIO UPPER EXTREM W/WO CONT,350,1 ,"$2,064.01 ","$1,548.01 ",$125.62 ,"$2,064.01 ","$1,329.22 ",$188.92 ,"$1,444.81 ",$125.62 ,"$2,064.01 ",$129.39 ,"$1,929.00 ","$1,960.81 ",$125.62 ,"$1,651.21 ","$1,898.89 ",$125.62 ,"$1,754.41 ","$1,960.81 ","$1,816.33 ","$1,568.65 ",$125.62 ,$125.62 ,$125.62 ,"$1,506.73 ","$1,135.21 ","$1,878.25 ","$1,878.25 ","$1,651.21 ",$194.59 ,"$1,135.21 ","$1,857.61 ",$188.92 ,"$1,857.61 ","$1,114.57 ","$1,940.17 ",$425.07 ,"$1,898.89 ",$133.16 ,"$1,878.25 ",$188.92 ,"$1,270.19 ","$1,270.19 ",$743.10 ,"$1,540.37 ","$1,857.61 ",$190.81 ,$125.62 ,"$1,960.81 ",$198.37 ,$125.62 ,"$1,795.69 ",$188.92 ,"$1,857.61 ",$188.92 ,"$1,857.61 ","$1,857.61 ","$1,857.61 ","$2,002.09 ","$1,671.85 ","$1,919.53 ","$1,775.05 ","$2,002.09 "
SACRED HEART HOSPITAL (ACU),35000074,73700,HC CT LOWER EXTRM WO CONT,350,1 ,"$1,290.67 ",$968.00 ,$37.88 ,"$1,290.67 ",$831.19 ,$115.15 ,$903.47 ,$37.88 ,"$1,290.67 ",$39.02 ,"$1,290.67 ","$1,226.14 ",$37.88 ,"$1,032.54 ","$1,187.42 ",$37.88 ,"$1,097.07 ","$1,226.14 ","$1,135.79 ",$980.91 ,$37.88 ,$37.88 ,$37.88 ,$942.19 ,$709.87 ,"$1,174.51 ","$1,174.51 ","$1,032.54 ",$118.60 ,$709.87 ,"$1,161.60 ",$115.15 ,"$1,161.60 ",$696.96 ,"$1,213.23 ",$259.08 ,"$1,187.42 ",$40.15 ,"$1,174.51 ",$115.15 ,$794.28 ,$794.28 ,$771.00 ,$963.23 ,"$1,161.60 ",$116.30 ,$37.88 ,"$1,226.14 ",$120.90 ,$37.88 ,"$1,122.88 ",$115.15 ,"$1,161.60 ",$115.15 ,"$1,161.60 ","$1,161.60 ","$1,161.60 ","$1,251.95 ","$1,045.44 ","$1,200.32 ","$1,109.98 ","$1,251.95 "
SACRED HEART HOSPITAL (ACU),35000075,73701,HC CT LOWER EXTREMITY W/CON,350,1 ,"$1,376.35 ","$1,032.26 ",$102.60 ,"$1,376.35 ",$886.37 ,$188.92 ,$963.45 ,$102.60 ,"$1,376.35 ",$105.68 ,"$1,376.35 ","$1,307.53 ",$102.60 ,"$1,101.08 ","$1,266.24 ",$102.60 ,"$1,169.90 ","$1,307.53 ","$1,211.19 ","$1,046.03 ",$102.60 ,$102.60 ,$102.60 ,"$1,004.74 ",$756.99 ,"$1,252.48 ","$1,252.48 ","$1,101.08 ",$194.59 ,$756.99 ,"$1,238.72 ",$188.92 ,"$1,238.72 ",$743.23 ,"$1,293.77 ",$425.07 ,"$1,266.24 ",$108.76 ,"$1,252.48 ",$188.92 ,$847.01 ,$847.01 ,$927.52 ,"$1,027.17 ","$1,238.72 ",$190.81 ,$102.60 ,"$1,307.53 ",$198.37 ,$102.60 ,"$1,197.42 ",$188.92 ,"$1,238.72 ",$188.92 ,"$1,238.72 ","$1,238.72 ","$1,238.72 ","$1,335.06 ","$1,114.84 ","$1,280.01 ","$1,183.66 ","$1,335.06 "
SACRED HEART HOSPITAL (ACU),35000077,73702,HC CT LOWER EXTR W/WO CONTR,350,1 ,$913.11 ,$684.83 ,$102.60 ,$913.11 ,$588.04 ,$188.92 ,$639.18 ,$102.60 ,$913.11 ,$105.68 ,$913.11 ,$867.45 ,$102.60 ,$730.49 ,$840.06 ,$102.60 ,$776.14 ,$867.45 ,$803.54 ,$693.96 ,$102.60 ,$102.60 ,$102.60 ,$666.57 ,$502.21 ,$830.93 ,$830.93 ,$730.49 ,$194.59 ,$502.21 ,$821.80 ,$188.92 ,$821.80 ,$493.08 ,$858.32 ,$425.07 ,$840.06 ,$108.76 ,$830.93 ,$188.92 ,$561.93 ,$561.93 ,$913.11 ,$681.45 ,$821.80 ,$190.81 ,$102.60 ,$867.45 ,$198.37 ,$102.60 ,$794.41 ,$188.92 ,$821.80 ,$188.92 ,$821.80 ,$821.80 ,$821.80 ,$885.72 ,$739.62 ,$849.19 ,$785.27 ,$885.72 
SACRED HEART HOSPITAL (ACU),35000078,73706,HC CT ANGIO LOWER EXTREM W/WO CONTR,350,1 ,"$4,320.88 ","$3,240.66 ",$125.62 ,"$4,320.88 ","$2,782.65 ",$188.92 ,"$3,024.62 ",$125.62 ,"$2,412.00 ",$129.39 ,"$1,929.00 ","$4,104.84 ",$125.62 ,"$3,456.70 ","$3,975.21 ",$125.62 ,"$3,672.75 ","$4,104.84 ","$3,802.37 ","$3,283.87 ",$125.62 ,$125.62 ,$125.62 ,"$3,154.24 ","$2,376.48 ","$3,932.00 ","$3,932.00 ","$3,456.70 ",$194.59 ,"$2,376.48 ","$3,888.79 ",$188.92 ,"$3,888.79 ","$2,333.28 ","$4,061.63 ",$425.07 ,"$3,975.21 ",$133.16 ,"$3,932.00 ",$188.92 ,"$2,659.07 ","$2,659.07 ",$743.10 ,"$3,224.67 ","$1,929.32 ",$190.81 ,$125.62 ,"$4,104.84 ",$198.37 ,$125.62 ,"$3,759.17 ",$188.92 ,"$3,888.79 ",$188.92 ,"$3,888.79 ","$3,888.79 ","$3,888.79 ","$4,191.25 ","$3,499.91 ","$4,018.42 ","$3,715.96 ","$4,191.25 "
SACRED HEART HOSPITAL (ACU),35000079,74150,HC CT ABD W/O CONTRAST,350,1 ,"$2,008.27 ","$1,506.20 ",$37.88 ,"$2,008.27 ","$1,293.33 ",$115.15 ,"$1,405.79 ",$37.88 ,"$2,008.27 ",$39.02 ,"$1,929.00 ","$1,907.86 ",$37.88 ,"$1,606.62 ","$1,847.61 ",$37.88 ,"$1,707.03 ","$1,907.86 ","$1,767.28 ","$1,526.29 ",$37.88 ,$37.88 ,$37.88 ,"$1,466.04 ","$1,104.55 ","$1,827.53 ","$1,827.53 ","$1,606.62 ",$118.60 ,"$1,104.55 ","$1,807.44 ",$115.15 ,"$1,807.44 ","$1,084.47 ","$1,887.77 ",$259.08 ,"$1,847.61 ",$40.15 ,"$1,827.53 ",$115.15 ,"$1,235.89 ","$1,235.89 ",$806.12 ,"$1,498.77 ","$1,807.44 ",$116.30 ,$37.88 ,"$1,907.86 ",$120.90 ,$37.88 ,"$1,747.19 ",$115.15 ,"$1,807.44 ",$115.15 ,"$1,807.44 ","$1,807.44 ","$1,807.44 ","$1,948.02 ","$1,626.70 ","$1,867.69 ","$1,727.11 ","$1,948.02 "
SACRED HEART HOSPITAL (ACU),35000080,74160,HC CT ABDOMEN W/CONTRAST,350,1 ,"$2,289.97 ","$1,717.48 ",$102.60 ,"$2,289.97 ","$1,474.74 ",$188.92 ,"$1,602.98 ",$102.60 ,"$2,289.97 ",$105.68 ,"$1,929.00 ","$2,175.47 ",$102.60 ,"$1,831.98 ","$2,106.77 ",$102.60 ,"$1,946.47 ","$2,175.47 ","$2,015.17 ","$1,740.38 ",$102.60 ,$102.60 ,$102.60 ,"$1,671.68 ","$1,259.48 ","$2,083.87 ","$2,083.87 ","$1,831.98 ",$194.59 ,"$1,259.48 ","$2,060.97 ",$188.92 ,"$2,060.97 ","$1,236.58 ","$2,152.57 ",$425.07 ,"$2,106.77 ",$108.76 ,"$2,083.87 ",$188.92 ,"$1,409.25 ","$1,409.25 ","$1,104.11 ","$1,709.00 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,175.47 ",$198.37 ,$102.60 ,"$1,992.27 ",$188.92 ,"$2,060.97 ",$188.92 ,"$2,060.97 ","$2,060.97 ","$2,060.97 ","$2,221.27 ","$1,854.88 ","$2,129.67 ","$1,969.37 ","$2,221.27 "
SACRED HEART HOSPITAL (ACU),35000081,74170,HC CT ABDOMEN W AND W/O CONTRAST,350,1 ,"$2,435.20 ","$1,826.40 ",$102.60 ,"$2,435.20 ","$1,568.27 ",$188.92 ,"$1,704.64 ",$102.60 ,"$2,412.00 ",$105.68 ,"$1,929.00 ","$2,313.44 ",$102.60 ,"$1,948.16 ","$2,240.38 ",$102.60 ,"$2,069.92 ","$2,313.44 ","$2,142.98 ","$1,850.75 ",$102.60 ,$102.60 ,$102.60 ,"$1,777.70 ","$1,339.36 ","$2,216.03 ","$2,216.03 ","$1,948.16 ",$194.59 ,"$1,339.36 ","$2,191.68 ",$188.92 ,"$2,191.68 ","$1,315.01 ","$2,289.09 ",$425.07 ,"$2,240.38 ",$108.76 ,"$2,216.03 ",$188.92 ,"$1,498.62 ","$1,498.62 ","$1,187.43 ","$1,817.39 ","$1,929.32 ",$190.81 ,$102.60 ,"$2,313.44 ",$198.37 ,$102.60 ,"$2,118.62 ",$188.92 ,"$2,191.68 ",$188.92 ,"$2,191.68 ","$2,191.68 ","$2,191.68 ","$2,362.14 ","$1,972.51 ","$2,264.74 ","$2,094.27 ","$2,362.14 "
SACRED HEART HOSPITAL (ACU),35000082,74175,HC CTA ABDOMEN W AND W/O CONTRAST,350,1 ,"$3,861.03 ","$2,895.77 ",$125.62 ,"$3,861.03 ","$2,486.50 ",$188.92 ,"$2,702.72 ",$125.62 ,"$2,412.00 ",$129.39 ,"$1,929.00 ","$3,667.98 ",$125.62 ,"$3,088.82 ","$3,552.15 ",$125.62 ,"$3,281.88 ","$3,667.98 ","$3,397.71 ","$2,934.38 ",$125.62 ,$125.62 ,$125.62 ,"$2,818.55 ","$2,123.57 ","$3,513.54 ","$3,513.54 ","$3,088.82 ",$194.59 ,"$2,123.57 ","$3,474.93 ",$188.92 ,"$3,474.93 ","$2,084.96 ","$3,629.37 ",$425.07 ,"$3,552.15 ",$133.16 ,"$3,513.54 ",$188.92 ,"$2,376.08 ","$2,376.08 ",$845.54 ,"$2,881.49 ","$1,929.32 ",$190.81 ,$125.62 ,"$3,667.98 ",$198.37 ,$125.62 ,"$3,359.10 ",$188.92 ,"$3,474.93 ",$188.92 ,"$3,474.93 ","$3,474.93 ","$3,474.93 ","$3,745.20 ","$3,127.43 ","$3,590.76 ","$3,320.49 ","$3,745.20 "
SACRED HEART HOSPITAL (ACU),35000083,74176,HC CT ABDOMEN/PELVIS W/O CONTRAST,350,1 ,"$2,595.20 ","$1,946.40 ",$102.60 ,"$2,595.20 ","$1,671.31 ",$243.36 ,"$1,816.64 ",$102.60 ,"$2,412.00 ",$105.68 ,"$1,929.00 ","$2,465.44 ",$102.60 ,"$2,076.16 ","$2,387.58 ",$102.60 ,"$2,205.92 ","$2,465.44 ","$2,283.78 ","$1,972.35 ",$102.60 ,$102.60 ,$102.60 ,"$1,894.50 ","$1,427.36 ","$2,361.63 ","$2,361.63 ","$2,076.16 ",$250.66 ,"$1,427.36 ","$2,335.68 ",$243.36 ,"$2,335.68 ","$1,401.41 ","$2,439.49 ",$547.56 ,"$2,387.58 ",$108.76 ,"$2,361.63 ",$243.36 ,"$1,597.09 ","$1,597.09 ",$265.59 ,"$1,936.80 ","$1,929.32 ",$245.79 ,$102.60 ,"$2,465.44 ",$255.53 ,$102.60 ,"$2,257.82 ",$243.36 ,"$2,335.68 ",$243.36 ,"$2,335.68 ","$2,335.68 ","$2,335.68 ","$2,517.34 ","$2,102.11 ","$2,413.54 ","$2,231.87 ","$2,517.34 "
SACRED HEART HOSPITAL (ACU),35000084,74177,HC CT ABDOMEN/PELVIS W/CONTRAST,350,1 ,"$3,537.84 ","$2,653.38 ",$102.60 ,"$3,537.84 ","$2,278.37 ",$389.47 ,"$2,476.49 ",$102.60 ,"$2,412.00 ",$105.68 ,"$1,929.00 ","$3,360.95 ",$102.60 ,"$2,830.27 ","$3,254.81 ",$102.60 ,"$3,007.16 ","$3,360.95 ","$3,113.30 ","$2,688.76 ",$102.60 ,$102.60 ,$102.60 ,"$2,582.62 ","$1,945.81 ","$3,219.43 ","$3,219.43 ","$2,830.27 ",$401.15 ,"$1,945.81 ","$3,184.06 ",$389.47 ,"$3,184.06 ","$1,910.43 ","$3,325.57 ",$876.31 ,"$3,254.81 ",$108.76 ,"$3,219.43 ",$389.47 ,"$2,177.19 ","$2,177.19 ",$506.53 ,"$2,640.29 ","$1,929.32 ",$393.37 ,$102.60 ,"$3,360.95 ",$408.94 ,$102.60 ,"$3,077.92 ",$389.47 ,"$3,184.06 ",$389.47 ,"$3,184.06 ","$3,184.06 ","$3,184.06 ","$3,431.70 ","$2,865.65 ","$3,290.19 ","$3,042.54 ","$3,431.70 "
SACRED HEART HOSPITAL (ACU),35000085,74178,HC CT ABDOMEN/PELVIS W AND W/O CONTR,350,1 ,"$3,659.03 ","$2,744.27 ",$102.60 ,"$3,659.03 ","$2,356.42 ",$389.47 ,"$2,561.32 ",$102.60 ,"$2,412.00 ",$105.68 ,"$1,929.00 ","$3,476.08 ",$102.60 ,"$2,927.22 ","$3,366.31 ",$102.60 ,"$3,110.18 ","$3,476.08 ","$3,219.95 ","$2,780.86 ",$102.60 ,$102.60 ,$102.60 ,"$2,671.09 ","$2,012.47 ","$3,329.72 ","$3,329.72 ","$2,927.22 ",$401.15 ,"$2,012.47 ","$3,293.13 ",$389.47 ,"$3,293.13 ","$1,975.88 ","$3,439.49 ",$876.31 ,"$3,366.31 ",$108.76 ,"$3,329.72 ",$389.47 ,"$2,251.77 ","$2,251.77 ",$669.44 ,"$2,730.73 ","$1,929.32 ",$393.37 ,$102.60 ,"$3,476.08 ",$408.94 ,$102.60 ,"$3,183.36 ",$389.47 ,"$3,293.13 ",$389.47 ,"$3,293.13 ","$3,293.13 ","$3,293.13 ","$3,549.26 ","$2,963.81 ","$3,402.90 ","$3,146.77 ","$3,549.26 "
SACRED HEART HOSPITAL (ACU),35000086,74261,HC CT VIRTUAL COLONOSCOPY DX,350,1 ,"$1,299.85 ",$974.89 ,$37.88 ,"$1,299.85 ",$837.10 ,$115.15 ,$909.90 ,$37.88 ,"$1,299.85 ",$39.02 ,"$1,299.85 ","$1,234.86 ",$37.88 ,"$1,039.88 ","$1,195.86 ",$37.88 ,"$1,104.87 ","$1,234.86 ","$1,143.87 ",$987.89 ,$37.88 ,$37.88 ,$37.88 ,$948.89 ,$714.92 ,"$1,182.86 ","$1,182.86 ","$1,039.88 ",$118.60 ,$714.92 ,"$1,169.87 ",$115.15 ,"$1,169.87 ",$701.92 ,"$1,221.86 ",$259.08 ,"$1,195.86 ",$40.15 ,"$1,182.86 ",$115.15 ,$799.93 ,$799.93 ,$566.08 ,$970.08 ,"$1,169.87 ",$116.30 ,$37.88 ,"$1,234.86 ",$120.90 ,$37.88 ,"$1,130.87 ",$115.15 ,"$1,169.87 ",$115.15 ,"$1,169.87 ","$1,169.87 ","$1,169.87 ","$1,260.85 ","$1,052.88 ","$1,208.86 ","$1,117.87 ","$1,260.85 "
SACRED HEART HOSPITAL (ACU),35000087,75571,HC CT HRT W/O DYE W/CA TEST,350,1 ,$755.82 ,$566.87 ,$37.88 ,$755.82 ,$486.75 ,$85.55 ,$529.07 ,$37.88 ,$755.82 ,$39.02 ,$755.82 ,$718.03 ,$37.88 ,$604.66 ,$695.35 ,$37.88 ,$642.45 ,$718.03 ,$665.12 ,$574.42 ,$37.88 ,$37.88 ,$37.88 ,$551.75 ,$415.70 ,$687.80 ,$687.80 ,$604.66 ,$88.12 ,$415.70 ,$680.24 ,$85.55 ,$680.24 ,$408.14 ,$710.47 ,$192.49 ,$695.35 ,$40.15 ,$687.80 ,$85.55 ,$465.13 ,$465.13 ,$117.05 ,$564.07 ,$680.24 ,$86.40 ,$37.88 ,$718.03 ,$89.83 ,$37.88 ,$657.56 ,$85.55 ,$680.24 ,$85.55 ,$680.24 ,$680.24 ,$680.24 ,$733.15 ,$612.21 ,$702.91 ,$650.01 ,$733.15 
SACRED HEART HOSPITAL (ACU),35000088,N/A,HC CT HRT W/O DYE W/CA TEST (PROMO),350,1 ,$100.00 ,$75.00 ,$54.00 ,$100.00 ,$64.40 , N/A ,$70.00 , N/A ,$100.00 , N/A ,$100.00 ,$95.00 , N/A ,$80.00 ,$92.00 , N/A ,$85.00 ,$95.00 ,$88.00 ,$76.00 , N/A , N/A , N/A ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 , N/A ,$55.00 ,$90.00 , N/A ,$90.00 ,$54.00 ,$94.00 , N/A ,$92.00 , N/A ,$91.00 , N/A ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$90.00 , N/A , N/A ,$95.00 , N/A , N/A ,$87.00 , N/A ,$90.00 , N/A ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),35000089,75572,HC CT HEART WO/W CONT FUNCT EVAL,350,1 ,"$1,140.05 ",$855.04 ,$102.60 ,"$1,140.05 ",$734.19 ,$188.92 ,$798.04 ,$102.60 ,"$1,140.05 ",$105.68 ,"$1,140.05 ","$1,083.05 ",$102.60 ,$912.04 ,"$1,048.85 ",$102.60 ,$969.04 ,"$1,083.05 ","$1,003.24 ",$866.44 ,$102.60 ,$102.60 ,$102.60 ,$832.24 ,$627.03 ,"$1,037.45 ","$1,037.45 ",$912.04 ,$194.59 ,$627.03 ,"$1,026.05 ",$188.92 ,"$1,026.05 ",$615.63 ,"$1,071.65 ",$425.07 ,"$1,048.85 ",$108.76 ,"$1,037.45 ",$188.92 ,$701.59 ,$701.59 ,$337.46 ,$850.82 ,"$1,026.05 ",$190.81 ,$102.60 ,"$1,083.05 ",$198.37 ,$102.60 ,$991.84 ,$188.92 ,"$1,026.05 ",$188.92 ,"$1,026.05 ","$1,026.05 ","$1,026.05 ","$1,105.85 ",$923.44 ,"$1,060.25 ",$980.44 ,"$1,105.85 "
SACRED HEART HOSPITAL (ACU),35000091,75574,HC CT CARD ANGIO W/CALC SCORING,350,1 ,"$1,891.06 ","$1,418.30 ",$125.62 ,"$1,891.06 ","$1,217.84 ",$188.92 ,"$1,323.74 ",$125.62 ,"$1,891.06 ",$129.39 ,"$1,891.06 ","$1,796.51 ",$125.62 ,"$1,512.85 ","$1,739.78 ",$125.62 ,"$1,607.40 ","$1,796.51 ","$1,664.13 ","$1,437.21 ",$125.62 ,$125.62 ,$125.62 ,"$1,380.47 ","$1,040.08 ","$1,720.86 ","$1,720.86 ","$1,512.85 ",$194.59 ,"$1,040.08 ","$1,701.95 ",$188.92 ,"$1,701.95 ","$1,021.17 ","$1,777.60 ",$425.07 ,"$1,739.78 ",$133.16 ,"$1,720.86 ",$188.92 ,"$1,163.76 ","$1,163.76 ",$880.27 ,"$1,411.30 ","$1,701.95 ",$190.81 ,$125.62 ,"$1,796.51 ",$198.37 ,$125.62 ,"$1,645.22 ",$188.92 ,"$1,701.95 ",$188.92 ,"$1,701.95 ","$1,701.95 ","$1,701.95 ","$1,834.33 ","$1,531.76 ","$1,758.69 ","$1,626.31 ","$1,834.33 "
SACRED HEART HOSPITAL (ACU),35000094,75574,HC CTA HEART CORONARY W/CONTRAST 3D POST,350,1 ,"$1,891.06 ","$1,418.30 ",$125.62 ,"$1,891.06 ","$1,217.84 ",$188.92 ,"$1,323.74 ",$125.62 ,"$1,891.06 ",$129.39 ,"$1,891.06 ","$1,796.51 ",$125.62 ,"$1,512.85 ","$1,739.78 ",$125.62 ,"$1,607.40 ","$1,796.51 ","$1,664.13 ","$1,437.21 ",$125.62 ,$125.62 ,$125.62 ,"$1,380.47 ","$1,040.08 ","$1,720.86 ","$1,720.86 ","$1,512.85 ",$194.59 ,"$1,040.08 ","$1,701.95 ",$188.92 ,"$1,701.95 ","$1,021.17 ","$1,777.60 ",$425.07 ,"$1,739.78 ",$133.16 ,"$1,720.86 ",$188.92 ,"$1,163.76 ","$1,163.76 ",$880.27 ,"$1,411.30 ","$1,701.95 ",$190.81 ,$125.62 ,"$1,796.51 ",$198.37 ,$125.62 ,"$1,645.22 ",$188.92 ,"$1,701.95 ",$188.92 ,"$1,701.95 ","$1,701.95 ","$1,701.95 ","$1,834.33 ","$1,531.76 ","$1,758.69 ","$1,626.31 ","$1,834.33 "
SACRED HEART HOSPITAL (ACU),35000098,75635,HC CTA ABDOMEN AORTA ILIOFEM RUNOFF,350,1 ,"$4,406.26 ","$3,304.70 ",$125.62 ,"$4,406.26 ","$2,837.63 ",$188.92 ,"$3,084.38 ",$125.62 ,"$2,412.00 ",$129.39 ,"$1,929.00 ","$4,185.95 ",$125.62 ,"$3,525.01 ","$4,053.76 ",$125.62 ,"$3,745.32 ","$4,185.95 ","$3,877.51 ","$3,348.76 ",$125.62 ,$125.62 ,$125.62 ,"$3,216.57 ","$2,423.44 ","$4,009.70 ","$4,009.70 ","$3,525.01 ",$194.59 ,"$2,423.44 ","$3,965.63 ",$188.92 ,"$3,965.63 ","$2,379.38 ","$4,141.88 ",$425.07 ,"$4,053.76 ",$133.16 ,"$4,009.70 ",$188.92 ,"$2,711.61 ","$2,711.61 ",$845.54 ,"$3,288.39 ","$1,929.32 ",$190.81 ,$125.62 ,"$4,185.95 ",$198.37 ,$125.62 ,"$3,833.45 ",$188.92 ,"$3,965.63 ",$188.92 ,"$3,965.63 ","$3,965.63 ","$3,965.63 ","$4,274.07 ","$3,569.07 ","$4,097.82 ","$3,789.38 ","$4,274.07 "
SACRED HEART HOSPITAL (ACU),35000099,76376,HC 3D RENDER CT NOT REQUIRE INDEP,350,1 ,$291.00 ,$218.25 ,$157.14 ,$291.00 ,$187.40 , N/A ,$203.70 , N/A ,$291.00 , N/A ,$291.00 ,$276.45 , N/A ,$232.80 ,$267.72 , N/A ,$247.35 ,$276.45 ,$256.08 ,$221.16 , N/A , N/A , N/A ,$212.43 ,$160.05 ,$264.81 ,$264.81 ,$232.80 , N/A ,$160.05 ,$261.90 , N/A ,$261.90 ,$157.14 ,$273.54 , N/A ,$267.72 , N/A ,$264.81 , N/A ,$179.08 ,$179.08 ,$270.22 ,$217.17 ,$261.90 , N/A , N/A ,$276.45 , N/A , N/A ,$253.17 , N/A ,$261.90 , N/A ,$261.90 ,$261.90 ,$261.90 ,$282.27 ,$235.71 ,$270.63 ,$250.26 ,$282.27 
SACRED HEART HOSPITAL (ACU),35000100,76377,HC 3D RENDER CT REQUIRES INDEPENDENT,350,1 ,"$1,275.00 ",$956.25 ,$287.93 ,"$1,275.00 ",$821.10 , N/A ,$892.50 , N/A ,"$1,275.00 ", N/A ,"$1,275.00 ","$1,211.25 ", N/A ,"$1,020.00 ","$1,173.00 ", N/A ,"$1,083.75 ","$1,211.25 ","$1,122.00 ",$969.00 , N/A , N/A , N/A ,$930.75 ,$701.25 ,"$1,160.25 ","$1,160.25 ","$1,020.00 ", N/A ,$701.25 ,"$1,147.50 ", N/A ,"$1,147.50 ",$688.50 ,"$1,198.50 ", N/A ,"$1,173.00 ", N/A ,"$1,160.25 ", N/A ,$784.64 ,$784.64 ,$287.93 ,$951.53 ,"$1,147.50 ", N/A , N/A ,"$1,211.25 ", N/A , N/A ,"$1,109.25 ", N/A ,"$1,147.50 ", N/A ,"$1,147.50 ","$1,147.50 ","$1,147.50 ","$1,236.75 ","$1,032.75 ","$1,185.75 ","$1,096.50 ","$1,236.75 "
SACRED HEART HOSPITAL (ACU),35000101,76380,HC CT LMTD OR LOCALIZ FU STUDY,350,1 ,$469.22 ,$351.92 ,$37.88 ,$469.22 ,$302.18 ,$85.55 ,$328.45 ,$37.88 ,$469.22 ,$39.02 ,$469.22 ,$445.76 ,$37.88 ,$375.38 ,$431.68 ,$37.88 ,$398.84 ,$445.76 ,$412.91 ,$356.61 ,$37.88 ,$37.88 ,$37.88 ,$342.53 ,$258.07 ,$426.99 ,$426.99 ,$375.38 ,$88.12 ,$258.07 ,$422.30 ,$85.55 ,$422.30 ,$253.38 ,$441.07 ,$192.49 ,$431.68 ,$40.15 ,$426.99 ,$85.55 ,$288.76 ,$288.76 ,$469.22 ,$350.18 ,$422.30 ,$86.40 ,$37.88 ,$445.76 ,$89.83 ,$37.88 ,$408.22 ,$85.55 ,$422.30 ,$85.55 ,$422.30 ,$422.30 ,$422.30 ,$455.14 ,$380.07 ,$436.37 ,$403.53 ,$455.14 
SACRED HEART HOSPITAL (ACU),35000106,77012,HC CT GUIDED NEEDLE PLACEMENT,350,1 ,"$1,833.07 ","$1,374.80 ",$30.21 ,"$1,833.07 ","$1,180.50 ", N/A ,"$1,283.15 ",$30.21 ,"$1,833.07 ",$31.12 ,"$1,833.07 ","$1,741.42 ",$30.21 ,"$1,466.46 ","$1,686.42 ",$30.21 ,"$1,558.11 ","$1,741.42 ","$1,613.10 ","$1,393.13 ",$30.21 ,$30.21 ,$30.21 ,"$1,338.14 ","$1,008.19 ","$1,668.09 ","$1,668.09 ","$1,466.46 ", N/A ,"$1,008.19 ","$1,649.76 ", N/A ,"$1,649.76 ",$989.86 ,"$1,723.09 ", N/A ,"$1,686.42 ",$32.02 ,"$1,668.09 ", N/A ,"$1,128.07 ","$1,128.07 ",$517.77 ,"$1,368.02 ","$1,649.76 ", N/A ,$30.21 ,"$1,741.42 ", N/A ,$30.21 ,"$1,594.77 ", N/A ,"$1,649.76 ", N/A ,"$1,649.76 ","$1,649.76 ","$1,649.76 ","$1,778.08 ","$1,484.79 ","$1,704.76 ","$1,576.44 ","$1,778.08 "
SACRED HEART HOSPITAL (ACU),35000109,77013,HC CT GUIDED FOR ABLATION,350,1 ,$807.28 ,$605.46 ,$30.21 ,$807.28 ,$519.89 , N/A ,$565.10 ,$30.21 ,$807.28 ,$31.12 ,$807.28 ,$766.92 ,$30.21 ,$645.82 ,$742.70 ,$30.21 ,$686.19 ,$766.92 ,$710.41 ,$613.53 ,$30.21 ,$30.21 ,$30.21 ,$589.31 ,$444.00 ,$734.62 ,$734.62 ,$645.82 , N/A ,$444.00 ,$726.55 , N/A ,$726.55 ,$435.93 ,$758.84 , N/A ,$742.70 ,$32.02 ,$734.62 , N/A ,$496.80 ,$496.80 ,$188.95 ,$602.47 ,$726.55 , N/A ,$30.21 ,$766.92 , N/A ,$30.21 ,$702.33 , N/A ,$726.55 , N/A ,$726.55 ,$726.55 ,$726.55 ,$783.06 ,$653.90 ,$750.77 ,$694.26 ,$783.06 
SACRED HEART HOSPITAL (ACU),35000110,77014,HC CT GUIDED THRPY PLACEMENT,350,1 ,$279.30 ,$209.48 ,$30.21 ,$279.30 ,$179.87 , N/A ,$195.51 ,$30.21 ,$279.30 ,$31.12 ,$279.30 ,$265.34 ,$30.21 ,$223.44 ,$256.96 ,$30.21 ,$237.41 ,$265.34 ,$245.78 ,$212.27 ,$30.21 ,$30.21 ,$30.21 ,$203.89 ,$153.62 ,$254.16 ,$254.16 ,$223.44 , N/A ,$153.62 ,$251.37 , N/A ,$251.37 ,$150.82 ,$262.54 , N/A ,$256.96 ,$32.02 ,$254.16 , N/A ,$171.88 ,$171.88 ,$249.73 ,$208.44 ,$251.37 , N/A ,$30.21 ,$265.34 , N/A ,$30.21 ,$242.99 , N/A ,$251.37 , N/A ,$251.37 ,$251.37 ,$251.37 ,$270.92 ,$226.23 ,$259.75 ,$240.20 ,$270.92 
SACRED HEART HOSPITAL (ACU),35000111,77014,HC CT GUIDED THRPY PLACEMENT UNENHAN,350,1 ,$279.30 ,$209.48 ,$30.21 ,$279.30 ,$179.87 , N/A ,$195.51 ,$30.21 ,$279.30 ,$31.12 ,$279.30 ,$265.34 ,$30.21 ,$223.44 ,$256.96 ,$30.21 ,$237.41 ,$265.34 ,$245.78 ,$212.27 ,$30.21 ,$30.21 ,$30.21 ,$203.89 ,$153.62 ,$254.16 ,$254.16 ,$223.44 , N/A ,$153.62 ,$251.37 , N/A ,$251.37 ,$150.82 ,$262.54 , N/A ,$256.96 ,$32.02 ,$254.16 , N/A ,$171.88 ,$171.88 ,$249.73 ,$208.44 ,$251.37 , N/A ,$30.21 ,$265.34 , N/A ,$30.21 ,$242.99 , N/A ,$251.37 , N/A ,$251.37 ,$251.37 ,$251.37 ,$270.92 ,$226.23 ,$259.75 ,$240.20 ,$270.92 
SACRED HEART HOSPITAL (ACU),35000113,51102,HC ASPIRATION OF BLADDER AND INSERT SUPRAPUBIC CATH,350,1 ,"$2,039.00 ","$1,529.25 ",$506.66 ,"$4,260.86 ","$1,313.12 ","$1,893.71 ","$1,427.30 ",$506.66 ,"$2,039.00 ",$521.86 ,"$1,929.00 ","$1,937.05 ",$506.66 ,"$1,631.20 ","$1,875.88 ",$506.66 ,"$1,733.15 ","$1,937.05 ","$1,794.32 ","$1,549.64 ",$506.66 ,$506.66 ,$506.66 ,"$1,488.47 ","$1,121.45 ","$1,855.49 ","$1,855.49 ","$1,631.20 ","$1,950.52 ","$1,121.45 ","$1,835.10 ","$1,893.71 ","$1,835.10 ","$1,101.06 ","$1,916.66 ","$4,260.86 ","$1,875.88 ",$537.06 ,"$1,855.49 ","$1,893.71 ","$1,254.80 ","$1,254.80 ","$1,835.10 ","$1,521.71 ","$1,835.10 ","$1,912.65 ",$506.66 ,"$1,937.05 ","$1,988.40 ",$506.66 ,"$1,773.93 ","$1,893.71 ","$1,835.10 ","$1,893.71 ","$1,835.10 ","$1,835.10 ","$1,835.10 ","$1,977.83 ","$1,651.59 ","$1,896.27 ","$1,753.54 ","$1,977.83 "
SACRED HEART HOSPITAL (ACU),35000116,64510,HC INJECT STELLATE GANGLION,350,1 ,"$2,438.00 ","$1,828.50 ",$376.63 ,"$2,438.00 ","$1,570.07 ",$870.64 ,"$1,706.60 ",$376.63 ,"$2,412.00 ",$387.93 ,"$1,929.00 ","$2,316.10 ",$376.63 ,"$1,950.40 ","$2,242.96 ",$376.63 ,"$2,072.30 ","$2,316.10 ","$2,145.44 ","$1,852.88 ",$376.63 ,$376.63 ,$376.63 ,"$1,779.74 ","$1,340.90 ","$2,218.58 ","$2,218.58 ","$1,950.40 ",$896.76 ,"$1,340.90 ","$2,194.20 ",$870.64 ,"$2,194.20 ","$1,316.52 ","$2,291.72 ","$1,958.95 ","$2,242.96 ",$399.23 ,"$2,218.58 ",$870.64 ,"$1,500.35 ","$1,500.35 ","$2,194.20 ","$1,819.48 ","$1,929.32 ",$879.35 ,$376.63 ,"$2,316.10 ",$914.18 ,$376.63 ,"$2,121.06 ",$870.64 ,"$2,194.20 ",$870.64 ,"$2,194.20 ","$2,194.20 ","$2,194.20 ","$2,364.86 ","$1,974.78 ","$2,267.34 ","$2,096.68 ","$2,364.86 "
SACRED HEART HOSPITAL (ACU),35000120,74174,HC CT ANGIO ABD/PELV W  AND  WO CONTRAST,350,1 ,"$1,798.80 ","$1,349.10 ",$125.62 ,"$1,798.80 ","$1,158.43 ",$389.47 ,"$1,259.16 ",$125.62 ,"$1,798.80 ",$129.39 ,"$1,798.80 ","$1,708.86 ",$125.62 ,"$1,439.04 ","$1,654.90 ",$125.62 ,"$1,528.98 ","$1,708.86 ","$1,582.94 ","$1,367.09 ",$125.62 ,$125.62 ,$125.62 ,"$1,313.12 ",$989.34 ,"$1,636.91 ","$1,636.91 ","$1,439.04 ",$401.15 ,$989.34 ,"$1,618.92 ",$389.47 ,"$1,618.92 ",$971.35 ,"$1,690.87 ",$876.31 ,"$1,654.90 ",$133.16 ,"$1,636.91 ",$389.47 ,"$1,106.98 ","$1,106.98 ",$918.60 ,"$1,342.44 ","$1,618.92 ",$393.37 ,$125.62 ,"$1,708.86 ",$408.94 ,$125.62 ,"$1,564.96 ",$389.47 ,"$1,618.92 ",$389.47 ,"$1,618.92 ","$1,618.92 ","$1,618.92 ","$1,744.84 ","$1,457.03 ","$1,672.88 ","$1,546.97 ","$1,744.84 "
SACRED HEART HOSPITAL (ACU),35000132,G0260,HC INJECTION SACRO JOINT W/ ANESTH,350,1 ,"$2,023.00 ","$1,517.25 ",$159.92 ,"$2,023.00 ","$1,302.81 ",$671.59 ,"$1,416.10 ",$159.92 ,"$2,023.00 ",$164.72 ,"$1,929.00 ","$1,921.85 ",$159.92 ,"$1,618.40 ","$1,861.16 ",$159.92 ,"$1,719.55 ","$1,921.85 ","$1,780.24 ","$1,537.48 ",$159.92 ,$159.92 ,$159.92 ,"$1,476.79 ","$1,112.65 ","$1,840.93 ","$1,840.93 ","$1,618.40 ",$691.74 ,"$1,112.65 ","$1,820.70 ",$671.59 ,"$1,820.70 ","$1,092.42 ","$1,901.62 ","$1,511.09 ","$1,861.16 ",$169.52 ,"$1,840.93 ",$671.59 ,"$1,244.95 ","$1,244.95 ","$1,820.70 ","$1,509.76 ","$1,820.70 ",$678.31 ,$159.92 ,"$1,921.85 ",$705.17 ,$159.92 ,"$1,760.01 ",$671.59 ,"$1,820.70 ",$671.59 ,"$1,820.70 ","$1,820.70 ","$1,820.70 ","$1,962.31 ","$1,638.63 ","$1,881.39 ","$1,739.78 ","$1,962.31 "
SACRED HEART HOSPITAL (ACU),35000154,71271,HC CT THORAX LOW DOSE LUNG SCN W/O CONTAST,350,1 ,$479.75 ,$359.81 ,$37.88 ,$479.75 ,$308.96 ,$115.15 ,$335.83 ,$37.88 ,$479.75 ,$39.02 ,$479.75 ,$455.76 ,$37.88 ,$383.80 ,$441.37 ,$37.88 ,$407.79 ,$455.76 ,$422.18 ,$364.61 ,$37.88 ,$37.88 ,$37.88 ,$350.22 ,$263.86 ,$436.57 ,$436.57 ,$383.80 ,$118.60 ,$263.86 ,$431.78 ,$115.15 ,$431.78 ,$259.07 ,$450.97 ,$259.08 ,$441.37 ,$40.15 ,$436.57 ,$115.15 ,$295.24 ,$295.24 ,$431.78 ,$358.04 ,$431.78 ,$116.30 ,$37.88 ,$455.76 ,$120.90 ,$37.88 ,$417.38 ,$115.15 ,$431.78 ,$115.15 ,$431.78 ,$431.78 ,$431.78 ,$465.36 ,$388.60 ,$446.17 ,$412.59 ,$465.36 
SACRED HEART HOSPITAL (ACU),35200004,74263,HC CT COLONOGRAPHY SCREENING,352,1 ,"$1,147.52 ",$860.64 ,$37.88 ,"$1,147.52 ",$739.00 , N/A ,$803.26 ,$37.88 ,"$1,147.52 ",$39.02 ,"$1,147.52 ","$1,090.14 ",$37.88 ,$918.02 ,"$1,055.72 ",$37.88 ,$975.39 ,"$1,090.14 ","$1,009.82 ",$872.12 ,$37.88 ,$37.88 ,$37.88 ,$837.69 ,$631.14 ,"$1,044.24 ","$1,044.24 ",$918.02 , N/A ,$631.14 ,"$1,032.77 ", N/A ,"$1,032.77 ",$619.66 ,"$1,078.67 ", N/A ,"$1,055.72 ",$40.15 ,"$1,044.24 ", N/A ,$706.18 ,$706.18 ,"$1,119.16 ",$856.39 ,"$1,032.77 ", N/A ,$37.88 ,"$1,090.14 ", N/A ,$37.88 ,$998.34 , N/A ,"$1,032.77 ", N/A ,"$1,032.77 ","$1,032.77 ","$1,032.77 ","$1,113.09 ",$929.49 ,"$1,067.19 ",$986.87 ,"$1,113.09 "
SACRED HEART HOSPITAL (ACU),36000025,10021,HC ASP FINE NDL W/O IMAGING GUIDE,360,1 ,"$1,117.00 ",$837.75 ,$205.03 ,"$1,117.00 ",$719.35 ,$365.56 ,$781.90 ,$205.03 ,"$1,117.00 ",$211.18 ,"$1,117.00 ","$1,061.15 ",$205.03 ,$893.60 ,"$1,027.64 ",$205.03 ,$750.00 ,"$1,061.15 ",$982.96 ,$848.92 ,$205.03 ,$205.03 ,$205.03 ,$815.41 ,$614.35 ,"$1,016.47 ","$1,016.47 ",$893.60 ,$376.53 ,$614.35 ,"$1,005.30 ",$365.56 ,"$1,005.30 ",$603.18 ,"$1,049.98 ",$822.51 ,"$1,027.64 ",$217.33 ,"$1,016.47 ",$365.56 ,$687.40 ,$687.40 ,"$1,005.30 ",$833.62 ,$794.24 ,$369.22 ,$205.03 ,"$1,061.15 ",$383.84 ,$205.03 ,$971.79 ,$365.56 ,"$1,005.30 ",$365.56 ,"$1,005.30 ","$1,005.30 ","$1,005.30 ","$1,083.49 ",$904.77 ,"$1,038.81 ",$960.62 ,"$1,083.49 "
SACRED HEART HOSPITAL (ACU),36000027,10060,HC I AND D ABSC SMP FAC,360,1 ,$436.00 ,$327.00 ,$53.09 ,$436.00 ,$280.78 ,$189.93 ,$305.20 ,$53.09 ,$436.00 ,$54.68 ,$436.00 ,$414.20 ,$53.09 ,$348.80 ,$401.12 ,$53.09 , N/A ,$414.20 ,$383.68 ,$331.36 ,$53.09 ,$53.09 ,$53.09 ,$318.28 ,$239.80 ,$396.76 ,$396.76 ,$348.80 ,$195.63 ,$239.80 ,$392.40 ,$189.93 ,$392.40 ,$235.44 ,$409.84 ,$427.33 ,$401.12 ,$56.28 ,$396.76 ,$189.93 ,$268.31 ,$268.31 ,$392.40 ,$325.39 ,$392.40 ,$191.82 ,$53.09 ,$414.20 ,$199.42 ,$53.09 ,$379.32 ,$189.93 ,$392.40 ,$189.93 ,$392.40 ,$392.40 ,$392.40 ,$422.92 ,$353.16 ,$405.48 ,$374.96 ,$422.92 
SACRED HEART HOSPITAL (ACU),36000029,10140,HC I AND D HEMATOMA/SEROMA/FLUID,360,1 ,"$1,555.00 ","$1,166.25 ",$356.47 ,"$3,348.27 ","$1,001.42 ","$1,488.12 ","$1,088.50 ",$356.47 ,"$1,555.00 ",$367.16 ,"$1,555.00 ","$1,477.25 ",$356.47 ,"$1,244.00 ","$1,430.60 ",$356.47 , N/A ,"$1,477.25 ","$1,368.40 ","$1,181.80 ",$356.47 ,$356.47 ,$356.47 ,"$1,135.15 ",$855.25 ,"$1,415.05 ","$1,415.05 ","$1,244.00 ","$1,532.76 ",$855.25 ,"$1,399.50 ","$1,488.12 ","$1,399.50 ",$839.70 ,"$1,461.70 ","$3,348.27 ","$1,430.60 ",$377.86 ,"$1,415.05 ","$1,488.12 ",$956.95 ,$956.95 ,"$1,399.50 ","$1,160.50 ","$1,399.50 ","$1,503.00 ",$356.47 ,"$1,477.25 ","$1,562.52 ",$356.47 ,"$1,352.85 ","$1,488.12 ","$1,399.50 ","$1,488.12 ","$1,399.50 ","$1,399.50 ","$1,399.50 ","$1,508.35 ","$1,259.55 ","$1,446.15 ","$1,337.30 ","$1,508.35 "
SACRED HEART HOSPITAL (ACU),36000030,10160,HC ASP ABSC/HEMA/CYST/BULLA FAC,360,1 ,$448.00 ,$336.00 ,$53.09 ,$822.51 ,$288.51 ,$365.56 ,$313.60 ,$53.09 ,$448.00 ,$54.68 ,$448.00 ,$425.60 ,$53.09 ,$358.40 ,$412.16 ,$53.09 , N/A ,$425.60 ,$394.24 ,$340.48 ,$53.09 ,$53.09 ,$53.09 ,$327.04 ,$246.40 ,$407.68 ,$407.68 ,$358.40 ,$376.53 ,$246.40 ,$403.20 ,$365.56 ,$403.20 ,$241.92 ,$421.12 ,$822.51 ,$412.16 ,$56.28 ,$407.68 ,$365.56 ,$275.70 ,$275.70 ,$403.20 ,$334.34 ,$403.20 ,$369.22 ,$53.09 ,$425.60 ,$383.84 ,$53.09 ,$389.76 ,$365.56 ,$403.20 ,$365.56 ,$403.20 ,$403.20 ,$403.20 ,$434.56 ,$362.88 ,$416.64 ,$385.28 ,$434.56 
SACRED HEART HOSPITAL (ACU),36000035,10030,HC GUIDE CATHET FLUID DRAINAGE,360,1 ,$540.00 ,$405.00 ,$291.60 ,"$1,480.84 ",$347.76 ,$658.15 ,$378.00 ,$356.47 ,$540.00 ,$367.16 ,$540.00 ,$513.00 ,$356.47 ,$432.00 ,$496.80 ,$356.47 , N/A ,$513.00 ,$475.20 ,$410.40 ,$356.47 ,$356.47 ,$356.47 ,$394.20 ,$297.00 ,$491.40 ,$491.40 ,$432.00 ,$677.89 ,$297.00 ,$486.00 ,$658.15 ,$486.00 ,$291.60 ,$507.60 ,"$1,480.84 ",$496.80 ,$377.86 ,$491.40 ,$658.15 ,$332.32 ,$332.32 ,$486.00 ,$403.00 ,$486.00 ,$664.73 ,$356.47 ,$513.00 ,$691.06 ,$356.47 ,$469.80 ,$658.15 ,$486.00 ,$658.15 ,$486.00 ,$486.00 ,$486.00 ,$523.80 ,$437.40 ,$502.20 ,$464.40 ,$523.80 
SACRED HEART HOSPITAL (ACU),36000040,31652,HC BRONCH RIGID/FLEX EBUS 1 OR 2 NODES,360,1 ,"$3,355.00 ","$2,516.25 ","$1,106.05 ","$7,371.32 ","$2,160.62 ","$3,276.14 ","$2,348.50 ","$1,106.05 ","$3,355.00 ","$1,139.23 ","$3,355.00 ","$3,187.25 ","$1,106.05 ","$2,684.00 ","$3,086.60 ","$1,106.05 ", N/A ,"$3,187.25 ","$2,952.40 ","$2,549.80 ","$1,106.05 ","$1,106.05 ","$1,106.05 ","$2,449.15 ","$1,845.25 ","$3,053.05 ","$3,053.05 ","$2,684.00 ","$3,374.42 ","$1,845.25 ","$3,019.50 ","$3,276.14 ","$3,019.50 ","$1,811.70 ","$3,153.70 ","$7,371.32 ","$3,086.60 ","$1,172.41 ","$3,053.05 ","$3,276.14 ","$2,064.67 ","$2,064.67 ","$3,019.50 ","$2,503.84 ","$3,019.50 ","$3,308.90 ","$1,106.05 ","$3,187.25 ","$3,439.95 ","$1,106.05 ","$2,918.85 ","$3,276.14 ","$3,019.50 ","$3,276.14 ","$3,019.50 ","$3,019.50 ","$3,019.50 ","$3,254.35 ","$2,717.55 ","$3,120.15 ","$2,885.30 ","$3,254.35 "
SACRED HEART HOSPITAL (ACU),36000041,31653,HC BRONCH RIGID/FLEX EBUS 3 OR MORE NODES,360,1 ,"$3,355.00 ","$2,516.25 ","$1,106.05 ","$7,371.32 ","$2,160.62 ","$3,276.14 ","$2,348.50 ","$1,106.05 ","$3,355.00 ","$1,139.23 ","$3,355.00 ","$3,187.25 ","$1,106.05 ","$2,684.00 ","$3,086.60 ","$1,106.05 ", N/A ,"$3,187.25 ","$2,952.40 ","$2,549.80 ","$1,106.05 ","$1,106.05 ","$1,106.05 ","$2,449.15 ","$1,845.25 ","$3,053.05 ","$3,053.05 ","$2,684.00 ","$3,374.42 ","$1,845.25 ","$3,019.50 ","$3,276.14 ","$3,019.50 ","$1,811.70 ","$3,153.70 ","$7,371.32 ","$3,086.60 ","$1,172.41 ","$3,053.05 ","$3,276.14 ","$2,064.67 ","$2,064.67 ","$3,019.50 ","$2,503.84 ","$3,019.50 ","$3,308.90 ","$1,106.05 ","$3,187.25 ","$3,439.95 ","$1,106.05 ","$2,918.85 ","$3,276.14 ","$3,019.50 ","$3,276.14 ","$3,019.50 ","$3,019.50 ","$3,019.50 ","$3,254.35 ","$2,717.55 ","$3,120.15 ","$2,885.30 ","$3,254.35 "
SACRED HEART HOSPITAL (ACU),36000042,31654,HC BRONCH RIGID/FLEX EBUS FOR PHERIPHERAL LESIONS ADD ON,360,1 ,"$2,406.00 ","$1,804.50 ","$1,106.05 ","$2,406.00 ","$1,549.46 ", N/A ,"$1,684.20 ","$1,106.05 ","$2,406.00 ","$1,139.23 ","$2,406.00 ","$2,285.70 ","$1,106.05 ","$1,924.80 ","$2,213.52 ","$1,106.05 ", N/A ,"$2,285.70 ","$2,117.28 ","$1,828.56 ","$1,106.05 ","$1,106.05 ","$1,106.05 ","$1,756.38 ","$1,323.30 ","$2,189.46 ","$2,189.46 ","$1,924.80 ", N/A ,"$1,323.30 ","$2,165.40 ", N/A ,"$2,165.40 ","$1,299.24 ","$2,261.64 ", N/A ,"$2,213.52 ","$1,172.41 ","$2,189.46 ", N/A ,"$1,480.65 ","$1,480.65 ","$2,165.40 ","$1,795.60 ","$1,203.00 ", N/A ,"$1,106.05 ","$2,285.70 ", N/A ,"$1,106.05 ","$2,093.22 ", N/A ,"$2,165.40 ", N/A ,"$2,165.40 ","$2,165.40 ","$2,165.40 ","$2,333.82 ","$1,948.86 ","$2,237.58 ","$2,069.16 ","$2,333.82 "
SACRED HEART HOSPITAL (ACU),36000078,19000,HC ASP CYST BREAST,360,1 ,"$1,204.00 ",$903.00 ,$205.03 ,"$1,480.84 ",$775.38 ,$658.15 ,$842.80 ,$205.03 ,"$1,204.00 ",$211.18 ,"$1,204.00 ","$1,143.80 ",$205.03 ,$963.20 ,"$1,107.68 ",$205.03 , N/A ,"$1,143.80 ","$1,059.52 ",$915.04 ,$205.03 ,$205.03 ,$205.03 ,$878.92 ,$662.20 ,"$1,095.64 ","$1,095.64 ",$963.20 ,$677.89 ,$662.20 ,"$1,083.60 ",$658.15 ,"$1,083.60 ",$650.16 ,"$1,131.76 ","$1,480.84 ","$1,107.68 ",$217.33 ,"$1,095.64 ",$658.15 ,$740.94 ,$740.94 ,"$1,083.60 ",$898.55 ,"$1,083.60 ",$664.73 ,$205.03 ,"$1,143.80 ",$691.06 ,$205.03 ,"$1,047.48 ",$658.15 ,"$1,083.60 ",$658.15 ,"$1,083.60 ","$1,083.60 ","$1,083.60 ","$1,167.88 ",$975.24 ,"$1,119.72 ","$1,035.44 ","$1,167.88 "
SACRED HEART HOSPITAL (ACU),36000079,19001,HC ASP CYST BREAST EA ADDL,360,1 ,$787.00 ,$590.25 ,$205.03 ,$787.00 ,$506.83 , N/A ,$550.90 ,$205.03 ,$787.00 ,$211.18 ,$787.00 ,$747.65 ,$205.03 ,$629.60 ,$724.04 ,$205.03 , N/A ,$747.65 ,$692.56 ,$598.12 ,$205.03 ,$205.03 ,$205.03 ,$574.51 ,$432.85 ,$716.17 ,$716.17 ,$629.60 , N/A ,$432.85 ,$708.30 , N/A ,$708.30 ,$424.98 ,$739.78 , N/A ,$724.04 ,$217.33 ,$716.17 , N/A ,$484.32 ,$484.32 ,$708.30 ,$587.34 ,$708.30 , N/A ,$205.03 ,$747.65 , N/A ,$205.03 ,$684.69 , N/A ,$708.30 , N/A ,$708.30 ,$708.30 ,$708.30 ,$763.39 ,$637.47 ,$731.91 ,$676.82 ,$763.39 
SACRED HEART HOSPITAL (ACU),36000080,19020,HC BREAST ABSCESS DRAINAGE,360,1 ,"$4,389.00 ","$3,291.75 ",$454.28 ,"$4,389.00 ","$2,826.52 ","$1,488.12 ","$3,072.30 ",$454.28 ,"$4,389.00 ",$467.91 ,"$3,859.00 ","$4,169.55 ",$454.28 ,"$3,511.20 ","$4,037.88 ",$454.28 , N/A ,"$4,169.55 ","$3,862.32 ","$3,335.64 ",$454.28 ,$454.28 ,$454.28 ,"$3,203.97 ","$2,413.95 ","$3,993.99 ","$3,993.99 ","$3,511.20 ","$1,532.76 ","$2,413.95 ","$3,950.10 ","$1,488.12 ","$3,950.10 ","$2,370.06 ","$4,125.66 ","$3,348.27 ","$4,037.88 ",$481.54 ,"$3,993.99 ","$1,488.12 ","$2,700.99 ","$2,700.99 ","$3,950.10 ","$3,275.51 ","$3,360.24 ","$1,503.00 ",$454.28 ,"$4,169.55 ","$1,562.52 ",$454.28 ,"$3,818.43 ","$1,488.12 ","$3,950.10 ","$1,488.12 ","$3,950.10 ","$3,950.10 ","$3,950.10 ","$4,257.33 ","$3,555.09 ","$4,081.77 ","$3,774.54 ","$4,257.33 "
SACRED HEART HOSPITAL (ACU),36000082,19083,HC BREAST BIOPSY W/IMAG GUIDE ULTRA,360,1 ,"$3,045.15 ","$2,283.86 ",$454.28 ,"$3,348.27 ","$1,961.08 ","$1,488.12 ","$2,131.61 ",$454.28 ,"$3,045.15 ",$467.91 ,"$3,045.15 ","$2,892.89 ",$454.28 ,"$2,436.12 ","$2,801.54 ",$454.28 , N/A ,"$2,892.89 ","$2,679.73 ","$2,314.31 ",$454.28 ,$454.28 ,$454.28 ,"$2,222.96 ","$1,674.83 ","$2,771.09 ","$2,771.09 ","$2,436.12 ","$1,532.76 ","$1,674.83 ","$2,740.64 ","$1,488.12 ","$2,740.64 ","$1,644.38 ","$2,862.44 ","$3,348.27 ","$2,801.54 ",$481.54 ,"$2,771.09 ","$1,488.12 ","$1,873.99 ","$1,873.99 ","$2,740.64 ","$2,272.60 ","$2,740.64 ","$1,503.00 ",$454.28 ,"$2,892.89 ","$1,562.52 ",$454.28 ,"$2,649.28 ","$1,488.12 ","$2,740.64 ","$1,488.12 ","$2,740.64 ","$2,740.64 ","$2,740.64 ","$2,953.80 ","$2,466.57 ","$2,831.99 ","$2,618.83 ","$2,953.80 "
SACRED HEART HOSPITAL (ACU),36000085,19285,HC PLCMNT NEEDLE LOC WIRE BRST ULTRA,360,1 ,"$1,197.49 ",$898.12 ,$266.73 ,"$1,480.84 ",$771.18 ,$658.15 ,$838.24 ,$266.73 ,"$1,197.49 ",$274.73 ,"$1,197.49 ","$1,137.62 ",$266.73 ,$957.99 ,"$1,101.69 ",$266.73 , N/A ,"$1,137.62 ","$1,053.79 ",$910.09 ,$266.73 ,$266.73 ,$266.73 ,$874.17 ,$658.62 ,"$1,089.72 ","$1,089.72 ",$957.99 ,$677.89 ,$658.62 ,"$1,077.74 ",$658.15 ,"$1,077.74 ",$646.64 ,"$1,125.64 ","$1,480.84 ","$1,101.69 ",$282.73 ,"$1,089.72 ",$658.15 ,$736.94 ,$736.94 ,"$1,077.74 ",$893.69 ,"$1,077.74 ",$664.73 ,$266.73 ,"$1,137.62 ",$691.06 ,$266.73 ,"$1,041.82 ",$658.15 ,"$1,077.74 ",$658.15 ,"$1,077.74 ","$1,077.74 ","$1,077.74 ","$1,161.57 ",$969.97 ,"$1,113.67 ","$1,029.84 ","$1,161.57 "
SACRED HEART HOSPITAL (ACU),36000088,20206,HC BX MUSCLE NEEDLE PERC,360,1 ,"$1,204.00 ",$903.00 ,$205.03 ,"$3,348.27 ",$775.38 ,"$1,488.12 ",$842.80 ,$205.03 ,"$1,204.00 ",$211.18 ,"$1,204.00 ","$1,143.80 ",$205.03 ,$963.20 ,"$1,107.68 ",$205.03 , N/A ,"$1,143.80 ","$1,059.52 ",$915.04 ,$205.03 ,$205.03 ,$205.03 ,$878.92 ,$662.20 ,"$1,095.64 ","$1,095.64 ",$963.20 ,"$1,532.76 ",$662.20 ,"$1,083.60 ","$1,488.12 ","$1,083.60 ",$650.16 ,"$1,131.76 ","$3,348.27 ","$1,107.68 ",$217.33 ,"$1,095.64 ","$1,488.12 ",$740.94 ,$740.94 ,"$1,083.60 ",$898.55 ,"$1,083.60 ","$1,503.00 ",$205.03 ,"$1,143.80 ","$1,562.52 ",$205.03 ,"$1,047.48 ","$1,488.12 ","$1,083.60 ","$1,488.12 ","$1,083.60 ","$1,083.60 ","$1,083.60 ","$1,167.88 ",$975.24 ,"$1,119.72 ","$1,035.44 ","$1,167.88 "
SACRED HEART HOSPITAL (ACU),36000089,20220,HC BX BONE NEEDLE SUPERFIC FAC,360,1 ,"$2,980.00 ","$2,235.00 ",$205.03 ,"$3,348.27 ","$1,919.12 ","$1,488.12 ","$2,086.00 ",$205.03 ,"$2,980.00 ",$211.18 ,"$2,980.00 ","$2,831.00 ",$205.03 ,"$2,384.00 ","$2,741.60 ",$205.03 , N/A ,"$2,831.00 ","$2,622.40 ","$2,264.80 ",$205.03 ,$205.03 ,$205.03 ,"$2,175.40 ","$1,639.00 ","$2,711.80 ","$2,711.80 ","$2,384.00 ","$1,532.76 ","$1,639.00 ","$2,682.00 ","$1,488.12 ","$2,682.00 ","$1,609.20 ","$2,801.20 ","$3,348.27 ","$2,741.60 ",$217.33 ,"$2,711.80 ","$1,488.12 ","$1,833.89 ","$1,833.89 ","$2,682.00 ","$2,223.97 ","$2,682.00 ","$1,503.00 ",$205.03 ,"$2,831.00 ","$1,562.52 ",$205.03 ,"$2,592.60 ","$1,488.12 ","$2,682.00 ","$1,488.12 ","$2,682.00 ","$2,682.00 ","$2,682.00 ","$2,890.60 ","$2,413.80 ","$2,771.40 ","$2,562.80 ","$2,890.60 "
SACRED HEART HOSPITAL (ACU),36000090,20225,HC BX BONE NEEDLE DEEP,360,1 ,"$1,168.00 ",$876.00 ,$566.44 ,"$3,348.27 ",$752.19 ,"$1,488.12 ",$817.60 ,$566.44 ,"$1,168.00 ",$583.43 ,"$1,168.00 ","$1,109.60 ",$566.44 ,$934.40 ,"$1,074.56 ",$566.44 , N/A ,"$1,109.60 ","$1,027.84 ",$887.68 ,$566.44 ,$566.44 ,$566.44 ,$852.64 ,$642.40 ,"$1,062.88 ","$1,062.88 ",$934.40 ,"$1,532.76 ",$642.40 ,"$1,051.20 ","$1,488.12 ","$1,051.20 ",$630.72 ,"$1,097.92 ","$3,348.27 ","$1,074.56 ",$600.43 ,"$1,062.88 ","$1,488.12 ",$718.79 ,$718.79 ,"$1,051.20 ",$871.68 ,"$1,051.20 ","$1,503.00 ",$566.44 ,"$1,109.60 ","$1,562.52 ",$566.44 ,"$1,016.16 ","$1,488.12 ","$1,051.20 ","$1,488.12 ","$1,051.20 ","$1,051.20 ","$1,051.20 ","$1,132.96 ",$946.08 ,"$1,086.24 ","$1,004.48 ","$1,132.96 "
SACRED HEART HOSPITAL (ACU),36000109,19084,HC BREAST LOC BX ULTRA ADDN LESION,360,1 ,$370.78 ,$278.09 ,$200.22 ,$481.54 ,$238.78 , N/A ,$259.55 ,$370.78 ,$370.78 ,$467.91 ,$370.78 ,$352.24 ,$454.28 ,$296.62 ,$341.12 ,$370.78 , N/A ,$352.24 ,$326.29 ,$281.79 ,$370.78 ,$370.78 ,$454.28 ,$270.67 ,$203.93 ,$337.41 ,$337.41 ,$296.62 , N/A ,$203.93 ,$333.70 , N/A ,$333.70 ,$200.22 ,$348.53 , N/A ,$341.12 ,$481.54 ,$337.41 , N/A ,$228.18 ,$228.18 ,$333.70 ,$276.71 ,$333.70 , N/A ,$370.78 ,$352.24 , N/A ,$370.78 ,$322.58 , N/A ,$333.70 , N/A ,$333.70 ,$333.70 ,$333.70 ,$359.66 ,$300.33 ,$344.83 ,$318.87 ,$359.66 
SACRED HEART HOSPITAL (ACU),36000110,19085,HC BX BREAST 1ST LESION MR IMAG,360,1 ,"$2,135.47 ","$1,601.60 ",$454.28 ,"$3,348.27 ","$1,375.24 ","$1,488.12 ","$1,494.83 ",$454.28 ,"$2,135.47 ",$467.91 ,"$2,135.47 ","$2,028.70 ",$454.28 ,"$1,708.38 ","$1,964.63 ",$454.28 , N/A ,"$2,028.70 ","$1,879.21 ","$1,622.96 ",$454.28 ,$454.28 ,$454.28 ,"$1,558.89 ","$1,174.51 ","$1,943.28 ","$1,943.28 ","$1,708.38 ","$1,532.76 ","$1,174.51 ","$1,921.92 ","$1,488.12 ","$1,921.92 ","$1,153.15 ","$2,007.34 ","$3,348.27 ","$1,964.63 ",$481.54 ,"$1,943.28 ","$1,488.12 ","$1,314.17 ","$1,314.17 ","$1,921.92 ","$1,593.70 ","$1,921.92 ","$1,503.00 ",$454.28 ,"$2,028.70 ","$1,562.52 ",$454.28 ,"$1,857.86 ","$1,488.12 ","$1,921.92 ","$1,488.12 ","$1,921.92 ","$1,921.92 ","$1,921.92 ","$2,071.41 ","$1,729.73 ","$1,985.99 ","$1,836.50 ","$2,071.41 "
SACRED HEART HOSPITAL (ACU),36000111,19086,HC BX BREAST ADDN LESION MR IMAG,360,1 ,$781.38 ,$586.04 ,$421.95 ,$781.38 ,$503.21 , N/A ,$546.97 ,$454.28 ,$781.38 ,$467.91 ,$781.38 ,$742.31 ,$454.28 ,$625.10 ,$718.87 ,$454.28 , N/A ,$742.31 ,$687.61 ,$593.85 ,$454.28 ,$454.28 ,$454.28 ,$570.41 ,$429.76 ,$711.06 ,$711.06 ,$625.10 , N/A ,$429.76 ,$703.24 , N/A ,$703.24 ,$421.95 ,$734.50 , N/A ,$718.87 ,$481.54 ,$711.06 , N/A ,$480.86 ,$480.86 ,$703.24 ,$583.14 ,$703.24 , N/A ,$454.28 ,$742.31 , N/A ,$454.28 ,$679.80 , N/A ,$703.24 , N/A ,$703.24 ,$703.24 ,$703.24 ,$757.94 ,$632.92 ,$726.68 ,$671.99 ,$757.94 
SACRED HEART HOSPITAL (ACU),36000112,19287,HC PERCUTAN DEV BREAST 1ST MR GUIDE,360,1 ,"$2,135.47 ","$1,601.60 ",$266.73 ,"$2,135.47 ","$1,375.24 ",$658.15 ,"$1,494.83 ",$266.73 ,"$2,135.47 ",$274.73 ,"$2,135.47 ","$2,028.70 ",$266.73 ,"$1,708.38 ","$1,964.63 ",$266.73 , N/A ,"$2,028.70 ","$1,879.21 ","$1,622.96 ",$266.73 ,$266.73 ,$266.73 ,"$1,558.89 ","$1,174.51 ","$1,943.28 ","$1,943.28 ","$1,708.38 ",$677.89 ,"$1,174.51 ","$1,921.92 ",$658.15 ,"$1,921.92 ","$1,153.15 ","$2,007.34 ","$1,480.84 ","$1,964.63 ",$282.73 ,"$1,943.28 ",$658.15 ,"$1,314.17 ","$1,314.17 ","$1,921.92 ","$1,593.70 ","$1,921.92 ",$664.73 ,$266.73 ,"$2,028.70 ",$691.06 ,$266.73 ,"$1,857.86 ",$658.15 ,"$1,921.92 ",$658.15 ,"$1,921.92 ","$1,921.92 ","$1,921.92 ","$2,071.41 ","$1,729.73 ","$1,985.99 ","$1,836.50 ","$2,071.41 "
SACRED HEART HOSPITAL (ACU),36000113,19288,HC PERCUTAN DEV BREAST ADDN MR GUIDE,360,1 ,$781.38 ,$586.04 ,$266.73 ,$781.38 ,$503.21 , N/A ,$546.97 ,$266.73 ,$781.38 ,$274.73 ,$781.38 ,$742.31 ,$266.73 ,$625.10 ,$718.87 ,$266.73 , N/A ,$742.31 ,$687.61 ,$593.85 ,$266.73 ,$266.73 ,$266.73 ,$570.41 ,$429.76 ,$711.06 ,$711.06 ,$625.10 , N/A ,$429.76 ,$703.24 , N/A ,$703.24 ,$421.95 ,$734.50 , N/A ,$718.87 ,$282.73 ,$711.06 , N/A ,$480.86 ,$480.86 ,$703.24 ,$583.14 ,$703.24 , N/A ,$266.73 ,$742.31 , N/A ,$266.73 ,$679.80 , N/A ,$703.24 , N/A ,$703.24 ,$703.24 ,$703.24 ,$757.94 ,$632.92 ,$726.68 ,$671.99 ,$757.94 
SACRED HEART HOSPITAL (ACU),36000116,19286,HC BREAST NDL LOC BX ULTRA  ADDN LESION,360,1 ,$370.78 ,$278.09 ,$200.22 ,$370.78 ,$238.78 , N/A ,$259.55 ,$266.73 ,$370.78 ,$274.73 ,$370.78 ,$352.24 ,$266.73 ,$296.62 ,$341.12 ,$266.73 , N/A ,$352.24 ,$326.29 ,$281.79 ,$266.73 ,$266.73 ,$266.73 ,$270.67 ,$203.93 ,$337.41 ,$337.41 ,$296.62 , N/A ,$203.93 ,$333.70 , N/A ,$333.70 ,$200.22 ,$348.53 , N/A ,$341.12 ,$282.73 ,$337.41 , N/A ,$228.18 ,$228.18 ,$333.70 ,$276.71 ,$333.70 , N/A ,$266.73 ,$352.24 , N/A ,$266.73 ,$322.58 , N/A ,$333.70 , N/A ,$333.70 ,$333.70 ,$333.70 ,$359.66 ,$300.33 ,$344.83 ,$318.87 ,$359.66 
SACRED HEART HOSPITAL (ACU),36000121,36500,HC CATH VENOUS BLOOD SELECT SMPL,360,1 ,$611.19 ,$458.39 ,$206.34 ,$611.19 ,$393.61 , N/A ,$427.83 ,$206.34 ,$611.19 ,$212.53 ,$611.19 ,$580.63 ,$206.34 ,$488.95 ,$562.29 ,$206.34 , N/A ,$580.63 ,$537.85 ,$464.50 ,$206.34 ,$206.34 ,$206.34 ,$446.17 ,$336.15 ,$556.18 ,$556.18 ,$488.95 , N/A ,$336.15 ,$550.07 , N/A ,$550.07 ,$330.04 ,$574.52 , N/A ,$562.29 ,$218.72 ,$556.18 , N/A ,$376.13 ,$376.13 ,$550.07 ,$456.13 ,$550.07 , N/A ,$206.34 ,$580.63 , N/A ,$206.34 ,$531.74 , N/A ,$550.07 , N/A ,$550.07 ,$550.07 ,$550.07 ,$592.85 ,$495.06 ,$568.41 ,$525.62 ,$592.85 
SACRED HEART HOSPITAL (ACU),36000122,36555,HC INS CATH CV NON-TUNL <5 YRS,360,1 ,"$1,795.00 ","$1,346.25 ",$365.14 ,"$6,812.22 ","$1,155.98 ","$3,027.65 ","$1,256.50 ",$365.14 ,"$1,795.00 ",$376.09 ,"$1,795.00 ","$1,705.25 ",$365.14 ,"$1,436.00 ","$1,651.40 ",$365.14 ,$750.00 ,"$1,705.25 ","$1,579.60 ","$1,364.20 ",$365.14 ,$365.14 ,$365.14 ,"$1,310.35 ",$987.25 ,"$1,633.45 ","$1,633.45 ","$1,436.00 ","$3,118.48 ",$987.25 ,"$1,615.50 ","$3,027.65 ","$1,615.50 ",$969.30 ,"$1,687.30 ","$6,812.22 ","$1,651.40 ",$387.05 ,"$1,633.45 ","$3,027.65 ","$1,104.64 ","$1,104.64 ","$1,615.50 ","$1,339.61 ","$1,615.50 ","$3,057.93 ",$365.14 ,"$1,705.25 ","$3,179.04 ",$365.14 ,"$1,561.65 ","$3,027.65 ","$1,615.50 ","$3,027.65 ","$1,615.50 ","$1,615.50 ","$1,615.50 ","$1,741.15 ","$1,453.95 ","$1,669.35 ","$1,543.70 ","$1,741.15 "
SACRED HEART HOSPITAL (ACU),36000123,36556,HC INS CATH CV NON-TUNL >5 YR,360,1 ,"$2,132.00 ","$1,599.00 ",$365.14 ,"$6,812.22 ","$1,373.01 ","$3,027.65 ","$1,492.40 ",$365.14 ,"$2,132.00 ",$376.09 ,"$2,132.00 ","$2,025.40 ",$365.14 ,"$1,705.60 ","$1,961.44 ",$365.14 ,$750.00 ,"$2,025.40 ","$1,876.16 ","$1,620.32 ",$365.14 ,$365.14 ,$365.14 ,"$1,556.36 ","$1,172.60 ","$1,940.12 ","$1,940.12 ","$1,705.60 ","$3,118.48 ","$1,172.60 ","$1,918.80 ","$3,027.65 ","$1,918.80 ","$1,151.28 ","$2,004.08 ","$6,812.22 ","$1,961.44 ",$387.05 ,"$1,940.12 ","$3,027.65 ","$1,312.03 ","$1,312.03 ","$1,918.80 ","$1,591.11 ","$1,918.80 ","$3,057.93 ",$365.14 ,"$2,025.40 ","$3,179.04 ",$365.14 ,"$1,854.84 ","$3,027.65 ","$1,918.80 ","$3,027.65 ","$1,918.80 ","$1,918.80 ","$1,918.80 ","$2,068.04 ","$1,726.92 ","$1,982.76 ","$1,833.52 ","$2,068.04 "
SACRED HEART HOSPITAL (ACU),36000124,36557,HC INSERT TUNNELED CVC <5 YEARS OLD,360,1 ,"$1,623.00 ","$1,217.25 ",$713.20 ,"$11,347.95 ","$1,045.21 ","$5,043.53 ","$1,136.10 ",$713.20 ,"$1,623.00 ",$734.60 ,"$1,623.00 ","$1,541.85 ",$713.20 ,"$1,298.40 ","$1,493.16 ",$713.20 ,"$1,125.00 ","$1,541.85 ","$1,428.24 ","$1,233.48 ",$713.20 ,$713.20 ,$713.20 ,"$1,184.79 ",$892.65 ,"$1,476.93 ","$1,476.93 ","$1,298.40 ","$5,194.84 ",$892.65 ,"$1,460.70 ","$5,043.53 ","$1,460.70 ",$876.42 ,"$1,525.62 ","$11,347.95 ","$1,493.16 ",$755.99 ,"$1,476.93 ","$5,043.53 ",$998.79 ,$998.79 ,"$1,460.70 ","$1,211.24 ","$1,460.70 ","$5,093.97 ",$713.20 ,"$1,541.85 ","$5,295.71 ",$713.20 ,"$1,412.01 ","$5,043.53 ","$1,460.70 ","$5,043.53 ","$1,460.70 ","$1,460.70 ","$1,460.70 ","$1,574.31 ","$1,314.63 ","$1,509.39 ","$1,395.78 ","$1,574.31 "
SACRED HEART HOSPITAL (ACU),36000125,36558,HC INSERT TUNNELED CVC > 5 YEARS OLD,360,1 ,"$1,695.00 ","$1,271.25 ",$713.20 ,"$6,812.22 ","$1,091.58 ","$3,027.65 ","$1,186.50 ",$713.20 ,"$1,695.00 ",$734.60 ,"$1,695.00 ","$1,610.25 ",$713.20 ,"$1,356.00 ","$1,559.40 ",$713.20 ,"$1,125.00 ","$1,610.25 ","$1,491.60 ","$1,288.20 ",$713.20 ,$713.20 ,$713.20 ,"$1,237.35 ",$932.25 ,"$1,542.45 ","$1,542.45 ","$1,356.00 ","$3,118.48 ",$932.25 ,"$1,525.50 ","$3,027.65 ","$1,525.50 ",$915.30 ,"$1,593.30 ","$6,812.22 ","$1,559.40 ",$755.99 ,"$1,542.45 ","$3,027.65 ","$1,043.10 ","$1,043.10 ","$1,525.50 ","$1,264.98 ","$1,525.50 ","$3,057.93 ",$713.20 ,"$1,610.25 ","$3,179.04 ",$713.20 ,"$1,474.65 ","$3,027.65 ","$1,525.50 ","$3,027.65 ","$1,525.50 ","$1,525.50 ","$1,525.50 ","$1,644.15 ","$1,372.95 ","$1,576.35 ","$1,457.70 ","$1,644.15 "
SACRED HEART HOSPITAL (ACU),36000126,36560,HC INS DEVICE CV W/PORT <5 YRS,360,1 ,"$1,606.00 ","$1,204.50 ",$713.20 ,"$6,812.22 ","$1,034.26 ","$3,027.65 ","$1,124.20 ",$713.20 ,"$1,606.00 ",$734.60 ,"$1,606.00 ","$1,525.70 ",$713.20 ,"$1,284.80 ","$1,477.52 ",$713.20 ,"$1,125.00 ","$1,525.70 ","$1,413.28 ","$1,220.56 ",$713.20 ,$713.20 ,$713.20 ,"$1,172.38 ",$883.30 ,"$1,461.46 ","$1,461.46 ","$1,284.80 ","$3,118.48 ",$883.30 ,"$1,445.40 ","$3,027.65 ","$1,445.40 ",$867.24 ,"$1,509.64 ","$6,812.22 ","$1,477.52 ",$755.99 ,"$1,461.46 ","$3,027.65 ",$988.33 ,$988.33 ,"$1,445.40 ","$1,198.56 ","$1,445.40 ","$3,057.93 ",$713.20 ,"$1,525.70 ","$3,179.04 ",$713.20 ,"$1,397.22 ","$3,027.65 ","$1,445.40 ","$3,027.65 ","$1,445.40 ","$1,445.40 ","$1,445.40 ","$1,557.82 ","$1,300.86 ","$1,493.58 ","$1,381.16 ","$1,557.82 "
SACRED HEART HOSPITAL (ACU),36000127,36561,HC INSERT TUNEL CV CATH>5YR W/PORT,360,1 ,"$2,786.00 ","$2,089.50 ",$713.20 ,"$6,812.22 ","$1,794.18 ","$3,027.65 ","$1,950.20 ",$713.20 ,"$2,786.00 ",$734.60 ,"$2,786.00 ","$2,646.70 ",$713.20 ,"$2,228.80 ","$2,563.12 ",$713.20 ,"$1,125.00 ","$2,646.70 ","$2,451.68 ","$2,117.36 ",$713.20 ,$713.20 ,$713.20 ,"$2,033.78 ","$1,532.30 ","$2,535.26 ","$2,535.26 ","$2,228.80 ","$3,118.48 ","$1,532.30 ","$2,507.40 ","$3,027.65 ","$2,507.40 ","$1,504.44 ","$2,618.84 ","$6,812.22 ","$2,563.12 ",$755.99 ,"$2,535.26 ","$3,027.65 ","$1,714.50 ","$1,714.50 ","$2,507.40 ","$2,079.19 ","$2,507.40 ","$3,057.93 ",$713.20 ,"$2,646.70 ","$3,179.04 ",$713.20 ,"$2,423.82 ","$3,027.65 ","$2,507.40 ","$3,027.65 ","$2,507.40 ","$2,507.40 ","$2,507.40 ","$2,702.42 ","$2,256.66 ","$2,590.98 ","$2,395.96 ","$2,702.42 "
SACRED HEART HOSPITAL (ACU),36000128,36563,HC INS PUMP IV INFUSION,360,1 ,"$1,512.00 ","$1,134.00 ",$713.20 ,"$11,347.95 ",$973.73 ,"$5,043.53 ","$1,058.40 ",$713.20 ,"$1,512.00 ",$734.60 ,"$1,512.00 ","$1,436.40 ",$713.20 ,"$1,209.60 ","$1,391.04 ",$713.20 , N/A ,"$1,436.40 ","$1,330.56 ","$1,149.12 ",$713.20 ,$713.20 ,$713.20 ,"$1,103.76 ",$831.60 ,"$1,375.92 ","$1,375.92 ","$1,209.60 ","$5,194.84 ",$831.60 ,"$1,360.80 ","$5,043.53 ","$1,360.80 ",$816.48 ,"$1,421.28 ","$11,347.95 ","$1,391.04 ",$755.99 ,"$1,375.92 ","$5,043.53 ",$930.48 ,$930.48 ,"$1,360.80 ","$1,128.41 ","$1,360.80 ","$5,093.97 ",$713.20 ,"$1,436.40 ","$5,295.71 ",$713.20 ,"$1,315.44 ","$5,043.53 ","$1,360.80 ","$5,043.53 ","$1,360.80 ","$1,360.80 ","$1,360.80 ","$1,466.64 ","$1,224.72 ","$1,406.16 ","$1,300.32 ","$1,466.64 "
SACRED HEART HOSPITAL (ACU),36000129,36565,HC INS DEVICE CV 2 W/O,360,1 ,"$1,668.00 ","$1,251.00 ",$713.20 ,"$6,812.22 ","$1,074.19 ","$3,027.65 ","$1,167.60 ",$713.20 ,"$1,668.00 ",$734.60 ,"$1,668.00 ","$1,584.60 ",$713.20 ,"$1,334.40 ","$1,534.56 ",$713.20 ,"$1,125.00 ","$1,584.60 ","$1,467.84 ","$1,267.68 ",$713.20 ,$713.20 ,$713.20 ,"$1,217.64 ",$917.40 ,"$1,517.88 ","$1,517.88 ","$1,334.40 ","$3,118.48 ",$917.40 ,"$1,501.20 ","$3,027.65 ","$1,501.20 ",$900.72 ,"$1,567.92 ","$6,812.22 ","$1,534.56 ",$755.99 ,"$1,517.88 ","$3,027.65 ","$1,026.49 ","$1,026.49 ","$1,501.20 ","$1,244.83 ","$1,501.20 ","$3,057.93 ",$713.20 ,"$1,584.60 ","$3,179.04 ",$713.20 ,"$1,451.16 ","$3,027.65 ","$1,501.20 ","$3,027.65 ","$1,501.20 ","$1,501.20 ","$1,501.20 ","$1,617.96 ","$1,351.08 ","$1,551.24 ","$1,434.48 ","$1,617.96 "
SACRED HEART HOSPITAL (ACU),36000130,36566,HC INS DEVICE CV 2 CATH W/PORT,360,1 ,"$1,305.00 ",$978.75 ,$704.70 ,"$11,347.95 ",$840.42 ,"$5,043.53 ",$913.50 ,$713.20 ,"$1,305.00 ",$734.60 ,"$1,305.00 ","$1,239.75 ",$713.20 ,"$1,044.00 ","$1,200.60 ",$713.20 ,"$1,125.00 ","$1,239.75 ","$1,148.40 ",$991.80 ,$713.20 ,$713.20 ,$713.20 ,$952.65 ,$717.75 ,"$1,187.55 ","$1,187.55 ","$1,044.00 ","$5,194.84 ",$717.75 ,"$1,174.50 ","$5,043.53 ","$1,174.50 ",$704.70 ,"$1,226.70 ","$11,347.95 ","$1,200.60 ",$755.99 ,"$1,187.55 ","$5,043.53 ",$803.10 ,$803.10 ,"$1,174.50 ",$973.92 ,"$1,174.50 ","$5,093.97 ",$713.20 ,"$1,239.75 ","$5,295.71 ",$713.20 ,"$1,135.35 ","$5,043.53 ","$1,174.50 ","$5,043.53 ","$1,174.50 ","$1,174.50 ","$1,174.50 ","$1,265.85 ","$1,057.05 ","$1,213.65 ","$1,122.30 ","$1,265.85 "
SACRED HEART HOSPITAL (ACU),36000131,36568,HC INS CATH PERIPH CV W/O PORT <5,360,1 ,"$1,695.00 ","$1,271.25 ",$365.14 ,"$3,346.33 ","$1,091.58 ","$1,487.26 ","$1,186.50 ",$365.14 ,"$1,695.00 ",$376.09 ,"$1,695.00 ","$1,610.25 ",$365.14 ,"$1,356.00 ","$1,559.40 ",$365.14 ,$750.00 ,"$1,610.25 ","$1,491.60 ","$1,288.20 ",$365.14 ,$365.14 ,$365.14 ,"$1,237.35 ",$932.25 ,"$1,542.45 ","$1,542.45 ","$1,356.00 ","$1,531.88 ",$932.25 ,"$1,525.50 ","$1,487.26 ","$1,525.50 ",$915.30 ,"$1,593.30 ","$3,346.33 ","$1,559.40 ",$387.05 ,"$1,542.45 ","$1,487.26 ","$1,043.10 ","$1,043.10 ","$1,525.50 ","$1,264.98 ","$1,525.50 ","$1,502.13 ",$365.14 ,"$1,610.25 ","$1,561.62 ",$365.14 ,"$1,474.65 ","$1,487.26 ","$1,525.50 ","$1,487.26 ","$1,525.50 ","$1,525.50 ","$1,525.50 ","$1,644.15 ","$1,372.95 ","$1,576.35 ","$1,457.70 ","$1,644.15 "
SACRED HEART HOSPITAL (ACU),36000132,36569,HC INS PER CV CATH W/O PORT 5>,360,1 ,"$2,239.00 ","$1,679.25 ",$365.14 ,"$3,346.33 ","$1,441.92 ","$1,487.26 ","$1,567.30 ",$365.14 ,"$2,239.00 ",$376.09 ,"$2,239.00 ","$2,127.05 ",$365.14 ,"$1,791.20 ","$2,059.88 ",$365.14 ,$750.00 ,"$2,127.05 ","$1,970.32 ","$1,701.64 ",$365.14 ,$365.14 ,$365.14 ,"$1,634.47 ","$1,231.45 ","$2,037.49 ","$2,037.49 ","$1,791.20 ","$1,531.88 ","$1,231.45 ","$2,015.10 ","$1,487.26 ","$2,015.10 ","$1,209.06 ","$2,104.66 ","$3,346.33 ","$2,059.88 ",$387.05 ,"$2,037.49 ","$1,487.26 ","$1,377.88 ","$1,377.88 ","$2,015.10 ","$1,670.97 ","$2,015.10 ","$1,502.13 ",$365.14 ,"$2,127.05 ","$1,561.62 ",$365.14 ,"$1,947.93 ","$1,487.26 ","$2,015.10 ","$1,487.26 ","$2,015.10 ","$2,015.10 ","$2,015.10 ","$2,171.83 ","$1,813.59 ","$2,082.27 ","$1,925.54 ","$2,171.83 "
SACRED HEART HOSPITAL (ACU),36000133,36576,HC RPR CATH CV W/PORT/PUMP,360,1 ,"$1,856.00 ","$1,392.00 ",$237.34 ,"$3,346.33 ","$1,195.26 ","$1,487.26 ","$1,299.20 ",$237.34 ,"$1,856.00 ",$244.46 ,"$1,856.00 ","$1,763.20 ",$237.34 ,"$1,484.80 ","$1,707.52 ",$237.34 ,"$1,000.00 ","$1,763.20 ","$1,633.28 ","$1,410.56 ",$237.34 ,$237.34 ,$237.34 ,"$1,354.88 ","$1,020.80 ","$1,688.96 ","$1,688.96 ","$1,484.80 ","$1,531.88 ","$1,020.80 ","$1,670.40 ","$1,487.26 ","$1,670.40 ","$1,002.24 ","$1,744.64 ","$3,346.33 ","$1,707.52 ",$251.58 ,"$1,688.96 ","$1,487.26 ","$1,142.18 ","$1,142.18 ","$1,670.40 ","$1,385.13 ","$1,670.40 ","$1,502.13 ",$237.34 ,"$1,763.20 ","$1,561.62 ",$237.34 ,"$1,614.72 ","$1,487.26 ","$1,670.40 ","$1,487.26 ","$1,670.40 ","$1,670.40 ","$1,670.40 ","$1,800.32 ","$1,503.36 ","$1,726.08 ","$1,596.16 ","$1,800.32 "
SACRED HEART HOSPITAL (ACU),36000134,36578,HC REPLACE CATH CV W/PORT/PUMP,360,1 ,"$1,656.00 ","$1,242.00 ",$237.34 ,"$6,812.22 ","$1,066.46 ","$3,027.65 ","$1,159.20 ",$237.34 ,"$1,656.00 ",$244.46 ,"$1,656.00 ","$1,573.20 ",$237.34 ,"$1,324.80 ","$1,523.52 ",$237.34 ,"$1,000.00 ","$1,573.20 ","$1,457.28 ","$1,258.56 ",$237.34 ,$237.34 ,$237.34 ,"$1,208.88 ",$910.80 ,"$1,506.96 ","$1,506.96 ","$1,324.80 ","$3,118.48 ",$910.80 ,"$1,490.40 ","$3,027.65 ","$1,490.40 ",$894.24 ,"$1,556.64 ","$6,812.22 ","$1,523.52 ",$251.58 ,"$1,506.96 ","$3,027.65 ","$1,019.10 ","$1,019.10 ","$1,490.40 ","$1,235.87 ","$1,490.40 ","$3,057.93 ",$237.34 ,"$1,573.20 ","$3,179.04 ",$237.34 ,"$1,440.72 ","$3,027.65 ","$1,490.40 ","$3,027.65 ","$1,490.40 ","$1,490.40 ","$1,490.40 ","$1,606.32 ","$1,341.36 ","$1,540.08 ","$1,424.16 ","$1,606.32 "
SACRED HEART HOSPITAL (ACU),36000135,36580,HC REPL CATH CV NON-TNL W/O PORT,360,1 ,"$1,623.00 ","$1,217.25 ",$365.14 ,"$3,346.33 ","$1,045.21 ","$1,487.26 ","$1,136.10 ",$365.14 ,"$1,623.00 ",$376.09 ,"$1,623.00 ","$1,541.85 ",$365.14 ,"$1,298.40 ","$1,493.16 ",$365.14 ,$750.00 ,"$1,541.85 ","$1,428.24 ","$1,233.48 ",$365.14 ,$365.14 ,$365.14 ,"$1,184.79 ",$892.65 ,"$1,476.93 ","$1,476.93 ","$1,298.40 ","$1,531.88 ",$892.65 ,"$1,460.70 ","$1,487.26 ","$1,460.70 ",$876.42 ,"$1,525.62 ","$3,346.33 ","$1,493.16 ",$387.05 ,"$1,476.93 ","$1,487.26 ",$998.79 ,$998.79 ,"$1,460.70 ","$1,211.24 ","$1,460.70 ","$1,502.13 ",$365.14 ,"$1,541.85 ","$1,561.62 ",$365.14 ,"$1,412.01 ","$1,487.26 ","$1,460.70 ","$1,487.26 ","$1,460.70 ","$1,460.70 ","$1,460.70 ","$1,574.31 ","$1,314.63 ","$1,509.39 ","$1,395.78 ","$1,574.31 "
SACRED HEART HOSPITAL (ACU),36000136,36581,HC REPL CATH CV TNL W/O PORT,360,1 ,"$1,623.00 ","$1,217.25 ",$713.20 ,"$6,812.22 ","$1,045.21 ","$3,027.65 ","$1,136.10 ",$713.20 ,"$1,623.00 ",$734.60 ,"$1,623.00 ","$1,541.85 ",$713.20 ,"$1,298.40 ","$1,493.16 ",$713.20 ,"$1,000.00 ","$1,541.85 ","$1,428.24 ","$1,233.48 ",$713.20 ,$713.20 ,$713.20 ,"$1,184.79 ",$892.65 ,"$1,476.93 ","$1,476.93 ","$1,298.40 ","$3,118.48 ",$892.65 ,"$1,460.70 ","$3,027.65 ","$1,460.70 ",$876.42 ,"$1,525.62 ","$6,812.22 ","$1,493.16 ",$755.99 ,"$1,476.93 ","$3,027.65 ",$998.79 ,$998.79 ,"$1,460.70 ","$1,211.24 ","$1,460.70 ","$3,057.93 ",$713.20 ,"$1,541.85 ","$3,179.04 ",$713.20 ,"$1,412.01 ","$3,027.65 ","$1,460.70 ","$3,027.65 ","$1,460.70 ","$1,460.70 ","$1,460.70 ","$1,574.31 ","$1,314.63 ","$1,509.39 ","$1,395.78 ","$1,574.31 "
SACRED HEART HOSPITAL (ACU),36000137,36582,HC REPL DEVICE CV TNL W/PORT,360,1 ,"$1,503.00 ","$1,127.25 ",$713.20 ,"$6,812.22 ",$967.93 ,"$3,027.65 ","$1,052.10 ",$713.20 ,"$1,503.00 ",$734.60 ,"$1,503.00 ","$1,427.85 ",$713.20 ,"$1,202.40 ","$1,382.76 ",$713.20 ,"$1,000.00 ","$1,427.85 ","$1,322.64 ","$1,142.28 ",$713.20 ,$713.20 ,$713.20 ,"$1,097.19 ",$826.65 ,"$1,367.73 ","$1,367.73 ","$1,202.40 ","$3,118.48 ",$826.65 ,"$1,352.70 ","$3,027.65 ","$1,352.70 ",$811.62 ,"$1,412.82 ","$6,812.22 ","$1,382.76 ",$755.99 ,"$1,367.73 ","$3,027.65 ",$924.95 ,$924.95 ,"$1,352.70 ","$1,121.69 ","$1,352.70 ","$3,057.93 ",$713.20 ,"$1,427.85 ","$3,179.04 ",$713.20 ,"$1,307.61 ","$3,027.65 ","$1,352.70 ","$3,027.65 ","$1,352.70 ","$1,352.70 ","$1,352.70 ","$1,457.91 ","$1,217.43 ","$1,397.79 ","$1,292.58 ","$1,457.91 "
SACRED HEART HOSPITAL (ACU),36000138,36583,HC REPLACE DEVICE CV TNL W/PUMP,360,1 ,"$1,606.00 ","$1,204.50 ",$713.20 ,"$11,347.95 ","$1,034.26 ","$5,043.53 ","$1,124.20 ",$713.20 ,"$1,606.00 ",$734.60 ,"$1,606.00 ","$1,525.70 ",$713.20 ,"$1,284.80 ","$1,477.52 ",$713.20 ,"$1,000.00 ","$1,525.70 ","$1,413.28 ","$1,220.56 ",$713.20 ,$713.20 ,$713.20 ,"$1,172.38 ",$883.30 ,"$1,461.46 ","$1,461.46 ","$1,284.80 ","$5,194.84 ",$883.30 ,"$1,445.40 ","$5,043.53 ","$1,445.40 ",$867.24 ,"$1,509.64 ","$11,347.95 ","$1,477.52 ",$755.99 ,"$1,461.46 ","$5,043.53 ",$988.33 ,$988.33 ,"$1,445.40 ","$1,198.56 ","$1,445.40 ","$5,093.97 ",$713.20 ,"$1,525.70 ","$5,295.71 ",$713.20 ,"$1,397.22 ","$5,043.53 ","$1,445.40 ","$5,043.53 ","$1,445.40 ","$1,445.40 ","$1,445.40 ","$1,557.82 ","$1,300.86 ","$1,493.58 ","$1,381.16 ","$1,557.82 "
SACRED HEART HOSPITAL (ACU),36000139,36584,HC REPL PICC W/O PORT/PUMP,360,1 ,"$3,665.00 ","$2,748.75 ",$365.14 ,"$3,665.00 ","$2,360.26 ","$1,487.26 ","$2,565.50 ",$365.14 ,"$3,665.00 ",$376.09 ,"$3,665.00 ","$3,481.75 ",$365.14 ,"$2,932.00 ","$3,371.80 ",$365.14 ,$750.00 ,"$3,481.75 ","$3,225.20 ","$2,785.40 ",$365.14 ,$365.14 ,$365.14 ,"$2,675.45 ","$2,015.75 ","$3,335.15 ","$3,335.15 ","$2,932.00 ","$1,531.88 ","$2,015.75 ","$3,298.50 ","$1,487.26 ","$3,298.50 ","$1,979.10 ","$3,445.10 ","$3,346.33 ","$3,371.80 ",$387.05 ,"$3,335.15 ","$1,487.26 ","$2,255.44 ","$2,255.44 ","$3,298.50 ","$2,735.19 ","$2,519.91 ","$1,502.13 ",$365.14 ,"$3,481.75 ","$1,561.62 ",$365.14 ,"$3,188.55 ","$1,487.26 ","$3,298.50 ","$1,487.26 ","$3,298.50 ","$3,298.50 ","$3,298.50 ","$3,555.05 ","$2,968.65 ","$3,408.45 ","$3,151.90 ","$3,555.05 "
SACRED HEART HOSPITAL (ACU),36000140,36585,HC REPL PICC W/PORT,360,1 ,"$1,503.00 ","$1,127.25 ",$365.14 ,"$6,812.22 ",$967.93 ,"$3,027.65 ","$1,052.10 ",$365.14 ,"$1,503.00 ",$376.09 ,"$1,503.00 ","$1,427.85 ",$365.14 ,"$1,202.40 ","$1,382.76 ",$365.14 ,"$1,000.00 ","$1,427.85 ","$1,322.64 ","$1,142.28 ",$365.14 ,$365.14 ,$365.14 ,"$1,097.19 ",$826.65 ,"$1,367.73 ","$1,367.73 ","$1,202.40 ","$3,118.48 ",$826.65 ,"$1,352.70 ","$3,027.65 ","$1,352.70 ",$811.62 ,"$1,412.82 ","$6,812.22 ","$1,382.76 ",$387.05 ,"$1,367.73 ","$3,027.65 ",$924.95 ,$924.95 ,"$1,352.70 ","$1,121.69 ","$1,352.70 ","$3,057.93 ",$365.14 ,"$1,427.85 ","$3,179.04 ",$365.14 ,"$1,307.61 ","$3,027.65 ","$1,352.70 ","$3,027.65 ","$1,352.70 ","$1,352.70 ","$1,352.70 ","$1,457.91 ","$1,217.43 ","$1,397.79 ","$1,292.58 ","$1,457.91 "
SACRED HEART HOSPITAL (ACU),36000141,36589,HC REMOVE TUNNELED CATH-NO PORT,360,1 ,"$1,695.00 ","$1,271.25 ",$237.34 ,"$1,695.00 ","$1,091.58 ",$571.68 ,"$1,186.50 ",$237.34 ,"$1,695.00 ",$244.46 ,"$1,695.00 ","$1,610.25 ",$237.34 ,"$1,356.00 ","$1,559.40 ",$237.34 ,$750.00 ,"$1,610.25 ","$1,491.60 ","$1,288.20 ",$237.34 ,$237.34 ,$237.34 ,"$1,237.35 ",$932.25 ,"$1,542.45 ","$1,542.45 ","$1,356.00 ",$588.83 ,$932.25 ,"$1,525.50 ",$571.68 ,"$1,525.50 ",$915.30 ,"$1,593.30 ","$1,286.28 ","$1,559.40 ",$251.58 ,"$1,542.45 ",$571.68 ,"$1,043.10 ","$1,043.10 ","$1,525.50 ","$1,264.98 ","$1,525.50 ",$577.40 ,$237.34 ,"$1,610.25 ",$600.27 ,$237.34 ,"$1,474.65 ",$571.68 ,"$1,525.50 ",$571.68 ,"$1,525.50 ","$1,525.50 ","$1,525.50 ","$1,644.15 ","$1,372.95 ","$1,576.35 ","$1,457.70 ","$1,644.15 "
SACRED HEART HOSPITAL (ACU),36000142,36590,HC REM TNL CV ACC W/PORT/PUMP,360,1 ,"$1,850.00 ","$1,387.50 ",$237.34 ,"$3,346.33 ","$1,191.40 ","$1,487.26 ","$1,295.00 ",$237.34 ,"$1,850.00 ",$244.46 ,"$1,850.00 ","$1,757.50 ",$237.34 ,"$1,480.00 ","$1,702.00 ",$237.34 ,$750.00 ,"$1,757.50 ","$1,628.00 ","$1,406.00 ",$237.34 ,$237.34 ,$237.34 ,"$1,350.50 ","$1,017.50 ","$1,683.50 ","$1,683.50 ","$1,480.00 ","$1,531.88 ","$1,017.50 ","$1,665.00 ","$1,487.26 ","$1,665.00 ",$999.00 ,"$1,739.00 ","$3,346.33 ","$1,702.00 ",$251.58 ,"$1,683.50 ","$1,487.26 ","$1,138.49 ","$1,138.49 ","$1,665.00 ","$1,380.66 ","$1,665.00 ","$1,502.13 ",$237.34 ,"$1,757.50 ","$1,561.62 ",$237.34 ,"$1,609.50 ","$1,487.26 ","$1,665.00 ","$1,487.26 ","$1,665.00 ","$1,665.00 ","$1,665.00 ","$1,794.50 ","$1,498.50 ","$1,720.50 ","$1,591.00 ","$1,794.50 "
SACRED HEART HOSPITAL (ACU),36000144,36595,HC REM PERICATHETER MAT CV DEV,360,1 ,"$1,512.00 ","$1,134.00 ",$237.34 ,"$6,812.22 ",$973.73 ,"$3,027.65 ","$1,058.40 ",$237.34 ,"$1,512.00 ",$244.46 ,"$1,512.00 ","$1,436.40 ",$237.34 ,"$1,209.60 ","$1,391.04 ",$237.34 , N/A ,"$1,436.40 ","$1,330.56 ","$1,149.12 ",$237.34 ,$237.34 ,$237.34 ,"$1,103.76 ",$831.60 ,"$1,375.92 ","$1,375.92 ","$1,209.60 ","$3,118.48 ",$831.60 ,"$1,360.80 ","$3,027.65 ","$1,360.80 ",$816.48 ,"$1,421.28 ","$6,812.22 ","$1,391.04 ",$251.58 ,"$1,375.92 ","$3,027.65 ",$930.48 ,$930.48 ,"$1,360.80 ","$1,128.41 ","$1,360.80 ","$3,057.93 ",$237.34 ,"$1,436.40 ","$3,179.04 ",$237.34 ,"$1,315.44 ","$3,027.65 ","$1,360.80 ","$3,027.65 ","$1,360.80 ","$1,360.80 ","$1,360.80 ","$1,466.64 ","$1,224.72 ","$1,406.16 ","$1,300.32 ","$1,466.64 "
SACRED HEART HOSPITAL (ACU),36000145,36596,HC REM INTRALUM MAT CV LUMEN,360,1 ,"$1,512.00 ","$1,134.00 ",$237.34 ,"$3,346.33 ",$973.73 ,"$1,487.26 ","$1,058.40 ",$237.34 ,"$1,512.00 ",$244.46 ,"$1,512.00 ","$1,436.40 ",$237.34 ,"$1,209.60 ","$1,391.04 ",$237.34 , N/A ,"$1,436.40 ","$1,330.56 ","$1,149.12 ",$237.34 ,$237.34 ,$237.34 ,"$1,103.76 ",$831.60 ,"$1,375.92 ","$1,375.92 ","$1,209.60 ","$1,531.88 ",$831.60 ,"$1,360.80 ","$1,487.26 ","$1,360.80 ",$816.48 ,"$1,421.28 ","$3,346.33 ","$1,391.04 ",$251.58 ,"$1,375.92 ","$1,487.26 ",$930.48 ,$930.48 ,"$1,360.80 ","$1,128.41 ","$1,360.80 ","$1,502.13 ",$237.34 ,"$1,436.40 ","$1,561.62 ",$237.34 ,"$1,315.44 ","$1,487.26 ","$1,360.80 ","$1,487.26 ","$1,360.80 ","$1,360.80 ","$1,360.80 ","$1,466.64 ","$1,224.72 ","$1,406.16 ","$1,300.32 ","$1,466.64 "
SACRED HEART HOSPITAL (ACU),36000146,36597,HC REPOSITION CENTRAL VENOUS CATH,360,1 ,"$1,434.00 ","$1,075.50 ",$237.34 ,"$3,346.33 ",$923.50 ,"$1,487.26 ","$1,003.80 ",$237.34 ,"$1,434.00 ",$244.46 ,"$1,434.00 ","$1,362.30 ",$237.34 ,"$1,147.20 ","$1,319.28 ",$237.34 , N/A ,"$1,362.30 ","$1,261.92 ","$1,089.84 ",$237.34 ,$237.34 ,$237.34 ,"$1,046.82 ",$788.70 ,"$1,304.94 ","$1,304.94 ","$1,147.20 ","$1,531.88 ",$788.70 ,"$1,290.60 ","$1,487.26 ","$1,290.60 ",$774.36 ,"$1,347.96 ","$3,346.33 ","$1,319.28 ",$251.58 ,"$1,304.94 ","$1,487.26 ",$882.48 ,$882.48 ,"$1,290.60 ","$1,070.19 ","$1,290.60 ","$1,502.13 ",$237.34 ,"$1,362.30 ","$1,561.62 ",$237.34 ,"$1,247.58 ","$1,487.26 ","$1,290.60 ","$1,487.26 ","$1,290.60 ","$1,290.60 ","$1,290.60 ","$1,390.98 ","$1,161.54 ","$1,333.62 ","$1,233.24 ","$1,390.98 "
SACRED HEART HOSPITAL (ACU),36000148,36620,HC CATH/CANN ARTERY PERC 36620,360,1 ,$324.00 ,$243.00 ,$174.96 ,$324.00 ,$208.66 , N/A ,$226.80 ,$206.34 ,$324.00 ,$212.53 ,$324.00 ,$307.80 ,$206.34 ,$259.20 ,$298.08 ,$206.34 , N/A ,$307.80 ,$285.12 ,$246.24 ,$206.34 ,$206.34 ,$206.34 ,$236.52 ,$178.20 ,$294.84 ,$294.84 ,$259.20 , N/A ,$178.20 ,$291.60 , N/A ,$291.60 ,$174.96 ,$304.56 , N/A ,$298.08 ,$218.72 ,$294.84 , N/A ,$199.39 ,$199.39 ,$291.60 ,$241.80 ,$291.60 , N/A ,$206.34 ,$307.80 , N/A ,$206.34 ,$281.88 , N/A ,$291.60 , N/A ,$291.60 ,$291.60 ,$291.60 ,$314.28 ,$262.44 ,$301.32 ,$278.64 ,$314.28 
SACRED HEART HOSPITAL (ACU),36000158,38221,HC BX BONE MARROW ONLY,360,1 ,$745.00 ,$558.75 ,$385.73 ,"$3,348.27 ",$479.78 ,"$1,488.12 ",$521.50 ,$385.73 ,$745.00 ,$397.30 ,$745.00 ,$707.75 ,$385.73 ,$596.00 ,$685.40 ,$385.73 ,$745.00 ,$707.75 ,$655.60 ,$566.20 ,$385.73 ,$385.73 ,$385.73 ,$543.85 ,$409.75 ,$677.95 ,$677.95 ,$596.00 ,"$1,532.76 ",$409.75 ,$670.50 ,"$1,488.12 ",$670.50 ,$402.30 ,$700.30 ,"$3,348.27 ",$685.40 ,$408.87 ,$677.95 ,"$1,488.12 ",$458.47 ,$458.47 ,$670.50 ,$555.99 ,$670.50 ,"$1,503.00 ",$385.73 ,$707.75 ,"$1,562.52 ",$385.73 ,$648.15 ,"$1,488.12 ",$670.50 ,"$1,488.12 ",$670.50 ,$670.50 ,$670.50 ,$722.65 ,$603.45 ,$692.85 ,$640.70 ,$722.65 
SACRED HEART HOSPITAL (ACU),36000159,38505,HC LYMPH NODE BIOPSY SUPERFICIAL,360,1 ,$884.00 ,$663.00 ,$373.05 ,"$3,348.27 ",$569.30 ,"$1,488.12 ",$618.80 ,$373.05 ,$884.00 ,$384.24 ,$884.00 ,$839.80 ,$373.05 ,$707.20 ,$813.28 ,$373.05 , N/A ,$839.80 ,$777.92 ,$671.84 ,$373.05 ,$373.05 ,$373.05 ,$645.32 ,$486.20 ,$804.44 ,$804.44 ,$707.20 ,"$1,532.76 ",$486.20 ,$795.60 ,"$1,488.12 ",$795.60 ,$477.36 ,$830.96 ,"$3,348.27 ",$813.28 ,$395.43 ,$804.44 ,"$1,488.12 ",$544.01 ,$544.01 ,$795.60 ,$659.73 ,$795.60 ,"$1,503.00 ",$373.05 ,$839.80 ,"$1,562.52 ",$373.05 ,$769.08 ,"$1,488.12 ",$795.60 ,"$1,488.12 ",$795.60 ,$795.60 ,$795.60 ,$857.48 ,$716.04 ,$822.12 ,$760.24 ,$857.48 
SACRED HEART HOSPITAL (ACU),36000161,38792,HC INJ LYMPH NODE NO IMAGING,360,1 ,$686.00 ,$514.50 ,$124.60 ,$897.05 ,$441.78 ,$398.69 ,$480.20 ,$124.60 ,$686.00 ,$128.34 ,$686.00 ,$651.70 ,$124.60 ,$548.80 ,$631.12 ,$124.60 ,$686.00 ,$651.70 ,$603.68 ,$521.36 ,$124.60 ,$124.60 ,$124.60 ,$500.78 ,$377.30 ,$624.26 ,$624.26 ,$548.80 ,$410.65 ,$377.30 ,$617.40 ,$398.69 ,$617.40 ,$370.44 ,$644.84 ,$897.05 ,$631.12 ,$132.08 ,$624.26 ,$398.69 ,$422.16 ,$422.16 ,$617.40 ,$511.96 ,$617.40 ,$402.67 ,$124.60 ,$651.70 ,$418.62 ,$124.60 ,$596.82 ,$398.69 ,$617.40 ,$398.69 ,$617.40 ,$617.40 ,$617.40 ,$665.42 ,$555.66 ,$637.98 ,$589.96 ,$665.42 
SACRED HEART HOSPITAL (ACU),36000171,47490,HC CHOLECYSTOSTOMY PERC,360,1 ,"$1,636.65 ","$1,227.49 ",$817.89 ,"$7,571.16 ","$1,054.00 ","$3,364.96 ","$1,145.66 ",$817.89 ,"$1,636.65 ",$842.43 ,"$1,636.65 ","$1,554.82 ",$817.89 ,"$1,309.32 ","$1,505.72 ",$817.89 , N/A ,"$1,554.82 ","$1,440.25 ","$1,243.85 ",$817.89 ,$817.89 ,$817.89 ,"$1,194.75 ",$900.16 ,"$1,489.35 ","$1,489.35 ","$1,309.32 ","$3,465.91 ",$900.16 ,"$1,472.99 ","$3,364.96 ","$1,472.99 ",$883.79 ,"$1,538.45 ","$7,571.16 ","$1,505.72 ",$866.96 ,"$1,489.35 ","$3,364.96 ","$1,007.19 ","$1,007.19 ","$1,472.99 ","$1,221.43 ","$1,472.99 ","$3,398.61 ",$817.89 ,"$1,554.82 ","$3,533.21 ",$817.89 ,"$1,423.89 ","$3,364.96 ","$1,472.99 ","$3,364.96 ","$1,472.99 ","$1,472.99 ","$1,472.99 ","$1,587.55 ","$1,325.69 ","$1,522.08 ","$1,407.52 ","$1,587.55 "
SACRED HEART HOSPITAL (ACU),36000176,49418,HC INSERT INTRAPERITONEAL CATH,360,1 ,"$1,610.00 ","$1,207.50 ",$869.40 ,"$7,571.16 ","$1,036.84 ","$3,364.96 ","$1,127.00 ","$1,209.18 ","$1,610.00 ","$1,245.46 ","$1,610.00 ","$1,529.50 ","$1,209.18 ","$1,288.00 ","$1,481.20 ","$1,209.18 ", N/A ,"$1,529.50 ","$1,416.80 ","$1,223.60 ","$1,209.18 ","$1,209.18 ","$1,209.18 ","$1,175.30 ",$885.50 ,"$1,465.10 ","$1,465.10 ","$1,288.00 ","$3,465.91 ",$885.50 ,"$1,449.00 ","$3,364.96 ","$1,449.00 ",$869.40 ,"$1,513.40 ","$7,571.16 ","$1,481.20 ","$1,281.73 ","$1,465.10 ","$3,364.96 ",$990.79 ,$990.79 ,"$1,449.00 ","$1,201.54 ","$1,449.00 ","$3,398.61 ","$1,209.18 ","$1,529.50 ","$3,533.21 ","$1,209.18 ","$1,400.70 ","$3,364.96 ","$1,449.00 ","$3,364.96 ","$1,449.00 ","$1,449.00 ","$1,449.00 ","$1,561.70 ","$1,304.10 ","$1,497.30 ","$1,384.60 ","$1,561.70 "
SACRED HEART HOSPITAL (ACU),36000178,49422,HC REM CATH INTRAPERITONEAL,360,1 ,$638.00 ,$478.50 ,$239.96 ,"$6,812.22 ",$410.87 ,"$3,027.65 ",$446.60 ,$239.96 ,$638.00 ,$247.16 ,$638.00 ,$606.10 ,$239.96 ,$510.40 ,$586.96 ,$239.96 , N/A ,$606.10 ,$561.44 ,$484.88 ,$239.96 ,$239.96 ,$239.96 ,$465.74 ,$350.90 ,$580.58 ,$580.58 ,$510.40 ,"$3,118.48 ",$350.90 ,$574.20 ,"$3,027.65 ",$574.20 ,$344.52 ,$599.72 ,"$6,812.22 ",$586.96 ,$254.36 ,$580.58 ,"$3,027.65 ",$392.63 ,$392.63 ,$574.20 ,$476.14 ,$574.20 ,"$3,057.93 ",$239.96 ,$606.10 ,"$3,179.04 ",$239.96 ,$555.06 ,"$3,027.65 ",$574.20 ,"$3,027.65 ",$574.20 ,$574.20 ,$574.20 ,$618.86 ,$516.78 ,$593.34 ,$548.68 ,$618.86 
SACRED HEART HOSPITAL (ACU),36000183,51710,HC CHG TUBE CYSTOSTOMY CPLX,360,1 ,$709.00 ,$531.75 ,$64.85 ,"$1,369.05 ",$456.60 ,$608.47 ,$496.30 ,$64.85 ,$709.00 ,$66.80 ,$709.00 ,$673.55 ,$64.85 ,$567.20 ,$652.28 ,$64.85 , N/A ,$673.55 ,$623.92 ,$538.84 ,$64.85 ,$64.85 ,$64.85 ,$517.57 ,$389.95 ,$645.19 ,$645.19 ,$567.20 ,$626.72 ,$389.95 ,$638.10 ,$608.47 ,$638.10 ,$382.86 ,$666.46 ,"$1,369.05 ",$652.28 ,$68.74 ,$645.19 ,$608.47 ,$436.32 ,$436.32 ,$638.10 ,$529.13 ,$638.10 ,$614.55 ,$64.85 ,$673.55 ,$638.89 ,$64.85 ,$616.83 ,$608.47 ,$638.10 ,$608.47 ,$638.10 ,$638.10 ,$638.10 ,$687.73 ,$574.29 ,$659.37 ,$609.74 ,$687.73 
SACRED HEART HOSPITAL (ACU),36000184,51784,HC EMG BOWEL/BLADDER SPHINCTER,360,1 ,$288.00 ,$216.00 ,$44.29 ,$332.24 ,$185.47 ,$147.66 ,$201.60 ,$44.29 ,$288.00 ,$45.62 ,$288.00 ,$273.60 ,$44.29 ,$230.40 ,$264.96 ,$44.29 , N/A ,$273.60 ,$253.44 ,$218.88 ,$44.29 ,$44.29 ,$44.29 ,$210.24 ,$158.40 ,$262.08 ,$262.08 ,$230.40 ,$152.09 ,$158.40 ,$259.20 ,$147.66 ,$259.20 ,$155.52 ,$270.72 ,$332.24 ,$264.96 ,$46.95 ,$262.08 ,$147.66 ,$177.24 ,$177.24 ,$259.20 ,$214.93 ,$259.20 ,$149.14 ,$44.29 ,$273.60 ,$155.05 ,$44.29 ,$250.56 ,$147.66 ,$259.20 ,$147.66 ,$259.20 ,$259.20 ,$259.20 ,$279.36 ,$233.28 ,$267.84 ,$247.68 ,$279.36 
SACRED HEART HOSPITAL (ACU),36000187,54150,HC CIRCUMCISION OP,360,1 ,$417.00 ,$312.75 ,$225.18 ,"$4,260.86 ",$268.55 ,"$1,893.71 ",$291.90 ,$417.00 ,$417.00 ,$656.60 ,$417.00 ,$396.15 ,$637.48 ,$333.60 ,$383.64 ,$417.00 , N/A ,$396.15 ,$366.96 ,$316.92 ,$417.00 ,$417.00 ,$637.48 ,$304.41 ,$229.35 ,$379.47 ,$379.47 ,$333.60 ,"$1,950.52 ",$229.35 ,$375.30 ,"$1,893.71 ",$375.30 ,$225.18 ,$391.98 ,"$4,260.86 ",$383.64 ,$675.73 ,$379.47 ,"$1,893.71 ",$256.62 ,$256.62 ,$375.30 ,$311.21 ,$375.30 ,"$1,912.65 ",$417.00 ,$396.15 ,"$1,988.40 ",$417.00 ,$362.79 ,"$1,893.71 ",$375.30 ,"$1,893.71 ",$375.30 ,$375.30 ,$375.30 ,$404.49 ,$337.77 ,$387.81 ,$358.62 ,$404.49 
SACRED HEART HOSPITAL (ACU),36000190,61624,HC OCC/EMB TRANSCATH CNS PERC,360,1 ,"$1,741.34 ","$1,306.01 ",$940.32 ,"$3,867.78 ","$1,121.42 ", N/A ,"$1,218.94 ","$1,741.34 ","$1,741.34 ","$3,758.32 ","$1,741.34 ","$1,654.27 ","$3,648.85 ","$1,393.07 ","$1,602.03 ","$1,741.34 ", N/A ,"$1,654.27 ","$1,532.38 ","$1,323.42 ","$1,741.34 ","$1,741.34 ","$3,648.85 ","$1,271.18 ",$957.74 ,"$1,584.62 ","$1,584.62 ","$1,393.07 ", N/A ,$957.74 ,"$1,567.21 ", N/A ,"$1,567.21 ",$940.32 ,"$1,636.86 ", N/A ,"$1,602.03 ","$3,867.78 ","$1,584.62 ", N/A ,"$1,071.62 ","$1,071.62 ","$1,567.21 ","$1,299.56 ","$1,567.21 ", N/A ,"$1,741.34 ","$1,654.27 ", N/A ,"$1,741.34 ","$1,514.97 ", N/A ,"$1,567.21 ", N/A ,"$1,567.21 ","$1,567.21 ","$1,567.21 ","$1,689.10 ","$1,410.49 ","$1,619.45 ","$1,497.55 ","$1,689.10 "
SACRED HEART HOSPITAL (ACU),36000191,61626,HC OCC/EMB TRANSCATH EXT CRAN VSS,360,1 ,"$5,081.02 ","$3,810.77 ","$2,743.75 ","$23,902.85 ","$3,272.18 ","$10,623.49 ","$3,556.71 ","$3,648.85 ","$5,081.02 ","$3,758.32 ","$5,081.02 ","$4,826.97 ","$3,648.85 ","$4,064.82 ","$4,674.54 ","$3,648.85 ", N/A ,"$4,826.97 ","$4,471.30 ","$3,861.58 ","$3,648.85 ","$3,648.85 ","$3,648.85 ","$3,709.14 ","$2,794.56 ","$4,623.73 ","$4,623.73 ","$4,064.82 ","$10,942.19 ","$2,794.56 ","$4,572.92 ","$10,623.49 ","$4,572.92 ","$2,743.75 ","$4,776.16 ","$23,902.85 ","$4,674.54 ","$3,867.78 ","$4,623.73 ","$10,623.49 ","$3,126.86 ","$3,126.86 ","$4,572.92 ","$3,791.97 ","$4,572.92 ","$10,729.72 ","$3,648.85 ","$4,826.97 ","$11,154.66 ","$3,648.85 ","$4,420.49 ","$10,623.49 ","$4,572.92 ","$10,623.49 ","$4,572.92 ","$4,572.92 ","$4,572.92 ","$4,928.59 ","$4,115.63 ","$4,725.35 ","$4,369.68 ","$4,928.59 "
SACRED HEART HOSPITAL (ACU),36000193,62267,HC DISC ASPIRATION,360,1 ,"$1,412.00 ","$1,059.00 ",$277.73 ,"$1,480.84 ",$909.33 ,$658.15 ,$988.40 ,$277.73 ,"$1,412.00 ",$286.06 ,"$1,412.00 ","$1,341.40 ",$277.73 ,"$1,129.60 ","$1,299.04 ",$277.73 , N/A ,"$1,341.40 ","$1,242.56 ","$1,073.12 ",$277.73 ,$277.73 ,$277.73 ,"$1,030.76 ",$776.60 ,"$1,284.92 ","$1,284.92 ","$1,129.60 ",$677.89 ,$776.60 ,"$1,270.80 ",$658.15 ,"$1,270.80 ",$762.48 ,"$1,327.28 ","$1,480.84 ","$1,299.04 ",$294.39 ,"$1,284.92 ",$658.15 ,$868.94 ,$868.94 ,"$1,270.80 ","$1,053.78 ","$1,270.80 ",$664.73 ,$277.73 ,"$1,341.40 ",$691.06 ,$277.73 ,"$1,228.44 ",$658.15 ,"$1,270.80 ",$658.15 ,"$1,270.80 ","$1,270.80 ","$1,270.80 ","$1,369.64 ","$1,143.72 ","$1,313.16 ","$1,214.32 ","$1,369.64 "
SACRED HEART HOSPITAL (ACU),36000194,62270,HC LUMBAR PUNCTURE,360,1 ,$655.00 ,$491.25 ,$277.73 ,"$1,511.09 ",$421.82 ,$671.59 ,$458.50 ,$277.73 ,$655.00 ,$286.06 ,$655.00 ,$622.25 ,$277.73 ,$524.00 ,$602.60 ,$277.73 , N/A ,$622.25 ,$576.40 ,$497.80 ,$277.73 ,$277.73 ,$277.73 ,$478.15 ,$360.25 ,$596.05 ,$596.05 ,$524.00 ,$691.74 ,$360.25 ,$589.50 ,$671.59 ,$589.50 ,$353.70 ,$615.70 ,"$1,511.09 ",$602.60 ,$294.39 ,$596.05 ,$671.59 ,$403.09 ,$403.09 ,$589.50 ,$488.83 ,$589.50 ,$678.31 ,$277.73 ,$622.25 ,$705.17 ,$277.73 ,$569.85 ,$671.59 ,$589.50 ,$671.59 ,$589.50 ,$589.50 ,$589.50 ,$635.35 ,$530.55 ,$609.15 ,$563.30 ,$635.35 
SACRED HEART HOSPITAL (ACU),36000216,50593,HC ABLATION RENAL PERC CRYO,360,1 ,$988.00 ,$741.00 ,$533.52 ,"$21,195.25 ",$636.27 ,"$9,420.11 ",$691.60 ,$988.00 ,$988.00 ,"$2,319.25 ",$988.00 ,$938.60 ,"$2,251.70 ",$790.40 ,$908.96 ,$988.00 , N/A ,$938.60 ,$869.44 ,$750.88 ,$988.00 ,$988.00 ,"$2,251.70 ",$721.24 ,$543.40 ,$899.08 ,$899.08 ,$790.40 ,"$9,702.71 ",$543.40 ,$889.20 ,"$9,420.11 ",$889.20 ,$533.52 ,$928.72 ,"$21,195.25 ",$908.96 ,"$2,386.80 ",$899.08 ,"$9,420.11 ",$608.02 ,$608.02 ,$889.20 ,$737.34 ,$889.20 ,"$9,514.31 ",$988.00 ,$938.60 ,"$9,891.12 ",$988.00 ,$859.56 ,"$9,420.11 ",$889.20 ,"$9,420.11 ",$889.20 ,$889.20 ,$889.20 ,$958.36 ,$800.28 ,$918.84 ,$849.68 ,$958.36 
SACRED HEART HOSPITAL (ACU),36000221,36570,HC INS CATH PERIPH CV W/PORT <5,360,1 ,"$1,341.00 ","$1,005.75 ",$365.14 ,"$6,812.22 ",$863.60 ,"$3,027.65 ",$938.70 ,$365.14 ,"$1,341.00 ",$376.09 ,"$1,341.00 ","$1,273.95 ",$365.14 ,"$1,072.80 ","$1,233.72 ",$365.14 ,"$1,125.00 ","$1,273.95 ","$1,180.08 ","$1,019.16 ",$365.14 ,$365.14 ,$365.14 ,$978.93 ,$737.55 ,"$1,220.31 ","$1,220.31 ","$1,072.80 ","$3,118.48 ",$737.55 ,"$1,206.90 ","$3,027.65 ","$1,206.90 ",$724.14 ,"$1,260.54 ","$6,812.22 ","$1,233.72 ",$387.05 ,"$1,220.31 ","$3,027.65 ",$825.25 ,$825.25 ,"$1,206.90 ","$1,000.79 ","$1,206.90 ","$3,057.93 ",$365.14 ,"$1,273.95 ","$3,179.04 ",$365.14 ,"$1,166.67 ","$3,027.65 ","$1,206.90 ","$3,027.65 ","$1,206.90 ","$1,206.90 ","$1,206.90 ","$1,300.77 ","$1,086.21 ","$1,247.13 ","$1,153.26 ","$1,300.77 "
SACRED HEART HOSPITAL (ACU),36000222,36571,HC INS CATH PERIPH CV W/PORT >5,360,1 ,"$1,884.00 ","$1,413.00 ",$365.14 ,"$6,812.22 ","$1,213.30 ","$3,027.65 ","$1,318.80 ",$365.14 ,"$1,884.00 ",$376.09 ,"$1,884.00 ","$1,789.80 ",$365.14 ,"$1,507.20 ","$1,733.28 ",$365.14 ,"$1,125.00 ","$1,789.80 ","$1,657.92 ","$1,431.84 ",$365.14 ,$365.14 ,$365.14 ,"$1,375.32 ","$1,036.20 ","$1,714.44 ","$1,714.44 ","$1,507.20 ","$3,118.48 ","$1,036.20 ","$1,695.60 ","$3,027.65 ","$1,695.60 ","$1,017.36 ","$1,770.96 ","$6,812.22 ","$1,733.28 ",$387.05 ,"$1,714.44 ","$3,027.65 ","$1,159.41 ","$1,159.41 ","$1,695.60 ","$1,406.03 ","$1,695.60 ","$3,057.93 ",$365.14 ,"$1,789.80 ","$3,179.04 ",$365.14 ,"$1,639.08 ","$3,027.65 ","$1,695.60 ","$3,027.65 ","$1,695.60 ","$1,695.60 ","$1,695.60 ","$1,827.48 ","$1,526.04 ","$1,752.12 ","$1,620.24 ","$1,827.48 "
SACRED HEART HOSPITAL (ACU),36000223,36575,HC REPAIR CATH CV W/O PORT/PUMP,360,1 ,"$1,364.00 ","$1,023.00 ",$237.34 ,"$1,364.00 ",$878.42 ,$571.68 ,$954.80 ,$237.34 ,"$1,364.00 ",$244.46 ,"$1,364.00 ","$1,295.80 ",$237.34 ,"$1,091.20 ","$1,254.88 ",$237.34 ,"$1,000.00 ","$1,295.80 ","$1,200.32 ","$1,036.64 ",$237.34 ,$237.34 ,$237.34 ,$995.72 ,$750.20 ,"$1,241.24 ","$1,241.24 ","$1,091.20 ",$588.83 ,$750.20 ,"$1,227.60 ",$571.68 ,"$1,227.60 ",$736.56 ,"$1,282.16 ","$1,286.28 ","$1,254.88 ",$251.58 ,"$1,241.24 ",$571.68 ,$839.41 ,$839.41 ,"$1,227.60 ","$1,017.95 ","$1,227.60 ",$577.40 ,$237.34 ,"$1,295.80 ",$600.27 ,$237.34 ,"$1,186.68 ",$571.68 ,"$1,227.60 ",$571.68 ,"$1,227.60 ","$1,227.60 ","$1,227.60 ","$1,323.08 ","$1,104.84 ","$1,268.52 ","$1,173.04 ","$1,323.08 "
SACRED HEART HOSPITAL (ACU),36000251,50592,HC ABLATION RENAL PERC RADIOFREQ,360,1 ,"$1,475.00 ","$1,106.25 ",$796.50 ,"$12,041.00 ",$949.90 ,"$5,351.56 ","$1,032.50 ",$955.28 ,"$1,475.00 ",$983.94 ,"$1,475.00 ","$1,401.25 ",$955.28 ,"$1,180.00 ","$1,357.00 ",$955.28 , N/A ,"$1,401.25 ","$1,298.00 ","$1,121.00 ",$955.28 ,$955.28 ,$955.28 ,"$1,076.75 ",$811.25 ,"$1,342.25 ","$1,342.25 ","$1,180.00 ","$5,512.11 ",$811.25 ,"$1,327.50 ","$5,351.56 ","$1,327.50 ",$796.50 ,"$1,386.50 ","$12,041.00 ","$1,357.00 ","$1,012.60 ","$1,342.25 ","$5,351.56 ",$907.72 ,$907.72 ,"$1,327.50 ","$1,100.79 ","$1,327.50 ","$5,405.07 ",$955.28 ,"$1,401.25 ","$5,619.13 ",$955.28 ,"$1,283.25 ","$5,351.56 ","$1,327.50 ","$5,351.56 ","$1,327.50 ","$1,327.50 ","$1,327.50 ","$1,430.75 ","$1,194.75 ","$1,371.75 ","$1,268.50 ","$1,430.75 "
SACRED HEART HOSPITAL (ACU),36000300,64635,HC RADIOFREQ;LUMBO/SACRAL;SINGLE,360,1 ,"$4,217.62 ","$3,163.22 ",$277.73 ,"$4,217.62 ","$2,716.15 ","$1,857.12 ","$2,952.33 ",$277.73 ,"$4,217.62 ",$286.06 ,"$3,859.00 ","$4,006.74 ",$277.73 ,"$3,374.10 ","$3,880.21 ",$277.73 , N/A ,"$4,006.74 ","$3,711.51 ","$3,205.39 ",$277.73 ,$277.73 ,$277.73 ,"$3,078.86 ","$2,319.69 ","$3,838.03 ","$3,838.03 ","$3,374.10 ","$1,912.83 ","$2,319.69 ","$3,795.86 ","$1,857.12 ","$3,795.86 ","$2,277.51 ","$3,964.56 ","$4,178.51 ","$3,880.21 ",$294.39 ,"$3,838.03 ","$1,857.12 ","$2,595.52 ","$2,595.52 ","$3,795.86 ","$3,147.61 ","$3,360.24 ","$1,875.69 ",$277.73 ,"$4,006.74 ","$1,949.97 ",$277.73 ,"$3,669.33 ","$1,857.12 ","$3,795.86 ","$1,857.12 ","$3,795.86 ","$3,795.86 ","$3,795.86 ","$4,091.09 ","$3,416.27 ","$3,922.39 ","$3,627.15 ","$4,091.09 "
SACRED HEART HOSPITAL (ACU),36000301,64636,HC RADIOFREQ;LUMBO/SACRAL;ADDTL,360,1 ,"$1,852.76 ","$1,389.57 ",$277.73 ,"$1,852.76 ","$1,193.18 ", N/A ,"$1,296.93 ",$277.73 ,"$1,852.76 ",$286.06 ,"$1,852.76 ","$1,760.12 ",$277.73 ,"$1,482.21 ","$1,704.54 ",$277.73 , N/A ,"$1,760.12 ","$1,630.43 ","$1,408.10 ",$277.73 ,$277.73 ,$277.73 ,"$1,352.51 ","$1,019.02 ","$1,686.01 ","$1,686.01 ","$1,482.21 ", N/A ,"$1,019.02 ","$1,667.48 ", N/A ,"$1,667.48 ","$1,000.49 ","$1,741.59 ", N/A ,"$1,704.54 ",$294.39 ,"$1,686.01 ", N/A ,"$1,140.19 ","$1,140.19 ","$1,667.48 ","$1,382.71 ","$1,667.48 ", N/A ,$277.73 ,"$1,760.12 ", N/A ,$277.73 ,"$1,611.90 ", N/A ,"$1,667.48 ", N/A ,"$1,667.48 ","$1,667.48 ","$1,667.48 ","$1,797.18 ","$1,500.74 ","$1,723.07 ","$1,593.37 ","$1,797.18 "
SACRED HEART HOSPITAL (ACU),36000302,64633,HC RADIOFREQ;CERV/THOR;SINGLE,360,1 ,"$4,501.17 ","$3,375.88 ",$277.73 ,"$4,501.17 ","$2,898.75 ","$1,857.12 ","$3,150.82 ",$277.73 ,"$4,501.17 ",$286.06 ,"$3,859.00 ","$4,276.11 ",$277.73 ,"$3,600.94 ","$4,141.08 ",$277.73 , N/A ,"$4,276.11 ","$3,961.03 ","$3,420.89 ",$277.73 ,$277.73 ,$277.73 ,"$3,285.85 ","$2,475.64 ","$4,096.06 ","$4,096.06 ","$3,600.94 ","$1,912.83 ","$2,475.64 ","$4,051.05 ","$1,857.12 ","$4,051.05 ","$2,430.63 ","$4,231.10 ","$4,178.51 ","$4,141.08 ",$294.39 ,"$4,096.06 ","$1,857.12 ","$2,770.02 ","$2,770.02 ","$4,051.05 ","$3,359.22 ","$3,360.24 ","$1,875.69 ",$277.73 ,"$4,276.11 ","$1,949.97 ",$277.73 ,"$3,916.02 ","$1,857.12 ","$4,051.05 ","$1,857.12 ","$4,051.05 ","$4,051.05 ","$4,051.05 ","$4,366.13 ","$3,645.95 ","$4,186.09 ","$3,871.01 ","$4,366.13 "
SACRED HEART HOSPITAL (ACU),36000303,64634,HC RADIOFREQ;CERV/THOR;ADDTL,360,1 ,"$1,243.77 ",$932.83 ,$277.73 ,"$1,243.77 ",$800.99 , N/A ,$870.64 ,$277.73 ,"$1,243.77 ",$286.06 ,"$1,243.77 ","$1,181.58 ",$277.73 ,$995.02 ,"$1,144.27 ",$277.73 , N/A ,"$1,181.58 ","$1,094.52 ",$945.27 ,$277.73 ,$277.73 ,$277.73 ,$907.95 ,$684.07 ,"$1,131.83 ","$1,131.83 ",$995.02 , N/A ,$684.07 ,"$1,119.39 ", N/A ,"$1,119.39 ",$671.64 ,"$1,169.14 ", N/A ,"$1,144.27 ",$294.39 ,"$1,131.83 ", N/A ,$765.42 ,$765.42 ,"$1,119.39 ",$928.23 ,$794.24 , N/A ,$277.73 ,"$1,181.58 ", N/A ,$277.73 ,"$1,082.08 ", N/A ,"$1,119.39 ", N/A ,"$1,119.39 ","$1,119.39 ","$1,119.39 ","$1,206.46 ","$1,007.45 ","$1,156.71 ","$1,069.64 ","$1,206.46 "
SACRED HEART HOSPITAL (ACU),36000309,27096,HC INJECTION SACRAL JOINT,360,1 ,"$1,426.00 ","$1,069.50 ",$159.92 ,"$1,426.00 ",$918.34 , N/A ,$998.20 ,$159.92 ,"$1,426.00 ",$164.72 ,"$1,426.00 ","$1,354.70 ",$159.92 ,"$1,140.80 ","$1,311.92 ",$159.92 , N/A ,"$1,354.70 ","$1,254.88 ","$1,083.76 ",$159.92 ,$159.92 ,$159.92 ,"$1,040.98 ",$784.30 ,"$1,297.66 ","$1,297.66 ","$1,140.80 ", N/A ,$784.30 ,"$1,283.40 ", N/A ,"$1,283.40 ",$770.04 ,"$1,340.44 ", N/A ,"$1,311.92 ",$169.52 ,"$1,297.66 ", N/A ,$877.56 ,$877.56 ,"$1,283.40 ","$1,064.22 ","$1,283.40 ", N/A ,$159.92 ,"$1,354.70 ", N/A ,$159.92 ,"$1,240.62 ", N/A ,"$1,283.40 ", N/A ,"$1,283.40 ","$1,283.40 ","$1,283.40 ","$1,383.22 ","$1,155.06 ","$1,326.18 ","$1,226.36 ","$1,383.22 "
SACRED HEART HOSPITAL (ACU),36000310,64421,HC INJ ANES INTERCOSTAL NERVE EA ADDNT LEVEL,360,1 ,"$1,776.00 ","$1,332.00 ",$376.63 ,"$1,958.95 ","$1,143.74 ",$870.64 ,"$1,243.20 ",$376.63 ,"$1,776.00 ",$387.93 ,"$1,776.00 ","$1,687.20 ",$376.63 ,"$1,420.80 ","$1,633.92 ",$376.63 , N/A ,"$1,687.20 ","$1,562.88 ","$1,349.76 ",$376.63 ,$376.63 ,$376.63 ,"$1,296.48 ",$976.80 ,"$1,616.16 ","$1,616.16 ","$1,420.80 ",$896.76 ,$976.80 ,"$1,598.40 ",$870.64 ,"$1,598.40 ",$959.04 ,"$1,669.44 ","$1,958.95 ","$1,633.92 ",$399.23 ,"$1,616.16 ",$870.64 ,"$1,092.95 ","$1,092.95 ","$1,598.40 ","$1,325.43 ","$1,598.40 ",$879.35 ,$376.63 ,"$1,687.20 ",$914.18 ,$376.63 ,"$1,545.12 ",$870.64 ,"$1,598.40 ",$870.64 ,"$1,598.40 ","$1,598.40 ","$1,598.40 ","$1,722.72 ","$1,438.56 ","$1,651.68 ","$1,527.36 ","$1,722.72 "
SACRED HEART HOSPITAL (ACU),36000311,64420,HC INJ INTERCOSTAL NERVE;SINGLE,360,1 ,"$1,332.00 ",$999.00 ,$141.34 ,"$1,511.09 ",$857.81 ,$671.59 ,$932.40 ,$141.34 ,"$1,332.00 ",$145.58 ,"$1,332.00 ","$1,265.40 ",$141.34 ,"$1,065.60 ","$1,225.44 ",$141.34 , N/A ,"$1,265.40 ","$1,172.16 ","$1,012.32 ",$141.34 ,$141.34 ,$141.34 ,$972.36 ,$732.60 ,"$1,212.12 ","$1,212.12 ","$1,065.60 ",$691.74 ,$732.60 ,"$1,198.80 ",$671.59 ,"$1,198.80 ",$719.28 ,"$1,252.08 ","$1,511.09 ","$1,225.44 ",$149.82 ,"$1,212.12 ",$671.59 ,$819.71 ,$819.71 ,"$1,198.80 ",$994.07 ,$794.24 ,$678.31 ,$141.34 ,"$1,265.40 ",$705.17 ,$141.34 ,"$1,158.84 ",$671.59 ,"$1,198.80 ",$671.59 ,"$1,198.80 ","$1,198.80 ","$1,198.80 ","$1,292.04 ","$1,078.92 ","$1,238.76 ","$1,145.52 ","$1,292.04 "
SACRED HEART HOSPITAL (ACU),36000313,64493,HC INJ FACET LUMBO SACRAL;SINGLE,360,1 ,"$1,339.00 ","$1,004.25 ",$277.73 ,"$1,958.95 ",$862.32 ,$870.64 ,$937.30 ,$277.73 ,"$1,339.00 ",$286.06 ,"$1,339.00 ","$1,272.05 ",$277.73 ,"$1,071.20 ","$1,231.88 ",$277.73 , N/A ,"$1,272.05 ","$1,178.32 ","$1,017.64 ",$277.73 ,$277.73 ,$277.73 ,$977.47 ,$736.45 ,"$1,218.49 ","$1,218.49 ","$1,071.20 ",$896.76 ,$736.45 ,"$1,205.10 ",$870.64 ,"$1,205.10 ",$723.06 ,"$1,258.66 ","$1,958.95 ","$1,231.88 ",$294.39 ,"$1,218.49 ",$870.64 ,$824.02 ,$824.02 ,"$1,205.10 ",$999.30 ,"$1,205.10 ",$879.35 ,$277.73 ,"$1,272.05 ",$914.18 ,$277.73 ,"$1,164.93 ",$870.64 ,"$1,205.10 ",$870.64 ,"$1,205.10 ","$1,205.10 ","$1,205.10 ","$1,298.83 ","$1,084.59 ","$1,245.27 ","$1,151.54 ","$1,298.83 "
SACRED HEART HOSPITAL (ACU),36000314,64494,HC INJ FACET LUMBO/SACRAL;2ND LEVEL,360,1 ,$508.00 ,$381.00 ,$274.32 ,$508.00 ,$327.15 , N/A ,$355.60 ,$277.73 ,$508.00 ,$286.06 ,$508.00 ,$482.60 ,$277.73 ,$406.40 ,$467.36 ,$277.73 , N/A ,$482.60 ,$447.04 ,$386.08 ,$277.73 ,$277.73 ,$277.73 ,$370.84 ,$279.40 ,$462.28 ,$462.28 ,$406.40 , N/A ,$279.40 ,$457.20 , N/A ,$457.20 ,$274.32 ,$477.52 , N/A ,$467.36 ,$294.39 ,$462.28 , N/A ,$312.62 ,$312.62 ,$457.20 ,$379.12 ,$457.20 , N/A ,$277.73 ,$482.60 , N/A ,$277.73 ,$441.96 , N/A ,$457.20 , N/A ,$457.20 ,$457.20 ,$457.20 ,$492.76 ,$411.48 ,$472.44 ,$436.88 ,$492.76 
SACRED HEART HOSPITAL (ACU),36000315,64495,HC INJ FACET LUMBO/SACRAL;3RD LEVEL,360,1 ,$862.00 ,$646.50 ,$277.73 ,$862.00 ,$555.13 , N/A ,$603.40 ,$277.73 ,$862.00 ,$286.06 ,$862.00 ,$818.90 ,$277.73 ,$689.60 ,$793.04 ,$277.73 , N/A ,$818.90 ,$758.56 ,$655.12 ,$277.73 ,$277.73 ,$277.73 ,$629.26 ,$474.10 ,$784.42 ,$784.42 ,$689.60 , N/A ,$474.10 ,$775.80 , N/A ,$775.80 ,$465.48 ,$810.28 , N/A ,$793.04 ,$294.39 ,$784.42 , N/A ,$530.47 ,$530.47 ,$775.80 ,$643.31 ,$775.80 , N/A ,$277.73 ,$818.90 , N/A ,$277.73 ,$749.94 , N/A ,$775.80 , N/A ,$775.80 ,$775.80 ,$775.80 ,$836.14 ,$698.22 ,$801.66 ,$741.32 ,$836.14 
SACRED HEART HOSPITAL (ACU),36000316,64490,HC INJ FACET CER/THORACIC;SINGLE,360,1 ,"$1,339.00 ","$1,004.25 ",$277.73 ,"$1,958.95 ",$862.32 ,$870.64 ,$937.30 ,$277.73 ,"$1,339.00 ",$286.06 ,"$1,339.00 ","$1,272.05 ",$277.73 ,"$1,071.20 ","$1,231.88 ",$277.73 , N/A ,"$1,272.05 ","$1,178.32 ","$1,017.64 ",$277.73 ,$277.73 ,$277.73 ,$977.47 ,$736.45 ,"$1,218.49 ","$1,218.49 ","$1,071.20 ",$896.76 ,$736.45 ,"$1,205.10 ",$870.64 ,"$1,205.10 ",$723.06 ,"$1,258.66 ","$1,958.95 ","$1,231.88 ",$294.39 ,"$1,218.49 ",$870.64 ,$824.02 ,$824.02 ,"$1,205.10 ",$999.30 ,"$1,205.10 ",$879.35 ,$277.73 ,"$1,272.05 ",$914.18 ,$277.73 ,"$1,164.93 ",$870.64 ,"$1,205.10 ",$870.64 ,"$1,205.10 ","$1,205.10 ","$1,205.10 ","$1,298.83 ","$1,084.59 ","$1,245.27 ","$1,151.54 ","$1,298.83 "
SACRED HEART HOSPITAL (ACU),36000317,64491,HC INJ FACET CER/THORACIC 2ND LEVEL,360,1 ,$784.00 ,$588.00 ,$277.73 ,$784.00 ,$504.90 , N/A ,$548.80 ,$277.73 ,$784.00 ,$286.06 ,$784.00 ,$744.80 ,$277.73 ,$627.20 ,$721.28 ,$277.73 , N/A ,$744.80 ,$689.92 ,$595.84 ,$277.73 ,$277.73 ,$277.73 ,$572.32 ,$431.20 ,$713.44 ,$713.44 ,$627.20 , N/A ,$431.20 ,$705.60 , N/A ,$705.60 ,$423.36 ,$736.96 , N/A ,$721.28 ,$294.39 ,$713.44 , N/A ,$482.47 ,$482.47 ,$705.60 ,$585.10 ,$705.60 , N/A ,$277.73 ,$744.80 , N/A ,$277.73 ,$682.08 , N/A ,$705.60 , N/A ,$705.60 ,$705.60 ,$705.60 ,$760.48 ,$635.04 ,$729.12 ,$674.24 ,$760.48 
SACRED HEART HOSPITAL (ACU),36000318,64492,HC INJ FACET CER/THORACIC 3RD LEVEL,360,1 ,$793.33 ,$595.00 ,$277.73 ,$793.33 ,$510.90 , N/A ,$555.33 ,$277.73 ,$793.33 ,$286.06 ,$793.33 ,$753.66 ,$277.73 ,$634.66 ,$729.86 ,$277.73 , N/A ,$753.66 ,$698.13 ,$602.93 ,$277.73 ,$277.73 ,$277.73 ,$579.13 ,$436.33 ,$721.93 ,$721.93 ,$634.66 , N/A ,$436.33 ,$714.00 , N/A ,$714.00 ,$428.40 ,$745.73 , N/A ,$729.86 ,$294.39 ,$721.93 , N/A ,$488.22 ,$488.22 ,$714.00 ,$592.06 ,$714.00 , N/A ,$277.73 ,$753.66 , N/A ,$277.73 ,$690.20 , N/A ,$714.00 , N/A ,$714.00 ,$714.00 ,$714.00 ,$769.53 ,$642.60 ,$737.80 ,$682.26 ,$769.53 
SACRED HEART HOSPITAL (ACU),36000322,64479,HC INJ TRANSF CERV/THORACIC SINGLE,360,1 ,"$2,775.00 ","$2,081.25 ",$277.73 ,"$2,775.00 ","$1,787.10 ",$870.64 ,"$1,942.50 ",$277.73 ,"$2,775.00 ",$286.06 ,"$2,572.00 ","$2,636.25 ",$277.73 ,"$2,220.00 ","$2,553.00 ",$277.73 , N/A ,"$2,636.25 ","$2,442.00 ","$2,109.00 ",$277.73 ,$277.73 ,$277.73 ,"$2,025.75 ","$1,526.25 ","$2,525.25 ","$2,525.25 ","$2,220.00 ",$896.76 ,"$1,526.25 ","$2,497.50 ",$870.64 ,"$2,497.50 ","$1,498.50 ","$2,608.50 ","$1,958.95 ","$2,553.00 ",$294.39 ,"$2,525.25 ",$870.64 ,"$1,707.74 ","$1,707.74 ","$2,497.50 ","$2,070.98 ","$2,240.16 ",$879.35 ,$277.73 ,"$2,636.25 ",$914.18 ,$277.73 ,"$2,414.25 ",$870.64 ,"$2,497.50 ",$870.64 ,"$2,497.50 ","$2,497.50 ","$2,497.50 ","$2,691.75 ","$2,247.75 ","$2,580.75 ","$2,386.50 ","$2,691.75 "
SACRED HEART HOSPITAL (ACU),36000323,64480,HC INJ TRANSF CERV/THORACIC ADDL,360,1 ,"$1,321.00 ",$990.75 ,$277.73 ,"$1,321.00 ",$850.72 , N/A ,$924.70 ,$277.73 ,"$1,321.00 ",$286.06 ,"$1,321.00 ","$1,254.95 ",$277.73 ,"$1,056.80 ","$1,215.32 ",$277.73 , N/A ,"$1,254.95 ","$1,162.48 ","$1,003.96 ",$277.73 ,$277.73 ,$277.73 ,$964.33 ,$726.55 ,"$1,202.11 ","$1,202.11 ","$1,056.80 ", N/A ,$726.55 ,"$1,188.90 ", N/A ,"$1,188.90 ",$713.34 ,"$1,241.74 ", N/A ,"$1,215.32 ",$294.39 ,"$1,202.11 ", N/A ,$812.94 ,$812.94 ,"$1,188.90 ",$985.86 ,$794.24 , N/A ,$277.73 ,"$1,254.95 ", N/A ,$277.73 ,"$1,149.27 ", N/A ,"$1,188.90 ", N/A ,"$1,188.90 ","$1,188.90 ","$1,188.90 ","$1,281.37 ","$1,070.01 ","$1,228.53 ","$1,136.06 ","$1,281.37 "
SACRED HEART HOSPITAL (ACU),36000324,64483,HC INJ TRANSF LUMBAR SACRAL SINGLE,360,1 ,"$2,779.00 ","$2,084.25 ",$277.73 ,"$2,779.00 ","$1,789.68 ",$870.64 ,"$1,945.30 ",$277.73 ,"$2,779.00 ",$286.06 ,"$2,572.00 ","$2,640.05 ",$277.73 ,"$2,223.20 ","$2,556.68 ",$277.73 , N/A ,"$2,640.05 ","$2,445.52 ","$2,112.04 ",$277.73 ,$277.73 ,$277.73 ,"$2,028.67 ","$1,528.45 ","$2,528.89 ","$2,528.89 ","$2,223.20 ",$896.76 ,"$1,528.45 ","$2,501.10 ",$870.64 ,"$2,501.10 ","$1,500.66 ","$2,612.26 ","$1,958.95 ","$2,556.68 ",$294.39 ,"$2,528.89 ",$870.64 ,"$1,710.20 ","$1,710.20 ","$2,501.10 ","$2,073.97 ","$2,240.16 ",$879.35 ,$277.73 ,"$2,640.05 ",$914.18 ,$277.73 ,"$2,417.73 ",$870.64 ,"$2,501.10 ",$870.64 ,"$2,501.10 ","$2,501.10 ","$2,501.10 ","$2,695.63 ","$2,250.99 ","$2,584.47 ","$2,389.94 ","$2,695.63 "
SACRED HEART HOSPITAL (ACU),36000325,64484,HC INJ TRANSF LUMBAR SACRAL ADDL,360,1 ,"$1,173.00 ",$879.75 ,$277.73 ,"$1,173.00 ",$755.41 , N/A ,$821.10 ,$277.73 ,"$1,173.00 ",$286.06 ,"$1,173.00 ","$1,114.35 ",$277.73 ,$938.40 ,"$1,079.16 ",$277.73 , N/A ,"$1,114.35 ","$1,032.24 ",$891.48 ,$277.73 ,$277.73 ,$277.73 ,$856.29 ,$645.15 ,"$1,067.43 ","$1,067.43 ",$938.40 , N/A ,$645.15 ,"$1,055.70 ", N/A ,"$1,055.70 ",$633.42 ,"$1,102.62 ", N/A ,"$1,079.16 ",$294.39 ,"$1,067.43 ", N/A ,$721.86 ,$721.86 ,"$1,055.70 ",$875.41 ,$794.24 , N/A ,$277.73 ,"$1,114.35 ", N/A ,$277.73 ,"$1,020.51 ", N/A ,"$1,055.70 ", N/A ,"$1,055.70 ","$1,055.70 ","$1,055.70 ","$1,137.81 ",$950.13 ,"$1,090.89 ","$1,008.78 ","$1,137.81 "
SACRED HEART HOSPITAL (ACU),36000326,64405,HC NERVE BLOCK; OCCIPITAL,360,1 ,"$1,655.00 ","$1,241.25 ",$141.34 ,"$1,655.00 ","$1,065.82 ",$276.32 ,"$1,158.50 ",$141.34 ,"$1,655.00 ",$145.58 ,"$1,655.00 ","$1,572.25 ",$141.34 ,"$1,324.00 ","$1,522.60 ",$141.34 , N/A ,"$1,572.25 ","$1,456.40 ","$1,257.80 ",$141.34 ,$141.34 ,$141.34 ,"$1,208.15 ",$910.25 ,"$1,506.05 ","$1,506.05 ","$1,324.00 ",$284.61 ,$910.25 ,"$1,489.50 ",$276.32 ,"$1,489.50 ",$893.70 ,"$1,555.70 ",$621.73 ,"$1,522.60 ",$149.82 ,"$1,506.05 ",$276.32 ,"$1,018.49 ","$1,018.49 ","$1,489.50 ","$1,235.13 ",$827.50 ,$279.09 ,$141.34 ,"$1,572.25 ",$290.14 ,$141.34 ,"$1,439.85 ",$276.32 ,"$1,489.50 ",$276.32 ,"$1,489.50 ","$1,489.50 ","$1,489.50 ","$1,605.35 ","$1,340.55 ","$1,539.15 ","$1,423.30 ","$1,605.35 "
SACRED HEART HOSPITAL (ACU),36000331,64520,HC NERVE BLOCK;L/S PARAVERTEBAL SYMP,360,1 ,"$2,733.00 ","$2,049.75 ",$277.73 ,"$2,733.00 ","$1,760.05 ",$870.64 ,"$1,913.10 ",$277.73 ,"$2,733.00 ",$286.06 ,"$2,572.00 ","$2,596.35 ",$277.73 ,"$2,186.40 ","$2,514.36 ",$277.73 , N/A ,"$2,596.35 ","$2,405.04 ","$2,077.08 ",$277.73 ,$277.73 ,$277.73 ,"$1,995.09 ","$1,503.15 ","$2,487.03 ","$2,487.03 ","$2,186.40 ",$896.76 ,"$1,503.15 ","$2,459.70 ",$870.64 ,"$2,459.70 ","$1,475.82 ","$2,569.02 ","$1,958.95 ","$2,514.36 ",$294.39 ,"$2,487.03 ",$870.64 ,"$1,681.89 ","$1,681.89 ","$2,459.70 ","$2,039.64 ","$2,240.16 ",$879.35 ,$277.73 ,"$2,596.35 ",$914.18 ,$277.73 ,"$2,377.71 ",$870.64 ,"$2,459.70 ",$870.64 ,"$2,459.70 ","$2,459.70 ","$2,459.70 ","$2,651.01 ","$2,213.73 ","$2,541.69 ","$2,350.38 ","$2,651.01 "
SACRED HEART HOSPITAL (ACU),36000334,63650,HC IMPLANT NEUROELECTRODES,360,1 ,"$7,260.31 ","$5,445.23 ","$1,926.15 ","$14,668.74 ","$4,675.64 ","$6,519.44 ","$5,082.22 ","$1,926.15 ","$7,260.31 ","$1,983.93 ","$7,260.31 ","$6,897.29 ","$1,926.15 ","$5,808.25 ","$6,679.49 ","$1,926.15 ", N/A ,"$6,897.29 ","$6,389.07 ","$5,517.84 ","$1,926.15 ","$1,926.15 ","$1,926.15 ","$5,300.03 ","$3,993.17 ","$6,606.88 ","$6,606.88 ","$5,808.25 ","$6,715.02 ","$3,993.17 ","$6,534.28 ","$6,519.44 ","$6,534.28 ","$3,920.57 ","$6,824.69 ","$14,668.74 ","$6,679.49 ","$2,041.72 ","$6,606.88 ","$6,519.44 ","$4,467.99 ","$4,467.99 ","$6,534.28 ","$5,418.37 ","$6,534.28 ","$6,584.64 ","$1,926.15 ","$6,897.29 ","$6,845.41 ","$1,926.15 ","$6,316.47 ","$6,519.44 ","$6,534.28 ","$6,519.44 ","$6,534.28 ","$6,534.28 ","$6,534.28 ","$7,042.50 ","$5,880.85 ","$6,752.09 ","$6,243.87 ","$7,042.50 "
SACRED HEART HOSPITAL (ACU),36000359,33880,HC ENDOVASC REPAIR TAA W/LT SUBCLVN ARTERY,360,1 ,"$5,099.00 ","$3,824.25 ","$2,753.46 ","$6,153.96 ","$3,283.76 ", N/A ,"$3,569.30 ","$5,099.00 ","$5,099.00 ","$5,979.79 ","$5,099.00 ","$4,844.05 ","$5,805.62 ","$4,079.20 ","$4,691.08 ","$5,099.00 ", N/A ,"$4,844.05 ","$4,487.12 ","$3,875.24 ","$5,099.00 ","$5,099.00 ","$5,805.62 ","$3,722.27 ","$2,804.45 ","$4,640.09 ","$4,640.09 ","$4,079.20 ", N/A ,"$2,804.45 ","$4,589.10 ", N/A ,"$4,589.10 ","$2,753.46 ","$4,793.06 ", N/A ,"$4,691.08 ","$6,153.96 ","$4,640.09 ", N/A ,"$3,137.92 ","$3,137.92 ","$4,589.10 ","$3,805.38 ","$3,551.45 ", N/A ,"$5,099.00 ","$4,844.05 ", N/A ,"$5,099.00 ","$4,436.13 ", N/A ,"$4,589.10 ", N/A ,"$4,589.10 ","$4,589.10 ","$4,589.10 ","$4,946.03 ","$4,130.19 ","$4,742.07 ","$4,385.14 ","$4,946.03 "
SACRED HEART HOSPITAL (ACU),36000360,33881,HC ENDOVASC REPAIR TAA W/O LT SUBCLVN ARTERY,360,1 ,"$2,291.00 ","$1,718.25 ","$1,237.14 ","$6,153.96 ","$1,475.40 ", N/A ,"$1,603.70 ","$2,291.00 ","$2,291.00 ","$5,979.79 ","$2,291.00 ","$2,176.45 ","$5,805.62 ","$1,832.80 ","$2,107.72 ","$2,291.00 ", N/A ,"$2,176.45 ","$2,016.08 ","$1,741.16 ","$2,291.00 ","$2,291.00 ","$5,805.62 ","$1,672.43 ","$1,260.05 ","$2,084.81 ","$2,084.81 ","$1,832.80 ", N/A ,"$1,260.05 ","$2,061.90 ", N/A ,"$2,061.90 ","$1,237.14 ","$2,153.54 ", N/A ,"$2,107.72 ","$6,153.96 ","$2,084.81 ", N/A ,"$1,409.88 ","$1,409.88 ","$2,061.90 ","$1,709.77 ","$1,595.68 ", N/A ,"$2,291.00 ","$2,176.45 ", N/A ,"$2,291.00 ","$1,993.17 ", N/A ,"$2,061.90 ", N/A ,"$2,061.90 ","$2,061.90 ","$2,061.90 ","$2,222.27 ","$1,855.71 ","$2,130.63 ","$1,970.26 ","$2,222.27 "
SACRED HEART HOSPITAL (ACU),36000363,33886,HC PLACE PROSTHESIS DISTAL EXT POST ENDOVASC RPR,360,1 ,"$2,923.00 ","$2,192.25 ","$1,578.42 ","$6,153.96 ","$1,882.41 ", N/A ,"$2,046.10 ","$2,923.00 ","$2,923.00 ","$5,979.79 ","$2,923.00 ","$2,776.85 ","$5,805.62 ","$2,338.40 ","$2,689.16 ","$2,923.00 ", N/A ,"$2,776.85 ","$2,572.24 ","$2,221.48 ","$2,923.00 ","$2,923.00 ","$5,805.62 ","$2,133.79 ","$1,607.65 ","$2,659.93 ","$2,659.93 ","$2,338.40 ", N/A ,"$1,607.65 ","$2,630.70 ", N/A ,"$2,630.70 ","$1,578.42 ","$2,747.62 ", N/A ,"$2,689.16 ","$6,153.96 ","$2,659.93 ", N/A ,"$1,798.81 ","$1,798.81 ","$2,630.70 ","$2,181.43 ","$2,035.87 ", N/A ,"$2,923.00 ","$2,776.85 ", N/A ,"$2,923.00 ","$2,543.01 ", N/A ,"$2,630.70 ", N/A ,"$2,630.70 ","$2,630.70 ","$2,630.70 ","$2,835.31 ","$2,367.63 ","$2,718.39 ","$2,513.78 ","$2,835.31 "
SACRED HEART HOSPITAL (ACU),36000368,34808,HC ENDOVASC PLACEMENT ILIAC ARTRY OCCLUSION DEVICE,360,1 ,"$1,167.00 ",$875.25 ,$630.18 ,"$6,153.96 ",$751.55 , N/A ,$816.90 ,"$1,167.00 ","$1,167.00 ","$5,979.79 ","$1,167.00 ","$1,108.65 ","$5,805.62 ",$933.60 ,"$1,073.64 ","$1,167.00 ", N/A ,"$1,108.65 ","$1,026.96 ",$886.92 ,"$1,167.00 ","$1,167.00 ","$5,805.62 ",$851.91 ,$641.85 ,"$1,061.97 ","$1,061.97 ",$933.60 , N/A ,$641.85 ,"$1,050.30 ", N/A ,"$1,050.30 ",$630.18 ,"$1,096.98 ", N/A ,"$1,073.64 ","$6,153.96 ","$1,061.97 ", N/A ,$718.17 ,$718.17 ,"$1,050.30 ",$870.93 , N/A , N/A ,"$1,167.00 ","$1,108.65 ", N/A ,"$1,167.00 ","$1,015.29 ", N/A ,"$1,050.30 ", N/A ,"$1,050.30 ","$1,050.30 ","$1,050.30 ","$1,131.99 ",$945.27 ,"$1,085.31 ","$1,003.62 ","$1,131.99 "
SACRED HEART HOSPITAL (ACU),36000371,35875,HC THROMBECTOMY ART/VEN GRAFT,360,1 ,"$4,288.00 ","$3,216.00 ","$1,189.63 ","$11,347.95 ","$2,761.47 ","$5,043.53 ","$3,001.60 ","$1,189.63 ","$4,288.00 ","$1,225.32 ","$4,288.00 ","$4,073.60 ","$1,189.63 ","$3,430.40 ","$3,944.96 ","$1,189.63 ", N/A ,"$4,073.60 ","$3,773.44 ","$3,258.88 ","$1,189.63 ","$1,189.63 ","$1,189.63 ","$3,130.24 ","$2,358.40 ","$3,902.08 ","$3,902.08 ","$3,430.40 ","$5,194.84 ","$2,358.40 ","$3,859.20 ","$5,043.53 ","$3,859.20 ","$2,315.52 ","$4,030.72 ","$11,347.95 ","$3,944.96 ","$1,261.01 ","$3,902.08 ","$5,043.53 ","$2,638.84 ","$2,638.84 ","$3,859.20 ","$3,200.13 ","$3,859.20 ","$5,093.97 ","$1,189.63 ","$4,073.60 ","$5,295.71 ","$1,189.63 ","$3,730.56 ","$5,043.53 ","$3,859.20 ","$5,043.53 ","$3,859.20 ","$3,859.20 ","$3,859.20 ","$4,159.36 ","$3,473.28 ","$3,987.84 ","$3,687.68 ","$4,159.36 "
SACRED HEART HOSPITAL (ACU),36000379,47553,HC ENDOSCOPY BILIARY W/BIOPSY SINGLE/MULTIPLE,360,1 ,"$4,242.00 ","$3,181.50 ","$1,394.97 ","$7,571.16 ","$2,731.85 ","$3,364.96 ","$2,969.40 ","$1,394.97 ","$4,242.00 ","$1,436.82 ","$4,242.00 ","$4,029.90 ","$1,394.97 ","$3,393.60 ","$3,902.64 ","$1,394.97 ", N/A ,"$4,029.90 ","$3,732.96 ","$3,223.92 ","$1,394.97 ","$1,394.97 ","$1,394.97 ","$3,096.66 ","$2,333.10 ","$3,860.22 ","$3,860.22 ","$3,393.60 ","$3,465.91 ","$2,333.10 ","$3,817.80 ","$3,364.96 ","$3,817.80 ","$2,290.68 ","$3,987.48 ","$7,571.16 ","$3,902.64 ","$1,478.67 ","$3,860.22 ","$3,364.96 ","$2,610.53 ","$2,610.53 ","$3,817.80 ","$3,165.80 ","$3,817.80 ","$3,398.61 ","$1,394.97 ","$4,029.90 ","$3,533.21 ","$1,394.97 ","$3,690.54 ","$3,364.96 ","$3,817.80 ","$3,364.96 ","$3,817.80 ","$3,817.80 ","$3,817.80 ","$4,114.74 ","$3,436.02 ","$3,945.06 ","$3,648.12 ","$4,114.74 "
SACRED HEART HOSPITAL (ACU),36000380,47554,HC ENDOSCOPY BILIARY W/REMOVAL CALCULUS,360,1 ,"$1,295.00 ",$971.25 ,$699.30 ,"$12,041.00 ",$833.98 ,"$5,351.56 ",$906.50 ,"$1,295.00 ","$1,295.00 ","$1,436.82 ","$1,295.00 ","$1,230.25 ","$1,394.97 ","$1,036.00 ","$1,191.40 ","$1,295.00 ", N/A ,"$1,230.25 ","$1,139.60 ",$984.20 ,"$1,295.00 ","$1,295.00 ","$1,394.97 ",$945.35 ,$712.25 ,"$1,178.45 ","$1,178.45 ","$1,036.00 ","$5,512.11 ",$712.25 ,"$1,165.50 ","$5,351.56 ","$1,165.50 ",$699.30 ,"$1,217.30 ","$12,041.00 ","$1,191.40 ","$1,478.67 ","$1,178.45 ","$5,351.56 ",$796.94 ,$796.94 ,"$1,165.50 ",$966.46 ,"$1,165.50 ","$5,405.07 ","$1,295.00 ","$1,230.25 ","$5,619.13 ","$1,295.00 ","$1,126.65 ","$5,351.56 ","$1,165.50 ","$5,351.56 ","$1,165.50 ","$1,165.50 ","$1,165.50 ","$1,256.15 ","$1,048.95 ","$1,204.35 ","$1,113.70 ","$1,256.15 "
SACRED HEART HOSPITAL (ACU),36000382,47556,HC ENDOSCOPY BILIARY W/DILAT BIL DUCT W/STENT,360,1 ,"$1,928.00 ","$1,446.00 ","$1,041.12 ","$12,041.00 ","$1,241.63 ","$5,351.56 ","$1,349.60 ","$1,394.97 ","$1,928.00 ","$1,436.82 ","$1,928.00 ","$1,831.60 ","$1,394.97 ","$1,542.40 ","$1,773.76 ","$1,394.97 ", N/A ,"$1,831.60 ","$1,696.64 ","$1,465.28 ","$1,394.97 ","$1,394.97 ","$1,394.97 ","$1,407.44 ","$1,060.40 ","$1,754.48 ","$1,754.48 ","$1,542.40 ","$5,512.11 ","$1,060.40 ","$1,735.20 ","$5,351.56 ","$1,735.20 ","$1,041.12 ","$1,812.32 ","$12,041.00 ","$1,773.76 ","$1,478.67 ","$1,754.48 ","$5,351.56 ","$1,186.49 ","$1,186.49 ","$1,735.20 ","$1,438.87 ","$1,735.20 ","$5,405.07 ","$1,394.97 ","$1,831.60 ","$5,619.13 ","$1,394.97 ","$1,677.36 ","$5,351.56 ","$1,735.20 ","$5,351.56 ","$1,735.20 ","$1,735.20 ","$1,735.20 ","$1,870.16 ","$1,561.68 ","$1,793.04 ","$1,658.08 ","$1,870.16 "
SACRED HEART HOSPITAL (ACU),36000387,61623,HC ENDOVASC TEMP BALLOON ART OCCLUS HEAD/NECK,360,1 ,"$1,094.46 ",$820.85 ,$591.01 ,"$23,902.85 ",$704.83 ,"$10,623.49 ",$766.12 ,"$1,094.46 ","$1,094.46 ","$3,758.32 ","$1,094.46 ","$1,039.74 ","$3,648.85 ",$875.57 ,"$1,006.90 ","$1,094.46 ", N/A ,"$1,039.74 ",$963.12 ,$831.79 ,"$1,094.46 ","$1,094.46 ","$3,648.85 ",$798.96 ,$601.95 ,$995.96 ,$995.96 ,$875.57 ,"$10,942.19 ",$601.95 ,$985.01 ,"$10,623.49 ",$985.01 ,$591.01 ,"$1,028.79 ","$23,902.85 ","$1,006.90 ","$3,867.78 ",$995.96 ,"$10,623.49 ",$673.53 ,$673.53 ,$985.01 ,$816.80 ,$985.01 ,"$10,729.72 ","$1,094.46 ","$1,039.74 ","$11,154.66 ","$1,094.46 ",$952.18 ,"$10,623.49 ",$985.01 ,"$10,623.49 ",$985.01 ,$985.01 ,$985.01 ,"$1,061.63 ",$886.51 ,"$1,017.85 ",$941.24 ,"$1,061.63 "
SACRED HEART HOSPITAL (ACU),36000388,61630,HC ANGIOPLASTY BALLOON INTRACRANIAL PERC,360,1 ,"$1,774.30 ","$1,330.73 ",$958.12 ,"$3,867.78 ","$1,142.65 ", N/A ,"$1,242.01 ","$1,774.30 ","$1,774.30 ","$3,758.32 ","$1,774.30 ","$1,685.59 ","$3,648.85 ","$1,419.44 ","$1,632.36 ","$1,774.30 ", N/A ,"$1,685.59 ","$1,561.38 ","$1,348.47 ","$1,774.30 ","$1,774.30 ","$3,648.85 ","$1,295.24 ",$975.87 ,"$1,614.61 ","$1,614.61 ","$1,419.44 ", N/A ,$975.87 ,"$1,596.87 ", N/A ,"$1,596.87 ",$958.12 ,"$1,667.84 ", N/A ,"$1,632.36 ","$3,867.78 ","$1,614.61 ", N/A ,"$1,091.90 ","$1,091.90 ","$1,596.87 ","$1,324.16 ","$1,235.80 ", N/A ,"$1,774.30 ","$1,685.59 ", N/A ,"$1,774.30 ","$1,543.64 ", N/A ,"$1,596.87 ", N/A ,"$1,596.87 ","$1,596.87 ","$1,596.87 ","$1,721.07 ","$1,437.18 ","$1,650.10 ","$1,525.90 ","$1,721.07 "
SACRED HEART HOSPITAL (ACU),36000389,61635,HC PLACE STENT INTRACRAN/INTRAVASC,360,1 ,"$1,774.30 ","$1,330.73 ",$958.12 ,"$3,867.78 ","$1,142.65 ", N/A ,"$1,242.01 ","$1,774.30 ","$1,774.30 ","$3,758.32 ","$1,774.30 ","$1,685.59 ","$3,648.85 ","$1,419.44 ","$1,632.36 ","$1,774.30 ", N/A ,"$1,685.59 ","$1,561.38 ","$1,348.47 ","$1,774.30 ","$1,774.30 ","$3,648.85 ","$1,295.24 ",$975.87 ,"$1,614.61 ","$1,614.61 ","$1,419.44 ", N/A ,$975.87 ,"$1,596.87 ", N/A ,"$1,596.87 ",$958.12 ,"$1,667.84 ", N/A ,"$1,632.36 ","$3,867.78 ","$1,614.61 ", N/A ,"$1,091.90 ","$1,091.90 ","$1,596.87 ","$1,324.16 ","$1,235.80 ", N/A ,"$1,774.30 ","$1,685.59 ", N/A ,"$1,774.30 ","$1,543.64 ", N/A ,"$1,596.87 ", N/A ,"$1,596.87 ","$1,596.87 ","$1,596.87 ","$1,721.07 ","$1,437.18 ","$1,650.10 ","$1,525.90 ","$1,721.07 "
SACRED HEART HOSPITAL (ACU),36000390,61640,HC BALLOON DILAT INTRACRAN VASO PERC INIT,360,1 ,"$1,774.30 ","$1,330.73 ",$958.12 ,"$3,867.78 ","$1,142.65 ", N/A ,"$1,242.01 ","$1,774.30 ","$1,774.30 ","$3,758.32 ","$1,774.30 ","$1,685.59 ","$3,648.85 ","$1,419.44 ","$1,632.36 ","$1,774.30 ", N/A ,"$1,685.59 ","$1,561.38 ","$1,348.47 ","$1,774.30 ","$1,774.30 ","$3,648.85 ","$1,295.24 ",$975.87 ,"$1,614.61 ","$1,614.61 ","$1,419.44 ", N/A ,$975.87 ,"$1,596.87 ", N/A ,"$1,596.87 ",$958.12 ,"$1,667.84 ", N/A ,"$1,632.36 ","$3,867.78 ","$1,614.61 ", N/A ,"$1,091.90 ","$1,091.90 ","$1,596.87 ","$1,324.16 ","$1,235.80 ", N/A ,"$1,774.30 ","$1,685.59 ", N/A ,"$1,774.30 ","$1,543.64 ", N/A ,"$1,596.87 ", N/A ,"$1,596.87 ","$1,596.87 ","$1,596.87 ","$1,721.07 ","$1,437.18 ","$1,650.10 ","$1,525.90 ","$1,721.07 "
SACRED HEART HOSPITAL (ACU),36000391,61641,HC BALLOON DILAT INTRACRAN VASO PERC SAME EA ADDL,360,1 ,"$1,774.30 ","$1,330.73 ",$958.12 ,"$3,867.78 ","$1,142.65 ", N/A ,"$1,242.01 ","$1,774.30 ","$1,774.30 ","$3,758.32 ","$1,774.30 ","$1,685.59 ","$3,648.85 ","$1,419.44 ","$1,632.36 ","$1,774.30 ", N/A ,"$1,685.59 ","$1,561.38 ","$1,348.47 ","$1,774.30 ","$1,774.30 ","$3,648.85 ","$1,295.24 ",$975.87 ,"$1,614.61 ","$1,614.61 ","$1,419.44 ", N/A ,$975.87 ,"$1,596.87 ", N/A ,"$1,596.87 ",$958.12 ,"$1,667.84 ", N/A ,"$1,632.36 ","$3,867.78 ","$1,614.61 ", N/A ,"$1,091.90 ","$1,091.90 ","$1,596.87 ","$1,324.16 ","$1,235.80 ", N/A ,"$1,774.30 ","$1,685.59 ", N/A ,"$1,774.30 ","$1,543.64 ", N/A ,"$1,596.87 ", N/A ,"$1,596.87 ","$1,596.87 ","$1,596.87 ","$1,721.07 ","$1,437.18 ","$1,650.10 ","$1,525.90 ","$1,721.07 "
SACRED HEART HOSPITAL (ACU),36000392,61642,HC BALLOON DILAT INTRACRAN VASO PERC DIFF EA ADDL,360,1 ,"$2,643.48 ","$1,982.61 ","$1,427.48 ","$3,867.78 ","$1,702.40 ", N/A ,"$1,850.44 ","$2,643.48 ","$2,643.48 ","$3,758.32 ","$2,643.48 ","$2,511.31 ","$3,648.85 ","$2,114.78 ","$2,432.00 ","$2,643.48 ", N/A ,"$2,511.31 ","$2,326.26 ","$2,009.04 ","$2,643.48 ","$2,643.48 ","$3,648.85 ","$1,929.74 ","$1,453.91 ","$2,405.57 ","$2,405.57 ","$2,114.78 ", N/A ,"$1,453.91 ","$2,379.13 ", N/A ,"$2,379.13 ","$1,427.48 ","$2,484.87 ", N/A ,"$2,432.00 ","$3,867.78 ","$2,405.57 ", N/A ,"$1,626.80 ","$1,626.80 ","$2,379.13 ","$1,972.83 ","$1,841.18 ", N/A ,"$2,643.48 ","$2,511.31 ", N/A ,"$2,643.48 ","$2,299.83 ", N/A ,"$2,379.13 ", N/A ,"$2,379.13 ","$2,379.13 ","$2,379.13 ","$2,564.18 ","$2,141.22 ","$2,458.44 ","$2,273.39 ","$2,564.18 "
SACRED HEART HOSPITAL (ACU),36000393,61645,HC PERC ART THROMBECTOMY/INFUS W/GUID,360,1 ,"$1,952.86 ","$1,464.65 ","$1,054.54 ","$3,867.78 ","$1,257.64 ", N/A ,"$1,367.00 ","$1,952.86 ","$1,952.86 ","$3,758.32 ","$1,952.86 ","$1,855.22 ","$3,648.85 ","$1,562.29 ","$1,796.63 ","$1,952.86 ", N/A ,"$1,855.22 ","$1,718.52 ","$1,484.17 ","$1,952.86 ","$1,952.86 ","$3,648.85 ","$1,425.59 ","$1,074.07 ","$1,777.10 ","$1,777.10 ","$1,562.29 ", N/A ,"$1,074.07 ","$1,757.57 ", N/A ,"$1,757.57 ","$1,054.54 ","$1,835.69 ", N/A ,"$1,796.63 ","$3,867.78 ","$1,777.10 ", N/A ,"$1,201.79 ","$1,201.79 ","$1,757.57 ","$1,457.42 ", N/A , N/A ,"$1,952.86 ","$1,855.22 ", N/A ,"$1,952.86 ","$1,698.99 ", N/A ,"$1,757.57 ", N/A ,"$1,757.57 ","$1,757.57 ","$1,757.57 ","$1,894.27 ","$1,581.82 ","$1,816.16 ","$1,679.46 ","$1,894.27 "
SACRED HEART HOSPITAL (ACU),36000395,62294,HC INJ OCCLUS ART ARTERIOVENOUS MALFORM SPINAL,360,1 ,$748.41 ,$561.31 ,$277.73 ,"$1,958.95 ",$481.98 ,$870.64 ,$523.89 ,$277.73 ,$748.41 ,$286.06 ,$748.41 ,$710.99 ,$277.73 ,$598.73 ,$688.54 ,$277.73 , N/A ,$710.99 ,$658.60 ,$568.79 ,$277.73 ,$277.73 ,$277.73 ,$546.34 ,$411.63 ,$681.05 ,$681.05 ,$598.73 ,$896.76 ,$411.63 ,$673.57 ,$870.64 ,$673.57 ,$404.14 ,$703.51 ,"$1,958.95 ",$688.54 ,$294.39 ,$681.05 ,$870.64 ,$460.57 ,$460.57 ,$673.57 ,$558.54 ,$673.57 ,$879.35 ,$277.73 ,$710.99 ,$914.18 ,$277.73 ,$651.12 ,$870.64 ,$673.57 ,$870.64 ,$673.57 ,$673.57 ,$673.57 ,$725.96 ,$606.21 ,$696.02 ,$643.63 ,$725.96 
SACRED HEART HOSPITAL (ACU),36000396,0076T,HC TRANSCATH XCRAN STENT PLACEMENT EA ADDL VSL,360,1 ,"$2,642.00 ","$1,981.50 ","$1,426.68 ","$3,775.50 ","$1,701.45 ", N/A ,"$1,849.40 ","$2,642.00 ","$2,642.00 ","$3,668.64 ","$2,642.00 ","$2,509.90 ","$3,561.79 ","$2,113.60 ","$2,430.64 ","$2,642.00 ", N/A ,"$2,509.90 ","$2,324.96 ","$2,007.92 ","$2,642.00 ","$2,642.00 ","$3,561.79 ","$1,928.66 ","$1,453.10 ","$2,404.22 ","$2,404.22 ","$2,113.60 ", N/A ,"$1,453.10 ","$2,377.80 ", N/A ,"$2,377.80 ","$1,426.68 ","$2,483.48 ", N/A ,"$2,430.64 ","$3,775.50 ","$2,404.22 ", N/A ,"$1,625.89 ","$1,625.89 ","$2,377.80 ","$1,971.72 ","$1,840.15 ", N/A ,"$2,642.00 ","$2,509.90 ", N/A ,"$2,642.00 ","$2,298.54 ", N/A ,"$2,377.80 ", N/A ,"$2,377.80 ","$2,377.80 ","$2,377.80 ","$2,562.74 ","$2,140.02 ","$2,457.06 ","$2,272.12 ","$2,562.74 "
SACRED HEART HOSPITAL (ACU),36000398,N/A,HC PERFUSION LEVEL I,360,1 ,"$3,614.00 ","$2,710.50 ","$1,951.56 ","$3,614.00 ","$2,327.42 ", N/A ,"$2,529.80 ", N/A , N/A , N/A , N/A ,"$3,433.30 ", N/A ,"$2,891.20 ","$3,324.88 ", N/A , N/A ,"$3,433.30 ","$3,180.32 ","$2,746.64 ", N/A , N/A , N/A ,"$2,638.22 ","$1,987.70 ","$3,288.74 ","$3,288.74 ","$2,891.20 ", N/A ,"$1,987.70 ","$3,252.60 ", N/A ,"$3,252.60 ","$1,951.56 ","$3,397.16 ", N/A ,"$3,324.88 ", N/A ,"$3,288.74 ", N/A , N/A , N/A ,"$3,252.60 ","$2,697.13 ", N/A , N/A , N/A ,"$3,433.30 ", N/A , N/A ,"$3,144.18 ", N/A ,"$3,252.60 ", N/A ,"$3,252.60 ","$3,252.60 ","$3,252.60 ","$3,505.58 ","$2,927.34 ","$3,361.02 ","$3,108.04 ","$3,505.58 "
SACRED HEART HOSPITAL (ACU),36000399,N/A,HC PERFUSION LEVEL II,360,1 ,"$7,227.00 ","$5,420.25 ","$3,902.58 ","$7,227.00 ","$4,654.19 ", N/A ,"$5,058.90 ", N/A , N/A , N/A , N/A ,"$6,865.65 ", N/A ,"$5,781.60 ","$6,648.84 ", N/A , N/A ,"$6,865.65 ","$6,359.76 ","$5,492.52 ", N/A , N/A , N/A ,"$5,275.71 ","$3,974.85 ","$6,576.57 ","$6,576.57 ","$5,781.60 ", N/A ,"$3,974.85 ","$6,504.30 ", N/A ,"$6,504.30 ","$3,902.58 ","$6,793.38 ", N/A ,"$6,648.84 ", N/A ,"$6,576.57 ", N/A , N/A , N/A ,"$6,504.30 ","$5,393.51 ", N/A , N/A , N/A ,"$6,865.65 ", N/A , N/A ,"$6,287.49 ", N/A ,"$6,504.30 ", N/A ,"$6,504.30 ","$6,504.30 ","$6,504.30 ","$7,010.19 ","$5,853.87 ","$6,721.11 ","$6,215.22 ","$7,010.19 "
SACRED HEART HOSPITAL (ACU),36000400,N/A,HC PERFUSION PER HR,360,1 ,$183.00 ,$137.25 ,$98.82 ,$183.00 ,$117.85 , N/A ,$128.10 , N/A , N/A , N/A , N/A ,$173.85 , N/A ,$146.40 ,$168.36 , N/A , N/A ,$173.85 ,$161.04 ,$139.08 , N/A , N/A , N/A ,$133.59 ,$100.65 ,$166.53 ,$166.53 ,$146.40 , N/A ,$100.65 ,$164.70 , N/A ,$164.70 ,$98.82 ,$172.02 , N/A ,$168.36 , N/A ,$166.53 , N/A , N/A , N/A ,$164.70 ,$136.57 , N/A , N/A , N/A ,$173.85 , N/A , N/A ,$159.21 , N/A ,$164.70 , N/A ,$164.70 ,$164.70 ,$164.70 ,$177.51 ,$148.23 ,$170.19 ,$157.38 ,$177.51 
SACRED HEART HOSPITAL (ACU),36000419,26727,HC TX FX FINGER/THUMB W/MANIP EACH,360,1 ,$149.00 ,$111.75 ,$80.46 ,"$6,739.17 ",$95.96 ,"$2,995.19 ",$104.30 ,$149.00 ,$149.00 ,"$1,776.50 ",$149.00 ,$141.55 ,"$1,724.76 ",$119.20 ,$137.08 ,$149.00 , N/A ,$141.55 ,$131.12 ,$113.24 ,$149.00 ,$149.00 ,"$1,724.76 ",$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,"$3,085.05 ",$81.95 ,$134.10 ,"$2,995.19 ",$134.10 ,$80.46 ,$140.06 ,"$6,739.17 ",$137.08 ,"$1,828.25 ",$135.59 ,"$2,995.19 ",$91.69 ,$91.69 ,$134.10 ,$111.20 ,$134.10 ,"$3,025.14 ",$149.00 ,$141.55 ,"$3,144.95 ",$149.00 ,$129.63 ,"$2,995.19 ",$134.10 ,"$2,995.19 ",$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),36000576,52310,HC CYSTOURETHROSCOPY W/REM FB/STONE/STENT,360,1 ,"$5,788.00 ","$4,341.00 ",$506.66 ,"$5,788.00 ","$3,727.47 ","$1,893.71 ","$4,051.60 ",$506.66 ,"$4,824.00 ",$521.86 ,"$3,859.00 ","$5,498.60 ",$506.66 ,"$4,630.40 ","$5,324.96 ",$506.66 ,"$1,000.00 ","$5,498.60 ","$5,093.44 ","$4,398.88 ",$506.66 ,$506.66 ,$506.66 ,"$4,225.24 ","$3,183.40 ","$5,267.08 ","$5,267.08 ","$4,630.40 ","$1,950.52 ","$3,183.40 ","$5,209.20 ","$1,893.71 ","$5,209.20 ","$3,125.52 ","$5,440.72 ","$4,260.86 ","$5,324.96 ",$537.06 ,"$5,267.08 ","$1,893.71 ","$3,561.94 ","$3,561.94 ","$5,209.20 ","$4,319.58 ","$5,091.27 ","$1,912.65 ",$506.66 ,"$5,498.60 ","$1,988.40 ",$506.66 ,"$5,035.56 ","$1,893.71 ","$5,209.20 ","$1,893.71 ","$5,209.20 ","$5,209.20 ","$5,209.20 ","$5,614.36 ","$4,688.28 ","$5,382.84 ","$4,977.68 ","$5,614.36 "
SACRED HEART HOSPITAL (ACU),36000584,33990,HC INSERT VAD ARTERIAL ACCESS,360,1 ,"$11,370.00 ","$8,527.50 ","$2,694.63 ","$11,370.00 ","$7,322.28 ", N/A ,"$7,959.00 ","$2,694.63 ","$11,370.00 ","$2,775.47 ","$11,370.00 ","$10,801.50 ","$2,694.63 ","$9,096.00 ","$10,460.40 ","$2,694.63 ", N/A ,"$10,801.50 ","$10,005.60 ","$8,641.20 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$8,300.10 ","$6,253.50 ","$10,346.70 ","$10,346.70 ","$9,096.00 ", N/A ,"$6,253.50 ","$10,233.00 ", N/A ,"$10,233.00 ","$6,139.80 ","$10,687.80 ", N/A ,"$10,460.40 ","$2,856.31 ","$10,346.70 ", N/A ,"$6,997.10 ","$6,997.10 ","$10,233.00 ","$8,485.43 ", N/A , N/A ,"$2,694.63 ","$10,801.50 ", N/A ,"$2,694.63 ","$9,891.90 ", N/A ,"$10,233.00 ", N/A ,"$10,233.00 ","$10,233.00 ","$10,233.00 ","$11,028.90 ","$9,209.70 ","$10,574.10 ","$9,778.20 ","$11,028.90 "
SACRED HEART HOSPITAL (ACU),36000591,69420,HC MYRINGOTOMY ASPIR W/EUSTACHIAN INFLATION,360,1 ,$660.00 ,$495.00 ,$36.07 ,$660.00 ,$425.04 ,$223.76 ,$462.00 ,$36.07 ,$660.00 ,$37.15 ,$660.00 ,$627.00 ,$36.07 ,$528.00 ,$607.20 ,$36.07 , N/A ,$627.00 ,$580.80 ,$501.60 ,$36.07 ,$36.07 ,$36.07 ,$481.80 ,$363.00 ,$600.60 ,$600.60 ,$528.00 ,$230.47 ,$363.00 ,$594.00 ,$223.76 ,$594.00 ,$356.40 ,$620.40 ,$503.46 ,$607.20 ,$38.23 ,$600.60 ,$223.76 ,$406.16 ,$406.16 ,$594.00 ,$492.56 ,$594.00 ,$226.00 ,$36.07 ,$627.00 ,$234.95 ,$36.07 ,$574.20 ,$223.76 ,$594.00 ,$223.76 ,$594.00 ,$594.00 ,$594.00 ,$640.20 ,$534.60 ,$613.80 ,$567.60 ,$640.20 
SACRED HEART HOSPITAL (ACU),36000650,36475,HC ABLATION THPY EXTREM PERC RADFQ INIT VEIN,360,1 ,"$5,126.00 ","$3,844.50 ",$829.76 ,"$6,812.22 ","$3,301.14 ","$3,027.65 ","$3,588.20 ",$829.76 ,"$5,126.00 ",$854.65 ,"$5,126.00 ","$4,869.70 ",$829.76 ,"$4,100.80 ","$4,715.92 ",$829.76 , N/A ,"$4,869.70 ","$4,510.88 ","$3,895.76 ",$829.76 ,$829.76 ,$829.76 ,"$3,741.98 ","$2,819.30 ","$4,664.66 ","$4,664.66 ","$4,100.80 ","$3,118.48 ","$2,819.30 ","$4,613.40 ","$3,027.65 ","$4,613.40 ","$2,768.04 ","$4,818.44 ","$6,812.22 ","$4,715.92 ",$879.55 ,"$4,664.66 ","$3,027.65 ","$3,154.54 ","$3,154.54 ","$4,613.40 ","$3,825.53 ","$4,613.40 ","$3,057.93 ",$829.76 ,"$4,869.70 ","$3,179.04 ",$829.76 ,"$4,459.62 ","$3,027.65 ","$4,613.40 ","$3,027.65 ","$4,613.40 ","$4,613.40 ","$4,613.40 ","$4,972.22 ","$4,152.06 ","$4,767.18 ","$4,408.36 ","$4,972.22 "
SACRED HEART HOSPITAL (ACU),36000651,36476,HC ABLATION THPY EXTREM PERC RADFQ ADDL VEIN,360,1 ,"$2,766.00 ","$2,074.50 ",$829.76 ,"$2,766.00 ","$1,781.30 ", N/A ,"$1,936.20 ",$829.76 ,"$2,766.00 ",$854.65 ,"$2,766.00 ","$2,627.70 ",$829.76 ,"$2,212.80 ","$2,544.72 ",$829.76 , N/A ,"$2,627.70 ","$2,434.08 ","$2,102.16 ",$829.76 ,$829.76 ,$829.76 ,"$2,019.18 ","$1,521.30 ","$2,517.06 ","$2,517.06 ","$2,212.80 ", N/A ,"$1,521.30 ","$2,489.40 ", N/A ,"$2,489.40 ","$1,493.64 ","$2,600.04 ", N/A ,"$2,544.72 ",$879.55 ,"$2,517.06 ", N/A ,"$1,702.20 ","$1,702.20 ","$2,489.40 ","$2,064.27 ","$1,383.00 ", N/A ,$829.76 ,"$2,627.70 ", N/A ,$829.76 ,"$2,406.42 ", N/A ,"$2,489.40 ", N/A ,"$2,489.40 ","$2,489.40 ","$2,489.40 ","$2,683.02 ","$2,240.46 ","$2,572.38 ","$2,378.76 ","$2,683.02 "
SACRED HEART HOSPITAL (ACU),36000692,34703,HC ENDOVASC RPR AORTA-UNILAC GRAFT OTHER THAN RUPTURE,360,1 ,$733.00 ,$549.75 ,$395.82 ,"$6,153.96 ",$472.05 , N/A ,$513.10 ,$733.00 ,$733.00 ,"$5,979.79 ",$733.00 ,$696.35 ,"$5,805.62 ",$586.40 ,$674.36 ,$733.00 , N/A ,$696.35 ,$645.04 ,$557.08 ,$733.00 ,$733.00 ,"$5,805.62 ",$535.09 ,$403.15 ,$667.03 ,$667.03 ,$586.40 , N/A ,$403.15 ,$659.70 , N/A ,$659.70 ,$395.82 ,$689.02 , N/A ,$674.36 ,"$6,153.96 ",$667.03 , N/A ,$451.09 ,$451.09 ,$659.70 ,$547.04 , N/A , N/A ,$733.00 ,$696.35 , N/A ,$733.00 ,$637.71 , N/A ,$659.70 , N/A ,$659.70 ,$659.70 ,$659.70 ,$711.01 ,$593.73 ,$681.69 ,$630.38 ,$711.01 
SACRED HEART HOSPITAL (ACU),36000694,34705,HC ENDOVASC RPR AORTA-BILIAC GRAFT OTHER THAN RUPTURE,360,1 ,"$1,100.00 ",$825.00 ,$594.00 ,"$6,153.96 ",$708.40 , N/A ,$770.00 ,"$1,100.00 ","$1,100.00 ","$5,979.79 ","$1,100.00 ","$1,045.00 ","$5,805.62 ",$880.00 ,"$1,012.00 ","$1,100.00 ", N/A ,"$1,045.00 ",$968.00 ,$836.00 ,"$1,100.00 ","$1,100.00 ","$5,805.62 ",$803.00 ,$605.00 ,"$1,001.00 ","$1,001.00 ",$880.00 , N/A ,$605.00 ,$990.00 , N/A ,$990.00 ,$594.00 ,"$1,034.00 ", N/A ,"$1,012.00 ","$6,153.96 ","$1,001.00 ", N/A ,$676.94 ,$676.94 ,$990.00 ,$820.93 , N/A , N/A ,"$1,100.00 ","$1,045.00 ", N/A ,"$1,100.00 ",$957.00 , N/A ,$990.00 , N/A ,$990.00 ,$990.00 ,$990.00 ,"$1,067.00 ",$891.00 ,"$1,023.00 ",$946.00 ,"$1,067.00 "
SACRED HEART HOSPITAL (ACU),36000761,54115,HC REMOVAL FOREIGN BODY DEEP PENILE TISSUE,360,1 ,"$7,127.00 ","$5,345.25 ",$637.48 ,"$7,127.00 ","$4,589.79 ","$2,507.71 ","$4,988.90 ",$637.48 ,"$7,127.00 ",$656.60 ,"$7,127.00 ","$6,770.65 ",$637.48 ,"$5,701.60 ","$6,556.84 ",$637.48 , N/A ,"$6,770.65 ","$6,271.76 ","$5,416.52 ",$637.48 ,$637.48 ,$637.48 ,"$5,202.71 ","$3,919.85 ","$6,485.57 ","$6,485.57 ","$5,701.60 ","$2,582.94 ","$3,919.85 ","$6,414.30 ","$2,507.71 ","$6,414.30 ","$3,848.58 ","$6,699.38 ","$5,642.34 ","$6,556.84 ",$675.73 ,"$6,485.57 ","$2,507.71 ","$4,385.96 ","$4,385.96 ","$6,414.30 ","$5,318.88 ","$5,091.27 ","$2,532.79 ",$637.48 ,"$6,770.65 ","$2,633.09 ",$637.48 ,"$6,200.49 ","$2,507.71 ","$6,414.30 ","$2,507.71 ","$6,414.30 ","$6,414.30 ","$6,414.30 ","$6,913.19 ","$5,772.87 ","$6,628.11 ","$6,129.22 ","$6,913.19 "
SACRED HEART HOSPITAL (ACU),36010639,N/A,HC CYSTOSCOPY FLEXIBLE BEDSIDE,360,1 ,$168.00 ,$126.00 ,$90.72 ,$168.00 ,$108.19 , N/A ,$117.60 , N/A , N/A , N/A , N/A ,$159.60 , N/A ,$134.40 ,$154.56 , N/A , N/A ,$159.60 ,$147.84 ,$127.68 , N/A , N/A , N/A ,$122.64 ,$92.40 ,$152.88 ,$152.88 ,$134.40 , N/A ,$92.40 ,$151.20 , N/A ,$151.20 ,$90.72 ,$157.92 , N/A ,$154.56 , N/A ,$152.88 , N/A , N/A , N/A ,$151.20 ,$125.38 , N/A , N/A , N/A ,$159.60 , N/A , N/A ,$146.16 , N/A ,$151.20 , N/A ,$151.20 ,$151.20 ,$151.20 ,$162.96 ,$136.08 ,$156.24 ,$144.48 ,$162.96 
SACRED HEART HOSPITAL (ACU),36050237,N/A,HC PERFUSIONIST STANDBY FEE,360,1 ,"$4,074.00 ","$3,055.50 ","$2,199.96 ","$4,074.00 ","$2,623.66 ", N/A ,"$2,851.80 ", N/A , N/A , N/A , N/A ,"$3,870.30 ", N/A ,"$3,259.20 ","$3,748.08 ", N/A , N/A ,"$3,870.30 ","$3,585.12 ","$3,096.24 ", N/A , N/A , N/A ,"$2,974.02 ","$2,240.70 ","$3,707.34 ","$3,707.34 ","$3,259.20 ", N/A ,"$2,240.70 ","$3,666.60 ", N/A ,"$3,666.60 ","$2,199.96 ","$3,829.56 ", N/A ,"$3,748.08 ", N/A ,"$3,707.34 ", N/A , N/A , N/A ,"$3,666.60 ","$3,040.43 ", N/A , N/A , N/A ,"$3,870.30 ", N/A , N/A ,"$3,544.38 ", N/A ,"$3,666.60 ", N/A ,"$3,666.60 ","$3,666.60 ","$3,666.60 ","$3,951.78 ","$3,299.94 ","$3,788.82 ","$3,503.64 ","$3,951.78 "
SACRED HEART HOSPITAL (ACU),36060013,N/A,HC OR LEVEL 1 INITIAL 15MIN,360,1 ,"$1,252.00 ",$939.00 ,$676.08 ,"$1,252.00 ",$806.29 , N/A ,$876.40 , N/A , N/A , N/A , N/A ,"$1,189.40 ", N/A ,"$1,001.60 ","$1,151.84 ", N/A , N/A ,"$1,189.40 ","$1,101.76 ",$951.52 , N/A , N/A , N/A ,$913.96 ,$688.60 ,"$1,139.32 ","$1,139.32 ","$1,001.60 ", N/A ,$688.60 ,"$1,126.80 ", N/A ,"$1,126.80 ",$676.08 ,"$1,176.88 ", N/A ,"$1,151.84 ", N/A ,"$1,139.32 ", N/A , N/A , N/A ,"$1,126.80 ",$934.37 , N/A , N/A , N/A ,"$1,189.40 ", N/A , N/A ,"$1,089.24 ", N/A ,"$1,126.80 ", N/A ,"$1,126.80 ","$1,126.80 ","$1,126.80 ","$1,214.44 ","$1,014.12 ","$1,164.36 ","$1,076.72 ","$1,214.44 "
SACRED HEART HOSPITAL (ACU),36060014,N/A,HC OR LEVEL 1 ADDL 15MIN,360,1 ,"$1,252.00 ",$939.00 ,$676.08 ,"$1,252.00 ",$806.29 , N/A ,$876.40 , N/A , N/A , N/A , N/A ,"$1,189.40 ", N/A ,"$1,001.60 ","$1,151.84 ", N/A , N/A ,"$1,189.40 ","$1,101.76 ",$951.52 , N/A , N/A , N/A ,$913.96 ,$688.60 ,"$1,139.32 ","$1,139.32 ","$1,001.60 ", N/A ,$688.60 ,"$1,126.80 ", N/A ,"$1,126.80 ",$676.08 ,"$1,176.88 ", N/A ,"$1,151.84 ", N/A ,"$1,139.32 ", N/A , N/A , N/A ,"$1,126.80 ",$934.37 , N/A , N/A , N/A ,"$1,189.40 ", N/A , N/A ,"$1,089.24 ", N/A ,"$1,126.80 ", N/A ,"$1,126.80 ","$1,126.80 ","$1,126.80 ","$1,214.44 ","$1,014.12 ","$1,164.36 ","$1,076.72 ","$1,214.44 "
SACRED HEART HOSPITAL (ACU),36060015,N/A,HC OR LEVEL 2 INITIAL 15MIN,360,1 ,"$1,393.00 ","$1,044.75 ",$752.22 ,"$1,393.00 ",$897.09 , N/A ,$975.10 , N/A , N/A , N/A , N/A ,"$1,323.35 ", N/A ,"$1,114.40 ","$1,281.56 ", N/A , N/A ,"$1,323.35 ","$1,225.84 ","$1,058.68 ", N/A , N/A , N/A ,"$1,016.89 ",$766.15 ,"$1,267.63 ","$1,267.63 ","$1,114.40 ", N/A ,$766.15 ,"$1,253.70 ", N/A ,"$1,253.70 ",$752.22 ,"$1,309.42 ", N/A ,"$1,281.56 ", N/A ,"$1,267.63 ", N/A , N/A , N/A ,"$1,253.70 ","$1,039.60 ", N/A , N/A , N/A ,"$1,323.35 ", N/A , N/A ,"$1,211.91 ", N/A ,"$1,253.70 ", N/A ,"$1,253.70 ","$1,253.70 ","$1,253.70 ","$1,351.21 ","$1,128.33 ","$1,295.49 ","$1,197.98 ","$1,351.21 "
SACRED HEART HOSPITAL (ACU),36060016,N/A,HC OR LEVEL 2 ADDL 15MIN,360,1 ,"$1,393.00 ","$1,044.75 ",$752.22 ,"$1,393.00 ",$897.09 , N/A ,$975.10 , N/A , N/A , N/A , N/A ,"$1,323.35 ", N/A ,"$1,114.40 ","$1,281.56 ", N/A , N/A ,"$1,323.35 ","$1,225.84 ","$1,058.68 ", N/A , N/A , N/A ,"$1,016.89 ",$766.15 ,"$1,267.63 ","$1,267.63 ","$1,114.40 ", N/A ,$766.15 ,"$1,253.70 ", N/A ,"$1,253.70 ",$752.22 ,"$1,309.42 ", N/A ,"$1,281.56 ", N/A ,"$1,267.63 ", N/A , N/A , N/A ,"$1,253.70 ","$1,039.60 ", N/A , N/A , N/A ,"$1,323.35 ", N/A , N/A ,"$1,211.91 ", N/A ,"$1,253.70 ", N/A ,"$1,253.70 ","$1,253.70 ","$1,253.70 ","$1,351.21 ","$1,128.33 ","$1,295.49 ","$1,197.98 ","$1,351.21 "
SACRED HEART HOSPITAL (ACU),36060017,N/A,HC OR LEVEL 3 INITIAL 15MIN,360,1 ,"$1,504.00 ","$1,128.00 ",$812.16 ,"$1,504.00 ",$968.58 , N/A ,"$1,052.80 ", N/A , N/A , N/A , N/A ,"$1,428.80 ", N/A ,"$1,203.20 ","$1,383.68 ", N/A , N/A ,"$1,428.80 ","$1,323.52 ","$1,143.04 ", N/A , N/A , N/A ,"$1,097.92 ",$827.20 ,"$1,368.64 ","$1,368.64 ","$1,203.20 ", N/A ,$827.20 ,"$1,353.60 ", N/A ,"$1,353.60 ",$812.16 ,"$1,413.76 ", N/A ,"$1,383.68 ", N/A ,"$1,368.64 ", N/A , N/A , N/A ,"$1,353.60 ","$1,122.44 ", N/A , N/A , N/A ,"$1,428.80 ", N/A , N/A ,"$1,308.48 ", N/A ,"$1,353.60 ", N/A ,"$1,353.60 ","$1,353.60 ","$1,353.60 ","$1,458.88 ","$1,218.24 ","$1,398.72 ","$1,293.44 ","$1,458.88 "
SACRED HEART HOSPITAL (ACU),36060018,N/A,HC OR LEVEL 3 ADDL 15MIN,360,1 ,"$1,504.00 ","$1,128.00 ",$812.16 ,"$1,504.00 ",$968.58 , N/A ,"$1,052.80 ", N/A , N/A , N/A , N/A ,"$1,428.80 ", N/A ,"$1,203.20 ","$1,383.68 ", N/A , N/A ,"$1,428.80 ","$1,323.52 ","$1,143.04 ", N/A , N/A , N/A ,"$1,097.92 ",$827.20 ,"$1,368.64 ","$1,368.64 ","$1,203.20 ", N/A ,$827.20 ,"$1,353.60 ", N/A ,"$1,353.60 ",$812.16 ,"$1,413.76 ", N/A ,"$1,383.68 ", N/A ,"$1,368.64 ", N/A , N/A , N/A ,"$1,353.60 ","$1,122.44 ", N/A , N/A , N/A ,"$1,428.80 ", N/A , N/A ,"$1,308.48 ", N/A ,"$1,353.60 ", N/A ,"$1,353.60 ","$1,353.60 ","$1,353.60 ","$1,458.88 ","$1,218.24 ","$1,398.72 ","$1,293.44 ","$1,458.88 "
SACRED HEART HOSPITAL (ACU),36060019,N/A,HC OR LEVEL 4 INITIAL 15MIN,360,1 ,"$1,825.00 ","$1,368.75 ",$985.50 ,"$1,825.00 ","$1,175.30 ", N/A ,"$1,277.50 ", N/A , N/A , N/A , N/A ,"$1,733.75 ", N/A ,"$1,460.00 ","$1,679.00 ", N/A , N/A ,"$1,733.75 ","$1,606.00 ","$1,387.00 ", N/A , N/A , N/A ,"$1,332.25 ","$1,003.75 ","$1,660.75 ","$1,660.75 ","$1,460.00 ", N/A ,"$1,003.75 ","$1,642.50 ", N/A ,"$1,642.50 ",$985.50 ,"$1,715.50 ", N/A ,"$1,679.00 ", N/A ,"$1,660.75 ", N/A , N/A , N/A ,"$1,642.50 ","$1,362.00 ", N/A , N/A , N/A ,"$1,733.75 ", N/A , N/A ,"$1,587.75 ", N/A ,"$1,642.50 ", N/A ,"$1,642.50 ","$1,642.50 ","$1,642.50 ","$1,770.25 ","$1,478.25 ","$1,697.25 ","$1,569.50 ","$1,770.25 "
SACRED HEART HOSPITAL (ACU),36060020,N/A,HC OR LEVEL 4 ADDL 15MIN,360,1 ,"$1,825.00 ","$1,368.75 ",$985.50 ,"$1,825.00 ","$1,175.30 ", N/A ,"$1,277.50 ", N/A , N/A , N/A , N/A ,"$1,733.75 ", N/A ,"$1,460.00 ","$1,679.00 ", N/A , N/A ,"$1,733.75 ","$1,606.00 ","$1,387.00 ", N/A , N/A , N/A ,"$1,332.25 ","$1,003.75 ","$1,660.75 ","$1,660.75 ","$1,460.00 ", N/A ,"$1,003.75 ","$1,642.50 ", N/A ,"$1,642.50 ",$985.50 ,"$1,715.50 ", N/A ,"$1,679.00 ", N/A ,"$1,660.75 ", N/A , N/A , N/A ,"$1,642.50 ","$1,362.00 ", N/A , N/A , N/A ,"$1,733.75 ", N/A , N/A ,"$1,587.75 ", N/A ,"$1,642.50 ", N/A ,"$1,642.50 ","$1,642.50 ","$1,642.50 ","$1,770.25 ","$1,478.25 ","$1,697.25 ","$1,569.50 ","$1,770.25 "
SACRED HEART HOSPITAL (ACU),36060021,N/A,HC OR LEVEL 5 INITIAL 15MIN,360,1 ,"$2,144.00 ","$1,608.00 ","$1,157.76 ","$2,144.00 ","$1,380.74 ", N/A ,"$1,500.80 ", N/A , N/A , N/A , N/A ,"$2,036.80 ", N/A ,"$1,715.20 ","$1,972.48 ", N/A , N/A ,"$2,036.80 ","$1,886.72 ","$1,629.44 ", N/A , N/A , N/A ,"$1,565.12 ","$1,179.20 ","$1,951.04 ","$1,951.04 ","$1,715.20 ", N/A ,"$1,179.20 ","$1,929.60 ", N/A ,"$1,929.60 ","$1,157.76 ","$2,015.36 ", N/A ,"$1,972.48 ", N/A ,"$1,951.04 ", N/A , N/A , N/A ,"$1,929.60 ","$1,600.07 ", N/A , N/A , N/A ,"$2,036.80 ", N/A , N/A ,"$1,865.28 ", N/A ,"$1,929.60 ", N/A ,"$1,929.60 ","$1,929.60 ","$1,929.60 ","$2,079.68 ","$1,736.64 ","$1,993.92 ","$1,843.84 ","$2,079.68 "
SACRED HEART HOSPITAL (ACU),36060022,N/A,HC OR LEVEL 5 ADDL 15MIN,360,1 ,"$2,144.00 ","$1,608.00 ","$1,157.76 ","$2,144.00 ","$1,380.74 ", N/A ,"$1,500.80 ", N/A , N/A , N/A , N/A ,"$2,036.80 ", N/A ,"$1,715.20 ","$1,972.48 ", N/A , N/A ,"$2,036.80 ","$1,886.72 ","$1,629.44 ", N/A , N/A , N/A ,"$1,565.12 ","$1,179.20 ","$1,951.04 ","$1,951.04 ","$1,715.20 ", N/A ,"$1,179.20 ","$1,929.60 ", N/A ,"$1,929.60 ","$1,157.76 ","$2,015.36 ", N/A ,"$1,972.48 ", N/A ,"$1,951.04 ", N/A , N/A , N/A ,"$1,929.60 ","$1,600.07 ", N/A , N/A , N/A ,"$2,036.80 ", N/A , N/A ,"$1,865.28 ", N/A ,"$1,929.60 ", N/A ,"$1,929.60 ","$1,929.60 ","$1,929.60 ","$2,079.68 ","$1,736.64 ","$1,993.92 ","$1,843.84 ","$2,079.68 "
SACRED HEART HOSPITAL (ACU),36060023,N/A,HC OR LEVEL 6 INITIAL 15MIN,360,1 ,"$2,250.00 ","$1,687.50 ","$1,215.00 ","$2,250.00 ","$1,449.00 ", N/A ,"$1,575.00 ", N/A , N/A , N/A , N/A ,"$2,137.50 ", N/A ,"$1,800.00 ","$2,070.00 ", N/A , N/A ,"$2,137.50 ","$1,980.00 ","$1,710.00 ", N/A , N/A , N/A ,"$1,642.50 ","$1,237.50 ","$2,047.50 ","$2,047.50 ","$1,800.00 ", N/A ,"$1,237.50 ","$2,025.00 ", N/A ,"$2,025.00 ","$1,215.00 ","$2,115.00 ", N/A ,"$2,070.00 ", N/A ,"$2,047.50 ", N/A , N/A , N/A ,"$2,025.00 ","$1,679.18 ", N/A , N/A , N/A ,"$2,137.50 ", N/A , N/A ,"$1,957.50 ", N/A ,"$2,025.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,025.00 ","$2,182.50 ","$1,822.50 ","$2,092.50 ","$1,935.00 ","$2,182.50 "
SACRED HEART HOSPITAL (ACU),36060024,N/A,HC OR LEVEL 6 ADDL 15MIN,360,1 ,"$2,250.00 ","$1,687.50 ","$1,215.00 ","$2,250.00 ","$1,449.00 ", N/A ,"$1,575.00 ", N/A , N/A , N/A , N/A ,"$2,137.50 ", N/A ,"$1,800.00 ","$2,070.00 ", N/A , N/A ,"$2,137.50 ","$1,980.00 ","$1,710.00 ", N/A , N/A , N/A ,"$1,642.50 ","$1,237.50 ","$2,047.50 ","$2,047.50 ","$1,800.00 ", N/A ,"$1,237.50 ","$2,025.00 ", N/A ,"$2,025.00 ","$1,215.00 ","$2,115.00 ", N/A ,"$2,070.00 ", N/A ,"$2,047.50 ", N/A , N/A , N/A ,"$2,025.00 ","$1,679.18 ", N/A , N/A , N/A ,"$2,137.50 ", N/A , N/A ,"$1,957.50 ", N/A ,"$2,025.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,025.00 ","$2,182.50 ","$1,822.50 ","$2,092.50 ","$1,935.00 ","$2,182.50 "
SACRED HEART HOSPITAL (ACU),36063346,N/A,HC PERCUTANEOUS TENOTOMY,360,1 ,"$9,661.00 ","$7,245.75 ","$5,216.94 ","$9,661.00 ","$6,221.68 ", N/A ,"$6,762.70 ", N/A , N/A , N/A , N/A ,"$9,177.95 ", N/A ,"$7,728.80 ","$8,888.12 ", N/A , N/A ,"$9,177.95 ","$8,501.68 ","$7,342.36 ", N/A , N/A , N/A ,"$7,052.53 ","$5,313.55 ","$8,791.51 ","$8,791.51 ","$7,728.80 ", N/A ,"$5,313.55 ","$8,694.90 ", N/A ,"$8,694.90 ","$5,216.94 ","$9,081.34 ", N/A ,"$8,888.12 ", N/A ,"$8,791.51 ", N/A , N/A , N/A ,"$8,694.90 ","$7,210.00 ", N/A , N/A , N/A ,"$9,177.95 ", N/A , N/A ,"$8,405.07 ", N/A ,"$8,694.90 ", N/A ,"$8,694.90 ","$8,694.90 ","$8,694.90 ","$9,371.17 ","$7,825.41 ","$8,984.73 ","$8,308.46 ","$9,371.17 "
SACRED HEART HOSPITAL (ACU),36080001,63661,HC RM SPINAL NEUROSTIM ELECTRD,360,1 ,"$5,621.17 ","$4,215.88 ","$1,218.70 ","$5,621.17 ","$3,620.03 ","$1,857.12 ","$3,934.82 ","$1,218.70 ","$4,824.00 ","$1,255.26 ","$3,859.00 ","$5,340.11 ","$1,218.70 ","$4,496.94 ","$5,171.48 ","$1,218.70 ", N/A ,"$5,340.11 ","$4,946.63 ","$4,272.09 ","$1,218.70 ","$1,218.70 ","$1,218.70 ","$4,103.45 ","$3,091.64 ","$5,115.26 ","$5,115.26 ","$4,496.94 ","$1,912.83 ","$3,091.64 ","$5,059.05 ","$1,857.12 ","$5,059.05 ","$3,035.43 ","$5,283.90 ","$4,178.51 ","$5,171.48 ","$1,291.82 ","$5,115.26 ","$1,857.12 ","$3,459.27 ","$3,459.27 ","$5,059.05 ","$4,195.08 ","$3,360.24 ","$1,875.69 ","$1,218.70 ","$5,340.11 ","$1,949.97 ","$1,218.70 ","$4,890.42 ","$1,857.12 ","$5,059.05 ","$1,857.12 ","$5,059.05 ","$5,059.05 ","$5,059.05 ","$5,452.53 ","$4,553.15 ","$5,227.69 ","$4,834.21 ","$5,452.53 "
SACRED HEART HOSPITAL (ACU),36080002,63688,HC REV/RM SPINAL NEUROSTIM GEN,360,1 ,"$8,723.60 ","$6,542.70 ","$1,218.70 ","$8,723.60 ","$5,618.00 ","$3,464.77 ","$6,106.52 ","$1,218.70 ","$8,723.60 ","$1,255.26 ","$7,718.00 ","$8,287.42 ","$1,218.70 ","$6,978.88 ","$8,025.71 ","$1,218.70 ", N/A ,"$8,287.42 ","$7,676.77 ","$6,629.94 ","$1,218.70 ","$1,218.70 ","$1,218.70 ","$6,368.23 ","$4,797.98 ","$7,938.48 ","$7,938.48 ","$6,978.88 ","$3,568.71 ","$4,797.98 ","$7,851.24 ","$3,464.77 ","$7,851.24 ","$4,710.74 ","$8,200.18 ","$7,795.73 ","$8,025.71 ","$1,291.82 ","$7,938.48 ","$3,464.77 ","$5,368.50 ","$5,368.50 ","$7,851.24 ","$6,510.42 ","$6,618.65 ","$3,499.42 ","$1,218.70 ","$8,287.42 ","$3,638.01 ","$1,218.70 ","$7,589.53 ","$3,464.77 ","$7,851.24 ","$3,464.77 ","$7,851.24 ","$7,851.24 ","$7,851.24 ","$8,461.89 ","$7,066.12 ","$8,112.95 ","$7,502.30 ","$8,461.89 "
SACRED HEART HOSPITAL (ACU),36080006,64400,HC NERVE BLOCK TRIGEMINAL,360,1 ,$589.00 ,$441.75 ,$141.34 ,$621.73 ,$379.32 ,$276.32 ,$412.30 ,$141.34 ,$589.00 ,$145.58 ,$589.00 ,$559.55 ,$141.34 ,$471.20 ,$541.88 ,$141.34 , N/A ,$559.55 ,$518.32 ,$447.64 ,$141.34 ,$141.34 ,$141.34 ,$429.97 ,$323.95 ,$535.99 ,$535.99 ,$471.20 ,$284.61 ,$323.95 ,$530.10 ,$276.32 ,$530.10 ,$318.06 ,$553.66 ,$621.73 ,$541.88 ,$149.82 ,$535.99 ,$276.32 ,$362.47 ,$362.47 ,$530.10 ,$439.57 ,$530.10 ,$279.09 ,$141.34 ,$559.55 ,$290.14 ,$141.34 ,$512.43 ,$276.32 ,$530.10 ,$276.32 ,$530.10 ,$530.10 ,$530.10 ,$571.33 ,$477.09 ,$547.77 ,$506.54 ,$571.33 
SACRED HEART HOSPITAL (ACU),36100001,47537,HC REM BIL CATH W G SI CHOLANG,361,1 ,"$4,252.78 ","$3,189.59 ",$64.85 ,"$4,252.78 ","$2,738.79 ",$855.79 ,"$2,976.95 ",$64.85 ,"$3,216.00 ",$66.80 ,"$2,572.00 ","$4,040.14 ",$64.85 ,"$3,402.22 ","$3,912.56 ",$64.85 , N/A ,"$4,040.14 ","$3,742.45 ","$3,232.11 ",$64.85 ,$64.85 ,$64.85 ,"$3,104.53 ","$2,339.03 ","$3,870.03 ","$3,870.03 ","$3,402.22 ",$881.46 ,"$2,339.03 ","$3,827.50 ",$855.79 ,"$3,827.50 ","$2,296.50 ","$3,997.61 ","$1,925.53 ","$3,912.56 ",$68.74 ,"$3,870.03 ",$855.79 ,"$2,617.16 ","$2,617.16 ","$3,827.50 ","$3,173.85 ","$2,240.16 ",$864.35 ,$64.85 ,"$4,040.14 ",$898.58 ,$64.85 ,"$3,699.92 ",$855.79 ,"$3,827.50 ",$855.79 ,"$3,827.50 ","$3,827.50 ","$3,827.50 ","$4,125.20 ","$3,444.75 ","$3,955.09 ","$3,657.39 ","$4,125.20 "
SACRED HEART HOSPITAL (ACU),36100002,47538,HC PLC BILE SNT W G SI EX/REMOVAL CHOLANG,361,1 ,"$4,404.00 ","$3,303.00 ",$817.89 ,"$12,041.00 ","$2,836.18 ","$5,351.56 ","$3,082.80 ",$817.89 ,"$4,404.00 ",$842.43 ,"$4,404.00 ","$4,183.80 ",$817.89 ,"$3,523.20 ","$4,051.68 ",$817.89 , N/A ,"$4,183.80 ","$3,875.52 ","$3,347.04 ",$817.89 ,$817.89 ,$817.89 ,"$3,214.92 ","$2,422.20 ","$4,007.64 ","$4,007.64 ","$3,523.20 ","$5,512.11 ","$2,422.20 ","$3,963.60 ","$5,351.56 ","$3,963.60 ","$2,378.16 ","$4,139.76 ","$12,041.00 ","$4,051.68 ",$866.96 ,"$4,007.64 ","$5,351.56 ","$2,710.22 ","$2,710.22 ","$3,963.60 ","$3,286.71 ","$3,963.60 ","$5,405.07 ",$817.89 ,"$4,183.80 ","$5,619.13 ",$817.89 ,"$3,831.48 ","$5,351.56 ","$3,963.60 ","$5,351.56 ","$3,963.60 ","$3,963.60 ","$3,963.60 ","$4,271.88 ","$3,567.24 ","$4,095.72 ","$3,787.44 ","$4,271.88 "
SACRED HEART HOSPITAL (ACU),36100003,47540,HC PLC BILE SNT W GD SI  NEW ACCESS,361,1 ,"$4,252.78 ","$3,189.59 ","$2,072.01 ","$12,041.00 ","$2,738.79 ","$5,351.56 ","$2,976.95 ","$2,072.01 ","$4,252.78 ","$2,134.17 ","$4,252.78 ","$4,040.14 ","$2,072.01 ","$3,402.22 ","$3,912.56 ","$2,072.01 ", N/A ,"$4,040.14 ","$3,742.45 ","$3,232.11 ","$2,072.01 ","$2,072.01 ","$2,072.01 ","$3,104.53 ","$2,339.03 ","$3,870.03 ","$3,870.03 ","$3,402.22 ","$5,512.11 ","$2,339.03 ","$3,827.50 ","$5,351.56 ","$3,827.50 ","$2,296.50 ","$3,997.61 ","$12,041.00 ","$3,912.56 ","$2,196.33 ","$3,870.03 ","$5,351.56 ","$2,617.16 ","$2,617.16 ","$3,827.50 ","$3,173.85 ","$3,827.50 ","$5,405.07 ","$2,072.01 ","$4,040.14 ","$5,619.13 ","$2,072.01 ","$3,699.92 ","$5,351.56 ","$3,827.50 ","$5,351.56 ","$3,827.50 ","$3,827.50 ","$3,827.50 ","$4,125.20 ","$3,444.75 ","$3,955.09 ","$3,657.39 ","$4,125.20 "
SACRED HEART HOSPITAL (ACU),36100004,50430,HC INJ NEPH URET W G SI NEW ACCESS,361,1 ,"$2,374.00 ","$1,780.50 ",$123.38 ,"$2,374.00 ","$1,528.86 ",$608.47 ,"$1,661.80 ",$123.38 ,"$2,374.00 ",$127.08 ,"$2,374.00 ","$2,255.30 ",$123.38 ,"$1,899.20 ","$2,184.08 ",$123.38 , N/A ,"$2,255.30 ","$2,089.12 ","$1,804.24 ",$123.38 ,$123.38 ,$123.38 ,"$1,733.02 ","$1,305.70 ","$2,160.34 ","$2,160.34 ","$1,899.20 ",$626.72 ,"$1,305.70 ","$2,136.60 ",$608.47 ,"$2,136.60 ","$1,281.96 ","$2,231.56 ","$1,369.05 ","$2,184.08 ",$130.78 ,"$2,160.34 ",$608.47 ,"$1,460.96 ","$1,460.96 ","$2,136.60 ","$1,771.72 ","$2,136.60 ",$614.55 ,$123.38 ,"$2,255.30 ",$638.89 ,$123.38 ,"$2,065.38 ",$608.47 ,"$2,136.60 ",$608.47 ,"$2,136.60 ","$2,136.60 ","$2,136.60 ","$2,302.78 ","$1,922.94 ","$2,207.82 ","$2,041.64 ","$2,302.78 "
SACRED HEART HOSPITAL (ACU),36100005,50433,HC PL NEPH CAT W GD S AND I NEW ACCESS,361,1 ,"$4,168.46 ","$3,126.35 ",$955.28 ,"$7,316.47 ","$2,684.49 ","$3,251.76 ","$2,917.92 ",$955.28 ,"$4,168.46 ",$983.94 ,"$3,859.00 ","$3,960.04 ",$955.28 ,"$3,334.77 ","$3,834.98 ",$955.28 , N/A ,"$3,960.04 ","$3,668.24 ","$3,168.03 ",$955.28 ,$955.28 ,$955.28 ,"$3,042.98 ","$2,292.65 ","$3,793.30 ","$3,793.30 ","$3,334.77 ","$3,349.31 ","$2,292.65 ","$3,751.61 ","$3,251.76 ","$3,751.61 ","$2,250.97 ","$3,918.35 ","$7,316.47 ","$3,834.98 ","$1,012.60 ","$3,793.30 ","$3,251.76 ","$2,565.27 ","$2,565.27 ","$3,751.61 ","$3,110.92 ","$3,751.61 ","$3,284.28 ",$955.28 ,"$3,960.04 ","$3,414.35 ",$955.28 ,"$3,626.56 ","$3,251.76 ","$3,751.61 ","$3,251.76 ","$3,751.61 ","$3,751.61 ","$3,751.61 ","$4,043.41 ","$3,376.45 ","$3,876.67 ","$3,584.88 ","$4,043.41 "
SACRED HEART HOSPITAL (ACU),36100006,50434,HC CONVERT NEPH CTH NEPHUR CTH WG S AND I EXST TRACT,361,1 ,"$4,168.46 ","$3,126.35 ",$490.07 ,"$4,260.86 ","$2,684.49 ","$1,893.71 ","$2,917.92 ",$490.07 ,"$4,168.46 ",$504.77 ,"$3,859.00 ","$3,960.04 ",$490.07 ,"$3,334.77 ","$3,834.98 ",$490.07 , N/A ,"$3,960.04 ","$3,668.24 ","$3,168.03 ",$490.07 ,$490.07 ,$490.07 ,"$3,042.98 ","$2,292.65 ","$3,793.30 ","$3,793.30 ","$3,334.77 ","$1,950.52 ","$2,292.65 ","$3,751.61 ","$1,893.71 ","$3,751.61 ","$2,250.97 ","$3,918.35 ","$4,260.86 ","$3,834.98 ",$519.47 ,"$3,793.30 ","$1,893.71 ","$2,565.27 ","$2,565.27 ","$3,751.61 ","$3,110.92 ","$3,751.61 ","$1,912.65 ",$490.07 ,"$3,960.04 ","$1,988.40 ",$490.07 ,"$3,626.56 ","$1,893.71 ","$3,751.61 ","$1,893.71 ","$3,751.61 ","$3,751.61 ","$3,751.61 ","$4,043.41 ","$3,376.45 ","$3,876.67 ","$3,584.88 ","$4,043.41 "
SACRED HEART HOSPITAL (ACU),36100008,50694,HC PL URT STNT W G SI NEW ACCESS WO NEPH CATH,361,1 ,"$2,268.00 ","$1,701.00 ",$955.28 ,"$7,316.47 ","$1,460.59 ","$3,251.76 ","$1,587.60 ",$955.28 ,"$2,268.00 ",$983.94 ,"$2,268.00 ","$2,154.60 ",$955.28 ,"$1,814.40 ","$2,086.56 ",$955.28 , N/A ,"$2,154.60 ","$1,995.84 ","$1,723.68 ",$955.28 ,$955.28 ,$955.28 ,"$1,655.64 ","$1,247.40 ","$2,063.88 ","$2,063.88 ","$1,814.40 ","$3,349.31 ","$1,247.40 ","$2,041.20 ","$3,251.76 ","$2,041.20 ","$1,224.72 ","$2,131.92 ","$7,316.47 ","$2,086.56 ","$1,012.60 ","$2,063.88 ","$3,251.76 ","$1,395.73 ","$1,395.73 ","$2,041.20 ","$1,692.61 ","$2,041.20 ","$3,284.28 ",$955.28 ,"$2,154.60 ","$3,414.35 ",$955.28 ,"$1,973.16 ","$3,251.76 ","$2,041.20 ","$3,251.76 ","$2,041.20 ","$2,041.20 ","$2,041.20 ","$2,199.96 ","$1,837.08 ","$2,109.24 ","$1,950.48 ","$2,199.96 "
SACRED HEART HOSPITAL (ACU),36100009,50695,HC PL URT STNT W G SI NEW ACCESS WITH NEPH CATH,361,1 ,"$2,268.00 ","$1,701.00 ",$955.28 ,"$7,316.47 ","$1,460.59 ","$3,251.76 ","$1,587.60 ",$955.28 ,"$2,268.00 ",$983.94 ,"$2,268.00 ","$2,154.60 ",$955.28 ,"$1,814.40 ","$2,086.56 ",$955.28 , N/A ,"$2,154.60 ","$1,995.84 ","$1,723.68 ",$955.28 ,$955.28 ,$955.28 ,"$1,655.64 ","$1,247.40 ","$2,063.88 ","$2,063.88 ","$1,814.40 ","$3,349.31 ","$1,247.40 ","$2,041.20 ","$3,251.76 ","$2,041.20 ","$1,224.72 ","$2,131.92 ","$7,316.47 ","$2,086.56 ","$1,012.60 ","$2,063.88 ","$3,251.76 ","$1,395.73 ","$1,395.73 ","$2,041.20 ","$1,692.61 ","$2,041.20 ","$3,284.28 ",$955.28 ,"$2,154.60 ","$3,414.35 ",$955.28 ,"$1,973.16 ","$3,251.76 ","$2,041.20 ","$3,251.76 ","$2,041.20 ","$2,041.20 ","$2,041.20 ","$2,199.96 ","$1,837.08 ","$2,109.24 ","$1,950.48 ","$2,199.96 "
SACRED HEART HOSPITAL (ACU),36100011,49185,HC SCLEROTHERAPY FLUID COLLECTION PERC INJECT IG SI,361,1 ,"$4,186.00 ","$3,139.50 ",$239.96 ,"$4,186.00 ","$2,695.78 ",$658.15 ,"$2,930.20 ",$239.96 ,"$3,216.00 ",$247.16 ,"$2,572.00 ","$3,976.70 ",$239.96 ,"$3,348.80 ","$3,851.12 ",$239.96 , N/A ,"$3,976.70 ","$3,683.68 ","$3,181.36 ",$239.96 ,$239.96 ,$239.96 ,"$3,055.78 ","$2,302.30 ","$3,809.26 ","$3,809.26 ","$3,348.80 ",$677.89 ,"$2,302.30 ","$3,767.40 ",$658.15 ,"$3,767.40 ","$2,260.44 ","$3,934.84 ","$1,480.84 ","$3,851.12 ",$254.36 ,"$3,809.26 ",$658.15 ,"$2,576.06 ","$2,576.06 ","$3,767.40 ","$3,124.01 ","$2,240.16 ",$664.73 ,$239.96 ,"$3,976.70 ",$691.06 ,$239.96 ,"$3,641.82 ",$658.15 ,"$3,767.40 ",$658.15 ,"$3,767.40 ","$3,767.40 ","$3,767.40 ","$4,060.42 ","$3,390.66 ","$3,892.98 ","$3,599.96 ","$4,060.42 "
SACRED HEART HOSPITAL (ACU),36100012,50706,HC BALLOON DILATION URETERAL IG SI,361,1 ,"$1,987.55 ","$1,490.66 ",$993.78 ,"$2,386.80 ","$1,279.98 ", N/A ,"$1,391.29 ","$1,987.55 ","$1,987.55 ","$2,319.25 ","$1,987.55 ","$1,888.17 ","$2,251.70 ","$1,590.04 ","$1,828.55 ","$1,987.55 ", N/A ,"$1,888.17 ","$1,749.04 ","$1,510.54 ","$1,987.55 ","$1,987.55 ","$2,251.70 ","$1,450.91 ","$1,093.15 ","$1,808.67 ","$1,808.67 ","$1,590.04 ", N/A ,"$1,093.15 ","$1,788.80 ", N/A ,"$1,788.80 ","$1,073.28 ","$1,868.30 ", N/A ,"$1,828.55 ","$2,386.80 ","$1,808.67 ", N/A ,"$1,223.14 ","$1,223.14 ","$1,788.80 ","$1,483.31 ",$993.78 , N/A ,"$1,987.55 ","$1,888.17 ", N/A ,"$1,987.55 ","$1,729.17 ", N/A ,"$1,788.80 ", N/A ,"$1,788.80 ","$1,788.80 ","$1,788.80 ","$1,927.92 ","$1,609.92 ","$1,848.42 ","$1,709.29 ","$1,927.92 "
SACRED HEART HOSPITAL (ACU),36100013,47541,HC PLCMENT ACCESS BILIARY TREE BOWEL PERC IG SI,361,1 ,"$4,066.63 ","$3,049.97 ","$2,072.01 ","$7,571.16 ","$2,618.91 ","$3,364.96 ","$2,846.64 ","$2,072.01 ","$4,066.63 ","$2,134.17 ","$4,066.63 ","$3,863.30 ","$2,072.01 ","$3,253.30 ","$3,741.30 ","$2,072.01 ", N/A ,"$3,863.30 ","$3,578.63 ","$3,090.64 ","$2,072.01 ","$2,072.01 ","$2,072.01 ","$2,968.64 ","$2,236.65 ","$3,700.63 ","$3,700.63 ","$3,253.30 ","$3,465.91 ","$2,236.65 ","$3,659.97 ","$3,364.96 ","$3,659.97 ","$2,195.98 ","$3,822.63 ","$7,571.16 ","$3,741.30 ","$2,196.33 ","$3,700.63 ","$3,364.96 ","$2,502.60 ","$2,502.60 ","$3,659.97 ","$3,034.93 ","$3,659.97 ","$3,398.61 ","$2,072.01 ","$3,863.30 ","$3,533.21 ","$2,072.01 ","$3,537.97 ","$3,364.96 ","$3,659.97 ","$3,364.96 ","$3,659.97 ","$3,659.97 ","$3,659.97 ","$3,944.63 ","$3,293.97 ","$3,781.97 ","$3,497.30 ","$3,944.63 "
SACRED HEART HOSPITAL (ACU),36100015,11010,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISSUE,361,1 ,$291.00 ,$218.25 ,$122.07 ,"$1,480.84 ",$187.40 ,$658.15 ,$203.70 ,$122.07 ,$291.00 ,$125.73 ,$291.00 ,$276.45 ,$122.07 ,$232.80 ,$267.72 ,$122.07 , N/A ,$276.45 ,$256.08 ,$221.16 ,$122.07 ,$122.07 ,$122.07 ,$212.43 ,$160.05 ,$264.81 ,$264.81 ,$232.80 ,$677.89 ,$160.05 ,$261.90 ,$658.15 ,$261.90 ,$157.14 ,$273.54 ,"$1,480.84 ",$267.72 ,$129.39 ,$264.81 ,$658.15 ,$179.08 ,$179.08 ,$261.90 ,$217.17 ,$261.90 ,$664.73 ,$122.07 ,$276.45 ,$691.06 ,$122.07 ,$253.17 ,$658.15 ,$261.90 ,$658.15 ,$261.90 ,$261.90 ,$261.90 ,$282.27 ,$235.71 ,$270.63 ,$250.26 ,$282.27 
SACRED HEART HOSPITAL (ACU),36100017,11012,HC DEBRID/REMOVE FOREIGN BODY SKIN/SUBQ TISS/MUSCLE/BONE,361,1 ,$179.00 ,$134.25 ,$96.66 ,"$5,642.34 ",$115.28 ,"$2,507.71 ",$125.30 ,$179.00 ,$179.00 ,$335.49 ,$179.00 ,$170.05 ,$325.72 ,$143.20 ,$164.68 ,$179.00 , N/A ,$170.05 ,$157.52 ,$136.04 ,$179.00 ,$179.00 ,$325.72 ,$130.67 ,$98.45 ,$162.89 ,$162.89 ,$143.20 ,"$2,582.94 ",$98.45 ,$161.10 ,"$2,507.71 ",$161.10 ,$96.66 ,$168.26 ,"$5,642.34 ",$164.68 ,$345.26 ,$162.89 ,"$2,507.71 ",$110.16 ,$110.16 ,$161.10 ,$133.59 ,$161.10 ,"$2,532.79 ",$179.00 ,$170.05 ,"$2,633.09 ",$179.00 ,$155.73 ,"$2,507.71 ",$161.10 ,"$2,507.71 ",$161.10 ,$161.10 ,$161.10 ,$173.63 ,$144.99 ,$166.47 ,$153.94 ,$173.63 
SACRED HEART HOSPITAL (ACU),36100018,11601,HC EXCISION MALIGNT LESION BENIGN TRUNK/ARM 0.6-1.0CM,361,1 ,$630.00 ,$472.50 ,$144.67 ,"$1,480.84 ",$405.72 ,$658.15 ,$441.00 ,$144.67 ,$630.00 ,$149.01 ,$630.00 ,$598.50 ,$144.67 ,$504.00 ,$579.60 ,$144.67 , N/A ,$598.50 ,$554.40 ,$478.80 ,$144.67 ,$144.67 ,$144.67 ,$459.90 ,$346.50 ,$573.30 ,$573.30 ,$504.00 ,$677.89 ,$346.50 ,$567.00 ,$658.15 ,$567.00 ,$340.20 ,$592.20 ,"$1,480.84 ",$579.60 ,$153.35 ,$573.30 ,$658.15 ,$387.70 ,$387.70 ,$567.00 ,$470.17 ,$567.00 ,$664.73 ,$144.67 ,$598.50 ,$691.06 ,$144.67 ,$548.10 ,$658.15 ,$567.00 ,$658.15 ,$567.00 ,$567.00 ,$567.00 ,$611.10 ,$510.30 ,$585.90 ,$541.80 ,$611.10 
SACRED HEART HOSPITAL (ACU),36100026,36510,HC UMBILICAL CATHETER INSERTION NEWBORN,361,1 ,$314.19 ,$235.64 ,$19.05 ,$314.19 ,$202.34 , N/A ,$219.93 ,$19.05 ,$314.19 ,$19.62 ,$314.19 ,$298.48 ,$19.05 ,$251.35 ,$289.05 ,$19.05 , N/A ,$298.48 ,$276.49 ,$238.78 ,$19.05 ,$19.05 ,$19.05 ,$229.36 ,$172.80 ,$285.91 ,$285.91 ,$251.35 , N/A ,$172.80 ,$282.77 , N/A ,$282.77 ,$169.66 ,$295.34 , N/A ,$289.05 ,$20.19 ,$285.91 , N/A ,$193.35 ,$193.35 ,$282.77 ,$234.48 ,$282.77 , N/A ,$19.05 ,$298.48 , N/A ,$19.05 ,$273.35 , N/A ,$282.77 , N/A ,$282.77 ,$282.77 ,$282.77 ,$304.76 ,$254.49 ,$292.20 ,$270.20 ,$304.76 
SACRED HEART HOSPITAL (ACU),36100027,47380,HC ABLATION LIVER TUMOR OPEN RADIOFREQUENCY,361,1 ,"$2,047.40 ","$1,535.55 ","$1,105.60 ","$2,196.33 ","$1,318.53 ", N/A ,"$1,433.18 ","$2,047.40 ","$2,047.40 ","$2,134.17 ","$2,047.40 ","$1,945.03 ","$2,072.01 ","$1,637.92 ","$1,883.61 ","$2,047.40 ", N/A ,"$1,945.03 ","$1,801.71 ","$1,556.02 ","$2,047.40 ","$2,047.40 ","$2,072.01 ","$1,494.60 ","$1,126.07 ","$1,863.13 ","$1,863.13 ","$1,637.92 ", N/A ,"$1,126.07 ","$1,842.66 ", N/A ,"$1,842.66 ","$1,105.60 ","$1,924.56 ", N/A ,"$1,883.61 ","$2,196.33 ","$1,863.13 ", N/A ,"$1,259.97 ","$1,259.97 ","$1,842.66 ","$1,527.97 ","$1,426.01 ", N/A ,"$2,047.40 ","$1,945.03 ", N/A ,"$2,047.40 ","$1,781.24 ", N/A ,"$1,842.66 ", N/A ,"$1,842.66 ","$1,842.66 ","$1,842.66 ","$1,985.98 ","$1,658.39 ","$1,904.08 ","$1,760.76 ","$1,985.98 "
SACRED HEART HOSPITAL (ACU),36100028,47383,HC ABLATION TUMOR LIVER CRYOABLATION,361,1 ,"$6,551.05 ","$4,913.29 ","$2,072.01 ","$12,041.00 ","$4,218.88 ","$5,351.56 ","$4,585.74 ","$2,072.01 ","$6,551.05 ","$2,134.17 ","$6,551.05 ","$6,223.50 ","$2,072.01 ","$5,240.84 ","$6,026.97 ","$2,072.01 ", N/A ,"$6,223.50 ","$5,764.92 ","$4,978.80 ","$2,072.01 ","$2,072.01 ","$2,072.01 ","$4,782.27 ","$3,603.08 ","$5,961.46 ","$5,961.46 ","$5,240.84 ","$5,512.11 ","$3,603.08 ","$5,895.95 ","$5,351.56 ","$5,895.95 ","$3,537.57 ","$6,157.99 ","$12,041.00 ","$6,026.97 ","$2,196.33 ","$5,961.46 ","$5,351.56 ","$4,031.52 ","$4,031.52 ","$5,895.95 ","$4,889.05 ","$5,895.95 ","$5,405.07 ","$2,072.01 ","$6,223.50 ","$5,619.13 ","$2,072.01 ","$5,699.41 ","$5,351.56 ","$5,895.95 ","$5,351.56 ","$5,895.95 ","$5,895.95 ","$5,895.95 ","$6,354.52 ","$5,306.35 ","$6,092.48 ","$5,633.90 ","$6,354.52 "
SACRED HEART HOSPITAL (ACU),36100030,51726,HC CYSTOMETROGRAM COMPLEX,361,1 ,"$1,591.00 ","$1,193.25 ",$123.38 ,"$1,591.00 ","$1,024.60 ",$281.44 ,"$1,113.70 ",$123.38 ,"$1,591.00 ",$127.08 ,"$1,591.00 ","$1,511.45 ",$123.38 ,"$1,272.80 ","$1,463.72 ",$123.38 , N/A ,"$1,511.45 ","$1,400.08 ","$1,209.16 ",$123.38 ,$123.38 ,$123.38 ,"$1,161.43 ",$875.05 ,"$1,447.81 ","$1,447.81 ","$1,272.80 ",$289.88 ,$875.05 ,"$1,431.90 ",$281.44 ,"$1,431.90 ",$859.14 ,"$1,495.54 ",$633.24 ,"$1,463.72 ",$130.78 ,"$1,447.81 ",$281.44 ,$979.10 ,$979.10 ,"$1,431.90 ","$1,187.36 ","$1,431.90 ",$284.25 ,$123.38 ,"$1,511.45 ",$295.51 ,$123.38 ,"$1,384.17 ",$281.44 ,"$1,431.90 ",$281.44 ,"$1,431.90 ","$1,431.90 ","$1,431.90 ","$1,543.27 ","$1,288.71 ","$1,479.63 ","$1,368.26 ","$1,543.27 "
SACRED HEART HOSPITAL (ACU),36100033,51741,HC UROFLOWMETRY COMPLEX,361,1 ,$545.00 ,$408.75 ,$123.38 ,$545.00 ,$350.98 ,$147.66 ,$381.50 ,$123.38 ,$545.00 ,$127.08 ,$545.00 ,$517.75 ,$123.38 ,$436.00 ,$501.40 ,$123.38 , N/A ,$517.75 ,$479.60 ,$414.20 ,$123.38 ,$123.38 ,$123.38 ,$397.85 ,$299.75 ,$495.95 ,$495.95 ,$436.00 ,$152.09 ,$299.75 ,$490.50 ,$147.66 ,$490.50 ,$294.30 ,$512.30 ,$332.24 ,$501.40 ,$130.78 ,$495.95 ,$147.66 ,$335.39 ,$335.39 ,$490.50 ,$406.73 ,$490.50 ,$149.14 ,$123.38 ,$517.75 ,$155.05 ,$123.38 ,$474.15 ,$147.66 ,$490.50 ,$147.66 ,$490.50 ,$490.50 ,$490.50 ,$528.65 ,$441.45 ,$506.85 ,$468.70 ,$528.65 
SACRED HEART HOSPITAL (ACU),36100034,55876,HC PLACE DEVICE/MARKER PROSTATE,361,1 ,"$7,318.27 ","$5,488.70 ",$568.52 ,"$7,318.27 ","$4,712.97 ","$1,335.56 ","$5,122.79 ",$568.52 ,"$4,824.00 ",$585.58 ,"$3,859.00 ","$6,952.36 ",$568.52 ,"$5,854.62 ","$6,732.81 ",$568.52 , N/A ,"$6,952.36 ","$6,440.08 ","$5,561.89 ",$568.52 ,$568.52 ,$568.52 ,"$5,342.34 ","$4,025.05 ","$6,659.63 ","$6,659.63 ","$5,854.62 ","$1,375.63 ","$4,025.05 ","$6,586.44 ","$1,335.56 ","$6,586.44 ","$3,951.87 ","$6,879.17 ","$3,005.00 ","$6,732.81 ",$602.63 ,"$6,659.63 ","$1,335.56 ","$4,503.66 ","$4,503.66 ","$6,586.44 ","$5,461.62 ","$3,659.14 ","$1,348.91 ",$568.52 ,"$6,952.36 ","$1,402.33 ",$568.52 ,"$6,366.89 ","$1,335.56 ","$6,586.44 ","$1,335.56 ","$6,586.44 ","$6,586.44 ","$6,586.44 ","$7,098.72 ","$5,927.80 ","$6,805.99 ","$6,293.71 ","$7,098.72 "
SACRED HEART HOSPITAL (ACU),36100037,62355,HC REMOVE SPINAL CATHETER,361,1 ,"$6,433.72 ","$4,825.29 ",$277.73 ,"$6,433.72 ","$4,143.32 ","$1,857.12 ","$4,503.60 ",$277.73 ,"$4,824.00 ",$286.06 ,"$3,859.00 ","$6,112.03 ",$277.73 ,"$5,146.98 ","$5,919.02 ",$277.73 , N/A ,"$6,112.03 ","$5,661.67 ","$4,889.63 ",$277.73 ,$277.73 ,$277.73 ,"$4,696.62 ","$3,538.55 ","$5,854.69 ","$5,854.69 ","$5,146.98 ","$1,912.83 ","$3,538.55 ","$5,790.35 ","$1,857.12 ","$5,790.35 ","$3,474.21 ","$6,047.70 ","$4,178.51 ","$5,919.02 ",$294.39 ,"$5,854.69 ","$1,857.12 ","$3,959.31 ","$3,959.31 ","$5,790.35 ","$4,801.49 ","$3,360.24 ","$1,875.69 ",$277.73 ,"$6,112.03 ","$1,949.97 ",$277.73 ,"$5,597.34 ","$1,857.12 ","$5,790.35 ","$1,857.12 ","$5,790.35 ","$5,790.35 ","$5,790.35 ","$6,240.71 ","$5,211.31 ","$5,983.36 ","$5,533.00 ","$6,240.71 "
SACRED HEART HOSPITAL (ACU),36100038,62365,HC REMOVE SPINAL INFUSION DEVICE SUBSQ,361,1 ,"$9,377.77 ","$7,033.33 ","$1,511.00 ","$13,570.12 ","$6,039.28 ","$6,031.17 ","$6,564.44 ","$1,511.00 ","$9,377.77 ","$1,556.33 ","$9,004.00 ","$8,908.88 ","$1,511.00 ","$7,502.22 ","$8,627.55 ","$1,511.00 ", N/A ,"$8,908.88 ","$8,252.44 ","$7,127.11 ","$1,511.00 ","$1,511.00 ","$1,511.00 ","$6,845.77 ","$5,157.77 ","$8,533.77 ","$8,533.77 ","$7,502.22 ","$6,212.11 ","$5,157.77 ","$8,439.99 ","$6,031.17 ","$8,439.99 ","$5,064.00 ","$8,815.10 ","$13,570.12 ","$8,627.55 ","$1,601.66 ","$8,533.77 ","$6,031.17 ","$5,771.08 ","$5,771.08 ","$8,439.99 ","$6,998.63 ","$7,127.78 ","$6,091.48 ","$1,511.00 ","$8,908.88 ","$6,332.72 ","$1,511.00 ","$8,158.66 ","$6,031.17 ","$8,439.99 ","$6,031.17 ","$8,439.99 ","$8,439.99 ","$8,439.99 ","$9,096.44 ","$7,595.99 ","$8,721.33 ","$8,064.88 ","$9,096.44 "
SACRED HEART HOSPITAL (ACU),36100039,63663,HC REVISE SPINE ELECTRD PERQ ARRAY W/FLUORO,361,1 ,"$8,368.63 ","$6,276.47 ","$1,926.15 ","$14,668.74 ","$5,389.40 ","$6,519.44 ","$5,858.04 ","$1,926.15 ","$8,368.63 ","$1,983.93 ","$8,368.63 ","$7,950.20 ","$1,926.15 ","$6,694.90 ","$7,699.14 ","$1,926.15 ", N/A ,"$7,950.20 ","$7,364.39 ","$6,360.16 ","$1,926.15 ","$1,926.15 ","$1,926.15 ","$6,109.10 ","$4,602.75 ","$7,615.45 ","$7,615.45 ","$6,694.90 ","$6,715.02 ","$4,602.75 ","$7,531.77 ","$6,519.44 ","$7,531.77 ","$4,519.06 ","$7,866.51 ","$14,668.74 ","$7,699.14 ","$2,041.72 ","$7,615.45 ","$6,519.44 ","$5,150.05 ","$5,150.05 ","$7,531.77 ","$6,245.51 ","$7,127.78 ","$6,584.64 ","$1,926.15 ","$7,950.20 ","$6,845.41 ","$1,926.15 ","$7,280.71 ","$6,519.44 ","$7,531.77 ","$6,519.44 ","$7,531.77 ","$7,531.77 ","$7,531.77 ","$8,117.57 ","$6,778.59 ","$7,782.83 ","$7,197.02 ","$8,117.57 "
SACRED HEART HOSPITAL (ACU),36100040,63685,HC INSERT/REPLACE SPINAL NEURO GEN/RECR,361,1 ,"$11,556.50 ","$8,667.38 ","$6,240.51 ","$70,049.56 ","$7,442.39 ","$31,133.14 ","$8,089.55 ","$6,706.46 ","$11,556.50 ","$6,907.65 ","$11,556.50 ","$10,978.68 ","$6,706.46 ","$9,245.20 ","$10,631.98 ","$6,706.46 ", N/A ,"$10,978.68 ","$10,169.72 ","$8,782.94 ","$6,706.46 ","$6,706.46 ","$6,706.46 ","$8,436.25 ","$6,356.08 ","$10,516.42 ","$10,516.42 ","$9,245.20 ","$32,067.13 ","$6,356.08 ","$10,400.85 ","$31,133.14 ","$10,400.85 ","$6,240.51 ","$10,863.11 ","$70,049.56 ","$10,631.98 ","$7,108.85 ","$10,516.42 ","$31,133.14 ","$7,111.87 ","$7,111.87 ","$10,400.85 ","$8,624.62 ","$7,127.78 ","$31,444.47 ","$6,706.46 ","$10,978.68 ","$32,689.80 ","$6,706.46 ","$10,054.16 ","$31,133.14 ","$10,400.85 ","$31,133.14 ","$10,400.85 ","$10,400.85 ","$10,400.85 ","$11,209.81 ","$9,360.77 ","$10,747.55 ","$9,938.59 ","$11,209.81 "
SACRED HEART HOSPITAL (ACU),36100041,64646,HC CHEMODENERVATION TRUNK 1-5 MUSCLES,361,1 ,$901.00 ,$675.75 ,$141.34 ,"$1,511.09 ",$580.24 ,$671.59 ,$630.70 ,$141.34 ,$901.00 ,$145.58 ,$901.00 ,$855.95 ,$141.34 ,$720.80 ,$828.92 ,$141.34 , N/A ,$855.95 ,$792.88 ,$684.76 ,$141.34 ,$141.34 ,$141.34 ,$657.73 ,$495.55 ,$819.91 ,$819.91 ,$720.80 ,$691.74 ,$495.55 ,$810.90 ,$671.59 ,$810.90 ,$486.54 ,$846.94 ,"$1,511.09 ",$828.92 ,$149.82 ,$819.91 ,$671.59 ,$554.48 ,$554.48 ,$810.90 ,$672.42 ,$794.24 ,$678.31 ,$141.34 ,$855.95 ,$705.17 ,$141.34 ,$783.87 ,$671.59 ,$810.90 ,$671.59 ,$810.90 ,$810.90 ,$810.90 ,$873.97 ,$729.81 ,$837.93 ,$774.86 ,$873.97 
SACRED HEART HOSPITAL (ACU),36100042,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-BIL,361,1 ,"$1,046.00 ",$784.50 ,$117.15 ,"$1,046.00 ",$673.62 ,$414.49 ,$732.20 ,$117.15 ,"$1,046.00 ",$120.66 ,"$1,046.00 ",$993.70 ,$117.15 ,$836.80 ,$962.32 ,$117.15 , N/A ,$993.70 ,$920.48 ,$794.96 ,$117.15 ,$117.15 ,$117.15 ,$763.58 ,$575.30 ,$951.86 ,$951.86 ,$836.80 ,$426.92 ,$575.30 ,$941.40 ,$414.49 ,$941.40 ,$564.84 ,$983.24 ,$932.59 ,$962.32 ,$124.18 ,$951.86 ,$414.49 ,$965.56 ,$643.71 ,$941.40 ,$780.63 ,$941.40 ,$418.63 ,$117.15 ,$993.70 ,$435.21 ,$117.15 ,$910.02 ,$414.49 ,$941.40 ,$414.49 ,$941.40 ,$941.40 ,$941.40 ,"$1,014.62 ",$847.26 ,$972.78 ,$899.56 ,"$1,014.62 "
SACRED HEART HOSPITAL (ACU),36100063,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-LT,361,1 ,"$1,046.00 ",$784.50 ,$78.10 ,"$1,046.00 ",$673.62 ,$276.32 ,$732.20 ,$78.10 ,"$1,046.00 ",$80.44 ,"$1,046.00 ",$993.70 ,$78.10 ,$836.80 ,$962.32 ,$78.10 , N/A ,$993.70 ,$920.48 ,$794.96 ,$78.10 ,$78.10 ,$78.10 ,$763.58 ,$575.30 ,$951.86 ,$951.86 ,$836.80 ,$284.61 ,$575.30 ,$941.40 ,$276.32 ,$941.40 ,$564.84 ,$983.24 ,$621.73 ,$962.32 ,$82.79 ,$951.86 ,$276.32 ,$643.71 ,$643.71 ,$941.40 ,$780.63 ,$794.24 ,$279.09 ,$78.10 ,$993.70 ,$290.14 ,$78.10 ,$910.02 ,$276.32 ,$941.40 ,$276.32 ,$941.40 ,$941.40 ,$941.40 ,"$1,014.62 ",$847.26 ,$972.78 ,$899.56 ,"$1,014.62 "
SACRED HEART HOSPITAL (ACU),36100064,20600,HC ARTHROCNT/ASP/INJ JNT SMALL W/O US GUID-RT,361,1 ,"$1,046.00 ",$784.50 ,$78.10 ,"$1,046.00 ",$673.62 ,$276.32 ,$732.20 ,$78.10 ,"$1,046.00 ",$80.44 ,"$1,046.00 ",$993.70 ,$78.10 ,$836.80 ,$962.32 ,$78.10 , N/A ,$993.70 ,$920.48 ,$794.96 ,$78.10 ,$78.10 ,$78.10 ,$763.58 ,$575.30 ,$951.86 ,$951.86 ,$836.80 ,$284.61 ,$575.30 ,$941.40 ,$276.32 ,$941.40 ,$564.84 ,$983.24 ,$621.73 ,$962.32 ,$82.79 ,$951.86 ,$276.32 ,$643.71 ,$643.71 ,$941.40 ,$780.63 ,$794.24 ,$279.09 ,$78.10 ,$993.70 ,$290.14 ,$78.10 ,$910.02 ,$276.32 ,$941.40 ,$276.32 ,$941.40 ,$941.40 ,$941.40 ,"$1,014.62 ",$847.26 ,$972.78 ,$899.56 ,"$1,014.62 "
SACRED HEART HOSPITAL (ACU),36100065,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-LT,361,1 ,$412.00 ,$309.00 ,$78.10 ,$621.73 ,$265.33 ,$276.32 ,$288.40 ,$78.10 ,$412.00 ,$80.44 ,$412.00 ,$391.40 ,$78.10 ,$329.60 ,$379.04 ,$78.10 , N/A ,$391.40 ,$362.56 ,$313.12 ,$78.10 ,$78.10 ,$78.10 ,$300.76 ,$226.60 ,$374.92 ,$374.92 ,$329.60 ,$284.61 ,$226.60 ,$370.80 ,$276.32 ,$370.80 ,$222.48 ,$387.28 ,$621.73 ,$379.04 ,$82.79 ,$374.92 ,$276.32 ,$253.54 ,$253.54 ,$370.80 ,$307.48 ,$370.80 ,$279.09 ,$78.10 ,$391.40 ,$290.14 ,$78.10 ,$358.44 ,$276.32 ,$370.80 ,$276.32 ,$370.80 ,$370.80 ,$370.80 ,$399.64 ,$333.72 ,$383.16 ,$354.32 ,$399.64 
SACRED HEART HOSPITAL (ACU),36100066,20605,HC ARTHROCNT/ASP/INJ JNT INTRM W/O US GUID-RT,361,1 ,$412.00 ,$309.00 ,$78.10 ,$621.73 ,$265.33 ,$276.32 ,$288.40 ,$78.10 ,$412.00 ,$80.44 ,$412.00 ,$391.40 ,$78.10 ,$329.60 ,$379.04 ,$78.10 , N/A ,$391.40 ,$362.56 ,$313.12 ,$78.10 ,$78.10 ,$78.10 ,$300.76 ,$226.60 ,$374.92 ,$374.92 ,$329.60 ,$284.61 ,$226.60 ,$370.80 ,$276.32 ,$370.80 ,$222.48 ,$387.28 ,$621.73 ,$379.04 ,$82.79 ,$374.92 ,$276.32 ,$253.54 ,$253.54 ,$370.80 ,$307.48 ,$370.80 ,$279.09 ,$78.10 ,$391.40 ,$290.14 ,$78.10 ,$358.44 ,$276.32 ,$370.80 ,$276.32 ,$370.80 ,$370.80 ,$370.80 ,$399.64 ,$333.72 ,$383.16 ,$354.32 ,$399.64 
SACRED HEART HOSPITAL (ACU),36100067,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-LT,361,1 ,$517.00 ,$387.75 ,$78.10 ,$621.73 ,$332.95 ,$276.32 ,$361.90 ,$78.10 ,$517.00 ,$80.44 ,$517.00 ,$491.15 ,$78.10 ,$413.60 ,$475.64 ,$78.10 , N/A ,$491.15 ,$454.96 ,$392.92 ,$78.10 ,$78.10 ,$78.10 ,$377.41 ,$284.35 ,$470.47 ,$470.47 ,$413.60 ,$284.61 ,$284.35 ,$465.30 ,$276.32 ,$465.30 ,$279.18 ,$485.98 ,$621.73 ,$475.64 ,$82.79 ,$470.47 ,$276.32 ,$318.16 ,$318.16 ,$465.30 ,$385.84 ,$465.30 ,$279.09 ,$78.10 ,$491.15 ,$290.14 ,$78.10 ,$449.79 ,$276.32 ,$465.30 ,$276.32 ,$465.30 ,$465.30 ,$465.30 ,$501.49 ,$418.77 ,$480.81 ,$444.62 ,$501.49 
SACRED HEART HOSPITAL (ACU),36100068,20610,HC ARTHROCNT/ASP/INJ JNT MAJOR W/O US GUID-RT,361,1 ,$517.00 ,$387.75 ,$78.10 ,$621.73 ,$332.95 ,$276.32 ,$361.90 ,$78.10 ,$517.00 ,$80.44 ,$517.00 ,$491.15 ,$78.10 ,$413.60 ,$475.64 ,$78.10 , N/A ,$491.15 ,$454.96 ,$392.92 ,$78.10 ,$78.10 ,$78.10 ,$377.41 ,$284.35 ,$470.47 ,$470.47 ,$413.60 ,$284.61 ,$284.35 ,$465.30 ,$276.32 ,$465.30 ,$279.18 ,$485.98 ,$621.73 ,$475.64 ,$82.79 ,$470.47 ,$276.32 ,$318.16 ,$318.16 ,$465.30 ,$385.84 ,$465.30 ,$279.09 ,$78.10 ,$491.15 ,$290.14 ,$78.10 ,$449.79 ,$276.32 ,$465.30 ,$276.32 ,$465.30 ,$465.30 ,$465.30 ,$501.49 ,$418.77 ,$480.81 ,$444.62 ,$501.49 
SACRED HEART HOSPITAL (ACU),36100069,29125,HC APPL SHRT ARM SPLNT STAT-LT,361,1 ,$350.00 ,$262.50 ,$14.12 ,$350.00 ,$225.40 ,$119.26 ,$245.00 ,$14.12 ,$350.00 ,$14.54 ,$350.00 ,$332.50 ,$14.12 ,$280.00 ,$322.00 ,$14.12 , N/A ,$332.50 ,$308.00 ,$266.00 ,$14.12 ,$14.12 ,$14.12 ,$255.50 ,$192.50 ,$318.50 ,$318.50 ,$280.00 ,$122.84 ,$192.50 ,$315.00 ,$119.26 ,$315.00 ,$189.00 ,$329.00 ,$268.33 ,$322.00 ,$14.97 ,$318.50 ,$119.26 ,$215.39 ,$215.39 ,$315.00 ,$261.21 ,$315.00 ,$120.45 ,$14.12 ,$332.50 ,$125.22 ,$14.12 ,$304.50 ,$119.26 ,$315.00 ,$119.26 ,$315.00 ,$315.00 ,$315.00 ,$339.50 ,$283.50 ,$325.50 ,$301.00 ,$339.50 
SACRED HEART HOSPITAL (ACU),36100070,29125,HC APPL SHRT ARM SPLNT STAT-RT,361,1 ,$350.00 ,$262.50 ,$14.12 ,$350.00 ,$225.40 ,$119.26 ,$245.00 ,$14.12 ,$350.00 ,$14.54 ,$350.00 ,$332.50 ,$14.12 ,$280.00 ,$322.00 ,$14.12 , N/A ,$332.50 ,$308.00 ,$266.00 ,$14.12 ,$14.12 ,$14.12 ,$255.50 ,$192.50 ,$318.50 ,$318.50 ,$280.00 ,$122.84 ,$192.50 ,$315.00 ,$119.26 ,$315.00 ,$189.00 ,$329.00 ,$268.33 ,$322.00 ,$14.97 ,$318.50 ,$119.26 ,$215.39 ,$215.39 ,$315.00 ,$261.21 ,$315.00 ,$120.45 ,$14.12 ,$332.50 ,$125.22 ,$14.12 ,$304.50 ,$119.26 ,$315.00 ,$119.26 ,$315.00 ,$315.00 ,$315.00 ,$339.50 ,$283.50 ,$325.50 ,$301.00 ,$339.50 
SACRED HEART HOSPITAL (ACU),36100074,64616,HC CHEM/DEST NERVE MUSCLE NECK-LT,361,1 ,$918.00 ,$688.50 ,$141.34 ,$918.00 ,$591.19 ,$276.32 ,$642.60 ,$141.34 ,$918.00 ,$145.58 ,$918.00 ,$872.10 ,$141.34 ,$734.40 ,$844.56 ,$141.34 , N/A ,$872.10 ,$807.84 ,$697.68 ,$141.34 ,$141.34 ,$141.34 ,$670.14 ,$504.90 ,$835.38 ,$835.38 ,$734.40 ,$284.61 ,$504.90 ,$826.20 ,$276.32 ,$826.20 ,$495.72 ,$862.92 ,$621.73 ,$844.56 ,$149.82 ,$835.38 ,$276.32 ,$564.94 ,$564.94 ,$826.20 ,$685.10 ,$794.24 ,$279.09 ,$141.34 ,$872.10 ,$290.14 ,$141.34 ,$798.66 ,$276.32 ,$826.20 ,$276.32 ,$826.20 ,$826.20 ,$826.20 ,$890.46 ,$743.58 ,$853.74 ,$789.48 ,$890.46 
SACRED HEART HOSPITAL (ACU),36100075,64616,HC CHEM/DEST NERVE MUSCLE NECK-RT,361,1 ,$918.00 ,$688.50 ,$141.34 ,$918.00 ,$591.19 ,$276.32 ,$642.60 ,$141.34 ,$918.00 ,$145.58 ,$918.00 ,$872.10 ,$141.34 ,$734.40 ,$844.56 ,$141.34 , N/A ,$872.10 ,$807.84 ,$697.68 ,$141.34 ,$141.34 ,$141.34 ,$670.14 ,$504.90 ,$835.38 ,$835.38 ,$734.40 ,$284.61 ,$504.90 ,$826.20 ,$276.32 ,$826.20 ,$495.72 ,$862.92 ,$621.73 ,$844.56 ,$149.82 ,$835.38 ,$276.32 ,$564.94 ,$564.94 ,$826.20 ,$685.10 ,$794.24 ,$279.09 ,$141.34 ,$872.10 ,$290.14 ,$141.34 ,$798.66 ,$276.32 ,$826.20 ,$276.32 ,$826.20 ,$826.20 ,$826.20 ,$890.46 ,$743.58 ,$853.74 ,$789.48 ,$890.46 
SACRED HEART HOSPITAL (ACU),36100093,N/A,HC CENTRAL LINE INSERTION,361,1 ,$476.00 ,$357.00 ,$257.04 ,$476.00 ,$306.54 , N/A ,$333.20 , N/A , N/A , N/A , N/A ,$452.20 , N/A ,$380.80 ,$437.92 , N/A , N/A ,$452.20 ,$418.88 ,$361.76 , N/A , N/A , N/A ,$347.48 ,$261.80 ,$433.16 ,$433.16 ,$380.80 , N/A ,$261.80 ,$428.40 , N/A ,$428.40 ,$257.04 ,$447.44 , N/A ,$437.92 , N/A ,$433.16 , N/A , N/A , N/A ,$428.40 ,$355.24 , N/A , N/A , N/A ,$452.20 , N/A , N/A ,$414.12 , N/A ,$428.40 , N/A ,$428.40 ,$428.40 ,$428.40 ,$461.72 ,$385.56 ,$442.68 ,$409.36 ,$461.72 
SACRED HEART HOSPITAL (ACU),36100094,N/A,HC PARACENTESIS,361,1 ,$464.00 ,$348.00 ,$250.56 ,$464.00 ,$298.82 , N/A ,$324.80 , N/A , N/A , N/A , N/A ,$440.80 , N/A ,$371.20 ,$426.88 , N/A , N/A ,$440.80 ,$408.32 ,$352.64 , N/A , N/A , N/A ,$338.72 ,$255.20 ,$422.24 ,$422.24 ,$371.20 , N/A ,$255.20 ,$417.60 , N/A ,$417.60 ,$250.56 ,$436.16 , N/A ,$426.88 , N/A ,$422.24 , N/A , N/A , N/A ,$417.60 ,$346.28 , N/A , N/A , N/A ,$440.80 , N/A , N/A ,$403.68 , N/A ,$417.60 , N/A ,$417.60 ,$417.60 ,$417.60 ,$450.08 ,$375.84 ,$431.52 ,$399.04 ,$450.08 
SACRED HEART HOSPITAL (ACU),36100098,N/A,HC BRONCHOSCOPY DIAGNOSTIC,361,1 ,"$1,998.00 ","$1,498.50 ","$1,078.92 ","$1,998.00 ","$1,286.71 ", N/A ,"$1,398.60 ", N/A , N/A , N/A , N/A ,"$1,898.10 ", N/A ,"$1,598.40 ","$1,838.16 ", N/A , N/A ,"$1,898.10 ","$1,758.24 ","$1,518.48 ", N/A , N/A , N/A ,"$1,458.54 ","$1,098.90 ","$1,818.18 ","$1,818.18 ","$1,598.40 ", N/A ,"$1,098.90 ","$1,798.20 ", N/A ,"$1,798.20 ","$1,078.92 ","$1,878.12 ", N/A ,"$1,838.16 ", N/A ,"$1,818.18 ", N/A , N/A , N/A ,"$1,798.20 ","$1,491.11 ", N/A , N/A , N/A ,"$1,898.10 ", N/A , N/A ,"$1,738.26 ", N/A ,"$1,798.20 ", N/A ,"$1,798.20 ","$1,798.20 ","$1,798.20 ","$1,938.06 ","$1,618.38 ","$1,858.14 ","$1,718.28 ","$1,938.06 "
SACRED HEART HOSPITAL (ACU),36100099,N/A,HC BRONCHOSCOPY THERAPEUTIC,361,1 ,"$2,100.00 ","$1,575.00 ","$1,134.00 ","$2,100.00 ","$1,352.40 ", N/A ,"$1,470.00 ", N/A , N/A , N/A , N/A ,"$1,995.00 ", N/A ,"$1,680.00 ","$1,932.00 ", N/A , N/A ,"$1,995.00 ","$1,848.00 ","$1,596.00 ", N/A , N/A , N/A ,"$1,533.00 ","$1,155.00 ","$1,911.00 ","$1,911.00 ","$1,680.00 ", N/A ,"$1,155.00 ","$1,890.00 ", N/A ,"$1,890.00 ","$1,134.00 ","$1,974.00 ", N/A ,"$1,932.00 ", N/A ,"$1,911.00 ", N/A , N/A , N/A ,"$1,890.00 ","$1,567.23 ", N/A , N/A , N/A ,"$1,995.00 ", N/A , N/A ,"$1,827.00 ", N/A ,"$1,890.00 ", N/A ,"$1,890.00 ","$1,890.00 ","$1,890.00 ","$2,037.00 ","$1,701.00 ","$1,953.00 ","$1,806.00 ","$2,037.00 "
SACRED HEART HOSPITAL (ACU),36100100,62320,HC INJ INTRLAMNR CERV/THOR W/O GUIDE,361,1 ,"$1,865.00 ","$1,398.75 ",$277.73 ,"$1,865.00 ","$1,201.06 ",$671.59 ,"$1,305.50 ",$277.73 ,"$1,865.00 ",$286.06 ,"$1,865.00 ","$1,771.75 ",$277.73 ,"$1,492.00 ","$1,715.80 ",$277.73 , N/A ,"$1,771.75 ","$1,641.20 ","$1,417.40 ",$277.73 ,$277.73 ,$277.73 ,"$1,361.45 ","$1,025.75 ","$1,697.15 ","$1,697.15 ","$1,492.00 ",$691.74 ,"$1,025.75 ","$1,678.50 ",$671.59 ,"$1,678.50 ","$1,007.10 ","$1,753.10 ","$1,511.09 ","$1,715.80 ",$294.39 ,"$1,697.15 ",$671.59 ,"$1,147.72 ","$1,147.72 ","$1,678.50 ","$1,391.85 ",$932.50 ,$678.31 ,$277.73 ,"$1,771.75 ",$705.17 ,$277.73 ,"$1,622.55 ",$671.59 ,"$1,678.50 ",$671.59 ,"$1,678.50 ","$1,678.50 ","$1,678.50 ","$1,809.05 ","$1,510.65 ","$1,734.45 ","$1,603.90 ","$1,809.05 "
SACRED HEART HOSPITAL (ACU),36100101,62321,HC INJ INTRLAMNR CERV/THOR W/GUIDE,361,1 ,"$1,865.00 ","$1,398.75 ",$277.73 ,"$1,865.00 ","$1,201.06 ",$671.59 ,"$1,305.50 ",$277.73 ,"$1,865.00 ",$286.06 ,"$1,865.00 ","$1,771.75 ",$277.73 ,"$1,492.00 ","$1,715.80 ",$277.73 , N/A ,"$1,771.75 ","$1,641.20 ","$1,417.40 ",$277.73 ,$277.73 ,$277.73 ,"$1,361.45 ","$1,025.75 ","$1,697.15 ","$1,697.15 ","$1,492.00 ",$691.74 ,"$1,025.75 ","$1,678.50 ",$671.59 ,"$1,678.50 ","$1,007.10 ","$1,753.10 ","$1,511.09 ","$1,715.80 ",$294.39 ,"$1,697.15 ",$671.59 ,"$1,147.72 ","$1,147.72 ","$1,678.50 ","$1,391.85 ",$932.50 ,$678.31 ,$277.73 ,"$1,771.75 ",$705.17 ,$277.73 ,"$1,622.55 ",$671.59 ,"$1,678.50 ",$671.59 ,"$1,678.50 ","$1,678.50 ","$1,678.50 ","$1,809.05 ","$1,510.65 ","$1,734.45 ","$1,603.90 ","$1,809.05 "
SACRED HEART HOSPITAL (ACU),36100102,62322,HC INJ INTRLAMNR LUM/SAC W/O GUIDE,361,1 ,"$1,012.00 ",$759.00 ,$277.73 ,"$1,511.09 ",$651.73 ,$671.59 ,$708.40 ,$277.73 ,"$1,012.00 ",$286.06 ,"$1,012.00 ",$961.40 ,$277.73 ,$809.60 ,$931.04 ,$277.73 , N/A ,$961.40 ,$890.56 ,$769.12 ,$277.73 ,$277.73 ,$277.73 ,$738.76 ,$556.60 ,$920.92 ,$920.92 ,$809.60 ,$691.74 ,$556.60 ,$910.80 ,$671.59 ,$910.80 ,$546.48 ,$951.28 ,"$1,511.09 ",$931.04 ,$294.39 ,$920.92 ,$671.59 ,$622.78 ,$622.78 ,$910.80 ,$755.26 ,$794.24 ,$678.31 ,$277.73 ,$961.40 ,$705.17 ,$277.73 ,$880.44 ,$671.59 ,$910.80 ,$671.59 ,$910.80 ,$910.80 ,$910.80 ,$981.64 ,$819.72 ,$941.16 ,$870.32 ,$981.64 
SACRED HEART HOSPITAL (ACU),36100103,62323,HC INJ INTRLAMNR LUM/SAC W/GUIDE,361,1 ,"$1,012.00 ",$759.00 ,$277.73 ,"$1,511.09 ",$651.73 ,$671.59 ,$708.40 ,$277.73 ,"$1,012.00 ",$286.06 ,"$1,012.00 ",$961.40 ,$277.73 ,$809.60 ,$931.04 ,$277.73 , N/A ,$961.40 ,$890.56 ,$769.12 ,$277.73 ,$277.73 ,$277.73 ,$738.76 ,$556.60 ,$920.92 ,$920.92 ,$809.60 ,$691.74 ,$556.60 ,$910.80 ,$671.59 ,$910.80 ,$546.48 ,$951.28 ,"$1,511.09 ",$931.04 ,$294.39 ,$920.92 ,$671.59 ,$622.78 ,$622.78 ,$910.80 ,$755.26 ,$794.24 ,$678.31 ,$277.73 ,$961.40 ,$705.17 ,$277.73 ,$880.44 ,$671.59 ,$910.80 ,$671.59 ,$910.80 ,$910.80 ,$910.80 ,$981.64 ,$819.72 ,$941.16 ,$870.32 ,$981.64 
SACRED HEART HOSPITAL (ACU),36100106,62326,HC INJ W/CATH LUM/SAC W/O GUIDE,361,1 ,"$2,695.00 ","$2,021.25 ",$277.73 ,"$2,695.00 ","$1,735.58 ",$870.64 ,"$1,886.50 ",$277.73 ,"$2,695.00 ",$286.06 ,"$2,572.00 ","$2,560.25 ",$277.73 ,"$2,156.00 ","$2,479.40 ",$277.73 , N/A ,"$2,560.25 ","$2,371.60 ","$2,048.20 ",$277.73 ,$277.73 ,$277.73 ,"$1,967.35 ","$1,482.25 ","$2,452.45 ","$2,452.45 ","$2,156.00 ",$896.76 ,"$1,482.25 ","$2,425.50 ",$870.64 ,"$2,425.50 ","$1,455.30 ","$2,533.30 ","$1,958.95 ","$2,479.40 ",$294.39 ,"$2,452.45 ",$870.64 ,"$1,658.50 ","$1,658.50 ","$2,425.50 ","$2,011.28 ","$2,240.16 ",$879.35 ,$277.73 ,"$2,560.25 ",$914.18 ,$277.73 ,"$2,344.65 ",$870.64 ,"$2,425.50 ",$870.64 ,"$2,425.50 ","$2,425.50 ","$2,425.50 ","$2,614.15 ","$2,182.95 ","$2,506.35 ","$2,317.70 ","$2,614.15 "
SACRED HEART HOSPITAL (ACU),36100107,62327,HC INJ W/CATH LUM/SAC W/GUIDE,361,1 ,"$2,695.00 ","$2,021.25 ",$277.73 ,"$2,695.00 ","$1,735.58 ",$870.64 ,"$1,886.50 ",$277.73 ,"$2,695.00 ",$286.06 ,"$2,572.00 ","$2,560.25 ",$277.73 ,"$2,156.00 ","$2,479.40 ",$277.73 , N/A ,"$2,560.25 ","$2,371.60 ","$2,048.20 ",$277.73 ,$277.73 ,$277.73 ,"$1,967.35 ","$1,482.25 ","$2,452.45 ","$2,452.45 ","$2,156.00 ",$896.76 ,"$1,482.25 ","$2,425.50 ",$870.64 ,"$2,425.50 ","$1,455.30 ","$2,533.30 ","$1,958.95 ","$2,479.40 ",$294.39 ,"$2,452.45 ",$870.64 ,"$1,658.50 ","$1,658.50 ","$2,425.50 ","$2,011.28 ","$2,240.16 ",$879.35 ,$277.73 ,"$2,560.25 ",$914.18 ,$277.73 ,"$2,344.65 ",$870.64 ,"$2,425.50 ",$870.64 ,"$2,425.50 ","$2,425.50 ","$2,425.50 ","$2,614.15 ","$2,182.95 ","$2,506.35 ","$2,317.70 ","$2,614.15 "
SACRED HEART HOSPITAL (ACU),36100230,50436,HC DILATION EXIST TRACT ENDOURAL W/GUIDE,361,1 ,"$2,301.00 ","$1,725.75 ",$490.07 ,"$7,316.47 ","$1,481.84 ","$3,251.76 ","$1,610.70 ",$490.07 ,"$2,301.00 ",$504.77 ,"$2,301.00 ","$2,185.95 ",$490.07 ,"$1,840.80 ","$2,116.92 ",$490.07 , N/A ,"$2,185.95 ","$2,024.88 ","$1,748.76 ",$490.07 ,$490.07 ,$490.07 ,"$1,679.73 ","$1,265.55 ","$2,093.91 ","$2,093.91 ","$1,840.80 ","$3,349.31 ","$1,265.55 ","$2,070.90 ","$3,251.76 ","$2,070.90 ","$1,242.54 ","$2,162.94 ","$7,316.47 ","$2,116.92 ",$519.47 ,"$2,093.91 ","$3,251.76 ","$1,416.04 ","$1,416.04 ","$2,070.90 ","$1,717.24 ","$2,070.90 ","$3,284.28 ",$490.07 ,"$2,185.95 ","$3,414.35 ",$490.07 ,"$2,001.87 ","$3,251.76 ","$2,070.90 ","$3,251.76 ","$2,070.90 ","$2,070.90 ","$2,070.90 ","$2,231.97 ","$1,863.81 ","$2,139.93 ","$1,978.86 ","$2,231.97 "
SACRED HEART HOSPITAL (ACU),36100231,50437,HC DILATION EXIST TRACT ENDOURAL W/GUIDE  AND  NEW RENAL ACCESS,361,1 ,"$3,029.00 ","$2,271.75 ",$490.07 ,"$7,316.47 ","$1,950.68 ","$3,251.76 ","$2,120.30 ",$490.07 ,"$3,029.00 ",$504.77 ,"$3,029.00 ","$2,877.55 ",$490.07 ,"$2,423.20 ","$2,786.68 ",$490.07 , N/A ,"$2,877.55 ","$2,665.52 ","$2,302.04 ",$490.07 ,$490.07 ,$490.07 ,"$2,211.17 ","$1,665.95 ","$2,756.39 ","$2,756.39 ","$2,423.20 ","$3,349.31 ","$1,665.95 ","$2,726.10 ","$3,251.76 ","$2,726.10 ","$1,635.66 ","$2,847.26 ","$7,316.47 ","$2,786.68 ",$519.47 ,"$2,756.39 ","$3,251.76 ","$1,864.05 ","$1,864.05 ","$2,726.10 ","$2,260.54 ","$2,726.10 ","$3,284.28 ",$490.07 ,"$2,877.55 ","$3,414.35 ",$490.07 ,"$2,635.23 ","$3,251.76 ","$2,726.10 ","$3,251.76 ","$2,726.10 ","$2,726.10 ","$2,726.10 ","$2,938.13 ","$2,453.49 ","$2,816.97 ","$2,604.94 ","$2,938.13 "
SACRED HEART HOSPITAL (ACU),36100233,11105,HC BIOPSY SKIN PUNCH ADDL LESN,361,1 ,$327.00 ,$245.25 ,$144.67 ,$327.00 ,$210.59 , N/A ,$228.90 ,$144.67 , N/A ,$149.01 , N/A ,$310.65 ,$144.67 ,$261.60 ,$300.84 ,$144.67 , N/A ,$310.65 ,$287.76 ,$248.52 ,$144.67 ,$144.67 ,$144.67 ,$238.71 ,$179.85 ,$297.57 ,$297.57 ,$261.60 , N/A ,$179.85 ,$294.30 , N/A ,$294.30 ,$176.58 ,$307.38 , N/A ,$300.84 ,$153.35 ,$297.57 , N/A ,$201.24 ,$201.24 ,$294.30 ,$244.04 , N/A , N/A ,$144.67 ,$310.65 , N/A ,$144.67 ,$284.49 , N/A ,$294.30 , N/A ,$294.30 ,$294.30 ,$294.30 ,$317.19 ,$264.87 ,$304.11 ,$281.22 ,$317.19 
SACRED HEART HOSPITAL (ACU),36100236,11104,HC BIOPSY SKIN PUNCH INIT LESN,361,1 ,$591.00 ,$443.25 ,$144.67 ,$822.51 ,$380.60 ,$365.56 ,$413.70 ,$144.67 ,$591.00 ,$149.01 ,$591.00 ,$561.45 ,$144.67 ,$472.80 ,$543.72 ,$144.67 , N/A ,$561.45 ,$520.08 ,$449.16 ,$144.67 ,$144.67 ,$144.67 ,$431.43 ,$325.05 ,$537.81 ,$537.81 ,$472.80 ,$376.53 ,$325.05 ,$531.90 ,$365.56 ,$531.90 ,$319.14 ,$555.54 ,$822.51 ,$543.72 ,$153.35 ,$537.81 ,$365.56 ,$363.70 ,$363.70 ,$531.90 ,$441.06 ,$531.90 ,$369.22 ,$144.67 ,$561.45 ,$383.84 ,$144.67 ,$514.17 ,$365.56 ,$531.90 ,$365.56 ,$531.90 ,$531.90 ,$531.90 ,$573.27 ,$478.71 ,$549.63 ,$508.26 ,$573.27 
SACRED HEART HOSPITAL (ACU),36100238,10005,HC ASP FINE NDL W/US GUIDE INIT LESN,361,1 ,"$1,137.00 ",$852.75 ,$205.03 ,"$1,480.84 ",$732.23 ,$658.15 ,$795.90 ,$205.03 ,"$1,137.00 ",$211.18 ,"$1,137.00 ","$1,080.15 ",$205.03 ,$909.60 ,"$1,046.04 ",$205.03 , N/A ,"$1,080.15 ","$1,000.56 ",$864.12 ,$205.03 ,$205.03 ,$205.03 ,$830.01 ,$625.35 ,"$1,034.67 ","$1,034.67 ",$909.60 ,$677.89 ,$625.35 ,"$1,023.30 ",$658.15 ,"$1,023.30 ",$613.98 ,"$1,068.78 ","$1,480.84 ","$1,046.04 ",$217.33 ,"$1,034.67 ",$658.15 ,$699.71 ,$699.71 ,"$1,023.30 ",$848.54 ,"$1,023.30 ",$664.73 ,$205.03 ,"$1,080.15 ",$691.06 ,$205.03 ,$989.19 ,$658.15 ,"$1,023.30 ",$658.15 ,"$1,023.30 ","$1,023.30 ","$1,023.30 ","$1,102.89 ",$920.97 ,"$1,057.41 ",$977.82 ,"$1,102.89 "
SACRED HEART HOSPITAL (ACU),36100239,10006,HC ASP FINE NDL W/US GUIDE EA ADDL LESN,361,1 ,"$1,137.00 ",$852.75 ,$205.03 ,"$1,137.00 ",$732.23 , N/A ,$795.90 ,$205.03 , N/A ,$211.18 , N/A ,"$1,080.15 ",$205.03 ,$909.60 ,"$1,046.04 ",$205.03 , N/A ,"$1,080.15 ","$1,000.56 ",$864.12 ,$205.03 ,$205.03 ,$205.03 ,$830.01 ,$625.35 ,"$1,034.67 ","$1,034.67 ",$909.60 , N/A ,$625.35 ,"$1,023.30 ", N/A ,"$1,023.30 ",$613.98 ,"$1,068.78 ", N/A ,"$1,046.04 ",$217.33 ,"$1,034.67 ", N/A ,$699.71 ,$699.71 ,"$1,023.30 ",$848.54 , N/A , N/A ,$205.03 ,"$1,080.15 ", N/A ,$205.03 ,$989.19 , N/A ,"$1,023.30 ", N/A ,"$1,023.30 ","$1,023.30 ","$1,023.30 ","$1,102.89 ",$920.97 ,"$1,057.41 ",$977.82 ,"$1,102.89 "
SACRED HEART HOSPITAL (ACU),36100240,10007,HC ASP FINE NDL W/FLUORO GUIDE INIT LESN,361,1 ,"$1,137.00 ",$852.75 ,$205.03 ,"$1,480.84 ",$732.23 ,$658.15 ,$795.90 ,$205.03 ,"$1,137.00 ",$211.18 ,"$1,137.00 ","$1,080.15 ",$205.03 ,$909.60 ,"$1,046.04 ",$205.03 , N/A ,"$1,080.15 ","$1,000.56 ",$864.12 ,$205.03 ,$205.03 ,$205.03 ,$830.01 ,$625.35 ,"$1,034.67 ","$1,034.67 ",$909.60 ,$677.89 ,$625.35 ,"$1,023.30 ",$658.15 ,"$1,023.30 ",$613.98 ,"$1,068.78 ","$1,480.84 ","$1,046.04 ",$217.33 ,"$1,034.67 ",$658.15 ,$699.71 ,$699.71 ,"$1,023.30 ",$848.54 ,"$1,023.30 ",$664.73 ,$205.03 ,"$1,080.15 ",$691.06 ,$205.03 ,$989.19 ,$658.15 ,"$1,023.30 ",$658.15 ,"$1,023.30 ","$1,023.30 ","$1,023.30 ","$1,102.89 ",$920.97 ,"$1,057.41 ",$977.82 ,"$1,102.89 "
SACRED HEART HOSPITAL (ACU),36100241,10008,HC ASP FINE NDL W/FLUORO GUIDE EA ADDL LESN,361,1 ,"$1,035.00 ",$776.25 ,$205.03 ,"$1,035.00 ",$666.54 , N/A ,$724.50 ,$205.03 , N/A ,$211.18 , N/A ,$983.25 ,$205.03 ,$828.00 ,$952.20 ,$205.03 , N/A ,$983.25 ,$910.80 ,$786.60 ,$205.03 ,$205.03 ,$205.03 ,$755.55 ,$569.25 ,$941.85 ,$941.85 ,$828.00 , N/A ,$569.25 ,$931.50 , N/A ,$931.50 ,$558.90 ,$972.90 , N/A ,$952.20 ,$217.33 ,$941.85 , N/A ,$636.94 ,$636.94 ,$931.50 ,$772.42 , N/A , N/A ,$205.03 ,$983.25 , N/A ,$205.03 ,$900.45 , N/A ,$931.50 , N/A ,$931.50 ,$931.50 ,$931.50 ,"$1,003.95 ",$838.35 ,$962.55 ,$890.10 ,"$1,003.95 "
SACRED HEART HOSPITAL (ACU),36100242,10009,HC ASP FINE NDL W/CT GUIDE INIT LESN,361,1 ,"$1,137.00 ",$852.75 ,$205.03 ,"$1,480.84 ",$732.23 ,$658.15 ,$795.90 ,$205.03 ,"$1,137.00 ",$211.18 ,"$1,137.00 ","$1,080.15 ",$205.03 ,$909.60 ,"$1,046.04 ",$205.03 , N/A ,"$1,080.15 ","$1,000.56 ",$864.12 ,$205.03 ,$205.03 ,$205.03 ,$830.01 ,$625.35 ,"$1,034.67 ","$1,034.67 ",$909.60 ,$677.89 ,$625.35 ,"$1,023.30 ",$658.15 ,"$1,023.30 ",$613.98 ,"$1,068.78 ","$1,480.84 ","$1,046.04 ",$217.33 ,"$1,034.67 ",$658.15 ,$699.71 ,$699.71 ,"$1,023.30 ",$848.54 ,"$1,023.30 ",$664.73 ,$205.03 ,"$1,080.15 ",$691.06 ,$205.03 ,$989.19 ,$658.15 ,"$1,023.30 ",$658.15 ,"$1,023.30 ","$1,023.30 ","$1,023.30 ","$1,102.89 ",$920.97 ,"$1,057.41 ",$977.82 ,"$1,102.89 "
SACRED HEART HOSPITAL (ACU),36100243,10010,HC ASP FINE NDL W/CT GUIDE EA ADDL LESN,361,1 ,"$1,035.00 ",$776.25 ,$205.03 ,"$1,035.00 ",$666.54 , N/A ,$724.50 ,$205.03 , N/A ,$211.18 , N/A ,$983.25 ,$205.03 ,$828.00 ,$952.20 ,$205.03 , N/A ,$983.25 ,$910.80 ,$786.60 ,$205.03 ,$205.03 ,$205.03 ,$755.55 ,$569.25 ,$941.85 ,$941.85 ,$828.00 , N/A ,$569.25 ,$931.50 , N/A ,$931.50 ,$558.90 ,$972.90 , N/A ,$952.20 ,$217.33 ,$941.85 , N/A ,$636.94 ,$636.94 ,$931.50 ,$772.42 , N/A , N/A ,$205.03 ,$983.25 , N/A ,$205.03 ,$900.45 , N/A ,$931.50 , N/A ,$931.50 ,$931.50 ,$931.50 ,"$1,003.95 ",$838.35 ,$962.55 ,$890.10 ,"$1,003.95 "
SACRED HEART HOSPITAL (ACU),36100246,36572,HC INS CATH PERIPH CV W/O PORT W/GUIDANCE <5,361,1 ,"$4,704.00 ","$3,528.00 ",$365.14 ,"$4,704.00 ","$3,029.38 ",$571.68 ,"$3,292.80 ",$365.14 ,"$3,216.00 ",$376.09 ,"$2,572.00 ","$4,468.80 ",$365.14 ,"$3,763.20 ","$4,327.68 ",$365.14 , N/A ,"$4,468.80 ","$4,139.52 ","$3,575.04 ",$365.14 ,$365.14 ,$365.14 ,"$3,433.92 ","$2,587.20 ","$4,280.64 ","$4,280.64 ","$3,763.20 ",$588.83 ,"$2,587.20 ","$4,233.60 ",$571.68 ,"$4,233.60 ","$2,540.16 ","$4,421.76 ","$1,286.28 ","$4,327.68 ",$387.05 ,"$4,280.64 ",$571.68 ,"$2,894.84 ","$2,894.84 ","$4,233.60 ","$3,510.60 ","$2,352.00 ",$577.40 ,$365.14 ,"$4,468.80 ",$600.27 ,$365.14 ,"$4,092.48 ",$571.68 ,"$4,233.60 ",$571.68 ,"$4,233.60 ","$4,233.60 ","$4,233.60 ","$4,562.88 ","$3,810.24 ","$4,374.72 ","$4,045.44 ","$4,562.88 "
SACRED HEART HOSPITAL (ACU),36100247,36573,HC INS PER CV CATH W/O PORT W/GUIDANCE 5>,361,1 ,"$4,833.00 ","$3,624.75 ",$365.14 ,"$4,833.00 ","$3,112.45 ","$1,487.26 ","$3,383.10 ",$365.14 ,"$4,824.00 ",$376.09 ,"$3,859.00 ","$4,591.35 ",$365.14 ,"$3,866.40 ","$4,446.36 ",$365.14 , N/A ,"$4,591.35 ","$4,253.04 ","$3,673.08 ",$365.14 ,$365.14 ,$365.14 ,"$3,528.09 ","$2,658.15 ","$4,398.03 ","$4,398.03 ","$3,866.40 ","$1,531.88 ","$2,658.15 ","$4,349.70 ","$1,487.26 ","$4,349.70 ","$2,609.82 ","$4,543.02 ","$3,346.33 ","$4,446.36 ",$387.05 ,"$4,398.03 ","$1,487.26 ","$2,974.23 ","$2,974.23 ","$4,349.70 ","$3,606.87 ","$3,360.24 ","$1,502.13 ",$365.14 ,"$4,591.35 ","$1,561.62 ",$365.14 ,"$4,204.71 ","$1,487.26 ","$4,349.70 ","$1,487.26 ","$4,349.70 ","$4,349.70 ","$4,349.70 ","$4,688.01 ","$3,914.73 ","$4,494.69 ","$4,156.38 ","$4,688.01 "
SACRED HEART HOSPITAL (ACU),36100248,G2170,HC CREATE AV FISTULA PERC,361,1 ,"$2,661.00 ","$1,995.75 ","$1,145.48 ","$38,218.28 ","$1,713.68 ","$16,985.90 ","$1,862.70 ","$1,145.48 ", N/A ,"$1,179.84 ", N/A ,"$2,527.95 ","$1,145.48 ","$2,128.80 ","$2,448.12 ","$1,145.48 ", N/A ,"$2,527.95 ","$2,341.68 ","$2,022.36 ","$1,145.48 ","$1,145.48 ","$1,145.48 ","$1,942.53 ","$1,463.55 ","$2,421.51 ","$2,421.51 ","$2,128.80 ","$17,495.48 ","$1,463.55 ","$2,394.90 ","$16,985.90 ","$2,394.90 ","$1,436.94 ","$2,501.34 ","$38,218.28 ","$2,448.12 ","$1,214.21 ","$2,421.51 ","$16,985.90 ","$1,637.58 ","$1,637.58 ","$2,394.90 ","$1,985.90 ","$2,394.90 ","$17,155.76 ","$1,145.48 ","$2,527.95 ","$17,835.20 ","$1,145.48 ","$2,315.07 ","$16,985.90 ","$2,394.90 ","$16,985.90 ","$2,394.90 ","$2,394.90 ","$2,394.90 ","$2,581.17 ","$2,155.41 ","$2,474.73 ","$2,288.46 ","$2,581.17 "
SACRED HEART HOSPITAL (ACU),36100249,G2171,HC CREATE AV FISTULA PERC W/RAD FREQ MAGNETIC GUIDE,361,1 ,"$2,661.00 ","$1,995.75 ","$1,145.48 ","$38,218.28 ","$1,713.68 ","$16,985.90 ","$1,862.70 ","$1,145.48 ", N/A ,"$1,179.84 ", N/A ,"$2,527.95 ","$1,145.48 ","$2,128.80 ","$2,448.12 ","$1,145.48 ", N/A ,"$2,527.95 ","$2,341.68 ","$2,022.36 ","$1,145.48 ","$1,145.48 ","$1,145.48 ","$1,942.53 ","$1,463.55 ","$2,421.51 ","$2,421.51 ","$2,128.80 ","$17,495.48 ","$1,463.55 ","$2,394.90 ","$16,985.90 ","$2,394.90 ","$1,436.94 ","$2,501.34 ","$38,218.28 ","$2,448.12 ","$1,214.21 ","$2,421.51 ","$16,985.90 ","$1,637.58 ","$1,637.58 ","$2,394.90 ","$1,985.90 ","$2,394.90 ","$17,155.76 ","$1,145.48 ","$2,527.95 ","$17,835.20 ","$1,145.48 ","$2,315.07 ","$16,985.90 ","$2,394.90 ","$16,985.90 ","$2,394.90 ","$2,394.90 ","$2,394.90 ","$2,581.17 ","$2,155.41 ","$2,474.73 ","$2,288.46 ","$2,581.17 "
SACRED HEART HOSPITAL (ACU),36100270,62328,HC LUMBAR PUNCTURE DIAGNOSTIC W/FLUORO OR CT GUID,361,1 ,"$1,016.00 ",$762.00 ,$277.73 ,"$1,511.09 ",$654.30 ,$671.59 ,$711.20 ,$277.73 ,"$1,016.00 ",$286.06 ,"$1,016.00 ",$965.20 ,$277.73 ,$812.80 ,$934.72 ,$277.73 , N/A ,$965.20 ,$894.08 ,$772.16 ,$277.73 ,$277.73 ,$277.73 ,$741.68 ,$558.80 ,$924.56 ,$924.56 ,$812.80 ,$691.74 ,$558.80 ,$914.40 ,$671.59 ,$914.40 ,$548.64 ,$955.04 ,"$1,511.09 ",$934.72 ,$294.39 ,$924.56 ,$671.59 ,$625.25 ,$625.25 ,$914.40 ,$758.24 ,$914.40 ,$678.31 ,$277.73 ,$965.20 ,$705.17 ,$277.73 ,$883.92 ,$671.59 ,$914.40 ,$671.59 ,$914.40 ,$914.40 ,$914.40 ,$985.52 ,$822.96 ,$944.88 ,$873.76 ,$985.52 
SACRED HEART HOSPITAL (ACU),36100271,62329,HC LUMBAR PUNCTURE THERAPEUTIC/DRAINAGE W//FLUORO OR CT GUID,361,1 ,"$1,016.00 ",$762.00 ,$277.73 ,"$1,511.09 ",$654.30 ,$671.59 ,$711.20 ,$277.73 ,"$1,016.00 ",$286.06 ,"$1,016.00 ",$965.20 ,$277.73 ,$812.80 ,$934.72 ,$277.73 , N/A ,$965.20 ,$894.08 ,$772.16 ,$277.73 ,$277.73 ,$277.73 ,$741.68 ,$558.80 ,$924.56 ,$924.56 ,$812.80 ,$691.74 ,$558.80 ,$914.40 ,$671.59 ,$914.40 ,$548.64 ,$955.04 ,"$1,511.09 ",$934.72 ,$294.39 ,$924.56 ,$671.59 ,$625.25 ,$625.25 ,$914.40 ,$758.24 ,$914.40 ,$678.31 ,$277.73 ,$965.20 ,$705.17 ,$277.73 ,$883.92 ,$671.59 ,$914.40 ,$671.59 ,$914.40 ,$914.40 ,$914.40 ,$985.52 ,$822.96 ,$944.88 ,$873.76 ,$985.52 
SACRED HEART HOSPITAL (ACU),36100281,32408,HC CORE NDL BX LUNG/MEDIASTINUM PERQ W IMG,361,1 ,"$4,545.00 ","$3,408.75 ",$309.29 ,"$4,545.00 ","$2,926.98 ","$1,488.12 ","$3,181.50 ",$309.29 ,"$4,545.00 ",$318.57 ,"$3,859.00 ","$4,317.75 ",$309.29 ,"$3,636.00 ","$4,181.40 ",$309.29 , N/A ,"$4,317.75 ","$3,999.60 ","$3,454.20 ",$309.29 ,$309.29 ,$309.29 ,"$3,317.85 ","$2,499.75 ","$4,135.95 ","$4,135.95 ","$3,636.00 ","$1,532.76 ","$2,499.75 ","$4,090.50 ","$1,488.12 ","$4,090.50 ","$2,454.30 ","$4,272.30 ","$3,348.27 ","$4,181.40 ",$327.85 ,"$4,135.95 ","$1,488.12 ","$2,796.99 ","$2,796.99 ","$4,090.50 ","$3,391.93 ","$3,360.24 ","$1,503.00 ",$309.29 ,"$4,317.75 ","$1,562.52 ",$309.29 ,"$3,954.15 ","$1,488.12 ","$4,090.50 ","$1,488.12 ","$4,090.50 ","$4,090.50 ","$4,090.50 ","$4,408.65 ","$3,681.45 ","$4,226.85 ","$3,908.70 ","$4,408.65 "
SACRED HEART HOSPITAL (ACU),36100284,53060,HC DRAIN OF SKENE GLAND ABS OR CYST,450,1 ,"$5,593.00 ","$4,194.75 ",$953.81 ,"$5,593.00 ","$3,601.89 ","$1,893.71 ","$3,915.10 ",$953.81 ,"$4,642.19 ",$982.42 ,"$3,691.38 ","$5,313.35 ",$953.81 ,"$4,474.40 ","$5,145.56 ",$953.81 ,"$4,754.05 ","$5,313.35 ","$4,921.84 ","$4,250.68 ",$953.81 ,$953.81 ,$953.81 ,"$4,082.89 ","$3,076.15 ","$5,089.63 ","$5,089.63 ","$4,474.40 ","$1,950.52 ","$3,076.15 ","$5,033.70 ","$1,893.71 ","$5,033.70 ","$3,020.22 ","$5,257.42 ","$4,260.86 ","$5,145.56 ","$1,011.04 ","$5,089.63 ","$1,893.71 ","$3,441.93 ","$3,441.93 ","$5,033.70 ","$4,174.06 ","$3,895.52 ","$1,912.65 ",$953.81 ,"$5,313.35 ","$1,988.40 ",$953.81 ,"$4,865.91 ","$1,893.71 ","$5,033.70 ","$1,893.71 ","$5,033.70 ","$5,033.70 ","$5,033.70 ","$5,425.21 ","$4,530.33 ","$5,201.49 ","$4,809.98 ","$5,425.21 "
SACRED HEART HOSPITAL (ACU),36100504,55874,HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,361,1 ,"$13,705.00 ","$10,278.75 ","$1,393.89 ","$13,705.00 ","$8,826.02 ","$4,666.21 ","$9,593.50 ","$1,393.89 ","$11,255.00 ","$1,435.71 ","$9,004.00 ","$13,019.75 ","$1,393.89 ","$10,964.00 ","$12,608.60 ","$1,393.89 ", N/A ,"$13,019.75 ","$12,060.40 ","$10,415.80 ","$1,393.89 ","$1,393.89 ","$1,393.89 ","$10,004.65 ","$7,537.75 ","$12,471.55 ","$12,471.55 ","$10,964.00 ","$4,806.20 ","$7,537.75 ","$12,334.50 ","$4,666.21 ","$12,334.50 ","$7,400.70 ","$12,882.70 ","$10,498.97 ","$12,608.60 ","$1,477.52 ","$12,471.55 ","$4,666.21 ","$8,434.06 ","$8,434.06 ","$12,334.50 ","$10,228.04 ","$6,852.50 ","$4,712.87 ","$1,393.89 ","$13,019.75 ","$4,899.52 ","$1,393.89 ","$11,923.35 ","$4,666.21 ","$12,334.50 ","$4,666.21 ","$12,334.50 ","$12,334.50 ","$12,334.50 ","$13,293.85 ","$11,101.05 ","$12,745.65 ","$11,786.30 ","$13,293.85 "
SACRED HEART HOSPITAL (ACU),37000013,31500,HC INTUBATION ENDOTRACHEAL,361,1 ,$739.38 ,$554.54 ,$223.76 ,$739.38 ,$476.16 ,$223.76 ,$517.57 ,$295.01 ,$739.38 ,$303.86 ,$739.38 ,$702.41 ,$295.01 ,$591.50 ,$680.23 ,$295.01 , N/A ,$702.41 ,$650.65 ,$561.93 ,$295.01 ,$295.01 ,$295.01 ,$539.75 ,$406.66 ,$672.84 ,$672.84 ,$591.50 ,$230.47 ,$406.66 ,$665.44 ,$223.76 ,$665.44 ,$399.27 ,$695.02 ,$503.46 ,$680.23 ,$312.71 ,$672.84 ,$223.76 ,$455.01 ,$455.01 ,$665.44 ,$551.80 ,$665.44 ,$226.00 ,$295.01 ,$702.41 ,$234.95 ,$295.01 ,$643.26 ,$223.76 ,$665.44 ,$223.76 ,$665.44 ,$665.44 ,$665.44 ,$717.20 ,$598.90 ,$687.62 ,$635.87 ,$717.20 
SACRED HEART HOSPITAL (ACU),37000017,99153,HC MODERATE SEDATION SAME PHY EA ADDL 15MIN,370,1 ,$304.00 ,$228.00 ,$7.77 ,$304.00 ,$195.78 , N/A ,$212.80 ,$7.77 ,$252.32 ,$8.00 ,$200.64 ,$288.80 ,$7.77 ,$243.20 ,$279.68 ,$7.77 ,$258.40 ,$288.80 ,$267.52 ,$231.04 ,$7.77 ,$7.77 ,$7.77 ,$221.92 ,$167.20 ,$276.64 ,$276.64 ,$243.20 , N/A ,$167.20 ,$273.60 , N/A ,$273.60 ,$164.16 ,$285.76 , N/A ,$279.68 ,$8.24 ,$276.64 , N/A ,$187.08 ,$187.08 ,$273.60 ,$226.88 ,$211.74 , N/A ,$7.77 ,$288.80 , N/A ,$7.77 ,$264.48 , N/A ,$273.60 , N/A ,$273.60 ,$273.60 ,$273.60 ,$294.88 ,$246.24 ,$282.72 ,$261.44 ,$294.88 
SACRED HEART HOSPITAL (ACU),37000020,99157,HC MODERATE SEDATION DIFF PHY EA ADDL 15MIN,370,1 ,$145.00 ,$108.75 ,$7.77 ,$145.00 ,$93.38 , N/A ,$101.50 ,$7.77 ,$120.35 ,$8.00 ,$95.70 ,$137.75 ,$7.77 ,$116.00 ,$133.40 ,$7.77 ,$123.25 ,$137.75 ,$127.60 ,$110.20 ,$7.77 ,$7.77 ,$7.77 ,$105.85 ,$79.75 ,$131.95 ,$131.95 ,$116.00 , N/A ,$79.75 ,$130.50 , N/A ,$130.50 ,$78.30 ,$136.30 , N/A ,$133.40 ,$8.24 ,$131.95 , N/A ,$89.23 ,$89.23 ,$130.50 ,$108.21 ,$100.99 , N/A ,$7.77 ,$137.75 , N/A ,$7.77 ,$126.15 , N/A ,$130.50 , N/A ,$130.50 ,$130.50 ,$130.50 ,$140.65 ,$117.45 ,$134.85 ,$124.70 ,$140.65 
SACRED HEART HOSPITAL (ACU),37000021,64447,HC FEMORAL NERVE BLOCK SINGLE,370,1 ,"$1,742.00 ","$1,306.50 ",$141.34 ,"$1,742.00 ","$1,121.85 ",$671.59 ,"$1,219.40 ",$141.34 ,"$1,445.86 ",$145.58 ,"$1,149.72 ","$1,654.90 ",$141.34 ,"$1,393.60 ","$1,602.64 ",$141.34 ,"$1,480.70 ","$1,654.90 ","$1,532.96 ","$1,323.92 ",$141.34 ,$141.34 ,$141.34 ,"$1,271.66 ",$958.10 ,"$1,585.22 ","$1,585.22 ","$1,393.60 ",$691.74 ,$958.10 ,"$1,567.80 ",$671.59 ,"$1,567.80 ",$940.68 ,"$1,637.48 ","$1,511.09 ","$1,602.64 ",$149.82 ,"$1,585.22 ",$671.59 ,"$1,072.03 ","$1,072.03 ","$1,567.80 ","$1,300.05 ","$1,213.30 ",$678.31 ,$141.34 ,"$1,654.90 ",$705.17 ,$141.34 ,"$1,515.54 ",$671.59 ,"$1,567.80 ",$671.59 ,"$1,567.80 ","$1,567.80 ","$1,567.80 ","$1,689.74 ","$1,411.02 ","$1,620.06 ","$1,498.12 ","$1,689.74 "
SACRED HEART HOSPITAL (ACU),37000022,64415,HC INTRASCALENE BLOCK SINGLE,370,1 ,"$1,848.00 ","$1,386.00 ",$376.63 ,"$1,958.95 ","$1,190.11 ",$870.64 ,"$1,293.60 ",$376.63 ,"$1,533.84 ",$387.93 ,"$1,219.68 ","$1,755.60 ",$376.63 ,"$1,478.40 ","$1,700.16 ",$376.63 ,"$1,570.80 ","$1,755.60 ","$1,626.24 ","$1,404.48 ",$376.63 ,$376.63 ,$376.63 ,"$1,349.04 ","$1,016.40 ","$1,681.68 ","$1,681.68 ","$1,478.40 ",$896.76 ,"$1,016.40 ","$1,663.20 ",$870.64 ,"$1,663.20 ",$997.92 ,"$1,737.12 ","$1,958.95 ","$1,700.16 ",$399.23 ,"$1,681.68 ",$870.64 ,"$1,137.26 ","$1,137.26 ","$1,663.20 ","$1,379.16 ","$1,287.13 ",$879.35 ,$376.63 ,"$1,755.60 ",$914.18 ,$376.63 ,"$1,607.76 ",$870.64 ,"$1,663.20 ",$870.64 ,"$1,663.20 ","$1,663.20 ","$1,663.20 ","$1,792.56 ","$1,496.88 ","$1,718.64 ","$1,589.28 ","$1,792.56 "
SACRED HEART HOSPITAL (ACU),37000024,N/A,HC EPIDURAL NERVE BLOCK,370,1 ,$501.00 ,$375.75 ,$270.54 ,$501.00 ,$322.64 , N/A ,$350.70 , N/A ,$415.83 , N/A ,$330.66 ,$475.95 , N/A ,$400.80 ,$460.92 , N/A ,$425.85 ,$475.95 ,$440.88 ,$380.76 , N/A , N/A , N/A ,$365.73 ,$275.55 ,$455.91 ,$455.91 ,$400.80 , N/A ,$275.55 ,$450.90 , N/A ,$450.90 ,$270.54 ,$470.94 , N/A ,$460.92 , N/A ,$455.91 , N/A ,$308.32 ,$308.32 ,$450.90 ,$373.90 ,$348.95 , N/A , N/A ,$475.95 , N/A , N/A ,$435.87 , N/A ,$450.90 , N/A ,$450.90 ,$450.90 ,$450.90 ,$485.97 ,$405.81 ,$465.93 ,$430.86 ,$485.97 
SACRED HEART HOSPITAL (ACU),37000026,N/A,HC ANES BLOCK PERIPHERAL,370,1 ,$588.00 ,$441.00 ,$317.52 ,$588.00 ,$378.67 , N/A ,$411.60 , N/A ,$488.04 , N/A ,$388.08 ,$558.60 , N/A ,$470.40 ,$540.96 , N/A ,$499.80 ,$558.60 ,$517.44 ,$446.88 , N/A , N/A , N/A ,$429.24 ,$323.40 ,$535.08 ,$535.08 ,$470.40 , N/A ,$323.40 ,$529.20 , N/A ,$529.20 ,$317.52 ,$552.72 , N/A ,$540.96 , N/A ,$535.08 , N/A ,$361.86 ,$361.86 ,$529.20 ,$438.82 ,$409.54 , N/A , N/A ,$558.60 , N/A , N/A ,$511.56 , N/A ,$529.20 , N/A ,$529.20 ,$529.20 ,$529.20 ,$570.36 ,$476.28 ,$546.84 ,$505.68 ,$570.36 
SACRED HEART HOSPITAL (ACU),37000028,N/A,HC ANES CENTRAL LINE,370,1 ,$458.00 ,$343.50 ,$247.32 ,$458.00 ,$294.95 , N/A ,$320.60 , N/A ,$380.14 , N/A ,$302.28 ,$435.10 , N/A ,$366.40 ,$421.36 , N/A ,$389.30 ,$435.10 ,$403.04 ,$348.08 , N/A , N/A , N/A ,$334.34 ,$251.90 ,$416.78 ,$416.78 ,$366.40 , N/A ,$251.90 ,$412.20 , N/A ,$412.20 ,$247.32 ,$430.52 , N/A ,$421.36 , N/A ,$416.78 , N/A ,$281.85 ,$281.85 ,$412.20 ,$341.81 ,$319.00 , N/A , N/A ,$435.10 , N/A , N/A ,$398.46 , N/A ,$412.20 , N/A ,$412.20 ,$412.20 ,$412.20 ,$444.26 ,$370.98 ,$425.94 ,$393.88 ,$444.26 
SACRED HEART HOSPITAL (ACU),37000060,N/A,HC ANESTHESIA LOCAL EACH 15MIN,370,1 ,$41.00 ,$30.75 ,$22.14 ,$41.00 ,$26.40 , N/A ,$28.70 , N/A ,$34.03 , N/A ,$27.06 ,$38.95 , N/A ,$32.80 ,$37.72 , N/A ,$34.85 ,$38.95 ,$36.08 ,$31.16 , N/A , N/A , N/A ,$29.93 ,$22.55 ,$37.31 ,$37.31 ,$32.80 , N/A ,$22.55 ,$36.90 , N/A ,$36.90 ,$22.14 ,$38.54 , N/A ,$37.72 , N/A ,$37.31 , N/A ,$25.23 ,$25.23 ,$36.90 ,$30.60 ,$28.56 , N/A , N/A ,$38.95 , N/A , N/A ,$35.67 , N/A ,$36.90 , N/A ,$36.90 ,$36.90 ,$36.90 ,$39.77 ,$33.21 ,$38.13 ,$35.26 ,$39.77 
SACRED HEART HOSPITAL (ACU),37000061,N/A,HC ANESTHESIA GENERAL INITIAL 15MIN,370,1 ,$519.00 ,$389.25 ,$280.26 ,$519.00 ,$334.24 , N/A ,$363.30 , N/A ,$430.77 , N/A ,$342.54 ,$493.05 , N/A ,$415.20 ,$477.48 , N/A ,$441.15 ,$493.05 ,$456.72 ,$394.44 , N/A , N/A , N/A ,$378.87 ,$285.45 ,$472.29 ,$472.29 ,$415.20 , N/A ,$285.45 ,$467.10 , N/A ,$467.10 ,$280.26 ,$487.86 , N/A ,$477.48 , N/A ,$472.29 , N/A ,$319.39 ,$319.39 ,$467.10 ,$387.33 ,$361.48 , N/A , N/A ,$493.05 , N/A , N/A ,$451.53 , N/A ,$467.10 , N/A ,$467.10 ,$467.10 ,$467.10 ,$503.43 ,$420.39 ,$482.67 ,$446.34 ,$503.43 
SACRED HEART HOSPITAL (ACU),37000062,N/A,HC ANESTHESIA GENERAL ADDL 15MIN,370,1 ,$519.00 ,$389.25 ,$280.26 ,$519.00 ,$334.24 , N/A ,$363.30 , N/A ,$430.77 , N/A ,$342.54 ,$493.05 , N/A ,$415.20 ,$477.48 , N/A ,$441.15 ,$493.05 ,$456.72 ,$394.44 , N/A , N/A , N/A ,$378.87 ,$285.45 ,$472.29 ,$472.29 ,$415.20 , N/A ,$285.45 ,$467.10 , N/A ,$467.10 ,$280.26 ,$487.86 , N/A ,$477.48 , N/A ,$472.29 , N/A ,$319.39 ,$319.39 ,$467.10 ,$387.33 ,$361.48 , N/A , N/A ,$493.05 , N/A , N/A ,$451.53 , N/A ,$467.10 , N/A ,$467.10 ,$467.10 ,$467.10 ,$503.43 ,$420.39 ,$482.67 ,$446.34 ,$503.43 
SACRED HEART HOSPITAL (ACU),37000063,N/A,HC ANESTHESIA REGIONAL BLOCK INITIAL 15MIN,370,1 ,$380.00 ,$285.00 ,$205.20 ,$380.00 ,$244.72 , N/A ,$266.00 , N/A ,$315.40 , N/A ,$250.80 ,$361.00 , N/A ,$304.00 ,$349.60 , N/A ,$323.00 ,$361.00 ,$334.40 ,$288.80 , N/A , N/A , N/A ,$277.40 ,$209.00 ,$345.80 ,$345.80 ,$304.00 , N/A ,$209.00 ,$342.00 , N/A ,$342.00 ,$205.20 ,$357.20 , N/A ,$349.60 , N/A ,$345.80 , N/A ,$233.85 ,$233.85 ,$342.00 ,$283.59 ,$264.67 , N/A , N/A ,$361.00 , N/A , N/A ,$330.60 , N/A ,$342.00 , N/A ,$342.00 ,$342.00 ,$342.00 ,$368.60 ,$307.80 ,$353.40 ,$326.80 ,$368.60 
SACRED HEART HOSPITAL (ACU),37000064,N/A,HC ANESTHESIA REGIONAL BLOCK ADDL 15MIN,370,1 ,$380.00 ,$285.00 ,$205.20 ,$380.00 ,$244.72 , N/A ,$266.00 , N/A ,$315.40 , N/A ,$250.80 ,$361.00 , N/A ,$304.00 ,$349.60 , N/A ,$323.00 ,$361.00 ,$334.40 ,$288.80 , N/A , N/A , N/A ,$277.40 ,$209.00 ,$345.80 ,$345.80 ,$304.00 , N/A ,$209.00 ,$342.00 , N/A ,$342.00 ,$205.20 ,$357.20 , N/A ,$349.60 , N/A ,$345.80 , N/A ,$233.85 ,$233.85 ,$342.00 ,$283.59 ,$264.67 , N/A , N/A ,$361.00 , N/A , N/A ,$330.60 , N/A ,$342.00 , N/A ,$342.00 ,$342.00 ,$342.00 ,$368.60 ,$307.80 ,$353.40 ,$326.80 ,$368.60 
SACRED HEART HOSPITAL (ACU),37000065,N/A,HC CONSCIOUS SEDATION,370,1 ,$214.00 ,$160.50 ,$115.56 ,$214.00 ,$137.82 , N/A ,$149.80 , N/A ,$177.62 , N/A ,$141.24 ,$203.30 , N/A ,$171.20 ,$196.88 , N/A ,$181.90 ,$203.30 ,$188.32 ,$162.64 , N/A , N/A , N/A ,$156.22 ,$117.70 ,$194.74 ,$194.74 ,$171.20 , N/A ,$117.70 ,$192.60 , N/A ,$192.60 ,$115.56 ,$201.16 , N/A ,$196.88 , N/A ,$194.74 , N/A ,$131.70 ,$131.70 ,$192.60 ,$159.71 ,$149.05 , N/A , N/A ,$203.30 , N/A , N/A ,$186.18 , N/A ,$192.60 , N/A ,$192.60 ,$192.60 ,$192.60 ,$207.58 ,$173.34 ,$199.02 ,$184.04 ,$207.58 
SACRED HEART HOSPITAL (ACU),37000072,99151,HC MODERATE SEDATION SAME PHY <5YR 1ST 15MIN,370,1 ,$270.00 ,$202.50 ,$7.77 ,$270.00 ,$173.88 , N/A ,$189.00 ,$7.77 ,$224.10 ,$8.00 ,$178.20 ,$256.50 ,$7.77 ,$216.00 ,$248.40 ,$7.77 ,$229.50 ,$256.50 ,$237.60 ,$205.20 ,$7.77 ,$7.77 ,$7.77 ,$197.10 ,$148.50 ,$245.70 ,$245.70 ,$216.00 , N/A ,$148.50 ,$243.00 , N/A ,$243.00 ,$145.80 ,$253.80 , N/A ,$248.40 ,$8.24 ,$245.70 , N/A ,$166.16 ,$166.16 ,$243.00 ,$201.50 ,$188.06 , N/A ,$7.77 ,$256.50 , N/A ,$7.77 ,$234.90 , N/A ,$243.00 , N/A ,$243.00 ,$243.00 ,$243.00 ,$261.90 ,$218.70 ,$251.10 ,$232.20 ,$261.90 
SACRED HEART HOSPITAL (ACU),37000073,99152,HC MODERATE SEDATION SAME PHY >5YR 1ST 15MIN,370,1 ,$270.00 ,$202.50 ,$7.77 ,$270.00 ,$173.88 , N/A ,$189.00 ,$7.77 ,$224.10 ,$8.00 ,$178.20 ,$256.50 ,$7.77 ,$216.00 ,$248.40 ,$7.77 ,$229.50 ,$256.50 ,$237.60 ,$205.20 ,$7.77 ,$7.77 ,$7.77 ,$197.10 ,$148.50 ,$245.70 ,$245.70 ,$216.00 , N/A ,$148.50 ,$243.00 , N/A ,$243.00 ,$145.80 ,$253.80 , N/A ,$248.40 ,$8.24 ,$245.70 , N/A ,$166.16 ,$166.16 ,$243.00 ,$201.50 ,$188.06 , N/A ,$7.77 ,$256.50 , N/A ,$7.77 ,$234.90 , N/A ,$243.00 , N/A ,$243.00 ,$243.00 ,$243.00 ,$261.90 ,$218.70 ,$251.10 ,$232.20 ,$261.90 
SACRED HEART HOSPITAL (ACU),37000074,99155,HC MODERATE SEDATION DIFF PHY <5YR 1ST 15MIN,370,1 ,$243.00 ,$182.25 ,$7.77 ,$243.00 ,$156.49 , N/A ,$170.10 ,$7.77 ,$201.69 ,$8.00 ,$160.38 ,$230.85 ,$7.77 ,$194.40 ,$223.56 ,$7.77 ,$206.55 ,$230.85 ,$213.84 ,$184.68 ,$7.77 ,$7.77 ,$7.77 ,$177.39 ,$133.65 ,$221.13 ,$221.13 ,$194.40 , N/A ,$133.65 ,$218.70 , N/A ,$218.70 ,$131.22 ,$228.42 , N/A ,$223.56 ,$8.24 ,$221.13 , N/A ,$149.54 ,$149.54 ,$218.70 ,$181.35 ,$169.25 , N/A ,$7.77 ,$230.85 , N/A ,$7.77 ,$211.41 , N/A ,$218.70 , N/A ,$218.70 ,$218.70 ,$218.70 ,$235.71 ,$196.83 ,$225.99 ,$208.98 ,$235.71 
SACRED HEART HOSPITAL (ACU),37000075,99156,HC MODERATE SEDATION DIFF PHY >5YR 1ST 15MIN,370,1 ,$270.00 ,$202.50 ,$7.77 ,$270.00 ,$173.88 , N/A ,$189.00 ,$7.77 ,$224.10 ,$8.00 ,$178.20 ,$256.50 ,$7.77 ,$216.00 ,$248.40 ,$7.77 ,$229.50 ,$256.50 ,$237.60 ,$205.20 ,$7.77 ,$7.77 ,$7.77 ,$197.10 ,$148.50 ,$245.70 ,$245.70 ,$216.00 , N/A ,$148.50 ,$243.00 , N/A ,$243.00 ,$145.80 ,$253.80 , N/A ,$248.40 ,$8.24 ,$245.70 , N/A ,$166.16 ,$166.16 ,$243.00 ,$201.50 ,$188.06 , N/A ,$7.77 ,$256.50 , N/A ,$7.77 ,$234.90 , N/A ,$243.00 , N/A ,$243.00 ,$243.00 ,$243.00 ,$261.90 ,$218.70 ,$251.10 ,$232.20 ,$261.90 
SACRED HEART HOSPITAL (ACU),37080000,64447,HC FEMORAL NERVE BLOCK SINGLE,360,1 ,"$1,742.00 ","$1,306.50 ",$141.34 ,"$1,742.00 ","$1,121.85 ",$671.59 ,"$1,219.40 ",$141.34 ,"$1,742.00 ",$145.58 ,"$1,742.00 ","$1,654.90 ",$141.34 ,"$1,393.60 ","$1,602.64 ",$141.34 , N/A ,"$1,654.90 ","$1,532.96 ","$1,323.92 ",$141.34 ,$141.34 ,$141.34 ,"$1,271.66 ",$958.10 ,"$1,585.22 ","$1,585.22 ","$1,393.60 ",$691.74 ,$958.10 ,"$1,567.80 ",$671.59 ,"$1,567.80 ",$940.68 ,"$1,637.48 ","$1,511.09 ","$1,602.64 ",$149.82 ,"$1,585.22 ",$671.59 ,"$1,072.03 ","$1,072.03 ","$1,567.80 ","$1,300.05 ",$871.00 ,$678.31 ,$141.34 ,"$1,654.90 ",$705.17 ,$141.34 ,"$1,515.54 ",$671.59 ,"$1,567.80 ",$671.59 ,"$1,567.80 ","$1,567.80 ","$1,567.80 ","$1,689.74 ","$1,411.02 ","$1,620.06 ","$1,498.12 ","$1,689.74 "
SACRED HEART HOSPITAL (ACU),39000128,P9047,HC ALBUMIN VL 25% 100 ML,390,1 ,$174.92 ,$131.19 ,$48.30 ,$174.92 ,$112.65 ,$52.45 ,$122.44 ,$48.30 ,$145.18 ,$49.75 ,$115.45 ,$166.17 ,$48.30 ,$139.94 ,$160.93 ,$48.30 ,$148.68 ,$166.17 ,$153.93 ,$132.94 ,$48.30 ,$48.30 ,$48.30 ,$127.69 ,$96.21 ,$159.18 ,$159.18 ,$139.94 ,$54.02 ,$96.21 ,$157.43 ,$52.45 ,$157.43 ,$94.46 ,$164.42 ,$118.01 ,$160.93 ,$51.20 ,$159.18 ,$52.45 ,$107.65 ,$107.65 ,$157.43 ,$130.54 ,$121.83 ,$52.97 ,$48.30 ,$166.17 ,$55.07 ,$48.30 ,$152.18 ,$52.45 ,$157.43 ,$52.45 ,$157.43 ,$157.43 ,$157.43 ,$169.67 ,$141.69 ,$162.68 ,$150.43 ,$169.67 
SACRED HEART HOSPITAL (ACU),39000144,86965,HC BLOOD PRODUCT POOL,390,1 ,$322.95 ,$242.21 ,$8.64 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$8.64 ,$268.05 ,$8.90 ,$213.15 ,$306.80 ,$8.64 ,$258.36 ,$297.11 ,$8.64 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$8.64 ,$8.64 ,$8.64 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$9.16 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$290.66 ,$241.02 ,$224.93 ,$159.32 ,$8.64 ,$306.80 ,$165.63 ,$8.64 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),39000145,86985,HC SPLITTING BLOOD PRODUCT EA,390,1 ,$322.95 ,$242.21 ,$8.64 ,$354.91 ,$207.98 ,$157.74 ,$226.07 ,$8.64 ,$268.05 ,$8.90 ,$213.15 ,$306.80 ,$8.64 ,$258.36 ,$297.11 ,$8.64 ,$274.51 ,$306.80 ,$284.20 ,$245.44 ,$8.64 ,$8.64 ,$8.64 ,$235.75 ,$177.62 ,$293.88 ,$293.88 ,$258.36 ,$162.47 ,$177.62 ,$290.66 ,$157.74 ,$290.66 ,$174.39 ,$303.57 ,$354.91 ,$297.11 ,$9.16 ,$293.88 ,$157.74 ,$198.74 ,$198.74 ,$290.66 ,$241.02 ,$224.93 ,$159.32 ,$8.64 ,$306.80 ,$165.63 ,$8.64 ,$280.97 ,$157.74 ,$290.66 ,$157.74 ,$290.66 ,$290.66 ,$290.66 ,$313.26 ,$261.59 ,$300.34 ,$277.74 ,$313.26 
SACRED HEART HOSPITAL (ACU),39000146,P9012,HC CRYOPRECIPITATE EA UNIT,390,1 ,$174.52 ,$130.89 ,$48.30 ,$183.44 ,$112.39 ,$81.53 ,$122.16 ,$48.30 ,$144.85 ,$49.75 ,$115.18 ,$165.79 ,$48.30 ,$139.62 ,$160.56 ,$48.30 ,$148.34 ,$165.79 ,$153.58 ,$132.64 ,$48.30 ,$48.30 ,$48.30 ,$127.40 ,$95.99 ,$158.81 ,$158.81 ,$139.62 ,$83.98 ,$95.99 ,$157.07 ,$81.53 ,$157.07 ,$94.24 ,$164.05 ,$183.44 ,$160.56 ,$51.20 ,$158.81 ,$81.53 ,$107.40 ,$107.40 ,$157.07 ,$130.24 ,$121.55 ,$82.35 ,$48.30 ,$165.79 ,$85.61 ,$48.30 ,$151.83 ,$81.53 ,$157.07 ,$81.53 ,$157.07 ,$157.07 ,$157.07 ,$169.28 ,$141.36 ,$162.30 ,$150.09 ,$169.28 
SACRED HEART HOSPITAL (ACU),39000147,P9016,HC RED CELLS L/R EA,390,1 ,$773.68 ,$580.26 ,$192.39 ,$773.68 ,$498.25 ,$192.39 ,$541.58 ,$449.49 ,$642.15 ,$462.97 ,$510.63 ,$735.00 ,$449.49 ,$618.94 ,$711.79 ,$449.49 ,$657.63 ,$735.00 ,$680.84 ,$588.00 ,$449.49 ,$449.49 ,$449.49 ,$564.79 ,$425.52 ,$704.05 ,$704.05 ,$618.94 ,$198.16 ,$425.52 ,$696.31 ,$192.39 ,$696.31 ,$417.79 ,$727.26 ,$432.88 ,$711.79 ,$476.46 ,$704.05 ,$192.39 ,$476.12 ,$476.12 ,$696.31 ,$577.40 ,$538.87 ,$194.31 ,$449.49 ,$735.00 ,$202.01 ,$449.49 ,$673.10 ,$192.39 ,$696.31 ,$192.39 ,$696.31 ,$696.31 ,$696.31 ,$750.47 ,$626.68 ,$719.52 ,$665.36 ,$750.47 
SACRED HEART HOSPITAL (ACU),39000150,P9022,HC RED CELLS WASHED EA UNIT,390,1 ,$993.78 ,$745.34 ,$121.37 ,$993.78 ,$639.99 ,$387.85 ,$695.65 ,$121.37 ,$824.84 ,$125.01 ,$655.89 ,$944.09 ,$121.37 ,$795.02 ,$914.28 ,$121.37 ,$844.71 ,$944.09 ,$874.53 ,$755.27 ,$121.37 ,$121.37 ,$121.37 ,$725.46 ,$546.58 ,$904.34 ,$904.34 ,$795.02 ,$399.49 ,$546.58 ,$894.40 ,$387.85 ,$894.40 ,$536.64 ,$934.15 ,$872.66 ,$914.28 ,$128.65 ,$904.34 ,$387.85 ,$611.57 ,$611.57 ,$894.40 ,$741.66 ,$692.17 ,$391.73 ,$121.37 ,$944.09 ,$407.24 ,$121.37 ,$864.59 ,$387.85 ,$894.40 ,$387.85 ,$894.40 ,$894.40 ,$894.40 ,$963.97 ,$804.96 ,$924.22 ,$854.65 ,$963.97 
SACRED HEART HOSPITAL (ACU),39000151,P9031,HC PLATELETS LEUKO RD EA UNIT,390,1 ,$291.75 ,$218.81 ,$48.30 ,$344.41 ,$187.89 ,$153.07 ,$204.23 ,$48.30 ,$242.15 ,$49.75 ,$192.56 ,$277.16 ,$48.30 ,$233.40 ,$268.41 ,$48.30 ,$247.99 ,$277.16 ,$256.74 ,$221.73 ,$48.30 ,$48.30 ,$48.30 ,$212.98 ,$160.46 ,$265.49 ,$265.49 ,$233.40 ,$157.66 ,$160.46 ,$262.58 ,$153.07 ,$262.58 ,$157.55 ,$274.25 ,$344.41 ,$268.41 ,$51.20 ,$265.49 ,$153.07 ,$179.54 ,$179.54 ,$262.58 ,$217.73 ,$203.20 ,$154.60 ,$48.30 ,$277.16 ,$160.72 ,$48.30 ,$253.82 ,$153.07 ,$262.58 ,$153.07 ,$262.58 ,$262.58 ,$262.58 ,$283.00 ,$236.32 ,$271.33 ,$250.91 ,$283.00 
SACRED HEART HOSPITAL (ACU),39000152,P9033,HC PLATELETS L/R IRR EA,390,1 ,$419.13 ,$314.35 ,$121.37 ,$489.74 ,$269.92 ,$217.66 ,$293.39 ,$121.37 ,$347.88 ,$125.01 ,$276.63 ,$398.17 ,$121.37 ,$335.30 ,$385.60 ,$121.37 ,$356.26 ,$398.17 ,$368.83 ,$318.54 ,$121.37 ,$121.37 ,$121.37 ,$305.96 ,$230.52 ,$381.41 ,$381.41 ,$335.30 ,$224.19 ,$230.52 ,$377.22 ,$217.66 ,$377.22 ,$226.33 ,$393.98 ,$489.74 ,$385.60 ,$128.65 ,$381.41 ,$217.66 ,$257.93 ,$257.93 ,$377.22 ,$312.80 ,$291.92 ,$219.84 ,$121.37 ,$398.17 ,$228.54 ,$121.37 ,$364.64 ,$217.66 ,$377.22 ,$217.66 ,$377.22 ,$377.22 ,$377.22 ,$406.56 ,$339.50 ,$389.79 ,$360.45 ,$406.56 
SACRED HEART HOSPITAL (ACU),39000153,P9035,HC PLATELETS PHER L/R EA,390,1 ,"$1,527.32 ","$1,145.49 ",$121.37 ,"$1,527.32 ",$983.59 ,$496.91 ,"$1,069.12 ",$121.37 ,"$1,267.68 ",$125.01 ,"$1,008.03 ","$1,450.95 ",$121.37 ,"$1,221.86 ","$1,405.13 ",$121.37 ,"$1,298.22 ","$1,450.95 ","$1,344.04 ","$1,160.76 ",$121.37 ,$121.37 ,$121.37 ,"$1,114.94 ",$840.03 ,"$1,389.86 ","$1,389.86 ","$1,221.86 ",$511.82 ,$840.03 ,"$1,374.59 ",$496.91 ,"$1,374.59 ",$824.75 ,"$1,435.68 ","$1,118.05 ","$1,405.13 ",$128.65 ,"$1,389.86 ",$496.91 ,$939.91 ,$939.91 ,"$1,374.59 ","$1,139.84 ","$1,063.78 ",$501.88 ,$121.37 ,"$1,450.95 ",$521.76 ,$121.37 ,"$1,328.77 ",$496.91 ,"$1,374.59 ",$496.91 ,"$1,374.59 ","$1,374.59 ","$1,374.59 ","$1,481.50 ","$1,237.13 ","$1,420.41 ","$1,313.50 ","$1,481.50 "
SACRED HEART HOSPITAL (ACU),39000154,P9037,HC PLATELETS PHER L/R IRR EA,390,1 ,"$1,614.72 ","$1,211.04 ",$121.37 ,"$1,614.72 ","$1,039.88 ",$630.32 ,"$1,130.30 ",$121.37 ,"$1,340.22 ",$125.01 ,"$1,065.72 ","$1,533.98 ",$121.37 ,"$1,291.78 ","$1,485.54 ",$121.37 ,"$1,372.51 ","$1,533.98 ","$1,420.95 ","$1,227.19 ",$121.37 ,$121.37 ,$121.37 ,"$1,178.75 ",$888.10 ,"$1,469.40 ","$1,469.40 ","$1,291.78 ",$649.23 ,$888.10 ,"$1,453.25 ",$630.32 ,"$1,453.25 ",$871.95 ,"$1,517.84 ","$1,418.22 ","$1,485.54 ",$128.65 ,"$1,469.40 ",$630.32 ,$993.70 ,$993.70 ,"$1,453.25 ","$1,205.07 ","$1,124.65 ",$636.62 ,$121.37 ,"$1,533.98 ",$661.84 ,$121.37 ,"$1,404.81 ",$630.32 ,"$1,453.25 ",$630.32 ,"$1,453.25 ","$1,453.25 ","$1,453.25 ","$1,566.28 ","$1,307.92 ","$1,501.69 ","$1,388.66 ","$1,566.28 "
SACRED HEART HOSPITAL (ACU),39000155,P9040,HC RED CELLS L/R IRR EA,390,1 ,$952.09 ,$714.07 ,$48.30 ,$952.09 ,$613.15 ,$266.03 ,$666.46 ,$48.30 ,$790.23 ,$49.75 ,$628.38 ,$904.49 ,$48.30 ,$761.67 ,$875.92 ,$48.30 ,$809.28 ,$904.49 ,$837.84 ,$723.59 ,$48.30 ,$48.30 ,$48.30 ,$695.03 ,$523.65 ,$866.40 ,$866.40 ,$761.67 ,$274.01 ,$523.65 ,$856.88 ,$266.03 ,$856.88 ,$514.13 ,$894.96 ,$598.57 ,$875.92 ,$51.20 ,$866.40 ,$266.03 ,$585.92 ,$585.92 ,$856.88 ,$710.54 ,$663.13 ,$268.69 ,$48.30 ,$904.49 ,$279.33 ,$48.30 ,$828.32 ,$266.03 ,$856.88 ,$266.03 ,$856.88 ,$856.88 ,$856.88 ,$923.53 ,$771.19 ,$885.44 ,$818.80 ,$923.53 
SACRED HEART HOSPITAL (ACU),39000156,P9051,HC RBC L/R CMV NEG EA,390,1 ,$781.68 ,$586.26 ,$48.30 ,$781.68 ,$503.40 ,$216.68 ,$547.18 ,$48.30 ,$648.79 ,$49.75 ,$515.91 ,$742.60 ,$48.30 ,$625.34 ,$719.15 ,$48.30 ,$664.43 ,$742.60 ,$687.88 ,$594.08 ,$48.30 ,$48.30 ,$48.30 ,$570.63 ,$429.92 ,$711.33 ,$711.33 ,$625.34 ,$223.18 ,$429.92 ,$703.51 ,$216.68 ,$703.51 ,$422.11 ,$734.78 ,$487.53 ,$719.15 ,$51.20 ,$711.33 ,$216.68 ,$481.05 ,$481.05 ,$703.51 ,$583.37 ,$544.44 ,$218.85 ,$48.30 ,$742.60 ,$227.51 ,$48.30 ,$680.06 ,$216.68 ,$703.51 ,$216.68 ,$703.51 ,$703.51 ,$703.51 ,$758.23 ,$633.16 ,$726.96 ,$672.24 ,$758.23 
SACRED HEART HOSPITAL (ACU),39000157,P9052,HC PLT APHER/PHER L/R HLA EA,390,1 ,"$1,923.30 ","$1,442.48 ",$121.37 ,"$1,923.30 ","$1,238.61 ",$822.11 ,"$1,346.31 ",$121.37 ,"$1,596.34 ",$125.01 ,"$1,269.38 ","$1,827.14 ",$121.37 ,"$1,538.64 ","$1,769.44 ",$121.37 ,"$1,634.81 ","$1,827.14 ","$1,692.50 ","$1,461.71 ",$121.37 ,$121.37 ,$121.37 ,"$1,404.01 ","$1,057.82 ","$1,750.20 ","$1,750.20 ","$1,538.64 ",$846.77 ,"$1,057.82 ","$1,730.97 ",$822.11 ,"$1,730.97 ","$1,038.58 ","$1,807.90 ","$1,849.75 ","$1,769.44 ",$128.65 ,"$1,750.20 ",$822.11 ,"$1,183.60 ","$1,183.60 ","$1,730.97 ","$1,435.36 ","$1,339.58 ",$830.33 ,$121.37 ,"$1,827.14 ",$863.22 ,$121.37 ,"$1,673.27 ",$822.11 ,"$1,730.97 ",$822.11 ,"$1,730.97 ","$1,730.97 ","$1,730.97 ","$1,865.60 ","$1,557.87 ","$1,788.67 ","$1,654.04 ","$1,865.60 "
SACRED HEART HOSPITAL (ACU),39000158,P9055,HC PHER PLT LR CMV NEG,390,1 ,$851.11 ,$638.33 ,$121.37 ,"$1,102.79 ",$548.11 ,$490.13 ,$595.78 ,$121.37 ,$706.42 ,$125.01 ,$561.73 ,$808.55 ,$121.37 ,$680.89 ,$783.02 ,$121.37 ,$723.44 ,$808.55 ,$748.98 ,$646.84 ,$121.37 ,$121.37 ,$121.37 ,$621.31 ,$468.11 ,$774.51 ,$774.51 ,$680.89 ,$504.83 ,$468.11 ,$766.00 ,$490.13 ,$766.00 ,$459.60 ,$800.04 ,"$1,102.79 ",$783.02 ,$128.65 ,$774.51 ,$490.13 ,$523.77 ,$523.77 ,$766.00 ,$635.18 ,$592.80 ,$495.03 ,$121.37 ,$808.55 ,$514.64 ,$121.37 ,$740.47 ,$490.13 ,$766.00 ,$490.13 ,$766.00 ,$766.00 ,$766.00 ,$825.58 ,$689.40 ,$791.53 ,$731.95 ,$825.58 
SACRED HEART HOSPITAL (ACU),39000160,P9059,HC PLASMA FROZEN 8-24 HRS EA UNIT,390,1 ,$325.28 ,$243.96 ,$48.30 ,$325.28 ,$209.48 ,$72.64 ,$227.70 ,$48.30 ,$269.98 ,$49.75 ,$214.68 ,$309.02 ,$48.30 ,$260.22 ,$299.26 ,$48.30 ,$276.49 ,$309.02 ,$286.25 ,$247.21 ,$48.30 ,$48.30 ,$48.30 ,$237.45 ,$178.90 ,$296.00 ,$296.00 ,$260.22 ,$74.82 ,$178.90 ,$292.75 ,$72.64 ,$292.75 ,$175.65 ,$305.76 ,$163.44 ,$299.26 ,$51.20 ,$296.00 ,$72.64 ,$200.18 ,$200.18 ,$292.75 ,$242.76 ,$226.56 ,$73.37 ,$48.30 ,$309.02 ,$76.27 ,$48.30 ,$282.99 ,$72.64 ,$292.75 ,$72.64 ,$292.75 ,$292.75 ,$292.75 ,$315.52 ,$263.48 ,$302.51 ,$279.74 ,$315.52 
SACRED HEART HOSPITAL (ACU),39000204,P9073,HC PLATELETS PHERESIS PATH REDUCED EA UN,390,1 ,"$1,650.00 ","$1,237.50 ",$121.37 ,"$1,650.00 ","$1,062.60 ",$596.13 ,"$1,155.00 ",$121.37 ,"$1,369.50 ",$125.01 ,"$1,089.00 ","$1,567.50 ",$121.37 ,"$1,320.00 ","$1,518.00 ",$121.37 ,"$1,402.50 ","$1,567.50 ","$1,452.00 ","$1,254.00 ",$121.37 ,$121.37 ,$121.37 ,"$1,204.50 ",$907.50 ,"$1,501.50 ","$1,501.50 ","$1,320.00 ",$614.01 ,$907.50 ,"$1,485.00 ",$596.13 ,"$1,485.00 ",$891.00 ,"$1,551.00 ","$1,341.29 ","$1,518.00 ",$128.65 ,"$1,501.50 ",$596.13 ,"$1,015.41 ","$1,015.41 ","$1,485.00 ","$1,231.40 ","$1,149.23 ",$602.09 ,$121.37 ,"$1,567.50 ",$625.94 ,$121.37 ,"$1,435.50 ",$596.13 ,"$1,485.00 ",$596.13 ,"$1,485.00 ","$1,485.00 ","$1,485.00 ","$1,600.50 ","$1,336.50 ","$1,534.50 ","$1,419.00 ","$1,600.50 "
SACRED HEART HOSPITAL (ACU),39000211,P9059,HC COVID CONVALESCENT PLASMA,390,1 ,"$1,594.00 ","$1,195.50 ",$48.30 ,"$1,594.00 ","$1,026.54 ",$72.64 ,"$1,115.80 ",$48.30 ,"$1,323.02 ",$49.75 ,"$1,052.04 ","$1,514.30 ",$48.30 ,"$1,275.20 ","$1,466.48 ",$48.30 ,"$1,354.90 ","$1,514.30 ","$1,402.72 ","$1,211.44 ",$48.30 ,$48.30 ,$48.30 ,"$1,163.62 ",$876.70 ,"$1,450.54 ","$1,450.54 ","$1,275.20 ",$74.82 ,$876.70 ,"$1,434.60 ",$72.64 ,"$1,434.60 ",$860.76 ,"$1,498.36 ",$163.44 ,"$1,466.48 ",$51.20 ,"$1,450.54 ",$72.64 ,$980.95 ,$980.95 ,"$1,434.60 ","$1,189.60 ","$1,110.22 ",$73.37 ,$48.30 ,"$1,514.30 ",$76.27 ,$48.30 ,"$1,386.78 ",$72.64 ,"$1,434.60 ",$72.64 ,"$1,434.60 ","$1,434.60 ","$1,434.60 ","$1,546.18 ","$1,291.14 ","$1,482.42 ","$1,370.84 ","$1,546.18 "
SACRED HEART HOSPITAL (ACU),39100001,36430,HC BLOOD PROD ADMIN,391,1 ,$824.00 ,$618.00 ,$149.46 ,$944.53 ,$530.66 ,$419.79 ,$576.80 ,$149.46 ,$683.92 ,$153.94 ,$543.84 ,$782.80 ,$149.46 ,$659.20 ,$758.08 ,$149.46 ,$700.40 ,$782.80 ,$725.12 ,$626.24 ,$149.46 ,$149.46 ,$149.46 ,$601.52 ,$453.20 ,$749.84 ,$749.84 ,$659.20 ,$432.38 ,$453.20 ,$741.60 ,$419.79 ,$741.60 ,$444.96 ,$774.56 ,$944.53 ,$758.08 ,$158.43 ,$749.84 ,$419.79 ,$507.09 ,$507.09 ,$741.60 ,$614.95 ,$573.92 ,$423.99 ,$149.46 ,$782.80 ,$440.78 ,$149.46 ,$716.88 ,$419.79 ,$741.60 ,$419.79 ,$741.60 ,$741.60 ,$741.60 ,$799.28 ,$667.44 ,$766.32 ,$708.64 ,$799.28 
SACRED HEART HOSPITAL (ACU),40100003,77066,HC MAMMOGRAM DIAG BILAT W/CAD,401,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$108.66 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$111.92 ,$164.24 ,$268.76 ,$108.66 ,$268.76 ,$161.25 ,$280.70 ,$244.49 ,$274.73 ,$17.43 ,$271.74 ,$108.66 ,$183.77 ,$183.77 ,$298.62 ,$222.86 ,$267.96 ,$109.75 ,$16.44 ,$283.69 ,$114.09 ,$16.44 ,$259.80 ,$108.66 ,$268.76 ,$108.66 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40100004,77066,HC MAMMOGRAM DIAG BILAT W/CAD ADDNT VIEW,401,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$108.66 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$111.92 ,$164.24 ,$268.76 ,$108.66 ,$268.76 ,$161.25 ,$280.70 ,$244.49 ,$274.73 ,$17.43 ,$271.74 ,$108.66 ,$183.77 ,$183.77 ,$298.62 ,$222.86 ,$267.96 ,$109.75 ,$16.44 ,$283.69 ,$114.09 ,$16.44 ,$259.80 ,$108.66 ,$268.76 ,$108.66 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40100005,77066,HC MAMMOGRAM DIAG BILAT W/CAD IMPLANT,401,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$108.66 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$111.92 ,$164.24 ,$268.76 ,$108.66 ,$268.76 ,$161.25 ,$280.70 ,$244.49 ,$274.73 ,$17.43 ,$271.74 ,$108.66 ,$183.77 ,$183.77 ,$298.62 ,$222.86 ,$267.96 ,$109.75 ,$16.44 ,$283.69 ,$114.09 ,$16.44 ,$259.80 ,$108.66 ,$268.76 ,$108.66 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40100007,77065,HC MAMMOGRAM DIAG UNIL W/CAD,401,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$85.19 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$87.75 ,$164.24 ,$268.76 ,$85.19 ,$268.76 ,$161.25 ,$280.70 ,$191.68 ,$274.73 ,$17.43 ,$271.74 ,$85.19 ,$183.77 ,$183.77 ,$257.37 ,$222.86 ,$267.96 ,$86.04 ,$16.44 ,$283.69 ,$89.45 ,$16.44 ,$259.80 ,$85.19 ,$268.76 ,$85.19 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40100008,77065,HC MAMMOGRAM DIAG UNIL W/CAD  ADDNT VIEW,401,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$85.19 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$87.75 ,$164.24 ,$268.76 ,$85.19 ,$268.76 ,$161.25 ,$280.70 ,$191.68 ,$274.73 ,$17.43 ,$271.74 ,$85.19 ,$183.77 ,$183.77 ,$257.37 ,$222.86 ,$267.96 ,$86.04 ,$16.44 ,$283.69 ,$89.45 ,$16.44 ,$259.80 ,$85.19 ,$268.76 ,$85.19 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40100009,77065,HC MAMMOGRAM DIAG UNIL W/CAD IMPLANT,401,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$85.19 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$87.75 ,$164.24 ,$268.76 ,$85.19 ,$268.76 ,$161.25 ,$280.70 ,$191.68 ,$274.73 ,$17.43 ,$271.74 ,$85.19 ,$183.77 ,$183.77 ,$257.37 ,$222.86 ,$267.96 ,$86.04 ,$16.44 ,$283.69 ,$89.45 ,$16.44 ,$259.80 ,$85.19 ,$268.76 ,$85.19 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40100014,G0279,HC DIAGNOSTIC DIGITAL BREAST TOMOSYTH UNI/BIL,401,1 ,$40.00 ,$30.00 ,$16.44 ,$51.35 ,$25.76 ,$22.82 ,$28.00 ,$16.44 ,$33.20 ,$16.93 ,$26.40 ,$38.00 ,$16.44 ,$32.00 ,$36.80 ,$16.44 ,$34.00 ,$38.00 ,$35.20 ,$30.40 ,$16.44 ,$16.44 ,$16.44 ,$29.20 ,$22.00 ,$36.40 ,$36.40 ,$32.00 ,$23.50 ,$22.00 ,$36.00 ,$22.82 ,$36.00 ,$21.60 ,$37.60 ,$51.35 ,$36.80 ,$17.43 ,$36.40 ,$22.82 ,$24.62 ,$24.62 ,$36.00 ,$29.85 ,$36.00 ,$23.05 ,$16.44 ,$38.00 ,$23.96 ,$16.44 ,$34.80 ,$22.82 ,$36.00 ,$22.82 ,$36.00 ,$36.00 ,$36.00 ,$38.80 ,$32.40 ,$37.20 ,$34.40 ,$38.80 
SACRED HEART HOSPITAL (ACU),40200007,51798,HC US BLADDER SCAN,402,1 ,$149.00 ,$111.75 ,$23.39 ,$149.00 ,$95.96 ,$58.87 ,$104.30 ,$23.39 ,$149.00 ,$24.09 ,$149.00 ,$141.55 ,$23.39 ,$119.20 ,$137.08 ,$23.39 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$23.39 ,$23.39 ,$23.39 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,$60.64 ,$81.95 ,$134.10 ,$58.87 ,$134.10 ,$80.46 ,$140.06 ,$132.46 ,$137.08 ,$24.79 ,$135.59 ,$58.87 ,$91.69 ,$91.69 ,$134.10 ,$111.20 ,$134.10 ,$59.46 ,$23.39 ,$141.55 ,$61.82 ,$23.39 ,$129.63 ,$58.87 ,$134.10 ,$58.87 ,$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),40200009,49407,HC DRAIN ABSC PELVIC TRNSVAG PERC,402,1 ,"$2,202.11 ","$1,651.58 ",$239.96 ,"$3,348.27 ","$1,418.16 ","$1,488.12 ","$1,541.48 ",$239.96 ,$428.00 ,$247.16 ,$342.00 ,"$2,092.00 ",$239.96 ,"$1,761.69 ","$2,025.94 ",$239.96 ,"$1,871.79 ","$2,092.00 ","$1,937.86 ","$1,673.60 ",$239.96 ,$239.96 ,$239.96 ,"$1,607.54 ","$1,211.16 ","$2,003.92 ","$2,003.92 ","$1,761.69 ","$1,532.76 ","$1,211.16 ","$1,981.90 ","$1,488.12 ","$1,981.90 ","$1,189.14 ","$2,069.98 ","$3,348.27 ","$2,025.94 ",$254.36 ,"$2,003.92 ","$1,488.12 ","$1,355.18 ","$1,355.18 ","$1,981.90 ","$1,643.43 ",$460.89 ,"$1,503.00 ",$239.96 ,"$2,092.00 ","$1,562.52 ",$239.96 ,"$1,915.84 ","$1,488.12 ","$1,981.90 ","$1,488.12 ","$1,981.90 ","$1,981.90 ","$1,981.90 ","$2,136.05 ","$1,783.71 ","$2,047.96 ","$1,893.81 ","$2,136.05 "
SACRED HEART HOSPITAL (ACU),40200010,59000,HC AMNIOCENTESIS DIAGNOSTIC,402,1 ,$712.00 ,$534.00 ,$211.31 ,"$1,508.64 ",$458.53 ,$670.51 ,$498.40 ,$211.31 ,$428.00 ,$217.65 ,$342.00 ,$676.40 ,$211.31 ,$569.60 ,$655.04 ,$211.31 ,$605.20 ,$676.40 ,$626.56 ,$541.12 ,$211.31 ,$211.31 ,$211.31 ,$519.76 ,$391.60 ,$647.92 ,$647.92 ,$569.60 ,$690.63 ,$391.60 ,$640.80 ,$670.51 ,$640.80 ,$384.48 ,$669.28 ,"$1,508.64 ",$655.04 ,$223.99 ,$647.92 ,$670.51 ,$438.16 ,$438.16 ,$640.80 ,$531.37 ,$460.89 ,$677.21 ,$211.31 ,$676.40 ,$704.03 ,$211.31 ,$619.44 ,$670.51 ,$640.80 ,$670.51 ,$640.80 ,$640.80 ,$640.80 ,$690.64 ,$576.72 ,$662.16 ,$612.32 ,$690.64 
SACRED HEART HOSPITAL (ACU),40200011,60300,HC ASP/INJ CYST THYROID,402,1 ,$503.00 ,$377.25 ,$271.62 ,"$1,480.84 ",$323.93 ,$658.15 ,$352.10 ,$298.28 ,$428.00 ,$307.23 ,$342.00 ,$477.85 ,$298.28 ,$402.40 ,$462.76 ,$298.28 ,$427.55 ,$477.85 ,$442.64 ,$382.28 ,$298.28 ,$298.28 ,$298.28 ,$367.19 ,$276.65 ,$457.73 ,$457.73 ,$402.40 ,$677.89 ,$276.65 ,$452.70 ,$658.15 ,$452.70 ,$271.62 ,$472.82 ,"$1,480.84 ",$462.76 ,$316.18 ,$457.73 ,$658.15 ,$309.55 ,$309.55 ,$452.70 ,$375.39 ,$452.70 ,$664.73 ,$298.28 ,$477.85 ,$691.06 ,$298.28 ,$437.61 ,$658.15 ,$452.70 ,$658.15 ,$452.70 ,$452.70 ,$452.70 ,$487.91 ,$407.43 ,$467.79 ,$432.58 ,$487.91 
SACRED HEART HOSPITAL (ACU),40200012,76506,HC US ENCEPHALOGRAM,402,1 ,"$1,293.00 ",$969.75 ,$35.91 ,"$1,293.00 ",$832.69 ,$115.15 ,$905.10 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,"$1,228.35 ",$35.91 ,"$1,034.40 ","$1,189.56 ",$35.91 ,"$1,099.05 ","$1,228.35 ","$1,137.84 ",$982.68 ,$35.91 ,$35.91 ,$35.91 ,$943.89 ,$711.15 ,"$1,176.63 ","$1,176.63 ","$1,034.40 ",$118.60 ,$711.15 ,"$1,163.70 ",$115.15 ,"$1,163.70 ",$698.22 ,"$1,215.42 ",$259.08 ,"$1,189.56 ",$38.06 ,"$1,176.63 ",$115.15 ,$795.71 ,$795.71 ,$317.34 ,$964.97 ,$460.89 ,$116.30 ,$35.91 ,"$1,228.35 ",$120.90 ,$35.91 ,"$1,124.91 ",$115.15 ,"$1,163.70 ",$115.15 ,"$1,163.70 ","$1,163.70 ","$1,163.70 ","$1,254.21 ","$1,047.33 ","$1,202.49 ","$1,111.98 ","$1,254.21 "
SACRED HEART HOSPITAL (ACU),40200013,76536,HC US SOFT TISSUE HEAD/NECK,402,1 ,$595.00 ,$446.25 ,$35.91 ,$595.00 ,$383.18 ,$115.15 ,$416.50 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$565.25 ,$35.91 ,$476.00 ,$547.40 ,$35.91 ,$505.75 ,$565.25 ,$523.60 ,$452.20 ,$35.91 ,$35.91 ,$35.91 ,$434.35 ,$327.25 ,$541.45 ,$541.45 ,$476.00 ,$118.60 ,$327.25 ,$535.50 ,$115.15 ,$535.50 ,$321.30 ,$559.30 ,$259.08 ,$547.40 ,$38.06 ,$541.45 ,$115.15 ,$366.16 ,$366.16 ,$271.72 ,$444.05 ,$460.89 ,$116.30 ,$35.91 ,$565.25 ,$120.90 ,$35.91 ,$517.65 ,$115.15 ,$535.50 ,$115.15 ,$535.50 ,$535.50 ,$535.50 ,$577.15 ,$481.95 ,$553.35 ,$511.70 ,$577.15 
SACRED HEART HOSPITAL (ACU),40200014,76604,HC US CHEST,402,1 ,$822.00 ,$616.50 ,$35.91 ,$822.00 ,$529.37 ,$115.15 ,$575.40 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$780.90 ,$35.91 ,$657.60 ,$756.24 ,$35.91 ,$698.70 ,$780.90 ,$723.36 ,$624.72 ,$35.91 ,$35.91 ,$35.91 ,$600.06 ,$452.10 ,$748.02 ,$748.02 ,$657.60 ,$118.60 ,$452.10 ,$739.80 ,$115.15 ,$739.80 ,$443.88 ,$772.68 ,$259.08 ,$756.24 ,$38.06 ,$748.02 ,$115.15 ,$505.86 ,$505.86 ,$266.93 ,$613.46 ,$460.89 ,$116.30 ,$35.91 ,$780.90 ,$120.90 ,$35.91 ,$715.14 ,$115.15 ,$739.80 ,$115.15 ,$739.80 ,$739.80 ,$739.80 ,$797.34 ,$665.82 ,$764.46 ,$706.92 ,$797.34 
SACRED HEART HOSPITAL (ACU),40200015,76641,HC US BREAST COMPLETE,402,1 ,$595.00 ,$446.25 ,$35.91 ,$595.00 ,$383.18 ,$115.15 ,$416.50 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$565.25 ,$35.91 ,$476.00 ,$547.40 ,$35.91 ,$505.75 ,$565.25 ,$523.60 ,$452.20 ,$35.91 ,$35.91 ,$35.91 ,$434.35 ,$327.25 ,$541.45 ,$541.45 ,$476.00 ,$118.60 ,$327.25 ,$535.50 ,$115.15 ,$535.50 ,$321.30 ,$559.30 ,$259.08 ,$547.40 ,$38.06 ,$541.45 ,$115.15 ,$366.16 ,$366.16 ,$209.46 ,$444.05 ,$460.89 ,$116.30 ,$35.91 ,$565.25 ,$120.90 ,$35.91 ,$517.65 ,$115.15 ,$535.50 ,$115.15 ,$535.50 ,$535.50 ,$535.50 ,$577.15 ,$481.95 ,$553.35 ,$511.70 ,$577.15 
SACRED HEART HOSPITAL (ACU),40200016,76642,HC US BREAST LIMITED,402,1 ,$595.00 ,$446.25 ,$35.91 ,$595.00 ,$383.18 ,$85.55 ,$416.50 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$565.25 ,$35.91 ,$476.00 ,$547.40 ,$35.91 ,$505.75 ,$565.25 ,$523.60 ,$452.20 ,$35.91 ,$35.91 ,$35.91 ,$434.35 ,$327.25 ,$541.45 ,$541.45 ,$476.00 ,$88.12 ,$327.25 ,$535.50 ,$85.55 ,$535.50 ,$321.30 ,$559.30 ,$192.49 ,$547.40 ,$38.06 ,$541.45 ,$85.55 ,$366.16 ,$366.16 ,$172.49 ,$444.05 ,$460.89 ,$86.40 ,$35.91 ,$565.25 ,$89.83 ,$35.91 ,$517.65 ,$85.55 ,$535.50 ,$85.55 ,$535.50 ,$535.50 ,$535.50 ,$577.15 ,$481.95 ,$553.35 ,$511.70 ,$577.15 
SACRED HEART HOSPITAL (ACU),40200017,76700,HC US ABDOMEN CMPL,402,1 ,$968.00 ,$726.00 ,$54.52 ,$968.00 ,$623.39 ,$115.15 ,$677.60 ,$54.52 ,$428.00 ,$56.16 ,$342.00 ,$919.60 ,$54.52 ,$774.40 ,$890.56 ,$54.52 ,$822.80 ,$919.60 ,$851.84 ,$735.68 ,$54.52 ,$54.52 ,$54.52 ,$706.64 ,$532.40 ,$880.88 ,$880.88 ,$774.40 ,$118.60 ,$532.40 ,$871.20 ,$115.15 ,$871.20 ,$522.72 ,$909.92 ,$259.08 ,$890.56 ,$57.79 ,$880.88 ,$115.15 ,$595.71 ,$595.71 ,$383.51 ,$722.42 ,$460.89 ,$116.30 ,$54.52 ,$919.60 ,$120.90 ,$54.52 ,$842.16 ,$115.15 ,$871.20 ,$115.15 ,$871.20 ,$871.20 ,$871.20 ,$938.96 ,$784.08 ,$900.24 ,$832.48 ,$938.96 
SACRED HEART HOSPITAL (ACU),40200018,76705,HC US ABDOMEN LTD,402,1 ,$848.00 ,$636.00 ,$35.91 ,$848.00 ,$546.11 ,$115.15 ,$593.60 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$805.60 ,$35.91 ,$678.40 ,$780.16 ,$35.91 ,$720.80 ,$805.60 ,$746.24 ,$644.48 ,$35.91 ,$35.91 ,$35.91 ,$619.04 ,$466.40 ,$771.68 ,$771.68 ,$678.40 ,$118.60 ,$466.40 ,$763.20 ,$115.15 ,$763.20 ,$457.92 ,$797.12 ,$259.08 ,$780.16 ,$38.06 ,$771.68 ,$115.15 ,$521.86 ,$521.86 ,$319.64 ,$632.86 ,$460.89 ,$116.30 ,$35.91 ,$805.60 ,$120.90 ,$35.91 ,$737.76 ,$115.15 ,$763.20 ,$115.15 ,$763.20 ,$763.20 ,$763.20 ,$822.56 ,$686.88 ,$788.64 ,$729.28 ,$822.56 
SACRED HEART HOSPITAL (ACU),40200019,76770,HC US RETROPERITIONEAL,402,1 ,$974.00 ,$730.50 ,$54.52 ,$974.00 ,$627.26 ,$115.15 ,$681.80 ,$54.52 ,$428.00 ,$56.16 ,$342.00 ,$925.30 ,$54.52 ,$779.20 ,$896.08 ,$54.52 ,$827.90 ,$925.30 ,$857.12 ,$740.24 ,$54.52 ,$54.52 ,$54.52 ,$711.02 ,$535.70 ,$886.34 ,$886.34 ,$779.20 ,$118.60 ,$535.70 ,$876.60 ,$115.15 ,$876.60 ,$525.96 ,$915.56 ,$259.08 ,$896.08 ,$57.79 ,$886.34 ,$115.15 ,$599.40 ,$599.40 ,$402.08 ,$726.90 ,$460.89 ,$116.30 ,$54.52 ,$925.30 ,$120.90 ,$54.52 ,$847.38 ,$115.15 ,$876.60 ,$115.15 ,$876.60 ,$876.60 ,$876.60 ,$944.78 ,$788.94 ,$905.82 ,$837.64 ,$944.78 
SACRED HEART HOSPITAL (ACU),40200020,76775,HC US RETROPERITONEAL LTD,402,1 ,$606.00 ,$454.50 ,$35.91 ,$606.00 ,$390.26 ,$115.15 ,$424.20 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$575.70 ,$35.91 ,$484.80 ,$557.52 ,$35.91 ,$515.10 ,$575.70 ,$533.28 ,$460.56 ,$35.91 ,$35.91 ,$35.91 ,$442.38 ,$333.30 ,$551.46 ,$551.46 ,$484.80 ,$118.60 ,$333.30 ,$545.40 ,$115.15 ,$545.40 ,$327.24 ,$569.64 ,$259.08 ,$557.52 ,$38.06 ,$551.46 ,$115.15 ,$372.93 ,$372.93 ,$321.02 ,$452.26 ,$460.89 ,$116.30 ,$35.91 ,$575.70 ,$120.90 ,$35.91 ,$527.22 ,$115.15 ,$545.40 ,$115.15 ,$545.40 ,$545.40 ,$545.40 ,$587.82 ,$490.86 ,$563.58 ,$521.16 ,$587.82 
SACRED HEART HOSPITAL (ACU),40200022,76800,HC US SPINAL CANAL  AND  CONTENTS,402,1 ,$556.00 ,$417.00 ,$35.91 ,$556.00 ,$358.06 ,$115.15 ,$389.20 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$528.20 ,$35.91 ,$444.80 ,$511.52 ,$35.91 ,$472.60 ,$528.20 ,$489.28 ,$422.56 ,$35.91 ,$35.91 ,$35.91 ,$405.88 ,$305.80 ,$505.96 ,$505.96 ,$444.80 ,$118.60 ,$305.80 ,$500.40 ,$115.15 ,$500.40 ,$300.24 ,$522.64 ,$259.08 ,$511.52 ,$38.06 ,$505.96 ,$115.15 ,$342.16 ,$342.16 ,$249.39 ,$414.94 ,$460.89 ,$116.30 ,$35.91 ,$528.20 ,$120.90 ,$35.91 ,$483.72 ,$115.15 ,$500.40 ,$115.15 ,$500.40 ,$500.40 ,$500.40 ,$539.32 ,$450.36 ,$517.08 ,$478.16 ,$539.32 
SACRED HEART HOSPITAL (ACU),40200023,76801,HC US PREGNANCY <14 WEEKS SGL,402,1 ,$646.00 ,$484.50 ,$33.02 ,$646.00 ,$416.02 ,$115.15 ,$452.20 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$613.70 ,$33.02 ,$516.80 ,$594.32 ,$33.02 ,$549.10 ,$613.70 ,$568.48 ,$490.96 ,$33.02 ,$33.02 ,$33.02 ,$471.58 ,$355.30 ,$587.86 ,$587.86 ,$516.80 ,$118.60 ,$355.30 ,$581.40 ,$115.15 ,$581.40 ,$348.84 ,$607.24 ,$259.08 ,$594.32 ,$35.00 ,$587.86 ,$115.15 ,$397.55 ,$397.55 ,$94.73 ,$482.11 ,$460.89 ,$116.30 ,$33.02 ,$613.70 ,$120.90 ,$33.02 ,$562.02 ,$115.15 ,$581.40 ,$115.15 ,$581.40 ,$581.40 ,$581.40 ,$626.62 ,$523.26 ,$600.78 ,$555.56 ,$626.62 
SACRED HEART HOSPITAL (ACU),40200024,76802,HC US PREGNANCY <14 WEEKS ADDL,402,1 ,$519.00 ,$389.25 ,$33.02 ,$519.00 ,$334.24 , N/A ,$363.30 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$493.05 ,$33.02 ,$415.20 ,$477.48 ,$33.02 ,$441.15 ,$493.05 ,$456.72 ,$394.44 ,$33.02 ,$33.02 ,$33.02 ,$378.87 ,$285.45 ,$472.29 ,$472.29 ,$415.20 , N/A ,$285.45 ,$467.10 , N/A ,$467.10 ,$280.26 ,$487.86 , N/A ,$477.48 ,$35.00 ,$472.29 , N/A ,$319.39 ,$319.39 ,$67.30 ,$387.33 ,$460.89 , N/A ,$33.02 ,$493.05 , N/A ,$33.02 ,$451.53 , N/A ,$467.10 , N/A ,$467.10 ,$467.10 ,$467.10 ,$503.43 ,$420.39 ,$482.67 ,$446.34 ,$503.43 
SACRED HEART HOSPITAL (ACU),40200025,76805,HC US PREGNANCY >14 WEEKS SGL,402,1 ,$859.00 ,$644.25 ,$33.02 ,$859.00 ,$553.20 ,$115.15 ,$601.30 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$816.05 ,$33.02 ,$687.20 ,$790.28 ,$33.02 ,$730.15 ,$816.05 ,$755.92 ,$652.84 ,$33.02 ,$33.02 ,$33.02 ,$627.07 ,$472.45 ,$781.69 ,$781.69 ,$687.20 ,$118.60 ,$472.45 ,$773.10 ,$115.15 ,$773.10 ,$463.86 ,$807.46 ,$259.08 ,$790.28 ,$35.00 ,$781.69 ,$115.15 ,$528.63 ,$528.63 ,$303.92 ,$641.07 ,$460.89 ,$116.30 ,$33.02 ,$816.05 ,$120.90 ,$33.02 ,$747.33 ,$115.15 ,$773.10 ,$115.15 ,$773.10 ,$773.10 ,$773.10 ,$833.23 ,$695.79 ,$798.87 ,$738.74 ,$833.23 
SACRED HEART HOSPITAL (ACU),40200027,76810,HC US PREGNANCY >14 WEEKS ADDL,402,1 ,"$1,028.00 ",$771.00 ,$33.02 ,"$1,028.00 ",$662.03 , N/A ,$719.60 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$976.60 ,$33.02 ,$822.40 ,$945.76 ,$33.02 ,$873.80 ,$976.60 ,$904.64 ,$781.28 ,$33.02 ,$33.02 ,$33.02 ,$750.44 ,$565.40 ,$935.48 ,$935.48 ,$822.40 , N/A ,$565.40 ,$925.20 , N/A ,$925.20 ,$555.12 ,$966.32 , N/A ,$945.76 ,$35.00 ,$935.48 , N/A ,$632.63 ,$632.63 ,$649.81 ,$767.20 ,$460.89 , N/A ,$33.02 ,$976.60 , N/A ,$33.02 ,$894.36 , N/A ,$925.20 , N/A ,$925.20 ,$925.20 ,$925.20 ,$997.16 ,$832.68 ,$956.04 ,$884.08 ,$997.16 
SACRED HEART HOSPITAL (ACU),40200028,76811,HC US PREGNANCY DETAILED SGL,402,1 ,"$1,032.00 ",$774.00 ,$33.02 ,"$1,032.00 ",$664.61 ,$243.36 ,$722.40 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$980.40 ,$33.02 ,$825.60 ,$949.44 ,$33.02 ,$877.20 ,$980.40 ,$908.16 ,$784.32 ,$33.02 ,$33.02 ,$33.02 ,$753.36 ,$567.60 ,$939.12 ,$939.12 ,$825.60 ,$250.66 ,$567.60 ,$928.80 ,$243.36 ,$928.80 ,$557.28 ,$970.08 ,$547.56 ,$949.44 ,$35.00 ,$939.12 ,$243.36 ,$635.09 ,$635.09 ,$321.53 ,$770.18 ,$460.89 ,$245.79 ,$33.02 ,$980.40 ,$255.53 ,$33.02 ,$897.84 ,$243.36 ,$928.80 ,$243.36 ,$928.80 ,$928.80 ,$928.80 ,"$1,001.04 ",$835.92 ,$959.76 ,$887.52 ,"$1,001.04 "
SACRED HEART HOSPITAL (ACU),40200029,76812,HC US PREGNANCY DETAILED ADDL,402,1 ,$535.00 ,$401.25 ,$33.02 ,$535.00 ,$344.54 , N/A ,$374.50 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$508.25 ,$33.02 ,$428.00 ,$492.20 ,$33.02 ,$454.75 ,$508.25 ,$470.80 ,$406.60 ,$33.02 ,$33.02 ,$33.02 ,$390.55 ,$294.25 ,$486.85 ,$486.85 ,$428.00 , N/A ,$294.25 ,$481.50 , N/A ,$481.50 ,$288.90 ,$502.90 , N/A ,$492.20 ,$35.00 ,$486.85 , N/A ,$329.24 ,$329.24 ,$114.66 ,$399.27 ,$460.89 , N/A ,$33.02 ,$508.25 , N/A ,$33.02 ,$465.45 , N/A ,$481.50 , N/A ,$481.50 ,$481.50 ,$481.50 ,$518.95 ,$433.35 ,$497.55 ,$460.10 ,$518.95 
SACRED HEART HOSPITAL (ACU),40200030,76816,HC US OB GROWTH FOLLOWUP,402,1 ,$463.00 ,$347.25 ,$33.02 ,$463.00 ,$298.17 ,$115.15 ,$324.10 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$439.85 ,$33.02 ,$370.40 ,$425.96 ,$33.02 ,$393.55 ,$439.85 ,$407.44 ,$351.88 ,$33.02 ,$33.02 ,$33.02 ,$337.99 ,$254.65 ,$421.33 ,$421.33 ,$370.40 ,$118.60 ,$254.65 ,$416.70 ,$115.15 ,$416.70 ,$250.02 ,$435.22 ,$259.08 ,$425.96 ,$35.00 ,$421.33 ,$115.15 ,$284.93 ,$284.93 ,$238.50 ,$345.54 ,$416.70 ,$116.30 ,$33.02 ,$439.85 ,$120.90 ,$33.02 ,$402.81 ,$115.15 ,$416.70 ,$115.15 ,$416.70 ,$416.70 ,$416.70 ,$449.11 ,$375.03 ,$430.59 ,$398.18 ,$449.11 
SACRED HEART HOSPITAL (ACU),40200031,76815,HC US FETAL HEART BEAT,402,1 ,$411.00 ,$308.25 ,$33.02 ,$411.00 ,$264.68 ,$115.15 ,$287.70 ,$33.02 ,$411.00 ,$34.01 ,$342.00 ,$390.45 ,$33.02 ,$328.80 ,$378.12 ,$33.02 ,$349.35 ,$390.45 ,$361.68 ,$312.36 ,$33.02 ,$33.02 ,$33.02 ,$300.03 ,$226.05 ,$374.01 ,$374.01 ,$328.80 ,$118.60 ,$226.05 ,$369.90 ,$115.15 ,$369.90 ,$221.94 ,$386.34 ,$259.08 ,$378.12 ,$35.00 ,$374.01 ,$115.15 ,$252.93 ,$252.93 ,$193.78 ,$306.73 ,$369.90 ,$116.30 ,$33.02 ,$390.45 ,$120.90 ,$33.02 ,$357.57 ,$115.15 ,$369.90 ,$115.15 ,$369.90 ,$369.90 ,$369.90 ,$398.67 ,$332.91 ,$382.23 ,$353.46 ,$398.67 
SACRED HEART HOSPITAL (ACU),40200032,76817,HC US PREGNANCY TRANSVAGINAL,402,1 ,$683.00 ,$512.25 ,$33.02 ,$683.00 ,$439.85 ,$115.15 ,$478.10 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$648.85 ,$33.02 ,$546.40 ,$628.36 ,$33.02 ,$580.55 ,$648.85 ,$601.04 ,$519.08 ,$33.02 ,$33.02 ,$33.02 ,$498.59 ,$375.65 ,$621.53 ,$621.53 ,$546.40 ,$118.60 ,$375.65 ,$614.70 ,$115.15 ,$614.70 ,$368.82 ,$642.02 ,$259.08 ,$628.36 ,$35.00 ,$621.53 ,$115.15 ,$420.32 ,$420.32 ,$129.60 ,$509.72 ,$460.89 ,$116.30 ,$33.02 ,$648.85 ,$120.90 ,$33.02 ,$594.21 ,$115.15 ,$614.70 ,$115.15 ,$614.70 ,$614.70 ,$614.70 ,$662.51 ,$553.23 ,$635.19 ,$587.38 ,$662.51 
SACRED HEART HOSPITAL (ACU),40200033,76818,HC US FETAL BIO PROFILE W/NST,402,1 ,$578.00 ,$433.50 ,$33.02 ,$578.00 ,$372.23 ,$115.15 ,$404.60 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$549.10 ,$33.02 ,$462.40 ,$531.76 ,$33.02 ,$491.30 ,$549.10 ,$508.64 ,$439.28 ,$33.02 ,$33.02 ,$33.02 ,$421.94 ,$317.90 ,$525.98 ,$525.98 ,$462.40 ,$118.60 ,$317.90 ,$520.20 ,$115.15 ,$520.20 ,$312.12 ,$543.32 ,$259.08 ,$531.76 ,$35.00 ,$525.98 ,$115.15 ,$355.70 ,$355.70 ,$270.99 ,$431.36 ,$460.89 ,$116.30 ,$33.02 ,$549.10 ,$120.90 ,$33.02 ,$502.86 ,$115.15 ,$520.20 ,$115.15 ,$520.20 ,$520.20 ,$520.20 ,$560.66 ,$468.18 ,$537.54 ,$497.08 ,$560.66 
SACRED HEART HOSPITAL (ACU),40200034,76819,HC US FETAL BIO PROFILE W/O NST,402,1 ,$444.00 ,$333.00 ,$33.02 ,$444.00 ,$285.94 ,$115.15 ,$310.80 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$421.80 ,$33.02 ,$355.20 ,$408.48 ,$33.02 ,$377.40 ,$421.80 ,$390.72 ,$337.44 ,$33.02 ,$33.02 ,$33.02 ,$324.12 ,$244.20 ,$404.04 ,$404.04 ,$355.20 ,$118.60 ,$244.20 ,$399.60 ,$115.15 ,$399.60 ,$239.76 ,$417.36 ,$259.08 ,$408.48 ,$35.00 ,$404.04 ,$115.15 ,$273.24 ,$273.24 ,$162.35 ,$331.36 ,$399.60 ,$116.30 ,$33.02 ,$421.80 ,$120.90 ,$33.02 ,$386.28 ,$115.15 ,$399.60 ,$115.15 ,$399.60 ,$399.60 ,$399.60 ,$430.68 ,$359.64 ,$412.92 ,$381.84 ,$430.68 
SACRED HEART HOSPITAL (ACU),40200035,76819,HC US FETAL BIO PROFILE W/O NST EA ADDN,402,1 ,$340.00 ,$255.00 ,$33.02 ,$340.00 ,$218.96 ,$115.15 ,$238.00 ,$33.02 ,$340.00 ,$34.01 ,$340.00 ,$323.00 ,$33.02 ,$272.00 ,$312.80 ,$33.02 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$33.02 ,$33.02 ,$33.02 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 ,$118.60 ,$187.00 ,$306.00 ,$115.15 ,$306.00 ,$183.60 ,$319.60 ,$259.08 ,$312.80 ,$35.00 ,$309.40 ,$115.15 ,$209.24 ,$209.24 ,$162.35 ,$253.74 ,$306.00 ,$116.30 ,$33.02 ,$323.00 ,$120.90 ,$33.02 ,$295.80 ,$115.15 ,$306.00 ,$115.15 ,$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),40200038,76830,HC US TRANSVAGINAL,402,1 ,"$1,140.00 ",$855.00 ,$35.91 ,"$1,140.00 ",$734.16 ,$115.15 ,$798.00 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,"$1,083.00 ",$35.91 ,$912.00 ,"$1,048.80 ",$35.91 ,$969.00 ,"$1,083.00 ","$1,003.20 ",$866.40 ,$35.91 ,$35.91 ,$35.91 ,$832.20 ,$627.00 ,"$1,037.40 ","$1,037.40 ",$912.00 ,$118.60 ,$627.00 ,"$1,026.00 ",$115.15 ,"$1,026.00 ",$615.60 ,"$1,071.60 ",$259.08 ,"$1,048.80 ",$38.06 ,"$1,037.40 ",$115.15 ,$701.56 ,$701.56 ,$422.59 ,$850.78 ,$460.89 ,$116.30 ,$35.91 ,"$1,083.00 ",$120.90 ,$35.91 ,$991.80 ,$115.15 ,"$1,026.00 ",$115.15 ,"$1,026.00 ","$1,026.00 ","$1,026.00 ","$1,105.80 ",$923.40 ,"$1,060.20 ",$980.40 ,"$1,105.80 "
SACRED HEART HOSPITAL (ACU),40200040,76856,HC US PELVIS NON OB,402,1 ,"$1,010.00 ",$757.50 ,$54.52 ,"$1,010.00 ",$650.44 ,$115.15 ,$707.00 ,$54.52 ,$428.00 ,$56.16 ,$342.00 ,$959.50 ,$54.52 ,$808.00 ,$929.20 ,$54.52 ,$858.50 ,$959.50 ,$888.80 ,$767.60 ,$54.52 ,$54.52 ,$54.52 ,$737.30 ,$555.50 ,$919.10 ,$919.10 ,$808.00 ,$118.60 ,$555.50 ,$909.00 ,$115.15 ,$909.00 ,$545.40 ,$949.40 ,$259.08 ,$929.20 ,$57.79 ,$919.10 ,$115.15 ,$621.55 ,$621.55 ,$355.03 ,$753.76 ,$460.89 ,$116.30 ,$54.52 ,$959.50 ,$120.90 ,$54.52 ,$878.70 ,$115.15 ,$909.00 ,$115.15 ,$909.00 ,$909.00 ,$909.00 ,$979.70 ,$818.10 ,$939.30 ,$868.60 ,$979.70 
SACRED HEART HOSPITAL (ACU),40200041,76857,HC US PELVIS NON-OB LTD,402,1 ,$604.00 ,$453.00 ,$35.91 ,$604.00 ,$388.98 ,$115.15 ,$422.80 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$573.80 ,$35.91 ,$483.20 ,$555.68 ,$35.91 ,$513.40 ,$573.80 ,$531.52 ,$459.04 ,$35.91 ,$35.91 ,$35.91 ,$440.92 ,$332.20 ,$549.64 ,$549.64 ,$483.20 ,$118.60 ,$332.20 ,$543.60 ,$115.15 ,$543.60 ,$326.16 ,$567.76 ,$259.08 ,$555.68 ,$38.06 ,$549.64 ,$115.15 ,$371.70 ,$371.70 ,$209.22 ,$450.77 ,$460.89 ,$116.30 ,$35.91 ,$573.80 ,$120.90 ,$35.91 ,$525.48 ,$115.15 ,$543.60 ,$115.15 ,$543.60 ,$543.60 ,$543.60 ,$585.88 ,$489.24 ,$561.72 ,$519.44 ,$585.88 
SACRED HEART HOSPITAL (ACU),40200042,76870,HC US SCROTUM,402,1 ,$797.00 ,$597.75 ,$35.91 ,$797.00 ,$513.27 ,$115.15 ,$557.90 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$757.15 ,$35.91 ,$637.60 ,$733.24 ,$35.91 ,$677.45 ,$757.15 ,$701.36 ,$605.72 ,$35.91 ,$35.91 ,$35.91 ,$581.81 ,$438.35 ,$725.27 ,$725.27 ,$637.60 ,$118.60 ,$438.35 ,$717.30 ,$115.15 ,$717.30 ,$430.38 ,$749.18 ,$259.08 ,$733.24 ,$38.06 ,$725.27 ,$115.15 ,$490.47 ,$490.47 ,$399.71 ,$594.80 ,$460.89 ,$116.30 ,$35.91 ,$757.15 ,$120.90 ,$35.91 ,$693.39 ,$115.15 ,$717.30 ,$115.15 ,$717.30 ,$717.30 ,$717.30 ,$773.09 ,$645.57 ,$741.21 ,$685.42 ,$773.09 
SACRED HEART HOSPITAL (ACU),40200044,76873,HC US TRANSRECTAL PROSTATE VOLUME,402,1 ,"$1,050.00 ",$787.50 ,$54.52 ,"$1,050.00 ",$676.20 ,$115.15 ,$735.00 ,$54.52 ,$428.00 ,$56.16 ,$342.00 ,$997.50 ,$54.52 ,$840.00 ,$966.00 ,$54.52 ,$892.50 ,$997.50 ,$924.00 ,$798.00 ,$54.52 ,$54.52 ,$54.52 ,$766.50 ,$577.50 ,$955.50 ,$955.50 ,$840.00 ,$118.60 ,$577.50 ,$945.00 ,$115.15 ,$945.00 ,$567.00 ,$987.00 ,$259.08 ,$966.00 ,$57.79 ,$955.50 ,$115.15 ,$646.17 ,$646.17 ,$228.58 ,$783.62 ,$460.89 ,$116.30 ,$54.52 ,$997.50 ,$120.90 ,$54.52 ,$913.50 ,$115.15 ,$945.00 ,$115.15 ,$945.00 ,$945.00 ,$945.00 ,"$1,018.50 ",$850.50 ,$976.50 ,$903.00 ,"$1,018.50 "
SACRED HEART HOSPITAL (ACU),40200045,76881,HC US EXTREMITY NON VASCULAR COMP,402,1 ,$590.00 ,$442.50 ,$35.91 ,$590.00 ,$379.96 ,$115.15 ,$413.00 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$560.50 ,$35.91 ,$472.00 ,$542.80 ,$35.91 ,$501.50 ,$560.50 ,$519.20 ,$448.40 ,$35.91 ,$35.91 ,$35.91 ,$430.70 ,$324.50 ,$536.90 ,$536.90 ,$472.00 ,$118.60 ,$324.50 ,$531.00 ,$115.15 ,$531.00 ,$318.60 ,$554.60 ,$259.08 ,$542.80 ,$38.06 ,$536.90 ,$115.15 ,$363.09 ,$363.09 ,$173.86 ,$440.32 ,$460.89 ,$116.30 ,$35.91 ,$560.50 ,$120.90 ,$35.91 ,$513.30 ,$115.15 ,$531.00 ,$115.15 ,$531.00 ,$531.00 ,$531.00 ,$572.30 ,$477.90 ,$548.70 ,$507.40 ,$572.30 
SACRED HEART HOSPITAL (ACU),40200046,76882,HC US EXTREMITY NON VASCULAR LMTD,402,1 ,$470.00 ,$352.50 ,$35.91 ,$470.00 ,$302.68 ,$115.15 ,$329.00 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$446.50 ,$35.91 ,$376.00 ,$432.40 ,$35.91 ,$399.50 ,$446.50 ,$413.60 ,$357.20 ,$35.91 ,$35.91 ,$35.91 ,$343.10 ,$258.50 ,$427.70 ,$427.70 ,$376.00 ,$118.60 ,$258.50 ,$423.00 ,$115.15 ,$423.00 ,$253.80 ,$441.80 ,$259.08 ,$432.40 ,$38.06 ,$427.70 ,$115.15 ,$289.24 ,$289.24 ,$40.39 ,$350.76 ,$423.00 ,$116.30 ,$35.91 ,$446.50 ,$120.90 ,$35.91 ,$408.90 ,$115.15 ,$423.00 ,$115.15 ,$423.00 ,$423.00 ,$423.00 ,$455.90 ,$380.70 ,$437.10 ,$404.20 ,$455.90 
SACRED HEART HOSPITAL (ACU),40200048,76885,HC US HIPS INFANT DYNAMIC,402,1 ,$494.00 ,$370.50 ,$35.91 ,$494.00 ,$318.14 ,$85.55 ,$345.80 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$469.30 ,$35.91 ,$395.20 ,$454.48 ,$35.91 ,$419.90 ,$469.30 ,$434.72 ,$375.44 ,$35.91 ,$35.91 ,$35.91 ,$360.62 ,$271.70 ,$449.54 ,$449.54 ,$395.20 ,$88.12 ,$271.70 ,$444.60 ,$85.55 ,$444.60 ,$266.76 ,$464.36 ,$192.49 ,$454.48 ,$38.06 ,$449.54 ,$85.55 ,$304.01 ,$304.01 ,$171.00 ,$368.67 ,$444.60 ,$86.40 ,$35.91 ,$469.30 ,$89.83 ,$35.91 ,$429.78 ,$85.55 ,$444.60 ,$85.55 ,$444.60 ,$444.60 ,$444.60 ,$479.18 ,$400.14 ,$459.42 ,$424.84 ,$479.18 
SACRED HEART HOSPITAL (ACU),40200051,76937,HC US GUIDED VASCULAR ACCESS 76937,402,1 ,$511.00 ,$383.25 ,$36.75 ,$511.00 ,$329.08 , N/A ,$357.70 ,$36.75 ,$428.00 ,$37.85 ,$342.00 ,$485.45 ,$36.75 ,$408.80 ,$470.12 ,$36.75 ,$434.35 ,$485.45 ,$449.68 ,$388.36 ,$36.75 ,$36.75 ,$36.75 ,$373.03 ,$281.05 ,$465.01 ,$465.01 ,$408.80 , N/A ,$281.05 ,$459.90 , N/A ,$459.90 ,$275.94 ,$480.34 , N/A ,$470.12 ,$38.96 ,$465.01 , N/A ,$314.47 ,$314.47 ,$37.84 ,$381.36 ,$459.90 , N/A ,$36.75 ,$485.45 , N/A ,$36.75 ,$444.57 , N/A ,$459.90 , N/A ,$459.90 ,$459.90 ,$459.90 ,$495.67 ,$413.91 ,$475.23 ,$439.46 ,$495.67 
SACRED HEART HOSPITAL (ACU),40200052,76940,HC US GUIDANCE TISSUE ABLATION,402,1 ,$788.00 ,$591.00 ,$36.75 ,$788.00 ,$507.47 , N/A ,$551.60 ,$36.75 ,$428.00 ,$37.85 ,$342.00 ,$748.60 ,$36.75 ,$630.40 ,$724.96 ,$36.75 ,$669.80 ,$748.60 ,$693.44 ,$598.88 ,$36.75 ,$36.75 ,$36.75 ,$575.24 ,$433.40 ,$717.08 ,$717.08 ,$630.40 , N/A ,$433.40 ,$709.20 , N/A ,$709.20 ,$425.52 ,$740.72 , N/A ,$724.96 ,$38.96 ,$717.08 , N/A ,$484.94 ,$484.94 ,$145.73 ,$588.08 ,$460.89 , N/A ,$36.75 ,$748.60 , N/A ,$36.75 ,$685.56 , N/A ,$709.20 , N/A ,$709.20 ,$709.20 ,$709.20 ,$764.36 ,$638.28 ,$732.84 ,$677.68 ,$764.36 
SACRED HEART HOSPITAL (ACU),40200053,76942,HC US GUIDED NEEDLE PLCMT,402,1 ,$932.00 ,$699.00 ,$36.75 ,$932.00 ,$600.21 , N/A ,$652.40 ,$36.75 ,$428.00 ,$37.85 ,$342.00 ,$885.40 ,$36.75 ,$745.60 ,$857.44 ,$36.75 ,$792.20 ,$885.40 ,$820.16 ,$708.32 ,$36.75 ,$36.75 ,$36.75 ,$680.36 ,$512.60 ,$848.12 ,$848.12 ,$745.60 , N/A ,$512.60 ,$838.80 , N/A ,$838.80 ,$503.28 ,$876.08 , N/A ,$857.44 ,$38.96 ,$848.12 , N/A ,$573.55 ,$573.55 ,$370.51 ,$695.55 ,$460.89 , N/A ,$36.75 ,$885.40 , N/A ,$36.75 ,$810.84 , N/A ,$838.80 , N/A ,$838.80 ,$838.80 ,$838.80 ,$904.04 ,$754.92 ,$866.76 ,$801.52 ,$904.04 
SACRED HEART HOSPITAL (ACU),40200059,76946,HC US GUIDED AMNIOCENTESIS,402,1 ,$771.00 ,$578.25 ,$36.75 ,$771.00 ,$496.52 , N/A ,$539.70 ,$36.75 ,$428.00 ,$37.85 ,$342.00 ,$732.45 ,$36.75 ,$616.80 ,$709.32 ,$36.75 ,$655.35 ,$732.45 ,$678.48 ,$585.96 ,$36.75 ,$36.75 ,$36.75 ,$562.83 ,$424.05 ,$701.61 ,$701.61 ,$616.80 , N/A ,$424.05 ,$693.90 , N/A ,$693.90 ,$416.34 ,$724.74 , N/A ,$709.32 ,$38.96 ,$701.61 , N/A ,$474.47 ,$474.47 ,$327.98 ,$575.40 ,$460.89 , N/A ,$36.75 ,$732.45 , N/A ,$36.75 ,$670.77 , N/A ,$693.90 , N/A ,$693.90 ,$693.90 ,$693.90 ,$747.87 ,$624.51 ,$717.03 ,$663.06 ,$747.87 
SACRED HEART HOSPITAL (ACU),40200060,77387,HC US GUIDED RAD THRPY FIELDS,402,1 ,$262.00 ,$196.50 ,$38.15 ,$262.00 ,$168.73 , N/A ,$183.40 ,$38.15 ,$262.00 ,$39.29 ,$262.00 ,$248.90 ,$38.15 ,$209.60 ,$241.04 ,$38.15 ,$222.70 ,$248.90 ,$230.56 ,$199.12 ,$38.15 ,$38.15 ,$38.15 ,$191.26 ,$144.10 ,$238.42 ,$238.42 ,$209.60 , N/A ,$144.10 ,$235.80 , N/A ,$235.80 ,$141.48 ,$246.28 , N/A ,$241.04 ,$40.44 ,$238.42 , N/A ,$161.23 ,$161.23 ,$121.16 ,$195.53 ,$235.80 , N/A ,$38.15 ,$248.90 , N/A ,$38.15 ,$227.94 , N/A ,$235.80 , N/A ,$235.80 ,$235.80 ,$235.80 ,$254.14 ,$212.22 ,$243.66 ,$225.32 ,$254.14 
SACRED HEART HOSPITAL (ACU),40200061,76965,HC US GUIDED INTERSTITIAL THRPY,402,1 ,$687.00 ,$515.25 ,$36.75 ,$687.00 ,$442.43 , N/A ,$480.90 ,$36.75 ,$428.00 ,$37.85 ,$342.00 ,$652.65 ,$36.75 ,$549.60 ,$632.04 ,$36.75 ,$583.95 ,$652.65 ,$604.56 ,$522.12 ,$36.75 ,$36.75 ,$36.75 ,$501.51 ,$377.85 ,$625.17 ,$625.17 ,$549.60 , N/A ,$377.85 ,$618.30 , N/A ,$618.30 ,$370.98 ,$645.78 , N/A ,$632.04 ,$38.96 ,$625.17 , N/A ,$422.78 ,$422.78 ,$684.56 ,$512.71 ,$460.89 , N/A ,$36.75 ,$652.65 , N/A ,$36.75 ,$597.69 , N/A ,$618.30 , N/A ,$618.30 ,$618.30 ,$618.30 ,$666.39 ,$556.47 ,$638.91 ,$590.82 ,$666.39 
SACRED HEART HOSPITAL (ACU),40200062,76998,HC US INTRAOPERATIVE,402,1 ,$330.00 ,$247.50 ,$36.75 ,$330.00 ,$212.52 , N/A ,$231.00 ,$36.75 ,$330.00 ,$37.85 ,$330.00 ,$313.50 ,$36.75 ,$264.00 ,$303.60 ,$36.75 ,$280.50 ,$313.50 ,$290.40 ,$250.80 ,$36.75 ,$36.75 ,$36.75 ,$240.90 ,$181.50 ,$300.30 ,$300.30 ,$264.00 , N/A ,$181.50 ,$297.00 , N/A ,$297.00 ,$178.20 ,$310.20 , N/A ,$303.60 ,$38.96 ,$300.30 , N/A ,$203.08 ,$203.08 ,$122.39 ,$246.28 ,$297.00 , N/A ,$36.75 ,$313.50 , N/A ,$36.75 ,$287.10 , N/A ,$297.00 , N/A ,$297.00 ,$297.00 ,$297.00 ,$320.10 ,$267.30 ,$306.90 ,$283.80 ,$320.10 
SACRED HEART HOSPITAL (ACU),40200063,76999,HC UNLISTED PROCEDURE ULTRASOUND,402,1 ,$274.00 ,$205.50 ,$35.91 ,$274.00 ,$176.46 ,$85.55 ,$191.80 ,$35.91 ,$274.00 ,$36.99 ,$274.00 ,$260.30 ,$35.91 ,$219.20 ,$252.08 ,$35.91 ,$232.90 ,$260.30 ,$241.12 ,$208.24 ,$35.91 ,$35.91 ,$35.91 ,$200.02 ,$150.70 ,$249.34 ,$249.34 ,$219.20 ,$88.12 ,$150.70 ,$246.60 ,$85.55 ,$246.60 ,$147.96 ,$257.56 ,$192.49 ,$252.08 ,$38.06 ,$249.34 ,$85.55 ,$168.62 ,$168.62 ,$246.60 ,$204.49 ,$246.60 ,$86.40 ,$35.91 ,$260.30 ,$89.83 ,$35.91 ,$238.38 ,$85.55 ,$246.60 ,$85.55 ,$246.60 ,$246.60 ,$246.60 ,$265.78 ,$221.94 ,$254.82 ,$235.64 ,$265.78 
SACRED HEART HOSPITAL (ACU),40200064,93975,HC DUPLEX ABD/PEL/RETRO CMPL,402,1 ,$863.00 ,$647.25 ,$54.52 ,$863.00 ,$555.77 ,$243.36 ,$604.10 ,$54.52 ,$428.00 ,$56.16 ,$342.00 ,$819.85 ,$54.52 ,$690.40 ,$793.96 ,$54.52 ,$733.55 ,$819.85 ,$759.44 ,$655.88 ,$54.52 ,$54.52 ,$54.52 ,$629.99 ,$474.65 ,$785.33 ,$785.33 ,$690.40 ,$250.66 ,$474.65 ,$776.70 ,$243.36 ,$776.70 ,$466.02 ,$811.22 ,$547.56 ,$793.96 ,$57.79 ,$785.33 ,$243.36 ,$531.09 ,$531.09 ,$198.32 ,$644.06 ,$460.89 ,$245.79 ,$54.52 ,$819.85 ,$255.53 ,$54.52 ,$750.81 ,$243.36 ,$776.70 ,$243.36 ,$776.70 ,$776.70 ,$776.70 ,$837.11 ,$699.03 ,$802.59 ,$742.18 ,$837.11 
SACRED HEART HOSPITAL (ACU),40200067,93975,HC DUPLEX ABD/PEL/RETRO CMPL AORTA,402,1 ,$863.00 ,$647.25 ,$54.52 ,$863.00 ,$555.77 ,$243.36 ,$604.10 ,$54.52 ,$428.00 ,$56.16 ,$342.00 ,$819.85 ,$54.52 ,$690.40 ,$793.96 ,$54.52 ,$733.55 ,$819.85 ,$759.44 ,$655.88 ,$54.52 ,$54.52 ,$54.52 ,$629.99 ,$474.65 ,$785.33 ,$785.33 ,$690.40 ,$250.66 ,$474.65 ,$776.70 ,$243.36 ,$776.70 ,$466.02 ,$811.22 ,$547.56 ,$793.96 ,$57.79 ,$785.33 ,$243.36 ,$531.09 ,$531.09 ,$198.32 ,$644.06 ,$460.89 ,$245.79 ,$54.52 ,$819.85 ,$255.53 ,$54.52 ,$750.81 ,$243.36 ,$776.70 ,$243.36 ,$776.70 ,$776.70 ,$776.70 ,$837.11 ,$699.03 ,$802.59 ,$742.18 ,$837.11 
SACRED HEART HOSPITAL (ACU),40200068,93976,HC DUPLEX ABD/PEL/RETRO LTD,402,1 ,$340.00 ,$255.00 ,$54.52 ,$340.00 ,$218.96 ,$115.15 ,$238.00 ,$54.52 ,$340.00 ,$56.16 ,$340.00 ,$323.00 ,$54.52 ,$272.00 ,$312.80 ,$54.52 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$54.52 ,$54.52 ,$54.52 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 ,$118.60 ,$187.00 ,$306.00 ,$115.15 ,$306.00 ,$183.60 ,$319.60 ,$259.08 ,$312.80 ,$57.79 ,$309.40 ,$115.15 ,$209.24 ,$209.24 ,$267.97 ,$253.74 ,$306.00 ,$116.30 ,$54.52 ,$323.00 ,$120.90 ,$54.52 ,$295.80 ,$115.15 ,$306.00 ,$115.15 ,$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),40200071,93976,HC DUPLEX ABD/PEL/RETRO SCAN LTD AORTA,402,1 ,$824.00 ,$618.00 ,$54.52 ,$824.00 ,$530.66 ,$115.15 ,$576.80 ,$54.52 ,$428.00 ,$56.16 ,$342.00 ,$782.80 ,$54.52 ,$659.20 ,$758.08 ,$54.52 ,$700.40 ,$782.80 ,$725.12 ,$626.24 ,$54.52 ,$54.52 ,$54.52 ,$601.52 ,$453.20 ,$749.84 ,$749.84 ,$659.20 ,$118.60 ,$453.20 ,$741.60 ,$115.15 ,$741.60 ,$444.96 ,$774.56 ,$259.08 ,$758.08 ,$57.79 ,$749.84 ,$115.15 ,$507.09 ,$507.09 ,$267.97 ,$614.95 ,$460.89 ,$116.30 ,$54.52 ,$782.80 ,$120.90 ,$54.52 ,$716.88 ,$115.15 ,$741.60 ,$115.15 ,$741.60 ,$741.60 ,$741.60 ,$799.28 ,$667.44 ,$766.32 ,$708.64 ,$799.28 
SACRED HEART HOSPITAL (ACU),40200073,93978,HC DUPLEX AORTA/IVC/GRAFT CMPL,921,1 ,$921.00 ,$690.75 ,$54.52 ,$921.00 ,$593.12 ,$243.36 ,$644.70 ,$54.52 ,$764.43 ,$56.16 ,$607.86 ,$874.95 ,$54.52 ,$736.80 ,$847.32 ,$54.52 ,$782.85 ,$874.95 ,$810.48 ,$699.96 ,$54.52 ,$54.52 ,$54.52 ,$672.33 ,$506.55 ,$838.11 ,$838.11 ,$736.80 ,$250.66 ,$506.55 ,$828.90 ,$243.36 ,$828.90 ,$497.34 ,$865.74 ,$547.56 ,$847.32 ,$57.79 ,$838.11 ,$243.36 ,$566.78 ,$566.78 ,$828.90 ,$687.34 ,$641.48 ,$245.79 ,$54.52 ,$874.95 ,$255.53 ,$54.52 ,$801.27 ,$243.36 ,$828.90 ,$243.36 ,$828.90 ,$828.90 ,$828.90 ,$893.37 ,$746.01 ,$856.53 ,$792.06 ,$893.37 
SACRED HEART HOSPITAL (ACU),40200074,93979,HC DUPLEX AORTA/IVC/GRAFT LTD,402,1 ,$741.00 ,$555.75 ,$35.91 ,$741.00 ,$477.20 ,$115.15 ,$518.70 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$703.95 ,$35.91 ,$592.80 ,$681.72 ,$35.91 ,$629.85 ,$703.95 ,$652.08 ,$563.16 ,$35.91 ,$35.91 ,$35.91 ,$540.93 ,$407.55 ,$674.31 ,$674.31 ,$592.80 ,$118.60 ,$407.55 ,$666.90 ,$115.15 ,$666.90 ,$400.14 ,$696.54 ,$259.08 ,$681.72 ,$38.06 ,$674.31 ,$115.15 ,$456.01 ,$456.01 ,$134.44 ,$553.01 ,$460.89 ,$116.30 ,$35.91 ,$703.95 ,$120.90 ,$35.91 ,$644.67 ,$115.15 ,$666.90 ,$115.15 ,$666.90 ,$666.90 ,$666.90 ,$718.77 ,$600.21 ,$689.13 ,$637.26 ,$718.77 
SACRED HEART HOSPITAL (ACU),40200075,76706,HC US AORTA (SCREENING),402,1 ,$515.00 ,$386.25 ,$35.91 ,$515.00 ,$331.66 ,$115.15 ,$360.50 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$489.25 ,$35.91 ,$412.00 ,$473.80 ,$35.91 ,$437.75 ,$489.25 ,$453.20 ,$391.40 ,$35.91 ,$35.91 ,$35.91 ,$375.95 ,$283.25 ,$468.65 ,$468.65 ,$412.00 ,$118.60 ,$283.25 ,$463.50 ,$115.15 ,$463.50 ,$278.10 ,$484.10 ,$259.08 ,$473.80 ,$38.06 ,$468.65 ,$115.15 ,$316.93 ,$316.93 ,$182.08 ,$384.34 ,$460.89 ,$116.30 ,$35.91 ,$489.25 ,$120.90 ,$35.91 ,$448.05 ,$115.15 ,$463.50 ,$115.15 ,$463.50 ,$463.50 ,$463.50 ,$499.55 ,$417.15 ,$478.95 ,$442.90 ,$499.55 
SACRED HEART HOSPITAL (ACU),40200092,76813,HC US FETAL NUCHAL TRANSLUCENCY SNG,402,1 ,$577.00 ,$432.75 ,$33.02 ,$577.00 ,$371.59 ,$115.15 ,$403.90 ,$33.02 ,$428.00 ,$34.01 ,$342.00 ,$548.15 ,$33.02 ,$461.60 ,$530.84 ,$33.02 ,$490.45 ,$548.15 ,$507.76 ,$438.52 ,$33.02 ,$33.02 ,$33.02 ,$421.21 ,$317.35 ,$525.07 ,$525.07 ,$461.60 ,$118.60 ,$317.35 ,$519.30 ,$115.15 ,$519.30 ,$311.58 ,$542.38 ,$259.08 ,$530.84 ,$35.00 ,$525.07 ,$115.15 ,$355.09 ,$355.09 ,$136.94 ,$430.62 ,$460.89 ,$116.30 ,$33.02 ,$548.15 ,$120.90 ,$33.02 ,$501.99 ,$115.15 ,$519.30 ,$115.15 ,$519.30 ,$519.30 ,$519.30 ,$559.69 ,$467.37 ,$536.61 ,$496.22 ,$559.69 
SACRED HEART HOSPITAL (ACU),40200093,76814,HC US FETAL NUCHAL TRANSLUCENCY ADDL,402,1 ,$363.00 ,$272.25 ,$33.02 ,$363.00 ,$233.77 , N/A ,$254.10 ,$33.02 ,$363.00 ,$34.01 ,$342.00 ,$344.85 ,$33.02 ,$290.40 ,$333.96 ,$33.02 ,$308.55 ,$344.85 ,$319.44 ,$275.88 ,$33.02 ,$33.02 ,$33.02 ,$264.99 ,$199.65 ,$330.33 ,$330.33 ,$290.40 , N/A ,$199.65 ,$326.70 , N/A ,$326.70 ,$196.02 ,$341.22 , N/A ,$333.96 ,$35.00 ,$330.33 , N/A ,$223.39 ,$223.39 ,$95.93 ,$270.91 ,$326.70 , N/A ,$33.02 ,$344.85 , N/A ,$33.02 ,$315.81 , N/A ,$326.70 , N/A ,$326.70 ,$326.70 ,$326.70 ,$352.11 ,$294.03 ,$337.59 ,$312.18 ,$352.11 
SACRED HEART HOSPITAL (ACU),40200095,91200,HC LIVER ELASTOGRAPHY W/O IMAGE W/INTERP  AND  REPORT,402,1 ,$450.00 ,$337.50 ,$35.91 ,$450.00 ,$289.80 ,$147.66 ,$315.00 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$427.50 ,$35.91 ,$360.00 ,$414.00 ,$35.91 ,$382.50 ,$427.50 ,$396.00 ,$342.00 ,$35.91 ,$35.91 ,$35.91 ,$328.50 ,$247.50 ,$409.50 ,$409.50 ,$360.00 ,$152.09 ,$247.50 ,$405.00 ,$147.66 ,$405.00 ,$243.00 ,$423.00 ,$332.24 ,$414.00 ,$38.06 ,$409.50 ,$147.66 ,$276.93 ,$276.93 ,$405.00 ,$335.84 ,$405.00 ,$149.14 ,$35.91 ,$427.50 ,$155.05 ,$35.91 ,$391.50 ,$147.66 ,$405.00 ,$147.66 ,$405.00 ,$405.00 ,$405.00 ,$436.50 ,$364.50 ,$418.50 ,$387.00 ,$436.50 
SACRED HEART HOSPITAL (ACU),40200097,76816,HC US OB GROWTH FOLLOWUP EA ADDN,402,1 ,$340.00 ,$255.00 ,$33.02 ,$340.00 ,$218.96 ,$115.15 ,$238.00 ,$33.02 ,$340.00 ,$34.01 ,$340.00 ,$323.00 ,$33.02 ,$272.00 ,$312.80 ,$33.02 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$33.02 ,$33.02 ,$33.02 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 ,$118.60 ,$187.00 ,$306.00 ,$115.15 ,$306.00 ,$183.60 ,$319.60 ,$259.08 ,$312.80 ,$35.00 ,$309.40 ,$115.15 ,$209.24 ,$209.24 ,$238.50 ,$253.74 ,$306.00 ,$116.30 ,$33.02 ,$323.00 ,$120.90 ,$33.02 ,$295.80 ,$115.15 ,$306.00 ,$115.15 ,$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),40200101,76981,HC US ELASTOGRAPHY SINGLE ORGAN,402,1 ,$545.00 ,$408.75 ,$35.91 ,$545.00 ,$350.98 ,$115.15 ,$381.50 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$517.75 ,$35.91 ,$436.00 ,$501.40 ,$35.91 ,$463.25 ,$517.75 ,$479.60 ,$414.20 ,$35.91 ,$35.91 ,$35.91 ,$397.85 ,$299.75 ,$495.95 ,$495.95 ,$436.00 ,$118.60 ,$299.75 ,$490.50 ,$115.15 ,$490.50 ,$294.30 ,$512.30 ,$259.08 ,$501.40 ,$38.06 ,$495.95 ,$115.15 ,$335.39 ,$335.39 ,$490.50 ,$406.73 ,$460.89 ,$116.30 ,$35.91 ,$517.75 ,$120.90 ,$35.91 ,$474.15 ,$115.15 ,$490.50 ,$115.15 ,$490.50 ,$490.50 ,$490.50 ,$528.65 ,$441.45 ,$506.85 ,$468.70 ,$528.65 
SACRED HEART HOSPITAL (ACU),40200102,76982,HC US ELASTOGRAPHY FIRST LESION,402,1 ,$545.00 ,$408.75 ,$35.91 ,$545.00 ,$350.98 ,$115.15 ,$381.50 ,$35.91 ,$428.00 ,$36.99 ,$342.00 ,$517.75 ,$35.91 ,$436.00 ,$501.40 ,$35.91 ,$463.25 ,$517.75 ,$479.60 ,$414.20 ,$35.91 ,$35.91 ,$35.91 ,$397.85 ,$299.75 ,$495.95 ,$495.95 ,$436.00 ,$118.60 ,$299.75 ,$490.50 ,$115.15 ,$490.50 ,$294.30 ,$512.30 ,$259.08 ,$501.40 ,$38.06 ,$495.95 ,$115.15 ,$335.39 ,$335.39 ,$490.50 ,$406.73 ,$460.89 ,$116.30 ,$35.91 ,$517.75 ,$120.90 ,$35.91 ,$474.15 ,$115.15 ,$490.50 ,$115.15 ,$490.50 ,$490.50 ,$490.50 ,$528.65 ,$441.45 ,$506.85 ,$468.70 ,$528.65 
SACRED HEART HOSPITAL (ACU),40200103,76983,HC US ELASTOGRAPHY EA ADDL LESION,402,1 ,$325.00 ,$243.75 ,$35.91 ,$325.00 ,$209.30 , N/A ,$227.50 ,$35.91 ,$325.00 ,$36.99 ,$325.00 ,$308.75 ,$35.91 ,$260.00 ,$299.00 ,$35.91 ,$276.25 ,$308.75 ,$286.00 ,$247.00 ,$35.91 ,$35.91 ,$35.91 ,$237.25 ,$178.75 ,$295.75 ,$295.75 ,$260.00 , N/A ,$178.75 ,$292.50 , N/A ,$292.50 ,$175.50 ,$305.50 , N/A ,$299.00 ,$38.06 ,$295.75 , N/A ,$200.01 ,$200.01 ,$292.50 ,$242.55 ,$292.50 , N/A ,$35.91 ,$308.75 , N/A ,$35.91 ,$282.75 , N/A ,$292.50 , N/A ,$292.50 ,$292.50 ,$292.50 ,$315.25 ,$263.25 ,$302.25 ,$279.50 ,$315.25 
SACRED HEART HOSPITAL (ACU),40300003,77067,HC MAMMOGRAM SCREEN DIGI W/CAD,403,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$89.75 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$92.44 ,$164.24 ,$268.76 ,$89.75 ,$268.76 ,$161.25 ,$280.70 ,$201.94 ,$274.73 ,$17.43 ,$271.74 ,$89.75 ,$183.77 ,$183.77 ,$263.53 ,$222.86 ,$267.96 ,$90.65 ,$16.44 ,$283.69 ,$94.24 ,$16.44 ,$259.80 ,$89.75 ,$268.76 ,$89.75 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40300005,77067,HC MAMMOGRAM SCREEN W/CAD IMPLANT,403,1 ,$298.62 ,$223.97 ,$16.44 ,$298.62 ,$192.31 ,$89.75 ,$209.03 ,$16.44 ,$214.00 ,$16.93 ,$172.00 ,$283.69 ,$16.44 ,$238.90 ,$274.73 ,$16.44 ,$253.83 ,$283.69 ,$262.79 ,$226.95 ,$16.44 ,$16.44 ,$16.44 ,$217.99 ,$164.24 ,$271.74 ,$271.74 ,$238.90 ,$92.44 ,$164.24 ,$268.76 ,$89.75 ,$268.76 ,$161.25 ,$280.70 ,$201.94 ,$274.73 ,$17.43 ,$271.74 ,$89.75 ,$183.77 ,$183.77 ,$263.53 ,$222.86 ,$267.96 ,$90.65 ,$16.44 ,$283.69 ,$94.24 ,$16.44 ,$259.80 ,$89.75 ,$268.76 ,$89.75 ,$268.76 ,$268.76 ,$268.76 ,$289.66 ,$241.88 ,$277.72 ,$256.81 ,$289.66 
SACRED HEART HOSPITAL (ACU),40300006,77063,HC SCREEN DIGITAL BREAST TOMOSYTH BIL,403,1 ,$40.00 ,$30.00 ,$16.44 ,$51.35 ,$25.76 ,$22.82 ,$28.00 ,$16.44 ,$33.20 ,$16.93 ,$26.40 ,$38.00 ,$16.44 ,$32.00 ,$36.80 ,$16.44 ,$34.00 ,$38.00 ,$35.20 ,$30.40 ,$16.44 ,$16.44 ,$16.44 ,$29.20 ,$22.00 ,$36.40 ,$36.40 ,$32.00 ,$23.50 ,$22.00 ,$36.00 ,$22.82 ,$36.00 ,$21.60 ,$37.60 ,$51.35 ,$36.80 ,$17.43 ,$36.40 ,$22.82 ,$24.62 ,$24.62 ,$40.00 ,$29.85 , N/A ,$23.05 ,$16.44 ,$38.00 ,$23.96 ,$16.44 ,$34.80 ,$22.82 ,$36.00 ,$22.82 ,$36.00 ,$36.00 ,$36.00 ,$38.80 ,$32.40 ,$37.20 ,$34.40 ,$38.80 
SACRED HEART HOSPITAL (ACU),40400003,78814,HC PET W/CT TUMR LIMITED AREA,404,1 ,"$3,581.00 ","$2,685.75 ",$425.11 ,"$3,581.00 ","$2,306.16 ","$1,565.34 ","$2,506.70 ",$425.11 ,"$2,680.00 ",$437.86 ,"$2,143.00 ","$3,401.95 ",$425.11 ,"$2,864.80 ","$3,294.52 ",$425.11 ,"$3,043.85 ","$3,401.95 ","$3,151.28 ","$2,721.56 ",$425.11 ,$425.11 ,$425.11 ,"$2,614.13 ","$1,969.55 ","$3,258.71 ","$3,258.71 ","$2,864.80 ","$1,612.30 ","$1,969.55 ","$3,222.90 ","$1,565.34 ","$3,222.90 ","$1,933.74 ","$3,366.14 ","$3,522.02 ","$3,294.52 ",$450.62 ,"$3,258.71 ","$1,565.34 ","$2,203.75 ","$2,203.75 ",$543.86 ,"$2,672.50 ","$2,947.58 ","$1,580.99 ",$425.11 ,"$3,401.95 ","$1,643.61 ",$425.11 ,"$3,115.47 ","$1,565.34 ","$3,222.90 ","$1,565.34 ","$3,222.90 ","$3,222.90 ","$3,222.90 ","$3,473.57 ","$2,900.61 ","$3,330.33 ","$3,079.66 ","$3,473.57 "
SACRED HEART HOSPITAL (ACU),40400004,78815,HC PET W/CT TUMR SKULL MID-THIGH,404,1 ,"$3,523.00 ","$2,642.25 ",$425.11 ,"$3,523.00 ","$2,268.81 ","$1,565.34 ","$2,466.10 ",$425.11 ,"$2,680.00 ",$437.86 ,"$2,143.00 ","$3,346.85 ",$425.11 ,"$2,818.40 ","$3,241.16 ",$425.11 ,"$2,994.55 ","$3,346.85 ","$3,100.24 ","$2,677.48 ",$425.11 ,$425.11 ,$425.11 ,"$2,571.79 ","$1,937.65 ","$3,205.93 ","$3,205.93 ","$2,818.40 ","$1,612.30 ","$1,937.65 ","$3,170.70 ","$1,565.34 ","$3,170.70 ","$1,902.42 ","$3,311.62 ","$3,522.02 ","$3,241.16 ",$450.62 ,"$3,205.93 ","$1,565.34 ","$2,168.05 ","$2,168.05 ",$600.38 ,"$2,629.21 ","$2,947.58 ","$1,580.99 ",$425.11 ,"$3,346.85 ","$1,643.61 ",$425.11 ,"$3,065.01 ","$1,565.34 ","$3,170.70 ","$1,565.34 ","$3,170.70 ","$3,170.70 ","$3,170.70 ","$3,417.31 ","$2,853.63 ","$3,276.39 ","$3,029.78 ","$3,417.31 "
SACRED HEART HOSPITAL (ACU),40400005,78816,HC PET W/CT MELAN IMAG WHOLE BODY,404,1 ,"$3,367.00 ","$2,525.25 ",$425.11 ,"$3,522.02 ","$2,168.35 ","$1,565.34 ","$2,356.90 ",$425.11 ,"$2,680.00 ",$437.86 ,"$2,143.00 ","$3,198.65 ",$425.11 ,"$2,693.60 ","$3,097.64 ",$425.11 ,"$2,861.95 ","$3,198.65 ","$2,962.96 ","$2,558.92 ",$425.11 ,$425.11 ,$425.11 ,"$2,457.91 ","$1,851.85 ","$3,063.97 ","$3,063.97 ","$2,693.60 ","$1,612.30 ","$1,851.85 ","$3,030.30 ","$1,565.34 ","$3,030.30 ","$1,818.18 ","$3,164.98 ","$3,522.02 ","$3,097.64 ",$450.62 ,"$3,063.97 ","$1,565.34 ","$2,072.05 ","$2,072.05 ",$614.50 ,"$2,512.79 ","$2,947.58 ","$1,580.99 ",$425.11 ,"$3,198.65 ","$1,643.61 ",$425.11 ,"$2,929.29 ","$1,565.34 ","$3,030.30 ","$1,565.34 ","$3,030.30 ","$3,030.30 ","$3,030.30 ","$3,265.99 ","$2,727.27 ","$3,131.31 ","$2,895.62 ","$3,265.99 "
SACRED HEART HOSPITAL (ACU),40400006,78608,HC PET BRAIN LIMITED ALZHEIMERS,404,1 ,"$7,629.00 ","$5,721.75 ",$425.11 ,"$7,629.00 ","$4,913.08 ","$1,565.34 ","$5,340.30 ",$425.11 ,"$2,680.00 ",$437.86 ,"$2,143.00 ","$7,247.55 ",$425.11 ,"$6,103.20 ","$7,018.68 ",$425.11 ,"$6,484.65 ","$7,247.55 ","$6,713.52 ","$5,798.04 ",$425.11 ,$425.11 ,$425.11 ,"$5,569.17 ","$4,195.95 ","$6,942.39 ","$6,942.39 ","$6,103.20 ","$1,612.30 ","$4,195.95 ","$6,866.10 ","$1,565.34 ","$6,866.10 ","$4,119.66 ","$7,171.26 ","$3,522.02 ","$7,018.68 ",$450.62 ,"$6,942.39 ","$1,565.34 ","$4,694.89 ","$4,694.89 ",$442.32 ,"$5,693.52 ","$2,947.58 ","$1,580.99 ",$425.11 ,"$7,247.55 ","$1,643.61 ",$425.11 ,"$6,637.23 ","$1,565.34 ","$6,866.10 ","$1,565.34 ","$6,866.10 ","$6,866.10 ","$6,866.10 ","$7,400.13 ","$6,179.49 ","$7,094.97 ","$6,560.94 ","$7,400.13 "
SACRED HEART HOSPITAL (ACU),40400007,78459,HC PET MYOCARDIAL METABOLIC EVAL,404,1 ,"$3,743.00 ","$2,807.25 ",$263.76 ,"$3,743.00 ","$2,410.49 ","$1,382.11 ","$2,620.10 ",$425.11 ,"$2,680.00 ",$437.86 ,"$2,143.00 ","$3,555.85 ",$425.11 ,"$2,994.40 ","$3,443.56 ",$425.11 ,"$3,181.55 ","$3,555.85 ","$3,293.84 ","$2,844.68 ",$425.11 ,$425.11 ,$425.11 ,"$2,732.39 ","$2,058.65 ","$3,406.13 ","$3,406.13 ","$2,994.40 ","$1,423.57 ","$2,058.65 ","$3,368.70 ","$1,382.11 ","$3,368.70 ","$2,021.22 ","$3,518.42 ","$3,109.74 ","$3,443.56 ",$450.62 ,"$3,406.13 ","$1,382.11 ","$2,303.44 ","$2,303.44 ",$263.76 ,"$2,793.40 ","$2,947.58 ","$1,395.93 ",$425.11 ,"$3,555.85 ","$1,451.21 ",$425.11 ,"$3,256.41 ","$1,382.11 ","$3,368.70 ","$1,382.11 ","$3,368.70 ","$3,368.70 ","$3,368.70 ","$3,630.71 ","$3,031.83 ","$3,480.99 ","$3,218.98 ","$3,630.71 "
SACRED HEART HOSPITAL (ACU),41000002,31502,HC CHG TUBE TRACHEOTOMY,410,1 ,$683.00 ,$512.25 ,$36.07 ,$683.00 ,$439.85 ,$223.76 ,$478.10 ,$36.07 ,$566.89 ,$37.15 ,$450.78 ,$648.85 ,$36.07 ,$546.40 ,$628.36 ,$36.07 ,$580.55 ,$648.85 ,$601.04 ,$519.08 ,$36.07 ,$36.07 ,$36.07 ,$498.59 ,$375.65 ,$621.53 ,$621.53 ,$546.40 ,$230.47 ,$375.65 ,$614.70 ,$223.76 ,$614.70 ,$368.82 ,$642.02 ,$503.46 ,$628.36 ,$38.23 ,$621.53 ,$223.76 ,$420.32 ,$420.32 ,$614.70 ,$509.72 ,$475.71 ,$226.00 ,$36.07 ,$648.85 ,$234.95 ,$36.07 ,$594.21 ,$223.76 ,$614.70 ,$223.76 ,$614.70 ,$614.70 ,$614.70 ,$662.51 ,$553.23 ,$635.19 ,$587.38 ,$662.51 
SACRED HEART HOSPITAL (ACU),41000004,N/A,HC COUGH ASSIST,410,1 ,$45.00 ,$33.75 ,$24.30 ,$45.00 ,$28.98 , N/A ,$31.50 , N/A ,$37.35 , N/A ,$29.70 ,$42.75 , N/A ,$36.00 ,$41.40 , N/A ,$38.25 ,$42.75 ,$39.60 ,$34.20 , N/A , N/A , N/A ,$32.85 ,$24.75 ,$40.95 ,$40.95 ,$36.00 , N/A ,$24.75 ,$40.50 , N/A ,$40.50 ,$24.30 ,$42.30 , N/A ,$41.40 , N/A ,$40.95 , N/A ,$27.69 ,$27.69 ,$40.50 ,$33.58 ,$31.34 , N/A , N/A ,$42.75 , N/A , N/A ,$39.15 , N/A ,$40.50 , N/A ,$40.50 ,$40.50 ,$40.50 ,$43.65 ,$36.45 ,$41.85 ,$38.70 ,$43.65 
SACRED HEART HOSPITAL (ACU),41000005,92950,HC CPR,480,1 ,"$1,482.00 ","$1,111.50 ",$279.91 ,"$1,482.00 ",$954.41 ,$279.91 ,"$1,037.40 ",$295.01 ,"$1,230.06 ",$303.86 ,$978.12 ,"$1,407.90 ",$295.01 ,"$1,185.60 ","$1,363.44 ",$295.01 ,"$1,259.70 ","$1,407.90 ","$1,304.16 ","$1,126.32 ",$295.01 ,$295.01 ,$295.01 ,"$1,081.86 ",$815.10 ,"$1,348.62 ","$1,348.62 ","$1,185.60 ",$288.31 ,$815.10 ,"$1,333.80 ",$279.91 ,"$1,333.80 ",$800.28 ,"$1,393.08 ",$629.79 ,"$1,363.44 ",$312.71 ,"$1,348.62 ",$279.91 ,$912.02 ,$912.02 ,"$1,333.80 ","$1,106.02 ","$1,032.21 ",$282.71 ,$295.01 ,"$1,407.90 ",$293.90 ,$295.01 ,"$1,289.34 ",$279.91 ,"$1,333.80 ",$279.91 ,"$1,333.80 ","$1,333.80 ","$1,333.80 ","$1,437.54 ","$1,200.42 ","$1,378.26 ","$1,274.52 ","$1,437.54 "
SACRED HEART HOSPITAL (ACU),41000009,94002,HC VENT MANGMNT INPT/OBS INIT DAY,410,1 ,"$1,120.00 ",$840.00 ,$208.98 ,"$1,159.30 ",$721.28 ,$515.24 ,$784.00 ,$208.98 ,$929.60 ,$215.25 ,$739.20 ,"$1,064.00 ",$208.98 ,$896.00 ,"$1,030.40 ",$208.98 ,$952.00 ,"$1,064.00 ",$985.60 ,$851.20 ,$208.98 ,$208.98 ,$208.98 ,$817.60 ,$616.00 ,"$1,019.20 ","$1,019.20 ",$896.00 ,$530.70 ,$616.00 ,"$1,008.00 ",$515.24 ,"$1,008.00 ",$604.80 ,"$1,052.80 ","$1,159.30 ","$1,030.40 ",$221.52 ,"$1,019.20 ",$515.24 ,$689.25 ,$689.25 ,"$1,008.00 ",$835.86 ,$780.08 ,$520.39 ,$208.98 ,"$1,064.00 ",$541.00 ,$208.98 ,$974.40 ,$515.24 ,"$1,008.00 ",$515.24 ,"$1,008.00 ","$1,008.00 ","$1,008.00 ","$1,086.40 ",$907.20 ,"$1,041.60 ",$963.20 ,"$1,086.40 "
SACRED HEART HOSPITAL (ACU),41000013,94660,HC VENT NONINVAS ADULT INTL DAY,410,1 ,$699.00 ,$524.25 ,$40.28 ,$699.00 ,$450.16 ,$198.80 ,$489.30 ,$40.28 ,$580.17 ,$41.49 ,$461.34 ,$664.05 ,$40.28 ,$559.20 ,$643.08 ,$40.28 ,$594.15 ,$664.05 ,$615.12 ,$531.24 ,$40.28 ,$40.28 ,$40.28 ,$510.27 ,$384.45 ,$636.09 ,$636.09 ,$559.20 ,$204.76 ,$384.45 ,$629.10 ,$198.80 ,$629.10 ,$377.46 ,$657.06 ,$447.30 ,$643.08 ,$42.70 ,$636.09 ,$198.80 ,$430.16 ,$430.16 ,$629.10 ,$521.66 ,$486.85 ,$200.79 ,$40.28 ,$664.05 ,$208.74 ,$40.28 ,$608.13 ,$198.80 ,$629.10 ,$198.80 ,$629.10 ,$629.10 ,$629.10 ,$678.03 ,$566.19 ,$650.07 ,$601.14 ,$678.03 
SACRED HEART HOSPITAL (ACU),41000014,94002,HC VENT WEANING FIRST DAY,410,1 ,"$1,120.00 ",$840.00 ,$208.98 ,"$1,159.30 ",$721.28 ,$515.24 ,$784.00 ,$208.98 ,$929.60 ,$215.25 ,$739.20 ,"$1,064.00 ",$208.98 ,$896.00 ,"$1,030.40 ",$208.98 ,$952.00 ,"$1,064.00 ",$985.60 ,$851.20 ,$208.98 ,$208.98 ,$208.98 ,$817.60 ,$616.00 ,"$1,019.20 ","$1,019.20 ",$896.00 ,$530.70 ,$616.00 ,"$1,008.00 ",$515.24 ,"$1,008.00 ",$604.80 ,"$1,052.80 ","$1,159.30 ","$1,030.40 ",$221.52 ,"$1,019.20 ",$515.24 ,$689.25 ,$689.25 ,"$1,008.00 ",$835.86 ,$780.08 ,$520.39 ,$208.98 ,"$1,064.00 ",$541.00 ,$208.98 ,$974.40 ,$515.24 ,"$1,008.00 ",$515.24 ,"$1,008.00 ","$1,008.00 ","$1,008.00 ","$1,086.40 ",$907.20 ,"$1,041.60 ",$963.20 ,"$1,086.40 "
SACRED HEART HOSPITAL (ACU),41000015,94002,HC VENT NEONATAL INTL DAY,410,1 ,$501.00 ,$375.75 ,$208.98 ,"$1,159.30 ",$322.64 ,$515.24 ,$350.70 ,$208.98 ,$415.83 ,$215.25 ,$330.66 ,$475.95 ,$208.98 ,$400.80 ,$460.92 ,$208.98 ,$425.85 ,$475.95 ,$440.88 ,$380.76 ,$208.98 ,$208.98 ,$208.98 ,$365.73 ,$275.55 ,$455.91 ,$455.91 ,$400.80 ,$530.70 ,$275.55 ,$450.90 ,$515.24 ,$450.90 ,$270.54 ,$470.94 ,"$1,159.30 ",$460.92 ,$221.52 ,$455.91 ,$515.24 ,$308.32 ,$308.32 ,$450.90 ,$373.90 ,$348.95 ,$520.39 ,$208.98 ,$475.95 ,$541.00 ,$208.98 ,$435.87 ,$515.24 ,$450.90 ,$515.24 ,$450.90 ,$450.90 ,$450.90 ,$485.97 ,$405.81 ,$465.93 ,$430.86 ,$485.97 
SACRED HEART HOSPITAL (ACU),41000016,94660,HC VENT NONINVAS NEO INTL DAY,410,1 ,$699.00 ,$524.25 ,$40.28 ,$699.00 ,$450.16 ,$198.80 ,$489.30 ,$40.28 ,$580.17 ,$41.49 ,$461.34 ,$664.05 ,$40.28 ,$559.20 ,$643.08 ,$40.28 ,$594.15 ,$664.05 ,$615.12 ,$531.24 ,$40.28 ,$40.28 ,$40.28 ,$510.27 ,$384.45 ,$636.09 ,$636.09 ,$559.20 ,$204.76 ,$384.45 ,$629.10 ,$198.80 ,$629.10 ,$377.46 ,$657.06 ,$447.30 ,$643.08 ,$42.70 ,$636.09 ,$198.80 ,$430.16 ,$430.16 ,$629.10 ,$521.66 ,$486.85 ,$200.79 ,$40.28 ,$664.05 ,$208.74 ,$40.28 ,$608.13 ,$198.80 ,$629.10 ,$198.80 ,$629.10 ,$629.10 ,$629.10 ,$678.03 ,$566.19 ,$650.07 ,$601.14 ,$678.03 
SACRED HEART HOSPITAL (ACU),41000018,94660,HC VENT NONINVAS PEDS INTL DAY,410,1 ,$607.00 ,$455.25 ,$40.28 ,$607.00 ,$390.91 ,$198.80 ,$424.90 ,$40.28 ,$503.81 ,$41.49 ,$400.62 ,$576.65 ,$40.28 ,$485.60 ,$558.44 ,$40.28 ,$515.95 ,$576.65 ,$534.16 ,$461.32 ,$40.28 ,$40.28 ,$40.28 ,$443.11 ,$333.85 ,$552.37 ,$552.37 ,$485.60 ,$204.76 ,$333.85 ,$546.30 ,$198.80 ,$546.30 ,$327.78 ,$570.58 ,$447.30 ,$558.44 ,$42.70 ,$552.37 ,$198.80 ,$373.55 ,$373.55 ,$546.30 ,$453.00 ,$422.78 ,$200.79 ,$40.28 ,$576.65 ,$208.74 ,$40.28 ,$528.09 ,$198.80 ,$546.30 ,$198.80 ,$546.30 ,$546.30 ,$546.30 ,$588.79 ,$491.67 ,$564.51 ,$522.02 ,$588.79 
SACRED HEART HOSPITAL (ACU),41000027,94003,HC VENT MANGMNT INPT/OBS SUBS DAY,410,1 ,"$1,120.00 ",$840.00 ,$208.98 ,"$1,159.30 ",$721.28 ,$515.24 ,$784.00 ,$208.98 ,$929.60 ,$215.25 ,$739.20 ,"$1,064.00 ",$208.98 ,$896.00 ,"$1,030.40 ",$208.98 ,$952.00 ,"$1,064.00 ",$985.60 ,$851.20 ,$208.98 ,$208.98 ,$208.98 ,$817.60 ,$616.00 ,"$1,019.20 ","$1,019.20 ",$896.00 ,$530.70 ,$616.00 ,"$1,008.00 ",$515.24 ,"$1,008.00 ",$604.80 ,"$1,052.80 ","$1,159.30 ","$1,030.40 ",$221.52 ,"$1,019.20 ",$515.24 ,$689.25 ,$689.25 ,"$1,008.00 ",$835.86 ,$780.08 ,$520.39 ,$208.98 ,"$1,064.00 ",$541.00 ,$208.98 ,$974.40 ,$515.24 ,"$1,008.00 ",$515.24 ,"$1,008.00 ","$1,008.00 ","$1,008.00 ","$1,086.40 ",$907.20 ,"$1,041.60 ",$963.20 ,"$1,086.40 "
SACRED HEART HOSPITAL (ACU),41000029,94660,HC VENT NONINVAS ADLT SUBQ DAY,410,1 ,$323.00 ,$242.25 ,$40.28 ,$447.30 ,$208.01 ,$198.80 ,$226.10 ,$40.28 ,$268.09 ,$41.49 ,$213.18 ,$306.85 ,$40.28 ,$258.40 ,$297.16 ,$40.28 ,$274.55 ,$306.85 ,$284.24 ,$245.48 ,$40.28 ,$40.28 ,$40.28 ,$235.79 ,$177.65 ,$293.93 ,$293.93 ,$258.40 ,$204.76 ,$177.65 ,$290.70 ,$198.80 ,$290.70 ,$174.42 ,$303.62 ,$447.30 ,$297.16 ,$42.70 ,$293.93 ,$198.80 ,$198.77 ,$198.77 ,$290.70 ,$241.05 ,$224.97 ,$200.79 ,$40.28 ,$306.85 ,$208.74 ,$40.28 ,$281.01 ,$198.80 ,$290.70 ,$198.80 ,$290.70 ,$290.70 ,$290.70 ,$313.31 ,$261.63 ,$300.39 ,$277.78 ,$313.31 
SACRED HEART HOSPITAL (ACU),41000030,94003,HC VENT WEANING SUBQ DAY,410,1 ,"$1,120.00 ",$840.00 ,$208.98 ,"$1,159.30 ",$721.28 ,$515.24 ,$784.00 ,$208.98 ,$929.60 ,$215.25 ,$739.20 ,"$1,064.00 ",$208.98 ,$896.00 ,"$1,030.40 ",$208.98 ,$952.00 ,"$1,064.00 ",$985.60 ,$851.20 ,$208.98 ,$208.98 ,$208.98 ,$817.60 ,$616.00 ,"$1,019.20 ","$1,019.20 ",$896.00 ,$530.70 ,$616.00 ,"$1,008.00 ",$515.24 ,"$1,008.00 ",$604.80 ,"$1,052.80 ","$1,159.30 ","$1,030.40 ",$221.52 ,"$1,019.20 ",$515.24 ,$689.25 ,$689.25 ,"$1,008.00 ",$835.86 ,$780.08 ,$520.39 ,$208.98 ,"$1,064.00 ",$541.00 ,$208.98 ,$974.40 ,$515.24 ,"$1,008.00 ",$515.24 ,"$1,008.00 ","$1,008.00 ","$1,008.00 ","$1,086.40 ",$907.20 ,"$1,041.60 ",$963.20 ,"$1,086.40 "
SACRED HEART HOSPITAL (ACU),41000031,94003,HC VENT NEONATL SUBQ DAY,410,1 ,"$1,120.00 ",$840.00 ,$208.98 ,"$1,159.30 ",$721.28 ,$515.24 ,$784.00 ,$208.98 ,$929.60 ,$215.25 ,$739.20 ,"$1,064.00 ",$208.98 ,$896.00 ,"$1,030.40 ",$208.98 ,$952.00 ,"$1,064.00 ",$985.60 ,$851.20 ,$208.98 ,$208.98 ,$208.98 ,$817.60 ,$616.00 ,"$1,019.20 ","$1,019.20 ",$896.00 ,$530.70 ,$616.00 ,"$1,008.00 ",$515.24 ,"$1,008.00 ",$604.80 ,"$1,052.80 ","$1,159.30 ","$1,030.40 ",$221.52 ,"$1,019.20 ",$515.24 ,$689.25 ,$689.25 ,"$1,008.00 ",$835.86 ,$780.08 ,$520.39 ,$208.98 ,"$1,064.00 ",$541.00 ,$208.98 ,$974.40 ,$515.24 ,"$1,008.00 ",$515.24 ,"$1,008.00 ","$1,008.00 ","$1,008.00 ","$1,086.40 ",$907.20 ,"$1,041.60 ",$963.20 ,"$1,086.40 "
SACRED HEART HOSPITAL (ACU),41000033,94660,HC VENT NONINVAS PEDS SUBQ DAY,410,1 ,$699.00 ,$524.25 ,$40.28 ,$699.00 ,$450.16 ,$198.80 ,$489.30 ,$40.28 ,$580.17 ,$41.49 ,$461.34 ,$664.05 ,$40.28 ,$559.20 ,$643.08 ,$40.28 ,$594.15 ,$664.05 ,$615.12 ,$531.24 ,$40.28 ,$40.28 ,$40.28 ,$510.27 ,$384.45 ,$636.09 ,$636.09 ,$559.20 ,$204.76 ,$384.45 ,$629.10 ,$198.80 ,$629.10 ,$377.46 ,$657.06 ,$447.30 ,$643.08 ,$42.70 ,$636.09 ,$198.80 ,$430.16 ,$430.16 ,$629.10 ,$521.66 ,$486.85 ,$200.79 ,$40.28 ,$664.05 ,$208.74 ,$40.28 ,$608.13 ,$198.80 ,$629.10 ,$198.80 ,$629.10 ,$629.10 ,$629.10 ,$678.03 ,$566.19 ,$650.07 ,$601.14 ,$678.03 
SACRED HEART HOSPITAL (ACU),41000034,94640,HC IPPB,410,1 ,$389.00 ,$291.75 ,$16.90 ,$447.30 ,$250.52 ,$198.80 ,$272.30 ,$16.90 ,$322.87 ,$17.41 ,$256.74 ,$369.55 ,$16.90 ,$311.20 ,$357.88 ,$16.90 ,$330.65 ,$369.55 ,$342.32 ,$295.64 ,$16.90 ,$16.90 ,$16.90 ,$283.97 ,$213.95 ,$353.99 ,$353.99 ,$311.20 ,$204.76 ,$213.95 ,$350.10 ,$198.80 ,$350.10 ,$210.06 ,$365.66 ,$447.30 ,$357.88 ,$17.91 ,$353.99 ,$198.80 ,$239.39 ,$239.39 ,$350.10 ,$290.31 ,$270.94 ,$200.79 ,$16.90 ,$369.55 ,$208.74 ,$16.90 ,$338.43 ,$198.80 ,$350.10 ,$198.80 ,$350.10 ,$350.10 ,$350.10 ,$377.33 ,$315.09 ,$361.77 ,$334.54 ,$377.33 
SACRED HEART HOSPITAL (ACU),41000035,94640,HC NEBULIZER TREATMENT EACH,410,1 ,$159.00 ,$119.25 ,$16.90 ,$447.30 ,$102.40 ,$198.80 ,$111.30 ,$16.90 ,$131.97 ,$17.41 ,$104.94 ,$151.05 ,$16.90 ,$127.20 ,$146.28 ,$16.90 ,$135.15 ,$151.05 ,$139.92 ,$120.84 ,$16.90 ,$16.90 ,$16.90 ,$116.07 ,$87.45 ,$144.69 ,$144.69 ,$127.20 ,$204.76 ,$87.45 ,$143.10 ,$198.80 ,$143.10 ,$85.86 ,$149.46 ,$447.30 ,$146.28 ,$17.91 ,$144.69 ,$198.80 ,$97.85 ,$97.85 ,$143.10 ,$118.66 ,$110.74 ,$200.79 ,$16.90 ,$151.05 ,$208.74 ,$16.90 ,$138.33 ,$198.80 ,$143.10 ,$198.80 ,$143.10 ,$143.10 ,$143.10 ,$154.23 ,$128.79 ,$147.87 ,$136.74 ,$154.23 
SACRED HEART HOSPITAL (ACU),41000040,94640,HC EZ PAP TREATMENT,410,1 ,$389.00 ,$291.75 ,$16.90 ,$447.30 ,$250.52 ,$198.80 ,$272.30 ,$16.90 ,$322.87 ,$17.41 ,$256.74 ,$369.55 ,$16.90 ,$311.20 ,$357.88 ,$16.90 ,$330.65 ,$369.55 ,$342.32 ,$295.64 ,$16.90 ,$16.90 ,$16.90 ,$283.97 ,$213.95 ,$353.99 ,$353.99 ,$311.20 ,$204.76 ,$213.95 ,$350.10 ,$198.80 ,$350.10 ,$210.06 ,$365.66 ,$447.30 ,$357.88 ,$17.91 ,$353.99 ,$198.80 ,$239.39 ,$239.39 ,$350.10 ,$290.31 ,$270.94 ,$200.79 ,$16.90 ,$369.55 ,$208.74 ,$16.90 ,$338.43 ,$198.80 ,$350.10 ,$198.80 ,$350.10 ,$350.10 ,$350.10 ,$377.33 ,$315.09 ,$361.77 ,$334.54 ,$377.33 
SACRED HEART HOSPITAL (ACU),41000041,94640,HC MDI/DPI TX INITIAL,410,1 ,$146.00 ,$109.50 ,$16.90 ,$447.30 ,$94.02 ,$198.80 ,$102.20 ,$16.90 ,$121.18 ,$17.41 ,$96.36 ,$138.70 ,$16.90 ,$116.80 ,$134.32 ,$16.90 ,$124.10 ,$138.70 ,$128.48 ,$110.96 ,$16.90 ,$16.90 ,$16.90 ,$106.58 ,$80.30 ,$132.86 ,$132.86 ,$116.80 ,$204.76 ,$80.30 ,$131.40 ,$198.80 ,$131.40 ,$78.84 ,$137.24 ,$447.30 ,$134.32 ,$17.91 ,$132.86 ,$198.80 ,$89.85 ,$89.85 ,$131.40 ,$108.96 ,$101.69 ,$200.79 ,$16.90 ,$138.70 ,$208.74 ,$16.90 ,$127.02 ,$198.80 ,$131.40 ,$198.80 ,$131.40 ,$131.40 ,$131.40 ,$141.62 ,$118.26 ,$135.78 ,$125.56 ,$141.62 
SACRED HEART HOSPITAL (ACU),41000049,94642,HC AEROSOL INHALATION PENTAMIDINE,410,1 ,$293.00 ,$219.75 ,$16.90 ,$447.30 ,$188.69 ,$198.80 ,$205.10 ,$16.90 ,$243.19 ,$17.41 ,$193.38 ,$278.35 ,$16.90 ,$234.40 ,$269.56 ,$16.90 ,$249.05 ,$278.35 ,$257.84 ,$222.68 ,$16.90 ,$16.90 ,$16.90 ,$213.89 ,$161.15 ,$266.63 ,$266.63 ,$234.40 ,$204.76 ,$161.15 ,$263.70 ,$198.80 ,$263.70 ,$158.22 ,$275.42 ,$447.30 ,$269.56 ,$17.91 ,$266.63 ,$198.80 ,$180.31 ,$180.31 ,$263.70 ,$218.67 ,$204.07 ,$200.79 ,$16.90 ,$278.35 ,$208.74 ,$16.90 ,$254.91 ,$198.80 ,$263.70 ,$198.80 ,$263.70 ,$263.70 ,$263.70 ,$284.21 ,$237.33 ,$272.49 ,$251.98 ,$284.21 
SACRED HEART HOSPITAL (ACU),41000050,94644,HC AEROSOL CONTINUOUS 1ST HR,410,1 ,$488.89 ,$366.67 ,$16.90 ,$488.89 ,$314.85 ,$119.26 ,$342.22 ,$16.90 ,$405.78 ,$17.41 ,$322.67 ,$464.45 ,$16.90 ,$391.11 ,$449.78 ,$16.90 ,$415.56 ,$464.45 ,$430.22 ,$371.56 ,$16.90 ,$16.90 ,$16.90 ,$356.89 ,$268.89 ,$444.89 ,$444.89 ,$391.11 ,$122.84 ,$268.89 ,$440.00 ,$119.26 ,$440.00 ,$264.00 ,$459.56 ,$268.33 ,$449.78 ,$17.91 ,$444.89 ,$119.26 ,$300.86 ,$300.86 ,$440.00 ,$364.86 ,$340.51 ,$120.45 ,$16.90 ,$464.45 ,$125.22 ,$16.90 ,$425.33 ,$119.26 ,$440.00 ,$119.26 ,$440.00 ,$440.00 ,$440.00 ,$474.22 ,$396.00 ,$454.67 ,$420.45 ,$474.22 
SACRED HEART HOSPITAL (ACU),41000051,94645,HC AEROSOL CONTINUOUS ADDL HR,410,1 ,$165.65 ,$124.24 ,$16.90 ,$165.65 ,$106.68 , N/A ,$115.96 ,$16.90 ,$137.49 ,$17.41 ,$109.33 ,$157.37 ,$16.90 ,$132.52 ,$152.40 ,$16.90 ,$140.80 ,$157.37 ,$145.77 ,$125.89 ,$16.90 ,$16.90 ,$16.90 ,$120.92 ,$91.11 ,$150.74 ,$150.74 ,$132.52 , N/A ,$91.11 ,$149.09 , N/A ,$149.09 ,$89.45 ,$155.71 , N/A ,$152.40 ,$17.91 ,$150.74 , N/A ,$101.94 ,$101.94 ,$149.09 ,$123.62 ,$115.38 , N/A ,$16.90 ,$157.37 , N/A ,$16.90 ,$144.12 , N/A ,$149.09 , N/A ,$149.09 ,$149.09 ,$149.09 ,$160.68 ,$134.18 ,$154.05 ,$142.46 ,$160.68 
SACRED HEART HOSPITAL (ACU),41000052,94660,HC CPAP,410,1 ,$607.00 ,$455.25 ,$40.28 ,$607.00 ,$390.91 ,$198.80 ,$424.90 ,$40.28 ,$503.81 ,$41.49 ,$400.62 ,$576.65 ,$40.28 ,$485.60 ,$558.44 ,$40.28 ,$515.95 ,$576.65 ,$534.16 ,$461.32 ,$40.28 ,$40.28 ,$40.28 ,$443.11 ,$333.85 ,$552.37 ,$552.37 ,$485.60 ,$204.76 ,$333.85 ,$546.30 ,$198.80 ,$546.30 ,$327.78 ,$570.58 ,$447.30 ,$558.44 ,$42.70 ,$552.37 ,$198.80 ,$373.55 ,$373.55 ,$546.30 ,$453.00 ,$422.78 ,$200.79 ,$40.28 ,$576.65 ,$208.74 ,$40.28 ,$528.09 ,$198.80 ,$546.30 ,$198.80 ,$546.30 ,$546.30 ,$546.30 ,$588.79 ,$491.67 ,$564.51 ,$522.02 ,$588.79 
SACRED HEART HOSPITAL (ACU),41000053,94660,HC CPAP DAILY EST PT,410,1 ,$174.00 ,$130.50 ,$40.28 ,$447.30 ,$112.06 ,$198.80 ,$121.80 ,$40.28 ,$144.42 ,$41.49 ,$114.84 ,$165.30 ,$40.28 ,$139.20 ,$160.08 ,$40.28 ,$147.90 ,$165.30 ,$153.12 ,$132.24 ,$40.28 ,$40.28 ,$40.28 ,$127.02 ,$95.70 ,$158.34 ,$158.34 ,$139.20 ,$204.76 ,$95.70 ,$156.60 ,$198.80 ,$156.60 ,$93.96 ,$163.56 ,$447.30 ,$160.08 ,$42.70 ,$158.34 ,$198.80 ,$107.08 ,$107.08 ,$156.60 ,$129.86 ,$121.19 ,$200.79 ,$40.28 ,$165.30 ,$208.74 ,$40.28 ,$151.38 ,$198.80 ,$156.60 ,$198.80 ,$156.60 ,$156.60 ,$156.60 ,$168.78 ,$140.94 ,$161.82 ,$149.64 ,$168.78 
SACRED HEART HOSPITAL (ACU),41000054,94660,HC CPAP NEONATAL/DAY,410,1 ,$585.00 ,$438.75 ,$40.28 ,$585.00 ,$376.74 ,$198.80 ,$409.50 ,$40.28 ,$485.55 ,$41.49 ,$386.10 ,$555.75 ,$40.28 ,$468.00 ,$538.20 ,$40.28 ,$497.25 ,$555.75 ,$514.80 ,$444.60 ,$40.28 ,$40.28 ,$40.28 ,$427.05 ,$321.75 ,$532.35 ,$532.35 ,$468.00 ,$204.76 ,$321.75 ,$526.50 ,$198.80 ,$526.50 ,$315.90 ,$549.90 ,$447.30 ,$538.20 ,$42.70 ,$532.35 ,$198.80 ,$360.01 ,$360.01 ,$526.50 ,$436.59 ,$407.45 ,$200.79 ,$40.28 ,$555.75 ,$208.74 ,$40.28 ,$508.95 ,$198.80 ,$526.50 ,$198.80 ,$526.50 ,$526.50 ,$526.50 ,$567.45 ,$473.85 ,$544.05 ,$503.10 ,$567.45 
SACRED HEART HOSPITAL (ACU),41000057,94664,HC DEMO/EVAL/MDI/NEB DAILY,410,1 ,$146.00 ,$109.50 ,$16.90 ,$447.30 ,$94.02 ,$198.80 ,$102.20 ,$16.90 ,$121.18 ,$17.41 ,$96.36 ,$138.70 ,$16.90 ,$116.80 ,$134.32 ,$16.90 ,$124.10 ,$138.70 ,$128.48 ,$110.96 ,$16.90 ,$16.90 ,$16.90 ,$106.58 ,$80.30 ,$132.86 ,$132.86 ,$116.80 ,$204.76 ,$80.30 ,$131.40 ,$198.80 ,$131.40 ,$78.84 ,$137.24 ,$447.30 ,$134.32 ,$17.91 ,$132.86 ,$198.80 ,$89.85 ,$89.85 ,$131.40 ,$108.96 ,$101.69 ,$200.79 ,$16.90 ,$138.70 ,$208.74 ,$16.90 ,$127.02 ,$198.80 ,$131.40 ,$198.80 ,$131.40 ,$131.40 ,$131.40 ,$141.62 ,$118.26 ,$135.78 ,$125.56 ,$141.62 
SACRED HEART HOSPITAL (ACU),41000058,94667,HC CHEST PHYSIOTHRPY INIT,410,1 ,$107.00 ,$80.25 ,$16.90 ,$268.33 ,$68.91 ,$119.26 ,$74.90 ,$16.90 ,$88.81 ,$17.41 ,$70.62 ,$101.65 ,$16.90 ,$85.60 ,$98.44 ,$16.90 ,$90.95 ,$101.65 ,$94.16 ,$81.32 ,$16.90 ,$16.90 ,$16.90 ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 ,$122.84 ,$58.85 ,$96.30 ,$119.26 ,$96.30 ,$57.78 ,$100.58 ,$268.33 ,$98.44 ,$17.91 ,$97.37 ,$119.26 ,$65.85 ,$65.85 ,$96.30 ,$79.85 ,$74.53 ,$120.45 ,$16.90 ,$101.65 ,$125.22 ,$16.90 ,$93.09 ,$119.26 ,$96.30 ,$119.26 ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),41000059,94667,HC CHEST PHYSIOTHRPY INIT ACAPELLA,410,1 ,$145.00 ,$108.75 ,$16.90 ,$268.33 ,$93.38 ,$119.26 ,$101.50 ,$16.90 ,$120.35 ,$17.41 ,$95.70 ,$137.75 ,$16.90 ,$116.00 ,$133.40 ,$16.90 ,$123.25 ,$137.75 ,$127.60 ,$110.20 ,$16.90 ,$16.90 ,$16.90 ,$105.85 ,$79.75 ,$131.95 ,$131.95 ,$116.00 ,$122.84 ,$79.75 ,$130.50 ,$119.26 ,$130.50 ,$78.30 ,$136.30 ,$268.33 ,$133.40 ,$17.91 ,$131.95 ,$119.26 ,$89.23 ,$89.23 ,$130.50 ,$108.21 ,$100.99 ,$120.45 ,$16.90 ,$137.75 ,$125.22 ,$16.90 ,$126.15 ,$119.26 ,$130.50 ,$119.26 ,$130.50 ,$130.50 ,$130.50 ,$140.65 ,$117.45 ,$134.85 ,$124.70 ,$140.65 
SACRED HEART HOSPITAL (ACU),41000060,94668,HC CHEST PHYSIOTHRPY SUBSQ,410,1 ,$98.00 ,$73.50 ,$16.90 ,$268.33 ,$63.11 ,$119.26 ,$68.60 ,$16.90 ,$81.34 ,$17.41 ,$64.68 ,$93.10 ,$16.90 ,$78.40 ,$90.16 ,$16.90 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$16.90 ,$16.90 ,$16.90 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$122.84 ,$53.90 ,$88.20 ,$119.26 ,$88.20 ,$52.92 ,$92.12 ,$268.33 ,$90.16 ,$17.91 ,$89.18 ,$119.26 ,$60.31 ,$60.31 ,$88.20 ,$73.14 ,$68.26 ,$120.45 ,$16.90 ,$93.10 ,$125.22 ,$16.90 ,$85.26 ,$119.26 ,$88.20 ,$119.26 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),41000061,94668,HC CHEST PHYSIOTHRPY SUBSQ ACAPELLA,410,1 ,$145.00 ,$108.75 ,$16.90 ,$268.33 ,$93.38 ,$119.26 ,$101.50 ,$16.90 ,$120.35 ,$17.41 ,$95.70 ,$137.75 ,$16.90 ,$116.00 ,$133.40 ,$16.90 ,$123.25 ,$137.75 ,$127.60 ,$110.20 ,$16.90 ,$16.90 ,$16.90 ,$105.85 ,$79.75 ,$131.95 ,$131.95 ,$116.00 ,$122.84 ,$79.75 ,$130.50 ,$119.26 ,$130.50 ,$78.30 ,$136.30 ,$268.33 ,$133.40 ,$17.91 ,$131.95 ,$119.26 ,$89.23 ,$89.23 ,$130.50 ,$108.21 ,$100.99 ,$120.45 ,$16.90 ,$137.75 ,$125.22 ,$16.90 ,$126.15 ,$119.26 ,$130.50 ,$119.26 ,$130.50 ,$130.50 ,$130.50 ,$140.65 ,$117.45 ,$134.85 ,$124.70 ,$140.65 
SACRED HEART HOSPITAL (ACU),41000068,G0237,HC RESP STRENGTH/ENDURANCE,410,1 ,$61.00 ,$45.75 ,$11.55 ,$61.00 ,$39.28 ,$26.13 ,$42.70 ,$11.55 ,$50.63 ,$11.90 ,$40.26 ,$57.95 ,$11.55 ,$48.80 ,$56.12 ,$11.55 ,$51.85 ,$57.95 ,$53.68 ,$46.36 ,$11.55 ,$11.55 ,$11.55 ,$44.53 ,$33.55 ,$55.51 ,$55.51 ,$48.80 ,$26.91 ,$33.55 ,$54.90 ,$26.13 ,$54.90 ,$32.94 ,$57.34 ,$58.79 ,$56.12 ,$12.24 ,$55.51 ,$26.13 ,$37.54 ,$37.54 ,$54.90 ,$45.52 ,$42.49 ,$26.39 ,$11.55 ,$57.95 ,$27.43 ,$11.55 ,$53.07 ,$26.13 ,$54.90 ,$26.13 ,$54.90 ,$54.90 ,$54.90 ,$59.17 ,$49.41 ,$56.73 ,$52.46 ,$59.17 
SACRED HEART HOSPITAL (ACU),41000069,G0238,HC RESP THRP FUNCTION,410,1 ,$113.00 ,$84.75 ,$11.55 ,$113.00 ,$72.77 ,$26.13 ,$79.10 ,$11.55 ,$93.79 ,$11.90 ,$74.58 ,$107.35 ,$11.55 ,$90.40 ,$103.96 ,$11.55 ,$96.05 ,$107.35 ,$99.44 ,$85.88 ,$11.55 ,$11.55 ,$11.55 ,$82.49 ,$62.15 ,$102.83 ,$102.83 ,$90.40 ,$26.91 ,$62.15 ,$101.70 ,$26.13 ,$101.70 ,$61.02 ,$106.22 ,$58.79 ,$103.96 ,$12.24 ,$102.83 ,$26.13 ,$69.54 ,$69.54 ,$101.70 ,$84.33 ,$78.70 ,$26.39 ,$11.55 ,$107.35 ,$27.43 ,$11.55 ,$98.31 ,$26.13 ,$101.70 ,$26.13 ,$101.70 ,$101.70 ,$101.70 ,$109.61 ,$91.53 ,$105.09 ,$97.18 ,$109.61 
SACRED HEART HOSPITAL (ACU),41000070,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$570.00 ,$427.50 ,$11.55 ,$570.00 ,$367.08 ,$35.80 ,$399.00 ,$11.55 ,$473.10 ,$11.90 ,$376.20 ,$541.50 ,$11.55 ,$456.00 ,$524.40 ,$11.55 ,$484.50 ,$541.50 ,$501.60 ,$433.20 ,$11.55 ,$11.55 ,$11.55 ,$416.10 ,$313.50 ,$518.70 ,$518.70 ,$456.00 ,$36.87 ,$313.50 ,$513.00 ,$35.80 ,$513.00 ,$307.80 ,$535.80 ,$80.55 ,$524.40 ,$12.24 ,$518.70 ,$35.80 ,$350.78 ,$350.78 ,$513.00 ,$425.39 ,$397.01 ,$36.16 ,$11.55 ,$541.50 ,$37.59 ,$11.55 ,$495.90 ,$35.80 ,$513.00 ,$35.80 ,$513.00 ,$513.00 ,$513.00 ,$552.90 ,$461.70 ,$530.10 ,$490.20 ,$552.90 
SACRED HEART HOSPITAL (ACU),41000073,94660,HC VENT NONINVAS NEON SUBQ DAY,410,1 ,$585.00 ,$438.75 ,$40.28 ,$585.00 ,$376.74 ,$198.80 ,$409.50 ,$40.28 ,$485.55 ,$41.49 ,$386.10 ,$555.75 ,$40.28 ,$468.00 ,$538.20 ,$40.28 ,$497.25 ,$555.75 ,$514.80 ,$444.60 ,$40.28 ,$40.28 ,$40.28 ,$427.05 ,$321.75 ,$532.35 ,$532.35 ,$468.00 ,$204.76 ,$321.75 ,$526.50 ,$198.80 ,$526.50 ,$315.90 ,$549.90 ,$447.30 ,$538.20 ,$42.70 ,$532.35 ,$198.80 ,$360.01 ,$360.01 ,$526.50 ,$436.59 ,$407.45 ,$200.79 ,$40.28 ,$555.75 ,$208.74 ,$40.28 ,$508.95 ,$198.80 ,$526.50 ,$198.80 ,$526.50 ,$526.50 ,$526.50 ,$567.45 ,$473.85 ,$544.05 ,$503.10 ,$567.45 
SACRED HEART HOSPITAL (ACU),41000074,94640,HC IPPB SUBSQ,410,1 ,$153.00 ,$114.75 ,$16.90 ,$447.30 ,$98.53 ,$198.80 ,$107.10 ,$16.90 ,$126.99 ,$17.41 ,$100.98 ,$145.35 ,$16.90 ,$122.40 ,$140.76 ,$16.90 ,$130.05 ,$145.35 ,$134.64 ,$116.28 ,$16.90 ,$16.90 ,$16.90 ,$111.69 ,$84.15 ,$139.23 ,$139.23 ,$122.40 ,$204.76 ,$84.15 ,$137.70 ,$198.80 ,$137.70 ,$82.62 ,$143.82 ,$447.30 ,$140.76 ,$17.91 ,$139.23 ,$198.80 ,$94.16 ,$94.16 ,$137.70 ,$114.18 ,$106.56 ,$200.79 ,$16.90 ,$145.35 ,$208.74 ,$16.90 ,$133.11 ,$198.80 ,$137.70 ,$198.80 ,$137.70 ,$137.70 ,$137.70 ,$148.41 ,$123.93 ,$142.29 ,$131.58 ,$148.41 
SACRED HEART HOSPITAL (ACU),41000075,94640,HC IPV INIT,410,1 ,$389.00 ,$291.75 ,$16.90 ,$447.30 ,$250.52 ,$198.80 ,$272.30 ,$16.90 ,$322.87 ,$17.41 ,$256.74 ,$369.55 ,$16.90 ,$311.20 ,$357.88 ,$16.90 ,$330.65 ,$369.55 ,$342.32 ,$295.64 ,$16.90 ,$16.90 ,$16.90 ,$283.97 ,$213.95 ,$353.99 ,$353.99 ,$311.20 ,$204.76 ,$213.95 ,$350.10 ,$198.80 ,$350.10 ,$210.06 ,$365.66 ,$447.30 ,$357.88 ,$17.91 ,$353.99 ,$198.80 ,$239.39 ,$239.39 ,$350.10 ,$290.31 ,$270.94 ,$200.79 ,$16.90 ,$369.55 ,$208.74 ,$16.90 ,$338.43 ,$198.80 ,$350.10 ,$198.80 ,$350.10 ,$350.10 ,$350.10 ,$377.33 ,$315.09 ,$361.77 ,$334.54 ,$377.33 
SACRED HEART HOSPITAL (ACU),41000076,94640,HC NEBULIZER SUBSQ,410,1 ,$140.00 ,$105.00 ,$16.90 ,$447.30 ,$90.16 ,$198.80 ,$98.00 ,$16.90 ,$116.20 ,$17.41 ,$92.40 ,$133.00 ,$16.90 ,$112.00 ,$128.80 ,$16.90 ,$119.00 ,$133.00 ,$123.20 ,$106.40 ,$16.90 ,$16.90 ,$16.90 ,$102.20 ,$77.00 ,$127.40 ,$127.40 ,$112.00 ,$204.76 ,$77.00 ,$126.00 ,$198.80 ,$126.00 ,$75.60 ,$131.60 ,$447.30 ,$128.80 ,$17.91 ,$127.40 ,$198.80 ,$86.16 ,$86.16 ,$126.00 ,$104.48 ,$97.51 ,$200.79 ,$16.90 ,$133.00 ,$208.74 ,$16.90 ,$121.80 ,$198.80 ,$126.00 ,$198.80 ,$126.00 ,$126.00 ,$126.00 ,$135.80 ,$113.40 ,$130.20 ,$120.40 ,$135.80 
SACRED HEART HOSPITAL (ACU),41000077,94762,HC PULSE OX PER DAY,410,1 ,$293.70 ,$220.28 ,$16.90 ,$332.24 ,$189.14 ,$147.66 ,$205.59 ,$16.90 ,$243.77 ,$17.41 ,$193.84 ,$279.02 ,$16.90 ,$234.96 ,$270.20 ,$16.90 ,$249.65 ,$279.02 ,$258.46 ,$223.21 ,$16.90 ,$16.90 ,$16.90 ,$214.40 ,$161.54 ,$267.27 ,$267.27 ,$234.96 ,$152.09 ,$161.54 ,$264.33 ,$147.66 ,$264.33 ,$158.60 ,$276.08 ,$332.24 ,$270.20 ,$17.91 ,$267.27 ,$147.66 ,$180.74 ,$180.74 ,$264.33 ,$219.19 ,$204.56 ,$149.14 ,$16.90 ,$279.02 ,$155.05 ,$16.90 ,$255.52 ,$147.66 ,$264.33 ,$147.66 ,$264.33 ,$264.33 ,$264.33 ,$284.89 ,$237.90 ,$273.14 ,$252.58 ,$284.89 
SACRED HEART HOSPITAL (ACU),41000078,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$86.00 ,$64.50 ,$11.55 ,$86.00 ,$55.38 ,$35.80 ,$60.20 ,$11.55 ,$71.38 ,$11.90 ,$56.76 ,$81.70 ,$11.55 ,$68.80 ,$79.12 ,$11.55 ,$73.10 ,$81.70 ,$75.68 ,$65.36 ,$11.55 ,$11.55 ,$11.55 ,$62.78 ,$47.30 ,$78.26 ,$78.26 ,$68.80 ,$36.87 ,$47.30 ,$77.40 ,$35.80 ,$77.40 ,$46.44 ,$80.84 ,$80.55 ,$79.12 ,$12.24 ,$78.26 ,$35.80 ,$52.92 ,$52.92 ,$77.40 ,$64.18 ,$59.90 ,$36.16 ,$11.55 ,$81.70 ,$37.59 ,$11.55 ,$74.82 ,$35.80 ,$77.40 ,$35.80 ,$77.40 ,$77.40 ,$77.40 ,$83.42 ,$69.66 ,$79.98 ,$73.96 ,$83.42 
SACRED HEART HOSPITAL (ACU),41000079,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$173.00 ,$129.75 ,$11.55 ,$173.00 ,$111.41 ,$35.80 ,$121.10 ,$11.55 ,$143.59 ,$11.90 ,$114.18 ,$164.35 ,$11.55 ,$138.40 ,$159.16 ,$11.55 ,$147.05 ,$164.35 ,$152.24 ,$131.48 ,$11.55 ,$11.55 ,$11.55 ,$126.29 ,$95.15 ,$157.43 ,$157.43 ,$138.40 ,$36.87 ,$95.15 ,$155.70 ,$35.80 ,$155.70 ,$93.42 ,$162.62 ,$80.55 ,$159.16 ,$12.24 ,$157.43 ,$35.80 ,$106.46 ,$106.46 ,$155.70 ,$129.11 ,$120.49 ,$36.16 ,$11.55 ,$164.35 ,$37.59 ,$11.55 ,$150.51 ,$35.80 ,$155.70 ,$35.80 ,$155.70 ,$155.70 ,$155.70 ,$167.81 ,$140.13 ,$160.89 ,$148.78 ,$167.81 
SACRED HEART HOSPITAL (ACU),41000080,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$259.00 ,$194.25 ,$11.55 ,$259.00 ,$166.80 ,$35.80 ,$181.30 ,$11.55 ,$214.97 ,$11.90 ,$170.94 ,$246.05 ,$11.55 ,$207.20 ,$238.28 ,$11.55 ,$220.15 ,$246.05 ,$227.92 ,$196.84 ,$11.55 ,$11.55 ,$11.55 ,$189.07 ,$142.45 ,$235.69 ,$235.69 ,$207.20 ,$36.87 ,$142.45 ,$233.10 ,$35.80 ,$233.10 ,$139.86 ,$243.46 ,$80.55 ,$238.28 ,$12.24 ,$235.69 ,$35.80 ,$159.39 ,$159.39 ,$233.10 ,$193.29 ,$180.39 ,$36.16 ,$11.55 ,$246.05 ,$37.59 ,$11.55 ,$225.33 ,$35.80 ,$233.10 ,$35.80 ,$233.10 ,$233.10 ,$233.10 ,$251.23 ,$209.79 ,$240.87 ,$222.74 ,$251.23 
SACRED HEART HOSPITAL (ACU),41000081,G0239,HC THERAPEUTIC RT EXERCISE GROUP,410,1 ,$323.00 ,$242.25 ,$11.55 ,$323.00 ,$208.01 ,$35.80 ,$226.10 ,$11.55 ,$268.09 ,$11.90 ,$213.18 ,$306.85 ,$11.55 ,$258.40 ,$297.16 ,$11.55 ,$274.55 ,$306.85 ,$284.24 ,$245.48 ,$11.55 ,$11.55 ,$11.55 ,$235.79 ,$177.65 ,$293.93 ,$293.93 ,$258.40 ,$36.87 ,$177.65 ,$290.70 ,$35.80 ,$290.70 ,$174.42 ,$303.62 ,$80.55 ,$297.16 ,$12.24 ,$293.93 ,$35.80 ,$198.77 ,$198.77 ,$290.70 ,$241.05 ,$224.97 ,$36.16 ,$11.55 ,$306.85 ,$37.59 ,$11.55 ,$281.01 ,$35.80 ,$290.70 ,$35.80 ,$290.70 ,$290.70 ,$290.70 ,$313.31 ,$261.63 ,$300.39 ,$277.78 ,$313.31 
SACRED HEART HOSPITAL (ACU),41000082,94640,HC EZPAP TREATMENT SUBSQ,410,1 ,$389.00 ,$291.75 ,$16.90 ,$447.30 ,$250.52 ,$198.80 ,$272.30 ,$16.90 ,$322.87 ,$17.41 ,$256.74 ,$369.55 ,$16.90 ,$311.20 ,$357.88 ,$16.90 ,$330.65 ,$369.55 ,$342.32 ,$295.64 ,$16.90 ,$16.90 ,$16.90 ,$283.97 ,$213.95 ,$353.99 ,$353.99 ,$311.20 ,$204.76 ,$213.95 ,$350.10 ,$198.80 ,$350.10 ,$210.06 ,$365.66 ,$447.30 ,$357.88 ,$17.91 ,$353.99 ,$198.80 ,$239.39 ,$239.39 ,$350.10 ,$290.31 ,$270.94 ,$200.79 ,$16.90 ,$369.55 ,$208.74 ,$16.90 ,$338.43 ,$198.80 ,$350.10 ,$198.80 ,$350.10 ,$350.10 ,$350.10 ,$377.33 ,$315.09 ,$361.77 ,$334.54 ,$377.33 
SACRED HEART HOSPITAL (ACU),41000083,94660,HC CPAP/BIPAP SUBSQ,410,1 ,$585.00 ,$438.75 ,$40.28 ,$585.00 ,$376.74 ,$198.80 ,$409.50 ,$40.28 ,$485.55 ,$41.49 ,$386.10 ,$555.75 ,$40.28 ,$468.00 ,$538.20 ,$40.28 ,$497.25 ,$555.75 ,$514.80 ,$444.60 ,$40.28 ,$40.28 ,$40.28 ,$427.05 ,$321.75 ,$532.35 ,$532.35 ,$468.00 ,$204.76 ,$321.75 ,$526.50 ,$198.80 ,$526.50 ,$315.90 ,$549.90 ,$447.30 ,$538.20 ,$42.70 ,$532.35 ,$198.80 ,$360.01 ,$360.01 ,$526.50 ,$436.59 ,$407.45 ,$200.79 ,$40.28 ,$555.75 ,$208.74 ,$40.28 ,$508.95 ,$198.80 ,$526.50 ,$198.80 ,$526.50 ,$526.50 ,$526.50 ,$567.45 ,$473.85 ,$544.05 ,$503.10 ,$567.45 
SACRED HEART HOSPITAL (ACU),41000085,32601,HC PLEUROSCOPY,410,1 ,"$5,102.00 ","$3,826.50 ","$1,687.95 ","$12,041.00 ","$3,285.69 ","$5,351.56 ","$3,571.40 ","$1,687.95 ","$4,234.66 ","$1,738.59 ","$3,367.32 ","$4,846.90 ","$1,687.95 ","$4,081.60 ","$4,693.84 ","$1,687.95 ","$4,336.70 ","$4,846.90 ","$4,489.76 ","$3,877.52 ","$1,687.95 ","$1,687.95 ","$1,687.95 ","$3,724.46 ","$2,806.10 ","$4,642.82 ","$4,642.82 ","$4,081.60 ","$5,512.11 ","$2,806.10 ","$4,591.80 ","$5,351.56 ","$4,591.80 ","$2,755.08 ","$4,795.88 ","$12,041.00 ","$4,693.84 ","$1,789.23 ","$4,642.82 ","$5,351.56 ","$3,139.77 ","$3,139.77 ","$4,591.80 ","$3,807.62 ","$3,553.54 ","$5,405.07 ","$1,687.95 ","$4,846.90 ","$5,619.13 ","$1,687.95 ","$4,438.74 ","$5,351.56 ","$4,591.80 ","$5,351.56 ","$4,591.80 ","$4,591.80 ","$4,591.80 ","$4,948.94 ","$4,132.62 ","$4,744.86 ","$4,387.72 ","$4,948.94 "
SACRED HEART HOSPITAL (ACU),41000086,94640,HC IPV SUBSQ,410,1 ,$389.00 ,$291.75 ,$16.90 ,$447.30 ,$250.52 ,$198.80 ,$272.30 ,$16.90 ,$322.87 ,$17.41 ,$256.74 ,$369.55 ,$16.90 ,$311.20 ,$357.88 ,$16.90 ,$330.65 ,$369.55 ,$342.32 ,$295.64 ,$16.90 ,$16.90 ,$16.90 ,$283.97 ,$213.95 ,$353.99 ,$353.99 ,$311.20 ,$204.76 ,$213.95 ,$350.10 ,$198.80 ,$350.10 ,$210.06 ,$365.66 ,$447.30 ,$357.88 ,$17.91 ,$353.99 ,$198.80 ,$239.39 ,$239.39 ,$350.10 ,$290.31 ,$270.94 ,$200.79 ,$16.90 ,$369.55 ,$208.74 ,$16.90 ,$338.43 ,$198.80 ,$350.10 ,$198.80 ,$350.10 ,$350.10 ,$350.10 ,$377.33 ,$315.09 ,$361.77 ,$334.54 ,$377.33 
SACRED HEART HOSPITAL (ACU),41000087,94669,HC MECHANICAL CHEST WALL OSCILLATION INITIAL,410,1 ,$145.00 ,$108.75 ,$16.90 ,$447.30 ,$93.38 ,$198.80 ,$101.50 ,$16.90 ,$120.35 ,$17.41 ,$95.70 ,$137.75 ,$16.90 ,$116.00 ,$133.40 ,$16.90 ,$123.25 ,$137.75 ,$127.60 ,$110.20 ,$16.90 ,$16.90 ,$16.90 ,$105.85 ,$79.75 ,$131.95 ,$131.95 ,$116.00 ,$204.76 ,$79.75 ,$130.50 ,$198.80 ,$130.50 ,$78.30 ,$136.30 ,$447.30 ,$133.40 ,$17.91 ,$131.95 ,$198.80 ,$89.23 ,$89.23 ,$130.50 ,$108.21 ,$100.99 ,$200.79 ,$16.90 ,$137.75 ,$208.74 ,$16.90 ,$126.15 ,$198.80 ,$130.50 ,$198.80 ,$130.50 ,$130.50 ,$130.50 ,$140.65 ,$117.45 ,$134.85 ,$124.70 ,$140.65 
SACRED HEART HOSPITAL (ACU),41000088,94669,HC MECHANICAL CHEST WALL OSCILLATION SUBSQ,410,1 ,$145.00 ,$108.75 ,$16.90 ,$447.30 ,$93.38 ,$198.80 ,$101.50 ,$16.90 ,$120.35 ,$17.41 ,$95.70 ,$137.75 ,$16.90 ,$116.00 ,$133.40 ,$16.90 ,$123.25 ,$137.75 ,$127.60 ,$110.20 ,$16.90 ,$16.90 ,$16.90 ,$105.85 ,$79.75 ,$131.95 ,$131.95 ,$116.00 ,$204.76 ,$79.75 ,$130.50 ,$198.80 ,$130.50 ,$78.30 ,$136.30 ,$447.30 ,$133.40 ,$17.91 ,$131.95 ,$198.80 ,$89.23 ,$89.23 ,$130.50 ,$108.21 ,$100.99 ,$200.79 ,$16.90 ,$137.75 ,$208.74 ,$16.90 ,$126.15 ,$198.80 ,$130.50 ,$198.80 ,$130.50 ,$130.50 ,$130.50 ,$140.65 ,$117.45 ,$134.85 ,$124.70 ,$140.65 
SACRED HEART HOSPITAL (ACU),41000090,94640,HC MDI/DPI INHAL TX SUBSQ,410,1 ,$140.00 ,$105.00 ,$16.90 ,$447.30 ,$90.16 ,$198.80 ,$98.00 ,$16.90 ,$116.20 ,$17.41 ,$92.40 ,$133.00 ,$16.90 ,$112.00 ,$128.80 ,$16.90 ,$119.00 ,$133.00 ,$123.20 ,$106.40 ,$16.90 ,$16.90 ,$16.90 ,$102.20 ,$77.00 ,$127.40 ,$127.40 ,$112.00 ,$204.76 ,$77.00 ,$126.00 ,$198.80 ,$126.00 ,$75.60 ,$131.60 ,$447.30 ,$128.80 ,$17.91 ,$127.40 ,$198.80 ,$86.16 ,$86.16 ,$126.00 ,$104.48 ,$97.51 ,$200.79 ,$16.90 ,$133.00 ,$208.74 ,$16.90 ,$121.80 ,$198.80 ,$126.00 ,$198.80 ,$126.00 ,$126.00 ,$126.00 ,$135.80 ,$113.40 ,$130.20 ,$120.40 ,$135.80 
SACRED HEART HOSPITAL (ACU),42000002,29580,HC APPLY UNNA BOOT BILATERAL PT/OT,420,1 ,$410.00 ,$307.50 ,$61.15 ,$410.00 ,$264.04 ,$149.42 ,$287.00 , N/A ,$268.00 , N/A ,$214.00 ,$389.50 ,$61.15 ,$328.00 ,$377.20 , N/A ,$348.50 ,$389.50 ,$360.80 ,$311.60 ,$61.15 ,$61.15 , N/A ,$299.30 ,$225.50 ,$373.10 ,$373.10 ,$328.00 ,$153.90 ,$225.50 ,$369.00 ,$149.42 ,$369.00 ,$221.40 ,$385.40 ,$336.20 ,$377.20 ,$64.82 ,$373.10 ,$149.42 ,$252.31 ,$252.31 ,$369.00 ,$305.98 ,$155.42 ,$150.92 ,$287.00 ,$389.50 ,$156.89 ,$61.15 ,$356.70 ,$149.42 ,$369.00 ,$149.42 ,$369.00 ,$369.00 ,$369.00 ,$397.70 ,$332.10 ,$381.30 ,$352.60 ,$397.70 
SACRED HEART HOSPITAL (ACU),42000009,97012,HC TRACTION MECH APP,420,1 ,$110.00 ,$82.50 ,$10.49 ,$110.00 ,$70.84 ,$13.97 ,$77.00 ,$25.78 ,$110.00 , N/A ,$110.00 ,$104.50 ,$10.49 ,$88.00 ,$101.20 ,$25.78 ,$93.50 ,$104.50 ,$96.80 ,$83.60 ,$10.49 ,$10.49 ,$25.78 ,$80.30 ,$60.50 ,$100.10 ,$100.10 ,$88.00 ,$14.39 ,$60.50 ,$99.00 ,$13.97 ,$99.00 ,$59.40 ,$103.40 ,$31.43 ,$101.20 ,$11.12 ,$100.10 ,$13.97 ,$67.69 ,$67.69 ,$99.00 ,$82.09 ,$99.00 ,$14.11 ,$25.78 ,$104.50 ,$14.67 ,$10.49 ,$95.70 ,$13.97 ,$99.00 ,$13.97 ,$99.00 ,$99.00 ,$99.00 ,$106.70 ,$89.10 ,$102.30 ,$94.60 ,$106.70 
SACRED HEART HOSPITAL (ACU),42000010,97016,HC APPLY VASOPNEUMATIC DEVICE,420,1 ,$126.00 ,$94.50 ,$10.49 ,$126.00 ,$81.14 ,$11.55 ,$88.20 ,$25.19 ,$126.00 , N/A ,$126.00 ,$119.70 ,$10.49 ,$100.80 ,$115.92 ,$25.19 ,$107.10 ,$119.70 ,$110.88 ,$95.76 ,$10.49 ,$10.49 ,$25.19 ,$91.98 ,$69.30 ,$114.66 ,$114.66 ,$100.80 ,$11.90 ,$69.30 ,$113.40 ,$11.55 ,$113.40 ,$68.04 ,$118.44 ,$25.99 ,$115.92 ,$11.12 ,$114.66 ,$11.55 ,$77.54 ,$77.54 ,$113.40 ,$94.03 ,$113.40 ,$11.67 ,$25.19 ,$119.70 ,$12.13 ,$10.49 ,$109.62 ,$11.55 ,$113.40 ,$11.55 ,$113.40 ,$113.40 ,$113.40 ,$122.22 ,$102.06 ,$117.18 ,$108.36 ,$122.22 
SACRED HEART HOSPITAL (ACU),42000015,97022,HC WHIRLPOOL BATH,420,1 ,$117.00 ,$87.75 ,$10.49 ,$117.00 ,$75.35 ,$16.74 ,$81.90 ,$25.78 ,$117.00 , N/A ,$117.00 ,$111.15 ,$10.49 ,$93.60 ,$107.64 ,$25.78 ,$99.45 ,$111.15 ,$102.96 ,$88.92 ,$10.49 ,$10.49 ,$25.78 ,$85.41 ,$64.35 ,$106.47 ,$106.47 ,$93.60 ,$17.24 ,$64.35 ,$105.30 ,$16.74 ,$105.30 ,$63.18 ,$109.98 ,$37.67 ,$107.64 ,$11.12 ,$106.47 ,$16.74 ,$72.00 ,$72.00 ,$105.30 ,$87.32 ,$105.30 ,$16.91 ,$25.78 ,$111.15 ,$17.58 ,$10.49 ,$101.79 ,$16.74 ,$105.30 ,$16.74 ,$105.30 ,$105.30 ,$105.30 ,$113.49 ,$94.77 ,$108.81 ,$100.62 ,$113.49 
SACRED HEART HOSPITAL (ACU),42000020,97022,HC FLUIDOTHERAPY,420,1 ,$114.00 ,$85.50 ,$10.49 ,$114.00 ,$73.42 ,$16.74 ,$79.80 ,$25.78 ,$114.00 , N/A ,$114.00 ,$108.30 ,$10.49 ,$91.20 ,$104.88 ,$25.78 ,$96.90 ,$108.30 ,$100.32 ,$86.64 ,$10.49 ,$10.49 ,$25.78 ,$83.22 ,$62.70 ,$103.74 ,$103.74 ,$91.20 ,$17.24 ,$62.70 ,$102.60 ,$16.74 ,$102.60 ,$61.56 ,$107.16 ,$37.67 ,$104.88 ,$11.12 ,$103.74 ,$16.74 ,$70.16 ,$70.16 ,$102.60 ,$85.08 ,$102.60 ,$16.91 ,$25.78 ,$108.30 ,$17.58 ,$10.49 ,$99.18 ,$16.74 ,$102.60 ,$16.74 ,$102.60 ,$102.60 ,$102.60 ,$110.58 ,$92.34 ,$106.02 ,$98.04 ,$110.58 
SACRED HEART HOSPITAL (ACU),42000025,97032,HC ELECTRIC STIM EACH 15 MIN,420,1 ,$120.00 ,$90.00 ,$10.49 ,$120.00 ,$77.28 ,$14.30 ,$84.00 ,$22.38 ,$120.00 , N/A ,$120.00 ,$114.00 ,$10.49 ,$96.00 ,$110.40 ,$22.38 ,$102.00 ,$114.00 ,$105.60 ,$91.20 ,$10.49 ,$10.49 ,$22.38 ,$87.60 ,$66.00 ,$109.20 ,$109.20 ,$96.00 ,$14.73 ,$66.00 ,$108.00 ,$14.30 ,$108.00 ,$64.80 ,$112.80 ,$32.18 ,$110.40 ,$11.12 ,$109.20 ,$14.30 ,$73.85 ,$73.85 ,$108.00 ,$89.56 ,$108.00 ,$14.44 ,$22.38 ,$114.00 ,$15.02 ,$10.49 ,$104.40 ,$14.30 ,$108.00 ,$14.30 ,$108.00 ,$108.00 ,$108.00 ,$116.40 ,$97.20 ,$111.60 ,$103.20 ,$116.40 
SACRED HEART HOSPITAL (ACU),42000031,97033,HC IONTOPHORESIS; EA 15 MIN,420,1 ,$151.00 ,$113.25 ,$10.49 ,$151.00 ,$97.24 ,$19.21 ,$105.70 ,$23.51 ,$151.00 , N/A ,$151.00 ,$143.45 ,$10.49 ,$120.80 ,$138.92 ,$23.51 ,$128.35 ,$143.45 ,$132.88 ,$114.76 ,$10.49 ,$10.49 ,$23.51 ,$110.23 ,$83.05 ,$137.41 ,$137.41 ,$120.80 ,$19.79 ,$83.05 ,$135.90 ,$19.21 ,$135.90 ,$81.54 ,$141.94 ,$43.22 ,$138.92 ,$11.12 ,$137.41 ,$19.21 ,$92.93 ,$92.93 ,$135.90 ,$112.69 ,$135.90 ,$19.40 ,$23.51 ,$143.45 ,$20.17 ,$10.49 ,$131.37 ,$19.21 ,$135.90 ,$19.21 ,$135.90 ,$135.90 ,$135.90 ,$146.47 ,$122.31 ,$140.43 ,$129.86 ,$146.47 
SACRED HEART HOSPITAL (ACU),42000033,97035,HC ULTRASOUND EA 15MIN,420,1 ,$139.00 ,$104.25 ,$10.49 ,$139.00 ,$89.52 ,$13.89 ,$97.30 ,$18.49 ,$139.00 , N/A ,$139.00 ,$132.05 ,$10.49 ,$111.20 ,$127.88 ,$18.49 ,$118.15 ,$132.05 ,$122.32 ,$105.64 ,$10.49 ,$10.49 ,$18.49 ,$101.47 ,$76.45 ,$126.49 ,$126.49 ,$111.20 ,$14.31 ,$76.45 ,$125.10 ,$13.89 ,$125.10 ,$75.06 ,$130.66 ,$31.25 ,$127.88 ,$11.12 ,$126.49 ,$13.89 ,$85.54 ,$85.54 ,$125.10 ,$103.74 ,$125.10 ,$14.03 ,$18.49 ,$132.05 ,$14.58 ,$10.49 ,$120.93 ,$13.89 ,$125.10 ,$13.89 ,$125.10 ,$125.10 ,$125.10 ,$134.83 ,$112.59 ,$129.27 ,$119.54 ,$134.83 
SACRED HEART HOSPITAL (ACU),42000037,97110,HC THERA EXER; EA 15 MIN,420,1 ,$123.00 ,$92.25 ,$12.54 ,$123.00 ,$79.21 ,$28.82 ,$86.10 ,$19.63 ,$123.00 , N/A ,$123.00 ,$116.85 ,$12.54 ,$98.40 ,$113.16 ,$19.63 ,$104.55 ,$116.85 ,$108.24 ,$93.48 ,$12.54 ,$12.54 ,$19.63 ,$89.79 ,$67.65 ,$111.93 ,$111.93 ,$98.40 ,$29.68 ,$67.65 ,$110.70 ,$28.82 ,$110.70 ,$66.42 ,$115.62 ,$64.85 ,$113.16 ,$13.29 ,$111.93 ,$28.82 ,$75.69 ,$75.69 ,$110.70 ,$91.79 ,$110.70 ,$29.11 ,$19.63 ,$116.85 ,$30.26 ,$12.54 ,$107.01 ,$28.82 ,$110.70 ,$28.82 ,$110.70 ,$110.70 ,$110.70 ,$119.31 ,$99.63 ,$114.39 ,$105.78 ,$119.31 
SACRED HEART HOSPITAL (ACU),42000045,97112,HC NEUROMUSCULAR RE ED EA 15 MIN,420,1 ,$107.00 ,$80.25 ,$12.54 ,$107.00 ,$68.91 ,$33.48 ,$74.90 ,$19.32 ,$107.00 , N/A ,$107.00 ,$101.65 ,$12.54 ,$85.60 ,$98.44 ,$19.32 ,$90.95 ,$101.65 ,$94.16 ,$81.32 ,$12.54 ,$12.54 ,$19.32 ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 ,$34.48 ,$58.85 ,$96.30 ,$33.48 ,$96.30 ,$57.78 ,$100.58 ,$75.33 ,$98.44 ,$13.29 ,$97.37 ,$33.48 ,$65.85 ,$65.85 ,$96.30 ,$79.85 ,$96.30 ,$33.81 ,$19.32 ,$101.65 ,$35.15 ,$12.54 ,$93.09 ,$33.48 ,$96.30 ,$33.48 ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),42000049,97116,HC AMBULATION GAIT TRAIN EA 15 MIN,420,1 ,$111.00 ,$83.25 ,$10.49 ,$111.00 ,$71.48 ,$28.82 ,$77.70 ,$16.47 ,$111.00 , N/A ,$111.00 ,$105.45 ,$10.49 ,$88.80 ,$102.12 ,$16.47 ,$94.35 ,$105.45 ,$97.68 ,$84.36 ,$10.49 ,$10.49 ,$16.47 ,$81.03 ,$61.05 ,$101.01 ,$101.01 ,$88.80 ,$29.68 ,$61.05 ,$99.90 ,$28.82 ,$99.90 ,$59.94 ,$104.34 ,$64.85 ,$102.12 ,$11.12 ,$101.01 ,$28.82 ,$68.31 ,$68.31 ,$99.90 ,$82.84 ,$99.90 ,$29.11 ,$16.47 ,$105.45 ,$30.26 ,$10.49 ,$96.57 ,$28.82 ,$99.90 ,$28.82 ,$99.90 ,$99.90 ,$99.90 ,$107.67 ,$89.91 ,$103.23 ,$95.46 ,$107.67 
SACRED HEART HOSPITAL (ACU),42000053,97124,HC THERAPEUTIC MASSAGE EA 15 MIN,420,1 ,$141.00 ,$105.75 ,$10.49 ,$141.00 ,$90.80 ,$29.17 ,$98.70 ,$23.41 ,$141.00 , N/A ,$141.00 ,$133.95 ,$10.49 ,$112.80 ,$129.72 ,$23.41 ,$119.85 ,$133.95 ,$124.08 ,$107.16 ,$10.49 ,$10.49 ,$23.41 ,$102.93 ,$77.55 ,$128.31 ,$128.31 ,$112.80 ,$30.05 ,$77.55 ,$126.90 ,$29.17 ,$126.90 ,$76.14 ,$132.54 ,$65.63 ,$129.72 ,$11.12 ,$128.31 ,$29.17 ,$86.77 ,$86.77 ,$126.90 ,$105.23 ,$126.90 ,$29.46 ,$23.41 ,$133.95 ,$30.63 ,$10.49 ,$122.67 ,$29.17 ,$126.90 ,$29.17 ,$126.90 ,$126.90 ,$126.90 ,$136.77 ,$114.21 ,$131.13 ,$121.26 ,$136.77 
SACRED HEART HOSPITAL (ACU),42000056,97140,HC MANUAL THERAPY EA 15 MIN,420,1 ,$129.00 ,$96.75 ,$12.54 ,$129.00 ,$83.08 ,$26.50 ,$90.30 ,$25.53 ,$129.00 , N/A ,$129.00 ,$122.55 ,$12.54 ,$103.20 ,$118.68 ,$25.53 ,$109.65 ,$122.55 ,$113.52 ,$98.04 ,$12.54 ,$12.54 ,$25.53 ,$94.17 ,$70.95 ,$117.39 ,$117.39 ,$103.20 ,$27.30 ,$70.95 ,$116.10 ,$26.50 ,$116.10 ,$69.66 ,$121.26 ,$59.63 ,$118.68 ,$13.29 ,$117.39 ,$26.50 ,$79.39 ,$79.39 ,$116.10 ,$96.27 ,$116.10 ,$26.77 ,$25.53 ,$122.55 ,$27.83 ,$12.54 ,$112.23 ,$26.50 ,$116.10 ,$26.50 ,$116.10 ,$116.10 ,$116.10 ,$125.13 ,$104.49 ,$119.97 ,$110.94 ,$125.13 
SACRED HEART HOSPITAL (ACU),42000063,97150,HC GROUP TREATMENT 15MIN,420,1 ,$30.00 ,$22.50 ,$6.08 ,$38.95 ,$19.32 ,$17.31 ,$21.00 ,$6.08 ,$30.00 , N/A ,$30.00 ,$28.50 ,$12.54 ,$24.00 ,$27.60 ,$6.08 ,$25.50 ,$28.50 ,$26.40 ,$22.80 ,$12.54 ,$12.54 ,$6.08 ,$21.90 ,$16.50 ,$27.30 ,$27.30 ,$24.00 ,$17.83 ,$16.50 ,$27.00 ,$17.31 ,$27.00 ,$16.20 ,$28.20 ,$38.95 ,$27.60 ,$13.29 ,$27.30 ,$17.31 ,$18.46 ,$18.46 ,$27.00 ,$22.39 ,$27.00 ,$17.48 ,$6.08 ,$28.50 ,$18.18 ,$12.54 ,$26.10 ,$17.31 ,$27.00 ,$17.31 ,$27.00 ,$27.00 ,$27.00 ,$29.10 ,$24.30 ,$27.90 ,$25.80 ,$29.10 
SACRED HEART HOSPITAL (ACU),42000065,97530,HC THERAPEUTIC ACTIVITIES EA 15 MIN,420,1 ,$113.00 ,$84.75 ,$12.54 ,$113.00 ,$72.77 ,$36.29 ,$79.10 ,$18.05 ,$113.00 , N/A ,$113.00 ,$107.35 ,$12.54 ,$90.40 ,$103.96 ,$18.05 ,$96.05 ,$107.35 ,$99.44 ,$85.88 ,$12.54 ,$12.54 ,$18.05 ,$82.49 ,$62.15 ,$102.83 ,$102.83 ,$90.40 ,$37.38 ,$62.15 ,$101.70 ,$36.29 ,$101.70 ,$61.02 ,$106.22 ,$81.65 ,$103.96 ,$13.29 ,$102.83 ,$36.29 ,$69.54 ,$69.54 ,$101.70 ,$84.33 ,$101.70 ,$36.65 ,$18.05 ,$107.35 ,$38.10 ,$12.54 ,$98.31 ,$36.29 ,$101.70 ,$36.29 ,$101.70 ,$101.70 ,$101.70 ,$109.61 ,$91.53 ,$105.09 ,$97.18 ,$109.61 
SACRED HEART HOSPITAL (ACU),42000083,97598,HC DEBR SKIN PART THICKNESS EA ADDN>20CM FACIL,420,1 ,$466.00 ,$349.50 ,$35.14 ,$466.00 ,$300.10 , N/A ,$326.20 ,$35.14 ,$268.00 , N/A ,$214.00 ,$442.70 ,$325.72 ,$372.80 ,$428.72 ,$35.14 ,$396.10 ,$442.70 ,$410.08 ,$354.16 ,$325.72 ,$325.72 ,$35.14 ,$340.18 ,$256.30 ,$424.06 ,$424.06 ,$372.80 , N/A ,$256.30 ,$419.40 , N/A ,$419.40 ,$251.64 ,$438.04 , N/A ,$428.72 ,$345.26 ,$424.06 , N/A ,$286.78 ,$286.78 ,$419.40 ,$347.78 ,$155.42 , N/A ,$35.14 ,$442.70 , N/A ,$325.72 ,$405.42 , N/A ,$419.40 , N/A ,$419.40 ,$419.40 ,$419.40 ,$452.02 ,$377.46 ,$433.38 ,$400.76 ,$452.02 
SACRED HEART HOSPITAL (ACU),42000084,97602,HC DEBRIDEMENT NONSELECTIVE,420,1 ,$315.00 ,$236.25 ,$122.07 ,$315.00 ,$202.86 , N/A ,$220.50 , N/A ,$268.00 , N/A ,$214.00 ,$299.25 ,$122.07 ,$252.00 ,$289.80 , N/A ,$267.75 ,$299.25 ,$277.20 ,$239.40 ,$122.07 ,$122.07 , N/A ,$229.95 ,$173.25 ,$286.65 ,$286.65 ,$252.00 , N/A ,$173.25 ,$283.50 , N/A ,$283.50 ,$170.10 ,$296.10 , N/A ,$289.80 ,$129.39 ,$286.65 , N/A ,$193.85 ,$193.85 ,$283.50 ,$235.08 ,$155.42 , N/A ,$220.50 ,$299.25 , N/A ,$122.07 ,$274.05 , N/A ,$283.50 , N/A ,$283.50 ,$283.50 ,$283.50 ,$305.55 ,$255.15 ,$292.95 ,$270.90 ,$305.55 
SACRED HEART HOSPITAL (ACU),42000085,97605,HC NWPT <50 SQ CM FAC,420,1 ,$315.00 ,$236.25 ,$41.41 ,$315.00 ,$202.86 ,$41.41 ,$220.50 , N/A ,$268.00 , N/A ,$214.00 ,$299.25 ,$60.69 ,$252.00 ,$289.80 , N/A ,$267.75 ,$299.25 ,$277.20 ,$239.40 ,$60.69 ,$60.69 , N/A ,$229.95 ,$173.25 ,$286.65 ,$286.65 ,$252.00 ,$42.65 ,$173.25 ,$283.50 ,$41.41 ,$283.50 ,$170.10 ,$296.10 ,$93.17 ,$289.80 ,$64.33 ,$286.65 ,$41.41 ,$193.85 ,$193.85 ,$283.50 ,$235.08 ,$155.42 ,$41.82 ,$220.50 ,$299.25 ,$43.48 ,$60.69 ,$274.05 ,$41.41 ,$283.50 ,$41.41 ,$283.50 ,$283.50 ,$283.50 ,$305.55 ,$255.15 ,$292.95 ,$270.90 ,$305.55 
SACRED HEART HOSPITAL (ACU),42000089,97606,HC NWPT >50 SQ CM FAC,420,1 ,$538.00 ,$403.50 ,$49.00 ,$538.00 ,$346.47 ,$49.00 ,$376.60 , N/A ,$268.00 , N/A ,$214.00 ,$511.10 ,$122.07 ,$430.40 ,$494.96 , N/A ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$122.07 ,$122.07 , N/A ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,$50.47 ,$295.90 ,$484.20 ,$49.00 ,$484.20 ,$290.52 ,$505.72 ,$110.25 ,$494.96 ,$129.39 ,$489.58 ,$49.00 ,$331.09 ,$331.09 ,$484.20 ,$401.51 ,$155.42 ,$49.49 ,$376.60 ,$511.10 ,$51.45 ,$122.07 ,$468.06 ,$49.00 ,$484.20 ,$49.00 ,$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),42000093,97750,HC PHYSICAL PERFORMANCE TST EA 15 MIN,420,1 ,$82.00 ,$61.50 ,$12.54 ,$82.00 ,$52.81 ,$32.73 ,$57.40 , N/A ,$82.00 , N/A ,$82.00 ,$77.90 ,$12.54 ,$65.60 ,$75.44 , N/A ,$69.70 ,$77.90 ,$72.16 ,$62.32 ,$12.54 ,$12.54 , N/A ,$59.86 ,$45.10 ,$74.62 ,$74.62 ,$65.60 ,$33.71 ,$45.10 ,$73.80 ,$32.73 ,$73.80 ,$44.28 ,$77.08 ,$73.64 ,$75.44 ,$13.29 ,$74.62 ,$32.73 ,$50.46 ,$50.46 ,$73.80 ,$61.20 ,$73.80 ,$33.06 ,$57.40 ,$77.90 ,$34.37 ,$12.54 ,$71.34 ,$32.73 ,$73.80 ,$32.73 ,$73.80 ,$73.80 ,$73.80 ,$79.54 ,$66.42 ,$76.26 ,$70.52 ,$79.54 
SACRED HEART HOSPITAL (ACU),42000094,97761,HC PROSTHETIC TRAINING EA 15 MIN,420,1 ,$152.00 ,$114.00 ,$12.54 ,$152.00 ,$97.89 ,$40.65 ,$106.40 ,$21.40 ,$152.00 , N/A ,$152.00 ,$144.40 ,$12.54 ,$121.60 ,$139.84 ,$21.40 ,$129.20 ,$144.40 ,$133.76 ,$115.52 ,$12.54 ,$12.54 ,$21.40 ,$110.96 ,$83.60 ,$138.32 ,$138.32 ,$121.60 ,$41.87 ,$83.60 ,$136.80 ,$40.65 ,$136.80 ,$82.08 ,$142.88 ,$91.46 ,$139.84 ,$13.29 ,$138.32 ,$40.65 ,$93.54 ,$93.54 ,$136.80 ,$113.44 ,$136.80 ,$41.06 ,$21.40 ,$144.40 ,$42.68 ,$12.54 ,$132.24 ,$40.65 ,$136.80 ,$40.65 ,$136.80 ,$136.80 ,$136.80 ,$147.44 ,$123.12 ,$141.36 ,$130.72 ,$147.44 
SACRED HEART HOSPITAL (ACU),42000095,97763,HC ORTHTC/PRSTHTC CHECK EA 15MIN,420,1 ,$176.00 ,$132.00 ,$12.54 ,$176.00 ,$113.34 ,$52.67 ,$123.20 ,$28.15 ,$176.00 , N/A ,$176.00 ,$167.20 ,$12.54 ,$140.80 ,$161.92 ,$28.15 ,$149.60 ,$167.20 ,$154.88 ,$133.76 ,$12.54 ,$12.54 ,$28.15 ,$128.48 ,$96.80 ,$160.16 ,$160.16 ,$140.80 ,$54.25 ,$96.80 ,$158.40 ,$52.67 ,$158.40 ,$95.04 ,$165.44 ,$118.51 ,$161.92 ,$13.29 ,$160.16 ,$52.67 ,$108.31 ,$108.31 ,$158.40 ,$131.35 ,$155.42 ,$53.20 ,$28.15 ,$167.20 ,$55.30 ,$12.54 ,$153.12 ,$52.67 ,$158.40 ,$52.67 ,$158.40 ,$158.40 ,$158.40 ,$170.72 ,$142.56 ,$163.68 ,$151.36 ,$170.72 
SACRED HEART HOSPITAL (ACU),42000104,G0175,HC FAMILY CONFERENCE,420,1 ,$278.61 ,$208.96 ,$33.65 ,$865.66 ,$179.42 ,$384.74 ,$195.03 , N/A ,$268.00 , N/A ,$214.00 ,$264.68 ,$33.65 ,$222.89 ,$256.32 , N/A ,$236.82 ,$264.68 ,$245.18 ,$211.74 ,$33.65 ,$33.65 , N/A ,$203.39 ,$153.24 ,$253.54 ,$253.54 ,$222.89 ,$396.28 ,$153.24 ,$250.75 ,$384.74 ,$250.75 ,$150.45 ,$261.89 ,$865.66 ,$256.32 ,$35.67 ,$253.54 ,$384.74 ,$171.46 ,$171.46 ,$250.75 ,$207.93 ,$155.42 ,$388.59 ,$195.03 ,$264.68 ,$403.98 ,$33.65 ,$242.39 ,$384.74 ,$250.75 ,$384.74 ,$250.75 ,$250.75 ,$250.75 ,$270.25 ,$225.67 ,$259.11 ,$239.60 ,$270.25 
SACRED HEART HOSPITAL (ACU),42000110,G0283,HC ELECT STIM(UNATTEND) OTHER,420,1 ,$77.00 ,$57.75 ,$10.49 ,$77.00 ,$49.59 ,$11.87 ,$53.90 ,$22.38 ,$77.00 , N/A ,$77.00 ,$73.15 ,$10.49 ,$61.60 ,$70.84 ,$22.38 ,$65.45 ,$73.15 ,$67.76 ,$58.52 ,$10.49 ,$10.49 ,$22.38 ,$56.21 ,$42.35 ,$70.07 ,$70.07 ,$61.60 ,$12.23 ,$42.35 ,$69.30 ,$11.87 ,$69.30 ,$41.58 ,$72.38 ,$26.71 ,$70.84 ,$11.12 ,$70.07 ,$11.87 ,$47.39 ,$47.39 ,$69.30 ,$57.47 ,$69.30 ,$11.99 ,$22.38 ,$73.15 ,$12.46 ,$10.49 ,$66.99 ,$11.87 ,$69.30 ,$11.87 ,$69.30 ,$69.30 ,$69.30 ,$74.69 ,$62.37 ,$71.61 ,$66.22 ,$74.69 
SACRED HEART HOSPITAL (ACU),42000120,97150,HC GROUP TREATMENT 30MIN,420,1 ,$59.00 ,$44.25 ,$6.08 ,$59.00 ,$38.00 ,$17.31 ,$41.30 ,$6.08 ,$59.00 , N/A ,$59.00 ,$56.05 ,$12.54 ,$47.20 ,$54.28 ,$6.08 ,$50.15 ,$56.05 ,$51.92 ,$44.84 ,$12.54 ,$12.54 ,$6.08 ,$43.07 ,$32.45 ,$53.69 ,$53.69 ,$47.20 ,$17.83 ,$32.45 ,$53.10 ,$17.31 ,$53.10 ,$31.86 ,$55.46 ,$38.95 ,$54.28 ,$13.29 ,$53.69 ,$17.31 ,$36.31 ,$36.31 ,$53.10 ,$44.03 ,$53.10 ,$17.48 ,$6.08 ,$56.05 ,$18.18 ,$12.54 ,$51.33 ,$17.31 ,$53.10 ,$17.31 ,$53.10 ,$53.10 ,$53.10 ,$57.23 ,$47.79 ,$54.87 ,$50.74 ,$57.23 
SACRED HEART HOSPITAL (ACU),42000121,97150,HC GROUP TREATMENT 45MIN,420,1 ,$88.00 ,$66.00 ,$6.08 ,$88.00 ,$56.67 ,$17.31 ,$61.60 ,$6.08 ,$88.00 , N/A ,$88.00 ,$83.60 ,$12.54 ,$70.40 ,$80.96 ,$6.08 ,$74.80 ,$83.60 ,$77.44 ,$66.88 ,$12.54 ,$12.54 ,$6.08 ,$64.24 ,$48.40 ,$80.08 ,$80.08 ,$70.40 ,$17.83 ,$48.40 ,$79.20 ,$17.31 ,$79.20 ,$47.52 ,$82.72 ,$38.95 ,$80.96 ,$13.29 ,$80.08 ,$17.31 ,$54.16 ,$54.16 ,$79.20 ,$65.67 ,$79.20 ,$17.48 ,$6.08 ,$83.60 ,$18.18 ,$12.54 ,$76.56 ,$17.31 ,$79.20 ,$17.31 ,$79.20 ,$79.20 ,$79.20 ,$85.36 ,$71.28 ,$81.84 ,$75.68 ,$85.36 
SACRED HEART HOSPITAL (ACU),42000122,97150,HC GROUP TREATMENT 60MIN,420,1 ,$118.00 ,$88.50 ,$6.08 ,$118.00 ,$75.99 ,$17.31 ,$82.60 ,$6.08 ,$118.00 , N/A ,$118.00 ,$112.10 ,$12.54 ,$94.40 ,$108.56 ,$6.08 ,$100.30 ,$112.10 ,$103.84 ,$89.68 ,$12.54 ,$12.54 ,$6.08 ,$86.14 ,$64.90 ,$107.38 ,$107.38 ,$94.40 ,$17.83 ,$64.90 ,$106.20 ,$17.31 ,$106.20 ,$63.72 ,$110.92 ,$38.95 ,$108.56 ,$13.29 ,$107.38 ,$17.31 ,$72.62 ,$72.62 ,$106.20 ,$88.06 ,$106.20 ,$17.48 ,$6.08 ,$112.10 ,$18.18 ,$12.54 ,$102.66 ,$17.31 ,$106.20 ,$17.31 ,$106.20 ,$106.20 ,$106.20 ,$114.46 ,$95.58 ,$109.74 ,$101.48 ,$114.46 
SACRED HEART HOSPITAL (ACU),42000151,29581,HC APPL MULTI COMP WRAP PT/OT,420,1 ,$405.00 ,$303.75 ,$61.15 ,$405.00 ,$260.82 ,$149.42 ,$283.50 , N/A ,$268.00 , N/A ,$214.00 ,$384.75 ,$61.15 ,$324.00 ,$372.60 , N/A ,$344.25 ,$384.75 ,$356.40 ,$307.80 ,$61.15 ,$61.15 , N/A ,$295.65 ,$222.75 ,$368.55 ,$368.55 ,$324.00 ,$153.90 ,$222.75 ,$364.50 ,$149.42 ,$364.50 ,$218.70 ,$380.70 ,$336.20 ,$372.60 ,$64.82 ,$368.55 ,$149.42 ,$249.24 ,$249.24 ,$364.50 ,$302.25 ,$155.42 ,$150.92 ,$283.50 ,$384.75 ,$156.89 ,$61.15 ,$352.35 ,$149.42 ,$364.50 ,$149.42 ,$364.50 ,$364.50 ,$364.50 ,$392.85 ,$328.05 ,$376.65 ,$348.30 ,$392.85 
SACRED HEART HOSPITAL (ACU),42000160,97113,HC THERAPEUTIC ACT W/AQUA,420,1 ,$145.00 ,$108.75 ,$12.54 ,$145.00 ,$93.38 ,$36.05 ,$101.50 ,$36.96 ,$145.00 , N/A ,$145.00 ,$137.75 ,$12.54 ,$116.00 ,$133.40 ,$36.96 ,$123.25 ,$137.75 ,$127.60 ,$110.20 ,$12.54 ,$12.54 ,$36.96 ,$105.85 ,$79.75 ,$131.95 ,$131.95 ,$116.00 ,$37.13 ,$79.75 ,$130.50 ,$36.05 ,$130.50 ,$78.30 ,$136.30 ,$81.11 ,$133.40 ,$13.29 ,$131.95 ,$36.05 ,$89.23 ,$89.23 ,$130.50 ,$108.21 ,$130.50 ,$36.41 ,$36.96 ,$137.75 ,$37.85 ,$12.54 ,$126.15 ,$36.05 ,$130.50 ,$36.05 ,$130.50 ,$130.50 ,$130.50 ,$140.65 ,$117.45 ,$134.85 ,$124.70 ,$140.65 
SACRED HEART HOSPITAL (ACU),42000168,97150,HC GROUP TREATMENT 120MIN,420,1 ,$236.00 ,$177.00 ,$6.08 ,$236.00 ,$151.98 ,$17.31 ,$165.20 ,$6.08 ,$236.00 , N/A ,$214.00 ,$224.20 ,$12.54 ,$188.80 ,$217.12 ,$6.08 ,$200.60 ,$224.20 ,$207.68 ,$179.36 ,$12.54 ,$12.54 ,$6.08 ,$172.28 ,$129.80 ,$214.76 ,$214.76 ,$188.80 ,$17.83 ,$129.80 ,$212.40 ,$17.31 ,$212.40 ,$127.44 ,$221.84 ,$38.95 ,$217.12 ,$13.29 ,$214.76 ,$17.31 ,$145.23 ,$145.23 ,$212.40 ,$176.13 ,$155.42 ,$17.48 ,$6.08 ,$224.20 ,$18.18 ,$12.54 ,$205.32 ,$17.31 ,$212.40 ,$17.31 ,$212.40 ,$212.40 ,$212.40 ,$228.92 ,$191.16 ,$219.48 ,$202.96 ,$228.92 
SACRED HEART HOSPITAL (ACU),42000169,97150,HC GROUP TREATMENT 150MIN,420,1 ,$244.00 ,$183.00 ,$6.08 ,$244.00 ,$157.14 ,$17.31 ,$170.80 ,$6.08 ,$244.00 , N/A ,$214.00 ,$231.80 ,$12.54 ,$195.20 ,$224.48 ,$6.08 ,$207.40 ,$231.80 ,$214.72 ,$185.44 ,$12.54 ,$12.54 ,$6.08 ,$178.12 ,$134.20 ,$222.04 ,$222.04 ,$195.20 ,$17.83 ,$134.20 ,$219.60 ,$17.31 ,$219.60 ,$131.76 ,$229.36 ,$38.95 ,$224.48 ,$13.29 ,$222.04 ,$17.31 ,$150.16 ,$150.16 ,$219.60 ,$182.10 ,$155.42 ,$17.48 ,$6.08 ,$231.80 ,$18.18 ,$12.54 ,$212.28 ,$17.31 ,$219.60 ,$17.31 ,$219.60 ,$219.60 ,$219.60 ,$236.68 ,$197.64 ,$226.92 ,$209.84 ,$236.68 
SACRED HEART HOSPITAL (ACU),42000170,97150,HC GROUP TREATMENT 180MIN,420,1 ,$292.00 ,$219.00 ,$6.08 ,$292.00 ,$188.05 ,$17.31 ,$204.40 ,$6.08 ,$268.00 , N/A ,$214.00 ,$277.40 ,$12.54 ,$233.60 ,$268.64 ,$6.08 ,$248.20 ,$277.40 ,$256.96 ,$221.92 ,$12.54 ,$12.54 ,$6.08 ,$213.16 ,$160.60 ,$265.72 ,$265.72 ,$233.60 ,$17.83 ,$160.60 ,$262.80 ,$17.31 ,$262.80 ,$157.68 ,$274.48 ,$38.95 ,$268.64 ,$13.29 ,$265.72 ,$17.31 ,$179.70 ,$179.70 ,$262.80 ,$217.92 ,$155.42 ,$17.48 ,$6.08 ,$277.40 ,$18.18 ,$12.54 ,$254.04 ,$17.31 ,$262.80 ,$17.31 ,$262.80 ,$262.80 ,$262.80 ,$283.24 ,$236.52 ,$271.56 ,$251.12 ,$283.24 
SACRED HEART HOSPITAL (ACU),42000171,97150,HC GROUP TREATMENT 90MIN,420,1 ,$178.00 ,$133.50 ,$6.08 ,$178.00 ,$114.63 ,$17.31 ,$124.60 ,$6.08 ,$178.00 , N/A ,$178.00 ,$169.10 ,$12.54 ,$142.40 ,$163.76 ,$6.08 ,$151.30 ,$169.10 ,$156.64 ,$135.28 ,$12.54 ,$12.54 ,$6.08 ,$129.94 ,$97.90 ,$161.98 ,$161.98 ,$142.40 ,$17.83 ,$97.90 ,$160.20 ,$17.31 ,$160.20 ,$96.12 ,$167.32 ,$38.95 ,$163.76 ,$13.29 ,$161.98 ,$17.31 ,$109.54 ,$109.54 ,$160.20 ,$132.84 ,$155.42 ,$17.48 ,$6.08 ,$169.10 ,$18.18 ,$12.54 ,$154.86 ,$17.31 ,$160.20 ,$17.31 ,$160.20 ,$160.20 ,$160.20 ,$172.66 ,$144.18 ,$165.54 ,$153.08 ,$172.66 
SACRED HEART HOSPITAL (ACU),42000173,97605,HC NEG PRESS WND THPY <50 SQ CM 30MIN,420,1 ,$365.00 ,$273.75 ,$41.41 ,$365.00 ,$235.06 ,$41.41 ,$255.50 , N/A ,$268.00 , N/A ,$214.00 ,$346.75 ,$60.69 ,$292.00 ,$335.80 , N/A ,$310.25 ,$346.75 ,$321.20 ,$277.40 ,$60.69 ,$60.69 , N/A ,$266.45 ,$200.75 ,$332.15 ,$332.15 ,$292.00 ,$42.65 ,$200.75 ,$328.50 ,$41.41 ,$328.50 ,$197.10 ,$343.10 ,$93.17 ,$335.80 ,$64.33 ,$332.15 ,$41.41 ,$224.62 ,$224.62 ,$328.50 ,$272.40 ,$155.42 ,$41.82 ,$255.50 ,$346.75 ,$43.48 ,$60.69 ,$317.55 ,$41.41 ,$328.50 ,$41.41 ,$328.50 ,$328.50 ,$328.50 ,$354.05 ,$295.65 ,$339.45 ,$313.90 ,$354.05 
SACRED HEART HOSPITAL (ACU),42000174,97605,HC NEG PRESS WND THPY <50 SQ CM 45MIN,420,1 ,$487.00 ,$365.25 ,$41.41 ,$487.00 ,$313.63 ,$41.41 ,$340.90 , N/A ,$268.00 , N/A ,$214.00 ,$462.65 ,$60.69 ,$389.60 ,$448.04 , N/A ,$413.95 ,$462.65 ,$428.56 ,$370.12 ,$60.69 ,$60.69 , N/A ,$355.51 ,$267.85 ,$443.17 ,$443.17 ,$389.60 ,$42.65 ,$267.85 ,$438.30 ,$41.41 ,$438.30 ,$262.98 ,$457.78 ,$93.17 ,$448.04 ,$64.33 ,$443.17 ,$41.41 ,$299.70 ,$299.70 ,$438.30 ,$363.45 ,$155.42 ,$41.82 ,$340.90 ,$462.65 ,$43.48 ,$60.69 ,$423.69 ,$41.41 ,$438.30 ,$41.41 ,$438.30 ,$438.30 ,$438.30 ,$472.39 ,$394.47 ,$452.91 ,$418.82 ,$472.39 
SACRED HEART HOSPITAL (ACU),42000175,97605,HC NEG PRESS WND THPY <50 SQ CM 60MIN,420,1 ,$529.00 ,$396.75 ,$41.41 ,$529.00 ,$340.68 ,$41.41 ,$370.30 , N/A ,$268.00 , N/A ,$214.00 ,$502.55 ,$60.69 ,$423.20 ,$486.68 , N/A ,$449.65 ,$502.55 ,$465.52 ,$402.04 ,$60.69 ,$60.69 , N/A ,$386.17 ,$290.95 ,$481.39 ,$481.39 ,$423.20 ,$42.65 ,$290.95 ,$476.10 ,$41.41 ,$476.10 ,$285.66 ,$497.26 ,$93.17 ,$486.68 ,$64.33 ,$481.39 ,$41.41 ,$325.55 ,$325.55 ,$476.10 ,$394.79 ,$155.42 ,$41.82 ,$370.30 ,$502.55 ,$43.48 ,$60.69 ,$460.23 ,$41.41 ,$476.10 ,$41.41 ,$476.10 ,$476.10 ,$476.10 ,$513.13 ,$428.49 ,$491.97 ,$454.94 ,$513.13 
SACRED HEART HOSPITAL (ACU),42000176,97605,HC NEG PRESS WND THPY <50 SQ CM 75MIN,420,1 ,$351.00 ,$263.25 ,$41.41 ,$351.00 ,$226.04 ,$41.41 ,$245.70 , N/A ,$268.00 , N/A ,$214.00 ,$333.45 ,$60.69 ,$280.80 ,$322.92 , N/A ,$298.35 ,$333.45 ,$308.88 ,$266.76 ,$60.69 ,$60.69 , N/A ,$256.23 ,$193.05 ,$319.41 ,$319.41 ,$280.80 ,$42.65 ,$193.05 ,$315.90 ,$41.41 ,$315.90 ,$189.54 ,$329.94 ,$93.17 ,$322.92 ,$64.33 ,$319.41 ,$41.41 ,$216.01 ,$216.01 ,$315.90 ,$261.95 ,$155.42 ,$41.82 ,$245.70 ,$333.45 ,$43.48 ,$60.69 ,$305.37 ,$41.41 ,$315.90 ,$41.41 ,$315.90 ,$315.90 ,$315.90 ,$340.47 ,$284.31 ,$326.43 ,$301.86 ,$340.47 
SACRED HEART HOSPITAL (ACU),42000177,97605,HC NEG PRESS WND THPY <50 SQ CM 90MIN,420,1 ,$398.00 ,$298.50 ,$41.41 ,$398.00 ,$256.31 ,$41.41 ,$278.60 , N/A ,$268.00 , N/A ,$214.00 ,$378.10 ,$60.69 ,$318.40 ,$366.16 , N/A ,$338.30 ,$378.10 ,$350.24 ,$302.48 ,$60.69 ,$60.69 , N/A ,$290.54 ,$218.90 ,$362.18 ,$362.18 ,$318.40 ,$42.65 ,$218.90 ,$358.20 ,$41.41 ,$358.20 ,$214.92 ,$374.12 ,$93.17 ,$366.16 ,$64.33 ,$362.18 ,$41.41 ,$244.93 ,$244.93 ,$358.20 ,$297.03 ,$155.42 ,$41.82 ,$278.60 ,$378.10 ,$43.48 ,$60.69 ,$346.26 ,$41.41 ,$358.20 ,$41.41 ,$358.20 ,$358.20 ,$358.20 ,$386.06 ,$322.38 ,$370.14 ,$342.28 ,$386.06 
SACRED HEART HOSPITAL (ACU),42000178,97605,HC NEG PRESS WND THPY <50 SQ CM 105MIN,420,1 ,$464.00 ,$348.00 ,$41.41 ,$464.00 ,$298.82 ,$41.41 ,$324.80 , N/A ,$268.00 , N/A ,$214.00 ,$440.80 ,$60.69 ,$371.20 ,$426.88 , N/A ,$394.40 ,$440.80 ,$408.32 ,$352.64 ,$60.69 ,$60.69 , N/A ,$338.72 ,$255.20 ,$422.24 ,$422.24 ,$371.20 ,$42.65 ,$255.20 ,$417.60 ,$41.41 ,$417.60 ,$250.56 ,$436.16 ,$93.17 ,$426.88 ,$64.33 ,$422.24 ,$41.41 ,$285.55 ,$285.55 ,$417.60 ,$346.28 ,$155.42 ,$41.82 ,$324.80 ,$440.80 ,$43.48 ,$60.69 ,$403.68 ,$41.41 ,$417.60 ,$41.41 ,$417.60 ,$417.60 ,$417.60 ,$450.08 ,$375.84 ,$431.52 ,$399.04 ,$450.08 
SACRED HEART HOSPITAL (ACU),42000179,97605,HC NEG PRESS WND THPY <50 SQ CM 120MIN,420,1 ,$531.00 ,$398.25 ,$41.41 ,$531.00 ,$341.96 ,$41.41 ,$371.70 , N/A ,$268.00 , N/A ,$214.00 ,$504.45 ,$60.69 ,$424.80 ,$488.52 , N/A ,$451.35 ,$504.45 ,$467.28 ,$403.56 ,$60.69 ,$60.69 , N/A ,$387.63 ,$292.05 ,$483.21 ,$483.21 ,$424.80 ,$42.65 ,$292.05 ,$477.90 ,$41.41 ,$477.90 ,$286.74 ,$499.14 ,$93.17 ,$488.52 ,$64.33 ,$483.21 ,$41.41 ,$326.78 ,$326.78 ,$477.90 ,$396.29 ,$155.42 ,$41.82 ,$371.70 ,$504.45 ,$43.48 ,$60.69 ,$461.97 ,$41.41 ,$477.90 ,$41.41 ,$477.90 ,$477.90 ,$477.90 ,$515.07 ,$430.11 ,$493.83 ,$456.66 ,$515.07 
SACRED HEART HOSPITAL (ACU),42000180,97606,HC NEG PRESS WND THPY >50 SQ CM 30MIN,420,1 ,$365.00 ,$273.75 ,$49.00 ,$365.00 ,$235.06 ,$49.00 ,$255.50 , N/A ,$268.00 , N/A ,$214.00 ,$346.75 ,$122.07 ,$292.00 ,$335.80 , N/A ,$310.25 ,$346.75 ,$321.20 ,$277.40 ,$122.07 ,$122.07 , N/A ,$266.45 ,$200.75 ,$332.15 ,$332.15 ,$292.00 ,$50.47 ,$200.75 ,$328.50 ,$49.00 ,$328.50 ,$197.10 ,$343.10 ,$110.25 ,$335.80 ,$129.39 ,$332.15 ,$49.00 ,$224.62 ,$224.62 ,$328.50 ,$272.40 ,$155.42 ,$49.49 ,$255.50 ,$346.75 ,$51.45 ,$122.07 ,$317.55 ,$49.00 ,$328.50 ,$49.00 ,$328.50 ,$328.50 ,$328.50 ,$354.05 ,$295.65 ,$339.45 ,$313.90 ,$354.05 
SACRED HEART HOSPITAL (ACU),42000181,97606,HC NEG PRESS WND THPY >50 SQ CM 45MIN,420,1 ,$487.00 ,$365.25 ,$49.00 ,$487.00 ,$313.63 ,$49.00 ,$340.90 , N/A ,$268.00 , N/A ,$214.00 ,$462.65 ,$122.07 ,$389.60 ,$448.04 , N/A ,$413.95 ,$462.65 ,$428.56 ,$370.12 ,$122.07 ,$122.07 , N/A ,$355.51 ,$267.85 ,$443.17 ,$443.17 ,$389.60 ,$50.47 ,$267.85 ,$438.30 ,$49.00 ,$438.30 ,$262.98 ,$457.78 ,$110.25 ,$448.04 ,$129.39 ,$443.17 ,$49.00 ,$299.70 ,$299.70 ,$438.30 ,$363.45 ,$155.42 ,$49.49 ,$340.90 ,$462.65 ,$51.45 ,$122.07 ,$423.69 ,$49.00 ,$438.30 ,$49.00 ,$438.30 ,$438.30 ,$438.30 ,$472.39 ,$394.47 ,$452.91 ,$418.82 ,$472.39 
SACRED HEART HOSPITAL (ACU),42000182,97606,HC NEG PRESS WND THPY >50 SQ CM 60MIN,420,1 ,$559.00 ,$419.25 ,$49.00 ,$559.00 ,$360.00 ,$49.00 ,$391.30 , N/A ,$268.00 , N/A ,$214.00 ,$531.05 ,$122.07 ,$447.20 ,$514.28 , N/A ,$475.15 ,$531.05 ,$491.92 ,$424.84 ,$122.07 ,$122.07 , N/A ,$408.07 ,$307.45 ,$508.69 ,$508.69 ,$447.20 ,$50.47 ,$307.45 ,$503.10 ,$49.00 ,$503.10 ,$301.86 ,$525.46 ,$110.25 ,$514.28 ,$129.39 ,$508.69 ,$49.00 ,$344.01 ,$344.01 ,$503.10 ,$417.18 ,$155.42 ,$49.49 ,$391.30 ,$531.05 ,$51.45 ,$122.07 ,$486.33 ,$49.00 ,$503.10 ,$49.00 ,$503.10 ,$503.10 ,$503.10 ,$542.23 ,$452.79 ,$519.87 ,$480.74 ,$542.23 
SACRED HEART HOSPITAL (ACU),42000183,97606,HC NEG PRESS WND THPY >50 SQ CM 75MIN,420,1 ,$351.00 ,$263.25 ,$49.00 ,$351.00 ,$226.04 ,$49.00 ,$245.70 , N/A ,$268.00 , N/A ,$214.00 ,$333.45 ,$122.07 ,$280.80 ,$322.92 , N/A ,$298.35 ,$333.45 ,$308.88 ,$266.76 ,$122.07 ,$122.07 , N/A ,$256.23 ,$193.05 ,$319.41 ,$319.41 ,$280.80 ,$50.47 ,$193.05 ,$315.90 ,$49.00 ,$315.90 ,$189.54 ,$329.94 ,$110.25 ,$322.92 ,$129.39 ,$319.41 ,$49.00 ,$216.01 ,$216.01 ,$315.90 ,$261.95 ,$155.42 ,$49.49 ,$245.70 ,$333.45 ,$51.45 ,$122.07 ,$305.37 ,$49.00 ,$315.90 ,$49.00 ,$315.90 ,$315.90 ,$315.90 ,$340.47 ,$284.31 ,$326.43 ,$301.86 ,$340.47 
SACRED HEART HOSPITAL (ACU),42000184,97606,HC NEG PRESS WND THPY >50 SQ CM 90MIN,420,1 ,$398.00 ,$298.50 ,$49.00 ,$398.00 ,$256.31 ,$49.00 ,$278.60 , N/A ,$268.00 , N/A ,$214.00 ,$378.10 ,$122.07 ,$318.40 ,$366.16 , N/A ,$338.30 ,$378.10 ,$350.24 ,$302.48 ,$122.07 ,$122.07 , N/A ,$290.54 ,$218.90 ,$362.18 ,$362.18 ,$318.40 ,$50.47 ,$218.90 ,$358.20 ,$49.00 ,$358.20 ,$214.92 ,$374.12 ,$110.25 ,$366.16 ,$129.39 ,$362.18 ,$49.00 ,$244.93 ,$244.93 ,$358.20 ,$297.03 ,$155.42 ,$49.49 ,$278.60 ,$378.10 ,$51.45 ,$122.07 ,$346.26 ,$49.00 ,$358.20 ,$49.00 ,$358.20 ,$358.20 ,$358.20 ,$386.06 ,$322.38 ,$370.14 ,$342.28 ,$386.06 
SACRED HEART HOSPITAL (ACU),42000185,97606,HC NEG PRESS WND THPY >50 SQ CM 105MIN,420,1 ,$491.00 ,$368.25 ,$49.00 ,$491.00 ,$316.20 ,$49.00 ,$343.70 , N/A ,$268.00 , N/A ,$214.00 ,$466.45 ,$122.07 ,$392.80 ,$451.72 , N/A ,$417.35 ,$466.45 ,$432.08 ,$373.16 ,$122.07 ,$122.07 , N/A ,$358.43 ,$270.05 ,$446.81 ,$446.81 ,$392.80 ,$50.47 ,$270.05 ,$441.90 ,$49.00 ,$441.90 ,$265.14 ,$461.54 ,$110.25 ,$451.72 ,$129.39 ,$446.81 ,$49.00 ,$302.16 ,$302.16 ,$441.90 ,$366.43 ,$155.42 ,$49.49 ,$343.70 ,$466.45 ,$51.45 ,$122.07 ,$427.17 ,$49.00 ,$441.90 ,$49.00 ,$441.90 ,$441.90 ,$441.90 ,$476.27 ,$397.71 ,$456.63 ,$422.26 ,$476.27 
SACRED HEART HOSPITAL (ACU),42000186,97606,HC NEG PRESS WND THPY >50 SQ CM 120MIN,420,1 ,$531.00 ,$398.25 ,$49.00 ,$531.00 ,$341.96 ,$49.00 ,$371.70 , N/A ,$268.00 , N/A ,$214.00 ,$504.45 ,$122.07 ,$424.80 ,$488.52 , N/A ,$451.35 ,$504.45 ,$467.28 ,$403.56 ,$122.07 ,$122.07 , N/A ,$387.63 ,$292.05 ,$483.21 ,$483.21 ,$424.80 ,$50.47 ,$292.05 ,$477.90 ,$49.00 ,$477.90 ,$286.74 ,$499.14 ,$110.25 ,$488.52 ,$129.39 ,$483.21 ,$49.00 ,$326.78 ,$326.78 ,$477.90 ,$396.29 ,$155.42 ,$49.49 ,$371.70 ,$504.45 ,$51.45 ,$122.07 ,$461.97 ,$49.00 ,$477.90 ,$49.00 ,$477.90 ,$477.90 ,$477.90 ,$515.07 ,$430.11 ,$493.83 ,$456.66 ,$515.07 
SACRED HEART HOSPITAL (ACU),42000188,97799,HC PT PATIENT-TEAM EVAL,420,1 ,$75.00 ,$56.25 ,$10.49 ,$84.18 ,$48.30 , N/A ,$52.50 ,$75.00 ,$75.00 ,$84.18 ,$75.00 ,$71.25 ,$10.49 ,$60.00 ,$69.00 ,$75.00 ,$63.75 ,$71.25 ,$66.00 ,$57.00 ,$10.49 ,$10.49 ,$81.73 ,$54.75 ,$41.25 ,$68.25 ,$68.25 ,$60.00 , N/A ,$41.25 ,$67.50 , N/A ,$67.50 ,$40.50 ,$70.50 ,$45.00 ,$69.00 ,$11.12 ,$68.25 , N/A ,$46.16 ,$46.16 ,$67.50 ,$55.97 ,$67.50 ,$61.50 ,$75.00 ,$71.25 , N/A ,$10.49 ,$65.25 , N/A ,$67.50 , N/A ,$67.50 ,$67.50 ,$67.50 ,$72.75 ,$60.75 ,$69.75 ,$64.50 ,$72.75 
SACRED HEART HOSPITAL (ACU),42000191,97602,HC DEBRIDEMENT NONSELECTIVE W/O ANESTH 30MIN,420,1 ,$161.00 ,$120.75 ,$86.94 ,$161.00 ,$103.68 , N/A ,$112.70 , N/A ,$161.00 , N/A ,$161.00 ,$152.95 ,$122.07 ,$128.80 ,$148.12 , N/A ,$136.85 ,$152.95 ,$141.68 ,$122.36 ,$122.07 ,$122.07 , N/A ,$117.53 ,$88.55 ,$146.51 ,$146.51 ,$128.80 , N/A ,$88.55 ,$144.90 , N/A ,$144.90 ,$86.94 ,$151.34 , N/A ,$148.12 ,$129.39 ,$146.51 , N/A ,$99.08 ,$99.08 ,$144.90 ,$120.15 ,$144.90 , N/A ,$112.70 ,$152.95 , N/A ,$122.07 ,$140.07 , N/A ,$144.90 , N/A ,$144.90 ,$144.90 ,$144.90 ,$156.17 ,$130.41 ,$149.73 ,$138.46 ,$156.17 
SACRED HEART HOSPITAL (ACU),42000192,97602,HC DEBRIDEMENT NONSELECTIVE W/O ANESTH 45MIN,420,1 ,$257.00 ,$192.75 ,$122.07 ,$257.00 ,$165.51 , N/A ,$179.90 , N/A ,$257.00 , N/A ,$214.00 ,$244.15 ,$122.07 ,$205.60 ,$236.44 , N/A ,$218.45 ,$244.15 ,$226.16 ,$195.32 ,$122.07 ,$122.07 , N/A ,$187.61 ,$141.35 ,$233.87 ,$233.87 ,$205.60 , N/A ,$141.35 ,$231.30 , N/A ,$231.30 ,$138.78 ,$241.58 , N/A ,$236.44 ,$129.39 ,$233.87 , N/A ,$158.16 ,$158.16 ,$231.30 ,$191.80 ,$155.42 , N/A ,$179.90 ,$244.15 , N/A ,$122.07 ,$223.59 , N/A ,$231.30 , N/A ,$231.30 ,$231.30 ,$231.30 ,$249.29 ,$208.17 ,$239.01 ,$221.02 ,$249.29 
SACRED HEART HOSPITAL (ACU),42000193,97602,HC DEBRIDEMENT NONSELECTIVE W/O ANESTH 60MIN,420,1 ,$319.00 ,$239.25 ,$122.07 ,$319.00 ,$205.44 , N/A ,$223.30 , N/A ,$268.00 , N/A ,$214.00 ,$303.05 ,$122.07 ,$255.20 ,$293.48 , N/A ,$271.15 ,$303.05 ,$280.72 ,$242.44 ,$122.07 ,$122.07 , N/A ,$232.87 ,$175.45 ,$290.29 ,$290.29 ,$255.20 , N/A ,$175.45 ,$287.10 , N/A ,$287.10 ,$172.26 ,$299.86 , N/A ,$293.48 ,$129.39 ,$290.29 , N/A ,$196.31 ,$196.31 ,$287.10 ,$238.07 ,$155.42 , N/A ,$223.30 ,$303.05 , N/A ,$122.07 ,$277.53 , N/A ,$287.10 , N/A ,$287.10 ,$287.10 ,$287.10 ,$309.43 ,$258.39 ,$296.67 ,$274.34 ,$309.43 
SACRED HEART HOSPITAL (ACU),42400087,97161,HC PT EVAL LOW COMPLEXITY,424,1 ,$170.00 ,$127.50 ,$62.66 ,$220.55 ,$109.48 ,$98.02 ,$119.00 ,$62.66 ,$170.00 , N/A ,$170.00 ,$161.50 ,$77.71 ,$136.00 ,$156.40 ,$62.66 ,$144.50 ,$161.50 ,$149.60 ,$129.20 ,$77.71 ,$77.71 ,$62.66 ,$124.10 ,$93.50 ,$154.70 ,$154.70 ,$136.00 ,$100.96 ,$93.50 ,$153.00 ,$98.02 ,$153.00 ,$91.80 ,$159.80 ,$220.55 ,$156.40 ,$82.37 ,$154.70 ,$98.02 ,$104.62 ,$104.62 ,$153.00 ,$126.87 ,$153.00 ,$99.00 ,$62.66 ,$161.50 ,$102.92 ,$77.71 ,$147.90 ,$98.02 ,$153.00 ,$98.02 ,$153.00 ,$153.00 ,$153.00 ,$164.90 ,$137.70 ,$158.10 ,$146.20 ,$164.90 
SACRED HEART HOSPITAL (ACU),42400088,97162,HC PT EVAL MOD COMPLEXITY,424,1 ,$275.00 ,$206.25 ,$62.66 ,$275.00 ,$177.10 ,$98.02 ,$192.50 ,$62.66 ,$268.00 , N/A ,$214.00 ,$261.25 ,$77.71 ,$220.00 ,$253.00 ,$62.66 ,$233.75 ,$261.25 ,$242.00 ,$209.00 ,$77.71 ,$77.71 ,$62.66 ,$200.75 ,$151.25 ,$250.25 ,$250.25 ,$220.00 ,$100.96 ,$151.25 ,$247.50 ,$98.02 ,$247.50 ,$148.50 ,$258.50 ,$220.55 ,$253.00 ,$82.37 ,$250.25 ,$98.02 ,$169.24 ,$169.24 ,$247.50 ,$205.23 ,$155.42 ,$99.00 ,$62.66 ,$261.25 ,$102.92 ,$77.71 ,$239.25 ,$98.02 ,$247.50 ,$98.02 ,$247.50 ,$247.50 ,$247.50 ,$266.75 ,$222.75 ,$255.75 ,$236.50 ,$266.75 
SACRED HEART HOSPITAL (ACU),42400089,97163,HC PT EVAL HIGH COMPLEXITY,424,1 ,$467.00 ,$350.25 ,$62.66 ,$467.00 ,$300.75 ,$98.02 ,$326.90 ,$62.66 ,$268.00 , N/A ,$214.00 ,$443.65 ,$77.71 ,$373.60 ,$429.64 ,$62.66 ,$396.95 ,$443.65 ,$410.96 ,$354.92 ,$77.71 ,$77.71 ,$62.66 ,$340.91 ,$256.85 ,$424.97 ,$424.97 ,$373.60 ,$100.96 ,$256.85 ,$420.30 ,$98.02 ,$420.30 ,$252.18 ,$438.98 ,$220.55 ,$429.64 ,$82.37 ,$424.97 ,$98.02 ,$287.39 ,$287.39 ,$420.30 ,$348.52 ,$155.42 ,$99.00 ,$62.66 ,$443.65 ,$102.92 ,$77.71 ,$406.29 ,$98.02 ,$420.30 ,$98.02 ,$420.30 ,$420.30 ,$420.30 ,$452.99 ,$378.27 ,$434.31 ,$401.62 ,$452.99 
SACRED HEART HOSPITAL (ACU),42400090,97164,HC PT RE-EVAL,424,1 ,$155.00 ,$116.25 ,$62.66 ,$155.00 ,$99.82 ,$67.53 ,$108.50 ,$62.66 ,$155.00 , N/A ,$155.00 ,$147.25 ,$77.71 ,$124.00 ,$142.60 ,$62.66 ,$131.75 ,$147.25 ,$136.40 ,$117.80 ,$77.71 ,$77.71 ,$62.66 ,$113.15 ,$85.25 ,$141.05 ,$141.05 ,$124.00 ,$69.56 ,$85.25 ,$139.50 ,$67.53 ,$139.50 ,$83.70 ,$145.70 ,$151.94 ,$142.60 ,$82.37 ,$141.05 ,$67.53 ,$95.39 ,$95.39 ,$139.50 ,$115.68 ,$139.50 ,$68.21 ,$62.66 ,$147.25 ,$70.91 ,$77.71 ,$134.85 ,$67.53 ,$139.50 ,$67.53 ,$139.50 ,$139.50 ,$139.50 ,$150.35 ,$125.55 ,$144.15 ,$133.30 ,$150.35 
SACRED HEART HOSPITAL (ACU),43000012,97018,HC PARAFFIN BATH,430,1 ,$76.00 ,$57.00 ,$5.44 ,$76.00 ,$48.94 ,$5.44 ,$53.20 ,$18.94 ,$76.00 , N/A ,$76.00 ,$72.20 ,$10.49 ,$60.80 ,$69.92 ,$18.94 ,$64.60 ,$72.20 ,$66.88 ,$57.76 ,$10.49 ,$10.49 ,$18.94 ,$55.48 ,$41.80 ,$69.16 ,$69.16 ,$60.80 ,$5.60 ,$41.80 ,$68.40 ,$5.44 ,$68.40 ,$41.04 ,$71.44 ,$12.24 ,$69.92 ,$11.12 ,$69.16 ,$5.44 ,$46.77 ,$46.77 ,$68.40 ,$56.72 ,$68.40 ,$5.49 ,$18.94 ,$72.20 ,$5.71 ,$10.49 ,$66.12 ,$5.44 ,$68.40 ,$5.44 ,$68.40 ,$68.40 ,$68.40 ,$73.72 ,$61.56 ,$70.68 ,$65.36 ,$73.72 
SACRED HEART HOSPITAL (ACU),43000013,97034,HC CONTRAST BATH EA 15 MIN,430,1 ,$94.00 ,$70.50 ,$10.49 ,$94.00 ,$60.54 ,$14.22 ,$65.80 ,$15.93 ,$94.00 , N/A ,$94.00 ,$89.30 ,$10.49 ,$75.20 ,$86.48 ,$15.93 ,$79.90 ,$89.30 ,$82.72 ,$71.44 ,$10.49 ,$10.49 ,$15.93 ,$68.62 ,$51.70 ,$85.54 ,$85.54 ,$75.20 ,$14.65 ,$51.70 ,$84.60 ,$14.22 ,$84.60 ,$50.76 ,$88.36 ,$32.00 ,$86.48 ,$11.12 ,$85.54 ,$14.22 ,$57.85 ,$57.85 ,$84.60 ,$70.15 ,$84.60 ,$14.36 ,$15.93 ,$89.30 ,$14.93 ,$10.49 ,$81.78 ,$14.22 ,$84.60 ,$14.22 ,$84.60 ,$84.60 ,$84.60 ,$91.18 ,$76.14 ,$87.42 ,$80.84 ,$91.18 
SACRED HEART HOSPITAL (ACU),43000015,97533,HC PERCEPTUAL ACTIVITY EA 15 MIN,430,1 ,$108.00 ,$81.00 ,$12.54 ,$141.26 ,$69.55 ,$62.78 ,$75.60 ,$18.87 ,$108.00 , N/A ,$108.00 ,$102.60 ,$12.54 ,$86.40 ,$99.36 ,$18.87 ,$91.80 ,$102.60 ,$95.04 ,$82.08 ,$12.54 ,$12.54 ,$18.87 ,$78.84 ,$59.40 ,$98.28 ,$98.28 ,$86.40 ,$64.66 ,$59.40 ,$97.20 ,$62.78 ,$97.20 ,$58.32 ,$101.52 ,$141.26 ,$99.36 ,$13.29 ,$98.28 ,$62.78 ,$66.46 ,$66.46 ,$97.20 ,$80.60 ,$97.20 ,$63.41 ,$18.87 ,$102.60 ,$65.92 ,$12.54 ,$93.96 ,$62.78 ,$97.20 ,$62.78 ,$97.20 ,$97.20 ,$97.20 ,$104.76 ,$87.48 ,$100.44 ,$92.88 ,$104.76 
SACRED HEART HOSPITAL (ACU),43000016,97535,HC SELF CARE ADL TRAINING EA 15MIN,430,1 ,$106.00 ,$79.50 ,$10.49 ,$106.00 ,$68.26 ,$32.08 ,$74.20 ,$20.93 ,$106.00 , N/A ,$106.00 ,$100.70 ,$10.49 ,$84.80 ,$97.52 ,$20.93 ,$90.10 ,$100.70 ,$93.28 ,$80.56 ,$10.49 ,$10.49 ,$20.93 ,$77.38 ,$58.30 ,$96.46 ,$96.46 ,$84.80 ,$33.04 ,$58.30 ,$95.40 ,$32.08 ,$95.40 ,$57.24 ,$99.64 ,$72.18 ,$97.52 ,$11.12 ,$96.46 ,$32.08 ,$65.23 ,$65.23 ,$95.40 ,$79.11 ,$95.40 ,$32.40 ,$20.93 ,$100.70 ,$33.68 ,$10.49 ,$92.22 ,$32.08 ,$95.40 ,$32.08 ,$95.40 ,$95.40 ,$95.40 ,$102.82 ,$85.86 ,$98.58 ,$91.16 ,$102.82 
SACRED HEART HOSPITAL (ACU),43000023,97537,HC WORK TASK ANALYSIS EA 15 MIN,430,1 ,$130.00 ,$97.50 ,$12.54 ,$130.00 ,$83.72 ,$31.16 ,$91.00 , N/A ,$130.00 , N/A ,$130.00 ,$123.50 ,$12.54 ,$104.00 ,$119.60 , N/A ,$110.50 ,$123.50 ,$114.40 ,$98.80 ,$12.54 ,$12.54 , N/A ,$94.90 ,$71.50 ,$118.30 ,$118.30 ,$104.00 ,$32.09 ,$71.50 ,$117.00 ,$31.16 ,$117.00 ,$70.20 ,$122.20 ,$70.11 ,$119.60 ,$13.29 ,$118.30 ,$31.16 ,$80.00 ,$80.00 ,$117.00 ,$97.02 ,$117.00 ,$31.47 ,$91.00 ,$123.50 ,$32.72 ,$12.54 ,$113.10 ,$31.16 ,$117.00 ,$31.16 ,$117.00 ,$117.00 ,$117.00 ,$126.10 ,$105.30 ,$120.90 ,$111.80 ,$126.10 
SACRED HEART HOSPITAL (ACU),43000024,97542,HC SEATING CLINIC EA 15 MIN,430,1 ,$86.00 ,$64.50 ,$12.54 ,$86.00 ,$55.38 ,$31.16 ,$60.20 ,$18.94 ,$86.00 , N/A ,$86.00 ,$81.70 ,$12.54 ,$68.80 ,$79.12 ,$18.94 ,$73.10 ,$81.70 ,$75.68 ,$65.36 ,$12.54 ,$12.54 ,$18.94 ,$62.78 ,$47.30 ,$78.26 ,$78.26 ,$68.80 ,$32.09 ,$47.30 ,$77.40 ,$31.16 ,$77.40 ,$46.44 ,$80.84 ,$70.11 ,$79.12 ,$13.29 ,$78.26 ,$31.16 ,$52.92 ,$52.92 ,$77.40 ,$64.18 ,$77.40 ,$31.47 ,$18.94 ,$81.70 ,$32.72 ,$12.54 ,$74.82 ,$31.16 ,$77.40 ,$31.16 ,$77.40 ,$77.40 ,$77.40 ,$83.42 ,$69.66 ,$79.98 ,$73.96 ,$83.42 
SACRED HEART HOSPITAL (ACU),43000027,97760,HC ORTHOTICS FABRICATION EA 15 MIN,430,1 ,$152.00 ,$114.00 ,$12.54 ,$152.00 ,$97.89 ,$47.50 ,$106.40 , N/A ,$152.00 , N/A ,$152.00 ,$144.40 ,$12.54 ,$121.60 ,$139.84 , N/A ,$129.20 ,$144.40 ,$133.76 ,$115.52 ,$12.54 ,$12.54 , N/A ,$110.96 ,$83.60 ,$138.32 ,$138.32 ,$121.60 ,$48.93 ,$83.60 ,$136.80 ,$47.50 ,$136.80 ,$82.08 ,$142.88 ,$106.88 ,$139.84 ,$13.29 ,$138.32 ,$47.50 ,$93.54 ,$93.54 ,$136.80 ,$113.44 ,$136.80 ,$47.98 ,$106.40 ,$144.40 ,$49.88 ,$12.54 ,$132.24 ,$47.50 ,$136.80 ,$47.50 ,$136.80 ,$136.80 ,$136.80 ,$147.44 ,$123.12 ,$141.36 ,$130.72 ,$147.44 
SACRED HEART HOSPITAL (ACU),43000035,97545,HC WORK HARDENING/CONDITIONING FIRST 2 HRS,430,1 ,$240.00 ,$180.00 ,$10.49 ,$240.00 ,$154.56 , N/A ,$168.00 , N/A ,$240.00 , N/A ,$214.00 ,$228.00 ,$10.49 ,$192.00 ,$220.80 , N/A ,$204.00 ,$228.00 ,$211.20 ,$182.40 ,$10.49 ,$10.49 , N/A ,$175.20 ,$132.00 ,$218.40 ,$218.40 ,$192.00 , N/A ,$132.00 ,$216.00 , N/A ,$216.00 ,$129.60 ,$225.60 , N/A ,$220.80 ,$11.12 ,$218.40 , N/A ,$147.70 ,$147.70 ,$216.00 ,$179.11 ,$155.42 , N/A ,$168.00 ,$228.00 , N/A ,$10.49 ,$208.80 , N/A ,$216.00 , N/A ,$216.00 ,$216.00 ,$216.00 ,$232.80 ,$194.40 ,$223.20 ,$206.40 ,$232.80 
SACRED HEART HOSPITAL (ACU),43000036,97546,HC WORK HARDENING/CONDITIONINS ADD 1 HOUR,430,1 ,$119.00 ,$89.25 ,$10.49 ,$119.00 ,$76.64 , N/A ,$83.30 , N/A ,$119.00 , N/A ,$119.00 ,$113.05 ,$10.49 ,$95.20 ,$109.48 , N/A ,$101.15 ,$113.05 ,$104.72 ,$90.44 ,$10.49 ,$10.49 , N/A ,$86.87 ,$65.45 ,$108.29 ,$108.29 ,$95.20 , N/A ,$65.45 ,$107.10 , N/A ,$107.10 ,$64.26 ,$111.86 , N/A ,$109.48 ,$11.12 ,$108.29 , N/A ,$73.23 ,$73.23 ,$107.10 ,$88.81 ,$107.10 , N/A ,$83.30 ,$113.05 , N/A ,$10.49 ,$103.53 , N/A ,$107.10 , N/A ,$107.10 ,$107.10 ,$107.10 ,$115.43 ,$96.39 ,$110.67 ,$102.34 ,$115.43 
SACRED HEART HOSPITAL (ACU),43000037,N/A,HC POST-OFFER JOB SCREEN,430,1 ,$38.00 ,$28.50 ,$20.52 ,$38.00 ,$24.47 , N/A ,$26.60 , N/A ,$38.00 , N/A ,$38.00 ,$36.10 , N/A ,$30.40 ,$34.96 , N/A ,$32.30 ,$36.10 ,$33.44 ,$28.88 , N/A , N/A , N/A ,$27.74 ,$20.90 ,$34.58 ,$34.58 ,$30.40 , N/A ,$20.90 ,$34.20 , N/A ,$34.20 ,$20.52 ,$35.72 , N/A ,$34.96 , N/A ,$34.58 , N/A ,$23.39 ,$23.39 ,$34.20 ,$28.36 ,$34.20 , N/A ,$26.60 ,$36.10 , N/A , N/A ,$33.06 , N/A ,$34.20 , N/A ,$34.20 ,$34.20 ,$34.20 ,$36.86 ,$30.78 ,$35.34 ,$32.68 ,$36.86 
SACRED HEART HOSPITAL (ACU),43000061,97129,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION INITIAL 15 MIN,430,1 ,$65.00 ,$48.75 ,$12.54 ,$65.00 ,$41.86 ,$22.40 ,$45.50 , N/A ,$65.00 , N/A ,$65.00 ,$61.75 ,$12.54 ,$52.00 ,$59.80 , N/A ,$55.25 ,$61.75 ,$57.20 ,$49.40 ,$12.54 ,$12.54 , N/A ,$47.45 ,$35.75 ,$59.15 ,$59.15 ,$52.00 ,$23.07 ,$35.75 ,$58.50 ,$22.40 ,$58.50 ,$35.10 ,$61.10 ,$50.40 ,$59.80 ,$13.29 ,$59.15 ,$22.40 ,$40.00 ,$40.00 ,$58.50 ,$48.51 ,$58.50 ,$22.62 ,$45.50 ,$61.75 ,$23.52 ,$12.54 ,$56.55 ,$22.40 ,$58.50 ,$22.40 ,$58.50 ,$58.50 ,$58.50 ,$63.05 ,$52.65 ,$60.45 ,$55.90 ,$63.05 
SACRED HEART HOSPITAL (ACU),43000062,97130,HC COGNITIVE FUNCTION THERAPEUTIC INTERVENTION ADDL 15 MIN,430,1 ,$65.00 ,$48.75 ,$12.54 ,$65.00 ,$41.86 ,$21.71 ,$45.50 , N/A ,$65.00 , N/A ,$65.00 ,$61.75 ,$12.54 ,$52.00 ,$59.80 , N/A ,$55.25 ,$61.75 ,$57.20 ,$49.40 ,$12.54 ,$12.54 , N/A ,$47.45 ,$35.75 ,$59.15 ,$59.15 ,$52.00 ,$22.36 ,$35.75 ,$58.50 ,$21.71 ,$58.50 ,$35.10 ,$61.10 ,$48.85 ,$59.80 ,$13.29 ,$59.15 ,$21.71 ,$40.00 ,$40.00 ,$58.50 ,$48.51 ,$58.50 ,$21.93 ,$45.50 ,$61.75 ,$22.80 ,$12.54 ,$56.55 ,$21.71 ,$58.50 ,$21.71 ,$58.50 ,$58.50 ,$58.50 ,$63.05 ,$52.65 ,$60.45 ,$55.90 ,$63.05 
SACRED HEART HOSPITAL (ACU),43400023,97799,HC OT PATIENT TEAM EVAL,434,1 ,$73.00 ,$54.75 ,$10.49 ,$84.18 ,$47.01 , N/A ,$51.10 ,$73.00 ,$73.00 ,$84.18 ,$73.00 ,$69.35 ,$10.49 ,$58.40 ,$67.16 ,$73.00 ,$62.05 ,$69.35 ,$64.24 ,$55.48 ,$10.49 ,$10.49 ,$81.73 ,$53.29 ,$40.15 ,$66.43 ,$66.43 ,$58.40 , N/A ,$40.15 ,$65.70 , N/A ,$65.70 ,$39.42 ,$68.62 ,$43.80 ,$67.16 ,$11.12 ,$66.43 , N/A ,$44.92 ,$44.92 ,$65.70 ,$54.48 ,$65.70 ,$59.86 ,$73.00 ,$69.35 , N/A ,$10.49 ,$63.51 , N/A ,$65.70 , N/A ,$65.70 ,$65.70 ,$65.70 ,$70.81 ,$59.13 ,$67.89 ,$62.78 ,$70.81 
SACRED HEART HOSPITAL (ACU),43400078,97165,HC OT EVAL LOW COMPLEXITY,434,1 ,$176.00 ,$132.00 ,$59.96 ,$222.01 ,$113.34 ,$98.67 ,$123.20 ,$62.66 ,$176.00 , N/A ,$176.00 ,$167.20 ,$59.96 ,$140.80 ,$161.92 ,$62.66 ,$149.60 ,$167.20 ,$154.88 ,$133.76 ,$59.96 ,$59.96 ,$62.66 ,$128.48 ,$96.80 ,$160.16 ,$160.16 ,$140.80 ,$101.63 ,$96.80 ,$158.40 ,$98.67 ,$158.40 ,$95.04 ,$165.44 ,$222.01 ,$161.92 ,$63.56 ,$160.16 ,$98.67 ,$108.31 ,$108.31 ,$158.40 ,$131.35 ,$155.42 ,$99.66 ,$62.66 ,$167.20 ,$103.60 ,$59.96 ,$153.12 ,$98.67 ,$158.40 ,$98.67 ,$158.40 ,$158.40 ,$158.40 ,$170.72 ,$142.56 ,$163.68 ,$151.36 ,$170.72 
SACRED HEART HOSPITAL (ACU),43400079,97166,HC OT EVAL MOD COMPLEXITY,434,1 ,$279.00 ,$209.25 ,$59.96 ,$279.00 ,$179.68 ,$98.67 ,$195.30 ,$62.66 ,$268.00 , N/A ,$214.00 ,$265.05 ,$59.96 ,$223.20 ,$256.68 ,$62.66 ,$237.15 ,$265.05 ,$245.52 ,$212.04 ,$59.96 ,$59.96 ,$62.66 ,$203.67 ,$153.45 ,$253.89 ,$253.89 ,$223.20 ,$101.63 ,$153.45 ,$251.10 ,$98.67 ,$251.10 ,$150.66 ,$262.26 ,$222.01 ,$256.68 ,$63.56 ,$253.89 ,$98.67 ,$171.70 ,$171.70 ,$251.10 ,$208.22 ,$155.42 ,$99.66 ,$62.66 ,$265.05 ,$103.60 ,$59.96 ,$242.73 ,$98.67 ,$251.10 ,$98.67 ,$251.10 ,$251.10 ,$251.10 ,$270.63 ,$225.99 ,$259.47 ,$239.94 ,$270.63 
SACRED HEART HOSPITAL (ACU),43400080,97167,HC OT EVAL HIGH COMPLEXITY,434,1 ,$456.00 ,$342.00 ,$59.96 ,$456.00 ,$293.66 ,$98.67 ,$319.20 ,$62.66 ,$268.00 , N/A ,$214.00 ,$433.20 ,$59.96 ,$364.80 ,$419.52 ,$62.66 ,$387.60 ,$433.20 ,$401.28 ,$346.56 ,$59.96 ,$59.96 ,$62.66 ,$332.88 ,$250.80 ,$414.96 ,$414.96 ,$364.80 ,$101.63 ,$250.80 ,$410.40 ,$98.67 ,$410.40 ,$246.24 ,$428.64 ,$222.01 ,$419.52 ,$63.56 ,$414.96 ,$98.67 ,$280.62 ,$280.62 ,$410.40 ,$340.31 ,$155.42 ,$99.66 ,$62.66 ,$433.20 ,$103.60 ,$59.96 ,$396.72 ,$98.67 ,$410.40 ,$98.67 ,$410.40 ,$410.40 ,$410.40 ,$442.32 ,$369.36 ,$424.08 ,$392.16 ,$442.32 
SACRED HEART HOSPITAL (ACU),43400081,97168,HC OT RE-EVAL,434,1 ,$158.00 ,$118.50 ,$59.96 ,$158.00 ,$101.75 ,$67.86 ,$110.60 ,$62.66 ,$158.00 , N/A ,$158.00 ,$150.10 ,$59.96 ,$126.40 ,$145.36 ,$62.66 ,$134.30 ,$150.10 ,$139.04 ,$120.08 ,$59.96 ,$59.96 ,$62.66 ,$115.34 ,$86.90 ,$143.78 ,$143.78 ,$126.40 ,$69.90 ,$86.90 ,$142.20 ,$67.86 ,$142.20 ,$85.32 ,$148.52 ,$152.69 ,$145.36 ,$63.56 ,$143.78 ,$67.86 ,$97.23 ,$97.23 ,$142.20 ,$117.92 ,$142.20 ,$68.54 ,$62.66 ,$150.10 ,$71.25 ,$59.96 ,$137.46 ,$67.86 ,$142.20 ,$67.86 ,$142.20 ,$142.20 ,$142.20 ,$153.26 ,$127.98 ,$146.94 ,$135.88 ,$153.26 
SACRED HEART HOSPITAL (ACU),44000000,92507,HC SPEECH THERAPY TREATMENT 15MIN,440,1 ,$138.00 ,$103.50 ,$47.91 ,$169.13 ,$88.87 ,$75.17 ,$96.60 ,$47.91 ,$138.00 ,$89.23 ,$138.00 ,$131.10 ,$75.01 ,$110.40 ,$126.96 ,$47.91 ,$117.30 ,$131.10 ,$121.44 ,$104.88 ,$75.01 ,$75.01 ,$47.91 ,$100.74 ,$75.90 ,$125.58 ,$125.58 ,$110.40 ,$77.43 ,$75.90 ,$124.20 ,$75.17 ,$124.20 ,$74.52 ,$129.72 ,$169.13 ,$126.96 ,$79.51 ,$125.58 ,$75.17 ,$84.93 ,$84.93 ,$124.20 ,$102.99 ,$124.20 ,$75.92 ,$47.91 ,$131.10 ,$78.93 ,$75.01 ,$120.06 ,$75.17 ,$124.20 ,$75.17 ,$124.20 ,$124.20 ,$124.20 ,$133.86 ,$111.78 ,$128.34 ,$118.68 ,$133.86 
SACRED HEART HOSPITAL (ACU),44000001,92507,HC SPEECH THERAPY TREATMENT 30MIN,440,1 ,$289.00 ,$216.75 ,$47.91 ,$289.00 ,$186.12 ,$75.17 ,$202.30 ,$47.91 ,$289.00 ,$89.23 ,$258.00 ,$274.55 ,$75.01 ,$231.20 ,$265.88 ,$47.91 ,$245.65 ,$274.55 ,$254.32 ,$219.64 ,$75.01 ,$75.01 ,$47.91 ,$210.97 ,$158.95 ,$262.99 ,$262.99 ,$231.20 ,$77.43 ,$158.95 ,$260.10 ,$75.17 ,$260.10 ,$156.06 ,$271.66 ,$169.13 ,$265.88 ,$79.51 ,$262.99 ,$75.17 ,$177.85 ,$177.85 ,$260.10 ,$215.68 ,$155.42 ,$75.92 ,$47.91 ,$274.55 ,$78.93 ,$75.01 ,$251.43 ,$75.17 ,$260.10 ,$75.17 ,$260.10 ,$260.10 ,$260.10 ,$280.33 ,$234.09 ,$268.77 ,$248.54 ,$280.33 
SACRED HEART HOSPITAL (ACU),44000002,92507,HC SPEECH THERAPY TREATMENT 45MIN,440,1 ,$439.00 ,$329.25 ,$47.91 ,$439.00 ,$282.72 ,$75.17 ,$307.30 ,$47.91 ,$322.00 ,$89.23 ,$258.00 ,$417.05 ,$75.01 ,$351.20 ,$403.88 ,$47.91 ,$373.15 ,$417.05 ,$386.32 ,$333.64 ,$75.01 ,$75.01 ,$47.91 ,$320.47 ,$241.45 ,$399.49 ,$399.49 ,$351.20 ,$77.43 ,$241.45 ,$395.10 ,$75.17 ,$395.10 ,$237.06 ,$412.66 ,$169.13 ,$403.88 ,$79.51 ,$399.49 ,$75.17 ,$270.16 ,$270.16 ,$395.10 ,$327.63 ,$155.42 ,$75.92 ,$47.91 ,$417.05 ,$78.93 ,$75.01 ,$381.93 ,$75.17 ,$395.10 ,$75.17 ,$395.10 ,$395.10 ,$395.10 ,$425.83 ,$355.59 ,$408.27 ,$377.54 ,$425.83 
SACRED HEART HOSPITAL (ACU),44000003,92507,HC SPEECH THERAPY TREATMENT 60MIN,440,1 ,$589.00 ,$441.75 ,$47.91 ,$589.00 ,$379.32 ,$75.17 ,$412.30 ,$47.91 ,$322.00 ,$89.23 ,$258.00 ,$559.55 ,$75.01 ,$471.20 ,$541.88 ,$47.91 ,$500.65 ,$559.55 ,$518.32 ,$447.64 ,$75.01 ,$75.01 ,$47.91 ,$429.97 ,$323.95 ,$535.99 ,$535.99 ,$471.20 ,$77.43 ,$323.95 ,$530.10 ,$75.17 ,$530.10 ,$318.06 ,$553.66 ,$169.13 ,$541.88 ,$79.51 ,$535.99 ,$75.17 ,$362.47 ,$362.47 ,$530.10 ,$439.57 ,$155.42 ,$75.92 ,$47.91 ,$559.55 ,$78.93 ,$75.01 ,$512.43 ,$75.17 ,$530.10 ,$75.17 ,$530.10 ,$530.10 ,$530.10 ,$571.33 ,$477.09 ,$547.77 ,$506.54 ,$571.33 
SACRED HEART HOSPITAL (ACU),44000009,92526,HC DYSPHAGIA TREATMENT 15MIN,440,1 ,$133.00 ,$99.75 ,$12.54 ,$187.65 ,$85.65 ,$83.40 ,$93.10 ,$48.82 ,$133.00 , N/A ,$133.00 ,$126.35 ,$12.54 ,$106.40 ,$122.36 ,$48.82 ,$113.05 ,$126.35 ,$117.04 ,$101.08 ,$12.54 ,$12.54 ,$48.82 ,$97.09 ,$73.15 ,$121.03 ,$121.03 ,$106.40 ,$85.90 ,$73.15 ,$119.70 ,$83.40 ,$119.70 ,$71.82 ,$125.02 ,$187.65 ,$122.36 ,$13.29 ,$121.03 ,$83.40 ,$81.85 ,$81.85 ,$119.70 ,$99.26 ,$119.70 ,$84.23 ,$48.82 ,$126.35 ,$87.57 ,$12.54 ,$115.71 ,$83.40 ,$119.70 ,$83.40 ,$119.70 ,$119.70 ,$119.70 ,$129.01 ,$107.73 ,$123.69 ,$114.38 ,$129.01 
SACRED HEART HOSPITAL (ACU),44000015,92526,HC DYSPHAGIA TREATMENT 30MIN,440,1 ,$222.00 ,$166.50 ,$12.54 ,$222.00 ,$142.97 ,$83.40 ,$155.40 ,$48.82 ,$222.00 , N/A ,$222.00 ,$210.90 ,$12.54 ,$177.60 ,$204.24 ,$48.82 ,$188.70 ,$210.90 ,$195.36 ,$168.72 ,$12.54 ,$12.54 ,$48.82 ,$162.06 ,$122.10 ,$202.02 ,$202.02 ,$177.60 ,$85.90 ,$122.10 ,$199.80 ,$83.40 ,$199.80 ,$119.88 ,$208.68 ,$187.65 ,$204.24 ,$13.29 ,$202.02 ,$83.40 ,$136.62 ,$136.62 ,$199.80 ,$165.68 ,$155.42 ,$84.23 ,$48.82 ,$210.90 ,$87.57 ,$12.54 ,$193.14 ,$83.40 ,$199.80 ,$83.40 ,$199.80 ,$199.80 ,$199.80 ,$215.34 ,$179.82 ,$206.46 ,$190.92 ,$215.34 
SACRED HEART HOSPITAL (ACU),44000016,92526,HC DYSPHAGIA TREATMENT 45MIN,440,1 ,$333.00 ,$249.75 ,$12.54 ,$333.00 ,$214.45 ,$83.40 ,$233.10 ,$48.82 ,$322.00 , N/A ,$258.00 ,$316.35 ,$12.54 ,$266.40 ,$306.36 ,$48.82 ,$283.05 ,$316.35 ,$293.04 ,$253.08 ,$12.54 ,$12.54 ,$48.82 ,$243.09 ,$183.15 ,$303.03 ,$303.03 ,$266.40 ,$85.90 ,$183.15 ,$299.70 ,$83.40 ,$299.70 ,$179.82 ,$313.02 ,$187.65 ,$306.36 ,$13.29 ,$303.03 ,$83.40 ,$204.93 ,$204.93 ,$299.70 ,$248.52 ,$155.42 ,$84.23 ,$48.82 ,$316.35 ,$87.57 ,$12.54 ,$289.71 ,$83.40 ,$299.70 ,$83.40 ,$299.70 ,$299.70 ,$299.70 ,$323.01 ,$269.73 ,$309.69 ,$286.38 ,$323.01 
SACRED HEART HOSPITAL (ACU),44000017,92526,HC DYSPHAGIA TREATMENT 60MIN,440,1 ,$444.00 ,$333.00 ,$12.54 ,$444.00 ,$285.94 ,$83.40 ,$310.80 ,$48.82 ,$322.00 , N/A ,$258.00 ,$421.80 ,$12.54 ,$355.20 ,$408.48 ,$48.82 ,$377.40 ,$421.80 ,$390.72 ,$337.44 ,$12.54 ,$12.54 ,$48.82 ,$324.12 ,$244.20 ,$404.04 ,$404.04 ,$355.20 ,$85.90 ,$244.20 ,$399.60 ,$83.40 ,$399.60 ,$239.76 ,$417.36 ,$187.65 ,$408.48 ,$13.29 ,$404.04 ,$83.40 ,$273.24 ,$273.24 ,$399.60 ,$331.36 ,$155.42 ,$84.23 ,$48.82 ,$421.80 ,$87.57 ,$12.54 ,$386.28 ,$83.40 ,$399.60 ,$83.40 ,$399.60 ,$399.60 ,$399.60 ,$430.68 ,$359.64 ,$412.92 ,$381.84 ,$430.68 
SACRED HEART HOSPITAL (ACU),44000022,92507,HC SPEECH THERAPY TREATMENT 75MIN,440,1 ,$680.00 ,$510.00 ,$47.91 ,$680.00 ,$437.92 ,$75.17 ,$476.00 ,$47.91 ,$322.00 ,$89.23 ,$258.00 ,$646.00 ,$75.01 ,$544.00 ,$625.60 ,$47.91 ,$578.00 ,$646.00 ,$598.40 ,$516.80 ,$75.01 ,$75.01 ,$47.91 ,$496.40 ,$374.00 ,$618.80 ,$618.80 ,$544.00 ,$77.43 ,$374.00 ,$612.00 ,$75.17 ,$612.00 ,$367.20 ,$639.20 ,$169.13 ,$625.60 ,$79.51 ,$618.80 ,$75.17 ,$418.47 ,$418.47 ,$612.00 ,$507.48 ,$155.42 ,$75.92 ,$47.91 ,$646.00 ,$78.93 ,$75.01 ,$591.60 ,$75.17 ,$612.00 ,$75.17 ,$612.00 ,$612.00 ,$612.00 ,$659.60 ,$550.80 ,$632.40 ,$584.80 ,$659.60 
SACRED HEART HOSPITAL (ACU),44000023,92507,HC SPEECH THERAPY TREATMENT 90MIN,440,1 ,$739.00 ,$554.25 ,$47.91 ,$739.00 ,$475.92 ,$75.17 ,$517.30 ,$47.91 ,$322.00 ,$89.23 ,$258.00 ,$702.05 ,$75.01 ,$591.20 ,$679.88 ,$47.91 ,$628.15 ,$702.05 ,$650.32 ,$561.64 ,$75.01 ,$75.01 ,$47.91 ,$539.47 ,$406.45 ,$672.49 ,$672.49 ,$591.20 ,$77.43 ,$406.45 ,$665.10 ,$75.17 ,$665.10 ,$399.06 ,$694.66 ,$169.13 ,$679.88 ,$79.51 ,$672.49 ,$75.17 ,$454.78 ,$454.78 ,$665.10 ,$551.52 ,$155.42 ,$75.92 ,$47.91 ,$702.05 ,$78.93 ,$75.01 ,$642.93 ,$75.17 ,$665.10 ,$75.17 ,$665.10 ,$665.10 ,$665.10 ,$716.83 ,$598.59 ,$687.27 ,$635.54 ,$716.83 
SACRED HEART HOSPITAL (ACU),44000024,92507,HC SPEECH THERAPY TREATMENT 105MIN,440,1 ,$921.00 ,$690.75 ,$47.91 ,$921.00 ,$593.12 ,$75.17 ,$644.70 ,$47.91 ,$322.00 ,$89.23 ,$258.00 ,$874.95 ,$75.01 ,$736.80 ,$847.32 ,$47.91 ,$782.85 ,$874.95 ,$810.48 ,$699.96 ,$75.01 ,$75.01 ,$47.91 ,$672.33 ,$506.55 ,$838.11 ,$838.11 ,$736.80 ,$77.43 ,$506.55 ,$828.90 ,$75.17 ,$828.90 ,$497.34 ,$865.74 ,$169.13 ,$847.32 ,$79.51 ,$838.11 ,$75.17 ,$566.78 ,$566.78 ,$828.90 ,$687.34 ,$155.42 ,$75.92 ,$47.91 ,$874.95 ,$78.93 ,$75.01 ,$801.27 ,$75.17 ,$828.90 ,$75.17 ,$828.90 ,$828.90 ,$828.90 ,$893.37 ,$746.01 ,$856.53 ,$792.06 ,$893.37 
SACRED HEART HOSPITAL (ACU),44000033,92508,HC SPEECH THERAPY TREATMENT GROUP 30MIN,440,1 ,$93.00 ,$69.75 ,$12.54 ,$93.00 ,$59.89 ,$23.26 ,$65.10 ,$28.29 ,$93.00 , N/A ,$93.00 ,$88.35 ,$12.54 ,$74.40 ,$85.56 ,$28.29 ,$79.05 ,$88.35 ,$81.84 ,$70.68 ,$12.54 ,$12.54 ,$28.29 ,$67.89 ,$51.15 ,$84.63 ,$84.63 ,$74.40 ,$23.96 ,$51.15 ,$83.70 ,$23.26 ,$83.70 ,$50.22 ,$87.42 ,$52.34 ,$85.56 ,$13.29 ,$84.63 ,$23.26 ,$57.23 ,$57.23 ,$83.70 ,$69.41 ,$83.70 ,$23.49 ,$28.29 ,$88.35 ,$24.42 ,$12.54 ,$80.91 ,$23.26 ,$83.70 ,$23.26 ,$83.70 ,$83.70 ,$83.70 ,$90.21 ,$75.33 ,$86.49 ,$79.98 ,$90.21 
SACRED HEART HOSPITAL (ACU),44000034,92508,HC SPEECH THERAPY TREATMENT GROUP 45MIN,440,1 ,$129.00 ,$96.75 ,$12.54 ,$129.00 ,$83.08 ,$23.26 ,$90.30 ,$28.29 ,$129.00 , N/A ,$129.00 ,$122.55 ,$12.54 ,$103.20 ,$118.68 ,$28.29 ,$109.65 ,$122.55 ,$113.52 ,$98.04 ,$12.54 ,$12.54 ,$28.29 ,$94.17 ,$70.95 ,$117.39 ,$117.39 ,$103.20 ,$23.96 ,$70.95 ,$116.10 ,$23.26 ,$116.10 ,$69.66 ,$121.26 ,$52.34 ,$118.68 ,$13.29 ,$117.39 ,$23.26 ,$79.39 ,$79.39 ,$116.10 ,$96.27 ,$116.10 ,$23.49 ,$28.29 ,$122.55 ,$24.42 ,$12.54 ,$112.23 ,$23.26 ,$116.10 ,$23.26 ,$116.10 ,$116.10 ,$116.10 ,$125.13 ,$104.49 ,$119.97 ,$110.94 ,$125.13 
SACRED HEART HOSPITAL (ACU),44000035,92508,HC SPEECH THERAPY TREATMENT GROUP 60MIN,440,1 ,$185.00 ,$138.75 ,$12.54 ,$185.00 ,$119.14 ,$23.26 ,$129.50 ,$28.29 ,$185.00 , N/A ,$185.00 ,$175.75 ,$12.54 ,$148.00 ,$170.20 ,$28.29 ,$157.25 ,$175.75 ,$162.80 ,$140.60 ,$12.54 ,$12.54 ,$28.29 ,$135.05 ,$101.75 ,$168.35 ,$168.35 ,$148.00 ,$23.96 ,$101.75 ,$166.50 ,$23.26 ,$166.50 ,$99.90 ,$173.90 ,$52.34 ,$170.20 ,$13.29 ,$168.35 ,$23.26 ,$113.85 ,$113.85 ,$166.50 ,$138.07 ,$155.42 ,$23.49 ,$28.29 ,$175.75 ,$24.42 ,$12.54 ,$160.95 ,$23.26 ,$166.50 ,$23.26 ,$166.50 ,$166.50 ,$166.50 ,$179.45 ,$149.85 ,$172.05 ,$159.10 ,$179.45 
SACRED HEART HOSPITAL (ACU),44000036,92526,HC SPEECH THERAPY TREATMENT DYSPHAGIA 75MIN,440,1 ,$494.00 ,$370.50 ,$12.54 ,$494.00 ,$318.14 ,$83.40 ,$345.80 ,$48.82 ,$322.00 , N/A ,$258.00 ,$469.30 ,$12.54 ,$395.20 ,$454.48 ,$48.82 ,$419.90 ,$469.30 ,$434.72 ,$375.44 ,$12.54 ,$12.54 ,$48.82 ,$360.62 ,$271.70 ,$449.54 ,$449.54 ,$395.20 ,$85.90 ,$271.70 ,$444.60 ,$83.40 ,$444.60 ,$266.76 ,$464.36 ,$187.65 ,$454.48 ,$13.29 ,$449.54 ,$83.40 ,$304.01 ,$304.01 ,$444.60 ,$368.67 ,$155.42 ,$84.23 ,$48.82 ,$469.30 ,$87.57 ,$12.54 ,$429.78 ,$83.40 ,$444.60 ,$83.40 ,$444.60 ,$444.60 ,$444.60 ,$479.18 ,$400.14 ,$459.42 ,$424.84 ,$479.18 
SACRED HEART HOSPITAL (ACU),44000037,92526,HC SPEECH THERAPY TREATMENT DYSPHAGIA 90MIN,440,1 ,$539.00 ,$404.25 ,$12.54 ,$539.00 ,$347.12 ,$83.40 ,$377.30 ,$48.82 ,$322.00 , N/A ,$258.00 ,$512.05 ,$12.54 ,$431.20 ,$495.88 ,$48.82 ,$458.15 ,$512.05 ,$474.32 ,$409.64 ,$12.54 ,$12.54 ,$48.82 ,$393.47 ,$296.45 ,$490.49 ,$490.49 ,$431.20 ,$85.90 ,$296.45 ,$485.10 ,$83.40 ,$485.10 ,$291.06 ,$506.66 ,$187.65 ,$495.88 ,$13.29 ,$490.49 ,$83.40 ,$331.70 ,$331.70 ,$485.10 ,$402.26 ,$155.42 ,$84.23 ,$48.82 ,$512.05 ,$87.57 ,$12.54 ,$468.93 ,$83.40 ,$485.10 ,$83.40 ,$485.10 ,$485.10 ,$485.10 ,$522.83 ,$436.59 ,$501.27 ,$463.54 ,$522.83 
SACRED HEART HOSPITAL (ACU),44000038,92526,HC SPEECH THERAPY TREATMENT DYSPHAGIA 105MIN,440,1 ,$584.00 ,$438.00 ,$12.54 ,$584.00 ,$376.10 ,$83.40 ,$408.80 ,$48.82 ,$322.00 , N/A ,$258.00 ,$554.80 ,$12.54 ,$467.20 ,$537.28 ,$48.82 ,$496.40 ,$554.80 ,$513.92 ,$443.84 ,$12.54 ,$12.54 ,$48.82 ,$426.32 ,$321.20 ,$531.44 ,$531.44 ,$467.20 ,$85.90 ,$321.20 ,$525.60 ,$83.40 ,$525.60 ,$315.36 ,$548.96 ,$187.65 ,$537.28 ,$13.29 ,$531.44 ,$83.40 ,$359.39 ,$359.39 ,$525.60 ,$435.84 ,$155.42 ,$84.23 ,$48.82 ,$554.80 ,$87.57 ,$12.54 ,$508.08 ,$83.40 ,$525.60 ,$83.40 ,$525.60 ,$525.60 ,$525.60 ,$566.48 ,$473.04 ,$543.12 ,$502.24 ,$566.48 
SACRED HEART HOSPITAL (ACU),44000041,97799,HC SPEECH THERAPY EVAL TEAM INIT,440,1 ,$73.00 ,$54.75 ,$10.49 ,$84.18 ,$47.01 , N/A ,$51.10 ,$73.00 ,$73.00 ,$84.18 ,$73.00 ,$69.35 ,$10.49 ,$58.40 ,$67.16 ,$73.00 ,$62.05 ,$69.35 ,$64.24 ,$55.48 ,$10.49 ,$10.49 ,$81.73 ,$53.29 ,$40.15 ,$66.43 ,$66.43 ,$58.40 , N/A ,$40.15 ,$65.70 , N/A ,$65.70 ,$39.42 ,$68.62 ,$43.80 ,$67.16 ,$11.12 ,$66.43 , N/A ,$44.92 ,$44.92 ,$65.70 ,$54.48 ,$65.70 ,$59.86 ,$73.00 ,$69.35 , N/A ,$10.49 ,$63.51 , N/A ,$65.70 , N/A ,$65.70 ,$65.70 ,$65.70 ,$70.81 ,$59.13 ,$67.89 ,$62.78 ,$70.81 
SACRED HEART HOSPITAL (ACU),44000043,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 30MIN,440,1 ,$93.00 ,$69.75 ,$12.54 ,$228.42 ,$59.89 ,$101.52 ,$65.10 ,$47.64 ,$93.00 , N/A ,$93.00 ,$88.35 ,$12.54 ,$74.40 ,$85.56 ,$47.64 ,$79.05 ,$88.35 ,$81.84 ,$70.68 ,$12.54 ,$12.54 ,$47.64 ,$67.89 ,$51.15 ,$84.63 ,$84.63 ,$74.40 ,$104.57 ,$51.15 ,$83.70 ,$101.52 ,$83.70 ,$50.22 ,$87.42 ,$228.42 ,$85.56 ,$13.29 ,$84.63 ,$101.52 ,$57.23 ,$57.23 ,$83.70 ,$69.41 ,$83.70 ,$102.54 ,$47.64 ,$88.35 ,$106.60 ,$12.54 ,$80.91 ,$101.52 ,$83.70 ,$101.52 ,$83.70 ,$83.70 ,$83.70 ,$90.21 ,$75.33 ,$86.49 ,$79.98 ,$90.21 
SACRED HEART HOSPITAL (ACU),44000044,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 45MIN,440,1 ,$116.00 ,$87.00 ,$12.54 ,$228.42 ,$74.70 ,$101.52 ,$81.20 ,$47.64 ,$116.00 , N/A ,$116.00 ,$110.20 ,$12.54 ,$92.80 ,$106.72 ,$47.64 ,$98.60 ,$110.20 ,$102.08 ,$88.16 ,$12.54 ,$12.54 ,$47.64 ,$84.68 ,$63.80 ,$105.56 ,$105.56 ,$92.80 ,$104.57 ,$63.80 ,$104.40 ,$101.52 ,$104.40 ,$62.64 ,$109.04 ,$228.42 ,$106.72 ,$13.29 ,$105.56 ,$101.52 ,$71.39 ,$71.39 ,$104.40 ,$86.57 ,$104.40 ,$102.54 ,$47.64 ,$110.20 ,$106.60 ,$12.54 ,$100.92 ,$101.52 ,$104.40 ,$101.52 ,$104.40 ,$104.40 ,$104.40 ,$112.52 ,$93.96 ,$107.88 ,$99.76 ,$112.52 
SACRED HEART HOSPITAL (ACU),44000045,92609,HC SPEECH THERAPY SPEECH GENERATING DVC 60MIN,440,1 ,$140.00 ,$105.00 ,$12.54 ,$228.42 ,$90.16 ,$101.52 ,$98.00 ,$47.64 ,$140.00 , N/A ,$140.00 ,$133.00 ,$12.54 ,$112.00 ,$128.80 ,$47.64 ,$119.00 ,$133.00 ,$123.20 ,$106.40 ,$12.54 ,$12.54 ,$47.64 ,$102.20 ,$77.00 ,$127.40 ,$127.40 ,$112.00 ,$104.57 ,$77.00 ,$126.00 ,$101.52 ,$126.00 ,$75.60 ,$131.60 ,$228.42 ,$128.80 ,$13.29 ,$127.40 ,$101.52 ,$86.16 ,$86.16 ,$126.00 ,$104.48 ,$126.00 ,$102.54 ,$47.64 ,$133.00 ,$106.60 ,$12.54 ,$121.80 ,$101.52 ,$126.00 ,$101.52 ,$126.00 ,$126.00 ,$126.00 ,$135.80 ,$113.40 ,$130.20 ,$120.40 ,$135.80 
SACRED HEART HOSPITAL (ACU),44000056,92508,HC SPEECH THERAPY TREATMENT GROUP 75MIN,440,1 ,$220.00 ,$165.00 ,$12.54 ,$220.00 ,$141.68 ,$23.26 ,$154.00 ,$28.29 ,$220.00 , N/A ,$220.00 ,$209.00 ,$12.54 ,$176.00 ,$202.40 ,$28.29 ,$187.00 ,$209.00 ,$193.60 ,$167.20 ,$12.54 ,$12.54 ,$28.29 ,$160.60 ,$121.00 ,$200.20 ,$200.20 ,$176.00 ,$23.96 ,$121.00 ,$198.00 ,$23.26 ,$198.00 ,$118.80 ,$206.80 ,$52.34 ,$202.40 ,$13.29 ,$200.20 ,$23.26 ,$135.39 ,$135.39 ,$198.00 ,$164.19 ,$155.42 ,$23.49 ,$28.29 ,$209.00 ,$24.42 ,$12.54 ,$191.40 ,$23.26 ,$198.00 ,$23.26 ,$198.00 ,$198.00 ,$198.00 ,$213.40 ,$178.20 ,$204.60 ,$189.20 ,$213.40 
SACRED HEART HOSPITAL (ACU),44000057,92508,HC SPEECH THERAPY TREATMENT GROUP 90MIN,440,1 ,$237.00 ,$177.75 ,$12.54 ,$237.00 ,$152.63 ,$23.26 ,$165.90 ,$28.29 ,$237.00 , N/A ,$237.00 ,$225.15 ,$12.54 ,$189.60 ,$218.04 ,$28.29 ,$201.45 ,$225.15 ,$208.56 ,$180.12 ,$12.54 ,$12.54 ,$28.29 ,$173.01 ,$130.35 ,$215.67 ,$215.67 ,$189.60 ,$23.96 ,$130.35 ,$213.30 ,$23.26 ,$213.30 ,$127.98 ,$222.78 ,$52.34 ,$218.04 ,$13.29 ,$215.67 ,$23.26 ,$145.85 ,$145.85 ,$213.30 ,$176.87 ,$155.42 ,$23.49 ,$28.29 ,$225.15 ,$24.42 ,$12.54 ,$206.19 ,$23.26 ,$213.30 ,$23.26 ,$213.30 ,$213.30 ,$213.30 ,$229.89 ,$191.97 ,$220.41 ,$203.82 ,$229.89 
SACRED HEART HOSPITAL (ACU),44000058,92508,HC SPEECH THERAPY TREATMENT GROUP 105MIN,440,1 ,$277.00 ,$207.75 ,$12.54 ,$277.00 ,$178.39 ,$23.26 ,$193.90 ,$28.29 ,$277.00 , N/A ,$258.00 ,$263.15 ,$12.54 ,$221.60 ,$254.84 ,$28.29 ,$235.45 ,$263.15 ,$243.76 ,$210.52 ,$12.54 ,$12.54 ,$28.29 ,$202.21 ,$152.35 ,$252.07 ,$252.07 ,$221.60 ,$23.96 ,$152.35 ,$249.30 ,$23.26 ,$249.30 ,$149.58 ,$260.38 ,$52.34 ,$254.84 ,$13.29 ,$252.07 ,$23.26 ,$170.47 ,$170.47 ,$249.30 ,$206.73 ,$155.42 ,$23.49 ,$28.29 ,$263.15 ,$24.42 ,$12.54 ,$240.99 ,$23.26 ,$249.30 ,$23.26 ,$249.30 ,$249.30 ,$249.30 ,$268.69 ,$224.37 ,$257.61 ,$238.22 ,$268.69 
SACRED HEART HOSPITAL (ACU),44000059,92508,HC SPEECH THERAPY TREATMENT GROUP 120MIN,440,1 ,$316.00 ,$237.00 ,$12.54 ,$316.00 ,$203.50 ,$23.26 ,$221.20 ,$28.29 ,$316.00 , N/A ,$258.00 ,$300.20 ,$12.54 ,$252.80 ,$290.72 ,$28.29 ,$268.60 ,$300.20 ,$278.08 ,$240.16 ,$12.54 ,$12.54 ,$28.29 ,$230.68 ,$173.80 ,$287.56 ,$287.56 ,$252.80 ,$23.96 ,$173.80 ,$284.40 ,$23.26 ,$284.40 ,$170.64 ,$297.04 ,$52.34 ,$290.72 ,$13.29 ,$287.56 ,$23.26 ,$194.47 ,$194.47 ,$284.40 ,$235.83 ,$155.42 ,$23.49 ,$28.29 ,$300.20 ,$24.42 ,$12.54 ,$274.92 ,$23.26 ,$284.40 ,$23.26 ,$284.40 ,$284.40 ,$284.40 ,$306.52 ,$255.96 ,$293.88 ,$271.76 ,$306.52 
SACRED HEART HOSPITAL (ACU),44000060,92508,HC SPEECH THERAPY TREATMENT GROUP 150MIN,440,1 ,$405.00 ,$303.75 ,$12.54 ,$405.00 ,$260.82 ,$23.26 ,$283.50 ,$28.29 ,$322.00 , N/A ,$258.00 ,$384.75 ,$12.54 ,$324.00 ,$372.60 ,$28.29 ,$344.25 ,$384.75 ,$356.40 ,$307.80 ,$12.54 ,$12.54 ,$28.29 ,$295.65 ,$222.75 ,$368.55 ,$368.55 ,$324.00 ,$23.96 ,$222.75 ,$364.50 ,$23.26 ,$364.50 ,$218.70 ,$380.70 ,$52.34 ,$372.60 ,$13.29 ,$368.55 ,$23.26 ,$249.24 ,$249.24 ,$364.50 ,$302.25 ,$155.42 ,$23.49 ,$28.29 ,$384.75 ,$24.42 ,$12.54 ,$352.35 ,$23.26 ,$364.50 ,$23.26 ,$364.50 ,$364.50 ,$364.50 ,$392.85 ,$328.05 ,$376.65 ,$348.30 ,$392.85 
SACRED HEART HOSPITAL (ACU),44000061,92508,HC SPEECH THERAPY TREATMENT GROUP 180MIN,440,1 ,$474.00 ,$355.50 ,$12.54 ,$474.00 ,$305.26 ,$23.26 ,$331.80 ,$28.29 ,$322.00 , N/A ,$258.00 ,$450.30 ,$12.54 ,$379.20 ,$436.08 ,$28.29 ,$402.90 ,$450.30 ,$417.12 ,$360.24 ,$12.54 ,$12.54 ,$28.29 ,$346.02 ,$260.70 ,$431.34 ,$431.34 ,$379.20 ,$23.96 ,$260.70 ,$426.60 ,$23.26 ,$426.60 ,$255.96 ,$445.56 ,$52.34 ,$436.08 ,$13.29 ,$431.34 ,$23.26 ,$291.70 ,$291.70 ,$426.60 ,$353.75 ,$155.42 ,$23.49 ,$28.29 ,$450.30 ,$24.42 ,$12.54 ,$412.38 ,$23.26 ,$426.60 ,$23.26 ,$426.60 ,$426.60 ,$426.60 ,$459.78 ,$383.94 ,$440.82 ,$407.64 ,$459.78 
SACRED HEART HOSPITAL (ACU),44200001,96105,HC ASSESS. APHASIA PER HOUR,442,1 ,$201.25 ,$150.94 ,$95.49 ,$214.85 ,$129.61 ,$95.49 ,$140.88 , N/A ,$201.25 , N/A ,$201.25 ,$191.19 ,$188.01 ,$161.00 ,$185.15 , N/A ,$171.06 ,$191.19 ,$177.10 ,$152.95 ,$188.01 ,$188.01 , N/A ,$146.91 ,$110.69 ,$183.14 ,$183.14 ,$161.00 ,$98.35 ,$110.69 ,$181.13 ,$95.49 ,$181.13 ,$108.68 ,$189.18 ,$214.85 ,$185.15 ,$199.29 ,$183.14 ,$95.49 ,$123.85 ,$123.85 ,$181.13 ,$150.19 ,$155.42 ,$96.44 ,$140.88 ,$191.19 ,$100.26 ,$188.01 ,$175.09 ,$95.49 ,$181.13 ,$95.49 ,$181.13 ,$181.13 ,$181.13 ,$195.21 ,$163.01 ,$187.16 ,$173.08 ,$195.21 
SACRED HEART HOSPITAL (ACU),44400015,92597,HC VOICE PROST EVAL/FITTING,444,1 ,$251.00 ,$188.25 ,$70.40 ,$251.00 ,$161.64 ,$70.40 ,$175.70 ,$75.94 ,$251.00 , N/A ,$251.00 ,$238.45 ,$75.01 ,$200.80 ,$230.92 ,$75.94 ,$213.35 ,$238.45 ,$220.88 ,$190.76 ,$75.01 ,$75.01 ,$75.94 ,$183.23 ,$138.05 ,$228.41 ,$228.41 ,$200.80 ,$72.51 ,$138.05 ,$225.90 ,$70.40 ,$225.90 ,$135.54 ,$235.94 ,$158.40 ,$230.92 ,$79.51 ,$228.41 ,$70.40 ,$154.47 ,$154.47 ,$225.90 ,$187.32 ,$155.42 ,$71.10 ,$75.94 ,$238.45 ,$73.92 ,$75.01 ,$218.37 ,$70.40 ,$225.90 ,$70.40 ,$225.90 ,$225.90 ,$225.90 ,$243.47 ,$203.31 ,$233.43 ,$215.86 ,$243.47 
SACRED HEART HOSPITAL (ACU),44400017,92610,HC DYSPHAGIA EVALUATION 15MIN,444,1 ,$104.00 ,$78.00 ,$56.16 ,$187.18 ,$66.98 ,$83.19 ,$72.80 ,$72.23 ,$104.00 , N/A ,$104.00 ,$98.80 ,$75.01 ,$83.20 ,$95.68 ,$72.23 ,$88.40 ,$98.80 ,$91.52 ,$79.04 ,$75.01 ,$75.01 ,$72.23 ,$75.92 ,$57.20 ,$94.64 ,$94.64 ,$83.20 ,$85.69 ,$57.20 ,$93.60 ,$83.19 ,$93.60 ,$56.16 ,$97.76 ,$187.18 ,$95.68 ,$79.51 ,$94.64 ,$83.19 ,$64.00 ,$64.00 ,$93.60 ,$77.62 ,$93.60 ,$84.02 ,$72.23 ,$98.80 ,$87.35 ,$75.01 ,$90.48 ,$83.19 ,$93.60 ,$83.19 ,$93.60 ,$93.60 ,$93.60 ,$100.88 ,$84.24 ,$96.72 ,$89.44 ,$100.88 
SACRED HEART HOSPITAL (ACU),44400018,92610,HC DYSPHAGIA EVALUATION  30MIN,444,1 ,$186.00 ,$139.50 ,$72.23 ,$187.18 ,$119.78 ,$83.19 ,$130.20 ,$72.23 ,$186.00 , N/A ,$186.00 ,$176.70 ,$75.01 ,$148.80 ,$171.12 ,$72.23 ,$158.10 ,$176.70 ,$163.68 ,$141.36 ,$75.01 ,$75.01 ,$72.23 ,$135.78 ,$102.30 ,$169.26 ,$169.26 ,$148.80 ,$85.69 ,$102.30 ,$167.40 ,$83.19 ,$167.40 ,$100.44 ,$174.84 ,$187.18 ,$171.12 ,$79.51 ,$169.26 ,$83.19 ,$114.46 ,$114.46 ,$167.40 ,$138.81 ,$155.42 ,$84.02 ,$72.23 ,$176.70 ,$87.35 ,$75.01 ,$161.82 ,$83.19 ,$167.40 ,$83.19 ,$167.40 ,$167.40 ,$167.40 ,$180.42 ,$150.66 ,$172.98 ,$159.96 ,$180.42 
SACRED HEART HOSPITAL (ACU),44400019,92610,HC DYSPHAGIA EVALUATION 45MIN,444,1 ,$249.00 ,$186.75 ,$72.23 ,$249.00 ,$160.36 ,$83.19 ,$174.30 ,$72.23 ,$249.00 , N/A ,$249.00 ,$236.55 ,$75.01 ,$199.20 ,$229.08 ,$72.23 ,$211.65 ,$236.55 ,$219.12 ,$189.24 ,$75.01 ,$75.01 ,$72.23 ,$181.77 ,$136.95 ,$226.59 ,$226.59 ,$199.20 ,$85.69 ,$136.95 ,$224.10 ,$83.19 ,$224.10 ,$134.46 ,$234.06 ,$187.18 ,$229.08 ,$79.51 ,$226.59 ,$83.19 ,$153.23 ,$153.23 ,$224.10 ,$185.83 ,$155.42 ,$84.02 ,$72.23 ,$236.55 ,$87.35 ,$75.01 ,$216.63 ,$83.19 ,$224.10 ,$83.19 ,$224.10 ,$224.10 ,$224.10 ,$241.53 ,$201.69 ,$231.57 ,$214.14 ,$241.53 
SACRED HEART HOSPITAL (ACU),44400020,92610,HC DYSPHAGIA EVALUATION 60MIN,444,1 ,$313.00 ,$234.75 ,$72.23 ,$313.00 ,$201.57 ,$83.19 ,$219.10 ,$72.23 ,$313.00 , N/A ,$258.00 ,$297.35 ,$75.01 ,$250.40 ,$287.96 ,$72.23 ,$266.05 ,$297.35 ,$275.44 ,$237.88 ,$75.01 ,$75.01 ,$72.23 ,$228.49 ,$172.15 ,$284.83 ,$284.83 ,$250.40 ,$85.69 ,$172.15 ,$281.70 ,$83.19 ,$281.70 ,$169.02 ,$294.22 ,$187.18 ,$287.96 ,$79.51 ,$284.83 ,$83.19 ,$192.62 ,$192.62 ,$281.70 ,$233.59 ,$155.42 ,$84.02 ,$72.23 ,$297.35 ,$87.35 ,$75.01 ,$272.31 ,$83.19 ,$281.70 ,$83.19 ,$281.70 ,$281.70 ,$281.70 ,$303.61 ,$253.53 ,$291.09 ,$269.18 ,$303.61 
SACRED HEART HOSPITAL (ACU),44400031,92611,HC DYSPHAGIA EVAL-VIDEO 45MIN,444,1 ,$381.00 ,$285.75 ,$39.20 ,$381.00 ,$245.36 ,$89.02 ,$266.70 ,$116.92 ,$322.00 , N/A ,$258.00 ,$361.95 ,$39.20 ,$304.80 ,$350.52 ,$116.92 ,$323.85 ,$361.95 ,$335.28 ,$289.56 ,$39.20 ,$39.20 ,$116.92 ,$278.13 ,$209.55 ,$346.71 ,$346.71 ,$304.80 ,$91.69 ,$209.55 ,$342.90 ,$89.02 ,$342.90 ,$205.74 ,$358.14 ,$200.30 ,$350.52 ,$41.55 ,$346.71 ,$89.02 ,$234.47 ,$234.47 ,$342.90 ,$284.34 ,$155.42 ,$89.91 ,$116.92 ,$361.95 ,$93.47 ,$39.20 ,$331.47 ,$89.02 ,$342.90 ,$89.02 ,$342.90 ,$342.90 ,$342.90 ,$369.57 ,$308.61 ,$354.33 ,$327.66 ,$369.57 
SACRED HEART HOSPITAL (ACU),44400032,92611,HC DYSPHAGIA EVAL-VIDEO 60MIN,444,1 ,$480.00 ,$360.00 ,$39.20 ,$480.00 ,$309.12 ,$89.02 ,$336.00 ,$116.92 ,$322.00 , N/A ,$258.00 ,$456.00 ,$39.20 ,$384.00 ,$441.60 ,$116.92 ,$408.00 ,$456.00 ,$422.40 ,$364.80 ,$39.20 ,$39.20 ,$116.92 ,$350.40 ,$264.00 ,$436.80 ,$436.80 ,$384.00 ,$91.69 ,$264.00 ,$432.00 ,$89.02 ,$432.00 ,$259.20 ,$451.20 ,$200.30 ,$441.60 ,$41.55 ,$436.80 ,$89.02 ,$295.39 ,$295.39 ,$432.00 ,$358.22 ,$155.42 ,$89.91 ,$116.92 ,$456.00 ,$93.47 ,$39.20 ,$417.60 ,$89.02 ,$432.00 ,$89.02 ,$432.00 ,$432.00 ,$432.00 ,$465.60 ,$388.80 ,$446.40 ,$412.80 ,$465.60 
SACRED HEART HOSPITAL (ACU),44400040,92521,HC EVALUATION OF SPEECH FLUENCY 15 MIN,444,1 ,$173.00 ,$129.75 ,$30.27 ,$293.11 ,$111.41 ,$130.27 ,$121.10 ,$30.27 ,$173.00 , N/A ,$173.00 ,$164.35 ,$75.01 ,$138.40 ,$159.16 ,$30.27 ,$147.05 ,$164.35 ,$152.24 ,$131.48 ,$75.01 ,$75.01 ,$30.27 ,$126.29 ,$95.15 ,$157.43 ,$157.43 ,$138.40 ,$134.18 ,$95.15 ,$155.70 ,$130.27 ,$155.70 ,$93.42 ,$162.62 ,$293.11 ,$159.16 ,$79.51 ,$157.43 ,$130.27 ,$106.46 ,$106.46 ,$155.70 ,$129.11 ,$155.42 ,$131.57 ,$30.27 ,$164.35 ,$136.78 ,$75.01 ,$150.51 ,$130.27 ,$155.70 ,$130.27 ,$155.70 ,$155.70 ,$155.70 ,$167.81 ,$140.13 ,$160.89 ,$148.78 ,$167.81 
SACRED HEART HOSPITAL (ACU),44400041,92522,HC EVALUATE SPEECH PRODUCTION 15MIN,444,1 ,$178.00 ,$133.50 ,$24.58 ,$245.45 ,$114.63 ,$109.09 ,$124.60 ,$24.58 ,$178.00 , N/A ,$178.00 ,$169.10 ,$75.01 ,$142.40 ,$163.76 ,$24.58 ,$151.30 ,$169.10 ,$156.64 ,$135.28 ,$75.01 ,$75.01 ,$24.58 ,$129.94 ,$97.90 ,$161.98 ,$161.98 ,$142.40 ,$112.36 ,$97.90 ,$160.20 ,$109.09 ,$160.20 ,$96.12 ,$167.32 ,$245.45 ,$163.76 ,$79.51 ,$161.98 ,$109.09 ,$109.54 ,$109.54 ,$160.20 ,$132.84 ,$155.42 ,$110.18 ,$24.58 ,$169.10 ,$114.54 ,$75.01 ,$154.86 ,$109.09 ,$160.20 ,$109.09 ,$160.20 ,$160.20 ,$160.20 ,$172.66 ,$144.18 ,$165.54 ,$153.08 ,$172.66 
SACRED HEART HOSPITAL (ACU),44400042,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 15MIN,444,1 ,$173.00 ,$129.75 ,$48.63 ,$502.00 ,$111.41 ,$223.11 ,$121.10 ,$48.63 ,$173.00 , N/A ,$173.00 ,$164.35 ,$75.01 ,$138.40 ,$159.16 ,$48.63 ,$147.05 ,$164.35 ,$152.24 ,$131.48 ,$75.01 ,$75.01 ,$48.63 ,$126.29 ,$95.15 ,$157.43 ,$157.43 ,$138.40 ,$229.80 ,$95.15 ,$155.70 ,$223.11 ,$155.70 ,$93.42 ,$162.62 ,$502.00 ,$159.16 ,$79.51 ,$157.43 ,$223.11 ,$106.46 ,$106.46 ,$155.70 ,$129.11 ,$155.42 ,$225.34 ,$48.63 ,$164.35 ,$234.27 ,$75.01 ,$150.51 ,$223.11 ,$155.70 ,$223.11 ,$155.70 ,$155.70 ,$155.70 ,$167.81 ,$140.13 ,$160.89 ,$148.78 ,$167.81 
SACRED HEART HOSPITAL (ACU),44400043,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 15MIN,444,1 ,$173.00 ,$129.75 ,$25.62 ,$241.79 ,$111.41 ,$107.46 ,$121.10 ,$25.62 ,$173.00 , N/A ,$173.00 ,$164.35 ,$75.01 ,$138.40 ,$159.16 ,$25.62 ,$147.05 ,$164.35 ,$152.24 ,$131.48 ,$75.01 ,$75.01 ,$25.62 ,$126.29 ,$95.15 ,$157.43 ,$157.43 ,$138.40 ,$110.68 ,$95.15 ,$155.70 ,$107.46 ,$155.70 ,$93.42 ,$162.62 ,$241.79 ,$159.16 ,$79.51 ,$157.43 ,$107.46 ,$106.46 ,$106.46 ,$155.70 ,$129.11 ,$155.42 ,$108.53 ,$25.62 ,$164.35 ,$112.83 ,$75.01 ,$150.51 ,$107.46 ,$155.70 ,$107.46 ,$155.70 ,$155.70 ,$155.70 ,$167.81 ,$140.13 ,$160.89 ,$148.78 ,$167.81 
SACRED HEART HOSPITAL (ACU),44400045,92607,HC EVAL AAC; SP GEN 1ST HR,444,1 ,$284.00 ,$213.00 ,$63.60 ,$284.00 ,$182.90 ,$121.24 ,$198.80 ,$63.60 ,$284.00 , N/A ,$258.00 ,$269.80 ,$75.01 ,$227.20 ,$261.28 ,$63.60 ,$241.40 ,$269.80 ,$249.92 ,$215.84 ,$75.01 ,$75.01 ,$63.60 ,$207.32 ,$156.20 ,$258.44 ,$258.44 ,$227.20 ,$124.88 ,$156.20 ,$255.60 ,$121.24 ,$255.60 ,$153.36 ,$266.96 ,$272.79 ,$261.28 ,$79.51 ,$258.44 ,$121.24 ,$174.77 ,$174.77 ,$255.60 ,$211.95 ,$155.42 ,$122.45 ,$63.60 ,$269.80 ,$127.30 ,$75.01 ,$247.08 ,$121.24 ,$255.60 ,$121.24 ,$255.60 ,$255.60 ,$255.60 ,$275.48 ,$230.04 ,$264.12 ,$244.24 ,$275.48 
SACRED HEART HOSPITAL (ACU),44400052,92521,HC EVALUATION OF SPEECH FLUENCY 30MIN,444,1 ,$303.00 ,$227.25 ,$30.27 ,$303.00 ,$195.13 ,$130.27 ,$212.10 ,$30.27 ,$303.00 , N/A ,$258.00 ,$287.85 ,$75.01 ,$242.40 ,$278.76 ,$30.27 ,$257.55 ,$287.85 ,$266.64 ,$230.28 ,$75.01 ,$75.01 ,$30.27 ,$221.19 ,$166.65 ,$275.73 ,$275.73 ,$242.40 ,$134.18 ,$166.65 ,$272.70 ,$130.27 ,$272.70 ,$163.62 ,$284.82 ,$293.11 ,$278.76 ,$79.51 ,$275.73 ,$130.27 ,$186.47 ,$186.47 ,$272.70 ,$226.13 ,$155.42 ,$131.57 ,$30.27 ,$287.85 ,$136.78 ,$75.01 ,$263.61 ,$130.27 ,$272.70 ,$130.27 ,$272.70 ,$272.70 ,$272.70 ,$293.91 ,$245.43 ,$281.79 ,$260.58 ,$293.91 
SACRED HEART HOSPITAL (ACU),44400053,92521,HC EVALUATION OF SPEECH FLUENCY 45MIN,444,1 ,$433.00 ,$324.75 ,$30.27 ,$433.00 ,$278.85 ,$130.27 ,$303.10 ,$30.27 ,$322.00 , N/A ,$258.00 ,$411.35 ,$75.01 ,$346.40 ,$398.36 ,$30.27 ,$368.05 ,$411.35 ,$381.04 ,$329.08 ,$75.01 ,$75.01 ,$30.27 ,$316.09 ,$238.15 ,$394.03 ,$394.03 ,$346.40 ,$134.18 ,$238.15 ,$389.70 ,$130.27 ,$389.70 ,$233.82 ,$407.02 ,$293.11 ,$398.36 ,$79.51 ,$394.03 ,$130.27 ,$266.47 ,$266.47 ,$389.70 ,$323.15 ,$155.42 ,$131.57 ,$30.27 ,$411.35 ,$136.78 ,$75.01 ,$376.71 ,$130.27 ,$389.70 ,$130.27 ,$389.70 ,$389.70 ,$389.70 ,$420.01 ,$350.73 ,$402.69 ,$372.38 ,$420.01 
SACRED HEART HOSPITAL (ACU),44400054,92521,HC EVALUATION OF SPEECH FLUENCY 60MIN,444,1 ,$563.00 ,$422.25 ,$30.27 ,$563.00 ,$362.57 ,$130.27 ,$394.10 ,$30.27 ,$322.00 , N/A ,$258.00 ,$534.85 ,$75.01 ,$450.40 ,$517.96 ,$30.27 ,$478.55 ,$534.85 ,$495.44 ,$427.88 ,$75.01 ,$75.01 ,$30.27 ,$410.99 ,$309.65 ,$512.33 ,$512.33 ,$450.40 ,$134.18 ,$309.65 ,$506.70 ,$130.27 ,$506.70 ,$304.02 ,$529.22 ,$293.11 ,$517.96 ,$79.51 ,$512.33 ,$130.27 ,$346.47 ,$346.47 ,$506.70 ,$420.17 ,$155.42 ,$131.57 ,$30.27 ,$534.85 ,$136.78 ,$75.01 ,$489.81 ,$130.27 ,$506.70 ,$130.27 ,$506.70 ,$506.70 ,$506.70 ,$546.11 ,$456.03 ,$523.59 ,$484.18 ,$546.11 
SACRED HEART HOSPITAL (ACU),44400055,92522,HC EVALUATE SPEECH PRODUCTION 30MIN,444,1 ,$312.00 ,$234.00 ,$24.58 ,$312.00 ,$200.93 ,$109.09 ,$218.40 ,$24.58 ,$312.00 , N/A ,$258.00 ,$296.40 ,$75.01 ,$249.60 ,$287.04 ,$24.58 ,$265.20 ,$296.40 ,$274.56 ,$237.12 ,$75.01 ,$75.01 ,$24.58 ,$227.76 ,$171.60 ,$283.92 ,$283.92 ,$249.60 ,$112.36 ,$171.60 ,$280.80 ,$109.09 ,$280.80 ,$168.48 ,$293.28 ,$245.45 ,$287.04 ,$79.51 ,$283.92 ,$109.09 ,$192.00 ,$192.00 ,$280.80 ,$232.85 ,$155.42 ,$110.18 ,$24.58 ,$296.40 ,$114.54 ,$75.01 ,$271.44 ,$109.09 ,$280.80 ,$109.09 ,$280.80 ,$280.80 ,$280.80 ,$302.64 ,$252.72 ,$290.16 ,$268.32 ,$302.64 
SACRED HEART HOSPITAL (ACU),44400056,92522,HC EVALUATE SPEECH PRODUCTION 45MIN,444,1 ,$446.00 ,$334.50 ,$24.58 ,$446.00 ,$287.22 ,$109.09 ,$312.20 ,$24.58 ,$322.00 , N/A ,$258.00 ,$423.70 ,$75.01 ,$356.80 ,$410.32 ,$24.58 ,$379.10 ,$423.70 ,$392.48 ,$338.96 ,$75.01 ,$75.01 ,$24.58 ,$325.58 ,$245.30 ,$405.86 ,$405.86 ,$356.80 ,$112.36 ,$245.30 ,$401.40 ,$109.09 ,$401.40 ,$240.84 ,$419.24 ,$245.45 ,$410.32 ,$79.51 ,$405.86 ,$109.09 ,$274.47 ,$274.47 ,$401.40 ,$332.85 ,$155.42 ,$110.18 ,$24.58 ,$423.70 ,$114.54 ,$75.01 ,$388.02 ,$109.09 ,$401.40 ,$109.09 ,$401.40 ,$401.40 ,$401.40 ,$432.62 ,$361.26 ,$414.78 ,$383.56 ,$432.62 
SACRED HEART HOSPITAL (ACU),44400057,92522,HC EVALUATE SPEECH PRODUCTION 60MIN,444,1 ,$580.00 ,$435.00 ,$24.58 ,$580.00 ,$373.52 ,$109.09 ,$406.00 ,$24.58 ,$322.00 , N/A ,$258.00 ,$551.00 ,$75.01 ,$464.00 ,$533.60 ,$24.58 ,$493.00 ,$551.00 ,$510.40 ,$440.80 ,$75.01 ,$75.01 ,$24.58 ,$423.40 ,$319.00 ,$527.80 ,$527.80 ,$464.00 ,$112.36 ,$319.00 ,$522.00 ,$109.09 ,$522.00 ,$313.20 ,$545.20 ,$245.45 ,$533.60 ,$79.51 ,$527.80 ,$109.09 ,$356.93 ,$356.93 ,$522.00 ,$432.85 ,$155.42 ,$110.18 ,$24.58 ,$551.00 ,$114.54 ,$75.01 ,$504.60 ,$109.09 ,$522.00 ,$109.09 ,$522.00 ,$522.00 ,$522.00 ,$562.60 ,$469.80 ,$539.40 ,$498.80 ,$562.60 
SACRED HEART HOSPITAL (ACU),44400058,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 30MIN,444,1 ,$312.00 ,$234.00 ,$48.63 ,$502.00 ,$200.93 ,$223.11 ,$218.40 ,$48.63 ,$312.00 , N/A ,$258.00 ,$296.40 ,$75.01 ,$249.60 ,$287.04 ,$48.63 ,$265.20 ,$296.40 ,$274.56 ,$237.12 ,$75.01 ,$75.01 ,$48.63 ,$227.76 ,$171.60 ,$283.92 ,$283.92 ,$249.60 ,$229.80 ,$171.60 ,$280.80 ,$223.11 ,$280.80 ,$168.48 ,$293.28 ,$502.00 ,$287.04 ,$79.51 ,$283.92 ,$223.11 ,$192.00 ,$192.00 ,$280.80 ,$232.85 ,$155.42 ,$225.34 ,$48.63 ,$296.40 ,$234.27 ,$75.01 ,$271.44 ,$223.11 ,$280.80 ,$223.11 ,$280.80 ,$280.80 ,$280.80 ,$302.64 ,$252.72 ,$290.16 ,$268.32 ,$302.64 
SACRED HEART HOSPITAL (ACU),44400059,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 45MIN,444,1 ,$446.00 ,$334.50 ,$48.63 ,$502.00 ,$287.22 ,$223.11 ,$312.20 ,$48.63 ,$322.00 , N/A ,$258.00 ,$423.70 ,$75.01 ,$356.80 ,$410.32 ,$48.63 ,$379.10 ,$423.70 ,$392.48 ,$338.96 ,$75.01 ,$75.01 ,$48.63 ,$325.58 ,$245.30 ,$405.86 ,$405.86 ,$356.80 ,$229.80 ,$245.30 ,$401.40 ,$223.11 ,$401.40 ,$240.84 ,$419.24 ,$502.00 ,$410.32 ,$79.51 ,$405.86 ,$223.11 ,$274.47 ,$274.47 ,$401.40 ,$332.85 ,$155.42 ,$225.34 ,$48.63 ,$423.70 ,$234.27 ,$75.01 ,$388.02 ,$223.11 ,$401.40 ,$223.11 ,$401.40 ,$401.40 ,$401.40 ,$432.62 ,$361.26 ,$414.78 ,$383.56 ,$432.62 
SACRED HEART HOSPITAL (ACU),44400060,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 60MIN,444,1 ,$580.00 ,$435.00 ,$48.63 ,$580.00 ,$373.52 ,$223.11 ,$406.00 ,$48.63 ,$322.00 , N/A ,$258.00 ,$551.00 ,$75.01 ,$464.00 ,$533.60 ,$48.63 ,$493.00 ,$551.00 ,$510.40 ,$440.80 ,$75.01 ,$75.01 ,$48.63 ,$423.40 ,$319.00 ,$527.80 ,$527.80 ,$464.00 ,$229.80 ,$319.00 ,$522.00 ,$223.11 ,$522.00 ,$313.20 ,$545.20 ,$502.00 ,$533.60 ,$79.51 ,$527.80 ,$223.11 ,$356.93 ,$356.93 ,$522.00 ,$432.85 ,$155.42 ,$225.34 ,$48.63 ,$551.00 ,$234.27 ,$75.01 ,$504.60 ,$223.11 ,$522.00 ,$223.11 ,$522.00 ,$522.00 ,$522.00 ,$562.60 ,$469.80 ,$539.40 ,$498.80 ,$562.60 
SACRED HEART HOSPITAL (ACU),44400061,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 30MIN,444,1 ,$303.00 ,$227.25 ,$25.62 ,$303.00 ,$195.13 ,$107.46 ,$212.10 ,$25.62 ,$303.00 , N/A ,$258.00 ,$287.85 ,$75.01 ,$242.40 ,$278.76 ,$25.62 ,$257.55 ,$287.85 ,$266.64 ,$230.28 ,$75.01 ,$75.01 ,$25.62 ,$221.19 ,$166.65 ,$275.73 ,$275.73 ,$242.40 ,$110.68 ,$166.65 ,$272.70 ,$107.46 ,$272.70 ,$163.62 ,$284.82 ,$241.79 ,$278.76 ,$79.51 ,$275.73 ,$107.46 ,$186.47 ,$186.47 ,$272.70 ,$226.13 ,$155.42 ,$108.53 ,$25.62 ,$287.85 ,$112.83 ,$75.01 ,$263.61 ,$107.46 ,$272.70 ,$107.46 ,$272.70 ,$272.70 ,$272.70 ,$293.91 ,$245.43 ,$281.79 ,$260.58 ,$293.91 
SACRED HEART HOSPITAL (ACU),44400062,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 45MIN,444,1 ,$433.00 ,$324.75 ,$25.62 ,$433.00 ,$278.85 ,$107.46 ,$303.10 ,$25.62 ,$322.00 , N/A ,$258.00 ,$411.35 ,$75.01 ,$346.40 ,$398.36 ,$25.62 ,$368.05 ,$411.35 ,$381.04 ,$329.08 ,$75.01 ,$75.01 ,$25.62 ,$316.09 ,$238.15 ,$394.03 ,$394.03 ,$346.40 ,$110.68 ,$238.15 ,$389.70 ,$107.46 ,$389.70 ,$233.82 ,$407.02 ,$241.79 ,$398.36 ,$79.51 ,$394.03 ,$107.46 ,$266.47 ,$266.47 ,$389.70 ,$323.15 ,$155.42 ,$108.53 ,$25.62 ,$411.35 ,$112.83 ,$75.01 ,$376.71 ,$107.46 ,$389.70 ,$107.46 ,$389.70 ,$389.70 ,$389.70 ,$420.01 ,$350.73 ,$402.69 ,$372.38 ,$420.01 
SACRED HEART HOSPITAL (ACU),44400063,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 60MIN,444,1 ,$563.00 ,$422.25 ,$25.62 ,$563.00 ,$362.57 ,$107.46 ,$394.10 ,$25.62 ,$322.00 , N/A ,$258.00 ,$534.85 ,$75.01 ,$450.40 ,$517.96 ,$25.62 ,$478.55 ,$534.85 ,$495.44 ,$427.88 ,$75.01 ,$75.01 ,$25.62 ,$410.99 ,$309.65 ,$512.33 ,$512.33 ,$450.40 ,$110.68 ,$309.65 ,$506.70 ,$107.46 ,$506.70 ,$304.02 ,$529.22 ,$241.79 ,$517.96 ,$79.51 ,$512.33 ,$107.46 ,$346.47 ,$346.47 ,$506.70 ,$420.17 ,$155.42 ,$108.53 ,$25.62 ,$534.85 ,$112.83 ,$75.01 ,$489.81 ,$107.46 ,$506.70 ,$107.46 ,$506.70 ,$506.70 ,$506.70 ,$546.11 ,$456.03 ,$523.59 ,$484.18 ,$546.11 
SACRED HEART HOSPITAL (ACU),44400064,92521,HC EVALUATION SPEECH FLUENCY 75MIN,444,1 ,$692.00 ,$519.00 ,$30.27 ,$692.00 ,$445.65 ,$130.27 ,$484.40 ,$30.27 ,$322.00 , N/A ,$258.00 ,$657.40 ,$75.01 ,$553.60 ,$636.64 ,$30.27 ,$588.20 ,$657.40 ,$608.96 ,$525.92 ,$75.01 ,$75.01 ,$30.27 ,$505.16 ,$380.60 ,$629.72 ,$629.72 ,$553.60 ,$134.18 ,$380.60 ,$622.80 ,$130.27 ,$622.80 ,$373.68 ,$650.48 ,$293.11 ,$636.64 ,$79.51 ,$629.72 ,$130.27 ,$425.86 ,$425.86 ,$622.80 ,$516.44 ,$155.42 ,$131.57 ,$30.27 ,$657.40 ,$136.78 ,$75.01 ,$602.04 ,$130.27 ,$622.80 ,$130.27 ,$622.80 ,$622.80 ,$622.80 ,$671.24 ,$560.52 ,$643.56 ,$595.12 ,$671.24 
SACRED HEART HOSPITAL (ACU),44400065,92521,HC EVALUATION SPEECH FLUENCY 90MIN,444,1 ,$822.00 ,$616.50 ,$30.27 ,$822.00 ,$529.37 ,$130.27 ,$575.40 ,$30.27 ,$322.00 , N/A ,$258.00 ,$780.90 ,$75.01 ,$657.60 ,$756.24 ,$30.27 ,$698.70 ,$780.90 ,$723.36 ,$624.72 ,$75.01 ,$75.01 ,$30.27 ,$600.06 ,$452.10 ,$748.02 ,$748.02 ,$657.60 ,$134.18 ,$452.10 ,$739.80 ,$130.27 ,$739.80 ,$443.88 ,$772.68 ,$293.11 ,$756.24 ,$79.51 ,$748.02 ,$130.27 ,$505.86 ,$505.86 ,$739.80 ,$613.46 ,$155.42 ,$131.57 ,$30.27 ,$780.90 ,$136.78 ,$75.01 ,$715.14 ,$130.27 ,$739.80 ,$130.27 ,$739.80 ,$739.80 ,$739.80 ,$797.34 ,$665.82 ,$764.46 ,$706.92 ,$797.34 
SACRED HEART HOSPITAL (ACU),44400068,92522,HC EVALUATE SPEECH PRODUCTION 75MIN,444,1 ,$713.00 ,$534.75 ,$24.58 ,$713.00 ,$459.17 ,$109.09 ,$499.10 ,$24.58 ,$322.00 , N/A ,$258.00 ,$677.35 ,$75.01 ,$570.40 ,$655.96 ,$24.58 ,$606.05 ,$677.35 ,$627.44 ,$541.88 ,$75.01 ,$75.01 ,$24.58 ,$520.49 ,$392.15 ,$648.83 ,$648.83 ,$570.40 ,$112.36 ,$392.15 ,$641.70 ,$109.09 ,$641.70 ,$385.02 ,$670.22 ,$245.45 ,$655.96 ,$79.51 ,$648.83 ,$109.09 ,$438.78 ,$438.78 ,$641.70 ,$532.11 ,$155.42 ,$110.18 ,$24.58 ,$677.35 ,$114.54 ,$75.01 ,$620.31 ,$109.09 ,$641.70 ,$109.09 ,$641.70 ,$641.70 ,$641.70 ,$691.61 ,$577.53 ,$663.09 ,$613.18 ,$691.61 
SACRED HEART HOSPITAL (ACU),44400069,92522,HC EVALUATE SPEECH PRODUCTION 90MIN,444,1 ,$822.00 ,$616.50 ,$24.58 ,$822.00 ,$529.37 ,$109.09 ,$575.40 ,$24.58 ,$322.00 , N/A ,$258.00 ,$780.90 ,$75.01 ,$657.60 ,$756.24 ,$24.58 ,$698.70 ,$780.90 ,$723.36 ,$624.72 ,$75.01 ,$75.01 ,$24.58 ,$600.06 ,$452.10 ,$748.02 ,$748.02 ,$657.60 ,$112.36 ,$452.10 ,$739.80 ,$109.09 ,$739.80 ,$443.88 ,$772.68 ,$245.45 ,$756.24 ,$79.51 ,$748.02 ,$109.09 ,$505.86 ,$505.86 ,$739.80 ,$613.46 ,$155.42 ,$110.18 ,$24.58 ,$780.90 ,$114.54 ,$75.01 ,$715.14 ,$109.09 ,$739.80 ,$109.09 ,$739.80 ,$739.80 ,$739.80 ,$797.34 ,$665.82 ,$764.46 ,$706.92 ,$797.34 
SACRED HEART HOSPITAL (ACU),44400072,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 75MIN,444,1 ,$692.00 ,$519.00 ,$48.63 ,$692.00 ,$445.65 ,$223.11 ,$484.40 ,$48.63 ,$322.00 , N/A ,$258.00 ,$657.40 ,$75.01 ,$553.60 ,$636.64 ,$48.63 ,$588.20 ,$657.40 ,$608.96 ,$525.92 ,$75.01 ,$75.01 ,$48.63 ,$505.16 ,$380.60 ,$629.72 ,$629.72 ,$553.60 ,$229.80 ,$380.60 ,$622.80 ,$223.11 ,$622.80 ,$373.68 ,$650.48 ,$502.00 ,$636.64 ,$79.51 ,$629.72 ,$223.11 ,$425.86 ,$425.86 ,$622.80 ,$516.44 ,$155.42 ,$225.34 ,$48.63 ,$657.40 ,$234.27 ,$75.01 ,$602.04 ,$223.11 ,$622.80 ,$223.11 ,$622.80 ,$622.80 ,$622.80 ,$671.24 ,$560.52 ,$643.56 ,$595.12 ,$671.24 
SACRED HEART HOSPITAL (ACU),44400073,92523,HC SPEECH SOUND LANGUAGE COMPRHEN 90MIN,444,1 ,$822.00 ,$616.50 ,$48.63 ,$822.00 ,$529.37 ,$223.11 ,$575.40 ,$48.63 ,$322.00 , N/A ,$258.00 ,$780.90 ,$75.01 ,$657.60 ,$756.24 ,$48.63 ,$698.70 ,$780.90 ,$723.36 ,$624.72 ,$75.01 ,$75.01 ,$48.63 ,$600.06 ,$452.10 ,$748.02 ,$748.02 ,$657.60 ,$229.80 ,$452.10 ,$739.80 ,$223.11 ,$739.80 ,$443.88 ,$772.68 ,$502.00 ,$756.24 ,$79.51 ,$748.02 ,$223.11 ,$505.86 ,$505.86 ,$739.80 ,$613.46 ,$155.42 ,$225.34 ,$48.63 ,$780.90 ,$234.27 ,$75.01 ,$715.14 ,$223.11 ,$739.80 ,$223.11 ,$739.80 ,$739.80 ,$739.80 ,$797.34 ,$665.82 ,$764.46 ,$706.92 ,$797.34 
SACRED HEART HOSPITAL (ACU),44400076,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 75MIN,444,1 ,$692.00 ,$519.00 ,$25.62 ,$692.00 ,$445.65 ,$107.46 ,$484.40 ,$25.62 ,$322.00 , N/A ,$258.00 ,$657.40 ,$75.01 ,$553.60 ,$636.64 ,$25.62 ,$588.20 ,$657.40 ,$608.96 ,$525.92 ,$75.01 ,$75.01 ,$25.62 ,$505.16 ,$380.60 ,$629.72 ,$629.72 ,$553.60 ,$110.68 ,$380.60 ,$622.80 ,$107.46 ,$622.80 ,$373.68 ,$650.48 ,$241.79 ,$636.64 ,$79.51 ,$629.72 ,$107.46 ,$425.86 ,$425.86 ,$622.80 ,$516.44 ,$155.42 ,$108.53 ,$25.62 ,$657.40 ,$112.83 ,$75.01 ,$602.04 ,$107.46 ,$622.80 ,$107.46 ,$622.80 ,$622.80 ,$622.80 ,$671.24 ,$560.52 ,$643.56 ,$595.12 ,$671.24 
SACRED HEART HOSPITAL (ACU),44400077,92524,HC BEHAVIORAL QUALITY ANALYSIS VOICE 90MIN,444,1 ,$822.00 ,$616.50 ,$25.62 ,$822.00 ,$529.37 ,$107.46 ,$575.40 ,$25.62 ,$322.00 , N/A ,$258.00 ,$780.90 ,$75.01 ,$657.60 ,$756.24 ,$25.62 ,$698.70 ,$780.90 ,$723.36 ,$624.72 ,$75.01 ,$75.01 ,$25.62 ,$600.06 ,$452.10 ,$748.02 ,$748.02 ,$657.60 ,$110.68 ,$452.10 ,$739.80 ,$107.46 ,$739.80 ,$443.88 ,$772.68 ,$241.79 ,$756.24 ,$79.51 ,$748.02 ,$107.46 ,$505.86 ,$505.86 ,$739.80 ,$613.46 ,$155.42 ,$108.53 ,$25.62 ,$780.90 ,$112.83 ,$75.01 ,$715.14 ,$107.46 ,$739.80 ,$107.46 ,$739.80 ,$739.80 ,$739.80 ,$797.34 ,$665.82 ,$764.46 ,$706.92 ,$797.34 
SACRED HEART HOSPITAL (ACU),44400084,92611,HC DYSPHAGIA EVAL-VIDEO 75MIN,444,1 ,$431.00 ,$323.25 ,$39.20 ,$431.00 ,$277.56 ,$89.02 ,$301.70 ,$116.92 ,$322.00 , N/A ,$258.00 ,$409.45 ,$39.20 ,$344.80 ,$396.52 ,$116.92 ,$366.35 ,$409.45 ,$379.28 ,$327.56 ,$39.20 ,$39.20 ,$116.92 ,$314.63 ,$237.05 ,$392.21 ,$392.21 ,$344.80 ,$91.69 ,$237.05 ,$387.90 ,$89.02 ,$387.90 ,$232.74 ,$405.14 ,$200.30 ,$396.52 ,$41.55 ,$392.21 ,$89.02 ,$265.24 ,$265.24 ,$387.90 ,$321.66 ,$155.42 ,$89.91 ,$116.92 ,$409.45 ,$93.47 ,$39.20 ,$374.97 ,$89.02 ,$387.90 ,$89.02 ,$387.90 ,$387.90 ,$387.90 ,$418.07 ,$349.11 ,$400.83 ,$370.66 ,$418.07 
SACRED HEART HOSPITAL (ACU),44400085,92611,HC DYSPHAGIA EVAL-VIDEO 90MIN,444,1 ,$530.00 ,$397.50 ,$39.20 ,$530.00 ,$341.32 ,$89.02 ,$371.00 ,$116.92 ,$322.00 , N/A ,$258.00 ,$503.50 ,$39.20 ,$424.00 ,$487.60 ,$116.92 ,$450.50 ,$503.50 ,$466.40 ,$402.80 ,$39.20 ,$39.20 ,$116.92 ,$386.90 ,$291.50 ,$482.30 ,$482.30 ,$424.00 ,$91.69 ,$291.50 ,$477.00 ,$89.02 ,$477.00 ,$286.20 ,$498.20 ,$200.30 ,$487.60 ,$41.55 ,$482.30 ,$89.02 ,$326.16 ,$326.16 ,$477.00 ,$395.54 ,$155.42 ,$89.91 ,$116.92 ,$503.50 ,$93.47 ,$39.20 ,$461.10 ,$89.02 ,$477.00 ,$89.02 ,$477.00 ,$477.00 ,$477.00 ,$514.10 ,$429.30 ,$492.90 ,$455.80 ,$514.10 
SACRED HEART HOSPITAL (ACU),45000002,10061,HC I AND D ABSC CMPLX,450,1 ,$436.00 ,$327.00 ,$53.09 ,$822.51 ,$280.78 ,$365.56 ,$305.20 ,$53.09 ,$361.88 ,$54.68 ,$287.76 ,$414.20 ,$53.09 ,$348.80 ,$401.12 ,$53.09 ,$370.60 ,$414.20 ,$383.68 ,$331.36 ,$53.09 ,$53.09 ,$53.09 ,$318.28 ,$239.80 ,$396.76 ,$396.76 ,$348.80 ,$376.53 ,$239.80 ,$392.40 ,$365.56 ,$392.40 ,$235.44 ,$409.84 ,$822.51 ,$401.12 ,$56.28 ,$396.76 ,$365.56 ,$268.31 ,$268.31 ,$392.40 ,$325.39 ,$303.67 ,$369.22 ,$53.09 ,$414.20 ,$383.84 ,$53.09 ,$379.32 ,$365.56 ,$392.40 ,$365.56 ,$392.40 ,$392.40 ,$392.40 ,$422.92 ,$353.16 ,$405.48 ,$374.96 ,$422.92 
SACRED HEART HOSPITAL (ACU),45000003,10080,HC I AND D CYST PILONIDAL SMP,450,1 ,$579.00 ,$434.25 ,$53.09 ,"$1,480.84 ",$372.88 ,$658.15 ,$405.30 ,$53.09 ,$480.57 ,$54.68 ,$382.14 ,$550.05 ,$53.09 ,$463.20 ,$532.68 ,$53.09 ,$492.15 ,$550.05 ,$509.52 ,$440.04 ,$53.09 ,$53.09 ,$53.09 ,$422.67 ,$318.45 ,$526.89 ,$526.89 ,$463.20 ,$677.89 ,$318.45 ,$521.10 ,$658.15 ,$521.10 ,$312.66 ,$544.26 ,"$1,480.84 ",$532.68 ,$56.28 ,$526.89 ,$658.15 ,$356.32 ,$356.32 ,$521.10 ,$432.11 ,$403.27 ,$664.73 ,$53.09 ,$550.05 ,$691.06 ,$53.09 ,$503.73 ,$658.15 ,$521.10 ,$658.15 ,$521.10 ,$521.10 ,$521.10 ,$561.63 ,$468.99 ,$538.47 ,$497.94 ,$561.63 
SACRED HEART HOSPITAL (ACU),45000005,10120,HC INCISION/REM FB SUBQ SMP,450,1 ,$350.00 ,$262.50 ,$53.09 ,$822.51 ,$225.40 ,$365.56 ,$245.00 ,$53.09 ,$290.50 ,$54.68 ,$231.00 ,$332.50 ,$53.09 ,$280.00 ,$322.00 ,$53.09 ,$297.50 ,$332.50 ,$308.00 ,$266.00 ,$53.09 ,$53.09 ,$53.09 ,$255.50 ,$192.50 ,$318.50 ,$318.50 ,$280.00 ,$376.53 ,$192.50 ,$315.00 ,$365.56 ,$315.00 ,$189.00 ,$329.00 ,$822.51 ,$322.00 ,$56.28 ,$318.50 ,$365.56 ,$215.39 ,$215.39 ,$315.00 ,$261.21 ,$243.78 ,$369.22 ,$53.09 ,$332.50 ,$383.84 ,$53.09 ,$304.50 ,$365.56 ,$315.00 ,$365.56 ,$315.00 ,$315.00 ,$315.00 ,$339.50 ,$283.50 ,$325.50 ,$301.00 ,$339.50 
SACRED HEART HOSPITAL (ACU),45000009,11730,HC AVULSION NAIL PLATE SINGLE FAC,450,1 ,$297.00 ,$222.75 ,$21.30 ,$427.33 ,$191.27 ,$189.93 ,$207.90 ,$21.30 ,$246.51 ,$21.94 ,$196.02 ,$282.15 ,$21.30 ,$237.60 ,$273.24 ,$21.30 ,$252.45 ,$282.15 ,$261.36 ,$225.72 ,$21.30 ,$21.30 ,$21.30 ,$216.81 ,$163.35 ,$270.27 ,$270.27 ,$237.60 ,$195.63 ,$163.35 ,$267.30 ,$189.93 ,$267.30 ,$160.38 ,$279.18 ,$427.33 ,$273.24 ,$22.58 ,$270.27 ,$189.93 ,$182.77 ,$182.77 ,$267.30 ,$221.65 ,$206.86 ,$191.82 ,$21.30 ,$282.15 ,$199.42 ,$21.30 ,$258.39 ,$189.93 ,$267.30 ,$189.93 ,$267.30 ,$267.30 ,$267.30 ,$288.09 ,$240.57 ,$276.21 ,$255.42 ,$288.09 
SACRED HEART HOSPITAL (ACU),45000011,11740,HC EVAC HEMATOMA SUBUNGAL,450,1 ,$211.00 ,$158.25 ,$21.30 ,$268.33 ,$135.88 ,$119.26 ,$147.70 ,$21.30 ,$175.13 ,$21.94 ,$139.26 ,$200.45 ,$21.30 ,$168.80 ,$194.12 ,$21.30 ,$179.35 ,$200.45 ,$185.68 ,$160.36 ,$21.30 ,$21.30 ,$21.30 ,$154.03 ,$116.05 ,$192.01 ,$192.01 ,$168.80 ,$122.84 ,$116.05 ,$189.90 ,$119.26 ,$189.90 ,$113.94 ,$198.34 ,$268.33 ,$194.12 ,$22.58 ,$192.01 ,$119.26 ,$129.85 ,$129.85 ,$189.90 ,$157.47 ,$146.96 ,$120.45 ,$21.30 ,$200.45 ,$125.22 ,$21.30 ,$183.57 ,$119.26 ,$189.90 ,$119.26 ,$189.90 ,$189.90 ,$189.90 ,$204.67 ,$170.91 ,$196.23 ,$181.46 ,$204.67 
SACRED HEART HOSPITAL (ACU),45000012,11760,HC REPAIR NAIL BED,450,1 ,$219.00 ,$164.25 ,$21.30 ,"$1,246.32 ",$141.04 ,$553.92 ,$153.30 ,$21.30 ,$181.77 ,$21.94 ,$144.54 ,$208.05 ,$21.30 ,$175.20 ,$201.48 ,$21.30 ,$186.15 ,$208.05 ,$192.72 ,$166.44 ,$21.30 ,$21.30 ,$21.30 ,$159.87 ,$120.45 ,$199.29 ,$199.29 ,$175.20 ,$570.54 ,$120.45 ,$197.10 ,$553.92 ,$197.10 ,$118.26 ,$205.86 ,"$1,246.32 ",$201.48 ,$22.58 ,$199.29 ,$553.92 ,$134.77 ,$134.77 ,$197.10 ,$163.44 ,$152.53 ,$559.46 ,$21.30 ,$208.05 ,$581.62 ,$21.30 ,$190.53 ,$553.92 ,$197.10 ,$553.92 ,$197.10 ,$197.10 ,$197.10 ,$212.43 ,$177.39 ,$203.67 ,$188.34 ,$212.43 
SACRED HEART HOSPITAL (ACU),45000013,11765,HC EXC WEDGE SKIN NAIL FOLD,450,1 ,$182.00 ,$136.50 ,$21.30 ,$822.51 ,$117.21 ,$365.56 ,$127.40 ,$21.30 ,$151.06 ,$21.94 ,$120.12 ,$172.90 ,$21.30 ,$145.60 ,$167.44 ,$21.30 ,$154.70 ,$172.90 ,$160.16 ,$138.32 ,$21.30 ,$21.30 ,$21.30 ,$132.86 ,$100.10 ,$165.62 ,$165.62 ,$145.60 ,$376.53 ,$100.10 ,$163.80 ,$365.56 ,$163.80 ,$98.28 ,$171.08 ,$822.51 ,$167.44 ,$22.58 ,$165.62 ,$365.56 ,$112.00 ,$112.00 ,$163.80 ,$135.83 ,$126.76 ,$369.22 ,$21.30 ,$172.90 ,$383.84 ,$21.30 ,$158.34 ,$365.56 ,$163.80 ,$365.56 ,$163.80 ,$163.80 ,$163.80 ,$176.54 ,$147.42 ,$169.26 ,$156.52 ,$176.54 
SACRED HEART HOSPITAL (ACU),45000014,12001,HC SIMP S/N/AX/GN/TRK/EXT 2.5CM <,450,1 ,$654.00 ,$490.50 ,$60.69 ,$654.00 ,$421.18 ,$189.93 ,$457.80 ,$60.69 ,$542.82 ,$62.51 ,$431.64 ,$621.30 ,$60.69 ,$523.20 ,$601.68 ,$60.69 ,$555.90 ,$621.30 ,$575.52 ,$497.04 ,$60.69 ,$60.69 ,$60.69 ,$477.42 ,$359.70 ,$595.14 ,$595.14 ,$523.20 ,$195.63 ,$359.70 ,$588.60 ,$189.93 ,$588.60 ,$353.16 ,$614.76 ,$427.33 ,$601.68 ,$64.33 ,$595.14 ,$189.93 ,$402.47 ,$402.47 ,$588.60 ,$488.08 ,$455.51 ,$191.82 ,$60.69 ,$621.30 ,$199.42 ,$60.69 ,$568.98 ,$189.93 ,$588.60 ,$189.93 ,$588.60 ,$588.60 ,$588.60 ,$634.38 ,$529.74 ,$608.22 ,$562.44 ,$634.38 
SACRED HEART HOSPITAL (ACU),45000015,12002,HC SIMP S/N/AX/GN/TRK/EXT 2.6-7.5,450,1 ,$359.00 ,$269.25 ,$60.69 ,$427.33 ,$231.20 ,$189.93 ,$251.30 ,$60.69 ,$297.97 ,$62.51 ,$236.94 ,$341.05 ,$60.69 ,$287.20 ,$330.28 ,$60.69 ,$305.15 ,$341.05 ,$315.92 ,$272.84 ,$60.69 ,$60.69 ,$60.69 ,$262.07 ,$197.45 ,$326.69 ,$326.69 ,$287.20 ,$195.63 ,$197.45 ,$323.10 ,$189.93 ,$323.10 ,$193.86 ,$337.46 ,$427.33 ,$330.28 ,$64.33 ,$326.69 ,$189.93 ,$220.93 ,$220.93 ,$323.10 ,$267.92 ,$250.04 ,$191.82 ,$60.69 ,$341.05 ,$199.42 ,$60.69 ,$312.33 ,$189.93 ,$323.10 ,$189.93 ,$323.10 ,$323.10 ,$323.10 ,$348.23 ,$290.79 ,$333.87 ,$308.74 ,$348.23 
SACRED HEART HOSPITAL (ACU),45000016,12004,HC SIMP S/N/AX/GN/TRK/EXT7.6-12.5,450,1 ,$460.00 ,$345.00 ,$60.69 ,$460.00 ,$296.24 ,$189.93 ,$322.00 ,$60.69 ,$381.80 ,$62.51 ,$303.60 ,$437.00 ,$60.69 ,$368.00 ,$423.20 ,$60.69 ,$391.00 ,$437.00 ,$404.80 ,$349.60 ,$60.69 ,$60.69 ,$60.69 ,$335.80 ,$253.00 ,$418.60 ,$418.60 ,$368.00 ,$195.63 ,$253.00 ,$414.00 ,$189.93 ,$414.00 ,$248.40 ,$432.40 ,$427.33 ,$423.20 ,$64.33 ,$418.60 ,$189.93 ,$283.08 ,$283.08 ,$414.00 ,$343.30 ,$320.39 ,$191.82 ,$60.69 ,$437.00 ,$199.42 ,$60.69 ,$400.20 ,$189.93 ,$414.00 ,$189.93 ,$414.00 ,$414.00 ,$414.00 ,$446.20 ,$372.60 ,$427.80 ,$395.60 ,$446.20 
SACRED HEART HOSPITAL (ACU),45000017,12005,HC SIMP S/N/AX/GN/TRK/EXT 12.6-20,450,1 ,$486.00 ,$364.50 ,$60.69 ,$822.51 ,$312.98 ,$365.56 ,$340.20 ,$60.69 ,$403.38 ,$62.51 ,$320.76 ,$461.70 ,$60.69 ,$388.80 ,$447.12 ,$60.69 ,$413.10 ,$461.70 ,$427.68 ,$369.36 ,$60.69 ,$60.69 ,$60.69 ,$354.78 ,$267.30 ,$442.26 ,$442.26 ,$388.80 ,$376.53 ,$267.30 ,$437.40 ,$365.56 ,$437.40 ,$262.44 ,$456.84 ,$822.51 ,$447.12 ,$64.33 ,$442.26 ,$365.56 ,$299.08 ,$299.08 ,$437.40 ,$362.70 ,$338.50 ,$369.22 ,$60.69 ,$461.70 ,$383.84 ,$60.69 ,$422.82 ,$365.56 ,$437.40 ,$365.56 ,$437.40 ,$437.40 ,$437.40 ,$471.42 ,$393.66 ,$451.98 ,$417.96 ,$471.42 
SACRED HEART HOSPITAL (ACU),45000020,12011,HC SIMP F/E/E/N/L/MM 2.5CM OR <,450,1 ,$575.00 ,$431.25 ,$60.69 ,$575.00 ,$370.30 ,$189.93 ,$402.50 ,$60.69 ,$477.25 ,$62.51 ,$379.50 ,$546.25 ,$60.69 ,$460.00 ,$529.00 ,$60.69 ,$488.75 ,$546.25 ,$506.00 ,$437.00 ,$60.69 ,$60.69 ,$60.69 ,$419.75 ,$316.25 ,$523.25 ,$523.25 ,$460.00 ,$195.63 ,$316.25 ,$517.50 ,$189.93 ,$517.50 ,$310.50 ,$540.50 ,$427.33 ,$529.00 ,$64.33 ,$523.25 ,$189.93 ,$353.86 ,$353.86 ,$517.50 ,$429.12 ,$400.49 ,$191.82 ,$60.69 ,$546.25 ,$199.42 ,$60.69 ,$500.25 ,$189.93 ,$517.50 ,$189.93 ,$517.50 ,$517.50 ,$517.50 ,$557.75 ,$465.75 ,$534.75 ,$494.50 ,$557.75 
SACRED HEART HOSPITAL (ACU),45000021,12013,HC SIMP F/E/E/N/L/MM 2.6CM TO 5CM,450,1 ,$578.00 ,$433.50 ,$60.69 ,$578.00 ,$372.23 ,$189.93 ,$404.60 ,$60.69 ,$479.74 ,$62.51 ,$381.48 ,$549.10 ,$60.69 ,$462.40 ,$531.76 ,$60.69 ,$491.30 ,$549.10 ,$508.64 ,$439.28 ,$60.69 ,$60.69 ,$60.69 ,$421.94 ,$317.90 ,$525.98 ,$525.98 ,$462.40 ,$195.63 ,$317.90 ,$520.20 ,$189.93 ,$520.20 ,$312.12 ,$543.32 ,$427.33 ,$531.76 ,$64.33 ,$525.98 ,$189.93 ,$355.70 ,$355.70 ,$520.20 ,$431.36 ,$402.58 ,$191.82 ,$60.69 ,$549.10 ,$199.42 ,$60.69 ,$502.86 ,$189.93 ,$520.20 ,$189.93 ,$520.20 ,$520.20 ,$520.20 ,$560.66 ,$468.18 ,$537.54 ,$497.08 ,$560.66 
SACRED HEART HOSPITAL (ACU),45000022,12014,HC SIMP F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$262.00 ,$196.50 ,$60.69 ,$427.33 ,$168.73 ,$189.93 ,$183.40 ,$60.69 ,$217.46 ,$62.51 ,$172.92 ,$248.90 ,$60.69 ,$209.60 ,$241.04 ,$60.69 ,$222.70 ,$248.90 ,$230.56 ,$199.12 ,$60.69 ,$60.69 ,$60.69 ,$191.26 ,$144.10 ,$238.42 ,$238.42 ,$209.60 ,$195.63 ,$144.10 ,$235.80 ,$189.93 ,$235.80 ,$141.48 ,$246.28 ,$427.33 ,$241.04 ,$64.33 ,$238.42 ,$189.93 ,$161.23 ,$161.23 ,$235.80 ,$195.53 ,$182.48 ,$191.82 ,$60.69 ,$248.90 ,$199.42 ,$60.69 ,$227.94 ,$189.93 ,$235.80 ,$189.93 ,$235.80 ,$235.80 ,$235.80 ,$254.14 ,$212.22 ,$243.66 ,$225.32 ,$254.14 
SACRED HEART HOSPITAL (ACU),45000023,12015,HC SIMP F/E/E/N/L/MM 7.6 -12.5CM,450,1 ,$298.00 ,$223.50 ,$60.69 ,$427.33 ,$191.91 ,$189.93 ,$208.60 ,$60.69 ,$247.34 ,$62.51 ,$196.68 ,$283.10 ,$60.69 ,$238.40 ,$274.16 ,$60.69 ,$253.30 ,$283.10 ,$262.24 ,$226.48 ,$60.69 ,$60.69 ,$60.69 ,$217.54 ,$163.90 ,$271.18 ,$271.18 ,$238.40 ,$195.63 ,$163.90 ,$268.20 ,$189.93 ,$268.20 ,$160.92 ,$280.12 ,$427.33 ,$274.16 ,$64.33 ,$271.18 ,$189.93 ,$183.39 ,$183.39 ,$268.20 ,$222.40 ,$207.56 ,$191.82 ,$60.69 ,$283.10 ,$199.42 ,$60.69 ,$259.26 ,$189.93 ,$268.20 ,$189.93 ,$268.20 ,$268.20 ,$268.20 ,$289.06 ,$241.38 ,$277.14 ,$256.28 ,$289.06 
SACRED HEART HOSPITAL (ACU),45000024,12016,HC SIMP F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$352.00 ,$264.00 ,$60.69 ,$822.51 ,$226.69 ,$365.56 ,$246.40 ,$60.69 ,$292.16 ,$62.51 ,$232.32 ,$334.40 ,$60.69 ,$281.60 ,$323.84 ,$60.69 ,$299.20 ,$334.40 ,$309.76 ,$267.52 ,$60.69 ,$60.69 ,$60.69 ,$256.96 ,$193.60 ,$320.32 ,$320.32 ,$281.60 ,$376.53 ,$193.60 ,$316.80 ,$365.56 ,$316.80 ,$190.08 ,$330.88 ,$822.51 ,$323.84 ,$64.33 ,$320.32 ,$365.56 ,$216.62 ,$216.62 ,$316.80 ,$262.70 ,$245.17 ,$369.22 ,$60.69 ,$334.40 ,$383.84 ,$60.69 ,$306.24 ,$365.56 ,$316.80 ,$365.56 ,$316.80 ,$316.80 ,$316.80 ,$341.44 ,$285.12 ,$327.36 ,$302.72 ,$341.44 
SACRED HEART HOSPITAL (ACU),45000027,12020,HC SIMP SUPERFICIAL DEHISCENCE,450,1 ,$793.00 ,$594.75 ,$122.07 ,"$1,246.32 ",$510.69 ,$553.92 ,$555.10 ,$122.07 ,$658.19 ,$125.73 ,$523.38 ,$753.35 ,$122.07 ,$634.40 ,$729.56 ,$122.07 ,$674.05 ,$753.35 ,$697.84 ,$602.68 ,$122.07 ,$122.07 ,$122.07 ,$578.89 ,$436.15 ,$721.63 ,$721.63 ,$634.40 ,$570.54 ,$436.15 ,$713.70 ,$553.92 ,$713.70 ,$428.22 ,$745.42 ,"$1,246.32 ",$729.56 ,$129.39 ,$721.63 ,$553.92 ,$488.01 ,$488.01 ,$713.70 ,$591.82 ,$552.32 ,$559.46 ,$122.07 ,$753.35 ,$581.62 ,$122.07 ,$689.91 ,$553.92 ,$713.70 ,$553.92 ,$713.70 ,$713.70 ,$713.70 ,$769.21 ,$642.33 ,$737.49 ,$681.98 ,$769.21 
SACRED HEART HOSPITAL (ACU),45000029,12031,HC INTRM S/A/T/EXT 2.5CM OR <,450,1 ,$267.00 ,$200.25 ,$122.07 ,$822.51 ,$171.95 ,$365.56 ,$186.90 ,$122.07 ,$221.61 ,$125.73 ,$176.22 ,$253.65 ,$122.07 ,$213.60 ,$245.64 ,$122.07 ,$226.95 ,$253.65 ,$234.96 ,$202.92 ,$122.07 ,$122.07 ,$122.07 ,$194.91 ,$146.85 ,$242.97 ,$242.97 ,$213.60 ,$376.53 ,$146.85 ,$240.30 ,$365.56 ,$240.30 ,$144.18 ,$250.98 ,$822.51 ,$245.64 ,$129.39 ,$242.97 ,$365.56 ,$164.31 ,$164.31 ,$240.30 ,$199.26 ,$185.97 ,$369.22 ,$122.07 ,$253.65 ,$383.84 ,$122.07 ,$232.29 ,$365.56 ,$240.30 ,$365.56 ,$240.30 ,$240.30 ,$240.30 ,$258.99 ,$216.27 ,$248.31 ,$229.62 ,$258.99 
SACRED HEART HOSPITAL (ACU),45000030,12032,HC INTRM S/A/T/EXT 2.6-7.5CM,450,1 ,$229.00 ,$171.75 ,$122.07 ,$822.51 ,$147.48 ,$365.56 ,$160.30 ,$122.07 ,$190.07 ,$125.73 ,$151.14 ,$217.55 ,$122.07 ,$183.20 ,$210.68 ,$122.07 ,$194.65 ,$217.55 ,$201.52 ,$174.04 ,$122.07 ,$122.07 ,$122.07 ,$167.17 ,$125.95 ,$208.39 ,$208.39 ,$183.20 ,$376.53 ,$125.95 ,$206.10 ,$365.56 ,$206.10 ,$123.66 ,$215.26 ,$822.51 ,$210.68 ,$129.39 ,$208.39 ,$365.56 ,$140.93 ,$140.93 ,$206.10 ,$170.90 ,$159.50 ,$369.22 ,$122.07 ,$217.55 ,$383.84 ,$122.07 ,$199.23 ,$365.56 ,$206.10 ,$365.56 ,$206.10 ,$206.10 ,$206.10 ,$222.13 ,$185.49 ,$212.97 ,$196.94 ,$222.13 
SACRED HEART HOSPITAL (ACU),45000031,12034,HC INTRM S/A/T/EXT 7.6-12.5CM,450,1 ,$352.00 ,$264.00 ,$122.07 ,$822.51 ,$226.69 ,$365.56 ,$246.40 ,$122.07 ,$292.16 ,$125.73 ,$232.32 ,$334.40 ,$122.07 ,$281.60 ,$323.84 ,$122.07 ,$299.20 ,$334.40 ,$309.76 ,$267.52 ,$122.07 ,$122.07 ,$122.07 ,$256.96 ,$193.60 ,$320.32 ,$320.32 ,$281.60 ,$376.53 ,$193.60 ,$316.80 ,$365.56 ,$316.80 ,$190.08 ,$330.88 ,$822.51 ,$323.84 ,$129.39 ,$320.32 ,$365.56 ,$216.62 ,$216.62 ,$316.80 ,$262.70 ,$245.17 ,$369.22 ,$122.07 ,$334.40 ,$383.84 ,$122.07 ,$306.24 ,$365.56 ,$316.80 ,$365.56 ,$316.80 ,$316.80 ,$316.80 ,$341.44 ,$285.12 ,$327.36 ,$302.72 ,$341.44 
SACRED HEART HOSPITAL (ACU),45000032,12035,HC INTRM S/A/T/EXT 12.6-20.0CM,450,1 ,$441.00 ,$330.75 ,$122.07 ,$822.51 ,$284.00 ,$365.56 ,$308.70 ,$122.07 ,$366.03 ,$125.73 ,$291.06 ,$418.95 ,$122.07 ,$352.80 ,$405.72 ,$122.07 ,$374.85 ,$418.95 ,$388.08 ,$335.16 ,$122.07 ,$122.07 ,$122.07 ,$321.93 ,$242.55 ,$401.31 ,$401.31 ,$352.80 ,$376.53 ,$242.55 ,$396.90 ,$365.56 ,$396.90 ,$238.14 ,$414.54 ,$822.51 ,$405.72 ,$129.39 ,$401.31 ,$365.56 ,$271.39 ,$271.39 ,$396.90 ,$329.12 ,$307.16 ,$369.22 ,$122.07 ,$418.95 ,$383.84 ,$122.07 ,$383.67 ,$365.56 ,$396.90 ,$365.56 ,$396.90 ,$396.90 ,$396.90 ,$427.77 ,$357.21 ,$410.13 ,$379.26 ,$427.77 
SACRED HEART HOSPITAL (ACU),45000034,12037,HC INTRM S/A/T/EXT OVER 30CM,450,1 ,"$1,403.00 ","$1,052.25 ",$122.07 ,"$4,075.87 ",$903.53 ,"$1,811.50 ",$982.10 ,$122.07 ,"$1,164.49 ",$125.73 ,$925.98 ,"$1,332.85 ",$122.07 ,"$1,122.40 ","$1,290.76 ",$122.07 ,"$1,192.55 ","$1,332.85 ","$1,234.64 ","$1,066.28 ",$122.07 ,$122.07 ,$122.07 ,"$1,024.19 ",$771.65 ,"$1,276.73 ","$1,276.73 ","$1,122.40 ","$1,865.85 ",$771.65 ,"$1,262.70 ","$1,811.50 ","$1,262.70 ",$757.62 ,"$1,318.82 ","$4,075.87 ","$1,290.76 ",$129.39 ,"$1,276.73 ","$1,811.50 ",$863.41 ,$863.41 ,"$1,262.70 ","$1,047.06 ",$977.19 ,"$1,829.61 ",$122.07 ,"$1,332.85 ","$1,902.07 ",$122.07 ,"$1,220.61 ","$1,811.50 ","$1,262.70 ","$1,811.50 ","$1,262.70 ","$1,262.70 ","$1,262.70 ","$1,360.91 ","$1,136.43 ","$1,304.79 ","$1,206.58 ","$1,360.91 "
SACRED HEART HOSPITAL (ACU),45000035,12041,HC INTRM N/H/F/GEN 2.5CM OR <,450,1 ,$267.00 ,$200.25 ,$122.07 ,$822.51 ,$171.95 ,$365.56 ,$186.90 ,$122.07 ,$221.61 ,$125.73 ,$176.22 ,$253.65 ,$122.07 ,$213.60 ,$245.64 ,$122.07 ,$226.95 ,$253.65 ,$234.96 ,$202.92 ,$122.07 ,$122.07 ,$122.07 ,$194.91 ,$146.85 ,$242.97 ,$242.97 ,$213.60 ,$376.53 ,$146.85 ,$240.30 ,$365.56 ,$240.30 ,$144.18 ,$250.98 ,$822.51 ,$245.64 ,$129.39 ,$242.97 ,$365.56 ,$164.31 ,$164.31 ,$240.30 ,$199.26 ,$185.97 ,$369.22 ,$122.07 ,$253.65 ,$383.84 ,$122.07 ,$232.29 ,$365.56 ,$240.30 ,$365.56 ,$240.30 ,$240.30 ,$240.30 ,$258.99 ,$216.27 ,$248.31 ,$229.62 ,$258.99 
SACRED HEART HOSPITAL (ACU),45000036,12042,HC INTRM N/H/F/GEN 2.6-7.5CM,450,1 ,$267.00 ,$200.25 ,$122.07 ,$822.51 ,$171.95 ,$365.56 ,$186.90 ,$122.07 ,$221.61 ,$125.73 ,$176.22 ,$253.65 ,$122.07 ,$213.60 ,$245.64 ,$122.07 ,$226.95 ,$253.65 ,$234.96 ,$202.92 ,$122.07 ,$122.07 ,$122.07 ,$194.91 ,$146.85 ,$242.97 ,$242.97 ,$213.60 ,$376.53 ,$146.85 ,$240.30 ,$365.56 ,$240.30 ,$144.18 ,$250.98 ,$822.51 ,$245.64 ,$129.39 ,$242.97 ,$365.56 ,$164.31 ,$164.31 ,$240.30 ,$199.26 ,$185.97 ,$369.22 ,$122.07 ,$253.65 ,$383.84 ,$122.07 ,$232.29 ,$365.56 ,$240.30 ,$365.56 ,$240.30 ,$240.30 ,$240.30 ,$258.99 ,$216.27 ,$248.31 ,$229.62 ,$258.99 
SACRED HEART HOSPITAL (ACU),45000037,12044,HC INTRM N/H/F/GEN 7.6-12.5CM,450,1 ,$281.00 ,$210.75 ,$122.07 ,"$1,246.32 ",$180.96 ,$553.92 ,$196.70 ,$122.07 ,$233.23 ,$125.73 ,$185.46 ,$266.95 ,$122.07 ,$224.80 ,$258.52 ,$122.07 ,$238.85 ,$266.95 ,$247.28 ,$213.56 ,$122.07 ,$122.07 ,$122.07 ,$205.13 ,$154.55 ,$255.71 ,$255.71 ,$224.80 ,$570.54 ,$154.55 ,$252.90 ,$553.92 ,$252.90 ,$151.74 ,$264.14 ,"$1,246.32 ",$258.52 ,$129.39 ,$255.71 ,$553.92 ,$172.93 ,$172.93 ,$252.90 ,$209.71 ,$195.72 ,$559.46 ,$122.07 ,$266.95 ,$581.62 ,$122.07 ,$244.47 ,$553.92 ,$252.90 ,$553.92 ,$252.90 ,$252.90 ,$252.90 ,$272.57 ,$227.61 ,$261.33 ,$241.66 ,$272.57 
SACRED HEART HOSPITAL (ACU),45000041,12051,HC INTRM F/E/E/N/L/MM 2.5CM OR <,450,1 ,$411.00 ,$308.25 ,$122.07 ,$822.51 ,$264.68 ,$365.56 ,$287.70 ,$122.07 ,$341.13 ,$125.73 ,$271.26 ,$390.45 ,$122.07 ,$328.80 ,$378.12 ,$122.07 ,$349.35 ,$390.45 ,$361.68 ,$312.36 ,$122.07 ,$122.07 ,$122.07 ,$300.03 ,$226.05 ,$374.01 ,$374.01 ,$328.80 ,$376.53 ,$226.05 ,$369.90 ,$365.56 ,$369.90 ,$221.94 ,$386.34 ,$822.51 ,$378.12 ,$129.39 ,$374.01 ,$365.56 ,$252.93 ,$252.93 ,$369.90 ,$306.73 ,$286.26 ,$369.22 ,$122.07 ,$390.45 ,$383.84 ,$122.07 ,$357.57 ,$365.56 ,$369.90 ,$365.56 ,$369.90 ,$369.90 ,$369.90 ,$398.67 ,$332.91 ,$382.23 ,$353.46 ,$398.67 
SACRED HEART HOSPITAL (ACU),45000042,12052,HC INTRM F/E/E/N/L/MM 2.6-5.0CM,450,1 ,$506.00 ,$379.50 ,$122.07 ,$822.51 ,$325.86 ,$365.56 ,$354.20 ,$122.07 ,$419.98 ,$125.73 ,$333.96 ,$480.70 ,$122.07 ,$404.80 ,$465.52 ,$122.07 ,$430.10 ,$480.70 ,$445.28 ,$384.56 ,$122.07 ,$122.07 ,$122.07 ,$369.38 ,$278.30 ,$460.46 ,$460.46 ,$404.80 ,$376.53 ,$278.30 ,$455.40 ,$365.56 ,$455.40 ,$273.24 ,$475.64 ,$822.51 ,$465.52 ,$129.39 ,$460.46 ,$365.56 ,$311.39 ,$311.39 ,$455.40 ,$377.63 ,$352.43 ,$369.22 ,$122.07 ,$480.70 ,$383.84 ,$122.07 ,$440.22 ,$365.56 ,$455.40 ,$365.56 ,$455.40 ,$455.40 ,$455.40 ,$490.82 ,$409.86 ,$470.58 ,$435.16 ,$490.82 
SACRED HEART HOSPITAL (ACU),45000043,12053,HC INTRM F/E/E/N/L/MM 5.1-7.5CM,450,1 ,$489.00 ,$366.75 ,$122.07 ,$822.51 ,$314.92 ,$365.56 ,$342.30 ,$122.07 ,$405.87 ,$125.73 ,$322.74 ,$464.55 ,$122.07 ,$391.20 ,$449.88 ,$122.07 ,$415.65 ,$464.55 ,$430.32 ,$371.64 ,$122.07 ,$122.07 ,$122.07 ,$356.97 ,$268.95 ,$444.99 ,$444.99 ,$391.20 ,$376.53 ,$268.95 ,$440.10 ,$365.56 ,$440.10 ,$264.06 ,$459.66 ,$822.51 ,$449.88 ,$129.39 ,$444.99 ,$365.56 ,$300.93 ,$300.93 ,$440.10 ,$364.94 ,$340.59 ,$369.22 ,$122.07 ,$464.55 ,$383.84 ,$122.07 ,$425.43 ,$365.56 ,$440.10 ,$365.56 ,$440.10 ,$440.10 ,$440.10 ,$474.33 ,$396.09 ,$454.77 ,$420.54 ,$474.33 
SACRED HEART HOSPITAL (ACU),45000045,12055,HC INTRM F/E/E/N/L/MM 12.6-20.0CM,450,1 ,$582.00 ,$436.50 ,$122.07 ,$822.51 ,$374.81 ,$365.56 ,$407.40 ,$122.07 ,$483.06 ,$125.73 ,$384.12 ,$552.90 ,$122.07 ,$465.60 ,$535.44 ,$122.07 ,$494.70 ,$552.90 ,$512.16 ,$442.32 ,$122.07 ,$122.07 ,$122.07 ,$424.86 ,$320.10 ,$529.62 ,$529.62 ,$465.60 ,$376.53 ,$320.10 ,$523.80 ,$365.56 ,$523.80 ,$314.28 ,$547.08 ,$822.51 ,$535.44 ,$129.39 ,$529.62 ,$365.56 ,$358.16 ,$358.16 ,$523.80 ,$434.35 ,$405.36 ,$369.22 ,$122.07 ,$552.90 ,$383.84 ,$122.07 ,$506.34 ,$365.56 ,$523.80 ,$365.56 ,$523.80 ,$523.80 ,$523.80 ,$564.54 ,$471.42 ,$541.26 ,$500.52 ,$564.54 
SACRED HEART HOSPITAL (ACU),45000051,13120,HC CMPLX S/A/L 1.1-2.5 CM,450,1 ,"$1,692.00 ","$1,269.00 ",$144.67 ,"$1,692.00 ","$1,089.65 ",$553.92 ,"$1,184.40 ",$144.67 ,"$1,404.36 ",$149.01 ,"$1,116.72 ","$1,607.40 ",$144.67 ,"$1,353.60 ","$1,556.64 ",$144.67 ,"$1,438.20 ","$1,607.40 ","$1,488.96 ","$1,285.92 ",$144.67 ,$144.67 ,$144.67 ,"$1,235.16 ",$930.60 ,"$1,539.72 ","$1,539.72 ","$1,353.60 ",$570.54 ,$930.60 ,"$1,522.80 ",$553.92 ,"$1,522.80 ",$913.68 ,"$1,590.48 ","$1,246.32 ","$1,556.64 ",$153.35 ,"$1,539.72 ",$553.92 ,"$1,041.26 ","$1,041.26 ","$1,522.80 ","$1,262.74 ","$1,178.48 ",$559.46 ,$144.67 ,"$1,607.40 ",$581.62 ,$144.67 ,"$1,472.04 ",$553.92 ,"$1,522.80 ",$553.92 ,"$1,522.80 ","$1,522.80 ","$1,522.80 ","$1,641.24 ","$1,370.52 ","$1,573.56 ","$1,455.12 ","$1,641.24 "
SACRED HEART HOSPITAL (ACU),45000052,13121,HC CMPLX S/A/L 2.6-7.5 CM,450,1 ,$471.00 ,$353.25 ,$144.67 ,"$1,246.32 ",$303.32 ,$553.92 ,$329.70 ,$144.67 ,$390.93 ,$149.01 ,$310.86 ,$447.45 ,$144.67 ,$376.80 ,$433.32 ,$144.67 ,$400.35 ,$447.45 ,$414.48 ,$357.96 ,$144.67 ,$144.67 ,$144.67 ,$343.83 ,$259.05 ,$428.61 ,$428.61 ,$376.80 ,$570.54 ,$259.05 ,$423.90 ,$553.92 ,$423.90 ,$254.34 ,$442.74 ,"$1,246.32 ",$433.32 ,$153.35 ,$428.61 ,$553.92 ,$289.85 ,$289.85 ,$423.90 ,$351.51 ,$328.05 ,$559.46 ,$144.67 ,$447.45 ,$581.62 ,$144.67 ,$409.77 ,$553.92 ,$423.90 ,$553.92 ,$423.90 ,$423.90 ,$423.90 ,$456.87 ,$381.51 ,$438.03 ,$405.06 ,$456.87 
SACRED HEART HOSPITAL (ACU),45000053,13122,HC CMPLX S/A/L EA ADDL 5 CM OR LESS,450,1 ,$283.00 ,$212.25 ,$144.67 ,$283.00 ,$182.25 , N/A ,$198.10 ,$144.67 ,$234.89 ,$149.01 ,$186.78 ,$268.85 ,$144.67 ,$226.40 ,$260.36 ,$144.67 ,$240.55 ,$268.85 ,$249.04 ,$215.08 ,$144.67 ,$144.67 ,$144.67 ,$206.59 ,$155.65 ,$257.53 ,$257.53 ,$226.40 , N/A ,$155.65 ,$254.70 , N/A ,$254.70 ,$152.82 ,$266.02 , N/A ,$260.36 ,$153.35 ,$257.53 , N/A ,$174.16 ,$174.16 ,$254.70 ,$211.20 ,$197.11 , N/A ,$144.67 ,$268.85 , N/A ,$144.67 ,$246.21 , N/A ,$254.70 , N/A ,$254.70 ,$254.70 ,$254.70 ,$274.51 ,$229.23 ,$263.19 ,$243.38 ,$274.51 
SACRED HEART HOSPITAL (ACU),45000054,13131,HC CMPLX F/C/C/M/N/A/G/H/F 1.1-2.5 CM,450,1 ,$256.00 ,$192.00 ,$138.24 ,$822.51 ,$164.86 ,$365.56 ,$179.20 ,$144.67 ,$212.48 ,$149.01 ,$168.96 ,$243.20 ,$144.67 ,$204.80 ,$235.52 ,$144.67 ,$217.60 ,$243.20 ,$225.28 ,$194.56 ,$144.67 ,$144.67 ,$144.67 ,$186.88 ,$140.80 ,$232.96 ,$232.96 ,$204.80 ,$376.53 ,$140.80 ,$230.40 ,$365.56 ,$230.40 ,$138.24 ,$240.64 ,$822.51 ,$235.52 ,$153.35 ,$232.96 ,$365.56 ,$157.54 ,$157.54 ,$230.40 ,$191.05 ,$178.30 ,$369.22 ,$144.67 ,$243.20 ,$383.84 ,$144.67 ,$222.72 ,$365.56 ,$230.40 ,$365.56 ,$230.40 ,$230.40 ,$230.40 ,$248.32 ,$207.36 ,$238.08 ,$220.16 ,$248.32 
SACRED HEART HOSPITAL (ACU),45000055,13132,HC CMPLX F/C/C/M/N/A/G/H/F 2.6-7.5 CM,450,1 ,$398.00 ,$298.50 ,$144.67 ,"$1,246.32 ",$256.31 ,$553.92 ,$278.60 ,$144.67 ,$330.34 ,$149.01 ,$262.68 ,$378.10 ,$144.67 ,$318.40 ,$366.16 ,$144.67 ,$338.30 ,$378.10 ,$350.24 ,$302.48 ,$144.67 ,$144.67 ,$144.67 ,$290.54 ,$218.90 ,$362.18 ,$362.18 ,$318.40 ,$570.54 ,$218.90 ,$358.20 ,$553.92 ,$358.20 ,$214.92 ,$374.12 ,"$1,246.32 ",$366.16 ,$153.35 ,$362.18 ,$553.92 ,$244.93 ,$244.93 ,$358.20 ,$297.03 ,$277.21 ,$559.46 ,$144.67 ,$378.10 ,$581.62 ,$144.67 ,$346.26 ,$553.92 ,$358.20 ,$553.92 ,$358.20 ,$358.20 ,$358.20 ,$386.06 ,$322.38 ,$370.14 ,$342.28 ,$386.06 
SACRED HEART HOSPITAL (ACU),45000058,13151,HC CMPLX E/N/E/L 1.1-2.5 CM,450,1 ,$300.00 ,$225.00 ,$144.67 ,"$1,246.32 ",$193.20 ,$553.92 ,$210.00 ,$144.67 ,$249.00 ,$149.01 ,$198.00 ,$285.00 ,$144.67 ,$240.00 ,$276.00 ,$144.67 ,$255.00 ,$285.00 ,$264.00 ,$228.00 ,$144.67 ,$144.67 ,$144.67 ,$219.00 ,$165.00 ,$273.00 ,$273.00 ,$240.00 ,$570.54 ,$165.00 ,$270.00 ,$553.92 ,$270.00 ,$162.00 ,$282.00 ,"$1,246.32 ",$276.00 ,$153.35 ,$273.00 ,$553.92 ,$184.62 ,$184.62 ,$270.00 ,$223.89 ,$208.95 ,$559.46 ,$144.67 ,$285.00 ,$581.62 ,$144.67 ,$261.00 ,$553.92 ,$270.00 ,$553.92 ,$270.00 ,$270.00 ,$270.00 ,$291.00 ,$243.00 ,$279.00 ,$258.00 ,$291.00 
SACRED HEART HOSPITAL (ACU),45000059,13152,HC CMPLX E/N/E/L 2.6-7.5 CM,450,1 ,$296.00 ,$222.00 ,$144.67 ,"$1,246.32 ",$190.62 ,$553.92 ,$207.20 ,$144.67 ,$245.68 ,$149.01 ,$195.36 ,$281.20 ,$144.67 ,$236.80 ,$272.32 ,$144.67 ,$251.60 ,$281.20 ,$260.48 ,$224.96 ,$144.67 ,$144.67 ,$144.67 ,$216.08 ,$162.80 ,$269.36 ,$269.36 ,$236.80 ,$570.54 ,$162.80 ,$266.40 ,$553.92 ,$266.40 ,$159.84 ,$278.24 ,"$1,246.32 ",$272.32 ,$153.35 ,$269.36 ,$553.92 ,$182.16 ,$182.16 ,$266.40 ,$220.90 ,$206.16 ,$559.46 ,$144.67 ,$281.20 ,$581.62 ,$144.67 ,$257.52 ,$553.92 ,$266.40 ,$553.92 ,$266.40 ,$266.40 ,$266.40 ,$287.12 ,$239.76 ,$275.28 ,$254.56 ,$287.12 
SACRED HEART HOSPITAL (ACU),45000061,16000,HC TX BURN 1ST DEGREE INIT,450,1 ,$153.00 ,$114.75 ,$60.69 ,$427.33 ,$98.53 ,$189.93 ,$107.10 ,$60.69 ,$126.99 ,$62.51 ,$100.98 ,$145.35 ,$60.69 ,$122.40 ,$140.76 ,$60.69 ,$130.05 ,$145.35 ,$134.64 ,$116.28 ,$60.69 ,$60.69 ,$60.69 ,$111.69 ,$84.15 ,$139.23 ,$139.23 ,$122.40 ,$195.63 ,$84.15 ,$137.70 ,$189.93 ,$137.70 ,$82.62 ,$143.82 ,$427.33 ,$140.76 ,$64.33 ,$139.23 ,$189.93 ,$94.16 ,$94.16 ,$137.70 ,$114.18 ,$106.56 ,$191.82 ,$60.69 ,$145.35 ,$199.42 ,$60.69 ,$133.11 ,$189.93 ,$137.70 ,$189.93 ,$137.70 ,$137.70 ,$137.70 ,$148.41 ,$123.93 ,$142.29 ,$131.58 ,$148.41 
SACRED HEART HOSPITAL (ACU),45000062,16020,HC DRESS/DEB BURN <5% TOTAL SM,450,1 ,$538.00 ,$403.50 ,$60.69 ,$538.00 ,$346.47 ,$189.93 ,$376.60 ,$60.69 ,$446.54 ,$62.51 ,$355.08 ,$511.10 ,$60.69 ,$430.40 ,$494.96 ,$60.69 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$60.69 ,$60.69 ,$60.69 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,$195.63 ,$295.90 ,$484.20 ,$189.93 ,$484.20 ,$290.52 ,$505.72 ,$427.33 ,$494.96 ,$64.33 ,$489.58 ,$189.93 ,$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,$191.82 ,$60.69 ,$511.10 ,$199.42 ,$60.69 ,$468.06 ,$189.93 ,$484.20 ,$189.93 ,$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000063,16025,HC DRESS/DEB BURN 5-10% TOTAL MED,450,1 ,$538.00 ,$403.50 ,$60.69 ,$538.00 ,$346.47 ,$189.93 ,$376.60 ,$60.69 ,$446.54 ,$62.51 ,$355.08 ,$511.10 ,$60.69 ,$430.40 ,$494.96 ,$60.69 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$60.69 ,$60.69 ,$60.69 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,$195.63 ,$295.90 ,$484.20 ,$189.93 ,$484.20 ,$290.52 ,$505.72 ,$427.33 ,$494.96 ,$64.33 ,$489.58 ,$189.93 ,$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,$191.82 ,$60.69 ,$511.10 ,$199.42 ,$60.69 ,$468.06 ,$189.93 ,$484.20 ,$189.93 ,$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000064,16030,HC DRESS/DEBR BURN >10% TOTAL LRG,450,1 ,$507.00 ,$380.25 ,$122.07 ,$822.51 ,$326.51 ,$365.56 ,$354.90 ,$122.07 ,$420.81 ,$125.73 ,$334.62 ,$481.65 ,$122.07 ,$405.60 ,$466.44 ,$122.07 ,$430.95 ,$481.65 ,$446.16 ,$385.32 ,$122.07 ,$122.07 ,$122.07 ,$370.11 ,$278.85 ,$461.37 ,$461.37 ,$405.60 ,$376.53 ,$278.85 ,$456.30 ,$365.56 ,$456.30 ,$273.78 ,$476.58 ,$822.51 ,$466.44 ,$129.39 ,$461.37 ,$365.56 ,$312.01 ,$312.01 ,$456.30 ,$378.37 ,$353.13 ,$369.22 ,$122.07 ,$481.65 ,$383.84 ,$122.07 ,$441.09 ,$365.56 ,$456.30 ,$365.56 ,$456.30 ,$456.30 ,$456.30 ,$491.79 ,$410.67 ,$471.51 ,$436.02 ,$491.79 
SACRED HEART HOSPITAL (ACU),45000068,20103,HC EXPL PENTR WOUND EXTREMITY,450,1 ,$291.00 ,$218.25 ,$122.07 ,"$1,480.84 ",$187.40 ,$658.15 ,$203.70 ,$122.07 ,$241.53 ,$125.73 ,$192.06 ,$276.45 ,$122.07 ,$232.80 ,$267.72 ,$122.07 ,$247.35 ,$276.45 ,$256.08 ,$221.16 ,$122.07 ,$122.07 ,$122.07 ,$212.43 ,$160.05 ,$264.81 ,$264.81 ,$232.80 ,$677.89 ,$160.05 ,$261.90 ,$658.15 ,$261.90 ,$157.14 ,$273.54 ,"$1,480.84 ",$267.72 ,$129.39 ,$264.81 ,$658.15 ,$179.08 ,$179.08 ,$261.90 ,$217.17 ,$202.68 ,$664.73 ,$122.07 ,$276.45 ,$691.06 ,$122.07 ,$253.17 ,$658.15 ,$261.90 ,$658.15 ,$261.90 ,$261.90 ,$261.90 ,$282.27 ,$235.71 ,$270.63 ,$250.26 ,$282.27 
SACRED HEART HOSPITAL (ACU),45000069,20600,HC ARTHROCENT ASP/INJ JT SMALL,450,1 ,"$1,046.00 ",$784.50 ,$78.10 ,"$1,046.00 ",$673.62 ,$276.32 ,$732.20 ,$78.10 ,$868.18 ,$80.44 ,$690.36 ,$993.70 ,$78.10 ,$836.80 ,$962.32 ,$78.10 ,$889.10 ,$993.70 ,$920.48 ,$794.96 ,$78.10 ,$78.10 ,$78.10 ,$763.58 ,$575.30 ,$951.86 ,$951.86 ,$836.80 ,$284.61 ,$575.30 ,$941.40 ,$276.32 ,$941.40 ,$564.84 ,$983.24 ,$621.73 ,$962.32 ,$82.79 ,$951.86 ,$276.32 ,$643.71 ,$643.71 ,$941.40 ,$780.63 ,$728.54 ,$279.09 ,$78.10 ,$993.70 ,$290.14 ,$78.10 ,$910.02 ,$276.32 ,$941.40 ,$276.32 ,$941.40 ,$941.40 ,$941.40 ,"$1,014.62 ",$847.26 ,$972.78 ,$899.56 ,"$1,014.62 "
SACRED HEART HOSPITAL (ACU),45000070,20605,HC ARTHROCNT ASP/INJ JT INTRM,450,1 ,$604.00 ,$453.00 ,$78.10 ,$621.73 ,$388.98 ,$276.32 ,$422.80 ,$78.10 ,$501.32 ,$80.44 ,$398.64 ,$573.80 ,$78.10 ,$483.20 ,$555.68 ,$78.10 ,$513.40 ,$573.80 ,$531.52 ,$459.04 ,$78.10 ,$78.10 ,$78.10 ,$440.92 ,$332.20 ,$549.64 ,$549.64 ,$483.20 ,$284.61 ,$332.20 ,$543.60 ,$276.32 ,$543.60 ,$326.16 ,$567.76 ,$621.73 ,$555.68 ,$82.79 ,$549.64 ,$276.32 ,$371.70 ,$371.70 ,$543.60 ,$450.77 ,$420.69 ,$279.09 ,$78.10 ,$573.80 ,$290.14 ,$78.10 ,$525.48 ,$276.32 ,$543.60 ,$276.32 ,$543.60 ,$543.60 ,$543.60 ,$585.88 ,$489.24 ,$561.72 ,$519.44 ,$585.88 
SACRED HEART HOSPITAL (ACU),45000071,20610,HC ASPIR/INJECT MAJOR JOINT OR BURSA,450,1 ,$546.00 ,$409.50 ,$78.10 ,$621.73 ,$351.62 ,$276.32 ,$382.20 ,$78.10 ,$453.18 ,$80.44 ,$360.36 ,$518.70 ,$78.10 ,$436.80 ,$502.32 ,$78.10 ,$464.10 ,$518.70 ,$480.48 ,$414.96 ,$78.10 ,$78.10 ,$78.10 ,$398.58 ,$300.30 ,$496.86 ,$496.86 ,$436.80 ,$284.61 ,$300.30 ,$491.40 ,$276.32 ,$491.40 ,$294.84 ,$513.24 ,$621.73 ,$502.32 ,$82.79 ,$496.86 ,$276.32 ,$336.01 ,$336.01 ,$491.40 ,$407.48 ,$380.29 ,$279.09 ,$78.10 ,$518.70 ,$290.14 ,$78.10 ,$475.02 ,$276.32 ,$491.40 ,$276.32 ,$491.40 ,$491.40 ,$491.40 ,$529.62 ,$442.26 ,$507.78 ,$469.56 ,$529.62 
SACRED HEART HOSPITAL (ACU),45000074,23650,HC TX DISL SHLDR W/MAN CLS,450,1 ,$388.00 ,$291.00 ,$144.24 ,$490.48 ,$249.87 ,$217.99 ,$271.60 ,$144.24 ,$322.04 ,$148.57 ,$256.08 ,$368.60 ,$144.24 ,$310.40 ,$356.96 ,$144.24 ,$329.80 ,$368.60 ,$341.44 ,$294.88 ,$144.24 ,$144.24 ,$144.24 ,$283.24 ,$213.40 ,$353.08 ,$353.08 ,$310.40 ,$224.53 ,$213.40 ,$349.20 ,$217.99 ,$349.20 ,$209.52 ,$364.72 ,$490.48 ,$356.96 ,$152.89 ,$353.08 ,$217.99 ,$238.78 ,$238.78 ,$349.20 ,$289.56 ,$270.24 ,$220.17 ,$144.24 ,$368.60 ,$228.89 ,$144.24 ,$337.56 ,$217.99 ,$349.20 ,$217.99 ,$349.20 ,$349.20 ,$349.20 ,$376.36 ,$314.28 ,$360.84 ,$333.68 ,$376.36 
SACRED HEART HOSPITAL (ACU),45000075,23655,HC TX DISL SHLDR W/MAN/ANES CLS,450,1 ,$149.00 ,$111.75 ,$80.46 ,"$3,314.53 ",$95.96 ,"$1,473.12 ",$104.30 ,$149.00 ,$123.67 ,$330.15 ,$98.34 ,$141.55 ,$320.53 ,$119.20 ,$137.08 ,$149.00 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$149.00 ,$149.00 ,$320.53 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,"$1,517.31 ",$81.95 ,$134.10 ,"$1,473.12 ",$134.10 ,$80.46 ,$140.06 ,"$3,314.53 ",$137.08 ,$339.76 ,$135.59 ,"$1,473.12 ",$91.69 ,$91.69 ,$134.10 ,$111.20 ,$103.78 ,"$1,487.85 ",$149.00 ,$141.55 ,"$1,546.78 ",$149.00 ,$129.63 ,"$1,473.12 ",$134.10 ,"$1,473.12 ",$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),45000076,24600,HC TX DISL ELBOW W/O ANES CLS,450,1 ,$168.00 ,$126.00 ,$90.72 ,$490.48 ,$108.19 ,$217.99 ,$117.60 ,$144.24 ,$139.44 ,$148.57 ,$110.88 ,$159.60 ,$144.24 ,$134.40 ,$154.56 ,$144.24 ,$142.80 ,$159.60 ,$147.84 ,$127.68 ,$144.24 ,$144.24 ,$144.24 ,$122.64 ,$92.40 ,$152.88 ,$152.88 ,$134.40 ,$224.53 ,$92.40 ,$151.20 ,$217.99 ,$151.20 ,$90.72 ,$157.92 ,$490.48 ,$154.56 ,$152.89 ,$152.88 ,$217.99 ,$103.39 ,$103.39 ,$151.20 ,$125.38 ,$117.01 ,$220.17 ,$144.24 ,$159.60 ,$228.89 ,$144.24 ,$146.16 ,$217.99 ,$151.20 ,$217.99 ,$151.20 ,$151.20 ,$151.20 ,$162.96 ,$136.08 ,$156.24 ,$144.48 ,$162.96 
SACRED HEART HOSPITAL (ACU),45000079,24640,HC DISLOCATION NURSEMAID ELBOW,450,1 ,$134.00 ,$100.50 ,$72.36 ,$490.48 ,$86.30 ,$217.99 ,$93.80 ,$134.00 ,$111.22 ,$148.57 ,$88.44 ,$127.30 ,$144.24 ,$107.20 ,$123.28 ,$134.00 ,$113.90 ,$127.30 ,$117.92 ,$101.84 ,$134.00 ,$134.00 ,$144.24 ,$97.82 ,$73.70 ,$121.94 ,$121.94 ,$107.20 ,$224.53 ,$73.70 ,$120.60 ,$217.99 ,$120.60 ,$72.36 ,$125.96 ,$490.48 ,$123.28 ,$152.89 ,$121.94 ,$217.99 ,$82.46 ,$82.46 ,$120.60 ,$100.00 ,$93.33 ,$220.17 ,$134.00 ,$127.30 ,$228.89 ,$134.00 ,$116.58 ,$217.99 ,$120.60 ,$217.99 ,$120.60 ,$120.60 ,$120.60 ,$129.98 ,$108.54 ,$124.62 ,$115.24 ,$129.98 
SACRED HEART HOSPITAL (ACU),45000081,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP,450,1 ,$538.00 ,$403.50 ,$144.24 ,"$3,314.53 ",$346.47 ,"$1,473.12 ",$376.60 ,$144.24 ,$446.54 ,$148.57 ,$355.08 ,$511.10 ,$144.24 ,$430.40 ,$494.96 ,$144.24 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$144.24 ,$144.24 ,$144.24 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,"$1,517.31 ",$295.90 ,$484.20 ,"$1,473.12 ",$484.20 ,$290.52 ,$505.72 ,"$3,314.53 ",$494.96 ,$152.89 ,$489.58 ,"$1,473.12 ",$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,"$1,487.85 ",$144.24 ,$511.10 ,"$1,546.78 ",$144.24 ,$468.06 ,"$1,473.12 ",$484.20 ,"$1,473.12 ",$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000082,25605,HC CL TX DIS RADIAL FX/EPIP SEP,450,1 ,$538.00 ,$403.50 ,$144.24 ,"$3,314.53 ",$346.47 ,"$1,473.12 ",$376.60 ,$144.24 ,$446.54 ,$148.57 ,$355.08 ,$511.10 ,$144.24 ,$430.40 ,$494.96 ,$144.24 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$144.24 ,$144.24 ,$144.24 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,"$1,517.31 ",$295.90 ,$484.20 ,"$1,473.12 ",$484.20 ,$290.52 ,$505.72 ,"$3,314.53 ",$494.96 ,$152.89 ,$489.58 ,"$1,473.12 ",$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,"$1,487.85 ",$144.24 ,$511.10 ,"$1,546.78 ",$144.24 ,$468.06 ,"$1,473.12 ",$484.20 ,"$1,473.12 ",$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000083,26010,HC DRAIN ABSC FINGER SIMPLE,450,1 ,$272.00 ,$204.00 ,$53.09 ,$427.33 ,$175.17 ,$189.93 ,$190.40 ,$53.09 ,$225.76 ,$54.68 ,$179.52 ,$258.40 ,$53.09 ,$217.60 ,$250.24 ,$53.09 ,$231.20 ,$258.40 ,$239.36 ,$206.72 ,$53.09 ,$53.09 ,$53.09 ,$198.56 ,$149.60 ,$247.52 ,$247.52 ,$217.60 ,$195.63 ,$149.60 ,$244.80 ,$189.93 ,$244.80 ,$146.88 ,$255.68 ,$427.33 ,$250.24 ,$56.28 ,$247.52 ,$189.93 ,$167.39 ,$167.39 ,$244.80 ,$202.99 ,$189.45 ,$191.82 ,$53.09 ,$258.40 ,$199.42 ,$53.09 ,$236.64 ,$189.93 ,$244.80 ,$189.93 ,$244.80 ,$244.80 ,$244.80 ,$263.84 ,$220.32 ,$252.96 ,$233.92 ,$263.84 
SACRED HEART HOSPITAL (ACU),45000084,26011,HC DRAIN ABSC FINGER COMPLCD,450,1 ,"$4,088.04 ","$3,066.03 ",$356.47 ,"$4,088.04 ","$2,632.70 ","$1,488.12 ","$2,861.63 ",$356.47 ,"$3,393.07 ",$367.16 ,"$2,698.11 ","$3,883.64 ",$356.47 ,"$3,270.43 ","$3,761.00 ",$356.47 ,"$3,474.83 ","$3,883.64 ","$3,597.48 ","$3,106.91 ",$356.47 ,$356.47 ,$356.47 ,"$2,984.27 ","$2,248.42 ","$3,720.12 ","$3,720.12 ","$3,270.43 ","$1,532.76 ","$2,248.42 ","$3,679.24 ","$1,488.12 ","$3,679.24 ","$2,207.54 ","$3,842.76 ","$3,348.27 ","$3,761.00 ",$377.86 ,"$3,720.12 ","$1,488.12 ","$2,515.78 ","$2,515.78 ","$3,679.24 ","$3,050.90 ","$2,847.32 ","$1,503.00 ",$356.47 ,"$3,883.64 ","$1,562.52 ",$356.47 ,"$3,556.59 ","$1,488.12 ","$3,679.24 ","$1,488.12 ","$3,679.24 ","$3,679.24 ","$3,679.24 ","$3,965.40 ","$3,311.31 ","$3,801.88 ","$3,515.71 ","$3,965.40 "
SACRED HEART HOSPITAL (ACU),45000087,26725,HC TX FX PHALANX PROX W/MAN CLS,450,1 ,$136.00 ,$102.00 ,$73.44 ,$490.48 ,$87.58 ,$217.99 ,$95.20 ,$136.00 ,$112.88 ,$148.57 ,$89.76 ,$129.20 ,$144.24 ,$108.80 ,$125.12 ,$136.00 ,$115.60 ,$129.20 ,$119.68 ,$103.36 ,$136.00 ,$136.00 ,$144.24 ,$99.28 ,$74.80 ,$123.76 ,$123.76 ,$108.80 ,$224.53 ,$74.80 ,$122.40 ,$217.99 ,$122.40 ,$73.44 ,$127.84 ,$490.48 ,$125.12 ,$152.89 ,$123.76 ,$217.99 ,$83.69 ,$83.69 ,$122.40 ,$101.50 ,$94.72 ,$220.17 ,$136.00 ,$129.20 ,$228.89 ,$136.00 ,$118.32 ,$217.99 ,$122.40 ,$217.99 ,$122.40 ,$122.40 ,$122.40 ,$131.92 ,$110.16 ,$126.48 ,$116.96 ,$131.92 
SACRED HEART HOSPITAL (ACU),45000088,26742,HC TX FX (M-P)(I-P) JT W/MAN,450,1 ,"$1,903.00 ","$1,427.25 ",$144.24 ,"$3,314.53 ","$1,225.53 ","$1,473.12 ","$1,332.10 ",$144.24 ,"$1,579.49 ",$148.57 ,"$1,255.98 ","$1,807.85 ",$144.24 ,"$1,522.40 ","$1,750.76 ",$144.24 ,"$1,617.55 ","$1,807.85 ","$1,674.64 ","$1,446.28 ",$144.24 ,$144.24 ,$144.24 ,"$1,389.19 ","$1,046.65 ","$1,731.73 ","$1,731.73 ","$1,522.40 ","$1,517.31 ","$1,046.65 ","$1,712.70 ","$1,473.12 ","$1,712.70 ","$1,027.62 ","$1,788.82 ","$3,314.53 ","$1,750.76 ",$152.89 ,"$1,731.73 ","$1,473.12 ","$1,171.11 ","$1,171.11 ","$1,712.70 ","$1,420.21 ","$1,325.44 ","$1,487.85 ",$144.24 ,"$1,807.85 ","$1,546.78 ",$144.24 ,"$1,655.61 ","$1,473.12 ","$1,712.70 ","$1,473.12 ","$1,712.70 ","$1,712.70 ","$1,712.70 ","$1,845.91 ","$1,541.43 ","$1,769.79 ","$1,636.58 ","$1,845.91 "
SACRED HEART HOSPITAL (ACU),45000090,26770,HC TX DISL (I-P) HAND W/O ANES,450,1 ,$152.00 ,$114.00 ,$82.08 ,$490.48 ,$97.89 ,$217.99 ,$106.40 ,$144.24 ,$126.16 ,$148.57 ,$100.32 ,$144.40 ,$144.24 ,$121.60 ,$139.84 ,$144.24 ,$129.20 ,$144.40 ,$133.76 ,$115.52 ,$144.24 ,$144.24 ,$144.24 ,$110.96 ,$83.60 ,$138.32 ,$138.32 ,$121.60 ,$224.53 ,$83.60 ,$136.80 ,$217.99 ,$136.80 ,$82.08 ,$142.88 ,$490.48 ,$139.84 ,$152.89 ,$138.32 ,$217.99 ,$93.54 ,$93.54 ,$136.80 ,$113.44 ,$105.87 ,$220.17 ,$144.24 ,$144.40 ,$228.89 ,$144.24 ,$132.24 ,$217.99 ,$136.80 ,$217.99 ,$136.80 ,$136.80 ,$136.80 ,$147.44 ,$123.12 ,$141.36 ,$130.72 ,$147.44 
SACRED HEART HOSPITAL (ACU),45000091,26951,HC AMPUT FINGER/THUMB SGL CLSR,450,1 ,$279.00 ,$209.25 ,$150.66 ,"$6,739.17 ",$179.68 ,"$2,995.19 ",$195.30 ,$279.00 ,$231.57 ,$442.92 ,$184.14 ,$265.05 ,$430.02 ,$223.20 ,$256.68 ,$279.00 ,$237.15 ,$265.05 ,$245.52 ,$212.04 ,$279.00 ,$279.00 ,$430.02 ,$203.67 ,$153.45 ,$253.89 ,$253.89 ,$223.20 ,"$3,085.05 ",$153.45 ,$251.10 ,"$2,995.19 ",$251.10 ,$150.66 ,$262.26 ,"$6,739.17 ",$256.68 ,$455.82 ,$253.89 ,"$2,995.19 ",$171.70 ,$171.70 ,$251.10 ,$208.22 ,$194.32 ,"$3,025.14 ",$279.00 ,$265.05 ,"$3,144.95 ",$279.00 ,$242.73 ,"$2,995.19 ",$251.10 ,"$2,995.19 ",$251.10 ,$251.10 ,$251.10 ,$270.63 ,$225.99 ,$259.47 ,$239.94 ,$270.63 
SACRED HEART HOSPITAL (ACU),45000092,27250,HC TX DISCL HIP CLOSED W/O ANES,450,1 ,$644.00 ,$483.00 ,$144.24 ,$644.00 ,$414.74 ,$217.99 ,$450.80 ,$144.24 ,$534.52 ,$148.57 ,$425.04 ,$611.80 ,$144.24 ,$515.20 ,$592.48 ,$144.24 ,$547.40 ,$611.80 ,$566.72 ,$489.44 ,$144.24 ,$144.24 ,$144.24 ,$470.12 ,$354.20 ,$586.04 ,$586.04 ,$515.20 ,$224.53 ,$354.20 ,$579.60 ,$217.99 ,$579.60 ,$347.76 ,$605.36 ,$490.48 ,$592.48 ,$152.89 ,$586.04 ,$217.99 ,$396.32 ,$396.32 ,$579.60 ,$480.62 ,$448.55 ,$220.17 ,$144.24 ,$611.80 ,$228.89 ,$144.24 ,$560.28 ,$217.99 ,$579.60 ,$217.99 ,$579.60 ,$579.60 ,$579.60 ,$624.68 ,$521.64 ,$598.92 ,$553.84 ,$624.68 
SACRED HEART HOSPITAL (ACU),45000094,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT,450,1 ,$680.00 ,$510.00 ,$144.24 ,$680.00 ,$437.92 ,$217.99 ,$476.00 ,$144.24 ,$564.40 ,$148.57 ,$448.80 ,$646.00 ,$144.24 ,$544.00 ,$625.60 ,$144.24 ,$578.00 ,$646.00 ,$598.40 ,$516.80 ,$144.24 ,$144.24 ,$144.24 ,$496.40 ,$374.00 ,$618.80 ,$618.80 ,$544.00 ,$224.53 ,$374.00 ,$612.00 ,$217.99 ,$612.00 ,$367.20 ,$639.20 ,$490.48 ,$625.60 ,$152.89 ,$618.80 ,$217.99 ,$418.47 ,$418.47 ,$612.00 ,$507.48 ,$473.62 ,$220.17 ,$144.24 ,$646.00 ,$228.89 ,$144.24 ,$591.60 ,$217.99 ,$612.00 ,$217.99 ,$612.00 ,$612.00 ,$612.00 ,$659.60 ,$550.80 ,$632.40 ,$584.80 ,$659.60 
SACRED HEART HOSPITAL (ACU),45000095,27266,HC CL TX POST HIP ARTHROPLASTY DISLOCAT W ANESTH,450,1 ,"$4,343.00 ","$3,257.25 ",$320.53 ,"$4,343.00 ","$2,796.89 ","$1,473.12 ","$3,040.10 ",$320.53 ,"$3,604.69 ",$330.15 ,"$2,866.38 ","$4,125.85 ",$320.53 ,"$3,474.40 ","$3,995.56 ",$320.53 ,"$3,691.55 ","$4,125.85 ","$3,821.84 ","$3,300.68 ",$320.53 ,$320.53 ,$320.53 ,"$3,170.39 ","$2,388.65 ","$3,952.13 ","$3,952.13 ","$3,474.40 ","$1,517.31 ","$2,388.65 ","$3,908.70 ","$1,473.12 ","$3,908.70 ","$2,345.22 ","$4,082.42 ","$3,314.53 ","$3,995.56 ",$339.76 ,"$3,952.13 ","$1,473.12 ","$2,672.68 ","$2,672.68 ","$3,908.70 ","$3,241.18 ","$3,024.90 ","$1,487.85 ",$320.53 ,"$4,125.85 ","$1,546.78 ",$320.53 ,"$3,778.41 ","$1,473.12 ","$3,908.70 ","$1,473.12 ","$3,908.70 ","$3,908.70 ","$3,908.70 ","$4,212.71 ","$3,517.83 ","$4,038.99 ","$3,734.98 ","$4,212.71 "
SACRED HEART HOSPITAL (ACU),45000096,27560,HC TX DSL PTLR W/O ANS CL,450,1 ,$437.00 ,$327.75 ,$144.24 ,$490.48 ,$281.43 ,$217.99 ,$305.90 ,$144.24 ,$362.71 ,$148.57 ,$288.42 ,$415.15 ,$144.24 ,$349.60 ,$402.04 ,$144.24 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$144.24 ,$144.24 ,$144.24 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 ,$224.53 ,$240.35 ,$393.30 ,$217.99 ,$393.30 ,$235.98 ,$410.78 ,$490.48 ,$402.04 ,$152.89 ,$397.67 ,$217.99 ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 ,$220.17 ,$144.24 ,$415.15 ,$228.89 ,$144.24 ,$380.19 ,$217.99 ,$393.30 ,$217.99 ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),45000097,28190,HC REM FB FOOT SUBQ,450,1 ,"$1,278.00 ",$958.50 ,$144.67 ,"$1,480.84 ",$823.03 ,$658.15 ,$894.60 ,$144.67 ,"$1,060.74 ",$149.01 ,$843.48 ,"$1,214.10 ",$144.67 ,"$1,022.40 ","$1,175.76 ",$144.67 ,"$1,086.30 ","$1,214.10 ","$1,124.64 ",$971.28 ,$144.67 ,$144.67 ,$144.67 ,$932.94 ,$702.90 ,"$1,162.98 ","$1,162.98 ","$1,022.40 ",$677.89 ,$702.90 ,"$1,150.20 ",$658.15 ,"$1,150.20 ",$690.12 ,"$1,201.32 ","$1,480.84 ","$1,175.76 ",$153.35 ,"$1,162.98 ",$658.15 ,$786.48 ,$786.48 ,"$1,150.20 ",$953.77 ,$890.13 ,$664.73 ,$144.67 ,"$1,214.10 ",$691.06 ,$144.67 ,"$1,111.86 ",$658.15 ,"$1,150.20 ",$658.15 ,"$1,150.20 ","$1,150.20 ","$1,150.20 ","$1,239.66 ","$1,035.18 ","$1,188.54 ","$1,099.08 ","$1,239.66 "
SACRED HEART HOSPITAL (ACU),45000098,29065,HC APPL CAST ARM LONG,450,1 ,$659.00 ,$494.25 ,$61.15 ,$659.00 ,$424.40 ,$255.15 ,$461.30 ,$61.15 ,$546.97 ,$62.98 ,$434.94 ,$626.05 ,$61.15 ,$527.20 ,$606.28 ,$61.15 ,$560.15 ,$626.05 ,$579.92 ,$500.84 ,$61.15 ,$61.15 ,$61.15 ,$481.07 ,$362.45 ,$599.69 ,$599.69 ,$527.20 ,$262.80 ,$362.45 ,$593.10 ,$255.15 ,$593.10 ,$355.86 ,$619.46 ,$574.08 ,$606.28 ,$64.82 ,$599.69 ,$255.15 ,$405.55 ,$405.55 ,$593.10 ,$491.81 ,$458.99 ,$257.70 ,$61.15 ,$626.05 ,$267.90 ,$61.15 ,$573.33 ,$255.15 ,$593.10 ,$255.15 ,$593.10 ,$593.10 ,$593.10 ,$639.23 ,$533.79 ,$612.87 ,$566.74 ,$639.23 
SACRED HEART HOSPITAL (ACU),45000099,29075,HC CAST APPL; ELBOW TO FINGERS,450,1 ,$406.00 ,$304.50 ,$61.15 ,$574.08 ,$261.46 ,$255.15 ,$284.20 ,$61.15 ,$336.98 ,$62.98 ,$267.96 ,$385.70 ,$61.15 ,$324.80 ,$373.52 ,$61.15 ,$345.10 ,$385.70 ,$357.28 ,$308.56 ,$61.15 ,$61.15 ,$61.15 ,$296.38 ,$223.30 ,$369.46 ,$369.46 ,$324.80 ,$262.80 ,$223.30 ,$365.40 ,$255.15 ,$365.40 ,$219.24 ,$381.64 ,$574.08 ,$373.52 ,$64.82 ,$369.46 ,$255.15 ,$249.85 ,$249.85 ,$365.40 ,$303.00 ,$282.78 ,$257.70 ,$61.15 ,$385.70 ,$267.90 ,$61.15 ,$353.22 ,$255.15 ,$365.40 ,$255.15 ,$365.40 ,$365.40 ,$365.40 ,$393.82 ,$328.86 ,$377.58 ,$349.16 ,$393.82 
SACRED HEART HOSPITAL (ACU),45000100,29105,HC APPL SPLNT ARM LONG,450,1 ,$356.00 ,$267.00 ,$14.12 ,$356.00 ,$229.26 ,$149.42 ,$249.20 ,$14.12 ,$295.48 ,$14.54 ,$234.96 ,$338.20 ,$14.12 ,$284.80 ,$327.52 ,$14.12 ,$302.60 ,$338.20 ,$313.28 ,$270.56 ,$14.12 ,$14.12 ,$14.12 ,$259.88 ,$195.80 ,$323.96 ,$323.96 ,$284.80 ,$153.90 ,$195.80 ,$320.40 ,$149.42 ,$320.40 ,$192.24 ,$334.64 ,$336.20 ,$327.52 ,$14.97 ,$323.96 ,$149.42 ,$219.08 ,$219.08 ,$320.40 ,$265.68 ,$247.95 ,$150.92 ,$14.12 ,$338.20 ,$156.89 ,$14.12 ,$309.72 ,$149.42 ,$320.40 ,$149.42 ,$320.40 ,$320.40 ,$320.40 ,$345.32 ,$288.36 ,$331.08 ,$306.16 ,$345.32 
SACRED HEART HOSPITAL (ACU),45000101,29125,HC APPL SPLINT ARM SHORT STATIC,450,1 ,$218.00 ,$163.50 ,$14.12 ,$268.33 ,$140.39 ,$119.26 ,$152.60 ,$14.12 ,$180.94 ,$14.54 ,$143.88 ,$207.10 ,$14.12 ,$174.40 ,$200.56 ,$14.12 ,$185.30 ,$207.10 ,$191.84 ,$165.68 ,$14.12 ,$14.12 ,$14.12 ,$159.14 ,$119.90 ,$198.38 ,$198.38 ,$174.40 ,$122.84 ,$119.90 ,$196.20 ,$119.26 ,$196.20 ,$117.72 ,$204.92 ,$268.33 ,$200.56 ,$14.97 ,$198.38 ,$119.26 ,$134.16 ,$134.16 ,$196.20 ,$162.69 ,$151.84 ,$120.45 ,$14.12 ,$207.10 ,$125.22 ,$14.12 ,$189.66 ,$119.26 ,$196.20 ,$119.26 ,$196.20 ,$196.20 ,$196.20 ,$211.46 ,$176.58 ,$202.74 ,$187.48 ,$211.46 
SACRED HEART HOSPITAL (ACU),45000102,29126,HC APPL SHRT ARM SPLNT DYNAM,450,1 ,$249.00 ,$186.75 ,$14.12 ,$268.33 ,$160.36 ,$119.26 ,$174.30 ,$14.12 ,$206.67 ,$14.54 ,$164.34 ,$236.55 ,$14.12 ,$199.20 ,$229.08 ,$14.12 ,$211.65 ,$236.55 ,$219.12 ,$189.24 ,$14.12 ,$14.12 ,$14.12 ,$181.77 ,$136.95 ,$226.59 ,$226.59 ,$199.20 ,$122.84 ,$136.95 ,$224.10 ,$119.26 ,$224.10 ,$134.46 ,$234.06 ,$268.33 ,$229.08 ,$14.97 ,$226.59 ,$119.26 ,$153.23 ,$153.23 ,$224.10 ,$185.83 ,$173.43 ,$120.45 ,$14.12 ,$236.55 ,$125.22 ,$14.12 ,$216.63 ,$119.26 ,$224.10 ,$119.26 ,$224.10 ,$224.10 ,$224.10 ,$241.53 ,$201.69 ,$231.57 ,$214.14 ,$241.53 
SACRED HEART HOSPITAL (ACU),45000103,29130,HC APPL SPLNT FINGER STATIC,450,1 ,$138.00 ,$103.50 ,$14.12 ,$268.33 ,$88.87 ,$119.26 ,$96.60 ,$14.12 ,$114.54 ,$14.54 ,$91.08 ,$131.10 ,$14.12 ,$110.40 ,$126.96 ,$14.12 ,$117.30 ,$131.10 ,$121.44 ,$104.88 ,$14.12 ,$14.12 ,$14.12 ,$100.74 ,$75.90 ,$125.58 ,$125.58 ,$110.40 ,$122.84 ,$75.90 ,$124.20 ,$119.26 ,$124.20 ,$74.52 ,$129.72 ,$268.33 ,$126.96 ,$14.97 ,$125.58 ,$119.26 ,$84.93 ,$84.93 ,$124.20 ,$102.99 ,$96.12 ,$120.45 ,$14.12 ,$131.10 ,$125.22 ,$14.12 ,$120.06 ,$119.26 ,$124.20 ,$119.26 ,$124.20 ,$124.20 ,$124.20 ,$133.86 ,$111.78 ,$128.34 ,$118.68 ,$133.86 
SACRED HEART HOSPITAL (ACU),45000104,29131,HC APPL FINGER SPLINT DYNAMIC,450,1 ,$149.00 ,$111.75 ,$14.12 ,$149.00 ,$95.96 ,$58.87 ,$104.30 ,$14.12 ,$123.67 ,$14.54 ,$98.34 ,$141.55 ,$14.12 ,$119.20 ,$137.08 ,$14.12 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$14.12 ,$14.12 ,$14.12 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,$60.64 ,$81.95 ,$134.10 ,$58.87 ,$134.10 ,$80.46 ,$140.06 ,$132.46 ,$137.08 ,$14.97 ,$135.59 ,$58.87 ,$91.69 ,$91.69 ,$134.10 ,$111.20 ,$103.78 ,$59.46 ,$14.12 ,$141.55 ,$61.82 ,$14.12 ,$129.63 ,$58.87 ,$134.10 ,$58.87 ,$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),45000105,29240,HC STRAPPING SHLDR,450,1 ,$213.00 ,$159.75 ,$14.12 ,$268.33 ,$137.17 ,$119.26 ,$149.10 ,$14.12 ,$176.79 ,$14.54 ,$140.58 ,$202.35 ,$14.12 ,$170.40 ,$195.96 ,$14.12 ,$181.05 ,$202.35 ,$187.44 ,$161.88 ,$14.12 ,$14.12 ,$14.12 ,$155.49 ,$117.15 ,$193.83 ,$193.83 ,$170.40 ,$122.84 ,$117.15 ,$191.70 ,$119.26 ,$191.70 ,$115.02 ,$200.22 ,$268.33 ,$195.96 ,$14.97 ,$193.83 ,$119.26 ,$131.08 ,$131.08 ,$191.70 ,$158.96 ,$148.35 ,$120.45 ,$14.12 ,$202.35 ,$125.22 ,$14.12 ,$185.31 ,$119.26 ,$191.70 ,$119.26 ,$191.70 ,$191.70 ,$191.70 ,$206.61 ,$172.53 ,$198.09 ,$183.18 ,$206.61 
SACRED HEART HOSPITAL (ACU),45000106,29405,HC APPL CAST SHORT LEG,450,1 ,$720.00 ,$540.00 ,$61.15 ,$720.00 ,$463.68 ,$255.15 ,$504.00 ,$61.15 ,$597.60 ,$62.98 ,$475.20 ,$684.00 ,$61.15 ,$576.00 ,$662.40 ,$61.15 ,$612.00 ,$684.00 ,$633.60 ,$547.20 ,$61.15 ,$61.15 ,$61.15 ,$525.60 ,$396.00 ,$655.20 ,$655.20 ,$576.00 ,$262.80 ,$396.00 ,$648.00 ,$255.15 ,$648.00 ,$388.80 ,$676.80 ,$574.08 ,$662.40 ,$64.82 ,$655.20 ,$255.15 ,$443.09 ,$443.09 ,$648.00 ,$537.34 ,$501.48 ,$257.70 ,$61.15 ,$684.00 ,$267.90 ,$61.15 ,$626.40 ,$255.15 ,$648.00 ,$255.15 ,$648.00 ,$648.00 ,$648.00 ,$698.40 ,$583.20 ,$669.60 ,$619.20 ,$698.40 
SACRED HEART HOSPITAL (ACU),45000107,29505,HC APPL LONG LEG SPLNT,450,1 ,$774.00 ,$580.50 ,$14.12 ,$774.00 ,$498.46 ,$149.42 ,$541.80 ,$14.12 ,$642.42 ,$14.54 ,$510.84 ,$735.30 ,$14.12 ,$619.20 ,$712.08 ,$14.12 ,$657.90 ,$735.30 ,$681.12 ,$588.24 ,$14.12 ,$14.12 ,$14.12 ,$565.02 ,$425.70 ,$704.34 ,$704.34 ,$619.20 ,$153.90 ,$425.70 ,$696.60 ,$149.42 ,$696.60 ,$417.96 ,$727.56 ,$336.20 ,$712.08 ,$14.97 ,$704.34 ,$149.42 ,$476.32 ,$476.32 ,$696.60 ,$577.64 ,$539.09 ,$150.92 ,$14.12 ,$735.30 ,$156.89 ,$14.12 ,$673.38 ,$149.42 ,$696.60 ,$149.42 ,$696.60 ,$696.60 ,$696.60 ,$750.78 ,$626.94 ,$719.82 ,$665.64 ,$750.78 
SACRED HEART HOSPITAL (ACU),45000108,29515,HC APPL SHRT LEG SPLNT FAC,450,1 ,$702.00 ,$526.50 ,$14.12 ,$702.00 ,$452.09 ,$149.42 ,$491.40 ,$14.12 ,$582.66 ,$14.54 ,$463.32 ,$666.90 ,$14.12 ,$561.60 ,$645.84 ,$14.12 ,$596.70 ,$666.90 ,$617.76 ,$533.52 ,$14.12 ,$14.12 ,$14.12 ,$512.46 ,$386.10 ,$638.82 ,$638.82 ,$561.60 ,$153.90 ,$386.10 ,$631.80 ,$149.42 ,$631.80 ,$379.08 ,$659.88 ,$336.20 ,$645.84 ,$14.97 ,$638.82 ,$149.42 ,$432.01 ,$432.01 ,$631.80 ,$523.90 ,$488.94 ,$150.92 ,$14.12 ,$666.90 ,$156.89 ,$14.12 ,$610.74 ,$149.42 ,$631.80 ,$149.42 ,$631.80 ,$631.80 ,$631.80 ,$680.94 ,$568.62 ,$652.86 ,$603.72 ,$680.94 
SACRED HEART HOSPITAL (ACU),45000110,30300,HC REM FB INTRANASAL,450,1 ,$247.00 ,$185.25 ,$36.07 ,$268.33 ,$159.07 ,$119.26 ,$172.90 ,$36.07 ,$205.01 ,$37.15 ,$163.02 ,$234.65 ,$36.07 ,$197.60 ,$227.24 ,$36.07 ,$209.95 ,$234.65 ,$217.36 ,$187.72 ,$36.07 ,$36.07 ,$36.07 ,$180.31 ,$135.85 ,$224.77 ,$224.77 ,$197.60 ,$122.84 ,$135.85 ,$222.30 ,$119.26 ,$222.30 ,$133.38 ,$232.18 ,$268.33 ,$227.24 ,$38.23 ,$224.77 ,$119.26 ,$152.00 ,$152.00 ,$222.30 ,$184.34 ,$172.04 ,$120.45 ,$36.07 ,$234.65 ,$125.22 ,$36.07 ,$214.89 ,$119.26 ,$222.30 ,$119.26 ,$222.30 ,$222.30 ,$222.30 ,$239.59 ,$200.07 ,$229.71 ,$212.42 ,$239.59 
SACRED HEART HOSPITAL (ACU),45000111,30901,HC CNTRL NOSEBLEED ANT SMP,450,1 ,$443.00 ,$332.25 ,$36.07 ,$443.00 ,$285.29 ,$119.26 ,$310.10 ,$36.07 ,$367.69 ,$37.15 ,$292.38 ,$420.85 ,$36.07 ,$354.40 ,$407.56 ,$36.07 ,$376.55 ,$420.85 ,$389.84 ,$336.68 ,$36.07 ,$36.07 ,$36.07 ,$323.39 ,$243.65 ,$403.13 ,$403.13 ,$354.40 ,$122.84 ,$243.65 ,$398.70 ,$119.26 ,$398.70 ,$239.22 ,$416.42 ,$268.33 ,$407.56 ,$38.23 ,$403.13 ,$119.26 ,$272.62 ,$272.62 ,$398.70 ,$330.61 ,$308.55 ,$120.45 ,$36.07 ,$420.85 ,$125.22 ,$36.07 ,$385.41 ,$119.26 ,$398.70 ,$119.26 ,$398.70 ,$398.70 ,$398.70 ,$429.71 ,$358.83 ,$411.99 ,$380.98 ,$429.71 
SACRED HEART HOSPITAL (ACU),45000112,30903,HC CNTRL NOSEBLEED ANT CPLX,450,1 ,$557.00 ,$417.75 ,$36.07 ,$557.00 ,$358.71 ,$119.26 ,$389.90 ,$36.07 ,$462.31 ,$37.15 ,$367.62 ,$529.15 ,$36.07 ,$445.60 ,$512.44 ,$36.07 ,$473.45 ,$529.15 ,$490.16 ,$423.32 ,$36.07 ,$36.07 ,$36.07 ,$406.61 ,$306.35 ,$506.87 ,$506.87 ,$445.60 ,$122.84 ,$306.35 ,$501.30 ,$119.26 ,$501.30 ,$300.78 ,$523.58 ,$268.33 ,$512.44 ,$38.23 ,$506.87 ,$119.26 ,$342.78 ,$342.78 ,$501.30 ,$415.69 ,$387.95 ,$120.45 ,$36.07 ,$529.15 ,$125.22 ,$36.07 ,$484.59 ,$119.26 ,$501.30 ,$119.26 ,$501.30 ,$501.30 ,$501.30 ,$540.29 ,$451.17 ,$518.01 ,$479.02 ,$540.29 
SACRED HEART HOSPITAL (ACU),45000113,30905,HC CNTRL NOSEBLEED POST INIT,450,1 ,$350.00 ,$262.50 ,$36.07 ,$350.00 ,$225.40 ,$119.26 ,$245.00 ,$36.07 ,$290.50 ,$37.15 ,$231.00 ,$332.50 ,$36.07 ,$280.00 ,$322.00 ,$36.07 ,$297.50 ,$332.50 ,$308.00 ,$266.00 ,$36.07 ,$36.07 ,$36.07 ,$255.50 ,$192.50 ,$318.50 ,$318.50 ,$280.00 ,$122.84 ,$192.50 ,$315.00 ,$119.26 ,$315.00 ,$189.00 ,$329.00 ,$268.33 ,$322.00 ,$38.23 ,$318.50 ,$119.26 ,$215.39 ,$215.39 ,$315.00 ,$261.21 ,$243.78 ,$120.45 ,$36.07 ,$332.50 ,$125.22 ,$36.07 ,$304.50 ,$119.26 ,$315.00 ,$119.26 ,$315.00 ,$315.00 ,$315.00 ,$339.50 ,$283.50 ,$325.50 ,$301.00 ,$339.50 
SACRED HEART HOSPITAL (ACU),45000114,31238,HC NASAL ENDO W EPISTAX CONTROL,450,1 ,"$4,026.00 ","$3,019.50 ",$631.96 ,"$4,026.00 ","$2,592.74 ","$1,582.37 ","$2,818.20 ",$631.96 ,"$3,341.58 ",$650.92 ,"$2,657.16 ","$3,824.70 ",$631.96 ,"$3,220.80 ","$3,703.92 ",$631.96 ,"$3,422.10 ","$3,824.70 ","$3,542.88 ","$3,059.76 ",$631.96 ,$631.96 ,$631.96 ,"$2,938.98 ","$2,214.30 ","$3,663.66 ","$3,663.66 ","$3,220.80 ","$1,629.84 ","$2,214.30 ","$3,623.40 ","$1,582.37 ","$3,623.40 ","$2,174.04 ","$3,784.44 ","$3,560.32 ","$3,703.92 ",$669.88 ,"$3,663.66 ","$1,582.37 ","$2,477.60 ","$2,477.60 ","$3,623.40 ","$3,004.60 ","$2,804.11 ","$1,598.19 ",$631.96 ,"$3,824.70 ","$1,661.48 ",$631.96 ,"$3,502.62 ","$1,582.37 ","$3,623.40 ","$1,582.37 ","$3,623.40 ","$3,623.40 ","$3,623.40 ","$3,905.22 ","$3,261.06 ","$3,744.18 ","$3,462.36 ","$3,905.22 "
SACRED HEART HOSPITAL (ACU),45000132,36680,HC PLACE NDL INFS INTRAOSSEOUS,450,1 ,$597.00 ,$447.75 ,$78.10 ,$645.84 ,$384.47 ,$287.04 ,$417.90 ,$78.10 ,$495.51 ,$80.44 ,$394.02 ,$567.15 ,$78.10 ,$477.60 ,$549.24 ,$78.10 ,$507.45 ,$567.15 ,$525.36 ,$453.72 ,$78.10 ,$78.10 ,$78.10 ,$435.81 ,$328.35 ,$543.27 ,$543.27 ,$477.60 ,$295.65 ,$328.35 ,$537.30 ,$287.04 ,$537.30 ,$322.38 ,$561.18 ,$645.84 ,$549.24 ,$82.79 ,$543.27 ,$287.04 ,$367.39 ,$367.39 ,$537.30 ,$445.54 ,$415.81 ,$289.91 ,$78.10 ,$567.15 ,$301.39 ,$78.10 ,$519.39 ,$287.04 ,$537.30 ,$287.04 ,$537.30 ,$537.30 ,$537.30 ,$579.09 ,$483.57 ,$555.21 ,$513.42 ,$579.09 
SACRED HEART HOSPITAL (ACU),45000133,40650,HC RPR LIP FULL THICK VERMILN,450,1 ,$290.00 ,$217.50 ,$156.60 ,"$1,076.25 ",$186.76 ,$478.33 ,$203.00 ,$290.00 ,$240.70 ,$307.23 ,$191.40 ,$275.50 ,$298.28 ,$232.00 ,$266.80 ,$290.00 ,$246.50 ,$275.50 ,$255.20 ,$220.40 ,$290.00 ,$290.00 ,$298.28 ,$211.70 ,$159.50 ,$263.90 ,$263.90 ,$232.00 ,$492.68 ,$159.50 ,$261.00 ,$478.33 ,$261.00 ,$156.60 ,$272.60 ,"$1,076.25 ",$266.80 ,$316.18 ,$263.90 ,$478.33 ,$178.47 ,$178.47 ,$261.00 ,$216.43 ,$201.99 ,$483.12 ,$290.00 ,$275.50 ,$502.25 ,$290.00 ,$252.30 ,$478.33 ,$261.00 ,$478.33 ,$261.00 ,$261.00 ,$261.00 ,$281.30 ,$234.90 ,$269.70 ,$249.40 ,$281.30 
SACRED HEART HOSPITAL (ACU),45000136,40800,HC DRAINAGE MOUTH LESION,450,1 ,$483.00 ,$362.25 ,$36.07 ,"$1,480.84 ",$311.05 ,$658.15 ,$338.10 ,$36.07 ,$400.89 ,$37.15 ,$318.78 ,$458.85 ,$36.07 ,$386.40 ,$444.36 ,$36.07 ,$410.55 ,$458.85 ,$425.04 ,$367.08 ,$36.07 ,$36.07 ,$36.07 ,$352.59 ,$265.65 ,$439.53 ,$439.53 ,$386.40 ,$677.89 ,$265.65 ,$434.70 ,$658.15 ,$434.70 ,$260.82 ,$454.02 ,"$1,480.84 ",$444.36 ,$38.23 ,$439.53 ,$658.15 ,$297.24 ,$297.24 ,$434.70 ,$360.46 ,$336.41 ,$664.73 ,$36.07 ,$458.85 ,$691.06 ,$36.07 ,$420.21 ,$658.15 ,$434.70 ,$658.15 ,$434.70 ,$434.70 ,$434.70 ,$468.51 ,$391.23 ,$449.19 ,$415.38 ,$468.51 
SACRED HEART HOSPITAL (ACU),45000138,41250,HC RPR LAC MOUTH/TONGUE <2.5CM,450,1 ,$453.00 ,$339.75 ,$36.07 ,$645.84 ,$291.73 ,$287.04 ,$317.10 ,$36.07 ,$375.99 ,$37.15 ,$298.98 ,$430.35 ,$36.07 ,$362.40 ,$416.76 ,$36.07 ,$385.05 ,$430.35 ,$398.64 ,$344.28 ,$36.07 ,$36.07 ,$36.07 ,$330.69 ,$249.15 ,$412.23 ,$412.23 ,$362.40 ,$295.65 ,$249.15 ,$407.70 ,$287.04 ,$407.70 ,$244.62 ,$425.82 ,$645.84 ,$416.76 ,$38.23 ,$412.23 ,$287.04 ,$278.78 ,$278.78 ,$407.70 ,$338.07 ,$315.51 ,$289.91 ,$36.07 ,$430.35 ,$301.39 ,$36.07 ,$394.11 ,$287.04 ,$407.70 ,$287.04 ,$407.70 ,$407.70 ,$407.70 ,$439.41 ,$366.93 ,$421.29 ,$389.58 ,$439.41 
SACRED HEART HOSPITAL (ACU),45000139,41800,HC DRAIN ABSC/CYST DENTOALVLR,450,1 ,$160.00 ,$120.00 ,$36.07 ,$268.33 ,$103.04 ,$119.26 ,$112.00 ,$36.07 ,$132.80 ,$37.15 ,$105.60 ,$152.00 ,$36.07 ,$128.00 ,$147.20 ,$36.07 ,$136.00 ,$152.00 ,$140.80 ,$121.60 ,$36.07 ,$36.07 ,$36.07 ,$116.80 ,$88.00 ,$145.60 ,$145.60 ,$128.00 ,$122.84 ,$88.00 ,$144.00 ,$119.26 ,$144.00 ,$86.40 ,$150.40 ,$268.33 ,$147.20 ,$38.23 ,$145.60 ,$119.26 ,$98.46 ,$98.46 ,$144.00 ,$119.41 ,$111.44 ,$120.45 ,$36.07 ,$152.00 ,$125.22 ,$36.07 ,$139.20 ,$119.26 ,$144.00 ,$119.26 ,$144.00 ,$144.00 ,$144.00 ,$155.20 ,$129.60 ,$148.80 ,$137.60 ,$155.20 
SACRED HEART HOSPITAL (ACU),45000140,42700,HC I AND D ABSC PERITONSILLAR,450,1 ,$233.00 ,$174.75 ,$36.07 ,$503.46 ,$150.05 ,$223.76 ,$163.10 ,$36.07 ,$193.39 ,$37.15 ,$153.78 ,$221.35 ,$36.07 ,$186.40 ,$214.36 ,$36.07 ,$198.05 ,$221.35 ,$205.04 ,$177.08 ,$36.07 ,$36.07 ,$36.07 ,$170.09 ,$128.15 ,$212.03 ,$212.03 ,$186.40 ,$230.47 ,$128.15 ,$209.70 ,$223.76 ,$209.70 ,$125.82 ,$219.02 ,$503.46 ,$214.36 ,$38.23 ,$212.03 ,$223.76 ,$143.39 ,$143.39 ,$209.70 ,$173.89 ,$162.28 ,$226.00 ,$36.07 ,$221.35 ,$234.95 ,$36.07 ,$202.71 ,$223.76 ,$209.70 ,$223.76 ,$209.70 ,$209.70 ,$209.70 ,$226.01 ,$188.73 ,$216.69 ,$200.38 ,$226.01 
SACRED HEART HOSPITAL (ACU),45000141,42809,HC REMOVE PHARYNX FOREIGN BODY,450,1 ,$786.00 ,$589.50 ,$36.07 ,$786.00 ,$506.18 ,$287.04 ,$550.20 ,$36.07 ,$652.38 ,$37.15 ,$518.76 ,$746.70 ,$36.07 ,$628.80 ,$723.12 ,$36.07 ,$668.10 ,$746.70 ,$691.68 ,$597.36 ,$36.07 ,$36.07 ,$36.07 ,$573.78 ,$432.30 ,$715.26 ,$715.26 ,$628.80 ,$295.65 ,$432.30 ,$707.40 ,$287.04 ,$707.40 ,$424.44 ,$738.84 ,$645.84 ,$723.12 ,$38.23 ,$715.26 ,$287.04 ,$483.70 ,$483.70 ,$707.40 ,$586.59 ,$547.45 ,$289.91 ,$36.07 ,$746.70 ,$301.39 ,$36.07 ,$683.82 ,$287.04 ,$707.40 ,$287.04 ,$707.40 ,$707.40 ,$707.40 ,$762.42 ,$636.66 ,$730.98 ,$675.96 ,$762.42 
SACRED HEART HOSPITAL (ACU),45000146,46040,HC INCISION RECTAL ABSCESS,450,1 ,"$1,708.00 ","$1,281.00 ",$478.29 ,"$2,467.67 ","$1,099.95 ","$1,096.74 ","$1,195.60 ",$478.29 ,"$1,417.64 ",$492.64 ,"$1,127.28 ","$1,622.60 ",$478.29 ,"$1,366.40 ","$1,571.36 ",$478.29 ,"$1,451.80 ","$1,622.60 ","$1,503.04 ","$1,298.08 ",$478.29 ,$478.29 ,$478.29 ,"$1,246.84 ",$939.40 ,"$1,554.28 ","$1,554.28 ","$1,366.40 ","$1,129.64 ",$939.40 ,"$1,537.20 ","$1,096.74 ","$1,537.20 ",$922.32 ,"$1,605.52 ","$2,467.67 ","$1,571.36 ",$506.99 ,"$1,554.28 ","$1,096.74 ","$1,051.10 ","$1,051.10 ","$1,537.20 ","$1,274.68 ","$1,189.62 ","$1,107.71 ",$478.29 ,"$1,622.60 ","$1,151.58 ",$478.29 ,"$1,485.96 ","$1,096.74 ","$1,537.20 ","$1,096.74 ","$1,537.20 ","$1,537.20 ","$1,537.20 ","$1,656.76 ","$1,383.48 ","$1,588.44 ","$1,468.88 ","$1,656.76 "
SACRED HEART HOSPITAL (ACU),45000147,46050,HC I AND D ABSC PERIANAL SUPFIC,450,1 ,$344.00 ,$258.00 ,$185.76 ,"$1,888.46 ",$221.54 ,$839.32 ,$240.80 ,$344.00 ,$285.52 ,$492.64 ,$227.04 ,$326.80 ,$478.29 ,$275.20 ,$316.48 ,$344.00 ,$292.40 ,$326.80 ,$302.72 ,$261.44 ,$344.00 ,$344.00 ,$478.29 ,$251.12 ,$189.20 ,$313.04 ,$313.04 ,$275.20 ,$864.50 ,$189.20 ,$309.60 ,$839.32 ,$309.60 ,$185.76 ,$323.36 ,"$1,888.46 ",$316.48 ,$506.99 ,$313.04 ,$839.32 ,$211.70 ,$211.70 ,$309.60 ,$256.73 ,$239.60 ,$847.71 ,$344.00 ,$326.80 ,$881.28 ,$344.00 ,$299.28 ,$839.32 ,$309.60 ,$839.32 ,$309.60 ,$309.60 ,$309.60 ,$333.68 ,$278.64 ,$319.92 ,$295.84 ,$333.68 
SACRED HEART HOSPITAL (ACU),45000148,46083,HC INC HEMORRHOID EXTERNAL,450,1 ,$220.00 ,$165.00 ,$118.80 ,$633.24 ,$141.68 ,$281.44 ,$154.00 ,$220.00 ,$182.60 ,$492.64 ,$145.20 ,$209.00 ,$478.29 ,$176.00 ,$202.40 ,$220.00 ,$187.00 ,$209.00 ,$193.60 ,$167.20 ,$220.00 ,$220.00 ,$478.29 ,$160.60 ,$121.00 ,$200.20 ,$200.20 ,$176.00 ,$289.88 ,$121.00 ,$198.00 ,$281.44 ,$198.00 ,$118.80 ,$206.80 ,$633.24 ,$202.40 ,$506.99 ,$200.20 ,$281.44 ,$135.39 ,$135.39 ,$198.00 ,$164.19 ,$153.23 ,$284.25 ,$220.00 ,$209.00 ,$295.51 ,$220.00 ,$191.40 ,$281.44 ,$198.00 ,$281.44 ,$198.00 ,$198.00 ,$198.00 ,$213.40 ,$178.20 ,$204.60 ,$189.20 ,$213.40 
SACRED HEART HOSPITAL (ACU),45000150,46600,HC ANOSCOPY,450,1 ,$174.00 ,$130.50 ,$58.37 ,$268.33 ,$112.06 ,$119.26 ,$121.80 ,$58.37 ,$144.42 ,$60.12 ,$114.84 ,$165.30 ,$58.37 ,$139.20 ,$160.08 ,$58.37 ,$147.90 ,$165.30 ,$153.12 ,$132.24 ,$58.37 ,$58.37 ,$58.37 ,$127.02 ,$95.70 ,$158.34 ,$158.34 ,$139.20 ,$122.84 ,$95.70 ,$156.60 ,$119.26 ,$156.60 ,$93.96 ,$163.56 ,$268.33 ,$160.08 ,$61.87 ,$158.34 ,$119.26 ,$107.08 ,$107.08 ,$156.60 ,$129.86 ,$121.19 ,$120.45 ,$58.37 ,$165.30 ,$125.22 ,$58.37 ,$151.38 ,$119.26 ,$156.60 ,$119.26 ,$156.60 ,$156.60 ,$156.60 ,$168.78 ,$140.94 ,$161.82 ,$149.64 ,$168.78 
SACRED HEART HOSPITAL (ACU),45000156,51700,HC IRRIG/LAVG/INSTL BLADDER,450,1 ,$384.00 ,$288.00 ,$23.39 ,$633.24 ,$247.30 ,$281.44 ,$268.80 ,$23.39 ,$318.72 ,$24.09 ,$253.44 ,$364.80 ,$23.39 ,$307.20 ,$353.28 ,$23.39 ,$326.40 ,$364.80 ,$337.92 ,$291.84 ,$23.39 ,$23.39 ,$23.39 ,$280.32 ,$211.20 ,$349.44 ,$349.44 ,$307.20 ,$289.88 ,$211.20 ,$345.60 ,$281.44 ,$345.60 ,$207.36 ,$360.96 ,$633.24 ,$353.28 ,$24.79 ,$349.44 ,$281.44 ,$236.31 ,$236.31 ,$345.60 ,$286.58 ,$267.46 ,$284.25 ,$23.39 ,$364.80 ,$295.51 ,$23.39 ,$334.08 ,$281.44 ,$345.60 ,$281.44 ,$345.60 ,$345.60 ,$345.60 ,$372.48 ,$311.04 ,$357.12 ,$330.24 ,$372.48 
SACRED HEART HOSPITAL (ACU),45000157,51705,HC CHG TUBE CYSTOSTOMY SMP,450,1 ,$520.00 ,$390.00 ,$64.85 ,$633.24 ,$334.88 ,$281.44 ,$364.00 ,$64.85 ,$431.60 ,$66.80 ,$343.20 ,$494.00 ,$64.85 ,$416.00 ,$478.40 ,$64.85 ,$442.00 ,$494.00 ,$457.60 ,$395.20 ,$64.85 ,$64.85 ,$64.85 ,$379.60 ,$286.00 ,$473.20 ,$473.20 ,$416.00 ,$289.88 ,$286.00 ,$468.00 ,$281.44 ,$468.00 ,$280.80 ,$488.80 ,$633.24 ,$478.40 ,$68.74 ,$473.20 ,$281.44 ,$320.01 ,$320.01 ,$468.00 ,$388.08 ,$362.18 ,$284.25 ,$64.85 ,$494.00 ,$295.51 ,$64.85 ,$452.40 ,$281.44 ,$468.00 ,$281.44 ,$468.00 ,$468.00 ,$468.00 ,$504.40 ,$421.20 ,$483.60 ,$447.20 ,$504.40 
SACRED HEART HOSPITAL (ACU),45000163,56405,HC I AND D ABSC VULVA/PERINEAL,450,1 ,$392.00 ,$294.00 ,$64.05 ,$671.15 ,$252.45 ,$298.29 ,$274.40 ,$64.05 ,$325.36 ,$65.97 ,$258.72 ,$372.40 ,$64.05 ,$313.60 ,$360.64 ,$64.05 ,$333.20 ,$372.40 ,$344.96 ,$297.92 ,$64.05 ,$64.05 ,$64.05 ,$286.16 ,$215.60 ,$356.72 ,$356.72 ,$313.60 ,$307.24 ,$215.60 ,$352.80 ,$298.29 ,$352.80 ,$211.68 ,$368.48 ,$671.15 ,$360.64 ,$67.89 ,$356.72 ,$298.29 ,$241.24 ,$241.24 ,$352.80 ,$292.55 ,$273.03 ,$301.27 ,$64.05 ,$372.40 ,$313.20 ,$64.05 ,$341.04 ,$298.29 ,$352.80 ,$298.29 ,$352.80 ,$352.80 ,$352.80 ,$380.24 ,$317.52 ,$364.56 ,$337.12 ,$380.24 
SACRED HEART HOSPITAL (ACU),45000164,56420,HC I AND D ABSC GLAND BARTHOLIN'S,450,1 ,$163.00 ,$122.25 ,$64.05 ,$405.41 ,$104.97 ,$180.18 ,$114.10 ,$64.05 ,$135.29 ,$65.97 ,$107.58 ,$154.85 ,$64.05 ,$130.40 ,$149.96 ,$64.05 ,$138.55 ,$154.85 ,$143.44 ,$123.88 ,$64.05 ,$64.05 ,$64.05 ,$118.99 ,$89.65 ,$148.33 ,$148.33 ,$130.40 ,$185.59 ,$89.65 ,$146.70 ,$180.18 ,$146.70 ,$88.02 ,$153.22 ,$405.41 ,$149.96 ,$67.89 ,$148.33 ,$180.18 ,$100.31 ,$100.31 ,$146.70 ,$121.65 ,$113.53 ,$181.98 ,$64.05 ,$154.85 ,$189.19 ,$64.05 ,$141.81 ,$180.18 ,$146.70 ,$180.18 ,$146.70 ,$146.70 ,$146.70 ,$158.11 ,$132.03 ,$151.59 ,$140.18 ,$158.11 
SACRED HEART HOSPITAL (ACU),45000165,58301,HC REM DVC INTRAUTERINE,450,1 ,$909.00 ,$681.75 ,$64.05 ,$909.00 ,$585.40 ,$298.29 ,$636.30 ,$64.05 ,$754.47 ,$65.97 ,$599.94 ,$863.55 ,$64.05 ,$727.20 ,$836.28 ,$64.05 ,$772.65 ,$863.55 ,$799.92 ,$690.84 ,$64.05 ,$64.05 ,$64.05 ,$663.57 ,$499.95 ,$827.19 ,$827.19 ,$727.20 ,$307.24 ,$499.95 ,$818.10 ,$298.29 ,$818.10 ,$490.86 ,$854.46 ,$671.15 ,$836.28 ,$67.89 ,$827.19 ,$298.29 ,$559.40 ,$559.40 ,$818.10 ,$678.39 ,$633.12 ,$301.27 ,$64.05 ,$863.55 ,$313.20 ,$64.05 ,$790.83 ,$298.29 ,$818.10 ,$298.29 ,$818.10 ,$818.10 ,$818.10 ,$881.73 ,$736.29 ,$845.37 ,$781.74 ,$881.73 
SACRED HEART HOSPITAL (ACU),45000166,59414,HC DELIVERY OF PLACENTA,450,1 ,"$7,056.00 ","$5,292.00 ",$615.85 ,"$7,056.00 ","$4,544.06 ","$2,774.90 ","$4,939.20 ",$615.85 ,"$5,856.48 ",$634.33 ,"$4,656.96 ","$6,703.20 ",$615.85 ,"$5,644.80 ","$6,491.52 ",$615.85 ,"$5,997.60 ","$6,703.20 ","$6,209.28 ","$5,362.56 ",$615.85 ,$615.85 ,$615.85 ,"$5,150.88 ","$3,880.80 ","$6,420.96 ","$6,420.96 ","$5,644.80 ","$2,858.15 ","$3,880.80 ","$6,350.40 ","$2,774.90 ","$6,350.40 ","$3,810.24 ","$6,632.64 ","$6,243.52 ","$6,491.52 ",$652.80 ,"$6,420.96 ","$2,774.90 ","$4,342.26 ","$4,342.26 ","$6,350.40 ","$5,265.89 ","$4,914.50 ","$2,802.65 ",$615.85 ,"$6,703.20 ","$2,913.64 ",$615.85 ,"$6,138.72 ","$2,774.90 ","$6,350.40 ","$2,774.90 ","$6,350.40 ","$6,350.40 ","$6,350.40 ","$6,844.32 ","$5,715.36 ","$6,562.08 ","$6,068.16 ","$6,844.32 "
SACRED HEART HOSPITAL (ACU),45000168,64400,HC DENTAL BLOCK,450,1 ,$589.00 ,$441.75 ,$141.34 ,$621.73 ,$379.32 ,$276.32 ,$412.30 ,$141.34 ,$488.87 ,$145.58 ,$388.74 ,$559.55 ,$141.34 ,$471.20 ,$541.88 ,$141.34 ,$500.65 ,$559.55 ,$518.32 ,$447.64 ,$141.34 ,$141.34 ,$141.34 ,$429.97 ,$323.95 ,$535.99 ,$535.99 ,$471.20 ,$284.61 ,$323.95 ,$530.10 ,$276.32 ,$530.10 ,$318.06 ,$553.66 ,$621.73 ,$541.88 ,$149.82 ,$535.99 ,$276.32 ,$362.47 ,$362.47 ,$530.10 ,$439.57 ,$410.24 ,$279.09 ,$141.34 ,$559.55 ,$290.14 ,$141.34 ,$512.43 ,$276.32 ,$530.10 ,$276.32 ,$530.10 ,$530.10 ,$530.10 ,$571.33 ,$477.09 ,$547.77 ,$506.54 ,$571.33 
SACRED HEART HOSPITAL (ACU),45000169,64999,HC INJECTION FACIAL NERVE,450,1 ,$929.26 ,$696.95 ,$141.34 ,$929.26 ,$598.44 ,$276.32 ,$650.48 ,$141.34 ,$771.29 ,$145.58 ,$613.31 ,$882.80 ,$141.34 ,$743.41 ,$854.92 ,$141.34 ,$789.87 ,$882.80 ,$817.75 ,$706.24 ,$141.34 ,$141.34 ,$141.34 ,$678.36 ,$511.09 ,$845.63 ,$845.63 ,$743.41 ,$284.61 ,$511.09 ,$836.33 ,$276.32 ,$836.33 ,$501.80 ,$873.50 ,$621.73 ,$854.92 ,$149.82 ,$845.63 ,$276.32 ,$571.87 ,$571.87 ,$836.33 ,$693.51 ,$647.23 ,$279.09 ,$141.34 ,$882.80 ,$290.14 ,$141.34 ,$808.46 ,$276.32 ,$836.33 ,$276.32 ,$836.33 ,$836.33 ,$836.33 ,$901.38 ,$752.70 ,$864.21 ,$799.16 ,$901.38 
SACRED HEART HOSPITAL (ACU),45000170,64450,HC INJ ANES NERVE PERIPHERAL,450,1 ,$638.00 ,$478.50 ,$141.34 ,"$1,511.09 ",$410.87 ,$671.59 ,$446.60 ,$141.34 ,$529.54 ,$145.58 ,$421.08 ,$606.10 ,$141.34 ,$510.40 ,$586.96 ,$141.34 ,$542.30 ,$606.10 ,$561.44 ,$484.88 ,$141.34 ,$141.34 ,$141.34 ,$465.74 ,$350.90 ,$580.58 ,$580.58 ,$510.40 ,$691.74 ,$350.90 ,$574.20 ,$671.59 ,$574.20 ,$344.52 ,$599.72 ,"$1,511.09 ",$586.96 ,$149.82 ,$580.58 ,$671.59 ,$392.63 ,$392.63 ,$574.20 ,$476.14 ,$444.37 ,$678.31 ,$141.34 ,$606.10 ,$705.17 ,$141.34 ,$555.06 ,$671.59 ,$574.20 ,$671.59 ,$574.20 ,$574.20 ,$574.20 ,$618.86 ,$516.78 ,$593.34 ,$548.68 ,$618.86 
SACRED HEART HOSPITAL (ACU),45000171,65205,HC REM EYE FB CONJUCT SUPER,450,1 ,$453.00 ,$339.75 ,$23.62 ,$453.00 ,$291.73 ,$119.26 ,$317.10 ,$23.62 ,$375.99 ,$24.33 ,$298.98 ,$430.35 ,$23.62 ,$362.40 ,$416.76 ,$23.62 ,$385.05 ,$430.35 ,$398.64 ,$344.28 ,$23.62 ,$23.62 ,$23.62 ,$330.69 ,$249.15 ,$412.23 ,$412.23 ,$362.40 ,$122.84 ,$249.15 ,$407.70 ,$119.26 ,$407.70 ,$244.62 ,$425.82 ,$268.33 ,$416.76 ,$25.04 ,$412.23 ,$119.26 ,$278.78 ,$278.78 ,$407.70 ,$338.07 ,$315.51 ,$120.45 ,$23.62 ,$430.35 ,$125.22 ,$23.62 ,$394.11 ,$119.26 ,$407.70 ,$119.26 ,$407.70 ,$407.70 ,$407.70 ,$439.41 ,$366.93 ,$421.29 ,$389.58 ,$439.41 
SACRED HEART HOSPITAL (ACU),45000172,65210,HC REM EYE FB CONJUCT EMBED,450,1 ,$175.00 ,$131.25 ,$23.62 ,$645.84 ,$112.70 ,$287.04 ,$122.50 ,$23.62 ,$145.25 ,$24.33 ,$115.50 ,$166.25 ,$23.62 ,$140.00 ,$161.00 ,$23.62 ,$148.75 ,$166.25 ,$154.00 ,$133.00 ,$23.62 ,$23.62 ,$23.62 ,$127.75 ,$96.25 ,$159.25 ,$159.25 ,$140.00 ,$295.65 ,$96.25 ,$157.50 ,$287.04 ,$157.50 ,$94.50 ,$164.50 ,$645.84 ,$161.00 ,$25.04 ,$159.25 ,$287.04 ,$107.70 ,$107.70 ,$157.50 ,$130.60 ,$121.89 ,$289.91 ,$23.62 ,$166.25 ,$301.39 ,$23.62 ,$152.25 ,$287.04 ,$157.50 ,$287.04 ,$157.50 ,$157.50 ,$157.50 ,$169.75 ,$141.75 ,$162.75 ,$150.50 ,$169.75 
SACRED HEART HOSPITAL (ACU),45000173,65220,HC REM FB CORNL W/O SLIT LA,450,1 ,$165.00 ,$123.75 ,$23.62 ,$645.84 ,$106.26 ,$287.04 ,$115.50 ,$23.62 ,$136.95 ,$24.33 ,$108.90 ,$156.75 ,$23.62 ,$132.00 ,$151.80 ,$23.62 ,$140.25 ,$156.75 ,$145.20 ,$125.40 ,$23.62 ,$23.62 ,$23.62 ,$120.45 ,$90.75 ,$150.15 ,$150.15 ,$132.00 ,$295.65 ,$90.75 ,$148.50 ,$287.04 ,$148.50 ,$89.10 ,$155.10 ,$645.84 ,$151.80 ,$25.04 ,$150.15 ,$287.04 ,$101.54 ,$101.54 ,$148.50 ,$123.14 ,$114.92 ,$289.91 ,$23.62 ,$156.75 ,$301.39 ,$23.62 ,$143.55 ,$287.04 ,$148.50 ,$287.04 ,$148.50 ,$148.50 ,$148.50 ,$160.05 ,$133.65 ,$153.45 ,$141.90 ,$160.05 
SACRED HEART HOSPITAL (ACU),45000174,65222,HC REM FB CORNL W/ SLIT LA,450,1 ,$166.00 ,$124.50 ,$23.62 ,$268.33 ,$106.90 ,$119.26 ,$116.20 ,$23.62 ,$137.78 ,$24.33 ,$109.56 ,$157.70 ,$23.62 ,$132.80 ,$152.72 ,$23.62 ,$141.10 ,$157.70 ,$146.08 ,$126.16 ,$23.62 ,$23.62 ,$23.62 ,$121.18 ,$91.30 ,$151.06 ,$151.06 ,$132.80 ,$122.84 ,$91.30 ,$149.40 ,$119.26 ,$149.40 ,$89.64 ,$156.04 ,$268.33 ,$152.72 ,$25.04 ,$151.06 ,$119.26 ,$102.16 ,$102.16 ,$149.40 ,$123.89 ,$115.62 ,$120.45 ,$23.62 ,$157.70 ,$125.22 ,$23.62 ,$144.42 ,$119.26 ,$149.40 ,$119.26 ,$149.40 ,$149.40 ,$149.40 ,$161.02 ,$134.46 ,$154.38 ,$142.76 ,$161.02 
SACRED HEART HOSPITAL (ACU),45000179,69000,HC DRAIN ABSC/HEMA EAR EXT SMP,450,1 ,$286.00 ,$214.50 ,$36.07 ,"$1,480.84 ",$184.18 ,$658.15 ,$200.20 ,$36.07 ,$237.38 ,$37.15 ,$188.76 ,$271.70 ,$36.07 ,$228.80 ,$263.12 ,$36.07 ,$243.10 ,$271.70 ,$251.68 ,$217.36 ,$36.07 ,$36.07 ,$36.07 ,$208.78 ,$157.30 ,$260.26 ,$260.26 ,$228.80 ,$677.89 ,$157.30 ,$257.40 ,$658.15 ,$257.40 ,$154.44 ,$268.84 ,"$1,480.84 ",$263.12 ,$38.23 ,$260.26 ,$658.15 ,$176.00 ,$176.00 ,$257.40 ,$213.44 ,$199.20 ,$664.73 ,$36.07 ,$271.70 ,$691.06 ,$36.07 ,$248.82 ,$658.15 ,$257.40 ,$658.15 ,$257.40 ,$257.40 ,$257.40 ,$277.42 ,$231.66 ,$265.98 ,$245.96 ,$277.42 
SACRED HEART HOSPITAL (ACU),45000181,69200,HC FB REMOVAL EAR,450,1 ,$101.00 ,$75.75 ,$36.07 ,$268.33 ,$65.04 ,$119.26 ,$70.70 ,$36.07 ,$83.83 ,$37.15 ,$66.66 ,$95.95 ,$36.07 ,$80.80 ,$92.92 ,$36.07 ,$85.85 ,$95.95 ,$88.88 ,$76.76 ,$36.07 ,$36.07 ,$36.07 ,$73.73 ,$55.55 ,$91.91 ,$91.91 ,$80.80 ,$122.84 ,$55.55 ,$90.90 ,$119.26 ,$90.90 ,$54.54 ,$94.94 ,$268.33 ,$92.92 ,$38.23 ,$91.91 ,$119.26 ,$62.16 ,$62.16 ,$90.90 ,$75.38 ,$70.35 ,$120.45 ,$36.07 ,$95.95 ,$125.22 ,$36.07 ,$87.87 ,$119.26 ,$90.90 ,$119.26 ,$90.90 ,$90.90 ,$90.90 ,$97.97 ,$81.81 ,$93.93 ,$86.86 ,$97.97 
SACRED HEART HOSPITAL (ACU),45000183,69210,HC REMOVE CERUMEN IMPACTED BY INSTRUMENTATION,450,1 ,$222.00 ,$166.50 ,$36.07 ,$222.00 ,$142.97 ,$58.87 ,$155.40 ,$36.07 ,$184.26 ,$37.15 ,$146.52 ,$210.90 ,$36.07 ,$177.60 ,$204.24 ,$36.07 ,$188.70 ,$210.90 ,$195.36 ,$168.72 ,$36.07 ,$36.07 ,$36.07 ,$162.06 ,$122.10 ,$202.02 ,$202.02 ,$177.60 ,$60.64 ,$122.10 ,$199.80 ,$58.87 ,$199.80 ,$119.88 ,$208.68 ,$132.46 ,$204.24 ,$38.23 ,$202.02 ,$58.87 ,$136.62 ,$136.62 ,$199.80 ,$165.68 ,$154.62 ,$59.46 ,$36.07 ,$210.90 ,$61.82 ,$36.07 ,$193.14 ,$58.87 ,$199.80 ,$58.87 ,$199.80 ,$199.80 ,$199.80 ,$215.34 ,$179.82 ,$206.46 ,$190.92 ,$215.34 
SACRED HEART HOSPITAL (ACU),45000187,92977,HC THROMBOLYSIS CORONARY IV INFS,450,1 ,$623.00 ,$467.25 ,$166.51 ,$758.76 ,$401.21 ,$337.23 ,$436.10 ,$166.51 ,$517.09 ,$171.51 ,$411.18 ,$591.85 ,$166.51 ,$498.40 ,$573.16 ,$166.51 ,$529.55 ,$591.85 ,$548.24 ,$473.48 ,$166.51 ,$166.51 ,$166.51 ,$454.79 ,$342.65 ,$566.93 ,$566.93 ,$498.40 ,$347.35 ,$342.65 ,$560.70 ,$337.23 ,$560.70 ,$336.42 ,$585.62 ,$758.76 ,$573.16 ,$176.50 ,$566.93 ,$337.23 ,$383.39 ,$383.39 ,$560.70 ,$464.94 ,$433.92 ,$340.60 ,$166.51 ,$591.85 ,$354.09 ,$166.51 ,$542.01 ,$337.23 ,$560.70 ,$337.23 ,$560.70 ,$560.70 ,$560.70 ,$604.31 ,$504.63 ,$579.39 ,$535.78 ,$604.31 
SACRED HEART HOSPITAL (ACU),45000188,99281,HC ER LEVEL 1,450,1 ,$164.00 ,$123.00 ,$39.52 ,$172.61 ,$105.62 ,$76.72 ,$114.80 ,$39.52 ,$164.00 ,$40.71 ,$164.00 ,$155.80 ,$39.52 ,$131.20 ,$150.88 ,$39.52 ,$139.40 ,$155.80 ,$144.32 ,$124.64 ,$39.52 ,$39.52 ,$39.52 ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 ,$79.02 ,$90.20 ,$147.60 ,$76.72 ,$147.60 ,$88.56 ,$154.16 ,$172.61 ,$150.88 ,$41.89 ,$149.24 ,$76.72 ,$100.93 ,$100.93 ,$147.60 ,$122.39 ,$147.60 ,$77.48 ,$39.52 ,$155.80 ,$80.55 ,$39.52 ,$142.68 ,$76.72 ,$147.60 ,$76.72 ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),45000189,99282,HC ER LEVEL 2,450,1 ,$240.00 ,$180.00 ,$39.52 ,$312.58 ,$154.56 ,$138.92 ,$168.00 ,$39.52 ,$240.00 ,$40.71 ,$240.00 ,$228.00 ,$39.52 ,$192.00 ,$220.80 ,$39.52 ,$204.00 ,$228.00 ,$211.20 ,$182.40 ,$39.52 ,$39.52 ,$39.52 ,$175.20 ,$132.00 ,$218.40 ,$218.40 ,$192.00 ,$143.09 ,$132.00 ,$216.00 ,$138.92 ,$216.00 ,$129.60 ,$225.60 ,$312.58 ,$220.80 ,$41.89 ,$218.40 ,$138.92 ,$147.70 ,$147.70 ,$216.00 ,$179.11 ,$216.00 ,$140.31 ,$39.52 ,$228.00 ,$145.87 ,$39.52 ,$208.80 ,$138.92 ,$216.00 ,$138.92 ,$216.00 ,$216.00 ,$216.00 ,$232.80 ,$194.40 ,$223.20 ,$206.40 ,$232.80 
SACRED HEART HOSPITAL (ACU),45000190,99283,HC ER LEVEL 3,450,1 ,$511.00 ,$383.25 ,$39.52 ,$550.71 ,$329.08 ,$244.76 ,$357.70 ,$39.52 ,$511.00 ,$40.71 ,$511.00 ,$485.45 ,$39.52 ,$408.80 ,$470.12 ,$39.52 ,$434.35 ,$485.45 ,$449.68 ,$388.36 ,$39.52 ,$39.52 ,$39.52 ,$373.03 ,$281.05 ,$465.01 ,$465.01 ,$408.80 ,$252.10 ,$281.05 ,$459.90 ,$244.76 ,$459.90 ,$275.94 ,$480.34 ,$550.71 ,$470.12 ,$41.89 ,$465.01 ,$244.76 ,$314.47 ,$314.47 ,$459.90 ,$381.36 ,$459.90 ,$247.21 ,$39.52 ,$485.45 ,$257.00 ,$39.52 ,$444.57 ,$244.76 ,$459.90 ,$244.76 ,$459.90 ,$459.90 ,$459.90 ,$495.67 ,$413.91 ,$475.23 ,$439.46 ,$495.67 
SACRED HEART HOSPITAL (ACU),45000191,99284,HC ER LEVEL 4,450,1 ,"$1,014.00 ",$760.50 ,$39.52 ,"$1,014.00 ",$653.02 ,$384.74 ,$709.80 ,$39.52 ,"$1,014.00 ",$40.71 ,"$1,014.00 ",$963.30 ,$39.52 ,$811.20 ,$932.88 ,$39.52 ,$861.90 ,$963.30 ,$892.32 ,$770.64 ,$39.52 ,$39.52 ,$39.52 ,$740.22 ,$557.70 ,$922.74 ,$922.74 ,$811.20 ,$396.28 ,$557.70 ,$912.60 ,$384.74 ,$912.60 ,$547.56 ,$953.16 ,$865.66 ,$932.88 ,$41.89 ,$922.74 ,$384.74 ,$624.02 ,$624.02 ,$912.60 ,$756.75 ,$912.60 ,$388.59 ,$39.52 ,$963.30 ,$403.98 ,$39.52 ,$882.18 ,$384.74 ,$912.60 ,$384.74 ,$912.60 ,$912.60 ,$912.60 ,$983.58 ,$821.34 ,$943.02 ,$872.04 ,$983.58 
SACRED HEART HOSPITAL (ACU),45000192,99285,HC ER LEVEL 5,450,1 ,"$1,486.00 ","$1,114.50 ",$39.52 ,"$1,486.00 ",$956.98 ,$552.24 ,"$1,040.20 ",$39.52 ,"$1,486.00 ",$40.71 ,"$1,486.00 ","$1,411.70 ",$39.52 ,"$1,188.80 ","$1,367.12 ",$39.52 ,"$1,263.10 ","$1,411.70 ","$1,307.68 ","$1,129.36 ",$39.52 ,$39.52 ,$39.52 ,"$1,084.78 ",$817.30 ,"$1,352.26 ","$1,352.26 ","$1,188.80 ",$568.81 ,$817.30 ,"$1,337.40 ",$552.24 ,"$1,337.40 ",$802.44 ,"$1,396.84 ","$1,242.55 ","$1,367.12 ",$41.89 ,"$1,352.26 ",$552.24 ,$914.48 ,$914.48 ,"$1,337.40 ","$1,109.00 ","$1,337.40 ",$557.77 ,$39.52 ,"$1,411.70 ",$579.86 ,$39.52 ,"$1,292.82 ",$552.24 ,"$1,337.40 ",$552.24 ,"$1,337.40 ","$1,337.40 ","$1,337.40 ","$1,441.42 ","$1,203.66 ","$1,381.98 ","$1,277.96 ","$1,441.42 "
SACRED HEART HOSPITAL (ACU),45000193,99291,HC CRITICAL CARE 30-74 MIN,450,1 ,"$2,048.00 ","$1,536.00 ",$39.52 ,"$2,048.00 ","$1,318.91 ",$787.81 ,"$1,433.60 ",$39.52 ,"$2,048.00 ",$40.71 ,"$2,048.00 ","$1,945.60 ",$39.52 ,"$1,638.40 ","$1,884.16 ",$39.52 ,"$1,740.80 ","$1,945.60 ","$1,802.24 ","$1,556.48 ",$39.52 ,$39.52 ,$39.52 ,"$1,495.04 ","$1,126.40 ","$1,863.68 ","$1,863.68 ","$1,638.40 ",$811.44 ,"$1,126.40 ","$1,843.20 ",$787.81 ,"$1,843.20 ","$1,105.92 ","$1,925.12 ","$1,772.57 ","$1,884.16 ",$41.89 ,"$1,863.68 ",$787.81 ,"$1,260.34 ","$1,260.34 ","$1,843.20 ","$1,528.42 ","$1,843.20 ",$795.69 ,$39.52 ,"$1,945.60 ",$827.20 ,$39.52 ,"$1,781.76 ",$787.81 ,"$1,843.20 ",$787.81 ,"$1,843.20 ","$1,843.20 ","$1,843.20 ","$1,986.56 ","$1,658.88 ","$1,904.64 ","$1,761.28 ","$1,986.56 "
SACRED HEART HOSPITAL (ACU),45000195,99292,HC CRITICAL CARE EA ADDN'T 30 MIN,450,1 ,$306.00 ,$229.50 ,$39.52 ,$306.00 ,$197.06 , N/A ,$214.20 ,$39.52 ,$253.98 ,$40.71 ,$201.96 ,$290.70 ,$39.52 ,$244.80 ,$281.52 ,$39.52 ,$260.10 ,$290.70 ,$269.28 ,$232.56 ,$39.52 ,$39.52 ,$39.52 ,$223.38 ,$168.30 ,$278.46 ,$278.46 ,$244.80 , N/A ,$168.30 ,$275.40 , N/A ,$275.40 ,$165.24 ,$287.64 , N/A ,$281.52 ,$41.89 ,$278.46 , N/A ,$188.31 ,$188.31 ,$275.40 ,$228.37 ,$213.13 , N/A ,$39.52 ,$290.70 , N/A ,$39.52 ,$266.22 , N/A ,$275.40 , N/A ,$275.40 ,$275.40 ,$275.40 ,$296.82 ,$247.86 ,$284.58 ,$263.16 ,$296.82 
SACRED HEART HOSPITAL (ACU),45000196,27810,HC TX FX BIM ANKLE W/MAN CLS,450,1 ,"$3,746.00 ","$2,809.50 ",$144.24 ,"$3,746.00 ","$2,412.42 ","$1,473.12 ","$2,622.20 ",$144.24 ,"$3,109.18 ",$148.57 ,"$2,472.36 ","$3,558.70 ",$144.24 ,"$2,996.80 ","$3,446.32 ",$144.24 ,"$3,184.10 ","$3,558.70 ","$3,296.48 ","$2,846.96 ",$144.24 ,$144.24 ,$144.24 ,"$2,734.58 ","$2,060.30 ","$3,408.86 ","$3,408.86 ","$2,996.80 ","$1,517.31 ","$2,060.30 ","$3,371.40 ","$1,473.12 ","$3,371.40 ","$2,022.84 ","$3,521.24 ","$3,314.53 ","$3,446.32 ",$152.89 ,"$3,408.86 ","$1,473.12 ","$2,305.29 ","$2,305.29 ","$3,371.40 ","$2,795.64 ","$2,609.09 ","$1,487.85 ",$144.24 ,"$3,558.70 ","$1,546.78 ",$144.24 ,"$3,259.02 ","$1,473.12 ","$3,371.40 ","$1,473.12 ","$3,371.40 ","$3,371.40 ","$3,371.40 ","$3,633.62 ","$3,034.26 ","$3,483.78 ","$3,221.56 ","$3,633.62 "
SACRED HEART HOSPITAL (ACU),45000197,26700,HC TX DISL (M-P) W/O ANES CLS,450,1 ,$124.00 ,$93.00 ,$66.96 ,$490.48 ,$79.86 ,$217.99 ,$86.80 ,$124.00 ,$102.92 ,$148.57 ,$81.84 ,$117.80 ,$144.24 ,$99.20 ,$114.08 ,$124.00 ,$105.40 ,$117.80 ,$109.12 ,$94.24 ,$124.00 ,$124.00 ,$144.24 ,$90.52 ,$68.20 ,$112.84 ,$112.84 ,$99.20 ,$224.53 ,$68.20 ,$111.60 ,$217.99 ,$111.60 ,$66.96 ,$116.56 ,$490.48 ,$114.08 ,$152.89 ,$112.84 ,$217.99 ,$76.31 ,$76.31 ,$111.60 ,$92.54 ,$86.37 ,$220.17 ,$124.00 ,$117.80 ,$228.89 ,$124.00 ,$107.88 ,$217.99 ,$111.60 ,$217.99 ,$111.60 ,$111.60 ,$111.60 ,$120.28 ,$100.44 ,$115.32 ,$106.64 ,$120.28 
SACRED HEART HOSPITAL (ACU),45000198,21480,HC TX DISL JAW CLS-UNI,450,1 ,$170.00 ,$127.50 ,$36.07 ,$490.48 ,$109.48 ,$217.99 ,$119.00 ,$36.07 ,$141.10 ,$37.15 ,$112.20 ,$161.50 ,$36.07 ,$136.00 ,$156.40 ,$36.07 ,$144.50 ,$161.50 ,$149.60 ,$129.20 ,$36.07 ,$36.07 ,$36.07 ,$124.10 ,$93.50 ,$154.70 ,$154.70 ,$136.00 ,$224.53 ,$93.50 ,$153.00 ,$217.99 ,$153.00 ,$91.80 ,$159.80 ,$490.48 ,$156.40 ,$38.23 ,$154.70 ,$217.99 ,$104.62 ,$104.62 ,$153.00 ,$126.87 ,$118.41 ,$220.17 ,$36.07 ,$161.50 ,$228.89 ,$36.07 ,$147.90 ,$217.99 ,$153.00 ,$217.99 ,$153.00 ,$153.00 ,$153.00 ,$164.90 ,$137.70 ,$158.10 ,$146.20 ,$164.90 
SACRED HEART HOSPITAL (ACU),45000204,23931,HC I AND D BURSA ELBOW/ARM,450,1 ,$385.48 ,$289.11 ,$208.16 ,"$3,348.27 ",$248.25 ,"$1,488.12 ",$269.84 ,$385.48 ,$319.95 ,$583.43 ,$254.42 ,$366.21 ,$566.44 ,$308.38 ,$354.64 ,$385.48 ,$327.66 ,$366.21 ,$339.22 ,$292.96 ,$385.48 ,$385.48 ,$566.44 ,$281.40 ,$212.01 ,$350.79 ,$350.79 ,$308.38 ,"$1,532.76 ",$212.01 ,$346.93 ,"$1,488.12 ",$346.93 ,$208.16 ,$362.35 ,"$3,348.27 ",$354.64 ,$600.43 ,$350.79 ,"$1,488.12 ",$237.22 ,$237.22 ,$346.93 ,$287.68 ,$268.49 ,"$1,503.00 ",$385.48 ,$366.21 ,"$1,562.52 ",$385.48 ,$335.37 ,"$1,488.12 ",$346.93 ,"$1,488.12 ",$346.93 ,$346.93 ,$346.93 ,$373.92 ,$312.24 ,$358.50 ,$331.51 ,$373.92 
SACRED HEART HOSPITAL (ACU),45000208,45005,HC I  AND  D RECTAL ABSCESS,450,1 ,$340.00 ,$255.00 ,$183.60 ,"$2,467.67 ",$218.96 ,"$1,096.74 ",$238.00 ,$340.00 ,$282.20 ,$492.64 ,$224.40 ,$323.00 ,$478.29 ,$272.00 ,$312.80 ,$340.00 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$340.00 ,$340.00 ,$478.29 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 ,"$1,129.64 ",$187.00 ,$306.00 ,"$1,096.74 ",$306.00 ,$183.60 ,$319.60 ,"$2,467.67 ",$312.80 ,$506.99 ,$309.40 ,"$1,096.74 ",$209.24 ,$209.24 ,$306.00 ,$253.74 ,$236.81 ,"$1,107.71 ",$340.00 ,$323.00 ,"$1,151.58 ",$340.00 ,$295.80 ,"$1,096.74 ",$306.00 ,"$1,096.74 ",$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),45000210,25680,HC CLSD WRIST FX W/MANIP,450,1 ,$671.00 ,$503.25 ,$144.24 ,$671.00 ,$432.12 ,$217.99 ,$469.70 ,$144.24 ,$556.93 ,$148.57 ,$442.86 ,$637.45 ,$144.24 ,$536.80 ,$617.32 ,$144.24 ,$570.35 ,$637.45 ,$590.48 ,$509.96 ,$144.24 ,$144.24 ,$144.24 ,$489.83 ,$369.05 ,$610.61 ,$610.61 ,$536.80 ,$224.53 ,$369.05 ,$603.90 ,$217.99 ,$603.90 ,$362.34 ,$630.74 ,$490.48 ,$617.32 ,$152.89 ,$610.61 ,$217.99 ,$412.93 ,$412.93 ,$603.90 ,$500.77 ,$467.35 ,$220.17 ,$144.24 ,$637.45 ,$228.89 ,$144.24 ,$583.77 ,$217.99 ,$603.90 ,$217.99 ,$603.90 ,$603.90 ,$603.90 ,$650.87 ,$543.51 ,$624.03 ,$577.06 ,$650.87 
SACRED HEART HOSPITAL (ACU),45000211,26641,HC CLSD DISCL THUMB W/MANIP,450,1 ,$295.00 ,$221.25 ,$144.24 ,$490.48 ,$189.98 ,$217.99 ,$206.50 ,$144.24 ,$244.85 ,$148.57 ,$194.70 ,$280.25 ,$144.24 ,$236.00 ,$271.40 ,$144.24 ,$250.75 ,$280.25 ,$259.60 ,$224.20 ,$144.24 ,$144.24 ,$144.24 ,$215.35 ,$162.25 ,$268.45 ,$268.45 ,$236.00 ,$224.53 ,$162.25 ,$265.50 ,$217.99 ,$265.50 ,$159.30 ,$277.30 ,$490.48 ,$271.40 ,$152.89 ,$268.45 ,$217.99 ,$181.54 ,$181.54 ,$265.50 ,$220.16 ,$205.47 ,$220.17 ,$144.24 ,$280.25 ,$228.89 ,$144.24 ,$256.65 ,$217.99 ,$265.50 ,$217.99 ,$265.50 ,$265.50 ,$265.50 ,$286.15 ,$238.95 ,$274.35 ,$253.70 ,$286.15 
SACRED HEART HOSPITAL (ACU),45000212,25690,HC CLSD WRIST DISLOC,450,1 ,"$4,045.47 ","$3,034.10 ",$144.24 ,"$4,045.47 ","$2,605.28 ","$1,473.12 ","$2,831.83 ",$144.24 ,"$3,357.74 ",$148.57 ,"$2,670.01 ","$3,843.20 ",$144.24 ,"$3,236.38 ","$3,721.83 ",$144.24 ,"$3,438.65 ","$3,843.20 ","$3,560.01 ","$3,074.56 ",$144.24 ,$144.24 ,$144.24 ,"$2,953.19 ","$2,225.01 ","$3,681.38 ","$3,681.38 ","$3,236.38 ","$1,517.31 ","$2,225.01 ","$3,640.92 ","$1,473.12 ","$3,640.92 ","$2,184.55 ","$3,802.74 ","$3,314.53 ","$3,721.83 ",$152.89 ,"$3,681.38 ","$1,473.12 ","$2,489.58 ","$2,489.58 ","$3,640.92 ","$3,019.13 ","$2,817.67 ","$1,487.85 ",$144.24 ,"$3,843.20 ","$1,546.78 ",$144.24 ,"$3,519.56 ","$1,473.12 ","$3,640.92 ","$1,473.12 ","$3,640.92 ","$3,640.92 ","$3,640.92 ","$3,924.11 ","$3,276.83 ","$3,762.29 ","$3,479.10 ","$3,924.11 "
SACRED HEART HOSPITAL (ACU),45000213,26720,HC FINGER FX W/O MANIP,450,1 ,$887.00 ,$665.25 ,$144.24 ,$887.00 ,$571.23 ,$217.99 ,$620.90 ,$144.24 ,$736.21 ,$148.57 ,$585.42 ,$842.65 ,$144.24 ,$709.60 ,$816.04 ,$144.24 ,$753.95 ,$842.65 ,$780.56 ,$674.12 ,$144.24 ,$144.24 ,$144.24 ,$647.51 ,$487.85 ,$807.17 ,$807.17 ,$709.60 ,$224.53 ,$487.85 ,$798.30 ,$217.99 ,$798.30 ,$478.98 ,$833.78 ,$490.48 ,$816.04 ,$152.89 ,$807.17 ,$217.99 ,$545.86 ,$545.86 ,$798.30 ,$661.97 ,$617.80 ,$220.17 ,$144.24 ,$842.65 ,$228.89 ,$144.24 ,$771.69 ,$217.99 ,$798.30 ,$217.99 ,$798.30 ,$798.30 ,$798.30 ,$860.39 ,$718.47 ,$824.91 ,$762.82 ,$860.39 
SACRED HEART HOSPITAL (ACU),45000215,27786,HC DIST FIB FX W/O MANIP,450,1 ,$776.00 ,$582.00 ,$144.24 ,$776.00 ,$499.74 ,$217.99 ,$543.20 ,$144.24 ,$644.08 ,$148.57 ,$512.16 ,$737.20 ,$144.24 ,$620.80 ,$713.92 ,$144.24 ,$659.60 ,$737.20 ,$682.88 ,$589.76 ,$144.24 ,$144.24 ,$144.24 ,$566.48 ,$426.80 ,$706.16 ,$706.16 ,$620.80 ,$224.53 ,$426.80 ,$698.40 ,$217.99 ,$698.40 ,$419.04 ,$729.44 ,$490.48 ,$713.92 ,$152.89 ,$706.16 ,$217.99 ,$477.55 ,$477.55 ,$698.40 ,$579.13 ,$540.48 ,$220.17 ,$144.24 ,$737.20 ,$228.89 ,$144.24 ,$675.12 ,$217.99 ,$698.40 ,$217.99 ,$698.40 ,$698.40 ,$698.40 ,$752.72 ,$628.56 ,$721.68 ,$667.36 ,$752.72 
SACRED HEART HOSPITAL (ACU),45000218,23500,HC CLOSED TREATMENT CLAVICLE FX,450,1 ,"$1,061.00 ",$795.75 ,$144.24 ,"$1,061.00 ",$683.28 ,$217.99 ,$742.70 ,$144.24 ,$880.63 ,$148.57 ,$700.26 ,"$1,007.95 ",$144.24 ,$848.80 ,$976.12 ,$144.24 ,$901.85 ,"$1,007.95 ",$933.68 ,$806.36 ,$144.24 ,$144.24 ,$144.24 ,$774.53 ,$583.55 ,$965.51 ,$965.51 ,$848.80 ,$224.53 ,$583.55 ,$954.90 ,$217.99 ,$954.90 ,$572.94 ,$997.34 ,$490.48 ,$976.12 ,$152.89 ,$965.51 ,$217.99 ,$652.94 ,$652.94 ,$954.90 ,$791.82 ,$738.99 ,$220.17 ,$144.24 ,"$1,007.95 ",$228.89 ,$144.24 ,$923.07 ,$217.99 ,$954.90 ,$217.99 ,$954.90 ,$954.90 ,$954.90 ,"$1,029.17 ",$859.41 ,$986.73 ,$912.46 ,"$1,029.17 "
SACRED HEART HOSPITAL (ACU),45000219,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP,450,1 ,$380.00 ,$285.00 ,$144.24 ,"$3,314.53 ",$244.72 ,"$1,473.12 ",$266.00 ,$144.24 ,$315.40 ,$148.57 ,$250.80 ,$361.00 ,$144.24 ,$304.00 ,$349.60 ,$144.24 ,$323.00 ,$361.00 ,$334.40 ,$288.80 ,$144.24 ,$144.24 ,$144.24 ,$277.40 ,$209.00 ,$345.80 ,$345.80 ,$304.00 ,"$1,517.31 ",$209.00 ,$342.00 ,"$1,473.12 ",$342.00 ,$205.20 ,$357.20 ,"$3,314.53 ",$349.60 ,$152.89 ,$345.80 ,"$1,473.12 ",$233.85 ,$233.85 ,$342.00 ,$283.59 ,$264.67 ,"$1,487.85 ",$144.24 ,$361.00 ,"$1,546.78 ",$144.24 ,$330.60 ,"$1,473.12 ",$342.00 ,"$1,473.12 ",$342.00 ,$342.00 ,$342.00 ,$368.60 ,$307.80 ,$353.40 ,$326.80 ,$368.60 
SACRED HEART HOSPITAL (ACU),45000220,29280,HC STRAPPING HAND/FINGER,450,1 ,$196.00 ,$147.00 ,$14.12 ,$196.00 ,$126.22 ,$58.87 ,$137.20 ,$14.12 ,$162.68 ,$14.54 ,$129.36 ,$186.20 ,$14.12 ,$156.80 ,$180.32 ,$14.12 ,$166.60 ,$186.20 ,$172.48 ,$148.96 ,$14.12 ,$14.12 ,$14.12 ,$143.08 ,$107.80 ,$178.36 ,$178.36 ,$156.80 ,$60.64 ,$107.80 ,$176.40 ,$58.87 ,$176.40 ,$105.84 ,$184.24 ,$132.46 ,$180.32 ,$14.97 ,$178.36 ,$58.87 ,$120.62 ,$120.62 ,$176.40 ,$146.27 ,$136.51 ,$59.46 ,$14.12 ,$186.20 ,$61.82 ,$14.12 ,$170.52 ,$58.87 ,$176.40 ,$58.87 ,$176.40 ,$176.40 ,$176.40 ,$190.12 ,$158.76 ,$182.28 ,$168.56 ,$190.12 
SACRED HEART HOSPITAL (ACU),45000224,25630,HC CLSD CARPAL BONE FX,450,1 ,$248.00 ,$186.00 ,$133.92 ,$490.48 ,$159.71 ,$217.99 ,$173.60 ,$144.24 ,$205.84 ,$148.57 ,$163.68 ,$235.60 ,$144.24 ,$198.40 ,$228.16 ,$144.24 ,$210.80 ,$235.60 ,$218.24 ,$188.48 ,$144.24 ,$144.24 ,$144.24 ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 ,$224.53 ,$136.40 ,$223.20 ,$217.99 ,$223.20 ,$133.92 ,$233.12 ,$490.48 ,$228.16 ,$152.89 ,$225.68 ,$217.99 ,$152.62 ,$152.62 ,$223.20 ,$185.08 ,$172.73 ,$220.17 ,$144.24 ,$235.60 ,$228.89 ,$144.24 ,$215.76 ,$217.99 ,$223.20 ,$217.99 ,$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),45000225,23540,HC CLOSED ACROM.W/O MANIP,450,1 ,"$1,212.00 ",$909.00 ,$144.24 ,"$1,212.00 ",$780.53 ,$217.99 ,$848.40 ,$144.24 ,"$1,005.96 ",$148.57 ,$799.92 ,"$1,151.40 ",$144.24 ,$969.60 ,"$1,115.04 ",$144.24 ,"$1,030.20 ","$1,151.40 ","$1,066.56 ",$921.12 ,$144.24 ,$144.24 ,$144.24 ,$884.76 ,$666.60 ,"$1,102.92 ","$1,102.92 ",$969.60 ,$224.53 ,$666.60 ,"$1,090.80 ",$217.99 ,"$1,090.80 ",$654.48 ,"$1,139.28 ",$490.48 ,"$1,115.04 ",$152.89 ,"$1,102.92 ",$217.99 ,$745.86 ,$745.86 ,"$1,090.80 ",$904.52 ,$844.16 ,$220.17 ,$144.24 ,"$1,151.40 ",$228.89 ,$144.24 ,"$1,054.44 ",$217.99 ,"$1,090.80 ",$217.99 ,"$1,090.80 ","$1,090.80 ","$1,090.80 ","$1,175.64 ",$981.72 ,"$1,127.16 ","$1,042.32 ","$1,175.64 "
SACRED HEART HOSPITAL (ACU),45000227,25600,HC CLSD DIS.RADIUS W/O MANIP,450,1 ,$641.00 ,$480.75 ,$144.24 ,$641.00 ,$412.80 ,$217.99 ,$448.70 ,$144.24 ,$532.03 ,$148.57 ,$423.06 ,$608.95 ,$144.24 ,$512.80 ,$589.72 ,$144.24 ,$544.85 ,$608.95 ,$564.08 ,$487.16 ,$144.24 ,$144.24 ,$144.24 ,$467.93 ,$352.55 ,$583.31 ,$583.31 ,$512.80 ,$224.53 ,$352.55 ,$576.90 ,$217.99 ,$576.90 ,$346.14 ,$602.54 ,$490.48 ,$589.72 ,$152.89 ,$583.31 ,$217.99 ,$394.47 ,$394.47 ,$576.90 ,$478.38 ,$446.46 ,$220.17 ,$144.24 ,$608.95 ,$228.89 ,$144.24 ,$557.67 ,$217.99 ,$576.90 ,$217.99 ,$576.90 ,$576.90 ,$576.90 ,$621.77 ,$519.21 ,$596.13 ,$551.26 ,$621.77 
SACRED HEART HOSPITAL (ACU),45000228,26750,HC CLSD DIST PHALANGEAL W/O MANIP,450,1 ,$887.00 ,$665.25 ,$144.24 ,$887.00 ,$571.23 ,$217.99 ,$620.90 ,$144.24 ,$736.21 ,$148.57 ,$585.42 ,$842.65 ,$144.24 ,$709.60 ,$816.04 ,$144.24 ,$753.95 ,$842.65 ,$780.56 ,$674.12 ,$144.24 ,$144.24 ,$144.24 ,$647.51 ,$487.85 ,$807.17 ,$807.17 ,$709.60 ,$224.53 ,$487.85 ,$798.30 ,$217.99 ,$798.30 ,$478.98 ,$833.78 ,$490.48 ,$816.04 ,$152.89 ,$807.17 ,$217.99 ,$545.86 ,$545.86 ,$798.30 ,$661.97 ,$617.80 ,$220.17 ,$144.24 ,$842.65 ,$228.89 ,$144.24 ,$771.69 ,$217.99 ,$798.30 ,$217.99 ,$798.30 ,$798.30 ,$798.30 ,$860.39 ,$718.47 ,$824.91 ,$762.82 ,$860.39 
SACRED HEART HOSPITAL (ACU),45000230,26605,HC CLSD METACARPAL FX W/MANIP,450,1 ,$320.00 ,$240.00 ,$144.24 ,$490.48 ,$206.08 ,$217.99 ,$224.00 ,$144.24 ,$265.60 ,$148.57 ,$211.20 ,$304.00 ,$144.24 ,$256.00 ,$294.40 ,$144.24 ,$272.00 ,$304.00 ,$281.60 ,$243.20 ,$144.24 ,$144.24 ,$144.24 ,$233.60 ,$176.00 ,$291.20 ,$291.20 ,$256.00 ,$224.53 ,$176.00 ,$288.00 ,$217.99 ,$288.00 ,$172.80 ,$300.80 ,$490.48 ,$294.40 ,$152.89 ,$291.20 ,$217.99 ,$196.93 ,$196.93 ,$288.00 ,$238.82 ,$222.88 ,$220.17 ,$144.24 ,$304.00 ,$228.89 ,$144.24 ,$278.40 ,$217.99 ,$288.00 ,$217.99 ,$288.00 ,$288.00 ,$288.00 ,$310.40 ,$259.20 ,$297.60 ,$275.20 ,$310.40 
SACRED HEART HOSPITAL (ACU),45000231,25505,HC RADIUS FX W MANIP,450,1 ,$489.00 ,$366.75 ,$144.24 ,"$3,314.53 ",$314.92 ,"$1,473.12 ",$342.30 ,$144.24 ,$405.87 ,$148.57 ,$322.74 ,$464.55 ,$144.24 ,$391.20 ,$449.88 ,$144.24 ,$415.65 ,$464.55 ,$430.32 ,$371.64 ,$144.24 ,$144.24 ,$144.24 ,$356.97 ,$268.95 ,$444.99 ,$444.99 ,$391.20 ,"$1,517.31 ",$268.95 ,$440.10 ,"$1,473.12 ",$440.10 ,$264.06 ,$459.66 ,"$3,314.53 ",$449.88 ,$152.89 ,$444.99 ,"$1,473.12 ",$300.93 ,$300.93 ,$440.10 ,$364.94 ,$340.59 ,"$1,487.85 ",$144.24 ,$464.55 ,"$1,546.78 ",$144.24 ,$425.43 ,"$1,473.12 ",$440.10 ,"$1,473.12 ",$440.10 ,$440.10 ,$440.10 ,$474.33 ,$396.09 ,$454.77 ,$420.54 ,$474.33 
SACRED HEART HOSPITAL (ACU),45000232,26600,HC CLSD METACARPAL W/O MANIP,450,1 ,$248.00 ,$186.00 ,$133.92 ,$490.48 ,$159.71 ,$217.99 ,$173.60 ,$144.24 ,$205.84 ,$148.57 ,$163.68 ,$235.60 ,$144.24 ,$198.40 ,$228.16 ,$144.24 ,$210.80 ,$235.60 ,$218.24 ,$188.48 ,$144.24 ,$144.24 ,$144.24 ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 ,$224.53 ,$136.40 ,$223.20 ,$217.99 ,$223.20 ,$133.92 ,$233.12 ,$490.48 ,$228.16 ,$152.89 ,$225.68 ,$217.99 ,$152.62 ,$152.62 ,$223.20 ,$185.08 ,$172.73 ,$220.17 ,$144.24 ,$235.60 ,$228.89 ,$144.24 ,$215.76 ,$217.99 ,$223.20 ,$217.99 ,$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),45000235,28470,HC CLSD METATARSAL W/O MANIP,450,1 ,$157.00 ,$117.75 ,$84.78 ,$490.48 ,$101.11 ,$217.99 ,$109.90 ,$144.24 ,$130.31 ,$148.57 ,$103.62 ,$149.15 ,$144.24 ,$125.60 ,$144.44 ,$144.24 ,$133.45 ,$149.15 ,$138.16 ,$119.32 ,$144.24 ,$144.24 ,$144.24 ,$114.61 ,$86.35 ,$142.87 ,$142.87 ,$125.60 ,$224.53 ,$86.35 ,$141.30 ,$217.99 ,$141.30 ,$84.78 ,$147.58 ,$490.48 ,$144.44 ,$152.89 ,$142.87 ,$217.99 ,$96.62 ,$96.62 ,$141.30 ,$117.17 ,$109.35 ,$220.17 ,$144.24 ,$149.15 ,$228.89 ,$144.24 ,$136.59 ,$217.99 ,$141.30 ,$217.99 ,$141.30 ,$141.30 ,$141.30 ,$152.29 ,$127.17 ,$146.01 ,$135.02 ,$152.29 
SACRED HEART HOSPITAL (ACU),45000238,26670,HC HAND DISL W/MANIP W/O ANES,450,1 ,$404.00 ,$303.00 ,$144.24 ,$490.48 ,$260.18 ,$217.99 ,$282.80 ,$144.24 ,$335.32 ,$148.57 ,$266.64 ,$383.80 ,$144.24 ,$323.20 ,$371.68 ,$144.24 ,$343.40 ,$383.80 ,$355.52 ,$307.04 ,$144.24 ,$144.24 ,$144.24 ,$294.92 ,$222.20 ,$367.64 ,$367.64 ,$323.20 ,$224.53 ,$222.20 ,$363.60 ,$217.99 ,$363.60 ,$218.16 ,$379.76 ,$490.48 ,$371.68 ,$152.89 ,$367.64 ,$217.99 ,$248.62 ,$248.62 ,$363.60 ,$301.51 ,$281.39 ,$220.17 ,$144.24 ,$383.80 ,$228.89 ,$144.24 ,$351.48 ,$217.99 ,$363.60 ,$217.99 ,$363.60 ,$363.60 ,$363.60 ,$391.88 ,$327.24 ,$375.72 ,$347.44 ,$391.88 
SACRED HEART HOSPITAL (ACU),45000240,27750,HC TIBIA SHAFT FX W/O MANIP,450,1 ,$352.00 ,$264.00 ,$144.24 ,$490.48 ,$226.69 ,$217.99 ,$246.40 ,$144.24 ,$292.16 ,$148.57 ,$232.32 ,$334.40 ,$144.24 ,$281.60 ,$323.84 ,$144.24 ,$299.20 ,$334.40 ,$309.76 ,$267.52 ,$144.24 ,$144.24 ,$144.24 ,$256.96 ,$193.60 ,$320.32 ,$320.32 ,$281.60 ,$224.53 ,$193.60 ,$316.80 ,$217.99 ,$316.80 ,$190.08 ,$330.88 ,$490.48 ,$323.84 ,$152.89 ,$320.32 ,$217.99 ,$216.62 ,$216.62 ,$316.80 ,$262.70 ,$245.17 ,$220.17 ,$144.24 ,$334.40 ,$228.89 ,$144.24 ,$306.24 ,$217.99 ,$316.80 ,$217.99 ,$316.80 ,$316.80 ,$316.80 ,$341.44 ,$285.12 ,$327.36 ,$302.72 ,$341.44 
SACRED HEART HOSPITAL (ACU),45000244,28495,HC GREAT TOE RED FX,510,1 ,$644.00 ,$483.00 ,$128.00 ,$644.00 ,$414.74 ,$217.99 ,$450.80 ,$144.24 ,$162.00 ,$148.57 ,$128.00 ,$611.80 ,$144.24 ,$515.20 ,$592.48 ,$144.24 ,$547.40 ,$611.80 ,$566.72 ,$489.44 ,$144.24 ,$144.24 ,$144.24 ,$470.12 ,$354.20 ,$586.04 ,$586.04 ,$515.20 ,$224.53 ,$354.20 ,$579.60 ,$217.99 ,$579.60 ,$347.76 ,$605.36 ,$490.48 ,$592.48 ,$152.89 ,$586.04 ,$217.99 ,$396.32 ,$396.32 ,$579.60 ,$480.62 ,$448.55 ,$220.17 ,$144.24 ,$611.80 ,$228.89 ,$144.24 ,$560.28 ,$217.99 ,$579.60 ,$217.99 ,$579.60 ,$579.60 ,$579.60 ,$624.68 ,$521.64 ,$598.92 ,$553.84 ,$624.68 
SACRED HEART HOSPITAL (ACU),45000245,28490,HC GREAT TOE W/O RED FX,450,1 ,$691.00 ,$518.25 ,$144.24 ,$691.00 ,$445.00 ,$217.99 ,$483.70 ,$144.24 ,$573.53 ,$148.57 ,$456.06 ,$656.45 ,$144.24 ,$552.80 ,$635.72 ,$144.24 ,$587.35 ,$656.45 ,$608.08 ,$525.16 ,$144.24 ,$144.24 ,$144.24 ,$504.43 ,$380.05 ,$628.81 ,$628.81 ,$552.80 ,$224.53 ,$380.05 ,$621.90 ,$217.99 ,$621.90 ,$373.14 ,$649.54 ,$490.48 ,$635.72 ,$152.89 ,$628.81 ,$217.99 ,$425.24 ,$425.24 ,$621.90 ,$515.69 ,$481.28 ,$220.17 ,$144.24 ,$656.45 ,$228.89 ,$144.24 ,$601.17 ,$217.99 ,$621.90 ,$217.99 ,$621.90 ,$621.90 ,$621.90 ,$670.27 ,$559.71 ,$642.63 ,$594.26 ,$670.27 
SACRED HEART HOSPITAL (ACU),45000248,28475,HC CLSD METATARSAL W/MANIP,450,1 ,$644.00 ,$483.00 ,$144.24 ,$644.00 ,$414.74 ,$217.99 ,$450.80 ,$144.24 ,$534.52 ,$148.57 ,$425.04 ,$611.80 ,$144.24 ,$515.20 ,$592.48 ,$144.24 ,$547.40 ,$611.80 ,$566.72 ,$489.44 ,$144.24 ,$144.24 ,$144.24 ,$470.12 ,$354.20 ,$586.04 ,$586.04 ,$515.20 ,$224.53 ,$354.20 ,$579.60 ,$217.99 ,$579.60 ,$347.76 ,$605.36 ,$490.48 ,$592.48 ,$152.89 ,$586.04 ,$217.99 ,$396.32 ,$396.32 ,$579.60 ,$480.62 ,$448.55 ,$220.17 ,$144.24 ,$611.80 ,$228.89 ,$144.24 ,$560.28 ,$217.99 ,$579.60 ,$217.99 ,$579.60 ,$579.60 ,$579.60 ,$624.68 ,$521.64 ,$598.92 ,$553.84 ,$624.68 
SACRED HEART HOSPITAL (ACU),45000249,28515,HC TOE FX W/MANIP,450,1 ,$163.00 ,$122.25 ,$88.02 ,$490.48 ,$104.97 ,$217.99 ,$114.10 ,$144.24 ,$135.29 ,$148.57 ,$107.58 ,$154.85 ,$144.24 ,$130.40 ,$149.96 ,$144.24 ,$138.55 ,$154.85 ,$143.44 ,$123.88 ,$144.24 ,$144.24 ,$144.24 ,$118.99 ,$89.65 ,$148.33 ,$148.33 ,$130.40 ,$224.53 ,$89.65 ,$146.70 ,$217.99 ,$146.70 ,$88.02 ,$153.22 ,$490.48 ,$149.96 ,$152.89 ,$148.33 ,$217.99 ,$100.31 ,$100.31 ,$146.70 ,$121.65 ,$113.53 ,$220.17 ,$144.24 ,$154.85 ,$228.89 ,$144.24 ,$141.81 ,$217.99 ,$146.70 ,$217.99 ,$146.70 ,$146.70 ,$146.70 ,$158.11 ,$132.03 ,$151.59 ,$140.18 ,$158.11 
SACRED HEART HOSPITAL (ACU),45000250,28510,HC TOE FX W/O MANIP EACH,450,1 ,$666.00 ,$499.50 ,$144.24 ,$666.00 ,$428.90 ,$217.99 ,$466.20 ,$144.24 ,$552.78 ,$148.57 ,$439.56 ,$632.70 ,$144.24 ,$532.80 ,$612.72 ,$144.24 ,$566.10 ,$632.70 ,$586.08 ,$506.16 ,$144.24 ,$144.24 ,$144.24 ,$486.18 ,$366.30 ,$606.06 ,$606.06 ,$532.80 ,$224.53 ,$366.30 ,$599.40 ,$217.99 ,$599.40 ,$359.64 ,$626.04 ,$490.48 ,$612.72 ,$152.89 ,$606.06 ,$217.99 ,$409.86 ,$409.86 ,$599.40 ,$497.04 ,$463.87 ,$220.17 ,$144.24 ,$632.70 ,$228.89 ,$144.24 ,$579.42 ,$217.99 ,$599.40 ,$217.99 ,$599.40 ,$599.40 ,$599.40 ,$646.02 ,$539.46 ,$619.38 ,$572.76 ,$646.02 
SACRED HEART HOSPITAL (ACU),45000251,24650,HC RADIAL HEAD W/O RED;ADULT,450,1 ,"$1,440.00 ","$1,080.00 ",$144.24 ,"$1,440.00 ",$927.36 ,$217.99 ,"$1,008.00 ",$144.24 ,"$1,195.20 ",$148.57 ,$950.40 ,"$1,368.00 ",$144.24 ,"$1,152.00 ","$1,324.80 ",$144.24 ,"$1,224.00 ","$1,368.00 ","$1,267.20 ","$1,094.40 ",$144.24 ,$144.24 ,$144.24 ,"$1,051.20 ",$792.00 ,"$1,310.40 ","$1,310.40 ","$1,152.00 ",$224.53 ,$792.00 ,"$1,296.00 ",$217.99 ,"$1,296.00 ",$777.60 ,"$1,353.60 ",$490.48 ,"$1,324.80 ",$152.89 ,"$1,310.40 ",$217.99 ,$886.18 ,$886.18 ,"$1,296.00 ","$1,074.67 ","$1,002.96 ",$220.17 ,$144.24 ,"$1,368.00 ",$228.89 ,$144.24 ,"$1,252.80 ",$217.99 ,"$1,296.00 ",$217.99 ,"$1,296.00 ","$1,296.00 ","$1,296.00 ","$1,396.80 ","$1,166.40 ","$1,339.20 ","$1,238.40 ","$1,396.80 "
SACRED HEART HOSPITAL (ACU),45000252,20520,HC MUSCLE FB REM W/ INC,450,1 ,$745.00 ,$558.75 ,$402.30 ,"$3,348.27 ",$479.78 ,"$1,488.12 ",$521.50 ,$566.44 ,$618.35 ,$583.43 ,$491.70 ,$707.75 ,$566.44 ,$596.00 ,$685.40 ,$566.44 ,$633.25 ,$707.75 ,$655.60 ,$566.20 ,$566.44 ,$566.44 ,$566.44 ,$543.85 ,$409.75 ,$677.95 ,$677.95 ,$596.00 ,"$1,532.76 ",$409.75 ,$670.50 ,"$1,488.12 ",$670.50 ,$402.30 ,$700.30 ,"$3,348.27 ",$685.40 ,$600.43 ,$677.95 ,"$1,488.12 ",$458.47 ,$458.47 ,$670.50 ,$555.99 ,$518.89 ,"$1,503.00 ",$566.44 ,$707.75 ,"$1,562.52 ",$566.44 ,$648.15 ,"$1,488.12 ",$670.50 ,"$1,488.12 ",$670.50 ,$670.50 ,$670.50 ,$722.65 ,$603.45 ,$692.85 ,$640.70 ,$722.65 
SACRED HEART HOSPITAL (ACU),45000258,29345,HC LONG LEG CAST,450,1 ,"$1,060.00 ",$795.00 ,$61.15 ,"$1,060.00 ",$682.64 ,$255.15 ,$742.00 ,$61.15 ,$879.80 ,$62.98 ,$699.60 ,"$1,007.00 ",$61.15 ,$848.00 ,$975.20 ,$61.15 ,$901.00 ,"$1,007.00 ",$932.80 ,$805.60 ,$61.15 ,$61.15 ,$61.15 ,$773.80 ,$583.00 ,$964.60 ,$964.60 ,$848.00 ,$262.80 ,$583.00 ,$954.00 ,$255.15 ,$954.00 ,$572.40 ,$996.40 ,$574.08 ,$975.20 ,$64.82 ,$964.60 ,$255.15 ,$652.32 ,$652.32 ,$954.00 ,$791.08 ,$738.29 ,$257.70 ,$61.15 ,"$1,007.00 ",$267.90 ,$61.15 ,$922.20 ,$255.15 ,$954.00 ,$255.15 ,$954.00 ,$954.00 ,$954.00 ,"$1,028.20 ",$858.60 ,$985.80 ,$911.60 ,"$1,028.20 "
SACRED HEART HOSPITAL (ACU),45000264,11400,HC EXC LESION 0.5<,450,1 ,$253.00 ,$189.75 ,$136.62 ,"$1,480.84 ",$162.93 ,$658.15 ,$177.10 ,$144.67 ,$209.99 ,$149.01 ,$166.98 ,$240.35 ,$144.67 ,$202.40 ,$232.76 ,$144.67 ,$215.05 ,$240.35 ,$222.64 ,$192.28 ,$144.67 ,$144.67 ,$144.67 ,$184.69 ,$139.15 ,$230.23 ,$230.23 ,$202.40 ,$677.89 ,$139.15 ,$227.70 ,$658.15 ,$227.70 ,$136.62 ,$237.82 ,"$1,480.84 ",$232.76 ,$153.35 ,$230.23 ,$658.15 ,$155.70 ,$155.70 ,$227.70 ,$188.81 ,$176.21 ,$664.73 ,$144.67 ,$240.35 ,$691.06 ,$144.67 ,$220.11 ,$658.15 ,$227.70 ,$658.15 ,$227.70 ,$227.70 ,$227.70 ,$245.41 ,$204.93 ,$235.29 ,$217.58 ,$245.41 
SACRED HEART HOSPITAL (ACU),45000270,20606,HC ARTHROCNT ASP/INJ JT INTRM W/ULTRA,450,1 ,"$1,805.00 ","$1,353.75 ",$159.92 ,"$1,805.00 ","$1,162.42 ",$671.59 ,"$1,263.50 ",$159.92 ,"$1,498.15 ",$164.72 ,"$1,191.30 ","$1,714.75 ",$159.92 ,"$1,444.00 ","$1,660.60 ",$159.92 ,"$1,534.25 ","$1,714.75 ","$1,588.40 ","$1,371.80 ",$159.92 ,$159.92 ,$159.92 ,"$1,317.65 ",$992.75 ,"$1,642.55 ","$1,642.55 ","$1,444.00 ",$691.74 ,$992.75 ,"$1,624.50 ",$671.59 ,"$1,624.50 ",$974.70 ,"$1,696.70 ","$1,511.09 ","$1,660.60 ",$169.52 ,"$1,642.55 ",$671.59 ,"$1,110.80 ","$1,110.80 ","$1,624.50 ","$1,347.07 ","$1,257.18 ",$678.31 ,$159.92 ,"$1,714.75 ",$705.17 ,$159.92 ,"$1,570.35 ",$671.59 ,"$1,624.50 ",$671.59 ,"$1,624.50 ","$1,624.50 ","$1,624.50 ","$1,750.85 ","$1,462.05 ","$1,678.65 ","$1,552.30 ","$1,750.85 "
SACRED HEART HOSPITAL (ACU),45000271,20604,HC ARTHROCNT ASP/INJ JT SMALL W/ULTRA,450,1 ,"$1,715.00 ","$1,286.25 ",$159.92 ,"$1,715.00 ","$1,104.46 ",$276.32 ,"$1,200.50 ",$159.92 ,"$1,423.45 ",$164.72 ,"$1,131.90 ","$1,629.25 ",$159.92 ,"$1,372.00 ","$1,577.80 ",$159.92 ,"$1,457.75 ","$1,629.25 ","$1,509.20 ","$1,303.40 ",$159.92 ,$159.92 ,$159.92 ,"$1,251.95 ",$943.25 ,"$1,560.65 ","$1,560.65 ","$1,372.00 ",$284.61 ,$943.25 ,"$1,543.50 ",$276.32 ,"$1,543.50 ",$926.10 ,"$1,612.10 ",$621.73 ,"$1,577.80 ",$169.52 ,"$1,560.65 ",$276.32 ,"$1,055.41 ","$1,055.41 ","$1,543.50 ","$1,279.90 ","$1,194.50 ",$279.09 ,$159.92 ,"$1,629.25 ",$290.14 ,$159.92 ,"$1,492.05 ",$276.32 ,"$1,543.50 ",$276.32 ,"$1,543.50 ","$1,543.50 ","$1,543.50 ","$1,663.55 ","$1,389.15 ","$1,594.95 ","$1,474.90 ","$1,663.55 "
SACRED HEART HOSPITAL (ACU),45000272,20611,HC ARTHROCNT ASP/INJ JT MAJOR W/ ULTRA,450,1 ,"$1,398.00 ","$1,048.50 ",$159.92 ,"$1,398.00 ",$900.31 ,$276.32 ,$978.60 ,$159.92 ,"$1,160.34 ",$164.72 ,$922.68 ,"$1,328.10 ",$159.92 ,"$1,118.40 ","$1,286.16 ",$159.92 ,"$1,188.30 ","$1,328.10 ","$1,230.24 ","$1,062.48 ",$159.92 ,$159.92 ,$159.92 ,"$1,020.54 ",$768.90 ,"$1,272.18 ","$1,272.18 ","$1,118.40 ",$284.61 ,$768.90 ,"$1,258.20 ",$276.32 ,"$1,258.20 ",$754.92 ,"$1,314.12 ",$621.73 ,"$1,286.16 ",$169.52 ,"$1,272.18 ",$276.32 ,$860.33 ,$860.33 ,"$1,258.20 ","$1,043.33 ",$973.71 ,$279.09 ,$159.92 ,"$1,328.10 ",$290.14 ,$159.92 ,"$1,216.26 ",$276.32 ,"$1,258.20 ",$276.32 ,"$1,258.20 ","$1,258.20 ","$1,258.20 ","$1,356.06 ","$1,132.38 ","$1,300.14 ","$1,202.28 ","$1,356.06 "
SACRED HEART HOSPITAL (ACU),45000273,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI,450,1 ,$110.00 ,$82.50 ,$36.07 ,$132.46 ,$70.84 ,$58.87 ,$77.00 ,$36.07 ,$91.30 ,$37.15 ,$72.60 ,$104.50 ,$36.07 ,$88.00 ,$101.20 ,$36.07 ,$93.50 ,$104.50 ,$96.80 ,$83.60 ,$36.07 ,$36.07 ,$36.07 ,$80.30 ,$60.50 ,$100.10 ,$100.10 ,$88.00 ,$60.64 ,$60.50 ,$99.00 ,$58.87 ,$99.00 ,$59.40 ,$103.40 ,$132.46 ,$101.20 ,$38.23 ,$100.10 ,$58.87 ,$67.69 ,$67.69 ,$99.00 ,$82.09 ,$76.62 ,$59.46 ,$36.07 ,$104.50 ,$61.82 ,$36.07 ,$95.70 ,$58.87 ,$99.00 ,$58.87 ,$99.00 ,$99.00 ,$99.00 ,$106.70 ,$89.10 ,$102.30 ,$94.60 ,$106.70 
SACRED HEART HOSPITAL (ACU),45000274,99281,HC ER LEVEL 1-25,450,1 ,$164.00 ,$123.00 ,$39.52 ,$172.61 ,$105.62 ,$76.72 ,$114.80 ,$39.52 ,$164.00 ,$40.71 ,$164.00 ,$155.80 ,$39.52 ,$131.20 ,$150.88 ,$39.52 ,$139.40 ,$155.80 ,$144.32 ,$124.64 ,$39.52 ,$39.52 ,$39.52 ,$119.72 ,$90.20 ,$149.24 ,$149.24 ,$131.20 ,$79.02 ,$90.20 ,$147.60 ,$76.72 ,$147.60 ,$88.56 ,$154.16 ,$172.61 ,$150.88 ,$41.89 ,$149.24 ,$76.72 ,$100.93 ,$100.93 ,$147.60 ,$122.39 ,$147.60 ,$77.48 ,$39.52 ,$155.80 ,$80.55 ,$39.52 ,$142.68 ,$76.72 ,$147.60 ,$76.72 ,$147.60 ,$147.60 ,$147.60 ,$159.08 ,$132.84 ,$152.52 ,$141.04 ,$159.08 
SACRED HEART HOSPITAL (ACU),45000275,99282,HC ER LEVEL 2-25,450,1 ,$240.00 ,$180.00 ,$39.52 ,$312.58 ,$154.56 ,$138.92 ,$168.00 ,$39.52 ,$240.00 ,$40.71 ,$240.00 ,$228.00 ,$39.52 ,$192.00 ,$220.80 ,$39.52 ,$204.00 ,$228.00 ,$211.20 ,$182.40 ,$39.52 ,$39.52 ,$39.52 ,$175.20 ,$132.00 ,$218.40 ,$218.40 ,$192.00 ,$143.09 ,$132.00 ,$216.00 ,$138.92 ,$216.00 ,$129.60 ,$225.60 ,$312.58 ,$220.80 ,$41.89 ,$218.40 ,$138.92 ,$147.70 ,$147.70 ,$216.00 ,$179.11 ,$216.00 ,$140.31 ,$39.52 ,$228.00 ,$145.87 ,$39.52 ,$208.80 ,$138.92 ,$216.00 ,$138.92 ,$216.00 ,$216.00 ,$216.00 ,$232.80 ,$194.40 ,$223.20 ,$206.40 ,$232.80 
SACRED HEART HOSPITAL (ACU),45000276,99283,HC ER LEVEL 3-25,450,1 ,$511.00 ,$383.25 ,$39.52 ,$550.71 ,$329.08 ,$244.76 ,$357.70 ,$39.52 ,$511.00 ,$40.71 ,$511.00 ,$485.45 ,$39.52 ,$408.80 ,$470.12 ,$39.52 ,$434.35 ,$485.45 ,$449.68 ,$388.36 ,$39.52 ,$39.52 ,$39.52 ,$373.03 ,$281.05 ,$465.01 ,$465.01 ,$408.80 ,$252.10 ,$281.05 ,$459.90 ,$244.76 ,$459.90 ,$275.94 ,$480.34 ,$550.71 ,$470.12 ,$41.89 ,$465.01 ,$244.76 ,$314.47 ,$314.47 ,$459.90 ,$381.36 ,$459.90 ,$247.21 ,$39.52 ,$485.45 ,$257.00 ,$39.52 ,$444.57 ,$244.76 ,$459.90 ,$244.76 ,$459.90 ,$459.90 ,$459.90 ,$495.67 ,$413.91 ,$475.23 ,$439.46 ,$495.67 
SACRED HEART HOSPITAL (ACU),45000277,99284,HC ER LEVEL 4-25,450,1 ,"$1,014.00 ",$760.50 ,$39.52 ,"$1,014.00 ",$653.02 ,$384.74 ,$709.80 ,$39.52 ,"$1,014.00 ",$40.71 ,"$1,014.00 ",$963.30 ,$39.52 ,$811.20 ,$932.88 ,$39.52 ,$861.90 ,$963.30 ,$892.32 ,$770.64 ,$39.52 ,$39.52 ,$39.52 ,$740.22 ,$557.70 ,$922.74 ,$922.74 ,$811.20 ,$396.28 ,$557.70 ,$912.60 ,$384.74 ,$912.60 ,$547.56 ,$953.16 ,$865.66 ,$932.88 ,$41.89 ,$922.74 ,$384.74 ,$624.02 ,$624.02 ,$912.60 ,$756.75 ,$912.60 ,$388.59 ,$39.52 ,$963.30 ,$403.98 ,$39.52 ,$882.18 ,$384.74 ,$912.60 ,$384.74 ,$912.60 ,$912.60 ,$912.60 ,$983.58 ,$821.34 ,$943.02 ,$872.04 ,$983.58 
SACRED HEART HOSPITAL (ACU),45000278,99285,HC ER LEVEL 5-25,450,1 ,"$1,486.00 ","$1,114.50 ",$39.52 ,"$1,486.00 ",$956.98 ,$552.24 ,"$1,040.20 ",$39.52 ,"$1,486.00 ",$40.71 ,"$1,486.00 ","$1,411.70 ",$39.52 ,"$1,188.80 ","$1,367.12 ",$39.52 ,"$1,263.10 ","$1,411.70 ","$1,307.68 ","$1,129.36 ",$39.52 ,$39.52 ,$39.52 ,"$1,084.78 ",$817.30 ,"$1,352.26 ","$1,352.26 ","$1,188.80 ",$568.81 ,$817.30 ,"$1,337.40 ",$552.24 ,"$1,337.40 ",$802.44 ,"$1,396.84 ","$1,242.55 ","$1,367.12 ",$41.89 ,"$1,352.26 ",$552.24 ,$914.48 ,$914.48 ,"$1,337.40 ","$1,109.00 ","$1,337.40 ",$557.77 ,$39.52 ,"$1,411.70 ",$579.86 ,$39.52 ,"$1,292.82 ",$552.24 ,"$1,337.40 ",$552.24 ,"$1,337.40 ","$1,337.40 ","$1,337.40 ","$1,441.42 ","$1,203.66 ","$1,381.98 ","$1,277.96 ","$1,441.42 "
SACRED HEART HOSPITAL (ACU),45000279,99291,HC CRITICAL CARE 30-74 MIN -25,450,1 ,"$2,048.00 ","$1,536.00 ",$39.52 ,"$2,048.00 ","$1,318.91 ",$787.81 ,"$1,433.60 ",$39.52 ,"$2,048.00 ",$40.71 ,"$2,048.00 ","$1,945.60 ",$39.52 ,"$1,638.40 ","$1,884.16 ",$39.52 ,"$1,740.80 ","$1,945.60 ","$1,802.24 ","$1,556.48 ",$39.52 ,$39.52 ,$39.52 ,"$1,495.04 ","$1,126.40 ","$1,863.68 ","$1,863.68 ","$1,638.40 ",$811.44 ,"$1,126.40 ","$1,843.20 ",$787.81 ,"$1,843.20 ","$1,105.92 ","$1,925.12 ","$1,772.57 ","$1,884.16 ",$41.89 ,"$1,863.68 ",$787.81 ,"$1,260.34 ","$1,260.34 ","$1,843.20 ","$1,528.42 ","$1,843.20 ",$795.69 ,$39.52 ,"$1,945.60 ",$827.20 ,$39.52 ,"$1,781.76 ",$787.81 ,"$1,843.20 ",$787.81 ,"$1,843.20 ","$1,843.20 ","$1,843.20 ","$1,986.56 ","$1,658.88 ","$1,904.64 ","$1,761.28 ","$1,986.56 "
SACRED HEART HOSPITAL (ACU),45000280,99292,HC CRITICAL CARE ADDL 30MIN -25,450,1 ,$306.00 ,$229.50 ,$39.52 ,$306.00 ,$197.06 , N/A ,$214.20 ,$39.52 ,$253.98 ,$40.71 ,$201.96 ,$290.70 ,$39.52 ,$244.80 ,$281.52 ,$39.52 ,$260.10 ,$290.70 ,$269.28 ,$232.56 ,$39.52 ,$39.52 ,$39.52 ,$223.38 ,$168.30 ,$278.46 ,$278.46 ,$244.80 , N/A ,$168.30 ,$275.40 , N/A ,$275.40 ,$165.24 ,$287.64 , N/A ,$281.52 ,$41.89 ,$278.46 , N/A ,$188.31 ,$188.31 ,$275.40 ,$228.37 ,$213.13 , N/A ,$39.52 ,$290.70 , N/A ,$39.52 ,$266.22 , N/A ,$275.40 , N/A ,$275.40 ,$275.40 ,$275.40 ,$296.82 ,$247.86 ,$284.58 ,$263.16 ,$296.82 
SACRED HEART HOSPITAL (ACU),45000281,N/A,HC ED PROC LEVEL 1,450,1 ,$211.00 ,$158.25 ,$113.94 ,$211.00 ,$135.88 , N/A ,$147.70 , N/A ,$175.13 , N/A ,$139.26 ,$200.45 , N/A ,$168.80 ,$194.12 , N/A ,$179.35 ,$200.45 ,$185.68 ,$160.36 , N/A , N/A , N/A ,$154.03 ,$116.05 ,$192.01 ,$192.01 ,$168.80 , N/A ,$116.05 ,$189.90 , N/A ,$189.90 ,$113.94 ,$198.34 , N/A ,$194.12 , N/A ,$192.01 , N/A ,$129.85 ,$129.85 ,$189.90 ,$157.47 ,$146.96 , N/A , N/A ,$200.45 , N/A , N/A ,$183.57 , N/A ,$189.90 , N/A ,$189.90 ,$189.90 ,$189.90 ,$204.67 ,$170.91 ,$196.23 ,$181.46 ,$204.67 
SACRED HEART HOSPITAL (ACU),45000282,N/A,HC ED PROC LEVEL 2,450,1 ,$357.00 ,$267.75 ,$192.78 ,$357.00 ,$229.91 , N/A ,$249.90 , N/A ,$296.31 , N/A ,$235.62 ,$339.15 , N/A ,$285.60 ,$328.44 , N/A ,$303.45 ,$339.15 ,$314.16 ,$271.32 , N/A , N/A , N/A ,$260.61 ,$196.35 ,$324.87 ,$324.87 ,$285.60 , N/A ,$196.35 ,$321.30 , N/A ,$321.30 ,$192.78 ,$335.58 , N/A ,$328.44 , N/A ,$324.87 , N/A ,$219.70 ,$219.70 ,$321.30 ,$266.43 ,$248.65 , N/A , N/A ,$339.15 , N/A , N/A ,$310.59 , N/A ,$321.30 , N/A ,$321.30 ,$321.30 ,$321.30 ,$346.29 ,$289.17 ,$332.01 ,$307.02 ,$346.29 
SACRED HEART HOSPITAL (ACU),45000283,N/A,HC ED PROC LEVEL 3,450,1 ,$468.00 ,$351.00 ,$252.72 ,$468.00 ,$301.39 , N/A ,$327.60 , N/A ,$388.44 , N/A ,$308.88 ,$444.60 , N/A ,$374.40 ,$430.56 , N/A ,$397.80 ,$444.60 ,$411.84 ,$355.68 , N/A , N/A , N/A ,$341.64 ,$257.40 ,$425.88 ,$425.88 ,$374.40 , N/A ,$257.40 ,$421.20 , N/A ,$421.20 ,$252.72 ,$439.92 , N/A ,$430.56 , N/A ,$425.88 , N/A ,$288.01 ,$288.01 ,$421.20 ,$349.27 ,$325.96 , N/A , N/A ,$444.60 , N/A , N/A ,$407.16 , N/A ,$421.20 , N/A ,$421.20 ,$421.20 ,$421.20 ,$453.96 ,$379.08 ,$435.24 ,$402.48 ,$453.96 
SACRED HEART HOSPITAL (ACU),45000284,N/A,HC ED PROC LEVEL 4,450,1 ,$580.00 ,$435.00 ,$313.20 ,$580.00 ,$373.52 , N/A ,$406.00 , N/A ,$481.40 , N/A ,$382.80 ,$551.00 , N/A ,$464.00 ,$533.60 , N/A ,$493.00 ,$551.00 ,$510.40 ,$440.80 , N/A , N/A , N/A ,$423.40 ,$319.00 ,$527.80 ,$527.80 ,$464.00 , N/A ,$319.00 ,$522.00 , N/A ,$522.00 ,$313.20 ,$545.20 , N/A ,$533.60 , N/A ,$527.80 , N/A ,$356.93 ,$356.93 ,$522.00 ,$432.85 ,$403.97 , N/A , N/A ,$551.00 , N/A , N/A ,$504.60 , N/A ,$522.00 , N/A ,$522.00 ,$522.00 ,$522.00 ,$562.60 ,$469.80 ,$539.40 ,$498.80 ,$562.60 
SACRED HEART HOSPITAL (ACU),45000285,N/A,HC ED PROC LEVEL 5,450,1 ,$803.00 ,$602.25 ,$433.62 ,$803.00 ,$517.13 , N/A ,$562.10 , N/A ,$666.49 , N/A ,$529.98 ,$762.85 , N/A ,$642.40 ,$738.76 , N/A ,$682.55 ,$762.85 ,$706.64 ,$610.28 , N/A , N/A , N/A ,$586.19 ,$441.65 ,$730.73 ,$730.73 ,$642.40 , N/A ,$441.65 ,$722.70 , N/A ,$722.70 ,$433.62 ,$754.82 , N/A ,$738.76 , N/A ,$730.73 , N/A ,$494.17 ,$494.17 ,$722.70 ,$599.28 ,$559.29 , N/A , N/A ,$762.85 , N/A , N/A ,$698.61 , N/A ,$722.70 , N/A ,$722.70 ,$722.70 ,$722.70 ,$778.91 ,$650.43 ,$746.79 ,$690.58 ,$778.91 
SACRED HEART HOSPITAL (ACU),45000286,11401,HC EXCISION LESION BENIGN TRUNK/ARM/LEG  0.6-1.0CM,450,1 ,$597.00 ,$447.75 ,$144.67 ,$822.51 ,$384.47 ,$365.56 ,$417.90 ,$144.67 ,$495.51 ,$149.01 ,$394.02 ,$567.15 ,$144.67 ,$477.60 ,$549.24 ,$144.67 ,$507.45 ,$567.15 ,$525.36 ,$453.72 ,$144.67 ,$144.67 ,$144.67 ,$435.81 ,$328.35 ,$543.27 ,$543.27 ,$477.60 ,$376.53 ,$328.35 ,$537.30 ,$365.56 ,$537.30 ,$322.38 ,$561.18 ,$822.51 ,$549.24 ,$153.35 ,$543.27 ,$365.56 ,$367.39 ,$367.39 ,$537.30 ,$445.54 ,$415.81 ,$369.22 ,$144.67 ,$567.15 ,$383.84 ,$144.67 ,$519.39 ,$365.56 ,$537.30 ,$365.56 ,$537.30 ,$537.30 ,$537.30 ,$579.09 ,$483.57 ,$555.21 ,$513.42 ,$579.09 
SACRED HEART HOSPITAL (ACU),45000288,11403,HC EXCISION LESION BENIGN TRUNK/ARM/LEG 2.1-3.0CM,450,1 ,"$2,252.00 ","$1,689.00 ",$144.67 ,"$2,252.00 ","$1,450.29 ",$658.15 ,"$1,576.40 ",$144.67 ,"$1,869.16 ",$149.01 ,"$1,486.32 ","$2,139.40 ",$144.67 ,"$1,801.60 ","$2,071.84 ",$144.67 ,"$1,914.20 ","$2,139.40 ","$1,981.76 ","$1,711.52 ",$144.67 ,$144.67 ,$144.67 ,"$1,643.96 ","$1,238.60 ","$2,049.32 ","$2,049.32 ","$1,801.60 ",$677.89 ,"$1,238.60 ","$2,026.80 ",$658.15 ,"$2,026.80 ","$1,216.08 ","$2,116.88 ","$1,480.84 ","$2,071.84 ",$153.35 ,"$2,049.32 ",$658.15 ,"$1,385.88 ","$1,385.88 ","$2,026.80 ","$1,680.67 ","$1,568.52 ",$664.73 ,$144.67 ,"$2,139.40 ",$691.06 ,$144.67 ,"$1,959.24 ",$658.15 ,"$2,026.80 ",$658.15 ,"$2,026.80 ","$2,026.80 ","$2,026.80 ","$2,184.44 ","$1,824.12 ","$2,094.36 ","$1,936.72 ","$2,184.44 "
SACRED HEART HOSPITAL (ACU),45000294,11441,HC EXCISION LESION BENIGN FACE/EAR 0.6-1.0CM,450,1 ,$258.00 ,$193.50 ,$139.32 ,"$1,480.84 ",$166.15 ,$658.15 ,$180.60 ,$144.67 ,$214.14 ,$149.01 ,$170.28 ,$245.10 ,$144.67 ,$206.40 ,$237.36 ,$144.67 ,$219.30 ,$245.10 ,$227.04 ,$196.08 ,$144.67 ,$144.67 ,$144.67 ,$188.34 ,$141.90 ,$234.78 ,$234.78 ,$206.40 ,$677.89 ,$141.90 ,$232.20 ,$658.15 ,$232.20 ,$139.32 ,$242.52 ,"$1,480.84 ",$237.36 ,$153.35 ,$234.78 ,$658.15 ,$158.77 ,$158.77 ,$232.20 ,$192.55 ,$179.70 ,$664.73 ,$144.67 ,$245.10 ,$691.06 ,$144.67 ,$224.46 ,$658.15 ,$232.20 ,$658.15 ,$232.20 ,$232.20 ,$232.20 ,$250.26 ,$208.98 ,$239.94 ,$221.88 ,$250.26 
SACRED HEART HOSPITAL (ACU),45000298,20102,HC EXPLORE WOUND ABDOMEN/FLANK/BACK,450,1 ,"$2,952.00 ","$2,214.00 ",$325.72 ,"$4,075.87 ","$1,901.09 ","$1,811.50 ","$2,066.40 ",$325.72 ,"$2,450.16 ",$335.49 ,"$1,948.32 ","$2,804.40 ",$325.72 ,"$2,361.60 ","$2,715.84 ",$325.72 ,"$2,509.20 ","$2,804.40 ","$2,597.76 ","$2,243.52 ",$325.72 ,$325.72 ,$325.72 ,"$2,154.96 ","$1,623.60 ","$2,686.32 ","$2,686.32 ","$2,361.60 ","$1,865.85 ","$1,623.60 ","$2,656.80 ","$1,811.50 ","$2,656.80 ","$1,594.08 ","$2,774.88 ","$4,075.87 ","$2,715.84 ",$345.26 ,"$2,686.32 ","$1,811.50 ","$1,816.66 ","$1,816.66 ","$2,656.80 ","$2,203.08 ","$2,056.07 ","$1,829.61 ",$325.72 ,"$2,804.40 ","$1,902.07 ",$325.72 ,"$2,568.24 ","$1,811.50 ","$2,656.80 ","$1,811.50 ","$2,656.80 ","$2,656.80 ","$2,656.80 ","$2,863.44 ","$2,391.12 ","$2,745.36 ","$2,538.72 ","$2,863.44 "
SACRED HEART HOSPITAL (ACU),45000299,20525,HC REMOVAL FOREIGN BODY MUSCLE DEEP/COMPLICATED,450,1 ,"$2,214.00 ","$1,660.50 ",$566.44 ,"$5,642.34 ","$1,425.82 ","$2,507.71 ","$1,549.80 ",$566.44 ,"$1,837.62 ",$583.43 ,"$1,461.24 ","$2,103.30 ",$566.44 ,"$1,771.20 ","$2,036.88 ",$566.44 ,"$1,881.90 ","$2,103.30 ","$1,948.32 ","$1,682.64 ",$566.44 ,$566.44 ,$566.44 ,"$1,616.22 ","$1,217.70 ","$2,014.74 ","$2,014.74 ","$1,771.20 ","$2,582.94 ","$1,217.70 ","$1,992.60 ","$2,507.71 ","$1,992.60 ","$1,195.56 ","$2,081.16 ","$5,642.34 ","$2,036.88 ",$600.43 ,"$2,014.74 ","$2,507.71 ","$1,362.50 ","$1,362.50 ","$1,992.60 ","$1,652.31 ","$1,542.05 ","$2,532.79 ",$566.44 ,"$2,103.30 ","$2,633.09 ",$566.44 ,"$1,926.18 ","$2,507.71 ","$1,992.60 ","$2,507.71 ","$1,992.60 ","$1,992.60 ","$1,992.60 ","$2,147.58 ","$1,793.34 ","$2,059.02 ","$1,904.04 ","$2,147.58 "
SACRED HEART HOSPITAL (ACU),45000300,21310,HC CLOSED TX FX NASAL BONE W/O MANIPULATION,450,1 ,$93.00 ,$69.75 ,$50.22 ,$93.00 ,$59.89 , N/A ,$65.10 , N/A ,$77.19 , N/A ,$61.38 ,$88.35 , N/A ,$74.40 ,$85.56 , N/A ,$79.05 ,$88.35 ,$81.84 ,$70.68 , N/A , N/A , N/A ,$67.89 ,$51.15 ,$84.63 ,$84.63 ,$74.40 , N/A ,$51.15 ,$83.70 , N/A ,$83.70 ,$50.22 ,$87.42 , N/A ,$85.56 , N/A ,$84.63 , N/A ,$57.23 ,$57.23 ,$83.70 ,$69.41 ,$64.77 , N/A , N/A ,$88.35 , N/A , N/A ,$80.91 , N/A ,$83.70 , N/A ,$83.70 ,$83.70 ,$83.70 ,$90.21 ,$75.33 ,$86.49 ,$79.98 ,$90.21 
SACRED HEART HOSPITAL (ACU),45000302,24565,HC CLOSED TX HUMERUS EPICONDYLR FX W/MANIP,450,1 ,$385.00 ,$288.75 ,$144.24 ,"$3,314.53 ",$247.94 ,"$1,473.12 ",$269.50 ,$144.24 ,$319.55 ,$148.57 ,$254.10 ,$365.75 ,$144.24 ,$308.00 ,$354.20 ,$144.24 ,$327.25 ,$365.75 ,$338.80 ,$292.60 ,$144.24 ,$144.24 ,$144.24 ,$281.05 ,$211.75 ,$350.35 ,$350.35 ,$308.00 ,"$1,517.31 ",$211.75 ,$346.50 ,"$1,473.12 ",$346.50 ,$207.90 ,$361.90 ,"$3,314.53 ",$354.20 ,$152.89 ,$350.35 ,"$1,473.12 ",$236.93 ,$236.93 ,$346.50 ,$287.33 ,$268.15 ,"$1,487.85 ",$144.24 ,$365.75 ,"$1,546.78 ",$144.24 ,$334.95 ,"$1,473.12 ",$346.50 ,"$1,473.12 ",$346.50 ,$346.50 ,$346.50 ,$373.45 ,$311.85 ,$358.05 ,$331.10 ,$373.45 
SACRED HEART HOSPITAL (ACU),45000303,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP,450,1 ,$385.00 ,$288.75 ,$144.24 ,"$3,314.53 ",$247.94 ,"$1,473.12 ",$269.50 ,$144.24 ,$319.55 ,$148.57 ,$254.10 ,$365.75 ,$144.24 ,$308.00 ,$354.20 ,$144.24 ,$327.25 ,$365.75 ,$338.80 ,$292.60 ,$144.24 ,$144.24 ,$144.24 ,$281.05 ,$211.75 ,$350.35 ,$350.35 ,$308.00 ,"$1,517.31 ",$211.75 ,$346.50 ,"$1,473.12 ",$346.50 ,$207.90 ,$361.90 ,"$3,314.53 ",$354.20 ,$152.89 ,$350.35 ,"$1,473.12 ",$236.93 ,$236.93 ,$346.50 ,$287.33 ,$268.15 ,"$1,487.85 ",$144.24 ,$365.75 ,"$1,546.78 ",$144.24 ,$334.95 ,"$1,473.12 ",$346.50 ,"$1,473.12 ",$346.50 ,$346.50 ,$346.50 ,$373.45 ,$311.85 ,$358.05 ,$331.10 ,$373.45 
SACRED HEART HOSPITAL (ACU),45000304,25650,HC CLOSED TX ULNAR STYLOID FX,450,1 ,$786.00 ,$589.50 ,$144.24 ,$786.00 ,$506.18 ,$217.99 ,$550.20 ,$144.24 ,$652.38 ,$148.57 ,$518.76 ,$746.70 ,$144.24 ,$628.80 ,$723.12 ,$144.24 ,$668.10 ,$746.70 ,$691.68 ,$597.36 ,$144.24 ,$144.24 ,$144.24 ,$573.78 ,$432.30 ,$715.26 ,$715.26 ,$628.80 ,$224.53 ,$432.30 ,$707.40 ,$217.99 ,$707.40 ,$424.44 ,$738.84 ,$490.48 ,$723.12 ,$152.89 ,$715.26 ,$217.99 ,$483.70 ,$483.70 ,$707.40 ,$586.59 ,$547.45 ,$220.17 ,$144.24 ,$746.70 ,$228.89 ,$144.24 ,$683.82 ,$217.99 ,$707.40 ,$217.99 ,$707.40 ,$707.40 ,$707.40 ,$762.42 ,$636.66 ,$730.98 ,$675.96 ,$762.42 
SACRED HEART HOSPITAL (ACU),45000305,26160,HC REMOVE TENDON SHEATH LESION,450,1 ,$218.00 ,$163.50 ,$117.72 ,"$3,314.53 ",$140.39 ,"$1,473.12 ",$152.60 ,$218.00 ,$180.94 ,$442.92 ,$143.88 ,$207.10 ,$430.02 ,$174.40 ,$200.56 ,$218.00 ,$185.30 ,$207.10 ,$191.84 ,$165.68 ,$218.00 ,$218.00 ,$430.02 ,$159.14 ,$119.90 ,$198.38 ,$198.38 ,$174.40 ,"$1,517.31 ",$119.90 ,$196.20 ,"$1,473.12 ",$196.20 ,$117.72 ,$204.92 ,"$3,314.53 ",$200.56 ,$455.82 ,$198.38 ,"$1,473.12 ",$134.16 ,$134.16 ,$196.20 ,$162.69 ,$151.84 ,"$1,487.85 ",$218.00 ,$207.10 ,"$1,546.78 ",$218.00 ,$189.66 ,"$1,473.12 ",$196.20 ,"$1,473.12 ",$196.20 ,$196.20 ,$196.20 ,$211.46 ,$176.58 ,$202.74 ,$187.48 ,$211.46 
SACRED HEART HOSPITAL (ACU),45000308,28570,HC CLOSED TX FOOT DISLOCATION W/O ANES,450,1 ,$345.00 ,$258.75 ,$144.24 ,$490.48 ,$222.18 ,$217.99 ,$241.50 ,$144.24 ,$286.35 ,$148.57 ,$227.70 ,$327.75 ,$144.24 ,$276.00 ,$317.40 ,$144.24 ,$293.25 ,$327.75 ,$303.60 ,$262.20 ,$144.24 ,$144.24 ,$144.24 ,$251.85 ,$189.75 ,$313.95 ,$313.95 ,$276.00 ,$224.53 ,$189.75 ,$310.50 ,$217.99 ,$310.50 ,$186.30 ,$324.30 ,$490.48 ,$317.40 ,$152.89 ,$313.95 ,$217.99 ,$212.31 ,$212.31 ,$310.50 ,$257.47 ,$240.29 ,$220.17 ,$144.24 ,$327.75 ,$228.89 ,$144.24 ,$300.15 ,$217.99 ,$310.50 ,$217.99 ,$310.50 ,$310.50 ,$310.50 ,$334.65 ,$279.45 ,$320.85 ,$296.70 ,$334.65 
SACRED HEART HOSPITAL (ACU),45000309,28660,HC CLOSED TX I-P JOINT DISLOCATION W/O ANES,450,1 ,$567.00 ,$425.25 ,$144.24 ,$567.00 ,$365.15 ,$217.99 ,$396.90 ,$144.24 ,$470.61 ,$148.57 ,$374.22 ,$538.65 ,$144.24 ,$453.60 ,$521.64 ,$144.24 ,$481.95 ,$538.65 ,$498.96 ,$430.92 ,$144.24 ,$144.24 ,$144.24 ,$413.91 ,$311.85 ,$515.97 ,$515.97 ,$453.60 ,$224.53 ,$311.85 ,$510.30 ,$217.99 ,$510.30 ,$306.18 ,$532.98 ,$490.48 ,$521.64 ,$152.89 ,$515.97 ,$217.99 ,$348.93 ,$348.93 ,$510.30 ,$423.15 ,$394.92 ,$220.17 ,$144.24 ,$538.65 ,$228.89 ,$144.24 ,$493.29 ,$217.99 ,$510.30 ,$217.99 ,$510.30 ,$510.30 ,$510.30 ,$549.99 ,$459.27 ,$527.31 ,$487.62 ,$549.99 
SACRED HEART HOSPITAL (ACU),45000310,31505,HC LARYNGOSCOPY INDIRECT,450,1 ,$477.63 ,$358.22 ,$36.07 ,$477.63 ,$307.59 ,$174.10 ,$334.34 ,$36.07 ,$396.43 ,$37.15 ,$315.24 ,$453.75 ,$36.07 ,$382.10 ,$439.42 ,$36.07 ,$405.99 ,$453.75 ,$420.31 ,$363.00 ,$36.07 ,$36.07 ,$36.07 ,$348.67 ,$262.70 ,$434.64 ,$434.64 ,$382.10 ,$179.32 ,$262.70 ,$429.87 ,$174.10 ,$429.87 ,$257.92 ,$448.97 ,$391.73 ,$439.42 ,$38.23 ,$434.64 ,$174.10 ,$293.93 ,$293.93 ,$429.87 ,$356.46 ,$332.67 ,$175.84 ,$36.07 ,$453.75 ,$182.81 ,$36.07 ,$415.54 ,$174.10 ,$429.87 ,$174.10 ,$429.87 ,$429.87 ,$429.87 ,$463.30 ,$386.88 ,$444.20 ,$410.76 ,$463.30 
SACRED HEART HOSPITAL (ACU),45000313,41008,HC DRAINAGE OF MOUTH LESION,450,1 ,$172.00 ,$129.00 ,$92.88 ,"$6,510.13 ",$110.77 ,"$2,893.39 ",$120.40 ,$172.00 ,$142.76 ,$307.23 ,$113.52 ,$163.40 ,$298.28 ,$137.60 ,$158.24 ,$172.00 ,$146.20 ,$163.40 ,$151.36 ,$130.72 ,$172.00 ,$172.00 ,$298.28 ,$125.56 ,$94.60 ,$156.52 ,$156.52 ,$137.60 ,"$2,980.19 ",$94.60 ,$154.80 ,"$2,893.39 ",$154.80 ,$92.88 ,$161.68 ,"$6,510.13 ",$158.24 ,$316.18 ,$156.52 ,"$2,893.39 ",$105.85 ,$105.85 ,$154.80 ,$128.36 ,$119.80 ,"$2,922.32 ",$172.00 ,$163.40 ,"$3,038.06 ",$172.00 ,$149.64 ,"$2,893.39 ",$154.80 ,"$2,893.39 ",$154.80 ,$154.80 ,$154.80 ,$166.84 ,$139.32 ,$159.96 ,$147.92 ,$166.84 
SACRED HEART HOSPITAL (ACU),45000314,41252,HC RPR LAC MOUTH/TONGUE >2.6CM OR COMPLEX,450,1 ,"$2,253.46 ","$1,690.10 ",$36.07 ,"$2,253.46 ","$1,451.23 ",$223.76 ,"$1,577.42 ",$36.07 ,"$1,870.37 ",$37.15 ,"$1,487.28 ","$2,140.79 ",$36.07 ,"$1,802.77 ","$2,073.18 ",$36.07 ,"$1,915.44 ","$2,140.79 ","$1,983.04 ","$1,712.63 ",$36.07 ,$36.07 ,$36.07 ,"$1,645.03 ","$1,239.40 ","$2,050.65 ","$2,050.65 ","$1,802.77 ",$230.47 ,"$1,239.40 ","$2,028.11 ",$223.76 ,"$2,028.11 ","$1,216.87 ","$2,118.25 ",$503.46 ,"$2,073.18 ",$38.23 ,"$2,050.65 ",$223.76 ,"$1,386.78 ","$1,386.78 ","$2,028.11 ","$1,681.76 ","$1,569.53 ",$226.00 ,$36.07 ,"$2,140.79 ",$234.95 ,$36.07 ,"$1,960.51 ",$223.76 ,"$2,028.11 ",$223.76 ,"$2,028.11 ","$2,028.11 ","$2,028.11 ","$2,185.86 ","$1,825.30 ","$2,095.72 ","$1,937.98 ","$2,185.86 "
SACRED HEART HOSPITAL (ACU),45000315,46500,HC INJ SCLEROSING SOLUT HEMORRHOID,450,1 ,$381.00 ,$285.75 ,$205.74 ,"$1,888.46 ",$245.36 ,$839.32 ,$266.70 ,$381.00 ,$316.23 ,$492.64 ,$251.46 ,$361.95 ,$478.29 ,$304.80 ,$350.52 ,$381.00 ,$323.85 ,$361.95 ,$335.28 ,$289.56 ,$381.00 ,$381.00 ,$478.29 ,$278.13 ,$209.55 ,$346.71 ,$346.71 ,$304.80 ,$864.50 ,$209.55 ,$342.90 ,$839.32 ,$342.90 ,$205.74 ,$358.14 ,"$1,888.46 ",$350.52 ,$506.99 ,$346.71 ,$839.32 ,$234.47 ,$234.47 ,$342.90 ,$284.34 ,$265.37 ,$847.71 ,$381.00 ,$361.95 ,$881.28 ,$381.00 ,$331.47 ,$839.32 ,$342.90 ,$839.32 ,$342.90 ,$342.90 ,$342.90 ,$369.57 ,$308.61 ,$354.33 ,$327.66 ,$369.57 
SACRED HEART HOSPITAL (ACU),45000316,66720,HC DESTRUCTION CILIARY BODY,450,1 ,$248.00 ,$186.00 ,$133.92 ,"$4,761.93 ",$159.71 ,"$2,116.41 ",$173.60 ,$248.00 ,$205.84 ,$307.44 ,$163.68 ,$235.60 ,$298.49 ,$198.40 ,$228.16 ,$248.00 ,$210.80 ,$235.60 ,$218.24 ,$188.48 ,$248.00 ,$248.00 ,$298.49 ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 ,"$2,179.90 ",$136.40 ,$223.20 ,"$2,116.41 ",$223.20 ,$133.92 ,$233.12 ,"$4,761.93 ",$228.16 ,$316.40 ,$225.68 ,"$2,116.41 ",$152.62 ,$152.62 ,$223.20 ,$185.08 ,$172.73 ,"$2,137.58 ",$248.00 ,$235.60 ,"$2,222.24 ",$248.00 ,$215.76 ,"$2,116.41 ",$223.20 ,"$2,116.41 ",$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),45000317,67208,HC TX RETINAL LESION,450,1 ,$248.00 ,$186.00 ,$102.33 ,$622.50 ,$159.71 ,$276.67 ,$173.60 ,$102.33 ,$205.84 ,$105.40 ,$163.68 ,$235.60 ,$102.33 ,$198.40 ,$228.16 ,$102.33 ,$210.80 ,$235.60 ,$218.24 ,$188.48 ,$102.33 ,$102.33 ,$102.33 ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 ,$284.97 ,$136.40 ,$223.20 ,$276.67 ,$223.20 ,$133.92 ,$233.12 ,$622.50 ,$228.16 ,$108.47 ,$225.68 ,$276.67 ,$152.62 ,$152.62 ,$223.20 ,$185.08 ,$172.73 ,$279.43 ,$102.33 ,$235.60 ,$290.50 ,$102.33 ,$215.76 ,$276.67 ,$223.20 ,$276.67 ,$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),45000325,24655,HC CLOSED TX FX RADIAL HEAD/NECK W/MANIP,450,1 ,"$3,746.00 ","$2,809.50 ",$144.24 ,"$3,746.00 ","$2,412.42 ","$1,473.12 ","$2,622.20 ",$144.24 ,"$3,109.18 ",$148.57 ,"$2,472.36 ","$3,558.70 ",$144.24 ,"$2,996.80 ","$3,446.32 ",$144.24 ,"$3,184.10 ","$3,558.70 ","$3,296.48 ","$2,846.96 ",$144.24 ,$144.24 ,$144.24 ,"$2,734.58 ","$2,060.30 ","$3,408.86 ","$3,408.86 ","$2,996.80 ","$1,517.31 ","$2,060.30 ","$3,371.40 ","$1,473.12 ","$3,371.40 ","$2,022.84 ","$3,521.24 ","$3,314.53 ","$3,446.32 ",$152.89 ,"$3,408.86 ","$1,473.12 ","$2,305.29 ","$2,305.29 ","$3,371.40 ","$2,795.64 ","$2,609.09 ","$1,487.85 ",$144.24 ,"$3,558.70 ","$1,546.78 ",$144.24 ,"$3,259.02 ","$1,473.12 ","$3,371.40 ","$1,473.12 ","$3,371.40 ","$3,371.40 ","$3,371.40 ","$3,633.62 ","$3,034.26 ","$3,483.78 ","$3,221.56 ","$3,633.62 "
SACRED HEART HOSPITAL (ACU),45000328,27550,HC CLSD TX KNEE DISLOC W/O ANESTH,450,1 ,$592.00 ,$444.00 ,$144.24 ,$592.00 ,$381.25 ,$217.99 ,$414.40 ,$144.24 ,$491.36 ,$148.57 ,$390.72 ,$562.40 ,$144.24 ,$473.60 ,$544.64 ,$144.24 ,$503.20 ,$562.40 ,$520.96 ,$449.92 ,$144.24 ,$144.24 ,$144.24 ,$432.16 ,$325.60 ,$538.72 ,$538.72 ,$473.60 ,$224.53 ,$325.60 ,$532.80 ,$217.99 ,$532.80 ,$319.68 ,$556.48 ,$490.48 ,$544.64 ,$152.89 ,$538.72 ,$217.99 ,$364.32 ,$364.32 ,$532.80 ,$441.81 ,$412.33 ,$220.17 ,$144.24 ,$562.40 ,$228.89 ,$144.24 ,$515.04 ,$217.99 ,$532.80 ,$217.99 ,$532.80 ,$532.80 ,$532.80 ,$574.24 ,$479.52 ,$550.56 ,$509.12 ,$574.24 
SACRED HEART HOSPITAL (ACU),45000329,27752,HC CLSD TX FX TIBIAL SHAFT W/MANIP,450,1 ,"$4,343.00 ","$3,257.25 ",$144.24 ,"$4,343.00 ","$2,796.89 ","$1,473.12 ","$3,040.10 ",$144.24 ,"$3,604.69 ",$148.57 ,"$2,866.38 ","$4,125.85 ",$144.24 ,"$3,474.40 ","$3,995.56 ",$144.24 ,"$3,691.55 ","$4,125.85 ","$3,821.84 ","$3,300.68 ",$144.24 ,$144.24 ,$144.24 ,"$3,170.39 ","$2,388.65 ","$3,952.13 ","$3,952.13 ","$3,474.40 ","$1,517.31 ","$2,388.65 ","$3,908.70 ","$1,473.12 ","$3,908.70 ","$2,345.22 ","$4,082.42 ","$3,314.53 ","$3,995.56 ",$152.89 ,"$3,952.13 ","$1,473.12 ","$2,672.68 ","$2,672.68 ","$3,908.70 ","$3,241.18 ","$3,024.90 ","$1,487.85 ",$144.24 ,"$4,125.85 ","$1,546.78 ",$144.24 ,"$3,778.41 ","$1,473.12 ","$3,908.70 ","$1,473.12 ","$3,908.70 ","$3,908.70 ","$3,908.70 ","$4,212.71 ","$3,517.83 ","$4,038.99 ","$3,734.98 ","$4,212.71 "
SACRED HEART HOSPITAL (ACU),45000332,27808,HC CLOSED TX FX BIMALLEOLAR W/O MANIP,450,1 ,$381.00 ,$285.75 ,$144.24 ,$490.48 ,$245.36 ,$217.99 ,$266.70 ,$144.24 ,$316.23 ,$148.57 ,$251.46 ,$361.95 ,$144.24 ,$304.80 ,$350.52 ,$144.24 ,$323.85 ,$361.95 ,$335.28 ,$289.56 ,$144.24 ,$144.24 ,$144.24 ,$278.13 ,$209.55 ,$346.71 ,$346.71 ,$304.80 ,$224.53 ,$209.55 ,$342.90 ,$217.99 ,$342.90 ,$205.74 ,$358.14 ,$490.48 ,$350.52 ,$152.89 ,$346.71 ,$217.99 ,$234.47 ,$234.47 ,$342.90 ,$284.34 ,$265.37 ,$220.17 ,$144.24 ,$361.95 ,$228.89 ,$144.24 ,$331.47 ,$217.99 ,$342.90 ,$217.99 ,$342.90 ,$342.90 ,$342.90 ,$369.57 ,$308.61 ,$354.33 ,$327.66 ,$369.57 
SACRED HEART HOSPITAL (ACU),45000334,29260,HC STRAPPING ELBOW/WRIST,450,1 ,$156.00 ,$117.00 ,$14.12 ,$156.00 ,$100.46 ,$58.87 ,$109.20 ,$14.12 ,$129.48 ,$14.54 ,$102.96 ,$148.20 ,$14.12 ,$124.80 ,$143.52 ,$14.12 ,$132.60 ,$148.20 ,$137.28 ,$118.56 ,$14.12 ,$14.12 ,$14.12 ,$113.88 ,$85.80 ,$141.96 ,$141.96 ,$124.80 ,$60.64 ,$85.80 ,$140.40 ,$58.87 ,$140.40 ,$84.24 ,$146.64 ,$132.46 ,$143.52 ,$14.97 ,$141.96 ,$58.87 ,$96.00 ,$96.00 ,$140.40 ,$116.42 ,$108.65 ,$59.46 ,$14.12 ,$148.20 ,$61.82 ,$14.12 ,$135.72 ,$58.87 ,$140.40 ,$58.87 ,$140.40 ,$140.40 ,$140.40 ,$151.32 ,$126.36 ,$145.08 ,$134.16 ,$151.32 
SACRED HEART HOSPITAL (ACU),45000335,29530,HC STRAPPING KNEE,450,1 ,$317.00 ,$237.75 ,$14.12 ,$317.00 ,$204.15 ,$119.26 ,$221.90 ,$14.12 ,$263.11 ,$14.54 ,$209.22 ,$301.15 ,$14.12 ,$253.60 ,$291.64 ,$14.12 ,$269.45 ,$301.15 ,$278.96 ,$240.92 ,$14.12 ,$14.12 ,$14.12 ,$231.41 ,$174.35 ,$288.47 ,$288.47 ,$253.60 ,$122.84 ,$174.35 ,$285.30 ,$119.26 ,$285.30 ,$171.18 ,$297.98 ,$268.33 ,$291.64 ,$14.97 ,$288.47 ,$119.26 ,$195.08 ,$195.08 ,$285.30 ,$236.58 ,$220.79 ,$120.45 ,$14.12 ,$301.15 ,$125.22 ,$14.12 ,$275.79 ,$119.26 ,$285.30 ,$119.26 ,$285.30 ,$285.30 ,$285.30 ,$307.49 ,$256.77 ,$294.81 ,$272.62 ,$307.49 
SACRED HEART HOSPITAL (ACU),45000336,29550,HC STRAPPING TOES,450,1 ,$107.00 ,$80.25 ,$14.12 ,$132.46 ,$68.91 ,$58.87 ,$74.90 ,$14.12 ,$88.81 ,$14.54 ,$70.62 ,$101.65 ,$14.12 ,$85.60 ,$98.44 ,$14.12 ,$90.95 ,$101.65 ,$94.16 ,$81.32 ,$14.12 ,$14.12 ,$14.12 ,$78.11 ,$58.85 ,$97.37 ,$97.37 ,$85.60 ,$60.64 ,$58.85 ,$96.30 ,$58.87 ,$96.30 ,$57.78 ,$100.58 ,$132.46 ,$98.44 ,$14.97 ,$97.37 ,$58.87 ,$65.85 ,$65.85 ,$96.30 ,$79.85 ,$74.53 ,$59.46 ,$14.12 ,$101.65 ,$61.82 ,$14.12 ,$93.09 ,$58.87 ,$96.30 ,$58.87 ,$96.30 ,$96.30 ,$96.30 ,$103.79 ,$86.67 ,$99.51 ,$92.02 ,$103.79 
SACRED HEART HOSPITAL (ACU),45000346,23625,HC CLOSED TX GR TUBER HUM FX W/MANIP,450,1 ,$409.00 ,$306.75 ,$144.24 ,"$3,314.53 ",$263.40 ,"$1,473.12 ",$286.30 ,$144.24 ,$339.47 ,$148.57 ,$269.94 ,$388.55 ,$144.24 ,$327.20 ,$376.28 ,$144.24 ,$347.65 ,$388.55 ,$359.92 ,$310.84 ,$144.24 ,$144.24 ,$144.24 ,$298.57 ,$224.95 ,$372.19 ,$372.19 ,$327.20 ,"$1,517.31 ",$224.95 ,$368.10 ,"$1,473.12 ",$368.10 ,$220.86 ,$384.46 ,"$3,314.53 ",$376.28 ,$152.89 ,$372.19 ,"$1,473.12 ",$251.70 ,$251.70 ,$368.10 ,$305.24 ,$284.87 ,"$1,487.85 ",$144.24 ,$388.55 ,"$1,546.78 ",$144.24 ,$355.83 ,"$1,473.12 ",$368.10 ,"$1,473.12 ",$368.10 ,$368.10 ,$368.10 ,$396.73 ,$331.29 ,$380.37 ,$351.74 ,$396.73 
SACRED HEART HOSPITAL (ACU),45000347,28665,HC CLSD TX DISLOC (I-P) JOINT W/ANES,450,1 ,$223.00 ,$167.25 ,$120.42 ,$574.08 ,$143.61 ,$255.15 ,$156.10 ,$223.00 ,$185.09 ,$330.15 ,$147.18 ,$211.85 ,$320.53 ,$178.40 ,$205.16 ,$223.00 ,$189.55 ,$211.85 ,$196.24 ,$169.48 ,$223.00 ,$223.00 ,$320.53 ,$162.79 ,$122.65 ,$202.93 ,$202.93 ,$178.40 ,$262.80 ,$122.65 ,$200.70 ,$255.15 ,$200.70 ,$120.42 ,$209.62 ,$574.08 ,$205.16 ,$339.76 ,$202.93 ,$255.15 ,$137.23 ,$137.23 ,$200.70 ,$166.42 ,$155.32 ,$257.70 ,$223.00 ,$211.85 ,$267.90 ,$223.00 ,$194.01 ,$255.15 ,$200.70 ,$255.15 ,$200.70 ,$200.70 ,$200.70 ,$216.31 ,$180.63 ,$207.39 ,$191.78 ,$216.31 
SACRED HEART HOSPITAL (ACU),45000350,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-LT,450,1 ,$96.00 ,$72.00 ,$36.07 ,$132.46 ,$61.82 ,$58.87 ,$67.20 ,$36.07 ,$79.68 ,$37.15 ,$63.36 ,$91.20 ,$36.07 ,$76.80 ,$88.32 ,$36.07 ,$81.60 ,$91.20 ,$84.48 ,$72.96 ,$36.07 ,$36.07 ,$36.07 ,$70.08 ,$52.80 ,$87.36 ,$87.36 ,$76.80 ,$60.64 ,$52.80 ,$86.40 ,$58.87 ,$86.40 ,$51.84 ,$90.24 ,$132.46 ,$88.32 ,$38.23 ,$87.36 ,$58.87 ,$59.08 ,$59.08 ,$86.40 ,$71.64 ,$66.86 ,$59.46 ,$36.07 ,$91.20 ,$61.82 ,$36.07 ,$83.52 ,$58.87 ,$86.40 ,$58.87 ,$86.40 ,$86.40 ,$86.40 ,$93.12 ,$77.76 ,$89.28 ,$82.56 ,$93.12 
SACRED HEART HOSPITAL (ACU),45000351,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-RT,450,1 ,$96.00 ,$72.00 ,$36.07 ,$132.46 ,$61.82 ,$58.87 ,$67.20 ,$36.07 ,$79.68 ,$37.15 ,$63.36 ,$91.20 ,$36.07 ,$76.80 ,$88.32 ,$36.07 ,$81.60 ,$91.20 ,$84.48 ,$72.96 ,$36.07 ,$36.07 ,$36.07 ,$70.08 ,$52.80 ,$87.36 ,$87.36 ,$76.80 ,$60.64 ,$52.80 ,$86.40 ,$58.87 ,$86.40 ,$51.84 ,$90.24 ,$132.46 ,$88.32 ,$38.23 ,$87.36 ,$58.87 ,$59.08 ,$59.08 ,$86.40 ,$71.64 ,$66.86 ,$59.46 ,$36.07 ,$91.20 ,$61.82 ,$36.07 ,$83.52 ,$58.87 ,$86.40 ,$58.87 ,$86.40 ,$86.40 ,$86.40 ,$93.12 ,$77.76 ,$89.28 ,$82.56 ,$93.12 
SACRED HEART HOSPITAL (ACU),45000352,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNI-50,450,1 ,$96.00 ,$72.00 ,$51.84 ,$132.46 ,$61.82 ,$58.87 ,$67.20 ,$54.11 ,$79.68 ,$55.73 ,$63.36 ,$91.20 ,$54.11 ,$76.80 ,$88.32 ,$54.11 ,$81.60 ,$91.20 ,$84.48 ,$72.96 ,$54.11 ,$54.11 ,$54.11 ,$70.08 ,$52.80 ,$87.36 ,$87.36 ,$76.80 ,$60.64 ,$52.80 ,$86.40 ,$58.87 ,$86.40 ,$51.84 ,$90.24 ,$132.46 ,$88.32 ,$57.36 ,$87.36 ,$58.87 ,$59.08 ,$59.08 ,$86.40 ,$71.64 ,$66.86 ,$59.46 ,$54.11 ,$91.20 ,$61.82 ,$54.11 ,$83.52 ,$58.87 ,$86.40 ,$58.87 ,$86.40 ,$86.40 ,$86.40 ,$93.12 ,$77.76 ,$89.28 ,$82.56 ,$93.12 
SACRED HEART HOSPITAL (ACU),45000353,21480,HC TX DISL JAW CLS-LT,450,1 ,$170.00 ,$127.50 ,$36.07 ,$490.48 ,$109.48 ,$217.99 ,$119.00 ,$36.07 ,$141.10 ,$37.15 ,$112.20 ,$161.50 ,$36.07 ,$136.00 ,$156.40 ,$36.07 ,$144.50 ,$161.50 ,$149.60 ,$129.20 ,$36.07 ,$36.07 ,$36.07 ,$124.10 ,$93.50 ,$154.70 ,$154.70 ,$136.00 ,$224.53 ,$93.50 ,$153.00 ,$217.99 ,$153.00 ,$91.80 ,$159.80 ,$490.48 ,$156.40 ,$38.23 ,$154.70 ,$217.99 ,$104.62 ,$104.62 ,$153.00 ,$126.87 ,$118.41 ,$220.17 ,$36.07 ,$161.50 ,$228.89 ,$36.07 ,$147.90 ,$217.99 ,$153.00 ,$217.99 ,$153.00 ,$153.00 ,$153.00 ,$164.90 ,$137.70 ,$158.10 ,$146.20 ,$164.90 
SACRED HEART HOSPITAL (ACU),45000354,21480,HC TX DISL JAW CLS-RT,450,1 ,$170.00 ,$127.50 ,$36.07 ,$490.48 ,$109.48 ,$217.99 ,$119.00 ,$36.07 ,$141.10 ,$37.15 ,$112.20 ,$161.50 ,$36.07 ,$136.00 ,$156.40 ,$36.07 ,$144.50 ,$161.50 ,$149.60 ,$129.20 ,$36.07 ,$36.07 ,$36.07 ,$124.10 ,$93.50 ,$154.70 ,$154.70 ,$136.00 ,$224.53 ,$93.50 ,$153.00 ,$217.99 ,$153.00 ,$91.80 ,$159.80 ,$490.48 ,$156.40 ,$38.23 ,$154.70 ,$217.99 ,$104.62 ,$104.62 ,$153.00 ,$126.87 ,$118.41 ,$220.17 ,$36.07 ,$161.50 ,$228.89 ,$36.07 ,$147.90 ,$217.99 ,$153.00 ,$217.99 ,$153.00 ,$153.00 ,$153.00 ,$164.90 ,$137.70 ,$158.10 ,$146.20 ,$164.90 
SACRED HEART HOSPITAL (ACU),45000355,23625,HC CLOSED TX GR TUBER HUM FX W/MANIP-LT,450,1 ,$409.00 ,$306.75 ,$144.24 ,"$3,314.53 ",$263.40 ,"$1,473.12 ",$286.30 ,$144.24 ,$339.47 ,$148.57 ,$269.94 ,$388.55 ,$144.24 ,$327.20 ,$376.28 ,$144.24 ,$347.65 ,$388.55 ,$359.92 ,$310.84 ,$144.24 ,$144.24 ,$144.24 ,$298.57 ,$224.95 ,$372.19 ,$372.19 ,$327.20 ,"$1,517.31 ",$224.95 ,$368.10 ,"$1,473.12 ",$368.10 ,$220.86 ,$384.46 ,"$3,314.53 ",$376.28 ,$152.89 ,$372.19 ,"$1,473.12 ",$251.70 ,$251.70 ,$368.10 ,$305.24 ,$284.87 ,"$1,487.85 ",$144.24 ,$388.55 ,"$1,546.78 ",$144.24 ,$355.83 ,"$1,473.12 ",$368.10 ,"$1,473.12 ",$368.10 ,$368.10 ,$368.10 ,$396.73 ,$331.29 ,$380.37 ,$351.74 ,$396.73 
SACRED HEART HOSPITAL (ACU),45000356,23625,HC CLOSED TX GR TUBER HUM FX W/MANIP-RT,450,1 ,$409.00 ,$306.75 ,$144.24 ,"$3,314.53 ",$263.40 ,"$1,473.12 ",$286.30 ,$144.24 ,$339.47 ,$148.57 ,$269.94 ,$388.55 ,$144.24 ,$327.20 ,$376.28 ,$144.24 ,$347.65 ,$388.55 ,$359.92 ,$310.84 ,$144.24 ,$144.24 ,$144.24 ,$298.57 ,$224.95 ,$372.19 ,$372.19 ,$327.20 ,"$1,517.31 ",$224.95 ,$368.10 ,"$1,473.12 ",$368.10 ,$220.86 ,$384.46 ,"$3,314.53 ",$376.28 ,$152.89 ,$372.19 ,"$1,473.12 ",$251.70 ,$251.70 ,$368.10 ,$305.24 ,$284.87 ,"$1,487.85 ",$144.24 ,$388.55 ,"$1,546.78 ",$144.24 ,$355.83 ,"$1,473.12 ",$368.10 ,"$1,473.12 ",$368.10 ,$368.10 ,$368.10 ,$396.73 ,$331.29 ,$380.37 ,$351.74 ,$396.73 
SACRED HEART HOSPITAL (ACU),45000357,23650,HC TX DISL SHLDR W/MAN CLS-LT,450,1 ,$388.00 ,$291.00 ,$144.24 ,$490.48 ,$249.87 ,$217.99 ,$271.60 ,$144.24 ,$322.04 ,$148.57 ,$256.08 ,$368.60 ,$144.24 ,$310.40 ,$356.96 ,$144.24 ,$329.80 ,$368.60 ,$341.44 ,$294.88 ,$144.24 ,$144.24 ,$144.24 ,$283.24 ,$213.40 ,$353.08 ,$353.08 ,$310.40 ,$224.53 ,$213.40 ,$349.20 ,$217.99 ,$349.20 ,$209.52 ,$364.72 ,$490.48 ,$356.96 ,$152.89 ,$353.08 ,$217.99 ,$238.78 ,$238.78 ,$349.20 ,$289.56 ,$270.24 ,$220.17 ,$144.24 ,$368.60 ,$228.89 ,$144.24 ,$337.56 ,$217.99 ,$349.20 ,$217.99 ,$349.20 ,$349.20 ,$349.20 ,$376.36 ,$314.28 ,$360.84 ,$333.68 ,$376.36 
SACRED HEART HOSPITAL (ACU),45000358,23650,HC TX DISL SHLDR W/MAN CLS-RT,450,1 ,$388.00 ,$291.00 ,$144.24 ,$490.48 ,$249.87 ,$217.99 ,$271.60 ,$144.24 ,$322.04 ,$148.57 ,$256.08 ,$368.60 ,$144.24 ,$310.40 ,$356.96 ,$144.24 ,$329.80 ,$368.60 ,$341.44 ,$294.88 ,$144.24 ,$144.24 ,$144.24 ,$283.24 ,$213.40 ,$353.08 ,$353.08 ,$310.40 ,$224.53 ,$213.40 ,$349.20 ,$217.99 ,$349.20 ,$209.52 ,$364.72 ,$490.48 ,$356.96 ,$152.89 ,$353.08 ,$217.99 ,$238.78 ,$238.78 ,$349.20 ,$289.56 ,$270.24 ,$220.17 ,$144.24 ,$368.60 ,$228.89 ,$144.24 ,$337.56 ,$217.99 ,$349.20 ,$217.99 ,$349.20 ,$349.20 ,$349.20 ,$376.36 ,$314.28 ,$360.84 ,$333.68 ,$376.36 
SACRED HEART HOSPITAL (ACU),45000359,23655,HC TX DISL SHLDR W/MAN/ANES CLS-LT,450,1 ,$149.00 ,$111.75 ,$80.46 ,"$3,314.53 ",$95.96 ,"$1,473.12 ",$104.30 ,$149.00 ,$123.67 ,$330.15 ,$98.34 ,$141.55 ,$320.53 ,$119.20 ,$137.08 ,$149.00 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$149.00 ,$149.00 ,$320.53 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,"$1,517.31 ",$81.95 ,$134.10 ,"$1,473.12 ",$134.10 ,$80.46 ,$140.06 ,"$3,314.53 ",$137.08 ,$339.76 ,$135.59 ,"$1,473.12 ",$91.69 ,$91.69 ,$134.10 ,$111.20 ,$103.78 ,"$1,487.85 ",$149.00 ,$141.55 ,"$1,546.78 ",$149.00 ,$129.63 ,"$1,473.12 ",$134.10 ,"$1,473.12 ",$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),45000360,23655,HC TX DISL SHLDR W/MAN/ANES CLS-RT,450,1 ,$149.00 ,$111.75 ,$80.46 ,"$3,314.53 ",$95.96 ,"$1,473.12 ",$104.30 ,$149.00 ,$123.67 ,$330.15 ,$98.34 ,$141.55 ,$320.53 ,$119.20 ,$137.08 ,$149.00 ,$126.65 ,$141.55 ,$131.12 ,$113.24 ,$149.00 ,$149.00 ,$320.53 ,$108.77 ,$81.95 ,$135.59 ,$135.59 ,$119.20 ,"$1,517.31 ",$81.95 ,$134.10 ,"$1,473.12 ",$134.10 ,$80.46 ,$140.06 ,"$3,314.53 ",$137.08 ,$339.76 ,$135.59 ,"$1,473.12 ",$91.69 ,$91.69 ,$134.10 ,$111.20 ,$103.78 ,"$1,487.85 ",$149.00 ,$141.55 ,"$1,546.78 ",$149.00 ,$129.63 ,"$1,473.12 ",$134.10 ,"$1,473.12 ",$134.10 ,$134.10 ,$134.10 ,$144.53 ,$120.69 ,$138.57 ,$128.14 ,$144.53 
SACRED HEART HOSPITAL (ACU),45000361,23931,HC I AND D BURSA ELBOW/ARM-LT,450,1 ,$370.15 ,$277.61 ,$199.88 ,"$3,348.27 ",$238.38 ,"$1,488.12 ",$259.11 ,$370.15 ,$307.22 ,$583.43 ,$244.30 ,$351.64 ,$566.44 ,$296.12 ,$340.54 ,$370.15 ,$314.63 ,$351.64 ,$325.73 ,$281.31 ,$370.15 ,$370.15 ,$566.44 ,$270.21 ,$203.58 ,$336.84 ,$336.84 ,$296.12 ,"$1,532.76 ",$203.58 ,$333.14 ,"$1,488.12 ",$333.14 ,$199.88 ,$347.94 ,"$3,348.27 ",$340.54 ,$600.43 ,$336.84 ,"$1,488.12 ",$227.79 ,$227.79 ,$333.14 ,$276.24 ,$257.81 ,"$1,503.00 ",$370.15 ,$351.64 ,"$1,562.52 ",$370.15 ,$322.03 ,"$1,488.12 ",$333.14 ,"$1,488.12 ",$333.14 ,$333.14 ,$333.14 ,$359.05 ,$299.82 ,$344.24 ,$318.33 ,$359.05 
SACRED HEART HOSPITAL (ACU),45000362,23931,HC I AND D BURSA ELBOW/ARM-RT,450,1 ,$370.15 ,$277.61 ,$199.88 ,"$3,348.27 ",$238.38 ,"$1,488.12 ",$259.11 ,$370.15 ,$307.22 ,$583.43 ,$244.30 ,$351.64 ,$566.44 ,$296.12 ,$340.54 ,$370.15 ,$314.63 ,$351.64 ,$325.73 ,$281.31 ,$370.15 ,$370.15 ,$566.44 ,$270.21 ,$203.58 ,$336.84 ,$336.84 ,$296.12 ,"$1,532.76 ",$203.58 ,$333.14 ,"$1,488.12 ",$333.14 ,$199.88 ,$347.94 ,"$3,348.27 ",$340.54 ,$600.43 ,$336.84 ,"$1,488.12 ",$227.79 ,$227.79 ,$333.14 ,$276.24 ,$257.81 ,"$1,503.00 ",$370.15 ,$351.64 ,"$1,562.52 ",$370.15 ,$322.03 ,"$1,488.12 ",$333.14 ,"$1,488.12 ",$333.14 ,$333.14 ,$333.14 ,$359.05 ,$299.82 ,$344.24 ,$318.33 ,$359.05 
SACRED HEART HOSPITAL (ACU),45000363,24565,HC CLOSED TX HUMERUS EPICONDYLR FX W/MANIP-LT,450,1 ,$369.00 ,$276.75 ,$144.24 ,"$3,314.53 ",$237.64 ,"$1,473.12 ",$258.30 ,$144.24 ,$306.27 ,$148.57 ,$243.54 ,$350.55 ,$144.24 ,$295.20 ,$339.48 ,$144.24 ,$313.65 ,$350.55 ,$324.72 ,$280.44 ,$144.24 ,$144.24 ,$144.24 ,$269.37 ,$202.95 ,$335.79 ,$335.79 ,$295.20 ,"$1,517.31 ",$202.95 ,$332.10 ,"$1,473.12 ",$332.10 ,$199.26 ,$346.86 ,"$3,314.53 ",$339.48 ,$152.89 ,$335.79 ,"$1,473.12 ",$227.08 ,$227.08 ,$332.10 ,$275.38 ,$257.01 ,"$1,487.85 ",$144.24 ,$350.55 ,"$1,546.78 ",$144.24 ,$321.03 ,"$1,473.12 ",$332.10 ,"$1,473.12 ",$332.10 ,$332.10 ,$332.10 ,$357.93 ,$298.89 ,$343.17 ,$317.34 ,$357.93 
SACRED HEART HOSPITAL (ACU),45000364,24565,HC CLOSED TX HUMERUS EPICONDYLR FX W/MANIP-RT,450,1 ,$369.00 ,$276.75 ,$144.24 ,"$3,314.53 ",$237.64 ,"$1,473.12 ",$258.30 ,$144.24 ,$306.27 ,$148.57 ,$243.54 ,$350.55 ,$144.24 ,$295.20 ,$339.48 ,$144.24 ,$313.65 ,$350.55 ,$324.72 ,$280.44 ,$144.24 ,$144.24 ,$144.24 ,$269.37 ,$202.95 ,$335.79 ,$335.79 ,$295.20 ,"$1,517.31 ",$202.95 ,$332.10 ,"$1,473.12 ",$332.10 ,$199.26 ,$346.86 ,"$3,314.53 ",$339.48 ,$152.89 ,$335.79 ,"$1,473.12 ",$227.08 ,$227.08 ,$332.10 ,$275.38 ,$257.01 ,"$1,487.85 ",$144.24 ,$350.55 ,"$1,546.78 ",$144.24 ,$321.03 ,"$1,473.12 ",$332.10 ,"$1,473.12 ",$332.10 ,$332.10 ,$332.10 ,$357.93 ,$298.89 ,$343.17 ,$317.34 ,$357.93 
SACRED HEART HOSPITAL (ACU),45000365,24600,HC TX DISL ELBOW W/O ANES CLS-LT,450,1 ,$168.00 ,$126.00 ,$90.72 ,$490.48 ,$108.19 ,$217.99 ,$117.60 ,$144.24 ,$139.44 ,$148.57 ,$110.88 ,$159.60 ,$144.24 ,$134.40 ,$154.56 ,$144.24 ,$142.80 ,$159.60 ,$147.84 ,$127.68 ,$144.24 ,$144.24 ,$144.24 ,$122.64 ,$92.40 ,$152.88 ,$152.88 ,$134.40 ,$224.53 ,$92.40 ,$151.20 ,$217.99 ,$151.20 ,$90.72 ,$157.92 ,$490.48 ,$154.56 ,$152.89 ,$152.88 ,$217.99 ,$103.39 ,$103.39 ,$151.20 ,$125.38 ,$117.01 ,$220.17 ,$144.24 ,$159.60 ,$228.89 ,$144.24 ,$146.16 ,$217.99 ,$151.20 ,$217.99 ,$151.20 ,$151.20 ,$151.20 ,$162.96 ,$136.08 ,$156.24 ,$144.48 ,$162.96 
SACRED HEART HOSPITAL (ACU),45000366,24600,HC TX DISL ELBOW W/O ANES CLS-RT,450,1 ,$168.00 ,$126.00 ,$90.72 ,$490.48 ,$108.19 ,$217.99 ,$117.60 ,$144.24 ,$139.44 ,$148.57 ,$110.88 ,$159.60 ,$144.24 ,$134.40 ,$154.56 ,$144.24 ,$142.80 ,$159.60 ,$147.84 ,$127.68 ,$144.24 ,$144.24 ,$144.24 ,$122.64 ,$92.40 ,$152.88 ,$152.88 ,$134.40 ,$224.53 ,$92.40 ,$151.20 ,$217.99 ,$151.20 ,$90.72 ,$157.92 ,$490.48 ,$154.56 ,$152.89 ,$152.88 ,$217.99 ,$103.39 ,$103.39 ,$151.20 ,$125.38 ,$117.01 ,$220.17 ,$144.24 ,$159.60 ,$228.89 ,$144.24 ,$146.16 ,$217.99 ,$151.20 ,$217.99 ,$151.20 ,$151.20 ,$151.20 ,$162.96 ,$136.08 ,$156.24 ,$144.48 ,$162.96 
SACRED HEART HOSPITAL (ACU),45000367,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP-LT,450,1 ,$369.00 ,$276.75 ,$144.24 ,"$3,314.53 ",$237.64 ,"$1,473.12 ",$258.30 ,$144.24 ,$306.27 ,$148.57 ,$243.54 ,$350.55 ,$144.24 ,$295.20 ,$339.48 ,$144.24 ,$313.65 ,$350.55 ,$324.72 ,$280.44 ,$144.24 ,$144.24 ,$144.24 ,$269.37 ,$202.95 ,$335.79 ,$335.79 ,$295.20 ,"$1,517.31 ",$202.95 ,$332.10 ,"$1,473.12 ",$332.10 ,$199.26 ,$346.86 ,"$3,314.53 ",$339.48 ,$152.89 ,$335.79 ,"$1,473.12 ",$227.08 ,$227.08 ,$332.10 ,$275.38 ,$257.01 ,"$1,487.85 ",$144.24 ,$350.55 ,"$1,546.78 ",$144.24 ,$321.03 ,"$1,473.12 ",$332.10 ,"$1,473.12 ",$332.10 ,$332.10 ,$332.10 ,$357.93 ,$298.89 ,$343.17 ,$317.34 ,$357.93 
SACRED HEART HOSPITAL (ACU),45000368,24620,HC CLOSED TX ELBOW FRACTURE W/MANIP-RT,450,1 ,$369.00 ,$276.75 ,$144.24 ,"$3,314.53 ",$237.64 ,"$1,473.12 ",$258.30 ,$144.24 ,$306.27 ,$148.57 ,$243.54 ,$350.55 ,$144.24 ,$295.20 ,$339.48 ,$144.24 ,$313.65 ,$350.55 ,$324.72 ,$280.44 ,$144.24 ,$144.24 ,$144.24 ,$269.37 ,$202.95 ,$335.79 ,$335.79 ,$295.20 ,"$1,517.31 ",$202.95 ,$332.10 ,"$1,473.12 ",$332.10 ,$199.26 ,$346.86 ,"$3,314.53 ",$339.48 ,$152.89 ,$335.79 ,"$1,473.12 ",$227.08 ,$227.08 ,$332.10 ,$275.38 ,$257.01 ,"$1,487.85 ",$144.24 ,$350.55 ,"$1,546.78 ",$144.24 ,$321.03 ,"$1,473.12 ",$332.10 ,"$1,473.12 ",$332.10 ,$332.10 ,$332.10 ,$357.93 ,$298.89 ,$343.17 ,$317.34 ,$357.93 
SACRED HEART HOSPITAL (ACU),45000369,24640,HC DISLOCATION NURSEMAID ELBOW-LT,450,1 ,$134.00 ,$100.50 ,$72.36 ,$490.48 ,$86.30 ,$217.99 ,$93.80 ,$134.00 ,$111.22 ,$148.57 ,$88.44 ,$127.30 ,$144.24 ,$107.20 ,$123.28 ,$134.00 ,$113.90 ,$127.30 ,$117.92 ,$101.84 ,$134.00 ,$134.00 ,$144.24 ,$97.82 ,$73.70 ,$121.94 ,$121.94 ,$107.20 ,$224.53 ,$73.70 ,$120.60 ,$217.99 ,$120.60 ,$72.36 ,$125.96 ,$490.48 ,$123.28 ,$152.89 ,$121.94 ,$217.99 ,$82.46 ,$82.46 ,$120.60 ,$100.00 ,$93.33 ,$220.17 ,$134.00 ,$127.30 ,$228.89 ,$134.00 ,$116.58 ,$217.99 ,$120.60 ,$217.99 ,$120.60 ,$120.60 ,$120.60 ,$129.98 ,$108.54 ,$124.62 ,$115.24 ,$129.98 
SACRED HEART HOSPITAL (ACU),45000370,24640,HC DISLOCATION NURSEMAID ELBOW-RT,450,1 ,$134.00 ,$100.50 ,$72.36 ,$490.48 ,$86.30 ,$217.99 ,$93.80 ,$134.00 ,$111.22 ,$148.57 ,$88.44 ,$127.30 ,$144.24 ,$107.20 ,$123.28 ,$134.00 ,$113.90 ,$127.30 ,$117.92 ,$101.84 ,$134.00 ,$134.00 ,$144.24 ,$97.82 ,$73.70 ,$121.94 ,$121.94 ,$107.20 ,$224.53 ,$73.70 ,$120.60 ,$217.99 ,$120.60 ,$72.36 ,$125.96 ,$490.48 ,$123.28 ,$152.89 ,$121.94 ,$217.99 ,$82.46 ,$82.46 ,$120.60 ,$100.00 ,$93.33 ,$220.17 ,$134.00 ,$127.30 ,$228.89 ,$134.00 ,$116.58 ,$217.99 ,$120.60 ,$217.99 ,$120.60 ,$120.60 ,$120.60 ,$129.98 ,$108.54 ,$124.62 ,$115.24 ,$129.98 
SACRED HEART HOSPITAL (ACU),45000371,25505,HC RADIUS FX W MANIP-LT,450,1 ,$522.00 ,$391.50 ,$144.24 ,"$3,314.53 ",$336.17 ,"$1,473.12 ",$365.40 ,$144.24 ,$433.26 ,$148.57 ,$344.52 ,$495.90 ,$144.24 ,$417.60 ,$480.24 ,$144.24 ,$443.70 ,$495.90 ,$459.36 ,$396.72 ,$144.24 ,$144.24 ,$144.24 ,$381.06 ,$287.10 ,$475.02 ,$475.02 ,$417.60 ,"$1,517.31 ",$287.10 ,$469.80 ,"$1,473.12 ",$469.80 ,$281.88 ,$490.68 ,"$3,314.53 ",$480.24 ,$152.89 ,$475.02 ,"$1,473.12 ",$321.24 ,$321.24 ,$469.80 ,$389.57 ,$363.57 ,"$1,487.85 ",$144.24 ,$495.90 ,"$1,546.78 ",$144.24 ,$454.14 ,"$1,473.12 ",$469.80 ,"$1,473.12 ",$469.80 ,$469.80 ,$469.80 ,$506.34 ,$422.82 ,$485.46 ,$448.92 ,$506.34 
SACRED HEART HOSPITAL (ACU),45000372,25505,HC RADIUS FX W MANIP-RT,450,1 ,$522.00 ,$391.50 ,$144.24 ,"$3,314.53 ",$336.17 ,"$1,473.12 ",$365.40 ,$144.24 ,$433.26 ,$148.57 ,$344.52 ,$495.90 ,$144.24 ,$417.60 ,$480.24 ,$144.24 ,$443.70 ,$495.90 ,$459.36 ,$396.72 ,$144.24 ,$144.24 ,$144.24 ,$381.06 ,$287.10 ,$475.02 ,$475.02 ,$417.60 ,"$1,517.31 ",$287.10 ,$469.80 ,"$1,473.12 ",$469.80 ,$281.88 ,$490.68 ,"$3,314.53 ",$480.24 ,$152.89 ,$475.02 ,"$1,473.12 ",$321.24 ,$321.24 ,$469.80 ,$389.57 ,$363.57 ,"$1,487.85 ",$144.24 ,$495.90 ,"$1,546.78 ",$144.24 ,$454.14 ,"$1,473.12 ",$469.80 ,"$1,473.12 ",$469.80 ,$469.80 ,$469.80 ,$506.34 ,$422.82 ,$485.46 ,$448.92 ,$506.34 
SACRED HEART HOSPITAL (ACU),45000373,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP-LT,450,1 ,$538.00 ,$403.50 ,$144.24 ,"$3,314.53 ",$346.47 ,"$1,473.12 ",$376.60 ,$144.24 ,$446.54 ,$148.57 ,$355.08 ,$511.10 ,$144.24 ,$430.40 ,$494.96 ,$144.24 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$144.24 ,$144.24 ,$144.24 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,"$1,517.31 ",$295.90 ,$484.20 ,"$1,473.12 ",$484.20 ,$290.52 ,$505.72 ,"$3,314.53 ",$494.96 ,$152.89 ,$489.58 ,"$1,473.12 ",$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,"$1,487.85 ",$144.24 ,$511.10 ,"$1,546.78 ",$144.24 ,$468.06 ,"$1,473.12 ",$484.20 ,"$1,473.12 ",$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000374,25565,HC CL TX RADIAL/ULNAR SHAFT FX W MANIP-RT,450,1 ,$538.00 ,$403.50 ,$144.24 ,"$3,314.53 ",$346.47 ,"$1,473.12 ",$376.60 ,$144.24 ,$446.54 ,$148.57 ,$355.08 ,$511.10 ,$144.24 ,$430.40 ,$494.96 ,$144.24 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$144.24 ,$144.24 ,$144.24 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,"$1,517.31 ",$295.90 ,$484.20 ,"$1,473.12 ",$484.20 ,$290.52 ,$505.72 ,"$3,314.53 ",$494.96 ,$152.89 ,$489.58 ,"$1,473.12 ",$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,"$1,487.85 ",$144.24 ,$511.10 ,"$1,546.78 ",$144.24 ,$468.06 ,"$1,473.12 ",$484.20 ,"$1,473.12 ",$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000375,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-LT",450,1 ,$538.00 ,$403.50 ,$144.24 ,"$3,314.53 ",$346.47 ,"$1,473.12 ",$376.60 ,$144.24 ,$446.54 ,$148.57 ,$355.08 ,$511.10 ,$144.24 ,$430.40 ,$494.96 ,$144.24 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$144.24 ,$144.24 ,$144.24 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,"$1,517.31 ",$295.90 ,$484.20 ,"$1,473.12 ",$484.20 ,$290.52 ,$505.72 ,"$3,314.53 ",$494.96 ,$152.89 ,$489.58 ,"$1,473.12 ",$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,"$1,487.85 ",$144.24 ,$511.10 ,"$1,546.78 ",$144.24 ,$468.06 ,"$1,473.12 ",$484.20 ,"$1,473.12 ",$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000376,25605,"HC CLOSED TX DIST RAD/ULNA FX,MANIPUL-RT",450,1 ,$538.00 ,$403.50 ,$144.24 ,"$3,314.53 ",$346.47 ,"$1,473.12 ",$376.60 ,$144.24 ,$446.54 ,$148.57 ,$355.08 ,$511.10 ,$144.24 ,$430.40 ,$494.96 ,$144.24 ,$457.30 ,$511.10 ,$473.44 ,$408.88 ,$144.24 ,$144.24 ,$144.24 ,$392.74 ,$295.90 ,$489.58 ,$489.58 ,$430.40 ,"$1,517.31 ",$295.90 ,$484.20 ,"$1,473.12 ",$484.20 ,$290.52 ,$505.72 ,"$3,314.53 ",$494.96 ,$152.89 ,$489.58 ,"$1,473.12 ",$331.09 ,$331.09 ,$484.20 ,$401.51 ,$374.72 ,"$1,487.85 ",$144.24 ,$511.10 ,"$1,546.78 ",$144.24 ,$468.06 ,"$1,473.12 ",$484.20 ,"$1,473.12 ",$484.20 ,$484.20 ,$484.20 ,$521.86 ,$435.78 ,$500.34 ,$462.68 ,$521.86 
SACRED HEART HOSPITAL (ACU),45000377,25630,HC CLSD CARPAL BONE FX-LT,450,1 ,$280.00 ,$210.00 ,$144.24 ,$490.48 ,$180.32 ,$217.99 ,$196.00 ,$144.24 ,$232.40 ,$148.57 ,$184.80 ,$266.00 ,$144.24 ,$224.00 ,$257.60 ,$144.24 ,$238.00 ,$266.00 ,$246.40 ,$212.80 ,$144.24 ,$144.24 ,$144.24 ,$204.40 ,$154.00 ,$254.80 ,$254.80 ,$224.00 ,$224.53 ,$154.00 ,$252.00 ,$217.99 ,$252.00 ,$151.20 ,$263.20 ,$490.48 ,$257.60 ,$152.89 ,$254.80 ,$217.99 ,$172.31 ,$172.31 ,$252.00 ,$208.96 ,$195.02 ,$220.17 ,$144.24 ,$266.00 ,$228.89 ,$144.24 ,$243.60 ,$217.99 ,$252.00 ,$217.99 ,$252.00 ,$252.00 ,$252.00 ,$271.60 ,$226.80 ,$260.40 ,$240.80 ,$271.60 
SACRED HEART HOSPITAL (ACU),45000378,25630,HC CLSD CARPAL BONE FX-RT,450,1 ,$280.00 ,$210.00 ,$144.24 ,$490.48 ,$180.32 ,$217.99 ,$196.00 ,$144.24 ,$232.40 ,$148.57 ,$184.80 ,$266.00 ,$144.24 ,$224.00 ,$257.60 ,$144.24 ,$238.00 ,$266.00 ,$246.40 ,$212.80 ,$144.24 ,$144.24 ,$144.24 ,$204.40 ,$154.00 ,$254.80 ,$254.80 ,$224.00 ,$224.53 ,$154.00 ,$252.00 ,$217.99 ,$252.00 ,$151.20 ,$263.20 ,$490.48 ,$257.60 ,$152.89 ,$254.80 ,$217.99 ,$172.31 ,$172.31 ,$252.00 ,$208.96 ,$195.02 ,$220.17 ,$144.24 ,$266.00 ,$228.89 ,$144.24 ,$243.60 ,$217.99 ,$252.00 ,$217.99 ,$252.00 ,$252.00 ,$252.00 ,$271.60 ,$226.80 ,$260.40 ,$240.80 ,$271.60 
SACRED HEART HOSPITAL (ACU),45000379,26600,HC CLSD METACARPAL W/O MANIP-LT,450,1 ,$280.00 ,$210.00 ,$144.24 ,$490.48 ,$180.32 ,$217.99 ,$196.00 ,$144.24 ,$232.40 ,$148.57 ,$184.80 ,$266.00 ,$144.24 ,$224.00 ,$257.60 ,$144.24 ,$238.00 ,$266.00 ,$246.40 ,$212.80 ,$144.24 ,$144.24 ,$144.24 ,$204.40 ,$154.00 ,$254.80 ,$254.80 ,$224.00 ,$224.53 ,$154.00 ,$252.00 ,$217.99 ,$252.00 ,$151.20 ,$263.20 ,$490.48 ,$257.60 ,$152.89 ,$254.80 ,$217.99 ,$172.31 ,$172.31 ,$252.00 ,$208.96 ,$195.02 ,$220.17 ,$144.24 ,$266.00 ,$228.89 ,$144.24 ,$243.60 ,$217.99 ,$252.00 ,$217.99 ,$252.00 ,$252.00 ,$252.00 ,$271.60 ,$226.80 ,$260.40 ,$240.80 ,$271.60 
SACRED HEART HOSPITAL (ACU),45000380,26600,HC CLSD METACARPAL W/O MANIP-RT,450,1 ,$280.00 ,$210.00 ,$144.24 ,$490.48 ,$180.32 ,$217.99 ,$196.00 ,$144.24 ,$232.40 ,$148.57 ,$184.80 ,$266.00 ,$144.24 ,$224.00 ,$257.60 ,$144.24 ,$238.00 ,$266.00 ,$246.40 ,$212.80 ,$144.24 ,$144.24 ,$144.24 ,$204.40 ,$154.00 ,$254.80 ,$254.80 ,$224.00 ,$224.53 ,$154.00 ,$252.00 ,$217.99 ,$252.00 ,$151.20 ,$263.20 ,$490.48 ,$257.60 ,$152.89 ,$254.80 ,$217.99 ,$172.31 ,$172.31 ,$252.00 ,$208.96 ,$195.02 ,$220.17 ,$144.24 ,$266.00 ,$228.89 ,$144.24 ,$243.60 ,$217.99 ,$252.00 ,$217.99 ,$252.00 ,$252.00 ,$252.00 ,$271.60 ,$226.80 ,$260.40 ,$240.80 ,$271.60 
SACRED HEART HOSPITAL (ACU),45000381,26605,HC CLSD METACARPAL FX W/MANIP-LT,450,1 ,$320.00 ,$240.00 ,$144.24 ,$490.48 ,$206.08 ,$217.99 ,$224.00 ,$144.24 ,$265.60 ,$148.57 ,$211.20 ,$304.00 ,$144.24 ,$256.00 ,$294.40 ,$144.24 ,$272.00 ,$304.00 ,$281.60 ,$243.20 ,$144.24 ,$144.24 ,$144.24 ,$233.60 ,$176.00 ,$291.20 ,$291.20 ,$256.00 ,$224.53 ,$176.00 ,$288.00 ,$217.99 ,$288.00 ,$172.80 ,$300.80 ,$490.48 ,$294.40 ,$152.89 ,$291.20 ,$217.99 ,$196.93 ,$196.93 ,$288.00 ,$238.82 ,$222.88 ,$220.17 ,$144.24 ,$304.00 ,$228.89 ,$144.24 ,$278.40 ,$217.99 ,$288.00 ,$217.99 ,$288.00 ,$288.00 ,$288.00 ,$310.40 ,$259.20 ,$297.60 ,$275.20 ,$310.40 
SACRED HEART HOSPITAL (ACU),45000382,26605,HC CLSD METACARPAL FX W/MANIP-RT,450,1 ,$320.00 ,$240.00 ,$144.24 ,$490.48 ,$206.08 ,$217.99 ,$224.00 ,$144.24 ,$265.60 ,$148.57 ,$211.20 ,$304.00 ,$144.24 ,$256.00 ,$294.40 ,$144.24 ,$272.00 ,$304.00 ,$281.60 ,$243.20 ,$144.24 ,$144.24 ,$144.24 ,$233.60 ,$176.00 ,$291.20 ,$291.20 ,$256.00 ,$224.53 ,$176.00 ,$288.00 ,$217.99 ,$288.00 ,$172.80 ,$300.80 ,$490.48 ,$294.40 ,$152.89 ,$291.20 ,$217.99 ,$196.93 ,$196.93 ,$288.00 ,$238.82 ,$222.88 ,$220.17 ,$144.24 ,$304.00 ,$228.89 ,$144.24 ,$278.40 ,$217.99 ,$288.00 ,$217.99 ,$288.00 ,$288.00 ,$288.00 ,$310.40 ,$259.20 ,$297.60 ,$275.20 ,$310.40 
SACRED HEART HOSPITAL (ACU),45000383,26641,HC CLSD DISCL THUMB W/MANIP-LT,450,1 ,$327.00 ,$245.25 ,$144.24 ,$490.48 ,$210.59 ,$217.99 ,$228.90 ,$144.24 ,$271.41 ,$148.57 ,$215.82 ,$310.65 ,$144.24 ,$261.60 ,$300.84 ,$144.24 ,$277.95 ,$310.65 ,$287.76 ,$248.52 ,$144.24 ,$144.24 ,$144.24 ,$238.71 ,$179.85 ,$297.57 ,$297.57 ,$261.60 ,$224.53 ,$179.85 ,$294.30 ,$217.99 ,$294.30 ,$176.58 ,$307.38 ,$490.48 ,$300.84 ,$152.89 ,$297.57 ,$217.99 ,$201.24 ,$201.24 ,$294.30 ,$244.04 ,$227.76 ,$220.17 ,$144.24 ,$310.65 ,$228.89 ,$144.24 ,$284.49 ,$217.99 ,$294.30 ,$217.99 ,$294.30 ,$294.30 ,$294.30 ,$317.19 ,$264.87 ,$304.11 ,$281.22 ,$317.19 
SACRED HEART HOSPITAL (ACU),45000384,26641,HC CLSD DISCL THUMB W/MANIP-RT,450,1 ,$327.00 ,$245.25 ,$144.24 ,$490.48 ,$210.59 ,$217.99 ,$228.90 ,$144.24 ,$271.41 ,$148.57 ,$215.82 ,$310.65 ,$144.24 ,$261.60 ,$300.84 ,$144.24 ,$277.95 ,$310.65 ,$287.76 ,$248.52 ,$144.24 ,$144.24 ,$144.24 ,$238.71 ,$179.85 ,$297.57 ,$297.57 ,$261.60 ,$224.53 ,$179.85 ,$294.30 ,$217.99 ,$294.30 ,$176.58 ,$307.38 ,$490.48 ,$300.84 ,$152.89 ,$297.57 ,$217.99 ,$201.24 ,$201.24 ,$294.30 ,$244.04 ,$227.76 ,$220.17 ,$144.24 ,$310.65 ,$228.89 ,$144.24 ,$284.49 ,$217.99 ,$294.30 ,$217.99 ,$294.30 ,$294.30 ,$294.30 ,$317.19 ,$264.87 ,$304.11 ,$281.22 ,$317.19 
SACRED HEART HOSPITAL (ACU),45000385,26670,HC HAND DISL W/MANIP W/O ANES-LT,450,1 ,$437.00 ,$327.75 ,$144.24 ,$490.48 ,$281.43 ,$217.99 ,$305.90 ,$144.24 ,$362.71 ,$148.57 ,$288.42 ,$415.15 ,$144.24 ,$349.60 ,$402.04 ,$144.24 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$144.24 ,$144.24 ,$144.24 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 ,$224.53 ,$240.35 ,$393.30 ,$217.99 ,$393.30 ,$235.98 ,$410.78 ,$490.48 ,$402.04 ,$152.89 ,$397.67 ,$217.99 ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 ,$220.17 ,$144.24 ,$415.15 ,$228.89 ,$144.24 ,$380.19 ,$217.99 ,$393.30 ,$217.99 ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),45000386,26670,HC HAND DISL W/MANIP W/O ANES-RT,450,1 ,$437.00 ,$327.75 ,$144.24 ,$490.48 ,$281.43 ,$217.99 ,$305.90 ,$144.24 ,$362.71 ,$148.57 ,$288.42 ,$415.15 ,$144.24 ,$349.60 ,$402.04 ,$144.24 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$144.24 ,$144.24 ,$144.24 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 ,$224.53 ,$240.35 ,$393.30 ,$217.99 ,$393.30 ,$235.98 ,$410.78 ,$490.48 ,$402.04 ,$152.89 ,$397.67 ,$217.99 ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 ,$220.17 ,$144.24 ,$415.15 ,$228.89 ,$144.24 ,$380.19 ,$217.99 ,$393.30 ,$217.99 ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),45000387,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-LT,450,1 ,$680.00 ,$510.00 ,$144.24 ,$680.00 ,$437.92 ,$217.99 ,$476.00 ,$144.24 ,$564.40 ,$148.57 ,$448.80 ,$646.00 ,$144.24 ,$544.00 ,$625.60 ,$144.24 ,$578.00 ,$646.00 ,$598.40 ,$516.80 ,$144.24 ,$144.24 ,$144.24 ,$496.40 ,$374.00 ,$618.80 ,$618.80 ,$544.00 ,$224.53 ,$374.00 ,$612.00 ,$217.99 ,$612.00 ,$367.20 ,$639.20 ,$490.48 ,$625.60 ,$152.89 ,$618.80 ,$217.99 ,$418.47 ,$418.47 ,$612.00 ,$507.48 ,$473.62 ,$220.17 ,$144.24 ,$646.00 ,$228.89 ,$144.24 ,$591.60 ,$217.99 ,$612.00 ,$217.99 ,$612.00 ,$612.00 ,$612.00 ,$659.60 ,$550.80 ,$632.40 ,$584.80 ,$659.60 
SACRED HEART HOSPITAL (ACU),45000388,27265,HC CL TX POST HIP ARTHROPLASTY DISLOCAT-RT,450,1 ,$680.00 ,$510.00 ,$144.24 ,$680.00 ,$437.92 ,$217.99 ,$476.00 ,$144.24 ,$564.40 ,$148.57 ,$448.80 ,$646.00 ,$144.24 ,$544.00 ,$625.60 ,$144.24 ,$578.00 ,$646.00 ,$598.40 ,$516.80 ,$144.24 ,$144.24 ,$144.24 ,$496.40 ,$374.00 ,$618.80 ,$618.80 ,$544.00 ,$224.53 ,$374.00 ,$612.00 ,$217.99 ,$612.00 ,$367.20 ,$639.20 ,$490.48 ,$625.60 ,$152.89 ,$618.80 ,$217.99 ,$418.47 ,$418.47 ,$612.00 ,$507.48 ,$473.62 ,$220.17 ,$144.24 ,$646.00 ,$228.89 ,$144.24 ,$591.60 ,$217.99 ,$612.00 ,$217.99 ,$612.00 ,$612.00 ,$612.00 ,$659.60 ,$550.80 ,$632.40 ,$584.80 ,$659.60 
SACRED HEART HOSPITAL (ACU),45000389,27550,HC CLSD TX KNEE DISLOC W/O ANESTH-LT,450,1 ,$592.00 ,$444.00 ,$144.24 ,$592.00 ,$381.25 ,$217.99 ,$414.40 ,$144.24 ,$491.36 ,$148.57 ,$390.72 ,$562.40 ,$144.24 ,$473.60 ,$544.64 ,$144.24 ,$503.20 ,$562.40 ,$520.96 ,$449.92 ,$144.24 ,$144.24 ,$144.24 ,$432.16 ,$325.60 ,$538.72 ,$538.72 ,$473.60 ,$224.53 ,$325.60 ,$532.80 ,$217.99 ,$532.80 ,$319.68 ,$556.48 ,$490.48 ,$544.64 ,$152.89 ,$538.72 ,$217.99 ,$364.32 ,$364.32 ,$532.80 ,$441.81 ,$412.33 ,$220.17 ,$144.24 ,$562.40 ,$228.89 ,$144.24 ,$515.04 ,$217.99 ,$532.80 ,$217.99 ,$532.80 ,$532.80 ,$532.80 ,$574.24 ,$479.52 ,$550.56 ,$509.12 ,$574.24 
SACRED HEART HOSPITAL (ACU),45000390,27550,HC CLSD TX KNEE DISLOC W/O ANESTH-RT,450,1 ,$592.00 ,$444.00 ,$144.24 ,$592.00 ,$381.25 ,$217.99 ,$414.40 ,$144.24 ,$491.36 ,$148.57 ,$390.72 ,$562.40 ,$144.24 ,$473.60 ,$544.64 ,$144.24 ,$503.20 ,$562.40 ,$520.96 ,$449.92 ,$144.24 ,$144.24 ,$144.24 ,$432.16 ,$325.60 ,$538.72 ,$538.72 ,$473.60 ,$224.53 ,$325.60 ,$532.80 ,$217.99 ,$532.80 ,$319.68 ,$556.48 ,$490.48 ,$544.64 ,$152.89 ,$538.72 ,$217.99 ,$364.32 ,$364.32 ,$532.80 ,$441.81 ,$412.33 ,$220.17 ,$144.24 ,$562.40 ,$228.89 ,$144.24 ,$515.04 ,$217.99 ,$532.80 ,$217.99 ,$532.80 ,$532.80 ,$532.80 ,$574.24 ,$479.52 ,$550.56 ,$509.12 ,$574.24 
SACRED HEART HOSPITAL (ACU),45000391,27560,HC TX DSL PTLR W/O ANS CL-LT,450,1 ,$437.00 ,$327.75 ,$144.24 ,$490.48 ,$281.43 ,$217.99 ,$305.90 ,$144.24 ,$362.71 ,$148.57 ,$288.42 ,$415.15 ,$144.24 ,$349.60 ,$402.04 ,$144.24 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$144.24 ,$144.24 ,$144.24 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 ,$224.53 ,$240.35 ,$393.30 ,$217.99 ,$393.30 ,$235.98 ,$410.78 ,$490.48 ,$402.04 ,$152.89 ,$397.67 ,$217.99 ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 ,$220.17 ,$144.24 ,$415.15 ,$228.89 ,$144.24 ,$380.19 ,$217.99 ,$393.30 ,$217.99 ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),45000392,27560,HC TX DSL PTLR W/O ANS CL-RT,450,1 ,$437.00 ,$327.75 ,$144.24 ,$490.48 ,$281.43 ,$217.99 ,$305.90 ,$144.24 ,$362.71 ,$148.57 ,$288.42 ,$415.15 ,$144.24 ,$349.60 ,$402.04 ,$144.24 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$144.24 ,$144.24 ,$144.24 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 ,$224.53 ,$240.35 ,$393.30 ,$217.99 ,$393.30 ,$235.98 ,$410.78 ,$490.48 ,$402.04 ,$152.89 ,$397.67 ,$217.99 ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 ,$220.17 ,$144.24 ,$415.15 ,$228.89 ,$144.24 ,$380.19 ,$217.99 ,$393.30 ,$217.99 ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),45000393,27750,HC TIBIA SHAFT FX W/O MANIP-LT,450,1 ,$342.00 ,$256.50 ,$144.24 ,$490.48 ,$220.25 ,$217.99 ,$239.40 ,$144.24 ,$283.86 ,$148.57 ,$225.72 ,$324.90 ,$144.24 ,$273.60 ,$314.64 ,$144.24 ,$290.70 ,$324.90 ,$300.96 ,$259.92 ,$144.24 ,$144.24 ,$144.24 ,$249.66 ,$188.10 ,$311.22 ,$311.22 ,$273.60 ,$224.53 ,$188.10 ,$307.80 ,$217.99 ,$307.80 ,$184.68 ,$321.48 ,$490.48 ,$314.64 ,$152.89 ,$311.22 ,$217.99 ,$210.47 ,$210.47 ,$307.80 ,$255.23 ,$238.20 ,$220.17 ,$144.24 ,$324.90 ,$228.89 ,$144.24 ,$297.54 ,$217.99 ,$307.80 ,$217.99 ,$307.80 ,$307.80 ,$307.80 ,$331.74 ,$277.02 ,$318.06 ,$294.12 ,$331.74 
SACRED HEART HOSPITAL (ACU),45000394,27750,HC TIBIA SHAFT FX W/O MANIP-RT,450,1 ,$342.00 ,$256.50 ,$144.24 ,$490.48 ,$220.25 ,$217.99 ,$239.40 ,$144.24 ,$283.86 ,$148.57 ,$225.72 ,$324.90 ,$144.24 ,$273.60 ,$314.64 ,$144.24 ,$290.70 ,$324.90 ,$300.96 ,$259.92 ,$144.24 ,$144.24 ,$144.24 ,$249.66 ,$188.10 ,$311.22 ,$311.22 ,$273.60 ,$224.53 ,$188.10 ,$307.80 ,$217.99 ,$307.80 ,$184.68 ,$321.48 ,$490.48 ,$314.64 ,$152.89 ,$311.22 ,$217.99 ,$210.47 ,$210.47 ,$307.80 ,$255.23 ,$238.20 ,$220.17 ,$144.24 ,$324.90 ,$228.89 ,$144.24 ,$297.54 ,$217.99 ,$307.80 ,$217.99 ,$307.80 ,$307.80 ,$307.80 ,$331.74 ,$277.02 ,$318.06 ,$294.12 ,$331.74 
SACRED HEART HOSPITAL (ACU),45000395,27808,HC CLOSED TX FX BIMALLEOLAR W/O MANIP-LT,450,1 ,$381.00 ,$285.75 ,$144.24 ,$490.48 ,$245.36 ,$217.99 ,$266.70 ,$144.24 ,$316.23 ,$148.57 ,$251.46 ,$361.95 ,$144.24 ,$304.80 ,$350.52 ,$144.24 ,$323.85 ,$361.95 ,$335.28 ,$289.56 ,$144.24 ,$144.24 ,$144.24 ,$278.13 ,$209.55 ,$346.71 ,$346.71 ,$304.80 ,$224.53 ,$209.55 ,$342.90 ,$217.99 ,$342.90 ,$205.74 ,$358.14 ,$490.48 ,$350.52 ,$152.89 ,$346.71 ,$217.99 ,$234.47 ,$234.47 ,$342.90 ,$284.34 ,$265.37 ,$220.17 ,$144.24 ,$361.95 ,$228.89 ,$144.24 ,$331.47 ,$217.99 ,$342.90 ,$217.99 ,$342.90 ,$342.90 ,$342.90 ,$369.57 ,$308.61 ,$354.33 ,$327.66 ,$369.57 
SACRED HEART HOSPITAL (ACU),45000396,27808,HC CLOSED TX FX BIMALLEOLAR W/O MANIP-RT,450,1 ,$381.00 ,$285.75 ,$144.24 ,$490.48 ,$245.36 ,$217.99 ,$266.70 ,$144.24 ,$316.23 ,$148.57 ,$251.46 ,$361.95 ,$144.24 ,$304.80 ,$350.52 ,$144.24 ,$323.85 ,$361.95 ,$335.28 ,$289.56 ,$144.24 ,$144.24 ,$144.24 ,$278.13 ,$209.55 ,$346.71 ,$346.71 ,$304.80 ,$224.53 ,$209.55 ,$342.90 ,$217.99 ,$342.90 ,$205.74 ,$358.14 ,$490.48 ,$350.52 ,$152.89 ,$346.71 ,$217.99 ,$234.47 ,$234.47 ,$342.90 ,$284.34 ,$265.37 ,$220.17 ,$144.24 ,$361.95 ,$228.89 ,$144.24 ,$331.47 ,$217.99 ,$342.90 ,$217.99 ,$342.90 ,$342.90 ,$342.90 ,$369.57 ,$308.61 ,$354.33 ,$327.66 ,$369.57 
SACRED HEART HOSPITAL (ACU),45000397,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP-LT,450,1 ,$414.00 ,$310.50 ,$144.24 ,"$3,314.53 ",$266.62 ,"$1,473.12 ",$289.80 ,$144.24 ,$343.62 ,$148.57 ,$273.24 ,$393.30 ,$144.24 ,$331.20 ,$380.88 ,$144.24 ,$351.90 ,$393.30 ,$364.32 ,$314.64 ,$144.24 ,$144.24 ,$144.24 ,$302.22 ,$227.70 ,$376.74 ,$376.74 ,$331.20 ,"$1,517.31 ",$227.70 ,$372.60 ,"$1,473.12 ",$372.60 ,$223.56 ,$389.16 ,"$3,314.53 ",$380.88 ,$152.89 ,$376.74 ,"$1,473.12 ",$254.78 ,$254.78 ,$372.60 ,$308.97 ,$288.35 ,"$1,487.85 ",$144.24 ,$393.30 ,"$1,546.78 ",$144.24 ,$360.18 ,"$1,473.12 ",$372.60 ,"$1,473.12 ",$372.60 ,$372.60 ,$372.60 ,$401.58 ,$335.34 ,$385.02 ,$356.04 ,$401.58 
SACRED HEART HOSPITAL (ACU),45000398,27818,HC TRIMALLEOLAR ANKLE FX W/MANIP-RT,450,1 ,$414.00 ,$310.50 ,$144.24 ,"$3,314.53 ",$266.62 ,"$1,473.12 ",$289.80 ,$144.24 ,$343.62 ,$148.57 ,$273.24 ,$393.30 ,$144.24 ,$331.20 ,$380.88 ,$144.24 ,$351.90 ,$393.30 ,$364.32 ,$314.64 ,$144.24 ,$144.24 ,$144.24 ,$302.22 ,$227.70 ,$376.74 ,$376.74 ,$331.20 ,"$1,517.31 ",$227.70 ,$372.60 ,"$1,473.12 ",$372.60 ,$223.56 ,$389.16 ,"$3,314.53 ",$380.88 ,$152.89 ,$376.74 ,"$1,473.12 ",$254.78 ,$254.78 ,$372.60 ,$308.97 ,$288.35 ,"$1,487.85 ",$144.24 ,$393.30 ,"$1,546.78 ",$144.24 ,$360.18 ,"$1,473.12 ",$372.60 ,"$1,473.12 ",$372.60 ,$372.60 ,$372.60 ,$401.58 ,$335.34 ,$385.02 ,$356.04 ,$401.58 
SACRED HEART HOSPITAL (ACU),45000399,28470,HC CLSD METATARSAL W/O MANIP-LT,450,1 ,$190.00 ,$142.50 ,$102.60 ,$490.48 ,$122.36 ,$217.99 ,$133.00 ,$144.24 ,$157.70 ,$148.57 ,$125.40 ,$180.50 ,$144.24 ,$152.00 ,$174.80 ,$144.24 ,$161.50 ,$180.50 ,$167.20 ,$144.40 ,$144.24 ,$144.24 ,$144.24 ,$138.70 ,$104.50 ,$172.90 ,$172.90 ,$152.00 ,$224.53 ,$104.50 ,$171.00 ,$217.99 ,$171.00 ,$102.60 ,$178.60 ,$490.48 ,$174.80 ,$152.89 ,$172.90 ,$217.99 ,$116.93 ,$116.93 ,$171.00 ,$141.80 ,$132.34 ,$220.17 ,$144.24 ,$180.50 ,$228.89 ,$144.24 ,$165.30 ,$217.99 ,$171.00 ,$217.99 ,$171.00 ,$171.00 ,$171.00 ,$184.30 ,$153.90 ,$176.70 ,$163.40 ,$184.30 
SACRED HEART HOSPITAL (ACU),45000400,28470,HC CLSD METATARSAL W/O MANIP-RT,450,1 ,$190.00 ,$142.50 ,$102.60 ,$490.48 ,$122.36 ,$217.99 ,$133.00 ,$144.24 ,$157.70 ,$148.57 ,$125.40 ,$180.50 ,$144.24 ,$152.00 ,$174.80 ,$144.24 ,$161.50 ,$180.50 ,$167.20 ,$144.40 ,$144.24 ,$144.24 ,$144.24 ,$138.70 ,$104.50 ,$172.90 ,$172.90 ,$152.00 ,$224.53 ,$104.50 ,$171.00 ,$217.99 ,$171.00 ,$102.60 ,$178.60 ,$490.48 ,$174.80 ,$152.89 ,$172.90 ,$217.99 ,$116.93 ,$116.93 ,$171.00 ,$141.80 ,$132.34 ,$220.17 ,$144.24 ,$180.50 ,$228.89 ,$144.24 ,$165.30 ,$217.99 ,$171.00 ,$217.99 ,$171.00 ,$171.00 ,$171.00 ,$184.30 ,$153.90 ,$176.70 ,$163.40 ,$184.30 
SACRED HEART HOSPITAL (ACU),45000401,28570,HC CLOSED TX FOOT DISLOCATION W/O ANES-LT,450,1 ,$335.00 ,$251.25 ,$144.24 ,$490.48 ,$215.74 ,$217.99 ,$234.50 ,$144.24 ,$278.05 ,$148.57 ,$221.10 ,$318.25 ,$144.24 ,$268.00 ,$308.20 ,$144.24 ,$284.75 ,$318.25 ,$294.80 ,$254.60 ,$144.24 ,$144.24 ,$144.24 ,$244.55 ,$184.25 ,$304.85 ,$304.85 ,$268.00 ,$224.53 ,$184.25 ,$301.50 ,$217.99 ,$301.50 ,$180.90 ,$314.90 ,$490.48 ,$308.20 ,$152.89 ,$304.85 ,$217.99 ,$206.16 ,$206.16 ,$301.50 ,$250.01 ,$233.33 ,$220.17 ,$144.24 ,$318.25 ,$228.89 ,$144.24 ,$291.45 ,$217.99 ,$301.50 ,$217.99 ,$301.50 ,$301.50 ,$301.50 ,$324.95 ,$271.35 ,$311.55 ,$288.10 ,$324.95 
SACRED HEART HOSPITAL (ACU),45000402,28570,HC CLOSED TX FOOT DISLOCATION W/O ANES-RT,450,1 ,$335.00 ,$251.25 ,$144.24 ,$490.48 ,$215.74 ,$217.99 ,$234.50 ,$144.24 ,$278.05 ,$148.57 ,$221.10 ,$318.25 ,$144.24 ,$268.00 ,$308.20 ,$144.24 ,$284.75 ,$318.25 ,$294.80 ,$254.60 ,$144.24 ,$144.24 ,$144.24 ,$244.55 ,$184.25 ,$304.85 ,$304.85 ,$268.00 ,$224.53 ,$184.25 ,$301.50 ,$217.99 ,$301.50 ,$180.90 ,$314.90 ,$490.48 ,$308.20 ,$152.89 ,$304.85 ,$217.99 ,$206.16 ,$206.16 ,$301.50 ,$250.01 ,$233.33 ,$220.17 ,$144.24 ,$318.25 ,$228.89 ,$144.24 ,$291.45 ,$217.99 ,$301.50 ,$217.99 ,$301.50 ,$301.50 ,$301.50 ,$324.95 ,$271.35 ,$311.55 ,$288.10 ,$324.95 
SACRED HEART HOSPITAL (ACU),45000403,29065,HC APPL CAST ARM LONG-LT,450,1 ,$659.00 ,$494.25 ,$61.15 ,$659.00 ,$424.40 ,$255.15 ,$461.30 ,$61.15 ,$546.97 ,$62.98 ,$434.94 ,$626.05 ,$61.15 ,$527.20 ,$606.28 ,$61.15 ,$560.15 ,$626.05 ,$579.92 ,$500.84 ,$61.15 ,$61.15 ,$61.15 ,$481.07 ,$362.45 ,$599.69 ,$599.69 ,$527.20 ,$262.80 ,$362.45 ,$593.10 ,$255.15 ,$593.10 ,$355.86 ,$619.46 ,$574.08 ,$606.28 ,$64.82 ,$599.69 ,$255.15 ,$405.55 ,$405.55 ,$593.10 ,$491.81 ,$458.99 ,$257.70 ,$61.15 ,$626.05 ,$267.90 ,$61.15 ,$573.33 ,$255.15 ,$593.10 ,$255.15 ,$593.10 ,$593.10 ,$593.10 ,$639.23 ,$533.79 ,$612.87 ,$566.74 ,$639.23 
SACRED HEART HOSPITAL (ACU),45000404,29065,HC APPL CAST ARM LONG-RT,450,1 ,$659.00 ,$494.25 ,$61.15 ,$659.00 ,$424.40 ,$255.15 ,$461.30 ,$61.15 ,$546.97 ,$62.98 ,$434.94 ,$626.05 ,$61.15 ,$527.20 ,$606.28 ,$61.15 ,$560.15 ,$626.05 ,$579.92 ,$500.84 ,$61.15 ,$61.15 ,$61.15 ,$481.07 ,$362.45 ,$599.69 ,$599.69 ,$527.20 ,$262.80 ,$362.45 ,$593.10 ,$255.15 ,$593.10 ,$355.86 ,$619.46 ,$574.08 ,$606.28 ,$64.82 ,$599.69 ,$255.15 ,$405.55 ,$405.55 ,$593.10 ,$491.81 ,$458.99 ,$257.70 ,$61.15 ,$626.05 ,$267.90 ,$61.15 ,$573.33 ,$255.15 ,$593.10 ,$255.15 ,$593.10 ,$593.10 ,$593.10 ,$639.23 ,$533.79 ,$612.87 ,$566.74 ,$639.23 
SACRED HEART HOSPITAL (ACU),45000405,29105,HC APPL SPLNT ARM LONG-LT,450,1 ,$356.00 ,$267.00 ,$14.12 ,$356.00 ,$229.26 ,$149.42 ,$249.20 ,$14.12 ,$295.48 ,$14.54 ,$234.96 ,$338.20 ,$14.12 ,$284.80 ,$327.52 ,$14.12 ,$302.60 ,$338.20 ,$313.28 ,$270.56 ,$14.12 ,$14.12 ,$14.12 ,$259.88 ,$195.80 ,$323.96 ,$323.96 ,$284.80 ,$153.90 ,$195.80 ,$320.40 ,$149.42 ,$320.40 ,$192.24 ,$334.64 ,$336.20 ,$327.52 ,$14.97 ,$323.96 ,$149.42 ,$219.08 ,$219.08 ,$320.40 ,$265.68 ,$247.95 ,$150.92 ,$14.12 ,$338.20 ,$156.89 ,$14.12 ,$309.72 ,$149.42 ,$320.40 ,$149.42 ,$320.40 ,$320.40 ,$320.40 ,$345.32 ,$288.36 ,$331.08 ,$306.16 ,$345.32 
SACRED HEART HOSPITAL (ACU),45000406,29105,HC APPL SPLNT ARM LONG-RT,450,1 ,$356.00 ,$267.00 ,$14.12 ,$356.00 ,$229.26 ,$149.42 ,$249.20 ,$14.12 ,$295.48 ,$14.54 ,$234.96 ,$338.20 ,$14.12 ,$284.80 ,$327.52 ,$14.12 ,$302.60 ,$338.20 ,$313.28 ,$270.56 ,$14.12 ,$14.12 ,$14.12 ,$259.88 ,$195.80 ,$323.96 ,$323.96 ,$284.80 ,$153.90 ,$195.80 ,$320.40 ,$149.42 ,$320.40 ,$192.24 ,$334.64 ,$336.20 ,$327.52 ,$14.97 ,$323.96 ,$149.42 ,$219.08 ,$219.08 ,$320.40 ,$265.68 ,$247.95 ,$150.92 ,$14.12 ,$338.20 ,$156.89 ,$14.12 ,$309.72 ,$149.42 ,$320.40 ,$149.42 ,$320.40 ,$320.40 ,$320.40 ,$345.32 ,$288.36 ,$331.08 ,$306.16 ,$345.32 
SACRED HEART HOSPITAL (ACU),45000407,29126,HC APPL SHRT ARM SPLNT DYNAM-LT,450,1 ,$281.00 ,$210.75 ,$14.12 ,$281.00 ,$180.96 ,$119.26 ,$196.70 ,$14.12 ,$233.23 ,$14.54 ,$185.46 ,$266.95 ,$14.12 ,$224.80 ,$258.52 ,$14.12 ,$238.85 ,$266.95 ,$247.28 ,$213.56 ,$14.12 ,$14.12 ,$14.12 ,$205.13 ,$154.55 ,$255.71 ,$255.71 ,$224.80 ,$122.84 ,$154.55 ,$252.90 ,$119.26 ,$252.90 ,$151.74 ,$264.14 ,$268.33 ,$258.52 ,$14.97 ,$255.71 ,$119.26 ,$172.93 ,$172.93 ,$252.90 ,$209.71 ,$195.72 ,$120.45 ,$14.12 ,$266.95 ,$125.22 ,$14.12 ,$244.47 ,$119.26 ,$252.90 ,$119.26 ,$252.90 ,$252.90 ,$252.90 ,$272.57 ,$227.61 ,$261.33 ,$241.66 ,$272.57 
SACRED HEART HOSPITAL (ACU),45000408,29126,HC APPL SHRT ARM SPLNT DYNAM-RT,450,1 ,$281.00 ,$210.75 ,$14.12 ,$281.00 ,$180.96 ,$119.26 ,$196.70 ,$14.12 ,$233.23 ,$14.54 ,$185.46 ,$266.95 ,$14.12 ,$224.80 ,$258.52 ,$14.12 ,$238.85 ,$266.95 ,$247.28 ,$213.56 ,$14.12 ,$14.12 ,$14.12 ,$205.13 ,$154.55 ,$255.71 ,$255.71 ,$224.80 ,$122.84 ,$154.55 ,$252.90 ,$119.26 ,$252.90 ,$151.74 ,$264.14 ,$268.33 ,$258.52 ,$14.97 ,$255.71 ,$119.26 ,$172.93 ,$172.93 ,$252.90 ,$209.71 ,$195.72 ,$120.45 ,$14.12 ,$266.95 ,$125.22 ,$14.12 ,$244.47 ,$119.26 ,$252.90 ,$119.26 ,$252.90 ,$252.90 ,$252.90 ,$272.57 ,$227.61 ,$261.33 ,$241.66 ,$272.57 
SACRED HEART HOSPITAL (ACU),45000409,29240,HC STRAPPING SHLDR-LT,450,1 ,$213.00 ,$159.75 ,$14.12 ,$268.33 ,$137.17 ,$119.26 ,$149.10 ,$14.12 ,$176.79 ,$14.54 ,$140.58 ,$202.35 ,$14.12 ,$170.40 ,$195.96 ,$14.12 ,$181.05 ,$202.35 ,$187.44 ,$161.88 ,$14.12 ,$14.12 ,$14.12 ,$155.49 ,$117.15 ,$193.83 ,$193.83 ,$170.40 ,$122.84 ,$117.15 ,$191.70 ,$119.26 ,$191.70 ,$115.02 ,$200.22 ,$268.33 ,$195.96 ,$14.97 ,$193.83 ,$119.26 ,$131.08 ,$131.08 ,$191.70 ,$158.96 ,$148.35 ,$120.45 ,$14.12 ,$202.35 ,$125.22 ,$14.12 ,$185.31 ,$119.26 ,$191.70 ,$119.26 ,$191.70 ,$191.70 ,$191.70 ,$206.61 ,$172.53 ,$198.09 ,$183.18 ,$206.61 
SACRED HEART HOSPITAL (ACU),45000410,29240,HC STRAPPING SHLDR-RT,450,1 ,$213.00 ,$159.75 ,$14.12 ,$268.33 ,$137.17 ,$119.26 ,$149.10 ,$14.12 ,$176.79 ,$14.54 ,$140.58 ,$202.35 ,$14.12 ,$170.40 ,$195.96 ,$14.12 ,$181.05 ,$202.35 ,$187.44 ,$161.88 ,$14.12 ,$14.12 ,$14.12 ,$155.49 ,$117.15 ,$193.83 ,$193.83 ,$170.40 ,$122.84 ,$117.15 ,$191.70 ,$119.26 ,$191.70 ,$115.02 ,$200.22 ,$268.33 ,$195.96 ,$14.97 ,$193.83 ,$119.26 ,$131.08 ,$131.08 ,$191.70 ,$158.96 ,$148.35 ,$120.45 ,$14.12 ,$202.35 ,$125.22 ,$14.12 ,$185.31 ,$119.26 ,$191.70 ,$119.26 ,$191.70 ,$191.70 ,$191.70 ,$206.61 ,$172.53 ,$198.09 ,$183.18 ,$206.61 
SACRED HEART HOSPITAL (ACU),45000411,29260,HC STRAPPING ELBOW/WRIST-LT,450,1 ,$156.00 ,$117.00 ,$14.12 ,$156.00 ,$100.46 ,$58.87 ,$109.20 ,$14.12 ,$129.48 ,$14.54 ,$102.96 ,$148.20 ,$14.12 ,$124.80 ,$143.52 ,$14.12 ,$132.60 ,$148.20 ,$137.28 ,$118.56 ,$14.12 ,$14.12 ,$14.12 ,$113.88 ,$85.80 ,$141.96 ,$141.96 ,$124.80 ,$60.64 ,$85.80 ,$140.40 ,$58.87 ,$140.40 ,$84.24 ,$146.64 ,$132.46 ,$143.52 ,$14.97 ,$141.96 ,$58.87 ,$96.00 ,$96.00 ,$140.40 ,$116.42 ,$108.65 ,$59.46 ,$14.12 ,$148.20 ,$61.82 ,$14.12 ,$135.72 ,$58.87 ,$140.40 ,$58.87 ,$140.40 ,$140.40 ,$140.40 ,$151.32 ,$126.36 ,$145.08 ,$134.16 ,$151.32 
SACRED HEART HOSPITAL (ACU),45000412,29260,HC STRAPPING ELBOW/WRIST-RT,450,1 ,$156.00 ,$117.00 ,$14.12 ,$156.00 ,$100.46 ,$58.87 ,$109.20 ,$14.12 ,$129.48 ,$14.54 ,$102.96 ,$148.20 ,$14.12 ,$124.80 ,$143.52 ,$14.12 ,$132.60 ,$148.20 ,$137.28 ,$118.56 ,$14.12 ,$14.12 ,$14.12 ,$113.88 ,$85.80 ,$141.96 ,$141.96 ,$124.80 ,$60.64 ,$85.80 ,$140.40 ,$58.87 ,$140.40 ,$84.24 ,$146.64 ,$132.46 ,$143.52 ,$14.97 ,$141.96 ,$58.87 ,$96.00 ,$96.00 ,$140.40 ,$116.42 ,$108.65 ,$59.46 ,$14.12 ,$148.20 ,$61.82 ,$14.12 ,$135.72 ,$58.87 ,$140.40 ,$58.87 ,$140.40 ,$140.40 ,$140.40 ,$151.32 ,$126.36 ,$145.08 ,$134.16 ,$151.32 
SACRED HEART HOSPITAL (ACU),45000413,29345,HC LONG LEG CAST-LT,450,1 ,"$1,060.00 ",$795.00 ,$61.15 ,"$1,060.00 ",$682.64 ,$255.15 ,$742.00 ,$61.15 ,$879.80 ,$62.98 ,$699.60 ,"$1,007.00 ",$61.15 ,$848.00 ,$975.20 ,$61.15 ,$901.00 ,"$1,007.00 ",$932.80 ,$805.60 ,$61.15 ,$61.15 ,$61.15 ,$773.80 ,$583.00 ,$964.60 ,$964.60 ,$848.00 ,$262.80 ,$583.00 ,$954.00 ,$255.15 ,$954.00 ,$572.40 ,$996.40 ,$574.08 ,$975.20 ,$64.82 ,$964.60 ,$255.15 ,$652.32 ,$652.32 ,$954.00 ,$791.08 ,$738.29 ,$257.70 ,$61.15 ,"$1,007.00 ",$267.90 ,$61.15 ,$922.20 ,$255.15 ,$954.00 ,$255.15 ,$954.00 ,$954.00 ,$954.00 ,"$1,028.20 ",$858.60 ,$985.80 ,$911.60 ,"$1,028.20 "
SACRED HEART HOSPITAL (ACU),45000414,29345,HC LONG LEG CAST-RT,450,1 ,"$1,060.00 ",$795.00 ,$61.15 ,"$1,060.00 ",$682.64 ,$255.15 ,$742.00 ,$61.15 ,$879.80 ,$62.98 ,$699.60 ,"$1,007.00 ",$61.15 ,$848.00 ,$975.20 ,$61.15 ,$901.00 ,"$1,007.00 ",$932.80 ,$805.60 ,$61.15 ,$61.15 ,$61.15 ,$773.80 ,$583.00 ,$964.60 ,$964.60 ,$848.00 ,$262.80 ,$583.00 ,$954.00 ,$255.15 ,$954.00 ,$572.40 ,$996.40 ,$574.08 ,$975.20 ,$64.82 ,$964.60 ,$255.15 ,$652.32 ,$652.32 ,$954.00 ,$791.08 ,$738.29 ,$257.70 ,$61.15 ,"$1,007.00 ",$267.90 ,$61.15 ,$922.20 ,$255.15 ,$954.00 ,$255.15 ,$954.00 ,$954.00 ,$954.00 ,"$1,028.20 ",$858.60 ,$985.80 ,$911.60 ,"$1,028.20 "
SACRED HEART HOSPITAL (ACU),45000415,29405,HC APPLY SHORT LEG CAST-LT,450,1 ,$634.00 ,$475.50 ,$61.15 ,$634.00 ,$408.30 ,$255.15 ,$443.80 ,$61.15 ,$526.22 ,$62.98 ,$418.44 ,$602.30 ,$61.15 ,$507.20 ,$583.28 ,$61.15 ,$538.90 ,$602.30 ,$557.92 ,$481.84 ,$61.15 ,$61.15 ,$61.15 ,$462.82 ,$348.70 ,$576.94 ,$576.94 ,$507.20 ,$262.80 ,$348.70 ,$570.60 ,$255.15 ,$570.60 ,$342.36 ,$595.96 ,$574.08 ,$583.28 ,$64.82 ,$576.94 ,$255.15 ,$390.16 ,$390.16 ,$570.60 ,$473.15 ,$441.58 ,$257.70 ,$61.15 ,$602.30 ,$267.90 ,$61.15 ,$551.58 ,$255.15 ,$570.60 ,$255.15 ,$570.60 ,$570.60 ,$570.60 ,$614.98 ,$513.54 ,$589.62 ,$545.24 ,$614.98 
SACRED HEART HOSPITAL (ACU),45000416,29405,HC APPLY SHORT LEG CAST-RT,450,1 ,$634.00 ,$475.50 ,$61.15 ,$634.00 ,$408.30 ,$255.15 ,$443.80 ,$61.15 ,$526.22 ,$62.98 ,$418.44 ,$602.30 ,$61.15 ,$507.20 ,$583.28 ,$61.15 ,$538.90 ,$602.30 ,$557.92 ,$481.84 ,$61.15 ,$61.15 ,$61.15 ,$462.82 ,$348.70 ,$576.94 ,$576.94 ,$507.20 ,$262.80 ,$348.70 ,$570.60 ,$255.15 ,$570.60 ,$342.36 ,$595.96 ,$574.08 ,$583.28 ,$64.82 ,$576.94 ,$255.15 ,$390.16 ,$390.16 ,$570.60 ,$473.15 ,$441.58 ,$257.70 ,$61.15 ,$602.30 ,$267.90 ,$61.15 ,$551.58 ,$255.15 ,$570.60 ,$255.15 ,$570.60 ,$570.60 ,$570.60 ,$614.98 ,$513.54 ,$589.62 ,$545.24 ,$614.98 
SACRED HEART HOSPITAL (ACU),45000417,29505,HC APPL LONG LEG SPLNT-LT,450,1 ,$774.00 ,$580.50 ,$14.12 ,$774.00 ,$498.46 ,$149.42 ,$541.80 ,$14.12 ,$642.42 ,$14.54 ,$510.84 ,$735.30 ,$14.12 ,$619.20 ,$712.08 ,$14.12 ,$657.90 ,$735.30 ,$681.12 ,$588.24 ,$14.12 ,$14.12 ,$14.12 ,$565.02 ,$425.70 ,$704.34 ,$704.34 ,$619.20 ,$153.90 ,$425.70 ,$696.60 ,$149.42 ,$696.60 ,$417.96 ,$727.56 ,$336.20 ,$712.08 ,$14.97 ,$704.34 ,$149.42 ,$476.32 ,$476.32 ,$696.60 ,$577.64 ,$539.09 ,$150.92 ,$14.12 ,$735.30 ,$156.89 ,$14.12 ,$673.38 ,$149.42 ,$696.60 ,$149.42 ,$696.60 ,$696.60 ,$696.60 ,$750.78 ,$626.94 ,$719.82 ,$665.64 ,$750.78 
SACRED HEART HOSPITAL (ACU),45000418,29505,HC APPL LONG LEG SPLNT-RT,450,1 ,$774.00 ,$580.50 ,$14.12 ,$774.00 ,$498.46 ,$149.42 ,$541.80 ,$14.12 ,$642.42 ,$14.54 ,$510.84 ,$735.30 ,$14.12 ,$619.20 ,$712.08 ,$14.12 ,$657.90 ,$735.30 ,$681.12 ,$588.24 ,$14.12 ,$14.12 ,$14.12 ,$565.02 ,$425.70 ,$704.34 ,$704.34 ,$619.20 ,$153.90 ,$425.70 ,$696.60 ,$149.42 ,$696.60 ,$417.96 ,$727.56 ,$336.20 ,$712.08 ,$14.97 ,$704.34 ,$149.42 ,$476.32 ,$476.32 ,$696.60 ,$577.64 ,$539.09 ,$150.92 ,$14.12 ,$735.30 ,$156.89 ,$14.12 ,$673.38 ,$149.42 ,$696.60 ,$149.42 ,$696.60 ,$696.60 ,$696.60 ,$750.78 ,$626.94 ,$719.82 ,$665.64 ,$750.78 
SACRED HEART HOSPITAL (ACU),45000419,29515,HC APPL SHRT LEG SPLNT FAC-LT,450,1 ,$735.00 ,$551.25 ,$14.12 ,$735.00 ,$473.34 ,$149.42 ,$514.50 ,$14.12 ,$610.05 ,$14.54 ,$485.10 ,$698.25 ,$14.12 ,$588.00 ,$676.20 ,$14.12 ,$624.75 ,$698.25 ,$646.80 ,$558.60 ,$14.12 ,$14.12 ,$14.12 ,$536.55 ,$404.25 ,$668.85 ,$668.85 ,$588.00 ,$153.90 ,$404.25 ,$661.50 ,$149.42 ,$661.50 ,$396.90 ,$690.90 ,$336.20 ,$676.20 ,$14.97 ,$668.85 ,$149.42 ,$452.32 ,$452.32 ,$661.50 ,$548.53 ,$511.93 ,$150.92 ,$14.12 ,$698.25 ,$156.89 ,$14.12 ,$639.45 ,$149.42 ,$661.50 ,$149.42 ,$661.50 ,$661.50 ,$661.50 ,$712.95 ,$595.35 ,$683.55 ,$632.10 ,$712.95 
SACRED HEART HOSPITAL (ACU),45000420,29515,HC APPL SHRT LEG SPLNT FAC-RT,450,1 ,$735.00 ,$551.25 ,$14.12 ,$735.00 ,$473.34 ,$149.42 ,$514.50 ,$14.12 ,$610.05 ,$14.54 ,$485.10 ,$698.25 ,$14.12 ,$588.00 ,$676.20 ,$14.12 ,$624.75 ,$698.25 ,$646.80 ,$558.60 ,$14.12 ,$14.12 ,$14.12 ,$536.55 ,$404.25 ,$668.85 ,$668.85 ,$588.00 ,$153.90 ,$404.25 ,$661.50 ,$149.42 ,$661.50 ,$396.90 ,$690.90 ,$336.20 ,$676.20 ,$14.97 ,$668.85 ,$149.42 ,$452.32 ,$452.32 ,$661.50 ,$548.53 ,$511.93 ,$150.92 ,$14.12 ,$698.25 ,$156.89 ,$14.12 ,$639.45 ,$149.42 ,$661.50 ,$149.42 ,$661.50 ,$661.50 ,$661.50 ,$712.95 ,$595.35 ,$683.55 ,$632.10 ,$712.95 
SACRED HEART HOSPITAL (ACU),45000421,29530,HC STRAPPING KNEE-LT,450,1 ,$349.00 ,$261.75 ,$14.12 ,$349.00 ,$224.76 ,$119.26 ,$244.30 ,$14.12 ,$289.67 ,$14.54 ,$230.34 ,$331.55 ,$14.12 ,$279.20 ,$321.08 ,$14.12 ,$296.65 ,$331.55 ,$307.12 ,$265.24 ,$14.12 ,$14.12 ,$14.12 ,$254.77 ,$191.95 ,$317.59 ,$317.59 ,$279.20 ,$122.84 ,$191.95 ,$314.10 ,$119.26 ,$314.10 ,$188.46 ,$328.06 ,$268.33 ,$321.08 ,$14.97 ,$317.59 ,$119.26 ,$214.77 ,$214.77 ,$314.10 ,$260.46 ,$243.08 ,$120.45 ,$14.12 ,$331.55 ,$125.22 ,$14.12 ,$303.63 ,$119.26 ,$314.10 ,$119.26 ,$314.10 ,$314.10 ,$314.10 ,$338.53 ,$282.69 ,$324.57 ,$300.14 ,$338.53 
SACRED HEART HOSPITAL (ACU),45000422,29530,HC STRAPPING KNEE-RT,450,1 ,$349.00 ,$261.75 ,$14.12 ,$349.00 ,$224.76 ,$119.26 ,$244.30 ,$14.12 ,$289.67 ,$14.54 ,$230.34 ,$331.55 ,$14.12 ,$279.20 ,$321.08 ,$14.12 ,$296.65 ,$331.55 ,$307.12 ,$265.24 ,$14.12 ,$14.12 ,$14.12 ,$254.77 ,$191.95 ,$317.59 ,$317.59 ,$279.20 ,$122.84 ,$191.95 ,$314.10 ,$119.26 ,$314.10 ,$188.46 ,$328.06 ,$268.33 ,$321.08 ,$14.97 ,$317.59 ,$119.26 ,$214.77 ,$214.77 ,$314.10 ,$260.46 ,$243.08 ,$120.45 ,$14.12 ,$331.55 ,$125.22 ,$14.12 ,$303.63 ,$119.26 ,$314.10 ,$119.26 ,$314.10 ,$314.10 ,$314.10 ,$338.53 ,$282.69 ,$324.57 ,$300.14 ,$338.53 
SACRED HEART HOSPITAL (ACU),45000423,30300,HC REMOVE NASAL FOREIGN BODY-LT,450,1 ,$247.00 ,$185.25 ,$36.07 ,$268.33 ,$159.07 ,$119.26 ,$172.90 ,$36.07 ,$205.01 ,$37.15 ,$163.02 ,$234.65 ,$36.07 ,$197.60 ,$227.24 ,$36.07 ,$209.95 ,$234.65 ,$217.36 ,$187.72 ,$36.07 ,$36.07 ,$36.07 ,$180.31 ,$135.85 ,$224.77 ,$224.77 ,$197.60 ,$122.84 ,$135.85 ,$222.30 ,$119.26 ,$222.30 ,$133.38 ,$232.18 ,$268.33 ,$227.24 ,$38.23 ,$224.77 ,$119.26 ,$152.00 ,$152.00 ,$222.30 ,$184.34 ,$172.04 ,$120.45 ,$36.07 ,$234.65 ,$125.22 ,$36.07 ,$214.89 ,$119.26 ,$222.30 ,$119.26 ,$222.30 ,$222.30 ,$222.30 ,$239.59 ,$200.07 ,$229.71 ,$212.42 ,$239.59 
SACRED HEART HOSPITAL (ACU),45000424,30300,HC REMOVE NASAL FOREIGN BODY-RT,450,1 ,$247.00 ,$185.25 ,$36.07 ,$268.33 ,$159.07 ,$119.26 ,$172.90 ,$36.07 ,$205.01 ,$37.15 ,$163.02 ,$234.65 ,$36.07 ,$197.60 ,$227.24 ,$36.07 ,$209.95 ,$234.65 ,$217.36 ,$187.72 ,$36.07 ,$36.07 ,$36.07 ,$180.31 ,$135.85 ,$224.77 ,$224.77 ,$197.60 ,$122.84 ,$135.85 ,$222.30 ,$119.26 ,$222.30 ,$133.38 ,$232.18 ,$268.33 ,$227.24 ,$38.23 ,$224.77 ,$119.26 ,$152.00 ,$152.00 ,$222.30 ,$184.34 ,$172.04 ,$120.45 ,$36.07 ,$234.65 ,$125.22 ,$36.07 ,$214.89 ,$119.26 ,$222.30 ,$119.26 ,$222.30 ,$222.30 ,$222.30 ,$239.59 ,$200.07 ,$229.71 ,$212.42 ,$239.59 
SACRED HEART HOSPITAL (ACU),45000425,30901,HC CNTRL NOSEBLEED ANT SMP-LT,450,1 ,$443.00 ,$332.25 ,$36.07 ,$443.00 ,$285.29 ,$119.26 ,$310.10 ,$36.07 ,$367.69 ,$37.15 ,$292.38 ,$420.85 ,$36.07 ,$354.40 ,$407.56 ,$36.07 ,$376.55 ,$420.85 ,$389.84 ,$336.68 ,$36.07 ,$36.07 ,$36.07 ,$323.39 ,$243.65 ,$403.13 ,$403.13 ,$354.40 ,$122.84 ,$243.65 ,$398.70 ,$119.26 ,$398.70 ,$239.22 ,$416.42 ,$268.33 ,$407.56 ,$38.23 ,$403.13 ,$119.26 ,$272.62 ,$272.62 ,$398.70 ,$330.61 ,$308.55 ,$120.45 ,$36.07 ,$420.85 ,$125.22 ,$36.07 ,$385.41 ,$119.26 ,$398.70 ,$119.26 ,$398.70 ,$398.70 ,$398.70 ,$429.71 ,$358.83 ,$411.99 ,$380.98 ,$429.71 
SACRED HEART HOSPITAL (ACU),45000426,30901,HC CNTRL NOSEBLEED ANT SMP-RT,450,1 ,$443.00 ,$332.25 ,$36.07 ,$443.00 ,$285.29 ,$119.26 ,$310.10 ,$36.07 ,$367.69 ,$37.15 ,$292.38 ,$420.85 ,$36.07 ,$354.40 ,$407.56 ,$36.07 ,$376.55 ,$420.85 ,$389.84 ,$336.68 ,$36.07 ,$36.07 ,$36.07 ,$323.39 ,$243.65 ,$403.13 ,$403.13 ,$354.40 ,$122.84 ,$243.65 ,$398.70 ,$119.26 ,$398.70 ,$239.22 ,$416.42 ,$268.33 ,$407.56 ,$38.23 ,$403.13 ,$119.26 ,$272.62 ,$272.62 ,$398.70 ,$330.61 ,$308.55 ,$120.45 ,$36.07 ,$420.85 ,$125.22 ,$36.07 ,$385.41 ,$119.26 ,$398.70 ,$119.26 ,$398.70 ,$398.70 ,$398.70 ,$429.71 ,$358.83 ,$411.99 ,$380.98 ,$429.71 
SACRED HEART HOSPITAL (ACU),45000427,30903,HC CNTRL NOSEBLEED ANT CPLX-LT,450,1 ,$557.00 ,$417.75 ,$36.07 ,$557.00 ,$358.71 ,$119.26 ,$389.90 ,$36.07 ,$462.31 ,$37.15 ,$367.62 ,$529.15 ,$36.07 ,$445.60 ,$512.44 ,$36.07 ,$473.45 ,$529.15 ,$490.16 ,$423.32 ,$36.07 ,$36.07 ,$36.07 ,$406.61 ,$306.35 ,$506.87 ,$506.87 ,$445.60 ,$122.84 ,$306.35 ,$501.30 ,$119.26 ,$501.30 ,$300.78 ,$523.58 ,$268.33 ,$512.44 ,$38.23 ,$506.87 ,$119.26 ,$342.78 ,$342.78 ,$501.30 ,$415.69 ,$387.95 ,$120.45 ,$36.07 ,$529.15 ,$125.22 ,$36.07 ,$484.59 ,$119.26 ,$501.30 ,$119.26 ,$501.30 ,$501.30 ,$501.30 ,$540.29 ,$451.17 ,$518.01 ,$479.02 ,$540.29 
SACRED HEART HOSPITAL (ACU),45000428,30903,HC CNTRL NOSEBLEED ANT CPLX-RT,450,1 ,$557.00 ,$417.75 ,$36.07 ,$557.00 ,$358.71 ,$119.26 ,$389.90 ,$36.07 ,$462.31 ,$37.15 ,$367.62 ,$529.15 ,$36.07 ,$445.60 ,$512.44 ,$36.07 ,$473.45 ,$529.15 ,$490.16 ,$423.32 ,$36.07 ,$36.07 ,$36.07 ,$406.61 ,$306.35 ,$506.87 ,$506.87 ,$445.60 ,$122.84 ,$306.35 ,$501.30 ,$119.26 ,$501.30 ,$300.78 ,$523.58 ,$268.33 ,$512.44 ,$38.23 ,$506.87 ,$119.26 ,$342.78 ,$342.78 ,$501.30 ,$415.69 ,$387.95 ,$120.45 ,$36.07 ,$529.15 ,$125.22 ,$36.07 ,$484.59 ,$119.26 ,$501.30 ,$119.26 ,$501.30 ,$501.30 ,$501.30 ,$540.29 ,$451.17 ,$518.01 ,$479.02 ,$540.29 
SACRED HEART HOSPITAL (ACU),45000429,30905,HC CONTROL OF NOSEBLEED-LT,450,1 ,$350.00 ,$262.50 ,$36.07 ,$350.00 ,$225.40 ,$119.26 ,$245.00 ,$36.07 ,$290.50 ,$37.15 ,$231.00 ,$332.50 ,$36.07 ,$280.00 ,$322.00 ,$36.07 ,$297.50 ,$332.50 ,$308.00 ,$266.00 ,$36.07 ,$36.07 ,$36.07 ,$255.50 ,$192.50 ,$318.50 ,$318.50 ,$280.00 ,$122.84 ,$192.50 ,$315.00 ,$119.26 ,$315.00 ,$189.00 ,$329.00 ,$268.33 ,$322.00 ,$38.23 ,$318.50 ,$119.26 ,$215.39 ,$215.39 ,$315.00 ,$261.21 ,$243.78 ,$120.45 ,$36.07 ,$332.50 ,$125.22 ,$36.07 ,$304.50 ,$119.26 ,$315.00 ,$119.26 ,$315.00 ,$315.00 ,$315.00 ,$339.50 ,$283.50 ,$325.50 ,$301.00 ,$339.50 
SACRED HEART HOSPITAL (ACU),45000430,30905,HC CONTROL OF NOSEBLEED-RT,450,1 ,$350.00 ,$262.50 ,$36.07 ,$350.00 ,$225.40 ,$119.26 ,$245.00 ,$36.07 ,$290.50 ,$37.15 ,$231.00 ,$332.50 ,$36.07 ,$280.00 ,$322.00 ,$36.07 ,$297.50 ,$332.50 ,$308.00 ,$266.00 ,$36.07 ,$36.07 ,$36.07 ,$255.50 ,$192.50 ,$318.50 ,$318.50 ,$280.00 ,$122.84 ,$192.50 ,$315.00 ,$119.26 ,$315.00 ,$189.00 ,$329.00 ,$268.33 ,$322.00 ,$38.23 ,$318.50 ,$119.26 ,$215.39 ,$215.39 ,$315.00 ,$261.21 ,$243.78 ,$120.45 ,$36.07 ,$332.50 ,$125.22 ,$36.07 ,$304.50 ,$119.26 ,$315.00 ,$119.26 ,$315.00 ,$315.00 ,$315.00 ,$339.50 ,$283.50 ,$325.50 ,$301.00 ,$339.50 
SACRED HEART HOSPITAL (ACU),45000431,32551,HC TUBE THORACOSTOMY-LT,450,1 ,$692.00 ,$519.00 ,$309.29 ,"$3,346.33 ",$445.65 ,"$1,487.26 ",$484.40 ,$309.29 ,$574.36 ,$318.57 ,$456.72 ,$657.40 ,$309.29 ,$553.60 ,$636.64 ,$309.29 ,$588.20 ,$657.40 ,$608.96 ,$525.92 ,$309.29 ,$309.29 ,$309.29 ,$505.16 ,$380.60 ,$629.72 ,$629.72 ,$553.60 ,"$1,531.88 ",$380.60 ,$622.80 ,"$1,487.26 ",$622.80 ,$373.68 ,$650.48 ,"$3,346.33 ",$636.64 ,$327.85 ,$629.72 ,"$1,487.26 ",$425.86 ,$425.86 ,$622.80 ,$516.44 ,$481.98 ,"$1,502.13 ",$309.29 ,$657.40 ,"$1,561.62 ",$309.29 ,$602.04 ,"$1,487.26 ",$622.80 ,"$1,487.26 ",$622.80 ,$622.80 ,$622.80 ,$671.24 ,$560.52 ,$643.56 ,$595.12 ,$671.24 
SACRED HEART HOSPITAL (ACU),45000432,32551,HC TUBE THORACOSTOMY-RT,450,1 ,$692.00 ,$519.00 ,$309.29 ,"$3,346.33 ",$445.65 ,"$1,487.26 ",$484.40 ,$309.29 ,$574.36 ,$318.57 ,$456.72 ,$657.40 ,$309.29 ,$553.60 ,$636.64 ,$309.29 ,$588.20 ,$657.40 ,$608.96 ,$525.92 ,$309.29 ,$309.29 ,$309.29 ,$505.16 ,$380.60 ,$629.72 ,$629.72 ,$553.60 ,"$1,531.88 ",$380.60 ,$622.80 ,"$1,487.26 ",$622.80 ,$373.68 ,$650.48 ,"$3,346.33 ",$636.64 ,$327.85 ,$629.72 ,"$1,487.26 ",$425.86 ,$425.86 ,$622.80 ,$516.44 ,$481.98 ,"$1,502.13 ",$309.29 ,$657.40 ,"$1,561.62 ",$309.29 ,$602.04 ,"$1,487.26 ",$622.80 ,"$1,487.26 ",$622.80 ,$622.80 ,$622.80 ,$671.24 ,$560.52 ,$643.56 ,$595.12 ,$671.24 
SACRED HEART HOSPITAL (ACU),45000433,32554,HC THORACENTESIS ASPIRATION WO IMAGING-LT,450,1 ,"$1,253.00 ",$939.75 ,$309.29 ,"$1,286.28 ",$806.93 ,$571.68 ,$877.10 ,$309.29 ,"$1,039.99 ",$318.57 ,$826.98 ,"$1,190.35 ",$309.29 ,"$1,002.40 ","$1,152.76 ",$309.29 ,"$1,065.05 ","$1,190.35 ","$1,102.64 ",$952.28 ,$309.29 ,$309.29 ,$309.29 ,$914.69 ,$689.15 ,"$1,140.23 ","$1,140.23 ","$1,002.40 ",$588.83 ,$689.15 ,"$1,127.70 ",$571.68 ,"$1,127.70 ",$676.62 ,"$1,177.82 ","$1,286.28 ","$1,152.76 ",$327.85 ,"$1,140.23 ",$571.68 ,$771.10 ,$771.10 ,"$1,127.70 ",$935.11 ,$872.71 ,$577.40 ,$309.29 ,"$1,190.35 ",$600.27 ,$309.29 ,"$1,090.11 ",$571.68 ,"$1,127.70 ",$571.68 ,"$1,127.70 ","$1,127.70 ","$1,127.70 ","$1,215.41 ","$1,014.93 ","$1,165.29 ","$1,077.58 ","$1,215.41 "
SACRED HEART HOSPITAL (ACU),45000434,32554,HC THORACENTESIS ASPIRATION WO IMAGING-RT,450,1 ,"$1,253.00 ",$939.75 ,$309.29 ,"$1,286.28 ",$806.93 ,$571.68 ,$877.10 ,$309.29 ,"$1,039.99 ",$318.57 ,$826.98 ,"$1,190.35 ",$309.29 ,"$1,002.40 ","$1,152.76 ",$309.29 ,"$1,065.05 ","$1,190.35 ","$1,102.64 ",$952.28 ,$309.29 ,$309.29 ,$309.29 ,$914.69 ,$689.15 ,"$1,140.23 ","$1,140.23 ","$1,002.40 ",$588.83 ,$689.15 ,"$1,127.70 ",$571.68 ,"$1,127.70 ",$676.62 ,"$1,177.82 ","$1,286.28 ","$1,152.76 ",$327.85 ,"$1,140.23 ",$571.68 ,$771.10 ,$771.10 ,"$1,127.70 ",$935.11 ,$872.71 ,$577.40 ,$309.29 ,"$1,190.35 ",$600.27 ,$309.29 ,"$1,090.11 ",$571.68 ,"$1,127.70 ",$571.68 ,"$1,127.70 ","$1,127.70 ","$1,127.70 ","$1,215.41 ","$1,014.93 ","$1,165.29 ","$1,077.58 ","$1,215.41 "
SACRED HEART HOSPITAL (ACU),45000435,56420,HC I AND D ABSC GLAND BARTHOLINS-LT,450,1 ,$163.00 ,$122.25 ,$64.05 ,$405.41 ,$104.97 ,$180.18 ,$114.10 ,$64.05 ,$135.29 ,$65.97 ,$107.58 ,$154.85 ,$64.05 ,$130.40 ,$149.96 ,$64.05 ,$138.55 ,$154.85 ,$143.44 ,$123.88 ,$64.05 ,$64.05 ,$64.05 ,$118.99 ,$89.65 ,$148.33 ,$148.33 ,$130.40 ,$185.59 ,$89.65 ,$146.70 ,$180.18 ,$146.70 ,$88.02 ,$153.22 ,$405.41 ,$149.96 ,$67.89 ,$148.33 ,$180.18 ,$100.31 ,$100.31 ,$146.70 ,$121.65 ,$113.53 ,$181.98 ,$64.05 ,$154.85 ,$189.19 ,$64.05 ,$141.81 ,$180.18 ,$146.70 ,$180.18 ,$146.70 ,$146.70 ,$146.70 ,$158.11 ,$132.03 ,$151.59 ,$140.18 ,$158.11 
SACRED HEART HOSPITAL (ACU),45000436,56420,HC I AND D ABSC GLAND BARTHOLINS-RT,450,1 ,$163.00 ,$122.25 ,$64.05 ,$405.41 ,$104.97 ,$180.18 ,$114.10 ,$64.05 ,$135.29 ,$65.97 ,$107.58 ,$154.85 ,$64.05 ,$130.40 ,$149.96 ,$64.05 ,$138.55 ,$154.85 ,$143.44 ,$123.88 ,$64.05 ,$64.05 ,$64.05 ,$118.99 ,$89.65 ,$148.33 ,$148.33 ,$130.40 ,$185.59 ,$89.65 ,$146.70 ,$180.18 ,$146.70 ,$88.02 ,$153.22 ,$405.41 ,$149.96 ,$67.89 ,$148.33 ,$180.18 ,$100.31 ,$100.31 ,$146.70 ,$121.65 ,$113.53 ,$181.98 ,$64.05 ,$154.85 ,$189.19 ,$64.05 ,$141.81 ,$180.18 ,$146.70 ,$180.18 ,$146.70 ,$146.70 ,$146.70 ,$158.11 ,$132.03 ,$151.59 ,$140.18 ,$158.11 
SACRED HEART HOSPITAL (ACU),45000437,64400,HC NERVE BLOCK TRIGEMINAL-LT,450,1 ,$589.00 ,$441.75 ,$141.34 ,$621.73 ,$379.32 ,$276.32 ,$412.30 ,$141.34 ,$488.87 ,$145.58 ,$388.74 ,$559.55 ,$141.34 ,$471.20 ,$541.88 ,$141.34 ,$500.65 ,$559.55 ,$518.32 ,$447.64 ,$141.34 ,$141.34 ,$141.34 ,$429.97 ,$323.95 ,$535.99 ,$535.99 ,$471.20 ,$284.61 ,$323.95 ,$530.10 ,$276.32 ,$530.10 ,$318.06 ,$553.66 ,$621.73 ,$541.88 ,$149.82 ,$535.99 ,$276.32 ,$362.47 ,$362.47 ,$530.10 ,$439.57 ,$410.24 ,$279.09 ,$141.34 ,$559.55 ,$290.14 ,$141.34 ,$512.43 ,$276.32 ,$530.10 ,$276.32 ,$530.10 ,$530.10 ,$530.10 ,$571.33 ,$477.09 ,$547.77 ,$506.54 ,$571.33 
SACRED HEART HOSPITAL (ACU),45000438,64400,HC NERVE BLOCK TRIGEMINAL-RT,450,1 ,$589.00 ,$441.75 ,$141.34 ,$621.73 ,$379.32 ,$276.32 ,$412.30 ,$141.34 ,$488.87 ,$145.58 ,$388.74 ,$559.55 ,$141.34 ,$471.20 ,$541.88 ,$141.34 ,$500.65 ,$559.55 ,$518.32 ,$447.64 ,$141.34 ,$141.34 ,$141.34 ,$429.97 ,$323.95 ,$535.99 ,$535.99 ,$471.20 ,$284.61 ,$323.95 ,$530.10 ,$276.32 ,$530.10 ,$318.06 ,$553.66 ,$621.73 ,$541.88 ,$149.82 ,$535.99 ,$276.32 ,$362.47 ,$362.47 ,$530.10 ,$439.57 ,$410.24 ,$279.09 ,$141.34 ,$559.55 ,$290.14 ,$141.34 ,$512.43 ,$276.32 ,$530.10 ,$276.32 ,$530.10 ,$530.10 ,$530.10 ,$571.33 ,$477.09 ,$547.77 ,$506.54 ,$571.33 
SACRED HEART HOSPITAL (ACU),45000439,64450,HC INJ ANES OTHER THAN PERIPHERAL-LT,450,1 ,$507.00 ,$380.25 ,$141.34 ,"$1,511.09 ",$326.51 ,$671.59 ,$354.90 ,$141.34 ,$420.81 ,$145.58 ,$334.62 ,$481.65 ,$141.34 ,$405.60 ,$466.44 ,$141.34 ,$430.95 ,$481.65 ,$446.16 ,$385.32 ,$141.34 ,$141.34 ,$141.34 ,$370.11 ,$278.85 ,$461.37 ,$461.37 ,$405.60 ,$691.74 ,$278.85 ,$456.30 ,$671.59 ,$456.30 ,$273.78 ,$476.58 ,"$1,511.09 ",$466.44 ,$149.82 ,$461.37 ,$671.59 ,$312.01 ,$312.01 ,$456.30 ,$378.37 ,$353.13 ,$678.31 ,$141.34 ,$481.65 ,$705.17 ,$141.34 ,$441.09 ,$671.59 ,$456.30 ,$671.59 ,$456.30 ,$456.30 ,$456.30 ,$491.79 ,$410.67 ,$471.51 ,$436.02 ,$491.79 
SACRED HEART HOSPITAL (ACU),45000440,64450,HC INJ ANES OTHER THAN PERIPHERAL-RT,450,1 ,$507.00 ,$380.25 ,$141.34 ,"$1,511.09 ",$326.51 ,$671.59 ,$354.90 ,$141.34 ,$420.81 ,$145.58 ,$334.62 ,$481.65 ,$141.34 ,$405.60 ,$466.44 ,$141.34 ,$430.95 ,$481.65 ,$446.16 ,$385.32 ,$141.34 ,$141.34 ,$141.34 ,$370.11 ,$278.85 ,$461.37 ,$461.37 ,$405.60 ,$691.74 ,$278.85 ,$456.30 ,$671.59 ,$456.30 ,$273.78 ,$476.58 ,"$1,511.09 ",$466.44 ,$149.82 ,$461.37 ,$671.59 ,$312.01 ,$312.01 ,$456.30 ,$378.37 ,$353.13 ,$678.31 ,$141.34 ,$481.65 ,$705.17 ,$141.34 ,$441.09 ,$671.59 ,$456.30 ,$671.59 ,$456.30 ,$456.30 ,$456.30 ,$491.79 ,$410.67 ,$471.51 ,$436.02 ,$491.79 
SACRED HEART HOSPITAL (ACU),45000441,65210,HC REMOVE EYE FB CONJUCT EMBED-LT,450,1 ,$175.00 ,$131.25 ,$23.62 ,$645.84 ,$112.70 ,$287.04 ,$122.50 ,$23.62 ,$145.25 ,$24.33 ,$115.50 ,$166.25 ,$23.62 ,$140.00 ,$161.00 ,$23.62 ,$148.75 ,$166.25 ,$154.00 ,$133.00 ,$23.62 ,$23.62 ,$23.62 ,$127.75 ,$96.25 ,$159.25 ,$159.25 ,$140.00 ,$295.65 ,$96.25 ,$157.50 ,$287.04 ,$157.50 ,$94.50 ,$164.50 ,$645.84 ,$161.00 ,$25.04 ,$159.25 ,$287.04 ,$107.70 ,$107.70 ,$157.50 ,$130.60 ,$121.89 ,$289.91 ,$23.62 ,$166.25 ,$301.39 ,$23.62 ,$152.25 ,$287.04 ,$157.50 ,$287.04 ,$157.50 ,$157.50 ,$157.50 ,$169.75 ,$141.75 ,$162.75 ,$150.50 ,$169.75 
SACRED HEART HOSPITAL (ACU),45000442,65210,HC REMOVE EYE FB CONJUCT EMBED-RT,450,1 ,$175.00 ,$131.25 ,$23.62 ,$645.84 ,$112.70 ,$287.04 ,$122.50 ,$23.62 ,$145.25 ,$24.33 ,$115.50 ,$166.25 ,$23.62 ,$140.00 ,$161.00 ,$23.62 ,$148.75 ,$166.25 ,$154.00 ,$133.00 ,$23.62 ,$23.62 ,$23.62 ,$127.75 ,$96.25 ,$159.25 ,$159.25 ,$140.00 ,$295.65 ,$96.25 ,$157.50 ,$287.04 ,$157.50 ,$94.50 ,$164.50 ,$645.84 ,$161.00 ,$25.04 ,$159.25 ,$287.04 ,$107.70 ,$107.70 ,$157.50 ,$130.60 ,$121.89 ,$289.91 ,$23.62 ,$166.25 ,$301.39 ,$23.62 ,$152.25 ,$287.04 ,$157.50 ,$287.04 ,$157.50 ,$157.50 ,$157.50 ,$169.75 ,$141.75 ,$162.75 ,$150.50 ,$169.75 
SACRED HEART HOSPITAL (ACU),45000443,65220,HC REMOVE FB CORNL W/O SLIT LAMP-LT,450,1 ,$165.00 ,$123.75 ,$23.62 ,$645.84 ,$106.26 ,$287.04 ,$115.50 ,$23.62 ,$136.95 ,$24.33 ,$108.90 ,$156.75 ,$23.62 ,$132.00 ,$151.80 ,$23.62 ,$140.25 ,$156.75 ,$145.20 ,$125.40 ,$23.62 ,$23.62 ,$23.62 ,$120.45 ,$90.75 ,$150.15 ,$150.15 ,$132.00 ,$295.65 ,$90.75 ,$148.50 ,$287.04 ,$148.50 ,$89.10 ,$155.10 ,$645.84 ,$151.80 ,$25.04 ,$150.15 ,$287.04 ,$101.54 ,$101.54 ,$148.50 ,$123.14 ,$114.92 ,$289.91 ,$23.62 ,$156.75 ,$301.39 ,$23.62 ,$143.55 ,$287.04 ,$148.50 ,$287.04 ,$148.50 ,$148.50 ,$148.50 ,$160.05 ,$133.65 ,$153.45 ,$141.90 ,$160.05 
SACRED HEART HOSPITAL (ACU),45000444,65220,HC REMOVE FB CORNL W/O SLIT LAMP-RT,450,1 ,$165.00 ,$123.75 ,$23.62 ,$645.84 ,$106.26 ,$287.04 ,$115.50 ,$23.62 ,$136.95 ,$24.33 ,$108.90 ,$156.75 ,$23.62 ,$132.00 ,$151.80 ,$23.62 ,$140.25 ,$156.75 ,$145.20 ,$125.40 ,$23.62 ,$23.62 ,$23.62 ,$120.45 ,$90.75 ,$150.15 ,$150.15 ,$132.00 ,$295.65 ,$90.75 ,$148.50 ,$287.04 ,$148.50 ,$89.10 ,$155.10 ,$645.84 ,$151.80 ,$25.04 ,$150.15 ,$287.04 ,$101.54 ,$101.54 ,$148.50 ,$123.14 ,$114.92 ,$289.91 ,$23.62 ,$156.75 ,$301.39 ,$23.62 ,$143.55 ,$287.04 ,$148.50 ,$287.04 ,$148.50 ,$148.50 ,$148.50 ,$160.05 ,$133.65 ,$153.45 ,$141.90 ,$160.05 
SACRED HEART HOSPITAL (ACU),45000445,65222,HC REMOVE FB CORNL W/ SLIT LAMP-LT,450,1 ,$166.00 ,$124.50 ,$23.62 ,$268.33 ,$106.90 ,$119.26 ,$116.20 ,$23.62 ,$137.78 ,$24.33 ,$109.56 ,$157.70 ,$23.62 ,$132.80 ,$152.72 ,$23.62 ,$141.10 ,$157.70 ,$146.08 ,$126.16 ,$23.62 ,$23.62 ,$23.62 ,$121.18 ,$91.30 ,$151.06 ,$151.06 ,$132.80 ,$122.84 ,$91.30 ,$149.40 ,$119.26 ,$149.40 ,$89.64 ,$156.04 ,$268.33 ,$152.72 ,$25.04 ,$151.06 ,$119.26 ,$102.16 ,$102.16 ,$149.40 ,$123.89 ,$115.62 ,$120.45 ,$23.62 ,$157.70 ,$125.22 ,$23.62 ,$144.42 ,$119.26 ,$149.40 ,$119.26 ,$149.40 ,$149.40 ,$149.40 ,$161.02 ,$134.46 ,$154.38 ,$142.76 ,$161.02 
SACRED HEART HOSPITAL (ACU),45000446,65222,HC REMOVE FB CORNL W/ SLIT LAMP-RT,450,1 ,$166.00 ,$124.50 ,$23.62 ,$268.33 ,$106.90 ,$119.26 ,$116.20 ,$23.62 ,$137.78 ,$24.33 ,$109.56 ,$157.70 ,$23.62 ,$132.80 ,$152.72 ,$23.62 ,$141.10 ,$157.70 ,$146.08 ,$126.16 ,$23.62 ,$23.62 ,$23.62 ,$121.18 ,$91.30 ,$151.06 ,$151.06 ,$132.80 ,$122.84 ,$91.30 ,$149.40 ,$119.26 ,$149.40 ,$89.64 ,$156.04 ,$268.33 ,$152.72 ,$25.04 ,$151.06 ,$119.26 ,$102.16 ,$102.16 ,$149.40 ,$123.89 ,$115.62 ,$120.45 ,$23.62 ,$157.70 ,$125.22 ,$23.62 ,$144.42 ,$119.26 ,$149.40 ,$119.26 ,$149.40 ,$149.40 ,$149.40 ,$161.02 ,$134.46 ,$154.38 ,$142.76 ,$161.02 
SACRED HEART HOSPITAL (ACU),45000447,66720,HC DESTRUCTION CILIARY BODY-LT,450,1 ,$228.00 ,$171.00 ,$123.12 ,"$4,761.93 ",$146.83 ,"$2,116.41 ",$159.60 ,$228.00 ,$189.24 ,$307.44 ,$150.48 ,$216.60 ,$298.49 ,$182.40 ,$209.76 ,$228.00 ,$193.80 ,$216.60 ,$200.64 ,$173.28 ,$228.00 ,$228.00 ,$298.49 ,$166.44 ,$125.40 ,$207.48 ,$207.48 ,$182.40 ,"$2,179.90 ",$125.40 ,$205.20 ,"$2,116.41 ",$205.20 ,$123.12 ,$214.32 ,"$4,761.93 ",$209.76 ,$316.40 ,$207.48 ,"$2,116.41 ",$140.31 ,$140.31 ,$205.20 ,$170.16 ,$158.80 ,"$2,137.58 ",$228.00 ,$216.60 ,"$2,222.24 ",$228.00 ,$198.36 ,"$2,116.41 ",$205.20 ,"$2,116.41 ",$205.20 ,$205.20 ,$205.20 ,$221.16 ,$184.68 ,$212.04 ,$196.08 ,$221.16 
SACRED HEART HOSPITAL (ACU),45000448,66720,HC DESTRUCTION CILIARY BODY-RT,450,1 ,$228.00 ,$171.00 ,$123.12 ,"$4,761.93 ",$146.83 ,"$2,116.41 ",$159.60 ,$228.00 ,$189.24 ,$307.44 ,$150.48 ,$216.60 ,$298.49 ,$182.40 ,$209.76 ,$228.00 ,$193.80 ,$216.60 ,$200.64 ,$173.28 ,$228.00 ,$228.00 ,$298.49 ,$166.44 ,$125.40 ,$207.48 ,$207.48 ,$182.40 ,"$2,179.90 ",$125.40 ,$205.20 ,"$2,116.41 ",$205.20 ,$123.12 ,$214.32 ,"$4,761.93 ",$209.76 ,$316.40 ,$207.48 ,"$2,116.41 ",$140.31 ,$140.31 ,$205.20 ,$170.16 ,$158.80 ,"$2,137.58 ",$228.00 ,$216.60 ,"$2,222.24 ",$228.00 ,$198.36 ,"$2,116.41 ",$205.20 ,"$2,116.41 ",$205.20 ,$205.20 ,$205.20 ,$221.16 ,$184.68 ,$212.04 ,$196.08 ,$221.16 
SACRED HEART HOSPITAL (ACU),45000449,67208,HC TX RETINAL LESION-LT,450,1 ,$228.00 ,$171.00 ,$102.33 ,$622.50 ,$146.83 ,$276.67 ,$159.60 ,$102.33 ,$189.24 ,$105.40 ,$150.48 ,$216.60 ,$102.33 ,$182.40 ,$209.76 ,$102.33 ,$193.80 ,$216.60 ,$200.64 ,$173.28 ,$102.33 ,$102.33 ,$102.33 ,$166.44 ,$125.40 ,$207.48 ,$207.48 ,$182.40 ,$284.97 ,$125.40 ,$205.20 ,$276.67 ,$205.20 ,$123.12 ,$214.32 ,$622.50 ,$209.76 ,$108.47 ,$207.48 ,$276.67 ,$140.31 ,$140.31 ,$205.20 ,$170.16 ,$158.80 ,$279.43 ,$102.33 ,$216.60 ,$290.50 ,$102.33 ,$198.36 ,$276.67 ,$205.20 ,$276.67 ,$205.20 ,$205.20 ,$205.20 ,$221.16 ,$184.68 ,$212.04 ,$196.08 ,$221.16 
SACRED HEART HOSPITAL (ACU),45000450,67208,HC TX RETINAL LESION-RT,450,1 ,$228.00 ,$171.00 ,$102.33 ,$622.50 ,$146.83 ,$276.67 ,$159.60 ,$102.33 ,$189.24 ,$105.40 ,$150.48 ,$216.60 ,$102.33 ,$182.40 ,$209.76 ,$102.33 ,$193.80 ,$216.60 ,$200.64 ,$173.28 ,$102.33 ,$102.33 ,$102.33 ,$166.44 ,$125.40 ,$207.48 ,$207.48 ,$182.40 ,$284.97 ,$125.40 ,$205.20 ,$276.67 ,$205.20 ,$123.12 ,$214.32 ,$622.50 ,$209.76 ,$108.47 ,$207.48 ,$276.67 ,$140.31 ,$140.31 ,$205.20 ,$170.16 ,$158.80 ,$279.43 ,$102.33 ,$216.60 ,$290.50 ,$102.33 ,$198.36 ,$276.67 ,$205.20 ,$276.67 ,$205.20 ,$205.20 ,$205.20 ,$221.16 ,$184.68 ,$212.04 ,$196.08 ,$221.16 
SACRED HEART HOSPITAL (ACU),45000451,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-LT,450,1 ,$286.00 ,$214.50 ,$36.07 ,"$1,480.84 ",$184.18 ,$658.15 ,$200.20 ,$36.07 ,$237.38 ,$37.15 ,$188.76 ,$271.70 ,$36.07 ,$228.80 ,$263.12 ,$36.07 ,$243.10 ,$271.70 ,$251.68 ,$217.36 ,$36.07 ,$36.07 ,$36.07 ,$208.78 ,$157.30 ,$260.26 ,$260.26 ,$228.80 ,$677.89 ,$157.30 ,$257.40 ,$658.15 ,$257.40 ,$154.44 ,$268.84 ,"$1,480.84 ",$263.12 ,$38.23 ,$260.26 ,$658.15 ,$176.00 ,$176.00 ,$257.40 ,$213.44 ,$199.20 ,$664.73 ,$36.07 ,$271.70 ,$691.06 ,$36.07 ,$248.82 ,$658.15 ,$257.40 ,$658.15 ,$257.40 ,$257.40 ,$257.40 ,$277.42 ,$231.66 ,$265.98 ,$245.96 ,$277.42 
SACRED HEART HOSPITAL (ACU),45000452,69000,HC DRAIN ABSC/HEMA EAR EXT SMP-RT,450,1 ,$286.00 ,$214.50 ,$36.07 ,"$1,480.84 ",$184.18 ,$658.15 ,$200.20 ,$36.07 ,$237.38 ,$37.15 ,$188.76 ,$271.70 ,$36.07 ,$228.80 ,$263.12 ,$36.07 ,$243.10 ,$271.70 ,$251.68 ,$217.36 ,$36.07 ,$36.07 ,$36.07 ,$208.78 ,$157.30 ,$260.26 ,$260.26 ,$228.80 ,$677.89 ,$157.30 ,$257.40 ,$658.15 ,$257.40 ,$154.44 ,$268.84 ,"$1,480.84 ",$263.12 ,$38.23 ,$260.26 ,$658.15 ,$176.00 ,$176.00 ,$257.40 ,$213.44 ,$199.20 ,$664.73 ,$36.07 ,$271.70 ,$691.06 ,$36.07 ,$248.82 ,$658.15 ,$257.40 ,$658.15 ,$257.40 ,$257.40 ,$257.40 ,$277.42 ,$231.66 ,$265.98 ,$245.96 ,$277.42 
SACRED HEART HOSPITAL (ACU),45000453,69200,HC REM FOREIGN BODY CANAL AUD EXT-LT,450,1 ,$101.00 ,$75.75 ,$36.07 ,$268.33 ,$65.04 ,$119.26 ,$70.70 ,$36.07 ,$83.83 ,$37.15 ,$66.66 ,$95.95 ,$36.07 ,$80.80 ,$92.92 ,$36.07 ,$85.85 ,$95.95 ,$88.88 ,$76.76 ,$36.07 ,$36.07 ,$36.07 ,$73.73 ,$55.55 ,$91.91 ,$91.91 ,$80.80 ,$122.84 ,$55.55 ,$90.90 ,$119.26 ,$90.90 ,$54.54 ,$94.94 ,$268.33 ,$92.92 ,$38.23 ,$91.91 ,$119.26 ,$62.16 ,$62.16 ,$90.90 ,$75.38 ,$70.35 ,$120.45 ,$36.07 ,$95.95 ,$125.22 ,$36.07 ,$87.87 ,$119.26 ,$90.90 ,$119.26 ,$90.90 ,$90.90 ,$90.90 ,$97.97 ,$81.81 ,$93.93 ,$86.86 ,$97.97 
SACRED HEART HOSPITAL (ACU),45000454,69200,HC REM FOREIGN BODY CANAL AUD EXT-RT,450,1 ,$101.00 ,$75.75 ,$36.07 ,$268.33 ,$65.04 ,$119.26 ,$70.70 ,$36.07 ,$83.83 ,$37.15 ,$66.66 ,$95.95 ,$36.07 ,$80.80 ,$92.92 ,$36.07 ,$85.85 ,$95.95 ,$88.88 ,$76.76 ,$36.07 ,$36.07 ,$36.07 ,$73.73 ,$55.55 ,$91.91 ,$91.91 ,$80.80 ,$122.84 ,$55.55 ,$90.90 ,$119.26 ,$90.90 ,$54.54 ,$94.94 ,$268.33 ,$92.92 ,$38.23 ,$91.91 ,$119.26 ,$62.16 ,$62.16 ,$90.90 ,$75.38 ,$70.35 ,$120.45 ,$36.07 ,$95.95 ,$125.22 ,$36.07 ,$87.87 ,$119.26 ,$90.90 ,$119.26 ,$90.90 ,$90.90 ,$90.90 ,$97.97 ,$81.81 ,$93.93 ,$86.86 ,$97.97 
SACRED HEART HOSPITAL (ACU),45000455,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-LT,450,1 ,$222.00 ,$166.50 ,$36.07 ,$222.00 ,$142.97 ,$58.87 ,$155.40 ,$36.07 ,$184.26 ,$37.15 ,$146.52 ,$210.90 ,$36.07 ,$177.60 ,$204.24 ,$36.07 ,$188.70 ,$210.90 ,$195.36 ,$168.72 ,$36.07 ,$36.07 ,$36.07 ,$162.06 ,$122.10 ,$202.02 ,$202.02 ,$177.60 ,$60.64 ,$122.10 ,$199.80 ,$58.87 ,$199.80 ,$119.88 ,$208.68 ,$132.46 ,$204.24 ,$38.23 ,$202.02 ,$58.87 ,$136.62 ,$136.62 ,$199.80 ,$165.68 ,$154.62 ,$59.46 ,$36.07 ,$210.90 ,$61.82 ,$36.07 ,$193.14 ,$58.87 ,$199.80 ,$58.87 ,$199.80 ,$199.80 ,$199.80 ,$215.34 ,$179.82 ,$206.46 ,$190.92 ,$215.34 
SACRED HEART HOSPITAL (ACU),45000456,69210,HC REMOVE CERUMEN IMPACTED W/INSTRUMENT-RT,450,1 ,$222.00 ,$166.50 ,$36.07 ,$222.00 ,$142.97 ,$58.87 ,$155.40 ,$36.07 ,$184.26 ,$37.15 ,$146.52 ,$210.90 ,$36.07 ,$177.60 ,$204.24 ,$36.07 ,$188.70 ,$210.90 ,$195.36 ,$168.72 ,$36.07 ,$36.07 ,$36.07 ,$162.06 ,$122.10 ,$202.02 ,$202.02 ,$177.60 ,$60.64 ,$122.10 ,$199.80 ,$58.87 ,$199.80 ,$119.88 ,$208.68 ,$132.46 ,$204.24 ,$38.23 ,$202.02 ,$58.87 ,$136.62 ,$136.62 ,$199.80 ,$165.68 ,$154.62 ,$59.46 ,$36.07 ,$210.90 ,$61.82 ,$36.07 ,$193.14 ,$58.87 ,$199.80 ,$58.87 ,$199.80 ,$199.80 ,$199.80 ,$215.34 ,$179.82 ,$206.46 ,$190.92 ,$215.34 
SACRED HEART HOSPITAL (ACU),45001024,27768,HC CLSD TX POSTERIOR WITH MANIP,450,1 ,"$4,343.00 ","$3,257.25 ",$144.24 ,"$4,343.00 ","$2,796.89 ","$1,473.12 ","$3,040.10 ",$144.24 ,"$3,604.69 ",$148.57 ,"$2,866.38 ","$4,125.85 ",$144.24 ,"$3,474.40 ","$3,995.56 ",$144.24 ,"$3,691.55 ","$4,125.85 ","$3,821.84 ","$3,300.68 ",$144.24 ,$144.24 ,$144.24 ,"$3,170.39 ","$2,388.65 ","$3,952.13 ","$3,952.13 ","$3,474.40 ","$1,517.31 ","$2,388.65 ","$3,908.70 ","$1,473.12 ","$3,908.70 ","$2,345.22 ","$4,082.42 ","$3,314.53 ","$3,995.56 ",$152.89 ,"$3,952.13 ","$1,473.12 ","$2,672.68 ","$2,672.68 ","$3,908.70 ","$3,241.18 ","$3,024.90 ","$1,487.85 ",$144.24 ,"$4,125.85 ","$1,546.78 ",$144.24 ,"$3,778.41 ","$1,473.12 ","$3,908.70 ","$1,473.12 ","$3,908.70 ","$3,908.70 ","$3,908.70 ","$4,212.71 ","$3,517.83 ","$4,038.99 ","$3,734.98 ","$4,212.71 "
SACRED HEART HOSPITAL (ACU),45001168,52281,HC CYSTOURETHROSCOPY W/CALIBRATION/DILATION,450,1 ,"$5,209.53 ","$3,907.15 ",$506.66 ,"$5,209.53 ","$3,354.94 ","$1,893.71 ","$3,646.67 ",$506.66 ,"$4,323.91 ",$521.86 ,"$3,438.29 ","$4,949.05 ",$506.66 ,"$4,167.62 ","$4,792.77 ",$506.66 ,"$4,428.10 ","$4,949.05 ","$4,584.39 ","$3,959.24 ",$506.66 ,$506.66 ,$506.66 ,"$3,802.96 ","$2,865.24 ","$4,740.67 ","$4,740.67 ","$4,167.62 ","$1,950.52 ","$2,865.24 ","$4,688.58 ","$1,893.71 ","$4,688.58 ","$2,813.15 ","$4,896.96 ","$4,260.86 ","$4,792.77 ",$537.06 ,"$4,740.67 ","$1,893.71 ","$3,205.94 ","$3,205.94 ","$4,688.58 ","$3,887.87 ","$3,628.44 ","$1,912.65 ",$506.66 ,"$4,949.05 ","$1,988.40 ",$506.66 ,"$4,532.29 ","$1,893.71 ","$4,688.58 ","$1,893.71 ","$4,688.58 ","$4,688.58 ","$4,688.58 ","$5,053.24 ","$4,219.72 ","$4,844.86 ","$4,480.20 ","$5,053.24 "
SACRED HEART HOSPITAL (ACU),45001281,25520,HC TX FX RADIUS SHAFT W/DISLOC CLOSED,450,1 ,"$4,045.47 ","$3,034.10 ",$144.24 ,"$4,045.47 ","$2,605.28 ","$1,473.12 ","$2,831.83 ",$144.24 ,"$3,357.74 ",$148.57 ,"$2,670.01 ","$3,843.20 ",$144.24 ,"$3,236.38 ","$3,721.83 ",$144.24 ,"$3,438.65 ","$3,843.20 ","$3,560.01 ","$3,074.56 ",$144.24 ,$144.24 ,$144.24 ,"$2,953.19 ","$2,225.01 ","$3,681.38 ","$3,681.38 ","$3,236.38 ","$1,517.31 ","$2,225.01 ","$3,640.92 ","$1,473.12 ","$3,640.92 ","$2,184.55 ","$3,802.74 ","$3,314.53 ","$3,721.83 ",$152.89 ,"$3,681.38 ","$1,473.12 ","$2,489.58 ","$2,489.58 ","$3,640.92 ","$3,019.13 ","$2,817.67 ","$1,487.85 ",$144.24 ,"$3,843.20 ","$1,546.78 ",$144.24 ,"$3,519.56 ","$1,473.12 ","$3,640.92 ","$1,473.12 ","$3,640.92 ","$3,640.92 ","$3,640.92 ","$3,924.11 ","$3,276.83 ","$3,762.29 ","$3,479.10 ","$3,924.11 "
SACRED HEART HOSPITAL (ACU),45001296,27762,HC TX FX CLOSED MEDIAL MALLEOLUS W/MANIP,450,1 ,"$4,495.00 ","$3,371.25 ",$144.24 ,"$4,495.00 ","$2,894.78 ","$1,473.12 ","$3,146.50 ",$144.24 ,"$3,730.85 ",$148.57 ,"$2,966.70 ","$4,270.25 ",$144.24 ,"$3,596.00 ","$4,135.40 ",$144.24 ,"$3,820.75 ","$4,270.25 ","$3,955.60 ","$3,416.20 ",$144.24 ,$144.24 ,$144.24 ,"$3,281.35 ","$2,472.25 ","$4,090.45 ","$4,090.45 ","$3,596.00 ","$1,517.31 ","$2,472.25 ","$4,045.50 ","$1,473.12 ","$4,045.50 ","$2,427.30 ","$4,225.30 ","$3,314.53 ","$4,135.40 ",$152.89 ,"$4,090.45 ","$1,473.12 ","$2,766.22 ","$2,766.22 ","$4,045.50 ","$3,354.62 ","$3,130.77 ","$1,487.85 ",$144.24 ,"$4,270.25 ","$1,546.78 ",$144.24 ,"$3,910.65 ","$1,473.12 ","$4,045.50 ","$1,473.12 ","$4,045.50 ","$4,045.50 ","$4,045.50 ","$4,360.15 ","$3,640.95 ","$4,180.35 ","$3,865.70 ","$4,360.15 "
SACRED HEART HOSPITAL (ACU),45001331,43762,HC REPLACE GASTRO TUBE PERC,450,1 ,$602.00 ,$451.50 ,$64.85 ,$633.24 ,$387.69 ,$281.44 ,$421.40 ,$64.85 ,$499.66 ,$66.80 ,$397.32 ,$571.90 ,$64.85 ,$481.60 ,$553.84 ,$64.85 ,$511.70 ,$571.90 ,$529.76 ,$457.52 ,$64.85 ,$64.85 ,$64.85 ,$439.46 ,$331.10 ,$547.82 ,$547.82 ,$481.60 ,$289.88 ,$331.10 ,$541.80 ,$281.44 ,$541.80 ,$325.08 ,$565.88 ,$633.24 ,$553.84 ,$68.74 ,$547.82 ,$281.44 ,$370.47 ,$370.47 ,$541.80 ,$449.27 ,$419.29 ,$284.25 ,$64.85 ,$571.90 ,$295.51 ,$64.85 ,$523.74 ,$281.44 ,$541.80 ,$281.44 ,$541.80 ,$541.80 ,$541.80 ,$583.94 ,$487.62 ,$559.86 ,$517.72 ,$583.94 
SACRED HEART HOSPITAL (ACU),45001360,31577,HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),450,1 ,"$1,175.00 ",$881.25 ,$246.82 ,"$1,175.00 ",$756.70 ,$397.54 ,$822.50 ,$246.82 ,$975.25 ,$254.22 ,$775.50 ,"$1,116.25 ",$246.82 ,$940.00 ,"$1,081.00 ",$246.82 ,$998.75 ,"$1,116.25 ","$1,034.00 ",$893.00 ,$246.82 ,$246.82 ,$246.82 ,$857.75 ,$646.25 ,"$1,069.25 ","$1,069.25 ",$940.00 ,$409.47 ,$646.25 ,"$1,057.50 ",$397.54 ,"$1,057.50 ",$634.50 ,"$1,104.50 ",$894.46 ,"$1,081.00 ",$261.63 ,"$1,069.25 ",$397.54 ,$723.10 ,$723.10 ,"$1,057.50 ",$876.90 ,$818.39 ,$401.51 ,$246.82 ,"$1,116.25 ",$417.42 ,$246.82 ,"$1,022.25 ",$397.54 ,"$1,057.50 ",$397.54 ,"$1,057.50 ","$1,057.50 ","$1,057.50 ","$1,139.75 ",$951.75 ,"$1,092.75 ","$1,010.50 ","$1,139.75 "
SACRED HEART HOSPITAL (ACU),45001361,27256,HC TX SPONT HIP DISC,450,1 ,$644.00 ,$483.00 ,$144.24 ,$644.00 ,$414.74 ,$217.99 ,$450.80 ,$144.24 ,$534.52 ,$148.57 ,$425.04 ,$611.80 ,$144.24 ,$515.20 ,$592.48 ,$144.24 ,$547.40 ,$611.80 ,$566.72 ,$489.44 ,$144.24 ,$144.24 ,$144.24 ,$470.12 ,$354.20 ,$586.04 ,$586.04 ,$515.20 ,$224.53 ,$354.20 ,$579.60 ,$217.99 ,$579.60 ,$347.76 ,$605.36 ,$490.48 ,$592.48 ,$152.89 ,$586.04 ,$217.99 ,$396.32 ,$396.32 ,$579.60 ,$480.62 ,$448.55 ,$220.17 ,$144.24 ,$611.80 ,$228.89 ,$144.24 ,$560.28 ,$217.99 ,$579.60 ,$217.99 ,$579.60 ,$579.60 ,$579.60 ,$624.68 ,$521.64 ,$598.92 ,$553.84 ,$624.68 
SACRED HEART HOSPITAL (ACU),45080001,10060,HC I AND D ABSC SMP,450,1 ,$200.00 ,$150.00 ,$53.09 ,$427.33 ,$128.80 ,$189.93 ,$140.00 ,$53.09 ,$166.00 ,$54.68 ,$132.00 ,$190.00 ,$53.09 ,$160.00 ,$184.00 ,$53.09 ,$170.00 ,$190.00 ,$176.00 ,$152.00 ,$53.09 ,$53.09 ,$53.09 ,$146.00 ,$110.00 ,$182.00 ,$182.00 ,$160.00 ,$195.63 ,$110.00 ,$180.00 ,$189.93 ,$180.00 ,$108.00 ,$188.00 ,$427.33 ,$184.00 ,$56.28 ,$182.00 ,$189.93 ,$123.08 ,$123.08 ,$180.00 ,$149.26 ,$139.30 ,$191.82 ,$53.09 ,$190.00 ,$199.42 ,$53.09 ,$174.00 ,$189.93 ,$180.00 ,$189.93 ,$180.00 ,$180.00 ,$180.00 ,$194.00 ,$162.00 ,$186.00 ,$172.00 ,$194.00 
SACRED HEART HOSPITAL (ACU),45080002,42000,HC I AND D PALATE OR UVULA,450,1 ,$683.00 ,$512.25 ,$36.07 ,$683.00 ,$439.85 ,$223.76 ,$478.10 ,$36.07 ,$566.89 ,$37.15 ,$450.78 ,$648.85 ,$36.07 ,$546.40 ,$628.36 ,$36.07 ,$580.55 ,$648.85 ,$601.04 ,$519.08 ,$36.07 ,$36.07 ,$36.07 ,$498.59 ,$375.65 ,$621.53 ,$621.53 ,$546.40 ,$230.47 ,$375.65 ,$614.70 ,$223.76 ,$614.70 ,$368.82 ,$642.02 ,$503.46 ,$628.36 ,$38.23 ,$621.53 ,$223.76 ,$420.32 ,$420.32 ,$614.70 ,$509.72 ,$475.71 ,$226.00 ,$36.07 ,$648.85 ,$234.95 ,$36.07 ,$594.21 ,$223.76 ,$614.70 ,$223.76 ,$614.70 ,$614.70 ,$614.70 ,$662.51 ,$553.23 ,$635.19 ,$587.38 ,$662.51 
SACRED HEART HOSPITAL (ACU),46000002,94010,HC SPIROMETRY/PFT PKG,460,1 ,$326.87 ,$245.15 ,$16.90 ,$332.24 ,$210.50 ,$147.66 ,$228.81 ,$16.90 ,$271.30 ,$17.41 ,$215.73 ,$310.53 ,$16.90 ,$261.50 ,$300.72 ,$16.90 ,$277.84 ,$310.53 ,$287.65 ,$248.42 ,$16.90 ,$16.90 ,$16.90 ,$238.62 ,$179.78 ,$297.45 ,$297.45 ,$261.50 ,$152.09 ,$179.78 ,$294.18 ,$147.66 ,$294.18 ,$176.51 ,$307.26 ,$332.24 ,$300.72 ,$17.91 ,$297.45 ,$147.66 ,$201.16 ,$201.16 ,$294.18 ,$243.94 ,$227.67 ,$149.14 ,$16.90 ,$310.53 ,$155.05 ,$16.90 ,$284.38 ,$147.66 ,$294.18 ,$147.66 ,$294.18 ,$294.18 ,$294.18 ,$317.06 ,$264.76 ,$303.99 ,$281.11 ,$317.06 
SACRED HEART HOSPITAL (ACU),46000004,94060,HC SPIROMETRY/PFT PRE  AND  POST,460,1 ,$585.04 ,$438.78 ,$33.22 ,$629.79 ,$376.77 ,$279.91 ,$409.53 ,$33.22 ,$485.58 ,$34.22 ,$386.13 ,$555.79 ,$33.22 ,$468.03 ,$538.24 ,$33.22 ,$497.28 ,$555.79 ,$514.84 ,$444.63 ,$33.22 ,$33.22 ,$33.22 ,$427.08 ,$321.77 ,$532.39 ,$532.39 ,$468.03 ,$288.31 ,$321.77 ,$526.54 ,$279.91 ,$526.54 ,$315.92 ,$549.94 ,$629.79 ,$538.24 ,$35.21 ,$532.39 ,$279.91 ,$360.03 ,$360.03 ,$526.54 ,$436.62 ,$407.48 ,$282.71 ,$33.22 ,$555.79 ,$293.90 ,$33.22 ,$508.98 ,$279.91 ,$526.54 ,$279.91 ,$526.54 ,$526.54 ,$526.54 ,$567.49 ,$473.88 ,$544.09 ,$503.13 ,$567.49 
SACRED HEART HOSPITAL (ACU),46000006,94070,HC SPIROMETRY/PFT CPLX,460,1 ,$910.82 ,$683.12 ,$33.22 ,$910.82 ,$586.57 ,$279.91 ,$637.57 ,$33.22 ,$755.98 ,$34.22 ,$601.14 ,$865.28 ,$33.22 ,$728.66 ,$837.95 ,$33.22 ,$774.20 ,$865.28 ,$801.52 ,$692.22 ,$33.22 ,$33.22 ,$33.22 ,$664.90 ,$500.95 ,$828.85 ,$828.85 ,$728.66 ,$288.31 ,$500.95 ,$819.74 ,$279.91 ,$819.74 ,$491.84 ,$856.17 ,$629.79 ,$837.95 ,$35.21 ,$828.85 ,$279.91 ,$560.52 ,$560.52 ,$819.74 ,$679.75 ,$634.39 ,$282.71 ,$33.22 ,$865.28 ,$293.90 ,$33.22 ,$792.41 ,$279.91 ,$819.74 ,$279.91 ,$819.74 ,$819.74 ,$819.74 ,$883.50 ,$737.76 ,$847.06 ,$783.31 ,$883.50 
SACRED HEART HOSPITAL (ACU),46000007,94150,HC VITAL CAPACITY TOTAL,460,1 ,$198.18 ,$148.64 ,$16.90 ,$332.24 ,$127.63 ,$147.66 ,$138.73 ,$16.90 ,$164.49 ,$17.41 ,$130.80 ,$188.27 ,$16.90 ,$158.54 ,$182.33 ,$16.90 ,$168.45 ,$188.27 ,$174.40 ,$150.62 ,$16.90 ,$16.90 ,$16.90 ,$144.67 ,$109.00 ,$180.34 ,$180.34 ,$158.54 ,$152.09 ,$109.00 ,$178.36 ,$147.66 ,$178.36 ,$107.02 ,$186.29 ,$332.24 ,$182.33 ,$17.91 ,$180.34 ,$147.66 ,$121.96 ,$121.96 ,$178.36 ,$147.90 ,$138.03 ,$149.14 ,$16.90 ,$188.27 ,$155.05 ,$16.90 ,$172.42 ,$147.66 ,$178.36 ,$147.66 ,$178.36 ,$178.36 ,$178.36 ,$192.23 ,$160.53 ,$184.31 ,$170.43 ,$192.23 
SACRED HEART HOSPITAL (ACU),46000013,94726,HC PLETHYSMOGRAPHY,460,1 ,$278.12 ,$208.59 ,$33.22 ,$629.79 ,$179.11 ,$279.91 ,$194.68 ,$33.22 ,$230.84 ,$34.22 ,$183.56 ,$264.21 ,$33.22 ,$222.50 ,$255.87 ,$33.22 ,$236.40 ,$264.21 ,$244.75 ,$211.37 ,$33.22 ,$33.22 ,$33.22 ,$203.03 ,$152.97 ,$253.09 ,$253.09 ,$222.50 ,$288.31 ,$152.97 ,$250.31 ,$279.91 ,$250.31 ,$150.18 ,$261.43 ,$629.79 ,$255.87 ,$35.21 ,$253.09 ,$279.91 ,$171.16 ,$171.16 ,$250.31 ,$207.56 ,$193.71 ,$282.71 ,$33.22 ,$264.21 ,$293.90 ,$33.22 ,$241.96 ,$279.91 ,$250.31 ,$279.91 ,$250.31 ,$250.31 ,$250.31 ,$269.78 ,$225.28 ,$258.65 ,$239.18 ,$269.78 
SACRED HEART HOSPITAL (ACU),46000014,94618,HC WALK TEST 6 MIN,460,1 ,$115.58 ,$86.69 ,$16.90 ,$268.33 ,$74.43 ,$119.26 ,$80.91 ,$16.90 ,$95.93 ,$17.41 ,$76.28 ,$109.80 ,$16.90 ,$92.46 ,$106.33 ,$16.90 ,$98.24 ,$109.80 ,$101.71 ,$87.84 ,$16.90 ,$16.90 ,$16.90 ,$84.37 ,$63.57 ,$105.18 ,$105.18 ,$92.46 ,$122.84 ,$63.57 ,$104.02 ,$119.26 ,$104.02 ,$62.41 ,$108.65 ,$268.33 ,$106.33 ,$17.91 ,$105.18 ,$119.26 ,$71.13 ,$71.13 ,$104.02 ,$86.26 ,$80.50 ,$120.45 ,$16.90 ,$109.80 ,$125.22 ,$16.90 ,$100.55 ,$119.26 ,$104.02 ,$119.26 ,$104.02 ,$104.02 ,$104.02 ,$112.11 ,$93.62 ,$107.49 ,$99.40 ,$112.11 
SACRED HEART HOSPITAL (ACU),46000017,94729,HC CARBON MONOXIDE DIFF (DLCO),460,1 ,$370.79 ,$278.09 ,$16.90 ,$370.79 ,$238.79 , N/A ,$259.55 ,$16.90 ,$307.76 ,$17.41 ,$244.72 ,$352.25 ,$16.90 ,$296.63 ,$341.13 ,$16.90 ,$315.17 ,$352.25 ,$326.30 ,$281.80 ,$16.90 ,$16.90 ,$16.90 ,$270.68 ,$203.93 ,$337.42 ,$337.42 ,$296.63 , N/A ,$203.93 ,$333.71 , N/A ,$333.71 ,$200.23 ,$348.54 , N/A ,$341.13 ,$17.91 ,$337.42 , N/A ,$228.18 ,$228.18 ,$333.71 ,$276.72 ,$258.26 , N/A ,$16.90 ,$352.25 , N/A ,$16.90 ,$322.59 , N/A ,$333.71 , N/A ,$333.71 ,$333.71 ,$333.71 ,$359.67 ,$300.34 ,$344.83 ,$318.88 ,$359.67 
SACRED HEART HOSPITAL (ACU),46000018,94762,HC OXIMETRY OVERNIGHT,460,1 ,$293.70 ,$220.28 ,$16.90 ,$332.24 ,$189.14 ,$147.66 ,$205.59 ,$16.90 ,$243.77 ,$17.41 ,$193.84 ,$279.02 ,$16.90 ,$234.96 ,$270.20 ,$16.90 ,$249.65 ,$279.02 ,$258.46 ,$223.21 ,$16.90 ,$16.90 ,$16.90 ,$214.40 ,$161.54 ,$267.27 ,$267.27 ,$234.96 ,$152.09 ,$161.54 ,$264.33 ,$147.66 ,$264.33 ,$158.60 ,$276.08 ,$332.24 ,$270.20 ,$17.91 ,$267.27 ,$147.66 ,$180.74 ,$180.74 ,$264.33 ,$219.19 ,$204.56 ,$149.14 ,$16.90 ,$279.02 ,$155.05 ,$16.90 ,$255.52 ,$147.66 ,$264.33 ,$147.66 ,$264.33 ,$264.33 ,$264.33 ,$284.89 ,$237.90 ,$273.14 ,$252.58 ,$284.89 
SACRED HEART HOSPITAL (ACU),46000021,94760,HC PULSE OX SINGLE,460,1 ,$75.52 ,$56.64 ,$40.78 ,$75.52 ,$48.63 , N/A ,$52.86 , N/A ,$62.68 , N/A ,$49.84 ,$71.74 , N/A ,$60.42 ,$69.48 , N/A ,$64.19 ,$71.74 ,$66.46 ,$57.40 , N/A , N/A , N/A ,$55.13 ,$41.54 ,$68.72 ,$68.72 ,$60.42 , N/A ,$41.54 ,$67.97 , N/A ,$67.97 ,$40.78 ,$70.99 , N/A ,$69.48 , N/A ,$68.72 , N/A ,$46.48 ,$46.48 ,$67.97 ,$56.36 ,$52.60 , N/A , N/A ,$71.74 , N/A , N/A ,$65.70 , N/A ,$67.97 , N/A ,$67.97 ,$67.97 ,$67.97 ,$73.25 ,$61.17 ,$70.23 ,$64.95 ,$73.25 
SACRED HEART HOSPITAL (ACU),46000023,94761,HC PULSE OX MULTI DETERMIN,360,1 ,$214.51 ,$160.88 ,$115.84 ,$214.51 ,$138.14 , N/A ,$150.16 , N/A , N/A , N/A , N/A ,$203.78 , N/A ,$171.61 ,$197.35 , N/A , N/A ,$203.78 ,$188.77 ,$163.03 , N/A , N/A , N/A ,$156.59 ,$117.98 ,$195.20 ,$195.20 ,$171.61 , N/A ,$117.98 ,$193.06 , N/A ,$193.06 ,$115.84 ,$201.64 , N/A ,$197.35 , N/A ,$195.20 , N/A ,$132.01 ,$132.01 ,$193.06 ,$160.09 , N/A , N/A , N/A ,$203.78 , N/A , N/A ,$186.62 , N/A ,$193.06 , N/A ,$193.06 ,$193.06 ,$193.06 ,$208.07 ,$173.75 ,$199.49 ,$184.48 ,$208.07 
SACRED HEART HOSPITAL (ACU),47000000,92585,HC AUDITORY EVOKED POTENT COMPR,470,1 ,$950.34 ,$712.76 ,$513.18 ,$950.34 ,$612.02 , N/A ,$665.24 , N/A ,$788.78 , N/A ,$627.22 ,$902.82 , N/A ,$760.27 ,$874.31 , N/A ,$807.79 ,$902.82 ,$836.30 ,$722.26 , N/A , N/A , N/A ,$693.75 ,$522.69 ,$864.81 ,$864.81 ,$760.27 , N/A ,$522.69 ,$855.31 , N/A ,$855.31 ,$513.18 ,$893.32 , N/A ,$874.31 , N/A ,$864.81 , N/A ,$584.84 ,$584.84 ,$855.31 ,$709.24 ,$661.91 , N/A , N/A ,$902.82 , N/A , N/A ,$826.80 , N/A ,$855.31 , N/A ,$855.31 ,$855.31 ,$855.31 ,$921.83 ,$769.78 ,$883.82 ,$817.29 ,$921.83 
SACRED HEART HOSPITAL (ACU),47000003,92586,HC NEWBORN HEARING SCREENING,470,1 ,$580.86 ,$435.65 ,$313.66 ,$580.86 ,$374.07 , N/A ,$406.60 , N/A ,$482.11 , N/A ,$383.37 ,$551.82 , N/A ,$464.69 ,$534.39 , N/A ,$493.73 ,$551.82 ,$511.16 ,$441.45 , N/A , N/A , N/A ,$424.03 ,$319.47 ,$528.58 ,$528.58 ,$464.69 , N/A ,$319.47 ,$522.77 , N/A ,$522.77 ,$313.66 ,$546.01 , N/A ,$534.39 , N/A ,$528.58 , N/A ,$357.46 ,$357.46 ,$522.77 ,$433.50 ,$404.57 , N/A , N/A ,$551.82 , N/A , N/A ,$505.35 , N/A ,$522.77 , N/A ,$522.77 ,$522.77 ,$522.77 ,$563.43 ,$470.50 ,$540.20 ,$499.54 ,$563.43 
SACRED HEART HOSPITAL (ACU),47000090,92650,HC AEP SCR AUDITORY POT W STIMULI,470,1 ,$413.00 ,$309.75 ,$11.24 ,$413.00 ,$265.97 , N/A ,$289.10 ,$11.24 ,$342.79 ,$11.58 ,$272.58 ,$392.35 ,$11.24 ,$330.40 ,$379.96 ,$11.24 ,$351.05 ,$392.35 ,$363.44 ,$313.88 ,$11.24 ,$11.24 ,$11.24 ,$301.49 ,$227.15 ,$375.83 ,$375.83 ,$330.40 , N/A ,$227.15 ,$371.70 , N/A ,$371.70 ,$223.02 ,$388.22 , N/A ,$379.96 ,$11.91 ,$375.83 , N/A ,$254.16 ,$254.16 ,$371.70 ,$308.22 ,$287.65 , N/A ,$11.24 ,$392.35 , N/A ,$11.24 ,$359.31 , N/A ,$371.70 , N/A ,$371.70 ,$371.70 ,$371.70 ,$400.61 ,$334.53 ,$384.09 ,$355.18 ,$400.61 
SACRED HEART HOSPITAL (ACU),47000091,92651,HC AEP HEARING STATUS DETER BB STIM I AND R,470,1 ,$413.00 ,$309.75 ,$26.53 ,$413.00 ,$265.97 ,$147.66 ,$289.10 ,$26.53 ,$342.79 ,$27.33 ,$272.58 ,$392.35 ,$26.53 ,$330.40 ,$379.96 ,$26.53 ,$351.05 ,$392.35 ,$363.44 ,$313.88 ,$26.53 ,$26.53 ,$26.53 ,$301.49 ,$227.15 ,$375.83 ,$375.83 ,$330.40 ,$152.09 ,$227.15 ,$371.70 ,$147.66 ,$371.70 ,$223.02 ,$388.22 ,$332.24 ,$379.96 ,$28.12 ,$375.83 ,$147.66 ,$254.16 ,$254.16 ,$371.70 ,$308.22 ,$287.65 ,$149.14 ,$26.53 ,$392.35 ,$155.05 ,$26.53 ,$359.31 ,$147.66 ,$371.70 ,$147.66 ,$371.70 ,$371.70 ,$371.70 ,$400.61 ,$334.53 ,$384.09 ,$355.18 ,$400.61 
SACRED HEART HOSPITAL (ACU),47100009,92558,HC AUD EVOKED OTOACOUS EMISSIONS SCREENING,471,1 ,$80.00 ,$60.00 ,$11.24 ,$80.00 ,$51.52 , N/A ,$56.00 ,$11.24 ,$66.40 ,$11.58 ,$52.80 ,$76.00 ,$11.24 ,$64.00 ,$73.60 ,$11.24 ,$68.00 ,$76.00 ,$70.40 ,$60.80 ,$11.24 ,$11.24 ,$11.24 ,$58.40 ,$44.00 ,$72.80 ,$72.80 ,$64.00 , N/A ,$44.00 ,$72.00 , N/A ,$72.00 ,$43.20 ,$75.20 , N/A ,$73.60 ,$11.91 ,$72.80 , N/A ,$49.23 ,$49.23 ,$72.00 ,$59.70 ,$55.72 , N/A ,$11.24 ,$76.00 , N/A ,$11.24 ,$69.60 , N/A ,$72.00 , N/A ,$72.00 ,$72.00 ,$72.00 ,$77.60 ,$64.80 ,$74.40 ,$68.80 ,$77.60 
SACRED HEART HOSPITAL (ACU),48000005,92960,HC CARDIOVERSION EXTERNAL,480,1 ,"$2,001.00 ","$1,500.75 ",$209.77 ,"$2,001.00 ","$1,288.64 ",$594.14 ,"$1,400.70 ",$209.77 ,"$1,660.83 ",$216.06 ,"$1,320.66 ","$1,900.95 ",$209.77 ,"$1,600.80 ","$1,840.92 ",$209.77 ,"$1,700.85 ","$1,900.95 ","$1,760.88 ","$1,520.76 ",$209.77 ,$209.77 ,$209.77 ,"$1,460.73 ","$1,100.55 ","$1,820.91 ","$1,820.91 ","$1,600.80 ",$611.96 ,"$1,100.55 ","$1,800.90 ",$594.14 ,"$1,800.90 ","$1,080.54 ","$1,880.94 ","$1,336.82 ","$1,840.92 ",$222.36 ,"$1,820.91 ",$594.14 ,"$1,231.42 ","$1,231.42 ","$1,800.90 ","$1,493.35 ","$1,393.70 ",$600.08 ,$209.77 ,"$1,900.95 ",$623.85 ,$209.77 ,"$1,740.87 ",$594.14 ,"$1,800.90 ",$594.14 ,"$1,800.90 ","$1,800.90 ","$1,800.90 ","$1,940.97 ","$1,620.81 ","$1,860.93 ","$1,720.86 ","$1,940.97 "
SACRED HEART HOSPITAL (ACU),48100002,33206,HC INS/REPL PCMKR PERM ATRIAL 33206,481,1 ,"$17,449.00 ","$13,086.75 ","$2,694.63 ","$24,743.60 ","$11,237.16 ","$10,997.16 ","$12,214.30 ","$2,694.63 ","$17,449.00 ","$2,775.47 ","$15,007.00 ","$16,576.55 ","$2,694.63 ","$13,959.20 ","$16,053.08 ","$2,694.63 ","$14,831.65 ","$16,576.55 ","$15,355.12 ","$13,261.24 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$12,737.77 ","$9,596.95 ","$15,878.59 ","$15,878.59 ","$13,959.20 ","$11,327.07 ","$9,596.95 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$9,422.46 ","$16,402.06 ","$24,743.60 ","$16,053.08 ","$2,856.31 ","$15,878.59 ","$10,997.16 ","$10,738.11 ","$10,738.11 ","$15,704.10 ","$13,022.19 ","$8,724.50 ","$11,107.13 ","$2,694.63 ","$16,576.55 ","$11,547.01 ","$2,694.63 ","$15,180.63 ","$10,997.16 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$15,704.10 ","$15,704.10 ","$16,925.53 ","$14,133.69 ","$16,227.57 ","$15,006.14 ","$16,925.53 "
SACRED HEART HOSPITAL (ACU),48100003,33207,HC INS/REPL PACEMKR PERM VENTRIC 33207,481,1 ,"$17,449.00 ","$13,086.75 ","$2,694.63 ","$24,743.60 ","$11,237.16 ","$10,997.16 ","$12,214.30 ","$2,694.63 ","$17,449.00 ","$2,775.47 ","$15,007.00 ","$16,576.55 ","$2,694.63 ","$13,959.20 ","$16,053.08 ","$2,694.63 ","$14,831.65 ","$16,576.55 ","$15,355.12 ","$13,261.24 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$12,737.77 ","$9,596.95 ","$15,878.59 ","$15,878.59 ","$13,959.20 ","$11,327.07 ","$9,596.95 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$9,422.46 ","$16,402.06 ","$24,743.60 ","$16,053.08 ","$2,856.31 ","$15,878.59 ","$10,997.16 ","$10,738.11 ","$10,738.11 ","$15,704.10 ","$13,022.19 ","$8,724.50 ","$11,107.13 ","$2,694.63 ","$16,576.55 ","$11,547.01 ","$2,694.63 ","$15,180.63 ","$10,997.16 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$15,704.10 ","$15,704.10 ","$16,925.53 ","$14,133.69 ","$16,227.57 ","$15,006.14 ","$16,925.53 "
SACRED HEART HOSPITAL (ACU),48100004,33208,HC INS/REPL PACEMKR PERM A/V 33208,481,1 ,"$17,449.00 ","$13,086.75 ","$2,694.63 ","$24,743.60 ","$11,237.16 ","$10,997.16 ","$12,214.30 ","$2,694.63 ","$17,449.00 ","$2,775.47 ","$15,007.00 ","$16,576.55 ","$2,694.63 ","$13,959.20 ","$16,053.08 ","$2,694.63 ","$14,831.65 ","$16,576.55 ","$15,355.12 ","$13,261.24 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$12,737.77 ","$9,596.95 ","$15,878.59 ","$15,878.59 ","$13,959.20 ","$11,327.07 ","$9,596.95 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$9,422.46 ","$16,402.06 ","$24,743.60 ","$16,053.08 ","$2,856.31 ","$15,878.59 ","$10,997.16 ","$10,738.11 ","$10,738.11 ","$15,704.10 ","$13,022.19 ","$8,724.50 ","$11,107.13 ","$2,694.63 ","$16,576.55 ","$11,547.01 ","$2,694.63 ","$15,180.63 ","$10,997.16 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$15,704.10 ","$15,704.10 ","$16,925.53 ","$14,133.69 ","$16,227.57 ","$15,006.14 ","$16,925.53 "
SACRED HEART HOSPITAL (ACU),48100005,33210,HC INS/REPL TPM SGL ELEC/CATH 33210,481,1 ,"$5,557.00 ","$4,167.75 ",$551.72 ,"$19,414.88 ","$3,578.71 ","$8,628.84 ","$3,889.90 ",$551.72 ,"$5,557.00 ",$568.27 ,"$5,557.00 ","$5,279.15 ",$551.72 ,"$4,445.60 ","$5,112.44 ",$551.72 ,"$4,723.45 ","$5,279.15 ","$4,890.16 ","$4,223.32 ",$551.72 ,$551.72 ,$551.72 ,"$4,056.61 ","$3,056.35 ","$5,056.87 ","$5,056.87 ","$4,445.60 ","$8,887.71 ","$3,056.35 ","$5,001.30 ","$8,628.84 ","$5,001.30 ","$3,000.78 ","$5,223.58 ","$19,414.88 ","$5,112.44 ",$584.82 ,"$5,056.87 ","$8,628.84 ","$3,419.78 ","$3,419.78 ","$5,001.30 ","$4,147.19 ","$5,001.30 ","$8,715.12 ",$551.72 ,"$5,279.15 ","$9,060.28 ",$551.72 ,"$4,834.59 ","$8,628.84 ","$5,001.30 ","$8,628.84 ","$5,001.30 ","$5,001.30 ","$5,001.30 ","$5,390.29 ","$4,501.17 ","$5,168.01 ","$4,779.02 ","$5,390.29 "
SACRED HEART HOSPITAL (ACU),48100007,33213,HC INS PULSE GEN DUAL CHAMBER 33213,481,1 ,"$17,449.00 ","$13,086.75 ","$2,694.63 ","$24,743.60 ","$11,237.16 ","$10,997.16 ","$12,214.30 ","$2,694.63 ","$17,449.00 ","$2,775.47 ","$15,007.00 ","$16,576.55 ","$2,694.63 ","$13,959.20 ","$16,053.08 ","$2,694.63 ","$14,831.65 ","$16,576.55 ","$15,355.12 ","$13,261.24 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$12,737.77 ","$9,596.95 ","$15,878.59 ","$15,878.59 ","$13,959.20 ","$11,327.07 ","$9,596.95 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$9,422.46 ","$16,402.06 ","$24,743.60 ","$16,053.08 ","$2,856.31 ","$15,878.59 ","$10,997.16 ","$10,738.11 ","$10,738.11 ","$15,704.10 ","$13,022.19 ","$8,724.50 ","$11,107.13 ","$2,694.63 ","$16,576.55 ","$11,547.01 ","$2,694.63 ","$15,180.63 ","$10,997.16 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$15,704.10 ","$15,704.10 ","$16,925.53 ","$14,133.69 ","$16,227.57 ","$15,006.14 ","$16,925.53 "
SACRED HEART HOSPITAL (ACU),48100008,33214,HC UPGRADE PACEMAKER SYSTEM 33214,481,1 ,"$17,449.00 ","$13,086.75 ","$2,694.63 ","$24,743.60 ","$11,237.16 ","$10,997.16 ","$12,214.30 ","$2,694.63 ","$17,449.00 ","$2,775.47 ","$15,007.00 ","$16,576.55 ","$2,694.63 ","$13,959.20 ","$16,053.08 ","$2,694.63 ","$14,831.65 ","$16,576.55 ","$15,355.12 ","$13,261.24 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$12,737.77 ","$9,596.95 ","$15,878.59 ","$15,878.59 ","$13,959.20 ","$11,327.07 ","$9,596.95 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$9,422.46 ","$16,402.06 ","$24,743.60 ","$16,053.08 ","$2,856.31 ","$15,878.59 ","$10,997.16 ","$10,738.11 ","$10,738.11 ","$15,704.10 ","$13,022.19 ","$8,724.50 ","$11,107.13 ","$2,694.63 ","$16,576.55 ","$11,547.01 ","$2,694.63 ","$15,180.63 ","$10,997.16 ","$15,704.10 ","$10,997.16 ","$15,704.10 ","$15,704.10 ","$15,704.10 ","$16,925.53 ","$14,133.69 ","$16,227.57 ","$15,006.14 ","$16,925.53 "
SACRED HEART HOSPITAL (ACU),48100009,33215,HC REPOSITION PACE/DEFIB LEAD 33215,481,1 ,"$6,263.00 ","$4,697.25 ",$551.72 ,"$6,812.22 ","$4,033.37 ","$3,027.65 ","$4,384.10 ",$551.72 ,"$6,263.00 ",$568.27 ,"$6,263.00 ","$5,949.85 ",$551.72 ,"$5,010.40 ","$5,761.96 ",$551.72 ,"$5,323.55 ","$5,949.85 ","$5,511.44 ","$4,759.88 ",$551.72 ,$551.72 ,$551.72 ,"$4,571.99 ","$3,444.65 ","$5,699.33 ","$5,699.33 ","$5,010.40 ","$3,118.48 ","$3,444.65 ","$5,636.70 ","$3,027.65 ","$5,636.70 ","$3,382.02 ","$5,887.22 ","$6,812.22 ","$5,761.96 ",$584.82 ,"$5,699.33 ","$3,027.65 ","$3,854.25 ","$3,854.25 ","$5,636.70 ","$4,674.08 ","$5,091.27 ","$3,057.93 ",$551.72 ,"$5,949.85 ","$3,179.04 ",$551.72 ,"$5,448.81 ","$3,027.65 ","$5,636.70 ","$3,027.65 ","$5,636.70 ","$5,636.70 ","$5,636.70 ","$6,075.11 ","$5,073.03 ","$5,824.59 ","$5,386.18 ","$6,075.11 "
SACRED HEART HOSPITAL (ACU),48100010,33216,HC INS ELECTRODE SGL CHAMBER 33216,481,1 ,"$7,743.00 ","$5,807.25 ",$551.72 ,"$19,414.88 ","$4,986.49 ","$8,628.84 ","$5,420.10 ",$551.72 ,"$7,743.00 ",$568.27 ,"$7,743.00 ","$7,355.85 ",$551.72 ,"$6,194.40 ","$7,123.56 ",$551.72 ,"$6,581.55 ","$7,355.85 ","$6,813.84 ","$5,884.68 ",$551.72 ,$551.72 ,$551.72 ,"$5,652.39 ","$4,258.65 ","$7,046.13 ","$7,046.13 ","$6,194.40 ","$8,887.71 ","$4,258.65 ","$6,968.70 ","$8,628.84 ","$6,968.70 ","$4,181.22 ","$7,278.42 ","$19,414.88 ","$7,123.56 ",$584.82 ,"$7,046.13 ","$8,628.84 ","$4,765.04 ","$4,765.04 ","$6,968.70 ","$5,778.60 ","$6,968.70 ","$8,715.12 ",$551.72 ,"$7,355.85 ","$9,060.28 ",$551.72 ,"$6,736.41 ","$8,628.84 ","$6,968.70 ","$8,628.84 ","$6,968.70 ","$6,968.70 ","$6,968.70 ","$7,510.71 ","$6,271.83 ","$7,200.99 ","$6,658.98 ","$7,510.71 "
SACRED HEART HOSPITAL (ACU),48100011,33217,HC INS ELECTRODE DUAL CHAMBER 33217,481,1 ,"$7,743.00 ","$5,807.25 ",$551.72 ,"$19,414.88 ","$4,986.49 ","$8,628.84 ","$5,420.10 ",$551.72 ,"$7,743.00 ",$568.27 ,"$7,743.00 ","$7,355.85 ",$551.72 ,"$6,194.40 ","$7,123.56 ",$551.72 ,"$6,581.55 ","$7,355.85 ","$6,813.84 ","$5,884.68 ",$551.72 ,$551.72 ,$551.72 ,"$5,652.39 ","$4,258.65 ","$7,046.13 ","$7,046.13 ","$6,194.40 ","$8,887.71 ","$4,258.65 ","$6,968.70 ","$8,628.84 ","$6,968.70 ","$4,181.22 ","$7,278.42 ","$19,414.88 ","$7,123.56 ",$584.82 ,"$7,046.13 ","$8,628.84 ","$4,765.04 ","$4,765.04 ","$6,968.70 ","$5,778.60 ","$6,618.65 ","$8,715.12 ",$551.72 ,"$7,355.85 ","$9,060.28 ",$551.72 ,"$6,736.41 ","$8,628.84 ","$6,968.70 ","$8,628.84 ","$6,968.70 ","$6,968.70 ","$6,968.70 ","$7,510.71 ","$6,271.83 ","$7,200.99 ","$6,658.98 ","$7,510.71 "
SACRED HEART HOSPITAL (ACU),48100012,33222,HC REVISE PACEMAKER POCKET 33222,481,1 ,"$6,511.00 ","$4,883.25 ",$551.72 ,"$6,511.00 ","$4,193.08 ","$1,811.50 ","$4,557.70 ",$551.72 ,"$4,824.00 ",$568.27 ,"$3,859.00 ","$6,185.45 ",$551.72 ,"$5,208.80 ","$5,990.12 ",$551.72 ,"$5,534.35 ","$6,185.45 ","$5,729.68 ","$4,948.36 ",$551.72 ,$551.72 ,$551.72 ,"$4,753.03 ","$3,581.05 ","$5,925.01 ","$5,925.01 ","$5,208.80 ","$1,865.85 ","$3,581.05 ","$5,859.90 ","$1,811.50 ","$5,859.90 ","$3,515.94 ","$6,120.34 ","$4,075.87 ","$5,990.12 ",$584.82 ,"$5,925.01 ","$1,811.50 ","$4,006.87 ","$4,006.87 ","$5,859.90 ","$4,859.16 ","$3,360.24 ","$1,829.61 ",$551.72 ,"$6,185.45 ","$1,902.07 ",$551.72 ,"$5,664.57 ","$1,811.50 ","$5,859.90 ","$1,811.50 ","$5,859.90 ","$5,859.90 ","$5,859.90 ","$6,315.67 ","$5,273.91 ","$6,055.23 ","$5,599.46 ","$6,315.67 "
SACRED HEART HOSPITAL (ACU),48100013,33223,HC REVISE C-D POCKET 33223,481,1 ,"$1,203.00 ",$902.25 ,$551.72 ,"$4,075.87 ",$774.73 ,"$1,811.50 ",$842.10 ,$551.72 ,"$1,203.00 ",$568.27 ,"$1,203.00 ","$1,142.85 ",$551.72 ,$962.40 ,"$1,106.76 ",$551.72 ,"$1,022.55 ","$1,142.85 ","$1,058.64 ",$914.28 ,$551.72 ,$551.72 ,$551.72 ,$878.19 ,$661.65 ,"$1,094.73 ","$1,094.73 ",$962.40 ,"$1,865.85 ",$661.65 ,"$1,082.70 ","$1,811.50 ","$1,082.70 ",$649.62 ,"$1,130.82 ","$4,075.87 ","$1,106.76 ",$584.82 ,"$1,094.73 ","$1,811.50 ",$740.33 ,$740.33 ,"$1,082.70 ",$897.80 ,"$1,082.70 ","$1,829.61 ",$551.72 ,"$1,142.85 ","$1,902.07 ",$551.72 ,"$1,046.61 ","$1,811.50 ","$1,082.70 ","$1,811.50 ","$1,082.70 ","$1,082.70 ","$1,082.70 ","$1,166.91 ",$974.43 ,"$1,118.79 ","$1,034.58 ","$1,166.91 "
SACRED HEART HOSPITAL (ACU),48100014,33224,HC INSERT LV PACING ELECTRODE 33224,481,1 ,"$15,523.00 ","$11,642.25 ","$2,694.63 ","$24,743.60 ","$9,996.81 ","$10,997.16 ","$10,866.10 ","$2,694.63 ","$15,523.00 ","$2,775.47 ","$15,007.00 ","$14,746.85 ","$2,694.63 ","$12,418.40 ","$14,281.16 ","$2,694.63 ","$13,194.55 ","$14,746.85 ","$13,660.24 ","$11,797.48 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$11,331.79 ","$8,537.65 ","$14,125.93 ","$14,125.93 ","$12,418.40 ","$11,327.07 ","$8,537.65 ","$13,970.70 ","$10,997.16 ","$13,970.70 ","$8,382.42 ","$14,591.62 ","$24,743.60 ","$14,281.16 ","$2,856.31 ","$14,125.93 ","$10,997.16 ","$9,552.85 ","$9,552.85 ","$13,970.70 ","$11,584.81 ","$7,761.50 ","$11,107.13 ","$2,694.63 ","$14,746.85 ","$11,547.01 ","$2,694.63 ","$13,505.01 ","$10,997.16 ","$13,970.70 ","$10,997.16 ","$13,970.70 ","$13,970.70 ","$13,970.70 ","$15,057.31 ","$12,573.63 ","$14,436.39 ","$13,349.78 ","$15,057.31 "
SACRED HEART HOSPITAL (ACU),48100015,33225,HC INS LV PACING ELCT W/C-D/PACE 33225,481,1 ,"$6,511.00 ","$4,883.25 ","$2,694.63 ","$6,511.00 ","$4,193.08 ", N/A ,"$4,557.70 ","$2,694.63 ","$5,521.00 ","$2,775.47 ","$4,416.00 ","$6,185.45 ","$2,694.63 ","$5,208.80 ","$5,990.12 ","$2,694.63 ","$5,534.35 ","$6,185.45 ","$5,729.68 ","$4,948.36 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$4,753.03 ","$3,581.05 ","$5,925.01 ","$5,925.01 ","$5,208.80 ", N/A ,"$3,581.05 ","$5,859.90 ", N/A ,"$5,859.90 ","$3,515.94 ","$6,120.34 ", N/A ,"$5,990.12 ","$2,856.31 ","$5,925.01 ", N/A ,"$4,006.87 ","$4,006.87 ","$5,859.90 ","$4,859.16 ","$4,534.91 ", N/A ,"$2,694.63 ","$6,185.45 ", N/A ,"$2,694.63 ","$5,664.57 ", N/A ,"$5,859.90 ", N/A ,"$5,859.90 ","$5,859.90 ","$5,859.90 ","$6,315.67 ","$5,273.91 ","$6,055.23 ","$5,599.46 ","$6,315.67 "
SACRED HEART HOSPITAL (ACU),48100016,33226,HC REPOSITION LV ELECTRODE 33226,481,1 ,"$4,613.00 ","$3,459.75 ","$2,269.96 ","$6,812.22 ","$2,970.77 ","$3,027.65 ","$3,229.10 ","$2,269.96 ","$4,613.00 ","$2,338.06 ","$4,613.00 ","$4,382.35 ","$2,269.96 ","$3,690.40 ","$4,243.96 ","$2,269.96 ","$3,921.05 ","$4,382.35 ","$4,059.44 ","$3,505.88 ","$2,269.96 ","$2,269.96 ","$2,269.96 ","$3,367.49 ","$2,537.15 ","$4,197.83 ","$4,197.83 ","$3,690.40 ","$3,118.48 ","$2,537.15 ","$4,151.70 ","$3,027.65 ","$4,151.70 ","$2,491.02 ","$4,336.22 ","$6,812.22 ","$4,243.96 ","$2,406.16 ","$4,197.83 ","$3,027.65 ","$2,838.84 ","$2,838.84 ","$4,151.70 ","$3,442.68 ","$4,151.70 ","$3,057.93 ","$2,269.96 ","$4,382.35 ","$3,179.04 ","$2,269.96 ","$4,013.31 ","$3,027.65 ","$4,151.70 ","$3,027.65 ","$4,151.70 ","$4,151.70 ","$4,151.70 ","$4,474.61 ","$3,736.53 ","$4,290.09 ","$3,967.18 ","$4,474.61 "
SACRED HEART HOSPITAL (ACU),48100017,33233,HC REMOVE PPM 33233,481,1 ,"$7,743.00 ","$5,807.25 ","$2,269.96 ","$19,414.88 ","$4,986.49 ","$8,628.84 ","$5,420.10 ","$2,269.96 ","$7,743.00 ","$2,338.06 ","$7,743.00 ","$7,355.85 ","$2,269.96 ","$6,194.40 ","$7,123.56 ","$2,269.96 ","$6,581.55 ","$7,355.85 ","$6,813.84 ","$5,884.68 ","$2,269.96 ","$2,269.96 ","$2,269.96 ","$5,652.39 ","$4,258.65 ","$7,046.13 ","$7,046.13 ","$6,194.40 ","$8,887.71 ","$4,258.65 ","$6,968.70 ","$8,628.84 ","$6,968.70 ","$4,181.22 ","$7,278.42 ","$19,414.88 ","$7,123.56 ","$2,406.16 ","$7,046.13 ","$8,628.84 ","$4,765.04 ","$4,765.04 ","$6,968.70 ","$5,778.60 ","$6,968.70 ","$8,715.12 ","$2,269.96 ","$7,355.85 ","$9,060.28 ","$2,269.96 ","$6,736.41 ","$8,628.84 ","$6,968.70 ","$8,628.84 ","$6,968.70 ","$6,968.70 ","$6,968.70 ","$7,510.71 ","$6,271.83 ","$7,200.99 ","$6,658.98 ","$7,510.71 "
SACRED HEART HOSPITAL (ACU),48100018,33234,HC REMOVE ELECTRODE SGL 33234,481,1 ,"$15,523.00 ","$11,642.25 ",$551.72 ,"$15,523.00 ","$9,996.81 ","$3,641.95 ","$10,866.10 ",$551.72 ,"$9,649.00 ",$568.27 ,"$7,718.00 ","$14,746.85 ",$551.72 ,"$12,418.40 ","$14,281.16 ",$551.72 ,"$13,194.55 ","$14,746.85 ","$13,660.24 ","$11,797.48 ",$551.72 ,$551.72 ,$551.72 ,"$11,331.79 ","$8,537.65 ","$14,125.93 ","$14,125.93 ","$12,418.40 ","$3,751.21 ","$8,537.65 ","$13,970.70 ","$3,641.95 ","$13,970.70 ","$8,382.42 ","$14,591.62 ","$8,194.38 ","$14,281.16 ",$584.82 ,"$14,125.93 ","$3,641.95 ","$9,552.85 ","$9,552.85 ","$13,970.70 ","$11,584.81 ","$7,761.50 ","$3,678.37 ",$551.72 ,"$14,746.85 ","$3,824.05 ",$551.72 ,"$13,505.01 ","$3,641.95 ","$13,970.70 ","$3,641.95 ","$13,970.70 ","$13,970.70 ","$13,970.70 ","$15,057.31 ","$12,573.63 ","$14,436.39 ","$13,349.78 ","$15,057.31 "
SACRED HEART HOSPITAL (ACU),48100019,33235,HC REMOVE ELECTRODE DUAL 33235,481,1 ,"$15,523.00 ","$11,642.25 ",$551.72 ,"$15,523.00 ","$9,996.81 ","$3,641.95 ","$10,866.10 ",$551.72 ,"$9,649.00 ",$568.27 ,"$7,718.00 ","$14,746.85 ",$551.72 ,"$12,418.40 ","$14,281.16 ",$551.72 ,"$13,194.55 ","$14,746.85 ","$13,660.24 ","$11,797.48 ",$551.72 ,$551.72 ,$551.72 ,"$11,331.79 ","$8,537.65 ","$14,125.93 ","$14,125.93 ","$12,418.40 ","$3,751.21 ","$8,537.65 ","$13,970.70 ","$3,641.95 ","$13,970.70 ","$8,382.42 ","$14,591.62 ","$8,194.38 ","$14,281.16 ",$584.82 ,"$14,125.93 ","$3,641.95 ","$9,552.85 ","$9,552.85 ","$13,970.70 ","$11,584.81 ","$7,761.50 ","$3,678.37 ",$551.72 ,"$14,746.85 ","$3,824.05 ",$551.72 ,"$13,505.01 ","$3,641.95 ","$13,970.70 ","$3,641.95 ","$13,970.70 ","$13,970.70 ","$13,970.70 ","$15,057.31 ","$12,573.63 ","$14,436.39 ","$13,349.78 ","$15,057.31 "
SACRED HEART HOSPITAL (ACU),48100022,33241,HC REMOVE C-D PULSE GENERATOR 33241,481,1 ,"$5,878.00 ","$4,408.50 ","$2,269.96 ","$8,194.38 ","$3,785.43 ","$3,641.95 ","$4,114.60 ","$2,269.96 ","$5,878.00 ","$2,338.06 ","$5,878.00 ","$5,584.10 ","$2,269.96 ","$4,702.40 ","$5,407.76 ","$2,269.96 ","$4,996.30 ","$5,584.10 ","$5,172.64 ","$4,467.28 ","$2,269.96 ","$2,269.96 ","$2,269.96 ","$4,290.94 ","$3,232.90 ","$5,348.98 ","$5,348.98 ","$4,702.40 ","$3,751.21 ","$3,232.90 ","$5,290.20 ","$3,641.95 ","$5,290.20 ","$3,174.12 ","$5,525.32 ","$8,194.38 ","$5,407.76 ","$2,406.16 ","$5,348.98 ","$3,641.95 ","$3,617.32 ","$3,617.32 ","$5,290.20 ","$4,386.75 ","$5,290.20 ","$3,678.37 ","$2,269.96 ","$5,584.10 ","$3,824.05 ","$2,269.96 ","$5,113.86 ","$3,641.95 ","$5,290.20 ","$3,641.95 ","$5,290.20 ","$5,290.20 ","$5,290.20 ","$5,701.66 ","$4,761.18 ","$5,466.54 ","$5,055.08 ","$5,701.66 "
SACRED HEART HOSPITAL (ACU),48100023,33244,HC REMOVE C-D ELECTRODES 33244,481,1 ,"$5,878.00 ","$4,408.50 ",$551.72 ,"$8,194.38 ","$3,785.43 ","$3,641.95 ","$4,114.60 ",$551.72 ,"$5,878.00 ",$568.27 ,"$5,878.00 ","$5,584.10 ",$551.72 ,"$4,702.40 ","$5,407.76 ",$551.72 ,"$4,996.30 ","$5,584.10 ","$5,172.64 ","$4,467.28 ",$551.72 ,$551.72 ,$551.72 ,"$4,290.94 ","$3,232.90 ","$5,348.98 ","$5,348.98 ","$4,702.40 ","$3,751.21 ","$3,232.90 ","$5,290.20 ","$3,641.95 ","$5,290.20 ","$3,174.12 ","$5,525.32 ","$8,194.38 ","$5,407.76 ",$584.82 ,"$5,348.98 ","$3,641.95 ","$3,617.32 ","$3,617.32 ","$5,290.20 ","$4,386.75 ","$5,290.20 ","$3,678.37 ",$551.72 ,"$5,584.10 ","$3,824.05 ",$551.72 ,"$5,113.86 ","$3,641.95 ","$5,290.20 ","$3,641.95 ","$5,290.20 ","$5,290.20 ","$5,290.20 ","$5,701.66 ","$4,761.18 ","$5,466.54 ","$5,055.08 ","$5,701.66 "
SACRED HEART HOSPITAL (ACU),48100024,33249,HC INS/REPOS DEFIB LEAD/GEN 33249,481,1 ,"$3,952.00 ","$2,964.00 ","$2,134.08 ","$78,166.42 ","$2,545.09 ","$34,740.63 ","$2,766.40 ","$3,952.00 ","$3,952.00 ","$8,321.68 ","$3,952.00 ","$3,754.40 ","$8,079.30 ","$3,161.60 ","$3,635.84 ","$3,952.00 ","$3,359.20 ","$3,754.40 ","$3,477.76 ","$3,003.52 ","$3,952.00 ","$3,952.00 ","$8,079.30 ","$2,884.96 ","$2,173.60 ","$3,596.32 ","$3,596.32 ","$3,161.60 ","$35,782.85 ","$2,173.60 ","$3,556.80 ","$34,740.63 ","$3,556.80 ","$2,134.08 ","$3,714.88 ","$78,166.42 ","$3,635.84 ","$8,564.06 ","$3,596.32 ","$34,740.63 ","$2,432.06 ","$2,432.06 ","$3,556.80 ","$2,949.38 ","$3,556.80 ","$35,088.04 ","$3,952.00 ","$3,754.40 ","$36,477.66 ","$3,952.00 ","$3,438.24 ","$34,740.63 ","$3,556.80 ","$34,740.63 ","$3,556.80 ","$3,556.80 ","$3,556.80 ","$3,833.44 ","$3,201.12 ","$3,675.36 ","$3,398.72 ","$3,833.44 "
SACRED HEART HOSPITAL (ACU),48100028,33285,HC IMPLANT CARDIAC EVENT RECORDER,481,1 ,"$6,431.00 ","$4,823.25 ","$2,694.63 ","$19,414.88 ","$4,141.56 ","$8,628.84 ","$4,501.70 ","$2,694.63 ","$6,431.00 ","$2,775.47 ","$6,431.00 ","$6,109.45 ","$2,694.63 ","$5,144.80 ","$5,916.52 ","$2,694.63 ","$5,466.35 ","$6,109.45 ","$5,659.28 ","$4,887.56 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$4,694.63 ","$3,537.05 ","$5,852.21 ","$5,852.21 ","$5,144.80 ","$8,887.71 ","$3,537.05 ","$5,787.90 ","$8,628.84 ","$5,787.90 ","$3,472.74 ","$6,045.14 ","$19,414.88 ","$5,916.52 ","$2,856.31 ","$5,852.21 ","$8,628.84 ","$3,957.64 ","$3,957.64 ","$5,787.90 ","$4,799.46 ","$5,787.90 ","$8,715.12 ","$2,694.63 ","$6,109.45 ","$9,060.28 ","$2,694.63 ","$5,594.97 ","$8,628.84 ","$5,787.90 ","$8,628.84 ","$5,787.90 ","$5,787.90 ","$5,787.90 ","$6,238.07 ","$5,209.11 ","$5,980.83 ","$5,530.66 ","$6,238.07 "
SACRED HEART HOSPITAL (ACU),48100029,33286,HC REMOVE CARDIAC EVENT RECORDER,481,1 ,"$2,210.00 ","$1,657.50 ",$551.72 ,"$2,210.00 ","$1,423.24 ",$658.15 ,"$1,547.00 ",$551.72 ,"$2,210.00 ",$568.27 ,"$2,210.00 ","$2,099.50 ",$551.72 ,"$1,768.00 ","$2,033.20 ",$551.72 ,"$1,878.50 ","$2,099.50 ","$1,944.80 ","$1,679.60 ",$551.72 ,$551.72 ,$551.72 ,"$1,613.30 ","$1,215.50 ","$2,011.10 ","$2,011.10 ","$1,768.00 ",$677.89 ,"$1,215.50 ","$1,989.00 ",$658.15 ,"$1,989.00 ","$1,193.40 ","$2,077.40 ","$1,480.84 ","$2,033.20 ",$584.82 ,"$2,011.10 ",$658.15 ,"$1,360.03 ","$1,360.03 ","$1,989.00 ","$1,649.32 ","$1,989.00 ",$664.73 ,$551.72 ,"$2,099.50 ",$691.06 ,$551.72 ,"$1,922.70 ",$658.15 ,"$1,989.00 ",$658.15 ,"$1,989.00 ","$1,989.00 ","$1,989.00 ","$2,143.70 ","$1,790.10 ","$2,055.30 ","$1,900.60 ","$2,143.70 "
SACRED HEART HOSPITAL (ACU),48100030,33967,HC IABP INSERTION 33967,481,1 ,"$4,564.00 ","$3,423.00 ","$2,464.56 ","$4,564.00 ","$2,939.22 ", N/A ,"$3,194.80 ","$2,694.63 ","$4,564.00 ","$2,775.47 ","$4,564.00 ","$4,335.80 ","$2,694.63 ","$3,651.20 ","$4,198.88 ","$2,694.63 ","$3,879.40 ","$4,335.80 ","$4,016.32 ","$3,468.64 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$3,331.72 ","$2,510.20 ","$4,153.24 ","$4,153.24 ","$3,651.20 ", N/A ,"$2,510.20 ","$4,107.60 ", N/A ,"$4,107.60 ","$2,464.56 ","$4,290.16 ", N/A ,"$4,198.88 ","$2,856.31 ","$4,153.24 ", N/A ,"$2,808.69 ","$2,808.69 ","$4,107.60 ","$3,406.11 ","$4,107.60 ", N/A ,"$2,694.63 ","$4,335.80 ", N/A ,"$2,694.63 ","$3,970.68 ", N/A ,"$4,107.60 ", N/A ,"$4,107.60 ","$4,107.60 ","$4,107.60 ","$4,427.08 ","$3,696.84 ","$4,244.52 ","$3,925.04 ","$4,427.08 "
SACRED HEART HOSPITAL (ACU),48100039,36010,HC INTRO CATH VENA CAVA SUP/IN,481,1 ,$852.00 ,$639.00 ,$206.34 ,$852.00 ,$548.69 , N/A ,$596.40 ,$206.34 ,$852.00 ,$212.53 ,$852.00 ,$809.40 ,$206.34 ,$681.60 ,$783.84 ,$206.34 ,$724.20 ,$809.40 ,$749.76 ,$647.52 ,$206.34 ,$206.34 ,$206.34 ,$621.96 ,$468.60 ,$775.32 ,$775.32 ,$681.60 , N/A ,$468.60 ,$766.80 , N/A ,$766.80 ,$460.08 ,$800.88 , N/A ,$783.84 ,$218.72 ,$775.32 , N/A ,$524.32 ,$524.32 ,$766.80 ,$635.85 ,$766.80 , N/A ,$206.34 ,$809.40 , N/A ,$206.34 ,$741.24 , N/A ,$766.80 , N/A ,$766.80 ,$766.80 ,$766.80 ,$826.44 ,$690.12 ,$792.36 ,$732.72 ,$826.44 
SACRED HEART HOSPITAL (ACU),48100040,36011,"HC CATH PLCMT VENOUS, 1ST ORDER",481,1 ,$887.00 ,$665.25 ,$206.34 ,$887.00 ,$571.23 , N/A ,$620.90 ,$206.34 ,$887.00 ,$212.53 ,$887.00 ,$842.65 ,$206.34 ,$709.60 ,$816.04 ,$206.34 ,$753.95 ,$842.65 ,$780.56 ,$674.12 ,$206.34 ,$206.34 ,$206.34 ,$647.51 ,$487.85 ,$807.17 ,$807.17 ,$709.60 , N/A ,$487.85 ,$798.30 , N/A ,$798.30 ,$478.98 ,$833.78 , N/A ,$816.04 ,$218.72 ,$807.17 , N/A ,$545.86 ,$545.86 ,$798.30 ,$661.97 ,$798.30 , N/A ,$206.34 ,$842.65 , N/A ,$206.34 ,$771.69 , N/A ,$798.30 , N/A ,$798.30 ,$798.30 ,$798.30 ,$860.39 ,$718.47 ,$824.91 ,$762.82 ,$860.39 
SACRED HEART HOSPITAL (ACU),48100041,36012,"HC CATH PLCMT VENOUS, 2ND ORDER",481,1 ,$616.00 ,$462.00 ,$206.34 ,$616.00 ,$396.70 , N/A ,$431.20 ,$206.34 ,$616.00 ,$212.53 ,$616.00 ,$585.20 ,$206.34 ,$492.80 ,$566.72 ,$206.34 ,$523.60 ,$585.20 ,$542.08 ,$468.16 ,$206.34 ,$206.34 ,$206.34 ,$449.68 ,$338.80 ,$560.56 ,$560.56 ,$492.80 , N/A ,$338.80 ,$554.40 , N/A ,$554.40 ,$332.64 ,$579.04 , N/A ,$566.72 ,$218.72 ,$560.56 , N/A ,$379.09 ,$379.09 ,$554.40 ,$459.72 ,$554.40 , N/A ,$206.34 ,$585.20 , N/A ,$206.34 ,$535.92 , N/A ,$554.40 , N/A ,$554.40 ,$554.40 ,$554.40 ,$597.52 ,$498.96 ,$572.88 ,$529.76 ,$597.52 
SACRED HEART HOSPITAL (ACU),48100042,36013,HC INTRO CATH ARTERY HEART/PULM,481,1 ,"$1,087.00 ",$815.25 ,$206.34 ,"$1,087.00 ",$700.03 , N/A ,$760.90 ,$206.34 ,"$1,087.00 ",$212.53 ,"$1,087.00 ","$1,032.65 ",$206.34 ,$869.60 ,"$1,000.04 ",$206.34 ,$923.95 ,"$1,032.65 ",$956.56 ,$826.12 ,$206.34 ,$206.34 ,$206.34 ,$793.51 ,$597.85 ,$989.17 ,$989.17 ,$869.60 , N/A ,$597.85 ,$978.30 , N/A ,$978.30 ,$586.98 ,"$1,021.78 ", N/A ,"$1,000.04 ",$218.72 ,$989.17 , N/A ,$668.94 ,$668.94 ,$978.30 ,$811.23 ,$978.30 , N/A ,$206.34 ,"$1,032.65 ", N/A ,$206.34 ,$945.69 , N/A ,$978.30 , N/A ,$978.30 ,$978.30 ,$978.30 ,"$1,054.39 ",$880.47 ,"$1,010.91 ",$934.82 ,"$1,054.39 "
SACRED HEART HOSPITAL (ACU),48100043,36014,HC SELECT CATH L/R PULM ART,481,1 ,$764.00 ,$573.00 ,$206.34 ,$764.00 ,$492.02 , N/A ,$534.80 ,$206.34 ,$764.00 ,$212.53 ,$764.00 ,$725.80 ,$206.34 ,$611.20 ,$702.88 ,$206.34 ,$649.40 ,$725.80 ,$672.32 ,$580.64 ,$206.34 ,$206.34 ,$206.34 ,$557.72 ,$420.20 ,$695.24 ,$695.24 ,$611.20 , N/A ,$420.20 ,$687.60 , N/A ,$687.60 ,$412.56 ,$718.16 , N/A ,$702.88 ,$218.72 ,$695.24 , N/A ,$470.17 ,$470.17 ,$687.60 ,$570.17 ,$687.60 , N/A ,$206.34 ,$725.80 , N/A ,$206.34 ,$664.68 , N/A ,$687.60 , N/A ,$687.60 ,$687.60 ,$687.60 ,$741.08 ,$618.84 ,$710.52 ,$657.04 ,$741.08 
SACRED HEART HOSPITAL (ACU),48100044,36015,HC PLACE CATH ARTERY PULM SEG,481,1 ,"$1,087.00 ",$815.25 ,$206.34 ,"$1,087.00 ",$700.03 , N/A ,$760.90 ,$206.34 ,"$1,087.00 ",$212.53 ,"$1,087.00 ","$1,032.65 ",$206.34 ,$869.60 ,"$1,000.04 ",$206.34 ,$923.95 ,"$1,032.65 ",$956.56 ,$826.12 ,$206.34 ,$206.34 ,$206.34 ,$793.51 ,$597.85 ,$989.17 ,$989.17 ,$869.60 , N/A ,$597.85 ,$978.30 , N/A ,$978.30 ,$586.98 ,"$1,021.78 ", N/A ,"$1,000.04 ",$218.72 ,$989.17 , N/A ,$668.94 ,$668.94 ,$978.30 ,$811.23 ,$978.30 , N/A ,$206.34 ,"$1,032.65 ", N/A ,$206.34 ,$945.69 , N/A ,$978.30 , N/A ,$978.30 ,$978.30 ,$978.30 ,"$1,054.39 ",$880.47 ,"$1,010.91 ",$934.82 ,"$1,054.39 "
SACRED HEART HOSPITAL (ACU),48100047,36140,HC INTRO NDL/CATH ARTERY EXTREM 36140,481,1 ,"$1,088.00 ",$816.00 ,$206.34 ,"$1,088.00 ",$700.67 , N/A ,$761.60 ,$206.34 ,"$1,088.00 ",$212.53 ,"$1,088.00 ","$1,033.60 ",$206.34 ,$870.40 ,"$1,000.96 ",$206.34 ,$924.80 ,"$1,033.60 ",$957.44 ,$826.88 ,$206.34 ,$206.34 ,$206.34 ,$794.24 ,$598.40 ,$990.08 ,$990.08 ,$870.40 , N/A ,$598.40 ,$979.20 , N/A ,$979.20 ,$587.52 ,"$1,022.72 ", N/A ,"$1,000.96 ",$218.72 ,$990.08 , N/A ,$669.56 ,$669.56 ,$979.20 ,$811.97 ,$794.24 , N/A ,$206.34 ,"$1,033.60 ", N/A ,$206.34 ,$946.56 , N/A ,$979.20 , N/A ,$979.20 ,$979.20 ,$979.20 ,"$1,055.36 ",$881.28 ,"$1,011.84 ",$935.68 ,"$1,055.36 "
SACRED HEART HOSPITAL (ACU),48100051,36200,HC INTRO CATH AORTA 36200,481,1 ,$736.00 ,$552.00 ,$206.34 ,$736.00 ,$473.98 , N/A ,$515.20 ,$206.34 ,$736.00 ,$212.53 ,$736.00 ,$699.20 ,$206.34 ,$588.80 ,$677.12 ,$206.34 ,$625.60 ,$699.20 ,$647.68 ,$559.36 ,$206.34 ,$206.34 ,$206.34 ,$537.28 ,$404.80 ,$669.76 ,$669.76 ,$588.80 , N/A ,$404.80 ,$662.40 , N/A ,$662.40 ,$397.44 ,$691.84 , N/A ,$677.12 ,$218.72 ,$669.76 , N/A ,$452.93 ,$452.93 ,$662.40 ,$549.28 ,$662.40 , N/A ,$206.34 ,$699.20 , N/A ,$206.34 ,$640.32 , N/A ,$662.40 , N/A ,$662.40 ,$662.40 ,$662.40 ,$713.92 ,$596.16 ,$684.48 ,$632.96 ,$713.92 
SACRED HEART HOSPITAL (ACU),48100052,36215,HC PLACE CATH THOR/BRAC 1ST ORDER 36215,481,1 ,"$2,952.00 ","$2,214.00 ",$206.34 ,"$2,952.00 ","$1,901.09 ", N/A ,"$2,066.40 ",$206.34 ,"$2,952.00 ",$212.53 ,"$2,952.00 ","$2,804.40 ",$206.34 ,"$2,361.60 ","$2,715.84 ",$206.34 ,"$2,509.20 ","$2,804.40 ","$2,597.76 ","$2,243.52 ",$206.34 ,$206.34 ,$206.34 ,"$2,154.96 ","$1,623.60 ","$2,686.32 ","$2,686.32 ","$2,361.60 ", N/A ,"$1,623.60 ","$2,656.80 ", N/A ,"$2,656.80 ","$1,594.08 ","$2,774.88 ", N/A ,"$2,715.84 ",$218.72 ,"$2,686.32 ", N/A ,"$1,816.66 ","$1,816.66 ","$2,656.80 ","$2,203.08 ","$2,519.91 ", N/A ,$206.34 ,"$2,804.40 ", N/A ,$206.34 ,"$2,568.24 ", N/A ,"$2,656.80 ", N/A ,"$2,656.80 ","$2,656.80 ","$2,656.80 ","$2,863.44 ","$2,391.12 ","$2,745.36 ","$2,538.72 ","$2,863.44 "
SACRED HEART HOSPITAL (ACU),48100053,36216,HC PL CATH THOR/BRAC 2ND ORDER 36216,481,1 ,"$1,797.00 ","$1,347.75 ",$206.34 ,"$1,797.00 ","$1,157.27 ", N/A ,"$1,257.90 ",$206.34 ,"$1,797.00 ",$212.53 ,"$1,797.00 ","$1,707.15 ",$206.34 ,"$1,437.60 ","$1,653.24 ",$206.34 ,"$1,527.45 ","$1,707.15 ","$1,581.36 ","$1,365.72 ",$206.34 ,$206.34 ,$206.34 ,"$1,311.81 ",$988.35 ,"$1,635.27 ","$1,635.27 ","$1,437.60 ", N/A ,$988.35 ,"$1,617.30 ", N/A ,"$1,617.30 ",$970.38 ,"$1,689.18 ", N/A ,"$1,653.24 ",$218.72 ,"$1,635.27 ", N/A ,"$1,105.87 ","$1,105.87 ","$1,617.30 ","$1,341.10 ","$1,617.30 ", N/A ,$206.34 ,"$1,707.15 ", N/A ,$206.34 ,"$1,563.39 ", N/A ,"$1,617.30 ", N/A ,"$1,617.30 ","$1,617.30 ","$1,617.30 ","$1,743.09 ","$1,455.57 ","$1,671.21 ","$1,545.42 ","$1,743.09 "
SACRED HEART HOSPITAL (ACU),48100054,36217,HC PL CATH THOR/BRAC 3RD ORDER 36217,481,1 ,"$1,797.00 ","$1,347.75 ",$206.34 ,"$1,797.00 ","$1,157.27 ", N/A ,"$1,257.90 ",$206.34 ,"$1,797.00 ",$212.53 ,"$1,797.00 ","$1,707.15 ",$206.34 ,"$1,437.60 ","$1,653.24 ",$206.34 ,"$1,527.45 ","$1,707.15 ","$1,581.36 ","$1,365.72 ",$206.34 ,$206.34 ,$206.34 ,"$1,311.81 ",$988.35 ,"$1,635.27 ","$1,635.27 ","$1,437.60 ", N/A ,$988.35 ,"$1,617.30 ", N/A ,"$1,617.30 ",$970.38 ,"$1,689.18 ", N/A ,"$1,653.24 ",$218.72 ,"$1,635.27 ", N/A ,"$1,105.87 ","$1,105.87 ","$1,617.30 ","$1,341.10 ","$1,617.30 ", N/A ,$206.34 ,"$1,707.15 ", N/A ,$206.34 ,"$1,563.39 ", N/A ,"$1,617.30 ", N/A ,"$1,617.30 ","$1,617.30 ","$1,617.30 ","$1,743.09 ","$1,455.57 ","$1,671.21 ","$1,545.42 ","$1,743.09 "
SACRED HEART HOSPITAL (ACU),48100055,36218,HC PL CATH THOR/BRAC ADDL 36218,481,1 ,"$1,708.00 ","$1,281.00 ",$206.34 ,"$1,708.00 ","$1,099.95 ", N/A ,"$1,195.60 ",$206.34 ,"$1,708.00 ",$212.53 ,"$1,708.00 ","$1,622.60 ",$206.34 ,"$1,366.40 ","$1,571.36 ",$206.34 ,"$1,451.80 ","$1,622.60 ","$1,503.04 ","$1,298.08 ",$206.34 ,$206.34 ,$206.34 ,"$1,246.84 ",$939.40 ,"$1,554.28 ","$1,554.28 ","$1,366.40 ", N/A ,$939.40 ,"$1,537.20 ", N/A ,"$1,537.20 ",$922.32 ,"$1,605.52 ", N/A ,"$1,571.36 ",$218.72 ,"$1,554.28 ", N/A ,"$1,051.10 ","$1,051.10 ","$1,537.20 ","$1,274.68 ",$854.00 , N/A ,$206.34 ,"$1,622.60 ", N/A ,$206.34 ,"$1,485.96 ", N/A ,"$1,537.20 ", N/A ,"$1,537.20 ","$1,537.20 ","$1,537.20 ","$1,656.76 ","$1,383.48 ","$1,588.44 ","$1,468.88 ","$1,656.76 "
SACRED HEART HOSPITAL (ACU),48100056,36245,HC ABD 1ST ORDER 36245,481,1 ,"$3,015.00 ","$2,261.25 ",$206.34 ,"$3,015.00 ","$1,941.66 ", N/A ,"$2,110.50 ",$206.34 ,"$3,015.00 ",$212.53 ,"$3,015.00 ","$2,864.25 ",$206.34 ,"$2,412.00 ","$2,773.80 ",$206.34 ,"$2,562.75 ","$2,864.25 ","$2,653.20 ","$2,291.40 ",$206.34 ,$206.34 ,$206.34 ,"$2,200.95 ","$1,658.25 ","$2,743.65 ","$2,743.65 ","$2,412.00 ", N/A ,"$1,658.25 ","$2,713.50 ", N/A ,"$2,713.50 ","$1,628.10 ","$2,834.10 ", N/A ,"$2,773.80 ",$218.72 ,"$2,743.65 ", N/A ,"$1,855.43 ","$1,855.43 ","$2,713.50 ","$2,250.09 ","$2,519.91 ", N/A ,$206.34 ,"$2,864.25 ", N/A ,$206.34 ,"$2,623.05 ", N/A ,"$2,713.50 ", N/A ,"$2,713.50 ","$2,713.50 ","$2,713.50 ","$2,924.55 ","$2,442.15 ","$2,803.95 ","$2,592.90 ","$2,924.55 "
SACRED HEART HOSPITAL (ACU),48100057,36246,HC ABD INITIAL 2ND ORDER 36246,481,1 ,"$1,776.00 ","$1,332.00 ",$206.34 ,"$1,776.00 ","$1,143.74 ", N/A ,"$1,243.20 ",$206.34 ,"$1,776.00 ",$212.53 ,"$1,776.00 ","$1,687.20 ",$206.34 ,"$1,420.80 ","$1,633.92 ",$206.34 ,"$1,509.60 ","$1,687.20 ","$1,562.88 ","$1,349.76 ",$206.34 ,$206.34 ,$206.34 ,"$1,296.48 ",$976.80 ,"$1,616.16 ","$1,616.16 ","$1,420.80 ", N/A ,$976.80 ,"$1,598.40 ", N/A ,"$1,598.40 ",$959.04 ,"$1,669.44 ", N/A ,"$1,633.92 ",$218.72 ,"$1,616.16 ", N/A ,"$1,092.95 ","$1,092.95 ","$1,598.40 ","$1,325.43 ","$1,598.40 ", N/A ,$206.34 ,"$1,687.20 ", N/A ,$206.34 ,"$1,545.12 ", N/A ,"$1,598.40 ", N/A ,"$1,598.40 ","$1,598.40 ","$1,598.40 ","$1,722.72 ","$1,438.56 ","$1,651.68 ","$1,527.36 ","$1,722.72 "
SACRED HEART HOSPITAL (ACU),48100058,36247,HC ABD INT 3RD/PLUS ORDER 36247,481,1 ,"$1,835.00 ","$1,376.25 ",$206.34 ,"$1,835.00 ","$1,181.74 ", N/A ,"$1,284.50 ",$206.34 ,"$1,835.00 ",$212.53 ,"$1,835.00 ","$1,743.25 ",$206.34 ,"$1,468.00 ","$1,688.20 ",$206.34 ,"$1,559.75 ","$1,743.25 ","$1,614.80 ","$1,394.60 ",$206.34 ,$206.34 ,$206.34 ,"$1,339.55 ","$1,009.25 ","$1,669.85 ","$1,669.85 ","$1,468.00 ", N/A ,"$1,009.25 ","$1,651.50 ", N/A ,"$1,651.50 ",$990.90 ,"$1,724.90 ", N/A ,"$1,688.20 ",$218.72 ,"$1,669.85 ", N/A ,"$1,129.26 ","$1,129.26 ","$1,651.50 ","$1,369.46 ","$1,651.50 ", N/A ,$206.34 ,"$1,743.25 ", N/A ,$206.34 ,"$1,596.45 ", N/A ,"$1,651.50 ", N/A ,"$1,651.50 ","$1,651.50 ","$1,651.50 ","$1,779.95 ","$1,486.35 ","$1,706.55 ","$1,578.10 ","$1,779.95 "
SACRED HEART HOSPITAL (ACU),48100059,36248,HC ABD ADDL 2ND/PLUS ORDER 36248,481,1 ,"$1,776.00 ","$1,332.00 ",$206.34 ,"$1,776.00 ","$1,143.74 ", N/A ,"$1,243.20 ",$206.34 ,"$1,776.00 ",$212.53 ,"$1,776.00 ","$1,687.20 ",$206.34 ,"$1,420.80 ","$1,633.92 ",$206.34 ,"$1,509.60 ","$1,687.20 ","$1,562.88 ","$1,349.76 ",$206.34 ,$206.34 ,$206.34 ,"$1,296.48 ",$976.80 ,"$1,616.16 ","$1,616.16 ","$1,420.80 ", N/A ,$976.80 ,"$1,598.40 ", N/A ,"$1,598.40 ",$959.04 ,"$1,669.44 ", N/A ,"$1,633.92 ",$218.72 ,"$1,616.16 ", N/A ,"$1,092.95 ","$1,092.95 ","$1,598.40 ","$1,325.43 ",$888.00 , N/A ,$206.34 ,"$1,687.20 ", N/A ,$206.34 ,"$1,545.12 ", N/A ,"$1,598.40 ", N/A ,"$1,598.40 ","$1,598.40 ","$1,598.40 ","$1,722.72 ","$1,438.56 ","$1,651.68 ","$1,527.36 ","$1,722.72 "
SACRED HEART HOSPITAL (ACU),48100060,37184,HC PERIPH THROMBECK ONLY W/TPA 37184,481,1 ,"$1,767.99 ","$1,325.99 ",$954.71 ,"$23,902.85 ","$1,138.59 ","$10,623.49 ","$1,237.59 ","$1,767.99 ","$1,767.99 ","$1,971.09 ","$1,767.99 ","$1,679.59 ","$1,913.68 ","$1,414.39 ","$1,626.55 ","$1,767.99 ","$1,502.79 ","$1,679.59 ","$1,555.83 ","$1,343.67 ","$1,767.99 ","$1,767.99 ","$1,913.68 ","$1,290.63 ",$972.39 ,"$1,608.87 ","$1,608.87 ","$1,414.39 ","$10,942.19 ",$972.39 ,"$1,591.19 ","$10,623.49 ","$1,591.19 ",$954.71 ,"$1,661.91 ","$23,902.85 ","$1,626.55 ","$2,028.50 ","$1,608.87 ","$10,623.49 ","$1,088.02 ","$1,088.02 ","$1,591.19 ","$1,319.45 ","$1,591.19 ","$10,729.72 ","$1,767.99 ","$1,679.59 ","$11,154.66 ","$1,767.99 ","$1,538.15 ","$10,623.49 ","$1,591.19 ","$10,623.49 ","$1,591.19 ","$1,591.19 ","$1,591.19 ","$1,714.95 ","$1,432.07 ","$1,644.23 ","$1,520.47 ","$1,714.95 "
SACRED HEART HOSPITAL (ACU),48100061,37185,HC PRIM PERC THROMB EA ADDL 37185,481,1 ,"$1,977.34 ","$1,483.01 ",$988.67 ,"$2,028.50 ","$1,273.41 ", N/A ,"$1,384.14 ","$1,913.68 ","$1,977.34 ","$1,971.09 ","$1,977.34 ","$1,878.47 ","$1,913.68 ","$1,581.87 ","$1,819.15 ","$1,913.68 ","$1,680.74 ","$1,878.47 ","$1,740.06 ","$1,502.78 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$1,443.46 ","$1,087.54 ","$1,799.38 ","$1,799.38 ","$1,581.87 ", N/A ,"$1,087.54 ","$1,779.61 ", N/A ,"$1,779.61 ","$1,067.76 ","$1,858.70 ", N/A ,"$1,819.15 ","$2,028.50 ","$1,799.38 ", N/A ,"$1,216.86 ","$1,216.86 ","$1,779.61 ","$1,475.69 ",$988.67 , N/A ,"$1,913.68 ","$1,878.47 ", N/A ,"$1,913.68 ","$1,720.29 ", N/A ,"$1,779.61 ", N/A ,"$1,779.61 ","$1,779.61 ","$1,779.61 ","$1,918.02 ","$1,601.65 ","$1,838.93 ","$1,700.51 ","$1,918.02 "
SACRED HEART HOSPITAL (ACU),48100062,37186,HC SEC PERC THROMB EA VESSEL ADDL 37186,481,1 ,"$1,977.34 ","$1,483.01 ",$988.67 ,"$3,775.50 ","$1,273.41 ", N/A ,"$1,384.14 ","$1,977.34 ","$1,977.34 ","$3,668.64 ","$1,977.34 ","$1,878.47 ","$3,561.79 ","$1,581.87 ","$1,819.15 ","$1,977.34 ","$1,680.74 ","$1,878.47 ","$1,740.06 ","$1,502.78 ","$1,977.34 ","$1,977.34 ","$3,561.79 ","$1,443.46 ","$1,087.54 ","$1,799.38 ","$1,799.38 ","$1,581.87 ", N/A ,"$1,087.54 ","$1,779.61 ", N/A ,"$1,779.61 ","$1,067.76 ","$1,858.70 ", N/A ,"$1,819.15 ","$3,775.50 ","$1,799.38 ", N/A ,"$1,216.86 ","$1,216.86 ","$1,779.61 ","$1,475.69 ",$988.67 , N/A ,"$1,977.34 ","$1,878.47 ", N/A ,"$1,977.34 ","$1,720.29 ", N/A ,"$1,779.61 ", N/A ,"$1,779.61 ","$1,779.61 ","$1,779.61 ","$1,918.02 ","$1,601.65 ","$1,838.93 ","$1,700.51 ","$1,918.02 "
SACRED HEART HOSPITAL (ACU),48100063,37187,HC PRIMARY VENOUS THROMBECTOMY,481,1 ,"$1,767.99 ","$1,325.99 ",$954.71 ,"$23,902.85 ","$1,138.59 ","$10,623.49 ","$1,237.59 ","$1,161.13 ","$1,767.99 ","$1,195.96 ","$1,767.99 ","$1,679.59 ","$1,161.13 ","$1,414.39 ","$1,626.55 ","$1,161.13 ","$1,502.79 ","$1,679.59 ","$1,555.83 ","$1,343.67 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$1,290.63 ",$972.39 ,"$1,608.87 ","$1,608.87 ","$1,414.39 ","$10,942.19 ",$972.39 ,"$1,591.19 ","$10,623.49 ","$1,591.19 ",$954.71 ,"$1,661.91 ","$23,902.85 ","$1,626.55 ","$1,230.80 ","$1,608.87 ","$10,623.49 ","$1,088.02 ","$1,088.02 ","$1,591.19 ","$1,319.45 ","$1,591.19 ","$10,729.72 ","$1,161.13 ","$1,679.59 ","$11,154.66 ","$1,161.13 ","$1,538.15 ","$10,623.49 ","$1,591.19 ","$10,623.49 ","$1,591.19 ","$1,591.19 ","$1,591.19 ","$1,714.95 ","$1,432.07 ","$1,644.23 ","$1,520.47 ","$1,714.95 "
SACRED HEART HOSPITAL (ACU),48100064,37188,HC SUBSEQUENT VENOUS THROMBECTOMY,481,1 ,"$1,874.32 ","$1,405.74 ","$1,012.13 ","$6,812.22 ","$1,207.06 ","$3,027.65 ","$1,312.02 ","$1,161.13 ","$1,874.32 ","$1,195.96 ","$1,874.32 ","$1,780.60 ","$1,161.13 ","$1,499.46 ","$1,724.37 ","$1,161.13 ","$1,593.17 ","$1,780.60 ","$1,649.40 ","$1,424.48 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$1,368.25 ","$1,030.88 ","$1,705.63 ","$1,705.63 ","$1,499.46 ","$3,118.48 ","$1,030.88 ","$1,686.89 ","$3,027.65 ","$1,686.89 ","$1,012.13 ","$1,761.86 ","$6,812.22 ","$1,724.37 ","$1,230.80 ","$1,705.63 ","$3,027.65 ","$1,153.46 ","$1,153.46 ","$1,686.89 ","$1,398.81 ","$1,686.89 ","$3,057.93 ","$1,161.13 ","$1,780.60 ","$3,179.04 ","$1,161.13 ","$1,630.66 ","$3,027.65 ","$1,686.89 ","$3,027.65 ","$1,686.89 ","$1,686.89 ","$1,686.89 ","$1,818.09 ","$1,518.20 ","$1,743.12 ","$1,611.92 ","$1,818.09 "
SACRED HEART HOSPITAL (ACU),48100065,37200,HC BIOPSY TRANSCATHETER,481,1 ,"$1,559.60 ","$1,169.70 ",$842.18 ,"$11,347.95 ","$1,004.38 ","$5,043.53 ","$1,091.72 ","$1,161.13 ","$1,559.60 ","$1,195.96 ","$1,559.60 ","$1,481.62 ","$1,161.13 ","$1,247.68 ","$1,434.83 ","$1,161.13 ","$1,325.66 ","$1,481.62 ","$1,372.45 ","$1,185.30 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$1,138.51 ",$857.78 ,"$1,419.24 ","$1,419.24 ","$1,247.68 ","$5,194.84 ",$857.78 ,"$1,403.64 ","$5,043.53 ","$1,403.64 ",$842.18 ,"$1,466.02 ","$11,347.95 ","$1,434.83 ","$1,230.80 ","$1,419.24 ","$5,043.53 ",$959.78 ,$959.78 ,"$1,403.64 ","$1,163.93 ","$1,403.64 ","$5,093.97 ","$1,161.13 ","$1,481.62 ","$5,295.71 ","$1,161.13 ","$1,356.85 ","$5,043.53 ","$1,403.64 ","$5,043.53 ","$1,403.64 ","$1,403.64 ","$1,403.64 ","$1,512.81 ","$1,263.28 ","$1,450.43 ","$1,341.26 ","$1,512.81 "
SACRED HEART HOSPITAL (ACU),48100067,61650,HC THPY INFS NON-THROMBO INTITIAL,481,1 ,$928.36 ,$696.27 ,$501.31 ,"$3,867.78 ",$597.86 , N/A ,$649.85 ,$928.36 ,$928.36 ,"$3,758.32 ",$928.36 ,$881.94 ,"$3,648.85 ",$742.69 ,$854.09 ,$928.36 ,$789.11 ,$881.94 ,$816.96 ,$705.55 ,$928.36 ,$928.36 ,"$3,648.85 ",$677.70 ,$510.60 ,$844.81 ,$844.81 ,$742.69 , N/A ,$510.60 ,$835.52 , N/A ,$835.52 ,$501.31 ,$872.66 , N/A ,$854.09 ,"$3,867.78 ",$844.81 , N/A ,$571.31 ,$571.31 ,$835.52 ,$692.84 , N/A , N/A ,$928.36 ,$881.94 , N/A ,$928.36 ,$807.67 , N/A ,$835.52 , N/A ,$835.52 ,$835.52 ,$835.52 ,$900.51 ,$751.97 ,$863.37 ,$798.39 ,$900.51 
SACRED HEART HOSPITAL (ACU),48100076,37215,HC PL STENT TRNSCATH CAROT ART W/ 37215,481,1 ,"$3,001.61 ","$2,251.21 ","$1,620.87 ","$3,867.78 ","$1,933.04 ", N/A ,"$2,101.13 ","$3,001.61 ","$3,001.61 ","$3,758.32 ","$3,001.61 ","$2,851.53 ","$3,648.85 ","$2,401.29 ","$2,761.48 ","$3,001.61 ","$2,551.37 ","$2,851.53 ","$2,641.42 ","$2,281.22 ","$3,001.61 ","$3,001.61 ","$3,648.85 ","$2,191.18 ","$1,650.89 ","$2,731.47 ","$2,731.47 ","$2,401.29 ", N/A ,"$1,650.89 ","$2,701.45 ", N/A ,"$2,701.45 ","$1,620.87 ","$2,821.51 ", N/A ,"$2,761.48 ","$3,867.78 ","$2,731.47 ", N/A ,"$1,847.19 ","$1,847.19 ","$2,701.45 ","$2,240.10 ","$2,090.62 ", N/A ,"$3,001.61 ","$2,851.53 ", N/A ,"$3,001.61 ","$2,611.40 ", N/A ,"$2,701.45 ", N/A ,"$2,701.45 ","$2,701.45 ","$2,701.45 ","$2,911.56 ","$2,431.30 ","$2,791.50 ","$2,581.38 ","$2,911.56 "
SACRED HEART HOSPITAL (ACU),48100077,37220,HC RVC EN PRC ICA W/ANG INT VSL 37220,481,1 ,"$17,231.00 ","$12,923.25 ","$1,913.68 ","$17,231.00 ","$11,096.76 ","$5,241.99 ","$12,061.70 ","$1,913.68 ","$17,231.00 ","$1,971.09 ","$14,150.00 ","$16,369.45 ","$1,913.68 ","$13,784.80 ","$15,852.52 ","$1,913.68 ","$14,646.35 ","$16,369.45 ","$15,163.28 ","$13,095.56 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$12,578.63 ","$9,477.05 ","$15,680.21 ","$15,680.21 ","$13,784.80 ","$5,399.25 ","$9,477.05 ","$15,507.90 ","$5,241.99 ","$15,507.90 ","$9,304.74 ","$16,197.14 ","$11,794.48 ","$15,852.52 ","$2,028.50 ","$15,680.21 ","$5,241.99 ","$10,603.96 ","$10,603.96 ","$15,507.90 ","$12,859.50 ","$8,615.50 ","$5,294.41 ","$1,913.68 ","$16,369.45 ","$5,504.09 ","$1,913.68 ","$14,990.97 ","$5,241.99 ","$15,507.90 ","$5,241.99 ","$15,507.90 ","$15,507.90 ","$15,507.90 ","$16,714.07 ","$13,957.11 ","$16,024.83 ","$14,818.66 ","$16,714.07 "
SACRED HEART HOSPITAL (ACU),48100078,37221,HC RVC EN PRC ICA W/TRN SNT INT V 37221,481,1 ,"$22,446.00 ","$16,834.50 ","$3,561.79 ","$23,902.85 ","$14,455.22 ","$10,623.49 ","$15,712.20 ","$3,561.79 ","$18,759.00 ","$3,668.64 ","$15,007.00 ","$21,323.70 ","$3,561.79 ","$17,956.80 ","$20,650.32 ","$3,561.79 ","$19,079.10 ","$21,323.70 ","$19,752.48 ","$17,058.96 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$16,385.58 ","$12,345.30 ","$20,425.86 ","$20,425.86 ","$17,956.80 ","$10,942.19 ","$12,345.30 ","$20,201.40 ","$10,623.49 ","$20,201.40 ","$12,120.84 ","$21,099.24 ","$23,902.85 ","$20,650.32 ","$3,775.50 ","$20,425.86 ","$10,623.49 ","$13,813.27 ","$13,813.27 ","$20,201.40 ","$16,751.45 ","$11,223.00 ","$10,729.72 ","$3,561.79 ","$21,323.70 ","$11,154.66 ","$3,561.79 ","$19,528.02 ","$10,623.49 ","$20,201.40 ","$10,623.49 ","$20,201.40 ","$20,201.40 ","$20,201.40 ","$21,772.62 ","$18,181.26 ","$20,874.78 ","$19,303.56 ","$21,772.62 "
SACRED HEART HOSPITAL (ACU),48100079,37222,HC RVC EN PRC ICA W/ANG EA AD VS 37222,481,1 ,"$11,627.00 ","$8,720.25 ","$3,561.79 ","$11,627.00 ","$7,487.79 ", N/A ,"$8,138.90 ","$3,561.79 ","$5,521.00 ","$3,668.64 ","$4,416.00 ","$11,045.65 ","$3,561.79 ","$9,301.60 ","$10,696.84 ","$3,561.79 ","$9,882.95 ","$11,045.65 ","$10,231.76 ","$8,836.52 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$8,487.71 ","$6,394.85 ","$10,580.57 ","$10,580.57 ","$9,301.60 ", N/A ,"$6,394.85 ","$10,464.30 ", N/A ,"$10,464.30 ","$6,278.58 ","$10,929.38 ", N/A ,"$10,696.84 ","$3,775.50 ","$10,580.57 ", N/A ,"$7,155.26 ","$7,155.26 ","$10,464.30 ","$8,677.23 ", N/A , N/A ,"$3,561.79 ","$11,045.65 ", N/A ,"$3,561.79 ","$10,115.49 ", N/A ,"$10,464.30 ", N/A ,"$10,464.30 ","$10,464.30 ","$10,464.30 ","$11,278.19 ","$9,417.87 ","$10,813.11 ","$9,999.22 ","$11,278.19 "
SACRED HEART HOSPITAL (ACU),48100080,37223,HC RVC EN PRC ICA W/TRN ST AD VS 37223,481,1 ,"$17,010.00 ","$12,757.50 ","$3,561.79 ","$17,010.00 ","$10,954.44 ", N/A ,"$11,907.00 ","$3,561.79 ","$5,521.00 ","$3,668.64 ","$4,416.00 ","$16,159.50 ","$3,561.79 ","$13,608.00 ","$15,649.20 ","$3,561.79 ","$14,458.50 ","$16,159.50 ","$14,968.80 ","$12,927.60 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$12,417.30 ","$9,355.50 ","$15,479.10 ","$15,479.10 ","$13,608.00 ", N/A ,"$9,355.50 ","$15,309.00 ", N/A ,"$15,309.00 ","$9,185.40 ","$15,989.40 ", N/A ,"$15,649.20 ","$3,775.50 ","$15,479.10 ", N/A ,"$10,467.95 ","$10,467.95 ","$15,309.00 ","$12,694.56 ", N/A , N/A ,"$3,561.79 ","$16,159.50 ", N/A ,"$3,561.79 ","$14,798.70 ", N/A ,"$15,309.00 ", N/A ,"$15,309.00 ","$15,309.00 ","$15,309.00 ","$16,499.70 ","$13,778.10 ","$15,819.30 ","$14,628.60 ","$16,499.70 "
SACRED HEART HOSPITAL (ACU),48100081,37224,HC RVC EN PRC R/P W/ANG INT VSL 37224,481,1 ,"$19,401.00 ","$14,550.75 ","$1,913.68 ","$19,401.00 ","$12,494.24 ","$5,241.99 ","$13,580.70 ","$1,913.68 ","$17,687.00 ","$1,971.09 ","$14,150.00 ","$18,430.95 ","$1,913.68 ","$15,520.80 ","$17,848.92 ","$1,913.68 ","$16,490.85 ","$18,430.95 ","$17,072.88 ","$14,744.76 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$14,162.73 ","$10,670.55 ","$17,654.91 ","$17,654.91 ","$15,520.80 ","$5,399.25 ","$10,670.55 ","$17,460.90 ","$5,241.99 ","$17,460.90 ","$10,476.54 ","$18,236.94 ","$11,794.48 ","$17,848.92 ","$2,028.50 ","$17,654.91 ","$5,241.99 ","$11,939.38 ","$11,939.38 ","$17,460.90 ","$14,478.97 ","$9,700.50 ","$5,294.41 ","$1,913.68 ","$18,430.95 ","$5,504.09 ","$1,913.68 ","$16,878.87 ","$5,241.99 ","$17,460.90 ","$5,241.99 ","$17,460.90 ","$17,460.90 ","$17,460.90 ","$18,818.97 ","$15,714.81 ","$18,042.93 ","$16,684.86 ","$18,818.97 "
SACRED HEART HOSPITAL (ACU),48100082,37225,HC RVC EN PRC F/P W/ANT INT VSL 37225,481,1 ,"$21,989.00 ","$16,491.75 ","$3,561.79 ","$23,902.85 ","$14,160.92 ","$10,623.49 ","$15,392.30 ","$3,561.79 ","$18,759.00 ","$3,668.64 ","$15,007.00 ","$20,889.55 ","$3,561.79 ","$17,591.20 ","$20,229.88 ","$3,561.79 ","$18,690.65 ","$20,889.55 ","$19,350.32 ","$16,711.64 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$16,051.97 ","$12,093.95 ","$20,009.99 ","$20,009.99 ","$17,591.20 ","$10,942.19 ","$12,093.95 ","$19,790.10 ","$10,623.49 ","$19,790.10 ","$11,874.06 ","$20,669.66 ","$23,902.85 ","$20,229.88 ","$3,775.50 ","$20,009.99 ","$10,623.49 ","$13,532.03 ","$13,532.03 ","$19,790.10 ","$16,410.39 ","$10,994.50 ","$10,729.72 ","$3,561.79 ","$20,889.55 ","$11,154.66 ","$3,561.79 ","$19,130.43 ","$10,623.49 ","$19,790.10 ","$10,623.49 ","$19,790.10 ","$19,790.10 ","$19,790.10 ","$21,329.33 ","$17,811.09 ","$20,449.77 ","$18,910.54 ","$21,329.33 "
SACRED HEART HOSPITAL (ACU),48100083,37226,HC RVC EN PRC F/P W/TRN SNT IN VS 37226,481,1 ,"$20,858.00 ","$15,643.50 ","$3,561.79 ","$23,902.85 ","$13,432.55 ","$10,623.49 ","$14,600.60 ","$3,561.79 ","$18,759.00 ","$3,668.64 ","$15,007.00 ","$19,815.10 ","$3,561.79 ","$16,686.40 ","$19,189.36 ","$3,561.79 ","$17,729.30 ","$19,815.10 ","$18,355.04 ","$15,852.08 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$15,226.34 ","$11,471.90 ","$18,980.78 ","$18,980.78 ","$16,686.40 ","$10,942.19 ","$11,471.90 ","$18,772.20 ","$10,623.49 ","$18,772.20 ","$11,263.32 ","$19,606.52 ","$23,902.85 ","$19,189.36 ","$3,775.50 ","$18,980.78 ","$10,623.49 ","$12,836.01 ","$12,836.01 ","$18,772.20 ","$15,566.33 ","$10,429.00 ","$10,729.72 ","$3,561.79 ","$19,815.10 ","$11,154.66 ","$3,561.79 ","$18,146.46 ","$10,623.49 ","$18,772.20 ","$10,623.49 ","$18,772.20 ","$18,772.20 ","$18,772.20 ","$20,232.26 ","$16,894.98 ","$19,397.94 ","$17,937.88 ","$20,232.26 "
SACRED HEART HOSPITAL (ACU),48100084,37227,HC RVC EN PRC F/P W/AN/TR ST INT 37227,481,1 ,"$31,391.00 ","$23,543.25 ","$3,561.79 ","$38,218.28 ","$20,215.80 ","$16,985.90 ","$21,973.70 ","$3,561.79 ","$19,295.00 ","$3,668.64 ","$15,436.00 ","$29,821.45 ","$3,561.79 ","$25,112.80 ","$28,879.72 ","$3,561.79 ","$26,682.35 ","$29,821.45 ","$27,624.08 ","$23,857.16 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$22,915.43 ","$17,265.05 ","$28,565.81 ","$28,565.81 ","$25,112.80 ","$17,495.48 ","$17,265.05 ","$28,251.90 ","$16,985.90 ","$28,251.90 ","$16,951.14 ","$29,507.54 ","$38,218.28 ","$28,879.72 ","$3,775.50 ","$28,565.81 ","$16,985.90 ","$19,318.02 ","$19,318.02 ","$28,251.90 ","$23,427.10 ","$15,695.50 ","$17,155.76 ","$3,561.79 ","$29,821.45 ","$17,835.20 ","$3,561.79 ","$27,310.17 ","$16,985.90 ","$28,251.90 ","$16,985.90 ","$28,251.90 ","$28,251.90 ","$28,251.90 ","$30,449.27 ","$25,426.71 ","$29,193.63 ","$26,996.26 ","$30,449.27 "
SACRED HEART HOSPITAL (ACU),48100085,37228,HC RVC EN PRC T/P W/ANG INT VSL 37228,481,1 ,"$18,812.00 ","$14,109.00 ","$1,913.68 ","$23,902.85 ","$12,114.93 ","$10,623.49 ","$13,168.40 ","$1,913.68 ","$18,759.00 ","$1,971.09 ","$15,007.00 ","$17,871.40 ","$1,913.68 ","$15,049.60 ","$17,307.04 ","$1,913.68 ","$15,990.20 ","$17,871.40 ","$16,554.56 ","$14,297.12 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$13,732.76 ","$10,346.60 ","$17,118.92 ","$17,118.92 ","$15,049.60 ","$10,942.19 ","$10,346.60 ","$16,930.80 ","$10,623.49 ","$16,930.80 ","$10,158.48 ","$17,683.28 ","$23,902.85 ","$17,307.04 ","$2,028.50 ","$17,118.92 ","$10,623.49 ","$11,576.90 ","$11,576.90 ","$16,930.80 ","$14,039.40 ","$9,673.41 ","$10,729.72 ","$1,913.68 ","$17,871.40 ","$11,154.66 ","$1,913.68 ","$16,366.44 ","$10,623.49 ","$16,930.80 ","$10,623.49 ","$16,930.80 ","$16,930.80 ","$16,930.80 ","$18,247.64 ","$15,237.72 ","$17,495.16 ","$16,178.32 ","$18,247.64 "
SACRED HEART HOSPITAL (ACU),48100086,37229,HC RVC EN PRC T/P W/ANT INT VSL 37229,481,1 ,"$20,687.00 ","$15,515.25 ","$3,561.79 ","$38,218.28 ","$13,322.43 ","$16,985.90 ","$14,480.90 ","$3,561.79 ","$19,295.00 ","$3,668.64 ","$15,436.00 ","$19,652.65 ","$3,561.79 ","$16,549.60 ","$19,032.04 ","$3,561.79 ","$17,583.95 ","$19,652.65 ","$18,204.56 ","$15,722.12 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$15,101.51 ","$11,377.85 ","$18,825.17 ","$18,825.17 ","$16,549.60 ","$17,495.48 ","$11,377.85 ","$18,618.30 ","$16,985.90 ","$18,618.30 ","$11,170.98 ","$19,445.78 ","$38,218.28 ","$19,032.04 ","$3,775.50 ","$18,825.17 ","$16,985.90 ","$12,730.78 ","$12,730.78 ","$18,618.30 ","$15,438.71 ","$10,343.50 ","$17,155.76 ","$3,561.79 ","$19,652.65 ","$17,835.20 ","$3,561.79 ","$17,997.69 ","$16,985.90 ","$18,618.30 ","$16,985.90 ","$18,618.30 ","$18,618.30 ","$18,618.30 ","$20,066.39 ","$16,756.47 ","$19,238.91 ","$17,790.82 ","$20,066.39 "
SACRED HEART HOSPITAL (ACU),48100087,37230,HC RVC EN PRC T/P W/TRN SNT IN VS 37230,481,1 ,"$23,931.00 ","$17,948.25 ","$3,561.79 ","$38,218.28 ","$15,411.56 ","$16,985.90 ","$16,751.70 ","$3,561.79 ","$19,295.00 ","$3,668.64 ","$15,436.00 ","$22,734.45 ","$3,561.79 ","$19,144.80 ","$22,016.52 ","$3,561.79 ","$20,341.35 ","$22,734.45 ","$21,059.28 ","$18,187.56 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$17,469.63 ","$13,162.05 ","$21,777.21 ","$21,777.21 ","$19,144.80 ","$17,495.48 ","$13,162.05 ","$21,537.90 ","$16,985.90 ","$21,537.90 ","$12,922.74 ","$22,495.14 ","$38,218.28 ","$22,016.52 ","$3,775.50 ","$21,777.21 ","$16,985.90 ","$14,727.14 ","$14,727.14 ","$21,537.90 ","$17,859.71 ","$11,965.50 ","$17,155.76 ","$3,561.79 ","$22,734.45 ","$17,835.20 ","$3,561.79 ","$20,819.97 ","$16,985.90 ","$21,537.90 ","$16,985.90 ","$21,537.90 ","$21,537.90 ","$21,537.90 ","$23,213.07 ","$19,384.11 ","$22,255.83 ","$20,580.66 ","$23,213.07 "
SACRED HEART HOSPITAL (ACU),48100088,37231,HC RVC EN PRC T/P W/AN/TR ST IN V 37231,481,1 ,"$28,483.00 ","$21,362.25 ","$3,561.79 ","$38,218.28 ","$18,343.05 ","$16,985.90 ","$19,938.10 ","$3,561.79 ","$19,295.00 ","$3,668.64 ","$15,436.00 ","$27,058.85 ","$3,561.79 ","$22,786.40 ","$26,204.36 ","$3,561.79 ","$24,210.55 ","$27,058.85 ","$25,065.04 ","$21,647.08 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$20,792.59 ","$15,665.65 ","$25,919.53 ","$25,919.53 ","$22,786.40 ","$17,495.48 ","$15,665.65 ","$25,634.70 ","$16,985.90 ","$25,634.70 ","$15,380.82 ","$26,774.02 ","$38,218.28 ","$26,204.36 ","$3,775.50 ","$25,919.53 ","$16,985.90 ","$17,528.44 ","$17,528.44 ","$25,634.70 ","$21,256.86 ","$14,241.50 ","$17,155.76 ","$3,561.79 ","$27,058.85 ","$17,835.20 ","$3,561.79 ","$24,780.21 ","$16,985.90 ","$25,634.70 ","$16,985.90 ","$25,634.70 ","$25,634.70 ","$25,634.70 ","$27,628.51 ","$23,071.23 ","$26,489.19 ","$24,495.38 ","$27,628.51 "
SACRED HEART HOSPITAL (ACU),48100089,37232,HC RVC EN PRC T/P W/ANG EA AD VS 37232,481,1 ,"$13,670.00 ","$10,252.50 ","$3,561.79 ","$13,670.00 ","$8,803.48 ", N/A ,"$9,569.00 ","$3,561.79 ","$5,521.00 ","$3,668.64 ","$4,416.00 ","$12,986.50 ","$3,561.79 ","$10,936.00 ","$12,576.40 ","$3,561.79 ","$11,619.50 ","$12,986.50 ","$12,029.60 ","$10,389.20 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$9,979.10 ","$7,518.50 ","$12,439.70 ","$12,439.70 ","$10,936.00 ", N/A ,"$7,518.50 ","$12,303.00 ", N/A ,"$12,303.00 ","$7,381.80 ","$12,849.80 ", N/A ,"$12,576.40 ","$3,775.50 ","$12,439.70 ", N/A ,"$8,412.52 ","$8,412.52 ","$12,303.00 ","$10,201.92 ", N/A , N/A ,"$3,561.79 ","$12,986.50 ", N/A ,"$3,561.79 ","$11,892.90 ", N/A ,"$12,303.00 ", N/A ,"$12,303.00 ","$12,303.00 ","$12,303.00 ","$13,259.90 ","$11,072.70 ","$12,713.10 ","$11,756.20 ","$13,259.90 "
SACRED HEART HOSPITAL (ACU),48100090,37233,HC RVC EN PRC T/P W/ANT EA AD VS 37233,481,1 ,"$10,747.00 ","$8,060.25 ","$3,561.79 ","$10,747.00 ","$6,921.07 ", N/A ,"$7,522.90 ","$3,561.79 ","$5,521.00 ","$3,668.64 ","$4,416.00 ","$10,209.65 ","$3,561.79 ","$8,597.60 ","$9,887.24 ","$3,561.79 ","$9,134.95 ","$10,209.65 ","$9,457.36 ","$8,167.72 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$7,845.31 ","$5,910.85 ","$9,779.77 ","$9,779.77 ","$8,597.60 ", N/A ,"$5,910.85 ","$9,672.30 ", N/A ,"$9,672.30 ","$5,803.38 ","$10,102.18 ", N/A ,"$9,887.24 ","$3,775.50 ","$9,779.77 ", N/A ,"$6,613.70 ","$6,613.70 ","$9,672.30 ","$8,020.49 ","$9,672.30 ", N/A ,"$3,561.79 ","$10,209.65 ", N/A ,"$3,561.79 ","$9,349.89 ", N/A ,"$9,672.30 ", N/A ,"$9,672.30 ","$9,672.30 ","$9,672.30 ","$10,424.59 ","$8,705.07 ","$9,994.71 ","$9,242.42 ","$10,424.59 "
SACRED HEART HOSPITAL (ACU),48100091,37234,HC RVC EN PRC T/P W/TRN SNT EA VS 37234,481,1 ,"$13,543.00 ","$10,157.25 ","$3,561.79 ","$13,543.00 ","$8,721.69 ", N/A ,"$9,480.10 ","$3,561.79 ","$5,521.00 ","$3,668.64 ","$4,416.00 ","$12,865.85 ","$3,561.79 ","$10,834.40 ","$12,459.56 ","$3,561.79 ","$11,511.55 ","$12,865.85 ","$11,917.84 ","$10,292.68 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$9,886.39 ","$7,448.65 ","$12,324.13 ","$12,324.13 ","$10,834.40 ", N/A ,"$7,448.65 ","$12,188.70 ", N/A ,"$12,188.70 ","$7,313.22 ","$12,730.42 ", N/A ,"$12,459.56 ","$3,775.50 ","$12,324.13 ", N/A ,"$8,334.36 ","$8,334.36 ","$12,188.70 ","$10,107.14 ", N/A , N/A ,"$3,561.79 ","$12,865.85 ", N/A ,"$3,561.79 ","$11,782.41 ", N/A ,"$12,188.70 ", N/A ,"$12,188.70 ","$12,188.70 ","$12,188.70 ","$13,136.71 ","$10,969.83 ","$12,594.99 ","$11,646.98 ","$13,136.71 "
SACRED HEART HOSPITAL (ACU),48100092,37235,HC RVC EN PRC T/P W/AN/TR ST AD V 37235,481,1 ,"$12,884.00 ","$9,663.00 ","$3,561.79 ","$12,884.00 ","$8,297.30 ", N/A ,"$9,018.80 ","$3,561.79 ","$5,521.00 ","$3,668.64 ","$4,416.00 ","$12,239.80 ","$3,561.79 ","$10,307.20 ","$11,853.28 ","$3,561.79 ","$10,951.40 ","$12,239.80 ","$11,337.92 ","$9,791.84 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$9,405.32 ","$7,086.20 ","$11,724.44 ","$11,724.44 ","$10,307.20 ", N/A ,"$7,086.20 ","$11,595.60 ", N/A ,"$11,595.60 ","$6,957.36 ","$12,110.96 ", N/A ,"$11,853.28 ","$3,775.50 ","$11,724.44 ", N/A ,"$7,928.81 ","$7,928.81 ","$11,595.60 ","$9,615.33 ", N/A , N/A ,"$3,561.79 ","$12,239.80 ", N/A ,"$3,561.79 ","$11,209.08 ", N/A ,"$11,595.60 ", N/A ,"$11,595.60 ","$11,595.60 ","$11,595.60 ","$12,497.48 ","$10,436.04 ","$11,982.12 ","$11,080.24 ","$12,497.48 "
SACRED HEART HOSPITAL (ACU),48100093,37252,HC US VASCULAR NON-CORONARY INIT 37252,481,1 ,"$4,726.00 ","$3,544.50 ",$592.92 ,"$4,726.00 ","$3,043.54 ", N/A ,"$3,308.20 ",$592.92 ,"$4,726.00 ",$610.71 ,"$4,416.00 ","$4,489.70 ",$592.92 ,"$3,780.80 ","$4,347.92 ",$592.92 ,"$4,017.10 ","$4,489.70 ","$4,158.88 ","$3,591.76 ",$592.92 ,$592.92 ,$592.92 ,"$3,449.98 ","$2,599.30 ","$4,300.66 ","$4,300.66 ","$3,780.80 ", N/A ,"$2,599.30 ","$4,253.40 ", N/A ,"$4,253.40 ","$2,552.04 ","$4,442.44 ", N/A ,"$4,347.92 ",$628.50 ,"$4,300.66 ", N/A ,"$2,908.38 ","$2,908.38 ","$4,253.40 ","$3,527.01 ","$2,363.00 ", N/A ,$592.92 ,"$4,489.70 ", N/A ,$592.92 ,"$4,111.62 ", N/A ,"$4,253.40 ", N/A ,"$4,253.40 ","$4,253.40 ","$4,253.40 ","$4,584.22 ","$3,828.06 ","$4,395.18 ","$4,064.36 ","$4,584.22 "
SACRED HEART HOSPITAL (ACU),48100094,37253,HC US VASCULAR NON-CORON ADDL EA 37253,481,1 ,"$3,300.00 ","$2,475.00 ",$592.92 ,"$3,300.00 ","$2,125.20 ", N/A ,"$2,310.00 ",$592.92 ,"$3,300.00 ",$610.71 ,"$3,300.00 ","$3,135.00 ",$592.92 ,"$2,640.00 ","$3,036.00 ",$592.92 ,"$2,805.00 ","$3,135.00 ","$2,904.00 ","$2,508.00 ",$592.92 ,$592.92 ,$592.92 ,"$2,409.00 ","$1,815.00 ","$3,003.00 ","$3,003.00 ","$2,640.00 ", N/A ,"$1,815.00 ","$2,970.00 ", N/A ,"$2,970.00 ","$1,782.00 ","$3,102.00 ", N/A ,"$3,036.00 ",$628.50 ,"$3,003.00 ", N/A ,"$2,030.82 ","$2,030.82 ","$2,970.00 ","$2,462.79 ","$1,650.00 ", N/A ,$592.92 ,"$3,135.00 ", N/A ,$592.92 ,"$2,871.00 ", N/A ,"$2,970.00 ", N/A ,"$2,970.00 ","$2,970.00 ","$2,970.00 ","$3,201.00 ","$2,673.00 ","$3,069.00 ","$2,838.00 ","$3,201.00 "
SACRED HEART HOSPITAL (ACU),48100096,92973,HC PTC TRANSLUM CORONARY THROMB 92973,481,1 ,"$4,137.00 ","$3,102.75 ","$2,233.98 ","$4,137.00 ","$2,664.23 ", N/A ,"$2,895.90 ","$2,792.29 ", N/A ,"$2,876.06 ", N/A ,"$3,930.15 ","$2,792.29 ","$3,309.60 ","$3,806.04 ","$2,792.29 ","$3,516.45 ","$3,930.15 ","$3,640.56 ","$3,144.12 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$3,020.01 ","$2,275.35 ","$3,764.67 ","$3,764.67 ","$3,309.60 ", N/A ,"$2,275.35 ","$3,723.30 ", N/A ,"$3,723.30 ","$2,233.98 ","$3,888.78 ", N/A ,"$3,806.04 ","$2,959.83 ","$3,764.67 ", N/A ,"$2,545.91 ","$2,545.91 ","$3,723.30 ","$3,087.44 ", N/A , N/A ,"$2,792.29 ","$3,930.15 ", N/A ,"$2,792.29 ","$3,599.19 ", N/A ,"$3,723.30 ", N/A ,"$3,723.30 ","$3,723.30 ","$3,723.30 ","$4,012.89 ","$3,350.97 ","$3,847.41 ","$3,557.82 ","$4,012.89 "
SACRED HEART HOSPITAL (ACU),48100097,92978,HC INTRAVASCULAR ULTRSOUND INTIAL 92978,481,1 ,"$4,571.46 ","$3,428.60 ",$58.37 ,"$4,571.46 ","$2,944.02 ", N/A ,"$3,200.02 ",$58.37 ,"$4,571.46 ",$60.12 ,"$4,416.00 ","$4,342.89 ",$58.37 ,"$3,657.17 ","$4,205.74 ",$58.37 ,"$3,885.74 ","$4,342.89 ","$4,022.88 ","$3,474.31 ",$58.37 ,$58.37 ,$58.37 ,"$3,337.17 ","$2,514.30 ","$4,160.03 ","$4,160.03 ","$3,657.17 ", N/A ,"$2,514.30 ","$4,114.31 ", N/A ,"$4,114.31 ","$2,468.59 ","$4,297.17 ", N/A ,"$4,205.74 ",$61.87 ,"$4,160.03 ", N/A ,"$2,813.28 ","$2,813.28 ","$4,114.31 ","$3,411.68 ", N/A , N/A ,$58.37 ,"$4,342.89 ", N/A ,$58.37 ,"$3,977.17 ", N/A ,"$4,114.31 ", N/A ,"$4,114.31 ","$4,114.31 ","$4,114.31 ","$4,434.32 ","$3,702.88 ","$4,251.46 ","$3,931.46 ","$4,434.32 "
SACRED HEART HOSPITAL (ACU),48100098,92979,HC INTRAVASCULAR ULTRSOUND EA ADD 92979,481,1 ,"$2,482.17 ","$1,861.63 ",$58.37 ,"$2,482.17 ","$1,598.52 ", N/A ,"$1,737.52 ",$58.37 , N/A ,$60.12 , N/A ,"$2,358.06 ",$58.37 ,"$1,985.74 ","$2,283.60 ",$58.37 ,"$2,109.84 ","$2,358.06 ","$2,184.31 ","$1,886.45 ",$58.37 ,$58.37 ,$58.37 ,"$1,811.98 ","$1,365.19 ","$2,258.77 ","$2,258.77 ","$1,985.74 ", N/A ,"$1,365.19 ","$2,233.95 ", N/A ,"$2,233.95 ","$1,340.37 ","$2,333.24 ", N/A ,"$2,283.60 ",$61.87 ,"$2,258.77 ", N/A ,"$1,527.53 ","$1,527.53 ","$2,233.95 ","$1,852.44 ", N/A , N/A ,$58.37 ,"$2,358.06 ", N/A ,$58.37 ,"$2,159.49 ", N/A ,"$2,233.95 ", N/A ,"$2,233.95 ","$2,233.95 ","$2,233.95 ","$2,407.70 ","$2,010.56 ","$2,308.42 ","$2,134.67 ","$2,407.70 "
SACRED HEART HOSPITAL (ACU),48100107,93451,HC CATH RIGHT HEART 93451,481,1 ,"$9,391.00 ","$7,043.25 ",$764.33 ,"$9,391.00 ","$6,047.80 ","$3,066.89 ","$6,573.70 ",$764.33 ,"$9,391.00 ",$787.26 ,"$9,391.00 ","$8,921.45 ",$764.33 ,"$7,512.80 ","$8,639.72 ",$764.33 ,"$7,982.35 ","$8,921.45 ","$8,264.08 ","$7,137.16 ",$764.33 ,$764.33 ,$764.33 ,"$6,855.43 ","$5,165.05 ","$8,545.81 ","$8,545.81 ","$7,512.80 ","$3,158.90 ","$5,165.05 ","$8,451.90 ","$3,066.89 ","$8,451.90 ","$5,071.14 ","$8,827.54 ","$6,900.50 ","$8,639.72 ",$810.19 ,"$8,545.81 ","$3,066.89 ","$5,779.22 ","$5,779.22 ","$8,451.90 ","$7,008.50 ","$8,451.90 ","$3,097.56 ",$764.33 ,"$8,921.45 ","$3,220.24 ",$764.33 ,"$8,170.17 ","$3,066.89 ","$8,451.90 ","$3,066.89 ","$8,451.90 ","$8,451.90 ","$8,451.90 ","$9,109.27 ","$7,606.71 ","$8,733.63 ","$8,076.26 ","$9,109.27 "
SACRED HEART HOSPITAL (ACU),48100110,93454,HC CORONARY ANGIO ONLY/NO LV 93454,481,1 ,"$11,380.00 ","$8,535.00 ",$764.33 ,"$11,380.00 ","$7,328.72 ","$3,066.89 ","$7,966.00 ",$764.33 ,"$11,380.00 ",$787.26 ,"$11,380.00 ","$10,811.00 ",$764.33 ,"$9,104.00 ","$10,469.60 ",$764.33 ,"$9,673.00 ","$10,811.00 ","$10,014.40 ","$8,648.80 ",$764.33 ,$764.33 ,$764.33 ,"$8,307.40 ","$6,259.00 ","$10,355.80 ","$10,355.80 ","$9,104.00 ","$3,158.90 ","$6,259.00 ","$10,242.00 ","$3,066.89 ","$10,242.00 ","$6,145.20 ","$10,697.20 ","$6,900.50 ","$10,469.60 ",$810.19 ,"$10,355.80 ","$3,066.89 ","$7,003.25 ","$7,003.25 ","$10,242.00 ","$8,492.89 ","$10,242.00 ","$3,097.56 ",$764.33 ,"$10,811.00 ","$3,220.24 ",$764.33 ,"$9,900.60 ","$3,066.89 ","$10,242.00 ","$3,066.89 ","$10,242.00 ","$10,242.00 ","$10,242.00 ","$11,038.60 ","$9,217.80 ","$10,583.40 ","$9,786.80 ","$11,038.60 "
SACRED HEART HOSPITAL (ACU),48100111,93455,HC CORO ANGIO  AND  GRAFTS ONLY NO LV 93455,481,1 ,"$11,717.00 ","$8,787.75 ",$764.33 ,"$11,717.00 ","$7,545.75 ","$3,066.89 ","$8,201.90 ",$764.33 ,"$11,717.00 ",$787.26 ,"$11,717.00 ","$11,131.15 ",$764.33 ,"$9,373.60 ","$10,779.64 ",$764.33 ,"$9,959.45 ","$11,131.15 ","$10,310.96 ","$8,904.92 ",$764.33 ,$764.33 ,$764.33 ,"$8,553.41 ","$6,444.35 ","$10,662.47 ","$10,662.47 ","$9,373.60 ","$3,158.90 ","$6,444.35 ","$10,545.30 ","$3,066.89 ","$10,545.30 ","$6,327.18 ","$11,013.98 ","$6,900.50 ","$10,779.64 ",$810.19 ,"$10,662.47 ","$3,066.89 ","$7,210.64 ","$7,210.64 ","$10,545.30 ","$8,744.40 ","$10,545.30 ","$3,097.56 ",$764.33 ,"$11,131.15 ","$3,220.24 ",$764.33 ,"$10,193.79 ","$3,066.89 ","$10,545.30 ","$3,066.89 ","$10,545.30 ","$10,545.30 ","$10,545.30 ","$11,365.49 ","$9,490.77 ","$10,896.81 ","$10,076.62 ","$11,365.49 "
SACRED HEART HOSPITAL (ACU),48100112,93456,HC RHC CORONARY ANGIO/NO LV 93456,481,1 ,"$21,584.00 ","$16,188.00 ",$764.33 ,"$21,584.00 ","$13,900.10 ","$3,066.89 ","$15,108.80 ",$764.33 ,"$16,080.00 ",$787.26 ,"$12,863.00 ","$20,504.80 ",$764.33 ,"$17,267.20 ","$19,857.28 ",$764.33 ,"$18,346.40 ","$20,504.80 ","$18,993.92 ","$16,403.84 ",$764.33 ,$764.33 ,$764.33 ,"$15,756.32 ","$11,871.20 ","$19,641.44 ","$19,641.44 ","$17,267.20 ","$3,158.90 ","$11,871.20 ","$19,425.60 ","$3,066.89 ","$19,425.60 ","$11,655.36 ","$20,288.96 ","$6,900.50 ","$19,857.28 ",$810.19 ,"$19,641.44 ","$3,066.89 ","$13,282.79 ","$13,282.79 ","$19,425.60 ","$16,108.14 ","$12,219.05 ","$3,097.56 ",$764.33 ,"$20,504.80 ","$3,220.24 ",$764.33 ,"$18,778.08 ","$3,066.89 ","$19,425.60 ","$3,066.89 ","$19,425.60 ","$19,425.60 ","$19,425.60 ","$20,936.48 ","$17,483.04 ","$20,073.12 ","$18,562.24 ","$20,936.48 "
SACRED HEART HOSPITAL (ACU),48100113,93457,HC RHC CORO ANGIO  AND  GRAFTS/NO LV 93457,481,1 ,"$21,247.00 ","$15,935.25 ",$764.33 ,"$21,247.00 ","$13,683.07 ","$3,066.89 ","$14,872.90 ",$764.33 ,"$16,080.00 ",$787.26 ,"$12,863.00 ","$20,184.65 ",$764.33 ,"$16,997.60 ","$19,547.24 ",$764.33 ,"$18,059.95 ","$20,184.65 ","$18,697.36 ","$16,147.72 ",$764.33 ,$764.33 ,$764.33 ,"$15,510.31 ","$11,685.85 ","$19,334.77 ","$19,334.77 ","$16,997.60 ","$3,158.90 ","$11,685.85 ","$19,122.30 ","$3,066.89 ","$19,122.30 ","$11,473.38 ","$19,972.18 ","$6,900.50 ","$19,547.24 ",$810.19 ,"$19,334.77 ","$3,066.89 ","$13,075.40 ","$13,075.40 ","$19,122.30 ","$15,856.64 ","$12,219.05 ","$3,097.56 ",$764.33 ,"$20,184.65 ","$3,220.24 ",$764.33 ,"$18,484.89 ","$3,066.89 ","$19,122.30 ","$3,066.89 ","$19,122.30 ","$19,122.30 ","$19,122.30 ","$20,609.59 ","$17,210.07 ","$19,759.71 ","$18,272.42 ","$20,609.59 "
SACRED HEART HOSPITAL (ACU),48100114,93458,HC CORONARY ANGIO WITH LV 93458,481,1 ,"$13,712.00 ","$10,284.00 ",$764.33 ,"$13,712.00 ","$8,830.53 ","$3,066.89 ","$9,598.40 ",$764.33 ,"$13,712.00 ",$787.26 ,"$12,863.00 ","$13,026.40 ",$764.33 ,"$10,969.60 ","$12,615.04 ",$764.33 ,"$11,655.20 ","$13,026.40 ","$12,066.56 ","$10,421.12 ",$764.33 ,$764.33 ,$764.33 ,"$10,009.76 ","$7,541.60 ","$12,477.92 ","$12,477.92 ","$10,969.60 ","$3,158.90 ","$7,541.60 ","$12,340.80 ","$3,066.89 ","$12,340.80 ","$7,404.48 ","$12,889.28 ","$6,900.50 ","$12,615.04 ",$810.19 ,"$12,477.92 ","$3,066.89 ","$8,438.36 ","$8,438.36 ","$12,340.80 ","$10,233.27 ","$12,219.05 ","$3,097.56 ",$764.33 ,"$13,026.40 ","$3,220.24 ",$764.33 ,"$11,929.44 ","$3,066.89 ","$12,340.80 ","$3,066.89 ","$12,340.80 ","$12,340.80 ","$12,340.80 ","$13,300.64 ","$11,106.72 ","$12,752.16 ","$11,792.32 ","$13,300.64 "
SACRED HEART HOSPITAL (ACU),48100115,93459,HC CORONARY ANGIO W GRAFTS AND LV 93459,481,1 ,"$14,471.00 ","$10,853.25 ",$764.33 ,"$14,471.00 ","$9,319.32 ","$3,066.89 ","$10,129.70 ",$764.33 ,"$14,471.00 ",$787.26 ,"$12,863.00 ","$13,747.45 ",$764.33 ,"$11,576.80 ","$13,313.32 ",$764.33 ,"$12,300.35 ","$13,747.45 ","$12,734.48 ","$10,997.96 ",$764.33 ,$764.33 ,$764.33 ,"$10,563.83 ","$7,959.05 ","$13,168.61 ","$13,168.61 ","$11,576.80 ","$3,158.90 ","$7,959.05 ","$13,023.90 ","$3,066.89 ","$13,023.90 ","$7,814.34 ","$13,602.74 ","$6,900.50 ","$13,313.32 ",$810.19 ,"$13,168.61 ","$3,066.89 ","$8,905.45 ","$8,905.45 ","$13,023.90 ","$10,799.71 ","$12,219.05 ","$3,097.56 ",$764.33 ,"$13,747.45 ","$3,220.24 ",$764.33 ,"$12,589.77 ","$3,066.89 ","$13,023.90 ","$3,066.89 ","$13,023.90 ","$13,023.90 ","$13,023.90 ","$14,036.87 ","$11,721.51 ","$13,458.03 ","$12,445.06 ","$14,036.87 "
SACRED HEART HOSPITAL (ACU),48100116,93460,HC RHC/LHC/CORONAY ANGIO AND LV 93460,481,1 ,"$15,701.00 ","$11,775.75 ",$764.33 ,"$15,701.00 ","$10,111.44 ","$3,066.89 ","$10,990.70 ",$764.33 ,"$15,701.00 ",$787.26 ,"$12,863.00 ","$14,915.95 ",$764.33 ,"$12,560.80 ","$14,444.92 ",$764.33 ,"$13,345.85 ","$14,915.95 ","$13,816.88 ","$11,932.76 ",$764.33 ,$764.33 ,$764.33 ,"$11,461.73 ","$8,635.55 ","$14,287.91 ","$14,287.91 ","$12,560.80 ","$3,158.90 ","$8,635.55 ","$14,130.90 ","$3,066.89 ","$14,130.90 ","$8,478.54 ","$14,758.94 ","$6,900.50 ","$14,444.92 ",$810.19 ,"$14,287.91 ","$3,066.89 ","$9,662.40 ","$9,662.40 ","$14,130.90 ","$11,717.66 ","$12,219.05 ","$3,097.56 ",$764.33 ,"$14,915.95 ","$3,220.24 ",$764.33 ,"$13,659.87 ","$3,066.89 ","$14,130.90 ","$3,066.89 ","$14,130.90 ","$14,130.90 ","$14,130.90 ","$15,229.97 ","$12,717.81 ","$14,601.93 ","$13,502.86 ","$15,229.97 "
SACRED HEART HOSPITAL (ACU),48100117,93461,HC RHC/LHC/CORON ANGIO GRAFTS  AND LV 93461,481,1 ,"$14,650.00 ","$10,987.50 ",$764.33 ,"$14,650.00 ","$9,434.60 ","$3,066.89 ","$10,255.00 ",$764.33 ,"$14,650.00 ",$787.26 ,"$12,863.00 ","$13,917.50 ",$764.33 ,"$11,720.00 ","$13,478.00 ",$764.33 ,"$12,452.50 ","$13,917.50 ","$12,892.00 ","$11,134.00 ",$764.33 ,$764.33 ,$764.33 ,"$10,694.50 ","$8,057.50 ","$13,331.50 ","$13,331.50 ","$11,720.00 ","$3,158.90 ","$8,057.50 ","$13,185.00 ","$3,066.89 ","$13,185.00 ","$7,911.00 ","$13,771.00 ","$6,900.50 ","$13,478.00 ",$810.19 ,"$13,331.50 ","$3,066.89 ","$9,015.61 ","$9,015.61 ","$13,185.00 ","$10,933.30 ","$12,219.05 ","$3,097.56 ",$764.33 ,"$13,917.50 ","$3,220.24 ",$764.33 ,"$12,745.50 ","$3,066.89 ","$13,185.00 ","$3,066.89 ","$13,185.00 ","$13,185.00 ","$13,185.00 ","$14,210.50 ","$11,866.50 ","$13,624.50 ","$12,599.00 ","$14,210.50 "
SACRED HEART HOSPITAL (ACU),48100119,93567,HC AORTAGRAM 93567,481,1 ,$449.00 ,$336.75 ,$98.34 ,$449.00 ,$289.16 , N/A ,$314.30 ,$98.34 ,$449.00 ,$101.29 ,$449.00 ,$426.55 ,$98.34 ,$359.20 ,$413.08 ,$98.34 ,$381.65 ,$426.55 ,$395.12 ,$341.24 ,$98.34 ,$98.34 ,$98.34 ,$327.77 ,$246.95 ,$408.59 ,$408.59 ,$359.20 , N/A ,$246.95 ,$404.10 , N/A ,$404.10 ,$242.46 ,$422.06 , N/A ,$413.08 ,$104.24 ,$408.59 , N/A ,$276.31 ,$276.31 ,$404.10 ,$335.09 , N/A , N/A ,$98.34 ,$426.55 , N/A ,$98.34 ,$390.63 , N/A ,$404.10 , N/A ,$404.10 ,$404.10 ,$404.10 ,$435.53 ,$363.69 ,$417.57 ,$386.14 ,$435.53 
SACRED HEART HOSPITAL (ACU),48100120,93571,HC INTRAVASC DOPP COLOR FLOW INIT 93571,481,1 ,"$3,132.19 ","$2,349.14 ",$592.92 ,"$3,132.19 ","$2,017.13 ", N/A ,"$2,192.53 ",$592.92 ,"$3,132.19 ",$610.71 ,"$3,132.19 ","$2,975.58 ",$592.92 ,"$2,505.75 ","$2,881.61 ",$592.92 ,"$2,662.36 ","$2,975.58 ","$2,756.33 ","$2,380.46 ",$592.92 ,$592.92 ,$592.92 ,"$2,286.50 ","$1,722.70 ","$2,850.29 ","$2,850.29 ","$2,505.75 ", N/A ,"$1,722.70 ","$2,818.97 ", N/A ,"$2,818.97 ","$1,691.38 ","$2,944.26 ", N/A ,"$2,881.61 ",$628.50 ,"$2,850.29 ", N/A ,"$1,927.55 ","$1,927.55 ","$2,818.97 ","$2,337.55 ", N/A , N/A ,$592.92 ,"$2,975.58 ", N/A ,$592.92 ,"$2,725.01 ", N/A ,"$2,818.97 ", N/A ,"$2,818.97 ","$2,818.97 ","$2,818.97 ","$3,038.22 ","$2,537.07 ","$2,912.94 ","$2,693.68 ","$3,038.22 "
SACRED HEART HOSPITAL (ACU),48100121,93572,HC INTRAVASC DOPP COLOR FLOW ADDL 93572,481,1 ,$868.60 ,$651.45 ,$469.04 ,$868.60 ,$559.38 , N/A ,$608.02 ,$592.92 ,$868.60 ,$610.71 ,$868.60 ,$825.17 ,$592.92 ,$694.88 ,$799.11 ,$592.92 ,$738.31 ,$825.17 ,$764.37 ,$660.14 ,$592.92 ,$592.92 ,$592.92 ,$634.08 ,$477.73 ,$790.43 ,$790.43 ,$694.88 , N/A ,$477.73 ,$781.74 , N/A ,$781.74 ,$469.04 ,$816.48 , N/A ,$799.11 ,$628.50 ,$790.43 , N/A ,$534.54 ,$534.54 ,$781.74 ,$648.24 , N/A , N/A ,$592.92 ,$825.17 , N/A ,$592.92 ,$755.68 , N/A ,$781.74 , N/A ,$781.74 ,$781.74 ,$781.74 ,$842.54 ,$703.57 ,$807.80 ,$747.00 ,$842.54 
SACRED HEART HOSPITAL (ACU),48100133,93641,HC EP EVAL CARDIO/DEFIB GENERATOR 93641,481,1 ,"$3,028.90 ","$2,271.68 ","$1,635.61 ","$3,028.90 ","$1,950.61 ", N/A ,"$2,120.23 ","$2,012.10 ", N/A ,"$2,072.46 ", N/A ,"$2,877.46 ","$2,012.10 ","$2,423.12 ","$2,786.59 ","$2,012.10 ","$2,574.57 ","$2,877.46 ","$2,665.43 ","$2,301.96 ","$2,012.10 ","$2,012.10 ","$2,012.10 ","$2,211.10 ","$1,665.90 ","$2,756.30 ","$2,756.30 ","$2,423.12 ", N/A ,"$1,665.90 ","$2,726.01 ", N/A ,"$2,726.01 ","$1,635.61 ","$2,847.17 ", N/A ,"$2,786.59 ","$2,132.83 ","$2,756.30 ", N/A ,"$1,863.99 ","$1,863.99 ","$2,726.01 ","$2,260.47 ","$2,519.91 ", N/A ,"$2,012.10 ","$2,877.46 ", N/A ,"$2,012.10 ","$2,635.14 ", N/A ,"$2,726.01 ", N/A ,"$2,726.01 ","$2,726.01 ","$2,726.01 ","$2,938.03 ","$2,453.41 ","$2,816.88 ","$2,604.85 ","$2,938.03 "
SACRED HEART HOSPITAL (ACU),48100135,93642,HC EP EVAL CARDIO/DEFIB SGL/DUAL 93642,481,1 ,"$1,322.34 ",$991.76 ,$714.06 ,"$2,650.48 ",$851.59 ,"$1,177.99 ",$925.64 ,"$1,322.34 ", N/A ,"$2,072.46 ", N/A ,"$1,256.22 ","$2,012.10 ","$1,057.87 ","$1,216.55 ","$1,322.34 ","$1,123.99 ","$1,256.22 ","$1,163.66 ","$1,004.98 ","$1,322.34 ","$1,322.34 ","$2,012.10 ",$965.31 ,$727.29 ,"$1,203.33 ","$1,203.33 ","$1,057.87 ","$1,213.33 ",$727.29 ,"$1,190.11 ","$1,177.99 ","$1,190.11 ",$714.06 ,"$1,243.00 ","$2,650.48 ","$1,216.55 ","$2,132.83 ","$1,203.33 ","$1,177.99 ",$813.77 ,$813.77 ,"$1,190.11 ",$986.86 ,"$1,190.11 ","$1,189.77 ","$1,322.34 ","$1,256.22 ","$1,236.89 ","$1,322.34 ","$1,150.44 ","$1,177.99 ","$1,190.11 ","$1,177.99 ","$1,190.11 ","$1,190.11 ","$1,190.11 ","$1,282.67 ","$1,071.10 ","$1,229.78 ","$1,137.21 ","$1,282.67 "
SACRED HEART HOSPITAL (ACU),48100139,93660,HC TILT TABLE EVALUATION 93660,481,1 ,"$1,175.60 ",$881.70 ,$54.42 ,"$1,175.60 ",$757.09 ,$516.27 ,$822.92 ,$54.42 ,"$1,175.60 ",$56.05 ,"$1,175.60 ","$1,116.82 ",$54.42 ,$940.48 ,"$1,081.55 ",$54.42 ,$999.26 ,"$1,116.82 ","$1,034.53 ",$893.46 ,$54.42 ,$54.42 ,$54.42 ,$858.19 ,$646.58 ,"$1,069.80 ","$1,069.80 ",$940.48 ,$531.76 ,$646.58 ,"$1,058.04 ",$516.27 ,"$1,058.04 ",$634.82 ,"$1,105.06 ","$1,161.60 ","$1,081.55 ",$57.69 ,"$1,069.80 ",$516.27 ,$723.46 ,$723.46 ,"$1,058.04 ",$877.35 ,$794.24 ,$521.43 ,$54.42 ,"$1,116.82 ",$542.08 ,$54.42 ,"$1,022.77 ",$516.27 ,"$1,058.04 ",$516.27 ,"$1,058.04 ","$1,058.04 ","$1,058.04 ","$1,140.33 ",$952.24 ,"$1,093.31 ","$1,011.02 ","$1,140.33 "
SACRED HEART HOSPITAL (ACU),48100151,33227,HC REM/REPL PCMKR PUL GEN SGL 33227,481,1 ,"$11,602.00 ","$8,701.50 ","$2,694.63 ","$19,414.88 ","$7,471.69 ","$8,628.84 ","$8,121.40 ","$2,694.63 ","$11,602.00 ","$2,775.47 ","$11,602.00 ","$11,021.90 ","$2,694.63 ","$9,281.60 ","$10,673.84 ","$2,694.63 ","$9,861.70 ","$11,021.90 ","$10,209.76 ","$8,817.52 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$8,469.46 ","$6,381.10 ","$10,557.82 ","$10,557.82 ","$9,281.60 ","$8,887.71 ","$6,381.10 ","$10,441.80 ","$8,628.84 ","$10,441.80 ","$6,265.08 ","$10,905.88 ","$19,414.88 ","$10,673.84 ","$2,856.31 ","$10,557.82 ","$8,628.84 ","$7,139.87 ","$7,139.87 ","$10,441.80 ","$8,658.57 ","$6,618.65 ","$8,715.12 ","$2,694.63 ","$11,021.90 ","$9,060.28 ","$2,694.63 ","$10,093.74 ","$8,628.84 ","$10,441.80 ","$8,628.84 ","$10,441.80 ","$10,441.80 ","$10,441.80 ","$11,253.94 ","$9,397.62 ","$10,789.86 ","$9,977.72 ","$11,253.94 "
SACRED HEART HOSPITAL (ACU),48100152,33228,HC REM/REPL PCMKR PUL GEN DUAL 33228,481,1 ,"$15,524.00 ","$11,643.00 ","$2,694.63 ","$24,743.60 ","$9,997.46 ","$10,997.16 ","$10,866.80 ","$2,694.63 ","$15,524.00 ","$2,775.47 ","$15,007.00 ","$14,747.80 ","$2,694.63 ","$12,419.20 ","$14,282.08 ","$2,694.63 ","$13,195.40 ","$14,747.80 ","$13,661.12 ","$11,798.24 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$11,332.52 ","$8,538.20 ","$14,126.84 ","$14,126.84 ","$12,419.20 ","$11,327.07 ","$8,538.20 ","$13,971.60 ","$10,997.16 ","$13,971.60 ","$8,382.96 ","$14,592.56 ","$24,743.60 ","$14,282.08 ","$2,856.31 ","$14,126.84 ","$10,997.16 ","$9,553.47 ","$9,553.47 ","$13,971.60 ","$11,585.56 ","$7,762.00 ","$11,107.13 ","$2,694.63 ","$14,747.80 ","$11,547.01 ","$2,694.63 ","$13,505.88 ","$10,997.16 ","$13,971.60 ","$10,997.16 ","$13,971.60 ","$13,971.60 ","$13,971.60 ","$15,058.28 ","$12,574.44 ","$14,437.32 ","$13,350.64 ","$15,058.28 "
SACRED HEART HOSPITAL (ACU),48100153,33229,HC REM/REPL PCMKR PUL GEN MULT 33229,481,1 ,"$23,267.00 ","$17,450.25 ","$2,694.63 ","$44,319.49 ","$14,983.95 ","$19,697.55 ","$16,286.90 ","$2,694.63 ","$19,295.00 ","$2,775.47 ","$15,436.00 ","$22,103.65 ","$2,694.63 ","$18,613.60 ","$21,405.64 ","$2,694.63 ","$19,776.95 ","$22,103.65 ","$20,474.96 ","$17,682.92 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$16,984.91 ","$12,796.85 ","$21,172.97 ","$21,172.97 ","$18,613.60 ","$20,288.48 ","$12,796.85 ","$20,940.30 ","$19,697.55 ","$20,940.30 ","$12,564.18 ","$21,870.98 ","$44,319.49 ","$21,405.64 ","$2,856.31 ","$21,172.97 ","$19,697.55 ","$14,318.51 ","$14,318.51 ","$20,940.30 ","$17,364.16 ","$11,633.50 ","$19,894.53 ","$2,694.63 ","$22,103.65 ","$20,682.43 ","$2,694.63 ","$20,242.29 ","$19,697.55 ","$20,940.30 ","$19,697.55 ","$20,940.30 ","$20,940.30 ","$20,940.30 ","$22,568.99 ","$18,846.27 ","$21,638.31 ","$20,009.62 ","$22,568.99 "
SACRED HEART HOSPITAL (ACU),48100154,33262,HC REM/REPL DEFIB PUL GEN SGL 33262,481,1 ,"$32,973.00 ","$24,729.75 ","$8,079.30 ","$54,874.78 ","$21,234.61 ","$24,388.79 ","$23,081.10 ","$8,079.30 ","$19,295.00 ","$8,321.68 ","$15,436.00 ","$31,324.35 ","$8,079.30 ","$26,378.40 ","$30,335.16 ","$8,079.30 ","$28,027.05 ","$31,324.35 ","$29,016.24 ","$25,059.48 ","$8,079.30 ","$8,079.30 ","$8,079.30 ","$24,070.29 ","$18,135.15 ","$30,005.43 ","$30,005.43 ","$26,378.40 ","$25,120.45 ","$18,135.15 ","$29,675.70 ","$24,388.79 ","$29,675.70 ","$17,805.42 ","$30,994.62 ","$54,874.78 ","$30,335.16 ","$8,564.06 ","$30,005.43 ","$24,388.79 ","$20,291.58 ","$20,291.58 ","$29,675.70 ","$24,607.75 ","$16,486.50 ","$24,632.68 ","$8,079.30 ","$31,324.35 ","$25,608.23 ","$8,079.30 ","$28,686.51 ","$24,388.79 ","$29,675.70 ","$24,388.79 ","$29,675.70 ","$29,675.70 ","$29,675.70 ","$31,983.81 ","$26,708.13 ","$30,664.89 ","$28,356.78 ","$31,983.81 "
SACRED HEART HOSPITAL (ACU),48100155,33263,HC REM/REPL DEFIB PUL GEN DUAL 33263,481,1 ,"$32,973.00 ","$24,729.75 ","$8,079.30 ","$54,874.78 ","$21,234.61 ","$24,388.79 ","$23,081.10 ","$8,079.30 ","$19,295.00 ","$8,321.68 ","$15,436.00 ","$31,324.35 ","$8,079.30 ","$26,378.40 ","$30,335.16 ","$8,079.30 ","$28,027.05 ","$31,324.35 ","$29,016.24 ","$25,059.48 ","$8,079.30 ","$8,079.30 ","$8,079.30 ","$24,070.29 ","$18,135.15 ","$30,005.43 ","$30,005.43 ","$26,378.40 ","$25,120.45 ","$18,135.15 ","$29,675.70 ","$24,388.79 ","$29,675.70 ","$17,805.42 ","$30,994.62 ","$54,874.78 ","$30,335.16 ","$8,564.06 ","$30,005.43 ","$24,388.79 ","$20,291.58 ","$20,291.58 ","$29,675.70 ","$24,607.75 ","$16,486.50 ","$24,632.68 ","$8,079.30 ","$31,324.35 ","$25,608.23 ","$8,079.30 ","$28,686.51 ","$24,388.79 ","$29,675.70 ","$24,388.79 ","$29,675.70 ","$29,675.70 ","$29,675.70 ","$31,983.81 ","$26,708.13 ","$30,664.89 ","$28,356.78 ","$31,983.81 "
SACRED HEART HOSPITAL (ACU),48100156,33264,HC REM/REPL DEFIB PUL GEN MULT 33264,481,1 ,"$32,973.00 ","$24,729.75 ","$8,079.30 ","$78,166.42 ","$21,234.61 ","$34,740.63 ","$23,081.10 ","$8,079.30 ","$19,295.00 ","$8,321.68 ","$15,436.00 ","$31,324.35 ","$8,079.30 ","$26,378.40 ","$30,335.16 ","$8,079.30 ","$28,027.05 ","$31,324.35 ","$29,016.24 ","$25,059.48 ","$8,079.30 ","$8,079.30 ","$8,079.30 ","$24,070.29 ","$18,135.15 ","$30,005.43 ","$30,005.43 ","$26,378.40 ","$35,782.85 ","$18,135.15 ","$29,675.70 ","$34,740.63 ","$29,675.70 ","$17,805.42 ","$30,994.62 ","$78,166.42 ","$30,335.16 ","$8,564.06 ","$30,005.43 ","$34,740.63 ","$20,291.58 ","$20,291.58 ","$29,675.70 ","$24,607.75 ","$16,486.50 ","$35,088.04 ","$8,079.30 ","$31,324.35 ","$36,477.66 ","$8,079.30 ","$28,686.51 ","$34,740.63 ","$29,675.70 ","$34,740.63 ","$29,675.70 ","$29,675.70 ","$29,675.70 ","$31,983.81 ","$26,708.13 ","$30,664.89 ","$28,356.78 ","$31,983.81 "
SACRED HEART HOSPITAL (ACU),48100171,36253,HC PLC CATH RENAL ANGIO 1< UNI,481,1 ,"$2,168.00 ","$1,626.00 ","$1,170.72 ","$11,347.95 ","$1,396.19 ","$5,043.53 ","$1,517.60 ","$1,336.71 ","$2,168.00 ","$1,376.81 ","$2,168.00 ","$2,059.60 ","$1,336.71 ","$1,734.40 ","$1,994.56 ","$1,336.71 ","$1,842.80 ","$2,059.60 ","$1,907.84 ","$1,647.68 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$1,582.64 ","$1,192.40 ","$1,972.88 ","$1,972.88 ","$1,734.40 ","$5,194.84 ","$1,192.40 ","$1,951.20 ","$5,043.53 ","$1,951.20 ","$1,170.72 ","$2,037.92 ","$11,347.95 ","$1,994.56 ","$1,416.91 ","$1,972.88 ","$5,043.53 ","$1,334.19 ","$1,334.19 ","$1,951.20 ","$1,617.98 ","$1,951.20 ","$5,093.97 ","$1,336.71 ","$2,059.60 ","$5,295.71 ","$1,336.71 ","$1,886.16 ","$5,043.53 ","$1,951.20 ","$5,043.53 ","$1,951.20 ","$1,951.20 ","$1,951.20 ","$2,102.96 ","$1,756.08 ","$2,016.24 ","$1,864.48 ","$2,102.96 "
SACRED HEART HOSPITAL (ACU),48100172,36254,HC PLC CATH RENAL ANGIO 1< BIL,481,1 ,"$2,951.00 ","$2,213.25 ","$1,336.71 ","$6,812.22 ","$1,900.44 ","$3,027.65 ","$2,065.70 ","$1,336.71 ","$2,951.00 ","$1,376.81 ","$2,951.00 ","$2,803.45 ","$1,336.71 ","$2,360.80 ","$2,714.92 ","$1,336.71 ","$2,508.35 ","$2,803.45 ","$2,596.88 ","$2,242.76 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$2,154.23 ","$1,623.05 ","$2,685.41 ","$2,685.41 ","$2,360.80 ","$3,118.48 ","$1,623.05 ","$2,655.90 ","$3,027.65 ","$2,655.90 ","$1,593.54 ","$2,773.94 ","$6,812.22 ","$2,714.92 ","$1,416.91 ","$2,685.41 ","$3,027.65 ","$1,816.05 ","$1,816.05 ","$2,655.90 ","$2,202.33 ","$2,655.90 ","$3,057.93 ","$1,336.71 ","$2,803.45 ","$3,179.04 ","$1,336.71 ","$2,567.37 ","$3,027.65 ","$2,655.90 ","$3,027.65 ","$2,655.90 ","$2,655.90 ","$2,655.90 ","$2,862.47 ","$2,390.31 ","$2,744.43 ","$2,537.86 ","$2,862.47 "
SACRED HEART HOSPITAL (ACU),48100173,37193,HC FILTER REMOVAL,481,1 ,"$3,139.00 ","$2,354.25 ","$1,161.13 ","$6,812.22 ","$2,021.52 ","$3,027.65 ","$2,197.30 ","$1,161.13 ","$3,139.00 ","$1,195.96 ","$3,139.00 ","$2,982.05 ","$1,161.13 ","$2,511.20 ","$2,887.88 ","$1,161.13 ","$2,668.15 ","$2,982.05 ","$2,762.32 ","$2,385.64 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$2,291.47 ","$1,726.45 ","$2,856.49 ","$2,856.49 ","$2,511.20 ","$3,118.48 ","$1,726.45 ","$2,825.10 ","$3,027.65 ","$2,825.10 ","$1,695.06 ","$2,950.66 ","$6,812.22 ","$2,887.88 ","$1,230.80 ","$2,856.49 ","$3,027.65 ","$1,931.74 ","$1,931.74 ","$2,825.10 ","$2,342.64 ","$2,825.10 ","$3,057.93 ","$1,161.13 ","$2,982.05 ","$3,179.04 ","$1,161.13 ","$2,730.93 ","$3,027.65 ","$2,825.10 ","$3,027.65 ","$2,825.10 ","$2,825.10 ","$2,825.10 ","$3,044.83 ","$2,542.59 ","$2,919.27 ","$2,699.54 ","$3,044.83 "
SACRED HEART HOSPITAL (ACU),48100176,37216,HC PL STENT TRNSCATH CAROT ART W/O,481,1 ,"$2,841.01 ","$2,130.76 ","$1,534.15 ","$3,867.78 ","$1,829.61 ", N/A ,"$1,988.71 ","$2,841.01 ","$2,841.01 ","$3,758.32 ","$2,841.01 ","$2,698.96 ","$3,648.85 ","$2,272.81 ","$2,613.73 ","$2,841.01 ","$2,414.86 ","$2,698.96 ","$2,500.09 ","$2,159.17 ","$2,841.01 ","$2,841.01 ","$3,648.85 ","$2,073.94 ","$1,562.56 ","$2,585.32 ","$2,585.32 ","$2,272.81 ", N/A ,"$1,562.56 ","$2,556.91 ", N/A ,"$2,556.91 ","$1,534.15 ","$2,670.55 ", N/A ,"$2,613.73 ","$3,867.78 ","$2,585.32 ", N/A ,"$1,748.36 ","$1,748.36 ","$2,556.91 ","$2,120.25 ","$1,978.76 ", N/A ,"$2,841.01 ","$2,698.96 ", N/A ,"$2,841.01 ","$2,471.68 ", N/A ,"$2,556.91 ", N/A ,"$2,556.91 ","$2,556.91 ","$2,556.91 ","$2,755.78 ","$2,301.22 ","$2,642.14 ","$2,443.27 ","$2,755.78 "
SACRED HEART HOSPITAL (ACU),48100181,37212,HC VENOUS THROMBOLYSIS; INIT DAY 37212,481,1 ,"$6,273.98 ","$4,705.49 ","$1,161.13 ","$6,812.22 ","$4,040.44 ","$3,027.65 ","$4,391.79 ","$1,161.13 ","$6,273.98 ","$1,195.96 ","$6,273.98 ","$5,960.28 ","$1,161.13 ","$5,019.18 ","$5,772.06 ","$1,161.13 ","$5,332.88 ","$5,960.28 ","$5,521.10 ","$4,768.22 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$4,580.01 ","$3,450.69 ","$5,709.32 ","$5,709.32 ","$5,019.18 ","$3,118.48 ","$3,450.69 ","$5,646.58 ","$3,027.65 ","$5,646.58 ","$3,387.95 ","$5,897.54 ","$6,812.22 ","$5,772.06 ","$1,230.80 ","$5,709.32 ","$3,027.65 ","$3,861.01 ","$3,861.01 ","$5,646.58 ","$4,682.27 ","$5,091.27 ","$3,057.93 ","$1,161.13 ","$5,960.28 ","$3,179.04 ","$1,161.13 ","$5,458.36 ","$3,027.65 ","$5,646.58 ","$3,027.65 ","$5,646.58 ","$5,646.58 ","$5,646.58 ","$6,085.76 ","$5,081.92 ","$5,834.80 ","$5,395.62 ","$6,085.76 "
SACRED HEART HOSPITAL (ACU),48100182,37214,HC THROMBO CESS/CLOS; SUBSQ DAY 37214,481,1 ,"$1,102.28 ",$826.71 ,$595.23 ,"$6,812.22 ",$709.87 ,"$3,027.65 ",$771.60 ,"$1,102.28 ","$1,102.28 ","$1,195.96 ","$1,102.28 ","$1,047.17 ","$1,161.13 ",$881.82 ,"$1,014.10 ","$1,102.28 ",$936.94 ,"$1,047.17 ",$970.01 ,$837.73 ,"$1,102.28 ","$1,102.28 ","$1,161.13 ",$804.66 ,$606.25 ,"$1,003.07 ","$1,003.07 ",$881.82 ,"$3,118.48 ",$606.25 ,$992.05 ,"$3,027.65 ",$992.05 ,$595.23 ,"$1,036.14 ","$6,812.22 ","$1,014.10 ","$1,230.80 ","$1,003.07 ","$3,027.65 ",$678.34 ,$678.34 ,$992.05 ,$822.63 ,$992.05 ,"$3,057.93 ","$1,102.28 ","$1,047.17 ","$3,179.04 ","$1,102.28 ",$958.98 ,"$3,027.65 ",$992.05 ,"$3,027.65 ",$992.05 ,$992.05 ,$992.05 ,"$1,069.21 ",$892.85 ,"$1,025.12 ",$947.96 ,"$1,069.21 "
SACRED HEART HOSPITAL (ACU),48100183,36225,HC CATH PLCMT SEL SUBCL/INOM VERTEB UNI 36225,481,1 ,"$10,984.00 ","$8,238.00 ","$1,336.71 ","$10,984.00 ","$7,073.70 ","$3,027.65 ","$7,688.80 ","$1,336.71 ","$9,649.00 ","$1,376.81 ","$7,718.00 ","$10,434.80 ","$1,336.71 ","$8,787.20 ","$10,105.28 ","$1,336.71 ","$9,336.40 ","$10,434.80 ","$9,665.92 ","$8,347.84 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$8,018.32 ","$6,041.20 ","$9,995.44 ","$9,995.44 ","$8,787.20 ","$3,118.48 ","$6,041.20 ","$9,885.60 ","$3,027.65 ","$9,885.60 ","$5,931.36 ","$10,324.96 ","$6,812.22 ","$10,105.28 ","$1,416.91 ","$9,995.44 ","$3,027.65 ","$6,759.55 ","$6,759.55 ","$9,885.60 ","$8,197.36 ","$5,492.00 ","$3,057.93 ","$1,336.71 ","$10,434.80 ","$3,179.04 ","$1,336.71 ","$9,556.08 ","$3,027.65 ","$9,885.60 ","$3,027.65 ","$9,885.60 ","$9,885.60 ","$9,885.60 ","$10,654.48 ","$8,897.04 ","$10,215.12 ","$9,446.24 ","$10,654.48 "
SACRED HEART HOSPITAL (ACU),48100184,36228,HC CATH PLCMT SEL EA INTRACRN BRANCH UNI 36228,481,1 ,"$4,159.00 ","$3,119.25 ","$1,336.71 ","$4,159.00 ","$2,678.40 ", N/A ,"$2,911.30 ","$1,336.71 ","$4,159.00 ","$1,376.81 ","$4,159.00 ","$3,951.05 ","$1,336.71 ","$3,327.20 ","$3,826.28 ","$1,336.71 ","$3,535.15 ","$3,951.05 ","$3,659.92 ","$3,160.84 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$3,036.07 ","$2,287.45 ","$3,784.69 ","$3,784.69 ","$3,327.20 ", N/A ,"$2,287.45 ","$3,743.10 ", N/A ,"$3,743.10 ","$2,245.86 ","$3,909.46 ", N/A ,"$3,826.28 ","$1,416.91 ","$3,784.69 ", N/A ,"$2,559.45 ","$2,559.45 ","$3,743.10 ","$3,103.86 ","$2,079.50 ", N/A ,"$1,336.71 ","$3,951.05 ", N/A ,"$1,336.71 ","$3,618.33 ", N/A ,"$3,743.10 ", N/A ,"$3,743.10 ","$3,743.10 ","$3,743.10 ","$4,034.23 ","$3,368.79 ","$3,867.87 ","$3,576.74 ","$4,034.23 "
SACRED HEART HOSPITAL (ACU),48100185,37211,HC ARTRL THROMBOLYSIS; INIT DAY 37211,481,1 ,"$6,273.98 ","$4,705.49 ","$1,161.13 ","$11,347.95 ","$4,040.44 ","$5,043.53 ","$4,391.79 ","$1,161.13 ","$6,273.98 ","$1,195.96 ","$6,273.98 ","$5,960.28 ","$1,161.13 ","$5,019.18 ","$5,772.06 ","$1,161.13 ","$5,332.88 ","$5,960.28 ","$5,521.10 ","$4,768.22 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$4,580.01 ","$3,450.69 ","$5,709.32 ","$5,709.32 ","$5,019.18 ","$5,194.84 ","$3,450.69 ","$5,646.58 ","$5,043.53 ","$5,646.58 ","$3,387.95 ","$5,897.54 ","$11,347.95 ","$5,772.06 ","$1,230.80 ","$5,709.32 ","$5,043.53 ","$3,861.01 ","$3,861.01 ","$5,646.58 ","$4,682.27 ","$5,646.58 ","$5,093.97 ","$1,161.13 ","$5,960.28 ","$5,295.71 ","$1,161.13 ","$5,458.36 ","$5,043.53 ","$5,646.58 ","$5,043.53 ","$5,646.58 ","$5,646.58 ","$5,646.58 ","$6,085.76 ","$5,081.92 ","$5,834.80 ","$5,395.62 ","$6,085.76 "
SACRED HEART HOSPITAL (ACU),48100186,37213,HC ARTRL/VENOUS THROMBOLYSIS; SUBSQ DAY 37213,481,1 ,$918.57 ,$688.93 ,$496.03 ,"$6,812.22 ",$591.56 ,"$3,027.65 ",$643.00 ,$918.57 ,$918.57 ,"$1,195.96 ",$918.57 ,$872.64 ,"$1,161.13 ",$734.86 ,$845.08 ,$918.57 ,$780.78 ,$872.64 ,$808.34 ,$698.11 ,$918.57 ,$918.57 ,"$1,161.13 ",$670.56 ,$505.21 ,$835.90 ,$835.90 ,$734.86 ,"$3,118.48 ",$505.21 ,$826.71 ,"$3,027.65 ",$826.71 ,$496.03 ,$863.46 ,"$6,812.22 ",$845.08 ,"$1,230.80 ",$835.90 ,"$3,027.65 ",$565.29 ,$565.29 ,$826.71 ,$685.53 ,$826.71 ,"$3,057.93 ",$918.57 ,$872.64 ,"$3,179.04 ",$918.57 ,$799.16 ,"$3,027.65 ",$826.71 ,"$3,027.65 ",$826.71 ,$826.71 ,$826.71 ,$891.01 ,$744.04 ,$854.27 ,$789.97 ,$891.01 
SACRED HEART HOSPITAL (ACU),48100187,37197,HC TRANSCATH RETRVAL FOREIGN BODY 37197,481,1 ,"$3,456.58 ","$2,592.44 ","$1,161.13 ","$6,812.22 ","$2,226.04 ","$3,027.65 ","$2,419.61 ","$1,161.13 ","$3,456.58 ","$1,195.96 ","$3,456.58 ","$3,283.75 ","$1,161.13 ","$2,765.26 ","$3,180.05 ","$1,161.13 ","$2,938.09 ","$3,283.75 ","$3,041.79 ","$2,627.00 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$2,523.30 ","$1,901.12 ","$3,145.49 ","$3,145.49 ","$2,765.26 ","$3,118.48 ","$1,901.12 ","$3,110.92 ","$3,027.65 ","$3,110.92 ","$1,866.55 ","$3,249.19 ","$6,812.22 ","$3,180.05 ","$1,230.80 ","$3,145.49 ","$3,027.65 ","$2,127.18 ","$2,127.18 ","$3,110.92 ","$2,579.65 ","$3,110.92 ","$3,057.93 ","$1,161.13 ","$3,283.75 ","$3,179.04 ","$1,161.13 ","$3,007.22 ","$3,027.65 ","$3,110.92 ","$3,027.65 ","$3,110.92 ","$3,110.92 ","$3,110.92 ","$3,352.88 ","$2,799.83 ","$3,214.62 ","$2,972.66 ","$3,352.88 "
SACRED HEART HOSPITAL (ACU),48100188,36221,HC CATH PLCMT NON SEL THORAC AORTA 36221,481,1 ,"$4,902.00 ","$3,676.50 ","$1,336.71 ","$6,812.22 ","$3,156.89 ","$3,027.65 ","$3,431.40 ","$1,336.71 ","$4,902.00 ","$1,376.81 ","$4,902.00 ","$4,656.90 ","$1,336.71 ","$3,921.60 ","$4,509.84 ","$1,336.71 ","$4,166.70 ","$4,656.90 ","$4,313.76 ","$3,725.52 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$3,578.46 ","$2,696.10 ","$4,460.82 ","$4,460.82 ","$3,921.60 ","$3,118.48 ","$2,696.10 ","$4,411.80 ","$3,027.65 ","$4,411.80 ","$2,647.08 ","$4,607.88 ","$6,812.22 ","$4,509.84 ","$1,416.91 ","$4,460.82 ","$3,027.65 ","$3,016.69 ","$3,016.69 ","$4,411.80 ","$3,658.36 ","$4,411.80 ","$3,057.93 ","$1,336.71 ","$4,656.90 ","$3,179.04 ","$1,336.71 ","$4,264.74 ","$3,027.65 ","$4,411.80 ","$3,027.65 ","$4,411.80 ","$4,411.80 ","$4,411.80 ","$4,754.94 ","$3,970.62 ","$4,558.86 ","$4,215.72 ","$4,754.94 "
SACRED HEART HOSPITAL (ACU),48100189,36222,HC CATH PLCMT SEL COM CAR/INOM EXTRACRN UNI 36222,481,1 ,"$10,312.00 ","$7,734.00 ","$1,336.71 ","$10,312.00 ","$6,640.93 ","$3,027.65 ","$7,218.40 ","$1,336.71 ","$9,649.00 ","$1,376.81 ","$7,718.00 ","$9,796.40 ","$1,336.71 ","$8,249.60 ","$9,487.04 ","$1,336.71 ","$8,765.20 ","$9,796.40 ","$9,074.56 ","$7,837.12 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$7,527.76 ","$5,671.60 ","$9,383.92 ","$9,383.92 ","$8,249.60 ","$3,118.48 ","$5,671.60 ","$9,280.80 ","$3,027.65 ","$9,280.80 ","$5,568.48 ","$9,693.28 ","$6,812.22 ","$9,487.04 ","$1,416.91 ","$9,383.92 ","$3,027.65 ","$6,346.00 ","$6,346.00 ","$9,280.80 ","$7,695.85 ","$5,156.00 ","$3,057.93 ","$1,336.71 ","$9,796.40 ","$3,179.04 ","$1,336.71 ","$8,971.44 ","$3,027.65 ","$9,280.80 ","$3,027.65 ","$9,280.80 ","$9,280.80 ","$9,280.80 ","$10,002.64 ","$8,352.72 ","$9,590.16 ","$8,868.32 ","$10,002.64 "
SACRED HEART HOSPITAL (ACU),48100190,36223,HC CATH PLCMT SEL COM CAR/INOM INTRACRN UNI 36223,481,1 ,"$14,523.00 ","$10,892.25 ","$1,336.71 ","$14,523.00 ","$9,352.81 ","$5,043.53 ","$10,166.10 ","$1,336.71 ","$11,255.00 ","$1,376.81 ","$9,004.00 ","$13,796.85 ","$1,336.71 ","$11,618.40 ","$13,361.16 ","$1,336.71 ","$12,344.55 ","$13,796.85 ","$12,780.24 ","$11,037.48 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$10,601.79 ","$7,987.65 ","$13,215.93 ","$13,215.93 ","$11,618.40 ","$5,194.84 ","$7,987.65 ","$13,070.70 ","$5,043.53 ","$13,070.70 ","$7,842.42 ","$13,651.62 ","$11,347.95 ","$13,361.16 ","$1,416.91 ","$13,215.93 ","$5,043.53 ","$8,937.45 ","$8,937.45 ","$13,070.70 ","$10,838.51 ","$7,261.50 ","$5,093.97 ","$1,336.71 ","$13,796.85 ","$5,295.71 ","$1,336.71 ","$12,635.01 ","$5,043.53 ","$13,070.70 ","$5,043.53 ","$13,070.70 ","$13,070.70 ","$13,070.70 ","$14,087.31 ","$11,763.63 ","$13,506.39 ","$12,489.78 ","$14,087.31 "
SACRED HEART HOSPITAL (ACU),48100191,36224,HC CATH PLCMT SEL INTERNAL CAR UNI 36224,481,1 ,"$13,813.00 ","$10,359.75 ","$1,336.71 ","$13,813.00 ","$8,895.57 ","$5,043.53 ","$9,669.10 ","$1,336.71 ","$11,255.00 ","$1,376.81 ","$9,004.00 ","$13,122.35 ","$1,336.71 ","$11,050.40 ","$12,707.96 ","$1,336.71 ","$11,741.05 ","$13,122.35 ","$12,155.44 ","$10,497.88 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$10,083.49 ","$7,597.15 ","$12,569.83 ","$12,569.83 ","$11,050.40 ","$5,194.84 ","$7,597.15 ","$12,431.70 ","$5,043.53 ","$12,431.70 ","$7,459.02 ","$12,984.22 ","$11,347.95 ","$12,707.96 ","$1,416.91 ","$12,569.83 ","$5,043.53 ","$8,500.52 ","$8,500.52 ","$12,431.70 ","$10,308.64 ","$7,127.78 ","$5,093.97 ","$1,336.71 ","$13,122.35 ","$5,295.71 ","$1,336.71 ","$12,017.31 ","$5,043.53 ","$12,431.70 ","$5,043.53 ","$12,431.70 ","$12,431.70 ","$12,431.70 ","$13,398.61 ","$11,188.53 ","$12,846.09 ","$11,879.18 ","$13,398.61 "
SACRED HEART HOSPITAL (ACU),48100192,36226,HC CATH PLCMT SEL VERTEBRAL UNI 36226,481,1 ,"$10,691.00 ","$8,018.25 ","$1,336.71 ","$11,347.95 ","$6,885.00 ","$5,043.53 ","$7,483.70 ","$1,336.71 ","$10,691.00 ","$1,376.81 ","$9,004.00 ","$10,156.45 ","$1,336.71 ","$8,552.80 ","$9,835.72 ","$1,336.71 ","$9,087.35 ","$10,156.45 ","$9,408.08 ","$8,125.16 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$7,804.43 ","$5,880.05 ","$9,728.81 ","$9,728.81 ","$8,552.80 ","$5,194.84 ","$5,880.05 ","$9,621.90 ","$5,043.53 ","$9,621.90 ","$5,773.14 ","$10,049.54 ","$11,347.95 ","$9,835.72 ","$1,416.91 ","$9,728.81 ","$5,043.53 ","$6,579.24 ","$6,579.24 ","$9,621.90 ","$7,978.69 ","$7,127.78 ","$5,093.97 ","$1,336.71 ","$10,156.45 ","$5,295.71 ","$1,336.71 ","$9,301.17 ","$5,043.53 ","$9,621.90 ","$5,043.53 ","$9,621.90 ","$9,621.90 ","$9,621.90 ","$10,370.27 ","$8,659.71 ","$9,942.63 ","$9,194.26 ","$10,370.27 "
SACRED HEART HOSPITAL (ACU),48100193,36227,HC CATH PLCMT SEL EXTERNAL CAR UNI 36227,481,1 ,"$2,660.00 ","$1,995.00 ","$1,330.00 ","$2,660.00 ","$1,713.04 ", N/A ,"$1,862.00 ","$1,336.71 ","$2,660.00 ","$1,376.81 ","$2,660.00 ","$2,527.00 ","$1,336.71 ","$2,128.00 ","$2,447.20 ","$1,336.71 ","$2,261.00 ","$2,527.00 ","$2,340.80 ","$2,021.60 ","$1,336.71 ","$1,336.71 ","$1,336.71 ","$1,941.80 ","$1,463.00 ","$2,420.60 ","$2,420.60 ","$2,128.00 ", N/A ,"$1,463.00 ","$2,394.00 ", N/A ,"$2,394.00 ","$1,436.40 ","$2,500.40 ", N/A ,"$2,447.20 ","$1,416.91 ","$2,420.60 ", N/A ,"$1,636.96 ","$1,636.96 ","$2,394.00 ","$1,985.16 ","$1,330.00 ", N/A ,"$1,336.71 ","$2,527.00 ", N/A ,"$1,336.71 ","$2,314.20 ", N/A ,"$2,394.00 ", N/A ,"$2,394.00 ","$2,394.00 ","$2,394.00 ","$2,580.20 ","$2,154.60 ","$2,473.80 ","$2,287.60 ","$2,580.20 "
SACRED HEART HOSPITAL (ACU),48100200,92920,HC PTCA SINGL MAJ ART/BRANCH 92920,481,1 ,"$11,328.00 ","$8,496.00 ","$2,792.29 ","$11,794.48 ","$7,295.23 ","$5,241.99 ","$7,929.60 ","$2,792.29 ","$11,328.00 ","$2,876.06 ","$11,328.00 ","$10,761.60 ","$2,792.29 ","$9,062.40 ","$10,421.76 ","$2,792.29 ","$9,628.80 ","$10,761.60 ","$9,968.64 ","$8,609.28 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$8,269.44 ","$6,230.40 ","$10,308.48 ","$10,308.48 ","$9,062.40 ","$5,399.25 ","$6,230.40 ","$10,195.20 ","$5,241.99 ","$10,195.20 ","$6,117.12 ","$10,648.32 ","$11,794.48 ","$10,421.76 ","$2,959.83 ","$10,308.48 ","$5,241.99 ","$6,971.25 ","$6,971.25 ","$10,195.20 ","$8,454.09 ","$10,195.20 ","$5,294.41 ","$2,792.29 ","$10,761.60 ","$5,504.09 ","$2,792.29 ","$9,855.36 ","$5,241.99 ","$10,195.20 ","$5,241.99 ","$10,195.20 ","$10,195.20 ","$10,195.20 ","$10,988.16 ","$9,175.68 ","$10,535.04 ","$9,742.08 ","$10,988.16 "
SACRED HEART HOSPITAL (ACU),48100201,92921,HC PTCA EA ADDL BRANCH MAJ ART 92921,481,1 ,"$6,481.00 ","$4,860.75 ","$2,792.29 ","$6,481.00 ","$4,173.76 ", N/A ,"$4,536.70 ","$2,792.29 ","$6,481.00 ","$2,876.06 ","$6,481.00 ","$6,156.95 ","$2,792.29 ","$5,184.80 ","$5,962.52 ","$2,792.29 ","$5,508.85 ","$6,156.95 ","$5,703.28 ","$4,925.56 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$4,731.13 ","$3,564.55 ","$5,897.71 ","$5,897.71 ","$5,184.80 ", N/A ,"$3,564.55 ","$5,832.90 ", N/A ,"$5,832.90 ","$3,499.74 ","$6,092.14 ", N/A ,"$5,962.52 ","$2,959.83 ","$5,897.71 ", N/A ,"$3,988.41 ","$3,988.41 ","$5,832.90 ","$4,836.77 ","$5,832.90 ", N/A ,"$2,792.29 ","$6,156.95 ", N/A ,"$2,792.29 ","$5,638.47 ", N/A ,"$5,832.90 ", N/A ,"$5,832.90 ","$5,832.90 ","$5,832.90 ","$6,286.57 ","$5,249.61 ","$6,027.33 ","$5,573.66 ","$6,286.57 "
SACRED HEART HOSPITAL (ACU),48100202,92924,HC ROTOBLATOR SINGL MAJ ART/BRANCH 92924,481,1 ,"$18,347.00 ","$13,760.25 ","$2,792.29 ","$23,902.85 ","$11,815.47 ","$10,623.49 ","$12,842.90 ","$2,792.29 ","$18,347.00 ","$2,876.06 ","$15,007.00 ","$17,429.65 ","$2,792.29 ","$14,677.60 ","$16,879.24 ","$2,792.29 ","$15,594.95 ","$17,429.65 ","$16,145.36 ","$13,943.72 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$13,393.31 ","$10,090.85 ","$16,695.77 ","$16,695.77 ","$14,677.60 ","$10,942.19 ","$10,090.85 ","$16,512.30 ","$10,623.49 ","$16,512.30 ","$9,907.38 ","$17,246.18 ","$23,902.85 ","$16,879.24 ","$2,959.83 ","$16,695.77 ","$10,623.49 ","$11,290.74 ","$11,290.74 ","$16,512.30 ","$13,692.37 ","$16,512.30 ","$10,729.72 ","$2,792.29 ","$17,429.65 ","$11,154.66 ","$2,792.29 ","$15,961.89 ","$10,623.49 ","$16,512.30 ","$10,623.49 ","$16,512.30 ","$16,512.30 ","$16,512.30 ","$17,796.59 ","$14,861.07 ","$17,062.71 ","$15,778.42 ","$17,796.59 "
SACRED HEART HOSPITAL (ACU),48100203,92925,HC ROTOBLATOR EA ADDL BRANCH MAJ ART 92925,481,1 ,"$3,105.00 ","$2,328.75 ","$1,676.70 ","$3,105.00 ","$1,999.62 ", N/A ,"$2,173.50 ","$2,792.29 ","$3,105.00 ","$2,876.06 ","$3,105.00 ","$2,949.75 ","$2,792.29 ","$2,484.00 ","$2,856.60 ","$2,792.29 ","$2,639.25 ","$2,949.75 ","$2,732.40 ","$2,359.80 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$2,266.65 ","$1,707.75 ","$2,825.55 ","$2,825.55 ","$2,484.00 ", N/A ,"$1,707.75 ","$2,794.50 ", N/A ,"$2,794.50 ","$1,676.70 ","$2,918.70 ", N/A ,"$2,856.60 ","$2,959.83 ","$2,825.55 ", N/A ,"$1,910.82 ","$1,910.82 ","$2,794.50 ","$2,317.26 ","$2,794.50 ", N/A ,"$2,792.29 ","$2,949.75 ", N/A ,"$2,792.29 ","$2,701.35 ", N/A ,"$2,794.50 ", N/A ,"$2,794.50 ","$2,794.50 ","$2,794.50 ","$3,011.85 ","$2,515.05 ","$2,887.65 ","$2,670.30 ","$3,011.85 "
SACRED HEART HOSPITAL (ACU),48100204,92928,HC BMS SINGL MAJ ART/BRANCH 92928,481,1 ,"$20,598.00 ","$15,448.50 ","$2,792.29 ","$23,902.85 ","$13,265.11 ","$10,623.49 ","$14,418.60 ","$2,792.29 ","$18,759.00 ","$2,876.06 ","$15,007.00 ","$19,568.10 ","$2,792.29 ","$16,478.40 ","$18,950.16 ","$2,792.29 ","$17,508.30 ","$19,568.10 ","$18,126.24 ","$15,654.48 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$15,036.54 ","$11,328.90 ","$18,744.18 ","$18,744.18 ","$16,478.40 ","$10,942.19 ","$11,328.90 ","$18,538.20 ","$10,623.49 ","$18,538.20 ","$11,122.92 ","$19,362.12 ","$23,902.85 ","$18,950.16 ","$2,959.83 ","$18,744.18 ","$10,623.49 ","$12,676.01 ","$12,676.01 ","$18,538.20 ","$15,372.29 ","$18,538.20 ","$10,729.72 ","$2,792.29 ","$19,568.10 ","$11,154.66 ","$2,792.29 ","$17,920.26 ","$10,623.49 ","$18,538.20 ","$10,623.49 ","$18,538.20 ","$18,538.20 ","$18,538.20 ","$19,980.06 ","$16,684.38 ","$19,156.14 ","$17,714.28 ","$19,980.06 "
SACRED HEART HOSPITAL (ACU),48100205,92929,HC BMS EA ADDL BRANCH MAJ ART 92929,481,1 ,"$4,431.00 ","$3,323.25 ","$2,392.74 ","$4,431.00 ","$2,853.56 ", N/A ,"$3,101.70 ","$2,792.29 ","$4,431.00 ","$2,876.06 ","$4,431.00 ","$4,209.45 ","$2,792.29 ","$3,544.80 ","$4,076.52 ","$2,792.29 ","$3,766.35 ","$4,209.45 ","$3,899.28 ","$3,367.56 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$3,234.63 ","$2,437.05 ","$4,032.21 ","$4,032.21 ","$3,544.80 ", N/A ,"$2,437.05 ","$3,987.90 ", N/A ,"$3,987.90 ","$2,392.74 ","$4,165.14 ", N/A ,"$4,076.52 ","$2,959.83 ","$4,032.21 ", N/A ,"$2,726.84 ","$2,726.84 ","$3,987.90 ","$3,306.86 ","$3,987.90 ", N/A ,"$2,792.29 ","$4,209.45 ", N/A ,"$2,792.29 ","$3,854.97 ", N/A ,"$3,987.90 ", N/A ,"$3,987.90 ","$3,987.90 ","$3,987.90 ","$4,298.07 ","$3,589.11 ","$4,120.83 ","$3,810.66 ","$4,298.07 "
SACRED HEART HOSPITAL (ACU),48100206,92933,HC ROTOBLATOR/BMS SINGL MAJ ART/BRANCH 92933,481,1 ,"$29,135.00 ","$21,851.25 ","$2,792.29 ","$38,218.28 ","$18,762.94 ","$16,985.90 ","$20,394.50 ","$2,792.29 ","$19,295.00 ","$2,876.06 ","$15,436.00 ","$27,678.25 ","$2,792.29 ","$23,308.00 ","$26,804.20 ","$2,792.29 ","$24,764.75 ","$27,678.25 ","$25,638.80 ","$22,142.60 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$21,268.55 ","$16,024.25 ","$26,512.85 ","$26,512.85 ","$23,308.00 ","$17,495.48 ","$16,024.25 ","$26,221.50 ","$16,985.90 ","$26,221.50 ","$15,732.90 ","$27,386.90 ","$38,218.28 ","$26,804.20 ","$2,959.83 ","$26,512.85 ","$16,985.90 ","$17,929.68 ","$17,929.68 ","$26,221.50 ","$21,743.45 ","$24,438.09 ","$17,155.76 ","$2,792.29 ","$27,678.25 ","$17,835.20 ","$2,792.29 ","$25,347.45 ","$16,985.90 ","$26,221.50 ","$16,985.90 ","$26,221.50 ","$26,221.50 ","$26,221.50 ","$28,260.95 ","$23,599.35 ","$27,095.55 ","$25,056.10 ","$28,260.95 "
SACRED HEART HOSPITAL (ACU),48100207,92934,HC ROTOBLATOR/BMS EA ADDL BRANCH MAJ ART 92934,481,1 ,"$4,285.00 ","$3,213.75 ","$2,313.90 ","$4,285.00 ","$2,759.54 ", N/A ,"$2,999.50 ","$2,792.29 ","$4,285.00 ","$2,876.06 ","$4,285.00 ","$4,070.75 ","$2,792.29 ","$3,428.00 ","$3,942.20 ","$2,792.29 ","$3,642.25 ","$4,070.75 ","$3,770.80 ","$3,256.60 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$3,128.05 ","$2,356.75 ","$3,899.35 ","$3,899.35 ","$3,428.00 ", N/A ,"$2,356.75 ","$3,856.50 ", N/A ,"$3,856.50 ","$2,313.90 ","$4,027.90 ", N/A ,"$3,942.20 ","$2,959.83 ","$3,899.35 ", N/A ,"$2,636.99 ","$2,636.99 ","$3,856.50 ","$3,197.90 ","$3,856.50 ", N/A ,"$2,792.29 ","$4,070.75 ", N/A ,"$2,792.29 ","$3,727.95 ", N/A ,"$3,856.50 ", N/A ,"$3,856.50 ","$3,856.50 ","$3,856.50 ","$4,156.45 ","$3,470.85 ","$3,985.05 ","$3,685.10 ","$4,156.45 "
SACRED HEART HOSPITAL (ACU),48100208,92937,HC BYPASS GRAFT BMS SINGL MAJ ART/BRANCH 92937,481,1 ,"$20,075.00 ","$15,056.25 ","$2,792.29 ","$23,902.85 ","$12,928.30 ","$10,623.49 ","$14,052.50 ","$2,792.29 ","$18,759.00 ","$2,876.06 ","$15,007.00 ","$19,071.25 ","$2,792.29 ","$16,060.00 ","$18,469.00 ","$2,792.29 ","$17,063.75 ","$19,071.25 ","$17,666.00 ","$15,257.00 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$14,654.75 ","$11,041.25 ","$18,268.25 ","$18,268.25 ","$16,060.00 ","$10,942.19 ","$11,041.25 ","$18,067.50 ","$10,623.49 ","$18,067.50 ","$10,840.50 ","$18,870.50 ","$23,902.85 ","$18,469.00 ","$2,959.83 ","$18,268.25 ","$10,623.49 ","$12,354.16 ","$12,354.16 ","$18,067.50 ","$14,981.97 ","$18,067.50 ","$10,729.72 ","$2,792.29 ","$19,071.25 ","$11,154.66 ","$2,792.29 ","$17,465.25 ","$10,623.49 ","$18,067.50 ","$10,623.49 ","$18,067.50 ","$18,067.50 ","$18,067.50 ","$19,472.75 ","$16,260.75 ","$18,669.75 ","$17,264.50 ","$19,472.75 "
SACRED HEART HOSPITAL (ACU),48100209,92938,HC BYPASS GRAFT BMS EA ADDL BRNCH MAJ ART 92938,481,1 ,"$4,434.00 ","$3,325.50 ","$2,394.36 ","$4,434.00 ","$2,855.50 ", N/A ,"$3,103.80 ","$2,792.29 ","$4,434.00 ","$2,876.06 ","$4,434.00 ","$4,212.30 ","$2,792.29 ","$3,547.20 ","$4,079.28 ","$2,792.29 ","$3,768.90 ","$4,212.30 ","$3,901.92 ","$3,369.84 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$3,236.82 ","$2,438.70 ","$4,034.94 ","$4,034.94 ","$3,547.20 ", N/A ,"$2,438.70 ","$3,990.60 ", N/A ,"$3,990.60 ","$2,394.36 ","$4,167.96 ", N/A ,"$4,079.28 ","$2,959.83 ","$4,034.94 ", N/A ,"$2,728.68 ","$2,728.68 ","$3,990.60 ","$3,309.09 ","$3,990.60 ", N/A ,"$2,792.29 ","$4,212.30 ", N/A ,"$2,792.29 ","$3,857.58 ", N/A ,"$3,990.60 ", N/A ,"$3,990.60 ","$3,990.60 ","$3,990.60 ","$4,300.98 ","$3,591.54 ","$4,123.62 ","$3,813.24 ","$4,300.98 "
SACRED HEART HOSPITAL (ACU),48100210,92941,HC STEMI/NSTEMI BMS SING VESS 92941,481,1 ,"$22,869.00 ","$17,151.75 ","$2,792.29 ","$22,869.00 ","$14,727.64 ", N/A ,"$16,008.30 ","$2,792.29 ","$18,759.00 ","$2,876.06 ","$15,007.00 ","$21,725.55 ","$2,792.29 ","$18,295.20 ","$21,039.48 ","$2,792.29 ","$19,438.65 ","$21,725.55 ","$20,124.72 ","$17,380.44 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$16,694.37 ","$12,577.95 ","$20,810.79 ","$20,810.79 ","$18,295.20 ", N/A ,"$12,577.95 ","$20,582.10 ", N/A ,"$20,582.10 ","$12,349.26 ","$21,496.86 ", N/A ,"$21,039.48 ","$2,959.83 ","$20,810.79 ", N/A ,"$14,073.58 ","$14,073.58 ","$20,582.10 ","$17,067.13 ","$20,582.10 ", N/A ,"$2,792.29 ","$21,725.55 ", N/A ,"$2,792.29 ","$19,896.03 ", N/A ,"$20,582.10 ", N/A ,"$20,582.10 ","$20,582.10 ","$20,582.10 ","$22,182.93 ","$18,523.89 ","$21,268.17 ","$19,667.34 ","$22,182.93 "
SACRED HEART HOSPITAL (ACU),48100211,92943,HC CTO BMS SING MAJ ART/BRNCH 92943,481,1 ,"$22,547.00 ","$16,910.25 ","$2,792.29 ","$23,902.85 ","$14,520.27 ","$10,623.49 ","$15,782.90 ","$2,792.29 ","$18,759.00 ","$2,876.06 ","$15,007.00 ","$21,419.65 ","$2,792.29 ","$18,037.60 ","$20,743.24 ","$2,792.29 ","$19,164.95 ","$21,419.65 ","$19,841.36 ","$17,135.72 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$16,459.31 ","$12,400.85 ","$20,517.77 ","$20,517.77 ","$18,037.60 ","$10,942.19 ","$12,400.85 ","$20,292.30 ","$10,623.49 ","$20,292.30 ","$12,175.38 ","$21,194.18 ","$23,902.85 ","$20,743.24 ","$2,959.83 ","$20,517.77 ","$10,623.49 ","$13,875.42 ","$13,875.42 ","$20,292.30 ","$16,826.83 ","$20,292.30 ","$10,729.72 ","$2,792.29 ","$21,419.65 ","$11,154.66 ","$2,792.29 ","$19,615.89 ","$10,623.49 ","$20,292.30 ","$10,623.49 ","$20,292.30 ","$20,292.30 ","$20,292.30 ","$21,870.59 ","$18,263.07 ","$20,968.71 ","$19,390.42 ","$21,870.59 "
SACRED HEART HOSPITAL (ACU),48100212,92944,HC CTO BMS EA ADD BNCH MAJ ART 92944,481,1 ,"$6,480.00 ","$4,860.00 ","$2,792.29 ","$6,480.00 ","$4,173.12 ", N/A ,"$4,536.00 ","$2,792.29 ","$6,480.00 ","$2,876.06 ","$6,480.00 ","$6,156.00 ","$2,792.29 ","$5,184.00 ","$5,961.60 ","$2,792.29 ","$5,508.00 ","$6,156.00 ","$5,702.40 ","$4,924.80 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$4,730.40 ","$3,564.00 ","$5,896.80 ","$5,896.80 ","$5,184.00 ", N/A ,"$3,564.00 ","$5,832.00 ", N/A ,"$5,832.00 ","$3,499.20 ","$6,091.20 ", N/A ,"$5,961.60 ","$2,959.83 ","$5,896.80 ", N/A ,"$3,987.79 ","$3,987.79 ","$5,832.00 ","$4,836.02 ","$5,832.00 ", N/A ,"$2,792.29 ","$6,156.00 ", N/A ,"$2,792.29 ","$5,637.60 ", N/A ,"$5,832.00 ", N/A ,"$5,832.00 ","$5,832.00 ","$5,832.00 ","$6,285.60 ","$5,248.80 ","$6,026.40 ","$5,572.80 ","$6,285.60 "
SACRED HEART HOSPITAL (ACU),48100218,C9600,HC DES SING MAJ ART/BRNCH C9600,481,1 ,"$21,198.00 ","$15,898.50 ","$2,792.29 ","$23,902.85 ","$13,651.51 ","$10,623.49 ","$14,838.60 ","$2,792.29 ","$18,759.00 ","$2,876.06 ","$15,007.00 ","$20,138.10 ","$2,792.29 ","$16,958.40 ","$19,502.16 ","$2,792.29 ","$18,018.30 ","$20,138.10 ","$18,654.24 ","$16,110.48 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$15,474.54 ","$11,658.90 ","$19,290.18 ","$19,290.18 ","$16,958.40 ","$10,942.19 ","$11,658.90 ","$19,078.20 ","$10,623.49 ","$19,078.20 ","$11,446.92 ","$19,926.12 ","$23,902.85 ","$19,502.16 ","$2,959.83 ","$19,290.18 ","$10,623.49 ","$13,045.25 ","$13,045.25 ","$19,078.20 ","$15,820.07 ","$19,078.20 ","$10,729.72 ","$2,792.29 ","$20,138.10 ","$11,154.66 ","$2,792.29 ","$18,442.26 ","$10,623.49 ","$19,078.20 ","$10,623.49 ","$19,078.20 ","$19,078.20 ","$19,078.20 ","$20,562.06 ","$17,170.38 ","$19,714.14 ","$18,230.28 ","$20,562.06 "
SACRED HEART HOSPITAL (ACU),48100219,C9601,HC DES EA ADD BNCH MAJ ART C9601,481,1 ,"$7,600.00 ","$5,700.00 ","$2,792.29 ","$7,600.00 ","$4,894.40 ", N/A ,"$5,320.00 ","$2,792.29 ","$7,600.00 ","$2,876.06 ","$7,600.00 ","$7,220.00 ","$2,792.29 ","$6,080.00 ","$6,992.00 ","$2,792.29 ","$6,460.00 ","$7,220.00 ","$6,688.00 ","$5,776.00 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$5,548.00 ","$4,180.00 ","$6,916.00 ","$6,916.00 ","$6,080.00 ", N/A ,"$4,180.00 ","$6,840.00 ", N/A ,"$6,840.00 ","$4,104.00 ","$7,144.00 ", N/A ,"$6,992.00 ","$2,959.83 ","$6,916.00 ", N/A ,"$4,677.04 ","$4,677.04 ","$6,840.00 ","$5,671.88 ","$6,840.00 ", N/A ,"$2,792.29 ","$7,220.00 ", N/A ,"$2,792.29 ","$6,612.00 ", N/A ,"$6,840.00 ", N/A ,"$6,840.00 ","$6,840.00 ","$6,840.00 ","$7,372.00 ","$6,156.00 ","$7,068.00 ","$6,536.00 ","$7,372.00 "
SACRED HEART HOSPITAL (ACU),48100220,C9602,HC ROTOBLAT/DES SING MAJ ART/BRNCH C9602,481,1 ,"$29,135.00 ","$21,851.25 ","$2,792.29 ","$38,218.28 ","$18,762.94 ","$16,985.90 ","$20,394.50 ","$2,792.29 ","$19,295.00 ","$2,876.06 ","$15,436.00 ","$27,678.25 ","$2,792.29 ","$23,308.00 ","$26,804.20 ","$2,792.29 ","$24,764.75 ","$27,678.25 ","$25,638.80 ","$22,142.60 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$21,268.55 ","$16,024.25 ","$26,512.85 ","$26,512.85 ","$23,308.00 ","$17,495.48 ","$16,024.25 ","$26,221.50 ","$16,985.90 ","$26,221.50 ","$15,732.90 ","$27,386.90 ","$38,218.28 ","$26,804.20 ","$2,959.83 ","$26,512.85 ","$16,985.90 ","$17,929.68 ","$17,929.68 ","$26,221.50 ","$21,743.45 ","$24,438.09 ","$17,155.76 ","$2,792.29 ","$27,678.25 ","$17,835.20 ","$2,792.29 ","$25,347.45 ","$16,985.90 ","$26,221.50 ","$16,985.90 ","$26,221.50 ","$26,221.50 ","$26,221.50 ","$28,260.95 ","$23,599.35 ","$27,095.55 ","$25,056.10 ","$28,260.95 "
SACRED HEART HOSPITAL (ACU),48100221,C9603,HC ROTOBLAT/DES EA ADD BNCH MAJ ART C9603,481,1 ,"$4,714.00 ","$3,535.50 ","$2,545.56 ","$4,714.00 ","$3,035.82 ", N/A ,"$3,299.80 ","$2,792.29 ","$4,714.00 ","$2,876.06 ","$4,714.00 ","$4,478.30 ","$2,792.29 ","$3,771.20 ","$4,336.88 ","$2,792.29 ","$4,006.90 ","$4,478.30 ","$4,148.32 ","$3,582.64 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$3,441.22 ","$2,592.70 ","$4,289.74 ","$4,289.74 ","$3,771.20 ", N/A ,"$2,592.70 ","$4,242.60 ", N/A ,"$4,242.60 ","$2,545.56 ","$4,431.16 ", N/A ,"$4,336.88 ","$2,959.83 ","$4,289.74 ", N/A ,"$2,901.00 ","$2,901.00 ","$4,242.60 ","$3,518.06 ","$4,242.60 ", N/A ,"$2,792.29 ","$4,478.30 ", N/A ,"$2,792.29 ","$4,101.18 ", N/A ,"$4,242.60 ", N/A ,"$4,242.60 ","$4,242.60 ","$4,242.60 ","$4,572.58 ","$3,818.34 ","$4,384.02 ","$4,054.04 ","$4,572.58 "
SACRED HEART HOSPITAL (ACU),48100222,C9604,HC BYPASS GRAFT DES SING MAJ ART/BRNCH C9604,481,1 ,"$20,075.00 ","$15,056.25 ","$2,792.29 ","$23,902.85 ","$12,928.30 ","$10,623.49 ","$14,052.50 ","$2,792.29 ","$18,759.00 ","$2,876.06 ","$15,007.00 ","$19,071.25 ","$2,792.29 ","$16,060.00 ","$18,469.00 ","$2,792.29 ","$17,063.75 ","$19,071.25 ","$17,666.00 ","$15,257.00 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$14,654.75 ","$11,041.25 ","$18,268.25 ","$18,268.25 ","$16,060.00 ","$10,942.19 ","$11,041.25 ","$18,067.50 ","$10,623.49 ","$18,067.50 ","$10,840.50 ","$18,870.50 ","$23,902.85 ","$18,469.00 ","$2,959.83 ","$18,268.25 ","$10,623.49 ","$12,354.16 ","$12,354.16 ","$18,067.50 ","$14,981.97 ","$18,067.50 ","$10,729.72 ","$2,792.29 ","$19,071.25 ","$11,154.66 ","$2,792.29 ","$17,465.25 ","$10,623.49 ","$18,067.50 ","$10,623.49 ","$18,067.50 ","$18,067.50 ","$18,067.50 ","$19,472.75 ","$16,260.75 ","$18,669.75 ","$17,264.50 ","$19,472.75 "
SACRED HEART HOSPITAL (ACU),48100223,C9605,HC BYPASS GRFT DES EA ADD BRNCH MAJ ART C9605,481,1 ,"$4,434.00 ","$3,325.50 ","$2,394.36 ","$4,434.00 ","$2,855.50 ", N/A ,"$3,103.80 ","$2,792.29 ","$4,434.00 ","$2,876.06 ","$4,434.00 ","$4,212.30 ","$2,792.29 ","$3,547.20 ","$4,079.28 ","$2,792.29 ","$3,768.90 ","$4,212.30 ","$3,901.92 ","$3,369.84 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$3,236.82 ","$2,438.70 ","$4,034.94 ","$4,034.94 ","$3,547.20 ", N/A ,"$2,438.70 ","$3,990.60 ", N/A ,"$3,990.60 ","$2,394.36 ","$4,167.96 ", N/A ,"$4,079.28 ","$2,959.83 ","$4,034.94 ", N/A ,"$2,728.68 ","$2,728.68 ","$3,990.60 ","$3,309.09 ","$3,990.60 ", N/A ,"$2,792.29 ","$4,212.30 ", N/A ,"$2,792.29 ","$3,857.58 ", N/A ,"$3,990.60 ", N/A ,"$3,990.60 ","$3,990.60 ","$3,990.60 ","$4,300.98 ","$3,591.54 ","$4,123.62 ","$3,813.24 ","$4,300.98 "
SACRED HEART HOSPITAL (ACU),48100224,C9607,HC CTO DES SING MAJ ART/BRNCH C9607,481,1 ,"$22,475.00 ","$16,856.25 ","$2,792.29 ","$38,218.28 ","$14,473.90 ","$16,985.90 ","$15,732.50 ","$2,792.29 ","$19,295.00 ","$2,876.06 ","$15,436.00 ","$21,351.25 ","$2,792.29 ","$17,980.00 ","$20,677.00 ","$2,792.29 ","$19,103.75 ","$21,351.25 ","$19,778.00 ","$17,081.00 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$16,406.75 ","$12,361.25 ","$20,452.25 ","$20,452.25 ","$17,980.00 ","$17,495.48 ","$12,361.25 ","$20,227.50 ","$16,985.90 ","$20,227.50 ","$12,136.50 ","$21,126.50 ","$38,218.28 ","$20,677.00 ","$2,959.83 ","$20,452.25 ","$16,985.90 ","$13,831.12 ","$13,831.12 ","$20,227.50 ","$16,773.09 ","$20,227.50 ","$17,155.76 ","$2,792.29 ","$21,351.25 ","$17,835.20 ","$2,792.29 ","$19,553.25 ","$16,985.90 ","$20,227.50 ","$16,985.90 ","$20,227.50 ","$20,227.50 ","$20,227.50 ","$21,800.75 ","$18,204.75 ","$20,901.75 ","$19,328.50 ","$21,800.75 "
SACRED HEART HOSPITAL (ACU),48100225,C9608,HC CTO DES EA ADD BRNCH MAJ ART C9608,481,1 ,"$9,352.00 ","$7,014.00 ","$2,792.29 ","$9,352.00 ","$6,022.69 ", N/A ,"$6,546.40 ","$2,792.29 ","$9,352.00 ","$2,876.06 ","$7,718.00 ","$8,884.40 ","$2,792.29 ","$7,481.60 ","$8,603.84 ","$2,792.29 ","$7,949.20 ","$8,884.40 ","$8,229.76 ","$7,107.52 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$6,826.96 ","$5,143.60 ","$8,510.32 ","$8,510.32 ","$7,481.60 ", N/A ,"$5,143.60 ","$8,416.80 ", N/A ,"$8,416.80 ","$5,050.08 ","$8,790.88 ", N/A ,"$8,603.84 ","$2,959.83 ","$8,510.32 ", N/A ,"$5,755.22 ","$5,755.22 ","$8,416.80 ","$6,979.40 ","$8,416.80 ", N/A ,"$2,792.29 ","$8,884.40 ", N/A ,"$2,792.29 ","$8,136.24 ", N/A ,"$8,416.80 ", N/A ,"$8,416.80 ","$8,416.80 ","$8,416.80 ","$9,071.44 ","$7,575.12 ","$8,697.36 ","$8,042.72 ","$9,071.44 "
SACRED HEART HOSPITAL (ACU),48100226,C9606,HC STEMI/NSTEMI DES SINGL VESSEL C9606,481,1 ,"$23,515.00 ","$17,636.25 ","$2,792.29 ","$23,515.00 ","$15,143.66 ", N/A ,"$16,460.50 ","$2,792.29 ","$19,295.00 ","$2,876.06 ","$15,436.00 ","$22,339.25 ","$2,792.29 ","$18,812.00 ","$21,633.80 ","$2,792.29 ","$19,987.75 ","$22,339.25 ","$20,693.20 ","$17,871.40 ","$2,792.29 ","$2,792.29 ","$2,792.29 ","$17,165.95 ","$12,933.25 ","$21,398.65 ","$21,398.65 ","$18,812.00 ", N/A ,"$12,933.25 ","$21,163.50 ", N/A ,"$21,163.50 ","$12,698.10 ","$22,104.10 ", N/A ,"$21,633.80 ","$2,959.83 ","$21,398.65 ", N/A ,"$14,471.13 ","$14,471.13 ","$21,163.50 ","$17,549.24 ","$21,163.50 ", N/A ,"$2,792.29 ","$22,339.25 ", N/A ,"$2,792.29 ","$20,458.05 ", N/A ,"$21,163.50 ", N/A ,"$21,163.50 ","$21,163.50 ","$21,163.50 ","$22,809.55 ","$19,047.15 ","$21,868.95 ","$20,222.90 ","$22,809.55 "
SACRED HEART HOSPITAL (ACU),48100230,37241,HC VENOUS EMBO FOR VEIN MALFORMATION 37241,481,1 ,"$8,896.42 ","$6,672.32 ","$3,561.79 ","$23,902.85 ","$5,729.29 ","$10,623.49 ","$6,227.49 ","$3,561.79 ","$8,896.42 ","$3,668.64 ","$8,896.42 ","$8,451.60 ","$3,561.79 ","$7,117.14 ","$8,184.71 ","$3,561.79 ","$7,561.96 ","$8,451.60 ","$7,828.85 ","$6,761.28 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$6,494.39 ","$4,893.03 ","$8,095.74 ","$8,095.74 ","$7,117.14 ","$10,942.19 ","$4,893.03 ","$8,006.78 ","$10,623.49 ","$8,006.78 ","$4,804.07 ","$8,362.63 ","$23,902.85 ","$8,184.71 ","$3,775.50 ","$8,095.74 ","$10,623.49 ","$5,474.86 ","$5,474.86 ","$8,006.78 ","$6,639.40 ","$8,006.78 ","$10,729.72 ","$3,561.79 ","$8,451.60 ","$11,154.66 ","$3,561.79 ","$7,739.89 ","$10,623.49 ","$8,006.78 ","$10,623.49 ","$8,006.78 ","$8,006.78 ","$8,006.78 ","$8,629.53 ","$7,206.10 ","$8,273.67 ","$7,650.92 ","$8,629.53 "
SACRED HEART HOSPITAL (ACU),48100231,37242,HC ARTERIAL EMBO FOR AVM ANER PRE/PST AAA 37242,481,1 ,"$8,897.24 ","$6,672.93 ","$3,561.79 ","$23,902.85 ","$5,729.82 ","$10,623.49 ","$6,228.07 ","$3,561.79 ","$8,897.24 ","$3,668.64 ","$8,897.24 ","$8,452.38 ","$3,561.79 ","$7,117.79 ","$8,185.46 ","$3,561.79 ","$7,562.65 ","$8,452.38 ","$7,829.57 ","$6,761.90 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$6,494.99 ","$4,893.48 ","$8,096.49 ","$8,096.49 ","$7,117.79 ","$10,942.19 ","$4,893.48 ","$8,007.52 ","$10,623.49 ","$8,007.52 ","$4,804.51 ","$8,363.41 ","$23,902.85 ","$8,185.46 ","$3,775.50 ","$8,096.49 ","$10,623.49 ","$5,475.36 ","$5,475.36 ","$8,007.52 ","$6,640.01 ","$8,007.52 ","$10,729.72 ","$3,561.79 ","$8,452.38 ","$11,154.66 ","$3,561.79 ","$7,740.60 ","$10,623.49 ","$8,007.52 ","$10,623.49 ","$8,007.52 ","$8,007.52 ","$8,007.52 ","$8,630.32 ","$7,206.76 ","$8,274.43 ","$7,651.63 ","$8,630.32 "
SACRED HEART HOSPITAL (ACU),48100232,37243,HC EMBOLIZATION OF TUMOR UFE CHEMO 37243,481,1 ,"$8,896.42 ","$6,672.32 ","$3,561.79 ","$23,902.85 ","$5,729.29 ","$10,623.49 ","$6,227.49 ","$3,561.79 ","$8,896.42 ","$3,668.64 ","$8,896.42 ","$8,451.60 ","$3,561.79 ","$7,117.14 ","$8,184.71 ","$3,561.79 ","$7,561.96 ","$8,451.60 ","$7,828.85 ","$6,761.28 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$6,494.39 ","$4,893.03 ","$8,095.74 ","$8,095.74 ","$7,117.14 ","$10,942.19 ","$4,893.03 ","$8,006.78 ","$10,623.49 ","$8,006.78 ","$4,804.07 ","$8,362.63 ","$23,902.85 ","$8,184.71 ","$3,775.50 ","$8,095.74 ","$10,623.49 ","$5,474.86 ","$5,474.86 ","$8,006.78 ","$6,639.40 ","$8,006.78 ","$10,729.72 ","$3,561.79 ","$8,451.60 ","$11,154.66 ","$3,561.79 ","$7,739.89 ","$10,623.49 ","$8,006.78 ","$10,623.49 ","$8,006.78 ","$8,006.78 ","$8,006.78 ","$8,629.53 ","$7,206.10 ","$8,273.67 ","$7,650.92 ","$8,629.53 "
SACRED HEART HOSPITAL (ACU),48100233,37244,HC EMBOLIZATION FOR HEMORRAGE ART/VEN 37244,481,1 ,"$8,897.24 ","$6,672.93 ","$3,561.79 ","$23,902.85 ","$5,729.82 ","$10,623.49 ","$6,228.07 ","$3,561.79 ","$8,897.24 ","$3,668.64 ","$8,897.24 ","$8,452.38 ","$3,561.79 ","$7,117.79 ","$8,185.46 ","$3,561.79 ","$7,562.65 ","$8,452.38 ","$7,829.57 ","$6,761.90 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$6,494.99 ","$4,893.48 ","$8,096.49 ","$8,096.49 ","$7,117.79 ","$10,942.19 ","$4,893.48 ","$8,007.52 ","$10,623.49 ","$8,007.52 ","$4,804.51 ","$8,363.41 ","$23,902.85 ","$8,185.46 ","$3,775.50 ","$8,096.49 ","$10,623.49 ","$5,475.36 ","$5,475.36 ","$8,007.52 ","$6,640.01 ","$8,007.52 ","$10,729.72 ","$3,561.79 ","$8,452.38 ","$11,154.66 ","$3,561.79 ","$7,740.60 ","$10,623.49 ","$8,007.52 ","$10,623.49 ","$8,007.52 ","$8,007.52 ","$8,007.52 ","$8,630.32 ","$7,206.76 ","$8,274.43 ","$7,651.63 ","$8,630.32 "
SACRED HEART HOSPITAL (ACU),48100234,37236,HC STENT INIT ARTERY UPPER EXT VISCERAL 37236,481,1 ,"$7,403.00 ","$5,552.25 ","$3,561.79 ","$23,902.85 ","$4,767.53 ","$10,623.49 ","$5,182.10 ","$3,561.79 ","$7,403.00 ","$3,668.64 ","$7,403.00 ","$7,032.85 ","$3,561.79 ","$5,922.40 ","$6,810.76 ","$3,561.79 ","$6,292.55 ","$7,032.85 ","$6,514.64 ","$5,626.28 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$5,404.19 ","$4,071.65 ","$6,736.73 ","$6,736.73 ","$5,922.40 ","$10,942.19 ","$4,071.65 ","$6,662.70 ","$10,623.49 ","$6,662.70 ","$3,997.62 ","$6,958.82 ","$23,902.85 ","$6,810.76 ","$3,775.50 ","$6,736.73 ","$10,623.49 ","$4,555.81 ","$4,555.81 ","$6,662.70 ","$5,524.86 ","$6,662.70 ","$10,729.72 ","$3,561.79 ","$7,032.85 ","$11,154.66 ","$3,561.79 ","$6,440.61 ","$10,623.49 ","$6,662.70 ","$10,623.49 ","$6,662.70 ","$6,662.70 ","$6,662.70 ","$7,180.91 ","$5,996.43 ","$6,884.79 ","$6,366.58 ","$7,180.91 "
SACRED HEART HOSPITAL (ACU),48100235,37237,HC STENT ADDN ARTERY UPPER EXT VISERAL 37237,481,1 ,"$2,199.00 ","$1,649.25 ","$1,187.46 ","$3,775.50 ","$1,416.16 ", N/A ,"$1,539.30 ","$2,199.00 ","$2,199.00 ","$3,668.64 ","$2,199.00 ","$2,089.05 ","$3,561.79 ","$1,759.20 ","$2,023.08 ","$2,199.00 ","$1,869.15 ","$2,089.05 ","$1,935.12 ","$1,671.24 ","$2,199.00 ","$2,199.00 ","$3,561.79 ","$1,605.27 ","$1,209.45 ","$2,001.09 ","$2,001.09 ","$1,759.20 ", N/A ,"$1,209.45 ","$1,979.10 ", N/A ,"$1,979.10 ","$1,187.46 ","$2,067.06 ", N/A ,"$2,023.08 ","$3,775.50 ","$2,001.09 ", N/A ,"$1,353.26 ","$1,353.26 ","$1,979.10 ","$1,641.11 ","$1,531.60 ", N/A ,"$2,199.00 ","$2,089.05 ", N/A ,"$2,199.00 ","$1,913.13 ", N/A ,"$1,979.10 ", N/A ,"$1,979.10 ","$1,979.10 ","$1,979.10 ","$2,133.03 ","$1,781.19 ","$2,045.07 ","$1,891.14 ","$2,133.03 "
SACRED HEART HOSPITAL (ACU),48100236,37238,HC STENT INIT VENOUS UPPER EXT VISERAL 37238,481,1 ,"$6,138.00 ","$4,603.50 ","$3,314.52 ","$23,902.85 ","$3,952.87 ","$10,623.49 ","$4,296.60 ","$3,561.79 ","$6,138.00 ","$3,668.64 ","$6,138.00 ","$5,831.10 ","$3,561.79 ","$4,910.40 ","$5,646.96 ","$3,561.79 ","$5,217.30 ","$5,831.10 ","$5,401.44 ","$4,664.88 ","$3,561.79 ","$3,561.79 ","$3,561.79 ","$4,480.74 ","$3,375.90 ","$5,585.58 ","$5,585.58 ","$4,910.40 ","$10,942.19 ","$3,375.90 ","$5,524.20 ","$10,623.49 ","$5,524.20 ","$3,314.52 ","$5,769.72 ","$23,902.85 ","$5,646.96 ","$3,775.50 ","$5,585.58 ","$10,623.49 ","$3,777.33 ","$3,777.33 ","$5,524.20 ","$4,580.79 ","$5,524.20 ","$10,729.72 ","$3,561.79 ","$5,831.10 ","$11,154.66 ","$3,561.79 ","$5,340.06 ","$10,623.49 ","$5,524.20 ","$10,623.49 ","$5,524.20 ","$5,524.20 ","$5,524.20 ","$5,953.86 ","$4,971.78 ","$5,708.34 ","$5,278.68 ","$5,953.86 "
SACRED HEART HOSPITAL (ACU),48100237,37239,HC STENT ADDN VENOUS UPPER EXT VISERAL 37239,481,1 ,"$2,199.00 ","$1,649.25 ","$1,187.46 ","$3,775.50 ","$1,416.16 ", N/A ,"$1,539.30 ","$2,199.00 ","$2,199.00 ","$3,668.64 ","$2,199.00 ","$2,089.05 ","$3,561.79 ","$1,759.20 ","$2,023.08 ","$2,199.00 ","$1,869.15 ","$2,089.05 ","$1,935.12 ","$1,671.24 ","$2,199.00 ","$2,199.00 ","$3,561.79 ","$1,605.27 ","$1,209.45 ","$2,001.09 ","$2,001.09 ","$1,759.20 ", N/A ,"$1,209.45 ","$1,979.10 ", N/A ,"$1,979.10 ","$1,187.46 ","$2,067.06 ", N/A ,"$2,023.08 ","$3,775.50 ","$2,001.09 ", N/A ,"$1,353.26 ","$1,353.26 ","$1,979.10 ","$1,641.11 ","$1,531.60 ", N/A ,"$2,199.00 ","$2,089.05 ", N/A ,"$2,199.00 ","$1,913.13 ", N/A ,"$1,979.10 ", N/A ,"$1,979.10 ","$1,979.10 ","$1,979.10 ","$2,133.03 ","$1,781.19 ","$2,045.07 ","$1,891.14 ","$2,133.03 "
SACRED HEART HOSPITAL (ACU),48100238,37217,HC STENT CAROTID OPEN 37217,481,1 ,"$2,789.00 ","$2,091.75 ","$1,506.06 ","$3,867.78 ","$1,796.12 ", N/A ,"$1,952.30 ","$2,789.00 ","$2,789.00 ","$3,758.32 ","$2,789.00 ","$2,649.55 ","$3,648.85 ","$2,231.20 ","$2,565.88 ","$2,789.00 ","$2,370.65 ","$2,649.55 ","$2,454.32 ","$2,119.64 ","$2,789.00 ","$2,789.00 ","$3,648.85 ","$2,035.97 ","$1,533.95 ","$2,537.99 ","$2,537.99 ","$2,231.20 ", N/A ,"$1,533.95 ","$2,510.10 ", N/A ,"$2,510.10 ","$1,506.06 ","$2,621.66 ", N/A ,"$2,565.88 ","$3,867.78 ","$2,537.99 ", N/A ,"$1,716.35 ","$1,716.35 ","$2,510.10 ","$2,081.43 ","$1,942.54 ", N/A ,"$2,789.00 ","$2,649.55 ", N/A ,"$2,789.00 ","$2,426.43 ", N/A ,"$2,510.10 ", N/A ,"$2,510.10 ","$2,510.10 ","$2,510.10 ","$2,705.33 ","$2,259.09 ","$2,593.77 ","$2,398.54 ","$2,705.33 "
SACRED HEART HOSPITAL (ACU),48100241,33361,HC REPL TAVR W/PRO PERC FEM ART,481,1 ,"$16,100.00 ","$12,075.00 ","$3,281.56 ","$16,100.00 ","$10,368.40 ", N/A ,"$11,270.00 ","$3,281.56 ","$16,100.00 ","$3,380.01 ","$15,007.00 ","$15,295.00 ","$3,281.56 ","$12,880.00 ","$14,812.00 ","$3,281.56 ","$13,685.00 ","$15,295.00 ","$14,168.00 ","$12,236.00 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$11,753.00 ","$8,855.00 ","$14,651.00 ","$14,651.00 ","$12,880.00 ", N/A ,"$8,855.00 ","$14,490.00 ", N/A ,"$14,490.00 ","$8,694.00 ","$15,134.00 ", N/A ,"$14,812.00 ","$3,478.45 ","$14,651.00 ", N/A ,"$9,907.94 ","$9,907.94 ","$14,490.00 ","$12,015.43 ","$11,213.65 ", N/A ,"$3,281.56 ","$15,295.00 ", N/A ,"$3,281.56 ","$14,007.00 ", N/A ,"$14,490.00 ", N/A ,"$14,490.00 ","$14,490.00 ","$14,490.00 ","$15,617.00 ","$13,041.00 ","$14,973.00 ","$13,846.00 ","$15,617.00 "
SACRED HEART HOSPITAL (ACU),48100242,33362,HC REPL TAVR W/PRO OPEN FEM ART,481,1 ,"$20,700.00 ","$15,525.00 ","$3,281.56 ","$20,700.00 ","$13,330.80 ", N/A ,"$14,490.00 ","$3,281.56 ","$18,759.00 ","$3,380.01 ","$15,007.00 ","$19,665.00 ","$3,281.56 ","$16,560.00 ","$19,044.00 ","$3,281.56 ","$17,595.00 ","$19,665.00 ","$18,216.00 ","$15,732.00 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$15,111.00 ","$11,385.00 ","$18,837.00 ","$18,837.00 ","$16,560.00 ", N/A ,"$11,385.00 ","$18,630.00 ", N/A ,"$18,630.00 ","$11,178.00 ","$19,458.00 ", N/A ,"$19,044.00 ","$3,478.45 ","$18,837.00 ", N/A ,"$12,738.78 ","$12,738.78 ","$18,630.00 ","$15,448.41 ", N/A , N/A ,"$3,281.56 ","$19,665.00 ", N/A ,"$3,281.56 ","$18,009.00 ", N/A ,"$18,630.00 ", N/A ,"$18,630.00 ","$18,630.00 ","$18,630.00 ","$20,079.00 ","$16,767.00 ","$19,251.00 ","$17,802.00 ","$20,079.00 "
SACRED HEART HOSPITAL (ACU),48100243,33363,HC REPL TAVR W/PRO OPEN AXIL ART,481,1 ,"$20,700.00 ","$15,525.00 ","$3,281.56 ","$20,700.00 ","$13,330.80 ", N/A ,"$14,490.00 ","$3,281.56 ","$18,759.00 ","$3,380.01 ","$15,007.00 ","$19,665.00 ","$3,281.56 ","$16,560.00 ","$19,044.00 ","$3,281.56 ","$17,595.00 ","$19,665.00 ","$18,216.00 ","$15,732.00 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$15,111.00 ","$11,385.00 ","$18,837.00 ","$18,837.00 ","$16,560.00 ", N/A ,"$11,385.00 ","$18,630.00 ", N/A ,"$18,630.00 ","$11,178.00 ","$19,458.00 ", N/A ,"$19,044.00 ","$3,478.45 ","$18,837.00 ", N/A ,"$12,738.78 ","$12,738.78 ","$18,630.00 ","$15,448.41 ", N/A , N/A ,"$3,281.56 ","$19,665.00 ", N/A ,"$3,281.56 ","$18,009.00 ", N/A ,"$18,630.00 ", N/A ,"$18,630.00 ","$18,630.00 ","$18,630.00 ","$20,079.00 ","$16,767.00 ","$19,251.00 ","$17,802.00 ","$20,079.00 "
SACRED HEART HOSPITAL (ACU),48100244,33364,HC REPL TAVR W/PRO OPEN ILIAC ART,481,1 ,"$20,700.00 ","$15,525.00 ","$3,281.56 ","$20,700.00 ","$13,330.80 ", N/A ,"$14,490.00 ","$3,281.56 ","$18,759.00 ","$3,380.01 ","$15,007.00 ","$19,665.00 ","$3,281.56 ","$16,560.00 ","$19,044.00 ","$3,281.56 ","$17,595.00 ","$19,665.00 ","$18,216.00 ","$15,732.00 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$15,111.00 ","$11,385.00 ","$18,837.00 ","$18,837.00 ","$16,560.00 ", N/A ,"$11,385.00 ","$18,630.00 ", N/A ,"$18,630.00 ","$11,178.00 ","$19,458.00 ", N/A ,"$19,044.00 ","$3,478.45 ","$18,837.00 ", N/A ,"$12,738.78 ","$12,738.78 ","$18,630.00 ","$15,448.41 ", N/A , N/A ,"$3,281.56 ","$19,665.00 ", N/A ,"$3,281.56 ","$18,009.00 ", N/A ,"$18,630.00 ", N/A ,"$18,630.00 ","$18,630.00 ","$18,630.00 ","$20,079.00 ","$16,767.00 ","$19,251.00 ","$17,802.00 ","$20,079.00 "
SACRED HEART HOSPITAL (ACU),48100245,33365,HC REPL TAVR TRANSAORTIC APPRCH,481,1 ,"$29,900.00 ","$22,425.00 ","$3,281.56 ","$29,900.00 ","$19,255.60 ", N/A ,"$20,930.00 ","$3,281.56 ","$18,759.00 ","$3,380.01 ","$15,007.00 ","$28,405.00 ","$3,281.56 ","$23,920.00 ","$27,508.00 ","$3,281.56 ","$25,415.00 ","$28,405.00 ","$26,312.00 ","$22,724.00 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$21,827.00 ","$16,445.00 ","$27,209.00 ","$27,209.00 ","$23,920.00 ", N/A ,"$16,445.00 ","$26,910.00 ", N/A ,"$26,910.00 ","$16,146.00 ","$28,106.00 ", N/A ,"$27,508.00 ","$3,478.45 ","$27,209.00 ", N/A ,"$18,400.46 ","$18,400.46 ","$26,910.00 ","$22,314.37 ", N/A , N/A ,"$3,281.56 ","$28,405.00 ", N/A ,"$3,281.56 ","$26,013.00 ", N/A ,"$26,910.00 ", N/A ,"$26,910.00 ","$26,910.00 ","$26,910.00 ","$29,003.00 ","$24,219.00 ","$27,807.00 ","$25,714.00 ","$29,003.00 "
SACRED HEART HOSPITAL (ACU),48100246,33366,HC REPL TAVR TRANSAPICAL APPRCH,481,1 ,"$28,750.00 ","$21,562.50 ","$3,281.56 ","$28,750.00 ","$18,515.00 ", N/A ,"$20,125.00 ","$3,281.56 ","$18,759.00 ","$3,380.01 ","$15,007.00 ","$27,312.50 ","$3,281.56 ","$23,000.00 ","$26,450.00 ","$3,281.56 ","$24,437.50 ","$27,312.50 ","$25,300.00 ","$21,850.00 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$20,987.50 ","$15,812.50 ","$26,162.50 ","$26,162.50 ","$23,000.00 ", N/A ,"$15,812.50 ","$25,875.00 ", N/A ,"$25,875.00 ","$15,525.00 ","$27,025.00 ", N/A ,"$26,450.00 ","$3,478.45 ","$26,162.50 ", N/A ,"$17,692.75 ","$17,692.75 ","$25,875.00 ","$21,456.13 ","$20,024.38 ", N/A ,"$3,281.56 ","$27,312.50 ", N/A ,"$3,281.56 ","$25,012.50 ", N/A ,"$25,875.00 ", N/A ,"$25,875.00 ","$25,875.00 ","$25,875.00 ","$27,887.50 ","$23,287.50 ","$26,737.50 ","$24,725.00 ","$27,887.50 "
SACRED HEART HOSPITAL (ACU),48100247,33367,HC REPL TAVR W/ PERC PERIPH BYPASS,481,1 ,"$4,054.00 ","$3,040.50 ","$2,189.16 ","$4,054.00 ","$2,610.78 ", N/A ,"$2,837.80 ","$3,281.56 ","$4,054.00 ","$3,380.01 ","$4,054.00 ","$3,851.30 ","$3,281.56 ","$3,243.20 ","$3,729.68 ","$3,281.56 ","$3,445.90 ","$3,851.30 ","$3,567.52 ","$3,081.04 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$2,959.42 ","$2,229.70 ","$3,689.14 ","$3,689.14 ","$3,243.20 ", N/A ,"$2,229.70 ","$3,648.60 ", N/A ,"$3,648.60 ","$2,189.16 ","$3,810.76 ", N/A ,"$3,729.68 ","$3,478.45 ","$3,689.14 ", N/A ,"$2,494.83 ","$2,494.83 ","$3,648.60 ","$3,025.50 ", N/A , N/A ,"$3,281.56 ","$3,851.30 ", N/A ,"$3,281.56 ","$3,526.98 ", N/A ,"$3,648.60 ", N/A ,"$3,648.60 ","$3,648.60 ","$3,648.60 ","$3,932.38 ","$3,283.74 ","$3,770.22 ","$3,486.44 ","$3,932.38 "
SACRED HEART HOSPITAL (ACU),48100248,33368,HC REPL TAVR W/OPEN PERIPH BYPASS,481,1 ,"$4,054.00 ","$3,040.50 ","$2,189.16 ","$4,054.00 ","$2,610.78 ", N/A ,"$2,837.80 ","$3,281.56 ","$4,054.00 ","$3,380.01 ","$4,054.00 ","$3,851.30 ","$3,281.56 ","$3,243.20 ","$3,729.68 ","$3,281.56 ","$3,445.90 ","$3,851.30 ","$3,567.52 ","$3,081.04 ","$3,281.56 ","$3,281.56 ","$3,281.56 ","$2,959.42 ","$2,229.70 ","$3,689.14 ","$3,689.14 ","$3,243.20 ", N/A ,"$2,229.70 ","$3,648.60 ", N/A ,"$3,648.60 ","$2,189.16 ","$3,810.76 ", N/A ,"$3,729.68 ","$3,478.45 ","$3,689.14 ", N/A ,"$2,494.83 ","$2,494.83 ","$3,648.60 ","$3,025.50 ", N/A , N/A ,"$3,281.56 ","$3,851.30 ", N/A ,"$3,281.56 ","$3,526.98 ", N/A ,"$3,648.60 ", N/A ,"$3,648.60 ","$3,648.60 ","$3,648.60 ","$3,932.38 ","$3,283.74 ","$3,770.22 ","$3,486.44 ","$3,932.38 "
SACRED HEART HOSPITAL (ACU),48100255,61651,HC THPY INFS NON-THROMBO ADDNT,481,1 ,"$1,193.23 ",$894.92 ,$644.34 ,"$3,867.78 ",$768.44 , N/A ,$835.26 ,"$1,193.23 ","$1,193.23 ","$3,758.32 ","$1,193.23 ","$1,133.57 ","$3,648.85 ",$954.58 ,"$1,097.77 ","$1,193.23 ","$1,014.25 ","$1,133.57 ","$1,050.04 ",$906.85 ,"$1,193.23 ","$1,193.23 ","$3,648.85 ",$871.06 ,$656.28 ,"$1,085.84 ","$1,085.84 ",$954.58 , N/A ,$656.28 ,"$1,073.91 ", N/A ,"$1,073.91 ",$644.34 ,"$1,121.64 ", N/A ,"$1,097.77 ","$3,867.78 ","$1,085.84 ", N/A ,$734.31 ,$734.31 ,"$1,073.91 ",$890.51 , N/A , N/A ,"$1,193.23 ","$1,133.57 ", N/A ,"$1,193.23 ","$1,038.11 ", N/A ,"$1,073.91 ", N/A ,"$1,073.91 ","$1,073.91 ","$1,073.91 ","$1,157.43 ",$966.52 ,"$1,109.70 ","$1,026.18 ","$1,157.43 "
SACRED HEART HOSPITAL (ACU),48100256,N/A,HC PACEMAKER INSERTION DURING PROCEDURE,481,1 ,$844.00 ,$633.00 ,$455.76 ,$844.00 ,$543.54 , N/A ,$590.80 , N/A , N/A , N/A , N/A ,$801.80 , N/A ,$675.20 ,$776.48 , N/A ,$717.40 ,$801.80 ,$742.72 ,$641.44 , N/A , N/A , N/A ,$616.12 ,$464.20 ,$768.04 ,$768.04 ,$675.20 , N/A ,$464.20 ,$759.60 , N/A ,$759.60 ,$455.76 ,$793.36 , N/A ,$776.48 , N/A ,$768.04 , N/A , N/A , N/A ,$759.60 ,$629.88 , N/A , N/A , N/A ,$801.80 , N/A , N/A ,$734.28 , N/A ,$759.60 , N/A ,$759.60 ,$759.60 ,$759.60 ,$818.68 ,$683.64 ,$784.92 ,$725.84 ,$818.68 
SACRED HEART HOSPITAL (ACU),48100257,N/A,HC PACEMAKER INSERTION,481,1 ,"$19,154.00 ","$14,365.50 ","$10,343.16 ","$19,154.00 ","$12,335.18 ", N/A ,"$13,407.80 ", N/A , N/A , N/A , N/A ,"$18,196.30 ", N/A ,"$15,323.20 ","$17,621.68 ", N/A ,"$16,280.90 ","$18,196.30 ","$16,855.52 ","$14,557.04 ", N/A , N/A , N/A ,"$13,982.42 ","$10,534.70 ","$17,430.14 ","$17,430.14 ","$15,323.20 ", N/A ,"$10,534.70 ","$17,238.60 ", N/A ,"$17,238.60 ","$10,343.16 ","$18,004.76 ", N/A ,"$17,621.68 ", N/A ,"$17,430.14 ", N/A , N/A , N/A ,"$17,238.60 ","$14,294.63 ", N/A , N/A , N/A ,"$18,196.30 ", N/A , N/A ,"$16,663.98 ", N/A ,"$17,238.60 ", N/A ,"$17,238.60 ","$17,238.60 ","$17,238.60 ","$18,579.38 ","$15,514.74 ","$17,813.22 ","$16,472.44 ","$18,579.38 "
SACRED HEART HOSPITAL (ACU),48100258,N/A,HC PACEMAKER BATTERY CHANGE,481,1 ,"$8,500.00 ","$6,375.00 ","$4,590.00 ","$8,500.00 ","$5,474.00 ", N/A ,"$5,950.00 ", N/A , N/A , N/A , N/A ,"$8,075.00 ", N/A ,"$6,800.00 ","$7,820.00 ", N/A ,"$7,225.00 ","$8,075.00 ","$7,480.00 ","$6,460.00 ", N/A , N/A , N/A ,"$6,205.00 ","$4,675.00 ","$7,735.00 ","$7,735.00 ","$6,800.00 ", N/A ,"$4,675.00 ","$7,650.00 ", N/A ,"$7,650.00 ","$4,590.00 ","$7,990.00 ", N/A ,"$7,820.00 ", N/A ,"$7,735.00 ", N/A , N/A , N/A ,"$7,650.00 ","$6,343.55 ", N/A , N/A , N/A ,"$8,075.00 ", N/A , N/A ,"$7,395.00 ", N/A ,"$7,650.00 ", N/A ,"$7,650.00 ","$7,650.00 ","$7,650.00 ","$8,245.00 ","$6,885.00 ","$7,905.00 ","$7,310.00 ","$8,245.00 "
SACRED HEART HOSPITAL (ACU),48100263,36902,HC INTRO CATH/CIRCUIT W/ANGIO 36902,481,1 ,"$1,999.00 ","$1,499.25 ","$1,079.46 ","$11,794.48 ","$1,287.36 ","$5,241.99 ","$1,399.30 ","$1,161.13 ","$1,999.00 ","$1,195.96 ","$1,999.00 ","$1,899.05 ","$1,161.13 ","$1,599.20 ","$1,839.08 ","$1,161.13 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ","$5,399.25 ","$1,099.45 ","$1,799.10 ","$5,241.99 ","$1,799.10 ","$1,079.46 ","$1,879.06 ","$11,794.48 ","$1,839.08 ","$1,230.80 ","$1,819.09 ","$5,241.99 ","$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ","$1,799.10 ","$5,294.41 ","$1,161.13 ","$1,899.05 ","$5,504.09 ","$1,161.13 ","$1,739.13 ","$5,241.99 ","$1,799.10 ","$5,241.99 ","$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100264,36905,HC THROMBECTOMY/INFUS CIRCUIT W/ANGIO 36905,481,1 ,"$1,999.00 ","$1,499.25 ","$1,079.46 ","$23,902.85 ","$1,287.36 ","$10,623.49 ","$1,399.30 ","$1,913.68 ","$1,999.00 ","$1,971.09 ","$1,999.00 ","$1,899.05 ","$1,913.68 ","$1,599.20 ","$1,839.08 ","$1,913.68 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ","$10,942.19 ","$1,099.45 ","$1,799.10 ","$10,623.49 ","$1,799.10 ","$1,079.46 ","$1,879.06 ","$23,902.85 ","$1,839.08 ","$2,028.50 ","$1,819.09 ","$10,623.49 ","$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ","$1,799.10 ","$10,729.72 ","$1,913.68 ","$1,899.05 ","$11,154.66 ","$1,913.68 ","$1,739.13 ","$10,623.49 ","$1,799.10 ","$10,623.49 ","$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100265,36907,HC ANGIOPLASTY CTR DIALYSIS SEGMENT 36907,481,1 ,"$1,999.00 ","$1,499.25 ",$999.50 ,"$2,028.50 ","$1,287.36 ", N/A ,"$1,399.30 ","$1,913.68 ", N/A ,"$1,971.09 ", N/A ,"$1,899.05 ","$1,913.68 ","$1,599.20 ","$1,839.08 ","$1,913.68 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ", N/A ,"$1,099.45 ","$1,799.10 ", N/A ,"$1,799.10 ","$1,079.46 ","$1,879.06 ", N/A ,"$1,839.08 ","$2,028.50 ","$1,819.09 ", N/A ,"$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ",$999.50 , N/A ,"$1,913.68 ","$1,899.05 ", N/A ,"$1,913.68 ","$1,739.13 ", N/A ,"$1,799.10 ", N/A ,"$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100266,37246,HC ANGIOPLASTY TRANLUM BALN INIT ARTERY 37246,481,1 ,"$4,782.00 ","$3,586.50 ","$1,161.13 ","$11,794.48 ","$3,079.61 ","$5,241.99 ","$3,347.40 ","$1,161.13 ","$4,782.00 ","$1,195.96 ","$4,782.00 ","$4,542.90 ","$1,161.13 ","$3,825.60 ","$4,399.44 ","$1,161.13 ","$4,064.70 ","$4,542.90 ","$4,208.16 ","$3,634.32 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$3,490.86 ","$2,630.10 ","$4,351.62 ","$4,351.62 ","$3,825.60 ","$5,399.25 ","$2,630.10 ","$4,303.80 ","$5,241.99 ","$4,303.80 ","$2,582.28 ","$4,495.08 ","$11,794.48 ","$4,399.44 ","$1,230.80 ","$4,351.62 ","$5,241.99 ","$2,942.84 ","$2,942.84 ","$4,303.80 ","$3,568.81 ","$4,303.80 ","$5,294.41 ","$1,161.13 ","$4,542.90 ","$5,504.09 ","$1,161.13 ","$4,160.34 ","$5,241.99 ","$4,303.80 ","$5,241.99 ","$4,303.80 ","$4,303.80 ","$4,303.80 ","$4,638.54 ","$3,873.42 ","$4,447.26 ","$4,112.52 ","$4,638.54 "
SACRED HEART HOSPITAL (ACU),48100267,37247,HC ANGIOPLASTY TRANLUM BALN ADDL ARTERY 37247,481,1 ,"$4,027.00 ","$3,020.25 ","$1,913.68 ","$4,027.00 ","$2,593.39 ", N/A ,"$2,818.90 ","$1,913.68 ", N/A ,"$1,971.09 ", N/A ,"$3,825.65 ","$1,913.68 ","$3,221.60 ","$3,704.84 ","$1,913.68 ","$3,422.95 ","$3,825.65 ","$3,543.76 ","$3,060.52 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$2,939.71 ","$2,214.85 ","$3,664.57 ","$3,664.57 ","$3,221.60 ", N/A ,"$2,214.85 ","$3,624.30 ", N/A ,"$3,624.30 ","$2,174.58 ","$3,785.38 ", N/A ,"$3,704.84 ","$2,028.50 ","$3,664.57 ", N/A ,"$2,478.22 ","$2,478.22 ","$3,624.30 ","$3,005.35 ","$2,013.50 ", N/A ,"$1,913.68 ","$3,825.65 ", N/A ,"$1,913.68 ","$3,503.49 ", N/A ,"$3,624.30 ", N/A ,"$3,624.30 ","$3,624.30 ","$3,624.30 ","$3,906.19 ","$3,261.87 ","$3,745.11 ","$3,463.22 ","$3,906.19 "
SACRED HEART HOSPITAL (ACU),48100268,37248,HC ANGIOPLASTY TRANLUM BALN INIT VEIN 37248,481,1 ,"$4,171.00 ","$3,128.25 ","$1,161.13 ","$11,794.48 ","$2,686.12 ","$5,241.99 ","$2,919.70 ","$1,161.13 ","$4,171.00 ","$1,195.96 ","$4,171.00 ","$3,962.45 ","$1,161.13 ","$3,336.80 ","$3,837.32 ","$1,161.13 ","$3,545.35 ","$3,962.45 ","$3,670.48 ","$3,169.96 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$3,044.83 ","$2,294.05 ","$3,795.61 ","$3,795.61 ","$3,336.80 ","$5,399.25 ","$2,294.05 ","$3,753.90 ","$5,241.99 ","$3,753.90 ","$2,252.34 ","$3,920.74 ","$11,794.48 ","$3,837.32 ","$1,230.80 ","$3,795.61 ","$5,241.99 ","$2,566.83 ","$2,566.83 ","$3,753.90 ","$3,112.82 ","$3,753.90 ","$5,294.41 ","$1,161.13 ","$3,962.45 ","$5,504.09 ","$1,161.13 ","$3,628.77 ","$5,241.99 ","$3,753.90 ","$5,241.99 ","$3,753.90 ","$3,753.90 ","$3,753.90 ","$4,045.87 ","$3,378.51 ","$3,879.03 ","$3,587.06 ","$4,045.87 "
SACRED HEART HOSPITAL (ACU),48100269,37249,HC ANGIOPLASTY TRANLUM BALN ADDL VEIN 37249,481,1 ,"$3,522.00 ","$2,641.50 ","$1,761.00 ","$3,522.00 ","$2,268.17 ", N/A ,"$2,465.40 ","$1,913.68 ", N/A ,"$1,971.09 ", N/A ,"$3,345.90 ","$1,913.68 ","$2,817.60 ","$3,240.24 ","$1,913.68 ","$2,993.70 ","$3,345.90 ","$3,099.36 ","$2,676.72 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$2,571.06 ","$1,937.10 ","$3,205.02 ","$3,205.02 ","$2,817.60 ", N/A ,"$1,937.10 ","$3,169.80 ", N/A ,"$3,169.80 ","$1,901.88 ","$3,310.68 ", N/A ,"$3,240.24 ","$2,028.50 ","$3,205.02 ", N/A ,"$2,167.44 ","$2,167.44 ","$3,169.80 ","$2,628.47 ","$1,761.00 ", N/A ,"$1,913.68 ","$3,345.90 ", N/A ,"$1,913.68 ","$3,064.14 ", N/A ,"$3,169.80 ", N/A ,"$3,169.80 ","$3,169.80 ","$3,169.80 ","$3,416.34 ","$2,852.82 ","$3,275.46 ","$3,028.92 ","$3,416.34 "
SACRED HEART HOSPITAL (ACU),48100270,36908,HC PLACE STENT CENTRAL DIAL SEGMENT 36908,481,1 ,"$1,999.00 ","$1,499.25 ",$999.50 ,"$2,028.50 ","$1,287.36 ", N/A ,"$1,399.30 ","$1,913.68 ", N/A ,"$1,971.09 ", N/A ,"$1,899.05 ","$1,913.68 ","$1,599.20 ","$1,839.08 ","$1,913.68 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,913.68 ","$1,913.68 ","$1,913.68 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ", N/A ,"$1,099.45 ","$1,799.10 ", N/A ,"$1,799.10 ","$1,079.46 ","$1,879.06 ", N/A ,"$1,839.08 ","$2,028.50 ","$1,819.09 ", N/A ,"$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ",$999.50 , N/A ,"$1,913.68 ","$1,899.05 ", N/A ,"$1,913.68 ","$1,739.13 ", N/A ,"$1,799.10 ", N/A ,"$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100271,36909,HC DIAL CIRCUIT VASC EMBOL/OCCUL 36909,481,1 ,"$1,999.00 ","$1,499.25 ",$999.50 ,"$3,775.50 ","$1,287.36 ", N/A ,"$1,399.30 ","$1,999.00 ", N/A ,"$3,668.64 ", N/A ,"$1,899.05 ","$3,561.79 ","$1,599.20 ","$1,839.08 ","$1,999.00 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,999.00 ","$1,999.00 ","$3,561.79 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ", N/A ,"$1,099.45 ","$1,799.10 ", N/A ,"$1,799.10 ","$1,079.46 ","$1,879.06 ", N/A ,"$1,839.08 ","$3,775.50 ","$1,819.09 ", N/A ,"$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ",$999.50 , N/A ,"$1,999.00 ","$1,899.05 ", N/A ,"$1,999.00 ","$1,739.13 ", N/A ,"$1,799.10 ", N/A ,"$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100272,36901,HC INTRO CATH DIALYSIS CIRCUIT 36901,481,1 ,"$1,999.00 ","$1,499.25 ",$592.92 ,"$3,346.33 ","$1,287.36 ","$1,487.26 ","$1,399.30 ",$592.92 ,"$1,999.00 ",$610.71 ,"$1,999.00 ","$1,899.05 ",$592.92 ,"$1,599.20 ","$1,839.08 ",$592.92 ,"$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ",$592.92 ,$592.92 ,$592.92 ,"$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ","$1,531.88 ","$1,099.45 ","$1,799.10 ","$1,487.26 ","$1,799.10 ","$1,079.46 ","$1,879.06 ","$3,346.33 ","$1,839.08 ",$628.50 ,"$1,819.09 ","$1,487.26 ","$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ","$1,799.10 ","$1,502.13 ",$592.92 ,"$1,899.05 ","$1,561.62 ",$592.92 ,"$1,739.13 ","$1,487.26 ","$1,799.10 ","$1,487.26 ","$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100273,36903,HC INTRO CATH/CIRCUIT W/STENT 36903,481,1 ,"$1,999.00 ","$1,499.25 ","$1,079.46 ","$23,902.85 ","$1,287.36 ","$10,623.49 ","$1,399.30 ","$1,999.00 ","$1,999.00 ","$3,668.64 ","$1,999.00 ","$1,899.05 ","$3,561.79 ","$1,599.20 ","$1,839.08 ","$1,999.00 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,999.00 ","$1,999.00 ","$3,561.79 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ","$10,942.19 ","$1,099.45 ","$1,799.10 ","$10,623.49 ","$1,799.10 ","$1,079.46 ","$1,879.06 ","$23,902.85 ","$1,839.08 ","$3,775.50 ","$1,819.09 ","$10,623.49 ","$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ","$1,799.10 ","$10,729.72 ","$1,999.00 ","$1,899.05 ","$11,154.66 ","$1,999.00 ","$1,739.13 ","$10,623.49 ","$1,799.10 ","$10,623.49 ","$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100274,36904,HC THROMBECTOMY/INFUS DIALYSIS CIRCUIT 36904,481,1 ,"$1,999.00 ","$1,499.25 ","$1,079.46 ","$11,794.48 ","$1,287.36 ","$5,241.99 ","$1,399.30 ","$1,161.13 ","$1,999.00 ","$1,195.96 ","$1,999.00 ","$1,899.05 ","$1,161.13 ","$1,599.20 ","$1,839.08 ","$1,161.13 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,161.13 ","$1,161.13 ","$1,161.13 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ","$5,399.25 ","$1,099.45 ","$1,799.10 ","$5,241.99 ","$1,799.10 ","$1,079.46 ","$1,879.06 ","$11,794.48 ","$1,839.08 ","$1,230.80 ","$1,819.09 ","$5,241.99 ","$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ","$1,799.10 ","$5,294.41 ","$1,161.13 ","$1,899.05 ","$5,504.09 ","$1,161.13 ","$1,739.13 ","$5,241.99 ","$1,799.10 ","$5,241.99 ","$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100275,36906,HC THROMBECTOMY/INFUS CIRCUIT W/STENT 36906,481,1 ,"$1,999.00 ","$1,499.25 ","$1,079.46 ","$38,218.28 ","$1,287.36 ","$16,985.90 ","$1,399.30 ","$1,999.00 ","$1,999.00 ","$3,668.64 ","$1,999.00 ","$1,899.05 ","$3,561.79 ","$1,599.20 ","$1,839.08 ","$1,999.00 ","$1,699.15 ","$1,899.05 ","$1,759.12 ","$1,519.24 ","$1,999.00 ","$1,999.00 ","$3,561.79 ","$1,459.27 ","$1,099.45 ","$1,819.09 ","$1,819.09 ","$1,599.20 ","$17,495.48 ","$1,099.45 ","$1,799.10 ","$16,985.90 ","$1,799.10 ","$1,079.46 ","$1,879.06 ","$38,218.28 ","$1,839.08 ","$3,775.50 ","$1,819.09 ","$16,985.90 ","$1,230.18 ","$1,230.18 ","$1,799.10 ","$1,491.85 ","$1,799.10 ","$17,155.76 ","$1,999.00 ","$1,899.05 ","$17,835.20 ","$1,999.00 ","$1,739.13 ","$16,985.90 ","$1,799.10 ","$16,985.90 ","$1,799.10 ","$1,799.10 ","$1,799.10 ","$1,939.03 ","$1,619.19 ","$1,859.07 ","$1,719.14 ","$1,939.03 "
SACRED HEART HOSPITAL (ACU),48100438,33992,HC REMOVE VAD SEPARATE SESSION,481,1 ,"$2,031.00 ","$1,523.25 ","$1,096.74 ","$2,406.16 ","$1,307.96 ", N/A ,"$1,421.70 ","$2,031.00 ","$2,031.00 ","$2,338.06 ","$2,031.00 ","$1,929.45 ","$2,269.96 ","$1,624.80 ","$1,868.52 ","$2,031.00 ","$1,726.35 ","$1,929.45 ","$1,787.28 ","$1,543.56 ","$2,031.00 ","$2,031.00 ","$2,269.96 ","$1,482.63 ","$1,117.05 ","$1,848.21 ","$1,848.21 ","$1,624.80 ", N/A ,"$1,117.05 ","$1,827.90 ", N/A ,"$1,827.90 ","$1,096.74 ","$1,909.14 ", N/A ,"$1,868.52 ","$2,406.16 ","$1,848.21 ", N/A ,"$1,249.88 ","$1,249.88 ","$1,827.90 ","$1,515.74 ", N/A , N/A ,"$2,031.00 ","$1,929.45 ", N/A ,"$2,031.00 ","$1,766.97 ", N/A ,"$1,827.90 ", N/A ,"$1,827.90 ","$1,827.90 ","$1,827.90 ","$1,970.07 ","$1,645.11 ","$1,888.83 ","$1,746.66 ","$1,970.07 "
SACRED HEART HOSPITAL (ACU),48100484,33274,HC TRANSCATH INS/REPLC VENTRIC PACEMAKER LEADLESS W/GUIDE,481,1 ,"$7,653.00 ","$5,739.75 ","$2,694.63 ","$38,218.28 ","$4,928.53 ","$16,985.90 ","$5,357.10 ","$2,694.63 ","$7,653.00 ","$2,775.47 ","$7,653.00 ","$7,270.35 ","$2,694.63 ","$6,122.40 ","$7,040.76 ","$2,694.63 ","$6,505.05 ","$7,270.35 ","$6,734.64 ","$5,816.28 ","$2,694.63 ","$2,694.63 ","$2,694.63 ","$5,586.69 ","$4,209.15 ","$6,964.23 ","$6,964.23 ","$6,122.40 ","$17,495.48 ","$4,209.15 ","$6,887.70 ","$16,985.90 ","$6,887.70 ","$4,132.62 ","$7,193.82 ","$38,218.28 ","$7,040.76 ","$2,856.31 ","$6,964.23 ","$16,985.90 ","$4,709.66 ","$4,709.66 ","$6,887.70 ","$5,711.43 ","$6,887.70 ","$17,155.76 ","$2,694.63 ","$7,270.35 ","$17,835.20 ","$2,694.63 ","$6,658.11 ","$16,985.90 ","$6,887.70 ","$16,985.90 ","$6,887.70 ","$6,887.70 ","$6,887.70 ","$7,423.41 ","$6,198.93 ","$7,117.29 ","$6,581.58 ","$7,423.41 "
SACRED HEART HOSPITAL (ACU),48100485,33275,HC TRANSCATH REMOVE VENTRIC PACEMAKER LEADLESS,481,1 ,"$6,637.00 ","$4,977.75 ","$2,269.96 ","$6,812.22 ","$4,274.23 ","$3,027.65 ","$4,645.90 ","$2,269.96 ","$6,637.00 ","$2,338.06 ","$6,637.00 ","$6,305.15 ","$2,269.96 ","$5,309.60 ","$6,106.04 ","$2,269.96 ","$5,641.45 ","$6,305.15 ","$5,840.56 ","$5,044.12 ","$2,269.96 ","$2,269.96 ","$2,269.96 ","$4,845.01 ","$3,650.35 ","$6,039.67 ","$6,039.67 ","$5,309.60 ","$3,118.48 ","$3,650.35 ","$5,973.30 ","$3,027.65 ","$5,973.30 ","$3,583.98 ","$6,238.78 ","$6,812.22 ","$6,106.04 ","$2,406.16 ","$6,039.67 ","$3,027.65 ","$4,084.41 ","$4,084.41 ","$5,973.30 ","$4,953.19 ","$5,091.27 ","$3,057.93 ","$2,269.96 ","$6,305.15 ","$3,179.04 ","$2,269.96 ","$5,774.19 ","$3,027.65 ","$5,973.30 ","$3,027.65 ","$5,973.30 ","$5,973.30 ","$5,973.30 ","$6,437.89 ","$5,375.97 ","$6,172.41 ","$5,707.82 ","$6,437.89 "
SACRED HEART HOSPITAL (ACU),48100493,34713,HC PERQ ACCESS/CLOSURE FEM ARTY ENDOGRAFT UNI,481,1 ,$557.00 ,$417.75 ,$300.78 ,"$6,153.96 ",$358.71 , N/A ,$389.90 ,$557.00 , N/A ,"$5,979.79 ", N/A ,$529.15 ,"$5,805.62 ",$445.60 ,$512.44 ,$557.00 ,$473.45 ,$529.15 ,$490.16 ,$423.32 ,$557.00 ,$557.00 ,"$5,805.62 ",$406.61 ,$306.35 ,$506.87 ,$506.87 ,$445.60 , N/A ,$306.35 ,$501.30 , N/A ,$501.30 ,$300.78 ,$523.58 , N/A ,$512.44 ,"$6,153.96 ",$506.87 , N/A ,$342.78 ,$342.78 ,$501.30 ,$415.69 , N/A , N/A ,$557.00 ,$529.15 , N/A ,$557.00 ,$484.59 , N/A ,$501.30 , N/A ,$501.30 ,$501.30 ,$501.30 ,$540.29 ,$451.17 ,$518.01 ,$479.02 ,$540.29 
SACRED HEART HOSPITAL (ACU),48100494,33993,HC REPOSTION PERC VAD W/IMAGE GUIDE 2ND SESSION,481,1 ,"$2,359.00 ","$1,769.25 ","$1,273.86 ","$2,406.16 ","$1,519.20 ", N/A ,"$1,651.30 ","$2,269.96 ","$2,359.00 ","$2,338.06 ","$2,359.00 ","$2,241.05 ","$2,269.96 ","$1,887.20 ","$2,170.28 ","$2,269.96 ","$2,005.15 ","$2,241.05 ","$2,075.92 ","$1,792.84 ","$2,269.96 ","$2,269.96 ","$2,269.96 ","$1,722.07 ","$1,297.45 ","$2,146.69 ","$2,146.69 ","$1,887.20 ", N/A ,"$1,297.45 ","$2,123.10 ", N/A ,"$2,123.10 ","$1,273.86 ","$2,217.46 ", N/A ,"$2,170.28 ","$2,406.16 ","$2,146.69 ", N/A ,"$1,451.73 ","$1,451.73 ","$2,123.10 ","$1,760.52 ", N/A , N/A ,"$2,269.96 ","$2,241.05 ", N/A ,"$2,269.96 ","$2,052.33 ", N/A ,"$2,123.10 ", N/A ,"$2,123.10 ","$2,123.10 ","$2,123.10 ","$2,288.23 ","$1,910.79 ","$2,193.87 ","$2,028.74 ","$2,288.23 "
SACRED HEART HOSPITAL (ACU),48100531,33999,HC TAVR CAROTID APPROACH,481,1 ,"$16,100.00 ","$12,075.00 ",$571.68 ,"$16,100.00 ","$10,368.40 ",$571.68 ,"$11,270.00 ",$704.84 ,"$16,100.00 ",$725.99 ,"$15,436.00 ","$15,295.00 ",$704.84 ,"$12,880.00 ","$14,812.00 ",$704.84 ,"$13,685.00 ","$15,295.00 ","$14,168.00 ","$12,236.00 ",$704.84 ,$704.84 ,$704.84 ,"$11,753.00 ","$8,855.00 ","$14,651.00 ","$14,651.00 ","$12,880.00 ",$588.83 ,"$8,855.00 ","$14,490.00 ",$571.68 ,"$14,490.00 ","$8,694.00 ","$15,134.00 ","$1,286.28 ","$14,812.00 ",$747.13 ,"$14,651.00 ",$571.68 ,"$9,907.94 ","$9,907.94 ","$14,490.00 ","$12,015.43 ","$8,050.00 ",$577.40 ,$704.84 ,"$15,295.00 ",$600.27 ,$704.84 ,"$14,007.00 ",$571.68 ,"$14,490.00 ",$571.68 ,"$14,490.00 ","$14,490.00 ","$14,490.00 ","$15,617.00 ","$13,041.00 ","$14,973.00 ","$13,846.00 ","$15,617.00 "
SACRED HEART HOSPITAL (ACU),48200000,93017,HC STRESS TEST TRACING ONLY,482,1 ,"$1,023.80 ",$767.85 ,$54.42 ,"$1,023.80 ",$659.33 ,$279.91 ,$716.66 ,$54.42 ,$849.75 ,$56.05 ,$675.71 ,$972.61 ,$54.42 ,$819.04 ,$941.90 ,$54.42 ,$870.23 ,$972.61 ,$900.94 ,$778.09 ,$54.42 ,$54.42 ,$54.42 ,$747.37 ,$563.09 ,$931.66 ,$931.66 ,$819.04 ,$288.31 ,$563.09 ,$921.42 ,$279.91 ,$921.42 ,$552.85 ,$962.37 ,$629.79 ,$941.90 ,$57.69 ,$931.66 ,$279.91 ,$630.05 ,$630.05 ,$921.42 ,$764.06 ,$713.08 ,$282.71 ,$54.42 ,$972.61 ,$293.90 ,$54.42 ,$890.71 ,$279.91 ,$921.42 ,$279.91 ,$921.42 ,$921.42 ,$921.42 ,$993.09 ,$829.28 ,$952.13 ,$880.47 ,$993.09 
SACRED HEART HOSPITAL (ACU),48300000,93306,HC ECHO/CARDIAC DOP/COLOR FLOW,483,1 ,"$3,543.52 ","$2,657.64 ",$150.67 ,"$3,543.52 ","$2,282.03 ",$511.04 ,"$2,480.46 ",$150.67 ,"$2,941.12 ",$155.19 ,"$2,338.72 ","$3,366.34 ",$150.67 ,"$2,834.82 ","$3,260.04 ",$150.67 ,"$3,011.99 ","$3,366.34 ","$3,118.30 ","$2,693.08 ",$150.67 ,$150.67 ,$150.67 ,"$2,586.77 ","$1,948.94 ","$3,224.60 ","$3,224.60 ","$2,834.82 ",$526.37 ,"$1,948.94 ","$3,189.17 ",$511.04 ,"$3,189.17 ","$1,913.50 ","$3,330.91 ","$1,149.84 ","$3,260.04 ",$159.71 ,"$3,224.60 ",$511.04 ,"$2,180.68 ","$2,180.68 ","$3,189.17 ","$2,644.53 ","$2,468.06 ",$516.15 ,$150.67 ,"$3,366.34 ",$536.59 ,$150.67 ,"$3,082.86 ",$511.04 ,"$3,189.17 ",$511.04 ,"$3,189.17 ","$3,189.17 ","$3,189.17 ","$3,437.21 ","$2,870.25 ","$3,295.47 ","$3,047.43 ","$3,437.21 "
SACRED HEART HOSPITAL (ACU),48300002,93308,HC ECHO 2D W/W/O M-MODE LTD,483,1 ,$687.38 ,$515.54 ,$150.67 ,$687.38 ,$442.67 ,$243.36 ,$481.17 ,$150.67 ,$570.53 ,$155.19 ,$453.67 ,$653.01 ,$150.67 ,$549.90 ,$632.39 ,$150.67 ,$584.27 ,$653.01 ,$604.89 ,$522.41 ,$150.67 ,$150.67 ,$150.67 ,$501.79 ,$378.06 ,$625.52 ,$625.52 ,$549.90 ,$250.66 ,$378.06 ,$618.64 ,$243.36 ,$618.64 ,$371.19 ,$646.14 ,$547.56 ,$632.39 ,$159.71 ,$625.52 ,$243.36 ,$423.01 ,$423.01 ,$618.64 ,$512.99 ,$478.76 ,$245.79 ,$150.67 ,$653.01 ,$255.53 ,$150.67 ,$598.02 ,$243.36 ,$618.64 ,$243.36 ,$618.64 ,$618.64 ,$618.64 ,$666.76 ,$556.78 ,$639.26 ,$591.15 ,$666.76 
SACRED HEART HOSPITAL (ACU),48300003,93312,HC ECHO TEE CMPL W/PF,483,1 ,"$1,552.45 ","$1,164.34 ",$150.67 ,"$1,552.45 ",$999.78 ,$511.04 ,"$1,086.72 ",$150.67 ,"$1,288.53 ",$155.19 ,"$1,024.62 ","$1,474.83 ",$150.67 ,"$1,241.96 ","$1,428.25 ",$150.67 ,"$1,319.58 ","$1,474.83 ","$1,366.16 ","$1,179.86 ",$150.67 ,$150.67 ,$150.67 ,"$1,133.29 ",$853.85 ,"$1,412.73 ","$1,412.73 ","$1,241.96 ",$526.37 ,$853.85 ,"$1,397.21 ",$511.04 ,"$1,397.21 ",$838.32 ,"$1,459.30 ","$1,149.84 ","$1,428.25 ",$159.71 ,"$1,412.73 ",$511.04 ,$955.38 ,$955.38 ,"$1,397.21 ","$1,158.59 ","$1,081.28 ",$516.15 ,$150.67 ,"$1,474.83 ",$536.59 ,$150.67 ,"$1,350.63 ",$511.04 ,"$1,397.21 ",$511.04 ,"$1,397.21 ","$1,397.21 ","$1,397.21 ","$1,505.88 ","$1,257.48 ","$1,443.78 ","$1,335.11 ","$1,505.88 "
SACRED HEART HOSPITAL (ACU),48300006,93325,HC ECHO COLOR FLOW MAPPING,483,1 ,$978.10 ,$733.58 ,$35.91 ,$978.10 ,$629.90 , N/A ,$684.67 ,$35.91 ,$811.82 ,$36.99 ,$645.55 ,$929.20 ,$35.91 ,$782.48 ,$899.85 ,$35.91 ,$831.39 ,$929.20 ,$860.73 ,$743.36 ,$35.91 ,$35.91 ,$35.91 ,$714.01 ,$537.96 ,$890.07 ,$890.07 ,$782.48 , N/A ,$537.96 ,$880.29 , N/A ,$880.29 ,$528.17 ,$919.41 , N/A ,$899.85 ,$38.06 ,$890.07 , N/A ,$601.92 ,$601.92 ,$880.29 ,$729.96 ,$681.25 , N/A ,$35.91 ,$929.20 , N/A ,$35.91 ,$850.95 , N/A ,$880.29 , N/A ,$880.29 ,$880.29 ,$880.29 ,$948.76 ,$792.26 ,$909.63 ,$841.17 ,$948.76 
SACRED HEART HOSPITAL (ACU),48300007,93350,HC ECHO REST  AND  STRESS W/PF,483,1 ,"$1,243.19 ",$932.39 ,$150.67 ,"$1,243.19 ",$800.61 ,$511.04 ,$870.23 ,$150.67 ,"$1,031.85 ",$155.19 ,$820.51 ,"$1,181.03 ",$150.67 ,$994.55 ,"$1,143.73 ",$150.67 ,"$1,056.71 ","$1,181.03 ","$1,094.01 ",$944.82 ,$150.67 ,$150.67 ,$150.67 ,$907.53 ,$683.75 ,"$1,131.30 ","$1,131.30 ",$994.55 ,$526.37 ,$683.75 ,"$1,118.87 ",$511.04 ,"$1,118.87 ",$671.32 ,"$1,168.60 ","$1,149.84 ","$1,143.73 ",$159.71 ,"$1,131.30 ",$511.04 ,$765.06 ,$765.06 ,"$1,118.87 ",$927.79 ,$865.88 ,$516.15 ,$150.67 ,"$1,181.03 ",$536.59 ,$150.67 ,"$1,081.58 ",$511.04 ,"$1,118.87 ",$511.04 ,"$1,118.87 ","$1,118.87 ","$1,118.87 ","$1,205.89 ","$1,006.98 ","$1,156.17 ","$1,069.14 ","$1,205.89 "
SACRED HEART HOSPITAL (ACU),48300010,93321,HC ECHO DOPPLER LMTD,483,1 ,$978.10 ,$733.58 ,$150.67 ,$978.10 ,$629.90 , N/A ,$684.67 ,$150.67 ,$811.82 ,$155.19 ,$645.55 ,$929.20 ,$150.67 ,$782.48 ,$899.85 ,$150.67 ,$831.39 ,$929.20 ,$860.73 ,$743.36 ,$150.67 ,$150.67 ,$150.67 ,$714.01 ,$537.96 ,$890.07 ,$890.07 ,$782.48 , N/A ,$537.96 ,$880.29 , N/A ,$880.29 ,$528.17 ,$919.41 , N/A ,$899.85 ,$159.71 ,$890.07 , N/A ,$601.92 ,$601.92 ,$880.29 ,$729.96 ,$681.25 , N/A ,$150.67 ,$929.20 , N/A ,$150.67 ,$850.95 , N/A ,$880.29 , N/A ,$880.29 ,$880.29 ,$880.29 ,$948.76 ,$792.26 ,$909.63 ,$841.17 ,$948.76 
SACRED HEART HOSPITAL (ACU),48300012,93313,HC ECHO TEE PROBE PLACEMENT,483,1 ,"$2,199.04 ","$1,649.28 ",$150.67 ,"$2,199.04 ","$1,416.18 ",$511.04 ,"$1,539.33 ",$150.67 ,"$1,825.20 ",$155.19 ,"$1,451.37 ","$2,089.09 ",$150.67 ,"$1,759.23 ","$2,023.12 ",$150.67 ,"$1,869.18 ","$2,089.09 ","$1,935.16 ","$1,671.27 ",$150.67 ,$150.67 ,$150.67 ,"$1,605.30 ","$1,209.47 ","$2,001.13 ","$2,001.13 ","$1,759.23 ",$526.37 ,"$1,209.47 ","$1,979.14 ",$511.04 ,"$1,979.14 ","$1,187.48 ","$2,067.10 ","$1,149.84 ","$2,023.12 ",$159.71 ,"$2,001.13 ",$511.04 ,"$1,353.29 ","$1,353.29 ","$1,979.14 ","$1,641.14 ","$1,531.63 ",$516.15 ,$150.67 ,"$2,089.09 ",$536.59 ,$150.67 ,"$1,913.16 ",$511.04 ,"$1,979.14 ",$511.04 ,"$1,979.14 ","$1,979.14 ","$1,979.14 ","$2,133.07 ","$1,781.22 ","$2,045.11 ","$1,891.17 ","$2,133.07 "
SACRED HEART HOSPITAL (ACU),48300016,C8924,HC ECHO TTE W/W/O CONT  AND  W/CONT LIMIT,483,1 ,"$1,001.72 ",$751.29 ,$150.67 ,"$1,001.72 ",$645.11 ,$389.47 ,$701.20 ,$150.67 ,$831.43 ,$155.19 ,$661.14 ,$951.63 ,$150.67 ,$801.38 ,$921.58 ,$150.67 ,$851.46 ,$951.63 ,$881.51 ,$761.31 ,$150.67 ,$150.67 ,$150.67 ,$731.26 ,$550.95 ,$911.57 ,$911.57 ,$801.38 ,$401.15 ,$550.95 ,$901.55 ,$389.47 ,$901.55 ,$540.93 ,$941.62 ,$876.31 ,$921.58 ,$159.71 ,$911.57 ,$389.47 ,$616.46 ,$616.46 ,$901.55 ,$747.58 ,$697.70 ,$393.37 ,$150.67 ,$951.63 ,$408.94 ,$150.67 ,$871.50 ,$389.47 ,$901.55 ,$389.47 ,$901.55 ,$901.55 ,$901.55 ,$971.67 ,$811.39 ,$931.60 ,$861.48 ,$971.67 
SACRED HEART HOSPITAL (ACU),48300017,C8925,HC ECHO TEE 2D W/W/O CONT  AND  W/CONT W/PF,483,1 ,"$2,369.73 ","$1,777.30 ",$150.67 ,"$2,369.73 ","$1,526.11 ",$756.67 ,"$1,658.81 ",$150.67 ,"$1,966.88 ",$155.19 ,"$1,564.02 ","$2,251.24 ",$150.67 ,"$1,895.78 ","$2,180.15 ",$150.67 ,"$2,014.27 ","$2,251.24 ","$2,085.36 ","$1,800.99 ",$150.67 ,$150.67 ,$150.67 ,"$1,729.90 ","$1,303.35 ","$2,156.45 ","$2,156.45 ","$1,895.78 ",$779.37 ,"$1,303.35 ","$2,132.76 ",$756.67 ,"$2,132.76 ","$1,279.65 ","$2,227.55 ","$1,702.50 ","$2,180.15 ",$159.71 ,"$2,156.45 ",$756.67 ,"$1,458.33 ","$1,458.33 ","$2,132.76 ","$1,768.53 ","$1,650.52 ",$764.23 ,$150.67 ,"$2,251.24 ",$794.50 ,$150.67 ,"$2,061.67 ",$756.67 ,"$2,132.76 ",$756.67 ,"$2,132.76 ","$2,132.76 ","$2,132.76 ","$2,298.64 ","$1,919.48 ","$2,203.85 ","$2,037.97 ","$2,298.64 "
SACRED HEART HOSPITAL (ACU),48300018,C8928,HC ECHO TTE 2D STRESS W/W/O CONT  AND  W/CONT W/PF,483,1 ,"$1,176.53 ",$882.40 ,$150.67 ,"$1,702.50 ",$757.69 ,$756.67 ,$823.57 ,$150.67 ,$976.52 ,$155.19 ,$776.51 ,"$1,117.70 ",$150.67 ,$941.22 ,"$1,082.41 ",$150.67 ,"$1,000.05 ","$1,117.70 ","$1,035.35 ",$894.16 ,$150.67 ,$150.67 ,$150.67 ,$858.87 ,$647.09 ,"$1,070.64 ","$1,070.64 ",$941.22 ,$779.37 ,$647.09 ,"$1,058.88 ",$756.67 ,"$1,058.88 ",$635.33 ,"$1,105.94 ","$1,702.50 ","$1,082.41 ",$159.71 ,"$1,070.64 ",$756.67 ,$724.04 ,$724.04 ,"$1,058.88 ",$878.04 ,$819.45 ,$764.23 ,$150.67 ,"$1,117.70 ",$794.50 ,$150.67 ,"$1,023.58 ",$756.67 ,"$1,058.88 ",$756.67 ,"$1,058.88 ","$1,058.88 ","$1,058.88 ","$1,141.23 ",$952.99 ,"$1,094.17 ","$1,011.82 ","$1,141.23 "
SACRED HEART HOSPITAL (ACU),48300019,C8929,HC ECHO TTE 2D W/DOPPLER W/W/O CONT  AND  W/CONT,483,1 ,"$3,351.00 ","$2,513.25 ",$150.67 ,"$3,351.00 ","$2,158.04 ",$756.67 ,"$2,345.70 ",$150.67 ,"$2,781.33 ",$155.19 ,"$2,211.66 ","$3,183.45 ",$150.67 ,"$2,680.80 ","$3,082.92 ",$150.67 ,"$2,848.35 ","$3,183.45 ","$2,948.88 ","$2,546.76 ",$150.67 ,$150.67 ,$150.67 ,"$2,446.23 ","$1,843.05 ","$3,049.41 ","$3,049.41 ","$2,680.80 ",$779.37 ,"$1,843.05 ","$3,015.90 ",$756.67 ,"$3,015.90 ","$1,809.54 ","$3,149.94 ","$1,702.50 ","$3,082.92 ",$159.71 ,"$3,049.41 ",$756.67 ,"$2,062.21 ","$2,062.21 ","$3,015.90 ","$2,500.85 ","$2,333.97 ",$764.23 ,$150.67 ,"$3,183.45 ",$794.50 ,$150.67 ,"$2,915.37 ",$756.67 ,"$3,015.90 ",$756.67 ,"$3,015.90 ","$3,015.90 ","$3,015.90 ","$3,250.47 ","$2,714.31 ","$3,116.43 ","$2,881.86 ","$3,250.47 "
SACRED HEART HOSPITAL (ACU),48300021,N/A,HC INTRA AORTIC BALLOON PUMP-DAILY,480,1 ,"$6,274.00 ","$4,705.50 ","$3,387.96 ","$6,274.00 ","$4,040.46 ", N/A ,"$4,391.80 ", N/A ,"$5,207.42 ", N/A ,"$4,140.84 ","$5,960.30 ", N/A ,"$5,019.20 ","$5,772.08 ", N/A ,"$5,332.90 ","$5,960.30 ","$5,521.12 ","$4,768.24 ", N/A , N/A , N/A ,"$4,580.02 ","$3,450.70 ","$5,709.34 ","$5,709.34 ","$5,019.20 ", N/A ,"$3,450.70 ","$5,646.60 ", N/A ,"$5,646.60 ","$3,387.96 ","$5,897.56 ", N/A ,"$5,772.08 ", N/A ,"$5,709.34 ", N/A ,"$3,861.02 ","$3,861.02 ","$5,646.60 ","$4,682.29 ","$4,369.84 ", N/A , N/A ,"$5,960.30 ", N/A , N/A ,"$5,458.38 ", N/A ,"$5,646.60 ", N/A ,"$5,646.60 ","$5,646.60 ","$5,646.60 ","$6,085.78 ","$5,081.94 ","$5,834.82 ","$5,395.64 ","$6,085.78 "
SACRED HEART HOSPITAL (ACU),51000005,11042,HC DEBR SKIN/SUBQ TISS INIT 20CM FAC,510,1 ,"$1,047.00 ",$785.25 ,$122.07 ,"$1,047.00 ",$674.27 ,$365.56 ,$732.90 ,$122.07 ,$162.00 ,$125.73 ,$128.00 ,$994.65 ,$122.07 ,$837.60 ,$963.24 ,$122.07 ,$889.95 ,$994.65 ,$921.36 ,$795.72 ,$122.07 ,$122.07 ,$122.07 ,$764.31 ,$575.85 ,$952.77 ,$952.77 ,$837.60 ,$376.53 ,$575.85 ,$942.30 ,$365.56 ,$942.30 ,$565.38 ,$984.18 ,$822.51 ,$963.24 ,$129.39 ,$952.77 ,$365.56 ,$644.32 ,$644.32 ,$942.30 ,$781.38 ,$729.24 ,$369.22 ,$122.07 ,$994.65 ,$383.84 ,$122.07 ,$910.89 ,$365.56 ,$942.30 ,$365.56 ,$942.30 ,$942.30 ,$942.30 ,"$1,015.59 ",$848.07 ,$973.71 ,$900.42 ,"$1,015.59 "
SACRED HEART HOSPITAL (ACU),51000006,11043,HC DEBR SKIN/SUBQ TISSUE/MUSCLE FAC,510,1 ,$992.00 ,$744.00 ,$122.07 ,"$1,246.32 ",$638.85 ,$553.92 ,$694.40 ,$122.07 ,$162.00 ,$125.73 ,$128.00 ,$942.40 ,$122.07 ,$793.60 ,$912.64 ,$122.07 ,$843.20 ,$942.40 ,$872.96 ,$753.92 ,$122.07 ,$122.07 ,$122.07 ,$724.16 ,$545.60 ,$902.72 ,$902.72 ,$793.60 ,$570.54 ,$545.60 ,$892.80 ,$553.92 ,$892.80 ,$535.68 ,$932.48 ,"$1,246.32 ",$912.64 ,$129.39 ,$902.72 ,$553.92 ,$610.48 ,$610.48 ,$892.80 ,$740.33 ,$690.93 ,$559.46 ,$122.07 ,$942.40 ,$581.62 ,$122.07 ,$863.04 ,$553.92 ,$892.80 ,$553.92 ,$892.80 ,$892.80 ,$892.80 ,$962.24 ,$803.52 ,$922.56 ,$853.12 ,$962.24 
SACRED HEART HOSPITAL (ACU),51000007,11044,HC DEBR SKIN/SUB TIS/MUS/BONE INT 20 FAC,510,1 ,"$2,980.00 ","$2,235.00 ",$128.00 ,"$3,348.27 ","$1,919.12 ","$1,488.12 ","$2,086.00 ",$325.72 ,$162.00 ,$335.49 ,$128.00 ,"$2,831.00 ",$325.72 ,"$2,384.00 ","$2,741.60 ",$325.72 ,"$2,533.00 ","$2,831.00 ","$2,622.40 ","$2,264.80 ",$325.72 ,$325.72 ,$325.72 ,"$2,175.40 ","$1,639.00 ","$2,711.80 ","$2,711.80 ","$2,384.00 ","$1,532.76 ","$1,639.00 ","$2,682.00 ","$1,488.12 ","$2,682.00 ","$1,609.20 ","$2,801.20 ","$3,348.27 ","$2,741.60 ",$345.26 ,"$2,711.80 ","$1,488.12 ","$1,833.89 ","$1,833.89 ","$2,682.00 ","$2,223.97 ","$2,075.57 ","$1,503.00 ",$325.72 ,"$2,831.00 ","$1,562.52 ",$325.72 ,"$2,592.60 ","$1,488.12 ","$2,682.00 ","$1,488.12 ","$2,682.00 ","$2,682.00 ","$2,682.00 ","$2,890.60 ","$2,413.80 ","$2,771.40 ","$2,562.80 ","$2,890.60 "
SACRED HEART HOSPITAL (ACU),51000019,11000,HC DEBR SKIN 10% BODY SURFACE,510,1 ,$110.00 ,$82.50 ,$59.40 ,"$1,246.32 ",$70.84 ,$553.92 ,$77.00 ,$110.00 ,$110.00 ,$125.73 ,$110.00 ,$104.50 ,$122.07 ,$88.00 ,$101.20 ,$110.00 ,$93.50 ,$104.50 ,$96.80 ,$83.60 ,$110.00 ,$110.00 ,$122.07 ,$80.30 ,$60.50 ,$100.10 ,$100.10 ,$88.00 ,$570.54 ,$60.50 ,$99.00 ,$553.92 ,$99.00 ,$59.40 ,$103.40 ,"$1,246.32 ",$101.20 ,$129.39 ,$100.10 ,$553.92 ,$67.69 ,$67.69 ,$99.00 ,$82.09 ,$76.62 ,$559.46 ,$110.00 ,$104.50 ,$581.62 ,$110.00 ,$95.70 ,$553.92 ,$99.00 ,$553.92 ,$99.00 ,$99.00 ,$99.00 ,$106.70 ,$89.10 ,$102.30 ,$94.60 ,$106.70 
SACRED HEART HOSPITAL (ACU),51000023,11720,HC DEBR NAIL(S) UP TO 5,510,1 ,$297.00 ,$222.75 ,$21.30 ,$297.00 ,$191.27 ,$58.87 ,$207.90 ,$21.30 ,$162.00 ,$21.94 ,$128.00 ,$282.15 ,$21.30 ,$237.60 ,$273.24 ,$21.30 ,$252.45 ,$282.15 ,$261.36 ,$225.72 ,$21.30 ,$21.30 ,$21.30 ,$216.81 ,$163.35 ,$270.27 ,$270.27 ,$237.60 ,$60.64 ,$163.35 ,$267.30 ,$58.87 ,$267.30 ,$160.38 ,$279.18 ,$132.46 ,$273.24 ,$22.58 ,$270.27 ,$58.87 ,$182.77 ,$182.77 ,$267.30 ,$221.65 ,$206.86 ,$59.46 ,$21.30 ,$282.15 ,$61.82 ,$21.30 ,$258.39 ,$58.87 ,$267.30 ,$58.87 ,$267.30 ,$267.30 ,$267.30 ,$288.09 ,$240.57 ,$276.21 ,$255.42 ,$288.09 
SACRED HEART HOSPITAL (ACU),51000025,11750,HC REMOVE NAIL BED FACIL,510,1 ,"$1,490.00 ","$1,117.50 ",$128.00 ,"$1,490.00 ",$959.56 ,$365.56 ,"$1,043.00 ",$144.67 ,$162.00 ,$149.01 ,$128.00 ,"$1,415.50 ",$144.67 ,"$1,192.00 ","$1,370.80 ",$144.67 ,"$1,266.50 ","$1,415.50 ","$1,311.20 ","$1,132.40 ",$144.67 ,$144.67 ,$144.67 ,"$1,087.70 ",$819.50 ,"$1,355.90 ","$1,355.90 ","$1,192.00 ",$376.53 ,$819.50 ,"$1,341.00 ",$365.56 ,"$1,341.00 ",$804.60 ,"$1,400.60 ",$822.51 ,"$1,370.80 ",$153.35 ,"$1,355.90 ",$365.56 ,$916.95 ,$916.95 ,"$1,341.00 ","$1,111.99 ","$1,037.79 ",$369.22 ,$144.67 ,"$1,415.50 ",$383.84 ,$144.67 ,"$1,296.30 ",$365.56 ,"$1,341.00 ",$365.56 ,"$1,341.00 ","$1,341.00 ","$1,341.00 ","$1,445.30 ","$1,206.90 ","$1,385.70 ","$1,281.40 ","$1,445.30 "
SACRED HEART HOSPITAL (ACU),51000045,36593,HC DECLOTTING/ACCESS DEVICE/CATH,510,1 ,$899.00 ,$674.25 ,$98.38 ,$899.00 ,$578.96 ,$337.23 ,$629.30 ,$98.38 ,$162.00 ,$101.33 ,$128.00 ,$854.05 ,$98.38 ,$719.20 ,$827.08 ,$98.38 ,$764.15 ,$854.05 ,$791.12 ,$683.24 ,$98.38 ,$98.38 ,$98.38 ,$656.27 ,$494.45 ,$818.09 ,$818.09 ,$719.20 ,$347.35 ,$494.45 ,$809.10 ,$337.23 ,$809.10 ,$485.46 ,$845.06 ,$758.76 ,$827.08 ,$104.28 ,$818.09 ,$337.23 ,$553.24 ,$553.24 ,$809.10 ,$670.92 ,$626.15 ,$340.60 ,$98.38 ,$854.05 ,$354.09 ,$98.38 ,$782.13 ,$337.23 ,$809.10 ,$337.23 ,$809.10 ,$809.10 ,$809.10 ,$872.03 ,$728.19 ,$836.07 ,$773.14 ,$872.03 
SACRED HEART HOSPITAL (ACU),51000055,29581,HC APPLY MULTI COMP LOWER LEG FAC,510,1 ,$405.00 ,$303.75 ,$61.15 ,$405.00 ,$260.82 ,$149.42 ,$283.50 ,$61.15 ,$162.00 ,$62.98 ,$128.00 ,$384.75 ,$61.15 ,$324.00 ,$372.60 ,$61.15 ,$344.25 ,$384.75 ,$356.40 ,$307.80 ,$61.15 ,$61.15 ,$61.15 ,$295.65 ,$222.75 ,$368.55 ,$368.55 ,$324.00 ,$153.90 ,$222.75 ,$364.50 ,$149.42 ,$364.50 ,$218.70 ,$380.70 ,$336.20 ,$372.60 ,$64.82 ,$368.55 ,$149.42 ,$249.24 ,$249.24 ,$364.50 ,$302.25 ,$282.08 ,$150.92 ,$61.15 ,$384.75 ,$156.89 ,$61.15 ,$352.35 ,$149.42 ,$364.50 ,$149.42 ,$364.50 ,$364.50 ,$364.50 ,$392.85 ,$328.05 ,$376.65 ,$348.30 ,$392.85 
SACRED HEART HOSPITAL (ACU),51000063,96372,HC INJECTION IM/SUBQ,260,1 ,$135.31 ,$101.48 ,$14.35 ,$147.54 ,$87.14 ,$65.57 ,$94.72 ,$14.35 ,$112.31 ,$14.78 ,$89.30 ,$128.54 ,$14.35 ,$108.25 ,$124.49 ,$14.35 ,$115.01 ,$128.54 ,$119.07 ,$102.84 ,$14.35 ,$14.35 ,$14.35 ,$98.78 ,$74.42 ,$123.13 ,$123.13 ,$108.25 ,$67.54 ,$74.42 ,$121.78 ,$65.57 ,$121.78 ,$73.07 ,$127.19 ,$147.54 ,$124.49 ,$15.21 ,$123.13 ,$65.57 ,$83.27 ,$83.27 ,$121.78 ,$100.98 ,$94.24 ,$66.23 ,$14.35 ,$128.54 ,$68.85 ,$14.35 ,$117.72 ,$65.57 ,$121.78 ,$65.57 ,$121.78 ,$121.78 ,$121.78 ,$131.25 ,$109.60 ,$125.84 ,$116.37 ,$131.25 
SACRED HEART HOSPITAL (ACU),51000065,96374,HC INJ IV PUSH SINGL/INITIAL,260,1 ,$245.53 ,$184.15 ,$14.35 ,$486.82 ,$158.12 ,$216.36 ,$171.87 ,$14.35 ,$203.79 ,$14.78 ,$162.05 ,$233.25 ,$14.35 ,$196.42 ,$225.89 ,$14.35 ,$208.70 ,$233.25 ,$216.07 ,$186.60 ,$14.35 ,$14.35 ,$14.35 ,$179.24 ,$135.04 ,$223.43 ,$223.43 ,$196.42 ,$222.85 ,$135.04 ,$220.98 ,$216.36 ,$220.98 ,$132.59 ,$230.80 ,$486.82 ,$225.89 ,$15.21 ,$223.43 ,$216.36 ,$151.10 ,$151.10 ,$220.98 ,$183.24 ,$171.01 ,$218.53 ,$14.35 ,$233.25 ,$227.18 ,$14.35 ,$213.61 ,$216.36 ,$220.98 ,$216.36 ,$220.98 ,$220.98 ,$220.98 ,$238.16 ,$198.88 ,$228.34 ,$211.16 ,$238.16 
SACRED HEART HOSPITAL (ACU),51000066,96375,HC INJ IV PUSH ADDL NEW DRUG,260,1 ,$201.78 ,$151.34 ,$14.35 ,$201.78 ,$129.95 ,$42.32 ,$141.25 ,$14.35 ,$167.48 ,$14.78 ,$133.17 ,$191.69 ,$14.35 ,$161.42 ,$185.64 ,$14.35 ,$171.51 ,$191.69 ,$177.57 ,$153.35 ,$14.35 ,$14.35 ,$14.35 ,$147.30 ,$110.98 ,$183.62 ,$183.62 ,$161.42 ,$43.59 ,$110.98 ,$181.60 ,$42.32 ,$181.60 ,$108.96 ,$189.67 ,$95.23 ,$185.64 ,$15.21 ,$183.62 ,$42.32 ,$124.18 ,$124.18 ,$181.60 ,$150.59 ,$140.54 ,$42.75 ,$14.35 ,$191.69 ,$44.44 ,$14.35 ,$175.55 ,$42.32 ,$181.60 ,$42.32 ,$181.60 ,$181.60 ,$181.60 ,$195.73 ,$163.44 ,$187.66 ,$173.53 ,$195.73 
SACRED HEART HOSPITAL (ACU),51000067,96376,HC INJ IV PUSH SAME DRUG >30MIN,260,1 ,$163.20 ,$122.40 ,$14.35 ,$163.20 ,$105.10 , N/A ,$114.24 ,$14.35 ,$135.46 ,$14.78 ,$107.71 ,$155.04 ,$14.35 ,$130.56 ,$150.14 ,$14.35 ,$138.72 ,$155.04 ,$143.62 ,$124.03 ,$14.35 ,$14.35 ,$14.35 ,$119.14 ,$89.76 ,$148.51 ,$148.51 ,$130.56 , N/A ,$89.76 ,$146.88 , N/A ,$146.88 ,$88.13 ,$153.41 , N/A ,$150.14 ,$15.21 ,$148.51 , N/A ,$100.43 ,$100.43 ,$146.88 ,$121.80 ,$113.67 , N/A ,$14.35 ,$155.04 , N/A ,$14.35 ,$141.98 , N/A ,$146.88 , N/A ,$146.88 ,$146.88 ,$146.88 ,$158.30 ,$132.19 ,$151.78 ,$140.35 ,$158.30 
SACRED HEART HOSPITAL (ACU),51000068,96523,HC IRRIGAT IMPLANT VEN ACCESS DEV,510,1 ,$98.00 ,$73.50 ,$14.35 ,$132.46 ,$63.11 ,$58.87 ,$68.60 ,$14.35 ,$98.00 ,$14.78 ,$98.00 ,$93.10 ,$14.35 ,$78.40 ,$90.16 ,$14.35 ,$83.30 ,$93.10 ,$86.24 ,$74.48 ,$14.35 ,$14.35 ,$14.35 ,$71.54 ,$53.90 ,$89.18 ,$89.18 ,$78.40 ,$60.64 ,$53.90 ,$88.20 ,$58.87 ,$88.20 ,$52.92 ,$92.12 ,$132.46 ,$90.16 ,$15.21 ,$89.18 ,$58.87 ,$60.31 ,$60.31 ,$88.20 ,$73.14 ,$68.26 ,$59.46 ,$14.35 ,$93.10 ,$61.82 ,$14.35 ,$85.26 ,$58.87 ,$88.20 ,$58.87 ,$88.20 ,$88.20 ,$88.20 ,$95.06 ,$79.38 ,$91.14 ,$84.28 ,$95.06 
SACRED HEART HOSPITAL (ACU),51000072,97597,HC DEBR SKIN PART THICKNESS <20CM FAC,510,1 ,$543.00 ,$407.25 ,$60.69 ,$543.00 ,$349.69 ,$189.93 ,$380.10 ,$60.69 ,$162.00 ,$62.51 ,$128.00 ,$515.85 ,$60.69 ,$434.40 ,$499.56 ,$60.69 ,$461.55 ,$515.85 ,$477.84 ,$412.68 ,$60.69 ,$60.69 ,$60.69 ,$396.39 ,$298.65 ,$494.13 ,$494.13 ,$434.40 ,$195.63 ,$298.65 ,$488.70 ,$189.93 ,$488.70 ,$293.22 ,$510.42 ,$427.33 ,$499.56 ,$64.33 ,$494.13 ,$189.93 ,$334.16 ,$334.16 ,$488.70 ,$405.24 ,$378.20 ,$191.82 ,$60.69 ,$515.85 ,$199.42 ,$60.69 ,$472.41 ,$189.93 ,$488.70 ,$189.93 ,$488.70 ,$488.70 ,$488.70 ,$526.71 ,$439.83 ,$504.99 ,$466.98 ,$526.71 
SACRED HEART HOSPITAL (ACU),51000101,99202,HC CLINIC VISIT LIMITED NEW,510,1 ,$212.64 ,$159.48 ,$39.52 ,$212.64 ,$136.94 , N/A ,$148.85 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$202.01 ,$39.52 ,$170.11 ,$195.63 ,$39.52 ,$180.74 ,$202.01 ,$187.12 ,$161.61 ,$39.52 ,$39.52 ,$39.52 ,$155.23 ,$116.95 ,$193.50 ,$193.50 ,$170.11 , N/A ,$116.95 ,$191.38 , N/A ,$191.38 ,$114.83 ,$199.88 , N/A ,$195.63 ,$41.89 ,$193.50 , N/A ,$130.86 ,$130.86 ,$191.38 ,$158.69 ,$148.10 , N/A ,$39.52 ,$202.01 , N/A ,$39.52 ,$185.00 , N/A ,$191.38 , N/A ,$191.38 ,$191.38 ,$191.38 ,$206.26 ,$172.24 ,$197.76 ,$182.87 ,$206.26 
SACRED HEART HOSPITAL (ACU),51000104,99203,HC CLINIC VISIT INTERM NEW,510,1 ,$278.07 ,$208.55 ,$39.52 ,$278.07 ,$179.08 , N/A ,$194.65 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$264.17 ,$39.52 ,$222.46 ,$255.82 ,$39.52 ,$236.36 ,$264.17 ,$244.70 ,$211.33 ,$39.52 ,$39.52 ,$39.52 ,$202.99 ,$152.94 ,$253.04 ,$253.04 ,$222.46 , N/A ,$152.94 ,$250.26 , N/A ,$250.26 ,$150.16 ,$261.39 , N/A ,$255.82 ,$41.89 ,$253.04 , N/A ,$171.12 ,$171.12 ,$250.26 ,$207.52 ,$193.68 , N/A ,$39.52 ,$264.17 , N/A ,$39.52 ,$241.92 , N/A ,$250.26 , N/A ,$250.26 ,$250.26 ,$250.26 ,$269.73 ,$225.24 ,$258.61 ,$239.14 ,$269.73 
SACRED HEART HOSPITAL (ACU),51000109,99204,HC CLINIC VISIT COMPLEX NEW,510,1 ,$389.74 ,$292.31 ,$39.52 ,$389.74 ,$250.99 , N/A ,$272.82 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$370.25 ,$39.52 ,$311.79 ,$358.56 ,$39.52 ,$331.28 ,$370.25 ,$342.97 ,$296.20 ,$39.52 ,$39.52 ,$39.52 ,$284.51 ,$214.36 ,$354.66 ,$354.66 ,$311.79 , N/A ,$214.36 ,$350.77 , N/A ,$350.77 ,$210.46 ,$366.36 , N/A ,$358.56 ,$41.89 ,$354.66 , N/A ,$239.85 ,$239.85 ,$350.77 ,$290.86 ,$271.45 , N/A ,$39.52 ,$370.25 , N/A ,$39.52 ,$339.07 , N/A ,$350.77 , N/A ,$350.77 ,$350.77 ,$350.77 ,$378.05 ,$315.69 ,$362.46 ,$335.18 ,$378.05 
SACRED HEART HOSPITAL (ACU),51000113,99205,HC CLINIC VISIT COMPREH NEW,510,1 ,$520.15 ,$390.11 ,$39.52 ,$520.15 ,$334.98 , N/A ,$364.11 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$494.14 ,$39.52 ,$416.12 ,$478.54 ,$39.52 ,$442.13 ,$494.14 ,$457.73 ,$395.31 ,$39.52 ,$39.52 ,$39.52 ,$379.71 ,$286.08 ,$473.34 ,$473.34 ,$416.12 , N/A ,$286.08 ,$468.14 , N/A ,$468.14 ,$280.88 ,$488.94 , N/A ,$478.54 ,$41.89 ,$473.34 , N/A ,$320.10 ,$320.10 ,$468.14 ,$388.19 ,$362.28 , N/A ,$39.52 ,$494.14 , N/A ,$39.52 ,$452.53 , N/A ,$468.14 , N/A ,$468.14 ,$468.14 ,$468.14 ,$504.55 ,$421.32 ,$483.74 ,$447.33 ,$504.55 
SACRED HEART HOSPITAL (ACU),51000114,99211,HC CLINIC VISIT BRIEF EST,510,1 ,$112.70 ,$84.53 ,$39.52 ,$112.70 ,$72.58 , N/A ,$78.89 ,$39.52 ,$112.70 ,$40.71 ,$112.70 ,$107.07 ,$39.52 ,$90.16 ,$103.68 ,$39.52 ,$95.80 ,$107.07 ,$99.18 ,$85.65 ,$39.52 ,$39.52 ,$39.52 ,$82.27 ,$61.99 ,$102.56 ,$102.56 ,$90.16 , N/A ,$61.99 ,$101.43 , N/A ,$101.43 ,$60.86 ,$105.94 , N/A ,$103.68 ,$41.89 ,$102.56 , N/A ,$69.36 ,$69.36 ,$101.43 ,$84.11 ,$78.50 , N/A ,$39.52 ,$107.07 , N/A ,$39.52 ,$98.05 , N/A ,$101.43 , N/A ,$101.43 ,$101.43 ,$101.43 ,$109.32 ,$91.29 ,$104.81 ,$96.92 ,$109.32 
SACRED HEART HOSPITAL (ACU),51000120,99212,HC CLINIC VISIT LIMIT EST,510,1 ,$138.00 ,$103.50 ,$39.52 ,$138.00 ,$88.87 , N/A ,$96.60 ,$39.52 ,$138.00 ,$40.71 ,$128.00 ,$131.10 ,$39.52 ,$110.40 ,$126.96 ,$39.52 ,$117.30 ,$131.10 ,$121.44 ,$104.88 ,$39.52 ,$39.52 ,$39.52 ,$100.74 ,$75.90 ,$125.58 ,$125.58 ,$110.40 , N/A ,$75.90 ,$124.20 , N/A ,$124.20 ,$74.52 ,$129.72 , N/A ,$126.96 ,$41.89 ,$125.58 , N/A ,$84.93 ,$84.93 ,$124.20 ,$102.99 ,$96.12 , N/A ,$39.52 ,$131.10 , N/A ,$39.52 ,$120.06 , N/A ,$124.20 , N/A ,$124.20 ,$124.20 ,$124.20 ,$133.86 ,$111.78 ,$128.34 ,$118.68 ,$133.86 
SACRED HEART HOSPITAL (ACU),51000131,99213,HC CLINIC VISIT INTERM EST,510,1 ,$173.88 ,$130.41 ,$39.52 ,$173.88 ,$111.98 , N/A ,$121.72 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$165.19 ,$39.52 ,$139.10 ,$159.97 ,$39.52 ,$147.80 ,$165.19 ,$153.01 ,$132.15 ,$39.52 ,$39.52 ,$39.52 ,$126.93 ,$95.63 ,$158.23 ,$158.23 ,$139.10 , N/A ,$95.63 ,$156.49 , N/A ,$156.49 ,$93.90 ,$163.45 , N/A ,$159.97 ,$41.89 ,$158.23 , N/A ,$107.01 ,$107.01 ,$156.49 ,$129.77 ,$121.11 , N/A ,$39.52 ,$165.19 , N/A ,$39.52 ,$151.28 , N/A ,$156.49 , N/A ,$156.49 ,$156.49 ,$156.49 ,$168.66 ,$140.84 ,$161.71 ,$149.54 ,$168.66 
SACRED HEART HOSPITAL (ACU),51000136,99214,HC CLINIC VISIT COMPLX EST,510,1 ,$256.96 ,$192.72 ,$39.52 ,$256.96 ,$165.48 , N/A ,$179.87 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$244.11 ,$39.52 ,$205.57 ,$236.40 ,$39.52 ,$218.42 ,$244.11 ,$226.12 ,$195.29 ,$39.52 ,$39.52 ,$39.52 ,$187.58 ,$141.33 ,$233.83 ,$233.83 ,$205.57 , N/A ,$141.33 ,$231.26 , N/A ,$231.26 ,$138.76 ,$241.54 , N/A ,$236.40 ,$41.89 ,$233.83 , N/A ,$158.13 ,$158.13 ,$231.26 ,$191.77 ,$178.97 , N/A ,$39.52 ,$244.11 , N/A ,$39.52 ,$223.56 , N/A ,$231.26 , N/A ,$231.26 ,$231.26 ,$231.26 ,$249.25 ,$208.14 ,$238.97 ,$220.99 ,$249.25 
SACRED HEART HOSPITAL (ACU),51000139,99215,HC CLINIC VISIT COMPRH EST,510,1 ,$392.92 ,$294.69 ,$39.52 ,$392.92 ,$253.04 , N/A ,$275.04 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$373.27 ,$39.52 ,$314.34 ,$361.49 ,$39.52 ,$333.98 ,$373.27 ,$345.77 ,$298.62 ,$39.52 ,$39.52 ,$39.52 ,$286.83 ,$216.11 ,$357.56 ,$357.56 ,$314.34 , N/A ,$216.11 ,$353.63 , N/A ,$353.63 ,$212.18 ,$369.34 , N/A ,$361.49 ,$41.89 ,$357.56 , N/A ,$241.80 ,$241.80 ,$353.63 ,$293.24 ,$273.67 , N/A ,$39.52 ,$373.27 , N/A ,$39.52 ,$341.84 , N/A ,$353.63 , N/A ,$353.63 ,$353.63 ,$353.63 ,$381.13 ,$318.27 ,$365.42 ,$337.91 ,$381.13 
SACRED HEART HOSPITAL (ACU),51000145,G0127,HC TRIM NAILS DYSTROPHIC FAC,510,1 ,$174.00 ,$130.50 ,$21.30 ,$174.00 ,$112.06 ,$58.87 ,$121.80 ,$21.30 ,$162.00 ,$21.94 ,$128.00 ,$165.30 ,$21.30 ,$139.20 ,$160.08 ,$21.30 ,$147.90 ,$165.30 ,$153.12 ,$132.24 ,$21.30 ,$21.30 ,$21.30 ,$127.02 ,$95.70 ,$158.34 ,$158.34 ,$139.20 ,$60.64 ,$95.70 ,$156.60 ,$58.87 ,$156.60 ,$93.96 ,$163.56 ,$132.46 ,$160.08 ,$22.58 ,$158.34 ,$58.87 ,$107.08 ,$107.08 ,$156.60 ,$129.86 ,$121.19 ,$59.46 ,$21.30 ,$165.30 ,$61.82 ,$21.30 ,$151.38 ,$58.87 ,$156.60 ,$58.87 ,$156.60 ,$156.60 ,$156.60 ,$168.78 ,$140.94 ,$161.82 ,$149.64 ,$168.78 
SACRED HEART HOSPITAL (ACU),51000147,P9612,HC CATH FOR SPECIMEN COLLECTION,300,1 ,$79.38 ,$59.54 ,$0.76 ,$79.38 ,$51.12 ,$3.00 ,$55.57 ,$0.76 ,$5.25 ,$0.78 ,$4.20 ,$75.41 ,$0.76 ,$63.50 ,$73.03 ,$0.76 ,$67.47 ,$75.41 ,$69.85 ,$60.33 ,$0.76 ,$0.76 ,$0.76 ,$57.95 ,$43.66 ,$72.24 ,$72.24 ,$63.50 ,$3.09 ,$43.66 ,$71.44 ,$3.00 ,$71.44 ,$42.87 ,$74.62 ,$6.75 ,$73.03 ,$0.81 ,$72.24 ,$3.00 ,$48.85 ,$48.85 ,$71.44 ,$59.24 ,$55.29 ,$3.03 ,$0.76 ,$75.41 ,$3.15 ,$0.76 ,$69.06 ,$3.00 ,$71.44 ,$3.00 ,$71.44 ,$71.44 ,$71.44 ,$77.00 ,$64.30 ,$73.82 ,$68.27 ,$77.00 
SACRED HEART HOSPITAL (ACU),51000159,16020,HC BURN DRS  AND /OR DEBRID <5% FACIL,510,1 ,$561.00 ,$420.75 ,$60.69 ,$561.00 ,$361.28 ,$189.93 ,$392.70 ,$60.69 ,$162.00 ,$62.51 ,$128.00 ,$532.95 ,$60.69 ,$448.80 ,$516.12 ,$60.69 ,$476.85 ,$532.95 ,$493.68 ,$426.36 ,$60.69 ,$60.69 ,$60.69 ,$409.53 ,$308.55 ,$510.51 ,$510.51 ,$448.80 ,$195.63 ,$308.55 ,$504.90 ,$189.93 ,$504.90 ,$302.94 ,$527.34 ,$427.33 ,$516.12 ,$64.33 ,$510.51 ,$189.93 ,$345.24 ,$345.24 ,$504.90 ,$418.67 ,$390.74 ,$191.82 ,$60.69 ,$532.95 ,$199.42 ,$60.69 ,$488.07 ,$189.93 ,$504.90 ,$189.93 ,$504.90 ,$504.90 ,$504.90 ,$544.17 ,$454.41 ,$521.73 ,$482.46 ,$544.17 
SACRED HEART HOSPITAL (ACU),51000161,17110,HC DESTRUCT BENIGN LESION <15 FACIL,510,1 ,$325.00 ,$243.75 ,$53.09 ,$427.33 ,$209.30 ,$189.93 ,$227.50 ,$53.09 ,$162.00 ,$54.68 ,$128.00 ,$308.75 ,$53.09 ,$260.00 ,$299.00 ,$53.09 ,$276.25 ,$308.75 ,$286.00 ,$247.00 ,$53.09 ,$53.09 ,$53.09 ,$237.25 ,$178.75 ,$295.75 ,$295.75 ,$260.00 ,$195.63 ,$178.75 ,$292.50 ,$189.93 ,$292.50 ,$175.50 ,$305.50 ,$427.33 ,$299.00 ,$56.28 ,$295.75 ,$189.93 ,$200.01 ,$200.01 ,$292.50 ,$242.55 ,$226.36 ,$191.82 ,$53.09 ,$308.75 ,$199.42 ,$53.09 ,$282.75 ,$189.93 ,$292.50 ,$189.93 ,$292.50 ,$292.50 ,$292.50 ,$315.25 ,$263.25 ,$302.25 ,$279.50 ,$315.25 
SACRED HEART HOSPITAL (ACU),51000171,51701,HC CATH BLADDER NON-INDWELLING,510,1 ,$242.00 ,$181.50 ,$23.39 ,$268.33 ,$155.85 ,$119.26 ,$169.40 ,$23.39 ,$162.00 ,$24.09 ,$128.00 ,$229.90 ,$23.39 ,$193.60 ,$222.64 ,$23.39 ,$205.70 ,$229.90 ,$212.96 ,$183.92 ,$23.39 ,$23.39 ,$23.39 ,$176.66 ,$133.10 ,$220.22 ,$220.22 ,$193.60 ,$122.84 ,$133.10 ,$217.80 ,$119.26 ,$217.80 ,$130.68 ,$227.48 ,$268.33 ,$222.64 ,$24.79 ,$220.22 ,$119.26 ,$148.93 ,$148.93 ,$217.80 ,$180.60 ,$168.55 ,$120.45 ,$23.39 ,$229.90 ,$125.22 ,$23.39 ,$210.54 ,$119.26 ,$217.80 ,$119.26 ,$217.80 ,$217.80 ,$217.80 ,$234.74 ,$196.02 ,$225.06 ,$208.12 ,$234.74 
SACRED HEART HOSPITAL (ACU),51000172,51702,HC CATH BLADDER SMP,510,1 ,$114.00 ,$85.50 ,$23.39 ,$268.33 ,$73.42 ,$119.26 ,$79.80 ,$23.39 ,$114.00 ,$24.09 ,$114.00 ,$108.30 ,$23.39 ,$91.20 ,$104.88 ,$23.39 ,$96.90 ,$108.30 ,$100.32 ,$86.64 ,$23.39 ,$23.39 ,$23.39 ,$83.22 ,$62.70 ,$103.74 ,$103.74 ,$91.20 ,$122.84 ,$62.70 ,$102.60 ,$119.26 ,$102.60 ,$61.56 ,$107.16 ,$268.33 ,$104.88 ,$24.79 ,$103.74 ,$119.26 ,$70.16 ,$70.16 ,$102.60 ,$85.08 ,$79.40 ,$120.45 ,$23.39 ,$108.30 ,$125.22 ,$23.39 ,$99.18 ,$119.26 ,$102.60 ,$119.26 ,$102.60 ,$102.60 ,$102.60 ,$110.58 ,$92.34 ,$106.02 ,$98.04 ,$110.58 
SACRED HEART HOSPITAL (ACU),51000173,51703,HC CATH BLADDER CPLX,510,1 ,$488.00 ,$366.00 ,$23.39 ,$488.00 ,$314.27 ,$147.66 ,$341.60 ,$23.39 ,$162.00 ,$24.09 ,$128.00 ,$463.60 ,$23.39 ,$390.40 ,$448.96 ,$23.39 ,$414.80 ,$463.60 ,$429.44 ,$370.88 ,$23.39 ,$23.39 ,$23.39 ,$356.24 ,$268.40 ,$444.08 ,$444.08 ,$390.40 ,$152.09 ,$268.40 ,$439.20 ,$147.66 ,$439.20 ,$263.52 ,$458.72 ,$332.24 ,$448.96 ,$24.79 ,$444.08 ,$147.66 ,$300.32 ,$300.32 ,$439.20 ,$364.19 ,$339.89 ,$149.14 ,$23.39 ,$463.60 ,$155.05 ,$23.39 ,$424.56 ,$147.66 ,$439.20 ,$147.66 ,$439.20 ,$439.20 ,$439.20 ,$473.36 ,$395.28 ,$453.84 ,$419.68 ,$473.36 
SACRED HEART HOSPITAL (ACU),51000175,94780,HC CARSEAT ANALYSIS FIRST 60MIN,510,1 ,$484.77 ,$363.58 ,$16.90 ,$484.77 ,$312.19 ,$35.80 ,$339.34 ,$16.90 ,$162.00 ,$17.41 ,$128.00 ,$460.53 ,$16.90 ,$387.82 ,$445.99 ,$16.90 ,$412.05 ,$460.53 ,$426.60 ,$368.43 ,$16.90 ,$16.90 ,$16.90 ,$353.88 ,$266.62 ,$441.14 ,$441.14 ,$387.82 ,$36.87 ,$266.62 ,$436.29 ,$35.80 ,$436.29 ,$261.78 ,$455.68 ,$80.55 ,$445.99 ,$17.91 ,$441.14 ,$35.80 ,$298.33 ,$298.33 ,$436.29 ,$361.78 ,$337.64 ,$36.16 ,$16.90 ,$460.53 ,$37.59 ,$16.90 ,$421.75 ,$35.80 ,$436.29 ,$35.80 ,$436.29 ,$436.29 ,$436.29 ,$470.23 ,$392.66 ,$450.84 ,$416.90 ,$470.23 
SACRED HEART HOSPITAL (ACU),51000207,52000,HC CYSTOURETHROSCOPY,510,1 ,"$8,183.00 ","$6,137.25 ",$128.00 ,"$8,183.00 ","$5,269.85 ",$608.47 ,"$5,728.10 ",$506.66 ,$162.00 ,$521.86 ,$128.00 ,"$7,773.85 ",$506.66 ,"$6,546.40 ","$7,528.36 ",$506.66 ,"$6,955.55 ","$7,773.85 ","$7,201.04 ","$6,219.08 ",$506.66 ,$506.66 ,$506.66 ,"$5,973.59 ","$4,500.65 ","$7,446.53 ","$7,446.53 ","$6,546.40 ",$626.72 ,"$4,500.65 ","$7,364.70 ",$608.47 ,"$7,364.70 ","$4,418.82 ","$7,692.02 ","$1,369.05 ","$7,528.36 ",$537.06 ,"$7,446.53 ",$608.47 ,"$5,035.82 ","$5,035.82 ","$7,364.70 ","$6,106.97 ","$5,699.46 ",$614.55 ,$506.66 ,"$7,773.85 ",$638.89 ,$506.66 ,"$7,119.21 ",$608.47 ,"$7,364.70 ",$608.47 ,"$7,364.70 ","$7,364.70 ","$7,364.70 ","$7,937.51 ","$6,628.23 ","$7,610.19 ","$7,037.38 ","$7,937.51 "
SACRED HEART HOSPITAL (ACU),51000315,38222,HC BM ASPIRATION (BX/ASP SAME SITE),360,1 ,"$1,346.00 ","$1,009.50 ",$385.73 ,"$5,642.34 ",$866.82 ,"$2,507.71 ",$942.20 ,$385.73 ,"$1,346.00 ",$397.30 ,"$1,346.00 ","$1,278.70 ",$385.73 ,"$1,076.80 ","$1,238.32 ",$385.73 , N/A ,"$1,278.70 ","$1,184.48 ","$1,022.96 ",$385.73 ,$385.73 ,$385.73 ,$982.58 ,$740.30 ,"$1,224.86 ","$1,224.86 ","$1,076.80 ","$2,582.94 ",$740.30 ,"$1,211.40 ","$2,507.71 ","$1,211.40 ",$726.84 ,"$1,265.24 ","$5,642.34 ","$1,238.32 ",$408.87 ,"$1,224.86 ","$2,507.71 ",$828.33 ,$828.33 ,"$1,211.40 ","$1,004.52 ","$1,211.40 ","$2,532.79 ",$385.73 ,"$1,278.70 ","$2,633.09 ",$385.73 ,"$1,171.02 ","$2,507.71 ","$1,211.40 ","$2,507.71 ","$1,211.40 ","$1,211.40 ","$1,211.40 ","$1,305.62 ","$1,090.26 ","$1,251.78 ","$1,157.56 ","$1,305.62 "
SACRED HEART HOSPITAL (ACU),51000320,94781,HC CARSEAT ANALYSIS  EA ADDN 30MIN,510,1 ,$242.38 ,$181.79 ,$16.90 ,$242.38 ,$156.09 , N/A ,$169.67 ,$16.90 ,$162.00 ,$17.41 ,$128.00 ,$230.26 ,$16.90 ,$193.90 ,$222.99 ,$16.90 ,$206.02 ,$230.26 ,$213.29 ,$184.21 ,$16.90 ,$16.90 ,$16.90 ,$176.94 ,$133.31 ,$220.57 ,$220.57 ,$193.90 , N/A ,$133.31 ,$218.14 , N/A ,$218.14 ,$130.89 ,$227.84 , N/A ,$222.99 ,$17.91 ,$220.57 , N/A ,$149.16 ,$149.16 ,$218.14 ,$180.89 ,$168.82 , N/A ,$16.90 ,$230.26 , N/A ,$16.90 ,$210.87 , N/A ,$218.14 , N/A ,$218.14 ,$218.14 ,$218.14 ,$235.11 ,$196.33 ,$225.41 ,$208.45 ,$235.11 
SACRED HEART HOSPITAL (ACU),51000400,29580,HC APPLY UNNA BOOT BILAT FAC,510,1 ,$809.00 ,$606.75 ,$91.72 ,$809.00 ,$521.00 ,$224.14 ,$566.30 ,$91.72 ,$162.00 ,$94.47 ,$128.00 ,$768.55 ,$91.72 ,$647.20 ,$744.28 ,$91.72 ,$687.65 ,$768.55 ,$711.92 ,$614.84 ,$91.72 ,$91.72 ,$91.72 ,$590.57 ,$444.95 ,$736.19 ,$736.19 ,$647.20 ,$230.86 ,$444.95 ,$728.10 ,$224.14 ,$728.10 ,$436.86 ,$760.46 ,$504.31 ,$744.28 ,$97.22 ,$736.19 ,$224.14 ,$497.86 ,$497.86 ,$728.10 ,$603.76 ,$563.47 ,$226.38 ,$91.72 ,$768.55 ,$235.34 ,$91.72 ,$703.83 ,$224.14 ,$728.10 ,$224.14 ,$728.10 ,$728.10 ,$728.10 ,$784.73 ,$655.29 ,$752.37 ,$695.74 ,$784.73 
SACRED HEART HOSPITAL (ACU),51000401,29581,HC APPLY MULTI COMP LWR LEG BIL FAC,510,1 ,$405.00 ,$303.75 ,$91.72 ,$504.31 ,$260.82 ,$224.14 ,$283.50 ,$91.72 ,$162.00 ,$94.47 ,$128.00 ,$384.75 ,$91.72 ,$324.00 ,$372.60 ,$91.72 ,$344.25 ,$384.75 ,$356.40 ,$307.80 ,$91.72 ,$91.72 ,$91.72 ,$295.65 ,$222.75 ,$368.55 ,$368.55 ,$324.00 ,$230.86 ,$222.75 ,$364.50 ,$224.14 ,$364.50 ,$218.70 ,$380.70 ,$504.31 ,$372.60 ,$97.22 ,$368.55 ,$224.14 ,$249.24 ,$249.24 ,$364.50 ,$302.25 ,$282.08 ,$226.38 ,$91.72 ,$384.75 ,$235.34 ,$91.72 ,$352.35 ,$224.14 ,$364.50 ,$224.14 ,$364.50 ,$364.50 ,$364.50 ,$392.85 ,$328.05 ,$376.65 ,$348.30 ,$392.85 
SACRED HEART HOSPITAL (ACU),51000407,11200,HC REMOVAL SKIN TAG LESIONS <=15 FAC,510,1 ,$386.00 ,$289.50 ,$53.09 ,$427.33 ,$248.58 ,$189.93 ,$270.20 ,$53.09 ,$162.00 ,$54.68 ,$128.00 ,$366.70 ,$53.09 ,$308.80 ,$355.12 ,$53.09 ,$328.10 ,$366.70 ,$339.68 ,$293.36 ,$53.09 ,$53.09 ,$53.09 ,$281.78 ,$212.30 ,$351.26 ,$351.26 ,$308.80 ,$195.63 ,$212.30 ,$347.40 ,$189.93 ,$347.40 ,$208.44 ,$362.84 ,$427.33 ,$355.12 ,$56.28 ,$351.26 ,$189.93 ,$237.54 ,$237.54 ,$347.40 ,$288.07 ,$268.85 ,$191.82 ,$53.09 ,$366.70 ,$199.42 ,$53.09 ,$335.82 ,$189.93 ,$347.40 ,$189.93 ,$347.40 ,$347.40 ,$347.40 ,$374.42 ,$312.66 ,$358.98 ,$331.96 ,$374.42 
SACRED HEART HOSPITAL (ACU),51000417,29515,HC APPL SHRT LEG SPLNT RN,510,1 ,$735.00 ,$551.25 ,$14.12 ,$735.00 ,$473.34 ,$149.42 ,$514.50 ,$14.12 ,$162.00 ,$14.54 ,$128.00 ,$698.25 ,$14.12 ,$588.00 ,$676.20 ,$14.12 ,$624.75 ,$698.25 ,$646.80 ,$558.60 ,$14.12 ,$14.12 ,$14.12 ,$536.55 ,$404.25 ,$668.85 ,$668.85 ,$588.00 ,$153.90 ,$404.25 ,$661.50 ,$149.42 ,$661.50 ,$396.90 ,$690.90 ,$336.20 ,$676.20 ,$14.97 ,$668.85 ,$149.42 ,$452.32 ,$452.32 ,$661.50 ,$548.53 ,$511.93 ,$150.92 ,$14.12 ,$698.25 ,$156.89 ,$14.12 ,$639.45 ,$149.42 ,$661.50 ,$149.42 ,$661.50 ,$661.50 ,$661.50 ,$712.95 ,$595.35 ,$683.55 ,$632.10 ,$712.95 
SACRED HEART HOSPITAL (ACU),51000427,17999,HC UNLISTED SKIN TISSUE PROCEDURE,510,1 ,$573.00 ,$429.75 ,$53.09 ,$573.00 ,$369.01 ,$189.93 ,$401.10 ,$53.09 ,$162.00 ,$54.68 ,$128.00 ,$544.35 ,$53.09 ,$458.40 ,$527.16 ,$53.09 ,$487.05 ,$544.35 ,$504.24 ,$435.48 ,$53.09 ,$53.09 ,$53.09 ,$418.29 ,$315.15 ,$521.43 ,$521.43 ,$458.40 ,$195.63 ,$315.15 ,$515.70 ,$189.93 ,$515.70 ,$309.42 ,$538.62 ,$427.33 ,$527.16 ,$56.28 ,$521.43 ,$189.93 ,$352.62 ,$352.62 ,$515.70 ,$427.63 ,$399.09 ,$191.82 ,$53.09 ,$544.35 ,$199.42 ,$53.09 ,$498.51 ,$189.93 ,$515.70 ,$189.93 ,$515.70 ,$515.70 ,$515.70 ,$555.81 ,$464.13 ,$532.89 ,$492.78 ,$555.81 
SACRED HEART HOSPITAL (ACU),51000464,99202,HC CLINIC VISIT LIMITED NEW -25,510,1 ,$212.64 ,$159.48 ,$39.52 ,$212.64 ,$136.94 , N/A ,$148.85 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$202.01 ,$39.52 ,$170.11 ,$195.63 ,$39.52 ,$180.74 ,$202.01 ,$187.12 ,$161.61 ,$39.52 ,$39.52 ,$39.52 ,$155.23 ,$116.95 ,$193.50 ,$193.50 ,$170.11 , N/A ,$116.95 ,$191.38 , N/A ,$191.38 ,$114.83 ,$199.88 , N/A ,$195.63 ,$41.89 ,$193.50 , N/A ,$130.86 ,$130.86 ,$191.38 ,$158.69 ,$148.10 , N/A ,$39.52 ,$202.01 , N/A ,$39.52 ,$185.00 , N/A ,$191.38 , N/A ,$191.38 ,$191.38 ,$191.38 ,$206.26 ,$172.24 ,$197.76 ,$182.87 ,$206.26 
SACRED HEART HOSPITAL (ACU),51000465,99203,HC CLINIC VISIT INTERM NEW -25,510,1 ,$278.07 ,$208.55 ,$39.52 ,$278.07 ,$179.08 , N/A ,$194.65 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$264.17 ,$39.52 ,$222.46 ,$255.82 ,$39.52 ,$236.36 ,$264.17 ,$244.70 ,$211.33 ,$39.52 ,$39.52 ,$39.52 ,$202.99 ,$152.94 ,$253.04 ,$253.04 ,$222.46 , N/A ,$152.94 ,$250.26 , N/A ,$250.26 ,$150.16 ,$261.39 , N/A ,$255.82 ,$41.89 ,$253.04 , N/A ,$171.12 ,$171.12 ,$250.26 ,$207.52 ,$193.68 , N/A ,$39.52 ,$264.17 , N/A ,$39.52 ,$241.92 , N/A ,$250.26 , N/A ,$250.26 ,$250.26 ,$250.26 ,$269.73 ,$225.24 ,$258.61 ,$239.14 ,$269.73 
SACRED HEART HOSPITAL (ACU),51000466,99204,HC CLINIC VISIT COMPLEX NEW -25,510,1 ,$389.74 ,$292.31 ,$39.52 ,$389.74 ,$250.99 , N/A ,$272.82 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$370.25 ,$39.52 ,$311.79 ,$358.56 ,$39.52 ,$331.28 ,$370.25 ,$342.97 ,$296.20 ,$39.52 ,$39.52 ,$39.52 ,$284.51 ,$214.36 ,$354.66 ,$354.66 ,$311.79 , N/A ,$214.36 ,$350.77 , N/A ,$350.77 ,$210.46 ,$366.36 , N/A ,$358.56 ,$41.89 ,$354.66 , N/A ,$239.85 ,$239.85 ,$350.77 ,$290.86 ,$271.45 , N/A ,$39.52 ,$370.25 , N/A ,$39.52 ,$339.07 , N/A ,$350.77 , N/A ,$350.77 ,$350.77 ,$350.77 ,$378.05 ,$315.69 ,$362.46 ,$335.18 ,$378.05 
SACRED HEART HOSPITAL (ACU),51000467,99205,HC CLINIC VISIT COMPREH NEW -25,510,1 ,$520.15 ,$390.11 ,$39.52 ,$520.15 ,$334.98 , N/A ,$364.11 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$494.14 ,$39.52 ,$416.12 ,$478.54 ,$39.52 ,$442.13 ,$494.14 ,$457.73 ,$395.31 ,$39.52 ,$39.52 ,$39.52 ,$379.71 ,$286.08 ,$473.34 ,$473.34 ,$416.12 , N/A ,$286.08 ,$468.14 , N/A ,$468.14 ,$280.88 ,$488.94 , N/A ,$478.54 ,$41.89 ,$473.34 , N/A ,$320.10 ,$320.10 ,$468.14 ,$388.19 ,$362.28 , N/A ,$39.52 ,$494.14 , N/A ,$39.52 ,$452.53 , N/A ,$468.14 , N/A ,$468.14 ,$468.14 ,$468.14 ,$504.55 ,$421.32 ,$483.74 ,$447.33 ,$504.55 
SACRED HEART HOSPITAL (ACU),51000468,99211,HC CLINIC VISIT BRIEF ESTAB -25,510,1 ,$112.70 ,$84.53 ,$39.52 ,$112.70 ,$72.58 , N/A ,$78.89 ,$39.52 ,$112.70 ,$40.71 ,$112.70 ,$107.07 ,$39.52 ,$90.16 ,$103.68 ,$39.52 ,$95.80 ,$107.07 ,$99.18 ,$85.65 ,$39.52 ,$39.52 ,$39.52 ,$82.27 ,$61.99 ,$102.56 ,$102.56 ,$90.16 , N/A ,$61.99 ,$101.43 , N/A ,$101.43 ,$60.86 ,$105.94 , N/A ,$103.68 ,$41.89 ,$102.56 , N/A ,$69.36 ,$69.36 ,$101.43 ,$84.11 ,$78.50 , N/A ,$39.52 ,$107.07 , N/A ,$39.52 ,$98.05 , N/A ,$101.43 , N/A ,$101.43 ,$101.43 ,$101.43 ,$109.32 ,$91.29 ,$104.81 ,$96.92 ,$109.32 
SACRED HEART HOSPITAL (ACU),51000469,99212,HC CLINIC VISIT LIMITED ESTAB -25,510,1 ,$138.00 ,$103.50 ,$39.52 ,$138.00 ,$88.87 , N/A ,$96.60 ,$39.52 ,$138.00 ,$40.71 ,$128.00 ,$131.10 ,$39.52 ,$110.40 ,$126.96 ,$39.52 ,$117.30 ,$131.10 ,$121.44 ,$104.88 ,$39.52 ,$39.52 ,$39.52 ,$100.74 ,$75.90 ,$125.58 ,$125.58 ,$110.40 , N/A ,$75.90 ,$124.20 , N/A ,$124.20 ,$74.52 ,$129.72 , N/A ,$126.96 ,$41.89 ,$125.58 , N/A ,$84.93 ,$84.93 ,$124.20 ,$102.99 ,$96.12 , N/A ,$39.52 ,$131.10 , N/A ,$39.52 ,$120.06 , N/A ,$124.20 , N/A ,$124.20 ,$124.20 ,$124.20 ,$133.86 ,$111.78 ,$128.34 ,$118.68 ,$133.86 
SACRED HEART HOSPITAL (ACU),51000470,99213,HC CLINIC VISIT INTERM EST -25,510,1 ,$173.88 ,$130.41 ,$39.52 ,$173.88 ,$111.98 , N/A ,$121.72 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$165.19 ,$39.52 ,$139.10 ,$159.97 ,$39.52 ,$147.80 ,$165.19 ,$153.01 ,$132.15 ,$39.52 ,$39.52 ,$39.52 ,$126.93 ,$95.63 ,$158.23 ,$158.23 ,$139.10 , N/A ,$95.63 ,$156.49 , N/A ,$156.49 ,$93.90 ,$163.45 , N/A ,$159.97 ,$41.89 ,$158.23 , N/A ,$107.01 ,$107.01 ,$156.49 ,$129.77 ,$121.11 , N/A ,$39.52 ,$165.19 , N/A ,$39.52 ,$151.28 , N/A ,$156.49 , N/A ,$156.49 ,$156.49 ,$156.49 ,$168.66 ,$140.84 ,$161.71 ,$149.54 ,$168.66 
SACRED HEART HOSPITAL (ACU),51000471,99214,HC CLINIC VISIT COMPLEX EST -25,510,1 ,$256.96 ,$192.72 ,$39.52 ,$256.96 ,$165.48 , N/A ,$179.87 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$244.11 ,$39.52 ,$205.57 ,$236.40 ,$39.52 ,$218.42 ,$244.11 ,$226.12 ,$195.29 ,$39.52 ,$39.52 ,$39.52 ,$187.58 ,$141.33 ,$233.83 ,$233.83 ,$205.57 , N/A ,$141.33 ,$231.26 , N/A ,$231.26 ,$138.76 ,$241.54 , N/A ,$236.40 ,$41.89 ,$233.83 , N/A ,$158.13 ,$158.13 ,$231.26 ,$191.77 ,$178.97 , N/A ,$39.52 ,$244.11 , N/A ,$39.52 ,$223.56 , N/A ,$231.26 , N/A ,$231.26 ,$231.26 ,$231.26 ,$249.25 ,$208.14 ,$238.97 ,$220.99 ,$249.25 
SACRED HEART HOSPITAL (ACU),51000472,99215,HC CLINIC VISIT COMPREH EST -25,510,1 ,$392.92 ,$294.69 ,$39.52 ,$392.92 ,$253.04 , N/A ,$275.04 ,$39.52 ,$162.00 ,$40.71 ,$128.00 ,$373.27 ,$39.52 ,$314.34 ,$361.49 ,$39.52 ,$333.98 ,$373.27 ,$345.77 ,$298.62 ,$39.52 ,$39.52 ,$39.52 ,$286.83 ,$216.11 ,$357.56 ,$357.56 ,$314.34 , N/A ,$216.11 ,$353.63 , N/A ,$353.63 ,$212.18 ,$369.34 , N/A ,$361.49 ,$41.89 ,$357.56 , N/A ,$241.80 ,$241.80 ,$353.63 ,$293.24 ,$273.67 , N/A ,$39.52 ,$373.27 , N/A ,$39.52 ,$341.84 , N/A ,$353.63 , N/A ,$353.63 ,$353.63 ,$353.63 ,$381.13 ,$318.27 ,$365.42 ,$337.91 ,$381.13 
SACRED HEART HOSPITAL (ACU),51000477,96377,HC APPL ON-BODY INJECTOR FOR SUBQ INJ,510,1 ,$141.40 ,$106.05 ,$14.35 ,$141.40 ,$91.06 ,$42.32 ,$98.98 ,$14.35 ,$141.40 ,$14.78 ,$128.00 ,$134.33 ,$14.35 ,$113.12 ,$130.09 ,$14.35 ,$120.19 ,$134.33 ,$124.43 ,$107.46 ,$14.35 ,$14.35 ,$14.35 ,$103.22 ,$77.77 ,$128.67 ,$128.67 ,$113.12 ,$43.59 ,$77.77 ,$127.26 ,$42.32 ,$127.26 ,$76.36 ,$132.92 ,$95.23 ,$130.09 ,$15.21 ,$128.67 ,$42.32 ,$87.02 ,$87.02 ,$127.26 ,$105.53 ,$98.49 ,$42.75 ,$14.35 ,$134.33 ,$44.44 ,$14.35 ,$123.02 ,$42.32 ,$127.26 ,$42.32 ,$127.26 ,$127.26 ,$127.26 ,$137.16 ,$114.53 ,$131.50 ,$121.60 ,$137.16 
SACRED HEART HOSPITAL (ACU),51070001,98960,HC EDUCATION SELF MGNT NON PHY HLTCARE PROF,510,1 ,$79.00 ,$59.25 ,$21.32 ,$79.00 ,$50.88 , N/A ,$55.30 ,$21.32 ,$79.00 ,$21.96 ,$79.00 ,$75.05 ,$21.32 ,$63.20 ,$72.68 ,$21.32 ,$67.15 ,$75.05 ,$69.52 ,$60.04 ,$21.32 ,$21.32 ,$21.32 ,$57.67 ,$43.45 ,$71.89 ,$71.89 ,$63.20 , N/A ,$43.45 ,$71.10 , N/A ,$71.10 ,$42.66 ,$74.26 , N/A ,$72.68 ,$22.60 ,$71.89 , N/A ,$48.62 ,$48.62 ,$71.10 ,$58.96 ,$55.02 , N/A ,$21.32 ,$75.05 , N/A ,$21.32 ,$68.73 , N/A ,$71.10 , N/A ,$71.10 ,$71.10 ,$71.10 ,$76.63 ,$63.99 ,$73.47 ,$67.94 ,$76.63 
SACRED HEART HOSPITAL (ACU),61000000,70543,HC MRI ORBIT/FACE/NECK W AND W/O CON,610,1 ,"$6,473.00 ","$4,854.75 ",$144.87 ,"$6,473.00 ","$4,168.61 ",$389.47 ,"$4,531.10 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$6,149.35 ",$144.87 ,"$5,178.40 ","$5,955.16 ",$144.87 ,"$5,502.05 ","$6,149.35 ","$5,696.24 ","$4,919.48 ",$144.87 ,$144.87 ,$144.87 ,"$4,725.29 ","$3,560.15 ","$5,890.43 ","$5,890.43 ","$5,178.40 ",$401.15 ,"$3,560.15 ","$5,825.70 ",$389.47 ,"$5,825.70 ","$3,495.42 ","$6,084.62 ",$876.31 ,"$5,955.16 ",$153.56 ,"$5,890.43 ",$389.47 ,"$3,983.48 ","$3,983.48 ","$2,455.46 ","$4,830.80 ","$2,143.69 ",$393.37 ,$144.87 ,"$6,149.35 ",$408.94 ,$144.87 ,"$5,631.51 ",$389.47 ,"$5,825.70 ",$389.47 ,"$5,825.70 ","$5,825.70 ","$5,825.70 ","$6,278.81 ","$5,243.13 ","$6,019.89 ","$5,566.78 ","$6,278.81 "
SACRED HEART HOSPITAL (ACU),61000001,70544,HC MRA HEAD W/O CONTRAST,610,1 ,"$3,692.00 ","$2,769.00 ",$162.10 ,"$3,692.00 ","$2,377.65 ",$243.36 ,"$2,584.40 ",$162.10 ,"$2,680.00 ",$166.96 ,"$2,143.00 ","$3,507.40 ",$162.10 ,"$2,953.60 ","$3,396.64 ",$162.10 ,"$3,138.20 ","$3,507.40 ","$3,248.96 ","$2,805.92 ",$162.10 ,$162.10 ,$162.10 ,"$2,695.16 ","$2,030.60 ","$3,359.72 ","$3,359.72 ","$2,953.60 ",$250.66 ,"$2,030.60 ","$3,322.80 ",$243.36 ,"$3,322.80 ","$1,993.68 ","$3,470.48 ",$547.56 ,"$3,396.64 ",$171.83 ,"$3,359.72 ",$243.36 ,"$2,272.06 ","$2,272.06 ","$1,122.87 ","$2,755.34 ","$2,143.69 ",$245.79 ,$162.10 ,"$3,507.40 ",$255.53 ,$162.10 ,"$3,212.04 ",$243.36 ,"$3,322.80 ",$243.36 ,"$3,322.80 ","$3,322.80 ","$3,322.80 ","$3,581.24 ","$2,990.52 ","$3,433.56 ","$3,175.12 ","$3,581.24 "
SACRED HEART HOSPITAL (ACU),61000002,70545,HC MRA HEAD W/CONTRAST,610,1 ,"$4,350.00 ","$3,262.50 ",$162.10 ,"$4,350.00 ","$2,801.40 ",$389.47 ,"$3,045.00 ",$162.10 ,"$2,680.00 ",$166.96 ,"$2,143.00 ","$4,132.50 ",$162.10 ,"$3,480.00 ","$4,002.00 ",$162.10 ,"$3,697.50 ","$4,132.50 ","$3,828.00 ","$3,306.00 ",$162.10 ,$162.10 ,$162.10 ,"$3,175.50 ","$2,392.50 ","$3,958.50 ","$3,958.50 ","$3,480.00 ",$401.15 ,"$2,392.50 ","$3,915.00 ",$389.47 ,"$3,915.00 ","$2,349.00 ","$4,089.00 ",$876.31 ,"$4,002.00 ",$171.83 ,"$3,958.50 ",$389.47 ,"$2,676.99 ","$2,676.99 ","$1,122.87 ","$3,246.41 ","$2,143.69 ",$393.37 ,$162.10 ,"$4,132.50 ",$408.94 ,$162.10 ,"$3,784.50 ",$389.47 ,"$3,915.00 ",$389.47 ,"$3,915.00 ","$3,915.00 ","$3,915.00 ","$4,219.50 ","$3,523.50 ","$4,045.50 ","$3,741.00 ","$4,219.50 "
SACRED HEART HOSPITAL (ACU),61000003,70546,HC MRA HEAD W AND W/O CONTRAST,610,1 ,"$4,562.00 ","$3,421.50 ",$162.10 ,"$4,562.00 ","$2,937.93 ",$389.47 ,"$3,193.40 ",$162.10 ,"$2,680.00 ",$166.96 ,"$2,143.00 ","$4,333.90 ",$162.10 ,"$3,649.60 ","$4,197.04 ",$162.10 ,"$3,877.70 ","$4,333.90 ","$4,014.56 ","$3,467.12 ",$162.10 ,$162.10 ,$162.10 ,"$3,330.26 ","$2,509.10 ","$4,151.42 ","$4,151.42 ","$3,649.60 ",$401.15 ,"$2,509.10 ","$4,105.80 ",$389.47 ,"$4,105.80 ","$2,463.48 ","$4,288.28 ",$876.31 ,"$4,197.04 ",$171.83 ,"$4,151.42 ",$389.47 ,"$2,807.45 ","$2,807.45 ","$2,197.45 ","$3,404.62 ","$2,143.69 ",$393.37 ,$162.10 ,"$4,333.90 ",$408.94 ,$162.10 ,"$3,968.94 ",$389.47 ,"$4,105.80 ",$389.47 ,"$4,105.80 ","$4,105.80 ","$4,105.80 ","$4,425.14 ","$3,695.22 ","$4,242.66 ","$3,923.32 ","$4,425.14 "
SACRED HEART HOSPITAL (ACU),61000005,70547,HC MRA NECK W/O CONTRAST,610,1 ,"$2,156.00 ","$1,617.00 ",$162.10 ,"$2,156.00 ","$1,388.46 ",$243.36 ,"$1,509.20 ",$162.10 ,"$2,156.00 ",$166.96 ,"$2,143.00 ","$2,048.20 ",$162.10 ,"$1,724.80 ","$1,983.52 ",$162.10 ,"$1,832.60 ","$2,048.20 ","$1,897.28 ","$1,638.56 ",$162.10 ,$162.10 ,$162.10 ,"$1,573.88 ","$1,185.80 ","$1,961.96 ","$1,961.96 ","$1,724.80 ",$250.66 ,"$1,185.80 ","$1,940.40 ",$243.36 ,"$1,940.40 ","$1,164.24 ","$2,026.64 ",$547.56 ,"$1,983.52 ",$171.83 ,"$1,961.96 ",$243.36 ,"$1,326.80 ","$1,326.80 ","$1,122.87 ","$1,609.02 ","$1,940.40 ",$245.79 ,$162.10 ,"$2,048.20 ",$255.53 ,$162.10 ,"$1,875.72 ",$243.36 ,"$1,940.40 ",$243.36 ,"$1,940.40 ","$1,940.40 ","$1,940.40 ","$2,091.32 ","$1,746.36 ","$2,005.08 ","$1,854.16 ","$2,091.32 "
SACRED HEART HOSPITAL (ACU),61000006,70548,HC MRA NECK W/CONTRAST,610,1 ,"$2,673.00 ","$2,004.75 ",$162.10 ,"$2,673.00 ","$1,721.41 ",$389.47 ,"$1,871.10 ",$162.10 ,"$2,673.00 ",$166.96 ,"$2,143.00 ","$2,539.35 ",$162.10 ,"$2,138.40 ","$2,459.16 ",$162.10 ,"$2,272.05 ","$2,539.35 ","$2,352.24 ","$2,031.48 ",$162.10 ,$162.10 ,$162.10 ,"$1,951.29 ","$1,470.15 ","$2,432.43 ","$2,432.43 ","$2,138.40 ",$401.15 ,"$1,470.15 ","$2,405.70 ",$389.47 ,"$2,405.70 ","$1,443.42 ","$2,512.62 ",$876.31 ,"$2,459.16 ",$171.83 ,"$2,432.43 ",$389.47 ,"$1,644.96 ","$1,644.96 ","$1,122.87 ","$1,994.86 ","$2,143.69 ",$393.37 ,$162.10 ,"$2,539.35 ",$408.94 ,$162.10 ,"$2,325.51 ",$389.47 ,"$2,405.70 ",$389.47 ,"$2,405.70 ","$2,405.70 ","$2,405.70 ","$2,592.81 ","$2,165.13 ","$2,485.89 ","$2,298.78 ","$2,592.81 "
SACRED HEART HOSPITAL (ACU),61000007,70549,HC MRA NECK W AND W/O CONTRAST,610,1 ,"$6,143.00 ","$4,607.25 ",$162.10 ,"$6,143.00 ","$3,956.09 ",$389.47 ,"$4,300.10 ",$162.10 ,"$2,680.00 ",$166.96 ,"$2,143.00 ","$5,835.85 ",$162.10 ,"$4,914.40 ","$5,651.56 ",$162.10 ,"$5,221.55 ","$5,835.85 ","$5,405.84 ","$4,668.68 ",$162.10 ,$162.10 ,$162.10 ,"$4,484.39 ","$3,378.65 ","$5,590.13 ","$5,590.13 ","$4,914.40 ",$401.15 ,"$3,378.65 ","$5,528.70 ",$389.47 ,"$5,528.70 ","$3,317.22 ","$5,774.42 ",$876.31 ,"$5,651.56 ",$171.83 ,"$5,590.13 ",$389.47 ,"$3,780.40 ","$3,780.40 ","$2,197.45 ","$4,584.52 ","$2,143.69 ",$393.37 ,$162.10 ,"$5,835.85 ",$408.94 ,$162.10 ,"$5,344.41 ",$389.47 ,"$5,528.70 ",$389.47 ,"$5,528.70 ","$5,528.70 ","$5,528.70 ","$5,958.71 ","$4,975.83 ","$5,712.99 ","$5,282.98 ","$5,958.71 "
SACRED HEART HOSPITAL (ACU),61000008,70551,HC MRI BRAIN W/O CONTRAST,610,1 ,"$5,157.00 ","$3,867.75 ",$82.68 ,"$5,157.00 ","$3,321.11 ",$243.36 ,"$3,609.90 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$4,899.15 ",$82.68 ,"$4,125.60 ","$4,744.44 ",$82.68 ,"$4,383.45 ","$4,899.15 ","$4,538.16 ","$3,919.32 ",$82.68 ,$82.68 ,$82.68 ,"$3,764.61 ","$2,836.35 ","$4,692.87 ","$4,692.87 ","$4,125.60 ",$250.66 ,"$2,836.35 ","$4,641.30 ",$243.36 ,"$4,641.30 ","$2,784.78 ","$4,847.58 ",$547.56 ,"$4,744.44 ",$87.64 ,"$4,692.87 ",$243.36 ,"$3,173.62 ","$3,173.62 ","$2,046.99 ","$3,848.67 ","$2,143.69 ",$245.79 ,$82.68 ,"$4,899.15 ",$255.53 ,$82.68 ,"$4,486.59 ",$243.36 ,"$4,641.30 ",$243.36 ,"$4,641.30 ","$4,641.30 ","$4,641.30 ","$5,002.29 ","$4,177.17 ","$4,796.01 ","$4,435.02 ","$5,002.29 "
SACRED HEART HOSPITAL (ACU),61000009,70552,HC MRI BRAIN W/CON,610,1 ,"$5,526.00 ","$4,144.50 ",$144.87 ,"$5,526.00 ","$3,558.74 ",$389.47 ,"$3,868.20 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$5,249.70 ",$144.87 ,"$4,420.80 ","$5,083.92 ",$144.87 ,"$4,697.10 ","$5,249.70 ","$4,862.88 ","$4,199.76 ",$144.87 ,$144.87 ,$144.87 ,"$4,033.98 ","$3,039.30 ","$5,028.66 ","$5,028.66 ","$4,420.80 ",$401.15 ,"$3,039.30 ","$4,973.40 ",$389.47 ,"$4,973.40 ","$2,984.04 ","$5,194.44 ",$876.31 ,"$5,083.92 ",$153.56 ,"$5,028.66 ",$389.47 ,"$3,400.70 ","$3,400.70 ","$2,481.72 ","$4,124.05 ","$2,143.69 ",$393.37 ,$144.87 ,"$5,249.70 ",$408.94 ,$144.87 ,"$4,807.62 ",$389.47 ,"$4,973.40 ",$389.47 ,"$4,973.40 ","$4,973.40 ","$4,973.40 ","$5,360.22 ","$4,476.06 ","$5,139.18 ","$4,752.36 ","$5,360.22 "
SACRED HEART HOSPITAL (ACU),61000010,70553,HC MRI BRAIN W AND W/O CONTRAST,610,1 ,"$5,384.00 ","$4,038.00 ",$144.87 ,"$5,384.00 ","$3,467.30 ",$389.47 ,"$3,768.80 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$5,114.80 ",$144.87 ,"$4,307.20 ","$4,953.28 ",$144.87 ,"$4,576.40 ","$5,114.80 ","$4,737.92 ","$4,091.84 ",$144.87 ,$144.87 ,$144.87 ,"$3,930.32 ","$2,961.20 ","$4,899.44 ","$4,899.44 ","$4,307.20 ",$401.15 ,"$2,961.20 ","$4,845.60 ",$389.47 ,"$4,845.60 ","$2,907.36 ","$5,060.96 ",$876.31 ,"$4,953.28 ",$153.56 ,"$4,899.44 ",$389.47 ,"$3,313.31 ","$3,313.31 ","$2,870.23 ","$4,018.08 ","$2,143.69 ",$393.37 ,$144.87 ,"$5,114.80 ",$408.94 ,$144.87 ,"$4,684.08 ",$389.47 ,"$4,845.60 ",$389.47 ,"$4,845.60 ","$4,845.60 ","$4,845.60 ","$5,222.48 ","$4,361.04 ","$5,007.12 ","$4,630.24 ","$5,222.48 "
SACRED HEART HOSPITAL (ACU),61000011,72141,HC MRI C-SPINE W/O CONTRAST,610,1 ,"$3,405.00 ","$2,553.75 ",$82.68 ,"$3,405.00 ","$2,192.82 ",$243.36 ,"$2,383.50 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$3,234.75 ",$82.68 ,"$2,724.00 ","$3,132.60 ",$82.68 ,"$2,894.25 ","$3,234.75 ","$2,996.40 ","$2,587.80 ",$82.68 ,$82.68 ,$82.68 ,"$2,485.65 ","$1,872.75 ","$3,098.55 ","$3,098.55 ","$2,724.00 ",$250.66 ,"$1,872.75 ","$3,064.50 ",$243.36 ,"$3,064.50 ","$1,838.70 ","$3,200.70 ",$547.56 ,"$3,132.60 ",$87.64 ,"$3,098.55 ",$243.36 ,"$2,095.44 ","$2,095.44 ","$2,051.16 ","$2,541.15 ","$2,143.69 ",$245.79 ,$82.68 ,"$3,234.75 ",$255.53 ,$82.68 ,"$2,962.35 ",$243.36 ,"$3,064.50 ",$243.36 ,"$3,064.50 ","$3,064.50 ","$3,064.50 ","$3,302.85 ","$2,758.05 ","$3,166.65 ","$2,928.30 ","$3,302.85 "
SACRED HEART HOSPITAL (ACU),61000012,72142,HC MRI C-SPINE W/CON,610,1 ,"$4,222.00 ","$3,166.50 ",$144.87 ,"$4,222.00 ","$2,718.97 ",$389.47 ,"$2,955.40 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,010.90 ",$144.87 ,"$3,377.60 ","$3,884.24 ",$144.87 ,"$3,588.70 ","$4,010.90 ","$3,715.36 ","$3,208.72 ",$144.87 ,$144.87 ,$144.87 ,"$3,082.06 ","$2,322.10 ","$3,842.02 ","$3,842.02 ","$3,377.60 ",$401.15 ,"$2,322.10 ","$3,799.80 ",$389.47 ,"$3,799.80 ","$2,279.88 ","$3,968.68 ",$876.31 ,"$3,884.24 ",$153.56 ,"$3,842.02 ",$389.47 ,"$2,598.22 ","$2,598.22 ","$1,882.91 ","$3,150.88 ","$2,143.69 ",$393.37 ,$144.87 ,"$4,010.90 ",$408.94 ,$144.87 ,"$3,673.14 ",$389.47 ,"$3,799.80 ",$389.47 ,"$3,799.80 ","$3,799.80 ","$3,799.80 ","$4,095.34 ","$3,419.82 ","$3,926.46 ","$3,630.92 ","$4,095.34 "
SACRED HEART HOSPITAL (ACU),61000013,72146,HC MRI T-SPINE W/O CONTRAST,610,1 ,"$4,140.00 ","$3,105.00 ",$82.68 ,"$4,140.00 ","$2,666.16 ",$243.36 ,"$2,898.00 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$3,933.00 ",$82.68 ,"$3,312.00 ","$3,808.80 ",$82.68 ,"$3,519.00 ","$3,933.00 ","$3,643.20 ","$3,146.40 ",$82.68 ,$82.68 ,$82.68 ,"$3,022.20 ","$2,277.00 ","$3,767.40 ","$3,767.40 ","$3,312.00 ",$250.66 ,"$2,277.00 ","$3,726.00 ",$243.36 ,"$3,726.00 ","$2,235.60 ","$3,891.60 ",$547.56 ,"$3,808.80 ",$87.64 ,"$3,767.40 ",$243.36 ,"$2,547.76 ","$2,547.76 ","$2,035.41 ","$3,089.68 ","$2,143.69 ",$245.79 ,$82.68 ,"$3,933.00 ",$255.53 ,$82.68 ,"$3,601.80 ",$243.36 ,"$3,726.00 ",$243.36 ,"$3,726.00 ","$3,726.00 ","$3,726.00 ","$4,015.80 ","$3,353.40 ","$3,850.20 ","$3,560.40 ","$4,015.80 "
SACRED HEART HOSPITAL (ACU),61000014,72147,HC MRI T-SPINE W/CON,610,1 ,"$4,110.00 ","$3,082.50 ",$144.87 ,"$4,110.00 ","$2,646.84 ",$389.47 ,"$2,877.00 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$3,904.50 ",$144.87 ,"$3,288.00 ","$3,781.20 ",$144.87 ,"$3,493.50 ","$3,904.50 ","$3,616.80 ","$3,123.60 ",$144.87 ,$144.87 ,$144.87 ,"$3,000.30 ","$2,260.50 ","$3,740.10 ","$3,740.10 ","$3,288.00 ",$401.15 ,"$2,260.50 ","$3,699.00 ",$389.47 ,"$3,699.00 ","$2,219.40 ","$3,863.40 ",$876.31 ,"$3,781.20 ",$153.56 ,"$3,740.10 ",$389.47 ,"$2,529.29 ","$2,529.29 ","$1,882.91 ","$3,067.29 ","$2,143.69 ",$393.37 ,$144.87 ,"$3,904.50 ",$408.94 ,$144.87 ,"$3,575.70 ",$389.47 ,"$3,699.00 ",$389.47 ,"$3,699.00 ","$3,699.00 ","$3,699.00 ","$3,986.70 ","$3,329.10 ","$3,822.30 ","$3,534.60 ","$3,986.70 "
SACRED HEART HOSPITAL (ACU),61000016,72148,HC MRI L-SPINE W/O CONTRAST,610,1 ,"$3,151.00 ","$2,363.25 ",$82.68 ,"$3,151.00 ","$2,029.24 ",$243.36 ,"$2,205.70 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$2,993.45 ",$82.68 ,"$2,520.80 ","$2,898.92 ",$82.68 ,"$2,678.35 ","$2,993.45 ","$2,772.88 ","$2,394.76 ",$82.68 ,$82.68 ,$82.68 ,"$2,300.23 ","$1,733.05 ","$2,867.41 ","$2,867.41 ","$2,520.80 ",$250.66 ,"$1,733.05 ","$2,835.90 ",$243.36 ,"$2,835.90 ","$1,701.54 ","$2,961.94 ",$547.56 ,"$2,898.92 ",$87.64 ,"$2,867.41 ",$243.36 ,"$1,939.13 ","$1,939.13 ","$2,061.43 ","$2,351.59 ","$2,143.69 ",$245.79 ,$82.68 ,"$2,993.45 ",$255.53 ,$82.68 ,"$2,741.37 ",$243.36 ,"$2,835.90 ",$243.36 ,"$2,835.90 ","$2,835.90 ","$2,835.90 ","$3,056.47 ","$2,552.31 ","$2,930.43 ","$2,709.86 ","$3,056.47 "
SACRED HEART HOSPITAL (ACU),61000017,72149,HC MRI L-SPINE W/CON,610,1 ,"$3,987.00 ","$2,990.25 ",$144.87 ,"$3,987.00 ","$2,567.63 ",$389.47 ,"$2,790.90 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$3,787.65 ",$144.87 ,"$3,189.60 ","$3,668.04 ",$144.87 ,"$3,388.95 ","$3,787.65 ","$3,508.56 ","$3,030.12 ",$144.87 ,$144.87 ,$144.87 ,"$2,910.51 ","$2,192.85 ","$3,628.17 ","$3,628.17 ","$3,189.60 ",$401.15 ,"$2,192.85 ","$3,588.30 ",$389.47 ,"$3,588.30 ","$2,152.98 ","$3,747.78 ",$876.31 ,"$3,668.04 ",$153.56 ,"$3,628.17 ",$389.47 ,"$2,453.60 ","$2,453.60 ","$2,428.60 ","$2,975.50 ","$2,143.69 ",$393.37 ,$144.87 ,"$3,787.65 ",$408.94 ,$144.87 ,"$3,468.69 ",$389.47 ,"$3,588.30 ",$389.47 ,"$3,588.30 ","$3,588.30 ","$3,588.30 ","$3,867.39 ","$3,229.47 ","$3,707.91 ","$3,428.82 ","$3,867.39 "
SACRED HEART HOSPITAL (ACU),61000018,72156,HC MRI C-SPINE W AND W/O CON,610,1 ,"$5,411.00 ","$4,058.25 ",$144.87 ,"$5,411.00 ","$3,484.68 ",$389.47 ,"$3,787.70 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$5,140.45 ",$144.87 ,"$4,328.80 ","$4,978.12 ",$144.87 ,"$4,599.35 ","$5,140.45 ","$4,761.68 ","$4,112.36 ",$144.87 ,$144.87 ,$144.87 ,"$3,950.03 ","$2,976.05 ","$4,924.01 ","$4,924.01 ","$4,328.80 ",$401.15 ,"$2,976.05 ","$4,869.90 ",$389.47 ,"$4,869.90 ","$2,921.94 ","$5,086.34 ",$876.31 ,"$4,978.12 ",$153.56 ,"$4,924.01 ",$389.47 ,"$3,329.93 ","$3,329.93 ","$2,581.91 ","$4,038.23 ","$2,143.69 ",$393.37 ,$144.87 ,"$5,140.45 ",$408.94 ,$144.87 ,"$4,707.57 ",$389.47 ,"$4,869.90 ",$389.47 ,"$4,869.90 ","$4,869.90 ","$4,869.90 ","$5,248.67 ","$4,382.91 ","$5,032.23 ","$4,653.46 ","$5,248.67 "
SACRED HEART HOSPITAL (ACU),61000019,72157,HC MRI T-SPINE W AND W/O CON,610,1 ,"$4,450.00 ","$3,337.50 ",$144.87 ,"$4,450.00 ","$2,865.80 ",$389.47 ,"$3,115.00 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,227.50 ",$144.87 ,"$3,560.00 ","$4,094.00 ",$144.87 ,"$3,782.50 ","$4,227.50 ","$3,916.00 ","$3,382.00 ",$144.87 ,$144.87 ,$144.87 ,"$3,248.50 ","$2,447.50 ","$4,049.50 ","$4,049.50 ","$3,560.00 ",$401.15 ,"$2,447.50 ","$4,005.00 ",$389.47 ,"$4,005.00 ","$2,403.00 ","$4,183.00 ",$876.31 ,"$4,094.00 ",$153.56 ,"$4,049.50 ",$389.47 ,"$2,738.53 ","$2,738.53 ","$2,581.91 ","$3,321.04 ","$2,143.69 ",$393.37 ,$144.87 ,"$4,227.50 ",$408.94 ,$144.87 ,"$3,871.50 ",$389.47 ,"$4,005.00 ",$389.47 ,"$4,005.00 ","$4,005.00 ","$4,005.00 ","$4,316.50 ","$3,604.50 ","$4,138.50 ","$3,827.00 ","$4,316.50 "
SACRED HEART HOSPITAL (ACU),61000020,72158,HC MRI L-SPINE W AND W/O CON,610,1 ,"$5,879.00 ","$4,409.25 ",$144.87 ,"$5,879.00 ","$3,786.08 ",$389.47 ,"$4,115.30 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$5,585.05 ",$144.87 ,"$4,703.20 ","$5,408.68 ",$144.87 ,"$4,997.15 ","$5,585.05 ","$5,173.52 ","$4,468.04 ",$144.87 ,$144.87 ,$144.87 ,"$4,291.67 ","$3,233.45 ","$5,349.89 ","$5,349.89 ","$4,703.20 ",$401.15 ,"$3,233.45 ","$5,291.10 ",$389.47 ,"$5,291.10 ","$3,174.66 ","$5,526.26 ",$876.31 ,"$5,408.68 ",$153.56 ,"$5,349.89 ",$389.47 ,"$3,617.94 ","$3,617.94 ","$2,608.80 ","$4,387.50 ","$2,143.69 ",$393.37 ,$144.87 ,"$5,585.05 ",$408.94 ,$144.87 ,"$5,114.73 ",$389.47 ,"$5,291.10 ",$389.47 ,"$5,291.10 ","$5,291.10 ","$5,291.10 ","$5,702.63 ","$4,761.99 ","$5,467.47 ","$5,055.94 ","$5,702.63 "
SACRED HEART HOSPITAL (ACU),61000021,72195,HC MRI PELVIS W/O CON,610,1 ,"$3,307.00 ","$2,480.25 ",$82.68 ,"$3,307.00 ","$2,129.71 ",$243.36 ,"$2,314.90 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$3,141.65 ",$82.68 ,"$2,645.60 ","$3,042.44 ",$82.68 ,"$2,810.95 ","$3,141.65 ","$2,910.16 ","$2,513.32 ",$82.68 ,$82.68 ,$82.68 ,"$2,414.11 ","$1,818.85 ","$3,009.37 ","$3,009.37 ","$2,645.60 ",$250.66 ,"$1,818.85 ","$2,976.30 ",$243.36 ,"$2,976.30 ","$1,785.78 ","$3,108.58 ",$547.56 ,"$3,042.44 ",$87.64 ,"$3,009.37 ",$243.36 ,"$2,035.13 ","$2,035.13 ","$1,111.27 ","$2,468.01 ","$2,143.69 ",$245.79 ,$82.68 ,"$3,141.65 ",$255.53 ,$82.68 ,"$2,877.09 ",$243.36 ,"$2,976.30 ",$243.36 ,"$2,976.30 ","$2,976.30 ","$2,976.30 ","$3,207.79 ","$2,678.67 ","$3,075.51 ","$2,844.02 ","$3,207.79 "
SACRED HEART HOSPITAL (ACU),61000022,72196,HC MRI PELVIS W/CON,610,1 ,"$3,468.00 ","$2,601.00 ",$144.87 ,"$3,468.00 ","$2,233.39 ",$389.47 ,"$2,427.60 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$3,294.60 ",$144.87 ,"$2,774.40 ","$3,190.56 ",$144.87 ,"$2,947.80 ","$3,294.60 ","$3,051.84 ","$2,635.68 ",$144.87 ,$144.87 ,$144.87 ,"$2,531.64 ","$1,907.40 ","$3,155.88 ","$3,155.88 ","$2,774.40 ",$401.15 ,"$1,907.40 ","$3,121.20 ",$389.47 ,"$3,121.20 ","$1,872.72 ","$3,259.92 ",$876.31 ,"$3,190.56 ",$153.56 ,"$3,155.88 ",$389.47 ,"$2,134.21 ","$2,134.21 ","$1,928.34 ","$2,588.17 ","$2,143.69 ",$393.37 ,$144.87 ,"$3,294.60 ",$408.94 ,$144.87 ,"$3,017.16 ",$389.47 ,"$3,121.20 ",$389.47 ,"$3,121.20 ","$3,121.20 ","$3,121.20 ","$3,363.96 ","$2,809.08 ","$3,225.24 ","$2,982.48 ","$3,363.96 "
SACRED HEART HOSPITAL (ACU),61000023,72197,HC MRI PELVIS W AND W/O CON,610,1 ,"$4,555.00 ","$3,416.25 ",$144.87 ,"$4,555.00 ","$2,933.42 ",$389.47 ,"$3,188.50 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,327.25 ",$144.87 ,"$3,644.00 ","$4,190.60 ",$144.87 ,"$3,871.75 ","$4,327.25 ","$4,008.40 ","$3,461.80 ",$144.87 ,$144.87 ,$144.87 ,"$3,325.15 ","$2,505.25 ","$4,145.05 ","$4,145.05 ","$3,644.00 ",$401.15 ,"$2,505.25 ","$4,099.50 ",$389.47 ,"$4,099.50 ","$2,459.70 ","$4,281.70 ",$876.31 ,"$4,190.60 ",$153.56 ,"$4,145.05 ",$389.47 ,"$2,803.15 ","$2,803.15 ","$2,461.24 ","$3,399.40 ","$2,143.69 ",$393.37 ,$144.87 ,"$4,327.25 ",$408.94 ,$144.87 ,"$3,962.85 ",$389.47 ,"$4,099.50 ",$389.47 ,"$4,099.50 ","$4,099.50 ","$4,099.50 ","$4,418.35 ","$3,689.55 ","$4,236.15 ","$3,917.30 ","$4,418.35 "
SACRED HEART HOSPITAL (ACU),61000024,73218,HC MRI UPPR EXT NONJOINT W/O CONTRAST,610,1 ,"$1,593.00 ","$1,194.75 ",$82.68 ,"$1,593.00 ","$1,025.89 ",$243.36 ,"$1,115.10 ",$82.68 ,"$1,593.00 ",$85.16 ,"$1,593.00 ","$1,513.35 ",$82.68 ,"$1,274.40 ","$1,465.56 ",$82.68 ,"$1,354.05 ","$1,513.35 ","$1,401.84 ","$1,210.68 ",$82.68 ,$82.68 ,$82.68 ,"$1,162.89 ",$876.15 ,"$1,449.63 ","$1,449.63 ","$1,274.40 ",$250.66 ,$876.15 ,"$1,433.70 ",$243.36 ,"$1,433.70 ",$860.22 ,"$1,497.42 ",$547.56 ,"$1,465.56 ",$87.64 ,"$1,449.63 ",$243.36 ,$980.33 ,$980.33 ,"$1,106.47 ","$1,188.86 ","$1,433.70 ",$245.79 ,$82.68 ,"$1,513.35 ",$255.53 ,$82.68 ,"$1,385.91 ",$243.36 ,"$1,433.70 ",$243.36 ,"$1,433.70 ","$1,433.70 ","$1,433.70 ","$1,545.21 ","$1,290.33 ","$1,481.49 ","$1,369.98 ","$1,545.21 "
SACRED HEART HOSPITAL (ACU),61000025,73219,HC MRI UPPR EXT NONJOINT W/CONTRAST,610,1 ,"$2,694.00 ","$2,020.50 ",$144.87 ,"$2,694.00 ","$1,734.94 ",$389.47 ,"$1,885.80 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$2,559.30 ",$144.87 ,"$2,155.20 ","$2,478.48 ",$144.87 ,"$2,289.90 ","$2,559.30 ","$2,370.72 ","$2,047.44 ",$144.87 ,$144.87 ,$144.87 ,"$1,966.62 ","$1,481.70 ","$2,451.54 ","$2,451.54 ","$2,155.20 ",$401.15 ,"$1,481.70 ","$2,424.60 ",$389.47 ,"$2,424.60 ","$1,454.76 ","$2,532.36 ",$876.31 ,"$2,478.48 ",$153.56 ,"$2,451.54 ",$389.47 ,"$1,657.89 ","$1,657.89 ","$1,326.78 ","$2,010.53 ","$2,143.69 ",$393.37 ,$144.87 ,"$2,559.30 ",$408.94 ,$144.87 ,"$2,343.78 ",$389.47 ,"$2,424.60 ",$389.47 ,"$2,424.60 ","$2,424.60 ","$2,424.60 ","$2,613.18 ","$2,182.14 ","$2,505.42 ","$2,316.84 ","$2,613.18 "
SACRED HEART HOSPITAL (ACU),61000026,73220,HC MRI UPPR EXT NONJOINT W AND W/O CONTRAST,610,1 ,"$3,010.00 ","$2,257.50 ",$144.87 ,"$3,010.00 ","$1,938.44 ",$389.47 ,"$2,107.00 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$2,859.50 ",$144.87 ,"$2,408.00 ","$2,769.20 ",$144.87 ,"$2,558.50 ","$2,859.50 ","$2,648.80 ","$2,287.60 ",$144.87 ,$144.87 ,$144.87 ,"$2,197.30 ","$1,655.50 ","$2,739.10 ","$2,739.10 ","$2,408.00 ",$401.15 ,"$1,655.50 ","$2,709.00 ",$389.47 ,"$2,709.00 ","$1,625.40 ","$2,829.40 ",$876.31 ,"$2,769.20 ",$153.56 ,"$2,739.10 ",$389.47 ,"$1,852.35 ","$1,852.35 ","$2,042.44 ","$2,246.36 ","$2,143.69 ",$393.37 ,$144.87 ,"$2,859.50 ",$408.94 ,$144.87 ,"$2,618.70 ",$389.47 ,"$2,709.00 ",$389.47 ,"$2,709.00 ","$2,709.00 ","$2,709.00 ","$2,919.70 ","$2,438.10 ","$2,799.30 ","$2,588.60 ","$2,919.70 "
SACRED HEART HOSPITAL (ACU),61000027,73221,HC MRI UPPR EXT JOINT W/O CONTRAST,610,1 ,"$3,151.00 ","$2,363.25 ",$82.68 ,"$3,151.00 ","$2,029.24 ",$243.36 ,"$2,205.70 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$2,993.45 ",$82.68 ,"$2,520.80 ","$2,898.92 ",$82.68 ,"$2,678.35 ","$2,993.45 ","$2,772.88 ","$2,394.76 ",$82.68 ,$82.68 ,$82.68 ,"$2,300.23 ","$1,733.05 ","$2,867.41 ","$2,867.41 ","$2,520.80 ",$250.66 ,"$1,733.05 ","$2,835.90 ",$243.36 ,"$2,835.90 ","$1,701.54 ","$2,961.94 ",$547.56 ,"$2,898.92 ",$87.64 ,"$2,867.41 ",$243.36 ,"$1,939.13 ","$1,939.13 ","$2,083.82 ","$2,351.59 ","$2,143.69 ",$245.79 ,$82.68 ,"$2,993.45 ",$255.53 ,$82.68 ,"$2,741.37 ",$243.36 ,"$2,835.90 ",$243.36 ,"$2,835.90 ","$2,835.90 ","$2,835.90 ","$3,056.47 ","$2,552.31 ","$2,930.43 ","$2,709.86 ","$3,056.47 "
SACRED HEART HOSPITAL (ACU),61000028,73222,HC MRI UPPR EXT JOINT W/CONTRAST,610,1 ,"$4,380.00 ","$3,285.00 ",$144.87 ,"$4,380.00 ","$2,820.72 ",$756.67 ,"$3,066.00 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,161.00 ",$144.87 ,"$3,504.00 ","$4,029.60 ",$144.87 ,"$3,723.00 ","$4,161.00 ","$3,854.40 ","$3,328.80 ",$144.87 ,$144.87 ,$144.87 ,"$3,197.40 ","$2,409.00 ","$3,985.80 ","$3,985.80 ","$3,504.00 ",$779.37 ,"$2,409.00 ","$3,942.00 ",$756.67 ,"$3,942.00 ","$2,365.20 ","$4,117.20 ","$1,702.50 ","$4,029.60 ",$153.56 ,"$3,985.80 ",$756.67 ,"$2,695.45 ","$2,695.45 ","$1,326.78 ","$3,268.79 ","$2,143.69 ",$764.23 ,$144.87 ,"$4,161.00 ",$794.50 ,$144.87 ,"$3,810.60 ",$756.67 ,"$3,942.00 ",$756.67 ,"$3,942.00 ","$3,942.00 ","$3,942.00 ","$4,248.60 ","$3,547.80 ","$4,073.40 ","$3,766.80 ","$4,248.60 "
SACRED HEART HOSPITAL (ACU),61000029,73223,HC MRI UPPR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,686.00 ","$3,514.50 ",$144.87 ,"$4,686.00 ","$3,017.78 ",$389.47 ,"$3,280.20 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,451.70 ",$144.87 ,"$3,748.80 ","$4,311.12 ",$144.87 ,"$3,983.10 ","$4,451.70 ","$4,123.68 ","$3,561.36 ",$144.87 ,$144.87 ,$144.87 ,"$3,420.78 ","$2,577.30 ","$4,264.26 ","$4,264.26 ","$3,748.80 ",$401.15 ,"$2,577.30 ","$4,217.40 ",$389.47 ,"$4,217.40 ","$2,530.44 ","$4,404.84 ",$876.31 ,"$4,311.12 ",$153.56 ,"$4,264.26 ",$389.47 ,"$2,883.76 ","$2,883.76 ","$2,455.46 ","$3,497.16 ","$2,143.69 ",$393.37 ,$144.87 ,"$4,451.70 ",$408.94 ,$144.87 ,"$4,076.82 ",$389.47 ,"$4,217.40 ",$389.47 ,"$4,217.40 ","$4,217.40 ","$4,217.40 ","$4,545.42 ","$3,795.66 ","$4,357.98 ","$4,029.96 ","$4,545.42 "
SACRED HEART HOSPITAL (ACU),61000030,73718,HC MRI LE NONJOINT WO CONTRAST,610,1 ,"$2,579.00 ","$1,934.25 ",$82.68 ,"$2,579.00 ","$1,660.88 ",$243.36 ,"$1,805.30 ",$82.68 ,"$2,579.00 ",$85.16 ,"$2,143.00 ","$2,450.05 ",$82.68 ,"$2,063.20 ","$2,372.68 ",$82.68 ,"$2,192.15 ","$2,450.05 ","$2,269.52 ","$1,960.04 ",$82.68 ,$82.68 ,$82.68 ,"$1,882.67 ","$1,418.45 ","$2,346.89 ","$2,346.89 ","$2,063.20 ",$250.66 ,"$1,418.45 ","$2,321.10 ",$243.36 ,"$2,321.10 ","$1,392.66 ","$2,424.26 ",$547.56 ,"$2,372.68 ",$87.64 ,"$2,346.89 ",$243.36 ,"$1,587.12 ","$1,587.12 ","$1,106.47 ","$1,924.71 ","$2,143.69 ",$245.79 ,$82.68 ,"$2,450.05 ",$255.53 ,$82.68 ,"$2,243.73 ",$243.36 ,"$2,321.10 ",$243.36 ,"$2,321.10 ","$2,321.10 ","$2,321.10 ","$2,501.63 ","$2,088.99 ","$2,398.47 ","$2,217.94 ","$2,501.63 "
SACRED HEART HOSPITAL (ACU),61000032,73719,HC MRI LE NONJOINT W/ CONTRAST,610,1 ,"$3,692.00 ","$2,769.00 ",$144.87 ,"$3,692.00 ","$2,377.65 ",$389.47 ,"$2,584.40 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$3,507.40 ",$144.87 ,"$2,953.60 ","$3,396.64 ",$144.87 ,"$3,138.20 ","$3,507.40 ","$3,248.96 ","$2,805.92 ",$144.87 ,$144.87 ,$144.87 ,"$2,695.16 ","$2,030.60 ","$3,359.72 ","$3,359.72 ","$2,953.60 ",$401.15 ,"$2,030.60 ","$3,322.80 ",$389.47 ,"$3,322.80 ","$1,993.68 ","$3,470.48 ",$876.31 ,"$3,396.64 ",$153.56 ,"$3,359.72 ",$389.47 ,"$2,272.06 ","$2,272.06 ","$1,326.78 ","$2,755.34 ","$2,143.69 ",$393.37 ,$144.87 ,"$3,507.40 ",$408.94 ,$144.87 ,"$3,212.04 ",$389.47 ,"$3,322.80 ",$389.47 ,"$3,322.80 ","$3,322.80 ","$3,322.80 ","$3,581.24 ","$2,990.52 ","$3,433.56 ","$3,175.12 ","$3,581.24 "
SACRED HEART HOSPITAL (ACU),61000033,73720,HC MRI LE NONJOINT W/WO CONTRAST,610,1 ,"$3,989.00 ","$2,991.75 ",$144.87 ,"$3,989.00 ","$2,568.92 ",$389.47 ,"$2,792.30 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$3,789.55 ",$144.87 ,"$3,191.20 ","$3,669.88 ",$144.87 ,"$3,390.65 ","$3,789.55 ","$3,510.32 ","$3,031.64 ",$144.87 ,$144.87 ,$144.87 ,"$2,911.97 ","$2,193.95 ","$3,629.99 ","$3,629.99 ","$3,191.20 ",$401.15 ,"$2,193.95 ","$3,590.10 ",$389.47 ,"$3,590.10 ","$2,154.06 ","$3,749.66 ",$876.31 ,"$3,669.88 ",$153.56 ,"$3,629.99 ",$389.47 ,"$2,454.83 ","$2,454.83 ","$2,042.44 ","$2,976.99 ","$2,143.69 ",$393.37 ,$144.87 ,"$3,789.55 ",$408.94 ,$144.87 ,"$3,470.43 ",$389.47 ,"$3,590.10 ",$389.47 ,"$3,590.10 ","$3,590.10 ","$3,590.10 ","$3,869.33 ","$3,231.09 ","$3,709.77 ","$3,430.54 ","$3,869.33 "
SACRED HEART HOSPITAL (ACU),61000034,73721,HC MRI LWR EXT JOINT W/O CONTRAST,610,1 ,"$4,250.00 ","$3,187.50 ",$82.68 ,"$4,250.00 ","$2,737.00 ",$243.36 ,"$2,975.00 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$4,037.50 ",$82.68 ,"$3,400.00 ","$3,910.00 ",$82.68 ,"$3,612.50 ","$4,037.50 ","$3,740.00 ","$3,230.00 ",$82.68 ,$82.68 ,$82.68 ,"$3,102.50 ","$2,337.50 ","$3,867.50 ","$3,867.50 ","$3,400.00 ",$250.66 ,"$2,337.50 ","$3,825.00 ",$243.36 ,"$3,825.00 ","$2,295.00 ","$3,995.00 ",$547.56 ,"$3,910.00 ",$87.64 ,"$3,867.50 ",$243.36 ,"$2,615.45 ","$2,615.45 ","$2,083.82 ","$3,171.78 ","$2,143.69 ",$245.79 ,$82.68 ,"$4,037.50 ",$255.53 ,$82.68 ,"$3,697.50 ",$243.36 ,"$3,825.00 ",$243.36 ,"$3,825.00 ","$3,825.00 ","$3,825.00 ","$4,122.50 ","$3,442.50 ","$3,952.50 ","$3,655.00 ","$4,122.50 "
SACRED HEART HOSPITAL (ACU),61000035,73722,HC MRI LWR EXT JOINT W/CONTRAST,610,1 ,"$4,273.00 ","$3,204.75 ",$144.87 ,"$4,273.00 ","$2,751.81 ",$756.67 ,"$2,991.10 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,059.35 ",$144.87 ,"$3,418.40 ","$3,931.16 ",$144.87 ,"$3,632.05 ","$4,059.35 ","$3,760.24 ","$3,247.48 ",$144.87 ,$144.87 ,$144.87 ,"$3,119.29 ","$2,350.15 ","$3,888.43 ","$3,888.43 ","$3,418.40 ",$779.37 ,"$2,350.15 ","$3,845.70 ",$756.67 ,"$3,845.70 ","$2,307.42 ","$4,016.62 ","$1,702.50 ","$3,931.16 ",$153.56 ,"$3,888.43 ",$756.67 ,"$2,629.60 ","$2,629.60 ","$1,326.78 ","$3,188.94 ","$2,143.69 ",$764.23 ,$144.87 ,"$4,059.35 ",$794.50 ,$144.87 ,"$3,717.51 ",$756.67 ,"$3,845.70 ",$756.67 ,"$3,845.70 ","$3,845.70 ","$3,845.70 ","$4,144.81 ","$3,461.13 ","$3,973.89 ","$3,674.78 ","$4,144.81 "
SACRED HEART HOSPITAL (ACU),61000036,73723,HC MRI LWR EXT JOINT W AND W/O CONTRAST,610,1 ,"$4,893.00 ","$3,669.75 ",$144.87 ,"$4,893.00 ","$3,151.09 ",$389.47 ,"$3,425.10 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,648.35 ",$144.87 ,"$3,914.40 ","$4,501.56 ",$144.87 ,"$4,159.05 ","$4,648.35 ","$4,305.84 ","$3,718.68 ",$144.87 ,$144.87 ,$144.87 ,"$3,571.89 ","$2,691.15 ","$4,452.63 ","$4,452.63 ","$3,914.40 ",$401.15 ,"$2,691.15 ","$4,403.70 ",$389.47 ,"$4,403.70 ","$2,642.22 ","$4,599.42 ",$876.31 ,"$4,501.56 ",$153.56 ,"$4,452.63 ",$389.47 ,"$3,011.15 ","$3,011.15 ","$2,455.46 ","$3,651.65 ","$2,143.69 ",$393.37 ,$144.87 ,"$4,648.35 ",$408.94 ,$144.87 ,"$4,256.91 ",$389.47 ,"$4,403.70 ",$389.47 ,"$4,403.70 ","$4,403.70 ","$4,403.70 ","$4,746.21 ","$3,963.33 ","$4,550.49 ","$4,207.98 ","$4,746.21 "
SACRED HEART HOSPITAL (ACU),61000038,74181,HC MRI ABDOMEN W/O CON,610,1 ,"$3,481.00 ","$2,610.75 ",$82.68 ,"$3,481.00 ","$2,241.76 ",$243.36 ,"$2,436.70 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$3,306.95 ",$82.68 ,"$2,784.80 ","$3,202.52 ",$82.68 ,"$2,958.85 ","$3,306.95 ","$3,063.28 ","$2,645.56 ",$82.68 ,$82.68 ,$82.68 ,"$2,541.13 ","$1,914.55 ","$3,167.71 ","$3,167.71 ","$2,784.80 ",$250.66 ,"$1,914.55 ","$3,132.90 ",$243.36 ,"$3,132.90 ","$1,879.74 ","$3,272.14 ",$547.56 ,"$3,202.52 ",$87.64 ,"$3,167.71 ",$243.36 ,"$2,142.21 ","$2,142.21 ","$2,014.28 ","$2,597.87 ","$2,143.69 ",$245.79 ,$82.68 ,"$3,306.95 ",$255.53 ,$82.68 ,"$3,028.47 ",$243.36 ,"$3,132.90 ",$243.36 ,"$3,132.90 ","$3,132.90 ","$3,132.90 ","$3,376.57 ","$2,819.61 ","$3,237.33 ","$2,993.66 ","$3,376.57 "
SACRED HEART HOSPITAL (ACU),61000039,74182,HC MRI ABDOMEN W/CON,610,1 ,"$3,944.00 ","$2,958.00 ",$144.87 ,"$3,944.00 ","$2,539.94 ",$389.47 ,"$2,760.80 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$3,746.80 ",$144.87 ,"$3,155.20 ","$3,628.48 ",$144.87 ,"$3,352.40 ","$3,746.80 ","$3,470.72 ","$2,997.44 ",$144.87 ,$144.87 ,$144.87 ,"$2,879.12 ","$2,169.20 ","$3,589.04 ","$3,589.04 ","$3,155.20 ",$401.15 ,"$2,169.20 ","$3,549.60 ",$389.47 ,"$3,549.60 ","$2,129.76 ","$3,707.36 ",$876.31 ,"$3,628.48 ",$153.56 ,"$3,589.04 ",$389.47 ,"$2,427.14 ","$2,427.14 ","$1,330.66 ","$2,943.41 ","$2,143.69 ",$393.37 ,$144.87 ,"$3,746.80 ",$408.94 ,$144.87 ,"$3,431.28 ",$389.47 ,"$3,549.60 ",$389.47 ,"$3,549.60 ","$3,549.60 ","$3,549.60 ","$3,825.68 ","$3,194.64 ","$3,667.92 ","$3,391.84 ","$3,825.68 "
SACRED HEART HOSPITAL (ACU),61000040,74183,HC MRI ABDOMEN W AND W/O CON,610,1 ,"$4,661.00 ","$3,495.75 ",$144.87 ,"$4,661.00 ","$3,001.68 ",$389.47 ,"$3,262.70 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$4,427.95 ",$144.87 ,"$3,728.80 ","$4,288.12 ",$144.87 ,"$3,961.85 ","$4,427.95 ","$4,101.68 ","$3,542.36 ",$144.87 ,$144.87 ,$144.87 ,"$3,402.53 ","$2,563.55 ","$4,241.51 ","$4,241.51 ","$3,728.80 ",$401.15 ,"$2,563.55 ","$4,194.90 ",$389.47 ,"$4,194.90 ","$2,516.94 ","$4,381.34 ",$876.31 ,"$4,288.12 ",$153.56 ,"$4,241.51 ",$389.47 ,"$2,868.38 ","$2,868.38 ","$2,461.24 ","$3,478.50 ","$2,143.69 ",$393.37 ,$144.87 ,"$4,427.95 ",$408.94 ,$144.87 ,"$4,055.07 ",$389.47 ,"$4,194.90 ",$389.47 ,"$4,194.90 ","$4,194.90 ","$4,194.90 ","$4,521.17 ","$3,775.41 ","$4,334.73 ","$4,008.46 ","$4,521.17 "
SACRED HEART HOSPITAL (ACU),61000041,75557,HC MRI CARDIAC W/O CON,610,1 ,"$1,154.00 ",$865.50 ,$82.68 ,"$1,154.00 ",$743.18 ,$243.36 ,$807.80 ,$82.68 ,"$1,154.00 ",$85.16 ,"$1,154.00 ","$1,096.30 ",$82.68 ,$923.20 ,"$1,061.68 ",$82.68 ,$980.90 ,"$1,096.30 ","$1,015.52 ",$877.04 ,$82.68 ,$82.68 ,$82.68 ,$842.42 ,$634.70 ,"$1,050.14 ","$1,050.14 ",$923.20 ,$250.66 ,$634.70 ,"$1,038.60 ",$243.36 ,"$1,038.60 ",$623.16 ,"$1,084.76 ",$547.56 ,"$1,061.68 ",$87.64 ,"$1,050.14 ",$243.36 ,$710.17 ,$710.17 ,$801.63 ,$861.23 ,"$1,038.60 ",$245.79 ,$82.68 ,"$1,096.30 ",$255.53 ,$82.68 ,"$1,003.98 ",$243.36 ,"$1,038.60 ",$243.36 ,"$1,038.60 ","$1,038.60 ","$1,038.60 ","$1,119.38 ",$934.74 ,"$1,073.22 ",$992.44 ,"$1,119.38 "
SACRED HEART HOSPITAL (ACU),61000042,75561,HC MRI CARD W/O AND W CON,610,1 ,"$2,367.00 ","$1,775.25 ",$144.87 ,"$2,367.00 ","$1,524.35 ",$389.47 ,"$1,656.90 ",$144.87 ,"$2,367.00 ",$149.22 ,"$2,143.00 ","$2,248.65 ",$144.87 ,"$1,893.60 ","$2,177.64 ",$144.87 ,"$2,011.95 ","$2,248.65 ","$2,082.96 ","$1,798.92 ",$144.87 ,$144.87 ,$144.87 ,"$1,727.91 ","$1,301.85 ","$2,153.97 ","$2,153.97 ","$1,893.60 ",$401.15 ,"$1,301.85 ","$2,130.30 ",$389.47 ,"$2,130.30 ","$1,278.18 ","$2,224.98 ",$876.31 ,"$2,177.64 ",$153.56 ,"$2,153.97 ",$389.47 ,"$1,456.65 ","$1,456.65 ","$1,138.02 ","$1,766.49 ","$2,130.30 ",$393.37 ,$144.87 ,"$2,248.65 ",$408.94 ,$144.87 ,"$2,059.29 ",$389.47 ,"$2,130.30 ",$389.47 ,"$2,130.30 ","$2,130.30 ","$2,130.30 ","$2,295.99 ","$1,917.27 ","$2,201.31 ","$2,035.62 ","$2,295.99 "
SACRED HEART HOSPITAL (ACU),61000043,76390,HC MRI SPECTROSCOPY,610,1 ,"$1,218.00 ",$913.50 ,$82.68 ,"$1,218.00 ",$784.39 ,$85.55 ,$852.60 ,$82.68 ,"$1,218.00 ",$85.16 ,"$1,218.00 ","$1,157.10 ",$82.68 ,$974.40 ,"$1,120.56 ",$82.68 ,"$1,035.30 ","$1,157.10 ","$1,071.84 ",$925.68 ,$82.68 ,$82.68 ,$82.68 ,$889.14 ,$669.90 ,"$1,108.38 ","$1,108.38 ",$974.40 ,$88.12 ,$669.90 ,"$1,096.20 ",$85.55 ,"$1,096.20 ",$657.72 ,"$1,144.92 ",$192.49 ,"$1,120.56 ",$87.64 ,"$1,108.38 ",$85.55 ,$749.56 ,$749.56 ,"$1,218.00 ",$908.99 ,"$1,096.20 ",$86.40 ,$82.68 ,"$1,157.10 ",$89.83 ,$82.68 ,"$1,059.66 ",$85.55 ,"$1,096.20 ",$85.55 ,"$1,096.20 ","$1,096.20 ","$1,096.20 ","$1,181.46 ",$986.58 ,"$1,132.74 ","$1,047.48 ","$1,181.46 "
SACRED HEART HOSPITAL (ACU),61000051,C8900,HC MRA ABDOMEN W/CONTRAST,610,1 ,"$1,914.00 ","$1,435.50 ",$162.10 ,"$1,914.00 ","$1,232.62 ",$389.47 ,"$1,339.80 ",$162.10 ,"$1,914.00 ",$166.96 ,"$1,914.00 ","$1,818.30 ",$162.10 ,"$1,531.20 ","$1,760.88 ",$162.10 ,"$1,626.90 ","$1,818.30 ","$1,684.32 ","$1,454.64 ",$162.10 ,$162.10 ,$162.10 ,"$1,397.22 ","$1,052.70 ","$1,741.74 ","$1,741.74 ","$1,531.20 ",$401.15 ,"$1,052.70 ","$1,722.60 ",$389.47 ,"$1,722.60 ","$1,033.56 ","$1,799.16 ",$876.31 ,"$1,760.88 ",$171.83 ,"$1,741.74 ",$389.47 ,"$1,177.88 ","$1,177.88 ","$1,722.60 ","$1,428.42 ","$1,722.60 ",$393.37 ,$162.10 ,"$1,818.30 ",$408.94 ,$162.10 ,"$1,665.18 ",$389.47 ,"$1,722.60 ",$389.47 ,"$1,722.60 ","$1,722.60 ","$1,722.60 ","$1,856.58 ","$1,550.34 ","$1,780.02 ","$1,646.04 ","$1,856.58 "
SACRED HEART HOSPITAL (ACU),61000053,C8902,HC MRA ABDOMEN W AND W/O CON,610,1 ,"$3,634.00 ","$2,725.50 ",$162.10 ,"$3,634.00 ","$2,340.30 ",$389.47 ,"$2,543.80 ",$162.10 ,"$2,680.00 ",$166.96 ,"$2,143.00 ","$3,452.30 ",$162.10 ,"$2,907.20 ","$3,343.28 ",$162.10 ,"$3,088.90 ","$3,452.30 ","$3,197.92 ","$2,761.84 ",$162.10 ,$162.10 ,$162.10 ,"$2,652.82 ","$1,998.70 ","$3,306.94 ","$3,306.94 ","$2,907.20 ",$401.15 ,"$1,998.70 ","$3,270.60 ",$389.47 ,"$3,270.60 ","$1,962.36 ","$3,415.96 ",$876.31 ,"$3,343.28 ",$171.83 ,"$3,306.94 ",$389.47 ,"$2,236.36 ","$2,236.36 ","$3,270.60 ","$2,712.05 ","$2,143.69 ",$393.37 ,$162.10 ,"$3,452.30 ",$408.94 ,$162.10 ,"$3,161.58 ",$389.47 ,"$3,270.60 ",$389.47 ,"$3,270.60 ","$3,270.60 ","$3,270.60 ","$3,524.98 ","$2,943.54 ","$3,379.62 ","$3,125.24 ","$3,524.98 "
SACRED HEART HOSPITAL (ACU),61000057,C8906,HC MRI BREAST BIL W/CONTRAST,610,1 ,"$1,167.00 ",$875.25 ,$144.87 ,"$1,167.00 ",$751.55 ,$389.47 ,$816.90 ,$144.87 ,"$1,167.00 ",$149.22 ,"$1,167.00 ","$1,108.65 ",$144.87 ,$933.60 ,"$1,073.64 ",$144.87 ,$991.95 ,"$1,108.65 ","$1,026.96 ",$886.92 ,$144.87 ,$144.87 ,$144.87 ,$851.91 ,$641.85 ,"$1,061.97 ","$1,061.97 ",$933.60 ,$401.15 ,$641.85 ,"$1,050.30 ",$389.47 ,"$1,050.30 ",$630.18 ,"$1,096.98 ",$876.31 ,"$1,073.64 ",$153.56 ,"$1,061.97 ",$389.47 ,$718.17 ,$718.17 ,"$1,050.30 ",$870.93 ,"$1,050.30 ",$393.37 ,$144.87 ,"$1,108.65 ",$408.94 ,$144.87 ,"$1,015.29 ",$389.47 ,"$1,050.30 ",$389.47 ,"$1,050.30 ","$1,050.30 ","$1,050.30 ","$1,131.99 ",$945.27 ,"$1,085.31 ","$1,003.62 ","$1,131.99 "
SACRED HEART HOSPITAL (ACU),61000058,77047,HC MRI BREAST BI W/O CON,610,1 ,"$1,575.00 ","$1,181.25 ",$82.68 ,"$1,575.00 ","$1,014.30 ",$243.36 ,"$1,102.50 ",$82.68 ,"$1,575.00 ",$85.16 ,"$1,575.00 ","$1,496.25 ",$82.68 ,"$1,260.00 ","$1,449.00 ",$82.68 ,"$1,338.75 ","$1,496.25 ","$1,386.00 ","$1,197.00 ",$82.68 ,$82.68 ,$82.68 ,"$1,149.75 ",$866.25 ,"$1,433.25 ","$1,433.25 ","$1,260.00 ",$250.66 ,$866.25 ,"$1,417.50 ",$243.36 ,"$1,417.50 ",$850.50 ,"$1,480.50 ",$547.56 ,"$1,449.00 ",$87.64 ,"$1,433.25 ",$243.36 ,$969.26 ,$969.26 ,"$1,417.50 ","$1,175.42 ","$1,417.50 ",$245.79 ,$82.68 ,"$1,496.25 ",$255.53 ,$82.68 ,"$1,370.25 ",$243.36 ,"$1,417.50 ",$243.36 ,"$1,417.50 ","$1,417.50 ","$1,417.50 ","$1,527.75 ","$1,275.75 ","$1,464.75 ","$1,354.50 ","$1,527.75 "
SACRED HEART HOSPITAL (ACU),61000059,C8908,HC MRI BREAST BI W AND W/O CON,610,1 ,"$2,908.00 ","$2,181.00 ",$144.87 ,"$2,908.00 ","$1,872.75 ",$389.47 ,"$2,035.60 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$2,762.60 ",$144.87 ,"$2,326.40 ","$2,675.36 ",$144.87 ,"$2,471.80 ","$2,762.60 ","$2,559.04 ","$2,210.08 ",$144.87 ,$144.87 ,$144.87 ,"$2,122.84 ","$1,599.40 ","$2,646.28 ","$2,646.28 ","$2,326.40 ",$401.15 ,"$1,599.40 ","$2,617.20 ",$389.47 ,"$2,617.20 ","$1,570.32 ","$2,733.52 ",$876.31 ,"$2,675.36 ",$153.56 ,"$2,646.28 ",$389.47 ,"$1,789.58 ","$1,789.58 ","$2,617.20 ","$2,170.24 ","$2,143.69 ",$393.37 ,$144.87 ,"$2,762.60 ",$408.94 ,$144.87 ,"$2,529.96 ",$389.47 ,"$2,617.20 ",$389.47 ,"$2,617.20 ","$2,617.20 ","$2,617.20 ","$2,820.76 ","$2,355.48 ","$2,704.44 ","$2,500.88 ","$2,820.76 "
SACRED HEART HOSPITAL (ACU),61000060,C8909,HC MRA CHEST W/CONTRAST,610,1 ,"$1,294.00 ",$970.50 ,$162.10 ,"$1,294.00 ",$833.34 ,$389.47 ,$905.80 ,$162.10 ,"$1,294.00 ",$166.96 ,"$1,294.00 ","$1,229.30 ",$162.10 ,"$1,035.20 ","$1,190.48 ",$162.10 ,"$1,099.90 ","$1,229.30 ","$1,138.72 ",$983.44 ,$162.10 ,$162.10 ,$162.10 ,$944.62 ,$711.70 ,"$1,177.54 ","$1,177.54 ","$1,035.20 ",$401.15 ,$711.70 ,"$1,164.60 ",$389.47 ,"$1,164.60 ",$698.76 ,"$1,216.36 ",$876.31 ,"$1,190.48 ",$171.83 ,"$1,177.54 ",$389.47 ,$796.33 ,$796.33 ,"$1,164.60 ",$965.71 ,"$1,164.60 ",$393.37 ,$162.10 ,"$1,229.30 ",$408.94 ,$162.10 ,"$1,125.78 ",$389.47 ,"$1,164.60 ",$389.47 ,"$1,164.60 ","$1,164.60 ","$1,164.60 ","$1,255.18 ","$1,048.14 ","$1,203.42 ","$1,112.84 ","$1,255.18 "
SACRED HEART HOSPITAL (ACU),61000062,C8911,HC MRA CHEST W AND W/O CONTRAST,610,1 ,"$2,427.00 ","$1,820.25 ",$162.10 ,"$2,427.00 ","$1,562.99 ",$389.47 ,"$1,698.90 ",$162.10 ,"$2,427.00 ",$166.96 ,"$2,143.00 ","$2,305.65 ",$162.10 ,"$1,941.60 ","$2,232.84 ",$162.10 ,"$2,062.95 ","$2,305.65 ","$2,135.76 ","$1,844.52 ",$162.10 ,$162.10 ,$162.10 ,"$1,771.71 ","$1,334.85 ","$2,208.57 ","$2,208.57 ","$1,941.60 ",$401.15 ,"$1,334.85 ","$2,184.30 ",$389.47 ,"$2,184.30 ","$1,310.58 ","$2,281.38 ",$876.31 ,"$2,232.84 ",$171.83 ,"$2,208.57 ",$389.47 ,"$1,493.58 ","$1,493.58 ","$2,184.30 ","$1,811.27 ","$2,143.69 ",$393.37 ,$162.10 ,"$2,305.65 ",$408.94 ,$162.10 ,"$2,111.49 ",$389.47 ,"$2,184.30 ",$389.47 ,"$2,184.30 ","$2,184.30 ","$2,184.30 ","$2,354.19 ","$1,965.87 ","$2,257.11 ","$2,087.22 ","$2,354.19 "
SACRED HEART HOSPITAL (ACU),61000063,C8912,HC MRA LWR EXT W/CON,610,1 ,"$1,362.00 ","$1,021.50 ",$162.10 ,"$1,362.00 ",$877.13 ,$389.47 ,$953.40 ,$162.10 ,"$1,362.00 ",$166.96 ,"$1,362.00 ","$1,293.90 ",$162.10 ,"$1,089.60 ","$1,253.04 ",$162.10 ,"$1,157.70 ","$1,293.90 ","$1,198.56 ","$1,035.12 ",$162.10 ,$162.10 ,$162.10 ,$994.26 ,$749.10 ,"$1,239.42 ","$1,239.42 ","$1,089.60 ",$401.15 ,$749.10 ,"$1,225.80 ",$389.47 ,"$1,225.80 ",$735.48 ,"$1,280.28 ",$876.31 ,"$1,253.04 ",$171.83 ,"$1,239.42 ",$389.47 ,$838.17 ,$838.17 ,"$1,225.80 ","$1,016.46 ","$1,225.80 ",$393.37 ,$162.10 ,"$1,293.90 ",$408.94 ,$162.10 ,"$1,184.94 ",$389.47 ,"$1,225.80 ",$389.47 ,"$1,225.80 ","$1,225.80 ","$1,225.80 ","$1,321.14 ","$1,103.22 ","$1,266.66 ","$1,171.32 ","$1,321.14 "
SACRED HEART HOSPITAL (ACU),61000064,C8913,HC MRA LWR EXT W/O CON,610,1 ,"$1,133.00 ",$849.75 ,$162.10 ,"$1,133.00 ",$729.65 ,$243.36 ,$793.10 ,$162.10 ,"$1,133.00 ",$166.96 ,"$1,133.00 ","$1,076.35 ",$162.10 ,$906.40 ,"$1,042.36 ",$162.10 ,$963.05 ,"$1,076.35 ",$997.04 ,$861.08 ,$162.10 ,$162.10 ,$162.10 ,$827.09 ,$623.15 ,"$1,031.03 ","$1,031.03 ",$906.40 ,$250.66 ,$623.15 ,"$1,019.70 ",$243.36 ,"$1,019.70 ",$611.82 ,"$1,065.02 ",$547.56 ,"$1,042.36 ",$171.83 ,"$1,031.03 ",$243.36 ,$697.25 ,$697.25 ,"$1,019.70 ",$845.56 ,"$1,019.70 ",$245.79 ,$162.10 ,"$1,076.35 ",$255.53 ,$162.10 ,$985.71 ,$243.36 ,"$1,019.70 ",$243.36 ,"$1,019.70 ","$1,019.70 ","$1,019.70 ","$1,099.01 ",$917.73 ,"$1,053.69 ",$974.38 ,"$1,099.01 "
SACRED HEART HOSPITAL (ACU),61000067,C8914,HC MRA LWR EXT W AND W/O CONTRAST,610,1 ,"$3,850.00 ","$2,887.50 ",$162.10 ,"$3,850.00 ","$2,479.40 ",$389.47 ,"$2,695.00 ",$162.10 ,"$2,680.00 ",$166.96 ,"$2,143.00 ","$3,657.50 ",$162.10 ,"$3,080.00 ","$3,542.00 ",$162.10 ,"$3,272.50 ","$3,657.50 ","$3,388.00 ","$2,926.00 ",$162.10 ,$162.10 ,$162.10 ,"$2,810.50 ","$2,117.50 ","$3,503.50 ","$3,503.50 ","$3,080.00 ",$401.15 ,"$2,117.50 ","$3,465.00 ",$389.47 ,"$3,465.00 ","$2,079.00 ","$3,619.00 ",$876.31 ,"$3,542.00 ",$171.83 ,"$3,503.50 ",$389.47 ,"$2,369.29 ","$2,369.29 ","$3,465.00 ","$2,873.26 ","$2,143.69 ",$393.37 ,$162.10 ,"$3,657.50 ",$408.94 ,$162.10 ,"$3,349.50 ",$389.47 ,"$3,465.00 ",$389.47 ,"$3,465.00 ","$3,465.00 ","$3,465.00 ","$3,734.50 ","$3,118.50 ","$3,580.50 ","$3,311.00 ","$3,734.50 "
SACRED HEART HOSPITAL (ACU),61000068,C8918,HC MRA PELVIS W/CON,610,1 ,"$2,195.00 ","$1,646.25 ",$162.10 ,"$2,195.00 ","$1,413.58 ",$389.47 ,"$1,536.50 ",$162.10 ,"$2,195.00 ",$166.96 ,"$2,143.00 ","$2,085.25 ",$162.10 ,"$1,756.00 ","$2,019.40 ",$162.10 ,"$1,865.75 ","$2,085.25 ","$1,931.60 ","$1,668.20 ",$162.10 ,$162.10 ,$162.10 ,"$1,602.35 ","$1,207.25 ","$1,997.45 ","$1,997.45 ","$1,756.00 ",$401.15 ,"$1,207.25 ","$1,975.50 ",$389.47 ,"$1,975.50 ","$1,185.30 ","$2,063.30 ",$876.31 ,"$2,019.40 ",$171.83 ,"$1,997.45 ",$389.47 ,"$1,350.80 ","$1,350.80 ","$1,975.50 ","$1,638.13 ","$1,975.50 ",$393.37 ,$162.10 ,"$2,085.25 ",$408.94 ,$162.10 ,"$1,909.65 ",$389.47 ,"$1,975.50 ",$389.47 ,"$1,975.50 ","$1,975.50 ","$1,975.50 ","$2,129.15 ","$1,777.95 ","$2,041.35 ","$1,887.70 ","$2,129.15 "
SACRED HEART HOSPITAL (ACU),61000069,C8919,HC MRA PELVIS W/O CON,610,1 ,"$1,733.00 ","$1,299.75 ",$162.10 ,"$1,733.00 ","$1,116.05 ",$243.36 ,"$1,213.10 ",$162.10 ,"$1,733.00 ",$166.96 ,"$1,733.00 ","$1,646.35 ",$162.10 ,"$1,386.40 ","$1,594.36 ",$162.10 ,"$1,473.05 ","$1,646.35 ","$1,525.04 ","$1,317.08 ",$162.10 ,$162.10 ,$162.10 ,"$1,265.09 ",$953.15 ,"$1,577.03 ","$1,577.03 ","$1,386.40 ",$250.66 ,$953.15 ,"$1,559.70 ",$243.36 ,"$1,559.70 ",$935.82 ,"$1,629.02 ",$547.56 ,"$1,594.36 ",$171.83 ,"$1,577.03 ",$243.36 ,"$1,066.49 ","$1,066.49 ","$1,559.70 ","$1,293.34 ","$1,559.70 ",$245.79 ,$162.10 ,"$1,646.35 ",$255.53 ,$162.10 ,"$1,507.71 ",$243.36 ,"$1,559.70 ",$243.36 ,"$1,559.70 ","$1,559.70 ","$1,559.70 ","$1,681.01 ","$1,403.73 ","$1,611.69 ","$1,490.38 ","$1,681.01 "
SACRED HEART HOSPITAL (ACU),61000070,C8920,HC MRA PELVIS W AND W/O CONTRAST,610,1 ,"$2,677.00 ","$2,007.75 ",$162.10 ,"$2,677.00 ","$1,723.99 ",$389.47 ,"$1,873.90 ",$162.10 ,"$2,677.00 ",$166.96 ,"$2,143.00 ","$2,543.15 ",$162.10 ,"$2,141.60 ","$2,462.84 ",$162.10 ,"$2,275.45 ","$2,543.15 ","$2,355.76 ","$2,034.52 ",$162.10 ,$162.10 ,$162.10 ,"$1,954.21 ","$1,472.35 ","$2,436.07 ","$2,436.07 ","$2,141.60 ",$401.15 ,"$1,472.35 ","$2,409.30 ",$389.47 ,"$2,409.30 ","$1,445.58 ","$2,516.38 ",$876.31 ,"$2,462.84 ",$171.83 ,"$2,436.07 ",$389.47 ,"$1,647.43 ","$1,647.43 ","$2,409.30 ","$1,997.85 ","$2,143.69 ",$393.37 ,$162.10 ,"$2,543.15 ",$408.94 ,$162.10 ,"$2,328.99 ",$389.47 ,"$2,409.30 ",$389.47 ,"$2,409.30 ","$2,409.30 ","$2,409.30 ","$2,596.69 ","$2,168.37 ","$2,489.61 ","$2,302.22 ","$2,596.69 "
SACRED HEART HOSPITAL (ACU),61000071,C8934,HC MRA UPPR EXT W/CONTRAST,610,1 ,"$1,720.00 ","$1,290.00 ",$162.10 ,"$1,720.00 ","$1,107.68 ",$389.47 ,"$1,204.00 ",$162.10 ,"$1,720.00 ",$166.96 ,"$1,720.00 ","$1,634.00 ",$162.10 ,"$1,376.00 ","$1,582.40 ",$162.10 ,"$1,462.00 ","$1,634.00 ","$1,513.60 ","$1,307.20 ",$162.10 ,$162.10 ,$162.10 ,"$1,255.60 ",$946.00 ,"$1,565.20 ","$1,565.20 ","$1,376.00 ",$401.15 ,$946.00 ,"$1,548.00 ",$389.47 ,"$1,548.00 ",$928.80 ,"$1,616.80 ",$876.31 ,"$1,582.40 ",$171.83 ,"$1,565.20 ",$389.47 ,"$1,058.49 ","$1,058.49 ","$1,548.00 ","$1,283.64 ","$1,548.00 ",$393.37 ,$162.10 ,"$1,634.00 ",$408.94 ,$162.10 ,"$1,496.40 ",$389.47 ,"$1,548.00 ",$389.47 ,"$1,548.00 ","$1,548.00 ","$1,548.00 ","$1,668.40 ","$1,393.20 ","$1,599.60 ","$1,479.20 ","$1,668.40 "
SACRED HEART HOSPITAL (ACU),61000073,70553,HC MRI BRAIN W AND W/O CONTRAST PITUITARY,610,1 ,"$5,384.00 ","$4,038.00 ",$144.87 ,"$5,384.00 ","$3,467.30 ",$389.47 ,"$3,768.80 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$5,114.80 ",$144.87 ,"$4,307.20 ","$4,953.28 ",$144.87 ,"$4,576.40 ","$5,114.80 ","$4,737.92 ","$4,091.84 ",$144.87 ,$144.87 ,$144.87 ,"$3,930.32 ","$2,961.20 ","$4,899.44 ","$4,899.44 ","$4,307.20 ",$401.15 ,"$2,961.20 ","$4,845.60 ",$389.47 ,"$4,845.60 ","$2,907.36 ","$5,060.96 ",$876.31 ,"$4,953.28 ",$153.56 ,"$4,899.44 ",$389.47 ,"$3,313.31 ","$3,313.31 ","$2,870.23 ","$4,018.08 ","$2,143.69 ",$393.37 ,$144.87 ,"$5,114.80 ",$408.94 ,$144.87 ,"$4,684.08 ",$389.47 ,"$4,845.60 ",$389.47 ,"$4,845.60 ","$4,845.60 ","$4,845.60 ","$5,222.48 ","$4,361.04 ","$5,007.12 ","$4,630.24 ","$5,222.48 "
SACRED HEART HOSPITAL (ACU),61000076,70542,HC MRI ORBIT/FACE/NECK W/CONTRAST,610,1 ,"$4,095.00 ","$3,071.25 ",$144.87 ,"$4,095.00 ","$2,637.18 ",$389.47 ,"$2,866.50 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$3,890.25 ",$144.87 ,"$3,276.00 ","$3,767.40 ",$144.87 ,"$3,480.75 ","$3,890.25 ","$3,603.60 ","$3,112.20 ",$144.87 ,$144.87 ,$144.87 ,"$2,989.35 ","$2,252.25 ","$3,726.45 ","$3,726.45 ","$3,276.00 ",$401.15 ,"$2,252.25 ","$3,685.50 ",$389.47 ,"$3,685.50 ","$2,211.30 ","$3,849.30 ",$876.31 ,"$3,767.40 ",$153.56 ,"$3,726.45 ",$389.47 ,"$2,520.06 ","$2,520.06 ","$1,326.78 ","$3,056.10 ","$2,143.69 ",$393.37 ,$144.87 ,"$3,890.25 ",$408.94 ,$144.87 ,"$3,562.65 ",$389.47 ,"$3,685.50 ",$389.47 ,"$3,685.50 ","$3,685.50 ","$3,685.50 ","$3,972.15 ","$3,316.95 ","$3,808.35 ","$3,521.70 ","$3,972.15 "
SACRED HEART HOSPITAL (ACU),61100001,70557,HC MRI BRAIN INTRAOP W/O CONTRAST,611,1 ,"$4,176.00 ","$3,132.00 ",$82.68 ,"$4,176.00 ","$2,689.34 ",$511.04 ,"$2,923.20 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$3,967.20 ",$82.68 ,"$3,340.80 ","$3,841.92 ",$82.68 ,"$3,549.60 ","$3,967.20 ","$3,674.88 ","$3,173.76 ",$82.68 ,$82.68 ,$82.68 ,"$3,048.48 ","$2,296.80 ","$3,800.16 ","$3,800.16 ","$3,340.80 ",$526.37 ,"$2,296.80 ","$3,758.40 ",$511.04 ,"$3,758.40 ","$2,255.04 ","$3,925.44 ","$1,149.84 ","$3,841.92 ",$87.64 ,"$3,800.16 ",$511.04 ,"$2,569.91 ","$2,569.91 ","$1,275.41 ","$3,116.55 ","$2,143.69 ",$516.15 ,$82.68 ,"$3,967.20 ",$536.59 ,$82.68 ,"$3,633.12 ",$511.04 ,"$3,758.40 ",$511.04 ,"$3,758.40 ","$3,758.40 ","$3,758.40 ","$4,050.72 ","$3,382.56 ","$3,883.68 ","$3,591.36 ","$4,050.72 "
SACRED HEART HOSPITAL (ACU),61100002,70558,HC MRI BRAIN INTRAOP W/CONTRAST,611,1 ,"$5,652.00 ","$4,239.00 ",$144.87 ,"$5,652.00 ","$3,639.89 ",$188.92 ,"$3,956.40 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$5,369.40 ",$144.87 ,"$4,521.60 ","$5,199.84 ",$144.87 ,"$4,804.20 ","$5,369.40 ","$4,973.76 ","$4,295.52 ",$144.87 ,$144.87 ,$144.87 ,"$4,125.96 ","$3,108.60 ","$5,143.32 ","$5,143.32 ","$4,521.60 ",$194.59 ,"$3,108.60 ","$5,086.80 ",$188.92 ,"$5,086.80 ","$3,052.08 ","$5,312.88 ",$425.07 ,"$5,199.84 ",$153.56 ,"$5,143.32 ",$188.92 ,"$3,478.24 ","$3,478.24 ","$1,410.67 ","$4,218.09 ","$2,143.69 ",$190.81 ,$144.87 ,"$5,369.40 ",$198.37 ,$144.87 ,"$4,917.24 ",$188.92 ,"$5,086.80 ",$188.92 ,"$5,086.80 ","$5,086.80 ","$5,086.80 ","$5,482.44 ","$4,578.12 ","$5,256.36 ","$4,860.72 ","$5,482.44 "
SACRED HEART HOSPITAL (ACU),61100003,70559,HC MRI BRAIN INTRAOP W/  AND  W/O CONTRAST,611,1 ,"$6,076.00 ","$4,557.00 ",$144.87 ,"$6,076.00 ","$3,912.94 ",$188.92 ,"$4,253.20 ",$144.87 ,"$2,680.00 ",$149.22 ,"$2,143.00 ","$5,772.20 ",$144.87 ,"$4,860.80 ","$5,589.92 ",$144.87 ,"$5,164.60 ","$5,772.20 ","$5,346.88 ","$4,617.76 ",$144.87 ,$144.87 ,$144.87 ,"$4,435.48 ","$3,341.80 ","$5,529.16 ","$5,529.16 ","$4,860.80 ",$194.59 ,"$3,341.80 ","$5,468.40 ",$188.92 ,"$5,468.40 ","$3,281.04 ","$5,711.44 ",$425.07 ,"$5,589.92 ",$153.56 ,"$5,529.16 ",$188.92 ,"$3,739.17 ","$3,739.17 ","$1,417.11 ","$4,534.52 ","$2,143.69 ",$190.81 ,$144.87 ,"$5,772.20 ",$198.37 ,$144.87 ,"$5,286.12 ",$188.92 ,"$5,468.40 ",$188.92 ,"$5,468.40 ","$5,468.40 ","$5,468.40 ","$5,893.72 ","$4,921.56 ","$5,650.68 ","$5,225.36 ","$5,893.72 "
SACRED HEART HOSPITAL (ACU),61100004,70554,HC MRI FUNCTIONAL BRAIN BY TECH,611,1 ,"$2,946.00 ","$2,209.50 ",$82.68 ,"$2,946.00 ","$1,897.22 ",$243.36 ,"$2,062.20 ",$82.68 ,"$2,680.00 ",$85.16 ,"$2,143.00 ","$2,798.70 ",$82.68 ,"$2,356.80 ","$2,710.32 ",$82.68 ,"$2,504.10 ","$2,798.70 ","$2,592.48 ","$2,238.96 ",$82.68 ,$82.68 ,$82.68 ,"$2,150.58 ","$1,620.30 ","$2,680.86 ","$2,680.86 ","$2,356.80 ",$250.66 ,"$1,620.30 ","$2,651.40 ",$243.36 ,"$2,651.40 ","$1,590.84 ","$2,769.24 ",$547.56 ,"$2,710.32 ",$87.64 ,"$2,680.86 ",$243.36 ,"$1,812.97 ","$1,812.97 ","$1,004.06 ","$2,198.60 ","$2,143.69 ",$245.79 ,$82.68 ,"$2,798.70 ",$255.53 ,$82.68 ,"$2,563.02 ",$243.36 ,"$2,651.40 ",$243.36 ,"$2,651.40 ","$2,651.40 ","$2,651.40 ","$2,857.62 ","$2,386.26 ","$2,739.78 ","$2,533.56 ","$2,857.62 "
SACRED HEART HOSPITAL (ACU),61800001,72198,HC MRA PELVIS W/ OR W/O CONTRAST,618,1 ,"$2,115.00 ","$1,586.25 ",$162.10 ,"$2,115.00 ","$1,362.06 ", N/A ,"$1,480.50 ",$162.10 ,"$2,115.00 ",$166.96 ,"$2,115.00 ","$2,009.25 ",$162.10 ,"$1,692.00 ","$1,945.80 ",$162.10 ,"$1,797.75 ","$2,009.25 ","$1,861.20 ","$1,607.40 ",$162.10 ,$162.10 ,$162.10 ,"$1,543.95 ","$1,163.25 ","$1,924.65 ","$1,924.65 ","$1,692.00 ", N/A ,"$1,163.25 ","$1,903.50 ", N/A ,"$1,903.50 ","$1,142.10 ","$1,988.10 ", N/A ,"$1,945.80 ",$171.83 ,"$1,924.65 ", N/A ,"$1,301.57 ","$1,301.57 ","$1,288.14 ","$1,578.42 ","$1,903.50 ", N/A ,$162.10 ,"$2,009.25 ", N/A ,$162.10 ,"$1,840.05 ", N/A ,"$1,903.50 ", N/A ,"$1,903.50 ","$1,903.50 ","$1,903.50 ","$2,051.55 ","$1,713.15 ","$1,966.95 ","$1,818.90 ","$2,051.55 "
SACRED HEART HOSPITAL (ACU),61800002,73225,HC MRA UPPER EXT W/ OR W/O CONTRAST,618,1 ,"$1,720.00 ","$1,290.00 ",$162.10 ,"$1,720.00 ","$1,107.68 ", N/A ,"$1,204.00 ",$162.10 ,"$1,720.00 ",$166.96 ,"$1,720.00 ","$1,634.00 ",$162.10 ,"$1,376.00 ","$1,582.40 ",$162.10 ,"$1,462.00 ","$1,634.00 ","$1,513.60 ","$1,307.20 ",$162.10 ,$162.10 ,$162.10 ,"$1,255.60 ",$946.00 ,"$1,565.20 ","$1,565.20 ","$1,376.00 ", N/A ,$946.00 ,"$1,548.00 ", N/A ,"$1,548.00 ",$928.80 ,"$1,616.80 ", N/A ,"$1,582.40 ",$171.83 ,"$1,565.20 ", N/A ,"$1,058.49 ","$1,058.49 ","$1,288.14 ","$1,283.64 ","$1,548.00 ", N/A ,$162.10 ,"$1,634.00 ", N/A ,$162.10 ,"$1,496.40 ", N/A ,"$1,548.00 ", N/A ,"$1,548.00 ","$1,548.00 ","$1,548.00 ","$1,668.40 ","$1,393.20 ","$1,599.60 ","$1,479.20 ","$1,668.40 "
SACRED HEART HOSPITAL (ACU),61800005,C8936,HC MRA UPPR EXT W/  AND  W/O CONTRAST,618,1 ,"$1,720.00 ","$1,290.00 ",$162.10 ,"$1,720.00 ","$1,107.68 ",$389.47 ,"$1,204.00 ",$162.10 ,"$1,720.00 ",$166.96 ,"$1,720.00 ","$1,634.00 ",$162.10 ,"$1,376.00 ","$1,582.40 ",$162.10 ,"$1,462.00 ","$1,634.00 ","$1,513.60 ","$1,307.20 ",$162.10 ,$162.10 ,$162.10 ,"$1,255.60 ",$946.00 ,"$1,565.20 ","$1,565.20 ","$1,376.00 ",$401.15 ,$946.00 ,"$1,548.00 ",$389.47 ,"$1,548.00 ",$928.80 ,"$1,616.80 ",$876.31 ,"$1,582.40 ",$171.83 ,"$1,565.20 ",$389.47 ,"$1,058.49 ","$1,058.49 ","$1,548.00 ","$1,283.64 ","$1,548.00 ",$393.37 ,$162.10 ,"$1,634.00 ",$408.94 ,$162.10 ,"$1,496.40 ",$389.47 ,"$1,548.00 ",$389.47 ,"$1,548.00 ","$1,548.00 ","$1,548.00 ","$1,668.40 ","$1,393.20 ","$1,599.60 ","$1,479.20 ","$1,668.40 "
SACRED HEART HOSPITAL (ACU),63600019,M1145,"HC MFN DRUG ADD-ON, PER DOSE",636,1 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 , N/A , N/A ,$0.01 , N/A , N/A ,$0.01 , N/A ,$0.01 , N/A ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 ,$0.01 
SACRED HEART HOSPITAL (ACU),63600175,Q9967,HC CONTRAST ISOVUE 300-399 PER ML,636,1 ,$1.15 ,$0.86 ,$0.17 ,$1.15 ,$0.74 , N/A ,$0.81 , N/A ,$0.21 , N/A ,$0.17 ,$1.09 , N/A ,$0.92 ,$1.06 , N/A ,$0.98 ,$1.09 ,$1.01 ,$0.87 , N/A , N/A , N/A ,$0.84 ,$0.63 ,$1.05 ,$1.05 ,$0.92 , N/A ,$0.63 ,$1.04 , N/A ,$1.04 ,$0.62 ,$1.08 , N/A ,$1.06 , N/A ,$1.05 , N/A ,$0.71 ,$0.71 ,$1.04 ,$0.86 ,$0.18 , N/A , N/A ,$1.09 , N/A , N/A ,$1.00 , N/A ,$1.04 , N/A ,$1.04 ,$1.04 ,$1.04 ,$1.12 ,$0.93 ,$1.07 ,$0.99 ,$1.12 
SACRED HEART HOSPITAL (ACU),63600177,Q9967,HC CONTRAST VISIPAQUE 300-399 PER ML,636,1 ,$1.50 ,$1.13 ,$0.17 ,$1.50 ,$0.97 , N/A ,$1.05 , N/A ,$0.21 , N/A ,$0.17 ,$1.43 , N/A ,$1.20 ,$1.38 , N/A ,$1.28 ,$1.43 ,$1.32 ,$1.14 , N/A , N/A , N/A ,$1.10 ,$0.83 ,$1.37 ,$1.37 ,$1.20 , N/A ,$0.83 ,$1.35 , N/A ,$1.35 ,$0.81 ,$1.41 , N/A ,$1.38 , N/A ,$1.37 , N/A ,$0.92 ,$0.92 ,$1.35 ,$1.12 ,$0.18 , N/A , N/A ,$1.43 , N/A , N/A ,$1.31 , N/A ,$1.35 , N/A ,$1.35 ,$1.35 ,$1.35 ,$1.46 ,$1.22 ,$1.40 ,$1.29 ,$1.46 
SACRED HEART HOSPITAL (ACU),63600190,Q4160,HC NUSHIELD PER SQ CM,636,1 ,"$1,305.00 ",$978.75 ,$134.32 ,"$1,305.00 ",$840.42 , N/A ,$913.50 , N/A ,$167.90 , N/A ,$134.32 ,"$1,239.75 ", N/A ,"$1,044.00 ","$1,200.60 ", N/A ,"$1,109.25 ","$1,239.75 ","$1,148.40 ",$991.80 , N/A , N/A , N/A ,$952.65 ,$717.75 ,"$1,187.55 ","$1,187.55 ","$1,044.00 ", N/A ,$717.75 ,"$1,174.50 ", N/A ,"$1,174.50 ",$704.70 ,"$1,226.70 ", N/A ,"$1,200.60 ", N/A ,"$1,187.55 ", N/A ,$803.10 ,$803.10 ,"$1,174.50 ",$973.92 ,$143.97 , N/A , N/A ,"$1,239.75 ", N/A , N/A ,"$1,135.35 ", N/A ,"$1,174.50 ", N/A ,"$1,174.50 ","$1,174.50 ","$1,174.50 ","$1,265.85 ","$1,057.05 ","$1,213.65 ","$1,122.30 ","$1,265.85 "
SACRED HEART HOSPITAL (ACU),68300003,G0390,HC LEVEL 2 TRAUMA ACTIVATION,683,1 ,"$5,981.00 ","$4,485.75 ",$39.52 ,"$5,981.00 ","$3,851.76 ", N/A ,"$4,186.70 ",$39.52 ,"$4,964.23 ",$40.71 ,"$3,947.46 ","$5,681.95 ",$39.52 ,"$4,784.80 ","$5,502.52 ",$39.52 ,"$5,083.85 ","$5,681.95 ","$5,263.28 ","$4,545.56 ",$39.52 ,$39.52 ,$39.52 ,"$4,366.13 ","$3,289.55 ","$5,442.71 ","$5,442.71 ","$4,784.80 ", N/A ,"$3,289.55 ","$5,382.90 ", N/A ,"$5,382.90 ","$3,229.74 ","$5,622.14 ", N/A ,"$5,502.52 ",$41.89 ,"$5,442.71 ", N/A ,"$3,680.71 ","$3,680.71 ","$5,382.90 ","$4,463.62 ","$4,165.77 ", N/A ,$39.52 ,"$5,681.95 ", N/A ,$39.52 ,"$5,203.47 ", N/A ,"$5,382.90 ", N/A ,"$5,382.90 ","$5,382.90 ","$5,382.90 ","$5,801.57 ","$4,844.61 ","$5,562.33 ","$5,143.66 ","$5,801.57 "
SACRED HEART HOSPITAL (ACU),68300004,N/A,HC TRAUMA RESPONSE LEVEL 3,683,1 ,"$3,040.00 ","$2,280.00 ","$1,641.60 ","$3,040.00 ","$1,957.76 ", N/A ,"$2,128.00 ", N/A ,"$2,523.20 ", N/A ,"$2,006.40 ","$2,888.00 ", N/A ,"$2,432.00 ","$2,796.80 ", N/A ,"$2,584.00 ","$2,888.00 ","$2,675.20 ","$2,310.40 ", N/A , N/A , N/A ,"$2,219.20 ","$1,672.00 ","$2,766.40 ","$2,766.40 ","$2,432.00 ", N/A ,"$1,672.00 ","$2,736.00 ", N/A ,"$2,736.00 ","$1,641.60 ","$2,857.60 ", N/A ,"$2,796.80 ", N/A ,"$2,766.40 ", N/A ,"$1,870.82 ","$1,870.82 ","$2,736.00 ","$2,268.75 ","$2,117.36 ", N/A , N/A ,"$2,888.00 ", N/A , N/A ,"$2,644.80 ", N/A ,"$2,736.00 ", N/A ,"$2,736.00 ","$2,736.00 ","$2,736.00 ","$2,948.80 ","$2,462.40 ","$2,827.20 ","$2,614.40 ","$2,948.80 "
SACRED HEART HOSPITAL (ACU),68300006,N/A,HC TRAUMA RESPONSE LEVEL 1,683,1 ,"$8,856.00 ","$6,642.00 ","$4,782.24 ","$8,856.00 ","$5,703.26 ", N/A ,"$6,199.20 ", N/A ,"$7,350.48 ", N/A ,"$5,844.96 ","$8,413.20 ", N/A ,"$7,084.80 ","$8,147.52 ", N/A ,"$7,527.60 ","$8,413.20 ","$7,793.28 ","$6,730.56 ", N/A , N/A , N/A ,"$6,464.88 ","$4,870.80 ","$8,058.96 ","$8,058.96 ","$7,084.80 ", N/A ,"$4,870.80 ","$7,970.40 ", N/A ,"$7,970.40 ","$4,782.24 ","$8,324.64 ", N/A ,"$8,147.52 ", N/A ,"$8,058.96 ", N/A ,"$5,449.98 ","$5,449.98 ","$7,970.40 ","$6,609.23 ","$6,168.20 ", N/A , N/A ,"$8,413.20 ", N/A , N/A ,"$7,704.72 ", N/A ,"$7,970.40 ", N/A ,"$7,970.40 ","$7,970.40 ","$7,970.40 ","$8,590.32 ","$7,173.36 ","$8,236.08 ","$7,616.16 ","$8,590.32 "
SACRED HEART HOSPITAL (ACU),68300007,N/A,HC TRAUMA RESPONSE LEVEL 2,683,1 ,"$5,981.00 ","$4,485.75 ","$3,229.74 ","$5,981.00 ","$3,851.76 ", N/A ,"$4,186.70 ", N/A ,"$4,964.23 ", N/A ,"$3,947.46 ","$5,681.95 ", N/A ,"$4,784.80 ","$5,502.52 ", N/A ,"$5,083.85 ","$5,681.95 ","$5,263.28 ","$4,545.56 ", N/A , N/A , N/A ,"$4,366.13 ","$3,289.55 ","$5,442.71 ","$5,442.71 ","$4,784.80 ", N/A ,"$3,289.55 ","$5,382.90 ", N/A ,"$5,382.90 ","$3,229.74 ","$5,622.14 ", N/A ,"$5,502.52 ", N/A ,"$5,442.71 ", N/A ,"$3,680.71 ","$3,680.71 ","$5,382.90 ","$4,463.62 ","$4,165.77 ", N/A , N/A ,"$5,681.95 ", N/A , N/A ,"$5,203.47 ", N/A ,"$5,382.90 ", N/A ,"$5,382.90 ","$5,382.90 ","$5,382.90 ","$5,801.57 ","$4,844.61 ","$5,562.33 ","$5,143.66 ","$5,801.57 "
SACRED HEART HOSPITAL (ACU),71000206,N/A,HC PACU RECOVERY INITIAL 15MIN,710,1 ,$386.00 ,$289.50 ,$208.44 ,$386.00 ,$248.58 , N/A ,$270.20 , N/A ,$320.38 , N/A ,$254.76 ,$366.70 , N/A ,$308.80 ,$355.12 , N/A ,$328.10 ,$366.70 ,$339.68 ,$293.36 , N/A , N/A , N/A ,$281.78 ,$212.30 ,$351.26 ,$351.26 ,$308.80 , N/A ,$212.30 ,$347.40 , N/A ,$347.40 ,$208.44 ,$362.84 , N/A ,$355.12 , N/A ,$351.26 , N/A ,$237.54 ,$237.54 ,$347.40 ,$288.07 ,$268.85 , N/A , N/A ,$366.70 , N/A , N/A ,$335.82 , N/A ,$347.40 , N/A ,$347.40 ,$347.40 ,$347.40 ,$374.42 ,$312.66 ,$358.98 ,$331.96 ,$374.42 
SACRED HEART HOSPITAL (ACU),71000207,N/A,HC PACU RECOVERY ADDL 15MIN,710,1 ,$386.00 ,$289.50 ,$208.44 ,$386.00 ,$248.58 , N/A ,$270.20 , N/A ,$320.38 , N/A ,$254.76 ,$366.70 , N/A ,$308.80 ,$355.12 , N/A ,$328.10 ,$366.70 ,$339.68 ,$293.36 , N/A , N/A , N/A ,$281.78 ,$212.30 ,$351.26 ,$351.26 ,$308.80 , N/A ,$212.30 ,$347.40 , N/A ,$347.40 ,$208.44 ,$362.84 , N/A ,$355.12 , N/A ,$351.26 , N/A ,$237.54 ,$237.54 ,$347.40 ,$288.07 ,$268.85 , N/A , N/A ,$366.70 , N/A , N/A ,$335.82 , N/A ,$347.40 , N/A ,$347.40 ,$347.40 ,$347.40 ,$374.42 ,$312.66 ,$358.98 ,$331.96 ,$374.42 
SACRED HEART HOSPITAL (ACU),71000214,N/A,HC PHASE II RECOVERY <1HR,710,1 ,$539.00 ,$404.25 ,$291.06 ,$539.00 ,$347.12 , N/A ,$377.30 , N/A ,$447.37 , N/A ,$355.74 ,$512.05 , N/A ,$431.20 ,$495.88 , N/A ,$458.15 ,$512.05 ,$474.32 ,$409.64 , N/A , N/A , N/A ,$393.47 ,$296.45 ,$490.49 ,$490.49 ,$431.20 , N/A ,$296.45 ,$485.10 , N/A ,$485.10 ,$291.06 ,$506.66 , N/A ,$495.88 , N/A ,$490.49 , N/A ,$331.70 ,$331.70 ,$485.10 ,$402.26 ,$375.41 , N/A , N/A ,$512.05 , N/A , N/A ,$468.93 , N/A ,$485.10 , N/A ,$485.10 ,$485.10 ,$485.10 ,$522.83 ,$436.59 ,$501.27 ,$463.54 ,$522.83 
SACRED HEART HOSPITAL (ACU),71000215,N/A,HC PHASE II RECOVERY 1-2HRS,710,1 ,"$1,077.00 ",$807.75 ,$581.58 ,"$1,077.00 ",$693.59 , N/A ,$753.90 , N/A ,$893.91 , N/A ,$710.82 ,"$1,023.15 ", N/A ,$861.60 ,$990.84 , N/A ,$915.45 ,"$1,023.15 ",$947.76 ,$818.52 , N/A , N/A , N/A ,$786.21 ,$592.35 ,$980.07 ,$980.07 ,$861.60 , N/A ,$592.35 ,$969.30 , N/A ,$969.30 ,$581.58 ,"$1,012.38 ", N/A ,$990.84 , N/A ,$980.07 , N/A ,$662.79 ,$662.79 ,$969.30 ,$803.77 ,$750.13 , N/A , N/A ,"$1,023.15 ", N/A , N/A ,$936.99 , N/A ,$969.30 , N/A ,$969.30 ,$969.30 ,$969.30 ,"$1,044.69 ",$872.37 ,"$1,001.61 ",$926.22 ,"$1,044.69 "
SACRED HEART HOSPITAL (ACU),71000216,N/A,HC PHASE II RECOVERY 2-3HRS,710,1 ,"$1,576.00 ","$1,182.00 ",$851.04 ,"$1,576.00 ","$1,014.94 ", N/A ,"$1,103.20 ", N/A ,"$1,308.08 ", N/A ,"$1,040.16 ","$1,497.20 ", N/A ,"$1,260.80 ","$1,449.92 ", N/A ,"$1,339.60 ","$1,497.20 ","$1,386.88 ","$1,197.76 ", N/A , N/A , N/A ,"$1,150.48 ",$866.80 ,"$1,434.16 ","$1,434.16 ","$1,260.80 ", N/A ,$866.80 ,"$1,418.40 ", N/A ,"$1,418.40 ",$851.04 ,"$1,481.44 ", N/A ,"$1,449.92 ", N/A ,"$1,434.16 ", N/A ,$969.87 ,$969.87 ,"$1,418.40 ","$1,176.17 ","$1,097.68 ", N/A , N/A ,"$1,497.20 ", N/A , N/A ,"$1,371.12 ", N/A ,"$1,418.40 ", N/A ,"$1,418.40 ","$1,418.40 ","$1,418.40 ","$1,528.72 ","$1,276.56 ","$1,465.68 ","$1,355.36 ","$1,528.72 "
SACRED HEART HOSPITAL (ACU),71000217,N/A,HC PHASE II RECOVERY 3-4HRS,710,1 ,"$2,102.00 ","$1,576.50 ","$1,135.08 ","$2,102.00 ","$1,353.69 ", N/A ,"$1,471.40 ", N/A ,"$1,744.66 ", N/A ,"$1,387.32 ","$1,996.90 ", N/A ,"$1,681.60 ","$1,933.84 ", N/A ,"$1,786.70 ","$1,996.90 ","$1,849.76 ","$1,597.52 ", N/A , N/A , N/A ,"$1,534.46 ","$1,156.10 ","$1,912.82 ","$1,912.82 ","$1,681.60 ", N/A ,"$1,156.10 ","$1,891.80 ", N/A ,"$1,891.80 ","$1,135.08 ","$1,975.88 ", N/A ,"$1,933.84 ", N/A ,"$1,912.82 ", N/A ,"$1,293.57 ","$1,293.57 ","$1,891.80 ","$1,568.72 ","$1,464.04 ", N/A , N/A ,"$1,996.90 ", N/A , N/A ,"$1,828.74 ", N/A ,"$1,891.80 ", N/A ,"$1,891.80 ","$1,891.80 ","$1,891.80 ","$2,038.94 ","$1,702.62 ","$1,954.86 ","$1,807.72 ","$2,038.94 "
SACRED HEART HOSPITAL (ACU),71000218,N/A,HC OUTPAT RECOVERY MAJOR,710,1 ,$580.00 ,$435.00 ,$313.20 ,$580.00 ,$373.52 , N/A ,$406.00 , N/A ,$481.40 , N/A ,$382.80 ,$551.00 , N/A ,$464.00 ,$533.60 , N/A ,$493.00 ,$551.00 ,$510.40 ,$440.80 , N/A , N/A , N/A ,$423.40 ,$319.00 ,$527.80 ,$527.80 ,$464.00 , N/A ,$319.00 ,$522.00 , N/A ,$522.00 ,$313.20 ,$545.20 , N/A ,$533.60 , N/A ,$527.80 , N/A ,$356.93 ,$356.93 ,$522.00 ,$432.85 ,$403.97 , N/A , N/A ,$551.00 , N/A , N/A ,$504.60 , N/A ,$522.00 , N/A ,$522.00 ,$522.00 ,$522.00 ,$562.60 ,$469.80 ,$539.40 ,$498.80 ,$562.60 
SACRED HEART HOSPITAL (ACU),71000219,N/A,HC OUTPAT RECOVERY MINOR,710,1 ,$312.00 ,$234.00 ,$168.48 ,$312.00 ,$200.93 , N/A ,$218.40 , N/A ,$258.96 , N/A ,$205.92 ,$296.40 , N/A ,$249.60 ,$287.04 , N/A ,$265.20 ,$296.40 ,$274.56 ,$237.12 , N/A , N/A , N/A ,$227.76 ,$171.60 ,$283.92 ,$283.92 ,$249.60 , N/A ,$171.60 ,$280.80 , N/A ,$280.80 ,$168.48 ,$293.28 , N/A ,$287.04 , N/A ,$283.92 , N/A ,$192.00 ,$192.00 ,$280.80 ,$232.85 ,$217.31 , N/A , N/A ,$296.40 , N/A , N/A ,$271.44 , N/A ,$280.80 , N/A ,$280.80 ,$280.80 ,$280.80 ,$302.64 ,$252.72 ,$290.16 ,$268.32 ,$302.64 
SACRED HEART HOSPITAL (ACU),71000220,N/A,HC C-SECTION RECOVERY,710,1 ,$815.00 ,$611.25 ,$440.10 ,$815.00 ,$524.86 , N/A ,$570.50 , N/A ,$676.45 , N/A ,$537.90 ,$774.25 , N/A ,$652.00 ,$749.80 , N/A ,$692.75 ,$774.25 ,$717.20 ,$619.40 , N/A , N/A , N/A ,$594.95 ,$448.25 ,$741.65 ,$741.65 ,$652.00 , N/A ,$448.25 ,$733.50 , N/A ,$733.50 ,$440.10 ,$766.10 , N/A ,$749.80 , N/A ,$741.65 , N/A ,$501.55 ,$501.55 ,$733.50 ,$608.23 ,$567.65 , N/A , N/A ,$774.25 , N/A , N/A ,$709.05 , N/A ,$733.50 , N/A ,$733.50 ,$733.50 ,$733.50 ,$790.55 ,$660.15 ,$757.95 ,$700.90 ,$790.55 
SACRED HEART HOSPITAL (ACU),71000227,N/A,HC C-SECTION RECOVERY 2HR,710,1 ,"$1,450.00 ","$1,087.50 ",$783.00 ,"$1,450.00 ",$933.80 , N/A ,"$1,015.00 ", N/A ,"$1,203.50 ", N/A ,$957.00 ,"$1,377.50 ", N/A ,"$1,160.00 ","$1,334.00 ", N/A ,"$1,232.50 ","$1,377.50 ","$1,276.00 ","$1,102.00 ", N/A , N/A , N/A ,"$1,058.50 ",$797.50 ,"$1,319.50 ","$1,319.50 ","$1,160.00 ", N/A ,$797.50 ,"$1,305.00 ", N/A ,"$1,305.00 ",$783.00 ,"$1,363.00 ", N/A ,"$1,334.00 ", N/A ,"$1,319.50 ", N/A ,$892.33 ,$892.33 ,"$1,305.00 ","$1,082.14 ","$1,009.93 ", N/A , N/A ,"$1,377.50 ", N/A , N/A ,"$1,261.50 ", N/A ,"$1,305.00 ", N/A ,"$1,305.00 ","$1,305.00 ","$1,305.00 ","$1,406.50 ","$1,174.50 ","$1,348.50 ","$1,247.00 ","$1,406.50 "
SACRED HEART HOSPITAL (ACU),72000001,N/A,HC FETAL MONITORING PER HOUR,720,1 ,$209.00 ,$156.75 ,$112.86 ,$209.00 ,$134.60 , N/A ,$146.30 , N/A ,$173.47 , N/A ,$137.94 ,$198.55 , N/A ,$167.20 ,$192.28 , N/A ,$177.65 ,$198.55 ,$183.92 ,$158.84 , N/A , N/A , N/A ,$152.57 ,$114.95 ,$190.19 ,$190.19 ,$167.20 , N/A ,$114.95 ,$188.10 , N/A ,$188.10 ,$112.86 ,$196.46 , N/A ,$192.28 , N/A ,$190.19 , N/A ,$128.62 ,$128.62 ,$188.10 ,$155.98 ,$145.57 , N/A , N/A ,$198.55 , N/A , N/A ,$181.83 , N/A ,$188.10 , N/A ,$188.10 ,$188.10 ,$188.10 ,$202.73 ,$169.29 ,$194.37 ,$179.74 ,$202.73 
SACRED HEART HOSPITAL (ACU),72000008,59412,HC EXTERNAL CEPHALIC VERSION,720,1 ,"$1,095.83 ",$821.87 ,$211.31 ,"$6,243.52 ",$705.71 ,"$2,774.90 ",$767.08 ,$211.31 ,$909.54 ,$217.65 ,$723.25 ,"$1,041.04 ",$211.31 ,$876.66 ,"$1,008.16 ",$211.31 ,$931.46 ,"$1,041.04 ",$964.33 ,$832.83 ,$211.31 ,$211.31 ,$211.31 ,$799.96 ,$602.71 ,$997.21 ,$997.21 ,$876.66 ,"$2,858.15 ",$602.71 ,$986.25 ,"$2,774.90 ",$986.25 ,$591.75 ,"$1,030.08 ","$6,243.52 ","$1,008.16 ",$223.99 ,$997.21 ,"$2,774.90 ",$674.37 ,$674.37 ,$986.25 ,$817.82 ,$763.25 ,"$2,802.65 ",$211.31 ,"$1,041.04 ","$2,913.64 ",$211.31 ,$953.37 ,"$2,774.90 ",$986.25 ,"$2,774.90 ",$986.25 ,$986.25 ,$986.25 ,"$1,062.96 ",$887.62 ,"$1,019.12 ",$942.41 ,"$1,062.96 "
SACRED HEART HOSPITAL (ACU),72000010,99465,HC DELIV/BIRTH ROOM RESUSCITATION,720,1 ,$415.68 ,$311.76 ,$224.47 ,"$1,336.82 ",$267.70 ,$594.14 ,$290.98 ,$295.01 ,$345.01 ,$303.86 ,$274.35 ,$394.90 ,$295.01 ,$332.54 ,$382.43 ,$295.01 ,$353.33 ,$394.90 ,$365.80 ,$315.92 ,$295.01 ,$295.01 ,$295.01 ,$303.45 ,$228.62 ,$378.27 ,$378.27 ,$332.54 ,$611.96 ,$228.62 ,$374.11 ,$594.14 ,$374.11 ,$224.47 ,$390.74 ,"$1,336.82 ",$382.43 ,$312.71 ,$378.27 ,$594.14 ,$255.81 ,$255.81 ,$374.11 ,$310.22 ,$289.52 ,$600.08 ,$295.01 ,$394.90 ,$623.85 ,$295.01 ,$361.64 ,$594.14 ,$374.11 ,$594.14 ,$374.11 ,$374.11 ,$374.11 ,$403.21 ,$336.70 ,$386.58 ,$357.48 ,$403.21 
SACRED HEART HOSPITAL (ACU),72000012,N/A,HC FHR AUSCULTATION,720,1 ,$71.00 ,$53.25 ,$38.34 ,$71.00 ,$45.72 , N/A ,$49.70 , N/A ,$58.93 , N/A ,$46.86 ,$67.45 , N/A ,$56.80 ,$65.32 , N/A ,$60.35 ,$67.45 ,$62.48 ,$53.96 , N/A , N/A , N/A ,$51.83 ,$39.05 ,$64.61 ,$64.61 ,$56.80 , N/A ,$39.05 ,$63.90 , N/A ,$63.90 ,$38.34 ,$66.74 , N/A ,$65.32 , N/A ,$64.61 , N/A ,$43.69 ,$43.69 ,$63.90 ,$52.99 ,$49.45 , N/A , N/A ,$67.45 , N/A , N/A ,$61.77 , N/A ,$63.90 , N/A ,$63.90 ,$63.90 ,$63.90 ,$68.87 ,$57.51 ,$66.03 ,$61.06 ,$68.87 
SACRED HEART HOSPITAL (ACU),72000016,N/A,HC POST PARTUM HEM CARE < 2 HRS,720,1 ,"$2,250.00 ","$1,687.50 ","$1,215.00 ","$2,250.00 ","$1,449.00 ", N/A ,"$1,575.00 ", N/A ,"$1,867.50 ", N/A ,"$1,485.00 ","$2,137.50 ", N/A ,"$1,800.00 ","$2,070.00 ", N/A ,"$1,912.50 ","$2,137.50 ","$1,980.00 ","$1,710.00 ", N/A , N/A , N/A ,"$1,642.50 ","$1,237.50 ","$2,047.50 ","$2,047.50 ","$1,800.00 ", N/A ,"$1,237.50 ","$2,025.00 ", N/A ,"$2,025.00 ","$1,215.00 ","$2,115.00 ", N/A ,"$2,070.00 ", N/A ,"$2,047.50 ", N/A ,"$1,384.65 ","$1,384.65 ","$2,025.00 ","$1,679.18 ","$1,567.13 ", N/A , N/A ,"$2,137.50 ", N/A , N/A ,"$1,957.50 ", N/A ,"$2,025.00 ", N/A ,"$2,025.00 ","$2,025.00 ","$2,025.00 ","$2,182.50 ","$1,822.50 ","$2,092.50 ","$1,935.00 ","$2,182.50 "
SACRED HEART HOSPITAL (ACU),72000017,N/A,HC POST PARTUM HEM CARE > 2 HRS,720,1 ,$817.00 ,$612.75 ,$441.18 ,$817.00 ,$526.15 , N/A ,$571.90 , N/A ,$678.11 , N/A ,$539.22 ,$776.15 , N/A ,$653.60 ,$751.64 , N/A ,$694.45 ,$776.15 ,$718.96 ,$620.92 , N/A , N/A , N/A ,$596.41 ,$449.35 ,$743.47 ,$743.47 ,$653.60 , N/A ,$449.35 ,$735.30 , N/A ,$735.30 ,$441.18 ,$767.98 , N/A ,$751.64 , N/A ,$743.47 , N/A ,$502.78 ,$502.78 ,$735.30 ,$609.73 ,$569.04 , N/A , N/A ,$776.15 , N/A , N/A ,$710.79 , N/A ,$735.30 , N/A ,$735.30 ,$735.30 ,$735.30 ,$792.49 ,$661.77 ,$759.81 ,$702.62 ,$792.49 
SACRED HEART HOSPITAL (ACU),72100007,N/A,HC LABOR PREMATURE,721,1 ,$652.00 ,$489.00 ,$352.08 ,$652.00 ,$419.89 , N/A ,$456.40 , N/A ,$541.16 , N/A ,$430.32 ,$619.40 , N/A ,$521.60 ,$599.84 , N/A ,$554.20 ,$619.40 ,$573.76 ,$495.52 , N/A , N/A , N/A ,$475.96 ,$358.60 ,$593.32 ,$593.32 ,$521.60 , N/A ,$358.60 ,$586.80 , N/A ,$586.80 ,$352.08 ,$612.88 , N/A ,$599.84 , N/A ,$593.32 , N/A ,$401.24 ,$401.24 ,$586.80 ,$486.59 ,$454.12 , N/A , N/A ,$619.40 , N/A , N/A ,$567.24 , N/A ,$586.80 , N/A ,$586.80 ,$586.80 ,$586.80 ,$632.44 ,$528.12 ,$606.36 ,$560.72 ,$632.44 
SACRED HEART HOSPITAL (ACU),72100008,N/A,HC LABOR LEVEL 1,721,1 ,"$1,203.00 ",$902.25 ,$649.62 ,"$1,203.00 ",$774.73 , N/A ,$842.10 , N/A ,$998.49 , N/A ,$793.98 ,"$1,142.85 ", N/A ,$962.40 ,"$1,106.76 ", N/A ,"$1,022.55 ","$1,142.85 ","$1,058.64 ",$914.28 , N/A , N/A , N/A ,$878.19 ,$661.65 ,"$1,094.73 ","$1,094.73 ",$962.40 , N/A ,$661.65 ,"$1,082.70 ", N/A ,"$1,082.70 ",$649.62 ,"$1,130.82 ", N/A ,"$1,106.76 ", N/A ,"$1,094.73 ", N/A ,$740.33 ,$740.33 ,"$1,082.70 ",$897.80 ,$837.89 , N/A , N/A ,"$1,142.85 ", N/A , N/A ,"$1,046.61 ", N/A ,"$1,082.70 ", N/A ,"$1,082.70 ","$1,082.70 ","$1,082.70 ","$1,166.91 ",$974.43 ,"$1,118.79 ","$1,034.58 ","$1,166.91 "
SACRED HEART HOSPITAL (ACU),72100009,N/A,HC LABOR LEVEL 2,721,1 ,"$2,671.00 ","$2,003.25 ","$1,442.34 ","$2,671.00 ","$1,720.12 ", N/A ,"$1,869.70 ", N/A ,"$2,216.93 ", N/A ,"$1,762.86 ","$2,537.45 ", N/A ,"$2,136.80 ","$2,457.32 ", N/A ,"$2,270.35 ","$2,537.45 ","$2,350.48 ","$2,029.96 ", N/A , N/A , N/A ,"$1,949.83 ","$1,469.05 ","$2,430.61 ","$2,430.61 ","$2,136.80 ", N/A ,"$1,469.05 ","$2,403.90 ", N/A ,"$2,403.90 ","$1,442.34 ","$2,510.74 ", N/A ,"$2,457.32 ", N/A ,"$2,430.61 ", N/A ,"$1,643.73 ","$1,643.73 ","$2,403.90 ","$1,993.37 ","$1,860.35 ", N/A , N/A ,"$2,537.45 ", N/A , N/A ,"$2,323.77 ", N/A ,"$2,403.90 ", N/A ,"$2,403.90 ","$2,403.90 ","$2,403.90 ","$2,590.87 ","$2,163.51 ","$2,484.03 ","$2,297.06 ","$2,590.87 "
SACRED HEART HOSPITAL (ACU),72100010,N/A,HC LABOR LEVEL 3,721,1 ,"$3,652.00 ","$2,739.00 ","$1,972.08 ","$3,652.00 ","$2,351.89 ", N/A ,"$2,556.40 ", N/A ,"$3,031.16 ", N/A ,"$2,410.32 ","$3,469.40 ", N/A ,"$2,921.60 ","$3,359.84 ", N/A ,"$3,104.20 ","$3,469.40 ","$3,213.76 ","$2,775.52 ", N/A , N/A , N/A ,"$2,665.96 ","$2,008.60 ","$3,323.32 ","$3,323.32 ","$2,921.60 ", N/A ,"$2,008.60 ","$3,286.80 ", N/A ,"$3,286.80 ","$1,972.08 ","$3,432.88 ", N/A ,"$3,359.84 ", N/A ,"$3,323.32 ", N/A ,"$2,247.44 ","$2,247.44 ","$3,286.80 ","$2,725.49 ","$2,543.62 ", N/A , N/A ,"$3,469.40 ", N/A , N/A ,"$3,177.24 ", N/A ,"$3,286.80 ", N/A ,"$3,286.80 ","$3,286.80 ","$3,286.80 ","$3,542.44 ","$2,958.12 ","$3,396.36 ","$3,140.72 ","$3,542.44 "
SACRED HEART HOSPITAL (ACU),72100011,N/A,HC LABOR LEVEL 4,721,1 ,"$6,172.00 ","$4,629.00 ","$3,332.88 ","$6,172.00 ","$3,974.77 ", N/A ,"$4,320.40 ", N/A ,"$5,122.76 ", N/A ,"$4,073.52 ","$5,863.40 ", N/A ,"$4,937.60 ","$5,678.24 ", N/A ,"$5,246.20 ","$5,863.40 ","$5,431.36 ","$4,690.72 ", N/A , N/A , N/A ,"$4,505.56 ","$3,394.60 ","$5,616.52 ","$5,616.52 ","$4,937.60 ", N/A ,"$3,394.60 ","$5,554.80 ", N/A ,"$5,554.80 ","$3,332.88 ","$5,801.68 ", N/A ,"$5,678.24 ", N/A ,"$5,616.52 ", N/A ,"$3,798.25 ","$3,798.25 ","$5,554.80 ","$4,606.16 ","$4,298.80 ", N/A , N/A ,"$5,863.40 ", N/A , N/A ,"$5,369.64 ", N/A ,"$5,554.80 ", N/A ,"$5,554.80 ","$5,554.80 ","$5,554.80 ","$5,986.84 ","$4,999.32 ","$5,739.96 ","$5,307.92 ","$5,986.84 "
SACRED HEART HOSPITAL (ACU),72200009,N/A,HC DELIVERY,722,1 ,"$2,687.00 ","$2,015.25 ","$1,450.98 ","$2,687.00 ","$1,730.43 ", N/A ,"$1,880.90 ", N/A ,"$2,230.21 ", N/A ,"$1,773.42 ","$2,552.65 ", N/A ,"$2,149.60 ","$2,472.04 ", N/A ,"$2,283.95 ","$2,552.65 ","$2,364.56 ","$2,042.12 ", N/A , N/A , N/A ,"$1,961.51 ","$1,477.85 ","$2,445.17 ","$2,445.17 ","$2,149.60 ", N/A ,"$1,477.85 ","$2,418.30 ", N/A ,"$2,418.30 ","$1,450.98 ","$2,525.78 ", N/A ,"$2,472.04 ", N/A ,"$2,445.17 ", N/A ,"$1,653.58 ","$1,653.58 ","$2,418.30 ","$2,005.31 ","$1,871.50 ", N/A , N/A ,"$2,552.65 ", N/A , N/A ,"$2,337.69 ", N/A ,"$2,418.30 ", N/A ,"$2,418.30 ","$2,418.30 ","$2,418.30 ","$2,606.39 ","$2,176.47 ","$2,498.91 ","$2,310.82 ","$2,606.39 "
SACRED HEART HOSPITAL (ACU),72200013,N/A,HC DEMISE CARE,722,1 ,$584.00 ,$438.00 ,$315.36 ,$584.00 ,$376.10 , N/A ,$408.80 , N/A ,$484.72 , N/A ,$385.44 ,$554.80 , N/A ,$467.20 ,$537.28 , N/A ,$496.40 ,$554.80 ,$513.92 ,$443.84 , N/A , N/A , N/A ,$426.32 ,$321.20 ,$531.44 ,$531.44 ,$467.20 , N/A ,$321.20 ,$525.60 , N/A ,$525.60 ,$315.36 ,$548.96 , N/A ,$537.28 , N/A ,$531.44 , N/A ,$359.39 ,$359.39 ,$525.60 ,$435.84 ,$406.76 , N/A , N/A ,$554.80 , N/A , N/A ,$508.08 , N/A ,$525.60 , N/A ,$525.60 ,$525.60 ,$525.60 ,$566.48 ,$473.04 ,$543.12 ,$502.24 ,$566.48 
SACRED HEART HOSPITAL (ACU),72300003,54150,HC CIRCUMCISION W/DEVICE,723,1 ,$417.00 ,$312.75 ,$225.18 ,"$4,260.86 ",$268.55 ,"$1,893.71 ",$291.90 ,$417.00 ,$346.11 ,$656.60 ,$275.22 ,$396.15 ,$637.48 ,$333.60 ,$383.64 ,$417.00 ,$354.45 ,$396.15 ,$366.96 ,$316.92 ,$417.00 ,$417.00 ,$637.48 ,$304.41 ,$229.35 ,$379.47 ,$379.47 ,$333.60 ,"$1,950.52 ",$229.35 ,$375.30 ,"$1,893.71 ",$375.30 ,$225.18 ,$391.98 ,"$4,260.86 ",$383.64 ,$675.73 ,$379.47 ,"$1,893.71 ",$256.62 ,$256.62 ,$375.30 ,$311.21 ,$290.44 ,"$1,912.65 ",$417.00 ,$396.15 ,"$1,988.40 ",$417.00 ,$362.79 ,"$1,893.71 ",$375.30 ,"$1,893.71 ",$375.30 ,$375.30 ,$375.30 ,$404.49 ,$337.77 ,$387.81 ,$358.62 ,$404.49 
SACRED HEART HOSPITAL (ACU),73000002,93005,HC EKG,730,1 ,$167.94 ,$125.96 ,$8.56 ,$167.94 ,$108.15 ,$58.87 ,$117.56 ,$8.56 ,$139.39 ,$8.82 ,$110.84 ,$159.54 ,$8.56 ,$134.35 ,$154.50 ,$8.56 ,$142.75 ,$159.54 ,$147.79 ,$127.63 ,$8.56 ,$8.56 ,$8.56 ,$122.60 ,$92.37 ,$152.83 ,$152.83 ,$134.35 ,$60.64 ,$92.37 ,$151.15 ,$58.87 ,$151.15 ,$90.69 ,$157.86 ,$132.46 ,$154.50 ,$9.07 ,$152.83 ,$58.87 ,$103.35 ,$103.35 ,$151.15 ,$125.33 ,$116.97 ,$59.46 ,$8.56 ,$159.54 ,$61.82 ,$8.56 ,$146.11 ,$58.87 ,$151.15 ,$58.87 ,$151.15 ,$151.15 ,$151.15 ,$162.90 ,$136.03 ,$156.18 ,$144.43 ,$162.90 
SACRED HEART HOSPITAL (ACU),73000003,93041,HC EKG RHYTHM STRIP TRACING,730,1 ,$143.84 ,$107.88 ,$8.56 ,$143.84 ,$92.63 ,$58.87 ,$100.69 ,$8.56 ,$119.39 ,$8.82 ,$94.93 ,$136.65 ,$8.56 ,$115.07 ,$132.33 ,$8.56 ,$122.26 ,$136.65 ,$126.58 ,$109.32 ,$8.56 ,$8.56 ,$8.56 ,$105.00 ,$79.11 ,$130.89 ,$130.89 ,$115.07 ,$60.64 ,$79.11 ,$129.46 ,$58.87 ,$129.46 ,$77.67 ,$135.21 ,$132.46 ,$132.33 ,$9.07 ,$130.89 ,$58.87 ,$88.52 ,$88.52 ,$129.46 ,$107.35 ,$100.18 ,$59.46 ,$8.56 ,$136.65 ,$61.82 ,$8.56 ,$125.14 ,$58.87 ,$129.46 ,$58.87 ,$129.46 ,$129.46 ,$129.46 ,$139.52 ,$116.51 ,$133.77 ,$123.70 ,$139.52 
SACRED HEART HOSPITAL (ACU),73100002,93226,HC HOLTER SCAN  AND  REPORT 48 HR,731,1 ,$393.93 ,$295.45 ,$22.18 ,$393.93 ,$253.69 ,$119.26 ,$275.75 ,$22.18 ,$326.96 ,$22.85 ,$259.99 ,$374.23 ,$22.18 ,$315.14 ,$362.42 ,$22.18 ,$334.84 ,$374.23 ,$346.66 ,$299.39 ,$22.18 ,$22.18 ,$22.18 ,$287.57 ,$216.66 ,$358.48 ,$358.48 ,$315.14 ,$122.84 ,$216.66 ,$354.54 ,$119.26 ,$354.54 ,$212.72 ,$370.29 ,$268.33 ,$362.42 ,$23.51 ,$358.48 ,$119.26 ,$242.42 ,$242.42 ,$354.54 ,$293.99 ,$274.37 ,$120.45 ,$22.18 ,$374.23 ,$125.22 ,$22.18 ,$342.72 ,$119.26 ,$354.54 ,$119.26 ,$354.54 ,$354.54 ,$354.54 ,$382.11 ,$319.08 ,$366.35 ,$338.78 ,$382.11 
SACRED HEART HOSPITAL (ACU),74000001,95803,HC ACTIGRAPHY TESTING 72HR TO 14 DAYS,740,1 ,$649.44 ,$487.08 ,$22.18 ,$649.44 ,$418.24 ,$58.87 ,$454.61 ,$22.18 ,$649.44 ,$22.85 ,$649.44 ,$616.97 ,$22.18 ,$519.55 ,$597.48 ,$22.18 ,$552.02 ,$616.97 ,$571.51 ,$493.57 ,$22.18 ,$22.18 ,$22.18 ,$474.09 ,$357.19 ,$590.99 ,$590.99 ,$519.55 ,$60.64 ,$357.19 ,$584.50 ,$58.87 ,$584.50 ,$350.70 ,$610.47 ,$132.46 ,$597.48 ,$23.51 ,$590.99 ,$58.87 ,$399.67 ,$399.67 ,$584.50 ,$484.68 ,$584.50 ,$59.46 ,$22.18 ,$616.97 ,$61.82 ,$22.18 ,$565.01 ,$58.87 ,$584.50 ,$58.87 ,$584.50 ,$584.50 ,$584.50 ,$629.96 ,$526.05 ,$603.98 ,$558.52 ,$629.96 
SACRED HEART HOSPITAL (ACU),74000002,95805,HC MULTIPLE SLEEP LATENCY,740,1 ,"$2,900.15 ","$2,175.11 ",$247.40 ,"$2,900.15 ","$1,867.70 ",$516.27 ,"$2,030.11 ",$247.40 ,"$2,900.15 ",$254.82 ,"$2,358.00 ","$2,755.14 ",$247.40 ,"$2,320.12 ","$2,668.14 ",$247.40 ,"$2,465.13 ","$2,755.14 ","$2,552.13 ","$2,204.11 ",$247.40 ,$247.40 ,$247.40 ,"$2,117.11 ","$1,595.08 ","$2,639.14 ","$2,639.14 ","$2,320.12 ",$531.76 ,"$1,595.08 ","$2,610.14 ",$516.27 ,"$2,610.14 ","$1,566.08 ","$2,726.14 ","$1,161.60 ","$2,668.14 ",$262.24 ,"$2,639.14 ",$516.27 ,"$1,784.75 ","$1,784.75 ","$2,610.14 ","$2,164.38 ","$2,036.51 ",$521.43 ,$247.40 ,"$2,755.14 ",$542.08 ,$247.40 ,"$2,523.13 ",$516.27 ,"$2,610.14 ",$516.27 ,"$2,610.14 ","$2,610.14 ","$2,610.14 ","$2,813.15 ","$2,349.12 ","$2,697.14 ","$2,494.13 ","$2,813.15 "
SACRED HEART HOSPITAL (ACU),74000003,95806,HC SLEEP STUDY UNATTENDED,740,1 ,$733.14 ,$549.86 ,$45.89 ,$733.14 ,$472.14 ,$147.66 ,$513.20 ,$45.89 ,$733.14 ,$47.27 ,$733.14 ,$696.48 ,$45.89 ,$586.51 ,$674.49 ,$45.89 ,$623.17 ,$696.48 ,$645.16 ,$557.19 ,$45.89 ,$45.89 ,$45.89 ,$535.19 ,$403.23 ,$667.16 ,$667.16 ,$586.51 ,$152.09 ,$403.23 ,$659.83 ,$147.66 ,$659.83 ,$395.90 ,$689.15 ,$332.24 ,$674.49 ,$48.64 ,$667.16 ,$147.66 ,$451.17 ,$451.17 ,$659.83 ,$547.14 ,$407.30 ,$149.14 ,$45.89 ,$696.48 ,$155.05 ,$45.89 ,$637.83 ,$147.66 ,$659.83 ,$147.66 ,$659.83 ,$659.83 ,$659.83 ,$711.15 ,$593.84 ,$681.82 ,$630.50 ,$711.15 
SACRED HEART HOSPITAL (ACU),74000006,95810,HC SLEEP STUDY,740,1 ,"$4,973.68 ","$3,730.26 ",$247.40 ,"$4,973.68 ","$3,203.05 ",$973.04 ,"$3,481.58 ",$247.40 ,"$2,948.00 ",$254.82 ,"$2,358.00 ","$4,725.00 ",$247.40 ,"$3,978.94 ","$4,575.79 ",$247.40 ,"$4,227.63 ","$4,725.00 ","$4,376.84 ","$3,780.00 ",$247.40 ,$247.40 ,$247.40 ,"$3,630.79 ","$2,735.52 ","$4,526.05 ","$4,526.05 ","$3,978.94 ","$1,002.23 ","$2,735.52 ","$4,476.31 ",$973.04 ,"$4,476.31 ","$2,685.79 ","$4,675.26 ","$2,189.34 ","$4,575.79 ",$262.24 ,"$4,526.05 ",$973.04 ,"$3,060.80 ","$3,060.80 ","$4,476.31 ","$3,711.86 ","$2,036.51 ",$982.77 ,$247.40 ,"$4,725.00 ","$1,021.69 ",$247.40 ,"$4,327.10 ",$973.04 ,"$4,476.31 ",$973.04 ,"$4,476.31 ","$4,476.31 ","$4,476.31 ","$4,824.47 ","$4,028.68 ","$4,625.52 ","$4,277.36 ","$4,824.47 "
SACRED HEART HOSPITAL (ACU),74000009,95811,HC SLEEP STUDY W/CPAP,740,1 ,"$5,825.45 ","$4,369.09 ",$247.40 ,"$5,825.45 ","$3,751.59 ",$973.04 ,"$4,077.82 ",$247.40 ,"$2,948.00 ",$254.82 ,"$2,358.00 ","$5,534.18 ",$247.40 ,"$4,660.36 ","$5,359.41 ",$247.40 ,"$4,951.63 ","$5,534.18 ","$5,126.40 ","$4,427.34 ",$247.40 ,$247.40 ,$247.40 ,"$4,252.58 ","$3,204.00 ","$5,301.16 ","$5,301.16 ","$4,660.36 ","$1,002.23 ","$3,204.00 ","$5,242.91 ",$973.04 ,"$5,242.91 ","$3,145.74 ","$5,475.92 ","$2,189.34 ","$5,359.41 ",$262.24 ,"$5,301.16 ",$973.04 ,"$3,584.98 ","$3,584.98 ","$5,242.91 ","$4,347.53 ","$2,036.51 ",$982.77 ,$247.40 ,"$5,534.18 ","$1,021.69 ",$247.40 ,"$5,068.14 ",$973.04 ,"$5,242.91 ",$973.04 ,"$5,242.91 ","$5,242.91 ","$5,242.91 ","$5,650.69 ","$4,718.61 ","$5,417.67 ","$5,009.89 ","$5,650.69 "
SACRED HEART HOSPITAL (ACU),74000014,95816,HC EEG AWAKE/DROWSY,740,1 ,"$1,377.10 ","$1,032.83 ",$103.70 ,"$1,377.10 ",$886.85 ,$279.91 ,$963.97 ,$103.70 ,"$1,142.99 ",$106.81 ,$908.89 ,"$1,308.25 ",$103.70 ,"$1,101.68 ","$1,266.93 ",$103.70 ,"$1,170.54 ","$1,308.25 ","$1,211.85 ","$1,046.60 ",$103.70 ,$103.70 ,$103.70 ,"$1,005.28 ",$757.41 ,"$1,253.16 ","$1,253.16 ","$1,101.68 ",$288.31 ,$757.41 ,"$1,239.39 ",$279.91 ,"$1,239.39 ",$743.63 ,"$1,294.47 ",$629.79 ,"$1,266.93 ",$109.92 ,"$1,253.16 ",$279.91 ,$847.47 ,$847.47 ,"$1,239.39 ","$1,027.73 ",$959.15 ,$282.71 ,$103.70 ,"$1,308.25 ",$293.90 ,$103.70 ,"$1,198.08 ",$279.91 ,"$1,239.39 ",$279.91 ,"$1,239.39 ","$1,239.39 ","$1,239.39 ","$1,335.79 ","$1,115.45 ","$1,280.70 ","$1,184.31 ","$1,335.79 "
SACRED HEART HOSPITAL (ACU),74000016,95819,HC EEG AWAKE/ASLEEP,740,1 ,"$1,377.10 ","$1,032.83 ",$103.70 ,"$1,377.10 ",$886.85 ,$279.91 ,$963.97 ,$103.70 ,"$1,142.99 ",$106.81 ,$908.89 ,"$1,308.25 ",$103.70 ,"$1,101.68 ","$1,266.93 ",$103.70 ,"$1,170.54 ","$1,308.25 ","$1,211.85 ","$1,046.60 ",$103.70 ,$103.70 ,$103.70 ,"$1,005.28 ",$757.41 ,"$1,253.16 ","$1,253.16 ","$1,101.68 ",$288.31 ,$757.41 ,"$1,239.39 ",$279.91 ,"$1,239.39 ",$743.63 ,"$1,294.47 ",$629.79 ,"$1,266.93 ",$109.92 ,"$1,253.16 ",$279.91 ,$847.47 ,$847.47 ,"$1,239.39 ","$1,027.73 ","$1,239.39 ",$282.71 ,$103.70 ,"$1,308.25 ",$293.90 ,$103.70 ,"$1,198.08 ",$279.91 ,"$1,239.39 ",$279.91 ,"$1,239.39 ","$1,239.39 ","$1,239.39 ","$1,335.79 ","$1,115.45 ","$1,280.70 ","$1,184.31 ","$1,335.79 "
SACRED HEART HOSPITAL (ACU),74000018,95822,HC EEG COMA OR SLEEP ONLY,740,1 ,"$1,377.10 ","$1,032.83 ",$103.70 ,"$1,377.10 ",$886.85 ,$279.91 ,$963.97 ,$103.70 ,"$1,142.99 ",$106.81 ,$908.89 ,"$1,308.25 ",$103.70 ,"$1,101.68 ","$1,266.93 ",$103.70 ,"$1,170.54 ","$1,308.25 ","$1,211.85 ","$1,046.60 ",$103.70 ,$103.70 ,$103.70 ,"$1,005.28 ",$757.41 ,"$1,253.16 ","$1,253.16 ","$1,101.68 ",$288.31 ,$757.41 ,"$1,239.39 ",$279.91 ,"$1,239.39 ",$743.63 ,"$1,294.47 ",$629.79 ,"$1,266.93 ",$109.92 ,"$1,253.16 ",$279.91 ,$847.47 ,$847.47 ,"$1,239.39 ","$1,027.73 ",$959.15 ,$282.71 ,$103.70 ,"$1,308.25 ",$293.90 ,$103.70 ,"$1,198.08 ",$279.91 ,"$1,239.39 ",$279.91 ,"$1,239.39 ","$1,239.39 ","$1,239.39 ","$1,335.79 ","$1,115.45 ","$1,280.70 ","$1,184.31 ","$1,335.79 "
SACRED HEART HOSPITAL (ACU),74000020,95824,HC EEG CEREBRAL DEATH EVAL,740,1 ,"$1,377.10 ","$1,032.83 ",$103.70 ,"$1,377.10 ",$886.85 ,$516.27 ,$963.97 ,$103.70 ,"$1,142.99 ",$106.81 ,$908.89 ,"$1,308.25 ",$103.70 ,"$1,101.68 ","$1,266.93 ",$103.70 ,"$1,170.54 ","$1,308.25 ","$1,211.85 ","$1,046.60 ",$103.70 ,$103.70 ,$103.70 ,"$1,005.28 ",$757.41 ,"$1,253.16 ","$1,253.16 ","$1,101.68 ",$531.76 ,$757.41 ,"$1,239.39 ",$516.27 ,"$1,239.39 ",$743.63 ,"$1,294.47 ","$1,161.60 ","$1,266.93 ",$109.92 ,"$1,253.16 ",$516.27 ,$847.47 ,$847.47 ,"$1,239.39 ","$1,027.73 ",$959.15 ,$521.43 ,$103.70 ,"$1,308.25 ",$542.08 ,$103.70 ,"$1,198.08 ",$516.27 ,"$1,239.39 ",$516.27 ,"$1,239.39 ","$1,239.39 ","$1,239.39 ","$1,335.79 ","$1,115.45 ","$1,280.70 ","$1,184.31 ","$1,335.79 "
SACRED HEART HOSPITAL (ACU),74000023,95928,HC TCMEP UPPER LIMBS,740,1 ,$765.95 ,$574.46 ,$44.29 ,"$2,189.34 ",$493.27 ,$973.04 ,$536.17 ,$44.29 ,$635.74 ,$45.62 ,$505.53 ,$727.65 ,$44.29 ,$612.76 ,$704.67 ,$44.29 ,$651.06 ,$727.65 ,$674.04 ,$582.12 ,$44.29 ,$44.29 ,$44.29 ,$559.14 ,$421.27 ,$697.01 ,$697.01 ,$612.76 ,"$1,002.23 ",$421.27 ,$689.36 ,$973.04 ,$689.36 ,$413.61 ,$719.99 ,"$2,189.34 ",$704.67 ,$46.95 ,$697.01 ,$973.04 ,$471.37 ,$471.37 ,$689.36 ,$571.63 ,$533.48 ,$982.77 ,$44.29 ,$727.65 ,"$1,021.69 ",$44.29 ,$666.38 ,$973.04 ,$689.36 ,$973.04 ,$689.36 ,$689.36 ,$689.36 ,$742.97 ,$620.42 ,$712.33 ,$658.72 ,$742.97 
SACRED HEART HOSPITAL (ACU),74000024,95929,HC TCMEP LWR LIMBS,740,1 ,$765.95 ,$574.46 ,$44.29 ,"$1,161.60 ",$493.27 ,$516.27 ,$536.17 ,$44.29 ,$635.74 ,$45.62 ,$505.53 ,$727.65 ,$44.29 ,$612.76 ,$704.67 ,$44.29 ,$651.06 ,$727.65 ,$674.04 ,$582.12 ,$44.29 ,$44.29 ,$44.29 ,$559.14 ,$421.27 ,$697.01 ,$697.01 ,$612.76 ,$531.76 ,$421.27 ,$689.36 ,$516.27 ,$689.36 ,$413.61 ,$719.99 ,"$1,161.60 ",$704.67 ,$46.95 ,$697.01 ,$516.27 ,$471.37 ,$471.37 ,$689.36 ,$571.63 ,$533.48 ,$521.43 ,$44.29 ,$727.65 ,$542.08 ,$44.29 ,$666.38 ,$516.27 ,$689.36 ,$516.27 ,$689.36 ,$689.36 ,$689.36 ,$742.97 ,$620.42 ,$712.33 ,$658.72 ,$742.97 
SACRED HEART HOSPITAL (ACU),74000029,95955,HC EEG INTRAOP,740,1 ,"$1,284.19 ",$963.14 ,$103.70 ,"$1,284.19 ",$827.02 , N/A ,$898.93 ,$103.70 ,"$1,065.88 ",$106.81 ,$847.57 ,"$1,219.98 ",$103.70 ,"$1,027.35 ","$1,181.45 ",$103.70 ,"$1,091.56 ","$1,219.98 ","$1,130.09 ",$975.98 ,$103.70 ,$103.70 ,$103.70 ,$937.46 ,$706.30 ,"$1,168.61 ","$1,168.61 ","$1,027.35 ", N/A ,$706.30 ,"$1,155.77 ", N/A ,"$1,155.77 ",$693.46 ,"$1,207.14 ", N/A ,"$1,181.45 ",$109.92 ,"$1,168.61 ", N/A ,$790.29 ,$790.29 ,"$1,155.77 ",$958.39 ,$894.44 , N/A ,$103.70 ,"$1,219.98 ", N/A ,$103.70 ,"$1,117.25 ", N/A ,"$1,155.77 ", N/A ,"$1,155.77 ","$1,155.77 ","$1,155.77 ","$1,245.66 ","$1,040.19 ","$1,194.30 ","$1,104.40 ","$1,245.66 "
SACRED HEART HOSPITAL (ACU),74000033,95939,HC TCMEP UPPER AND LOWER,740,1 ,$840.26 ,$630.20 ,$44.29 ,"$2,189.34 ",$541.13 ,$973.04 ,$588.18 ,$44.29 ,$697.42 ,$45.62 ,$554.57 ,$798.25 ,$44.29 ,$672.21 ,$773.04 ,$44.29 ,$714.22 ,$798.25 ,$739.43 ,$638.60 ,$44.29 ,$44.29 ,$44.29 ,$613.39 ,$462.14 ,$764.64 ,$764.64 ,$672.21 ,"$1,002.23 ",$462.14 ,$756.23 ,$973.04 ,$756.23 ,$453.74 ,$789.84 ,"$2,189.34 ",$773.04 ,$46.95 ,$764.64 ,$973.04 ,$517.10 ,$517.10 ,$756.23 ,$627.09 ,$585.24 ,$982.77 ,$44.29 ,$798.25 ,"$1,021.69 ",$44.29 ,$731.03 ,$973.04 ,$756.23 ,$973.04 ,$756.23 ,$756.23 ,$756.23 ,$815.05 ,$680.61 ,$781.44 ,$722.62 ,$815.05 
SACRED HEART HOSPITAL (ACU),74000045,95810,HC SLEEP STUDY PSG 4+ PARAMETERS >6YRS -52,740,1 ,"$2,395.04 ","$1,796.28 ",$247.40 ,"$2,395.04 ","$1,542.41 ",$486.52 ,"$1,676.53 ",$247.40 ,"$2,395.04 ",$254.82 ,"$2,358.00 ","$2,275.29 ",$247.40 ,"$1,916.03 ","$2,203.44 ",$247.40 ,"$2,035.78 ","$2,275.29 ","$2,107.64 ","$1,820.23 ",$247.40 ,$247.40 ,$247.40 ,"$1,748.38 ","$1,317.27 ","$2,179.49 ","$2,179.49 ","$1,916.03 ",$501.12 ,"$1,317.27 ","$2,155.54 ",$486.52 ,"$2,155.54 ","$1,293.32 ","$2,251.34 ","$1,094.67 ","$2,203.44 ",$262.24 ,"$2,179.49 ",$486.52 ,"$1,473.91 ","$1,473.91 ","$2,155.54 ","$1,787.42 ","$2,036.51 ",$491.39 ,$247.40 ,"$2,275.29 ",$510.85 ,$247.40 ,"$2,083.68 ",$486.52 ,"$2,155.54 ",$486.52 ,"$2,155.54 ","$2,155.54 ","$2,155.54 ","$2,323.19 ","$1,939.98 ","$2,227.39 ","$2,059.73 ","$2,323.19 "
SACRED HEART HOSPITAL (ACU),74000046,95811,HC SLEEP STUDY PSG 4+ PARAMTRS W/CPAP >6YR-52,740,1 ,"$2,446.07 ","$1,834.55 ",$247.40 ,"$2,446.07 ","$1,575.27 ",$486.52 ,"$1,712.25 ",$247.40 ,"$2,446.07 ",$254.82 ,"$2,358.00 ","$2,323.77 ",$247.40 ,"$1,956.86 ","$2,250.38 ",$247.40 ,"$2,079.16 ","$2,323.77 ","$2,152.54 ","$1,859.01 ",$247.40 ,$247.40 ,$247.40 ,"$1,785.63 ","$1,345.34 ","$2,225.92 ","$2,225.92 ","$1,956.86 ",$501.12 ,"$1,345.34 ","$2,201.46 ",$486.52 ,"$2,201.46 ","$1,320.88 ","$2,299.31 ","$1,094.67 ","$2,250.38 ",$262.24 ,"$2,225.92 ",$486.52 ,"$1,505.31 ","$1,505.31 ","$2,201.46 ","$1,825.50 ","$2,036.51 ",$491.39 ,$247.40 ,"$2,323.77 ",$510.85 ,$247.40 ,"$2,128.08 ",$486.52 ,"$2,201.46 ",$486.52 ,"$2,201.46 ","$2,201.46 ","$2,201.46 ","$2,372.69 ","$1,981.32 ","$2,274.85 ","$2,103.62 ","$2,372.69 "
SACRED HEART HOSPITAL (ACU),74000085,95707,HC EEG W/O VIDEO BY TECH 2-12 HOURS W/CONTINUOUS REAL-TIME MONITORING,740,1 ,"$1,008.10 ",$756.08 ,$103.70 ,"$1,008.10 ",$649.22 ,$279.91 ,$705.67 ,$103.70 ,$836.72 ,$106.81 ,$665.35 ,$957.70 ,$103.70 ,$806.48 ,$927.45 ,$103.70 ,$856.89 ,$957.70 ,$887.13 ,$766.16 ,$103.70 ,$103.70 ,$103.70 ,$735.91 ,$554.46 ,$917.37 ,$917.37 ,$806.48 ,$288.31 ,$554.46 ,$907.29 ,$279.91 ,$907.29 ,$544.37 ,$947.61 ,$629.79 ,$927.45 ,$109.92 ,$917.37 ,$279.91 ,$620.38 ,$620.38 ,$907.29 ,$752.35 ,$702.14 ,$282.71 ,$103.70 ,$957.70 ,$293.90 ,$103.70 ,$877.05 ,$279.91 ,$907.29 ,$279.91 ,$907.29 ,$907.29 ,$907.29 ,$977.86 ,$816.56 ,$937.53 ,$866.97 ,$977.86 
SACRED HEART HOSPITAL (ACU),74000091,95713,HC VEEG W/VIDEO BY TECH 2-12 HOURS W/CONTINUOUS REAL-TIME MONITORING,740,1 ,"$1,556.96 ","$1,167.72 ",$103.70 ,"$1,556.96 ","$1,002.68 ",$516.27 ,"$1,089.87 ",$103.70 ,"$1,292.28 ",$106.81 ,"$1,027.59 ","$1,479.11 ",$103.70 ,"$1,245.57 ","$1,432.40 ",$103.70 ,"$1,323.42 ","$1,479.11 ","$1,370.12 ","$1,183.29 ",$103.70 ,$103.70 ,$103.70 ,"$1,136.58 ",$856.33 ,"$1,416.83 ","$1,416.83 ","$1,245.57 ",$531.76 ,$856.33 ,"$1,401.26 ",$516.27 ,"$1,401.26 ",$840.76 ,"$1,463.54 ","$1,161.60 ","$1,432.40 ",$109.92 ,"$1,416.83 ",$516.27 ,$958.15 ,$958.15 ,"$1,401.26 ","$1,161.96 ","$1,084.42 ",$521.43 ,$103.70 ,"$1,479.11 ",$542.08 ,$103.70 ,"$1,354.56 ",$516.27 ,"$1,401.26 ",$516.27 ,"$1,401.26 ","$1,401.26 ","$1,401.26 ","$1,510.25 ","$1,261.14 ","$1,447.97 ","$1,338.99 ","$1,510.25 "
SACRED HEART HOSPITAL (ACU),74000094,95716,HC VEEG W/VIDEO BY TECH 12-26 HOURS EACH INCREMENT W/CONTINUOUS REAL-TIME MONITORING,740,1 ,"$3,291.18 ","$2,468.39 ",$164.47 ,"$3,291.18 ","$2,119.52 ",$973.04 ,"$2,303.83 ",$164.47 ,"$2,731.68 ",$169.40 ,"$2,172.18 ","$3,126.62 ",$164.47 ,"$2,632.94 ","$3,027.89 ",$164.47 ,"$2,797.50 ","$3,126.62 ","$2,896.24 ","$2,501.30 ",$164.47 ,$164.47 ,$164.47 ,"$2,402.56 ","$1,810.15 ","$2,994.97 ","$2,994.97 ","$2,632.94 ","$1,002.23 ","$1,810.15 ","$2,962.06 ",$973.04 ,"$2,962.06 ","$1,777.24 ","$3,093.71 ","$2,189.34 ","$3,027.89 ",$174.34 ,"$2,994.97 ",$973.04 ,"$2,025.39 ","$2,025.39 ","$2,962.06 ","$2,456.21 ","$2,292.31 ",$982.77 ,$164.47 ,"$3,126.62 ","$1,021.69 ",$164.47 ,"$2,863.33 ",$973.04 ,"$2,962.06 ",$973.04 ,"$2,962.06 ","$2,962.06 ","$2,962.06 ","$3,192.44 ","$2,665.86 ","$3,060.80 ","$2,830.41 ","$3,192.44 "
SACRED HEART HOSPITAL (ACU),75000018,N/A,HC EGD/BANDING,750,1 ,"$3,465.00 ","$2,598.75 ","$1,871.10 ","$3,465.00 ","$2,231.46 ", N/A ,"$2,425.50 ", N/A , N/A , N/A , N/A ,"$3,291.75 ", N/A ,"$2,772.00 ","$3,187.80 ", N/A ,"$2,945.25 ","$3,291.75 ","$3,049.20 ","$2,633.40 ", N/A , N/A , N/A ,"$2,529.45 ","$1,905.75 ","$3,153.15 ","$3,153.15 ","$2,772.00 ", N/A ,"$1,905.75 ","$3,118.50 ", N/A ,"$3,118.50 ","$1,871.10 ","$3,257.10 ", N/A ,"$3,187.80 ", N/A ,"$3,153.15 ", N/A , N/A , N/A ,"$3,118.50 ","$2,585.93 ", N/A , N/A , N/A ,"$3,291.75 ", N/A , N/A ,"$3,014.55 ", N/A ,"$3,118.50 ", N/A ,"$3,118.50 ","$3,118.50 ","$3,118.50 ","$3,361.05 ","$2,806.65 ","$3,222.45 ","$2,979.90 ","$3,361.05 "
SACRED HEART HOSPITAL (ACU),75000021,N/A,HC EGD/PEG PLACEMENT,750,1 ,"$2,393.00 ","$1,794.75 ","$1,292.22 ","$2,393.00 ","$1,541.09 ", N/A ,"$1,675.10 ", N/A , N/A , N/A , N/A ,"$2,273.35 ", N/A ,"$1,914.40 ","$2,201.56 ", N/A ,"$2,034.05 ","$2,273.35 ","$2,105.84 ","$1,818.68 ", N/A , N/A , N/A ,"$1,746.89 ","$1,316.15 ","$2,177.63 ","$2,177.63 ","$1,914.40 ", N/A ,"$1,316.15 ","$2,153.70 ", N/A ,"$2,153.70 ","$1,292.22 ","$2,249.42 ", N/A ,"$2,201.56 ", N/A ,"$2,177.63 ", N/A , N/A , N/A ,"$2,153.70 ","$1,785.90 ", N/A , N/A , N/A ,"$2,273.35 ", N/A , N/A ,"$2,081.91 ", N/A ,"$2,153.70 ", N/A ,"$2,153.70 ","$2,153.70 ","$2,153.70 ","$2,321.21 ","$1,938.33 ","$2,225.49 ","$2,057.98 ","$2,321.21 "
SACRED HEART HOSPITAL (ACU),75000039,N/A,HC ENTEROSCOPY,750,1 ,"$3,465.00 ","$2,598.75 ","$1,871.10 ","$3,465.00 ","$2,231.46 ", N/A ,"$2,425.50 ", N/A , N/A , N/A , N/A ,"$3,291.75 ", N/A ,"$2,772.00 ","$3,187.80 ", N/A ,"$2,945.25 ","$3,291.75 ","$3,049.20 ","$2,633.40 ", N/A , N/A , N/A ,"$2,529.45 ","$1,905.75 ","$3,153.15 ","$3,153.15 ","$2,772.00 ", N/A ,"$1,905.75 ","$3,118.50 ", N/A ,"$3,118.50 ","$1,871.10 ","$3,257.10 ", N/A ,"$3,187.80 ", N/A ,"$3,153.15 ", N/A , N/A , N/A ,"$3,118.50 ","$2,585.93 ", N/A , N/A , N/A ,"$3,291.75 ", N/A , N/A ,"$3,014.55 ", N/A ,"$3,118.50 ", N/A ,"$3,118.50 ","$3,118.50 ","$3,118.50 ","$3,361.05 ","$2,806.65 ","$3,222.45 ","$2,979.90 ","$3,361.05 "
SACRED HEART HOSPITAL (ACU),75000046,N/A,HC ERCP,750,1 ,"$3,876.00 ","$2,907.00 ","$2,093.04 ","$3,876.00 ","$2,496.14 ", N/A ,"$2,713.20 ", N/A , N/A , N/A , N/A ,"$3,682.20 ", N/A ,"$3,100.80 ","$3,565.92 ", N/A ,"$3,294.60 ","$3,682.20 ","$3,410.88 ","$2,945.76 ", N/A , N/A , N/A ,"$2,829.48 ","$2,131.80 ","$3,527.16 ","$3,527.16 ","$3,100.80 ", N/A ,"$2,131.80 ","$3,488.40 ", N/A ,"$3,488.40 ","$2,093.04 ","$3,643.44 ", N/A ,"$3,565.92 ", N/A ,"$3,527.16 ", N/A , N/A , N/A ,"$3,488.40 ","$2,892.66 ", N/A , N/A , N/A ,"$3,682.20 ", N/A , N/A ,"$3,372.12 ", N/A ,"$3,488.40 ", N/A ,"$3,488.40 ","$3,488.40 ","$3,488.40 ","$3,759.72 ","$3,139.56 ","$3,604.68 ","$3,333.36 ","$3,759.72 "
SACRED HEART HOSPITAL (ACU),75000067,N/A,HC ILEOSCOPY STOMA,750,1 ,"$2,800.00 ","$2,100.00 ","$1,512.00 ","$2,800.00 ","$1,803.20 ", N/A ,"$1,960.00 ", N/A , N/A , N/A , N/A ,"$2,660.00 ", N/A ,"$2,240.00 ","$2,576.00 ", N/A ,"$2,380.00 ","$2,660.00 ","$2,464.00 ","$2,128.00 ", N/A , N/A , N/A ,"$2,044.00 ","$1,540.00 ","$2,548.00 ","$2,548.00 ","$2,240.00 ", N/A ,"$1,540.00 ","$2,520.00 ", N/A ,"$2,520.00 ","$1,512.00 ","$2,632.00 ", N/A ,"$2,576.00 ", N/A ,"$2,548.00 ", N/A , N/A , N/A ,"$2,520.00 ","$2,089.64 ", N/A , N/A , N/A ,"$2,660.00 ", N/A , N/A ,"$2,436.00 ", N/A ,"$2,520.00 ", N/A ,"$2,520.00 ","$2,520.00 ","$2,520.00 ","$2,716.00 ","$2,268.00 ","$2,604.00 ","$2,408.00 ","$2,716.00 "
SACRED HEART HOSPITAL (ACU),75000098,49083,HC PARACENTESIS W/IMAGING,750,1 ,"$2,020.08 ","$1,515.06 ",$239.96 ,"$2,020.08 ","$1,300.93 ",$855.79 ,"$1,414.06 ",$239.96 ,"$2,020.08 ",$247.16 ,"$2,020.08 ","$1,919.08 ",$239.96 ,"$1,616.06 ","$1,858.47 ",$239.96 ,"$1,717.07 ","$1,919.08 ","$1,777.67 ","$1,535.26 ",$239.96 ,$239.96 ,$239.96 ,"$1,474.66 ","$1,111.04 ","$1,838.27 ","$1,838.27 ","$1,616.06 ",$881.46 ,"$1,111.04 ","$1,818.07 ",$855.79 ,"$1,818.07 ","$1,090.84 ","$1,898.88 ","$1,925.53 ","$1,858.47 ",$254.36 ,"$1,838.27 ",$855.79 ,"$1,243.16 ","$1,243.16 ","$1,818.07 ","$1,507.59 ","$1,818.07 ",$864.35 ,$239.96 ,"$1,919.08 ",$898.58 ,$239.96 ,"$1,757.47 ",$855.79 ,"$1,818.07 ",$855.79 ,"$1,818.07 ","$1,818.07 ","$1,818.07 ","$1,959.48 ","$1,636.26 ","$1,878.67 ","$1,737.27 ","$1,959.48 "
SACRED HEART HOSPITAL (ACU),75000149,43229,HC ESOPHAGOSCOPY W/ABLATION TUMOR/POLYP,750,1 ,"$3,266.00 ","$2,449.50 ",$673.06 ,"$7,306.82 ","$2,103.30 ","$3,247.48 ","$2,286.20 ",$673.06 ,"$3,266.00 ",$693.25 ,"$3,266.00 ","$3,102.70 ",$673.06 ,"$2,612.80 ","$3,004.72 ",$673.06 ,"$2,776.10 ","$3,102.70 ","$2,874.08 ","$2,482.16 ",$673.06 ,$673.06 ,$673.06 ,"$2,384.18 ","$1,796.30 ","$2,972.06 ","$2,972.06 ","$2,612.80 ","$3,344.90 ","$1,796.30 ","$2,939.40 ","$3,247.48 ","$2,939.40 ","$1,763.64 ","$3,070.04 ","$7,306.82 ","$3,004.72 ",$713.44 ,"$2,972.06 ","$3,247.48 ","$2,009.90 ","$2,009.90 ","$2,939.40 ","$2,437.42 ","$2,939.40 ","$3,279.95 ",$673.06 ,"$3,102.70 ","$3,409.85 ",$673.06 ,"$2,841.42 ","$3,247.48 ","$2,939.40 ","$3,247.48 ","$2,939.40 ","$2,939.40 ","$2,939.40 ","$3,168.02 ","$2,645.46 ","$3,037.38 ","$2,808.76 ","$3,168.02 "
SACRED HEART HOSPITAL (ACU),75001007,91010,HC MOTILITY STUDY ESOPHAGEAL,750,1 ,"$1,519.30 ","$1,139.48 ",$218.32 ,"$1,519.30 ",$978.43 ,$516.27 ,"$1,063.51 ",$218.32 ,"$1,519.30 ",$224.87 ,"$1,519.30 ","$1,443.34 ",$218.32 ,"$1,215.44 ","$1,397.76 ",$218.32 ,"$1,291.41 ","$1,443.34 ","$1,336.98 ","$1,154.67 ",$218.32 ,$218.32 ,$218.32 ,"$1,109.09 ",$835.62 ,"$1,382.56 ","$1,382.56 ","$1,215.44 ",$531.76 ,$835.62 ,"$1,367.37 ",$516.27 ,"$1,367.37 ",$820.42 ,"$1,428.14 ","$1,161.60 ","$1,397.76 ",$231.42 ,"$1,382.56 ",$516.27 ,$934.98 ,$934.98 ,"$1,367.37 ","$1,133.85 ",$794.24 ,$521.43 ,$218.32 ,"$1,443.34 ",$542.08 ,$218.32 ,"$1,321.79 ",$516.27 ,"$1,367.37 ",$516.27 ,"$1,367.37 ","$1,367.37 ","$1,367.37 ","$1,473.72 ","$1,230.63 ","$1,412.95 ","$1,306.60 ","$1,473.72 "
SACRED HEART HOSPITAL (ACU),75001008,N/A,HC EGD W/DILATION,750,1 ,"$3,465.00 ","$2,598.75 ","$1,871.10 ","$3,465.00 ","$2,231.46 ", N/A ,"$2,425.50 ", N/A , N/A , N/A , N/A ,"$3,291.75 ", N/A ,"$2,772.00 ","$3,187.80 ", N/A ,"$2,945.25 ","$3,291.75 ","$3,049.20 ","$2,633.40 ", N/A , N/A , N/A ,"$2,529.45 ","$1,905.75 ","$3,153.15 ","$3,153.15 ","$2,772.00 ", N/A ,"$1,905.75 ","$3,118.50 ", N/A ,"$3,118.50 ","$1,871.10 ","$3,257.10 ", N/A ,"$3,187.80 ", N/A ,"$3,153.15 ", N/A , N/A , N/A ,"$3,118.50 ","$2,585.93 ", N/A , N/A , N/A ,"$3,291.75 ", N/A , N/A ,"$3,014.55 ", N/A ,"$3,118.50 ", N/A ,"$3,118.50 ","$3,118.50 ","$3,118.50 ","$3,361.05 ","$2,806.65 ","$3,222.45 ","$2,979.90 ","$3,361.05 "
SACRED HEART HOSPITAL (ACU),75001009,N/A,HC COLONOSCOPY PROC LEVEL 1,750,1 ,"$1,814.00 ","$1,360.50 ",$979.56 ,"$1,814.00 ","$1,168.22 ", N/A ,"$1,269.80 ", N/A , N/A , N/A , N/A ,"$1,723.30 ", N/A ,"$1,451.20 ","$1,668.88 ", N/A ,"$1,541.90 ","$1,723.30 ","$1,596.32 ","$1,378.64 ", N/A , N/A , N/A ,"$1,324.22 ",$997.70 ,"$1,650.74 ","$1,650.74 ","$1,451.20 ", N/A ,$997.70 ,"$1,632.60 ", N/A ,"$1,632.60 ",$979.56 ,"$1,705.16 ", N/A ,"$1,668.88 ", N/A ,"$1,650.74 ", N/A , N/A , N/A ,"$1,632.60 ","$1,353.79 ", N/A , N/A , N/A ,"$1,723.30 ", N/A , N/A ,"$1,578.18 ", N/A ,"$1,632.60 ", N/A ,"$1,632.60 ","$1,632.60 ","$1,632.60 ","$1,759.58 ","$1,469.34 ","$1,687.02 ","$1,560.04 ","$1,759.58 "
SACRED HEART HOSPITAL (ACU),75001010,N/A,HC COLONOSCOPY PROC LEVEL 2,750,1 ,"$2,667.00 ","$2,000.25 ","$1,440.18 ","$2,667.00 ","$1,717.55 ", N/A ,"$1,866.90 ", N/A , N/A , N/A , N/A ,"$2,533.65 ", N/A ,"$2,133.60 ","$2,453.64 ", N/A ,"$2,266.95 ","$2,533.65 ","$2,346.96 ","$2,026.92 ", N/A , N/A , N/A ,"$1,946.91 ","$1,466.85 ","$2,426.97 ","$2,426.97 ","$2,133.60 ", N/A ,"$1,466.85 ","$2,400.30 ", N/A ,"$2,400.30 ","$1,440.18 ","$2,506.98 ", N/A ,"$2,453.64 ", N/A ,"$2,426.97 ", N/A , N/A , N/A ,"$2,400.30 ","$1,990.38 ", N/A , N/A , N/A ,"$2,533.65 ", N/A , N/A ,"$2,320.29 ", N/A ,"$2,400.30 ", N/A ,"$2,400.30 ","$2,400.30 ","$2,400.30 ","$2,586.99 ","$2,160.27 ","$2,480.31 ","$2,293.62 ","$2,586.99 "
SACRED HEART HOSPITAL (ACU),75001014,N/A,HC EGD PROC LEVEL 1,750,1 ,"$3,054.00 ","$2,290.50 ","$1,649.16 ","$3,054.00 ","$1,966.78 ", N/A ,"$2,137.80 ", N/A , N/A , N/A , N/A ,"$2,901.30 ", N/A ,"$2,443.20 ","$2,809.68 ", N/A ,"$2,595.90 ","$2,901.30 ","$2,687.52 ","$2,321.04 ", N/A , N/A , N/A ,"$2,229.42 ","$1,679.70 ","$2,779.14 ","$2,779.14 ","$2,443.20 ", N/A ,"$1,679.70 ","$2,748.60 ", N/A ,"$2,748.60 ","$1,649.16 ","$2,870.76 ", N/A ,"$2,809.68 ", N/A ,"$2,779.14 ", N/A , N/A , N/A ,"$2,748.60 ","$2,279.20 ", N/A , N/A , N/A ,"$2,901.30 ", N/A , N/A ,"$2,656.98 ", N/A ,"$2,748.60 ", N/A ,"$2,748.60 ","$2,748.60 ","$2,748.60 ","$2,962.38 ","$2,473.74 ","$2,840.22 ","$2,626.44 ","$2,962.38 "
SACRED HEART HOSPITAL (ACU),75001025,N/A,HC FLEX SIGMOIDOSCOPY PROC LEVEL 1,750,1 ,"$2,971.00 ","$2,228.25 ","$1,604.34 ","$2,971.00 ","$1,913.32 ", N/A ,"$2,079.70 ", N/A , N/A , N/A , N/A ,"$2,822.45 ", N/A ,"$2,376.80 ","$2,733.32 ", N/A ,"$2,525.35 ","$2,822.45 ","$2,614.48 ","$2,257.96 ", N/A , N/A , N/A ,"$2,168.83 ","$1,634.05 ","$2,703.61 ","$2,703.61 ","$2,376.80 ", N/A ,"$1,634.05 ","$2,673.90 ", N/A ,"$2,673.90 ","$1,604.34 ","$2,792.74 ", N/A ,"$2,733.32 ", N/A ,"$2,703.61 ", N/A , N/A , N/A ,"$2,673.90 ","$2,217.26 ", N/A , N/A , N/A ,"$2,822.45 ", N/A , N/A ,"$2,584.77 ", N/A ,"$2,673.90 ", N/A ,"$2,673.90 ","$2,673.90 ","$2,673.90 ","$2,881.87 ","$2,406.51 ","$2,763.03 ","$2,555.06 ","$2,881.87 "
SACRED HEART HOSPITAL (ACU),75001033,N/A,HC BONE MARROW BIOPSY,750,1 ,$888.00 ,$666.00 ,$479.52 ,$888.00 ,$571.87 , N/A ,$621.60 , N/A , N/A , N/A , N/A ,$843.60 , N/A ,$710.40 ,$816.96 , N/A ,$754.80 ,$843.60 ,$781.44 ,$674.88 , N/A , N/A , N/A ,$648.24 ,$488.40 ,$808.08 ,$808.08 ,$710.40 , N/A ,$488.40 ,$799.20 , N/A ,$799.20 ,$479.52 ,$834.72 , N/A ,$816.96 , N/A ,$808.08 , N/A , N/A , N/A ,$799.20 ,$662.71 , N/A , N/A , N/A ,$843.60 , N/A , N/A ,$772.56 , N/A ,$799.20 , N/A ,$799.20 ,$799.20 ,$799.20 ,$861.36 ,$719.28 ,$825.84 ,$763.68 ,$861.36 
SACRED HEART HOSPITAL (ACU),75001044,N/A,HC COLONOSCOPY W/BIOPSY/POLYP LEVEL 1,750,1 ,"$2,747.00 ","$2,060.25 ","$1,483.38 ","$2,747.00 ","$1,769.07 ", N/A ,"$1,922.90 ", N/A , N/A , N/A , N/A ,"$2,609.65 ", N/A ,"$2,197.60 ","$2,527.24 ", N/A ,"$2,334.95 ","$2,609.65 ","$2,417.36 ","$2,087.72 ", N/A , N/A , N/A ,"$2,005.31 ","$1,510.85 ","$2,499.77 ","$2,499.77 ","$2,197.60 ", N/A ,"$1,510.85 ","$2,472.30 ", N/A ,"$2,472.30 ","$1,483.38 ","$2,582.18 ", N/A ,"$2,527.24 ", N/A ,"$2,499.77 ", N/A , N/A , N/A ,"$2,472.30 ","$2,050.09 ", N/A , N/A , N/A ,"$2,609.65 ", N/A , N/A ,"$2,389.89 ", N/A ,"$2,472.30 ", N/A ,"$2,472.30 ","$2,472.30 ","$2,472.30 ","$2,664.59 ","$2,225.07 ","$2,554.71 ","$2,362.42 ","$2,664.59 "
SACRED HEART HOSPITAL (ACU),75001066,N/A,HC ESOPHAGOSCOPY FLEXIBLE DX W/BRUSH/WASH -43200,750,1 ,"$2,526.00 ","$1,894.50 ","$1,364.04 ","$2,526.00 ","$1,626.74 ", N/A ,"$1,768.20 ", N/A , N/A , N/A , N/A ,"$2,399.70 ", N/A ,"$2,020.80 ","$2,323.92 ", N/A ,"$2,147.10 ","$2,399.70 ","$2,222.88 ","$1,919.76 ", N/A , N/A , N/A ,"$1,843.98 ","$1,389.30 ","$2,298.66 ","$2,298.66 ","$2,020.80 ", N/A ,"$1,389.30 ","$2,273.40 ", N/A ,"$2,273.40 ","$1,364.04 ","$2,374.44 ", N/A ,"$2,323.92 ", N/A ,"$2,298.66 ", N/A , N/A , N/A ,"$2,273.40 ","$1,885.15 ", N/A , N/A , N/A ,"$2,399.70 ", N/A , N/A ,"$2,197.62 ", N/A ,"$2,273.40 ", N/A ,"$2,273.40 ","$2,273.40 ","$2,273.40 ","$2,450.22 ","$2,046.06 ","$2,349.18 ","$2,172.36 ","$2,450.22 "
SACRED HEART HOSPITAL (ACU),75001223,N/A,HC SMALL BOWEL ENDOSCOPY- 44378,750,1 ,"$5,069.00 ","$3,801.75 ","$2,737.26 ","$5,069.00 ","$3,264.44 ", N/A ,"$3,548.30 ", N/A , N/A , N/A , N/A ,"$4,815.55 ", N/A ,"$4,055.20 ","$4,663.48 ", N/A ,"$4,308.65 ","$4,815.55 ","$4,460.72 ","$3,852.44 ", N/A , N/A , N/A ,"$3,700.37 ","$2,787.95 ","$4,612.79 ","$4,612.79 ","$4,055.20 ", N/A ,"$2,787.95 ","$4,562.10 ", N/A ,"$4,562.10 ","$2,737.26 ","$4,764.86 ", N/A ,"$4,663.48 ", N/A ,"$4,612.79 ", N/A , N/A , N/A ,"$4,562.10 ","$3,782.99 ", N/A , N/A , N/A ,"$4,815.55 ", N/A , N/A ,"$4,410.03 ", N/A ,"$4,562.10 ", N/A ,"$4,562.10 ","$4,562.10 ","$4,562.10 ","$4,916.93 ","$4,105.89 ","$4,714.17 ","$4,359.34 ","$4,916.93 "
SACRED HEART HOSPITAL (ACU),76000012,36514,HC PLASMAPHERESIS THERAPY,361,1 ,"$2,382.00 ","$1,786.50 ",$555.62 ,"$3,245.81 ","$1,534.01 ","$1,442.58 ","$1,667.40 ",$555.62 ,"$2,382.00 ",$572.29 ,"$2,382.00 ","$2,262.90 ",$555.62 ,"$1,905.60 ","$2,191.44 ",$555.62 , N/A ,"$2,262.90 ","$2,096.16 ","$1,810.32 ",$555.62 ,$555.62 ,$555.62 ,"$1,738.86 ","$1,310.10 ","$2,167.62 ","$2,167.62 ","$1,905.60 ","$1,485.86 ","$1,310.10 ","$2,143.80 ","$1,442.58 ","$2,143.80 ","$1,286.28 ","$2,239.08 ","$3,245.81 ","$2,191.44 ",$588.96 ,"$2,167.62 ","$1,442.58 ","$1,465.88 ","$1,465.88 ","$2,143.80 ","$1,777.69 ","$2,143.80 ","$1,457.01 ",$555.62 ,"$2,262.90 ","$1,514.71 ",$555.62 ,"$2,072.34 ","$1,442.58 ","$2,143.80 ","$1,442.58 ","$2,143.80 ","$2,143.80 ","$2,143.80 ","$2,310.54 ","$1,929.42 ","$2,215.26 ","$2,048.52 ","$2,310.54 "
SACRED HEART HOSPITAL (ACU),76000014,62273,HC INJ EPIDURAL BLD/CLOT PATCH,760,1 ,"$1,717.00 ","$1,287.75 ",$277.73 ,"$1,717.00 ","$1,105.75 ",$671.59 ,"$1,201.90 ",$277.73 ,"$1,425.11 ",$286.06 ,"$1,133.22 ","$1,631.15 ",$277.73 ,"$1,373.60 ","$1,579.64 ",$277.73 ,"$1,459.45 ","$1,631.15 ","$1,510.96 ","$1,304.92 ",$277.73 ,$277.73 ,$277.73 ,"$1,253.41 ",$944.35 ,"$1,562.47 ","$1,562.47 ","$1,373.60 ",$691.74 ,$944.35 ,"$1,545.30 ",$671.59 ,"$1,545.30 ",$927.18 ,"$1,613.98 ","$1,511.09 ","$1,579.64 ",$294.39 ,"$1,562.47 ",$671.59 ,"$1,056.64 ","$1,056.64 ","$1,545.30 ","$1,281.40 ","$1,195.89 ",$678.31 ,$277.73 ,"$1,631.15 ",$705.17 ,$277.73 ,"$1,493.79 ",$671.59 ,"$1,545.30 ",$671.59 ,"$1,545.30 ","$1,545.30 ","$1,545.30 ","$1,665.49 ","$1,390.77 ","$1,596.81 ","$1,476.62 ","$1,665.49 "
SACRED HEART HOSPITAL (ACU),76200008,G0379,HC OBSERVATION DIRECT ADMIT,762,1 ,$248.00 ,$186.00 ,$39.52 ,$248.00 ,$159.71 , N/A ,$173.60 ,$39.52 ,$248.00 ,$40.71 ,$248.00 ,$235.60 ,$39.52 ,$198.40 ,$228.16 ,$39.52 ,$210.80 ,$235.60 ,$218.24 ,$188.48 ,$39.52 ,$39.52 ,$39.52 ,$181.04 ,$136.40 ,$225.68 ,$225.68 ,$198.40 , N/A ,$136.40 ,$223.20 , N/A ,$223.20 ,$133.92 ,$233.12 , N/A ,$228.16 ,$41.89 ,$225.68 , N/A ,$152.62 ,$152.62 ,$223.20 ,$185.08 ,$223.20 , N/A ,$39.52 ,$235.60 , N/A ,$39.52 ,$215.76 , N/A ,$223.20 , N/A ,$223.20 ,$223.20 ,$223.20 ,$240.56 ,$200.88 ,$230.64 ,$213.28 ,$240.56 
SACRED HEART HOSPITAL (ACU),76200009,G0378,HC OBSERVATION HOURLY,762,1 ,$88.00 ,$66.00 ,$47.52 ,$88.00 ,$56.67 , N/A ,$61.60 , N/A ,$88.00 , N/A ,$88.00 ,$83.60 , N/A ,$70.40 ,$80.96 , N/A ,$74.80 ,$83.60 ,$77.44 ,$66.88 , N/A , N/A , N/A ,$64.24 ,$48.40 ,$80.08 ,$80.08 ,$70.40 , N/A ,$48.40 ,$79.20 , N/A ,$79.20 ,$47.52 ,$82.72 , N/A ,$80.96 , N/A ,$80.08 , N/A ,$54.16 ,$54.16 ,$79.20 ,$65.67 ,$79.20 , N/A , N/A ,$83.60 , N/A , N/A ,$76.56 , N/A ,$79.20 , N/A ,$79.20 ,$79.20 ,$79.20 ,$85.36 ,$71.28 ,$81.84 ,$75.68 ,$85.36 
SACRED HEART HOSPITAL (ACU),77100000,90471,HC IMMUN ADMIN ONE VACC,771,1 ,$77.55 ,$58.16 ,$12.49 ,$147.54 ,$49.94 ,$65.57 ,$54.29 ,$12.49 ,$64.37 ,$12.86 ,$51.18 ,$73.67 ,$12.49 ,$62.04 ,$71.35 ,$12.49 ,$65.92 ,$73.67 ,$68.24 ,$58.94 ,$12.49 ,$12.49 ,$12.49 ,$56.61 ,$42.65 ,$70.57 ,$70.57 ,$62.04 ,$67.54 ,$42.65 ,$69.80 ,$65.57 ,$69.80 ,$41.88 ,$72.90 ,$147.54 ,$71.35 ,$13.24 ,$70.57 ,$65.57 ,$47.72 ,$47.72 ,$69.80 ,$57.88 ,$54.01 ,$66.23 ,$12.49 ,$73.67 ,$68.85 ,$12.49 ,$67.47 ,$65.57 ,$69.80 ,$65.57 ,$69.80 ,$69.80 ,$69.80 ,$75.22 ,$62.82 ,$72.12 ,$66.69 ,$75.22 
SACRED HEART HOSPITAL (ACU),77100002,90472,HC IMMUN ADMIN EA ADD VACC,771,1 ,$76.05 ,$57.04 ,$12.49 ,$76.05 ,$48.98 , N/A ,$53.24 ,$12.49 ,$63.12 ,$12.86 ,$50.19 ,$72.25 ,$12.49 ,$60.84 ,$69.97 ,$12.49 ,$64.64 ,$72.25 ,$66.92 ,$57.80 ,$12.49 ,$12.49 ,$12.49 ,$55.52 ,$41.83 ,$69.21 ,$69.21 ,$60.84 , N/A ,$41.83 ,$68.45 , N/A ,$68.45 ,$41.07 ,$71.49 , N/A ,$69.97 ,$13.24 ,$69.21 , N/A ,$46.80 ,$46.80 ,$68.45 ,$56.76 ,$52.97 , N/A ,$12.49 ,$72.25 , N/A ,$12.49 ,$66.16 , N/A ,$68.45 , N/A ,$68.45 ,$68.45 ,$68.45 ,$73.77 ,$61.60 ,$70.73 ,$65.40 ,$73.77 
SACRED HEART HOSPITAL (ACU),77100003,G0008,HC ADMIN INFLUENZA VACCINE,771,1 ,$69.80 ,$52.35 ,$12.49 ,$95.23 ,$44.95 ,$42.32 ,$48.86 ,$12.49 ,$57.93 ,$12.86 ,$46.07 ,$66.31 ,$12.49 ,$55.84 ,$64.22 ,$12.49 ,$59.33 ,$66.31 ,$61.42 ,$53.05 ,$12.49 ,$12.49 ,$12.49 ,$50.95 ,$38.39 ,$63.52 ,$63.52 ,$55.84 ,$43.59 ,$38.39 ,$62.82 ,$42.32 ,$62.82 ,$37.69 ,$65.61 ,$95.23 ,$64.22 ,$13.24 ,$63.52 ,$42.32 ,$42.95 ,$42.95 ,$62.82 ,$52.09 ,$48.62 ,$42.75 ,$12.49 ,$66.31 ,$44.44 ,$12.49 ,$60.73 ,$42.32 ,$62.82 ,$42.32 ,$62.82 ,$62.82 ,$62.82 ,$67.71 ,$56.54 ,$64.91 ,$60.03 ,$67.71 
SACRED HEART HOSPITAL (ACU),77100005,G0009,HC ADMIN PNEUMOCOCCAL VACCINE,771,1 ,$69.80 ,$52.35 ,$12.49 ,$95.23 ,$44.95 ,$42.32 ,$48.86 ,$12.49 ,$57.93 ,$12.86 ,$46.07 ,$66.31 ,$12.49 ,$55.84 ,$64.22 ,$12.49 ,$59.33 ,$66.31 ,$61.42 ,$53.05 ,$12.49 ,$12.49 ,$12.49 ,$50.95 ,$38.39 ,$63.52 ,$63.52 ,$55.84 ,$43.59 ,$38.39 ,$62.82 ,$42.32 ,$62.82 ,$37.69 ,$65.61 ,$95.23 ,$64.22 ,$13.24 ,$63.52 ,$42.32 ,$42.95 ,$42.95 ,$62.82 ,$52.09 ,$48.62 ,$42.75 ,$12.49 ,$66.31 ,$44.44 ,$12.49 ,$60.73 ,$42.32 ,$62.82 ,$42.32 ,$62.82 ,$62.82 ,$62.82 ,$67.71 ,$56.54 ,$64.91 ,$60.03 ,$67.71 
SACRED HEART HOSPITAL (ACU),77100006,G0010,HC INJECTION-HEPATITIS B VACCINE,771,1 ,$69.80 ,$52.35 ,$12.49 ,$95.23 ,$44.95 ,$42.32 ,$48.86 ,$12.49 ,$57.93 ,$12.86 ,$46.07 ,$66.31 ,$12.49 ,$55.84 ,$64.22 ,$12.49 ,$59.33 ,$66.31 ,$61.42 ,$53.05 ,$12.49 ,$12.49 ,$12.49 ,$50.95 ,$38.39 ,$63.52 ,$63.52 ,$55.84 ,$43.59 ,$38.39 ,$62.82 ,$42.32 ,$62.82 ,$37.69 ,$65.61 ,$95.23 ,$64.22 ,$13.24 ,$63.52 ,$42.32 ,$42.95 ,$42.95 ,$62.82 ,$52.09 ,$48.62 ,$42.75 ,$12.49 ,$66.31 ,$44.44 ,$12.49 ,$60.73 ,$42.32 ,$62.82 ,$42.32 ,$62.82 ,$62.82 ,$62.82 ,$67.71 ,$56.54 ,$64.91 ,$60.03 ,$67.71 
SACRED HEART HOSPITAL (ACU),77100007,90461,HC IMMUN ADMIN <8 YEARS,771,1 ,$58.96 ,$44.22 ,$12.49 ,$58.96 ,$37.97 , N/A ,$41.27 ,$12.49 ,$48.94 ,$12.86 ,$38.91 ,$56.01 ,$12.49 ,$47.17 ,$54.24 ,$12.49 ,$50.12 ,$56.01 ,$51.88 ,$44.81 ,$12.49 ,$12.49 ,$12.49 ,$43.04 ,$32.43 ,$53.65 ,$53.65 ,$47.17 , N/A ,$32.43 ,$53.06 , N/A ,$53.06 ,$31.84 ,$55.42 , N/A ,$54.24 ,$13.24 ,$53.65 , N/A ,$36.28 ,$36.28 ,$53.06 ,$44.00 ,$41.07 , N/A ,$12.49 ,$56.01 , N/A ,$12.49 ,$51.30 , N/A ,$53.06 , N/A ,$53.06 ,$53.06 ,$53.06 ,$57.19 ,$47.76 ,$54.83 ,$50.71 ,$57.19 
SACRED HEART HOSPITAL (ACU),77100009,0001A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML FIRST DOSE,771,1 ,$42.35 ,$31.76 ,$12.49 ,$93.20 ,$27.27 ,$41.42 ,$29.65 ,$12.49 ,$35.15 ,$12.86 ,$27.95 ,$40.23 ,$12.49 ,$33.88 ,$38.96 ,$12.49 ,$36.00 ,$40.23 ,$37.27 ,$32.19 ,$12.49 ,$12.49 ,$12.49 ,$30.92 ,$23.29 ,$38.54 ,$38.54 ,$33.88 ,$42.66 ,$23.29 ,$38.12 ,$41.42 ,$38.12 ,$22.87 ,$39.81 ,$93.20 ,$38.96 ,$13.24 ,$38.54 ,$41.42 ,$26.06 ,$26.06 ,$38.12 ,$31.61 ,$29.50 ,$41.84 ,$12.49 ,$40.23 ,$43.49 ,$12.49 ,$36.84 ,$41.42 ,$38.12 ,$41.42 ,$38.12 ,$38.12 ,$38.12 ,$41.08 ,$34.30 ,$39.39 ,$36.42 ,$41.08 
SACRED HEART HOSPITAL (ACU),77100010,0002A,HC ADMINISTRATION SARS-COV-2 VACCINE 30 MCG/0.3ML SECOND DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100011,0011A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5ML FIRST DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100012,0012A,HC ADMINISTRATION SARS-COV-2 VACCINE 100 MCG/0.5M SECOND DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100013,0021A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 , N/A ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 , N/A ,$55.00 ,$90.00 , N/A ,$90.00 ,$54.00 ,$94.00 , N/A ,$92.00 ,$13.24 ,$91.00 , N/A ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 , N/A ,$12.49 ,$95.00 , N/A ,$12.49 ,$87.00 , N/A ,$90.00 , N/A ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100014,0022A,HC ADMINISTRATION SARS-COV-2 VACCINE 5X10 VIRAL PARTICLES/0.5ML SECOND DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 , N/A ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 , N/A ,$55.00 ,$90.00 , N/A ,$90.00 ,$54.00 ,$94.00 , N/A ,$92.00 ,$13.24 ,$91.00 , N/A ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 , N/A ,$12.49 ,$95.00 , N/A ,$12.49 ,$87.00 , N/A ,$90.00 , N/A ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100015,0031A,HC ADMINISTRATION SARS-COV-2 VACCINE AD26 5X10 VIRAL PARTICLES/0.5ML FIRST DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100016,0041A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML FIRST DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 , N/A ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 , N/A ,$55.00 ,$90.00 , N/A ,$90.00 ,$54.00 ,$94.00 , N/A ,$92.00 ,$13.24 ,$91.00 , N/A ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 , N/A ,$12.49 ,$95.00 , N/A ,$12.49 ,$87.00 , N/A ,$90.00 , N/A ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100017,0042A,HC ADMIN SARS-COV-2 VACCINE 5 MCG/0.5ML SECOND DOSE,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 , N/A ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 , N/A ,$55.00 ,$90.00 , N/A ,$90.00 ,$54.00 ,$94.00 , N/A ,$92.00 ,$13.24 ,$91.00 , N/A ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 , N/A ,$12.49 ,$95.00 , N/A ,$12.49 ,$87.00 , N/A ,$90.00 , N/A ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100019,0013A,HC ADM SARSCOV2 100MCG/0.5ML 3RD - MODERNA,771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100020,0051A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, FIRST DOSE",771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100021,0052A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, SECOND DOSE",771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100022,0053A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, THIRD DOSE",771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100023,0004A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, DILUENT RECONSTITUTED, BOOSTER DOSE",771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100024,0054A,"HC ADMIN SARS-COV-2 VACCINE 30MCG/0.3ML, TRIS-SUCROSE, BOOSTER DOSE",771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),77100025,0064A,"HC ADMIN SARS-COV-2 VACCINE 50MCG/0.25ML, BOOSTER DOSE",771,1 ,$100.00 ,$75.00 ,$12.49 ,$100.00 ,$64.40 ,$41.42 ,$70.00 ,$12.49 ,$83.00 ,$12.86 ,$66.00 ,$95.00 ,$12.49 ,$80.00 ,$92.00 ,$12.49 ,$85.00 ,$95.00 ,$88.00 ,$76.00 ,$12.49 ,$12.49 ,$12.49 ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 ,$42.66 ,$55.00 ,$90.00 ,$41.42 ,$90.00 ,$54.00 ,$94.00 ,$93.20 ,$92.00 ,$13.24 ,$91.00 ,$41.42 ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 ,$41.84 ,$12.49 ,$95.00 ,$43.49 ,$12.49 ,$87.00 ,$41.42 ,$90.00 ,$41.42 ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),78000001,Q3014,HC TELEHEALTH ORIGINATING FAC FEE,780,1 ,$173.00 ,$129.75 ,$2.66 ,$173.00 ,$111.41 ,$27.59 ,$121.10 ,$2.66 ,$143.59 ,$2.74 ,$114.18 ,$164.35 ,$2.66 ,$138.40 ,$159.16 ,$2.66 ,$147.05 ,$164.35 ,$152.24 ,$131.48 ,$2.66 ,$2.66 ,$2.66 ,$126.29 ,$95.15 ,$157.43 ,$157.43 ,$138.40 ,$28.42 ,$95.15 ,$155.70 ,$27.59 ,$155.70 ,$93.42 ,$162.62 ,$62.08 ,$159.16 ,$2.82 ,$157.43 ,$27.59 ,$106.46 ,$106.46 ,$155.70 ,$129.11 ,$120.49 ,$27.87 ,$2.66 ,$164.35 ,$28.97 ,$2.66 ,$150.51 ,$27.59 ,$155.70 ,$27.59 ,$155.70 ,$155.70 ,$155.70 ,$167.81 ,$140.13 ,$160.89 ,$148.78 ,$167.81 
SACRED HEART HOSPITAL (ACU),82100001,90999,HC HEMODIALYSIS,821,1 ,$362.00 ,$271.50 ,$195.48 ,$362.00 ,$233.13 , N/A ,$253.40 ,$248.48 ,$300.46 ,$255.93 ,$238.92 ,$343.90 ,$248.48 ,$289.60 ,$333.04 ,$248.48 ,$307.70 ,$343.90 ,$318.56 ,$275.12 ,$248.48 ,$248.48 ,$248.48 ,$264.26 ,$199.10 ,$329.42 ,$329.42 ,$289.60 , N/A ,$199.10 ,$325.80 , N/A ,$325.80 ,$195.48 ,$340.28 , N/A ,$333.04 ,$263.39 ,$329.42 , N/A ,$222.77 ,$222.77 ,$325.80 ,$270.16 ,$252.13 , N/A ,$248.48 ,$343.90 , N/A ,$248.48 ,$314.94 , N/A ,$325.80 , N/A ,$325.80 ,$325.80 ,$325.80 ,$351.14 ,$293.22 ,$336.66 ,$311.32 ,$351.14 
SACRED HEART HOSPITAL (ACU),82100002,N/A,HC CONT VENO-VENOUS HEMOFILTRAT,821,1 ,"$2,857.00 ","$2,142.75 ","$1,542.78 ","$2,857.00 ","$1,839.91 ", N/A ,"$1,999.90 ", N/A ,"$2,371.31 ", N/A ,"$1,885.62 ","$2,714.15 ", N/A ,"$2,285.60 ","$2,628.44 ", N/A ,"$2,428.45 ","$2,714.15 ","$2,514.16 ","$2,171.32 ", N/A , N/A , N/A ,"$2,085.61 ","$1,571.35 ","$2,599.87 ","$2,599.87 ","$2,285.60 ", N/A ,"$1,571.35 ","$2,571.30 ", N/A ,"$2,571.30 ","$1,542.78 ","$2,685.58 ", N/A ,"$2,628.44 ", N/A ,"$2,599.87 ", N/A ,"$1,758.20 ","$1,758.20 ","$2,571.30 ","$2,132.18 ","$1,989.90 ", N/A , N/A ,"$2,714.15 ", N/A , N/A ,"$2,485.59 ", N/A ,"$2,571.30 ", N/A ,"$2,571.30 ","$2,571.30 ","$2,571.30 ","$2,771.29 ","$2,314.17 ","$2,657.01 ","$2,457.02 ","$2,771.29 "
SACRED HEART HOSPITAL (ACU),84100001,N/A,HC CAPD TRAINING,841,1 ,$578.00 ,$433.50 ,$312.12 ,$578.00 ,$372.23 , N/A ,$404.60 , N/A ,$479.74 , N/A ,$381.48 ,$549.10 , N/A ,$462.40 ,$531.76 , N/A ,$491.30 ,$549.10 ,$508.64 ,$439.28 , N/A , N/A , N/A ,$421.94 ,$317.90 ,$525.98 ,$525.98 ,$462.40 , N/A ,$317.90 ,$520.20 , N/A ,$520.20 ,$312.12 ,$543.32 , N/A ,$531.76 , N/A ,$525.98 , N/A ,$355.70 ,$355.70 ,$520.20 ,$431.36 ,$402.58 , N/A , N/A ,$549.10 , N/A , N/A ,$502.86 , N/A ,$520.20 , N/A ,$520.20 ,$520.20 ,$520.20 ,$560.66 ,$468.18 ,$537.54 ,$497.08 ,$560.66 
SACRED HEART HOSPITAL (ACU),84100002,N/A,HC CAPD COMPOSITE,841,1 ,$179.00 ,$134.25 ,$96.66 ,$179.00 ,$115.28 , N/A ,$125.30 , N/A ,$148.57 , N/A ,$118.14 ,$170.05 , N/A ,$143.20 ,$164.68 , N/A ,$152.15 ,$170.05 ,$157.52 ,$136.04 , N/A , N/A , N/A ,$130.67 ,$98.45 ,$162.89 ,$162.89 ,$143.20 , N/A ,$98.45 ,$161.10 , N/A ,$161.10 ,$96.66 ,$168.26 , N/A ,$164.68 , N/A ,$162.89 , N/A ,$110.16 ,$110.16 ,$161.10 ,$133.59 ,$124.67 , N/A , N/A ,$170.05 , N/A , N/A ,$155.73 , N/A ,$161.10 , N/A ,$161.10 ,$161.10 ,$161.10 ,$173.63 ,$144.99 ,$166.47 ,$153.94 ,$173.63 
SACRED HEART HOSPITAL (ACU),84500001,N/A,HC CAPD SUPP0RT SERVICES,845,1 ,$466.00 ,$349.50 ,$251.64 ,$466.00 ,$300.10 , N/A ,$326.20 , N/A ,$386.78 , N/A ,$307.56 ,$442.70 , N/A ,$372.80 ,$428.72 , N/A ,$396.10 ,$442.70 ,$410.08 ,$354.16 , N/A , N/A , N/A ,$340.18 ,$256.30 ,$424.06 ,$424.06 ,$372.80 , N/A ,$256.30 ,$419.40 , N/A ,$419.40 ,$251.64 ,$438.04 , N/A ,$428.72 , N/A ,$424.06 , N/A ,$286.78 ,$286.78 ,$419.40 ,$347.78 ,$324.57 , N/A , N/A ,$442.70 , N/A , N/A ,$405.42 , N/A ,$419.40 , N/A ,$419.40 ,$419.40 ,$419.40 ,$452.02 ,$377.46 ,$433.38 ,$400.76 ,$452.02 
SACRED HEART HOSPITAL (ACU),85100001,N/A,HC CCPD TRAINING,851,1 ,$363.00 ,$272.25 ,$196.02 ,$363.00 ,$233.77 , N/A ,$254.10 , N/A ,$301.29 , N/A ,$239.58 ,$344.85 , N/A ,$290.40 ,$333.96 , N/A ,$308.55 ,$344.85 ,$319.44 ,$275.88 , N/A , N/A , N/A ,$264.99 ,$199.65 ,$330.33 ,$330.33 ,$290.40 , N/A ,$199.65 ,$326.70 , N/A ,$326.70 ,$196.02 ,$341.22 , N/A ,$333.96 , N/A ,$330.33 , N/A ,$223.39 ,$223.39 ,$326.70 ,$270.91 ,$252.83 , N/A , N/A ,$344.85 , N/A , N/A ,$315.81 , N/A ,$326.70 , N/A ,$326.70 ,$326.70 ,$326.70 ,$352.11 ,$294.03 ,$337.59 ,$312.18 ,$352.11 
SACRED HEART HOSPITAL (ACU),85100002,N/A,HC CCPD COMPOSITE,851,1 ,$190.00 ,$142.50 ,$102.60 ,$190.00 ,$122.36 , N/A ,$133.00 , N/A ,$157.70 , N/A ,$125.40 ,$180.50 , N/A ,$152.00 ,$174.80 , N/A ,$161.50 ,$180.50 ,$167.20 ,$144.40 , N/A , N/A , N/A ,$138.70 ,$104.50 ,$172.90 ,$172.90 ,$152.00 , N/A ,$104.50 ,$171.00 , N/A ,$171.00 ,$102.60 ,$178.60 , N/A ,$174.80 , N/A ,$172.90 , N/A ,$116.93 ,$116.93 ,$171.00 ,$141.80 ,$132.34 , N/A , N/A ,$180.50 , N/A , N/A ,$165.30 , N/A ,$171.00 , N/A ,$171.00 ,$171.00 ,$171.00 ,$184.30 ,$153.90 ,$176.70 ,$163.40 ,$184.30 
SACRED HEART HOSPITAL (ACU),91400005,90832,HC THERAPY INDIVIDUAL PSYCH MASTERS 30MIN,914,1 ,$211.12 ,$158.34 ,$39.35 ,$318.40 ,$135.96 ,$141.51 ,$147.78 ,$39.35 ,$211.12 ,$40.53 ,$211.12 ,$200.56 ,$39.35 ,$168.90 ,$194.23 ,$39.35 ,$179.45 ,$200.56 ,$185.79 ,$160.45 ,$39.35 ,$39.35 ,$39.35 ,$154.12 ,$116.12 ,$192.12 ,$192.12 ,$168.90 ,$145.76 ,$116.12 ,$190.01 ,$141.51 ,$190.01 ,$114.00 ,$198.45 ,$318.40 ,$194.23 ,$41.71 ,$192.12 ,$141.51 ,$129.92 ,$129.92 ,$190.01 ,$157.56 ,$147.05 ,$142.93 ,$39.35 ,$200.56 ,$148.59 ,$39.35 ,$183.67 ,$141.51 ,$190.01 ,$141.51 ,$190.01 ,$190.01 ,$190.01 ,$204.79 ,$171.01 ,$196.34 ,$181.56 ,$204.79 
SACRED HEART HOSPITAL (ACU),91400008,90834,HC THERAPY INDIVIDUAL PSYCH MASTERS 45MIN,914,1 ,$354.20 ,$265.65 ,$47.46 ,$354.20 ,$228.10 ,$141.51 ,$247.94 ,$47.46 ,$322.00 ,$48.88 ,$258.00 ,$336.49 ,$47.46 ,$283.36 ,$325.86 ,$47.46 ,$301.07 ,$336.49 ,$311.70 ,$269.19 ,$47.46 ,$47.46 ,$47.46 ,$258.57 ,$194.81 ,$322.32 ,$322.32 ,$283.36 ,$145.76 ,$194.81 ,$318.78 ,$141.51 ,$318.78 ,$191.27 ,$332.95 ,$318.40 ,$325.86 ,$50.31 ,$322.32 ,$141.51 ,$217.97 ,$217.97 ,$318.78 ,$264.34 ,$246.70 ,$142.93 ,$47.46 ,$336.49 ,$148.59 ,$47.46 ,$308.15 ,$141.51 ,$318.78 ,$141.51 ,$318.78 ,$318.78 ,$318.78 ,$343.57 ,$286.90 ,$329.41 ,$304.61 ,$343.57 
SACRED HEART HOSPITAL (ACU),91400010,90837,HC THERAPY INDIVIDUAL PSYCH MASTERS 60MIN,914,1 ,$462.30 ,$346.73 ,$47.46 ,$462.30 ,$297.72 ,$141.51 ,$323.61 ,$47.46 ,$322.00 ,$48.88 ,$258.00 ,$439.19 ,$47.46 ,$369.84 ,$425.32 ,$47.46 ,$392.96 ,$439.19 ,$406.82 ,$351.35 ,$47.46 ,$47.46 ,$47.46 ,$337.48 ,$254.27 ,$420.69 ,$420.69 ,$369.84 ,$145.76 ,$254.27 ,$416.07 ,$141.51 ,$416.07 ,$249.64 ,$434.56 ,$318.40 ,$425.32 ,$50.31 ,$420.69 ,$141.51 ,$284.50 ,$284.50 ,$416.07 ,$345.01 ,$321.99 ,$142.93 ,$47.46 ,$439.19 ,$148.59 ,$47.46 ,$402.20 ,$141.51 ,$416.07 ,$141.51 ,$416.07 ,$416.07 ,$416.07 ,$448.43 ,$374.46 ,$429.94 ,$397.58 ,$448.43 
SACRED HEART HOSPITAL (ACU),92000001,59020,HC TEST STRESS FETAL,920,1 ,$692.00 ,$519.00 ,$59.81 ,$692.00 ,$445.65 ,$180.18 ,$484.40 ,$59.81 ,$574.36 ,$61.60 ,$456.72 ,$657.40 ,$59.81 ,$553.60 ,$636.64 ,$59.81 ,$588.20 ,$657.40 ,$608.96 ,$525.92 ,$59.81 ,$59.81 ,$59.81 ,$505.16 ,$380.60 ,$629.72 ,$629.72 ,$553.60 ,$185.59 ,$380.60 ,$622.80 ,$180.18 ,$622.80 ,$373.68 ,$650.48 ,$405.41 ,$636.64 ,$63.40 ,$629.72 ,$180.18 ,$425.86 ,$425.86 ,$622.80 ,$516.44 ,$481.98 ,$181.98 ,$59.81 ,$657.40 ,$189.19 ,$59.81 ,$602.04 ,$180.18 ,$622.80 ,$180.18 ,$622.80 ,$622.80 ,$622.80 ,$671.24 ,$560.52 ,$643.56 ,$595.12 ,$671.24 
SACRED HEART HOSPITAL (ACU),92000002,59025,HC TEST NON STRESS FETAL,920,1 ,$497.00 ,$372.75 ,$59.81 ,$497.00 ,$320.07 ,$180.18 ,$347.90 ,$59.81 ,$412.51 ,$61.60 ,$328.02 ,$472.15 ,$59.81 ,$397.60 ,$457.24 ,$59.81 ,$422.45 ,$472.15 ,$437.36 ,$377.72 ,$59.81 ,$59.81 ,$59.81 ,$362.81 ,$273.35 ,$452.27 ,$452.27 ,$397.60 ,$185.59 ,$273.35 ,$447.30 ,$180.18 ,$447.30 ,$268.38 ,$467.18 ,$405.41 ,$457.24 ,$63.40 ,$452.27 ,$180.18 ,$305.85 ,$305.85 ,$447.30 ,$370.91 ,$346.16 ,$181.98 ,$59.81 ,$472.15 ,$189.19 ,$59.81 ,$432.39 ,$180.18 ,$447.30 ,$180.18 ,$447.30 ,$447.30 ,$447.30 ,$482.09 ,$402.57 ,$462.21 ,$427.42 ,$482.09 
SACRED HEART HOSPITAL (ACU),92000012,93788,HC AMBUL BLOOD PRESS MONITR W/REPORT,920,1 ,$358.07 ,$268.55 ,$22.18 ,$358.07 ,$230.60 ,$119.26 ,$250.65 ,$22.18 ,$297.20 ,$22.85 ,$236.33 ,$340.17 ,$22.18 ,$286.46 ,$329.42 ,$22.18 ,$304.36 ,$340.17 ,$315.10 ,$272.13 ,$22.18 ,$22.18 ,$22.18 ,$261.39 ,$196.94 ,$325.84 ,$325.84 ,$286.46 ,$122.84 ,$196.94 ,$322.26 ,$119.26 ,$322.26 ,$193.36 ,$336.59 ,$268.33 ,$329.42 ,$23.51 ,$325.84 ,$119.26 ,$220.36 ,$220.36 ,$322.26 ,$267.23 ,$249.40 ,$120.45 ,$22.18 ,$340.17 ,$125.22 ,$22.18 ,$311.52 ,$119.26 ,$322.26 ,$119.26 ,$322.26 ,$322.26 ,$322.26 ,$347.33 ,$290.04 ,$333.01 ,$307.94 ,$347.33 
SACRED HEART HOSPITAL (ACU),92000013,95972,HC ANALYSIS PGS W/PROGRAMMING COMPLEX,920,1 ,$709.85 ,$532.39 ,$47.58 ,$709.85 ,$457.14 ,$106.18 ,$496.90 ,$47.58 ,$589.18 ,$49.01 ,$468.50 ,$674.36 ,$47.58 ,$567.88 ,$653.06 ,$47.58 ,$603.37 ,$674.36 ,$624.67 ,$539.49 ,$47.58 ,$47.58 ,$47.58 ,$518.19 ,$390.42 ,$645.96 ,$645.96 ,$567.88 ,$109.37 ,$390.42 ,$638.87 ,$106.18 ,$638.87 ,$383.32 ,$667.26 ,$238.90 ,$653.06 ,$50.43 ,$645.96 ,$106.18 ,$436.84 ,$436.84 ,$638.87 ,$529.76 ,$494.41 ,$107.24 ,$47.58 ,$674.36 ,$111.49 ,$47.58 ,$617.57 ,$106.18 ,$638.87 ,$106.18 ,$638.87 ,$638.87 ,$638.87 ,$688.55 ,$574.98 ,$660.16 ,$610.47 ,$688.55 
SACRED HEART HOSPITAL (ACU),92100002,93880,HC DUPLEX CAROTID BILAT,921,1 ,"$1,475.89 ","$1,106.92 ",$54.52 ,"$1,475.89 ",$950.47 ,$243.36 ,"$1,033.12 ",$54.52 ,"$1,224.99 ",$56.16 ,$974.09 ,"$1,402.10 ",$54.52 ,"$1,180.71 ","$1,357.82 ",$54.52 ,"$1,254.51 ","$1,402.10 ","$1,298.78 ","$1,121.68 ",$54.52 ,$54.52 ,$54.52 ,"$1,077.40 ",$811.74 ,"$1,343.06 ","$1,343.06 ","$1,180.71 ",$250.66 ,$811.74 ,"$1,328.30 ",$243.36 ,"$1,328.30 ",$796.98 ,"$1,387.34 ",$547.56 ,"$1,357.82 ",$57.79 ,"$1,343.06 ",$243.36 ,$908.26 ,$908.26 ,"$1,328.30 ","$1,101.46 ","$1,027.96 ",$245.79 ,$54.52 ,"$1,402.10 ",$255.53 ,$54.52 ,"$1,284.02 ",$243.36 ,"$1,328.30 ",$243.36 ,"$1,328.30 ","$1,328.30 ","$1,328.30 ","$1,431.61 ","$1,195.47 ","$1,372.58 ","$1,269.27 ","$1,431.61 "
SACRED HEART HOSPITAL (ACU),92100003,93882,HC DUPLEX CAROTID UNI,921,1 ,$613.92 ,$460.44 ,$35.91 ,$613.92 ,$395.36 ,$115.15 ,$429.74 ,$35.91 ,$509.55 ,$36.99 ,$405.19 ,$583.22 ,$35.91 ,$491.14 ,$564.81 ,$35.91 ,$521.83 ,$583.22 ,$540.25 ,$466.58 ,$35.91 ,$35.91 ,$35.91 ,$448.16 ,$337.66 ,$558.67 ,$558.67 ,$491.14 ,$118.60 ,$337.66 ,$552.53 ,$115.15 ,$552.53 ,$331.52 ,$577.08 ,$259.08 ,$564.81 ,$38.06 ,$558.67 ,$115.15 ,$377.81 ,$377.81 ,$552.53 ,$458.17 ,$427.60 ,$116.30 ,$35.91 ,$583.22 ,$120.90 ,$35.91 ,$534.11 ,$115.15 ,$552.53 ,$115.15 ,$552.53 ,$552.53 ,$552.53 ,$595.50 ,$497.28 ,$570.95 ,$527.97 ,$595.50 
SACRED HEART HOSPITAL (ACU),92100004,93888,HC DOPPLER TRANSCRANIAL LTD,921,1 ,$391.10 ,$293.33 ,$35.91 ,$391.10 ,$251.87 ,$115.15 ,$273.77 ,$35.91 ,$324.61 ,$36.99 ,$258.13 ,$371.55 ,$35.91 ,$312.88 ,$359.81 ,$35.91 ,$332.44 ,$371.55 ,$344.17 ,$297.24 ,$35.91 ,$35.91 ,$35.91 ,$285.50 ,$215.11 ,$355.90 ,$355.90 ,$312.88 ,$118.60 ,$215.11 ,$351.99 ,$115.15 ,$351.99 ,$211.19 ,$367.63 ,$259.08 ,$359.81 ,$38.06 ,$355.90 ,$115.15 ,$240.68 ,$240.68 ,$351.99 ,$291.88 ,$272.40 ,$116.30 ,$35.91 ,$371.55 ,$120.90 ,$35.91 ,$340.26 ,$115.15 ,$351.99 ,$115.15 ,$351.99 ,$351.99 ,$351.99 ,$379.37 ,$316.79 ,$363.72 ,$336.35 ,$379.37 
SACRED HEART HOSPITAL (ACU),92100005,93922,HC ABI/PPG SINGLE LEVEL,921,1 ,$331.28 ,$248.46 ,$35.91 ,$331.28 ,$213.34 ,$119.26 ,$231.90 ,$35.91 ,$274.96 ,$36.99 ,$218.64 ,$314.72 ,$35.91 ,$265.02 ,$304.78 ,$35.91 ,$281.59 ,$314.72 ,$291.53 ,$251.77 ,$35.91 ,$35.91 ,$35.91 ,$241.83 ,$182.20 ,$301.46 ,$301.46 ,$265.02 ,$122.84 ,$182.20 ,$298.15 ,$119.26 ,$298.15 ,$178.89 ,$311.40 ,$268.33 ,$304.78 ,$38.06 ,$301.46 ,$119.26 ,$203.87 ,$203.87 ,$298.15 ,$247.23 ,$230.74 ,$120.45 ,$35.91 ,$314.72 ,$125.22 ,$35.91 ,$288.21 ,$119.26 ,$298.15 ,$119.26 ,$298.15 ,$298.15 ,$298.15 ,$321.34 ,$268.34 ,$308.09 ,$284.90 ,$321.34 
SACRED HEART HOSPITAL (ACU),92100023,93923,HC TCPO2/ABI/PPG MULT LEVELS,921,1 ,$812.54 ,$609.41 ,$54.42 ,$812.54 ,$523.28 ,$147.66 ,$568.78 ,$54.42 ,$674.41 ,$56.05 ,$536.28 ,$771.91 ,$54.42 ,$650.03 ,$747.54 ,$54.42 ,$690.66 ,$771.91 ,$715.04 ,$617.53 ,$54.42 ,$54.42 ,$54.42 ,$593.15 ,$446.90 ,$739.41 ,$739.41 ,$650.03 ,$152.09 ,$446.90 ,$731.29 ,$147.66 ,$731.29 ,$438.77 ,$763.79 ,$332.24 ,$747.54 ,$57.69 ,$739.41 ,$147.66 ,$500.04 ,$500.04 ,$731.29 ,$606.40 ,$565.93 ,$149.14 ,$54.42 ,$771.91 ,$155.05 ,$54.42 ,$706.91 ,$147.66 ,$731.29 ,$147.66 ,$731.29 ,$731.29 ,$731.29 ,$788.16 ,$658.16 ,$755.66 ,$698.78 ,$788.16 
SACRED HEART HOSPITAL (ACU),92100030,93923,HC RESTING ARTERIAL LOWER BILATERAL,921,1 ,$812.54 ,$609.41 ,$54.42 ,$812.54 ,$523.28 ,$147.66 ,$568.78 ,$54.42 ,$674.41 ,$56.05 ,$536.28 ,$771.91 ,$54.42 ,$650.03 ,$747.54 ,$54.42 ,$690.66 ,$771.91 ,$715.04 ,$617.53 ,$54.42 ,$54.42 ,$54.42 ,$593.15 ,$446.90 ,$739.41 ,$739.41 ,$650.03 ,$152.09 ,$446.90 ,$731.29 ,$147.66 ,$731.29 ,$438.77 ,$763.79 ,$332.24 ,$747.54 ,$57.69 ,$739.41 ,$147.66 ,$500.04 ,$500.04 ,$731.29 ,$606.40 ,$565.93 ,$149.14 ,$54.42 ,$771.91 ,$155.05 ,$54.42 ,$706.91 ,$147.66 ,$731.29 ,$147.66 ,$731.29 ,$731.29 ,$731.29 ,$788.16 ,$658.16 ,$755.66 ,$698.78 ,$788.16 
SACRED HEART HOSPITAL (ACU),92100031,93923,HC RESTING ARTERIAL UPPER BILATERAL,921,1 ,$812.54 ,$609.41 ,$54.42 ,$812.54 ,$523.28 ,$147.66 ,$568.78 ,$54.42 ,$674.41 ,$56.05 ,$536.28 ,$771.91 ,$54.42 ,$650.03 ,$747.54 ,$54.42 ,$690.66 ,$771.91 ,$715.04 ,$617.53 ,$54.42 ,$54.42 ,$54.42 ,$593.15 ,$446.90 ,$739.41 ,$739.41 ,$650.03 ,$152.09 ,$446.90 ,$731.29 ,$147.66 ,$731.29 ,$438.77 ,$763.79 ,$332.24 ,$747.54 ,$57.69 ,$739.41 ,$147.66 ,$500.04 ,$500.04 ,$731.29 ,$606.40 ,$565.93 ,$149.14 ,$54.42 ,$771.91 ,$155.05 ,$54.42 ,$706.91 ,$147.66 ,$731.29 ,$147.66 ,$731.29 ,$731.29 ,$731.29 ,$788.16 ,$658.16 ,$755.66 ,$698.78 ,$788.16 
SACRED HEART HOSPITAL (ACU),92100032,93924,HC DOPPLER ARTERY LWR EXT STRESS,921,1 ,$739.16 ,$554.37 ,$35.91 ,$739.16 ,$476.02 ,$279.91 ,$517.41 ,$35.91 ,$613.50 ,$36.99 ,$487.85 ,$702.20 ,$35.91 ,$591.33 ,$680.03 ,$35.91 ,$628.29 ,$702.20 ,$650.46 ,$561.76 ,$35.91 ,$35.91 ,$35.91 ,$539.59 ,$406.54 ,$672.64 ,$672.64 ,$591.33 ,$288.31 ,$406.54 ,$665.24 ,$279.91 ,$665.24 ,$399.15 ,$694.81 ,$629.79 ,$680.03 ,$38.06 ,$672.64 ,$279.91 ,$454.88 ,$454.88 ,$665.24 ,$551.64 ,$514.82 ,$282.71 ,$35.91 ,$702.20 ,$293.90 ,$35.91 ,$643.07 ,$279.91 ,$665.24 ,$279.91 ,$665.24 ,$665.24 ,$665.24 ,$716.99 ,$598.72 ,$687.42 ,$635.68 ,$716.99 
SACRED HEART HOSPITAL (ACU),92100034,93925,HC DUPLEX ARTERIAL LWR EXT BI,921,1 ,"$1,111.00 ",$833.25 ,$54.52 ,"$1,111.00 ",$715.48 ,$243.36 ,$777.70 ,$54.52 ,$922.13 ,$56.16 ,$733.26 ,"$1,055.45 ",$54.52 ,$888.80 ,"$1,022.12 ",$54.52 ,$944.35 ,"$1,055.45 ",$977.68 ,$844.36 ,$54.52 ,$54.52 ,$54.52 ,$811.03 ,$611.05 ,"$1,011.01 ","$1,011.01 ",$888.80 ,$250.66 ,$611.05 ,$999.90 ,$243.36 ,$999.90 ,$599.94 ,"$1,044.34 ",$547.56 ,"$1,022.12 ",$57.79 ,"$1,011.01 ",$243.36 ,$683.71 ,$683.71 ,$999.90 ,$829.14 ,$773.81 ,$245.79 ,$54.52 ,"$1,055.45 ",$255.53 ,$54.52 ,$966.57 ,$243.36 ,$999.90 ,$243.36 ,$999.90 ,$999.90 ,$999.90 ,"$1,077.67 ",$899.91 ,"$1,033.23 ",$955.46 ,"$1,077.67 "
SACRED HEART HOSPITAL (ACU),92100035,93926,HC DUPLEX ARTRL LWR EXT UNI/LMT,921,1 ,$839.00 ,$629.25 ,$35.91 ,$839.00 ,$540.32 ,$115.15 ,$587.30 ,$35.91 ,$696.37 ,$36.99 ,$553.74 ,$797.05 ,$35.91 ,$671.20 ,$771.88 ,$35.91 ,$713.15 ,$797.05 ,$738.32 ,$637.64 ,$35.91 ,$35.91 ,$35.91 ,$612.47 ,$461.45 ,$763.49 ,$763.49 ,$671.20 ,$118.60 ,$461.45 ,$755.10 ,$115.15 ,$755.10 ,$453.06 ,$788.66 ,$259.08 ,$771.88 ,$38.06 ,$763.49 ,$115.15 ,$516.32 ,$516.32 ,$755.10 ,$626.15 ,$584.36 ,$116.30 ,$35.91 ,$797.05 ,$120.90 ,$35.91 ,$729.93 ,$115.15 ,$755.10 ,$115.15 ,$755.10 ,$755.10 ,$755.10 ,$813.83 ,$679.59 ,$780.27 ,$721.54 ,$813.83 
SACRED HEART HOSPITAL (ACU),92100037,93930,HC DUPLEX ARTERIAL UPR EXT BI,921,1 ,"$1,218.00 ",$913.50 ,$35.91 ,"$1,218.00 ",$784.39 ,$243.36 ,$852.60 ,$35.91 ,"$1,010.94 ",$36.99 ,$803.88 ,"$1,157.10 ",$35.91 ,$974.40 ,"$1,120.56 ",$35.91 ,"$1,035.30 ","$1,157.10 ","$1,071.84 ",$925.68 ,$35.91 ,$35.91 ,$35.91 ,$889.14 ,$669.90 ,"$1,108.38 ","$1,108.38 ",$974.40 ,$250.66 ,$669.90 ,"$1,096.20 ",$243.36 ,"$1,096.20 ",$657.72 ,"$1,144.92 ",$547.56 ,"$1,120.56 ",$38.06 ,"$1,108.38 ",$243.36 ,$749.56 ,$749.56 ,"$1,096.20 ",$908.99 ,$848.34 ,$245.79 ,$35.91 ,"$1,157.10 ",$255.53 ,$35.91 ,"$1,059.66 ",$243.36 ,"$1,096.20 ",$243.36 ,"$1,096.20 ","$1,096.20 ","$1,096.20 ","$1,181.46 ",$986.58 ,"$1,132.74 ","$1,047.48 ","$1,181.46 "
SACRED HEART HOSPITAL (ACU),92100038,93931,HC DUPLEX ARTRL UPR EXT UNI/LMT,921,1 ,$962.00 ,$721.50 ,$35.91 ,$962.00 ,$619.53 ,$115.15 ,$673.40 ,$35.91 ,$798.46 ,$36.99 ,$634.92 ,$913.90 ,$35.91 ,$769.60 ,$885.04 ,$35.91 ,$817.70 ,$913.90 ,$846.56 ,$731.12 ,$35.91 ,$35.91 ,$35.91 ,$702.26 ,$529.10 ,$875.42 ,$875.42 ,$769.60 ,$118.60 ,$529.10 ,$865.80 ,$115.15 ,$865.80 ,$519.48 ,$904.28 ,$259.08 ,$885.04 ,$38.06 ,$875.42 ,$115.15 ,$592.01 ,$592.01 ,$865.80 ,$717.94 ,$670.03 ,$116.30 ,$35.91 ,$913.90 ,$120.90 ,$35.91 ,$836.94 ,$115.15 ,$865.80 ,$115.15 ,$865.80 ,$865.80 ,$865.80 ,$933.14 ,$779.22 ,$894.66 ,$827.32 ,$933.14 
SACRED HEART HOSPITAL (ACU),92100041,93970,HC DUPLEX VENOUS EXT BI,921,1 ,"$1,334.00 ","$1,000.50 ",$54.52 ,"$1,334.00 ",$859.10 ,$243.36 ,$933.80 ,$54.52 ,"$1,107.22 ",$56.16 ,$880.44 ,"$1,267.30 ",$54.52 ,"$1,067.20 ","$1,227.28 ",$54.52 ,"$1,133.90 ","$1,267.30 ","$1,173.92 ","$1,013.84 ",$54.52 ,$54.52 ,$54.52 ,$973.82 ,$733.70 ,"$1,213.94 ","$1,213.94 ","$1,067.20 ",$250.66 ,$733.70 ,"$1,200.60 ",$243.36 ,"$1,200.60 ",$720.36 ,"$1,253.96 ",$547.56 ,"$1,227.28 ",$57.79 ,"$1,213.94 ",$243.36 ,$820.94 ,$820.94 ,"$1,200.60 ",$995.56 ,$929.13 ,$245.79 ,$54.52 ,"$1,267.30 ",$255.53 ,$54.52 ,"$1,160.58 ",$243.36 ,"$1,200.60 ",$243.36 ,"$1,200.60 ","$1,200.60 ","$1,200.60 ","$1,293.98 ","$1,080.54 ","$1,240.62 ","$1,147.24 ","$1,293.98 "
SACRED HEART HOSPITAL (ACU),92100043,93971,HC DUPLEX VENOUS EXT UNI/LMTD,921,1 ,$997.00 ,$747.75 ,$35.91 ,$997.00 ,$642.07 ,$115.15 ,$697.90 ,$35.91 ,$827.51 ,$36.99 ,$658.02 ,$947.15 ,$35.91 ,$797.60 ,$917.24 ,$35.91 ,$847.45 ,$947.15 ,$877.36 ,$757.72 ,$35.91 ,$35.91 ,$35.91 ,$727.81 ,$548.35 ,$907.27 ,$907.27 ,$797.60 ,$118.60 ,$548.35 ,$897.30 ,$115.15 ,$897.30 ,$538.38 ,$937.18 ,$259.08 ,$917.24 ,$38.06 ,$907.27 ,$115.15 ,$613.55 ,$613.55 ,$897.30 ,$744.06 ,$694.41 ,$116.30 ,$35.91 ,$947.15 ,$120.90 ,$35.91 ,$867.39 ,$115.15 ,$897.30 ,$115.15 ,$897.30 ,$897.30 ,$897.30 ,$967.09 ,$807.57 ,$927.21 ,$857.42 ,$967.09 
SACRED HEART HOSPITAL (ACU),92100044,93971,HC VENOUS REFLUX ASSESSMENT UNILAT,921,1 ,$997.00 ,$747.75 ,$35.91 ,$997.00 ,$642.07 ,$115.15 ,$697.90 ,$35.91 ,$827.51 ,$36.99 ,$658.02 ,$947.15 ,$35.91 ,$797.60 ,$917.24 ,$35.91 ,$847.45 ,$947.15 ,$877.36 ,$757.72 ,$35.91 ,$35.91 ,$35.91 ,$727.81 ,$548.35 ,$907.27 ,$907.27 ,$797.60 ,$118.60 ,$548.35 ,$897.30 ,$115.15 ,$897.30 ,$538.38 ,$937.18 ,$259.08 ,$917.24 ,$38.06 ,$907.27 ,$115.15 ,$613.55 ,$613.55 ,$897.30 ,$744.06 ,$694.41 ,$116.30 ,$35.91 ,$947.15 ,$120.90 ,$35.91 ,$867.39 ,$115.15 ,$897.30 ,$115.15 ,$897.30 ,$897.30 ,$897.30 ,$967.09 ,$807.57 ,$927.21 ,$857.42 ,$967.09 
SACRED HEART HOSPITAL (ACU),92100046,93990,HC DUPLEX HEMODIALYSIS ACCESS,921,1 ,$330.00 ,$247.50 ,$35.91 ,$330.00 ,$212.52 ,$115.15 ,$231.00 ,$35.91 ,$273.90 ,$36.99 ,$217.80 ,$313.50 ,$35.91 ,$264.00 ,$303.60 ,$35.91 ,$280.50 ,$313.50 ,$290.40 ,$250.80 ,$35.91 ,$35.91 ,$35.91 ,$240.90 ,$181.50 ,$300.30 ,$300.30 ,$264.00 ,$118.60 ,$181.50 ,$297.00 ,$115.15 ,$297.00 ,$178.20 ,$310.20 ,$259.08 ,$303.60 ,$38.06 ,$300.30 ,$115.15 ,$203.08 ,$203.08 ,$297.00 ,$246.28 ,$229.85 ,$116.30 ,$35.91 ,$313.50 ,$120.90 ,$35.91 ,$287.10 ,$115.15 ,$297.00 ,$115.15 ,$297.00 ,$297.00 ,$297.00 ,$320.10 ,$267.30 ,$306.90 ,$283.80 ,$320.10 
SACRED HEART HOSPITAL (ACU),92100053,93985,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL BILATERAL STUDY,921,1 ,$575.00 ,$431.25 ,$35.91 ,$575.00 ,$370.30 ,$243.36 ,$402.50 ,$35.91 ,$477.25 ,$36.99 ,$379.50 ,$546.25 ,$35.91 ,$460.00 ,$529.00 ,$35.91 ,$488.75 ,$546.25 ,$506.00 ,$437.00 ,$35.91 ,$35.91 ,$35.91 ,$419.75 ,$316.25 ,$523.25 ,$523.25 ,$460.00 ,$250.66 ,$316.25 ,$517.50 ,$243.36 ,$517.50 ,$310.50 ,$540.50 ,$547.56 ,$529.00 ,$38.06 ,$523.25 ,$243.36 ,$353.86 ,$353.86 ,$517.50 ,$429.12 ,$400.49 ,$245.79 ,$35.91 ,$546.25 ,$255.53 ,$35.91 ,$500.25 ,$243.36 ,$517.50 ,$243.36 ,$517.50 ,$517.50 ,$517.50 ,$557.75 ,$465.75 ,$534.75 ,$494.50 ,$557.75 
SACRED HEART HOSPITAL (ACU),92100054,93986,HC DUPLEX SCAN ARTERIAL/VENOUS HEMO ACCESS COMPL UNILATERAL STUDY,921,1 ,$575.00 ,$431.25 ,$35.91 ,$575.00 ,$370.30 ,$115.15 ,$402.50 ,$35.91 ,$477.25 ,$36.99 ,$379.50 ,$546.25 ,$35.91 ,$460.00 ,$529.00 ,$35.91 ,$488.75 ,$546.25 ,$506.00 ,$437.00 ,$35.91 ,$35.91 ,$35.91 ,$419.75 ,$316.25 ,$523.25 ,$523.25 ,$460.00 ,$118.60 ,$316.25 ,$517.50 ,$115.15 ,$517.50 ,$310.50 ,$540.50 ,$259.08 ,$529.00 ,$38.06 ,$523.25 ,$115.15 ,$353.86 ,$353.86 ,$517.50 ,$429.12 ,$400.49 ,$116.30 ,$35.91 ,$546.25 ,$120.90 ,$35.91 ,$500.25 ,$115.15 ,$517.50 ,$115.15 ,$517.50 ,$517.50 ,$517.50 ,$557.75 ,$465.75 ,$534.75 ,$494.50 ,$557.75 
SACRED HEART HOSPITAL (ACU),92200000,95860,HC EMG ONE EXTREMITY,922,1 ,$367.00 ,$275.25 ,$44.29 ,$367.00 ,$236.35 ,$119.26 ,$256.90 ,$44.29 ,$304.61 ,$45.62 ,$242.22 ,$348.65 ,$44.29 ,$293.60 ,$337.64 ,$44.29 ,$311.95 ,$348.65 ,$322.96 ,$278.92 ,$44.29 ,$44.29 ,$44.29 ,$267.91 ,$201.85 ,$333.97 ,$333.97 ,$293.60 ,$122.84 ,$201.85 ,$330.30 ,$119.26 ,$330.30 ,$198.18 ,$344.98 ,$268.33 ,$337.64 ,$46.95 ,$333.97 ,$119.26 ,$225.85 ,$225.85 ,$330.30 ,$273.89 ,$255.62 ,$120.45 ,$44.29 ,$348.65 ,$125.22 ,$44.29 ,$319.29 ,$119.26 ,$330.30 ,$119.26 ,$330.30 ,$330.30 ,$330.30 ,$355.99 ,$297.27 ,$341.31 ,$315.62 ,$355.99 
SACRED HEART HOSPITAL (ACU),92200001,95861,HC EMG TWO EXTREMITIES,922,1 ,$790.00 ,$592.50 ,$44.29 ,$790.00 ,$508.76 ,$119.26 ,$553.00 ,$44.29 ,$655.70 ,$45.62 ,$521.40 ,$750.50 ,$44.29 ,$632.00 ,$726.80 ,$44.29 ,$671.50 ,$750.50 ,$695.20 ,$600.40 ,$44.29 ,$44.29 ,$44.29 ,$576.70 ,$434.50 ,$718.90 ,$718.90 ,$632.00 ,$122.84 ,$434.50 ,$711.00 ,$119.26 ,$711.00 ,$426.60 ,$742.60 ,$268.33 ,$726.80 ,$46.95 ,$718.90 ,$119.26 ,$486.17 ,$486.17 ,$711.00 ,$589.58 ,$550.24 ,$120.45 ,$44.29 ,$750.50 ,$125.22 ,$44.29 ,$687.30 ,$119.26 ,$711.00 ,$119.26 ,$711.00 ,$711.00 ,$711.00 ,$766.30 ,$639.90 ,$734.70 ,$679.40 ,$766.30 
SACRED HEART HOSPITAL (ACU),92200003,95867,HC EMG CRANIAL NERVE UNI,922,1 ,$342.00 ,$256.50 ,$44.29 ,$629.79 ,$220.25 ,$279.91 ,$239.40 ,$44.29 ,$283.86 ,$45.62 ,$225.72 ,$324.90 ,$44.29 ,$273.60 ,$314.64 ,$44.29 ,$290.70 ,$324.90 ,$300.96 ,$259.92 ,$44.29 ,$44.29 ,$44.29 ,$249.66 ,$188.10 ,$311.22 ,$311.22 ,$273.60 ,$288.31 ,$188.10 ,$307.80 ,$279.91 ,$307.80 ,$184.68 ,$321.48 ,$629.79 ,$314.64 ,$46.95 ,$311.22 ,$279.91 ,$210.47 ,$210.47 ,$307.80 ,$255.23 ,$238.20 ,$282.71 ,$44.29 ,$324.90 ,$293.90 ,$44.29 ,$297.54 ,$279.91 ,$307.80 ,$279.91 ,$307.80 ,$307.80 ,$307.80 ,$331.74 ,$277.02 ,$318.06 ,$294.12 ,$331.74 
SACRED HEART HOSPITAL (ACU),92200008,95925,HC SSEP UPPER LIMBS,922,1 ,$736.08 ,$552.06 ,$44.29 ,$736.08 ,$474.04 ,$279.91 ,$515.26 ,$44.29 ,$610.95 ,$45.62 ,$485.81 ,$699.28 ,$44.29 ,$588.86 ,$677.19 ,$44.29 ,$625.67 ,$699.28 ,$647.75 ,$559.42 ,$44.29 ,$44.29 ,$44.29 ,$537.34 ,$404.84 ,$669.83 ,$669.83 ,$588.86 ,$288.31 ,$404.84 ,$662.47 ,$279.91 ,$662.47 ,$397.48 ,$691.92 ,$629.79 ,$677.19 ,$46.95 ,$669.83 ,$279.91 ,$452.98 ,$452.98 ,$662.47 ,$549.34 ,$512.68 ,$282.71 ,$44.29 ,$699.28 ,$293.90 ,$44.29 ,$640.39 ,$279.91 ,$662.47 ,$279.91 ,$662.47 ,$662.47 ,$662.47 ,$714.00 ,$596.22 ,$684.55 ,$633.03 ,$714.00 
SACRED HEART HOSPITAL (ACU),92200009,95926,HC SSEP LOWER LIMBS,922,1 ,$772.91 ,$579.68 ,$44.29 ,$772.91 ,$497.75 ,$279.91 ,$541.04 ,$44.29 ,$641.52 ,$45.62 ,$510.12 ,$734.26 ,$44.29 ,$618.33 ,$711.08 ,$44.29 ,$656.97 ,$734.26 ,$680.16 ,$587.41 ,$44.29 ,$44.29 ,$44.29 ,$564.22 ,$425.10 ,$703.35 ,$703.35 ,$618.33 ,$288.31 ,$425.10 ,$695.62 ,$279.91 ,$695.62 ,$417.37 ,$726.54 ,$629.79 ,$711.08 ,$46.95 ,$703.35 ,$279.91 ,$475.65 ,$475.65 ,$695.62 ,$576.82 ,$538.33 ,$282.71 ,$44.29 ,$734.26 ,$293.90 ,$44.29 ,$672.43 ,$279.91 ,$695.62 ,$279.91 ,$695.62 ,$695.62 ,$695.62 ,$749.72 ,$626.06 ,$718.81 ,$664.70 ,$749.72 
SACRED HEART HOSPITAL (ACU),92200015,95938,HC SSEP UPPER AND LOWER,922,1 ,$782.28 ,$586.71 ,$44.29 ,"$1,161.60 ",$503.79 ,$516.27 ,$547.60 ,$44.29 ,$649.29 ,$45.62 ,$516.30 ,$743.17 ,$44.29 ,$625.82 ,$719.70 ,$44.29 ,$664.94 ,$743.17 ,$688.41 ,$594.53 ,$44.29 ,$44.29 ,$44.29 ,$571.06 ,$430.25 ,$711.87 ,$711.87 ,$625.82 ,$531.76 ,$430.25 ,$704.05 ,$516.27 ,$704.05 ,$422.43 ,$735.34 ,"$1,161.60 ",$719.70 ,$46.95 ,$711.87 ,$516.27 ,$481.42 ,$481.42 ,$704.05 ,$583.82 ,$544.86 ,$521.43 ,$44.29 ,$743.17 ,$542.08 ,$44.29 ,$680.58 ,$516.27 ,$704.05 ,$516.27 ,$704.05 ,$704.05 ,$704.05 ,$758.81 ,$633.65 ,$727.52 ,$672.76 ,$758.81 
SACRED HEART HOSPITAL (ACU),92200021,95907,HC NVR CNDJ TST 1-2 STUDIES,922,1 ,$476.03 ,$357.02 ,$44.29 ,$476.03 ,$306.56 ,$147.66 ,$333.22 ,$44.29 ,$395.10 ,$45.62 ,$314.18 ,$452.23 ,$44.29 ,$380.82 ,$437.95 ,$44.29 ,$404.63 ,$452.23 ,$418.91 ,$361.78 ,$44.29 ,$44.29 ,$44.29 ,$347.50 ,$261.82 ,$433.19 ,$433.19 ,$380.82 ,$152.09 ,$261.82 ,$428.43 ,$147.66 ,$428.43 ,$257.06 ,$447.47 ,$332.24 ,$437.95 ,$46.95 ,$433.19 ,$147.66 ,$292.95 ,$292.95 ,$428.43 ,$355.26 ,$331.55 ,$149.14 ,$44.29 ,$452.23 ,$155.05 ,$44.29 ,$414.15 ,$147.66 ,$428.43 ,$147.66 ,$428.43 ,$428.43 ,$428.43 ,$461.75 ,$385.58 ,$442.71 ,$409.39 ,$461.75 
SACRED HEART HOSPITAL (ACU),92200028,95868,HC EMG CRANIAL NERVE BILAT,922,1 ,$913.00 ,$684.75 ,$44.29 ,$913.00 ,$587.97 ,$279.91 ,$639.10 ,$44.29 ,$757.79 ,$45.62 ,$602.58 ,$867.35 ,$44.29 ,$730.40 ,$839.96 ,$44.29 ,$776.05 ,$867.35 ,$803.44 ,$693.88 ,$44.29 ,$44.29 ,$44.29 ,$666.49 ,$502.15 ,$830.83 ,$830.83 ,$730.40 ,$288.31 ,$502.15 ,$821.70 ,$279.91 ,$821.70 ,$493.02 ,$858.22 ,$629.79 ,$839.96 ,$46.95 ,$830.83 ,$279.91 ,$561.86 ,$561.86 ,$821.70 ,$681.37 ,$635.90 ,$282.71 ,$44.29 ,$867.35 ,$293.90 ,$44.29 ,$794.31 ,$279.91 ,$821.70 ,$279.91 ,$821.70 ,$821.70 ,$821.70 ,$885.61 ,$739.53 ,$849.09 ,$785.18 ,$885.61 
SACRED HEART HOSPITAL (ACU),92200029,95870,HC EMG NON LIMB,922,1 ,$212.00 ,$159.00 ,$44.29 ,$268.33 ,$136.53 ,$119.26 ,$148.40 ,$44.29 ,$175.96 ,$45.62 ,$139.92 ,$201.40 ,$44.29 ,$169.60 ,$195.04 ,$44.29 ,$180.20 ,$201.40 ,$186.56 ,$161.12 ,$44.29 ,$44.29 ,$44.29 ,$154.76 ,$116.60 ,$192.92 ,$192.92 ,$169.60 ,$122.84 ,$116.60 ,$190.80 ,$119.26 ,$190.80 ,$114.48 ,$199.28 ,$268.33 ,$195.04 ,$46.95 ,$192.92 ,$119.26 ,$130.46 ,$130.46 ,$190.80 ,$158.22 ,$147.66 ,$120.45 ,$44.29 ,$201.40 ,$125.22 ,$44.29 ,$184.44 ,$119.26 ,$190.80 ,$119.26 ,$190.80 ,$190.80 ,$190.80 ,$205.64 ,$171.72 ,$197.16 ,$182.32 ,$205.64 
SACRED HEART HOSPITAL (ACU),94000101,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$251.00 ,$188.25 ,$19.05 ,$268.33 ,$161.64 ,$119.26 ,$175.70 ,$19.05 ,$208.33 ,$19.62 ,$165.66 ,$238.45 ,$19.05 ,$200.80 ,$230.92 ,$19.05 ,$213.35 ,$238.45 ,$220.88 ,$190.76 ,$19.05 ,$19.05 ,$19.05 ,$183.23 ,$138.05 ,$228.41 ,$228.41 ,$200.80 ,$122.84 ,$138.05 ,$225.90 ,$119.26 ,$225.90 ,$135.54 ,$235.94 ,$268.33 ,$230.92 ,$20.19 ,$228.41 ,$119.26 ,$154.47 ,$154.47 ,$225.90 ,$187.32 ,$174.82 ,$120.45 ,$19.05 ,$238.45 ,$125.22 ,$19.05 ,$218.37 ,$119.26 ,$225.90 ,$119.26 ,$225.90 ,$225.90 ,$225.90 ,$243.47 ,$203.31 ,$233.43 ,$215.86 ,$243.47 
SACRED HEART HOSPITAL (ACU),94000103,E0202,HC PHOTO THERAPY INITIATE,940,1 ,$370.27 ,$277.70 ,$74.05 ,$370.27 ,$238.45 ,$74.05 ,$259.19 , N/A ,$307.32 , N/A ,$244.38 ,$351.76 , N/A ,$296.22 ,$340.65 , N/A ,$314.73 ,$351.76 ,$325.84 ,$281.41 , N/A , N/A , N/A ,$270.30 ,$203.65 ,$336.95 ,$336.95 ,$296.22 ,$76.27 ,$203.65 ,$333.24 ,$74.05 ,$333.24 ,$199.95 ,$348.05 ,$166.62 ,$340.65 , N/A ,$336.95 ,$74.05 ,$227.86 ,$227.86 ,$333.24 ,$276.33 ,$257.89 ,$74.79 , N/A ,$351.76 ,$77.76 , N/A ,$322.13 ,$74.05 ,$333.24 ,$74.05 ,$333.24 ,$333.24 ,$333.24 ,$359.16 ,$299.92 ,$344.35 ,$318.43 ,$359.16 
SACRED HEART HOSPITAL (ACU),94000104,96372,HC INJECTION IM/SUBQ,940,1 ,$135.31 ,$101.48 ,$14.35 ,$147.54 ,$87.14 ,$65.57 ,$94.72 ,$14.35 ,$112.31 ,$14.78 ,$89.30 ,$128.54 ,$14.35 ,$108.25 ,$124.49 ,$14.35 ,$115.01 ,$128.54 ,$119.07 ,$102.84 ,$14.35 ,$14.35 ,$14.35 ,$98.78 ,$74.42 ,$123.13 ,$123.13 ,$108.25 ,$67.54 ,$74.42 ,$121.78 ,$65.57 ,$121.78 ,$73.07 ,$127.19 ,$147.54 ,$124.49 ,$15.21 ,$123.13 ,$65.57 ,$83.27 ,$83.27 ,$121.78 ,$100.98 ,$94.24 ,$66.23 ,$14.35 ,$128.54 ,$68.85 ,$14.35 ,$117.72 ,$65.57 ,$121.78 ,$65.57 ,$121.78 ,$121.78 ,$121.78 ,$131.25 ,$109.60 ,$125.84 ,$116.37 ,$131.25 
SACRED HEART HOSPITAL (ACU),94000105,96374,HC INJ IV PUSH SINGL/INITIAL,940,1 ,$245.53 ,$184.15 ,$14.35 ,$486.82 ,$158.12 ,$216.36 ,$171.87 ,$14.35 ,$203.79 ,$14.78 ,$162.05 ,$233.25 ,$14.35 ,$196.42 ,$225.89 ,$14.35 ,$208.70 ,$233.25 ,$216.07 ,$186.60 ,$14.35 ,$14.35 ,$14.35 ,$179.24 ,$135.04 ,$223.43 ,$223.43 ,$196.42 ,$222.85 ,$135.04 ,$220.98 ,$216.36 ,$220.98 ,$132.59 ,$230.80 ,$486.82 ,$225.89 ,$15.21 ,$223.43 ,$216.36 ,$151.10 ,$151.10 ,$220.98 ,$183.24 ,$171.01 ,$218.53 ,$14.35 ,$233.25 ,$227.18 ,$14.35 ,$213.61 ,$216.36 ,$220.98 ,$216.36 ,$220.98 ,$220.98 ,$220.98 ,$238.16 ,$198.88 ,$228.34 ,$211.16 ,$238.16 
SACRED HEART HOSPITAL (ACU),94000107,99195,HC PHLEBOTOMY THERAPEUTIC,940,1 ,$284.00 ,$213.00 ,$19.05 ,$284.00 ,$182.90 ,$119.26 ,$198.80 ,$19.05 ,$235.72 ,$19.62 ,$187.44 ,$269.80 ,$19.05 ,$227.20 ,$261.28 ,$19.05 ,$241.40 ,$269.80 ,$249.92 ,$215.84 ,$19.05 ,$19.05 ,$19.05 ,$207.32 ,$156.20 ,$258.44 ,$258.44 ,$227.20 ,$122.84 ,$156.20 ,$255.60 ,$119.26 ,$255.60 ,$153.36 ,$266.96 ,$268.33 ,$261.28 ,$20.19 ,$258.44 ,$119.26 ,$174.77 ,$174.77 ,$255.60 ,$211.95 ,$197.81 ,$120.45 ,$19.05 ,$269.80 ,$125.22 ,$19.05 ,$247.08 ,$119.26 ,$255.60 ,$119.26 ,$255.60 ,$255.60 ,$255.60 ,$275.48 ,$230.04 ,$264.12 ,$244.24 ,$275.48 
SACRED HEART HOSPITAL (ACU),94200017,99406,HC TOBACCO COUNSELING,942,1 ,$35.63 ,$26.72 ,$7.82 ,$62.54 ,$22.95 ,$27.80 ,$24.94 ,$7.82 ,$29.57 ,$8.05 ,$23.52 ,$33.85 ,$7.82 ,$28.50 ,$32.78 ,$7.82 ,$30.29 ,$33.85 ,$31.35 ,$27.08 ,$7.82 ,$7.82 ,$7.82 ,$26.01 ,$19.60 ,$32.42 ,$32.42 ,$28.50 ,$28.63 ,$19.60 ,$32.07 ,$27.80 ,$32.07 ,$19.24 ,$33.49 ,$62.54 ,$32.78 ,$8.29 ,$32.42 ,$27.80 ,$21.93 ,$21.93 ,$32.07 ,$26.59 ,$24.82 ,$28.07 ,$7.82 ,$33.85 ,$29.18 ,$7.82 ,$31.00 ,$27.80 ,$32.07 ,$27.80 ,$32.07 ,$32.07 ,$32.07 ,$34.56 ,$28.86 ,$33.14 ,$30.64 ,$34.56 
SACRED HEART HOSPITAL (ACU),94200018,99407,HC TOBACCO COUNSELING >10 MINUTES,942,1 ,$33.18 ,$24.89 ,$7.82 ,$62.54 ,$21.37 ,$27.80 ,$23.23 ,$7.82 ,$27.54 ,$8.05 ,$21.90 ,$31.52 ,$7.82 ,$26.54 ,$30.53 ,$7.82 ,$28.20 ,$31.52 ,$29.20 ,$25.22 ,$7.82 ,$7.82 ,$7.82 ,$24.22 ,$18.25 ,$30.19 ,$30.19 ,$26.54 ,$28.63 ,$18.25 ,$29.86 ,$27.80 ,$29.86 ,$17.92 ,$31.19 ,$62.54 ,$30.53 ,$8.29 ,$30.19 ,$27.80 ,$20.42 ,$20.42 ,$29.86 ,$24.76 ,$23.11 ,$28.07 ,$7.82 ,$31.52 ,$29.18 ,$7.82 ,$28.87 ,$27.80 ,$29.86 ,$27.80 ,$29.86 ,$29.86 ,$29.86 ,$32.18 ,$26.88 ,$30.86 ,$28.53 ,$32.18 
SACRED HEART HOSPITAL (ACU),94200019,N/A,HC LACTATION CONSULT 30 MIN,942,1 ,$291.00 ,$218.25 ,$157.14 ,$291.00 ,$187.40 , N/A ,$203.70 , N/A ,$241.53 , N/A ,$192.06 ,$276.45 , N/A ,$232.80 ,$267.72 , N/A ,$247.35 ,$276.45 ,$256.08 ,$221.16 , N/A , N/A , N/A ,$212.43 ,$160.05 ,$264.81 ,$264.81 ,$232.80 , N/A ,$160.05 ,$261.90 , N/A ,$261.90 ,$157.14 ,$273.54 , N/A ,$267.72 , N/A ,$264.81 , N/A ,$179.08 ,$179.08 ,$261.90 ,$217.17 ,$202.68 , N/A , N/A ,$276.45 , N/A , N/A ,$253.17 , N/A ,$261.90 , N/A ,$261.90 ,$261.90 ,$261.90 ,$282.27 ,$235.71 ,$270.63 ,$250.26 ,$282.27 
SACRED HEART HOSPITAL (ACU),94200020,N/A,HC LACTATION CONSULT 45 MIN,942,1 ,$322.00 ,$241.50 ,$173.88 ,$322.00 ,$207.37 , N/A ,$225.40 , N/A ,$267.26 , N/A ,$212.52 ,$305.90 , N/A ,$257.60 ,$296.24 , N/A ,$273.70 ,$305.90 ,$283.36 ,$244.72 , N/A , N/A , N/A ,$235.06 ,$177.10 ,$293.02 ,$293.02 ,$257.60 , N/A ,$177.10 ,$289.80 , N/A ,$289.80 ,$173.88 ,$302.68 , N/A ,$296.24 , N/A ,$293.02 , N/A ,$198.16 ,$198.16 ,$289.80 ,$240.31 ,$224.27 , N/A , N/A ,$305.90 , N/A , N/A ,$280.14 , N/A ,$289.80 , N/A ,$289.80 ,$289.80 ,$289.80 ,$312.34 ,$260.82 ,$299.46 ,$276.92 ,$312.34 
SACRED HEART HOSPITAL (ACU),94200021,N/A,HC LACTATION CONSULT 60 MIN,942,1 ,$438.00 ,$328.50 ,$236.52 ,$438.00 ,$282.07 , N/A ,$306.60 , N/A ,$363.54 , N/A ,$289.08 ,$416.10 , N/A ,$350.40 ,$402.96 , N/A ,$372.30 ,$416.10 ,$385.44 ,$332.88 , N/A , N/A , N/A ,$319.74 ,$240.90 ,$398.58 ,$398.58 ,$350.40 , N/A ,$240.90 ,$394.20 , N/A ,$394.20 ,$236.52 ,$411.72 , N/A ,$402.96 , N/A ,$398.58 , N/A ,$269.55 ,$269.55 ,$394.20 ,$326.88 ,$305.07 , N/A , N/A ,$416.10 , N/A , N/A ,$381.06 , N/A ,$394.20 , N/A ,$394.20 ,$394.20 ,$394.20 ,$424.86 ,$354.78 ,$407.34 ,$376.68 ,$424.86 
SACRED HEART HOSPITAL (ACU),94300004,93797,HC CARDIAC REHAB W/O EKG SESSION,943,1 ,$285.32 ,$213.99 ,$48.71 ,$285.32 ,$183.75 ,$122.77 ,$199.72 ,$48.71 ,$268.00 ,$50.17 ,$214.00 ,$271.05 ,$48.71 ,$228.26 ,$262.49 ,$48.71 ,$242.52 ,$271.05 ,$251.08 ,$216.84 ,$48.71 ,$48.71 ,$48.71 ,$208.28 ,$156.93 ,$259.64 ,$259.64 ,$228.26 ,$126.45 ,$156.93 ,$256.79 ,$122.77 ,$256.79 ,$154.07 ,$268.20 ,$276.23 ,$262.49 ,$51.63 ,$259.64 ,$122.77 ,$175.59 ,$175.59 ,$256.79 ,$212.93 ,$155.42 ,$124.00 ,$48.71 ,$271.05 ,$128.91 ,$48.71 ,$248.23 ,$122.77 ,$256.79 ,$122.77 ,$256.79 ,$256.79 ,$256.79 ,$276.76 ,$231.11 ,$265.35 ,$245.38 ,$276.76 
SACRED HEART HOSPITAL (ACU),94300009,93798,HC CARDIAC REHAB W/EKG SESSION (ASSESSMENT),943,1 ,$333.03 ,$249.77 ,$48.71 ,$333.03 ,$214.47 ,$122.77 ,$233.12 ,$48.71 ,$268.00 ,$50.17 ,$214.00 ,$316.38 ,$48.71 ,$266.42 ,$306.39 ,$48.71 ,$283.08 ,$316.38 ,$293.07 ,$253.10 ,$48.71 ,$48.71 ,$48.71 ,$243.11 ,$183.17 ,$303.06 ,$303.06 ,$266.42 ,$126.45 ,$183.17 ,$299.73 ,$122.77 ,$299.73 ,$179.84 ,$313.05 ,$276.23 ,$306.39 ,$51.63 ,$303.06 ,$122.77 ,$204.95 ,$204.95 ,$299.73 ,$248.54 ,$155.42 ,$124.00 ,$48.71 ,$316.38 ,$128.91 ,$48.71 ,$289.74 ,$122.77 ,$299.73 ,$122.77 ,$299.73 ,$299.73 ,$299.73 ,$323.04 ,$269.75 ,$309.72 ,$286.41 ,$323.04 
SACRED HEART HOSPITAL (ACU),94300015,93798,HC CARDIAC REHAB PHASE 1 15 MIN,943,1 ,$62.32 ,$46.74 ,$33.65 ,$276.23 ,$40.13 ,$122.77 ,$43.62 ,$48.71 ,$62.32 ,$50.17 ,$62.32 ,$59.20 ,$48.71 ,$49.86 ,$57.33 ,$48.71 ,$52.97 ,$59.20 ,$54.84 ,$47.36 ,$48.71 ,$48.71 ,$48.71 ,$45.49 ,$34.28 ,$56.71 ,$56.71 ,$49.86 ,$126.45 ,$34.28 ,$56.09 ,$122.77 ,$56.09 ,$33.65 ,$58.58 ,$276.23 ,$57.33 ,$51.63 ,$56.71 ,$122.77 ,$38.35 ,$38.35 ,$56.09 ,$46.51 ,$56.09 ,$124.00 ,$48.71 ,$59.20 ,$128.91 ,$48.71 ,$54.22 ,$122.77 ,$56.09 ,$122.77 ,$56.09 ,$56.09 ,$56.09 ,$60.45 ,$50.48 ,$57.96 ,$53.60 ,$60.45 
SACRED HEART HOSPITAL (ACU),94300016,N/A,HC CARDIAC REHAB PHASE 1 30 MIN,943,1 ,$121.00 ,$90.75 ,$65.34 ,$121.00 ,$77.92 , N/A ,$84.70 , N/A ,$121.00 , N/A ,$121.00 ,$114.95 , N/A ,$96.80 ,$111.32 , N/A ,$102.85 ,$114.95 ,$106.48 ,$91.96 , N/A , N/A , N/A ,$88.33 ,$66.55 ,$110.11 ,$110.11 ,$96.80 , N/A ,$66.55 ,$108.90 , N/A ,$108.90 ,$65.34 ,$113.74 , N/A ,$111.32 , N/A ,$110.11 , N/A ,$74.46 ,$74.46 ,$108.90 ,$90.30 ,$108.90 , N/A , N/A ,$114.95 , N/A , N/A ,$105.27 , N/A ,$108.90 , N/A ,$108.90 ,$108.90 ,$108.90 ,$117.37 ,$98.01 ,$112.53 ,$104.06 ,$117.37 
SACRED HEART HOSPITAL (ACU),94300017,N/A,HC CARDIAC  REHAB PHASE 1 45 MIN,943,1 ,$175.00 ,$131.25 ,$94.50 ,$175.00 ,$112.70 , N/A ,$122.50 , N/A ,$175.00 , N/A ,$175.00 ,$166.25 , N/A ,$140.00 ,$161.00 , N/A ,$148.75 ,$166.25 ,$154.00 ,$133.00 , N/A , N/A , N/A ,$127.75 ,$96.25 ,$159.25 ,$159.25 ,$140.00 , N/A ,$96.25 ,$157.50 , N/A ,$157.50 ,$94.50 ,$164.50 , N/A ,$161.00 , N/A ,$159.25 , N/A ,$107.70 ,$107.70 ,$157.50 ,$130.60 ,$155.42 , N/A , N/A ,$166.25 , N/A , N/A ,$152.25 , N/A ,$157.50 , N/A ,$157.50 ,$157.50 ,$157.50 ,$169.75 ,$141.75 ,$162.75 ,$150.50 ,$169.75 
SACRED HEART HOSPITAL (ACU),94300018,N/A,HC CARDIAC REHAB PHASE 1 60 MIN,943,1 ,$234.00 ,$175.50 ,$126.36 ,$234.00 ,$150.70 , N/A ,$163.80 , N/A ,$234.00 , N/A ,$214.00 ,$222.30 , N/A ,$187.20 ,$215.28 , N/A ,$198.90 ,$222.30 ,$205.92 ,$177.84 , N/A , N/A , N/A ,$170.82 ,$128.70 ,$212.94 ,$212.94 ,$187.20 , N/A ,$128.70 ,$210.60 , N/A ,$210.60 ,$126.36 ,$219.96 , N/A ,$215.28 , N/A ,$212.94 , N/A ,$144.00 ,$144.00 ,$210.60 ,$174.63 ,$155.42 , N/A , N/A ,$222.30 , N/A , N/A ,$203.58 , N/A ,$210.60 , N/A ,$210.60 ,$210.60 ,$210.60 ,$226.98 ,$189.54 ,$217.62 ,$201.24 ,$226.98 
SACRED HEART HOSPITAL (ACU),94300019,N/A,HC CARDIAC REHAB PHASE 3 FULL MONTH,943,1 ,$23.00 ,$17.25 ,$12.42 ,$23.00 ,$14.81 , N/A ,$16.10 , N/A ,$23.00 , N/A ,$23.00 ,$21.85 , N/A ,$18.40 ,$21.16 , N/A ,$19.55 ,$21.85 ,$20.24 ,$17.48 , N/A , N/A , N/A ,$16.79 ,$12.65 ,$20.93 ,$20.93 ,$18.40 , N/A ,$12.65 ,$20.70 , N/A ,$20.70 ,$12.42 ,$21.62 , N/A ,$21.16 , N/A ,$20.93 , N/A ,$14.15 ,$14.15 ,$20.70 ,$17.16 ,$20.70 , N/A , N/A ,$21.85 , N/A , N/A ,$20.01 , N/A ,$20.70 , N/A ,$20.70 ,$20.70 ,$20.70 ,$22.31 ,$18.63 ,$21.39 ,$19.78 ,$22.31 
SACRED HEART HOSPITAL (ACU),94400013,90832,HC DRUG THERAPY INDIVIDUAL 30MIN,944,1 ,$199.53 ,$149.65 ,$39.35 ,$318.40 ,$128.50 ,$141.51 ,$139.67 ,$39.35 ,$199.53 ,$40.53 ,$199.53 ,$189.55 ,$39.35 ,$159.62 ,$183.57 ,$39.35 ,$169.60 ,$189.55 ,$175.59 ,$151.64 ,$39.35 ,$39.35 ,$39.35 ,$145.66 ,$109.74 ,$181.57 ,$181.57 ,$159.62 ,$145.76 ,$109.74 ,$179.58 ,$141.51 ,$179.58 ,$107.75 ,$187.56 ,$318.40 ,$183.57 ,$41.71 ,$181.57 ,$141.51 ,$122.79 ,$122.79 ,$179.58 ,$148.91 ,$138.97 ,$142.93 ,$39.35 ,$189.55 ,$148.59 ,$39.35 ,$173.59 ,$141.51 ,$179.58 ,$141.51 ,$179.58 ,$179.58 ,$179.58 ,$193.54 ,$161.62 ,$185.56 ,$171.60 ,$193.54 
SACRED HEART HOSPITAL (ACU),94400014,90834,HC DRUG THERAPY INDIVIDUAL 45MIN,944,1 ,$327.75 ,$245.81 ,$47.46 ,$327.75 ,$211.07 ,$141.51 ,$229.43 ,$47.46 ,$327.75 ,$48.88 ,$327.75 ,$311.36 ,$47.46 ,$262.20 ,$301.53 ,$47.46 ,$278.59 ,$311.36 ,$288.42 ,$249.09 ,$47.46 ,$47.46 ,$47.46 ,$239.26 ,$180.26 ,$298.25 ,$298.25 ,$262.20 ,$145.76 ,$180.26 ,$294.98 ,$141.51 ,$294.98 ,$176.99 ,$308.09 ,$318.40 ,$301.53 ,$50.31 ,$298.25 ,$141.51 ,$201.70 ,$201.70 ,$294.98 ,$244.60 ,$228.28 ,$142.93 ,$47.46 ,$311.36 ,$148.59 ,$47.46 ,$285.14 ,$141.51 ,$294.98 ,$141.51 ,$294.98 ,$294.98 ,$294.98 ,$317.92 ,$265.48 ,$304.81 ,$281.87 ,$317.92 
SACRED HEART HOSPITAL (ACU),94400015,90837,HC DRUG THERAPY INDIVIDUAL 60MIN,944,1 ,$431.25 ,$323.44 ,$47.46 ,$431.25 ,$277.73 ,$141.51 ,$301.88 ,$47.46 ,$431.25 ,$48.88 ,$431.25 ,$409.69 ,$47.46 ,$345.00 ,$396.75 ,$47.46 ,$366.56 ,$409.69 ,$379.50 ,$327.75 ,$47.46 ,$47.46 ,$47.46 ,$314.81 ,$237.19 ,$392.44 ,$392.44 ,$345.00 ,$145.76 ,$237.19 ,$388.13 ,$141.51 ,$388.13 ,$232.88 ,$405.38 ,$318.40 ,$396.75 ,$50.31 ,$392.44 ,$141.51 ,$265.39 ,$265.39 ,$388.13 ,$321.84 ,$300.37 ,$142.93 ,$47.46 ,$409.69 ,$148.59 ,$47.46 ,$375.19 ,$141.51 ,$388.13 ,$141.51 ,$388.13 ,$388.13 ,$388.13 ,$418.31 ,$349.31 ,$401.06 ,$370.88 ,$418.31 
SACRED HEART HOSPITAL (ACU),94500010,90791,HC EVAL PSYCH DIAG ALCOHOL 60MIN,945,1 ,$471.50 ,$353.63 ,$85.31 ,$471.50 ,$303.65 ,$141.51 ,$330.05 ,$85.31 ,$471.50 ,$87.87 ,$471.50 ,$447.93 ,$85.31 ,$377.20 ,$433.78 ,$85.31 ,$400.78 ,$447.93 ,$414.92 ,$358.34 ,$85.31 ,$85.31 ,$85.31 ,$344.20 ,$259.33 ,$429.07 ,$429.07 ,$377.20 ,$145.76 ,$259.33 ,$424.35 ,$141.51 ,$424.35 ,$254.61 ,$443.21 ,$318.40 ,$433.78 ,$90.43 ,$429.07 ,$141.51 ,$290.16 ,$290.16 ,$424.35 ,$351.88 ,$328.40 ,$142.93 ,$85.31 ,$447.93 ,$148.59 ,$85.31 ,$410.21 ,$141.51 ,$424.35 ,$141.51 ,$424.35 ,$424.35 ,$424.35 ,$457.36 ,$381.92 ,$438.50 ,$405.49 ,$457.36 
SACRED HEART HOSPITAL (ACU),94500013,90832,HC ALCOHOL THERAPY INDIVIDUAL 30MIN,945,1 ,$199.53 ,$149.65 ,$39.35 ,$318.40 ,$128.50 ,$141.51 ,$139.67 ,$39.35 ,$199.53 ,$40.53 ,$199.53 ,$189.55 ,$39.35 ,$159.62 ,$183.57 ,$39.35 ,$169.60 ,$189.55 ,$175.59 ,$151.64 ,$39.35 ,$39.35 ,$39.35 ,$145.66 ,$109.74 ,$181.57 ,$181.57 ,$159.62 ,$145.76 ,$109.74 ,$179.58 ,$141.51 ,$179.58 ,$107.75 ,$187.56 ,$318.40 ,$183.57 ,$41.71 ,$181.57 ,$141.51 ,$122.79 ,$122.79 ,$179.58 ,$148.91 ,$138.97 ,$142.93 ,$39.35 ,$189.55 ,$148.59 ,$39.35 ,$173.59 ,$141.51 ,$179.58 ,$141.51 ,$179.58 ,$179.58 ,$179.58 ,$193.54 ,$161.62 ,$185.56 ,$171.60 ,$193.54 
SACRED HEART HOSPITAL (ACU),94500014,90834,HC ALCOHOL THERAPY INDIVIDUAL 45MIN,945,1 ,$327.75 ,$245.81 ,$47.46 ,$327.75 ,$211.07 ,$141.51 ,$229.43 ,$47.46 ,$327.75 ,$48.88 ,$327.75 ,$311.36 ,$47.46 ,$262.20 ,$301.53 ,$47.46 ,$278.59 ,$311.36 ,$288.42 ,$249.09 ,$47.46 ,$47.46 ,$47.46 ,$239.26 ,$180.26 ,$298.25 ,$298.25 ,$262.20 ,$145.76 ,$180.26 ,$294.98 ,$141.51 ,$294.98 ,$176.99 ,$308.09 ,$318.40 ,$301.53 ,$50.31 ,$298.25 ,$141.51 ,$201.70 ,$201.70 ,$294.98 ,$244.60 ,$228.28 ,$142.93 ,$47.46 ,$311.36 ,$148.59 ,$47.46 ,$285.14 ,$141.51 ,$294.98 ,$141.51 ,$294.98 ,$294.98 ,$294.98 ,$317.92 ,$265.48 ,$304.81 ,$281.87 ,$317.92 
SACRED HEART HOSPITAL (ACU),94500015,90837,HC ALCOHOL THERAPY INDIVIDUAL 60MIN,945,1 ,$431.25 ,$323.44 ,$47.46 ,$431.25 ,$277.73 ,$141.51 ,$301.88 ,$47.46 ,$431.25 ,$48.88 ,$431.25 ,$409.69 ,$47.46 ,$345.00 ,$396.75 ,$47.46 ,$366.56 ,$409.69 ,$379.50 ,$327.75 ,$47.46 ,$47.46 ,$47.46 ,$314.81 ,$237.19 ,$392.44 ,$392.44 ,$345.00 ,$145.76 ,$237.19 ,$388.13 ,$141.51 ,$388.13 ,$232.88 ,$405.38 ,$318.40 ,$396.75 ,$50.31 ,$392.44 ,$141.51 ,$265.39 ,$265.39 ,$388.13 ,$321.84 ,$300.37 ,$142.93 ,$47.46 ,$409.69 ,$148.59 ,$47.46 ,$375.19 ,$141.51 ,$388.13 ,$141.51 ,$388.13 ,$388.13 ,$388.13 ,$418.31 ,$349.31 ,$401.06 ,$370.88 ,$418.31 
SACRED HEART HOSPITAL (ACU),94800001,94625,HC PHY/QHP OP PULM RHB W/O MNTR,948,1 ,$177.00 ,$132.75 ,$11.55 ,$177.00 ,$113.99 ,$58.87 ,$123.90 ,$11.55 ,$146.91 ,$11.90 ,$116.82 ,$168.15 ,$11.55 ,$141.60 ,$162.84 ,$11.55 ,$150.45 ,$168.15 ,$155.76 ,$134.52 ,$11.55 ,$11.55 ,$11.55 ,$129.21 ,$97.35 ,$161.07 ,$161.07 ,$141.60 ,$60.64 ,$97.35 ,$159.30 ,$58.87 ,$159.30 ,$95.58 ,$166.38 ,$132.46 ,$162.84 ,$12.24 ,$161.07 ,$58.87 ,$108.93 ,$108.93 ,$159.30 ,$132.10 ,$123.28 ,$59.46 ,$11.55 ,$168.15 ,$61.82 ,$11.55 ,$153.99 ,$58.87 ,$159.30 ,$58.87 ,$159.30 ,$159.30 ,$159.30 ,$171.69 ,$143.37 ,$164.61 ,$152.22 ,$171.69 
SACRED HEART HOSPITAL (ACU),94800002,94626,HC PHY/QHP OP PULM RHB W/MNTR,948,1 ,$177.00 ,$132.75 ,$11.55 ,$177.00 ,$113.99 ,$58.87 ,$123.90 ,$11.55 ,$146.91 ,$11.90 ,$116.82 ,$168.15 ,$11.55 ,$141.60 ,$162.84 ,$11.55 ,$150.45 ,$168.15 ,$155.76 ,$134.52 ,$11.55 ,$11.55 ,$11.55 ,$129.21 ,$97.35 ,$161.07 ,$161.07 ,$141.60 ,$60.64 ,$97.35 ,$159.30 ,$58.87 ,$159.30 ,$95.58 ,$166.38 ,$132.46 ,$162.84 ,$12.24 ,$161.07 ,$58.87 ,$108.93 ,$108.93 ,$159.30 ,$132.10 ,$123.28 ,$59.46 ,$11.55 ,$168.15 ,$61.82 ,$11.55 ,$153.99 ,$58.87 ,$159.30 ,$58.87 ,$159.30 ,$159.30 ,$159.30 ,$171.69 ,$143.37 ,$164.61 ,$152.22 ,$171.69 
SACRED HEART HOSPITAL (ACU),96000016,99341,PC HOME VISIT NEW PAT LOW SEVERITY 20MIN,960,1 ,$170.00 ,$127.50 ,$39.52 ,$170.00 ,$109.48 , N/A ,$119.00 ,$39.52 ,$141.10 ,$40.71 ,$112.20 ,$161.50 ,$39.52 ,$136.00 ,$156.40 ,$39.52 ,$144.50 ,$161.50 ,$149.60 ,$129.20 ,$39.52 ,$39.52 ,$39.52 ,$124.10 ,$93.50 ,$154.70 ,$154.70 ,$136.00 , N/A ,$93.50 ,$153.00 , N/A ,$153.00 ,$91.80 ,$159.80 , N/A ,$156.40 ,$41.89 ,$154.70 , N/A ,$104.62 ,$104.62 ,$153.00 ,$126.87 ,$118.41 , N/A ,$39.52 ,$161.50 , N/A ,$39.52 ,$147.90 , N/A ,$153.00 , N/A ,$153.00 ,$153.00 ,$153.00 ,$164.90 ,$137.70 ,$158.10 ,$146.20 ,$164.90 
SACRED HEART HOSPITAL (ACU),96000017,99342,PC HOME VISIT NEW PAT MOD SEVERITY 30MIN,960,1 ,$243.00 ,$182.25 ,$39.52 ,$243.00 ,$156.49 , N/A ,$170.10 ,$39.52 ,$201.69 ,$40.71 ,$160.38 ,$230.85 ,$39.52 ,$194.40 ,$223.56 ,$39.52 ,$206.55 ,$230.85 ,$213.84 ,$184.68 ,$39.52 ,$39.52 ,$39.52 ,$177.39 ,$133.65 ,$221.13 ,$221.13 ,$194.40 , N/A ,$133.65 ,$218.70 , N/A ,$218.70 ,$131.22 ,$228.42 , N/A ,$223.56 ,$41.89 ,$221.13 , N/A ,$149.54 ,$149.54 ,$218.70 ,$181.35 ,$169.25 , N/A ,$39.52 ,$230.85 , N/A ,$39.52 ,$211.41 , N/A ,$218.70 , N/A ,$218.70 ,$218.70 ,$218.70 ,$235.71 ,$196.83 ,$225.99 ,$208.98 ,$235.71 
SACRED HEART HOSPITAL (ACU),96000018,99343,PC HOME VISIT NEW PAT MOD-HIGH SEVERITY 45MIN,960,1 ,$340.00 ,$255.00 ,$39.52 ,$340.00 ,$218.96 , N/A ,$238.00 ,$39.52 ,$282.20 ,$40.71 ,$224.40 ,$323.00 ,$39.52 ,$272.00 ,$312.80 ,$39.52 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$39.52 ,$39.52 ,$39.52 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 , N/A ,$187.00 ,$306.00 , N/A ,$306.00 ,$183.60 ,$319.60 , N/A ,$312.80 ,$41.89 ,$309.40 , N/A ,$209.24 ,$209.24 ,$306.00 ,$253.74 ,$236.81 , N/A ,$39.52 ,$323.00 , N/A ,$39.52 ,$295.80 , N/A ,$306.00 , N/A ,$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),96000019,99344,PC HOME VISIT NEW PAT HIGH SEVERITY 60MIN,960,1 ,$437.00 ,$327.75 ,$39.52 ,$437.00 ,$281.43 , N/A ,$305.90 ,$39.52 ,$362.71 ,$40.71 ,$288.42 ,$415.15 ,$39.52 ,$349.60 ,$402.04 ,$39.52 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$39.52 ,$39.52 ,$39.52 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 , N/A ,$240.35 ,$393.30 , N/A ,$393.30 ,$235.98 ,$410.78 , N/A ,$402.04 ,$41.89 ,$397.67 , N/A ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 , N/A ,$39.52 ,$415.15 , N/A ,$39.52 ,$380.19 , N/A ,$393.30 , N/A ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),96000020,99345,PC HOME VISIT NEW PAT COMPREHENSIVE 75MIN,960,1 ,$583.00 ,$437.25 ,$39.52 ,$583.00 ,$375.45 , N/A ,$408.10 ,$39.52 ,$483.89 ,$40.71 ,$384.78 ,$553.85 ,$39.52 ,$466.40 ,$536.36 ,$39.52 ,$495.55 ,$553.85 ,$513.04 ,$443.08 ,$39.52 ,$39.52 ,$39.52 ,$425.59 ,$320.65 ,$530.53 ,$530.53 ,$466.40 , N/A ,$320.65 ,$524.70 , N/A ,$524.70 ,$314.82 ,$548.02 , N/A ,$536.36 ,$41.89 ,$530.53 , N/A ,$358.78 ,$358.78 ,$524.70 ,$435.09 ,$406.06 , N/A ,$39.52 ,$553.85 , N/A ,$39.52 ,$507.21 , N/A ,$524.70 , N/A ,$524.70 ,$524.70 ,$524.70 ,$565.51 ,$472.23 ,$542.19 ,$501.38 ,$565.51 
SACRED HEART HOSPITAL (ACU),96000021,99347,PC HOME VISIT ESTAB PAT LIMITED 15MIN,960,1 ,$146.00 ,$109.50 ,$39.52 ,$146.00 ,$94.02 , N/A ,$102.20 ,$39.52 ,$121.18 ,$40.71 ,$96.36 ,$138.70 ,$39.52 ,$116.80 ,$134.32 ,$39.52 ,$124.10 ,$138.70 ,$128.48 ,$110.96 ,$39.52 ,$39.52 ,$39.52 ,$106.58 ,$80.30 ,$132.86 ,$132.86 ,$116.80 , N/A ,$80.30 ,$131.40 , N/A ,$131.40 ,$78.84 ,$137.24 , N/A ,$134.32 ,$41.89 ,$132.86 , N/A ,$89.85 ,$89.85 ,$131.40 ,$108.96 ,$101.69 , N/A ,$39.52 ,$138.70 , N/A ,$39.52 ,$127.02 , N/A ,$131.40 , N/A ,$131.40 ,$131.40 ,$131.40 ,$141.62 ,$118.26 ,$135.78 ,$125.56 ,$141.62 
SACRED HEART HOSPITAL (ACU),96000022,99348,PC HOME VISIT ESTAB PAT LOW-MOD SEVERITY 25MIN,960,1 ,$219.00 ,$164.25 ,$39.52 ,$219.00 ,$141.04 , N/A ,$153.30 ,$39.52 ,$181.77 ,$40.71 ,$144.54 ,$208.05 ,$39.52 ,$175.20 ,$201.48 ,$39.52 ,$186.15 ,$208.05 ,$192.72 ,$166.44 ,$39.52 ,$39.52 ,$39.52 ,$159.87 ,$120.45 ,$199.29 ,$199.29 ,$175.20 , N/A ,$120.45 ,$197.10 , N/A ,$197.10 ,$118.26 ,$205.86 , N/A ,$201.48 ,$41.89 ,$199.29 , N/A ,$134.77 ,$134.77 ,$197.10 ,$163.44 ,$152.53 , N/A ,$39.52 ,$208.05 , N/A ,$39.52 ,$190.53 , N/A ,$197.10 , N/A ,$197.10 ,$197.10 ,$197.10 ,$212.43 ,$177.39 ,$203.67 ,$188.34 ,$212.43 
SACRED HEART HOSPITAL (ACU),96000023,99349,PC HOME VISIT ESTAB PAT MOD-HIGH SEVERITY 40MIN,960,1 ,$316.00 ,$237.00 ,$39.52 ,$316.00 ,$203.50 , N/A ,$221.20 ,$39.52 ,$262.28 ,$40.71 ,$208.56 ,$300.20 ,$39.52 ,$252.80 ,$290.72 ,$39.52 ,$268.60 ,$300.20 ,$278.08 ,$240.16 ,$39.52 ,$39.52 ,$39.52 ,$230.68 ,$173.80 ,$287.56 ,$287.56 ,$252.80 , N/A ,$173.80 ,$284.40 , N/A ,$284.40 ,$170.64 ,$297.04 , N/A ,$290.72 ,$41.89 ,$287.56 , N/A ,$194.47 ,$194.47 ,$284.40 ,$235.83 ,$220.09 , N/A ,$39.52 ,$300.20 , N/A ,$39.52 ,$274.92 , N/A ,$284.40 , N/A ,$284.40 ,$284.40 ,$284.40 ,$306.52 ,$255.96 ,$293.88 ,$271.76 ,$306.52 
SACRED HEART HOSPITAL (ACU),96000024,99350,PC HOME VISIT ESTAB PAT COMPREHENSIVE 60 MIN,960,1 ,$437.00 ,$327.75 ,$39.52 ,$437.00 ,$281.43 , N/A ,$305.90 ,$39.52 ,$362.71 ,$40.71 ,$288.42 ,$415.15 ,$39.52 ,$349.60 ,$402.04 ,$39.52 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$39.52 ,$39.52 ,$39.52 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 , N/A ,$240.35 ,$393.30 , N/A ,$393.30 ,$235.98 ,$410.78 , N/A ,$402.04 ,$41.89 ,$397.67 , N/A ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 , N/A ,$39.52 ,$415.15 , N/A ,$39.52 ,$380.19 , N/A ,$393.30 , N/A ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),96000025,99324,PC ASSISTED LIVING VISIT NEW PAT LOW SEVERITY 20MIN,960,1 ,$170.00 ,$127.50 ,$39.52 ,$170.00 ,$109.48 , N/A ,$119.00 ,$39.52 ,$141.10 ,$40.71 ,$112.20 ,$161.50 ,$39.52 ,$136.00 ,$156.40 ,$39.52 ,$144.50 ,$161.50 ,$149.60 ,$129.20 ,$39.52 ,$39.52 ,$39.52 ,$124.10 ,$93.50 ,$154.70 ,$154.70 ,$136.00 , N/A ,$93.50 ,$153.00 , N/A ,$153.00 ,$91.80 ,$159.80 , N/A ,$156.40 ,$41.89 ,$154.70 , N/A ,$104.62 ,$104.62 ,$153.00 ,$126.87 ,$118.41 , N/A ,$39.52 ,$161.50 , N/A ,$39.52 ,$147.90 , N/A ,$153.00 , N/A ,$153.00 ,$153.00 ,$153.00 ,$164.90 ,$137.70 ,$158.10 ,$146.20 ,$164.90 
SACRED HEART HOSPITAL (ACU),96000026,99325,PC ASSISTED LIVING VISIT NEW PAT MOD SEVERITY 30MIN,960,1 ,$243.00 ,$182.25 ,$39.52 ,$243.00 ,$156.49 , N/A ,$170.10 ,$39.52 ,$201.69 ,$40.71 ,$160.38 ,$230.85 ,$39.52 ,$194.40 ,$223.56 ,$39.52 ,$206.55 ,$230.85 ,$213.84 ,$184.68 ,$39.52 ,$39.52 ,$39.52 ,$177.39 ,$133.65 ,$221.13 ,$221.13 ,$194.40 , N/A ,$133.65 ,$218.70 , N/A ,$218.70 ,$131.22 ,$228.42 , N/A ,$223.56 ,$41.89 ,$221.13 , N/A ,$149.54 ,$149.54 ,$218.70 ,$181.35 ,$169.25 , N/A ,$39.52 ,$230.85 , N/A ,$39.52 ,$211.41 , N/A ,$218.70 , N/A ,$218.70 ,$218.70 ,$218.70 ,$235.71 ,$196.83 ,$225.99 ,$208.98 ,$235.71 
SACRED HEART HOSPITAL (ACU),96000027,99326,PC ASSISTED LIVING VISIT NEW PAT MOD-HIGH SEVERITY 45MIN,960,1 ,$340.00 ,$255.00 ,$39.52 ,$340.00 ,$218.96 , N/A ,$238.00 ,$39.52 ,$282.20 ,$40.71 ,$224.40 ,$323.00 ,$39.52 ,$272.00 ,$312.80 ,$39.52 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$39.52 ,$39.52 ,$39.52 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 , N/A ,$187.00 ,$306.00 , N/A ,$306.00 ,$183.60 ,$319.60 , N/A ,$312.80 ,$41.89 ,$309.40 , N/A ,$209.24 ,$209.24 ,$306.00 ,$253.74 ,$236.81 , N/A ,$39.52 ,$323.00 , N/A ,$39.52 ,$295.80 , N/A ,$306.00 , N/A ,$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),96000028,99327,PC ASSISTED LIVING VISIT NEW PAT HIGH SEVERITY 60MIN,960,1 ,$437.00 ,$327.75 ,$39.52 ,$437.00 ,$281.43 , N/A ,$305.90 ,$39.52 ,$362.71 ,$40.71 ,$288.42 ,$415.15 ,$39.52 ,$349.60 ,$402.04 ,$39.52 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$39.52 ,$39.52 ,$39.52 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 , N/A ,$240.35 ,$393.30 , N/A ,$393.30 ,$235.98 ,$410.78 , N/A ,$402.04 ,$41.89 ,$397.67 , N/A ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 , N/A ,$39.52 ,$415.15 , N/A ,$39.52 ,$380.19 , N/A ,$393.30 , N/A ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),96000029,99328,PC ASSISTED LIVING VISIT NEW PAT COMPREHENSIVE 75MIN,960,1 ,$583.00 ,$437.25 ,$39.52 ,$583.00 ,$375.45 , N/A ,$408.10 ,$39.52 ,$483.89 ,$40.71 ,$384.78 ,$553.85 ,$39.52 ,$466.40 ,$536.36 ,$39.52 ,$495.55 ,$553.85 ,$513.04 ,$443.08 ,$39.52 ,$39.52 ,$39.52 ,$425.59 ,$320.65 ,$530.53 ,$530.53 ,$466.40 , N/A ,$320.65 ,$524.70 , N/A ,$524.70 ,$314.82 ,$548.02 , N/A ,$536.36 ,$41.89 ,$530.53 , N/A ,$358.78 ,$358.78 ,$524.70 ,$435.09 ,$406.06 , N/A ,$39.52 ,$553.85 , N/A ,$39.52 ,$507.21 , N/A ,$524.70 , N/A ,$524.70 ,$524.70 ,$524.70 ,$565.51 ,$472.23 ,$542.19 ,$501.38 ,$565.51 
SACRED HEART HOSPITAL (ACU),96000030,99334,PC ASSISTED LIVING VISIT ESTAB PAT LOW SEVERITY 15MIN,960,1 ,$146.00 ,$109.50 ,$39.52 ,$146.00 ,$94.02 , N/A ,$102.20 ,$39.52 ,$121.18 ,$40.71 ,$96.36 ,$138.70 ,$39.52 ,$116.80 ,$134.32 ,$39.52 ,$124.10 ,$138.70 ,$128.48 ,$110.96 ,$39.52 ,$39.52 ,$39.52 ,$106.58 ,$80.30 ,$132.86 ,$132.86 ,$116.80 , N/A ,$80.30 ,$131.40 , N/A ,$131.40 ,$78.84 ,$137.24 , N/A ,$134.32 ,$41.89 ,$132.86 , N/A ,$89.85 ,$89.85 ,$131.40 ,$108.96 ,$101.69 , N/A ,$39.52 ,$138.70 , N/A ,$39.52 ,$127.02 , N/A ,$131.40 , N/A ,$131.40 ,$131.40 ,$131.40 ,$141.62 ,$118.26 ,$135.78 ,$125.56 ,$141.62 
SACRED HEART HOSPITAL (ACU),96000031,99335,PC ASSISTED LIVING VISIT ESTAB PAT LOW-MOD SEVERITY 25MIN,960,1 ,$219.00 ,$164.25 ,$39.52 ,$219.00 ,$141.04 , N/A ,$153.30 ,$39.52 ,$181.77 ,$40.71 ,$144.54 ,$208.05 ,$39.52 ,$175.20 ,$201.48 ,$39.52 ,$186.15 ,$208.05 ,$192.72 ,$166.44 ,$39.52 ,$39.52 ,$39.52 ,$159.87 ,$120.45 ,$199.29 ,$199.29 ,$175.20 , N/A ,$120.45 ,$197.10 , N/A ,$197.10 ,$118.26 ,$205.86 , N/A ,$201.48 ,$41.89 ,$199.29 , N/A ,$134.77 ,$134.77 ,$197.10 ,$163.44 ,$152.53 , N/A ,$39.52 ,$208.05 , N/A ,$39.52 ,$190.53 , N/A ,$197.10 , N/A ,$197.10 ,$197.10 ,$197.10 ,$212.43 ,$177.39 ,$203.67 ,$188.34 ,$212.43 
SACRED HEART HOSPITAL (ACU),96000032,99336,PC ASSISTED LIVING VISIT ESTAB PAT MOD-HIGH SEVERITY 40MIN,960,1 ,$316.00 ,$237.00 ,$39.52 ,$316.00 ,$203.50 , N/A ,$221.20 ,$39.52 ,$262.28 ,$40.71 ,$208.56 ,$300.20 ,$39.52 ,$252.80 ,$290.72 ,$39.52 ,$268.60 ,$300.20 ,$278.08 ,$240.16 ,$39.52 ,$39.52 ,$39.52 ,$230.68 ,$173.80 ,$287.56 ,$287.56 ,$252.80 , N/A ,$173.80 ,$284.40 , N/A ,$284.40 ,$170.64 ,$297.04 , N/A ,$290.72 ,$41.89 ,$287.56 , N/A ,$194.47 ,$194.47 ,$284.40 ,$235.83 ,$220.09 , N/A ,$39.52 ,$300.20 , N/A ,$39.52 ,$274.92 , N/A ,$284.40 , N/A ,$284.40 ,$284.40 ,$284.40 ,$306.52 ,$255.96 ,$293.88 ,$271.76 ,$306.52 
SACRED HEART HOSPITAL (ACU),96000033,99337,PC ASSISTED LIVING VISIT ESTAB PAT COMPREHENSIVE 60MIN,960,1 ,$437.00 ,$327.75 ,$39.52 ,$437.00 ,$281.43 , N/A ,$305.90 ,$39.52 ,$362.71 ,$40.71 ,$288.42 ,$415.15 ,$39.52 ,$349.60 ,$402.04 ,$39.52 ,$371.45 ,$415.15 ,$384.56 ,$332.12 ,$39.52 ,$39.52 ,$39.52 ,$319.01 ,$240.35 ,$397.67 ,$397.67 ,$349.60 , N/A ,$240.35 ,$393.30 , N/A ,$393.30 ,$235.98 ,$410.78 , N/A ,$402.04 ,$41.89 ,$397.67 , N/A ,$268.93 ,$268.93 ,$393.30 ,$326.13 ,$304.37 , N/A ,$39.52 ,$415.15 , N/A ,$39.52 ,$380.19 , N/A ,$393.30 , N/A ,$393.30 ,$393.30 ,$393.30 ,$423.89 ,$353.97 ,$406.41 ,$375.82 ,$423.89 
SACRED HEART HOSPITAL (ACU),96000034,99304,PC NURSING FACILITY CARE INITIAL DAY LOW 25MIN,960,1 ,$194.00 ,$145.50 ,$39.52 ,$194.00 ,$124.94 , N/A ,$135.80 ,$39.52 ,$161.02 ,$40.71 ,$128.04 ,$184.30 ,$39.52 ,$155.20 ,$178.48 ,$39.52 ,$164.90 ,$184.30 ,$170.72 ,$147.44 ,$39.52 ,$39.52 ,$39.52 ,$141.62 ,$106.70 ,$176.54 ,$176.54 ,$155.20 , N/A ,$106.70 ,$174.60 , N/A ,$174.60 ,$104.76 ,$182.36 , N/A ,$178.48 ,$41.89 ,$176.54 , N/A ,$119.39 ,$119.39 ,$174.60 ,$144.78 ,$135.12 , N/A ,$39.52 ,$184.30 , N/A ,$39.52 ,$168.78 , N/A ,$174.60 , N/A ,$174.60 ,$174.60 ,$174.60 ,$188.18 ,$157.14 ,$180.42 ,$166.84 ,$188.18 
SACRED HEART HOSPITAL (ACU),96000035,99305,PC NURSING FACILITY CARE INITIAL DAY MOD 35MIN,960,1 ,$267.00 ,$200.25 ,$39.52 ,$267.00 ,$171.95 , N/A ,$186.90 ,$39.52 ,$221.61 ,$40.71 ,$176.22 ,$253.65 ,$39.52 ,$213.60 ,$245.64 ,$39.52 ,$226.95 ,$253.65 ,$234.96 ,$202.92 ,$39.52 ,$39.52 ,$39.52 ,$194.91 ,$146.85 ,$242.97 ,$242.97 ,$213.60 , N/A ,$146.85 ,$240.30 , N/A ,$240.30 ,$144.18 ,$250.98 , N/A ,$245.64 ,$41.89 ,$242.97 , N/A ,$164.31 ,$164.31 ,$240.30 ,$199.26 ,$185.97 , N/A ,$39.52 ,$253.65 , N/A ,$39.52 ,$232.29 , N/A ,$240.30 , N/A ,$240.30 ,$240.30 ,$240.30 ,$258.99 ,$216.27 ,$248.31 ,$229.62 ,$258.99 
SACRED HEART HOSPITAL (ACU),96000036,99306,PC NURSING FACILITY CARE INITIAL DAY HIGH 45MIN,960,1 ,$340.00 ,$255.00 ,$39.52 ,$340.00 ,$218.96 , N/A ,$238.00 ,$39.52 ,$282.20 ,$40.71 ,$224.40 ,$323.00 ,$39.52 ,$272.00 ,$312.80 ,$39.52 ,$289.00 ,$323.00 ,$299.20 ,$258.40 ,$39.52 ,$39.52 ,$39.52 ,$248.20 ,$187.00 ,$309.40 ,$309.40 ,$272.00 , N/A ,$187.00 ,$306.00 , N/A ,$306.00 ,$183.60 ,$319.60 , N/A ,$312.80 ,$41.89 ,$309.40 , N/A ,$209.24 ,$209.24 ,$306.00 ,$253.74 ,$236.81 , N/A ,$39.52 ,$323.00 , N/A ,$39.52 ,$295.80 , N/A ,$306.00 , N/A ,$306.00 ,$306.00 ,$306.00 ,$329.80 ,$275.40 ,$316.20 ,$292.40 ,$329.80 
SACRED HEART HOSPITAL (ACU),96000037,99318,PC NURSING FAC ANNUAL ASSESSMENT 30MIN,960,1 ,$243.00 ,$182.25 ,$39.52 ,$243.00 ,$156.49 , N/A ,$170.10 ,$39.52 ,$201.69 ,$40.71 ,$160.38 ,$230.85 ,$39.52 ,$194.40 ,$223.56 ,$39.52 ,$206.55 ,$230.85 ,$213.84 ,$184.68 ,$39.52 ,$39.52 ,$39.52 ,$177.39 ,$133.65 ,$221.13 ,$221.13 ,$194.40 , N/A ,$133.65 ,$218.70 , N/A ,$218.70 ,$131.22 ,$228.42 , N/A ,$223.56 ,$41.89 ,$221.13 , N/A ,$149.54 ,$149.54 ,$218.70 ,$181.35 ,$169.25 , N/A ,$39.52 ,$230.85 , N/A ,$39.52 ,$211.41 , N/A ,$218.70 , N/A ,$218.70 ,$218.70 ,$218.70 ,$235.71 ,$196.83 ,$225.99 ,$208.98 ,$235.71 
SACRED HEART HOSPITAL (ACU),96000038,99497,PC ADVANCED CARE PLANNING INIT 30MIN,960,1 ,$267.00 ,$200.25 ,$33.65 ,$267.00 ,$171.95 ,$79.14 ,$186.90 ,$33.65 ,$221.61 ,$34.66 ,$176.22 ,$253.65 ,$33.65 ,$213.60 ,$245.64 ,$33.65 ,$226.95 ,$253.65 ,$234.96 ,$202.92 ,$33.65 ,$33.65 ,$33.65 ,$194.91 ,$146.85 ,$242.97 ,$242.97 ,$213.60 ,$81.51 ,$146.85 ,$240.30 ,$79.14 ,$240.30 ,$144.18 ,$250.98 ,$178.06 ,$245.64 ,$35.67 ,$242.97 ,$79.14 ,$164.31 ,$164.31 ,$240.30 ,$199.26 ,$185.97 ,$79.93 ,$33.65 ,$253.65 ,$83.10 ,$33.65 ,$232.29 ,$79.14 ,$240.30 ,$79.14 ,$240.30 ,$240.30 ,$240.30 ,$258.99 ,$216.27 ,$248.31 ,$229.62 ,$258.99 
SACRED HEART HOSPITAL (ACU),96000039,99498,PC ADVANCED CARE PLANNING ADDL 30MIN,960,1 ,$219.00 ,$164.25 ,$33.65 ,$219.00 ,$141.04 , N/A ,$153.30 ,$33.65 ,$181.77 ,$34.66 ,$144.54 ,$208.05 ,$33.65 ,$175.20 ,$201.48 ,$33.65 ,$186.15 ,$208.05 ,$192.72 ,$166.44 ,$33.65 ,$33.65 ,$33.65 ,$159.87 ,$120.45 ,$199.29 ,$199.29 ,$175.20 , N/A ,$120.45 ,$197.10 , N/A ,$197.10 ,$118.26 ,$205.86 , N/A ,$201.48 ,$35.67 ,$199.29 , N/A ,$134.77 ,$134.77 ,$197.10 ,$163.44 ,$152.53 , N/A ,$33.65 ,$208.05 , N/A ,$33.65 ,$190.53 , N/A ,$197.10 , N/A ,$197.10 ,$197.10 ,$197.10 ,$212.43 ,$177.39 ,$203.67 ,$188.34 ,$212.43 
SACRED HEART HOSPITAL (ACU),96000040,99354,PC EXTENDED E AND M/PSYCH OP SERVICE INIT HR,960,1 ,$510.00 ,$382.50 ,$275.40 ,$510.00 ,$328.44 , N/A ,$357.00 , N/A ,$423.30 , N/A ,$336.60 ,$484.50 , N/A ,$408.00 ,$469.20 , N/A ,$433.50 ,$484.50 ,$448.80 ,$387.60 , N/A , N/A , N/A ,$372.30 ,$280.50 ,$464.10 ,$464.10 ,$408.00 , N/A ,$280.50 ,$459.00 , N/A ,$459.00 ,$275.40 ,$479.40 , N/A ,$469.20 , N/A ,$464.10 , N/A ,$313.85 ,$313.85 ,$459.00 ,$380.61 ,$355.22 , N/A , N/A ,$484.50 , N/A , N/A ,$443.70 , N/A ,$459.00 , N/A ,$459.00 ,$459.00 ,$459.00 ,$494.70 ,$413.10 ,$474.30 ,$438.60 ,$494.70 
SACRED HEART HOSPITAL (ACU),96000041,99355,PC EXTENDED E AND M/PSYCH OP SERVICE ADDL 30MIN,960,1 ,$219.00 ,$164.25 ,$118.26 ,$219.00 ,$141.04 , N/A ,$153.30 , N/A ,$181.77 , N/A ,$144.54 ,$208.05 , N/A ,$175.20 ,$201.48 , N/A ,$186.15 ,$208.05 ,$192.72 ,$166.44 , N/A , N/A , N/A ,$159.87 ,$120.45 ,$199.29 ,$199.29 ,$175.20 , N/A ,$120.45 ,$197.10 , N/A ,$197.10 ,$118.26 ,$205.86 , N/A ,$201.48 , N/A ,$199.29 , N/A ,$134.77 ,$134.77 ,$197.10 ,$163.44 ,$152.53 , N/A , N/A ,$208.05 , N/A , N/A ,$190.53 , N/A ,$197.10 , N/A ,$197.10 ,$197.10 ,$197.10 ,$212.43 ,$177.39 ,$203.67 ,$188.34 ,$212.43 
SACRED HEART HOSPITAL (ACU),96000042,99358,PC PROLONG E AND M BEFORE/AFTER DIRECT PAT CARE INIT HR,960,1 ,$510.00 ,$382.50 ,$275.40 ,$510.00 ,$328.44 , N/A ,$357.00 , N/A ,$423.30 , N/A ,$336.60 ,$484.50 , N/A ,$408.00 ,$469.20 , N/A ,$433.50 ,$484.50 ,$448.80 ,$387.60 , N/A , N/A , N/A ,$372.30 ,$280.50 ,$464.10 ,$464.10 ,$408.00 , N/A ,$280.50 ,$459.00 , N/A ,$459.00 ,$275.40 ,$479.40 , N/A ,$469.20 , N/A ,$464.10 , N/A ,$313.85 ,$313.85 ,$459.00 ,$380.61 ,$355.22 , N/A , N/A ,$484.50 , N/A , N/A ,$443.70 , N/A ,$459.00 , N/A ,$459.00 ,$459.00 ,$459.00 ,$494.70 ,$413.10 ,$474.30 ,$438.60 ,$494.70 
SACRED HEART HOSPITAL (ACU),96000043,99359,PC PROLONG E AND M BEFORE/AFTER DIRECT PAT CARE ADDL 30MIN,960,1 ,$219.00 ,$164.25 ,$118.26 ,$219.00 ,$141.04 , N/A ,$153.30 , N/A ,$181.77 , N/A ,$144.54 ,$208.05 , N/A ,$175.20 ,$201.48 , N/A ,$186.15 ,$208.05 ,$192.72 ,$166.44 , N/A , N/A , N/A ,$159.87 ,$120.45 ,$199.29 ,$199.29 ,$175.20 , N/A ,$120.45 ,$197.10 , N/A ,$197.10 ,$118.26 ,$205.86 , N/A ,$201.48 , N/A ,$199.29 , N/A ,$134.77 ,$134.77 ,$197.10 ,$163.44 ,$152.53 , N/A , N/A ,$208.05 , N/A , N/A ,$190.53 , N/A ,$197.10 , N/A ,$197.10 ,$197.10 ,$197.10 ,$212.43 ,$177.39 ,$203.67 ,$188.34 ,$212.43 
SACRED HEART HOSPITAL (ACU),96000052,M0239,"PC INTRAVENOUS INFUSION, BAMLANIVIMAB",960,1 ,$697.00 ,$522.75 ,$309.60 ,$697.00 ,$448.87 , N/A ,$487.90 ,$309.60 ,$578.51 ,$318.89 ,$460.02 ,$662.15 ,$309.60 ,$557.60 ,$641.24 ,$309.60 ,$592.45 ,$662.15 ,$613.36 ,$529.72 ,$309.60 ,$309.60 ,$309.60 ,$508.81 ,$383.35 ,$634.27 ,$634.27 ,$557.60 , N/A ,$383.35 ,$627.30 , N/A ,$627.30 ,$376.38 ,$655.18 , N/A ,$641.24 ,$328.18 ,$634.27 , N/A ,$428.93 ,$428.93 ,$627.30 ,$520.17 ,$485.46 , N/A ,$309.60 ,$662.15 , N/A ,$309.60 ,$606.39 , N/A ,$627.30 , N/A ,$627.30 ,$627.30 ,$627.30 ,$676.09 ,$564.57 ,$648.21 ,$599.42 ,$676.09 
SACRED HEART HOSPITAL (ACU),98180018,11012,PC DEBRIDE ASSOC FX/DISLO SKIN/MUS/BONE,981,1 ,$157.12 ,$117.84 ,$84.84 ,"$5,642.34 ",$101.19 ,"$2,507.71 ",$109.98 ,$157.12 ,$130.41 ,$335.49 ,$103.70 ,$149.26 ,$325.72 ,$125.70 ,$144.55 ,$157.12 ,$133.55 ,$149.26 ,$138.27 ,$119.41 ,$157.12 ,$157.12 ,$325.72 ,$114.70 ,$86.42 ,$142.98 ,$142.98 ,$125.70 ,"$2,582.94 ",$86.42 ,$141.41 ,"$2,507.71 ",$141.41 ,$84.84 ,$147.69 ,"$5,642.34 ",$144.55 ,$345.26 ,$142.98 ,"$2,507.71 ",$96.69 ,$96.69 ,$141.41 ,$117.26 ,$109.43 ,"$2,532.79 ",$157.12 ,$149.26 ,"$2,633.09 ",$157.12 ,$136.69 ,"$2,507.71 ",$141.41 ,"$2,507.71 ",$141.41 ,$141.41 ,$141.41 ,$152.41 ,$127.27 ,$146.12 ,$135.12 ,$152.41 
SACRED HEART HOSPITAL (ACU),98180019,11040,"PC SURGICAL CLEANSING, ABRASION",981,1 ,$161.50 ,$121.13 ,$87.21 ,$161.50 ,$104.01 , N/A ,$113.05 , N/A ,$134.05 , N/A ,$106.59 ,$153.43 , N/A ,$129.20 ,$148.58 , N/A ,$137.28 ,$153.43 ,$142.12 ,$122.74 , N/A , N/A , N/A ,$117.90 ,$88.83 ,$146.97 ,$146.97 ,$129.20 , N/A ,$88.83 ,$145.35 , N/A ,$145.35 ,$87.21 ,$151.81 , N/A ,$148.58 , N/A ,$146.97 , N/A ,$99.39 ,$99.39 ,$145.35 ,$120.53 ,$112.48 , N/A , N/A ,$153.43 , N/A , N/A ,$140.51 , N/A ,$145.35 , N/A ,$145.35 ,$145.35 ,$145.35 ,$156.66 ,$130.82 ,$150.20 ,$138.89 ,$156.66 
SACRED HEART HOSPITAL (ACU),98180118,23625,"PC CLOSED RX GR TUBER HUM FX,MANIP",981,1 ,$331.23 ,$248.42 ,$144.24 ,"$3,314.53 ",$213.31 ,"$1,473.12 ",$231.86 ,$144.24 ,$274.92 ,$148.57 ,$218.61 ,$314.67 ,$144.24 ,$264.98 ,$304.73 ,$144.24 ,$281.55 ,$314.67 ,$291.48 ,$251.73 ,$144.24 ,$144.24 ,$144.24 ,$241.80 ,$182.18 ,$301.42 ,$301.42 ,$264.98 ,"$1,517.31 ",$182.18 ,$298.11 ,"$1,473.12 ",$298.11 ,$178.86 ,$311.36 ,"$3,314.53 ",$304.73 ,$152.89 ,$301.42 ,"$1,473.12 ",$203.84 ,$203.84 ,$298.11 ,$247.20 ,$230.70 ,"$1,487.85 ",$144.24 ,$314.67 ,"$1,546.78 ",$144.24 ,$288.17 ,"$1,473.12 ",$298.11 ,"$1,473.12 ",$298.11 ,$298.11 ,$298.11 ,$321.29 ,$268.30 ,$308.04 ,$284.86 ,$321.29 
SACRED HEART HOSPITAL (ACU),98180191,26727,PC PERCUT RX PROX/MID FING SHFT FX,981,1 ,$102.23 ,$76.67 ,$55.20 ,"$6,739.17 ",$65.84 ,"$2,995.19 ",$71.56 ,$102.23 ,$84.85 ,"$1,776.50 ",$67.47 ,$97.12 ,"$1,724.76 ",$81.78 ,$94.05 ,$102.23 ,$86.90 ,$97.12 ,$89.96 ,$77.69 ,$102.23 ,$102.23 ,"$1,724.76 ",$74.63 ,$56.23 ,$93.03 ,$93.03 ,$81.78 ,"$3,085.05 ",$56.23 ,$92.01 ,"$2,995.19 ",$92.01 ,$55.20 ,$96.10 ,"$6,739.17 ",$94.05 ,"$1,828.25 ",$93.03 ,"$2,995.19 ",$62.91 ,$62.91 ,$92.01 ,$76.29 ,$71.20 ,"$3,025.14 ",$102.23 ,$97.12 ,"$3,144.95 ",$102.23 ,$88.94 ,"$2,995.19 ",$92.01 ,"$2,995.19 ",$92.01 ,$92.01 ,$92.01 ,$99.16 ,$82.81 ,$95.07 ,$87.92 ,$99.16 
SACRED HEART HOSPITAL (ACU),98180223,27510,"PC CLOSED RX FEMUR,DISTAL+MANIP",981,1 ,"$4,187.00 ","$3,140.25 ",$144.24 ,"$4,187.00 ","$2,696.43 ","$1,473.12 ","$2,930.90 ",$144.24 ,"$3,475.21 ",$148.57 ,"$2,763.42 ","$3,977.65 ",$144.24 ,"$3,349.60 ","$3,852.04 ",$144.24 ,"$3,558.95 ","$3,977.65 ","$3,684.56 ","$3,182.12 ",$144.24 ,$144.24 ,$144.24 ,"$3,056.51 ","$2,302.85 ","$3,810.17 ","$3,810.17 ","$3,349.60 ","$1,517.31 ","$2,302.85 ","$3,768.30 ","$1,473.12 ","$3,768.30 ","$2,260.98 ","$3,935.78 ","$3,314.53 ","$3,852.04 ",$152.89 ,"$3,810.17 ","$1,473.12 ","$2,576.68 ","$2,576.68 ","$3,768.30 ","$3,124.76 ","$2,916.25 ","$1,487.85 ",$144.24 ,"$3,977.65 ","$1,546.78 ",$144.24 ,"$3,642.69 ","$1,473.12 ","$3,768.30 ","$1,473.12 ","$3,768.30 ","$3,768.30 ","$3,768.30 ","$4,061.39 ","$3,391.47 ","$3,893.91 ","$3,600.82 ","$4,061.39 "
SACRED HEART HOSPITAL (ACU),98180229,27550,PC CLOSED RX KNEE DISLOCATN,981,1 ,$491.52 ,$368.64 ,$144.24 ,$491.52 ,$316.54 ,$217.99 ,$344.06 ,$144.24 ,$407.96 ,$148.57 ,$324.40 ,$466.94 ,$144.24 ,$393.22 ,$452.20 ,$144.24 ,$417.79 ,$466.94 ,$432.54 ,$373.56 ,$144.24 ,$144.24 ,$144.24 ,$358.81 ,$270.34 ,$447.28 ,$447.28 ,$393.22 ,$224.53 ,$270.34 ,$442.37 ,$217.99 ,$442.37 ,$265.42 ,$462.03 ,$490.48 ,$452.20 ,$152.89 ,$447.28 ,$217.99 ,$302.48 ,$302.48 ,$442.37 ,$366.82 ,$342.34 ,$220.17 ,$144.24 ,$466.94 ,$228.89 ,$144.24 ,$427.62 ,$217.99 ,$442.37 ,$217.99 ,$442.37 ,$442.37 ,$442.37 ,$476.77 ,$398.13 ,$457.11 ,$422.71 ,$476.77 
SACRED HEART HOSPITAL (ACU),98180244,27808,PC CLOSED RX BIMALLEOLAR FX,981,1 ,$306.79 ,$230.09 ,$144.24 ,$490.48 ,$197.57 ,$217.99 ,$214.75 ,$144.24 ,$254.64 ,$148.57 ,$202.48 ,$291.45 ,$144.24 ,$245.43 ,$282.25 ,$144.24 ,$260.77 ,$291.45 ,$269.98 ,$233.16 ,$144.24 ,$144.24 ,$144.24 ,$223.96 ,$168.73 ,$279.18 ,$279.18 ,$245.43 ,$224.53 ,$168.73 ,$276.11 ,$217.99 ,$276.11 ,$165.67 ,$288.38 ,$490.48 ,$282.25 ,$152.89 ,$279.18 ,$217.99 ,$188.80 ,$188.80 ,$276.11 ,$228.96 ,$213.68 ,$220.17 ,$144.24 ,$291.45 ,$228.89 ,$144.24 ,$266.91 ,$217.99 ,$276.11 ,$217.99 ,$276.11 ,$276.11 ,$276.11 ,$297.59 ,$248.50 ,$285.31 ,$263.84 ,$297.59 
SACRED HEART HOSPITAL (ACU),98180247,27818,"PC CLOSED RX TRIMALLEOLAR FX,MANIP",981,1 ,"$3,293.00 ","$2,469.75 ",$144.24 ,"$3,314.53 ","$2,120.69 ","$1,473.12 ","$2,305.10 ",$144.24 ,"$2,733.19 ",$148.57 ,"$2,173.38 ","$3,128.35 ",$144.24 ,"$2,634.40 ","$3,029.56 ",$144.24 ,"$2,799.05 ","$3,128.35 ","$2,897.84 ","$2,502.68 ",$144.24 ,$144.24 ,$144.24 ,"$2,403.89 ","$1,811.15 ","$2,996.63 ","$2,996.63 ","$2,634.40 ","$1,517.31 ","$1,811.15 ","$2,963.70 ","$1,473.12 ","$2,963.70 ","$1,778.22 ","$3,095.42 ","$3,314.53 ","$3,029.56 ",$152.89 ,"$2,996.63 ","$1,473.12 ","$2,026.51 ","$2,026.51 ","$2,963.70 ","$2,457.57 ","$2,293.57 ","$1,487.85 ",$144.24 ,"$3,128.35 ","$1,546.78 ",$144.24 ,"$2,864.91 ","$1,473.12 ","$2,963.70 ","$1,473.12 ","$2,963.70 ","$2,963.70 ","$2,963.70 ","$3,194.21 ","$2,667.33 ","$3,062.49 ","$2,831.98 ","$3,194.21 "
SACRED HEART HOSPITAL (ACU),98180268,28515,"PC CLOSED RX TOE FX,MANIPULATN",981,1 ,$585.26 ,$438.95 ,$144.24 ,$585.26 ,$376.91 ,$217.99 ,$409.68 ,$144.24 ,$485.77 ,$148.57 ,$386.27 ,$556.00 ,$144.24 ,$468.21 ,$538.44 ,$144.24 ,$497.47 ,$556.00 ,$515.03 ,$444.80 ,$144.24 ,$144.24 ,$144.24 ,$427.24 ,$321.89 ,$532.59 ,$532.59 ,$468.21 ,$224.53 ,$321.89 ,$526.73 ,$217.99 ,$526.73 ,$316.04 ,$550.14 ,$490.48 ,$538.44 ,$152.89 ,$532.59 ,$217.99 ,$360.17 ,$360.17 ,$526.73 ,$436.78 ,$407.63 ,$220.17 ,$144.24 ,$556.00 ,$228.89 ,$144.24 ,$509.18 ,$217.99 ,$526.73 ,$217.99 ,$526.73 ,$526.73 ,$526.73 ,$567.70 ,$474.06 ,$544.29 ,$503.32 ,$567.70 
SACRED HEART HOSPITAL (ACU),98180280,28665,"PC CLOSED RX I-P JT,TOE DISLOC,ANESTH",981,1 ,$167.75 ,$125.81 ,$90.59 ,$574.08 ,$108.03 ,$255.15 ,$117.43 ,$167.75 ,$139.23 ,$330.15 ,$110.72 ,$159.36 ,$320.53 ,$134.20 ,$154.33 ,$167.75 ,$142.59 ,$159.36 ,$147.62 ,$127.49 ,$167.75 ,$167.75 ,$320.53 ,$122.46 ,$92.26 ,$152.65 ,$152.65 ,$134.20 ,$262.80 ,$92.26 ,$150.98 ,$255.15 ,$150.98 ,$90.59 ,$157.69 ,$574.08 ,$154.33 ,$339.76 ,$152.65 ,$255.15 ,$103.23 ,$103.23 ,$150.98 ,$125.19 ,$116.84 ,$257.70 ,$167.75 ,$159.36 ,$267.90 ,$167.75 ,$145.94 ,$255.15 ,$150.98 ,$255.15 ,$150.98 ,$150.98 ,$150.98 ,$162.72 ,$135.88 ,$156.01 ,$144.27 ,$162.72 
SACRED HEART HOSPITAL (ACU),98180286,29105,PC APPLY LONG ARM SPLINT,981,1 ,$364.86 ,$273.65 ,$14.12 ,$364.86 ,$234.97 ,$149.42 ,$255.40 ,$14.12 ,$302.83 ,$14.54 ,$240.81 ,$346.62 ,$14.12 ,$291.89 ,$335.67 ,$14.12 ,$310.13 ,$346.62 ,$321.08 ,$277.29 ,$14.12 ,$14.12 ,$14.12 ,$266.35 ,$200.67 ,$332.02 ,$332.02 ,$291.89 ,$153.90 ,$200.67 ,$328.37 ,$149.42 ,$328.37 ,$197.02 ,$342.97 ,$336.20 ,$335.67 ,$14.97 ,$332.02 ,$149.42 ,$224.53 ,$224.53 ,$328.37 ,$272.30 ,$254.13 ,$150.92 ,$14.12 ,$346.62 ,$156.89 ,$14.12 ,$317.43 ,$149.42 ,$328.37 ,$149.42 ,$328.37 ,$328.37 ,$328.37 ,$353.91 ,$295.54 ,$339.32 ,$313.78 ,$353.91 
SACRED HEART HOSPITAL (ACU),98180287,29125,"PC APPLY FOREARM SPLINT,STATIC",981,1 ,$162.82 ,$122.12 ,$14.12 ,$268.33 ,$104.86 ,$119.26 ,$113.97 ,$14.12 ,$135.14 ,$14.54 ,$107.46 ,$154.68 ,$14.12 ,$130.26 ,$149.79 ,$14.12 ,$138.40 ,$154.68 ,$143.28 ,$123.74 ,$14.12 ,$14.12 ,$14.12 ,$118.86 ,$89.55 ,$148.17 ,$148.17 ,$130.26 ,$122.84 ,$89.55 ,$146.54 ,$119.26 ,$146.54 ,$87.92 ,$153.05 ,$268.33 ,$149.79 ,$14.97 ,$148.17 ,$119.26 ,$100.20 ,$100.20 ,$146.54 ,$121.51 ,$113.40 ,$120.45 ,$14.12 ,$154.68 ,$125.22 ,$14.12 ,$141.65 ,$119.26 ,$146.54 ,$119.26 ,$146.54 ,$146.54 ,$146.54 ,$157.94 ,$131.88 ,$151.42 ,$140.03 ,$157.94 
SACRED HEART HOSPITAL (ACU),98180290,29131,"PC APPLY FINGER SPLINT,DYNAMIC",981,1 ,$102.23 ,$76.67 ,$14.12 ,$132.46 ,$65.84 ,$58.87 ,$71.56 ,$14.12 ,$84.85 ,$14.54 ,$67.47 ,$97.12 ,$14.12 ,$81.78 ,$94.05 ,$14.12 ,$86.90 ,$97.12 ,$89.96 ,$77.69 ,$14.12 ,$14.12 ,$14.12 ,$74.63 ,$56.23 ,$93.03 ,$93.03 ,$81.78 ,$60.64 ,$56.23 ,$92.01 ,$58.87 ,$92.01 ,$55.20 ,$96.10 ,$132.46 ,$94.05 ,$14.97 ,$93.03 ,$58.87 ,$62.91 ,$62.91 ,$92.01 ,$76.29 ,$71.20 ,$59.46 ,$14.12 ,$97.12 ,$61.82 ,$14.12 ,$88.94 ,$58.87 ,$92.01 ,$58.87 ,$92.01 ,$92.01 ,$92.01 ,$99.16 ,$82.81 ,$95.07 ,$87.92 ,$99.16 
SACRED HEART HOSPITAL (ACU),98180292,29260,PC STRAPPING OF ELBOW OR WRIST,981,1 ,$109.02 ,$81.77 ,$14.12 ,$132.46 ,$70.21 ,$58.87 ,$76.31 ,$14.12 ,$90.49 ,$14.54 ,$71.95 ,$103.57 ,$14.12 ,$87.22 ,$100.30 ,$14.12 ,$92.67 ,$103.57 ,$95.94 ,$82.86 ,$14.12 ,$14.12 ,$14.12 ,$79.58 ,$59.96 ,$99.21 ,$99.21 ,$87.22 ,$60.64 ,$59.96 ,$98.12 ,$58.87 ,$98.12 ,$58.87 ,$102.48 ,$132.46 ,$100.30 ,$14.97 ,$99.21 ,$58.87 ,$67.09 ,$67.09 ,$98.12 ,$81.36 ,$75.93 ,$59.46 ,$14.12 ,$103.57 ,$61.82 ,$14.12 ,$94.85 ,$58.87 ,$98.12 ,$58.87 ,$98.12 ,$98.12 ,$98.12 ,$105.75 ,$88.31 ,$101.39 ,$93.76 ,$105.75 
SACRED HEART HOSPITAL (ACU),98180304,29505,PC APPLY LONG LEG SPLINT,981,1 ,$651.71 ,$488.78 ,$14.12 ,$651.71 ,$419.70 ,$149.42 ,$456.20 ,$14.12 ,$540.92 ,$14.54 ,$430.13 ,$619.12 ,$14.12 ,$521.37 ,$599.57 ,$14.12 ,$553.95 ,$619.12 ,$573.50 ,$495.30 ,$14.12 ,$14.12 ,$14.12 ,$475.75 ,$358.44 ,$593.06 ,$593.06 ,$521.37 ,$153.90 ,$358.44 ,$586.54 ,$149.42 ,$586.54 ,$351.92 ,$612.61 ,$336.20 ,$599.57 ,$14.97 ,$593.06 ,$149.42 ,$401.06 ,$401.06 ,$586.54 ,$486.37 ,$453.92 ,$150.92 ,$14.12 ,$619.12 ,$156.89 ,$14.12 ,$566.99 ,$149.42 ,$586.54 ,$149.42 ,$586.54 ,$586.54 ,$586.54 ,$632.16 ,$527.89 ,$606.09 ,$560.47 ,$632.16 
SACRED HEART HOSPITAL (ACU),98180362,90465,PC IMMUNIZ ADMIN COUNSEL 1ST,981,1 ,$72.43 ,$54.32 ,$39.11 ,$72.43 ,$46.64 , N/A ,$50.70 , N/A ,$60.12 , N/A ,$47.80 ,$68.81 , N/A ,$57.94 ,$66.64 , N/A ,$61.57 ,$68.81 ,$63.74 ,$55.05 , N/A , N/A , N/A ,$52.87 ,$39.84 ,$65.91 ,$65.91 ,$57.94 , N/A ,$39.84 ,$65.19 , N/A ,$65.19 ,$39.11 ,$68.08 , N/A ,$66.64 , N/A ,$65.91 , N/A ,$44.57 ,$44.57 ,$65.19 ,$54.05 ,$50.45 , N/A , N/A ,$68.81 , N/A , N/A ,$63.01 , N/A ,$65.19 , N/A ,$65.19 ,$65.19 ,$65.19 ,$70.26 ,$58.67 ,$67.36 ,$62.29 ,$70.26 
SACRED HEART HOSPITAL (ACU),98180382,90675,"PC RABIES VACCINE, IM",981,1 ,$72.43 ,$54.32 ,$35.63 ,$769.38 ,$46.64 ,$341.95 ,$50.70 ,$35.63 ,$60.12 ,$36.70 ,$47.80 ,$68.81 ,$35.63 ,$57.94 ,$66.64 ,$35.63 ,$61.57 ,$68.81 ,$63.74 ,$55.05 ,$35.63 ,$35.63 ,$35.63 ,$52.87 ,$39.84 ,$65.91 ,$65.91 ,$57.94 ,$352.21 ,$39.84 ,$65.19 ,$341.95 ,$65.19 ,$39.11 ,$68.08 ,$769.38 ,$66.64 ,$37.77 ,$65.91 ,$341.95 ,$44.57 ,$44.57 ,$65.19 ,$54.05 ,$50.45 ,$345.37 ,$35.63 ,$68.81 ,$359.04 ,$35.63 ,$63.01 ,$341.95 ,$65.19 ,$341.95 ,$65.19 ,$65.19 ,$65.19 ,$70.26 ,$58.67 ,$67.36 ,$62.29 ,$70.26 
SACRED HEART HOSPITAL (ACU),98180408,90718,"PC TD IMMUNIZATION,IM/JET>7YO",981,1 ,$68.53 ,$51.40 ,$37.01 ,$68.53 ,$44.13 , N/A ,$47.97 , N/A ,$56.88 , N/A ,$45.23 ,$65.10 , N/A ,$54.82 ,$63.05 , N/A ,$58.25 ,$65.10 ,$60.31 ,$52.08 , N/A , N/A , N/A ,$50.03 ,$37.69 ,$62.36 ,$62.36 ,$54.82 , N/A ,$37.69 ,$61.68 , N/A ,$61.68 ,$37.01 ,$64.42 , N/A ,$63.05 , N/A ,$62.36 , N/A ,$42.17 ,$42.17 ,$61.68 ,$51.14 ,$47.73 , N/A , N/A ,$65.10 , N/A , N/A ,$59.62 , N/A ,$61.68 , N/A ,$61.68 ,$61.68 ,$61.68 ,$66.47 ,$55.51 ,$63.73 ,$58.94 ,$66.47 
SACRED HEART HOSPITAL (ACU),98180418,90746,"PC HEPATITIS B VACCINE,ADULT,IM",981,1 ,$99.49 ,$74.62 ,$8.78 ,$99.49 ,$64.07 ,$29.85 ,$69.64 ,$8.78 ,$82.58 ,$9.04 ,$65.66 ,$94.52 ,$8.78 ,$79.59 ,$91.53 ,$8.78 ,$84.57 ,$94.52 ,$87.55 ,$75.61 ,$8.78 ,$8.78 ,$8.78 ,$72.63 ,$54.72 ,$90.54 ,$90.54 ,$79.59 ,$30.75 ,$54.72 ,$89.54 ,$29.85 ,$89.54 ,$53.72 ,$93.52 ,$67.16 ,$91.53 ,$9.31 ,$90.54 ,$29.85 ,$61.23 ,$61.23 ,$89.54 ,$74.25 ,$69.29 ,$30.15 ,$8.78 ,$94.52 ,$31.34 ,$8.78 ,$86.56 ,$29.85 ,$89.54 ,$29.85 ,$89.54 ,$89.54 ,$89.54 ,$96.51 ,$80.59 ,$92.53 ,$85.56 ,$96.51 
SACRED HEART HOSPITAL (ACU),98180447,93042,"PC RHYTHM ECG, REPORT",981,1 ,$92.40 ,$69.30 ,$8.56 ,$92.40 ,$59.51 , N/A ,$64.68 ,$8.56 ,$76.69 ,$8.82 ,$60.98 ,$87.78 ,$8.56 ,$73.92 ,$85.01 ,$8.56 ,$78.54 ,$87.78 ,$81.31 ,$70.22 ,$8.56 ,$8.56 ,$8.56 ,$67.45 ,$50.82 ,$84.08 ,$84.08 ,$73.92 , N/A ,$50.82 ,$83.16 , N/A ,$83.16 ,$49.90 ,$86.86 , N/A ,$85.01 ,$9.07 ,$84.08 , N/A ,$56.86 ,$56.86 ,$83.16 ,$68.96 ,$64.36 , N/A ,$8.56 ,$87.78 , N/A ,$8.56 ,$80.39 , N/A ,$83.16 , N/A ,$83.16 ,$83.16 ,$83.16 ,$89.63 ,$74.84 ,$85.93 ,$79.46 ,$89.63 
SACRED HEART HOSPITAL (ACU),98180550,43753,PC INTUBTION GASTRIC LAVAGE,981,1 ,$112.10 ,$84.08 ,$60.53 ,$629.79 ,$72.19 ,$279.91 ,$78.47 ,$112.10 ,$93.04 ,$224.87 ,$73.99 ,$106.50 ,$218.32 ,$89.68 ,$103.13 ,$112.10 ,$95.29 ,$106.50 ,$98.65 ,$85.20 ,$112.10 ,$112.10 ,$218.32 ,$81.83 ,$61.66 ,$102.01 ,$102.01 ,$89.68 ,$288.31 ,$61.66 ,$100.89 ,$279.91 ,$100.89 ,$60.53 ,$105.37 ,$629.79 ,$103.13 ,$231.42 ,$102.01 ,$279.91 ,$68.99 ,$68.99 ,$100.89 ,$83.66 ,$78.08 ,$282.71 ,$112.10 ,$106.50 ,$293.90 ,$112.10 ,$97.53 ,$279.91 ,$100.89 ,$279.91 ,$100.89 ,$100.89 ,$100.89 ,$108.74 ,$90.80 ,$104.25 ,$96.41 ,$108.74 
SACRED HEART HOSPITAL (ACU),98180614,30901,PC CONTROL NOSEBLEED ANTER SIMPLE-BILAT,981,1 ,$383.80 ,$287.85 ,$54.11 ,$383.80 ,$247.17 ,$119.26 ,$268.66 ,$54.11 ,$318.55 ,$55.73 ,$253.31 ,$364.61 ,$54.11 ,$307.04 ,$353.10 ,$54.11 ,$326.23 ,$364.61 ,$337.74 ,$291.69 ,$54.11 ,$54.11 ,$54.11 ,$280.17 ,$211.09 ,$349.26 ,$349.26 ,$307.04 ,$122.84 ,$211.09 ,$345.42 ,$119.26 ,$345.42 ,$207.25 ,$360.77 ,$268.33 ,$353.10 ,$57.36 ,$349.26 ,$119.26 ,$236.19 ,$236.19 ,$345.42 ,$286.43 ,$267.32 ,$120.45 ,$54.11 ,$364.61 ,$125.22 ,$54.11 ,$333.91 ,$119.26 ,$345.42 ,$119.26 ,$345.42 ,$345.42 ,$345.42 ,$372.29 ,$310.88 ,$356.93 ,$330.07 ,$372.29 
SACRED HEART HOSPITAL (ACU),98200006,99211,PC CLINIC VISIT BRIEF EST PRO,982,1 ,$93.70 ,$70.28 ,$39.52 ,$93.70 ,$60.34 , N/A ,$65.59 ,$39.52 ,$77.77 ,$40.71 ,$61.84 ,$89.02 ,$39.52 ,$74.96 ,$86.20 ,$39.52 ,$79.65 ,$89.02 ,$82.46 ,$71.21 ,$39.52 ,$39.52 ,$39.52 ,$68.40 ,$51.54 ,$85.27 ,$85.27 ,$74.96 , N/A ,$51.54 ,$84.33 , N/A ,$84.33 ,$50.60 ,$88.08 , N/A ,$86.20 ,$41.89 ,$85.27 , N/A ,$57.66 ,$57.66 ,$84.33 ,$69.93 ,$65.26 , N/A ,$39.52 ,$89.02 , N/A ,$39.52 ,$81.52 , N/A ,$84.33 , N/A ,$84.33 ,$84.33 ,$84.33 ,$90.89 ,$75.90 ,$87.14 ,$80.58 ,$90.89 
SACRED HEART HOSPITAL (ACU),98500000,93010,PC EKG INTER AND REPORT PRO,985,1 ,$95.10 ,$71.33 ,$8.56 ,$95.10 ,$61.24 , N/A ,$66.57 ,$8.56 ,$78.93 ,$8.82 ,$62.77 ,$90.35 ,$8.56 ,$76.08 ,$87.49 ,$8.56 ,$80.84 ,$90.35 ,$83.69 ,$72.28 ,$8.56 ,$8.56 ,$8.56 ,$69.42 ,$52.31 ,$86.54 ,$86.54 ,$76.08 , N/A ,$52.31 ,$85.59 , N/A ,$85.59 ,$51.35 ,$89.39 , N/A ,$87.49 ,$9.07 ,$86.54 , N/A ,$58.52 ,$58.52 ,$85.59 ,$70.97 ,$66.24 , N/A ,$8.56 ,$90.35 , N/A ,$8.56 ,$82.74 , N/A ,$85.59 , N/A ,$85.59 ,$85.59 ,$85.59 ,$92.25 ,$77.03 ,$88.44 ,$81.79 ,$92.25 
SACRED HEART HOSPITAL (ACU),98500004,93306,PC ECHO/CARDIAC DOP/COLOR FLOW-26,985,1 ,$995.82 ,$746.87 ,$150.67 ,"$1,149.84 ",$641.31 ,$511.04 ,$697.07 ,$150.67 ,$826.53 ,$155.19 ,$657.24 ,$946.03 ,$150.67 ,$796.66 ,$916.15 ,$150.67 ,$846.45 ,$946.03 ,$876.32 ,$756.82 ,$150.67 ,$150.67 ,$150.67 ,$726.95 ,$547.70 ,$906.20 ,$906.20 ,$796.66 ,$526.37 ,$547.70 ,$896.24 ,$511.04 ,$896.24 ,$537.74 ,$936.07 ,"$1,149.84 ",$916.15 ,$159.71 ,$906.20 ,$511.04 ,$612.83 ,$612.83 ,$896.24 ,$743.18 ,$693.59 ,$516.15 ,$150.67 ,$946.03 ,$536.59 ,$150.67 ,$866.36 ,$511.04 ,$896.24 ,$511.04 ,$896.24 ,$896.24 ,$896.24 ,$965.95 ,$806.61 ,$926.11 ,$856.41 ,$965.95 
SACRED HEART HOSPITAL (ACU),98500005,93308,PC ECHO 2D W/W/O M-MODE LTD-26,985,1 ,$433.96 ,$325.47 ,$150.67 ,$547.56 ,$279.47 ,$243.36 ,$303.77 ,$150.67 ,$360.19 ,$155.19 ,$286.41 ,$412.26 ,$150.67 ,$347.17 ,$399.24 ,$150.67 ,$368.87 ,$412.26 ,$381.88 ,$329.81 ,$150.67 ,$150.67 ,$150.67 ,$316.79 ,$238.68 ,$394.90 ,$394.90 ,$347.17 ,$250.66 ,$238.68 ,$390.56 ,$243.36 ,$390.56 ,$234.34 ,$407.92 ,$547.56 ,$399.24 ,$159.71 ,$394.90 ,$243.36 ,$267.06 ,$267.06 ,$390.56 ,$323.86 ,$302.25 ,$245.79 ,$150.67 ,$412.26 ,$255.53 ,$150.67 ,$377.55 ,$243.36 ,$390.56 ,$243.36 ,$390.56 ,$390.56 ,$390.56 ,$420.94 ,$351.51 ,$403.58 ,$373.21 ,$420.94 
SACRED HEART HOSPITAL (ACU),98600002,95810,PC SLEEP STUDY PSG 4+ PARAMETERS >6YRS-26,986,1 ,"$1,908.00 ","$1,431.00 ",$247.40 ,"$2,189.34 ","$1,228.75 ",$973.04 ,"$1,335.60 ",$247.40 ,"$1,583.64 ",$254.82 ,"$1,259.28 ","$1,812.60 ",$247.40 ,"$1,526.40 ","$1,755.36 ",$247.40 ,"$1,621.80 ","$1,812.60 ","$1,679.04 ","$1,450.08 ",$247.40 ,$247.40 ,$247.40 ,"$1,392.84 ","$1,049.40 ","$1,736.28 ","$1,736.28 ","$1,526.40 ","$1,002.23 ","$1,049.40 ","$1,717.20 ",$973.04 ,"$1,717.20 ","$1,030.32 ","$1,793.52 ","$2,189.34 ","$1,755.36 ",$262.24 ,"$1,736.28 ",$973.04 ,"$1,174.18 ","$1,174.18 ","$1,717.20 ","$1,423.94 ","$1,328.92 ",$982.77 ,$247.40 ,"$1,812.60 ","$1,021.69 ",$247.40 ,"$1,659.96 ",$973.04 ,"$1,717.20 ",$973.04 ,"$1,717.20 ","$1,717.20 ","$1,717.20 ","$1,850.76 ","$1,545.48 ","$1,774.44 ","$1,640.88 ","$1,850.76 "
SACRED HEART HOSPITAL (ACU),98780008,99224,PC SUBSQ OBSERVATION CARE LEV 1,987,1 ,$99.00 ,$74.25 ,$39.52 ,$99.00 ,$63.76 , N/A ,$69.30 ,$39.52 ,$82.17 ,$40.71 ,$65.34 ,$94.05 ,$39.52 ,$79.20 ,$91.08 ,$39.52 ,$84.15 ,$94.05 ,$87.12 ,$75.24 ,$39.52 ,$39.52 ,$39.52 ,$72.27 ,$54.45 ,$90.09 ,$90.09 ,$79.20 , N/A ,$54.45 ,$89.10 , N/A ,$89.10 ,$53.46 ,$93.06 , N/A ,$91.08 ,$41.89 ,$90.09 , N/A ,$60.92 ,$60.92 ,$89.10 ,$73.88 ,$68.95 , N/A ,$39.52 ,$94.05 , N/A ,$39.52 ,$86.13 , N/A ,$89.10 , N/A ,$89.10 ,$89.10 ,$89.10 ,$96.03 ,$80.19 ,$92.07 ,$85.14 ,$96.03 
SACRED HEART HOSPITAL (ACU),98780009,99225,PC SUBSQ OBSERVATION CARE LEV 2,987,1 ,$184.00 ,$138.00 ,$39.52 ,$184.00 ,$118.50 , N/A ,$128.80 ,$39.52 ,$152.72 ,$40.71 ,$121.44 ,$174.80 ,$39.52 ,$147.20 ,$169.28 ,$39.52 ,$156.40 ,$174.80 ,$161.92 ,$139.84 ,$39.52 ,$39.52 ,$39.52 ,$134.32 ,$101.20 ,$167.44 ,$167.44 ,$147.20 , N/A ,$101.20 ,$165.60 , N/A ,$165.60 ,$99.36 ,$172.96 , N/A ,$169.28 ,$41.89 ,$167.44 , N/A ,$113.23 ,$113.23 ,$165.60 ,$137.32 ,$128.16 , N/A ,$39.52 ,$174.80 , N/A ,$39.52 ,$160.08 , N/A ,$165.60 , N/A ,$165.60 ,$165.60 ,$165.60 ,$178.48 ,$149.04 ,$171.12 ,$158.24 ,$178.48 
SACRED HEART HOSPITAL (ACU),98780010,99226,PC SUBSQ OBSERVATION CARE LEV 3,987,1 ,$295.00 ,$221.25 ,$39.52 ,$295.00 ,$189.98 , N/A ,$206.50 ,$39.52 ,$244.85 ,$40.71 ,$194.70 ,$280.25 ,$39.52 ,$236.00 ,$271.40 ,$39.52 ,$250.75 ,$280.25 ,$259.60 ,$224.20 ,$39.52 ,$39.52 ,$39.52 ,$215.35 ,$162.25 ,$268.45 ,$268.45 ,$236.00 , N/A ,$162.25 ,$265.50 , N/A ,$265.50 ,$159.30 ,$277.30 , N/A ,$271.40 ,$41.89 ,$268.45 , N/A ,$181.54 ,$181.54 ,$265.50 ,$220.16 ,$205.47 , N/A ,$39.52 ,$280.25 , N/A ,$39.52 ,$256.65 , N/A ,$265.50 , N/A ,$265.50 ,$265.50 ,$265.50 ,$286.15 ,$238.95 ,$274.35 ,$253.70 ,$286.15 
SACRED HEART HOSPITAL (ACU),98800013,99221,PC INITIAL HOSPITAL CARE LVL 1 LOW 30MIN,987,1 ,$307.80 ,$230.85 ,$39.52 ,$307.80 ,$198.22 , N/A ,$215.46 ,$39.52 ,$255.47 ,$40.71 ,$203.15 ,$292.41 ,$39.52 ,$246.24 ,$283.18 ,$39.52 ,$261.63 ,$292.41 ,$270.86 ,$233.93 ,$39.52 ,$39.52 ,$39.52 ,$224.69 ,$169.29 ,$280.10 ,$280.10 ,$246.24 , N/A ,$169.29 ,$277.02 , N/A ,$277.02 ,$166.21 ,$289.33 , N/A ,$283.18 ,$41.89 ,$280.10 , N/A ,$189.42 ,$189.42 ,$277.02 ,$229.71 ,$214.38 , N/A ,$39.52 ,$292.41 , N/A ,$39.52 ,$267.79 , N/A ,$277.02 , N/A ,$277.02 ,$277.02 ,$277.02 ,$298.57 ,$249.32 ,$286.25 ,$264.71 ,$298.57 
SACRED HEART HOSPITAL (ACU),98800015,99222,PC INITIAL HOSPITAL CARE LVL 2 MOD 50MIN,987,1 ,$455.80 ,$341.85 ,$39.52 ,$455.80 ,$293.54 , N/A ,$319.06 ,$39.52 ,$378.31 ,$40.71 ,$300.83 ,$433.01 ,$39.52 ,$364.64 ,$419.34 ,$39.52 ,$387.43 ,$433.01 ,$401.10 ,$346.41 ,$39.52 ,$39.52 ,$39.52 ,$332.73 ,$250.69 ,$414.78 ,$414.78 ,$364.64 , N/A ,$250.69 ,$410.22 , N/A ,$410.22 ,$246.13 ,$428.45 , N/A ,$419.34 ,$41.89 ,$414.78 , N/A ,$280.50 ,$280.50 ,$410.22 ,$340.16 ,$317.46 , N/A ,$39.52 ,$433.01 , N/A ,$39.52 ,$396.55 , N/A ,$410.22 , N/A ,$410.22 ,$410.22 ,$410.22 ,$442.13 ,$369.20 ,$423.89 ,$391.99 ,$442.13 
SACRED HEART HOSPITAL (ACU),98800016,99223,PC INITIAL HOSPITAL CARE LVL 3 HIGH 70MIN,987,1 ,$621.80 ,$466.35 ,$39.52 ,$621.80 ,$400.44 , N/A ,$435.26 ,$39.52 ,$516.09 ,$40.71 ,$410.39 ,$590.71 ,$39.52 ,$497.44 ,$572.06 ,$39.52 ,$528.53 ,$590.71 ,$547.18 ,$472.57 ,$39.52 ,$39.52 ,$39.52 ,$453.91 ,$341.99 ,$565.84 ,$565.84 ,$497.44 , N/A ,$341.99 ,$559.62 , N/A ,$559.62 ,$335.77 ,$584.49 , N/A ,$572.06 ,$41.89 ,$565.84 , N/A ,$382.66 ,$382.66 ,$559.62 ,$464.05 ,$433.08 , N/A ,$39.52 ,$590.71 , N/A ,$39.52 ,$540.97 , N/A ,$559.62 , N/A ,$559.62 ,$559.62 ,$559.62 ,$603.15 ,$503.66 ,$578.27 ,$534.75 ,$603.15 
SACRED HEART HOSPITAL (ACU),98800017,99231,PC SUBSQ HOSPITAL CARE LVL 1 LOW 15MIN,987,1 ,$158.00 ,$118.50 ,$39.52 ,$158.00 ,$101.75 , N/A ,$110.60 ,$39.52 ,$131.14 ,$40.71 ,$104.28 ,$150.10 ,$39.52 ,$126.40 ,$145.36 ,$39.52 ,$134.30 ,$150.10 ,$139.04 ,$120.08 ,$39.52 ,$39.52 ,$39.52 ,$115.34 ,$86.90 ,$143.78 ,$143.78 ,$126.40 , N/A ,$86.90 ,$142.20 , N/A ,$142.20 ,$85.32 ,$148.52 , N/A ,$145.36 ,$41.89 ,$143.78 , N/A ,$97.23 ,$97.23 ,$142.20 ,$117.92 ,$110.05 , N/A ,$39.52 ,$150.10 , N/A ,$39.52 ,$137.46 , N/A ,$142.20 , N/A ,$142.20 ,$142.20 ,$142.20 ,$153.26 ,$127.98 ,$146.94 ,$135.88 ,$153.26 
SACRED HEART HOSPITAL (ACU),98800018,99232,PC SUBSQ HOSPITAL CARE LVL 2 MOD 25MIN,987,1 ,$229.40 ,$172.05 ,$39.52 ,$229.40 ,$147.73 , N/A ,$160.58 ,$39.52 ,$190.40 ,$40.71 ,$151.40 ,$217.93 ,$39.52 ,$183.52 ,$211.05 ,$39.52 ,$194.99 ,$217.93 ,$201.87 ,$174.34 ,$39.52 ,$39.52 ,$39.52 ,$167.46 ,$126.17 ,$208.75 ,$208.75 ,$183.52 , N/A ,$126.17 ,$206.46 , N/A ,$206.46 ,$123.88 ,$215.64 , N/A ,$211.05 ,$41.89 ,$208.75 , N/A ,$141.17 ,$141.17 ,$206.46 ,$171.20 ,$159.78 , N/A ,$39.52 ,$217.93 , N/A ,$39.52 ,$199.58 , N/A ,$206.46 , N/A ,$206.46 ,$206.46 ,$206.46 ,$222.52 ,$185.81 ,$213.34 ,$197.28 ,$222.52 
SACRED HEART HOSPITAL (ACU),98800019,99233,PC SUBSQ HOSPITAL CARE LVL 3 HIGH 35MIN,987,1 ,$335.10 ,$251.33 ,$39.52 ,$335.10 ,$215.80 , N/A ,$234.57 ,$39.52 ,$278.13 ,$40.71 ,$221.17 ,$318.35 ,$39.52 ,$268.08 ,$308.29 ,$39.52 ,$284.84 ,$318.35 ,$294.89 ,$254.68 ,$39.52 ,$39.52 ,$39.52 ,$244.62 ,$184.31 ,$304.94 ,$304.94 ,$268.08 , N/A ,$184.31 ,$301.59 , N/A ,$301.59 ,$180.95 ,$314.99 , N/A ,$308.29 ,$41.89 ,$304.94 , N/A ,$206.22 ,$206.22 ,$301.59 ,$250.09 ,$233.40 , N/A ,$39.52 ,$318.35 , N/A ,$39.52 ,$291.54 , N/A ,$301.59 , N/A ,$301.59 ,$301.59 ,$301.59 ,$325.05 ,$271.43 ,$311.64 ,$288.19 ,$325.05 
SACRED HEART HOSPITAL (ACU),98800022,99356,PC PROLONG VISIT IP FIRST HR,988,1 ,$100.00 ,$75.00 ,$54.00 ,$100.00 ,$64.40 , N/A ,$70.00 , N/A ,$83.00 , N/A ,$66.00 ,$95.00 , N/A ,$80.00 ,$92.00 , N/A ,$85.00 ,$95.00 ,$88.00 ,$76.00 , N/A , N/A , N/A ,$73.00 ,$55.00 ,$91.00 ,$91.00 ,$80.00 , N/A ,$55.00 ,$90.00 , N/A ,$90.00 ,$54.00 ,$94.00 , N/A ,$92.00 , N/A ,$91.00 , N/A ,$61.54 ,$61.54 ,$90.00 ,$74.63 ,$69.65 , N/A , N/A ,$95.00 , N/A , N/A ,$87.00 , N/A ,$90.00 , N/A ,$90.00 ,$90.00 ,$90.00 ,$97.00 ,$81.00 ,$93.00 ,$86.00 ,$97.00 
SACRED HEART HOSPITAL (ACU),98800023,99357,PC PROLONG VST IP EA ADD 30MI,988,1 ,$50.00 ,$37.50 ,$27.00 ,$50.00 ,$32.20 , N/A ,$35.00 , N/A ,$41.50 , N/A ,$33.00 ,$47.50 , N/A ,$40.00 ,$46.00 , N/A ,$42.50 ,$47.50 ,$44.00 ,$38.00 , N/A , N/A , N/A ,$36.50 ,$27.50 ,$45.50 ,$45.50 ,$40.00 , N/A ,$27.50 ,$45.00 , N/A ,$45.00 ,$27.00 ,$47.00 , N/A ,$46.00 , N/A ,$45.50 , N/A ,$30.77 ,$30.77 ,$45.00 ,$37.32 ,$34.83 , N/A , N/A ,$47.50 , N/A , N/A ,$43.50 , N/A ,$45.00 , N/A ,$45.00 ,$45.00 ,$45.00 ,$48.50 ,$40.50 ,$46.50 ,$43.00 ,$48.50 
SACRED HEART HOSPITAL (ACU),98880000,99251,PC INPATIENT CONSULTATION 1 LIMITED 20MIN,988,1 ,$213.82 ,$160.37 ,$39.52 ,$213.82 ,$137.70 , N/A ,$149.67 ,$39.52 ,$177.47 ,$40.71 ,$141.12 ,$203.13 ,$39.52 ,$171.06 ,$196.71 ,$39.52 ,$181.75 ,$203.13 ,$188.16 ,$162.50 ,$39.52 ,$39.52 ,$39.52 ,$156.09 ,$117.60 ,$194.58 ,$194.58 ,$171.06 , N/A ,$117.60 ,$192.44 , N/A ,$192.44 ,$115.46 ,$200.99 , N/A ,$196.71 ,$41.89 ,$194.58 , N/A ,$131.58 ,$131.58 ,$192.44 ,$159.57 ,$148.93 , N/A ,$39.52 ,$203.13 , N/A ,$39.52 ,$186.02 , N/A ,$192.44 , N/A ,$192.44 ,$192.44 ,$192.44 ,$207.41 ,$173.19 ,$198.85 ,$183.89 ,$207.41 
SACRED HEART HOSPITAL (ACU),98880001,99252,PC INPATIENT CONSULTATION 2 LOW 40MIN,988,1 ,$309.50 ,$232.13 ,$39.52 ,$309.50 ,$199.32 , N/A ,$216.65 ,$39.52 ,$256.89 ,$40.71 ,$204.27 ,$294.03 ,$39.52 ,$247.60 ,$284.74 ,$39.52 ,$263.08 ,$294.03 ,$272.36 ,$235.22 ,$39.52 ,$39.52 ,$39.52 ,$225.94 ,$170.23 ,$281.65 ,$281.65 ,$247.60 , N/A ,$170.23 ,$278.55 , N/A ,$278.55 ,$167.13 ,$290.93 , N/A ,$284.74 ,$41.89 ,$281.65 , N/A ,$190.47 ,$190.47 ,$278.55 ,$230.98 ,$215.57 , N/A ,$39.52 ,$294.03 , N/A ,$39.52 ,$269.27 , N/A ,$278.55 , N/A ,$278.55 ,$278.55 ,$278.55 ,$300.22 ,$250.70 ,$287.84 ,$266.17 ,$300.22 
SACRED HEART HOSPITAL (ACU),98880002,99253,PC INPATIENT CONSULTATION 3 MOD 55MIN,988,1 ,$342.50 ,$256.88 ,$39.52 ,$342.50 ,$220.57 , N/A ,$239.75 ,$39.52 ,$284.28 ,$40.71 ,$226.05 ,$325.38 ,$39.52 ,$274.00 ,$315.10 ,$39.52 ,$291.13 ,$325.38 ,$301.40 ,$260.30 ,$39.52 ,$39.52 ,$39.52 ,$250.03 ,$188.38 ,$311.68 ,$311.68 ,$274.00 , N/A ,$188.38 ,$308.25 , N/A ,$308.25 ,$184.95 ,$321.95 , N/A ,$315.10 ,$41.89 ,$311.68 , N/A ,$210.77 ,$210.77 ,$308.25 ,$255.61 ,$238.55 , N/A ,$39.52 ,$325.38 , N/A ,$39.52 ,$297.98 , N/A ,$308.25 , N/A ,$308.25 ,$308.25 ,$308.25 ,$332.23 ,$277.43 ,$318.53 ,$294.55 ,$332.23 
SACRED HEART HOSPITAL (ACU),98880003,99254,PC INPATIENT CONSULTATION 4 MOD-HIGH 80MIN,988,1 ,$734.60 ,$550.95 ,$39.52 ,$734.60 ,$473.08 , N/A ,$514.22 ,$39.52 ,$609.72 ,$40.71 ,$484.84 ,$697.87 ,$39.52 ,$587.68 ,$675.83 ,$39.52 ,$624.41 ,$697.87 ,$646.45 ,$558.30 ,$39.52 ,$39.52 ,$39.52 ,$536.26 ,$404.03 ,$668.49 ,$668.49 ,$587.68 , N/A ,$404.03 ,$661.14 , N/A ,$661.14 ,$396.68 ,$690.52 , N/A ,$675.83 ,$41.89 ,$668.49 , N/A ,$452.07 ,$452.07 ,$661.14 ,$548.23 ,$511.65 , N/A ,$39.52 ,$697.87 , N/A ,$39.52 ,$639.10 , N/A ,$661.14 , N/A ,$661.14 ,$661.14 ,$661.14 ,$712.56 ,$595.03 ,$683.18 ,$631.76 ,$712.56 
SACRED HEART HOSPITAL (ACU),98880004,99255,PC INPATIENT CONSULTATION 5 HIGH 110MIN,988,1 ,$677.30 ,$507.98 ,$39.52 ,$677.30 ,$436.18 , N/A ,$474.11 ,$39.52 ,$562.16 ,$40.71 ,$447.02 ,$643.44 ,$39.52 ,$541.84 ,$623.12 ,$39.52 ,$575.71 ,$643.44 ,$596.02 ,$514.75 ,$39.52 ,$39.52 ,$39.52 ,$494.43 ,$372.52 ,$616.34 ,$616.34 ,$541.84 , N/A ,$372.52 ,$609.57 , N/A ,$609.57 ,$365.74 ,$636.66 , N/A ,$623.12 ,$41.89 ,$616.34 , N/A ,$416.81 ,$416.81 ,$609.57 ,$505.47 ,$471.74 , N/A ,$39.52 ,$643.44 , N/A ,$39.52 ,$589.25 , N/A ,$609.57 , N/A ,$609.57 ,$609.57 ,$609.57 ,$656.98 ,$548.61 ,$629.89 ,$582.48 ,$656.98 
SACRED HEART HOSPITAL (ACU),99900151,N/A,HC BARIATRIC PACKAGE PRE-SURGICAL CARE,999,1 ,$414.00 ,$310.50 ,$223.56 ,$414.00 ,$266.62 , N/A ,$289.80 , N/A ,$343.62 , N/A ,$273.24 ,$393.30 , N/A ,$331.20 ,$380.88 , N/A ,$351.90 ,$393.30 ,$364.32 ,$314.64 , N/A , N/A , N/A ,$302.22 ,$227.70 ,$376.74 ,$376.74 ,$331.20 , N/A ,$227.70 ,$372.60 , N/A ,$372.60 ,$223.56 ,$389.16 , N/A ,$380.88 , N/A ,$376.74 , N/A ,$254.78 ,$254.78 ,$372.60 ,$308.97 ,$288.35 , N/A , N/A ,$393.30 , N/A , N/A ,$360.18 , N/A ,$372.60 , N/A ,$372.60 ,$372.60 ,$372.60 ,$401.58 ,$335.34 ,$385.02 ,$356.04 ,$401.58 
SACRED HEART HOSPITAL (ACU),99900152,N/A,HC BARIATRIC PACKAGE POST-SURGICAL CARE,999,1 ,$198.00 ,$148.50 ,$106.92 ,$198.00 ,$127.51 , N/A ,$138.60 , N/A ,$164.34 , N/A ,$130.68 ,$188.10 , N/A ,$158.40 ,$182.16 , N/A ,$168.30 ,$188.10 ,$174.24 ,$150.48 , N/A , N/A , N/A ,$144.54 ,$108.90 ,$180.18 ,$180.18 ,$158.40 , N/A ,$108.90 ,$178.20 , N/A ,$178.20 ,$106.92 ,$186.12 , N/A ,$182.16 , N/A ,$180.18 , N/A ,$121.85 ,$121.85 ,$178.20 ,$147.77 ,$137.91 , N/A , N/A ,$188.10 , N/A , N/A ,$172.26 , N/A ,$178.20 , N/A ,$178.20 ,$178.20 ,$178.20 ,$192.06 ,$160.38 ,$184.14 ,$170.28 ,$192.06