Hospital Name: Carson Valley Medical Center
For Machine Readable File, click on the View Standard Charges link to https://www.carsonvalleyhealth.org/patients-visitors/price-transparency/																									
TAX ID: 88-0405927																									
Price Effective Date: 04/01/2023																									
																									
Charge Code/EAP	Procedure Name	Rev Code	Rev Code Description	CPT Code	 Gross Charge 	 Cash Price/Self Pay 	 Minimum 	 Maximum 	 Aetna HMO/PPO 	 Aetna Medicare 	 Ambetter/Silversummit 	 Anthem BCBS/FEP 	 Anthem Pathway 	 Atrio St. Mary's Medicare HMO 	 Cigna Medical 	 First Health 	 Hometown Health Fully Insured/Self Insured/PPO 	 Hometown Health-Leased Network Access 	 Medicare 	 Multiplan 	 Public Employee Benefits Program (PEBP) 	 Prominence HMO/PPO 	 Prominence Medicare 	 UHC HMO/PPO 	 UHC Medicare 
772001	HCHG CVMC ROOM/CARE - PRIVATE (0110)	0110	ROOM & BOARD - PRIVATE (MEDICAL OR GENERAL) - GENERAL CLASSIFICATION		" $3,130.00 "	" $2,191.00 "	 $970.30 	" $3,130.00 "	" $2,723.10 "	" $3,109.00 "	" $2,394.45 "	" $3,130.00 "	" $3,130.00 "	" $3,109.00 "	" $2,817.00 "	" $2,660.50 "	" $3,130.00 "	" $3,130.00 "	" $3,109.00 "	" $2,817.00 "	" $2,544.69 "	" $3,130.00 "	 $970.30 	" $2,544.69 "	" $3,109.00 "
772002	HCHG CVMC ROOM/CARE - SEMI PRIVATE (0120)	0120	ROOM & BOARD - SEMI-PRIVATE TWO BED (MEDICAL OR GENERAL) - GENERAL CLASSIFICATION		" $2,980.00 "	" $2,086.00 "	 $923.80 	" $2,980.00 "	" $2,592.60 "	" $2,980.00 "	" $2,279.70 "	" $2,980.00 "	" $2,980.00 "	" $2,980.00 "	" $2,682.00 "	" $2,533.00 "	" $2,980.00 "	" $2,980.00 "	" $2,980.00 "	" $2,682.00 "	" $2,422.74 "	" $2,980.00 "	 $923.80 	" $2,422.74 "	" $2,980.00 "
772003	HCHG CVMC ROOM/CARE - SEMI PRIVATE TELEMETRY (0120)	0120	ROOM & BOARD - SEMI-PRIVATE TWO BED (MEDICAL OR GENERAL) - GENERAL CLASSIFICATION	772003	" $3,700.00 "	" $2,590.00 "	" $1,147.00 "	" $3,700.00 "	" $3,219.00 "	" $3,109.00 "	" $2,830.50 "	" $3,700.00 "	" $3,500.00 "	" $3,109.00 "	" $3,330.00 "	" $3,145.00 "	" $3,700.00 "	" $3,700.00 "	" $3,109.00 "	" $3,330.00 "	" $3,008.10 "	" $3,700.00 "	" $1,147.00 "	" $3,008.10 "	" $3,109.00 "
772004	HCHG CVMC ROOM/CARE - SWING BED (0120)	0120	ROOM & BOARD - SEMI-PRIVATE TWO BED (MEDICAL OR GENERAL) - GENERAL CLASSIFICATION		" $2,280.00 "	" $1,596.00 "	 $706.80 	" $2,280.00 "	" $1,983.60 "	" $2,187.00 "	" $1,744.20 "	" $2,280.00 "	" $2,280.00 "	" $2,187.00 "	" $2,052.00 "	" $1,938.00 "	" $2,280.00 "	" $2,280.00 "	" $2,187.00 "	" $2,052.00 "	" $1,853.64 "	" $2,280.00 "	 $706.80 	" $1,853.64 "	" $2,187.00 "
770022	HCHG ROOM/CARE - ICU (200)	0200	INTENSIVE CARE - GENERAL CLASSIFICATION		" $4,340.00 "	" $3,038.00 "	" $1,345.40 "	" $4,340.00 "	" $3,775.80 "	" $3,109.00 "	" $3,320.10 "	" $4,340.00 "	" $3,500.00 "	" $3,109.00 "	" $3,906.00 "	" $3,689.00 "	" $4,340.00 "	" $4,340.00 "	" $3,109.00 "	" $3,906.00 "	" $3,528.42 "	 $-   	" $1,345.40 "	" $3,528.42 "	" $3,109.00 "
308248	HCHG CVMC LIDOCAINE HCL 4% 50ML	0250	PHARMACY - GENERAL CLASSIFICATION	J2001	 $74.73 	 $52.31 	 $17.79 	 $67.26 	 $65.02 	 $17.94 	 $57.17 	 $62.77 	 $62.77 	 $18.47 	 $67.26 	 $63.52 	 $49.32 	 $60.53 	 $17.94 	 $67.26 	 $60.76 	 $63.52 	 $17.79 	 $60.76 	 $17.94 
310113	HCHG CVMC PULMICORT RESPULES 0.5MG/2ML	0250	PHARMACY - GENERAL CLASSIFICATION		 $61.81 	 $43.27 	 $14.71 	 $55.63 	 $53.77 	 $14.83 	 $47.28 	 $51.92 	 $51.92 	 $15.28 	 $55.63 	 $52.54 	 $40.79 	 $50.07 	 $14.83 	 $55.63 	 $50.25 	 $52.54 	 $14.71 	 $50.25 	 $14.83 
310114	HCHG CVMC COMBIVENT MDI (PER PUFF)	0250	PHARMACY - GENERAL CLASSIFICATION		 $2.89 	 $2.02 	 $0.69 	 $2.60 	 $2.51 	 $0.69 	 $2.21 	 $2.43 	 $2.43 	 $0.71 	 $2.60 	 $2.46 	 $1.91 	 $2.34 	 $0.69 	 $2.60 	 $2.35 	 $2.46 	 $0.69 	 $2.35 	 $0.69 
310115	HCHG CVMC ATROVENT MDI (PER PUFF)	0250	PHARMACY - GENERAL CLASSIFICATION		 $2.89 	 $2.02 	 $0.69 	 $2.60 	 $2.51 	 $0.69 	 $2.21 	 $2.43 	 $2.43 	 $0.71 	 $2.60 	 $2.46 	 $1.91 	 $2.34 	 $0.69 	 $2.60 	 $2.35 	 $2.46 	 $0.69 	 $2.35 	 $0.69 
310116	HCHG CVMC ALBUTEROL MDI (PER PUFF)	0250	PHARMACY - GENERAL CLASSIFICATION		 $2.48 	 $1.74 	 $0.59 	 $2.23 	 $2.16 	 $0.60 	 $1.90 	 $2.08 	 $2.08 	 $0.61 	 $2.23 	 $2.11 	 $1.64 	 $2.01 	 $0.60 	 $2.23 	 $2.02 	 $2.11 	 $0.59 	 $2.02 	 $0.60 
310117	HCHG CVMC XOPENES LEVALBUTEROL 0.63/0.31MG	0250	PHARMACY - GENERAL CLASSIFICATION		 $47.02 	 $32.91 	 $11.19 	 $42.32 	 $40.91 	 $11.28 	 $35.97 	 $39.50 	 $39.50 	 $11.62 	 $42.32 	 $39.97 	 $31.03 	 $38.09 	 $11.28 	 $42.32 	 $38.23 	 $39.97 	 $11.19 	 $38.23 	 $11.28 
310118	HCHG CVMC MUCOMYST/MUCOSIL/ACETYCYSTEINE 10%	0250	PHARMACY - GENERAL CLASSIFICATION		 $51.59 	 $36.11 	 $12.28 	 $46.43 	 $44.88 	 $12.38 	 $39.47 	 $43.34 	 $43.34 	 $12.75 	 $46.43 	 $43.85 	 $34.05 	 $41.79 	 $12.38 	 $46.43 	 $41.94 	 $43.85 	 $12.28 	 $41.94 	 $12.38 
310120	HCHG CVMC FLOVENT 110MCG MDI (PER PUFF)	0250	PHARMACY - GENERAL CLASSIFICATION		 $13.41 	 $9.39 	 $3.19 	 $12.07 	 $11.67 	 $3.22 	 $10.26 	 $11.26 	 $11.26 	 $3.31 	 $12.07 	 $11.40 	 $8.85 	 $10.86 	 $3.22 	 $12.07 	 $10.90 	 $11.40 	 $3.19 	 $10.90 	 $3.22 
310121	HCHG CVMC RACEPINEPHRINE INHAL SOL 2.25/5ML	0250	PHARMACY - GENERAL CLASSIFICATION		 $39.27 	 $27.49 	 $9.35 	 $35.34 	 $34.16 	 $9.42 	 $30.04 	 $32.99 	 $32.99 	 $9.71 	 $35.34 	 $33.38 	 $25.92 	 $31.81 	 $9.42 	 $35.34 	 $31.93 	 $33.38 	 $9.35 	 $31.93 	 $9.42 
310122	HCHG IPRATROPIUM BROMIDE INHAL SOL 0.5MG	0250	PHARMACY - GENERAL CLASSIFICATION		 $32.27 	 $22.59 	 $7.68 	 $29.04 	 $28.07 	 $7.74 	 $24.69 	 $27.11 	 $27.11 	 $7.98 	 $29.04 	 $27.43 	 $21.30 	 $26.14 	 $7.74 	 $29.04 	 $26.24 	 $27.43 	 $7.68 	 $26.24 	 $7.74 
310123	HCHG ALBUTEROL SULFATE INHAL SOL 2.5MG	0250	PHARMACY - GENERAL CLASSIFICATION		 $33.90 	 $23.73 	 $8.07 	 $30.51 	 $29.49 	 $8.14 	 $25.93 	 $28.48 	 $28.48 	 $8.38 	 $30.51 	 $28.82 	 $22.37 	 $27.46 	 $8.14 	 $30.51 	 $27.56 	 $28.82 	 $8.07 	 $27.56 	 $8.14 
310124	HCHG 3% HYPERTONIC SALINE 15ML	0250	PHARMACY - GENERAL CLASSIFICATION		 $36.05 	 $25.24 	 $8.58 	 $32.45 	 $31.36 	 $8.65 	 $27.58 	 $30.28 	 $30.28 	 $8.91 	 $32.45 	 $30.64 	 $23.79 	 $29.20 	 $8.65 	 $32.45 	 $29.31 	 $30.64 	 $8.58 	 $29.31 	 $8.65 
350610	HCHG BMH/CVMC RHOGRAM	0250	PHARMACY - GENERAL CLASSIFICATION	90384	 $420.30 	 $294.21 	 $100.03 	 $378.27 	 $365.66 	 $100.87 	 $321.53 	 $353.05 	 $353.05 	 $103.90 	 $378.27 	 $357.26 	 $277.40 	 $340.44 	 $100.87 	 $378.27 	 $341.70 	 $357.26 	 $100.03 	 $341.70 	 $100.87 
351006	HCHG BMH/CVMC RHO(D)IMMUNE GLOBULIN(RHIG)HUMAN MINI-DOSE	0250	PHARMACY - GENERAL CLASSIFICATION	90385	 $48.21 	 $33.75 	 $11.47 	 $43.39 	 $41.94 	 $11.57 	 $36.88 	 $40.50 	 $40.50 	 $11.92 	 $43.39 	 $40.98 	 $31.82 	 $39.05 	 $11.57 	 $43.39 	 $39.19 	 $40.98 	 $11.47 	 $39.19 	 $11.57 
5271905	"HCHG CVMC LEXISCAN, PER 1MG"	0250	PHARMACY - GENERAL CLASSIFICATION	J2785	 $365.66 	 $255.96 	 $87.03 	 $329.09 	 $318.12 	 $87.76 	 $279.73 	 $307.15 	 $307.15 	 $90.39 	 $329.09 	 $310.81 	 $241.34 	 $296.18 	 $87.76 	 $329.09 	 $297.28 	 $310.81 	 $87.03 	 $297.28 	 $87.76 
4401004	HCHG CVMC CONTRAST/LOW OSMOLAR 300-399MG-OMNIPAQUE	0255	PHARMACY - DRUGS INCIDENT TO RADIOLOGY	Q9967	 $2.56 	 $1.79 	 $0.61 	 $2.30 	 $2.23 	 $0.61 	 $1.96 	 $2.15 	 $2.15 	 $0.63 	 $2.30 	 $2.18 	 $1.77 	 $2.05 	 $0.61 	 $2.30 	 $2.08 	 $2.18 	 $0.61 	 $2.08 	 $0.61 
4401017	HCHG VISIPAQUE 300-399 MG/ML PER ML	0255	PHARMACY - DRUGS INCIDENT TO RADIOLOGY	Q9967	 $8.82 	 $6.17 	 $2.10 	 $7.94 	 $7.67 	 $2.12 	 $6.75 	 $7.41 	 $7.41 	 $2.18 	 $7.94 	 $7.50 	 $6.09 	 $7.06 	 $2.12 	 $7.94 	 $7.17 	 $7.50 	 $2.10 	 $7.17 	 $2.12 
4410179	HCHG INJECTION GAD CONTRAST PER ML	0255	PHARMACY - DRUGS INCIDENT TO RADIOLOGY	A9579	 $18.03 	 $12.62 	 $4.29 	 $16.23 	 $15.69 	 $4.33 	 $13.79 	 $15.15 	 $15.15 	 $4.46 	 $16.23 	 $15.33 	 $12.44 	 $14.42 	 $4.33 	 $16.23 	 $14.66 	 $15.33 	 $4.29 	 $14.66 	 $4.33 
4410518	HCHG BMH/CVMC IONIC CONTRAST 200	0255	PHARMACY - DRUGS INCIDENT TO RADIOLOGY	Q9966	 $30.68 	 $21.48 	 $7.30 	 $27.61 	 $26.69 	 $7.36 	 $23.47 	 $25.77 	 $25.77 	 $7.58 	 $27.61 	 $26.08 	 $21.17 	 $24.54 	 $7.36 	 $27.61 	 $24.94 	 $26.08 	 $7.30 	 $24.94 	 $7.36 
5270001	"HCHG CVMC CONTRAST, IS0VUE-ALL"	0255	PHARMACY - DRUGS INCIDENT TO RADIOLOGY	Q9966	 $243.06 	 $170.14 	 $57.85 	 $218.75 	 $211.46 	 $58.33 	 $185.94 	 $204.17 	 $204.17 	 $60.08 	 $218.75 	 $206.60 	 $167.71 	 $194.45 	 $58.33 	 $218.75 	 $197.61 	 $206.60 	 $57.85 	 $197.61 	 $58.33 
307886	HCHG CVMC IV .9% NACL 250 ML	0258	PHARMACY - IV SOLUTIONS	J7050	 $121.77 	 $85.24 	 $28.98 	 $109.59 	 $105.94 	 $29.22 	 $93.15 	 $102.29 	 $102.29 	 $30.10 	 $109.59 	 $103.50 	 $84.02 	 $97.42 	 $29.22 	 $109.59 	 $99.00 	 $103.50 	 $28.98 	 $99.00 	 $29.22 
309610	HCHG BMH/CVMC IV .9% NACL 500ML	0258	PHARMACY - IV SOLUTIONS	J7040	 $62.29 	 $43.60 	 $14.83 	 $56.06 	 $54.19 	 $14.95 	 $47.65 	 $52.32 	 $52.32 	 $15.40 	 $56.06 	 $52.95 	 $42.98 	 $49.83 	 $14.95 	 $56.06 	 $50.64 	 $52.95 	 $14.83 	 $50.64 	 $14.95 
309623	HCHG BMH/CVMC IV 10% DEXTROSE 500ML	0258	PHARMACY - IV SOLUTIONS		 $37.50 	 $26.25 	 $8.93 	 $33.75 	 $32.63 	 $9.00 	 $28.69 	 $31.50 	 $31.50 	 $9.27 	 $33.75 	 $31.88 	 $25.88 	 $30.00 	 $9.00 	 $33.75 	 $30.49 	 $31.88 	 $8.93 	 $30.49 	 $9.00 
309625	HCHG CVMC IV .9% NACL 25ML	0258	PHARMACY - IV SOLUTIONS		 $71.41 	 $49.99 	 $17.00 	 $64.27 	 $62.13 	 $17.14 	 $54.63 	 $59.98 	 $59.98 	 $17.65 	 $64.27 	 $60.70 	 $49.27 	 $57.13 	 $17.14 	 $64.27 	 $58.06 	 $60.70 	 $17.00 	 $58.06 	 $17.14 
309626	HCHG CVMC IV .9% NACL 50ML	0258	PHARMACY - IV SOLUTIONS		 $70.72 	 $49.50 	 $16.83 	 $63.65 	 $61.53 	 $16.97 	 $54.10 	 $59.40 	 $59.40 	 $17.48 	 $63.65 	 $60.11 	 $48.80 	 $56.58 	 $16.97 	 $63.65 	 $57.50 	 $60.11 	 $16.83 	 $57.50 	 $16.97 
309627	HCHG BMH/CVMC IV .9% NACL 100ML	0258	PHARMACY - IV SOLUTIONS		 $66.40 	 $46.48 	 $15.80 	 $59.76 	 $57.77 	 $15.94 	 $50.80 	 $55.78 	 $55.78 	 $16.41 	 $59.76 	 $56.44 	 $45.82 	 $53.12 	 $15.94 	 $59.76 	 $53.98 	 $56.44 	 $15.80 	 $53.98 	 $15.94 
309661	HCHG CVMC IV 5% DEXTROSE 500ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $36.15 	 $25.31 	 $8.60 	 $32.54 	 $31.45 	 $8.68 	 $27.65 	 $30.37 	 $30.37 	 $8.94 	 $32.54 	 $30.73 	 $24.94 	 $28.92 	 $8.68 	 $32.54 	 $29.39 	 $30.73 	 $8.60 	 $29.39 	 $8.68 
309662	HCHG CVMC IV 5% DEXTROS .25% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $39.33 	 $27.53 	 $9.36 	 $35.40 	 $34.22 	 $9.44 	 $30.09 	 $33.04 	 $33.04 	 $9.72 	 $35.40 	 $33.43 	 $27.14 	 $31.46 	 $9.44 	 $35.40 	 $31.98 	 $33.43 	 $9.36 	 $31.98 	 $9.44 
309663	HCHG CVMC IV 5%DEX 20%NACL 20MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $56.77 	 $39.74 	 $13.51 	 $51.09 	 $49.39 	 $13.62 	 $43.43 	 $47.69 	 $47.69 	 $14.03 	 $51.09 	 $48.25 	 $39.17 	 $45.42 	 $13.62 	 $51.09 	 $46.15 	 $48.25 	 $13.51 	 $46.15 	 $13.62 
309664	HCHG CVMC IV 5% DEX.45%NACL 20MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $73.00 	 $51.10 	 $17.37 	 $65.70 	 $63.51 	 $17.52 	 $55.85 	 $61.32 	 $61.32 	 $18.05 	 $65.70 	 $62.05 	 $50.37 	 $58.40 	 $17.52 	 $65.70 	 $59.35 	 $62.05 	 $17.37 	 $59.35 	 $17.52 
309665	HCHG CVMC IV 5% DEX .9 NACL 20MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $80.36 	 $56.25 	 $19.13 	 $72.32 	 $69.91 	 $19.29 	 $61.48 	 $67.50 	 $67.50 	 $19.86 	 $72.32 	 $68.31 	 $55.45 	 $64.29 	 $19.29 	 $72.32 	 $65.33 	 $68.31 	 $19.13 	 $65.33 	 $19.29 
309666	HCHG CVMC IV LACTATED RINGER 3000ML	0258	PHARMACY - IV SOLUTIONS	J7120	 $117.57 	 $82.30 	 $27.98 	 $105.81 	 $102.29 	 $28.22 	 $89.94 	 $98.76 	 $98.76 	 $29.06 	 $105.81 	 $99.93 	 $81.12 	 $94.06 	 $28.22 	 $105.81 	 $95.58 	 $99.93 	 $27.98 	 $95.58 	 $28.22 
309667	HCHG CVMC IV LACTATED RINGER 500ML	0258	PHARMACY - IV SOLUTIONS	J7120	 $36.45 	 $25.52 	 $8.68 	 $32.81 	 $31.71 	 $8.75 	 $27.88 	 $30.62 	 $30.62 	 $9.01 	 $32.81 	 $30.98 	 $25.15 	 $29.16 	 $8.75 	 $32.81 	 $29.63 	 $30.98 	 $8.68 	 $29.63 	 $8.75 
309668	HCHG CVMC IV .45% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $73.59 	 $51.51 	 $17.51 	 $66.23 	 $64.02 	 $17.66 	 $56.30 	 $61.82 	 $61.82 	 $18.19 	 $66.23 	 $62.55 	 $50.78 	 $58.87 	 $17.66 	 $66.23 	 $59.83 	 $62.55 	 $17.51 	 $59.83 	 $17.66 
309669	HCHG CVMC IV .9% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $39.06 	 $27.34 	 $9.30 	 $35.15 	 $33.98 	 $9.37 	 $29.88 	 $32.81 	 $32.81 	 $9.66 	 $35.15 	 $33.20 	 $26.95 	 $31.25 	 $9.37 	 $35.15 	 $31.76 	 $33.20 	 $9.30 	 $31.76 	 $9.37 
309670	HCHG CVMC IV .9% NACL 20MEQ KCL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $83.45 	 $58.42 	 $19.86 	 $75.11 	 $72.60 	 $20.03 	 $63.84 	 $70.10 	 $70.10 	 $20.63 	 $75.11 	 $70.93 	 $57.58 	 $66.76 	 $20.03 	 $75.11 	 $67.84 	 $70.93 	 $19.86 	 $67.84 	 $20.03 
309671	HCHG CVMC IV .45% NACL 20MEQ KCL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $76.29 	 $53.40 	 $18.16 	 $68.66 	 $66.37 	 $18.31 	 $58.36 	 $64.08 	 $64.08 	 $18.86 	 $68.66 	 $64.85 	 $52.64 	 $61.03 	 $18.31 	 $68.66 	 $62.02 	 $64.85 	 $18.16 	 $62.02 	 $18.31 
309672	HCHG CVMC IV .9%NACL 40MEQ KCL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $62.10 	 $43.47 	 $14.78 	 $55.89 	 $54.03 	 $14.90 	 $47.51 	 $52.16 	 $52.16 	 $15.35 	 $55.89 	 $52.79 	 $42.85 	 $49.68 	 $14.90 	 $55.89 	 $50.49 	 $52.79 	 $14.78 	 $50.49 	 $14.90 
309686	HCHG CVMC IV .9% NACL MINI BAG PLUS 50ML	0258	PHARMACY - IV SOLUTIONS		 $18.01 	 $12.61 	 $4.29 	 $16.21 	 $15.67 	 $4.32 	 $13.78 	 $15.13 	 $15.13 	 $4.45 	 $16.21 	 $15.31 	 $12.43 	 $14.41 	 $4.32 	 $16.21 	 $14.64 	 $15.31 	 $4.29 	 $14.64 	 $4.32 
309687	HCHG CVMC IV 5% DEXTROSE LR 1000ML	0258	PHARMACY - IV SOLUTIONS		 $37.73 	 $26.41 	 $8.98 	 $33.96 	 $32.83 	 $9.06 	 $28.86 	 $31.69 	 $31.69 	 $9.33 	 $33.96 	 $32.07 	 $26.03 	 $30.18 	 $9.06 	 $33.96 	 $30.67 	 $32.07 	 $8.98 	 $30.67 	 $9.06 
309688	HCHG CVMC IV PRE FILLED SYRINGE .9% NACL 10ML	0258	PHARMACY - IV SOLUTIONS		 $2.00 	 $1.40 	 $0.48 	 $1.80 	 $1.74 	 $0.48 	 $1.53 	 $1.68 	 $1.68 	 $0.49 	 $1.80 	 $1.70 	 $1.38 	 $1.60 	 $0.48 	 $1.80 	 $1.63 	 $1.70 	 $0.48 	 $1.63 	 $0.48 
309689	HCHG CVMC IV.9% NACL MINI BAG PLUS 100ML	0258	PHARMACY - IV SOLUTIONS		 $18.01 	 $12.61 	 $4.29 	 $16.21 	 $15.67 	 $4.32 	 $13.78 	 $15.13 	 $15.13 	 $4.45 	 $16.21 	 $15.31 	 $12.43 	 $14.41 	 $4.32 	 $16.21 	 $14.64 	 $15.31 	 $4.29 	 $14.64 	 $4.32 
309691	HCHG CVMC SOL SOD CHL 0.9% 10ML VIAL	0258	PHARMACY - IV SOLUTIONS		 $3.32 	 $2.32 	 $0.79 	 $2.99 	 $2.89 	 $0.80 	 $2.54 	 $2.79 	 $2.79 	 $0.82 	 $2.99 	 $2.82 	 $2.29 	 $2.66 	 $0.80 	 $2.99 	 $2.70 	 $2.82 	 $0.79 	 $2.70 	 $0.80 
310020	HCHG CVMC IV 5%DEX .45%NACL 40MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS		 $11.14 	 $7.80 	 $2.65 	 $10.03 	 $9.69 	 $2.67 	 $8.52 	 $9.36 	 $9.36 	 $2.75 	 $10.03 	 $9.47 	 $7.69 	 $8.91 	 $2.67 	 $10.03 	 $9.06 	 $9.47 	 $2.65 	 $9.06 	 $2.67 
310030	HCHG CVMC 1000 ML LACTATED RINGERS	0258	PHARMACY - IV SOLUTIONS	J7120	 $10.52 	 $7.36 	 $2.50 	 $9.47 	 $9.15 	 $2.52 	 $8.05 	 $8.84 	 $8.84 	 $2.60 	 $9.47 	 $8.94 	 $7.26 	 $8.42 	 $2.52 	 $9.47 	 $8.55 	 $8.94 	 $2.50 	 $8.55 	 $2.52 
310031	HCHG CVMC 1000 ML 5% DEXTROSE	0258	PHARMACY - IV SOLUTIONS	J7070	 $9.10 	 $6.37 	 $2.17 	 $8.19 	 $7.92 	 $2.18 	 $6.96 	 $7.64 	 $7.64 	 $2.25 	 $8.19 	 $7.74 	 $6.28 	 $7.28 	 $2.18 	 $8.19 	 $7.40 	 $7.74 	 $2.17 	 $7.40 	 $2.18 
310032	HCHG CVMC 1000 ML DEXTROSE 5% .45% NACL	0258	PHARMACY - IV SOLUTIONS	J7042	 $9.19 	 $6.43 	 $2.19 	 $8.27 	 $8.00 	 $2.21 	 $7.03 	 $7.72 	 $7.72 	 $2.27 	 $8.27 	 $7.81 	 $6.34 	 $7.35 	 $2.21 	 $8.27 	 $7.47 	 $7.81 	 $2.19 	 $7.47 	 $2.21 
310033	HCHG CVMC 1000 ML DEXTROSE 5%.9% NACL	0258	PHARMACY - IV SOLUTIONS	J7042	 $9.10 	 $6.37 	 $2.17 	 $8.19 	 $7.92 	 $2.18 	 $6.96 	 $7.64 	 $7.64 	 $2.25 	 $8.19 	 $7.74 	 $6.28 	 $7.28 	 $2.18 	 $8.19 	 $7.40 	 $7.74 	 $2.17 	 $7.40 	 $2.18 
310034	HCHG .9% NACL 1000 ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $9.46 	 $6.62 	 $2.25 	 $8.51 	 $8.23 	 $2.27 	 $7.24 	 $7.95 	 $7.95 	 $2.34 	 $8.51 	 $8.04 	 $6.53 	 $7.57 	 $2.27 	 $8.51 	 $7.69 	 $8.04 	 $2.25 	 $7.69 	 $2.27 
310039	HCHG CVMC IV PRE FILLED SYRINGE .9% NACL 10ML	0258	PHARMACY - IV SOLUTIONS		 $2.00 	 $1.40 	 $0.48 	 $1.80 	 $1.74 	 $0.48 	 $1.53 	 $1.68 	 $1.68 	 $0.49 	 $1.80 	 $1.70 	 $1.38 	 $1.60 	 $0.48 	 $1.80 	 $1.63 	 $1.70 	 $0.48 	 $1.63 	 $0.48 
310046	HCHG SOL SOD CHL 0.9% 10ML VIAL	0258	PHARMACY - IV SOLUTIONS		 $3.32 	 $2.32 	 $0.79 	 $2.99 	 $2.89 	 $0.80 	 $2.54 	 $2.79 	 $2.79 	 $0.82 	 $2.99 	 $2.82 	 $2.29 	 $2.66 	 $0.80 	 $2.99 	 $2.70 	 $2.82 	 $0.79 	 $2.70 	 $0.80 
310047	HCHG CVMC IV 5% DEXTROSE 100ML IN 150ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $36.53 	 $25.57 	 $8.69 	 $32.88 	 $31.78 	 $8.77 	 $27.95 	 $30.69 	 $30.69 	 $9.03 	 $32.88 	 $31.05 	 $25.21 	 $29.22 	 $8.77 	 $32.88 	 $29.70 	 $31.05 	 $8.69 	 $29.70 	 $8.77 
310048	HCHG CVMC IV 5% DEXTROSE 250ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $69.88 	 $48.92 	 $16.63 	 $62.89 	 $60.80 	 $16.77 	 $53.46 	 $58.70 	 $58.70 	 $17.27 	 $62.89 	 $59.40 	 $48.22 	 $55.90 	 $16.77 	 $62.89 	 $56.81 	 $59.40 	 $16.63 	 $56.81 	 $16.77 
310049	HCHG CVMC IV 5% DEXTROSE 500ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $36.15 	 $25.31 	 $8.60 	 $32.54 	 $31.45 	 $8.68 	 $27.65 	 $30.37 	 $30.37 	 $8.94 	 $32.54 	 $30.73 	 $24.94 	 $28.92 	 $8.68 	 $32.54 	 $29.39 	 $30.73 	 $8.60 	 $29.39 	 $8.68 
310050	HCHG CVMC IV 5% DEXTROSE 1000ML	0258	PHARMACY - IV SOLUTIONS	J7070	 $37.33 	 $26.13 	 $8.88 	 $33.60 	 $32.48 	 $8.96 	 $28.56 	 $31.36 	 $31.36 	 $9.23 	 $33.60 	 $31.73 	 $25.76 	 $29.86 	 $8.96 	 $33.60 	 $30.35 	 $31.73 	 $8.88 	 $30.35 	 $8.96 
310051	HCHG CVMC IV 5% DEXTROS .25% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $39.33 	 $27.53 	 $9.36 	 $35.40 	 $34.22 	 $9.44 	 $30.09 	 $33.04 	 $33.04 	 $9.72 	 $35.40 	 $33.43 	 $27.14 	 $31.46 	 $9.44 	 $35.40 	 $31.98 	 $33.43 	 $9.36 	 $31.98 	 $9.44 
310052	HCHG CVMC IV 5%DEX 20%NACL 20MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $56.77 	 $39.74 	 $13.51 	 $51.09 	 $49.39 	 $13.62 	 $43.43 	 $47.69 	 $47.69 	 $14.03 	 $51.09 	 $48.25 	 $39.17 	 $45.42 	 $13.62 	 $51.09 	 $46.15 	 $48.25 	 $13.51 	 $46.15 	 $13.62 
310053	HCHG CVMC IV 5% DEXTROSE .45% NACL 500ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $61.07 	 $42.75 	 $14.53 	 $54.96 	 $53.13 	 $14.66 	 $46.72 	 $51.30 	 $51.30 	 $15.10 	 $54.96 	 $51.91 	 $42.14 	 $48.86 	 $14.66 	 $54.96 	 $49.65 	 $51.91 	 $14.53 	 $49.65 	 $14.66 
310054	HCHG CVMC IV 5% DEXTROS .45 NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $54.62 	 $38.23 	 $13.00 	 $49.16 	 $47.52 	 $13.11 	 $41.78 	 $45.88 	 $45.88 	 $13.50 	 $49.16 	 $46.43 	 $37.69 	 $43.70 	 $13.11 	 $49.16 	 $44.41 	 $46.43 	 $13.00 	 $44.41 	 $13.11 
310055	HCHG CVMC IV 5% DEX.45%NACL 20MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $59.83 	 $41.88 	 $14.24 	 $53.85 	 $52.05 	 $14.36 	 $45.77 	 $50.26 	 $50.26 	 $14.79 	 $53.85 	 $50.86 	 $41.28 	 $47.86 	 $14.36 	 $53.85 	 $48.64 	 $50.86 	 $14.24 	 $48.64 	 $14.36 
310056	HCHG CVMC IV 5% DEX .9 NACL 20MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $79.91 	 $55.94 	 $19.02 	 $71.92 	 $69.52 	 $19.18 	 $61.13 	 $67.12 	 $67.12 	 $19.75 	 $71.92 	 $67.92 	 $55.14 	 $63.93 	 $19.18 	 $71.92 	 $64.97 	 $67.92 	 $19.02 	 $64.97 	 $19.18 
310057	HCHG CVMC IV 5% DEXTROSE .9% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $52.97 	 $37.08 	 $12.61 	 $47.67 	 $46.08 	 $12.71 	 $40.52 	 $44.49 	 $44.49 	 $13.09 	 $47.67 	 $45.02 	 $36.55 	 $42.38 	 $12.71 	 $47.67 	 $43.06 	 $45.02 	 $12.61 	 $43.06 	 $12.71 
310058	HCHG CVMC IV 5% DEXTROSE LR 1000ML	0258	PHARMACY - IV SOLUTIONS		 $68.15 	 $47.71 	 $16.22 	 $61.34 	 $59.29 	 $16.36 	 $52.13 	 $57.25 	 $57.25 	 $16.85 	 $61.34 	 $57.93 	 $47.02 	 $54.52 	 $16.36 	 $61.34 	 $55.41 	 $57.93 	 $16.22 	 $55.41 	 $16.36 
310059	HCHG CVMC IV 10% DEXTROSE 500ML	0258	PHARMACY - IV SOLUTIONS		 $73.20 	 $51.24 	 $17.42 	 $65.88 	 $63.68 	 $17.57 	 $56.00 	 $61.49 	 $61.49 	 $18.10 	 $65.88 	 $62.22 	 $50.51 	 $58.56 	 $17.57 	 $65.88 	 $59.51 	 $62.22 	 $17.42 	 $59.51 	 $17.57 
310063	HCHG CVMC IV LACTATED RINGER 3000ML	0258	PHARMACY - IV SOLUTIONS	J7120	 $117.57 	 $82.30 	 $27.98 	 $105.81 	 $102.29 	 $28.22 	 $89.94 	 $98.76 	 $98.76 	 $29.06 	 $105.81 	 $99.93 	 $81.12 	 $94.06 	 $28.22 	 $105.81 	 $95.58 	 $99.93 	 $27.98 	 $95.58 	 $28.22 
310064	HCHG CVMC IV LACTATED RINGER 500ML	0258	PHARMACY - IV SOLUTIONS	J7120	 $36.45 	 $25.52 	 $8.68 	 $32.81 	 $31.71 	 $8.75 	 $27.88 	 $30.62 	 $30.62 	 $9.01 	 $32.81 	 $30.98 	 $25.15 	 $29.16 	 $8.75 	 $32.81 	 $29.63 	 $30.98 	 $8.68 	 $29.63 	 $8.75 
310065	HCHG CVMC IV LACTATED RINGER 1000ML	0258	PHARMACY - IV SOLUTIONS	J7120	 $70.56 	 $49.39 	 $16.79 	 $63.50 	 $61.39 	 $16.93 	 $53.98 	 $59.27 	 $59.27 	 $17.44 	 $63.50 	 $59.98 	 $48.69 	 $56.45 	 $16.93 	 $63.50 	 $57.37 	 $59.98 	 $16.79 	 $57.37 	 $16.93 
310069	HCHG CVMC IV .45% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $66.69 	 $46.68 	 $15.87 	 $60.02 	 $58.02 	 $16.01 	 $51.02 	 $56.02 	 $56.02 	 $16.49 	 $60.02 	 $56.69 	 $46.02 	 $53.35 	 $16.01 	 $60.02 	 $54.22 	 $56.69 	 $15.87 	 $54.22 	 $16.01 
310070	HCHG CVMC IV .9% NACL 25ML	0258	PHARMACY - IV SOLUTIONS		 $71.41 	 $49.99 	 $17.00 	 $64.27 	 $62.13 	 $17.14 	 $54.63 	 $59.98 	 $59.98 	 $17.65 	 $64.27 	 $60.70 	 $49.27 	 $57.13 	 $17.14 	 $64.27 	 $58.06 	 $60.70 	 $17.00 	 $58.06 	 $17.14 
310071	HCHG CVMC IV .9% NACL 50ML	0258	PHARMACY - IV SOLUTIONS		 $47.28 	 $33.10 	 $11.25 	 $42.55 	 $41.13 	 $11.35 	 $36.17 	 $39.72 	 $39.72 	 $11.69 	 $42.55 	 $40.19 	 $32.62 	 $37.82 	 $11.35 	 $42.55 	 $38.44 	 $40.19 	 $11.25 	 $38.44 	 $11.35 
310072	HCHG CVMC IV .9% NACL 100ML	0258	PHARMACY - IV SOLUTIONS		 $63.50 	 $44.45 	 $15.11 	 $57.15 	 $55.25 	 $15.24 	 $48.58 	 $53.34 	 $53.34 	 $15.70 	 $57.15 	 $53.98 	 $43.82 	 $50.80 	 $15.24 	 $57.15 	 $51.63 	 $53.98 	 $15.11 	 $51.63 	 $15.24 
310073	HCHG CVMC IV .9% NACL 250 ML	0258	PHARMACY - IV SOLUTIONS	J7050	 $62.31 	 $43.62 	 $14.83 	 $56.08 	 $54.21 	 $14.95 	 $47.67 	 $52.34 	 $52.34 	 $15.40 	 $56.08 	 $52.96 	 $42.99 	 $49.85 	 $14.95 	 $56.08 	 $50.66 	 $52.96 	 $14.83 	 $50.66 	 $14.95 
310074	HCHG CVMC IV .9% NACL 500ML	0258	PHARMACY - IV SOLUTIONS	J7040	 $61.06 	 $42.74 	 $14.53 	 $54.95 	 $53.12 	 $14.65 	 $46.71 	 $51.29 	 $51.29 	 $15.09 	 $54.95 	 $51.90 	 $42.13 	 $48.85 	 $14.65 	 $54.95 	 $49.64 	 $51.90 	 $14.53 	 $49.64 	 $14.65 
310075	HCHG CVMC IV .9% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $63.73 	 $44.61 	 $15.17 	 $57.36 	 $55.45 	 $15.30 	 $48.75 	 $53.53 	 $53.53 	 $15.75 	 $57.36 	 $54.17 	 $43.97 	 $50.98 	 $15.30 	 $57.36 	 $51.81 	 $54.17 	 $15.17 	 $51.81 	 $15.30 
310076	HCHG CVMC IV .9% NACL 20MEQ KCL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $77.13 	 $53.99 	 $18.36 	 $69.42 	 $67.10 	 $18.51 	 $59.00 	 $64.79 	 $64.79 	 $19.07 	 $69.42 	 $65.56 	 $53.22 	 $61.70 	 $18.51 	 $69.42 	 $62.71 	 $65.56 	 $18.36 	 $62.71 	 $18.51 
310077	HCHG CVMC IV .45% NACL 20MEQ KCL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $76.29 	 $53.40 	 $18.16 	 $68.66 	 $66.37 	 $18.31 	 $58.36 	 $64.08 	 $64.08 	 $18.86 	 $68.66 	 $64.85 	 $52.64 	 $61.03 	 $18.31 	 $68.66 	 $62.02 	 $64.85 	 $18.16 	 $62.02 	 $18.31 
310078	HCHG CVMC IV .9%NACL 40MEQ KCL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7030	 $76.91 	 $53.84 	 $18.30 	 $69.22 	 $66.91 	 $18.46 	 $58.84 	 $64.60 	 $64.60 	 $19.01 	 $69.22 	 $65.37 	 $53.07 	 $61.53 	 $18.46 	 $69.22 	 $62.53 	 $65.37 	 $18.30 	 $62.53 	 $18.46 
310083	HCHG CVMC IV .9% NACL MINI BAG PLUS 50ML	0258	PHARMACY - IV SOLUTIONS		 $18.01 	 $12.61 	 $4.29 	 $16.21 	 $15.67 	 $4.32 	 $13.78 	 $15.13 	 $15.13 	 $4.45 	 $16.21 	 $15.31 	 $12.43 	 $14.41 	 $4.32 	 $16.21 	 $14.64 	 $15.31 	 $4.29 	 $14.64 	 $4.32 
310084	HCHG CVMC IV.9% NACL MINI BAG PLUS 100ML	0258	PHARMACY - IV SOLUTIONS		 $18.01 	 $12.61 	 $4.29 	 $16.21 	 $15.67 	 $4.32 	 $13.78 	 $15.13 	 $15.13 	 $4.45 	 $16.21 	 $15.31 	 $12.43 	 $14.41 	 $4.32 	 $16.21 	 $14.64 	 $15.31 	 $4.29 	 $14.64 	 $4.32 
310085	HCHG CVMC IV 5%DEX .45%NACL 40MEQ 1000ML	0258	PHARMACY - IV SOLUTIONS		 $11.14 	 $7.80 	 $2.65 	 $10.03 	 $9.69 	 $2.67 	 $8.52 	 $9.36 	 $9.36 	 $2.75 	 $10.03 	 $9.47 	 $7.69 	 $8.91 	 $2.67 	 $10.03 	 $9.06 	 $9.47 	 $2.65 	 $9.06 	 $2.67 
310119	HCHG CVMC NORMAL SALINE 15ML/3ML	0258	PHARMACY - IV SOLUTIONS	J7050	 $33.38 	 $23.37 	 $7.94 	 $30.04 	 $29.04 	 $8.01 	 $25.54 	 $28.04 	 $28.04 	 $8.25 	 $30.04 	 $28.37 	 $23.03 	 $26.70 	 $8.01 	 $30.04 	 $27.14 	 $28.37 	 $7.94 	 $27.14 	 $8.01 
330902	HCHG CVMC IV 5% DEXTROSE 100ML IN 150ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $109.60 	 $76.72 	 $26.08 	 $98.64 	 $95.35 	 $26.30 	 $83.84 	 $92.06 	 $92.06 	 $27.09 	 $98.64 	 $93.16 	 $75.62 	 $87.68 	 $26.30 	 $98.64 	 $89.10 	 $93.16 	 $26.08 	 $89.10 	 $26.30 
330905	HCHG CVMC IV 5% DEXTROSE 250ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $121.77 	 $85.24 	 $28.98 	 $109.59 	 $105.94 	 $29.22 	 $93.15 	 $102.29 	 $102.29 	 $30.10 	 $109.59 	 $103.50 	 $84.02 	 $97.42 	 $29.22 	 $109.59 	 $99.00 	 $103.50 	 $28.98 	 $99.00 	 $29.22 
330907	HCHG CVMC IV 5% DEXTROS .45 NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $13.27 	 $9.29 	 $3.16 	 $11.94 	 $11.54 	 $3.18 	 $10.15 	 $11.15 	 $11.15 	 $3.28 	 $11.94 	 $11.28 	 $9.16 	 $10.62 	 $3.18 	 $11.94 	 $10.79 	 $11.28 	 $3.16 	 $10.79 	 $3.18 
330916	HCHG BMH/CVMC IV .9% NACL 500ML	0258	PHARMACY - IV SOLUTIONS	J7040	 $159.26 	 $111.48 	 $37.90 	 $143.33 	 $138.56 	 $38.22 	 $121.83 	 $133.78 	 $133.78 	 $39.37 	 $143.33 	 $135.37 	 $109.89 	 $127.41 	 $38.22 	 $143.33 	 $129.48 	 $135.37 	 $37.90 	 $129.48 	 $38.22 
330917	HCHG CVMC IV 5% DEXTROSE .45% NACL 500M	0258	PHARMACY - IV SOLUTIONS	J7042	 $159.26 	 $111.48 	 $37.90 	 $143.33 	 $138.56 	 $38.22 	 $121.83 	 $133.78 	 $133.78 	 $39.37 	 $143.33 	 $135.37 	 $109.89 	 $127.41 	 $38.22 	 $143.33 	 $129.48 	 $135.37 	 $37.90 	 $129.48 	 $38.22 
330918	HCHG CVMC IV 5% DEXTROS.45%NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $169.65 	 $118.76 	 $40.38 	 $152.69 	 $147.60 	 $40.72 	 $129.78 	 $142.51 	 $142.51 	 $41.94 	 $152.69 	 $144.20 	 $117.06 	 $135.72 	 $40.72 	 $152.69 	 $137.93 	 $144.20 	 $40.38 	 $137.93 	 $40.72 
330919	HCHG CVMC IV 5% DEXTROSE .9%NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $169.65 	 $118.76 	 $40.38 	 $152.69 	 $147.60 	 $40.72 	 $129.78 	 $142.51 	 $142.51 	 $41.94 	 $152.69 	 $144.20 	 $117.06 	 $135.72 	 $40.72 	 $152.69 	 $137.93 	 $144.20 	 $40.38 	 $137.93 	 $40.72 
330920	HCHG CVMC IV 5% DEXTROSE 1000ML	0258	PHARMACY - IV SOLUTIONS	J7070	 $169.65 	 $118.76 	 $40.38 	 $152.69 	 $147.60 	 $40.72 	 $129.78 	 $142.51 	 $142.51 	 $41.94 	 $152.69 	 $144.20 	 $117.06 	 $135.72 	 $40.72 	 $152.69 	 $137.93 	 $144.20 	 $40.38 	 $137.93 	 $40.72 
330921	HCHG BMH/CVMC IV LACTATED RINGER 1000ML	0258	PHARMACY - IV SOLUTIONS	J7120	 $169.65 	 $118.76 	 $40.38 	 $152.69 	 $147.60 	 $40.72 	 $129.78 	 $142.51 	 $142.51 	 $41.94 	 $152.69 	 $144.20 	 $117.06 	 $135.72 	 $40.72 	 $152.69 	 $137.93 	 $144.20 	 $40.38 	 $137.93 	 $40.72 
330955	HCHG CVMC IV 5% DEXTROSE .45% NACL 500ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $36.45 	 $25.52 	 $8.68 	 $32.81 	 $31.71 	 $8.75 	 $27.88 	 $30.62 	 $30.62 	 $9.01 	 $32.81 	 $30.98 	 $25.15 	 $29.16 	 $8.75 	 $32.81 	 $29.63 	 $30.98 	 $8.68 	 $29.63 	 $8.75 
330956	HCHG CVMC IV 5% DEXTROSE 100ML IN 150ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $36.53 	 $25.57 	 $8.69 	 $32.88 	 $31.78 	 $8.77 	 $27.95 	 $30.69 	 $30.69 	 $9.03 	 $32.88 	 $31.05 	 $25.21 	 $29.22 	 $8.77 	 $32.88 	 $29.70 	 $31.05 	 $8.69 	 $29.70 	 $8.77 
330972	HCHG CVMC IV .9% NACL 250 ML	0258	PHARMACY - IV SOLUTIONS	J7050	 $63.48 	 $44.44 	 $15.11 	 $57.13 	 $55.23 	 $15.24 	 $48.56 	 $53.32 	 $53.32 	 $15.69 	 $57.13 	 $53.96 	 $43.80 	 $50.78 	 $15.24 	 $57.13 	 $51.61 	 $53.96 	 $15.11 	 $51.61 	 $15.24 
330975	HCHG CVMC IV 5% DEXTROSE 250ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $69.88 	 $48.92 	 $16.63 	 $62.89 	 $60.80 	 $16.77 	 $53.46 	 $58.70 	 $58.70 	 $17.27 	 $62.89 	 $59.40 	 $48.22 	 $55.90 	 $16.77 	 $62.89 	 $56.81 	 $59.40 	 $16.63 	 $56.81 	 $16.77 
330977	HCHG CVMC IV LACTATED RINGER 1000ML	0258	PHARMACY - IV SOLUTIONS	J7120	 $72.52 	 $50.76 	 $17.26 	 $65.27 	 $63.09 	 $17.40 	 $55.48 	 $60.92 	 $60.92 	 $17.93 	 $65.27 	 $61.64 	 $50.04 	 $58.02 	 $17.40 	 $65.27 	 $58.96 	 $61.64 	 $17.26 	 $58.96 	 $17.40 
330978	HCHG CVMC IV 5% DEXTROSE 1000ML	0258	PHARMACY - IV SOLUTIONS	J7070	 $72.87 	 $51.01 	 $17.34 	 $65.58 	 $63.40 	 $17.49 	 $55.75 	 $61.21 	 $61.21 	 $18.01 	 $65.58 	 $61.94 	 $50.28 	 $58.30 	 $17.49 	 $65.58 	 $59.24 	 $61.94 	 $17.34 	 $59.24 	 $17.49 
330979	HCHG CVMC IV 5% DEXTROSE .9% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS	J7042	 $72.97 	 $51.08 	 $17.37 	 $65.67 	 $63.48 	 $17.51 	 $55.82 	 $61.29 	 $61.29 	 $18.04 	 $65.67 	 $62.02 	 $50.35 	 $58.38 	 $17.51 	 $65.67 	 $59.32 	 $62.02 	 $17.37 	 $59.32 	 $17.51 
5270002	HCHG CVMC IRRIGATION SOLUTION 1000CC	0258	PHARMACY - IV SOLUTIONS		 $91.38 	 $63.97 	 $21.75 	 $82.24 	 $79.50 	 $21.93 	 $69.91 	 $76.76 	 $76.76 	 $22.59 	 $82.24 	 $77.67 	 $63.05 	 $73.10 	 $21.93 	 $82.24 	 $74.29 	 $77.67 	 $21.75 	 $74.29 	 $21.93 
5270003	HCHG CVMC IRRIGATION SOLUTION 3000CC	0258	PHARMACY - IV SOLUTIONS		 $44.12 	 $30.88 	 $10.50 	 $39.71 	 $38.38 	 $10.59 	 $33.75 	 $37.06 	 $37.06 	 $10.91 	 $39.71 	 $37.50 	 $30.44 	 $35.30 	 $10.59 	 $39.71 	 $35.87 	 $37.50 	 $10.50 	 $35.87 	 $10.59 
5271906	HCHG CVMC IV 5% DEXTROSE 500ML	0258	PHARMACY - IV SOLUTIONS	J7060	 $7.60 	 $5.32 	 $1.81 	 $6.84 	 $6.61 	 $1.82 	 $5.81 	 $6.38 	 $6.38 	 $1.88 	 $6.84 	 $6.46 	 $5.24 	 $6.08 	 $1.82 	 $6.84 	 $6.18 	 $6.46 	 $1.81 	 $6.18 	 $1.82 
5271907	HCHG CVMC IV 5% DEXTROSE 500ML GLASS BTL	0258	PHARMACY - IV SOLUTIONS	J7060	 $21.48 	 $15.04 	 $5.11 	 $19.33 	 $18.69 	 $5.16 	 $16.43 	 $18.04 	 $18.04 	 $5.31 	 $19.33 	 $18.26 	 $14.82 	 $17.18 	 $5.16 	 $19.33 	 $17.46 	 $18.26 	 $5.11 	 $17.46 	 $5.16 
5271915	HCHG CVMC IV .45% NACL 1000ML	0258	PHARMACY - IV SOLUTIONS		 $8.49 	 $5.94 	 $2.02 	 $7.64 	 $7.39 	 $2.04 	 $6.49 	 $7.13 	 $7.13 	 $2.10 	 $7.64 	 $7.22 	 $5.86 	 $6.79 	 $2.04 	 $7.64 	 $6.90 	 $7.22 	 $2.02 	 $6.90 	 $2.04 
5271916	HCHG CVMC IV .9% NACL 50ML MINI-BAG PLUS	0258	PHARMACY - IV SOLUTIONS		 $18.21 	 $12.75 	 $4.33 	 $16.39 	 $15.84 	 $4.37 	 $13.93 	 $15.30 	 $15.30 	 $4.50 	 $16.39 	 $15.48 	 $12.56 	 $14.57 	 $4.37 	 $16.39 	 $14.80 	 $15.48 	 $4.33 	 $14.80 	 $4.37 
5271917	HCHG CVMC IV .9% NACL 100ML MINI-BAG PLU	0258	PHARMACY - IV SOLUTIONS	5271917	 $18.21 	 $12.75 	 $4.33 	 $16.39 	 $15.84 	 $4.37 	 $13.93 	 $15.30 	 $15.30 	 $4.50 	 $16.39 	 $15.48 	 $12.56 	 $14.57 	 $4.37 	 $16.39 	 $14.80 	 $15.48 	 $4.33 	 $14.80 	 $4.37 
304072	HCHG INF THERAPY-HYDRATION 31-60MIN	0260	IV THERAPY - GENERAL CLASSIFICATION	96360	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $103.82 	 $378.00 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
304073	HCHG INF THERAPY-HYDRATION EA ADDHR	0260	IV THERAPY - GENERAL CLASSIFICATION	96361	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $108.00 	 $102.00 	 $82.80 	 $96.00 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
304074	HCHG INF THERAPY-TH/DIAG-CONC < 1HR	0260	IV THERAPY - GENERAL CLASSIFICATION	96368	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $171.00 	 $161.50 	 $131.10 	 $152.00 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
304075	HCHG INF THERAPY-TH/DIAG-INIT < 1HR	0260	IV THERAPY - GENERAL CLASSIFICATION	96365	 $590.00 	 $413.00 	 $140.42 	 $531.00 	 $513.30 	 $141.60 	 $451.35 	 $495.60 	 $495.60 	 $145.85 	 $531.00 	 $501.50 	 $407.10 	 $472.00 	 $141.60 	 $531.00 	 $479.67 	 $501.50 	 $140.42 	 $479.67 	 $141.60 
304076	HCHG INF THERAPY/DIAG ADD HR	0260	IV THERAPY - GENERAL CLASSIFICATION	96366	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $51.91 	 $189.00 	 $178.50 	 $144.90 	 $168.00 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
304077	HCHG INF THERAPY-TH/DIAG-SEQ < 1HR	0260	IV THERAPY - GENERAL CLASSIFICATION	96367	 $380.00 	 $266.00 	 $90.44 	 $342.00 	 $330.60 	 $91.20 	 $290.70 	 $319.20 	 $319.20 	 $93.94 	 $342.00 	 $323.00 	 $262.20 	 $304.00 	 $91.20 	 $342.00 	 $308.94 	 $323.00 	 $90.44 	 $308.94 	 $91.20 
304122	HCHG TX-PRO-DX IV PUSH SNGL/INITIAL	0260	IV THERAPY - GENERAL CLASSIFICATION	96374	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $56.86 	 $207.00 	 $195.50 	 $158.70 	 $184.00 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
304123	HCHG INJECTION-DIAG/THERAP-SQ/IM	0260	IV THERAPY - GENERAL CLASSIFICATION	96372	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $162.00 	 $153.00 	 $124.20 	 $144.00 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
304125	HCHG TX-PRO-DX IV PUSH NEW DRG	0260	IV THERAPY - GENERAL CLASSIFICATION	96375	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $180.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
304127	HCHG TX-PRO-DX IV PSH SAME DRG	0260	IV THERAPY - GENERAL CLASSIFICATION	96376	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $153.00 	 $144.50 	 $117.30 	 $136.00 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
310028	HCHG CVMC COLLECT BLOOD VENOUS DEVICE	0260	IV THERAPY - GENERAL CLASSIFICATION	36591	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $234.00 	 $221.00 	 $179.40 	 $208.00 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
310029	HCHG CVMC COLLECT BLOOD FROM PICC	0260	IV THERAPY - GENERAL CLASSIFICATION	36592	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $234.00 	 $221.00 	 $179.40 	 $208.00 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
307022	HCHG SWABSTICK PVP IODINE PREP 3/PK	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	A4247	 $1.94 	 $1.36 	 $0.46 	 $1.75 	 $1.69 	 $0.47 	 $1.48 	 $1.63 	 $1.63 	 $0.48 	 $1.75 	 $1.65 	 $1.34 	 $1.55 	 $0.47 	 $1.75 	 $1.58 	 $1.65 	 $0.46 	 $1.58 	 $0.47 
309618	HCHG CVMC RESTRAINT/CHEST	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $114.15 	 $79.91 	 $27.17 	 $102.74 	 $99.31 	 $27.40 	 $87.32 	 $95.89 	 $95.89 	 $28.22 	 $102.74 	 $97.03 	 $78.76 	 $91.32 	 $27.40 	 $102.74 	 $92.80 	 $97.03 	 $27.17 	 $92.80 	 $27.40 
309619	HCHG CVMC RESTRAINT/LIMB DISP	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $25.43 	 $17.80 	 $6.05 	 $22.89 	 $22.12 	 $6.10 	 $19.45 	 $21.36 	 $21.36 	 $6.29 	 $22.89 	 $21.62 	 $17.55 	 $20.34 	 $6.10 	 $22.89 	 $20.67 	 $21.62 	 $6.05 	 $20.67 	 $6.10 
309620	HCHG CVMC SKIN GLUE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $163.52 	 $114.46 	 $38.92 	 $147.17 	 $142.26 	 $39.24 	 $125.09 	 $137.36 	 $137.36 	 $40.42 	 $147.17 	 $138.99 	 $112.83 	 $130.82 	 $39.24 	 $147.17 	 $132.94 	 $138.99 	 $38.92 	 $132.94 	 $39.24 
309628	HCHG CVMC VELCRO WRIST SPLINT	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $57.19 	 $40.03 	 $13.61 	 $51.47 	 $49.76 	 $13.73 	 $43.75 	 $48.04 	 $48.04 	 $14.14 	 $51.47 	 $48.61 	 $39.46 	 $45.75 	 $13.73 	 $51.47 	 $46.50 	 $48.61 	 $13.61 	 $46.50 	 $13.73 
309629	HCHG CVMC CANNULA	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $72.10 	 $50.47 	 $17.16 	 $64.89 	 $62.73 	 $17.30 	 $55.16 	 $60.56 	 $60.56 	 $17.82 	 $64.89 	 $61.29 	 $49.75 	 $57.68 	 $17.30 	 $64.89 	 $58.62 	 $61.29 	 $17.16 	 $58.62 	 $17.30 
309637	HCHG CVMC ORTHO SHOE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $173.30 	 $121.31 	 $41.25 	 $155.97 	 $150.77 	 $41.59 	 $132.57 	 $145.57 	 $145.57 	 $42.84 	 $155.97 	 $147.31 	 $119.58 	 $138.64 	 $41.59 	 $155.97 	 $140.89 	 $147.31 	 $41.25 	 $140.89 	 $41.59 
501777	HCHG DRESSING BIOBRANE 5X5	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	501777	 $437.42 	 $306.19 	 $104.11 	 $393.68 	 $380.56 	 $104.98 	 $334.63 	 $367.43 	 $367.43 	 $108.13 	 $393.68 	 $371.81 	 $301.82 	 $349.94 	 $104.98 	 $393.68 	 $355.62 	 $371.81 	 $104.11 	 $355.62 	 $104.98 
503530	HCHG ALGINATE CAL MAXORB-EXTRA 4X4IN	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	A6196	 $25.46 	 $17.82 	 $6.06 	 $22.91 	 $22.15 	 $6.11 	 $19.48 	 $21.39 	 $21.39 	 $6.29 	 $22.91 	 $21.64 	 $17.57 	 $20.37 	 $6.11 	 $22.91 	 $20.70 	 $21.64 	 $6.06 	 $20.70 	 $6.11 
5270004	HCHG CVMC DRESS ADAPTIC 3X3	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $5.69 	 $3.98 	 $1.35 	 $5.12 	 $4.95 	 $1.37 	 $4.35 	 $4.78 	 $4.78 	 $1.41 	 $5.12 	 $4.84 	 $3.93 	 $4.55 	 $1.37 	 $5.12 	 $4.63 	 $4.84 	 $1.35 	 $4.63 	 $1.37 
5270005	HCHG CVMC DRESS ADAPTIC 3X9	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $19.14 	 $13.40 	 $4.56 	 $17.23 	 $16.65 	 $4.59 	 $14.64 	 $16.08 	 $16.08 	 $4.73 	 $17.23 	 $16.27 	 $13.21 	 $15.31 	 $4.59 	 $17.23 	 $15.56 	 $16.27 	 $4.56 	 $15.56 	 $4.59 
5270006	HCHG CVMC DRESS STERISTRP	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $25.91 	 $18.14 	 $6.17 	 $23.32 	 $22.54 	 $6.22 	 $19.82 	 $21.76 	 $21.76 	 $6.40 	 $23.32 	 $22.02 	 $17.88 	 $20.73 	 $6.22 	 $23.32 	 $21.06 	 $22.02 	 $6.17 	 $21.06 	 $6.22 
5270007	HCHG CVMC AGEE WRIST JACK	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $6,259.81 "	" $4,381.87 "	" $1,489.83 "	" $5,633.83 "	" $5,446.03 "	" $1,502.35 "	" $4,788.75 "	" $3,786.00 "	" $3,283.00 "	" $1,547.43 "	" $5,633.83 "	" $5,320.84 "	" $4,319.27 "	" $5,007.85 "	" $1,502.35 "	" $5,633.83 "	" $5,089.23 "	" $5,320.84 "	" $1,489.83 "	" $5,089.23 "	" $1,502.35 "
5270008	HCHG CVMC ORTHOSORB ARTHROSCOPE PINS	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	C1713	" $2,551.73 "	" $1,786.21 "	 $607.31 	" $2,296.56 "	" $2,220.01 "	 $612.42 	" $1,952.07 "	" $2,143.45 "	" $2,143.45 "	 $630.79 	" $2,296.56 "	" $2,168.97 "	" $1,760.69 "	" $2,041.38 "	 $612.42 	" $2,296.56 "	" $2,074.56 "	" $2,168.97 "	 $607.31 	" $2,074.56 "	 $612.42 
5270009	HCHG CVMC CATHETER FOLEY ALL	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $69.39 	 $48.57 	 $16.51 	 $62.45 	 $60.37 	 $16.65 	 $53.08 	 $58.29 	 $58.29 	 $17.15 	 $62.45 	 $58.98 	 $47.88 	 $55.51 	 $16.65 	 $62.45 	 $56.41 	 $58.98 	 $16.51 	 $56.41 	 $16.65 
5270010	"HCHG CVMC CATHETER, IRRIGATING"	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $332.85 	 $233.00 	 $79.22 	 $299.57 	 $289.58 	 $79.88 	 $254.63 	 $279.59 	 $279.59 	 $82.28 	 $299.57 	 $282.92 	 $229.67 	 $266.28 	 $79.88 	 $299.57 	 $270.61 	 $282.92 	 $79.22 	 $270.61 	 $79.88 
5270011	"HCHG CVMC CATHETER, ROBINSON-ALL"	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $52.29 	 $36.60 	 $12.45 	 $47.06 	 $45.49 	 $12.55 	 $40.00 	 $43.92 	 $43.92 	 $12.93 	 $47.06 	 $44.45 	 $36.08 	 $41.83 	 $12.55 	 $47.06 	 $42.51 	 $44.45 	 $12.45 	 $42.51 	 $12.55 
5270012	HCHG CVMC STAPLER ENDOCLIP 5MM	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $1,460.11 "	" $1,022.08 "	 $347.51 	" $1,314.10 "	" $1,270.30 "	 $350.43 	" $1,116.98 "	" $1,226.49 "	" $1,226.49 "	 $360.94 	" $1,314.10 "	" $1,241.09 "	" $1,007.48 "	" $1,168.09 "	 $350.43 	" $1,314.10 "	" $1,187.07 "	" $1,241.09 "	 $347.51 	" $1,187.07 "	 $350.43 
5270013	HCHG CVMC ENDOCLOSE SUTURING DEVICE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $295.44 	 $206.81 	 $70.31 	 $265.90 	 $257.03 	 $70.91 	 $226.01 	 $248.17 	 $248.17 	 $73.03 	 $265.90 	 $251.12 	 $203.85 	 $236.35 	 $70.91 	 $265.90 	 $240.19 	 $251.12 	 $70.31 	 $240.19 	 $70.91 
5270014	HCHG CVMC GELFILM OPTHALMIC DRESSING	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $191.09 	 $133.76 	 $45.48 	 $171.98 	 $166.25 	 $45.86 	 $146.18 	 $160.52 	 $160.52 	 $47.24 	 $171.98 	 $162.43 	 $131.85 	 $152.87 	 $45.86 	 $171.98 	 $155.36 	 $162.43 	 $45.48 	 $155.36 	 $45.86 
5270015	HCHG CVMC GUIDE WIRE-ALL	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	C1713	 $139.32 	 $97.52 	 $33.16 	 $125.39 	 $121.21 	 $33.44 	 $106.58 	 $117.03 	 $117.03 	 $34.44 	 $125.39 	 $118.42 	 $96.13 	 $111.46 	 $33.44 	 $125.39 	 $113.27 	 $118.42 	 $33.16 	 $113.27 	 $33.44 
5270016	"HCHG CVMC CHOLANGIOGRAM CATHETER, ALL"	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $79.90 	 $55.93 	 $19.02 	 $71.91 	 $69.51 	 $19.18 	 $61.12 	 $67.12 	 $67.12 	 $19.75 	 $71.91 	 $67.92 	 $55.13 	 $63.92 	 $19.18 	 $71.91 	 $64.96 	 $67.92 	 $19.02 	 $64.96 	 $19.18 
5270017	HCHG CVMC BUR-ALL	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $378.13 	 $264.69 	 $89.99 	 $340.32 	 $328.97 	 $90.75 	 $289.27 	 $317.63 	 $317.63 	 $93.47 	 $340.32 	 $321.41 	 $260.91 	 $302.50 	 $90.75 	 $340.32 	 $307.42 	 $321.41 	 $89.99 	 $307.42 	 $90.75 
5270018	HCHG CVMC TED HOSE-ALL	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $94.54 	 $66.18 	 $22.50 	 $85.09 	 $82.25 	 $22.69 	 $72.32 	 $79.41 	 $79.41 	 $23.37 	 $85.09 	 $80.36 	 $65.23 	 $75.63 	 $22.69 	 $85.09 	 $76.86 	 $80.36 	 $22.50 	 $76.86 	 $22.69 
5270019	HCHG CVMC FIBRIN SEALANT/2.0ML/TISSEAL	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,118.21 "	" $1,482.75 "	 $504.13 	" $1,906.39 "	" $1,842.84 "	 $508.37 	" $1,620.43 "	" $1,779.30 "	" $1,779.30 "	 $523.62 	" $1,906.39 "	" $1,800.48 "	" $1,461.56 "	" $1,694.57 "	 $508.37 	" $1,906.39 "	" $1,722.10 "	" $1,800.48 "	 $504.13 	" $1,722.10 "	 $508.37 
5270022	HCHG CVMC BONE WAX	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $75.79 	 $53.05 	 $18.04 	 $68.21 	 $65.94 	 $18.19 	 $57.98 	 $63.66 	 $63.66 	 $18.74 	 $68.21 	 $64.42 	 $52.30 	 $60.63 	 $18.19 	 $68.21 	 $61.62 	 $64.42 	 $18.04 	 $61.62 	 $18.19 
5270023	HCHG CVMC MONOFILAMENT WIRE/ALL GAUGES	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	C1713	 $111.72 	 $78.20 	 $26.59 	 $100.55 	 $97.20 	 $26.81 	 $85.47 	 $93.84 	 $93.84 	 $27.62 	 $100.55 	 $94.96 	 $77.09 	 $89.38 	 $26.81 	 $100.55 	 $90.83 	 $94.96 	 $26.59 	 $90.83 	 $26.81 
5270024	HCHG CVMC ARTHROTEK ONE-STEP GUIDE PINS	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	C1713	" $1,843.13 "	" $1,290.19 "	 $438.66 	" $1,658.82 "	" $1,603.52 "	 $442.35 	" $1,409.99 "	" $1,548.23 "	" $1,548.23 "	 $455.62 	" $1,658.82 "	" $1,566.66 "	" $1,271.76 "	" $1,474.50 "	 $442.35 	" $1,658.82 "	" $1,498.46 "	" $1,566.66 "	 $438.66 	" $1,498.46 "	 $442.35 
5270025	HCHG CVMC STRYKER IRRIGATOR	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $659.48 	 $461.64 	 $156.96 	 $593.53 	 $573.75 	 $158.28 	 $504.50 	 $553.96 	 $553.96 	 $163.02 	 $593.53 	 $560.56 	 $455.04 	 $527.58 	 $158.28 	 $593.53 	 $536.16 	 $560.56 	 $156.96 	 $536.16 	 $158.28 
5270026	HCHG CVMC FORCE FIBER SUTURE/INDIV NEEDLED (TAPERED) SIZE 2	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $189.16 	 $132.41 	 $45.02 	 $170.24 	 $164.57 	 $45.40 	 $144.71 	 $158.89 	 $158.89 	 $46.76 	 $170.24 	 $160.79 	 $130.52 	 $151.33 	 $45.40 	 $170.24 	 $153.79 	 $160.79 	 $45.02 	 $153.79 	 $45.40 
5270027	HCHG CVMC DRUG DELIVERY SYSTEM <=5 ML	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION	A4306	" $1,865.79 "	" $1,306.05 "	 $444.06 	" $1,679.21 "	" $1,623.24 "	 $447.79 	" $1,427.33 "	" $1,567.26 "	" $1,567.26 "	 $461.22 	" $1,679.21 "	" $1,585.92 "	" $1,287.40 "	" $1,492.63 "	 $447.79 	" $1,679.21 "	" $1,516.89 "	" $1,585.92 "	 $444.06 	" $1,516.89 "	 $447.79 
5271281	HCHG CVMC INDWELLING SLIT CATHETER KIT	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $717.75 	 $502.43 	 $170.82 	 $645.98 	 $624.44 	 $172.26 	 $549.08 	 $602.91 	 $602.91 	 $177.43 	 $645.98 	 $610.09 	 $495.25 	 $574.20 	 $172.26 	 $645.98 	 $583.53 	 $610.09 	 $170.82 	 $583.53 	 $172.26 
5271734	HCHG CVMC CLAMP EXTERNAL FIXATION SPRING-LOADED NUT	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $398.71 	 $279.10 	 $94.89 	 $358.84 	 $346.88 	 $95.69 	 $305.01 	 $334.92 	 $334.92 	 $98.56 	 $358.84 	 $338.90 	 $275.11 	 $318.97 	 $95.69 	 $358.84 	 $324.15 	 $338.90 	 $94.89 	 $324.15 	 $95.69 
5271735	HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE DYNAMIZ CLIP	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $830.10 	 $581.07 	 $197.56 	 $747.09 	 $722.19 	 $199.22 	 $635.03 	 $697.28 	 $697.28 	 $205.20 	 $747.09 	 $705.59 	 $572.77 	 $664.08 	 $199.22 	 $747.09 	 $674.87 	 $705.59 	 $197.56 	 $674.87 	 $199.22 
5271736	HCHG CVMC CLIP EXTERNAL FIXATION DYNAMIZATION 4 MED COMBO	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $781.34 	 $546.94 	 $185.96 	 $703.21 	 $679.77 	 $187.52 	 $597.73 	 $656.33 	 $656.33 	 $193.15 	 $703.21 	 $664.14 	 $539.12 	 $625.07 	 $187.52 	 $703.21 	 $635.23 	 $664.14 	 $185.96 	 $635.23 	 $187.52 
5271737	HCHG CVMC POST EXTERNAL FIXATION OURTIGGER 11MM MR	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $833.43 	 $583.40 	 $198.36 	 $750.09 	 $725.08 	 $200.02 	 $637.57 	 $700.08 	 $700.08 	 $206.02 	 $750.09 	 $708.42 	 $575.07 	 $666.74 	 $200.02 	 $750.09 	 $677.58 	 $708.42 	 $198.36 	 $677.58 	 $200.02 
5271738	HCHG CVMC POST EXTERNAL FIXATION 90DEG OUTRIGGER POST 8MM	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $859.48 	 $601.64 	 $204.56 	 $773.53 	 $747.75 	 $206.28 	 $657.50 	 $721.96 	 $721.96 	 $212.46 	 $773.53 	 $730.56 	 $593.04 	 $687.58 	 $206.28 	 $773.53 	 $698.76 	 $730.56 	 $204.56 	 $698.76 	 $206.28 
5271739	HCHG CVMC ROD EXTERNAL FIXATION ATTACHMENT 4 MED MULTI-PIN	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $1,688.66 "	" $1,182.06 "	 $401.90 	" $1,519.79 "	" $1,469.13 "	 $405.28 	" $1,291.82 "	" $1,418.47 "	" $1,418.47 "	 $417.44 	" $1,519.79 "	" $1,435.36 "	" $1,165.18 "	" $1,350.93 "	 $405.28 	" $1,519.79 "	" $1,372.88 "	" $1,435.36 "	 $401.90 	" $1,372.88 "	 $405.28 
5271740	HCHG CVMC CLAMP EXTERNAL FIXATION MEDIUM PIN 6POS	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,006.82 "	" $1,404.77 "	 $477.62 	" $1,806.14 "	" $1,745.93 "	 $481.64 	" $1,535.22 "	" $1,685.73 "	" $1,685.73 "	 $496.09 	" $1,806.14 "	" $1,705.80 "	" $1,384.71 "	" $1,605.46 "	 $481.64 	" $1,806.14 "	" $1,631.54 "	" $1,705.80 "	 $477.62 	" $1,631.54 "	 $481.64 
5271741	HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE LG PIN 4POS	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,070.78 "	" $1,449.55 "	 $492.85 	" $1,863.70 "	" $1,801.58 "	 $496.99 	" $1,584.15 "	" $1,739.46 "	" $1,739.46 "	 $511.90 	" $1,863.70 "	" $1,760.16 "	" $1,428.84 "	" $1,656.62 "	 $496.99 	" $1,863.70 "	" $1,683.54 "	" $1,760.16 "	 $492.85 	" $1,683.54 "	 $496.99 
5271742	HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE LG PIN 6POS	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,125.69 "	" $1,487.98 "	 $505.91 	" $1,913.12 "	" $1,849.35 "	 $510.17 	" $1,626.15 "	" $1,785.58 "	" $1,785.58 "	 $525.47 	" $1,913.12 "	" $1,806.84 "	" $1,466.73 "	" $1,700.55 "	 $510.17 	" $1,913.12 "	" $1,728.19 "	" $1,806.84 "	 $505.91 	" $1,728.19 "	 $510.17 
5271743	HCHG CVMC CLAMP EXTERNAL FIXATION COMBO MEDIUM	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,433.35 "	" $1,703.35 "	 $579.14 	" $2,190.02 "	" $2,117.01 "	 $584.00 	" $1,861.51 "	" $2,044.01 "	" $2,044.01 "	 $601.52 	" $2,190.02 "	" $2,068.35 "	" $1,679.01 "	" $1,946.68 "	 $584.00 	" $2,190.02 "	" $1,978.31 "	" $2,068.35 "	 $579.14 	" $1,978.31 "	 $584.00 
5271744	HCHG CVMC CLAMP EXTERNAL FIXATION SMALL ADJUSTABLE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,534.74 "	" $1,774.32 "	 $603.27 	" $2,281.27 "	" $2,205.22 "	 $608.34 	" $1,939.08 "	" $2,129.18 "	" $2,129.18 "	 $626.59 	" $2,281.27 "	" $2,154.53 "	" $1,748.97 "	" $2,027.79 "	 $608.34 	" $2,281.27 "	" $2,060.74 "	" $2,154.53 "	 $603.27 	" $2,060.74 "	 $608.34 
5271745	HCHG CVMC CLAMP EXTERNAL FIXATION COMBO 8/11MM	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,800.45 "	" $1,960.32 "	 $666.51 	" $2,520.41 "	" $2,436.39 "	 $672.11 	" $2,142.34 "	" $2,352.38 "	" $2,352.38 "	 $692.27 	" $2,520.41 "	" $2,380.38 "	" $1,932.31 "	" $2,240.36 "	 $672.11 	" $2,520.41 "	" $2,276.77 "	" $2,380.38 "	 $666.51 	" $2,276.77 "	 $672.11 
5271746	HCHG CVMC CLAMP EXTERNAL FIXATION MR SAFE TUBE-TO-TUBE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $3,087.14 "	" $2,161.00 "	 $734.74 	" $2,778.43 "	" $2,685.81 "	 $740.91 	" $2,361.66 "	" $2,593.20 "	" $2,593.20 "	 $763.14 	" $2,778.43 "	" $2,624.07 "	" $2,130.13 "	" $2,469.71 "	 $740.91 	" $2,778.43 "	" $2,509.84 "	" $2,624.07 "	 $734.74 	" $2,509.84 "	 $740.91 
5271747	HCHG CVMC CLAMP EXTERNAL FIXATION	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $3,204.65 "	" $2,243.26 "	 $762.71 	" $2,884.19 "	" $2,788.05 "	 $769.12 	" $2,451.56 "	" $2,691.91 "	" $2,691.91 "	 $792.19 	" $2,884.19 "	" $2,723.95 "	" $2,211.21 "	" $2,563.72 "	 $769.12 	" $2,884.19 "	" $2,605.38 "	" $2,723.95 "	 $762.71 	" $2,605.38 "	 $769.12 
5271748	HCHG CVMC CLAMP EXTERNAL FIXATION ADJUSTABLE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $3,538.15 "	" $2,476.71 "	 $842.08 	" $3,283.00 "	" $3,078.19 "	 $849.16 	" $2,706.68 "	" $2,972.05 "	" $3,283.00 "	 $874.63 	" $3,184.34 "	" $3,007.43 "	" $2,441.32 "	" $2,830.52 "	 $849.16 	" $3,184.34 "	" $2,876.52 "	" $3,007.43 "	 $842.08 	" $2,876.52 "	 $849.16 
5271749	HCHG CVMC POST EXTERNAL FIXATION 30DEG OUTRIGGER 8MM	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $786.55 	 $550.59 	 $187.20 	 $707.90 	 $684.30 	 $188.77 	 $601.71 	 $660.70 	 $660.70 	 $194.44 	 $707.90 	 $668.57 	 $542.72 	 $629.24 	 $188.77 	 $707.90 	 $639.47 	 $668.57 	 $187.20 	 $639.47 	 $188.77 
5271750	HCHG CVMC POST EXTERNAL FIXATION OUTRIGGER POST 11MM MR SAF	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		 $916.78 	 $641.75 	 $218.19 	 $825.10 	 $797.60 	 $220.03 	 $701.34 	 $770.10 	 $770.10 	 $226.63 	 $825.10 	 $779.26 	 $632.58 	 $733.42 	 $220.03 	 $825.10 	 $745.34 	 $779.26 	 $218.19 	 $745.34 	 $220.03 
5271751	HCHG CVMC CLAMP EXTERNAL FIXATION  MR SAFE ROD ATTACH	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $1,915.91 "	" $1,341.14 "	 $455.99 	" $1,724.32 "	" $1,666.84 "	 $459.82 	" $1,465.67 "	" $1,609.36 "	" $1,609.36 "	 $473.61 	" $1,724.32 "	" $1,628.52 "	" $1,321.98 "	" $1,532.73 "	 $459.82 	" $1,724.32 "	" $1,557.63 "	" $1,628.52 "	 $455.99 	" $1,557.63 "	 $459.82 
5271752	HCHG CVMC EXTERNAL FIXATOR ADJUSTIBLE LARGE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $13,865.19 "	" $9,705.63 "	" $3,283.00 "	" $12,478.67 "	" $12,062.72 "	" $3,327.65 "	" $10,606.87 "	" $3,786.00 "	" $3,283.00 "	" $3,427.47 "	" $12,478.67 "	" $11,785.41 "	" $9,566.98 "	" $11,092.15 "	" $3,327.65 "	" $12,478.67 "	" $11,272.40 "	" $11,785.41 "	" $3,299.92 "	" $11,272.40 "	" $3,327.65 "
5271753	HCHG CVMC CLAMP ADJUSTABLE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $1,845.99 "	" $1,292.19 "	 $439.35 	" $1,661.39 "	" $1,606.01 "	 $443.04 	" $1,412.18 "	" $1,550.63 "	" $1,550.63 "	 $456.33 	" $1,661.39 "	" $1,569.09 "	" $1,273.73 "	" $1,476.79 "	 $443.04 	" $1,661.39 "	" $1,500.79 "	" $1,569.09 "	 $439.35 	" $1,500.79 "	 $443.04 
5271754	HCHG CVMC CLAMP UNIVERSAL	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $3,020.71 "	" $2,114.50 "	 $718.93 	" $2,718.64 "	" $2,628.02 "	 $724.97 	" $2,310.84 "	" $2,537.40 "	" $2,537.40 "	 $746.72 	" $2,718.64 "	" $2,567.60 "	" $2,084.29 "	" $2,416.57 "	 $724.97 	" $2,718.64 "	" $2,455.84 "	" $2,567.60 "	 $718.93 	" $2,455.84 "	 $724.97 
5271755	HCHG CVMC CLAMP TRANSVERSE	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $3,087.14 "	" $2,161.00 "	 $734.74 	" $2,778.43 "	" $2,685.81 "	 $740.91 	" $2,361.66 "	" $2,593.20 "	" $2,593.20 "	 $763.14 	" $2,778.43 "	" $2,624.07 "	" $2,130.13 "	" $2,469.71 "	 $740.91 	" $2,778.43 "	" $2,509.84 "	" $2,624.07 "	 $734.74 	" $2,509.84 "	 $740.91 
5271756	HCHG CVMC CLAMP UNIV JOINT FOR 2 TUBES	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $3,359.84 "	" $2,351.89 "	 $799.64 	" $3,283.00 "	" $2,923.06 "	 $806.36 	" $2,570.28 "	" $2,822.27 "	" $3,283.00 "	 $830.55 	" $3,023.86 "	" $2,855.86 "	" $2,318.29 "	" $2,687.87 "	 $806.36 	" $3,023.86 "	" $2,731.55 "	" $2,855.86 "	 $799.64 	" $2,731.55 "	 $806.36 
5271757	HCHG CVMC CLAMP OPEN	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $1,635.61 "	" $1,144.93 "	 $389.28 	" $1,472.05 "	" $1,422.98 "	 $392.55 	" $1,251.24 "	" $1,373.91 "	" $1,373.91 "	 $404.32 	" $1,472.05 "	" $1,390.27 "	" $1,128.57 "	" $1,308.49 "	 $392.55 	" $1,472.05 "	" $1,329.75 "	" $1,390.27 "	 $389.28 	" $1,329.75 "	 $392.55 
5271912	HCHG CVMC CLAMP OPEN COMPRESSOR	0270	MEDICAL/SURGICAL SUPPLIES AND DEVICES - GENERAL CLASSIFICATION		" $2,341.09 "	" $1,638.76 "	 $557.18 	" $2,106.98 "	" $2,036.75 "	 $561.86 	" $1,790.93 "	" $1,966.52 "	" $1,966.52 "	 $578.72 	" $2,106.98 "	" $1,989.93 "	" $1,615.35 "	" $1,872.87 "	 $561.86 	" $2,106.98 "	" $1,903.31 "	" $1,989.93 "	 $557.18 	" $1,903.31 "	 $561.86 
302401	HCHG COFLEX 2 LAYER TLC	0271	MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON STERILE SUPPLY	A6441	 $86.71 	 $60.70 	 $20.64 	 $78.04 	 $75.44 	 $20.81 	 $66.33 	 $72.84 	 $72.84 	 $21.43 	 $78.04 	 $73.70 	 $59.83 	 $69.37 	 $20.81 	 $78.04 	 $70.50 	 $73.70 	 $20.64 	 $70.50 	 $20.81 
307007	"HCHG COBAN 2"" BLUE, NON-STERILE"	0271	MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON STERILE SUPPLY	A6453	 $6.89 	 $4.82 	 $1.64 	 $6.20 	 $5.99 	 $1.65 	 $5.27 	 $5.79 	 $5.79 	 $1.70 	 $6.20 	 $5.86 	 $4.75 	 $5.51 	 $1.65 	 $6.20 	 $5.60 	 $5.86 	 $1.64 	 $5.60 	 $1.65 
307024	"HCHG ACE 4"" NON-STERILE"	0271	MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON STERILE SUPPLY	A6449	 $4.68 	 $3.28 	 $1.11 	 $4.21 	 $4.07 	 $1.12 	 $3.58 	 $3.93 	 $3.93 	 $1.16 	 $4.21 	 $3.98 	 $3.23 	 $3.74 	 $1.12 	 $4.21 	 $3.80 	 $3.98 	 $1.11 	 $3.80 	 $1.12 
307025	"HCHG ACE 6"" NON-STERILE"	0271	MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON STERILE SUPPLY	A6450	 $6.63 	 $4.64 	 $1.58 	 $5.97 	 $5.77 	 $1.59 	 $5.07 	 $5.57 	 $5.57 	 $1.64 	 $5.97 	 $5.64 	 $4.57 	 $5.30 	 $1.59 	 $5.97 	 $5.39 	 $5.64 	 $1.58 	 $5.39 	 $1.59 
307026	"HCHG COBAN 4"" TAN NON-STERILE"	0271	MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON STERILE SUPPLY	A6454	 $12.29 	 $8.60 	 $2.93 	 $11.06 	 $10.69 	 $2.95 	 $9.40 	 $10.32 	 $10.32 	 $3.04 	 $11.06 	 $10.45 	 $8.48 	 $9.83 	 $2.95 	 $11.06 	 $9.99 	 $10.45 	 $2.93 	 $9.99 	 $2.95 
307157	HCHG VISCOPASTE UNNAS TYPE	0271	MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON STERILE SUPPLY	A6261	 $38.18 	 $26.73 	 $9.09 	 $34.36 	 $33.22 	 $9.16 	 $29.21 	 $32.07 	 $32.07 	 $9.16 	 $34.36 	 $32.45 	 $26.34 	 $30.54 	 $9.16 	 $34.36 	 $31.04 	 $32.45 	 $9.09 	 $31.04 	 $9.16 
310104	HCHG CVMC O2 PER HR BY NASAL/MASK	0271	MEDICAL/SURGICAL SUPPLIES AND DEVICES - NON STERILE SUPPLY		 $35.00 	 $24.50 	 $8.33 	 $31.50 	 $30.45 	 $8.40 	 $26.78 	 $29.40 	 $29.40 	 $8.65 	 $31.50 	 $29.75 	 $24.15 	 $28.00 	 $8.40 	 $31.50 	 $28.46 	 $29.75 	 $8.33 	 $28.46 	 $8.40 
301019	HCHG SCRUB SPONGE E-Z 4%	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6402	 $5.75 	 $4.03 	 $1.37 	 $5.18 	 $5.00 	 $1.38 	 $4.40 	 $4.83 	 $4.83 	 $1.38 	 $5.18 	 $4.89 	 $3.97 	 $4.60 	 $1.38 	 $5.18 	 $4.67 	 $4.89 	 $1.37 	 $4.67 	 $1.38 
302247	HCHG OPTIFOAM HEEL DRESSING	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6210	 $64.00 	 $44.80 	 $15.23 	 $57.60 	 $55.68 	 $15.36 	 $48.96 	 $53.76 	 $53.76 	 $15.36 	 $57.60 	 $54.40 	 $44.16 	 $51.20 	 $15.36 	 $57.60 	 $52.03 	 $54.40 	 $15.23 	 $52.03 	 $15.36 
302400	HCHG MARATHON SKIN PROTECTANT	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6250	 $44.20 	 $30.94 	 $10.52 	 $39.78 	 $38.45 	 $10.61 	 $33.81 	 $37.13 	 $37.13 	 $10.61 	 $39.78 	 $37.57 	 $30.50 	 $35.36 	 $10.61 	 $39.78 	 $35.93 	 $37.57 	 $10.52 	 $35.93 	 $10.61 
302402	HCHG OPTILOCK DRESSING	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6251	 $16.97 	 $11.88 	 $4.04 	 $15.27 	 $14.76 	 $4.07 	 $12.98 	 $14.25 	 $14.25 	 $4.07 	 $15.27 	 $14.42 	 $11.71 	 $13.58 	 $4.07 	 $15.27 	 $13.80 	 $14.42 	 $4.04 	 $13.80 	 $4.07 
302765	"HCHG FOAM-NON ADHESIVE 4X4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6212	 $16.62 	 $11.63 	 $3.96 	 $14.96 	 $14.46 	 $3.99 	 $12.71 	 $13.96 	 $13.96 	 $4.11 	 $14.96 	 $14.13 	 $11.47 	 $13.30 	 $3.99 	 $14.96 	 $13.51 	 $14.13 	 $3.96 	 $13.51 	 $3.99 
302892	HCHG TEMP PACING KIT	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	302892	" $1,346.00 "	 $942.20 	 $320.35 	" $1,211.40 "	" $1,171.02 "	 $323.04 	" $1,029.69 "	" $1,130.64 "	" $1,130.64 "	 $323.04 	" $1,211.40 "	" $1,144.10 "	 $928.74 	" $1,076.80 "	 $323.04 	" $1,211.40 "	" $1,094.30 "	" $1,144.10 "	 $320.35 	" $1,094.30 "	 $323.04 
303307	HCHG DRESSING PRMOGRN PRISMA MATRIX 4X4	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6021	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $72.00 	 $68.00 	 $55.20 	 $64.00 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
303308	"HCHG CVMC ALLEVYN LIFE 6"" X 6"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6212	 $25.00 	 $17.50 	 $5.95 	 $22.50 	 $21.75 	 $6.00 	 $19.13 	 $21.00 	 $21.00 	 $6.18 	 $22.50 	 $21.25 	 $17.25 	 $20.00 	 $6.00 	 $22.50 	 $20.33 	 $21.25 	 $5.95 	 $20.33 	 $6.00 
303309	HCHG CVMC ALLEVYN LIFE SACRUM SMALL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6213	 $48.00 	 $33.60 	 $11.42 	 $43.20 	 $41.76 	 $11.52 	 $36.72 	 $40.32 	 $40.32 	 $11.87 	 $43.20 	 $40.80 	 $33.12 	 $38.40 	 $11.52 	 $43.20 	 $39.02 	 $40.80 	 $11.42 	 $39.02 	 $11.52 
303310	"HCHG CVMC ADAPTIC 3"" X 3"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6222	 $2.00 	 $1.40 	 $0.48 	 $1.80 	 $1.74 	 $0.48 	 $1.53 	 $1.68 	 $1.68 	 $0.49 	 $1.80 	 $1.70 	 $1.38 	 $1.60 	 $0.48 	 $1.80 	 $1.63 	 $1.70 	 $0.48 	 $1.63 	 $0.48 
303311	"HCHG CVMC ADAPTIC 3"" X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6222	 $4.00 	 $2.80 	 $0.95 	 $3.60 	 $3.48 	 $0.96 	 $3.06 	 $3.36 	 $3.36 	 $0.99 	 $3.60 	 $3.40 	 $2.76 	 $3.20 	 $0.96 	 $3.60 	 $3.25 	 $3.40 	 $0.95 	 $3.25 	 $0.96 
303326	"HCHG DRESSING PROMOGRAN W/O SILVER 4.34"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6021	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $54.00 	 $51.00 	 $41.40 	 $48.00 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
303489	"HCHG DRESSING-CA ALGINATE ROPE 12"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6199	 $25.36 	 $17.75 	 $6.04 	 $22.82 	 $22.06 	 $6.09 	 $19.40 	 $21.30 	 $21.30 	 $6.27 	 $22.82 	 $21.56 	 $17.50 	 $20.29 	 $6.09 	 $22.82 	 $20.62 	 $21.56 	 $6.04 	 $20.62 	 $6.09 
305007	"HCHG HYDROCOLLOID 4X4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6235	 $25.91 	 $18.14 	 $6.17 	 $23.32 	 $22.54 	 $6.22 	 $19.82 	 $21.76 	 $21.76 	 $6.40 	 $23.32 	 $22.02 	 $17.88 	 $20.73 	 $6.22 	 $23.32 	 $21.06 	 $22.02 	 $6.17 	 $21.06 	 $6.22 
305071	"HCHG DRESSING, SILVASORB GEL 0.25OZ"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6248	 $51.86 	 $36.30 	 $12.34 	 $46.67 	 $45.12 	 $12.45 	 $39.67 	 $43.56 	 $43.56 	 $12.82 	 $46.67 	 $44.08 	 $35.78 	 $41.49 	 $12.45 	 $46.67 	 $42.16 	 $44.08 	 $12.34 	 $42.16 	 $12.45 
305072	HCHG CASTELLANI PANT 1 OZ	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	305072	 $181.20 	 $126.84 	 $43.13 	 $163.08 	 $157.64 	 $43.49 	 $138.62 	 $152.21 	 $152.21 	 $44.79 	 $163.08 	 $154.02 	 $125.03 	 $144.96 	 $43.49 	 $163.08 	 $147.32 	 $154.02 	 $43.13 	 $147.32 	 $43.49 
306251	HCHG HYDROGEL SILVER 3 0Z.	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6248	 $39.98 	 $27.99 	 $9.52 	 $35.98 	 $34.78 	 $9.60 	 $30.58 	 $33.58 	 $33.58 	 $9.88 	 $35.98 	 $33.98 	 $27.59 	 $31.98 	 $9.60 	 $35.98 	 $32.50 	 $33.98 	 $9.52 	 $32.50 	 $9.60 
306604	HCHG DRSSNG ADH FM 5 5/8X5 5/8	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6212	 $23.05 	 $16.14 	 $5.49 	 $20.75 	 $20.05 	 $5.53 	 $17.63 	 $19.36 	 $19.36 	 $5.70 	 $20.75 	 $19.59 	 $15.90 	 $18.44 	 $5.53 	 $20.75 	 $18.74 	 $19.59 	 $5.49 	 $18.74 	 $5.53 
307008	"HCHG ACTICOAT FLEX-7  2"" X 2"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6206	 $44.28 	 $31.00 	 $10.54 	 $39.85 	 $38.52 	 $10.63 	 $33.87 	 $37.20 	 $37.20 	 $10.95 	 $39.85 	 $37.64 	 $30.55 	 $35.42 	 $10.63 	 $39.85 	 $36.00 	 $37.64 	 $10.54 	 $36.00 	 $10.63 
307009	"HCHG ACTICOAT FLEX-7  4"" X 5"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6206	 $120.92 	 $84.64 	 $28.78 	 $108.83 	 $105.20 	 $29.02 	 $92.50 	 $101.57 	 $101.57 	 $29.89 	 $108.83 	 $102.78 	 $83.43 	 $96.74 	 $29.02 	 $108.83 	 $98.31 	 $102.78 	 $28.78 	 $98.31 	 $29.02 
307010	"HCHG ADAPTIC  3"" X 16"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6222	 $4.60 	 $3.22 	 $1.09 	 $4.14 	 $4.00 	 $1.10 	 $3.52 	 $3.86 	 $3.86 	 $1.14 	 $4.14 	 $3.91 	 $3.17 	 $3.68 	 $1.10 	 $4.14 	 $3.74 	 $3.91 	 $1.09 	 $3.74 	 $1.10 
307011	"HCHG ALLEVYN LIFE  4"" X 4"" ADHESIVE"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6212	 $16.62 	 $11.63 	 $3.96 	 $14.96 	 $14.46 	 $3.99 	 $12.71 	 $13.96 	 $13.96 	 $4.11 	 $14.96 	 $14.13 	 $11.47 	 $13.30 	 $3.99 	 $14.96 	 $13.51 	 $14.13 	 $3.96 	 $13.51 	 $3.99 
307012	"HCHG ALLEVYN  2"" X 2"" ADHESIVE"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6209	 $15.11 	 $10.58 	 $3.60 	 $13.60 	 $13.15 	 $3.63 	 $11.56 	 $12.69 	 $12.69 	 $3.74 	 $13.60 	 $12.84 	 $10.43 	 $12.09 	 $3.63 	 $13.60 	 $12.28 	 $12.84 	 $3.60 	 $12.28 	 $3.63 
307013	"HCHG DURAFIBER AG 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6196	 $99.44 	 $69.61 	 $23.67 	 $89.50 	 $86.51 	 $23.87 	 $76.07 	 $83.53 	 $83.53 	 $24.58 	 $89.50 	 $84.52 	 $68.61 	 $79.55 	 $23.87 	 $89.50 	 $80.84 	 $84.52 	 $23.67 	 $80.84 	 $23.87 
307014	"HCHG KERLIX, STERILE LG, 4.5"" X 4.1"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6446	 $4.77 	 $3.34 	 $1.14 	 $4.29 	 $4.15 	 $1.14 	 $3.65 	 $4.01 	 $4.01 	 $1.18 	 $4.29 	 $4.05 	 $3.29 	 $3.82 	 $1.14 	 $4.29 	 $3.88 	 $4.05 	 $1.14 	 $3.88 	 $1.14 
307015	HCHG OPSITE FLEXIFIX FILM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6257	 $134.62 	 $94.23 	 $32.04 	 $121.16 	 $117.12 	 $32.31 	 $102.98 	 $113.08 	 $113.08 	 $32.31 	 $121.16 	 $114.43 	 $92.89 	 $107.70 	 $32.31 	 $121.16 	 $109.45 	 $114.43 	 $32.04 	 $109.45 	 $32.31 
307016	"HCHG REPLICARE SACRUM  7"" X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6235	 $71.69 	 $50.18 	 $17.06 	 $64.52 	 $62.37 	 $17.21 	 $54.84 	 $60.22 	 $60.22 	 $17.21 	 $64.52 	 $60.94 	 $49.47 	 $57.35 	 $17.21 	 $64.52 	 $58.28 	 $60.94 	 $17.06 	 $58.28 	 $17.21 
307017	"HCHG SILVERCEL 1"" X 12"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6196	 $56.75 	 $39.73 	 $13.51 	 $51.08 	 $49.37 	 $13.62 	 $43.41 	 $47.67 	 $47.67 	 $13.62 	 $51.08 	 $48.24 	 $39.16 	 $45.40 	 $13.62 	 $51.08 	 $46.14 	 $48.24 	 $13.51 	 $46.14 	 $13.62 
307018	HCHG PICC/CENTRAL LINE DRESSING CHANGE KIT	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A4649	 $30.94 	 $21.66 	 $7.36 	 $27.85 	 $26.92 	 $7.43 	 $23.67 	 $25.99 	 $25.99 	 $7.43 	 $27.85 	 $26.30 	 $21.35 	 $24.75 	 $7.43 	 $27.85 	 $25.15 	 $26.30 	 $7.36 	 $25.15 	 $7.43 
307020	"HCHG TELFA, ISLAND 2"" X 3-1/4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6219	 $0.62 	 $0.43 	 $0.15 	 $0.56 	 $0.54 	 $0.15 	 $0.47 	 $0.52 	 $0.52 	 $0.15 	 $0.56 	 $0.53 	 $0.43 	 $0.50 	 $0.15 	 $0.56 	 $0.50 	 $0.53 	 $0.15 	 $0.50 	 $0.15 
307021	"HCHG ABD PAD 8""X10"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6253	 $1.68 	 $1.18 	 $0.40 	 $1.51 	 $1.46 	 $0.40 	 $1.29 	 $1.41 	 $1.41 	 $0.42 	 $1.51 	 $1.43 	 $1.16 	 $1.34 	 $0.40 	 $1.51 	 $1.37 	 $1.43 	 $0.40 	 $1.37 	 $0.40 
307023	"HCHG KLING CONFORM 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6446	 $2.12 	 $1.48 	 $0.50 	 $1.91 	 $1.84 	 $0.51 	 $1.62 	 $1.78 	 $1.78 	 $0.52 	 $1.91 	 $1.80 	 $1.46 	 $1.70 	 $0.51 	 $1.91 	 $1.72 	 $1.80 	 $0.50 	 $1.72 	 $0.51 
307027	"HCHG 1/4"" PLAIN PACKING NUGAUZE"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6407	 $12.99 	 $9.09 	 $3.09 	 $11.69 	 $11.30 	 $3.12 	 $9.94 	 $10.91 	 $10.91 	 $3.21 	 $11.69 	 $11.04 	 $8.96 	 $10.39 	 $3.12 	 $11.69 	 $10.56 	 $11.04 	 $3.09 	 $10.56 	 $3.12 
307152	"HCHG 1/2"" PLAIN PACKING NUGAUZE"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6407	 $13.08 	 $9.16 	 $3.11 	 $11.77 	 $11.38 	 $3.14 	 $10.01 	 $10.99 	 $10.99 	 $3.23 	 $11.77 	 $11.12 	 $9.03 	 $10.46 	 $3.14 	 $11.77 	 $10.63 	 $11.12 	 $3.11 	 $10.63 	 $3.14 
307153	"HCHG 1/4"" IODOFORM PACKING"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6407	 $13.52 	 $9.46 	 $3.22 	 $12.17 	 $11.76 	 $3.24 	 $10.34 	 $11.36 	 $11.36 	 $3.34 	 $12.17 	 $11.49 	 $9.33 	 $10.82 	 $3.24 	 $12.17 	 $10.99 	 $11.49 	 $3.22 	 $10.99 	 $3.24 
307154	"HCHG 1/2"" IODOFORM PACKING"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6266	 $16.18 	 $11.33 	 $3.85 	 $14.56 	 $14.08 	 $3.88 	 $12.38 	 $13.59 	 $13.59 	 $4.00 	 $14.56 	 $13.75 	 $11.16 	 $12.94 	 $3.88 	 $14.56 	 $13.15 	 $13.75 	 $3.85 	 $13.15 	 $3.88 
307155	HCHG DEBRIDEMENT TRAY	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A4550	 $17.15 	 $12.01 	 $4.08 	 $15.44 	 $14.92 	 $4.12 	 $13.12 	 $14.41 	 $14.41 	 $4.24 	 $15.44 	 $14.58 	 $11.83 	 $13.72 	 $4.12 	 $15.44 	 $13.94 	 $14.58 	 $4.08 	 $13.94 	 $4.12 
307156	HCHG INTRASITE GEL FILLER 15GM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6261	 $21.48 	 $15.04 	 $5.11 	 $19.33 	 $18.69 	 $5.16 	 $16.43 	 $18.04 	 $18.04 	 $5.31 	 $19.33 	 $18.26 	 $14.82 	 $17.18 	 $5.16 	 $19.33 	 $17.46 	 $18.26 	 $5.11 	 $17.46 	 $5.16 
309151	HCHG CVMC SALINE FLUSH	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A4216	 $42.78 	 $29.95 	 $10.18 	 $38.50 	 $37.22 	 $10.27 	 $32.73 	 $35.94 	 $35.94 	 $10.58 	 $38.50 	 $36.36 	 $29.52 	 $34.22 	 $10.27 	 $38.50 	 $34.78 	 $36.36 	 $10.18 	 $34.78 	 $10.27 
309156	HCHG CVMC 3-WAY CATHETER	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A4355	 $26.09 	 $18.26 	 $6.21 	 $23.48 	 $22.70 	 $6.26 	 $19.96 	 $21.92 	 $21.92 	 $6.45 	 $23.48 	 $22.18 	 $18.00 	 $20.87 	 $6.26 	 $23.48 	 $21.21 	 $22.18 	 $6.21 	 $21.21 	 $6.26 
309158	"HCHG CVMC DRESSING ALGISITE 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6196	 $26.55 	 $18.59 	 $6.32 	 $23.90 	 $23.10 	 $6.37 	 $20.31 	 $22.30 	 $22.30 	 $6.56 	 $23.90 	 $22.57 	 $18.32 	 $21.24 	 $6.37 	 $23.90 	 $21.59 	 $22.57 	 $6.32 	 $21.59 	 $6.37 
309162	"HCHG CVMC DRESSING ALLEVYN 5"" X 5"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6214	 $35.11 	 $24.58 	 $8.36 	 $31.60 	 $30.55 	 $8.43 	 $26.86 	 $29.49 	 $29.49 	 $8.68 	 $31.60 	 $29.84 	 $24.23 	 $28.09 	 $8.43 	 $31.60 	 $28.54 	 $29.84 	 $8.36 	 $28.54 	 $8.43 
309163	"HCHG CVMC DRESSING ALLEVYN 7"" X 7"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6214	 $53.00 	 $37.10 	 $12.61 	 $47.70 	 $46.11 	 $12.72 	 $40.55 	 $44.52 	 $44.52 	 $13.10 	 $47.70 	 $45.05 	 $36.57 	 $42.40 	 $12.72 	 $47.70 	 $43.09 	 $45.05 	 $12.61 	 $43.09 	 $12.72 
309164	"HCHG CVMC DRESSING COVERSITE 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6219	 $4.77 	 $3.34 	 $1.14 	 $4.29 	 $4.15 	 $1.14 	 $3.65 	 $4.01 	 $4.01 	 $1.18 	 $4.29 	 $4.05 	 $3.29 	 $3.82 	 $1.14 	 $4.29 	 $3.88 	 $4.05 	 $1.14 	 $3.88 	 $1.14 
309165	"HCHG CVMC DRESSING COVERSITE 6"" X 6"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6219	 $8.91 	 $6.24 	 $2.12 	 $8.02 	 $7.75 	 $2.14 	 $6.82 	 $7.48 	 $7.48 	 $2.20 	 $8.02 	 $7.57 	 $6.15 	 $7.13 	 $2.14 	 $8.02 	 $7.24 	 $7.57 	 $2.12 	 $7.24 	 $2.14 
309167	"HCHG CVMC DRESSING REPLICARE 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6234	 $42.48 	 $29.74 	 $10.11 	 $38.23 	 $36.96 	 $10.20 	 $32.50 	 $35.68 	 $35.68 	 $10.50 	 $38.23 	 $36.11 	 $29.31 	 $33.98 	 $10.20 	 $38.23 	 $34.54 	 $36.11 	 $10.11 	 $34.54 	 $10.20 
309173	"HCHG CVMC DRESSING ACTICOAT 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A9270	 $62.93 	 $44.05 	 $14.98 	 $56.64 	 $54.75 	 $15.10 	 $48.14 	 $52.86 	 $52.86 	 $15.56 	 $56.64 	 $53.49 	 $43.42 	 $50.34 	 $15.10 	 $56.64 	 $51.16 	 $53.49 	 $14.98 	 $51.16 	 $15.10 
309621	HCHG CVMC SKIN STAPLES	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $226.68 	 $158.68 	 $53.95 	 $204.01 	 $197.21 	 $54.40 	 $173.41 	 $190.41 	 $190.41 	 $56.04 	 $204.01 	 $192.68 	 $156.41 	 $181.34 	 $54.40 	 $204.01 	 $184.29 	 $192.68 	 $53.95 	 $184.29 	 $54.40 
309622	HCHG CVMC IV SOLUSET	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $132.87 	 $93.01 	 $31.62 	 $119.58 	 $115.60 	 $31.89 	 $101.65 	 $111.61 	 $111.61 	 $32.85 	 $119.58 	 $112.94 	 $91.68 	 $106.30 	 $31.89 	 $119.58 	 $108.02 	 $112.94 	 $31.62 	 $108.02 	 $31.89 
309624	HCHG CVMC IRRIG .9 NACL 1000ML BOTTLE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $112.98 	 $79.09 	 $26.89 	 $101.68 	 $98.29 	 $27.12 	 $86.43 	 $94.90 	 $94.90 	 $27.93 	 $101.68 	 $96.03 	 $77.96 	 $90.38 	 $27.12 	 $101.68 	 $91.85 	 $96.03 	 $26.89 	 $91.85 	 $27.12 
309630	"HCHG CVMC SUTURE, ALL COMMON"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $54.78 	 $38.35 	 $13.04 	 $49.30 	 $47.66 	 $13.15 	 $41.91 	 $46.02 	 $46.02 	 $13.54 	 $49.30 	 $46.56 	 $37.80 	 $43.82 	 $13.15 	 $49.30 	 $44.54 	 $46.56 	 $13.04 	 $44.54 	 $13.15 
309631	"HCHG CVMC DRESS, LG BURN"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $179.53 	 $125.67 	 $42.73 	 $161.58 	 $156.19 	 $43.09 	 $137.34 	 $150.81 	 $150.81 	 $44.38 	 $161.58 	 $152.60 	 $123.88 	 $143.62 	 $43.09 	 $161.58 	 $145.96 	 $152.60 	 $42.73 	 $145.96 	 $43.09 
309632	HCHG CVMC DRESS MED BURN	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $134.72 	 $94.30 	 $32.06 	 $121.25 	 $117.21 	 $32.33 	 $103.06 	 $113.16 	 $113.16 	 $33.30 	 $121.25 	 $114.51 	 $92.96 	 $107.78 	 $32.33 	 $121.25 	 $109.53 	 $114.51 	 $32.06 	 $109.53 	 $32.33 
309633	"HCHG CVMC DRESS, SM BURN"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $89.88 	 $62.92 	 $21.39 	 $80.89 	 $78.20 	 $21.57 	 $68.76 	 $75.50 	 $75.50 	 $22.22 	 $80.89 	 $76.40 	 $62.02 	 $71.90 	 $21.57 	 $80.89 	 $73.07 	 $76.40 	 $21.39 	 $73.07 	 $21.57 
309634	HCHG CVMC TRACH DISP INNER CANNULA	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $179.53 	 $125.67 	 $42.73 	 $161.58 	 $156.19 	 $43.09 	 $137.34 	 $150.81 	 $150.81 	 $44.38 	 $161.58 	 $152.60 	 $123.88 	 $143.62 	 $43.09 	 $161.58 	 $145.96 	 $152.60 	 $42.73 	 $145.96 	 $43.09 
309635	HCHG CVMC TEGADERM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6257	 $12.71 	 $8.90 	 $3.02 	 $11.44 	 $11.06 	 $3.05 	 $9.72 	 $10.68 	 $10.68 	 $3.14 	 $11.44 	 $10.80 	 $8.77 	 $10.17 	 $3.05 	 $11.44 	 $10.33 	 $10.80 	 $3.02 	 $10.33 	 $3.05 
309636	HCHG CVMC TEGADERM LG	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6258	 $15.96 	 $11.17 	 $3.80 	 $14.36 	 $13.89 	 $3.83 	 $12.21 	 $13.41 	 $13.41 	 $3.95 	 $14.36 	 $13.57 	 $11.01 	 $12.77 	 $3.83 	 $14.36 	 $12.98 	 $13.57 	 $3.80 	 $12.98 	 $3.83 
309638	HCHG CVMC COVRSITE PLUS 4X4	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $18.03 	 $12.62 	 $4.29 	 $16.23 	 $15.69 	 $4.33 	 $13.79 	 $15.15 	 $15.15 	 $4.46 	 $16.23 	 $15.33 	 $12.44 	 $14.42 	 $4.33 	 $16.23 	 $14.66 	 $15.33 	 $4.29 	 $14.66 	 $4.33 
309639	HCHG CVMC COVRSITE 6X6	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $29.59 	 $20.71 	 $7.04 	 $26.63 	 $25.74 	 $7.10 	 $22.64 	 $24.86 	 $24.86 	 $7.31 	 $26.63 	 $25.15 	 $20.42 	 $23.67 	 $7.10 	 $26.63 	 $24.06 	 $25.15 	 $7.04 	 $24.06 	 $7.10 
309673	HCHG CVMC DRESSING BIOPATCH ANTIMICROBIAL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $68.53 	 $47.97 	 $16.31 	 $61.68 	 $59.62 	 $16.45 	 $52.43 	 $57.57 	 $57.57 	 $16.94 	 $61.68 	 $58.25 	 $47.29 	 $54.82 	 $16.45 	 $61.68 	 $55.71 	 $58.25 	 $16.31 	 $55.71 	 $16.45 
309674	"HCHG CVMC DRESSING SOFT CLOTH 3""X10"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $7.47 	 $5.23 	 $1.78 	 $6.72 	 $6.50 	 $1.79 	 $5.71 	 $6.27 	 $6.27 	 $1.85 	 $6.72 	 $6.35 	 $5.15 	 $5.98 	 $1.79 	 $6.72 	 $6.07 	 $6.35 	 $1.78 	 $6.07 	 $1.79 
309675	"HCHG CVMC DRESSING UNNA BOOT 4""X10'"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $62.16 	 $43.51 	 $14.79 	 $55.94 	 $54.08 	 $14.92 	 $47.55 	 $52.21 	 $52.21 	 $15.37 	 $55.94 	 $52.84 	 $42.89 	 $49.73 	 $14.92 	 $55.94 	 $50.54 	 $52.84 	 $14.79 	 $50.54 	 $14.92 
309676	"HCHG CVMC DRESSING XEROFORM 1"" X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $3.45 	 $2.42 	 $0.82 	 $3.11 	 $3.00 	 $0.83 	 $2.64 	 $2.90 	 $2.90 	 $0.85 	 $3.11 	 $2.93 	 $2.38 	 $2.76 	 $0.83 	 $3.11 	 $2.80 	 $2.93 	 $0.82 	 $2.80 	 $0.83 
309677	"HCHG CVMC DRESSING XEROFORM 5"" X 9"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $3.89 	 $2.72 	 $0.93 	 $3.50 	 $3.38 	 $0.93 	 $2.98 	 $3.27 	 $3.27 	 $0.96 	 $3.50 	 $3.31 	 $2.68 	 $3.11 	 $0.93 	 $3.50 	 $3.16 	 $3.31 	 $0.93 	 $3.16 	 $0.93 
309678	"HCHG CVMC DRESSING, COBAN 2 COMPRESSION"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $95.68 	 $66.98 	 $22.77 	 $86.11 	 $83.24 	 $22.96 	 $73.20 	 $80.37 	 $80.37 	 $23.65 	 $86.11 	 $81.33 	 $66.02 	 $76.54 	 $22.96 	 $86.11 	 $77.79 	 $81.33 	 $22.77 	 $77.79 	 $22.96 
309679	"HCHG CVMC GAUZE VASELINE 1/2"" X 72"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $7.87 	 $5.51 	 $1.87 	 $7.08 	 $6.85 	 $1.89 	 $6.02 	 $6.61 	 $6.61 	 $1.95 	 $7.08 	 $6.69 	 $5.43 	 $6.30 	 $1.89 	 $7.08 	 $6.40 	 $6.69 	 $1.87 	 $6.40 	 $1.89 
309680	"HCHG CVMC GAUZE VASELINE 3"" X 9"" OVERWRP"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $12.91 	 $9.04 	 $3.07 	 $11.62 	 $11.23 	 $3.10 	 $9.88 	 $10.84 	 $10.84 	 $3.19 	 $11.62 	 $10.97 	 $8.91 	 $10.33 	 $3.10 	 $11.62 	 $10.50 	 $10.97 	 $3.07 	 $10.50 	 $3.10 
309681	HCHG CVMC IRRIG .9% NACL 250ML BOTTLE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $29.21 	 $20.45 	 $6.95 	 $26.29 	 $25.41 	 $7.01 	 $22.35 	 $24.54 	 $24.54 	 $7.22 	 $26.29 	 $24.83 	 $20.15 	 $23.37 	 $7.01 	 $26.29 	 $23.75 	 $24.83 	 $6.95 	 $23.75 	 $7.01 
309682	HCHG CVMC IRRIG .9% NACL 500ML BOTTLE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $38.23 	 $26.76 	 $9.10 	 $34.41 	 $33.26 	 $9.18 	 $29.25 	 $32.11 	 $32.11 	 $9.45 	 $34.41 	 $32.50 	 $26.38 	 $30.58 	 $9.18 	 $34.41 	 $31.08 	 $32.50 	 $9.10 	 $31.08 	 $9.18 
309683	HCHG CVMC IRRIG WATER STERILE 1000ML	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $38.73 	 $27.11 	 $9.22 	 $34.86 	 $33.70 	 $9.30 	 $29.63 	 $32.53 	 $32.53 	 $9.57 	 $34.86 	 $32.92 	 $26.72 	 $30.98 	 $9.30 	 $34.86 	 $31.49 	 $32.92 	 $9.22 	 $31.49 	 $9.30 
309684	HCHG CVMC IRRIG WATER STERILE 2000ML	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $43.75 	 $30.63 	 $10.41 	 $39.38 	 $38.06 	 $10.50 	 $33.47 	 $36.75 	 $36.75 	 $10.82 	 $39.38 	 $37.19 	 $30.19 	 $35.00 	 $10.50 	 $39.38 	 $35.57 	 $37.19 	 $10.41 	 $35.57 	 $10.50 
309685	HCHG CVMC IRRIG WATER STERILE 500ML	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $30.25 	 $21.18 	 $7.20 	 $27.23 	 $26.32 	 $7.26 	 $23.14 	 $25.41 	 $25.41 	 $7.48 	 $27.23 	 $25.71 	 $20.87 	 $24.20 	 $7.26 	 $27.23 	 $24.59 	 $25.71 	 $7.20 	 $24.59 	 $7.26 
309690	HCHG CVMC SILVASORB GEL 1.5 OZ. TUBE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $127.28 	 $89.10 	 $30.29 	 $114.55 	 $110.73 	 $30.55 	 $97.37 	 $106.92 	 $106.92 	 $31.46 	 $114.55 	 $108.19 	 $87.82 	 $101.82 	 $30.55 	 $114.55 	 $103.48 	 $108.19 	 $30.29 	 $103.48 	 $30.55 
309692	HCHG CVMC WATER 10ML FOR INJ/STERIL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $2.21 	 $1.55 	 $0.53 	 $1.99 	 $1.92 	 $0.53 	 $1.69 	 $1.86 	 $1.86 	 $0.55 	 $1.99 	 $1.88 	 $1.52 	 $1.77 	 $0.53 	 $1.99 	 $1.80 	 $1.88 	 $0.53 	 $1.80 	 $0.53 
310040	HCHG CVMC SILVASORB GEL 1.5 OZ. TUBE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $127.28 	 $89.10 	 $30.29 	 $114.55 	 $110.73 	 $30.55 	 $97.37 	 $106.92 	 $106.92 	 $31.46 	 $114.55 	 $108.19 	 $87.82 	 $101.82 	 $30.55 	 $114.55 	 $103.48 	 $108.19 	 $30.29 	 $103.48 	 $30.55 
310041	"HCHG CVMC GAUZE VASELINE 3"" X 9"" OVERWRP"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $12.91 	 $9.04 	 $3.07 	 $11.62 	 $11.23 	 $3.10 	 $9.88 	 $10.84 	 $10.84 	 $3.19 	 $11.62 	 $10.97 	 $8.91 	 $10.33 	 $3.10 	 $11.62 	 $10.50 	 $10.97 	 $3.07 	 $10.50 	 $3.10 
310042	"HCHG CVMC GAUZE VASELINE 1/2"" X 72"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $6.05 	 $4.24 	 $1.44 	 $5.45 	 $5.26 	 $1.45 	 $4.63 	 $5.08 	 $5.08 	 $1.50 	 $5.45 	 $5.14 	 $4.17 	 $4.84 	 $1.45 	 $5.45 	 $4.92 	 $5.14 	 $1.44 	 $4.92 	 $1.45 
310043	"HCHG CVMC DRESSING XEROFORM 1"" X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $3.45 	 $2.42 	 $0.82 	 $3.11 	 $3.00 	 $0.83 	 $2.64 	 $2.90 	 $2.90 	 $0.85 	 $3.11 	 $2.93 	 $2.38 	 $2.76 	 $0.83 	 $3.11 	 $2.80 	 $2.93 	 $0.82 	 $2.80 	 $0.83 
310044	"HCHG CVMC DRESSING XEROFORM 5"" X 9"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $2.99 	 $2.09 	 $0.71 	 $2.69 	 $2.60 	 $0.72 	 $2.29 	 $2.51 	 $2.51 	 $0.74 	 $2.69 	 $2.54 	 $2.06 	 $2.39 	 $0.72 	 $2.69 	 $2.43 	 $2.54 	 $0.71 	 $2.43 	 $0.72 
310045	HCHG CVMC WATER 10ML FOR INJ/STERIL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $35.43 	 $24.80 	 $8.43 	 $31.89 	 $30.82 	 $8.50 	 $27.10 	 $29.76 	 $29.76 	 $8.76 	 $31.89 	 $30.12 	 $24.45 	 $28.34 	 $8.50 	 $31.89 	 $28.80 	 $30.12 	 $8.43 	 $28.80 	 $8.50 
310060	HCHG CVMC IRRIG WATER STERILE 500ML	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $36.92 	 $25.84 	 $8.79 	 $33.23 	 $32.12 	 $8.86 	 $28.24 	 $31.01 	 $31.01 	 $9.13 	 $33.23 	 $31.38 	 $25.47 	 $29.54 	 $8.86 	 $33.23 	 $30.02 	 $31.38 	 $8.79 	 $30.02 	 $8.86 
310061	HCHG CVMC IRRIG WATER STERILE 1000ML	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $50.35 	 $35.25 	 $11.98 	 $45.32 	 $43.80 	 $12.08 	 $38.52 	 $42.29 	 $42.29 	 $12.45 	 $45.32 	 $42.80 	 $34.74 	 $40.28 	 $12.08 	 $45.32 	 $40.93 	 $42.80 	 $11.98 	 $40.93 	 $12.08 
310062	HCHG CVMC IRRIG WATER STERILE 2000ML	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $43.75 	 $30.63 	 $10.41 	 $39.38 	 $38.06 	 $10.50 	 $33.47 	 $36.75 	 $36.75 	 $10.82 	 $39.38 	 $37.19 	 $30.19 	 $35.00 	 $10.50 	 $39.38 	 $35.57 	 $37.19 	 $10.41 	 $35.57 	 $10.50 
310066	HCHG CVMC IRRIG .9% NACL 250ML BOTTLE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $22.57 	 $15.80 	 $5.37 	 $20.31 	 $19.64 	 $5.42 	 $17.27 	 $18.96 	 $18.96 	 $5.58 	 $20.31 	 $19.18 	 $15.57 	 $18.06 	 $5.42 	 $20.31 	 $18.35 	 $19.18 	 $5.37 	 $18.35 	 $5.42 
310067	HCHG CVMC IRRIG .9% NACL 500ML BOTTLE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $49.70 	 $34.79 	 $11.83 	 $44.73 	 $43.24 	 $11.93 	 $38.02 	 $41.75 	 $41.75 	 $12.29 	 $44.73 	 $42.25 	 $34.29 	 $39.76 	 $11.93 	 $44.73 	 $40.41 	 $42.25 	 $11.83 	 $40.41 	 $11.93 
310068	HCHG CVMC IRRIG .9% NACL 1000ML BOTTLE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $50.35 	 $35.25 	 $11.98 	 $45.32 	 $43.80 	 $12.08 	 $38.52 	 $42.29 	 $42.29 	 $12.45 	 $45.32 	 $42.80 	 $34.74 	 $40.28 	 $12.08 	 $45.32 	 $40.93 	 $42.80 	 $11.98 	 $40.93 	 $12.08 
310079	"HCHG CVMC DRESSING, UNNA BOOT 4""X10'"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $62.16 	 $43.51 	 $14.79 	 $55.94 	 $54.08 	 $14.92 	 $47.55 	 $52.21 	 $52.21 	 $15.37 	 $55.94 	 $52.84 	 $42.89 	 $49.73 	 $14.92 	 $55.94 	 $50.54 	 $52.84 	 $14.79 	 $50.54 	 $14.92 
310080	"HCHG CVMC DRESSING, COBAN 2 COMPRESSION"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $95.68 	 $66.98 	 $22.77 	 $86.11 	 $83.24 	 $22.96 	 $73.20 	 $80.37 	 $80.37 	 $23.65 	 $86.11 	 $81.33 	 $66.02 	 $76.54 	 $22.96 	 $86.11 	 $77.79 	 $81.33 	 $22.77 	 $77.79 	 $22.96 
310081	"HCHG CVMC DRESSING, SOFT CLOTH 3""X10"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $7.47 	 $5.23 	 $1.78 	 $6.72 	 $6.50 	 $1.79 	 $5.71 	 $6.27 	 $6.27 	 $1.85 	 $6.72 	 $6.35 	 $5.15 	 $5.98 	 $1.79 	 $6.72 	 $6.07 	 $6.35 	 $1.78 	 $6.07 	 $1.79 
310082	HCHG CVMC DRESSING BIOPATCH ANTIMICROBIAL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $68.53 	 $47.97 	 $16.31 	 $61.68 	 $59.62 	 $16.45 	 $52.43 	 $57.57 	 $57.57 	 $16.94 	 $61.68 	 $58.25 	 $47.29 	 $54.82 	 $16.45 	 $61.68 	 $55.71 	 $58.25 	 $16.31 	 $55.71 	 $16.45 
338925	"HCHG CVMC DRESSING, ALLEVYN 3"" X 3"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6212	 $19.36 	 $13.55 	 $4.61 	 $17.42 	 $16.84 	 $4.65 	 $14.81 	 $16.26 	 $16.26 	 $4.79 	 $17.42 	 $16.46 	 $13.36 	 $15.49 	 $4.65 	 $17.42 	 $15.74 	 $16.46 	 $4.61 	 $15.74 	 $4.65 
338926	"HCHG CVMC DRESSING, ALLEVYN 5"" X 5"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6213	 $25.63 	 $17.94 	 $6.10 	 $23.07 	 $22.30 	 $6.15 	 $19.61 	 $21.53 	 $21.53 	 $6.34 	 $23.07 	 $21.79 	 $17.68 	 $20.50 	 $6.15 	 $23.07 	 $20.84 	 $21.79 	 $6.10 	 $20.84 	 $6.15 
338927	"HCHG CVMC DRESSING, ALLEVYN 6"" X 6"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6213	 $59.13 	 $41.39 	 $14.07 	 $53.22 	 $51.44 	 $14.19 	 $45.23 	 $49.67 	 $49.67 	 $14.62 	 $53.22 	 $50.26 	 $40.80 	 $47.30 	 $14.19 	 $53.22 	 $48.07 	 $50.26 	 $14.07 	 $48.07 	 $14.19 
338928	"HCHG CVMC DRESSING,ALLEVYN SACRUM 6""X6"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6213	 $53.03 	 $37.12 	 $12.62 	 $47.73 	 $46.14 	 $12.73 	 $40.57 	 $44.55 	 $44.55 	 $13.11 	 $47.73 	 $45.08 	 $36.59 	 $42.42 	 $12.73 	 $47.73 	 $43.11 	 $45.08 	 $12.62 	 $43.11 	 $12.73 
338929	"HCHG CVMC DRESSING, REPLICARE 3.5""X5.5"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6235	 $22.19 	 $15.53 	 $5.28 	 $19.97 	 $19.31 	 $5.33 	 $16.98 	 $18.64 	 $18.64 	 $5.49 	 $19.97 	 $18.86 	 $15.31 	 $17.75 	 $5.33 	 $19.97 	 $18.04 	 $18.86 	 $5.28 	 $18.04 	 $5.33 
338930	"HCHG CVMC DRESSING, REPLICARE 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6234	 $34.38 	 $24.07 	 $8.18 	 $30.94 	 $29.91 	 $8.25 	 $26.30 	 $28.88 	 $28.88 	 $8.50 	 $30.94 	 $29.22 	 $23.72 	 $27.50 	 $8.25 	 $30.94 	 $27.95 	 $29.22 	 $8.18 	 $27.95 	 $8.25 
338931	"HCHG CVMC DRESSING, ALGISITE 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6196	 $25.46 	 $17.82 	 $6.06 	 $22.91 	 $22.15 	 $6.11 	 $19.48 	 $21.39 	 $21.39 	 $6.29 	 $22.91 	 $21.64 	 $17.57 	 $20.37 	 $6.11 	 $22.91 	 $20.70 	 $21.64 	 $6.06 	 $20.70 	 $6.11 
338932	"HCHG CVMC DRESSING, ALGISITE PER 6 INCHES"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6199	 $14.41 	 $10.09 	 $3.43 	 $12.97 	 $12.54 	 $3.46 	 $11.02 	 $12.10 	 $12.10 	 $3.56 	 $12.97 	 $12.25 	 $9.94 	 $11.53 	 $3.46 	 $12.97 	 $11.72 	 $12.25 	 $3.43 	 $11.72 	 $3.46 
338933	"HCHG CVMC DRESSING, COVRSITE 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6220	 $4.77 	 $3.34 	 $1.14 	 $4.29 	 $4.15 	 $1.14 	 $3.65 	 $4.01 	 $4.01 	 $1.18 	 $4.29 	 $4.05 	 $3.29 	 $3.82 	 $1.14 	 $4.29 	 $3.88 	 $4.05 	 $1.14 	 $3.88 	 $1.14 
338934	"HCHG CVMC DRESSING, COVRSITE 6"" X 6"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6219	 $8.66 	 $6.06 	 $2.06 	 $7.79 	 $7.53 	 $2.08 	 $6.62 	 $7.27 	 $7.27 	 $2.14 	 $7.79 	 $7.36 	 $5.98 	 $6.93 	 $2.08 	 $7.79 	 $7.04 	 $7.36 	 $2.06 	 $7.04 	 $2.08 
338935	"HCHG CVMC DRESSING, FLEXIGEL STRANDS PER GRAM"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6262	 $11.43 	 $8.00 	 $2.72 	 $10.29 	 $9.94 	 $2.74 	 $8.74 	 $9.60 	 $9.60 	 $2.83 	 $10.29 	 $9.72 	 $7.89 	 $9.14 	 $2.74 	 $10.29 	 $9.29 	 $9.72 	 $2.72 	 $9.29 	 $2.74 
338936	"HCHG CVMC DRESSING, SOLOSITE GEL PER OZ"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6248	 $15.03 	 $10.52 	 $3.58 	 $13.53 	 $13.08 	 $3.61 	 $11.50 	 $12.63 	 $12.63 	 $3.72 	 $13.53 	 $12.78 	 $10.37 	 $12.02 	 $3.61 	 $13.53 	 $12.22 	 $12.78 	 $3.58 	 $12.22 	 $3.61 
338937	"HCHG CVMC DRESSING, FLEXIGEL SHEET, 2"" X 2"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6242	 $17.32 	 $12.12 	 $4.12 	 $15.59 	 $15.07 	 $4.16 	 $13.25 	 $14.55 	 $14.55 	 $4.28 	 $15.59 	 $14.72 	 $11.95 	 $13.86 	 $4.16 	 $15.59 	 $14.08 	 $14.72 	 $4.12 	 $14.08 	 $4.16 
338938	"HCHG CVMC DRESSING, FLEXIGEL SHEET,4""X4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6242	 $23.69 	 $16.58 	 $5.64 	 $21.32 	 $20.61 	 $5.69 	 $18.12 	 $19.90 	 $19.90 	 $5.86 	 $21.32 	 $20.14 	 $16.35 	 $18.95 	 $5.69 	 $21.32 	 $19.26 	 $20.14 	 $5.64 	 $19.26 	 $5.69 
338939	"HCHG CVMC DRESSING, TEGADERM 4"" X 4.75"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6258	 $5.57 	 $3.90 	 $1.33 	 $5.01 	 $4.85 	 $1.34 	 $4.26 	 $4.68 	 $4.68 	 $1.38 	 $5.01 	 $4.73 	 $3.84 	 $4.46 	 $1.34 	 $5.01 	 $4.53 	 $4.73 	 $1.33 	 $4.53 	 $1.34 
338940	"HCHG CVMC DRESSING, TEGADERM 4"" X 10"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6258	 $13.26 	 $9.28 	 $3.16 	 $11.93 	 $11.54 	 $3.18 	 $10.14 	 $11.14 	 $11.14 	 $3.28 	 $11.93 	 $11.27 	 $9.15 	 $10.61 	 $3.18 	 $11.93 	 $10.78 	 $11.27 	 $3.16 	 $10.78 	 $3.18 
338941	"HCHG CVMC DRESSING, TEGADERM 6"" X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6258	 $11.23 	 $7.86 	 $2.67 	 $10.11 	 $9.77 	 $2.70 	 $8.59 	 $9.43 	 $9.43 	 $2.78 	 $10.11 	 $9.55 	 $7.75 	 $8.98 	 $2.70 	 $10.11 	 $9.13 	 $9.55 	 $2.67 	 $9.13 	 $2.70 
338942	"HCHG CVMC DRESSING,TEGADERM 2.375"" X 2.75"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6257	 $1.86 	 $1.30 	 $0.44 	 $1.67 	 $1.62 	 $0.45 	 $1.42 	 $1.56 	 $1.56 	 $0.46 	 $1.67 	 $1.58 	 $1.28 	 $1.49 	 $0.45 	 $1.67 	 $1.51 	 $1.58 	 $0.44 	 $1.51 	 $0.45 
338943	"HCHG CVMC DRESSING, TEGADERM ABS,4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6203	 $39.95 	 $27.97 	 $9.51 	 $35.96 	 $34.76 	 $9.59 	 $30.56 	 $33.56 	 $33.56 	 $9.88 	 $35.96 	 $33.96 	 $27.57 	 $31.96 	 $9.59 	 $35.96 	 $32.48 	 $33.96 	 $9.51 	 $32.48 	 $9.59 
338944	"HCHG CVMC DRESSING, 3M SOFT CLOTH ADH 3""X10"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6220	 $7.87 	 $5.51 	 $1.87 	 $7.08 	 $6.85 	 $1.89 	 $6.02 	 $6.61 	 $6.61 	 $1.95 	 $7.08 	 $6.69 	 $5.43 	 $6.30 	 $1.89 	 $7.08 	 $6.40 	 $6.69 	 $1.87 	 $6.40 	 $1.89 
338945	"HCHG CVMC DRESSING, SILVASORB GEL 1.5OZ"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6248	 $133.74 	 $93.62 	 $31.83 	 $120.37 	 $116.35 	 $32.10 	 $102.31 	 $112.34 	 $112.34 	 $33.06 	 $120.37 	 $113.68 	 $92.28 	 $106.99 	 $32.10 	 $120.37 	 $108.73 	 $113.68 	 $31.83 	 $108.73 	 $32.10 
338946	"HCHG CVMC DRESSING,PETROLEUM GAUZE 1""X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6222	 $3.89 	 $2.72 	 $0.93 	 $3.50 	 $3.38 	 $0.93 	 $2.98 	 $3.27 	 $3.27 	 $0.96 	 $3.50 	 $3.31 	 $2.68 	 $3.11 	 $0.93 	 $3.50 	 $3.16 	 $3.31 	 $0.93 	 $3.16 	 $0.93 
338947	"HCHG CVMC DRESSING,PETROLEUM GAUZE 3""X 18"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6224	 $5.04 	 $3.53 	 $1.20 	 $4.54 	 $4.38 	 $1.21 	 $3.86 	 $4.23 	 $4.23 	 $1.25 	 $4.54 	 $4.28 	 $3.48 	 $4.03 	 $1.21 	 $4.54 	 $4.10 	 $4.28 	 $1.20 	 $4.10 	 $1.21 
338948	"HCHG CVMC DRESSING, VASELINE 3"" X 9"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6223	 $6.01 	 $4.21 	 $1.43 	 $5.41 	 $5.23 	 $1.44 	 $4.60 	 $5.05 	 $5.05 	 $1.49 	 $5.41 	 $5.11 	 $4.15 	 $4.81 	 $1.44 	 $5.41 	 $4.89 	 $5.11 	 $1.43 	 $4.89 	 $1.44 
338949	"HCHG CVMC DRESSING, VASELINE .5"" X 72"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6223	 $11.58 	 $8.11 	 $2.76 	 $10.42 	 $10.07 	 $2.78 	 $8.86 	 $9.73 	 $9.73 	 $2.86 	 $10.42 	 $9.84 	 $7.99 	 $9.26 	 $2.78 	 $10.42 	 $9.41 	 $9.84 	 $2.76 	 $9.41 	 $2.78 
338950	"HCHG CVMC DRESSING, XEROFORM 1"" X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6222	 $3.36 	 $2.35 	 $0.80 	 $3.02 	 $2.92 	 $0.81 	 $2.57 	 $2.82 	 $2.82 	 $0.83 	 $3.02 	 $2.86 	 $2.32 	 $2.69 	 $0.81 	 $3.02 	 $2.73 	 $2.86 	 $0.80 	 $2.73 	 $0.81 
338951	"HCHG CVMC DRESSING, XEROFORM 5"" X 9"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6223	 $3.80 	 $2.66 	 $0.90 	 $3.42 	 $3.31 	 $0.91 	 $2.91 	 $3.19 	 $3.19 	 $0.94 	 $3.42 	 $3.23 	 $2.62 	 $3.04 	 $0.91 	 $3.42 	 $3.09 	 $3.23 	 $0.90 	 $3.09 	 $0.91 
338952	"HCHG CVMC DRESSING,MAXORB AG SILVER ALGINATE"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6196	 $32.53 	 $22.77 	 $7.74 	 $29.28 	 $28.30 	 $7.81 	 $24.89 	 $27.33 	 $27.33 	 $8.04 	 $29.28 	 $27.65 	 $22.45 	 $26.02 	 $7.81 	 $29.28 	 $26.45 	 $27.65 	 $7.74 	 $26.45 	 $7.81 
338953	"HCHG CVMC DRESSING, SILVASORB STRANDS, 1GM"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6262	 $17.25 	 $12.08 	 $4.11 	 $15.53 	 $15.01 	 $4.14 	 $13.20 	 $14.49 	 $14.49 	 $4.26 	 $15.53 	 $14.66 	 $11.90 	 $13.80 	 $4.14 	 $15.53 	 $14.02 	 $14.66 	 $4.11 	 $14.02 	 $4.14 
338954	"HCHG CVMC DRESSING,SILVASORB SHEET,4""X4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6242	 $81.58 	 $57.11 	 $19.42 	 $73.42 	 $70.97 	 $19.58 	 $62.41 	 $68.53 	 $68.53 	 $20.17 	 $73.42 	 $69.34 	 $56.29 	 $65.26 	 $19.58 	 $73.42 	 $66.32 	 $69.34 	 $19.42 	 $66.32 	 $19.58 
338955	"HCHG CVMC DRESSING ACTICOAT 4"" X 4"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $59.40 	 $41.58 	 $14.14 	 $53.46 	 $51.68 	 $14.26 	 $45.44 	 $49.90 	 $49.90 	 $14.68 	 $53.46 	 $50.49 	 $40.99 	 $47.52 	 $14.26 	 $53.46 	 $48.29 	 $50.49 	 $14.14 	 $48.29 	 $14.26 
338956	"HCHG CVMC DRESSING,MEPIFORM,SOFT SILICONE 2X3"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A4649	 $44.28 	 $31.00 	 $10.54 	 $39.85 	 $38.52 	 $10.63 	 $33.87 	 $37.20 	 $37.20 	 $10.95 	 $39.85 	 $37.64 	 $30.55 	 $35.42 	 $10.63 	 $39.85 	 $36.00 	 $37.64 	 $10.54 	 $36.00 	 $10.63 
338957	"HCHG CVMC DRESSING,BIOPATCH DISK 2.5CM"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6209	 $53.65 	 $37.56 	 $12.77 	 $48.29 	 $46.68 	 $12.88 	 $41.04 	 $45.07 	 $45.07 	 $13.26 	 $48.29 	 $45.60 	 $37.02 	 $42.92 	 $12.88 	 $48.29 	 $43.62 	 $45.60 	 $12.77 	 $43.62 	 $12.88 
338959	"HCHG DRESSING,HYDROFERA BLUE 4X4"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6209	 $63.40 	 $44.38 	 $15.09 	 $57.06 	 $55.16 	 $15.22 	 $48.50 	 $53.26 	 $53.26 	 $15.67 	 $57.06 	 $53.89 	 $43.75 	 $50.72 	 $15.22 	 $57.06 	 $51.54 	 $53.89 	 $15.09 	 $51.54 	 $15.22 
342750	HCHG CVMC BIOSTEP 2X2 SHEET	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6021	 $69.03 	 $48.32 	 $16.43 	 $62.13 	 $60.06 	 $16.57 	 $52.81 	 $57.99 	 $57.99 	 $17.06 	 $62.13 	 $58.68 	 $47.63 	 $55.22 	 $16.57 	 $62.13 	 $56.12 	 $58.68 	 $16.43 	 $56.12 	 $16.57 
342751	HCHG CVMC ABDOMINAL BINDER	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $79.55 	 $55.69 	 $18.93 	 $71.60 	 $69.21 	 $19.09 	 $60.86 	 $66.82 	 $66.82 	 $19.66 	 $71.60 	 $67.62 	 $54.89 	 $63.64 	 $19.09 	 $71.60 	 $64.67 	 $67.62 	 $18.93 	 $64.67 	 $19.09 
342753	HCHG CVMC COMPRESSION STOCKING-THIGH HIGH	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $47.02 	 $32.91 	 $11.19 	 $42.32 	 $40.91 	 $11.28 	 $35.97 	 $39.50 	 $39.50 	 $11.62 	 $42.32 	 $39.97 	 $32.44 	 $37.62 	 $11.28 	 $42.32 	 $38.23 	 $39.97 	 $11.19 	 $38.23 	 $11.28 
343007	HCHG DRESSING POWDER ARGLAES PER GM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6262	 $102.09 	 $71.46 	 $24.30 	 $91.88 	 $88.82 	 $24.50 	 $78.10 	 $85.76 	 $85.76 	 $25.24 	 $91.88 	 $86.78 	 $70.44 	 $81.67 	 $24.50 	 $91.88 	 $83.00 	 $86.78 	 $24.30 	 $83.00 	 $24.50 
343752	HCHG CVMC COMPRESSION STOCKING-KNEE HIGH	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $22.54 	 $15.78 	 $5.36 	 $20.29 	 $19.61 	 $5.41 	 $17.24 	 $18.93 	 $18.93 	 $5.57 	 $20.29 	 $19.16 	 $15.55 	 $18.03 	 $5.41 	 $20.29 	 $18.33 	 $19.16 	 $5.36 	 $18.33 	 $5.41 
360830	HCHG ADAPTIC TOUCH NON-ADHERING SILICONE DRESSING 3X4 1/4	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6206	 $18.21 	 $12.75 	 $4.33 	 $16.39 	 $15.84 	 $4.37 	 $13.93 	 $15.30 	 $15.30 	 $4.50 	 $16.39 	 $15.48 	 $12.56 	 $14.57 	 $4.37 	 $16.39 	 $14.80 	 $15.48 	 $4.33 	 $14.80 	 $4.37 
4410296	"HCHG STENT, SHEATH INTRO"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1894	 $223.86 	 $156.70 	 $53.28 	 $201.47 	 $194.76 	 $53.73 	 $171.25 	 $188.04 	 $188.04 	 $53.73 	 $201.47 	 $190.28 	 $154.46 	 $179.09 	 $53.73 	 $201.47 	 $182.00 	 $190.28 	 $53.28 	 $182.00 	 $53.73 
4410475	"HCHG CATH, COMPLIANT OCCL BALLOON"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C2628	 $588.13 	 $411.69 	 $139.97 	 $529.32 	 $511.67 	 $141.15 	 $449.92 	 $494.03 	 $494.03 	 $145.39 	 $529.32 	 $499.91 	 $405.81 	 $470.50 	 $141.15 	 $529.32 	 $478.15 	 $499.91 	 $139.97 	 $478.15 	 $141.15 
4410477	"HCHG GUIDE WIRE, HYDROPHILIC HYBRID"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1769	 $276.78 	 $193.75 	 $65.87 	 $249.10 	 $240.80 	 $66.43 	 $211.74 	 $232.50 	 $232.50 	 $68.42 	 $249.10 	 $235.26 	 $190.98 	 $221.42 	 $66.43 	 $249.10 	 $225.02 	 $235.26 	 $65.87 	 $225.02 	 $66.43 
4410479	"HCHG CATH, MICROCATHETER 2710"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1887	" $1,129.47 "	 $790.63 	 $268.81 	" $1,016.52 "	 $982.64 	 $271.07 	 $864.04 	 $948.75 	 $948.75 	 $279.20 	" $1,016.52 "	 $960.05 	 $779.33 	 $903.58 	 $271.07 	" $1,016.52 "	 $918.26 	 $960.05 	 $268.81 	 $918.26 	 $271.07 
4410516	"HCHG CVMC ELECTROPHYSIOLOGY, DIAG"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1730	" $2,341.51 "	" $1,639.06 "	 $557.28 	" $2,107.36 "	" $2,037.11 "	 $561.96 	" $1,791.26 "	" $1,966.87 "	" $1,966.87 "	 $578.82 	" $2,107.36 "	" $1,990.28 "	" $1,615.64 "	" $1,873.21 "	 $561.96 	" $2,107.36 "	" $1,903.65 "	" $1,990.28 "	 $557.28 	" $1,903.65 "	 $561.96 
501783	HCHG SUTURE NICE LOOP SZ.5 GREEN	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	501783	 $595.69 	 $416.98 	 $141.77 	 $536.12 	 $518.25 	 $142.97 	 $455.70 	 $500.38 	 $500.38 	 $142.97 	 $536.12 	 $506.34 	 $411.03 	 $476.55 	 $142.97 	 $536.12 	 $484.30 	 $506.34 	 $141.77 	 $484.30 	 $142.97 
501784	HCHG SUTURE NICE LOOP SZ.5 WHITE/GREEN	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	501784	 $595.69 	 $416.98 	 $141.77 	 $536.12 	 $518.25 	 $142.97 	 $455.70 	 $500.38 	 $500.38 	 $142.97 	 $536.12 	 $506.34 	 $411.03 	 $476.55 	 $142.97 	 $536.12 	 $484.30 	 $506.34 	 $141.77 	 $484.30 	 $142.97 
501991	HCHG CVMC IODOSORB GEL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6261	 $86.89 	 $60.82 	 $20.68 	 $78.20 	 $75.59 	 $20.85 	 $66.47 	 $72.99 	 $72.99 	 $21.48 	 $78.20 	 $73.86 	 $59.95 	 $69.51 	 $20.85 	 $78.20 	 $70.64 	 $73.86 	 $20.68 	 $70.64 	 $20.85 
501992	HCHG CVMC IODOSORB FLEX 4/6	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6262	 $39.25 	 $27.48 	 $9.34 	 $35.33 	 $34.15 	 $9.42 	 $30.03 	 $32.97 	 $32.97 	 $9.70 	 $35.33 	 $33.36 	 $27.08 	 $31.40 	 $9.42 	 $35.33 	 $31.91 	 $33.36 	 $9.34 	 $31.91 	 $9.42 
501993	HCHG CVMC OASIS ULTRA TRI-LAYER MATRIX	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	Q4124	" $1,776.92 "	" $1,243.84 "	 $422.91 	" $1,599.23 "	" $1,545.92 "	 $426.46 	" $1,359.34 "	" $1,492.61 "	" $1,492.61 "	 $439.25 	" $1,599.23 "	" $1,510.38 "	" $1,226.07 "	" $1,421.54 "	 $426.46 	" $1,599.23 "	" $1,444.64 "	" $1,510.38 "	 $422.91 	" $1,444.64 "	 $426.46 
503853	HCHG COLLAGEN PURACOL 2X2	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6021	 $23.65 	 $16.56 	 $5.63 	 $21.29 	 $20.58 	 $5.68 	 $18.09 	 $19.87 	 $19.87 	 $5.85 	 $21.29 	 $20.10 	 $16.32 	 $18.92 	 $5.68 	 $21.29 	 $19.23 	 $20.10 	 $5.63 	 $19.23 	 $5.68 
503854	HCHG COLLAGEN PURACOL AG WITH SILVER 2X2	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6021	 $67.00 	 $46.90 	 $15.95 	 $60.30 	 $58.29 	 $16.08 	 $51.26 	 $56.28 	 $56.28 	 $16.56 	 $60.30 	 $56.95 	 $46.23 	 $53.60 	 $16.08 	 $60.30 	 $54.47 	 $56.95 	 $15.95 	 $54.47 	 $16.08 
503857	HCHG WOUND SUCTION DISPOSABLE INCL DRESS ALL ACCESS	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A9272	 $959.90 	 $671.93 	 $228.46 	 $863.91 	 $835.11 	 $230.38 	 $734.32 	 $806.32 	 $806.32 	 $230.38 	 $863.91 	 $815.92 	 $662.33 	 $767.92 	 $230.38 	 $863.91 	 $780.40 	 $815.92 	 $228.46 	 $780.40 	 $230.38 
503997	HCHG SAW BLADE SAGITTAL AGGRESSIVE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	503997	 $88.48 	 $61.94 	 $21.06 	 $79.63 	 $76.98 	 $21.24 	 $67.69 	 $74.32 	 $74.32 	 $21.24 	 $79.63 	 $75.21 	 $61.05 	 $70.78 	 $21.24 	 $79.63 	 $71.93 	 $75.21 	 $21.06 	 $71.93 	 $21.24 
504001	HCHG LASER FIBER FLEXIVA PULSE ID 500 MICRON	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1773	" $1,590.54 "	" $1,113.38 "	 $378.55 	" $1,431.49 "	" $1,383.77 "	 $381.73 	" $1,216.76 "	" $1,336.05 "	" $1,336.05 "	 $381.73 	" $1,431.49 "	" $1,351.96 "	" $1,097.47 "	" $1,272.43 "	 $381.73 	" $1,431.49 "	" $1,293.11 "	" $1,351.96 "	 $378.55 	" $1,293.11 "	 $381.73 
5270029	HCHG CVMC STAPLER/ENDOHERNIA/UNVRSL/4.0	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $1,757.96 "	" $1,230.57 "	 $418.39 	" $1,582.16 "	" $1,529.43 "	 $421.91 	" $1,344.84 "	" $1,476.69 "	" $1,476.69 "	 $434.57 	" $1,582.16 "	" $1,494.27 "	" $1,212.99 "	" $1,406.37 "	 $421.91 	" $1,582.16 "	" $1,429.22 "	" $1,494.27 "	 $418.39 	" $1,429.22 "	 $421.91 
5270030	HCHG CVMC ENDOSTITCH	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $1,065.74 "	 $746.02 	 $253.65 	 $959.17 	 $927.19 	 $255.78 	 $815.29 	 $895.22 	 $895.22 	 $263.45 	 $959.17 	 $905.88 	 $735.36 	 $852.59 	 $255.78 	 $959.17 	 $866.45 	 $905.88 	 $253.65 	 $866.45 	 $255.78 
5270031	HCHG CVMC ABSTACK-AUTOSUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $2,326.91 "	" $1,628.84 "	 $553.80 	" $2,094.22 "	" $2,024.41 "	 $558.46 	" $1,780.09 "	" $1,954.60 "	" $1,954.60 "	 $575.21 	" $2,094.22 "	" $1,977.87 "	" $1,605.57 "	" $1,861.53 "	 $558.46 	" $2,094.22 "	" $1,891.78 "	" $1,977.87 "	 $553.80 	" $1,891.78 "	 $558.46 
5270032	HCHG CVMC GIA STAPLER	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $1,179.37 "	 $825.56 	 $280.69 	" $1,061.43 "	" $1,026.05 "	 $283.05 	 $902.22 	 $990.67 	 $990.67 	 $291.54 	" $1,061.43 "	" $1,002.46 "	 $813.77 	 $943.50 	 $283.05 	" $1,061.43 "	 $958.83 	" $1,002.46 "	 $280.69 	 $958.83 	 $283.05 
5270033	HCHG CVMC HEMCLIP CARTRIDGE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $109.97 	 $76.98 	 $26.17 	 $98.97 	 $95.67 	 $26.39 	 $84.13 	 $92.37 	 $92.37 	 $27.18 	 $98.97 	 $93.47 	 $75.88 	 $87.98 	 $26.39 	 $98.97 	 $89.41 	 $93.47 	 $26.17 	 $89.41 	 $26.39 
5270034	HCHG CVMC OP-SITE DRESSING LARGE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $67.04 	 $46.93 	 $15.96 	 $60.34 	 $58.32 	 $16.09 	 $51.29 	 $56.31 	 $56.31 	 $16.57 	 $60.34 	 $56.98 	 $46.26 	 $53.63 	 $16.09 	 $60.34 	 $54.50 	 $56.98 	 $15.96 	 $54.50 	 $16.09 
5270035	HCHG CVMC ORTHOSORB ABSORBABLE PIN	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1713	" $1,170.49 "	 $819.34 	 $278.58 	" $1,053.44 "	" $1,018.33 "	 $280.92 	 $895.42 	 $983.21 	 $983.21 	 $289.35 	" $1,053.44 "	 $994.92 	 $807.64 	 $936.39 	 $280.92 	" $1,053.44 "	 $951.61 	 $994.92 	 $278.58 	 $951.61 	 $280.92 
5270036	HCHG CVMC SPIKED WASHERS	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1713	 $312.03 	 $218.42 	 $74.26 	 $280.83 	 $271.47 	 $74.89 	 $238.70 	 $262.11 	 $262.11 	 $77.13 	 $280.83 	 $265.23 	 $215.30 	 $249.62 	 $74.89 	 $280.83 	 $253.68 	 $265.23 	 $74.26 	 $253.68 	 $74.89 
5270039	HCHG CVMC TEGADERM LARGE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6258	 $14.39 	 $10.07 	 $3.42 	 $12.95 	 $12.52 	 $3.45 	 $11.01 	 $12.09 	 $12.09 	 $3.56 	 $12.95 	 $12.23 	 $9.93 	 $11.51 	 $3.45 	 $12.95 	 $11.70 	 $12.23 	 $3.42 	 $11.70 	 $3.45 
5270040	"HCHG CVMC TEGADERM, SMALL"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6257	 $12.68 	 $8.88 	 $3.02 	 $11.41 	 $11.03 	 $3.04 	 $9.70 	 $10.65 	 $10.65 	 $3.13 	 $11.41 	 $10.78 	 $8.75 	 $10.14 	 $3.04 	 $11.41 	 $10.31 	 $10.78 	 $3.02 	 $10.31 	 $3.04 
5270042	HCHG CVMC ENDOSTITCH SUTURE REFIL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $172.89 	 $121.02 	 $41.15 	 $155.60 	 $150.41 	 $41.49 	 $132.26 	 $145.23 	 $145.23 	 $42.74 	 $155.60 	 $146.96 	 $119.29 	 $138.31 	 $41.49 	 $155.60 	 $140.56 	 $146.96 	 $41.15 	 $140.56 	 $41.49 
5270043	HCHG CVMC PORT-A-CATH INTRODUCER SET	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $468.39 	 $327.87 	 $111.48 	 $421.55 	 $407.50 	 $112.41 	 $358.32 	 $393.45 	 $393.45 	 $115.79 	 $421.55 	 $398.13 	 $323.19 	 $374.71 	 $112.41 	 $421.55 	 $380.80 	 $398.13 	 $111.48 	 $380.80 	 $112.41 
5270044	HCHG CVMC CONCEPT SHUTTLE-RELAY SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $266.27 	 $186.39 	 $63.37 	 $239.64 	 $231.65 	 $63.90 	 $203.70 	 $223.67 	 $223.67 	 $65.82 	 $239.64 	 $226.33 	 $183.73 	 $213.02 	 $63.90 	 $239.64 	 $216.48 	 $226.33 	 $63.37 	 $216.48 	 $63.90 
5270056	HCHG CVMC FIBERWIRE 2 SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $159.11 	 $111.38 	 $37.87 	 $143.20 	 $138.43 	 $38.19 	 $121.72 	 $133.65 	 $133.65 	 $39.33 	 $143.20 	 $135.24 	 $109.79 	 $127.29 	 $38.19 	 $143.20 	 $129.36 	 $135.24 	 $37.87 	 $129.36 	 $38.19 
5270059	"HCHG CVMC DERMA-CLOSE KIT, SURGICAL STAPLE"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $1,942.32 "	" $1,359.62 "	 $462.27 	" $1,748.09 "	" $1,689.82 "	 $466.16 	" $1,485.87 "	" $1,631.55 "	" $1,631.55 "	 $480.14 	" $1,748.09 "	" $1,650.97 "	" $1,340.20 "	" $1,553.86 "	 $466.16 	" $1,748.09 "	" $1,579.11 "	" $1,650.97 "	 $462.27 	" $1,579.11 "	 $466.16 
5270060	HCHG CVMC FLEX NECK PERITONEAL DIALYSIS CATHETER	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1750	 $978.12 	 $684.68 	 $232.79 	 $880.31 	 $850.96 	 $234.75 	 $748.26 	 $821.62 	 $821.62 	 $241.79 	 $880.31 	 $831.40 	 $674.90 	 $782.50 	 $234.75 	 $880.31 	 $795.21 	 $831.40 	 $232.79 	 $795.21 	 $234.75 
5270061	HCHG CVMC 18 GUAGE SUTURE WIRE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $775.85 	 $543.10 	 $184.65 	 $698.27 	 $674.99 	 $186.20 	 $593.53 	 $651.71 	 $651.71 	 $191.79 	 $698.27 	 $659.47 	 $535.34 	 $620.68 	 $186.20 	 $698.27 	 $630.77 	 $659.47 	 $184.65 	 $630.77 	 $186.20 
5270062	HCHG CVMC FIBERTAPE-SUTURE FOR INTERNAL ROTATOR CUFF REPAIRS	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $777.09 	 $543.96 	 $184.95 	 $699.38 	 $676.07 	 $186.50 	 $594.47 	 $652.76 	 $652.76 	 $192.10 	 $699.38 	 $660.53 	 $536.19 	 $621.67 	 $186.50 	 $699.38 	 $631.77 	 $660.53 	 $184.95 	 $631.77 	 $186.50 
5270063	HCHG CVMC EXPRESSO SUTURES NEEDLES	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $819.94 	 $573.96 	 $195.15 	 $737.95 	 $713.35 	 $196.79 	 $627.25 	 $688.75 	 $688.75 	 $202.69 	 $737.95 	 $696.95 	 $565.76 	 $655.95 	 $196.79 	 $737.95 	 $666.61 	 $696.95 	 $195.15 	 $666.61 	 $196.79 
5270064	HCHG CVMC TOURNIER 5.0 MM INSITE BIO FORCE FIBER SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $2,191.59 "	" $1,534.11 "	 $521.60 	" $1,972.43 "	" $1,906.68 "	 $525.98 	" $1,676.57 "	" $1,840.94 "	" $1,840.94 "	 $541.76 	" $1,972.43 "	" $1,862.85 "	" $1,512.20 "	" $1,753.27 "	 $525.98 	" $1,972.43 "	" $1,781.76 "	" $1,862.85 "	 $521.60 	" $1,781.76 "	 $525.98 
5270065	HCHG CVMC ADEPT ADHESION REDUCTION SOLUTION	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $1,208.73 "	 $846.11 	 $287.68 	" $1,087.86 "	" $1,051.60 "	 $290.10 	 $924.68 	" $1,015.33 "	" $1,015.33 "	 $298.80 	" $1,087.86 "	" $1,027.42 "	 $834.02 	 $966.98 	 $290.10 	" $1,087.86 "	 $982.70 	" $1,027.42 "	 $287.68 	 $982.70 	 $290.10 
5270066	HCHG CVMC STAPLES RELOAD	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $380.77 	 $266.54 	 $90.62 	 $342.69 	 $331.27 	 $91.38 	 $291.29 	 $319.85 	 $319.85 	 $94.13 	 $342.69 	 $323.65 	 $262.73 	 $304.62 	 $91.38 	 $342.69 	 $309.57 	 $323.65 	 $90.62 	 $309.57 	 $91.38 
5270067	HCHG CVMC GIA RELOADS	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $644.64 	 $451.25 	 $153.42 	 $580.18 	 $560.84 	 $154.71 	 $493.15 	 $541.50 	 $541.50 	 $159.36 	 $580.18 	 $547.94 	 $444.80 	 $515.71 	 $154.71 	 $580.18 	 $524.09 	 $547.94 	 $153.42 	 $524.09 	 $154.71 
5270068	HCHG CVMC FLOSEAL	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $1,088.61 "	 $762.03 	 $259.09 	 $979.75 	 $947.09 	 $261.27 	 $832.79 	 $914.43 	 $914.43 	 $269.10 	 $979.75 	 $925.32 	 $751.14 	 $870.89 	 $261.27 	 $979.75 	 $885.04 	 $925.32 	 $259.09 	 $885.04 	 $261.27 
5270069	HCHG CVMC HEMOCLIPS-MED/LD	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $110.84 	 $77.59 	 $26.38 	 $99.76 	 $96.43 	 $26.60 	 $84.79 	 $93.11 	 $93.11 	 $27.40 	 $99.76 	 $94.21 	 $76.48 	 $88.67 	 $26.60 	 $99.76 	 $90.11 	 $94.21 	 $26.38 	 $90.11 	 $26.60 
5270070	HCHG CVMC HEMOCLIPS-LG	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $113.58 	 $79.51 	 $27.03 	 $102.22 	 $98.81 	 $27.26 	 $86.89 	 $95.41 	 $95.41 	 $28.08 	 $102.22 	 $96.54 	 $78.37 	 $90.86 	 $27.26 	 $102.22 	 $92.34 	 $96.54 	 $27.03 	 $92.34 	 $27.26 
5270071	HCHG CVMC HEMOCLIPS-MED	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $83.17 	 $58.22 	 $19.79 	 $74.85 	 $72.36 	 $19.96 	 $63.63 	 $69.86 	 $69.86 	 $20.56 	 $74.85 	 $70.69 	 $57.39 	 $66.54 	 $19.96 	 $74.85 	 $67.62 	 $70.69 	 $19.79 	 $67.62 	 $19.96 
5270072	HCHG CVMC HEMOCLIPS-SM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $46.23 	 $32.36 	 $11.00 	 $41.61 	 $40.22 	 $11.10 	 $35.37 	 $38.83 	 $38.83 	 $11.43 	 $41.61 	 $39.30 	 $31.90 	 $36.98 	 $11.10 	 $41.61 	 $37.58 	 $39.30 	 $11.00 	 $37.58 	 $11.10 
5270073	HCHG CVMC INTRATHECAL CATHETER PUMP SEGMENT REVISION KIT	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $1,553.86 "	" $1,087.70 "	 $369.82 	" $1,398.47 "	" $1,351.86 "	 $372.93 	" $1,188.70 "	" $1,305.24 "	" $1,305.24 "	 $384.11 	" $1,398.47 "	" $1,320.78 "	" $1,072.16 "	" $1,243.09 "	 $372.93 	" $1,398.47 "	" $1,263.29 "	" $1,320.78 "	 $369.82 	" $1,263.29 "	 $372.93 
5270074	HCHG CVMC HEM-O-LOK	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $201.75 	 $141.23 	 $48.02 	 $181.58 	 $175.52 	 $48.42 	 $154.34 	 $169.47 	 $169.47 	 $49.87 	 $181.58 	 $171.49 	 $139.21 	 $161.40 	 $48.42 	 $181.58 	 $164.02 	 $171.49 	 $48.02 	 $164.02 	 $48.42 
5270075	HCHG CVMC DACRON POUCH-MEDTRONIC	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $617.31 	 $432.12 	 $146.92 	 $555.58 	 $537.06 	 $148.15 	 $472.24 	 $518.54 	 $518.54 	 $152.60 	 $555.58 	 $524.71 	 $425.94 	 $493.85 	 $148.15 	 $555.58 	 $501.87 	 $524.71 	 $146.92 	 $501.87 	 $148.15 
5270076	HCHG CVMC SUTURE LESS CATHETER	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		" $2,699.84 "	" $1,889.89 "	 $642.56 	" $2,429.86 "	" $2,348.86 "	 $647.96 	" $2,065.38 "	" $2,267.87 "	" $2,267.87 "	 $667.40 	" $2,429.86 "	" $2,294.86 "	" $1,862.89 "	" $2,159.87 "	 $647.96 	" $2,429.86 "	" $2,194.97 "	" $2,294.86 "	 $642.56 	" $2,194.97 "	 $647.96 
5271298	HCHG CVMC CATHETER CV 7FR 3-LUMEN POWER	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A4300	 $864.57 	 $605.20 	 $205.77 	 $778.11 	 $752.18 	 $207.50 	 $661.40 	 $726.24 	 $726.24 	 $213.72 	 $778.11 	 $734.88 	 $596.55 	 $691.66 	 $207.50 	 $778.11 	 $702.90 	 $734.88 	 $205.77 	 $702.90 	 $207.50 
5271299	HCHG CVMC PREVENA WOUND MANAGEMENT SYSTEM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A4649	" $1,922.91 "	" $1,346.04 "	 $457.65 	" $1,730.62 "	" $1,672.93 "	 $461.50 	" $1,471.03 "	" $1,615.24 "	" $1,615.24 "	 $475.34 	" $1,730.62 "	" $1,634.47 "	" $1,326.81 "	" $1,538.33 "	 $461.50 	" $1,730.62 "	" $1,563.33 "	" $1,634.47 "	 $457.65 	" $1,563.33 "	 $461.50 
5271733	"HCHG CVMC CATHETER, GUIDING-ON-Q PAINBUSTER W/SILVERSOAKER"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1887	" $2,272.53 "	" $1,590.77 "	 $540.86 	" $2,045.28 "	" $1,977.10 "	 $545.41 	" $1,738.49 "	" $1,908.93 "	" $1,908.93 "	 $561.77 	" $2,045.28 "	" $1,931.65 "	" $1,568.05 "	" $1,818.02 "	 $545.41 	" $2,045.28 "	" $1,847.57 "	" $1,931.65 "	 $540.86 	" $1,847.57 "	 $545.41 
5271758	HCHG CVMC MONOCRYL 4-0 PS-2	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $113.32 	 $79.32 	 $26.97 	 $101.99 	 $98.59 	 $27.20 	 $86.69 	 $95.19 	 $95.19 	 $28.01 	 $101.99 	 $96.32 	 $78.19 	 $90.66 	 $27.20 	 $101.99 	 $92.13 	 $96.32 	 $26.97 	 $92.13 	 $27.20 
5271759	HCHG CVMC CAP PROTECTIVE 11MM TUBES&RODS	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $161.05 	 $112.74 	 $38.33 	 $144.95 	 $140.11 	 $38.65 	 $123.20 	 $135.28 	 $135.28 	 $39.81 	 $144.95 	 $136.89 	 $111.12 	 $128.84 	 $38.65 	 $144.95 	 $130.93 	 $136.89 	 $38.33 	 $130.93 	 $38.65 
5271760	HCHG CVMC CAP PROTECTIVE-PINS	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $330.08 	 $231.06 	 $78.56 	 $297.07 	 $287.17 	 $79.22 	 $252.51 	 $277.27 	 $277.27 	 $81.60 	 $297.07 	 $280.57 	 $227.76 	 $264.06 	 $79.22 	 $297.07 	 $268.36 	 $280.57 	 $78.56 	 $268.36 	 $79.22 
5271761	HCHG CVMC SUTURE WIRE FIBERWIRE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $168.47 	 $117.93 	 $40.10 	 $151.62 	 $146.57 	 $40.43 	 $128.88 	 $141.51 	 $141.51 	 $41.65 	 $151.62 	 $143.20 	 $116.24 	 $134.78 	 $40.43 	 $151.62 	 $136.97 	 $143.20 	 $40.10 	 $136.97 	 $40.43 
5271762	"HCHG CVMC SUTURE WIRE FIBERWIRE #5  38"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $261.45 	 $183.02 	 $62.23 	 $235.31 	 $227.46 	 $62.75 	 $200.01 	 $219.62 	 $219.62 	 $64.63 	 $235.31 	 $222.23 	 $180.40 	 $209.16 	 $62.75 	 $235.31 	 $212.56 	 $222.23 	 $62.23 	 $212.56 	 $62.75 
5271763	"HCHG CVMC SUTURE WIRE FIBERWIRE #2 38"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $312.29 	 $218.60 	 $74.33 	 $281.06 	 $271.69 	 $74.95 	 $238.90 	 $262.32 	 $262.32 	 $77.20 	 $281.06 	 $265.45 	 $215.48 	 $249.83 	 $74.95 	 $281.06 	 $253.89 	 $265.45 	 $74.33 	 $253.89 	 $74.95 
5271764	HCHG CVMC SUTURE WIRE FIBERSTICK #2	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $334.07 	 $233.85 	 $79.51 	 $300.66 	 $290.64 	 $80.18 	 $255.56 	 $280.62 	 $280.62 	 $82.58 	 $300.66 	 $283.96 	 $230.51 	 $267.26 	 $80.18 	 $300.66 	 $271.60 	 $283.96 	 $79.51 	 $271.60 	 $80.18 
5271765	HCHG CVMC SUTURE TK-5 TITANIUM TOP KNOT	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $254.19 	 $177.93 	 $60.50 	 $228.77 	 $221.15 	 $61.01 	 $194.46 	 $213.52 	 $213.52 	 $62.84 	 $228.77 	 $216.06 	 $175.39 	 $203.35 	 $61.01 	 $228.77 	 $206.66 	 $216.06 	 $60.50 	 $206.66 	 $61.01 
5271766	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $48.40 	 $33.88 	 $11.52 	 $43.56 	 $42.11 	 $11.62 	 $37.03 	 $40.66 	 $40.66 	 $11.96 	 $43.56 	 $41.14 	 $33.40 	 $38.72 	 $11.62 	 $43.56 	 $39.35 	 $41.14 	 $11.52 	 $39.35 	 $11.62 
5271767	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $115.38 	 $80.77 	 $27.46 	 $103.84 	 $100.38 	 $27.69 	 $88.27 	 $96.92 	 $96.92 	 $28.52 	 $103.84 	 $98.07 	 $79.61 	 $92.30 	 $27.69 	 $103.84 	 $93.80 	 $98.07 	 $27.46 	 $93.80 	 $27.69 
5271768	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $149.75 	 $104.83 	 $35.64 	 $134.78 	 $130.28 	 $35.94 	 $114.56 	 $125.79 	 $125.79 	 $37.02 	 $134.78 	 $127.29 	 $103.33 	 $119.80 	 $35.94 	 $134.78 	 $121.75 	 $127.29 	 $35.64 	 $121.75 	 $35.94 
5271769	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $168.64 	 $118.05 	 $40.14 	 $151.78 	 $146.72 	 $40.47 	 $129.01 	 $141.66 	 $141.66 	 $41.69 	 $151.78 	 $143.34 	 $116.36 	 $134.91 	 $40.47 	 $151.78 	 $137.10 	 $143.34 	 $40.14 	 $137.10 	 $40.47 
5271770	HCHG CVMC BONE WAX 2.5G	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $45.34 	 $31.74 	 $10.79 	 $40.81 	 $39.45 	 $10.88 	 $34.69 	 $38.09 	 $38.09 	 $11.21 	 $40.81 	 $38.54 	 $31.28 	 $36.27 	 $10.88 	 $40.81 	 $36.86 	 $38.54 	 $10.79 	 $36.86 	 $10.88 
5271771	HCHG CVMC SUTURE/BUTTON TENDON REPAIR	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $54.00 	 $37.80 	 $12.85 	 $48.60 	 $46.98 	 $12.96 	 $41.31 	 $45.36 	 $45.36 	 $13.35 	 $48.60 	 $45.90 	 $37.26 	 $43.20 	 $12.96 	 $48.60 	 $43.90 	 $45.90 	 $12.85 	 $43.90 	 $12.96 
5271772	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $65.57 	 $45.90 	 $15.61 	 $59.01 	 $57.05 	 $15.74 	 $50.16 	 $55.08 	 $55.08 	 $16.21 	 $59.01 	 $55.73 	 $45.24 	 $52.46 	 $15.74 	 $59.01 	 $53.31 	 $55.73 	 $15.61 	 $53.31 	 $15.74 
5271773	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $16.47 	 $11.53 	 $3.92 	 $14.82 	 $14.33 	 $3.95 	 $12.60 	 $13.83 	 $13.83 	 $4.07 	 $14.82 	 $14.00 	 $11.36 	 $13.18 	 $3.95 	 $14.82 	 $13.39 	 $14.00 	 $3.92 	 $13.39 	 $3.95 
5271774	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $30.86 	 $21.60 	 $7.34 	 $27.77 	 $26.85 	 $7.41 	 $23.61 	 $25.92 	 $25.92 	 $7.63 	 $27.77 	 $26.23 	 $21.29 	 $24.69 	 $7.41 	 $27.77 	 $25.09 	 $26.23 	 $7.34 	 $25.09 	 $7.41 
5271775	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $132.57 	 $92.80 	 $31.55 	 $119.31 	 $115.34 	 $31.82 	 $101.42 	 $111.36 	 $111.36 	 $32.77 	 $119.31 	 $112.68 	 $91.47 	 $106.06 	 $31.82 	 $119.31 	 $107.78 	 $112.68 	 $31.55 	 $107.78 	 $31.82 
5271776	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $204.45 	 $143.12 	 $48.66 	 $184.01 	 $177.87 	 $49.07 	 $156.40 	 $171.74 	 $171.74 	 $50.54 	 $184.01 	 $173.78 	 $141.07 	 $163.56 	 $49.07 	 $184.01 	 $166.22 	 $173.78 	 $48.66 	 $166.22 	 $49.07 
5271777	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $186.06 	 $130.24 	 $44.28 	 $167.45 	 $161.87 	 $44.65 	 $142.34 	 $156.29 	 $156.29 	 $45.99 	 $167.45 	 $158.15 	 $128.38 	 $148.85 	 $44.65 	 $167.45 	 $151.27 	 $158.15 	 $44.28 	 $151.27 	 $44.65 
5271778	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $197.18 	 $138.03 	 $46.93 	 $177.46 	 $171.55 	 $47.32 	 $150.84 	 $165.63 	 $165.63 	 $48.74 	 $177.46 	 $167.60 	 $136.05 	 $157.74 	 $47.32 	 $177.46 	 $160.31 	 $167.60 	 $46.93 	 $160.31 	 $47.32 
5271779	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $39.87 	 $27.91 	 $9.49 	 $35.88 	 $34.69 	 $9.57 	 $30.50 	 $33.49 	 $33.49 	 $9.86 	 $35.88 	 $33.89 	 $27.51 	 $31.90 	 $9.57 	 $35.88 	 $32.41 	 $33.89 	 $9.49 	 $32.41 	 $9.57 
5271780	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $77.99 	 $54.59 	 $18.56 	 $70.19 	 $67.85 	 $18.72 	 $59.66 	 $65.51 	 $65.51 	 $19.28 	 $70.19 	 $66.29 	 $53.81 	 $62.39 	 $18.72 	 $70.19 	 $63.41 	 $66.29 	 $18.56 	 $63.41 	 $18.72 
5271781	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $190.13 	 $133.09 	 $45.25 	 $171.12 	 $165.41 	 $45.63 	 $145.45 	 $159.71 	 $159.71 	 $47.00 	 $171.12 	 $161.61 	 $131.19 	 $152.10 	 $45.63 	 $171.12 	 $154.58 	 $161.61 	 $45.25 	 $154.58 	 $45.63 
5271782	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $21.13 	 $14.79 	 $5.03 	 $19.02 	 $18.38 	 $5.07 	 $16.16 	 $17.75 	 $17.75 	 $5.22 	 $19.02 	 $17.96 	 $14.58 	 $16.90 	 $5.07 	 $19.02 	 $17.18 	 $17.96 	 $5.03 	 $17.18 	 $5.07 
5271783	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $97.69 	 $68.38 	 $23.25 	 $87.92 	 $84.99 	 $23.45 	 $74.73 	 $82.06 	 $82.06 	 $24.15 	 $87.92 	 $83.04 	 $67.41 	 $78.15 	 $23.45 	 $87.92 	 $79.42 	 $83.04 	 $23.25 	 $79.42 	 $23.45 
5271784	HCHG CVMC SUTURE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $57.95 	 $40.57 	 $13.79 	 $52.16 	 $50.42 	 $13.91 	 $44.33 	 $48.68 	 $48.68 	 $14.33 	 $52.16 	 $49.26 	 $39.99 	 $46.36 	 $13.91 	 $52.16 	 $47.11 	 $49.26 	 $13.79 	 $47.11 	 $13.91 
5271785	"HCHG CVMC HEMOSTAT SURGICEL 2"" X 3"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $314.32 	 $220.02 	 $74.81 	 $282.89 	 $273.46 	 $75.44 	 $240.45 	 $264.03 	 $264.03 	 $77.70 	 $282.89 	 $267.17 	 $216.88 	 $251.46 	 $75.44 	 $282.89 	 $255.54 	 $267.17 	 $74.81 	 $255.54 	 $75.44 
5271786	"HCHG CVMC HEMOSTAT SURGICEL 4"" X 8"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $574.02 	 $401.81 	 $136.62 	 $516.62 	 $499.40 	 $137.76 	 $439.13 	 $482.18 	 $482.18 	 $141.90 	 $516.62 	 $487.92 	 $396.07 	 $459.22 	 $137.76 	 $516.62 	 $466.68 	 $487.92 	 $136.62 	 $466.68 	 $137.76 
5271787	HCHG CVMC TAPE UMBILICAL COTTON	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $27.05 	 $18.94 	 $6.44 	 $24.35 	 $23.53 	 $6.49 	 $20.69 	 $22.72 	 $22.72 	 $6.69 	 $24.35 	 $22.99 	 $18.66 	 $21.64 	 $6.49 	 $24.35 	 $21.99 	 $22.99 	 $6.44 	 $21.99 	 $6.49 
5271794	HCHG SUTURE WIRE	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $225.14 	 $157.60 	 $53.58 	 $202.63 	 $195.87 	 $54.03 	 $172.23 	 $189.12 	 $189.12 	 $54.03 	 $202.63 	 $191.37 	 $155.35 	 $180.11 	 $54.03 	 $202.63 	 $183.04 	 $191.37 	 $53.58 	 $183.04 	 $54.03 
5271795	HCHG CVMC DRESSING ALLEVYN SACRUM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6213	 $53.00 	 $37.10 	 $12.61 	 $47.70 	 $46.11 	 $12.72 	 $40.55 	 $44.52 	 $44.52 	 $13.10 	 $47.70 	 $45.05 	 $36.57 	 $42.40 	 $12.72 	 $47.70 	 $43.09 	 $45.05 	 $12.61 	 $43.09 	 $12.72 
5271796	"HCHG CVMC DRESSING, FLEXIGEL STRANDS PER GRAM"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	A6262	 $11.16 	 $7.81 	 $2.66 	 $10.04 	 $9.71 	 $2.68 	 $8.54 	 $9.37 	 $9.37 	 $2.76 	 $10.04 	 $9.49 	 $7.70 	 $8.93 	 $2.68 	 $10.04 	 $9.07 	 $9.49 	 $2.66 	 $9.07 	 $2.68 
5271901	"HCHG CVMC ON Q PAINBUSTER COMPONENT, TUNNELING"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	C1887	 $508.37 	 $355.86 	 $120.99 	 $457.53 	 $442.28 	 $122.01 	 $388.90 	 $427.03 	 $427.03 	 $125.67 	 $457.53 	 $432.11 	 $350.78 	 $406.70 	 $122.01 	 $457.53 	 $413.30 	 $432.11 	 $120.99 	 $413.30 	 $122.01 
5271910	HCHG CVMC ARISTA ABSORBABLE HEMOSTAT 1GM	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $718.98 	 $503.29 	 $171.12 	 $647.08 	 $625.51 	 $172.56 	 $550.02 	 $603.94 	 $603.94 	 $177.73 	 $647.08 	 $611.13 	 $496.10 	 $575.18 	 $172.56 	 $647.08 	 $584.53 	 $611.13 	 $171.12 	 $584.53 	 $172.56 
5271911	"HCHG CVMC SUTURE SURGITIE 2/0 21"" 5CM"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $167.85 	 $117.50 	 $39.95 	 $151.07 	 $146.03 	 $40.28 	 $128.41 	 $140.99 	 $140.99 	 $41.49 	 $151.07 	 $142.67 	 $115.82 	 $134.28 	 $40.28 	 $151.07 	 $136.46 	 $142.67 	 $39.95 	 $136.46 	 $40.28 
5271914	"HCHG CVMC FIBERLOOP 4-0 20"" W/NEEDLE"	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY		 $210.61 	 $147.43 	 $50.13 	 $189.55 	 $183.23 	 $50.55 	 $161.12 	 $176.91 	 $176.91 	 $52.06 	 $189.55 	 $179.02 	 $145.32 	 $168.49 	 $50.55 	 $189.55 	 $171.23 	 $179.02 	 $50.13 	 $171.23 	 $50.55 
5271929	"HCHG CVMC SUTURE PDS II 2-0 STP 10 27"""	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	5271929	 $286.07 	 $200.25 	 $68.08 	 $257.46 	 $248.88 	 $68.66 	 $218.84 	 $240.30 	 $240.30 	 $70.72 	 $257.46 	 $243.16 	 $197.39 	 $228.86 	 $68.66 	 $257.46 	 $232.57 	 $243.16 	 $68.08 	 $232.57 	 $68.66 
5271944	HCHG CVMC SMART PORT CT W/8FRCATHETER	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	5271944	" $1,262.52 "	 $883.76 	 $300.48 	" $1,136.27 "	" $1,098.39 "	 $303.00 	 $965.83 	" $1,060.52 "	" $1,060.52 "	 $312.09 	" $1,136.27 "	" $1,073.14 "	 $871.14 	" $1,010.02 "	 $303.00 	" $1,136.27 "	" $1,026.43 "	" $1,073.14 "	 $300.48 	" $1,026.43 "	 $303.00 
5271945	HCHG CVMC SMART PORT CT LP W/6.5FR CATH	0272	MEDICAL/SURGICAL SUPPLIES AND DEVICES - STERILE SUPPLY	5271945	" $1,262.52 "	 $883.76 	 $300.48 	" $1,136.27 "	" $1,098.39 "	 $303.00 	 $965.83 	" $1,060.52 "	" $1,060.52 "	 $312.09 	" $1,136.27 "	" $1,073.14 "	 $871.14 	" $1,010.02 "	 $303.00 	" $1,136.27 "	" $1,026.43 "	" $1,073.14 "	 $300.48 	" $1,026.43 "	 $303.00 
302040	HCHG GEL ANKLE CONTROL ORTHOSIS PREFAB	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L4350	 $101.00 	 $70.70 	 $24.04 	 $90.90 	 $87.87 	 $24.24 	 $77.27 	 $-   	 $-   	 $38.38 	 $63.63 	 $85.85 	 $66.66 	 $80.80 	 $24.24 	 $90.90 	 $82.11 	 $85.85 	 $24.04 	 $82.11 	 $24.24 
302061	"HCHG ANKLE BRACE, ALL"	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L1930	 $580.66 	 $406.46 	 $138.20 	 $522.59 	 $505.17 	 $139.36 	 $444.20 	 $-   	 $-   	 $220.65 	 $365.82 	 $493.56 	 $383.24 	 $464.53 	 $139.36 	 $522.59 	 $472.08 	 $493.56 	 $138.20 	 $472.08 	 $139.36 
302707	HCHG NON PNEUM WALK BOOT PRE OTS	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L4387	 $207.00 	 $144.90 	 $49.27 	 $186.30 	 $180.09 	 $49.68 	 $158.36 	 $-   	 $-   	 $78.66 	 $130.41 	 $175.95 	 $136.62 	 $165.60 	 $49.68 	 $186.30 	 $168.29 	 $175.95 	 $49.27 	 $168.29 	 $49.68 
304418	HCHG NECK COLLAR	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L0120	 $27.22 	 $19.05 	 $6.48 	 $24.50 	 $23.68 	 $6.53 	 $20.82 	 $-   	 $-   	 $10.34 	 $17.15 	 $23.14 	 $17.97 	 $21.78 	 $6.53 	 $24.50 	 $22.13 	 $23.14 	 $6.48 	 $22.13 	 $6.53 
304706	HCHG ORTHOTIC HEEL LIFT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3332	 $67.48 	 $47.24 	 $16.06 	 $60.73 	 $58.71 	 $16.20 	 $51.62 	 $-   	 $-   	 $25.64 	 $42.51 	 $57.36 	 $44.54 	 $53.98 	 $16.20 	 $60.73 	 $54.86 	 $57.36 	 $16.06 	 $54.86 	 $16.20 
304725	HCHG PALMER	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3931	 $209.09 	 $146.36 	 $49.76 	 $188.18 	 $181.91 	 $50.18 	 $159.95 	 $-   	 $-   	 $79.45 	 $131.73 	 $177.73 	 $138.00 	 $167.27 	 $50.18 	 $188.18 	 $169.99 	 $177.73 	 $49.76 	 $169.99 	 $50.18 
305138	"HCHG FINGER ORTHOTIC,PIP/DIP"	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3925	 $116.91 	 $81.84 	 $27.82 	 $105.22 	 $101.71 	 $28.06 	 $89.44 	 $-   	 $-   	 $44.43 	 $73.65 	 $99.37 	 $77.16 	 $93.53 	 $28.06 	 $105.22 	 $95.05 	 $99.37 	 $27.82 	 $95.05 	 $28.06 
309498	HCHG CVMC CERVICAL COLLAR PHILLY	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L0140	 $106.07 	 $74.25 	 $25.24 	 $95.46 	 $92.28 	 $25.46 	 $81.14 	 $-   	 $-   	 $40.31 	 $66.82 	 $90.16 	 $70.01 	 $84.86 	 $25.46 	 $95.46 	 $86.23 	 $90.16 	 $25.24 	 $86.23 	 $25.46 
309507	HCHG CVMC KNEE IMMOBILIZER ADULT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L1820	 $231.16 	 $161.81 	 $55.02 	 $208.04 	 $201.11 	 $55.48 	 $176.84 	 $-   	 $-   	 $87.84 	 $145.63 	 $196.49 	 $152.57 	 $184.93 	 $55.48 	 $208.04 	 $187.93 	 $196.49 	 $55.02 	 $187.93 	 $55.48 
309508	HCHG CVMC KNEE IMMOBILIZER CHILD	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L1820	 $208.16 	 $145.71 	 $49.54 	 $187.34 	 $181.10 	 $49.96 	 $159.24 	 $-   	 $-   	 $79.10 	 $131.14 	 $176.94 	 $137.39 	 $166.53 	 $49.96 	 $187.34 	 $169.23 	 $176.94 	 $49.54 	 $169.23 	 $49.96 
309513	HCHG CVMC CUSTOM ARCH SUPPORT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3010	 $137.27 	 $96.09 	 $32.67 	 $123.54 	 $119.42 	 $32.94 	 $105.01 	 $-   	 $-   	 $52.16 	 $86.48 	 $116.68 	 $90.60 	 $109.82 	 $32.94 	 $123.54 	 $111.60 	 $116.68 	 $32.67 	 $111.60 	 $32.94 
309518	HCHG CVMC LONGIT ARCH SUPPORT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3040	 $137.27 	 $96.09 	 $32.67 	 $123.54 	 $119.42 	 $32.94 	 $105.01 	 $-   	 $-   	 $52.16 	 $86.48 	 $116.68 	 $90.60 	 $109.82 	 $32.94 	 $123.54 	 $111.60 	 $116.68 	 $32.67 	 $111.60 	 $32.94 
309519	HCHG CVMC SHOULDER IMMOBILIZER	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3677	 $59.31 	 $41.52 	 $14.12 	 $53.38 	 $51.60 	 $14.23 	 $45.37 	 $-   	 $-   	 $22.54 	 $37.37 	 $50.41 	 $39.14 	 $47.45 	 $14.23 	 $53.38 	 $48.22 	 $50.41 	 $14.12 	 $48.22 	 $14.23 
309525	HCHG CVMC DYNAMIC SPLINT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3806	 $373.12 	 $261.18 	 $88.80 	 $335.81 	 $324.61 	 $89.55 	 $285.44 	 $-   	 $-   	 $141.79 	 $235.07 	 $317.15 	 $246.26 	 $298.50 	 $89.55 	 $335.81 	 $303.35 	 $317.15 	 $88.80 	 $303.35 	 $89.55 
309527	HCHG CVMC SPLINT FINGER	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3807	 $200.56 	 $140.39 	 $47.73 	 $180.50 	 $174.49 	 $48.13 	 $153.43 	 $-   	 $-   	 $76.21 	 $126.35 	 $170.48 	 $132.37 	 $160.45 	 $48.13 	 $180.50 	 $163.06 	 $170.48 	 $47.73 	 $163.06 	 $48.13 
309529	"HCHG CVMC WRIST HAND FINGER ORTHOSIS, W/O JOINT, PREFABRICATED"	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3807	 $151.33 	 $105.93 	 $36.02 	 $136.20 	 $131.66 	 $36.32 	 $115.77 	 $-   	 $-   	 $57.51 	 $95.34 	 $128.63 	 $99.88 	 $121.06 	 $36.32 	 $136.20 	 $123.03 	 $128.63 	 $36.02 	 $123.03 	 $36.32 
309534	HCHG CVMC LONG ARM SPLINT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3982	 $336.91 	 $235.84 	 $80.18 	 $303.22 	 $293.11 	 $80.86 	 $257.74 	 $-   	 $-   	 $128.03 	 $212.25 	 $286.37 	 $222.36 	 $269.53 	 $80.86 	 $303.22 	 $273.91 	 $286.37 	 $80.18 	 $273.91 	 $80.86 
309599	HCHG KNEE BRACE	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L1832	 $517.00 	 $361.90 	 $123.05 	 $465.30 	 $449.79 	 $124.08 	 $395.51 	 $-   	 $-   	 $196.46 	 $325.71 	 $439.45 	 $341.22 	 $413.60 	 $124.08 	 $465.30 	 $420.32 	 $439.45 	 $123.05 	 $420.32 	 $124.08 
310093	HCHG CVMC ELBOW BRACE	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES		 $116.91 	 $81.84 	 $27.82 	 $105.22 	 $101.71 	 $28.06 	 $89.44 	 $-   	 $-   	 $44.43 	 $73.65 	 $99.37 	 $77.16 	 $93.53 	 $28.06 	 $105.22 	 $95.05 	 $99.37 	 $27.82 	 $95.05 	 $28.06 
310094	"HCHG CVMC ELBOW ORTHOSIS, ELASTIC, PREFABRICATED"	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES		 $151.33 	 $105.93 	 $36.02 	 $136.20 	 $131.66 	 $36.32 	 $115.77 	 $-   	 $-   	 $57.51 	 $95.34 	 $128.63 	 $99.88 	 $121.06 	 $36.32 	 $136.20 	 $123.03 	 $128.63 	 $36.02 	 $123.03 	 $36.32 
310095	HCHG CVMC SHOULDER BRACE	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES		 $898.37 	 $628.86 	 $213.81 	 $808.53 	 $781.58 	 $215.61 	 $687.25 	 $-   	 $-   	 $341.38 	 $565.97 	 $763.61 	 $592.92 	 $718.70 	 $215.61 	 $808.53 	 $730.37 	 $763.61 	 $213.81 	 $730.37 	 $215.61 
330904	HCHG CVMC FINGER SPLINT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3929	 $116.91 	 $81.84 	 $27.82 	 $105.22 	 $101.71 	 $28.06 	 $89.44 	 $-   	 $-   	 $44.43 	 $73.65 	 $99.37 	 $77.16 	 $93.53 	 $28.06 	 $105.22 	 $95.05 	 $99.37 	 $27.82 	 $95.05 	 $28.06 
330909	HCHG CVMC DYNAMIC FINGER SPLINT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3929	 $134.72 	 $94.30 	 $32.06 	 $121.25 	 $117.21 	 $32.33 	 $103.06 	 $-   	 $-   	 $51.19 	 $84.87 	 $114.51 	 $88.92 	 $107.78 	 $32.33 	 $121.25 	 $109.53 	 $114.51 	 $32.06 	 $109.53 	 $32.33 
330929	HCHG CVMC SHORT THUMB SPICA (CUSTOM)	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3808	 $209.09 	 $146.36 	 $49.76 	 $188.18 	 $181.91 	 $50.18 	 $159.95 	 $-   	 $-   	 $79.45 	 $131.73 	 $177.73 	 $138.00 	 $167.27 	 $50.18 	 $188.18 	 $169.99 	 $177.73 	 $49.76 	 $169.99 	 $50.18 
330934	HCHG CVMC WALKING BOOT/SHORT - ALL SIZES	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L4360	 $217.15 	 $152.01 	 $51.68 	 $195.44 	 $188.92 	 $52.12 	 $166.12 	 $-   	 $-   	 $82.52 	 $136.80 	 $184.58 	 $143.32 	 $173.72 	 $52.12 	 $195.44 	 $176.54 	 $184.58 	 $51.68 	 $176.54 	 $52.12 
330941	HCHG CVMC CUSTOM WRIST COCK UP	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3908	 $269.43 	 $188.60 	 $64.12 	 $242.49 	 $234.40 	 $64.66 	 $206.11 	 $-   	 $-   	 $102.38 	 $169.74 	 $229.02 	 $177.82 	 $215.54 	 $64.66 	 $242.49 	 $219.05 	 $229.02 	 $64.12 	 $219.05 	 $64.66 
330942	HCHG CVMC WALKING BOOT-XLARGE	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L4360	 $274.26 	 $191.98 	 $65.27 	 $246.83 	 $238.61 	 $65.82 	 $209.81 	 $-   	 $-   	 $104.22 	 $172.78 	 $233.12 	 $181.01 	 $219.41 	 $65.82 	 $246.83 	 $222.97 	 $233.12 	 $65.27 	 $222.97 	 $65.82 
330952	HCHG CVMC LONG THUMB SPICA (CUSTOM)	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3808	 $336.91 	 $235.84 	 $80.18 	 $303.22 	 $293.11 	 $80.86 	 $257.74 	 $-   	 $-   	 $128.03 	 $212.25 	 $286.37 	 $222.36 	 $269.53 	 $80.86 	 $303.22 	 $273.91 	 $286.37 	 $80.18 	 $273.91 	 $80.86 
330981	HCHG CVMC WRIST SPLINT	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L3908	 $81.35 	 $56.95 	 $19.36 	 $73.22 	 $70.77 	 $19.52 	 $62.23 	 $-   	 $-   	 $30.91 	 $51.25 	 $69.15 	 $53.69 	 $65.08 	 $19.52 	 $73.22 	 $66.14 	 $69.15 	 $19.36 	 $66.14 	 $19.52 
5270077	HCHG CVMC KNEE BRACE/HINGED POST-OP	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L1810	 $830.41 	 $581.29 	 $197.64 	 $747.37 	 $722.46 	 $199.30 	 $635.26 	 $-   	 $-   	 $315.56 	 $523.16 	 $705.85 	 $548.07 	 $664.33 	 $199.30 	 $747.37 	 $675.12 	 $705.85 	 $197.64 	 $675.12 	 $199.30 
5271908	HCHG CVMC CUSTOM POST OP HIP ABDUCTION	0274	MEDICAL/SURGICAL SUPPLIES AND DEVICES - PROSTHETIC/ORTHOTIC DEVICES	L1685	" $4,284.86 "	" $2,999.40 "	" $1,019.80 "	" $4,284.86 "	" $3,727.83 "	" $1,028.37 "	" $3,277.92 "	" $4,284.86 "	" $4,284.86 "	" $1,628.25 "	" $2,699.46 "	" $3,642.13 "	" $2,828.01 "	" $3,427.89 "	" $1,028.37 "	" $3,856.37 "	" $3,483.59 "	" $3,642.13 "	" $1,019.80 "	" $3,483.59 "	" $1,028.37 "
5270078	HCHG CVMC LENS SUPPLY (ONLY)	0276	MEDICAL/SURGICAL SUPPLIES AND DEVICES - INTRAOCULAR LENS		 $32.50 	 $22.75 	 $7.74 	 $29.25 	 $28.28 	 $7.80 	 $24.86 	 $-   	 $-   	 $12.35 	 $20.48 	 $27.63 	 $21.45 	 $26.00 	 $7.80 	 $29.25 	 $26.42 	 $27.63 	 $7.74 	 $26.42 	 $7.80 
5270079	HCHG CVMC LENS/POSTERIOR CHAMBER INTRAOCULAR	0276	MEDICAL/SURGICAL SUPPLIES AND DEVICES - INTRAOCULAR LENS	V2632	 $954.95 	 $668.47 	 $227.28 	 $859.46 	 $830.81 	 $229.19 	 $730.54 	 $-   	 $-   	 $362.88 	 $601.62 	 $811.71 	 $630.27 	 $763.96 	 $229.19 	 $859.46 	 $776.37 	 $811.71 	 $227.28 	 $776.37 	 $229.19 
5270080	HCHG CVMC MULTIFOCAL INTRAOCULAR LENS	0276	MEDICAL/SURGICAL SUPPLIES AND DEVICES - INTRAOCULAR LENS	V2788	" $1,294.70 "	 $906.29 	 $308.14 	" $1,165.23 "	" $1,126.39 "	 $310.73 	 $990.45 	 $-   	 $-   	 $491.99 	 $815.66 	" $1,100.50 "	 $854.50 	" $1,035.76 "	 $310.73 	" $1,165.23 "	" $1,052.59 "	" $1,100.50 "	 $308.14 	" $1,052.59 "	 $310.73 
5270081	HCHG CVMC ASTIGMATISM CORRECTING IOL	0276	MEDICAL/SURGICAL SUPPLIES AND DEVICES - INTRAOCULAR LENS	V2787	 $732.91 	 $513.04 	 $174.43 	 $659.62 	 $637.63 	 $175.90 	 $560.68 	 $-   	 $-   	 $278.51 	 $461.73 	 $622.97 	 $483.72 	 $586.33 	 $175.90 	 $659.62 	 $595.86 	 $622.97 	 $174.43 	 $595.86 	 $175.90 
5270082	HCHG CVMC CRYSTALENS/PREBYOPIA CORRECTING FUNCTION	0276	MEDICAL/SURGICAL SUPPLIES AND DEVICES - INTRAOCULAR LENS	V2788	" $1,530.10 "	" $1,071.07 "	 $364.16 	" $1,530.10 "	" $1,331.19 "	 $367.22 	" $1,170.53 "	" $1,530.10 "	 $-   	 $581.44 	 $963.96 	" $1,300.59 "	" $1,009.87 "	" $1,224.08 "	 $367.22 	" $1,377.09 "	" $1,243.97 "	" $1,300.59 "	 $364.16 	" $1,243.97 "	 $367.22 
302524	HCHG PEEL AWAY SUPRAPUBIC CATHETER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C2627	 $628.00 	 $439.60 	 $149.46 	 $565.20 	 $546.36 	 $150.72 	 $480.42 	 $-   	 $-   	 $238.64 	 $395.64 	 $533.80 	 $414.48 	 $502.40 	 $150.72 	 $565.20 	 $510.56 	 $533.80 	 $149.46 	 $510.56 	 $150.72 
306407	HCHG SHEATH LASER LEAD EXTRACT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C2629	 $732.63 	 $512.84 	 $174.37 	 $659.37 	 $637.39 	 $175.83 	 $560.46 	 $-   	 $-   	 $278.40 	 $461.56 	 $622.74 	 $483.54 	 $586.10 	 $175.83 	 $659.37 	 $595.63 	 $622.74 	 $174.37 	 $595.63 	 $175.83 
310017	"HCHG CATH, STRAIGHT/ROBINSON"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1758	 $52.46 	 $36.72 	 $12.49 	 $47.21 	 $45.64 	 $12.59 	 $40.13 	 $-   	 $-   	 $19.93 	 $33.05 	 $44.59 	 $34.62 	 $41.97 	 $12.59 	 $47.21 	 $42.65 	 $44.59 	 $12.49 	 $42.65 	 $12.59 
310018	HCHG ARROW INTRODUCER (PERCUTAN KIT)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1894	 $336.65 	 $235.66 	 $80.12 	 $302.99 	 $292.89 	 $80.80 	 $257.54 	 $-   	 $-   	 $127.93 	 $212.09 	 $286.15 	 $222.19 	 $269.32 	 $80.80 	 $302.99 	 $273.70 	 $286.15 	 $80.12 	 $273.70 	 $80.80 
310019	HCHG CVMC KIT-FEMALE CATH	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1758	 $72.32 	 $50.62 	 $17.21 	 $65.09 	 $62.92 	 $17.36 	 $55.32 	 $-   	 $-   	 $27.48 	 $45.56 	 $61.47 	 $47.73 	 $57.86 	 $17.36 	 $65.09 	 $58.80 	 $61.47 	 $17.21 	 $58.80 	 $17.36 
310370	HCHG CVMC ARROW TRIPLELUMEN CATH	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1751	" $1,195.52 "	 $836.86 	 $284.53 	" $1,075.97 "	" $1,040.10 "	 $286.92 	 $914.57 	 $-   	 $-   	 $454.30 	 $753.18 	" $1,016.19 "	 $789.04 	 $956.42 	 $286.92 	" $1,075.97 "	 $971.96 	" $1,016.19 "	 $284.53 	 $971.96 	 $286.92 
343159	HCHG OASIS SKIN MATRIX PER SQUARE CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	Q4102	 $245.71 	 $172.00 	 $58.48 	 $221.14 	 $213.77 	 $58.97 	 $187.97 	 $-   	 $-   	 $93.37 	 $154.80 	 $208.85 	 $162.17 	 $196.57 	 $58.97 	 $221.14 	 $199.76 	 $208.85 	 $58.48 	 $199.76 	 $58.97 
360829	HCHG COVODIEN SYMBOTEX MESH 30CM X 20CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,003.92 "	" $2,802.74 "	 $952.93 	" $4,003.92 "	" $3,483.41 "	 $960.94 	" $3,063.00 "	" $4,003.92 "	" $4,003.92 "	" $1,521.49 "	" $2,522.47 "	" $3,403.33 "	" $2,642.59 "	" $3,203.14 "	 $960.94 	" $3,603.53 "	" $3,255.19 "	" $3,403.33 "	 $952.93 	" $3,255.19 "	 $960.94 
360831	HCHG CVMC 4.5MM NARROW LCP PLATE 4 HOLES/80MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,475.00 "	" $1,032.50 "	 $351.05 	" $1,327.50 "	" $1,283.25 "	 $354.00 	" $1,128.38 "	 $-   	 $-   	 $560.50 	 $929.25 	" $1,253.75 "	 $973.50 	" $1,180.00 "	 $354.00 	" $1,327.50 "	" $1,199.18 "	" $1,253.75 "	 $351.05 	" $1,199.18 "	 $354.00 
360832	HCHG CVMC 4.5MM NARROW LCP PLATE 5 HOLES/98MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,577.56 "	" $1,104.29 "	 $375.46 	" $1,577.56 "	" $1,372.48 "	 $378.61 	" $1,206.83 "	" $1,577.56 "	 $-   	 $599.47 	 $993.86 	" $1,340.93 "	" $1,041.19 "	" $1,262.05 "	 $378.61 	" $1,419.80 "	" $1,282.56 "	" $1,340.93 "	 $375.46 	" $1,282.56 "	 $378.61 
360833	HCHG CVMC 4.5MM NARROW LCP PLATE 6 HOLES/116MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,673.05 "	" $1,171.14 "	 $398.19 	" $1,673.05 "	" $1,455.55 "	 $401.53 	" $1,279.88 "	" $1,673.05 "	" $1,673.05 "	 $635.76 	" $1,054.02 "	" $1,422.09 "	" $1,104.21 "	" $1,338.44 "	 $401.53 	" $1,505.75 "	" $1,360.19 "	" $1,422.09 "	 $398.19 	" $1,360.19 "	 $401.53 
360834	HCHG CVMC 4.5MM NARROW LCP PLATE 7 HOLES/134MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,934.79 "	" $1,354.35 "	 $460.48 	" $1,934.79 "	" $1,683.27 "	 $464.35 	" $1,480.11 "	" $1,934.79 "	" $1,934.79 "	 $735.22 	" $1,218.92 "	" $1,644.57 "	" $1,276.96 "	" $1,547.83 "	 $464.35 	" $1,741.31 "	" $1,572.98 "	" $1,644.57 "	 $460.48 	" $1,572.98 "	 $464.35 
360835	HCHG CVMC 4.5MM NARROW LCP PLATE 8 HOLES/152MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,044.50 "	" $1,431.15 "	 $486.59 	" $2,044.50 "	" $1,778.72 "	 $490.68 	" $1,564.04 "	" $2,044.50 "	" $2,044.50 "	 $776.91 	" $1,288.04 "	" $1,737.83 "	" $1,349.37 "	" $1,635.60 "	 $490.68 	" $1,840.05 "	" $1,662.18 "	" $1,737.83 "	 $486.59 	" $1,662.18 "	 $490.68 
360836	HCHG CVMC 4.5MM NARROW LCP PLATE 9 HOLES/170MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,143.52 "	" $1,500.46 "	 $510.16 	" $2,143.52 "	" $1,864.86 "	 $514.44 	" $1,639.79 "	" $2,143.52 "	" $2,143.52 "	 $814.54 	" $1,350.42 "	" $1,821.99 "	" $1,414.72 "	" $1,714.82 "	 $514.44 	" $1,929.17 "	" $1,742.68 "	" $1,821.99 "	 $510.16 	" $1,742.68 "	 $514.44 
360837	HCHG CVMC 4.5MM NARROW LCP PLATE 10 HOLES/188MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,327.45 "	" $1,629.22 "	 $553.93 	" $2,327.45 "	" $2,024.88 "	 $558.59 	" $1,780.50 "	" $2,327.45 "	" $2,327.45 "	 $884.43 	" $1,466.29 "	" $1,978.33 "	" $1,536.12 "	" $1,861.96 "	 $558.59 	" $2,094.71 "	" $1,892.22 "	" $1,978.33 "	 $553.93 	" $1,892.22 "	 $558.59 
360838	HCHG CVMC 4.5MM NARROW LCP PLATE 11 HOLES/206MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,507.82 "	" $1,755.47 "	 $596.86 	" $2,507.82 "	" $2,181.80 "	 $601.88 	" $1,918.48 "	" $2,507.82 "	" $2,507.82 "	 $952.97 	" $1,579.93 "	" $2,131.65 "	" $1,655.16 "	" $2,006.26 "	 $601.88 	" $2,257.04 "	" $2,038.86 "	" $2,131.65 "	 $596.86 	" $2,038.86 "	 $601.88 
360839	HCHG CVMC 4.5MM NARROW LCP PLATE 12 HOLES/224MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,695.29 "	" $1,886.70 "	 $641.48 	" $2,695.29 "	" $2,344.90 "	 $646.87 	" $2,061.90 "	" $2,695.29 "	" $2,695.29 "	" $1,024.21 "	" $1,698.03 "	" $2,291.00 "	" $1,778.89 "	" $2,156.23 "	 $646.87 	" $2,425.76 "	" $2,191.27 "	" $2,291.00 "	 $641.48 	" $2,191.27 "	 $646.87 
360840	HCHG CVMC 4.5MM NARROW LCP PLATE 14 HOLES/260MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,024.29 "	" $2,117.00 "	 $719.78 	" $3,024.29 "	" $2,631.13 "	 $725.83 	" $2,313.58 "	" $3,024.29 "	" $3,024.29 "	" $1,149.23 "	" $1,905.30 "	" $2,570.65 "	" $1,996.03 "	" $2,419.43 "	 $725.83 	" $2,721.86 "	" $2,458.75 "	" $2,570.65 "	 $719.78 	" $2,458.75 "	 $725.83 
360841	HCHG CVMC 4.5MM NARROW LCP PLATE 16 HOLES/296MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,533.60 "	" $2,473.52 "	 $841.00 	" $3,533.60 "	" $3,074.23 "	 $848.06 	" $2,703.20 "	" $3,533.60 "	" $3,533.60 "	" $1,342.77 "	" $2,226.17 "	" $3,003.56 "	" $2,332.18 "	" $2,826.88 "	 $848.06 	" $3,180.24 "	" $2,872.82 "	" $3,003.56 "	 $841.00 	" $2,872.82 "	 $848.06 
360842	HCHG CVMC 4.5MM BROAD LCP PLATE 6 HOLES/116MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,782.71 "	" $1,247.90 "	 $424.28 	" $1,782.71 "	" $1,550.96 "	 $427.85 	" $1,363.77 "	" $1,782.71 "	" $1,782.71 "	 $677.43 	" $1,123.11 "	" $1,515.30 "	" $1,176.59 "	" $1,426.17 "	 $427.85 	" $1,604.44 "	" $1,449.34 "	" $1,515.30 "	 $424.28 	" $1,449.34 "	 $427.85 
360843	HCHG CVMC 4.5MM BROAD LCP PLATE 7 HOLES/134MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,892.37 "	" $1,324.66 "	 $450.38 	" $1,892.37 "	" $1,646.36 "	 $454.17 	" $1,447.66 "	" $1,892.37 "	" $1,892.37 "	 $719.10 	" $1,192.19 "	" $1,608.51 "	" $1,248.96 "	" $1,513.90 "	 $454.17 	" $1,703.13 "	" $1,538.50 "	" $1,608.51 "	 $450.38 	" $1,538.50 "	 $454.17 
360844	HCHG CVMC 4.5MM BROAD LCP PLATE 8 HOLES/152MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,316.85 "	" $1,621.80 "	 $551.41 	" $2,316.85 "	" $2,015.66 "	 $556.04 	" $1,772.39 "	" $2,316.85 "	" $2,316.85 "	 $880.40 	" $1,459.62 "	" $1,969.32 "	" $1,529.12 "	" $1,853.48 "	 $556.04 	" $2,085.17 "	" $1,883.60 "	" $1,969.32 "	 $551.41 	" $1,883.60 "	 $556.04 
360845	HCHG CVMC 4.5MM BROAD LCP PLATE 9 HOLES/170MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,507.82 "	" $1,755.47 "	 $596.86 	" $2,507.82 "	" $2,181.80 "	 $601.88 	" $1,918.48 "	" $2,507.82 "	" $2,507.82 "	 $952.97 	" $1,579.93 "	" $2,131.65 "	" $1,655.16 "	" $2,006.26 "	 $601.88 	" $2,257.04 "	" $2,038.86 "	" $2,131.65 "	 $596.86 	" $2,038.86 "	 $601.88 
360846	HCHG CVMC 4.5MM BROAD LCP PLATE 10 HOLES/188MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,695.29 "	" $1,886.70 "	 $641.48 	" $2,695.29 "	" $2,344.90 "	 $646.87 	" $2,061.90 "	" $2,695.29 "	" $2,695.29 "	" $1,024.21 "	" $1,698.03 "	" $2,291.00 "	" $1,778.89 "	" $2,156.23 "	 $646.87 	" $2,425.76 "	" $2,191.27 "	" $2,291.00 "	 $641.48 	" $2,191.27 "	 $646.87 
360847	HCHG CVMC 4.5MM BROAD LCP PLATE 11 HOLES/206MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,872.16 "	" $2,010.51 "	 $683.57 	" $2,872.16 "	" $2,498.78 "	 $689.32 	" $2,197.20 "	" $2,872.16 "	" $2,872.16 "	" $1,091.42 "	" $1,809.46 "	" $2,441.34 "	" $1,895.63 "	" $2,297.73 "	 $689.32 	" $2,584.94 "	" $2,335.07 "	" $2,441.34 "	 $683.57 	" $2,335.07 "	 $689.32 
360848	HCHG CVMC 4.5MM BROAD LCP PLATE 12 HOLES/224MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,045.46 "	" $2,131.82 "	 $724.82 	" $3,045.46 "	" $2,649.55 "	 $730.91 	" $2,329.78 "	" $3,045.46 "	" $3,045.46 "	" $1,157.27 "	" $1,918.64 "	" $2,588.64 "	" $2,010.00 "	" $2,436.37 "	 $730.91 	" $2,740.91 "	" $2,475.96 "	" $2,588.64 "	 $724.82 	" $2,475.96 "	 $730.91 
360849	HCHG CVMC 4.5MM BROAD LCP PLATE 14 HOLES/260MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,395.66 "	" $2,376.96 "	 $808.17 	" $3,395.66 "	" $2,954.22 "	 $814.96 	" $2,597.68 "	" $3,395.66 "	" $3,395.66 "	" $1,290.35 "	" $2,139.27 "	" $2,886.31 "	" $2,241.14 "	" $2,716.53 "	 $814.96 	" $3,056.09 "	" $2,760.67 "	" $2,886.31 "	 $808.17 	" $2,760.67 "	 $814.96 
360850	HCHG CVMC 4.5MM BROAD LCP PLATE 16 HOLES/296MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,351.67 "	" $2,346.17 "	 $797.70 	" $3,351.67 "	" $2,915.95 "	 $804.40 	" $2,564.03 "	" $3,351.67 "	" $3,351.67 "	" $1,273.63 "	" $2,111.55 "	" $2,848.92 "	" $2,212.10 "	" $2,681.34 "	 $804.40 	" $3,016.50 "	" $2,724.91 "	" $2,848.92 "	 $797.70 	" $2,724.91 "	 $804.40 
370035	HCHG ALLOFUSE DBM PUTTY 1.0CC/PER 0.5CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C9359	 $363.12 	 $254.18 	 $86.42 	 $326.81 	 $315.91 	 $87.15 	 $277.79 	 $-   	 $-   	 $137.99 	 $228.77 	 $308.65 	 $239.66 	 $290.50 	 $87.15 	 $326.81 	 $295.22 	 $308.65 	 $86.42 	 $295.22 	 $87.15 
370036	HCHG ALLOFUSE DBM PUTTY 2.5CC/PER 0.5CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C9359	 $363.12 	 $254.18 	 $86.42 	 $326.81 	 $315.91 	 $87.15 	 $277.79 	 $-   	 $-   	 $137.99 	 $228.77 	 $308.65 	 $239.66 	 $290.50 	 $87.15 	 $326.81 	 $295.22 	 $308.65 	 $86.42 	 $295.22 	 $87.15 
370037	HCHG CANCELLOUS CHIPS 5.0CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	 $726.25 	 $508.38 	 $172.85 	 $653.63 	 $631.84 	 $174.30 	 $555.58 	 $-   	 $-   	 $275.98 	 $457.54 	 $617.31 	 $479.33 	 $581.00 	 $174.30 	 $653.63 	 $590.44 	 $617.31 	 $172.85 	 $590.44 	 $174.30 
370038	HCHG CANCELLOUS CHIPS 15CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $1,089.37 "	 $762.56 	 $259.27 	 $980.43 	 $947.75 	 $261.45 	 $833.37 	 $-   	 $-   	 $413.96 	 $686.30 	 $925.96 	 $718.98 	 $871.50 	 $261.45 	 $980.43 	 $885.66 	 $925.96 	 $259.27 	 $885.66 	 $261.45 
4410129	HCHG FILTER OPTEASE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1880	" $1,831.54 "	" $1,282.08 "	 $435.91 	" $1,831.54 "	" $1,593.44 "	 $439.57 	" $1,401.13 "	" $1,831.54 "	" $1,831.54 "	 $695.99 	" $1,153.87 "	" $1,556.81 "	" $1,208.82 "	" $1,465.23 "	 $439.57 	" $1,648.39 "	" $1,489.04 "	" $1,556.81 "	 $435.91 	" $1,489.04 "	 $439.57 
4410252	"HCHG NEURO, PRECISE STENT 6FR"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1875	" $7,590.83 "	" $5,313.58 "	" $1,806.62 "	" $7,590.83 "	" $6,604.02 "	" $1,821.80 "	" $5,806.98 "	" $7,590.83 "	" $7,590.83 "	" $2,884.52 "	" $4,782.22 "	" $6,452.21 "	" $5,009.95 "	" $6,072.66 "	" $1,821.80 "	" $6,831.75 "	" $6,171.34 "	" $6,452.21 "	" $1,806.62 "	" $6,171.34 "	" $1,821.80 "
4410300	"HCHG STENT, URETERAL 8 X 28"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C2617	 $718.92 	 $503.24 	 $171.10 	 $647.03 	 $625.46 	 $172.54 	 $549.97 	 $-   	 $-   	 $273.19 	 $452.92 	 $611.08 	 $474.49 	 $575.14 	 $172.54 	 $647.03 	 $584.48 	 $611.08 	 $171.10 	 $584.48 	 $172.54 
4410301	"HCHG STENT, VIATORR"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1874	" $7,969.88 "	" $5,578.92 "	" $1,896.83 "	" $7,969.88 "	" $6,933.80 "	" $1,912.77 "	" $6,096.96 "	" $7,969.88 "	" $7,969.88 "	" $3,028.55 "	" $5,021.02 "	" $6,774.40 "	" $5,260.12 "	" $6,375.90 "	" $1,912.77 "	" $7,172.89 "	" $6,479.51 "	" $6,774.40 "	" $1,896.83 "	" $6,479.51 "	" $1,912.77 "
4410333	HCHG TITANIUM PORT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1788	" $1,409.73 "	 $986.81 	 $335.52 	" $1,268.76 "	" $1,226.47 "	 $338.34 	" $1,078.44 "	 $-   	 $-   	 $535.70 	 $888.13 	" $1,198.27 "	 $930.42 	" $1,127.78 "	 $338.34 	" $1,268.76 "	" $1,146.11 "	" $1,198.27 "	 $335.52 	" $1,146.11 "	 $338.34 
4410379	HCHG CATH PICC SOLO INTEGRATED 5FR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1751	" $1,072.27 "	 $750.59 	 $255.20 	 $965.04 	 $932.87 	 $257.34 	 $820.29 	 $-   	 $-   	 $407.46 	 $675.53 	 $911.43 	 $707.70 	 $857.82 	 $257.34 	 $965.04 	 $871.76 	 $911.43 	 $255.20 	 $871.76 	 $257.34 
4410434	"HCHG STENT, NCOV/NCOAT W/DEL SYS"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1876	" $4,539.38 "	" $3,177.57 "	" $1,080.37 "	" $4,539.38 "	" $3,949.26 "	" $1,089.45 "	" $3,472.63 "	" $4,539.38 "	" $4,539.38 "	" $1,724.96 "	" $2,859.81 "	" $3,858.47 "	" $2,995.99 "	" $3,631.50 "	" $1,089.45 "	" $4,085.44 "	" $3,690.52 "	" $3,858.47 "	" $1,080.37 "	" $3,690.52 "	" $1,089.45 "
4410453	"HCHG CATH, CORONARY LASER"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1885	" $1,170.61 "	 $819.43 	 $278.61 	" $1,053.55 "	" $1,018.43 "	 $280.95 	 $895.52 	 $-   	 $-   	 $444.83 	 $737.48 	 $995.02 	 $772.60 	 $936.49 	 $280.95 	" $1,053.55 "	 $951.71 	 $995.02 	 $278.61 	 $951.71 	 $280.95 
4410474	"HCHG CATH,MUSTANG BALLOON > 150MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1725	" $1,526.29 "	" $1,068.40 "	 $363.26 	" $1,526.29 "	" $1,327.87 "	 $366.31 	" $1,167.61 "	" $1,526.29 "	 $-   	 $579.99 	 $961.56 	" $1,297.35 "	" $1,007.35 "	" $1,221.03 "	 $366.31 	" $1,373.66 "	" $1,240.87 "	" $1,297.35 "	 $363.26 	" $1,240.87 "	 $366.31 
500153	"HCHG ICONIX 1 ANCHOR, 1.4 MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,359.63 "	 $951.74 	 $323.59 	" $1,223.67 "	" $1,182.88 "	 $326.31 	" $1,040.12 "	 $-   	 $-   	 $516.66 	 $856.57 	" $1,155.69 "	 $897.36 	" $1,087.70 "	 $326.31 	" $1,223.67 "	" $1,105.38 "	" $1,155.69 "	 $323.59 	" $1,105.38 "	 $326.31 
501776	HCHG ANCHOR FAST FIX  360 CURVE NEEDLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,755.87 "	" $1,229.11 "	 $417.90 	" $1,755.87 "	" $1,527.61 "	 $421.41 	" $1,343.24 "	" $1,755.87 "	" $1,755.87 "	 $667.23 	" $1,106.20 "	" $1,492.49 "	" $1,158.87 "	" $1,404.70 "	 $421.41 	" $1,580.28 "	" $1,427.52 "	" $1,492.49 "	 $417.90 	" $1,427.52 "	 $421.41 
501778	HCHG TIGHTROPE SYNDESMOSIS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,922.91 "	" $1,346.04 "	 $457.65 	" $1,922.91 "	" $1,672.93 "	 $461.50 	" $1,471.03 "	" $1,922.91 "	" $1,922.91 "	 $730.71 	" $1,211.43 "	" $1,634.47 "	" $1,269.12 "	" $1,538.33 "	 $461.50 	" $1,730.62 "	" $1,563.33 "	" $1,634.47 "	 $457.65 	" $1,563.33 "	 $461.50 
501779	HCHG TIGHTROPE KNOTLESS SYNDESMOSIS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,301.96 "	" $2,311.37 "	 $785.87 	" $3,301.96 "	" $2,872.71 "	 $792.47 	" $2,526.00 "	" $3,301.96 "	" $3,301.96 "	" $1,254.74 "	" $2,080.23 "	" $2,806.67 "	" $2,179.29 "	" $2,641.57 "	 $792.47 	" $2,971.76 "	" $2,684.49 "	" $2,806.67 "	 $785.87 	" $2,684.49 "	 $792.47 
501780	HCHG AEQ REV II 10 TILTED SPHERE 36MM DIA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $11,364.91 "	" $7,955.44 "	" $2,704.85 "	" $11,364.91 "	" $9,887.47 "	" $2,727.58 "	" $8,694.16 "	" $11,364.91 "	" $11,364.91 "	" $4,318.67 "	" $7,159.89 "	" $9,660.17 "	" $7,500.84 "	" $9,091.93 "	" $2,727.58 "	" $10,228.42 "	" $9,239.67 "	" $9,660.17 "	" $2,704.85 "	" $9,239.67 "	" $2,727.58 "
501781	HCHG AEQ REV FRAC HUMERAL STEM 9X130	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $19,572.90 "	" $13,701.03 "	" $4,658.35 "	" $19,572.90 "	" $17,028.42 "	" $4,697.50 "	" $14,973.27 "	" $19,572.90 "	" $19,572.90 "	" $7,437.70 "	" $12,330.93 "	" $16,636.97 "	" $12,918.11 "	" $15,658.32 "	" $4,697.50 "	" $17,615.61 "	" $15,912.77 "	" $16,636.97 "	" $4,658.35 "	" $15,912.77 "	" $4,697.50 "
501782	HCHG AEQ REV FRAC CONSTRAINED INSERT 36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,576.61 "	" $5,303.63 "	" $1,803.23 "	" $7,576.61 "	" $6,591.65 "	" $1,818.39 "	" $5,796.11 "	" $7,576.61 "	" $7,576.61 "	" $2,879.11 "	" $4,773.26 "	" $6,440.12 "	" $5,000.56 "	" $6,061.29 "	" $1,818.39 "	" $6,818.95 "	" $6,159.78 "	" $6,440.12 "	" $1,803.23 "	" $6,159.78 "	" $1,818.39 "
501785	"HCHG CANCELLOUS CHIPS 15CC ""CROUTON"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $1,351.43 "	 $946.00 	 $321.64 	" $1,216.29 "	" $1,175.74 "	 $324.34 	" $1,033.84 "	 $-   	 $-   	 $513.54 	 $851.40 	" $1,148.72 "	 $891.94 	" $1,081.14 "	 $324.34 	" $1,216.29 "	" $1,098.71 "	" $1,148.72 "	 $321.64 	" $1,098.71 "	 $324.34 
501786	HCHG CVMC MINIARC PRO SLING SYSTEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1771	" $5,887.66 "	" $4,121.36 "	" $1,401.26 "	" $5,887.66 "	" $5,122.26 "	" $1,413.04 "	" $4,504.06 "	" $5,887.66 "	" $5,887.66 "	" $2,237.31 "	" $3,709.23 "	" $5,004.51 "	" $3,885.86 "	" $4,710.13 "	" $1,413.04 "	" $5,298.89 "	" $4,786.67 "	" $5,004.51 "	" $1,401.26 "	" $4,786.67 "	" $1,413.04 "
5270083	HCHG CVMC SPIKED WASHER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $730.30 	 $511.21 	 $173.81 	 $657.27 	 $635.36 	 $175.27 	 $558.68 	 $-   	 $-   	 $277.51 	 $460.09 	 $620.76 	 $482.00 	 $584.24 	 $175.27 	 $657.27 	 $593.73 	 $620.76 	 $173.81 	 $593.73 	 $175.27 
5270084	"HCHG PLASMAX CONCENTRATOR KIT, CONNECTIVE TISSUE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $4,735.32 "	" $3,314.72 "	" $1,127.01 "	" $4,735.32 "	" $4,119.73 "	" $1,136.48 "	" $3,622.52 "	" $4,735.32 "	" $4,735.32 "	" $1,799.42 "	" $2,983.25 "	" $4,025.02 "	" $3,125.31 "	" $3,788.26 "	" $1,136.48 "	" $4,261.79 "	" $3,849.82 "	" $4,025.02 "	" $1,127.01 "	" $3,849.82 "	" $1,136.48 "
5270085	HCHG CVMC PLATE 1/4 TUBULAR 6 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $437.28 	 $306.10 	 $104.07 	 $393.55 	 $380.43 	 $104.95 	 $334.52 	 $-   	 $-   	 $166.17 	 $275.49 	 $371.69 	 $288.60 	 $349.82 	 $104.95 	 $393.55 	 $355.51 	 $371.69 	 $104.07 	 $355.51 	 $104.95 
5270086	HCHG CVMC METACARPOPHALANGEAL K-WIRE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $54.00 	 $37.80 	 $12.85 	 $48.60 	 $46.98 	 $12.96 	 $41.31 	 $-   	 $-   	 $20.52 	 $34.02 	 $45.90 	 $35.64 	 $43.20 	 $12.96 	 $48.60 	 $43.90 	 $45.90 	 $12.85 	 $43.90 	 $12.96 
5270087	HCHG CVMC ENDO GIA 30-3.5 DLU REFILL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,061.62 "	 $743.13 	 $252.67 	 $955.46 	 $923.61 	 $254.79 	 $812.14 	 $-   	 $-   	 $403.42 	 $668.82 	 $902.38 	 $700.67 	 $849.30 	 $254.79 	 $955.46 	 $863.10 	 $902.38 	 $252.67 	 $863.10 	 $254.79 
5270088	HCHG CVMC ENDO GIA 30 STAPLER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $2,552.29 "	" $1,786.60 "	 $607.45 	" $2,552.29 "	" $2,220.49 "	 $612.55 	" $1,952.50 "	" $2,552.29 "	" $2,552.29 "	 $969.87 	" $1,607.94 "	" $2,169.45 "	" $1,684.51 "	" $2,041.83 "	 $612.55 	" $2,297.06 "	" $2,075.01 "	" $2,169.45 "	 $607.45 	" $2,075.01 "	 $612.55 
5270089	HCHG CVMC ENDO HERNIA STAPLER REFILL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $559.34 	 $391.54 	 $133.12 	 $503.41 	 $486.63 	 $134.24 	 $427.90 	 $-   	 $-   	 $212.55 	 $352.38 	 $475.44 	 $369.16 	 $447.47 	 $134.24 	 $503.41 	 $454.74 	 $475.44 	 $133.12 	 $454.74 	 $134.24 
5270090	HCHG CVMC STAPLER/ENDOCLIP 10MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,081.60 "	 $757.12 	 $257.42 	 $973.44 	 $940.99 	 $259.58 	 $827.42 	 $-   	 $-   	 $411.01 	 $681.41 	 $919.36 	 $713.86 	 $865.28 	 $259.58 	 $973.44 	 $879.34 	 $919.36 	 $257.42 	 $879.34 	 $259.58 
5270091	HCHG CVMC MESH-ATRIUM 6X6	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $639.09 	 $447.36 	 $152.10 	 $575.18 	 $556.01 	 $153.38 	 $488.90 	 $-   	 $-   	 $242.85 	 $402.63 	 $543.23 	 $421.80 	 $511.27 	 $153.38 	 $575.18 	 $519.58 	 $543.23 	 $152.10 	 $519.58 	 $153.38 
5270092	HCHG CVMC LUPINE BR ANCHOR W/ORTHOCOD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,254.73 "	 $878.31 	 $298.63 	" $1,129.26 "	" $1,091.62 "	 $301.14 	 $959.87 	 $-   	 $-   	 $476.80 	 $790.48 	" $1,066.52 "	 $828.12 	" $1,003.78 "	 $301.14 	" $1,129.26 "	" $1,020.10 "	" $1,066.52 "	 $298.63 	" $1,020.10 "	 $301.14 
5270093	HCHG CVMC REABSORBABLE SCREW/BIOMET-ARTH	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,417.88 "	 $992.52 	 $337.46 	" $1,276.09 "	" $1,233.56 "	 $340.29 	" $1,084.68 "	 $-   	 $-   	 $538.79 	 $893.26 	" $1,205.20 "	 $935.80 	" $1,134.30 "	 $340.29 	" $1,276.09 "	" $1,152.74 "	" $1,205.20 "	 $337.46 	" $1,152.74 "	 $340.29 
5270094	HCHG CVMC CANCELLOUS 4-10MM 15CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $1,487.40 "	" $1,041.18 "	 $354.00 	" $1,338.66 "	" $1,294.04 "	 $356.98 	" $1,137.86 "	 $-   	 $-   	 $565.21 	 $937.06 	" $1,264.29 "	 $981.68 	" $1,189.92 "	 $356.98 	" $1,338.66 "	" $1,209.26 "	" $1,264.29 "	 $354.00 	" $1,209.26 "	 $356.98 
5270095	HCHG CVMC CANCELLOUS 4-10MM 30CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $1,972.75 "	" $1,380.93 "	 $469.51 	" $1,972.75 "	" $1,716.29 "	 $473.46 	" $1,509.15 "	" $1,972.75 "	" $1,972.75 "	 $749.65 	" $1,242.83 "	" $1,676.84 "	" $1,302.02 "	" $1,578.20 "	 $473.46 	" $1,775.48 "	" $1,603.85 "	" $1,676.84 "	 $469.51 	" $1,603.85 "	 $473.46 
5270096	HCHG CVMC PATELLA TENDON-WHOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $5,654.69 "	" $3,958.28 "	" $1,345.82 "	" $5,654.69 "	" $4,919.58 "	" $1,357.13 "	" $4,325.84 "	" $5,654.69 "	" $5,654.69 "	" $2,148.78 "	" $3,562.45 "	" $4,806.49 "	" $3,732.10 "	" $4,523.75 "	" $1,357.13 "	" $5,089.22 "	" $4,597.26 "	" $4,806.49 "	" $1,345.82 "	" $4,597.26 "	" $1,357.13 "
5270097	HCHG CVMC PATELLA TENDON-HEMI	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $5,326.56 "	" $3,728.59 "	" $1,267.72 "	" $5,326.56 "	" $4,634.11 "	" $1,278.37 "	" $4,074.82 "	" $5,326.56 "	" $5,326.56 "	" $2,024.09 "	" $3,355.73 "	" $4,527.58 "	" $3,515.53 "	" $4,261.25 "	" $1,278.37 "	" $4,793.90 "	" $4,330.49 "	" $4,527.58 "	" $1,267.72 "	" $4,330.49 "	" $1,278.37 "
5270098	HCHG CVMC PORT-A-CATH/TITANIUM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $2,663.78 "	" $1,864.65 "	 $633.98 	" $2,663.78 "	" $2,317.49 "	 $639.31 	" $2,037.79 "	" $2,663.78 "	" $2,663.78 "	" $1,012.24 "	" $1,678.18 "	" $2,264.21 "	" $1,758.09 "	" $2,131.02 "	 $639.31 	" $2,397.40 "	" $2,165.65 "	" $2,264.21 "	 $633.98 	" $2,165.65 "	 $639.31 
5270099	HCHG CVMC 5.5 BIO CORKSCREW SUTURE ANCHO	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,814.41 "	" $1,270.09 "	 $431.83 	" $1,814.41 "	" $1,578.54 "	 $435.46 	" $1,388.02 "	" $1,814.41 "	" $1,814.41 "	 $689.48 	" $1,143.08 "	" $1,542.25 "	" $1,197.51 "	" $1,451.53 "	 $435.46 	" $1,632.97 "	" $1,475.12 "	" $1,542.25 "	 $431.83 	" $1,475.12 "	 $435.46 
5270100	HCHG CVMC FASTAK SUTURE ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,291.04 "	 $903.73 	 $307.27 	" $1,161.94 "	" $1,123.20 "	 $309.85 	 $987.65 	 $-   	 $-   	 $490.60 	 $813.36 	" $1,097.38 "	 $852.09 	" $1,032.83 "	 $309.85 	" $1,161.94 "	" $1,049.62 "	" $1,097.38 "	 $307.27 	" $1,049.62 "	 $309.85 
5270101	HCHG CVMC PORT-A-CATH/DUAL LUMEN TITANIUM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $3,156.78 "	" $2,209.75 "	 $751.31 	" $3,156.78 "	" $2,746.40 "	 $757.63 	" $2,414.94 "	" $3,156.78 "	" $3,156.78 "	" $1,199.58 "	" $1,988.77 "	" $2,683.26 "	" $2,083.47 "	" $2,525.42 "	 $757.63 	" $2,841.10 "	" $2,566.46 "	" $2,683.26 "	 $751.31 	" $2,566.46 "	 $757.63 
5270102	HCHG CVMC MENISCUS ARROW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,320.02 "	 $924.01 	 $314.16 	" $1,188.02 "	" $1,148.42 "	 $316.80 	" $1,009.82 "	 $-   	 $-   	 $501.61 	 $831.61 	" $1,122.02 "	 $871.21 	" $1,056.02 "	 $316.80 	" $1,188.02 "	" $1,073.18 "	" $1,122.02 "	 $314.16 	" $1,073.18 "	 $316.80 
5270103	HCHG CVMC ROTATOR CUFF QUICK ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,017.87 "	" $1,412.51 "	 $480.25 	" $2,017.87 "	" $1,755.55 "	 $484.29 	" $1,543.67 "	" $2,017.87 "	" $2,017.87 "	 $766.79 	" $1,271.26 "	" $1,715.19 "	" $1,331.79 "	" $1,614.30 "	 $484.29 	" $1,816.08 "	" $1,640.53 "	" $1,715.19 "	 $480.25 	" $1,640.53 "	 $484.29 
5270104	HCHG CVMC STEINMAN PIN- ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $194.45 	 $136.12 	 $46.28 	 $175.01 	 $169.17 	 $46.67 	 $148.75 	 $-   	 $-   	 $73.89 	 $122.50 	 $165.28 	 $128.34 	 $155.56 	 $46.67 	 $175.01 	 $158.09 	 $165.28 	 $46.28 	 $158.09 	 $46.67 
5270105	"HCHG CVMC PROSTHESIS, BREAST IMPLANT"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	A4648	 $606.00 	 $424.20 	 $144.23 	 $545.40 	 $527.22 	 $145.44 	 $463.59 	 $-   	 $-   	 $230.28 	 $381.78 	 $515.10 	 $399.96 	 $484.80 	 $145.44 	 $545.40 	 $492.68 	 $515.10 	 $144.23 	 $492.68 	 $145.44 
5270106	HCHG CVMC ALLODERM-ACELLULAR DERMAL GRAFT 3CMX7CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $2,709.12 "	" $1,896.38 "	 $644.77 	" $2,709.12 "	" $2,356.93 "	 $650.19 	" $2,072.48 "	" $2,709.12 "	" $2,709.12 "	" $1,029.47 "	" $1,706.75 "	" $2,302.75 "	" $1,788.02 "	" $2,167.30 "	 $650.19 	" $2,438.21 "	" $2,202.51 "	" $2,302.75 "	 $644.77 	" $2,202.51 "	 $650.19 
5270107	HCHG CVMC ANTI-ADHESION FILM-SEPRAFILM MEMBRANE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,284.86 "	 $899.40 	 $305.80 	" $1,156.37 "	" $1,117.83 "	 $308.37 	 $982.92 	 $-   	 $-   	 $488.25 	 $809.46 	" $1,092.13 "	 $848.01 	" $1,027.89 "	 $308.37 	" $1,156.37 "	" $1,044.59 "	" $1,092.13 "	 $305.80 	" $1,044.59 "	 $308.37 
5270109	HCHG CVMC ANCHOR MINI QUICK MITEK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,827.14 "	" $1,279.00 "	 $434.86 	" $1,827.14 "	" $1,589.61 "	 $438.51 	" $1,397.76 "	" $1,827.14 "	" $1,827.14 "	 $694.31 	" $1,151.10 "	" $1,553.07 "	" $1,205.91 "	" $1,461.71 "	 $438.51 	" $1,644.43 "	" $1,485.46 "	" $1,553.07 "	 $434.86 	" $1,485.46 "	 $438.51 
5270110	HCHG CVMC ANCHOR ROTATOR CUFF MITEK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,026.70 "	" $1,418.69 "	 $482.35 	" $2,026.70 "	" $1,763.23 "	 $486.41 	" $1,550.43 "	" $2,026.70 "	" $2,026.70 "	 $770.15 	" $1,276.82 "	" $1,722.70 "	" $1,337.62 "	" $1,621.36 "	 $486.41 	" $1,824.03 "	" $1,647.71 "	" $1,722.70 "	 $482.35 	" $1,647.71 "	 $486.41 
5270111	HCHG CVMC 6.5MM CANCELLOUS SCREW-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $766.38 	 $536.47 	 $182.40 	 $689.74 	 $666.75 	 $183.93 	 $586.28 	 $-   	 $-   	 $291.22 	 $482.82 	 $651.42 	 $505.81 	 $613.10 	 $183.93 	 $689.74 	 $623.07 	 $651.42 	 $182.40 	 $623.07 	 $183.93 
5270113	HCHG CVMC 2.5MM CANCELLOUS SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $631.15 	 $441.81 	 $150.21 	 $568.04 	 $549.10 	 $151.48 	 $482.83 	 $-   	 $-   	 $239.84 	 $397.62 	 $536.48 	 $416.56 	 $504.92 	 $151.48 	 $568.04 	 $513.12 	 $536.48 	 $150.21 	 $513.12 	 $151.48 
5270114	HCHG CVMC CORTICAL SCREW 3.5MM-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $107.43 	 $75.20 	 $25.57 	 $96.69 	 $93.46 	 $25.78 	 $82.18 	 $-   	 $-   	 $40.82 	 $67.68 	 $91.32 	 $70.90 	 $85.94 	 $25.78 	 $96.69 	 $87.34 	 $91.32 	 $25.57 	 $87.34 	 $25.78 
5270115	HCHG CVMC CANCELLOUS SCREW 4.0MM-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $115.69 	 $80.98 	 $27.53 	 $104.12 	 $100.65 	 $27.77 	 $88.50 	 $-   	 $-   	 $43.96 	 $72.88 	 $98.34 	 $76.36 	 $92.55 	 $27.77 	 $104.12 	 $94.06 	 $98.34 	 $27.53 	 $94.06 	 $27.77 
5270116	HCHG CVMC SCREW CANNULATED FULL TH 12-65	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $902.88 	 $632.02 	 $214.89 	 $812.59 	 $785.51 	 $216.69 	 $690.70 	 $-   	 $-   	 $343.09 	 $568.81 	 $767.45 	 $595.90 	 $722.30 	 $216.69 	 $812.59 	 $734.04 	 $767.45 	 $214.89 	 $734.04 	 $216.69 
5270117	HCHG CVMC ZIMMER CANNULATED SCREW 4.0ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $830.80 	 $581.56 	 $197.73 	 $747.72 	 $722.80 	 $199.39 	 $635.56 	 $-   	 $-   	 $315.70 	 $523.40 	 $706.18 	 $548.33 	 $664.64 	 $199.39 	 $747.72 	 $675.44 	 $706.18 	 $197.73 	 $675.44 	 $199.39 
5270118	HCHG CVMC SCREW 5.0 CANN FULL TH 12.65	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $933.17 	 $653.22 	 $222.09 	 $839.85 	 $811.86 	 $223.96 	 $713.88 	 $-   	 $-   	 $354.60 	 $587.90 	 $793.19 	 $615.89 	 $746.54 	 $223.96 	 $839.85 	 $758.67 	 $793.19 	 $222.09 	 $758.67 	 $223.96 
5270119	HCHG CVMC SCREW 5.0MM CANN PART TH 42.70	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $933.17 	 $653.22 	 $222.09 	 $839.85 	 $811.86 	 $223.96 	 $713.88 	 $-   	 $-   	 $354.60 	 $587.90 	 $793.19 	 $615.89 	 $746.54 	 $223.96 	 $839.85 	 $758.67 	 $793.19 	 $222.09 	 $758.67 	 $223.96 
5270120	HCHG CVMC SCREW 7.0MM CANN 16MM 30-130	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $953.82 	 $667.67 	 $227.01 	 $858.44 	 $829.82 	 $228.92 	 $729.67 	 $-   	 $-   	 $362.45 	 $600.91 	 $810.75 	 $629.52 	 $763.06 	 $228.92 	 $858.44 	 $775.46 	 $810.75 	 $227.01 	 $775.46 	 $228.92 
5270121	HCHG CVMC SCREW 7.0 CANN 32MM TH 40-120	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $953.82 	 $667.67 	 $227.01 	 $858.44 	 $829.82 	 $228.92 	 $729.67 	 $-   	 $-   	 $362.45 	 $600.91 	 $810.75 	 $629.52 	 $763.06 	 $228.92 	 $858.44 	 $775.46 	 $810.75 	 $227.01 	 $775.46 	 $228.92 
5270122	HCHG CVMC SCREW COMPRESSING ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $290.76 	 $203.53 	 $69.20 	 $261.68 	 $252.96 	 $69.78 	 $222.43 	 $-   	 $-   	 $110.49 	 $183.18 	 $247.15 	 $191.90 	 $232.61 	 $69.78 	 $261.68 	 $236.39 	 $247.15 	 $69.20 	 $236.39 	 $69.78 
5270123	HCHG CVMC SCREW CORTICAL 1.5X6-16MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $130.25 	 $91.18 	 $31.00 	 $117.23 	 $113.32 	 $31.26 	 $99.64 	 $-   	 $-   	 $49.50 	 $82.06 	 $110.71 	 $85.97 	 $104.20 	 $31.26 	 $117.23 	 $105.89 	 $110.71 	 $31.00 	 $105.89 	 $31.26 
5270124	HCHG CVMC SCREW CORTICAL 2.0X10-18MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $130.25 	 $91.18 	 $31.00 	 $117.23 	 $113.32 	 $31.26 	 $99.64 	 $-   	 $-   	 $49.50 	 $82.06 	 $110.71 	 $85.97 	 $104.20 	 $31.26 	 $117.23 	 $105.89 	 $110.71 	 $31.00 	 $105.89 	 $31.26 
5270125	HCHG CVMC SCREW CORTICAL 4.5X80-120MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $218.92 	 $153.24 	 $52.10 	 $197.03 	 $190.46 	 $52.54 	 $167.47 	 $-   	 $-   	 $83.19 	 $137.92 	 $186.08 	 $144.49 	 $175.14 	 $52.54 	 $197.03 	 $177.98 	 $186.08 	 $52.10 	 $177.98 	 $52.54 
5270126	HCHG CVMC SCREW CORTICAL 4.5X14-75MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $119.82 	 $83.87 	 $28.52 	 $107.84 	 $104.24 	 $28.76 	 $91.66 	 $-   	 $-   	 $45.53 	 $75.49 	 $101.85 	 $79.08 	 $95.86 	 $28.76 	 $107.84 	 $97.41 	 $101.85 	 $28.52 	 $97.41 	 $28.76 
5270127	HCHG CVMC KNEE FEMORAL-JOINT IMPLANT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,983.71 "	" $7,688.60 "	" $2,614.12 "	" $10,983.71 "	" $9,555.83 "	" $2,636.09 "	" $8,402.54 "	" $10,983.71 "	" $10,983.71 "	" $4,173.81 "	" $6,919.74 "	" $9,336.15 "	" $7,249.25 "	" $8,786.97 "	" $2,636.09 "	" $9,885.34 "	" $8,929.76 "	" $9,336.15 "	" $2,614.12 "	" $8,929.76 "	" $2,636.09 "
5270128	HCHG CVMC KNEE JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,264.56 "	" $2,985.19 "	" $1,014.97 "	" $4,264.56 "	" $3,710.17 "	" $1,023.49 "	" $3,262.39 "	" $4,264.56 "	" $4,264.56 "	" $1,620.53 "	" $2,686.67 "	" $3,624.88 "	" $2,814.61 "	" $3,411.65 "	" $1,023.49 "	" $3,838.10 "	" $3,467.09 "	" $3,624.88 "	" $1,014.97 "	" $3,467.09 "	" $1,023.49 "
5270129	HCHG CVMC 6 HOLE SMALL LOCKING CLAVICLE PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,969.81 "	" $2,078.87 "	 $706.81 	" $2,969.81 "	" $2,583.73 "	 $712.75 	" $2,271.90 "	" $2,969.81 "	" $2,969.81 "	" $1,128.53 "	" $1,870.98 "	" $2,524.34 "	" $1,960.07 "	" $2,375.85 "	 $712.75 	" $2,672.83 "	" $2,414.46 "	" $2,524.34 "	 $706.81 	" $2,414.46 "	 $712.75 
5270130	HCHG CVMC CORTICAL SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $479.32 	 $335.52 	 $114.08 	 $431.39 	 $417.01 	 $115.04 	 $366.68 	 $-   	 $-   	 $182.14 	 $301.97 	 $407.42 	 $316.35 	 $383.46 	 $115.04 	 $431.39 	 $389.69 	 $407.42 	 $114.08 	 $389.69 	 $115.04 
5270131	HCHG CVMC LOCKING BONE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $559.21 	 $391.45 	 $133.09 	 $503.29 	 $486.51 	 $134.21 	 $427.80 	 $-   	 $-   	 $212.50 	 $352.30 	 $475.33 	 $369.08 	 $447.37 	 $134.21 	 $503.29 	 $454.64 	 $475.33 	 $133.09 	 $454.64 	 $134.21 
5270132	HCHG CVMC REUNITE ORTHO SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,308.01 "	 $915.61 	 $311.31 	" $1,177.21 "	" $1,137.97 "	 $313.92 	" $1,000.63 "	 $-   	 $-   	 $497.04 	 $824.05 	" $1,111.81 "	 $863.29 	" $1,046.41 "	 $313.92 	" $1,177.21 "	" $1,063.41 "	" $1,111.81 "	 $311.31 	" $1,063.41 "	 $313.92 
5270133	HCHG CVMC MEDIAL TIBIAL TRAY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,420.87 "	" $5,194.61 "	" $1,766.17 "	" $7,420.87 "	" $6,456.16 "	" $1,781.01 "	" $5,676.97 "	" $7,420.87 "	" $7,420.87 "	" $2,819.93 "	" $4,675.15 "	" $6,307.74 "	" $4,897.77 "	" $5,936.70 "	" $1,781.01 "	" $6,678.78 "	" $6,033.17 "	" $6,307.74 "	" $1,766.17 "	" $6,033.17 "	" $1,781.01 "
5270134	HCHG CVMC OCULAR IMPLANT ASSIST DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1783	" $1,041.79 "	 $729.25 	 $247.95 	 $937.61 	 $906.36 	 $250.03 	 $796.97 	 $-   	 $-   	 $395.88 	 $656.33 	 $885.52 	 $687.58 	 $833.43 	 $250.03 	 $937.61 	 $846.98 	 $885.52 	 $247.95 	 $846.98 	 $250.03 
5270135	HCHG CVMC ALLODERM REGENERATIVE TISSUE MATRIX ALLOGRAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $18,310.28 "	" $12,817.20 "	" $4,357.85 "	" $18,310.28 "	" $15,929.94 "	" $4,394.47 "	" $14,007.36 "	" $18,310.28 "	" $18,310.28 "	" $6,957.91 "	" $11,535.48 "	" $15,563.74 "	" $12,084.78 "	" $14,648.22 "	" $4,394.47 "	" $16,479.25 "	" $14,886.26 "	" $15,563.74 "	" $4,357.85 "	" $14,886.26 "	" $4,394.47 "
5270136	"HCHG CVMC DEPUY HUMERAL STEM W/POROCOAT, SHOULDER JOINT DEVICE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $12,187.75 "	" $8,531.43 "	" $2,900.68 "	" $12,187.75 "	" $10,603.34 "	" $2,925.06 "	" $9,323.63 "	" $12,187.75 "	" $12,187.75 "	" $4,631.35 "	" $7,678.28 "	" $10,359.59 "	" $8,043.92 "	" $9,750.20 "	" $2,925.06 "	" $10,968.98 "	" $9,908.64 "	" $10,359.59 "	" $2,900.68 "	" $9,908.64 "	" $2,925.06 "
5270137	HCHG CVMC SHOULDER JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,352.80 "	" $3,746.96 "	" $1,273.97 "	" $5,352.80 "	" $4,656.94 "	" $1,284.67 "	" $4,094.89 "	" $5,352.80 "	" $5,352.80 "	" $2,034.06 "	" $3,372.26 "	" $4,549.88 "	" $3,532.85 "	" $4,282.24 "	" $1,284.67 "	" $4,817.52 "	" $4,351.83 "	" $4,549.88 "	" $1,273.97 "	" $4,351.83 "	" $1,284.67 "
5270138	HCHG CVMC DEPUY-CROSSLINK ANCHOR PED GLENOID	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,354.80 "	" $4,448.36 "	" $1,512.44 "	" $6,354.80 "	" $5,528.68 "	" $1,525.15 "	" $4,861.42 "	" $6,354.80 "	" $6,354.80 "	" $2,414.82 "	" $4,003.52 "	" $5,401.58 "	" $4,194.17 "	" $5,083.84 "	" $1,525.15 "	" $5,719.32 "	" $5,166.45 "	" $5,401.58 "	" $1,512.44 "	" $5,166.45 "	" $1,525.15 "
5270139	HCHG CVMC KLS-FRACTURE PLATE CURVED SHORT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,360.11 "	 $952.08 	 $323.71 	" $1,224.10 "	" $1,183.30 "	 $326.43 	" $1,040.48 "	 $-   	 $-   	 $516.84 	 $856.87 	" $1,156.09 "	 $897.67 	" $1,088.09 "	 $326.43 	" $1,224.10 "	" $1,105.77 "	" $1,156.09 "	 $323.71 	" $1,105.77 "	 $326.43 
5270140	HCHG CVMC SYNTHES FIXATION NAIL 11MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,515.07 "	" $3,860.55 "	" $1,312.59 "	" $5,515.07 "	" $4,798.11 "	" $1,323.62 "	" $4,219.03 "	" $5,515.07 "	" $5,515.07 "	" $2,095.73 "	" $3,474.49 "	" $4,687.81 "	" $3,639.95 "	" $4,412.06 "	" $1,323.62 "	" $4,963.56 "	" $4,483.75 "	" $4,687.81 "	" $1,312.59 "	" $4,483.75 "	" $1,323.62 "
5270141	"HCHG CVMC COPELAND, HUMERAL RSRF HEAD"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,552.47 "	" $9,486.73 "	" $3,225.49 "	" $13,552.47 "	" $11,790.65 "	" $3,252.59 "	" $10,367.64 "	" $13,552.47 "	" $13,552.47 "	" $5,149.94 "	" $8,538.06 "	" $11,519.60 "	" $8,944.63 "	" $10,841.98 "	" $3,252.59 "	" $12,197.22 "	" $11,018.16 "	" $11,519.60 "	" $3,225.49 "	" $11,018.16 "	" $3,252.59 "
5270142	HCHG CVMC REGENERATION BONE PASTE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C9359	 $839.22 	 $587.45 	 $199.73 	 $755.30 	 $730.12 	 $201.41 	 $642.00 	 $-   	 $-   	 $318.90 	 $528.71 	 $713.34 	 $553.89 	 $671.38 	 $201.41 	 $755.30 	 $682.29 	 $713.34 	 $199.73 	 $682.29 	 $201.41 
5270143	HCHG CVMC TITANIUM CATHETER CONNECTOR FOR PD FLEX NECK CATHETER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1788	 $873.94 	 $611.76 	 $208.00 	 $786.55 	 $760.33 	 $209.75 	 $668.56 	 $-   	 $-   	 $332.10 	 $550.58 	 $742.85 	 $576.80 	 $699.15 	 $209.75 	 $786.55 	 $710.51 	 $742.85 	 $208.00 	 $710.51 	 $209.75 
5270144	HCHG CVMC TITANIUM HELICAL BLADE 80MM-120MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,246.82 "	" $1,572.77 "	 $534.74 	" $2,246.82 "	" $1,954.73 "	 $539.24 	" $1,718.82 "	" $2,246.82 "	" $2,246.82 "	 $853.79 	" $1,415.50 "	" $1,909.80 "	" $1,482.90 "	" $1,797.46 "	 $539.24 	" $2,022.14 "	" $1,826.66 "	" $1,909.80 "	 $534.74 	" $1,826.66 "	 $539.24 
5270145	HCHG CVMC ALLODERM REGENERATIVE TISSUE MATRIX 16X20 CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $33,557.59 "	" $23,490.31 "	" $7,986.71 "	" $33,557.59 "	" $29,195.10 "	" $8,053.82 "	" $25,671.56 "	" $33,557.59 "	" $33,557.59 "	" $12,751.88 "	" $21,141.28 "	" $28,523.95 "	" $22,148.01 "	" $26,846.07 "	" $8,053.82 "	" $30,201.83 "	" $27,282.32 "	" $28,523.95 "	" $7,986.71 "	" $27,282.32 "	" $8,053.82 "
5270146	HCHG CVMC CALCANEOUS PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,491.54 "	" $2,444.08 "	 $830.99 	" $3,491.54 "	" $3,037.64 "	 $837.97 	" $2,671.03 "	" $3,491.54 "	" $3,491.54 "	" $1,326.79 "	" $2,199.67 "	" $2,967.81 "	" $2,304.42 "	" $2,793.23 "	 $837.97 	" $3,142.39 "	" $2,838.62 "	" $2,967.81 "	 $830.99 	" $2,838.62 "	 $837.97 
5270147	HCHG CVMC BONE PASTE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1765	" $4,258.62 "	" $2,981.03 "	" $1,013.55 "	" $4,258.62 "	" $3,705.00 "	" $1,022.07 "	" $3,257.84 "	" $4,258.62 "	" $4,258.62 "	" $1,618.28 "	" $2,682.93 "	" $3,619.83 "	" $2,810.69 "	" $3,406.90 "	" $1,022.07 "	" $3,832.76 "	" $3,462.26 "	" $3,619.83 "	" $1,013.55 "	" $3,462.26 "	" $1,022.07 "
5270148	HCHG CVMC BONE GRAFT COMPOSITE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $4,719.52 "	" $3,303.66 "	" $1,123.25 "	" $4,719.52 "	" $4,105.98 "	" $1,132.68 "	" $3,610.43 "	" $4,719.52 "	" $4,719.52 "	" $1,793.42 "	" $2,973.30 "	" $4,011.59 "	" $3,114.88 "	" $3,775.62 "	" $1,132.68 "	" $4,247.57 "	" $3,836.97 "	" $4,011.59 "	" $1,123.25 "	" $3,836.97 "	" $1,132.68 "
5270149	HCHG CVMC CANNULATED HUMERAL NAIL 240MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,570.50 "	" $3,899.35 "	" $1,325.78 "	" $5,570.50 "	" $4,846.34 "	" $1,336.92 "	" $4,261.43 "	" $5,570.50 "	" $5,570.50 "	" $2,116.79 "	" $3,509.42 "	" $4,734.93 "	" $3,676.53 "	" $4,456.40 "	" $1,336.92 "	" $5,013.45 "	" $4,528.82 "	" $4,734.93 "	" $1,325.78 "	" $4,528.82 "	" $1,336.92 "
5270150	HCHG CVMC FEMORAL STEM (TAPERLOC)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $16,105.86 "	" $11,274.10 "	" $3,833.19 "	" $16,105.86 "	" $14,012.10 "	" $3,865.41 "	" $12,320.98 "	" $16,105.86 "	" $16,105.86 "	" $6,120.23 "	" $10,146.69 "	" $13,689.98 "	" $10,629.87 "	" $12,884.69 "	" $3,865.41 "	" $14,495.27 "	" $13,094.06 "	" $13,689.98 "	" $3,833.19 "	" $13,094.06 "	" $3,865.41 "
5270151	HCHG CVMC BIPOLAR ACETABULAR CUP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,779.88 "	" $2,645.92 "	 $899.61 	" $3,779.88 "	" $3,288.50 "	 $907.17 	" $2,891.61 "	" $3,779.88 "	" $3,779.88 "	" $1,436.35 "	" $2,381.32 "	" $3,212.90 "	" $2,494.72 "	" $3,023.90 "	 $907.17 	" $3,401.89 "	" $3,073.04 "	" $3,212.90 "	 $899.61 	" $3,073.04 "	 $907.17 
5270152	HCHG CVMC MODULAR HEAD COMPONENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $2,747.50 "	" $1,923.25 "	 $653.91 	" $2,747.50 "	" $2,390.33 "	 $659.40 	" $2,101.84 "	" $2,747.50 "	" $2,747.50 "	" $1,044.05 "	" $1,730.93 "	" $2,335.38 "	" $1,813.35 "	" $2,198.00 "	 $659.40 	" $2,472.75 "	" $2,233.72 "	" $2,335.38 "	 $653.91 	" $2,233.72 "	 $659.40 
5270153	HCHG CVMC TIBIAL BEARING 12X71/75MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,848.86 "	" $3,394.20 "	" $1,154.03 "	" $4,848.86 "	" $4,218.51 "	" $1,163.73 "	" $3,709.38 "	" $4,848.86 "	" $4,848.86 "	" $1,842.57 "	" $3,054.78 "	" $4,121.53 "	" $3,200.25 "	" $3,879.09 "	" $1,163.73 "	" $4,363.97 "	" $3,942.12 "	" $4,121.53 "	" $1,154.03 "	" $3,942.12 "	" $1,163.73 "
5270154	HCHG CVMC CRUCIATE TIBIAL PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,289.66 "	" $4,402.76 "	" $1,496.94 "	" $6,289.66 "	" $5,472.00 "	" $1,509.52 "	" $4,811.59 "	" $6,289.66 "	" $6,289.66 "	" $2,390.07 "	" $3,962.49 "	" $5,346.21 "	" $4,151.18 "	" $5,031.73 "	" $1,509.52 "	" $5,660.69 "	" $5,113.49 "	" $5,346.21 "	" $1,496.94 "	" $5,113.49 "	" $1,509.52 "
5270155	HCHG CVMC FEMORAL BOX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $13,113.02 "	" $9,179.11 "	" $3,120.90 "	" $13,113.02 "	" $11,408.33 "	" $3,147.12 "	" $10,031.46 "	" $13,113.02 "	" $13,113.02 "	" $4,982.95 "	" $8,261.20 "	" $11,146.07 "	" $8,654.59 "	" $10,490.42 "	" $3,147.12 "	" $11,801.72 "	" $10,660.89 "	" $11,146.07 "	" $3,120.90 "	" $10,660.89 "	" $3,147.12 "
5270156	HCHG CVMC BIOMET ALL POLY PATELLA BUTTON 37X10	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,956.01 "	" $2,069.21 "	 $703.53 	" $2,956.01 "	" $2,571.73 "	 $709.44 	" $2,261.35 "	" $2,956.01 "	" $2,956.01 "	" $1,123.28 "	" $1,862.29 "	" $2,512.61 "	" $1,950.97 "	" $2,364.81 "	 $709.44 	" $2,660.41 "	" $2,403.24 "	" $2,512.61 "	 $703.53 	" $2,403.24 "	 $709.44 
5270157	HCHG CVMC SUTURE ANCHOR BIO SWIVELOCK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,057.51 "	" $1,440.26 "	 $489.69 	" $2,057.51 "	" $1,790.03 "	 $493.80 	" $1,574.00 "	" $2,057.51 "	" $2,057.51 "	 $781.85 	" $1,296.23 "	" $1,748.88 "	" $1,357.96 "	" $1,646.01 "	 $493.80 	" $1,851.76 "	" $1,672.76 "	" $1,748.88 "	 $489.69 	" $1,672.76 "	 $493.80 
5270158	HCHG CVMC BIOMET COBALT HV BONE CEMENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,758.24 "	" $1,230.77 "	 $418.46 	" $1,758.24 "	" $1,529.67 "	 $421.98 	" $1,345.05 "	" $1,758.24 "	" $1,758.24 "	 $668.13 	" $1,107.69 "	" $1,494.50 "	" $1,160.44 "	" $1,406.59 "	 $421.98 	" $1,582.42 "	" $1,429.45 "	" $1,494.50 "	 $418.46 	" $1,429.45 "	 $421.98 
5270159	HCHG CVMC DISTAL CENTRALIZER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $990.86 	 $693.60 	 $235.82 	 $891.77 	 $862.05 	 $237.81 	 $758.01 	 $-   	 $-   	 $376.53 	 $624.24 	 $842.23 	 $653.97 	 $792.69 	 $237.81 	 $891.77 	 $805.57 	 $842.23 	 $235.82 	 $805.57 	 $237.81 
5270160	HCHG CVMC FEMORAL STEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,917.81 "	" $5,542.47 "	" $1,884.44 "	" $7,917.81 "	" $6,888.49 "	" $1,900.27 "	" $6,057.12 "	" $7,917.81 "	" $7,917.81 "	" $3,008.77 "	" $4,988.22 "	" $6,730.14 "	" $5,225.75 "	" $6,334.25 "	" $1,900.27 "	" $7,126.03 "	" $6,437.18 "	" $6,730.14 "	" $1,884.44 "	" $6,437.18 "	" $1,900.27 "
5270161	HCHG CVMC BIO CEMENT PLUG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $868.16 	 $607.71 	 $206.62 	 $781.34 	 $755.30 	 $208.36 	 $664.14 	 $-   	 $-   	 $329.90 	 $546.94 	 $737.94 	 $572.99 	 $694.53 	 $208.36 	 $781.34 	 $705.81 	 $737.94 	 $206.62 	 $705.81 	 $208.36 
5270162	HCHG CVMC SYNTHES DBX PUTTY 5 CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $3,657.80 "	" $2,560.46 "	 $870.56 	" $3,657.80 "	" $3,182.29 "	 $877.87 	" $2,798.22 "	" $3,657.80 "	" $3,657.80 "	" $1,389.96 "	" $2,304.41 "	" $3,109.13 "	" $2,414.15 "	" $2,926.24 "	 $877.87 	" $3,292.02 "	" $2,973.79 "	" $3,109.13 "	 $870.56 	" $2,973.79 "	 $877.87 
5270163	HCHG CVMC SYNTHES DBX PUTTY 10CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $4,560.17 "	" $3,192.12 "	" $1,085.32 "	" $4,560.17 "	" $3,967.35 "	" $1,094.44 "	" $3,488.53 "	" $4,560.17 "	" $4,560.17 "	" $1,732.86 "	" $2,872.91 "	" $3,876.14 "	" $3,009.71 "	" $3,648.14 "	" $1,094.44 "	" $4,104.15 "	" $3,707.42 "	" $3,876.14 "	" $1,085.32 "	" $3,707.42 "	" $1,094.44 "
5270164	HCHG CVMC SYNTHES DBX PUTTY MIX 5CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $3,615.76 "	" $2,531.03 "	 $860.55 	" $3,615.76 "	" $3,145.71 "	 $867.78 	" $2,766.06 "	" $3,615.76 "	" $3,615.76 "	" $1,373.99 "	" $2,277.93 "	" $3,073.40 "	" $2,386.40 "	" $2,892.61 "	 $867.78 	" $3,254.18 "	" $2,939.61 "	" $3,073.40 "	 $860.55 	" $2,939.61 "	 $867.78 
5270165	HCHG CVMC SYNTHES DBX PUTTY MIX 10CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $5,674.89 "	" $3,972.42 "	" $1,350.62 "	" $5,674.89 "	" $4,937.15 "	" $1,361.97 "	" $4,341.29 "	" $5,674.89 "	" $5,674.89 "	" $2,156.46 "	" $3,575.18 "	" $4,823.66 "	" $3,745.43 "	" $4,539.91 "	" $1,361.97 "	" $5,107.40 "	" $4,613.69 "	" $4,823.66 "	" $1,350.62 "	" $4,613.69 "	" $1,361.97 "
5270166	"HCHG CVMC MENISCAL BEARING-SMALL,MEDIUM, LARGE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,148.27 "	" $2,903.79 "	 $987.29 	" $4,148.27 "	" $3,608.99 "	 $995.58 	" $3,173.43 "	" $4,148.27 "	" $4,148.27 "	" $1,576.34 "	" $2,613.41 "	" $3,526.03 "	" $2,737.86 "	" $3,318.62 "	 $995.58 	" $3,733.44 "	" $3,372.54 "	" $3,526.03 "	 $987.29 	" $3,372.54 "	 $995.58 
5270167	"HCHG CVMC FEMORAL COMPONENT-SMALL, MEDIUM, LARGE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,684.31 "	" $7,479.02 "	" $2,542.87 "	" $10,684.31 "	" $9,295.35 "	" $2,564.23 "	" $8,173.50 "	" $10,684.31 "	" $10,684.31 "	" $4,060.04 "	" $6,731.12 "	" $9,081.66 "	" $7,051.64 "	" $8,547.45 "	" $2,564.23 "	" $9,615.88 "	" $8,686.34 "	" $9,081.66 "	" $2,542.87 "	" $8,686.34 "	" $2,564.23 "
5270168	"HCHG CVMC MEDIAL TIBIAL TRAY-SMALL, MEDIUM, LARGE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,218.58 "	" $5,053.01 "	" $1,718.02 "	" $7,218.58 "	" $6,280.16 "	" $1,732.46 "	" $5,522.21 "	" $7,218.58 "	" $7,218.58 "	" $2,743.06 "	" $4,547.71 "	" $6,135.79 "	" $4,764.26 "	" $5,774.86 "	" $1,732.46 "	" $6,496.72 "	" $5,868.71 "	" $6,135.79 "	" $1,718.02 "	" $5,868.71 "	" $1,732.46 "
5270169	HCHG CVMC MINI PUSHLOCK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,413.24 "	 $989.27 	 $336.35 	" $1,271.92 "	" $1,229.52 "	 $339.18 	" $1,081.13 "	 $-   	 $-   	 $537.03 	 $890.34 	" $1,201.25 "	 $932.74 	" $1,130.59 "	 $339.18 	" $1,271.92 "	" $1,148.96 "	" $1,201.25 "	 $336.35 	" $1,148.96 "	 $339.18 
5270170	HCHG CVMC JOINT DEVICE-GLOBAL CAP 48X18	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $17,869.12 "	" $12,508.38 "	" $4,252.85 "	" $17,869.12 "	" $15,546.13 "	" $4,288.59 "	" $13,669.88 "	" $17,869.12 "	" $17,869.12 "	" $6,790.27 "	" $11,257.55 "	" $15,188.75 "	" $11,793.62 "	" $14,295.30 "	" $4,288.59 "	" $16,082.21 "	" $14,527.59 "	" $15,188.75 "	" $4,252.85 "	" $14,527.59 "	" $4,288.59 "
5270171	HCHG CVMC BOIMET VANGUARD M SERIES KNEE JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,411.54 "	" $3,088.08 "	" $1,049.95 "	" $4,411.54 "	" $3,838.04 "	" $1,058.77 "	" $3,374.83 "	" $4,411.54 "	" $4,411.54 "	" $1,676.39 "	" $2,779.27 "	" $3,749.81 "	" $2,911.62 "	" $3,529.23 "	" $1,058.77 "	" $3,970.39 "	" $3,586.58 "	" $3,749.81 "	" $1,049.95 "	" $3,586.58 "	" $1,058.77 "
5270172	HCHG CVMC FEMORAL JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,684.30 "	" $7,479.01 "	" $2,542.86 "	" $10,684.30 "	" $9,295.34 "	" $2,564.23 "	" $8,173.49 "	" $10,684.30 "	" $10,684.30 "	" $4,060.03 "	" $6,731.11 "	" $9,081.66 "	" $7,051.64 "	" $8,547.44 "	" $2,564.23 "	" $9,615.87 "	" $8,686.34 "	" $9,081.66 "	" $2,542.86 "	" $8,686.34 "	" $2,564.23 "
5270173	HCHG CVMC TENDON ALLOGRAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $8,106.97 "	" $5,674.88 "	" $1,929.46 "	" $8,106.97 "	" $7,053.06 "	" $1,945.67 "	" $6,201.83 "	" $8,106.97 "	" $8,106.97 "	" $3,080.65 "	" $5,107.39 "	" $6,890.92 "	" $5,350.60 "	" $6,485.58 "	" $1,945.67 "	" $7,296.27 "	" $6,590.97 "	" $6,890.92 "	" $1,929.46 "	" $6,590.97 "	" $1,945.67 "
5270174	HCHG CVMC ACETABULAR SHELL-HIP JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,239.12 "	" $3,667.38 "	" $1,246.91 "	" $5,239.12 "	" $4,558.03 "	" $1,257.39 "	" $4,007.93 "	" $5,239.12 "	" $5,239.12 "	" $1,990.87 "	" $3,300.65 "	" $4,453.25 "	" $3,457.82 "	" $4,191.30 "	" $1,257.39 "	" $4,715.21 "	" $4,259.40 "	" $4,453.25 "	" $1,246.91 "	" $4,259.40 "	" $1,257.39 "
5270175	HCHG CVMC BIOMET RINGLOC ACETABULAR LINER-HIP COMPONENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,411.54 "	" $3,088.08 "	" $1,049.95 "	" $4,411.54 "	" $3,838.04 "	" $1,058.77 "	" $3,374.83 "	" $4,411.54 "	" $4,411.54 "	" $1,676.39 "	" $2,779.27 "	" $3,749.81 "	" $2,911.62 "	" $3,529.23 "	" $1,058.77 "	" $3,970.39 "	" $3,586.58 "	" $3,749.81 "	" $1,049.95 "	" $3,586.58 "	" $1,058.77 "
5270176	HCHG CVMC BIOMET MODULAR TIBIAL LOCKING BAR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	 $774.11 	 $541.88 	 $184.24 	 $696.70 	 $673.48 	 $185.79 	 $592.19 	 $-   	 $-   	 $294.16 	 $487.69 	 $657.99 	 $510.91 	 $619.29 	 $185.79 	 $696.70 	 $629.35 	 $657.99 	 $184.24 	 $629.35 	 $185.79 
5270177	HCHG CVMC GLENOID BASE-SHOULDER JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,178.19 "	" $4,324.73 "	" $1,470.41 "	" $6,178.19 "	" $5,375.03 "	" $1,482.77 "	" $4,726.32 "	" $6,178.19 "	" $6,178.19 "	" $2,347.71 "	" $3,892.26 "	" $5,251.46 "	" $4,077.61 "	" $4,942.55 "	" $1,482.77 "	" $5,560.37 "	" $5,022.87 "	" $5,251.46 "	" $1,470.41 "	" $5,022.87 "	" $1,482.77 "
5270178	HCHG CVMC MODULAR HEAD-SHOULDER JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,235.62 "	" $4,364.93 "	" $1,484.08 "	" $6,235.62 "	" $5,424.99 "	" $1,496.55 "	" $4,770.25 "	" $6,235.62 "	" $6,235.62 "	" $2,369.54 "	" $3,928.44 "	" $5,300.28 "	" $4,115.51 "	" $4,988.50 "	" $1,496.55 "	" $5,612.06 "	" $5,069.56 "	" $5,300.28 "	" $1,484.08 "	" $5,069.56 "	" $1,496.55 "
5270179	HCHG CVMC SHOULDER STEM- JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $15,021.54 "	" $10,515.08 "	" $3,575.13 "	" $15,021.54 "	" $13,068.74 "	" $3,605.17 "	" $11,491.48 "	" $15,021.54 "	" $15,021.54 "	" $5,708.19 "	" $9,463.57 "	" $12,768.31 "	" $9,914.22 "	" $12,017.23 "	" $3,605.17 "	" $13,519.39 "	" $12,212.51 "	" $12,768.31 "	" $3,575.13 "	" $12,212.51 "	" $3,605.17 "
5270180	HCHG CVMC STANDARD ADAPTER SHOULDER JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,306.70 "	 $914.69 	 $310.99 	" $1,176.03 "	" $1,136.83 "	 $313.61 	 $999.63 	 $-   	 $-   	 $496.55 	 $823.22 	" $1,110.70 "	 $862.42 	" $1,045.36 "	 $313.61 	" $1,176.03 "	" $1,062.35 "	" $1,110.70 "	 $310.99 	" $1,062.35 "	 $313.61 
5270181	HCHG CVMC GLENOID POST-SHOULDER JOINT DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $2,124.02 "	" $1,486.81 "	 $505.52 	" $2,124.02 "	" $1,847.90 "	 $509.76 	" $1,624.88 "	" $2,124.02 "	" $2,124.02 "	 $807.13 	" $1,338.13 "	" $1,805.42 "	" $1,401.85 "	" $1,699.22 "	 $509.76 	" $1,911.62 "	" $1,726.83 "	" $1,805.42 "	 $505.52 	" $1,726.83 "	 $509.76 
5270182	"HCHG CVMC DEPUY DISTAL RADIUS SET, PEGS-NON LOCKING, ALL SIZES"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $698.28 	 $488.80 	 $166.19 	 $628.45 	 $607.50 	 $167.59 	 $534.18 	 $-   	 $-   	 $265.35 	 $439.92 	 $593.54 	 $460.86 	 $558.62 	 $167.59 	 $628.45 	 $567.70 	 $593.54 	 $166.19 	 $567.70 	 $167.59 
5270183	"HCHG CVMC DEPUY DISTAL RADIUS SET, FRAGMENT PLATES, ALL"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,452.39 "	" $1,716.67 "	 $583.67 	" $2,452.39 "	" $2,133.58 "	 $588.57 	" $1,876.08 "	" $2,452.39 "	" $2,452.39 "	 $931.91 	" $1,545.01 "	" $2,084.53 "	" $1,618.58 "	" $1,961.91 "	 $588.57 	" $2,207.15 "	" $1,993.79 "	" $2,084.53 "	 $583.67 	" $1,993.79 "	 $588.57 
5270184	"HCHG CVMC VANGUARD CR FEMORAL, KNEE JOINT COMPONENT"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,656.84 "	" $9,559.79 "	" $3,250.33 "	" $13,656.84 "	" $11,881.45 "	" $3,277.64 "	" $10,447.48 "	" $13,656.84 "	" $13,656.84 "	" $5,189.60 "	" $8,603.81 "	" $11,608.31 "	" $9,013.51 "	" $10,925.47 "	" $3,277.64 "	" $12,291.16 "	" $11,103.01 "	" $11,608.31 "	" $3,250.33 "	" $11,103.01 "	" $3,277.64 "
5270185	"HCHG CVMC PEEK SUTURE TAK, 3MM SUTURE ANCHOR"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,577.09 "	" $1,803.96 "	 $613.35 	" $2,577.09 "	" $2,242.07 "	 $618.50 	" $1,971.47 "	" $2,577.09 "	" $2,577.09 "	 $979.29 	" $1,623.57 "	" $2,190.53 "	" $1,700.88 "	" $2,061.67 "	 $618.50 	" $2,319.38 "	" $2,095.17 "	" $2,190.53 "	 $613.35 	" $2,095.17 "	 $618.50 
5270186	"HCHG CVMC HAP MODULAR TAPERLOC FEMORAL, TOTAL HIP COMPONENT"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $17,757.65 "	" $12,430.36 "	" $4,226.32 "	" $17,757.65 "	" $15,449.16 "	" $4,261.84 "	" $13,584.60 "	" $17,757.65 "	" $17,757.65 "	" $6,747.91 "	" $11,187.32 "	" $15,094.00 "	" $11,720.05 "	" $14,206.12 "	" $4,261.84 "	" $15,981.89 "	" $14,436.97 "	" $15,094.00 "	" $4,226.32 "	" $14,436.97 "	" $4,261.84 "
5270187	HCHG CVMC SHORT BEND FUSION PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,196.04 "	" $3,637.23 "	" $1,236.66 "	" $5,196.04 "	" $4,520.55 "	" $1,247.05 "	" $3,974.97 "	" $5,196.04 "	" $5,196.04 "	" $1,974.50 "	" $3,273.51 "	" $4,416.63 "	" $3,429.39 "	" $4,156.83 "	" $1,247.05 "	" $4,676.44 "	" $4,224.38 "	" $4,416.63 "	" $1,236.66 "	" $4,224.38 "	" $1,247.05 "
5270188	"HCHG CVMC DHS PLATE-SHORT BARREL, ALL SIZES"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,547.27 "	" $1,083.09 "	 $368.25 	" $1,547.27 "	" $1,346.12 "	 $371.34 	" $1,183.66 "	" $1,547.27 "	 $-   	 $587.96 	 $974.78 	" $1,315.18 "	" $1,021.20 "	" $1,237.82 "	 $371.34 	" $1,392.54 "	" $1,257.93 "	" $1,315.18 "	 $368.25 	" $1,257.93 "	 $371.34 
5270189	HCHG CVMC DHS PLATE-LAG SCREWS 12.7 MM ALL LENGHTS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,356.52 "	 $949.56 	 $322.85 	" $1,220.87 "	" $1,180.17 "	 $325.56 	" $1,037.74 "	 $-   	 $-   	 $515.48 	 $854.61 	" $1,153.04 "	 $895.30 	" $1,085.22 "	 $325.56 	" $1,220.87 "	" $1,102.85 "	" $1,153.04 "	 $322.85 	" $1,102.85 "	 $325.56 
5270190	HCHG CVMC 4.5 CORTEX SCREW-DHS SET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $180.56 	 $126.39 	 $42.97 	 $162.50 	 $157.09 	 $43.33 	 $138.13 	 $-   	 $-   	 $68.61 	 $113.75 	 $153.48 	 $119.17 	 $144.45 	 $43.33 	 $162.50 	 $146.80 	 $153.48 	 $42.97 	 $146.80 	 $43.33 
5270191	"HCHG CVMC BIOSURE SCREWS,SMITH AND NEPHEW,ALL SIZES"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,455.34 "	" $1,018.74 "	 $346.37 	" $1,309.81 "	" $1,266.15 "	 $349.28 	" $1,113.34 "	 $-   	 $-   	 $553.03 	 $916.86 	" $1,237.04 "	 $960.52 	" $1,164.27 "	 $349.28 	" $1,309.81 "	" $1,183.19 "	" $1,237.04 "	 $346.37 	" $1,183.19 "	 $349.28 
5270192	HCHG CVMC BIOCLEANSE PATELLAR TENDON ALLOGRAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $11,147.08 "	" $7,802.96 "	" $2,653.01 "	" $11,147.08 "	" $9,697.96 "	" $2,675.30 "	" $8,527.52 "	" $11,147.08 "	" $11,147.08 "	" $4,235.89 "	" $7,022.66 "	" $9,475.02 "	" $7,357.07 "	" $8,917.66 "	" $2,675.30 "	" $10,032.37 "	" $9,062.58 "	" $9,475.02 "	" $2,653.01 "	" $9,062.58 "	" $2,675.30 "
5270193	"HCHG CVMC BIOMET SERIES A THIN PATELLA, JOINT DEVICE, TOTAL KNEE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,612.08 "	" $2,528.46 "	 $859.68 	" $3,612.08 "	" $3,142.51 "	 $866.90 	" $2,763.24 "	" $3,612.08 "	" $3,612.08 "	" $1,372.59 "	" $2,275.61 "	" $3,070.27 "	" $2,383.97 "	" $2,889.66 "	 $866.90 	" $3,250.87 "	" $2,936.62 "	" $3,070.27 "	 $859.68 	" $2,936.62 "	 $866.90 
5270194	HCHG CVMC BAR TO BAR CLAMP/EXTERNAL FIXATION SET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,362.86 "	" $1,654.00 "	 $562.36 	" $2,362.86 "	" $2,055.69 "	 $567.09 	" $1,807.59 "	" $2,362.86 "	" $2,362.86 "	 $897.89 	" $1,488.60 "	" $2,008.43 "	" $1,559.49 "	" $1,890.29 "	 $567.09 	" $2,126.57 "	" $1,921.01 "	" $2,008.43 "	 $562.36 	" $1,921.01 "	 $567.09 
5270195	"HCHG CVMC 6 MM BAR TO PIN CLAMP, EXTERNAL FIXATION"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,363.44 "	" $1,654.41 "	 $562.50 	" $2,363.44 "	" $2,056.19 "	 $567.23 	" $1,808.03 "	" $2,363.44 "	" $2,363.44 "	 $898.11 	" $1,488.97 "	" $2,008.92 "	" $1,559.87 "	" $1,890.75 "	 $567.23 	" $2,127.10 "	" $1,921.48 "	" $2,008.92 "	 $562.50 	" $1,921.48 "	 $567.23 
5270196	"HCHG CVMC 5 MM BAR TO PIN CLAMP, EXTERNAL FIXATION"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,647.43 "	" $1,853.20 "	 $630.09 	" $2,647.43 "	" $2,303.26 "	 $635.38 	" $2,025.28 "	" $2,647.43 "	" $2,647.43 "	" $1,006.02 "	" $1,667.88 "	" $2,250.32 "	" $1,747.30 "	" $2,117.94 "	 $635.38 	" $2,382.69 "	" $2,152.36 "	" $2,250.32 "	 $630.09 	" $2,152.36 "	 $635.38 
5270197	HCHG CVMC 200 MM BAR/EXTERNAL FIXATION	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,181.41 "	 $826.99 	 $281.18 	" $1,063.27 "	" $1,027.83 "	 $283.54 	 $903.78 	 $-   	 $-   	 $448.94 	 $744.29 	" $1,004.20 "	 $779.73 	 $945.13 	 $283.54 	" $1,063.27 "	 $960.49 	" $1,004.20 "	 $281.18 	 $960.49 	 $283.54 
5270198	HCHG CVMC 250MM BAR/EXTERNAL FIXATION	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,271.92 "	 $890.34 	 $302.72 	" $1,144.73 "	" $1,106.57 "	 $305.26 	 $973.02 	 $-   	 $-   	 $483.33 	 $801.31 	" $1,081.13 "	 $839.47 	" $1,017.54 "	 $305.26 	" $1,144.73 "	" $1,034.07 "	" $1,081.13 "	 $302.72 	" $1,034.07 "	 $305.26 
5270199	"HCHG CVMC 6MM HALF PIN, EXTERNAL FIXATION"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $900.35 	 $630.25 	 $214.28 	 $810.32 	 $783.30 	 $216.08 	 $688.77 	 $-   	 $-   	 $342.13 	 $567.22 	 $765.30 	 $594.23 	 $720.28 	 $216.08 	 $810.32 	 $731.98 	 $765.30 	 $214.28 	 $731.98 	 $216.08 
5270200	HCHG CVMC RING LOC ACETABULAR LINER 36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,147.94 "	" $3,603.56 "	" $1,225.21 "	" $5,147.94 "	" $4,478.71 "	" $1,235.51 "	" $3,938.17 "	" $5,147.94 "	" $5,147.94 "	" $1,956.22 "	" $3,243.20 "	" $4,375.75 "	" $3,397.64 "	" $4,118.35 "	" $1,235.51 "	" $4,633.15 "	" $4,185.28 "	" $4,375.75 "	" $1,225.21 "	" $4,185.28 "	" $1,235.51 "
5270201	HCHG CVMC ACETABULAR SHELL 56 MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,995.78 "	" $4,197.05 "	" $1,427.00 "	" $5,995.78 "	" $5,216.33 "	" $1,438.99 "	" $4,586.77 "	" $5,995.78 "	" $5,995.78 "	" $2,278.40 "	" $3,777.34 "	" $5,096.41 "	" $3,957.21 "	" $4,796.62 "	" $1,438.99 "	" $5,396.20 "	" $4,874.57 "	" $5,096.41 "	" $1,427.00 "	" $4,874.57 "	" $1,438.99 "
5270202	HCHG CVMC MODULAR HEAD 36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,486.00 "	" $2,440.20 "	 $829.67 	" $3,486.00 "	" $3,032.82 "	 $836.64 	" $2,666.79 "	" $3,486.00 "	" $3,486.00 "	" $1,324.68 "	" $2,196.18 "	" $2,963.10 "	" $2,300.76 "	" $2,788.80 "	 $836.64 	" $3,137.40 "	" $2,834.12 "	" $2,963.10 "	 $829.67 	" $2,834.12 "	 $836.64 
5270203	HCHG CVMC SYNTHES LARGE OPEN ADJUSTABLE CLAMP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,435.93 "	" $1,705.15 "	 $579.75 	" $2,435.93 "	" $2,119.26 "	 $584.62 	" $1,863.49 "	" $2,435.93 "	" $2,435.93 "	 $925.65 	" $1,534.64 "	" $2,070.54 "	" $1,607.71 "	" $1,948.74 "	 $584.62 	" $2,192.34 "	" $1,980.41 "	" $2,070.54 "	 $579.75 	" $1,980.41 "	 $584.62 
5270204	"HCHG CVMC SYNTHES,ATTACHMENT FOR LARGE MULTI PIN CLAMP"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,881.44 "	" $1,317.01 "	 $447.78 	" $1,881.44 "	" $1,636.85 "	 $451.55 	" $1,439.30 "	" $1,881.44 "	" $1,881.44 "	 $714.95 	" $1,185.31 "	" $1,599.22 "	" $1,241.75 "	" $1,505.15 "	 $451.55 	" $1,693.30 "	" $1,529.61 "	" $1,599.22 "	 $447.78 	" $1,529.61 "	 $451.55 
5270205	"HCHG CVMC SYNTHES,LARGE MULTI-PIN CLAMP-6 POSITION"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,286.42 "	" $2,300.49 "	 $782.17 	" $3,286.42 "	" $2,859.19 "	 $788.74 	" $2,514.11 "	" $3,286.42 "	" $3,286.42 "	" $1,248.84 "	" $2,070.44 "	" $2,793.46 "	" $2,169.04 "	" $2,629.14 "	 $788.74 	" $2,957.78 "	" $2,671.86 "	" $2,793.46 "	 $782.17 	" $2,671.86 "	 $788.74 
5270206	"HCHG CVMC SYNTHES,LARGE COMBINATION CLAMP"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,992.74 "	" $2,094.92 "	 $712.27 	" $2,992.74 "	" $2,603.68 "	 $718.26 	" $2,289.45 "	" $2,992.74 "	" $2,992.74 "	" $1,137.24 "	" $1,885.43 "	" $2,543.83 "	" $1,975.21 "	" $2,394.19 "	 $718.26 	" $2,693.47 "	" $2,433.10 "	" $2,543.83 "	 $712.27 	" $2,433.10 "	 $718.26 
5270208	"HCHG CVMC SYNTHES,CARBON FIBER ROD 150MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,492.74 "	" $1,044.92 "	 $355.27 	" $1,343.47 "	" $1,298.68 "	 $358.26 	" $1,141.95 "	 $-   	 $-   	 $567.24 	 $940.43 	" $1,268.83 "	 $985.21 	" $1,194.19 "	 $358.26 	" $1,343.47 "	" $1,213.60 "	" $1,268.83 "	 $355.27 	" $1,213.60 "	 $358.26 
5270209	"HCHG CVMC SYNTHES,CARBON FIBER ROD 200MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,492.74 "	" $1,044.92 "	 $355.27 	" $1,343.47 "	" $1,298.68 "	 $358.26 	" $1,141.95 "	 $-   	 $-   	 $567.24 	 $940.43 	" $1,268.83 "	 $985.21 	" $1,194.19 "	 $358.26 	" $1,343.47 "	" $1,213.60 "	" $1,268.83 "	 $355.27 	" $1,213.60 "	 $358.26 
5270210	"HCHG CVMC SYNTHES,CARBON FIBER ROD 250MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,600.99 "	" $1,120.69 "	 $381.04 	" $1,600.99 "	" $1,392.86 "	 $384.24 	" $1,224.76 "	" $1,600.99 "	" $1,600.99 "	 $608.38 	" $1,008.62 "	" $1,360.84 "	" $1,056.65 "	" $1,280.79 "	 $384.24 	" $1,440.89 "	" $1,301.60 "	" $1,360.84 "	 $381.04 	" $1,301.60 "	 $384.24 
5270212	"HCHG CVMC SYNTHES, CARBON FIBER ROD 400MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,181.64 "	 $827.15 	 $281.23 	" $1,063.48 "	" $1,028.03 "	 $283.59 	 $903.95 	 $-   	 $-   	 $449.02 	 $744.43 	" $1,004.39 "	 $779.88 	 $945.31 	 $283.59 	" $1,063.48 "	 $960.67 	" $1,004.39 "	 $281.23 	 $960.67 	 $283.59 
5270213	"HCHG CVMC SYNTHES, 5.0MM STEINMANN PIN W/CENTRAL THREAD 200MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $786.25 	 $550.38 	 $187.13 	 $707.63 	 $684.04 	 $188.70 	 $601.48 	 $-   	 $-   	 $298.78 	 $495.34 	 $668.31 	 $518.93 	 $629.00 	 $188.70 	 $707.63 	 $639.22 	 $668.31 	 $187.13 	 $639.22 	 $188.70 
5270214	"HCHG CVMC SYNTHES, SCHANZ SCREW BLUNTED TROCAR POINT 200MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $750.67 	 $525.47 	 $178.66 	 $675.60 	 $653.08 	 $180.16 	 $574.26 	 $-   	 $-   	 $285.25 	 $472.92 	 $638.07 	 $495.44 	 $600.54 	 $180.16 	 $675.60 	 $610.29 	 $638.07 	 $178.66 	 $610.29 	 $180.16 
5270215	"HCHG CVMC SYNTHES,PROTECTIVE CAPS FOR 6.0MM FIXATION PINS"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $321.72 	 $225.20 	 $76.57 	 $289.55 	 $279.90 	 $77.21 	 $246.12 	 $-   	 $-   	 $122.25 	 $202.68 	 $273.46 	 $212.34 	 $257.38 	 $77.21 	 $289.55 	 $261.56 	 $273.46 	 $76.57 	 $261.56 	 $77.21 
5270216	"HCHG CVMC SYNTHES,6.0MM TRANSFIXATION PIN 225MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $791.95 	 $554.37 	 $188.48 	 $712.76 	 $689.00 	 $190.07 	 $605.84 	 $-   	 $-   	 $300.94 	 $498.93 	 $673.16 	 $522.69 	 $633.56 	 $190.07 	 $712.76 	 $643.86 	 $673.16 	 $188.48 	 $643.86 	 $190.07 
5270217	"HCHG CVMC SYNTHES 11.0MM CARBON FIBER ROD,400MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,206.19 "	 $844.33 	 $287.07 	" $1,085.57 "	" $1,049.39 "	 $289.49 	 $922.74 	 $-   	 $-   	 $458.35 	 $759.90 	" $1,025.26 "	 $796.09 	 $964.95 	 $289.49 	" $1,085.57 "	 $980.63 	" $1,025.26 "	 $287.07 	 $980.63 	 $289.49 
5270218	HCHG CVMC SYNTHES PROTECTIVE CAPS FOR 6.0MM FIXATION PINS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $247.48 	 $173.24 	 $58.90 	 $222.73 	 $215.31 	 $59.40 	 $189.32 	 $-   	 $-   	 $94.04 	 $155.91 	 $210.36 	 $163.34 	 $197.98 	 $59.40 	 $222.73 	 $201.20 	 $210.36 	 $58.90 	 $201.20 	 $59.40 
5270219	"HCHG CVMC SYNTHES 5.0 STEINMANN PIN W/CENTRAL THREAD, 200MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $786.25 	 $550.38 	 $187.13 	 $707.63 	 $684.04 	 $188.70 	 $601.48 	 $-   	 $-   	 $298.78 	 $495.34 	 $668.31 	 $518.93 	 $629.00 	 $188.70 	 $707.63 	 $639.22 	 $668.31 	 $187.13 	 $639.22 	 $188.70 
5270220	HCHG CVMC SYNTHES LARGE OPEN ADJUSTABLE CLAMP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,478.80 "	" $1,735.16 "	 $589.95 	" $2,478.80 "	" $2,156.56 "	 $594.91 	" $1,896.28 "	" $2,478.80 "	" $2,478.80 "	 $941.94 	" $1,561.64 "	" $2,106.98 "	" $1,636.01 "	" $1,983.04 "	 $594.91 	" $2,230.92 "	" $2,015.26 "	" $2,106.98 "	 $589.95 	" $2,015.26 "	 $594.91 
5270221	"HCHG CVMC HUMERAL STEM, HA COATED FRACTURE 6.5MM DIA X 130MM LENG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $15,160.04 "	" $10,612.03 "	" $3,608.09 "	" $15,160.04 "	" $13,189.23 "	" $3,638.41 "	" $11,597.43 "	" $15,160.04 "	" $15,160.04 "	" $5,760.82 "	" $9,550.83 "	" $12,886.03 "	" $10,005.63 "	" $12,128.03 "	" $3,638.41 "	" $13,644.04 "	" $12,325.11 "	" $12,886.03 "	" $3,608.09 "	" $12,325.11 "	" $3,638.41 "
5270222	"HCHG CVMC AEQUALIS HUMERAL HEAD, 43MM X 16MM, SHOULDER COMPONENT"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,266.03 "	" $4,386.22 "	" $1,491.32 "	" $6,266.03 "	" $5,451.45 "	" $1,503.85 "	" $4,793.51 "	" $6,266.03 "	" $6,266.03 "	" $2,381.09 "	" $3,947.60 "	" $5,326.13 "	" $4,135.58 "	" $5,012.82 "	" $1,503.85 "	" $5,639.43 "	" $5,094.28 "	" $5,326.13 "	" $1,491.32 "	" $5,094.28 "	" $1,503.85 "
5270223	HCHG CVMC CEMENT RESTRICTOR 8-15 MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,145.68 "	 $801.98 	 $272.67 	" $1,031.11 "	 $996.74 	 $274.96 	 $876.45 	 $-   	 $-   	 $435.36 	 $721.78 	 $973.83 	 $756.15 	 $916.54 	 $274.96 	" $1,031.11 "	 $931.44 	 $973.83 	 $272.67 	 $931.44 	 $274.96 
5270224	HCHG CVMC 7.3 MM CANNULATED SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,416.38 "	 $991.47 	 $337.10 	" $1,274.74 "	" $1,232.25 "	 $339.93 	" $1,083.53 "	 $-   	 $-   	 $538.22 	 $892.32 	" $1,203.92 "	 $934.81 	" $1,133.10 "	 $339.93 	" $1,274.74 "	" $1,151.52 "	" $1,203.92 "	 $337.10 	" $1,151.52 "	 $339.93 
5270225	HCHG CVMC 4.5 MM HEADLESS COMPRESSION SCREW/LONG THREAD 34MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,800.60 "	" $1,260.42 "	 $428.54 	" $1,800.60 "	" $1,566.52 "	 $432.14 	" $1,377.46 "	" $1,800.60 "	" $1,800.60 "	 $684.23 	" $1,134.38 "	" $1,530.51 "	" $1,188.40 "	" $1,440.48 "	 $432.14 	" $1,620.54 "	" $1,463.89 "	" $1,530.51 "	 $428.54 	" $1,463.89 "	 $432.14 
5270226	HCHG CVMC ECHO FX HIP FEMORAL STEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,470.95 "	" $3,829.67 "	" $1,302.09 "	" $5,470.95 "	" $4,759.73 "	" $1,313.03 "	" $4,185.28 "	" $5,470.95 "	" $5,470.95 "	" $2,078.96 "	" $3,446.70 "	" $4,650.31 "	" $3,610.83 "	" $4,376.76 "	" $1,313.03 "	" $4,923.86 "	" $4,447.88 "	" $4,650.31 "	" $1,302.09 "	" $4,447.88 "	" $1,313.03 "
5270227	HCHG CVMC 5.0MM ALLTHREAD TI ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,371.55 "	" $2,360.09 "	 $802.43 	" $3,371.55 "	" $2,933.25 "	 $809.17 	" $2,579.24 "	" $3,371.55 "	" $3,371.55 "	" $1,281.19 "	" $2,124.08 "	" $2,865.82 "	" $2,225.22 "	" $2,697.24 "	 $809.17 	" $3,034.40 "	" $2,741.07 "	" $2,865.82 "	 $802.43 	" $2,741.07 "	 $809.17 
5270228	HCHG CVMC SIGNATURE FEMORAL BOX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $18,505.50 "	" $12,953.85 "	" $4,404.31 "	" $18,505.50 "	" $16,099.79 "	" $4,441.32 "	" $14,156.71 "	" $18,505.50 "	" $18,505.50 "	" $7,032.09 "	" $11,658.47 "	" $15,729.68 "	" $12,213.63 "	" $14,804.40 "	" $4,441.32 "	" $16,654.95 "	" $15,044.97 "	" $15,729.68 "	" $4,404.31 "	" $15,044.97 "	" $4,441.32 "
5270229	HCHG CVMC SIGNATURE TIBIAL PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $7,210.40 "	" $5,047.28 "	" $1,716.08 "	" $7,210.40 "	" $6,273.05 "	" $1,730.50 "	" $5,515.96 "	" $7,210.40 "	" $7,210.40 "	" $2,739.95 "	" $4,542.55 "	" $6,128.84 "	" $4,758.86 "	" $5,768.32 "	" $1,730.50 "	" $6,489.36 "	" $5,862.06 "	" $6,128.84 "	" $1,716.08 "	" $5,862.06 "	" $1,730.50 "
5270230	HCHG CVMC IMPLANT STEM AND SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,051.83 "	" $4,236.28 "	" $1,440.34 "	" $6,051.83 "	" $5,265.09 "	" $1,452.44 "	" $4,629.65 "	" $6,051.83 "	" $6,051.83 "	" $2,299.70 "	" $3,812.65 "	" $5,144.06 "	" $3,994.21 "	" $4,841.46 "	" $1,452.44 "	" $5,446.65 "	" $4,920.14 "	" $5,144.06 "	" $1,440.34 "	" $4,920.14 "	" $1,452.44 "
5270231	HCHG CVMC IMPLANT HEAD 14X24MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,104.75 "	" $3,573.33 "	" $1,214.93 "	" $5,104.75 "	" $4,441.13 "	" $1,225.14 "	" $3,905.13 "	" $5,104.75 "	" $5,104.75 "	" $1,939.81 "	" $3,215.99 "	" $4,339.04 "	" $3,369.14 "	" $4,083.80 "	" $1,225.14 "	" $4,594.28 "	" $4,150.16 "	" $4,339.04 "	" $1,214.93 "	" $4,150.16 "	" $1,225.14 "
5270234	"HCHG CVMC CORTEX SCREWS, ALL SIZES"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $262.46 	 $183.72 	 $62.47 	 $236.21 	 $228.34 	 $62.99 	 $200.78 	 $-   	 $-   	 $99.73 	 $165.35 	 $223.09 	 $173.22 	 $209.97 	 $62.99 	 $236.21 	 $213.38 	 $223.09 	 $62.47 	 $213.38 	 $62.99 
5270235	"HCHG CVMC SCHANZ SCREWS, ALL SIZES"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $517.82 	 $362.47 	 $123.24 	 $466.04 	 $450.50 	 $124.28 	 $396.13 	 $-   	 $-   	 $196.77 	 $326.23 	 $440.15 	 $341.76 	 $414.26 	 $124.28 	 $466.04 	 $420.99 	 $440.15 	 $123.24 	 $420.99 	 $124.28 
5270236	HCHG CVMC COMBINATION CLAMP-MEDIUM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,226.54 "	" $1,558.58 "	 $529.92 	" $2,226.54 "	" $1,937.09 "	 $534.37 	" $1,703.30 "	" $2,226.54 "	" $2,226.54 "	 $846.09 	" $1,402.72 "	" $1,892.56 "	" $1,469.52 "	" $1,781.23 "	 $534.37 	" $2,003.89 "	" $1,810.18 "	" $1,892.56 "	 $529.92 	" $1,810.18 "	 $534.37 
5270237	HCHG CVMC OPEN ADJUSTABLE CLAMP-MEDIUM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,368.45 "	 $957.92 	 $325.69 	" $1,231.61 "	" $1,190.55 "	 $328.43 	" $1,046.86 "	 $-   	 $-   	 $520.01 	 $862.12 	" $1,163.18 "	 $903.18 	" $1,094.76 "	 $328.43 	" $1,231.61 "	" $1,112.55 "	" $1,163.18 "	 $325.69 	" $1,112.55 "	 $328.43 
5270238	HCHG CVMC COMBINATION CLAMP 8.0MM/11MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,562.48 "	" $1,793.74 "	 $609.87 	" $2,562.48 "	" $2,229.36 "	 $615.00 	" $1,960.30 "	" $2,562.48 "	" $2,562.48 "	 $973.74 	" $1,614.36 "	" $2,178.11 "	" $1,691.24 "	" $2,049.98 "	 $615.00 	" $2,306.23 "	" $2,083.30 "	" $2,178.11 "	 $609.87 	" $2,083.30 "	 $615.00 
5270239	HCHG CVMC BAR(CARBON FIBER ROD) 120MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $591.31 	 $413.92 	 $140.73 	 $532.18 	 $514.44 	 $141.91 	 $452.35 	 $-   	 $-   	 $224.70 	 $372.53 	 $502.61 	 $390.26 	 $473.05 	 $141.91 	 $532.18 	 $480.74 	 $502.61 	 $140.73 	 $480.74 	 $141.91 
5270240	HCHG CVMC ELBOW HINGE FIXATOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,911.28 "	" $3,437.90 "	" $1,168.88 "	" $4,911.28 "	" $4,272.81 "	" $1,178.71 "	" $3,757.13 "	" $4,911.28 "	" $4,911.28 "	" $1,866.29 "	" $3,094.11 "	" $4,174.59 "	" $3,241.44 "	" $3,929.02 "	" $1,178.71 "	" $4,420.15 "	" $3,992.87 "	" $4,174.59 "	" $1,168.88 "	" $3,992.87 "	" $1,178.71 "
5270241	HCHG CVMC ACETABULAR SHELL (LIMITED HOLES/POROUS COATED) 54MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,603.53 "	" $3,922.47 "	" $1,333.64 "	" $5,603.53 "	" $4,875.07 "	" $1,344.85 "	" $4,286.70 "	" $5,603.53 "	" $5,603.53 "	" $2,129.34 "	" $3,530.22 "	" $4,763.00 "	" $3,698.33 "	" $4,482.82 "	" $1,344.85 "	" $5,043.18 "	" $4,555.67 "	" $4,763.00 "	" $1,333.64 "	" $4,555.67 "	" $1,344.85 "
5270242	HCHG CVMC BTB(BONE TENDON BONE)PRESHAPED PATELLAR TENDON ALLOGRAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $10,417.84 "	" $7,292.49 "	" $2,479.45 "	" $10,417.84 "	" $9,063.52 "	" $2,500.28 "	" $7,969.65 "	" $10,417.84 "	" $10,417.84 "	" $3,958.78 "	" $6,563.24 "	" $8,855.16 "	" $6,875.77 "	" $8,334.27 "	" $2,500.28 "	" $9,376.06 "	" $8,469.70 "	" $8,855.16 "	" $2,479.45 "	" $8,469.70 "	" $2,500.28 "
5270243	HCHG CVMC BIODESIGN-SURGISIS STAPLE LINE REINFORCEMENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $972.34 	 $680.64 	 $231.42 	 $875.11 	 $845.94 	 $233.36 	 $743.84 	 $-   	 $-   	 $369.49 	 $612.57 	 $826.49 	 $641.74 	 $777.87 	 $233.36 	 $875.11 	 $790.51 	 $826.49 	 $231.42 	 $790.51 	 $233.36 
5270244	HCHG CVMC OSTEOTOMY COMPRESSION PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,699.84 "	" $1,889.89 "	 $642.56 	" $2,699.84 "	" $2,348.86 "	 $647.96 	" $2,065.38 "	" $2,699.84 "	" $2,699.84 "	" $1,025.94 "	" $1,700.90 "	" $2,294.86 "	" $1,781.89 "	" $2,159.87 "	 $647.96 	" $2,429.86 "	" $2,194.97 "	" $2,294.86 "	 $642.56 	" $2,194.97 "	 $647.96 
5270245	HCHG CVMC CORTICAL HEX SCREW 3.2MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $544.69 	 $381.28 	 $129.64 	 $490.22 	 $473.88 	 $130.73 	 $416.69 	 $-   	 $-   	 $206.98 	 $343.15 	 $462.99 	 $359.50 	 $435.75 	 $130.73 	 $490.22 	 $442.83 	 $462.99 	 $129.64 	 $442.83 	 $130.73 
5270246	HCHG CVMC CORTICAL LAG SCREW 3.2MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $617.31 	 $432.12 	 $146.92 	 $555.58 	 $537.06 	 $148.15 	 $472.24 	 $-   	 $-   	 $234.58 	 $388.91 	 $524.71 	 $407.42 	 $493.85 	 $148.15 	 $555.58 	 $501.87 	 $524.71 	 $146.92 	 $501.87 	 $148.15 
5270247	HCHG CVMC DISTAL BICEPS REPAIR IMPLANT SYSTEM-ARTHREX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,301.96 "	" $2,311.37 "	 $785.87 	" $3,301.96 "	" $2,872.71 "	 $792.47 	" $2,526.00 "	" $3,301.96 "	" $3,301.96 "	" $1,254.74 "	" $2,080.23 "	" $2,806.67 "	" $2,179.29 "	" $2,641.57 "	 $792.47 	" $2,971.76 "	" $2,684.49 "	" $2,806.67 "	 $785.87 	" $2,684.49 "	 $792.47 
5270248	HCHG CVMC SYNTHES-TITANIUM CANNULATED TIBIAL NAIL 10MM X 360MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,542.43 "	" $3,179.70 "	" $1,081.10 "	" $4,542.43 "	" $3,951.91 "	" $1,090.18 "	" $3,474.96 "	" $4,542.43 "	" $4,542.43 "	" $1,726.12 "	" $2,861.73 "	" $3,861.07 "	" $2,998.00 "	" $3,633.94 "	" $1,090.18 "	" $4,088.19 "	" $3,693.00 "	" $3,861.07 "	" $1,081.10 "	" $3,693.00 "	" $1,090.18 "
5270250	HCHG CVMC ARTHREX-TIGHTROPE AND SYDESMOSIS SINGLE USE REPAIR KT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,622.10 "	" $1,835.47 "	 $624.06 	" $2,622.10 "	" $2,281.23 "	 $629.30 	" $2,005.91 "	" $2,622.10 "	" $2,622.10 "	 $996.40 	" $1,651.92 "	" $2,228.79 "	" $1,730.59 "	" $2,097.68 "	 $629.30 	" $2,359.89 "	" $2,131.77 "	" $2,228.79 "	 $624.06 	" $2,131.77 "	 $629.30 
5270251	HCHG CVMC TUTOPLAST PERICARDIUM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $2,058.88 "	" $1,441.22 "	 $490.01 	" $2,058.88 "	" $1,791.23 "	 $494.13 	" $1,575.04 "	" $2,058.88 "	" $2,058.88 "	 $782.37 	" $1,297.09 "	" $1,750.05 "	" $1,358.86 "	" $1,647.10 "	 $494.13 	" $1,852.99 "	" $1,673.87 "	" $1,750.05 "	 $490.01 	" $1,673.87 "	 $494.13 
5270252	HCHG CVMC GLAUCOMA IMPLANT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	L8612	" $2,715.38 "	" $1,900.77 "	 $646.26 	" $2,715.38 "	" $2,362.38 "	 $651.69 	" $2,077.27 "	" $2,715.38 "	" $2,715.38 "	" $1,031.84 "	" $1,710.69 "	" $2,308.07 "	" $1,792.15 "	" $2,172.30 "	 $651.69 	" $2,443.84 "	" $2,207.60 "	" $2,308.07 "	 $646.26 	" $2,207.60 "	 $651.69 
5270253	HCHG CVMC SYNTHES-LOCKING CALCANEAL PLATE-SHORT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,312.15 "	" $1,618.51 "	 $550.29 	" $2,312.15 "	" $2,011.57 "	 $554.92 	" $1,768.79 "	" $2,312.15 "	" $2,312.15 "	 $878.62 	" $1,456.65 "	" $1,965.33 "	" $1,526.02 "	" $1,849.72 "	 $554.92 	" $2,080.94 "	" $1,879.78 "	" $1,965.33 "	 $550.29 	" $1,879.78 "	 $554.92 
5270254	HCHG CVMC SYNTHES-LOCKING SCREW 2.0MM-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $708.81 	 $496.17 	 $168.70 	 $637.93 	 $616.66 	 $170.11 	 $542.24 	 $-   	 $-   	 $269.35 	 $446.55 	 $602.49 	 $467.81 	 $567.05 	 $170.11 	 $637.93 	 $576.26 	 $602.49 	 $168.70 	 $576.26 	 $170.11 
5270256	HCHG CVMC MTF-CANCELLOUS CHIPS (CROUTON) 3OCC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $1,618.85 "	" $1,133.20 "	 $385.29 	" $1,618.85 "	" $1,408.40 "	 $388.52 	" $1,238.42 "	" $1,618.85 "	" $1,618.85 "	 $615.16 	" $1,019.88 "	" $1,376.02 "	" $1,068.44 "	" $1,295.08 "	 $388.52 	" $1,456.97 "	" $1,316.13 "	" $1,376.02 "	 $385.29 	" $1,316.13 "	 $388.52 
5270257	HCHG CVMC PLATELET RICH PLASMA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C9250	" $1,922.91 "	" $1,346.04 "	 $457.65 	" $1,922.91 "	" $1,672.93 "	 $461.50 	" $1,471.03 "	" $1,922.91 "	" $1,922.91 "	 $730.71 	" $1,211.43 "	" $1,634.47 "	" $1,269.12 "	" $1,538.33 "	 $461.50 	" $1,730.62 "	" $1,563.33 "	" $1,634.47 "	 $457.65 	" $1,563.33 "	 $461.50 
5270258	HCHG CVMC CORTEX SCREW 2.0 ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $187.40 	 $131.18 	 $44.60 	 $168.66 	 $163.04 	 $44.98 	 $143.36 	 $-   	 $-   	 $71.21 	 $118.06 	 $159.29 	 $123.68 	 $149.92 	 $44.98 	 $168.66 	 $152.36 	 $159.29 	 $44.60 	 $152.36 	 $44.98 
5270259	"HCHG CVMC SYNTHES-T-PLATE 2 HOLES HEAD, 8 HOLE SHAFT"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,171.44 "	 $820.01 	 $278.80 	" $1,054.30 "	" $1,019.15 "	 $281.15 	 $896.15 	 $-   	 $-   	 $445.15 	 $738.01 	 $995.72 	 $773.15 	 $937.15 	 $281.15 	" $1,054.30 "	 $952.38 	 $995.72 	 $278.80 	 $952.38 	 $281.15 
5270260	HCHG CVMC BIORAPTOR 2.3 ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,597.41 "	" $1,118.19 "	 $380.18 	" $1,597.41 "	" $1,389.75 "	 $383.38 	" $1,222.02 "	" $1,597.41 "	 $-   	 $607.02 	" $1,006.37 "	" $1,357.80 "	" $1,054.29 "	" $1,277.93 "	 $383.38 	" $1,437.67 "	" $1,298.69 "	" $1,357.80 "	 $380.18 	" $1,298.69 "	 $383.38 
5270261	HCHG CVMC HEMA CARTIOD PATCH VASCULAR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1768	 $498.78 	 $349.15 	 $118.71 	 $448.90 	 $433.94 	 $119.71 	 $381.57 	 $-   	 $-   	 $189.54 	 $314.23 	 $423.96 	 $329.19 	 $399.02 	 $119.71 	 $448.90 	 $405.51 	 $423.96 	 $118.71 	 $405.51 	 $119.71 
5270262	HCHG CVMC SYNTHES LOCKING SCREW 2.7MM ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $737.87 	 $516.51 	 $175.61 	 $664.08 	 $641.95 	 $177.09 	 $564.47 	 $-   	 $-   	 $280.39 	 $464.86 	 $627.19 	 $486.99 	 $590.30 	 $177.09 	 $664.08 	 $599.89 	 $627.19 	 $175.61 	 $599.89 	 $177.09 
5270263	HCHG CVMC DEPUY SMALL BONE FIXATION SYSTEM 1.6MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,402.36 "	 $981.65 	 $333.76 	" $1,262.12 "	" $1,220.05 "	 $336.57 	" $1,072.81 "	 $-   	 $-   	 $532.90 	 $883.49 	" $1,192.01 "	 $925.56 	" $1,121.89 "	 $336.57 	" $1,262.12 "	" $1,140.12 "	" $1,192.01 "	 $333.76 	" $1,140.12 "	 $336.57 
5270264	HCHG CVMC CORTICAL SCREW 2.0 ALL SIZES-ZIMMER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $116.94 	 $81.86 	 $27.83 	 $105.25 	 $101.74 	 $28.07 	 $89.46 	 $-   	 $-   	 $44.44 	 $73.67 	 $99.40 	 $77.18 	 $93.55 	 $28.07 	 $105.25 	 $95.07 	 $99.40 	 $27.83 	 $95.07 	 $28.07 
5270265	HCHG CVMC RETRO SCREW-ARTHREX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,359.63 "	 $951.74 	 $323.59 	" $1,223.67 "	" $1,182.88 "	 $326.31 	" $1,040.12 "	 $-   	 $-   	 $516.66 	 $856.57 	" $1,155.69 "	 $897.36 	" $1,087.70 "	 $326.31 	" $1,223.67 "	" $1,105.38 "	" $1,155.69 "	 $323.59 	" $1,105.38 "	 $326.31 
5270266	"HCHG CVMC ANCHOR, 5.0 ALL THREAD BIOMET"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,491.71 "	" $1,044.20 "	 $355.03 	" $1,342.54 "	" $1,297.79 "	 $358.01 	" $1,141.16 "	 $-   	 $-   	 $566.85 	 $939.78 	" $1,267.95 "	 $984.53 	" $1,193.37 "	 $358.01 	" $1,342.54 "	" $1,212.76 "	" $1,267.95 "	 $355.03 	" $1,212.76 "	 $358.01 
5270267	HCHG CVMC CENTRAL SCREW-BIOMET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,082.30 "	 $757.61 	 $257.59 	 $974.07 	 $941.60 	 $259.75 	 $827.96 	 $-   	 $-   	 $411.27 	 $681.85 	 $919.96 	 $714.32 	 $865.84 	 $259.75 	 $974.07 	 $879.91 	 $919.96 	 $257.59 	 $879.91 	 $259.75 
5270268	HCHG CVMC FIXED LOCKING SCREW-BIOMET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,093.89 "	 $765.72 	 $260.35 	 $984.50 	 $951.68 	 $262.53 	 $836.83 	 $-   	 $-   	 $415.68 	 $689.15 	 $929.81 	 $721.97 	 $875.11 	 $262.53 	 $984.50 	 $889.33 	 $929.81 	 $260.35 	 $889.33 	 $262.53 
5270269	HCHG CVMC BIOMET REVERSE SHOULDER GLENOSPHERE (36MM+3)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,827.68 "	" $4,079.38 "	" $1,386.99 "	" $5,827.68 "	" $5,070.08 "	" $1,398.64 "	" $4,458.18 "	" $5,827.68 "	" $5,827.68 "	" $2,214.52 "	" $3,671.44 "	" $4,953.53 "	" $3,846.27 "	" $4,662.14 "	" $1,398.64 "	" $5,244.91 "	" $4,737.90 "	" $4,953.53 "	" $1,386.99 "	" $4,737.90 "	" $1,398.64 "
5270270	HCHG CVMC REVERSE SHOULDER HUMERAL TRAY W/LOCKING RING-BIOMET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,733.71 "	" $4,713.60 "	" $1,602.62 "	" $6,733.71 "	" $5,858.33 "	" $1,616.09 "	" $5,151.29 "	" $6,733.71 "	" $6,733.71 "	" $2,558.81 "	" $4,242.24 "	" $5,723.65 "	" $4,444.25 "	" $5,386.97 "	" $1,616.09 "	" $6,060.34 "	" $5,474.51 "	" $5,723.65 "	" $1,602.62 "	" $5,474.51 "	" $1,616.09 "
5270271	HCHG CVMC REVERSE SHOULDER HUMERAL BEARING (44-36MM)-BIOMET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,097.68 "	" $2,868.38 "	 $975.25 	" $4,097.68 "	" $3,564.98 "	 $983.44 	" $3,134.73 "	" $4,097.68 "	" $4,097.68 "	" $1,557.12 "	" $2,581.54 "	" $3,483.03 "	" $2,704.47 "	" $3,278.14 "	 $983.44 	" $3,687.91 "	" $3,331.41 "	" $3,483.03 "	 $975.25 	" $3,331.41 "	 $983.44 
5270272	HCHG CVMC CONDYLAR PLATE-SYNTHES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,430.73 "	" $1,001.51 "	 $340.51 	" $1,287.66 "	" $1,244.74 "	 $343.38 	" $1,094.51 "	 $-   	 $-   	 $543.68 	 $901.36 	" $1,216.12 "	 $944.28 	" $1,144.58 "	 $343.38 	" $1,287.66 "	" $1,163.18 "	" $1,216.12 "	 $340.51 	" $1,163.18 "	 $343.38 
5270273	HCHG CVMC TIBIAL ARTICULAR SURFACE 15MM-MG 11 TOTAL KNEE SYSTEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,536.78 "	" $4,575.75 "	" $1,555.75 "	" $6,536.78 "	" $5,687.00 "	" $1,568.83 "	" $5,000.64 "	" $6,536.78 "	" $6,536.78 "	" $2,483.98 "	" $4,118.17 "	" $5,556.26 "	" $4,314.27 "	" $5,229.42 "	" $1,568.83 "	" $5,883.10 "	" $5,314.40 "	" $5,556.26 "	" $1,555.75 "	" $5,314.40 "	" $1,568.83 "
5270274	HCHG CVMC METACARPOPHALANGEAL IMPLANT- SM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,623.04 "	" $7,436.13 "	" $2,528.28 "	" $10,623.04 "	" $9,242.04 "	" $2,549.53 "	" $8,126.63 "	" $10,623.04 "	" $10,623.04 "	" $4,036.76 "	" $6,692.52 "	" $9,029.58 "	" $7,011.21 "	" $8,498.43 "	" $2,549.53 "	" $9,560.74 "	" $8,636.53 "	" $9,029.58 "	" $2,528.28 "	" $8,636.53 "	" $2,549.53 "
5270275	HCHG CVMC VANGUARD PS OPEN BOX FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,770.48 "	" $9,639.34 "	" $3,277.37 "	" $13,770.48 "	" $11,980.32 "	" $3,304.92 "	" $10,534.42 "	" $13,770.48 "	" $13,770.48 "	" $5,232.78 "	" $8,675.40 "	" $11,704.91 "	" $9,088.52 "	" $11,016.38 "	" $3,304.92 "	" $12,393.43 "	" $11,195.40 "	" $11,704.91 "	" $3,277.37 "	" $11,195.40 "	" $3,304.92 "
5270276	HCHG CVMC FIBULA PLATE 2.7/3.5 MM 4 HOLE-SYNTHES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,376.63 "	" $1,663.64 "	 $565.64 	" $2,376.63 "	" $2,067.67 "	 $570.39 	" $1,818.12 "	" $2,376.63 "	" $2,376.63 "	 $903.12 	" $1,497.28 "	" $2,020.14 "	" $1,568.58 "	" $1,901.30 "	 $570.39 	" $2,138.97 "	" $1,932.20 "	" $2,020.14 "	 $565.64 	" $1,932.20 "	 $570.39 
5270277	HCHG CVMC PROXIMAL HUMERUS PLATE 3 HOLE-SYNTHES LCP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,154.50 "	" $2,908.15 "	 $988.77 	" $4,154.50 "	" $3,614.42 "	 $997.08 	" $3,178.19 "	" $4,154.50 "	" $4,154.50 "	" $1,578.71 "	" $2,617.34 "	" $3,531.33 "	" $2,741.97 "	" $3,323.60 "	 $997.08 	" $3,739.05 "	" $3,377.61 "	" $3,531.33 "	 $988.77 	" $3,377.61 "	 $997.08 
5270278	HCHG CVMC TIBIAL BEARING 10MM X 63/67MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,684.88 "	" $3,279.42 "	" $1,115.00 "	" $4,684.88 "	" $4,075.85 "	" $1,124.37 "	" $3,583.93 "	" $4,684.88 "	" $4,684.88 "	" $1,780.25 "	" $2,951.47 "	" $3,982.15 "	" $3,092.02 "	" $3,747.90 "	" $1,124.37 "	" $4,216.39 "	" $3,808.81 "	" $3,982.15 "	" $1,115.00 "	" $3,808.81 "	" $1,124.37 "
5270279	HCHG CVMC CRUCIATE TIBIAL PLATE 63MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,421.17 "	" $4,494.82 "	" $1,528.24 "	" $6,421.17 "	" $5,586.42 "	" $1,541.08 "	" $4,912.20 "	" $6,421.17 "	" $6,421.17 "	" $2,440.04 "	" $4,045.34 "	" $5,457.99 "	" $4,237.97 "	" $5,136.94 "	" $1,541.08 "	" $5,779.05 "	" $5,220.41 "	" $5,457.99 "	" $1,528.24 "	" $5,220.41 "	" $1,541.08 "
5270280	HCHG CVMC REGENEREX RINGLOC LIMITED HOLE ACETABULAR CUP (62MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,226.93 "	" $5,758.85 "	" $1,958.01 "	" $8,226.93 "	" $7,157.43 "	" $1,974.46 "	" $6,293.60 "	" $8,226.93 "	" $8,226.93 "	" $3,126.23 "	" $5,182.97 "	" $6,992.89 "	" $5,429.77 "	" $6,581.54 "	" $1,974.46 "	" $7,404.24 "	" $6,688.49 "	" $6,992.89 "	" $1,958.01 "	" $6,688.49 "	" $1,974.46 "
5270281	HCHG CVMC BIOMET: M2A MODULAR HEAD COMPONENT (38 MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,886.91 "	" $3,420.84 "	" $1,163.08 "	" $4,886.91 "	" $4,251.61 "	" $1,172.86 "	" $3,738.49 "	" $4,886.91 "	" $4,886.91 "	" $1,857.03 "	" $3,078.75 "	" $4,153.87 "	" $3,225.36 "	" $3,909.53 "	" $1,172.86 "	" $4,398.22 "	" $3,973.06 "	" $4,153.87 "	" $1,163.08 "	" $3,973.06 "	" $1,172.86 "
5270282	"HCHG CVMC SBI RADIO-CAPITELLIUM, STANDARD HEAD, SIZE 2"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,113.29 "	" $5,679.30 "	" $1,930.96 "	" $8,113.29 "	" $7,058.56 "	" $1,947.19 "	" $6,206.67 "	" $8,113.29 "	" $8,113.29 "	" $3,083.05 "	" $5,111.37 "	" $6,896.30 "	" $5,354.77 "	" $6,490.63 "	" $1,947.19 "	" $7,301.96 "	" $6,596.10 "	" $6,896.30 "	" $1,930.96 "	" $6,596.10 "	" $1,947.19 "
5270283	"HCHG CVMC SBI RADIAL IMPLANT, STANDARD STEM, SIZE 4"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,392.76 "	" $4,474.93 "	" $1,521.48 "	" $6,392.76 "	" $5,561.70 "	" $1,534.26 "	" $4,890.46 "	" $6,392.76 "	" $6,392.76 "	" $2,429.25 "	" $4,027.44 "	" $5,433.85 "	" $4,219.22 "	" $5,114.21 "	" $1,534.26 "	" $5,753.48 "	" $5,197.31 "	" $5,433.85 "	" $1,521.48 "	" $5,197.31 "	" $1,534.26 "
5270284	"HCHG CVMC SBI RADIO-CAPITELLUM, CAPITELLUM, RIGHT, LARGE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,444.76 "	" $5,911.33 "	" $2,009.85 "	" $8,444.76 "	" $7,346.94 "	" $2,026.74 "	" $6,460.24 "	" $8,444.76 "	" $8,444.76 "	" $3,209.01 "	" $5,320.20 "	" $7,178.05 "	" $5,573.54 "	" $6,755.81 "	" $2,026.74 "	" $7,600.28 "	" $6,865.59 "	" $7,178.05 "	" $2,009.85 "	" $6,865.59 "	" $2,026.74 "
5270285	HCHG CVMC BIOMET E-POLY-RINGLOC ACETABULAR LINER (38MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,232.50 "	" $5,062.75 "	" $1,721.34 "	" $7,232.50 "	" $6,292.28 "	" $1,735.80 "	" $5,532.86 "	" $7,232.50 "	" $7,232.50 "	" $2,748.35 "	" $4,556.48 "	" $6,147.63 "	" $4,773.45 "	" $5,786.00 "	" $1,735.80 "	" $6,509.25 "	" $5,880.02 "	" $6,147.63 "	" $1,721.34 "	" $5,880.02 "	" $1,735.80 "
5270286	HCHG CVMC LCP BONE PLATE 5 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,500.17 "	" $1,050.12 "	 $357.04 	" $1,500.17 "	" $1,305.15 "	 $360.04 	" $1,147.63 "	" $1,500.17 "	 $-   	 $570.06 	 $945.11 	" $1,275.14 "	 $990.11 	" $1,200.14 "	 $360.04 	" $1,350.15 "	" $1,219.64 "	" $1,275.14 "	 $357.04 	" $1,219.64 "	 $360.04 
5270288	HCHG CVMC LCP BONE PLATE 9 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,221.34 "	 $854.94 	 $290.68 	" $1,099.21 "	" $1,062.57 "	 $293.12 	 $934.33 	 $-   	 $-   	 $464.11 	 $769.44 	" $1,038.14 "	 $806.08 	 $977.07 	 $293.12 	" $1,099.21 "	 $992.95 	" $1,038.14 "	 $290.68 	 $992.95 	 $293.12 
5270293	HCHG CVMC MINI QUICK ANCHOR PLUS (#2/0 SUTURE) DEPUY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $934.71 	 $654.30 	 $222.46 	 $841.24 	 $813.20 	 $224.33 	 $715.05 	 $-   	 $-   	 $355.19 	 $588.87 	 $794.50 	 $616.91 	 $747.77 	 $224.33 	 $841.24 	 $759.92 	 $794.50 	 $222.46 	 $759.92 	 $224.33 
5270294	HCHG CVMC FEMORAL NAIL TITANIUM LATERAL ENTRY (ALL SIZES)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,321.19 "	" $3,024.83 "	" $1,028.44 "	" $4,321.19 "	" $3,759.44 "	" $1,037.09 "	" $3,305.71 "	" $4,321.19 "	" $4,321.19 "	" $1,642.05 "	" $2,722.35 "	" $3,673.01 "	" $2,851.99 "	" $3,456.95 "	" $1,037.09 "	" $3,889.07 "	" $3,513.13 "	" $3,673.01 "	" $1,028.44 "	" $3,513.13 "	" $1,037.09 "
5270295	HCHG CVMC Y-PLATE 3 HOLE HEAD 8 HOLE SHAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,277.93 "	 $894.55 	 $304.15 	" $1,150.14 "	" $1,111.80 "	 $306.70 	 $977.62 	 $-   	 $-   	 $485.61 	 $805.10 	" $1,086.24 "	 $843.43 	" $1,022.34 "	 $306.70 	" $1,150.14 "	" $1,038.96 "	" $1,086.24 "	 $304.15 	" $1,038.96 "	 $306.70 
5270296	HCHG CVMC FEMORAL STEM MODULAR TAPERLOC (11X142MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $15,775.14 "	" $11,042.60 "	" $3,754.48 "	" $15,775.14 "	" $13,724.37 "	" $3,786.03 "	" $12,067.98 "	" $15,775.14 "	" $15,775.14 "	" $5,994.55 "	" $9,938.34 "	" $13,408.87 "	" $10,411.59 "	" $12,620.11 "	" $3,786.03 "	" $14,197.63 "	" $12,825.19 "	" $13,408.87 "	" $3,754.48 "	" $12,825.19 "	" $3,786.03 "
5270297	HCHG CVMC M2A CARBON MODULAR HEAD (32MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,447.35 "	" $2,413.15 "	 $820.47 	" $3,447.35 "	" $2,999.19 "	 $827.36 	" $2,637.22 "	" $3,447.35 "	" $3,447.35 "	" $1,309.99 "	" $2,171.83 "	" $2,930.25 "	" $2,275.25 "	" $2,757.88 "	 $827.36 	" $3,102.62 "	" $2,802.70 "	" $2,930.25 "	 $820.47 	" $2,802.70 "	 $827.36 
5270298	HCHG CVMC RINGLOC ACETABULAR LINER (32MM) HI WALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,811.14 "	" $3,367.80 "	" $1,145.05 "	" $4,811.14 "	" $4,185.69 "	" $1,154.67 "	" $3,680.52 "	" $4,811.14 "	" $4,811.14 "	" $1,828.23 "	" $3,031.02 "	" $4,089.47 "	" $3,175.35 "	" $3,848.91 "	" $1,154.67 "	" $4,330.03 "	" $3,911.46 "	" $4,089.47 "	" $1,145.05 "	" $3,911.46 "	" $1,154.67 "
5270299	HCHG CVMC ACETABULAR SHELL (52MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,603.53 "	" $3,922.47 "	" $1,333.64 "	" $5,603.53 "	" $4,875.07 "	" $1,344.85 "	" $4,286.70 "	" $5,603.53 "	" $5,603.53 "	" $2,129.34 "	" $3,530.22 "	" $4,763.00 "	" $3,698.33 "	" $4,482.82 "	" $1,344.85 "	" $5,043.18 "	" $4,555.67 "	" $4,763.00 "	" $1,333.64 "	" $4,555.67 "	" $1,344.85 "
5270300	HCHG CVMC TIBIAL BEARING 14MM X 71/75MM VANGUARD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,463.88 "	" $3,124.72 "	" $1,062.40 "	" $4,463.88 "	" $3,883.58 "	" $1,071.33 "	" $3,414.87 "	" $4,463.88 "	" $4,463.88 "	" $1,696.27 "	" $2,812.24 "	" $3,794.30 "	" $2,946.16 "	" $3,571.10 "	" $1,071.33 "	" $4,017.49 "	" $3,629.13 "	" $3,794.30 "	" $1,062.40 "	" $3,629.13 "	" $1,071.33 "
5270301	HCHG CVMC PATELLA SERIES A STANDARD 34MM X 8.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,375.76 "	" $2,363.03 "	 $803.43 	" $3,375.76 "	" $2,936.91 "	 $810.18 	" $2,582.46 "	" $3,375.76 "	" $3,375.76 "	" $1,282.79 "	" $2,126.73 "	" $2,869.40 "	" $2,228.00 "	" $2,700.61 "	 $810.18 	" $3,038.18 "	" $2,744.49 "	" $2,869.40 "	 $803.43 	" $2,744.49 "	 $810.18 
5270302	HCHG CVMC VNAGUARD-CR FEMORAL 65MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $12,763.43 "	" $8,934.40 "	" $3,037.70 "	" $12,763.43 "	" $11,104.18 "	" $3,063.22 "	" $9,764.02 "	" $12,763.43 "	" $12,763.43 "	" $4,850.10 "	" $8,040.96 "	" $10,848.92 "	" $8,423.86 "	" $10,210.74 "	" $3,063.22 "	" $11,487.09 "	" $10,376.67 "	" $10,848.92 "	" $3,037.70 "	" $10,376.67 "	" $3,063.22 "
5270303	HCHG CVMC VANGUARD-PS FEMORAL OPEN BOX 70MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,464.26 "	" $9,424.98 "	" $3,204.49 "	" $13,464.26 "	" $11,713.91 "	" $3,231.42 "	" $10,300.16 "	" $13,464.26 "	" $13,464.26 "	" $5,116.42 "	" $8,482.48 "	" $11,444.62 "	" $8,886.41 "	" $10,771.41 "	" $3,231.42 "	" $12,117.83 "	" $10,946.44 "	" $11,444.62 "	" $3,204.49 "	" $10,946.44 "	" $3,231.42 "
5270304	HCHG CVMC VANGUARD-DCM PS TIBIAL BEARING 12X79/83MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,684.86 "	" $3,279.40 "	" $1,115.00 "	" $4,684.86 "	" $4,075.83 "	" $1,124.37 "	" $3,583.92 "	" $4,684.86 "	" $4,684.86 "	" $1,780.25 "	" $2,951.46 "	" $3,982.13 "	" $3,092.01 "	" $3,747.89 "	" $1,124.37 "	" $4,216.37 "	" $3,808.79 "	" $3,982.13 "	" $1,115.00 "	" $3,808.79 "	" $1,124.37 "
5270305	"HCHG CVMC LOCKING CALCANEAL PLATE-LONG, SYNTHES"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,493.95 "	" $1,745.77 "	 $593.56 	" $2,493.95 "	" $2,169.74 "	 $598.55 	" $1,907.87 "	" $2,493.95 "	" $2,493.95 "	 $947.70 	" $1,571.19 "	" $2,119.86 "	" $1,646.01 "	" $1,995.16 "	 $598.55 	" $2,244.56 "	" $2,027.58 "	" $2,119.86 "	 $593.56 	" $2,027.58 "	 $598.55 
5270306	HCHG CVMC 4.5 CORTEX SCREW(SELF-TAPPING) ALL SIZES-SYNTHES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $153.80 	 $107.66 	 $36.60 	 $138.42 	 $133.81 	 $36.91 	 $117.66 	 $-   	 $-   	 $58.44 	 $96.89 	 $130.73 	 $101.51 	 $123.04 	 $36.91 	 $138.42 	 $125.04 	 $130.73 	 $36.60 	 $125.04 	 $36.91 
5270307	HCHG CVMC DISTAL FIBULA PLATE-11 HOLE-SYNTHES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,343.22 "	" $1,640.25 "	 $557.69 	" $2,343.22 "	" $2,038.60 "	 $562.37 	" $1,792.56 "	" $2,343.22 "	" $2,343.22 "	 $890.42 	" $1,476.23 "	" $1,991.74 "	" $1,546.53 "	" $1,874.58 "	 $562.37 	" $2,108.90 "	" $1,905.04 "	" $1,991.74 "	 $557.69 	" $1,905.04 "	 $562.37 
5270308	HCHG CVMC IMPLANT PORT W/GROSHONG CATH	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $2,453.87 "	" $1,717.71 "	 $584.02 	" $2,453.87 "	" $2,134.87 "	 $588.93 	" $1,877.21 "	" $2,453.87 "	" $2,453.87 "	 $932.47 	" $1,545.94 "	" $2,085.79 "	" $1,619.55 "	" $1,963.10 "	 $588.93 	" $2,208.48 "	" $1,995.00 "	" $2,085.79 "	 $584.02 	" $1,995.00 "	 $588.93 
5270310	HCHG CVMC LINEAR LEADS WITH PRELOADED ENHANCED STYLET-NEUROSTIM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1778	" $6,844.20 "	" $4,790.94 "	" $1,628.92 "	" $6,844.20 "	" $5,954.45 "	" $1,642.61 "	" $5,235.81 "	" $6,844.20 "	" $6,844.20 "	" $2,600.80 "	" $4,311.85 "	" $5,817.57 "	" $4,517.17 "	" $5,475.36 "	" $1,642.61 "	" $6,159.78 "	" $5,564.33 "	" $5,817.57 "	" $1,628.92 "	" $5,564.33 "	" $1,642.61 "
5270311	HCHG CVMC IMPLANTABLE PULSE GENERATOR W/CHARGING KIT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1820	" $47,237.00 "	" $33,065.90 "	" $11,242.41 "	" $47,237.00 "	" $41,096.19 "	" $11,336.88 "	" $36,136.31 "	" $47,237.00 "	" $47,237.00 "	" $17,950.06 "	" $29,759.31 "	" $40,151.45 "	" $31,176.42 "	" $37,789.60 "	" $11,336.88 "	" $42,513.30 "	" $38,403.68 "	" $40,151.45 "	" $11,242.41 "	" $38,403.68 "	" $11,336.88 "
5270312	HCHG CVMC PRECISION PROGRAMMER KIT-NEUROSTIMRLATOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1787	" $3,510.49 "	" $2,457.34 "	 $835.50 	" $3,510.49 "	" $3,054.13 "	 $842.52 	" $2,685.52 "	" $3,510.49 "	" $3,510.49 "	" $1,333.99 "	" $2,211.61 "	" $2,983.92 "	" $2,316.92 "	" $2,808.39 "	 $842.52 	" $3,159.44 "	" $2,854.03 "	" $2,983.92 "	 $835.50 	" $2,854.03 "	 $842.52 
5270313	HCHG CVMC SYNTHES 5.0 CANNULATED SCREWS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,224.68 "	 $857.28 	 $291.47 	" $1,102.21 "	" $1,065.47 "	 $293.92 	 $936.88 	 $-   	 $-   	 $465.38 	 $771.55 	" $1,040.98 "	 $808.29 	 $979.74 	 $293.92 	" $1,102.21 "	 $995.66 	" $1,040.98 "	 $291.47 	 $995.66 	 $293.92 
5270314	HCHG CVMC MEDTRONIC-SYNCHROMED PUMP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1772	" $35,357.50 "	" $24,750.25 "	" $8,415.09 "	" $35,357.50 "	" $30,761.03 "	" $8,485.80 "	" $27,048.49 "	" $35,357.50 "	" $35,357.50 "	" $13,435.85 "	" $22,275.23 "	" $30,053.88 "	" $23,335.95 "	" $28,286.00 "	" $8,485.80 "	" $31,821.75 "	" $28,745.65 "	" $30,053.88 "	" $8,415.09 "	" $28,745.65 "	" $8,485.80 "
5270315	HCHG CVMC MENISCAL CINCH-ARTHREX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,584.93 "	" $1,109.45 "	 $377.21 	" $1,584.93 "	" $1,378.89 "	 $380.38 	" $1,212.47 "	" $1,584.93 "	 $-   	 $602.27 	 $998.51 	" $1,347.19 "	" $1,046.05 "	" $1,267.94 "	 $380.38 	" $1,426.44 "	" $1,288.55 "	" $1,347.19 "	 $377.21 	" $1,288.55 "	 $380.38 
5270316	HCHG CVMC TIBIAL BEARING 12 MM X63/67 MM-BIOMET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,987.93 "	" $3,491.55 "	" $1,187.13 "	" $4,987.93 "	" $4,339.50 "	" $1,197.10 "	" $3,815.77 "	" $4,987.93 "	" $4,987.93 "	" $1,895.41 "	" $3,142.40 "	" $4,239.74 "	" $3,292.03 "	" $3,990.34 "	" $1,197.10 "	" $4,489.14 "	" $4,055.19 "	" $4,239.74 "	" $1,187.13 "	" $4,055.19 "	" $1,197.10 "
5270317	HCHG CVMC SYNTHES TITANIUM CANNULATED HUMERAL NAIL 11-7MM ALL LENG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,046.02 "	" $3,532.21 "	" $1,200.95 "	" $5,046.02 "	" $4,390.04 "	" $1,211.04 "	" $3,860.21 "	" $5,046.02 "	" $5,046.02 "	" $1,917.49 "	" $3,178.99 "	" $4,289.12 "	" $3,330.37 "	" $4,036.82 "	" $1,211.04 "	" $4,541.42 "	" $4,102.41 "	" $4,289.12 "	" $1,200.95 "	" $4,102.41 "	" $1,211.04 "
5270318	HCHG CVMC SYNTHES TITANIUM LOCKING SCREWS 4.0 MM FOR IM NAILS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $407.10 	 $284.97 	 $96.89 	 $366.39 	 $354.18 	 $97.70 	 $311.43 	 $-   	 $-   	 $154.70 	 $256.47 	 $346.04 	 $268.69 	 $325.68 	 $97.70 	 $366.39 	 $330.97 	 $346.04 	 $96.89 	 $330.97 	 $97.70 
5270319	HCHG CVMC SYNTHES TITANIUM SPIRAL BLADE FOR HUMERAL NAILS(34-54MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,057.32 "	" $1,440.12 "	 $489.64 	" $2,057.32 "	" $1,789.87 "	 $493.76 	" $1,573.85 "	" $2,057.32 "	" $2,057.32 "	 $781.78 	" $1,296.11 "	" $1,748.72 "	" $1,357.83 "	" $1,645.86 "	 $493.76 	" $1,851.59 "	" $1,672.60 "	" $1,748.72 "	 $489.64 	" $1,672.60 "	 $493.76 
5270320	"HCHG CVMC PATIENT PROGRAMMER, MEDTRONIC NEUROSTIMULATOR"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1787	" $4,009.29 "	" $2,806.50 "	 $954.21 	" $4,009.29 "	" $3,488.08 "	 $962.23 	" $3,067.11 "	" $4,009.29 "	" $4,009.29 "	" $1,523.53 "	" $2,525.85 "	" $3,407.90 "	" $2,646.13 "	" $3,207.43 "	 $962.23 	" $3,608.36 "	" $3,259.55 "	" $3,407.90 "	 $954.21 	" $3,259.55 "	 $962.23 
5270321	"HCHG CVMC OCTAD LEAD, MEDTRONIC NEUROSTIMULATOR"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1778	" $8,299.54 "	" $5,809.68 "	" $1,975.29 "	" $8,299.54 "	" $7,220.60 "	" $1,991.89 "	" $6,349.15 "	" $8,299.54 "	" $8,299.54 "	" $3,153.83 "	" $5,228.71 "	" $7,054.61 "	" $5,477.70 "	" $6,639.63 "	" $1,991.89 "	" $7,469.59 "	" $6,747.53 "	" $7,054.61 "	" $1,975.29 "	" $6,747.53 "	" $1,991.89 "
5270322	"HCHG CVMC NEUROSTIMULATOR W/RECHARGING UNIT, MEDTRONIC"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1820	" $66,737.29 "	" $46,716.10 "	" $15,883.48 "	" $66,737.29 "	" $58,061.44 "	" $16,016.95 "	" $51,054.03 "	" $66,737.29 "	" $66,737.29 "	" $25,360.17 "	" $42,044.49 "	" $56,726.70 "	" $44,046.61 "	" $53,389.83 "	" $16,016.95 "	" $60,063.56 "	" $54,257.42 "	" $56,726.70 "	" $15,883.48 "	" $54,257.42 "	" $16,016.95 "
5270323	"HCHG CVMC TITAN ANCHOR, MEDTRONIC NEUROSTIMULATOR"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $868.17 	 $607.72 	 $206.62 	 $781.35 	 $755.31 	 $208.36 	 $664.15 	 $-   	 $-   	 $329.90 	 $546.95 	 $737.94 	 $572.99 	 $694.54 	 $208.36 	 $781.35 	 $705.82 	 $737.94 	 $206.62 	 $705.82 	 $208.36 
5270324	HCHG CVMC DISTAL FIBULA PLATE 7 HOLE LCP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,159.87 "	" $1,511.91 "	 $514.05 	" $2,159.87 "	" $1,879.09 "	 $518.37 	" $1,652.30 "	" $2,159.87 "	" $2,159.87 "	 $820.75 	" $1,360.72 "	" $1,835.89 "	" $1,425.51 "	" $1,727.90 "	 $518.37 	" $1,943.88 "	" $1,755.97 "	" $1,835.89 "	 $514.05 	" $1,755.97 "	 $518.37 
5270325	HCHG CVMC 2.5 HEADLESS SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,165.40 "	 $815.78 	 $277.37 	" $1,048.86 "	" $1,013.90 "	 $279.70 	 $891.53 	 $-   	 $-   	 $442.85 	 $734.20 	 $990.59 	 $769.16 	 $932.32 	 $279.70 	" $1,048.86 "	 $947.47 	 $990.59 	 $277.37 	 $947.47 	 $279.70 
5270326	HCHG CVMC 1.0 MM CABLE W/CRIMP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,003.32 "	" $1,402.32 "	 $476.79 	" $2,003.32 "	" $1,742.89 "	 $480.80 	" $1,532.54 "	" $2,003.32 "	" $2,003.32 "	 $761.26 	" $1,262.09 "	" $1,702.82 "	" $1,322.19 "	" $1,602.66 "	 $480.80 	" $1,802.99 "	" $1,628.70 "	" $1,702.82 "	 $476.79 	" $1,628.70 "	 $480.80 
5270327	HCHG CVMC BONE SCREW 3.0 X 28 MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $896.46 	 $627.52 	 $213.36 	 $806.81 	 $779.92 	 $215.15 	 $685.79 	 $-   	 $-   	 $340.65 	 $564.77 	 $761.99 	 $591.66 	 $717.17 	 $215.15 	 $806.81 	 $728.82 	 $761.99 	 $213.36 	 $728.82 	 $215.15 
5270328	"HCHG CVMC TIBIAL BEARING-ANTIOXIDANT INFUSED, VANGUARD"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,590.68 "	" $4,613.48 "	" $1,568.58 "	" $6,590.68 "	" $5,733.89 "	" $1,581.76 "	" $5,041.87 "	" $6,590.68 "	" $6,590.68 "	" $2,504.46 "	" $4,152.13 "	" $5,602.08 "	" $4,349.85 "	" $5,272.54 "	" $1,581.76 "	" $5,931.61 "	" $5,358.22 "	" $5,602.08 "	" $1,568.58 "	" $5,358.22 "	" $1,581.76 "
5270329	HCHG CVMC MENISCAL BEARING MED 3MM THICK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $2,700.38 "	" $1,890.27 "	 $642.69 	" $2,700.38 "	" $2,349.33 "	 $648.09 	" $2,065.79 "	" $2,700.38 "	" $2,700.38 "	" $1,026.14 "	" $1,701.24 "	" $2,295.32 "	" $1,782.25 "	" $2,160.30 "	 $648.09 	" $2,430.34 "	" $2,195.41 "	" $2,295.32 "	 $642.69 	" $2,195.41 "	 $648.09 
5270330	HCHG CVMC REVERSE STEINMAN PIN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $645.55 	 $451.89 	 $153.64 	 $581.00 	 $561.63 	 $154.93 	 $493.85 	 $-   	 $-   	 $245.31 	 $406.70 	 $548.72 	 $426.06 	 $516.44 	 $154.93 	 $581.00 	 $524.83 	 $548.72 	 $153.64 	 $524.83 	 $154.93 
5270331	HCHG CVMC CENTRAL SCREW 6.5 MM (20-25MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $868.16 	 $607.71 	 $206.62 	 $781.34 	 $755.30 	 $208.36 	 $664.14 	 $-   	 $-   	 $329.90 	 $546.94 	 $737.94 	 $572.99 	 $694.53 	 $208.36 	 $781.34 	 $705.81 	 $737.94 	 $206.62 	 $705.81 	 $208.36 
5270332	HCHG CVMC NON LOCKING SCREW 4.75MM (20-30MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $877.06 	 $613.94 	 $208.74 	 $789.35 	 $763.04 	 $210.49 	 $670.95 	 $-   	 $-   	 $333.28 	 $552.55 	 $745.50 	 $578.86 	 $701.65 	 $210.49 	 $789.35 	 $713.05 	 $745.50 	 $208.74 	 $713.05 	 $210.49 
5270333	HCHG CVMC GLENOSPHERE BASEPLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,873.80 "	" $3,411.66 "	" $1,159.96 "	" $4,873.80 "	" $4,240.21 "	" $1,169.71 "	" $3,728.46 "	" $4,873.80 "	" $4,873.80 "	" $1,852.04 "	" $3,070.49 "	" $4,142.73 "	" $3,216.71 "	" $3,899.04 "	" $1,169.71 "	" $4,386.42 "	" $3,962.40 "	" $4,142.73 "	" $1,159.96 "	" $3,962.40 "	" $1,169.71 "
5270334	HCHG CVMC FIXED LOCKING SCREW 4.75MM (25-45MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $877.06 	 $613.94 	 $208.74 	 $789.35 	 $763.04 	 $210.49 	 $670.95 	 $-   	 $-   	 $333.28 	 $552.55 	 $745.50 	 $578.86 	 $701.65 	 $210.49 	 $789.35 	 $713.05 	 $745.50 	 $208.74 	 $713.05 	 $210.49 
5270335	HCHG CVMC VERSA-DIAL SHOULDER SYSTEM STANDARD ADAPTER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	 $903.77 	 $632.64 	 $215.10 	 $813.39 	 $786.28 	 $216.90 	 $691.38 	 $-   	 $-   	 $343.43 	 $569.38 	 $768.20 	 $596.49 	 $723.02 	 $216.90 	 $813.39 	 $734.77 	 $768.20 	 $215.10 	 $734.77 	 $216.90 
5270336	HCHG CVMC PRIMARY MINI LENGHT SHOULDER STEM (15X83MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $11,605.32 "	" $8,123.72 "	" $2,762.07 "	" $11,605.32 "	" $10,096.63 "	" $2,785.28 "	" $8,878.07 "	" $11,605.32 "	" $11,605.32 "	" $4,410.02 "	" $7,311.35 "	" $9,864.52 "	" $7,659.51 "	" $9,284.26 "	" $2,785.28 "	" $10,444.79 "	" $9,435.13 "	" $9,864.52 "	" $2,762.07 "	" $9,435.13 "	" $2,785.28 "
5270337	HCHG CVMC TIBIAL BEARING 10MM X 71/75	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,987.93 "	" $3,491.55 "	" $1,187.13 "	" $4,987.93 "	" $4,339.50 "	" $1,197.10 "	" $3,815.77 "	" $4,987.93 "	" $4,987.93 "	" $1,895.41 "	" $3,142.40 "	" $4,239.74 "	" $3,292.03 "	" $3,990.34 "	" $1,197.10 "	" $4,489.14 "	" $4,055.19 "	" $4,239.74 "	" $1,187.13 "	" $4,055.19 "	" $1,197.10 "
5270338	"HCHG CVMC TIBIAL PLATE, FIXED CRUCIATE, 71MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,421.18 "	" $4,494.83 "	" $1,528.24 "	" $6,421.18 "	" $5,586.43 "	" $1,541.08 "	" $4,912.20 "	" $6,421.18 "	" $6,421.18 "	" $2,440.05 "	" $4,045.34 "	" $5,458.00 "	" $4,237.98 "	" $5,136.94 "	" $1,541.08 "	" $5,779.06 "	" $5,220.42 "	" $5,458.00 "	" $1,528.24 "	" $5,220.42 "	" $1,541.08 "
5270339	HCHG CVMC LCP WRIST FUSION PLATES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,432.32 "	" $3,102.62 "	" $1,054.89 "	" $4,432.32 "	" $3,856.12 "	" $1,063.76 "	" $3,390.72 "	" $4,432.32 "	" $4,432.32 "	" $1,684.28 "	" $2,792.36 "	" $3,767.47 "	" $2,925.33 "	" $3,545.86 "	" $1,063.76 "	" $3,989.09 "	" $3,603.48 "	" $3,767.47 "	" $1,054.89 "	" $3,603.48 "	" $1,063.76 "
5270340	HCHG CVMC FINGER JOINT IMPLANT W/GROMMETS (SIZE 4-6)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,690.44 "	" $2,583.31 "	 $878.32 	" $3,690.44 "	" $3,210.68 "	 $885.71 	" $2,823.19 "	" $3,690.44 "	" $3,690.44 "	" $1,402.37 "	" $2,324.98 "	" $3,136.87 "	" $2,435.69 "	" $2,952.35 "	 $885.71 	" $3,321.40 "	" $3,000.33 "	" $3,136.87 "	 $878.32 	" $3,000.33 "	 $885.71 
5270341	HCHG CVMC LOCKING DELTOID HOOK PLATE-3 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,204.84 "	" $2,243.39 "	 $762.75 	" $3,204.84 "	" $2,788.21 "	 $769.16 	" $2,451.70 "	" $3,204.84 "	" $3,204.84 "	" $1,217.84 "	" $2,019.05 "	" $2,724.11 "	" $2,115.19 "	" $2,563.87 "	 $769.16 	" $2,884.36 "	" $2,605.53 "	" $2,724.11 "	 $762.75 	" $2,605.53 "	 $769.16 
5270342	HCHG CVMC TUBULAR HOOK PLATE-3 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,719.26 "	" $1,903.48 "	 $647.18 	" $2,719.26 "	" $2,365.76 "	 $652.62 	" $2,080.23 "	" $2,719.26 "	" $2,719.26 "	" $1,033.32 "	" $1,713.13 "	" $2,311.37 "	" $1,794.71 "	" $2,175.41 "	 $652.62 	" $2,447.33 "	" $2,210.76 "	" $2,311.37 "	 $647.18 	" $2,210.76 "	 $652.62 
5270343	HCHG CVMC WASHER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $217.87 	 $152.51 	 $51.85 	 $196.08 	 $189.55 	 $52.29 	 $166.67 	 $-   	 $-   	 $82.79 	 $137.26 	 $185.19 	 $143.79 	 $174.30 	 $52.29 	 $196.08 	 $177.13 	 $185.19 	 $51.85 	 $177.13 	 $52.29 
5270344	HCHG CVMC CANCELLOUS SCREW 3X12-14	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $254.19 	 $177.93 	 $60.50 	 $228.77 	 $221.15 	 $61.01 	 $194.46 	 $-   	 $-   	 $96.59 	 $160.14 	 $216.06 	 $167.77 	 $203.35 	 $61.01 	 $228.77 	 $206.66 	 $216.06 	 $60.50 	 $206.66 	 $61.01 
5270345	HCHG CVMC CANCELLOUS SCREW 4X14-22	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $254.19 	 $177.93 	 $60.50 	 $228.77 	 $221.15 	 $61.01 	 $194.46 	 $-   	 $-   	 $96.59 	 $160.14 	 $216.06 	 $167.77 	 $203.35 	 $61.01 	 $228.77 	 $206.66 	 $216.06 	 $60.50 	 $206.66 	 $61.01 
5270346	HCHG CVMC CORTICAL SCREW 3.5X14	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $254.19 	 $177.93 	 $60.50 	 $228.77 	 $221.15 	 $61.01 	 $194.46 	 $-   	 $-   	 $96.59 	 $160.14 	 $216.06 	 $167.77 	 $203.35 	 $61.01 	 $228.77 	 $206.66 	 $216.06 	 $60.50 	 $206.66 	 $61.01 
5270347	HCHG CVMC LOCKING SCREW 3.5X14-16	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $798.87 	 $559.21 	 $190.13 	 $718.98 	 $695.02 	 $191.73 	 $611.14 	 $-   	 $-   	 $303.57 	 $503.29 	 $679.04 	 $527.25 	 $639.10 	 $191.73 	 $718.98 	 $649.48 	 $679.04 	 $190.13 	 $649.48 	 $191.73 
5270348	HCHG CVMC HEADED SCREW 2.5X20	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,232.79 "	 $862.95 	 $293.40 	" $1,109.51 "	" $1,072.53 "	 $295.87 	 $943.08 	 $-   	 $-   	 $468.46 	 $776.66 	" $1,047.87 "	 $813.64 	 $986.23 	 $295.87 	" $1,109.51 "	" $1,002.26 "	" $1,047.87 "	 $293.40 	" $1,002.26 "	 $295.87 
5270349	HCHG CVMC HEADLESS SCREW 2.5X20	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,200.36 "	 $840.25 	 $285.69 	" $1,080.32 "	" $1,044.31 "	 $288.09 	 $918.28 	 $-   	 $-   	 $456.14 	 $756.23 	" $1,020.31 "	 $792.24 	 $960.29 	 $288.09 	" $1,080.32 "	 $975.89 	" $1,020.31 "	 $285.69 	 $975.89 	 $288.09 
5270350	HCHG CVMC MENISCAL BEARING SMALL 4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,510.49 "	" $2,457.34 "	 $835.50 	" $3,510.49 "	" $3,054.13 "	 $842.52 	" $2,685.52 "	" $3,510.49 "	" $3,510.49 "	" $1,333.99 "	" $2,211.61 "	" $2,983.92 "	" $2,316.92 "	" $2,808.39 "	 $842.52 	" $3,159.44 "	" $2,854.03 "	" $2,983.92 "	 $835.50 	" $2,854.03 "	 $842.52 
5270351	HCHG CVMC HEADED SCREW 4.0 X 22MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,684.23 "	" $1,178.96 "	 $400.85 	" $1,684.23 "	" $1,465.28 "	 $404.22 	" $1,288.44 "	" $1,684.23 "	" $1,684.23 "	 $640.01 	" $1,061.06 "	" $1,431.60 "	" $1,111.59 "	" $1,347.38 "	 $404.22 	" $1,515.81 "	" $1,369.28 "	" $1,431.60 "	 $400.85 	" $1,369.28 "	 $404.22 
5270352	HCHG CVMC HEADLESS SCREW 2.5 X 22MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,200.35 "	 $840.25 	 $285.68 	" $1,080.32 "	" $1,044.30 "	 $288.08 	 $918.27 	 $-   	 $-   	 $456.13 	 $756.22 	" $1,020.30 "	 $792.23 	 $960.28 	 $288.08 	" $1,080.32 "	 $975.88 	" $1,020.30 "	 $285.68 	 $975.88 	 $288.08 
5270353	HCHG CVMC HEADED SCREW 2.0 X 16 MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,174.91 "	 $822.44 	 $279.63 	" $1,057.42 "	" $1,022.17 "	 $281.98 	 $898.81 	 $-   	 $-   	 $446.47 	 $740.19 	 $998.67 	 $775.44 	 $939.93 	 $281.98 	" $1,057.42 "	 $955.20 	 $998.67 	 $279.63 	 $955.20 	 $281.98 
5270354	HCHG CVMC HEADED SCREW 2.0 X 12MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,174.91 "	 $822.44 	 $279.63 	" $1,057.42 "	" $1,022.17 "	 $281.98 	 $898.81 	 $-   	 $-   	 $446.47 	 $740.19 	 $998.67 	 $775.44 	 $939.93 	 $281.98 	" $1,057.42 "	 $955.20 	 $998.67 	 $279.63 	 $955.20 	 $281.98 
5270355	HCHG CVMC RINGLOC ACETABULAR CUP 28MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,044.00 "	" $2,830.80 "	 $962.47 	" $4,044.00 "	" $3,518.28 "	 $970.56 	" $3,093.66 "	" $4,044.00 "	" $4,044.00 "	" $1,536.72 "	" $2,547.72 "	" $3,437.40 "	" $2,669.04 "	" $3,235.20 "	 $970.56 	" $3,639.60 "	" $3,287.77 "	" $3,437.40 "	 $962.47 	" $3,287.77 "	 $970.56 
5270356	HCHG CVMC MODULAR HEAD COMPONENT 28MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,608.84 "	" $2,526.19 "	 $858.90 	" $3,608.84 "	" $3,139.69 "	 $866.12 	" $2,760.76 "	" $3,608.84 "	" $3,608.84 "	" $1,371.36 "	" $2,273.57 "	" $3,067.51 "	" $2,381.83 "	" $2,887.07 "	 $866.12 	" $3,247.96 "	" $2,933.99 "	" $3,067.51 "	 $858.90 	" $2,933.99 "	 $866.12 
5270357	HCHG CVMC LCP PROXIMAL TIBIA PLATE 4 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,974.56 "	" $2,782.19 "	 $945.95 	" $3,974.56 "	" $3,457.87 "	 $953.89 	" $3,040.54 "	" $3,974.56 "	" $3,974.56 "	" $1,510.33 "	" $2,503.97 "	" $3,378.38 "	" $2,623.21 "	" $3,179.65 "	 $953.89 	" $3,577.10 "	" $3,231.32 "	" $3,378.38 "	 $945.95 	" $3,231.32 "	 $953.89 
5270358	HCHG CVMC DISTAL RADIUS PLATE 8 HEAD/3 SHAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,820.26 "	" $1,974.18 "	 $671.22 	" $2,820.26 "	" $2,453.63 "	 $676.86 	" $2,157.50 "	" $2,820.26 "	" $2,820.26 "	" $1,071.70 "	" $1,776.76 "	" $2,397.22 "	" $1,861.37 "	" $2,256.21 "	 $676.86 	" $2,538.23 "	" $2,292.87 "	" $2,397.22 "	 $671.22 	" $2,292.87 "	 $676.86 
5270359	HCHG CVMC FINGER JOINT IMPLANTS W/GROMETS (SIZE 4-6)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $2,838.79 "	" $1,987.15 "	 $675.63 	" $2,838.79 "	" $2,469.75 "	 $681.31 	" $2,171.67 "	" $2,838.79 "	" $2,838.79 "	" $1,078.74 "	" $1,788.44 "	" $2,412.97 "	" $1,873.60 "	" $2,271.03 "	 $681.31 	" $2,554.91 "	" $2,307.94 "	" $2,412.97 "	 $675.63 	" $2,307.94 "	 $681.31 
5270360	HCHG CVMC CANCELLOUS BONE SCREW 6.5 32MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $254.18 	 $177.93 	 $60.49 	 $228.76 	 $221.14 	 $61.00 	 $194.45 	 $-   	 $-   	 $96.59 	 $160.13 	 $216.05 	 $167.76 	 $203.34 	 $61.00 	 $228.76 	 $206.65 	 $216.05 	 $60.49 	 $206.65 	 $61.00 
5270361	HCHG CVMC ANATOMIC ARCOM MENISCAL BEARING SMALL 4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,510.49 "	" $2,457.34 "	 $835.50 	" $3,510.49 "	" $3,054.13 "	 $842.52 	" $2,685.52 "	" $3,510.49 "	" $3,510.49 "	" $1,333.99 "	" $2,211.61 "	" $2,983.92 "	" $2,316.92 "	" $2,808.39 "	 $842.52 	" $3,159.44 "	" $2,854.03 "	" $2,983.92 "	 $835.50 	" $2,854.03 "	 $842.52 
5270362	HCHG CVMC TITANIUM END CAP FOR HINDFOOT ARTHRODESIS NAILS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,048.97 "	 $734.28 	 $249.65 	 $944.07 	 $912.60 	 $251.75 	 $802.46 	 $-   	 $-   	 $398.61 	 $660.85 	 $891.62 	 $692.32 	 $839.18 	 $251.75 	 $944.07 	 $852.81 	 $891.62 	 $249.65 	 $852.81 	 $251.75 
5270363	HCHG CVMC TITANIUM SPIRAL BLADE FOR RETROGRADE FEMORAL NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,262.27 "	" $1,583.59 "	 $538.42 	" $2,262.27 "	" $1,968.17 "	 $542.94 	" $1,730.64 "	" $2,262.27 "	" $2,262.27 "	 $859.66 	" $1,425.23 "	" $1,922.93 "	" $1,493.10 "	" $1,809.82 "	 $542.94 	" $2,036.04 "	" $1,839.23 "	" $1,922.93 "	 $538.42 	" $1,839.23 "	 $542.94 
5270364	HCHG CVMC TITANIUM HINDFOOT ARTHRODESIS NAIL-ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,166.87 "	" $3,616.81 "	" $1,229.72 "	" $5,166.87 "	" $4,495.18 "	" $1,240.05 "	" $3,952.66 "	" $5,166.87 "	" $5,166.87 "	" $1,963.41 "	" $3,255.13 "	" $4,391.84 "	" $3,410.13 "	" $4,133.50 "	" $1,240.05 "	" $4,650.18 "	" $4,200.67 "	" $4,391.84 "	" $1,229.72 "	" $4,200.67 "	" $1,240.05 "
5270365	HCHG CVMC NEUROSTIMULATOR W/CHARGE UNIT-RESTORE ADVANCED	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1820	" $63,580.37 "	" $44,506.26 "	" $15,132.13 "	" $63,580.37 "	" $55,314.92 "	" $15,259.29 "	" $48,638.98 "	" $63,580.37 "	" $63,580.37 "	" $24,160.54 "	" $40,055.63 "	" $54,043.31 "	" $41,963.04 "	" $50,864.30 "	" $15,259.29 "	" $57,222.33 "	" $51,690.84 "	" $54,043.31 "	" $15,132.13 "	" $51,690.84 "	" $15,259.29 "
5270366	HCHG CVMC ACHILLES TENDON ALLOGRAFT 10MM-BIO CLEANSE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $10,102.14 "	" $7,071.50 "	" $2,404.31 "	" $10,102.14 "	" $8,788.86 "	" $2,424.51 "	" $7,728.14 "	" $10,102.14 "	" $10,102.14 "	" $3,838.81 "	" $6,364.35 "	" $8,586.82 "	" $6,667.41 "	" $8,081.71 "	" $2,424.51 "	" $9,091.93 "	" $8,213.04 "	" $8,586.82 "	" $2,404.31 "	" $8,213.04 "	" $2,424.51 "
5270367	"HCHG CVMC CONTACT EXTENSION KIT (55CM, 8 CONTACT) NEUROSTIM COMP"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1883	" $3,138.81 "	" $2,197.17 "	 $747.04 	" $3,138.81 "	" $2,730.76 "	 $753.31 	" $2,401.19 "	" $3,138.81 "	" $3,138.81 "	" $1,192.75 "	" $1,977.45 "	" $2,667.99 "	" $2,071.61 "	" $2,511.05 "	 $753.31 	" $2,824.93 "	" $2,551.85 "	" $2,667.99 "	 $747.04 	" $2,551.85 "	 $753.31 
5270368	HCHG CVMC GLENOSPHERE 36MM BIOMET COMPREHENSIVE REVERSE SHOULDER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,061.29 "	" $4,242.90 "	" $1,442.59 "	" $6,061.29 "	" $5,273.32 "	" $1,454.71 "	" $4,636.89 "	" $6,061.29 "	" $6,061.29 "	" $2,303.29 "	" $3,818.61 "	" $5,152.10 "	" $4,000.45 "	" $4,849.03 "	" $1,454.71 "	" $5,455.16 "	" $4,927.83 "	" $5,152.10 "	" $1,442.59 "	" $4,927.83 "	" $1,454.71 "
5270369	HCHG CVMC NEUROSTIMULATOR W/PROGRAMMER MEDTRONIC PRIME ADVANCED	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1820	" $48,711.28 "	" $34,097.90 "	" $11,593.28 "	" $48,711.28 "	" $42,378.81 "	" $11,690.71 "	" $37,264.13 "	" $48,711.28 "	" $48,711.28 "	" $18,510.29 "	" $30,688.11 "	" $41,404.59 "	" $32,149.44 "	" $38,969.02 "	" $11,690.71 "	" $43,840.15 "	" $39,602.27 "	" $41,404.59 "	" $11,593.28 "	" $39,602.27 "	" $11,690.71 "
5270370	HCHG CVMC AUTOFIX COMPRESSION SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,481.66 "	" $1,037.16 "	 $352.64 	" $1,333.49 "	" $1,289.04 "	 $355.60 	" $1,133.47 "	 $-   	 $-   	 $563.03 	 $933.45 	" $1,259.41 "	 $977.90 	" $1,185.33 "	 $355.60 	" $1,333.49 "	" $1,204.59 "	" $1,259.41 "	 $352.64 	" $1,204.59 "	 $355.60 
5270371	HCHG CVMC HELICAL BLADE FOR TROCH NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,451.69 "	" $1,716.18 "	 $583.50 	" $2,451.69 "	" $2,132.97 "	 $588.41 	" $1,875.54 "	" $2,451.69 "	" $2,451.69 "	 $931.64 	" $1,544.56 "	" $2,083.94 "	" $1,618.12 "	" $1,961.35 "	 $588.41 	" $2,206.52 "	" $1,993.22 "	" $2,083.94 "	 $583.50 	" $1,993.22 "	 $588.41 
5270372	HCHG CVMC SMART TOE-IMPLANT (ALL SIZES)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,551.54 "	" $2,486.08 "	 $845.27 	" $3,551.54 "	" $3,089.84 "	 $852.37 	" $2,716.93 "	" $3,551.54 "	" $3,551.54 "	" $1,349.59 "	" $2,237.47 "	" $3,018.81 "	" $2,344.02 "	" $2,841.23 "	 $852.37 	" $3,196.39 "	" $2,887.40 "	" $3,018.81 "	 $845.27 	" $2,887.40 "	 $852.37 
5270373	HCHG CVMC PROXIMAL INTERPHALANGEAL IMPLANT SIZE 3(SBI)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,626.38 "	" $7,438.47 "	" $2,529.08 "	" $10,626.38 "	" $9,244.95 "	" $2,550.33 "	" $8,129.18 "	" $10,626.38 "	" $10,626.38 "	" $4,038.02 "	" $6,694.62 "	" $9,032.42 "	" $7,013.41 "	" $8,501.10 "	" $2,550.33 "	" $9,563.74 "	" $8,639.25 "	" $9,032.42 "	" $2,529.08 "	" $8,639.25 "	" $2,550.33 "
5270374	HCHG CVMC TITANIUM LOCK SCREWS-IM NAILS 6.0MM (SYNTHES)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,086.24 "	 $760.37 	 $258.53 	 $977.62 	 $945.03 	 $260.70 	 $830.97 	 $-   	 $-   	 $412.77 	 $684.33 	 $923.30 	 $716.92 	 $868.99 	 $260.70 	 $977.62 	 $883.11 	 $923.30 	 $258.53 	 $883.11 	 $260.70 
5270375	HCHG CVMC LCP PROXIMAL HUMERUS PLATE 2 HOLE/9 HOLE SHAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,268.52 "	" $3,687.96 "	" $1,253.91 "	" $5,268.52 "	" $4,583.61 "	" $1,264.44 "	" $4,030.42 "	" $5,268.52 "	" $5,268.52 "	" $2,002.04 "	" $3,319.17 "	" $4,478.24 "	" $3,477.22 "	" $4,214.82 "	" $1,264.44 "	" $4,741.67 "	" $4,283.31 "	" $4,478.24 "	" $1,253.91 "	" $4,283.31 "	" $1,264.44 "
5270376	HCHG CVMC DENOVO NATURAL TISSUE GRAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $13,732.60 "	" $9,612.82 "	" $3,268.36 "	" $13,732.60 "	" $11,947.36 "	" $3,295.82 "	" $10,505.44 "	" $13,732.60 "	" $13,732.60 "	" $5,218.39 "	" $8,651.54 "	" $11,672.71 "	" $9,063.52 "	" $10,986.08 "	" $3,295.82 "	" $12,359.34 "	" $11,164.60 "	" $11,672.71 "	" $3,268.36 "	" $11,164.60 "	" $3,295.82 "
5270377	HCHG CVMC EVICEL FIBRIN SEALANT (HUMAN) 1ML	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	 $901.21 	 $630.85 	 $214.49 	 $811.09 	 $784.05 	 $216.29 	 $689.43 	 $-   	 $-   	 $342.46 	 $567.76 	 $766.03 	 $594.80 	 $720.97 	 $216.29 	 $811.09 	 $732.68 	 $766.03 	 $214.49 	 $732.68 	 $216.29 
5270378	HCHG CVMC EVICEL FIBRIN SEALANT(HUMAN) 2ML	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $1,668.89 "	" $1,168.22 "	 $397.20 	" $1,668.89 "	" $1,451.93 "	 $400.53 	" $1,276.70 "	" $1,668.89 "	" $1,668.89 "	 $634.18 	" $1,051.40 "	" $1,418.56 "	" $1,101.47 "	" $1,335.11 "	 $400.53 	" $1,502.00 "	" $1,356.81 "	" $1,418.56 "	 $397.20 	" $1,356.81 "	 $400.53 
5270379	HCHG CVMC EVICEL FIBRIN SEALANT(HUMAN) 5ML	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $2,576.38 "	" $1,803.47 "	 $613.18 	" $2,576.38 "	" $2,241.45 "	 $618.33 	" $1,970.93 "	" $2,576.38 "	" $2,576.38 "	 $979.02 	" $1,623.12 "	" $2,189.92 "	" $1,700.41 "	" $2,061.10 "	 $618.33 	" $2,318.74 "	" $2,094.60 "	" $2,189.92 "	 $613.18 	" $2,094.60 "	 $618.33 
5270380	"HCHG CVMC STANDARD ACUTRAK 2 BONE SCREW, ACUMED 22 MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,225.91 "	" $1,558.14 "	 $529.77 	" $2,225.91 "	" $1,936.54 "	 $534.22 	" $1,702.82 "	" $2,225.91 "	" $2,225.91 "	 $845.85 	" $1,402.32 "	" $1,892.02 "	" $1,469.10 "	" $1,780.73 "	 $534.22 	" $2,003.32 "	" $1,809.66 "	" $1,892.02 "	 $529.77 	" $1,809.66 "	 $534.22 
5270381	HCHG CVMC MEDTRONIC SPINAL STIMULATOR LEAD 1X8 COMPACT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1897	" $4,388.12 "	" $3,071.68 "	" $1,044.37 "	" $4,388.12 "	" $3,817.66 "	" $1,053.15 "	" $3,356.91 "	" $4,388.12 "	" $4,388.12 "	" $1,667.49 "	" $2,764.52 "	" $3,729.90 "	" $2,896.16 "	" $3,510.50 "	" $1,053.15 "	" $3,949.31 "	" $3,567.54 "	" $3,729.90 "	" $1,044.37 "	" $3,567.54 "	" $1,053.15 "
5270382	HCHG CVMC INTRATHECAL CATHETER-MEDTRONIC INDURA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	E0785	" $2,699.84 "	" $1,889.89 "	 $642.56 	" $2,699.84 "	" $2,348.86 "	 $647.96 	" $2,065.38 "	" $2,699.84 "	" $2,699.84 "	" $1,025.94 "	" $1,700.90 "	" $2,294.86 "	" $1,781.89 "	" $2,159.87 "	 $647.96 	" $2,429.86 "	" $2,194.97 "	" $2,294.86 "	 $642.56 	" $2,194.97 "	 $647.96 
5270383	HCHG CVMC SYNCHROMED II PUMP MEDTRONIC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1772	" $35,357.50 "	" $24,750.25 "	" $8,415.09 "	" $35,357.50 "	" $30,761.03 "	" $8,485.80 "	" $27,048.49 "	" $35,357.50 "	" $35,357.50 "	" $13,435.85 "	" $22,275.23 "	" $30,053.88 "	" $23,335.95 "	" $28,286.00 "	" $8,485.80 "	" $31,821.75 "	" $28,745.65 "	" $30,053.88 "	" $8,415.09 "	" $28,745.65 "	" $8,485.80 "
5270384	HCHG CVMC CLIK ANCHOR-BOSTON SCIENTIFIC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,456.75 "	" $1,019.73 "	 $346.71 	" $1,311.08 "	" $1,267.37 "	 $349.62 	" $1,114.41 "	 $-   	 $-   	 $553.57 	 $917.75 	" $1,238.24 "	 $961.46 	" $1,165.40 "	 $349.62 	" $1,311.08 "	" $1,184.34 "	" $1,238.24 "	 $346.71 	" $1,184.34 "	 $349.62 
5270385	"HCHG CVMC ATRIUM, PROLITE MESH 3X6"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $207.56 	 $145.29 	 $49.40 	 $186.80 	 $180.58 	 $49.81 	 $158.78 	 $-   	 $-   	 $78.87 	 $130.76 	 $176.43 	 $136.99 	 $166.05 	 $49.81 	 $186.80 	 $168.75 	 $176.43 	 $49.40 	 $168.75 	 $49.81 
5270386	HCHG CVMC LCP SUPERIOR CLAVICLE PLATE 7 HOLE-SYNTHES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,267.41 "	" $2,287.19 "	 $777.64 	" $3,267.41 "	" $2,842.65 "	 $784.18 	" $2,499.57 "	" $3,267.41 "	" $3,267.41 "	" $1,241.62 "	" $2,058.47 "	" $2,777.30 "	" $2,156.49 "	" $2,613.93 "	 $784.18 	" $2,940.67 "	" $2,656.40 "	" $2,777.30 "	 $777.64 	" $2,656.40 "	 $784.18 
5270387	"HCHG CVMC VANGUARD M SERIES, PARTIAL KNEE JOINT COMPONENT"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,864.18 "	" $3,404.93 "	" $1,157.67 "	" $4,864.18 "	" $4,231.84 "	" $1,167.40 "	" $3,721.10 "	" $4,864.18 "	" $4,864.18 "	" $1,848.39 "	" $3,064.43 "	" $4,134.55 "	" $3,210.36 "	" $3,891.34 "	" $1,167.40 "	" $4,377.76 "	" $3,954.58 "	" $4,134.55 "	" $1,157.67 "	" $3,954.58 "	" $1,167.40 "
5270389	HCHG CVMC AMBIODRY ALLOGRAFT 1X2CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $2,410.55 "	" $1,687.39 "	 $573.71 	" $2,410.55 "	" $2,097.18 "	 $578.53 	" $1,844.07 "	" $2,410.55 "	" $2,410.55 "	 $916.01 	" $1,518.65 "	" $2,048.97 "	" $1,590.96 "	" $1,928.44 "	 $578.53 	" $2,169.50 "	" $1,959.78 "	" $2,048.97 "	 $573.71 	" $1,959.78 "	 $578.53 
5270390	HCHG CVMC AMBIODRY ALLOGRAFT 2X3CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $3,019.52 "	" $2,113.66 "	 $718.65 	" $3,019.52 "	" $2,626.98 "	 $724.68 	" $2,309.93 "	" $3,019.52 "	" $3,019.52 "	" $1,147.42 "	" $1,902.30 "	" $2,566.59 "	" $1,992.88 "	" $2,415.62 "	 $724.68 	" $2,717.57 "	" $2,454.87 "	" $2,566.59 "	 $718.65 	" $2,454.87 "	 $724.68 
5270391	HCHG CVMC AMBIODRY ALLOGRAFT 4X4CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $3,679.25 "	" $2,575.48 "	 $875.66 	" $3,679.25 "	" $3,200.95 "	 $883.02 	" $2,814.63 "	" $3,679.25 "	" $3,679.25 "	" $1,398.12 "	" $2,317.93 "	" $3,127.36 "	" $2,428.31 "	" $2,943.40 "	 $883.02 	" $3,311.33 "	" $2,991.23 "	" $3,127.36 "	 $875.66 	" $2,991.23 "	 $883.02 
5270392	HCHG CVMC AMBIODRY ALLOGRAFT 6X8CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $6,166.34 "	" $4,316.44 "	" $1,467.59 "	" $6,166.34 "	" $5,364.72 "	" $1,479.92 "	" $4,717.25 "	" $6,166.34 "	" $6,166.34 "	" $2,343.21 "	" $3,884.79 "	" $5,241.39 "	" $4,069.78 "	" $4,933.07 "	" $1,479.92 "	" $5,549.71 "	" $5,013.23 "	" $5,241.39 "	" $1,467.59 "	" $5,013.23 "	" $1,479.92 "
5270393	HCHG CVMC ORTHOGNATHIC SCREW #25-676-05	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $72.71 	 $50.90 	 $17.30 	 $65.44 	 $63.26 	 $17.45 	 $55.62 	 $-   	 $-   	 $27.63 	 $45.81 	 $61.80 	 $47.99 	 $58.17 	 $17.45 	 $65.44 	 $59.11 	 $61.80 	 $17.30 	 $59.11 	 $17.45 
5270394	HCHG CVMC ORTHOGNATHIC SCREW #25-678-07	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $79.99 	 $55.99 	 $19.04 	 $71.99 	 $69.59 	 $19.20 	 $61.19 	 $-   	 $-   	 $30.40 	 $50.39 	 $67.99 	 $52.79 	 $63.99 	 $19.20 	 $71.99 	 $65.03 	 $67.99 	 $19.04 	 $65.03 	 $19.20 
5270395	HCHG CVMC ORTHOGNATHIC SCREW #25-678-05	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $79.99 	 $55.99 	 $19.04 	 $71.99 	 $69.59 	 $19.20 	 $61.19 	 $-   	 $-   	 $30.40 	 $50.39 	 $67.99 	 $52.79 	 $63.99 	 $19.20 	 $71.99 	 $65.03 	 $67.99 	 $19.04 	 $65.03 	 $19.20 
5270396	HCHG CVMC 11 HOLE PLATE #50-280-03	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $390.82 	 $273.57 	 $93.02 	 $351.74 	 $340.01 	 $93.80 	 $298.98 	 $-   	 $-   	 $148.51 	 $246.22 	 $332.20 	 $257.94 	 $312.66 	 $93.80 	 $351.74 	 $317.74 	 $332.20 	 $93.02 	 $317.74 	 $93.80 
5270397	HCHG CVMC 11-HOLE PLATE #50-282-03	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $390.82 	 $273.57 	 $93.02 	 $351.74 	 $340.01 	 $93.80 	 $298.98 	 $-   	 $-   	 $148.51 	 $246.22 	 $332.20 	 $257.94 	 $312.66 	 $93.80 	 $351.74 	 $317.74 	 $332.20 	 $93.02 	 $317.74 	 $93.80 
5270398	HCHG CVMC ORTHOGNATHIC SCREW #25-679-07	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $72.71 	 $50.90 	 $17.30 	 $65.44 	 $63.26 	 $17.45 	 $55.62 	 $-   	 $-   	 $27.63 	 $45.81 	 $61.80 	 $47.99 	 $58.17 	 $17.45 	 $65.44 	 $59.11 	 $61.80 	 $17.30 	 $59.11 	 $17.45 
5270399	HCHG CVMC ORTHOGNATHIC SCREW #25-679-05	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $72.71 	 $50.90 	 $17.30 	 $65.44 	 $63.26 	 $17.45 	 $55.62 	 $-   	 $-   	 $27.63 	 $45.81 	 $61.80 	 $47.99 	 $58.17 	 $17.45 	 $65.44 	 $59.11 	 $61.80 	 $17.30 	 $59.11 	 $17.45 
5270400	HCHG CVMC 4-HOLE PLATE #50-321-04	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $132.69 	 $92.88 	 $31.58 	 $119.42 	 $115.44 	 $31.85 	 $101.51 	 $-   	 $-   	 $50.42 	 $83.59 	 $112.79 	 $87.58 	 $106.15 	 $31.85 	 $119.42 	 $107.88 	 $112.79 	 $31.58 	 $107.88 	 $31.85 
5270406	HCHG CVMC MESH-KUGEL COMPOSIX MEDIUM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,649.14 "	" $2,554.40 "	 $868.50 	" $3,649.14 "	" $3,174.75 "	 $875.79 	" $2,791.59 "	" $3,649.14 "	" $3,649.14 "	" $1,386.67 "	" $2,298.96 "	" $3,101.77 "	" $2,408.43 "	" $2,919.31 "	 $875.79 	" $3,284.23 "	" $2,966.75 "	" $3,101.77 "	 $868.50 	" $2,966.75 "	 $875.79 
5270407	HCHG CVMC MESH-KUGEL COMPOSIX LARGE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,821.01 "	" $2,674.71 "	 $909.40 	" $3,821.01 "	" $3,324.28 "	 $917.04 	" $2,923.07 "	" $3,821.01 "	" $3,821.01 "	" $1,451.98 "	" $2,407.24 "	" $3,247.86 "	" $2,521.87 "	" $3,056.81 "	 $917.04 	" $3,438.91 "	" $3,106.48 "	" $3,247.86 "	 $909.40 	" $3,106.48 "	 $917.04 
5270408	HCHG CVMC MESH-HERNIA PLUG LARGE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $840.84 	 $588.59 	 $200.12 	 $756.76 	 $731.53 	 $201.80 	 $643.24 	 $-   	 $-   	 $319.52 	 $529.73 	 $714.71 	 $554.95 	 $672.67 	 $201.80 	 $756.76 	 $683.60 	 $714.71 	 $200.12 	 $683.60 	 $201.80 
5270409	HCHG CVMC MESH-HERNIA PLUG MEDIUM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $823.88 	 $576.72 	 $196.08 	 $741.49 	 $716.78 	 $197.73 	 $630.27 	 $-   	 $-   	 $313.07 	 $519.04 	 $700.30 	 $543.76 	 $659.10 	 $197.73 	 $741.49 	 $669.81 	 $700.30 	 $196.08 	 $669.81 	 $197.73 
5270410	HCHG CVMC MESH-HERNIA PLUG SMALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $806.98 	 $564.89 	 $192.06 	 $726.28 	 $702.07 	 $193.68 	 $617.34 	 $-   	 $-   	 $306.65 	 $508.40 	 $685.93 	 $532.61 	 $645.58 	 $193.68 	 $726.28 	 $656.07 	 $685.93 	 $192.06 	 $656.07 	 $193.68 
5270411	HCHG CVMC ARTHREX FASTAK II SPEAR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $639.09 	 $447.36 	 $152.10 	 $575.18 	 $556.01 	 $153.38 	 $488.90 	 $-   	 $-   	 $242.85 	 $402.63 	 $543.23 	 $421.80 	 $511.27 	 $153.38 	 $575.18 	 $519.58 	 $543.23 	 $152.10 	 $519.58 	 $153.38 
5270412	HCHG CVMC 3.0 BIO-SUTURE TAK/ ANCHOR]	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,559.74 "	" $1,091.82 "	 $371.22 	" $1,559.74 "	" $1,356.97 "	 $374.34 	" $1,193.20 "	" $1,559.74 "	 $-   	 $592.70 	 $982.64 	" $1,325.78 "	" $1,029.43 "	" $1,247.79 "	 $374.34 	" $1,403.77 "	" $1,268.07 "	" $1,325.78 "	 $371.22 	" $1,268.07 "	 $374.34 
5270413	HCHG CVMC ONE THIRD TUBULAR 7 HOLE PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $281.81 	 $197.27 	 $67.07 	 $253.63 	 $245.17 	 $67.63 	 $215.58 	 $-   	 $-   	 $107.09 	 $177.54 	 $239.54 	 $185.99 	 $225.45 	 $67.63 	 $253.63 	 $229.11 	 $239.54 	 $67.07 	 $229.11 	 $67.63 
5270414	HCHG CVMC ONE THIRD TUBULAR 6 HOLE PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $298.84 	 $209.19 	 $71.12 	 $268.96 	 $259.99 	 $71.72 	 $228.61 	 $-   	 $-   	 $113.56 	 $188.27 	 $254.01 	 $197.23 	 $239.07 	 $71.72 	 $268.96 	 $242.96 	 $254.01 	 $71.12 	 $242.96 	 $71.72 
5270415	HCHG CVMC CORTICAL SCREW 2.7MM ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $113.84 	 $79.69 	 $27.09 	 $102.46 	 $99.04 	 $27.32 	 $87.09 	 $-   	 $-   	 $43.26 	 $71.72 	 $96.76 	 $75.13 	 $91.07 	 $27.32 	 $102.46 	 $92.55 	 $96.76 	 $27.09 	 $92.55 	 $27.32 
5270416	HCHG CVMC HUMAN AMNIOTIC MEMBRANE W/TISSEAL GLUE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $3,705.55 "	" $2,593.89 "	 $881.92 	" $3,705.55 "	" $3,223.83 "	 $889.33 	" $2,834.75 "	" $3,705.55 "	" $3,705.55 "	" $1,408.11 "	" $2,334.50 "	" $3,149.72 "	" $2,445.66 "	" $2,964.44 "	 $889.33 	" $3,335.00 "	" $3,012.61 "	" $3,149.72 "	 $881.92 	" $3,012.61 "	 $889.33 
5270417	HCHG CVMC ACL INTERFERENCE SCREW 9MM-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,101.39 "	 $770.97 	 $262.13 	 $991.25 	 $958.21 	 $264.33 	 $842.56 	 $-   	 $-   	 $418.53 	 $693.88 	 $936.18 	 $726.92 	 $881.11 	 $264.33 	 $991.25 	 $895.43 	 $936.18 	 $262.13 	 $895.43 	 $264.33 
5270418	HCHG CVMC FLEXIBLE HINGE W/GROMMETS/TOE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,208.97 "	" $3,646.28 "	" $1,239.73 "	" $5,208.97 "	" $4,531.80 "	" $1,250.15 "	" $3,984.86 "	" $5,208.97 "	" $5,208.97 "	" $1,979.41 "	" $3,281.65 "	" $4,427.62 "	" $3,437.92 "	" $4,167.18 "	" $1,250.15 "	" $4,688.07 "	" $4,234.89 "	" $4,427.62 "	" $1,239.73 "	" $4,234.89 "	" $1,250.15 "
5270419	HCHG CVMC BIO-TENODESIS SCREW-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,878.05 "	" $1,314.64 "	 $446.98 	" $1,878.05 "	" $1,633.90 "	 $450.73 	" $1,436.71 "	" $1,878.05 "	" $1,878.05 "	 $713.66 	" $1,183.17 "	" $1,596.34 "	" $1,239.51 "	" $1,502.44 "	 $450.73 	" $1,690.25 "	" $1,526.85 "	" $1,596.34 "	 $446.98 	" $1,526.85 "	 $450.73 
5270420	HCHG CVMC PORT A CATH/OPTILOCK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,687.83 "	" $1,181.48 "	 $401.70 	" $1,687.83 "	" $1,468.41 "	 $405.08 	" $1,291.19 "	" $1,687.83 "	" $1,687.83 "	 $641.38 	" $1,063.33 "	" $1,434.66 "	" $1,113.97 "	" $1,350.26 "	 $405.08 	" $1,519.05 "	" $1,372.21 "	" $1,434.66 "	 $401.70 	" $1,372.21 "	 $405.08 
5270421	HCHG CVMC 11 HOLE MM PLATE #50-282-00	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $399.92 	 $279.94 	 $95.18 	 $359.93 	 $347.93 	 $95.98 	 $305.94 	 $-   	 $-   	 $151.97 	 $251.95 	 $339.93 	 $263.95 	 $319.94 	 $95.98 	 $359.93 	 $325.13 	 $339.93 	 $95.18 	 $325.13 	 $95.98 
5270422	HCHG CVMC 11 HOLE MM PLATE #50-280-00	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $399.92 	 $279.94 	 $95.18 	 $359.93 	 $347.93 	 $95.98 	 $305.94 	 $-   	 $-   	 $151.97 	 $251.95 	 $339.93 	 $263.95 	 $319.94 	 $95.98 	 $359.93 	 $325.13 	 $339.93 	 $95.18 	 $325.13 	 $95.98 
5270423	HCHG CVMC 6 HOLE PLATE #50-331-06	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $236.30 	 $165.41 	 $56.24 	 $212.67 	 $205.58 	 $56.71 	 $180.77 	 $-   	 $-   	 $89.79 	 $148.87 	 $200.86 	 $155.96 	 $189.04 	 $56.71 	 $212.67 	 $192.11 	 $200.86 	 $56.24 	 $192.11 	 $56.71 
5270424	HCHG CVMC 6 HOLE PLATE #50-330-06	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $236.30 	 $165.41 	 $56.24 	 $212.67 	 $205.58 	 $56.71 	 $180.77 	 $-   	 $-   	 $89.79 	 $148.87 	 $200.86 	 $155.96 	 $189.04 	 $56.71 	 $212.67 	 $192.11 	 $200.86 	 $56.24 	 $192.11 	 $56.71 
5270425	HCHG CVMC ARTHREX BI-CORTICAL POST	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $967.67 	 $677.37 	 $230.31 	 $870.90 	 $841.87 	 $232.24 	 $740.27 	 $-   	 $-   	 $367.71 	 $609.63 	 $822.52 	 $638.66 	 $774.14 	 $232.24 	 $870.90 	 $786.72 	 $822.52 	 $230.31 	 $786.72 	 $232.24 
5270426	HCHG CVMC CANNULATED DELTA BIO SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,769.82 "	" $1,238.87 "	 $421.22 	" $1,769.82 "	" $1,539.74 "	 $424.76 	" $1,353.91 "	" $1,769.82 "	" $1,769.82 "	 $672.53 	" $1,114.99 "	" $1,504.35 "	" $1,168.08 "	" $1,415.86 "	 $424.76 	" $1,592.84 "	" $1,438.86 "	" $1,504.35 "	 $421.22 	" $1,438.86 "	 $424.76 
5270427	HCHG CVMC ARTHREX BIO-TRANSFIX PIN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,602.37 "	" $1,121.66 "	 $381.36 	" $1,602.37 "	" $1,394.06 "	 $384.57 	" $1,225.81 "	" $1,602.37 "	" $1,602.37 "	 $608.90 	" $1,009.49 "	" $1,362.01 "	" $1,057.56 "	" $1,281.90 "	 $384.57 	" $1,442.13 "	" $1,302.73 "	" $1,362.01 "	 $381.36 	" $1,302.73 "	 $384.57 
5270428	HCHG CVMC WASHER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $231.66 	 $162.16 	 $55.14 	 $208.49 	 $201.54 	 $55.60 	 $177.22 	 $-   	 $-   	 $88.03 	 $145.95 	 $196.91 	 $152.90 	 $185.33 	 $55.60 	 $208.49 	 $188.34 	 $196.91 	 $55.14 	 $188.34 	 $55.60 
5270429	HCHG CVMC RETRO SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,769.82 "	" $1,238.87 "	 $421.22 	" $1,769.82 "	" $1,539.74 "	 $424.76 	" $1,353.91 "	" $1,769.82 "	" $1,769.82 "	 $672.53 	" $1,114.99 "	" $1,504.35 "	" $1,168.08 "	" $1,415.86 "	 $424.76 	" $1,592.84 "	" $1,438.86 "	" $1,504.35 "	 $421.22 	" $1,438.86 "	 $424.76 
5270430	HCHG CVMC FEMORAL RETRO SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,769.82 "	" $1,238.87 "	 $421.22 	" $1,769.82 "	" $1,539.74 "	 $424.76 	" $1,353.91 "	" $1,769.82 "	" $1,769.82 "	 $672.53 	" $1,114.99 "	" $1,504.35 "	" $1,168.08 "	" $1,415.86 "	 $424.76 	" $1,592.84 "	" $1,438.86 "	" $1,504.35 "	 $421.22 	" $1,438.86 "	 $424.76 
5270431	HCHG CVMC BIO AMNIOGRAFT W/ TISSEAL (D)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $3,165.06 "	" $2,215.54 "	 $753.28 	" $3,165.06 "	" $2,753.60 "	 $759.61 	" $2,421.27 "	" $3,165.06 "	" $3,165.06 "	" $1,202.72 "	" $1,993.99 "	" $2,690.30 "	" $2,088.94 "	" $2,532.05 "	 $759.61 	" $2,848.55 "	" $2,573.19 "	" $2,690.30 "	 $753.28 	" $2,573.19 "	 $759.61 
5270432	HCHG CVMC SUTURE ANCHOR 6.5MM BIOCORKSCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,655.24 "	" $1,158.67 "	 $393.95 	" $1,655.24 "	" $1,440.06 "	 $397.26 	" $1,266.26 "	" $1,655.24 "	" $1,655.24 "	 $628.99 	" $1,042.80 "	" $1,406.95 "	" $1,092.46 "	" $1,324.19 "	 $397.26 	" $1,489.72 "	" $1,345.71 "	" $1,406.95 "	 $393.95 	" $1,345.71 "	 $397.26 
5270433	HCHG CVMC SYNTHES TITANIUM LOCKING SCREWS-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,012.74 "	 $708.92 	 $241.03 	 $911.47 	 $881.08 	 $243.06 	 $774.75 	 $-   	 $-   	 $384.84 	 $638.03 	 $860.83 	 $668.41 	 $810.19 	 $243.06 	 $911.47 	 $823.36 	 $860.83 	 $241.03 	 $823.36 	 $243.06 
5270434	HCHG CVMC GRAFT JACKET X-PRESS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $6,233.38 "	" $4,363.37 "	" $1,483.54 "	" $6,233.38 "	" $5,423.04 "	" $1,496.01 "	" $4,768.54 "	" $6,233.38 "	" $6,233.38 "	" $2,368.68 "	" $3,927.03 "	" $5,298.37 "	" $4,114.03 "	" $4,986.70 "	" $1,496.01 "	" $5,610.04 "	" $5,067.74 "	" $5,298.37 "	" $1,483.54 "	" $5,067.74 "	" $1,496.01 "
5270435	HCHG CVMC GRAFT JACKET 5X5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $6,858.48 "	" $4,800.94 "	" $1,632.32 "	" $6,858.48 "	" $5,966.88 "	" $1,646.04 "	" $5,246.74 "	" $6,858.48 "	" $6,858.48 "	" $2,606.22 "	" $4,320.84 "	" $5,829.71 "	" $4,526.60 "	" $5,486.78 "	" $1,646.04 "	" $6,172.63 "	" $5,575.94 "	" $5,829.71 "	" $1,632.32 "	" $5,575.94 "	" $1,646.04 "
5270436	HCHG CVMC MEDICAL GRAFT JACKET 4X4	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $4,497.08 "	" $3,147.96 "	" $1,070.31 "	" $4,497.08 "	" $3,912.46 "	" $1,079.30 "	" $3,440.27 "	" $4,497.08 "	" $4,497.08 "	" $1,708.89 "	" $2,833.16 "	" $3,822.52 "	" $2,968.07 "	" $3,597.66 "	" $1,079.30 "	" $4,047.37 "	" $3,656.13 "	" $3,822.52 "	" $1,070.31 "	" $3,656.13 "	" $1,079.30 "
5270437	HCHG CVMC MICRONIZED ALLODERM TISSUE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $1,661.62 "	" $1,163.13 "	 $395.47 	" $1,661.62 "	" $1,445.61 "	 $398.79 	" $1,271.14 "	" $1,661.62 "	" $1,661.62 "	 $631.42 	" $1,046.82 "	" $1,412.38 "	" $1,096.67 "	" $1,329.30 "	 $398.79 	" $1,495.46 "	" $1,350.90 "	" $1,412.38 "	 $395.47 	" $1,350.90 "	 $398.79 
5270438	HCHG CVMC TIBIALIS TENDON ANTERIOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $6,233.38 "	" $4,363.37 "	" $1,483.54 "	" $6,233.38 "	" $5,423.04 "	" $1,496.01 "	" $4,768.54 "	" $6,233.38 "	" $6,233.38 "	" $2,368.68 "	" $3,927.03 "	" $5,298.37 "	" $4,114.03 "	" $4,986.70 "	" $1,496.01 "	" $5,610.04 "	" $5,067.74 "	" $5,298.37 "	" $1,483.54 "	" $5,067.74 "	" $1,496.01 "
5270439	HCHG CVMC DVRA SHORT RIGHT PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,969.73 "	" $2,078.81 "	 $706.80 	" $2,969.73 "	" $2,583.67 "	 $712.74 	" $2,271.84 "	" $2,969.73 "	" $2,969.73 "	" $1,128.50 "	" $1,870.93 "	" $2,524.27 "	" $1,960.02 "	" $2,375.78 "	 $712.74 	" $2,672.76 "	" $2,414.39 "	" $2,524.27 "	 $706.80 	" $2,414.39 "	 $712.74 
5270440	HCHG CVMC PEG PARTIAL THREAD-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $599.16 	 $419.41 	 $142.60 	 $539.24 	 $521.27 	 $143.80 	 $458.36 	 $-   	 $-   	 $227.68 	 $377.47 	 $509.29 	 $395.45 	 $479.33 	 $143.80 	 $539.24 	 $487.12 	 $509.29 	 $142.60 	 $487.12 	 $143.80 
5270441	HCHG CVMC CORTICAL SCREW-ALL (DEPUY)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $599.16 	 $419.41 	 $142.60 	 $539.24 	 $521.27 	 $143.80 	 $458.36 	 $-   	 $-   	 $227.68 	 $377.47 	 $509.29 	 $395.45 	 $479.33 	 $143.80 	 $539.24 	 $487.12 	 $509.29 	 $142.60 	 $487.12 	 $143.80 
5270442	HCHG CVMC BIO-FULLTHREADED CORKSCREW-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,538.29 "	" $1,076.80 "	 $366.11 	" $1,538.29 "	" $1,338.31 "	 $369.19 	" $1,176.79 "	" $1,538.29 "	 $-   	 $584.55 	 $969.12 	" $1,307.55 "	" $1,015.27 "	" $1,230.63 "	 $369.19 	" $1,384.46 "	" $1,250.63 "	" $1,307.55 "	 $366.11 	" $1,250.63 "	 $369.19 
5270443	HCHG CVMC BIO-PUSHLOCK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,452.82 "	" $1,016.97 "	 $345.77 	" $1,307.54 "	" $1,263.95 "	 $348.68 	" $1,111.41 "	 $-   	 $-   	 $552.07 	 $915.28 	" $1,234.90 "	 $958.86 	" $1,162.26 "	 $348.68 	" $1,307.54 "	" $1,181.14 "	" $1,234.90 "	 $345.77 	" $1,181.14 "	 $348.68 
5270444	HCHG CVMC LP PLATE STRAIGHT 4 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $112.71 	 $78.90 	 $26.82 	 $101.44 	 $98.06 	 $27.05 	 $86.22 	 $-   	 $-   	 $42.83 	 $71.01 	 $95.80 	 $74.39 	 $90.17 	 $27.05 	 $101.44 	 $91.63 	 $95.80 	 $26.82 	 $91.63 	 $27.05 
5270445	HCHG CVMC LP PLATE L-SHAPE/4 HOLE-LONG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $227.21 	 $159.05 	 $54.08 	 $204.49 	 $197.67 	 $54.53 	 $173.82 	 $-   	 $-   	 $86.34 	 $143.14 	 $193.13 	 $149.96 	 $181.77 	 $54.53 	 $204.49 	 $184.72 	 $193.13 	 $54.08 	 $184.72 	 $54.53 
5270446	HCHG CVMC LP PLATE L-SHAPE/4 HOLE SHORT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $112.71 	 $78.90 	 $26.82 	 $101.44 	 $98.06 	 $27.05 	 $86.22 	 $-   	 $-   	 $42.83 	 $71.01 	 $95.80 	 $74.39 	 $90.17 	 $27.05 	 $101.44 	 $91.63 	 $95.80 	 $26.82 	 $91.63 	 $27.05 
5270447	HCHG CVMC STRAIGHT PLATE 17 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $354.47 	 $248.13 	 $84.36 	 $319.02 	 $308.39 	 $85.07 	 $271.17 	 $-   	 $-   	 $134.70 	 $223.32 	 $301.30 	 $233.95 	 $283.58 	 $85.07 	 $319.02 	 $288.18 	 $301.30 	 $84.36 	 $288.18 	 $85.07 
5270448	HCHG CVMC PRE STEPPED CHIN PLATE 5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $281.75 	 $197.23 	 $67.06 	 $253.58 	 $245.12 	 $67.62 	 $215.54 	 $-   	 $-   	 $107.07 	 $177.50 	 $239.49 	 $185.96 	 $225.40 	 $67.62 	 $253.58 	 $229.06 	 $239.49 	 $67.06 	 $229.06 	 $67.62 
5270449	HCHG CVMC CROSS DRIVE SCREW 2.0X11MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $69.07 	 $48.35 	 $16.44 	 $62.16 	 $60.09 	 $16.58 	 $52.84 	 $-   	 $-   	 $26.25 	 $43.51 	 $58.71 	 $45.59 	 $55.26 	 $16.58 	 $62.16 	 $56.15 	 $58.71 	 $16.44 	 $56.15 	 $16.58 
5270450	HCHG CVMC KYPHX HV-R BONE CEMENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $763.95 	 $534.77 	 $181.82 	 $687.56 	 $664.64 	 $183.35 	 $584.42 	 $-   	 $-   	 $290.30 	 $481.29 	 $649.36 	 $504.21 	 $611.16 	 $183.35 	 $687.56 	 $621.09 	 $649.36 	 $181.82 	 $621.09 	 $183.35 
5270451	HCHG CVMC ORTHOGNATHIC SCREW #25-673-05	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $79.99 	 $55.99 	 $19.04 	 $71.99 	 $69.59 	 $19.20 	 $61.19 	 $-   	 $-   	 $30.40 	 $50.39 	 $67.99 	 $52.79 	 $63.99 	 $19.20 	 $71.99 	 $65.03 	 $67.99 	 $19.04 	 $65.03 	 $19.20 
5270452	HCHG CVMC ORTHO MINI SCREW #25-672-09-1	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $69.07 	 $48.35 	 $16.44 	 $62.16 	 $60.09 	 $16.58 	 $52.84 	 $-   	 $-   	 $26.25 	 $43.51 	 $58.71 	 $45.59 	 $55.26 	 $16.58 	 $62.16 	 $56.15 	 $58.71 	 $16.44 	 $56.15 	 $16.58 
5270453	HCHG CVMC MINI 4 HOLE PLATE #25-550-04	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $107.25 	 $75.08 	 $25.53 	 $96.53 	 $93.31 	 $25.74 	 $82.05 	 $-   	 $-   	 $40.76 	 $67.57 	 $91.16 	 $70.79 	 $85.80 	 $25.74 	 $96.53 	 $87.19 	 $91.16 	 $25.53 	 $87.19 	 $25.74 
5270454	HCHG CVMC 8 HOLE PLATE #51-110-08	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,814.40 "	" $1,270.08 "	 $431.83 	" $1,814.40 "	" $1,578.53 "	 $435.46 	" $1,388.02 "	" $1,814.40 "	" $1,814.40 "	 $689.47 	" $1,143.07 "	" $1,542.24 "	" $1,197.50 "	" $1,451.52 "	 $435.46 	" $1,632.96 "	" $1,475.11 "	" $1,542.24 "	 $431.83 	" $1,475.11 "	 $435.46 
5270455	HCHG CVMC SCREW #22-673-07	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $351.49 	 $246.04 	 $83.65 	 $316.34 	 $305.80 	 $84.36 	 $268.89 	 $-   	 $-   	 $133.57 	 $221.44 	 $298.77 	 $231.98 	 $281.19 	 $84.36 	 $316.34 	 $285.76 	 $298.77 	 $83.65 	 $285.76 	 $84.36 
5270456	HCHG CVMC SCREW #25-673-11	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $351.49 	 $246.04 	 $83.65 	 $316.34 	 $305.80 	 $84.36 	 $268.89 	 $-   	 $-   	 $133.57 	 $221.44 	 $298.77 	 $231.98 	 $281.19 	 $84.36 	 $316.34 	 $285.76 	 $298.77 	 $83.65 	 $285.76 	 $84.36 
5270457	HCHG CVMC SCREW #25-677-08	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $599.16 	 $419.41 	 $142.60 	 $539.24 	 $521.27 	 $143.80 	 $458.36 	 $-   	 $-   	 $227.68 	 $377.47 	 $509.29 	 $395.45 	 $479.33 	 $143.80 	 $539.24 	 $487.12 	 $509.29 	 $142.60 	 $487.12 	 $143.80 
5270458	HCHG CVMC SCREW #25-677-10	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $599.16 	 $419.41 	 $142.60 	 $539.24 	 $521.27 	 $143.80 	 $458.36 	 $-   	 $-   	 $227.68 	 $377.47 	 $509.29 	 $395.45 	 $479.33 	 $143.80 	 $539.24 	 $487.12 	 $509.29 	 $142.60 	 $487.12 	 $143.80 
5270459	HCHG CVMC TENDON GRAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $5,886.13 "	" $4,120.29 "	" $1,400.90 "	" $5,886.13 "	" $5,120.93 "	" $1,412.67 "	" $4,502.89 "	" $5,886.13 "	" $5,886.13 "	" $2,236.73 "	" $3,708.26 "	" $5,003.21 "	" $3,884.85 "	" $4,708.90 "	" $1,412.67 "	" $5,297.52 "	" $4,785.42 "	" $5,003.21 "	" $1,400.90 "	" $4,785.42 "	" $1,412.67 "
5270460	HCHG CVMC HERBERT BONE SCREW 3MMX18MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,687.08 "	" $1,180.96 "	 $401.53 	" $1,687.08 "	" $1,467.76 "	 $404.90 	" $1,290.62 "	" $1,687.08 "	" $1,687.08 "	 $641.09 	" $1,062.86 "	" $1,434.02 "	" $1,113.47 "	" $1,349.66 "	 $404.90 	" $1,518.37 "	" $1,371.60 "	" $1,434.02 "	 $401.53 	" $1,371.60 "	 $404.90 
5270461	HCHG CVMC CALAXO SCREW 11MMX30MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,846.22 "	" $1,292.35 "	 $439.40 	" $1,846.22 "	" $1,606.21 "	 $443.09 	" $1,412.36 "	" $1,846.22 "	" $1,846.22 "	 $701.56 	" $1,163.12 "	" $1,569.29 "	" $1,218.51 "	" $1,476.98 "	 $443.09 	" $1,661.60 "	" $1,500.98 "	" $1,569.29 "	 $439.40 	" $1,500.98 "	 $443.09 
5270462	HCHG CVMC TRUFIT PLUG 9MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $2,136.51 "	" $1,495.56 "	 $508.49 	" $2,136.51 "	" $1,858.76 "	 $512.76 	" $1,634.43 "	" $2,136.51 "	" $2,136.51 "	 $811.87 	" $1,346.00 "	" $1,816.03 "	" $1,410.10 "	" $1,709.21 "	 $512.76 	" $1,922.86 "	" $1,736.98 "	" $1,816.03 "	 $508.49 	" $1,736.98 "	 $512.76 
5270463	HCHG CVMC CALAXO SCREW 12MMX35MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,846.22 "	" $1,292.35 "	 $439.40 	" $1,846.22 "	" $1,606.21 "	 $443.09 	" $1,412.36 "	" $1,846.22 "	" $1,846.22 "	 $701.56 	" $1,163.12 "	" $1,569.29 "	" $1,218.51 "	" $1,476.98 "	 $443.09 	" $1,661.60 "	" $1,500.98 "	" $1,569.29 "	 $439.40 	" $1,500.98 "	 $443.09 
5270465	HCHG CVMC CORTEX SCREW 2.7MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $259.65 	 $181.76 	 $61.80 	 $233.69 	 $225.90 	 $62.32 	 $198.63 	 $-   	 $-   	 $98.67 	 $163.58 	 $220.70 	 $171.37 	 $207.72 	 $62.32 	 $233.69 	 $211.10 	 $220.70 	 $61.80 	 $211.10 	 $62.32 
5270466	HCHG CVMC LOCKING SCREW 2.4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $830.80 	 $581.56 	 $197.73 	 $747.72 	 $722.80 	 $199.39 	 $635.56 	 $-   	 $-   	 $315.70 	 $523.40 	 $706.18 	 $548.33 	 $664.64 	 $199.39 	 $747.72 	 $675.44 	 $706.18 	 $197.73 	 $675.44 	 $199.39 
5270467	HCHG CVMC DISTAL RADIUS PLATE / 4 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,166.28 "	" $2,216.40 "	 $753.57 	" $3,166.28 "	" $2,754.66 "	 $759.91 	" $2,422.20 "	" $3,166.28 "	" $3,166.28 "	" $1,203.19 "	" $1,994.76 "	" $2,691.34 "	" $2,089.74 "	" $2,533.02 "	 $759.91 	" $2,849.65 "	" $2,574.19 "	" $2,691.34 "	 $753.57 	" $2,574.19 "	 $759.91 
5270468	HCHG CVMC SCREW PEGS/ ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $599.16 	 $419.41 	 $142.60 	 $539.24 	 $521.27 	 $143.80 	 $458.36 	 $-   	 $-   	 $227.68 	 $377.47 	 $509.29 	 $395.45 	 $479.33 	 $143.80 	 $539.24 	 $487.12 	 $509.29 	 $142.60 	 $487.12 	 $143.80 
5270469	HCHG CVMC PEG SMOOTH/ ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $599.16 	 $419.41 	 $142.60 	 $539.24 	 $521.27 	 $143.80 	 $458.36 	 $-   	 $-   	 $227.68 	 $377.47 	 $509.29 	 $395.45 	 $479.33 	 $143.80 	 $539.24 	 $487.12 	 $509.29 	 $142.60 	 $487.12 	 $143.80 
5270470	HCHG CVMC LCP OLECRANAN PLATE 8 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,085.11 "	" $2,859.58 "	 $972.26 	" $4,085.11 "	" $3,554.05 "	 $980.43 	" $3,125.11 "	" $4,085.11 "	" $4,085.11 "	" $1,552.34 "	" $2,573.62 "	" $3,472.34 "	" $2,696.17 "	" $3,268.09 "	 $980.43 	" $3,676.60 "	" $3,321.19 "	" $3,472.34 "	 $972.26 	" $3,321.19 "	 $980.43 
5270471	HCHG CVMC WRIGHT GRAFT JACKET 2.0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $11,285.92 "	" $7,900.14 "	" $2,686.05 "	" $11,285.92 "	" $9,818.75 "	" $2,708.62 "	" $8,633.73 "	" $11,285.92 "	" $11,285.92 "	" $4,288.65 "	" $7,110.13 "	" $9,593.03 "	" $7,448.71 "	" $9,028.74 "	" $2,708.62 "	" $10,157.33 "	" $9,175.45 "	" $9,593.03 "	" $2,686.05 "	" $9,175.45 "	" $2,708.62 "
5270472	HCHG CVMC SYNTHES CANNULATED SCREW 4.0 ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,158.68 "	 $811.08 	 $275.77 	" $1,042.81 "	" $1,008.05 "	 $278.08 	 $886.39 	 $-   	 $-   	 $440.30 	 $729.97 	 $984.88 	 $764.73 	 $926.94 	 $278.08 	" $1,042.81 "	 $942.01 	 $984.88 	 $275.77 	 $942.01 	 $278.08 
5270473	HCHG CVMC 1/3 TUBULAR PLATE 6 HOLES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $961.32 	 $672.92 	 $228.79 	 $865.19 	 $836.35 	 $230.72 	 $735.41 	 $-   	 $-   	 $365.30 	 $605.63 	 $817.12 	 $634.47 	 $769.06 	 $230.72 	 $865.19 	 $781.55 	 $817.12 	 $228.79 	 $781.55 	 $230.72 
5270474	HCHG CVMC LCP PROXIMAL HUMERUS PLATE. 5 HOLES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,247.05 "	" $3,672.94 "	" $1,248.80 "	" $5,247.05 "	" $4,564.93 "	" $1,259.29 "	" $4,013.99 "	" $5,247.05 "	" $5,247.05 "	" $1,993.88 "	" $3,305.64 "	" $4,459.99 "	" $3,463.05 "	" $4,197.64 "	" $1,259.29 "	" $4,722.35 "	" $4,265.85 "	" $4,459.99 "	" $1,248.80 "	" $4,265.85 "	" $1,259.29 "
5270475	HCHG CVMC SYNTHES CONICAL SCREW ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $699.39 	 $489.57 	 $166.45 	 $629.45 	 $608.47 	 $167.85 	 $535.03 	 $-   	 $-   	 $265.77 	 $440.62 	 $594.48 	 $461.60 	 $559.51 	 $167.85 	 $629.45 	 $568.60 	 $594.48 	 $166.45 	 $568.60 	 $167.85 
5270476	HCHG CVMC SYNTHES LOCKING SCREW 3.5-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $870.77 	 $609.54 	 $207.24 	 $783.69 	 $757.57 	 $208.98 	 $666.14 	 $-   	 $-   	 $330.89 	 $548.59 	 $740.15 	 $574.71 	 $696.62 	 $208.98 	 $783.69 	 $707.94 	 $740.15 	 $207.24 	 $707.94 	 $208.98 
5270477	HCHG CVMC CANCELLOUS BONE CHIPS-30CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $2,136.54 "	" $1,495.58 "	 $508.50 	" $2,136.54 "	" $1,858.79 "	 $512.77 	" $1,634.45 "	" $2,136.54 "	" $2,136.54 "	 $811.89 	" $1,346.02 "	" $1,816.06 "	" $1,410.12 "	" $1,709.23 "	 $512.77 	" $1,922.89 "	" $1,737.01 "	" $1,816.06 "	 $508.50 	" $1,737.01 "	 $512.77 
5270478	HCHG CVMC CALAXO SCREW 11MMX35MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,846.23 "	" $1,292.36 "	 $439.40 	" $1,846.23 "	" $1,606.22 "	 $443.10 	" $1,412.37 "	" $1,846.23 "	" $1,846.23 "	 $701.57 	" $1,163.12 "	" $1,569.30 "	" $1,218.51 "	" $1,476.98 "	 $443.10 	" $1,661.61 "	" $1,500.98 "	" $1,569.30 "	 $439.40 	" $1,500.98 "	 $443.10 
5270479	HCHG CVMC SYNTHES CORTEX SCREW 3.5-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $189.58 	 $132.71 	 $45.12 	 $170.62 	 $164.93 	 $45.50 	 $145.03 	 $-   	 $-   	 $72.04 	 $119.44 	 $161.14 	 $125.12 	 $151.66 	 $45.50 	 $170.62 	 $154.13 	 $161.14 	 $45.12 	 $154.13 	 $45.50 
5270480	"HCHG CVMC KLS-SCREW, TITANIUM ALLOY"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $384.92 	 $269.44 	 $91.61 	 $346.43 	 $334.88 	 $92.38 	 $294.46 	 $-   	 $-   	 $146.27 	 $242.50 	 $327.18 	 $254.05 	 $307.94 	 $92.38 	 $346.43 	 $312.94 	 $327.18 	 $91.61 	 $312.94 	 $92.38 
5270482	HCHG CVMC CANCELLOUS SCREW 4.0/THREAD SYN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $138.53 	 $96.97 	 $32.97 	 $124.68 	 $120.52 	 $33.25 	 $105.98 	 $-   	 $-   	 $52.64 	 $87.27 	 $117.75 	 $91.43 	 $110.82 	 $33.25 	 $124.68 	 $112.62 	 $117.75 	 $32.97 	 $112.62 	 $33.25 
5270483	HCHG CVMC SYNTHES CANNULATED SCREW 6.5-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,496.38 "	" $1,047.47 "	 $356.14 	" $1,346.74 "	" $1,301.85 "	 $359.13 	" $1,144.73 "	 $-   	 $-   	 $568.62 	 $942.72 	" $1,271.92 "	 $987.61 	" $1,197.10 "	 $359.13 	" $1,346.74 "	" $1,216.56 "	" $1,271.92 "	 $356.14 	" $1,216.56 "	 $359.13 
5270484	HCHG CVMC GROSHONG IMPLANTABLE CATHETER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,772.07 "	" $1,240.45 "	 $421.75 	" $1,772.07 "	" $1,541.70 "	 $425.30 	" $1,355.63 "	" $1,772.07 "	" $1,772.07 "	 $673.39 	" $1,116.40 "	" $1,506.26 "	" $1,169.57 "	" $1,417.66 "	 $425.30 	" $1,594.86 "	" $1,440.69 "	" $1,506.26 "	 $421.75 	" $1,440.69 "	 $425.30 
5270486	HCHG CVMC 1/3 TUBULAR PLATE-7 HOLES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $986.78 	 $690.75 	 $234.85 	 $888.10 	 $858.50 	 $236.83 	 $754.89 	 $-   	 $-   	 $374.98 	 $621.67 	 $838.76 	 $651.27 	 $789.42 	 $236.83 	 $888.10 	 $802.25 	 $838.76 	 $234.85 	 $802.25 	 $236.83 
5270487	HCHG CVMC TWIN FIX SUTURE ANCHOR 5.0	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,527.66 "	" $1,069.36 "	 $363.58 	" $1,527.66 "	" $1,329.06 "	 $366.64 	" $1,168.66 "	" $1,527.66 "	 $-   	 $580.51 	 $962.43 	" $1,298.51 "	" $1,008.26 "	" $1,222.13 "	 $366.64 	" $1,374.89 "	" $1,241.99 "	" $1,298.51 "	 $363.58 	" $1,241.99 "	 $366.64 
5270488	HCHG CVMC TWIN FX SUTURE ANCHOR W/DIA 5.	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,821.79 "	" $1,275.25 "	 $433.59 	" $1,821.79 "	" $1,584.96 "	 $437.23 	" $1,393.67 "	" $1,821.79 "	" $1,821.79 "	 $692.28 	" $1,147.73 "	" $1,548.52 "	" $1,202.38 "	" $1,457.43 "	 $437.23 	" $1,639.61 "	" $1,481.12 "	" $1,548.52 "	 $433.59 	" $1,481.12 "	 $437.23 
5270489	HCHG CVMC MEMODYN STAPLE 12MM X 10 MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,388.75 "	 $972.13 	 $330.52 	" $1,249.88 "	" $1,208.21 "	 $333.30 	" $1,062.39 "	 $-   	 $-   	 $527.73 	 $874.91 	" $1,180.44 "	 $916.58 	" $1,111.00 "	 $333.30 	" $1,249.88 "	" $1,129.05 "	" $1,180.44 "	 $330.52 	" $1,129.05 "	 $333.30 
5270490	HCHG CVMC REUNITE ORTHO SCREW 2.5X2.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,184.13 "	 $828.89 	 $281.82 	" $1,065.72 "	" $1,030.19 "	 $284.19 	 $905.86 	 $-   	 $-   	 $449.97 	 $746.00 	" $1,006.51 "	 $781.53 	 $947.30 	 $284.19 	" $1,065.72 "	 $962.70 	" $1,006.51 "	 $281.82 	 $962.70 	 $284.19 
5270491	HCHG CVMC MICROPLATE L RT LONG 25-331-85	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $954.95 	 $668.47 	 $227.28 	 $859.46 	 $830.81 	 $229.19 	 $730.54 	 $-   	 $-   	 $362.88 	 $601.62 	 $811.71 	 $630.27 	 $763.96 	 $229.19 	 $859.46 	 $776.37 	 $811.71 	 $227.28 	 $776.37 	 $229.19 
5270492	HCHG CVMC MICROPLATE L LT LONG 25-330-85	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $954.95 	 $668.47 	 $227.28 	 $859.46 	 $830.81 	 $229.19 	 $730.54 	 $-   	 $-   	 $362.88 	 $601.62 	 $811.71 	 $630.27 	 $763.96 	 $229.19 	 $859.46 	 $776.37 	 $811.71 	 $227.28 	 $776.37 	 $229.19 
5270493	HCHG CVMC ORTHO SCREW #25-678-04	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $367.47 	 $257.23 	 $87.46 	 $330.72 	 $319.70 	 $88.19 	 $281.11 	 $-   	 $-   	 $139.64 	 $231.51 	 $312.35 	 $242.53 	 $293.98 	 $88.19 	 $330.72 	 $298.75 	 $312.35 	 $87.46 	 $298.75 	 $88.19 
5270494	HCHG CVMC PRO OSTEON BONE GFT SUBSTITUTE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $2,735.54 "	" $1,914.88 "	 $651.06 	" $2,735.54 "	" $2,379.92 "	 $656.53 	" $2,092.69 "	" $2,735.54 "	" $2,735.54 "	" $1,039.51 "	" $1,723.39 "	" $2,325.21 "	" $1,805.46 "	" $2,188.43 "	 $656.53 	" $2,461.99 "	" $2,223.99 "	" $2,325.21 "	 $651.06 	" $2,223.99 "	 $656.53 
5270495	HCHG CVMC MICROPLATE L RT LONG 25-315-85	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $891.29 	 $623.90 	 $212.13 	 $802.16 	 $775.42 	 $213.91 	 $681.84 	 $-   	 $-   	 $338.69 	 $561.51 	 $757.60 	 $588.25 	 $713.03 	 $213.91 	 $802.16 	 $724.62 	 $757.60 	 $212.13 	 $724.62 	 $213.91 
5270496	HCHG CVMC BIORAPTOR 2 SUTURE ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,645.01 "	" $1,151.51 "	 $391.51 	" $1,645.01 "	" $1,431.16 "	 $394.80 	" $1,258.43 "	" $1,645.01 "	" $1,645.01 "	 $625.10 	" $1,036.36 "	" $1,398.26 "	" $1,085.71 "	" $1,316.01 "	 $394.80 	" $1,480.51 "	" $1,337.39 "	" $1,398.26 "	 $391.51 	" $1,337.39 "	 $394.80 
5270497	HCHG CVMC BIORAPTOR 1 SUTURE ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,458.39 "	" $1,020.87 "	 $347.10 	" $1,312.55 "	" $1,268.80 "	 $350.01 	" $1,115.67 "	 $-   	 $-   	 $554.19 	 $918.79 	" $1,239.63 "	 $962.54 	" $1,166.71 "	 $350.01 	" $1,312.55 "	" $1,185.67 "	" $1,239.63 "	 $347.10 	" $1,185.67 "	 $350.01 
5270498	HCHG CVMC DISTAL RADIUS PLATE 5/3 HOLES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,166.36 "	" $2,216.45 "	 $753.59 	" $3,166.36 "	" $2,754.73 "	 $759.93 	" $2,422.27 "	" $3,166.36 "	" $3,166.36 "	" $1,203.22 "	" $1,994.81 "	" $2,691.41 "	" $2,089.80 "	" $2,533.09 "	 $759.93 	" $2,849.72 "	" $2,574.25 "	" $2,691.41 "	 $753.59 	" $2,574.25 "	 $759.93 
5270499	HCHG CVMC CANNULATED SCREW 4.5MM-ALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,177.77 "	 $824.44 	 $280.31 	" $1,059.99 "	" $1,024.66 "	 $282.66 	 $900.99 	 $-   	 $-   	 $447.55 	 $742.00 	" $1,001.10 "	 $777.33 	 $942.22 	 $282.66 	" $1,059.99 "	 $957.53 	" $1,001.10 "	 $280.31 	 $957.53 	 $282.66 
5270500	HCHG CVMC CANCELLOUS BONE CHIPS 15CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $1,388.75 "	 $972.13 	 $330.52 	" $1,249.88 "	" $1,208.21 "	 $333.30 	" $1,062.39 "	 $-   	 $-   	 $527.73 	 $874.91 	" $1,180.44 "	 $916.58 	" $1,111.00 "	 $333.30 	" $1,249.88 "	" $1,129.05 "	" $1,180.44 "	 $330.52 	" $1,129.05 "	 $333.30 
5270501	HCHG CVMC CYMETRA ASSEMBLY 2CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $1,346.02 "	 $942.21 	 $320.35 	" $1,211.42 "	" $1,171.04 "	 $323.04 	" $1,029.71 "	 $-   	 $-   	 $511.49 	 $847.99 	" $1,144.12 "	 $888.37 	" $1,076.82 "	 $323.04 	" $1,211.42 "	" $1,094.31 "	" $1,144.12 "	 $320.35 	" $1,094.31 "	 $323.04 
5270502	HCHG CVMC BIO AMNIOGRAFT SIZE B W/TISEEL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $3,806.01 "	" $2,664.21 "	 $905.83 	" $3,806.01 "	" $3,311.23 "	 $913.44 	" $2,911.60 "	" $3,806.01 "	" $3,806.01 "	" $1,446.28 "	" $2,397.79 "	" $3,235.11 "	" $2,511.97 "	" $3,044.81 "	 $913.44 	" $3,425.41 "	" $3,094.29 "	" $3,235.11 "	 $905.83 	" $3,094.29 "	 $913.44 
5270503	HCHG CVMC SMALL FRAG LOCKING PLATE HF-Y	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,243.37 "	" $1,570.36 "	 $533.92 	" $2,243.37 "	" $1,951.73 "	 $538.41 	" $1,716.18 "	" $2,243.37 "	" $2,243.37 "	 $852.48 	" $1,413.32 "	" $1,906.86 "	" $1,480.62 "	" $1,794.70 "	 $538.41 	" $2,019.03 "	" $1,823.86 "	" $1,906.86 "	 $533.92 	" $1,823.86 "	 $538.41 
5270504	HCHG CVMC SMOOTH/THREADED PEG ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $699.39 	 $489.57 	 $166.45 	 $629.45 	 $608.47 	 $167.85 	 $535.03 	 $-   	 $-   	 $265.77 	 $440.62 	 $594.48 	 $461.60 	 $559.51 	 $167.85 	 $629.45 	 $568.60 	 $594.48 	 $166.45 	 $568.60 	 $167.85 
5270505	HCHG CVMC FAST FIX CURVED ABSORB ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,879.72 "	" $1,315.80 "	 $447.37 	" $1,879.72 "	" $1,635.36 "	 $451.13 	" $1,437.99 "	" $1,879.72 "	" $1,879.72 "	 $714.29 	" $1,184.22 "	" $1,597.76 "	" $1,240.62 "	" $1,503.78 "	 $451.13 	" $1,691.75 "	" $1,528.21 "	" $1,597.76 "	 $447.37 	" $1,528.21 "	 $451.13 
5270506	HCHG CVMC S&N 25MM ENDOBUTTON	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,492.96 "	" $1,045.07 "	 $355.32 	" $1,343.66 "	" $1,298.88 "	 $358.31 	" $1,142.11 "	 $-   	 $-   	 $567.32 	 $940.56 	" $1,269.02 "	 $985.35 	" $1,194.37 "	 $358.31 	" $1,343.66 "	" $1,213.78 "	" $1,269.02 "	 $355.32 	" $1,213.78 "	 $358.31 
5270507	HCHG CVMC ARTHREX PEEK TENO SCREW 5.5X8.0	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,878.06 "	" $1,314.64 "	 $446.98 	" $1,878.06 "	" $1,633.91 "	 $450.73 	" $1,436.72 "	" $1,878.06 "	" $1,878.06 "	 $713.66 	" $1,183.18 "	" $1,596.35 "	" $1,239.52 "	" $1,502.45 "	 $450.73 	" $1,690.25 "	" $1,526.86 "	" $1,596.35 "	 $446.98 	" $1,526.86 "	 $450.73 
5270508	HCHG CVMC GRAFTON DBM PUTTY/ 5CC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1763	" $3,204.81 "	" $2,243.37 "	 $762.74 	" $3,204.81 "	" $2,788.18 "	 $769.15 	" $2,451.68 "	" $3,204.81 "	" $3,204.81 "	" $1,217.83 "	" $2,019.03 "	" $2,724.09 "	" $2,115.17 "	" $2,563.85 "	 $769.15 	" $2,884.33 "	" $2,605.51 "	" $2,724.09 "	 $762.74 	" $2,605.51 "	 $769.15 
5270510	HCHG CVMC S&N 30MM ENDOBUTTON W/LOOP SUT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,492.96 "	" $1,045.07 "	 $355.32 	" $1,343.66 "	" $1,298.88 "	 $358.31 	" $1,142.11 "	 $-   	 $-   	 $567.32 	 $940.56 	" $1,269.02 "	 $985.35 	" $1,194.37 "	 $358.31 	" $1,343.66 "	" $1,213.78 "	" $1,269.02 "	 $355.32 	" $1,213.78 "	 $358.31 
5270511	HCHG CVMC BIOABSORBABLE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,360.11 "	 $952.08 	 $323.71 	" $1,224.10 "	" $1,183.30 "	 $326.43 	" $1,040.48 "	 $-   	 $-   	 $516.84 	 $856.87 	" $1,156.09 "	 $897.67 	" $1,088.09 "	 $326.43 	" $1,224.10 "	" $1,105.77 "	" $1,156.09 "	 $323.71 	" $1,105.77 "	 $326.43 
5270512	HCHG CVMC TUNNELOC INTERF SCREW 7MMX20MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,101.40 "	 $770.98 	 $262.13 	 $991.26 	 $958.22 	 $264.34 	 $842.57 	 $-   	 $-   	 $418.53 	 $693.88 	 $936.19 	 $726.92 	 $881.12 	 $264.34 	 $991.26 	 $895.44 	 $936.19 	 $262.13 	 $895.44 	 $264.34 
5270513	HCHG CVMC ARTHREX CHONDRAL DART 18MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,005.89 "	 $704.12 	 $239.40 	 $905.30 	 $875.12 	 $241.41 	 $769.51 	 $-   	 $-   	 $382.24 	 $633.71 	 $855.01 	 $663.89 	 $804.71 	 $241.41 	 $905.30 	 $817.79 	 $855.01 	 $239.40 	 $817.79 	 $241.41 
5270514	HCHG CVMC ORTHOSORBABLE PIN #84-1070	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,047.85 "	 $733.50 	 $249.39 	 $943.07 	 $911.63 	 $251.48 	 $801.61 	 $-   	 $-   	 $398.18 	 $660.15 	 $890.67 	 $691.58 	 $838.28 	 $251.48 	 $943.07 	 $851.90 	 $890.67 	 $249.39 	 $851.90 	 $251.48 
5270515	HCHG CVMC FASTIN ROTATOR CUFF ANCHOR 6.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,846.25 "	" $1,292.38 "	 $439.41 	" $1,846.25 "	" $1,606.24 "	 $443.10 	" $1,412.38 "	" $1,846.25 "	" $1,846.25 "	 $701.58 	" $1,163.14 "	" $1,569.31 "	" $1,218.53 "	" $1,477.00 "	 $443.10 	" $1,661.63 "	" $1,501.00 "	" $1,569.31 "	 $439.41 	" $1,501.00 "	 $443.10 
5270516	HCHG CVMC VERSALOK ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,504.13 "	" $1,052.89 "	 $357.98 	" $1,504.13 "	" $1,308.59 "	 $360.99 	" $1,150.66 "	" $1,504.13 "	 $-   	 $571.57 	 $947.60 	" $1,278.51 "	 $992.73 	" $1,203.30 "	 $360.99 	" $1,353.72 "	" $1,222.86 "	" $1,278.51 "	 $357.98 	" $1,222.86 "	 $360.99 
5270517	HCHG CVMC PARIETEX MESH PC09	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,615.22 "	" $1,130.65 "	 $384.42 	" $1,615.22 "	" $1,405.24 "	 $387.65 	" $1,235.64 "	" $1,615.22 "	" $1,615.22 "	 $613.78 	" $1,017.59 "	" $1,372.94 "	" $1,066.05 "	" $1,292.18 "	 $387.65 	" $1,453.70 "	" $1,313.17 "	" $1,372.94 "	 $384.42 	" $1,313.17 "	 $387.65 
5270518	HCHG CVMC PARIETEX MESH-PC0151005	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,815.12 "	" $1,970.58 "	 $670.00 	" $2,815.12 "	" $2,449.15 "	 $675.63 	" $2,153.57 "	" $2,815.12 "	" $2,815.12 "	" $1,069.75 "	" $1,773.53 "	" $2,392.85 "	" $1,857.98 "	" $2,252.10 "	 $675.63 	" $2,533.61 "	" $2,288.69 "	" $2,392.85 "	 $670.00 	" $2,288.69 "	 $675.63 
5270519	HCHG CVMC TITANIUM END CAP FOR ENDERNAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $567.20 	 $397.04 	 $134.99 	 $510.48 	 $493.46 	 $136.13 	 $433.91 	 $-   	 $-   	 $215.54 	 $357.34 	 $482.12 	 $374.35 	 $453.76 	 $136.13 	 $510.48 	 $461.13 	 $482.12 	 $134.99 	 $461.13 	 $136.13 
5270520	HCHG CVMC TITANIUM ELASTIC ENDERNAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,363.14 "	 $954.20 	 $324.43 	" $1,226.83 "	" $1,185.93 "	 $327.15 	" $1,042.80 "	 $-   	 $-   	 $517.99 	 $858.78 	" $1,158.67 "	 $899.67 	" $1,090.51 "	 $327.15 	" $1,226.83 "	" $1,108.23 "	" $1,158.67 "	 $324.43 	" $1,108.23 "	 $327.15 
5270521	HCHG CVMC PARIETEX MESH TECT 1510A	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,046.01 "	 $732.21 	 $248.95 	 $941.41 	 $910.03 	 $251.04 	 $800.20 	 $-   	 $-   	 $397.48 	 $658.99 	 $889.11 	 $690.37 	 $836.81 	 $251.04 	 $941.41 	 $850.41 	 $889.11 	 $248.95 	 $850.41 	 $251.04 
5270522	"HCHG CVMC HEADLESS COMPRESSION SCREWS, 3.0MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,309.13 "	 $916.39 	 $311.57 	" $1,178.22 "	" $1,138.94 "	 $314.19 	" $1,001.48 "	 $-   	 $-   	 $497.47 	 $824.75 	" $1,112.76 "	 $864.03 	" $1,047.30 "	 $314.19 	" $1,178.22 "	" $1,064.32 "	" $1,112.76 "	 $311.57 	" $1,064.32 "	 $314.19 
5270523	HCHG CVMC REPLIFORM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $3,412.93 "	" $2,389.05 "	 $812.28 	" $3,412.93 "	" $2,969.25 "	 $819.10 	" $2,610.89 "	" $3,412.93 "	" $3,412.93 "	" $1,296.91 "	" $2,150.15 "	" $2,900.99 "	" $2,252.53 "	" $2,730.34 "	 $819.10 	" $3,071.64 "	" $2,774.71 "	" $2,900.99 "	 $812.28 	" $2,774.71 "	 $819.10 
5270524	HCHG CVMC MESH 6.3 X 4 XL WITH SLIT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,146.78 "	 $802.75 	 $272.93 	" $1,032.10 "	 $997.70 	 $275.23 	 $877.29 	 $-   	 $-   	 $435.78 	 $722.47 	 $974.76 	 $756.87 	 $917.42 	 $275.23 	" $1,032.10 "	 $932.33 	 $974.76 	 $272.93 	 $932.33 	 $275.23 
5270525	HCHG CVMC BIOMET SCREW 4.5 X 3.5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $853.11 	 $597.18 	 $203.04 	 $767.80 	 $742.21 	 $204.75 	 $652.63 	 $-   	 $-   	 $324.18 	 $537.46 	 $725.14 	 $563.05 	 $682.49 	 $204.75 	 $767.80 	 $693.58 	 $725.14 	 $203.04 	 $693.58 	 $204.75 
5270526	HCHG CVMC ACUMED 3.5MM X 14.0MM SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $559.21 	 $391.45 	 $133.09 	 $503.29 	 $486.51 	 $134.21 	 $427.80 	 $-   	 $-   	 $212.50 	 $352.30 	 $475.33 	 $369.08 	 $447.37 	 $134.21 	 $503.29 	 $454.64 	 $475.33 	 $133.09 	 $454.64 	 $134.21 
5270527	HCHG CVMC ACUMED 3.5MM X 20.0 MM SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $479.32 	 $335.52 	 $114.08 	 $431.39 	 $417.01 	 $115.04 	 $366.68 	 $-   	 $-   	 $182.14 	 $301.97 	 $407.42 	 $316.35 	 $383.46 	 $115.04 	 $431.39 	 $389.69 	 $407.42 	 $114.08 	 $389.69 	 $115.04 
5270528	HCHG CVMC ACUMED 3.5MM X 16.0MM SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $479.32 	 $335.52 	 $114.08 	 $431.39 	 $417.01 	 $115.04 	 $366.68 	 $-   	 $-   	 $182.14 	 $301.97 	 $407.42 	 $316.35 	 $383.46 	 $115.04 	 $431.39 	 $389.69 	 $407.42 	 $114.08 	 $389.69 	 $115.04 
5270529	HCHG CVMC LOCKING CLAVICLE PLATE 8 HOLES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,969.81 "	" $2,078.87 "	 $706.81 	" $2,969.81 "	" $2,583.73 "	 $712.75 	" $2,271.90 "	" $2,969.81 "	" $2,969.81 "	" $1,128.53 "	" $1,870.98 "	" $2,524.34 "	" $1,960.07 "	" $2,375.85 "	 $712.75 	" $2,672.83 "	" $2,414.46 "	" $2,524.34 "	 $706.81 	" $2,414.46 "	 $712.75 
5270530	HCHG CVMC S&N SUTURE ANCHOR 5.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,782.60 "	" $1,247.82 "	 $424.26 	" $1,782.60 "	" $1,550.86 "	 $427.82 	" $1,363.69 "	" $1,782.60 "	" $1,782.60 "	 $677.39 	" $1,123.04 "	" $1,515.21 "	" $1,176.52 "	" $1,426.08 "	 $427.82 	" $1,604.34 "	" $1,449.25 "	" $1,515.21 "	 $424.26 	" $1,449.25 "	 $427.82 
5270531	HCHG CVMC BIOMET HAMMERTOE IMPLANT/2.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,642.55 "	" $1,149.79 "	 $390.93 	" $1,642.55 "	" $1,429.02 "	 $394.21 	" $1,256.55 "	" $1,642.55 "	" $1,642.55 "	 $624.17 	" $1,034.81 "	" $1,396.17 "	" $1,084.08 "	" $1,314.04 "	 $394.21 	" $1,478.30 "	" $1,335.39 "	" $1,396.17 "	 $390.93 	" $1,335.39 "	 $394.21 
5270532	HCHG CVMC BIOMET 2.8X17MM ORTHOSCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,438.81 "	" $1,007.17 "	 $342.44 	" $1,294.93 "	" $1,251.76 "	 $345.31 	" $1,100.69 "	 $-   	 $-   	 $546.75 	 $906.45 	" $1,222.99 "	 $949.61 	" $1,151.05 "	 $345.31 	" $1,294.93 "	" $1,169.75 "	" $1,222.99 "	 $342.44 	" $1,169.75 "	 $345.31 
5270533	HCHG CVMC OXFORD UNICOMP KNEE SM RT 3MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,851.08 "	" $2,695.76 "	 $916.56 	" $3,851.08 "	" $3,350.44 "	 $924.26 	" $2,946.08 "	" $3,851.08 "	" $3,851.08 "	" $1,463.41 "	" $2,426.18 "	" $3,273.42 "	" $2,541.71 "	" $3,080.86 "	 $924.26 	" $3,465.97 "	" $3,130.93 "	" $3,273.42 "	 $916.56 	" $3,130.93 "	 $924.26 
5270534	HCHG CVMC OXFORD UNICOMP KNEE SM FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $12,202.58 "	" $8,541.81 "	" $2,904.21 "	" $12,202.58 "	" $10,616.24 "	" $2,928.62 "	" $9,334.97 "	" $12,202.58 "	" $12,202.58 "	" $4,636.98 "	" $7,687.63 "	" $10,372.19 "	" $8,053.70 "	" $9,762.06 "	" $2,928.62 "	" $10,982.32 "	" $9,920.70 "	" $10,372.19 "	" $2,904.21 "	" $9,920.70 "	" $2,928.62 "
5270535	HCHG CVMC OXFORD UNICOMP KNEE MD FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $12,202.58 "	" $8,541.81 "	" $2,904.21 "	" $12,202.58 "	" $10,616.24 "	" $2,928.62 "	" $9,334.97 "	" $12,202.58 "	" $12,202.58 "	" $4,636.98 "	" $7,687.63 "	" $10,372.19 "	" $8,053.70 "	" $9,762.06 "	" $2,928.62 "	" $10,982.32 "	" $9,920.70 "	" $10,372.19 "	" $2,904.21 "	" $9,920.70 "	" $2,928.62 "
5270536	HCHG CVMC BIOMET COBALT HV BONE CEMENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $868.49 	 $607.94 	 $206.70 	 $781.64 	 $755.59 	 $208.44 	 $664.39 	 $-   	 $-   	 $330.03 	 $547.15 	 $738.22 	 $573.20 	 $694.79 	 $208.44 	 $781.64 	 $706.08 	 $738.22 	 $206.70 	 $706.08 	 $208.44 
5270537	HCHG CVMC OXFORD UNICOMP KNEE MED LT 4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,851.08 "	" $2,695.76 "	 $916.56 	" $3,851.08 "	" $3,350.44 "	 $924.26 	" $2,946.08 "	" $3,851.08 "	" $3,851.08 "	" $1,463.41 "	" $2,426.18 "	" $3,273.42 "	" $2,541.71 "	" $3,080.86 "	 $924.26 	" $3,465.97 "	" $3,130.93 "	" $3,273.42 "	 $916.56 	" $3,130.93 "	 $924.26 
5270538	HCHG CVMC ZIMMER CORTICAL SCREW 2.0X12	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $113.78 	 $79.65 	 $27.08 	 $102.40 	 $98.99 	 $27.31 	 $87.04 	 $-   	 $-   	 $43.24 	 $71.68 	 $96.71 	 $75.09 	 $91.02 	 $27.31 	 $102.40 	 $92.50 	 $96.71 	 $27.08 	 $92.50 	 $27.31 
5270539	HCHG CVMC LUMENS/MUTI-MED CV CATHETER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $886.26 	 $620.38 	 $210.93 	 $797.63 	 $771.05 	 $212.70 	 $677.99 	 $-   	 $-   	 $336.78 	 $558.34 	 $753.32 	 $584.93 	 $709.01 	 $212.70 	 $797.63 	 $720.53 	 $753.32 	 $210.93 	 $720.53 	 $212.70 
5270540	HCHG CVMC BRAUN EPIDURAL CATHETER SET:20	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $60.39 	 $42.27 	 $14.37 	 $54.35 	 $52.54 	 $14.49 	 $46.20 	 $-   	 $-   	 $22.95 	 $38.05 	 $51.33 	 $39.86 	 $48.31 	 $14.49 	 $54.35 	 $49.10 	 $51.33 	 $14.37 	 $49.10 	 $14.49 
5270541	HCHG CVMC DECELLULARIZED SOFT TISSUE SCAFFOLD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $9,844.95 "	" $6,891.47 "	" $2,343.10 "	" $9,844.95 "	" $8,565.11 "	" $2,362.79 "	" $7,531.39 "	" $9,844.95 "	" $9,844.95 "	" $3,741.08 "	" $6,202.32 "	" $8,368.21 "	" $6,497.67 "	" $7,875.96 "	" $2,362.79 "	" $8,860.46 "	" $8,003.94 "	" $8,368.21 "	" $2,343.10 "	" $8,003.94 "	" $2,362.79 "
5271197	HCHG CVMC MESH PLUG PARIETEX 6CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $829.52 	 $580.66 	 $197.43 	 $746.57 	 $721.68 	 $199.08 	 $634.58 	 $-   	 $-   	 $315.22 	 $522.60 	 $705.09 	 $547.48 	 $663.62 	 $199.08 	 $746.57 	 $674.40 	 $705.09 	 $197.43 	 $674.40 	 $199.08 
5271282	HCHG CVMC ENDOBUTTON CL ULTRA PAC 1.2	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,278.05 "	 $894.64 	 $304.18 	" $1,150.25 "	" $1,111.90 "	 $306.73 	 $977.71 	 $-   	 $-   	 $485.66 	 $805.17 	" $1,086.34 "	 $843.51 	" $1,022.44 "	 $306.73 	" $1,150.25 "	" $1,039.05 "	" $1,086.34 "	 $304.18 	" $1,039.05 "	 $306.73 
5271283	HCHG CVMC ENDOBUTTON CL ULTRA 35MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,219.78 "	 $853.85 	 $290.31 	" $1,097.80 "	" $1,061.21 "	 $292.75 	 $933.13 	 $-   	 $-   	 $463.52 	 $768.46 	" $1,036.81 "	 $805.05 	 $975.82 	 $292.75 	" $1,097.80 "	 $991.68 	" $1,036.81 "	 $290.31 	 $991.68 	 $292.75 
5271285	HCHG CVMC SUTURE ANCHOR TWINFIX 5.5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,846.27 "	" $1,292.39 "	 $439.41 	" $1,846.27 "	" $1,606.25 "	 $443.10 	" $1,412.40 "	" $1,846.27 "	" $1,846.27 "	 $701.58 	" $1,163.15 "	" $1,569.33 "	" $1,218.54 "	" $1,477.02 "	 $443.10 	" $1,661.64 "	" $1,501.02 "	" $1,569.33 "	 $439.41 	" $1,501.02 "	 $443.10 
5271290	HCHG CVMC LCP 1/3 TUBLR PLATE W/ COLLAR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,156.39 "	 $809.47 	 $275.22 	" $1,040.75 "	" $1,006.06 "	 $277.53 	 $884.64 	 $-   	 $-   	 $439.43 	 $728.53 	 $982.93 	 $763.22 	 $925.11 	 $277.53 	" $1,040.75 "	 $940.15 	 $982.93 	 $275.22 	 $940.15 	 $277.53 
5271293	HCHG CVMC PLATE TUBULAR 1/3 4 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,078.25 "	 $754.78 	 $256.62 	 $970.43 	 $938.08 	 $258.78 	 $824.86 	 $-   	 $-   	 $409.74 	 $679.30 	 $916.51 	 $711.65 	 $862.60 	 $258.78 	 $970.43 	 $876.62 	 $916.51 	 $256.62 	 $876.62 	 $258.78 
5271294	HCHG CVMC MENISCAL ARROW #10	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $885.52 	 $619.86 	 $210.75 	 $796.97 	 $770.40 	 $212.52 	 $677.42 	 $-   	 $-   	 $336.50 	 $557.88 	 $752.69 	 $584.44 	 $708.42 	 $212.52 	 $796.97 	 $719.93 	 $752.69 	 $210.75 	 $719.93 	 $212.52 
5271300	HCHG CVMC ROD CARBON FIBER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,526.22 "	" $1,068.35 "	 $363.24 	" $1,526.22 "	" $1,327.81 "	 $366.29 	" $1,167.56 "	" $1,526.22 "	 $-   	 $579.96 	 $961.52 	" $1,297.29 "	" $1,007.31 "	" $1,220.98 "	 $366.29 	" $1,373.60 "	" $1,240.82 "	" $1,297.29 "	 $363.24 	" $1,240.82 "	 $366.29 
5271301	HCHG CVMC ROD CARBON FIBER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,635.61 "	" $1,144.93 "	 $389.28 	" $1,635.61 "	" $1,422.98 "	 $392.55 	" $1,251.24 "	" $1,635.61 "	" $1,635.61 "	 $621.53 	" $1,030.43 "	" $1,390.27 "	" $1,079.50 "	" $1,308.49 "	 $392.55 	" $1,472.05 "	" $1,329.75 "	" $1,390.27 "	 $389.28 	" $1,329.75 "	 $392.55 
5271302	HCHG CVMC OSTEORAPTOR 2.9 SUTURE ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,235.32 "	 $864.72 	 $294.01 	" $1,111.79 "	" $1,074.73 "	 $296.48 	 $945.02 	 $-   	 $-   	 $469.42 	 $778.25 	" $1,050.02 "	 $815.31 	 $988.26 	 $296.48 	" $1,111.79 "	" $1,004.32 "	" $1,050.02 "	 $294.01 	" $1,004.32 "	 $296.48 
5271303	HCHG CVMC TI BONE SCREW LP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $856.58 	 $599.61 	 $203.87 	 $770.92 	 $745.22 	 $205.58 	 $655.28 	 $-   	 $-   	 $325.50 	 $539.65 	 $728.09 	 $565.34 	 $685.26 	 $205.58 	 $770.92 	 $696.40 	 $728.09 	 $203.87 	 $696.40 	 $205.58 
5271304	HCHG CVMC BONE SCREW TI GLENOID SCREW LP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $856.58 	 $599.61 	 $203.87 	 $770.92 	 $745.22 	 $205.58 	 $655.28 	 $-   	 $-   	 $325.50 	 $539.65 	 $728.09 	 $565.34 	 $685.26 	 $205.58 	 $770.92 	 $696.40 	 $728.09 	 $203.87 	 $696.40 	 $205.58 
5271305	HCHG CVMC BONE SCREW COMP RVS SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $954.98 	 $668.49 	 $227.29 	 $859.48 	 $830.83 	 $229.20 	 $730.56 	 $-   	 $-   	 $362.89 	 $601.64 	 $811.73 	 $630.29 	 $763.98 	 $229.20 	 $859.48 	 $776.40 	 $811.73 	 $227.29 	 $776.40 	 $229.20 
5271306	HCHG CVMC TIBIAL LOCKING BAR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $763.98 	 $534.79 	 $181.83 	 $687.58 	 $664.66 	 $183.36 	 $584.44 	 $-   	 $-   	 $290.31 	 $481.31 	 $649.38 	 $504.23 	 $611.18 	 $183.36 	 $687.58 	 $621.12 	 $649.38 	 $181.83 	 $621.12 	 $183.36 
5271307	HCHG CVMC BONE SCREW FIXED LOCKING SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $960.76 	 $672.53 	 $228.66 	 $864.68 	 $835.86 	 $230.58 	 $734.98 	 $-   	 $-   	 $365.09 	 $605.28 	 $816.65 	 $634.10 	 $768.61 	 $230.58 	 $864.68 	 $781.10 	 $816.65 	 $228.66 	 $781.10 	 $230.58 
5271308	HCHG CVMC VANGRD SSK FEMORAL STEM SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $551.95 	 $386.37 	 $131.36 	 $496.76 	 $480.20 	 $132.47 	 $422.24 	 $-   	 $-   	 $209.74 	 $347.73 	 $469.16 	 $364.29 	 $441.56 	 $132.47 	 $496.76 	 $448.74 	 $469.16 	 $131.36 	 $448.74 	 $132.47 
5271309	"HCHG CVMC COMP RVS SHLDR STEINMAN PIN 9"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $516.07 	 $361.25 	 $122.82 	 $464.46 	 $448.98 	 $123.86 	 $394.79 	 $-   	 $-   	 $196.11 	 $325.12 	 $438.66 	 $340.61 	 $412.86 	 $123.86 	 $464.46 	 $419.56 	 $438.66 	 $122.82 	 $419.56 	 $123.86 
5271310	HCHG CVMC SUTURE PATELLAR BUTTON	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,729.27 "	" $2,610.49 "	 $887.57 	" $3,729.27 "	" $3,244.46 "	 $895.02 	" $2,852.89 "	" $3,729.27 "	" $3,729.27 "	" $1,417.12 "	" $2,349.44 "	" $3,169.88 "	" $2,461.32 "	" $2,983.42 "	 $895.02 	" $3,356.34 "	" $3,031.90 "	" $3,169.88 "	 $887.57 	" $3,031.90 "	 $895.02 
5271311	HCHG CVMC EXPLOR IMPLANT LOCKING SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $763.98 	 $534.79 	 $181.83 	 $687.58 	 $664.66 	 $183.36 	 $584.44 	 $-   	 $-   	 $290.31 	 $481.31 	 $649.38 	 $504.23 	 $611.18 	 $183.36 	 $687.58 	 $621.12 	 $649.38 	 $181.83 	 $621.12 	 $183.36 
5271312	HCHG CVMC BONE NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $694.53 	 $486.17 	 $165.30 	 $625.08 	 $604.24 	 $166.69 	 $531.32 	 $-   	 $-   	 $263.92 	 $437.55 	 $590.35 	 $458.39 	 $555.62 	 $166.69 	 $625.08 	 $564.65 	 $590.35 	 $165.30 	 $564.65 	 $166.69 
5271313	HCHG CVMC VANGRD XL BONE NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $697.20 	 $488.04 	 $165.93 	 $627.48 	 $606.56 	 $167.33 	 $533.36 	 $-   	 $-   	 $264.94 	 $439.24 	 $592.62 	 $460.15 	 $557.76 	 $167.33 	 $627.48 	 $566.82 	 $592.62 	 $165.93 	 $566.82 	 $167.33 
5271314	HCHG CVMC ARTHROSURFACE-FIXATION STUD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,925.15 "	" $2,047.61 "	 $696.19 	" $2,925.15 "	" $2,544.88 "	 $702.04 	" $2,237.74 "	" $2,925.15 "	" $2,925.15 "	" $1,111.56 "	" $1,842.84 "	" $2,486.38 "	" $1,930.60 "	" $2,340.12 "	 $702.04 	" $2,632.64 "	" $2,378.15 "	" $2,486.38 "	 $696.19 	" $2,378.15 "	 $702.04 
5271315	HCHG CVMC 4.5MM LCP CURV CNDLR PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,631.31 "	" $3,241.92 "	" $1,102.25 "	" $4,631.31 "	" $4,029.24 "	" $1,111.51 "	" $3,542.95 "	" $4,631.31 "	" $4,631.31 "	" $1,759.90 "	" $2,917.73 "	" $3,936.61 "	" $3,056.66 "	" $3,705.05 "	" $1,111.51 "	" $4,168.18 "	" $3,765.26 "	" $3,936.61 "	" $1,102.25 "	" $3,765.26 "	" $1,111.51 "
5271316	HCHG CVMC 4.5MM LCP CURV CNDLR PLATE 12	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,750.65 "	" $4,025.46 "	" $1,368.65 "	" $5,750.65 "	" $5,003.07 "	" $1,380.16 "	" $4,399.25 "	" $5,750.65 "	" $5,750.65 "	" $2,185.25 "	" $3,622.91 "	" $4,888.05 "	" $3,795.43 "	" $4,600.52 "	" $1,380.16 "	" $5,175.59 "	" $4,675.28 "	" $4,888.05 "	" $1,368.65 "	" $4,675.28 "	" $1,380.16 "
5271317	HCHG CVMC 4.5MM LCP CURV CNDLR PLATE 14	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,869.97 "	" $4,108.98 "	" $1,397.05 "	" $5,869.97 "	" $5,106.87 "	" $1,408.79 "	" $4,490.53 "	" $5,869.97 "	" $5,869.97 "	" $2,230.59 "	" $3,698.08 "	" $4,989.47 "	" $3,874.18 "	" $4,695.98 "	" $1,408.79 "	" $5,282.97 "	" $4,772.29 "	" $4,989.47 "	" $1,397.05 "	" $4,772.29 "	" $1,408.79 "
5271318	HCHG CVMC 4.5MM LCP CURV CNDLR PLATE 18	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,108.64 "	" $4,276.05 "	" $1,453.86 "	" $6,108.64 "	" $5,314.52 "	" $1,466.07 "	" $4,673.11 "	" $6,108.64 "	" $6,108.64 "	" $2,321.28 "	" $3,848.44 "	" $5,192.34 "	" $4,031.70 "	" $4,886.91 "	" $1,466.07 "	" $5,497.78 "	" $4,966.32 "	" $5,192.34 "	" $1,453.86 "	" $4,966.32 "	" $1,466.07 "
5271319	HCHG CVMC 4.5MM LCP CURV CNDLR PLATE 22	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,384.24 "	" $4,468.97 "	" $1,519.45 "	" $6,384.24 "	" $5,554.29 "	" $1,532.22 "	" $4,883.94 "	" $6,384.24 "	" $6,384.24 "	" $2,426.01 "	" $4,022.07 "	" $5,426.60 "	" $4,213.60 "	" $5,107.39 "	" $1,532.22 "	" $5,745.82 "	" $5,190.39 "	" $5,426.60 "	" $1,519.45 "	" $5,190.39 "	" $1,532.22 "
5271320	HCHG CVMC 4.5MM LCP CURV CNDLR PLATE 16	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,983.63 "	" $4,188.54 "	" $1,424.10 "	" $5,983.63 "	" $5,205.76 "	" $1,436.07 "	" $4,577.48 "	" $5,983.63 "	" $5,983.63 "	" $2,273.78 "	" $3,769.69 "	" $5,086.09 "	" $3,949.20 "	" $4,786.90 "	" $1,436.07 "	" $5,385.27 "	" $4,864.69 "	" $5,086.09 "	" $1,424.10 "	" $4,864.69 "	" $1,436.07 "
5271321	HCHG CVMC PLATE UNI LOCK TROCH 131MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,182.06 "	" $1,527.44 "	 $519.33 	" $2,182.06 "	" $1,898.39 "	 $523.69 	" $1,669.28 "	" $2,182.06 "	" $2,182.06 "	 $829.18 	" $1,374.70 "	" $1,854.75 "	" $1,440.16 "	" $1,745.65 "	 $523.69 	" $1,963.85 "	" $1,774.01 "	" $1,854.75 "	 $519.33 	" $1,774.01 "	 $523.69 
5271322	HCHG CVMC PLATE DIA-META 4HX5H RT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,216.49 "	" $3,651.54 "	" $1,241.52 "	" $5,216.49 "	" $4,538.35 "	" $1,251.96 "	" $3,990.61 "	" $5,216.49 "	" $5,216.49 "	" $1,982.27 "	" $3,286.39 "	" $4,434.02 "	" $3,442.88 "	" $4,173.19 "	" $1,251.96 "	" $4,694.84 "	" $4,241.01 "	" $4,434.02 "	" $1,241.52 "	" $4,241.01 "	" $1,251.96 "
5271323	HCHG CVMC PLATE DIA-META 4HX9H RT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,469.36 "	" $3,828.55 "	" $1,301.71 "	" $5,469.36 "	" $4,758.34 "	" $1,312.65 "	" $4,184.06 "	" $5,469.36 "	" $5,469.36 "	" $2,078.36 "	" $3,445.70 "	" $4,648.96 "	" $3,609.78 "	" $4,375.49 "	" $1,312.65 "	" $4,922.42 "	" $4,446.59 "	" $4,648.96 "	" $1,301.71 "	" $4,446.59 "	" $1,312.65 "
5271324	HCHG CVMC PLATE DIA-META 4HX11H RT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,594.38 "	" $3,916.07 "	" $1,331.46 "	" $5,594.38 "	" $4,867.11 "	" $1,342.65 "	" $4,279.70 "	" $5,594.38 "	" $5,594.38 "	" $2,125.86 "	" $3,524.46 "	" $4,755.22 "	" $3,692.29 "	" $4,475.50 "	" $1,342.65 "	" $5,034.94 "	" $4,548.23 "	" $4,755.22 "	" $1,331.46 "	" $4,548.23 "	" $1,342.65 "
5271325	HCHG CVMC PLATE DIA-META 4HX7H LF	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,344.35 "	" $3,741.05 "	" $1,271.96 "	" $5,344.35 "	" $4,649.58 "	" $1,282.64 "	" $4,088.43 "	" $5,344.35 "	" $5,344.35 "	" $2,030.85 "	" $3,366.94 "	" $4,542.70 "	" $3,527.27 "	" $4,275.48 "	" $1,282.64 "	" $4,809.92 "	" $4,344.96 "	" $4,542.70 "	" $1,271.96 "	" $4,344.96 "	" $1,282.64 "
5271326	HCHG CVMC PLATE DIA-META 4HX9H LF	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,469.36 "	" $3,828.55 "	" $1,301.71 "	" $5,469.36 "	" $4,758.34 "	" $1,312.65 "	" $4,184.06 "	" $5,469.36 "	" $5,469.36 "	" $2,078.36 "	" $3,445.70 "	" $4,648.96 "	" $3,609.78 "	" $4,375.49 "	" $1,312.65 "	" $4,922.42 "	" $4,446.59 "	" $4,648.96 "	" $1,301.71 "	" $4,446.59 "	" $1,312.65 "
5271327	HCHG CVMC PLATE DIA-META 4HX11H LF	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,594.38 "	" $3,916.07 "	" $1,331.46 "	" $5,594.38 "	" $4,867.11 "	" $1,342.65 "	" $4,279.70 "	" $5,594.38 "	" $5,594.38 "	" $2,125.86 "	" $3,524.46 "	" $4,755.22 "	" $3,692.29 "	" $4,475.50 "	" $1,342.65 "	" $5,034.94 "	" $4,548.23 "	" $4,755.22 "	" $1,331.46 "	" $4,548.23 "	" $1,342.65 "
5271328	HCHG CVMC PLATE DIA-META 4HX13H LF STRL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,838.72 "	" $4,087.10 "	" $1,389.62 "	" $5,838.72 "	" $5,079.69 "	" $1,401.29 "	" $4,466.62 "	" $5,838.72 "	" $5,838.72 "	" $2,218.71 "	" $3,678.39 "	" $4,962.91 "	" $3,853.56 "	" $4,670.98 "	" $1,401.29 "	" $5,254.85 "	" $4,746.88 "	" $4,962.91 "	" $1,389.62 "	" $4,746.88 "	" $1,401.29 "
5271329	HCHG CVMC PLATE DIA-META 4HX15H LF STRL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,029.09 "	" $4,220.36 "	" $1,434.92 "	" $6,029.09 "	" $5,245.31 "	" $1,446.98 "	" $4,612.25 "	" $6,029.09 "	" $6,029.09 "	" $2,291.05 "	" $3,798.33 "	" $5,124.73 "	" $3,979.20 "	" $4,823.27 "	" $1,446.98 "	" $5,426.18 "	" $4,901.65 "	" $5,124.73 "	" $1,434.92 "	" $4,901.65 "	" $1,446.98 "
5271330	HCHG CVMC PLATE VOLAR DIST RAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,531.16 "	" $2,471.81 "	 $840.42 	" $3,531.16 "	" $3,072.11 "	 $847.48 	" $2,701.34 "	" $3,531.16 "	" $3,531.16 "	" $1,341.84 "	" $2,224.63 "	" $3,001.49 "	" $2,330.57 "	" $2,824.93 "	 $847.48 	" $3,178.04 "	" $2,870.83 "	" $3,001.49 "	 $840.42 	" $2,870.83 "	 $847.48 
5271331	HCHG CVMC PLATE VOLAR DIST RAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,643.03 "	" $2,550.12 "	 $867.04 	" $3,643.03 "	" $3,169.44 "	 $874.33 	" $2,786.92 "	" $3,643.03 "	" $3,643.03 "	" $1,384.35 "	" $2,295.11 "	" $3,096.58 "	" $2,404.40 "	" $2,914.42 "	 $874.33 	" $3,278.73 "	" $2,961.78 "	" $3,096.58 "	 $867.04 	" $2,961.78 "	 $874.33 
5271332	HCHG CVMC PLATE VOLAR DIST RAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,747.92 "	" $2,623.54 "	 $892.00 	" $3,747.92 "	" $3,260.69 "	 $899.50 	" $2,867.16 "	" $3,747.92 "	" $3,747.92 "	" $1,424.21 "	" $2,361.19 "	" $3,185.73 "	" $2,473.63 "	" $2,998.34 "	 $899.50 	" $3,373.13 "	" $3,047.06 "	" $3,185.73 "	 $892.00 	" $3,047.06 "	 $899.50 
5271333	HCHG CVMC 3.5 PERIART HUM PLATE 2H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,568.81 "	" $3,898.17 "	" $1,325.38 "	" $5,568.81 "	" $4,844.86 "	" $1,336.51 "	" $4,260.14 "	" $5,568.81 "	" $5,568.81 "	" $2,116.15 "	" $3,508.35 "	" $4,733.49 "	" $3,675.41 "	" $4,455.05 "	" $1,336.51 "	" $5,011.93 "	" $4,527.44 "	" $4,733.49 "	" $1,325.38 "	" $4,527.44 "	" $1,336.51 "
5271334	HCHG CVMC 3.5 PERIART HUM PLATE 3H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,650.89 "	" $3,955.62 "	" $1,344.91 "	" $5,650.89 "	" $4,916.27 "	" $1,356.21 "	" $4,322.93 "	" $5,650.89 "	" $5,650.89 "	" $2,147.34 "	" $3,560.06 "	" $4,803.26 "	" $3,729.59 "	" $4,520.71 "	" $1,356.21 "	" $5,085.80 "	" $4,594.17 "	" $4,803.26 "	" $1,344.91 "	" $4,594.17 "	" $1,356.21 "
5271335	HCHG CVMC 3.5 PERIART HUM PLATE 4H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,739.28 "	" $4,017.50 "	" $1,365.95 "	" $5,739.28 "	" $4,993.17 "	" $1,377.43 "	" $4,390.55 "	" $5,739.28 "	" $5,739.28 "	" $2,180.93 "	" $3,615.75 "	" $4,878.39 "	" $3,787.92 "	" $4,591.42 "	" $1,377.43 "	" $5,165.35 "	" $4,666.03 "	" $4,878.39 "	" $1,365.95 "	" $4,666.03 "	" $1,377.43 "
5271336	HCHG CVMC 3.5 PERIART HUM PLATE 5H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,878.18 "	" $4,114.73 "	" $1,399.01 "	" $5,878.18 "	" $5,114.02 "	" $1,410.76 "	" $4,496.81 "	" $5,878.18 "	" $5,878.18 "	" $2,233.71 "	" $3,703.25 "	" $4,996.45 "	" $3,879.60 "	" $4,702.54 "	" $1,410.76 "	" $5,290.36 "	" $4,778.96 "	" $4,996.45 "	" $1,399.01 "	" $4,778.96 "	" $1,410.76 "
5271337	HCHG CVMC 3.5 PERIART HUM PLATE 6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,045.50 "	" $4,231.85 "	" $1,438.83 "	" $6,045.50 "	" $5,259.59 "	" $1,450.92 "	" $4,624.81 "	" $6,045.50 "	" $6,045.50 "	" $2,297.29 "	" $3,808.67 "	" $5,138.68 "	" $3,990.03 "	" $4,836.40 "	" $1,450.92 "	" $5,440.95 "	" $4,914.99 "	" $5,138.68 "	" $1,438.83 "	" $4,914.99 "	" $1,450.92 "
5271338	HCHG CVMC 3.5 PERIART HUM PLATE 8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,279.11 "	" $4,395.38 "	" $1,494.43 "	" $6,279.11 "	" $5,462.83 "	" $1,506.99 "	" $4,803.52 "	" $6,279.11 "	" $6,279.11 "	" $2,386.06 "	" $3,955.84 "	" $5,337.24 "	" $4,144.21 "	" $5,023.29 "	" $1,506.99 "	" $5,651.20 "	" $5,104.92 "	" $5,337.24 "	" $1,494.43 "	" $5,104.92 "	" $1,506.99 "
5271339	HCHG CVMC BONE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $901.15 	 $630.81 	 $214.47 	 $811.04 	 $784.00 	 $216.28 	 $689.38 	 $-   	 $-   	 $342.44 	 $567.72 	 $765.98 	 $594.76 	 $720.92 	 $216.28 	 $811.04 	 $732.63 	 $765.98 	 $214.47 	 $732.63 	 $216.28 
5271340	HCHG CVMC SCREW PERIART LOCK CANN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,144.81 "	 $801.37 	 $272.46 	" $1,030.33 "	 $995.98 	 $274.75 	 $875.78 	 $-   	 $-   	 $435.03 	 $721.23 	 $973.09 	 $755.57 	 $915.85 	 $274.75 	" $1,030.33 "	 $930.73 	 $973.09 	 $272.46 	 $930.73 	 $274.75 
5271341	HCHG CVMC SCREW PERIART CON CANN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $958.45 	 $670.92 	 $228.11 	 $862.61 	 $833.85 	 $230.03 	 $733.21 	 $-   	 $-   	 $364.21 	 $603.82 	 $814.68 	 $632.58 	 $766.76 	 $230.03 	 $862.61 	 $779.22 	 $814.68 	 $228.11 	 $779.22 	 $230.03 
5271342	HCHG CVMC SCREW PERIART LOCK CANN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,693.26 "	" $1,185.28 "	 $403.00 	" $1,693.26 "	" $1,473.14 "	 $406.38 	" $1,295.34 "	" $1,693.26 "	" $1,693.26 "	 $643.44 	" $1,066.75 "	" $1,439.27 "	" $1,117.55 "	" $1,354.61 "	 $406.38 	" $1,523.93 "	" $1,376.62 "	" $1,439.27 "	 $403.00 	" $1,376.62 "	 $406.38 
5271343	HCHG CVMC 7.3MM CANN LOCK SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,693.26 "	" $1,185.28 "	 $403.00 	" $1,693.26 "	" $1,473.14 "	 $406.38 	" $1,295.34 "	" $1,693.26 "	" $1,693.26 "	 $643.44 	" $1,066.75 "	" $1,439.27 "	" $1,117.55 "	" $1,354.61 "	 $406.38 	" $1,523.93 "	" $1,376.62 "	" $1,439.27 "	 $403.00 	" $1,376.62 "	 $406.38 
5271344	HCHG CVMC SCREW PERIAR CANN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,512.22 "	" $1,058.55 "	 $359.91 	" $1,512.22 "	" $1,315.63 "	 $362.93 	" $1,156.85 "	" $1,512.22 "	 $-   	 $574.64 	 $952.70 	" $1,285.39 "	 $998.07 	" $1,209.78 "	 $362.93 	" $1,361.00 "	" $1,229.43 "	" $1,285.39 "	 $359.91 	" $1,229.43 "	 $362.93 
5271345	HCHG CVMC HEX SS CRLG BUTTON-S	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,000.12 "	 $700.08 	 $238.03 	 $900.11 	 $870.10 	 $240.03 	 $765.09 	 $-   	 $-   	 $380.05 	 $630.08 	 $850.10 	 $660.08 	 $800.10 	 $240.03 	 $900.11 	 $813.10 	 $850.10 	 $238.03 	 $813.10 	 $240.03 
5271346	HCHG CVMC PIN CRIMP POS SS STERILE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,672.08 "	" $1,170.46 "	 $397.96 	" $1,672.08 "	" $1,454.71 "	 $401.30 	" $1,279.14 "	" $1,672.08 "	" $1,672.08 "	 $635.39 	" $1,053.41 "	" $1,421.27 "	" $1,103.57 "	" $1,337.66 "	 $401.30 	" $1,504.87 "	" $1,359.40 "	" $1,421.27 "	 $397.96 	" $1,359.40 "	 $401.30 
5271347	HCHG CVMC TI END CAP T40	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $914.46 	 $640.12 	 $217.64 	 $823.01 	 $795.58 	 $219.47 	 $699.56 	 $-   	 $-   	 $347.49 	 $576.11 	 $777.29 	 $603.54 	 $731.57 	 $219.47 	 $823.01 	 $743.46 	 $777.29 	 $217.64 	 $743.46 	 $219.47 
5271348	HCHG CVMC TI END CAP TIB NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,604.36 "	" $1,123.05 "	 $381.84 	" $1,604.36 "	" $1,395.79 "	 $385.05 	" $1,227.34 "	" $1,604.36 "	" $1,604.36 "	 $609.66 	" $1,010.75 "	" $1,363.71 "	" $1,058.88 "	" $1,283.49 "	 $385.05 	" $1,443.92 "	" $1,304.34 "	" $1,363.71 "	 $381.84 	" $1,304.34 "	 $385.05 
5271349	HCHG CVMC TI NAIL CANN TIBIAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,989.20 "	" $3,492.44 "	" $1,187.43 "	" $4,989.20 "	" $4,340.60 "	" $1,197.41 "	" $3,816.74 "	" $4,989.20 "	" $4,989.20 "	" $1,895.90 "	" $3,143.20 "	" $4,240.82 "	" $3,292.87 "	" $3,991.36 "	" $1,197.41 "	" $4,490.28 "	" $4,056.22 "	" $4,240.82 "	" $1,187.43 "	" $4,056.22 "	" $1,197.41 "
5271350	HCHG CVMC 4MM TI LOCK SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,086.24 "	 $760.37 	 $258.53 	 $977.62 	 $945.03 	 $260.70 	 $830.97 	 $-   	 $-   	 $412.77 	 $684.33 	 $923.30 	 $716.92 	 $868.99 	 $260.70 	 $977.62 	 $883.11 	 $923.30 	 $258.53 	 $883.11 	 $260.70 
5271351	HCHG CVMC 5.0MM TI LOCK SCREW W/T25	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,099.09 "	 $769.36 	 $261.58 	 $989.18 	 $956.21 	 $263.78 	 $840.80 	 $-   	 $-   	 $417.65 	 $692.43 	 $934.23 	 $725.40 	 $879.27 	 $263.78 	 $989.18 	 $893.56 	 $934.23 	 $261.58 	 $893.56 	 $263.78 
5271352	HCHG CVMC 5MM TI LOCK SCREW DC T25	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,250.15 "	 $875.11 	 $297.54 	" $1,125.14 "	" $1,087.63 "	 $300.04 	 $956.36 	 $-   	 $-   	 $475.06 	 $787.59 	" $1,062.63 "	 $825.10 	" $1,000.12 "	 $300.04 	" $1,125.14 "	" $1,016.37 "	" $1,062.63 "	 $297.54 	" $1,016.37 "	 $300.04 
5271353	HCHG CVMC BONE NAIL TI CANN LAT FEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,994.25 "	" $3,495.98 "	" $1,188.63 "	" $4,994.25 "	" $4,345.00 "	" $1,198.62 "	" $3,820.60 "	" $4,994.25 "	" $4,994.25 "	" $1,897.82 "	" $3,146.38 "	" $4,245.11 "	" $3,296.21 "	" $3,995.40 "	" $1,198.62 "	" $4,494.83 "	" $4,060.33 "	" $4,245.11 "	" $1,188.63 "	" $4,060.33 "	" $1,198.62 "
5271354	HCHG CVMC BONE SCREW-3.5MM SCREW LCP SHFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $171.04 	 $119.73 	 $40.71 	 $153.94 	 $148.80 	 $41.05 	 $130.85 	 $-   	 $-   	 $65.00 	 $107.76 	 $145.38 	 $112.89 	 $136.83 	 $41.05 	 $153.94 	 $139.06 	 $145.38 	 $40.71 	 $139.06 	 $41.05 
5271355	HCHG CVMC BONE SCREW-4.0MM CANN SCREW SHRT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,234.52 "	 $864.16 	 $293.82 	" $1,111.07 "	" $1,074.03 "	 $296.28 	 $944.41 	 $-   	 $-   	 $469.12 	 $777.75 	" $1,049.34 "	 $814.78 	 $987.62 	 $296.28 	" $1,111.07 "	" $1,003.66 "	" $1,049.34 "	 $293.82 	" $1,003.66 "	 $296.28 
5271356	HCHG CVMC BONE SCREW-4.0MM CANN SCREW LNG THRD/50MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,128.84 "	 $790.19 	 $268.66 	" $1,015.96 "	 $982.09 	 $270.92 	 $863.56 	 $-   	 $-   	 $428.96 	 $711.17 	 $959.51 	 $745.03 	 $903.07 	 $270.92 	" $1,015.96 "	 $917.75 	 $959.51 	 $268.66 	 $917.75 	 $270.92 
5271357	HCHG CVMC BONE SCREW-7.0MM CANN SCREW 16MM THRD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,661.66 "	" $1,163.16 "	 $395.48 	" $1,661.66 "	" $1,445.64 "	 $398.80 	" $1,271.17 "	" $1,661.66 "	" $1,661.66 "	 $631.43 	" $1,046.85 "	" $1,412.41 "	" $1,096.70 "	" $1,329.33 "	 $398.80 	" $1,495.49 "	" $1,350.93 "	" $1,412.41 "	 $395.48 	" $1,350.93 "	 $398.80 
5271358	HCHG CVMC 4.5MM LCP CURV CNDLR PLATE 20	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,264.91 "	" $4,385.44 "	" $1,491.05 "	" $6,264.91 "	" $5,450.47 "	" $1,503.58 "	" $4,792.66 "	" $6,264.91 "	" $6,264.91 "	" $2,380.67 "	" $3,946.89 "	" $5,325.17 "	" $4,134.84 "	" $5,011.93 "	" $1,503.58 "	" $5,638.42 "	" $5,093.37 "	" $5,325.17 "	" $1,491.05 "	" $5,093.37 "	" $1,503.58 "
5271359	HCHG CVMC PLATE DIA-META 4HX7H RT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,344.35 "	" $3,741.05 "	" $1,271.96 "	" $5,344.35 "	" $4,649.58 "	" $1,282.64 "	" $4,088.43 "	" $5,344.35 "	" $5,344.35 "	" $2,030.85 "	" $3,366.94 "	" $4,542.70 "	" $3,527.27 "	" $4,275.48 "	" $1,282.64 "	" $4,809.92 "	" $4,344.96 "	" $4,542.70 "	" $1,271.96 "	" $4,344.96 "	" $1,282.64 "
5271360	HCHG CVMC PLATE DIA-META 4HX5H LF	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,216.49 "	" $3,651.54 "	" $1,241.52 "	" $5,216.49 "	" $4,538.35 "	" $1,251.96 "	" $3,990.61 "	" $5,216.49 "	" $5,216.49 "	" $1,982.27 "	" $3,286.39 "	" $4,434.02 "	" $3,442.88 "	" $4,173.19 "	" $1,251.96 "	" $4,694.84 "	" $4,241.01 "	" $4,434.02 "	" $1,241.52 "	" $4,241.01 "	" $1,251.96 "
5271361	HCHG CVMC BONE SCREW-6.5MM CANC SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $256.51 	 $179.56 	 $61.05 	 $230.86 	 $223.16 	 $61.56 	 $196.23 	 $-   	 $-   	 $97.47 	 $161.60 	 $218.03 	 $169.30 	 $205.21 	 $61.56 	 $230.86 	 $208.54 	 $218.03 	 $61.05 	 $208.54 	 $61.56 
5271362	HCHG CVMC BONE SCREW-6.5MM CANC SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $276.12 	 $193.28 	 $65.72 	 $248.51 	 $240.22 	 $66.27 	 $211.23 	 $-   	 $-   	 $104.93 	 $173.96 	 $234.70 	 $182.24 	 $220.90 	 $66.27 	 $248.51 	 $224.49 	 $234.70 	 $65.72 	 $224.49 	 $66.27 
5271363	HCHG CVMC BONE SCREW-6.5MM CANC BONE SCREW FULL THR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $290.50 	 $203.35 	 $69.14 	 $261.45 	 $252.74 	 $69.72 	 $222.23 	 $-   	 $-   	 $110.39 	 $183.02 	 $246.93 	 $191.73 	 $232.40 	 $69.72 	 $261.45 	 $236.18 	 $246.93 	 $69.14 	 $236.18 	 $69.72 
5271364	HCHG CVMC WASHER 10.0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $209.16 	 $146.41 	 $49.78 	 $188.24 	 $181.97 	 $50.20 	 $160.01 	 $-   	 $-   	 $79.48 	 $131.77 	 $177.79 	 $138.05 	 $167.33 	 $50.20 	 $188.24 	 $170.05 	 $177.79 	 $49.78 	 $170.05 	 $50.20 
5271365	HCHG CVMC WASHER AO SPIKED 8 X 3.2 SMALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $568.65 	 $398.06 	 $135.34 	 $511.79 	 $494.73 	 $136.48 	 $435.02 	 $-   	 $-   	 $216.09 	 $358.25 	 $483.35 	 $375.31 	 $454.92 	 $136.48 	 $511.79 	 $462.31 	 $483.35 	 $135.34 	 $462.31 	 $136.48 
5271366	HCHG CVMC WASHER AO SPIKED	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $848.54 	 $593.98 	 $201.95 	 $763.69 	 $738.23 	 $203.65 	 $649.13 	 $-   	 $-   	 $322.45 	 $534.58 	 $721.26 	 $560.04 	 $678.83 	 $203.65 	 $763.69 	 $689.86 	 $721.26 	 $201.95 	 $689.86 	 $203.65 
5271367	HCHG CVMC WASHER-IMPLANT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $197.68 	 $138.38 	 $47.05 	 $177.91 	 $171.98 	 $47.44 	 $151.23 	 $-   	 $-   	 $75.12 	 $124.54 	 $168.03 	 $130.47 	 $158.14 	 $47.44 	 $177.91 	 $160.71 	 $168.03 	 $47.05 	 $160.71 	 $47.44 
5271368	HCHG CVMC WASHER-IMPLANT METAL 13.0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $218.96 	 $153.27 	 $52.11 	 $197.06 	 $190.50 	 $52.55 	 $167.50 	 $-   	 $-   	 $83.20 	 $137.94 	 $186.12 	 $144.51 	 $175.17 	 $52.55 	 $197.06 	 $178.01 	 $186.12 	 $52.11 	 $178.01 	 $52.55 
5271369	HCHG CVMC SCREW NUT 5.0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,010.54 "	 $707.38 	 $240.51 	 $909.49 	 $879.17 	 $242.53 	 $773.06 	 $-   	 $-   	 $384.01 	 $636.64 	 $858.96 	 $666.96 	 $808.43 	 $242.53 	 $909.49 	 $821.57 	 $858.96 	 $240.51 	 $821.57 	 $242.53 
5271370	HCHG CVMC SCREW PERIART LOCKING	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $901.15 	 $630.81 	 $214.47 	 $811.04 	 $784.00 	 $216.28 	 $689.38 	 $-   	 $-   	 $342.44 	 $567.72 	 $765.98 	 $594.76 	 $720.92 	 $216.28 	 $811.04 	 $732.63 	 $765.98 	 $214.47 	 $732.63 	 $216.28 
5271371	HCHG CVMC BONE PLATE LCP CONDYLAR 4.5X6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,279.00 "	" $3,695.30 "	" $1,256.40 "	" $5,279.00 "	" $4,592.73 "	" $1,266.96 "	" $4,038.44 "	" $5,279.00 "	" $5,279.00 "	" $2,006.02 "	" $3,325.77 "	" $4,487.15 "	" $3,484.14 "	" $4,223.20 "	" $1,266.96 "	" $4,751.10 "	" $4,291.83 "	" $4,487.15 "	" $1,256.40 "	" $4,291.83 "	" $1,266.96 "
5271372	HCHG CVMC BONE PLATE LCP CONDYLAR 4.5X8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,378.44 "	" $3,764.91 "	" $1,280.07 "	" $5,378.44 "	" $4,679.24 "	" $1,290.83 "	" $4,114.51 "	" $5,378.44 "	" $5,378.44 "	" $2,043.81 "	" $3,388.42 "	" $4,571.67 "	" $3,549.77 "	" $4,302.75 "	" $1,290.83 "	" $4,840.60 "	" $4,372.67 "	" $4,571.67 "	" $1,280.07 "	" $4,372.67 "	" $1,290.83 "
5271373	HCHG CVMC BONE PLATE LCP CONDYLAR 4.5X10H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,577.33 "	" $3,904.13 "	" $1,327.40 "	" $5,577.33 "	" $4,852.28 "	" $1,338.56 "	" $4,266.66 "	" $5,577.33 "	" $5,577.33 "	" $2,119.39 "	" $3,513.72 "	" $4,740.73 "	" $3,681.04 "	" $4,461.86 "	" $1,338.56 "	" $5,019.60 "	" $4,534.37 "	" $4,740.73 "	" $1,327.40 "	" $4,534.37 "	" $1,338.56 "
5271374	HCHG CVMC BONE PLATE LCP CONDYLAR 4.5X12H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,690.98 "	" $3,983.69 "	" $1,354.45 "	" $5,690.98 "	" $4,951.15 "	" $1,365.84 "	" $4,353.60 "	" $5,690.98 "	" $5,690.98 "	" $2,162.57 "	" $3,585.32 "	" $4,837.33 "	" $3,756.05 "	" $4,552.78 "	" $1,365.84 "	" $5,121.88 "	" $4,626.77 "	" $4,837.33 "	" $1,354.45 "	" $4,626.77 "	" $1,365.84 "
5271375	HCHG CVMC BONE PLATE LCP CONDYLAR 4.5X14H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,804.63 "	" $4,063.24 "	" $1,381.50 "	" $5,804.63 "	" $5,050.03 "	" $1,393.11 "	" $4,440.54 "	" $5,804.63 "	" $5,804.63 "	" $2,205.76 "	" $3,656.92 "	" $4,933.94 "	" $3,831.06 "	" $4,643.70 "	" $1,393.11 "	" $5,224.17 "	" $4,719.16 "	" $4,933.94 "	" $1,381.50 "	" $4,719.16 "	" $1,393.11 "
5271376	HCHG CVMC BONE PLATE LCP CONDYLAR 4.5X16H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,921.12 "	" $4,144.78 "	" $1,409.23 "	" $5,921.12 "	" $5,151.37 "	" $1,421.07 "	" $4,529.66 "	" $5,921.12 "	" $5,921.12 "	" $2,250.03 "	" $3,730.31 "	" $5,032.95 "	" $3,907.94 "	" $4,736.90 "	" $1,421.07 "	" $5,329.01 "	" $4,813.87 "	" $5,032.95 "	" $1,409.23 "	" $4,813.87 "	" $1,421.07 "
5271377	HCHG CVMC BONE PLATE LCP CONDYLAR 4.5X18H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,040.45 "	" $4,228.32 "	" $1,437.63 "	" $6,040.45 "	" $5,255.19 "	" $1,449.71 "	" $4,620.94 "	" $6,040.45 "	" $6,040.45 "	" $2,295.37 "	" $3,805.48 "	" $5,134.38 "	" $3,986.70 "	" $4,832.36 "	" $1,449.71 "	" $5,436.41 "	" $4,910.89 "	" $5,134.38 "	" $1,437.63 "	" $4,910.89 "	" $1,449.71 "
5271378	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 6HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,639.54 "	" $2,547.68 "	 $866.21 	" $3,639.54 "	" $3,166.40 "	 $873.49 	" $2,784.25 "	" $3,639.54 "	" $3,639.54 "	" $1,383.03 "	" $2,292.91 "	" $3,093.61 "	" $2,402.10 "	" $2,911.63 "	 $873.49 	" $3,275.59 "	" $2,958.95 "	" $3,093.61 "	 $866.21 	" $2,958.95 "	 $873.49 
5271379	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 7 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,709.46 "	" $2,596.62 "	 $882.85 	" $3,709.46 "	" $3,227.23 "	 $890.27 	" $2,837.74 "	" $3,709.46 "	" $3,709.46 "	" $1,409.59 "	" $2,336.96 "	" $3,153.04 "	" $2,448.24 "	" $2,967.57 "	 $890.27 	" $3,338.51 "	" $3,015.79 "	" $3,153.04 "	 $882.85 	" $3,015.79 "	 $890.27 
5271380	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 8 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,765.40 "	" $2,635.78 "	 $896.17 	" $3,765.40 "	" $3,275.90 "	 $903.70 	" $2,880.53 "	" $3,765.40 "	" $3,765.40 "	" $1,430.85 "	" $2,372.20 "	" $3,200.59 "	" $2,485.16 "	" $3,012.32 "	 $903.70 	" $3,388.86 "	" $3,061.27 "	" $3,200.59 "	 $896.17 	" $3,061.27 "	 $903.70 
5271381	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 9 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,828.33 "	" $2,679.83 "	 $911.14 	" $3,828.33 "	" $3,330.65 "	 $918.80 	" $2,928.67 "	" $3,828.33 "	" $3,828.33 "	" $1,454.77 "	" $2,411.85 "	" $3,254.08 "	" $2,526.70 "	" $3,062.66 "	 $918.80 	" $3,445.50 "	" $3,112.43 "	" $3,254.08 "	 $911.14 	" $3,112.43 "	 $918.80 
5271382	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 10 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,159.45 "	" $2,211.62 "	 $751.95 	" $3,159.45 "	" $2,748.72 "	 $758.27 	" $2,416.98 "	" $3,159.45 "	" $3,159.45 "	" $1,200.59 "	" $1,990.45 "	" $2,685.53 "	" $2,085.24 "	" $2,527.56 "	 $758.27 	" $2,843.51 "	" $2,568.63 "	" $2,685.53 "	 $751.95 	" $2,568.63 "	 $758.27 
5271383	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 11 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,213.43 "	" $2,249.40 "	 $764.80 	" $3,213.43 "	" $2,795.68 "	 $771.22 	" $2,458.27 "	" $3,213.43 "	" $3,213.43 "	" $1,221.10 "	" $2,024.46 "	" $2,731.42 "	" $2,120.86 "	" $2,570.74 "	 $771.22 	" $2,892.09 "	" $2,612.52 "	" $2,731.42 "	 $764.80 	" $2,612.52 "	 $771.22 
5271384	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 12 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,148.19 "	" $2,903.73 "	 $987.27 	" $4,148.19 "	" $3,608.93 "	 $995.57 	" $3,173.37 "	" $4,148.19 "	" $4,148.19 "	" $1,576.31 "	" $2,613.36 "	" $3,525.96 "	" $2,737.81 "	" $3,318.55 "	 $995.57 	" $3,733.37 "	" $3,372.48 "	" $3,525.96 "	 $987.27 	" $3,372.48 "	 $995.57 
5271385	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 14 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,284.57 "	" $2,999.20 "	" $1,019.73 "	" $4,284.57 "	" $3,727.58 "	" $1,028.30 "	" $3,277.70 "	" $4,284.57 "	" $4,284.57 "	" $1,628.14 "	" $2,699.28 "	" $3,641.88 "	" $2,827.82 "	" $3,427.66 "	" $1,028.30 "	" $3,856.11 "	" $3,483.36 "	" $3,641.88 "	" $1,019.73 "	" $3,483.36 "	" $1,028.30 "
5271386	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 1 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,375.49 "	" $3,062.84 "	" $1,041.37 "	" $4,375.49 "	" $3,806.68 "	" $1,050.12 "	" $3,347.25 "	" $4,375.49 "	" $4,375.49 "	" $1,662.69 "	" $2,756.56 "	" $3,719.17 "	" $2,887.82 "	" $3,500.39 "	" $1,050.12 "	" $3,937.94 "	" $3,557.27 "	" $3,719.17 "	" $1,041.37 "	" $3,557.27 "	" $1,050.12 "
5271387	HCHG CVMC BONE PLATE 3.5MM LCP METPHY PLATE 18 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,457.89 "	" $3,120.52 "	" $1,060.98 "	" $4,457.89 "	" $3,878.36 "	" $1,069.89 "	" $3,410.29 "	" $4,457.89 "	" $4,457.89 "	" $1,694.00 "	" $2,808.47 "	" $3,789.21 "	" $2,942.21 "	" $3,566.31 "	" $1,069.89 "	" $4,012.10 "	" $3,624.26 "	" $3,789.21 "	" $1,060.98 "	" $3,624.26 "	" $1,069.89 "
5271388	HCHG CVMC BONE PLATE LCP 3.5MM 2 HOLE 33	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,625.19 "	" $1,137.63 "	 $386.80 	" $1,625.19 "	" $1,413.92 "	 $390.05 	" $1,243.27 "	" $1,625.19 "	" $1,625.19 "	 $617.57 	" $1,023.87 "	" $1,381.41 "	" $1,072.63 "	" $1,300.15 "	 $390.05 	" $1,462.67 "	" $1,321.28 "	" $1,381.41 "	 $386.80 	" $1,321.28 "	 $390.05 
5271389	HCHG CVMC BONE PLATE LCP 3.5MM 3 HOLE 46	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,687.70 "	" $1,181.39 "	 $401.67 	" $1,687.70 "	" $1,468.30 "	 $405.05 	" $1,291.09 "	" $1,687.70 "	" $1,687.70 "	 $641.33 	" $1,063.25 "	" $1,434.55 "	" $1,113.88 "	" $1,350.16 "	 $405.05 	" $1,518.93 "	" $1,372.10 "	" $1,434.55 "	 $401.67 	" $1,372.10 "	 $405.05 
5271390	HCHG CVMC BONE PLATE LCP 3.5MM 4 HOLE 59	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,181.71 "	 $827.20 	 $281.25 	" $1,063.54 "	" $1,028.09 "	 $283.61 	 $904.01 	 $-   	 $-   	 $449.05 	 $744.48 	" $1,004.45 "	 $779.93 	 $945.37 	 $283.61 	" $1,063.54 "	 $960.73 	" $1,004.45 "	 $281.25 	 $960.73 	 $283.61 
5271391	HCHG CVMC BONE PLATE LCP 3.5MM 5 HOLE 72	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,255.13 "	 $878.59 	 $298.72 	" $1,129.62 "	" $1,091.96 "	 $301.23 	 $960.17 	 $-   	 $-   	 $476.95 	 $790.73 	" $1,066.86 "	 $828.39 	" $1,004.10 "	 $301.23 	" $1,129.62 "	" $1,020.42 "	" $1,066.86 "	 $298.72 	" $1,020.42 "	 $301.23 
5271392	HCHG CVMC BONE PLATE LCP 3.5MM 6 HOLE 85	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,335.54 "	 $934.88 	 $317.86 	" $1,201.99 "	" $1,161.92 "	 $320.53 	" $1,021.69 "	 $-   	 $-   	 $507.51 	 $841.39 	" $1,135.21 "	 $881.46 	" $1,068.43 "	 $320.53 	" $1,201.99 "	" $1,085.79 "	" $1,135.21 "	 $317.86 	" $1,085.79 "	 $320.53 
5271393	HCHG CVMC BONE PLATE LCP 3.5MM 7 HOLE 98	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,394.98 "	 $976.49 	 $332.01 	" $1,255.48 "	" $1,213.63 "	 $334.80 	" $1,067.16 "	 $-   	 $-   	 $530.09 	 $878.84 	" $1,185.73 "	 $920.69 	" $1,115.98 "	 $334.80 	" $1,255.48 "	" $1,134.12 "	" $1,185.73 "	 $332.01 	" $1,134.12 "	 $334.80 
5271394	HCHG CVMC BONE PLATE LCP 3.5MM 8 HOLE 111	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,464.91 "	" $1,025.44 "	 $348.65 	" $1,318.42 "	" $1,274.47 "	 $351.58 	" $1,120.66 "	 $-   	 $-   	 $556.67 	 $922.89 	" $1,245.17 "	 $966.84 	" $1,171.93 "	 $351.58 	" $1,318.42 "	" $1,190.97 "	" $1,245.17 "	 $348.65 	" $1,190.97 "	 $351.58 
5271395	HCHG CVMC BONE PLATE LCP 3.5MM 9 HOLE 124	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,524.34 "	" $1,067.04 "	 $362.79 	" $1,524.34 "	" $1,326.18 "	 $365.84 	" $1,166.12 "	" $1,524.34 "	 $-   	 $579.25 	 $960.33 	" $1,295.69 "	" $1,006.06 "	" $1,219.47 "	 $365.84 	" $1,371.91 "	" $1,239.29 "	" $1,295.69 "	 $362.79 	" $1,239.29 "	 $365.84 
5271396	HCHG CVMC BONE PLATE LCP 3.5MM 10 HOLE 137	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,569.79 "	" $1,098.85 "	 $373.61 	" $1,569.79 "	" $1,365.72 "	 $376.75 	" $1,200.89 "	" $1,569.79 "	 $-   	 $596.52 	 $988.97 	" $1,334.32 "	" $1,036.06 "	" $1,255.83 "	 $376.75 	" $1,412.81 "	" $1,276.24 "	" $1,334.32 "	 $373.61 	" $1,276.24 "	 $376.75 
5271397	HCHG CVMC BONE PLATE LCP 3.5MM 11 HOLE 150	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,637.00 "	" $1,145.90 "	 $389.61 	" $1,637.00 "	" $1,424.19 "	 $392.88 	" $1,252.31 "	" $1,637.00 "	" $1,637.00 "	 $622.06 	" $1,031.31 "	" $1,391.45 "	" $1,080.42 "	" $1,309.60 "	 $392.88 	" $1,473.30 "	" $1,330.88 "	" $1,391.45 "	 $389.61 	" $1,330.88 "	 $392.88 
5271398	HCHG CVMC BONE PLATE LCP 3.5MM 12 HOLE 163	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,664.19 "	" $1,164.93 "	 $396.08 	" $1,664.19 "	" $1,447.85 "	 $399.41 	" $1,273.11 "	" $1,664.19 "	" $1,664.19 "	 $632.39 	" $1,048.44 "	" $1,414.56 "	" $1,098.37 "	" $1,331.35 "	 $399.41 	" $1,497.77 "	" $1,352.99 "	" $1,414.56 "	 $396.08 	" $1,352.99 "	 $399.41 
5271399	HCHG CVMC BONE PLATE LCP 3.5MM 13 HOLE 176	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,996.33 "	" $1,397.43 "	 $475.13 	" $1,996.33 "	" $1,736.81 "	 $479.12 	" $1,527.19 "	" $1,996.33 "	" $1,996.33 "	 $758.61 	" $1,257.69 "	" $1,696.88 "	" $1,317.58 "	" $1,597.06 "	 $479.12 	" $1,796.70 "	" $1,623.02 "	" $1,696.88 "	 $475.13 	" $1,623.02 "	 $479.12 
5271400	HCHG CVMC BONE PLATE LCP 3.5MM 14 HOLE 189	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,597.67 "	" $1,818.37 "	 $618.25 	" $2,597.67 "	" $2,259.97 "	 $623.44 	" $1,987.22 "	" $2,597.67 "	" $2,597.67 "	 $987.11 	" $1,636.53 "	" $2,208.02 "	" $1,714.46 "	" $2,078.14 "	 $623.44 	" $2,337.90 "	" $2,111.91 "	" $2,208.02 "	 $618.25 	" $2,111.91 "	 $623.44 
5271401	HCHG CVMC BONE PLATE LCP 3.5MM 15 HOLE 202	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,699.06 "	" $1,889.34 "	 $642.38 	" $2,699.06 "	" $2,348.18 "	 $647.77 	" $2,064.78 "	" $2,699.06 "	" $2,699.06 "	" $1,025.64 "	" $1,700.41 "	" $2,294.20 "	" $1,781.38 "	" $2,159.25 "	 $647.77 	" $2,429.15 "	" $2,194.34 "	" $2,294.20 "	 $642.38 	" $2,194.34 "	 $647.77 
5271402	HCHG CVMC BONE PLATE LCP 3.5MM 16 HOLE 215	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,824.92 "	" $1,977.44 "	 $672.33 	" $2,824.92 "	" $2,457.68 "	 $677.98 	" $2,161.06 "	" $2,824.92 "	" $2,824.92 "	" $1,073.47 "	" $1,779.70 "	" $2,401.18 "	" $1,864.45 "	" $2,259.94 "	 $677.98 	" $2,542.43 "	" $2,296.66 "	" $2,401.18 "	 $672.33 	" $2,296.66 "	 $677.98 
5271403	HCHG CVMC BONE PLATE LCP 3.5MM 18 HOLE 241	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,167.55 "	" $2,217.29 "	 $753.88 	" $3,167.55 "	" $2,755.77 "	 $760.21 	" $2,423.18 "	" $3,167.55 "	" $3,167.55 "	" $1,203.67 "	" $1,995.56 "	" $2,692.42 "	" $2,090.58 "	" $2,534.04 "	 $760.21 	" $2,850.80 "	" $2,575.22 "	" $2,692.42 "	 $753.88 	" $2,575.22 "	 $760.21 
5271404	HCHG CVMC BONE PLATE LCP 3.5MM 20 HOLE 267	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,517.17 "	" $2,462.02 "	 $837.09 	" $3,517.17 "	" $3,059.94 "	 $844.12 	" $2,690.64 "	" $3,517.17 "	" $3,517.17 "	" $1,336.52 "	" $2,215.82 "	" $2,989.59 "	" $2,321.33 "	" $2,813.74 "	 $844.12 	" $3,165.45 "	" $2,859.46 "	" $2,989.59 "	 $837.09 	" $2,859.46 "	 $844.12 
5271405	HCHG CVMC BONE PLATE 3.5MM LCP MED DIS PLATE 4-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,750.53 "	" $3,325.37 "	" $1,130.63 "	" $4,750.53 "	" $4,132.96 "	" $1,140.13 "	" $3,634.16 "	" $4,750.53 "	" $4,750.53 "	" $1,805.20 "	" $2,992.83 "	" $4,037.95 "	" $3,135.35 "	" $3,800.42 "	" $1,140.13 "	" $4,275.48 "	" $3,862.18 "	" $4,037.95 "	" $1,130.63 "	" $3,862.18 "	" $1,140.13 "
5271406	HCHG CVMC BONE PLATE 3.5MM LCP MED DIS PLATE 6-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,801.68 "	" $3,361.18 "	" $1,142.80 "	" $4,801.68 "	" $4,177.46 "	" $1,152.40 "	" $3,673.29 "	" $4,801.68 "	" $4,801.68 "	" $1,824.64 "	" $3,025.06 "	" $4,081.43 "	" $3,169.11 "	" $3,841.34 "	" $1,152.40 "	" $4,321.51 "	" $3,903.77 "	" $4,081.43 "	" $1,142.80 "	" $3,903.77 "	" $1,152.40 "
5271407	HCHG CVMC BONE PLATE 3.5MM LCP MED DIS PLATE 8-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,849.98 "	" $3,394.99 "	" $1,154.30 "	" $4,849.98 "	" $4,219.48 "	" $1,164.00 "	" $3,710.23 "	" $4,849.98 "	" $4,849.98 "	" $1,842.99 "	" $3,055.49 "	" $4,122.48 "	" $3,200.99 "	" $3,879.98 "	" $1,164.00 "	" $4,364.98 "	" $3,943.03 "	" $4,122.48 "	" $1,154.30 "	" $3,943.03 "	" $1,164.00 "
5271408	HCHG CVMC BONE PLATE 3.5MM LCP MED DIS PLATE 10-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,901.12 "	" $3,430.78 "	" $1,166.47 "	" $4,901.12 "	" $4,263.97 "	" $1,176.27 "	" $3,749.36 "	" $4,901.12 "	" $4,901.12 "	" $1,862.43 "	" $3,087.71 "	" $4,165.95 "	" $3,234.74 "	" $3,920.90 "	" $1,176.27 "	" $4,411.01 "	" $3,984.61 "	" $4,165.95 "	" $1,166.47 "	" $3,984.61 "	" $1,176.27 "
5271409	HCHG CVMC BONE PLATE 3.5MM LCP MED DIS PLATE 12-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,955.10 "	" $3,468.57 "	" $1,179.31 "	" $4,955.10 "	" $4,310.94 "	" $1,189.22 "	" $3,790.65 "	" $4,955.10 "	" $4,955.10 "	" $1,882.94 "	" $3,121.71 "	" $4,211.84 "	" $3,270.37 "	" $3,964.08 "	" $1,189.22 "	" $4,459.59 "	" $4,028.50 "	" $4,211.84 "	" $1,179.31 "	" $4,028.50 "	" $1,189.22 "
5271410	HCHG CVMC BONE PLATE 3.5MM LCP MED DIS PLATE 14-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,017.61 "	" $3,512.33 "	" $1,194.19 "	" $5,017.61 "	" $4,365.32 "	" $1,204.23 "	" $3,838.47 "	" $5,017.61 "	" $5,017.61 "	" $1,906.69 "	" $3,161.09 "	" $4,264.97 "	" $3,311.62 "	" $4,014.09 "	" $1,204.23 "	" $4,515.85 "	" $4,079.32 "	" $4,264.97 "	" $1,194.19 "	" $4,079.32 "	" $1,204.23 "
5271411	HCHG CVMC BONE PLATE MDT LOCKING 4HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,980.67 "	" $3,486.47 "	" $1,185.40 "	" $4,980.67 "	" $4,333.18 "	" $1,195.36 "	" $3,810.21 "	" $4,980.67 "	" $4,980.67 "	" $1,892.65 "	" $3,137.82 "	" $4,233.57 "	" $3,287.24 "	" $3,984.54 "	" $1,195.36 "	" $4,482.60 "	" $4,049.28 "	" $4,233.57 "	" $1,185.40 "	" $4,049.28 "	" $1,195.36 "
5271412	HCHG CVMC BONE PLATE MDT LOCKING 6HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,034.66 "	" $3,524.26 "	" $1,198.25 "	" $5,034.66 "	" $4,380.15 "	" $1,208.32 "	" $3,851.51 "	" $5,034.66 "	" $5,034.66 "	" $1,913.17 "	" $3,171.84 "	" $4,279.46 "	" $3,322.88 "	" $4,027.73 "	" $1,208.32 "	" $4,531.19 "	" $4,093.18 "	" $4,279.46 "	" $1,198.25 "	" $4,093.18 "	" $1,208.32 "
5271413	HCHG CVMC BONE PLATE MDT LOCKING 8-HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,082.96 "	" $3,558.07 "	" $1,209.74 "	" $5,082.96 "	" $4,422.18 "	" $1,219.91 "	" $3,888.46 "	" $5,082.96 "	" $5,082.96 "	" $1,931.52 "	" $3,202.26 "	" $4,320.52 "	" $3,354.75 "	" $4,066.37 "	" $1,219.91 "	" $4,574.66 "	" $4,132.45 "	" $4,320.52 "	" $1,209.74 "	" $4,132.45 "	" $1,219.91 "
5271414	HCHG CVMC BONE PLATE MDT LOCKING 10HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,136.94 "	" $3,595.86 "	" $1,222.59 "	" $5,136.94 "	" $4,469.14 "	" $1,232.87 "	" $3,929.76 "	" $5,136.94 "	" $5,136.94 "	" $1,952.04 "	" $3,236.27 "	" $4,366.40 "	" $3,390.38 "	" $4,109.55 "	" $1,232.87 "	" $4,623.25 "	" $4,176.33 "	" $4,366.40 "	" $1,222.59 "	" $4,176.33 "	" $1,232.87 "
5271415	HCHG CVMC BONE PLATE MDT LOCKING 12HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,193.77 "	" $3,635.64 "	" $1,236.12 "	" $5,193.77 "	" $4,518.58 "	" $1,246.50 "	" $3,973.23 "	" $5,193.77 "	" $5,193.77 "	" $1,973.63 "	" $3,272.08 "	" $4,414.70 "	" $3,427.89 "	" $4,155.02 "	" $1,246.50 "	" $4,674.39 "	" $4,222.54 "	" $4,414.70 "	" $1,236.12 "	" $4,222.54 "	" $1,246.50 "
5271416	HCHG CVMC BONE PLATE MDT LOCKING 14HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,259.11 "	" $3,681.38 "	" $1,251.67 "	" $5,259.11 "	" $4,575.43 "	" $1,262.19 "	" $4,023.22 "	" $5,259.11 "	" $5,259.11 "	" $1,998.46 "	" $3,313.24 "	" $4,470.24 "	" $3,471.01 "	" $4,207.29 "	" $1,262.19 "	" $4,733.20 "	" $4,275.66 "	" $4,470.24 "	" $1,251.67 "	" $4,275.66 "	" $1,262.19 "
5271417	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 4-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,855.66 "	" $3,398.96 "	" $1,155.65 "	" $4,855.66 "	" $4,224.42 "	" $1,165.36 "	" $3,714.58 "	" $4,855.66 "	" $4,855.66 "	" $1,845.15 "	" $3,059.07 "	" $4,127.31 "	" $3,204.74 "	" $3,884.53 "	" $1,165.36 "	" $4,370.09 "	" $3,947.65 "	" $4,127.31 "	" $1,155.65 "	" $3,947.65 "	" $1,165.36 "
5271418	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 4-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,869.86 "	" $3,408.90 "	" $1,159.03 "	" $4,869.86 "	" $4,236.78 "	" $1,168.77 "	" $3,725.44 "	" $4,869.86 "	" $4,869.86 "	" $1,850.55 "	" $3,068.01 "	" $4,139.38 "	" $3,214.11 "	" $3,895.89 "	" $1,168.77 "	" $4,382.87 "	" $3,959.20 "	" $4,139.38 "	" $1,159.03 "	" $3,959.20 "	" $1,168.77 "
5271419	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 6-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,921.01 "	" $3,444.71 "	" $1,171.20 "	" $4,921.01 "	" $4,281.28 "	" $1,181.04 "	" $3,764.57 "	" $4,921.01 "	" $4,921.01 "	" $1,869.98 "	" $3,100.24 "	" $4,182.86 "	" $3,247.87 "	" $3,936.81 "	" $1,181.04 "	" $4,428.91 "	" $4,000.78 "	" $4,182.86 "	" $1,171.20 "	" $4,000.78 "	" $1,181.04 "
5271420	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 6-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,929.53 "	" $3,450.67 "	" $1,173.23 "	" $4,929.53 "	" $4,288.69 "	" $1,183.09 "	" $3,771.09 "	" $4,929.53 "	" $4,929.53 "	" $1,873.22 "	" $3,105.60 "	" $4,190.10 "	" $3,253.49 "	" $3,943.62 "	" $1,183.09 "	" $4,436.58 "	" $4,007.71 "	" $4,190.10 "	" $1,173.23 "	" $4,007.71 "	" $1,183.09 "
5271421	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 8-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,977.83 "	" $3,484.48 "	" $1,184.72 "	" $4,977.83 "	" $4,330.71 "	" $1,194.68 "	" $3,808.04 "	" $4,977.83 "	" $4,977.83 "	" $1,891.58 "	" $3,136.03 "	" $4,231.16 "	" $3,285.37 "	" $3,982.26 "	" $1,194.68 "	" $4,480.05 "	" $4,046.98 "	" $4,231.16 "	" $1,184.72 "	" $4,046.98 "	" $1,194.68 "
5271422	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 8-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,986.36 "	" $3,490.45 "	" $1,186.75 "	" $4,986.36 "	" $4,338.13 "	" $1,196.73 "	" $3,814.57 "	" $4,986.36 "	" $4,986.36 "	" $1,894.82 "	" $3,141.41 "	" $4,238.41 "	" $3,291.00 "	" $3,989.09 "	" $1,196.73 "	" $4,487.72 "	" $4,053.91 "	" $4,238.41 "	" $1,186.75 "	" $4,053.91 "	" $1,196.73 "
5271423	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 10-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,034.66 "	" $3,524.26 "	" $1,198.25 "	" $5,034.66 "	" $4,380.15 "	" $1,208.32 "	" $3,851.51 "	" $5,034.66 "	" $5,034.66 "	" $1,913.17 "	" $3,171.84 "	" $4,279.46 "	" $3,322.88 "	" $4,027.73 "	" $1,208.32 "	" $4,531.19 "	" $4,093.18 "	" $4,279.46 "	" $1,198.25 "	" $4,093.18 "	" $1,208.32 "
5271424	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 10-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,040.34 "	" $3,528.24 "	" $1,199.60 "	" $5,040.34 "	" $4,385.10 "	" $1,209.68 "	" $3,855.86 "	" $5,040.34 "	" $5,040.34 "	" $1,915.33 "	" $3,175.41 "	" $4,284.29 "	" $3,326.62 "	" $4,032.27 "	" $1,209.68 "	" $4,536.31 "	" $4,097.80 "	" $4,284.29 "	" $1,199.60 "	" $4,097.80 "	" $1,209.68 "
5271425	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 12-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,091.48 "	" $3,564.04 "	" $1,211.77 "	" $5,091.48 "	" $4,429.59 "	" $1,221.96 "	" $3,894.98 "	" $5,091.48 "	" $5,091.48 "	" $1,934.76 "	" $3,207.63 "	" $4,327.76 "	" $3,360.38 "	" $4,073.18 "	" $1,221.96 "	" $4,582.33 "	" $4,139.37 "	" $4,327.76 "	" $1,211.77 "	" $4,139.37 "	" $1,221.96 "
5271426	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 12-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,105.69 "	" $3,573.98 "	" $1,215.15 "	" $5,105.69 "	" $4,441.95 "	" $1,225.37 "	" $3,905.85 "	" $5,105.69 "	" $5,105.69 "	" $1,940.16 "	" $3,216.58 "	" $4,339.84 "	" $3,369.76 "	" $4,084.55 "	" $1,225.37 "	" $4,595.12 "	" $4,150.93 "	" $4,339.84 "	" $1,215.15 "	" $4,150.93 "	" $1,225.37 "
5271427	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 14-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,151.15 "	" $3,605.81 "	" $1,225.97 "	" $5,151.15 "	" $4,481.50 "	" $1,236.28 "	" $3,940.63 "	" $5,151.15 "	" $5,151.15 "	" $1,957.44 "	" $3,245.22 "	" $4,378.48 "	" $3,399.76 "	" $4,120.92 "	" $1,236.28 "	" $4,636.04 "	" $4,187.88 "	" $4,378.48 "	" $1,225.97 "	" $4,187.88 "	" $1,236.28 "
5271428	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 14-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,162.51 "	" $3,613.76 "	" $1,228.68 "	" $5,162.51 "	" $4,491.38 "	" $1,239.00 "	" $3,949.32 "	" $5,162.51 "	" $5,162.51 "	" $1,961.75 "	" $3,252.38 "	" $4,388.13 "	" $3,407.26 "	" $4,130.01 "	" $1,239.00 "	" $4,646.26 "	" $4,197.12 "	" $4,388.13 "	" $1,228.68 "	" $4,197.12 "	" $1,239.00 "
5271429	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 6-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,213.65 "	" $3,649.56 "	" $1,240.85 "	" $5,213.65 "	" $4,535.88 "	" $1,251.28 "	" $3,988.44 "	" $5,213.65 "	" $5,213.65 "	" $1,981.19 "	" $3,284.60 "	" $4,431.60 "	" $3,441.01 "	" $4,170.92 "	" $1,251.28 "	" $4,692.29 "	" $4,238.70 "	" $4,431.60 "	" $1,240.85 "	" $4,238.70 "	" $1,251.28 "
5271430	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 16-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,330.14 "	" $3,731.10 "	" $1,268.57 "	" $5,330.14 "	" $4,637.22 "	" $1,279.23 "	" $4,077.56 "	" $5,330.14 "	" $5,330.14 "	" $2,025.45 "	" $3,357.99 "	" $4,530.62 "	" $3,517.89 "	" $4,264.11 "	" $1,279.23 "	" $4,797.13 "	" $4,333.40 "	" $4,530.62 "	" $1,268.57 "	" $4,333.40 "	" $1,279.23 "
5271431	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 16-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,344.35 "	" $3,741.05 "	" $1,271.96 "	" $5,344.35 "	" $4,649.58 "	" $1,282.64 "	" $4,088.43 "	" $5,344.35 "	" $5,344.35 "	" $2,030.85 "	" $3,366.94 "	" $4,542.70 "	" $3,527.27 "	" $4,275.48 "	" $1,282.64 "	" $4,809.92 "	" $4,344.96 "	" $4,542.70 "	" $1,271.96 "	" $4,344.96 "	" $1,282.64 "
5271432	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 18-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,520.51 "	" $3,864.36 "	" $1,313.88 "	" $5,520.51 "	" $4,802.84 "	" $1,324.92 "	" $4,223.19 "	" $5,520.51 "	" $5,520.51 "	" $2,097.79 "	" $3,477.92 "	" $4,692.43 "	" $3,643.54 "	" $4,416.41 "	" $1,324.92 "	" $4,968.46 "	" $4,488.17 "	" $4,692.43 "	" $1,313.88 "	" $4,488.17 "	" $1,324.92 "
5271433	HCHG CVMC BONE PLATE 3.5MM LCP PRX TIB PLATE 20-H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,702.34 "	" $3,991.64 "	" $1,357.16 "	" $5,702.34 "	" $4,961.04 "	" $1,368.56 "	" $4,362.29 "	" $5,702.34 "	" $5,702.34 "	" $2,166.89 "	" $3,592.47 "	" $4,846.99 "	" $3,763.54 "	" $4,561.87 "	" $1,368.56 "	" $5,132.11 "	" $4,636.00 "	" $4,846.99 "	" $1,357.16 "	" $4,636.00 "	" $1,368.56 "
5271434	HCHG CVMC BONE PLATE TIB PROX 4.5X106MM 4H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,872.71 "	" $3,410.90 "	" $1,159.70 "	" $4,872.71 "	" $4,239.26 "	" $1,169.45 "	" $3,727.62 "	" $4,872.71 "	" $4,872.71 "	" $1,851.63 "	" $3,069.81 "	" $4,141.80 "	" $3,215.99 "	" $3,898.17 "	" $1,169.45 "	" $4,385.44 "	" $3,961.51 "	" $4,141.80 "	" $1,159.70 "	" $3,961.51 "	" $1,169.45 "
5271435	HCHG CVMC BONE PLATE TIB PROX 4.5X4H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,907.12 "	" $3,434.98 "	" $1,167.89 "	" $4,907.12 "	" $4,269.19 "	" $1,177.71 "	" $3,753.95 "	" $4,907.12 "	" $4,907.12 "	" $1,864.71 "	" $3,091.49 "	" $4,171.05 "	" $3,238.70 "	" $3,925.70 "	" $1,177.71 "	" $4,416.41 "	" $3,989.49 "	" $4,171.05 "	" $1,167.89 "	" $3,989.49 "	" $1,177.71 "
5271436	HCHG CVMC BONE PLATE TIB PROX 4.5X142MM 6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,932.37 "	" $3,452.66 "	" $1,173.90 "	" $4,932.37 "	" $4,291.16 "	" $1,183.77 "	" $3,773.26 "	" $4,932.37 "	" $4,932.37 "	" $1,874.30 "	" $3,107.39 "	" $4,192.51 "	" $3,255.36 "	" $3,945.90 "	" $1,183.77 "	" $4,439.13 "	" $4,010.02 "	" $4,192.51 "	" $1,173.90 "	" $4,010.02 "	" $1,183.77 "
5271437	HCHG CVMC BONE PLATE TIB PROX 4.5X6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,935.21 "	" $3,454.65 "	" $1,174.58 "	" $4,935.21 "	" $4,293.63 "	" $1,184.45 "	" $3,775.44 "	" $4,935.21 "	" $4,935.21 "	" $1,875.38 "	" $3,109.18 "	" $4,194.93 "	" $3,257.24 "	" $3,948.17 "	" $1,184.45 "	" $4,441.69 "	" $4,012.33 "	" $4,194.93 "	" $1,174.58 "	" $4,012.33 "	" $1,184.45 "
5271438	HCHG CVMC BONE PLATE TIB PROX 4.5X178MM 8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,989.20 "	" $3,492.44 "	" $1,187.43 "	" $4,989.20 "	" $4,340.60 "	" $1,197.41 "	" $3,816.74 "	" $4,989.20 "	" $4,989.20 "	" $1,895.90 "	" $3,143.20 "	" $4,240.82 "	" $3,292.87 "	" $3,991.36 "	" $1,197.41 "	" $4,490.28 "	" $4,056.22 "	" $4,240.82 "	" $1,187.43 "	" $4,056.22 "	" $1,197.41 "
5271439	HCHG CVMC BONE PLATE TIB PROX 4.5X8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,992.04 "	" $3,494.43 "	" $1,188.11 "	" $4,992.04 "	" $4,343.07 "	" $1,198.09 "	" $3,818.91 "	" $4,992.04 "	" $4,992.04 "	" $1,896.98 "	" $3,144.99 "	" $4,243.23 "	" $3,294.75 "	" $3,993.63 "	" $1,198.09 "	" $4,492.84 "	" $4,058.53 "	" $4,243.23 "	" $1,188.11 "	" $4,058.53 "	" $1,198.09 "
5271440	HCHG CVMC BONE PLATE TIB PROX 4.5X214MM 10H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,043.18 "	" $3,530.23 "	" $1,200.28 "	" $5,043.18 "	" $4,387.57 "	" $1,210.36 "	" $3,858.03 "	" $5,043.18 "	" $5,043.18 "	" $1,916.41 "	" $3,177.20 "	" $4,286.70 "	" $3,328.50 "	" $4,034.54 "	" $1,210.36 "	" $4,538.86 "	" $4,100.11 "	" $4,286.70 "	" $1,200.28 "	" $4,100.11 "	" $1,210.36 "
5271441	HCHG CVMC BONE PLATE TIB PROX 4.5X10H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,046.02 "	" $3,532.21 "	" $1,200.95 "	" $5,046.02 "	" $4,390.04 "	" $1,211.04 "	" $3,860.21 "	" $5,046.02 "	" $5,046.02 "	" $1,917.49 "	" $3,178.99 "	" $4,289.12 "	" $3,330.37 "	" $4,036.82 "	" $1,211.04 "	" $4,541.42 "	" $4,102.41 "	" $4,289.12 "	" $1,200.95 "	" $4,102.41 "	" $1,211.04 "
5271442	HCHG CVMC BONE PLATE TIB PROX 4.5X12H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,102.85 "	" $3,572.00 "	" $1,214.48 "	" $5,102.85 "	" $4,439.48 "	" $1,224.68 "	" $3,903.68 "	" $5,102.85 "	" $5,102.85 "	" $1,939.08 "	" $3,214.80 "	" $4,337.42 "	" $3,367.88 "	" $4,082.28 "	" $1,224.68 "	" $4,592.57 "	" $4,148.62 "	" $4,337.42 "	" $1,214.48 "	" $4,148.62 "	" $1,224.68 "
5271443	HCHG CVMC BONE PLATE TIB PROX 4.5X250MM 12H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,105.69 "	" $3,573.98 "	" $1,215.15 "	" $5,105.69 "	" $4,441.95 "	" $1,225.37 "	" $3,905.85 "	" $5,105.69 "	" $5,105.69 "	" $1,940.16 "	" $3,216.58 "	" $4,339.84 "	" $3,369.76 "	" $4,084.55 "	" $1,225.37 "	" $4,595.12 "	" $4,150.93 "	" $4,339.84 "	" $1,215.15 "	" $4,150.93 "	" $1,225.37 "
5271444	HCHG CVMC BONE PLATE TIB PROX 4.5X14H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,159.67 "	" $3,611.77 "	" $1,228.00 "	" $5,159.67 "	" $4,488.91 "	" $1,238.32 "	" $3,947.15 "	" $5,159.67 "	" $5,159.67 "	" $1,960.67 "	" $3,250.59 "	" $4,385.72 "	" $3,405.38 "	" $4,127.74 "	" $1,238.32 "	" $4,643.70 "	" $4,194.81 "	" $4,385.72 "	" $1,228.00 "	" $4,194.81 "	" $1,238.32 "
5271445	HCHG CVMC BONE PLATE TIB PROX 4.5X286MM 14H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,162.51 "	" $3,613.76 "	" $1,228.68 "	" $5,162.51 "	" $4,491.38 "	" $1,239.00 "	" $3,949.32 "	" $5,162.51 "	" $5,162.51 "	" $1,961.75 "	" $3,252.38 "	" $4,388.13 "	" $3,407.26 "	" $4,130.01 "	" $1,239.00 "	" $4,646.26 "	" $4,197.12 "	" $4,388.13 "	" $1,228.68 "	" $4,197.12 "	" $1,239.00 "
5271446	HCHG CVMC BONE PLATE TIB PROX 4.5X322MM 16H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,213.65 "	" $3,649.56 "	" $1,240.85 "	" $5,213.65 "	" $4,535.88 "	" $1,251.28 "	" $3,988.44 "	" $5,213.65 "	" $5,213.65 "	" $1,981.19 "	" $3,284.60 "	" $4,431.60 "	" $3,441.01 "	" $4,170.92 "	" $1,251.28 "	" $4,692.29 "	" $4,238.70 "	" $4,431.60 "	" $1,240.85 "	" $4,238.70 "	" $1,251.28 "
5271447	HCHG CVMC BONE PLATE T 3H/3H 50MM RIGHT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,353.03 "	 $947.12 	 $322.02 	" $1,217.73 "	" $1,177.14 "	 $324.73 	" $1,035.07 "	 $-   	 $-   	 $514.15 	 $852.41 	" $1,150.08 "	 $893.00 	" $1,082.42 "	 $324.73 	" $1,217.73 "	" $1,100.01 "	" $1,150.08 "	 $322.02 	" $1,100.01 "	 $324.73 
5271448	HCHG CVMC BONE PLATE T 4H/4H 56MM RIGHT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,398.48 "	 $978.94 	 $332.84 	" $1,258.63 "	" $1,216.68 "	 $335.64 	" $1,069.84 "	 $-   	 $-   	 $531.42 	 $881.04 	" $1,188.71 "	 $923.00 	" $1,118.78 "	 $335.64 	" $1,258.63 "	" $1,136.96 "	" $1,188.71 "	 $332.84 	" $1,136.96 "	 $335.64 
5271449	HCHG CVMC BONE PLATE T 3H/3H 52MM OBLIQU R	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,517.35 "	" $1,062.15 "	 $361.13 	" $1,517.35 "	" $1,320.09 "	 $364.16 	" $1,160.77 "	" $1,517.35 "	 $-   	 $576.59 	 $955.93 	" $1,289.75 "	" $1,001.45 "	" $1,213.88 "	 $364.16 	" $1,365.62 "	" $1,233.61 "	" $1,289.75 "	 $361.13 	" $1,233.61 "	 $364.16 
5271450	HCHG CVMC BONE PLATE T 3H/5H 67MM RIGHT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,538.30 "	" $1,076.81 "	 $366.12 	" $1,538.30 "	" $1,338.32 "	 $369.19 	" $1,176.80 "	" $1,538.30 "	 $-   	 $584.55 	 $969.13 	" $1,307.56 "	" $1,015.28 "	" $1,230.64 "	 $369.19 	" $1,384.47 "	" $1,250.64 "	" $1,307.56 "	 $366.12 	" $1,250.64 "	 $369.19 
5271451	HCHG CVMC BONE PLATE T 3H/4H 63MM OBLIQU R	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,587.27 "	" $1,111.09 "	 $377.77 	" $1,587.27 "	" $1,380.92 "	 $380.94 	" $1,214.26 "	" $1,587.27 "	 $-   	 $603.16 	 $999.98 	" $1,349.18 "	" $1,047.60 "	" $1,269.82 "	 $380.94 	" $1,428.54 "	" $1,290.45 "	" $1,349.18 "	 $377.77 	" $1,290.45 "	 $380.94 
5271452	HCHG CVMC BONE PLATE T 3H/5H 74MM OBLIQU R	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,657.20 "	" $1,160.04 "	 $394.41 	" $1,657.20 "	" $1,441.76 "	 $397.73 	" $1,267.76 "	" $1,657.20 "	" $1,657.20 "	 $629.74 	" $1,044.04 "	" $1,408.62 "	" $1,093.75 "	" $1,325.76 "	 $397.73 	" $1,491.48 "	" $1,347.30 "	" $1,408.62 "	 $394.41 	" $1,347.30 "	 $397.73 
5271453	HCHG CVMC BONE PLATE T 4H/6H 78MM RIGHT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,793.55 "	" $1,255.49 "	 $426.86 	" $1,793.55 "	" $1,560.39 "	 $430.45 	" $1,372.07 "	" $1,793.55 "	" $1,793.55 "	 $681.55 	" $1,129.94 "	" $1,524.52 "	" $1,183.74 "	" $1,434.84 "	 $430.45 	" $1,614.20 "	" $1,458.16 "	" $1,524.52 "	 $426.86 	" $1,458.16 "	 $430.45 
5271454	HCHG CVMC BONE PLATE T 3H/7H 96MM OBLIQU R	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,800.54 "	" $1,260.38 "	 $428.53 	" $1,800.54 "	" $1,566.47 "	 $432.13 	" $1,377.41 "	" $1,800.54 "	" $1,800.54 "	 $684.21 	" $1,134.34 "	" $1,530.46 "	" $1,188.36 "	" $1,440.43 "	 $432.13 	" $1,620.49 "	" $1,463.84 "	" $1,530.46 "	 $428.53 	" $1,463.84 "	 $432.13 
5271455	HCHG CVMC BONE PLATE T 3H/7H 87MM RIGHT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,248.05 "	" $1,573.64 "	 $535.04 	" $2,248.05 "	" $1,955.80 "	 $539.53 	" $1,719.76 "	" $2,248.05 "	" $2,248.05 "	 $854.26 	" $1,416.27 "	" $1,910.84 "	" $1,483.71 "	" $1,798.44 "	 $539.53 	" $2,023.25 "	" $1,827.66 "	" $1,910.84 "	 $535.04 	" $1,827.66 "	 $539.53 
5271456	HCHG CVMC BONE PLATE 3.5MM LCP-T-PLATE 4H HEAD/ 3H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,349.53 "	 $944.67 	 $321.19 	" $1,214.58 "	" $1,174.09 "	 $323.89 	" $1,032.39 "	 $-   	 $-   	 $512.82 	 $850.20 	" $1,147.10 "	 $890.69 	" $1,079.62 "	 $323.89 	" $1,214.58 "	" $1,097.17 "	" $1,147.10 "	 $321.19 	" $1,097.17 "	 $323.89 
5271457	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 4H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,398.48 "	 $978.94 	 $332.84 	" $1,258.63 "	" $1,216.68 "	 $335.64 	" $1,069.84 "	 $-   	 $-   	 $531.42 	 $881.04 	" $1,188.71 "	 $923.00 	" $1,118.78 "	 $335.64 	" $1,258.63 "	" $1,136.96 "	" $1,188.71 "	 $332.84 	" $1,136.96 "	 $335.64 
5271458	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 4H HEAD/ 5H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,534.83 "	" $1,074.38 "	 $365.29 	" $1,534.83 "	" $1,335.30 "	 $368.36 	" $1,174.14 "	" $1,534.83 "	 $-   	 $583.24 	 $966.94 	" $1,304.61 "	" $1,012.99 "	" $1,227.86 "	 $368.36 	" $1,381.35 "	" $1,247.82 "	" $1,304.61 "	 $365.29 	" $1,247.82 "	 $368.36 
5271459	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,723.62 "	" $1,206.53 "	 $410.22 	" $1,723.62 "	" $1,499.55 "	 $413.67 	" $1,318.57 "	" $1,723.62 "	" $1,723.62 "	 $654.98 	" $1,085.88 "	" $1,465.08 "	" $1,137.59 "	" $1,378.90 "	 $413.67 	" $1,551.26 "	" $1,401.30 "	" $1,465.08 "	 $410.22 	" $1,401.30 "	 $413.67 
5271460	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,786.52 "	" $1,250.56 "	 $425.19 	" $1,786.52 "	" $1,554.27 "	 $428.76 	" $1,366.69 "	" $1,786.52 "	" $1,786.52 "	 $678.88 	" $1,125.51 "	" $1,518.54 "	" $1,179.10 "	" $1,429.22 "	 $428.76 	" $1,607.87 "	" $1,452.44 "	" $1,518.54 "	 $425.19 	" $1,452.44 "	 $428.76 
5271461	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,894.94 "	" $1,326.46 "	 $451.00 	" $1,894.94 "	" $1,648.60 "	 $454.79 	" $1,449.63 "	" $1,894.94 "	" $1,894.94 "	 $720.08 	" $1,193.81 "	" $1,610.70 "	" $1,250.66 "	" $1,515.95 "	 $454.79 	" $1,705.45 "	" $1,540.59 "	" $1,610.70 "	 $451.00 	" $1,540.59 "	 $454.79 
5271462	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 4H HEAD/ 7H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,237.56 "	" $1,566.29 "	 $532.54 	" $2,237.56 "	" $1,946.68 "	 $537.01 	" $1,711.73 "	" $2,237.56 "	" $2,237.56 "	 $850.27 	" $1,409.66 "	" $1,901.93 "	" $1,476.79 "	" $1,790.05 "	 $537.01 	" $2,013.80 "	" $1,819.14 "	" $1,901.93 "	 $532.54 	" $1,819.14 "	 $537.01 
5271463	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 4H HEAD/ 8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,601.17 "	" $1,820.82 "	 $619.08 	" $2,601.17 "	" $2,263.02 "	 $624.28 	" $1,989.90 "	" $2,601.17 "	" $2,601.17 "	 $988.44 	" $1,638.74 "	" $2,210.99 "	" $1,716.77 "	" $2,080.94 "	 $624.28 	" $2,341.05 "	" $2,114.75 "	" $2,210.99 "	 $619.08 	" $2,114.75 "	 $624.28 
5271464	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,611.66 "	" $1,828.16 "	 $621.58 	" $2,611.66 "	" $2,272.14 "	 $626.80 	" $1,997.92 "	" $2,611.66 "	" $2,611.66 "	 $992.43 	" $1,645.35 "	" $2,219.91 "	" $1,723.70 "	" $2,089.33 "	 $626.80 	" $2,350.49 "	" $2,123.28 "	" $2,219.91 "	 $621.58 	" $2,123.28 "	 $626.80 
5271465	HCHG CVMC BONE PLATE TUBULAR 1/3 3 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $932.40 	 $652.68 	 $221.91 	 $839.16 	 $811.19 	 $223.78 	 $713.29 	 $-   	 $-   	 $354.31 	 $587.41 	 $792.54 	 $615.38 	 $745.92 	 $223.78 	 $839.16 	 $758.04 	 $792.54 	 $221.91 	 $758.04 	 $223.78 
5271466	HCHG CVMC BONE PLATE TUBULAR 1/3 12H/141MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,198.06 "	 $838.64 	 $285.14 	" $1,078.25 "	" $1,042.31 "	 $287.53 	 $916.52 	 $-   	 $-   	 $455.26 	 $754.78 	" $1,018.35 "	 $790.72 	 $958.45 	 $287.53 	" $1,078.25 "	 $974.02 	" $1,018.35 "	 $285.14 	 $974.02 	 $287.53 
5271467	HCHG CVMC BONE PLATE PROX HUMERUS 3.5 3HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,225.02 "	" $3,657.51 "	" $1,243.55 "	" $5,225.02 "	" $4,545.77 "	" $1,254.00 "	" $3,997.14 "	" $5,225.02 "	" $5,225.02 "	" $1,985.51 "	" $3,291.76 "	" $4,441.27 "	" $3,448.51 "	" $4,180.02 "	" $1,254.00 "	" $4,702.52 "	" $4,247.94 "	" $4,441.27 "	" $1,243.55 "	" $4,247.94 "	" $1,254.00 "
5271468	HCHG CVMC BONE PLATE PROX HUMERUS 3.5 5HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,389.81 "	" $3,772.87 "	" $1,282.77 "	" $5,389.81 "	" $4,689.13 "	" $1,293.55 "	" $4,123.20 "	" $5,389.81 "	" $5,389.81 "	" $2,048.13 "	" $3,395.58 "	" $4,581.34 "	" $3,557.27 "	" $4,311.85 "	" $1,293.55 "	" $4,850.83 "	" $4,381.92 "	" $4,581.34 "	" $1,282.77 "	" $4,381.92 "	" $1,293.55 "
5271469	HCHG CVMC BONE PLATE 3.5MM LCP PROX HUM PLATE 5H LG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,440.95 "	" $3,808.67 "	" $1,294.95 "	" $5,440.95 "	" $4,733.63 "	" $1,305.83 "	" $4,162.33 "	" $5,440.95 "	" $5,440.95 "	" $2,067.56 "	" $3,427.80 "	" $4,624.81 "	" $3,591.03 "	" $4,352.76 "	" $1,305.83 "	" $4,896.86 "	" $4,423.49 "	" $4,624.81 "	" $1,294.95 "	" $4,423.49 "	" $1,305.83 "
5271470	HCHG CVMC BONE PLATE 3.5MM LCP PROX HUM PLATE 6H LG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,656.88 "	" $3,959.82 "	" $1,346.34 "	" $5,656.88 "	" $4,921.49 "	" $1,357.65 "	" $4,327.51 "	" $5,656.88 "	" $5,656.88 "	" $2,149.61 "	" $3,563.83 "	" $4,808.35 "	" $3,733.54 "	" $4,525.50 "	" $1,357.65 "	" $5,091.19 "	" $4,599.04 "	" $4,808.35 "	" $1,346.34 "	" $4,599.04 "	" $1,357.65 "
5271471	HCHG CVMC BONE PLATE 3.5MM LCP PROX HUM PLATE 8H LG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,875.66 "	" $4,112.96 "	" $1,398.41 "	" $5,875.66 "	" $5,111.82 "	" $1,410.16 "	" $4,494.88 "	" $5,875.66 "	" $5,875.66 "	" $2,232.75 "	" $3,701.67 "	" $4,994.31 "	" $3,877.94 "	" $4,700.53 "	" $1,410.16 "	" $5,288.09 "	" $4,776.91 "	" $4,994.31 "	" $1,398.41 "	" $4,776.91 "	" $1,410.16 "
5271472	HCHG CVMC BONE PLATE 3.5MM LCP PROX HUM PLATE 10H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,094.43 "	" $4,266.10 "	" $1,450.47 "	" $6,094.43 "	" $5,302.15 "	" $1,462.66 "	" $4,662.24 "	" $6,094.43 "	" $6,094.43 "	" $2,315.88 "	" $3,839.49 "	" $5,180.27 "	" $4,022.32 "	" $4,875.54 "	" $1,462.66 "	" $5,484.99 "	" $4,954.77 "	" $5,180.27 "	" $1,450.47 "	" $4,954.77 "	" $1,462.66 "
5271473	HCHG CVMC BONE PLATE 3.5MM LCP PROX HUM PLATE 12H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,307.53 "	" $4,415.27 "	" $1,501.19 "	" $6,307.53 "	" $5,487.55 "	" $1,513.81 "	" $4,825.26 "	" $6,307.53 "	" $6,307.53 "	" $2,396.86 "	" $3,973.74 "	" $5,361.40 "	" $4,162.97 "	" $5,046.02 "	" $1,513.81 "	" $5,676.78 "	" $5,128.02 "	" $5,361.40 "	" $1,501.19 "	" $5,128.02 "	" $1,513.81 "
5271474	HCHG CVMC BONE PLATE T 3H/3H 52MM OBLIQU L	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,520.84 "	" $1,064.59 "	 $361.96 	" $1,520.84 "	" $1,323.13 "	 $365.00 	" $1,163.44 "	" $1,520.84 "	 $-   	 $577.92 	 $958.13 	" $1,292.71 "	" $1,003.75 "	" $1,216.67 "	 $365.00 	" $1,368.76 "	" $1,236.44 "	" $1,292.71 "	 $361.96 	" $1,236.44 "	 $365.00 
5271475	HCHG CVMC BONE PLATE T 3H/4H 63MM OBLIQU L	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,594.26 "	" $1,115.98 "	 $379.43 	" $1,594.26 "	" $1,387.01 "	 $382.62 	" $1,219.61 "	" $1,594.26 "	 $-   	 $605.82 	" $1,004.38 "	" $1,355.12 "	" $1,052.21 "	" $1,275.41 "	 $382.62 	" $1,434.83 "	" $1,296.13 "	" $1,355.12 "	 $379.43 	" $1,296.13 "	 $382.62 
5271476	HCHG CVMC BONE PLATE T 3H/5H 74MM OBLIQU L	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,664.19 "	" $1,164.93 "	 $396.08 	" $1,664.19 "	" $1,447.85 "	 $399.41 	" $1,273.11 "	" $1,664.19 "	" $1,664.19 "	 $632.39 	" $1,048.44 "	" $1,414.56 "	" $1,098.37 "	" $1,331.35 "	 $399.41 	" $1,497.77 "	" $1,352.99 "	" $1,414.56 "	 $396.08 	" $1,352.99 "	 $399.41 
5271477	HCHG CVMC BONE PLATE T 3H/7H 96MM OBLIQU L	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,804.05 "	" $1,262.84 "	 $429.36 	" $1,804.05 "	" $1,569.52 "	 $432.97 	" $1,380.10 "	" $1,804.05 "	" $1,804.05 "	 $685.54 	" $1,136.55 "	" $1,533.44 "	" $1,190.67 "	" $1,443.24 "	 $432.97 	" $1,623.65 "	" $1,466.69 "	" $1,533.44 "	 $429.36 	" $1,466.69 "	 $432.97 
5271478	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,730.62 "	" $1,211.43 "	 $411.89 	" $1,730.62 "	" $1,505.64 "	 $415.35 	" $1,323.92 "	" $1,730.62 "	" $1,730.62 "	 $657.64 	" $1,090.29 "	" $1,471.03 "	" $1,142.21 "	" $1,384.50 "	 $415.35 	" $1,557.56 "	" $1,406.99 "	" $1,471.03 "	 $411.89 	" $1,406.99 "	 $415.35 
5271479	HCHG CVMC BONE PLATE 3.5MM LCP T-PLATE 3H HEAD/ 8H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,901.93 "	" $1,331.35 "	 $452.66 	" $1,901.93 "	" $1,654.68 "	 $456.46 	" $1,454.98 "	" $1,901.93 "	" $1,901.93 "	 $722.73 	" $1,198.22 "	" $1,616.64 "	" $1,255.27 "	" $1,521.54 "	 $456.46 	" $1,711.74 "	" $1,546.27 "	" $1,616.64 "	 $452.66 	" $1,546.27 "	 $456.46 
5271480	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 2 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,781.79 "	" $3,347.25 "	" $1,138.07 "	" $4,781.79 "	" $4,160.16 "	" $1,147.63 "	" $3,658.07 "	" $4,781.79 "	" $4,781.79 "	" $1,817.08 "	" $3,012.53 "	" $4,064.52 "	" $3,155.98 "	" $3,825.43 "	" $1,147.63 "	" $4,303.61 "	" $3,887.60 "	" $4,064.52 "	" $1,138.07 "	" $3,887.60 "	" $1,147.63 "
5271481	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 4 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,875.55 "	" $3,412.89 "	" $1,160.38 "	" $4,875.55 "	" $4,241.73 "	" $1,170.13 "	" $3,729.80 "	" $4,875.55 "	" $4,875.55 "	" $1,852.71 "	" $3,071.60 "	" $4,144.22 "	" $3,217.86 "	" $3,900.44 "	" $1,170.13 "	" $4,388.00 "	" $3,963.82 "	" $4,144.22 "	" $1,160.38 "	" $3,963.82 "	" $1,170.13 "
5271482	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 6 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,969.31 "	" $3,478.52 "	" $1,182.70 "	" $4,969.31 "	" $4,323.30 "	" $1,192.63 "	" $3,801.52 "	" $4,969.31 "	" $4,969.31 "	" $1,888.34 "	" $3,130.67 "	" $4,223.91 "	" $3,279.74 "	" $3,975.45 "	" $1,192.63 "	" $4,472.38 "	" $4,040.05 "	" $4,223.91 "	" $1,182.70 "	" $4,040.05 "	" $1,192.63 "
5271483	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 8 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,216.49 "	" $3,651.54 "	" $1,241.52 "	" $5,216.49 "	" $4,538.35 "	" $1,251.96 "	" $3,990.61 "	" $5,216.49 "	" $5,216.49 "	" $1,982.27 "	" $3,286.39 "	" $4,434.02 "	" $3,442.88 "	" $4,173.19 "	" $1,251.96 "	" $4,694.84 "	" $4,241.01 "	" $4,434.02 "	" $1,241.52 "	" $4,241.01 "	" $1,251.96 "
5271484	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,540.39 "	" $3,878.27 "	" $1,318.61 "	" $5,540.39 "	" $4,820.14 "	" $1,329.69 "	" $4,238.40 "	" $5,540.39 "	" $5,540.39 "	" $2,105.35 "	" $3,490.45 "	" $4,709.33 "	" $3,656.66 "	" $4,432.31 "	" $1,329.69 "	" $4,986.35 "	" $4,504.34 "	" $4,709.33 "	" $1,318.61 "	" $4,504.34 "	" $1,329.69 "
5271485	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 10	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,588.70 "	" $3,912.09 "	" $1,330.11 "	" $5,588.70 "	" $4,862.17 "	" $1,341.29 "	" $4,275.36 "	" $5,588.70 "	" $5,588.70 "	" $2,123.71 "	" $3,520.88 "	" $4,750.40 "	" $3,688.54 "	" $4,470.96 "	" $1,341.29 "	" $5,029.83 "	" $4,543.61 "	" $4,750.40 "	" $1,330.11 "	" $4,543.61 "	" $1,341.29 "
5271486	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,617.11 "	" $3,931.98 "	" $1,336.87 "	" $5,617.11 "	" $4,886.89 "	" $1,348.11 "	" $4,297.09 "	" $5,617.11 "	" $5,617.11 "	" $2,134.50 "	" $3,538.78 "	" $4,774.54 "	" $3,707.29 "	" $4,493.69 "	" $1,348.11 "	" $5,055.40 "	" $4,566.71 "	" $4,774.54 "	" $1,336.87 "	" $4,566.71 "	" $1,348.11 "
5271487	HCHG CVMC 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,702.34 "	" $3,991.64 "	" $1,357.16 "	" $5,702.34 "	" $4,961.04 "	" $1,368.56 "	" $4,362.29 "	" $5,702.34 "	" $5,702.34 "	" $2,166.89 "	" $3,592.47 "	" $4,846.99 "	" $3,763.54 "	" $4,561.87 "	" $1,368.56 "	" $5,132.11 "	" $4,636.00 "	" $4,846.99 "	" $1,357.16 "	" $4,636.00 "	" $1,368.56 "
5271488	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,915.44 "	" $4,140.81 "	" $1,407.87 "	" $5,915.44 "	" $5,146.43 "	" $1,419.71 "	" $4,525.31 "	" $5,915.44 "	" $5,915.44 "	" $2,247.87 "	" $3,726.73 "	" $5,028.12 "	" $3,904.19 "	" $4,732.35 "	" $1,419.71 "	" $5,323.90 "	" $4,809.25 "	" $5,028.12 "	" $1,407.87 "	" $4,809.25 "	" $1,419.71 "
5271489	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 12	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,918.28 "	" $4,142.80 "	" $1,408.55 "	" $5,918.28 "	" $5,148.90 "	" $1,420.39 "	" $4,527.48 "	" $5,918.28 "	" $5,918.28 "	" $2,248.95 "	" $3,728.52 "	" $5,030.54 "	" $3,906.06 "	" $4,734.62 "	" $1,420.39 "	" $5,326.45 "	" $4,811.56 "	" $5,030.54 "	" $1,408.55 "	" $4,811.56 "	" $1,420.39 "
5271490	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,219.45 "	" $4,353.62 "	" $1,480.23 "	" $6,219.45 "	" $5,410.92 "	" $1,492.67 "	" $4,757.88 "	" $6,219.45 "	" $6,219.45 "	" $2,363.39 "	" $3,918.25 "	" $5,286.53 "	" $4,104.84 "	" $4,975.56 "	" $1,492.67 "	" $5,597.51 "	" $5,056.41 "	" $5,286.53 "	" $1,480.23 "	" $5,056.41 "	" $1,492.67 "
5271491	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 14	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,392.76 "	" $4,474.93 "	" $1,521.48 "	" $6,392.76 "	" $5,561.70 "	" $1,534.26 "	" $4,890.46 "	" $6,392.76 "	" $6,392.76 "	" $2,429.25 "	" $4,027.44 "	" $5,433.85 "	" $4,219.22 "	" $5,114.21 "	" $1,534.26 "	" $5,753.48 "	" $5,197.31 "	" $5,433.85 "	" $1,521.48 "	" $5,197.31 "	" $1,534.26 "
5271492	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,421.18 "	" $4,494.83 "	" $1,528.24 "	" $6,421.18 "	" $5,586.43 "	" $1,541.08 "	" $4,912.20 "	" $6,421.18 "	" $6,421.18 "	" $2,440.05 "	" $4,045.34 "	" $5,458.00 "	" $4,237.98 "	" $5,136.94 "	" $1,541.08 "	" $5,779.06 "	" $5,220.42 "	" $5,458.00 "	" $1,528.24 "	" $5,220.42 "	" $1,541.08 "
5271493	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,495.05 "	" $4,546.54 "	" $1,545.82 "	" $6,495.05 "	" $5,650.69 "	" $1,558.81 "	" $4,968.71 "	" $6,495.05 "	" $6,495.05 "	" $2,468.12 "	" $4,091.88 "	" $5,520.79 "	" $4,286.73 "	" $5,196.04 "	" $1,558.81 "	" $5,845.55 "	" $5,280.48 "	" $5,520.79 "	" $1,545.82 "	" $5,280.48 "	" $1,558.81 "
5271494	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 16	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,585.97 "	" $4,610.18 "	" $1,567.46 "	" $6,585.97 "	" $5,729.79 "	" $1,580.63 "	" $5,038.27 "	" $6,585.97 "	" $6,585.97 "	" $2,502.67 "	" $4,149.16 "	" $5,598.07 "	" $4,346.74 "	" $5,268.78 "	" $1,580.63 "	" $5,927.37 "	" $5,354.39 "	" $5,598.07 "	" $1,567.46 "	" $5,354.39 "	" $1,580.63 "
5271495	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR HOOK PLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,710.98 "	" $4,697.69 "	" $1,597.21 "	" $6,710.98 "	" $5,838.55 "	" $1,610.64 "	" $5,133.90 "	" $6,710.98 "	" $6,710.98 "	" $2,550.17 "	" $4,227.92 "	" $5,704.33 "	" $4,429.25 "	" $5,368.78 "	" $1,610.64 "	" $6,039.88 "	" $5,456.03 "	" $5,704.33 "	" $1,597.21 "	" $5,456.03 "	" $1,610.64 "
5271496	HCHG CVMC BONE PLATE VOLAR DIST RAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,375.51 "	" $2,362.86 "	 $803.37 	" $3,375.51 "	" $2,936.69 "	 $810.12 	" $2,582.27 "	" $3,375.51 "	" $3,375.51 "	" $1,282.69 "	" $2,126.57 "	" $2,869.18 "	" $2,227.84 "	" $2,700.41 "	 $810.12 	" $3,037.96 "	" $2,744.29 "	" $2,869.18 "	 $803.37 	" $2,744.29 "	 $810.12 
5271497	HCHG CVMC BONE PLATE VOLAR DIST RAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,573.11 "	" $2,501.18 "	 $850.40 	" $3,573.11 "	" $3,108.61 "	 $857.55 	" $2,733.43 "	" $3,573.11 "	" $3,573.11 "	" $1,357.78 "	" $2,251.06 "	" $3,037.14 "	" $2,358.25 "	" $2,858.49 "	 $857.55 	" $3,215.80 "	" $2,904.94 "	" $3,037.14 "	 $850.40 	" $2,904.94 "	 $857.55 
5271498	HCHG CVMC BONE PLATE 2.4MM LCP DIST RAD PLATE ST/5H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,925.01 "	" $1,347.51 "	 $458.15 	" $1,925.01 "	" $1,674.76 "	 $462.00 	" $1,472.63 "	" $1,925.01 "	" $1,925.01 "	 $731.50 	" $1,212.76 "	" $1,636.26 "	" $1,270.51 "	" $1,540.01 "	 $462.00 	" $1,732.51 "	" $1,565.03 "	" $1,636.26 "	 $458.15 	" $1,565.03 "	 $462.00 
5271499	HCHG CVMC BONE PLATE 2.4MM LCP DIST RAD PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,922.91 "	" $1,346.04 "	 $457.65 	" $1,922.91 "	" $1,672.93 "	 $461.50 	" $1,471.03 "	" $1,922.91 "	" $1,922.91 "	 $730.71 	" $1,211.43 "	" $1,634.47 "	" $1,269.12 "	" $1,538.33 "	 $461.50 	" $1,730.62 "	" $1,563.33 "	" $1,634.47 "	 $457.65 	" $1,563.33 "	 $461.50 
5271500	HCHG CVMC BONE PLATE 2.4MM LCP DIST RAD T-PLATE 4H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,006.82 "	" $1,404.77 "	 $477.62 	" $2,006.82 "	" $1,745.93 "	 $481.64 	" $1,535.22 "	" $2,006.82 "	" $2,006.82 "	 $762.59 	" $1,264.30 "	" $1,705.80 "	" $1,324.50 "	" $1,605.46 "	 $481.64 	" $1,806.14 "	" $1,631.54 "	" $1,705.80 "	 $477.62 	" $1,631.54 "	 $481.64 
5271501	HCHG CVMC BONE PLATE 2.4MM DIST RAD L-PLATE/-90 2/3	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,859.98 "	" $1,301.99 "	 $442.68 	" $1,859.98 "	" $1,618.18 "	 $446.40 	" $1,422.88 "	" $1,859.98 "	" $1,859.98 "	 $706.79 	" $1,171.79 "	" $1,580.98 "	" $1,227.59 "	" $1,487.98 "	 $446.40 	" $1,673.98 "	" $1,512.16 "	" $1,580.98 "	 $442.68 	" $1,512.16 "	 $446.40 
5271502	HCHG CVMC BONE PLATE 2.4MM DIST RAD L-PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,954.37 "	" $1,368.06 "	 $465.14 	" $1,954.37 "	" $1,700.30 "	 $469.05 	" $1,495.09 "	" $1,954.37 "	" $1,954.37 "	 $742.66 	" $1,231.25 "	" $1,661.21 "	" $1,289.88 "	" $1,563.50 "	 $469.05 	" $1,758.93 "	" $1,588.90 "	" $1,661.21 "	 $465.14 	" $1,588.90 "	 $469.05 
5271503	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 2 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,781.79 "	" $3,347.25 "	" $1,138.07 "	" $4,781.79 "	" $4,160.16 "	" $1,147.63 "	" $3,658.07 "	" $4,781.79 "	" $4,781.79 "	" $1,817.08 "	" $3,012.53 "	" $4,064.52 "	" $3,155.98 "	" $3,825.43 "	" $1,147.63 "	" $4,303.61 "	" $3,887.60 "	" $4,064.52 "	" $1,138.07 "	" $3,887.60 "	" $1,147.63 "
5271504	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 4 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,875.55 "	" $3,412.89 "	" $1,160.38 "	" $4,875.55 "	" $4,241.73 "	" $1,170.13 "	" $3,729.80 "	" $4,875.55 "	" $4,875.55 "	" $1,852.71 "	" $3,071.60 "	" $4,144.22 "	" $3,217.86 "	" $3,900.44 "	" $1,170.13 "	" $4,388.00 "	" $3,963.82 "	" $4,144.22 "	" $1,160.38 "	" $3,963.82 "	" $1,170.13 "
5271505	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 6 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,969.31 "	" $3,478.52 "	" $1,182.70 "	" $4,969.31 "	" $4,323.30 "	" $1,192.63 "	" $3,801.52 "	" $4,969.31 "	" $4,969.31 "	" $1,888.34 "	" $3,130.67 "	" $4,223.91 "	" $3,279.74 "	" $3,975.45 "	" $1,192.63 "	" $4,472.38 "	" $4,040.05 "	" $4,223.91 "	" $1,182.70 "	" $4,040.05 "	" $1,192.63 "
5271506	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 8 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,216.49 "	" $3,651.54 "	" $1,241.52 "	" $5,216.49 "	" $4,538.35 "	" $1,251.96 "	" $3,990.61 "	" $5,216.49 "	" $5,216.49 "	" $1,982.27 "	" $3,286.39 "	" $4,434.02 "	" $3,442.88 "	" $4,173.19 "	" $1,251.96 "	" $4,694.84 "	" $4,241.01 "	" $4,434.02 "	" $1,241.52 "	" $4,241.01 "	" $1,251.96 "
5271507	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 10	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,588.70 "	" $3,912.09 "	" $1,330.11 "	" $5,588.70 "	" $4,862.17 "	" $1,341.29 "	" $4,275.36 "	" $5,588.70 "	" $5,588.70 "	" $2,123.71 "	" $3,520.88 "	" $4,750.40 "	" $3,688.54 "	" $4,470.96 "	" $1,341.29 "	" $5,029.83 "	" $4,543.61 "	" $4,750.40 "	" $1,330.11 "	" $4,543.61 "	" $1,341.29 "
5271508	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 12	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,918.28 "	" $4,142.80 "	" $1,408.55 "	" $5,918.28 "	" $5,148.90 "	" $1,420.39 "	" $4,527.48 "	" $5,918.28 "	" $5,918.28 "	" $2,248.95 "	" $3,728.52 "	" $5,030.54 "	" $3,906.06 "	" $4,734.62 "	" $1,420.39 "	" $5,326.45 "	" $4,811.56 "	" $5,030.54 "	" $1,408.55 "	" $4,811.56 "	" $1,420.39 "
5271509	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 14	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,392.76 "	" $4,474.93 "	" $1,521.48 "	" $6,392.76 "	" $5,561.70 "	" $1,534.26 "	" $4,890.46 "	" $6,392.76 "	" $6,392.76 "	" $2,429.25 "	" $4,027.44 "	" $5,433.85 "	" $4,219.22 "	" $5,114.21 "	" $1,534.26 "	" $5,753.48 "	" $5,197.31 "	" $5,433.85 "	" $1,521.48 "	" $5,197.31 "	" $1,534.26 "
5271510	HCHG CVMC BONE PLATE 4.5MM LCP PROX FEMUR PLATE 16	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,585.97 "	" $4,610.18 "	" $1,567.46 "	" $6,585.97 "	" $5,729.79 "	" $1,580.63 "	" $5,038.27 "	" $6,585.97 "	" $6,585.97 "	" $2,502.67 "	" $4,149.16 "	" $5,598.07 "	" $4,346.74 "	" $5,268.78 "	" $1,580.63 "	" $5,927.37 "	" $5,354.39 "	" $5,598.07 "	" $1,567.46 "	" $5,354.39 "	" $1,580.63 "
5271511	HCHG CVMC BONE PLATE 2.0MM LC-DCP PLATE 4 HL/27MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,317.87 "	 $922.51 	 $313.65 	" $1,186.08 "	" $1,146.55 "	 $316.29 	" $1,008.17 "	 $-   	 $-   	 $500.79 	 $830.26 	" $1,120.19 "	 $869.79 	" $1,054.30 "	 $316.29 	" $1,186.08 "	" $1,071.43 "	" $1,120.19 "	 $313.65 	" $1,071.43 "	 $316.29 
5271512	HCHG CVMC BONE PLATE 2.0MM LC-DCP PLATE 6 HL/39MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,547.06 "	" $1,082.94 "	 $368.20 	" $1,547.06 "	" $1,345.94 "	 $371.29 	" $1,183.50 "	" $1,547.06 "	 $-   	 $587.88 	 $974.65 	" $1,315.00 "	" $1,021.06 "	" $1,237.65 "	 $371.29 	" $1,392.35 "	" $1,257.76 "	" $1,315.00 "	 $368.20 	" $1,257.76 "	 $371.29 
5271513	HCHG CVMC BONE PLATE 2.0MM CNDLR PLATE 7 HL/39MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,573.10 "	" $1,101.17 "	 $374.40 	" $1,573.10 "	" $1,368.60 "	 $377.54 	" $1,203.42 "	" $1,573.10 "	 $-   	 $597.78 	 $991.05 	" $1,337.14 "	" $1,038.25 "	" $1,258.48 "	 $377.54 	" $1,415.79 "	" $1,278.93 "	" $1,337.14 "	 $374.40 	" $1,278.93 "	 $377.54 
5271514	HCHG CVMC BONE PLATE 2.0MM LCP-DCP PLATE 12 HL/71MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,619.99 "	" $1,133.99 "	 $385.56 	" $1,619.99 "	" $1,409.39 "	 $388.80 	" $1,239.29 "	" $1,619.99 "	" $1,619.99 "	 $615.60 	" $1,020.59 "	" $1,376.99 "	" $1,069.19 "	" $1,295.99 "	 $388.80 	" $1,457.99 "	" $1,317.05 "	" $1,376.99 "	 $385.56 	" $1,317.05 "	 $388.80 
5271515	HCHG CVMC BONE PLATE 2.0MM LC-DCP PLATE 8 HL/51MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,192.20 "	 $834.54 	 $283.74 	" $1,072.98 "	" $1,037.21 "	 $286.13 	 $912.03 	 $-   	 $-   	 $453.04 	 $751.09 	" $1,013.37 "	 $786.85 	 $953.76 	 $286.13 	" $1,072.98 "	 $969.26 	" $1,013.37 "	 $283.74 	 $969.26 	 $286.13 
5271516	HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 4 HL/56M	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,839.00 "	" $1,287.30 "	 $437.68 	" $1,839.00 "	" $1,599.93 "	 $441.36 	" $1,406.84 "	" $1,839.00 "	" $1,839.00 "	 $698.82 	" $1,158.57 "	" $1,563.15 "	" $1,213.74 "	" $1,471.20 "	 $441.36 	" $1,655.10 "	" $1,495.11 "	" $1,563.15 "	 $437.68 	" $1,495.11 "	 $441.36 
5271517	HCHG CVMC BONE PLATE RECON 3.5MM 5H/70	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,852.98 "	" $1,297.09 "	 $441.01 	" $1,852.98 "	" $1,612.09 "	 $444.72 	" $1,417.53 "	" $1,852.98 "	" $1,852.98 "	 $704.13 	" $1,167.38 "	" $1,575.03 "	" $1,222.97 "	" $1,482.38 "	 $444.72 	" $1,667.68 "	" $1,506.47 "	" $1,575.03 "	 $441.01 	" $1,506.47 "	 $444.72 
5271518	HCHG CVMC BONE PLATE RECON 3.5MM 6H/84	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,143.17 "	" $1,500.22 "	 $510.07 	" $2,143.17 "	" $1,864.56 "	 $514.36 	" $1,639.53 "	" $2,143.17 "	" $2,143.17 "	 $814.40 	" $1,350.20 "	" $1,821.69 "	" $1,414.49 "	" $1,714.54 "	 $514.36 	" $1,928.85 "	" $1,742.40 "	" $1,821.69 "	 $510.07 	" $1,742.40 "	 $514.36 
5271519	HCHG CVMC BONE PLATE RECON 3.5MM 7H/98	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,251.55 "	" $1,576.09 "	 $535.87 	" $2,251.55 "	" $1,958.85 "	 $540.37 	" $1,722.44 "	" $2,251.55 "	" $2,251.55 "	 $855.59 	" $1,418.48 "	" $1,913.82 "	" $1,486.02 "	" $1,801.24 "	 $540.37 	" $2,026.40 "	" $1,830.51 "	" $1,913.82 "	 $535.87 	" $1,830.51 "	 $540.37 
5271520	HCHG CVMC BONE PLATE RECON 3.5MM 8H/112	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,349.44 "	" $1,644.61 "	 $559.17 	" $2,349.44 "	" $2,044.01 "	 $563.87 	" $1,797.32 "	" $2,349.44 "	" $2,349.44 "	 $892.79 	" $1,480.15 "	" $1,997.02 "	" $1,550.63 "	" $1,879.55 "	 $563.87 	" $2,114.50 "	" $1,910.09 "	" $1,997.02 "	 $559.17 	" $1,910.09 "	 $563.87 
5271521	HCHG CVMC BONE PLATE RECON 3.5MM 9H/126	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,401.89 "	" $1,681.32 "	 $571.65 	" $2,401.89 "	" $2,089.64 "	 $576.45 	" $1,837.45 "	" $2,401.89 "	" $2,401.89 "	 $912.72 	" $1,513.19 "	" $2,041.61 "	" $1,585.25 "	" $1,921.51 "	 $576.45 	" $2,161.70 "	" $1,952.74 "	" $2,041.61 "	 $571.65 	" $1,952.74 "	 $576.45 
5271522	HCHG CVMC BONE PLATE RECON 3.5MM 10H/140	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,433.35 "	" $1,703.35 "	 $579.14 	" $2,433.35 "	" $2,117.01 "	 $584.00 	" $1,861.51 "	" $2,433.35 "	" $2,433.35 "	 $924.67 	" $1,533.01 "	" $2,068.35 "	" $1,606.01 "	" $1,946.68 "	 $584.00 	" $2,190.02 "	" $1,978.31 "	" $2,068.35 "	 $579.14 	" $1,978.31 "	 $584.00 
5271523	HCHG CVMC BONE PLATE RECON 3.5MM 11H/155	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,555.72 "	" $1,789.00 "	 $608.26 	" $2,555.72 "	" $2,223.48 "	 $613.37 	" $1,955.13 "	" $2,555.72 "	" $2,555.72 "	 $971.17 	" $1,610.10 "	" $2,172.36 "	" $1,686.78 "	" $2,044.58 "	 $613.37 	" $2,300.15 "	" $2,077.80 "	" $2,172.36 "	 $608.26 	" $2,077.80 "	 $613.37 
5271524	HCHG CVMC BONE PLATE RECON 3.5MM 12H/168	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,643.12 "	" $1,850.18 "	 $629.06 	" $2,643.12 "	" $2,299.51 "	 $634.35 	" $2,021.99 "	" $2,643.12 "	" $2,643.12 "	" $1,004.39 "	" $1,665.17 "	" $2,246.65 "	" $1,744.46 "	" $2,114.50 "	 $634.35 	" $2,378.81 "	" $2,148.86 "	" $2,246.65 "	 $629.06 	" $2,148.86 "	 $634.35 
5271525	HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 13 HL/18	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,779.47 "	" $1,945.63 "	 $661.51 	" $2,779.47 "	" $2,418.14 "	 $667.07 	" $2,126.29 "	" $2,779.47 "	" $2,779.47 "	" $1,056.20 "	" $1,751.07 "	" $2,362.55 "	" $1,834.45 "	" $2,223.58 "	 $667.07 	" $2,501.52 "	" $2,259.71 "	" $2,362.55 "	 $661.51 	" $2,259.71 "	 $667.07 
5271526	HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 14 HL/19	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,887.86 "	" $2,021.50 "	 $687.31 	" $2,887.86 "	" $2,512.44 "	 $693.09 	" $2,209.21 "	" $2,887.86 "	" $2,887.86 "	" $1,097.39 "	" $1,819.35 "	" $2,454.68 "	" $1,905.99 "	" $2,310.29 "	 $693.09 	" $2,599.07 "	" $2,347.83 "	" $2,454.68 "	 $687.31 	" $2,347.83 "	 $693.09 
5271527	HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 16 HL/22	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,129.09 "	" $2,190.36 "	 $744.72 	" $3,129.09 "	" $2,722.31 "	 $750.98 	" $2,393.75 "	" $3,129.09 "	" $3,129.09 "	" $1,189.05 "	" $1,971.33 "	" $2,659.73 "	" $2,065.20 "	" $2,503.27 "	 $750.98 	" $2,816.18 "	" $2,543.95 "	" $2,659.73 "	 $744.72 	" $2,543.95 "	 $750.98 
5271528	HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 18 HL/25	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,277.57 "	" $2,294.30 "	 $780.06 	" $3,277.57 "	" $2,851.49 "	 $786.62 	" $2,507.34 "	" $3,277.57 "	" $3,277.57 "	" $1,245.48 "	" $2,064.87 "	" $2,785.93 "	" $2,163.20 "	" $2,622.06 "	 $786.62 	" $2,949.81 "	" $2,664.66 "	" $2,785.93 "	 $780.06 	" $2,664.66 "	 $786.62 
5271529	HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 20 HL/28	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,236.16 "	" $2,265.31 "	 $770.21 	" $3,236.16 "	" $2,815.46 "	 $776.68 	" $2,475.66 "	" $3,236.16 "	" $3,236.16 "	" $1,229.74 "	" $2,038.78 "	" $2,750.74 "	" $2,135.87 "	" $2,588.93 "	 $776.68 	" $2,912.54 "	" $2,631.00 "	" $2,750.74 "	 $770.21 	" $2,631.00 "	 $776.68 
5271530	HCHG CVMC BONE PLATE 3.5MM LCP RECON PLATE 22 HL/30	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,358.33 "	" $2,350.83 "	 $799.28 	" $3,358.33 "	" $2,921.75 "	 $806.00 	" $2,569.12 "	" $3,358.33 "	" $3,358.33 "	" $1,276.17 "	" $2,115.75 "	" $2,854.58 "	" $2,216.50 "	" $2,686.66 "	 $806.00 	" $3,022.50 "	" $2,730.32 "	" $2,854.58 "	 $799.28 	" $2,730.32 "	 $806.00 
5271531	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 4 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,727.03 "	" $1,908.92 "	 $649.03 	" $2,727.03 "	" $2,372.52 "	 $654.49 	" $2,086.18 "	" $2,727.03 "	" $2,727.03 "	" $1,036.27 "	" $1,718.03 "	" $2,317.98 "	" $1,799.84 "	" $2,181.62 "	 $654.49 	" $2,454.33 "	" $2,217.08 "	" $2,317.98 "	 $649.03 	" $2,217.08 "	 $654.49 
5271532	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 6 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,950.79 "	" $2,065.55 "	 $702.29 	" $2,950.79 "	" $2,567.19 "	 $708.19 	" $2,257.35 "	" $2,950.79 "	" $2,950.79 "	" $1,121.30 "	" $1,859.00 "	" $2,508.17 "	" $1,947.52 "	" $2,360.63 "	 $708.19 	" $2,655.71 "	" $2,398.99 "	" $2,508.17 "	 $702.29 	" $2,398.99 "	 $708.19 
5271533	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 8 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,202.51 "	" $2,241.76 "	 $762.20 	" $3,202.51 "	" $2,786.18 "	 $768.60 	" $2,449.92 "	" $3,202.51 "	" $3,202.51 "	" $1,216.95 "	" $2,017.58 "	" $2,722.13 "	" $2,113.66 "	" $2,562.01 "	 $768.60 	" $2,882.26 "	" $2,603.64 "	" $2,722.13 "	 $762.20 	" $2,603.64 "	 $768.60 
5271534	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 10	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,356.35 "	" $2,349.45 "	 $798.81 	" $3,356.35 "	" $2,920.02 "	 $805.52 	" $2,567.61 "	" $3,356.35 "	" $3,356.35 "	" $1,275.41 "	" $2,114.50 "	" $2,852.90 "	" $2,215.19 "	" $2,685.08 "	 $805.52 	" $3,020.72 "	" $2,728.71 "	" $2,852.90 "	 $798.81 	" $2,728.71 "	 $805.52 
5271535	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 12	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,510.18 "	" $2,457.13 "	 $835.42 	" $3,510.18 "	" $3,053.86 "	 $842.44 	" $2,685.29 "	" $3,510.18 "	" $3,510.18 "	" $1,333.87 "	" $2,211.41 "	" $2,983.65 "	" $2,316.72 "	" $2,808.14 "	 $842.44 	" $3,159.16 "	" $2,853.78 "	" $2,983.65 "	 $835.42 	" $2,853.78 "	 $842.44 
5271536	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 14	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,207.75 "	" $2,245.43 "	 $763.44 	" $3,207.75 "	" $2,790.74 "	 $769.86 	" $2,453.93 "	" $3,207.75 "	" $3,207.75 "	" $1,218.95 "	" $2,020.88 "	" $2,726.59 "	" $2,117.12 "	" $2,566.20 "	 $769.86 	" $2,886.98 "	" $2,607.90 "	" $2,726.59 "	 $763.44 	" $2,607.90 "	 $769.86 
5271537	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 16	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,426.52 "	" $2,398.56 "	 $815.51 	" $3,426.52 "	" $2,981.07 "	 $822.36 	" $2,621.29 "	" $3,426.52 "	" $3,426.52 "	" $1,302.08 "	" $2,158.71 "	" $2,912.54 "	" $2,261.50 "	" $2,741.22 "	 $822.36 	" $3,083.87 "	" $2,785.76 "	" $2,912.54 "	 $815.51 	" $2,785.76 "	 $822.36 
5271538	HCHG CVMC BONE PLATE 3.5MM LCP CURV RECON PLATE 18	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,693.60 "	" $2,585.52 "	 $879.08 	" $3,693.60 "	" $3,213.43 "	 $886.46 	" $2,825.60 "	" $3,693.60 "	" $3,693.60 "	" $1,403.57 "	" $2,326.97 "	" $3,139.56 "	" $2,437.78 "	" $2,954.88 "	 $886.46 	" $3,324.24 "	" $3,002.90 "	" $3,139.56 "	 $879.08 	" $3,002.90 "	 $886.46 
5271539	HCHG CVMC BONE PLATE 1.5MM PLATE 3 HL HEAD/ 8 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,422.05 "	 $995.44 	 $338.45 	" $1,279.85 "	" $1,237.18 "	 $341.29 	" $1,087.87 "	 $-   	 $-   	 $540.38 	 $895.89 	" $1,208.74 "	 $938.55 	" $1,137.64 "	 $341.29 	" $1,279.85 "	" $1,156.13 "	" $1,208.74 "	 $338.45 	" $1,156.13 "	 $341.29 
5271540	HCHG CVMC BONE PLATE 1.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,484.55 "	" $1,039.19 "	 $353.32 	" $1,336.10 "	" $1,291.56 "	 $356.29 	" $1,135.68 "	 $-   	 $-   	 $564.13 	 $935.27 	" $1,261.87 "	 $979.80 	" $1,187.64 "	 $356.29 	" $1,336.10 "	" $1,206.94 "	" $1,261.87 "	 $353.32 	" $1,206.94 "	 $356.29 
5271541	HCHG CVMC BONE PLATE 1.5MM STRT PLATE 12 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,552.27 "	" $1,086.59 "	 $369.44 	" $1,552.27 "	" $1,350.47 "	 $372.54 	" $1,187.49 "	" $1,552.27 "	 $-   	 $589.86 	 $977.93 	" $1,319.43 "	" $1,024.50 "	" $1,241.82 "	 $372.54 	" $1,397.04 "	" $1,262.00 "	" $1,319.43 "	 $369.44 	" $1,262.00 "	 $372.54 
5271542	HCHG CVMC BONE PLATE 1.5MM CNDLR PLATE 7 HL/36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,213.18 "	 $849.23 	 $288.74 	" $1,091.86 "	" $1,055.47 "	 $291.16 	 $928.08 	 $-   	 $-   	 $461.01 	 $764.30 	" $1,031.20 "	 $800.70 	 $970.54 	 $291.16 	" $1,091.86 "	 $986.32 	" $1,031.20 "	 $288.74 	 $986.32 	 $291.16 
5271543	HCHG CVMC BONE PLATE 2.0MM STRT PLATE 6 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,354.33 "	 $948.03 	 $322.33 	" $1,218.90 "	" $1,178.27 "	 $325.04 	" $1,036.06 "	 $-   	 $-   	 $514.65 	 $853.23 	" $1,151.18 "	 $893.86 	" $1,083.46 "	 $325.04 	" $1,218.90 "	" $1,101.07 "	" $1,151.18 "	 $322.33 	" $1,101.07 "	 $325.04 
5271544	HCHG CVMC BONE PLATE 2.0MM T-PLATE 2 HL HEAD/ 8 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,484.55 "	" $1,039.19 "	 $353.32 	" $1,336.10 "	" $1,291.56 "	 $356.29 	" $1,135.68 "	 $-   	 $-   	 $564.13 	 $935.27 	" $1,261.87 "	 $979.80 	" $1,187.64 "	 $356.29 	" $1,336.10 "	" $1,206.94 "	" $1,261.87 "	 $353.32 	" $1,206.94 "	 $356.29 
5271545	HCHG CVMC BONE PLATE 2.0MM PLATE 3 HL HEAD/ 8 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,619.99 "	" $1,133.99 "	 $385.56 	" $1,619.99 "	" $1,409.39 "	 $388.80 	" $1,239.29 "	" $1,619.99 "	" $1,619.99 "	 $615.60 	" $1,020.59 "	" $1,376.99 "	" $1,069.19 "	" $1,295.99 "	 $388.80 	" $1,457.99 "	" $1,317.05 "	" $1,376.99 "	 $385.56 	" $1,317.05 "	 $388.80 
5271546	HCHG CVMC BONE PLATE 2.4MM STRT PLATE 6 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,174.72 "	 $822.30 	 $279.58 	" $1,057.25 "	" $1,022.01 "	 $281.93 	 $898.66 	 $-   	 $-   	 $446.39 	 $740.07 	 $998.51 	 $775.32 	 $939.78 	 $281.93 	" $1,057.25 "	 $955.05 	 $998.51 	 $279.58 	 $955.05 	 $281.93 
5271547	HCHG CVMC BONE PLATE 2.4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,575.71 "	" $1,103.00 "	 $375.02 	" $1,575.71 "	" $1,370.87 "	 $378.17 	" $1,205.42 "	" $1,575.71 "	 $-   	 $598.77 	 $992.70 	" $1,339.35 "	" $1,039.97 "	" $1,260.57 "	 $378.17 	" $1,418.14 "	" $1,281.05 "	" $1,339.35 "	 $375.02 	" $1,281.05 "	 $378.17 
5271548	HCHG CVMC BONE PLATE 2.4MM T-PLATE 2 HL HEAD/ 8 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,672.08 "	" $1,170.46 "	 $397.96 	" $1,672.08 "	" $1,454.71 "	 $401.30 	" $1,279.14 "	" $1,672.08 "	" $1,672.08 "	 $635.39 	" $1,053.41 "	" $1,421.27 "	" $1,103.57 "	" $1,337.66 "	 $401.30 	" $1,504.87 "	" $1,359.40 "	" $1,421.27 "	 $397.96 	" $1,359.40 "	 $401.30 
5271549	HCHG CVMC BONE PLATE 2.4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,721.56 "	" $1,205.09 "	 $409.73 	" $1,721.56 "	" $1,497.76 "	 $413.17 	" $1,316.99 "	" $1,721.56 "	" $1,721.56 "	 $654.19 	" $1,084.58 "	" $1,463.33 "	" $1,136.23 "	" $1,377.25 "	 $413.17 	" $1,549.40 "	" $1,399.63 "	" $1,463.33 "	 $409.73 	" $1,399.63 "	 $413.17 
5271550	HCHG CVMC BONE PLATE 2.4MM LC-DCP PLATE 4 HL/35MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,230.66 "	 $861.46 	 $292.90 	" $1,107.59 "	" $1,070.67 "	 $295.36 	 $941.45 	 $-   	 $-   	 $467.65 	 $775.32 	" $1,046.06 "	 $812.24 	 $984.53 	 $295.36 	" $1,107.59 "	" $1,000.53 "	" $1,046.06 "	 $292.90 	" $1,000.53 "	 $295.36 
5271551	HCHG CVMC BONE PLATE 2.4MM LC-DCP PLATE 6 HL/51MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,391.49 "	 $974.04 	 $331.17 	" $1,252.34 "	" $1,210.60 "	 $333.96 	" $1,064.49 "	 $-   	 $-   	 $528.77 	 $876.64 	" $1,182.77 "	 $918.38 	" $1,113.19 "	 $333.96 	" $1,252.34 "	" $1,131.28 "	" $1,182.77 "	 $331.17 	" $1,131.28 "	 $333.96 
5271552	HCHG CVMC BONE PLATE 2.4MM LC-DCP PLATE 8 HL/67MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,499.87 "	" $1,049.91 "	 $356.97 	" $1,349.88 "	" $1,304.89 "	 $359.97 	" $1,147.40 "	 $-   	 $-   	 $569.95 	 $944.92 	" $1,274.89 "	 $989.91 	" $1,199.90 "	 $359.97 	" $1,349.88 "	" $1,219.39 "	" $1,274.89 "	 $356.97 	" $1,219.39 "	 $359.97 
5271553	HCHG CVMC BONE SCREW DHS/DCS ONE-STEP LAG SCREW 14M	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,485.88 "	" $1,040.12 "	 $353.64 	" $1,337.29 "	" $1,292.72 "	 $356.61 	" $1,136.70 "	 $-   	 $-   	 $564.63 	 $936.10 	" $1,263.00 "	 $980.68 	" $1,188.70 "	 $356.61 	" $1,337.29 "	" $1,208.02 "	" $1,263.00 "	 $353.64 	" $1,208.02 "	 $356.61 
5271554	HCHG CVMC BONE SCREW DHS/DCS COMP SCREW 36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $321.87 	 $225.31 	 $76.61 	 $289.68 	 $280.03 	 $77.25 	 $246.23 	 $-   	 $-   	 $122.31 	 $202.78 	 $273.59 	 $212.43 	 $257.50 	 $77.25 	 $289.68 	 $261.68 	 $273.59 	 $76.61 	 $261.68 	 $77.25 
5271555	HCHG CVMC BONE PLATE DEG DHS PLATE-STD BRL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,501.72 "	" $1,751.20 "	 $595.41 	" $2,501.72 "	" $2,176.50 "	 $600.41 	" $1,913.82 "	" $2,501.72 "	" $2,501.72 "	 $950.65 	" $1,576.08 "	" $2,126.46 "	" $1,651.14 "	" $2,001.38 "	 $600.41 	" $2,251.55 "	" $2,033.90 "	" $2,126.46 "	 $595.41 	" $2,033.90 "	 $600.41 
5271556	HCHG CVMC BONE PLATE DEG DHS PLATE-STD BRL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,880.18 "	" $1,316.13 "	 $447.48 	" $1,880.18 "	" $1,635.76 "	 $451.24 	" $1,438.34 "	" $1,880.18 "	" $1,880.18 "	 $714.47 	" $1,184.51 "	" $1,598.15 "	" $1,240.92 "	" $1,504.14 "	 $451.24 	" $1,692.16 "	" $1,528.59 "	" $1,598.15 "	 $447.48 	" $1,528.59 "	 $451.24 
5271557	HCHG CVMC BONE PLATE 140 DEG DHS PLATE-STD BRL 4 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,122.19 "	" $1,485.53 "	 $505.08 	" $2,122.19 "	" $1,846.31 "	 $509.33 	" $1,623.48 "	" $2,122.19 "	" $2,122.19 "	 $806.43 	" $1,336.98 "	" $1,803.86 "	" $1,400.65 "	" $1,697.75 "	 $509.33 	" $1,909.97 "	" $1,725.34 "	" $1,803.86 "	 $505.08 	" $1,725.34 "	 $509.33 
5271558	HCHG CVMC BONE PLATE 95 DEG DCS PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,800.36 "	" $2,660.25 "	 $904.49 	" $3,800.36 "	" $3,306.31 "	 $912.09 	" $2,907.28 "	" $3,800.36 "	" $3,800.36 "	" $1,444.14 "	" $2,394.23 "	" $3,230.31 "	" $2,508.24 "	" $3,040.29 "	 $912.09 	" $3,420.32 "	" $3,089.69 "	" $3,230.31 "	 $904.49 	" $3,089.69 "	 $912.09 
5271559	HCHG CVMC BONE PLATE 95 DEG DCS PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,489.03 "	" $2,442.32 "	 $830.39 	" $3,489.03 "	" $3,035.46 "	 $837.37 	" $2,669.11 "	" $3,489.03 "	" $3,489.03 "	" $1,325.83 "	" $2,198.09 "	" $2,965.68 "	" $2,302.76 "	" $2,791.22 "	 $837.37 	" $3,140.13 "	" $2,836.58 "	" $2,965.68 "	 $830.39 	" $2,836.58 "	 $837.37 
5271560	HCHG CVMC BONE PLATE 95 DEG DCS PLATE 16 HL/274MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,719.17 "	" $2,603.42 "	 $885.16 	" $3,719.17 "	" $3,235.68 "	 $892.60 	" $2,845.17 "	" $3,719.17 "	" $3,719.17 "	" $1,413.28 "	" $2,343.08 "	" $3,161.29 "	" $2,454.65 "	" $2,975.34 "	 $892.60 	" $3,347.25 "	" $3,023.69 "	" $3,161.29 "	 $885.16 	" $3,023.69 "	 $892.60 
5271561	HCHG CVMC BONE PLATE 95 DEG DCS PLATE 18 HL/306MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,744.85 "	" $3,321.40 "	" $1,129.27 "	" $4,744.85 "	" $4,128.02 "	" $1,138.76 "	" $3,629.81 "	" $4,744.85 "	" $4,744.85 "	" $1,803.04 "	" $2,989.26 "	" $4,033.12 "	" $3,131.60 "	" $3,795.88 "	" $1,138.76 "	" $4,270.37 "	" $3,857.56 "	" $4,033.12 "	" $1,129.27 "	" $3,857.56 "	" $1,138.76 "
5271562	HCHG CVMC BONE PLATE 95 DEG DCS PLATE 20 HL/338MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,901.12 "	" $3,430.78 "	" $1,166.47 "	" $4,901.12 "	" $4,263.97 "	" $1,176.27 "	" $3,749.36 "	" $4,901.12 "	" $4,901.12 "	" $1,862.43 "	" $3,087.71 "	" $4,165.95 "	" $3,234.74 "	" $3,920.90 "	" $1,176.27 "	" $4,411.01 "	" $3,984.61 "	" $4,165.95 "	" $1,166.47 "	" $3,984.61 "	" $1,176.27 "
5271563	HCHG CVMC BONE PLATE 95 DEG DCS PLATE 22 HL/370MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,119.89 "	" $3,583.92 "	" $1,218.53 "	" $5,119.89 "	" $4,454.30 "	" $1,228.77 "	" $3,916.72 "	" $5,119.89 "	" $5,119.89 "	" $1,945.56 "	" $3,225.53 "	" $4,351.91 "	" $3,379.13 "	" $4,095.91 "	" $1,228.77 "	" $4,607.90 "	" $4,162.47 "	" $4,351.91 "	" $1,218.53 "	" $4,162.47 "	" $1,228.77 "
5271564	HCHG CVMC PIN STEINMAN TRACTION	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $318.60 	 $223.02 	 $75.83 	 $286.74 	 $277.18 	 $76.46 	 $243.73 	 $-   	 $-   	 $121.07 	 $200.72 	 $270.81 	 $210.28 	 $254.88 	 $76.46 	 $286.74 	 $259.02 	 $270.81 	 $75.83 	 $259.02 	 $76.46 
5271565	HCHG CVMC PIN STEIMANN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $591.53 	 $414.07 	 $140.78 	 $532.38 	 $514.63 	 $141.97 	 $452.52 	 $-   	 $-   	 $224.78 	 $372.66 	 $502.80 	 $390.41 	 $473.22 	 $141.97 	 $532.38 	 $480.91 	 $502.80 	 $140.78 	 $480.91 	 $141.97 
5271566	HCHG CVMC BONE SCREW SCHNZ	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $601.33 	 $420.93 	 $143.12 	 $541.20 	 $523.16 	 $144.32 	 $460.02 	 $-   	 $-   	 $228.51 	 $378.84 	 $511.13 	 $396.88 	 $481.06 	 $144.32 	 $541.20 	 $488.88 	 $511.13 	 $143.12 	 $488.88 	 $144.32 
5271567	HCHG CVMC BONE SCREW SCHNZ SPDE PT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $660.16 	 $462.11 	 $157.12 	 $594.14 	 $574.34 	 $158.44 	 $505.02 	 $-   	 $-   	 $250.86 	 $415.90 	 $561.14 	 $435.71 	 $528.13 	 $158.44 	 $594.14 	 $536.71 	 $561.14 	 $157.12 	 $536.71 	 $158.44 
5271568	HCHG CVMC BONE SCREW SCHNZ SD SS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $906.36 	 $634.45 	 $215.71 	 $815.72 	 $788.53 	 $217.53 	 $693.37 	 $-   	 $-   	 $344.42 	 $571.01 	 $770.41 	 $598.20 	 $725.09 	 $217.53 	 $815.72 	 $736.87 	 $770.41 	 $215.71 	 $736.87 	 $217.53 
5271569	HCHG CVMC BONE SCREW SCHNZ SD SS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,020.96 "	 $714.67 	 $242.99 	 $918.86 	 $888.24 	 $245.03 	 $781.03 	 $-   	 $-   	 $387.96 	 $643.20 	 $867.82 	 $673.83 	 $816.77 	 $245.03 	 $918.86 	 $830.04 	 $867.82 	 $242.99 	 $830.04 	 $245.03 
5271570	HCHG CVMC BONE SCREW SCHNZ SD DD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,093.88 "	 $765.72 	 $260.34 	 $984.49 	 $951.68 	 $262.53 	 $836.82 	 $-   	 $-   	 $415.67 	 $689.14 	 $929.80 	 $721.96 	 $875.10 	 $262.53 	 $984.49 	 $889.32 	 $929.80 	 $260.34 	 $889.32 	 $262.53 
5271571	HCHG CVMC BONE SCREW SCREW SCHNZ TROCR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $833.43 	 $583.40 	 $198.36 	 $750.09 	 $725.08 	 $200.02 	 $637.57 	 $-   	 $-   	 $316.70 	 $525.06 	 $708.42 	 $550.06 	 $666.74 	 $200.02 	 $750.09 	 $677.58 	 $708.42 	 $198.36 	 $677.58 	 $200.02 
5271572	HCHG CVMC CRLG POS PIN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,000.12 "	 $700.08 	 $238.03 	 $900.11 	 $870.10 	 $240.03 	 $765.09 	 $-   	 $-   	 $380.05 	 $630.08 	 $850.10 	 $660.08 	 $800.10 	 $240.03 	 $900.11 	 $813.10 	 $850.10 	 $238.03 	 $813.10 	 $240.03 
5271573	HCHG CVMC CLAMP EXTERNAL FIXATION MEDIUM MULTI-PIN 4POS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,947.29 "	" $2,063.10 "	 $701.46 	" $2,947.29 "	" $2,564.14 "	 $707.35 	" $2,254.68 "	" $2,947.29 "	" $2,947.29 "	" $1,119.97 "	" $1,856.79 "	" $2,505.20 "	" $1,945.21 "	" $2,357.83 "	 $707.35 	" $2,652.56 "	" $2,396.15 "	" $2,505.20 "	 $701.46 	" $2,396.15 "	 $707.35 
5271574	HCHG CVMC ROD CARBON FIBER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,304.08 "	 $912.86 	 $310.37 	" $1,173.67 "	" $1,134.55 "	 $312.98 	 $997.62 	 $-   	 $-   	 $495.55 	 $821.57 	" $1,108.47 "	 $860.69 	" $1,043.26 "	 $312.98 	" $1,173.67 "	" $1,060.22 "	" $1,108.47 "	 $310.37 	" $1,060.22 "	 $312.98 
5271575	HCHG CVMC ROD CURVD CARBN FIBR 11 X 213M	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,695.57 "	" $1,886.90 "	 $641.55 	" $2,695.57 "	" $2,345.15 "	 $646.94 	" $2,062.11 "	" $2,695.57 "	" $2,695.57 "	" $1,024.32 "	" $1,698.21 "	" $2,291.23 "	" $1,779.08 "	" $2,156.46 "	 $646.94 	" $2,426.01 "	" $2,191.50 "	" $2,291.23 "	 $641.55 	" $2,191.50 "	 $646.94 
5271576	HCHG CVMC ROD CURVD CARBN FIBR 11 X 425M	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,964.77 "	" $2,075.34 "	 $705.62 	" $2,964.77 "	" $2,579.35 "	 $711.54 	" $2,268.05 "	" $2,964.77 "	" $2,964.77 "	" $1,126.61 "	" $1,867.81 "	" $2,520.05 "	" $1,956.75 "	" $2,371.82 "	 $711.54 	" $2,668.29 "	" $2,410.36 "	" $2,520.05 "	 $705.62 	" $2,410.36 "	 $711.54 
5271577	HCHG CVMC ROD CURVD CARBN FIBR 11 X 638M	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,237.48 "	" $2,266.24 "	 $770.52 	" $3,237.48 "	" $2,816.61 "	 $777.00 	" $2,476.67 "	" $3,237.48 "	" $3,237.48 "	" $1,230.24 "	" $2,039.61 "	" $2,751.86 "	" $2,136.74 "	" $2,589.98 "	 $777.00 	" $2,913.73 "	" $2,632.07 "	" $2,751.86 "	 $770.52 	" $2,632.07 "	 $777.00 
5271578	HCHG CVMC ROD CURVD CARBN FIBR 11 X 850M	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,494.44 "	" $2,446.11 "	 $831.68 	" $3,494.44 "	" $3,040.16 "	 $838.67 	" $2,673.25 "	" $3,494.44 "	" $3,494.44 "	" $1,327.89 "	" $2,201.50 "	" $2,970.27 "	" $2,306.33 "	" $2,795.55 "	 $838.67 	" $3,145.00 "	" $2,840.98 "	" $2,970.27 "	 $831.68 	" $2,840.98 "	 $838.67 
5271579	HCHG CVMC ROD CARBON FIBER 8MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,026.16 "	 $718.31 	 $244.23 	 $923.54 	 $892.76 	 $246.28 	 $785.01 	 $-   	 $-   	 $389.94 	 $646.48 	 $872.24 	 $677.27 	 $820.93 	 $246.28 	 $923.54 	 $834.27 	 $872.24 	 $244.23 	 $834.27 	 $246.28 
5271580	HCHG CVMC ROD 8MM CARBON FIBER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,114.72 "	 $780.30 	 $265.30 	" $1,003.25 "	 $969.81 	 $267.53 	 $852.76 	 $-   	 $-   	 $423.59 	 $702.27 	 $947.51 	 $735.72 	 $891.78 	 $267.53 	" $1,003.25 "	 $906.27 	 $947.51 	 $265.30 	 $906.27 	 $267.53 
5271581	HCHG CVMC BONE PLATE TI LCP MED DIS TIB 3.5 4	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,750.53 "	" $3,325.37 "	" $1,130.63 "	" $4,750.53 "	" $4,132.96 "	" $1,140.13 "	" $3,634.16 "	" $4,750.53 "	" $4,750.53 "	" $1,805.20 "	" $2,992.83 "	" $4,037.95 "	" $3,135.35 "	" $3,800.42 "	" $1,140.13 "	" $4,275.48 "	" $3,862.18 "	" $4,037.95 "	" $1,130.63 "	" $3,862.18 "	" $1,140.13 "
5271582	HCHG CVMC BONE PLATE TI LCP MED DIS TIB 3.5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,801.68 "	" $3,361.18 "	" $1,142.80 "	" $4,801.68 "	" $4,177.46 "	" $1,152.40 "	" $3,673.29 "	" $4,801.68 "	" $4,801.68 "	" $1,824.64 "	" $3,025.06 "	" $4,081.43 "	" $3,169.11 "	" $3,841.34 "	" $1,152.40 "	" $4,321.51 "	" $3,903.77 "	" $4,081.43 "	" $1,142.80 "	" $3,903.77 "	" $1,152.40 "
5271583	HCHG CVMC BONE PLATE TI LCP MED DIS TIB 3.5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,901.12 "	" $3,430.78 "	" $1,166.47 "	" $4,901.12 "	" $4,263.97 "	" $1,176.27 "	" $3,749.36 "	" $4,901.12 "	" $4,901.12 "	" $1,862.43 "	" $3,087.71 "	" $4,165.95 "	" $3,234.74 "	" $3,920.90 "	" $1,176.27 "	" $4,411.01 "	" $3,984.61 "	" $4,165.95 "	" $1,166.47 "	" $3,984.61 "	" $1,176.27 "
5271584	HCHG CVMC BONE PLATE TI LCP MED DIS TIB 3.5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,955.10 "	" $3,468.57 "	" $1,179.31 "	" $4,955.10 "	" $4,310.94 "	" $1,189.22 "	" $3,790.65 "	" $4,955.10 "	" $4,955.10 "	" $1,882.94 "	" $3,121.71 "	" $4,211.84 "	" $3,270.37 "	" $3,964.08 "	" $1,189.22 "	" $4,459.59 "	" $4,028.50 "	" $4,211.84 "	" $1,179.31 "	" $4,028.50 "	" $1,189.22 "
5271585	HCHG CVMC BONE PLATE TI LCP MED DIS TIB 3.5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,017.61 "	" $3,512.33 "	" $1,194.19 "	" $5,017.61 "	" $4,365.32 "	" $1,204.23 "	" $3,838.47 "	" $5,017.61 "	" $5,017.61 "	" $1,906.69 "	" $3,161.09 "	" $4,264.97 "	" $3,311.62 "	" $4,014.09 "	" $1,204.23 "	" $4,515.85 "	" $4,079.32 "	" $4,264.97 "	" $1,194.19 "	" $4,079.32 "	" $1,204.23 "
5271586	HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,520.76 "	" $1,764.53 "	 $599.94 	" $2,520.76 "	" $2,193.06 "	 $604.98 	" $1,928.38 "	" $2,520.76 "	" $2,520.76 "	 $957.89 	" $1,588.08 "	" $2,142.65 "	" $1,663.70 "	" $2,016.61 "	 $604.98 	" $2,268.68 "	" $2,049.38 "	" $2,142.65 "	 $599.94 	" $2,049.38 "	 $604.98 
5271587	HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI  75MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,713.05 "	" $1,899.14 "	 $645.71 	" $2,713.05 "	" $2,360.35 "	 $651.13 	" $2,075.48 "	" $2,713.05 "	" $2,713.05 "	" $1,030.96 "	" $1,709.22 "	" $2,306.09 "	" $1,790.61 "	" $2,170.44 "	 $651.13 	" $2,441.75 "	" $2,205.71 "	" $2,306.09 "	 $645.71 	" $2,205.71 "	 $651.13 
5271588	HCHG CVMC BONE NAIL TI CANN NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,634.04 "	" $3,243.83 "	" $1,102.90 "	" $4,634.04 "	" $4,031.61 "	" $1,112.17 "	" $3,545.04 "	" $4,634.04 "	" $4,634.04 "	" $1,760.94 "	" $2,919.45 "	" $3,938.93 "	" $3,058.47 "	" $3,707.23 "	" $1,112.17 "	" $4,170.64 "	" $3,767.47 "	" $3,938.93 "	" $1,102.90 "	" $3,767.47 "	" $1,112.17 "
5271589	HCHG CVMC BONE NAIL TI CANN NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,100.12 "	" $4,270.08 "	" $1,451.83 "	" $6,100.12 "	" $5,307.10 "	" $1,464.03 "	" $4,666.59 "	" $6,100.12 "	" $6,100.12 "	" $2,318.05 "	" $3,843.08 "	" $5,185.10 "	" $4,026.08 "	" $4,880.10 "	" $1,464.03 "	" $5,490.11 "	" $4,959.40 "	" $5,185.10 "	" $1,451.83 "	" $4,959.40 "	" $1,464.03 "
5271590	HCHG CVMC BONE SCREW 5.0MM TI LOCK SCREW HR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,128.03 "	 $789.62 	 $268.47 	" $1,015.23 "	 $981.39 	 $270.73 	 $862.94 	 $-   	 $-   	 $428.65 	 $710.66 	 $958.83 	 $744.50 	 $902.42 	 $270.73 	" $1,015.23 "	 $917.09 	 $958.83 	 $268.47 	 $917.09 	 $270.73 
5271591	HCHG CVMC BONE BOLT 4.9MM TI LOCK BOLT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,093.88 "	 $765.72 	 $260.34 	 $984.49 	 $951.68 	 $262.53 	 $836.82 	 $-   	 $-   	 $415.67 	 $689.14 	 $929.80 	 $721.96 	 $875.10 	 $262.53 	 $984.49 	 $889.32 	 $929.80 	 $260.34 	 $889.32 	 $262.53 
5271592	HCHG CVMC BONE SCREW SCHNZ SD TI	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,010.54 "	 $707.38 	 $240.51 	 $909.49 	 $879.17 	 $242.53 	 $773.06 	 $-   	 $-   	 $384.01 	 $636.64 	 $858.96 	 $666.96 	 $808.43 	 $242.53 	 $909.49 	 $821.57 	 $858.96 	 $240.51 	 $821.57 	 $242.53 
5271593	HCHG CVMC BONE SCREW SCHNZ SD TI	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,166.81 "	 $816.77 	 $277.70 	" $1,050.13 "	" $1,015.12 "	 $280.03 	 $892.61 	 $-   	 $-   	 $443.39 	 $735.09 	 $991.79 	 $770.09 	 $933.45 	 $280.03 	" $1,050.13 "	 $948.62 	 $991.79 	 $277.70 	 $948.62 	 $280.03 
5271594	HCHG CVMC BONE SCREW SCHNZ SD TI	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,239.73 "	 $867.81 	 $295.06 	" $1,115.76 "	" $1,078.57 "	 $297.54 	 $948.39 	 $-   	 $-   	 $471.10 	 $781.03 	" $1,053.77 "	 $818.22 	 $991.78 	 $297.54 	" $1,115.76 "	" $1,007.90 "	" $1,053.77 "	 $295.06 	" $1,007.90 "	 $297.54 
5271595	HCHG CVMC CABLE TI CABLE W/ CRIMP 750MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,003.32 "	" $1,402.32 "	 $476.79 	" $2,003.32 "	" $1,742.89 "	 $480.80 	" $1,532.54 "	" $2,003.32 "	" $2,003.32 "	 $761.26 	" $1,262.09 "	" $1,702.82 "	" $1,322.19 "	" $1,602.66 "	 $480.80 	" $1,802.99 "	" $1,628.70 "	" $1,702.82 "	 $476.79 	" $1,628.70 "	 $480.80 
5271596	HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI  130MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,720.04 "	" $1,904.03 "	 $647.37 	" $2,720.04 "	" $2,366.43 "	 $652.81 	" $2,080.83 "	" $2,720.04 "	" $2,720.04 "	" $1,033.62 "	" $1,713.63 "	" $2,312.03 "	" $1,795.23 "	" $2,176.03 "	 $652.81 	" $2,448.04 "	" $2,211.39 "	" $2,312.03 "	 $647.37 	" $2,211.39 "	 $652.81 
5271597	HCHG CVMC IMPLANT PIN TRIM-IT DRILL PIN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,574.26 "	" $1,101.98 "	 $374.67 	" $1,574.26 "	" $1,369.61 "	 $377.82 	" $1,204.31 "	" $1,574.26 "	 $-   	 $598.22 	 $991.78 	" $1,338.12 "	" $1,039.01 "	" $1,259.41 "	 $377.82 	" $1,416.83 "	" $1,279.87 "	" $1,338.12 "	 $374.67 	" $1,279.87 "	 $377.82 
5271598	HCHG CVMC IMPLANT CHONDRAL DART	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,001.28 "	 $700.90 	 $238.30 	 $901.15 	 $871.11 	 $240.31 	 $765.98 	 $-   	 $-   	 $380.49 	 $630.81 	 $851.09 	 $660.84 	 $801.02 	 $240.31 	 $901.15 	 $814.04 	 $851.09 	 $238.30 	 $814.04 	 $240.31 
5271599	HCHG CVMC BONE PLATE LCP DIST RAD PLATE VOLAR 3H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,373.83 "	" $2,361.68 "	 $802.97 	" $3,373.83 "	" $2,935.23 "	 $809.72 	" $2,580.98 "	" $3,373.83 "	" $3,373.83 "	" $1,282.06 "	" $2,125.51 "	" $2,867.76 "	" $2,226.73 "	" $2,699.06 "	 $809.72 	" $3,036.45 "	" $2,742.92 "	" $2,867.76 "	 $802.97 	" $2,742.92 "	 $809.72 
5271600	HCHG CVMC BONE PLATE LCP DIST RAD PLATE VOLAR 5H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,573.11 "	" $2,501.18 "	 $850.40 	" $3,573.11 "	" $3,108.61 "	 $857.55 	" $2,733.43 "	" $3,573.11 "	" $3,573.11 "	" $1,357.78 "	" $2,251.06 "	" $3,037.14 "	" $2,358.25 "	" $2,858.49 "	 $857.55 	" $3,215.80 "	" $2,904.94 "	" $3,037.14 "	 $850.40 	" $2,904.94 "	 $857.55 
5271601	HCHG CVMC SUTURE ANCHOR JUGGERKNOT 1.4 MM SHORT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,456.75 "	" $1,019.73 "	 $346.71 	" $1,311.08 "	" $1,267.37 "	 $349.62 	" $1,114.41 "	 $-   	 $-   	 $553.57 	 $917.75 	" $1,238.24 "	 $961.46 	" $1,165.40 "	 $349.62 	" $1,311.08 "	" $1,184.34 "	" $1,238.24 "	 $346.71 	" $1,184.34 "	 $349.62 
5271602	HCHG CVMC PIN STEINMAN CEN THRD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $802.18 	 $561.53 	 $190.92 	 $721.96 	 $697.90 	 $192.52 	 $613.67 	 $-   	 $-   	 $304.83 	 $505.37 	 $681.85 	 $529.44 	 $641.74 	 $192.52 	 $721.96 	 $652.17 	 $681.85 	 $190.92 	 $652.17 	 $192.52 
5271603	HCHG CVMC SCREW BIO COMP INT.8X23MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,302.24 "	 $911.57 	 $309.93 	" $1,172.02 "	" $1,132.95 "	 $312.54 	 $996.21 	 $-   	 $-   	 $494.85 	 $820.41 	" $1,106.90 "	 $859.48 	" $1,041.79 "	 $312.54 	" $1,172.02 "	" $1,058.72 "	" $1,106.90 "	 $309.93 	" $1,058.72 "	 $312.54 
5271604	HCHG CVMC ANCHOR BIO SWIVELOCK ANCHOR 4.75MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,476.11 "	" $1,033.28 "	 $351.31 	" $1,328.50 "	" $1,284.22 "	 $354.27 	" $1,129.22 "	 $-   	 $-   	 $560.92 	 $929.95 	" $1,254.69 "	 $974.23 	" $1,180.89 "	 $354.27 	" $1,328.50 "	" $1,200.08 "	" $1,254.69 "	 $351.31 	" $1,200.08 "	 $354.27 
5271605	HCHG CVMC ANCHOR SUPER GII ANCHOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,546.09 "	" $1,082.26 "	 $367.97 	" $1,546.09 "	" $1,345.10 "	 $371.06 	" $1,182.76 "	" $1,546.09 "	 $-   	 $587.51 	 $974.04 	" $1,314.18 "	" $1,020.42 "	" $1,236.87 "	 $371.06 	" $1,391.48 "	" $1,256.97 "	" $1,314.18 "	 $367.97 	" $1,256.97 "	 $371.06 
5271606	HCHG CVMC BONE PLATE DVR ANATOMIC	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,160.08 "	" $2,212.06 "	 $752.10 	" $3,160.08 "	" $2,749.27 "	 $758.42 	" $2,417.46 "	" $3,160.08 "	" $3,160.08 "	" $1,200.83 "	" $1,990.85 "	" $2,686.07 "	" $2,085.65 "	" $2,528.06 "	 $758.42 	" $2,844.07 "	" $2,569.15 "	" $2,686.07 "	 $752.10 	" $2,569.15 "	 $758.42 
5271607	HCHG CVMC BONE PLATE F3 FRAG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,785.30 "	" $1,949.71 "	 $662.90 	" $2,785.30 "	" $2,423.21 "	 $668.47 	" $2,130.75 "	" $2,785.30 "	" $2,785.30 "	" $1,058.41 "	" $1,754.74 "	" $2,367.51 "	" $1,838.30 "	" $2,228.24 "	 $668.47 	" $2,506.77 "	" $2,264.45 "	" $2,367.51 "	 $662.90 	" $2,264.45 "	 $668.47 
5271608	HCHG CVMC BONE PLATE DORSAL NAIL DNP ANTM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,702.08 "	" $2,591.46 "	 $881.10 	" $3,702.08 "	" $3,220.81 "	 $888.50 	" $2,832.09 "	" $3,702.08 "	" $3,702.08 "	" $1,406.79 "	" $2,332.31 "	" $3,146.77 "	" $2,443.37 "	" $2,961.66 "	 $888.50 	" $3,331.87 "	" $3,009.79 "	" $3,146.77 "	 $881.10 	" $3,009.79 "	 $888.50 
5271609	HCHG CVMC PEG LOCKING	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $784.34 	 $549.04 	 $186.67 	 $705.91 	 $682.38 	 $188.24 	 $600.02 	 $-   	 $-   	 $298.05 	 $494.13 	 $666.69 	 $517.66 	 $627.47 	 $188.24 	 $705.91 	 $637.67 	 $666.69 	 $186.67 	 $637.67 	 $188.24 
5271610	HCHG CVMC PEG MULTI-DIR THREAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,105.46 "	 $773.82 	 $263.10 	 $994.91 	 $961.75 	 $265.31 	 $845.68 	 $-   	 $-   	 $420.07 	 $696.44 	 $939.64 	 $729.60 	 $884.37 	 $265.31 	 $994.91 	 $898.74 	 $939.64 	 $263.10 	 $898.74 	 $265.31 
5271611	HCHG CVMC BONE PLATE FRAG PLATE PEG FT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $784.34 	 $549.04 	 $186.67 	 $705.91 	 $682.38 	 $188.24 	 $600.02 	 $-   	 $-   	 $298.05 	 $494.13 	 $666.69 	 $517.66 	 $627.47 	 $188.24 	 $705.91 	 $637.67 	 $666.69 	 $186.67 	 $637.67 	 $188.24 
5271612	HCHG CVMC SCREW CORTICAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $784.34 	 $549.04 	 $186.67 	 $705.91 	 $682.38 	 $188.24 	 $600.02 	 $-   	 $-   	 $298.05 	 $494.13 	 $666.69 	 $517.66 	 $627.47 	 $188.24 	 $705.91 	 $637.67 	 $666.69 	 $186.67 	 $637.67 	 $188.24 
5271613	HCHG CVMC SCREW UNICORTICAL DNP-A	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $758.19 	 $530.73 	 $180.45 	 $682.37 	 $659.63 	 $181.97 	 $580.02 	 $-   	 $-   	 $288.11 	 $477.66 	 $644.46 	 $500.41 	 $606.55 	 $181.97 	 $682.37 	 $616.41 	 $644.46 	 $180.45 	 $616.41 	 $181.97 
5271614	HCHG CVMC BONE SCREW AEQ REV LOCK SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,041.79 "	 $729.25 	 $247.95 	 $937.61 	 $906.36 	 $250.03 	 $796.97 	 $-   	 $-   	 $395.88 	 $656.33 	 $885.52 	 $687.58 	 $833.43 	 $250.03 	 $937.61 	 $846.98 	 $885.52 	 $247.95 	 $846.98 	 $250.03 
5271615	HCHG CVMC BONE SCREW AEQ REV COMP SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $718.98 	 $503.29 	 $171.12 	 $647.08 	 $625.51 	 $172.56 	 $550.02 	 $-   	 $-   	 $273.21 	 $452.96 	 $611.13 	 $474.53 	 $575.18 	 $172.56 	 $647.08 	 $584.53 	 $611.13 	 $171.12 	 $584.53 	 $172.56 
5271616	HCHG CVMC BONE SCREW ACL INT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $761.09 	 $532.76 	 $181.14 	 $684.98 	 $662.15 	 $182.66 	 $582.23 	 $-   	 $-   	 $289.21 	 $479.49 	 $646.93 	 $502.32 	 $608.87 	 $182.66 	 $684.98 	 $618.77 	 $646.93 	 $181.14 	 $618.77 	 $182.66 
5271617	HCHG CVMC BONE SCREW ACL INT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,406.42 "	 $984.49 	 $334.73 	" $1,265.78 "	" $1,223.59 "	 $337.54 	" $1,075.91 "	 $-   	 $-   	 $534.44 	 $886.04 	" $1,195.46 "	 $928.24 	" $1,125.14 "	 $337.54 	" $1,265.78 "	" $1,143.42 "	" $1,195.46 "	 $334.73 	" $1,143.42 "	 $337.54 
5271618	HCHG CVMC BONE SCREW INT ACL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,481.66 "	" $1,037.16 "	 $352.64 	" $1,333.49 "	" $1,289.04 "	 $355.60 	" $1,133.47 "	 $-   	 $-   	 $563.03 	 $933.45 	" $1,259.41 "	 $977.90 	" $1,185.33 "	 $355.60 	" $1,333.49 "	" $1,204.59 "	" $1,259.41 "	 $352.64 	" $1,204.59 "	 $355.60 
5271619	HCHG CVMC BONE SCREW BIO-INTERFERENCE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,122.82 "	 $785.97 	 $267.23 	" $1,010.54 "	 $976.85 	 $269.48 	 $858.96 	 $-   	 $-   	 $426.67 	 $707.38 	 $954.40 	 $741.06 	 $898.26 	 $269.48 	" $1,010.54 "	 $912.85 	 $954.40 	 $267.23 	 $912.85 	 $269.48 
5271620	HCHG CVMC BIO-CORTICAL POST	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $726.25 	 $508.38 	 $172.85 	 $653.63 	 $631.84 	 $174.30 	 $555.58 	 $-   	 $-   	 $275.98 	 $457.54 	 $617.31 	 $479.33 	 $581.00 	 $174.30 	 $653.63 	 $590.44 	 $617.31 	 $172.85 	 $590.44 	 $174.30 
5271621	HCHG CVMC JOINT DEVICE COMPONENT ORTHOSORBABLE PIN LONG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,408.49 "	" $1,685.94 "	 $573.22 	" $2,408.49 "	" $2,095.39 "	 $578.04 	" $1,842.49 "	" $2,408.49 "	" $2,408.49 "	 $915.23 	" $1,517.35 "	" $2,047.22 "	" $1,589.60 "	" $1,926.79 "	 $578.04 	" $2,167.64 "	" $1,958.10 "	" $2,047.22 "	 $573.22 	" $1,958.10 "	 $578.04 
5271622	"HCHG CVMC MESH CENTRIFX 4.1"" X 6.3""  MED"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $810.28 	 $567.20 	 $192.85 	 $729.25 	 $704.94 	 $194.47 	 $619.86 	 $-   	 $-   	 $307.91 	 $510.48 	 $688.74 	 $534.78 	 $648.22 	 $194.47 	 $729.25 	 $658.76 	 $688.74 	 $192.85 	 $658.76 	 $194.47 
5271623	HCHG CVMC LOCKING HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $845.00 	 $591.50 	 $201.11 	 $760.50 	 $735.15 	 $202.80 	 $646.43 	 $-   	 $-   	 $321.10 	 $532.35 	 $718.25 	 $557.70 	 $676.00 	 $202.80 	 $760.50 	 $686.99 	 $718.25 	 $201.11 	 $686.99 	 $202.80 
5271624	HCHG CVMC BONE SCREW NON-LOCKING HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $566.47 	 $396.53 	 $134.82 	 $509.82 	 $492.83 	 $135.95 	 $433.35 	 $-   	 $-   	 $215.26 	 $356.88 	 $481.50 	 $373.87 	 $453.18 	 $135.95 	 $509.82 	 $460.54 	 $481.50 	 $134.82 	 $460.54 	 $135.95 
5271625	HCHG CVMC BONE SCREW NON-LOCKING HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $740.77 	 $518.54 	 $176.30 	 $666.69 	 $644.47 	 $177.78 	 $566.69 	 $-   	 $-   	 $281.49 	 $466.69 	 $629.65 	 $488.91 	 $592.62 	 $177.78 	 $666.69 	 $602.25 	 $629.65 	 $176.30 	 $602.25 	 $177.78 
5271626	HCHG CVMC BONE SCREW LOCKG HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $700.32 	 $490.22 	 $166.68 	 $630.29 	 $609.28 	 $168.08 	 $535.74 	 $-   	 $-   	 $266.12 	 $441.20 	 $595.27 	 $462.21 	 $560.26 	 $168.08 	 $630.29 	 $569.36 	 $595.27 	 $166.68 	 $569.36 	 $168.08 
5271627	HCHG CVMC BONE SCREW LOCKING HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $845.01 	 $591.51 	 $201.11 	 $760.51 	 $735.16 	 $202.80 	 $646.43 	 $-   	 $-   	 $321.10 	 $532.36 	 $718.26 	 $557.71 	 $676.01 	 $202.80 	 $760.51 	 $686.99 	 $718.26 	 $201.11 	 $686.99 	 $202.80 
5271628	HCHG CVMC BONE SCREW CORTICAL SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $479.32 	 $335.52 	 $114.08 	 $431.39 	 $417.01 	 $115.04 	 $366.68 	 $-   	 $-   	 $182.14 	 $301.97 	 $407.42 	 $316.35 	 $383.46 	 $115.04 	 $431.39 	 $389.69 	 $407.42 	 $114.08 	 $389.69 	 $115.04 
5271629	HCHG CVMC BONE SCREW CANCELLOUS SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $537.42 	 $376.19 	 $127.91 	 $483.68 	 $467.56 	 $128.98 	 $411.13 	 $-   	 $-   	 $204.22 	 $338.57 	 $456.81 	 $354.70 	 $429.94 	 $128.98 	 $483.68 	 $436.92 	 $456.81 	 $127.91 	 $436.92 	 $128.98 
5271630	HCHG CVMC CORTICAL SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $639.10 	 $447.37 	 $152.11 	 $575.19 	 $556.02 	 $153.38 	 $488.91 	 $-   	 $-   	 $242.86 	 $402.63 	 $543.24 	 $421.81 	 $511.28 	 $153.38 	 $575.19 	 $519.59 	 $543.24 	 $152.11 	 $519.59 	 $153.38 
5271631	HCHG CVMC BONE SCREW NO-TOG CORTICAL SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $646.36 	 $452.45 	 $153.83 	 $581.72 	 $562.33 	 $155.13 	 $494.47 	 $-   	 $-   	 $245.62 	 $407.21 	 $549.41 	 $426.60 	 $517.09 	 $155.13 	 $581.72 	 $525.49 	 $549.41 	 $153.83 	 $525.49 	 $155.13 
5271632	HCHG CVMC BONE SCREW CANCELLOUS SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $668.15 	 $467.71 	 $159.02 	 $601.34 	 $581.29 	 $160.36 	 $511.13 	 $-   	 $-   	 $253.90 	 $420.93 	 $567.93 	 $440.98 	 $534.52 	 $160.36 	 $601.34 	 $543.21 	 $567.93 	 $159.02 	 $543.21 	 $160.36 
5271633	HCHG CVMC BONE SCREW LOCKING CORTICAL SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $733.51 	 $513.46 	 $174.58 	 $660.16 	 $638.15 	 $176.04 	 $561.14 	 $-   	 $-   	 $278.73 	 $462.11 	 $623.48 	 $484.12 	 $586.81 	 $176.04 	 $660.16 	 $596.34 	 $623.48 	 $174.58 	 $596.34 	 $176.04 
5271634	HCHG CVMC BONE SCREW TAP-LOC SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $729.25 	 $510.48 	 $173.56 	 $656.33 	 $634.45 	 $175.02 	 $557.88 	 $-   	 $-   	 $277.12 	 $459.43 	 $619.86 	 $481.31 	 $583.40 	 $175.02 	 $656.33 	 $592.88 	 $619.86 	 $173.56 	 $592.88 	 $175.02 
5271635	HCHG CVMC BONE SCREW ACUTWIST ACUTK COMP SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,105.46 "	 $773.82 	 $263.10 	 $994.91 	 $961.75 	 $265.31 	 $845.68 	 $-   	 $-   	 $420.07 	 $696.44 	 $939.64 	 $729.60 	 $884.37 	 $265.31 	 $994.91 	 $898.74 	 $939.64 	 $263.10 	 $898.74 	 $265.31 
5271636	HCHG CVMC BONE PLATE OLECRANON PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,663.23 "	" $2,564.26 "	 $871.85 	" $3,663.23 "	" $3,187.01 "	 $879.18 	" $2,802.37 "	" $3,663.23 "	" $3,663.23 "	" $1,392.03 "	" $2,307.83 "	" $3,113.75 "	" $2,417.73 "	" $2,930.58 "	 $879.18 	" $3,296.91 "	" $2,978.21 "	" $3,113.75 "	 $871.85 	" $2,978.21 "	 $879.18 
5271637	HCHG CVMC BONE PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,682.66 "	" $2,577.86 "	 $876.47 	" $3,682.66 "	" $3,203.91 "	 $883.84 	" $2,817.23 "	" $3,682.66 "	" $3,682.66 "	" $1,399.41 "	" $2,320.08 "	" $3,130.26 "	" $2,430.56 "	" $2,946.13 "	 $883.84 	" $3,314.39 "	" $2,994.00 "	" $3,130.26 "	 $876.47 	" $2,994.00 "	 $883.84 
5271638	HCHG CVMC BONE PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,837.04 "	" $2,685.93 "	 $913.22 	" $3,837.04 "	" $3,338.22 "	 $920.89 	" $2,935.34 "	" $3,837.04 "	" $3,837.04 "	" $1,458.08 "	" $2,417.34 "	" $3,261.48 "	" $2,532.45 "	" $3,069.63 "	 $920.89 	" $3,453.34 "	" $3,119.51 "	" $3,261.48 "	 $913.22 	" $3,119.51 "	 $920.89 
5271639	HCHG CVMC BONE PLATE DISTAL CLAV PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,340.02 "	" $2,338.01 "	 $794.92 	" $3,340.02 "	" $2,905.82 "	 $801.60 	" $2,555.12 "	" $3,340.02 "	" $3,340.02 "	" $1,269.21 "	" $2,104.21 "	" $2,839.02 "	" $2,204.41 "	" $2,672.02 "	 $801.60 	" $3,006.02 "	" $2,715.44 "	" $2,839.02 "	 $794.92 	" $2,715.44 "	 $801.60 
5271640	HCHG CVMC BONE PLATE OLECRANON PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,377.90 "	" $2,364.53 "	 $803.94 	" $3,377.90 "	" $2,938.77 "	 $810.70 	" $2,584.09 "	" $3,377.90 "	" $3,377.90 "	" $1,283.60 "	" $2,128.08 "	" $2,871.22 "	" $2,229.41 "	" $2,702.32 "	 $810.70 	" $3,040.11 "	" $2,746.23 "	" $2,871.22 "	 $803.94 	" $2,746.23 "	 $810.70 
5271641	HCHG CVMC BONE PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,393.69 "	" $2,375.58 "	 $807.70 	" $3,393.69 "	" $2,952.51 "	 $814.49 	" $2,596.17 "	" $3,393.69 "	" $3,393.69 "	" $1,289.60 "	" $2,138.02 "	" $2,884.64 "	" $2,239.84 "	" $2,714.95 "	 $814.49 	" $3,054.32 "	" $2,759.07 "	" $2,884.64 "	 $807.70 	" $2,759.07 "	 $814.49 
5271642	HCHG CVMC BONE PLATE POST-LAT DIST HUM PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,444.20 "	" $2,410.94 "	 $819.72 	" $3,444.20 "	" $2,996.45 "	 $826.61 	" $2,634.81 "	" $3,444.20 "	" $3,444.20 "	" $1,308.80 "	" $2,169.85 "	" $2,927.57 "	" $2,273.17 "	" $2,755.36 "	 $826.61 	" $3,099.78 "	" $2,800.13 "	" $2,927.57 "	 $819.72 	" $2,800.13 "	 $826.61 
5271643	HCHG CVMC BONE PLATE CORONOID PLATE STD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,883.01 "	" $2,718.11 "	 $924.16 	" $3,883.01 "	" $3,378.22 "	 $931.92 	" $2,970.50 "	" $3,883.01 "	" $3,883.01 "	" $1,475.54 "	" $2,446.30 "	" $3,300.56 "	" $2,562.79 "	" $3,106.41 "	 $931.92 	" $3,494.71 "	" $3,156.89 "	" $3,300.56 "	 $924.16 	" $3,156.89 "	 $931.92 
5271644	HCHG CVMC TENSION BAND PIN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $341.34 	 $238.94 	 $81.24 	 $307.21 	 $296.97 	 $81.92 	 $261.13 	 $-   	 $-   	 $129.71 	 $215.04 	 $290.14 	 $225.28 	 $273.07 	 $81.92 	 $307.21 	 $277.51 	 $290.14 	 $81.24 	 $277.51 	 $81.92 
5271645	HCHG CVMC SUTURE ANCHOR HEALICOIL SA PK 5.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,398.48 "	 $978.94 	 $332.84 	" $1,258.63 "	" $1,216.68 "	 $335.64 	" $1,069.84 "	 $-   	 $-   	 $531.42 	 $881.04 	" $1,188.71 "	 $923.00 	" $1,118.78 "	 $335.64 	" $1,258.63 "	" $1,136.96 "	" $1,188.71 "	 $332.84 	" $1,136.96 "	 $335.64 
5271646	HCHG CVMC SCREW REFLECTION CANC. 6.5 X 4	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,287.49 "	 $901.24 	 $306.42 	" $1,158.74 "	" $1,120.12 "	 $309.00 	 $984.93 	 $-   	 $-   	 $489.25 	 $811.12 	" $1,094.37 "	 $849.74 	" $1,029.99 "	 $309.00 	" $1,158.74 "	" $1,046.73 "	" $1,094.37 "	 $306.42 	" $1,046.73 "	 $309.00 
5271647	HCHG CVMC HUMAN BONE GRAFTING MATERIAL CANCELLOUS CRUSHED 1-4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $1,748.10 "	" $1,223.67 "	 $416.05 	" $1,748.10 "	" $1,520.85 "	 $419.54 	" $1,337.30 "	" $1,748.10 "	" $1,748.10 "	 $664.28 	" $1,101.30 "	" $1,485.89 "	" $1,153.75 "	" $1,398.48 "	 $419.54 	" $1,573.29 "	" $1,421.21 "	" $1,485.89 "	 $416.05 	" $1,421.21 "	 $419.54 
5271648	HCHG CVMC CONNECTIVE TISSUE (HUMAN) TISSEEL GLUE W/DUPLOJECT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	 $838.81 	 $587.17 	 $199.64 	 $754.93 	 $729.76 	 $201.31 	 $641.69 	 $-   	 $-   	 $318.75 	 $528.45 	 $712.99 	 $553.61 	 $671.05 	 $201.31 	 $754.93 	 $681.95 	 $712.99 	 $199.64 	 $681.95 	 $201.31 
5271649	HCHG CVMC CONNECTIVE TISSUE (HUMAN) TISSEEL GLUE KIT 2ML ONLY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	 $757.44 	 $530.21 	 $180.27 	 $681.70 	 $658.97 	 $181.79 	 $579.44 	 $-   	 $-   	 $287.83 	 $477.19 	 $643.82 	 $499.91 	 $605.95 	 $181.79 	 $681.70 	 $615.80 	 $643.82 	 $180.27 	 $615.80 	 $181.79 
5271650	HCHG CVMC CONNECTIVE TISSUE (HUMAN) TISSEEL GLUE KIT 4ML ONLY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $1,191.11 "	 $833.78 	 $283.48 	" $1,072.00 "	" $1,036.27 "	 $285.87 	 $911.20 	 $-   	 $-   	 $452.62 	 $750.40 	" $1,012.44 "	 $786.13 	 $952.89 	 $285.87 	" $1,072.00 "	 $968.37 	" $1,012.44 "	 $283.48 	 $968.37 	 $285.87 
5271651	HCHG CVMC KWIRE TROC PT 1.6 X 150MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1769	 $159.10 	 $111.37 	 $37.87 	 $143.19 	 $138.42 	 $38.18 	 $121.71 	 $-   	 $-   	 $60.46 	 $100.23 	 $135.24 	 $105.01 	 $127.28 	 $38.18 	 $143.19 	 $129.35 	 $135.24 	 $37.87 	 $129.35 	 $38.18 
5271652	HCHG CVMC K-WIRE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1769	 $76.37 	 $53.46 	 $18.18 	 $68.73 	 $66.44 	 $18.33 	 $58.42 	 $-   	 $-   	 $29.02 	 $48.11 	 $64.91 	 $50.40 	 $61.10 	 $18.33 	 $68.73 	 $62.09 	 $64.91 	 $18.18 	 $62.09 	 $18.33 
5271653	HCHG CVMC K-WIRE 16MM SS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1769	 $181.56 	 $127.09 	 $43.21 	 $163.40 	 $157.96 	 $43.57 	 $138.89 	 $-   	 $-   	 $68.99 	 $114.38 	 $154.33 	 $119.83 	 $145.25 	 $43.57 	 $163.40 	 $147.61 	 $154.33 	 $43.21 	 $147.61 	 $43.57 
5271654	HCHG CVMC FEMORAL MOD TLOC PRO-JOINT COMPONENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $15,146.90 "	" $10,602.83 "	" $3,604.96 "	" $15,146.90 "	" $13,177.80 "	" $3,635.26 "	" $11,587.38 "	" $15,146.90 "	" $15,146.90 "	" $5,755.82 "	" $9,542.55 "	" $12,874.87 "	" $9,996.95 "	" $12,117.52 "	" $3,635.26 "	" $13,632.21 "	" $12,314.43 "	" $12,874.87 "	" $3,604.96 "	" $12,314.43 "	" $3,635.26 "
5271655	HCHG CVMC VERSA-DIAL MOD HEAD JOINT COMPONENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,884.50 "	" $4,119.15 "	" $1,400.51 "	" $5,884.50 "	" $5,119.52 "	" $1,412.28 "	" $4,501.64 "	" $5,884.50 "	" $5,884.50 "	" $2,236.11 "	" $3,707.24 "	" $5,001.83 "	" $3,883.77 "	" $4,707.60 "	" $1,412.28 "	" $5,296.05 "	" $4,784.10 "	" $5,001.83 "	" $1,400.51 "	" $4,784.10 "	" $1,412.28 "
5271656	HCHG CVMC JOINT COMPONENT-COMPR FX HMRL POS SLV	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,580.05 "	" $1,106.04 "	 $376.05 	" $1,580.05 "	" $1,374.64 "	 $379.21 	" $1,208.74 "	" $1,580.05 "	 $-   	 $600.42 	 $995.43 	" $1,343.04 "	" $1,042.83 "	" $1,264.04 "	 $379.21 	" $1,422.05 "	" $1,284.58 "	" $1,343.04 "	 $376.05 	" $1,284.58 "	 $379.21 
5271657	HCHG CVMC SHOULDER COMPONENT STEM MICRO	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $14,506.05 "	" $10,154.24 "	" $3,452.44 "	" $14,506.05 "	" $12,620.26 "	" $3,481.45 "	" $11,097.13 "	" $14,506.05 "	" $14,506.05 "	" $5,512.30 "	" $9,138.81 "	" $12,330.14 "	" $9,573.99 "	" $11,604.84 "	" $3,481.45 "	" $13,055.45 "	" $11,793.42 "	" $12,330.14 "	" $3,452.44 "	" $11,793.42 "	" $3,481.45 "
5271658	HCHG CVMC JOINT COMPONENT-COMPR STEM ALL SIZES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $11,159.71 "	" $7,811.80 "	" $2,656.01 "	" $11,159.71 "	" $9,708.95 "	" $2,678.33 "	" $8,537.18 "	" $11,159.71 "	" $11,159.71 "	" $4,240.69 "	" $7,030.62 "	" $9,485.75 "	" $7,365.41 "	" $8,927.77 "	" $2,678.33 "	" $10,043.74 "	" $9,072.84 "	" $9,485.75 "	" $2,656.01 "	" $9,072.84 "	" $2,678.33 "
5271659	HCHG CVMC COMPR STEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $15,330.00 "	" $10,731.00 "	" $3,648.54 "	" $15,330.00 "	" $13,337.10 "	" $3,679.20 "	" $11,727.45 "	" $15,330.00 "	" $15,330.00 "	" $5,825.40 "	" $9,657.90 "	" $13,030.50 "	" $10,117.80 "	" $12,264.00 "	" $3,679.20 "	" $13,797.00 "	" $12,463.29 "	" $13,030.50 "	" $3,648.54 "	" $12,463.29 "	" $3,679.20 "
5271660	HCHG CVMC JOINT DEVICE COMPONENT BIO-MOD HMRL HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,230.27 "	" $2,961.19 "	" $1,006.80 "	" $4,230.27 "	" $3,680.33 "	" $1,015.26 "	" $3,236.16 "	" $4,230.27 "	" $4,230.27 "	" $1,607.50 "	" $2,665.07 "	" $3,595.73 "	" $2,791.98 "	" $3,384.22 "	" $1,015.26 "	" $3,807.24 "	" $3,439.21 "	" $3,595.73 "	" $1,006.80 "	" $3,439.21 "	" $1,015.26 "
5271661	HCHG CVMC JOINT DEVICE COMPONENT SHLDR PC HYB GLENOID POST POLY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,608.99 "	" $1,126.29 "	 $382.94 	" $1,608.99 "	" $1,399.82 "	 $386.16 	" $1,230.88 "	" $1,608.99 "	" $1,608.99 "	 $611.42 	" $1,013.66 "	" $1,367.64 "	" $1,061.93 "	" $1,287.19 "	 $386.16 	" $1,448.09 "	" $1,308.11 "	" $1,367.64 "	 $382.94 	" $1,308.11 "	 $386.16 
5271662	HCHG CVMC JOINT DEVICE COMPONENT SHLDR HYBRID GLEN BASE-ALL 4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,429.90 "	" $3,800.93 "	" $1,292.32 "	" $5,429.90 "	" $4,724.01 "	" $1,303.18 "	" $4,153.87 "	" $5,429.90 "	" $5,429.90 "	" $2,063.36 "	" $3,420.84 "	" $4,615.42 "	" $3,583.73 "	" $4,343.92 "	" $1,303.18 "	" $4,886.91 "	" $4,414.51 "	" $4,615.42 "	" $1,292.32 "	" $4,414.51 "	" $1,303.18 "
5271663	HCHG CVMC JOINT DEVICE COMPONENT SHLDR COMP RVS GLNSR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,117.37 "	" $3,582.16 "	" $1,217.93 "	" $5,117.37 "	" $4,452.11 "	" $1,228.17 "	" $3,914.79 "	" $5,117.37 "	" $5,117.37 "	" $1,944.60 "	" $3,223.94 "	" $4,349.76 "	" $3,377.46 "	" $4,093.90 "	" $1,228.17 "	" $4,605.63 "	" $4,160.42 "	" $4,349.76 "	" $1,217.93 "	" $4,160.42 "	" $1,228.17 "
5271664	HCHG CVMC JOINT DEVICE COMPONENT SHLDR COMP RVS BASEPLAT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,423.59 "	" $3,796.51 "	" $1,290.81 "	" $5,423.59 "	" $4,718.52 "	" $1,301.66 "	" $4,149.05 "	" $5,423.59 "	" $5,423.59 "	" $2,060.96 "	" $3,416.86 "	" $4,610.05 "	" $3,579.57 "	" $4,338.87 "	" $1,301.66 "	" $4,881.23 "	" $4,409.38 "	" $4,610.05 "	" $1,290.81 "	" $4,409.38 "	" $1,301.66 "
5271665	HCHG CVMC JOINT DEVICE COMPONENT SHLDR COMP RVS HMRL TRY 44MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,916.07 "	" $4,141.25 "	" $1,408.02 "	" $5,916.07 "	" $5,146.98 "	" $1,419.86 "	" $4,525.79 "	" $5,916.07 "	" $5,916.07 "	" $2,248.11 "	" $3,727.12 "	" $5,028.66 "	" $3,904.61 "	" $4,732.86 "	" $1,419.86 "	" $5,324.46 "	" $4,809.76 "	" $5,028.66 "	" $1,408.02 "	" $4,809.76 "	" $1,419.86 "
5271666	HCHG CVMC VERSA-DIAL SHOULDER ADAPTER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,151.76 "	 $806.23 	 $274.12 	" $1,036.58 "	" $1,002.03 "	 $276.42 	 $881.10 	 $-   	 $-   	 $437.67 	 $725.61 	 $979.00 	 $760.16 	 $921.41 	 $276.42 	" $1,036.58 "	 $936.38 	 $979.00 	 $274.12 	 $936.38 	 $276.42 
5271667	HCHG CVMC JOINT DEVICE COMPONENT BIOMET INTLK PRI TIB TRAY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,982.36 "	" $4,187.65 "	" $1,423.80 "	" $5,982.36 "	" $5,204.65 "	" $1,435.77 "	" $4,576.51 "	" $5,982.36 "	" $5,982.36 "	" $2,273.30 "	" $3,768.89 "	" $5,085.01 "	" $3,948.36 "	" $4,785.89 "	" $1,435.77 "	" $5,384.12 "	" $4,863.66 "	" $5,085.01 "	" $1,423.80 "	" $4,863.66 "	" $1,435.77 "
5271668	HCHG CVMC JOINT DEVICE COMPONENT BIOMET I-BEAM TIB TRAY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,165.46 "	" $4,315.82 "	" $1,467.38 "	" $6,165.46 "	" $5,363.95 "	" $1,479.71 "	" $4,716.58 "	" $6,165.46 "	" $6,165.46 "	" $2,342.87 "	" $3,884.24 "	" $5,240.64 "	" $4,069.20 "	" $4,932.37 "	" $1,479.71 "	" $5,548.91 "	" $5,012.52 "	" $5,240.64 "	" $1,467.38 "	" $5,012.52 "	" $1,479.71 "
5271669	HCHG CVMC JOINT DEVICE COMPONENT OXFORD UNI FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,995.55 "	" $7,696.89 "	" $2,616.94 "	" $10,995.55 "	" $9,566.13 "	" $2,638.93 "	" $8,411.60 "	" $10,995.55 "	" $10,995.55 "	" $4,178.31 "	" $6,927.20 "	" $9,346.22 "	" $7,257.06 "	" $8,796.44 "	" $2,638.93 "	" $9,896.00 "	" $8,939.38 "	" $9,346.22 "	" $2,616.94 "	" $8,939.38 "	" $2,638.93 "
5271670	HCHG CVMC JOINT DEVICE COMPONENT OXFORD UNI TIB TRAY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,324.05 "	" $5,126.84 "	" $1,743.12 "	" $7,324.05 "	" $6,371.92 "	" $1,757.77 "	" $5,602.90 "	" $7,324.05 "	" $7,324.05 "	" $2,783.14 "	" $4,614.15 "	" $6,225.44 "	" $4,833.87 "	" $5,859.24 "	" $1,757.77 "	" $6,591.65 "	" $5,954.45 "	" $6,225.44 "	" $1,743.12 "	" $5,954.45 "	" $1,757.77 "
5271671	HCHG CVMC JOINT DEVICE OXFORD UNI FEMORAL XS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,995.55 "	" $7,696.89 "	" $2,616.94 "	" $10,995.55 "	" $9,566.13 "	" $2,638.93 "	" $8,411.60 "	" $10,995.55 "	" $10,995.55 "	" $4,178.31 "	" $6,927.20 "	" $9,346.22 "	" $7,257.06 "	" $8,796.44 "	" $2,638.93 "	" $9,896.00 "	" $8,939.38 "	" $9,346.22 "	" $2,616.94 "	" $8,939.38 "	" $2,638.93 "
5271672	HCHG CVMC JOINT DEVICE COMPONENT OXFORD UNI TIB TRAY	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,324.05 "	" $5,126.84 "	" $1,743.12 "	" $7,324.05 "	" $6,371.92 "	" $1,757.77 "	" $5,602.90 "	" $7,324.05 "	" $7,324.05 "	" $2,783.14 "	" $4,614.15 "	" $6,225.44 "	" $4,833.87 "	" $5,859.24 "	" $1,757.77 "	" $6,591.65 "	" $5,954.45 "	" $6,225.44 "	" $1,743.12 "	" $5,954.45 "	" $1,757.77 "
5271673	HCHG CVMC JOINT DEVICE COMPONENT OXFORD UNI KNEE BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,425.26 "	" $2,397.68 "	 $815.21 	" $3,425.26 "	" $2,979.98 "	 $822.06 	" $2,620.32 "	" $3,425.26 "	" $3,425.26 "	" $1,301.60 "	" $2,157.91 "	" $2,911.47 "	" $2,260.67 "	" $2,740.21 "	 $822.06 	" $3,082.73 "	" $2,784.74 "	" $2,911.47 "	 $815.21 	" $2,784.74 "	 $822.06 
5271674	HCHG CVMC JOINT DEVICE COMPONENT OXFORD TWIN-PEG UNI FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,995.55 "	" $7,696.89 "	" $2,616.94 "	" $10,995.55 "	" $9,566.13 "	" $2,638.93 "	" $8,411.60 "	" $10,995.55 "	" $10,995.55 "	" $4,178.31 "	" $6,927.20 "	" $9,346.22 "	" $7,257.06 "	" $8,796.44 "	" $2,638.93 "	" $9,896.00 "	" $8,939.38 "	" $9,346.22 "	" $2,616.94 "	" $8,939.38 "	" $2,638.93 "
5271675	HCHG CVMC JOINT DEVICE COMPONENT DISTAL CENTRALIZER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,030.22 "	 $721.15 	 $245.19 	 $927.20 	 $896.29 	 $247.25 	 $788.12 	 $-   	 $-   	 $391.48 	 $649.04 	 $875.69 	 $679.95 	 $824.18 	 $247.25 	 $927.20 	 $837.57 	 $875.69 	 $245.19 	 $837.57 	 $247.25 
5271676	HCHG CVMC JOINT DEVICE COMPONENT COCR OFFSET FEM HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,007.62 "	" $4,205.33 "	" $1,429.81 "	" $6,007.62 "	" $5,226.63 "	" $1,441.83 "	" $4,595.83 "	" $6,007.62 "	" $6,007.62 "	" $2,282.90 "	" $3,784.80 "	" $5,106.48 "	" $3,965.03 "	" $4,806.10 "	" $1,441.83 "	" $5,406.86 "	" $4,884.20 "	" $5,106.48 "	" $1,429.81 "	" $4,884.20 "	" $1,441.83 "
5271677	HCHG CVMC JOINT DEVICE COMPONENT MODULAR HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,469.00 "	" $2,428.30 "	 $825.62 	" $3,469.00 "	" $3,018.03 "	 $832.56 	" $2,653.79 "	" $3,469.00 "	" $3,469.00 "	" $1,318.22 "	" $2,185.47 "	" $2,948.65 "	" $2,289.54 "	" $2,775.20 "	 $832.56 	" $3,122.10 "	" $2,820.30 "	" $2,948.65 "	 $825.62 	" $2,820.30 "	 $832.56 
5271678	HCHG CVMC JOINT DEVICE COMPONENT VANGRD CR FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $12,084.69 "	" $8,459.28 "	" $2,876.16 "	" $12,084.69 "	" $10,513.68 "	" $2,900.33 "	" $9,244.79 "	" $12,084.69 "	" $12,084.69 "	" $4,592.18 "	" $7,613.35 "	" $10,271.99 "	" $7,975.90 "	" $9,667.75 "	" $2,900.33 "	" $10,876.22 "	" $9,824.85 "	" $10,271.99 "	" $2,876.16 "	" $9,824.85 "	" $2,900.33 "
5271679	HCHG CVMC JOINT DEVICE COMPONENT VANGRD CR POR FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $14,954.33 "	" $10,468.03 "	" $3,559.13 "	" $14,954.33 "	" $13,010.27 "	" $3,589.04 "	" $11,440.06 "	" $14,954.33 "	" $14,954.33 "	" $5,682.65 "	" $9,421.23 "	" $12,711.18 "	" $9,869.86 "	" $11,963.46 "	" $3,589.04 "	" $13,458.90 "	" $12,157.87 "	" $12,711.18 "	" $3,559.13 "	" $12,157.87 "	" $3,589.04 "
5271680	HCHG CVMC JOINT DEVICE COMPONENT VANGRD CR STEM HOUSING	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,103.84 "	" $2,172.69 "	 $738.71 	" $3,103.84 "	" $2,700.34 "	 $744.92 	" $2,374.44 "	" $3,103.84 "	" $3,103.84 "	" $1,179.46 "	" $1,955.42 "	" $2,638.26 "	" $2,048.53 "	" $2,483.07 "	 $744.92 	" $2,793.46 "	" $2,523.42 "	" $2,638.26 "	 $738.71 	" $2,523.42 "	 $744.92 
5271681	HCHG CVMC JOINT DEVICE COMPONENT VANGRD PS OP FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,034.92 "	" $9,124.44 "	" $3,102.31 "	" $13,034.92 "	" $11,340.38 "	" $3,128.38 "	" $9,971.71 "	" $13,034.92 "	" $13,034.92 "	" $4,953.27 "	" $8,212.00 "	" $11,079.68 "	" $8,603.05 "	" $10,427.94 "	" $3,128.38 "	" $11,731.43 "	" $10,597.39 "	" $11,079.68 "	" $3,102.31 "	" $10,597.39 "	" $3,128.38 "
5271682	HCHG CVMC JOINT DEVICE COMPONENT VANGRD PS CL FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,224.34 "	" $9,257.04 "	" $3,147.39 "	" $13,224.34 "	" $11,505.18 "	" $3,173.84 "	" $10,116.62 "	" $13,224.34 "	" $13,224.34 "	" $5,025.25 "	" $8,331.33 "	" $11,240.69 "	" $8,728.06 "	" $10,579.47 "	" $3,173.84 "	" $11,901.91 "	" $10,751.39 "	" $11,240.69 "	" $3,147.39 "	" $10,751.39 "	" $3,173.84 "
5271683	HCHG CVMC JOINT DEVICE COMPONENT VANGRD SSK FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $20,437.90 "	" $14,306.53 "	" $4,864.22 "	" $20,437.90 "	" $17,780.97 "	" $4,905.10 "	" $15,634.99 "	" $20,437.90 "	" $20,437.90 "	" $7,766.40 "	" $12,875.88 "	" $17,372.22 "	" $13,489.01 "	" $16,350.32 "	" $4,905.10 "	" $18,394.11 "	" $16,616.01 "	" $17,372.22 "	" $4,864.22 "	" $16,616.01 "	" $4,905.10 "
5271684	HCHG CVMC JOINT DEVICE COMPONENT VANGRD CR TIB BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,287.10 "	" $3,000.97 "	" $1,020.33 "	" $4,287.10 "	" $3,729.78 "	" $1,028.90 "	" $3,279.63 "	" $4,287.10 "	" $4,287.10 "	" $1,629.10 "	" $2,700.87 "	" $3,644.04 "	" $2,829.49 "	" $3,429.68 "	" $1,028.90 "	" $3,858.39 "	" $3,485.41 "	" $3,644.04 "	" $1,020.33 "	" $3,485.41 "	" $1,028.90 "
5271685	HCHG CVMC JOINT DEVICE COMPONENT VANGRD PS TIB BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,501.77 "	" $3,151.24 "	" $1,071.42 "	" $4,501.77 "	" $3,916.54 "	" $1,080.42 "	" $3,443.85 "	" $4,501.77 "	" $4,501.77 "	" $1,710.67 "	" $2,836.12 "	" $3,826.50 "	" $2,971.17 "	" $3,601.42 "	" $1,080.42 "	" $4,051.59 "	" $3,659.94 "	" $3,826.50 "	" $1,071.42 "	" $3,659.94 "	" $1,080.42 "
5271686	HCHG CVMC JOINT DEVICE COMPONENT VANGRD PS+ TIB BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,789.05 "	" $3,352.34 "	" $1,139.79 "	" $4,789.05 "	" $4,166.47 "	" $1,149.37 "	" $3,663.62 "	" $4,789.05 "	" $4,789.05 "	" $1,819.84 "	" $3,017.10 "	" $4,070.69 "	" $3,160.77 "	" $3,831.24 "	" $1,149.37 "	" $4,310.15 "	" $3,893.50 "	" $4,070.69 "	" $1,139.79 "	" $3,893.50 "	" $1,149.37 "
5271687	HCHG CVMC JOINT DEVICE COMPONENT BIOMET A STD PATELLA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,243.69 "	" $2,270.58 "	 $772.00 	" $3,243.69 "	" $2,822.01 "	 $778.49 	" $2,481.42 "	" $3,243.69 "	" $3,243.69 "	" $1,232.60 "	" $2,043.52 "	" $2,757.14 "	" $2,140.84 "	" $2,594.95 "	 $778.49 	" $2,919.32 "	" $2,637.12 "	" $2,757.14 "	 $772.00 	" $2,637.12 "	 $778.49 
5271688	HCHG CVMC JOINT DEVICE COMPONENT COPELAND MB HUMERAL HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $11,481.72 "	" $8,037.20 "	" $2,732.65 "	" $11,481.72 "	" $9,989.10 "	" $2,755.61 "	" $8,783.52 "	" $11,481.72 "	" $11,481.72 "	" $4,363.05 "	" $7,233.48 "	" $9,759.46 "	" $7,577.94 "	" $9,185.38 "	" $2,755.61 "	" $10,333.55 "	" $9,334.64 "	" $9,759.46 "	" $2,732.65 "	" $9,334.64 "	" $2,755.61 "
5271689	HCHG CVMC JOINT DEVICE COMPONENT COPELAND HA HUMERAL HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $12,431.95 "	" $8,702.37 "	" $2,958.80 "	" $12,431.95 "	" $10,815.80 "	" $2,983.67 "	" $9,510.44 "	" $12,431.95 "	" $12,431.95 "	" $4,724.14 "	" $7,832.13 "	" $10,567.16 "	" $8,205.09 "	" $9,945.56 "	" $2,983.67 "	" $11,188.76 "	" $10,107.18 "	" $10,567.16 "	" $2,958.80 "	" $10,107.18 "	" $2,983.67 "
5271690	HCHG CVMC JOINT DEVICE COMPONENT M2A HI-C MODULAR HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,311.61 "	" $2,318.13 "	 $788.16 	" $3,311.61 "	" $2,881.10 "	 $794.79 	" $2,533.38 "	" $3,311.61 "	" $3,311.61 "	" $1,258.41 "	" $2,086.31 "	" $2,814.87 "	" $2,185.66 "	" $2,649.29 "	 $794.79 	" $2,980.45 "	" $2,692.34 "	" $2,814.87 "	 $788.16 	" $2,692.34 "	 $794.79 
5271691	HCHG CVMC JOINT DEVICE COMPONENT RNGLC BI-POLAR 28 CUP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,886.17 "	" $2,720.32 "	 $924.91 	" $3,886.17 "	" $3,380.97 "	 $932.68 	" $2,972.92 "	" $3,886.17 "	" $3,886.17 "	" $1,476.74 "	" $2,448.29 "	" $3,303.24 "	" $2,564.87 "	" $3,108.94 "	 $932.68 	" $3,497.55 "	" $3,159.46 "	" $3,303.24 "	 $924.91 	" $3,159.46 "	 $932.68 
5271692	HCHG CVMC JOINT DEVICE COMPONENT M2A MODULAR HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,694.34 "	" $3,286.04 "	" $1,117.25 "	" $4,694.34 "	" $4,084.08 "	" $1,126.64 "	" $3,591.17 "	" $4,694.34 "	" $4,694.34 "	" $1,783.85 "	" $2,957.43 "	" $3,990.19 "	" $3,098.26 "	" $3,755.47 "	" $1,126.64 "	" $4,224.91 "	" $3,816.50 "	" $3,990.19 "	" $1,117.25 "	" $3,816.50 "	" $1,126.64 "
5271693	HCHG CVMC JOINT DEVICE COMPONENT EXPLOR IMPLANT HEAD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,924.05 "	" $2,746.84 "	 $933.92 	" $3,924.05 "	" $3,413.92 "	 $941.77 	" $3,001.90 "	" $3,924.05 "	" $3,924.05 "	" $1,491.14 "	" $2,472.15 "	" $3,335.44 "	" $2,589.87 "	" $3,139.24 "	 $941.77 	" $3,531.65 "	" $3,190.25 "	" $3,335.44 "	 $933.92 	" $3,190.25 "	 $941.77 
5271694	HCHG CVMC JOINT DEVICE COMPONENT EXPLOR IMPLANT STEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,650.14 "	" $3,255.10 "	" $1,106.73 "	" $4,650.14 "	" $4,045.62 "	" $1,116.03 "	" $3,557.36 "	" $4,650.14 "	" $4,650.14 "	" $1,767.05 "	" $2,929.59 "	" $3,952.62 "	" $3,069.09 "	" $3,720.11 "	" $1,116.03 "	" $4,185.13 "	" $3,780.56 "	" $3,952.62 "	" $1,106.73 "	" $3,780.56 "	" $1,116.03 "
5271695	HCHG CVMC JOINT DEVICE COMPONENT MODULAR HEAD 36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,849.70 "	" $2,694.79 "	 $916.23 	" $3,849.70 "	" $3,349.24 "	 $923.93 	" $2,945.02 "	" $3,849.70 "	" $3,849.70 "	" $1,462.89 "	" $2,425.31 "	" $3,272.25 "	" $2,540.80 "	" $3,079.76 "	 $923.93 	" $3,464.73 "	" $3,129.81 "	" $3,272.25 "	 $916.23 	" $3,129.81 "	 $923.93 
5271696	HCHG CVMC JOINT DEVICE COMPONENT ECHO PF HIP FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $9,082.46 "	" $6,357.72 "	" $2,161.63 "	" $9,082.46 "	" $7,901.74 "	" $2,179.79 "	" $6,948.08 "	" $9,082.46 "	" $9,082.46 "	" $3,451.33 "	" $5,721.95 "	" $7,720.09 "	" $5,994.42 "	" $7,265.97 "	" $2,179.79 "	" $8,174.21 "	" $7,384.04 "	" $7,720.09 "	" $2,161.63 "	" $7,384.04 "	" $2,179.79 "
5271697	HCHG CVMC JOINT DEVICE COMPONENT ECHO FX HIP/LAT FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,253.11 "	" $3,677.18 "	" $1,250.24 "	" $5,253.11 "	" $4,570.21 "	" $1,260.75 "	" $4,018.63 "	" $5,253.11 "	" $5,253.11 "	" $1,996.18 "	" $3,309.46 "	" $4,465.14 "	" $3,467.05 "	" $4,202.49 "	" $1,260.75 "	" $4,727.80 "	" $4,270.78 "	" $4,465.14 "	" $1,250.24 "	" $4,270.78 "	" $1,260.75 "
5271698	HCHG CVMC JOINT DEVICE COMPONENT TAPERLOC MP FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $19,490.82 "	" $13,643.57 "	" $4,638.82 "	" $19,490.82 "	" $16,957.01 "	" $4,677.80 "	" $14,910.48 "	" $19,490.82 "	" $19,490.82 "	" $7,406.51 "	" $12,279.22 "	" $16,567.20 "	" $12,863.94 "	" $15,592.66 "	" $4,677.80 "	" $17,541.74 "	" $15,846.04 "	" $16,567.20 "	" $4,638.82 "	" $15,846.04 "	" $4,677.80 "
5271699	HCHG CVMC JOINT DEVICE COMPONENT HA TPRLC FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $15,932.97 "	" $11,153.08 "	" $3,792.05 "	" $15,932.97 "	" $13,861.68 "	" $3,823.91 "	" $12,188.72 "	" $15,932.97 "	" $15,932.97 "	" $6,054.53 "	" $10,037.77 "	" $13,543.02 "	" $10,515.76 "	" $12,746.38 "	" $3,823.91 "	" $14,339.67 "	" $12,953.50 "	" $13,543.02 "	" $3,792.05 "	" $12,953.50 "	" $3,823.91 "
5271700	HCHG CVMC JOINT DEVICE COMPONENT E1 RNGLC LNR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,052.56 "	" $4,936.79 "	" $1,678.51 "	" $7,052.56 "	" $6,135.73 "	" $1,692.61 "	" $5,395.21 "	" $7,052.56 "	" $7,052.56 "	" $2,679.97 "	" $4,443.11 "	" $5,994.68 "	" $4,654.69 "	" $5,642.05 "	" $1,692.61 "	" $6,347.30 "	" $5,733.73 "	" $5,994.68 "	" $1,678.51 "	" $5,733.73 "	" $1,692.61 "
5271701	HCHG CVMC JOINT DEVICE COMPONENT E1 VANGRD CB TIB BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,356.37 "	" $5,849.46 "	" $1,988.82 "	" $8,356.37 "	" $7,270.04 "	" $2,005.53 "	" $6,392.62 "	" $8,356.37 "	" $8,356.37 "	" $3,175.42 "	" $5,264.51 "	" $7,102.91 "	" $5,515.20 "	" $6,685.10 "	" $2,005.53 "	" $7,520.73 "	" $6,793.73 "	" $7,102.91 "	" $1,988.82 "	" $6,793.73 "	" $2,005.53 "
5271702	HCHG CVMC JOINT DEVICE COMPONENT E1 VANGRD PS TIB BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,533.15 "	" $5,973.21 "	" $2,030.89 "	" $8,533.15 "	" $7,423.84 "	" $2,047.96 "	" $6,527.86 "	" $8,533.15 "	" $8,533.15 "	" $3,242.60 "	" $5,375.88 "	" $7,253.18 "	" $5,631.88 "	" $6,826.52 "	" $2,047.96 "	" $7,679.84 "	" $6,937.45 "	" $7,253.18 "	" $2,030.89 "	" $6,937.45 "	" $2,047.96 "
5271703	HCHG CVMC JOINT DEVICE COMPONENT REGENEREX RNGLC + CUP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,024.89 "	" $5,617.42 "	" $1,909.92 "	" $8,024.89 "	" $6,981.65 "	" $1,925.97 "	" $6,139.04 "	" $8,024.89 "	" $8,024.89 "	" $3,049.46 "	" $5,055.68 "	" $6,821.16 "	" $5,296.43 "	" $6,419.91 "	" $1,925.97 "	" $7,222.40 "	" $6,524.24 "	" $6,821.16 "	" $1,909.92 "	" $6,524.24 "	" $1,925.97 "
5271704	HCHG CVMC JOINT DEVICE COMPONENT VANGRD M UNI FEMORAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $9,394.99 "	" $6,576.49 "	" $2,236.01 "	" $9,394.99 "	" $8,173.64 "	" $2,254.80 "	" $7,187.17 "	" $9,394.99 "	" $9,394.99 "	" $3,570.10 "	" $5,918.84 "	" $7,985.74 "	" $6,200.69 "	" $7,515.99 "	" $2,254.80 "	" $8,455.49 "	" $7,638.13 "	" $7,985.74 "	" $2,236.01 "	" $7,638.13 "	" $2,254.80 "
5271705	HCHG CVMC JOINT DEVICE COMPONENT VANGRD M UNI BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,366.02 "	" $3,056.21 "	" $1,039.11 "	" $4,366.02 "	" $3,798.44 "	" $1,047.84 "	" $3,340.01 "	" $4,366.02 "	" $4,366.02 "	" $1,659.09 "	" $2,750.59 "	" $3,711.12 "	" $2,881.57 "	" $3,492.82 "	" $1,047.84 "	" $3,929.42 "	" $3,549.57 "	" $3,711.12 "	" $1,039.11 "	" $3,549.57 "	" $1,047.84 "
5271706	HCHG CVMC JOINT DEVICE COMPONENT ARCOMXL LNR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,886.91 "	" $3,420.84 "	" $1,163.08 "	" $4,886.91 "	" $4,251.61 "	" $1,172.86 "	" $3,738.49 "	" $4,886.91 "	" $4,886.91 "	" $1,857.03 "	" $3,078.75 "	" $4,153.87 "	" $3,225.36 "	" $3,909.53 "	" $1,172.86 "	" $4,398.22 "	" $3,973.06 "	" $4,153.87 "	" $1,163.08 "	" $3,973.06 "	" $1,172.86 "
5271707	HCHG CVMC JOINT DEVICE COMPONENT ARCOMXL LNR 28MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,665.93 "	" $3,266.15 "	" $1,110.49 "	" $4,665.93 "	" $4,059.36 "	" $1,119.82 "	" $3,569.44 "	" $4,665.93 "	" $4,665.93 "	" $1,773.05 "	" $2,939.54 "	" $3,966.04 "	" $3,079.51 "	" $3,732.74 "	" $1,119.82 "	" $4,199.34 "	" $3,793.40 "	" $3,966.04 "	" $1,110.49 "	" $3,793.40 "	" $1,119.82 "
5271708	HCHG CVMC JOINT DEVICE COMPONENT ARCOMXL LNR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,886.91 "	" $3,420.84 "	" $1,163.08 "	" $4,886.91 "	" $4,251.61 "	" $1,172.86 "	" $3,738.49 "	" $4,886.91 "	" $4,886.91 "	" $1,857.03 "	" $3,078.75 "	" $4,153.87 "	" $3,225.36 "	" $3,909.53 "	" $1,172.86 "	" $4,398.22 "	" $3,973.06 "	" $4,153.87 "	" $1,163.08 "	" $3,973.06 "	" $1,172.86 "
5271709	HCHG CVMC JOINT DEVICE COMPONENT ARCOMXL LNR 28MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,886.91 "	" $3,420.84 "	" $1,163.08 "	" $4,886.91 "	" $4,251.61 "	" $1,172.86 "	" $3,738.49 "	" $4,886.91 "	" $4,886.91 "	" $1,857.03 "	" $3,078.75 "	" $4,153.87 "	" $3,225.36 "	" $3,909.53 "	" $1,172.86 "	" $4,398.22 "	" $3,973.06 "	" $4,153.87 "	" $1,163.08 "	" $3,973.06 "	" $1,172.86 "
5271710	HCHG CVMC JOINT DEVICE COMPONENT ARCOMXL LNR 36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,665.93 "	" $3,266.15 "	" $1,110.49 "	" $4,665.93 "	" $4,059.36 "	" $1,119.82 "	" $3,569.44 "	" $4,665.93 "	" $4,665.93 "	" $1,773.05 "	" $2,939.54 "	" $3,966.04 "	" $3,079.51 "	" $3,732.74 "	" $1,119.82 "	" $4,199.34 "	" $3,793.40 "	" $3,966.04 "	" $1,110.49 "	" $3,793.40 "	" $1,119.82 "
5271711	HCHG CVMC JOINT DEVICE COMPONENT ARCOMXL HMRL BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,598.89 "	" $2,519.22 "	 $856.54 	" $3,598.89 "	" $3,131.03 "	 $863.73 	" $2,753.15 "	" $3,598.89 "	" $3,598.89 "	" $1,367.58 "	" $2,267.30 "	" $3,059.06 "	" $2,375.27 "	" $2,879.11 "	 $863.73 	" $3,239.00 "	" $2,925.90 "	" $3,059.06 "	 $856.54 	" $2,925.90 "	 $863.73 
5271712	HCHG CVMC JOINT DEVICE COMPONENT E1 VANGUARD PS+TIB BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,561.57 "	" $5,993.10 "	" $2,037.65 "	" $8,561.57 "	" $7,448.57 "	" $2,054.78 "	" $6,549.60 "	" $8,561.57 "	" $8,561.57 "	" $3,253.40 "	" $5,393.79 "	" $7,277.33 "	" $5,650.64 "	" $6,849.26 "	" $2,054.78 "	" $7,705.41 "	" $6,960.56 "	" $7,277.33 "	" $2,037.65 "	" $6,960.56 "	" $2,054.78 "
5271713	HCHG CVMC JOINT DEVICE COMPONENT E1 VANGRD AS TIB BRG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,618.39 "	" $6,032.87 "	" $2,051.18 "	" $8,618.39 "	" $7,498.00 "	" $2,068.41 "	" $6,593.07 "	" $8,618.39 "	" $8,618.39 "	" $3,274.99 "	" $5,429.59 "	" $7,325.63 "	" $5,688.14 "	" $6,894.71 "	" $2,068.41 "	" $7,756.55 "	" $7,006.75 "	" $7,325.63 "	" $2,051.18 "	" $7,006.75 "	" $2,068.41 "
5271714	HCHG CVMC ARTHROSURFACE-ANATOMIC PATELLA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,263.11 "	" $2,284.18 "	 $776.62 	" $3,263.11 "	" $2,838.91 "	 $783.15 	" $2,496.28 "	" $3,263.11 "	" $3,263.11 "	" $1,239.98 "	" $2,055.76 "	" $2,773.64 "	" $2,153.65 "	" $2,610.49 "	 $783.15 	" $2,936.80 "	" $2,652.91 "	" $2,773.64 "	 $776.62 	" $2,652.91 "	 $783.15 
5271715	HCHG CVMC ARTHROSURFACE-OFFSET TROCHLEA 20MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $21,356.56 "	" $14,949.59 "	" $5,082.86 "	" $21,356.56 "	" $18,580.21 "	" $5,125.57 "	" $16,337.77 "	" $21,356.56 "	" $21,356.56 "	" $8,115.49 "	" $13,454.63 "	" $18,153.08 "	" $14,095.33 "	" $17,085.25 "	" $5,125.57 "	" $19,220.90 "	" $17,362.88 "	" $18,153.08 "	" $5,082.86 "	" $17,362.88 "	" $5,125.57 "
5271716	HCHG CVMC JOINT DEVICE COMPONENT RINGLOC+ACET.SHELL LTD HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,830.83 "	" $4,081.58 "	" $1,387.74 "	" $5,830.83 "	" $5,072.82 "	" $1,399.40 "	" $4,460.58 "	" $5,830.83 "	" $5,830.83 "	" $2,215.72 "	" $3,673.42 "	" $4,956.21 "	" $3,848.35 "	" $4,664.66 "	" $1,399.40 "	" $5,247.75 "	" $4,740.46 "	" $4,956.21 "	" $1,387.74 "	" $4,740.46 "	" $1,399.40 "
5271717	HCHG CVMC JOINT DEVICE COMPONENT AEQ REV CEM HUMERAL STEM 9X100	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,081.71 "	" $5,657.20 "	" $1,923.45 "	" $8,081.71 "	" $7,031.09 "	" $1,939.61 "	" $6,182.51 "	" $8,081.71 "	" $8,081.71 "	" $3,071.05 "	" $5,091.48 "	" $6,869.45 "	" $5,333.93 "	" $6,465.37 "	" $1,939.61 "	" $7,273.54 "	" $6,570.43 "	" $6,869.45 "	" $1,923.45 "	" $6,570.43 "	" $1,939.61 "
5271718	HCHG CVMC JOINT DEVICE COMPONENT AEQ REV CEM HUM META 36MM DIA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,462.96 "	" $5,224.07 "	" $1,776.18 "	" $7,462.96 "	" $6,492.78 "	" $1,791.11 "	" $5,709.16 "	" $7,462.96 "	" $7,462.96 "	" $2,835.92 "	" $4,701.66 "	" $6,343.52 "	" $4,925.55 "	" $5,970.37 "	" $1,791.11 "	" $6,716.66 "	" $6,067.39 "	" $6,343.52 "	" $1,776.18 "	" $6,067.39 "	" $1,791.11 "
5271719	HCHG CVMC JOINT DEVICE COMPONENT AEQ REV LAT HUM INSERT 36MM DI	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,526.28 "	" $2,468.40 "	 $839.25 	" $3,526.28 "	" $3,067.86 "	 $846.31 	" $2,697.60 "	" $3,526.28 "	" $3,526.28 "	" $1,339.99 "	" $2,221.56 "	" $2,997.34 "	" $2,327.34 "	" $2,821.02 "	 $846.31 	" $3,173.65 "	" $2,866.87 "	" $2,997.34 "	 $839.25 	" $2,866.87 "	 $846.31 
5271720	HCHG CVMC JOINT DEVICE COMPONENT AEQ REV II RETROVERSION ROD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	 $897.10 	 $627.97 	 $213.51 	 $807.39 	 $780.48 	 $215.30 	 $686.28 	 $-   	 $-   	 $340.90 	 $565.17 	 $762.54 	 $592.09 	 $717.68 	 $215.30 	 $807.39 	 $729.34 	 $762.54 	 $213.51 	 $729.34 	 $215.30 
5271721	HCHG CVMC JOINT DEVICE COMPONENT AEQ REV II GLEN BASEPLATE 25MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,494.51 "	" $5,246.16 "	" $1,783.69 "	" $7,494.51 "	" $6,520.22 "	" $1,798.68 "	" $5,733.30 "	" $7,494.51 "	" $7,494.51 "	" $2,847.91 "	" $4,721.54 "	" $6,370.33 "	" $4,946.38 "	" $5,995.61 "	" $1,798.68 "	" $6,745.06 "	" $6,093.04 "	" $6,370.33 "	" $1,783.69 "	" $6,093.04 "	" $1,798.68 "
5271722	HCHG CVMC JOINT DEVICE COMPONENT AEQ REV II GLEN SPHERE 36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,274.85 "	" $9,292.40 "	" $3,159.41 "	" $13,274.85 "	" $11,549.12 "	" $3,185.96 "	" $10,155.26 "	" $13,274.85 "	" $13,274.85 "	" $5,044.44 "	" $8,363.16 "	" $11,283.62 "	" $8,761.40 "	" $10,619.88 "	" $3,185.96 "	" $11,947.37 "	" $10,792.45 "	" $11,283.62 "	" $3,159.41 "	" $10,792.45 "	" $3,185.96 "
5271723	HCHG CVMC FEMORAL SYNERGY SIZE 15	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $21,014.29 "	" $14,710.00 "	" $5,001.40 "	" $21,014.29 "	" $18,282.43 "	" $5,043.43 "	" $16,075.93 "	" $21,014.29 "	" $21,014.29 "	" $7,985.43 "	" $13,239.00 "	" $17,862.15 "	" $13,869.43 "	" $16,811.43 "	" $5,043.43 "	" $18,912.86 "	" $17,084.62 "	" $17,862.15 "	" $5,001.40 "	" $17,084.62 "	" $5,043.43 "
5271724	HCHG CVMC FEMORAL HEAD OXINUM 36MM +0	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,673.67 "	" $6,071.57 "	" $2,064.33 "	" $8,673.67 "	" $7,546.09 "	" $2,081.68 "	" $6,635.36 "	" $8,673.67 "	" $8,673.67 "	" $3,295.99 "	" $5,464.41 "	" $7,372.62 "	" $5,724.62 "	" $6,938.94 "	" $2,081.68 "	" $7,806.30 "	" $7,051.69 "	" $7,372.62 "	" $2,064.33 "	" $7,051.69 "	" $2,081.68 "
5271725	HCHG CVMC LINER ACETABULAR R3 20D 54MMOD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,971.22 "	" $5,579.85 "	" $1,897.15 "	" $7,971.22 "	" $6,934.96 "	" $1,913.09 "	" $6,097.98 "	" $7,971.22 "	" $7,971.22 "	" $3,029.06 "	" $5,021.87 "	" $6,775.54 "	" $5,261.01 "	" $6,376.98 "	" $1,913.09 "	" $7,174.10 "	" $6,480.60 "	" $6,775.54 "	" $1,897.15 "	" $6,480.60 "	" $1,913.09 "
5271726	HCHG CVMC ATRIUM V-PATCH 6.4 X 6.4	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,685.94 "	" $1,180.16 "	 $401.25 	" $1,685.94 "	" $1,466.77 "	 $404.63 	" $1,289.74 "	" $1,685.94 "	" $1,685.94 "	 $640.66 	" $1,062.14 "	" $1,433.05 "	" $1,112.72 "	" $1,348.75 "	 $404.63 	" $1,517.35 "	" $1,370.67 "	" $1,433.05 "	 $401.25 	" $1,370.67 "	 $404.63 
5271727	HCHG CVMC ATRIUM CENTRIFX 10.5 X 16CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $839.22 	 $587.45 	 $199.73 	 $755.30 	 $730.12 	 $201.41 	 $642.00 	 $-   	 $-   	 $318.90 	 $528.71 	 $713.34 	 $553.89 	 $671.38 	 $201.41 	 $755.30 	 $682.29 	 $713.34 	 $199.73 	 $682.29 	 $201.41 
5271728	HCHG CVMC ATRIUM V-PATCH MECH LG (8CM X 8CM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,114.61 "	" $1,480.23 "	 $503.28 	" $2,114.61 "	" $1,839.71 "	 $507.51 	" $1,617.68 "	" $2,114.61 "	" $2,114.61 "	 $803.55 	" $1,332.20 "	" $1,797.42 "	" $1,395.64 "	" $1,691.69 "	 $507.51 	" $1,903.15 "	" $1,719.18 "	" $1,797.42 "	 $503.28 	" $1,719.18 "	 $507.51 
5271729	HCHG CVMC ATRIUM V-PATCH SMALL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,685.94 "	" $1,180.16 "	 $401.25 	" $1,685.94 "	" $1,466.77 "	 $404.63 	" $1,289.74 "	" $1,685.94 "	" $1,685.94 "	 $640.66 	" $1,062.14 "	" $1,433.05 "	" $1,112.72 "	" $1,348.75 "	 $404.63 	" $1,517.35 "	" $1,370.67 "	" $1,433.05 "	 $401.25 	" $1,370.67 "	 $404.63 
5271730	HCHG CVMC MESH MYCROMESH 5CM X 10CM X1MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $902.89 	 $632.02 	 $214.89 	 $812.60 	 $785.51 	 $216.69 	 $690.71 	 $-   	 $-   	 $343.10 	 $568.82 	 $767.46 	 $595.91 	 $722.31 	 $216.69 	 $812.60 	 $734.05 	 $767.46 	 $214.89 	 $734.05 	 $216.69 
5271731	"HCHG CVMC MESH C-QUR TACHSHIELD 6"" X 8"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,837.94 "	" $1,986.56 "	 $675.43 	" $2,837.94 "	" $2,469.01 "	 $681.11 	" $2,171.02 "	" $2,837.94 "	" $2,837.94 "	" $1,078.42 "	" $1,787.90 "	" $2,412.25 "	" $1,873.04 "	" $2,270.35 "	 $681.11 	" $2,554.15 "	" $2,307.25 "	" $2,412.25 "	 $675.43 	" $2,307.25 "	 $681.11 
5271732	HCHG CVMC PRECISION PATIENT PROGRAMMER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1787	" $3,510.49 "	" $2,457.34 "	 $835.50 	" $3,510.49 "	" $3,054.13 "	 $842.52 	" $2,685.52 "	" $3,510.49 "	" $3,510.49 "	" $1,333.99 "	" $2,211.61 "	" $2,983.92 "	" $2,316.92 "	" $2,808.39 "	 $842.52 	" $3,159.44 "	" $2,854.03 "	" $2,983.92 "	 $835.50 	" $2,854.03 "	 $842.52 
5271788	HCHG CVMC 3/8-24 APICAL HOLE PLUG 1//CUP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $827.65 	 $579.36 	 $196.98 	 $744.89 	 $720.06 	 $198.64 	 $633.15 	 $-   	 $-   	 $314.51 	 $521.42 	 $703.50 	 $546.25 	 $662.12 	 $198.64 	 $744.89 	 $672.88 	 $703.50 	 $196.98 	 $672.88 	 $198.64 
5271789	HCHG CVMC OPTIONAL ACET APICAL PLUG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $845.01 	 $591.51 	 $201.11 	 $760.51 	 $735.16 	 $202.80 	 $646.43 	 $-   	 $-   	 $321.10 	 $532.36 	 $718.26 	 $557.71 	 $676.01 	 $202.80 	 $760.51 	 $686.99 	 $718.26 	 $201.11 	 $686.99 	 $202.80 
5271790	HCHG CVMC CLAMP EXTERNAL FIXATION MEDIUM PIN 4POS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,957.87 "	" $1,370.51 "	 $465.97 	" $1,957.87 "	" $1,703.35 "	 $469.89 	" $1,497.77 "	" $1,957.87 "	" $1,957.87 "	 $743.99 	" $1,233.46 "	" $1,664.19 "	" $1,292.19 "	" $1,566.30 "	 $469.89 	" $1,762.08 "	" $1,591.75 "	" $1,664.19 "	 $465.97 	" $1,591.75 "	 $469.89 
5271791	HCHG CVMC TI END CAP FOR TFN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $868.16 	 $607.71 	 $206.62 	 $781.34 	 $755.30 	 $208.36 	 $664.14 	 $-   	 $-   	 $329.90 	 $546.94 	 $737.94 	 $572.99 	 $694.53 	 $208.36 	 $781.34 	 $705.81 	 $737.94 	 $206.62 	 $705.81 	 $208.36 
5271792	HCHG CVMC CEMENT RESTRICTOR 24MM DIA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,493.23 "	" $1,045.26 "	 $355.39 	" $1,343.91 "	" $1,299.11 "	 $358.38 	" $1,142.32 "	 $-   	 $-   	 $567.43 	 $940.73 	" $1,269.25 "	 $985.53 	" $1,194.58 "	 $358.38 	" $1,343.91 "	" $1,214.00 "	" $1,269.25 "	 $355.39 	" $1,214.00 "	 $358.38 
5271793	HCHG CVMC CEMENT PLUG BIO-PLUG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		 $752.40 	 $526.68 	 $179.07 	 $677.16 	 $654.59 	 $180.58 	 $575.59 	 $-   	 $-   	 $285.91 	 $474.01 	 $639.54 	 $496.58 	 $601.92 	 $180.58 	 $677.16 	 $611.70 	 $639.54 	 $179.07 	 $611.70 	 $180.58 
5271797	HCHG CVMC LOW PROFILE SELF TAPING SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $805.08 	 $563.56 	 $191.61 	 $724.57 	 $700.42 	 $193.22 	 $615.89 	 $-   	 $-   	 $305.93 	 $507.20 	 $684.32 	 $531.35 	 $644.06 	 $193.22 	 $724.57 	 $654.53 	 $684.32 	 $191.61 	 $654.53 	 $193.22 
5271798	HCHG CVMC ACUMED-2.7-3.0 X 10-18 NON LOCKING HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $769.82 	 $538.87 	 $183.22 	 $692.84 	 $669.74 	 $184.76 	 $588.91 	 $-   	 $-   	 $292.53 	 $484.99 	 $654.35 	 $508.08 	 $615.86 	 $184.76 	 $692.84 	 $625.86 	 $654.35 	 $183.22 	 $625.86 	 $184.76 
5271799	HCHG CVMC ACUMED 3.0-3.5 X 16-45 NON LOCKING HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $493.85 	 $345.70 	 $117.54 	 $444.47 	 $429.65 	 $118.52 	 $377.80 	 $-   	 $-   	 $187.66 	 $311.13 	 $419.77 	 $325.94 	 $395.08 	 $118.52 	 $444.47 	 $401.50 	 $419.77 	 $117.54 	 $401.50 	 $118.52 
5271800	HCHG CVMC ACUMED-OLECRANON PLATE 5 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,321.38 "	" $2,324.97 "	 $790.49 	" $3,321.38 "	" $2,889.60 "	 $797.13 	" $2,540.86 "	" $3,321.38 "	" $3,321.38 "	" $1,262.12 "	" $2,092.47 "	" $2,823.17 "	" $2,192.11 "	" $2,657.10 "	 $797.13 	" $2,989.24 "	" $2,700.28 "	" $2,823.17 "	 $790.49 	" $2,700.28 "	 $797.13 
5271801	HCHG CVMC MANDIBLE TRAUMA TITANIUM CORTEX SCREWS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,262.51 "	 $883.76 	 $300.48 	" $1,136.26 "	" $1,098.38 "	 $303.00 	 $965.82 	 $-   	 $-   	 $479.75 	 $795.38 	" $1,073.13 "	 $833.26 	" $1,010.01 "	 $303.00 	" $1,136.26 "	" $1,026.42 "	" $1,073.13 "	 $300.48 	" $1,026.42 "	 $303.00 
5271802	HCHG CVMC MANDIBLE TRAUMA 2.0MM TITANIUM ADAPTION PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,155.99 "	" $1,509.19 "	 $513.13 	" $2,155.99 "	" $1,875.71 "	 $517.44 	" $1,649.33 "	" $2,155.99 "	" $2,155.99 "	 $819.28 	" $1,358.27 "	" $1,832.59 "	" $1,422.95 "	" $1,724.79 "	 $517.44 	" $1,940.39 "	" $1,752.82 "	" $1,832.59 "	 $513.13 	" $1,752.82 "	 $517.44 
5271803	HCHG CVMC ZIMMER-5 HOLE PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $530.01 	 $371.01 	 $126.14 	 $477.01 	 $461.11 	 $127.20 	 $405.46 	 $-   	 $-   	 $201.40 	 $333.91 	 $450.51 	 $349.81 	 $424.01 	 $127.20 	 $477.01 	 $430.90 	 $450.51 	 $126.14 	 $430.90 	 $127.20 
5271804	HCHG CVMC TRIMED-VOLAR BUTTRESS PIN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,204.24 "	 $842.97 	 $286.61 	" $1,083.82 "	" $1,047.69 "	 $289.02 	 $921.24 	 $-   	 $-   	 $457.61 	 $758.67 	" $1,023.60 "	 $794.80 	 $963.39 	 $289.02 	" $1,083.82 "	 $979.05 	" $1,023.60 "	 $286.61 	 $979.05 	 $289.02 
5271805	HCHG CVMC TRIMED-DORSAL BUTTRESS PIN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,204.24 "	 $842.97 	 $286.61 	" $1,083.82 "	" $1,047.69 "	 $289.02 	 $921.24 	 $-   	 $-   	 $457.61 	 $758.67 	" $1,023.60 "	 $794.80 	 $963.39 	 $289.02 	" $1,083.82 "	 $979.05 	" $1,023.60 "	 $286.61 	 $979.05 	 $289.02 
5271806	HCHG CVMC TRIMED-WIRE PLATES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,534.44 "	" $1,074.11 "	 $365.20 	" $1,534.44 "	" $1,334.96 "	 $368.27 	" $1,173.85 "	" $1,534.44 "	 $-   	 $583.09 	 $966.70 	" $1,304.27 "	" $1,012.73 "	" $1,227.55 "	 $368.27 	" $1,381.00 "	" $1,247.50 "	" $1,304.27 "	 $365.20 	" $1,247.50 "	 $368.27 
5271807	HCHG CVMC TRIMED-CORTICAL SCREWS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $544.68 	 $381.28 	 $129.63 	 $490.21 	 $473.87 	 $130.72 	 $416.68 	 $-   	 $-   	 $206.98 	 $343.15 	 $462.98 	 $359.49 	 $435.74 	 $130.72 	 $490.21 	 $442.82 	 $462.98 	 $129.63 	 $442.82 	 $130.72 
5271808	HCHG CVMC TRIMED-RADIAL COLUMN PIN PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,039.45 "	" $1,427.62 "	 $485.39 	" $2,039.45 "	" $1,774.32 "	 $489.47 	" $1,560.18 "	" $2,039.45 "	" $2,039.45 "	 $774.99 	" $1,284.85 "	" $1,733.53 "	" $1,346.04 "	" $1,631.56 "	 $489.47 	" $1,835.51 "	" $1,658.07 "	" $1,733.53 "	 $485.39 	" $1,658.07 "	 $489.47 
5271809	HCHG CVMC DHS COMPRESSION SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $321.87 	 $225.31 	 $76.61 	 $289.68 	 $280.03 	 $77.25 	 $246.23 	 $-   	 $-   	 $122.31 	 $202.78 	 $273.59 	 $212.43 	 $257.50 	 $77.25 	 $289.68 	 $261.68 	 $273.59 	 $76.61 	 $261.68 	 $77.25 
5271810	HCHG CVMC 2.4MM VA-LCP TWO COLUMN VOLAR DISTAL RADIAL PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,312.87 "	" $2,319.01 "	 $788.46 	" $3,312.87 "	" $2,882.20 "	 $795.09 	" $2,534.35 "	" $3,312.87 "	" $3,312.87 "	" $1,258.89 "	" $2,087.11 "	" $2,815.94 "	" $2,186.49 "	" $2,650.30 "	 $795.09 	" $2,981.58 "	" $2,693.36 "	" $2,815.94 "	 $788.46 	" $2,693.36 "	 $795.09 
5271811	HCHG CVMC ANTERIOR CLAVICLE PLATE 3.5MM 5 HOLE-SYNTHES	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,772.39 "	" $2,640.67 "	 $897.83 	" $3,772.39 "	" $3,281.98 "	 $905.37 	" $2,885.88 "	" $3,772.39 "	" $3,772.39 "	" $1,433.51 "	" $2,376.61 "	" $3,206.53 "	" $2,489.78 "	" $3,017.91 "	 $905.37 	" $3,395.15 "	" $3,066.95 "	" $3,206.53 "	 $897.83 	" $3,066.95 "	 $905.37 
5271812	HCHG CVMC PROXIMAL HUMERUS PLATE 13 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,313.84 "	" $4,419.69 "	" $1,502.69 "	" $6,313.84 "	" $5,493.04 "	" $1,515.32 "	" $4,830.09 "	" $6,313.84 "	" $6,313.84 "	" $2,399.26 "	" $3,977.72 "	" $5,366.76 "	" $4,167.13 "	" $5,051.07 "	" $1,515.32 "	" $5,682.46 "	" $5,133.15 "	" $5,366.76 "	" $1,502.69 "	" $5,133.15 "	" $1,515.32 "
5271813	HCHG CVMC AEQ REVERSED LOCKING SCREW (4.5X 20)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,174.91 "	 $822.44 	 $279.63 	" $1,057.42 "	" $1,022.17 "	 $281.98 	 $898.81 	 $-   	 $-   	 $446.47 	 $740.19 	 $998.67 	 $775.44 	 $939.93 	 $281.98 	" $1,057.42 "	 $955.20 	 $998.67 	 $279.63 	 $955.20 	 $281.98 
5271814	HCHG CVMC AEQ REVERSED LOCKING SCREW (4.5X 35)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,174.91 "	 $822.44 	 $279.63 	" $1,057.42 "	" $1,022.17 "	 $281.98 	 $898.81 	 $-   	 $-   	 $446.47 	 $740.19 	 $998.67 	 $775.44 	 $939.93 	 $281.98 	" $1,057.42 "	 $955.20 	 $998.67 	 $279.63 	 $955.20 	 $281.98 
5271815	HCHG CVMC AEQUALIS REVERSED II GLENOID BASE PLATE (25MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $7,494.53 "	" $5,246.17 "	" $1,783.70 "	" $7,494.53 "	" $6,520.24 "	" $1,798.69 "	" $5,733.32 "	" $7,494.53 "	" $7,494.53 "	" $2,847.92 "	" $4,721.55 "	" $6,370.35 "	" $4,946.39 "	" $5,995.62 "	" $1,798.69 "	" $6,745.08 "	" $6,093.05 "	" $6,370.35 "	" $1,783.70 "	" $6,093.05 "	" $1,798.69 "
5271816	HCHG CVMC AEQ REVERSED COMPRESSION SCREW (4.5 X 18-26MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $718.98 	 $503.29 	 $171.12 	 $647.08 	 $625.51 	 $172.56 	 $550.02 	 $-   	 $-   	 $273.21 	 $452.96 	 $611.13 	 $474.53 	 $575.18 	 $172.56 	 $647.08 	 $584.53 	 $611.13 	 $171.12 	 $584.53 	 $172.56 
5271817	HCHG CVMC SYNTHES LC-DCP 2.4 MM PLATE 4 HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,230.66 "	 $861.46 	 $292.90 	" $1,107.59 "	" $1,070.67 "	 $295.36 	 $941.45 	 $-   	 $-   	 $467.65 	 $775.32 	" $1,046.06 "	 $812.24 	 $984.53 	 $295.36 	" $1,107.59 "	" $1,000.53 "	" $1,046.06 "	 $292.90 	" $1,000.53 "	 $295.36 
5271818	HCHG CVMC BONE PLATE LCP 3.5MM 22 HOLE 293	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,520.67 "	" $2,464.47 "	 $837.92 	" $3,520.67 "	" $3,062.98 "	 $844.96 	" $2,693.31 "	" $3,520.67 "	" $3,520.67 "	" $1,337.85 "	" $2,218.02 "	" $2,992.57 "	" $2,323.64 "	" $2,816.54 "	 $844.96 	" $3,168.60 "	" $2,862.30 "	" $2,992.57 "	 $837.92 	" $2,862.30 "	 $844.96 
5271819	HCHG CVMC BONE PLATE 1.5MM STRT PLATE 6 HL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,234.52 "	 $864.16 	 $293.82 	" $1,111.07 "	" $1,074.03 "	 $296.28 	 $944.41 	 $-   	 $-   	 $469.12 	 $777.75 	" $1,049.34 "	 $814.78 	 $987.62 	 $296.28 	" $1,111.07 "	" $1,003.66 "	" $1,049.34 "	 $293.82 	" $1,003.66 "	 $296.28 
5271820	HCHG CVMC HELICAL BLADE IMPLANT 11.0MM TI HELICAL BLADE 125MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,547.65 "	" $1,083.36 "	 $368.34 	" $1,547.65 "	" $1,346.46 "	 $371.44 	" $1,183.95 "	" $1,547.65 "	 $-   	 $588.11 	 $975.02 	" $1,315.50 "	" $1,021.45 "	" $1,238.12 "	 $371.44 	" $1,392.89 "	" $1,258.24 "	" $1,315.50 "	 $368.34 	" $1,258.24 "	 $371.44 
5271821	HCHG CVMC SUTURE ANCHOR OSTEORAPTOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,235.32 "	 $864.72 	 $294.01 	" $1,111.79 "	" $1,074.73 "	 $296.48 	 $945.02 	 $-   	 $-   	 $469.42 	 $778.25 	" $1,050.02 "	 $815.31 	 $988.26 	 $296.48 	" $1,111.79 "	" $1,004.32 "	" $1,050.02 "	 $294.01 	" $1,004.32 "	 $296.48 
5271822	HCHG CVMC QUICKANCHOR SUPER PLUS DS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,546.09 "	" $1,082.26 "	 $367.97 	" $1,546.09 "	" $1,345.10 "	 $371.06 	" $1,182.76 "	" $1,546.09 "	 $-   	 $587.51 	 $974.04 	" $1,314.18 "	" $1,020.42 "	" $1,236.87 "	 $371.06 	" $1,391.48 "	" $1,256.97 "	" $1,314.18 "	 $367.97 	" $1,256.97 "	 $371.06 
5271823	HCHG CVMC BONE SCREW ACUTWIST ACUTK COMP SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,105.46 "	 $773.82 	 $263.10 	 $994.91 	 $961.75 	 $265.31 	 $845.68 	 $-   	 $-   	 $420.07 	 $696.44 	 $939.64 	 $729.60 	 $884.37 	 $265.31 	 $994.91 	 $898.74 	 $939.64 	 $263.10 	 $898.74 	 $265.31 
5271824	HCHG CVMC MINI BIOSUTURE TAK 2.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,012.85 "	 $709.00 	 $241.06 	 $911.57 	 $881.18 	 $243.08 	 $774.83 	 $-   	 $-   	 $384.88 	 $638.10 	 $860.92 	 $668.48 	 $810.28 	 $243.08 	 $911.57 	 $823.45 	 $860.92 	 $241.06 	 $823.45 	 $243.08 
5271825	HCHG CVMC LOCKING HEXALOBE SCREW	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $700.32 	 $490.22 	 $166.68 	 $630.29 	 $609.28 	 $168.08 	 $535.74 	 $-   	 $-   	 $266.12 	 $441.20 	 $595.27 	 $462.21 	 $560.26 	 $168.08 	 $630.29 	 $569.36 	 $595.27 	 $166.68 	 $569.36 	 $168.08 
5271826	HCHG CVMC LAG SCREW SOLID FIXED 90MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,781.42 "	" $1,946.99 "	 $661.98 	" $2,781.42 "	" $2,419.84 "	 $667.54 	" $2,127.79 "	" $2,781.42 "	" $2,781.42 "	" $1,056.94 "	" $1,752.29 "	" $2,364.21 "	" $1,835.74 "	" $2,225.14 "	 $667.54 	" $2,503.28 "	" $2,261.29 "	" $2,364.21 "	 $661.98 	" $2,261.29 "	 $667.54 
5271827	HCHG CVMC DOUBLE LEAD THREAD SCREW 5X36MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,597.41 "	" $1,118.19 "	 $380.18 	" $1,597.41 "	" $1,389.75 "	 $383.38 	" $1,222.02 "	" $1,597.41 "	 $-   	 $607.02 	" $1,006.37 "	" $1,357.80 "	" $1,054.29 "	" $1,277.93 "	 $383.38 	" $1,437.67 "	" $1,298.69 "	" $1,357.80 "	 $380.18 	" $1,298.69 "	 $383.38 
5271828	HCHG CVMC TROCH NAIL LONG RT 11MM X 34CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $9,398.15 "	" $6,578.71 "	" $2,236.76 "	" $9,398.15 "	" $8,176.39 "	" $2,255.56 "	" $7,189.58 "	" $9,398.15 "	" $9,398.15 "	" $3,571.30 "	" $5,920.83 "	" $7,988.43 "	" $6,202.78 "	" $7,518.52 "	" $2,255.56 "	" $8,458.34 "	" $7,640.70 "	" $7,988.43 "	" $2,236.76 "	" $7,640.70 "	" $2,255.56 "
5271829	HCHG CVMC PLATE PROX HUMERUS 3.5 11-HOLE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,487.47 "	" $4,541.23 "	" $1,544.02 "	" $6,487.47 "	" $5,644.10 "	" $1,556.99 "	" $4,962.91 "	" $6,487.47 "	" $6,487.47 "	" $2,465.24 "	" $4,087.11 "	" $5,514.35 "	" $4,281.73 "	" $5,189.98 "	" $1,556.99 "	" $5,838.72 "	" $5,274.31 "	" $5,514.35 "	" $1,544.02 "	" $5,274.31 "	" $1,556.99 "
5271830	HCHG CVMC SCREW CORTEX SLFTAP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $191.73 	 $134.21 	 $45.63 	 $172.56 	 $166.81 	 $46.02 	 $146.67 	 $-   	 $-   	 $72.86 	 $120.79 	 $162.97 	 $126.54 	 $153.38 	 $46.02 	 $172.56 	 $155.88 	 $162.97 	 $45.63 	 $155.88 	 $46.02 
5271831	HCHG CVMC SCREW CORTEX LCKG SLFTAP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $845.01 	 $591.51 	 $201.11 	 $760.51 	 $735.16 	 $202.80 	 $646.43 	 $-   	 $-   	 $321.10 	 $532.36 	 $718.26 	 $557.71 	 $676.01 	 $202.80 	 $760.51 	 $686.99 	 $718.26 	 $201.11 	 $686.99 	 $202.80 
5271832	HCHG CVMC PLATE TROCHANTER STAB.	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,205.71 "	" $1,544.00 "	 $524.96 	" $2,205.71 "	" $1,918.97 "	 $529.37 	" $1,687.37 "	" $2,205.71 "	" $2,205.71 "	 $838.17 	" $1,389.60 "	" $1,874.85 "	" $1,455.77 "	" $1,764.57 "	 $529.37 	" $1,985.14 "	" $1,793.24 "	" $1,874.85 "	 $524.96 	" $1,793.24 "	 $529.37 
5271833	HCHG CVMC PIN TRANSFIXATION 6.0X225MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $807.39 	 $565.17 	 $192.16 	 $726.65 	 $702.43 	 $193.77 	 $617.65 	 $-   	 $-   	 $306.81 	 $508.66 	 $686.28 	 $532.88 	 $645.91 	 $193.77 	 $726.65 	 $656.41 	 $686.28 	 $192.16 	 $656.41 	 $193.77 
5271834	HCHG CVMC ANKLE LOCKING NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $10,862.96 "	" $7,604.07 "	" $2,585.38 "	" $10,862.96 "	" $9,450.78 "	" $2,607.11 "	" $8,310.16 "	" $10,862.96 "	" $10,862.96 "	" $4,127.92 "	" $6,843.66 "	" $9,233.52 "	" $7,169.55 "	" $8,690.37 "	" $2,607.11 "	" $9,776.66 "	" $8,831.59 "	" $9,233.52 "	" $2,585.38 "	" $8,831.59 "	" $2,607.11 "
5271835	HCHG CVMC SCREW TI DBL CORTICAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,597.41 "	" $1,118.19 "	 $380.18 	" $1,597.41 "	" $1,389.75 "	 $383.38 	" $1,222.02 "	" $1,597.41 "	 $-   	 $607.02 	" $1,006.37 "	" $1,357.80 "	" $1,054.29 "	" $1,277.93 "	 $383.38 	" $1,437.67 "	" $1,298.69 "	" $1,357.80 "	 $380.18 	" $1,298.69 "	 $383.38 
5271836	HCHG CVMC BONE SCREW-REPOSE SUSPENSION	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $7,522.94 "	" $5,266.06 "	" $1,790.46 "	" $7,522.94 "	" $6,544.96 "	" $1,805.51 "	" $5,755.05 "	" $7,522.94 "	" $7,522.94 "	" $2,858.72 "	" $4,739.45 "	" $6,394.50 "	" $4,965.14 "	" $6,018.35 "	" $1,805.51 "	" $6,770.65 "	" $6,116.15 "	" $6,394.50 "	" $1,790.46 "	" $6,116.15 "	" $1,805.51 "
5271837	HCHG CVMC TIBIAL NAIL PHOENIX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $6,828.42 "	" $4,779.89 "	" $1,625.16 "	" $6,828.42 "	" $5,940.73 "	" $1,638.82 "	" $5,223.74 "	" $6,828.42 "	" $6,828.42 "	" $2,594.80 "	" $4,301.90 "	" $5,804.16 "	" $4,506.76 "	" $5,462.74 "	" $1,638.82 "	" $6,145.58 "	" $5,551.51 "	" $5,804.16 "	" $1,625.16 "	" $5,551.51 "	" $1,638.82 "
5271838	HCHG CVMC TIBIAL NAIL TRIGEN	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $7,766.02 "	" $5,436.21 "	" $1,848.31 "	" $7,766.02 "	" $6,756.44 "	" $1,863.84 "	" $5,941.01 "	" $7,766.02 "	" $7,766.02 "	" $2,951.09 "	" $4,892.59 "	" $6,601.12 "	" $5,125.57 "	" $6,212.82 "	" $1,863.84 "	" $6,989.42 "	" $6,313.77 "	" $6,601.12 "	" $1,848.31 "	" $6,313.77 "	" $1,863.84 "
5271839	HCHG CVMC SCREW CAPTURED INT. HEX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,649.50 "	" $1,154.65 "	 $392.58 	" $1,649.50 "	" $1,435.07 "	 $395.88 	" $1,261.87 "	" $1,649.50 "	" $1,649.50 "	 $626.81 	" $1,039.19 "	" $1,402.08 "	" $1,088.67 "	" $1,319.60 "	 $395.88 	" $1,484.55 "	" $1,341.04 "	" $1,402.08 "	 $392.58 	" $1,341.04 "	 $395.88 
5271840	HCHG CVMC NAIL AFFIXUS HIP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $9,205.58 "	" $6,443.91 "	" $2,190.93 "	" $9,205.58 "	" $8,008.85 "	" $2,209.34 "	" $7,042.27 "	" $9,205.58 "	" $9,205.58 "	" $3,498.12 "	" $5,799.52 "	" $7,824.74 "	" $6,075.68 "	" $7,364.46 "	" $2,209.34 "	" $8,285.02 "	" $7,484.14 "	" $7,824.74 "	" $2,190.93 "	" $7,484.14 "	" $2,209.34 "
5271841	HCHG CVMC SCREW AFFIXUS LAG	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,146.57 "	" $2,202.60 "	 $748.88 	" $3,146.57 "	" $2,737.52 "	 $755.18 	" $2,407.13 "	" $3,146.57 "	" $3,146.57 "	" $1,195.70 "	" $1,982.34 "	" $2,674.58 "	" $2,076.74 "	" $2,517.26 "	 $755.18 	" $2,831.91 "	" $2,558.16 "	" $2,674.58 "	 $748.88 	" $2,558.16 "	 $755.18 
5271842	HCHG CVMC SCREW AFFIXUS CORTICAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,342.75 "	 $939.93 	 $319.57 	" $1,208.48 "	" $1,168.19 "	 $322.26 	" $1,027.20 "	 $-   	 $-   	 $510.25 	 $845.93 	" $1,141.34 "	 $886.22 	" $1,074.20 "	 $322.26 	" $1,208.48 "	" $1,091.66 "	" $1,141.34 "	 $319.57 	" $1,091.66 "	 $322.26 
5271843	HCHG CVMC ANCHOR BIO-SWIVELOCK TENODESIS	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,476.17 "	" $1,033.32 "	 $351.33 	" $1,328.55 "	" $1,284.27 "	 $354.28 	" $1,129.27 "	 $-   	 $-   	 $560.94 	 $929.99 	" $1,254.74 "	 $974.27 	" $1,180.94 "	 $354.28 	" $1,328.55 "	" $1,200.13 "	" $1,254.74 "	 $351.33 	" $1,200.13 "	 $354.28 
5271844	"HCHG CVMC SCREW, BIO-COMP RETROSCREW 9MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,302.24 "	 $911.57 	 $309.93 	" $1,172.02 "	" $1,132.95 "	 $312.54 	 $996.21 	 $-   	 $-   	 $494.85 	 $820.41 	" $1,106.90 "	 $859.48 	" $1,041.79 "	 $312.54 	" $1,172.02 "	" $1,058.72 "	" $1,106.90 "	 $309.93 	" $1,058.72 "	 $312.54 
5271845	"HCHG CVMC SCREW, CANN. INTERFERENCE"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $835.18 	 $584.63 	 $198.77 	 $751.66 	 $726.61 	 $200.44 	 $638.91 	 $-   	 $-   	 $317.37 	 $526.16 	 $709.90 	 $551.22 	 $668.14 	 $200.44 	 $751.66 	 $679.00 	 $709.90 	 $198.77 	 $679.00 	 $200.44 
5271846	HCHG CVMC SCREW HEADLESS COMP	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,317.48 "	 $922.24 	 $313.56 	" $1,185.73 "	" $1,146.21 "	 $316.20 	" $1,007.87 "	 $-   	 $-   	 $500.64 	 $830.01 	" $1,119.86 "	 $869.54 	" $1,053.98 "	 $316.20 	" $1,185.73 "	" $1,071.11 "	" $1,119.86 "	 $313.56 	" $1,071.11 "	 $316.20 
5271847	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 3H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,436.85 "	" $1,705.80 "	 $579.97 	" $2,436.85 "	" $2,120.06 "	 $584.84 	" $1,864.19 "	" $2,436.85 "	" $2,436.85 "	 $926.00 	" $1,535.22 "	" $2,071.32 "	" $1,608.32 "	" $1,949.48 "	 $584.84 	" $2,193.17 "	" $1,981.16 "	" $2,071.32 "	 $579.97 	" $1,981.16 "	 $584.84 
5271848	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 4H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,476.47 "	" $1,733.53 "	 $589.40 	" $2,476.47 "	" $2,154.53 "	 $594.35 	" $1,894.50 "	" $2,476.47 "	" $2,476.47 "	 $941.06 	" $1,560.18 "	" $2,105.00 "	" $1,634.47 "	" $1,981.18 "	 $594.35 	" $2,228.82 "	" $2,013.37 "	" $2,105.00 "	 $589.40 	" $2,013.37 "	 $594.35 
5271849	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 5H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,509.49 "	" $1,756.64 "	 $597.26 	" $2,509.49 "	" $2,183.26 "	 $602.28 	" $1,919.76 "	" $2,509.49 "	" $2,509.49 "	 $953.61 	" $1,580.98 "	" $2,133.07 "	" $1,656.26 "	" $2,007.59 "	 $602.28 	" $2,258.54 "	" $2,040.22 "	" $2,133.07 "	 $597.26 	" $2,040.22 "	 $602.28 
5271850	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,549.11 "	" $1,784.38 "	 $606.69 	" $2,549.11 "	" $2,217.73 "	 $611.79 	" $1,950.07 "	" $2,549.11 "	" $2,549.11 "	 $968.66 	" $1,605.94 "	" $2,166.74 "	" $1,682.41 "	" $2,039.29 "	 $611.79 	" $2,294.20 "	" $2,072.43 "	" $2,166.74 "	 $606.69 	" $2,072.43 "	 $611.79 
5271851	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 7H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,585.44 "	" $1,809.81 "	 $615.33 	" $2,585.44 "	" $2,249.33 "	 $620.51 	" $1,977.86 "	" $2,585.44 "	" $2,585.44 "	 $982.47 	" $1,628.83 "	" $2,197.62 "	" $1,706.39 "	" $2,068.35 "	 $620.51 	" $2,326.90 "	" $2,101.96 "	" $2,197.62 "	 $615.33 	" $2,101.96 "	 $620.51 
5271852	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 9H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,621.76 "	" $1,835.23 "	 $623.98 	" $2,621.76 "	" $2,280.93 "	 $629.22 	" $2,005.65 "	" $2,621.76 "	" $2,621.76 "	 $996.27 	" $1,651.71 "	" $2,228.50 "	" $1,730.36 "	" $2,097.41 "	 $629.22 	" $2,359.58 "	" $2,131.49 "	" $2,228.50 "	 $623.98 	" $2,131.49 "	 $629.22 
5271853	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 11H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,661.38 "	" $1,862.97 "	 $633.41 	" $2,661.38 "	" $2,315.40 "	 $638.73 	" $2,035.96 "	" $2,661.38 "	" $2,661.38 "	" $1,011.32 "	" $1,676.67 "	" $2,262.17 "	" $1,756.51 "	" $2,129.10 "	 $638.73 	" $2,395.24 "	" $2,163.70 "	" $2,262.17 "	 $633.41 	" $2,163.70 "	 $638.73 
5271854	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 13H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,694.40 "	" $1,886.08 "	 $641.27 	" $2,694.40 "	" $2,344.13 "	 $646.66 	" $2,061.22 "	" $2,694.40 "	" $2,694.40 "	" $1,023.87 "	" $1,697.47 "	" $2,290.24 "	" $1,778.30 "	" $2,155.52 "	 $646.66 	" $2,424.96 "	" $2,190.55 "	" $2,290.24 "	 $641.27 	" $2,190.55 "	 $646.66 
5271855	HCHG CVMC PLATE LCP DFP 2.7/3.5MM 15H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,734.02 "	" $1,913.81 "	 $650.70 	" $2,734.02 "	" $2,378.60 "	 $656.16 	" $2,091.53 "	" $2,734.02 "	" $2,734.02 "	" $1,038.93 "	" $1,722.43 "	" $2,323.92 "	" $1,804.45 "	" $2,187.22 "	 $656.16 	" $2,460.62 "	" $2,222.76 "	" $2,323.92 "	 $650.70 	" $2,222.76 "	 $656.16 
5271856	HCHG CVMC CONNECTIVE TISSUE (HUMAN) GRAFT TUTOPLAST PERICARDIAL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $1,533.75 "	" $1,073.63 "	 $365.03 	" $1,533.75 "	" $1,334.36 "	 $368.10 	" $1,173.32 "	" $1,533.75 "	 $-   	 $582.83 	 $966.26 	" $1,303.69 "	" $1,012.28 "	" $1,227.00 "	 $368.10 	" $1,380.38 "	" $1,246.94 "	" $1,303.69 "	 $365.03 	" $1,246.94 "	 $368.10 
5271857	HCHG CVMC CONNECTIVE TISSUE (HUMAN) AMNIOGRAFT 2.0 X 1.5 CM SIZE B	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $2,311.37 "	" $1,617.96 "	 $550.11 	" $2,311.37 "	" $2,010.89 "	 $554.73 	" $1,768.20 "	" $2,311.37 "	" $2,311.37 "	 $878.32 	" $1,456.16 "	" $1,964.66 "	" $1,525.50 "	" $1,849.10 "	 $554.73 	" $2,080.23 "	" $1,879.14 "	" $1,964.66 "	 $550.11 	" $1,879.14 "	 $554.73 
5271858	HCHG CVMC GRAFT BTB	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $11,364.91 "	" $7,955.44 "	" $2,704.85 "	" $11,364.91 "	" $9,887.47 "	" $2,727.58 "	" $8,694.16 "	" $11,364.91 "	" $11,364.91 "	" $4,318.67 "	" $7,159.89 "	" $9,660.17 "	" $7,500.84 "	" $9,091.93 "	" $2,727.58 "	" $10,228.42 "	" $9,239.67 "	" $9,660.17 "	" $2,704.85 "	" $9,239.67 "	" $2,727.58 "
5271859	HCHG CVMC GRAFT PATELLAR LIGAMENT PRESHAPED	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $9,786.45 "	" $6,850.52 "	" $2,329.18 "	" $9,786.45 "	" $8,514.21 "	" $2,348.75 "	" $7,486.63 "	" $9,786.45 "	" $9,786.45 "	" $3,718.85 "	" $6,165.46 "	" $8,318.48 "	" $6,459.06 "	" $7,829.16 "	" $2,348.75 "	" $8,807.81 "	" $7,956.38 "	" $8,318.48 "	" $2,329.18 "	" $7,956.38 "	" $2,348.75 "
5271860	"HCHG CVMC MINIARC PRECISE, REPAIR DEVICE W/SLING"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1771	" $5,104.74 "	" $3,573.32 "	" $1,214.93 "	" $5,104.74 "	" $4,441.12 "	" $1,225.14 "	" $3,905.13 "	" $5,104.74 "	" $5,104.74 "	" $1,939.80 "	" $3,215.99 "	" $4,339.03 "	" $3,369.13 "	" $4,083.79 "	" $1,225.14 "	" $4,594.27 "	" $4,150.15 "	" $4,339.03 "	" $1,214.93 "	" $4,150.15 "	" $1,225.14 "
5271861	HCHG CVMC BIOMET-EXPLOR IMPLANT HEAD 18 X 28 MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,603.53 "	" $3,922.47 "	" $1,333.64 "	" $5,603.53 "	" $4,875.07 "	" $1,344.85 "	" $4,286.70 "	" $5,603.53 "	" $5,603.53 "	" $2,129.34 "	" $3,530.22 "	" $4,763.00 "	" $3,698.33 "	" $4,482.82 "	" $1,344.85 "	" $5,043.18 "	" $4,555.67 "	" $4,763.00 "	" $1,333.64 "	" $4,555.67 "	" $1,344.85 "
5271862	HCHG CVMC BIOMET-EXPLOR IMPLANT STEM W/SCREW 7 X 28	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $6,642.16 "	" $4,649.51 "	" $1,580.83 "	" $6,642.16 "	" $5,778.68 "	" $1,594.12 "	" $5,081.25 "	" $6,642.16 "	" $6,642.16 "	" $2,524.02 "	" $4,184.56 "	" $5,645.84 "	" $4,383.83 "	" $5,313.73 "	" $1,594.12 "	" $5,977.94 "	" $5,400.08 "	" $5,645.84 "	" $1,580.83 "	" $5,400.08 "	" $1,594.12 "
5271863	HCHG CVMC GENESIS II RESURFACING PATELLAR COMPONENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,630.46 "	" $2,541.32 "	 $864.05 	" $3,630.46 "	" $3,158.50 "	 $871.31 	" $2,777.30 "	" $3,630.46 "	" $3,630.46 "	" $1,379.57 "	" $2,287.19 "	" $3,085.89 "	" $2,396.10 "	" $2,904.37 "	 $871.31 	" $3,267.41 "	" $2,951.56 "	" $3,085.89 "	 $864.05 	" $2,951.56 "	 $871.31 
5271864	HCHG CVMC DEPUY-GLOBAL C.A.P.HEAD DUOFIX	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $18,943.60 "	" $13,260.52 "	" $4,508.58 "	" $18,943.60 "	" $16,480.93 "	" $4,546.46 "	" $14,491.85 "	" $18,943.60 "	" $18,943.60 "	" $7,198.57 "	" $11,934.47 "	" $16,102.06 "	" $12,502.78 "	" $15,154.88 "	" $4,546.46 "	" $17,049.24 "	" $15,401.15 "	" $16,102.06 "	" $4,508.58 "	" $15,401.15 "	" $4,546.46 "
5271865	HCHG CVMC REGENEREX RINGLOCK MULTI HOLE ACETABULAR CUP-56MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $9,934.83 "	" $6,954.38 "	" $2,364.49 "	" $9,934.83 "	" $8,643.30 "	" $2,384.36 "	" $7,600.14 "	" $9,934.83 "	" $9,934.83 "	" $3,775.24 "	" $6,258.94 "	" $8,444.61 "	" $6,556.99 "	" $7,947.86 "	" $2,384.36 "	" $8,941.35 "	" $8,077.02 "	" $8,444.61 "	" $2,364.49 "	" $8,077.02 "	" $2,384.36 "
5271866	HCHG CVMC CEMENTED TWIN PEGGED FEMORAL-JOINT COMPONENT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,995.55 "	" $7,696.89 "	" $2,616.94 "	" $10,995.55 "	" $9,566.13 "	" $2,638.93 "	" $8,411.60 "	" $10,995.55 "	" $10,995.55 "	" $4,178.31 "	" $6,927.20 "	" $9,346.22 "	" $7,257.06 "	" $8,796.44 "	" $2,638.93 "	" $9,896.00 "	" $8,939.38 "	" $9,346.22 "	" $2,616.94 "	" $8,939.38 "	" $2,638.93 "
5271867	HCHG CVMC STANDARD PATELLAR-BIOMET	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,243.69 "	" $2,270.58 "	 $772.00 	" $3,243.69 "	" $2,822.01 "	 $778.49 	" $2,481.42 "	" $3,243.69 "	" $3,243.69 "	" $1,232.60 "	" $2,043.52 "	" $2,757.14 "	" $2,140.84 "	" $2,594.95 "	 $778.49 	" $2,919.32 "	" $2,637.12 "	" $2,757.14 "	 $772.00 	" $2,637.12 "	 $778.49 
5271868	HCHG CVMC AEQUALIS REVERSED CEMENTED HUMERAL STEM (9MMX100MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $9,480.23 "	" $6,636.16 "	" $2,256.29 "	" $9,480.23 "	" $8,247.80 "	" $2,275.26 "	" $7,252.38 "	" $9,480.23 "	" $9,480.23 "	" $3,602.49 "	" $5,972.54 "	" $8,058.20 "	" $6,256.95 "	" $7,584.18 "	" $2,275.26 "	" $8,532.21 "	" $7,707.43 "	" $8,058.20 "	" $2,256.29 "	" $7,707.43 "	" $2,275.26 "
5271869	HCHG CVMC AEQUALIS REVERSED CEMENTED HUMERAL METAPHYSIS (36 MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $7,462.96 "	" $5,224.07 "	" $1,776.18 "	" $7,462.96 "	" $6,492.78 "	" $1,791.11 "	" $5,709.16 "	" $7,462.96 "	" $7,462.96 "	" $2,835.92 "	" $4,701.66 "	" $6,343.52 "	" $4,925.55 "	" $5,970.37 "	" $1,791.11 "	" $6,716.66 "	" $6,067.39 "	" $6,343.52 "	" $1,776.18 "	" $6,067.39 "	" $1,791.11 "
5271870	HCHG CVMC AEQUALIS REVERSED LATERALILZED HUMERAL INSERT(36MMX6MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $3,526.28 "	" $2,468.40 "	 $839.25 	" $3,526.28 "	" $3,067.86 "	 $846.31 	" $2,697.60 "	" $3,526.28 "	" $3,526.28 "	" $1,339.99 "	" $2,221.56 "	" $2,997.34 "	" $2,327.34 "	" $2,821.02 "	 $846.31 	" $3,173.65 "	" $2,866.87 "	" $2,997.34 "	 $839.25 	" $2,866.87 "	 $846.31 
5271871	HCHG CVMC AEQUALIS REVERSED II CENTERED GLENOID SPHERE (36MMX25MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $13,274.85 "	" $9,292.40 "	" $3,159.41 "	" $13,274.85 "	" $11,549.12 "	" $3,185.96 "	" $10,155.26 "	" $13,274.85 "	" $13,274.85 "	" $5,044.44 "	" $8,363.16 "	" $11,283.62 "	" $8,761.40 "	" $10,619.88 "	" $3,185.96 "	" $11,947.37 "	" $10,792.45 "	" $11,283.62 "	" $3,159.41 "	" $10,792.45 "	" $3,185.96 "
5271872	HCHG CVMC SHELL R3 STIKTITE COATING 54MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,086.36 "	" $7,060.45 "	" $2,400.55 "	" $10,086.36 "	" $8,775.13 "	" $2,420.73 "	" $7,716.07 "	" $10,086.36 "	" $10,086.36 "	" $3,832.82 "	" $6,354.41 "	" $8,573.41 "	" $6,657.00 "	" $8,069.09 "	" $2,420.73 "	" $9,077.72 "	" $8,200.21 "	" $8,573.41 "	" $2,400.55 "	" $8,200.21 "	" $2,420.73 "
5271873	HCHG CVMC FEMORAL CONQUEST FX SZ.13	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $9,707.53 "	" $6,795.27 "	" $2,310.39 "	" $9,707.53 "	" $8,445.55 "	" $2,329.81 "	" $7,426.26 "	" $9,707.53 "	" $9,707.53 "	" $3,688.86 "	" $6,115.74 "	" $8,251.40 "	" $6,406.97 "	" $7,766.02 "	" $2,329.81 "	" $8,736.78 "	" $7,892.22 "	" $8,251.40 "	" $2,310.39 "	" $7,892.22 "	" $2,329.81 "
5271874	HCHG CVMC FEMORAL HEAD CO-CR 28MM -3	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,514.40 "	" $3,160.08 "	" $1,074.43 "	" $4,514.40 "	" $3,927.53 "	" $1,083.46 "	" $3,453.52 "	" $4,514.40 "	" $4,514.40 "	" $1,715.47 "	" $2,844.07 "	" $3,837.24 "	" $2,979.50 "	" $3,611.52 "	" $1,083.46 "	" $4,062.96 "	" $3,670.21 "	" $3,837.24 "	" $1,074.43 "	" $3,670.21 "	" $1,083.46 "
5271875	HCHG CVMC SHELL COCR UHMWPE LINER 28/46M	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $5,603.53 "	" $3,922.47 "	" $1,333.64 "	" $5,603.53 "	" $4,875.07 "	" $1,344.85 "	" $4,286.70 "	" $5,603.53 "	" $5,603.53 "	" $2,129.34 "	" $3,530.22 "	" $4,763.00 "	" $3,698.33 "	" $4,482.82 "	" $1,344.85 "	" $5,043.18 "	" $4,555.67 "	" $4,763.00 "	" $1,333.64 "	" $4,555.67 "	" $1,344.85 "
5271876	HCHG CVMC DISTAL POST CENTRALIZER 11MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $1,151.76 "	 $806.23 	 $274.12 	" $1,036.58 "	" $1,002.03 "	 $276.42 	 $881.10 	 $-   	 $-   	 $437.67 	 $725.61 	 $979.00 	 $760.16 	 $921.41 	 $276.42 	" $1,036.58 "	 $936.38 	 $979.00 	 $274.12 	 $936.38 	 $276.42 
5271877	HCHG CVMC AEQ REV CEM HUM META 42MM DIA	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $10,354.70 "	" $7,248.29 "	" $2,464.42 "	" $10,354.70 "	" $9,008.59 "	" $2,485.13 "	" $7,921.35 "	" $10,354.70 "	" $10,354.70 "	" $3,934.79 "	" $6,523.46 "	" $8,801.50 "	" $6,834.10 "	" $8,283.76 "	" $2,485.13 "	" $9,319.23 "	" $8,418.37 "	" $8,801.50 "	" $2,464.42 "	" $8,418.37 "	" $2,485.13 "
5271878	HCHG CVMC AEQ REV LAT HUM INSERT 42MM DI	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,419.70 "	" $3,093.79 "	" $1,051.89 "	" $4,419.70 "	" $3,845.14 "	" $1,060.73 "	" $3,381.07 "	" $4,419.70 "	" $4,419.70 "	" $1,679.49 "	" $2,784.41 "	" $3,756.75 "	" $2,917.00 "	" $3,535.76 "	" $1,060.73 "	" $3,977.73 "	" $3,593.22 "	" $3,756.75 "	" $1,051.89 "	" $3,593.22 "	" $1,060.73 "
5271879	HCHG CVMC AEQ REV GLEN BASEPLATE 29MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $4,419.70 "	" $3,093.79 "	" $1,051.89 "	" $4,419.70 "	" $3,845.14 "	" $1,060.73 "	" $3,381.07 "	" $4,419.70 "	" $4,419.70 "	" $1,679.49 "	" $2,784.41 "	" $3,756.75 "	" $2,917.00 "	" $3,535.76 "	" $1,060.73 "	" $3,977.73 "	" $3,593.22 "	" $3,756.75 "	" $1,051.89 "	" $3,593.22 "	" $1,060.73 "
5271880	HCHG CVMC AEQ REV II GLEN SPHERE 42MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $11,996.30 "	" $8,397.41 "	" $2,855.12 "	" $11,996.30 "	" $10,436.78 "	" $2,879.11 "	" $9,177.17 "	" $11,996.30 "	" $11,996.30 "	" $4,558.59 "	" $7,557.67 "	" $10,196.86 "	" $7,917.56 "	" $9,597.04 "	" $2,879.11 "	" $10,796.67 "	" $9,752.99 "	" $10,196.86 "	" $2,855.12 "	" $9,752.99 "	" $2,879.11 "
5271881	HCHG CVMC CORTILOC PEGGED GLENOID(SZ 48)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $9,802.24 "	" $6,861.57 "	" $2,332.93 "	" $9,802.24 "	" $8,527.95 "	" $2,352.54 "	" $7,498.71 "	" $9,802.24 "	" $9,802.24 "	" $3,724.85 "	" $6,175.41 "	" $8,331.90 "	" $6,469.48 "	" $7,841.79 "	" $2,352.54 "	" $8,822.02 "	" $7,969.22 "	" $8,331.90 "	" $2,332.93 "	" $7,969.22 "	" $2,352.54 "
5271882	HCHG CVMC ASCEND HUMERAL HEAD (DIAMETER 48-THICK 184-OFFSET 400)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $8,286.92 "	" $5,800.84 "	" $1,972.29 "	" $8,286.92 "	" $7,209.62 "	" $1,988.86 "	" $6,339.49 "	" $8,286.92 "	" $8,286.92 "	" $3,149.03 "	" $5,220.76 "	" $7,043.88 "	" $5,469.37 "	" $6,629.54 "	" $1,988.86 "	" $7,458.23 "	" $6,737.27 "	" $7,043.88 "	" $1,972.29 "	" $6,737.27 "	" $1,988.86 "
5271883	HCHG CVMC ASCEND HUMERAL STEM (SIZE 4A-ANGLE 127.5-LENGTH 78)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1776	" $17,404.10 "	" $12,182.87 "	" $4,142.18 "	" $17,404.10 "	" $15,141.57 "	" $4,176.98 "	" $13,314.14 "	" $17,404.10 "	" $17,404.10 "	" $6,613.56 "	" $10,964.58 "	" $14,793.49 "	" $11,486.71 "	" $13,923.28 "	" $4,176.98 "	" $15,663.69 "	" $14,149.53 "	" $14,793.49 "	" $4,142.18 "	" $14,149.53 "	" $4,176.98 "
5271884	"HCHG CVMC PARIETEX MESH, PLUG AND PATCH"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $694.53 	 $486.17 	 $165.30 	 $625.08 	 $604.24 	 $166.69 	 $531.32 	 $-   	 $-   	 $263.92 	 $437.55 	 $590.35 	 $458.39 	 $555.62 	 $166.69 	 $625.08 	 $564.65 	 $590.35 	 $165.30 	 $564.65 	 $166.69 
5271885	HCHG CVMC SOLYX-MESH	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,141.25 "	" $2,898.88 "	 $985.62 	" $4,141.25 "	" $3,602.89 "	 $993.90 	" $3,168.06 "	" $4,141.25 "	" $4,141.25 "	" $1,573.68 "	" $2,608.99 "	" $3,520.06 "	" $2,733.23 "	" $3,313.00 "	 $993.90 	" $3,727.13 "	" $3,366.84 "	" $3,520.06 "	 $985.62 	" $3,366.84 "	 $993.90 
5271886	HCHG CVMC MESH ATRIUM-CENTRIFX MESH 9CMX15.5CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $810.28 	 $567.20 	 $192.85 	 $729.25 	 $704.94 	 $194.47 	 $619.86 	 $-   	 $-   	 $307.91 	 $510.48 	 $688.74 	 $534.78 	 $648.22 	 $194.47 	 $729.25 	 $658.76 	 $688.74 	 $192.85 	 $658.76 	 $194.47 
5271887	"HCHG CVMC MESH HERNIA PATCH 5.4"" X 7"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,450.45 "	" $2,415.32 "	 $821.21 	" $3,450.45 "	" $3,001.89 "	 $828.11 	" $2,639.59 "	" $3,450.45 "	" $3,450.45 "	" $1,311.17 "	" $2,173.78 "	" $2,932.88 "	" $2,277.30 "	" $2,760.36 "	 $828.11 	" $3,105.41 "	" $2,805.22 "	" $2,932.88 "	 $821.21 	" $2,805.22 "	 $828.11 
5271888	"HCHG CVMC MESH C-QUR TACHSHIELD 4.5"" ROUND"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,000.21 "	" $1,400.15 "	 $476.05 	" $2,000.21 "	" $1,740.18 "	 $480.05 	" $1,530.16 "	" $2,000.21 "	" $2,000.21 "	 $760.08 	" $1,260.13 "	" $1,700.18 "	" $1,320.14 "	" $1,600.17 "	 $480.05 	" $1,800.19 "	" $1,626.17 "	" $1,700.18 "	 $476.05 	" $1,626.17 "	 $480.05 
5271889	"HCHG CVMC MESH C-QUR TACHSHIELD 4""X6"" & 5""X5"" OBLONG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,752.95 "	" $1,227.07 "	 $417.20 	" $1,752.95 "	" $1,525.07 "	 $420.71 	" $1,341.01 "	" $1,752.95 "	" $1,752.95 "	 $666.12 	" $1,104.36 "	" $1,490.01 "	" $1,156.95 "	" $1,402.36 "	 $420.71 	" $1,577.66 "	" $1,425.15 "	" $1,490.01 "	 $417.20 	" $1,425.15 "	 $420.71 
5271890	"HCHG CVMC MESH C-QUR TACHSHIELD 6"" X 8"" OBLONG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,837.94 "	" $1,986.56 "	 $675.43 	" $2,837.94 "	" $2,469.01 "	 $681.11 	" $2,171.02 "	" $2,837.94 "	" $2,837.94 "	" $1,078.42 "	" $1,787.90 "	" $2,412.25 "	" $1,873.04 "	" $2,270.35 "	 $681.11 	" $2,554.15 "	" $2,307.25 "	" $2,412.25 "	 $675.43 	" $2,307.25 "	 $681.11 
5271891	"HCHG CVMC MESH C-QUR TACHSHIELD 8"" X 10"" OBLONG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,778.83 "	" $2,645.18 "	 $899.36 	" $3,778.83 "	" $3,287.58 "	 $906.92 	" $2,890.80 "	" $3,778.83 "	" $3,778.83 "	" $1,435.96 "	" $2,380.66 "	" $3,212.01 "	" $2,494.03 "	" $3,023.06 "	 $906.92 	" $3,400.95 "	" $3,072.19 "	" $3,212.01 "	 $899.36 	" $3,072.19 "	 $906.92 
5271892	"HCHG CVMC MESH C-QUR TACHSHIELD 8.7"" X 10.7"" OVAL"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,210.70 "	" $2,947.49 "	" $1,002.15 "	" $4,210.70 "	" $3,663.31 "	" $1,010.57 "	" $3,221.19 "	" $4,210.70 "	" $4,210.70 "	" $1,600.07 "	" $2,652.74 "	" $3,579.10 "	" $2,779.06 "	" $3,368.56 "	" $1,010.57 "	" $3,789.63 "	" $3,423.30 "	" $3,579.10 "	" $1,002.15 "	" $3,423.30 "	" $1,010.57 "
5271893	HCHG CVMC ANTERIOR ELEVATE MESH	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $6,945.22 "	" $4,861.65 "	" $1,652.96 "	" $6,945.22 "	" $6,042.34 "	" $1,666.85 "	" $5,313.09 "	" $6,945.22 "	" $6,945.22 "	" $2,639.18 "	" $4,375.49 "	" $5,903.44 "	" $4,583.85 "	" $5,556.18 "	" $1,666.85 "	" $6,250.70 "	" $5,646.46 "	" $5,903.44 "	" $1,652.96 "	" $5,646.46 "	" $1,666.85 "
5271894	HCHG CVMC MESH PARITEX COMPOSITE OPT ROUND 15CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,313.31 "	" $1,619.32 "	 $550.57 	" $2,313.31 "	" $2,012.58 "	 $555.19 	" $1,769.68 "	" $2,313.31 "	" $2,313.31 "	 $879.06 	" $1,457.39 "	" $1,966.31 "	" $1,526.78 "	" $1,850.65 "	 $555.19 	" $2,081.98 "	" $1,880.72 "	" $1,966.31 "	 $550.57 	" $1,880.72 "	 $555.19 
5271895	"HCHG CVMC MESH C-QUR  4"" X  6"" OBLONG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,704.49 "	" $1,193.14 "	 $405.67 	" $1,704.49 "	" $1,482.91 "	 $409.08 	" $1,303.93 "	" $1,704.49 "	" $1,704.49 "	 $647.71 	" $1,073.83 "	" $1,448.82 "	" $1,124.96 "	" $1,363.59 "	 $409.08 	" $1,534.04 "	" $1,385.75 "	" $1,448.82 "	 $405.67 	" $1,385.75 "	 $409.08 
5271896	"HCHG CVMC MESH C-QUR  6"" X  8"" OBLONG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,380.33 "	" $1,666.23 "	 $566.52 	" $2,380.33 "	" $2,070.89 "	 $571.28 	" $1,820.95 "	" $2,380.33 "	" $2,380.33 "	 $904.53 	" $1,499.61 "	" $2,023.28 "	" $1,571.02 "	" $1,904.26 "	 $571.28 	" $2,142.30 "	" $1,935.21 "	" $2,023.28 "	 $566.52 	" $1,935.21 "	 $571.28 
5271897	"HCHG CVMC MESH C-QUR 10"" X 14"" OBLONG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,528.60 "	" $3,170.02 "	" $1,077.81 "	" $4,528.60 "	" $3,939.88 "	" $1,086.86 "	" $3,464.38 "	" $4,528.60 "	" $4,528.60 "	" $1,720.87 "	" $2,853.02 "	" $3,849.31 "	" $2,988.88 "	" $3,622.88 "	" $1,086.86 "	" $4,075.74 "	" $3,681.75 "	" $3,849.31 "	" $1,077.81 "	" $3,681.75 "	" $1,086.86 "
5271898	HCHG CVMC POWER PORT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1788	" $2,152.10 "	" $1,506.47 "	 $512.20 	" $2,152.10 "	" $1,872.33 "	 $516.50 	" $1,646.36 "	" $2,152.10 "	" $2,152.10 "	 $817.80 	" $1,355.82 "	" $1,829.29 "	" $1,420.39 "	" $1,721.68 "	 $516.50 	" $1,936.89 "	" $1,749.66 "	" $1,829.29 "	 $512.20 	" $1,749.66 "	 $516.50 
5271899	HCHG CVMC POWER PORT MRI 9.5FR CATHETER	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1788	" $1,919.02 "	" $1,343.31 "	 $456.73 	" $1,919.02 "	" $1,669.55 "	 $460.56 	" $1,468.05 "	" $1,919.02 "	" $1,919.02 "	 $729.23 	" $1,208.98 "	" $1,631.17 "	" $1,266.55 "	" $1,535.22 "	 $460.56 	" $1,727.12 "	" $1,560.16 "	" $1,631.17 "	 $456.73 	" $1,560.16 "	 $460.56 
5271900	"HCHG CVMC ON-Q PAINBUSTER COMPONENT, EXPANSION"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1887	 $845.00 	 $591.50 	 $201.11 	 $760.50 	 $735.15 	 $202.80 	 $646.43 	 $-   	 $-   	 $321.10 	 $532.35 	 $718.25 	 $557.70 	 $676.00 	 $202.80 	 $760.50 	 $686.99 	 $718.25 	 $201.11 	 $686.99 	 $202.80 
5271902	HCHG CVMC ON-Q C-BLOCK	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1887	" $1,670.40 "	" $1,169.28 "	 $397.56 	" $1,670.40 "	" $1,453.25 "	 $400.90 	" $1,277.86 "	" $1,670.40 "	" $1,670.40 "	 $634.75 	" $1,052.35 "	" $1,419.84 "	" $1,102.46 "	" $1,336.32 "	 $400.90 	" $1,503.36 "	" $1,358.04 "	" $1,419.84 "	 $397.56 	" $1,358.04 "	 $400.90 
5271903	HCHG CVMC ON-Q PUMP DUAL 40MLX4ML/HR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1887	" $1,417.99 "	 $992.59 	 $337.48 	" $1,276.19 "	" $1,233.65 "	 $340.32 	" $1,084.76 "	 $-   	 $-   	 $538.84 	 $893.33 	" $1,205.29 "	 $935.87 	" $1,134.39 "	 $340.32 	" $1,276.19 "	" $1,152.83 "	" $1,205.29 "	 $337.48 	" $1,152.83 "	 $340.32 
5271904	HCHG CVMC AXOGUARD NERVE CONNECTOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C9352	" $2,525.03 "	" $1,767.52 "	 $600.96 	" $2,525.03 "	" $2,196.78 "	 $606.01 	" $1,931.65 "	" $2,525.03 "	" $2,525.03 "	 $959.51 	" $1,590.77 "	" $2,146.28 "	" $1,666.52 "	" $2,020.02 "	 $606.01 	" $2,272.53 "	" $2,052.85 "	" $2,146.28 "	 $600.96 	" $2,052.85 "	 $606.01 
5271909	HCHG CVMC CEMENT RESTRICTOR (24MM)	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,493.23 "	" $1,045.26 "	 $355.39 	" $1,343.91 "	" $1,299.11 "	 $358.38 	" $1,142.32 "	 $-   	 $-   	 $567.43 	 $940.73 	" $1,269.25 "	 $985.53 	" $1,194.58 "	 $358.38 	" $1,343.91 "	" $1,214.00 "	" $1,269.25 "	 $355.39 	" $1,214.00 "	 $358.38 
5271913	HCHG CVMC SCREW TRIGEN NAIL CAP 0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,423.78 "	 $996.65 	 $338.86 	" $1,281.40 "	" $1,238.69 "	 $341.71 	" $1,089.19 "	 $-   	 $-   	 $541.04 	 $896.98 	" $1,210.21 "	 $939.69 	" $1,139.02 "	 $341.71 	" $1,281.40 "	" $1,157.53 "	" $1,210.21 "	 $338.86 	" $1,157.53 "	 $341.71 
5271918	HCHG CVMC CAP FIXATION STUD 8.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $19,295.09 "	" $13,506.56 "	" $4,592.23 "	" $19,295.09 "	" $16,786.73 "	" $4,630.82 "	" $14,760.74 "	" $19,295.09 "	" $19,295.09 "	" $7,332.13 "	" $12,155.91 "	" $16,400.83 "	" $12,734.76 "	" $15,436.07 "	" $4,630.82 "	" $17,365.58 "	" $15,686.91 "	" $16,400.83 "	" $4,592.23 "	" $15,686.91 "	" $4,630.82 "
5271919	HCHG CVMC SCREW FEMORAL TROCHLEA 20MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,645.45 "	" $1,851.82 "	 $629.62 	" $2,645.45 "	" $2,301.54 "	 $634.91 	" $2,023.77 "	" $2,645.45 "	" $2,645.45 "	" $1,005.27 "	" $1,666.63 "	" $2,248.63 "	" $1,746.00 "	" $2,116.36 "	 $634.91 	" $2,380.91 "	" $2,150.75 "	" $2,248.63 "	 $629.62 	" $2,150.75 "	 $634.91 
5271920	HCHG CVMC PATELLA BUTTON 20MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,948.46 "	" $2,063.92 "	 $701.73 	" $2,948.46 "	" $2,565.16 "	 $707.63 	" $2,255.57 "	" $2,948.46 "	" $2,948.46 "	" $1,120.41 "	" $1,857.53 "	" $2,506.19 "	" $1,945.98 "	" $2,358.77 "	 $707.63 	" $2,653.61 "	" $2,397.10 "	" $2,506.19 "	 $701.73 	" $2,397.10 "	 $707.63 
5271921	HCHG CVMC OSTEORAPTOR 2.3 CVRD UB COB/BL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,549.98 "	" $1,084.99 "	 $368.90 	" $1,549.98 "	" $1,348.48 "	 $372.00 	" $1,185.73 "	" $1,549.98 "	 $-   	 $588.99 	 $976.49 	" $1,317.48 "	" $1,022.99 "	" $1,239.98 "	 $372.00 	" $1,394.98 "	" $1,260.13 "	" $1,317.48 "	 $368.90 	" $1,260.13 "	 $372.00 
5271922	HCHG CVMC NAIL LFN FEMORAL RECON	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,401.84 "	" $3,781.29 "	" $1,285.64 "	" $5,401.84 "	" $4,699.60 "	" $1,296.44 "	" $4,132.41 "	" $5,401.84 "	" $5,401.84 "	" $2,052.70 "	" $3,403.16 "	" $4,591.56 "	" $3,565.21 "	" $4,321.47 "	" $1,296.44 "	" $4,861.66 "	" $4,391.70 "	" $4,591.56 "	" $1,285.64 "	" $4,391.70 "	" $1,296.44 "
5271923	HCHG CVMC LAB SCREW TI NAIL	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $2,232.13 "	" $1,562.49 "	 $531.25 	" $2,232.13 "	" $1,941.95 "	 $535.71 	" $1,707.58 "	" $2,232.13 "	" $2,232.13 "	 $848.21 	" $1,406.24 "	" $1,897.31 "	" $1,473.21 "	" $1,785.70 "	 $535.71 	" $2,008.92 "	" $1,814.72 "	" $1,897.31 "	 $531.25 	" $1,814.72 "	 $535.71 
5271924	HCHG CVMC GRAFT PATELLAR LIGAMENT SPLIT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $7,260.92 "	" $5,082.64 "	" $1,728.10 "	" $7,260.92 "	" $6,317.00 "	" $1,742.62 "	" $5,554.60 "	" $7,260.92 "	" $7,260.92 "	" $2,759.15 "	" $4,574.38 "	" $6,171.78 "	" $4,792.21 "	" $5,808.74 "	" $1,742.62 "	" $6,534.83 "	" $5,903.13 "	" $6,171.78 "	" $1,728.10 "	" $5,903.13 "	" $1,742.62 "
5271925	"HCHG CVMC MESH C-QUR 12"" X 18"" OBLONG"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $7,073.71 "	" $4,951.60 "	" $1,683.54 "	" $7,073.71 "	" $6,154.13 "	" $1,697.69 "	" $5,411.39 "	" $7,073.71 "	" $7,073.71 "	" $2,688.01 "	" $4,456.44 "	" $6,012.65 "	" $4,668.65 "	" $5,658.97 "	" $1,697.69 "	" $6,366.34 "	" $5,750.93 "	" $6,012.65 "	" $1,683.54 "	" $5,750.93 "	" $1,697.69 "
5271927	HCHG CVMC K-WIRE THREADED	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1769	 $44.73 	 $31.31 	 $10.65 	 $40.26 	 $38.92 	 $10.74 	 $34.22 	 $-   	 $-   	 $17.00 	 $28.18 	 $38.02 	 $29.52 	 $35.78 	 $10.74 	 $40.26 	 $36.37 	 $38.02 	 $10.65 	 $36.37 	 $10.74 
5271928	HCHG CVMC K-WIRE TROCAR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1769	 $265.17 	 $185.62 	 $63.11 	 $238.65 	 $230.70 	 $63.64 	 $202.86 	 $-   	 $-   	 $100.76 	 $167.06 	 $225.39 	 $175.01 	 $212.14 	 $63.64 	 $238.65 	 $215.58 	 $225.39 	 $63.11 	 $215.58 	 $63.64 
5271930	HCHG CVMC SCREW CORTEX ST	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $540.11 	 $378.08 	 $128.55 	 $486.10 	 $469.90 	 $129.63 	 $413.18 	 $-   	 $-   	 $205.24 	 $340.27 	 $459.09 	 $356.47 	 $432.09 	 $129.63 	 $486.10 	 $439.11 	 $459.09 	 $128.55 	 $439.11 	 $129.63 
5271932	HCHG CVMC SCREW NON-LOCK GOLD	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $610.06 	 $427.04 	 $145.19 	 $549.05 	 $530.75 	 $146.41 	 $466.70 	 $-   	 $-   	 $231.82 	 $384.34 	 $518.55 	 $402.64 	 $488.05 	 $146.41 	 $549.05 	 $495.98 	 $518.55 	 $145.19 	 $495.98 	 $146.41 
5271933	HCHG CVMC SCREW LOCKING ST T8	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $698.58 	 $489.01 	 $166.26 	 $628.72 	 $607.76 	 $167.66 	 $534.41 	 $-   	 $-   	 $265.46 	 $440.11 	 $593.79 	 $461.06 	 $558.86 	 $167.66 	 $628.72 	 $567.95 	 $593.79 	 $166.26 	 $567.95 	 $167.66 
5271934	HCHG CVMC SCREW VC LOCKING 2.4	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $777.29 	 $544.10 	 $185.00 	 $699.56 	 $676.24 	 $186.55 	 $594.63 	 $-   	 $-   	 $295.37 	 $489.69 	 $660.70 	 $513.01 	 $621.83 	 $186.55 	 $699.56 	 $631.94 	 $660.70 	 $185.00 	 $631.94 	 $186.55 
5271935	HCHG CVMC SCREW LOCKING BLUE 2.5	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $781.34 	 $546.94 	 $185.96 	 $703.21 	 $679.77 	 $187.52 	 $597.73 	 $-   	 $-   	 $296.91 	 $492.24 	 $664.14 	 $515.68 	 $625.07 	 $187.52 	 $703.21 	 $635.23 	 $664.14 	 $185.96 	 $635.23 	 $187.52 
5271936	HCHG CVMC XTENDOBUTTON FIXATION DEVICE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	 $943.40 	 $660.38 	 $224.53 	 $849.06 	 $820.76 	 $226.42 	 $721.70 	 $-   	 $-   	 $358.49 	 $594.34 	 $801.89 	 $622.64 	 $754.72 	 $226.42 	 $849.06 	 $766.98 	 $801.89 	 $224.53 	 $766.98 	 $226.42 
5271937	HCHG CVMC PLATE STRAIGHT 1.3MM 6H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,165.94 "	 $816.16 	 $277.49 	" $1,049.35 "	" $1,014.37 "	 $279.83 	 $891.94 	 $-   	 $-   	 $443.06 	 $734.54 	 $991.05 	 $769.52 	 $932.75 	 $279.83 	" $1,049.35 "	 $947.91 	 $991.05 	 $277.49 	 $947.91 	 $279.83 
5271939	HCHG CVMC PLATE 1.3MM 3H-HEAD/8H SHAFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,343.04 "	 $940.13 	 $319.64 	" $1,208.74 "	" $1,168.44 "	 $322.33 	" $1,027.43 "	 $-   	 $-   	 $510.36 	 $846.12 	" $1,141.58 "	 $886.41 	" $1,074.43 "	 $322.33 	" $1,208.74 "	" $1,091.89 "	" $1,141.58 "	 $319.64 	" $1,091.89 "	 $322.33 
5271940	HCHG CVMC H-PLATE EXTENDED 1.3MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,402.08 "	 $981.46 	 $333.70 	" $1,261.87 "	" $1,219.81 "	 $336.50 	" $1,072.59 "	 $-   	 $-   	 $532.79 	 $883.31 	" $1,191.77 "	 $925.37 	" $1,121.66 "	 $336.50 	" $1,261.87 "	" $1,139.89 "	" $1,191.77 "	 $333.70 	" $1,139.89 "	 $336.50 
5271941	HCHG CVMC SCREW BIOSURE HA 8MMX25MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,458.51 "	" $1,020.96 "	 $347.13 	" $1,312.66 "	" $1,268.90 "	 $350.04 	" $1,115.76 "	 $-   	 $-   	 $554.23 	 $918.86 	" $1,239.73 "	 $962.62 	" $1,166.81 "	 $350.04 	" $1,312.66 "	" $1,185.77 "	" $1,239.73 "	 $347.13 	" $1,185.77 "	 $350.04 
5271942	HCHG CVMC PLATE STRAIGHT 1.3MM 12H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,466.03 "	" $1,026.22 "	 $348.92 	" $1,319.43 "	" $1,275.45 "	 $351.85 	" $1,121.51 "	 $-   	 $-   	 $557.09 	 $923.60 	" $1,246.13 "	 $967.58 	" $1,172.82 "	 $351.85 	" $1,319.43 "	" $1,191.88 "	" $1,246.13 "	 $348.92 	" $1,191.88 "	 $351.85 
5271943	HCHG CVMC MIRENA IUD SYSTEM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	5271943	" $1,226.12 "	 $858.28 	 $291.82 	" $1,103.51 "	" $1,066.72 "	 $294.27 	 $937.98 	 $-   	 $-   	 $465.93 	 $772.46 	" $1,042.20 "	 $809.24 	 $980.90 	 $294.27 	" $1,103.51 "	 $996.84 	" $1,042.20 "	 $291.82 	 $996.84 	 $294.27 
5271946	HCHG CVMC PLATE VADR 2COL 2.4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,704.80 "	" $2,593.36 "	 $881.74 	" $3,704.80 "	" $3,223.18 "	 $889.15 	" $2,834.17 "	" $3,704.80 "	" $3,704.80 "	" $1,407.82 "	" $2,334.02 "	" $3,149.08 "	" $2,445.17 "	" $2,963.84 "	 $889.15 	" $3,334.32 "	" $3,012.00 "	" $3,149.08 "	 $881.74 	" $3,012.00 "	 $889.15 
5271947	HCHG CVMC PLATE VADR 2COL 2.4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,850.09 "	" $2,695.06 "	 $916.32 	" $3,850.09 "	" $3,349.58 "	 $924.02 	" $2,945.32 "	" $3,850.09 "	" $3,850.09 "	" $1,463.03 "	" $2,425.56 "	" $3,272.58 "	" $2,541.06 "	" $3,080.07 "	 $924.02 	" $3,465.08 "	" $3,130.12 "	" $3,272.58 "	 $916.32 	" $3,130.12 "	 $924.02 
5271948	HCHG CVMC PLATE VADR 2COL 2.4MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,246.89 "	" $2,272.82 "	 $772.76 	" $3,246.89 "	" $2,824.79 "	 $779.25 	" $2,483.87 "	" $3,246.89 "	" $3,246.89 "	" $1,233.82 "	" $2,045.54 "	" $2,759.86 "	" $2,142.95 "	" $2,597.51 "	 $779.25 	" $2,922.20 "	" $2,639.72 "	" $2,759.86 "	 $772.76 	" $2,639.72 "	 $779.25 
5271949	HCHG CVMC PLATE 2.5 DR WATERSHED LEFT	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,298.98 "	" $2,309.29 "	 $785.16 	" $3,298.98 "	" $2,870.11 "	 $791.76 	" $2,523.72 "	" $3,298.98 "	" $3,298.98 "	" $1,253.61 "	" $2,078.36 "	" $2,804.13 "	" $2,177.33 "	" $2,639.18 "	 $791.76 	" $2,969.08 "	" $2,682.07 "	" $2,804.13 "	 $785.16 	" $2,682.07 "	 $791.76 
5271950	HCHG CVMC LCP WRIST FUSION PLATE	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $3,675.60 "	" $2,572.92 "	 $874.79 	" $3,675.60 "	" $3,197.77 "	 $882.14 	" $2,811.83 "	" $3,675.60 "	" $3,675.60 "	" $1,396.73 "	" $2,315.63 "	" $3,124.26 "	" $2,425.90 "	" $2,940.48 "	 $882.14 	" $3,308.04 "	" $2,988.26 "	" $3,124.26 "	 $874.79 	" $2,988.26 "	 $882.14 
5271951	"HCHG CVMC MESH C-QUR TACHSHIELD 6.3""X12"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,444.63 "	" $3,111.24 "	" $1,057.82 "	" $4,444.63 "	" $3,866.83 "	" $1,066.71 "	" $3,400.14 "	" $4,444.63 "	" $4,444.63 "	" $1,688.96 "	" $2,800.12 "	" $3,777.94 "	" $2,933.46 "	" $3,555.70 "	" $1,066.71 "	" $4,000.17 "	" $3,613.48 "	" $3,777.94 "	" $1,057.82 "	" $3,613.48 "	" $1,066.71 "
5271952	HCHG CVMC PLATE LCP MDT 10H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $4,628.83 "	" $3,240.18 "	" $1,101.66 "	" $4,628.83 "	" $4,027.08 "	" $1,110.92 "	" $3,541.05 "	" $4,628.83 "	" $4,628.83 "	" $1,758.96 "	" $2,916.16 "	" $3,934.51 "	" $3,055.03 "	" $3,703.06 "	" $1,110.92 "	" $4,165.95 "	" $3,763.24 "	" $3,934.51 "	" $1,101.66 "	" $3,763.24 "	" $1,110.92 "
5271953	HCHG CVMC GRAFT TIBIALIS TENDON ANTERIOR	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1762	" $5,366.76 "	" $3,756.73 "	" $1,277.29 "	" $5,366.76 "	" $4,669.08 "	" $1,288.02 "	" $4,105.57 "	" $5,366.76 "	" $5,366.76 "	" $2,039.37 "	" $3,381.06 "	" $4,561.75 "	" $3,542.06 "	" $4,293.41 "	" $1,288.02 "	" $4,830.08 "	" $4,363.18 "	" $4,561.75 "	" $1,277.29 "	" $4,363.18 "	" $1,288.02 "
5271954	"HCHG CVMC MESH C-QUR TACHSHIELD 10.8""X13"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $5,356.35 "	" $3,749.45 "	" $1,274.81 "	" $5,356.35 "	" $4,660.02 "	" $1,285.52 "	" $4,097.61 "	" $5,356.35 "	" $5,356.35 "	" $2,035.41 "	" $3,374.50 "	" $4,552.90 "	" $3,535.19 "	" $4,285.08 "	" $1,285.52 "	" $4,820.72 "	" $4,354.71 "	" $4,552.90 "	" $1,274.81 "	" $4,354.71 "	" $1,285.52 "
5271955	HCHG JUGGERKNOT 2.9MM DBL LOADED	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT		" $1,658.75 "	" $1,161.13 "	 $394.78 	" $1,658.75 "	" $1,443.11 "	 $398.10 	" $1,268.94 "	" $1,658.75 "	" $1,658.75 "	 $630.33 	" $1,045.01 "	" $1,409.94 "	" $1,094.78 "	" $1,327.00 "	 $398.10 	" $1,492.88 "	" $1,348.56 "	" $1,409.94 "	 $394.78 	" $1,348.56 "	 $398.10 
5272074	HCHG BIO-COMP TENODESIS SCREW 4MMX10MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,748.10 "	" $1,223.67 "	 $416.05 	" $1,748.10 "	" $1,520.85 "	 $419.54 	" $1,337.30 "	" $1,748.10 "	" $1,748.10 "	 $664.28 	" $1,101.30 "	" $1,485.89 "	" $1,153.75 "	" $1,398.48 "	 $419.54 	" $1,573.29 "	" $1,421.21 "	" $1,485.89 "	 $416.05 	" $1,421.21 "	 $419.54 
5272075	HCHG PLATE LCP ANT-LAT DIS TIBIA 17-19 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,268.55 "	" $3,687.99 "	" $1,253.91 "	" $5,268.55 "	" $4,583.64 "	" $1,264.45 "	" $4,030.44 "	" $5,268.55 "	" $5,268.55 "	" $2,002.05 "	" $3,319.19 "	" $4,478.27 "	" $3,477.24 "	" $4,214.84 "	" $1,264.45 "	" $4,741.70 "	" $4,283.33 "	" $4,478.27 "	" $1,253.91 "	" $4,283.33 "	" $1,264.45 "
5272076	HCHG PLATE LCP ANT-LAT DIS TIBIA 21 H	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $5,360.20 "	" $3,752.14 "	" $1,275.73 "	" $5,360.20 "	" $4,663.37 "	" $1,286.45 "	" $4,100.55 "	" $5,360.20 "	" $5,360.20 "	" $2,036.88 "	" $3,376.93 "	" $4,556.17 "	" $3,537.73 "	" $4,288.16 "	" $1,286.45 "	" $4,824.18 "	" $4,357.84 "	" $4,556.17 "	" $1,275.73 "	" $4,357.84 "	" $1,286.45 "
5272077	HCHG MESH PARIETEX PLUG PATCH 8CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $696.78 	 $487.75 	 $165.83 	 $627.10 	 $606.20 	 $167.23 	 $533.04 	 $-   	 $-   	 $264.78 	 $438.97 	 $592.26 	 $459.87 	 $557.42 	 $167.23 	 $627.10 	 $566.48 	 $592.26 	 $165.83 	 $566.48 	 $167.23 
5272078	HCHG MESH PARIETEX ANATOMICAL 15CM X 10CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $702.34 	 $491.64 	 $167.16 	 $632.11 	 $611.04 	 $168.56 	 $537.29 	 $-   	 $-   	 $266.89 	 $442.47 	 $596.99 	 $463.54 	 $561.87 	 $168.56 	 $632.11 	 $571.00 	 $596.99 	 $167.16 	 $571.00 	 $168.56 
5272079	HCHG MESH PRO GRIP LAP 15CM X 10CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,257.04 "	 $879.93 	 $299.18 	" $1,131.34 "	" $1,093.62 "	 $301.69 	 $961.64 	 $-   	 $-   	 $477.68 	 $791.94 	" $1,068.48 "	 $829.65 	" $1,005.63 "	 $301.69 	" $1,131.34 "	" $1,021.97 "	" $1,068.48 "	 $299.18 	" $1,021.97 "	 $301.69 
5272080	HCHG MESH PARIETEX SKIRT ROUND 8CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,375.87 "	 $963.11 	 $327.46 	" $1,238.28 "	" $1,197.01 "	 $330.21 	" $1,052.54 "	 $-   	 $-   	 $522.83 	 $866.80 	" $1,169.49 "	 $908.07 	" $1,100.70 "	 $330.21 	" $1,238.28 "	" $1,118.58 "	" $1,169.49 "	 $327.46 	" $1,118.58 "	 $330.21 
5272081	HCHG MESH PRO GRIP LAP 15CM X 10 CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,413.28 "	 $989.30 	 $336.36 	" $1,271.95 "	" $1,229.55 "	 $339.19 	" $1,081.16 "	 $-   	 $-   	 $537.05 	 $890.37 	" $1,201.29 "	 $932.76 	" $1,130.62 "	 $339.19 	" $1,271.95 "	" $1,149.00 "	" $1,201.29 "	 $336.36 	" $1,149.00 "	 $339.19 
5272082	HCHG MESH PARIETEX PCOX ROUND 12CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,448.32 "	" $1,013.82 "	 $344.70 	" $1,303.49 "	" $1,260.04 "	 $347.60 	" $1,107.96 "	 $-   	 $-   	 $550.36 	 $912.44 	" $1,231.07 "	 $955.89 	" $1,158.66 "	 $347.60 	" $1,303.49 "	" $1,177.48 "	" $1,231.07 "	 $344.70 	" $1,177.48 "	 $347.60 
5272083	HCHG PCO VENTRAL PATCH 4.6CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,485.34 "	" $1,039.74 "	 $353.51 	" $1,336.81 "	" $1,292.25 "	 $356.48 	" $1,136.29 "	 $-   	 $-   	 $564.43 	 $935.76 	" $1,262.54 "	 $980.32 	" $1,188.27 "	 $356.48 	" $1,336.81 "	" $1,207.58 "	" $1,262.54 "	 $353.51 	" $1,207.58 "	 $356.48 
5272084	HCHG PCO VENTRAL 6.6 CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,831.58 "	" $1,282.11 "	 $435.92 	" $1,831.58 "	" $1,593.47 "	 $439.58 	" $1,401.16 "	" $1,831.58 "	" $1,831.58 "	 $696.00 	" $1,153.90 "	" $1,556.84 "	" $1,208.84 "	" $1,465.26 "	 $439.58 	" $1,648.42 "	" $1,489.07 "	" $1,556.84 "	 $435.92 	" $1,489.07 "	 $439.58 
5272085	HCHG PARIETEX SKIRT 15CM X 10CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,840.59 "	" $1,288.41 "	 $438.06 	" $1,840.59 "	" $1,601.31 "	 $441.74 	" $1,408.05 "	" $1,840.59 "	" $1,840.59 "	 $699.42 	" $1,159.57 "	" $1,564.50 "	" $1,214.79 "	" $1,472.47 "	 $441.74 	" $1,656.53 "	" $1,496.40 "	" $1,564.50 "	 $438.06 	" $1,496.40 "	 $441.74 
5272086	HCHG MESH PARIETEX PCOX 20CM X 15CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,323.38 "	" $1,626.37 "	 $552.96 	" $2,323.38 "	" $2,021.34 "	 $557.61 	" $1,777.39 "	" $2,323.38 "	" $2,323.38 "	 $882.88 	" $1,463.73 "	" $1,974.87 "	" $1,533.43 "	" $1,858.70 "	 $557.61 	" $2,091.04 "	" $1,888.91 "	" $1,974.87 "	 $552.96 	" $1,888.91 "	 $557.61 
5272087	HCHG MESH PCO VENTRAL PATCH 8.6CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,352.63 "	" $1,646.84 "	 $559.93 	" $2,352.63 "	" $2,046.79 "	 $564.63 	" $1,799.76 "	" $2,352.63 "	" $2,352.63 "	 $894.00 	" $1,482.16 "	" $1,999.74 "	" $1,552.74 "	" $1,882.10 "	 $564.63 	" $2,117.37 "	" $1,912.69 "	" $1,999.74 "	 $559.93 	" $1,912.69 "	 $564.63 
5272088	HCHG PARIETEX SKIRT 20CM X 15CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,836.31 "	" $1,985.42 "	 $675.04 	" $2,836.31 "	" $2,467.59 "	 $680.71 	" $2,169.78 "	" $2,836.31 "	" $2,836.31 "	" $1,077.80 "	" $1,786.88 "	" $2,410.86 "	" $1,871.96 "	" $2,269.05 "	 $680.71 	" $2,552.68 "	" $2,305.92 "	" $2,410.86 "	 $675.04 	" $2,305.92 "	 $680.71 
5272089	HCHG MESH PARIETEX PCOX 25CM X 20CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,531.23 "	" $2,471.86 "	 $840.43 	" $3,531.23 "	" $3,072.17 "	 $847.50 	" $2,701.39 "	" $3,531.23 "	" $3,531.23 "	" $1,341.87 "	" $2,224.67 "	" $3,001.55 "	" $2,330.61 "	" $2,824.98 "	 $847.50 	" $3,178.11 "	" $2,870.89 "	" $3,001.55 "	 $840.43 	" $2,870.89 "	 $847.50 
5272090	HCHG MESH PARIETEX SKIRT 25CM X 20CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,849.77 "	" $2,694.84 "	 $916.25 	" $3,849.77 "	" $3,349.30 "	 $923.94 	" $2,945.07 "	" $3,849.77 "	" $3,849.77 "	" $1,462.91 "	" $2,425.36 "	" $3,272.30 "	" $2,540.85 "	" $3,079.82 "	 $923.94 	" $3,464.79 "	" $3,129.86 "	" $3,272.30 "	 $916.25 	" $3,129.86 "	 $923.94 
5272091	HCHG MESH PARIETEX PCOX 30CM X 20CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,923.29 "	" $2,746.30 "	 $933.74 	" $3,923.29 "	" $3,413.26 "	 $941.59 	" $3,001.32 "	" $3,923.29 "	" $3,923.29 "	" $1,490.85 "	" $2,471.67 "	" $3,334.80 "	" $2,589.37 "	" $3,138.63 "	 $941.59 	" $3,530.96 "	" $3,189.63 "	" $3,334.80 "	 $933.74 	" $3,189.63 "	 $941.59 
5272092	HCHG PERMACOL PROCINE 10CM X 10CM X 1.0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,003.70 "	" $2,802.59 "	 $952.88 	" $4,003.70 "	" $3,483.22 "	 $960.89 	" $3,062.83 "	" $4,003.70 "	" $4,003.70 "	" $1,521.41 "	" $2,522.33 "	" $3,403.15 "	" $2,642.44 "	" $3,202.96 "	 $960.89 	" $3,603.33 "	" $3,255.01 "	" $3,403.15 "	 $952.88 	" $3,255.01 "	 $960.89 
5272093	HCHG MESH PARIETEX SKIRT 30CM X 20CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,089.16 "	" $2,862.41 "	 $973.22 	" $4,089.16 "	" $3,557.57 "	 $981.40 	" $3,128.21 "	" $4,089.16 "	" $4,089.16 "	" $1,553.88 "	" $2,576.17 "	" $3,475.79 "	" $2,698.85 "	" $3,271.33 "	 $981.40 	" $3,680.24 "	" $3,324.49 "	" $3,475.79 "	 $973.22 	" $3,324.49 "	 $981.40 
5272094	HCHG MESH PARIETEX PCOX 37CM X 28CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $4,658.92 "	" $3,261.24 "	" $1,108.82 "	" $4,658.92 "	" $4,053.26 "	" $1,118.14 "	" $3,564.07 "	" $4,658.92 "	" $4,658.92 "	" $1,770.39 "	" $2,935.12 "	" $3,960.08 "	" $3,074.89 "	" $3,727.14 "	" $1,118.14 "	" $4,193.03 "	" $3,787.70 "	" $3,960.08 "	" $1,108.82 "	" $3,787.70 "	" $1,118.14 "
5272095	HCHG MESH PERMACOL PORCINE 10CM X 15CM X 1.0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $6,005.54 "	" $4,203.88 "	" $1,429.32 "	" $6,005.54 "	" $5,224.82 "	" $1,441.33 "	" $4,594.24 "	" $6,005.54 "	" $6,005.54 "	" $2,282.11 "	" $3,783.49 "	" $5,104.71 "	" $3,963.66 "	" $4,804.43 "	" $1,441.33 "	" $5,404.99 "	" $4,882.50 "	" $5,104.71 "	" $1,429.32 "	" $4,882.50 "	" $1,441.33 "
5272096	HCHG MESH PERMACOL PORCINE 15CM X 20CM X 1.0MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $12,011.07 "	" $8,407.75 "	" $2,858.63 "	" $12,011.07 "	" $10,449.63 "	" $2,882.66 "	" $9,188.47 "	" $12,011.07 "	" $12,011.07 "	" $4,564.21 "	" $7,566.97 "	" $10,209.41 "	" $7,927.31 "	" $9,608.86 "	" $2,882.66 "	" $10,809.96 "	" $9,765.00 "	" $10,209.41 "	" $2,858.63 "	" $9,765.00 "	" $2,882.66 "
5272097	HCHG MESH PERMACOL PORCINE 18CM X 28CM X 1.5MM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $22,196.46 "	" $15,537.52 "	" $5,282.76 "	" $22,196.46 "	" $19,310.92 "	" $5,327.15 "	" $16,980.29 "	" $22,196.46 "	" $22,196.46 "	" $8,434.65 "	" $13,983.77 "	" $18,866.99 "	" $14,649.66 "	" $17,757.17 "	" $5,327.15 "	" $19,976.81 "	" $18,045.72 "	" $18,866.99 "	" $5,282.76 "	" $18,045.72 "	" $5,327.15 "
5272098	HCHG MESH ACCUMESH ROUND 15CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,541.50 "	" $1,779.05 "	 $604.88 	" $2,541.50 "	" $2,211.11 "	 $609.96 	" $1,944.25 "	" $2,541.50 "	" $2,541.50 "	 $965.77 	" $1,601.15 "	" $2,160.28 "	" $1,677.39 "	" $2,033.20 "	 $609.96 	" $2,287.35 "	" $2,066.24 "	" $2,160.28 "	 $604.88 	" $2,066.24 "	 $609.96 
5272099	HCHG MESH ACCUMESH ROUND 20CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,408.44 "	" $2,385.91 "	 $811.21 	" $3,408.44 "	" $2,965.34 "	 $818.03 	" $2,607.46 "	" $3,408.44 "	" $3,408.44 "	" $1,295.21 "	" $2,147.32 "	" $2,897.17 "	" $2,249.57 "	" $2,726.75 "	 $818.03 	" $3,067.60 "	" $2,771.06 "	" $2,897.17 "	 $811.21 	" $2,771.06 "	 $818.03 
5272100	HCHG MESH ACCUMESH 20CM X 15CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,957.12 "	" $2,069.98 "	 $703.79 	" $2,957.12 "	" $2,572.69 "	 $709.71 	" $2,262.20 "	" $2,957.12 "	" $2,957.12 "	" $1,123.71 "	" $1,862.99 "	" $2,513.55 "	" $1,951.70 "	" $2,365.70 "	 $709.71 	" $2,661.41 "	" $2,404.14 "	" $2,513.55 "	 $703.79 	" $2,404.14 "	 $709.71 
5272101	"HCHG MESH SURGIPRO MONOFILAMENT 1"" X 4"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $184.68 	 $129.28 	 $43.95 	 $166.21 	 $160.67 	 $44.32 	 $141.28 	 $-   	 $-   	 $70.18 	 $116.35 	 $156.98 	 $121.89 	 $147.74 	 $44.32 	 $166.21 	 $150.14 	 $156.98 	 $43.95 	 $150.14 	 $44.32 
5272102	"HCHG MESH SURGIPRO MONOFILAMENT 3"" X 5"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $232.62 	 $162.83 	 $55.36 	 $209.36 	 $202.38 	 $55.83 	 $177.95 	 $-   	 $-   	 $88.40 	 $146.55 	 $197.73 	 $153.53 	 $186.10 	 $55.83 	 $209.36 	 $189.12 	 $197.73 	 $55.36 	 $189.12 	 $55.83 
5272103	"HCHG MESH SURGIPRO MONOFILAMENT 4"" X 6"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $240.02 	 $168.01 	 $57.12 	 $216.02 	 $208.82 	 $57.60 	 $183.62 	 $-   	 $-   	 $91.21 	 $151.21 	 $204.02 	 $158.41 	 $192.02 	 $57.60 	 $216.02 	 $195.14 	 $204.02 	 $57.12 	 $195.14 	 $57.60 
5272104	"HCHG MESH SURGIPRO MONOFILAMENT 6"" X 6"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $332.33 	 $232.63 	 $79.09 	 $299.10 	 $289.13 	 $79.76 	 $254.23 	 $-   	 $-   	 $126.29 	 $209.37 	 $282.48 	 $219.34 	 $265.86 	 $79.76 	 $299.10 	 $270.18 	 $282.48 	 $79.09 	 $270.18 	 $79.76 
5272105	"HCHG MESH SURGIPRO MONOFILAMENT 14"" X 9"""	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	 $775.48 	 $542.84 	 $184.56 	 $697.93 	 $674.67 	 $186.12 	 $593.24 	 $-   	 $-   	 $294.68 	 $488.55 	 $659.16 	 $511.82 	 $620.38 	 $186.12 	 $697.93 	 $630.47 	 $659.16 	 $184.56 	 $630.47 	 $186.12 
5272106	HCHG MESH PARIETEX PCOX ROUND 20CM	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,787.79 "	" $1,951.45 "	 $663.49 	" $2,787.79 "	" $2,425.38 "	 $669.07 	" $2,132.66 "	" $2,787.79 "	" $2,787.79 "	" $1,059.36 "	" $1,756.31 "	" $2,369.62 "	" $1,839.94 "	" $2,230.23 "	 $669.07 	" $2,509.01 "	" $2,266.47 "	" $2,369.62 "	 $663.49 	" $2,266.47 "	 $669.07 
5272110	"HCHG MESH, SYMBOTEX, COMP, ROUND 9CM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,681.97 "	" $1,177.38 "	 $400.31 	" $1,681.97 "	" $1,463.31 "	 $403.67 	" $1,286.71 "	" $1,681.97 "	" $1,681.97 "	 $639.15 	" $1,059.64 "	" $1,429.67 "	" $1,110.10 "	" $1,345.58 "	 $403.67 	" $1,513.77 "	" $1,367.44 "	" $1,429.67 "	 $400.31 	" $1,367.44 "	 $403.67 
5272111	"HCHG MESH, SYMBOTEX, COMP, ROUND 15 CM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,026.47 "	" $1,418.53 "	 $482.30 	" $2,026.47 "	" $1,763.03 "	 $486.35 	" $1,550.25 "	" $2,026.47 "	" $2,026.47 "	 $770.06 	" $1,276.68 "	" $1,722.50 "	" $1,337.47 "	" $1,621.18 "	 $486.35 	" $1,823.82 "	" $1,647.52 "	" $1,722.50 "	 $482.30 	" $1,647.52 "	 $486.35 
5272112	"HCHG MESH, SYMBOTEX, COMP, 15 CM X 10 CM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $1,407.49 "	 $985.24 	 $334.98 	" $1,266.74 "	" $1,224.52 "	 $337.80 	" $1,076.73 "	 $-   	 $-   	 $534.85 	 $886.72 	" $1,196.37 "	 $928.94 	" $1,125.99 "	 $337.80 	" $1,266.74 "	" $1,144.29 "	" $1,196.37 "	 $334.98 	" $1,144.29 "	 $337.80 
5272113	"HCHG MESH, SYMBOTEX, COMP, 20 CM X 15 CM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $2,257.88 "	" $1,580.52 "	 $537.38 	" $2,257.88 "	" $1,964.36 "	 $541.89 	" $1,727.28 "	" $2,257.88 "	" $2,257.88 "	 $857.99 	" $1,422.46 "	" $1,919.20 "	" $1,490.20 "	" $1,806.30 "	 $541.89 	" $2,032.09 "	" $1,835.66 "	" $1,919.20 "	 $537.38 	" $1,835.66 "	 $541.89 
5272114	"HCHG MESH, SYMBOTEX, COMP, 25 CM X 20 CM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1781	" $3,603.29 "	" $2,522.30 "	 $857.58 	" $3,603.29 "	" $3,134.86 "	 $864.79 	" $2,756.52 "	" $3,603.29 "	" $3,603.29 "	" $1,369.25 "	" $2,270.07 "	" $3,062.80 "	" $2,378.17 "	" $2,882.63 "	 $864.79 	" $3,242.96 "	" $2,929.47 "	" $3,062.80 "	 $857.58 	" $2,929.47 "	 $864.79 
5272115	"HCHG ICONIX 2 ANCHOR, 2.3 MM"	0278	MEDICAL/SURGICAL SUPPLIES AND DEVICES - OTHER IMPLANT	C1713	" $1,359.63 "	 $951.74 	 $323.59 	" $1,223.67 "	" $1,182.88 "	 $326.31 	" $1,040.12 "	 $-   	 $-   	 $516.66 	 $856.57 	" $1,155.69 "	 $897.36 	" $1,087.70 "	 $326.31 	" $1,223.67 "	" $1,105.38 "	" $1,155.69 "	 $323.59 	" $1,105.38 "	 $326.31 
351311	HCHG CVMC PROMOTIONAL GLYCOHEMOGLOBIN A1C	0300	LABORATORY - GENERAL CLASSIFICATION	83036	 $30.00 	 $30.00 	 $30.00 	 $30.00 																	
351312	HCHG CVMC PROMOTIONAL THYROXINE FREE	0300	LABORATORY - GENERAL CLASSIFICATION	84439	 $40.00 	 $40.00 	 $40.00 	 $40.00 																	
351313	HCHG CVMC PROMOTIONAL VITAMIN D 25 HYDROXY INCL FRACTIONS	0300	LABORATORY - GENERAL CLASSIFICATION	82306	 $50.00 	 $50.00 	 $50.00 	 $50.00 																	
308196	HCHG CVMC HEMOGLOBIN	0300	LABORATORY - GENERAL CLASSIFICATION	85018	 $44.00 	 $30.80 	 $10.47 	 $39.60 	 $38.28 	 $10.56 	 $33.66 	 $36.96 	 $36.96 	 $10.88 	 $27.72 	 $37.40 	 $12.67 	 $13.73 	 $10.56 	 $39.60 	 $35.77 	 $37.40 	 $10.47 	 $35.77 	 $10.56 
351002	HCHG BMH/CVMC AUTOLOGOUS BLOOD/COMPONENT-COLLECTION/STORAGE PREDEPOSIT	0300	LABORATORY - GENERAL CLASSIFICATION	86890	 $998.67 	 $699.07 	 $237.68 	 $898.80 	 $868.84 	 $239.68 	 $763.98 	 $838.88 	 $838.88 	 $246.87 	 $629.16 	 $848.87 	 $287.62 	 $311.59 	 $239.68 	 $898.80 	 $811.92 	 $848.87 	 $237.68 	 $811.92 	 $239.68 
355011	"HCHG BMH/CVMC EXAM,SYNOVIAL FLUID CRYSTALS"	0300	LABORATORY - GENERAL CLASSIFICATION	89060	 $213.33 	 $149.33 	 $50.77 	 $192.00 	 $185.60 	 $51.20 	 $163.20 	 $179.20 	 $179.20 	 $52.74 	 $134.40 	 $181.33 	 $61.44 	 $66.56 	 $51.20 	 $192.00 	 $173.44 	 $181.33 	 $50.77 	 $173.44 	 $51.20 
357243	HCHG COVID-19 CLINIC VISIT SPECIMEN COLLECTION RN	0300	LABORATORY - GENERAL CLASSIFICATION	C9803	 $43.00 	 $30.10 	 $10.23 	 $38.70 	 $37.41 	 $10.32 	 $32.90 	 $36.12 	 $36.12 	 $10.63 	 $27.09 	 $36.55 	 $12.38 	 $13.42 	 $10.32 	 $38.70 	 $34.96 	 $36.55 	 $10.23 	 $34.96 	 $10.32 
357310	HCHG CVMC CANDIDA ALBICANS AB *R	0300	LABORATORY - GENERAL CLASSIFICATION	357310	 $533.92 	 $373.74 	 $127.07 	 $480.53 	 $464.51 	 $128.14 	 $408.45 	 $448.49 	 $448.49 	 $131.99 	 $336.37 	 $453.83 	 $153.77 	 $166.58 	 $128.14 	 $480.53 	 $434.08 	 $453.83 	 $127.07 	 $434.08 	 $128.14 
357311	HCHG BMH CYSTIC FIBROSIS GENOTYPE*R	0300	LABORATORY - GENERAL CLASSIFICATION	81220	" $1,670.00 "	" $1,169.00 "	 $397.46 	" $1,503.00 "	" $1,452.90 "	 $400.80 	" $1,277.55 "	" $1,112.00 "	 $914.00 	 $412.82 	" $1,052.10 "	" $1,419.50 "	 $480.96 	 $521.04 	 $400.80 	" $1,503.00 "	" $1,357.71 "	" $1,419.50 "	 $397.46 	" $1,357.71 "	 $400.80 
357312	HCHG FACTOR II GENOTYPE PANEL*REF	0300	LABORATORY - GENERAL CLASSIFICATION	81240	 $702.31 	 $491.62 	 $167.15 	 $632.08 	 $611.01 	 $168.55 	 $537.27 	 $589.94 	 $589.94 	 $173.61 	 $442.46 	 $596.96 	 $202.27 	 $219.12 	 $168.55 	 $632.08 	 $570.98 	 $596.96 	 $167.15 	 $570.98 	 $168.55 
357313	HCHG FACTOR V GENOTYPE LEIDEN*REF	0300	LABORATORY - GENERAL CLASSIFICATION	81241	 $550.00 	 $385.00 	 $130.90 	 $495.00 	 $478.50 	 $132.00 	 $420.75 	 $462.00 	 $462.00 	 $135.96 	 $346.50 	 $467.50 	 $158.40 	 $171.60 	 $132.00 	 $495.00 	 $447.15 	 $467.50 	 $130.90 	 $447.15 	 $132.00 
357314	HCHG BMH HEMOCHROMATOSIS GENOTYPE PANEL*R	0300	LABORATORY - GENERAL CLASSIFICATION	81256	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
357315	"HCHG CVMC SENSITIVITY, MICROBIOLOGY"	0300	LABORATORY - GENERAL CLASSIFICATION	87186	 $281.57 	 $197.10 	 $67.01 	 $253.41 	 $244.97 	 $67.58 	 $215.40 	 $236.52 	 $236.52 	 $69.60 	 $177.39 	 $239.33 	 $81.09 	 $87.85 	 $67.58 	 $253.41 	 $228.92 	 $239.33 	 $67.01 	 $228.92 	 $67.58 
357318	HCHG O&P CRYPTOSPORIDIUM *R	0300	LABORATORY - GENERAL CLASSIFICATION	87207	 $79.00 	 $55.30 	 $18.80 	 $71.10 	 $68.73 	 $18.96 	 $60.44 	 $66.36 	 $66.36 	 $18.96 	 $49.77 	 $67.15 	 $22.75 	 $24.65 	 $18.96 	 $71.10 	 $64.23 	 $67.15 	 $18.80 	 $64.23 	 $18.96 
357319	HCHG O&P CYCLOSPORA *R	0300	LABORATORY - GENERAL CLASSIFICATION	87207	 $25.00 	 $17.50 	 $5.95 	 $22.50 	 $21.75 	 $6.00 	 $19.13 	 $21.00 	 $21.00 	 $6.00 	 $15.75 	 $21.25 	 $7.20 	 $7.80 	 $6.00 	 $22.50 	 $20.33 	 $21.25 	 $5.95 	 $20.33 	 $6.00 
357320	HCHG SMEAR COMPLEX STAIN REF	0300	LABORATORY - GENERAL CLASSIFICATION	87209	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360073	HCHG CAPILLARY BLOOD SPECIMEN COLL LAB	0300	LABORATORY - GENERAL CLASSIFICATION	36416	 $37.89 	 $26.52 	 $9.02 	 $34.10 	 $32.96 	 $9.09 	 $28.99 	 $31.83 	 $31.83 	 $9.37 	 $23.87 	 $32.21 	 $10.91 	 $11.82 	 $9.09 	 $34.10 	 $30.80 	 $32.21 	 $9.02 	 $30.80 	 $9.09 
360562	HCHG ROUTINE VENIPUNCTURE LAB	0300	LABORATORY - GENERAL CLASSIFICATION	36415	 $34.00 	 $23.80 	 $8.09 	 $30.60 	 $29.58 	 $8.16 	 $26.01 	 $28.56 	 $28.56 	 $8.16 	 $21.42 	 $28.90 	 $9.79 	 $10.61 	 $8.16 	 $30.60 	 $27.64 	 $28.90 	 $8.09 	 $27.64 	 $8.16 
360820	HCHG CVMC LEGAL SPEC COLLECT	0300	LABORATORY - GENERAL CLASSIFICATION	99001	 $87.80 	 $61.46 	 $20.90 	 $79.02 	 $76.39 	 $21.07 	 $67.17 	 $73.75 	 $73.75 	 $21.70 	 $55.31 	 $74.63 	 $25.29 	 $27.39 	 $21.07 	 $79.02 	 $71.38 	 $74.63 	 $20.90 	 $71.38 	 $21.07 
362176	HCHG NFCT DS CHRNC HCV 6 ASSAYS (FIBRO TEST) REF	0300	LABORATORY - GENERAL CLASSIFICATION	81596	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $64.80 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
351301	HCHG CVMC PROMOTIONAL- PSA	0301	LABORATORY - CHEMISTRY	84153	 $30.00 	 $30.00 	 $30.00 	 $30.00 																	
351302	HCHG CVMC PROMOTIONAL- TSH	0301	LABORATORY - CHEMISTRY	84443	 $35.00 	 $35.00 	 $35.00 	 $35.00 																	
351303	HCHG CVMC PROMOTIONAL- COMPREHENSIVE PANEL	0301	LABORATORY - CHEMISTRY	80053	 $20.00 	 $20.00 	 $20.00 	 $20.00 																	
351304	HCHG CVMC PROMOTIONAL- LIPID PANEL	0301	LABORATORY - CHEMISTRY	80061	 $20.00 	 $20.00 	 $20.00 	 $20.00 																	
356065	HCHG VITAMIN D 25 HYDROXY REF	0301	LABORATORY - CHEMISTRY	82306	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
356268	HCHG PSA DIAGNOSTIC TOTAL REF	0301	LABORATORY - CHEMISTRY	84153	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
360031	HCHG THYROXINE FREE LAB	0301	LABORATORY - CHEMISTRY	84439	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360092	HCHG COMP METABOLIC PANEL LAB	0301	LABORATORY - CHEMISTRY	80053	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
360098	HCHG LIPID PANEL LAB	0301	LABORATORY - CHEMISTRY	80061	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360220	HCHG GLYCOHEMOGLOBIN A1C LAB	0301	LABORATORY - CHEMISTRY	83036	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
360293	HCHG THYROXINE TOTAL LAB	0301	LABORATORY - CHEMISTRY	84436	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360295	HCHG TSH LAB	0301	LABORATORY - CHEMISTRY	84443	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $55.20 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
360341	HCHG PSA SCREENING TOTAL LAB	0301	LABORATORY - CHEMISTRY	84153	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
360342	HCHG PSA DIAGNOSTIC TOTAL LAB	0301	LABORATORY - CHEMISTRY	84153	 $170.00 	 $170.00 	 $40.46 	 $170.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $153.00 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
302739	HCHG LACTOFERRIN FECAL QUAL LAB	0301	LABORATORY - CHEMISTRY	83630	 $175.69 	 $122.98 	 $41.81 	 $158.12 	 $152.85 	 $42.17 	 $134.40 	 $147.58 	 $147.58 	 $43.43 	 $110.68 	 $149.34 	 $50.60 	 $54.82 	 $42.17 	 $158.12 	 $142.84 	 $149.34 	 $41.81 	 $142.84 	 $42.17 
302740	HCHG PROCALCITONIN (PCT) LAB	0301	LABORATORY - CHEMISTRY	84145	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $57.60 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
303098	HCHG DRUG SCREEN BENZO 1-12 CLONOPIN REF	0301	LABORATORY - CHEMISTRY	80346	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
303849	HCHG GLYCOHEMOGLOBIN A1C POC	0301	LABORATORY - CHEMISTRY	83036	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
303928	HCHG HEMOCULT TEST POC	0301	LABORATORY - CHEMISTRY	82270	 $37.00 	 $25.90 	 $8.81 	 $33.30 	 $32.19 	 $8.88 	 $28.31 	 $31.08 	 $31.08 	 $9.15 	 $23.31 	 $31.45 	 $10.66 	 $11.54 	 $8.88 	 $33.30 	 $30.08 	 $31.45 	 $8.81 	 $30.08 	 $8.88 
310110	HCHG CVMC CARBON MONOXIDE EVAL	0301	LABORATORY - CHEMISTRY	82375	 $151.00 	 $105.70 	 $35.94 	 $135.90 	 $131.37 	 $36.24 	 $115.52 	 $126.84 	 $126.84 	 $37.33 	 $95.13 	 $128.35 	 $43.49 	 $47.11 	 $36.24 	 $135.90 	 $122.76 	 $128.35 	 $35.94 	 $122.76 	 $36.24 
310129	HCHG GLUCOSE BLOOD TEST LAB	0301	LABORATORY - CHEMISTRY	82962	 $36.00 	 $25.20 	 $8.57 	 $32.40 	 $31.32 	 $8.64 	 $27.54 	 $30.24 	 $30.24 	 $8.90 	 $22.68 	 $30.60 	 $10.37 	 $11.23 	 $8.64 	 $32.40 	 $29.27 	 $30.60 	 $8.57 	 $29.27 	 $8.64 
330906	HCHG CVMC IMMUNOASSAY NONANTIBODY *R	0301	LABORATORY - CHEMISTRY	83516	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
330924	HCHG CVMC GLIADIN IGG *R	0301	LABORATORY - CHEMISTRY	83520	 $186.00 	 $130.20 	 $44.27 	 $167.40 	 $161.82 	 $44.64 	 $142.29 	 $156.24 	 $156.24 	 $45.98 	 $117.18 	 $158.10 	 $53.57 	 $58.03 	 $44.64 	 $167.40 	 $151.22 	 $158.10 	 $44.27 	 $151.22 	 $44.64 
330935	HCHG CVMC ENDOMYSIAL AB *R	0301	LABORATORY - CHEMISTRY	83516	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
330966	HCHG CVMC GANGLIOSIDE GM-1 AB'S 1 *R	0301	LABORATORY - CHEMISTRY	83520	 $498.85 	 $349.20 	 $118.73 	 $448.97 	 $434.00 	 $119.72 	 $381.62 	 $419.03 	 $419.03 	 $123.32 	 $314.28 	 $424.02 	 $143.67 	 $155.64 	 $119.72 	 $448.97 	 $405.57 	 $424.02 	 $118.73 	 $405.57 	 $119.72 
350153	HCHG ZONISAMIDE QUANT REF	0301	LABORATORY - CHEMISTRY	80203	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
350612	HCHG CVMC GASTRIC OCCULT BLOOD	0301	LABORATORY - CHEMISTRY	82271	 $85.77 	 $60.04 	 $20.41 	 $77.19 	 $74.62 	 $20.58 	 $65.61 	 $72.05 	 $72.05 	 $21.20 	 $54.04 	 $72.90 	 $24.70 	 $26.76 	 $20.58 	 $77.19 	 $69.73 	 $72.90 	 $20.41 	 $69.73 	 $20.58 
352100	"HCHG CARDIO IQ PANEL, APOLIOPOPROTEIN*R"	0301	LABORATORY - CHEMISTRY	82172	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
352101	"HCHG CARDIO IQ PANEL, CHOLESTEROL*R"	0301	LABORATORY - CHEMISTRY	82465	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
352102	"HCHG CARDIO IQ PANEL, HDL CHOL*R"	0301	LABORATORY - CHEMISTRY	83718	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $163.80 	 $221.00 	 $74.88 	 $81.12 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
352104	"HCHG CARDIO IQ PANEL, LIPOPROTEIN SUBCLASSES*R"	0301	LABORATORY - CHEMISTRY	83704	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
352105	"HCHG CARDIO IQ PANEL, TRIGLYCERIDES*R"	0301	LABORATORY - CHEMISTRY	84478	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356000	HCHG ACTH REF	0301	LABORATORY - CHEMISTRY	82024	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $88.99 	 $226.80 	 $306.00 	 $103.68 	 $112.32 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
356011	HCHG BETA 2 MICROGLOBULIN REF	0301	LABORATORY - CHEMISTRY	82232	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356014	HCHG ANGIOTENSIN I CONV ENZYME REF	0301	LABORATORY - CHEMISTRY	82164	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356023	HCHG C-PEPTIDE LEVEL REF	0301	LABORATORY - CHEMISTRY	84681	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
356026	HCHG ERYTHROPOIETIN REF	0301	LABORATORY - CHEMISTRY	82668	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $59.33 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
356031	"HCHG IGG SUBCLASSES 1,2,3 OR 4 EACH REF"	0301	LABORATORY - CHEMISTRY	82787	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
356055	HCHG RENIN REF	0301	LABORATORY - CHEMISTRY	84244	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $235.20 	 $235.20 	 $67.20 	 $176.40 	 $238.00 	 $80.64 	 $87.36 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
356056	HCHG SOMATOMEDIN-C IGF-1 (245) REF	0301	LABORATORY - CHEMISTRY	84305	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356057	HCHG SEROTONIN BLOOD REF	0301	LABORATORY - CHEMISTRY	84260	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $120.96 	 $131.04 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
356058	HCHG THYROXINE BINDING GLOBULIN REF	0301	LABORATORY - CHEMISTRY	84442	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356059	HCHG TRAZODONE  REF	0301	LABORATORY - CHEMISTRY	80299	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356060	HCHG THYROGLOBULIN REF	0301	LABORATORY - CHEMISTRY	84432	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
356061	HCHG VITAMIN B1 THIAMINE REF	0301	LABORATORY - CHEMISTRY	84425	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356062	HCHG VITAMIN B6 REF	0301	LABORATORY - CHEMISTRY	84207	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $60.00 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
356063	HCHG B-12 BINDING CAPACITY REF	0301	LABORATORY - CHEMISTRY	82608	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356064	HCHG ASCORBIC ACID VITAMIN C BLOOD REF	0301	LABORATORY - CHEMISTRY	82180	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
356066	HCHG VITAMIN D 1 25-DIHYDROXY REF	0301	LABORATORY - CHEMISTRY	82652	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $86.40 	 $226.80 	 $306.00 	 $103.68 	 $112.32 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
356070	HCHG ARSENIC REF	0301	LABORATORY - CHEMISTRY	82175	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356078	HCHG PROSTATE SPECIFIC AG FREE REF	0301	LABORATORY - CHEMISTRY	84154	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
356082	HCHG COLLAGEN CROSSLINKS ANY METH REF	0301	LABORATORY - CHEMISTRY	82523	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
356087	HCHG SEX HORMONE BINDING GLOBULIN REF	0301	LABORATORY - CHEMISTRY	84270	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356101	HCHG CALCIUM URINE QUANT REF	0301	LABORATORY - CHEMISTRY	82340	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356102	HCHG SODIUM SERUM REF	0301	LABORATORY - CHEMISTRY	84295	 $42.00 	 $29.40 	 $10.00 	 $37.80 	 $36.54 	 $10.08 	 $32.13 	 $35.28 	 $35.28 	 $10.08 	 $26.46 	 $35.70 	 $12.10 	 $13.10 	 $10.08 	 $37.80 	 $34.15 	 $35.70 	 $10.00 	 $34.15 	 $10.08 
356107	HCHG OSMOLALITY URINE REF	0301	LABORATORY - CHEMISTRY	83935	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356110	HCHG CALCIUM TOTAL REF	0301	LABORATORY - CHEMISTRY	82310	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
356111	HCHG MAGNESIUM REF	0301	LABORATORY - CHEMISTRY	83735	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356122	HCHG ALKALINE PHOSPHATASE REF	0301	LABORATORY - CHEMISTRY	84075	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356123	HCHG PHOSPHATES ALK-ISOENZYMES REF	0301	LABORATORY - CHEMISTRY	84080	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356126	HCHG CHOLESTEROL DIRECT LDL REF	0301	LABORATORY - CHEMISTRY	83721	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356130	HCHG TRIGLYCERIDES REF	0301	LABORATORY - CHEMISTRY	84478	 $100.14 	 $70.10 	 $23.83 	 $90.13 	 $87.12 	 $24.03 	 $76.61 	 $84.12 	 $84.12 	 $24.03 	 $63.09 	 $85.12 	 $28.84 	 $31.24 	 $24.03 	 $90.13 	 $81.41 	 $85.12 	 $23.83 	 $81.41 	 $24.03 
356131	HCHG PROTEIN E-PHORESIS SERUM REF	0301	LABORATORY - CHEMISTRY	84165	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356132	HCHG PROTEIN E-PHORESIS URINE CSF REF	0301	LABORATORY - CHEMISTRY	84166	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $55.20 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
356136	HCHG PLASMA HEMOGLOBIN REF	0301	LABORATORY - CHEMISTRY	83051	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356138	HCHG FRUCTOSAMINE REF	0301	LABORATORY - CHEMISTRY	82985	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356141	HCHG CHLORIDE OTHER SOURCE REF	0301	LABORATORY - CHEMISTRY	82438	 $43.00 	 $30.10 	 $10.23 	 $38.70 	 $37.41 	 $10.32 	 $32.90 	 $36.12 	 $36.12 	 $10.63 	 $27.09 	 $36.55 	 $12.38 	 $13.42 	 $10.32 	 $38.70 	 $34.96 	 $36.55 	 $10.23 	 $34.96 	 $10.32 
356142	HCHG IMMUNOASSAY NONANTIBODY REF	0301	LABORATORY - CHEMISTRY	83516	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
356143	HCHG IMMUNOASSAY ANAL QUANT NOS REF	0301	LABORATORY - CHEMISTRY	83520	 $390.00 	 $273.00 	 $92.82 	 $351.00 	 $339.30 	 $93.60 	 $298.35 	 $327.60 	 $327.60 	 $96.41 	 $245.70 	 $331.50 	 $112.32 	 $121.68 	 $93.60 	 $351.00 	 $317.07 	 $331.50 	 $92.82 	 $317.07 	 $93.60 
356145	HCHG L/S RATIO FETAL LUNG REF	0301	LABORATORY - CHEMISTRY	83661	 $727.21 	 $509.05 	 $173.08 	 $654.49 	 $632.67 	 $174.53 	 $556.32 	 $610.86 	 $610.86 	 $179.77 	 $458.14 	 $618.13 	 $209.44 	 $226.89 	 $174.53 	 $654.49 	 $591.22 	 $618.13 	 $173.08 	 $591.22 	 $174.53 
356147	HCHG VITAMIN A REF	0301	LABORATORY - CHEMISTRY	84590	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $50.40 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
356148	HCHG CHLORIDE URINE REF	0301	LABORATORY - CHEMISTRY	82436	 $44.00 	 $30.80 	 $10.47 	 $39.60 	 $38.28 	 $10.56 	 $33.66 	 $36.96 	 $36.96 	 $10.88 	 $27.72 	 $37.40 	 $12.67 	 $13.73 	 $10.56 	 $39.60 	 $35.77 	 $37.40 	 $10.47 	 $35.77 	 $10.56 
356149	HCHG VMA ACID URINE REF	0301	LABORATORY - CHEMISTRY	84585	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356150	HCHG HYDROXYINDOLACETIC ACID 5-HIAA REF	0301	LABORATORY - CHEMISTRY	83497	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
356151	HCHG HYDROXYPROGESTERONE 17-D REF	0301	LABORATORY - CHEMISTRY	83498	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $59.33 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
356153	HCHG CATECHOLAMINES FRACTIONATED REF	0301	LABORATORY - CHEMISTRY	82384	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356154	HCHG METANEPHRINES TOTAL REF	0301	LABORATORY - CHEMISTRY	83835	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $50.40 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
356155	HCHG OXALATE URINE QUANT REF	0301	LABORATORY - CHEMISTRY	83945	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
356156	HCHG PORPHYRINS URINE QUANT REF	0301	LABORATORY - CHEMISTRY	84120	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356160	HCHG PROTEIN TOTAL URINE REF	0301	LABORATORY - CHEMISTRY	84156	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356165	HCHG ZINC PROTOPORPHYRINS REF	0301	LABORATORY - CHEMISTRY	84202	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356169	HCHG CREATININE OTHER SOURCE REF	0301	LABORATORY - CHEMISTRY	82570	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356197	HCHG CARBAMAZEPINE TOTAL REF	0301	LABORATORY - CHEMISTRY	80156	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $51.91 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
356200	HCHG DRUG SCREEN QUANT PRIMIDONE REF	0301	LABORATORY - CHEMISTRY	80188	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356201	HCHG PHENOBARBITAL REF	0301	LABORATORY - CHEMISTRY	80184	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356203	HCHG QUINIDINE REF	0301	LABORATORY - CHEMISTRY	80194	 $74.57 	 $52.20 	 $17.75 	 $67.11 	 $64.88 	 $17.90 	 $57.05 	 $62.64 	 $62.64 	 $17.90 	 $46.98 	 $63.38 	 $21.48 	 $23.27 	 $17.90 	 $67.11 	 $60.63 	 $63.38 	 $17.75 	 $60.63 	 $17.90 
356205	HCHG LEAD BLOOD REF	0301	LABORATORY - CHEMISTRY	83655	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356208	HCHG ZINC SERUM REF	0301	LABORATORY - CHEMISTRY	84630	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356209	HCHG MERCURY LEVEL QUANT REF	0301	LABORATORY - CHEMISTRY	83825	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356210	HCHG COPPER SERUM REF	0301	LABORATORY - CHEMISTRY	82525	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
356221	HCHG TOPIRAMATE REF	0301	LABORATORY - CHEMISTRY	80201	 $107.25 	 $75.08 	 $25.53 	 $96.53 	 $93.31 	 $25.74 	 $82.05 	 $90.09 	 $90.09 	 $25.74 	 $67.57 	 $91.16 	 $30.89 	 $33.46 	 $25.74 	 $96.53 	 $87.19 	 $91.16 	 $25.53 	 $87.19 	 $25.74 
356222	HCHG ALDOLASE REF	0301	LABORATORY - CHEMISTRY	82085	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356226	HCHG TSH REF	0301	LABORATORY - CHEMISTRY	84443	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $50.40 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
356227	HCHG THYROID (T3 OR T4) REF	0301	LABORATORY - CHEMISTRY	84479	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356239	HCHG CYCLOSPORINE REF	0301	LABORATORY - CHEMISTRY	80158	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
356242	HCHG ACUTE HEPATITIS PANEL REF	0301	LABORATORY - CHEMISTRY	80074	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $111.24 	 $283.50 	 $382.50 	 $129.60 	 $140.40 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
356245	HCHG FOLIC ACID RBC REF	0301	LABORATORY - CHEMISTRY	82747	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356248	HCHG AFP SERUM REF	0301	LABORATORY - CHEMISTRY	82105	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356249	HCHG GROWTH HORMONE (HGH) REF	0301	LABORATORY - CHEMISTRY	83003	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356253	HCHG TESTOSTERONE TOTAL REF	0301	LABORATORY - CHEMISTRY	84403	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
356254	HCHG ESTRADIOL TOTAL REF	0301	LABORATORY - CHEMISTRY	82670	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
356255	HCHG DEHYDROEPIANDROSTERONE (DHEA-S) REF	0301	LABORATORY - CHEMISTRY	82627	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $51.91 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
356256	HCHG INSULIN TOTAL REF	0301	LABORATORY - CHEMISTRY	83525	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356257	HCHG PROINSULIN REF	0301	LABORATORY - CHEMISTRY	84206	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356260	HCHG GASTRIN REF	0301	LABORATORY - CHEMISTRY	82941	 $109.73 	 $76.81 	 $26.12 	 $98.76 	 $95.47 	 $26.34 	 $83.94 	 $92.17 	 $92.17 	 $27.13 	 $69.13 	 $93.27 	 $31.60 	 $34.24 	 $26.34 	 $98.76 	 $89.21 	 $93.27 	 $26.12 	 $89.21 	 $26.34 
356261	HCHG ESTROGEN TOTAL SERUM REF	0301	LABORATORY - CHEMISTRY	82672	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
356265	HCHG ALDOSTERONE REF	0301	LABORATORY - CHEMISTRY	82088	 $520.00 	 $364.00 	 $123.76 	 $468.00 	 $452.40 	 $124.80 	 $397.80 	 $436.80 	 $436.80 	 $128.54 	 $327.60 	 $442.00 	 $149.76 	 $162.24 	 $124.80 	 $468.00 	 $422.76 	 $442.00 	 $123.76 	 $422.76 	 $124.80 
356266	HCHG IMMUNOGLOBULIN IGE REF	0301	LABORATORY - CHEMISTRY	82785	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356267	HCHG PROSTATIC ACID PHOSPHATASE REF	0301	LABORATORY - CHEMISTRY	84066	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
356278	HCHG VITAMIN E REF	0301	LABORATORY - CHEMISTRY	84446	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
356285	HCHG GLUCOSE (G6PD) ENZYME REF	0301	LABORATORY - CHEMISTRY	82955	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
356295	HCHG ACETONE/KETONES QUANT REF	0301	LABORATORY - CHEMISTRY	82010	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356296	HCHG FATS/LIPIDS FECES QUAL REF	0301	LABORATORY - CHEMISTRY	82705	 $50.00 	 $35.00 	 $11.90 	 $45.00 	 $43.50 	 $12.00 	 $38.25 	 $42.00 	 $42.00 	 $12.36 	 $31.50 	 $42.50 	 $14.40 	 $15.60 	 $12.00 	 $45.00 	 $40.65 	 $42.50 	 $11.90 	 $40.65 	 $12.00 
356299	HCHG BILE ACIDS TOTAL REF	0301	LABORATORY - CHEMISTRY	82239	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356302	HCHG ESTRONE REF	0301	LABORATORY - CHEMISTRY	82679	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
356372	HCHG CORTISOL FREE REF	0301	LABORATORY - CHEMISTRY	82530	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $163.80 	 $221.00 	 $74.88 	 $81.12 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
356373	HCHG COENZYME Q10 REF	0301	LABORATORY - CHEMISTRY	82542	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356377	HCHG HEMOGLOBIN CHROMOTOGRAPHY REF	0301	LABORATORY - CHEMISTRY	83021	 $96.00 	 $67.20 	 $22.85 	 $86.40 	 $83.52 	 $23.04 	 $73.44 	 $80.64 	 $80.64 	 $23.73 	 $60.48 	 $81.60 	 $27.65 	 $29.95 	 $23.04 	 $86.40 	 $78.05 	 $81.60 	 $22.85 	 $78.05 	 $23.04 
356380	HCHG NEPHELOMETRY EA NOT SPEC REF	0301	LABORATORY - CHEMISTRY	83883	 $158.00 	 $110.60 	 $37.60 	 $142.20 	 $137.46 	 $37.92 	 $120.87 	 $132.72 	 $132.72 	 $37.92 	 $99.54 	 $134.30 	 $45.50 	 $49.30 	 $37.92 	 $142.20 	 $128.45 	 $134.30 	 $37.60 	 $128.45 	 $37.92 
356389	HCHG ORGANIC ACID SINGLE QUANT REF	0301	LABORATORY - CHEMISTRY	83921	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356392	HCHG PHOSPHATASE ACID TOTAL REF	0301	LABORATORY - CHEMISTRY	84060	 $33.67 	 $23.57 	 $8.01 	 $30.30 	 $29.29 	 $8.08 	 $25.76 	 $28.28 	 $28.28 	 $8.08 	 $21.21 	 $28.62 	 $9.70 	 $10.51 	 $8.08 	 $30.30 	 $27.37 	 $28.62 	 $8.01 	 $27.37 	 $8.08 
356393	HCHG RECEPTOR NON-ENDOCRINE REF	0301	LABORATORY - CHEMISTRY	84238	 $159.76 	 $111.83 	 $38.02 	 $143.78 	 $138.99 	 $38.34 	 $122.22 	 $134.20 	 $134.20 	 $38.34 	 $100.65 	 $135.80 	 $46.01 	 $49.85 	 $38.34 	 $143.78 	 $129.88 	 $135.80 	 $38.02 	 $129.88 	 $38.34 
356394	HCHG SELENIUM REF	0301	LABORATORY - CHEMISTRY	84255	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356395	HCHG SPECTROPHOTOMETRY ANALYTE NOS REF	0301	LABORATORY - CHEMISTRY	84311	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356396	HCHG TESTOSTERONE FREE REF	0301	LABORATORY - CHEMISTRY	84402	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
356397	HCHG TSI REF	0301	LABORATORY - CHEMISTRY	84445	 $500.00 	 $350.00 	 $119.00 	 $450.00 	 $435.00 	 $120.00 	 $382.50 	 $420.00 	 $420.00 	 $120.00 	 $315.00 	 $425.00 	 $144.00 	 $156.00 	 $120.00 	 $450.00 	 $406.50 	 $425.00 	 $119.00 	 $406.50 	 $120.00 
356398	HCHG TRIIODOTHYRONINE (T3) FREE REF	0301	LABORATORY - CHEMISTRY	84481	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
356399	HCHG TRIIODOTHYRONINE (T3) REVERSE REF	0301	LABORATORY - CHEMISTRY	84482	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356499	HCHG LIPOPROTEIN FRACTIONS REF	0301	LABORATORY - CHEMISTRY	83701	 $242.00 	 $169.40 	 $57.60 	 $217.80 	 $210.54 	 $58.08 	 $185.13 	 $203.28 	 $203.28 	 $58.08 	 $152.46 	 $205.70 	 $69.70 	 $75.50 	 $58.08 	 $217.80 	 $196.75 	 $205.70 	 $57.60 	 $196.75 	 $58.08 
356500	HCHG HISTAMINE REF	0301	LABORATORY - CHEMISTRY	83088	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $163.80 	 $221.00 	 $74.88 	 $81.12 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
356529	HCHG ENZYME CELL ACTIVITY REF	0301	LABORATORY - CHEMISTRY	82657	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
356549	HCHG ENZYME CELL ACTIVITY REF	0301	LABORATORY - CHEMISTRY	82657	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356551	HCHG SOMATOSTATIN REF	0301	LABORATORY - CHEMISTRY	84307	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356558	HCHG PANCREATIC ELASTASE FECAL QUAL REF	0301	LABORATORY - CHEMISTRY	82656	 $330.00 	 $231.00 	 $78.54 	 $297.00 	 $287.10 	 $79.20 	 $252.45 	 $277.20 	 $277.20 	 $79.20 	 $207.90 	 $280.50 	 $95.04 	 $102.96 	 $79.20 	 $297.00 	 $268.29 	 $280.50 	 $78.54 	 $268.29 	 $79.20 
356563	HCHG CHEMILUMINESCENT (IGFBP-3) REF	0301	LABORATORY - CHEMISTRY	82397	 $960.00 	 $672.00 	 $228.48 	 $864.00 	 $835.20 	 $230.40 	 $734.40 	 $806.40 	 $806.40 	 $237.31 	 $604.80 	 $816.00 	 $276.48 	 $299.52 	 $230.40 	 $864.00 	 $780.48 	 $816.00 	 $228.48 	 $780.48 	 $230.40 
356600	HCHG CRYOFIBRINOGEN REF	0301	LABORATORY - CHEMISTRY	82585	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
356601	HCHG VITAMIN K REF	0301	LABORATORY - CHEMISTRY	84597	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356607	HCHG ESTROGENS FRACTIONATED REF	0301	LABORATORY - CHEMISTRY	82671	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $235.20 	 $235.20 	 $69.22 	 $176.40 	 $238.00 	 $80.64 	 $87.36 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
356633	HCHG PTH RELATED PEPTIDE REF	0301	LABORATORY - CHEMISTRY	83519	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $153.60 	 $403.20 	 $544.00 	 $184.32 	 $199.68 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
356636	HCHG OXYCARBAZEPINE METABOLITE REF	0301	LABORATORY - CHEMISTRY	80299	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356649	HCHG VASOACTIVE INTESTINAL PEPTIDE REF	0301	LABORATORY - CHEMISTRY	84586	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
356717	HCHG ONCOPROTEIN (DCP) REF	0301	LABORATORY - CHEMISTRY	83951	 $330.00 	 $231.00 	 $78.54 	 $297.00 	 $287.10 	 $79.20 	 $252.45 	 $277.20 	 $277.20 	 $79.20 	 $207.90 	 $280.50 	 $95.04 	 $102.96 	 $79.20 	 $297.00 	 $268.29 	 $280.50 	 $78.54 	 $268.29 	 $79.20 
356729	HCHG APOLIPOPROTEIN A1 EA REF	0301	LABORATORY - CHEMISTRY	82172	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356730	HCHG APOLIPOPROTEIN B EA REF	0301	LABORATORY - CHEMISTRY	82172	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356758	HCHG IMMUNOGLOBULIN G (IGG) REF	0301	LABORATORY - CHEMISTRY	82784	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
356759	HCHG IMMUNOGLOBULIN A REF	0301	LABORATORY - CHEMISTRY	82784	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356760	HCHG IMMUNOGLOBULIN M (IGM) REF	0301	LABORATORY - CHEMISTRY	82784	 $142.64 	 $99.85 	 $33.95 	 $128.38 	 $124.10 	 $34.23 	 $109.12 	 $119.82 	 $119.82 	 $35.26 	 $89.86 	 $121.24 	 $41.08 	 $44.50 	 $34.23 	 $128.38 	 $115.97 	 $121.24 	 $33.95 	 $115.97 	 $34.23 
356764	HCHG CRYOGLOBULINS REF	0301	LABORATORY - CHEMISTRY	82595	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
356766	HCHG ALPHA 1 ANTITRYPSIN TOTAL REF	0301	LABORATORY - CHEMISTRY	82103	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356767	HCHG HAPTOGLOBIN QUANT REF	0301	LABORATORY - CHEMISTRY	83010	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356809	HCHG H PYLORI (C-13) BREATH REF	0301	LABORATORY - CHEMISTRY	83013	 $590.00 	 $413.00 	 $140.42 	 $531.00 	 $513.30 	 $141.60 	 $451.35 	 $495.60 	 $495.60 	 $145.85 	 $371.70 	 $501.50 	 $169.92 	 $184.08 	 $141.60 	 $531.00 	 $479.67 	 $501.50 	 $140.42 	 $479.67 	 $141.60 
356827	HCHG CERULOPLASMIN REF	0301	LABORATORY - CHEMISTRY	82390	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356839	HCHG TACROLIMUS REF	0301	LABORATORY - CHEMISTRY	80197	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356840	HCHG DRUG QUANTITATION NOT SPECIFED REF	0301	LABORATORY - CHEMISTRY	80299	 $107.01 	 $74.91 	 $25.47 	 $96.31 	 $93.10 	 $25.68 	 $81.86 	 $89.89 	 $89.89 	 $26.45 	 $67.42 	 $90.96 	 $30.82 	 $33.39 	 $25.68 	 $96.31 	 $87.00 	 $90.96 	 $25.47 	 $87.00 	 $25.68 
356844	HCHG IMMUNOASSAY ANAL QUANT NOS REF	0301	LABORATORY - CHEMISTRY	83520	 $960.00 	 $672.00 	 $228.48 	 $864.00 	 $835.20 	 $230.40 	 $734.40 	 $806.40 	 $806.40 	 $237.31 	 $604.80 	 $816.00 	 $276.48 	 $299.52 	 $230.40 	 $864.00 	 $780.48 	 $816.00 	 $228.48 	 $780.48 	 $230.40 
357040	HCHG AFP L3 FRACTION & TOTAL AFP REF	0301	LABORATORY - CHEMISTRY	82107	 $330.00 	 $231.00 	 $78.54 	 $297.00 	 $287.10 	 $79.20 	 $252.45 	 $277.20 	 $277.20 	 $81.58 	 $207.90 	 $280.50 	 $95.04 	 $102.96 	 $79.20 	 $297.00 	 $268.29 	 $280.50 	 $78.54 	 $268.29 	 $79.20 
357041	HCHG BILIRUBIN TOTAL REF	0301	LABORATORY - CHEMISTRY	82247	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
357042	HCHG LACTOFERRIN FECAL QUAL REF	0301	LABORATORY - CHEMISTRY	83630	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
357045	HCHG CALPROTECTIN FECAL REF	0301	LABORATORY - CHEMISTRY	83993	 $540.00 	 $378.00 	 $128.52 	 $486.00 	 $469.80 	 $129.60 	 $413.10 	 $453.60 	 $453.60 	 $133.49 	 $340.20 	 $459.00 	 $155.52 	 $168.48 	 $129.60 	 $486.00 	 $439.02 	 $459.00 	 $128.52 	 $439.02 	 $129.60 
357060	HCHG CVMC PROCAINAMIDE*R	0301	LABORATORY - CHEMISTRY	80190	 $85.05 	 $59.54 	 $20.24 	 $76.55 	 $73.99 	 $20.41 	 $65.06 	 $71.44 	 $71.44 	 $21.02 	 $53.58 	 $72.29 	 $24.49 	 $26.54 	 $20.41 	 $76.55 	 $69.15 	 $72.29 	 $20.24 	 $69.15 	 $20.41 
357065	HCHG CVMC CATECHOLAMIN*R	0301	LABORATORY - CHEMISTRY	82382	 $316.94 	 $221.86 	 $75.43 	 $285.25 	 $275.74 	 $76.07 	 $242.46 	 $266.23 	 $266.23 	 $78.35 	 $199.67 	 $269.40 	 $91.28 	 $98.89 	 $76.07 	 $285.25 	 $257.67 	 $269.40 	 $75.43 	 $257.67 	 $76.07 
357067	HCHG CVMC B12 VITAMIN	0301	LABORATORY - CHEMISTRY	82607	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
357073	HCHG CVMC G6PD *R	0301	LABORATORY - CHEMISTRY	82960	 $49.36 	 $34.55 	 $11.75 	 $44.42 	 $42.94 	 $11.85 	 $37.76 	 $41.46 	 $41.46 	 $12.20 	 $31.10 	 $41.96 	 $14.22 	 $15.40 	 $11.85 	 $44.42 	 $40.13 	 $41.96 	 $11.75 	 $40.13 	 $11.85 
357074	HCHG HEMOGLOBIN ELECTROPHORESIS REF	0301	LABORATORY - CHEMISTRY	83020	 $72.57 	 $50.80 	 $17.27 	 $65.31 	 $63.14 	 $17.42 	 $55.52 	 $60.96 	 $60.96 	 $17.94 	 $45.72 	 $61.68 	 $20.90 	 $22.64 	 $17.42 	 $65.31 	 $59.00 	 $61.68 	 $17.27 	 $59.00 	 $17.42 
357076	HCHG CVMC METHEMOGLOBIN *R	0301	LABORATORY - CHEMISTRY	83050	 $206.24 	 $144.37 	 $49.09 	 $185.62 	 $179.43 	 $49.50 	 $157.77 	 $173.24 	 $173.24 	 $50.98 	 $129.93 	 $175.30 	 $59.40 	 $64.35 	 $49.50 	 $185.62 	 $167.67 	 $175.30 	 $49.09 	 $167.67 	 $49.50 
357077	"HCHG BMH IMMUNOASSAY, NONANTIBODY TRANSGLUT*R"	0301	LABORATORY - CHEMISTRY	83516	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
357081	HCHG IA ANAL QUANT MITOCHONDRIAL AB REF	0301	LABORATORY - CHEMISTRY	83520	 $960.00 	 $672.00 	 $228.48 	 $864.00 	 $835.20 	 $230.40 	 $734.40 	 $806.40 	 $806.40 	 $237.31 	 $604.80 	 $816.00 	 $276.48 	 $299.52 	 $230.40 	 $864.00 	 $780.48 	 $816.00 	 $228.48 	 $780.48 	 $230.40 
357084	HCHG LIPOPROTEINS (A) REF	0301	LABORATORY - CHEMISTRY	83695	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
357085	HCHG CVMC VLDL *R	0301	LABORATORY - CHEMISTRY	83719	 $107.73 	 $75.41 	 $25.64 	 $96.96 	 $93.73 	 $25.86 	 $82.41 	 $90.49 	 $90.49 	 $26.63 	 $67.87 	 $91.57 	 $31.03 	 $33.61 	 $25.86 	 $96.96 	 $87.58 	 $91.57 	 $25.64 	 $87.58 	 $25.86 
357103	HCHG PROCALCITONIN (PCT) REF	0301	LABORATORY - CHEMISTRY	84145	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
357105	HCHG CVMC PKU INITIAL *H 84030	0301	LABORATORY - CHEMISTRY	84030	 $78.75 	 $55.13 	 $18.74 	 $70.88 	 $68.51 	 $18.90 	 $60.24 	 $66.15 	 $66.15 	 $19.47 	 $49.61 	 $66.94 	 $22.68 	 $24.57 	 $18.90 	 $70.88 	 $64.02 	 $66.94 	 $18.74 	 $64.02 	 $18.90 
357106	"HCHG CVMC PORPHOBILINOG, URINE *R"	0301	LABORATORY - CHEMISTRY	84106	 $28.16 	 $19.71 	 $6.70 	 $25.34 	 $24.50 	 $6.76 	 $21.54 	 $23.65 	 $23.65 	 $6.96 	 $17.74 	 $23.94 	 $8.11 	 $8.79 	 $6.76 	 $25.34 	 $22.89 	 $23.94 	 $6.70 	 $22.89 	 $6.76 
357107	"HCHG CVMC PORPHYRINS, URINE *R"	0301	LABORATORY - CHEMISTRY	84119	 $142.90 	 $100.03 	 $34.01 	 $128.61 	 $124.32 	 $34.30 	 $109.32 	 $120.04 	 $120.04 	 $35.32 	 $90.03 	 $121.47 	 $41.16 	 $44.58 	 $34.30 	 $128.61 	 $116.18 	 $121.47 	 $34.01 	 $116.18 	 $34.30 
357108	HCHG CVMC PROG&EST RC*R	0301	LABORATORY - CHEMISTRY	84233	 $907.72 	 $635.40 	 $216.04 	 $816.95 	 $789.72 	 $217.85 	 $694.41 	 $762.48 	 $762.48 	 $224.39 	 $571.86 	 $771.56 	 $261.42 	 $283.21 	 $217.85 	 $816.95 	 $737.98 	 $771.56 	 $216.04 	 $737.98 	 $217.85 
357178	HCHG CHOLINESTERASE SERUM REF	0301	LABORATORY - CHEMISTRY	82480	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
357188	HCHG DRUG SCREEN GABAPENTIN QUANT REF	0301	LABORATORY - CHEMISTRY	80171	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
357189	HCHG DRUG SCREEN LAMOTRIGINE QUANT REF	0301	LABORATORY - CHEMISTRY	80175	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
357190	HCHG DRUG SCREEN MYCOPHENOLATE QUANT REF	0301	LABORATORY - CHEMISTRY	80180	 $109.50 	 $76.65 	 $26.06 	 $98.55 	 $95.27 	 $26.28 	 $83.77 	 $91.98 	 $91.98 	 $27.07 	 $68.99 	 $93.08 	 $31.54 	 $34.16 	 $26.28 	 $98.55 	 $89.02 	 $93.08 	 $26.06 	 $89.02 	 $26.28 
357191	HCHG DRUG SCREEN LEVETIRACETAM QUANT REF	0301	LABORATORY - CHEMISTRY	80177	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
357192	HCHG DRUG SCREEN OXCARBAZEPINE QUANT REF	0301	LABORATORY - CHEMISTRY	80183	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
357205	HCHG RIBOFLAVIN ASSAY VITAMIN B-2 REF	0301	LABORATORY - CHEMISTRY	84252	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $43.20 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
357248	HCHG CLOZAPINE REF	0301	LABORATORY - CHEMISTRY	80159	 $90.75 	 $63.53 	 $21.60 	 $81.68 	 $78.95 	 $21.78 	 $69.42 	 $76.23 	 $76.23 	 $22.43 	 $57.17 	 $77.14 	 $26.14 	 $28.31 	 $21.78 	 $81.68 	 $73.78 	 $77.14 	 $21.60 	 $73.78 	 $21.78 
357272	HCHG CVMC ARSENIC LEVEL *R	0301	LABORATORY - CHEMISTRY	82175	 $117.86 	 $82.50 	 $28.05 	 $106.07 	 $102.54 	 $28.29 	 $90.16 	 $99.00 	 $99.00 	 $29.13 	 $74.25 	 $100.18 	 $33.94 	 $36.77 	 $28.29 	 $106.07 	 $95.82 	 $100.18 	 $28.05 	 $95.82 	 $28.29 
357273	HCHG CALCULUS SPECTROSCOPY REF	0301	LABORATORY - CHEMISTRY	82365	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
357274	HCHG GAMMAGLOBULIN IGA IGD IGG IGM REF	0301	LABORATORY - CHEMISTRY	82784	 $142.64 	 $99.85 	 $33.95 	 $128.38 	 $124.10 	 $34.23 	 $109.12 	 $119.82 	 $119.82 	 $35.26 	 $89.86 	 $121.24 	 $41.08 	 $44.50 	 $34.23 	 $128.38 	 $115.97 	 $121.24 	 $33.95 	 $115.97 	 $34.23 
357275	"HCHG BMH/CVMC GAMMAGLOBULIN (IMMUNOGLOBULIN) IGA,IGD,IGG,IGM,EACH *R"	0301	LABORATORY - CHEMISTRY	82784	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
357276	HCHG BMH HYDROXYPROGESTERONE 17-D*R	0301	LABORATORY - CHEMISTRY	83498	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
357277	HCHG CVMC TRANSGLUTAMINASE IGA *R	0301	LABORATORY - CHEMISTRY	83516	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
357279	HCHG BMH/CVMC LEAD LEVEL*R	0301	LABORATORY - CHEMISTRY	83655	 $87.49 	 $61.24 	 $20.82 	 $78.74 	 $76.12 	 $21.00 	 $66.93 	 $73.49 	 $73.49 	 $21.63 	 $55.12 	 $74.37 	 $25.20 	 $27.30 	 $21.00 	 $78.74 	 $71.13 	 $74.37 	 $20.82 	 $71.13 	 $21.00 
357280	HCHG CVMC MERCURY *R	0301	LABORATORY - CHEMISTRY	83825	 $71.04 	 $49.73 	 $16.91 	 $63.94 	 $61.80 	 $17.05 	 $54.35 	 $59.67 	 $59.67 	 $17.56 	 $44.76 	 $60.38 	 $20.46 	 $22.16 	 $17.05 	 $63.94 	 $57.76 	 $60.38 	 $16.91 	 $57.76 	 $17.05 
357316	HCHG BMH/CVMC NMR LIPO-PROFILE*R	0301	LABORATORY - CHEMISTRY	83704	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
357344	HCHG OCCULT BLOOD FECES IMMUNOASSAY REF	0301	LABORATORY - CHEMISTRY	82274	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
357361	HCHG FELBAMATE REF	0301	LABORATORY - CHEMISTRY	80167	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
357367	HCHG ACETAMINOPHEN LAB	0301	LABORATORY - CHEMISTRY	80143	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $88.99 	 $226.80 	 $306.00 	 $103.68 	 $112.32 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
357410	HCHG DIHYDROTESTOSTERONE (DHT) REF	0301	LABORATORY - CHEMISTRY	82642	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
357440	HCHG PANCREATIC ELASTASE FECAL QUANT REF	0301	LABORATORY - CHEMISTRY	82653	 $990.00 	 $693.00 	 $235.62 	 $891.00 	 $861.30 	 $237.60 	 $757.35 	 $831.60 	 $831.60 	 $237.60 	 $623.70 	 $841.50 	 $285.12 	 $308.88 	 $237.60 	 $891.00 	 $804.87 	 $841.50 	 $235.62 	 $804.87 	 $237.60 
357441	HCHG IG LIGHT CHAINS FREE EA REF	0301	LABORATORY - CHEMISTRY	83521	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $79.10 	 $201.60 	 $272.00 	 $92.16 	 $99.84 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
357502	HCHG DRUG TEST PRSMV INSTRMNT DIR OPT OBS LAB	0301	LABORATORY - CHEMISTRY	80306	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $71.69 	 $182.70 	 $246.50 	 $83.52 	 $90.48 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
360026	HCHG OCCULT BLOOD FECES IMMUNOASSAY LAB	0301	LABORATORY - CHEMISTRY	82274	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360035	HCHG HOMOCYSTEINE LAB	0301	LABORATORY - CHEMISTRY	83090	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
360046	HCHG MYOGLOBIN LAB	0301	LABORATORY - CHEMISTRY	83874	 $124.00 	 $86.80 	 $29.51 	 $111.60 	 $107.88 	 $29.76 	 $94.86 	 $104.16 	 $104.16 	 $29.76 	 $78.12 	 $105.40 	 $35.71 	 $38.69 	 $29.76 	 $111.60 	 $100.81 	 $105.40 	 $29.51 	 $100.81 	 $29.76 
360060	HCHG THYROGLOBULIN LAB	0301	LABORATORY - CHEMISTRY	84432	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
360079	HCHG PARATHORMONE LAB	0301	LABORATORY - CHEMISTRY	83970	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $86.40 	 $93.60 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
360093	HCHG RENAL FUNCTION PANEL LAB	0301	LABORATORY - CHEMISTRY	80069	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360094	HCHG HEPATIC FUNCTION PANEL LAB	0301	LABORATORY - CHEMISTRY	80076	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360096	HCHG BASIC METABOLIC PANEL TOTAL CA LAB	0301	LABORATORY - CHEMISTRY	80048	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
360099	HCHG ELECTROLYTE PANEL LAB	0301	LABORATORY - CHEMISTRY	80051	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
360103	HCHG GLUCOSE BLOOD QUANT LAB	0301	LABORATORY - CHEMISTRY	82947	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360104	HCHG GLUCOSE 1HR GESTATIONAL LOAD LAB	0301	LABORATORY - CHEMISTRY	82950	 $116.31 	 $81.42 	 $27.68 	 $104.68 	 $101.19 	 $27.91 	 $88.98 	 $97.70 	 $97.70 	 $28.75 	 $73.28 	 $98.86 	 $33.50 	 $36.29 	 $27.91 	 $104.68 	 $94.56 	 $98.86 	 $27.68 	 $94.56 	 $27.91 
360105	HCHG GLUCOSE BODY FLUID NOT BLOOD LAB	0301	LABORATORY - CHEMISTRY	82945	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360107	HCHG GLUCOSE TOLERANCE TEST (GTT) LAB	0301	LABORATORY - CHEMISTRY	82951	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $59.33 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
360108	HCHG GLUCOSE TOLERANCE (GTT) EA ADDL LAB	0301	LABORATORY - CHEMISTRY	82952	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360115	HCHG URIC ACID OTHER SOURCE LAB	0301	LABORATORY - CHEMISTRY	84560	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360116	HCHG PHOSPHORUS URINE LAB	0301	LABORATORY - CHEMISTRY	84105	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360117	HCHG CALCIUM URINE QUANT LAB	0301	LABORATORY - CHEMISTRY	82340	 $57.00 	 $39.90 	 $13.57 	 $51.30 	 $49.59 	 $13.68 	 $43.61 	 $47.88 	 $47.88 	 $14.09 	 $35.91 	 $48.45 	 $16.42 	 $17.78 	 $13.68 	 $51.30 	 $46.34 	 $48.45 	 $13.57 	 $46.34 	 $13.68 
360119	HCHG POTASSIUM SERUM PLASMA OR WB LAB	0301	LABORATORY - CHEMISTRY	84132	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360120	HCHG CHLORIDE BLOOD LAB	0301	LABORATORY - CHEMISTRY	82435	 $284.78 	 $199.35 	 $67.78 	 $256.30 	 $247.76 	 $68.35 	 $217.86 	 $239.22 	 $239.22 	 $70.40 	 $179.41 	 $242.06 	 $82.02 	 $88.85 	 $68.35 	 $256.30 	 $231.53 	 $242.06 	 $67.78 	 $231.53 	 $68.35 
360124	HCHG LITHIUM LAB	0301	LABORATORY - CHEMISTRY	80178	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360126	HCHG CALCIUM TOTAL LAB	0301	LABORATORY - CHEMISTRY	82310	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360127	HCHG PHOSPHORUS LAB	0301	LABORATORY - CHEMISTRY	84100	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360128	HCHG MAGNESIUM LAB	0301	LABORATORY - CHEMISTRY	83735	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360129	HCHG UREA NITROGEN QUANT LAB	0301	LABORATORY - CHEMISTRY	84520	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360130	HCHG CREATININE BLOOD LAB	0301	LABORATORY - CHEMISTRY	82565	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360131	HCHG CREATININE CLEARANCE LAB	0301	LABORATORY - CHEMISTRY	82575	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
360133	HCHG URIC ACID BLOOD LAB	0301	LABORATORY - CHEMISTRY	84550	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360134	HCHG PH BODY FLUID NOT SPECIFIED LAB	0301	LABORATORY - CHEMISTRY	83986	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360136	HCHG CREATINE KINASE (CK) (CPK) TOTAL LAB	0301	LABORATORY - CHEMISTRY	82550	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360138	HCHG LACTATE (LD) (LDH) ENZYME LAB	0301	LABORATORY - CHEMISTRY	83615	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360139	HCHG TRANSFERASE (AST) (SGOT) LAB	0301	LABORATORY - CHEMISTRY	84450	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360140	HCHG TRANSFERASE (ALT) (SGPT) LAB	0301	LABORATORY - CHEMISTRY	84460	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360141	HCHG GAMMA (GGT) LAB	0301	LABORATORY - CHEMISTRY	82977	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360142	HCHG ALKALINE PHOSPHATASE LAB	0301	LABORATORY - CHEMISTRY	84075	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360143	HCHG PHOSPHATES ALK-ISOENZYMES LAB	0301	LABORATORY - CHEMISTRY	84080	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360144	HCHG IRON LAB	0301	LABORATORY - CHEMISTRY	83540	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360145	HCHG IRON BINDING CAPACITY LAB	0301	LABORATORY - CHEMISTRY	83550	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360148	HCHG BILIRUBIN DIRECT LAB	0301	LABORATORY - CHEMISTRY	82248	 $44.00 	 $30.80 	 $10.47 	 $39.60 	 $38.28 	 $10.56 	 $33.66 	 $36.96 	 $36.96 	 $10.88 	 $27.72 	 $37.40 	 $12.67 	 $13.73 	 $10.56 	 $39.60 	 $35.77 	 $37.40 	 $10.47 	 $35.77 	 $10.56 
360149	HCHG BILIRUBIN TOTAL LAB	0301	LABORATORY - CHEMISTRY	82247	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360150	HCHG CALCIUM IONIZED LAB	0301	LABORATORY - CHEMISTRY	82330	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360151	HCHG AMYLASE LAB	0301	LABORATORY - CHEMISTRY	82150	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360152	HCHG LIPASE LAB	0301	LABORATORY - CHEMISTRY	83690	 $145.00 	 $101.50 	 $34.51 	 $130.50 	 $126.15 	 $34.80 	 $110.93 	 $121.80 	 $121.80 	 $34.80 	 $91.35 	 $123.25 	 $41.76 	 $45.24 	 $34.80 	 $130.50 	 $117.89 	 $123.25 	 $34.51 	 $117.89 	 $34.80 
360155	HCHG CHOLESTEROL SERUM WB TOTAL LAB	0301	LABORATORY - CHEMISTRY	82465	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360156	HCHG HIGH DENSITY LIPOPROTEIN (HDL) LAB	0301	LABORATORY - CHEMISTRY	83718	 $266.00 	 $186.20 	 $63.31 	 $239.40 	 $231.42 	 $63.84 	 $203.49 	 $223.44 	 $223.44 	 $65.76 	 $167.58 	 $226.10 	 $76.61 	 $82.99 	 $63.84 	 $239.40 	 $216.26 	 $226.10 	 $63.31 	 $216.26 	 $63.84 
360157	HCHG TRIGLYCERIDES LAB	0301	LABORATORY - CHEMISTRY	84478	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360159	HCHG PROTEIN E-PHORESIS SERUM LAB	0301	LABORATORY - CHEMISTRY	84165	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360160	HCHG ALBUMIN SERUM LAB	0301	LABORATORY - CHEMISTRY	82040	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360162	HCHG AMMONIA LAB	0301	LABORATORY - CHEMISTRY	82140	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360168	HCHG PROTEIN TOTAL SERUM PLASMA LAB	0301	LABORATORY - CHEMISTRY	84155	 $44.00 	 $30.80 	 $10.47 	 $39.60 	 $38.28 	 $10.56 	 $33.66 	 $36.96 	 $36.96 	 $10.56 	 $27.72 	 $37.40 	 $12.67 	 $13.73 	 $10.56 	 $39.60 	 $35.77 	 $37.40 	 $10.47 	 $35.77 	 $10.56 
360172	HCHG IMMUNOASSAY NONANTIBODY LAB	0301	LABORATORY - CHEMISTRY	83516	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
360173	HCHG CREATINE KINASE (CK) (CPK) MB FRACTION LAB	0301	LABORATORY - CHEMISTRY	82553	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
360176	HCHG TROPONIN QUANT LAB	0301	LABORATORY - CHEMISTRY	84484	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360202	HCHG MICROALBUMIN URINE QUANT LAB	0301	LABORATORY - CHEMISTRY	82043	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360203	HCHG PROTEIN TOTAL OTHER SOURCE LAB	0301	LABORATORY - CHEMISTRY	84157	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360204	HCHG PROTEIN TOTAL URINE LAB	0301	LABORATORY - CHEMISTRY	84156	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360207	HCHG UREA NITROGEN URINE LAB	0301	LABORATORY - CHEMISTRY	84540	 $41.00 	 $28.70 	 $9.76 	 $36.90 	 $35.67 	 $9.84 	 $31.37 	 $34.44 	 $34.44 	 $9.84 	 $25.83 	 $34.85 	 $11.81 	 $12.79 	 $9.84 	 $36.90 	 $33.33 	 $34.85 	 $9.76 	 $33.33 	 $9.84 
360209	HCHG VALPROIC ACID (DEPAKANE) TOTAL LAB	0301	LABORATORY - CHEMISTRY	80164	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360210	HCHG ZINC PROTOPORPHYRINS LAB	0301	LABORATORY - CHEMISTRY	84202	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360212	HCHG POTASSIUM RANDOM URINE LAB	0301	LABORATORY - CHEMISTRY	84133	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360215	HCHG SODIUM RANDOM URINE LAB	0301	LABORATORY - CHEMISTRY	84300	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360216	HCHG SODIUM OTHER SOURCE LAB	0301	LABORATORY - CHEMISTRY	84302	 $43.00 	 $30.10 	 $10.23 	 $38.70 	 $37.41 	 $10.32 	 $32.90 	 $36.12 	 $36.12 	 $10.32 	 $27.09 	 $36.55 	 $12.38 	 $13.42 	 $10.32 	 $38.70 	 $34.96 	 $36.55 	 $10.23 	 $34.96 	 $10.32 
360219	HCHG CREATININE OTHER SOURCE LAB	0301	LABORATORY - CHEMISTRY	82570	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360221	HCHG TOBRAMYCIN LAB	0301	LABORATORY - CHEMISTRY	80200	 $379.00 	 $265.30 	 $90.20 	 $341.10 	 $329.73 	 $90.96 	 $289.94 	 $318.36 	 $318.36 	 $90.96 	 $238.77 	 $322.15 	 $109.15 	 $118.25 	 $90.96 	 $341.10 	 $308.13 	 $322.15 	 $90.20 	 $308.13 	 $90.96 
360224	HCHG LACTIC ACID LAB	0301	LABORATORY - CHEMISTRY	83605	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360238	HCHG THEOPHYLLINE (AMINOPHYLLINE) LAB	0301	LABORATORY - CHEMISTRY	80198	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $57.60 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
360253	HCHG CARBAMAZEPINE TOTAL LAB	0301	LABORATORY - CHEMISTRY	80156	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $51.91 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
360254	HCHG PHENYTOIN TOTAL LAB	0301	LABORATORY - CHEMISTRY	80185	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
360256	HCHG MEPHOBARBITAL LAB	0301	LABORATORY - CHEMISTRY	80299	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360257	HCHG PHENOBARBITAL LAB	0301	LABORATORY - CHEMISTRY	80184	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
360262	HCHG CARBOXYHEMOGLOBIN QUANT LAB	0301	LABORATORY - CHEMISTRY	82375	 $117.00 	 $81.90 	 $27.85 	 $105.30 	 $101.79 	 $28.08 	 $89.51 	 $98.28 	 $98.28 	 $28.92 	 $73.71 	 $99.45 	 $33.70 	 $36.50 	 $28.08 	 $105.30 	 $95.12 	 $99.45 	 $27.85 	 $95.12 	 $28.08 
360272	HCHG ZINC SERUM LAB	0301	LABORATORY - CHEMISTRY	84630	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360292	HCHG DIGOXIN LAB	0301	LABORATORY - CHEMISTRY	80162	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
360294	HCHG TRIIODOTHYRONINE (T3) TOTAL LAB	0301	LABORATORY - CHEMISTRY	84480	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360303	HCHG CARCINOEMBRYONIC ANTIGEN LAB	0301	LABORATORY - CHEMISTRY	82378	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360309	HCHG CORTISOL TOTAL LAB	0301	LABORATORY - CHEMISTRY	82533	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360313	HCHG ACUTE HEPATITIS PANEL LAB	0301	LABORATORY - CHEMISTRY	80074	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $111.24 	 $283.50 	 $382.50 	 $129.60 	 $140.40 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
360314	HCHG FOLIC ACID SERUM LAB	0301	LABORATORY - CHEMISTRY	82746	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360315	HCHG VITAMIN B-12 LAB	0301	LABORATORY - CHEMISTRY	82607	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
360318	HCHG GONADOTROPIN CHORIONIC QUANT LAB	0301	LABORATORY - CHEMISTRY	84702	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
360321	HCHG PROGESTERONE LAB	0301	LABORATORY - CHEMISTRY	84144	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360322	HCHG GONADOTROPIN (FSH) LAB	0301	LABORATORY - CHEMISTRY	83001	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360323	HCHG GONADOTROPIN (LH) LAB	0301	LABORATORY - CHEMISTRY	83002	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360324	HCHG TESTOSTERONE TOTAL LAB	0301	LABORATORY - CHEMISTRY	84403	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
360325	HCHG ESTRADIOL TOTAL LAB	0301	LABORATORY - CHEMISTRY	82670	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
360330	HCHG GENTAMICIN LAB	0301	LABORATORY - CHEMISTRY	80170	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $79.10 	 $201.60 	 $272.00 	 $92.16 	 $99.84 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
360331	HCHG PROLACTIN LAB	0301	LABORATORY - CHEMISTRY	84146	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
360332	HCHG FERRITIN LAB	0301	LABORATORY - CHEMISTRY	82728	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360338	HCHG PROSTATIC ACID PHOSPHATASE LAB	0301	LABORATORY - CHEMISTRY	84066	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360344	HCHG VANCOMYCIN LAB	0301	LABORATORY - CHEMISTRY	80202	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $43.20 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
360367	HCHG HGB ELECTROPHORESIS ACID REF	0301	LABORATORY - CHEMISTRY	83020	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360368	HCHG HGB ELECTROPHORESIS ALK REF	0301	LABORATORY - CHEMISTRY	83020	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360370	HCHG GLUCOSE (G6PD) ENZYME LAB	0301	LABORATORY - CHEMISTRY	82955	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360381	HCHG SPECIFIC GRAVITY NON-URINE LAB	0301	LABORATORY - CHEMISTRY	84315	 $46.21 	 $32.35 	 $11.00 	 $41.59 	 $40.20 	 $11.09 	 $35.35 	 $38.82 	 $38.82 	 $11.09 	 $29.11 	 $39.28 	 $13.31 	 $14.42 	 $11.09 	 $41.59 	 $37.57 	 $39.28 	 $11.00 	 $37.57 	 $11.09 
360395	HCHG FETAL FIBRONECTIN LAB	0301	LABORATORY - CHEMISTRY	82731	 $560.84 	 $392.59 	 $133.48 	 $504.76 	 $487.93 	 $134.60 	 $429.04 	 $471.11 	 $471.11 	 $138.64 	 $353.33 	 $476.71 	 $161.52 	 $174.98 	 $134.60 	 $504.76 	 $455.96 	 $476.71 	 $133.48 	 $455.96 	 $134.60 
360399	HCHG ACETONE/KETONES QUANT LAB	0301	LABORATORY - CHEMISTRY	82010	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
360400	HCHG OCCULT BLOOD FECES COLORECTAL SCREENING LAB	0301	LABORATORY - CHEMISTRY	82270	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360405	HCHG OCCULT BLOOD FECES OTHER THAN COLORECTAL SCREEN LAB	0301	LABORATORY - CHEMISTRY	82272	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360407	HCHG BLOOD GASES ANY COMBO LAB	0301	LABORATORY - CHEMISTRY	82803	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $91.46 	 $233.10 	 $314.50 	 $106.56 	 $115.44 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
360413	HCHG NATRIURETIC PEPTIDE (BNP) LAB	0301	LABORATORY - CHEMISTRY	83880	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $123.84 	 $134.16 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
360468	HCHG PREALBUMIN LAB	0301	LABORATORY - CHEMISTRY	84134	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360481	HCHG IMMUNOGLOBULIN M (IGM) - LAB	0301	LABORATORY - CHEMISTRY	82784	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
360490	HCHG ALPHA 1 ANTITRYPSIN TOTAL LAB	0301	LABORATORY - CHEMISTRY	82103	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360502	HCHG TRANSFERRIN LAB	0301	LABORATORY - CHEMISTRY	84466	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360580	HCHG ASSAY SALICYLATE LAB	0301	LABORATORY - CHEMISTRY	G0480	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360581	HCHG ASSAY ACETAMINOPHEN LAB	0301	LABORATORY - CHEMISTRY	G0480	 $370.43 	 $259.30 	 $88.16 	 $333.39 	 $322.27 	 $88.90 	 $283.38 	 $311.16 	 $311.16 	 $91.57 	 $233.37 	 $314.87 	 $106.68 	 $115.57 	 $88.90 	 $333.39 	 $301.16 	 $314.87 	 $88.16 	 $301.16 	 $88.90 
360583	HCHG ASSAY ETHANOL LAB	0301	LABORATORY - CHEMISTRY	G0480	 $278.15 	 $194.71 	 $66.20 	 $250.34 	 $241.99 	 $66.76 	 $212.78 	 $233.65 	 $233.65 	 $68.76 	 $175.23 	 $236.43 	 $80.11 	 $86.78 	 $66.76 	 $250.34 	 $226.14 	 $236.43 	 $66.20 	 $226.14 	 $66.76 
360587	HCHG ASSAY OF DIHYDROTESTOSTERONE REF	0301	LABORATORY - CHEMISTRY	G0480	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
360598	HCHG PROCOLLAGEN 1 P1NP REF	0301	LABORATORY - CHEMISTRY	83519	 $790.00 	 $553.00 	 $188.02 	 $711.00 	 $687.30 	 $189.60 	 $604.35 	 $663.60 	 $663.60 	 $189.60 	 $497.70 	 $671.50 	 $227.52 	 $246.48 	 $189.60 	 $711.00 	 $642.27 	 $671.50 	 $188.02 	 $642.27 	 $189.60 
360743	HCHG TRIIODOTHYRONINE (T3) FREE LAB	0301	LABORATORY - CHEMISTRY	84481	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
360781	HCHG IMMUNOASSAY QUANTITATIVE NOS (KAPPA LAMBDA) REF	0301	LABORATORY - CHEMISTRY	83883	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360802	"HCHG BMH/CVMC GLUCOSE QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)"	0301	LABORATORY - CHEMISTRY	82947	 $132.81 	 $92.97 	 $31.61 	 $119.53 	 $115.54 	 $31.87 	 $101.60 	 $111.56 	 $111.56 	 $32.83 	 $83.67 	 $112.89 	 $38.25 	 $41.44 	 $31.87 	 $119.53 	 $107.97 	 $112.89 	 $31.61 	 $107.97 	 $31.87 
360803	"HCHG BMH/CVMC SUGARS, SINGLE, QUAL"	0301	LABORATORY - CHEMISTRY	84376	 $104.48 	 $73.14 	 $24.87 	 $94.03 	 $90.90 	 $25.08 	 $79.93 	 $87.76 	 $87.76 	 $25.83 	 $65.82 	 $88.81 	 $30.09 	 $32.60 	 $25.08 	 $94.03 	 $84.94 	 $88.81 	 $24.87 	 $84.94 	 $25.08 
360824	HCHG IMMUNOASSAY QUANTITATIVE NOS LAB	0301	LABORATORY - CHEMISTRY	83520	 $139.50 	 $97.65 	 $33.20 	 $125.55 	 $121.37 	 $33.48 	 $106.72 	 $117.18 	 $117.18 	 $34.48 	 $87.89 	 $118.58 	 $40.18 	 $43.52 	 $33.48 	 $125.55 	 $113.41 	 $118.58 	 $33.20 	 $113.41 	 $33.48 
361059	HCHG VALPROIC ACID (DEPAKANE) FREE REF	0301	LABORATORY - CHEMISTRY	80165	 $96.00 	 $67.20 	 $22.85 	 $86.40 	 $83.52 	 $23.04 	 $73.44 	 $80.64 	 $80.64 	 $23.04 	 $60.48 	 $81.60 	 $27.65 	 $29.95 	 $23.04 	 $86.40 	 $78.05 	 $81.60 	 $22.85 	 $78.05 	 $23.04 
362103	HCHG TRICHOMONAS VAG DNA AMP PROBE REF	0301	LABORATORY - CHEMISTRY	87661	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $96.00 	 $252.00 	 $340.00 	 $115.20 	 $124.80 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
362117	HCHG TESTOSTERONE BIOAVAILABLE REF	0301	LABORATORY - CHEMISTRY	84410	 $182.00 	 $127.40 	 $43.32 	 $163.80 	 $158.34 	 $43.68 	 $139.23 	 $152.88 	 $152.88 	 $43.68 	 $114.66 	 $154.70 	 $52.42 	 $56.78 	 $43.68 	 $163.80 	 $147.97 	 $154.70 	 $43.32 	 $147.97 	 $43.68 
362124	HCHG DRUG TEST PRSMV DIR OPT OBS LAB	0301	LABORATORY - CHEMISTRY	80305	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
362126	HCHG DRUG TEST PRSMV CHEM ANLYZR LAB	0301	LABORATORY - CHEMISTRY	80307	 $460.00 	 $322.00 	 $109.48 	 $414.00 	 $400.20 	 $110.40 	 $351.90 	 $386.40 	 $386.40 	 $113.71 	 $289.80 	 $391.00 	 $132.48 	 $143.52 	 $110.40 	 $414.00 	 $373.98 	 $391.00 	 $109.48 	 $373.98 	 $110.40 
362154	HCHG ASSAY SIROLIMUS REF	0301	LABORATORY - CHEMISTRY	80195	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
362203	HCHG PROTEIN TOTAL SERUM PLASMA REF	0301	LABORATORY - CHEMISTRY	84155	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
362256	HCHG DRUG ASSAY INFLIXIMAB REF	0301	LABORATORY - CHEMISTRY	80230	 $850.00 	 $595.00 	 $202.30 	 $765.00 	 $739.50 	 $204.00 	 $650.25 	 $714.00 	 $714.00 	 $210.12 	 $535.50 	 $722.50 	 $244.80 	 $265.20 	 $204.00 	 $765.00 	 $691.05 	 $722.50 	 $202.30 	 $691.05 	 $204.00 
362257	HCHG DRUG ASSAY LACOSAMIDE REF	0301	LABORATORY - CHEMISTRY	80235	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
369999	HCHG MISC LAB CHARGE	0301	LABORATORY - CHEMISTRY	369999	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $57.60 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
370000	HCHG CVMC PRENATAL PAN H	0301	LABORATORY - CHEMISTRY	80055	 $630.17 	 $441.12 	 $149.98 	 $567.15 	 $548.25 	 $151.24 	 $482.08 	 $529.34 	 $529.34 	 $155.78 	 $397.01 	 $535.64 	 $181.49 	 $196.61 	 $151.24 	 $567.15 	 $512.33 	 $535.64 	 $149.98 	 $512.33 	 $151.24 
370001	HCHG CVMC MAGNESIUM URINE	0301	LABORATORY - CHEMISTRY	83735	 $134.92 	 $94.44 	 $32.11 	 $121.43 	 $117.38 	 $32.38 	 $103.21 	 $113.33 	 $113.33 	 $33.35 	 $85.00 	 $114.68 	 $38.86 	 $42.10 	 $32.38 	 $121.43 	 $109.69 	 $114.68 	 $32.11 	 $109.69 	 $32.38 
370007	"HCHG BMH STONE ANALYSIS, KIDNEY*R"	0301	LABORATORY - CHEMISTRY	82365	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
370021	HCHG CVMC OSMOLALITY	0301	LABORATORY - CHEMISTRY	83930	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
301136	HCHG ALLERGEN SPEC IGE RECOMB EA REF	0302	LABORATORY - IMMUNOLOGY	86008	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
302318	HCHG PARANEOPLASTIC AB EIA RIA QUANT REF	0302	LABORATORY - IMMUNOLOGY	83519	 $610.00 	 $427.00 	 $145.18 	 $549.00 	 $530.70 	 $146.40 	 $466.65 	 $512.40 	 $512.40 	 $146.40 	 $384.30 	 $518.50 	 $175.68 	 $190.32 	 $146.40 	 $549.00 	 $495.93 	 $518.50 	 $145.18 	 $495.93 	 $146.40 
302319	HCHG PARANEOPLASTIC AB FLUORESCENT REF	0302	LABORATORY - IMMUNOLOGY	86255	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
304835	HCHG PPD TBC SKIN TEST POC	0302	LABORATORY - IMMUNOLOGY	86580	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
330958	HCHG CVMC ANTIBODY ID	0302	LABORATORY - IMMUNOLOGY	86870	 $490.00 	 $343.00 	 $116.62 	 $441.00 	 $426.30 	 $117.60 	 $374.85 	 $411.60 	 $411.60 	 $121.13 	 $308.70 	 $416.50 	 $141.12 	 $152.88 	 $117.60 	 $441.00 	 $398.37 	 $416.50 	 $116.62 	 $398.37 	 $117.60 
350643	HCHG RAPID HIV-1/2 ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86703	 $122.81 	 $85.97 	 $29.23 	 $110.53 	 $106.84 	 $29.47 	 $93.95 	 $103.16 	 $103.16 	 $29.47 	 $77.37 	 $104.39 	 $35.37 	 $38.32 	 $29.47 	 $110.53 	 $99.84 	 $104.39 	 $29.23 	 $99.84 	 $29.47 
351003	HCHG CVMC FFP/CRYO THAW	0302	LABORATORY - IMMUNOLOGY	86927	 $127.05 	 $88.94 	 $30.24 	 $114.35 	 $110.53 	 $30.49 	 $97.19 	 $106.72 	 $106.72 	 $31.41 	 $80.04 	 $107.99 	 $36.59 	 $39.64 	 $30.49 	 $114.35 	 $103.29 	 $107.99 	 $30.24 	 $103.29 	 $30.49 
351308	HCHG ANTINUCLEAR ANTIBODIES (ANA) TITER REF	0302	LABORATORY - IMMUNOLOGY	86039	 $50.00 	 $35.00 	 $11.90 	 $45.00 	 $43.50 	 $12.00 	 $38.25 	 $42.00 	 $42.00 	 $12.36 	 $31.50 	 $42.50 	 $14.40 	 $15.60 	 $12.00 	 $45.00 	 $40.65 	 $42.50 	 $11.90 	 $40.65 	 $12.00 
356001	HCHG INHIBIN A REF	0302	LABORATORY - IMMUNOLOGY	86336	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356003	HCHG ANTIBODY ID PLATELET ANTIBODIES REF	0302	LABORATORY - IMMUNOLOGY	86022	 $349.19 	 $244.43 	 $83.11 	 $314.27 	 $303.80 	 $83.81 	 $267.13 	 $293.32 	 $293.32 	 $86.32 	 $219.99 	 $296.81 	 $100.57 	 $108.95 	 $83.81 	 $314.27 	 $283.89 	 $296.81 	 $83.11 	 $283.89 	 $83.81 
356010	HCHG IMMUNOASSAY TUMOR CA 19-9 REF	0302	LABORATORY - IMMUNOLOGY	86301	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
356012	HCHG BLASTOMYCES ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86612	 $126.56 	 $88.59 	 $30.12 	 $113.90 	 $110.11 	 $30.37 	 $96.82 	 $106.31 	 $106.31 	 $31.29 	 $79.73 	 $107.58 	 $36.45 	 $39.49 	 $30.37 	 $113.90 	 $102.89 	 $107.58 	 $30.12 	 $102.89 	 $30.37 
356019	HCHG COCCIDIOIDES ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86635	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356030	HCHG T CELLS ABSOLUTE CD4/CD8 COUNT REF	0302	LABORATORY - IMMUNOLOGY	86360	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $62.40 	 $163.80 	 $221.00 	 $74.88 	 $81.12 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
356034	HCHG HISTOPLASMA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86698	 $196.80 	 $137.76 	 $46.84 	 $177.12 	 $171.22 	 $47.23 	 $150.55 	 $165.31 	 $165.31 	 $48.65 	 $123.98 	 $167.28 	 $56.68 	 $61.40 	 $47.23 	 $177.12 	 $160.00 	 $167.28 	 $46.84 	 $160.00 	 $47.23 
356040	HCHG INSULIN ANTIBODIES REF	0302	LABORATORY - IMMUNOLOGY	86337	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356041	HCHG LEGIONELLA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86713	 $121.21 	 $84.85 	 $28.85 	 $109.09 	 $105.45 	 $29.09 	 $92.73 	 $101.82 	 $101.82 	 $29.09 	 $76.36 	 $103.03 	 $34.91 	 $37.82 	 $29.09 	 $109.09 	 $98.54 	 $103.03 	 $28.85 	 $98.54 	 $29.09 
356045	HCHG MUMPS ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86735	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356046	HCHG MYCOPLASMA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86738	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356053	HCHG IMMUNOASSAY TUMOR CA 27.29 REF	0302	LABORATORY - IMMUNOLOGY	86300	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
356069	HCHG ASPERGILLUS ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86606	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356072	HCHG CHLAMYDIA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86631	 $769.32 	 $538.52 	 $183.10 	 $692.39 	 $669.31 	 $184.64 	 $588.53 	 $646.23 	 $646.23 	 $190.18 	 $484.67 	 $653.92 	 $221.56 	 $240.03 	 $184.64 	 $692.39 	 $625.46 	 $653.92 	 $183.10 	 $625.46 	 $184.64 
356076	HCHG FLUORESCENT ANTIBODY TITER REF	0302	LABORATORY - IMMUNOLOGY	86256	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $51.91 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
356080	HCHG IMMUNOASSAY INFECTIOUS AGENT REF	0302	LABORATORY - IMMUNOLOGY	86317	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356231	HCHG HEPATITIS BE ANTIBODY (HBEAB) REF	0302	LABORATORY - IMMUNOLOGY	86707	 $143.17 	 $100.22 	 $34.07 	 $128.85 	 $124.56 	 $34.36 	 $109.53 	 $120.26 	 $120.26 	 $35.39 	 $90.20 	 $121.69 	 $41.23 	 $44.67 	 $34.36 	 $128.85 	 $116.40 	 $121.69 	 $34.07 	 $116.40 	 $34.36 
356236	HCHG HEPATITIS A ANTIBODY (HAAB) REF	0302	LABORATORY - IMMUNOLOGY	86708	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356241	HCHG HEPATITIS C ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86803	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356410	HCHG AGGLUTININS FEBRILE EA ANTIGEN REF	0302	LABORATORY - IMMUNOLOGY	86000	 $339.22 	 $237.45 	 $80.73 	 $305.30 	 $295.12 	 $81.41 	 $259.50 	 $284.94 	 $284.94 	 $83.86 	 $213.71 	 $288.34 	 $97.70 	 $105.84 	 $81.41 	 $305.30 	 $275.79 	 $288.34 	 $80.73 	 $275.79 	 $81.41 
356411	HCHG ALLERGEN SPEC IGE QUAN SEMIQUAN REF	0302	LABORATORY - IMMUNOLOGY	86003	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356413	HCHG ANTIBODY ID PLATELET IG ASSAY REF	0302	LABORATORY - IMMUNOLOGY	86023	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
356416	HCHG COMPLEMENT FUNCTION ACTIVITY EA REF	0302	LABORATORY - IMMUNOLOGY	86161	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356418	HCHG IMMUNODIFFUSION OUCHTERLONY REF	0302	LABORATORY - IMMUNOLOGY	86331	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356419	HCHG IMMUNOFIX E-PHORESIS SERUM REF	0302	LABORATORY - IMMUNOLOGY	86334	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356420	HCHG ISLET CELL ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86341	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
356423	HCHG BACTERIUM ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86609	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356424	HCHG LYME DISEASE ANTIBODY CONFIRMATORY REF	0302	LABORATORY - IMMUNOLOGY	86617	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356426	HCHG CANDIDA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86628	 $81.83 	 $57.28 	 $19.48 	 $73.65 	 $71.19 	 $19.64 	 $62.60 	 $68.74 	 $68.74 	 $20.23 	 $51.55 	 $69.56 	 $23.57 	 $25.53 	 $19.64 	 $73.65 	 $66.53 	 $69.56 	 $19.48 	 $66.53 	 $19.64 
356430	HCHG CYTOMEGALOVIRUS (CMV) ANTIBODY (IGM) REF	0302	LABORATORY - IMMUNOLOGY	86645	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356436	HCHG FUNGUS ANTIBODY NES REF	0302	LABORATORY - IMMUNOLOGY	86671	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356437	HCHG HELMINTH ANTIBODY NES REF	0302	LABORATORY - IMMUNOLOGY	86682	 $132.41 	 $92.69 	 $31.51 	 $119.17 	 $115.20 	 $31.78 	 $101.29 	 $111.22 	 $111.22 	 $32.73 	 $83.42 	 $112.55 	 $38.13 	 $41.31 	 $31.78 	 $119.17 	 $107.65 	 $112.55 	 $31.51 	 $107.65 	 $31.78 
356439	HCHG HERPES SIMPLEX ANTIBODY TYPE 1 REF	0302	LABORATORY - IMMUNOLOGY	86695	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356440	HCHG HERPES SIMPLEX ANTIBODY TYPE 2 REF	0302	LABORATORY - IMMUNOLOGY	86696	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356442	HCHG PARVOVIRUS ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86747	 $115.22 	 $80.65 	 $27.42 	 $103.70 	 $100.24 	 $27.65 	 $88.14 	 $96.78 	 $96.78 	 $27.65 	 $72.59 	 $97.94 	 $33.18 	 $35.95 	 $27.65 	 $103.70 	 $93.67 	 $97.94 	 $27.42 	 $93.67 	 $27.65 
356445	HCHG RICKETTSIA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86757	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
356446	HCHG TOXOPLASMA ANTIBODY IGM REF	0302	LABORATORY - IMMUNOLOGY	86778	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
356448	HCHG HEPATITIS C CONFIRM ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86804	 $255.72 	 $179.00 	 $60.86 	 $230.15 	 $222.48 	 $61.37 	 $195.63 	 $214.80 	 $214.80 	 $63.21 	 $161.10 	 $217.36 	 $73.65 	 $79.78 	 $61.37 	 $230.15 	 $207.90 	 $217.36 	 $60.86 	 $207.90 	 $61.37 
356478	HCHG ALLERGEN SPECIFIC IGG REF	0302	LABORATORY - IMMUNOLOGY	86001	 $46.00 	 $32.20 	 $10.95 	 $41.40 	 $40.02 	 $11.04 	 $35.19 	 $38.64 	 $38.64 	 $11.37 	 $28.98 	 $39.10 	 $13.25 	 $14.35 	 $11.04 	 $41.40 	 $37.40 	 $39.10 	 $10.95 	 $37.40 	 $11.04 
356527	HCHG HAEMOPHILUS INFLUENZA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86684	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
356530	HCHG ANTI-PHOSPHOLIPID ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86148	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356542	HCHG DNA ANTIBODY SINGLE STRAND REF	0302	LABORATORY - IMMUNOLOGY	86226	 $87.52 	 $61.26 	 $20.83 	 $78.77 	 $76.14 	 $21.00 	 $66.95 	 $73.52 	 $73.52 	 $21.63 	 $55.14 	 $74.39 	 $25.21 	 $27.31 	 $21.00 	 $78.77 	 $71.15 	 $74.39 	 $20.83 	 $71.15 	 $21.00 
356579	HCHG T CELLS ABSOLUTE COUNT CD4 REF	0302	LABORATORY - IMMUNOLOGY	86361	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356635	HCHG IMMUNOASSAY TUMOR OTHER REF	0302	LABORATORY - IMMUNOLOGY	86316	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
356638	HCHG HLA TYPING A/B/C SINGLE ANTIGEN REF	0302	LABORATORY - IMMUNOLOGY	86812	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $98.88 	 $252.00 	 $340.00 	 $115.20 	 $124.80 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
356639	HCHG WEST NILE VIRUS ANTIBODY IGM REF	0302	LABORATORY - IMMUNOLOGY	86788	 $84.75 	 $59.33 	 $20.17 	 $76.28 	 $73.73 	 $20.34 	 $64.83 	 $71.19 	 $71.19 	 $20.34 	 $53.39 	 $72.04 	 $24.41 	 $26.44 	 $20.34 	 $76.28 	 $68.90 	 $72.04 	 $20.17 	 $68.90 	 $20.34 
356640	HCHG WEST NILE VIRUS ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86789	 $85.50 	 $59.85 	 $20.35 	 $76.95 	 $74.39 	 $20.52 	 $65.41 	 $71.82 	 $71.82 	 $20.52 	 $53.87 	 $72.68 	 $24.62 	 $26.68 	 $20.52 	 $76.95 	 $69.51 	 $72.68 	 $20.35 	 $69.51 	 $20.52 
356648	HCHG CYCLIC CITRULLINATED PEPTIDE (CCP) AB REF	0302	LABORATORY - IMMUNOLOGY	86200	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356656	HCHG T CELLS TOTAL COUNT REF	0302	LABORATORY - IMMUNOLOGY	86359	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $62.40 	 $163.80 	 $221.00 	 $74.88 	 $81.12 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
356657	HCHG B CELLS TOTAL COUNT REF	0302	LABORATORY - IMMUNOLOGY	86355	 $380.93 	 $266.65 	 $90.66 	 $342.84 	 $331.41 	 $91.42 	 $291.41 	 $319.98 	 $319.98 	 $94.17 	 $239.99 	 $323.79 	 $109.71 	 $118.85 	 $91.42 	 $342.84 	 $309.70 	 $323.79 	 $90.66 	 $309.70 	 $91.42 
356671	HCHG TB TEST CELL IMM MEASURE AG (QUANTIFERON) REF	0302	LABORATORY - IMMUNOLOGY	86480	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $129.60 	 $140.40 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
356726	HCHG COMPLEMENT TOTAL (CH50) REF	0302	LABORATORY - IMMUNOLOGY	86162	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
356732	HCHG NUCLEAR ANTIGEN ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86235	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356735	HCHG NUCLEAR ANTIGEN ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86235	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356736	HCHG SYPHILIS TEST NON-TREP QUAL REF	0302	LABORATORY - IMMUNOLOGY	86592	 $46.00 	 $32.20 	 $10.95 	 $41.40 	 $40.02 	 $11.04 	 $35.19 	 $38.64 	 $38.64 	 $11.04 	 $28.98 	 $39.10 	 $13.25 	 $14.35 	 $11.04 	 $41.40 	 $37.40 	 $39.10 	 $10.95 	 $37.40 	 $11.04 
356737	HCHG SYPHILIS TEST NON-TREP QUANT REF	0302	LABORATORY - IMMUNOLOGY	86593	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356738	HCHG COLD AGGLUTININ TITER REF	0302	LABORATORY - IMMUNOLOGY	86157	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356739	HCHG RHEUMATOID FACTOR QUANTITATIVE REF	0302	LABORATORY - IMMUNOLOGY	86431	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356742	HCHG ANTISTREPTOLYSIN O TITER REF	0302	LABORATORY - IMMUNOLOGY	86060	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356744	HCHG TREPONEMA PALLIDUM ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86780	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356750	HCHG RUBEOLA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86765	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356751	HCHG TOXOPLASMA ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86777	 $81.65 	 $57.16 	 $19.43 	 $73.49 	 $71.04 	 $19.60 	 $62.46 	 $68.59 	 $68.59 	 $19.60 	 $51.44 	 $69.40 	 $23.52 	 $25.47 	 $19.60 	 $73.49 	 $66.38 	 $69.40 	 $19.43 	 $66.38 	 $19.60 
356752	HCHG DNA ANTIBODY NATIVE REF	0302	LABORATORY - IMMUNOLOGY	86225	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356753	HCHG ANTINUCLEAR ANTIBODIES (ANA) REF	0302	LABORATORY - IMMUNOLOGY	86038	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356754	HCHG LYME DISEASE ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86618	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $43.20 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
356755	HCHG EPSTEIN-BARR ANTIBODY (EA) REF	0302	LABORATORY - IMMUNOLOGY	86663	 $57.34 	 $40.14 	 $13.65 	 $51.61 	 $49.89 	 $13.76 	 $43.87 	 $48.17 	 $48.17 	 $14.17 	 $36.12 	 $48.74 	 $16.51 	 $17.89 	 $13.76 	 $51.61 	 $46.62 	 $48.74 	 $13.65 	 $46.62 	 $13.76 
356756	HCHG EPSTEIN-BARR NUCLEAR ANTIGEN (EBNA) REF	0302	LABORATORY - IMMUNOLOGY	86664	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356757	HCHG EPSTEIN-BARR VIRAL CAPSID (VCA) REF	0302	LABORATORY - IMMUNOLOGY	86665	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356761	HCHG THYROGLOBULIN ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86800	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
356762	HCHG MICROSOMAL ANTIBODY EACH REF	0302	LABORATORY - IMMUNOLOGY	86376	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356765	HCHG COMPLEMENT ANTIGEN EA COMPONENT REF	0302	LABORATORY - IMMUNOLOGY	86160	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356770	HCHG HLA TYPING DR/DQ MULTI ANTIGENS REF	0302	LABORATORY - IMMUNOLOGY	86817	 $618.44 	 $432.91 	 $147.19 	 $556.60 	 $538.04 	 $148.43 	 $473.11 	 $519.49 	 $519.49 	 $152.88 	 $389.62 	 $525.67 	 $178.11 	 $192.95 	 $148.43 	 $556.60 	 $502.79 	 $525.67 	 $147.19 	 $502.79 	 $148.43 
356771	HCHG CARDIOLIPIN ANTIBODY EA IG REF	0302	LABORATORY - IMMUNOLOGY	86147	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $163.80 	 $221.00 	 $74.88 	 $81.12 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
356772	HCHG VIRUS ANTIBODY NES REF	0302	LABORATORY - IMMUNOLOGY	86790	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $57.60 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
356781	HCHG CYTOMEGALOVIRUS (CMV) ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86644	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
356782	HCHG HERPES SIMPLEX NES ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86694	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356842	HCHG FLUORESCENT ANTIBODY SCREEN REF	0302	LABORATORY - IMMUNOLOGY	86255	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $56.86 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
356843	HCHG FLUORESCENT ANTIBODY SCREEN REF	0302	LABORATORY - IMMUNOLOGY	86255	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $56.86 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
357003	HCHG HTLV/HIV CONFIRM ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86689	 $124.94 	 $87.46 	 $29.74 	 $112.45 	 $108.70 	 $29.99 	 $95.58 	 $104.95 	 $104.95 	 $30.89 	 $78.71 	 $106.20 	 $35.98 	 $38.98 	 $29.99 	 $112.45 	 $101.58 	 $106.20 	 $29.74 	 $101.58 	 $29.99 
357025	HCHG INTRINSIC FACTOR ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86340	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
357114	HCHG BMH/CVMC PROTEINASE-9 AB (PAN-ANCA) *R	0302	LABORATORY - IMMUNOLOGY	86021	 $344.00 	 $240.80 	 $81.87 	 $309.60 	 $299.28 	 $82.56 	 $263.16 	 $288.96 	 $288.96 	 $85.04 	 $216.72 	 $292.40 	 $99.07 	 $107.33 	 $82.56 	 $309.60 	 $279.67 	 $292.40 	 $81.87 	 $279.67 	 $82.56 
357115	HCHG ANCA SCREEN TITER WBC AB ID REF	0302	LABORATORY - IMMUNOLOGY	86021	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $84.05 	 $214.20 	 $289.00 	 $97.92 	 $106.08 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
357116	HCHG CVMC LEUKOCYTE ANTIBODY ID *R	0302	LABORATORY - IMMUNOLOGY	86021	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $235.20 	 $235.20 	 $69.22 	 $176.40 	 $238.00 	 $80.64 	 $87.36 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
357119	HCHG BMH ANTINUCLEAR ANTIBODIES*R	0302	LABORATORY - IMMUNOLOGY	86038	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
357121	HCHG CVMC IMMUNOELEC*R	0302	LABORATORY - IMMUNOLOGY	86320	 $405.91 	 $284.14 	 $96.61 	 $365.32 	 $353.14 	 $97.42 	 $310.52 	 $340.96 	 $340.96 	 $100.34 	 $255.72 	 $345.02 	 $116.90 	 $126.64 	 $97.42 	 $365.32 	 $330.00 	 $345.02 	 $96.61 	 $330.00 	 $97.42 
357122	HCHG NK CELL TOTAL COUNT REF	0302	LABORATORY - IMMUNOLOGY	86357	 $380.93 	 $266.65 	 $90.66 	 $342.84 	 $331.41 	 $91.42 	 $291.41 	 $319.98 	 $319.98 	 $91.42 	 $239.99 	 $323.79 	 $109.71 	 $118.85 	 $91.42 	 $342.84 	 $309.70 	 $323.79 	 $90.66 	 $309.70 	 $91.42 
357126	HCHG PARTICLE AGGLUTINATION ANTIBODY SCREEN REF	0302	LABORATORY - IMMUNOLOGY	86403	 $44.53 	 $31.17 	 $10.60 	 $40.08 	 $38.74 	 $10.69 	 $34.07 	 $37.41 	 $37.41 	 $10.69 	 $28.05 	 $37.85 	 $12.82 	 $13.89 	 $10.69 	 $40.08 	 $36.20 	 $37.85 	 $10.60 	 $36.20 	 $10.69 
357128	HCHG RHEUMATOID FACTOR QUANTITATIVE REF	0302	LABORATORY - IMMUNOLOGY	86431	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
357129	HCHG BMH/CVMC GIARDIA ANTIBODIES *R	0302	LABORATORY - IMMUNOLOGY	86674	 $157.11 	 $109.98 	 $37.39 	 $141.40 	 $136.69 	 $37.71 	 $120.19 	 $131.97 	 $131.97 	 $38.84 	 $98.98 	 $133.54 	 $45.25 	 $49.02 	 $37.71 	 $141.40 	 $127.73 	 $133.54 	 $37.39 	 $127.73 	 $37.71 
357180	HCHG CELIAC PANEL FLUORESCENT AB REF	0302	LABORATORY - IMMUNOLOGY	86255	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $56.86 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
357181	HCHG IFE PARAPROTEIN URINE REF	0302	LABORATORY - IMMUNOLOGY	86335	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
357284	HCHG CVMC RUSSELL VIPER VENOM DILUTED REF	0302	LABORATORY - IMMUNOLOGY	85613	 $129.75 	 $90.83 	 $30.88 	 $116.78 	 $112.88 	 $31.14 	 $99.26 	 $108.99 	 $108.99 	 $32.07 	 $81.74 	 $110.29 	 $37.37 	 $40.48 	 $31.14 	 $116.78 	 $105.49 	 $110.29 	 $30.88 	 $105.49 	 $31.14 
357286	HCHG CVMC ANTI-CARDIOLIPIN AB *R	0302	LABORATORY - IMMUNOLOGY	86147	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $74.16 	 $189.00 	 $255.00 	 $86.40 	 $93.60 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
357295	HCHG BMH ANTI SM/RNP *R	0302	LABORATORY - IMMUNOLOGY	86235	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
357296	"HCHG CVMC EXTRACTABLE NUC ANT,SS-B AB*R"	0302	LABORATORY - IMMUNOLOGY	86235	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
357297	HCHG CVMC ANTI-CENTROMERE AB *R	0302	LABORATORY - IMMUNOLOGY	86255	 $238.21 	 $166.75 	 $56.69 	 $214.39 	 $207.24 	 $57.17 	 $182.23 	 $200.10 	 $200.10 	 $58.89 	 $150.07 	 $202.48 	 $68.60 	 $74.32 	 $57.17 	 $214.39 	 $193.66 	 $202.48 	 $56.69 	 $193.66 	 $57.17 
357298	HCHG BMH ANALYZER PANEL MICROSOMAL AB*	0302	LABORATORY - IMMUNOLOGY	86376	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
357317	HCHG CHROMOGRANIN A *R	0302	LABORATORY - IMMUNOLOGY	86316	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
357443	HCHG ACTIN ASMA EACH REF	0302	LABORATORY - IMMUNOLOGY	86015	 $50.00 	 $35.00 	 $11.90 	 $45.00 	 $43.50 	 $12.00 	 $38.25 	 $42.00 	 $42.00 	 $12.36 	 $31.50 	 $42.50 	 $14.40 	 $15.60 	 $12.00 	 $45.00 	 $40.65 	 $42.50 	 $11.90 	 $40.65 	 $12.00 
357444	HCHG ANCA SCREEN EACH ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86036	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $91.46 	 $233.10 	 $314.50 	 $106.56 	 $115.44 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
357447	HCHG EMA EACH IG CLASS REF	0302	LABORATORY - IMMUNOLOGY	86231	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
357448	HCHG GLIADIN DGP ANTIBODY EACH IG CLASS REF	0302	LABORATORY - IMMUNOLOGY	86258	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
357450	HCHG TISSUE TRANSGLUTAMINASE EACH IG CLASS REF	0302	LABORATORY - IMMUNOLOGY	86364	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
357451	HCHG MITOCHONDRIAL ANTIBODY EACH REF	0302	LABORATORY - IMMUNOLOGY	86381	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360007	HCHG IMMUNOASSAY TUMOR CA 125 LAB	0302	LABORATORY - IMMUNOLOGY	86304	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $59.33 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
360039	HCHG INSULIN ANTIBODIES LAB	0302	LABORATORY - IMMUNOLOGY	86337	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360299	HCHG HEPATITIS A ANTIBODY (HAAB) IGM LAB	0302	LABORATORY - IMMUNOLOGY	86709	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360302	HCHG HEPATITIS B SURFACE ANTIBODY (HBSAB) LAB	0302	LABORATORY - IMMUNOLOGY	86706	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $56.86 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
360304	HCHG HEPATITIS B CORE ANTIBODY (HBCAB) TOTAL LAB	0302	LABORATORY - IMMUNOLOGY	86704	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
360312	HCHG HEPATITIS C ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86803	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360437	HCHG C-REACTIVE PROTEIN HS (HSCRP) LAB	0302	LABORATORY - IMMUNOLOGY	86141	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
360443	HCHG HIV-1/HIV-2 SINGLE RESULT ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86703	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360452	HCHG FLUORESCENT ANTIBODY SCREEN LAB	0302	LABORATORY - IMMUNOLOGY	86255	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360453	HCHG NUCLEAR ANTIGEN ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86235	 $114.00 	 $79.80 	 $27.13 	 $102.60 	 $99.18 	 $27.36 	 $87.21 	 $95.76 	 $95.76 	 $27.36 	 $71.82 	 $96.90 	 $32.83 	 $35.57 	 $27.36 	 $102.60 	 $92.68 	 $96.90 	 $27.13 	 $92.68 	 $27.36 
360454	HCHG SYPHILIS TEST NON-TREP QUAL LAB	0302	LABORATORY - IMMUNOLOGY	86592	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
360455	HCHG SYPHILIS TEST NON-TREP QUANT LAB	0302	LABORATORY - IMMUNOLOGY	86593	 $38.00 	 $26.60 	 $9.04 	 $34.20 	 $33.06 	 $9.12 	 $29.07 	 $31.92 	 $31.92 	 $9.12 	 $23.94 	 $32.30 	 $10.94 	 $11.86 	 $9.12 	 $34.20 	 $30.89 	 $32.30 	 $9.04 	 $30.89 	 $9.12 
360456	HCHG RHEUMATOID FACTOR QUALITATIVE LAB	0302	LABORATORY - IMMUNOLOGY	86430	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360460	HCHG ANTISTREPTOLYSIN O TITER LAB	0302	LABORATORY - IMMUNOLOGY	86060	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360462	HCHG HELICOBACTER PYLORI ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86677	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
360465	HCHG HETEROPHILE ANTIBODY SCREEN LAB	0302	LABORATORY - IMMUNOLOGY	86308	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360469	HCHG RUBELLA ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86762	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360474	HCHG ANTINUCLEAR ANTIBODIES (ANA) LAB	0302	LABORATORY - IMMUNOLOGY	86038	 $104.25 	 $72.98 	 $24.81 	 $93.83 	 $90.70 	 $25.02 	 $79.75 	 $87.57 	 $87.57 	 $25.77 	 $65.68 	 $88.61 	 $30.02 	 $32.53 	 $25.02 	 $93.83 	 $84.76 	 $88.61 	 $24.81 	 $84.76 	 $25.02 
360476	HCHG EPSTEIN-BARR ANTIBODY (EA) LAB	0302	LABORATORY - IMMUNOLOGY	86663	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360484	HCHG MICROSOMAL ANTIBODY EACH LAB	0302	LABORATORY - IMMUNOLOGY	86376	 $101.25 	 $70.88 	 $24.10 	 $91.13 	 $88.09 	 $24.30 	 $77.46 	 $85.05 	 $85.05 	 $24.30 	 $63.79 	 $86.06 	 $29.16 	 $31.59 	 $24.30 	 $91.13 	 $82.32 	 $86.06 	 $24.10 	 $82.32 	 $24.30 
360489	HCHG COMPLEMENT ANTIGEN EA COMPONENT LAB	0302	LABORATORY - IMMUNOLOGY	86160	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360495	HCHG CARDIOLIPIN ANTIBODY EA IG LAB	0302	LABORATORY - IMMUNOLOGY	86147	 $120.75 	 $84.53 	 $28.74 	 $108.68 	 $105.05 	 $28.98 	 $92.37 	 $101.43 	 $101.43 	 $29.85 	 $76.07 	 $102.64 	 $34.78 	 $37.67 	 $28.98 	 $108.68 	 $98.17 	 $102.64 	 $28.74 	 $98.17 	 $28.98 
360499	HCHG VARICELLA-ZOSTER ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86787	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360780	HCHG TREPONEMA PALLIDUM ANTIBODY LAB	0302	LABORATORY - IMMUNOLOGY	86780	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
360805	HCHG CVMC COLD AGGLOTININ	0302	LABORATORY - IMMUNOLOGY	86157	 $123.49 	 $86.44 	 $29.39 	 $111.14 	 $107.44 	 $29.64 	 $94.47 	 $103.73 	 $103.73 	 $30.53 	 $77.80 	 $104.97 	 $35.57 	 $38.53 	 $29.64 	 $111.14 	 $100.40 	 $104.97 	 $29.39 	 $100.40 	 $29.64 
360807	"HCHG BMH/CVMC RH TITRE/COOMBS TEST, INDIRECT, TITER"	0302	LABORATORY - IMMUNOLOGY	86886	 $215.46 	 $150.82 	 $51.28 	 $193.91 	 $187.45 	 $51.71 	 $164.83 	 $180.99 	 $180.99 	 $53.26 	 $135.74 	 $183.14 	 $62.05 	 $67.22 	 $51.71 	 $193.91 	 $175.17 	 $183.14 	 $51.28 	 $175.17 	 $51.71 
370003	"HCHG CVMC ANTISTREPTOLYSIN O, TITER"	0302	LABORATORY - IMMUNOLOGY	86060	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
370004	HCHG C-REACTIVE PROTEIN STANDARD LAB	0302	LABORATORY - IMMUNOLOGY	86140	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
370005	HCHG HIV-1 ANTIBODY REF	0302	LABORATORY - IMMUNOLOGY	86701	 $118.20 	 $82.74 	 $28.13 	 $106.38 	 $102.83 	 $28.37 	 $90.42 	 $99.29 	 $99.29 	 $29.22 	 $74.47 	 $100.47 	 $34.04 	 $36.88 	 $28.37 	 $106.38 	 $96.10 	 $100.47 	 $28.13 	 $96.10 	 $28.37 
370006	HCHG CVMC BBP SOURCE HEPATITIS B AB	0302	LABORATORY - IMMUNOLOGY	86706	 $115.35 	 $80.75 	 $27.45 	 $103.82 	 $100.35 	 $27.68 	 $88.24 	 $96.89 	 $96.89 	 $28.51 	 $72.67 	 $98.05 	 $33.22 	 $35.99 	 $27.68 	 $103.82 	 $93.78 	 $98.05 	 $27.45 	 $93.78 	 $27.68 
370008	HCHG CVMC RUBELLA TITR	0302	LABORATORY - IMMUNOLOGY	86762	 $114.72 	 $80.30 	 $27.30 	 $103.25 	 $99.81 	 $27.53 	 $87.76 	 $96.36 	 $96.36 	 $28.36 	 $72.27 	 $97.51 	 $33.04 	 $35.79 	 $27.53 	 $103.25 	 $93.27 	 $97.51 	 $27.30 	 $93.27 	 $27.53 
370009	HCHG CVMC BBP SOURCE HEPATITIS C AB	0302	LABORATORY - IMMUNOLOGY	86803	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
351300	HCHG CVMC PROMOTIONAL- CBC	0305	LABORATORY - HEMATOLOGY	85025	 $25.00 	 $25.00 	 $25.00 	 $25.00 																	
360354	HCHG COMPLETE CBC W/AUTO DIFF WBC LAB	0305	LABORATORY - HEMATOLOGY	85025	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
330938	HCHG CVMC PROTEIN C ACTIVITY *R	0305	LABORATORY - HEMATOLOGY	85303	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
330939	HCHG CVMC PROTEIN S ACTIVITY *R	0305	LABORATORY - HEMATOLOGY	85306	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
330943	"HCHG CVMC CLOTTING INHIBITORS OR ANTICOAGULANTS PROTEIN S, FREE*R"	0305	LABORATORY - HEMATOLOGY	85306	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
330946	HCHG CVMC PROTEIN C *R	0305	LABORATORY - HEMATOLOGY	85303	 $295.66 	 $206.96 	 $70.37 	 $266.09 	 $257.22 	 $70.96 	 $226.18 	 $248.35 	 $248.35 	 $73.09 	 $186.27 	 $251.31 	 $85.15 	 $92.25 	 $70.96 	 $266.09 	 $240.37 	 $251.31 	 $70.37 	 $240.37 	 $70.96 
356015	HCHG HEPARIN ASSAY REF	0305	LABORATORY - HEMATOLOGY	85520	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356051	HCHG CLOT INHIBITORS PROTEIN S TOTAL REF	0305	LABORATORY - HEMATOLOGY	85305	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
356052	HCHG CLOT INHIBITORS PROTEIN S FREE REF	0305	LABORATORY - HEMATOLOGY	85306	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
356279	HCHG BLOOD COUNT HEMATOCRIT (HCT) REF	0305	LABORATORY - HEMATOLOGY	85014	 $39.00 	 $27.30 	 $9.28 	 $35.10 	 $33.93 	 $9.36 	 $29.84 	 $32.76 	 $32.76 	 $9.64 	 $24.57 	 $33.15 	 $11.23 	 $12.17 	 $9.36 	 $35.10 	 $31.71 	 $33.15 	 $9.28 	 $31.71 	 $9.36 
356284	HCHG RBC SICKLE REDUCTION REF	0305	LABORATORY - HEMATOLOGY	85660	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356288	HCHG RUSSELL VIPER VENOM TIME DILUTED REF	0305	LABORATORY - HEMATOLOGY	85613	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
356298	HCHG CLOT FACTOR VIII VW MULTIMERIC REF	0305	LABORATORY - HEMATOLOGY	85247	 $126.45 	 $88.52 	 $30.10 	 $113.81 	 $110.01 	 $30.35 	 $96.73 	 $106.22 	 $106.22 	 $31.26 	 $79.66 	 $107.48 	 $36.42 	 $39.45 	 $30.35 	 $113.81 	 $102.80 	 $107.48 	 $30.10 	 $102.80 	 $30.35 
356347	HCHG CLOT FACTOR VIII AHG 1-STAGE REF	0305	LABORATORY - HEMATOLOGY	85240	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356349	HCHG THROMBIN TIME (TT) REF	0305	LABORATORY - HEMATOLOGY	85670	 $35.93 	 $25.15 	 $8.55 	 $32.34 	 $31.26 	 $8.62 	 $27.49 	 $30.18 	 $30.18 	 $8.62 	 $22.64 	 $30.54 	 $10.35 	 $11.21 	 $8.62 	 $32.34 	 $29.21 	 $30.54 	 $8.55 	 $29.21 	 $8.62 
356352	HCHG ANTITHROMBIN III ANTIGEN REF	0305	LABORATORY - HEMATOLOGY	85301	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
356353	HCHG ANTITHROMBIN III ACTIVITY REF	0305	LABORATORY - HEMATOLOGY	85300	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $51.91 	 $132.30 	 $178.50 	 $60.48 	 $65.52 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
356358	HCHG WBC ALKALINE PHOSPHATASE REF	0305	LABORATORY - HEMATOLOGY	85540	 $52.39 	 $36.67 	 $12.47 	 $47.15 	 $45.58 	 $12.57 	 $40.08 	 $44.01 	 $44.01 	 $12.57 	 $33.01 	 $44.53 	 $15.09 	 $16.35 	 $12.57 	 $47.15 	 $42.59 	 $44.53 	 $12.47 	 $42.59 	 $12.57 
356401	HCHG BLOOD COUNT (WBC) AUTOMATED REF	0305	LABORATORY - HEMATOLOGY	85048	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
356403	HCHG CLOT FACTOR VIII VW ANTIGEN REF	0305	LABORATORY - HEMATOLOGY	85246	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
356405	HCHG ACTIVATED PROTEIN C (APC) REF	0305	LABORATORY - HEMATOLOGY	85307	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $59.33 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
356408	HCHG MURAMIDASE REF	0305	LABORATORY - HEMATOLOGY	85549	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $46.08 	 $49.92 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
356415	HCHG BETA 2 GLYCOPROTEIN I AB EA REF	0305	LABORATORY - HEMATOLOGY	86146	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
356748	HCHG VISCOSITY REF	0305	LABORATORY - HEMATOLOGY	85810	 $55.35 	 $38.75 	 $13.17 	 $49.82 	 $48.15 	 $13.28 	 $42.34 	 $46.49 	 $46.49 	 $13.28 	 $34.87 	 $47.05 	 $15.94 	 $17.27 	 $13.28 	 $49.82 	 $45.00 	 $47.05 	 $13.17 	 $45.00 	 $13.28 
357110	HCHG CVMC RETICULOCYTE COUNT	0305	LABORATORY - HEMATOLOGY	85045	 $50.00 	 $35.00 	 $11.90 	 $45.00 	 $43.50 	 $12.00 	 $38.25 	 $42.00 	 $42.00 	 $12.36 	 $31.50 	 $42.50 	 $14.40 	 $15.60 	 $12.00 	 $45.00 	 $40.65 	 $42.50 	 $11.90 	 $40.65 	 $12.00 
357112	HCHG CVMC LUPUS ANTICOAG*R	0305	LABORATORY - HEMATOLOGY	85705	 $177.53 	 $124.27 	 $42.25 	 $159.78 	 $154.45 	 $42.61 	 $135.81 	 $149.13 	 $149.13 	 $43.89 	 $111.84 	 $150.90 	 $51.13 	 $55.39 	 $42.61 	 $159.78 	 $144.33 	 $150.90 	 $42.25 	 $144.33 	 $42.61 
360349	HCHG BLOOD COUNT HEMATOCRIT (HCT) LAB	0305	LABORATORY - HEMATOLOGY	85014	 $39.00 	 $27.30 	 $9.28 	 $35.10 	 $33.93 	 $9.36 	 $29.84 	 $32.76 	 $32.76 	 $9.64 	 $24.57 	 $33.15 	 $11.23 	 $12.17 	 $9.36 	 $35.10 	 $31.71 	 $33.15 	 $9.28 	 $31.71 	 $9.36 
360350	HCHG BLOOD COUNT HEMOGLOBIN (HGB) LAB	0305	LABORATORY - HEMATOLOGY	85018	 $44.00 	 $30.80 	 $10.47 	 $39.60 	 $38.28 	 $10.56 	 $33.66 	 $36.96 	 $36.96 	 $10.88 	 $27.72 	 $37.40 	 $12.67 	 $13.73 	 $10.56 	 $39.60 	 $35.77 	 $37.40 	 $10.47 	 $35.77 	 $10.56 
360352	HCHG RBC SED RATE NONAUTOMATED LAB	0305	LABORATORY - HEMATOLOGY	85651	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360353	HCHG RBC SED RATE AUTOMATED LAB	0305	LABORATORY - HEMATOLOGY	85652	 $74.74 	 $52.32 	 $17.79 	 $67.27 	 $65.02 	 $17.94 	 $57.18 	 $62.78 	 $62.78 	 $17.94 	 $47.09 	 $63.53 	 $21.53 	 $23.32 	 $17.94 	 $67.27 	 $60.76 	 $63.53 	 $17.79 	 $60.76 	 $17.94 
360356	HCHG COMPLETE CBC AUTOMATED LAB	0305	LABORATORY - HEMATOLOGY	85027	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360357	HCHG BLOOD COUNT PLATELET AUTOMATED LAB	0305	LABORATORY - HEMATOLOGY	85049	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360371	HCHG PROTHROMBIN TIME (PT) LAB	0305	LABORATORY - HEMATOLOGY	85610	 $40.00 	 $28.00 	 $9.52 	 $36.00 	 $34.80 	 $9.60 	 $30.60 	 $33.60 	 $33.60 	 $9.60 	 $25.20 	 $34.00 	 $11.52 	 $12.48 	 $9.60 	 $36.00 	 $32.52 	 $34.00 	 $9.52 	 $32.52 	 $9.60 
360372	HCHG THROMBOPLASTIN TIME PARTIAL (PTT) PLASMA LAB	0305	LABORATORY - HEMATOLOGY	85730	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
360374	HCHG BLEEDING TIME LAB	0305	LABORATORY - HEMATOLOGY	85002	 $168.73 	 $118.11 	 $40.16 	 $151.86 	 $146.80 	 $40.50 	 $129.08 	 $141.73 	 $141.73 	 $41.71 	 $106.30 	 $143.42 	 $48.59 	 $52.64 	 $40.50 	 $151.86 	 $137.18 	 $143.42 	 $40.16 	 $137.18 	 $40.50 
360379	HCHG BLOOD PLATELET AGGREGATION LAB	0305	LABORATORY - HEMATOLOGY	85576	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360412	HCHG AUTOMATED DIFF WBC COUNT LAB	0305	LABORATORY - HEMATOLOGY	85004	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360421	HCHG FIBRINOGEN ACTIVITY LAB	0305	LABORATORY - HEMATOLOGY	85384	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
360426	HCHG D-DIMER QUANTITATIVE LAB	0305	LABORATORY - HEMATOLOGY	85379	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360563	HCHG BLOOD COUNT (RBC) AUTOMATED LAB	0305	LABORATORY - HEMATOLOGY	85041	 $25.00 	 $17.50 	 $5.95 	 $22.50 	 $21.75 	 $6.00 	 $19.13 	 $21.00 	 $21.00 	 $6.18 	 $15.75 	 $21.25 	 $7.20 	 $7.80 	 $6.00 	 $22.50 	 $20.33 	 $21.25 	 $5.95 	 $20.33 	 $6.00 
360564	HCHG BLOOD COUNT (WBC) AUTOMATED LAB	0305	LABORATORY - HEMATOLOGY	85048	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
360744	HCHG CYCLIC CITRULLINATED PEPTIDE (CCP) AB LAB	0305	LABORATORY - HEMATOLOGY	86200	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
370002	HCHG CVMC SICKLE CELL PREP	0305	LABORATORY - HEMATOLOGY	85660	 $164.83 	 $115.38 	 $39.23 	 $148.35 	 $143.40 	 $39.56 	 $126.09 	 $138.46 	 $138.46 	 $40.75 	 $103.84 	 $140.11 	 $47.47 	 $51.43 	 $39.56 	 $148.35 	 $134.01 	 $140.11 	 $39.23 	 $134.01 	 $39.56 
301142	HCHG RESP VIRUS 12-25 TARGETS MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87633	 $980.00 	 $686.00 	 $233.24 	 $882.00 	 $852.60 	 $235.20 	 $749.70 	 $823.20 	 $823.20 	 $235.20 	 $617.40 	 $833.00 	 $282.24 	 $305.76 	 $235.20 	 $882.00 	 $796.74 	 $833.00 	 $233.24 	 $796.74 	 $235.20 
301159	HCHG IAAD IA SHIGA-LIKE TOXIN REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87427	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
310130	HCHG CVMC STREP A ASSAY W/ VISUAL	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87880	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
310131	HCHG POC INFLUENZA ASSAY W/ VISUAL	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87804	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
331116	HCHG CANDIDA DNA DIR PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87480	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
331117	HCHG GARDNERELLA VAG DNA DIR PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87510	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
331118	HCHG TRICHOMONAS VAG DNA DIR PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87660	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $43.20 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
343045	HCHG BMH/CVMC SENSITIVITY MICROSCAN	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87186	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $201.60 	 $201.60 	 $59.33 	 $151.20 	 $204.00 	 $69.12 	 $74.88 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
350154	HCHG RESP VIRUS 12-25 TARGETS REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87633	 $925.47 	 $647.83 	 $220.26 	 $832.92 	 $805.16 	 $222.11 	 $707.98 	 $777.39 	 $777.39 	 $222.11 	 $583.05 	 $786.65 	 $266.54 	 $288.75 	 $222.11 	 $832.92 	 $752.41 	 $786.65 	 $220.26 	 $752.41 	 $222.11 
352013	HCHG SKIN FUNGI CULTURE MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87101	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
352018	HCHG URINE CULTURE/COLONY COUNT MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87086	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
352019	HCHG SMEAR GRAM STAIN MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87205	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
352029	HCHG CRYPTOSPORIDIUM ANTIGEN IA MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87328	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
352033	HCHG FUNGUS ISOLATION CULTURE MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87102	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
352034	HCHG CLOSTRIDIUM DIFF AMP PROBE MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87493	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
352063	HCHG FUNGI IDENTIFICATION YEAST MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87106	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
352069	HCHG WET MOUNTS W/PREPARATIONS MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	Q0111	 $48.00 	 $33.60 	 $11.42 	 $43.20 	 $41.76 	 $11.52 	 $36.72 	 $40.32 	 $40.32 	 $11.52 	 $30.24 	 $40.80 	 $13.82 	 $14.98 	 $11.52 	 $43.20 	 $39.02 	 $40.80 	 $11.42 	 $39.02 	 $11.52 
352072	HCHG VIRUS INOCULATION SHELL VIA MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87254	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $40.80 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
352095	HCHG STAPH AUREUS DNA AMP PROBE MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87640	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
352099	HCHG BORDETELLA PERTUSSIS NDA QUAL REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87798	 $195.00 	 $136.50 	 $46.41 	 $175.50 	 $169.65 	 $46.80 	 $149.18 	 $163.80 	 $163.80 	 $48.20 	 $122.85 	 $165.75 	 $56.16 	 $60.84 	 $46.80 	 $175.50 	 $158.54 	 $165.75 	 $46.41 	 $158.54 	 $46.80 
356228	HCHG HEPATITIS B SURFACE ANTIGEN IA REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87340	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
356230	HCHG HEPATITIS BE ANTIGEN (HBEAG) IA REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87350	 $49.00 	 $34.30 	 $11.66 	 $44.10 	 $42.63 	 $11.76 	 $37.49 	 $41.16 	 $41.16 	 $12.11 	 $30.87 	 $41.65 	 $14.11 	 $15.29 	 $11.76 	 $44.10 	 $39.84 	 $41.65 	 $11.66 	 $39.84 	 $11.76 
356450	HCHG CONCENTRATION INF AGENTS REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87015	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
356452	HCHG HELICOBACTER PYLORI STOOL ANTIGEN IA REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87338	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
356454	HCHG INF AG DETECT NOS IA MULT REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87449	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
356455	HCHG CYTOMEGALOVIRUS (CMV) DNA AMP PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87496	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
356456	HCHG HEPATITIS B DNA QUANT REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87517	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $103.82 	 $264.60 	 $357.00 	 $120.96 	 $131.04 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
356461	HCHG GENOTYPE DNA HIV REVERSE T REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87901	" $1,124.63 "	 $787.24 	 $267.66 	" $1,012.17 "	 $978.43 	 $269.91 	 $860.34 	 $944.69 	 $914.00 	 $278.01 	 $708.52 	 $955.94 	 $323.89 	 $350.88 	 $269.91 	" $1,012.17 "	 $914.32 	 $955.94 	 $267.66 	 $914.32 	 $269.91 
356462	HCHG GENOTYPE DNA/RNA HEP C REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87902	 $900.00 	 $630.00 	 $214.20 	 $810.00 	 $783.00 	 $216.00 	 $688.50 	 $756.00 	 $756.00 	 $222.48 	 $567.00 	 $765.00 	 $259.20 	 $280.80 	 $216.00 	 $810.00 	 $731.70 	 $765.00 	 $214.20 	 $731.70 	 $216.00 
356466	HCHG CYTOMEGALOVIRUS (CMV) DNA AMP PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87496	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
356481	HCHG N GONORRHOEAE DNA AMP PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87591	 $330.00 	 $231.00 	 $78.54 	 $297.00 	 $287.10 	 $79.20 	 $252.45 	 $277.20 	 $277.20 	 $79.20 	 $207.90 	 $280.50 	 $95.04 	 $102.96 	 $79.20 	 $297.00 	 $268.29 	 $280.50 	 $78.54 	 $268.29 	 $79.20 
356482	HCHG CHLAMYDIA TRACHOMATIS DNA AMP PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87491	 $330.00 	 $231.00 	 $78.54 	 $297.00 	 $287.10 	 $79.20 	 $252.45 	 $277.20 	 $277.20 	 $81.58 	 $207.90 	 $280.50 	 $95.04 	 $102.96 	 $79.20 	 $297.00 	 $268.29 	 $280.50 	 $78.54 	 $268.29 	 $79.20 
356491	HCHG HIV-1 DNA AMP PROBE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87535	 $837.13 	 $585.99 	 $199.24 	 $753.42 	 $728.30 	 $200.91 	 $640.40 	 $703.19 	 $703.19 	 $206.94 	 $527.39 	 $711.56 	 $241.09 	 $261.18 	 $200.91 	 $753.42 	 $680.59 	 $711.56 	 $199.24 	 $680.59 	 $200.91 
356508	HCHG CULTURE SCREEN ONLY REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87081	 $130.16 	 $91.11 	 $30.98 	 $117.14 	 $113.24 	 $31.24 	 $99.57 	 $109.33 	 $109.33 	 $32.18 	 $82.00 	 $110.64 	 $37.49 	 $40.61 	 $31.24 	 $117.14 	 $105.82 	 $110.64 	 $30.98 	 $105.82 	 $31.24 
356617	HCHG DETECT AGENT NOS DNA QUANT REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87799	 $380.00 	 $266.00 	 $90.44 	 $342.00 	 $330.60 	 $91.20 	 $290.70 	 $319.20 	 $319.20 	 $93.94 	 $239.40 	 $323.00 	 $109.44 	 $118.56 	 $91.20 	 $342.00 	 $308.94 	 $323.00 	 $90.44 	 $308.94 	 $91.20 
356626	HCHG CYTOMEGALOVIRUS (CMV) DNA QUANT REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87497	 $380.00 	 $266.00 	 $90.44 	 $342.00 	 $330.60 	 $91.20 	 $290.70 	 $319.20 	 $319.20 	 $93.94 	 $239.40 	 $323.00 	 $109.44 	 $118.56 	 $91.20 	 $342.00 	 $308.94 	 $323.00 	 $90.44 	 $308.94 	 $91.20 
356678	HCHG HIV-1 DNA QUANT REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87536	 $410.00 	 $287.00 	 $97.58 	 $369.00 	 $356.70 	 $98.40 	 $313.65 	 $344.40 	 $344.40 	 $101.35 	 $258.30 	 $348.50 	 $118.08 	 $127.92 	 $98.40 	 $369.00 	 $333.33 	 $348.50 	 $97.58 	 $333.33 	 $98.40 
356830	HCHG SMEAR FLUORESCENT/ACID STAIN REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87206	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
356833	HCHG GIARDIA ANTIGEN IA REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87329	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
356835	HCHG CULTURE MYCOPLASMA REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87109	 $221.70 	 $155.19 	 $52.76 	 $199.53 	 $192.88 	 $53.21 	 $169.60 	 $186.23 	 $186.23 	 $54.80 	 $139.67 	 $188.45 	 $63.85 	 $69.17 	 $53.21 	 $199.53 	 $180.24 	 $188.45 	 $52.76 	 $180.24 	 $53.21 
356841	HCHG HEPATITIS C DNA QUANT REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87522	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $106.30 	 $270.90 	 $365.50 	 $123.84 	 $134.16 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
356849	HCHG SMEAR SPECIAL STAIN REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87207	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
357131	HCHG BMH/CVMC FUNGUS ISOLATION CULTURE*R	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87102	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
357133	HCHG AFB MYCOBACTERIA CULTURE REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87116	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
357134	HCHG OVA & PARASITES SMEARS REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87177	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
357135	HCHG SMEAR GRAM STAIN REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87205	 $60.41 	 $42.29 	 $14.38 	 $54.37 	 $52.56 	 $14.50 	 $46.21 	 $50.74 	 $50.74 	 $14.50 	 $38.06 	 $51.35 	 $17.40 	 $18.85 	 $14.50 	 $54.37 	 $49.11 	 $51.35 	 $14.38 	 $49.11 	 $14.50 
357137	HCHG CVMC INDIA INK PREP *R	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87210	 $46.87 	 $32.81 	 $11.16 	 $42.18 	 $40.78 	 $11.25 	 $35.86 	 $39.37 	 $39.37 	 $11.59 	 $29.53 	 $39.84 	 $13.50 	 $14.62 	 $11.25 	 $42.18 	 $38.11 	 $39.84 	 $11.16 	 $38.11 	 $11.25 
357138	HCHG BMH/CVMC VIRAL CULTURE*R	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87252	 $480.58 	 $336.41 	 $114.38 	 $432.52 	 $418.10 	 $115.34 	 $367.64 	 $403.69 	 $403.69 	 $118.80 	 $302.77 	 $408.49 	 $138.41 	 $149.94 	 $115.34 	 $432.52 	 $390.71 	 $408.49 	 $114.38 	 $390.71 	 $115.34 
357139	HCHG BMH HERPES CULTURE*R	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87255	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $74.16 	 $189.00 	 $255.00 	 $86.40 	 $93.60 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
357142	HCHG BMH/CVMC CHLAMYDIA / GC DNA PROBE *R	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87800	 $85.55 	 $59.89 	 $20.36 	 $77.00 	 $74.43 	 $20.53 	 $65.45 	 $71.86 	 $71.86 	 $21.15 	 $53.90 	 $72.72 	 $24.64 	 $26.69 	 $20.53 	 $77.00 	 $69.55 	 $72.72 	 $20.36 	 $69.55 	 $20.53 
357226	HCHG SARS-COV-2 RT PCR DIAGNOS PANEL REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87635	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
357238	HCHG SARS-COV-2 COVID-19 AMP PRB HIGH TECH REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	U0003	 $208.00 	 $145.60 	 $49.50 	 $187.20 	 $180.96 	 $49.92 	 $159.12 	 $174.72 	 $174.72 	 $49.92 	 $131.04 	 $176.80 	 $59.90 	 $64.90 	 $49.92 	 $187.20 	 $169.10 	 $176.80 	 $49.50 	 $169.10 	 $49.92 
357239	HCHG SARS-COV-2 COVID-19 AMP PRB HIGH TECH MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	U0003	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $55.20 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
357242	HCHG SARS COV-2 COVID-19 ANTIBODY MULTI STEP REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	86769	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $69.60 	 $182.70 	 $246.50 	 $83.52 	 $90.48 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
357245	HCHG SARS COV-2 COVID-19 ANTIBODY MULTI STEP LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	86769	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $69.60 	 $182.70 	 $246.50 	 $83.52 	 $90.48 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
357259	HCHG SARS COV-2 COVID-19 ANTIGEN EIA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87426	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
357305	HCHG CVMC HEP.C RNA PCR QUALITIVE	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87522	 $625.78 	 $438.05 	 $148.94 	 $563.20 	 $544.43 	 $150.19 	 $478.72 	 $525.66 	 $525.66 	 $154.69 	 $394.24 	 $531.91 	 $180.22 	 $195.24 	 $150.19 	 $563.20 	 $508.76 	 $531.91 	 $148.94 	 $508.76 	 $150.19 
357341	HCHG SARS-COV-2 COVID-19 IAADIA DIRECT OPTICAL OBS LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87811	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
357343	HCHG SARS-COV-2 COVID-19 IAADIA DIRECT OPTICAL OBS REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87811	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
357348	HCHG SARS-COV-2 COVID-19 NFCT DS RESP RNA 4 TRGT LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	0241U	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $123.84 	 $134.16 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
360298	HCHG HEPATITIS B SURFACE ANTIGEN IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87340	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360742	HCHG HIV-1 AG W/HIV-1&-2 AB AG IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87389	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $235.20 	 $235.20 	 $69.22 	 $176.40 	 $238.00 	 $80.64 	 $87.36 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
360749	HCHG BMH BLOOD CULTURE (BLOOD CULTURE FOR BACTERIA)	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87040	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
360751	HCHG BMH/CVMC CULTURE SETUP YERSINIA/VIBRIO	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87046	 $137.51 	 $96.26 	 $32.73 	 $123.76 	 $119.63 	 $33.00 	 $105.20 	 $115.51 	 $115.51 	 $33.99 	 $86.63 	 $116.88 	 $39.60 	 $42.90 	 $33.00 	 $123.76 	 $111.80 	 $116.88 	 $32.73 	 $111.80 	 $33.00 
360752	HCHG BMH CULTURE SETUP	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87070	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360754	HCHG BMH CULTURE ANAEROBIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87075	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
360757	"HCHG CVMC MICRO, ISOLATE ID"	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87077	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360765	HCHG CVMC CEFINASE-BETA LACTAMASE SENSIT	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87185	 $117.72 	 $82.40 	 $28.02 	 $105.95 	 $102.42 	 $28.25 	 $90.06 	 $98.88 	 $98.88 	 $29.10 	 $74.16 	 $100.06 	 $33.90 	 $36.73 	 $28.25 	 $105.95 	 $95.71 	 $100.06 	 $28.02 	 $95.71 	 $28.25 
360768	HCHG BMH/CVMC MALARIA	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87207	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
360769	HCHG CVMC TRICHOMONAS MT 87211	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87210	 $46.87 	 $32.81 	 $11.16 	 $42.18 	 $40.78 	 $11.25 	 $35.86 	 $39.37 	 $39.37 	 $11.59 	 $29.53 	 $39.84 	 $13.50 	 $14.62 	 $11.25 	 $42.18 	 $38.11 	 $39.84 	 $11.16 	 $38.11 	 $11.25 
360770	HCHG CRYPTOSPORIDIUM ANTIGEN IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87328	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360771	HCHG GIARDIA ANTIGEN IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87329	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
360772	HCHG INFLUENZA A/B EACH ANTIGEN IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87400	 $223.00 	 $156.10 	 $53.07 	 $200.70 	 $194.01 	 $53.52 	 $170.60 	 $187.32 	 $187.32 	 $55.13 	 $140.49 	 $189.55 	 $64.22 	 $69.58 	 $53.52 	 $200.70 	 $181.30 	 $189.55 	 $53.07 	 $181.30 	 $53.52 
360774	HCHG ROTAVIRUS ANTIGEN IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87425	 $149.00 	 $104.30 	 $35.46 	 $134.10 	 $129.63 	 $35.76 	 $113.99 	 $125.16 	 $125.16 	 $35.76 	 $93.87 	 $126.65 	 $42.91 	 $46.49 	 $35.76 	 $134.10 	 $121.14 	 $126.65 	 $35.46 	 $121.14 	 $35.76 
360775	"HCHG BMH/CVMC MR-STAPH, DNA, AMP PROBE"	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87641	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $235.20 	 $235.20 	 $69.22 	 $176.40 	 $238.00 	 $80.64 	 $87.36 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
360809	HCHG BMH/CVMC PIN WORM	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87172	 $78.67 	 $55.07 	 $18.72 	 $70.80 	 $68.44 	 $18.88 	 $60.18 	 $66.08 	 $66.08 	 $19.45 	 $49.56 	 $66.87 	 $22.66 	 $24.55 	 $18.88 	 $70.80 	 $63.96 	 $66.87 	 $18.72 	 $63.96 	 $18.88 
360810	HCHG SMEAR WET MOUNT SALINE/INK LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87210	 $40.00 	 $28.00 	 $9.52 	 $36.00 	 $34.80 	 $9.60 	 $30.60 	 $33.60 	 $33.60 	 $9.60 	 $25.20 	 $34.00 	 $11.52 	 $12.48 	 $9.60 	 $36.00 	 $32.52 	 $34.00 	 $9.52 	 $32.52 	 $9.60 
360811	HCHG BMH/CVMC KOH PREP	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87220	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360813	HCHG CLOSTRIDIUM ANTIGEN IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87324	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $163.80 	 $221.00 	 $74.88 	 $81.12 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
360814	HCHG STREPTOCCUS GROUP A LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87430	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
360815	HCHG ENTAMOEB HIST GROUP ANTIGEN IA LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87337	 $97.00 	 $67.90 	 $23.09 	 $87.30 	 $84.39 	 $23.28 	 $74.21 	 $81.48 	 $81.48 	 $23.98 	 $61.11 	 $82.45 	 $27.94 	 $30.26 	 $23.28 	 $87.30 	 $78.86 	 $82.45 	 $23.09 	 $78.86 	 $23.28 
360818	HCHG CVMC RSV	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87807	 $265.00 	 $185.50 	 $63.07 	 $238.50 	 $230.55 	 $63.60 	 $202.73 	 $222.60 	 $222.60 	 $65.51 	 $166.95 	 $225.25 	 $76.32 	 $82.68 	 $63.60 	 $238.50 	 $215.45 	 $225.25 	 $63.07 	 $215.45 	 $63.60 
360819	HCHG BMH/CVMC CAMPYLOBACTER ANTIGEN DETECT	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87899	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
360825	HCHG MYCOBACTERIA TB DNA AMP PROBE LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87556	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
360826	HCHG MTB RIFAMPIN RESISTANCE TESTING LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87798	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
361061	HCHG VIRUS ISOLATION HSV REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87255	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $40.32 	 $43.68 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
362107	HCHG HELICOBACTER PYLORI STOOL ANTIGEN IA MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87338	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $48.96 	 $53.04 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
362133	HCHG ASPERGILLUS ANTIGEN IA REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87305	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
370010	HCHG CVMC BLOOD CULTURE	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87040	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $57.60 	 $62.40 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
370011	HCHG CVMC CULTURE SALM & SHIGELLA	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87045	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
370012	"HCHG CVMC MICRO, CULTURE COMAPYLOBACTER"	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87046	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
370013	HCHG CVMC GC CULTURE	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87070	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
370014	"HCHG CVMC CULTURE, ANAEROBIC"	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87075	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
370015	"HCHG CVMC CULTURE ID, ANAEROBIC *R"	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87076	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $22.25 	 $56.70 	 $76.50 	 $25.92 	 $28.08 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
370016	HCHG CULTURE AEROBIC IDENTIFICATION REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87077	 $227.95 	 $159.57 	 $54.25 	 $205.16 	 $198.32 	 $54.71 	 $174.38 	 $191.48 	 $191.48 	 $56.35 	 $143.61 	 $193.76 	 $65.65 	 $71.12 	 $54.71 	 $205.16 	 $185.32 	 $193.76 	 $54.25 	 $185.32 	 $54.71 
370017	"HCHG BMH/CVMC MICRO, CULTURE SETUP"	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87081	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
370018	HCHG CVMC STREPTCOCCUS TYPING	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87147	 $99.73 	 $69.81 	 $23.74 	 $89.76 	 $86.77 	 $23.94 	 $76.29 	 $83.77 	 $83.77 	 $24.65 	 $62.83 	 $84.77 	 $28.72 	 $31.12 	 $23.94 	 $89.76 	 $81.08 	 $84.77 	 $23.74 	 $81.08 	 $23.94 
370019	HCHG CVMC CULTURE & SENSITIVITY	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87184	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $235.20 	 $235.20 	 $69.22 	 $176.40 	 $238.00 	 $80.64 	 $87.36 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
370020	HCHG SMEAR GRAM STAIN REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87205	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $17.28 	 $18.72 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
503387	HCHG LEGIONELLA PNEUMONPHILA ANTIGEN REF	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	87449	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
503522	HCHG SARS-COV-2 COVID-19 NFCT DS 22 TARGET MIC	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	0202U	" $1,250.00 "	 $875.00 	 $297.50 	" $1,125.00 "	" $1,087.50 "	 $300.00 	 $956.25 	" $1,050.00 "	 $914.00 	 $300.00 	 $787.50 	" $1,062.50 "	 $360.00 	 $390.00 	 $300.00 	" $1,125.00 "	" $1,016.25 "	" $1,062.50 "	 $297.50 	" $1,016.25 "	 $300.00 
503841	HCHG SARS-COV-2 COVID-19 AMP PRB HIGH TECH LAB	0306	LABORATORY - BACTERIOLOGY AND MICROBIOLOGY	U0003	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $55.20 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
302527	HCHG MICROALBUMIN SEMIQUANT LAB	0307	LABORATORY - UROLOGY	82044	 $31.00 	 $21.70 	 $7.38 	 $27.90 	 $26.97 	 $7.44 	 $23.72 	 $26.04 	 $26.04 	 $7.44 	 $19.53 	 $26.35 	 $8.93 	 $9.67 	 $7.44 	 $27.90 	 $25.20 	 $26.35 	 $7.38 	 $25.20 	 $7.44 
305619	HCHG URINE PREGNANCY TEST COLOR COMP POC	0307	LABORATORY - UROLOGY	81025	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360380	HCHG URINALYSIS AUTO W/O SCOPE LAB	0307	LABORATORY - UROLOGY	81003	 $40.00 	 $28.00 	 $9.52 	 $36.00 	 $34.80 	 $9.60 	 $30.60 	 $33.60 	 $33.60 	 $9.60 	 $25.20 	 $34.00 	 $11.52 	 $12.48 	 $9.60 	 $36.00 	 $32.52 	 $34.00 	 $9.52 	 $32.52 	 $9.60 
360391	HCHG URINE PREGNANCY TEST COLOR COMP LAB	0307	LABORATORY - UROLOGY	81025	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360565	HCHG URINE VOLUME MEASURE LAB	0307	LABORATORY - UROLOGY	81050	 $18.00 	 $12.60 	 $4.28 	 $16.20 	 $15.66 	 $4.32 	 $13.77 	 $15.12 	 $15.12 	 $4.32 	 $11.34 	 $15.30 	 $5.18 	 $5.62 	 $4.32 	 $16.20 	 $14.63 	 $15.30 	 $4.28 	 $14.63 	 $4.32 
309024	HCHG BMH/CVMC SPUTUM INDUCTION	0309	LABORATORY - OTHER LABORATORY	89220	 $171.09 	 $119.76 	 $40.72 	 $153.98 	 $148.85 	 $41.06 	 $130.88 	 $143.72 	 $143.72 	 $42.29 	 $107.79 	 $145.43 	 $49.27 	 $53.38 	 $41.06 	 $153.98 	 $139.10 	 $145.43 	 $40.72 	 $139.10 	 $41.06 
356999	HCHG BLOOD TYPING AG REAGENT REF	0309	LABORATORY - OTHER LABORATORY	86902	 $245.64 	 $171.95 	 $58.46 	 $221.08 	 $213.71 	 $58.95 	 $187.91 	 $206.34 	 $206.34 	 $60.72 	 $154.75 	 $208.79 	 $70.74 	 $76.64 	 $58.95 	 $221.08 	 $199.71 	 $208.79 	 $58.46 	 $199.71 	 $58.95 
360348	HCHG EXAM SYNOVIAL FLUID CRYSTALS LAB	0309	LABORATORY - OTHER LABORATORY	89060	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $43.20 	 $46.80 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
360351	HCHG BODY FLUID CELL COUNT LAB	0309	LABORATORY - OTHER LABORATORY	89050	 $152.89 	 $107.02 	 $36.39 	 $137.60 	 $133.01 	 $36.69 	 $116.96 	 $128.43 	 $128.43 	 $37.79 	 $96.32 	 $129.96 	 $44.03 	 $47.70 	 $36.69 	 $137.60 	 $124.30 	 $129.96 	 $36.39 	 $124.30 	 $36.69 
360355	HCHG BODY FLUID CELL COUNT W/DIFF LAB	0309	LABORATORY - OTHER LABORATORY	89051	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
360363	HCHG NASAL SMEAR EOSINOPHILS LAB	0309	LABORATORY - OTHER LABORATORY	89190	 $284.78 	 $199.35 	 $67.78 	 $256.30 	 $247.76 	 $68.35 	 $217.86 	 $239.22 	 $239.22 	 $68.35 	 $179.41 	 $242.06 	 $82.02 	 $88.85 	 $68.35 	 $256.30 	 $231.53 	 $242.06 	 $67.78 	 $231.53 	 $68.35 
360392	HCHG SEMEN ANALYSIS SPERM DETECTION LAB	0309	LABORATORY - OTHER LABORATORY	89321	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $34.56 	 $37.44 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
360393	HCHG SEMEN ANALYSIS VOLUME/COUNT/MOTILITY LAB	0309	LABORATORY - OTHER LABORATORY	89320	 $309.42 	 $216.59 	 $73.64 	 $278.48 	 $269.20 	 $74.26 	 $236.71 	 $259.91 	 $259.91 	 $74.26 	 $194.93 	 $263.01 	 $89.11 	 $96.54 	 $74.26 	 $278.48 	 $251.56 	 $263.01 	 $73.64 	 $251.56 	 $74.26 
360409	HCHG LEUKOCYTE ASSESSMENT FECAL LAB	0309	LABORATORY - OTHER LABORATORY	89055	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $28.80 	 $31.20 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
360745	HCHG BMH/CVMC DIRECT COOMBS 86880	0309	LABORATORY - OTHER LABORATORY	86880	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $27.19 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
360746	HCHG BMH/CVMC BLOOD TYPING ABO	0309	LABORATORY - OTHER LABORATORY	86900	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
360747	HCHG BMH/CVMC BLOOD TYPING RH	0309	LABORATORY - OTHER LABORATORY	86901	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
360748	HCHG BMH/CVMC BLOOD TYPING ANTIGEN SCREEN	0309	LABORATORY - OTHER LABORATORY	86902	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
301131	HCHG IGH VARI REGIONAL MUTATION REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81263	 $787.50 	 $551.25 	 $187.43 	 $708.75 	 $685.13 	 $189.00 	 $602.44 	 $661.50 	 $661.50 	 $194.67 	 $496.13 	 $669.38 	 $226.80 	 $245.70 	 $189.00 	 $708.75 	 $640.24 	 $669.38 	 $187.43 	 $640.24 	 $189.00 
301133	HCHG TPMT GENE ANAL COMMON VARIANTS REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81335	 $520.00 	 $364.00 	 $123.76 	 $468.00 	 $452.40 	 $124.80 	 $397.80 	 $436.80 	 $436.80 	 $124.80 	 $327.60 	 $442.00 	 $149.76 	 $162.24 	 $124.80 	 $468.00 	 $422.76 	 $442.00 	 $123.76 	 $422.76 	 $124.80 
301148	HCHG HLA II TYPING 1 LOC HR BLDR	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81382	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $91.46 	 $233.10 	 $314.50 	 $106.56 	 $115.44 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
350156	HCHG FMR1 GENE DETECTION (FRAGILE X) REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81243	 $336.75 	 $235.73 	 $80.15 	 $303.08 	 $292.97 	 $80.82 	 $257.61 	 $282.87 	 $282.87 	 $83.24 	 $212.15 	 $286.24 	 $96.98 	 $105.07 	 $80.82 	 $303.08 	 $273.78 	 $286.24 	 $80.15 	 $273.78 	 $80.82 
350619	HCHG HLA II TYPING 1 LOCUS LR REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81376	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $91.46 	 $233.10 	 $314.50 	 $106.56 	 $115.44 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
354047	HCHG CYTOPATH CELL ENHANCE TECH PAT	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	88112	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $235.20 	 $235.20 	 $69.22 	 $176.40 	 $238.00 	 $80.64 	 $87.36 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
354049	HCHG INTRAOP CYTO PATH CONSULT 1 PAT	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	88333	 $87.46 	 $61.22 	 $20.82 	 $78.71 	 $76.09 	 $20.99 	 $66.91 	 $73.47 	 $73.47 	 $21.62 	 $55.10 	 $74.34 	 $25.19 	 $27.29 	 $20.99 	 $78.71 	 $71.10 	 $74.34 	 $20.82 	 $71.10 	 $20.99 
354050	HCHG INTRAOP CYTO PATH CONSULT 2 PAT	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	88334	 $58.30 	 $40.81 	 $13.88 	 $52.47 	 $50.72 	 $13.99 	 $44.60 	 $48.97 	 $48.97 	 $14.41 	 $36.73 	 $49.56 	 $16.79 	 $18.19 	 $13.99 	 $52.47 	 $47.40 	 $49.56 	 $13.88 	 $47.40 	 $13.99 
357028	HCHG BCR/ABL1 TRANSLOCATION REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81206	 $440.00 	 $308.00 	 $104.72 	 $396.00 	 $382.80 	 $105.60 	 $336.60 	 $369.60 	 $369.60 	 $108.77 	 $277.20 	 $374.00 	 $126.72 	 $137.28 	 $105.60 	 $396.00 	 $357.72 	 $374.00 	 $104.72 	 $357.72 	 $105.60 
357029	HCHG BCR/ABL1 GENE MINOR BRK REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81207	 $380.00 	 $266.00 	 $90.44 	 $342.00 	 $330.60 	 $91.20 	 $290.70 	 $319.20 	 $319.20 	 $93.94 	 $239.40 	 $323.00 	 $109.44 	 $118.56 	 $91.20 	 $342.00 	 $308.94 	 $323.00 	 $90.44 	 $308.94 	 $91.20 
357031	HCHG CFTR GENE COMMON VAR REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81220	 $123.75 	 $86.63 	 $29.45 	 $111.38 	 $107.66 	 $29.70 	 $94.67 	 $103.95 	 $103.95 	 $30.59 	 $77.96 	 $105.19 	 $35.64 	 $38.61 	 $29.70 	 $111.38 	 $100.61 	 $105.19 	 $29.45 	 $100.61 	 $29.70 
357032	HCHG F2 GENE ANALYSIS A VARIANT REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81240	 $690.00 	 $483.00 	 $164.22 	 $621.00 	 $600.30 	 $165.60 	 $527.85 	 $579.60 	 $579.60 	 $170.57 	 $434.70 	 $586.50 	 $198.72 	 $215.28 	 $165.60 	 $621.00 	 $560.97 	 $586.50 	 $164.22 	 $560.97 	 $165.60 
357036	HCHG HFE GENE ANALYSIS REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81256	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
357038	HCHG MTHFR GENE COMMON VARIANT REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81291	 $730.00 	 $511.00 	 $173.74 	 $657.00 	 $635.10 	 $175.20 	 $558.45 	 $613.20 	 $613.20 	 $175.20 	 $459.90 	 $620.50 	 $210.24 	 $227.76 	 $175.20 	 $657.00 	 $593.49 	 $620.50 	 $173.74 	 $593.49 	 $175.20 
357087	HCHG BRCA1&2 SEQ FULL DUP DEL REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81162	" $9,384.75 "	" $6,569.33 "	 $914.00 	" $8,446.28 "	" $8,164.73 "	" $2,252.34 "	" $7,179.33 "	" $1,112.00 "	 $914.00 	" $2,319.91 "	" $5,912.39 "	" $7,977.04 "	" $2,702.81 "	" $2,928.04 "	" $2,252.34 "	" $8,446.28 "	" $7,629.80 "	" $7,977.04 "	" $2,233.57 "	" $7,629.80 "	" $2,252.34 "
357143	"HCHG BMH FLOWCYTOMETRY/ TC, 1 MARKER*R"	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	88184	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
357148	HCHG CYTOG ANAL CHROMO ABNOR SNP CGH REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81229	" $2,537.25 "	" $1,776.08 "	 $603.87 	" $2,283.53 "	" $2,207.41 "	 $608.94 	" $1,941.00 "	" $1,112.00 "	 $914.00 	 $627.21 	" $1,598.47 "	" $2,156.66 "	 $730.73 	 $791.62 	 $608.94 	" $2,283.53 "	" $2,062.78 "	" $2,156.66 "	 $603.87 	" $2,062.78 "	 $608.94 
357157	HCHG HLA II TYPING 1 LOC HR REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81382	 $505.50 	 $353.85 	 $120.31 	 $454.95 	 $439.79 	 $121.32 	 $386.71 	 $424.62 	 $424.62 	 $124.96 	 $318.47 	 $429.68 	 $145.58 	 $157.72 	 $121.32 	 $454.95 	 $410.97 	 $429.68 	 $120.31 	 $410.97 	 $121.32 
357160	HCHG MOPATH PROCEDURE LEVEL 4 REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81403	 $501.75 	 $351.23 	 $119.42 	 $451.58 	 $436.52 	 $120.42 	 $383.84 	 $421.47 	 $421.47 	 $120.42 	 $316.10 	 $426.49 	 $144.50 	 $156.55 	 $120.42 	 $451.58 	 $407.92 	 $426.49 	 $119.42 	 $407.92 	 $120.42 
357161	HCHG MOPATH PROCEDURE LEVEL 5 REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81404	 $700.50 	 $490.35 	 $166.72 	 $630.45 	 $609.44 	 $168.12 	 $535.88 	 $588.42 	 $588.42 	 $168.12 	 $441.32 	 $595.43 	 $201.74 	 $218.56 	 $168.12 	 $630.45 	 $569.51 	 $595.43 	 $166.72 	 $569.51 	 $168.12 
357163	HCHG UNLISTED MOLECULAR PATHOLOGY REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81479	 $519.00 	 $363.30 	 $123.52 	 $467.10 	 $451.53 	 $124.56 	 $397.04 	 $435.96 	 $435.96 	 $124.56 	 $326.97 	 $441.15 	 $149.47 	 $161.93 	 $124.56 	 $467.10 	 $421.95 	 $441.15 	 $123.52 	 $421.95 	 $124.56 
357194	HCHG JAK2 V617F MUTATION DETECT REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81270	 $880.00 	 $616.00 	 $209.44 	 $792.00 	 $765.60 	 $211.20 	 $673.20 	 $739.20 	 $739.20 	 $217.54 	 $554.40 	 $748.00 	 $253.44 	 $274.56 	 $211.20 	 $792.00 	 $715.44 	 $748.00 	 $209.44 	 $715.44 	 $211.20 
357209	HCHG BCR/ABL1 GENE OTHER BRK REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81208	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $158.21 	 $403.20 	 $544.00 	 $184.32 	 $199.68 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
357466	HCHG HTT GENE DETECT ABNORMAL ALLELES REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81271	" $1,200.00 "	 $840.00 	 $285.60 	" $1,080.00 "	" $1,044.00 "	 $288.00 	 $918.00 	" $1,008.00 "	 $914.00 	 $296.64 	 $756.00 	" $1,020.00 "	 $345.60 	 $374.40 	 $288.00 	" $1,080.00 "	 $975.60 	" $1,020.00 "	 $285.60 	 $975.60 	 $288.00 
357472	HCHG JAK2 V617F MUTATION DETECT PATREF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81270	 $880.00 	 $616.00 	 $209.44 	 $792.00 	 $765.60 	 $211.20 	 $673.20 	 $739.20 	 $739.20 	 $217.54 	 $554.40 	 $748.00 	 $253.44 	 $274.56 	 $211.20 	 $792.00 	 $715.44 	 $748.00 	 $209.44 	 $715.44 	 $211.20 
361060	HCHG IADNA-DNA/RNA PROBE TQ 6-11 LAB	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	87506	 $468.00 	 $327.60 	 $111.38 	 $421.20 	 $407.16 	 $112.32 	 $358.02 	 $393.12 	 $393.12 	 $115.69 	 $294.84 	 $397.80 	 $134.78 	 $146.02 	 $112.32 	 $421.20 	 $380.48 	 $397.80 	 $111.38 	 $380.48 	 $112.32 
362147	HCHG CALR GEN EXON 9 MUTATION PCR REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81219	 $480.00 	 $336.00 	 $114.24 	 $432.00 	 $417.60 	 $115.20 	 $367.20 	 $403.20 	 $403.20 	 $118.66 	 $302.40 	 $408.00 	 $138.24 	 $149.76 	 $115.20 	 $432.00 	 $390.24 	 $408.00 	 $114.24 	 $390.24 	 $115.20 
362285	HCHG JAK2 TARGETED SEQUENCE ANAL REF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81279	 $990.00 	 $693.00 	 $235.62 	 $891.00 	 $861.30 	 $237.60 	 $757.35 	 $831.60 	 $831.60 	 $244.73 	 $623.70 	 $841.50 	 $285.12 	 $308.88 	 $237.60 	 $891.00 	 $804.87 	 $841.50 	 $235.62 	 $804.87 	 $237.60 
362326	HCHG BCR/ABL1 TRANSLOCATION PATREF	0310	LABORATORY PATHOLOGICAL - GENERAL CLASSIFICATION	81206	 $900.00 	 $630.00 	 $214.20 	 $810.00 	 $783.00 	 $216.00 	 $688.50 	 $756.00 	 $756.00 	 $222.48 	 $567.00 	 $765.00 	 $259.20 	 $280.80 	 $216.00 	 $810.00 	 $731.70 	 $765.00 	 $214.20 	 $731.70 	 $216.00 
354007	HCHG CYTOPATH CONCENTRATE TECH PAT	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88108	 $511.62 	 $358.13 	 $121.77 	 $460.46 	 $445.11 	 $122.79 	 $391.39 	 $429.76 	 $429.76 	 $126.47 	 $322.32 	 $434.88 	 $147.35 	 $159.63 	 $122.79 	 $460.46 	 $415.95 	 $434.88 	 $121.77 	 $415.95 	 $122.79 
354008	HCHG CYTOPATH SMEAR OTHER SOURCE SCREEN PAT	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88160	 $294.07 	 $205.85 	 $69.99 	 $264.66 	 $255.84 	 $70.58 	 $224.96 	 $247.02 	 $247.02 	 $72.69 	 $185.26 	 $249.96 	 $84.69 	 $91.75 	 $70.58 	 $264.66 	 $239.08 	 $249.96 	 $69.99 	 $239.08 	 $70.58 
354009	HCHG CYTOPATH SMEAR OTHER SOURCE PREP PAT	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88161	 $166.86 	 $116.80 	 $39.71 	 $150.17 	 $145.17 	 $40.05 	 $127.65 	 $140.16 	 $140.16 	 $41.25 	 $105.12 	 $141.83 	 $48.06 	 $52.06 	 $40.05 	 $150.17 	 $135.66 	 $141.83 	 $39.71 	 $135.66 	 $40.05 
354010	HCHG CYTOPATH DX EVAL FNA 1ST EA SITE PAT	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88172	 $155.53 	 $108.87 	 $37.02 	 $139.98 	 $135.31 	 $37.33 	 $118.98 	 $130.65 	 $130.65 	 $38.45 	 $97.98 	 $132.20 	 $44.79 	 $48.53 	 $37.33 	 $139.98 	 $126.45 	 $132.20 	 $37.02 	 $126.45 	 $37.33 
354011	HCHG CYTOPATH EVAL FNA INTERP PAT	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88173	 $480.00 	 $336.00 	 $114.24 	 $432.00 	 $417.60 	 $115.20 	 $367.20 	 $403.20 	 $403.20 	 $118.66 	 $302.40 	 $408.00 	 $138.24 	 $149.76 	 $115.20 	 $432.00 	 $390.24 	 $408.00 	 $114.24 	 $390.24 	 $115.20 
354024	HCHG CYTOPATH FLUIDS NONGYN SMEARS PAT	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88104	 $146.90 	 $102.83 	 $34.96 	 $132.21 	 $127.80 	 $35.26 	 $112.38 	 $123.40 	 $123.40 	 $36.31 	 $92.55 	 $124.87 	 $42.31 	 $45.83 	 $35.26 	 $132.21 	 $119.43 	 $124.87 	 $34.96 	 $119.43 	 $35.26 
354048	HCHG CYTOPATH SMEAR OTHER SOURCE >5 SLIDES PAT	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88162	 $141.03 	 $98.72 	 $33.57 	 $126.93 	 $122.70 	 $33.85 	 $107.89 	 $118.47 	 $118.47 	 $34.86 	 $88.85 	 $119.88 	 $40.62 	 $44.00 	 $33.85 	 $126.93 	 $114.66 	 $119.88 	 $33.57 	 $114.66 	 $33.85 
355010	HCHG PATH MISC	0311	LABORATORY PATHOLOGICAL - CYTOLOGY		 $244.85 	 $171.40 	 $58.27 	 $220.37 	 $213.02 	 $58.76 	 $187.31 	 $205.67 	 $205.67 	 $58.76 	 $154.26 	 $208.12 	 $70.52 	 $76.39 	 $58.76 	 $220.37 	 $199.06 	 $208.12 	 $58.27 	 $199.06 	 $58.76 
356032	HCHG FLOWCYTOMETRY TC EA ADDL MARKER REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88185	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
356033	HCHG FLOWCYTOMETRY TC 1 MARKER REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88184	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
356468	HCHG CHROMOSOME ANALYSIS 20-25 CELLS REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88264	" $1,090.00 "	 $763.00 	 $259.42 	 $981.00 	 $948.30 	 $261.60 	 $833.85 	 $915.60 	 $914.00 	 $269.45 	 $686.70 	 $926.50 	 $313.92 	 $340.08 	 $261.60 	 $981.00 	 $886.17 	 $926.50 	 $259.42 	 $886.17 	 $261.60 
356470	HCHG CYTOGENETICS DNA PROBE REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88271	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $51.84 	 $56.16 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
356472	HCHG CYTOGENETICS 100-300 CELLS REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88275	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $54.38 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
357007	HCHG TISSUE CULTURE BONE MARROW REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88237	" $1,110.00 "	 $777.00 	 $264.18 	 $999.00 	 $965.70 	 $266.40 	 $849.15 	 $932.40 	 $914.00 	 $266.40 	 $699.30 	 $943.50 	 $319.68 	 $346.32 	 $266.40 	 $999.00 	 $902.43 	 $943.50 	 $264.18 	 $902.43 	 $266.40 
357052	HCHG FLOWCYTOMETRY READ 16+ MARKERS REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88189	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $72.00 	 $78.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
357384	HCHG CYTOPATH EVAL FNA INTERP PATREF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88173	 $480.00 	 $336.00 	 $114.24 	 $432.00 	 $417.60 	 $115.20 	 $367.20 	 $403.20 	 $403.20 	 $118.66 	 $302.40 	 $408.00 	 $138.24 	 $149.76 	 $115.20 	 $432.00 	 $390.24 	 $408.00 	 $114.24 	 $390.24 	 $115.20 
357385	HCHG FLOWCYTOMETRY TC 1 MARKER PATREF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88184	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
357386	HCHG FLOWCYTOMETRY TC EA ADDL MARKER PATREF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88185	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $17.30 	 $44.10 	 $59.50 	 $20.16 	 $21.84 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
357388	HCHG TISSUE CULTURE BONE MARROW PATREF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88237	" $1,110.00 "	 $777.00 	 $264.18 	 $999.00 	 $965.70 	 $266.40 	 $849.15 	 $932.40 	 $914.00 	 $266.40 	 $699.30 	 $943.50 	 $319.68 	 $346.32 	 $266.40 	 $999.00 	 $902.43 	 $943.50 	 $264.18 	 $902.43 	 $266.40 
360514	HCHG TISSUE CULTURE BONE MARROW LAB	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88237	" $1,130.69 "	 $791.48 	 $269.10 	" $1,017.62 "	 $983.70 	 $271.37 	 $864.98 	 $949.78 	 $914.00 	 $271.37 	 $712.33 	 $961.09 	 $325.64 	 $352.78 	 $271.37 	" $1,017.62 "	 $919.25 	 $961.09 	 $269.10 	 $919.25 	 $271.37 
362145	HCHG FLOWCYTOMETRY READ 2-8 MARKERS REF	0311	LABORATORY PATHOLOGICAL - CYTOLOGY	88187	" $1,310.00 "	 $917.00 	 $311.78 	" $1,179.00 "	" $1,139.70 "	 $314.40 	" $1,002.15 "	" $1,100.40 "	 $914.00 	 $323.83 	 $825.30 	" $1,113.50 "	 $377.28 	 $408.72 	 $314.40 	" $1,179.00 "	" $1,065.03 "	" $1,113.50 "	 $311.78 	" $1,065.03 "	 $314.40 
354003	HCHG PATH CONSULT INTRAOP EA ADDL BLOCK PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88332	 $141.03 	 $98.72 	 $33.57 	 $126.93 	 $122.70 	 $33.85 	 $107.89 	 $118.47 	 $118.47 	 $33.85 	 $88.85 	 $119.88 	 $40.62 	 $44.00 	 $33.85 	 $126.93 	 $114.66 	 $119.88 	 $33.57 	 $114.66 	 $33.85 
354012	HCHG DECALCIFICATION PROCEDURE PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88311	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $32.14 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
354016	HCHG PATH CONSULT INTRAOP PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88329	 $248.93 	 $174.25 	 $59.25 	 $224.04 	 $216.57 	 $59.74 	 $190.43 	 $209.10 	 $209.10 	 $59.74 	 $156.83 	 $211.59 	 $71.69 	 $77.67 	 $59.74 	 $224.04 	 $202.38 	 $211.59 	 $59.25 	 $202.38 	 $59.74 
354021	HCHG LEVEL I SURGICAL PATH PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88300	 $220.00 	 $154.00 	 $52.36 	 $198.00 	 $191.40 	 $52.80 	 $168.30 	 $184.80 	 $184.80 	 $52.80 	 $138.60 	 $187.00 	 $63.36 	 $68.64 	 $52.80 	 $198.00 	 $178.86 	 $187.00 	 $52.36 	 $178.86 	 $52.80 
354023	HCHG PATH CONSULT INTRAOP 1 BLOCK PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88331	 $264.34 	 $185.04 	 $62.91 	 $237.91 	 $229.98 	 $63.44 	 $202.22 	 $222.05 	 $222.05 	 $63.44 	 $166.53 	 $224.69 	 $76.13 	 $82.47 	 $63.44 	 $237.91 	 $214.91 	 $224.69 	 $62.91 	 $214.91 	 $63.44 
354025	HCHG SPECIAL STAINS GROUP I PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88312	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $129.60 	 $140.40 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
354026	HCHG SPECIAL STAINS GROUP II PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88313	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $55.20 	 $144.90 	 $195.50 	 $66.24 	 $71.76 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
354029	HCHG LEVEL II SURGICAL PATH PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88302	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $64.80 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
354030	HCHG LEVEL III SURGICAL PATH PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88304	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $81.60 	 $214.20 	 $289.00 	 $97.92 	 $106.08 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
354031	HCHG IMMUNOHISTO ANTIBODY 1ST STAIN PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88342	" $1,100.00 "	 $770.00 	 $261.80 	 $990.00 	 $957.00 	 $264.00 	 $841.50 	 $924.00 	 $914.00 	 $271.92 	 $693.00 	 $935.00 	 $316.80 	 $343.20 	 $264.00 	 $990.00 	 $894.30 	 $935.00 	 $261.80 	 $894.30 	 $264.00 
354032	HCHG LEVEL IV SURGICAL PATH PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88305	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $123.84 	 $134.16 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
354033	HCHG LEVEL V SURGICAL PATH PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88307	 $510.00 	 $357.00 	 $121.38 	 $459.00 	 $443.70 	 $122.40 	 $390.15 	 $428.40 	 $428.40 	 $122.40 	 $321.30 	 $433.50 	 $146.88 	 $159.12 	 $122.40 	 $459.00 	 $414.63 	 $433.50 	 $121.38 	 $414.63 	 $122.40 
354034	HCHG LEVEL VI SURGICAL PATH PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88309	 $910.00 	 $637.00 	 $216.58 	 $819.00 	 $791.70 	 $218.40 	 $696.15 	 $764.40 	 $764.40 	 $218.40 	 $573.30 	 $773.50 	 $262.08 	 $283.92 	 $218.40 	 $819.00 	 $739.83 	 $773.50 	 $216.58 	 $739.83 	 $218.40 
354058	HCHG IMMUNOHISTO ANTIBODY ADDL STAIN PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88341	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
354059	HCHG IMMUNOHISTO ANTIBODY ADDL STAIN REF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88341	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
354082	HCHG BMH/CVMC TUMOR IMMUNOHISTOCHEMISTRY/MANUAL	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88360	 $51.56 	 $36.09 	 $12.27 	 $46.40 	 $44.86 	 $12.37 	 $39.44 	 $43.31 	 $43.31 	 $12.75 	 $32.48 	 $43.83 	 $14.85 	 $16.09 	 $12.37 	 $46.40 	 $41.92 	 $43.83 	 $12.27 	 $41.92 	 $12.37 
355000	"HCHG BMH/CVMC CONSULT & REPORT, REFERRED MATERIAL, REQ PREP OF SLIDES"	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88323	 $67.08 	 $46.96 	 $15.97 	 $60.37 	 $58.36 	 $16.10 	 $51.32 	 $56.35 	 $56.35 	 $16.58 	 $42.26 	 $57.02 	 $19.32 	 $20.93 	 $16.10 	 $60.37 	 $54.54 	 $57.02 	 $15.97 	 $54.54 	 $16.10 
355001	HCHG BMH/CVMC MICROSLIDE CONSULTATION	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88323	 $82.37 	 $57.66 	 $19.60 	 $74.13 	 $71.66 	 $19.77 	 $63.01 	 $69.19 	 $69.19 	 $20.36 	 $51.89 	 $70.01 	 $23.72 	 $25.70 	 $19.77 	 $74.13 	 $66.97 	 $70.01 	 $19.60 	 $66.97 	 $19.77 
355004	HCHG BMH/CVMC IMMUNOHISTOCHEMISTRY*R	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88342	 $832.26 	 $582.58 	 $198.08 	 $749.03 	 $724.07 	 $199.74 	 $636.68 	 $699.10 	 $699.10 	 $205.73 	 $524.32 	 $707.42 	 $239.69 	 $259.67 	 $199.74 	 $749.03 	 $676.63 	 $707.42 	 $198.08 	 $676.63 	 $199.74 
355005	"HCHG BMH/CVMC IMMUNOHISTOCHEMISTRY, EACH ANTIBODY"	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88342	 $832.26 	 $582.58 	 $198.08 	 $749.03 	 $724.07 	 $199.74 	 $636.68 	 $699.10 	 $699.10 	 $205.73 	 $524.32 	 $707.42 	 $239.69 	 $259.67 	 $199.74 	 $749.03 	 $676.63 	 $707.42 	 $198.08 	 $676.63 	 $199.74 
355006	"HCHG BMH/CVMC TUMOR, IMMUNOHISTOCHEMICAL/MANUAL"	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88360	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
355007	HCHG TUMOR IMMUNOCHEM COMPUTER ASSISTED TECH PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88361	 $110.00 	 $77.00 	 $26.18 	 $99.00 	 $95.70 	 $26.40 	 $84.15 	 $92.40 	 $92.40 	 $26.40 	 $69.30 	 $93.50 	 $31.68 	 $34.32 	 $26.40 	 $99.00 	 $89.43 	 $93.50 	 $26.18 	 $89.43 	 $26.40 
355008	"HCHG BMH/CVMC IN SITU HYBRIDIZATION (EG, FISH), EACH PROBE"	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88365	 $123.82 	 $86.67 	 $29.47 	 $111.44 	 $107.72 	 $29.72 	 $94.72 	 $104.01 	 $104.01 	 $30.61 	 $78.01 	 $105.25 	 $35.66 	 $38.63 	 $29.72 	 $111.44 	 $100.67 	 $105.25 	 $29.47 	 $100.67 	 $29.72 
355009	"HCHG BMH/CVMC IN SITU HYBRIDIZATION, EACH PROBE MANUAL"	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88368	 $180.17 	 $126.12 	 $42.88 	 $162.15 	 $156.75 	 $43.24 	 $137.83 	 $151.34 	 $151.34 	 $44.54 	 $113.51 	 $153.14 	 $51.89 	 $56.21 	 $43.24 	 $162.15 	 $146.48 	 $153.14 	 $42.88 	 $146.48 	 $43.24 
356044	HCHG IMMUNOHISTO ANTIBODY 1ST STAIN REF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88342	" $1,100.00 "	 $770.00 	 $261.80 	 $990.00 	 $957.00 	 $264.00 	 $841.50 	 $924.00 	 $914.00 	 $271.92 	 $693.00 	 $935.00 	 $316.80 	 $343.20 	 $264.00 	 $990.00 	 $894.30 	 $935.00 	 $261.80 	 $894.30 	 $264.00 
357053	HCHG TUMOR IMMUNOHISTOCHEMISTRY MANUAL REF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88360	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $23.04 	 $24.96 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
357391	HCHG LEVEL IV SURGICAL PATH PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88305	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $123.84 	 $134.16 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
357396	HCHG MICROSLIDE CONSULT REQUIRING SLIDE PREP PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88323	 $130.00 	 $91.00 	 $30.94 	 $117.00 	 $113.10 	 $31.20 	 $99.45 	 $109.20 	 $109.20 	 $31.20 	 $81.90 	 $110.50 	 $37.44 	 $40.56 	 $31.20 	 $117.00 	 $105.69 	 $110.50 	 $30.94 	 $105.69 	 $31.20 
357397	HCHG IMMUNOHISTO ANTIBODY ADDL STAIN PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88341	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $77.76 	 $84.24 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
357403	HCHG TUMOR IMMUNOHISTOCHEMISTRY COMPUTER PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88361	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $54.72 	 $59.28 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
357404	HCHG IN SITU HYBRIDIZATION FISH EA ADDL PROBE STAIN PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88364	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $103.82 	 $264.60 	 $357.00 	 $120.96 	 $131.04 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
357405	HCHG IN SITU HYBRIDIZATION FISH INITIAL PROBE PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88365	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
357406	HCHG IN SITU HYBRIDIZATION COMPUTER EA MULTIPLEX PROBE PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88374	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $79.10 	 $201.60 	 $272.00 	 $92.16 	 $99.84 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
357407	HCHG IN SITU HYBRIDIZATION MANUAL EA MULTIPLEX PROBE PATREF	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88377	 $380.00 	 $266.00 	 $90.44 	 $342.00 	 $330.60 	 $91.20 	 $290.70 	 $319.20 	 $319.20 	 $93.94 	 $239.40 	 $323.00 	 $109.44 	 $118.56 	 $91.20 	 $342.00 	 $308.94 	 $323.00 	 $90.44 	 $308.94 	 $91.20 
360043	HCHG IMMUNOHISTO ANTIBODY 1ST STAIN LAB	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88342	" $1,100.00 "	 $770.00 	 $261.80 	 $990.00 	 $957.00 	 $264.00 	 $841.50 	 $924.00 	 $914.00 	 $271.92 	 $693.00 	 $935.00 	 $316.80 	 $343.20 	 $264.00 	 $990.00 	 $894.30 	 $935.00 	 $261.80 	 $894.30 	 $264.00 
362192	HCHG IN SITU HYBRIDIZATION FISH INITIAL PROBE PAT	0312	LABORATORY PATHOLOGICAL - HISTOLOGY	88365	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $89.28 	 $96.72 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
305029	HCHG MYELOGRAPHY VIA LUMBAR INJ CERVICAL	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	62302	" $1,535.10 "	" $1,074.57 "	 $365.35 	" $1,381.59 "	" $1,335.54 "	 $368.42 	" $1,174.35 "	" $1,289.48 "	" $1,289.48 "	 $368.42 	 $967.11 	" $1,304.84 "	" $1,059.22 "	" $1,228.08 "	 $368.42 	" $1,381.59 "	" $1,248.04 "	" $1,304.84 "	 $365.35 	" $1,248.04 "	 $368.42 
305030	HCHG MYELOGRAPHY VIA LUMBAR IN THORACIC	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	62303	" $1,540.00 "	" $1,078.00 "	 $366.52 	" $1,386.00 "	" $1,339.80 "	 $369.60 	" $1,178.10 "	" $1,293.60 "	" $1,293.60 "	 $369.60 	 $970.20 	" $1,309.00 "	" $1,062.60 "	" $1,232.00 "	 $369.60 	" $1,386.00 "	" $1,252.02 "	" $1,309.00 "	 $366.52 	" $1,252.02 "	 $369.60 
305031	HCHG MYELOGRAPHY VIA LUMBAR IN LUMBOSACRAL	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	62304	" $2,000.00 "	" $1,400.00 "	 $476.00 	" $1,800.00 "	" $1,740.00 "	 $480.00 	" $1,530.00 "	" $1,680.00 "	" $1,680.00 "	 $480.00 	" $1,260.00 "	" $1,700.00 "	" $1,380.00 "	" $1,600.00 "	 $480.00 	" $1,800.00 "	" $1,626.00 "	" $1,700.00 "	 $476.00 	" $1,626.00 "	 $480.00 
305032	HCHG MYELOGRAPHY VIA LUMBAR IN 2+ REGIONS	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	62305	" $1,535.10 "	" $1,074.57 "	 $365.35 	" $1,381.59 "	" $1,335.54 "	 $368.42 	" $1,174.35 "	" $1,289.48 "	" $1,289.48 "	 $368.42 	 $967.11 	" $1,304.84 "	" $1,059.22 "	" $1,228.08 "	 $368.42 	" $1,381.59 "	" $1,248.04 "	" $1,304.84 "	 $365.35 	" $1,248.04 "	 $368.42 
305039	HCHG DXA BONE DENSITY STUDY	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77085	 $237.45 	 $166.22 	 $56.51 	 $213.71 	 $206.58 	 $56.99 	 $181.65 	 $199.46 	 $199.46 	 $58.70 	 $149.59 	 $201.83 	 $163.84 	 $189.96 	 $56.99 	 $213.71 	 $193.05 	 $201.83 	 $56.51 	 $193.05 	 $56.99 
305040	HCHG VERTEBRAL FRACTURE ASSESSMENT VIA DXA	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77086	 $148.35 	 $103.85 	 $35.31 	 $133.52 	 $129.06 	 $35.60 	 $113.49 	 $124.61 	 $124.61 	 $35.60 	 $93.46 	 $126.10 	 $102.36 	 $118.68 	 $35.60 	 $133.52 	 $120.61 	 $126.10 	 $35.31 	 $120.61 	 $35.60 
343232	HCHG CVMC X-RAY EXAM OF SALIVARY DUCT	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70390	 $818.00 	 $572.60 	 $194.68 	 $736.20 	 $711.66 	 $196.32 	 $625.77 	 $687.12 	 $687.12 	 $202.21 	 $515.34 	 $695.30 	 $564.42 	 $654.40 	 $196.32 	 $736.20 	 $665.03 	 $695.30 	 $194.68 	 $665.03 	 $196.32 
343235	HCHG BMH/CVMC IVP	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74410	" $2,469.80 "	" $1,728.86 "	 $587.81 	" $2,222.82 "	" $2,148.73 "	 $592.75 	" $1,889.40 "	" $2,074.63 "	" $2,074.63 "	 $610.53 	" $1,555.97 "	" $2,099.33 "	" $1,704.16 "	" $1,975.84 "	 $592.75 	" $2,222.82 "	" $2,007.95 "	" $2,099.33 "	 $587.81 	" $2,007.95 "	 $592.75 
343237	HCHG BMH/CVMC IVP W/TOMO	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74415	" $2,963.59 "	" $2,074.51 "	 $705.33 	" $2,667.23 "	" $2,578.32 "	 $711.26 	" $2,267.15 "	" $2,489.42 "	" $2,489.42 "	 $732.60 	" $1,867.06 "	" $2,519.05 "	" $2,044.88 "	" $2,370.87 "	 $711.26 	" $2,667.23 "	" $2,409.40 "	" $2,519.05 "	 $705.33 	" $2,409.40 "	 $711.26 
362238	HCHG ESOPHAGRAM DOUBLE CONTRAST STUDY	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74221	 $460.00 	 $322.00 	 $109.48 	 $414.00 	 $400.20 	 $110.40 	 $351.90 	 $386.40 	 $386.40 	 $113.71 	 $289.80 	 $391.00 	 $317.40 	 $368.00 	 $110.40 	 $414.00 	 $373.98 	 $391.00 	 $109.48 	 $373.98 	 $110.40 
362239	HCHG UGI TRACT DOUBLE CONTRAST STUDY	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74246	 $650.00 	 $455.00 	 $154.70 	 $585.00 	 $565.50 	 $156.00 	 $497.25 	 $546.00 	 $546.00 	 $156.00 	 $409.50 	 $552.50 	 $448.50 	 $520.00 	 $156.00 	 $585.00 	 $528.45 	 $552.50 	 $154.70 	 $528.45 	 $156.00 
362240	HCHG SMALL INTESTINE FOLLOW-THROUGH	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74248	 $990.00 	 $693.00 	 $235.62 	 $891.00 	 $861.30 	 $237.60 	 $757.35 	 $831.60 	 $831.60 	 $237.60 	 $623.70 	 $841.50 	 $683.10 	 $792.00 	 $237.60 	 $891.00 	 $804.87 	 $841.50 	 $235.62 	 $804.87 	 $237.60 
4400111	HCHG CHANGE PERCUT TUBE/DRAIN CATH*	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75984	" $1,486.02 "	" $1,040.21 "	 $353.67 	" $1,337.42 "	" $1,292.84 "	 $356.64 	" $1,136.81 "	" $1,248.26 "	" $1,248.26 "	 $367.34 	 $936.19 	" $1,263.12 "	" $1,025.35 "	" $1,188.82 "	 $356.64 	" $1,337.42 "	" $1,208.13 "	" $1,263.12 "	 $353.67 	" $1,208.13 "	 $356.64 
4400226	HCHG CONTRAST XRAY THROAT/CERV ESO*	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74210	 $470.00 	 $329.00 	 $111.86 	 $423.00 	 $408.90 	 $112.80 	 $359.55 	 $394.80 	 $394.80 	 $116.18 	 $296.10 	 $399.50 	 $324.30 	 $376.00 	 $112.80 	 $423.00 	 $382.11 	 $399.50 	 $111.86 	 $382.11 	 $112.80 
4400278	HCHG DISCOGRAPHY LUMBAR SPINE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72295	" $2,915.42 "	" $2,040.79 "	 $693.87 	" $2,623.88 "	" $2,536.42 "	 $699.70 	" $2,230.30 "	" $2,448.95 "	" $2,448.95 "	 $720.69 	" $1,836.71 "	" $2,478.11 "	" $2,011.64 "	" $2,332.34 "	 $699.70 	" $2,623.88 "	" $2,370.24 "	" $2,478.11 "	 $693.87 	" $2,370.24 "	 $699.70 
4400319	HCHG ESOPHAGRAM SINGLE CONTRAST STUDY	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74220	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $158.21 	 $403.20 	 $544.00 	 $441.60 	 $512.00 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
4400328	HCHG FLUORO GUIDE VENOUS ACCESS DEVICE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77001	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $79.10 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
4400330	HCHG FLUOROSCOPE EXAMINATION	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	76000	 $940.00 	 $658.00 	 $223.72 	 $846.00 	 $817.80 	 $225.60 	 $719.10 	 $789.60 	 $789.60 	 $232.37 	 $592.20 	 $799.00 	 $648.60 	 $752.00 	 $225.60 	 $846.00 	 $764.22 	 $799.00 	 $223.72 	 $764.22 	 $225.60 
4400331	HCHG FLUORO GUIDE NEEDLE PLACEMENT	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77002	 $760.00 	 $532.00 	 $180.88 	 $684.00 	 $661.20 	 $182.40 	 $581.40 	 $638.40 	 $638.40 	 $187.87 	 $478.80 	 $646.00 	 $524.40 	 $608.00 	 $182.40 	 $684.00 	 $617.88 	 $646.00 	 $180.88 	 $617.88 	 $182.40 
4400332	HCHG FLUORO GUIDE SPINE INJECTION	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77003	 $820.00 	 $574.00 	 $195.16 	 $738.00 	 $713.40 	 $196.80 	 $627.30 	 $688.80 	 $688.80 	 $202.70 	 $516.60 	 $697.00 	 $565.80 	 $656.00 	 $196.80 	 $738.00 	 $666.66 	 $697.00 	 $195.16 	 $666.66 	 $196.80 
4400402	"HCHG JOINT SURVEY, SINGLE VIEW"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77077	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $74.16 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
4400483	HCHG MYELOGRAPHY CERV SPINE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72240	" $2,446.84 "	" $1,712.79 "	 $582.35 	" $2,202.16 "	" $2,128.75 "	 $587.24 	" $1,871.83 "	" $2,055.35 "	" $2,055.35 "	 $587.24 	" $1,541.51 "	" $2,079.81 "	" $1,688.32 "	" $1,957.47 "	 $587.24 	" $2,202.16 "	" $1,989.28 "	" $2,079.81 "	 $582.35 	" $1,989.28 "	 $587.24 
4400484	HCHG MYELOGRAPHY LUMBAR SPINE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72265	" $4,292.00 "	" $3,004.40 "	" $1,021.50 "	" $3,862.80 "	" $3,734.04 "	" $1,030.08 "	" $3,283.38 "	" $3,605.28 "	" $3,283.00 "	" $1,030.08 "	" $2,703.96 "	" $3,648.20 "	" $2,961.48 "	" $3,433.60 "	" $1,030.08 "	" $3,862.80 "	" $3,489.40 "	" $3,648.20 "	" $1,021.50 "	" $3,489.40 "	" $1,030.08 "
4400485	HCHG MYELOGRAPHY OF ENTIRE SPINE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72270	" $3,191.98 "	" $2,234.39 "	 $759.69 	" $2,872.78 "	" $2,777.02 "	 $766.08 	" $2,441.86 "	" $2,681.26 "	" $2,681.26 "	 $766.08 	" $2,010.95 "	" $2,713.18 "	" $2,202.47 "	" $2,553.58 "	 $766.08 	" $2,872.78 "	" $2,595.08 "	" $2,713.18 "	 $759.69 	" $2,595.08 "	 $766.08 
4400486	HCHG MYELOGRAPHY THORAX SPINE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72255	" $4,167.45 "	" $2,917.22 "	 $991.85 	" $3,750.71 "	" $3,625.68 "	" $1,000.19 "	" $3,188.10 "	" $3,500.66 "	" $3,283.00 "	" $1,000.19 "	" $2,625.49 "	" $3,542.33 "	" $2,875.54 "	" $3,333.96 "	" $1,000.19 "	" $3,750.71 "	" $3,388.14 "	" $3,542.33 "	 $991.85 	" $3,388.14 "	" $1,000.19 "
4400530	HCHG PERCUT XHEPATIC PORTO+DYNAMIC	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75885	" $3,309.97 "	" $2,316.98 "	 $787.77 	" $2,978.97 "	" $2,879.67 "	 $794.39 	" $2,532.13 "	" $2,780.37 "	" $2,780.37 "	 $794.39 	" $2,085.28 "	" $2,813.47 "	" $2,283.88 "	" $2,647.98 "	 $794.39 	" $2,978.97 "	" $2,691.01 "	" $2,813.47 "	 $787.77 	" $2,691.01 "	 $794.39 
4400612	"HCHG SWALLOWING FCN,W/CINE &/OR VIDEO"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74230	 $780.00 	 $546.00 	 $185.64 	 $702.00 	 $678.60 	 $187.20 	 $596.70 	 $655.20 	 $655.20 	 $187.20 	 $491.40 	 $663.00 	 $538.20 	 $624.00 	 $187.20 	 $702.00 	 $634.14 	 $663.00 	 $185.64 	 $634.14 	 $187.20 
4400632	HCHG TRANSCATHETER RX EMBOLIZATN	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75894	" $9,386.44 "	" $6,570.51 "	" $2,233.97 "	" $8,447.80 "	" $8,166.20 "	" $2,252.75 "	" $7,180.63 "	" $3,786.00 "	" $3,283.00 "	" $2,252.75 "	" $5,913.46 "	" $7,978.47 "	" $6,476.64 "	" $7,509.15 "	" $2,252.75 "	" $8,447.80 "	" $7,631.18 "	" $7,978.47 "	" $2,233.97 "	" $7,631.18 "	" $2,252.75 "
4400666	HCHG VASCULAR BIOPSY	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75970	" $7,008.23 "	" $4,905.76 "	" $1,667.96 "	" $6,307.41 "	" $6,097.16 "	" $1,681.98 "	" $5,361.30 "	" $3,786.00 "	" $3,283.00 "	" $1,681.98 "	" $4,415.18 "	" $5,957.00 "	" $4,835.68 "	" $5,606.58 "	" $1,681.98 "	" $6,307.41 "	" $5,697.69 "	" $5,957.00 "	" $1,667.96 "	" $5,697.69 "	" $1,681.98 "
4400671	HCHG VENOGRAM EXTREM BILATERAL	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75822	" $2,610.67 "	" $1,827.47 "	 $621.34 	" $2,349.60 "	" $2,271.28 "	 $626.56 	" $1,997.16 "	" $2,192.96 "	" $2,192.96 "	 $626.56 	" $1,644.72 "	" $2,219.07 "	" $1,801.36 "	" $2,088.54 "	 $626.56 	" $2,349.60 "	" $2,122.47 "	" $2,219.07 "	 $621.34 	" $2,122.47 "	 $626.56 
4400672	HCHG VENOGRAM EXTREM UNILAT	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75820	" $2,152.59 "	" $1,506.81 "	 $512.32 	" $1,937.33 "	" $1,872.75 "	 $516.62 	" $1,646.73 "	" $1,808.18 "	" $1,808.18 "	 $516.62 	" $1,356.13 "	" $1,829.70 "	" $1,485.29 "	" $1,722.07 "	 $516.62 	" $1,937.33 "	" $1,750.06 "	" $1,829.70 "	 $512.32 	" $1,750.06 "	 $516.62 
4400674	HCHG VENOGRAM HEPATIC W HEMODYNAMI*	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75889	" $8,367.85 "	" $5,857.50 "	" $1,991.55 "	" $7,531.07 "	" $7,280.03 "	" $2,008.28 "	" $6,401.41 "	" $3,786.00 "	" $3,283.00 "	" $2,008.28 "	" $5,271.75 "	" $7,112.67 "	" $5,773.82 "	" $6,694.28 "	" $2,008.28 "	" $7,531.07 "	" $6,803.06 "	" $7,112.67 "	" $1,991.55 "	" $6,803.06 "	" $2,008.28 "
4400675	HCHG INFERIOR VENOCAVOGRAM	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75825	" $3,896.95 "	" $2,727.87 "	 $927.47 	" $3,507.26 "	" $3,390.35 "	 $935.27 	" $2,981.17 "	" $3,273.44 "	" $3,273.44 "	 $963.33 	" $2,455.08 "	" $3,312.41 "	" $2,688.90 "	" $3,117.56 "	 $935.27 	" $3,507.26 "	" $3,168.22 "	" $3,312.41 "	 $927.47 	" $3,168.22 "	 $935.27 
4400681	HCHG SUPERIOR VENOCAVOGRAM	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75827	" $5,986.69 "	" $4,190.68 "	" $1,424.83 "	" $5,388.02 "	" $5,208.42 "	" $1,436.81 "	" $4,579.82 "	" $3,786.00 "	" $3,283.00 "	" $1,436.81 "	" $3,771.61 "	" $5,088.69 "	" $4,130.82 "	" $4,789.35 "	" $1,436.81 "	" $5,388.02 "	" $4,867.18 "	" $5,088.69 "	" $1,424.83 "	" $4,867.18 "	" $1,436.81 "
4400682	HCHG VENOUS SAMPLING BY CATHETER	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	75893	" $3,309.97 "	" $2,316.98 "	 $787.77 	" $2,978.97 "	" $2,879.67 "	 $794.39 	" $2,532.13 "	" $2,780.37 "	" $2,780.37 "	 $794.39 	" $2,085.28 "	" $2,813.47 "	" $2,283.88 "	" $2,647.98 "	 $794.39 	" $2,978.97 "	" $2,691.01 "	" $2,813.47 "	 $787.77 	" $2,691.01 "	 $794.39 
4400686	HCHG ABDOMEN COMP ACUTE SERIES	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74022	 $660.00 	 $462.00 	 $157.08 	 $594.00 	 $574.20 	 $158.40 	 $504.90 	 $554.40 	 $554.40 	 $163.15 	 $415.80 	 $561.00 	 $455.40 	 $528.00 	 $158.40 	 $594.00 	 $536.58 	 $561.00 	 $157.08 	 $536.58 	 $158.40 
4400687	HCHG X-RAY AC JTS	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73050	 $630.00 	 $441.00 	 $149.94 	 $567.00 	 $548.10 	 $151.20 	 $481.95 	 $529.20 	 $529.20 	 $151.20 	 $396.90 	 $535.50 	 $434.70 	 $504.00 	 $151.20 	 $567.00 	 $512.19 	 $535.50 	 $149.94 	 $512.19 	 $151.20 
4400688	HCHG X-RAY ANKLE 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73600	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $213.90 	 $248.00 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
4400689	HCHG X-RAY ANKLE 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73610	 $390.00 	 $273.00 	 $92.82 	 $351.00 	 $339.30 	 $93.60 	 $298.35 	 $327.60 	 $327.60 	 $93.60 	 $245.70 	 $331.50 	 $269.10 	 $312.00 	 $93.60 	 $351.00 	 $317.07 	 $331.50 	 $92.82 	 $317.07 	 $93.60 
4400691	"HCHG X-RAY ARM, INFANT"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73092	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $55.20 	 $144.90 	 $195.50 	 $158.70 	 $184.00 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
4400693	HCHG X-RAY BILE/PANCREAS ENDOSCOPY	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74330	" $2,593.23 "	" $1,815.26 "	 $617.19 	" $2,333.91 "	" $2,256.11 "	 $622.38 	" $1,983.82 "	" $2,178.31 "	" $2,178.31 "	 $622.38 	" $1,633.73 "	" $2,204.25 "	" $1,789.33 "	" $2,074.58 "	 $622.38 	" $2,333.91 "	" $2,108.30 "	" $2,204.25 "	 $617.19 	" $2,108.30 "	 $622.38 
4400694	HCHG X-RAY CERV SPINE 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72040	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
4400695	HCHG X-RAY CERV SPINE 4 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72050	 $620.00 	 $434.00 	 $147.56 	 $558.00 	 $539.40 	 $148.80 	 $474.30 	 $520.80 	 $520.80 	 $148.80 	 $390.60 	 $527.00 	 $427.80 	 $496.00 	 $148.80 	 $558.00 	 $504.06 	 $527.00 	 $147.56 	 $504.06 	 $148.80 
4400696	HCHG X-RAY CERV SPINE 7 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72052	 $830.00 	 $581.00 	 $197.54 	 $747.00 	 $722.10 	 $199.20 	 $634.95 	 $697.20 	 $697.20 	 $199.20 	 $522.90 	 $705.50 	 $572.70 	 $664.00 	 $199.20 	 $747.00 	 $674.79 	 $705.50 	 $197.54 	 $674.79 	 $199.20 
4400698	HCHG X-RAY CLAVICLE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73000	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $86.40 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
4400699	HCHG COLON DOUBLE CONTRAST	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74280	" $1,605.00 "	" $1,123.50 "	 $381.99 	" $1,444.50 "	" $1,396.35 "	 $385.20 	" $1,227.83 "	" $1,348.20 "	" $1,348.20 "	 $396.76 	" $1,011.15 "	" $1,364.25 "	" $1,107.45 "	" $1,284.00 "	 $385.20 	" $1,444.50 "	" $1,304.87 "	" $1,364.25 "	 $381.99 	" $1,304.87 "	 $385.20 
4400700	HCHG COLON SINGLE CONTRAST	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74270	" $1,741.00 "	" $1,218.70 "	 $414.36 	" $1,566.90 "	" $1,514.67 "	 $417.84 	" $1,331.87 "	" $1,462.44 "	" $1,462.44 "	 $430.38 	" $1,096.83 "	" $1,479.85 "	" $1,201.29 "	" $1,392.80 "	 $417.84 	" $1,566.90 "	" $1,415.43 "	" $1,479.85 "	 $414.36 	" $1,415.43 "	 $417.84 
4400703	"HCHG X-RAY CYSTOGRAM, MIN 3 VIEW"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74430	" $1,428.42 "	 $999.89 	 $339.96 	" $1,285.58 "	" $1,242.73 "	 $342.82 	" $1,092.74 "	" $1,199.87 "	" $1,199.87 "	 $342.82 	 $899.90 	" $1,214.16 "	 $985.61 	" $1,142.74 "	 $342.82 	" $1,285.58 "	" $1,161.31 "	" $1,214.16 "	 $339.96 	" $1,161.31 "	 $342.82 
4400704	HCHG X-RAY ELBOW 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73070	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
4400705	HCHG X-RAY ELBOW 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73080	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $84.00 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
4400706	HCHG X-RAY EXAM OF FINGER(S)	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73140	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $69.60 	 $182.70 	 $246.50 	 $200.10 	 $232.00 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
4400707	"HCHG X-RAY EXAM, BREAST SPECIMEN"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	76098	 $380.00 	 $266.00 	 $90.44 	 $342.00 	 $330.60 	 $91.20 	 $290.70 	 $319.20 	 $319.20 	 $91.20 	 $239.40 	 $323.00 	 $262.20 	 $304.00 	 $91.20 	 $342.00 	 $308.94 	 $323.00 	 $90.44 	 $308.94 	 $91.20 
4400709	HCHG X-RAY FACIAL BONES <3 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70140	 $700.00 	 $490.00 	 $166.60 	 $630.00 	 $609.00 	 $168.00 	 $535.50 	 $588.00 	 $588.00 	 $168.00 	 $441.00 	 $595.00 	 $483.00 	 $560.00 	 $168.00 	 $630.00 	 $569.10 	 $595.00 	 $166.60 	 $569.10 	 $168.00 
4400710	HCHG X-RAY FACIAL BONES 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70150	 $700.00 	 $490.00 	 $166.60 	 $630.00 	 $609.00 	 $168.00 	 $535.50 	 $588.00 	 $588.00 	 $168.00 	 $441.00 	 $595.00 	 $483.00 	 $560.00 	 $168.00 	 $630.00 	 $569.10 	 $595.00 	 $166.60 	 $569.10 	 $168.00 
4400712	"HCHG X-RAY FISTULA,ABSCESS,SINUS T*"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	76080	" $2,258.84 "	" $1,581.19 "	 $537.60 	" $2,032.96 "	" $1,965.19 "	 $542.12 	" $1,728.01 "	" $1,897.43 "	" $1,897.43 "	 $542.12 	" $1,423.07 "	" $1,920.01 "	" $1,558.60 "	" $1,807.07 "	 $542.12 	" $2,032.96 "	" $1,836.44 "	" $1,920.01 "	 $537.60 	" $1,836.44 "	 $542.12 
4400713	HCHG X-RAY FOOT 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73620	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $62.40 	 $163.80 	 $221.00 	 $179.40 	 $208.00 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
4400714	HCHG X-RAY FOOT 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73630	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
4400717	HCHG X-RAY FOREARM 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73090	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $81.60 	 $214.20 	 $289.00 	 $234.60 	 $272.00 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
4400721	HCHG X-RAY HAND 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73120	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
4400722	HCHG X-RAY HAND 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73130	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $76.80 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
4400723	HCHG X-RAY HEEL	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73650	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $88.80 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
4400728	HCHG X-RAY HUMERUS	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73060	 $390.00 	 $273.00 	 $92.82 	 $351.00 	 $339.30 	 $93.60 	 $298.35 	 $327.60 	 $327.60 	 $93.60 	 $245.70 	 $331.50 	 $269.10 	 $312.00 	 $93.60 	 $351.00 	 $317.07 	 $331.50 	 $92.82 	 $317.07 	 $93.60 
4400729	HCHG X-RAY HYSTEROSALPINGOGRAM	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74740	" $2,142.63 "	" $1,499.84 "	 $509.95 	" $1,928.37 "	" $1,864.09 "	 $514.23 	" $1,639.11 "	" $1,799.81 "	" $1,799.81 "	 $514.23 	" $1,349.86 "	" $1,821.24 "	" $1,478.41 "	" $1,714.10 "	 $514.23 	" $1,928.37 "	" $1,741.96 "	" $1,821.24 "	 $509.95 	" $1,741.96 "	 $514.23 
4400731	HCHG X-RAY JAW <4 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70100	 $771.00 	 $539.70 	 $183.50 	 $693.90 	 $670.77 	 $185.04 	 $589.82 	 $647.64 	 $647.64 	 $185.04 	 $485.73 	 $655.35 	 $531.99 	 $616.80 	 $185.04 	 $693.90 	 $626.82 	 $655.35 	 $183.50 	 $626.82 	 $185.04 
4400732	HCHG X-RAY JAW 4+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70110	" $1,700.00 "	" $1,190.00 "	 $404.60 	" $1,530.00 "	" $1,479.00 "	 $408.00 	" $1,300.50 "	" $1,428.00 "	" $1,428.00 "	 $408.00 	" $1,071.00 "	" $1,445.00 "	" $1,173.00 "	" $1,360.00 "	 $408.00 	" $1,530.00 "	" $1,382.10 "	" $1,445.00 "	 $404.60 	" $1,382.10 "	 $408.00 
4400733	HCHG X-RAY KNEE 1 OR 2 VIEW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73560	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $76.80 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
4400734	HCHG X-RAY KNEE 3 VIEW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73562	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $84.00 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
4400735	HCHG X-RAY KNEE 4+ VIEW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73564	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
4400736	HCHG X-RAY KNEE BILAT STANDING	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73565	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
4400737	"HCHG X-RAY LEG, INFANT"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73592	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $213.90 	 $248.00 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
4400738	HCHG X-RAY LUMBAR SPINE 2/3 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72100	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $310.50 	 $360.00 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
4400739	HCHG X-RAY LUMBAR SPINE 4 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72110	 $650.00 	 $455.00 	 $154.70 	 $585.00 	 $565.50 	 $156.00 	 $497.25 	 $546.00 	 $546.00 	 $156.00 	 $409.50 	 $552.50 	 $448.50 	 $520.00 	 $156.00 	 $585.00 	 $528.45 	 $552.50 	 $154.70 	 $528.45 	 $156.00 
4400740	HCHG X-RAY LUMBAR SPINE 6+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72114	" $1,050.96 "	 $735.67 	 $250.13 	 $945.86 	 $914.34 	 $252.23 	 $803.98 	 $882.81 	 $882.81 	 $252.23 	 $662.10 	 $893.32 	 $725.16 	 $840.77 	 $252.23 	 $945.86 	 $854.43 	 $893.32 	 $250.13 	 $854.43 	 $252.23 
4400741	HCHG X-RAY LUMBAR SPINE FLEX/EXTEN	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72120	 $797.73 	 $558.41 	 $189.86 	 $717.96 	 $694.03 	 $191.46 	 $610.26 	 $670.09 	 $670.09 	 $191.46 	 $502.57 	 $678.07 	 $550.43 	 $638.18 	 $191.46 	 $717.96 	 $648.55 	 $678.07 	 $189.86 	 $648.55 	 $191.46 
4400744	HCHG X-RAY MIDDLE EAR	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70134	" $1,358.59 "	 $951.01 	 $323.34 	" $1,222.73 "	" $1,181.97 "	 $326.06 	" $1,039.32 "	" $1,141.22 "	" $1,141.22 "	 $326.06 	 $855.91 	" $1,154.80 "	 $937.43 	" $1,086.87 "	 $326.06 	" $1,222.73 "	" $1,104.53 "	" $1,154.80 "	 $323.34 	" $1,104.53 "	 $326.06 
4400745	HCHG X-RAY NASAL BONES	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70160	 $562.00 	 $393.40 	 $133.76 	 $505.80 	 $488.94 	 $134.88 	 $429.93 	 $472.08 	 $472.08 	 $134.88 	 $354.06 	 $477.70 	 $387.78 	 $449.60 	 $134.88 	 $505.80 	 $456.91 	 $477.70 	 $133.76 	 $456.91 	 $134.88 
4400746	HCHG X-RAY NECK SOFT TISSUE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70360	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $76.80 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
4400748	HCHG X-RAY OPER CHOLANGIO ADDNL SET	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74301	 $238.89 	 $167.22 	 $56.86 	 $215.00 	 $207.83 	 $57.33 	 $182.75 	 $200.67 	 $200.67 	 $57.33 	 $150.50 	 $203.06 	 $164.83 	 $191.11 	 $57.33 	 $215.00 	 $194.22 	 $203.06 	 $56.86 	 $194.22 	 $57.33 
4400749	HCHG X-RAY OPER CHOLANGIOGRAM	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74300	" $1,860.00 "	" $1,302.00 "	 $442.68 	" $1,674.00 "	" $1,618.20 "	 $446.40 	" $1,422.90 "	" $1,562.40 "	" $1,562.40 "	 $446.40 	" $1,171.80 "	" $1,581.00 "	" $1,283.40 "	" $1,488.00 "	 $446.40 	" $1,674.00 "	" $1,512.18 "	" $1,581.00 "	 $442.68 	" $1,512.18 "	 $446.40 
4400750	HCHG X-RAY OPTIC FORAMEN	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70190	 $777.81 	 $544.47 	 $185.12 	 $700.03 	 $676.69 	 $186.67 	 $595.02 	 $653.36 	 $653.36 	 $186.67 	 $490.02 	 $661.14 	 $536.69 	 $622.25 	 $186.67 	 $700.03 	 $632.36 	 $661.14 	 $185.12 	 $632.36 	 $186.67 
4400751	HCHG X-RAY ORBITS	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70200	" $1,499.99 "	" $1,049.99 "	 $357.00 	" $1,349.99 "	" $1,304.99 "	 $360.00 	" $1,147.49 "	" $1,259.99 "	" $1,259.99 "	 $360.00 	 $944.99 	" $1,274.99 "	" $1,034.99 "	" $1,199.99 "	 $360.00 	" $1,349.99 "	" $1,219.49 "	" $1,274.99 "	 $357.00 	" $1,219.49 "	 $360.00 
4400752	HCHG X-RAY PELVIS 1/2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72170	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $88.80 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
4400753	HCHG X-RAY PELVIS 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72190	 $652.00 	 $456.40 	 $155.18 	 $586.80 	 $567.24 	 $156.48 	 $498.78 	 $547.68 	 $547.68 	 $156.48 	 $410.76 	 $554.20 	 $449.88 	 $521.60 	 $156.48 	 $586.80 	 $530.08 	 $554.20 	 $155.18 	 $530.08 	 $156.48 
4400758	HCHG X-RAY RETROGRADE PYELOGRAM	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74420	" $2,192.52 "	" $1,534.76 "	 $521.82 	" $1,973.27 "	" $1,907.49 "	 $526.20 	" $1,677.28 "	" $1,841.72 "	" $1,841.72 "	 $526.20 	" $1,381.29 "	" $1,863.64 "	" $1,512.84 "	" $1,754.02 "	 $526.20 	" $1,973.27 "	" $1,782.52 "	" $1,863.64 "	 $521.82 	" $1,782.52 "	 $526.20 
4400759	HCHG X-RAY RIBS 2 VW UNILAT	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	71100	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $76.80 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
4400761	"HCHG X-RAY RIBS, CHEST 3+ VW"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	71101	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $88.80 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
4400762	"HCHG X-RAY RIBS, CHEST 4+ VW"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	71111	 $950.00 	 $665.00 	 $226.10 	 $855.00 	 $826.50 	 $228.00 	 $726.75 	 $798.00 	 $798.00 	 $228.00 	 $598.50 	 $807.50 	 $655.50 	 $760.00 	 $228.00 	 $855.00 	 $772.35 	 $807.50 	 $226.10 	 $772.35 	 $228.00 
4400763	HCHG X-RAY SACROILIAC JTS <3 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72200	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $62.40 	 $163.80 	 $221.00 	 $179.40 	 $208.00 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
4400764	HCHG X-RAY SACROILIAC JTS 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72202	 $590.00 	 $413.00 	 $140.42 	 $531.00 	 $513.30 	 $141.60 	 $451.35 	 $495.60 	 $495.60 	 $141.60 	 $371.70 	 $501.50 	 $407.10 	 $472.00 	 $141.60 	 $531.00 	 $479.67 	 $501.50 	 $140.42 	 $479.67 	 $141.60 
4400765	HCHG X-RAY SACRUM/COCCYX 2+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72220	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
4400766	HCHG X-RAY SCAPULA	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73010	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $153.60 	 $403.20 	 $544.00 	 $441.60 	 $512.00 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
4400767	HCHG X-RAY SHOULDER 1 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73020	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $96.00 	 $252.00 	 $340.00 	 $276.00 	 $320.00 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
4400768	HCHG X-RAY SHOULDER 2+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73030	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $310.50 	 $360.00 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
4400769	HCHG X-RAY SIALOGRAM	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70390	 $818.00 	 $572.60 	 $194.68 	 $736.20 	 $711.66 	 $196.32 	 $625.77 	 $687.12 	 $687.12 	 $196.32 	 $515.34 	 $695.30 	 $564.42 	 $654.40 	 $196.32 	 $736.20 	 $665.03 	 $695.30 	 $194.68 	 $665.03 	 $196.32 
4400770	HCHG X-RAY SINUSES <3 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70210	 $580.00 	 $406.00 	 $138.04 	 $522.00 	 $504.60 	 $139.20 	 $443.70 	 $487.20 	 $487.20 	 $139.20 	 $365.40 	 $493.00 	 $400.20 	 $464.00 	 $139.20 	 $522.00 	 $471.54 	 $493.00 	 $138.04 	 $471.54 	 $139.20 
4400771	HCHG X-RAY SINUSES 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70220	 $750.00 	 $525.00 	 $178.50 	 $675.00 	 $652.50 	 $180.00 	 $573.75 	 $630.00 	 $630.00 	 $180.00 	 $472.50 	 $637.50 	 $517.50 	 $600.00 	 $180.00 	 $675.00 	 $609.75 	 $637.50 	 $178.50 	 $609.75 	 $180.00 
4400772	HCHG X-RAY SKULL <4 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70250	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $153.60 	 $403.20 	 $544.00 	 $441.60 	 $512.00 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
4400773	HCHG X-RAY SKULL 4+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70260	 $939.95 	 $657.97 	 $223.71 	 $845.96 	 $817.76 	 $225.59 	 $719.06 	 $789.56 	 $789.56 	 $225.59 	 $592.17 	 $798.96 	 $648.57 	 $751.96 	 $225.59 	 $845.96 	 $764.18 	 $798.96 	 $223.71 	 $764.18 	 $225.59 
4400774	HCHG SMALL INTESTINE DOUBLE CONTRAST	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74251	" $2,134.63 "	" $1,494.24 "	 $508.04 	" $1,921.17 "	" $1,857.13 "	 $512.31 	" $1,632.99 "	" $1,793.09 "	" $1,793.09 "	 $512.31 	" $1,344.82 "	" $1,814.44 "	" $1,472.89 "	" $1,707.70 "	 $512.31 	" $1,921.17 "	" $1,735.45 "	" $1,814.44 "	 $508.04 	" $1,735.45 "	 $512.31 
4400775	HCHG X-RAY SPINE ONE VIEW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72020	 $574.79 	 $402.35 	 $136.80 	 $517.31 	 $500.07 	 $137.95 	 $439.71 	 $482.82 	 $482.82 	 $137.95 	 $362.12 	 $488.57 	 $396.61 	 $459.83 	 $137.95 	 $517.31 	 $467.30 	 $488.57 	 $136.80 	 $467.30 	 $137.95 
4400777	HCHG X-RAY STERNO-CLAVICLUAR JT	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	71130	 $685.79 	 $480.05 	 $163.22 	 $617.21 	 $596.64 	 $164.59 	 $524.63 	 $576.06 	 $576.06 	 $164.59 	 $432.05 	 $582.92 	 $473.20 	 $548.63 	 $164.59 	 $617.21 	 $557.55 	 $582.92 	 $163.22 	 $557.55 	 $164.59 
4400778	HCHG X-RAY STERNUM 2+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	71120	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $153.60 	 $403.20 	 $544.00 	 $441.60 	 $512.00 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
4400780	HCHG X-RAY THORACIC SPINE 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72070	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
4400781	HCHG X-RAY THORACIC SPINE 4 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72074	" $1,040.00 "	 $728.00 	 $247.52 	 $936.00 	 $904.80 	 $249.60 	 $795.60 	 $873.60 	 $873.60 	 $249.60 	 $655.20 	 $884.00 	 $717.60 	 $832.00 	 $249.60 	 $936.00 	 $845.52 	 $884.00 	 $247.52 	 $845.52 	 $249.60 
4400782	HCHG X-RAY THORACIC SPINE+SWIM 3 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72072	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $86.40 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
4400783	HCHG X-RAY THOR-LUMB SP 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72080	 $500.00 	 $350.00 	 $119.00 	 $450.00 	 $435.00 	 $120.00 	 $382.50 	 $420.00 	 $420.00 	 $120.00 	 $315.00 	 $425.00 	 $345.00 	 $400.00 	 $120.00 	 $450.00 	 $406.50 	 $425.00 	 $119.00 	 $406.50 	 $120.00 
4400784	"HCHG X-RAY TIB + FIB, 2VW"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73590	 $440.00 	 $308.00 	 $104.72 	 $396.00 	 $382.80 	 $105.60 	 $336.60 	 $369.60 	 $369.60 	 $105.60 	 $277.20 	 $374.00 	 $303.60 	 $352.00 	 $105.60 	 $396.00 	 $357.72 	 $374.00 	 $104.72 	 $357.72 	 $105.60 
4400785	HCHG X-RAY TMJ BILAT	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70330	 $564.43 	 $395.10 	 $134.33 	 $507.99 	 $491.05 	 $135.46 	 $431.79 	 $474.12 	 $474.12 	 $135.46 	 $355.59 	 $479.77 	 $389.46 	 $451.54 	 $135.46 	 $507.99 	 $458.88 	 $479.77 	 $134.33 	 $458.88 	 $135.46 
4400786	HCHG X-RAY TOE(S)	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73660	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $86.40 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
4400790	HCHG UGI TRACT SINGLE CONTRAST STUDY	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74240	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $144.00 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
4400793	HCHG X-RAY URETHROCYSTOGRAM	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74450	" $1,469.05 "	" $1,028.34 "	 $349.63 	" $1,322.15 "	" $1,278.07 "	 $352.57 	" $1,123.82 "	" $1,234.00 "	" $1,234.00 "	 $352.57 	 $925.50 	" $1,248.69 "	" $1,013.64 "	" $1,175.24 "	 $352.57 	" $1,322.15 "	" $1,194.34 "	" $1,248.69 "	 $349.63 	" $1,194.34 "	 $352.57 
4400794	HCHG X-RAY URETHROCYSTOGRAM+VOIDING S&I	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74455	" $2,263.00 "	" $1,584.10 "	 $538.59 	" $2,036.70 "	" $1,968.81 "	 $543.12 	" $1,731.20 "	" $1,900.92 "	" $1,900.92 "	 $543.12 	" $1,425.69 "	" $1,923.55 "	" $1,561.47 "	" $1,810.40 "	 $543.12 	" $2,036.70 "	" $1,839.82 "	" $1,923.55 "	 $538.59 	" $1,839.82 "	 $543.12 
4400795	HCHG X-RAY WRIST 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73100	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $62.40 	 $163.80 	 $221.00 	 $179.40 	 $208.00 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
4400796	HCHG X-RAY WRIST 3+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73110	 $330.00 	 $231.00 	 $78.54 	 $297.00 	 $287.10 	 $79.20 	 $252.45 	 $277.20 	 $277.20 	 $79.20 	 $207.90 	 $280.50 	 $227.70 	 $264.00 	 $79.20 	 $297.00 	 $268.29 	 $280.50 	 $78.54 	 $268.29 	 $79.20 
4400800	HCHG SMALL INTESTINE SINGLE CONTRAST	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74250	" $1,090.00 "	 $763.00 	 $259.42 	 $981.00 	 $948.30 	 $261.60 	 $833.85 	 $915.60 	 $915.60 	 $261.60 	 $686.70 	 $926.50 	 $752.10 	 $872.00 	 $261.60 	 $981.00 	 $886.17 	 $926.50 	 $259.42 	 $886.17 	 $261.60 
4400802	HCHG X-RAYS FOR BONE AGE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77072	 $530.00 	 $371.00 	 $126.14 	 $477.00 	 $461.10 	 $127.20 	 $405.45 	 $445.20 	 $445.20 	 $127.20 	 $333.90 	 $450.50 	 $365.70 	 $424.00 	 $127.20 	 $477.00 	 $430.89 	 $450.50 	 $126.14 	 $430.89 	 $127.20 
4400803	"HCHG X-RAYS, BONE LENGTH STUDIES"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77073	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
4400804	"HCHG X-RAYS, BONE SURVEY COMPLETE"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77075	" $1,490.00 "	" $1,043.00 "	 $354.62 	" $1,341.00 "	" $1,296.30 "	 $357.60 	" $1,139.85 "	" $1,251.60 "	" $1,251.60 "	 $357.60 	 $938.70 	" $1,266.50 "	" $1,028.10 "	" $1,192.00 "	 $357.60 	" $1,341.00 "	" $1,211.37 "	" $1,266.50 "	 $354.62 	" $1,211.37 "	 $357.60 
4400805	"HCHG X-RAYS, BONE SURVEY, INFANT"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	77076	" $1,426.64 "	 $998.65 	 $339.54 	" $1,283.98 "	" $1,241.18 "	 $342.39 	" $1,091.38 "	" $1,198.38 "	" $1,198.38 "	 $342.39 	 $898.78 	" $1,212.64 "	 $984.38 	" $1,141.31 "	 $342.39 	" $1,283.98 "	" $1,159.86 "	" $1,212.64 "	 $339.54 	" $1,159.86 "	 $342.39 
4400881	HCHG X-RAY SALIVARY GLAND	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70380	 $821.94 	 $575.36 	 $195.62 	 $739.75 	 $715.09 	 $197.27 	 $628.78 	 $690.43 	 $690.43 	 $197.27 	 $517.82 	 $698.65 	 $567.14 	 $657.55 	 $197.27 	 $739.75 	 $668.24 	 $698.65 	 $195.62 	 $668.24 	 $197.27 
4400913	HCHG X-RAY GUIDE ENTEROCLYSIS TUBE	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74355	 $651.86 	 $456.30 	 $155.14 	 $586.67 	 $567.12 	 $156.45 	 $498.67 	 $547.56 	 $547.56 	 $156.45 	 $410.67 	 $554.08 	 $449.78 	 $521.49 	 $156.45 	 $586.67 	 $529.96 	 $554.08 	 $155.14 	 $529.96 	 $156.45 
4400915	"HCHG INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, 1ST LEVEL"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	64490	" $4,307.00 "	" $3,014.90 "	" $1,025.07 "	" $3,876.30 "	" $3,747.09 "	" $1,033.68 "	" $3,294.86 "	" $3,617.88 "	" $3,283.00 "	" $1,064.69 "	" $2,713.41 "	" $3,660.95 "	" $2,971.83 "	" $3,445.60 "	" $1,033.68 "	" $3,876.30 "	" $3,501.59 "	" $3,660.95 "	" $1,025.07 "	" $3,501.59 "	" $1,033.68 "
4400916	"HCHG INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, 2ND LEVEL"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	64491	" $2,328.00 "	" $1,629.60 "	 $554.06 	" $2,095.20 "	" $2,025.36 "	 $558.72 	" $1,780.92 "	" $1,955.52 "	" $1,955.52 "	 $575.48 	" $1,466.64 "	" $1,978.80 "	" $1,606.32 "	" $1,862.40 "	 $558.72 	" $2,095.20 "	" $1,892.66 "	" $1,978.80 "	 $554.06 	" $1,892.66 "	 $558.72 
4400917	"HCHG INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, ADD LEVEL"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	64492	" $1,343.00 "	 $940.10 	 $319.63 	" $1,208.70 "	" $1,168.41 "	 $322.32 	" $1,027.40 "	" $1,128.12 "	" $1,128.12 "	 $331.99 	 $846.09 	" $1,141.55 "	 $926.67 	" $1,074.40 "	 $322.32 	" $1,208.70 "	" $1,091.86 "	" $1,141.55 "	 $319.63 	" $1,091.86 "	 $322.32 
4400919	"HCHG INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, 2ND LEVEL"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	64494	" $1,790.58 "	" $1,253.41 "	 $426.16 	" $1,611.52 "	" $1,557.80 "	 $429.74 	" $1,369.79 "	" $1,504.09 "	" $1,504.09 "	 $442.63 	" $1,128.07 "	" $1,521.99 "	" $1,235.50 "	" $1,432.46 "	 $429.74 	" $1,611.52 "	" $1,455.74 "	" $1,521.99 "	 $426.16 	" $1,455.74 "	 $429.74 
4400920	"HCHG INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, ADD LEVEL"	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	64495	" $1,790.58 "	" $1,253.41 "	 $426.16 	" $1,611.52 "	" $1,557.80 "	 $429.74 	" $1,369.79 "	" $1,504.09 "	" $1,504.09 "	 $442.63 	" $1,128.07 "	" $1,521.99 "	" $1,235.50 "	" $1,432.46 "	 $429.74 	" $1,611.52 "	" $1,455.74 "	" $1,521.99 "	 $426.16 	" $1,455.74 "	 $429.74 
4400986	HCHG XRAY SKULL MRI SCREEN	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	70250	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $153.60 	 $403.20 	 $544.00 	 $441.60 	 $512.00 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
4401022	HCHG XRAY ABDOMEN 1 VIEW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74018	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $296.70 	 $344.00 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
4401023	HCHG XRAY ABDOMEN 2 VIEWS	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74019	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $310.50 	 $360.00 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
4401024	HCHG XRAY ABDOMEN 3/MORE VIEWS	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	74021	" $1,115.00 "	 $780.50 	 $265.37 	" $1,003.50 "	 $970.05 	 $267.60 	 $852.98 	 $936.60 	 $936.60 	 $267.60 	 $702.45 	 $947.75 	 $769.35 	 $892.00 	 $267.60 	" $1,003.50 "	 $906.50 	 $947.75 	 $265.37 	 $906.50 	 $267.60 
4401615	HCHG XR SPINE ENTIRE L/T ONE VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72081	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $110.40 	 $128.00 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
4401616	HCHG XR SPINE ENTIRE L/T 2/3 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72082	 $251.73 	 $176.21 	 $59.91 	 $226.56 	 $219.01 	 $60.42 	 $192.57 	 $211.45 	 $211.45 	 $60.42 	 $158.59 	 $213.97 	 $173.69 	 $201.38 	 $60.42 	 $226.56 	 $204.66 	 $213.97 	 $59.91 	 $204.66 	 $60.42 
4401617	HCHG XR SPINE ENTIRE L/T 4/5 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72083	 $479.93 	 $335.95 	 $114.22 	 $431.94 	 $417.54 	 $115.18 	 $367.15 	 $403.14 	 $403.14 	 $115.18 	 $302.36 	 $407.94 	 $331.15 	 $383.94 	 $115.18 	 $431.94 	 $390.18 	 $407.94 	 $114.22 	 $390.18 	 $115.18 
4401618	HCHG XR SPINE ENTIRE L/T 6/MORE VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	72084	 $479.93 	 $335.95 	 $114.22 	 $431.94 	 $417.54 	 $115.18 	 $367.15 	 $403.14 	 $403.14 	 $115.18 	 $302.36 	 $407.94 	 $331.15 	 $383.94 	 $115.18 	 $431.94 	 $390.18 	 $407.94 	 $114.22 	 $390.18 	 $115.18 
4401619	HCHG XRAY HIP UNI W/WO PELVIS 1 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73501	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $43.20 	 $113.40 	 $153.00 	 $124.20 	 $144.00 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
4401620	HCHG XRAY HIP UNI W/WO PELVIS 2-3 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73502	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
4401621	HCHG XRAY HIP UNI W/WO PELVIS 4+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73503	 $251.73 	 $176.21 	 $59.91 	 $226.56 	 $219.01 	 $60.42 	 $192.57 	 $211.45 	 $211.45 	 $60.42 	 $158.59 	 $213.97 	 $173.69 	 $201.38 	 $60.42 	 $226.56 	 $204.66 	 $213.97 	 $59.91 	 $204.66 	 $60.42 
4401622	HCHG XRAY HIP BIL W/WO PELVIS 2 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73521	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $213.90 	 $248.00 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
4401623	HCHG XRAY HIP BIL W/WO PELVIS 3-4 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73522	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $60.00 	 $157.50 	 $212.50 	 $172.50 	 $200.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
4401624	HCHG XRAY HIP BIL W/WO PELVIS 5+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73523	 $479.93 	 $335.95 	 $114.22 	 $431.94 	 $417.54 	 $115.18 	 $367.15 	 $403.14 	 $403.14 	 $115.18 	 $302.36 	 $407.94 	 $331.15 	 $383.94 	 $115.18 	 $431.94 	 $390.18 	 $407.94 	 $114.22 	 $390.18 	 $115.18 
4401625	HCHG XRAY FEMUR 1 VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73551	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $110.40 	 $128.00 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
4401626	HCHG XRAY FEMUR 2+ VW	0320	RADIOLOGY - DIAGNOSTIC - GENERAL CLASSIFICATION	73552	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
4400158	HCHG ARTHROGRAM OF ELBOW	0322	RADIOLOGY - DIAGNOSTIC - ARTHROGRAPHY	73085	" $1,820.42 "	" $1,274.29 "	 $433.26 	" $1,638.38 "	" $1,583.77 "	 $436.90 	" $1,392.62 "	" $1,529.15 "	" $1,529.15 "	 $450.01 	" $1,146.86 "	" $1,547.36 "	" $1,256.09 "	" $1,456.34 "	 $436.90 	" $1,638.38 "	" $1,480.00 "	" $1,547.36 "	 $433.26 	" $1,480.00 "	 $436.90 
4400159	HCHG ARTHROGRAM OF HIP	0322	RADIOLOGY - DIAGNOSTIC - ARTHROGRAPHY	73525	" $1,340.00 "	 $938.00 	 $318.92 	" $1,206.00 "	" $1,165.80 "	 $321.60 	" $1,025.10 "	" $1,125.60 "	" $1,125.60 "	 $331.25 	 $844.20 	" $1,139.00 "	 $924.60 	" $1,072.00 "	 $321.60 	" $1,206.00 "	" $1,089.42 "	" $1,139.00 "	 $318.92 	" $1,089.42 "	 $321.60 
4400160	HCHG ARTHROGRAM OF KNEE JOINT	0322	RADIOLOGY - DIAGNOSTIC - ARTHROGRAPHY	73580	" $1,820.42 "	" $1,274.29 "	 $433.26 	" $1,638.38 "	" $1,583.77 "	 $436.90 	" $1,392.62 "	" $1,529.15 "	" $1,529.15 "	 $450.01 	" $1,146.86 "	" $1,547.36 "	" $1,256.09 "	" $1,456.34 "	 $436.90 	" $1,638.38 "	" $1,480.00 "	" $1,547.36 "	 $433.26 	" $1,480.00 "	 $436.90 
4400161	HCHG ARTHROGRAM OF SHOULDER	0322	RADIOLOGY - DIAGNOSTIC - ARTHROGRAPHY	73040	" $1,880.00 "	" $1,316.00 "	 $447.44 	" $1,692.00 "	" $1,635.60 "	 $451.20 	" $1,438.20 "	" $1,579.20 "	" $1,579.20 "	 $464.74 	" $1,184.40 "	" $1,598.00 "	" $1,297.20 "	" $1,504.00 "	 $451.20 	" $1,692.00 "	" $1,528.44 "	" $1,598.00 "	 $447.44 	" $1,528.44 "	 $451.20 
4400162	HCHG ARTHROGRAM OF WRIST	0322	RADIOLOGY - DIAGNOSTIC - ARTHROGRAPHY	73115	 $852.15 	 $596.51 	 $202.81 	 $766.94 	 $741.37 	 $204.52 	 $651.89 	 $715.81 	 $715.81 	 $210.65 	 $536.85 	 $724.33 	 $587.98 	 $681.72 	 $204.52 	 $766.94 	 $692.80 	 $724.33 	 $202.81 	 $692.80 	 $204.52 
343208	"HCHG BMH/CVMC NON-SELECTIVE CATH PLACE,THORACIC AORTA,W/ANGIOGRAPHY"	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	36221	" $8,930.91 "	" $6,251.64 "	" $2,125.56 "	" $8,037.82 "	" $7,769.89 "	" $2,143.42 "	" $6,832.15 "	" $3,786.00 "	" $3,283.00 "	" $2,207.72 "	" $5,626.47 "	" $7,591.27 "	" $6,162.33 "	" $7,144.73 "	" $2,143.42 "	" $8,037.82 "	" $7,260.83 "	" $7,591.27 "	" $2,125.56 "	" $7,260.83 "	" $2,143.42 "
343210	"HCHG BMH/CVMC SELECTIVE CATH PLACE,COMMON CAROTID/INNOMINATE ARTERY"	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	36222	" $8,930.91 "	" $6,251.64 "	" $2,125.56 "	" $8,037.82 "	" $7,769.89 "	" $2,143.42 "	" $6,832.15 "	" $3,786.00 "	" $3,283.00 "	" $2,207.72 "	" $5,626.47 "	" $7,591.27 "	" $6,162.33 "	" $7,144.73 "	" $2,143.42 "	" $8,037.82 "	" $7,260.83 "	" $7,591.27 "	" $2,125.56 "	" $7,260.83 "	" $2,143.42 "
343213	"HCHG BMH/CVMC SELECTIVE CATH PLACEMENT,COMMON CAROTID/INNOMINATE ARTER"	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	36223	" $8,930.91 "	" $6,251.64 "	" $2,125.56 "	" $8,037.82 "	" $7,769.89 "	" $2,143.42 "	" $6,832.15 "	" $3,786.00 "	" $3,283.00 "	" $2,207.72 "	" $5,626.47 "	" $7,591.27 "	" $6,162.33 "	" $7,144.73 "	" $2,143.42 "	" $8,037.82 "	" $7,260.83 "	" $7,591.27 "	" $2,125.56 "	" $7,260.83 "	" $2,143.42 "
343215	"HCHG BMH/CVMC SELECTIVE CATHETER PLACEMENT, INTERNAL CAROTID ARTERY"	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	36224	" $14,606.00 "	" $10,224.20 "	" $3,283.00 "	" $13,145.40 "	" $12,707.22 "	" $3,505.44 "	" $11,173.59 "	" $3,786.00 "	" $3,283.00 "	" $3,610.60 "	" $9,201.78 "	" $12,415.10 "	" $10,078.14 "	" $11,684.80 "	" $3,505.44 "	" $13,145.40 "	" $11,874.68 "	" $12,415.10 "	" $3,476.23 "	" $11,874.68 "	" $3,505.44 "
343217	"HCHG BMH/CVMC PLACE CATHETER SUBCLAVIAN OR INNOMINATE ARTERY, UNILATER"	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	36225	" $8,930.00 "	" $6,251.00 "	" $2,125.34 "	" $8,037.00 "	" $7,769.10 "	" $2,143.20 "	" $6,831.45 "	" $3,786.00 "	" $3,283.00 "	" $2,207.50 "	" $5,625.90 "	" $7,590.50 "	" $6,161.70 "	" $7,144.00 "	" $2,143.20 "	" $8,037.00 "	" $7,260.09 "	" $7,590.50 "	" $2,125.34 "	" $7,260.09 "	" $2,143.20 "
343219	HCHG BMH/CVMC SELECTIVE CATHETER PLACEMENT VERTEBRAL ARTERY UNILATERAL	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	36226	" $14,606.00 "	" $10,224.20 "	" $3,283.00 "	" $13,145.40 "	" $12,707.22 "	" $3,505.44 "	" $11,173.59 "	" $3,786.00 "	" $3,283.00 "	" $3,610.60 "	" $9,201.78 "	" $12,415.10 "	" $10,078.14 "	" $11,684.80 "	" $3,505.44 "	" $13,145.40 "	" $11,874.68 "	" $12,415.10 "	" $3,476.23 "	" $11,874.68 "	" $3,505.44 "
343221	"HCHG BMH/CVMC SELECTIVE CATH PLACEMENT, EXTERNAL CAROTID ARTERY, UNILA"	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	36227	" $3,628.12 "	" $2,539.68 "	 $863.49 	" $3,265.31 "	" $3,156.46 "	 $870.75 	" $2,775.51 "	" $3,047.62 "	" $3,047.62 "	 $896.87 	" $2,285.72 "	" $3,083.90 "	" $2,503.40 "	" $2,902.50 "	 $870.75 	" $3,265.31 "	" $2,949.66 "	" $3,083.90 "	 $863.49 	" $2,949.66 "	 $870.75 
4400131	HCHG ABDOMINAL AORTOGRAM BILAT ILIOFEMORAL	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75630	" $15,475.77 "	" $10,833.04 "	" $3,283.00 "	" $13,928.19 "	" $13,463.92 "	" $3,714.18 "	" $11,838.96 "	" $3,786.00 "	" $3,283.00 "	" $3,825.61 "	" $9,749.74 "	" $13,154.40 "	" $10,678.28 "	" $12,380.62 "	" $3,714.18 "	" $13,928.19 "	" $12,581.80 "	" $13,154.40 "	" $3,683.23 "	" $12,581.80 "	" $3,714.18 "
4400132	HCHG ABDOMINAL AORTOGRAM S&I	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75625	" $16,017.49 "	" $11,212.24 "	" $3,283.00 "	" $14,415.74 "	" $13,935.22 "	" $3,844.20 "	" $12,253.38 "	" $3,786.00 "	" $3,283.00 "	" $3,959.52 "	" $10,091.02 "	" $13,614.87 "	" $11,052.07 "	" $12,813.99 "	" $3,844.20 "	" $14,415.74 "	" $13,022.22 "	" $13,614.87 "	" $3,812.16 "	" $13,022.22 "	" $3,844.20 "
4400133	HCHG DESCENDING THORACIC AORTOGRAM MULTI  IMAGE	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75605	" $4,829.16 "	" $3,380.41 "	" $1,149.34 "	" $4,346.24 "	" $4,201.37 "	" $1,159.00 "	" $3,694.31 "	" $3,786.00 "	" $3,283.00 "	" $1,193.77 "	" $3,042.37 "	" $4,104.79 "	" $3,332.12 "	" $3,863.33 "	" $1,159.00 "	" $4,346.24 "	" $3,926.11 "	" $4,104.79 "	" $1,149.34 "	" $3,926.11 "	" $1,159.00 "
4400140	HCHG EA ADDL VESSEL AFTER BASIC SELECTIVE	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75774	" $5,682.69 "	" $3,977.88 "	" $1,352.48 "	" $5,114.42 "	" $4,943.94 "	" $1,363.85 "	" $4,347.26 "	" $3,786.00 "	" $3,283.00 "	" $1,404.76 "	" $3,580.09 "	" $4,830.29 "	" $3,921.06 "	" $4,546.15 "	" $1,363.85 "	" $5,114.42 "	" $4,620.03 "	" $4,830.29 "	" $1,352.48 "	" $4,620.03 "	" $1,363.85 "
4400143	HCHG ANGIO EXTERMITY BILAT RS&I	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75716	" $16,548.20 "	" $11,583.74 "	" $3,283.00 "	" $14,893.38 "	" $14,396.93 "	" $3,971.57 "	" $12,659.37 "	" $3,786.00 "	" $3,283.00 "	" $4,090.72 "	" $10,425.37 "	" $14,065.97 "	" $11,418.26 "	" $13,238.56 "	" $3,971.57 "	" $14,893.38 "	" $13,453.69 "	" $14,065.97 "	" $3,938.47 "	" $13,453.69 "	" $3,971.57 "
4400144	HCHG ANGIO EXTREMITY UNILAT RS&I	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75710	" $17,242.14 "	" $12,069.50 "	" $3,283.00 "	" $15,517.93 "	" $15,000.66 "	" $4,138.11 "	" $13,190.24 "	" $3,786.00 "	" $3,283.00 "	" $4,262.26 "	" $10,862.55 "	" $14,655.82 "	" $11,897.08 "	" $13,793.71 "	" $4,138.11 "	" $15,517.93 "	" $14,017.86 "	" $14,655.82 "	" $4,103.63 "	" $14,017.86 "	" $4,138.11 "
4400146	HCHG ANGIO PELVIS SELECTIVE RS&I	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75736	" $17,137.47 "	" $11,996.23 "	" $3,283.00 "	" $15,423.72 "	" $14,909.60 "	" $4,112.99 "	" $13,110.16 "	" $3,786.00 "	" $3,283.00 "	" $4,236.38 "	" $10,796.61 "	" $14,566.85 "	" $11,824.85 "	" $13,709.98 "	" $4,112.99 "	" $15,423.72 "	" $13,932.76 "	" $14,566.85 "	" $4,078.72 "	" $13,932.76 "	" $4,112.99 "
4400154	HCHG ANGIO VISCERAL SELECTIVE W/WO AORTA ABDOMINAL	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75726	" $4,249.98 "	" $2,974.99 "	" $1,011.50 "	" $3,824.98 "	" $3,697.48 "	" $1,020.00 "	" $3,251.23 "	" $3,569.98 "	" $3,283.00 "	" $1,050.60 "	" $2,677.49 "	" $3,612.48 "	" $2,932.49 "	" $3,399.98 "	" $1,020.00 "	" $3,824.98 "	" $3,455.23 "	" $3,612.48 "	" $1,011.50 "	" $3,455.23 "	" $1,020.00 "
4400155	HCHG FOLLOW-UP ANGIO THRU EXISTING CATH	0323	RADIOLOGY - DIAGNOSTIC - ARTERIOGRAPHY	75898	" $1,900.24 "	" $1,330.17 "	 $452.26 	" $1,710.22 "	" $1,653.21 "	 $456.06 	" $1,453.68 "	" $1,596.20 "	" $1,596.20 "	 $469.74 	" $1,197.15 "	" $1,615.20 "	" $1,311.17 "	" $1,520.19 "	 $456.06 	" $1,710.22 "	" $1,544.90 "	" $1,615.20 "	 $452.26 	" $1,544.90 "	 $456.06 
4401018	HCHG CHEST XRAY SINGLE VIEW	0324	RADIOLOGY - DIAGNOSTIC - CHEST X-RAY	71045	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $88.99 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
4401019	HCHG CHEST XRAY 2 VIEWS	0324	RADIOLOGY - DIAGNOSTIC - CHEST X-RAY	71046	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $111.24 	 $283.50 	 $382.50 	 $310.50 	 $360.00 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
4401020	HCHG CHEST XRAY 3 VIEWS	0324	RADIOLOGY - DIAGNOSTIC - CHEST X-RAY	71047	 $529.46 	 $370.62 	 $126.01 	 $476.51 	 $460.63 	 $127.07 	 $405.04 	 $444.75 	 $444.75 	 $130.88 	 $333.56 	 $450.04 	 $365.33 	 $423.57 	 $127.07 	 $476.51 	 $430.45 	 $450.04 	 $126.01 	 $430.45 	 $127.07 
4401021	HCHG CHEST XRAY 4/MORE VIEWS	0324	RADIOLOGY - DIAGNOSTIC - CHEST X-RAY	71048	" $1,154.57 "	 $808.20 	 $274.79 	" $1,039.11 "	" $1,004.48 "	 $277.10 	 $883.25 	 $969.84 	 $969.84 	 $285.41 	 $727.38 	 $981.38 	 $796.65 	 $923.66 	 $277.10 	" $1,039.11 "	 $938.67 	 $981.38 	 $274.79 	 $938.67 	 $277.10 
303161	HCHG CHEMO ADMIN-IV-PUSH 1ST DRUG	0331	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - INJECTED	96409	 $630.00 	 $441.00 	 $149.94 	 $567.00 	 $548.10 	 $151.20 	 $481.95 	 $529.20 	 $529.20 	 $155.74 	 $396.90 	 $535.50 	 $434.70 	 $504.00 	 $151.20 	 $567.00 	 $512.19 	 $535.50 	 $149.94 	 $512.19 	 $151.20 
303163	HCHG CHEMO ADMIN-IV-PUSH ADDL DRUG	0331	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - INJECTED	96411	 $460.00 	 $322.00 	 $109.48 	 $414.00 	 $400.20 	 $110.40 	 $351.90 	 $386.40 	 $386.40 	 $113.71 	 $289.80 	 $391.00 	 $317.40 	 $368.00 	 $110.40 	 $414.00 	 $373.98 	 $391.00 	 $109.48 	 $373.98 	 $110.40 
303165	HCHG CHEMO ADMIN-SQ/IM HORMONAL	0331	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - INJECTED	96402	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $172.50 	 $200.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
303166	HCHG CHEMO ADMIN-SQ/IM NON HORMONAL	0331	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - INJECTED	96401	 $380.00 	 $266.00 	 $90.44 	 $342.00 	 $330.60 	 $91.20 	 $290.70 	 $319.20 	 $319.20 	 $93.94 	 $239.40 	 $323.00 	 $262.20 	 $304.00 	 $91.20 	 $342.00 	 $308.94 	 $323.00 	 $90.44 	 $308.94 	 $91.20 
303157	HCHG CHEMO ADMIN-IV INF-EA ADD HR	0335	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - IV	96415	 $440.00 	 $308.00 	 $104.72 	 $396.00 	 $382.80 	 $105.60 	 $336.60 	 $369.60 	 $369.60 	 $108.77 	 $277.20 	 $374.00 	 $303.60 	 $352.00 	 $105.60 	 $396.00 	 $357.72 	 $374.00 	 $104.72 	 $357.72 	 $105.60 
303158	HCHG CHEMO ADMIN-IV-1ST DRUG < 1 HR	0335	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - IV	96413	" $1,200.00 "	 $840.00 	 $285.60 	" $1,080.00 "	" $1,044.00 "	 $288.00 	 $918.00 	" $1,008.00 "	" $1,008.00 "	 $296.64 	 $756.00 	" $1,020.00 "	 $828.00 	 $960.00 	 $288.00 	" $1,080.00 "	 $975.60 	" $1,020.00 "	 $285.60 	 $975.60 	 $288.00 
303160	HCHG CHEMO ADMIN-IV-DIFF DRUG < 1HR	0335	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - IV	96417	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $213.90 	 $248.00 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
303164	HCHG CHEMO ADMIN-IV-W/PUMP > 8 HR	0335	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - IV	96416	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $158.21 	 $403.20 	 $544.00 	 $441.60 	 $512.00 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
343268	HCHG CVMC HIGHLY COMPLEX DRUG INF-1ST HR.-1ST SUBSTANC	0335	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - IV	96413	 $627.87 	 $439.51 	 $149.43 	 $565.08 	 $546.25 	 $150.69 	 $480.32 	 $527.41 	 $527.41 	 $155.21 	 $395.56 	 $533.69 	 $433.23 	 $502.30 	 $150.69 	 $565.08 	 $510.46 	 $533.69 	 $149.43 	 $510.46 	 $150.69 
343269	HCHG CVMC HIGHLY COMPLEX DRUG INFUSION-ADDITION HRS.	0335	RADIOLOGY - THERAPEUTIC AND/OR CHEMOTHERAPY ADMINISTRATION - CHEMOTHERAPY ADMINISTRATION - IV	96415	 $635.78 	 $445.05 	 $151.32 	 $572.20 	 $553.13 	 $152.59 	 $486.37 	 $534.06 	 $534.06 	 $157.16 	 $400.54 	 $540.41 	 $438.69 	 $508.62 	 $152.59 	 $572.20 	 $516.89 	 $540.41 	 $151.32 	 $516.89 	 $152.59 
4410691	HCHG LIVER IMAGING W/VASCULAR FLOW	0340	NUCLEAR MEDICINE - GENERAL CLASSIFICATION	78202	" $1,922.25 "	" $1,345.58 "	 $457.50 	" $1,730.03 "	" $1,672.36 "	 $461.34 	" $1,470.52 "	" $1,614.69 "	" $1,614.69 "	 $461.34 	" $1,211.02 "	" $1,633.91 "	" $1,326.35 "	" $1,537.80 "	 $461.34 	" $1,730.03 "	" $1,562.79 "	" $1,633.91 "	 $457.50 	" $1,562.79 "	 $461.34 
360937	HCHG GASTRIC EMPTY STUDY W SB TRANSIT	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78265	 $831.63 	 $582.14 	 $197.93 	 $748.47 	 $723.52 	 $199.59 	 $636.20 	 $698.57 	 $698.57 	 $205.58 	 $523.93 	 $706.89 	 $573.82 	 $665.30 	 $199.59 	 $748.47 	 $676.12 	 $706.89 	 $197.93 	 $676.12 	 $199.59 
360938	HCHG GASTRIC EMPTY STUDY W SB MULTI DAY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78266	" $1,103.40 "	 $772.38 	 $262.61 	 $993.06 	 $959.96 	 $264.82 	 $844.10 	 $926.86 	 $926.86 	 $272.76 	 $695.14 	 $937.89 	 $761.35 	 $882.72 	 $264.82 	 $993.06 	 $897.06 	 $937.89 	 $262.61 	 $897.06 	 $264.82 
4400104	HCHG BRAIN IMAGING MIN 4 STATIC VI*	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78605	" $3,665.80 "	" $2,566.06 "	 $872.46 	" $3,299.22 "	" $3,189.25 "	 $879.79 	" $2,804.34 "	" $3,079.27 "	" $3,079.27 "	 $906.19 	" $2,309.45 "	" $3,115.93 "	" $2,529.40 "	" $2,932.64 "	 $879.79 	" $3,299.22 "	" $2,980.30 "	" $3,115.93 "	 $872.46 	" $2,980.30 "	 $879.79 
4400105	HCHG BRAIN IMAGING MIN 4 STATIC VI*	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78606	" $4,811.51 "	" $3,368.06 "	" $1,145.14 "	" $4,330.36 "	" $4,186.01 "	" $1,154.76 "	" $3,680.81 "	" $3,786.00 "	" $3,283.00 "	" $1,189.41 "	" $3,031.25 "	" $4,089.78 "	" $3,319.94 "	" $3,849.21 "	" $1,154.76 "	" $4,330.36 "	" $3,911.76 "	" $4,089.78 "	" $1,145.14 "	" $3,911.76 "	" $1,154.76 "
4400124	HCHG ACUTE GI BLOOD LOSS IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78278	" $3,561.07 "	" $2,492.75 "	 $847.53 	" $3,204.96 "	" $3,098.13 "	 $854.66 	" $2,724.22 "	" $2,991.30 "	" $2,991.30 "	 $880.30 	" $2,243.47 "	" $3,026.91 "	" $2,457.14 "	" $2,848.86 "	 $854.66 	" $3,204.96 "	" $2,895.15 "	" $3,026.91 "	 $847.53 	" $2,895.15 "	 $854.66 
4400188	HCHG BONE/JOINT IMAGING 3 PHASE STUDY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78315	" $1,890.00 "	" $1,323.00 "	 $449.82 	" $1,701.00 "	" $1,644.30 "	 $453.60 	" $1,445.85 "	" $1,587.60 "	" $1,587.60 "	 $467.21 	" $1,190.70 "	" $1,606.50 "	" $1,304.10 "	" $1,512.00 "	 $453.60 	" $1,701.00 "	" $1,536.57 "	" $1,606.50 "	 $449.82 	" $1,536.57 "	 $453.60 
4400189	HCHG BONE/JOINT IMAGING LIMITED AREA	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78300	" $2,175.00 "	" $1,522.50 "	 $517.65 	" $1,957.50 "	" $1,892.25 "	 $522.00 	" $1,663.88 "	" $1,827.00 "	" $1,827.00 "	 $537.66 	" $1,370.25 "	" $1,848.75 "	" $1,500.75 "	" $1,740.00 "	 $522.00 	" $1,957.50 "	" $1,768.28 "	" $1,848.75 "	 $517.65 	" $1,768.28 "	 $522.00 
4400190	HCHG BONE/JOINT IMAGING MULTIPLE AREAS	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78305	" $3,136.86 "	" $2,195.80 "	 $746.57 	" $2,823.17 "	" $2,729.07 "	 $752.85 	" $2,399.70 "	" $2,634.96 "	" $2,634.96 "	 $775.43 	" $1,976.22 "	" $2,666.33 "	" $2,164.43 "	" $2,509.49 "	 $752.85 	" $2,823.17 "	" $2,550.27 "	" $2,666.33 "	 $746.57 	" $2,550.27 "	 $752.85 
4400191	HCHG BONE/JOINT IMAGING WHOLE BODY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78306	" $1,780.00 "	" $1,246.00 "	 $423.64 	" $1,602.00 "	" $1,548.60 "	 $427.20 	" $1,361.70 "	" $1,495.20 "	" $1,495.20 "	 $440.02 	" $1,121.40 "	" $1,513.00 "	" $1,228.20 "	" $1,424.00 "	 $427.20 	" $1,602.00 "	" $1,447.14 "	" $1,513.00 "	 $423.64 	" $1,447.14 "	 $427.20 
4400194	HCHG BOWEL IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78290	" $2,887.74 "	" $2,021.42 "	 $687.28 	" $2,598.97 "	" $2,512.33 "	 $693.06 	" $2,209.12 "	" $2,425.70 "	" $2,425.70 "	 $713.85 	" $1,819.28 "	" $2,454.58 "	" $1,992.54 "	" $2,310.19 "	 $693.06 	" $2,598.97 "	" $2,347.73 "	" $2,454.58 "	 $687.28 	" $2,347.73 "	 $693.06 
4400195	HCHG BRAIN FLOW IMAGING ONLY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78610	" $3,665.80 "	" $2,566.06 "	 $872.46 	" $3,299.22 "	" $3,189.25 "	 $879.79 	" $2,804.34 "	" $3,079.27 "	" $3,079.27 "	 $906.19 	" $2,309.45 "	" $3,115.93 "	" $2,529.40 "	" $2,932.64 "	 $879.79 	" $3,299.22 "	" $2,980.30 "	" $3,115.93 "	 $872.46 	" $2,980.30 "	 $879.79 
4400227	HCHG CSF FLUID SCAN CISTERNOGRAPHY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78630	" $4,811.51 "	" $3,368.06 "	" $1,145.14 "	" $4,330.36 "	" $4,186.01 "	" $1,154.76 "	" $3,680.81 "	" $3,786.00 "	" $3,283.00 "	" $1,189.41 "	" $3,031.25 "	" $4,089.78 "	" $3,319.94 "	" $3,849.21 "	" $1,154.76 "	" $4,330.36 "	" $3,911.76 "	" $4,089.78 "	" $1,145.14 "	" $3,911.76 "	" $1,154.76 "
4400228	HCHG CSF LEAKAGE DETECTION & LOCAL*	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78650	" $2,199.50 "	" $1,539.65 "	 $523.48 	" $1,979.55 "	" $1,913.57 "	 $527.88 	" $1,682.62 "	" $1,847.58 "	" $1,847.58 "	 $543.72 	" $1,385.69 "	" $1,869.58 "	" $1,517.66 "	" $1,759.60 "	 $527.88 	" $1,979.55 "	" $1,788.19 "	" $1,869.58 "	 $523.48 	" $1,788.19 "	 $527.88 
4400333	HCHG GASTRIC EMPTYING STUDY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78264	" $1,570.00 "	" $1,099.00 "	 $373.66 	" $1,413.00 "	" $1,365.90 "	 $376.80 	" $1,201.05 "	" $1,318.80 "	" $1,318.80 "	 $388.10 	 $989.10 	" $1,334.50 "	" $1,083.30 "	" $1,256.00 "	 $376.80 	" $1,413.00 "	" $1,276.41 "	" $1,334.50 "	 $373.66 	" $1,276.41 "	 $376.80 
4400336	"HCHG GATED HEART, PLANAR SINGLE"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78472	" $3,029.64 "	" $2,120.75 "	 $721.05 	" $2,726.68 "	" $2,635.79 "	 $727.11 	" $2,317.67 "	" $2,544.90 "	" $2,544.90 "	 $748.93 	" $1,908.67 "	" $2,575.19 "	" $2,090.45 "	" $2,423.71 "	 $727.11 	" $2,726.68 "	" $2,463.10 "	" $2,575.19 "	 $721.05 	" $2,463.10 "	 $727.11 
4400337	HCHG GI NUCLEAR PROCEDURE UNLISTED	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78299	" $1,428.91 "	" $1,000.24 "	 $340.08 	" $1,286.02 "	" $1,243.15 "	 $342.94 	" $1,093.12 "	" $1,200.28 "	" $1,200.28 "	 $353.23 	 $900.21 	" $1,214.57 "	 $985.95 	" $1,143.13 "	 $342.94 	" $1,286.02 "	" $1,161.70 "	" $1,214.57 "	 $340.08 	" $1,161.70 "	 $342.94 
4400341	"HCHG HEART FIRST PASS SINGLE,PLANAR"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78481	" $3,059.82 "	" $2,141.87 "	 $728.24 	" $2,753.84 "	" $2,662.04 "	 $734.36 	" $2,340.76 "	" $2,570.25 "	" $2,570.25 "	 $756.39 	" $1,927.69 "	" $2,600.85 "	" $2,111.28 "	" $2,447.86 "	 $734.36 	" $2,753.84 "	" $2,487.63 "	" $2,600.85 "	 $728.24 	" $2,487.63 "	 $734.36 
4400342	HCHG HEPATOBILIARY IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78226	" $1,930.00 "	" $1,351.00 "	 $459.34 	" $1,737.00 "	" $1,679.10 "	 $463.20 	" $1,476.45 "	" $1,621.20 "	" $1,621.20 "	 $477.10 	" $1,215.90 "	" $1,640.50 "	" $1,331.70 "	" $1,544.00 "	 $463.20 	" $1,737.00 "	" $1,569.09 "	" $1,640.50 "	 $459.34 	" $1,569.09 "	 $463.20 
4400405	HCHG LIVER AND SPLEEN IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78215	" $2,978.54 "	" $2,084.98 "	 $708.89 	" $2,680.69 "	" $2,591.33 "	 $714.85 	" $2,278.58 "	" $2,501.97 "	" $2,501.97 "	 $714.85 	" $1,876.48 "	" $2,531.76 "	" $2,055.19 "	" $2,382.83 "	 $714.85 	" $2,680.69 "	" $2,421.55 "	" $2,531.76 "	 $708.89 	" $2,421.55 "	 $714.85 
4400409	HCHG LUNG PERFUSION IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78580	" $1,860.00 "	" $1,302.00 "	 $442.68 	" $1,674.00 "	" $1,618.20 "	 $446.40 	" $1,422.90 "	" $1,562.40 "	" $1,562.40 "	 $446.40 	" $1,171.80 "	" $1,581.00 "	" $1,283.40 "	" $1,488.00 "	 $446.40 	" $1,674.00 "	" $1,512.18 "	" $1,581.00 "	 $442.68 	" $1,512.18 "	 $446.40 
4400411	HCHG LYMPHATICS & LYMPH GLANDS IMA*	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78195	" $2,498.06 "	" $1,748.64 "	 $594.54 	" $2,248.25 "	" $2,173.31 "	 $599.53 	" $1,911.02 "	" $2,098.37 "	" $2,098.37 "	 $599.53 	" $1,573.78 "	" $2,123.35 "	" $1,723.66 "	" $1,998.45 "	 $599.53 	" $2,248.25 "	" $2,030.92 "	" $2,123.35 "	 $594.54 	" $2,030.92 "	 $599.53 
4400487	HCHG MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78453	" $8,055.86 "	" $5,639.10 "	" $1,917.29 "	" $7,250.27 "	" $7,008.60 "	" $1,933.41 "	" $6,162.73 "	" $3,786.00 "	" $3,283.00 "	" $1,933.41 "	" $5,075.19 "	" $6,847.48 "	" $5,558.54 "	" $6,444.69 "	" $1,933.41 "	" $7,250.27 "	" $6,549.41 "	" $6,847.48 "	" $1,917.29 "	" $6,549.41 "	" $1,933.41 "
4400488	HCHG MYOCARDIAL SPECT MULTIPLE STUDIES	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78452	" $4,500.00 "	" $3,150.00 "	" $1,071.00 "	" $4,050.00 "	" $3,915.00 "	" $1,080.00 "	" $3,442.50 "	" $3,780.00 "	" $3,283.00 "	" $1,080.00 "	" $2,835.00 "	" $3,825.00 "	" $3,105.00 "	" $3,600.00 "	" $1,080.00 "	" $4,050.00 "	" $3,658.50 "	" $3,825.00 "	" $1,071.00 "	" $3,658.50 "	" $1,080.00 "
4400489	HCHG MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78451	" $8,298.00 "	" $5,808.60 "	" $1,974.92 "	" $7,468.20 "	" $7,219.26 "	" $1,991.52 "	" $6,347.97 "	" $3,786.00 "	" $3,283.00 "	" $1,991.52 "	" $5,227.74 "	" $7,053.30 "	" $5,725.62 "	" $6,638.40 "	" $1,991.52 "	" $7,468.20 "	" $6,746.27 "	" $7,053.30 "	" $1,974.92 "	" $6,746.27 "	" $1,991.52 "
4400509	HCHG PARATHYROID NUCLEAR IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78070	" $1,460.00 "	" $1,022.00 "	 $347.48 	" $1,314.00 "	" $1,270.20 "	 $350.40 	" $1,116.90 "	" $1,226.40 "	" $1,226.40 "	 $350.40 	 $919.80 	" $1,241.00 "	" $1,007.40 "	" $1,168.00 "	 $350.40 	" $1,314.00 "	" $1,186.98 "	" $1,241.00 "	 $347.48 	" $1,186.98 "	 $350.40 
4400578	"HCHG RENAL IMAGING, MORPH W/ FLOW"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78701	" $2,574.53 "	" $1,802.17 "	 $612.74 	" $2,317.08 "	" $2,239.84 "	 $617.89 	" $1,969.52 "	" $2,162.61 "	" $2,162.61 "	 $617.89 	" $1,621.95 "	" $2,188.35 "	" $1,776.43 "	" $2,059.62 "	 $617.89 	" $2,317.08 "	" $2,093.09 "	" $2,188.35 "	 $612.74 	" $2,093.09 "	 $617.89 
4400579	"HCHG RENAL IMAGING, MORPH W/ FLOW/*"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78707	" $2,884.84 "	" $2,019.39 "	 $686.59 	" $2,596.36 "	" $2,509.81 "	 $692.36 	" $2,206.90 "	" $2,423.27 "	" $2,423.27 "	 $692.36 	" $1,817.45 "	" $2,452.11 "	" $1,990.54 "	" $2,307.87 "	 $692.36 	" $2,596.36 "	" $2,345.37 "	" $2,452.11 "	 $686.59 	" $2,345.37 "	 $692.36 
4400580	"HCHG RENAL IMAGING, MORPH W/ FLOW/*"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78709	" $2,942.63 "	" $2,059.84 "	 $700.35 	" $2,648.37 "	" $2,560.09 "	 $706.23 	" $2,251.11 "	" $2,471.81 "	" $2,471.81 "	 $706.23 	" $1,853.86 "	" $2,501.24 "	" $2,030.41 "	" $2,354.10 "	 $706.23 	" $2,648.37 "	" $2,392.36 "	" $2,501.24 "	 $700.35 	" $2,392.36 "	 $706.23 
4400581	"HCHG RENAL IMAGING, MORPH W/ FLOW/*"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78708	" $2,650.00 "	" $1,855.00 "	 $630.70 	" $2,385.00 "	" $2,305.50 "	 $636.00 	" $2,027.25 "	" $2,226.00 "	" $2,226.00 "	 $636.00 	" $1,669.50 "	" $2,252.50 "	" $1,828.50 "	" $2,120.00 "	 $636.00 	" $2,385.00 "	" $2,154.45 "	" $2,252.50 "	 $630.70 	" $2,154.45 "	 $636.00 
4400582	"HCHG RENAL IMAGING, MORPHOLOGY"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78700	" $2,805.19 "	" $1,963.63 "	 $667.64 	" $2,524.67 "	" $2,440.52 "	 $673.25 	" $2,145.97 "	" $2,356.36 "	" $2,356.36 "	 $673.25 	" $1,767.27 "	" $2,384.41 "	" $1,935.58 "	" $2,244.15 "	 $673.25 	" $2,524.67 "	" $2,280.62 "	" $2,384.41 "	 $667.64 	" $2,280.62 "	 $673.25 
4400638	HCHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78803	" $2,680.00 "	" $1,876.00 "	 $637.84 	" $2,412.00 "	" $2,331.60 "	 $643.20 	" $2,050.20 "	" $2,251.20 "	" $2,251.20 "	 $643.20 	" $1,688.40 "	" $2,278.00 "	" $1,849.20 "	" $2,144.00 "	 $643.20 	" $2,412.00 "	" $2,178.84 "	" $2,278.00 "	 $637.84 	" $2,178.84 "	 $643.20 
4400639	HCHG TUMOR LOCALIZATION 1 AREA 1 DAY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78800	" $2,977.54 "	" $2,084.28 "	 $708.65 	" $2,679.79 "	" $2,590.46 "	 $714.61 	" $2,277.82 "	" $2,501.13 "	" $2,501.13 "	 $714.61 	" $1,875.85 "	" $2,530.91 "	" $2,054.50 "	" $2,382.03 "	 $714.61 	" $2,679.79 "	" $2,420.74 "	" $2,530.91 "	 $708.65 	" $2,420.74 "	 $714.61 
4400640	HCHG TUMOR LOCALIZATION WHOLE BODY 1 DAY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78802	" $2,977.54 "	" $2,084.28 "	 $708.65 	" $2,679.79 "	" $2,590.46 "	 $714.61 	" $2,277.82 "	" $2,501.13 "	" $2,501.13 "	 $714.61 	" $1,875.85 "	" $2,530.91 "	" $2,054.50 "	" $2,382.03 "	 $714.61 	" $2,679.79 "	" $2,420.74 "	" $2,530.91 "	 $708.65 	" $2,420.74 "	 $714.61 
4400641	HCHG TUMOR LOCALIZATION WHOLE BODY 2+DAY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78804	" $5,393.94 "	" $3,775.76 "	" $1,283.76 "	" $4,854.55 "	" $4,692.73 "	" $1,294.55 "	" $4,126.36 "	" $3,786.00 "	" $3,283.00 "	" $1,294.55 "	" $3,398.18 "	" $4,584.85 "	" $3,721.82 "	" $4,315.15 "	" $1,294.55 "	" $4,854.55 "	" $4,385.27 "	" $4,584.85 "	" $1,283.76 "	" $4,385.27 "	" $1,294.55 "
4400864	HCHG LUNG VENTILATION IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78579	" $2,904.66 "	" $2,033.26 "	 $691.31 	" $2,614.19 "	" $2,527.05 "	 $697.12 	" $2,222.06 "	" $2,439.91 "	" $2,439.91 "	 $697.12 	" $1,829.94 "	" $2,468.96 "	" $2,004.22 "	" $2,323.73 "	 $697.12 	" $2,614.19 "	" $2,361.49 "	" $2,468.96 "	 $691.31 	" $2,361.49 "	 $697.12 
4400865	HCHG LUNG VENT/PERF IMAGING	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78582	" $2,178.00 "	" $1,524.60 "	 $518.36 	" $1,960.20 "	" $1,894.86 "	 $522.72 	" $1,666.17 "	" $1,829.52 "	" $1,829.52 "	 $522.72 	" $1,372.14 "	" $1,851.30 "	" $1,502.82 "	" $1,742.40 "	 $522.72 	" $1,960.20 "	" $1,770.71 "	" $1,851.30 "	 $518.36 	" $1,770.71 "	 $522.72 
4400866	HCHG LUNG PERFUSION DIFFERENTIAL	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78597	" $3,052.34 "	" $2,136.64 "	 $726.46 	" $2,747.11 "	" $2,655.54 "	 $732.56 	" $2,335.04 "	" $2,563.97 "	" $2,563.97 "	 $732.56 	" $1,922.97 "	" $2,594.49 "	" $2,106.11 "	" $2,441.87 "	 $732.56 	" $2,747.11 "	" $2,481.55 "	" $2,594.49 "	 $726.46 	" $2,481.55 "	 $732.56 
4400867	HCHG QUANT DIFF LUNG PERF/VENT	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78598	" $3,052.34 "	" $2,136.64 "	 $726.46 	" $2,747.11 "	" $2,655.54 "	 $732.56 	" $2,335.04 "	" $2,563.97 "	" $2,563.97 "	 $732.56 	" $1,922.97 "	" $2,594.49 "	" $2,106.11 "	" $2,441.87 "	 $732.56 	" $2,747.11 "	" $2,481.55 "	" $2,594.49 "	 $726.46 	" $2,481.55 "	 $732.56 
4400869	HCHG HEPATOBILIARY WITH CCK	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78227	" $2,500.00 "	" $1,750.00 "	 $595.00 	" $2,250.00 "	" $2,175.00 "	 $600.00 	" $1,912.50 "	" $2,100.00 "	" $2,100.00 "	 $618.00 	" $1,575.00 "	" $2,125.00 "	" $1,725.00 "	" $2,000.00 "	 $600.00 	" $2,250.00 "	" $2,032.50 "	" $2,125.00 "	 $595.00 	" $2,032.50 "	 $600.00 
4400905	"HCHG HEART IMAGE, SPECT"	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78494	" $4,079.79 "	" $2,855.85 "	 $970.99 	" $3,671.81 "	" $3,549.42 "	 $979.15 	" $3,121.04 "	" $3,427.02 "	" $3,283.00 "	" $1,008.52 "	" $2,570.27 "	" $3,467.82 "	" $2,815.06 "	" $3,263.83 "	 $979.15 	" $3,671.81 "	" $3,316.87 "	" $3,467.82 "	 $970.99 	" $3,316.87 "	 $979.15 
4400906	HCHG HEART FIRST PASS ADD-ON	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78496	" $1,366.55 "	 $956.59 	 $325.24 	" $1,229.90 "	" $1,188.90 "	 $327.97 	" $1,045.41 "	" $1,147.90 "	" $1,147.90 "	 $337.81 	 $860.93 	" $1,161.57 "	 $942.92 	" $1,093.24 "	 $327.97 	" $1,229.90 "	" $1,111.01 "	" $1,161.57 "	 $325.24 	" $1,111.01 "	 $327.97 
4400907	HCHG BRAIN IMAGING < 4 STATIC VIEWS	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78600	" $3,665.80 "	" $2,566.06 "	 $872.46 	" $3,299.22 "	" $3,189.25 "	 $879.79 	" $2,804.34 "	" $3,079.27 "	" $3,079.27 "	 $906.19 	" $2,309.45 "	" $3,115.93 "	" $2,529.40 "	" $2,932.64 "	 $879.79 	" $3,299.22 "	" $2,980.30 "	" $3,115.93 "	 $872.46 	" $2,980.30 "	 $879.79 
4400910	HCHG BRAIN IMAGING < 4 STATIC VIEWS W V FLOW	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78601	" $3,665.80 "	" $2,566.06 "	 $872.46 	" $3,299.22 "	" $3,189.25 "	 $879.79 	" $2,804.34 "	" $3,079.27 "	" $3,079.27 "	 $906.19 	" $2,309.45 "	" $3,115.93 "	" $2,529.40 "	" $2,932.64 "	 $879.79 	" $3,299.22 "	" $2,980.30 "	" $3,115.93 "	 $872.46 	" $2,980.30 "	 $879.79 
4400911	HCHG TUMOR LOCALIZATION 2+AREA 1D/1 AREA 2+DAY	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78801	" $2,330.00 "	" $1,631.00 "	 $554.54 	" $2,097.00 "	" $2,027.10 "	 $559.20 	" $1,782.45 "	" $1,957.20 "	" $1,957.20 "	 $559.20 	" $1,467.90 "	" $1,980.50 "	" $1,607.70 "	" $1,864.00 "	 $559.20 	" $2,097.00 "	" $1,894.29 "	" $1,980.50 "	 $554.54 	" $1,894.29 "	 $559.20 
4410501	HCHG THYROID UPTAKE MEASUREMENT	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78012	 $473.00 	 $331.10 	 $112.57 	 $425.70 	 $411.51 	 $113.52 	 $361.85 	 $397.32 	 $397.32 	 $113.52 	 $297.99 	 $402.05 	 $326.37 	 $378.40 	 $113.52 	 $425.70 	 $384.55 	 $402.05 	 $112.57 	 $384.55 	 $113.52 
4410502	HCHG THYROID IMAGING W/BLOOD FLOW	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78013	 $603.66 	 $422.56 	 $143.67 	 $543.29 	 $525.18 	 $144.88 	 $461.80 	 $507.07 	 $507.07 	 $144.88 	 $380.31 	 $513.11 	 $416.53 	 $482.93 	 $144.88 	 $543.29 	 $490.78 	 $513.11 	 $143.67 	 $490.78 	 $144.88 
4410503	HCHG THYROID IMAGING W/BLOOD FLOW W/UPTAKE	0341	NUCLEAR MEDICINE - DIAGNOSTIC PROCEDURES	78014	 $876.00 	 $613.20 	 $208.49 	 $788.40 	 $762.12 	 $210.24 	 $670.14 	 $735.84 	 $735.84 	 $210.24 	 $551.88 	 $744.60 	 $604.44 	 $700.80 	 $210.24 	 $788.40 	 $712.19 	 $744.60 	 $208.49 	 $712.19 	 $210.24 
309174	HCHG CVMC TC 99M PERTECHNETATE PER MILLICURIE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9512	 $11.93 	 $8.35 	 $2.84 	 $10.74 	 $10.38 	 $2.86 	 $9.13 	 $10.02 	 $10.02 	 $2.95 	 $7.52 	 $10.14 	 $8.23 	 $9.54 	 $2.86 	 $10.74 	 $9.70 	 $10.14 	 $2.84 	 $9.70 	 $2.86 
309177	HCHG CVMC TC99M DTPA (AEROSOL)	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9567	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $84.05 	 $214.20 	 $289.00 	 $234.60 	 $272.00 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
309178	HCHG CVMC I 111 WBC ISOTOPE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9570	" $2,920.00 "	" $2,044.00 "	 $694.96 	" $2,628.00 "	" $2,540.40 "	 $700.80 	" $2,233.80 "	" $2,452.80 "	" $2,452.80 "	 $721.82 	" $1,839.60 "	" $2,482.00 "	" $2,014.80 "	" $2,336.00 "	 $700.80 	" $2,628.00 "	" $2,373.96 "	" $2,482.00 "	 $694.96 	" $2,373.96 "	 $700.80 
4401016	HCHG CVMC TC99M TETROFOSMIN	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9500	 $630.00 	 $441.00 	 $149.94 	 $567.00 	 $548.10 	 $151.20 	 $481.95 	 $529.20 	 $529.20 	 $155.74 	 $396.90 	 $535.50 	 $434.70 	 $504.00 	 $151.20 	 $567.00 	 $512.19 	 $535.50 	 $149.94 	 $512.19 	 $151.20 
4410131	HCHG GA67 GALLIUM DIAGNOSTIC PER MCI	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9556	" $1,402.48 "	 $981.74 	 $333.79 	" $1,262.23 "	" $1,220.16 "	 $336.60 	" $1,072.90 "	" $1,178.08 "	" $1,178.08 "	 $346.69 	 $883.56 	" $1,192.11 "	 $967.71 	" $1,121.98 "	 $336.60 	" $1,262.23 "	" $1,140.22 "	" $1,192.11 "	 $333.79 	" $1,140.22 "	 $336.60 
4410171	HCHG I-123 IODINE IOBENGUANE MIBG DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9582	 $930.45 	 $651.32 	 $221.45 	 $837.41 	 $809.49 	 $223.31 	 $711.79 	 $781.58 	 $781.58 	 $230.01 	 $586.18 	 $790.88 	 $642.01 	 $744.36 	 $223.31 	 $837.41 	 $756.46 	 $790.88 	 $221.45 	 $756.46 	 $223.31 
4410172	HCHG I-123 SODIUM IODIDE DIAGNOSTIC PER 100 UCI	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9516	 $328.00 	 $229.60 	 $78.06 	 $295.20 	 $285.36 	 $78.72 	 $250.92 	 $275.52 	 $275.52 	 $81.08 	 $206.64 	 $278.80 	 $226.32 	 $262.40 	 $78.72 	 $295.20 	 $266.66 	 $278.80 	 $78.06 	 $266.66 	 $78.72 
4410173	HCHG IN111 INDIUM PENTETATE DTPA DX PER 0.5 MCI	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9548	" $3,241.59 "	" $2,269.11 "	 $771.50 	" $2,917.43 "	" $2,820.18 "	 $777.98 	" $2,479.82 "	" $2,722.94 "	" $2,722.94 "	 $801.32 	" $2,042.20 "	" $2,755.35 "	" $2,236.70 "	" $2,593.27 "	 $777.98 	" $2,917.43 "	" $2,635.41 "	" $2,755.35 "	 $771.50 	" $2,635.41 "	 $777.98 
4410175	HCHG IN111 INDIUM PENTETROTIDE OCTREOSCAN DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9572	" $10,717.74 "	" $7,502.42 "	" $2,550.82 "	" $9,645.97 "	" $9,324.43 "	" $2,572.26 "	" $8,199.07 "	" $3,786.00 "	" $3,283.00 "	" $2,649.43 "	" $6,752.18 "	" $9,110.08 "	" $7,395.24 "	" $8,574.19 "	" $2,572.26 "	" $9,645.97 "	" $8,713.52 "	" $9,110.08 "	" $2,550.82 "	" $8,713.52 "	" $2,572.26 "
4410307	HCHG TC99M DTPA AEROSOL PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9567	 $540.00 	 $378.00 	 $128.52 	 $486.00 	 $469.80 	 $129.60 	 $413.10 	 $453.60 	 $453.60 	 $129.60 	 $340.20 	 $459.00 	 $372.60 	 $432.00 	 $129.60 	 $486.00 	 $439.02 	 $459.00 	 $128.52 	 $439.02 	 $129.60 
4410310	HCHG TC99M MEBROFENIN CHOLETEC DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9537	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $96.60 	 $112.00 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
4410317	HCHG TC99M EXAMETAZINE CERETEC DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9521	" $3,241.59 "	" $2,269.11 "	 $771.50 	" $2,917.43 "	" $2,820.18 "	 $777.98 	" $2,479.82 "	" $2,722.94 "	" $2,722.94 "	 $777.98 	" $2,042.20 "	" $2,755.35 "	" $2,236.70 "	" $2,593.27 "	 $777.98 	" $2,917.43 "	" $2,635.41 "	" $2,755.35 "	 $771.50 	" $2,635.41 "	 $777.98 
4410320	HCHG TC99M MEDRONATE MDP DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9503	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $131.10 	 $152.00 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
4410324	HCHG TC99M SESTAMIBI CARDIOLITE DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9500	 $540.00 	 $378.00 	 $128.52 	 $486.00 	 $469.80 	 $129.60 	 $413.10 	 $453.60 	 $453.60 	 $129.60 	 $340.20 	 $459.00 	 $372.60 	 $432.00 	 $129.60 	 $486.00 	 $439.02 	 $459.00 	 $128.52 	 $439.02 	 $129.60 
4410326	HCHG TC99M TETROFOSMIN MYOVIEW DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9502	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $55.20 	 $64.00 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
4410327	HCHG TC99M MERTIATIDE MAG3 DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9562	 $820.00 	 $574.00 	 $195.16 	 $738.00 	 $713.40 	 $196.80 	 $627.30 	 $688.80 	 $688.80 	 $196.80 	 $516.60 	 $697.00 	 $565.80 	 $656.00 	 $196.80 	 $738.00 	 $666.66 	 $697.00 	 $195.16 	 $666.66 	 $196.80 
4410328	HCHG TL201 THALLIUM CHLORIDE DX PER MCI	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9505	 $450.05 	 $315.04 	 $107.11 	 $405.05 	 $391.54 	 $108.01 	 $344.29 	 $378.04 	 $378.04 	 $108.01 	 $283.53 	 $382.54 	 $310.53 	 $360.04 	 $108.01 	 $405.05 	 $365.89 	 $382.54 	 $107.11 	 $365.89 	 $108.01 
4410346	HCHG TC99M PENTETATE DTPA DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9539	 $210.00 	 $147.00 	 $49.98 	 $189.00 	 $182.70 	 $50.40 	 $160.65 	 $176.40 	 $176.40 	 $50.40 	 $132.30 	 $178.50 	 $144.90 	 $168.00 	 $50.40 	 $189.00 	 $170.73 	 $178.50 	 $49.98 	 $170.73 	 $50.40 
4410484	HCHG TC99M LABELED RBC ULTRATAG VIALS DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9560	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $296.70 	 $344.00 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
4410557	HCHG TC99M MAA DIAGNOSTIC PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9540	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
4410558	HCHG TC99M SULFUR COLLOID DX PER DOSE	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9541	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $131.10 	 $152.00 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
503840	HCHG INDIUM IN-111 OXYQUINOLINE DIAG PER 0.5 MCI	0343	NUCLEAR MEDICINE - DIAGNOSTIC RADIOPHARMACEUTICALS	A9547	" $3,742.50 "	" $2,619.75 "	 $890.72 	" $3,368.25 "	" $3,255.98 "	 $898.20 	" $2,863.01 "	" $3,143.70 "	" $3,143.70 "	 $925.15 	" $2,357.78 "	" $3,181.13 "	" $2,582.33 "	" $2,994.00 "	 $898.20 	" $3,368.25 "	" $3,042.65 "	" $3,181.13 "	 $890.72 	" $3,042.65 "	 $898.20 
302432	HCHG CVMC PROMOTIONAL CT HEART W/O CONTRAST QUANT EVAL	0350	CT SCAN - GENERAL CLASSIFICATION	75571	 $150.00 	 $150.00 	 $150.00 	 $150.00 																	
4400117	HCHG 3D RENDER W/O IMAGE POSTPROCE*	0350	CT SCAN - GENERAL CLASSIFICATION	76376	 $853.93 	 $597.75 	 $203.24 	 $768.54 	 $742.92 	 $204.94 	 $653.26 	 $717.30 	 $717.30 	 $211.09 	 $537.98 	 $725.84 	 $563.59 	 $734.38 	 $204.94 	 $768.54 	 $694.25 	 $725.84 	 $203.24 	 $694.25 	 $204.94 
4400118	HCHG 3D RENDERING W/ IMAGE POSTPRO*	0350	CT SCAN - GENERAL CLASSIFICATION	76377	" $1,269.02 "	 $888.31 	 $302.03 	" $1,142.12 "	" $1,104.05 "	 $304.56 	 $970.80 	" $1,065.98 "	" $1,065.98 "	 $313.70 	 $799.48 	" $1,078.67 "	 $837.55 	" $1,091.36 "	 $304.56 	" $1,142.12 "	" $1,031.71 "	" $1,078.67 "	 $302.03 	" $1,031.71 "	 $304.56 
4400231	HCHG CT ANGIO HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST	0350	CT SCAN - GENERAL CLASSIFICATION	75574	" $2,797.41 "	" $1,958.19 "	 $665.78 	" $2,517.67 "	" $2,433.75 "	 $671.38 	" $2,140.02 "	" $2,349.82 "	" $2,349.82 "	 $691.52 	" $1,762.37 "	" $2,377.80 "	" $1,846.29 "	" $2,405.77 "	 $671.38 	" $2,517.67 "	" $2,274.29 "	" $2,377.80 "	 $665.78 	" $2,274.29 "	 $671.38 
4400239	HCHG CT GUIDANCE NEEDLE PLACEMENT	0350	CT SCAN - GENERAL CLASSIFICATION	77012	" $1,640.00 "	" $1,148.00 "	 $390.32 	" $1,476.00 "	" $1,426.80 "	 $393.60 	" $1,254.60 "	" $1,377.60 "	" $1,377.60 "	 $405.41 	" $1,033.20 "	" $1,394.00 "	" $1,082.40 "	" $1,410.40 "	 $393.60 	" $1,476.00 "	" $1,333.32 "	" $1,394.00 "	 $390.32 	" $1,333.32 "	 $393.60 
4400242	HCHG CT HEART CONTRAST EVAL CARDIAC STRUCT/MORPH	0350	CT SCAN - GENERAL CLASSIFICATION	75572	" $2,797.41 "	" $1,958.19 "	 $665.78 	" $2,517.67 "	" $2,433.75 "	 $671.38 	" $2,140.02 "	" $2,349.82 "	" $2,349.82 "	 $691.52 	" $1,762.37 "	" $2,377.80 "	" $1,846.29 "	" $2,405.77 "	 $671.38 	" $2,517.67 "	" $2,274.29 "	" $2,377.80 "	 $665.78 	" $2,274.29 "	 $671.38 
4400243	"HCHG CT HEART CONTRAST EVAL CARDIAC STRUCT/MORPH, CONGEN HEART DISEASE"	0350	CT SCAN - GENERAL CLASSIFICATION	75573	" $2,797.41 "	" $1,958.19 "	 $665.78 	" $2,517.67 "	" $2,433.75 "	 $671.38 	" $2,140.02 "	" $2,349.82 "	" $2,349.82 "	 $691.52 	" $1,762.37 "	" $2,377.80 "	" $1,846.29 "	" $2,405.77 "	 $671.38 	" $2,517.67 "	" $2,274.29 "	" $2,377.80 "	 $665.78 	" $2,274.29 "	 $671.38 
4400244	HCHG CT HEART W/O CONTRAST QUANT EVAL CORONARY CALCIUM	0350	CT SCAN - GENERAL CLASSIFICATION	75571	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $88.99 	 $226.80 	 $306.00 	 $237.60 	 $309.60 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
4400266	HCHG CT SCAN LIMITED LOCALIZED F/U STUDY	0350	CT SCAN - GENERAL CLASSIFICATION	76380	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400644	HCHG UNLISTED CT PROCEDURE	0350	CT SCAN - GENERAL CLASSIFICATION	76497	" $1,334.29 "	 $934.00 	 $317.56 	" $1,200.86 "	" $1,160.83 "	 $320.23 	" $1,020.73 "	" $1,120.80 "	" $1,120.80 "	 $320.23 	 $840.60 	" $1,134.15 "	 $880.63 	" $1,147.49 "	 $320.23 	" $1,200.86 "	" $1,084.78 "	" $1,134.15 "	 $317.56 	" $1,084.78 "	 $320.23 
4400235	"HCHG CT ANGIO,HEAD COMBO,INCL IMAG*"	0351	CT SCAN - HEAD SCAN	70496	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400237	"HCHG CT ANGIO,NECK COMBO,INCL IMAG*"	0351	CT SCAN - HEAD SCAN	70498	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400245	HCHG CT NECK TISSUE COMBO	0351	CT SCAN - HEAD SCAN	70492	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400246	HCHG CT NECK TISSUE CONTRAST	0351	CT SCAN - HEAD SCAN	70491	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400249	HCHG CT SCAN HEAD COMBO	0351	CT SCAN - HEAD SCAN	70470	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400250	HCHG CT SCAN HEAD CONTRAST	0351	CT SCAN - HEAD SCAN	70460	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400260	HCHG CT SCAN SKULL COMBO	0351	CT SCAN - HEAD SCAN	70482	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400261	HCHG CT SCAN SKULL CONTRAST	0351	CT SCAN - HEAD SCAN	70481	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400262	"HCHG CT SCAN, FACE/JAW CONTRAST"	0351	CT SCAN - HEAD SCAN	70487	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400265	"HCHG CT SCAN,HEAD/BRAIN,W/O CONTRA*"	0351	CT SCAN - HEAD SCAN	70450	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400269	"HCHG CT SCAN,MAXILLOFACIAL AREA,W/*"	0351	CT SCAN - HEAD SCAN	70486	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400270	"HCHG CT SCAN,ORBIT/SELLA/POST FOSS*"	0351	CT SCAN - HEAD SCAN	70480	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400272	"HCHG CT SCAN,SOFT TISSUE NECK,W/O *"	0351	CT SCAN - HEAD SCAN	70490	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400276	HCHG CT SCANS FACE/JAW COMBO	0351	CT SCAN - HEAD SCAN	70488	" $2,800.00 "	" $1,960.00 "	 $666.40 	" $2,520.00 "	" $2,436.00 "	 $672.00 	" $2,142.00 "	" $2,352.00 "	" $2,352.00 "	 $692.16 	" $1,764.00 "	" $2,380.00 "	" $1,848.00 "	" $2,408.00 "	 $672.00 	" $2,520.00 "	" $2,276.40 "	" $2,380.00 "	 $666.40 	" $2,276.40 "	 $672.00 
4400204	HCHG CAT SCAN OF CHEST COMBO	0352	CT SCAN - BODY SCAN	71270	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400205	HCHG CAT SCAN OF CHEST CONTRAST	0352	CT SCAN - BODY SCAN	71260	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400230	"HCHG CT ANGIO AORTOBIFEMORAL, COMBO"	0352	CT SCAN - BODY SCAN	75635	" $3,520.00 "	" $2,464.00 "	 $837.76 	" $3,168.00 "	" $3,062.40 "	 $844.80 	" $2,692.80 "	" $2,956.80 "	" $2,956.80 "	 $870.14 	" $2,217.60 "	" $2,992.00 "	" $2,323.20 "	" $3,027.20 "	 $844.80 	" $3,168.00 "	" $2,861.76 "	" $2,992.00 "	 $837.76 	" $2,861.76 "	 $844.80 
4400232	"HCHG CT ANGIO, ABD, COMBO,INCL IMA*"	0352	CT SCAN - BODY SCAN	74175	" $3,040.00 "	" $2,128.00 "	 $723.52 	" $2,736.00 "	" $2,644.80 "	 $729.60 	" $2,325.60 "	" $2,553.60 "	" $2,553.60 "	 $751.49 	" $1,915.20 "	" $2,584.00 "	" $2,006.40 "	" $2,614.40 "	 $729.60 	" $2,736.00 "	" $2,471.52 "	" $2,584.00 "	 $723.52 	" $2,471.52 "	 $729.60 
4400233	"HCHG CT ANGIO, CHEST (NON-CORON), COMBO, INCL IMG PROC"	0352	CT SCAN - BODY SCAN	71275	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400234	"HCHG CT ANGIO, PELVIS, COMBO, INCL IMAGE PROC"	0352	CT SCAN - BODY SCAN	72191	" $3,483.77 "	" $2,438.64 "	 $829.14 	" $3,135.39 "	" $3,030.88 "	 $836.10 	" $2,665.08 "	" $2,926.37 "	" $2,926.37 "	 $861.19 	" $2,194.78 "	" $2,961.20 "	" $2,299.29 "	" $2,996.04 "	 $836.10 	" $3,135.39 "	" $2,832.31 "	" $2,961.20 "	 $829.14 	" $2,832.31 "	 $836.10 
4400236	"HCHG CT ANGIO,LOWER EXTREM,COMBO,I*"	0352	CT SCAN - BODY SCAN	73706	" $2,940.00 "	" $2,058.00 "	 $699.72 	" $2,646.00 "	" $2,557.80 "	 $705.60 	" $2,249.10 "	" $2,469.60 "	" $2,469.60 "	 $726.77 	" $1,852.20 "	" $2,499.00 "	" $1,940.40 "	" $2,528.40 "	 $705.60 	" $2,646.00 "	" $2,390.22 "	" $2,499.00 "	 $699.72 	" $2,390.22 "	 $705.60 
4400238	"HCHG CT ANGIO,UPPER EXTREM,COMBO"	0352	CT SCAN - BODY SCAN	73206	" $2,560.00 "	" $1,792.00 "	 $609.28 	" $2,304.00 "	" $2,227.20 "	 $614.40 	" $1,958.40 "	" $2,150.40 "	" $2,150.40 "	 $632.83 	" $1,612.80 "	" $2,176.00 "	" $1,689.60 "	" $2,201.60 "	 $614.40 	" $2,304.00 "	" $2,081.28 "	" $2,176.00 "	 $609.28 	" $2,081.28 "	 $614.40 
4400247	HCHG CT SCAN CERV SPINE CONTRAST	0352	CT SCAN - BODY SCAN	72126	" $3,310.00 "	" $2,317.00 "	 $787.78 	" $2,979.00 "	" $2,879.70 "	 $794.40 	" $2,532.15 "	" $2,780.40 "	" $2,780.40 "	 $818.23 	" $2,085.30 "	" $2,813.50 "	" $2,184.60 "	" $2,846.60 "	 $794.40 	" $2,979.00 "	" $2,691.03 "	" $2,813.50 "	 $787.78 	" $2,691.03 "	 $794.40 
4400248	HCHG CT SCAN DORSAL SP CONTRAST	0352	CT SCAN - BODY SCAN	72129	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400251	HCHG CT SCAN LUMBAR SP CONTRAST	0352	CT SCAN - BODY SCAN	72132	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400252	HCHG CT SCAN OF ABDOMEN COMBO	0352	CT SCAN - BODY SCAN	74170	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400253	HCHG CT SCAN OF ABDOMEN CONTRAST	0352	CT SCAN - BODY SCAN	74160	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400254	HCHG CT SCAN OF ARM COMBO	0352	CT SCAN - BODY SCAN	73202	" $3,600.00 "	" $2,520.00 "	 $856.80 	" $3,240.00 "	" $3,132.00 "	 $864.00 	" $2,754.00 "	" $3,024.00 "	" $3,024.00 "	 $889.92 	" $2,268.00 "	" $3,060.00 "	" $2,376.00 "	" $3,096.00 "	 $864.00 	" $3,240.00 "	" $2,926.80 "	" $3,060.00 "	 $856.80 	" $2,926.80 "	 $864.00 
4400255	HCHG CT SCAN OF ARM CONTRAST	0352	CT SCAN - BODY SCAN	73201	" $3,140.00 "	" $2,198.00 "	 $747.32 	" $2,826.00 "	" $2,731.80 "	 $753.60 	" $2,402.10 "	" $2,637.60 "	" $2,637.60 "	 $776.21 	" $1,978.20 "	" $2,669.00 "	" $2,072.40 "	" $2,700.40 "	 $753.60 	" $2,826.00 "	" $2,552.82 "	" $2,669.00 "	 $747.32 	" $2,552.82 "	 $753.60 
4400256	HCHG CT SCAN OF LEG COMBO	0352	CT SCAN - BODY SCAN	73702	" $3,420.00 "	" $2,394.00 "	 $813.96 	" $3,078.00 "	" $2,975.40 "	 $820.80 	" $2,616.30 "	" $2,872.80 "	" $2,872.80 "	 $845.42 	" $2,154.60 "	" $2,907.00 "	" $2,257.20 "	" $2,941.20 "	 $820.80 	" $3,078.00 "	" $2,780.46 "	" $2,907.00 "	 $813.96 	" $2,780.46 "	 $820.80 
4400257	HCHG CT SCAN OF LEG CONTRAST	0352	CT SCAN - BODY SCAN	73701	" $3,140.00 "	" $2,198.00 "	 $747.32 	" $2,826.00 "	" $2,731.80 "	 $753.60 	" $2,402.10 "	" $2,637.60 "	" $2,637.60 "	 $776.21 	" $1,978.20 "	" $2,669.00 "	" $2,072.40 "	" $2,700.40 "	 $753.60 	" $2,826.00 "	" $2,552.82 "	" $2,669.00 "	 $747.32 	" $2,552.82 "	 $753.60 
4400258	HCHG CT SCAN OF PELVIS COMBO	0352	CT SCAN - BODY SCAN	72194	" $2,800.00 "	" $1,960.00 "	 $666.40 	" $2,520.00 "	" $2,436.00 "	 $672.00 	" $2,142.00 "	" $2,352.00 "	" $2,352.00 "	 $692.16 	" $1,764.00 "	" $2,380.00 "	" $1,848.00 "	" $2,408.00 "	 $672.00 	" $2,520.00 "	" $2,276.40 "	" $2,380.00 "	 $666.40 	" $2,276.40 "	 $672.00 
4400259	HCHG CT SCAN OF PELVIS CONTRAST	0352	CT SCAN - BODY SCAN	72193	" $2,380.00 "	" $1,666.00 "	 $566.44 	" $2,142.00 "	" $2,070.60 "	 $571.20 	" $1,820.70 "	" $1,999.20 "	" $1,999.20 "	 $588.34 	" $1,499.40 "	" $2,023.00 "	" $1,570.80 "	" $2,046.80 "	 $571.20 	" $2,142.00 "	" $1,934.94 "	" $2,023.00 "	 $566.44 	" $1,934.94 "	 $571.20 
4400263	"HCHG CT SCAN,ABDOMEN,W/O CONTRAST"	0352	CT SCAN - BODY SCAN	74150	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400264	"HCHG CT SCAN,CERVICAL SPINE,W/O CONTRAST"	0352	CT SCAN - BODY SCAN	72125	" $1,860.00 "	" $1,302.00 "	 $442.68 	" $1,674.00 "	" $1,618.20 "	 $446.40 	" $1,422.90 "	" $1,562.40 "	" $1,562.40 "	 $459.79 	" $1,171.80 "	" $1,581.00 "	" $1,227.60 "	" $1,599.60 "	 $446.40 	" $1,674.00 "	" $1,512.18 "	" $1,581.00 "	 $442.68 	" $1,512.18 "	 $446.40 
4400267	"HCHG CT SCAN,LOWER EXTREMITY,W/O C*"	0352	CT SCAN - BODY SCAN	73700	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400268	"HCHG CT SCAN,LUMBAR SPINE,W/O CONTRAST"	0352	CT SCAN - BODY SCAN	72131	" $1,520.00 "	" $1,064.00 "	 $361.76 	" $1,368.00 "	" $1,322.40 "	 $364.80 	" $1,162.80 "	" $1,276.80 "	" $1,276.80 "	 $375.74 	 $957.60 	" $1,292.00 "	" $1,003.20 "	" $1,307.20 "	 $364.80 	" $1,368.00 "	" $1,235.76 "	" $1,292.00 "	 $361.76 	" $1,235.76 "	 $364.80 
4400271	"HCHG CT SCAN,PELVIS,W/O CONTRAST"	0352	CT SCAN - BODY SCAN	72192	" $2,090.00 "	" $1,463.00 "	 $497.42 	" $1,881.00 "	" $1,818.30 "	 $501.60 	" $1,598.85 "	" $1,755.60 "	" $1,755.60 "	 $516.65 	" $1,316.70 "	" $1,776.50 "	" $1,379.40 "	" $1,797.40 "	 $501.60 	" $1,881.00 "	" $1,699.17 "	" $1,776.50 "	 $497.42 	" $1,699.17 "	 $501.60 
4400273	"HCHG CT SCAN,THORACIC SPINE,W/O CONTRAST"	0352	CT SCAN - BODY SCAN	72128	" $2,360.00 "	" $1,652.00 "	 $561.68 	" $2,124.00 "	" $2,053.20 "	 $566.40 	" $1,805.40 "	" $1,982.40 "	" $1,982.40 "	 $583.39 	" $1,486.80 "	" $2,006.00 "	" $1,557.60 "	" $2,029.60 "	 $566.40 	" $2,124.00 "	" $1,918.68 "	" $2,006.00 "	 $561.68 	" $1,918.68 "	 $566.40 
4400274	HCHG CT THORAX DIAG WO CONTRAST	0352	CT SCAN - BODY SCAN	71250	" $1,620.00 "	" $1,134.00 "	 $385.56 	" $1,458.00 "	" $1,409.40 "	 $388.80 	" $1,239.30 "	" $1,360.80 "	" $1,360.80 "	 $400.46 	" $1,020.60 "	" $1,377.00 "	" $1,069.20 "	" $1,393.20 "	 $388.80 	" $1,458.00 "	" $1,317.06 "	" $1,377.00 "	 $385.56 	" $1,317.06 "	 $388.80 
4400275	"HCHG CT SCAN,UPPER EXTREMITY,W/O C*"	0352	CT SCAN - BODY SCAN	73200	" $2,810.00 "	" $1,967.00 "	 $668.78 	" $2,529.00 "	" $2,444.70 "	 $674.40 	" $2,149.65 "	" $2,360.40 "	" $2,360.40 "	 $694.63 	" $1,770.30 "	" $2,388.50 "	" $1,854.60 "	" $2,416.60 "	 $674.40 	" $2,529.00 "	" $2,284.53 "	" $2,388.50 "	 $668.78 	" $2,284.53 "	 $674.40 
4400845	"HCHG CT SCAN,ABD & PELVIS,W/O CONTRAST"	0352	CT SCAN - BODY SCAN	74176	" $2,280.00 "	" $1,596.00 "	 $542.64 	" $2,052.00 "	" $1,983.60 "	 $547.20 	" $1,744.20 "	" $1,915.20 "	" $1,915.20 "	 $563.62 	" $1,436.40 "	" $1,938.00 "	" $1,504.80 "	" $1,960.80 "	 $547.20 	" $2,052.00 "	" $1,853.64 "	" $1,938.00 "	 $542.64 	" $1,853.64 "	 $547.20 
4400846	"HCHG CT SCAN,ABD & PELVIS,W CONTRAST"	0352	CT SCAN - BODY SCAN	74177	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400847	"HCHG CT SCAN,ABD &  PELVIS,COMBO"	0352	CT SCAN - BODY SCAN	74178	" $3,040.00 "	" $2,128.00 "	 $723.52 	" $2,736.00 "	" $2,644.80 "	 $729.60 	" $2,325.60 "	" $2,553.60 "	" $2,553.60 "	 $751.49 	" $1,915.20 "	" $2,584.00 "	" $2,006.40 "	" $2,614.40 "	 $729.60 	" $2,736.00 "	" $2,471.52 "	" $2,584.00 "	 $723.52 	" $2,471.52 "	 $729.60 
4400862	HCHG CTA ABD/PEL W & W/O	0352	CT SCAN - BODY SCAN	74174	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,755.60 "	" $2,287.60 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
4400912	HCHG CT SCAN CERV SP COMBO	0352	CT SCAN - BODY SCAN	72127	" $3,658.87 "	" $2,561.21 "	 $870.81 	" $3,292.98 "	" $3,183.22 "	 $878.13 	" $2,799.04 "	" $3,073.45 "	" $3,073.45 "	 $904.47 	" $2,305.09 "	" $3,110.04 "	" $2,414.85 "	" $3,146.63 "	 $878.13 	" $3,292.98 "	" $2,974.66 "	" $3,110.04 "	 $870.81 	" $2,974.66 "	 $878.13 
4401009	HCHG CT CHEST W/O LOW DOSE SCREEN	0352	CT SCAN - BODY SCAN	71250	" $1,700.00 "	" $1,190.00 "	 $404.60 	" $1,530.00 "	" $1,479.00 "	 $408.00 	" $1,300.50 "	" $1,428.00 "	" $1,428.00 "	 $420.24 	" $1,071.00 "	" $1,445.00 "	" $1,122.00 "	" $1,462.00 "	 $408.00 	" $1,530.00 "	" $1,382.10 "	" $1,445.00 "	 $404.60 	" $1,382.10 "	 $408.00 
110561	HCHG ESPHAGOSCOPY FLEXIBLE TRANSORAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43200	" $2,095.00 "	" $1,466.50 "	 $498.61 	" $1,885.50 "	" $1,822.65 "	 $502.80 	" $1,602.68 "	" $1,759.80 "	" $1,759.80 "	 $517.88 	" $1,319.85 "	" $1,780.75 "	" $1,445.55 "	" $1,676.00 "	 $502.80 	" $1,885.50 "	" $1,703.24 "	" $1,780.75 "	 $498.61 	" $1,703.24 "	 $502.80 
110562	HCHG CVMC ESPHAGOSCOPY FLEXIBLE TRANSORAL-2ND ROCEDURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43200	" $1,047.50 "	 $733.25 	 $249.31 	 $942.75 	 $911.33 	 $251.40 	 $801.34 	 $879.90 	 $879.90 	 $258.94 	 $659.93 	 $890.38 	 $722.78 	 $838.00 	 $251.40 	 $942.75 	 $851.62 	 $890.38 	 $249.31 	 $851.62 	 $251.40 
203287	HCHG CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23462	" $12,551.25 "	" $8,785.88 "	" $2,987.20 "	" $11,296.13 "	" $10,919.59 "	" $3,012.30 "	" $9,601.71 "	" $3,786.00 "	" $3,283.00 "	" $3,102.67 "	" $7,907.29 "	" $10,668.56 "	" $8,660.36 "	" $10,041.00 "	" $3,012.30 "	" $11,296.13 "	" $10,204.17 "	" $10,668.56 "	" $2,987.20 "	" $10,204.17 "	" $3,012.30 "
303284	HCHG TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25290	" $4,633.50 "	" $3,243.45 "	" $1,102.77 "	" $4,170.15 "	" $4,031.15 "	" $1,112.04 "	" $3,544.63 "	" $3,786.00 "	" $3,283.00 "	" $1,112.04 "	" $2,919.11 "	" $3,938.48 "	" $3,197.12 "	" $3,706.80 "	" $1,112.04 "	" $4,170.15 "	" $3,767.04 "	" $3,938.48 "	" $1,102.77 "	" $3,767.04 "	" $1,112.04 "
303286	HCHG EXCISION LESION TENDON SHEATH FOREARM&/WRIST	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25110	" $4,009.50 "	" $2,806.65 "	 $954.26 	" $3,608.55 "	" $3,488.27 "	 $962.28 	" $3,067.27 "	" $3,367.98 "	" $3,283.00 "	 $991.15 	" $2,525.99 "	" $3,408.08 "	" $2,766.56 "	" $3,207.60 "	 $962.28 	" $3,608.55 "	" $3,259.72 "	" $3,408.08 "	 $954.26 	" $3,259.72 "	 $962.28 
303288	HCHG CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28292	" $5,676.75 "	" $3,973.73 "	" $1,351.07 "	" $5,109.08 "	" $4,938.77 "	" $1,362.42 "	" $4,342.71 "	" $3,786.00 "	" $3,283.00 "	" $1,403.29 "	" $3,576.35 "	" $4,825.24 "	" $3,916.96 "	" $4,541.40 "	" $1,362.42 "	" $5,109.08 "	" $4,615.20 "	" $4,825.24 "	" $1,351.07 "	" $4,615.20 "	" $1,362.42 "
303289	HCHG ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28730	" $9,662.25 "	" $6,763.58 "	" $2,299.62 "	" $8,696.03 "	" $8,406.16 "	" $2,318.94 "	" $7,391.62 "	" $3,786.00 "	" $3,283.00 "	" $2,388.51 "	" $6,087.22 "	" $8,212.91 "	" $6,666.95 "	" $7,729.80 "	" $2,318.94 "	" $8,696.03 "	" $7,855.41 "	" $8,212.91 "	" $2,299.62 "	" $7,855.41 "	" $2,318.94 "
303291	HCHG SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29825	" $5,838.75 "	" $4,087.13 "	" $1,389.62 "	" $5,254.88 "	" $5,079.71 "	" $1,401.30 "	" $4,466.64 "	" $3,786.00 "	" $3,283.00 "	" $1,401.30 "	" $3,678.41 "	" $4,962.94 "	" $4,028.74 "	" $4,671.00 "	" $1,401.30 "	" $5,254.88 "	" $4,746.90 "	" $4,962.94 "	" $1,389.62 "	" $4,746.90 "	" $1,401.30 "
303294	HCHG ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29838	" $6,912.00 "	" $4,838.40 "	" $1,645.06 "	" $6,220.80 "	" $6,013.44 "	" $1,658.88 "	" $5,287.68 "	" $3,786.00 "	" $3,283.00 "	" $1,708.65 "	" $4,354.56 "	" $5,875.20 "	" $4,769.28 "	" $5,529.60 "	" $1,658.88 "	" $6,220.80 "	" $5,619.46 "	" $5,875.20 "	" $1,645.06 "	" $5,619.46 "	" $1,658.88 "
303299	HCHG MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44139	" $1,512.75 "	" $1,058.93 "	 $360.03 	" $1,361.48 "	" $1,316.09 "	 $363.06 	" $1,157.25 "	" $1,270.71 "	" $1,270.71 "	 $363.06 	 $953.03 	" $1,285.84 "	" $1,043.80 "	" $1,210.20 "	 $363.06 	" $1,361.48 "	" $1,229.87 "	" $1,285.84 "	 $360.03 	" $1,229.87 "	 $363.06 
303315	HCHG CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52235	" $6,309.75 "	" $4,416.83 "	" $1,501.72 "	" $5,678.78 "	" $5,489.48 "	" $1,514.34 "	" $4,826.96 "	" $3,786.00 "	" $3,283.00 "	" $1,559.77 "	" $3,975.14 "	" $5,363.29 "	" $4,353.73 "	" $5,047.80 "	" $1,514.34 "	" $5,678.78 "	" $5,129.83 "	" $5,363.29 "	" $1,501.72 "	" $5,129.83 "	" $1,514.34 "
303333	HCHG RMVL/REVJ SLING STRESS INCONTINENCE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	57287	" $7,011.75 "	" $4,908.23 "	" $1,668.80 "	" $6,310.58 "	" $6,100.22 "	" $1,682.82 "	" $5,363.99 "	" $3,786.00 "	" $3,283.00 "	" $1,682.82 "	" $4,417.40 "	" $5,959.99 "	" $4,838.11 "	" $5,609.40 "	" $1,682.82 "	" $6,310.58 "	" $5,700.55 "	" $5,959.99 "	" $1,668.80 "	" $5,700.55 "	" $1,682.82 "
303372	HCHG EXC LESION TDN SHTH/JT CAPSL HAND/FNGR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26160	" $3,997.50 "	" $2,798.25 "	 $951.41 	" $3,597.75 "	" $3,477.83 "	 $959.40 	" $3,058.09 "	" $3,357.90 "	" $3,283.00 "	 $988.18 	" $2,518.43 "	" $3,397.88 "	" $2,758.28 "	" $3,198.00 "	 $959.40 	" $3,597.75 "	" $3,249.97 "	" $3,397.88 "	 $951.41 	" $3,249.97 "	 $959.40 
304693	HCHG INJ/ASPIR-LARGE JT/BURSA WITH US GUIDE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	20611	" $1,094.34 "	 $766.04 	 $260.45 	 $984.91 	 $952.08 	 $262.64 	 $837.17 	 $919.25 	 $919.25 	 $270.52 	 $689.43 	 $930.19 	 $755.09 	 $875.47 	 $262.64 	 $984.91 	 $889.70 	 $930.19 	 $260.45 	 $889.70 	 $262.64 
305033	HCHG ILEOSCOPY STOMA W/BALLOON DILATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44381	" $2,130.23 "	" $1,491.16 "	 $506.99 	" $1,917.21 "	" $1,853.30 "	 $511.26 	" $1,629.63 "	" $1,789.39 "	" $1,789.39 "	 $526.59 	" $1,342.04 "	" $1,810.70 "	" $1,469.86 "	" $1,704.18 "	 $511.26 	" $1,917.21 "	" $1,731.88 "	" $1,810.70 "	 $506.99 	" $1,731.88 "	 $511.26 
305034	HCHG 2-ILEOSCOPY STOMA W/BALLOON DILATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44381	" $1,065.11 "	 $745.58 	 $253.50 	 $958.60 	 $926.65 	 $255.63 	 $814.81 	 $894.69 	 $894.69 	 $263.30 	 $671.02 	 $905.34 	 $734.93 	 $852.09 	 $255.63 	 $958.60 	 $865.93 	 $905.34 	 $253.50 	 $865.93 	 $255.63 
305035	HCHG COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44404	" $1,973.88 "	" $1,381.72 "	 $469.78 	" $1,776.49 "	" $1,717.28 "	 $473.73 	" $1,510.02 "	" $1,658.06 "	" $1,658.06 "	 $487.94 	" $1,243.54 "	" $1,677.80 "	" $1,361.98 "	" $1,579.10 "	 $473.73 	" $1,776.49 "	" $1,604.76 "	" $1,677.80 "	 $469.78 	" $1,604.76 "	 $473.73 
305036	HCHG 2-COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44404	" $1,579.10 "	" $1,105.37 "	 $375.83 	" $1,421.19 "	" $1,373.82 "	 $378.98 	" $1,208.01 "	" $1,326.44 "	" $1,326.44 "	 $390.35 	 $994.83 	" $1,342.24 "	" $1,089.58 "	" $1,263.28 "	 $378.98 	" $1,421.19 "	" $1,283.81 "	" $1,342.24 "	 $375.83 	" $1,283.81 "	 $378.98 
305037	HCHG COLONOSCOPY STOMA W/BALLOON DILATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44405	" $1,973.88 "	" $1,381.72 "	 $469.78 	" $1,776.49 "	" $1,717.28 "	 $473.73 	" $1,510.02 "	" $1,658.06 "	" $1,658.06 "	 $487.94 	" $1,243.54 "	" $1,677.80 "	" $1,361.98 "	" $1,579.10 "	 $473.73 	" $1,776.49 "	" $1,604.76 "	" $1,677.80 "	 $469.78 	" $1,604.76 "	 $473.73 
305038	HCHG 2-COLONOSCOPY STOMA W/BALLOON DILATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44405	" $1,579.10 "	" $1,105.37 "	 $375.83 	" $1,421.19 "	" $1,373.82 "	 $378.98 	" $1,208.01 "	" $1,326.44 "	" $1,326.44 "	 $390.35 	 $994.83 	" $1,342.24 "	" $1,089.58 "	" $1,263.28 "	 $378.98 	" $1,421.19 "	" $1,283.81 "	" $1,342.24 "	 $375.83 	" $1,283.81 "	 $378.98 
308642	HCHG DRAINAGE FINGER ABSCESS COMPLICATED	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26011	" $2,152.80 "	" $1,506.96 "	 $512.37 	" $1,937.52 "	" $1,872.94 "	 $516.67 	" $1,646.89 "	" $1,808.35 "	" $1,808.35 "	 $532.17 	" $1,356.26 "	" $1,829.88 "	" $1,485.43 "	" $1,722.24 "	 $516.67 	" $1,937.52 "	" $1,750.23 "	" $1,829.88 "	 $512.37 	" $1,750.23 "	 $516.67 
308837	HCHG LARYNGOSCOPY FLEXIBLE FIBEROPTIC DX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31575	 $770.00 	 $539.00 	 $183.26 	 $693.00 	 $669.90 	 $184.80 	 $589.05 	 $646.80 	 $646.80 	 $184.80 	 $485.10 	 $654.50 	 $531.30 	 $616.00 	 $184.80 	 $693.00 	 $626.01 	 $654.50 	 $183.26 	 $626.01 	 $184.80 
308842	"HCHG BMH/CVMC BRONCHOSCOPE/WASH/DX, INCLUDING FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31622	" $1,869.44 "	" $1,308.61 "	 $444.93 	" $1,682.50 "	" $1,626.41 "	 $448.67 	" $1,430.12 "	" $1,570.33 "	" $1,570.33 "	 $462.13 	" $1,177.75 "	" $1,589.02 "	" $1,289.91 "	" $1,495.55 "	 $448.67 	" $1,682.50 "	" $1,519.85 "	" $1,589.02 "	 $444.93 	" $1,519.85 "	 $448.67 
308843	"HCHG BMH/CVMC BRONCHOSCOPE/BRUSH/DX,INCLUDING FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31623	" $1,781.47 "	" $1,247.03 "	 $423.99 	" $1,603.32 "	" $1,549.88 "	 $427.55 	" $1,362.82 "	" $1,496.43 "	" $1,496.43 "	 $440.38 	" $1,122.33 "	" $1,514.25 "	" $1,229.21 "	" $1,425.18 "	 $427.55 	" $1,603.32 "	" $1,448.34 "	" $1,514.25 "	 $423.99 	" $1,448.34 "	 $427.55 
308844	"HCHG BMH/CVMC BRONCHOSCOPE/ALVEOLAR LAVAGE, INC FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31624	" $4,383.74 "	" $3,068.62 "	" $1,043.33 "	" $3,945.37 "	" $3,813.85 "	" $1,052.10 "	" $3,353.56 "	" $3,682.34 "	" $3,283.00 "	" $1,083.66 "	" $2,761.76 "	" $3,726.18 "	" $3,024.78 "	" $3,506.99 "	" $1,052.10 "	" $3,945.37 "	" $3,563.98 "	" $3,726.18 "	" $1,043.33 "	" $3,563.98 "	" $1,052.10 "
308845	"HCHG BMH/CVMC BRONCHOSCOPY W/BIOPSY, INCLUDING FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31625	" $1,664.10 "	" $1,164.87 "	 $396.06 	" $1,497.69 "	" $1,447.77 "	 $399.38 	" $1,273.04 "	" $1,397.84 "	" $1,397.84 "	 $411.37 	" $1,048.38 "	" $1,414.49 "	" $1,148.23 "	" $1,331.28 "	 $399.38 	" $1,497.69 "	" $1,352.91 "	" $1,414.49 "	 $396.06 	" $1,352.91 "	 $399.38 
308847	"HCHG BMH/CVMC BRONCHOSCOPY/LUNG BX ADD'L, W/WO  FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31632	 $775.70 	 $542.99 	 $184.62 	 $698.13 	 $674.86 	 $186.17 	 $593.41 	 $651.59 	 $651.59 	 $191.75 	 $488.69 	 $659.35 	 $535.23 	 $620.56 	 $186.17 	 $698.13 	 $630.64 	 $659.35 	 $184.62 	 $630.64 	 $186.17 
308849	"HCHG BMH/CVMC BRONCHOSCOPY CLEAR AIRWAYS,INC FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31645	" $1,517.17 "	" $1,062.02 "	 $361.09 	" $1,365.45 "	" $1,319.94 "	 $364.12 	" $1,160.64 "	" $1,274.42 "	" $1,274.42 "	 $375.04 	 $955.82 	" $1,289.59 "	" $1,046.85 "	" $1,213.74 "	 $364.12 	" $1,365.45 "	" $1,233.46 "	" $1,289.59 "	 $361.09 	" $1,233.46 "	 $364.12 
308850	"HCHG BMH/CVMC BRONCHOSCOPY, RECLEAR AIRWAY,INC FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31646	" $1,676.34 "	" $1,173.44 "	 $398.97 	" $1,508.71 "	" $1,458.42 "	 $402.32 	" $1,282.40 "	" $1,408.13 "	" $1,408.13 "	 $414.39 	" $1,056.09 "	" $1,424.89 "	" $1,156.67 "	" $1,341.07 "	 $402.32 	" $1,508.71 "	" $1,362.86 "	" $1,424.89 "	 $398.97 	" $1,362.86 "	 $402.32 
308854	HCHG BMH/CVMC TUBE THORACOSTOMY WITH/WITH OUT WATER SEAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	32551	" $1,600.00 "	" $1,120.00 "	 $380.80 	" $1,440.00 "	" $1,392.00 "	 $384.00 	" $1,224.00 "	" $1,344.00 "	" $1,344.00 "	 $395.52 	" $1,008.00 "	" $1,360.00 "	" $1,104.00 "	" $1,280.00 "	 $384.00 	" $1,440.00 "	" $1,300.80 "	" $1,360.00 "	 $380.80 	" $1,300.80 "	 $384.00 
309150	HCHG BMH/CVMC NEWBORN RESUSCITATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	99465	 $810.75 	 $567.53 	 $192.96 	 $729.68 	 $705.35 	 $194.58 	 $620.22 	 $681.03 	 $681.03 	 $200.42 	 $510.77 	 $689.14 	 $559.42 	 $648.60 	 $194.58 	 $729.68 	 $659.14 	 $689.14 	 $192.96 	 $659.14 	 $194.58 
309153	HCHG I&D FOREARM/WRIST DEEP ABSCESS/HEMA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25028	" $5,532.00 "	" $3,872.40 "	" $1,316.62 "	" $4,978.80 "	" $4,812.84 "	" $1,327.68 "	" $4,231.98 "	" $3,786.00 "	" $3,283.00 "	" $1,367.51 "	" $3,485.16 "	" $4,702.20 "	" $3,817.08 "	" $4,425.60 "	" $1,327.68 "	" $4,978.80 "	" $4,497.52 "	" $4,702.20 "	" $1,316.62 "	" $4,497.52 "	" $1,327.68 "
309171	HCHG DENTOALVEOLAR STRUCTURES 1ST HR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	41899	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $98.88 	 $252.00 	 $340.00 	 $276.00 	 $320.00 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
309172	HCHG DENTOALVEOLAR STRUCTURES ADDL 15 MIN	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	41899	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $69.00 	 $80.00 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
310035	HCHG TREAT HUMERUS FRACTURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $11,511.18 "	" $8,057.83 "	" $2,739.66 "	" $10,360.06 "	" $10,014.73 "	" $2,762.68 "	" $8,806.05 "	" $3,786.00 "	" $3,283.00 "	" $2,762.68 "	" $7,252.04 "	" $9,784.50 "	" $7,942.71 "	" $9,208.94 "	" $2,762.68 "	" $10,360.06 "	" $9,358.59 "	" $9,784.50 "	" $2,739.66 "	" $9,358.59 "	" $2,762.68 "
310036	HCHG FNA WITHOUT IMAGING GUIDANCE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	10021	 $990.00 	 $693.00 	 $235.62 	 $891.00 	 $861.30 	 $237.60 	 $757.35 	 $831.60 	 $831.60 	 $244.73 	 $623.70 	 $841.50 	 $683.10 	 $792.00 	 $237.60 	 $891.00 	 $804.87 	 $841.50 	 $235.62 	 $804.87 	 $237.60 
310037	HCHG INJ/ASPIR-LARGE JT/BURSA W/O US GUIDE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	20610	" $1,160.00 "	 $812.00 	 $276.08 	" $1,044.00 "	" $1,009.20 "	 $278.40 	 $887.40 	 $974.40 	 $974.40 	 $286.75 	 $730.80 	 $986.00 	 $800.40 	 $928.00 	 $278.40 	" $1,044.00 "	 $943.08 	 $986.00 	 $276.08 	 $943.08 	 $278.40 
330911	HCHG CVMC 2-ANOSCOPY DIAGNOSTIC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46600	 $141.01 	 $98.71 	 $33.56 	 $126.91 	 $122.68 	 $33.84 	 $107.87 	 $118.45 	 $118.45 	 $34.86 	 $88.84 	 $119.86 	 $97.30 	 $112.81 	 $33.84 	 $126.91 	 $114.64 	 $119.86 	 $33.56 	 $114.64 	 $33.84 
330913	HCHG CVMC 2-CHEMICAL CAUTERIZATION OF GRANULATION TISSUE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	17250	 $150.12 	 $105.08 	 $35.73 	 $135.11 	 $130.60 	 $36.03 	 $114.84 	 $126.10 	 $126.10 	 $37.11 	 $94.58 	 $127.60 	 $103.58 	 $120.10 	 $36.03 	 $135.11 	 $122.05 	 $127.60 	 $35.73 	 $122.05 	 $36.03 
330971	"HCHG SCREENING COLONOSCOPY, PT NOT HIGH RISK"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	G0121	 $621.24 	 $434.87 	 $147.86 	 $559.12 	 $540.48 	 $149.10 	 $475.25 	 $521.84 	 $521.84 	 $149.10 	 $391.38 	 $528.05 	 $428.66 	 $496.99 	 $149.10 	 $559.12 	 $505.07 	 $528.05 	 $147.86 	 $505.07 	 $149.10 
343200	"HCHG CVMC MAMMAPLASTY, AUGMENTATION WITH PROSTHETIC IMPLANT"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	19325	" $4,727.73 "	" $3,309.41 "	" $1,125.20 "	" $4,254.96 "	" $4,113.13 "	" $1,134.66 "	" $3,616.71 "	" $3,786.00 "	" $3,283.00 "	" $1,168.69 "	" $2,978.47 "	" $4,018.57 "	" $3,262.13 "	" $3,782.18 "	" $1,134.66 "	" $4,254.96 "	" $3,843.64 "	" $4,018.57 "	" $1,125.20 "	" $3,843.64 "	" $1,134.66 "
343212	"HCHG BMH/CVMC THORACENTESIS, NEEDLE OR CATHETER,W/IMAGING GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	32555	" $1,659.15 "	" $1,161.41 "	 $394.88 	" $1,493.24 "	" $1,443.46 "	 $398.20 	" $1,269.25 "	" $1,393.69 "	" $1,393.69 "	 $410.14 	" $1,045.26 "	" $1,410.28 "	" $1,144.81 "	" $1,327.32 "	 $398.20 	" $1,493.24 "	" $1,348.89 "	" $1,410.28 "	 $394.88 	" $1,348.89 "	 $398.20 
343214	"HCHG BMH/CVMC TRANSCATH RETRIEVAL,PERCUT,INTRAVASCULAR FOREIGN BODY"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37197	" $8,963.82 "	" $6,274.67 "	" $2,133.39 "	" $8,067.44 "	" $7,798.52 "	" $2,151.32 "	" $6,857.32 "	" $3,786.00 "	" $3,283.00 "	" $2,215.86 "	" $5,647.21 "	" $7,619.25 "	" $6,185.04 "	" $7,171.06 "	" $2,151.32 "	" $8,067.44 "	" $7,287.59 "	" $7,619.25 "	" $2,133.39 "	" $7,287.59 "	" $2,151.32 "
343216	HCHG CVMC TRANSCATHETER BIOPSY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37200	" $6,823.53 "	" $4,776.47 "	" $1,624.00 "	" $6,141.18 "	" $5,936.47 "	" $1,637.65 "	" $5,220.00 "	" $3,786.00 "	" $3,283.00 "	" $1,686.78 "	" $4,298.82 "	" $5,800.00 "	" $4,708.24 "	" $5,458.82 "	" $1,637.65 "	" $6,141.18 "	" $5,547.53 "	" $5,800.00 "	" $1,624.00 "	" $5,547.53 "	" $1,637.65 "
343218	HCHG TRANS THPY ART CORO/INTRAC DAY 1	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37211	" $3,162.60 "	" $2,213.82 "	 $752.70 	" $2,846.34 "	" $2,751.46 "	 $759.02 	" $2,419.39 "	" $2,656.58 "	" $2,656.58 "	 $759.02 	" $1,992.44 "	" $2,688.21 "	" $2,182.19 "	" $2,530.08 "	 $759.02 	" $2,846.34 "	" $2,571.19 "	" $2,688.21 "	 $752.70 	" $2,571.19 "	 $759.02 
343220	"HCHG BMH/CVMC TRANSCATHETER THERAPY, VENOUS INFUSION FOR THROMBOLYSIS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37212	" $3,162.60 "	" $2,213.82 "	 $752.70 	" $2,846.34 "	" $2,751.46 "	 $759.02 	" $2,419.39 "	" $2,656.58 "	" $2,656.58 "	 $781.79 	" $1,992.44 "	" $2,688.21 "	" $2,182.19 "	" $2,530.08 "	 $759.02 	" $2,846.34 "	" $2,571.19 "	" $2,688.21 "	 $752.70 	" $2,571.19 "	 $759.02 
343222	"HCHG BMH/CVMC TRANSCATH THERAPY,ARTERIAL/VENOUS INF FOR THROMBOLYSIS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37213	" $7,057.20 "	" $4,940.04 "	" $1,679.61 "	" $6,351.48 "	" $6,139.76 "	" $1,693.73 "	" $5,398.76 "	" $3,786.00 "	" $3,283.00 "	" $1,744.54 "	" $4,446.04 "	" $5,998.62 "	" $4,869.47 "	" $5,645.76 "	" $1,693.73 "	" $6,351.48 "	" $5,737.50 "	" $5,998.62 "	" $1,679.61 "	" $5,737.50 "	" $1,693.73 "
343224	"HCHG BMH/CVMC TRANSCATH THERAPY,ARTERIAL/VENOUS INF FOR THROMBOLYSIS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37214	" $7,057.20 "	" $4,940.04 "	" $1,679.61 "	" $6,351.48 "	" $6,139.76 "	" $1,693.73 "	" $5,398.76 "	" $3,786.00 "	" $3,283.00 "	" $1,744.54 "	" $4,446.04 "	" $5,998.62 "	" $4,869.47 "	" $5,645.76 "	" $1,693.73 "	" $6,351.48 "	" $5,737.50 "	" $5,998.62 "	" $1,679.61 "	" $5,737.50 "	" $1,693.73 "
343226	"HCHG CVMC HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S)"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46221	" $1,578.72 "	" $1,105.10 "	 $375.74 	" $1,420.85 "	" $1,373.49 "	 $378.89 	" $1,207.72 "	" $1,326.12 "	" $1,326.12 "	 $390.26 	 $994.59 	" $1,341.91 "	" $1,089.32 "	" $1,262.98 "	 $378.89 	" $1,420.85 "	" $1,283.50 "	" $1,341.91 "	 $375.74 	" $1,283.50 "	 $378.89 
343270	HCHG CVMC NEG PRESS WND TX <50 CM DME	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	97605	 $331.94 	 $232.36 	 $79.00 	 $298.75 	 $288.79 	 $79.67 	 $253.93 	 $278.83 	 $278.83 	 $82.06 	 $209.12 	 $282.15 	 $229.04 	 $265.55 	 $79.67 	 $298.75 	 $269.87 	 $282.15 	 $79.00 	 $269.87 	 $79.67 
343271	HCHG CVMC NEG PRESS WND TX >50 CM DME	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	97606	 $408.89 	 $286.22 	 $97.32 	 $368.00 	 $355.73 	 $98.13 	 $312.80 	 $343.47 	 $343.47 	 $101.08 	 $257.60 	 $347.56 	 $282.13 	 $327.11 	 $98.13 	 $368.00 	 $332.43 	 $347.56 	 $97.32 	 $332.43 	 $98.13 
343281	"HCHG CVMC INJ,PLATELET RICH PLASMA,ANY TISSUE,INC IMAGE GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	0232T	 $473.52 	 $331.46 	 $112.70 	 $426.17 	 $411.96 	 $113.64 	 $362.24 	 $397.76 	 $397.76 	 $117.05 	 $298.32 	 $402.49 	 $326.73 	 $378.82 	 $113.64 	 $426.17 	 $384.97 	 $402.49 	 $112.70 	 $384.97 	 $113.64 
4400279	"HCHG DISKECTOMY,PERCUTANEOUS LUMBAR"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	62287	" $10,151.25 "	" $7,105.88 "	" $2,416.00 "	" $9,136.13 "	" $8,831.59 "	" $2,436.30 "	" $7,765.71 "	" $3,786.00 "	" $3,283.00 "	" $2,509.39 "	" $6,395.29 "	" $8,628.56 "	" $7,004.36 "	" $8,121.00 "	" $2,436.30 "	" $9,136.13 "	" $8,252.97 "	" $8,628.56 "	" $2,416.00 "	" $8,252.97 "	" $2,436.30 "
4400886	HCHG INJ SCLEROSANT SGL INCOMPETENT VEIN	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	36470	 $145.78 	 $102.05 	 $34.70 	 $131.20 	 $126.83 	 $34.99 	 $111.52 	 $122.46 	 $122.46 	 $36.04 	 $91.84 	 $123.91 	 $100.59 	 $116.62 	 $34.99 	 $131.20 	 $118.52 	 $123.91 	 $34.70 	 $118.52 	 $34.99 
4400887	HCHG INJ SCLEROSANT MLT INCOMPETENT VEINS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	36471	 $145.78 	 $102.05 	 $34.70 	 $131.20 	 $126.83 	 $34.99 	 $111.52 	 $122.46 	 $122.46 	 $36.04 	 $91.84 	 $123.91 	 $100.59 	 $116.62 	 $34.99 	 $131.20 	 $118.52 	 $123.91 	 $34.70 	 $118.52 	 $34.99 
4400891	HCHG REPAIR TUNNELED CV CATH W/O PORT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	36575	" $2,425.06 "	" $1,697.54 "	 $577.16 	" $2,182.55 "	" $2,109.80 "	 $582.01 	" $1,855.17 "	" $2,037.05 "	" $2,037.05 "	 $582.01 	" $1,527.79 "	" $2,061.30 "	" $1,673.29 "	" $1,940.05 "	 $582.01 	" $2,182.55 "	" $1,971.57 "	" $2,061.30 "	 $577.16 	" $1,971.57 "	 $582.01 
4400892	HCHG REPAIR TUNNELED CV CATH W/PORT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	36576	" $3,490.54 "	" $2,443.38 "	 $830.75 	" $3,141.49 "	" $3,036.77 "	 $837.73 	" $2,670.26 "	" $2,932.05 "	" $2,932.05 "	 $837.73 	" $2,199.04 "	" $2,966.96 "	" $2,408.47 "	" $2,792.43 "	 $837.73 	" $3,141.49 "	" $2,837.81 "	" $2,966.96 "	 $830.75 	" $2,837.81 "	 $837.73 
4400893	HCHG REPLACE TUNNELED CV CATH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	36578	" $2,425.06 "	" $1,697.54 "	 $577.16 	" $2,182.55 "	" $2,109.80 "	 $582.01 	" $1,855.17 "	" $2,037.05 "	" $2,037.05 "	 $582.01 	" $1,527.79 "	" $2,061.30 "	" $1,673.29 "	" $1,940.05 "	 $582.01 	" $2,182.55 "	" $1,971.57 "	" $2,061.30 "	 $577.16 	" $1,971.57 "	 $582.01 
4400894	HCHG REPLACE TUNNELED CV CATH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	36583	" $10,546.25 "	" $7,382.38 "	" $2,510.01 "	" $9,491.63 "	" $9,175.24 "	" $2,531.10 "	" $8,067.88 "	" $3,786.00 "	" $3,283.00 "	" $2,531.10 "	" $6,644.14 "	" $8,964.31 "	" $7,276.91 "	" $8,437.00 "	" $2,531.10 "	" $9,491.63 "	" $8,574.10 "	" $8,964.31 "	" $2,510.01 "	" $8,574.10 "	" $2,531.10 "
4400896	HCHG PHLEB VEINS - EXTREM - TO 20	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37765	" $5,330.38 "	" $3,731.27 "	" $1,268.63 "	" $4,797.34 "	" $4,637.43 "	" $1,279.29 "	" $4,077.74 "	" $3,786.00 "	" $3,283.00 "	" $1,279.29 "	" $3,358.14 "	" $4,530.82 "	" $3,677.96 "	" $4,264.30 "	" $1,279.29 "	" $4,797.34 "	" $4,333.60 "	" $4,530.82 "	" $1,268.63 "	" $4,333.60 "	" $1,279.29 "
4400897	HCHG PHLEB VEINS - EXTREM 20+	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37766	" $7,201.10 "	" $5,040.77 "	" $1,713.86 "	" $6,480.99 "	" $6,264.96 "	" $1,728.26 "	" $5,508.84 "	" $3,786.00 "	" $3,283.00 "	" $1,728.26 "	" $4,536.69 "	" $6,120.94 "	" $4,968.76 "	" $5,760.88 "	" $1,728.26 "	" $6,480.99 "	" $5,854.49 "	" $6,120.94 "	" $1,713.86 "	" $5,854.49 "	" $1,728.26 "
4400898	HCHG VASCULAR SURGERY PROCEDURE UNLIST	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37799	" $3,482.97 "	" $2,438.08 "	 $828.95 	" $3,134.67 "	" $3,030.18 "	 $835.91 	" $2,664.47 "	" $2,925.69 "	" $2,925.69 "	 $835.91 	" $2,194.27 "	" $2,960.52 "	" $2,403.25 "	" $2,786.38 "	 $835.91 	" $3,134.67 "	" $2,831.65 "	" $2,960.52 "	 $828.95 	" $2,831.65 "	 $835.91 
4400903	"HCHG INJECT NERV BLCK,STELLATE GANGLION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64510	" $2,328.44 "	" $1,629.91 "	 $554.17 	" $2,095.60 "	" $2,025.74 "	 $558.83 	" $1,781.26 "	" $1,955.89 "	" $1,955.89 "	 $575.59 	" $1,466.92 "	" $1,979.17 "	" $1,606.62 "	" $1,862.75 "	 $558.83 	" $2,095.60 "	" $1,893.02 "	" $1,979.17 "	 $554.17 	" $1,893.02 "	 $558.83 
4400918	"HCHG INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, 1ST LEVEL"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64493	" $6,310.00 "	" $4,417.00 "	" $1,501.78 "	" $5,679.00 "	" $5,489.70 "	" $1,514.40 "	" $4,827.15 "	" $3,786.00 "	" $3,283.00 "	" $1,559.83 "	" $3,975.30 "	" $5,363.50 "	" $4,353.90 "	" $5,048.00 "	" $1,514.40 "	" $5,679.00 "	" $5,130.03 "	" $5,363.50 "	" $1,501.78 "	" $5,130.03 "	" $1,514.40 "
4400922	"HCHG LAP,ABLAT 1+ LIVER TUMOR(S),RADIOFREQ"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	47370	" $13,605.32 "	" $9,523.72 "	" $3,238.07 "	" $12,244.79 "	" $11,836.63 "	" $3,265.28 "	" $10,408.07 "	" $3,786.00 "	" $3,283.00 "	" $3,265.28 "	" $8,571.35 "	" $11,564.52 "	" $9,387.67 "	" $10,884.26 "	" $3,265.28 "	" $12,244.79 "	" $11,061.13 "	" $11,564.52 "	" $3,238.07 "	" $11,061.13 "	" $3,265.28 "
4400923	HCHG DRAINAGE OF KIDNEY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	50040	" $3,792.05 "	" $2,654.44 "	 $902.51 	" $3,412.85 "	" $3,299.08 "	 $910.09 	" $2,900.92 "	" $3,185.32 "	" $3,185.32 "	 $937.39 	" $2,388.99 "	" $3,223.24 "	" $2,616.51 "	" $3,033.64 "	 $910.09 	" $3,412.85 "	" $3,082.94 "	" $3,223.24 "	 $902.51 	" $3,082.94 "	 $910.09 
503484	HCHG N BLOCK INJ(S) GREATER OCCIPITAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64405	 $794.25 	 $555.98 	 $189.03 	 $714.83 	 $691.00 	 $190.62 	 $607.60 	 $667.17 	 $667.17 	 $190.62 	 $500.38 	 $675.11 	 $548.03 	 $635.40 	 $190.62 	 $714.83 	 $645.73 	 $675.11 	 $189.03 	 $645.73 	 $190.62 
503488	HCHG N BLOCK INJ(S) BRACHIAL PLEXUS (INCLUDES IG) (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64415	" $4,000.00 "	" $2,800.00 "	 $952.00 	" $3,600.00 "	" $3,480.00 "	 $960.00 	" $3,060.00 "	" $3,360.00 "	" $3,283.00 "	 $960.00 	" $2,520.00 "	" $3,400.00 "	" $2,760.00 "	" $3,200.00 "	 $960.00 	" $3,600.00 "	" $3,252.00 "	" $3,400.00 "	 $952.00 	" $3,252.00 "	 $960.00 
503489	HCHG N BLOCK INJ(S) AXILLARY (INCLUDES IG) (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64417	" $2,320.50 "	" $1,624.35 "	 $552.28 	" $2,088.45 "	" $2,018.84 "	 $556.92 	" $1,775.18 "	" $1,949.22 "	" $1,949.22 "	 $556.92 	" $1,461.92 "	" $1,972.43 "	" $1,601.15 "	" $1,856.40 "	 $556.92 	" $2,088.45 "	" $1,886.57 "	" $1,972.43 "	 $552.28 	" $1,886.57 "	 $556.92 
503492	HCHG N BLOCK INJ(S) INTERCOST MLT (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64421	" $1,605.75 "	" $1,124.03 "	 $382.17 	" $1,445.18 "	" $1,397.00 "	 $385.38 	" $1,228.40 "	" $1,348.83 "	" $1,348.83 "	 $385.38 	" $1,011.62 "	" $1,364.89 "	" $1,107.97 "	" $1,284.60 "	 $385.38 	" $1,445.18 "	" $1,305.47 "	" $1,364.89 "	 $382.17 	" $1,305.47 "	 $385.38 
503493	HCHG N BLOCK INJ(S) ILIO-ING/HYPOGI (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64425	" $1,478.25 "	" $1,034.78 "	 $351.82 	" $1,330.43 "	" $1,286.08 "	 $354.78 	" $1,130.86 "	" $1,241.73 "	" $1,241.73 "	 $354.78 	 $931.30 	" $1,256.51 "	" $1,019.99 "	" $1,182.60 "	 $354.78 	" $1,330.43 "	" $1,201.82 "	" $1,256.51 "	 $351.82 	" $1,201.82 "	 $354.78 
503494	HCHG N BLOCK INJ(S) PUDENDAL (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64430	" $2,025.75 "	" $1,418.03 "	 $482.13 	" $1,823.18 "	" $1,762.40 "	 $486.18 	" $1,549.70 "	" $1,701.63 "	" $1,701.63 "	 $486.18 	" $1,276.22 "	" $1,721.89 "	" $1,397.77 "	" $1,620.60 "	 $486.18 	" $1,823.18 "	" $1,646.93 "	" $1,721.89 "	 $482.13 	" $1,646.93 "	 $486.18 
503495	HCHG N BLOCK INJ(S) SCIATIC SNG (INCLUDES IG) (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64445	" $2,260.00 "	" $1,582.00 "	 $537.88 	" $2,034.00 "	" $1,966.20 "	 $542.40 	" $1,728.90 "	" $1,898.40 "	" $1,898.40 "	 $542.40 	" $1,423.80 "	" $1,921.00 "	" $1,559.40 "	" $1,808.00 "	 $542.40 	" $2,034.00 "	" $1,837.38 "	" $1,921.00 "	 $537.88 	" $1,837.38 "	 $542.40 
503497	HCHG N BLOCK INJ(S) LUMBAR PLEXUS (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64449	" $3,838.50 "	" $2,686.95 "	 $913.56 	" $3,454.65 "	" $3,339.50 "	 $921.24 	" $2,936.45 "	" $3,224.34 "	" $3,224.34 "	 $921.24 	" $2,418.26 "	" $3,262.73 "	" $2,648.57 "	" $3,070.80 "	 $921.24 	" $3,454.65 "	" $3,120.70 "	" $3,262.73 "	 $913.56 	" $3,120.70 "	 $921.24 
503498	HCHG TAP BLOCK UNIL BY INJECTION (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64486	" $3,030.00 "	" $2,121.00 "	 $721.14 	" $2,727.00 "	" $2,636.10 "	 $727.20 	" $2,317.95 "	" $2,545.20 "	" $2,545.20 "	 $727.20 	" $1,908.90 "	" $2,575.50 "	" $2,090.70 "	" $2,424.00 "	 $727.20 	" $2,727.00 "	" $2,463.39 "	" $2,575.50 "	 $721.14 	" $2,463.39 "	 $727.20 
503501	HCHG UNLISTED NERVOUS SYSTEM SURGERY (360)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64999	" $3,612.36 "	" $2,528.65 "	 $859.74 	" $3,251.12 "	" $3,142.75 "	 $866.97 	" $2,763.46 "	" $3,034.38 "	" $3,034.38 "	 $866.97 	" $2,275.79 "	" $3,070.51 "	" $2,492.53 "	" $2,889.89 "	 $866.97 	" $3,251.12 "	" $2,936.85 "	" $3,070.51 "	 $859.74 	" $2,936.85 "	 $866.97 
503554	HCHG DEBRIDEMENT GENITAL PERINEUM AB WALL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	11006	" $5,961.08 "	" $4,172.76 "	" $1,418.74 "	" $5,364.97 "	" $5,186.14 "	" $1,430.66 "	" $4,560.23 "	" $3,786.00 "	" $3,283.00 "	" $1,473.58 "	" $3,755.48 "	" $5,066.92 "	" $4,113.15 "	" $4,768.86 "	" $1,430.66 "	" $5,364.97 "	" $4,846.36 "	" $5,066.92 "	" $1,418.74 "	" $4,846.36 "	" $1,430.66 "
503555	HCHG REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	11008	" $4,220.00 "	" $2,954.00 "	" $1,004.36 "	" $3,798.00 "	" $3,671.40 "	" $1,012.80 "	" $3,228.30 "	" $3,544.80 "	" $3,283.00 "	" $1,012.80 "	" $2,658.60 "	" $3,587.00 "	" $2,911.80 "	" $3,376.00 "	" $1,012.80 "	" $3,798.00 "	" $3,430.86 "	" $3,587.00 "	" $1,004.36 "	" $3,430.86 "	" $1,012.80 "
503556	HCHG SECONDARY CLOSURE SURG WOUND/DEHSN EXTENSIVE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	13160	" $6,241.61 "	" $4,369.13 "	" $1,485.50 "	" $5,617.45 "	" $5,430.20 "	" $1,497.99 "	" $4,774.83 "	" $3,786.00 "	" $3,283.00 "	" $1,497.99 "	" $3,932.21 "	" $5,305.37 "	" $4,306.71 "	" $4,993.29 "	" $1,497.99 "	" $5,617.45 "	" $5,074.43 "	" $5,305.37 "	" $1,485.50 "	" $5,074.43 "	" $1,497.99 "
503557	HCHG MUSC MUSCLE MYO OR FASC FLAP TRUNK	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	15734	" $7,075.15 "	" $4,952.61 "	" $1,683.89 "	" $6,367.64 "	" $6,155.38 "	" $1,698.04 "	" $5,412.49 "	" $3,786.00 "	" $3,283.00 "	" $1,698.04 "	" $4,457.34 "	" $6,013.88 "	" $4,881.85 "	" $5,660.12 "	" $1,698.04 "	" $6,367.64 "	" $5,752.10 "	" $6,013.88 "	" $1,683.89 "	" $5,752.10 "	" $1,698.04 "
503558	HCHG BIOPSY BREAST OPEN INCISIONAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	19101	" $5,143.79 "	" $3,600.65 "	" $1,224.22 "	" $4,629.41 "	" $4,475.10 "	" $1,234.51 "	" $3,935.00 "	" $3,786.00 "	" $3,283.00 "	" $1,271.54 "	" $3,240.59 "	" $4,372.22 "	" $3,549.22 "	" $4,115.03 "	" $1,234.51 "	" $4,629.41 "	" $4,181.90 "	" $4,372.22 "	" $1,224.22 "	" $4,181.90 "	" $1,234.51 "
503559	HCHG EXC CYST ABERRANT BREAST TISSUE OPEN 1/> LESION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	19120	" $5,721.38 "	" $4,004.97 "	" $1,361.69 "	" $5,149.24 "	" $4,977.60 "	" $1,373.13 "	" $4,376.86 "	" $3,786.00 "	" $3,283.00 "	" $1,414.33 "	" $3,604.47 "	" $4,863.17 "	" $3,947.75 "	" $4,577.10 "	" $1,373.13 "	" $5,149.24 "	" $4,651.48 "	" $4,863.17 "	" $1,361.69 "	" $4,651.48 "	" $1,373.13 "
503560	HCHG MASTECTOMY PARTIAL W AXILLARY LYMPHADENECTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	19302	" $10,300.00 "	" $7,210.00 "	" $2,451.40 "	" $9,270.00 "	" $8,961.00 "	" $2,472.00 "	" $7,879.50 "	" $3,786.00 "	" $3,283.00 "	" $2,472.00 "	" $6,489.00 "	" $8,755.00 "	" $7,107.00 "	" $8,240.00 "	" $2,472.00 "	" $9,270.00 "	" $8,373.90 "	" $8,755.00 "	" $2,451.40 "	" $8,373.90 "	" $2,472.00 "
503561	HCHG MAST RAD W PEC MUSCLES AXILLARY LYMPH NODES	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	19305	" $10,266.41 "	" $7,186.49 "	" $2,443.41 "	" $9,239.77 "	" $8,931.78 "	" $2,463.94 "	" $7,853.80 "	" $3,786.00 "	" $3,283.00 "	" $2,463.94 "	" $6,467.84 "	" $8,726.45 "	" $7,083.82 "	" $8,213.13 "	" $2,463.94 "	" $9,239.77 "	" $8,346.59 "	" $8,726.45 "	" $2,443.41 "	" $8,346.59 "	" $2,463.94 "
503562	HCHG EXC TUMOR SOFT TISS NECK THORAX SUBFASC 5 CM/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21554	" $7,110.00 "	" $4,977.00 "	" $1,692.18 "	" $6,399.00 "	" $6,185.70 "	" $1,706.40 "	" $5,439.15 "	" $3,786.00 "	" $3,283.00 "	" $1,757.59 "	" $4,479.30 "	" $6,043.50 "	" $4,905.90 "	" $5,688.00 "	" $1,706.40 "	" $6,399.00 "	" $5,780.43 "	" $6,043.50 "	" $1,692.18 "	" $5,780.43 "	" $1,706.40 "
503563	HCHG EXC TUMOR SOFT TISS NECK/ANT THORAX SUBQ <3CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21555	" $4,933.67 "	" $3,453.57 "	" $1,174.21 "	" $4,440.30 "	" $4,292.29 "	" $1,184.08 "	" $3,774.26 "	" $3,786.00 "	" $3,283.00 "	" $1,219.60 "	" $3,108.21 "	" $4,193.62 "	" $3,404.23 "	" $3,946.94 "	" $1,184.08 "	" $4,440.30 "	" $4,011.07 "	" $4,193.62 "	" $1,174.21 "	" $4,011.07 "	" $1,184.08 "
503564	HCHG EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23075	" $4,041.21 "	" $2,828.85 "	 $961.81 	" $3,637.09 "	" $3,515.85 "	 $969.89 	" $3,091.53 "	" $3,394.62 "	" $3,283.00 "	 $998.99 	" $2,545.96 "	" $3,435.03 "	" $2,788.43 "	" $3,232.97 "	 $969.89 	" $3,637.09 "	" $3,285.50 "	" $3,435.03 "	 $961.81 	" $3,285.50 "	 $969.89 
503565	HCHG TENODESIS LONG TENDON BICEPS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23430	" $7,446.95 "	" $5,212.87 "	" $1,772.37 "	" $6,702.26 "	" $6,478.85 "	" $1,787.27 "	" $5,696.92 "	" $3,786.00 "	" $3,283.00 "	" $1,787.27 "	" $4,691.58 "	" $6,329.91 "	" $5,138.40 "	" $5,957.56 "	" $1,787.27 "	" $6,702.26 "	" $6,054.37 "	" $6,329.91 "	" $1,772.37 "	" $6,054.37 "	" $1,787.27 "
503566	HCHG CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23466	" $11,089.31 "	" $7,762.52 "	" $2,639.26 "	" $9,980.38 "	" $9,647.70 "	" $2,661.43 "	" $8,483.32 "	" $3,786.00 "	" $3,283.00 "	" $2,741.28 "	" $6,986.27 "	" $9,425.91 "	" $7,651.62 "	" $8,871.45 "	" $2,661.43 "	" $9,980.38 "	" $9,015.61 "	" $9,425.91 "	" $2,639.26 "	" $9,015.61 "	" $2,661.43 "
503567	HCHG ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23470	" $15,500.00 "	" $10,850.00 "	" $3,283.00 "	" $13,950.00 "	" $13,485.00 "	" $3,720.00 "	" $11,857.50 "	" $3,786.00 "	" $3,283.00 "	" $3,831.60 "	" $9,765.00 "	" $13,175.00 "	" $10,695.00 "	" $12,400.00 "	" $3,720.00 "	" $13,950.00 "	" $12,601.50 "	" $13,175.00 "	" $3,689.00 "	" $12,601.50 "	" $3,720.00 "
503568	HCHG ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23472	" $16,000.00 "	" $11,200.00 "	" $3,283.00 "	" $14,400.00 "	" $13,920.00 "	" $3,840.00 "	" $12,240.00 "	" $3,786.00 "	" $3,283.00 "	" $3,955.20 "	" $10,080.00 "	" $13,600.00 "	" $11,040.00 "	" $12,800.00 "	" $3,840.00 "	" $14,400.00 "	" $13,008.00 "	" $13,600.00 "	" $3,808.00 "	" $13,008.00 "	" $3,840.00 "
503569	HCHG REVIS SHOULDR ARTHRPLSTY HUMERAL GLENOID	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23473	" $16,503.87 "	" $11,552.71 "	" $3,283.00 "	" $14,853.48 "	" $14,358.37 "	" $3,960.93 "	" $12,625.46 "	" $3,786.00 "	" $3,283.00 "	" $3,960.93 "	" $10,397.44 "	" $14,028.29 "	" $11,387.67 "	" $13,203.10 "	" $3,960.93 "	" $14,853.48 "	" $13,417.65 "	" $14,028.29 "	" $3,927.92 "	" $13,417.65 "	" $3,960.93 "
503570	HCHG OPEN TX CLAVICULAR FX INTERNAL FIXATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23515	" $12,500.00 "	" $8,750.00 "	" $2,975.00 "	" $11,250.00 "	" $10,875.00 "	" $3,000.00 "	" $9,562.50 "	" $3,786.00 "	" $3,283.00 "	" $3,000.00 "	" $7,875.00 "	" $10,625.00 "	" $8,625.00 "	" $10,000.00 "	" $3,000.00 "	" $11,250.00 "	" $10,162.50 "	" $10,625.00 "	" $2,975.00 "	" $10,162.50 "	" $3,000.00 "
503571	HCHG OPEN TX CLAVICAL DISLOC W FASCIAL GRAFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23552	" $10,499.15 "	" $7,349.41 "	" $2,498.80 "	" $9,449.24 "	" $9,134.26 "	" $2,519.80 "	" $8,031.85 "	" $3,786.00 "	" $3,283.00 "	" $2,519.80 "	" $6,614.46 "	" $8,924.28 "	" $7,244.41 "	" $8,399.32 "	" $2,519.80 "	" $9,449.24 "	" $8,535.81 "	" $8,924.28 "	" $2,498.80 "	" $8,535.81 "	" $2,519.80 "
503572	HCHG OPEN TX SCAPULAR FX W INTERNAL FIXATION IF	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23585	" $12,903.86 "	" $9,032.70 "	" $3,071.12 "	" $11,613.47 "	" $11,226.36 "	" $3,096.93 "	" $9,871.45 "	" $3,786.00 "	" $3,283.00 "	" $3,096.93 "	" $8,129.43 "	" $10,968.28 "	" $8,903.66 "	" $10,323.09 "	" $3,096.93 "	" $11,613.47 "	" $10,490.84 "	" $10,968.28 "	" $3,071.12 "	" $10,490.84 "	" $3,096.93 "
503573	HCHG OPEN TXT PROXIMAL HUMERAL FRACTURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23615	" $14,000.00 "	" $9,800.00 "	" $3,283.00 "	" $12,600.00 "	" $12,180.00 "	" $3,360.00 "	" $10,710.00 "	" $3,786.00 "	" $3,283.00 "	" $3,360.00 "	" $8,820.00 "	" $11,900.00 "	" $9,660.00 "	" $11,200.00 "	" $3,360.00 "	" $12,600.00 "	" $11,382.00 "	" $11,900.00 "	" $3,332.00 "	" $11,382.00 "	" $3,360.00 "
503574	HCHG EXCISION OLECRANON BURSA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24105	" $6,271.38 "	" $4,389.97 "	" $1,492.59 "	" $5,644.24 "	" $5,456.10 "	" $1,505.13 "	" $4,797.61 "	" $3,786.00 "	" $3,283.00 "	" $1,550.29 "	" $3,950.97 "	" $5,330.67 "	" $4,327.25 "	" $5,017.10 "	" $1,505.13 "	" $5,644.24 "	" $5,098.63 "	" $5,330.67 "	" $1,492.59 "	" $5,098.63 "	" $1,505.13 "
503575	HCHG PARTIAL EXCISION BONE HUMERUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24140	" $5,993.77 "	" $4,195.64 "	" $1,426.52 "	" $5,394.39 "	" $5,214.58 "	" $1,438.50 "	" $4,585.23 "	" $3,786.00 "	" $3,283.00 "	" $1,438.50 "	" $3,776.08 "	" $5,094.70 "	" $4,135.70 "	" $4,795.02 "	" $1,438.50 "	" $5,394.39 "	" $4,872.94 "	" $5,094.70 "	" $1,426.52 "	" $4,872.94 "	" $1,438.50 "
503576	HCHG TENODESIS BICEPS TENDON ELBOW SEPARATE PX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24340	" $7,769.75 "	" $5,438.83 "	" $1,849.20 "	" $6,992.78 "	" $6,759.68 "	" $1,864.74 "	" $5,943.86 "	" $3,786.00 "	" $3,283.00 "	" $1,864.74 "	" $4,894.94 "	" $6,604.29 "	" $5,361.13 "	" $6,215.80 "	" $1,864.74 "	" $6,992.78 "	" $6,316.81 "	" $6,604.29 "	" $1,849.20 "	" $6,316.81 "	" $1,864.74 "
503577	HCHG REPAIR OF RUP TENDON W OR WO GRAFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24342	" $9,951.13 "	" $6,965.79 "	" $2,368.37 "	" $8,956.02 "	" $8,657.48 "	" $2,388.27 "	" $7,612.61 "	" $3,786.00 "	" $3,283.00 "	" $2,388.27 "	" $6,269.21 "	" $8,458.46 "	" $6,866.28 "	" $7,960.90 "	" $2,388.27 "	" $8,956.02 "	" $8,090.27 "	" $8,458.46 "	" $2,368.37 "	" $8,090.27 "	" $2,388.27 "
503578	HCHG ARTHRP ELBOW W DISTAL HUM&PROX UR PROS RPLCM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24363	" $17,458.93 "	" $12,221.25 "	" $3,283.00 "	" $15,713.04 "	" $15,189.27 "	" $4,190.14 "	" $13,356.08 "	" $3,786.00 "	" $3,283.00 "	" $4,315.85 "	" $10,999.13 "	" $14,840.09 "	" $12,046.66 "	" $13,967.14 "	" $4,190.14 "	" $15,713.04 "	" $14,194.11 "	" $14,840.09 "	" $4,155.23 "	" $14,194.11 "	" $4,190.14 "
503579	HCHG PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24538	" $9,411.17 "	" $6,587.82 "	" $2,239.86 "	" $8,470.05 "	" $8,187.72 "	" $2,258.68 "	" $7,199.55 "	" $3,786.00 "	" $3,283.00 "	" $2,258.68 "	" $5,929.04 "	" $7,999.49 "	" $6,493.71 "	" $7,528.94 "	" $2,258.68 "	" $8,470.05 "	" $7,651.28 "	" $7,999.49 "	" $2,239.86 "	" $7,651.28 "	" $2,258.68 "
503580	HCHG INCISION EXTENSOR TENDON SHEATH WRIST	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25000	" $4,421.75 "	" $3,095.23 "	" $1,052.38 "	" $3,979.58 "	" $3,846.92 "	" $1,061.22 "	" $3,382.64 "	" $3,714.27 "	" $3,283.00 "	" $1,093.06 "	" $2,785.70 "	" $3,758.49 "	" $3,051.01 "	" $3,537.40 "	" $1,061.22 "	" $3,979.58 "	" $3,594.88 "	" $3,758.49 "	" $1,052.38 "	" $3,594.88 "	" $1,061.22 "
503581	HCHG ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25447	" $7,613.09 "	" $5,329.16 "	" $1,811.92 "	" $6,851.78 "	" $6,623.39 "	" $1,827.14 "	" $5,824.01 "	" $3,786.00 "	" $3,283.00 "	" $1,881.96 "	" $4,796.25 "	" $6,471.13 "	" $5,253.03 "	" $6,090.47 "	" $1,827.14 "	" $6,851.78 "	" $6,189.44 "	" $6,471.13 "	" $1,811.92 "	" $6,189.44 "	" $1,827.14 "
503582	HCHG PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25606	" $6,110.67 "	" $4,277.47 "	" $1,454.34 "	" $5,499.60 "	" $5,316.28 "	" $1,466.56 "	" $4,674.66 "	" $3,786.00 "	" $3,283.00 "	" $1,466.56 "	" $3,849.72 "	" $5,194.07 "	" $4,216.36 "	" $4,888.54 "	" $1,466.56 "	" $5,499.60 "	" $4,967.97 "	" $5,194.07 "	" $1,454.34 "	" $4,967.97 "	" $1,466.56 "
503583	HCHG OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25607	" $10,100.00 "	" $7,070.00 "	" $2,403.80 "	" $9,090.00 "	" $8,787.00 "	" $2,424.00 "	" $7,726.50 "	" $3,786.00 "	" $3,283.00 "	" $2,424.00 "	" $6,363.00 "	" $8,585.00 "	" $6,969.00 "	" $8,080.00 "	" $2,424.00 "	" $9,090.00 "	" $8,211.30 "	" $8,585.00 "	" $2,403.80 "	" $8,211.30 "	" $2,424.00 "
503584	HCHG PERQ SKELETAL FIXATION ULNAR STYLOID FRACTURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25651	" $4,741.13 "	" $3,318.79 "	" $1,128.39 "	" $4,267.02 "	" $4,124.78 "	" $1,137.87 "	" $3,626.96 "	" $3,786.00 "	" $3,283.00 "	" $1,137.87 "	" $2,986.91 "	" $4,029.96 "	" $3,271.38 "	" $3,792.90 "	" $1,137.87 "	" $4,267.02 "	" $3,854.54 "	" $4,029.96 "	" $1,128.39 "	" $3,854.54 "	" $1,137.87 "
503585	HCHG EXC HAND TUMOR DEEP< 1.5 CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26116	" $4,477.25 "	" $3,134.08 "	" $1,065.59 "	" $4,029.53 "	" $3,895.21 "	" $1,074.54 "	" $3,425.10 "	" $3,760.89 "	" $3,283.00 "	" $1,106.78 "	" $2,820.67 "	" $3,805.66 "	" $3,089.30 "	" $3,581.80 "	" $1,074.54 "	" $4,029.53 "	" $3,640.00 "	" $3,805.66 "	" $1,065.59 "	" $3,640.00 "	" $1,074.54 "
503586	HCHG REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26410	" $4,870.00 "	" $3,409.00 "	" $1,159.06 "	" $4,383.00 "	" $4,236.90 "	" $1,168.80 "	" $3,725.55 "	" $3,786.00 "	" $3,283.00 "	" $1,168.80 "	" $3,068.10 "	" $4,139.50 "	" $3,360.30 "	" $3,896.00 "	" $1,168.80 "	" $4,383.00 "	" $3,959.31 "	" $4,139.50 "	" $1,159.06 "	" $3,959.31 "	" $1,168.80 "
503587	HCHG TENDON TRANSFER TRANSPLANT CARP MTCRPL GRAFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26483	" $4,156.59 "	" $2,909.61 "	 $989.27 	" $3,740.93 "	" $3,616.23 "	 $997.58 	" $3,179.79 "	" $3,491.54 "	" $3,283.00 "	 $997.58 	" $2,618.65 "	" $3,533.10 "	" $2,868.05 "	" $3,325.27 "	 $997.58 	" $3,740.93 "	" $3,379.31 "	" $3,533.10 "	 $989.27 	" $3,379.31 "	 $997.58 
503588	HCHG OPEN TX METACARPAL FRACTURE SINGLE EA BONE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26615	" $8,671.91 "	" $6,070.34 "	" $2,063.91 "	" $7,804.72 "	" $7,544.56 "	" $2,081.26 "	" $6,634.01 "	" $3,786.00 "	" $3,283.00 "	" $2,081.26 "	" $5,463.30 "	" $7,371.12 "	" $5,983.62 "	" $6,937.53 "	" $2,081.26 "	" $7,804.72 "	" $7,050.26 "	" $7,371.12 "	" $2,063.91 "	" $7,050.26 "	" $2,081.26 "
503589	HCHG OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26735	" $8,013.92 "	" $5,609.74 "	" $1,907.31 "	" $7,212.53 "	" $6,972.11 "	" $1,923.34 "	" $6,130.65 "	" $3,786.00 "	" $3,283.00 "	" $1,923.34 "	" $5,048.77 "	" $6,811.83 "	" $5,529.60 "	" $6,411.14 "	" $1,923.34 "	" $7,212.53 "	" $6,515.32 "	" $6,811.83 "	" $1,907.31 "	" $6,515.32 "	" $1,923.34 "
503590	HCHG HEMIARTHROPLASTY HIP PARTIAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27125	" $7,826.57 "	" $5,478.60 "	" $1,862.72 "	" $7,043.91 "	" $6,809.12 "	" $1,878.38 "	" $5,987.33 "	" $3,786.00 "	" $3,283.00 "	" $1,934.73 "	" $4,930.74 "	" $6,652.58 "	" $5,400.33 "	" $6,261.26 "	" $1,878.38 "	" $7,043.91 "	" $6,363.00 "	" $6,652.58 "	" $1,862.72 "	" $6,363.00 "	" $1,878.38 "
503591	HCHG TOTAL HIP ARTHROPLASTY W OR WO GRAFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27130	" $12,300.00 "	" $8,610.00 "	" $2,927.40 "	" $11,070.00 "	" $10,701.00 "	" $2,952.00 "	" $9,409.50 "	" $3,786.00 "	" $3,283.00 "	" $2,952.00 "	" $7,749.00 "	" $10,455.00 "	" $8,487.00 "	" $9,840.00 "	" $2,952.00 "	" $11,070.00 "	" $9,999.90 "	" $10,455.00 "	" $2,927.40 "	" $9,999.90 "	" $2,952.00 "
503592	HCHG TX THIGH FRACTURE W OR WO SCREWS CERCLAGE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27245	" $10,000.00 "	" $7,000.00 "	" $2,380.00 "	" $9,000.00 "	" $8,700.00 "	" $2,400.00 "	" $7,650.00 "	" $3,786.00 "	" $3,283.00 "	" $2,400.00 "	" $6,300.00 "	" $8,500.00 "	" $6,900.00 "	" $8,000.00 "	" $2,400.00 "	" $9,000.00 "	" $8,130.00 "	" $8,500.00 "	" $2,380.00 "	" $8,130.00 "	" $2,400.00 "
503593	HCHG PATELLECTOMY OR HEMIPATELLECTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27350	" $8,383.32 "	" $5,868.32 "	" $1,995.23 "	" $7,544.99 "	" $7,293.49 "	" $2,012.00 "	" $6,413.24 "	" $3,786.00 "	" $3,283.00 "	" $2,012.00 "	" $5,281.49 "	" $7,125.82 "	" $5,784.49 "	" $6,706.66 "	" $2,012.00 "	" $7,544.99 "	" $6,815.64 "	" $7,125.82 "	" $1,995.23 "	" $6,815.64 "	" $2,012.00 "
503594	HCHG SUTURE INFRAPATELLAR TENDON PRIMARY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27380	" $9,336.34 "	" $6,535.44 "	" $2,222.05 "	" $8,402.71 "	" $8,122.62 "	" $2,240.72 "	" $7,142.30 "	" $3,786.00 "	" $3,283.00 "	" $2,240.72 "	" $5,881.89 "	" $7,935.89 "	" $6,442.07 "	" $7,469.07 "	" $2,240.72 "	" $8,402.71 "	" $7,590.44 "	" $7,935.89 "	" $2,222.05 "	" $7,590.44 "	" $2,240.72 "
503595	HCHG RPR PRIMARY TORN LIGM& CAPSULE KNEE COLLATERAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27405	" $7,680.79 "	" $5,376.55 "	" $1,828.03 "	" $6,912.71 "	" $6,682.29 "	" $1,843.39 "	" $5,875.80 "	" $3,786.00 "	" $3,283.00 "	" $1,843.39 "	" $4,838.90 "	" $6,528.67 "	" $5,299.75 "	" $6,144.63 "	" $1,843.39 "	" $6,912.71 "	" $6,244.48 "	" $6,528.67 "	" $1,828.03 "	" $6,244.48 "	" $1,843.39 "
503596	HCHG LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27427	" $10,300.00 "	" $7,210.00 "	" $2,451.40 "	" $9,270.00 "	" $8,961.00 "	" $2,472.00 "	" $7,879.50 "	" $3,786.00 "	" $3,283.00 "	" $2,472.00 "	" $6,489.00 "	" $8,755.00 "	" $7,107.00 "	" $8,240.00 "	" $2,472.00 "	" $9,270.00 "	" $8,373.90 "	" $8,755.00 "	" $2,451.40 "	" $8,373.90 "	" $2,472.00 "
503597	HCHG ARTHROPLASTY KNEE MEDIAL OR LATERAL COMP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27446	" $16,000.00 "	" $11,200.00 "	" $3,283.00 "	" $14,400.00 "	" $13,920.00 "	" $3,840.00 "	" $12,240.00 "	" $3,786.00 "	" $3,283.00 "	" $3,955.20 "	" $10,080.00 "	" $13,600.00 "	" $11,040.00 "	" $12,800.00 "	" $3,840.00 "	" $14,400.00 "	" $13,008.00 "	" $13,600.00 "	" $3,808.00 "	" $13,008.00 "	" $3,840.00 "
503598	HCHG TOTAL KNEE ARTHROPLASTY MEDIAL AND LATERAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27447	" $12,500.00 "	" $8,750.00 "	" $2,975.00 "	" $11,250.00 "	" $10,875.00 "	" $3,000.00 "	" $9,562.50 "	" $3,786.00 "	" $3,283.00 "	" $3,000.00 "	" $7,875.00 "	" $10,625.00 "	" $8,625.00 "	" $10,000.00 "	" $3,000.00 "	" $11,250.00 "	" $10,162.50 "	" $10,625.00 "	" $2,975.00 "	" $10,162.50 "	" $3,000.00 "
503599	HCHG REVISE TOATL KNEE ARTHROPLASTY W OR WO GRAFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27486	" $11,700.85 "	" $8,190.60 "	" $2,784.80 "	" $10,530.77 "	" $10,179.74 "	" $2,808.20 "	" $8,951.15 "	" $3,786.00 "	" $3,283.00 "	" $2,808.20 "	" $7,371.54 "	" $9,945.72 "	" $8,073.59 "	" $9,360.68 "	" $2,808.20 "	" $10,530.77 "	" $9,512.79 "	" $9,945.72 "	" $2,784.80 "	" $9,512.79 "	" $2,808.20 "
503600	HCHG OPEN TX OF THIGH FX W IMPLANT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27506	" $12,100.00 "	" $8,470.00 "	" $2,879.80 "	" $10,890.00 "	" $10,527.00 "	" $2,904.00 "	" $9,256.50 "	" $3,786.00 "	" $3,283.00 "	" $2,904.00 "	" $7,623.00 "	" $10,285.00 "	" $8,349.00 "	" $9,680.00 "	" $2,904.00 "	" $10,890.00 "	" $9,837.30 "	" $10,285.00 "	" $2,879.80 "	" $9,837.30 "	" $2,904.00 "
503601	HCHG OPEN TX FEMORAL FRACTURE DISTAL MED LAT CONDYLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27514	" $11,300.00 "	" $7,910.00 "	" $2,689.40 "	" $10,170.00 "	" $9,831.00 "	" $2,712.00 "	" $8,644.50 "	" $3,786.00 "	" $3,283.00 "	" $2,712.00 "	" $7,119.00 "	" $9,605.00 "	" $7,797.00 "	" $9,040.00 "	" $2,712.00 "	" $10,170.00 "	" $9,186.90 "	" $9,605.00 "	" $2,689.40 "	" $9,186.90 "	" $2,712.00 "
503602	HCHG OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27536	" $13,985.87 "	" $9,790.11 "	" $3,283.00 "	" $12,587.28 "	" $12,167.71 "	" $3,356.61 "	" $10,699.19 "	" $3,786.00 "	" $3,283.00 "	" $3,356.61 "	" $8,811.10 "	" $11,887.99 "	" $9,650.25 "	" $11,188.70 "	" $3,356.61 "	" $12,587.28 "	" $11,370.51 "	" $11,887.99 "	" $3,328.64 "	" $11,370.51 "	" $3,356.61 "
503603	HCHG MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27570	" $3,560.00 "	" $2,492.00 "	 $847.28 	" $3,204.00 "	" $3,097.20 "	 $854.40 	" $2,723.40 "	" $2,990.40 "	" $2,990.40 "	 $854.40 	" $2,242.80 "	" $3,026.00 "	" $2,456.40 "	" $2,848.00 "	 $854.40 	" $3,204.00 "	" $2,894.28 "	" $3,026.00 "	 $847.28 	" $2,894.28 "	 $854.40 
503604	HCHG UNLISTED PROCEDURE FEMUR/KNEE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27599	" $6,519.31 "	" $4,563.52 "	" $1,551.60 "	" $5,867.38 "	" $5,671.80 "	" $1,564.63 "	" $4,987.27 "	" $3,786.00 "	" $3,283.00 "	" $1,564.63 "	" $4,107.17 "	" $5,541.41 "	" $4,498.32 "	" $5,215.45 "	" $1,564.63 "	" $5,867.38 "	" $5,300.20 "	" $5,541.41 "	" $1,551.60 "	" $5,300.20 "	" $1,564.63 "
503605	HCHG ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27610	" $5,543.11 "	" $3,880.18 "	" $1,319.26 "	" $4,988.80 "	" $4,822.51 "	" $1,330.35 "	" $4,240.48 "	" $3,786.00 "	" $3,283.00 "	" $1,370.26 "	" $3,492.16 "	" $4,711.64 "	" $3,824.75 "	" $4,434.49 "	" $1,330.35 "	" $4,988.80 "	" $4,506.55 "	" $4,711.64 "	" $1,319.26 "	" $4,506.55 "	" $1,330.35 "
503606	HCHG EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27630	" $5,096.04 "	" $3,567.23 "	" $1,212.86 "	" $4,586.44 "	" $4,433.55 "	" $1,223.05 "	" $3,898.47 "	" $3,786.00 "	" $3,283.00 "	" $1,259.74 "	" $3,210.51 "	" $4,331.63 "	" $3,516.27 "	" $4,076.83 "	" $1,223.05 "	" $4,586.44 "	" $4,143.08 "	" $4,331.63 "	" $1,212.86 "	" $4,143.08 "	" $1,223.05 "
503607	HCHG PARTIAL EXCISION BONE TIBIA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27640	" $6,001.29 "	" $4,200.90 "	" $1,428.31 "	" $5,401.16 "	" $5,221.12 "	" $1,440.31 "	" $4,590.99 "	" $3,786.00 "	" $3,283.00 "	" $1,440.31 "	" $3,780.81 "	" $5,101.10 "	" $4,140.89 "	" $4,801.03 "	" $1,440.31 "	" $5,401.16 "	" $4,879.05 "	" $5,101.10 "	" $1,428.31 "	" $4,879.05 "	" $1,440.31 "
503608	HCHG RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27695	" $6,796.44 "	" $4,757.51 "	" $1,617.55 "	" $6,116.80 "	" $5,912.90 "	" $1,631.15 "	" $5,199.28 "	" $3,786.00 "	" $3,283.00 "	" $1,631.15 "	" $4,281.76 "	" $5,776.97 "	" $4,689.54 "	" $5,437.15 "	" $1,631.15 "	" $6,116.80 "	" $5,525.51 "	" $5,776.97 "	" $1,617.55 "	" $5,525.51 "	" $1,631.15 "
503609	HCHG OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27784	" $9,754.07 "	" $6,827.85 "	" $2,321.47 "	" $8,778.66 "	" $8,486.04 "	" $2,340.98 "	" $7,461.86 "	" $3,786.00 "	" $3,283.00 "	" $2,340.98 "	" $6,145.06 "	" $8,290.96 "	" $6,730.31 "	" $7,803.26 "	" $2,340.98 "	" $8,778.66 "	" $7,930.06 "	" $8,290.96 "	" $2,321.47 "	" $7,930.06 "	" $2,340.98 "
503610	HCHG OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27814	" $11,096.42 "	" $7,767.49 "	" $2,640.95 "	" $9,986.78 "	" $9,653.89 "	" $2,663.14 "	" $8,488.76 "	" $3,786.00 "	" $3,283.00 "	" $2,663.14 "	" $6,990.74 "	" $9,431.96 "	" $7,656.53 "	" $8,877.14 "	" $2,663.14 "	" $9,986.78 "	" $9,021.39 "	" $9,431.96 "	" $2,640.95 "	" $9,021.39 "	" $2,663.14 "
503611	HCHG OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27828	" $15,100.04 "	" $10,570.03 "	" $3,283.00 "	" $13,590.04 "	" $13,137.03 "	" $3,624.01 "	" $11,551.53 "	" $3,786.00 "	" $3,283.00 "	" $3,624.01 "	" $9,513.03 "	" $12,835.03 "	" $10,419.03 "	" $12,080.03 "	" $3,624.01 "	" $13,590.04 "	" $12,276.33 "	" $12,835.03 "	" $3,593.81 "	" $12,276.33 "	" $3,624.01 "
503612	HCHG RELEASE TARSAL TUNNEL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28035	" $5,611.07 "	" $3,927.75 "	" $1,335.43 "	" $5,049.96 "	" $4,881.63 "	" $1,346.66 "	" $4,292.47 "	" $3,786.00 "	" $3,283.00 "	" $1,346.66 "	" $3,534.97 "	" $4,769.41 "	" $3,871.64 "	" $4,488.86 "	" $1,346.66 "	" $5,049.96 "	" $4,561.80 "	" $4,769.41 "	" $1,335.43 "	" $4,561.80 "	" $1,346.66 "
503613	HCHG EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28039	" $5,143.10 "	" $3,600.17 "	" $1,224.06 "	" $4,628.79 "	" $4,474.50 "	" $1,234.34 "	" $3,934.47 "	" $3,786.00 "	" $3,283.00 "	" $1,271.37 "	" $3,240.15 "	" $4,371.64 "	" $3,548.74 "	" $4,114.48 "	" $1,234.34 "	" $4,628.79 "	" $4,181.34 "	" $4,371.64 "	" $1,224.06 "	" $4,181.34 "	" $1,234.34 "
503614	HCHG EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28080	" $4,967.90 "	" $3,477.53 "	" $1,182.36 "	" $4,471.11 "	" $4,322.07 "	" $1,192.30 "	" $3,800.44 "	" $3,786.00 "	" $3,283.00 "	" $1,228.06 "	" $3,129.78 "	" $4,222.72 "	" $3,427.85 "	" $3,974.32 "	" $1,192.30 "	" $4,471.11 "	" $4,038.90 "	" $4,222.72 "	" $1,182.36 "	" $4,038.90 "	" $1,192.30 "
503615	HCHG TX OPEN TENDON FLEXOR TOE 1 TENDON SPX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28232	" $2,995.21 "	" $2,096.65 "	 $712.86 	" $2,695.69 "	" $2,605.83 "	 $718.85 	" $2,291.34 "	" $2,515.98 "	" $2,515.98 "	 $718.85 	" $1,886.98 "	" $2,545.93 "	" $2,066.69 "	" $2,396.17 "	 $718.85 	" $2,695.69 "	" $2,435.11 "	" $2,545.93 "	 $712.86 	" $2,435.11 "	 $718.85 
503616	HCHG TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28234	" $2,889.46 "	" $2,022.62 "	 $687.69 	" $2,600.51 "	" $2,513.83 "	 $693.47 	" $2,210.44 "	" $2,427.15 "	" $2,427.15 "	 $693.47 	" $1,820.36 "	" $2,456.04 "	" $1,993.73 "	" $2,311.57 "	 $693.47 	" $2,600.51 "	" $2,349.13 "	" $2,456.04 "	 $687.69 	" $2,349.13 "	 $693.47 
503617	HCHG CORRECTION HAMMERTOE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28285	" $4,917.85 "	" $3,442.50 "	" $1,170.45 "	" $4,426.07 "	" $4,278.53 "	" $1,180.28 "	" $3,762.16 "	" $3,786.00 "	" $3,283.00 "	" $1,215.69 "	" $3,098.25 "	" $4,180.17 "	" $3,393.32 "	" $3,934.28 "	" $1,180.28 "	" $4,426.07 "	" $3,998.21 "	" $4,180.17 "	" $1,170.45 "	" $3,998.21 "	" $1,180.28 "
503618	HCHG HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/IMPLT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28291	" $8,294.21 "	" $5,805.95 "	" $1,974.02 "	" $7,464.79 "	" $7,215.96 "	" $1,990.61 "	" $6,345.07 "	" $3,786.00 "	" $3,283.00 "	" $2,050.33 "	" $5,225.35 "	" $7,050.08 "	" $5,723.00 "	" $6,635.37 "	" $1,990.61 "	" $7,464.79 "	" $6,743.19 "	" $7,050.08 "	" $1,974.02 "	" $6,743.19 "	" $1,990.61 "
503619	HCHG CORRECT HALLUX VAGUS ANY METHOD	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28295	" $7,657.90 "	" $5,360.53 "	" $1,822.58 "	" $6,892.11 "	" $6,662.37 "	" $1,837.90 "	" $5,858.29 "	" $3,786.00 "	" $3,283.00 "	" $1,893.03 "	" $4,824.48 "	" $6,509.22 "	" $5,283.95 "	" $6,126.32 "	" $1,837.90 "	" $6,892.11 "	" $6,225.87 "	" $6,509.22 "	" $1,822.58 "	" $6,225.87 "	" $1,837.90 "
503620	HCHG OPEN TREATMENT METATARSAL FRACTURE EACH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28485	" $8,603.74 "	" $6,022.62 "	" $2,047.69 "	" $7,743.37 "	" $7,485.25 "	" $2,064.90 "	" $6,581.86 "	" $3,786.00 "	" $3,283.00 "	" $2,064.90 "	" $5,420.36 "	" $7,313.18 "	" $5,936.58 "	" $6,882.99 "	" $2,064.90 "	" $7,743.37 "	" $6,994.84 "	" $7,313.18 "	" $2,047.69 "	" $6,994.84 "	" $2,064.90 "
503621	HCHG OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28525	" $6,488.96 "	" $4,542.27 "	" $1,544.37 "	" $5,840.06 "	" $5,645.40 "	" $1,557.35 "	" $4,964.05 "	" $3,786.00 "	" $3,283.00 "	" $1,557.35 "	" $4,088.04 "	" $5,515.62 "	" $4,477.38 "	" $5,191.17 "	" $1,557.35 "	" $5,840.06 "	" $5,275.52 "	" $5,515.62 "	" $1,544.37 "	" $5,275.52 "	" $1,557.35 "
503622	HCHG AMPUTATION METATARSAL W/TOE SINGLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28810	" $5,741.64 "	" $4,019.15 "	" $1,366.51 "	" $5,167.48 "	" $4,995.23 "	" $1,377.99 "	" $4,392.35 "	" $3,786.00 "	" $3,283.00 "	" $1,419.33 "	" $3,617.23 "	" $4,880.39 "	" $3,961.73 "	" $4,593.31 "	" $1,377.99 "	" $5,167.48 "	" $4,667.95 "	" $4,880.39 "	" $1,366.51 "	" $4,667.95 "	" $1,377.99 "
503623	HCHG ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29806	" $9,467.17 "	" $6,627.02 "	" $2,253.19 "	" $8,520.45 "	" $8,236.44 "	" $2,272.12 "	" $7,242.39 "	" $3,786.00 "	" $3,283.00 "	" $2,340.28 "	" $5,964.32 "	" $8,047.09 "	" $6,532.35 "	" $7,573.74 "	" $2,272.12 "	" $8,520.45 "	" $7,696.81 "	" $8,047.09 "	" $2,253.19 "	" $7,696.81 "	" $2,272.12 "
503624	HCHG ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29807	" $6,840.54 "	" $4,788.38 "	" $1,628.05 "	" $6,156.49 "	" $5,951.27 "	" $1,641.73 "	" $5,233.01 "	" $3,786.00 "	" $3,283.00 "	" $1,690.98 "	" $4,309.54 "	" $5,814.46 "	" $4,719.97 "	" $5,472.43 "	" $1,641.73 "	" $6,156.49 "	" $5,561.36 "	" $5,814.46 "	" $1,628.05 "	" $5,561.36 "	" $1,641.73 "
503625	HCHG ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29823	" $6,000.00 "	" $4,200.00 "	" $1,428.00 "	" $5,400.00 "	" $5,220.00 "	" $1,440.00 "	" $4,590.00 "	" $3,786.00 "	" $3,283.00 "	" $1,483.20 "	" $3,780.00 "	" $5,100.00 "	" $4,140.00 "	" $4,800.00 "	" $1,440.00 "	" $5,400.00 "	" $4,878.00 "	" $5,100.00 "	" $1,428.00 "	" $4,878.00 "	" $1,440.00 "
503626	HCHG ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29824	" $4,250.00 "	" $2,975.00 "	" $1,011.50 "	" $3,825.00 "	" $3,697.50 "	" $1,020.00 "	" $3,251.25 "	" $3,570.00 "	" $3,283.00 "	" $1,050.60 "	" $2,677.50 "	" $3,612.50 "	" $2,932.50 "	" $3,400.00 "	" $1,020.00 "	" $3,825.00 "	" $3,455.25 "	" $3,612.50 "	" $1,011.50 "	" $3,455.25 "	" $1,020.00 "
503627	HCHG ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29826	" $4,250.00 "	" $2,975.00 "	" $1,011.50 "	" $3,825.00 "	" $3,697.50 "	" $1,020.00 "	" $3,251.25 "	" $3,570.00 "	" $3,283.00 "	" $1,050.60 "	" $2,677.50 "	" $3,612.50 "	" $2,932.50 "	" $3,400.00 "	" $1,020.00 "	" $3,825.00 "	" $3,455.25 "	" $3,612.50 "	" $1,011.50 "	" $3,455.25 "	" $1,020.00 "
503628	HCHG ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29827	" $8,000.00 "	" $5,600.00 "	" $1,904.00 "	" $7,200.00 "	" $6,960.00 "	" $1,920.00 "	" $6,120.00 "	" $3,786.00 "	" $3,283.00 "	" $1,977.60 "	" $5,040.00 "	" $6,800.00 "	" $5,520.00 "	" $6,400.00 "	" $1,920.00 "	" $7,200.00 "	" $6,504.00 "	" $6,800.00 "	" $1,904.00 "	" $6,504.00 "	" $1,920.00 "
503629	HCHG ARTHROSCOPY SHOULDER BICEPS TENODESIS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29828	" $5,352.35 "	" $3,746.65 "	" $1,273.86 "	" $4,817.12 "	" $4,656.54 "	" $1,284.56 "	" $4,094.55 "	" $3,786.00 "	" $3,283.00 "	" $1,323.10 "	" $3,371.98 "	" $4,549.50 "	" $3,693.12 "	" $4,281.88 "	" $1,284.56 "	" $4,817.12 "	" $4,351.46 "	" $4,549.50 "	" $1,273.86 "	" $4,351.46 "	" $1,284.56 "
503630	HCHG ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29881	" $7,060.00 "	" $4,942.00 "	" $1,680.28 "	" $6,354.00 "	" $6,142.20 "	" $1,694.40 "	" $5,400.90 "	" $3,786.00 "	" $3,283.00 "	" $1,745.23 "	" $4,447.80 "	" $6,001.00 "	" $4,871.40 "	" $5,648.00 "	" $1,694.40 "	" $6,354.00 "	" $5,739.78 "	" $6,001.00 "	" $1,680.28 "	" $5,739.78 "	" $1,694.40 "
503631	HCHG ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29888	" $15,000.00 "	" $10,500.00 "	" $3,283.00 "	" $13,500.00 "	" $13,050.00 "	" $3,600.00 "	" $11,475.00 "	" $3,786.00 "	" $3,283.00 "	" $3,708.00 "	" $9,450.00 "	" $12,750.00 "	" $10,350.00 "	" $12,000.00 "	" $3,600.00 "	" $13,500.00 "	" $12,195.00 "	" $12,750.00 "	" $3,570.00 "	" $12,195.00 "	" $3,600.00 "
503632	HCHG ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29898	" $6,734.48 "	" $4,714.14 "	" $1,602.81 "	" $6,061.03 "	" $5,859.00 "	" $1,616.28 "	" $5,151.88 "	" $3,786.00 "	" $3,283.00 "	" $1,664.76 "	" $4,242.72 "	" $5,724.31 "	" $4,646.79 "	" $5,387.58 "	" $1,616.28 "	" $6,061.03 "	" $5,475.13 "	" $5,724.31 "	" $1,602.81 "	" $5,475.13 "	" $1,616.28 "
503633	HCHG ARTHROSCOPY HIP W/FEMOROPLASTY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29914	" $8,639.00 "	" $6,047.30 "	" $2,056.08 "	" $7,775.10 "	" $7,515.93 "	" $2,073.36 "	" $6,608.84 "	" $3,786.00 "	" $3,283.00 "	" $2,135.56 "	" $5,442.57 "	" $7,343.15 "	" $5,960.91 "	" $6,911.20 "	" $2,073.36 "	" $7,775.10 "	" $7,023.51 "	" $7,343.15 "	" $2,056.08 "	" $7,023.51 "	" $2,073.36 "
503634	HCHG ARTHROSCOPY HIP W/LABRAL REPAIR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29916	" $10,100.00 "	" $7,070.00 "	" $2,403.80 "	" $9,090.00 "	" $8,787.00 "	" $2,424.00 "	" $7,726.50 "	" $3,786.00 "	" $3,283.00 "	" $2,496.72 "	" $6,363.00 "	" $8,585.00 "	" $6,969.00 "	" $8,080.00 "	" $2,424.00 "	" $9,090.00 "	" $8,211.30 "	" $8,585.00 "	" $2,403.80 "	" $8,211.30 "	" $2,424.00 "
503635	HCHG LIGATION/BIOPSY TEMPORAL ARTERY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	37609	" $5,838.03 "	" $4,086.62 "	" $1,389.45 "	" $5,254.23 "	" $5,079.09 "	" $1,401.13 "	" $4,466.09 "	" $3,786.00 "	" $3,283.00 "	" $1,401.13 "	" $3,677.96 "	" $4,962.33 "	" $4,028.24 "	" $4,670.42 "	" $1,401.13 "	" $5,254.23 "	" $4,746.32 "	" $4,962.33 "	" $1,389.45 "	" $4,746.32 "	" $1,401.13 "
503636	HCHG BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	38525	" $6,227.46 "	" $4,359.22 "	" $1,482.14 "	" $5,604.71 "	" $5,417.89 "	" $1,494.59 "	" $4,764.01 "	" $3,786.00 "	" $3,283.00 "	" $1,539.43 "	" $3,923.30 "	" $5,293.34 "	" $4,296.95 "	" $4,981.97 "	" $1,494.59 "	" $5,604.71 "	" $5,062.92 "	" $5,293.34 "	" $1,482.14 "	" $5,062.92 "	" $1,494.59 "
503637	HCHG EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	42420	" $16,315.84 "	" $11,421.09 "	" $3,283.00 "	" $14,684.26 "	" $14,194.78 "	" $3,915.80 "	" $12,481.62 "	" $3,786.00 "	" $3,283.00 "	" $4,033.28 "	" $10,278.98 "	" $13,868.46 "	" $11,257.93 "	" $13,052.67 "	" $3,915.80 "	" $14,684.26 "	" $13,264.78 "	" $13,868.46 "	" $3,883.17 "	" $13,264.78 "	" $3,915.80 "
503638	HCHG TONSILLECTOMY & ADENOIDECTOMY <AGE 12	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	42820	" $5,100.00 "	" $3,570.00 "	" $1,213.80 "	" $4,590.00 "	" $4,437.00 "	" $1,224.00 "	" $3,901.50 "	" $3,786.00 "	" $3,283.00 "	" $1,224.00 "	" $3,213.00 "	" $4,335.00 "	" $3,519.00 "	" $4,080.00 "	" $1,224.00 "	" $4,590.00 "	" $4,146.30 "	" $4,335.00 "	" $1,213.80 "	" $4,146.30 "	" $1,224.00 "
503639	HCHG TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	42826	" $5,067.77 "	" $3,547.44 "	" $1,206.13 "	" $4,560.99 "	" $4,408.96 "	" $1,216.26 "	" $3,876.84 "	" $3,786.00 "	" $3,283.00 "	" $1,216.26 "	" $3,192.70 "	" $4,307.60 "	" $3,496.76 "	" $4,054.22 "	" $1,216.26 "	" $4,560.99 "	" $4,120.10 "	" $4,307.60 "	" $1,206.13 "	" $4,120.10 "	" $1,216.26 "
503640	HCHG ADENOIDECTOMY PRIMARY <AGE 12	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	42830	" $7,878.39 "	" $5,514.87 "	" $1,875.06 "	" $7,090.55 "	" $6,854.20 "	" $1,890.81 "	" $6,026.97 "	" $3,786.00 "	" $3,283.00 "	" $1,947.54 "	" $4,963.39 "	" $6,696.63 "	" $5,436.09 "	" $6,302.71 "	" $1,890.81 "	" $7,090.55 "	" $6,405.13 "	" $6,696.63 "	" $1,875.06 "	" $6,405.13 "	" $1,890.81 "
503641	HCHG ENTEROLSS FRING INTSTINAL ADHESION SPX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44005	" $7,631.56 "	" $5,342.09 "	" $1,816.31 "	" $6,868.40 "	" $6,639.46 "	" $1,831.57 "	" $5,838.14 "	" $3,786.00 "	" $3,283.00 "	" $1,886.52 "	" $4,807.88 "	" $6,486.83 "	" $5,265.78 "	" $6,105.25 "	" $1,831.57 "	" $6,868.40 "	" $6,204.46 "	" $6,486.83 "	" $1,816.31 "	" $6,204.46 "	" $1,831.57 "
503642	HCHG ENTERECTOMY RESC SMALL INTESTINE 1 RESC & ANAST	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44120	" $11,200.00 "	" $7,840.00 "	" $2,665.60 "	" $10,080.00 "	" $9,744.00 "	" $2,688.00 "	" $8,568.00 "	" $3,786.00 "	" $3,283.00 "	" $2,768.64 "	" $7,056.00 "	" $9,520.00 "	" $7,728.00 "	" $8,960.00 "	" $2,688.00 "	" $10,080.00 "	" $9,105.60 "	" $9,520.00 "	" $2,665.60 "	" $9,105.60 "	" $2,688.00 "
503643	HCHG COLECTOMY PARTIAL W/ANASTOMOSIS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44140	" $10,100.00 "	" $7,070.00 "	" $2,403.80 "	" $9,090.00 "	" $8,787.00 "	" $2,424.00 "	" $7,726.50 "	" $3,786.00 "	" $3,283.00 "	" $2,496.72 "	" $6,363.00 "	" $8,585.00 "	" $6,969.00 "	" $8,080.00 "	" $2,424.00 "	" $9,090.00 "	" $8,211.30 "	" $8,585.00 "	" $2,403.80 "	" $8,211.30 "	" $2,424.00 "
503644	HCHG COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44141	" $14,355.45 "	" $10,048.82 "	" $3,283.00 "	" $12,919.91 "	" $12,489.24 "	" $3,445.31 "	" $10,981.92 "	" $3,786.00 "	" $3,283.00 "	" $3,548.67 "	" $9,043.93 "	" $12,202.13 "	" $9,905.26 "	" $11,484.36 "	" $3,445.31 "	" $12,919.91 "	" $11,670.98 "	" $12,202.13 "	" $3,416.60 "	" $11,670.98 "	" $3,445.31 "
503645	HCHG COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44143	" $12,300.00 "	" $8,610.00 "	" $2,927.40 "	" $11,070.00 "	" $10,701.00 "	" $2,952.00 "	" $9,409.50 "	" $3,786.00 "	" $3,283.00 "	" $3,040.56 "	" $7,749.00 "	" $10,455.00 "	" $8,487.00 "	" $9,840.00 "	" $2,952.00 "	" $11,070.00 "	" $9,999.90 "	" $10,455.00 "	" $2,927.40 "	" $9,999.90 "	" $2,952.00 "
503646	HCHG LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44205	" $10,630.87 "	" $7,441.61 "	" $2,530.15 "	" $9,567.78 "	" $9,248.86 "	" $2,551.41 "	" $8,132.62 "	" $3,786.00 "	" $3,283.00 "	" $2,551.41 "	" $6,697.45 "	" $9,036.24 "	" $7,335.30 "	" $8,504.70 "	" $2,551.41 "	" $9,567.78 "	" $8,642.90 "	" $9,036.24 "	" $2,530.15 "	" $8,642.90 "	" $2,551.41 "
503647	HCHG REV COLOSTOMY W/RPR PARACLST HERNIA SPX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44346	" $10,697.61 "	" $7,488.33 "	" $2,546.03 "	" $9,627.85 "	" $9,306.92 "	" $2,567.43 "	" $8,183.67 "	" $3,786.00 "	" $3,283.00 "	" $2,567.43 "	" $6,739.49 "	" $9,092.97 "	" $7,381.35 "	" $8,558.09 "	" $2,567.43 "	" $9,627.85 "	" $8,697.16 "	" $9,092.97 "	" $2,546.03 "	" $8,697.16 "	" $2,567.43 "
503648	HCHG CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44625	" $12,447.90 "	" $8,713.53 "	" $2,962.60 "	" $11,203.11 "	" $10,829.67 "	" $2,987.50 "	" $9,522.64 "	" $3,786.00 "	" $3,283.00 "	" $3,077.12 "	" $7,842.18 "	" $10,580.72 "	" $8,589.05 "	" $9,958.32 "	" $2,987.50 "	" $11,203.11 "	" $10,120.14 "	" $10,580.72 "	" $2,962.60 "	" $10,120.14 "	" $2,987.50 "
503649	HCHG APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44955	" $6,715.24 "	" $4,700.67 "	" $1,598.23 "	" $6,043.72 "	" $5,842.26 "	" $1,611.66 "	" $5,137.16 "	" $3,786.00 "	" $3,283.00 "	" $1,660.01 "	" $4,230.60 "	" $5,707.95 "	" $4,633.52 "	" $5,372.19 "	" $1,611.66 "	" $6,043.72 "	" $5,459.49 "	" $5,707.95 "	" $1,598.23 "	" $5,459.49 "	" $1,611.66 "
503650	HCHG LAPAROSCOPIC APPENDECTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44970	" $9,053.80 "	" $6,337.66 "	" $2,154.80 "	" $8,148.42 "	" $7,876.81 "	" $2,172.91 "	" $6,926.16 "	" $3,786.00 "	" $3,283.00 "	" $2,172.91 "	" $5,703.89 "	" $7,695.73 "	" $6,247.12 "	" $7,243.04 "	" $2,172.91 "	" $8,148.42 "	" $7,360.74 "	" $7,695.73 "	" $2,154.80 "	" $7,360.74 "	" $2,172.91 "
503651	HCHG HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46260	" $6,410.00 "	" $4,487.00 "	" $1,525.58 "	" $5,769.00 "	" $5,576.70 "	" $1,538.40 "	" $4,903.65 "	" $3,786.00 "	" $3,283.00 "	" $1,584.55 "	" $4,038.30 "	" $5,448.50 "	" $4,422.90 "	" $5,128.00 "	" $1,538.40 "	" $5,769.00 "	" $5,211.33 "	" $5,448.50 "	" $1,525.58 "	" $5,211.33 "	" $1,538.40 "
503652	HCHG SURG TX ANAL FISTULA INTERSPHINCTERIC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46275	" $5,371.02 "	" $3,759.71 "	" $1,278.30 "	" $4,833.92 "	" $4,672.79 "	" $1,289.04 "	" $4,108.83 "	" $3,786.00 "	" $3,283.00 "	" $1,289.04 "	" $3,383.74 "	" $4,565.37 "	" $3,706.00 "	" $4,296.82 "	" $1,289.04 "	" $4,833.92 "	" $4,366.64 "	" $4,565.37 "	" $1,278.30 "	" $4,366.64 "	" $1,289.04 "
503653	HCHG LAPAROSCOPY SURG CHOLECYSTECTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	47562	" $9,000.00 "	" $6,300.00 "	" $2,142.00 "	" $8,100.00 "	" $7,830.00 "	" $2,160.00 "	" $6,885.00 "	" $3,786.00 "	" $3,283.00 "	" $2,160.00 "	" $5,670.00 "	" $7,650.00 "	" $6,210.00 "	" $7,200.00 "	" $2,160.00 "	" $8,100.00 "	" $7,317.00 "	" $7,650.00 "	" $2,142.00 "	" $7,317.00 "	" $2,160.00 "
503654	HCHG EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49000	" $7,566.74 "	" $5,296.72 "	" $1,800.88 "	" $6,810.07 "	" $6,583.06 "	" $1,816.02 "	" $5,788.56 "	" $3,786.00 "	" $3,283.00 "	" $1,870.50 "	" $4,767.05 "	" $6,431.73 "	" $5,221.05 "	" $6,053.39 "	" $1,816.02 "	" $6,810.07 "	" $6,151.76 "	" $6,431.73 "	" $1,800.88 "	" $6,151.76 "	" $1,816.02 "
503655	HCHG REOPENING RECENT LAPAROTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49002	" $6,879.92 "	" $4,815.94 "	" $1,637.42 "	" $6,191.93 "	" $5,985.53 "	" $1,651.18 "	" $5,263.14 "	" $3,786.00 "	" $3,283.00 "	" $1,651.18 "	" $4,334.35 "	" $5,847.93 "	" $4,747.14 "	" $5,503.94 "	" $1,651.18 "	" $6,191.93 "	" $5,593.37 "	" $5,847.93 "	" $1,637.42 "	" $5,593.37 "	" $1,651.18 "
503656	HCHG EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49203	" $7,045.03 "	" $4,931.52 "	" $1,676.72 "	" $6,340.53 "	" $6,129.18 "	" $1,690.81 "	" $5,389.45 "	" $3,786.00 "	" $3,283.00 "	" $1,741.53 "	" $4,438.37 "	" $5,988.28 "	" $4,861.07 "	" $5,636.02 "	" $1,690.81 "	" $6,340.53 "	" $5,727.61 "	" $5,988.28 "	" $1,676.72 "	" $5,727.61 "	" $1,690.81 "
503657	HCHG RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49505	" $7,938.07 "	" $5,556.65 "	" $1,889.26 "	" $7,144.26 "	" $6,906.12 "	" $1,905.14 "	" $6,072.62 "	" $3,786.00 "	" $3,283.00 "	" $1,905.14 "	" $5,000.98 "	" $6,747.36 "	" $5,477.27 "	" $6,350.46 "	" $1,905.14 "	" $7,144.26 "	" $6,453.65 "	" $6,747.36 "	" $1,889.26 "	" $6,453.65 "	" $1,905.14 "
503658	HCHG RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49507	" $9,217.90 "	" $6,452.53 "	" $2,193.86 "	" $8,296.11 "	" $8,019.57 "	" $2,212.30 "	" $7,051.69 "	" $3,786.00 "	" $3,283.00 "	" $2,212.30 "	" $5,807.28 "	" $7,835.22 "	" $6,360.35 "	" $7,374.32 "	" $2,212.30 "	" $8,296.11 "	" $7,494.15 "	" $7,835.22 "	" $2,193.86 "	" $7,494.15 "	" $2,212.30 "
503662	HCHG LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49650	" $11,900.00 "	" $8,330.00 "	" $2,832.20 "	" $10,710.00 "	" $10,353.00 "	" $2,856.00 "	" $9,103.50 "	" $3,786.00 "	" $3,283.00 "	" $2,856.00 "	" $7,497.00 "	" $10,115.00 "	" $8,211.00 "	" $9,520.00 "	" $2,856.00 "	" $10,710.00 "	" $9,674.70 "	" $10,115.00 "	" $2,832.20 "	" $9,674.70 "	" $2,856.00 "
503664	HCHG SLING OPERATION STRESS INCONTINENCE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	57288	" $7,752.67 "	" $5,426.87 "	" $1,845.14 "	" $6,977.40 "	" $6,744.82 "	" $1,860.64 "	" $5,930.79 "	" $3,786.00 "	" $3,283.00 "	" $1,860.64 "	" $4,884.18 "	" $6,589.77 "	" $5,349.34 "	" $6,202.14 "	" $1,860.64 "	" $6,977.40 "	" $6,302.92 "	" $6,589.77 "	" $1,845.14 "	" $6,302.92 "	" $1,860.64 "
503665	HCHG LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	57425	" $17,927.11 "	" $12,548.98 "	" $3,283.00 "	" $16,134.40 "	" $15,596.59 "	" $4,302.51 "	" $13,714.24 "	" $3,786.00 "	" $3,283.00 "	" $4,302.51 "	" $11,294.08 "	" $15,238.04 "	" $12,369.71 "	" $14,341.69 "	" $4,302.51 "	" $16,134.40 "	" $14,574.74 "	" $15,238.04 "	" $4,266.65 "	" $14,574.74 "	" $4,302.51 "
503666	HCHG COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	57461	" $4,095.57 "	" $2,866.90 "	 $974.75 	" $3,686.01 "	" $3,563.15 "	 $982.94 	" $3,133.11 "	" $3,440.28 "	" $3,283.00 "	" $1,012.42 "	" $2,580.21 "	" $3,481.23 "	" $2,825.94 "	" $3,276.46 "	 $982.94 	" $3,686.01 "	" $3,329.70 "	" $3,481.23 "	 $974.75 	" $3,329.70 "	 $982.94 
503667	HCHG LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58542	" $15,736.94 "	" $11,015.86 "	" $3,283.00 "	" $14,163.25 "	" $13,691.14 "	" $3,776.87 "	" $12,038.76 "	" $3,786.00 "	" $3,283.00 "	" $3,776.87 "	" $9,914.27 "	" $13,376.40 "	" $10,858.49 "	" $12,589.55 "	" $3,776.87 "	" $14,163.25 "	" $12,794.13 "	" $13,376.40 "	" $3,745.39 "	" $12,794.13 "	" $3,776.87 "
503668	HCHG HYSTEROSCOPY BX ENDOMETRIUM POLYPC W/WO D&C	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58558	" $6,200.00 "	" $4,340.00 "	" $1,475.60 "	" $5,580.00 "	" $5,394.00 "	" $1,488.00 "	" $4,743.00 "	" $3,786.00 "	" $3,283.00 "	" $1,532.64 "	" $3,906.00 "	" $5,270.00 "	" $4,278.00 "	" $4,960.00 "	" $1,488.00 "	" $5,580.00 "	" $5,040.60 "	" $5,270.00 "	" $1,475.60 "	" $5,040.60 "	" $1,488.00 "
503669	HCHG HYSTEROSCOPY ENDOMETRIAL ABLATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58563	" $6,712.90 "	" $4,699.03 "	" $1,597.67 "	" $6,041.61 "	" $5,840.22 "	" $1,611.10 "	" $5,135.37 "	" $3,786.00 "	" $3,283.00 "	" $1,659.43 "	" $4,229.13 "	" $5,705.97 "	" $4,631.90 "	" $5,370.32 "	" $1,611.10 "	" $6,041.61 "	" $5,457.59 "	" $5,705.97 "	" $1,597.67 "	" $5,457.59 "	" $1,611.10 "
503670	HCHG LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58573	" $19,542.09 "	" $13,679.46 "	" $3,283.00 "	" $17,587.88 "	" $17,001.62 "	" $4,690.10 "	" $14,949.70 "	" $3,786.00 "	" $3,283.00 "	" $4,690.10 "	" $12,311.52 "	" $16,610.78 "	" $13,484.04 "	" $15,633.67 "	" $4,690.10 "	" $17,587.88 "	" $15,887.72 "	" $16,610.78 "	" $4,651.02 "	" $15,887.72 "	" $4,690.10 "
503671	HCHG LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58661	" $10,800.00 "	" $7,560.00 "	" $2,570.40 "	" $9,720.00 "	" $9,396.00 "	" $2,592.00 "	" $8,262.00 "	" $3,786.00 "	" $3,283.00 "	" $2,592.00 "	" $6,804.00 "	" $9,180.00 "	" $7,452.00 "	" $8,640.00 "	" $2,592.00 "	" $9,720.00 "	" $8,780.40 "	" $9,180.00 "	" $2,570.40 "	" $8,780.40 "	" $2,592.00 "
503672	HCHG LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58662	" $9,251.83 "	" $6,476.28 "	" $2,201.94 "	" $8,326.65 "	" $8,049.09 "	" $2,220.44 "	" $7,077.65 "	" $3,786.00 "	" $3,283.00 "	" $2,220.44 "	" $5,828.65 "	" $7,864.06 "	" $6,383.76 "	" $7,401.46 "	" $2,220.44 "	" $8,326.65 "	" $7,521.74 "	" $7,864.06 "	" $2,201.94 "	" $7,521.74 "	" $2,220.44 "
503673	HCHG LAPAROSCOPY FULGURATION OVIDUCTS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58670	" $7,080.00 "	" $4,956.00 "	" $1,685.04 "	" $6,372.00 "	" $6,159.60 "	" $1,699.20 "	" $5,416.20 "	" $3,786.00 "	" $3,283.00 "	" $1,699.20 "	" $4,460.40 "	" $6,018.00 "	" $4,885.20 "	" $5,664.00 "	" $1,699.20 "	" $6,372.00 "	" $5,756.04 "	" $6,018.00 "	" $1,685.04 "	" $5,756.04 "	" $1,699.20 "
503674	HCHG IMPLANT SPINAL CANAL CATH WO LAMINECTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	62350	" $8,331.61 "	" $5,832.13 "	" $1,982.92 "	" $7,498.45 "	" $7,248.50 "	" $1,999.59 "	" $6,373.68 "	" $3,786.00 "	" $3,283.00 "	" $2,059.57 "	" $5,248.91 "	" $7,081.87 "	" $5,748.81 "	" $6,665.29 "	" $1,999.59 "	" $7,498.45 "	" $6,773.60 "	" $7,081.87 "	" $1,982.92 "	" $6,773.60 "	" $1,999.59 "
503675	HCHG IMPLANT SPINE INFUSION PUMP NON PROGRAM PUMP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	62361	" $11,686.28 "	" $8,180.40 "	" $2,781.33 "	" $10,517.65 "	" $10,167.06 "	" $2,804.71 "	" $8,940.00 "	" $3,786.00 "	" $3,283.00 "	" $2,888.85 "	" $7,362.36 "	" $9,933.34 "	" $8,063.53 "	" $9,349.02 "	" $2,804.71 "	" $10,517.65 "	" $9,500.95 "	" $9,933.34 "	" $2,781.33 "	" $9,500.95 "	" $2,804.71 "
503676	HCHG IMPLANT SPINE INFUSION PUMP PROGRAM PUMP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	62362	" $13,000.00 "	" $9,100.00 "	" $3,094.00 "	" $11,700.00 "	" $11,310.00 "	" $3,120.00 "	" $9,945.00 "	" $3,786.00 "	" $3,283.00 "	" $3,213.60 "	" $8,190.00 "	" $11,050.00 "	" $8,970.00 "	" $10,400.00 "	" $3,120.00 "	" $11,700.00 "	" $10,569.00 "	" $11,050.00 "	" $3,094.00 "	" $10,569.00 "	" $3,120.00 "
503677	HCHG RMV SPINE INFUSION DEVICE PRV IMPLANTED	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	62365	" $7,580.00 "	" $5,306.00 "	" $1,804.04 "	" $6,822.00 "	" $6,594.60 "	" $1,819.20 "	" $5,798.70 "	" $3,786.00 "	" $3,283.00 "	" $1,819.20 "	" $4,775.40 "	" $6,443.00 "	" $5,230.20 "	" $6,064.00 "	" $1,819.20 "	" $6,822.00 "	" $6,162.54 "	" $6,443.00 "	" $1,804.04 "	" $6,162.54 "	" $1,819.20 "
503678	HCHG PERC IMPLNT NEUROSTIM ELECTRODE ARRAY EPIDURAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	63650	" $7,500.00 "	" $5,250.00 "	" $1,785.00 "	" $6,750.00 "	" $6,525.00 "	" $1,800.00 "	" $5,737.50 "	" $3,786.00 "	" $3,283.00 "	" $1,800.00 "	" $4,725.00 "	" $6,375.00 "	" $5,175.00 "	" $6,000.00 "	" $1,800.00 "	" $6,750.00 "	" $6,097.50 "	" $6,375.00 "	" $1,785.00 "	" $6,097.50 "	" $1,800.00 "
503679	HCHG INSERT OR REDO SPINE NEUROSTIM GENERATOR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	63685	" $11,400.00 "	" $7,980.00 "	" $2,713.20 "	" $10,260.00 "	" $9,918.00 "	" $2,736.00 "	" $8,721.00 "	" $3,786.00 "	" $3,283.00 "	" $2,818.08 "	" $7,182.00 "	" $9,690.00 "	" $7,866.00 "	" $9,120.00 "	" $2,736.00 "	" $10,260.00 "	" $9,268.20 "	" $9,690.00 "	" $2,713.20 "	" $9,268.20 "	" $2,736.00 "
503680	HCHG INJECTION ANES AGENT AND OR STEROID UTERINE NRV	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64435	" $1,970.00 "	" $1,379.00 "	 $468.86 	" $1,773.00 "	" $1,713.90 "	 $472.80 	" $1,507.05 "	" $1,654.80 "	" $1,654.80 "	 $486.98 	" $1,241.10 "	" $1,674.50 "	" $1,359.30 "	" $1,576.00 "	 $472.80 	" $1,773.00 "	" $1,601.61 "	" $1,674.50 "	 $468.86 	" $1,601.61 "	 $472.80 
503681	HCHG NEUROPLASTY & OR TRANSPOS ULNAR NERVE ELBOW	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64718	" $6,178.80 "	" $4,325.16 "	" $1,470.55 "	" $5,560.92 "	" $5,375.56 "	" $1,482.91 "	" $4,726.78 "	" $3,786.00 "	" $3,283.00 "	" $1,482.91 "	" $3,892.64 "	" $5,251.98 "	" $4,263.37 "	" $4,943.04 "	" $1,482.91 "	" $5,560.92 "	" $5,023.36 "	" $5,251.98 "	" $1,470.55 "	" $5,023.36 "	" $1,482.91 "
503682	HCHG NEUROPLASTY & OR TRANSPOS MEDIAN NRV CARPAL TUN	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64721	" $4,700.00 "	" $3,290.00 "	" $1,118.60 "	" $4,230.00 "	" $4,089.00 "	" $1,128.00 "	" $3,595.50 "	" $3,786.00 "	" $3,283.00 "	" $1,128.00 "	" $2,961.00 "	" $3,995.00 "	" $3,243.00 "	" $3,760.00 "	" $1,128.00 "	" $4,230.00 "	" $3,821.10 "	" $3,995.00 "	" $1,118.60 "	" $3,821.10 "	" $1,128.00 "
503683	HCHG TYMPANOSTOMY GENERAL ANESTHESIA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	69436	" $3,920.00 "	" $2,744.00 "	 $932.96 	" $3,528.00 "	" $3,410.40 "	 $940.80 	" $2,998.80 "	" $3,292.80 "	" $3,283.00 "	 $940.80 	" $2,469.60 "	" $3,332.00 "	" $2,704.80 "	" $3,136.00 "	 $940.80 	" $3,528.00 "	" $3,186.96 "	" $3,332.00 "	 $932.96 	" $3,186.96 "	 $940.80 
503688	HCHG LIGATION OR TRANSECTION OF FALLOPIAN TUBES	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58600	" $4,996.50 "	" $3,497.55 "	" $1,189.17 "	" $4,496.85 "	" $4,346.96 "	" $1,199.16 "	" $3,822.32 "	" $3,786.00 "	" $3,283.00 "	" $1,199.16 "	" $3,147.80 "	" $4,247.03 "	" $3,447.59 "	" $3,997.20 "	" $1,199.16 "	" $4,496.85 "	" $4,062.15 "	" $4,247.03 "	" $1,189.17 "	" $4,062.15 "	" $1,199.16 "
503689	HCHG SUBMUCOUS RESECTION INFERIOR TURBINATE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	30140	" $3,360.00 "	" $2,352.00 "	 $799.68 	" $3,024.00 "	" $2,923.20 "	 $806.40 	" $2,570.40 "	" $2,822.40 "	" $2,822.40 "	 $806.40 	" $2,116.80 "	" $2,856.00 "	" $2,318.40 "	" $2,688.00 "	 $806.40 	" $3,024.00 "	" $2,731.68 "	" $2,856.00 "	 $799.68 	" $2,731.68 "	 $806.40 
503690	HCHG SEPTOPLASTY/SUBMUCOUS RESEC W/WO CARTILAGE GRF	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	30520	" $4,330.00 "	" $3,031.00 "	" $1,030.54 "	" $3,897.00 "	" $3,767.10 "	" $1,039.20 "	" $3,312.45 "	" $3,637.20 "	" $3,283.00 "	" $1,039.20 "	" $2,727.90 "	" $3,680.50 "	" $2,987.70 "	" $3,464.00 "	" $1,039.20 "	" $3,897.00 "	" $3,520.29 "	" $3,680.50 "	" $1,030.54 "	" $3,520.29 "	" $1,039.20 "
503692	HCHG EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	11403	" $2,160.00 "	" $1,512.00 "	 $514.08 	" $1,944.00 "	" $1,879.20 "	 $518.40 	" $1,652.40 "	" $1,814.40 "	" $1,814.40 "	 $533.95 	" $1,360.80 "	" $1,836.00 "	" $1,490.40 "	" $1,728.00 "	 $518.40 	" $1,944.00 "	" $1,756.08 "	" $1,836.00 "	 $514.08 	" $1,756.08 "	 $518.40 
503693	HCHG EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24075	" $3,380.00 "	" $2,366.00 "	 $804.44 	" $3,042.00 "	" $2,940.60 "	 $811.20 	" $2,585.70 "	" $2,839.20 "	" $2,839.20 "	 $835.54 	" $2,129.40 "	" $2,873.00 "	" $2,332.20 "	" $2,704.00 "	 $811.20 	" $3,042.00 "	" $2,747.94 "	" $2,873.00 "	 $804.44 	" $2,747.94 "	 $811.20 
503694	HCHG EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26115	" $3,591.00 "	" $2,513.70 "	 $854.66 	" $3,231.90 "	" $3,124.17 "	 $861.84 	" $2,747.12 "	" $3,016.44 "	" $3,016.44 "	 $887.70 	" $2,262.33 "	" $3,052.35 "	" $2,477.79 "	" $2,872.80 "	 $861.84 	" $3,231.90 "	" $2,919.48 "	" $3,052.35 "	 $854.66 	" $2,919.48 "	 $861.84 
503695	HCHG REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27138	" $12,276.00 "	" $8,593.20 "	" $2,921.69 "	" $11,048.40 "	" $10,680.12 "	" $2,946.24 "	" $9,391.14 "	" $3,786.00 "	" $3,283.00 "	" $2,946.24 "	" $7,733.88 "	" $10,434.60 "	" $8,470.44 "	" $9,820.80 "	" $2,946.24 "	" $11,048.40 "	" $9,980.39 "	" $10,434.60 "	" $2,921.69 "	" $9,980.39 "	" $2,946.24 "
503696	HCHG OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27236	" $8,000.00 "	" $5,600.00 "	" $1,904.00 "	" $7,200.00 "	" $6,960.00 "	" $1,920.00 "	" $6,120.00 "	" $3,786.00 "	" $3,283.00 "	" $1,920.00 "	" $5,040.00 "	" $6,800.00 "	" $5,520.00 "	" $6,400.00 "	" $1,920.00 "	" $7,200.00 "	" $6,504.00 "	" $6,800.00 "	" $1,904.00 "	" $6,504.00 "	" $1,920.00 "
503697	HCHG OPEN TREATMENT GREATER TROCHANTERIC FRACTURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27248	" $9,315.75 "	" $6,521.03 "	" $2,217.15 "	" $8,384.18 "	" $8,104.70 "	" $2,235.78 "	" $7,126.55 "	" $3,786.00 "	" $3,283.00 "	" $2,235.78 "	" $5,868.92 "	" $7,918.39 "	" $6,427.87 "	" $7,452.60 "	" $2,235.78 "	" $8,384.18 "	" $7,573.70 "	" $7,918.39 "	" $2,217.15 "	" $7,573.70 "	" $2,235.78 "
503698	HCHG ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29876	" $5,530.00 "	" $3,871.00 "	" $1,316.14 "	" $4,977.00 "	" $4,811.10 "	" $1,327.20 "	" $4,230.45 "	" $3,786.00 "	" $3,283.00 "	" $1,367.02 "	" $3,483.90 "	" $4,700.50 "	" $3,815.70 "	" $4,424.00 "	" $1,327.20 "	" $4,977.00 "	" $4,495.89 "	" $4,700.50 "	" $1,316.14 "	" $4,495.89 "	" $1,327.20 "
503699	HCHG SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29822	" $5,800.50 "	" $4,060.35 "	" $1,380.52 "	" $5,220.45 "	" $5,046.44 "	" $1,392.12 "	" $4,437.38 "	" $3,786.00 "	" $3,283.00 "	" $1,392.12 "	" $3,654.32 "	" $4,930.43 "	" $4,002.35 "	" $4,640.40 "	" $1,392.12 "	" $5,220.45 "	" $4,715.81 "	" $4,930.43 "	" $1,380.52 "	" $4,715.81 "	" $1,392.12 "
503700	HCHG ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29880	" $7,000.00 "	" $4,900.00 "	" $1,666.00 "	" $6,300.00 "	" $6,090.00 "	" $1,680.00 "	" $5,355.00 "	" $3,786.00 "	" $3,283.00 "	" $1,730.40 "	" $4,410.00 "	" $5,950.00 "	" $4,830.00 "	" $5,600.00 "	" $1,680.00 "	" $6,300.00 "	" $5,691.00 "	" $5,950.00 "	" $1,666.00 "	" $5,691.00 "	" $1,680.00 "
503701	HCHG CYSTO BLADDER W/URETERAL CATHETERIZATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52005	" $4,439.25 "	" $3,107.48 "	" $1,056.54 "	" $3,995.33 "	" $3,862.15 "	" $1,065.42 "	" $3,396.03 "	" $3,728.97 "	" $3,283.00 "	" $1,097.38 "	" $2,796.73 "	" $3,773.36 "	" $3,063.08 "	" $3,551.40 "	" $1,065.42 "	" $3,995.33 "	" $3,609.11 "	" $3,773.36 "	" $1,056.54 "	" $3,609.11 "	" $1,065.42 "
503702	HCHG CYSTO W/INSERT URETERAL STENT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52332	" $4,740.00 "	" $3,318.00 "	" $1,128.12 "	" $4,266.00 "	" $4,123.80 "	" $1,137.60 "	" $3,626.10 "	" $3,786.00 "	" $3,283.00 "	" $1,171.73 "	" $2,986.20 "	" $4,029.00 "	" $3,270.60 "	" $3,792.00 "	" $1,137.60 "	" $4,266.00 "	" $3,853.62 "	" $4,029.00 "	" $1,128.12 "	" $3,853.62 "	" $1,137.60 "
503703	HCHG EXPLORATION PENETRATING WOUND SPX EXTREMITY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	20103	" $3,188.25 "	" $2,231.78 "	 $758.80 	" $2,869.43 "	" $2,773.78 "	 $765.18 	" $2,439.01 "	" $2,678.13 "	" $2,678.13 "	 $788.14 	" $2,008.60 "	" $2,710.01 "	" $2,199.89 "	" $2,550.60 "	 $765.18 	" $2,869.43 "	" $2,592.05 "	" $2,710.01 "	 $758.80 	" $2,592.05 "	 $765.18 
503704	HCHG EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	22902	" $3,839.25 "	" $2,687.48 "	 $913.74 	" $3,455.33 "	" $3,340.15 "	 $921.42 	" $2,937.03 "	" $3,224.97 "	" $3,224.97 "	 $949.06 	" $2,418.73 "	" $3,263.36 "	" $2,649.08 "	" $3,071.40 "	 $921.42 	" $3,455.33 "	" $3,121.31 "	" $3,263.36 "	 $913.74 	" $3,121.31 "	 $921.42 
503705	HCHG COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44146	" $5,673.78 "	" $3,971.65 "	" $1,350.36 "	" $5,106.40 "	" $4,936.19 "	" $1,361.71 "	" $4,340.44 "	" $3,786.00 "	" $3,283.00 "	" $1,402.56 "	" $3,574.48 "	" $4,822.71 "	" $3,914.91 "	" $4,539.02 "	" $1,361.71 "	" $5,106.40 "	" $4,612.78 "	" $4,822.71 "	" $1,350.36 "	" $4,612.78 "	" $1,361.71 "
503706	HCHG I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46040	" $3,740.00 "	" $2,618.00 "	 $890.12 	" $3,366.00 "	" $3,253.80 "	 $897.60 	" $2,861.10 "	" $3,141.60 "	" $3,141.60 "	 $924.53 	" $2,356.20 "	" $3,179.00 "	" $2,580.60 "	" $2,992.00 "	 $897.60 	" $3,366.00 "	" $3,040.62 "	" $3,179.00 "	 $890.12 	" $3,040.62 "	 $897.60 
503707	HCHG EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	11402	" $1,670.00 "	" $1,169.00 "	 $397.46 	" $1,503.00 "	" $1,452.90 "	 $400.80 	" $1,277.55 "	" $1,402.80 "	" $1,402.80 "	 $412.82 	" $1,052.10 "	" $1,419.50 "	" $1,152.30 "	" $1,336.00 "	 $400.80 	" $1,503.00 "	" $1,357.71 "	" $1,419.50 "	 $397.46 	" $1,357.71 "	 $400.80 
503708	HCHG REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26418	" $3,930.75 "	" $2,751.53 "	 $935.52 	" $3,537.68 "	" $3,419.75 "	 $943.38 	" $3,007.02 "	" $3,301.83 "	" $3,283.00 "	 $943.38 	" $2,476.37 "	" $3,341.14 "	" $2,712.22 "	" $3,144.60 "	 $943.38 	" $3,537.68 "	" $3,195.70 "	" $3,341.14 "	 $935.52 	" $3,195.70 "	 $943.38 
503709	HCHG ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29877	" $7,500.00 "	" $5,250.00 "	" $1,785.00 "	" $6,750.00 "	" $6,525.00 "	" $1,800.00 "	" $5,737.50 "	" $3,786.00 "	" $3,283.00 "	" $1,854.00 "	" $4,725.00 "	" $6,375.00 "	" $5,175.00 "	" $6,000.00 "	" $1,800.00 "	" $6,750.00 "	" $6,097.50 "	" $6,375.00 "	" $1,785.00 "	" $6,097.50 "	" $1,800.00 "
503710	HCHG CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52356	" $8,472.75 "	" $5,930.93 "	" $2,016.51 "	" $7,625.48 "	" $7,371.29 "	" $2,033.46 "	" $6,481.65 "	" $3,786.00 "	" $3,283.00 "	" $2,094.46 "	" $5,337.83 "	" $7,201.84 "	" $5,846.20 "	" $6,778.20 "	" $2,033.46 "	" $7,625.48 "	" $6,888.35 "	" $7,201.84 "	" $2,016.51 "	" $6,888.35 "	" $2,033.46 "
503711	HCHG ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29875	" $5,543.25 "	" $3,880.28 "	" $1,319.29 "	" $4,988.93 "	" $4,822.63 "	" $1,330.38 "	" $4,240.59 "	" $3,786.00 "	" $3,283.00 "	" $1,370.29 "	" $3,492.25 "	" $4,711.76 "	" $3,824.84 "	" $4,434.60 "	" $1,330.38 "	" $4,988.93 "	" $4,506.66 "	" $4,711.76 "	" $1,319.29 "	" $4,506.66 "	" $1,330.38 "
503712	HCHG I&D HEMATOMA SEROMA/FLUID COLLECTION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	10140	" $3,015.00 "	" $2,110.50 "	 $717.57 	" $2,713.50 "	" $2,623.05 "	 $723.60 	" $2,306.48 "	" $2,532.60 "	" $2,532.60 "	 $745.31 	" $1,899.45 "	" $2,562.75 "	" $2,080.35 "	" $2,412.00 "	 $723.60 	" $2,713.50 "	" $2,451.20 "	" $2,562.75 "	 $717.57 	" $2,451.20 "	 $723.60 
503713	HCHG LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	58600	" $5,000.00 "	" $3,500.00 "	" $1,190.00 "	" $4,500.00 "	" $4,350.00 "	" $1,200.00 "	" $3,825.00 "	" $3,786.00 "	" $3,283.00 "	" $1,200.00 "	" $3,150.00 "	" $4,250.00 "	" $3,450.00 "	" $4,000.00 "	" $1,200.00 "	" $4,500.00 "	" $4,065.00 "	" $4,250.00 "	" $1,190.00 "	" $4,065.00 "	" $1,200.00 "
503714	HCHG UNLISTED PROCEDURE ARTHROSCOPY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29999	" $5,178.00 "	" $3,624.60 "	" $1,232.36 "	" $4,660.20 "	" $4,504.86 "	" $1,242.72 "	" $3,961.17 "	" $3,786.00 "	" $3,283.00 "	" $1,242.72 "	" $3,262.14 "	" $4,401.30 "	" $3,572.82 "	" $4,142.40 "	" $1,242.72 "	" $4,660.20 "	" $4,209.71 "	" $4,401.30 "	" $1,232.36 "	" $4,209.71 "	" $1,242.72 "
503715	HCHG ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29874	" $6,772.50 "	" $4,740.75 "	" $1,611.86 "	" $6,095.25 "	" $5,892.08 "	" $1,625.40 "	" $5,180.96 "	" $3,786.00 "	" $3,283.00 "	" $1,674.16 "	" $4,266.68 "	" $5,756.63 "	" $4,673.03 "	" $5,418.00 "	" $1,625.40 "	" $6,095.25 "	" $5,506.04 "	" $5,756.63 "	" $1,611.86 "	" $5,506.04 "	" $1,625.40 "
503716	HCHG EXCISION PILONIDAL CYST/SINUS SIMPLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	11770	" $5,025.00 "	" $3,517.50 "	" $1,195.95 "	" $4,522.50 "	" $4,371.75 "	" $1,206.00 "	" $3,844.13 "	" $3,786.00 "	" $3,283.00 "	" $1,242.18 "	" $3,165.75 "	" $4,271.25 "	" $3,467.25 "	" $4,020.00 "	" $1,206.00 "	" $4,522.50 "	" $4,085.33 "	" $4,271.25 "	" $1,195.95 "	" $4,085.33 "	" $1,206.00 "
503717	HCHG REMOVAL IMPLANT DEEP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	20680	" $5,900.00 "	" $4,130.00 "	" $1,404.20 "	" $5,310.00 "	" $5,133.00 "	" $1,416.00 "	" $4,513.50 "	" $3,786.00 "	" $3,283.00 "	" $1,416.00 "	" $3,717.00 "	" $5,015.00 "	" $4,071.00 "	" $4,720.00 "	" $1,416.00 "	" $5,310.00 "	" $4,796.70 "	" $5,015.00 "	" $1,404.20 "	" $4,796.70 "	" $1,416.00 "
503718	HCHG EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21552	" $5,152.50 "	" $3,606.75 "	" $1,226.30 "	" $4,637.25 "	" $4,482.68 "	" $1,236.60 "	" $3,941.66 "	" $3,786.00 "	" $3,283.00 "	" $1,273.70 "	" $3,246.08 "	" $4,379.63 "	" $3,555.23 "	" $4,122.00 "	" $1,236.60 "	" $4,637.25 "	" $4,188.98 "	" $4,379.63 "	" $1,226.30 "	" $4,188.98 "	" $1,236.60 "
503719	HCHG UNLISTED PROCEDURE SHOULDER	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23929	" $5,383.50 "	" $3,768.45 "	" $1,281.27 "	" $4,845.15 "	" $4,683.65 "	" $1,292.04 "	" $4,118.38 "	" $3,786.00 "	" $3,283.00 "	" $1,292.04 "	" $3,391.61 "	" $4,575.98 "	" $3,714.62 "	" $4,306.80 "	" $1,292.04 "	" $4,845.15 "	" $4,376.79 "	" $4,575.98 "	" $1,281.27 "	" $4,376.79 "	" $1,292.04 "
503720	HCHG PARTIAL EXCISION BONE OLECRANON PROCESS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24147	" $5,558.25 "	" $3,890.78 "	" $1,322.86 "	" $5,002.43 "	" $4,835.68 "	" $1,333.98 "	" $4,252.06 "	" $3,786.00 "	" $3,283.00 "	" $1,333.98 "	" $3,501.70 "	" $4,724.51 "	" $3,835.19 "	" $4,446.60 "	" $1,333.98 "	" $5,002.43 "	" $4,518.86 "	" $4,724.51 "	" $1,322.86 "	" $4,518.86 "	" $1,333.98 "
503721	HCHG EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25111	" $4,290.00 "	" $3,003.00 "	" $1,021.02 "	" $3,861.00 "	" $3,732.30 "	" $1,029.60 "	" $3,281.85 "	" $3,603.60 "	" $3,283.00 "	" $1,060.49 "	" $2,702.70 "	" $3,646.50 "	" $2,960.10 "	" $3,432.00 "	" $1,029.60 "	" $3,861.00 "	" $3,487.77 "	" $3,646.50 "	" $1,021.02 "	" $3,487.77 "	" $1,029.60 "
503722	HCHG OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25608	" $9,091.50 "	" $6,364.05 "	" $2,163.78 "	" $8,182.35 "	" $7,909.61 "	" $2,181.96 "	" $6,955.00 "	" $3,786.00 "	" $3,283.00 "	" $2,181.96 "	" $5,727.65 "	" $7,727.78 "	" $6,273.14 "	" $7,273.20 "	" $2,181.96 "	" $8,182.35 "	" $7,391.39 "	" $7,727.78 "	" $2,163.78 "	" $7,391.39 "	" $2,181.96 "
503723	HCHG TENDON SHEATH INCISION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26055	" $3,310.00 "	" $2,317.00 "	 $787.78 	" $2,979.00 "	" $2,879.70 "	 $794.40 	" $2,532.15 "	" $2,780.40 "	" $2,780.40 "	 $794.40 	" $2,085.30 "	" $2,813.50 "	" $2,283.90 "	" $2,648.00 "	 $794.40 	" $2,979.00 "	" $2,691.03 "	" $2,813.50 "	 $787.78 	" $2,691.03 "	 $794.40 
503724	HCHG ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26850	" $6,740.00 "	" $4,718.00 "	" $1,604.12 "	" $6,066.00 "	" $5,863.80 "	" $1,617.60 "	" $5,156.10 "	" $3,786.00 "	" $3,283.00 "	" $1,666.13 "	" $4,246.20 "	" $5,729.00 "	" $4,650.60 "	" $5,392.00 "	" $1,617.60 "	" $6,066.00 "	" $5,479.62 "	" $5,729.00 "	" $1,604.12 "	" $5,479.62 "	" $1,617.60 "
503725	HCHG ARTHRT KNE W/EXPL DRG/RMVL FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27310	" $6,574.50 "	" $4,602.15 "	" $1,564.73 "	" $5,917.05 "	" $5,719.82 "	" $1,577.88 "	" $5,029.49 "	" $3,786.00 "	" $3,283.00 "	" $1,625.22 "	" $4,141.94 "	" $5,588.33 "	" $4,536.41 "	" $5,259.60 "	" $1,577.88 "	" $5,917.05 "	" $5,345.07 "	" $5,588.33 "	" $1,564.73 "	" $5,345.07 "	" $1,577.88 "
503726	HCHG OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27792	" $8,449.50 "	" $5,914.65 "	" $2,010.98 "	" $7,604.55 "	" $7,351.07 "	" $2,027.88 "	" $6,463.87 "	" $3,786.00 "	" $3,283.00 "	" $2,027.88 "	" $5,323.19 "	" $7,182.08 "	" $5,830.16 "	" $6,759.60 "	" $2,027.88 "	" $7,604.55 "	" $6,869.44 "	" $7,182.08 "	" $2,010.98 "	" $6,869.44 "	" $2,027.88 "
503727	HCHG OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27829	" $5,659.50 "	" $3,961.65 "	" $1,346.96 "	" $5,093.55 "	" $4,923.77 "	" $1,358.28 "	" $4,329.52 "	" $3,786.00 "	" $3,283.00 "	" $1,358.28 "	" $3,565.49 "	" $4,810.58 "	" $3,905.06 "	" $4,527.60 "	" $1,358.28 "	" $5,093.55 "	" $4,601.17 "	" $4,810.58 "	" $1,346.96 "	" $4,601.17 "	" $1,358.28 "
503728	HCHG SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29819	" $5,402.25 "	" $3,781.58 "	" $1,285.74 "	" $4,862.03 "	" $4,699.96 "	" $1,296.54 "	" $4,132.72 "	" $3,786.00 "	" $3,283.00 "	" $1,296.54 "	" $3,403.42 "	" $4,591.91 "	" $3,727.55 "	" $4,321.80 "	" $1,296.54 "	" $4,862.03 "	" $4,392.03 "	" $4,591.91 "	" $1,285.74 "	" $4,392.03 "	" $1,296.54 "
503729	HCHG ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29883	" $6,180.00 "	" $4,326.00 "	" $1,470.84 "	" $5,562.00 "	" $5,376.60 "	" $1,483.20 "	" $4,727.70 "	" $3,786.00 "	" $3,283.00 "	" $1,527.70 "	" $3,893.40 "	" $5,253.00 "	" $4,264.20 "	" $4,944.00 "	" $1,483.20 "	" $5,562.00 "	" $5,024.34 "	" $5,253.00 "	" $1,470.84 "	" $5,024.34 "	" $1,483.20 "
503730	HCHG SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	30140	" $3,360.00 "	" $2,352.00 "	 $799.68 	" $3,024.00 "	" $2,923.20 "	 $806.40 	" $2,570.40 "	" $2,822.40 "	" $2,822.40 "	 $806.40 	" $2,116.80 "	" $2,856.00 "	" $2,318.40 "	" $2,688.00 "	 $806.40 	" $3,024.00 "	" $2,731.68 "	" $2,856.00 "	 $799.68 	" $2,731.68 "	 $806.40 
503731	SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	30520	" $4,330.00 "	" $3,031.00 "	" $1,030.54 "	" $3,897.00 "	" $3,767.10 "	" $1,039.20 "	" $3,312.45 "	" $3,637.20 "	" $3,283.00 "	" $1,039.20 "	" $2,727.90 "	" $3,680.50 "	" $2,987.70 "	" $3,464.00 "	" $1,039.20 "	" $3,897.00 "	" $3,520.29 "	" $3,680.50 "	" $1,030.54 "	" $3,520.29 "	" $1,039.20 "
503732	HCHG CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52240	" $6,951.00 "	" $4,865.70 "	" $1,654.34 "	" $6,255.90 "	" $6,047.37 "	" $1,668.24 "	" $5,317.52 "	" $3,786.00 "	" $3,283.00 "	" $1,718.29 "	" $4,379.13 "	" $5,908.35 "	" $4,796.19 "	" $5,560.80 "	" $1,668.24 "	" $6,255.90 "	" $5,651.16 "	" $5,908.35 "	" $1,654.34 "	" $5,651.16 "	" $1,668.24 "
503733	HCHG LITHOLAPAXY SMPL/SM <2.5 CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52317	" $5,643.00 "	" $3,950.10 "	" $1,343.03 "	" $5,078.70 "	" $4,909.41 "	" $1,354.32 "	" $4,316.90 "	" $3,786.00 "	" $3,283.00 "	" $1,354.32 "	" $3,555.09 "	" $4,796.55 "	" $3,893.67 "	" $4,514.40 "	" $1,354.32 "	" $5,078.70 "	" $4,587.76 "	" $4,796.55 "	" $1,343.03 "	" $4,587.76 "	" $1,354.32 "
503734	HCHG EXCISION VAGINAL CYST/TUMOR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	57135	" $4,680.75 "	" $3,276.53 "	" $1,114.02 "	" $4,212.68 "	" $4,072.25 "	" $1,123.38 "	" $3,580.77 "	" $3,786.00 "	" $3,283.00 "	" $1,157.08 "	" $2,948.87 "	" $3,978.64 "	" $3,229.72 "	" $3,744.60 "	" $1,123.38 "	" $4,212.68 "	" $3,805.45 "	" $3,978.64 "	" $1,114.02 "	" $3,805.45 "	" $1,123.38 "
503752	HCHG EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21931	" $4,680.00 "	" $3,276.00 "	" $1,113.84 "	" $4,212.00 "	" $4,071.60 "	" $1,123.20 "	" $3,580.20 "	" $3,786.00 "	" $3,283.00 "	" $1,156.90 "	" $2,948.40 "	" $3,978.00 "	" $3,229.20 "	" $3,744.00 "	" $1,123.20 "	" $4,212.00 "	" $3,804.84 "	" $3,978.00 "	" $1,113.84 "	" $3,804.84 "	" $1,123.20 "
503753	HCHG CLAVICULECTOMY PARTIAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23120	" $5,300.25 "	" $3,710.18 "	" $1,261.46 "	" $4,770.23 "	" $4,611.22 "	" $1,272.06 "	" $4,054.69 "	" $3,786.00 "	" $3,283.00 "	" $1,310.22 "	" $3,339.16 "	" $4,505.21 "	" $3,657.17 "	" $4,240.20 "	" $1,272.06 "	" $4,770.23 "	" $4,309.10 "	" $4,505.21 "	" $1,261.46 "	" $4,309.10 "	" $1,272.06 "
503754	HCHG PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23130	" $4,977.00 "	" $3,483.90 "	" $1,184.53 "	" $4,479.30 "	" $4,329.99 "	" $1,194.48 "	" $3,807.41 "	" $3,786.00 "	" $3,283.00 "	" $1,194.48 "	" $3,135.51 "	" $4,230.45 "	" $3,434.13 "	" $3,981.60 "	" $1,194.48 "	" $4,479.30 "	" $4,046.30 "	" $4,230.45 "	" $1,184.53 "	" $4,046.30 "	" $1,194.48 "
503755	HCHG OPEN TX SHOULDER DISLOC W/NECK FX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23680	" $17,400.00 "	" $12,180.00 "	" $3,283.00 "	" $15,660.00 "	" $15,138.00 "	" $4,176.00 "	" $13,311.00 "	" $3,786.00 "	" $3,283.00 "	" $4,176.00 "	" $10,962.00 "	" $14,790.00 "	" $12,006.00 "	" $13,920.00 "	" $4,176.00 "	" $15,660.00 "	" $14,146.20 "	" $14,790.00 "	" $4,141.20 "	" $14,146.20 "	" $4,176.00 "
503756	HCHG ARTHRT ELBOW W/EXPLOR DRAIN/REMOVAL FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24000	" $4,791.75 "	" $3,354.23 "	" $1,140.44 "	" $4,312.58 "	" $4,168.82 "	" $1,150.02 "	" $3,665.69 "	" $3,786.00 "	" $3,283.00 "	" $1,184.52 "	" $3,018.80 "	" $4,072.99 "	" $3,306.31 "	" $3,833.40 "	" $1,150.02 "	" $4,312.58 "	" $3,895.69 "	" $4,072.99 "	" $1,140.44 "	" $3,895.69 "	" $1,150.02 "
503757	HCHG OPEN TX ULNAR FX PROXIMAL END	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24685	" $11,200.00 "	" $7,840.00 "	" $2,665.60 "	" $10,080.00 "	" $9,744.00 "	" $2,688.00 "	" $8,568.00 "	" $3,786.00 "	" $3,283.00 "	" $2,688.00 "	" $7,056.00 "	" $9,520.00 "	" $7,728.00 "	" $8,960.00 "	" $2,688.00 "	" $10,080.00 "	" $9,105.60 "	" $9,520.00 "	" $2,665.60 "	" $9,105.60 "	" $2,688.00 "
503758	HCHG OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25575	" $10,923.00 "	" $7,646.10 "	" $2,599.67 "	" $9,830.70 "	" $9,503.01 "	" $2,621.52 "	" $8,356.10 "	" $3,786.00 "	" $3,283.00 "	" $2,621.52 "	" $6,881.49 "	" $9,284.55 "	" $7,536.87 "	" $8,738.40 "	" $2,621.52 "	" $9,830.70 "	" $8,880.40 "	" $9,284.55 "	" $2,599.67 "	" $8,880.40 "	" $2,621.52 "
503759	HCHG PRQ SKELETAL FIXJ METACARPAL FX EACH BONE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26608	" $5,457.75 "	" $3,820.43 "	" $1,298.94 "	" $4,911.98 "	" $4,748.24 "	" $1,309.86 "	" $4,175.18 "	" $3,786.00 "	" $3,283.00 "	" $1,309.86 "	" $3,438.38 "	" $4,639.09 "	" $3,765.85 "	" $4,366.20 "	" $1,309.86 "	" $4,911.98 "	" $4,437.15 "	" $4,639.09 "	" $1,298.94 "	" $4,437.15 "	" $1,309.86 "
503760	HCHG ARTHRD CARPOMETACRP JT THMB W WO INT FX WAGRFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26842	" $7,438.50 "	" $5,206.95 "	" $1,770.36 "	" $6,694.65 "	" $6,471.50 "	" $1,785.24 "	" $5,690.45 "	" $3,786.00 "	" $3,283.00 "	" $1,838.80 "	" $4,686.26 "	" $6,322.73 "	" $5,132.57 "	" $5,950.80 "	" $1,785.24 "	" $6,694.65 "	" $6,047.50 "	" $6,322.73 "	" $1,770.36 "	" $6,047.50 "	" $1,785.24 "
503761	HCHG ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27334	" $8,100.75 "	" $5,670.53 "	" $1,927.98 "	" $7,290.68 "	" $7,047.65 "	" $1,944.18 "	" $6,197.07 "	" $3,786.00 "	" $3,283.00 "	" $2,002.51 "	" $5,103.47 "	" $6,885.64 "	" $5,589.52 "	" $6,480.60 "	" $1,944.18 "	" $7,290.68 "	" $6,585.91 "	" $6,885.64 "	" $1,927.98 "	" $6,585.91 "	" $1,944.18 "
503762	HCHG EXCISION PREPATELLAR BURSA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27340	" $5,540.00 "	" $3,878.00 "	" $1,318.52 "	" $4,986.00 "	" $4,819.80 "	" $1,329.60 "	" $4,238.10 "	" $3,786.00 "	" $3,283.00 "	" $1,369.49 "	" $3,490.20 "	" $4,709.00 "	" $3,822.60 "	" $4,432.00 "	" $1,329.60 "	" $4,986.00 "	" $4,504.02 "	" $4,709.00 "	" $1,318.52 "	" $4,504.02 "	" $1,329.60 "
503763	HCHG ARTHROTOMY W/MENISCUS REPAIR KNEE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27403	" $10,580.25 "	" $7,406.18 "	" $2,518.10 "	" $9,522.23 "	" $9,204.82 "	" $2,539.26 "	" $8,093.89 "	" $3,786.00 "	" $3,283.00 "	" $2,615.44 "	" $6,665.56 "	" $8,993.21 "	" $7,300.37 "	" $8,464.20 "	" $2,539.26 "	" $9,522.23 "	" $8,601.74 "	" $8,993.21 "	" $2,518.10 "	" $8,601.74 "	" $2,539.26 "
503764	HCHG DCMPRN FASCT LEG ANT&/LAT&PST CMPRT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27602	" $7,551.75 "	" $5,286.23 "	" $1,797.32 "	" $6,796.58 "	" $6,570.02 "	" $1,812.42 "	" $5,777.09 "	" $3,786.00 "	" $3,283.00 "	" $1,866.79 "	" $4,757.60 "	" $6,418.99 "	" $5,210.71 "	" $6,041.40 "	" $1,812.42 "	" $6,796.58 "	" $6,139.57 "	" $6,418.99 "	" $1,797.32 "	" $6,139.57 "	" $1,812.42 "
503765	HCHG INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27603	" $4,445.25 "	" $3,111.68 "	" $1,057.97 "	" $4,000.73 "	" $3,867.37 "	" $1,066.86 "	" $3,400.62 "	" $3,734.01 "	" $3,283.00 "	" $1,098.87 "	" $2,800.51 "	" $3,778.46 "	" $3,067.22 "	" $3,556.20 "	" $1,066.86 "	" $4,000.73 "	" $3,613.99 "	" $3,778.46 "	" $1,057.97 "	" $3,613.99 "	" $1,066.86 "
503766	HCHG TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27759	" $11,600.00 "	" $8,120.00 "	" $2,760.80 "	" $10,440.00 "	" $10,092.00 "	" $2,784.00 "	" $8,874.00 "	" $3,786.00 "	" $3,283.00 "	" $2,784.00 "	" $7,308.00 "	" $9,860.00 "	" $8,004.00 "	" $9,280.00 "	" $2,784.00 "	" $10,440.00 "	" $9,430.80 "	" $9,860.00 "	" $2,760.80 "	" $9,430.80 "	" $2,784.00 "
503767	HCHG OSTECTOMY COMPLETE 1ST METATARSAL HEAD	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28111	" $4,858.50 "	" $3,400.95 "	" $1,156.32 "	" $4,372.65 "	" $4,226.90 "	" $1,166.04 "	" $3,716.75 "	" $3,786.00 "	" $3,283.00 "	" $1,166.04 "	" $3,060.86 "	" $4,129.73 "	" $3,352.37 "	" $3,886.80 "	" $1,166.04 "	" $4,372.65 "	" $3,949.96 "	" $4,129.73 "	" $1,156.32 "	" $3,949.96 "	" $1,166.04 "
503768	HCHG RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28171	" $3,912.00 "	" $2,738.40 "	 $931.06 	" $3,520.80 "	" $3,403.44 "	 $938.88 	" $2,992.68 "	" $3,286.08 "	" $3,283.00 "	 $938.88 	" $2,464.56 "	" $3,325.20 "	" $2,699.28 "	" $3,129.60 "	 $938.88 	" $3,520.80 "	" $3,180.46 "	" $3,325.20 "	 $931.06 	" $3,180.46 "	 $938.88 
503769	HCHG HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28289	" $6,166.50 "	" $4,316.55 "	" $1,467.63 "	" $5,549.85 "	" $5,364.86 "	" $1,479.96 "	" $4,717.37 "	" $3,786.00 "	" $3,283.00 "	" $1,524.36 "	" $3,884.90 "	" $5,241.53 "	" $4,254.89 "	" $4,933.20 "	" $1,479.96 "	" $5,549.85 "	" $5,013.36 "	" $5,241.53 "	" $1,467.63 "	" $5,013.36 "	" $1,479.96 "
503770	HCHG OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28465	" $7,339.50 "	" $5,137.65 "	" $1,746.80 "	" $6,605.55 "	" $6,385.37 "	" $1,761.48 "	" $5,614.72 "	" $3,786.00 "	" $3,283.00 "	" $1,761.48 "	" $4,623.89 "	" $6,238.58 "	" $5,064.26 "	" $5,871.60 "	" $1,761.48 "	" $6,605.55 "	" $5,967.01 "	" $6,238.58 "	" $1,746.80 "	" $5,967.01 "	" $1,761.48 "
503771	HCHG ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29861	" $5,796.75 "	" $4,057.73 "	" $1,379.63 "	" $5,217.08 "	" $5,043.17 "	" $1,391.22 "	" $4,434.51 "	" $3,786.00 "	" $3,283.00 "	" $1,432.96 "	" $3,651.95 "	" $4,927.24 "	" $3,999.76 "	" $4,637.40 "	" $1,391.22 "	" $5,217.08 "	" $4,712.76 "	" $4,927.24 "	" $1,379.63 "	" $4,712.76 "	" $1,391.22 "
503772	HCHG PALATOPHARYNGOPLASTY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	42145	" $6,591.00 "	" $4,613.70 "	" $1,568.66 "	" $5,931.90 "	" $5,734.17 "	" $1,581.84 "	" $5,042.12 "	" $3,786.00 "	" $3,283.00 "	" $1,581.84 "	" $4,152.33 "	" $5,602.35 "	" $4,547.79 "	" $5,272.80 "	" $1,581.84 "	" $5,931.90 "	" $5,358.48 "	" $5,602.35 "	" $1,568.66 "	" $5,358.48 "	" $1,581.84 "
503773	HCHG RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49520	" $8,630.00 "	" $6,041.00 "	" $2,053.94 "	" $7,767.00 "	" $7,508.10 "	" $2,071.20 "	" $6,601.95 "	" $3,786.00 "	" $3,283.00 "	" $2,071.20 "	" $5,436.90 "	" $7,335.50 "	" $5,954.70 "	" $6,904.00 "	" $2,071.20 "	" $7,767.00 "	" $7,016.19 "	" $7,335.50 "	" $2,053.94 "	" $7,016.19 "	" $2,071.20 "
503774	HCHG TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52601	" $10,700.00 "	" $7,490.00 "	" $2,546.60 "	" $9,630.00 "	" $9,309.00 "	" $2,568.00 "	" $8,185.50 "	" $3,786.00 "	" $3,283.00 "	" $2,568.00 "	" $6,741.00 "	" $9,095.00 "	" $7,383.00 "	" $8,560.00 "	" $2,568.00 "	" $9,630.00 "	" $8,699.10 "	" $9,095.00 "	" $2,546.60 "	" $8,699.10 "	" $2,568.00 "
503775	HCHG EXCISION HYDROCELE BILATERAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	55041	" $7,541.25 "	" $5,278.88 "	" $1,794.82 "	" $6,787.13 "	" $6,560.89 "	" $1,809.90 "	" $5,769.06 "	" $3,786.00 "	" $3,283.00 "	" $1,864.20 "	" $4,750.99 "	" $6,410.06 "	" $5,203.46 "	" $6,033.00 "	" $1,809.90 "	" $6,787.13 "	" $6,131.04 "	" $6,410.06 "	" $1,794.82 "	" $6,131.04 "	" $1,809.90 "
503776	HCHG RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	63661	" $4,542.00 "	" $3,179.40 "	" $1,081.00 "	" $4,087.80 "	" $3,951.54 "	" $1,090.08 "	" $3,474.63 "	" $3,786.00 "	" $3,283.00 "	" $1,090.08 "	" $2,861.46 "	" $3,860.70 "	" $3,133.98 "	" $3,633.60 "	" $1,090.08 "	" $4,087.80 "	" $3,692.65 "	" $3,860.70 "	" $1,081.00 "	" $3,692.65 "	" $1,090.08 "
503777	HCHG REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GENERATOR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	63688	" $6,310.00 "	" $4,417.00 "	" $1,501.78 "	" $5,679.00 "	" $5,489.70 "	" $1,514.40 "	" $4,827.15 "	" $3,786.00 "	" $3,283.00 "	" $1,514.40 "	" $3,975.30 "	" $5,363.50 "	" $4,353.90 "	" $5,048.00 "	" $1,514.40 "	" $5,679.00 "	" $5,130.03 "	" $5,363.50 "	" $1,501.78 "	" $5,130.03 "	" $1,514.40 "
503778	HCHG REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64585	" $5,028.75 "	" $3,520.13 "	" $1,196.84 "	" $4,525.88 "	" $4,375.01 "	" $1,206.90 "	" $3,846.99 "	" $3,786.00 "	" $3,283.00 "	" $1,206.90 "	" $3,168.11 "	" $4,274.44 "	" $3,469.84 "	" $4,023.00 "	" $1,206.90 "	" $4,525.88 "	" $4,088.37 "	" $4,274.44 "	" $1,196.84 "	" $4,088.37 "	" $1,206.90 "
503779	HCHG CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26520	" $3,600.75 "	" $2,520.53 "	 $856.98 	" $3,240.68 "	" $3,132.65 "	 $864.18 	" $2,754.57 "	" $3,024.63 "	" $3,024.63 "	 $890.11 	" $2,268.47 "	" $3,060.64 "	" $2,484.52 "	" $2,880.60 "	 $864.18 	" $3,240.68 "	" $2,927.41 "	" $3,060.64 "	 $856.98 	" $2,927.41 "	 $864.18 
503780	HCHG I&D SHOULDER DEEP ABSCESS/HEMATOMA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23030	" $7,052.25 "	" $4,936.58 "	" $1,678.44 "	" $6,347.03 "	" $6,135.46 "	" $1,692.54 "	" $5,394.97 "	" $3,786.00 "	" $3,283.00 "	" $1,743.32 "	" $4,442.92 "	" $5,994.41 "	" $4,866.05 "	" $5,641.80 "	" $1,692.54 "	" $6,347.03 "	" $5,733.48 "	" $5,994.41 "	" $1,678.44 "	" $5,733.48 "	" $1,692.54 "
503782	HCHG REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27134	" $10,166.25 "	" $7,116.38 "	" $2,419.57 "	" $9,149.63 "	" $8,844.64 "	" $2,439.90 "	" $7,777.18 "	" $3,786.00 "	" $3,283.00 "	" $2,439.90 "	" $6,404.74 "	" $8,641.31 "	" $7,014.71 "	" $8,133.00 "	" $2,439.90 "	" $9,149.63 "	" $8,265.16 "	" $8,641.31 "	" $2,419.57 "	" $8,265.16 "	" $2,439.90 "
503783	HCHG TONSILLECTOMY & ADENOIDECTOMY AGE 12/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	42821	" $4,212.00 "	" $2,948.40 "	" $1,002.46 "	" $3,790.80 "	" $3,664.44 "	" $1,010.88 "	" $3,222.18 "	" $3,538.08 "	" $3,283.00 "	" $1,010.88 "	" $2,653.56 "	" $3,580.20 "	" $2,906.28 "	" $3,369.60 "	" $1,010.88 "	" $3,790.80 "	" $3,424.36 "	" $3,580.20 "	" $1,002.46 "	" $3,424.36 "	" $1,010.88 "
503784	HCHG ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29884	" $7,010.00 "	" $4,907.00 "	" $1,668.38 "	" $6,309.00 "	" $6,098.70 "	" $1,682.40 "	" $5,362.65 "	" $3,786.00 "	" $3,283.00 "	" $1,732.87 "	" $4,416.30 "	" $5,958.50 "	" $4,836.90 "	" $5,608.00 "	" $1,682.40 "	" $6,309.00 "	" $5,699.13 "	" $5,958.50 "	" $1,668.38 "	" $5,699.13 "	" $1,682.40 "
503787	HCHG BONE GRAFT ANY DONOR AREA MINOR/SMALL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	20900	" $5,848.50 "	" $4,093.95 "	" $1,391.94 "	" $5,263.65 "	" $5,088.20 "	" $1,403.64 "	" $4,474.10 "	" $3,786.00 "	" $3,283.00 "	" $1,445.75 "	" $3,684.56 "	" $4,971.23 "	" $4,035.47 "	" $4,678.80 "	" $1,403.64 "	" $5,263.65 "	" $4,754.83 "	" $4,971.23 "	" $1,391.94 "	" $4,754.83 "	" $1,403.64 "
503788	HCHG EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	22903	" $5,042.25 "	" $3,529.58 "	" $1,200.06 "	" $4,538.03 "	" $4,386.76 "	" $1,210.14 "	" $3,857.32 "	" $3,786.00 "	" $3,283.00 "	" $1,246.44 "	" $3,176.62 "	" $4,285.91 "	" $3,479.15 "	" $4,033.80 "	" $1,210.14 "	" $4,538.03 "	" $4,099.35 "	" $4,285.91 "	" $1,200.06 "	" $4,099.35 "	" $1,210.14 "
503789	HCHG CARPECTOMY 1 BONE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25210	" $4,887.75 "	" $3,421.43 "	" $1,163.28 "	" $4,398.98 "	" $4,252.34 "	" $1,173.06 "	" $3,739.13 "	" $3,786.00 "	" $3,283.00 "	" $1,208.25 "	" $3,079.28 "	" $4,154.59 "	" $3,372.55 "	" $3,910.20 "	" $1,173.06 "	" $4,398.98 "	" $3,973.74 "	" $4,154.59 "	" $1,163.28 "	" $3,973.74 "	" $1,173.06 "
503790	HCHG CLOSURE ENTEROSTOMY LG/SMALL INTESTINE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44620	" $11,507.25 "	" $8,055.08 "	" $2,738.73 "	" $10,356.53 "	" $10,011.31 "	" $2,761.74 "	" $8,803.05 "	" $3,786.00 "	" $3,283.00 "	" $2,844.59 "	" $7,249.57 "	" $9,781.16 "	" $7,940.00 "	" $9,205.80 "	" $2,761.74 "	" $10,356.53 "	" $9,355.39 "	" $9,781.16 "	" $2,738.73 "	" $9,355.39 "	" $2,761.74 "
503791	HCHG EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25135	" $5,645.25 "	" $3,951.68 "	" $1,343.57 "	" $5,080.73 "	" $4,911.37 "	" $1,354.86 "	" $4,318.62 "	" $3,786.00 "	" $3,283.00 "	" $1,395.51 "	" $3,556.51 "	" $4,798.46 "	" $3,895.22 "	" $4,516.20 "	" $1,354.86 "	" $5,080.73 "	" $4,589.59 "	" $4,798.46 "	" $1,343.57 "	" $4,589.59 "	" $1,354.86 "
503792	HCHG TENDON TRANSPLNT FOREARM W GRAFTS EA TENDON	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25312	" $5,469.00 "	" $3,828.30 "	" $1,301.62 "	" $4,922.10 "	" $4,758.03 "	" $1,312.56 "	" $4,183.79 "	" $3,786.00 "	" $3,283.00 "	" $1,312.56 "	" $3,445.47 "	" $4,648.65 "	" $3,773.61 "	" $4,375.20 "	" $1,312.56 "	" $4,922.10 "	" $4,446.30 "	" $4,648.65 "	" $1,301.62 "	" $4,446.30 "	" $1,312.56 "
503796	HCHG EXCISION PILONIDAL CYST/SINUS COMPLICATED	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	11772	" $6,456.00 "	" $4,519.20 "	" $1,536.53 "	" $5,810.40 "	" $5,616.72 "	" $1,549.44 "	" $4,938.84 "	" $3,786.00 "	" $3,283.00 "	" $1,595.92 "	" $4,067.28 "	" $5,487.60 "	" $4,454.64 "	" $5,164.80 "	" $1,549.44 "	" $5,810.40 "	" $5,248.73 "	" $5,487.60 "	" $1,536.53 "	" $5,248.73 "	" $1,549.44 "
503798	HCHG MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	20702	 $445.98 	 $312.19 	 $106.14 	 $401.38 	 $388.00 	 $107.04 	 $341.17 	 $374.62 	 $374.62 	 $107.04 	 $280.97 	 $379.08 	 $307.73 	 $356.78 	 $107.04 	 $401.38 	 $362.58 	 $379.08 	 $106.14 	 $362.58 	 $107.04 
503799	HCHG EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21012	" $4,754.25 "	" $3,327.98 "	" $1,131.51 "	" $4,278.83 "	" $4,136.20 "	" $1,141.02 "	" $3,637.00 "	" $3,786.00 "	" $3,283.00 "	" $1,175.25 "	" $2,995.18 "	" $4,041.11 "	" $3,280.43 "	" $3,803.40 "	" $1,141.02 "	" $4,278.83 "	" $3,865.21 "	" $4,041.11 "	" $1,131.51 "	" $3,865.21 "	" $1,141.02 "
503800	HCHG EXCISION MAXILLARY TORUS PALATINUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21032	" $5,792.25 "	" $4,054.58 "	" $1,378.56 "	" $5,213.03 "	" $5,039.26 "	" $1,390.14 "	" $4,431.07 "	" $3,786.00 "	" $3,283.00 "	" $1,431.84 "	" $3,649.12 "	" $4,923.41 "	" $3,996.65 "	" $4,633.80 "	" $1,390.14 "	" $5,213.03 "	" $4,709.10 "	" $4,923.41 "	" $1,378.56 "	" $4,709.10 "	" $1,390.14 "
503801	HCHG EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21556	" $6,239.25 "	" $4,367.48 "	" $1,484.94 "	" $5,615.33 "	" $5,428.15 "	" $1,497.42 "	" $4,773.03 "	" $3,786.00 "	" $3,283.00 "	" $1,542.34 "	" $3,930.73 "	" $5,303.36 "	" $4,305.08 "	" $4,991.40 "	" $1,497.42 "	" $5,615.33 "	" $5,072.51 "	" $5,303.36 "	" $1,484.94 "	" $5,072.51 "	" $1,497.42 "
503802	HCHG ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23040	" $9,752.25 "	" $6,826.58 "	" $2,321.04 "	" $8,777.03 "	" $8,484.46 "	" $2,340.54 "	" $7,460.47 "	" $3,786.00 "	" $3,283.00 "	" $2,410.76 "	" $6,143.92 "	" $8,289.41 "	" $6,729.05 "	" $7,801.80 "	" $2,340.54 "	" $8,777.03 "	" $7,928.58 "	" $8,289.41 "	" $2,321.04 "	" $7,928.58 "	" $2,340.54 "
503803	HCHG ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23044	" $7,225.50 "	" $5,057.85 "	" $1,719.67 "	" $6,502.95 "	" $6,286.19 "	" $1,734.12 "	" $5,527.51 "	" $3,786.00 "	" $3,283.00 "	" $1,786.14 "	" $4,552.07 "	" $6,141.68 "	" $4,985.60 "	" $5,780.40 "	" $1,734.12 "	" $6,502.95 "	" $5,874.33 "	" $6,141.68 "	" $1,719.67 "	" $5,874.33 "	" $1,734.12 "
503804	HCHG OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23550	" $23,550.00 "	" $16,485.00 "	" $3,283.00 "	" $21,195.00 "	" $20,488.50 "	" $5,652.00 "	" $18,015.75 "	" $3,786.00 "	" $3,283.00 "	" $5,652.00 "	" $14,836.50 "	" $20,017.50 "	" $16,249.50 "	" $18,840.00 "	" $5,652.00 "	" $21,195.00 "	" $19,146.15 "	" $20,017.50 "	" $5,604.90 "	" $19,146.15 "	" $5,652.00 "
503805	HCHG OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23670	" $12,394.50 "	" $8,676.15 "	" $2,949.89 "	" $11,155.05 "	" $10,783.22 "	" $2,974.68 "	" $9,481.79 "	" $3,786.00 "	" $3,283.00 "	" $2,974.68 "	" $7,808.54 "	" $10,535.33 "	" $8,552.21 "	" $9,915.60 "	" $2,974.68 "	" $11,155.05 "	" $10,076.73 "	" $10,535.33 "	" $2,949.89 "	" $10,076.73 "	" $2,974.68 "
503806	HCHG MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23700	" $3,444.00 "	" $2,410.80 "	 $819.67 	" $3,099.60 "	" $2,996.28 "	 $826.56 	" $2,634.66 "	" $2,892.96 "	" $2,892.96 "	 $826.56 	" $2,169.72 "	" $2,927.40 "	" $2,376.36 "	" $2,755.20 "	 $826.56 	" $3,099.60 "	" $2,799.97 "	" $2,927.40 "	 $819.67 	" $2,799.97 "	 $826.56 
503807	HCHG EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24120	" $5,129.25 "	" $3,590.48 "	" $1,220.76 "	" $4,616.33 "	" $4,462.45 "	" $1,231.02 "	" $3,923.88 "	" $3,786.00 "	" $3,283.00 "	" $1,267.95 "	" $3,231.43 "	" $4,359.86 "	" $3,539.18 "	" $4,103.40 "	" $1,231.02 "	" $4,616.33 "	" $4,170.08 "	" $4,359.86 "	" $1,220.76 "	" $4,170.08 "	" $1,231.02 "
503808	HCHG OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24545	" $14,682.75 "	" $10,277.93 "	" $3,283.00 "	" $13,214.48 "	" $12,773.99 "	" $3,523.86 "	" $11,232.30 "	" $3,786.00 "	" $3,283.00 "	" $3,523.86 "	" $9,250.13 "	" $12,480.34 "	" $10,131.10 "	" $11,746.20 "	" $3,523.86 "	" $13,214.48 "	" $11,937.08 "	" $12,480.34 "	" $3,494.49 "	" $11,937.08 "	" $3,523.86 "
503809	HCHG CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25320	" $7,164.75 "	" $5,015.33 "	" $1,705.21 "	" $6,448.28 "	" $6,233.33 "	" $1,719.54 "	" $5,481.03 "	" $3,786.00 "	" $3,283.00 "	" $1,771.13 "	" $4,513.79 "	" $6,090.04 "	" $4,943.68 "	" $5,731.80 "	" $1,719.54 "	" $6,448.28 "	" $5,824.94 "	" $6,090.04 "	" $1,705.21 "	" $5,824.94 "	" $1,719.54 "
503810	HCHG OSTEOTOMY RADIUS DISTAL THIRD	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25350	" $8,329.50 "	" $5,830.65 "	" $1,982.42 "	" $7,496.55 "	" $7,246.67 "	" $1,999.08 "	" $6,372.07 "	" $3,786.00 "	" $3,283.00 "	" $1,999.08 "	" $5,247.59 "	" $7,080.08 "	" $5,747.36 "	" $6,663.60 "	" $1,999.08 "	" $7,496.55 "	" $6,771.88 "	" $7,080.08 "	" $1,982.42 "	" $6,771.88 "	" $1,999.08 "
503811	HCHG FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26123	" $6,069.00 "	" $4,248.30 "	" $1,444.42 "	" $5,462.10 "	" $5,280.03 "	" $1,456.56 "	" $4,642.79 "	" $3,786.00 "	" $3,283.00 "	" $1,500.26 "	" $3,823.47 "	" $5,158.65 "	" $4,187.61 "	" $4,855.20 "	" $1,456.56 "	" $5,462.10 "	" $4,934.10 "	" $5,158.65 "	" $1,444.42 "	" $4,934.10 "	" $1,456.56 "
503812	HCHG FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26125	" $3,275.25 "	" $2,292.68 "	 $779.51 	" $2,947.73 "	" $2,849.47 "	 $786.06 	" $2,505.57 "	" $2,751.21 "	" $2,751.21 "	 $809.64 	" $2,063.41 "	" $2,783.96 "	" $2,259.92 "	" $2,620.20 "	 $786.06 	" $2,947.73 "	" $2,662.78 "	" $2,783.96 "	 $779.51 	" $2,662.78 "	 $786.06 
503813	HCHG EXC LESION TDN SHTH/JT CAPSL HAND/FNGR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26160	" $3,997.50 "	" $2,798.25 "	 $951.41 	" $3,597.75 "	" $3,477.83 "	 $959.40 	" $3,058.09 "	" $3,357.90 "	" $3,283.00 "	 $988.18 	" $2,518.43 "	" $3,397.88 "	" $2,758.28 "	" $3,198.00 "	 $959.40 	" $3,597.75 "	" $3,249.97 "	" $3,397.88 "	 $951.41 	" $3,249.97 "	 $959.40 
503814	HCHG TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26485	" $4,443.75 "	" $3,110.63 "	" $1,057.61 "	" $3,999.38 "	" $3,866.06 "	" $1,066.50 "	" $3,399.47 "	" $3,732.75 "	" $3,283.00 "	" $1,066.50 "	" $2,799.56 "	" $3,777.19 "	" $3,066.19 "	" $3,555.00 "	" $1,066.50 "	" $3,999.38 "	" $3,612.77 "	" $3,777.19 "	" $1,057.61 "	" $3,612.77 "	" $1,066.50 "
503815	HCHG ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27033	" $11,075.25 "	" $7,752.68 "	" $2,635.91 "	" $9,967.73 "	" $9,635.47 "	" $2,658.06 "	" $8,472.57 "	" $3,786.00 "	" $3,283.00 "	" $2,737.80 "	" $6,977.41 "	" $9,413.96 "	" $7,641.92 "	" $8,860.20 "	" $2,658.06 "	" $9,967.73 "	" $9,004.18 "	" $9,413.96 "	" $2,635.91 "	" $9,004.18 "	" $2,658.06 "
503816	HCHG LATERAL RETINACULAR RELEASE OPEN	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27425	" $6,740.25 "	" $4,718.18 "	" $1,604.18 "	" $6,066.23 "	" $5,864.02 "	" $1,617.66 "	" $5,156.29 "	" $3,786.00 "	" $3,283.00 "	" $1,617.66 "	" $4,246.36 "	" $5,729.21 "	" $4,650.77 "	" $5,392.20 "	" $1,617.66 "	" $6,066.23 "	" $5,479.82 "	" $5,729.21 "	" $1,604.18 "	" $5,479.82 "	" $1,617.66 "
503817	HCHG OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27822	" $11,028.00 "	" $7,719.60 "	" $2,624.66 "	" $9,925.20 "	" $9,594.36 "	" $2,646.72 "	" $8,436.42 "	" $3,786.00 "	" $3,283.00 "	" $2,646.72 "	" $6,947.64 "	" $9,373.80 "	" $7,609.32 "	" $8,822.40 "	" $2,646.72 "	" $9,925.20 "	" $8,965.76 "	" $9,373.80 "	" $2,624.66 "	" $8,965.76 "	" $2,646.72 "
503818	HCHG AMPUTATION FOOT TRANSMETARSAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28805	" $4,827.00 "	" $3,378.90 "	" $1,148.83 "	" $4,344.30 "	" $4,199.49 "	" $1,158.48 "	" $3,692.66 "	" $3,786.00 "	" $3,283.00 "	" $1,193.23 "	" $3,041.01 "	" $4,102.95 "	" $3,330.63 "	" $3,861.60 "	" $1,158.48 "	" $4,344.30 "	" $3,924.35 "	" $4,102.95 "	" $1,148.83 "	" $3,924.35 "	" $1,158.48 "
503819	HCHG ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29879	" $5,259.75 "	" $3,681.83 "	" $1,251.82 "	" $4,733.78 "	" $4,575.98 "	" $1,262.34 "	" $4,023.71 "	" $3,786.00 "	" $3,283.00 "	" $1,300.21 "	" $3,313.64 "	" $4,470.79 "	" $3,629.23 "	" $4,207.80 "	" $1,262.34 "	" $4,733.78 "	" $4,276.18 "	" $4,470.79 "	" $1,251.82 "	" $4,276.18 "	" $1,262.34 "
503820	HCHG NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31256	" $3,678.75 "	" $2,575.13 "	 $875.54 	" $3,310.88 "	" $3,200.51 "	 $882.90 	" $2,814.24 "	" $3,090.15 "	" $3,090.15 "	 $882.90 	" $2,317.61 "	" $3,126.94 "	" $2,538.34 "	" $2,943.00 "	 $882.90 	" $3,310.88 "	" $2,990.82 "	" $3,126.94 "	 $875.54 	" $2,990.82 "	 $882.90 
503821	HCHG NASAL/SINUS NDSC TOTAL W/SPHENOIDOTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31257	" $4,620.00 "	" $3,234.00 "	" $1,099.56 "	" $4,158.00 "	" $4,019.40 "	" $1,108.80 "	" $3,534.30 "	" $3,786.00 "	" $3,283.00 "	" $1,108.80 "	" $2,910.60 "	" $3,927.00 "	" $3,187.80 "	" $3,696.00 "	" $1,108.80 "	" $4,158.00 "	" $3,756.06 "	" $3,927.00 "	" $1,099.56 "	" $3,756.06 "	" $1,108.80 "
503822	HCHG GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43501	" $12,672.00 "	" $8,870.40 "	" $3,015.94 "	" $11,404.80 "	" $11,024.64 "	" $3,041.28 "	" $9,694.08 "	" $3,786.00 "	" $3,283.00 "	" $3,132.52 "	" $7,983.36 "	" $10,771.20 "	" $8,743.68 "	" $10,137.60 "	" $3,041.28 "	" $11,404.80 "	" $10,302.34 "	" $10,771.20 "	" $3,015.94 "	" $10,302.34 "	" $3,041.28 "
503823	HCHG GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43840	" $12,487.50 "	" $8,741.25 "	" $2,972.03 "	" $11,238.75 "	" $10,864.13 "	" $2,997.00 "	" $9,552.94 "	" $3,786.00 "	" $3,283.00 "	" $3,086.91 "	" $7,867.13 "	" $10,614.38 "	" $8,616.38 "	" $9,990.00 "	" $2,997.00 "	" $11,238.75 "	" $10,152.34 "	" $10,614.38 "	" $2,972.03 "	" $10,152.34 "	" $2,997.00 "
503824	HCHG CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	47610	" $10,476.75 "	" $7,333.73 "	" $2,493.47 "	" $9,429.08 "	" $9,114.77 "	" $2,514.42 "	" $8,014.71 "	" $3,786.00 "	" $3,283.00 "	" $2,589.85 "	" $6,600.35 "	" $8,905.24 "	" $7,228.96 "	" $8,381.40 "	" $2,514.42 "	" $9,429.08 "	" $8,517.60 "	" $8,905.24 "	" $2,493.47 "	" $8,517.60 "	" $2,514.42 "
503825	HCHG RPR RECRT INGUN HERNIA ANY AGE INCARCERATED	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49521	" $9,751.50 "	" $6,826.05 "	" $2,320.86 "	" $8,776.35 "	" $8,483.81 "	" $2,340.36 "	" $7,459.90 "	" $3,786.00 "	" $3,283.00 "	" $2,340.36 "	" $6,143.45 "	" $8,288.78 "	" $6,728.54 "	" $7,801.20 "	" $2,340.36 "	" $8,776.35 "	" $7,927.97 "	" $8,288.78 "	" $2,320.86 "	" $7,927.97 "	" $2,340.36 "
503827	HCHG REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	63663	" $9,070.50 "	" $6,349.35 "	" $2,158.78 "	" $8,163.45 "	" $7,891.34 "	" $2,176.92 "	" $6,938.93 "	" $3,786.00 "	" $3,283.00 "	" $2,176.92 "	" $5,714.42 "	" $7,709.93 "	" $6,258.65 "	" $7,256.40 "	" $2,176.92 "	" $8,163.45 "	" $7,374.32 "	" $7,709.93 "	" $2,158.78 "	" $7,374.32 "	" $2,176.92 "
503828	HCHG INJ AA&/STRD BRACHIAL PLEXUS CONT NFS CATH (INCLUDES IG)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64416	" $2,578.50 "	" $1,804.95 "	 $613.68 	" $2,320.65 "	" $2,243.30 "	 $618.84 	" $1,972.55 "	" $2,165.94 "	" $2,165.94 "	 $637.41 	" $1,624.46 "	" $2,191.73 "	" $1,779.17 "	" $2,062.80 "	 $618.84 	" $2,320.65 "	" $2,096.32 "	" $2,191.73 "	 $613.68 	" $2,096.32 "	 $618.84 
503829	HCHG INJ AA&/STRD SCIATIC NV CONT NFS CATH (INCLUDES IG)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64446	" $2,789.25 "	" $1,952.48 "	 $663.84 	" $2,510.33 "	" $2,426.65 "	 $669.42 	" $2,133.78 "	" $2,342.97 "	" $2,342.97 "	 $689.50 	" $1,757.23 "	" $2,370.86 "	" $1,924.58 "	" $2,231.40 "	 $669.42 	" $2,510.33 "	" $2,267.66 "	" $2,370.86 "	 $663.84 	" $2,267.66 "	 $669.42 
503830	HCHG INJECTION AA&/STRD FEMORAL NERVE CONT NFS CATH (INCLUDES IG)	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	64448	" $3,838.50 "	" $2,686.95 "	 $913.56 	" $3,454.65 "	" $3,339.50 "	 $921.24 	" $2,936.45 "	" $3,224.34 "	" $3,224.34 "	 $948.88 	" $2,418.26 "	" $3,262.73 "	" $2,648.57 "	" $3,070.80 "	 $921.24 	" $3,454.65 "	" $3,120.70 "	" $3,262.73 "	 $913.56 	" $3,120.70 "	 $921.24 
503842	HCHG DECROMPRESSIVE FASCIOTOMY HAND	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26037	" $3,767.25 "	" $2,637.08 "	 $896.61 	" $3,390.53 "	" $3,277.51 "	 $904.14 	" $2,881.95 "	" $3,164.49 "	" $3,164.49 "	 $931.26 	" $2,373.37 "	" $3,202.16 "	" $2,599.40 "	" $3,013.80 "	 $904.14 	" $3,390.53 "	" $3,062.77 "	" $3,202.16 "	 $896.61 	" $3,062.77 "	 $904.14 
503860	HCHG DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	11005	" $4,905.75 "	" $3,434.03 "	" $1,167.57 "	" $4,415.18 "	" $4,268.00 "	" $1,177.38 "	" $3,752.90 "	" $3,786.00 "	" $3,283.00 "	" $1,212.70 "	" $3,090.62 "	" $4,169.89 "	" $3,384.97 "	" $3,924.60 "	" $1,177.38 "	" $4,415.18 "	" $3,988.37 "	" $4,169.89 "	" $1,167.57 "	" $3,988.37 "	" $1,177.38 "
503861	HCHG ADJT TIS TRNS/REARGMT 10SQCM/<	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	14040	" $4,960.50 "	" $3,472.35 "	" $1,180.60 "	" $4,464.45 "	" $4,315.64 "	" $1,190.52 "	" $3,794.78 "	" $3,786.00 "	" $3,283.00 "	" $1,226.24 "	" $3,125.12 "	" $4,216.43 "	" $3,422.75 "	" $3,968.40 "	" $1,190.52 "	" $4,464.45 "	" $4,032.89 "	" $4,216.43 "	" $1,180.60 "	" $4,032.89 "	" $1,190.52 "
503862	HCHG I&D BELOW FASCIA FOOT MULT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28003	" $4,772.25 "	" $3,340.58 "	" $1,135.80 "	" $4,295.03 "	" $4,151.86 "	" $1,145.34 "	" $3,650.77 "	" $3,786.00 "	" $3,283.00 "	" $1,179.70 "	" $3,006.52 "	" $4,056.41 "	" $3,292.85 "	" $3,817.80 "	" $1,145.34 "	" $4,295.03 "	" $3,879.84 "	" $4,056.41 "	" $1,135.80 "	" $3,879.84 "	" $1,145.34 "
503863	HCHG OSTECTOMY CALCANEUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28118	" $5,527.50 "	" $3,869.25 "	" $1,315.55 "	" $4,974.75 "	" $4,808.93 "	" $1,326.60 "	" $4,228.54 "	" $3,786.00 "	" $3,283.00 "	" $1,326.60 "	" $3,482.33 "	" $4,698.38 "	" $3,813.98 "	" $4,422.00 "	" $1,326.60 "	" $4,974.75 "	" $4,493.86 "	" $4,698.38 "	" $1,315.55 "	" $4,493.86 "	" $1,326.60 "
503864	HCHG ARTHROSCOPY KNEE LATERAL RELEASE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	29873	" $5,939.25 "	" $4,157.48 "	" $1,413.54 "	" $5,345.33 "	" $5,167.15 "	" $1,425.42 "	" $4,543.53 "	" $3,786.00 "	" $3,283.00 "	" $1,468.18 "	" $3,741.73 "	" $5,048.36 "	" $4,098.08 "	" $4,751.40 "	" $1,425.42 "	" $5,345.33 "	" $4,828.61 "	" $5,048.36 "	" $1,413.54 "	" $4,828.61 "	" $1,425.42 "
503865	HCHG CORRJ MALROTATION BANDS&/RDCTJ VOLV	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44055	" $3,936.00 "	" $2,755.20 "	 $936.77 	" $3,542.40 "	" $3,424.32 "	 $944.64 	" $3,011.04 "	" $3,306.24 "	" $3,283.00 "	 $972.98 	" $2,479.68 "	" $3,345.60 "	" $2,715.84 "	" $3,148.80 "	 $944.64 	" $3,542.40 "	" $3,199.97 "	" $3,345.60 "	 $936.77 	" $3,199.97 "	 $944.64 
503866	HCHG COLECTOMY PRTL W/COLOST/ILEOST & MUCOFIST	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44144	" $24,364.50 "	" $17,055.15 "	" $3,283.00 "	" $21,928.05 "	" $21,197.12 "	" $5,847.48 "	" $18,638.84 "	" $3,786.00 "	" $3,283.00 "	" $6,022.90 "	" $15,349.64 "	" $20,709.83 "	" $16,811.51 "	" $19,491.60 "	" $5,847.48 "	" $21,928.05 "	" $19,808.34 "	" $20,709.83 "	" $5,798.75 "	" $19,808.34 "	" $5,847.48 "
503867	HCHG LAPAROSCOPY ENTEROLYSIS SEPARATE PX	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44180	" $10,379.25 "	" $7,265.48 "	" $2,470.26 "	" $9,341.33 "	" $9,029.95 "	" $2,491.02 "	" $7,940.13 "	" $3,786.00 "	" $3,283.00 "	" $2,491.02 "	" $6,538.93 "	" $8,822.36 "	" $7,161.68 "	" $8,303.40 "	" $2,491.02 "	" $9,341.33 "	" $8,438.33 "	" $8,822.36 "	" $2,470.26 "	" $8,438.33 "	" $2,491.02 "
503868	HCHG LAPS CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	47563	" $10,965.75 "	" $7,676.03 "	" $2,609.85 "	" $9,869.18 "	" $9,540.20 "	" $2,631.78 "	" $8,388.80 "	" $3,786.00 "	" $3,283.00 "	" $2,631.78 "	" $6,908.42 "	" $9,320.89 "	" $7,566.37 "	" $8,772.60 "	" $2,631.78 "	" $9,869.18 "	" $8,915.15 "	" $9,320.89 "	" $2,609.85 "	" $8,915.15 "	" $2,631.78 "
503869	HCHG OMENTAL FLAP INTRA-ABDOMINAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49905	" $5,577.00 "	" $3,903.90 "	" $1,327.33 "	" $5,019.30 "	" $4,851.99 "	" $1,338.48 "	" $4,266.41 "	" $3,786.00 "	" $3,283.00 "	" $1,338.48 "	" $3,513.51 "	" $4,740.45 "	" $3,848.13 "	" $4,461.60 "	" $1,338.48 "	" $5,019.30 "	" $4,534.10 "	" $4,740.45 "	" $1,327.33 "	" $4,534.10 "	" $1,338.48 "
503870	HCHG UNLISTED LAP PX ABD PERTONEUM & OMENTUM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49329	" $9,189.75 "	" $6,432.83 "	" $2,187.16 "	" $8,270.78 "	" $7,995.08 "	" $2,205.54 "	" $7,030.16 "	" $3,786.00 "	" $3,283.00 "	" $2,205.54 "	" $5,789.54 "	" $7,811.29 "	" $6,340.93 "	" $7,351.80 "	" $2,205.54 "	" $8,270.78 "	" $7,471.27 "	" $7,811.29 "	" $2,187.16 "	" $7,471.27 "	" $2,205.54 "
503871	HCHG CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	52281	" $4,760.25 "	" $3,332.18 "	" $1,132.94 "	" $4,284.23 "	" $4,141.42 "	" $1,142.46 "	" $3,641.59 "	" $3,786.00 "	" $3,283.00 "	" $1,176.73 "	" $2,998.96 "	" $4,046.21 "	" $3,284.57 "	" $3,808.20 "	" $1,142.46 "	" $4,284.23 "	" $3,870.08 "	" $4,046.21 "	" $1,132.94 "	" $3,870.08 "	" $1,142.46 "
503872	HCHG OPEN TX FX GREAT TOE/PHALANX/PHALANGES	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28505	" $6,259.50 "	" $4,381.65 "	" $1,489.76 "	" $5,633.55 "	" $5,445.77 "	" $1,502.28 "	" $4,788.52 "	" $3,786.00 "	" $3,283.00 "	" $1,502.28 "	" $3,943.49 "	" $5,320.58 "	" $4,319.06 "	" $5,007.60 "	" $1,502.28 "	" $5,633.55 "	" $5,088.97 "	" $5,320.58 "	" $1,489.76 "	" $5,088.97 "	" $1,502.28 "
503873	HCHG PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28122	" $4,905.00 "	" $3,433.50 "	" $1,167.39 "	" $4,414.50 "	" $4,267.35 "	" $1,177.20 "	" $3,752.33 "	" $3,786.00 "	" $3,283.00 "	" $1,177.20 "	" $3,090.15 "	" $4,169.25 "	" $3,384.45 "	" $3,924.00 "	" $1,177.20 "	" $4,414.50 "	" $3,987.77 "	" $4,169.25 "	" $1,167.39 "	" $3,987.77 "	" $1,177.20 "
503874	HCHG EXC TMR SFT TISS SHOULDER SUBFASC <5CM	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23076	" $5,424.00 "	" $3,796.80 "	" $1,290.91 "	" $4,881.60 "	" $4,718.88 "	" $1,301.76 "	" $4,149.36 "	" $3,786.00 "	" $3,283.00 "	" $1,340.81 "	" $3,417.12 "	" $4,610.40 "	" $3,742.56 "	" $4,339.20 "	" $1,301.76 "	" $4,881.60 "	" $4,409.71 "	" $4,610.40 "	" $1,290.91 "	" $4,409.71 "	" $1,301.76 "
503875	HCHG BONE GRAFT ANY DONOR AREA MAJOR/LARGE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	20902	" $6,053.25 "	" $4,237.28 "	" $1,440.67 "	" $5,447.93 "	" $5,266.33 "	" $1,452.78 "	" $4,630.74 "	" $3,786.00 "	" $3,283.00 "	" $1,496.36 "	" $3,813.55 "	" $5,145.26 "	" $4,176.74 "	" $4,842.60 "	" $1,452.78 "	" $5,447.93 "	" $4,921.29 "	" $5,145.26 "	" $1,440.67 "	" $4,921.29 "	" $1,452.78 "
503876	HCHG ARTH GLNHMRL JT W/JT EXPL W/WO RMVL LOOSE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	23107	" $6,807.75 "	" $4,765.43 "	" $1,620.24 "	" $6,126.98 "	" $5,922.74 "	" $1,633.86 "	" $5,207.93 "	" $3,786.00 "	" $3,283.00 "	" $1,682.88 "	" $4,288.88 "	" $5,786.59 "	" $4,697.35 "	" $5,446.20 "	" $1,633.86 "	" $6,126.98 "	" $5,534.70 "	" $5,786.59 "	" $1,620.24 "	" $5,534.70 "	" $1,633.86 "
503877	HCHG PRQ SKEL FIXJ METAR FX W/MANJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	28476	" $6,229.50 "	" $4,360.65 "	" $1,482.62 "	" $5,606.55 "	" $5,419.67 "	" $1,495.08 "	" $4,765.57 "	" $3,786.00 "	" $3,283.00 "	" $1,495.08 "	" $3,924.59 "	" $5,295.08 "	" $4,298.36 "	" $4,983.60 "	" $1,495.08 "	" $5,606.55 "	" $5,064.58 "	" $5,295.08 "	" $1,482.62 "	" $5,064.58 "	" $1,495.08 "
503878	HCHG PRQ SKEL FIXJ FEMORAL FX PROX END NECK	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27235	" $9,402.75 "	" $6,581.93 "	" $2,237.85 "	" $8,462.48 "	" $8,180.39 "	" $2,256.66 "	" $7,193.10 "	" $3,786.00 "	" $3,283.00 "	" $2,256.66 "	" $5,923.73 "	" $7,992.34 "	" $6,487.90 "	" $7,522.20 "	" $2,256.66 "	" $8,462.48 "	" $7,644.44 "	" $7,992.34 "	" $2,237.85 "	" $7,644.44 "	" $2,256.66 "
503879	HCHG RCNSTJ DISLC PATELLA W/PATELLECTOMY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27424	" $14,328.00 "	" $10,029.60 "	" $3,283.00 "	" $12,895.20 "	" $12,465.36 "	" $3,438.72 "	" $10,960.92 "	" $3,786.00 "	" $3,283.00 "	" $3,438.72 "	" $9,026.64 "	" $12,178.80 "	" $9,886.32 "	" $11,462.40 "	" $3,438.72 "	" $12,895.20 "	" $11,648.66 "	" $12,178.80 "	" $3,410.06 "	" $11,648.66 "	" $3,438.72 "
503880	HCHG CLOSED TX PATELLAR FRACTURE W/O MANIP	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27520	 $566.25 	 $396.38 	 $134.77 	 $509.63 	 $492.64 	 $135.90 	 $433.18 	 $475.65 	 $475.65 	 $139.98 	 $356.74 	 $481.31 	 $390.71 	 $453.00 	 $135.90 	 $509.63 	 $460.36 	 $481.31 	 $134.77 	 $460.36 	 $135.90 
503881	HCHG OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27524	" $10,743.00 "	" $7,520.10 "	" $2,556.83 "	" $9,668.70 "	" $9,346.41 "	" $2,578.32 "	" $8,218.40 "	" $3,786.00 "	" $3,283.00 "	" $2,578.32 "	" $6,768.09 "	" $9,131.55 "	" $7,412.67 "	" $8,594.40 "	" $2,578.32 "	" $9,668.70 "	" $8,734.06 "	" $9,131.55 "	" $2,556.83 "	" $8,734.06 "	" $2,578.32 "
503882	HCHG CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	21320	" $3,724.50 "	" $2,607.15 "	 $886.43 	" $3,352.05 "	" $3,240.32 "	 $893.88 	" $2,849.24 "	" $3,128.58 "	" $3,128.58 "	 $920.70 	" $2,346.44 "	" $3,165.83 "	" $2,569.91 "	" $2,979.60 "	 $893.88 	" $3,352.05 "	" $3,028.02 "	" $3,165.83 "	 $886.43 	" $3,028.02 "	 $893.88 
503883	HCHG TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	24358	" $5,587.50 "	" $3,911.25 "	" $1,329.83 "	" $5,028.75 "	" $4,861.13 "	" $1,341.00 "	" $4,274.44 "	" $3,786.00 "	" $3,283.00 "	" $1,341.00 "	" $3,520.13 "	" $4,749.38 "	" $3,855.38 "	" $4,470.00 "	" $1,341.00 "	" $5,028.75 "	" $4,542.64 "	" $4,749.38 "	" $1,329.83 "	" $4,542.64 "	" $1,341.00 "
503884	HCHG RPR NONUNION/MALUNIRDS/ULNA W/O ATGRFT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	25400	" $10,222.50 "	" $7,155.75 "	" $2,432.96 "	" $9,200.25 "	" $8,893.58 "	" $2,453.40 "	" $7,820.21 "	" $3,786.00 "	" $3,283.00 "	" $2,453.40 "	" $6,440.18 "	" $8,689.13 "	" $7,053.53 "	" $8,178.00 "	" $2,453.40 "	" $9,200.25 "	" $8,310.89 "	" $8,689.13 "	" $2,432.96 "	" $8,310.89 "	" $2,453.40 "
503885	HCHG FASCIOTOMY HIP/THIGH ANY TYPE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27025	" $5,405.20 "	" $3,783.64 "	" $1,286.44 "	" $4,864.68 "	" $4,702.52 "	" $1,297.25 "	" $4,134.98 "	" $3,786.00 "	" $3,283.00 "	" $1,336.17 "	" $3,405.28 "	" $4,594.42 "	" $3,729.59 "	" $4,324.16 "	" $1,297.25 "	" $4,864.68 "	" $4,394.43 "	" $4,594.42 "	" $1,286.44 "	" $4,394.43 "	" $1,297.25 "
503886	HCHG DCMP FASCT LG ANT&/LAT CMPRTMNTS ONLY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27600	" $5,565.00 "	" $3,895.50 "	" $1,324.47 "	" $5,008.50 "	" $4,841.55 "	" $1,335.60 "	" $4,257.23 "	" $3,786.00 "	" $3,283.00 "	" $1,375.67 "	" $3,505.95 "	" $4,730.25 "	" $3,839.85 "	" $4,452.00 "	" $1,335.60 "	" $5,008.50 "	" $4,524.35 "	" $4,730.25 "	" $1,324.47 "	" $4,524.35 "	" $1,335.60 "
503887	HCHG COLCT TOT ABDL W/O PRC W/ILEOST/ILEOPXTS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44150	" $2,184.00 "	" $1,528.80 "	 $519.79 	" $1,965.60 "	" $1,900.08 "	 $524.16 	" $1,670.76 "	" $1,834.56 "	" $1,834.56 "	 $539.88 	" $1,375.92 "	" $1,856.40 "	" $1,506.96 "	" $1,747.20 "	 $524.16 	" $1,965.60 "	" $1,775.59 "	" $1,856.40 "	 $519.79 	" $1,775.59 "	 $524.16 
503888	HCHG EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	26075	" $9,070.50 "	" $6,349.35 "	" $2,158.78 "	" $8,163.45 "	" $7,891.34 "	" $2,176.92 "	" $6,938.93 "	" $3,786.00 "	" $3,283.00 "	" $2,242.23 "	" $5,714.42 "	" $7,709.93 "	" $6,258.65 "	" $7,256.40 "	" $2,176.92 "	" $8,163.45 "	" $7,374.32 "	" $7,709.93 "	" $2,158.78 "	" $7,374.32 "	" $2,176.92 "
503989	HCHG HERNIA REPAIR VENTRAL ANY APPROACH <3CM REDUCIBLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49591	" $2,656.45 "	" $1,859.52 "	 $632.24 	" $2,390.81 "	" $2,311.11 "	 $637.55 	" $2,032.18 "	" $2,231.42 "	" $2,231.42 "	 $656.67 	" $1,673.56 "	" $2,257.98 "	" $1,832.95 "	" $2,125.16 "	 $637.55 	" $2,390.81 "	" $2,159.69 "	" $2,257.98 "	 $632.24 	" $2,159.69 "	 $637.55 
503990	HCHG HERNIA REPAIR VENTRAL ANY APPROACH <3CM STRANGULATED	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49592	" $3,909.11 "	" $2,736.38 "	 $930.37 	" $3,518.20 "	" $3,400.93 "	 $938.19 	" $2,990.47 "	" $3,283.65 "	" $3,283.00 "	 $966.33 	" $2,462.74 "	" $3,322.74 "	" $2,697.29 "	" $3,127.29 "	 $938.19 	" $3,518.20 "	" $3,178.11 "	" $3,322.74 "	 $930.37 	" $3,178.11 "	 $938.19 
503991	HCHG HERNIA REPAIR VENTRAL ANY APPROACH 3-10 CM REDUCIBLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49593	" $2,656.45 "	" $1,859.52 "	 $632.24 	" $2,390.81 "	" $2,311.11 "	 $637.55 	" $2,032.18 "	" $2,231.42 "	" $2,231.42 "	 $656.67 	" $1,673.56 "	" $2,257.98 "	" $1,832.95 "	" $2,125.16 "	 $637.55 	" $2,390.81 "	" $2,159.69 "	" $2,257.98 "	 $632.24 	" $2,159.69 "	 $637.55 
503992	HCHG HERNIA REPAIR VENTRAL ANY APPROACH >10 CM REDUCIBLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49595	" $2,656.45 "	" $1,859.52 "	 $632.24 	" $2,390.81 "	" $2,311.11 "	 $637.55 	" $2,032.18 "	" $2,231.42 "	" $2,231.42 "	 $656.67 	" $1,673.56 "	" $2,257.98 "	" $1,832.95 "	" $2,125.16 "	 $637.55 	" $2,390.81 "	" $2,159.69 "	" $2,257.98 "	 $632.24 	" $2,159.69 "	 $637.55 
503993	HCHG HERNIA REPAIR VENTRAL ANY APPROACH < 3CM REDUCIBLE RECURRENT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49613	" $2,656.45 "	" $1,859.52 "	 $632.24 	" $2,390.81 "	" $2,311.11 "	 $637.55 	" $2,032.18 "	" $2,231.42 "	" $2,231.42 "	 $656.67 	" $1,673.56 "	" $2,257.98 "	" $1,832.95 "	" $2,125.16 "	 $637.55 	" $2,390.81 "	" $2,159.69 "	" $2,257.98 "	 $632.24 	" $2,159.69 "	 $637.55 
503994	HCHG HERNIA REPAIR VENTRAL ANY APPROACH < 3CM STRANGULATED RECURRENT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49614	" $3,909.11 "	" $2,736.38 "	 $930.37 	" $3,518.20 "	" $3,400.93 "	 $938.19 	" $2,990.47 "	" $3,283.65 "	" $3,283.00 "	 $966.33 	" $2,462.74 "	" $3,322.74 "	" $2,697.29 "	" $3,127.29 "	 $938.19 	" $3,518.20 "	" $3,178.11 "	" $3,322.74 "	 $930.37 	" $3,178.11 "	 $938.19 
503995	HCHG HERNIA REPAIR VENTRAL ANY APPROACH 3-10 CM STRANGULATED RECURRENT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49616	" $3,909.11 "	" $2,736.38 "	 $930.37 	" $3,518.20 "	" $3,400.93 "	 $938.19 	" $2,990.47 "	" $3,283.65 "	" $3,283.00 "	 $966.33 	" $2,462.74 "	" $3,322.74 "	" $2,697.29 "	" $3,127.29 "	 $938.19 	" $3,518.20 "	" $3,178.11 "	" $3,322.74 "	 $930.37 	" $3,178.11 "	 $938.19 
503996	HCHG HERNIA REPAIR VENTRAL ANY APPROACH >10 CM STRANGULATED RECURRENT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49618	" $3,909.11 "	" $2,736.38 "	 $930.37 	" $3,518.20 "	" $3,400.93 "	 $938.19 	" $2,990.47 "	" $3,283.65 "	" $3,283.00 "	 $966.33 	" $2,462.74 "	" $3,322.74 "	" $2,697.29 "	" $3,127.29 "	 $938.19 	" $3,518.20 "	" $3,178.11 "	" $3,322.74 "	 $930.37 	" $3,178.11 "	 $938.19 
503998	HCHG ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	27331	" $7,155.75 "	" $5,009.03 "	" $1,703.07 "	" $6,440.18 "	" $6,225.50 "	" $1,717.38 "	" $5,474.15 "	" $3,786.00 "	" $3,283.00 "	" $1,768.90 "	" $4,508.12 "	" $6,082.39 "	" $4,937.47 "	" $5,724.60 "	" $1,717.38 "	" $6,440.18 "	" $5,817.62 "	" $6,082.39 "	" $1,703.07 "	" $5,817.62 "	" $1,717.38 "
5060034	HCHG BMH/CVMC CARDIOVERSION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	92960	" $1,802.82 "	" $1,261.97 "	 $429.07 	" $1,622.54 "	" $1,568.45 "	 $432.68 	" $1,379.16 "	" $1,514.37 "	" $1,514.37 "	 $445.66 	" $1,135.78 "	" $1,532.40 "	" $1,243.95 "	" $1,442.26 "	 $432.68 	" $1,622.54 "	" $1,465.69 "	" $1,532.40 "	 $429.07 	" $1,465.69 "	 $432.68 
5200001	HCHG MAJOR SURGERY-LAPAROSCOPIC 1ST HOUR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $8,200.00 "	" $5,740.00 "	" $1,951.60 "	" $7,380.00 "	" $7,134.00 "	" $1,968.00 "	" $6,273.00 "	" $3,786.00 "	" $3,283.00 "	" $1,968.00 "	" $5,166.00 "	" $6,970.00 "	" $5,658.00 "	" $6,560.00 "	" $1,968.00 "	" $7,380.00 "	" $6,666.60 "	" $6,970.00 "	" $1,951.60 "	" $6,666.60 "	" $1,968.00 "
5200002	HCHG BMH/CVMC MINOR SURGERY-LAPAROSCOPIC 1ST HOUR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $6,200.00 "	" $4,340.00 "	" $1,475.60 "	" $5,580.00 "	" $5,394.00 "	" $1,488.00 "	" $4,743.00 "	" $3,786.00 "	" $3,283.00 "	" $1,532.64 "	" $3,906.00 "	" $5,270.00 "	" $4,278.00 "	" $4,960.00 "	" $1,488.00 "	" $5,580.00 "	" $5,040.60 "	" $5,270.00 "	" $1,475.60 "	" $5,040.60 "	" $1,488.00 "
5200004	HCHG BMH/CVMC MINOR SURGERY/ORTHO/ARTHRO  1ST HOUR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $6,200.00 "	" $4,340.00 "	" $1,475.60 "	" $5,580.00 "	" $5,394.00 "	" $1,488.00 "	" $4,743.00 "	" $3,786.00 "	" $3,283.00 "	" $1,532.64 "	" $3,906.00 "	" $5,270.00 "	" $4,278.00 "	" $4,960.00 "	" $1,488.00 "	" $5,580.00 "	" $5,040.60 "	" $5,270.00 "	" $1,475.60 "	" $5,040.60 "	" $1,488.00 "
5200007	HCHG CVMC MAJOR SURGERY-GENERAL  1ST HOUR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $6,700.00 "	" $4,690.00 "	" $1,594.60 "	" $6,030.00 "	" $5,829.00 "	" $1,608.00 "	" $5,125.50 "	" $3,786.00 "	" $3,283.00 "	" $1,656.24 "	" $4,221.00 "	" $5,695.00 "	" $4,623.00 "	" $5,360.00 "	" $1,608.00 "	" $6,030.00 "	" $5,447.10 "	" $5,695.00 "	" $1,594.60 "	" $5,447.10 "	" $1,608.00 "
5200008	HCHG BMH/CVMC MINOR SURGERY-GENERAL  1ST HOUR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $4,000.00 "	" $2,800.00 "	 $952.00 	" $3,600.00 "	" $3,480.00 "	 $960.00 	" $3,060.00 "	" $3,360.00 "	" $3,283.00 "	 $988.80 	" $2,520.00 "	" $3,400.00 "	" $2,760.00 "	" $3,200.00 "	 $960.00 	" $3,600.00 "	" $3,252.00 "	" $3,400.00 "	 $952.00 	" $3,252.00 "	 $960.00 
5200017	HCHG CVMC CASE CANCLLED/OUT PATIENT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		 $748.10 	 $523.67 	 $178.05 	 $673.29 	 $650.85 	 $179.54 	 $572.30 	 $628.40 	 $628.40 	 $184.93 	 $471.30 	 $635.89 	 $516.19 	 $598.48 	 $179.54 	 $673.29 	 $608.21 	 $635.89 	 $178.05 	 $608.21 	 $179.54 
5200145	HCHG CVMC LUMBAR/CERVICAL INJ-1ST PROCEDURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $1,500.00 "	" $1,050.00 "	 $357.00 	" $1,350.00 "	" $1,305.00 "	 $360.00 	" $1,147.50 "	" $1,260.00 "	" $1,260.00 "	 $370.80 	 $945.00 	" $1,275.00 "	" $1,035.00 "	" $1,200.00 "	 $360.00 	" $1,350.00 "	" $1,219.50 "	" $1,275.00 "	 $357.00 	" $1,219.50 "	 $360.00 
5200146	HCHG CVMC LUMBAR/CERVICAL INJ-EACH ADDL INJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $1,500.00 "	" $1,050.00 "	 $357.00 	" $1,350.00 "	" $1,305.00 "	 $360.00 	" $1,147.50 "	" $1,260.00 "	" $1,260.00 "	 $370.80 	 $945.00 	" $1,275.00 "	" $1,035.00 "	" $1,200.00 "	 $360.00 	" $1,350.00 "	" $1,219.50 "	" $1,275.00 "	 $357.00 	" $1,219.50 "	 $360.00 
5200149	"HCHG CVMC RADIO FREQUENCY NERVE ABLATION, 1ST"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $3,082.39 "	" $2,157.67 "	 $733.61 	" $2,774.15 "	" $2,681.68 "	 $739.77 	" $2,358.03 "	" $2,589.21 "	" $2,589.21 "	 $761.97 	" $1,941.91 "	" $2,620.03 "	" $2,126.85 "	" $2,465.91 "	 $739.77 	" $2,774.15 "	" $2,505.98 "	" $2,620.03 "	 $733.61 	" $2,505.98 "	 $739.77 
5200150	"HCHG CVMC RADIO FREQUENCY NERVE ABLATION, ADDITIONAL"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $1,540.49 "	" $1,078.34 "	 $366.64 	" $1,386.44 "	" $1,340.23 "	 $369.72 	" $1,178.47 "	" $1,294.01 "	" $1,294.01 "	 $380.81 	 $970.51 	" $1,309.42 "	" $1,062.94 "	" $1,232.39 "	 $369.72 	" $1,386.44 "	" $1,252.42 "	" $1,309.42 "	 $366.64 	" $1,252.42 "	 $369.72 
5200151	HCHG CVMC RHINOPLASTY-2ND PROCEDURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200151	" $1,006.83 "	 $704.78 	 $239.63 	 $906.15 	 $875.94 	 $241.64 	 $770.22 	 $845.74 	 $845.74 	 $248.89 	 $634.30 	 $855.81 	 $694.71 	 $805.46 	 $241.64 	 $906.15 	 $818.55 	 $855.81 	 $239.63 	 $818.55 	 $241.64 
5200152	HCHG CVMC RHINOPLASTY-OR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200152	" $2,101.22 "	" $1,470.85 "	 $500.09 	" $1,891.10 "	" $1,828.06 "	 $504.29 	" $1,607.43 "	" $1,765.02 "	" $1,765.02 "	 $519.42 	" $1,323.77 "	" $1,786.04 "	" $1,449.84 "	" $1,680.98 "	 $504.29 	" $1,891.10 "	" $1,708.29 "	" $1,786.04 "	 $500.09 	" $1,708.29 "	 $504.29 
5200153	HCHG CVMC RHINOPLASTY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200153	 $963.06 	 $674.14 	 $229.21 	 $866.75 	 $837.86 	 $231.13 	 $736.74 	 $808.97 	 $808.97 	 $238.07 	 $606.73 	 $818.60 	 $664.51 	 $770.45 	 $231.13 	 $866.75 	 $782.97 	 $818.60 	 $229.21 	 $782.97 	 $231.13 
5200154	"HCHG CVMC FACELIFT:EYES, CORNOAL LIFT W/ENDO-2ND PROCEDURE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200154	" $1,006.83 "	 $704.78 	 $239.63 	 $906.15 	 $875.94 	 $241.64 	 $770.22 	 $845.74 	 $845.74 	 $248.89 	 $634.30 	 $855.81 	 $694.71 	 $805.46 	 $241.64 	 $906.15 	 $818.55 	 $855.81 	 $239.63 	 $818.55 	 $241.64 
5200155	HCHG CVMC FACELIFT:EYES/CORNAL W/ENDO-OR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200155	" $2,801.62 "	" $1,961.13 "	 $666.79 	" $2,521.46 "	" $2,437.41 "	 $672.39 	" $2,143.24 "	" $2,353.36 "	" $2,353.36 "	 $692.56 	" $1,765.02 "	" $2,381.38 "	" $1,933.12 "	" $2,241.30 "	 $672.39 	" $2,521.46 "	" $2,277.72 "	" $2,381.38 "	 $666.79 	" $2,277.72 "	 $672.39 
5200156	HCHG CVMC FACELIFT:EYES CORONAL LIFT W/ENDO	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200156	" $1,532.14 "	" $1,072.50 "	 $364.65 	" $1,378.93 "	" $1,332.96 "	 $367.71 	" $1,172.09 "	" $1,287.00 "	" $1,287.00 "	 $378.75 	 $965.25 	" $1,302.32 "	" $1,057.18 "	" $1,225.71 "	 $367.71 	" $1,378.93 "	" $1,245.63 "	" $1,302.32 "	 $364.65 	" $1,245.63 "	 $367.71 
5200157	HCHG CVMC FACELIFT:NECK/MIDFACE-2ND PROC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200157	" $1,006.83 "	 $704.78 	 $239.63 	 $906.15 	 $875.94 	 $241.64 	 $770.22 	 $845.74 	 $845.74 	 $248.89 	 $634.30 	 $855.81 	 $694.71 	 $805.46 	 $241.64 	 $906.15 	 $818.55 	 $855.81 	 $239.63 	 $818.55 	 $241.64 
5200158	HCHG CVMC FACELIFT:NECK/MIDFACE-OR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200158	" $2,626.51 "	" $1,838.56 "	 $625.11 	" $2,363.86 "	" $2,285.06 "	 $630.36 	" $2,009.28 "	" $2,206.27 "	" $2,206.27 "	 $649.27 	" $1,654.70 "	" $2,232.53 "	" $1,812.29 "	" $2,101.21 "	 $630.36 	" $2,363.86 "	" $2,135.35 "	" $2,232.53 "	 $625.11 	" $2,135.35 "	 $630.36 
5200159	HCHG CVMC FACELIFT:NECK/MIDFACE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200159	" $1,313.27 "	 $919.29 	 $312.56 	" $1,181.94 "	" $1,142.54 "	 $315.18 	" $1,004.65 "	" $1,103.15 "	" $1,103.15 "	 $324.64 	 $827.36 	" $1,116.28 "	 $906.16 	" $1,050.62 "	 $315.18 	" $1,181.94 "	" $1,067.69 "	" $1,116.28 "	 $312.56 	" $1,067.69 "	 $315.18 
5200160	HCHG CVMC BLEPHAROPLASTY/BILATERAL-2ND PROCEDURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200160	" $1,006.83 "	 $704.78 	 $239.63 	 $906.15 	 $875.94 	 $241.64 	 $770.22 	 $845.74 	 $845.74 	 $248.89 	 $634.30 	 $855.81 	 $694.71 	 $805.46 	 $241.64 	 $906.15 	 $818.55 	 $855.81 	 $239.63 	 $818.55 	 $241.64 
5200161	HCHG CVMC BLEPHAROPLASTY/BILETRAL-OR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200161	" $1,488.36 "	" $1,041.85 "	 $354.23 	" $1,339.52 "	" $1,294.87 "	 $357.21 	" $1,138.60 "	" $1,250.22 "	" $1,250.22 "	 $367.92 	 $937.67 	" $1,265.11 "	" $1,026.97 "	" $1,190.69 "	 $357.21 	" $1,339.52 "	" $1,210.04 "	" $1,265.11 "	 $354.23 	" $1,210.04 "	 $357.21 
5200162	HCHG CVMC BLEPHAROPLASTY/BILATERAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200162	 $875.50 	 $612.85 	 $208.37 	 $787.95 	 $761.69 	 $210.12 	 $669.76 	 $735.42 	 $735.42 	 $216.42 	 $551.57 	 $744.18 	 $604.10 	 $700.40 	 $210.12 	 $787.95 	 $711.78 	 $744.18 	 $208.37 	 $711.78 	 $210.12 
5200163	HCHG CVMC BLEPHAROPLASTY-QUAD 2ND PROC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200163	" $1,006.83 "	 $704.78 	 $239.63 	 $906.15 	 $875.94 	 $241.64 	 $770.22 	 $845.74 	 $845.74 	 $248.89 	 $634.30 	 $855.81 	 $694.71 	 $805.46 	 $241.64 	 $906.15 	 $818.55 	 $855.81 	 $239.63 	 $818.55 	 $241.64 
5200164	HCHG CVMC BLEPHAROPLASTY/QUAD-OR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200164	" $1,838.56 "	" $1,286.99 "	 $437.58 	" $1,654.70 "	" $1,599.55 "	 $441.25 	" $1,406.50 "	" $1,544.39 "	" $1,544.39 "	 $454.49 	" $1,158.29 "	" $1,562.78 "	" $1,268.61 "	" $1,470.85 "	 $441.25 	" $1,654.70 "	" $1,494.75 "	" $1,562.78 "	 $437.58 	" $1,494.75 "	 $441.25 
5200165	HCHG CVMC BLEPHAROPLASTY-QUAD	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200165	 $875.50 	 $612.85 	 $208.37 	 $787.95 	 $761.69 	 $210.12 	 $669.76 	 $735.42 	 $735.42 	 $216.42 	 $551.57 	 $744.18 	 $604.10 	 $700.40 	 $210.12 	 $787.95 	 $711.78 	 $744.18 	 $208.37 	 $711.78 	 $210.12 
5200166	HCHG CVMC LIPSUCTION 2ND PROCEDURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200166	" $1,006.83 "	 $704.78 	 $239.63 	 $906.15 	 $875.94 	 $241.64 	 $770.22 	 $845.74 	 $845.74 	 $248.89 	 $634.30 	 $855.81 	 $694.71 	 $805.46 	 $241.64 	 $906.15 	 $818.55 	 $855.81 	 $239.63 	 $818.55 	 $241.64 
5200167	HCHG CVMC LIPOSUCTION-OR	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200167	" $1,488.36 "	" $1,041.85 "	 $354.23 	" $1,339.52 "	" $1,294.87 "	 $357.21 	" $1,138.60 "	" $1,250.22 "	" $1,250.22 "	 $367.92 	 $937.67 	" $1,265.11 "	" $1,026.97 "	" $1,190.69 "	 $357.21 	" $1,339.52 "	" $1,210.04 "	" $1,265.11 "	 $354.23 	" $1,210.04 "	 $357.21 
5200168	HCHG CVMC LIPOSUCTION-2ND WI	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	5200168	 $875.50 	 $612.85 	 $208.37 	 $787.95 	 $761.69 	 $210.12 	 $669.76 	 $735.42 	 $735.42 	 $216.42 	 $551.57 	 $744.18 	 $604.10 	 $700.40 	 $210.12 	 $787.95 	 $711.78 	 $744.18 	 $208.37 	 $711.78 	 $210.12 
5200190	"HCHG CVMC BRONCHOSCOPE/WASH/DX, INCLUDING FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31622	" $1,869.44 "	" $1,308.61 "	 $444.93 	" $1,682.50 "	" $1,626.41 "	 $448.67 	" $1,430.12 "	" $1,570.33 "	" $1,570.33 "	 $462.13 	" $1,177.75 "	" $1,589.02 "	" $1,289.91 "	" $1,495.55 "	 $448.67 	" $1,682.50 "	" $1,519.85 "	" $1,589.02 "	 $444.93 	" $1,519.85 "	 $448.67 
5200191	HCHG CVMC BRONCHOSCOPE/BRUSH/DX.INCLUDING FLUOROSCOPIC GUIDANCE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31623	" $1,781.47 "	" $1,247.03 "	 $423.99 	" $1,603.32 "	" $1,549.88 "	 $427.55 	" $1,362.82 "	" $1,496.43 "	" $1,496.43 "	 $440.38 	" $1,122.33 "	" $1,514.25 "	" $1,229.21 "	" $1,425.18 "	 $427.55 	" $1,603.32 "	" $1,448.34 "	" $1,514.25 "	 $423.99 	" $1,448.34 "	 $427.55 
5200192	"HCHG CVMC BRONCHOSCOPE/ALVEOLAR LAVAGE, INC FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31624	" $4,383.74 "	" $3,068.62 "	" $1,043.33 "	" $3,945.37 "	" $3,813.85 "	" $1,052.10 "	" $3,353.56 "	" $3,682.34 "	" $3,283.00 "	" $1,083.66 "	" $2,761.76 "	" $3,726.18 "	" $3,024.78 "	" $3,506.99 "	" $1,052.10 "	" $3,945.37 "	" $3,563.98 "	" $3,726.18 "	" $1,043.33 "	" $3,563.98 "	" $1,052.10 "
5200193	"HCHG CVMC BRONCHOSCOPY W/BIOPSY, INCLUDING FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31625	" $1,664.10 "	" $1,164.87 "	 $396.06 	" $1,497.69 "	" $1,447.77 "	 $399.38 	" $1,273.04 "	" $1,397.84 "	" $1,397.84 "	 $411.37 	" $1,048.38 "	" $1,414.49 "	" $1,148.23 "	" $1,331.28 "	 $399.38 	" $1,497.69 "	" $1,352.91 "	" $1,414.49 "	 $396.06 	" $1,352.91 "	 $399.38 
5200194	"HCHG CVMC BRONCHOSCOPY/LUNG BX ADD'L, W/WO  FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31632	 $775.70 	 $542.99 	 $184.62 	 $698.13 	 $674.86 	 $186.17 	 $593.41 	 $651.59 	 $651.59 	 $191.75 	 $488.69 	 $659.35 	 $535.23 	 $620.56 	 $186.17 	 $698.13 	 $630.64 	 $659.35 	 $184.62 	 $630.64 	 $186.17 
5200195	"HCHG CVMC BRONCHOSCOPY CLEAR AIRWAYS, INC FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31645	" $1,517.17 "	" $1,062.02 "	 $361.09 	" $1,365.45 "	" $1,319.94 "	 $364.12 	" $1,160.64 "	" $1,274.42 "	" $1,274.42 "	 $375.04 	 $955.82 	" $1,289.59 "	" $1,046.85 "	" $1,213.74 "	 $364.12 	" $1,365.45 "	" $1,233.46 "	" $1,289.59 "	 $361.09 	" $1,233.46 "	 $364.12 
5200196	"HCHG CVMC BRONCHOSCOPY, RECLEAR AIRWAY,INC FLUOROSCOPIC GUIDANCE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	31646	" $1,676.34 "	" $1,173.44 "	 $398.97 	" $1,508.71 "	" $1,458.42 "	 $402.32 	" $1,282.40 "	" $1,408.13 "	" $1,408.13 "	 $414.39 	" $1,056.09 "	" $1,424.89 "	" $1,156.67 "	" $1,341.07 "	 $402.32 	" $1,508.71 "	" $1,362.86 "	" $1,424.89 "	 $398.97 	" $1,362.86 "	 $402.32 
5200197	HCHG CVMC PLACE GASTROSTOMY TUBE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43246	" $4,197.16 "	" $2,938.01 "	 $998.92 	" $3,777.44 "	" $3,651.53 "	" $1,007.32 "	" $3,210.83 "	" $3,525.61 "	" $3,283.00 "	" $1,037.54 "	" $2,644.21 "	" $3,567.59 "	" $2,896.04 "	" $3,357.73 "	" $1,007.32 "	" $3,777.44 "	" $3,412.29 "	" $3,567.59 "	 $998.92 	" $3,412.29 "	" $1,007.32 "
5200199	HCHG CVMC PERCUTANEOUS LYSIS OF EPIDURAL ADHESIONS/SOLUTION INJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	62263	" $2,714.80 "	" $1,900.36 "	 $646.12 	" $2,443.32 "	" $2,361.88 "	 $651.55 	" $2,076.82 "	" $2,280.43 "	" $2,280.43 "	 $671.10 	" $1,710.32 "	" $2,307.58 "	" $1,873.21 "	" $2,171.84 "	 $651.55 	" $2,443.32 "	" $2,207.13 "	" $2,307.58 "	 $646.12 	" $2,207.13 "	 $651.55 
5260002	HCHG CVMC SURG ORTHO 1/4H FRAC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		" $1,246.88 "	 $872.82 	 $296.76 	" $1,122.19 "	" $1,084.79 "	 $299.25 	 $953.86 	" $1,047.38 "	" $1,047.38 "	 $308.23 	 $785.53 	" $1,059.85 "	 $860.35 	 $997.50 	 $299.25 	" $1,122.19 "	" $1,013.71 "	" $1,059.85 "	 $296.76 	" $1,013.71 "	 $299.25 
5400095	"HCHG CVMC ESOPHAGOSCOPY,RIGID OR FLEXIBLE,WITH INJ OF SCLEROSIS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43204	" $2,287.84 "	" $1,601.49 "	 $544.51 	" $2,059.06 "	" $1,990.42 "	 $549.08 	" $1,750.20 "	" $1,921.79 "	" $1,921.79 "	 $565.55 	" $1,441.34 "	" $1,944.66 "	" $1,578.61 "	" $1,830.27 "	 $549.08 	" $2,059.06 "	" $1,860.01 "	" $1,944.66 "	 $544.51 	" $1,860.01 "	 $549.08 
5400096	"HCHG CVMC 2-ESOPHAGOSCOPY,RIGID OR FLEXIBLE,WITH INJ OF SCLEROSIS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43204	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400097	"HCHG CVMC ESOPHAGOSCOPY,RIGID OR FLEXIBLE,WITH BAND LIGATION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43205	" $2,529.54 "	" $1,770.68 "	 $602.03 	" $2,276.59 "	" $2,200.70 "	 $607.09 	" $1,935.10 "	" $2,124.81 "	" $2,124.81 "	 $625.30 	" $1,593.61 "	" $2,150.11 "	" $1,745.38 "	" $2,023.63 "	 $607.09 	" $2,276.59 "	" $2,056.52 "	" $2,150.11 "	 $602.03 	" $2,056.52 "	 $607.09 
5400098	"HCHG CVMC 2-ESOPHAGOSCOPY,RIGID OR FLEXIBLE,WITH BAND LIGATION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43205	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400099	"HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY INC ESOPHAGUS,STOMACH"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43235	" $2,270.25 "	" $1,589.18 "	 $540.32 	" $2,043.23 "	" $1,975.12 "	 $544.86 	" $1,736.74 "	" $1,907.01 "	" $1,907.01 "	 $561.21 	" $1,430.26 "	" $1,929.71 "	" $1,566.47 "	" $1,816.20 "	 $544.86 	" $2,043.23 "	" $1,845.71 "	" $1,929.71 "	 $540.32 	" $1,845.71 "	 $544.86 
5400100	"HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY INC ESOPHAGUS,STOMACH"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43235	" $2,270.25 "	" $1,589.18 "	 $540.32 	" $2,043.23 "	" $1,975.12 "	 $544.86 	" $1,736.74 "	" $1,907.01 "	" $1,907.01 "	 $561.21 	" $1,430.26 "	" $1,929.71 "	" $1,566.47 "	" $1,816.20 "	 $544.86 	" $2,043.23 "	" $1,845.71 "	" $1,929.71 "	 $540.32 	" $1,845.71 "	 $544.86 
5400101	HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY W/SUBMUCOSAL INJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43236	" $2,287.84 "	" $1,601.49 "	 $544.51 	" $2,059.06 "	" $1,990.42 "	 $549.08 	" $1,750.20 "	" $1,921.79 "	" $1,921.79 "	 $565.55 	" $1,441.34 "	" $1,944.66 "	" $1,578.61 "	" $1,830.27 "	 $549.08 	" $2,059.06 "	" $1,860.01 "	" $1,944.66 "	 $544.51 	" $1,860.01 "	 $549.08 
5400102	HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY WITH SUBMUCOSAL INJ	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43236	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400103	HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY WITH BIOPSY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43239	" $4,000.00 "	" $2,800.00 "	 $952.00 	" $3,600.00 "	" $3,480.00 "	 $960.00 	" $3,060.00 "	" $3,360.00 "	" $3,283.00 "	 $988.80 	" $2,520.00 "	" $3,400.00 "	" $2,760.00 "	" $3,200.00 "	 $960.00 	" $3,600.00 "	" $3,252.00 "	" $3,400.00 "	 $952.00 	" $3,252.00 "	 $960.00 
5400104	HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY WITH BIOPSY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43239	" $2,000.00 "	" $1,400.00 "	 $476.00 	" $1,800.00 "	" $1,740.00 "	 $480.00 	" $1,530.00 "	" $1,680.00 "	" $1,680.00 "	 $494.40 	" $1,260.00 "	" $1,700.00 "	" $1,380.00 "	" $1,600.00 "	 $480.00 	" $1,800.00 "	" $1,626.00 "	" $1,700.00 "	 $476.00 	" $1,626.00 "	 $480.00 
5400105	HCHG CVMC UPPER GI ENDOSCOPY W/TRANSENDOSCOPIC INTRALUMINAL TUBE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43241	" $2,292.34 "	" $1,604.64 "	 $545.58 	" $2,063.11 "	" $1,994.34 "	 $550.16 	" $1,753.64 "	" $1,925.57 "	" $1,925.57 "	 $566.67 	" $1,444.17 "	" $1,948.49 "	" $1,581.71 "	" $1,833.87 "	 $550.16 	" $2,063.11 "	" $1,863.67 "	" $1,948.49 "	 $545.58 	" $1,863.67 "	 $550.16 
5400106	HCHG CVMC 2-UPPER GI ENDOSCOPY W/TRANSENDOSCOPIC INTRALUMINAL TUBE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43241	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400107	HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY W/INJECTION SCLEROSIS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43243	" $2,585.27 "	" $1,809.69 "	 $615.29 	" $2,326.74 "	" $2,249.18 "	 $620.46 	" $1,977.73 "	" $2,171.63 "	" $2,171.63 "	 $639.08 	" $1,628.72 "	" $2,197.48 "	" $1,783.84 "	" $2,068.22 "	 $620.46 	" $2,326.74 "	" $2,101.82 "	" $2,197.48 "	 $615.29 	" $2,101.82 "	 $620.46 
5400108	HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY W/ INJECT SCLEROSIS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43243	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400109	HCHG EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43244	" $3,136.63 "	" $2,195.64 "	 $746.52 	" $2,822.97 "	" $2,728.87 "	 $752.79 	" $2,399.52 "	" $2,634.77 "	" $2,634.77 "	 $775.37 	" $1,976.08 "	" $2,666.14 "	" $2,164.27 "	" $2,509.30 "	 $752.79 	" $2,822.97 "	" $2,550.08 "	" $2,666.14 "	 $746.52 	" $2,550.08 "	 $752.79 
5400110	HCHG CVMC 2-UPPER GI ENDOSCOPY/LIGATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43244	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5400111	HCHG CVMC UPPER GI ENDOSCOPY W/PLACEMENT OF GASTROSTOMY TUBE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43246	" $4,197.16 "	" $2,938.01 "	 $998.92 	" $3,777.44 "	" $3,651.53 "	" $1,007.32 "	" $3,210.83 "	" $3,525.61 "	" $3,283.00 "	" $1,037.54 "	" $2,644.21 "	" $3,567.59 "	" $2,896.04 "	" $3,357.73 "	" $1,007.32 "	" $3,777.44 "	" $3,412.29 "	" $3,567.59 "	 $998.92 	" $3,412.29 "	" $1,007.32 "
5400112	HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY W FOREIGN BODY REMOVAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43247	" $2,770.00 "	" $1,939.00 "	 $659.26 	" $2,493.00 "	" $2,409.90 "	 $664.80 	" $2,119.05 "	" $2,326.80 "	" $2,326.80 "	 $684.74 	" $1,745.10 "	" $2,354.50 "	" $1,911.30 "	" $2,216.00 "	 $664.80 	" $2,493.00 "	" $2,252.01 "	" $2,354.50 "	 $659.26 	" $2,252.01 "	 $664.80 
5400113	HCHG CVMC 2-UPPR GASTROINTESTINAL ENDOSCOPY W FOREIGN BODY REMOVAL	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43247	" $2,770.00 "	" $1,939.00 "	 $659.26 	" $2,493.00 "	" $2,409.90 "	 $664.80 	" $2,119.05 "	" $2,326.80 "	" $2,326.80 "	 $684.74 	" $1,745.10 "	" $2,354.50 "	" $1,911.30 "	" $2,216.00 "	 $664.80 	" $2,493.00 "	" $2,252.01 "	" $2,354.50 "	 $659.26 	" $2,252.01 "	 $664.80 
5400114	HCHG CVMC UPPER GASTROINTESTIONAL ENDOSCOPY W/BALLOON DILATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43249	" $3,200.00 "	" $2,240.00 "	 $761.60 	" $2,880.00 "	" $2,784.00 "	 $768.00 	" $2,448.00 "	" $2,688.00 "	" $2,688.00 "	 $791.04 	" $2,016.00 "	" $2,720.00 "	" $2,208.00 "	" $2,560.00 "	 $768.00 	" $2,880.00 "	" $2,601.60 "	" $2,720.00 "	 $761.60 	" $2,601.60 "	 $768.00 
5400115	HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY W/BALLOON DILATION	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43249	" $1,600.00 "	" $1,120.00 "	 $380.80 	" $1,440.00 "	" $1,392.00 "	 $384.00 	" $1,224.00 "	" $1,344.00 "	" $1,344.00 "	 $395.52 	" $1,008.00 "	" $1,360.00 "	" $1,104.00 "	" $1,280.00 "	 $384.00 	" $1,440.00 "	" $1,300.80 "	" $1,360.00 "	 $380.80 	" $1,300.80 "	 $384.00 
5400116	HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY W/CONTROL OF BLEEDING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43255	" $4,768.27 "	" $3,337.79 "	" $1,134.85 "	" $4,291.44 "	" $4,148.39 "	" $1,144.38 "	" $3,647.73 "	" $3,786.00 "	" $3,283.00 "	" $1,178.72 "	" $3,004.01 "	" $4,053.03 "	" $3,290.11 "	" $3,814.62 "	" $1,144.38 "	" $4,291.44 "	" $3,876.60 "	" $4,053.03 "	" $1,134.85 "	" $3,876.60 "	" $1,144.38 "
5400117	HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY W/CONTROL OF BLEEDING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43255	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400119	HCHG CVM COLONOSCOPY THROUGH STOMA DIAGNOSTIC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44388	" $2,475.49 "	" $1,732.84 "	 $589.17 	" $2,227.94 "	" $2,153.68 "	 $594.12 	" $1,893.75 "	" $2,079.41 "	" $2,079.41 "	 $611.94 	" $1,559.56 "	" $2,104.17 "	" $1,708.09 "	" $1,980.39 "	 $594.12 	" $2,227.94 "	" $2,012.57 "	" $2,104.17 "	 $589.17 	" $2,012.57 "	 $594.12 
5400120	HCHG CVM 2-COLONOSCOPY THROUGH STOMA DIAGNOSTIC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44388	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5400121	"HCHG CVM COLONOSCOPY THROUGH STOMA WITH BIOPSY,SINGLE OR MULITPLE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44389	" $2,528.65 "	" $1,770.06 "	 $601.82 	" $2,275.79 "	" $2,199.93 "	 $606.88 	" $1,934.42 "	" $2,124.07 "	" $2,124.07 "	 $625.08 	" $1,593.05 "	" $2,149.35 "	" $1,744.77 "	" $2,022.92 "	 $606.88 	" $2,275.79 "	" $2,055.79 "	" $2,149.35 "	 $601.82 	" $2,055.79 "	 $606.88 
5400122	HCHG CVM 2-COLONOSCOPY THROUGH STOMA W/ BIOPSY SINGLE OR MULTIPLE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44389	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400123	HCHG CVM COLONOSCOPY THROUGH STOMA WITH CONTROL OF BLEEDING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44391	" $2,771.23 "	" $1,939.86 "	 $659.55 	" $2,494.11 "	" $2,410.97 "	 $665.10 	" $2,119.99 "	" $2,327.83 "	" $2,327.83 "	 $685.05 	" $1,745.87 "	" $2,355.55 "	" $1,912.15 "	" $2,216.98 "	 $665.10 	" $2,494.11 "	" $2,253.01 "	" $2,355.55 "	 $659.55 	" $2,253.01 "	 $665.10 
5400124	HCHG CVM 2-COLONOSCOPY THROUGH STOMA WITH CONTROL OF BLEEDING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44391	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5400125	"HCHG CVM PROCTOSIGMOIDOSCOPY,RIGID WITH CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45317	" $2,823.78 "	" $1,976.65 "	 $672.06 	" $2,541.40 "	" $2,456.69 "	 $677.71 	" $2,160.19 "	" $2,371.98 "	" $2,371.98 "	 $698.04 	" $1,778.98 "	" $2,400.21 "	" $1,948.41 "	" $2,259.02 "	 $677.71 	" $2,541.40 "	" $2,295.73 "	" $2,400.21 "	 $672.06 	" $2,295.73 "	 $677.71 
5400126	"HCHG CVM 2-PROCTOSIGMIODOSCOPY,RIGID WITH CONTROL OF BLEED"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45317	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400127	"HCHG CVM SIGMOIDOSCOPY,FLEXIBLE DIAGNOSTIC"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45330	" $3,250.00 "	" $2,275.00 "	 $773.50 	" $2,925.00 "	" $2,827.50 "	 $780.00 	" $2,486.25 "	" $2,730.00 "	" $2,730.00 "	 $803.40 	" $2,047.50 "	" $2,762.50 "	" $2,242.50 "	" $2,600.00 "	 $780.00 	" $2,925.00 "	" $2,642.25 "	" $2,762.50 "	 $773.50 	" $2,642.25 "	 $780.00 
5400128	"HCHG CVM 2-SIGMOIDOSCOPY,FLEXIBLE DIAGNOSTIC"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45330	 $600.48 	 $420.34 	 $142.91 	 $540.43 	 $522.42 	 $144.12 	 $459.37 	 $504.40 	 $504.40 	 $148.44 	 $378.30 	 $510.41 	 $414.33 	 $480.38 	 $144.12 	 $540.43 	 $488.19 	 $510.41 	 $142.91 	 $488.19 	 $144.12 
5400129	"HCHG CVM SIGMOIDOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45331	" $2,497.03 "	" $1,747.92 "	 $594.29 	" $2,247.33 "	" $2,172.42 "	 $599.29 	" $1,910.23 "	" $2,097.51 "	" $2,097.51 "	 $617.27 	" $1,573.13 "	" $2,122.48 "	" $1,722.95 "	" $1,997.62 "	 $599.29 	" $2,247.33 "	" $2,030.09 "	" $2,122.48 "	 $594.29 	" $2,030.09 "	 $599.29 
5400130	"HCHG CVM 2-SIGMOIDOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45331	 $600.48 	 $420.34 	 $142.91 	 $540.43 	 $522.42 	 $144.12 	 $459.37 	 $504.40 	 $504.40 	 $148.44 	 $378.30 	 $510.41 	 $414.33 	 $480.38 	 $144.12 	 $540.43 	 $488.19 	 $510.41 	 $142.91 	 $488.19 	 $144.12 
5400131	"HCHG CVM SIGMOIDOSCOPY,FLEXIBLE WITH CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45334	" $2,519.03 "	" $1,763.32 "	 $599.53 	" $2,267.13 "	" $2,191.56 "	 $604.57 	" $1,927.06 "	" $2,115.99 "	" $2,115.99 "	 $622.70 	" $1,586.99 "	" $2,141.18 "	" $1,738.13 "	" $2,015.22 "	 $604.57 	" $2,267.13 "	" $2,047.97 "	" $2,141.18 "	 $599.53 	" $2,047.97 "	 $604.57 
5400132	"HCHG CVM 2-SIGMOIDOSCOPY,FLEXIBLE WITH CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45334	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400133	"HCHG CVM SIGMOIDOSCOPY, FLEXIBLE WITH DIRECTED SUBMUCOSAL INJ"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45335	" $1,948.77 "	" $1,364.14 "	 $463.81 	" $1,753.89 "	" $1,695.43 "	 $467.70 	" $1,490.81 "	" $1,636.97 "	" $1,636.97 "	 $481.74 	" $1,227.73 "	" $1,656.45 "	" $1,344.65 "	" $1,559.02 "	 $467.70 	" $1,753.89 "	" $1,584.35 "	" $1,656.45 "	 $463.81 	" $1,584.35 "	 $467.70 
5400134	"HCHG CVM 2-SIGMOISOSCOPY,FLEXIBLE WITH DIRECTED SUBMUCOSAL INJ"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45335	 $974.39 	 $682.07 	 $231.90 	 $876.95 	 $847.72 	 $233.85 	 $745.41 	 $818.49 	 $818.49 	 $240.87 	 $613.87 	 $828.23 	 $672.33 	 $779.51 	 $233.85 	 $876.95 	 $792.18 	 $828.23 	 $231.90 	 $792.18 	 $233.85 
5400135	"HCHG CVMC COLONOSCOPY,FLEXIBLE,PROXIMAL TO SPLENIC FLEXURE,DIAGNOS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45378	" $2,870.00 "	" $2,009.00 "	 $683.06 	" $2,583.00 "	" $2,496.90 "	 $688.80 	" $2,195.55 "	" $2,410.80 "	" $2,410.80 "	 $709.46 	" $1,808.10 "	" $2,439.50 "	" $1,980.30 "	" $2,296.00 "	 $688.80 	" $2,583.00 "	" $2,333.31 "	" $2,439.50 "	 $683.06 	" $2,333.31 "	 $688.80 
5400136	"HCHG CVMC COLONOSCOPY,FLEXIBLE,PROXIMAL TO SPLENIC FLEXURE,DIAGNOS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45378	" $3,150.00 "	" $2,205.00 "	 $749.70 	" $2,835.00 "	" $2,740.50 "	 $756.00 	" $2,409.75 "	" $2,646.00 "	" $2,646.00 "	 $778.68 	" $1,984.50 "	" $2,677.50 "	" $2,173.50 "	" $2,520.00 "	 $756.00 	" $2,835.00 "	" $2,560.95 "	" $2,677.50 "	 $749.70 	" $2,560.95 "	 $756.00 
5400137	"HCHG CVM COLONOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45380	" $3,310.00 "	" $2,317.00 "	 $787.78 	" $2,979.00 "	" $2,879.70 "	 $794.40 	" $2,532.15 "	" $2,780.40 "	" $2,780.40 "	 $818.23 	" $2,085.30 "	" $2,813.50 "	" $2,283.90 "	" $2,648.00 "	 $794.40 	" $2,979.00 "	" $2,691.03 "	" $2,813.50 "	 $787.78 	" $2,691.03 "	 $794.40 
5400138	"HCHG CVM 2-COLONOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45380	" $3,310.00 "	" $2,317.00 "	 $787.78 	" $2,979.00 "	" $2,879.70 "	 $794.40 	" $2,532.15 "	" $2,780.40 "	" $2,780.40 "	 $818.23 	" $2,085.30 "	" $2,813.50 "	" $2,283.90 "	" $2,648.00 "	 $794.40 	" $2,979.00 "	" $2,691.03 "	" $2,813.50 "	 $787.78 	" $2,691.03 "	 $794.40 
5400139	"HCHG CVM COLONOSCOPY,FLEXIBLE WITH DIRECTED SUBMUCOSAL INJ"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45381	" $3,841.01 "	" $2,688.71 "	 $914.16 	" $3,456.91 "	" $3,341.68 "	 $921.84 	" $2,938.37 "	" $3,226.45 "	" $3,226.45 "	 $949.50 	" $2,419.84 "	" $3,264.86 "	" $2,650.30 "	" $3,072.81 "	 $921.84 	" $3,456.91 "	" $3,122.74 "	" $3,264.86 "	 $914.16 	" $3,122.74 "	 $921.84 
5400140	"HCHG CVM 2-COLONOSCOPY,FLEXIBLE WITH DIRECTED SUBMUCOSAL INJ"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45381	" $3,841.01 "	" $2,688.71 "	 $914.16 	" $3,456.91 "	" $3,341.68 "	 $921.84 	" $2,938.37 "	" $3,226.45 "	" $3,226.45 "	 $949.50 	" $2,419.84 "	" $3,264.86 "	" $2,650.30 "	" $3,072.81 "	 $921.84 	" $3,456.91 "	" $3,122.74 "	" $3,264.86 "	 $914.16 	" $3,122.74 "	 $921.84 
5400141	"HCHG CVM COLONOSCOPY,FLEXIBLE WITH CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45382	" $2,715.68 "	" $1,900.98 "	 $646.33 	" $2,444.11 "	" $2,362.64 "	 $651.76 	" $2,077.50 "	" $2,281.17 "	" $2,281.17 "	 $671.32 	" $1,710.88 "	" $2,308.33 "	" $1,873.82 "	" $2,172.54 "	 $651.76 	" $2,444.11 "	" $2,207.85 "	" $2,308.33 "	 $646.33 	" $2,207.85 "	 $651.76 
5400142	"HCHG CVM 2-COLONOSCOPY,FLEXIBLE WITH CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45382	" $2,715.68 "	" $1,900.98 "	 $646.33 	" $2,444.11 "	" $2,362.64 "	 $651.76 	" $2,077.50 "	" $2,281.17 "	" $2,281.17 "	 $671.32 	" $1,710.88 "	" $2,308.33 "	" $1,873.82 "	" $2,172.54 "	 $651.76 	" $2,444.11 "	" $2,207.85 "	" $2,308.33 "	 $646.33 	" $2,207.85 "	 $651.76 
5400143	HCHG CVM ANOSCOPY WITH CONTROL OF BLEEDING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46614	" $2,701.80 "	" $1,891.26 "	 $643.03 	" $2,431.62 "	" $2,350.57 "	 $648.43 	" $2,066.88 "	" $2,269.51 "	" $2,269.51 "	 $667.88 	" $1,702.13 "	" $2,296.53 "	" $1,864.24 "	" $2,161.44 "	 $648.43 	" $2,431.62 "	" $2,196.56 "	" $2,296.53 "	 $643.03 	" $2,196.56 "	 $648.43 
5400144	HCHG CVM 2-ANOSCOPY WITH CONTROL OF BLEEDING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46614	" $2,701.80 "	" $1,891.26 "	 $643.03 	" $2,431.62 "	" $2,350.57 "	 $648.43 	" $2,066.88 "	" $2,269.51 "	" $2,269.51 "	 $667.88 	" $1,702.13 "	" $2,296.53 "	" $1,864.24 "	" $2,161.44 "	 $648.43 	" $2,431.62 "	" $2,196.56 "	" $2,296.53 "	 $643.03 	" $2,196.56 "	 $648.43 
5400145	HCHG CVMC PLACE GASTROSTOMY TUBE PERCUTANEOUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49440	" $7,217.34 "	" $5,052.14 "	" $1,717.73 "	" $6,495.61 "	" $6,279.09 "	" $1,732.16 "	" $5,521.27 "	" $3,786.00 "	" $3,283.00 "	" $1,784.13 "	" $4,546.92 "	" $6,134.74 "	" $4,979.96 "	" $5,773.87 "	" $1,732.16 "	" $6,495.61 "	" $5,867.70 "	" $6,134.74 "	" $1,717.73 "	" $5,867.70 "	" $1,732.16 "
5400146	HCHG CVMC PLACE GASTROSTOMY TUBE PERCUTANEOUS	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	49440	" $7,217.34 "	" $5,052.14 "	" $1,717.73 "	" $6,495.61 "	" $6,279.09 "	" $1,732.16 "	" $5,521.27 "	" $3,786.00 "	" $3,283.00 "	" $1,784.13 "	" $4,546.92 "	" $6,134.74 "	" $4,979.96 "	" $5,773.87 "	" $1,732.16 "	" $6,495.61 "	" $5,867.70 "	" $6,134.74 "	" $1,717.73 "	" $5,867.70 "	" $1,732.16 "
5400147	HCHG ESOPHAGOSCOPY FLEX REMOVAL FB	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43215	" $5,012.05 "	" $3,508.44 "	" $1,192.87 "	" $4,510.85 "	" $4,360.48 "	" $1,202.89 "	" $3,834.22 "	" $3,786.00 "	" $3,283.00 "	" $1,238.98 "	" $3,157.59 "	" $4,260.24 "	" $3,458.31 "	" $4,009.64 "	" $1,202.89 "	" $4,510.85 "	" $4,074.80 "	" $4,260.24 "	" $1,192.87 "	" $4,074.80 "	" $1,202.89 "
5400148	"HCHG CVMC 2-ESOPHAGOSCOPY,RIGID OR FLEXIBLE REMOVAL OF FOREIGN BOD"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43215	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400149	"HCHG CVMC ESOPHAGOSCOPY,RIGID OR FLEXIBLE,WITH CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43227	" $2,292.34 "	" $1,604.64 "	 $545.58 	" $2,063.11 "	" $1,994.34 "	 $550.16 	" $1,753.64 "	" $1,925.57 "	" $1,925.57 "	 $566.67 	" $1,444.17 "	" $1,948.49 "	" $1,581.71 "	" $1,833.87 "	 $550.16 	" $2,063.11 "	" $1,863.67 "	" $1,948.49 "	 $545.58 	" $1,863.67 "	 $550.16 
5400150	"HCHG CVMC 2-ESOPHAGOSCOPY,RIGID OR FLEXIBLE,W/CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43227	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400151	HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY W/DIALTION OF GASTRIC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43245	" $3,432.92 "	" $2,403.04 "	 $817.03 	" $3,089.63 "	" $2,986.64 "	 $823.90 	" $2,626.18 "	" $2,883.65 "	" $2,883.65 "	 $848.62 	" $2,162.74 "	" $2,917.98 "	" $2,368.71 "	" $2,746.34 "	 $823.90 	" $3,089.63 "	" $2,790.96 "	" $2,917.98 "	 $817.03 	" $2,790.96 "	 $823.90 
5400152	HCHG CVMC 2-UPPER GASTROINTESTINAL ENDOSCOPY W/DILATION OF GASTRIC	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43245	 $971.45 	 $680.02 	 $231.21 	 $874.31 	 $845.16 	 $233.15 	 $743.16 	 $816.02 	 $816.02 	 $240.14 	 $612.01 	 $825.73 	 $670.30 	 $777.16 	 $233.15 	 $874.31 	 $789.79 	 $825.73 	 $231.21 	 $789.79 	 $233.15 
5400153	HCHG CVMC 2-UPPER GI ENDOSCOPY W/PLACEMENT OF GASTROSTOMY TUBE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43246	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400154	HCHG CVMC UPPER GASTROINTESTINAL ENDOSCOPY WITH INSERT GUIDE WIRE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43248	" $3,093.26 "	" $2,165.28 "	 $736.20 	" $2,783.93 "	" $2,691.14 "	 $742.38 	" $2,366.34 "	" $2,598.34 "	" $2,598.34 "	 $764.65 	" $1,948.75 "	" $2,629.27 "	" $2,134.35 "	" $2,474.61 "	 $742.38 	" $2,783.93 "	" $2,514.82 "	" $2,629.27 "	 $736.20 	" $2,514.82 "	 $742.38 
5400155	HCHG CVMC 2-UPPR GASTROINTESTINAL ENDOSCOPY WITH INSERT GUIDE WIRE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43248	 $900.73 	 $630.51 	 $214.37 	 $810.66 	 $783.64 	 $216.18 	 $689.06 	 $756.61 	 $756.61 	 $222.66 	 $567.46 	 $765.62 	 $621.50 	 $720.58 	 $216.18 	 $810.66 	 $732.29 	 $765.62 	 $214.37 	 $732.29 	 $216.18 
5400156	"HCHG CVMC UPPER GI ENDOSCOPY W/REMOVAL OF TUMOR, POLYP OR LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43250	" $5,012.05 "	" $3,508.44 "	" $1,192.87 "	" $4,510.85 "	" $4,360.48 "	" $1,202.89 "	" $3,834.22 "	" $3,786.00 "	" $3,283.00 "	" $1,238.98 "	" $3,157.59 "	" $4,260.24 "	" $3,458.31 "	" $4,009.64 "	" $1,202.89 "	" $4,510.85 "	" $4,074.80 "	" $4,260.24 "	" $1,192.87 "	" $4,074.80 "	" $1,202.89 "
5400157	"HCHG CVMC 2-UPPER GI ENDOSCOPY W/REMOVAL OF TUMOR, POLYP OR LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43250	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400158	"HCHG CVMC UPPER GI ENDOSCOPY W/REMOVAL OF TUMOR, POLYP OR LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43251	" $2,860.00 "	" $2,002.00 "	 $680.68 	" $2,574.00 "	" $2,488.20 "	 $686.40 	" $2,187.90 "	" $2,402.40 "	" $2,402.40 "	 $706.99 	" $1,801.80 "	" $2,431.00 "	" $1,973.40 "	" $2,288.00 "	 $686.40 	" $2,574.00 "	" $2,325.18 "	" $2,431.00 "	 $680.68 	" $2,325.18 "	 $686.40 
5400159	"HCHG CVMC 2-UPPER GI ENDOSCOPY W/REMOVAL OF TUMOR, POLYP OR LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43251	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400160	HCHG CVMC 2-ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43262	" $2,251.82 "	" $1,576.27 "	 $535.93 	" $2,026.64 "	" $1,959.08 "	 $540.44 	" $1,722.64 "	" $1,891.53 "	" $1,891.53 "	 $556.65 	" $1,418.65 "	" $1,914.05 "	" $1,553.76 "	" $1,801.46 "	 $540.44 	" $2,026.64 "	" $1,830.73 "	" $1,914.05 "	 $535.93 	" $1,830.73 "	 $540.44 
5400161	HCHG CVMC 2-ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPH	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43264	" $2,251.82 "	" $1,576.27 "	 $535.93 	" $2,026.64 "	" $1,959.08 "	 $540.44 	" $1,722.64 "	" $1,891.53 "	" $1,891.53 "	 $556.65 	" $1,418.65 "	" $1,914.05 "	" $1,553.76 "	" $1,801.46 "	 $540.44 	" $2,026.64 "	" $1,830.73 "	" $1,914.05 "	 $535.93 	" $1,830.73 "	 $540.44 
5400162	"HCHG CVMC DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43450	" $1,281.98 "	 $897.39 	 $305.11 	" $1,153.78 "	" $1,115.32 "	 $307.68 	 $980.71 	" $1,076.86 "	" $1,076.86 "	 $316.91 	 $807.65 	" $1,089.68 "	 $884.57 	" $1,025.58 "	 $307.68 	" $1,153.78 "	" $1,042.25 "	" $1,089.68 "	 $305.11 	" $1,042.25 "	 $307.68 
5400163	HCHG CVMC NASAL/OROGASTRIC TUBE PLACEMENT W/STENT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	43752	 $602.33 	 $421.63 	 $143.35 	 $542.10 	 $524.03 	 $144.56 	 $460.78 	 $505.96 	 $505.96 	 $148.90 	 $379.47 	 $511.98 	 $415.61 	 $481.86 	 $144.56 	 $542.10 	 $489.69 	 $511.98 	 $143.35 	 $489.69 	 $144.56 
5400164	HCHG CVMC SMALL INTESTIONAL ENDOSCOPY WITH BIPOSY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44361	" $2,467.99 "	" $1,727.59 "	 $587.38 	" $2,221.19 "	" $2,147.15 "	 $592.32 	" $1,888.01 "	" $2,073.11 "	" $2,073.11 "	 $610.09 	" $1,554.83 "	" $2,097.79 "	" $1,702.91 "	" $1,974.39 "	 $592.32 	" $2,221.19 "	" $2,006.48 "	" $2,097.79 "	 $587.38 	" $2,006.48 "	 $592.32 
5400165	HCHG CVMC 2-SMALL INTESTIONAL ENDOSCOPY WITH BIOPSY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44361	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5400166	HCHG CVMC SMALL INTESTINAL ENDOSCOPY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44366	" $2,911.60 "	" $2,038.12 "	 $692.96 	" $2,620.44 "	" $2,533.09 "	 $698.78 	" $2,227.37 "	" $2,445.74 "	" $2,445.74 "	 $719.75 	" $1,834.31 "	" $2,474.86 "	" $2,009.00 "	" $2,329.28 "	 $698.78 	" $2,620.44 "	" $2,367.13 "	" $2,474.86 "	 $692.96 	" $2,367.13 "	 $698.78 
5400167	HCHG CVMC 2-SMALL INTESTINAL ENDOSCOPY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44366	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5400168	HCHG CVMC SMALL INTESTINAL ENDOSCOPY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44378	" $3,535.49 "	" $2,474.84 "	 $841.45 	" $3,181.94 "	" $3,075.88 "	 $848.52 	" $2,704.65 "	" $2,969.81 "	" $2,969.81 "	 $873.97 	" $2,227.36 "	" $3,005.17 "	" $2,439.49 "	" $2,828.39 "	 $848.52 	" $3,181.94 "	" $2,874.35 "	" $3,005.17 "	 $841.45 	" $2,874.35 "	 $848.52 
5400169	HCHG CVMC 2-SMALL INTESTINAL ENDOSCOPY	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44378	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5400170	"HCHG CVMC ILEOSCOPY,THROUGH STOMA,DIAGNOSTIC"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	44380	" $5,544.84 "	" $3,881.39 "	" $1,319.67 "	" $4,990.36 "	" $4,824.01 "	" $1,330.76 "	" $4,241.80 "	" $3,786.00 "	" $3,283.00 "	" $1,370.68 "	" $3,493.25 "	" $4,713.11 "	" $3,825.94 "	" $4,435.87 "	" $1,330.76 "	" $4,990.36 "	" $4,507.95 "	" $4,713.11 "	" $1,319.67 "	" $4,507.95 "	" $1,330.76 "
5400171	"HCHG CVMC SIGMOIDOSCOPY,FLEXIBLE W/REMOVAL OF TUMOR,POLYP,LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45338	" $3,100.00 "	" $2,170.00 "	 $737.80 	" $2,790.00 "	" $2,697.00 "	 $744.00 	" $2,371.50 "	" $2,604.00 "	" $2,604.00 "	 $766.32 	" $1,953.00 "	" $2,635.00 "	" $2,139.00 "	" $2,480.00 "	 $744.00 	" $2,790.00 "	" $2,520.30 "	" $2,635.00 "	 $737.80 	" $2,520.30 "	 $744.00 
5400172	"HCHG CVMC 2-SIGMOIDOSCOPY,FLEXIBLE W/REMOVAL OF TUMOR,POLYP,LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45338	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5400173	"HCHG CVMC COLONOSCOPY,FLEXIBLE WITH FOREIGN BODY REMOVAL"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45379	" $2,480.00 "	" $1,736.00 "	 $590.24 	" $2,232.00 "	" $2,157.60 "	 $595.20 	" $1,897.20 "	" $2,083.20 "	" $2,083.20 "	 $613.06 	" $1,562.40 "	" $2,108.00 "	" $1,711.20 "	" $1,984.00 "	 $595.20 	" $2,232.00 "	" $2,016.24 "	" $2,108.00 "	 $590.24 	" $2,016.24 "	 $595.20 
5400174	"HCHG CVMC 2-COLONOSCOPY,FLEXIBLE WITH FOERIGN BODY REMOVAL"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45379	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5400177	"HCHG CVMC COLONOSCOPY,WITH REMOVAL OF TUMOR,POLYP,OR LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45385	" $3,150.00 "	" $2,205.00 "	 $749.70 	" $2,835.00 "	" $2,740.50 "	 $756.00 	" $2,409.75 "	" $2,646.00 "	" $2,646.00 "	 $778.68 	" $1,984.50 "	" $2,677.50 "	" $2,173.50 "	" $2,520.00 "	 $756.00 	" $2,835.00 "	" $2,560.95 "	" $2,677.50 "	 $749.70 	" $2,560.95 "	 $756.00 
5400178	"HCHG CVMC 2-COLONOSCOPY W/REMOVAL OF TUMOR,POLYP OR LESION"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45385	" $1,660.94 "	" $1,162.66 "	 $395.30 	" $1,494.85 "	" $1,445.02 "	 $398.63 	" $1,270.62 "	" $1,395.19 "	" $1,395.19 "	 $410.58 	" $1,046.39 "	" $1,411.80 "	" $1,146.05 "	" $1,328.75 "	 $398.63 	" $1,494.85 "	" $1,350.34 "	" $1,411.80 "	 $395.30 	" $1,350.34 "	 $398.63 
5400179	"HCHG CVMC COLONOSCOPY,FLEXIBLE WITH DILATION BY BALLOON"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45386	" $2,702.18 "	" $1,891.53 "	 $643.12 	" $2,431.96 "	" $2,350.90 "	 $648.52 	" $2,067.17 "	" $2,269.83 "	" $2,269.83 "	 $667.98 	" $1,702.37 "	" $2,296.85 "	" $1,864.50 "	" $2,161.74 "	 $648.52 	" $2,431.96 "	" $2,196.87 "	" $2,296.85 "	 $643.12 	" $2,196.87 "	 $648.52 
5400180	"HCHG CVMC 2-COLONOSCOPY,FLEXIBLE WITH DILATION BY BALLOON"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45386	" $1,200.97 "	 $840.68 	 $285.83 	" $1,080.87 "	" $1,044.84 "	 $288.23 	 $918.74 	" $1,008.81 "	" $1,008.81 "	 $296.88 	 $756.61 	" $1,020.82 "	 $828.67 	 $960.78 	 $288.23 	" $1,080.87 "	 $976.39 	" $1,020.82 "	 $285.83 	 $976.39 	 $288.23 
5400183	"HCHG CVMC BIOPSY OF LIVER,NEEDLE PERCUTANEOUS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	47000	 $686.35 	 $480.45 	 $163.35 	 $617.72 	 $597.12 	 $164.72 	 $525.06 	 $576.53 	 $576.53 	 $169.67 	 $432.40 	 $583.40 	 $473.58 	 $549.08 	 $164.72 	 $617.72 	 $558.00 	 $583.40 	 $163.35 	 $558.00 	 $164.72 
5400184	"HCHG CVMC 2-BIOPSY OF LIVER,NEEDLE PERCUTANEOUS"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	47000	 $572.63 	 $400.84 	 $136.29 	 $515.37 	 $498.19 	 $137.43 	 $438.06 	 $481.01 	 $481.01 	 $141.55 	 $360.76 	 $486.74 	 $395.11 	 $458.10 	 $137.43 	 $515.37 	 $465.55 	 $486.74 	 $136.29 	 $465.55 	 $137.43 
5400192	HCHG CVMC GI THIRD PROCEDURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		 $328.77 	 $230.14 	 $78.25 	 $295.89 	 $286.03 	 $78.90 	 $251.51 	 $276.17 	 $276.17 	 $81.27 	 $207.13 	 $279.45 	 $226.85 	 $263.02 	 $78.90 	 $295.89 	 $267.29 	 $279.45 	 $78.25 	 $267.29 	 $78.90 
5400193	HCHG CVMC GI FOURTH PROCEDURE	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION		 $246.57 	 $172.60 	 $58.68 	 $221.91 	 $214.52 	 $59.18 	 $188.63 	 $207.12 	 $207.12 	 $60.95 	 $155.34 	 $209.58 	 $170.13 	 $197.26 	 $59.18 	 $221.91 	 $200.46 	 $209.58 	 $58.68 	 $200.46 	 $59.18 
5401001	"HCHG CVMC 2-COLONOSCOPY,FLEXIBLE WITH CONTROL OF BLEEDING"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45382	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $259.77 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5401002	"HCHG CVMC 2-COLONOSCOPY,FLEXIBLE WITH DIRECTED SUBMUCOSAL INJ"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45381	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
5401003	"HCHG CVMC 2-COLONOSCOPY,FLEXIBLE WITH BIOPSY,SINGLE OR MULTIPLE"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45380	" $1,748.00 "	" $1,223.60 "	 $416.02 	" $1,573.20 "	" $1,520.76 "	 $419.52 	" $1,337.22 "	" $1,468.32 "	" $1,468.32 "	 $432.11 	" $1,101.24 "	" $1,485.80 "	" $1,206.12 "	" $1,398.40 "	 $419.52 	" $1,573.20 "	" $1,421.12 "	" $1,485.80 "	 $416.02 	" $1,421.12 "	 $419.52 
5401004	HCHG CVMC 2-ANOSCOPY WITH CONTROL OF BLEEDING	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	46614	 $600.48 	 $420.34 	 $142.91 	 $540.43 	 $522.42 	 $144.12 	 $459.37 	 $504.40 	 $504.40 	 $148.44 	 $378.30 	 $510.41 	 $414.33 	 $480.38 	 $144.12 	 $540.43 	 $488.19 	 $510.41 	 $142.91 	 $488.19 	 $144.12 
5401008	HCHG SCREENING COLONOSCOPY. HIGH RISK PT	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	G0105	" $1,050.85 "	 $735.60 	 $250.10 	 $945.77 	 $914.24 	 $252.20 	 $803.90 	 $882.71 	 $882.71 	 $252.20 	 $662.04 	 $893.22 	 $725.09 	 $840.68 	 $252.20 	 $945.77 	 $854.34 	 $893.22 	 $250.10 	 $854.34 	 $252.20 
5401009	"HCHG CVMC 2-COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE DI"	0360	OPERATING ROOM SERVICES - GENERAL CLASSIFICATION	45378	" $3,150.00 "	" $2,205.00 "	 $749.70 	" $2,835.00 "	" $2,740.50 "	 $756.00 	" $2,409.75 "	" $2,646.00 "	" $2,646.00 "	 $778.68 	" $1,984.50 "	" $2,677.50 "	" $2,173.50 "	" $2,520.00 "	 $756.00 	" $2,835.00 "	" $2,560.95 "	" $2,677.50 "	 $749.70 	" $2,560.95 "	 $756.00 
308677	"HCHG CVMC INJ SACROILIAC JOINT,ARTHROGRAPHY OR ANESTHETIC/STEROID"	0361	OPERATING ROOM SERVICES - MINOR SURGERY	27096	" $1,350.00 "	 $945.00 	 $321.30 	" $1,215.00 "	" $1,174.50 "	 $324.00 	" $1,032.75 "	" $1,134.00 "	" $1,134.00 "	 $333.72 	 $850.50 	" $1,147.50 "	 $931.50 	" $1,080.00 "	 $324.00 	" $1,215.00 "	" $1,097.55 "	" $1,147.50 "	 $321.30 	" $1,097.55 "	 $324.00 
5200198	HCHG CVMC URINARY REFLEX STUDY	0361	OPERATING ROOM SERVICES - MINOR SURGERY	51792	 $708.52 	 $495.96 	 $168.63 	 $637.67 	 $616.41 	 $170.04 	 $542.02 	 $595.16 	 $595.16 	 $175.15 	 $446.37 	 $602.24 	 $488.88 	 $566.82 	 $170.04 	 $637.67 	 $576.03 	 $602.24 	 $168.63 	 $576.03 	 $170.04 
302794	HCHG ANESTH UPPR ARM PROCEDURE	0370	ANESTHESIA - GENERAL CLASSIFICATION	01730	 $73.00 	 $51.10 	 $17.37 	 $65.70 	 $63.51 	 $17.52 	 $55.85 	 $61.32 	 $61.32 	 $18.05 	 $45.99 	 $62.05 	 $50.37 	 $58.40 	 $17.52 	 $65.70 	 $59.35 	 $62.05 	 $17.37 	 $59.35 	 $17.52 
303599	HCHG CON SEDATION< 5 YR 1ST 15 MIN (370)	0370	ANESTHESIA - GENERAL CLASSIFICATION	99151	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
303600	HCHG CON SEDATION/>5 YR 1ST 15 MIN (370)	0370	ANESTHESIA - GENERAL CLASSIFICATION	99152	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $98.88 	 $252.00 	 $340.00 	 $276.00 	 $320.00 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
303601	HCHG CON SEDATION EA ADDL 15 MIN (370)	0370	ANESTHESIA - GENERAL CLASSIFICATION	99153	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $98.88 	 $252.00 	 $340.00 	 $276.00 	 $320.00 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
5200169	HCHG CVMC NON GENERAL ANESTHISIA CARE 1/4 HR	0370	ANESTHESIA - GENERAL CLASSIFICATION	5200169	 $406.00 	 $284.20 	 $96.63 	 $365.40 	 $353.22 	 $97.44 	 $310.59 	 $341.04 	 $341.04 	 $100.36 	 $255.78 	 $345.10 	 $280.14 	 $324.80 	 $97.44 	 $365.40 	 $330.08 	 $345.10 	 $96.63 	 $330.08 	 $97.44 
5260003	HCHG CVMC GEN ANESTH CARE 1/4 HR	0370	ANESTHESIA - GENERAL CLASSIFICATION		 $650.00 	 $455.00 	 $154.70 	 $585.00 	 $565.50 	 $156.00 	 $497.25 	 $546.00 	 $546.00 	 $160.68 	 $409.50 	 $552.50 	 $448.50 	 $520.00 	 $156.00 	 $585.00 	 $528.45 	 $552.50 	 $154.70 	 $528.45 	 $156.00 
303602	HCHG CON SEDATION< 5 YR 1ST 15 MIN	0371	ANESTHESIA - ANESTHESIA INCIDENT TO RADIOLOGY	99151	 $191.00 	 $133.70 	 $45.46 	 $171.90 	 $166.17 	 $45.84 	 $146.12 	 $160.44 	 $160.44 	 $47.22 	 $120.33 	 $162.35 	 $131.79 	 $152.80 	 $45.84 	 $171.90 	 $155.28 	 $162.35 	 $45.46 	 $155.28 	 $45.84 
303603	HCHG CON SEDATION/>5 YR 1ST 15 MIN	0371	ANESTHESIA - ANESTHESIA INCIDENT TO RADIOLOGY	99152	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $98.88 	 $252.00 	 $340.00 	 $276.00 	 $320.00 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
305750	HCHG CON SEDATION EA ADDL 15 MIN	0371	ANESTHESIA - ANESTHESIA INCIDENT TO RADIOLOGY	99153	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $71.69 	 $182.70 	 $246.50 	 $200.10 	 $232.00 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
350600	HCHG BMH/CVMC CRYOPRECIPITATE EACH UNIT	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9012	 $221.94 	 $155.36 	 $52.82 	 $199.75 	 $193.09 	 $53.27 	 $169.78 	 $186.43 	 $186.43 	 $54.86 	 $139.82 	 $188.65 	 $153.14 	 $177.55 	 $53.27 	 $199.75 	 $180.44 	 $188.65 	 $52.82 	 $180.44 	 $53.27 
350601	HCHG FRESH FROZEN PLASMA < 8HRS EA UNIT BLD	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9017	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $88.99 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
350602	HCHG BMH/CVMC WHOLE BLOOD/RED BLOOD CELLS/LEUKOCYTES REG	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9051	 $643.59 	 $450.51 	 $153.17 	 $579.23 	 $559.92 	 $154.46 	 $492.35 	 $540.62 	 $540.62 	 $159.10 	 $405.46 	 $547.05 	 $444.08 	 $514.87 	 $154.46 	 $579.23 	 $523.24 	 $547.05 	 $153.17 	 $523.24 	 $154.46 
350603	"HCHG BMH/CVMC PRBC,LEUKOREDUCED,CMV,IRRADIAT"	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9058	 $900.00 	 $630.00 	 $214.20 	 $810.00 	 $783.00 	 $216.00 	 $688.50 	 $756.00 	 $756.00 	 $222.48 	 $567.00 	 $765.00 	 $621.00 	 $720.00 	 $216.00 	 $810.00 	 $731.70 	 $765.00 	 $214.20 	 $731.70 	 $216.00 
350604	"HCHG BMH/CVMC PRBC,LEUKOREDUCED,IRRADIATED"	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9040	" $1,540.00 "	" $1,078.00 "	 $366.52 	" $1,386.00 "	" $1,339.80 "	 $369.60 	" $1,178.10 "	" $1,293.60 "	" $1,293.60 "	 $380.69 	 $970.20 	" $1,309.00 "	" $1,062.60 "	" $1,232.00 "	 $369.60 	" $1,386.00 "	" $1,252.02 "	" $1,309.00 "	 $366.52 	" $1,252.02 "	 $369.60 
350605	"HCHG BMH/CVMC PLT PHERESIS,LEUKOREDUCED,CMV"	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9055	" $1,540.12 "	" $1,078.08 "	 $366.55 	" $1,386.11 "	" $1,339.90 "	 $369.63 	" $1,178.19 "	" $1,293.70 "	" $1,293.70 "	 $380.72 	 $970.28 	" $1,309.10 "	" $1,062.68 "	" $1,232.10 "	 $369.63 	" $1,386.11 "	" $1,252.12 "	" $1,309.10 "	 $366.55 	" $1,252.12 "	 $369.63 
350606	"HCHG BMH/CVMC PLT,PHER,L/R CMV-NEG,IRRADIATE"	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9053	" $1,960.00 "	" $1,372.00 "	 $466.48 	" $1,764.00 "	" $1,705.20 "	 $470.40 	" $1,499.40 "	" $1,646.40 "	" $1,646.40 "	 $484.51 	" $1,234.80 "	" $1,666.00 "	" $1,352.40 "	" $1,568.00 "	 $470.40 	" $1,764.00 "	" $1,593.48 "	" $1,666.00 "	 $466.48 	" $1,593.48 "	 $470.40 
350607	"HCHG BMH/CVMC PLT PHERESIS,LEUKOREDUCED,IRRA"	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9037	" $2,760.00 "	" $1,932.00 "	 $656.88 	" $2,484.00 "	" $2,401.20 "	 $662.40 	" $2,111.40 "	" $2,318.40 "	" $2,318.40 "	 $682.27 	" $1,738.80 "	" $2,346.00 "	" $1,904.40 "	" $2,208.00 "	 $662.40 	" $2,484.00 "	" $2,243.88 "	" $2,346.00 "	 $656.88 	" $2,243.88 "	 $662.40 
350608	HCHG BMH/CVMC PLATELETPHERESIS LR	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9035	" $1,500.00 "	" $1,050.00 "	 $357.00 	" $1,350.00 "	" $1,305.00 "	 $360.00 	" $1,147.50 "	" $1,260.00 "	" $1,260.00 "	 $370.80 	 $945.00 	" $1,275.00 "	" $1,035.00 "	" $1,200.00 "	 $360.00 	" $1,350.00 "	" $1,219.50 "	" $1,275.00 "	 $357.00 	" $1,219.50 "	 $360.00 
350609	HCHG BMH/CVMC LEUKOCYTE POOR PRBC'S	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9016	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
351008	"HCHG BMH/CVMC PLATELETS, EACH UNIT"	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	P9019	 $226.47 	 $158.53 	 $53.90 	 $203.82 	 $197.03 	 $54.35 	 $173.25 	 $190.23 	 $190.23 	 $55.98 	 $142.68 	 $192.50 	 $156.26 	 $181.18 	 $54.35 	 $203.82 	 $184.12 	 $192.50 	 $53.90 	 $184.12 	 $54.35 
360806	HCHG BMH/CVMC ANTIBODY SCREEN	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	86850	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $86.52 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
360808	HCHG BMH/CVMC ABBREV X-MATCH 86920	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	86920	 $285.11 	 $199.58 	 $67.86 	 $256.60 	 $248.05 	 $68.43 	 $218.11 	 $239.49 	 $239.49 	 $70.48 	 $179.62 	 $242.34 	 $196.73 	 $228.09 	 $68.43 	 $256.60 	 $231.79 	 $242.34 	 $67.86 	 $231.79 	 $68.43 
362100	HCHG BMH/CVMC CROSS MATCH 86922	0390	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - GENERAL CLASSIFICATION"	86922	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $163.80 	 $221.00 	 $179.40 	 $208.00 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
310010	HCHG BMH/CVMC BLOOD TRANSFUSION 1ST HOUR	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	 $930.00 	 $651.00 	 $221.34 	 $837.00 	 $809.10 	 $223.20 	 $711.45 	 $781.20 	 $781.20 	 $229.90 	 $585.90 	 $790.50 	 $641.70 	 $744.00 	 $223.20 	 $837.00 	 $756.09 	 $790.50 	 $221.34 	 $756.09 	 $223.20 
310011	HCHG BLOOD TRANSFUSION >1HR TO 4 HRS.	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $1,310.00 "	 $917.00 	 $311.78 	" $1,179.00 "	" $1,139.70 "	 $314.40 	" $1,002.15 "	" $1,100.40 "	" $1,100.40 "	 $323.83 	 $825.30 	" $1,113.50 "	 $903.90 	" $1,048.00 "	 $314.40 	" $1,179.00 "	" $1,065.03 "	" $1,113.50 "	 $311.78 	" $1,065.03 "	 $314.40 
310012	HCHG BLOOD TRANSFUSION 4 TO 6 HRS	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $1,577.00 "	" $1,103.90 "	 $375.33 	" $1,419.30 "	" $1,371.99 "	 $378.48 	" $1,206.41 "	" $1,324.68 "	" $1,324.68 "	 $389.83 	 $993.51 	" $1,340.45 "	" $1,088.13 "	" $1,261.60 "	 $378.48 	" $1,419.30 "	" $1,282.10 "	" $1,340.45 "	 $375.33 	" $1,282.10 "	 $378.48 
310013	HCHG BLOOD TRANSFUSION 6 TO 8	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $2,200.00 "	" $1,540.00 "	 $523.60 	" $1,980.00 "	" $1,914.00 "	 $528.00 	" $1,683.00 "	" $1,848.00 "	" $1,848.00 "	 $543.84 	" $1,386.00 "	" $1,870.00 "	" $1,518.00 "	" $1,760.00 "	 $528.00 	" $1,980.00 "	" $1,788.60 "	" $1,870.00 "	 $523.60 	" $1,788.60 "	 $528.00 
310014	HCHG BLOOD TRANSFUSION 8 TO 10 HR	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $2,500.00 "	" $1,750.00 "	 $595.00 	" $2,250.00 "	" $2,175.00 "	 $600.00 	" $1,912.50 "	" $2,100.00 "	" $2,100.00 "	 $618.00 	" $1,575.00 "	" $2,125.00 "	" $1,725.00 "	" $2,000.00 "	 $600.00 	" $2,250.00 "	" $2,032.50 "	" $2,125.00 "	 $595.00 	" $2,032.50 "	 $600.00 
310023	HCHG CVMC BLOOD TRANSFUSION 1ST HOUR	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	 $930.00 	 $651.00 	 $221.34 	 $837.00 	 $809.10 	 $223.20 	 $711.45 	 $781.20 	 $781.20 	 $229.90 	 $585.90 	 $790.50 	 $641.70 	 $744.00 	 $223.20 	 $837.00 	 $756.09 	 $790.50 	 $221.34 	 $756.09 	 $223.20 
310024	HCHG CVMC BLOOD TRANSFUSION > 1HR TO 4 HRS.	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $1,310.00 "	 $917.00 	 $311.78 	" $1,179.00 "	" $1,139.70 "	 $314.40 	" $1,002.15 "	" $1,100.40 "	" $1,100.40 "	 $323.83 	 $825.30 	" $1,113.50 "	 $903.90 	" $1,048.00 "	 $314.40 	" $1,179.00 "	" $1,065.03 "	" $1,113.50 "	 $311.78 	" $1,065.03 "	 $314.40 
310025	HCHG CVMC BLOOD TRANSFUSION 4 TO 6 HOURS	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $1,740.00 "	" $1,218.00 "	 $414.12 	" $1,566.00 "	" $1,513.80 "	 $417.60 	" $1,331.10 "	" $1,461.60 "	" $1,461.60 "	 $430.13 	" $1,096.20 "	" $1,479.00 "	" $1,200.60 "	" $1,392.00 "	 $417.60 	" $1,566.00 "	" $1,414.62 "	" $1,479.00 "	 $414.12 	" $1,414.62 "	 $417.60 
310026	HCHG CVMC BLOOD TRANSFUSION 6 TO 8 HOURS	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $2,103.00 "	" $1,472.10 "	 $500.51 	" $1,892.70 "	" $1,829.61 "	 $504.72 	" $1,608.80 "	" $1,766.52 "	" $1,766.52 "	 $519.86 	" $1,324.89 "	" $1,787.55 "	" $1,451.07 "	" $1,682.40 "	 $504.72 	" $1,892.70 "	" $1,709.74 "	" $1,787.55 "	 $500.51 	" $1,709.74 "	 $504.72 
310027	HCHG BLOOD TRANSFUSION 8 TO 10 HR	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $2,500.00 "	" $1,750.00 "	 $595.00 	" $2,250.00 "	" $2,175.00 "	 $600.00 	" $1,912.50 "	" $2,100.00 "	" $2,100.00 "	 $618.00 	" $1,575.00 "	" $2,125.00 "	" $1,725.00 "	" $2,000.00 "	 $600.00 	" $2,250.00 "	" $2,032.50 "	" $2,125.00 "	 $595.00 	" $2,032.50 "	 $600.00 
310086	HCHG CVMC BLOOD 1ST HR UP TO 60 MIN.	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	 $841.00 	 $588.70 	 $200.16 	 $756.90 	 $731.67 	 $201.84 	 $643.37 	 $706.44 	 $706.44 	 $207.90 	 $529.83 	 $714.85 	 $580.29 	 $672.80 	 $201.84 	 $756.90 	 $683.73 	 $714.85 	 $200.16 	 $683.73 	 $201.84 
310087	HCHG CVMC BLOOD TRANSFUSION >1HR TO 4HRS	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $1,190.00 "	 $833.00 	 $283.22 	" $1,071.00 "	" $1,035.30 "	 $285.60 	 $910.35 	 $999.60 	 $999.60 	 $294.17 	 $749.70 	" $1,011.50 "	 $821.10 	 $952.00 	 $285.60 	" $1,071.00 "	 $967.47 	" $1,011.50 "	 $283.22 	 $967.47 	 $285.60 
310088	HCHG CVMC BLOOD TRANSFUSION 4-6 HRS.	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $1,577.00 "	" $1,103.90 "	 $375.33 	" $1,419.30 "	" $1,371.99 "	 $378.48 	" $1,206.41 "	" $1,324.68 "	" $1,324.68 "	 $389.83 	 $993.51 	" $1,340.45 "	" $1,088.13 "	" $1,261.60 "	 $378.48 	" $1,419.30 "	" $1,282.10 "	" $1,340.45 "	 $375.33 	" $1,282.10 "	 $378.48 
310089	HCHG CVMC BLOOD TRANSFUSION 6 TO 8 HOURS	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $2,103.00 "	" $1,472.10 "	 $500.51 	" $1,892.70 "	" $1,829.61 "	 $504.72 	" $1,608.80 "	" $1,766.52 "	" $1,766.52 "	 $519.86 	" $1,324.89 "	" $1,787.55 "	" $1,451.07 "	" $1,682.40 "	 $504.72 	" $1,892.70 "	" $1,709.74 "	" $1,787.55 "	 $500.51 	" $1,709.74 "	 $504.72 
310090	HCHG CVMC BLOOD TRANSFUSION >8 HOURS	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	" $2,500.00 "	" $1,750.00 "	 $595.00 	" $2,250.00 "	" $2,175.00 "	 $600.00 	" $1,912.50 "	" $2,100.00 "	" $2,100.00 "	 $618.00 	" $1,575.00 "	" $2,125.00 "	" $1,725.00 "	" $2,000.00 "	 $600.00 	" $2,250.00 "	" $2,032.50 "	" $2,125.00 "	 $595.00 	" $2,032.50 "	 $600.00 
343223	HCHG CVMC BLOOD TRANSFUSION HOUR	0391	"ADMINISTRATION, PROCESSING, AND STORAGE FOR BLOOD AND BLOOD COMPONENTS - ADMINISTRATION (E.G., TRANS"	36430	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
305840	HCHG DX MAMMO UNILATERAL W/WO CAD	0401	OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY	77065	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $71.69 	 $182.70 	 $246.50 	 $200.10 	 $232.00 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
305841	HCHG DX MAMMO BILAT W/WO CAD	0401	OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY	77066	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $98.88 	 $252.00 	 $340.00 	 $276.00 	 $320.00 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
4400949	HCHG DIAG BREAST TOMOSYNTHESIS UNI-BIL	0401	OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY	G0279	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
4410525	HCHG BX BREAST 1ST LESION STRTCTC	0401	OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY	19081	" $3,560.25 "	" $2,492.18 "	 $847.34 	" $3,204.23 "	" $3,097.42 "	 $854.46 	" $2,723.59 "	" $2,990.61 "	" $2,990.61 "	 $880.09 	" $2,242.96 "	" $3,026.21 "	" $2,456.57 "	" $2,848.20 "	 $854.46 	" $3,204.23 "	" $2,894.48 "	" $3,026.21 "	 $847.34 	" $2,894.48 "	 $854.46 
4410526	HCHG BX BREAST ADD LESION STRTCTC	0401	OTHER IMAGING SERVICES - DIAGNOSTIC MAMMOGRAPHY	19082	" $2,503.79 "	" $1,752.65 "	 $595.90 	" $2,253.41 "	" $2,178.30 "	 $600.91 	" $1,915.40 "	" $2,103.18 "	" $2,103.18 "	 $618.94 	" $1,577.39 "	" $2,128.22 "	" $1,727.62 "	" $2,003.03 "	 $600.91 	" $2,253.41 "	" $2,035.58 "	" $2,128.22 "	 $595.90 	" $2,035.58 "	 $600.91 
302989	HCHG ULTRASOUND NERVES 1 EXTR INCL IMAG	0402	OTHER IMAGING SERVICES - ULTRASOUND	76883	" $1,000.00 "	 $700.00 	 $238.00 	 $900.00 	 $870.00 	 $240.00 	 $765.00 	 $840.00 	 $840.00 	 $240.00 	 $630.00 	 $850.00 	 $690.00 	 $800.00 	 $240.00 	 $900.00 	 $813.00 	 $850.00 	 $238.00 	 $813.00 	 $240.00 
305843	HCHG US ABDOMINAL AORTA SCREEN AAA	0402	OTHER IMAGING SERVICES - ULTRASOUND	76706	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $84.00 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
4400119	"HCHG ABDOM,B-SCAN &/OR REAL TIME,C*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76700	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
4400120	HCHG ABDOMEN LIMITED	0402	OTHER IMAGING SERVICES - ULTRASOUND	76705	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $148.32 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
4400220	"HCHG CHEST,REAL TIME"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76604	" $1,010.00 "	 $707.00 	 $240.38 	 $909.00 	 $878.70 	 $242.40 	 $772.65 	 $848.40 	 $848.40 	 $249.67 	 $636.30 	 $858.50 	 $696.90 	 $808.00 	 $242.40 	 $909.00 	 $821.13 	 $858.50 	 $240.38 	 $821.13 	 $242.40 
4400310	"HCHG ECHO,SCROTUM & CONTENTS"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76870	 $750.00 	 $525.00 	 $178.50 	 $675.00 	 $652.50 	 $180.00 	 $573.75 	 $630.00 	 $630.00 	 $185.40 	 $472.50 	 $637.50 	 $517.50 	 $600.00 	 $180.00 	 $675.00 	 $609.75 	 $637.50 	 $178.50 	 $609.75 	 $180.00 
4400311	"HCHG ECHO,TRANSRECTAL"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76872	" $1,531.91 "	" $1,072.34 "	 $364.59 	" $1,378.72 "	" $1,332.76 "	 $367.66 	" $1,171.91 "	" $1,286.80 "	" $1,286.80 "	 $378.69 	 $965.10 	" $1,302.12 "	" $1,057.02 "	" $1,225.53 "	 $367.66 	" $1,378.72 "	" $1,245.44 "	" $1,302.12 "	 $364.59 	" $1,245.44 "	 $367.66 
4400313	"HCHG ECHOGRAPHY,TRANSVAGINAL"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76830	 $900.00 	 $630.00 	 $214.20 	 $810.00 	 $783.00 	 $216.00 	 $688.50 	 $756.00 	 $756.00 	 $222.48 	 $567.00 	 $765.00 	 $621.00 	 $720.00 	 $216.00 	 $810.00 	 $731.70 	 $765.00 	 $214.20 	 $731.70 	 $216.00 
4400325	HCHG FETAL BIOPHYSICAL PROFILE WO NST	0402	OTHER IMAGING SERVICES - ULTRASOUND	76819	 $732.59 	 $512.81 	 $174.36 	 $659.33 	 $637.35 	 $175.82 	 $560.43 	 $615.38 	 $615.38 	 $181.10 	 $461.53 	 $622.70 	 $505.49 	 $586.07 	 $175.82 	 $659.33 	 $595.60 	 $622.70 	 $174.36 	 $595.60 	 $175.82 
4400339	"HCHG HEAD, REAL TIME"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76506	" $1,084.02 "	 $758.81 	 $258.00 	 $975.62 	 $943.10 	 $260.16 	 $829.28 	 $910.58 	 $910.58 	 $267.97 	 $682.93 	 $921.42 	 $747.97 	 $867.22 	 $260.16 	 $975.62 	 $881.31 	 $921.42 	 $258.00 	 $881.31 	 $260.16 
4400340	"HCHG HEAD/NECK TISSUES,REAL TIME"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76536	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
4400503	"HCHG OB < 14 WKS, ADD'L FETUS"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76802	 $930.00 	 $651.00 	 $221.34 	 $837.00 	 $809.10 	 $223.20 	 $711.45 	 $781.20 	 $781.20 	 $223.20 	 $585.90 	 $790.50 	 $641.70 	 $744.00 	 $223.20 	 $837.00 	 $756.09 	 $790.50 	 $221.34 	 $756.09 	 $223.20 
4400504	"HCHG OB < 14 WKS, SINGLE FETUS"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76801	" $1,110.00 "	 $777.00 	 $264.18 	 $999.00 	 $965.70 	 $266.40 	 $849.15 	 $932.40 	 $932.40 	 $266.40 	 $699.30 	 $943.50 	 $765.90 	 $888.00 	 $266.40 	 $999.00 	 $902.43 	 $943.50 	 $264.18 	 $902.43 	 $266.40 
4400505	"HCHG OB >/= 14 WKS, ADDL FETUS"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76810	" $2,183.79 "	" $1,528.65 "	 $519.74 	" $1,965.41 "	" $1,899.90 "	 $524.11 	" $1,670.60 "	" $1,834.38 "	" $1,834.38 "	 $524.11 	" $1,375.79 "	" $1,856.22 "	" $1,506.82 "	" $1,747.03 "	 $524.11 	" $1,965.41 "	" $1,775.42 "	" $1,856.22 "	 $519.74 	" $1,775.42 "	 $524.11 
4400506	"HCHG OB >/= 14 WKS, SNGL FETUS"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76805	" $1,210.41 "	 $847.29 	 $288.08 	" $1,089.37 "	" $1,053.06 "	 $290.50 	 $925.96 	" $1,016.74 "	" $1,016.74 "	 $290.50 	 $762.56 	" $1,028.85 "	 $835.18 	 $968.33 	 $290.50 	" $1,089.37 "	 $984.06 	" $1,028.85 "	 $288.08 	 $984.06 	 $290.50 
4400568	"HCHG RAD GUIDED,PERCUT DRAINAGE,W/*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	75989	" $1,712.00 "	" $1,198.40 "	 $407.46 	" $1,540.80 "	" $1,489.44 "	 $410.88 	" $1,309.68 "	" $1,438.08 "	" $1,438.08 "	 $410.88 	" $1,078.56 "	" $1,455.20 "	" $1,181.28 "	" $1,369.60 "	 $410.88 	" $1,540.80 "	" $1,391.86 "	" $1,455.20 "	 $407.46 	" $1,391.86 "	 $410.88 
4400594	"HCHG RETROPERITNL ABD,  LTD"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76775	 $500.00 	 $350.00 	 $119.00 	 $450.00 	 $435.00 	 $120.00 	 $382.50 	 $420.00 	 $420.00 	 $120.00 	 $315.00 	 $425.00 	 $345.00 	 $400.00 	 $120.00 	 $450.00 	 $406.50 	 $425.00 	 $119.00 	 $406.50 	 $120.00 
4400600	HCHG US GUIDANCE FOR AMNIOCENTESIS	0402	OTHER IMAGING SERVICES - ULTRASOUND	76946	 $788.01 	 $551.61 	 $187.55 	 $709.21 	 $685.57 	 $189.12 	 $602.83 	 $661.93 	 $661.93 	 $189.12 	 $496.45 	 $669.81 	 $543.73 	 $630.41 	 $189.12 	 $709.21 	 $640.65 	 $669.81 	 $187.55 	 $640.65 	 $189.12 
4400603	HCHG US GUIDANCE FOR NEEDLE PLACEMENT	0402	OTHER IMAGING SERVICES - ULTRASOUND	76942	 $650.00 	 $455.00 	 $154.70 	 $585.00 	 $565.50 	 $156.00 	 $497.25 	 $546.00 	 $546.00 	 $156.00 	 $409.50 	 $552.50 	 $448.50 	 $520.00 	 $156.00 	 $585.00 	 $528.45 	 $552.50 	 $154.70 	 $528.45 	 $156.00 
4400607	HCHG SPINAL CANAL & CONTENTS	0402	OTHER IMAGING SERVICES - ULTRASOUND	76800	" $1,436.39 "	" $1,005.47 "	 $341.86 	" $1,292.75 "	" $1,249.66 "	 $344.73 	" $1,098.84 "	" $1,206.57 "	" $1,206.57 "	 $344.73 	 $904.93 	" $1,220.93 "	 $991.11 	" $1,149.11 "	 $344.73 	" $1,292.75 "	" $1,167.79 "	" $1,220.93 "	 $341.86 	" $1,167.79 "	 $344.73 
4400642	HCHG US GUIDANCE INTRAOPERATIVE	0402	OTHER IMAGING SERVICES - ULTRASOUND	76998	" $1,772.55 "	" $1,240.79 "	 $421.87 	" $1,595.30 "	" $1,542.12 "	 $425.41 	" $1,356.00 "	" $1,488.94 "	" $1,488.94 "	 $425.41 	" $1,116.71 "	" $1,506.67 "	" $1,223.06 "	" $1,418.04 "	 $425.41 	" $1,595.30 "	" $1,441.08 "	" $1,506.67 "	 $421.87 	" $1,441.08 "	 $425.41 
4400651	"HCHG US GUID,COMP REPAIR,PSEUDO-AN*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76936	" $1,080.00 "	 $756.00 	 $257.04 	 $972.00 	 $939.60 	 $259.20 	 $826.20 	 $907.20 	 $907.20 	 $259.20 	 $680.40 	 $918.00 	 $745.20 	 $864.00 	 $259.20 	 $972.00 	 $878.04 	 $918.00 	 $257.04 	 $878.04 	 $259.20 
4400653	HCHG US GUIDANCE FOR VASCULAR ACCESS	0402	OTHER IMAGING SERVICES - ULTRASOUND	76937	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
4400657	"HCHG US,PELVIC (NONOBSTETRIC),REAL*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76856	 $750.00 	 $525.00 	 $178.50 	 $675.00 	 $652.50 	 $180.00 	 $573.75 	 $630.00 	 $630.00 	 $180.00 	 $472.50 	 $637.50 	 $517.50 	 $600.00 	 $180.00 	 $675.00 	 $609.75 	 $637.50 	 $178.50 	 $609.75 	 $180.00 
4400658	"HCHG US,PELVIC (NONOBSTETRIC),REAL*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76857	 $570.00 	 $399.00 	 $135.66 	 $513.00 	 $495.90 	 $136.80 	 $436.05 	 $478.80 	 $478.80 	 $136.80 	 $359.10 	 $484.50 	 $393.30 	 $456.00 	 $136.80 	 $513.00 	 $463.41 	 $484.50 	 $135.66 	 $463.41 	 $136.80 
4400659	"HCHG US,PREG UTER,FET & MAT,+ DETL*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76811	" $2,260.00 "	" $1,582.00 "	 $537.88 	" $2,034.00 "	" $1,966.20 "	 $542.40 	" $1,728.90 "	" $1,898.40 "	" $1,898.40 "	 $542.40 	" $1,423.80 "	" $1,921.00 "	" $1,559.40 "	" $1,808.00 "	 $542.40 	" $2,034.00 "	" $1,837.38 "	" $1,921.00 "	 $537.88 	" $1,837.38 "	 $542.40 
4400660	"HCHG US,PREG UTER,FET & MAT,+ DETL*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76812	" $1,479.00 "	" $1,035.30 "	 $352.00 	" $1,331.10 "	" $1,286.73 "	 $354.96 	" $1,131.44 "	" $1,242.36 "	" $1,242.36 "	 $354.96 	 $931.77 	" $1,257.15 "	" $1,020.51 "	" $1,183.20 "	 $354.96 	" $1,331.10 "	" $1,202.43 "	" $1,257.15 "	 $352.00 	" $1,202.43 "	 $354.96 
4400661	"HCHG US,PREGNANT UTERUS,F/U,TRANSA*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76816	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $310.50 	 $360.00 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
4400662	"HCHG US,PREGNANT UTERUS,LIMITED, 1*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76815	 $960.00 	 $672.00 	 $228.48 	 $864.00 	 $835.20 	 $230.40 	 $734.40 	 $806.40 	 $806.40 	 $230.40 	 $604.80 	 $816.00 	 $662.40 	 $768.00 	 $230.40 	 $864.00 	 $780.48 	 $816.00 	 $228.48 	 $780.48 	 $230.40 
4400663	"HCHG US,PREGNANT UTERUS,TRANSVAGIN*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76817	 $960.00 	 $672.00 	 $228.48 	 $864.00 	 $835.20 	 $230.40 	 $734.40 	 $806.40 	 $806.40 	 $230.40 	 $604.80 	 $816.00 	 $662.40 	 $768.00 	 $230.40 	 $864.00 	 $780.48 	 $816.00 	 $228.48 	 $780.48 	 $230.40 
4400664	"HCHG US,RETROPERIT,REAL TIME,COMPL*"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76770	 $770.00 	 $539.00 	 $183.26 	 $693.00 	 $669.90 	 $184.80 	 $589.05 	 $646.80 	 $646.80 	 $184.80 	 $485.10 	 $654.50 	 $531.30 	 $616.00 	 $184.80 	 $693.00 	 $626.01 	 $654.50 	 $183.26 	 $626.01 	 $184.80 
4400665	"HCHG US,TRANSPLANTED KIDNEY, REAL TIME/ DOPPLER"	0402	OTHER IMAGING SERVICES - ULTRASOUND	76776	 $709.50 	 $496.65 	 $168.86 	 $638.55 	 $617.27 	 $170.28 	 $542.77 	 $595.98 	 $595.98 	 $170.28 	 $446.99 	 $603.08 	 $489.56 	 $567.60 	 $170.28 	 $638.55 	 $576.82 	 $603.08 	 $168.86 	 $576.82 	 $170.28 
4400840	HCHG US COMPL JOINT RT W/IMAGE DOC	0402	OTHER IMAGING SERVICES - ULTRASOUND	76881	 $720.00 	 $504.00 	 $171.36 	 $648.00 	 $626.40 	 $172.80 	 $550.80 	 $604.80 	 $604.80 	 $172.80 	 $453.60 	 $612.00 	 $496.80 	 $576.00 	 $172.80 	 $648.00 	 $585.36 	 $612.00 	 $171.36 	 $585.36 	 $172.80 
4400841	HCHG US LTD JOINT OR OTHER NON VAS RT W/IMAGE DOC	0402	OTHER IMAGING SERVICES - ULTRASOUND	76882	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
4410527	HCHG BX BREAST 1ST LESION US IMAG	0402	OTHER IMAGING SERVICES - ULTRASOUND	19083	" $4,330.00 "	" $3,031.00 "	" $1,030.54 "	" $3,897.00 "	" $3,767.10 "	" $1,039.20 "	" $3,312.45 "	" $3,637.20 "	" $3,283.00 "	" $1,070.38 "	" $2,727.90 "	" $3,680.50 "	" $2,987.70 "	" $3,464.00 "	" $1,039.20 "	" $3,897.00 "	" $3,520.29 "	" $3,680.50 "	" $1,030.54 "	" $3,520.29 "	" $1,039.20 "
4410528	HCHG BX BREAST ADD LESION US IMAG	0402	OTHER IMAGING SERVICES - ULTRASOUND	19084	" $1,350.00 "	 $945.00 	 $321.30 	" $1,215.00 "	" $1,174.50 "	 $324.00 	" $1,032.75 "	" $1,134.00 "	" $1,134.00 "	 $333.72 	 $850.50 	" $1,147.50 "	 $931.50 	" $1,080.00 "	 $324.00 	" $1,215.00 "	" $1,097.55 "	" $1,147.50 "	 $321.30 	" $1,097.55 "	 $324.00 
4410531	HCHG PERQ DEVICE BREAST 1ST IMAG	0402	OTHER IMAGING SERVICES - ULTRASOUND	19281	" $2,375.25 "	" $1,662.68 "	 $565.31 	" $2,137.73 "	" $2,066.47 "	 $570.06 	" $1,817.07 "	" $1,995.21 "	" $1,995.21 "	 $570.06 	" $1,496.41 "	" $2,018.96 "	" $1,638.92 "	" $1,900.20 "	 $570.06 	" $2,137.73 "	" $1,931.08 "	" $2,018.96 "	 $565.31 	" $1,931.08 "	 $570.06 
4410532	HCHG PERQ DEVICE BREAST EA IMAG	0402	OTHER IMAGING SERVICES - ULTRASOUND	19282	" $1,087.63 "	 $761.34 	 $258.86 	 $978.87 	 $946.24 	 $261.03 	 $832.04 	 $913.61 	 $913.61 	 $261.03 	 $685.21 	 $924.49 	 $750.46 	 $870.10 	 $261.03 	 $978.87 	 $884.24 	 $924.49 	 $258.86 	 $884.24 	 $261.03 
4410533	HCHG PERQ DEV BREAST 1ST STRTCTC	0402	OTHER IMAGING SERVICES - ULTRASOUND	19283	" $2,375.25 "	" $1,662.68 "	 $565.31 	" $2,137.73 "	" $2,066.47 "	 $570.06 	" $1,817.07 "	" $1,995.21 "	" $1,995.21 "	 $570.06 	" $1,496.41 "	" $2,018.96 "	" $1,638.92 "	" $1,900.20 "	 $570.06 	" $2,137.73 "	" $1,931.08 "	" $2,018.96 "	 $565.31 	" $1,931.08 "	 $570.06 
4410534	HCHG PERQ DEV BREAST ADD STRTCTC	0402	OTHER IMAGING SERVICES - ULTRASOUND	19284	" $1,087.63 "	 $761.34 	 $258.86 	 $978.87 	 $946.24 	 $261.03 	 $832.04 	 $913.61 	 $913.61 	 $261.03 	 $685.21 	 $924.49 	 $750.46 	 $870.10 	 $261.03 	 $978.87 	 $884.24 	 $924.49 	 $258.86 	 $884.24 	 $261.03 
4410535	HCHG PERQ DEV BREAST 1ST US IMAG	0402	OTHER IMAGING SERVICES - ULTRASOUND	19285	" $1,780.00 "	" $1,246.00 "	 $423.64 	" $1,602.00 "	" $1,548.60 "	 $427.20 	" $1,361.70 "	" $1,495.20 "	" $1,495.20 "	 $427.20 	" $1,121.40 "	" $1,513.00 "	" $1,228.20 "	" $1,424.00 "	 $427.20 	" $1,602.00 "	" $1,447.14 "	" $1,513.00 "	 $423.64 	" $1,447.14 "	 $427.20 
4410536	HCHG PERQ DEV BREAST ADD US IMAG	0402	OTHER IMAGING SERVICES - ULTRASOUND	19286	" $1,090.00 "	 $763.00 	 $259.42 	 $981.00 	 $948.30 	 $261.60 	 $833.85 	 $915.60 	 $915.60 	 $261.60 	 $686.70 	 $926.50 	 $752.10 	 $872.00 	 $261.60 	 $981.00 	 $886.17 	 $926.50 	 $259.42 	 $886.17 	 $261.60 
4410553	HCHG ULTRASOUND BREAST COMPLETE	0402	OTHER IMAGING SERVICES - ULTRASOUND	76641	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $296.70 	 $344.00 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
4410554	HCHG ULTRASOUND BREAST LIMITED	0402	OTHER IMAGING SERVICES - ULTRASOUND	76642	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $84.00 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
305842	HCHG SCREENING MAMMO BILAT W/WO CAD	0403	OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY	77067	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $81.60 	 $214.20 	 $289.00 	 $234.60 	 $272.00 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
305844	HCHG SCRN MAMMO UNI W/WO CAD (52MOD)	0403	OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY	77067	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $81.60 	 $214.20 	 $289.00 	 $234.60 	 $272.00 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
305848	HCHG SCR BREAST TOMOSYNTHESIS UNI(52MOD)	0403	OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY	77063	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $62.10 	 $72.00 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
4400948	HCHG SCRN BREAST TOMOSYNTHESIS BILAT	0403	OTHER IMAGING SERVICES - SCREENING MAMMOGRAPHY	77063	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $62.10 	 $72.00 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
302827	HCHG ARTERIAL PUNCTURE-BLOOD DX	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	36600	 $230.00 	 $161.00 	 $54.74 	 $207.00 	 $200.10 	 $55.20 	 $175.95 	 $193.20 	 $193.20 	 $56.86 	 $144.90 	 $195.50 	 $158.70 	 $184.00 	 $55.20 	 $207.00 	 $186.99 	 $195.50 	 $54.74 	 $186.99 	 $55.20 
303172	HCHG CHEST PHYSIOTHERAPY-PEP-INIT	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94667	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $46.97 	 $119.70 	 $161.50 	 $131.10 	 $152.00 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
303174	HCHG CHEST PHYSIOTHERAPY-SUBSQ	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94668	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $124.20 	 $144.00 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
303283	HCHG CPAP INITIATION/MANAGEMENT	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94660	" $1,060.00 "	 $742.00 	 $252.28 	 $954.00 	 $922.20 	 $254.40 	 $810.90 	 $890.40 	 $890.40 	 $262.03 	 $667.80 	 $901.00 	 $731.40 	 $848.00 	 $254.40 	 $954.00 	 $861.78 	 $901.00 	 $252.28 	 $861.78 	 $254.40 
303381	HCHG CVMC MASK CPAP/BIPAP SUBQ DAY	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94660	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
305669	HCHG VENTILATION(BIPAP)-FIRST DAY	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94002	" $3,000.00 "	" $2,100.00 "	 $714.00 	" $2,700.00 "	" $2,610.00 "	 $720.00 	" $2,295.00 "	" $2,520.00 "	" $2,520.00 "	 $720.00 	" $1,890.00 "	" $2,550.00 "	" $2,070.00 "	" $2,400.00 "	 $720.00 	" $2,700.00 "	" $2,439.00 "	" $2,550.00 "	 $714.00 	" $2,439.00 "	 $720.00 
305670	HCHG VENTILATION(BIPAP)-SUBSQ DAY	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94003	" $2,030.00 "	" $1,421.00 "	 $483.14 	" $1,827.00 "	" $1,766.10 "	 $487.20 	" $1,552.95 "	" $1,705.20 "	" $1,705.20 "	 $487.20 	" $1,278.90 "	" $1,725.50 "	" $1,400.70 "	" $1,624.00 "	 $487.20 	" $1,827.00 "	" $1,650.39 "	" $1,725.50 "	 $483.14 	" $1,650.39 "	 $487.20 
309070	HCHG CONT INHALATION TREATMENT W/MEDS 1ST HR	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94644	 $550.00 	 $385.00 	 $130.90 	 $495.00 	 $478.50 	 $132.00 	 $420.75 	 $462.00 	 $462.00 	 $135.96 	 $346.50 	 $467.50 	 $379.50 	 $440.00 	 $132.00 	 $495.00 	 $447.15 	 $467.50 	 $130.90 	 $447.15 	 $132.00 
309071	HCHG CONT INHALATION TREATMENT W/MED EA ADD HR	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94645	 $349.09 	 $244.36 	 $83.08 	 $314.18 	 $303.71 	 $83.78 	 $267.05 	 $293.24 	 $293.24 	 $86.30 	 $219.93 	 $296.73 	 $240.87 	 $279.27 	 $83.78 	 $314.18 	 $283.81 	 $296.73 	 $83.08 	 $283.81 	 $83.78 
310107	HCHG CVMC OXYGEN HOOD SET UP	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION		 $443.18 	 $310.23 	 $105.48 	 $398.86 	 $385.57 	 $106.36 	 $339.03 	 $372.27 	 $372.27 	 $109.55 	 $279.20 	 $376.70 	 $305.79 	 $354.54 	 $106.36 	 $398.86 	 $360.31 	 $376.70 	 $105.48 	 $360.31 	 $106.36 
310137	HCHG MECH CHEST WALL OSCIL PER/SESSION	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94669	 $372.00 	 $260.40 	 $88.54 	 $334.80 	 $323.64 	 $89.28 	 $284.58 	 $312.48 	 $312.48 	 $89.28 	 $234.36 	 $316.20 	 $256.68 	 $297.60 	 $89.28 	 $334.80 	 $302.44 	 $316.20 	 $88.54 	 $302.44 	 $89.28 
330670	HCHG CVMC HND HELD NEB INITIAL	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $203.14 	 $142.20 	 $48.35 	 $182.83 	 $176.73 	 $48.75 	 $155.40 	 $170.64 	 $170.64 	 $50.22 	 $127.98 	 $172.67 	 $140.17 	 $162.51 	 $48.75 	 $182.83 	 $165.15 	 $172.67 	 $48.35 	 $165.15 	 $48.75 
330671	HCHG CVMC IPPB TX INIT	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $225.98 	 $158.19 	 $53.78 	 $203.38 	 $196.60 	 $54.24 	 $172.87 	 $189.82 	 $189.82 	 $55.86 	 $142.37 	 $192.08 	 $155.93 	 $180.78 	 $54.24 	 $203.38 	 $183.72 	 $192.08 	 $53.78 	 $183.72 	 $54.24 
330923	HCHG CVMC AERO TX INLINE	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
330928	HCHG CVMC AIRWAY INHALATION TREATMENT	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $124.20 	 $144.00 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
330936	HCHG CVMC IPPB RX	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $294.00 	 $205.80 	 $69.97 	 $264.60 	 $255.78 	 $70.56 	 $224.91 	 $246.96 	 $246.96 	 $72.68 	 $185.22 	 $249.90 	 $202.86 	 $235.20 	 $70.56 	 $264.60 	 $239.02 	 $249.90 	 $69.97 	 $239.02 	 $70.56 
330937	HCHG CVMC INHALER INITIAL	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94664	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $213.90 	 $248.00 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
330964	HCHG CVMC BREATH ACTIVATED NEBULIZER INITIAL	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $400.00 	 $280.00 	 $95.20 	 $360.00 	 $348.00 	 $96.00 	 $306.00 	 $336.00 	 $336.00 	 $98.88 	 $252.00 	 $340.00 	 $276.00 	 $320.00 	 $96.00 	 $360.00 	 $325.20 	 $340.00 	 $95.20 	 $325.20 	 $96.00 
330965	HCHG CVMC USN INITIAL	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94664	 $486.57 	 $340.60 	 $115.80 	 $437.91 	 $423.32 	 $116.78 	 $372.23 	 $408.72 	 $408.72 	 $120.28 	 $306.54 	 $413.58 	 $335.73 	 $389.26 	 $116.78 	 $437.91 	 $395.58 	 $413.58 	 $115.80 	 $395.58 	 $116.78 
330970	HCHG CVMC MDI DOSE TITRATION	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $615.03 	 $430.52 	 $146.38 	 $553.53 	 $535.08 	 $147.61 	 $470.50 	 $516.63 	 $516.63 	 $152.04 	 $387.47 	 $522.78 	 $424.37 	 $492.02 	 $147.61 	 $553.53 	 $500.02 	 $522.78 	 $146.38 	 $500.02 	 $147.61 
330980	HCHG CVMC CONTINUOUS NEB < 1 HOUR	0410	RESPIRATORY SERVICES - GENERAL CLASSIFICATION	94640	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $148.32 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
303268	HCHG CONTRAST BATHS EA 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97034	 $78.57 	 $55.00 	 $18.70 	 $70.71 	 $68.36 	 $18.86 	 $60.11 	 $66.00 	 $66.00 	 $19.42 	 $49.50 	 $66.78 	 $54.21 	 $62.86 	 $18.86 	 $70.71 	 $63.88 	 $66.78 	 $18.70 	 $63.88 	 $18.86 
304204	HCHG IONTOPHORESIS EA 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97033	 $71.00 	 $49.70 	 $16.90 	 $63.90 	 $61.77 	 $17.04 	 $54.32 	 $59.64 	 $59.64 	 $17.55 	 $44.73 	 $60.35 	 $48.99 	 $56.80 	 $17.04 	 $63.90 	 $57.72 	 $60.35 	 $16.90 	 $57.72 	 $17.04 
304362	HCHG MASSAGE	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97124	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $82.80 	 $96.00 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
304365	HCHG MECHANICAL TRACTION - PT	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97012	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $62.10 	 $72.00 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
305189	HCHG SENSORY INT TCHNQS 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97533	 $95.00 	 $66.50 	 $22.61 	 $85.50 	 $82.65 	 $22.80 	 $72.68 	 $79.80 	 $79.80 	 $22.80 	 $59.85 	 $80.75 	 $65.55 	 $76.00 	 $22.80 	 $85.50 	 $77.24 	 $80.75 	 $22.61 	 $77.24 	 $22.80 
305599	HCHG ULTRASOUND PER 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97035	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.40 	 $37.80 	 $51.00 	 $41.40 	 $48.00 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
305651	HCHG VASOPNEUMATIC PUMP THERAPY	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97016	 $117.44 	 $82.21 	 $27.95 	 $105.70 	 $102.17 	 $28.19 	 $89.84 	 $98.65 	 $98.65 	 $28.19 	 $73.99 	 $99.82 	 $81.03 	 $93.95 	 $28.19 	 $105.70 	 $95.48 	 $99.82 	 $27.95 	 $95.48 	 $28.19 
305772	HCHG INIT PROSTHETIC TRAINING EA 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97761	 $154.05 	 $107.84 	 $36.66 	 $138.65 	 $134.02 	 $36.97 	 $117.85 	 $129.40 	 $129.40 	 $38.08 	 $97.05 	 $130.94 	 $106.29 	 $123.24 	 $36.97 	 $138.65 	 $125.24 	 $130.94 	 $36.66 	 $125.24 	 $36.97 
305773	HCHG E STIM-UNATTENDED-NON WND CAR*	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97014	 $60.00 	 $42.00 	 $14.28 	 $54.00 	 $52.20 	 $14.40 	 $45.90 	 $50.40 	 $50.40 	 $14.83 	 $37.80 	 $51.00 	 $41.40 	 $48.00 	 $14.40 	 $54.00 	 $48.78 	 $51.00 	 $14.28 	 $48.78 	 $14.40 
305775	HCHG STERILE WHIRLPOOL-M59	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97022	 $265.25 	 $185.68 	 $63.13 	 $238.73 	 $230.77 	 $63.66 	 $202.92 	 $222.81 	 $222.81 	 $63.66 	 $167.11 	 $225.46 	 $183.02 	 $212.20 	 $63.66 	 $238.73 	 $215.65 	 $225.46 	 $63.13 	 $215.65 	 $63.66 
305777	HCHG THERAPEUTIC EXERCISE EA 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97110	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $110.40 	 $128.00 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
305778	HCHG INITIAL ORTHOTIC TRAINING EA 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97760	 $173.00 	 $121.10 	 $41.17 	 $155.70 	 $150.51 	 $41.52 	 $132.35 	 $145.32 	 $145.32 	 $42.77 	 $108.99 	 $147.05 	 $119.37 	 $138.40 	 $41.52 	 $155.70 	 $140.65 	 $147.05 	 $41.17 	 $140.65 	 $41.52 
305782	HCHG THERAPEUTIC ACTIVITIES 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97530	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $36.00 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
305783	HCHG WHEELCHAIR MAIN/PROP TRNG 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97542	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $38.40 	 $100.80 	 $136.00 	 $110.40 	 $128.00 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
305789	HCHG GAIT TRAINING-M59	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97116	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $96.60 	 $112.00 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
305846	HCHG SUBSQ PROS/ORTHO TRAINING EA 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97763	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $69.00 	 $80.00 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
305919	HCHG MANUAL THERAPY TECHNIQUE 15MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97140	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $96.60 	 $112.00 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
343267	HCHG CVMC CANALITH REPOSITIONING	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	95992	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $69.00 	 $80.00 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
343272	HCHG CVMC PHYSICAL PERFORMANCE TEST-PER 15 MIN	0420	PHYSICAL THERAPY - GENERAL CLASSIFICATION	97750	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $34.61 	 $88.20 	 $119.00 	 $96.60 	 $112.00 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
307203	HCHG PT EVAL LOW COMPLEX 20 MIN	0424	PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION	97161	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $159.60 	 $159.60 	 $45.60 	 $119.70 	 $161.50 	 $131.10 	 $152.00 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
307204	HCHG PT EVAL MOD COMPLEX 30 MIN	0424	PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION	97162	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $69.60 	 $182.70 	 $246.50 	 $200.10 	 $232.00 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
307205	HCHG PT EVAL HIGH COMPLEX 45 MIN	0424	PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION	97163	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $88.80 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
307206	HCHG PT RE-EVAL EST PLAN CARE	0424	PHYSICAL THERAPY - EVALUATION OR RE-EVALUATION	97164	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $96.60 	 $112.00 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
305776	HCHG COMMUNITY WORK REINTEGRATE15MIN	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97537	 $97.86 	 $68.50 	 $23.29 	 $88.07 	 $85.14 	 $23.49 	 $74.86 	 $82.20 	 $82.20 	 $24.19 	 $61.65 	 $83.18 	 $67.52 	 $78.29 	 $23.49 	 $88.07 	 $79.56 	 $83.18 	 $23.29 	 $79.56 	 $23.49 
305787	HCHG SELF CARE ADL TRAINING 15 MIN	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97535	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $96.60 	 $112.00 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
305797	HCHG AQUATIC THERAPY-M59	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97113	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
305798	HCHG NEUROMUSCULAR RE-EDUCATION-M59	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97112	 $140.00 	 $98.00 	 $33.32 	 $126.00 	 $121.80 	 $33.60 	 $107.10 	 $117.60 	 $117.60 	 $33.60 	 $88.20 	 $119.00 	 $96.60 	 $112.00 	 $33.60 	 $126.00 	 $113.82 	 $119.00 	 $33.32 	 $113.82 	 $33.60 
305799	HCHG PARAFFIN TREATMENT-M59	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97018	 $70.00 	 $49.00 	 $16.66 	 $63.00 	 $60.90 	 $16.80 	 $53.55 	 $58.80 	 $58.80 	 $16.80 	 $44.10 	 $59.50 	 $48.30 	 $56.00 	 $16.80 	 $63.00 	 $56.91 	 $59.50 	 $16.66 	 $56.91 	 $16.80 
343082	HCHG SELF CARE MANAGEMENT TRAINING	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97535	 $95.00 	 $66.50 	 $22.61 	 $85.50 	 $82.65 	 $22.80 	 $72.68 	 $79.80 	 $79.80 	 $22.80 	 $59.85 	 $80.75 	 $65.55 	 $76.00 	 $22.80 	 $85.50 	 $77.24 	 $80.75 	 $22.61 	 $77.24 	 $22.80 
362241	HCHG COGNITIVE INTERVENTION FIRST 15 MIN	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97129	 $73.05 	 $51.14 	 $17.39 	 $65.75 	 $63.55 	 $17.53 	 $55.88 	 $61.36 	 $61.36 	 $18.06 	 $46.02 	 $62.09 	 $50.40 	 $58.44 	 $17.53 	 $65.75 	 $59.39 	 $62.09 	 $17.39 	 $59.39 	 $17.53 
362242	HCHG COGNITIVE INTERVENTION ADDL 15 MIN	0430	OCCUPATIONAL THERAPY - GENERAL CLASSIFICATION	97130	 $70.86 	 $49.60 	 $16.86 	 $63.77 	 $61.65 	 $17.01 	 $54.21 	 $59.52 	 $59.52 	 $17.52 	 $44.64 	 $60.23 	 $48.89 	 $56.69 	 $17.01 	 $63.77 	 $57.61 	 $60.23 	 $16.86 	 $57.61 	 $17.01 
307207	HCHG OT EVAL LOW COMPLEX 30 MIN	0434	OCCUPATIONAL THERAPY - EVALUATION OR REEVALUATION	97165	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $74.40 	 $195.30 	 $263.50 	 $213.90 	 $248.00 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
307208	HCHG OT EVAL MOD COMPLEX 45 MIN	0434	OCCUPATIONAL THERAPY - EVALUATION OR REEVALUATION	97166	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $84.00 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
307209	HCHG OT EVAL HIGH COMPLEX 60 MIN	0434	OCCUPATIONAL THERAPY - EVALUATION OR REEVALUATION	97167	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $88.80 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
307210	HCHG OT RE-EVAL EST PLAN CARE	0434	OCCUPATIONAL THERAPY - EVALUATION OR REEVALUATION	97168	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
302833	HCHG ASSESSMENT OF APHASIA PER HR	0440	SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION	96105	 $480.00 	 $336.00 	 $114.24 	 $432.00 	 $417.60 	 $115.20 	 $367.20 	 $403.20 	 $403.20 	 $118.66 	 $302.40 	 $408.00 	 $331.20 	 $384.00 	 $115.20 	 $432.00 	 $390.24 	 $408.00 	 $114.24 	 $390.24 	 $115.20 
304553	HCHG NONSPEECH GEN DEVICE TREATMENT	0440	SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION	92606	 $289.57 	 $202.70 	 $68.92 	 $260.61 	 $251.93 	 $69.50 	 $221.52 	 $243.24 	 $243.24 	 $69.50 	 $182.43 	 $246.13 	 $199.80 	 $231.66 	 $69.50 	 $260.61 	 $235.42 	 $246.13 	 $68.92 	 $235.42 	 $69.50 
305266	HCHG SPEECH GEN DEVICE TREATMENT	0440	SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION	92609	 $209.54 	 $146.68 	 $49.87 	 $188.59 	 $182.30 	 $50.29 	 $160.30 	 $176.01 	 $176.01 	 $50.29 	 $132.01 	 $178.11 	 $144.58 	 $167.63 	 $50.29 	 $188.59 	 $170.36 	 $178.11 	 $49.87 	 $170.36 	 $50.29 
305267	HCHG SPEECH LANG TX-INDIVIDUAL	0440	SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION	92507	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $64.80 	 $170.10 	 $229.50 	 $186.30 	 $216.00 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
305393	HCHG SWALLOWING DYSFUNCTION TREATMT	0440	SPEECH THERAPY - LANGUAGE PATHOLOGY - GENERAL CLASSIFICATION	92526	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $76.80 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
305268	HCHG SPEECH LANGUAGE TX-GROUP	0443	SPEECH THERAPY - LANGUAGE PATHOLOGY - GROUP	92508	 $143.53 	 $100.47 	 $34.16 	 $129.18 	 $124.87 	 $34.45 	 $109.80 	 $120.57 	 $120.57 	 $34.45 	 $90.42 	 $122.00 	 $99.04 	 $114.82 	 $34.45 	 $129.18 	 $116.69 	 $122.00 	 $34.16 	 $116.69 	 $34.45 
303678	HCHG EVAL SPEECH-GEN DEVICE 1ST HR	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92607	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $218.40 	 $218.40 	 $64.27 	 $163.80 	 $221.00 	 $179.40 	 $208.00 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
304702	HCHG ORAL PHARYNGEAL EVALUATION	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92610	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $76.80 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
305685	HCHG VIDEO FLEX FIBERENDO EVAL	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92612	 $305.25 	 $213.68 	 $72.65 	 $274.73 	 $265.57 	 $73.26 	 $233.52 	 $256.41 	 $256.41 	 $73.26 	 $192.31 	 $259.46 	 $210.62 	 $244.20 	 $73.26 	 $274.73 	 $248.17 	 $259.46 	 $72.65 	 $248.17 	 $73.26 
305690	HCHG VIDEOFLUOROSCOPIC EVALUATION	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92611	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $144.00 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
310133	HCHG BEHAVRAL QUALIT ANALYS VOICE	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92524	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $91.46 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
310134	HCHG EVALUATION OF SPEECH FLUENCY	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92521	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $91.46 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
310135	HCHG EVALUATE SPEECH PRODUCTION	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92522	 $390.00 	 $273.00 	 $92.82 	 $351.00 	 $339.30 	 $93.60 	 $298.35 	 $327.60 	 $327.60 	 $96.41 	 $245.70 	 $331.50 	 $269.10 	 $312.00 	 $93.60 	 $351.00 	 $317.07 	 $331.50 	 $92.82 	 $317.07 	 $93.60 
310136	HCHG SPEECH SOUND LANG COMPREHEN	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92523	 $330.00 	 $231.00 	 $78.54 	 $297.00 	 $287.10 	 $79.20 	 $252.45 	 $277.20 	 $277.20 	 $79.20 	 $207.90 	 $280.50 	 $227.70 	 $264.00 	 $79.20 	 $297.00 	 $268.29 	 $280.50 	 $78.54 	 $268.29 	 $79.20 
330957	HCHG CVMC EVALUATION OF VOICE PROSTHETIC	0444	SPEECH THERAPY - LANGUAGE PATHOLOGY - EVALUATION OR REEVALUATION	92607	 $364.78 	 $255.35 	 $86.82 	 $328.30 	 $317.36 	 $87.55 	 $279.06 	 $306.42 	 $306.42 	 $90.17 	 $229.81 	 $310.06 	 $251.70 	 $291.82 	 $87.55 	 $328.30 	 $296.57 	 $310.06 	 $86.82 	 $296.57 	 $87.55 
310132	HCHG CVMC SWALLOW EVAL MEDI-CAL ONLY	0444	PROFESSIONAL FEES - EMERGENCY ROOM	X4320	 $333.63 	 $233.54 	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   	 $-   
302708	HCHG REMOVE DRUG IMPLANT DEVICE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11982	" $1,800.00 "	" $1,260.00 "	 $428.40 	" $1,620.00 "	" $1,566.00 "	 $432.00 	" $1,377.00 "	" $1,512.00 "	" $1,512.00 "	 $432.00 	" $1,134.00 "	" $1,530.00 "	" $1,242.00 "	" $1,440.00 "	 $432.00 	" $1,620.00 "	" $1,463.40 "	" $1,530.00 "	 $428.40 	" $1,463.40 "	 $432.00 
302768	HCHG CLSD TREATMNT GREATER TROCHANTERIC FRACTURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27246	 $587.00 	 $410.90 	 $139.71 	 $528.30 	 $510.69 	 $140.88 	 $449.06 	 $493.08 	 $493.08 	 $145.11 	 $369.81 	 $498.95 	 $405.03 	 $469.60 	 $140.88 	 $528.30 	 $477.23 	 $498.95 	 $139.71 	 $477.23 	 $140.88 
302775	HCHG ANASCOPY DIAGNOSTIC	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46600	 $160.00 	 $112.00 	 $38.08 	 $144.00 	 $139.20 	 $38.40 	 $122.40 	 $134.40 	 $134.40 	 $39.55 	 $100.80 	 $136.00 	 $110.40 	 $128.00 	 $38.40 	 $144.00 	 $130.08 	 $136.00 	 $38.08 	 $130.08 	 $38.40 
302850	HCHG AVULSION NAIL PLATE SINGLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11730	 $650.00 	 $455.00 	 $154.70 	 $585.00 	 $565.50 	 $156.00 	 $497.25 	 $546.00 	 $546.00 	 $160.68 	 $409.50 	 $552.50 	 $448.50 	 $520.00 	 $156.00 	 $585.00 	 $528.45 	 $552.50 	 $154.70 	 $528.45 	 $156.00 
302931	HCHG BLADDER IRRIGATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	51700	 $510.00 	 $357.00 	 $121.38 	 $459.00 	 $443.70 	 $122.40 	 $390.15 	 $428.40 	 $428.40 	 $126.07 	 $321.30 	 $433.50 	 $351.90 	 $408.00 	 $122.40 	 $459.00 	 $414.63 	 $433.50 	 $121.38 	 $414.63 	 $122.40 
303059	HCHG CAST REMOVAL FULL ARM/LEG	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29705	 $303.00 	 $212.10 	 $72.11 	 $272.70 	 $263.61 	 $72.72 	 $231.80 	 $254.52 	 $254.52 	 $74.90 	 $190.89 	 $257.55 	 $209.07 	 $242.40 	 $72.72 	 $272.70 	 $246.34 	 $257.55 	 $72.11 	 $246.34 	 $72.72 
303292	HCHG CRITICAL CARE-30 TO 74 MINUTES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99291	" $4,000.00 "	" $2,800.00 "	 $952.00 	" $3,600.00 "	" $3,480.00 "	 $960.00 	" $3,060.00 "	" $3,360.00 "	" $3,283.00 "	 $988.80 	" $2,520.00 "	" $3,400.00 "	" $2,760.00 "	" $3,200.00 "	 $960.00 	" $3,600.00 "	" $3,252.00 "	" $3,400.00 "	 $952.00 	" $3,252.00 "	 $960.00 
303293	HCHG CRITICAL CARE-EA ADDL 30 MIN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99292	" $1,800.00 "	" $1,260.00 "	 $428.40 	" $1,620.00 "	" $1,566.00 "	 $432.00 	" $1,377.00 "	" $1,512.00 "	" $1,512.00 "	 $444.96 	" $1,134.00 "	" $1,530.00 "	" $1,242.00 "	" $1,440.00 "	 $432.00 	" $1,620.00 "	" $1,463.40 "	" $1,530.00 "	 $428.40 	" $1,463.40 "	 $432.00 
303449	HCHG DISLOC ACROMIOCLAVICULAR CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23540	 $437.83 	 $306.48 	 $104.20 	 $394.05 	 $380.91 	 $105.08 	 $334.94 	 $367.78 	 $367.78 	 $108.23 	 $275.83 	 $372.16 	 $302.10 	 $350.26 	 $105.08 	 $394.05 	 $355.96 	 $372.16 	 $104.20 	 $355.96 	 $105.08 
303450	HCHG DISLOC SHOULDER W/MANIP CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23650	 $970.00 	 $679.00 	 $230.86 	 $873.00 	 $843.90 	 $232.80 	 $742.05 	 $814.80 	 $814.80 	 $239.78 	 $611.10 	 $824.50 	 $669.30 	 $776.00 	 $232.80 	 $873.00 	 $788.61 	 $824.50 	 $230.86 	 $788.61 	 $232.80 
303451	HCHG DISLOC STERNOCLAVICULAR CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23520	" $1,158.38 "	 $810.87 	 $275.69 	" $1,042.54 "	" $1,007.79 "	 $278.01 	 $886.16 	 $973.04 	 $973.04 	 $286.35 	 $729.78 	 $984.62 	 $799.28 	 $926.70 	 $278.01 	" $1,042.54 "	 $941.76 	 $984.62 	 $275.69 	 $941.76 	 $278.01 
303452	HCHG DISLOC TX ANKLE WO ANESTH CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27840	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
303454	HCHG DISLOC TX ELBOW W/O ANES CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24600	 $880.00 	 $616.00 	 $209.44 	 $792.00 	 $765.60 	 $211.20 	 $673.20 	 $739.20 	 $739.20 	 $217.54 	 $554.40 	 $748.00 	 $607.20 	 $704.00 	 $211.20 	 $792.00 	 $715.44 	 $748.00 	 $209.44 	 $715.44 	 $211.20 
303455	HCHG DISLOC TX KNEE W/O ANES CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27550	 $591.25 	 $413.88 	 $140.72 	 $532.13 	 $514.39 	 $141.90 	 $452.31 	 $496.65 	 $496.65 	 $146.16 	 $372.49 	 $502.56 	 $407.96 	 $473.00 	 $141.90 	 $532.13 	 $480.69 	 $502.56 	 $140.72 	 $480.69 	 $141.90 
303817	HCHG GASTRIC INTUBATION TREATMENT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	43753	 $650.25 	 $455.18 	 $154.76 	 $585.23 	 $565.72 	 $156.06 	 $497.44 	 $546.21 	 $546.21 	 $160.74 	 $409.66 	 $552.71 	 $448.67 	 $520.20 	 $156.06 	 $585.23 	 $528.65 	 $552.71 	 $154.76 	 $528.65 	 $156.06 
304029	HCHG INCISION HEMORRHOID EXTERNAL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46083	 $712.00 	 $498.40 	 $169.46 	 $640.80 	 $619.44 	 $170.88 	 $544.68 	 $598.08 	 $598.08 	 $176.01 	 $448.56 	 $605.20 	 $491.28 	 $569.60 	 $170.88 	 $640.80 	 $578.86 	 $605.20 	 $169.46 	 $578.86 	 $170.88 
304030	HCHG INCISION/REM FB SUBQ CPLX	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	10121	" $4,640.00 "	" $3,248.00 "	" $1,104.32 "	" $4,176.00 "	" $4,036.80 "	" $1,113.60 "	" $3,549.60 "	" $3,786.00 "	" $3,283.00 "	" $1,147.01 "	" $2,923.20 "	" $3,944.00 "	" $3,201.60 "	" $3,712.00 "	" $1,113.60 "	" $4,176.00 "	" $3,772.32 "	" $3,944.00 "	" $1,104.32 "	" $3,772.32 "	" $1,113.60 "
304031	HCHG INCISION/REM FB SUBQ SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	10120	" $1,740.00 "	" $1,218.00 "	 $414.12 	" $1,566.00 "	" $1,513.80 "	 $417.60 	" $1,331.10 "	" $1,461.60 "	" $1,461.60 "	 $430.13 	" $1,096.20 "	" $1,479.00 "	" $1,200.60 "	" $1,392.00 "	 $417.60 	" $1,566.00 "	" $1,414.62 "	" $1,479.00 "	 $414.12 	" $1,414.62 "	 $417.60 
304307	HCHG LEVEL I BRIEF	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99281	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
304312	HCHG LEVEL II LIMITED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99282	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $144.00 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
304317	HCHG LEVEL III INTERMEDIATE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99283	" $1,300.00 "	 $910.00 	 $309.40 	" $1,170.00 "	" $1,131.00 "	 $312.00 	 $994.50 	" $1,092.00 "	" $1,092.00 "	 $312.00 	 $819.00 	" $1,105.00 "	 $897.00 	" $1,040.00 "	 $312.00 	" $1,170.00 "	" $1,056.90 "	" $1,105.00 "	 $309.40 	" $1,056.90 "	 $312.00 
304322	HCHG LEVEL IV EXTENDED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99284	" $2,000.00 "	" $1,400.00 "	 $476.00 	" $1,800.00 "	" $1,740.00 "	 $480.00 	" $1,530.00 "	" $1,680.00 "	" $1,680.00 "	 $480.00 	" $1,260.00 "	" $1,700.00 "	" $1,380.00 "	" $1,600.00 "	 $480.00 	" $1,800.00 "	" $1,626.00 "	" $1,700.00 "	 $476.00 	" $1,626.00 "	 $480.00 
304325	HCHG LEVEL V COMPREHENSIVE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99285	" $2,700.00 "	" $1,890.00 "	 $642.60 	" $2,430.00 "	" $2,349.00 "	 $648.00 	" $2,065.50 "	" $2,268.00 "	" $2,268.00 "	 $648.00 	" $1,701.00 "	" $2,295.00 "	" $1,863.00 "	" $2,160.00 "	 $648.00 	" $2,430.00 "	" $2,195.10 "	" $2,295.00 "	 $642.60 	" $2,195.10 "	 $648.00 
304690	HCHG INJ/ASPIR-LARGE JT/BURSA WITH US GUIDE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20611	" $1,094.34 "	 $766.04 	 $260.45 	 $984.91 	 $952.08 	 $262.64 	 $837.17 	 $919.25 	 $919.25 	 $270.52 	 $689.43 	 $930.19 	 $755.09 	 $875.47 	 $262.64 	 $984.91 	 $889.70 	 $930.19 	 $260.45 	 $889.70 	 $262.64 
304973	HCHG REMOVE FB EYE EXTERNAL CONJ SUP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	65205	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $144.00 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
305285	HCHG SPLINT APPLICATION FINGER	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29130	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $64.80 	 $170.10 	 $229.50 	 $186.30 	 $216.00 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
305286	HCHG SPLINT APPLICATION LONG ARM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29105	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $86.40 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
305287	HCHG SPLINT APPLICATION SHORT ARM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29125	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $88.80 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
305288	HCHG SPLINT APPLICATION SHORT LEG	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29515	 $530.00 	 $371.00 	 $126.14 	 $477.00 	 $461.10 	 $127.20 	 $405.45 	 $445.20 	 $445.20 	 $127.20 	 $333.90 	 $450.50 	 $365.70 	 $424.00 	 $127.20 	 $477.00 	 $430.89 	 $450.50 	 $126.14 	 $430.89 	 $127.20 
305290	HCHG SPLINT APPLICATION LONG LEG	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29505	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
305510	HCHG THROMBOLYTIC THERAPY(CORONARY)	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	92977	" $1,144.68 "	 $801.28 	 $272.43 	" $1,030.21 "	 $995.87 	 $274.72 	 $875.68 	 $961.53 	 $961.53 	 $274.72 	 $721.15 	 $972.98 	 $789.83 	 $915.74 	 $274.72 	" $1,030.21 "	 $930.62 	 $972.98 	 $272.43 	 $930.62 	 $274.72 
305568	"HCHG TREATMENT,MISSED AB,ANY TRI."	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	59812	" $4,203.39 "	" $2,942.37 "	" $1,000.41 "	" $3,783.05 "	" $3,656.95 "	" $1,008.81 "	" $3,215.59 "	" $3,530.85 "	" $3,283.00 "	" $1,008.81 "	" $2,648.14 "	" $3,572.88 "	" $2,900.34 "	" $3,362.71 "	" $1,008.81 "	" $3,783.05 "	" $3,417.36 "	" $3,572.88 "	" $1,000.41 "	" $3,417.36 "	" $1,008.81 "
305587	HCHG TX ELBOW CHILD W/MANIP CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24640	 $760.00 	 $532.00 	 $180.88 	 $684.00 	 $661.20 	 $182.40 	 $581.40 	 $638.40 	 $638.40 	 $182.40 	 $478.80 	 $646.00 	 $524.40 	 $608.00 	 $182.40 	 $684.00 	 $617.88 	 $646.00 	 $180.88 	 $617.88 	 $182.40 
305639	HCHG VAGINAL DELIVERY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	59409	" $3,741.00 "	" $2,618.70 "	 $890.36 	" $3,366.90 "	" $3,254.67 "	 $897.84 	" $2,861.87 "	" $3,142.44 "	" $3,142.44 "	 $897.84 	" $2,356.83 "	" $3,179.85 "	" $2,581.29 "	" $2,992.80 "	 $897.84 	" $3,366.90 "	" $3,041.43 "	" $3,179.85 "	 $890.36 	" $3,041.43 "	 $897.84 
306584	HCHG INJ(S) TRIGGER PT(S) 1/2 MUSCLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20552	 $960.00 	 $672.00 	 $228.48 	 $864.00 	 $835.20 	 $230.40 	 $734.40 	 $806.40 	 $806.40 	 $237.31 	 $604.80 	 $816.00 	 $662.40 	 $768.00 	 $230.40 	 $864.00 	 $780.48 	 $816.00 	 $228.48 	 $780.48 	 $230.40 
306825	HCHG ASPIRATION PUNCTURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	10160	 $810.00 	 $567.00 	 $192.78 	 $729.00 	 $704.70 	 $194.40 	 $619.65 	 $680.40 	 $680.40 	 $200.23 	 $510.30 	 $688.50 	 $558.90 	 $648.00 	 $194.40 	 $729.00 	 $658.53 	 $688.50 	 $192.78 	 $658.53 	 $194.40 
307077	HCHG DISLOC TX FINGER W/O ANES CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26770	 $820.00 	 $574.00 	 $195.16 	 $738.00 	 $713.40 	 $196.80 	 $627.30 	 $688.80 	 $688.80 	 $202.70 	 $516.60 	 $697.00 	 $565.80 	 $656.00 	 $196.80 	 $738.00 	 $666.66 	 $697.00 	 $195.16 	 $666.66 	 $196.80 
307081	"HCHG REPOSITION,NASO/GASTRIC TUBE"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	43761	" $1,126.00 "	 $788.20 	 $267.99 	" $1,013.40 "	 $979.62 	 $270.24 	 $861.39 	 $945.84 	 $945.84 	 $270.24 	 $709.38 	 $957.10 	 $776.94 	 $900.80 	 $270.24 	" $1,013.40 "	 $915.44 	 $957.10 	 $267.99 	 $915.44 	 $270.24 
307082	HCHG NASO GASTRIC TUBE PLACEMENT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	43752	 $660.00 	 $462.00 	 $157.08 	 $594.00 	 $574.20 	 $158.40 	 $504.90 	 $554.40 	 $554.40 	 $158.40 	 $415.80 	 $561.00 	 $455.40 	 $528.00 	 $158.40 	 $594.00 	 $536.58 	 $561.00 	 $157.08 	 $536.58 	 $158.40 
307105	HCHG DISLOC TX RADIUS/ULNA CLSD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25605	" $2,480.00 "	" $1,736.00 "	 $590.24 	" $2,232.00 "	" $2,157.60 "	 $595.20 	" $1,897.20 "	" $2,083.20 "	" $2,083.20 "	 $613.06 	" $1,562.40 "	" $2,108.00 "	" $1,711.20 "	" $1,984.00 "	 $595.20 	" $2,232.00 "	" $2,016.24 "	" $2,108.00 "	 $590.24 	" $2,016.24 "	 $595.20 
308140	"HCHG BMH/CVMC COLPORRHAPHY,SUTURE OF INJURY OF VAGINA (NONO*"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	57200	" $3,970.47 "	" $2,779.33 "	 $944.97 	" $3,573.42 "	" $3,454.31 "	 $952.91 	" $3,037.41 "	" $3,335.19 "	" $3,283.00 "	 $981.50 	" $2,501.40 "	" $3,374.90 "	" $2,739.62 "	" $3,176.38 "	 $952.91 	" $3,573.42 "	" $3,227.99 "	" $3,374.90 "	 $944.97 	" $3,227.99 "	 $952.91 
308281	HCHG INCISION DRAINAGE OF PILONIDAL CYST SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	10080	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $148.32 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
308283	HCHG DRAINAGE OF PILONIDAL CYST COMPLICATED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	10081	" $1,218.85 "	 $853.20 	 $290.09 	" $1,096.97 "	" $1,060.40 "	 $292.52 	 $932.42 	" $1,023.83 "	" $1,023.83 "	 $301.30 	 $767.88 	" $1,036.02 "	 $841.01 	 $975.08 	 $292.52 	" $1,096.97 "	 $990.93 	" $1,036.02 "	 $290.09 	 $990.93 	 $292.52 
308288	HCHG BMH/CVMC DRAINAGE OF HEMATOMA/FLUID	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	10140	" $3,320.00 "	" $2,324.00 "	 $790.16 	" $2,988.00 "	" $2,888.40 "	 $796.80 	" $2,539.80 "	" $2,788.80 "	" $2,788.80 "	 $820.70 	" $2,091.60 "	" $2,822.00 "	" $2,290.80 "	" $2,656.00 "	 $796.80 	" $2,988.00 "	" $2,699.16 "	" $2,822.00 "	 $790.16 	" $2,699.16 "	 $796.80 
308291	HCHG I&D COMPLEX POSTOP WOUND INFECTION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	10180	" $4,390.00 "	" $3,073.00 "	" $1,044.82 "	" $3,951.00 "	" $3,819.30 "	" $1,053.60 "	" $3,358.35 "	" $3,687.60 "	" $3,283.00 "	" $1,085.21 "	" $2,765.70 "	" $3,731.50 "	" $3,029.10 "	" $3,512.00 "	" $1,053.60 "	" $3,951.00 "	" $3,569.07 "	" $3,731.50 "	" $1,044.82 "	" $3,569.07 "	" $1,053.60 "
308298	HCHG DEBRIDE REMOVAL FOREIGN MATERIAL FX	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11010	" $3,011.25 "	" $2,107.88 "	 $716.68 	" $2,710.13 "	" $2,619.79 "	 $722.70 	" $2,303.61 "	" $2,529.45 "	" $2,529.45 "	 $744.38 	" $1,897.09 "	" $2,559.56 "	" $2,077.76 "	" $2,409.00 "	 $722.70 	" $2,710.13 "	" $2,448.15 "	" $2,559.56 "	 $716.68 	" $2,448.15 "	 $722.70 
308300	"HCHG CVMC DEBRIDE,FX,SKIN,TISSUE,MUSCLE FASCIA AND MUSCLE"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11011	" $2,389.42 "	" $1,672.59 "	 $568.68 	" $2,150.48 "	" $2,078.80 "	 $573.46 	" $1,827.91 "	" $2,007.11 "	" $2,007.11 "	 $590.66 	" $1,505.33 "	" $2,031.01 "	" $1,648.70 "	" $1,911.54 "	 $573.46 	" $2,150.48 "	" $1,942.60 "	" $2,031.01 "	 $568.68 	" $1,942.60 "	 $573.46 
308302	HCHG DEBRIDE SKIN TISSUE MUSCLE BONE FX	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11012	" $1,760.00 "	" $1,232.00 "	 $418.88 	" $1,584.00 "	" $1,531.20 "	 $422.40 	" $1,346.40 "	" $1,478.40 "	" $1,478.40 "	 $435.07 	" $1,108.80 "	" $1,496.00 "	" $1,214.40 "	" $1,408.00 "	 $422.40 	" $1,584.00 "	" $1,430.88 "	" $1,496.00 "	 $418.88 	" $1,430.88 "	 $422.40 
308312	HCHG REMOVAL SKIN TAGS UP TO 15 LESIONS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11200	 $647.92 	 $453.54 	 $154.20 	 $583.13 	 $563.69 	 $155.50 	 $495.66 	 $544.25 	 $544.25 	 $155.50 	 $408.19 	 $550.73 	 $447.06 	 $518.34 	 $155.50 	 $583.13 	 $526.76 	 $550.73 	 $154.20 	 $526.76 	 $155.50 
308403	HCHG BMH/CVMC DRAIN BLOOD FROM UNDER NAIL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11740	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $71.69 	 $182.70 	 $246.50 	 $200.10 	 $232.00 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
308407	HCHG BMH/CVMC REPAIR OF NAIL BED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11760	" $1,230.00 "	 $861.00 	 $292.74 	" $1,107.00 "	" $1,070.10 "	 $295.20 	 $940.95 	" $1,033.20 "	" $1,033.20 "	 $304.06 	 $774.90 	" $1,045.50 "	 $848.70 	 $984.00 	 $295.20 	" $1,107.00 "	 $999.99 	" $1,045.50 "	 $292.74 	 $999.99 	 $295.20 
308409	HCHG WEDGE EXCISION SKIN NAIL FOLD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	11765	 $710.00 	 $497.00 	 $168.98 	 $639.00 	 $617.70 	 $170.40 	 $543.15 	 $596.40 	 $596.40 	 $170.40 	 $447.30 	 $603.50 	 $489.90 	 $568.00 	 $170.40 	 $639.00 	 $577.23 	 $603.50 	 $168.98 	 $577.23 	 $170.40 
308414	HCHG BMH/CVMC REPAIR WOUND 7.6-12.5CM SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12004	 $690.00 	 $483.00 	 $164.22 	 $621.00 	 $600.30 	 $165.60 	 $527.85 	 $579.60 	 $579.60 	 $170.57 	 $434.70 	 $586.50 	 $476.10 	 $552.00 	 $165.60 	 $621.00 	 $560.97 	 $586.50 	 $164.22 	 $560.97 	 $165.60 
308416	HCHG BMH/CVMC REPAIR WOUND 12.6-20.0 SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12005	 $745.00 	 $521.50 	 $177.31 	 $670.50 	 $648.15 	 $178.80 	 $569.93 	 $625.80 	 $625.80 	 $184.16 	 $469.35 	 $633.25 	 $514.05 	 $596.00 	 $178.80 	 $670.50 	 $605.69 	 $633.25 	 $177.31 	 $605.69 	 $178.80 
308418	HCHG BMH/CVMC REPAIR SUPERFICIAL WOUND 20.1-30.0CM SCALP NECK AXILLAE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12006	 $700.00 	 $490.00 	 $166.60 	 $630.00 	 $609.00 	 $168.00 	 $535.50 	 $588.00 	 $588.00 	 $173.04 	 $441.00 	 $595.00 	 $483.00 	 $560.00 	 $168.00 	 $630.00 	 $569.10 	 $595.00 	 $166.60 	 $569.10 	 $168.00 
308419	HCHG BMH/CVMC REPAIR SUPERFICIAL WOUND >30.0CM SCALP NECK AXILLAE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12007	 $596.91 	 $417.84 	 $142.06 	 $537.22 	 $519.31 	 $143.26 	 $456.64 	 $501.40 	 $501.40 	 $147.56 	 $376.05 	 $507.37 	 $411.87 	 $477.53 	 $143.26 	 $537.22 	 $485.29 	 $507.37 	 $142.06 	 $485.29 	 $143.26 
308425	HCHG BMH/CVMC REPAIR SUPERFICIAL WOUND 7.6-12.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12015	 $620.00 	 $434.00 	 $147.56 	 $558.00 	 $539.40 	 $148.80 	 $474.30 	 $520.80 	 $520.80 	 $153.26 	 $390.60 	 $527.00 	 $427.80 	 $496.00 	 $148.80 	 $558.00 	 $504.06 	 $527.00 	 $147.56 	 $504.06 	 $148.80 
308427	HCHG BMH/CVMC REPAIR SUPERFICIAL WOUND 12.6-20.0CM FACE EAR EYELID LIP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12016	 $640.00 	 $448.00 	 $152.32 	 $576.00 	 $556.80 	 $153.60 	 $489.60 	 $537.60 	 $537.60 	 $158.21 	 $403.20 	 $544.00 	 $441.60 	 $512.00 	 $153.60 	 $576.00 	 $520.32 	 $544.00 	 $152.32 	 $520.32 	 $153.60 
308428	HCHG SIMPLE REPAIR SUPERFICIAL WOUND 20.1 CM-30.0 CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12017	 $537.51 	 $376.26 	 $127.93 	 $483.76 	 $467.63 	 $129.00 	 $411.20 	 $451.51 	 $451.51 	 $129.00 	 $338.63 	 $456.88 	 $370.88 	 $430.01 	 $129.00 	 $483.76 	 $437.00 	 $456.88 	 $127.93 	 $437.00 	 $129.00 
308431	HCHG SIMPLE REPAIR SUPERFICIAL WND > 30CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12018	 $247.29 	 $173.10 	 $58.86 	 $222.56 	 $215.14 	 $59.35 	 $189.18 	 $207.72 	 $207.72 	 $59.35 	 $155.79 	 $210.20 	 $170.63 	 $197.83 	 $59.35 	 $222.56 	 $201.05 	 $210.20 	 $58.86 	 $201.05 	 $59.35 
308433	HCHG BMH/CVMC CLOSURE OF SPLIT WOUND SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12020	" $2,370.00 "	" $1,659.00 "	 $564.06 	" $2,133.00 "	" $2,061.90 "	 $568.80 	" $1,813.05 "	" $1,990.80 "	" $1,990.80 "	 $585.86 	" $1,493.10 "	" $2,014.50 "	" $1,635.30 "	" $1,896.00 "	 $568.80 	" $2,133.00 "	" $1,926.81 "	" $2,014.50 "	 $564.06 	" $1,926.81 "	 $568.80 
308437	HCHG BMH/CVMC LAYER OF CLOSURE WOUND 7.6-12.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12034	 $890.00 	 $623.00 	 $211.82 	 $801.00 	 $774.30 	 $213.60 	 $680.85 	 $747.60 	 $747.60 	 $220.01 	 $560.70 	 $756.50 	 $614.10 	 $712.00 	 $213.60 	 $801.00 	 $723.57 	 $756.50 	 $211.82 	 $723.57 	 $213.60 
308439	HCHG BMH/CVMC LAYER CLOSE WOUND 12.6-20.0CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12035	 $960.00 	 $672.00 	 $228.48 	 $864.00 	 $835.20 	 $230.40 	 $734.40 	 $806.40 	 $806.40 	 $237.31 	 $604.80 	 $816.00 	 $662.40 	 $768.00 	 $230.40 	 $864.00 	 $780.48 	 $816.00 	 $228.48 	 $780.48 	 $230.40 
308441	"HCHG BMH/CVMC REPAIR, INTMD, WOUNDS 20.1-30.0 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12036	 $793.63 	 $555.54 	 $188.88 	 $714.27 	 $690.46 	 $190.47 	 $607.13 	 $666.65 	 $666.65 	 $196.19 	 $499.99 	 $674.59 	 $547.60 	 $634.90 	 $190.47 	 $714.27 	 $645.22 	 $674.59 	 $188.88 	 $645.22 	 $190.47 
308443	"HCHG CVMC REPAIR, INTERMEDIATE, WOUNDS 30.0 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12037	" $1,541.59 "	" $1,079.11 "	 $366.90 	" $1,387.43 "	" $1,341.18 "	 $369.98 	" $1,179.32 "	" $1,294.94 "	" $1,294.94 "	 $381.08 	 $971.20 	" $1,310.35 "	" $1,063.70 "	" $1,233.27 "	 $369.98 	" $1,387.43 "	" $1,253.31 "	" $1,310.35 "	 $366.90 	" $1,253.31 "	 $369.98 
308445	HCHG BMH/CVMC LAYER CLOSURE OF WOUND 2.5CM OR <	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12041	" $1,100.00 "	 $770.00 	 $261.80 	 $990.00 	 $957.00 	 $264.00 	 $841.50 	 $924.00 	 $924.00 	 $271.92 	 $693.00 	 $935.00 	 $759.00 	 $880.00 	 $264.00 	 $990.00 	 $894.30 	 $935.00 	 $261.80 	 $894.30 	 $264.00 
308447	HCHG BMH/CVMC LAYER CLOSURE WOUND 2.6-7.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12042	" $1,120.00 "	 $784.00 	 $266.56 	" $1,008.00 "	 $974.40 	 $268.80 	 $856.80 	 $940.80 	 $940.80 	 $276.86 	 $705.60 	 $952.00 	 $772.80 	 $896.00 	 $268.80 	" $1,008.00 "	 $910.56 	 $952.00 	 $266.56 	 $910.56 	 $268.80 
308449	"HCHG CVMC REPAIR, INTERMEDIATE, WOUNDS 7.6 CM-12.5 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12044	 $730.00 	 $511.00 	 $173.74 	 $657.00 	 $635.10 	 $175.20 	 $558.45 	 $613.20 	 $613.20 	 $180.46 	 $459.90 	 $620.50 	 $503.70 	 $584.00 	 $175.20 	 $657.00 	 $593.49 	 $620.50 	 $173.74 	 $593.49 	 $175.20 
308451	"HCHG CVMC REPAIR, INTERMEDIATE, WOUNDS  12.6 CM-20.0 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12045	 $604.78 	 $423.35 	 $143.94 	 $544.30 	 $526.16 	 $145.15 	 $462.66 	 $508.02 	 $508.02 	 $149.50 	 $381.01 	 $514.06 	 $417.30 	 $483.82 	 $145.15 	 $544.30 	 $491.69 	 $514.06 	 $143.94 	 $491.69 	 $145.15 
308453	"HCHG CVMC REPAIR, INTERMEDIATE, WOUNDS  20.1 CM-30.0 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12046	" $1,235.95 "	 $865.17 	 $294.16 	" $1,112.36 "	" $1,075.28 "	 $296.63 	 $945.50 	" $1,038.20 "	" $1,038.20 "	 $305.53 	 $778.65 	" $1,050.56 "	 $852.81 	 $988.76 	 $296.63 	" $1,112.36 "	" $1,004.83 "	" $1,050.56 "	 $294.16 	" $1,004.83 "	 $296.63 
308455	"HCHG CVMC REPAIR, INTERMEDIATE, WOUNDS OVER 30.0 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12047	" $1,057.08 "	 $739.96 	 $251.59 	 $951.37 	 $919.66 	 $253.70 	 $808.67 	 $887.95 	 $887.95 	 $261.31 	 $665.96 	 $898.52 	 $729.39 	 $845.66 	 $253.70 	 $951.37 	 $859.41 	 $898.52 	 $251.59 	 $859.41 	 $253.70 
308457	HCHG LAYER CLOSURE OF WOUND 2.5CM OR <	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12051	 $840.00 	 $588.00 	 $199.92 	 $756.00 	 $730.80 	 $201.60 	 $642.60 	 $705.60 	 $705.60 	 $201.60 	 $529.20 	 $714.00 	 $579.60 	 $672.00 	 $201.60 	 $756.00 	 $682.92 	 $714.00 	 $199.92 	 $682.92 	 $201.60 
308459	HCHG LAYER OF CLOSURE WOUND 2.6-5.0CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12052	 $930.00 	 $651.00 	 $221.34 	 $837.00 	 $809.10 	 $223.20 	 $711.45 	 $781.20 	 $781.20 	 $223.20 	 $585.90 	 $790.50 	 $641.70 	 $744.00 	 $223.20 	 $837.00 	 $756.09 	 $790.50 	 $221.34 	 $756.09 	 $223.20 
308461	HCHG BMH/CVMC LAYER CLOSURE OF WOUND 5.1-7.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12053	 $935.00 	 $654.50 	 $222.53 	 $841.50 	 $813.45 	 $224.40 	 $715.28 	 $785.40 	 $785.40 	 $231.13 	 $589.05 	 $794.75 	 $645.15 	 $748.00 	 $224.40 	 $841.50 	 $760.16 	 $794.75 	 $222.53 	 $760.16 	 $224.40 
308463	HCHG BMH/CVMC LAYER CLOSSURE WOUND 7.6-12.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12054	 $975.00 	 $682.50 	 $232.05 	 $877.50 	 $848.25 	 $234.00 	 $745.88 	 $819.00 	 $819.00 	 $241.02 	 $614.25 	 $828.75 	 $672.75 	 $780.00 	 $234.00 	 $877.50 	 $792.68 	 $828.75 	 $232.05 	 $792.68 	 $234.00 
308465	HCHG BMH/CVMC LAYER CLOSE WOUND 12.6-20.0CM FACE EARS EJYELID NOSE LIP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12055	 $645.08 	 $451.56 	 $153.53 	 $580.57 	 $561.22 	 $154.82 	 $493.49 	 $541.87 	 $541.87 	 $159.46 	 $406.40 	 $548.32 	 $445.11 	 $516.06 	 $154.82 	 $580.57 	 $524.45 	 $548.32 	 $153.53 	 $524.45 	 $154.82 
308467	"HCHG CVMC REPAIR, INTERMEDIATE, WOUNDS 20.1 CM-30.0 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12056	 $547.28 	 $383.10 	 $130.25 	 $492.55 	 $476.13 	 $131.35 	 $418.67 	 $459.72 	 $459.72 	 $135.29 	 $344.79 	 $465.19 	 $377.62 	 $437.82 	 $131.35 	 $492.55 	 $444.94 	 $465.19 	 $130.25 	 $444.94 	 $131.35 
308469	"HCHG CVMC REPAIR, INTERMEDIATE, WOUNDS OVER 30.0 CM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	12057	 $648.45 	 $453.92 	 $154.33 	 $583.61 	 $564.15 	 $155.63 	 $496.06 	 $544.70 	 $544.70 	 $160.30 	 $408.52 	 $551.18 	 $447.43 	 $518.76 	 $155.63 	 $583.61 	 $527.19 	 $551.18 	 $154.33 	 $527.19 	 $155.63 
308471	HCHG CVMC REPAIR COMPLEX TRUNK 1.1-2.5 CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13100	" $1,529.86 "	" $1,070.90 "	 $364.11 	" $1,376.87 "	" $1,330.98 "	 $367.17 	" $1,170.34 "	" $1,285.08 "	" $1,285.08 "	 $378.18 	 $963.81 	" $1,300.38 "	" $1,055.60 "	" $1,223.89 "	 $367.17 	" $1,376.87 "	" $1,243.78 "	" $1,300.38 "	 $364.11 	" $1,243.78 "	 $367.17 
308473	HCHG BMH/CVMC REPAIR WOUND/LESION 2.6-7.5CM COMPLEX TRUNK	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13101	" $1,507.19 "	" $1,055.03 "	 $358.71 	" $1,356.47 "	" $1,311.26 "	 $361.73 	" $1,153.00 "	" $1,266.04 "	" $1,266.04 "	 $372.58 	 $949.53 	" $1,281.11 "	" $1,039.96 "	" $1,205.75 "	 $361.73 	" $1,356.47 "	" $1,225.35 "	" $1,281.11 "	 $358.71 	" $1,225.35 "	 $361.73 
308475	HCHG BMH/CVMC REPAIR WOUND/LESION ADD-ON 5 CM OR LESS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13102	 $559.89 	 $391.92 	 $133.25 	 $503.90 	 $487.10 	 $134.37 	 $428.32 	 $470.31 	 $470.31 	 $138.40 	 $352.73 	 $475.91 	 $386.32 	 $447.91 	 $134.37 	 $503.90 	 $455.19 	 $475.91 	 $133.25 	 $455.19 	 $134.37 
308477	HCHG BMH/CVMC REPAIR WOUND/LESION 1.1-2.5CM COMPLEX SCALP ARM LEG	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13120	 $829.48 	 $580.64 	 $197.42 	 $746.53 	 $721.65 	 $199.08 	 $634.55 	 $696.76 	 $696.76 	 $205.05 	 $522.57 	 $705.06 	 $572.34 	 $663.58 	 $199.08 	 $746.53 	 $674.37 	 $705.06 	 $197.42 	 $674.37 	 $199.08 
308479	HCHG BMH/CVMC REPAIR WOUND/LESION 2.6-7.5CM COMPLEX SCALP ARM LEG	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13121	" $1,040.00 "	 $728.00 	 $247.52 	 $936.00 	 $904.80 	 $249.60 	 $795.60 	 $873.60 	 $873.60 	 $257.09 	 $655.20 	 $884.00 	 $717.60 	 $832.00 	 $249.60 	 $936.00 	 $845.52 	 $884.00 	 $247.52 	 $845.52 	 $249.60 
308481	"HCHG BMH/CVMC REPAIR WOUND/LESION ADD-ON 5CM OR< COMPLEX SCALP,ARM,LEG"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13122	 $670.00 	 $469.00 	 $159.46 	 $603.00 	 $582.90 	 $160.80 	 $512.55 	 $562.80 	 $562.80 	 $165.62 	 $422.10 	 $569.50 	 $462.30 	 $536.00 	 $160.80 	 $603.00 	 $544.71 	 $569.50 	 $159.46 	 $544.71 	 $160.80 
308483	"HCHG BMH/CVMC REPAIR WOUND/LESION1.1-2.5CM COMPLEX FOREHEAD,CHEEK,CHIN"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13131	 $816.00 	 $571.20 	 $194.21 	 $734.40 	 $709.92 	 $195.84 	 $624.24 	 $685.44 	 $685.44 	 $201.72 	 $514.08 	 $693.60 	 $563.04 	 $652.80 	 $195.84 	 $734.40 	 $663.41 	 $693.60 	 $194.21 	 $663.41 	 $195.84 
308485	HCHG BMH/CVMC REPAIR WOUND/LESION 2.6-7.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13132	" $1,900.00 "	" $1,330.00 "	 $452.20 	" $1,710.00 "	" $1,653.00 "	 $456.00 	" $1,453.50 "	" $1,596.00 "	" $1,596.00 "	 $469.68 	" $1,197.00 "	" $1,615.00 "	" $1,311.00 "	" $1,520.00 "	 $456.00 	" $1,710.00 "	" $1,544.70 "	" $1,615.00 "	 $452.20 	" $1,544.70 "	 $456.00 
308487	HCHG BMH/CVMC REPAIR COMPLEX FOREHEAD CHEEK CHIN MOUTH NECK ADD<5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13133	" $1,300.00 "	 $910.00 	 $309.40 	" $1,170.00 "	" $1,131.00 "	 $312.00 	 $994.50 	" $1,092.00 "	" $1,092.00 "	 $321.36 	 $819.00 	" $1,105.00 "	 $897.00 	" $1,040.00 "	 $312.00 	" $1,170.00 "	" $1,056.90 "	" $1,105.00 "	 $309.40 	" $1,056.90 "	 $312.00 
308491	"HCHG BMH/CVMC REPAIR WOUND/LESION1.1-2.5CM COMPLEX EYELID,NOSE,EAR,LIP"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13151	" $1,090.00 "	 $763.00 	 $259.42 	 $981.00 	 $948.30 	 $261.60 	 $833.85 	 $915.60 	 $915.60 	 $269.45 	 $686.70 	 $926.50 	 $752.10 	 $872.00 	 $261.60 	 $981.00 	 $886.17 	 $926.50 	 $259.42 	 $886.17 	 $261.60 
308493	HCHG REPAIR COMPLEX WOUND 2.6-7.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13152	 $870.00 	 $609.00 	 $207.06 	 $783.00 	 $756.90 	 $208.80 	 $665.55 	 $730.80 	 $730.80 	 $208.80 	 $548.10 	 $739.50 	 $600.30 	 $696.00 	 $208.80 	 $783.00 	 $707.31 	 $739.50 	 $207.06 	 $707.31 	 $208.80 
308495	HCHG REPAIR COMPLEX WOUND EA ADDL 5CM <	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	13153	 $580.00 	 $406.00 	 $138.04 	 $522.00 	 $504.60 	 $139.20 	 $443.70 	 $487.20 	 $487.20 	 $139.20 	 $365.40 	 $493.00 	 $400.20 	 $464.00 	 $139.20 	 $522.00 	 $471.54 	 $493.00 	 $138.04 	 $471.54 	 $139.20 
308508	HCHG SKIN TISSUE PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	17999	" $2,777.48 "	" $1,944.24 "	 $661.04 	" $2,499.73 "	" $2,416.41 "	 $666.60 	" $2,124.77 "	" $2,333.08 "	" $2,333.08 "	 $666.60 	" $1,749.81 "	" $2,360.86 "	" $1,916.46 "	" $2,221.98 "	 $666.60 	" $2,499.73 "	" $2,258.09 "	" $2,360.86 "	 $661.04 	" $2,258.09 "	 $666.60 
308511	"HCHG BMH/CVMC MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	19020	" $2,684.68 "	" $1,879.28 "	 $638.95 	" $2,416.21 "	" $2,335.67 "	 $644.32 	" $2,053.78 "	" $2,255.13 "	" $2,255.13 "	 $663.65 	" $1,691.35 "	" $2,281.98 "	" $1,852.43 "	" $2,147.74 "	 $644.32 	" $2,416.21 "	" $2,182.64 "	" $2,281.98 "	 $638.95 	" $2,182.64 "	 $644.32 
308514	HCHG CVMC EXPLORATION OF PENETRATING WOUND(SEPARATE PROCEDURE)NECK	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20100	" $1,191.40 "	 $833.98 	 $283.55 	" $1,072.26 "	" $1,036.52 "	 $285.94 	 $911.42 	" $1,000.78 "	" $1,000.78 "	 $294.51 	 $750.58 	" $1,012.69 "	 $822.07 	 $953.12 	 $285.94 	" $1,072.26 "	 $968.61 	" $1,012.69 "	 $283.55 	 $968.61 	 $285.94 
308516	HCHG EXPLORE PENETRATING WOUND (SEPARATE PROCEDURE) CHEST	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20101	" $2,480.00 "	" $1,736.00 "	 $590.24 	" $2,232.00 "	" $2,157.60 "	 $595.20 	" $1,897.20 "	" $2,083.20 "	" $2,083.20 "	 $613.06 	" $1,562.40 "	" $2,108.00 "	" $1,711.20 "	" $1,984.00 "	 $595.20 	" $2,232.00 "	" $2,016.24 "	" $2,108.00 "	 $590.24 	" $2,016.24 "	 $595.20 
308518	HCHG EXPLORE PENETRATING WOUND ABDOMEN/FLANK/BACK	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20102	" $3,599.90 "	" $2,519.93 "	 $856.78 	" $3,239.91 "	" $3,131.91 "	 $863.98 	" $2,753.92 "	" $3,023.92 "	" $3,023.92 "	 $889.90 	" $2,267.94 "	" $3,059.92 "	" $2,483.93 "	" $2,879.92 "	 $863.98 	" $3,239.91 "	" $2,926.72 "	" $3,059.92 "	 $856.78 	" $2,926.72 "	 $863.98 
308520	HCHG BMH/CVMC EXPLORE OF PENETRATIN WOUND EXTREMITY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20103	" $1,832.98 "	" $1,283.09 "	 $436.25 	" $1,649.68 "	" $1,594.69 "	 $439.92 	" $1,402.23 "	" $1,539.70 "	" $1,539.70 "	 $453.11 	" $1,154.78 "	" $1,558.03 "	" $1,264.76 "	" $1,466.38 "	 $439.92 	" $1,649.68 "	" $1,490.21 "	" $1,558.03 "	 $436.25 	" $1,490.21 "	 $439.92 
308522	HCHG BMH/CVMC REMOVAL OF FOREIGN BODY SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20520	" $2,854.60 "	" $1,998.22 "	 $679.39 	" $2,569.14 "	" $2,483.50 "	 $685.10 	" $2,183.77 "	" $2,397.86 "	" $2,397.86 "	 $705.66 	" $1,798.40 "	" $2,426.41 "	" $1,969.67 "	" $2,283.68 "	 $685.10 	" $2,569.14 "	" $2,320.79 "	" $2,426.41 "	 $679.39 	" $2,320.79 "	 $685.10 
308524	HCHG REMOVAL FB DEEP COMPLICATED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20525	" $4,607.37 "	" $3,225.16 "	" $1,096.55 "	" $4,146.63 "	" $4,008.41 "	" $1,105.77 "	" $3,524.64 "	" $3,786.00 "	" $3,283.00 "	" $1,105.77 "	" $2,902.64 "	" $3,916.26 "	" $3,179.09 "	" $3,685.90 "	" $1,105.77 "	" $4,146.63 "	" $3,745.79 "	" $3,916.26 "	" $1,096.55 "	" $3,745.79 "	" $1,105.77 "
308534	HCHG CVMC REMOVAL OF SUPPORT IMPLANT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20680	" $5,240.00 "	" $3,668.00 "	" $1,247.12 "	" $4,716.00 "	" $4,558.80 "	" $1,257.60 "	" $4,008.60 "	" $3,786.00 "	" $3,283.00 "	" $1,295.33 "	" $3,301.20 "	" $4,454.00 "	" $3,615.60 "	" $4,192.00 "	" $1,257.60 "	" $4,716.00 "	" $4,260.12 "	" $4,454.00 "	" $1,247.12 "	" $4,260.12 "	" $1,257.60 "
308535	HCHG CVMC MUSCULOSKELETAL SURGERY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20999	" $4,294.96 "	" $3,006.47 "	" $1,022.20 "	" $3,865.46 "	" $3,736.62 "	" $1,030.79 "	" $3,285.64 "	" $3,607.77 "	" $3,283.00 "	" $1,061.71 "	" $2,705.82 "	" $3,650.72 "	" $2,963.52 "	" $3,435.97 "	" $1,030.79 "	" $3,865.46 "	" $3,491.80 "	" $3,650.72 "	" $1,022.20 "	" $3,491.80 "	" $1,030.79 "
308539	HCHG CLOSED TX OF NASAL BONE FRACTURE W/O STABIL W/ MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	21315	" $3,218.59 "	" $2,253.01 "	 $766.02 	" $2,896.73 "	" $2,800.17 "	 $772.46 	" $2,462.22 "	" $2,703.62 "	" $2,703.62 "	 $795.64 	" $2,027.71 "	" $2,735.80 "	" $2,220.83 "	" $2,574.87 "	 $772.46 	" $2,896.73 "	" $2,616.71 "	" $2,735.80 "	 $766.02 	" $2,616.71 "	 $772.46 
308540	HCHG PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	32556	" $1,690.00 "	" $1,183.00 "	 $402.22 	" $1,521.00 "	" $1,470.30 "	 $405.60 	" $1,292.85 "	" $1,419.60 "	" $1,419.60 "	 $405.60 	" $1,064.70 "	" $1,436.50 "	" $1,166.10 "	" $1,352.00 "	 $405.60 	" $1,521.00 "	" $1,373.97 "	" $1,436.50 "	 $402.22 	" $1,373.97 "	 $405.60 
308542	HCHG BMH/CVMC TREAT DENTAL RIDGE FRACTURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	21440	" $4,664.49 "	" $3,265.14 "	" $1,110.15 "	" $4,198.04 "	" $4,058.11 "	" $1,119.48 "	" $3,568.33 "	" $3,786.00 "	" $3,283.00 "	" $1,153.06 "	" $2,938.63 "	" $3,964.82 "	" $3,218.50 "	" $3,731.59 "	" $1,119.48 "	" $4,198.04 "	" $3,792.23 "	" $3,964.82 "	" $1,110.15 "	" $3,792.23 "	" $1,119.48 "
308545	HCHG RESET DISLOCATED JAW CLOSED TX INITIAL OR SUBSEQUENT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	21480	 $690.00 	 $483.00 	 $164.22 	 $621.00 	 $600.30 	 $165.60 	 $527.85 	 $579.60 	 $579.60 	 $165.60 	 $434.70 	 $586.50 	 $476.10 	 $552.00 	 $165.60 	 $621.00 	 $560.97 	 $586.50 	 $164.22 	 $560.97 	 $165.60 
308547	HCHG BMH/CVMC DRAIN NECK/CHEST LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	21501	" $4,135.84 "	" $2,895.09 "	 $984.33 	" $3,722.26 "	" $3,598.18 "	 $992.60 	" $3,163.92 "	" $3,474.11 "	" $3,283.00 "	" $1,022.38 "	" $2,605.58 "	" $3,515.46 "	" $2,853.73 "	" $3,308.67 "	 $992.60 	" $3,722.26 "	" $3,362.44 "	" $3,515.46 "	 $984.33 	" $3,362.44 "	 $992.60 
308553	HCHG BMH/CVMC TREAT CLAVICLE FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23500	 $580.00 	 $406.00 	 $138.04 	 $522.00 	 $504.60 	 $139.20 	 $443.70 	 $487.20 	 $487.20 	 $143.38 	 $365.40 	 $493.00 	 $400.20 	 $464.00 	 $139.20 	 $522.00 	 $471.54 	 $493.00 	 $138.04 	 $471.54 	 $139.20 
308555	HCHG BMH/CVMC TREAT CLAVICLE FRACTURE CLOSED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23505	" $1,262.00 "	 $883.40 	 $300.36 	" $1,135.80 "	" $1,097.94 "	 $302.88 	 $965.43 	" $1,060.08 "	" $1,060.08 "	 $311.97 	 $795.06 	" $1,072.70 "	 $870.78 	" $1,009.60 "	 $302.88 	" $1,135.80 "	" $1,026.01 "	" $1,072.70 "	 $300.36 	" $1,026.01 "	 $302.88 
308558	HCHG CVMC CLOSED TX OF STERNOCLAVICULAR DISLOCATION W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23525	" $1,158.38 "	 $810.87 	 $275.69 	" $1,042.54 "	" $1,007.79 "	 $278.01 	 $886.16 	 $973.04 	 $973.04 	 $286.35 	 $729.78 	 $984.62 	 $799.28 	 $926.70 	 $278.01 	" $1,042.54 "	 $941.76 	 $984.62 	 $275.69 	 $941.76 	 $278.01 
308561	HCHG BMH/CVMC TREAT CLAVICLE DISLOCATION CLOSED W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23545	 $875.20 	 $612.64 	 $208.30 	 $787.68 	 $761.42 	 $210.05 	 $669.53 	 $735.17 	 $735.17 	 $216.35 	 $551.38 	 $743.92 	 $603.89 	 $700.16 	 $210.05 	 $787.68 	 $711.54 	 $743.92 	 $208.30 	 $711.54 	 $210.05 
308563	HCHG BMH/CVMC TREAT SHOULDER BLADE FX W/O MANI	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23570	 $513.41 	 $359.39 	 $122.19 	 $462.07 	 $446.67 	 $123.22 	 $392.76 	 $431.26 	 $431.26 	 $126.91 	 $323.45 	 $436.40 	 $354.25 	 $410.73 	 $123.22 	 $462.07 	 $417.40 	 $436.40 	 $122.19 	 $417.40 	 $123.22 
308565	HCHG BMH/CVMC TREAT SHOULDER BLADE FX	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23575	" $1,158.38 "	 $810.87 	 $275.69 	" $1,042.54 "	" $1,007.79 "	 $278.01 	 $886.16 	 $973.04 	 $973.04 	 $286.35 	 $729.78 	 $984.62 	 $799.28 	 $926.70 	 $278.01 	" $1,042.54 "	 $941.76 	 $984.62 	 $275.69 	 $941.76 	 $278.01 
308567	HCHG BMH/CVMC TREAT HUMERUS FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23600	 $556.95 	 $389.87 	 $132.55 	 $501.26 	 $484.55 	 $133.67 	 $426.07 	 $467.84 	 $467.84 	 $137.68 	 $350.88 	 $473.41 	 $384.30 	 $445.56 	 $133.67 	 $501.26 	 $452.80 	 $473.41 	 $132.55 	 $452.80 	 $133.67 
308568	HCHG TREAT HUMERUS FRACTURE CLOSED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23605	" $5,100.00 "	" $3,570.00 "	" $1,213.80 "	" $4,590.00 "	" $4,437.00 "	" $1,224.00 "	" $3,901.50 "	" $3,786.00 "	" $3,283.00 "	" $1,224.00 "	" $3,213.00 "	" $4,335.00 "	" $3,519.00 "	" $4,080.00 "	" $1,224.00 "	" $4,590.00 "	" $4,146.30 "	" $4,335.00 "	" $1,213.80 "	" $4,146.30 "	" $1,224.00 "
308570	HCHG BMH/CVMC TREAT HUMERUS FRACTURE W/O MAN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23620	 $546.44 	 $382.51 	 $130.05 	 $491.80 	 $475.40 	 $131.15 	 $418.03 	 $459.01 	 $459.01 	 $135.08 	 $344.26 	 $464.47 	 $377.04 	 $437.15 	 $131.15 	 $491.80 	 $444.26 	 $464.47 	 $130.05 	 $444.26 	 $131.15 
308574	HCHG BMH/CVMC TREAT SHOULDER DISLOCATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23655	" $2,350.00 "	" $1,645.00 "	 $559.30 	" $2,115.00 "	" $2,044.50 "	 $564.00 	" $1,797.75 "	" $1,974.00 "	" $1,974.00 "	 $580.92 	" $1,480.50 "	" $1,997.50 "	" $1,621.50 "	" $1,880.00 "	 $564.00 	" $2,115.00 "	" $1,910.55 "	" $1,997.50 "	 $559.30 	" $1,910.55 "	 $564.00 
308576	HCHG BMH/CVMC TREAT DISLOCATION/FRACTURE W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23665	" $1,407.00 "	 $984.90 	 $334.87 	" $1,266.30 "	" $1,224.09 "	 $337.68 	" $1,076.36 "	" $1,181.88 "	" $1,181.88 "	 $347.81 	 $886.41 	" $1,195.95 "	 $970.83 	" $1,125.60 "	 $337.68 	" $1,266.30 "	" $1,143.89 "	" $1,195.95 "	 $334.87 	" $1,143.89 "	 $337.68 
308578	"HCHG CVMC CLOSED TREATMENT OF SHOULDER DISLOCATION,WITH MANIPULATI"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23675	 $925.46 	 $647.82 	 $220.26 	 $832.91 	 $805.15 	 $222.11 	 $707.98 	 $777.39 	 $777.39 	 $228.77 	 $583.04 	 $786.64 	 $638.57 	 $740.37 	 $222.11 	 $832.91 	 $752.40 	 $786.64 	 $220.26 	 $752.40 	 $222.11 
308580	HCHG CVMC INCISION AND DRAINAGE OF UPPER ARM/ELBOW  BURSA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	23931	" $3,076.39 "	" $2,153.47 "	 $732.18 	" $2,768.75 "	" $2,676.46 "	 $738.33 	" $2,353.44 "	" $2,584.17 "	" $2,584.17 "	 $760.48 	" $1,938.13 "	" $2,614.93 "	" $2,122.71 "	" $2,461.11 "	 $738.33 	" $2,768.75 "	" $2,501.11 "	" $2,614.93 "	 $732.18 	" $2,501.11 "	 $738.33 
308582	HCHG CLOSED TX OF HUMERAL SHAFT FRACTURE W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24500	 $710.00 	 $497.00 	 $168.98 	 $639.00 	 $617.70 	 $170.40 	 $543.15 	 $596.40 	 $596.40 	 $175.51 	 $447.30 	 $603.50 	 $489.90 	 $568.00 	 $170.40 	 $639.00 	 $577.23 	 $603.50 	 $168.98 	 $577.23 	 $170.40 
308584	HCHG BMH/CVMC TREAT HUMERUS FRACTURE W/WO SKELETAL TRACTION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24505	" $1,276.00 "	 $893.20 	 $303.69 	" $1,148.40 "	" $1,110.12 "	 $306.24 	 $976.14 	" $1,071.84 "	" $1,071.84 "	 $315.43 	 $803.88 	" $1,084.60 "	 $880.44 	" $1,020.80 "	 $306.24 	" $1,148.40 "	" $1,037.39 "	" $1,084.60 "	 $303.69 	" $1,037.39 "	 $306.24 
308586	HCHG BMH/CVMC CLOSED TX HUMERUS FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24530	 $668.04 	 $467.63 	 $158.99 	 $601.24 	 $581.19 	 $160.33 	 $511.05 	 $561.15 	 $561.15 	 $165.14 	 $420.87 	 $567.83 	 $460.95 	 $534.43 	 $160.33 	 $601.24 	 $543.12 	 $567.83 	 $158.99 	 $543.12 	 $160.33 
308588	HCHG BMH/CVMC TREAT HUMERUS FRACTURE CLOSED W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24535	" $1,510.21 "	" $1,057.15 "	 $359.43 	" $1,359.19 "	" $1,313.88 "	 $362.45 	" $1,155.31 "	" $1,268.58 "	" $1,268.58 "	 $373.32 	 $951.43 	" $1,283.68 "	" $1,042.04 "	" $1,208.17 "	 $362.45 	" $1,359.19 "	" $1,227.80 "	" $1,283.68 "	 $359.43 	" $1,227.80 "	 $362.45 
308590	HCHG BMH/CVMC TX HUMERUS FX-W MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24565	 $653.92 	 $457.74 	 $155.63 	 $588.53 	 $568.91 	 $156.94 	 $500.25 	 $549.29 	 $549.29 	 $161.65 	 $411.97 	 $555.83 	 $451.20 	 $523.14 	 $156.94 	 $588.53 	 $531.64 	 $555.83 	 $155.63 	 $531.64 	 $156.94 
308592	HCHG BMH/CVMC TREAT HUMERUS FRACTURE CLOSED  MEDIAL/LATERAL W/MAN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24577	" $1,238.50 "	 $866.95 	 $294.76 	" $1,114.65 "	" $1,077.50 "	 $297.24 	 $947.45 	" $1,040.34 "	" $1,040.34 "	 $306.16 	 $780.26 	" $1,052.73 "	 $854.57 	 $990.80 	 $297.24 	" $1,114.65 "	" $1,006.90 "	" $1,052.73 "	 $294.76 	" $1,006.90 "	 $297.24 
308595	HCHG TREAT ELBOW DISLOCATION W/ANE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24605	" $9,017.43 "	" $6,312.20 "	" $2,146.15 "	" $8,115.69 "	" $7,845.16 "	" $2,164.18 "	" $6,898.33 "	" $3,786.00 "	" $3,283.00 "	" $2,164.18 "	" $5,680.98 "	" $7,664.82 "	" $6,222.03 "	" $7,213.94 "	" $2,164.18 "	" $8,115.69 "	" $7,331.17 "	" $7,664.82 "	" $2,146.15 "	" $7,331.17 "	" $2,164.18 "
308597	HCHG BMH/CVMC CLOSED TX OF MONTEGGIA TYPE OF FX  DISLOCATION AT ELBOW	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24620	" $3,857.00 "	" $2,699.90 "	 $917.97 	" $3,471.30 "	" $3,355.59 "	 $925.68 	" $2,950.61 "	" $3,239.88 "	" $3,239.88 "	 $953.45 	" $2,429.91 "	" $3,278.45 "	" $2,661.33 "	" $3,085.60 "	 $925.68 	" $3,471.30 "	" $3,135.74 "	" $3,278.45 "	 $917.97 	" $3,135.74 "	 $925.68 
308600	HCHG BMH/CVMC CLOSED TX RADIUS FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24650	 $523.92 	 $366.74 	 $124.69 	 $471.53 	 $455.81 	 $125.74 	 $400.80 	 $440.09 	 $440.09 	 $129.51 	 $330.07 	 $445.33 	 $361.50 	 $419.14 	 $125.74 	 $471.53 	 $425.95 	 $445.33 	 $124.69 	 $425.95 	 $125.74 
308602	HCHG BMH/CVMC TREAT RADIUS FX W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24655	 $908.23 	 $635.76 	 $216.16 	 $817.41 	 $790.16 	 $217.98 	 $694.80 	 $762.91 	 $762.91 	 $224.51 	 $572.18 	 $772.00 	 $626.68 	 $726.58 	 $217.98 	 $817.41 	 $738.39 	 $772.00 	 $216.16 	 $738.39 	 $217.98 
308604	HCHG BMH/CVMC CLOSED TX ULNAR FX WO MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24670	 $551.28 	 $385.90 	 $131.20 	 $496.15 	 $479.61 	 $132.31 	 $421.73 	 $463.08 	 $463.08 	 $136.28 	 $347.31 	 $468.59 	 $380.38 	 $441.02 	 $132.31 	 $496.15 	 $448.19 	 $468.59 	 $131.20 	 $448.19 	 $132.31 
308606	HCHG TX ULNAR FX W MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	24675	" $1,711.38 "	" $1,197.97 "	 $407.31 	" $1,540.24 "	" $1,488.90 "	 $410.73 	" $1,309.21 "	" $1,437.56 "	" $1,437.56 "	 $410.73 	" $1,078.17 "	" $1,454.67 "	" $1,180.85 "	" $1,369.10 "	 $410.73 	" $1,540.24 "	" $1,391.35 "	" $1,454.67 "	 $407.31 	" $1,391.35 "	 $410.73 
308609	HCHG BMH/CVMC TX FRACTURE OF RADIUS W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25500	 $547.94 	 $383.56 	 $130.41 	 $493.15 	 $476.71 	 $131.51 	 $419.17 	 $460.27 	 $460.27 	 $135.45 	 $345.20 	 $465.75 	 $378.08 	 $438.35 	 $131.51 	 $493.15 	 $445.48 	 $465.75 	 $130.41 	 $445.48 	 $131.51 
308611	HCHG BMH/CVMC CLOSED TX OF RADIAL SHAFT W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25505	 $810.00 	 $567.00 	 $192.78 	 $729.00 	 $704.70 	 $194.40 	 $619.65 	 $680.40 	 $680.40 	 $200.23 	 $510.30 	 $688.50 	 $558.90 	 $648.00 	 $194.40 	 $729.00 	 $658.53 	 $688.50 	 $192.78 	 $658.53 	 $194.40 
308614	HCHG BMH/CVMC TX FX OF ULNA W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25530	 $480.39 	 $336.27 	 $114.33 	 $432.35 	 $417.94 	 $115.29 	 $367.50 	 $403.53 	 $403.53 	 $118.75 	 $302.65 	 $408.33 	 $331.47 	 $384.31 	 $115.29 	 $432.35 	 $390.56 	 $408.33 	 $114.33 	 $390.56 	 $115.29 
308616	HCHG BMH/CVMC TREAT FRACTURE OF ULNA WITH MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25535	 $648.03 	 $453.62 	 $154.23 	 $583.23 	 $563.79 	 $155.53 	 $495.74 	 $544.35 	 $544.35 	 $160.19 	 $408.26 	 $550.83 	 $447.14 	 $518.42 	 $155.53 	 $583.23 	 $526.85 	 $550.83 	 $154.23 	 $526.85 	 $155.53 
308618	HCHG TREAT FX RADIUS/ULNA W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25560	 $609.49 	 $426.64 	 $145.06 	 $548.54 	 $530.26 	 $146.28 	 $466.26 	 $511.97 	 $511.97 	 $146.28 	 $383.98 	 $518.07 	 $420.55 	 $487.59 	 $146.28 	 $548.54 	 $495.52 	 $518.07 	 $145.06 	 $495.52 	 $146.28 
308620	HCHG TREAT FX RADIUS/ULNA W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25565	" $3,920.00 "	" $2,744.00 "	 $932.96 	" $3,528.00 "	" $3,410.40 "	 $940.80 	" $2,998.80 "	" $3,292.80 "	" $3,283.00 "	 $940.80 	" $2,469.60 "	" $3,332.00 "	" $2,704.80 "	" $3,136.00 "	 $940.80 	" $3,528.00 "	" $3,186.96 "	" $3,332.00 "	 $932.96 	" $3,186.96 "	 $940.80 
308622	HCHG TREAT FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25600	 $626.00 	 $438.20 	 $148.99 	 $563.40 	 $544.62 	 $150.24 	 $478.89 	 $525.84 	 $525.84 	 $150.24 	 $394.38 	 $532.10 	 $431.94 	 $500.80 	 $150.24 	 $563.40 	 $508.94 	 $532.10 	 $148.99 	 $508.94 	 $150.24 
308625	HCHG BMH/CVMC CLOSED TX WRIST BONE FX WO MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25622	 $575.72 	 $403.00 	 $137.02 	 $518.15 	 $500.88 	 $138.17 	 $440.43 	 $483.60 	 $483.60 	 $142.32 	 $362.70 	 $489.36 	 $397.25 	 $460.58 	 $138.17 	 $518.15 	 $468.06 	 $489.36 	 $137.02 	 $468.06 	 $138.17 
308627	HCHG BMH/CVMC CLOSED TX OF CARPAL SCAPHOID FRACTURE W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25624	" $1,158.38 "	 $810.87 	 $275.69 	" $1,042.54 "	" $1,007.79 "	 $278.01 	 $886.16 	 $973.04 	 $973.04 	 $286.35 	 $729.78 	 $984.62 	 $799.28 	 $926.70 	 $278.01 	" $1,042.54 "	 $941.76 	 $984.62 	 $275.69 	 $941.76 	 $278.01 
308629	HCHG BMH/CVMC CLOSED TX WRIST BONE FX WO MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25630	 $430.10 	 $301.07 	 $102.36 	 $387.09 	 $374.19 	 $103.22 	 $329.03 	 $361.28 	 $361.28 	 $106.32 	 $270.96 	 $365.59 	 $296.77 	 $344.08 	 $103.22 	 $387.09 	 $349.67 	 $365.59 	 $102.36 	 $349.67 	 $103.22 
308631	HCHG BMH/CVMC TX OF CARPAL BONE FX W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25635	 $950.27 	 $665.19 	 $226.16 	 $855.24 	 $826.73 	 $228.06 	 $726.96 	 $798.23 	 $798.23 	 $234.91 	 $598.67 	 $807.73 	 $655.69 	 $760.22 	 $228.06 	 $855.24 	 $772.57 	 $807.73 	 $226.16 	 $772.57 	 $228.06 
308633	HCHG BMH/CVMC TREAT WRIST BONE FRACTURE CLOSED/ULNAR STYLOID	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25650	 $600.48 	 $420.34 	 $142.91 	 $540.43 	 $522.42 	 $144.12 	 $459.37 	 $504.40 	 $504.40 	 $148.44 	 $378.30 	 $510.41 	 $414.33 	 $480.38 	 $144.12 	 $540.43 	 $488.19 	 $510.41 	 $142.91 	 $488.19 	 $144.12 
308635	HCHG BMH/CVMC TREAT WRIST DISLOCATION CLOSED W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25675	 $925.46 	 $647.82 	 $220.26 	 $832.91 	 $805.15 	 $222.11 	 $707.98 	 $777.39 	 $777.39 	 $228.77 	 $583.04 	 $786.64 	 $638.57 	 $740.37 	 $222.11 	 $832.91 	 $752.40 	 $786.64 	 $220.26 	 $752.40 	 $222.11 
308638	"HCHG BMH/CVMC CLOSED TREATMENT OF LUNATE DISLOCATION, W/MANIPULATION"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	25690	" $3,744.36 "	" $2,621.05 "	 $891.16 	" $3,369.92 "	" $3,257.59 "	 $898.65 	" $2,864.44 "	" $3,145.26 "	" $3,145.26 "	 $925.61 	" $2,358.95 "	" $3,182.71 "	" $2,583.61 "	" $2,995.49 "	 $898.65 	" $3,369.92 "	" $3,044.16 "	" $3,182.71 "	 $891.16 	" $3,044.16 "	 $898.65 
308640	HCHG BMH/CVMC DRAINAGE OF FINGER ABSCESS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26010	 $520.92 	 $364.64 	 $123.98 	 $468.83 	 $453.20 	 $125.02 	 $398.50 	 $437.57 	 $437.57 	 $128.77 	 $328.18 	 $442.78 	 $359.43 	 $416.74 	 $125.02 	 $468.83 	 $423.51 	 $442.78 	 $123.98 	 $423.51 	 $125.02 
308644	HCHG INCISE FINGER TENDON SHEATH	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26055	" $3,331.11 "	" $2,331.78 "	 $792.80 	" $2,998.00 "	" $2,898.07 "	 $799.47 	" $2,548.30 "	" $2,798.13 "	" $2,798.13 "	 $823.45 	" $2,098.60 "	" $2,831.44 "	" $2,298.47 "	" $2,664.89 "	 $799.47 	" $2,998.00 "	" $2,708.19 "	" $2,831.44 "	 $792.80 	" $2,708.19 "	 $799.47 
308645	HCHG BMH REPAIR FINGER TENDON W/O GRAFT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26418	 $395.00 	 $276.50 	 $94.01 	 $355.50 	 $343.65 	 $94.80 	 $302.18 	 $331.80 	 $331.80 	 $97.64 	 $248.85 	 $335.75 	 $272.55 	 $316.00 	 $94.80 	 $355.50 	 $321.14 	 $335.75 	 $94.01 	 $321.14 	 $94.80 
308647	HCHG BMH/CVMC TREAT METACARPAL FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26600	 $462.37 	 $323.66 	 $110.04 	 $416.13 	 $402.26 	 $110.97 	 $353.71 	 $388.39 	 $388.39 	 $114.30 	 $291.29 	 $393.01 	 $319.04 	 $369.90 	 $110.97 	 $416.13 	 $375.91 	 $393.01 	 $110.04 	 $375.91 	 $110.97 
308649	HCHG TREAT METACARPAL FX W MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26605	" $1,183.00 "	 $828.10 	 $281.55 	" $1,064.70 "	" $1,029.21 "	 $283.92 	 $905.00 	 $993.72 	 $993.72 	 $283.92 	 $745.29 	" $1,005.55 "	 $816.27 	 $946.40 	 $283.92 	" $1,064.70 "	 $961.78 	" $1,005.55 "	 $281.55 	 $961.78 	 $283.92 
308651	HCHG BMH/CVMC TREAT METACARPAL FRACTURE W/MANIPULATION EACH BONE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26607	" $3,745.97 "	" $2,622.18 "	 $891.54 	" $3,371.37 "	" $3,258.99 "	 $899.03 	" $2,865.67 "	" $3,146.61 "	" $3,146.61 "	 $926.00 	" $2,359.96 "	" $3,184.07 "	" $2,584.72 "	" $2,996.78 "	 $899.03 	" $3,371.37 "	" $3,045.47 "	" $3,184.07 "	 $891.54 	" $3,045.47 "	 $899.03 
308653	HCHG BMH/CVMC TEAT THUMB DISLOCATION W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26641	 $644.47 	 $451.13 	 $153.38 	 $580.02 	 $560.69 	 $154.67 	 $493.02 	 $541.35 	 $541.35 	 $159.31 	 $406.02 	 $547.80 	 $444.68 	 $515.58 	 $154.67 	 $580.02 	 $523.95 	 $547.80 	 $153.38 	 $523.95 	 $154.67 
308655	HCHG BMH/CVMC TREAT THUMB FRACTURE CLOSED W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26645	 $885.72 	 $620.00 	 $210.80 	 $797.15 	 $770.58 	 $212.57 	 $677.58 	 $744.00 	 $744.00 	 $218.95 	 $558.00 	 $752.86 	 $611.15 	 $708.58 	 $212.57 	 $797.15 	 $720.09 	 $752.86 	 $210.80 	 $720.09 	 $212.57 
308657	HCHG BMH/CVMC TX HAND DISLOCATION W/MANIPULATION W/O ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26670	 $454.12 	 $317.88 	 $108.08 	 $408.71 	 $395.08 	 $108.99 	 $347.40 	 $381.46 	 $381.46 	 $112.26 	 $286.10 	 $386.00 	 $313.34 	 $363.30 	 $108.99 	 $408.71 	 $369.20 	 $386.00 	 $108.08 	 $369.20 	 $108.99 
308659	HCHG BMH/CVMC TX KNUCKLE DISLOCATION W/MANIPULATION W/O ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26700	 $610.00 	 $427.00 	 $145.18 	 $549.00 	 $530.70 	 $146.40 	 $466.65 	 $512.40 	 $512.40 	 $150.79 	 $384.30 	 $518.50 	 $420.90 	 $488.00 	 $146.40 	 $549.00 	 $495.93 	 $518.50 	 $145.18 	 $495.93 	 $146.40 
308661	HCHG BMH/CVMC TREAT FINGER FX EACH W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26720	 $590.00 	 $413.00 	 $140.42 	 $531.00 	 $513.30 	 $141.60 	 $451.35 	 $495.60 	 $495.60 	 $145.85 	 $371.70 	 $501.50 	 $407.10 	 $472.00 	 $141.60 	 $531.00 	 $479.67 	 $501.50 	 $140.42 	 $479.67 	 $141.60 
308663	HCHG TX FINGER FX-W MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26725	 $720.00 	 $504.00 	 $171.36 	 $648.00 	 $626.40 	 $172.80 	 $550.80 	 $604.80 	 $604.80 	 $172.80 	 $453.60 	 $612.00 	 $496.80 	 $576.00 	 $172.80 	 $648.00 	 $585.36 	 $612.00 	 $171.36 	 $585.36 	 $172.80 
308665	HCHG BMH/CVMC TX FINGER FX EACH W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26740	 $423.34 	 $296.34 	 $100.75 	 $381.01 	 $368.31 	 $101.60 	 $323.86 	 $355.61 	 $355.61 	 $104.65 	 $266.70 	 $359.84 	 $292.10 	 $338.67 	 $101.60 	 $381.01 	 $344.18 	 $359.84 	 $100.75 	 $344.18 	 $101.60 
308667	HCHG BMH/CVMC TREAT FINGER FRACTURE EACH CLOSED W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26742	 $659.03 	 $461.32 	 $156.85 	 $593.13 	 $573.36 	 $158.17 	 $504.16 	 $553.59 	 $553.59 	 $162.91 	 $415.19 	 $560.18 	 $454.73 	 $527.22 	 $158.17 	 $593.13 	 $535.79 	 $560.18 	 $156.85 	 $535.79 	 $158.17 
308669	HCHG BMH/CVMC CLOSED TX FINGER FX W/O MAN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26750	 $499.91 	 $349.94 	 $118.98 	 $449.92 	 $434.92 	 $119.98 	 $382.43 	 $419.92 	 $419.92 	 $123.58 	 $314.94 	 $424.92 	 $344.94 	 $399.93 	 $119.98 	 $449.92 	 $406.43 	 $424.92 	 $118.98 	 $406.43 	 $119.98 
308671	HCHG BMH/CVMC TREAT FINGER FX EACH W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26755	 $637.00 	 $445.90 	 $151.61 	 $573.30 	 $554.19 	 $152.88 	 $487.31 	 $535.08 	 $535.08 	 $157.47 	 $401.31 	 $541.45 	 $439.53 	 $509.60 	 $152.88 	 $573.30 	 $517.88 	 $541.45 	 $151.61 	 $517.88 	 $152.88 
308673	HCHG AMPUTATION FINGER THUMB	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26951	" $4,790.00 "	" $3,353.00 "	" $1,140.02 "	" $4,311.00 "	" $4,167.30 "	" $1,149.60 "	" $3,664.35 "	" $3,786.00 "	" $3,283.00 "	" $1,184.09 "	" $3,017.70 "	" $4,071.50 "	" $3,305.10 "	" $3,832.00 "	" $1,149.60 "	" $4,311.00 "	" $3,894.27 "	" $4,071.50 "	" $1,140.02 "	" $3,894.27 "	" $1,149.60 "
308676	HCHG CVMC REMOVAL OF FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISSUE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27086	" $3,533.85 "	" $2,473.70 "	 $841.06 	" $3,180.47 "	" $3,074.45 "	 $848.12 	" $2,703.40 "	" $2,968.43 "	" $2,968.43 "	 $873.57 	" $2,226.33 "	" $3,003.77 "	" $2,438.36 "	" $2,827.08 "	 $848.12 	" $3,180.47 "	" $2,873.02 "	" $3,003.77 "	 $841.06 	" $2,873.02 "	 $848.12 
308680	"HCHG BMH/CVMC CLOSED TX THIGH FX W/O MAN PROXIMAL END,NECK"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27230	 $690.00 	 $483.00 	 $164.22 	 $621.00 	 $600.30 	 $165.60 	 $527.85 	 $579.60 	 $579.60 	 $170.57 	 $434.70 	 $586.50 	 $476.10 	 $552.00 	 $165.60 	 $621.00 	 $560.97 	 $586.50 	 $164.22 	 $560.97 	 $165.60 
308682	HCHG TREAT HIP DISLOCATION W/O ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27250	" $1,020.00 "	 $714.00 	 $242.76 	 $918.00 	 $887.40 	 $244.80 	 $780.30 	 $856.80 	 $856.80 	 $244.80 	 $642.60 	 $867.00 	 $703.80 	 $816.00 	 $244.80 	 $918.00 	 $829.26 	 $867.00 	 $242.76 	 $829.26 	 $244.80 
308684	HCHG TREAT HIP DISLOCATION WO ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27265	" $1,020.00 "	 $714.00 	 $242.76 	 $918.00 	 $887.40 	 $244.80 	 $780.30 	 $856.80 	 $856.80 	 $244.80 	 $642.60 	 $867.00 	 $703.80 	 $816.00 	 $244.80 	 $918.00 	 $829.26 	 $867.00 	 $242.76 	 $829.26 	 $244.80 
308686	HCHG BMH/CVMC CLOSED TX POST HIP ARTHROPLASTY DISLOCATION W/ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27266	" $3,310.00 "	" $2,317.00 "	 $787.78 	" $2,979.00 "	" $2,879.70 "	 $794.40 	" $2,532.15 "	" $2,780.40 "	" $2,780.40 "	 $818.23 	" $2,085.30 "	" $2,813.50 "	" $2,283.90 "	" $2,648.00 "	 $794.40 	" $2,979.00 "	" $2,691.03 "	" $2,813.50 "	 $787.78 	" $2,691.03 "	 $794.40 
308688	HCHG SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE PRIMARY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27385	" $10,300.00 "	" $7,210.00 "	" $2,451.40 "	" $9,270.00 "	" $8,961.00 "	" $2,472.00 "	" $7,879.50 "	" $3,786.00 "	" $3,283.00 "	" $2,472.00 "	" $6,489.00 "	" $8,755.00 "	" $7,107.00 "	" $8,240.00 "	" $2,472.00 "	" $9,270.00 "	" $8,373.90 "	" $8,755.00 "	" $2,451.40 "	" $8,373.90 "	" $2,472.00 "
308690	HCHG BMH/CVMC CLOSED TX OF THIGH FX W/O MAN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27500	 $735.60 	 $514.92 	 $175.07 	 $662.04 	 $639.97 	 $176.54 	 $562.73 	 $617.90 	 $617.90 	 $181.84 	 $463.43 	 $625.26 	 $507.56 	 $588.48 	 $176.54 	 $662.04 	 $598.04 	 $625.26 	 $175.07 	 $598.04 	 $176.54 
308692	HCHG BMH/CVMC CLOSED TX OF THIGH FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27501	 $761.11 	 $532.78 	 $181.14 	 $685.00 	 $662.17 	 $182.67 	 $582.25 	 $639.33 	 $639.33 	 $188.15 	 $479.50 	 $646.94 	 $525.17 	 $608.89 	 $182.67 	 $685.00 	 $618.78 	 $646.94 	 $181.14 	 $618.78 	 $182.67 
308694	HCHG BMH/CVMC TREATMENT OF THIGH FRACTURE W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27503	" $2,950.05 "	" $2,065.04 "	 $702.11 	" $2,655.05 "	" $2,566.54 "	 $708.01 	" $2,256.79 "	" $2,478.04 "	" $2,478.04 "	 $729.25 	" $1,858.53 "	" $2,507.54 "	" $2,035.53 "	" $2,360.04 "	 $708.01 	" $2,655.05 "	" $2,398.39 "	" $2,507.54 "	 $702.11 	" $2,398.39 "	 $708.01 
308696	HCHG BMH/CVMC CLOSED TX OF THIGH FX W/O MANIPULATION MEDIAL OR LATERAL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27508	 $668.04 	 $467.63 	 $158.99 	 $601.24 	 $581.19 	 $160.33 	 $511.05 	 $561.15 	 $561.15 	 $165.14 	 $420.87 	 $567.83 	 $460.95 	 $534.43 	 $160.33 	 $601.24 	 $543.12 	 $567.83 	 $158.99 	 $543.12 	 $160.33 
308699	HCHG BMH/CVMC CLOSED TX KNEE FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27530	 $668.04 	 $467.63 	 $158.99 	 $601.24 	 $581.19 	 $160.33 	 $511.05 	 $561.15 	 $561.15 	 $165.14 	 $420.87 	 $567.83 	 $460.95 	 $534.43 	 $160.33 	 $601.24 	 $543.12 	 $567.83 	 $158.99 	 $543.12 	 $160.33 
308702	HCHG TREAT KNEECAP DISLOCATION WO ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27560	 $690.00 	 $483.00 	 $164.22 	 $621.00 	 $600.30 	 $165.60 	 $527.85 	 $579.60 	 $579.60 	 $165.60 	 $434.70 	 $586.50 	 $476.10 	 $552.00 	 $165.60 	 $621.00 	 $560.97 	 $586.50 	 $164.22 	 $560.97 	 $165.60 
308704	"HCHG CVMC REPAIR, OPEN OR PERCUT RUPTURED ACHILLES TENDON"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27650	" $8,700.00 "	" $6,090.00 "	" $2,070.60 "	" $7,830.00 "	" $7,569.00 "	" $2,088.00 "	" $6,655.50 "	" $3,786.00 "	" $3,283.00 "	" $2,150.64 "	" $5,481.00 "	" $7,395.00 "	" $6,003.00 "	" $6,960.00 "	" $2,088.00 "	" $7,830.00 "	" $7,073.10 "	" $7,395.00 "	" $2,070.60 "	" $7,073.10 "	" $2,088.00 "
308706	HCHG BMH/CVMC TX OF TIBIA FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27750	 $669.54 	 $468.68 	 $159.35 	 $602.59 	 $582.50 	 $160.69 	 $512.20 	 $562.41 	 $562.41 	 $165.51 	 $421.81 	 $569.11 	 $461.98 	 $535.63 	 $160.69 	 $602.59 	 $544.34 	 $569.11 	 $159.35 	 $544.34 	 $160.69 
308708	HCHG CLOSED TX TIBIAL SHAFT FX W&WO FIBULAR FX WMANIP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27752	" $4,240.00 "	" $2,968.00 "	" $1,009.12 "	" $3,816.00 "	" $3,688.80 "	" $1,017.60 "	" $3,243.60 "	" $3,561.60 "	" $3,283.00 "	" $1,048.13 "	" $2,671.20 "	" $3,604.00 "	" $2,925.60 "	" $3,392.00 "	" $1,017.60 "	" $3,816.00 "	" $3,447.12 "	" $3,604.00 "	" $1,009.12 "	" $3,447.12 "	" $1,017.60 "
308710	HCHG BMH/CVMC CLOSED TX OF ANKLE FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27760	 $595.98 	 $417.19 	 $141.84 	 $536.38 	 $518.50 	 $143.04 	 $455.92 	 $500.62 	 $500.62 	 $147.33 	 $375.47 	 $506.58 	 $411.23 	 $476.78 	 $143.04 	 $536.38 	 $484.53 	 $506.58 	 $141.84 	 $484.53 	 $143.04 
308714	HCHG BMH/CVMC CLOSED TX OF PROXIMAL FIBULA OR SHAFT FX W/O MAN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27780	 $544.94 	 $381.46 	 $129.70 	 $490.45 	 $474.10 	 $130.79 	 $416.88 	 $457.75 	 $457.75 	 $134.71 	 $343.31 	 $463.20 	 $376.01 	 $435.95 	 $130.79 	 $490.45 	 $443.04 	 $463.20 	 $129.70 	 $443.04 	 $130.79 
308716	HCHG BMH/CVMC CLOSED TX OF PROXIMAL FIBULA/SHAFT FX W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27781	" $3,744.36 "	" $2,621.05 "	 $891.16 	" $3,369.92 "	" $3,257.59 "	 $898.65 	" $2,864.44 "	" $3,145.26 "	" $3,145.26 "	 $925.61 	" $2,358.95 "	" $3,182.71 "	" $2,583.61 "	" $2,995.49 "	 $898.65 	" $3,369.92 "	" $3,044.16 "	" $3,182.71 "	 $891.16 	" $3,044.16 "	 $898.65 
308718	HCHG BMH/CVMC CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE W/O MAN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27786	 $620.00 	 $434.00 	 $147.56 	 $558.00 	 $539.40 	 $148.80 	 $474.30 	 $520.80 	 $520.80 	 $153.26 	 $390.60 	 $527.00 	 $427.80 	 $496.00 	 $148.80 	 $558.00 	 $504.06 	 $527.00 	 $147.56 	 $504.06 	 $148.80 
308720	HCHG BMH/CVMC TX OF ANKLE FX W/MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27788	 $957.29 	 $670.10 	 $227.84 	 $861.56 	 $832.84 	 $229.75 	 $732.33 	 $804.12 	 $804.12 	 $236.64 	 $603.09 	 $813.70 	 $660.53 	 $765.83 	 $229.75 	 $861.56 	 $778.28 	 $813.70 	 $227.84 	 $778.28 	 $229.75 
308722	HCHG BMH/CVMC TX OF ANKLE FX-W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27808	 $565.96 	 $396.17 	 $134.70 	 $509.36 	 $492.39 	 $135.83 	 $432.96 	 $475.41 	 $475.41 	 $139.91 	 $356.55 	 $481.07 	 $390.51 	 $452.77 	 $135.83 	 $509.36 	 $460.13 	 $481.07 	 $134.70 	 $460.13 	 $135.83 
308724	HCHG TX OF ANKLE FX W MANIP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27810	" $1,070.00 "	 $749.00 	 $254.66 	 $963.00 	 $930.90 	 $256.80 	 $818.55 	 $898.80 	 $898.80 	 $256.80 	 $674.10 	 $909.50 	 $738.30 	 $856.00 	 $256.80 	 $963.00 	 $869.91 	 $909.50 	 $254.66 	 $869.91 	 $256.80 
308726	HCHG BMH/CVMC CLOSED TX OF TRIMALLEOLAR ANKLE FX W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27816	 $742.36 	 $519.65 	 $176.68 	 $668.12 	 $645.85 	 $178.17 	 $567.91 	 $623.58 	 $623.58 	 $183.51 	 $467.69 	 $631.01 	 $512.23 	 $593.89 	 $178.17 	 $668.12 	 $603.54 	 $631.01 	 $176.68 	 $603.54 	 $178.17 
308728	HCHG TREATMENT OF ANKLE FRACTURE W MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27818	" $4,030.00 "	" $2,821.00 "	 $959.14 	" $3,627.00 "	" $3,506.10 "	 $967.20 	" $3,082.95 "	" $3,385.20 "	" $3,283.00 "	 $967.20 	" $2,538.90 "	" $3,425.50 "	" $2,780.70 "	" $3,224.00 "	 $967.20 	" $3,627.00 "	" $3,276.39 "	" $3,425.50 "	 $959.14 	" $3,276.39 "	 $967.20 
308730	HCHG BMH/CVMC CLOSED TX FX OF  LOWER LEG W/WO ANES  W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27824	 $561.46 	 $393.02 	 $133.63 	 $505.31 	 $488.47 	 $134.75 	 $429.52 	 $471.63 	 $471.63 	 $138.79 	 $353.72 	 $477.24 	 $387.41 	 $449.17 	 $134.75 	 $505.31 	 $456.47 	 $477.24 	 $133.63 	 $456.47 	 $134.75 
308732	HCHG BMH/CVMC TREAT LOWER LEG FRACTURE W/WO ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27825	" $3,744.36 "	" $2,621.05 "	 $891.16 	" $3,369.92 "	" $3,257.59 "	 $898.65 	" $2,864.44 "	" $3,145.26 "	" $3,145.26 "	 $925.61 	" $2,358.95 "	" $3,182.71 "	" $2,583.61 "	" $2,995.49 "	 $898.65 	" $3,369.92 "	" $3,044.16 "	" $3,182.71 "	 $891.16 	" $3,044.16 "	 $898.65 
308735	HCHG BMH/CVMC CLOSED TREATMENT OF ANKLE DISLOCATION W/ANESTHESIA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27842	" $2,689.43 "	" $1,882.60 "	 $640.08 	" $2,420.49 "	" $2,339.80 "	 $645.46 	" $2,057.41 "	" $2,259.12 "	" $2,259.12 "	 $664.83 	" $1,694.34 "	" $2,286.02 "	" $1,855.71 "	" $2,151.54 "	 $645.46 	" $2,420.49 "	" $2,186.51 "	" $2,286.02 "	 $640.08 	" $2,186.51 "	 $645.46 
308737	HCHG CVMC MANIPULATION OF ANKLE UNDER GENERAL ANESTHESIA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27860	" $9,920.00 "	" $6,944.00 "	" $2,360.96 "	" $8,928.00 "	" $8,630.40 "	" $2,380.80 "	" $7,588.80 "	" $3,786.00 "	" $3,283.00 "	" $2,452.22 "	" $6,249.60 "	" $8,432.00 "	" $6,844.80 "	" $7,936.00 "	" $2,380.80 "	" $8,928.00 "	" $8,064.96 "	" $8,432.00 "	" $2,360.96 "	" $8,064.96 "	" $2,380.80 "
308738	HCHG CVMC LEG/ANKLE SURGERY PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27899	" $4,190.77 "	" $2,933.54 "	 $997.40 	" $3,771.69 "	" $3,645.97 "	" $1,005.78 "	" $3,205.94 "	" $3,520.25 "	" $3,283.00 "	" $1,035.96 "	" $2,640.19 "	" $3,562.15 "	" $2,891.63 "	" $3,352.62 "	" $1,005.78 "	" $3,771.69 "	" $3,407.10 "	" $3,562.15 "	 $997.40 	" $3,407.10 "	" $1,005.78 "
308740	HCHG CVMC INCISION & DRAINAGE BELOW FACIA/FOOT/SINGE BURSAL SPACE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28002	" $3,156.30 "	" $2,209.41 "	 $751.20 	" $2,840.67 "	" $2,745.98 "	 $757.51 	" $2,414.57 "	" $2,651.29 "	" $2,651.29 "	 $780.24 	" $1,988.47 "	" $2,682.86 "	" $2,177.85 "	" $2,525.04 "	 $757.51 	" $2,840.67 "	" $2,566.07 "	" $2,682.86 "	 $751.20 	" $2,566.07 "	 $757.51 
308742	HCHG BMH/CVMC REMOVAL OF FOOT FOREIGN BODY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28190	" $1,820.00 "	" $1,274.00 "	 $433.16 	" $1,638.00 "	" $1,583.40 "	 $436.80 	" $1,392.30 "	" $1,528.80 "	" $1,528.80 "	 $449.90 	" $1,146.60 "	" $1,547.00 "	" $1,255.80 "	" $1,456.00 "	 $436.80 	" $1,638.00 "	" $1,479.66 "	" $1,547.00 "	 $433.16 	" $1,479.66 "	 $436.80 
308744	HCHG CVMC REMOVAL OF FOOT FOREIGN BODY DEEP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28192	" $4,931.47 "	" $3,452.03 "	" $1,173.69 "	" $4,438.32 "	" $4,290.38 "	" $1,183.55 "	" $3,772.57 "	" $3,786.00 "	" $3,283.00 "	" $1,219.06 "	" $3,106.83 "	" $4,191.75 "	" $3,402.71 "	" $3,945.18 "	" $1,183.55 "	" $4,438.32 "	" $4,009.29 "	" $4,191.75 "	" $1,173.69 "	" $4,009.29 "	" $1,183.55 "
308746	HCHG CVMC REMOVAL OF FOOT FOREIGN BODY COMPLICATED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28193	" $5,121.61 "	" $3,585.13 "	" $1,218.94 "	" $4,609.45 "	" $4,455.80 "	" $1,229.19 "	" $3,918.03 "	" $3,786.00 "	" $3,283.00 "	" $1,266.06 "	" $3,226.61 "	" $4,353.37 "	" $3,533.91 "	" $4,097.29 "	" $1,229.19 "	" $4,609.45 "	" $4,163.87 "	" $4,353.37 "	" $1,218.94 "	" $4,163.87 "	" $1,229.19 "
308748	HCHG CVMC REPAIR OF FOOT TENDON PRIMARY OR SECONDARY EACH TENDON	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28208	" $4,206.23 "	" $2,944.36 "	" $1,001.08 "	" $3,785.61 "	" $3,659.42 "	" $1,009.50 "	" $3,217.77 "	" $3,533.23 "	" $3,283.00 "	" $1,039.78 "	" $2,649.92 "	" $3,575.30 "	" $2,902.30 "	" $3,364.98 "	" $1,009.50 "	" $3,785.61 "	" $3,419.66 "	" $3,575.30 "	" $1,001.08 "	" $3,419.66 "	" $1,009.50 "
308750	HCHG BMH/CVMC TREATMENT OF HEEL FX  W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28400	 $506.13 	 $354.29 	 $120.46 	 $455.52 	 $440.33 	 $121.47 	 $387.19 	 $425.15 	 $425.15 	 $125.12 	 $318.86 	 $430.21 	 $349.23 	 $404.90 	 $121.47 	 $455.52 	 $411.48 	 $430.21 	 $120.46 	 $411.48 	 $121.47 
308751	HCHG CLOSED TREATMENT OF TALUS FRACTURE W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28430	 $317.00 	 $221.90 	 $75.45 	 $285.30 	 $275.79 	 $76.08 	 $242.51 	 $266.28 	 $266.28 	 $78.36 	 $199.71 	 $269.45 	 $218.73 	 $253.60 	 $76.08 	 $285.30 	 $257.72 	 $269.45 	 $75.45 	 $257.72 	 $76.08 
308753	HCHG BMH/CVMC TREATMENT OF ANKLE FRACTURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28435	" $1,426.16 "	 $998.31 	 $339.43 	" $1,283.54 "	" $1,240.76 "	 $342.28 	" $1,091.01 "	" $1,197.97 "	" $1,197.97 "	 $352.55 	 $898.48 	" $1,212.24 "	 $984.05 	" $1,140.93 "	 $342.28 	" $1,283.54 "	" $1,159.47 "	" $1,212.24 "	 $339.43 	" $1,159.47 "	 $342.28 
308755	HCHG BMH/CVMC TREAT MIDFOOT FX EACH W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28450	 $471.38 	 $329.97 	 $112.19 	 $424.24 	 $410.10 	 $113.13 	 $360.61 	 $395.96 	 $395.96 	 $116.53 	 $296.97 	 $400.67 	 $325.25 	 $377.10 	 $113.13 	 $424.24 	 $383.23 	 $400.67 	 $112.19 	 $383.23 	 $113.13 
308757	HCHG BMH/CVMC TREAT METATARSAL FRACTURE W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28470	 $610.00 	 $427.00 	 $145.18 	 $549.00 	 $530.70 	 $146.40 	 $466.65 	 $512.40 	 $512.40 	 $150.79 	 $384.30 	 $518.50 	 $420.90 	 $488.00 	 $146.40 	 $549.00 	 $495.93 	 $518.50 	 $145.18 	 $495.93 	 $146.40 
308758	HCHG CLOSED TREATMENT OF METATARSAL FRACTURE WITH MANIPULATI	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28475	" $1,821.00 "	" $1,274.70 "	 $433.40 	" $1,638.90 "	" $1,584.27 "	 $437.04 	" $1,393.07 "	" $1,529.64 "	" $1,529.64 "	 $450.15 	" $1,147.23 "	" $1,547.85 "	" $1,256.49 "	" $1,456.80 "	 $437.04 	" $1,638.90 "	" $1,480.47 "	" $1,547.85 "	 $433.40 	" $1,480.47 "	 $437.04 
308760	HCHG BMH/CVMC TREAT BIG TOE FRACTURE W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28490	 $437.00 	 $305.90 	 $104.01 	 $393.30 	 $380.19 	 $104.88 	 $334.31 	 $367.08 	 $367.08 	 $108.03 	 $275.31 	 $371.45 	 $301.53 	 $349.60 	 $104.88 	 $393.30 	 $355.28 	 $371.45 	 $104.01 	 $355.28 	 $104.88 
308762	HCHG TREAT BIG TOE FRACTURE WITH MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28495	 $530.00 	 $371.00 	 $126.14 	 $477.00 	 $461.10 	 $127.20 	 $405.45 	 $445.20 	 $445.20 	 $127.20 	 $333.90 	 $450.50 	 $365.70 	 $424.00 	 $127.20 	 $477.00 	 $430.89 	 $450.50 	 $126.14 	 $430.89 	 $127.20 
308764	HCHG BMH/CVMC TREATMENT OF TOE FX-W/O MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28510	 $446.62 	 $312.63 	 $106.30 	 $401.96 	 $388.56 	 $107.19 	 $341.66 	 $375.16 	 $375.16 	 $110.40 	 $281.37 	 $379.63 	 $308.17 	 $357.30 	 $107.19 	 $401.96 	 $363.10 	 $379.63 	 $106.30 	 $363.10 	 $107.19 
308766	HCHG TX OF TOE FX W MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28515	 $560.00 	 $392.00 	 $133.28 	 $504.00 	 $487.20 	 $134.40 	 $428.40 	 $470.40 	 $470.40 	 $134.40 	 $352.80 	 $476.00 	 $386.40 	 $448.00 	 $134.40 	 $504.00 	 $455.28 	 $476.00 	 $133.28 	 $455.28 	 $134.40 
308768	HCHG CVMC TREAT FOOT DISLOCATION W/O ANESTHESIA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28540	 $426.34 	 $298.44 	 $101.47 	 $383.71 	 $370.92 	 $102.32 	 $326.15 	 $358.13 	 $358.13 	 $105.39 	 $268.59 	 $362.39 	 $294.17 	 $341.07 	 $102.32 	 $383.71 	 $346.61 	 $362.39 	 $101.47 	 $346.61 	 $102.32 
308770	HCHG CVMC TREAT FOOT DISLOCATION W/O ANESTHESIA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28570	" $1,158.38 "	 $810.87 	 $275.69 	" $1,042.54 "	" $1,007.79 "	 $278.01 	 $886.16 	 $973.04 	 $973.04 	 $286.35 	 $729.78 	 $984.62 	 $799.28 	 $926.70 	 $278.01 	" $1,042.54 "	 $941.76 	 $984.62 	 $275.69 	 $941.76 	 $278.01 
308772	HCHG BMH/CVMC TREAT FOOT DISLOCATION W/O ANESTHESIA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28600	 $301.05 	 $210.74 	 $71.65 	 $270.95 	 $261.91 	 $72.25 	 $230.30 	 $252.88 	 $252.88 	 $74.42 	 $189.66 	 $255.89 	 $207.72 	 $240.84 	 $72.25 	 $270.95 	 $244.75 	 $255.89 	 $71.65 	 $244.75 	 $72.25 
308774	HCHG BMH/CVMC TREAT TOE DISLOCATION W/O ANESTHESIA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28630	 $480.08 	 $336.06 	 $114.26 	 $432.07 	 $417.67 	 $115.22 	 $367.26 	 $403.27 	 $403.27 	 $118.68 	 $302.45 	 $408.07 	 $331.26 	 $384.06 	 $115.22 	 $432.07 	 $390.31 	 $408.07 	 $114.26 	 $390.31 	 $115.22 
308775	HCHG BMH TREAT TOE DISLOCATION W/ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28635	" $1,848.75 "	" $1,294.13 "	 $440.00 	" $1,663.88 "	" $1,608.41 "	 $443.70 	" $1,414.29 "	" $1,552.95 "	" $1,552.95 "	 $457.01 	" $1,164.71 "	" $1,571.44 "	" $1,275.64 "	" $1,479.00 "	 $443.70 	" $1,663.88 "	" $1,503.03 "	" $1,571.44 "	 $440.00 	" $1,503.03 "	 $443.70 
308777	HCHG TREAT TOE DISLOCATION WO ANES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28660	 $523.00 	 $366.10 	 $124.47 	 $470.70 	 $455.01 	 $125.52 	 $400.10 	 $439.32 	 $439.32 	 $125.52 	 $329.49 	 $444.55 	 $360.87 	 $418.40 	 $125.52 	 $470.70 	 $425.20 	 $444.55 	 $124.47 	 $425.20 	 $125.52 
308779	HCHG CVMC APPLICATION OF CAST FIGURE OF EIGHT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29049	 $235.31 	 $164.72 	 $56.00 	 $211.78 	 $204.72 	 $56.47 	 $180.01 	 $197.66 	 $197.66 	 $58.17 	 $148.25 	 $200.01 	 $162.36 	 $188.25 	 $56.47 	 $211.78 	 $191.31 	 $200.01 	 $56.00 	 $191.31 	 $56.47 
308784	HCHG CVMC APPLY FOREARM SPLINT(FOREARM TO HAND)DYNAMIC	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29126	 $387.31 	 $271.12 	 $92.18 	 $348.58 	 $336.96 	 $92.95 	 $296.29 	 $325.34 	 $325.34 	 $95.74 	 $244.01 	 $329.21 	 $267.24 	 $309.85 	 $92.95 	 $348.58 	 $314.88 	 $329.21 	 $92.18 	 $314.88 	 $92.95 
308787	HCHG CVMC APPLICATION OF FINGER SPLINT DYNAMIC	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29131	 $336.27 	 $235.39 	 $80.03 	 $302.64 	 $292.55 	 $80.70 	 $257.25 	 $282.47 	 $282.47 	 $83.13 	 $211.85 	 $285.83 	 $232.03 	 $269.02 	 $80.70 	 $302.64 	 $273.39 	 $285.83 	 $80.03 	 $273.39 	 $80.70 
308789	HCHG BMH/CVMC STRAPPING OF CHEST	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29200	 $266.01 	 $186.21 	 $63.31 	 $239.41 	 $231.43 	 $63.84 	 $203.50 	 $223.45 	 $223.45 	 $65.76 	 $167.59 	 $226.11 	 $183.55 	 $212.81 	 $63.84 	 $239.41 	 $216.27 	 $226.11 	 $63.31 	 $216.27 	 $63.84 
308791	HCHG BMH/CVMC STRAPPING OF SHOULDER	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29240	 $248.95 	 $174.27 	 $59.25 	 $224.06 	 $216.59 	 $59.75 	 $190.45 	 $209.12 	 $209.12 	 $61.54 	 $156.84 	 $211.61 	 $171.78 	 $199.16 	 $59.75 	 $224.06 	 $202.40 	 $211.61 	 $59.25 	 $202.40 	 $59.75 
308793	HCHG BMH/CVMC STRAPPING OF ELBOW OR WRIST	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29260	 $285.24 	 $199.67 	 $67.89 	 $256.72 	 $248.16 	 $68.46 	 $218.21 	 $239.60 	 $239.60 	 $70.51 	 $179.70 	 $242.45 	 $196.82 	 $228.19 	 $68.46 	 $256.72 	 $231.90 	 $242.45 	 $67.89 	 $231.90 	 $68.46 
308795	HCHG CVMC STRAPPING OF HAND OR FINGER	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29280	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $213.90 	 $248.00 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
308799	HCHG BMH/CVMC STRAPPING OF KNEE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29530	 $248.95 	 $174.27 	 $59.25 	 $224.06 	 $216.59 	 $59.75 	 $190.45 	 $209.12 	 $209.12 	 $61.54 	 $156.84 	 $211.61 	 $171.78 	 $199.16 	 $59.75 	 $224.06 	 $202.40 	 $211.61 	 $59.25 	 $202.40 	 $59.75 
308801	HCHG BMH/CVMC STRAPPING OF ANKLE AND/OR FOOT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29540	 $248.95 	 $174.27 	 $59.25 	 $224.06 	 $216.59 	 $59.75 	 $190.45 	 $209.12 	 $209.12 	 $61.54 	 $156.84 	 $211.61 	 $171.78 	 $199.16 	 $59.75 	 $224.06 	 $202.40 	 $211.61 	 $59.25 	 $202.40 	 $59.75 
308803	HCHG CVMC STRAPPING OF TOES	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29550	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $74.16 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
308804	HCHG BMH APPLICATION OF PASTE BOOT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29580	 $283.94 	 $198.76 	 $67.58 	 $255.55 	 $247.03 	 $68.15 	 $217.21 	 $238.51 	 $238.51 	 $70.19 	 $178.88 	 $241.35 	 $195.92 	 $227.15 	 $68.15 	 $255.55 	 $230.84 	 $241.35 	 $67.58 	 $230.84 	 $68.15 
308811	HCHG BMH/CVMC CASTING/STRAPPING PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	29799	 $306.31 	 $214.42 	 $72.90 	 $275.68 	 $266.49 	 $73.51 	 $234.33 	 $257.30 	 $257.30 	 $75.72 	 $192.98 	 $260.36 	 $211.35 	 $245.05 	 $73.51 	 $275.68 	 $249.03 	 $260.36 	 $72.90 	 $249.03 	 $73.51 
308813	HCHG DRAINAGE ABSCESS HEMATOMA NASAL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30000	 $747.45 	 $523.22 	 $177.89 	 $672.71 	 $650.28 	 $179.39 	 $571.80 	 $627.86 	 $627.86 	 $184.77 	 $470.89 	 $635.33 	 $515.74 	 $597.96 	 $179.39 	 $672.71 	 $607.68 	 $635.33 	 $177.89 	 $607.68 	 $179.39 
308815	HCHG CVMC DRAINAGE OF NOSE LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30020	" $2,828.28 "	" $1,979.80 "	 $673.13 	" $2,545.45 "	" $2,460.60 "	 $678.79 	" $2,163.63 "	" $2,375.76 "	" $2,375.76 "	 $699.15 	" $1,781.82 "	" $2,404.04 "	" $1,951.51 "	" $2,262.62 "	 $678.79 	" $2,545.45 "	" $2,299.39 "	" $2,404.04 "	 $673.13 	" $2,299.39 "	 $678.79 
308817	HCHG REMOVE NASAL FOREIGN BODY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30300	 $348.00 	 $243.60 	 $82.82 	 $313.20 	 $302.76 	 $83.52 	 $266.22 	 $292.32 	 $292.32 	 $83.52 	 $219.24 	 $295.80 	 $240.12 	 $278.40 	 $83.52 	 $313.20 	 $282.92 	 $295.80 	 $82.82 	 $282.92 	 $83.52 
308819	HCHG BMH/CVMC CONTROL OF NOSEBLEED SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30901	 $550.00 	 $385.00 	 $130.90 	 $495.00 	 $478.50 	 $132.00 	 $420.75 	 $462.00 	 $462.00 	 $135.96 	 $346.50 	 $467.50 	 $379.50 	 $440.00 	 $132.00 	 $495.00 	 $447.15 	 $467.50 	 $130.90 	 $447.15 	 $132.00 
308821	HCHG BMH/CVMC CONTROL OF NOSEBLEED COMPLEX	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30903	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $148.32 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
308823	HCHG BMH/CVMC CONTROL NOSEBLEED-INITIAL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30905	 $600.00 	 $420.00 	 $142.80 	 $540.00 	 $522.00 	 $144.00 	 $459.00 	 $504.00 	 $504.00 	 $148.32 	 $378.00 	 $510.00 	 $414.00 	 $480.00 	 $144.00 	 $540.00 	 $487.80 	 $510.00 	 $142.80 	 $487.80 	 $144.00 
308825	HCHG BMH/CVMC REPEAT CONTROL OF NOSEBLEED ANY METHOD SUBSEQUENT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30906	 $540.00 	 $378.00 	 $128.52 	 $486.00 	 $469.80 	 $129.60 	 $413.10 	 $453.60 	 $453.60 	 $133.49 	 $340.20 	 $459.00 	 $372.60 	 $432.00 	 $129.60 	 $486.00 	 $439.02 	 $459.00 	 $128.52 	 $439.02 	 $129.60 
308827	HCHG BMH/CVMC CONTROL OF NOSEBLEED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	30915	" $3,398.72 "	" $2,379.10 "	 $808.90 	" $3,058.85 "	" $2,956.89 "	 $815.69 	" $2,600.02 "	" $2,854.92 "	" $2,854.92 "	 $840.16 	" $2,141.19 "	" $2,888.91 "	" $2,345.12 "	" $2,718.98 "	 $815.69 	" $3,058.85 "	" $2,763.16 "	" $2,888.91 "	 $808.90 	" $2,763.16 "	 $815.69 
308831	HCHG BMH/CVMC DIAGNOSTIC LARYNGOSCOPY-INDIRECT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	31505	 $510.00 	 $357.00 	 $121.38 	 $459.00 	 $443.70 	 $122.40 	 $390.15 	 $428.40 	 $428.40 	 $126.07 	 $321.30 	 $433.50 	 $351.90 	 $408.00 	 $122.40 	 $459.00 	 $414.63 	 $433.50 	 $121.38 	 $414.63 	 $122.40 
308833	HCHG BMH/CVMC LARYNGOSCOPY DIRECT W/WO TRACHEOSCOPY DX -NO NEWBORN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	31525	" $3,373.00 "	" $2,361.10 "	 $802.77 	" $3,035.70 "	" $2,934.51 "	 $809.52 	" $2,580.35 "	" $2,833.32 "	" $2,833.32 "	 $833.81 	" $2,124.99 "	" $2,867.05 "	" $2,327.37 "	" $2,698.40 "	 $809.52 	" $3,035.70 "	" $2,742.25 "	" $2,867.05 "	 $802.77 	" $2,742.25 "	 $809.52 
308835	"HCHG CVMC LARYNGOSCOPY,DIRECT,OPERATIVE,WITH FOREIGN BODY REMOVAL"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	31530	" $5,071.00 "	" $3,549.70 "	" $1,206.90 "	" $4,563.90 "	" $4,411.77 "	" $1,217.04 "	" $3,879.32 "	" $3,786.00 "	" $3,283.00 "	" $1,253.55 "	" $3,194.73 "	" $4,310.35 "	" $3,498.99 "	" $4,056.80 "	" $1,217.04 "	" $4,563.90 "	" $4,122.72 "	" $4,310.35 "	" $1,206.90 "	" $4,122.72 "	" $1,217.04 "
308839	HCHG CVMC INCISION OF WINDPIPE EMERGENCY TRACHEOSTOMY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	31603	" $1,699.37 "	" $1,189.56 "	 $404.45 	" $1,529.43 "	" $1,478.45 "	 $407.85 	" $1,300.02 "	" $1,427.47 "	" $1,427.47 "	 $420.08 	" $1,070.60 "	" $1,444.46 "	" $1,172.57 "	" $1,359.50 "	 $407.85 	" $1,529.43 "	" $1,381.59 "	" $1,444.46 "	 $404.45 	" $1,381.59 "	 $407.85 
308841	HCHG INCISION WINDPIPE TRACH EMERGENCY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	31605	" $2,168.20 "	" $1,517.74 "	 $516.03 	" $1,951.38 "	" $1,886.33 "	 $520.37 	" $1,658.67 "	" $1,821.29 "	" $1,821.29 "	 $535.98 	" $1,365.97 "	" $1,842.97 "	" $1,496.06 "	" $1,734.56 "	 $520.37 	" $1,951.38 "	" $1,762.75 "	" $1,842.97 "	 $516.03 	" $1,762.75 "	 $520.37 
308860	HCHG CVMC REPAIR BLOOD VESSEL LESION DIRECT/NECK	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	35201	" $5,104.66 "	" $3,573.26 "	" $1,214.91 "	" $4,594.19 "	" $4,441.05 "	" $1,225.12 "	" $3,905.06 "	" $3,786.00 "	" $3,283.00 "	" $1,261.87 "	" $3,215.94 "	" $4,338.96 "	" $3,522.22 "	" $4,083.73 "	" $1,225.12 "	" $4,594.19 "	" $4,150.09 "	" $4,338.96 "	" $1,214.91 "	" $4,150.09 "	" $1,225.12 "
308862	HCHG BMH/CVMC REPAIR BLOOD VESSEL LESION/UPPER EXTREMITY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	35206	" $4,600.53 "	" $3,220.37 "	" $1,094.93 "	" $4,140.48 "	" $4,002.46 "	" $1,104.13 "	" $3,519.41 "	" $3,786.00 "	" $3,283.00 "	" $1,137.25 "	" $2,898.33 "	" $3,910.45 "	" $3,174.37 "	" $3,680.42 "	" $1,104.13 "	" $4,140.48 "	" $3,740.23 "	" $3,910.45 "	" $1,094.93 "	" $3,740.23 "	" $1,104.13 "
308864	"HCHG REPAIR BLOOD VESSEL, DIRECT HAND, FINGER"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	35207	" $4,609.76 "	" $3,226.83 "	" $1,097.12 "	" $4,148.78 "	" $4,010.49 "	" $1,106.34 "	" $3,526.47 "	" $3,786.00 "	" $3,283.00 "	" $1,106.34 "	" $2,904.15 "	" $3,918.30 "	" $3,180.73 "	" $3,687.81 "	" $1,106.34 "	" $4,148.78 "	" $3,747.73 "	" $3,918.30 "	" $1,097.12 "	" $3,747.73 "	" $1,106.34 "
308866	HCHG CVMC REPAIR BLOOD VESSEL LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	35226	" $2,638.01 "	" $1,846.61 "	 $627.85 	" $2,374.21 "	" $2,295.07 "	 $633.12 	" $2,018.08 "	" $2,215.93 "	" $2,215.93 "	 $652.12 	" $1,661.95 "	" $2,242.31 "	" $1,820.23 "	" $2,110.41 "	 $633.12 	" $2,374.21 "	" $2,144.70 "	" $2,242.31 "	 $627.85 	" $2,144.70 "	 $633.12 
308871	HCHG CVMC NON ROTUINE BL DRAW >3 YEARS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	36410	 $249.20 	 $174.44 	 $59.31 	 $224.28 	 $216.80 	 $59.81 	 $190.64 	 $209.33 	 $209.33 	 $61.60 	 $157.00 	 $211.82 	 $171.95 	 $199.36 	 $59.81 	 $224.28 	 $202.60 	 $211.82 	 $59.31 	 $202.60 	 $59.81 
308873	HCHG CVMC VEIN ACCESS CUTDOWN <1 YEAR VENIPUNCTURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	36420	" $1,341.34 "	 $938.94 	 $319.24 	" $1,207.21 "	" $1,166.97 "	 $321.92 	" $1,026.13 "	" $1,126.73 "	" $1,126.73 "	 $331.58 	 $845.04 	" $1,140.14 "	 $925.52 	" $1,073.07 "	 $321.92 	" $1,207.21 "	" $1,090.51 "	" $1,140.14 "	 $319.24 	" $1,090.51 "	 $321.92 
308881	HCHG CVMC WITHDRAWAL OF ARTERIAL BLOOD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	36600	 $176.46 	 $123.52 	 $42.00 	 $158.81 	 $153.52 	 $42.35 	 $134.99 	 $148.23 	 $148.23 	 $43.62 	 $111.17 	 $149.99 	 $121.76 	 $141.17 	 $42.35 	 $158.81 	 $143.46 	 $149.99 	 $42.00 	 $143.46 	 $42.35 
308883	HCHG CVMC INSERTION CATHETER ARTERY FOR SAMPLING MONITORING TRANSF	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	36620	 $836.03 	 $585.22 	 $198.98 	 $752.43 	 $727.35 	 $200.65 	 $639.56 	 $702.27 	 $702.27 	 $206.67 	 $526.70 	 $710.63 	 $576.86 	 $668.82 	 $200.65 	 $752.43 	 $679.69 	 $710.63 	 $198.98 	 $679.69 	 $200.65 
308885	HCHG CVMC INSERTION CATHETER ARTERY FOR SAMPLING MONITOR TRANSFUSE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	36625	 $916.04 	 $641.23 	 $218.02 	 $824.44 	 $796.95 	 $219.85 	 $700.77 	 $769.47 	 $769.47 	 $226.45 	 $577.11 	 $778.63 	 $632.07 	 $732.83 	 $219.85 	 $824.44 	 $744.74 	 $778.63 	 $218.02 	 $744.74 	 $219.85 
308887	HCHG INSERT NEEDLE BONE CAVITY FOR INTRASSEOS INFUSION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	36680	 $409.00 	 $286.30 	 $97.34 	 $368.10 	 $355.83 	 $98.16 	 $312.89 	 $343.56 	 $343.56 	 $101.10 	 $257.67 	 $347.65 	 $282.21 	 $327.20 	 $98.16 	 $368.10 	 $332.52 	 $347.65 	 $97.34 	 $332.52 	 $98.16 
308889	HCHG BMH/CVMC REPAIR LIP-VERMILLION ONLY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	40650	" $1,693.86 "	" $1,185.70 "	 $403.14 	" $1,524.47 "	" $1,473.66 "	 $406.53 	" $1,295.80 "	" $1,422.84 "	" $1,422.84 "	 $418.72 	" $1,067.13 "	" $1,439.78 "	" $1,168.76 "	" $1,355.09 "	 $406.53 	" $1,524.47 "	" $1,377.11 "	" $1,439.78 "	 $403.14 	" $1,377.11 "	 $406.53 
308891	HCHG BMH/CVMC REPAIR LIP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	40652	" $2,145.22 "	" $1,501.65 "	 $510.56 	" $1,930.70 "	" $1,866.34 "	 $514.85 	" $1,641.09 "	" $1,801.98 "	" $1,801.98 "	 $530.30 	" $1,351.49 "	" $1,823.44 "	" $1,480.20 "	" $1,716.18 "	 $514.85 	" $1,930.70 "	" $1,744.06 "	" $1,823.44 "	 $510.56 	" $1,744.06 "	 $514.85 
308893	HCHG BMH/CVMC REPAIR LIP COMPLEX	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	40654	" $2,498.01 "	" $1,748.61 "	 $594.53 	" $2,248.21 "	" $2,173.27 "	 $599.52 	" $1,910.98 "	" $2,098.33 "	" $2,098.33 "	 $617.51 	" $1,573.75 "	" $2,123.31 "	" $1,723.63 "	" $1,998.41 "	 $599.52 	" $2,248.21 "	" $2,030.88 "	" $2,123.31 "	 $594.53 	" $2,030.88 "	 $599.52 
308895	HCHG BMH/CVMC DRAINAGE OF MOUTH LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	40800	 $583.40 	 $408.38 	 $138.85 	 $525.06 	 $507.56 	 $140.02 	 $446.30 	 $490.06 	 $490.06 	 $144.22 	 $367.54 	 $495.89 	 $402.55 	 $466.72 	 $140.02 	 $525.06 	 $474.30 	 $495.89 	 $138.85 	 $474.30 	 $140.02 
308897	HCHG BMH/CVMC REPAIR MOUTH LACERATION 2.5 OR <	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	40830	 $514.91 	 $360.44 	 $122.55 	 $463.42 	 $447.97 	 $123.58 	 $393.91 	 $432.52 	 $432.52 	 $127.29 	 $324.39 	 $437.67 	 $355.29 	 $411.93 	 $123.58 	 $463.42 	 $418.62 	 $437.67 	 $122.55 	 $418.62 	 $123.58 
308899	HCHG BMH/CVMC REPAIR MOUTH LACERATION>2.5CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	40831	 $899.23 	 $629.46 	 $214.02 	 $809.31 	 $782.33 	 $215.82 	 $687.91 	 $755.35 	 $755.35 	 $222.29 	 $566.51 	 $764.35 	 $620.47 	 $719.38 	 $215.82 	 $809.31 	 $731.07 	 $764.35 	 $214.02 	 $731.07 	 $215.82 
308901	HCHG BMH/CVMC DRAINAGE OF MOUTH LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	41000	" $2,346.39 "	" $1,642.47 "	 $558.44 	" $2,111.75 "	" $2,041.36 "	 $563.13 	" $1,794.99 "	" $1,970.97 "	" $1,970.97 "	 $580.03 	" $1,478.23 "	" $1,994.43 "	" $1,619.01 "	" $1,877.11 "	 $563.13 	" $2,111.75 "	" $1,907.62 "	" $1,994.43 "	 $558.44 	" $1,907.62 "	 $563.13 
308903	HCHG BMH/CVMC REPAIR TONGUE LACERATION 2.5CM OR <	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	41250	 $453.11 	 $317.18 	 $107.84 	 $407.80 	 $394.21 	 $108.75 	 $346.63 	 $380.61 	 $380.61 	 $112.01 	 $285.46 	 $385.14 	 $312.65 	 $362.49 	 $108.75 	 $407.80 	 $368.38 	 $385.14 	 $107.84 	 $368.38 	 $108.75 
308905	HCHG BMH/CVMC REPAIR TONGUE LACERATION>2.6CM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	41252	" $1,034.58 "	 $724.21 	 $246.23 	 $931.12 	 $900.08 	 $248.30 	 $791.45 	 $869.05 	 $869.05 	 $255.75 	 $651.79 	 $879.39 	 $713.86 	 $827.66 	 $248.30 	 $931.12 	 $841.11 	 $879.39 	 $246.23 	 $841.11 	 $248.30 
308907	HCHG BMH/CVMC DRAINAGE OF GUM LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	41800	 $740.00 	 $518.00 	 $176.12 	 $666.00 	 $643.80 	 $177.60 	 $566.10 	 $621.60 	 $621.60 	 $182.93 	 $466.20 	 $629.00 	 $510.60 	 $592.00 	 $177.60 	 $666.00 	 $601.62 	 $629.00 	 $176.12 	 $601.62 	 $177.60 
308909	HCHG CVMC DENTAL SURGERY PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	41899	" $7,332.08 "	" $5,132.46 "	" $1,745.04 "	" $6,598.87 "	" $6,378.91 "	" $1,759.70 "	" $5,609.04 "	" $3,786.00 "	" $3,283.00 "	" $1,812.49 "	" $4,619.21 "	" $6,232.27 "	" $5,059.14 "	" $5,865.66 "	" $1,759.70 "	" $6,598.87 "	" $5,960.98 "	" $6,232.27 "	" $1,745.04 "	" $5,960.98 "	" $1,759.70 "
308911	HCHG BMH/CVMC DRAINAGE MOUTH ROOF LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42000	 $433.84 	 $303.69 	 $103.25 	 $390.46 	 $377.44 	 $104.12 	 $331.89 	 $364.43 	 $364.43 	 $107.25 	 $273.32 	 $368.76 	 $299.35 	 $347.07 	 $104.12 	 $390.46 	 $352.71 	 $368.76 	 $103.25 	 $352.71 	 $104.12 
308913	"HCHG DRAINAGE OF ABSCESS SUBMAXILLARY, EXTERNAL"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42320	 $623.09 	 $436.16 	 $148.30 	 $560.78 	 $542.09 	 $149.54 	 $476.66 	 $523.40 	 $523.40 	 $154.03 	 $392.55 	 $529.63 	 $429.93 	 $498.47 	 $149.54 	 $560.78 	 $506.57 	 $529.63 	 $148.30 	 $506.57 	 $149.54 
308915	HCHG DRAINAGE OF TONSIL ABSCESS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42700	 $780.00 	 $546.00 	 $185.64 	 $702.00 	 $678.60 	 $187.20 	 $596.70 	 $655.20 	 $655.20 	 $192.82 	 $491.40 	 $663.00 	 $538.20 	 $624.00 	 $187.20 	 $702.00 	 $634.14 	 $663.00 	 $185.64 	 $634.14 	 $187.20 
308917	HCHG BMH/CVMC DRAINAGE OF THROAT ABSCESS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42720	" $3,248.40 "	" $2,273.88 "	 $773.12 	" $2,923.56 "	" $2,826.11 "	 $779.62 	" $2,485.03 "	" $2,728.66 "	" $2,728.66 "	 $803.00 	" $2,046.49 "	" $2,761.14 "	" $2,241.40 "	" $2,598.72 "	 $779.62 	" $2,923.56 "	" $2,640.95 "	" $2,761.14 "	 $773.12 	" $2,640.95 "	 $779.62 
308919	HCHG BMH/CVMC REMOVE PHARYNX FOREIGN BODY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42809	 $511.17 	 $357.82 	 $121.66 	 $460.05 	 $444.72 	 $122.68 	 $391.05 	 $429.38 	 $429.38 	 $126.36 	 $322.04 	 $434.49 	 $352.71 	 $408.94 	 $122.68 	 $460.05 	 $415.58 	 $434.49 	 $121.66 	 $415.58 	 $122.68 
308921	HCHG CVMC CONTROL THROAT BLEEDING	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42960	" $3,512.83 "	" $2,458.98 "	 $836.05 	" $3,161.55 "	" $3,056.16 "	 $843.08 	" $2,687.31 "	" $2,950.78 "	" $2,950.78 "	 $868.37 	" $2,213.08 "	" $2,985.91 "	" $2,423.85 "	" $2,810.26 "	 $843.08 	" $3,161.55 "	" $2,855.93 "	" $2,985.91 "	 $836.05 	" $2,855.93 "	 $843.08 
308923	HCHG CVMC CONTROL THROAT BLEEDING W/2ND SURGICAL INTERVENTION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42962	" $3,373.21 "	" $2,361.25 "	 $802.82 	" $3,035.89 "	" $2,934.69 "	 $809.57 	" $2,580.51 "	" $2,833.50 "	" $2,833.50 "	 $833.86 	" $2,125.12 "	" $2,867.23 "	" $2,327.51 "	" $2,698.57 "	 $809.57 	" $3,035.89 "	" $2,742.42 "	" $2,867.23 "	 $802.82 	" $2,742.42 "	 $809.57 
308925	HCHG CVMC CONTROL NOSE/THROAT BLEEDING SIMPLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	42970	 $798.65 	 $559.06 	 $190.08 	 $718.79 	 $694.83 	 $191.68 	 $610.97 	 $670.87 	 $670.87 	 $197.43 	 $503.15 	 $678.85 	 $551.07 	 $638.92 	 $191.68 	 $718.79 	 $649.30 	 $678.85 	 $190.08 	 $649.30 	 $191.68 
308928	HCHG ASPIRATION OF BLADDER BY NEEDLE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	51100	 $352.30 	 $246.61 	 $83.85 	 $317.07 	 $306.50 	 $84.55 	 $269.51 	 $295.93 	 $295.93 	 $87.09 	 $221.95 	 $299.46 	 $243.09 	 $281.84 	 $84.55 	 $317.07 	 $286.42 	 $299.46 	 $83.85 	 $286.42 	 $84.55 
308930	HCHG ASPIRATION OF BLADDER BY TROCAR OR INTRACATHETER	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	51101	 $199.19 	 $139.43 	 $47.41 	 $179.27 	 $173.30 	 $47.81 	 $152.38 	 $167.32 	 $167.32 	 $49.24 	 $125.49 	 $169.31 	 $137.44 	 $159.35 	 $47.81 	 $179.27 	 $161.94 	 $169.31 	 $47.41 	 $161.94 	 $47.81 
308932	HCHG CVMC ASPIRATION OF BLADDER W/INSERTION OF SUPRAPUBIC CATHETER	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	51102	" $4,229.00 "	" $2,960.30 "	" $1,006.50 "	" $3,806.10 "	" $3,679.23 "	" $1,014.96 "	" $3,235.19 "	" $3,552.36 "	" $3,283.00 "	" $1,045.41 "	" $2,664.27 "	" $3,594.65 "	" $2,918.01 "	" $3,383.20 "	" $1,014.96 "	" $3,806.10 "	" $3,438.18 "	" $3,594.65 "	" $1,006.50 "	" $3,438.18 "	" $1,014.96 "
308934	HCHG BMH/CVMC INSERT BLADDER CATHETER COMPLEX	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	51703	 $540.00 	 $378.00 	 $128.52 	 $486.00 	 $469.80 	 $129.60 	 $413.10 	 $453.60 	 $453.60 	 $133.49 	 $340.20 	 $459.00 	 $372.60 	 $432.00 	 $129.60 	 $486.00 	 $439.02 	 $459.00 	 $128.52 	 $439.02 	 $129.60 
308936	HCHG BMH/CVMC CHANGE BLADDER TUBE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	51705	" $1,190.00 "	 $833.00 	 $283.22 	" $1,071.00 "	" $1,035.30 "	 $285.60 	 $910.35 	 $999.60 	 $999.60 	 $294.17 	 $749.70 	" $1,011.50 "	 $821.10 	 $952.00 	 $285.60 	" $1,071.00 "	 $967.47 	" $1,011.50 "	 $283.22 	 $967.47 	 $285.60 
308940	"HCHG CVMC CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	52315	" $5,635.55 "	" $3,944.89 "	" $1,341.26 "	" $5,072.00 "	" $4,902.93 "	" $1,352.53 "	" $4,311.20 "	" $3,786.00 "	" $3,283.00 "	" $1,393.11 "	" $3,550.40 "	" $4,790.22 "	" $3,888.53 "	" $4,508.44 "	" $1,352.53 "	" $5,072.00 "	" $4,581.70 "	" $4,790.22 "	" $1,341.26 "	" $4,581.70 "	" $1,352.53 "
308942	HCHG CVMC DRAINAGE OF SKENE'S GLAND ABSCESS OR CYST	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	53060	" $3,742.56 "	" $2,619.79 "	 $890.73 	" $3,368.30 "	" $3,256.03 "	 $898.21 	" $2,863.06 "	" $3,143.75 "	" $3,143.75 "	 $925.16 	" $2,357.81 "	" $3,181.18 "	" $2,582.37 "	" $2,994.05 "	 $898.21 	" $3,368.30 "	" $3,042.70 "	" $3,181.18 "	 $890.73 	" $3,042.70 "	 $898.21 
308944	HCHG CVMC DILATE URETHRA STRICTURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	53600	" $1,385.62 "	 $969.93 	 $329.78 	" $1,247.06 "	" $1,205.49 "	 $332.55 	" $1,060.00 "	" $1,163.92 "	" $1,163.92 "	 $342.53 	 $872.94 	" $1,177.78 "	 $956.08 	" $1,108.50 "	 $332.55 	" $1,247.06 "	" $1,126.51 "	" $1,177.78 "	 $329.78 	" $1,126.51 "	 $332.55 
308946	HCHG IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	54220	 $767.12 	 $536.98 	 $182.57 	 $690.41 	 $667.39 	 $184.11 	 $586.85 	 $644.38 	 $644.38 	 $189.63 	 $483.29 	 $652.05 	 $529.31 	 $613.70 	 $184.11 	 $690.41 	 $623.67 	 $652.05 	 $182.57 	 $623.67 	 $184.11 
308948	HCHG BMH/CVMC INCISION AND DRAINAGE OF SCROTUM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	54700	" $4,226.29 "	" $2,958.40 "	" $1,005.86 "	" $3,803.66 "	" $3,676.87 "	" $1,014.31 "	" $3,233.11 "	" $3,550.08 "	" $3,283.00 "	" $1,044.74 "	" $2,662.56 "	" $3,592.35 "	" $2,916.14 "	" $3,381.03 "	" $1,014.31 "	" $3,803.66 "	" $3,435.97 "	" $3,592.35 "	" $1,005.86 "	" $3,435.97 "	" $1,014.31 "
308950	HCHG CVMC DRAINAGE OF SCROTUM ABSCESS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	55100	" $2,315.77 "	" $1,621.04 "	 $551.15 	" $2,084.19 "	" $2,014.72 "	 $555.78 	" $1,771.56 "	" $1,945.25 "	" $1,945.25 "	 $572.46 	" $1,458.94 "	" $1,968.40 "	" $1,597.88 "	" $1,852.62 "	 $555.78 	" $2,084.19 "	" $1,882.72 "	" $1,968.40 "	 $551.15 	" $1,882.72 "	 $555.78 
308951	HCHG GENITAL MALE SURGERY PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	55899	" $3,057.97 "	" $2,140.58 "	 $727.80 	" $2,752.17 "	" $2,660.43 "	 $733.91 	" $2,339.35 "	" $2,568.69 "	" $2,568.69 "	 $755.93 	" $1,926.52 "	" $2,599.27 "	" $2,110.00 "	" $2,446.38 "	 $733.91 	" $2,752.17 "	" $2,486.13 "	" $2,599.27 "	 $727.80 	" $2,486.13 "	 $733.91 
308953	HCHG CVMC I & D OF VULVA/PERINEUM	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	56405	 $919.23 	 $643.46 	 $218.78 	 $827.31 	 $799.73 	 $220.62 	 $703.21 	 $772.15 	 $772.15 	 $227.23 	 $579.11 	 $781.35 	 $634.27 	 $735.38 	 $220.62 	 $827.31 	 $747.33 	 $781.35 	 $218.78 	 $747.33 	 $220.62 
308961	HCHG BMH/CVMC REMOVE VAGINAL FOREIGN BODY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	57415	" $4,488.62 "	" $3,142.03 "	" $1,068.29 "	" $4,039.76 "	" $3,905.10 "	" $1,077.27 "	" $3,433.79 "	" $3,770.44 "	" $3,283.00 "	" $1,109.59 "	" $2,827.83 "	" $3,815.33 "	" $3,097.15 "	" $3,590.90 "	" $1,077.27 "	" $4,039.76 "	" $3,649.25 "	" $3,815.33 "	" $1,068.29 "	" $3,649.25 "	" $1,077.27 "
308968	HCHG CVMC GENITAL SURGERY PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	58999	" $2,592.15 "	" $1,814.51 "	 $616.93 	" $2,332.94 "	" $2,255.17 "	 $622.12 	" $1,982.99 "	" $2,177.41 "	" $2,177.41 "	 $640.78 	" $1,633.05 "	" $2,203.33 "	" $1,788.58 "	" $2,073.72 "	 $622.12 	" $2,332.94 "	" $2,107.42 "	" $2,203.33 "	 $616.93 	" $2,107.42 "	 $622.12 
308973	HCHG CVMC TX OF MISSED ABORTION COMPLETED SURGICALLY 2ND TRIMESTER	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	59821	" $3,727.67 "	" $2,609.37 "	 $887.19 	" $3,354.90 "	" $3,243.07 "	 $894.64 	" $2,851.67 "	" $3,131.24 "	" $3,131.24 "	 $921.48 	" $2,348.43 "	" $3,168.52 "	" $2,572.09 "	" $2,982.14 "	 $894.64 	" $3,354.90 "	" $3,030.60 "	" $3,168.52 "	 $887.19 	" $3,030.60 "	 $894.64 
308981	HCHG INJ(S) ANES FEMORAL NERVE (INCLUDES IG)	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	64447	" $3,410.00 "	" $2,387.00 "	 $811.58 	" $3,069.00 "	" $2,966.70 "	 $818.40 	" $2,608.65 "	" $2,864.40 "	" $2,864.40 "	 $842.95 	" $2,148.30 "	" $2,898.50 "	" $2,352.90 "	" $2,728.00 "	 $818.40 	" $3,069.00 "	" $2,772.33 "	" $2,898.50 "	 $811.58 	" $2,772.33 "	 $818.40 
308985	HCHG REMOVE FB EYE EXTERNAL CONJ EMB	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	65210	 $510.41 	 $357.29 	 $121.48 	 $459.37 	 $444.06 	 $122.50 	 $390.46 	 $428.74 	 $428.74 	 $122.50 	 $321.56 	 $433.85 	 $352.18 	 $408.33 	 $122.50 	 $459.37 	 $414.96 	 $433.85 	 $121.48 	 $414.96 	 $122.50 
308987	HCHG REMOVE FOREIGN BODY FROM EYE CORNEAL WO SLIT LAMP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	65220	 $650.00 	 $455.00 	 $154.70 	 $585.00 	 $565.50 	 $156.00 	 $497.25 	 $546.00 	 $546.00 	 $156.00 	 $409.50 	 $552.50 	 $448.50 	 $520.00 	 $156.00 	 $585.00 	 $528.45 	 $552.50 	 $154.70 	 $528.45 	 $156.00 
308989	HCHG REMOVE FOREIGN BODY FROM EYE CORNEAL W SLIT LAMP	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	65222	 $470.00 	 $329.00 	 $111.86 	 $423.00 	 $408.90 	 $112.80 	 $359.55 	 $394.80 	 $394.80 	 $112.80 	 $296.10 	 $399.50 	 $324.30 	 $376.00 	 $112.80 	 $423.00 	 $382.11 	 $399.50 	 $111.86 	 $382.11 	 $112.80 
308991	HCHG BMH/CVMC REMOVE FOREIGN BODY FROM EYE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	65235	" $3,563.88 "	" $2,494.72 "	 $848.20 	" $3,207.49 "	" $3,100.58 "	 $855.33 	" $2,726.37 "	" $2,993.66 "	" $2,993.66 "	 $880.99 	" $2,245.24 "	" $3,029.30 "	" $2,459.08 "	" $2,851.10 "	 $855.33 	" $3,207.49 "	" $2,897.43 "	" $3,029.30 "	 $848.20 	" $2,897.43 "	 $855.33 
308993	HCHG CVMC REMOVAL OF CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	65435	" $2,739.31 "	" $1,917.52 "	 $651.96 	" $2,465.38 "	" $2,383.20 "	 $657.43 	" $2,095.57 "	" $2,301.02 "	" $2,301.02 "	 $677.16 	" $1,725.77 "	" $2,328.41 "	" $1,890.12 "	" $2,191.45 "	 $657.43 	" $2,465.38 "	" $2,227.06 "	" $2,328.41 "	 $651.96 	" $2,227.06 "	 $657.43 
308994	HCHG CVMC EYE SURGERY PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	66999	" $2,681.16 "	" $1,876.81 "	 $638.12 	" $2,413.04 "	" $2,332.61 "	 $643.48 	" $2,051.09 "	" $2,252.17 "	" $2,252.17 "	 $662.78 	" $1,689.13 "	" $2,278.99 "	" $1,850.00 "	" $2,144.93 "	 $643.48 	" $2,413.04 "	" $2,179.78 "	" $2,278.99 "	 $638.12 	" $2,179.78 "	 $643.48 
308996	"HCHG BMH/CVMC BLEPHAROTOMY, DRAINAGE OF ABSCESS EYELID"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	67700	 $998.30 	 $698.81 	 $237.60 	 $898.47 	 $868.52 	 $239.59 	 $763.70 	 $838.57 	 $838.57 	 $246.78 	 $628.93 	 $848.56 	 $688.83 	 $798.64 	 $239.59 	 $898.47 	 $811.62 	 $848.56 	 $237.60 	 $811.62 	 $239.59 
308998	HCHG INCISION OF EYELID FOLD	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	67715	" $2,895.00 "	" $2,026.50 "	 $689.01 	" $2,605.50 "	" $2,518.65 "	 $694.80 	" $2,214.68 "	" $2,431.80 "	" $2,431.80 "	 $715.64 	" $1,823.85 "	" $2,460.75 "	" $1,997.55 "	" $2,316.00 "	 $694.80 	" $2,605.50 "	" $2,353.64 "	" $2,460.75 "	 $689.01 	" $2,353.64 "	 $694.80 
309001	HCHG CVMC SUTURE OF RECENT WOUND EYELID	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	67935	" $3,977.86 "	" $2,784.50 "	 $946.73 	" $3,580.07 "	" $3,460.74 "	 $954.69 	" $3,043.06 "	" $3,341.40 "	" $3,283.00 "	 $983.33 	" $2,506.05 "	" $3,381.18 "	" $2,744.72 "	" $3,182.29 "	 $954.69 	" $3,580.07 "	" $3,234.00 "	" $3,381.18 "	 $946.73 	" $3,234.00 "	 $954.69 
309003	HCHG BMH/CVMC REMOVE EYELID FOREIGN BODY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	67938	 $983.89 	 $688.72 	 $234.17 	 $885.50 	 $855.98 	 $236.13 	 $752.68 	 $826.47 	 $826.47 	 $243.22 	 $619.85 	 $836.31 	 $678.88 	 $787.11 	 $236.13 	 $885.50 	 $799.90 	 $836.31 	 $234.17 	 $799.90 	 $236.13 
309005	HCHG BMH/CVMC DRAIN EXTERNAL EAR LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	69000	 $563.62 	 $394.53 	 $134.14 	 $507.26 	 $490.35 	 $135.27 	 $431.17 	 $473.44 	 $473.44 	 $139.33 	 $355.08 	 $479.08 	 $388.90 	 $450.90 	 $135.27 	 $507.26 	 $458.22 	 $479.08 	 $134.14 	 $458.22 	 $135.27 
309007	HCHG BMH/CVMC CLEAR OUTER EAR CANAL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	69200	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $71.69 	 $182.70 	 $246.50 	 $200.10 	 $232.00 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
309034	HCHG BMH/CVMC NASOPHARYNGOSCOPY W ENDOSCOPE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	92511	 $452.00 	 $316.40 	 $107.58 	 $406.80 	 $393.24 	 $108.48 	 $345.78 	 $379.68 	 $379.68 	 $111.73 	 $284.76 	 $384.20 	 $311.88 	 $361.60 	 $108.48 	 $406.80 	 $367.48 	 $384.20 	 $107.58 	 $367.48 	 $108.48 
309040	HCHG BMH/CVMC TEMPORARY TRANSCUTANEOUS PACING	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	92953	 $968.28 	 $677.80 	 $230.45 	 $871.45 	 $842.40 	 $232.39 	 $740.73 	 $813.36 	 $813.36 	 $239.36 	 $610.02 	 $823.04 	 $668.11 	 $774.62 	 $232.39 	 $871.45 	 $787.21 	 $823.04 	 $230.45 	 $787.21 	 $232.39 
309584	HCHG BMH/CVMC DRAINAGE OF BREAST LESION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	19000	 $662.49 	 $463.74 	 $157.67 	 $596.24 	 $576.37 	 $159.00 	 $506.80 	 $556.49 	 $556.49 	 $163.77 	 $417.37 	 $563.12 	 $457.12 	 $529.99 	 $159.00 	 $596.24 	 $538.60 	 $563.12 	 $157.67 	 $538.60 	 $159.00 
309587	HCHG BMH/CVMC INCISION OF RETAL ABSCESS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46040	" $3,340.00 "	" $2,338.00 "	 $794.92 	" $3,006.00 "	" $2,905.80 "	 $801.60 	" $2,555.10 "	" $2,805.60 "	" $2,805.60 "	 $825.65 	" $2,104.20 "	" $2,839.00 "	" $2,304.60 "	" $2,672.00 "	 $801.60 	" $3,006.00 "	" $2,715.42 "	" $2,839.00 "	 $794.92 	" $2,715.42 "	 $801.60 
309588	HCHG BMH/CVMC INCISION AND DRAINAGE OF ANAL ABSCESS SUPERFICIAL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46050	" $2,670.00 "	" $1,869.00 "	 $635.46 	" $2,403.00 "	" $2,322.90 "	 $640.80 	" $2,042.55 "	" $2,242.80 "	" $2,242.80 "	 $660.02 	" $1,682.10 "	" $2,269.50 "	" $1,842.30 "	" $2,136.00 "	 $640.80 	" $2,403.00 "	" $2,170.71 "	" $2,269.50 "	 $635.46 	" $2,170.71 "	 $640.80 
309589	"HCHG BMH/CVMC EXCISION OF THROMBOSED HEMORRHOID, EXTERNAL"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46320	" $3,605.16 "	" $2,523.61 "	 $858.03 	" $3,244.64 "	" $3,136.49 "	 $865.24 	" $2,757.95 "	" $3,028.33 "	" $3,028.33 "	 $891.20 	" $2,271.25 "	" $3,064.39 "	" $2,487.56 "	" $2,884.13 "	 $865.24 	" $3,244.64 "	" $2,931.00 "	" $3,064.39 "	 $858.03 	" $2,931.00 "	 $865.24 
309590	HCHG BMH/CVMC REPLACEMENT OF GASTROSTOMY OR CECOSTOMY TUBE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	49450	 $950.00 	 $665.00 	 $226.10 	 $855.00 	 $826.50 	 $228.00 	 $726.75 	 $798.00 	 $798.00 	 $234.84 	 $598.50 	 $807.50 	 $655.50 	 $760.00 	 $228.00 	 $855.00 	 $772.35 	 $807.50 	 $226.10 	 $772.35 	 $228.00 
309603	"HCHG CVMC UPPER GI ENDOSCOPY, DIAGNOSTIC"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	43235	" $2,270.25 "	" $1,589.18 "	 $540.32 	" $2,043.23 "	" $1,975.12 "	 $544.86 	" $1,736.74 "	" $1,907.01 "	" $1,907.01 "	 $561.21 	" $1,430.26 "	" $1,929.71 "	" $1,566.47 "	" $1,816.20 "	 $544.86 	" $2,043.23 "	" $1,845.71 "	" $1,929.71 "	 $540.32 	" $1,845.71 "	 $544.86 
309604	HCHG CVMC STOMACH SURGERY PROCEDURE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	43999	" $2,604.60 "	" $1,823.22 "	 $619.89 	" $2,344.14 "	" $2,266.00 "	 $625.10 	" $1,992.52 "	" $2,187.86 "	" $2,187.86 "	 $643.86 	" $1,640.90 "	" $2,213.91 "	" $1,797.17 "	" $2,083.68 "	 $625.10 	" $2,344.14 "	" $2,117.54 "	" $2,213.91 "	 $619.89 	" $2,117.54 "	 $625.10 
309605	HCHG CVMC REMOVAL FECAL IMPACTION/FOREIGN BODY UNDER ANESTHESIA	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	45915	" $2,770.00 "	" $1,939.00 "	 $659.26 	" $2,493.00 "	" $2,409.90 "	 $664.80 	" $2,119.05 "	" $2,326.80 "	" $2,326.80 "	 $684.74 	" $1,745.10 "	" $2,354.50 "	" $1,911.30 "	" $2,216.00 "	 $664.80 	" $2,493.00 "	" $2,252.01 "	" $2,354.50 "	 $659.26 	" $2,252.01 "	 $664.80 
309606	"HCHG CVMC UNLISTED PROCEDURE, RECTUM"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	45999	" $3,486.23 "	" $2,440.36 "	 $829.72 	" $3,137.61 "	" $3,033.02 "	 $836.70 	" $2,666.97 "	" $2,928.43 "	" $2,928.43 "	 $861.80 	" $2,196.32 "	" $2,963.30 "	" $2,405.50 "	" $2,788.98 "	 $836.70 	" $3,137.61 "	" $2,834.30 "	" $2,963.30 "	 $829.72 	" $2,834.30 "	 $836.70 
309607	"HCHG CVMC HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S)"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46221	" $1,501.21 "	" $1,050.85 "	 $357.29 	" $1,351.09 "	" $1,306.05 "	 $360.29 	" $1,148.43 "	" $1,261.02 "	" $1,261.02 "	 $371.10 	 $945.76 	" $1,276.03 "	" $1,035.83 "	" $1,200.97 "	 $360.29 	" $1,351.09 "	" $1,220.48 "	" $1,276.03 "	 $357.29 	" $1,220.48 "	 $360.29 
309608	"HCHG CVMC HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE COLUMNS/GROUPS"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46250	" $4,372.37 "	" $3,060.66 "	" $1,040.62 "	" $3,935.13 "	" $3,803.96 "	" $1,049.37 "	" $3,344.86 "	" $3,672.79 "	" $3,283.00 "	" $1,080.85 "	" $2,754.59 "	" $3,716.51 "	" $3,016.94 "	" $3,497.90 "	" $1,049.37 "	" $3,935.13 "	" $3,554.74 "	" $3,716.51 "	" $1,040.62 "	" $3,554.74 "	" $1,049.37 "
309609	HCHG BMH/CVMC ANUS SURGERY PROCEDURE UNLISTED	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46999	" $3,334.19 "	" $2,333.93 "	 $793.54 	" $3,000.77 "	" $2,900.75 "	 $800.21 	" $2,550.66 "	" $2,800.72 "	" $2,800.72 "	 $824.21 	" $2,100.54 "	" $2,834.06 "	" $2,300.59 "	" $2,667.35 "	 $800.21 	" $3,000.77 "	" $2,710.70 "	" $2,834.06 "	 $793.54 	" $2,710.70 "	 $800.21 
309660	"HCHG CVMC EXCISION OF MULTIPLE EXTERNAL PAPILLAE OR TAGS, ANUS"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46230	" $3,437.78 "	" $2,406.45 "	 $818.19 	" $3,094.00 "	" $2,990.87 "	 $825.07 	" $2,629.90 "	" $2,887.74 "	" $2,887.74 "	 $849.82 	" $2,165.80 "	" $2,922.11 "	" $2,372.07 "	" $2,750.22 "	 $825.07 	" $3,094.00 "	" $2,794.92 "	" $2,922.11 "	 $818.19 	" $2,794.92 "	 $825.07 
310005	HCHG INJ/ASPIR-LARGE JT/BURSA W/O US GUIDE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	20610	" $1,160.00 "	 $812.00 	 $276.08 	" $1,044.00 "	" $1,009.20 "	 $278.40 	 $887.40 	 $974.40 	 $974.40 	 $286.75 	 $730.80 	 $986.00 	 $800.40 	 $928.00 	 $278.40 	" $1,044.00 "	 $943.08 	 $986.00 	 $276.08 	 $943.08 	 $278.40 
310007	HCHG ABDOMEN PARACENTESIS W/IMAGING	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	49083	" $3,500.00 "	" $2,450.00 "	 $833.00 	" $3,150.00 "	" $3,045.00 "	 $840.00 	" $2,677.50 "	" $2,940.00 "	" $2,940.00 "	 $865.20 	" $2,205.00 "	" $2,975.00 "	" $2,415.00 "	" $2,800.00 "	 $840.00 	" $3,150.00 "	" $2,845.50 "	" $2,975.00 "	 $833.00 	" $2,845.50 "	 $840.00 
310008	"HCHG SPINAL PUNCTURE,THERA,DRAINAGE OF CEREBROSPINAL FLUID"	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	62272	 $973.50 	 $681.45 	 $231.69 	 $876.15 	 $846.95 	 $233.64 	 $744.73 	 $817.74 	 $817.74 	 $233.64 	 $613.31 	 $827.48 	 $671.72 	 $778.80 	 $233.64 	 $876.15 	 $791.46 	 $827.48 	 $231.69 	 $791.46 	 $233.64 
310009	HCHG CVMC PRO-APPLICATION OF FINGER SPLINT	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	21451	" $4,611.50 "	" $3,228.05 "	" $1,097.54 "	" $4,150.35 "	" $4,012.01 "	" $1,106.76 "	" $3,527.80 "	" $3,786.00 "	" $3,283.00 "	" $1,139.96 "	" $2,905.25 "	" $3,919.78 "	" $3,181.94 "	" $3,689.20 "	" $1,106.76 "	" $4,150.35 "	" $3,749.15 "	" $3,919.78 "	" $1,097.54 "	" $3,749.15 "	" $1,106.76 "
330951	HCHG BMH/CVMC REMOVAL OF  DEVITALIZED TISSUE 20 CM/<	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	97597	 $336.18 	 $235.33 	 $80.01 	 $302.56 	 $292.48 	 $80.68 	 $257.18 	 $282.39 	 $282.39 	 $83.10 	 $211.79 	 $285.75 	 $231.96 	 $268.94 	 $80.68 	 $302.56 	 $273.31 	 $285.75 	 $80.01 	 $273.31 	 $80.68 
330963	HCHG CLOSED TX OF NASAL BONE FRACTURE W STABIL W/ MANIPULATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	21320	" $4,660.00 "	" $3,262.00 "	" $1,109.08 "	" $4,194.00 "	" $4,054.20 "	" $1,118.40 "	" $3,564.90 "	" $3,786.00 "	" $3,283.00 "	" $1,151.95 "	" $2,935.80 "	" $3,961.00 "	" $3,215.40 "	" $3,728.00 "	" $1,118.40 "	" $4,194.00 "	" $3,788.58 "	" $3,961.00 "	" $1,109.08 "	" $3,788.58 "	" $1,118.40 "
343051	HCHG REVISE/RMV PN/GASTR STIMUL	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	64595	" $7,578.72 "	" $5,305.10 "	" $1,803.74 "	" $6,820.85 "	" $6,593.49 "	" $1,818.89 "	" $5,797.72 "	" $3,786.00 "	" $3,283.00 "	" $1,818.89 "	" $4,774.59 "	" $6,441.91 "	" $5,229.32 "	" $6,062.98 "	" $1,818.89 "	" $6,820.85 "	" $6,161.50 "	" $6,441.91 "	" $1,803.74 "	" $6,161.50 "	" $1,818.89 "
343113	HCHG OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE EACH	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26765	" $5,610.00 "	" $3,927.00 "	" $1,335.18 "	" $5,049.00 "	" $4,880.70 "	" $1,346.40 "	" $4,291.65 "	" $3,786.00 "	" $3,283.00 "	" $1,346.40 "	" $3,534.30 "	" $4,768.50 "	" $3,870.90 "	" $4,488.00 "	" $1,346.40 "	" $5,049.00 "	" $4,560.93 "	" $4,768.50 "	" $1,335.18 "	" $4,560.93 "	" $1,346.40 "
343114	HCHG CLOSED TX FINGER DISLOCATION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26775	" $4,650.00 "	" $3,255.00 "	" $1,106.70 "	" $4,185.00 "	" $4,045.50 "	" $1,116.00 "	" $3,557.25 "	" $3,786.00 "	" $3,283.00 "	" $1,149.48 "	" $2,929.50 "	" $3,952.50 "	" $3,208.50 "	" $3,720.00 "	" $1,116.00 "	" $4,185.00 "	" $3,780.45 "	" $3,952.50 "	" $1,106.70 "	" $3,780.45 "	" $1,116.00 "
343118	HCHG BMH NON-ROUTINE BLOOD DRAW >3YRS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	36410	 $249.20 	 $174.44 	 $59.31 	 $224.28 	 $216.80 	 $59.81 	 $190.64 	 $209.33 	 $209.33 	 $61.60 	 $157.00 	 $211.82 	 $171.95 	 $199.36 	 $59.81 	 $224.28 	 $202.60 	 $211.82 	 $59.31 	 $202.60 	 $59.81 
343201	HCHG BMH CLOSED TX VERT FX W/O MANI	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	22310	" $1,431.00 "	" $1,001.70 "	 $340.58 	" $1,287.90 "	" $1,244.97 "	 $343.44 	" $1,094.72 "	" $1,202.04 "	" $1,202.04 "	 $353.74 	 $901.53 	" $1,216.35 "	 $987.39 	" $1,144.80 "	 $343.44 	" $1,287.90 "	" $1,163.40 "	" $1,216.35 "	 $340.58 	" $1,163.40 "	 $343.44 
343209	HCHG BMH/CVMC ASPIRATE PLEURA W IMAGING	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	32555	" $2,160.00 "	" $1,512.00 "	 $514.08 	" $1,944.00 "	" $1,879.20 "	 $518.40 	" $1,652.40 "	" $1,814.40 "	" $1,814.40 "	 $533.95 	" $1,360.80 "	" $1,836.00 "	" $1,490.40 "	" $1,728.00 "	 $518.40 	" $1,944.00 "	" $1,756.08 "	" $1,836.00 "	 $514.08 	" $1,756.08 "	 $518.40 
343227	HCHG CVMC ANOSCOPY REMOVE FOREIGN BODY	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	46608	" $2,042.12 "	" $1,429.48 "	 $486.02 	" $1,837.91 "	" $1,776.64 "	 $490.11 	" $1,562.22 "	" $1,715.38 "	" $1,715.38 "	 $504.81 	" $1,286.54 "	" $1,735.80 "	" $1,409.06 "	" $1,633.70 "	 $490.11 	" $1,837.91 "	" $1,660.24 "	" $1,735.80 "	 $486.02 	" $1,660.24 "	 $490.11 
343230	HCHG CVMC REMOVE INTRAUTERINE DEVICE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	58301	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $106.30 	 $270.90 	 $365.50 	 $296.70 	 $344.00 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
362121	HCHG PARTIAL REMOVAL OF FINGER BONE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	26236	" $5,900.00 "	" $4,130.00 "	" $1,404.20 "	" $5,310.00 "	" $5,133.00 "	" $1,416.00 "	" $4,513.50 "	" $3,786.00 "	" $3,283.00 "	" $1,416.00 "	" $3,717.00 "	" $5,015.00 "	" $4,071.00 "	" $4,720.00 "	" $1,416.00 "	" $5,310.00 "	" $4,796.70 "	" $5,015.00 "	" $1,404.20 "	" $4,796.70 "	" $1,416.00 "
362122	HCHG PARTIAL EXCISION PHAL TOE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28124	" $4,499.86 "	" $3,149.90 "	" $1,070.97 "	" $4,049.87 "	" $3,914.88 "	" $1,079.97 "	" $3,442.39 "	" $3,779.88 "	" $3,283.00 "	" $1,079.97 "	" $2,834.91 "	" $3,824.88 "	" $3,104.90 "	" $3,599.89 "	" $1,079.97 "	" $4,049.87 "	" $3,658.39 "	" $3,824.88 "	" $1,070.97 "	" $3,658.39 "	" $1,079.97 "
362123	HCHG EXCISION INTERPHAN JT TOE	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	28160	" $4,827.36 "	" $3,379.15 "	" $1,148.91 "	" $4,344.62 "	" $4,199.80 "	" $1,158.57 "	" $3,692.93 "	" $3,786.00 "	" $3,283.00 "	" $1,193.32 "	" $3,041.24 "	" $4,103.26 "	" $3,330.88 "	" $3,861.89 "	" $1,158.57 "	" $4,344.62 "	" $3,924.64 "	" $4,103.26 "	" $1,148.91 "	" $3,924.64 "	" $1,158.57 "
503433	HCHG REPLACE GTUBE WO IMAGE ENDO OR TRACT REV	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	43762	 $790.00 	 $553.00 	 $188.02 	 $711.00 	 $687.30 	 $189.60 	 $604.35 	 $663.60 	 $663.60 	 $189.60 	 $497.70 	 $671.50 	 $545.10 	 $632.00 	 $189.60 	 $711.00 	 $642.27 	 $671.50 	 $188.02 	 $642.27 	 $189.60 
503473	HCHG TOOTH EXTRACTION	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	41899	" $5,040.00 "	" $3,528.00 "	" $1,199.52 "	" $4,536.00 "	" $4,384.80 "	" $1,209.60 "	" $3,855.60 "	" $3,786.00 "	" $3,283.00 "	" $1,209.60 "	" $3,175.20 "	" $4,284.00 "	" $3,477.60 "	" $4,032.00 "	" $1,209.60 "	" $4,536.00 "	" $4,097.52 "	" $4,284.00 "	" $1,199.52 "	" $4,097.52 "	" $1,209.60 "
503785	HCHG CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	27767	" $1,016.25 "	 $711.38 	 $241.87 	 $914.63 	 $884.14 	 $243.90 	 $777.43 	 $853.65 	 $853.65 	 $251.22 	 $640.24 	 $863.81 	 $701.21 	 $813.00 	 $243.90 	 $914.63 	 $826.21 	 $863.81 	 $241.87 	 $826.21 	 $243.90 
503831	HCHG DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	69020	" $1,527.00 "	" $1,068.90 "	 $363.43 	" $1,374.30 "	" $1,328.49 "	 $366.48 	" $1,168.16 "	" $1,282.68 "	" $1,282.68 "	 $377.47 	 $962.01 	" $1,297.95 "	" $1,053.63 "	" $1,221.60 "	 $366.48 	" $1,374.30 "	" $1,241.45 "	" $1,297.95 "	 $363.43 	" $1,241.45 "	 $366.48 
503833	HCHG RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	90375	" $1,726.50 "	" $1,208.55 "	 $410.91 	" $1,553.85 "	" $1,502.06 "	 $414.36 	" $1,320.77 "	" $1,450.26 "	" $1,450.26 "	 $414.36 	" $1,087.70 "	" $1,467.53 "	" $1,191.29 "	" $1,381.20 "	 $414.36 	" $1,553.85 "	" $1,403.64 "	" $1,467.53 "	 $410.91 	" $1,403.64 "	 $414.36 
503834	HCHG OFFICE-OP CONSULTATION NEW/ESTAB PATIENT 40 MIN	0450	EMERGENCY ROOM - GENERAL CLASSIFICATION	99243	 $177.00 	 $123.90 	 $42.13 	 $159.30 	 $153.99 	 $42.48 	 $135.41 	 $148.68 	 $148.68 	 $42.48 	 $111.51 	 $150.45 	 $122.13 	 $141.60 	 $42.48 	 $159.30 	 $143.90 	 $150.45 	 $42.13 	 $143.90 	 $42.48 
305699	HCHG VITAL CAPACITY	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94150	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
309077	HCHG BMH/CVMC OVERNIGHT OXIMETRY (MEASURE BLOOD OXYGEN LEVEL)	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94762	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $88.99 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
309078	HCHG CVMC LAVAGE A SUCTION	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94799	 $145.63 	 $101.94 	 $34.66 	 $131.07 	 $126.70 	 $34.95 	 $111.41 	 $122.33 	 $122.33 	 $36.00 	 $91.75 	 $123.79 	 $100.48 	 $116.50 	 $34.95 	 $131.07 	 $118.40 	 $123.79 	 $34.66 	 $118.40 	 $34.95 
309102	HCHG CO2 EXPIRED GAS DETERMINATION	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94799	 $180.00 	 $126.00 	 $42.84 	 $162.00 	 $156.60 	 $43.20 	 $137.70 	 $151.20 	 $151.20 	 $44.50 	 $113.40 	 $153.00 	 $124.20 	 $144.00 	 $43.20 	 $162.00 	 $146.34 	 $153.00 	 $42.84 	 $146.34 	 $43.20 
330947	HCHG CVMC PULMONARY FUNCT TEST BY PLETHYSMOGRAPHY	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94726	 $410.00 	 $287.00 	 $97.58 	 $369.00 	 $356.70 	 $98.40 	 $313.65 	 $344.40 	 $344.40 	 $101.35 	 $258.30 	 $348.50 	 $282.90 	 $328.00 	 $98.40 	 $369.00 	 $333.33 	 $348.50 	 $97.58 	 $333.33 	 $98.40 
330948	HCHG CVMC PULMONARY FUNCTION TEST BY OSCILLMETRY	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94728	 $311.32 	 $217.92 	 $74.09 	 $280.19 	 $270.85 	 $74.72 	 $238.16 	 $261.51 	 $261.51 	 $76.96 	 $196.13 	 $264.62 	 $214.81 	 $249.06 	 $74.72 	 $280.19 	 $253.10 	 $264.62 	 $74.09 	 $253.10 	 $74.72 
330967	HCHG CVMC PULMONARY FUNCTION TEST BY GAS	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94727	 $510.00 	 $357.00 	 $121.38 	 $459.00 	 $443.70 	 $122.40 	 $390.15 	 $428.40 	 $428.40 	 $126.07 	 $321.30 	 $433.50 	 $351.90 	 $408.00 	 $122.40 	 $459.00 	 $414.63 	 $433.50 	 $121.38 	 $414.63 	 $122.40 
330968	HCHG CVMC CO2/MEMBRANE DIFFUSE CAPACITY	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94729	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $103.82 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
330976	HCHG CVMC SPIRO PRE & POST	0460	PULMONARY FUNCTION - GENERAL CLASSIFICATION	94060	 $870.00 	 $609.00 	 $207.06 	 $783.00 	 $756.90 	 $208.80 	 $665.55 	 $730.80 	 $730.80 	 $215.06 	 $548.10 	 $739.50 	 $600.30 	 $696.00 	 $208.80 	 $783.00 	 $707.31 	 $739.50 	 $207.06 	 $707.31 	 $208.80 
304948	HCHG PURETONE AUDIOMETRY AIR ONLY	0471	AUDIOLOGY - DIAGNOSTIC	92552	 $132.26 	 $92.58 	 $31.48 	 $119.03 	 $115.07 	 $31.74 	 $101.18 	 $111.10 	 $111.10 	 $31.74 	 $83.32 	 $112.42 	 $91.26 	 $105.81 	 $31.74 	 $119.03 	 $107.53 	 $112.42 	 $31.48 	 $107.53 	 $31.74 
303027	HCHG CARDIOPULMONARY RESUSCITATION	0480	CARDIOLOGY - GENERAL CLASSIFICATION	92950	 $950.00 	 $665.00 	 $226.10 	 $855.00 	 $826.50 	 $228.00 	 $726.75 	 $798.00 	 $798.00 	 $234.84 	 $598.50 	 $807.50 	 $655.50 	 $760.00 	 $228.00 	 $855.00 	 $772.35 	 $807.50 	 $226.10 	 $772.35 	 $228.00 
303030	HCHG CARDIOVERSION EXTERNAL ELECTVE	0480	CARDIOLOGY - GENERAL CLASSIFICATION	92960	" $1,770.00 "	" $1,239.00 "	 $421.26 	" $1,593.00 "	" $1,539.90 "	 $424.80 	" $1,354.05 "	" $1,486.80 "	" $1,486.80 "	 $437.54 	" $1,115.10 "	" $1,504.50 "	" $1,221.30 "	" $1,416.00 "	 $424.80 	" $1,593.00 "	" $1,439.01 "	" $1,504.50 "	 $421.26 	" $1,439.01 "	 $424.80 
305396	HCHG SWAN LINE INSERTION	0481	CARDIOLOGY - CARDIAC CATH LAB	93503	" $3,563.88 "	" $2,494.72 "	 $848.20 	" $3,207.49 "	" $3,100.58 "	 $855.33 	" $2,726.37 "	" $2,993.66 "	" $2,993.66 "	 $855.33 	" $2,245.24 "	" $3,029.30 "	" $2,459.08 "	" $2,851.10 "	 $855.33 	" $3,207.49 "	" $2,897.43 "	" $3,029.30 "	 $848.20 	" $2,897.43 "	 $855.33 
303026	HCHG CARDIO STRESS TEST	0482	CARDIOLOGY - STRESS TEST	93017	" $1,082.00 "	 $757.40 	 $257.52 	 $973.80 	 $941.34 	 $259.68 	 $827.73 	 $908.88 	 $908.88 	 $267.47 	 $681.66 	 $919.70 	 $746.58 	 $865.60 	 $259.68 	 $973.80 	 $879.67 	 $919.70 	 $257.52 	 $879.67 	 $259.68 
305566	HCHG CARDIOVASC STRESS TST TRACING ONLY	0482	CARDIOLOGY - STRESS TEST	93017	" $1,080.00 "	 $756.00 	 $257.04 	 $972.00 	 $939.60 	 $259.20 	 $826.20 	 $907.20 	 $907.20 	 $266.98 	 $680.40 	 $918.00 	 $745.20 	 $864.00 	 $259.20 	 $972.00 	 $878.04 	 $918.00 	 $257.04 	 $878.04 	 $259.20 
303011	HCHG CARDIAC DOPPLER EXAM(2ND)	0483	CARDIOLOGY - ECHOCARDIOLOGY	93320	 $600.24 	 $420.17 	 $142.86 	 $540.22 	 $522.21 	 $144.06 	 $459.18 	 $504.20 	 $504.20 	 $148.38 	 $378.15 	 $510.20 	 $414.17 	 $480.19 	 $144.06 	 $540.22 	 $488.00 	 $510.20 	 $142.86 	 $488.00 	 $144.06 
303012	HCHG CARDIAC DOPPLER LIMITED	0483	CARDIOLOGY - ECHOCARDIOLOGY	93321	 $710.00 	 $497.00 	 $168.98 	 $639.00 	 $617.70 	 $170.40 	 $543.15 	 $596.40 	 $596.40 	 $175.51 	 $447.30 	 $603.50 	 $489.90 	 $568.00 	 $170.40 	 $639.00 	 $577.23 	 $603.50 	 $168.98 	 $577.23 	 $170.40 
303231	HCHG COLOR FLOW MAPPING	0483	CARDIOLOGY - ECHOCARDIOLOGY	93325	 $579.75 	 $405.83 	 $137.98 	 $521.78 	 $504.38 	 $139.14 	 $443.51 	 $486.99 	 $486.99 	 $143.31 	 $365.24 	 $492.79 	 $400.03 	 $463.80 	 $139.14 	 $521.78 	 $471.34 	 $492.79 	 $137.98 	 $471.34 	 $139.14 
303511	HCHG ECHO COMP W/O CONT W/O CF	0483	CARDIOLOGY - ECHOCARDIOLOGY	93307	" $1,426.28 "	 $998.40 	 $339.45 	" $1,283.65 "	" $1,240.86 "	 $342.31 	" $1,091.10 "	" $1,198.08 "	" $1,198.08 "	 $352.58 	 $898.56 	" $1,212.34 "	 $984.13 	" $1,141.02 "	 $342.31 	" $1,283.65 "	" $1,159.57 "	" $1,212.34 "	 $339.45 	" $1,159.57 "	 $342.31 
303512	HCHG ECHO-CONGENITAL COMP W/O CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93303	" $1,714.56 "	" $1,200.19 "	 $408.07 	" $1,543.10 "	" $1,491.67 "	 $411.49 	" $1,311.64 "	" $1,440.23 "	" $1,440.23 "	 $423.84 	" $1,080.17 "	" $1,457.38 "	" $1,183.05 "	" $1,371.65 "	 $411.49 	" $1,543.10 "	" $1,393.94 "	" $1,457.38 "	 $408.07 	" $1,393.94 "	 $411.49 
303513	HCHG ECHO-CONGENITAL LTD W/O CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93304	" $1,227.30 "	 $859.11 	 $292.10 	" $1,104.57 "	" $1,067.75 "	 $294.55 	 $938.88 	" $1,030.93 "	" $1,030.93 "	 $303.39 	 $773.20 	" $1,043.21 "	 $846.84 	 $981.84 	 $294.55 	" $1,104.57 "	 $997.79 	" $1,043.21 "	 $292.10 	 $997.79 	 $294.55 
303514	HCHG ECHOCARDIOGRAM LTD W/O CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93308	" $1,080.00 "	 $756.00 	 $257.04 	 $972.00 	 $939.60 	 $259.20 	 $826.20 	 $907.20 	 $907.20 	 $266.98 	 $680.40 	 $918.00 	 $745.20 	 $864.00 	 $259.20 	 $972.00 	 $878.04 	 $918.00 	 $257.04 	 $878.04 	 $259.20 
303515	HCHG ECHO REST/STRESS W/O CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93350	" $1,791.75 "	" $1,254.23 "	 $426.44 	" $1,612.58 "	" $1,558.82 "	 $430.02 	" $1,370.69 "	" $1,505.07 "	" $1,505.07 "	 $442.92 	" $1,128.80 "	" $1,522.99 "	" $1,236.31 "	" $1,433.40 "	 $430.02 	" $1,612.58 "	" $1,456.69 "	" $1,522.99 "	 $426.44 	" $1,456.69 "	 $430.02 
305045	HCHG ECHO TEE TAVR TMVR LAAC W WO CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93355	" $1,300.00 "	 $910.00 	 $309.40 	" $1,170.00 "	" $1,131.00 "	 $312.00 	 $994.50 	" $1,092.00 "	" $1,092.00 "	 $321.36 	 $819.00 	" $1,105.00 "	 $897.00 	" $1,040.00 "	 $312.00 	" $1,170.00 "	" $1,056.90 "	" $1,105.00 "	 $309.40 	" $1,056.90 "	 $312.00 
305546	HCHG TRANSESOPHAGEAL ECHO W/O CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93312	" $2,062.56 "	" $1,443.79 "	 $490.89 	" $1,856.30 "	" $1,794.43 "	 $495.01 	" $1,577.86 "	" $1,732.55 "	" $1,732.55 "	 $495.01 	" $1,299.41 "	" $1,753.18 "	" $1,423.17 "	" $1,650.05 "	 $495.01 	" $1,856.30 "	" $1,676.86 "	" $1,753.18 "	 $490.89 	" $1,676.86 "	 $495.01 
305547	HCHG TEE CONGENITAL W/O CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93315	" $2,431.96 "	" $1,702.37 "	 $578.81 	" $2,188.76 "	" $2,115.81 "	 $583.67 	" $1,860.45 "	" $2,042.85 "	" $2,042.85 "	 $583.67 	" $1,532.13 "	" $2,067.17 "	" $1,678.05 "	" $1,945.57 "	 $583.67 	" $2,188.76 "	" $1,977.18 "	" $2,067.17 "	 $578.81 	" $1,977.18 "	 $583.67 
306369	HCHG ECHO COMP W/O CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93306	" $2,300.00 "	" $1,610.00 "	 $547.40 	" $2,070.00 "	" $2,001.00 "	 $552.00 	" $1,759.50 "	" $1,932.00 "	" $1,932.00 "	 $568.56 	" $1,449.00 "	" $1,955.00 "	" $1,587.00 "	" $1,840.00 "	 $552.00 	" $2,070.00 "	" $1,869.90 "	" $1,955.00 "	 $547.40 	" $1,869.90 "	 $552.00 
306370	HCHG ECHO COMP W/ CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93306	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,835.40 "	" $2,128.00 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
306512	HCHG ECHO-CNGNTL COMP W/ CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93303	" $1,714.56 "	" $1,200.19 "	 $408.07 	" $1,543.10 "	" $1,491.67 "	 $411.49 	" $1,311.64 "	" $1,440.23 "	" $1,440.23 "	 $423.84 	" $1,080.17 "	" $1,457.38 "	" $1,183.05 "	" $1,371.65 "	 $411.49 	" $1,543.10 "	" $1,393.94 "	" $1,457.38 "	 $408.07 	" $1,393.94 "	 $411.49 
306513	HCHG ECHO-CNGNTL LTD W/ CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93304	" $1,227.30 "	 $859.11 	 $292.10 	" $1,104.57 "	" $1,067.75 "	 $294.55 	 $938.88 	" $1,030.93 "	" $1,030.93 "	 $303.39 	 $773.20 	" $1,043.21 "	 $846.84 	 $981.84 	 $294.55 	" $1,104.57 "	 $997.79 	" $1,043.21 "	 $292.10 	 $997.79 	 $294.55 
306514	HCHG ECHOCRDGRM LTD W/ CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93308	" $1,267.82 "	 $887.47 	 $301.74 	" $1,141.04 "	" $1,103.00 "	 $304.28 	 $969.88 	" $1,064.97 "	" $1,064.97 "	 $313.41 	 $798.73 	" $1,077.65 "	 $874.80 	" $1,014.26 "	 $304.28 	" $1,141.04 "	" $1,030.74 "	" $1,077.65 "	 $301.74 	" $1,030.74 "	 $304.28 
306515	HCHG ECHO REST/STRESS W/ CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93350	" $1,885.00 "	" $1,319.50 "	 $448.63 	" $1,696.50 "	" $1,639.95 "	 $452.40 	" $1,442.03 "	" $1,583.40 "	" $1,583.40 "	 $465.97 	" $1,187.55 "	" $1,602.25 "	" $1,300.65 "	" $1,508.00 "	 $452.40 	" $1,696.50 "	" $1,532.51 "	" $1,602.25 "	 $448.63 	" $1,532.51 "	 $452.40 
306547	HCHG TRANSESOPHAGEAL ECHO W/ CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93312	" $2,352.00 "	" $1,646.40 "	 $559.78 	" $2,116.80 "	" $2,046.24 "	 $564.48 	" $1,799.28 "	" $1,975.68 "	" $1,975.68 "	 $564.48 	" $1,481.76 "	" $1,999.20 "	" $1,622.88 "	" $1,881.60 "	 $564.48 	" $2,116.80 "	" $1,912.18 "	" $1,999.20 "	 $559.78 	" $1,912.18 "	 $564.48 
306549	HCHG TEE CONGENITAL W/ CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93315	" $2,431.96 "	" $1,702.37 "	 $578.81 	" $2,188.76 "	" $2,115.81 "	 $583.67 	" $1,860.45 "	" $2,042.85 "	" $2,042.85 "	 $583.67 	" $1,532.13 "	" $2,067.17 "	" $1,678.05 "	" $1,945.57 "	 $583.67 	" $2,188.76 "	" $1,977.18 "	" $2,067.17 "	 $578.81 	" $1,977.18 "	 $583.67 
306671	HCHG ECHO 2D W/CF COMP W/CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93306	" $2,660.00 "	" $1,862.00 "	 $633.08 	" $2,394.00 "	" $2,314.20 "	 $638.40 	" $2,034.90 "	" $2,234.40 "	" $2,234.40 "	 $657.55 	" $1,675.80 "	" $2,261.00 "	" $1,835.40 "	" $2,128.00 "	 $638.40 	" $2,394.00 "	" $2,162.58 "	" $2,261.00 "	 $633.08 	" $2,162.58 "	 $638.40 
306673	HCHG ECHO 2D COMP W/CF W/CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93307	" $1,426.28 "	 $998.40 	 $339.45 	" $1,283.65 "	" $1,240.86 "	 $342.31 	" $1,091.10 "	" $1,198.08 "	" $1,198.08 "	 $352.58 	 $898.56 	" $1,212.34 "	 $984.13 	" $1,141.02 "	 $342.31 	" $1,283.65 "	" $1,159.57 "	" $1,212.34 "	 $339.45 	" $1,159.57 "	 $342.31 
306675	HCHG ECHO LIMITED W/CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93308	" $1,267.82 "	 $887.47 	 $301.74 	" $1,141.04 "	" $1,103.00 "	 $304.28 	 $969.88 	" $1,064.97 "	" $1,064.97 "	 $313.41 	 $798.73 	" $1,077.65 "	 $874.80 	" $1,014.26 "	 $304.28 	" $1,141.04 "	" $1,030.74 "	" $1,077.65 "	 $301.74 	" $1,030.74 "	 $304.28 
306677	HCHG ECHO TRANSESOPHAGEAL W/CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93312	" $2,062.56 "	" $1,443.79 "	 $490.89 	" $1,856.30 "	" $1,794.43 "	 $495.01 	" $1,577.86 "	" $1,732.55 "	" $1,732.55 "	 $509.86 	" $1,299.41 "	" $1,753.18 "	" $1,423.17 "	" $1,650.05 "	 $495.01 	" $1,856.30 "	" $1,676.86 "	" $1,753.18 "	 $490.89 	" $1,676.86 "	 $495.01 
306678	HCHG ECHO DOPPLER EXAM COMP	0483	CARDIOLOGY - ECHOCARDIOLOGY	93320	 $600.24 	 $420.17 	 $142.86 	 $540.22 	 $522.21 	 $144.06 	 $459.18 	 $504.20 	 $504.20 	 $148.38 	 $378.15 	 $510.20 	 $414.17 	 $480.19 	 $144.06 	 $540.22 	 $488.00 	 $510.20 	 $142.86 	 $488.00 	 $144.06 
306679	HCHG ECHO DOPPLER EXAM LIMITED	0483	CARDIOLOGY - ECHOCARDIOLOGY	93321	 $945.35 	 $661.75 	 $224.99 	 $850.82 	 $822.45 	 $226.88 	 $723.19 	 $794.09 	 $794.09 	 $233.69 	 $595.57 	 $803.55 	 $652.29 	 $756.28 	 $226.88 	 $850.82 	 $768.57 	 $803.55 	 $224.99 	 $768.57 	 $226.88 
307053	HCHG ECHO CONGENITAL COMP W/CONT	0483	CARDIOLOGY - ECHOCARDIOLOGY	93303	" $1,714.56 "	" $1,200.19 "	 $408.07 	" $1,543.10 "	" $1,491.67 "	 $411.49 	" $1,311.64 "	" $1,440.23 "	" $1,440.23 "	 $423.84 	" $1,080.17 "	" $1,457.38 "	" $1,183.05 "	" $1,371.65 "	 $411.49 	" $1,543.10 "	" $1,393.94 "	" $1,457.38 "	 $408.07 	" $1,393.94 "	 $411.49 
4410594	HCHG MYOCARDIAL STRAIN IMAGING STE	0483	CARDIOLOGY - ECHOCARDIOLOGY	93356	 $471.75 	 $330.23 	 $112.28 	 $424.58 	 $410.42 	 $113.22 	 $360.89 	 $396.27 	 $396.27 	 $113.22 	 $297.20 	 $400.99 	 $325.51 	 $377.40 	 $113.22 	 $424.58 	 $383.53 	 $400.99 	 $112.28 	 $383.53 	 $113.22 
4410673	HCHG ECHO COMP W/BUBBLES W/O CONTRAST	0483	CARDIOLOGY - ECHOCARDIOLOGY	93306	" $2,710.00 "	" $1,897.00 "	 $644.98 	" $2,439.00 "	" $2,357.70 "	 $650.40 	" $2,073.15 "	" $2,276.40 "	" $2,276.40 "	 $669.91 	" $1,707.30 "	" $2,303.50 "	" $1,869.90 "	" $2,168.00 "	 $650.40 	" $2,439.00 "	" $2,203.23 "	" $2,303.50 "	 $644.98 	" $2,203.23 "	 $650.40 
302748	HCHG REMOVAL SUTURE OR STAPLES - NO ANES	0510	CLINIC - GENERAL CLASSIFICATION	15853	 $209.90 	 $146.93 	 $49.96 	 $188.91 	 $182.61 	 $50.38 	 $160.57 	 $176.32 	 $176.32 	 $50.38 	 $132.24 	 $178.42 	 $144.83 	 $167.92 	 $50.38 	 $188.91 	 $170.65 	 $178.42 	 $49.96 	 $170.65 	 $50.38 
302749	HCHG REMOVAL SUTURE AND STAPLES - NO ANES	0510	CLINIC - GENERAL CLASSIFICATION	15854	 $209.90 	 $146.93 	 $49.96 	 $188.91 	 $182.61 	 $50.38 	 $160.57 	 $176.32 	 $176.32 	 $50.38 	 $132.24 	 $178.42 	 $144.83 	 $167.92 	 $50.38 	 $188.91 	 $170.65 	 $178.42 	 $49.96 	 $170.65 	 $50.38 
303124	HCHG CAUTERIZATION CHEM TISSUE GRAN	0510	CLINIC - GENERAL CLASSIFICATION	17250	 $324.26 	 $226.98 	 $77.17 	 $291.83 	 $282.11 	 $77.82 	 $248.06 	 $272.38 	 $272.38 	 $80.16 	 $204.28 	 $275.62 	 $223.74 	 $259.41 	 $77.82 	 $291.83 	 $263.62 	 $275.62 	 $77.17 	 $263.62 	 $77.82 
303507	HCHG EAR/PULSE OXIMETRY-MULTIPLE	0510	CLINIC - GENERAL CLASSIFICATION	94761	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $55.20 	 $64.00 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
303508	HCHG EAR/PULSE OXIMETRY SINGLE DETM	0510	CLINIC - GENERAL CLASSIFICATION	94760	 $40.00 	 $28.00 	 $9.52 	 $36.00 	 $34.80 	 $9.60 	 $30.60 	 $33.60 	 $33.60 	 $9.89 	 $25.20 	 $34.00 	 $27.60 	 $32.00 	 $9.60 	 $36.00 	 $32.52 	 $34.00 	 $9.52 	 $32.52 	 $9.60 
303668	HCHG EST PT FACILITY DETAILED	0510	CLINIC - GENERAL CLASSIFICATION	99214	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $74.16 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
303702	"HCHG EXCISION,BENIGN LESION,>4.0 CM"	0510	CLINIC - GENERAL CLASSIFICATION	11426	" $4,452.00 "	" $3,116.40 "	" $1,059.58 "	" $4,006.80 "	" $3,873.24 "	" $1,068.48 "	" $3,405.78 "	" $3,739.68 "	" $3,283.00 "	" $1,100.53 "	" $2,804.76 "	" $3,784.20 "	" $3,071.88 "	" $3,561.60 "	" $1,068.48 "	" $4,006.80 "	" $3,619.48 "	" $3,784.20 "	" $1,059.58 "	" $3,619.48 "	" $1,068.48 "
303710	"HCHG EXCISION,BGN LESN SNE <.5 CM"	0510	CLINIC - GENERAL CLASSIFICATION	11420	" $2,328.00 "	" $1,629.60 "	 $554.06 	" $2,095.20 "	" $2,025.36 "	 $558.72 	" $1,780.92 "	" $1,955.52 "	" $1,955.52 "	 $575.48 	" $1,466.64 "	" $1,978.80 "	" $1,606.32 "	" $1,862.40 "	 $558.72 	" $2,095.20 "	" $1,892.66 "	" $1,978.80 "	 $554.06 	" $1,892.66 "	 $558.72 
303712	"HCHG EXCISION,BGN LESN SNE 2.1-3 CM"	0510	CLINIC - GENERAL CLASSIFICATION	11423	" $2,892.00 "	" $2,024.40 "	 $688.30 	" $2,602.80 "	" $2,516.04 "	 $694.08 	" $2,212.38 "	" $2,429.28 "	" $2,429.28 "	 $714.90 	" $1,821.96 "	" $2,458.20 "	" $1,995.48 "	" $2,313.60 "	 $694.08 	" $2,602.80 "	" $2,351.20 "	" $2,458.20 "	 $688.30 	" $2,351.20 "	 $694.08 
303714	"HCHG EXCISION,BGN LESN TAL .6-1 CM"	0510	CLINIC - GENERAL CLASSIFICATION	11401	" $1,629.07 "	" $1,140.35 "	 $387.72 	" $1,466.16 "	" $1,417.29 "	 $390.98 	" $1,246.24 "	" $1,368.42 "	" $1,368.42 "	 $402.71 	" $1,026.31 "	" $1,384.71 "	" $1,124.06 "	" $1,303.26 "	 $390.98 	" $1,466.16 "	" $1,324.43 "	" $1,384.71 "	 $387.72 	" $1,324.43 "	 $390.98 
303718	"HCHG EXCISION,BGN LESN TAL 3.1-4 CM"	0510	CLINIC - GENERAL CLASSIFICATION	11404	" $2,796.00 "	" $1,957.20 "	 $665.45 	" $2,516.40 "	" $2,432.52 "	 $671.04 	" $2,138.94 "	" $2,348.64 "	" $2,348.64 "	 $691.17 	" $1,761.48 "	" $2,376.60 "	" $1,929.24 "	" $2,236.80 "	 $671.04 	" $2,516.40 "	" $2,273.15 "	" $2,376.60 "	 $665.45 	" $2,273.15 "	 $671.04 
303737	HCHG EXCISION/BGN LESN TAL <.5 CM	0510	CLINIC - GENERAL CLASSIFICATION	11400	" $1,993.41 "	" $1,395.39 "	 $474.43 	" $1,794.07 "	" $1,734.27 "	 $478.42 	" $1,524.96 "	" $1,674.46 "	" $1,674.46 "	 $492.77 	" $1,255.85 "	" $1,694.40 "	" $1,375.45 "	" $1,594.73 "	 $478.42 	" $1,794.07 "	" $1,620.64 "	" $1,694.40 "	 $474.43 	" $1,620.64 "	 $478.42 
303738	HCHG EXCISION-NAIL & MATRIX	0510	CLINIC - GENERAL CLASSIFICATION	11750	" $2,590.00 "	" $1,813.00 "	 $616.42 	" $2,331.00 "	" $2,253.30 "	 $621.60 	" $1,981.35 "	" $2,175.60 "	" $2,175.60 "	 $640.25 	" $1,631.70 "	" $2,201.50 "	" $1,787.10 "	" $2,072.00 "	 $621.60 	" $2,331.00 "	" $2,105.67 "	" $2,201.50 "	 $616.42 	" $2,105.67 "	 $621.60 
303978	"HCHG I&D ABSCESS, SIMPLE OR SINGLE"	0510	CLINIC - GENERAL CLASSIFICATION	10060	 $620.00 	 $434.00 	 $147.56 	 $558.00 	 $539.40 	 $148.80 	 $474.30 	 $520.80 	 $520.80 	 $153.26 	 $390.60 	 $527.00 	 $427.80 	 $496.00 	 $148.80 	 $558.00 	 $504.06 	 $527.00 	 $147.56 	 $504.06 	 $148.80 
303980	HCHG I&D BARTHOLIN GLAND ABSCESS	0510	CLINIC - GENERAL CLASSIFICATION	56420	 $580.00 	 $406.00 	 $138.04 	 $522.00 	 $504.60 	 $139.20 	 $443.70 	 $487.20 	 $487.20 	 $143.38 	 $365.40 	 $493.00 	 $400.20 	 $464.00 	 $139.20 	 $522.00 	 $471.54 	 $493.00 	 $138.04 	 $471.54 	 $139.20 
304011	"HCHG CATH ASPIRATION, NASAL TRACHEAL"	0510	CLINIC - GENERAL CLASSIFICATION	31720	 $254.25 	 $177.98 	 $60.51 	 $228.83 	 $221.20 	 $61.02 	 $194.50 	 $213.57 	 $213.57 	 $62.85 	 $160.18 	 $216.11 	 $175.43 	 $203.40 	 $61.02 	 $228.83 	 $206.71 	 $216.11 	 $60.51 	 $206.71 	 $61.02 
304099	HCHG INJ(S) TRIGGER PT(S) 3/MORE MS	0510	CLINIC - GENERAL CLASSIFICATION	20553	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
304103	HCHG INJ/ASPIR-SMALL JT/BURSA W/O US GUIDE	0510	CLINIC - GENERAL CLASSIFICATION	20600	 $931.60 	 $652.12 	 $221.72 	 $838.44 	 $810.49 	 $223.58 	 $712.67 	 $782.54 	 $782.54 	 $230.29 	 $586.91 	 $791.86 	 $642.80 	 $745.28 	 $223.58 	 $838.44 	 $757.39 	 $791.86 	 $221.72 	 $757.39 	 $223.58 
304114	HCHG INJ(S) ANES GREATER OCCIPITAL NERVE	0510	CLINIC - GENERAL CLASSIFICATION	64405	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
304120	"HCHG INJECTION,THERAPEUTIC CARPAL T"	0510	CLINIC - GENERAL CLASSIFICATION	20526	 $623.85 	 $436.70 	 $148.48 	 $561.47 	 $542.75 	 $149.72 	 $477.25 	 $524.03 	 $524.03 	 $154.22 	 $393.03 	 $530.27 	 $430.46 	 $499.08 	 $149.72 	 $561.47 	 $507.19 	 $530.27 	 $148.48 	 $507.19 	 $149.72 
304139	HCHG INJ(S) SNGL TENDON SHEATH/LIGAMNT	0510	CLINIC - GENERAL CLASSIFICATION	20550	 $563.10 	 $394.17 	 $134.02 	 $506.79 	 $489.90 	 $135.14 	 $430.77 	 $473.00 	 $473.00 	 $139.20 	 $354.75 	 $478.64 	 $388.54 	 $450.48 	 $135.14 	 $506.79 	 $457.80 	 $478.64 	 $134.02 	 $457.80 	 $135.14 
304147	HCHG INSERTION CATH-SIMPLE (FOLEY)	0510	CLINIC - GENERAL CLASSIFICATION	51702	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $117.30 	 $136.00 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
304148	HCHG INSERTION CATH-STRAIGHT (MINI)	0510	CLINIC - GENERAL CLASSIFICATION	51701	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
304151	HCHG EAR/PULSE OXIMETRY-NIGHT MONITOR	0510	CLINIC - GENERAL CLASSIFICATION	94762	 $360.00 	 $252.00 	 $85.68 	 $324.00 	 $313.20 	 $86.40 	 $275.40 	 $302.40 	 $302.40 	 $88.99 	 $226.80 	 $306.00 	 $248.40 	 $288.00 	 $86.40 	 $324.00 	 $292.68 	 $306.00 	 $85.68 	 $292.68 	 $86.40 
304315	HCHG LEVEL II VISIT ESTABLISHED PT	0510	CLINIC - GENERAL CLASSIFICATION	99212	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $48.00 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
304320	HCHG LEVEL III VISIT ESTABLISHED	0510	CLINIC - GENERAL CLASSIFICATION	99213	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $60.00 	 $157.50 	 $212.50 	 $172.50 	 $200.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
304324	HCHG LEVEL IV VISIT ESTABLISHED PT	0510	CLINIC - GENERAL CLASSIFICATION	99214	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
304328	HCHG PROLONGED OUTPATIENT VISIT EA 15 MIN	0510	CLINIC - GENERAL CLASSIFICATION	99417	 $192.00 	 $134.40 	 $45.70 	 $172.80 	 $167.04 	 $46.08 	 $146.88 	 $161.28 	 $161.28 	 $46.08 	 $120.96 	 $163.20 	 $132.48 	 $153.60 	 $46.08 	 $172.80 	 $156.10 	 $163.20 	 $45.70 	 $156.10 	 $46.08 
304368	HCHG MED NUT THERAPY INITIAL 15 MIN	0510	CLINIC - GENERAL CLASSIFICATION	97802	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $69.00 	 $80.00 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
304369	HCHG MED NUT THERAPY REASSMT 15 MIN	0510	CLINIC - GENERAL CLASSIFICATION	97803	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $62.10 	 $72.00 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
304596	HCHG OFFICE VISIT-EST-LEVEL 5	0510	CLINIC - GENERAL CLASSIFICATION	99215	 $370.00 	 $259.00 	 $88.06 	 $333.00 	 $321.90 	 $88.80 	 $283.05 	 $310.80 	 $310.80 	 $88.80 	 $233.10 	 $314.50 	 $255.30 	 $296.00 	 $88.80 	 $333.00 	 $300.81 	 $314.50 	 $88.06 	 $300.81 	 $88.80 
304652	HCHG OFFICE VISIT-NEW-LEVEL 3	0510	CLINIC - GENERAL CLASSIFICATION	99203	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $72.00 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
304654	HCHG OFFICE VISIT-NEW-LEVEL 4	0510	CLINIC - GENERAL CLASSIFICATION	99204	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $100.80 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
304663	HCHG INJ/ASPIR-SMALL JT/BURSA WITH US GUIDE	0510	CLINIC - GENERAL CLASSIFICATION	20604	 $931.60 	 $652.12 	 $221.72 	 $838.44 	 $810.49 	 $223.58 	 $712.67 	 $782.54 	 $782.54 	 $230.29 	 $586.91 	 $791.86 	 $642.80 	 $745.28 	 $223.58 	 $838.44 	 $757.39 	 $791.86 	 $221.72 	 $757.39 	 $223.58 
304691	HCHG INJ/ASPIR-LARGE JT/BURSA WITH US GUIDE	0510	CLINIC - GENERAL CLASSIFICATION	20611	" $1,094.34 "	 $766.04 	 $260.45 	 $984.91 	 $952.08 	 $262.64 	 $837.17 	 $919.25 	 $919.25 	 $270.52 	 $689.43 	 $930.19 	 $755.09 	 $875.47 	 $262.64 	 $984.91 	 $889.70 	 $930.19 	 $260.45 	 $889.70 	 $262.64 
304692	HCHG INJ/ASPIR-LARGE JT/BURSA WITH US GUIDE	0510	CLINIC - GENERAL CLASSIFICATION	20611	 $880.00 	 $616.00 	 $209.44 	 $792.00 	 $765.60 	 $211.20 	 $673.20 	 $739.20 	 $739.20 	 $217.54 	 $554.40 	 $748.00 	 $607.20 	 $704.00 	 $211.20 	 $792.00 	 $715.44 	 $748.00 	 $209.44 	 $715.44 	 $211.20 
304730	HCHG PARING BENIGN LESION-ONE	0510	CLINIC - GENERAL CLASSIFICATION	11055	 $252.54 	 $176.78 	 $60.10 	 $227.29 	 $219.71 	 $60.61 	 $193.19 	 $212.13 	 $212.13 	 $60.61 	 $159.10 	 $214.66 	 $174.25 	 $202.03 	 $60.61 	 $227.29 	 $205.32 	 $214.66 	 $60.10 	 $205.32 	 $60.61 
304731	HCHG PARING BENIGN LESIONS > 4	0510	CLINIC - GENERAL CLASSIFICATION	11057	 $190.13 	 $133.09 	 $45.25 	 $171.12 	 $165.41 	 $45.63 	 $145.45 	 $159.71 	 $159.71 	 $45.63 	 $119.78 	 $161.61 	 $131.19 	 $152.10 	 $45.63 	 $171.12 	 $154.58 	 $161.61 	 $45.25 	 $154.58 	 $45.63 
304732	HCHG PARING BENIGN LESIONS-2 TO 4	0510	CLINIC - GENERAL CLASSIFICATION	11056	 $275.00 	 $192.50 	 $65.45 	 $247.50 	 $239.25 	 $66.00 	 $210.38 	 $231.00 	 $231.00 	 $66.00 	 $173.25 	 $233.75 	 $189.75 	 $220.00 	 $66.00 	 $247.50 	 $223.58 	 $233.75 	 $65.45 	 $223.58 	 $66.00 
304997	HCHG REPAIR-INT-SATE <2.5 CM	0510	CLINIC - GENERAL CLASSIFICATION	12031	 $650.00 	 $455.00 	 $154.70 	 $585.00 	 $565.50 	 $156.00 	 $497.25 	 $546.00 	 $546.00 	 $156.00 	 $409.50 	 $552.50 	 $448.50 	 $520.00 	 $156.00 	 $585.00 	 $528.45 	 $552.50 	 $154.70 	 $528.45 	 $156.00 
304998	HCHG REPAIR-INT-SATE 2.6-7.5 CM	0510	CLINIC - GENERAL CLASSIFICATION	12032	" $1,060.00 "	 $742.00 	 $252.28 	 $954.00 	 $922.20 	 $254.40 	 $810.90 	 $890.40 	 $890.40 	 $254.40 	 $667.80 	 $901.00 	 $731.40 	 $848.00 	 $254.40 	 $954.00 	 $861.78 	 $901.00 	 $252.28 	 $861.78 	 $254.40 
305586	HCHG TX BURN 1ST DEGREE INITIAL	0510	CLINIC - GENERAL CLASSIFICATION	16000	 $480.00 	 $336.00 	 $114.24 	 $432.00 	 $417.60 	 $115.20 	 $367.20 	 $403.20 	 $403.20 	 $115.20 	 $302.40 	 $408.00 	 $331.20 	 $384.00 	 $115.20 	 $432.00 	 $390.24 	 $408.00 	 $114.24 	 $390.24 	 $115.20 
305733	HCHG WOUND CARE W/ PACKING	0510	CLINIC - GENERAL CLASSIFICATION	12021	 $634.86 	 $444.40 	 $151.10 	 $571.37 	 $552.33 	 $152.37 	 $485.67 	 $533.28 	 $533.28 	 $152.37 	 $399.96 	 $539.63 	 $438.05 	 $507.89 	 $152.37 	 $571.37 	 $516.14 	 $539.63 	 $151.10 	 $516.14 	 $152.37 
305946	HCHG SPIROMETRY W/ GRAPHIC RCD (NO PROFEE)	0510	CLINIC - GENERAL CLASSIFICATION	94010	 $320.00 	 $224.00 	 $76.16 	 $288.00 	 $278.40 	 $76.80 	 $244.80 	 $268.80 	 $268.80 	 $76.80 	 $201.60 	 $272.00 	 $220.80 	 $256.00 	 $76.80 	 $288.00 	 $260.16 	 $272.00 	 $76.16 	 $260.16 	 $76.80 
306551	HCHG  SMOKING COUNSELING VISIT > 10 MIN	0510	CLINIC - GENERAL CLASSIFICATION	99407	 $90.07 	 $63.05 	 $21.44 	 $81.06 	 $78.36 	 $21.62 	 $68.90 	 $75.66 	 $75.66 	 $22.27 	 $56.74 	 $76.56 	 $62.15 	 $72.06 	 $21.62 	 $81.06 	 $73.23 	 $76.56 	 $21.44 	 $73.23 	 $21.62 
308293	HCHG BMH/CVMC DEBRIDE INFECTED SKIN	0510	CLINIC - GENERAL CLASSIFICATION	11000	" $2,016.12 "	" $1,411.28 "	 $479.84 	" $1,814.51 "	" $1,754.02 "	 $483.87 	" $1,542.33 "	" $1,693.54 "	" $1,693.54 "	 $498.38 	" $1,270.16 "	" $1,713.70 "	" $1,391.12 "	" $1,612.90 "	 $483.87 	" $1,814.51 "	" $1,639.11 "	" $1,713.70 "	 $479.84 	" $1,639.11 "	 $483.87 
308305	"HCHG DEBRIDEMENT SKIN, SUBCUTANEOUS TISSUE, AND MUSCLE"	0510	CLINIC - GENERAL CLASSIFICATION	11043	" $2,296.11 "	" $1,607.28 "	 $546.47 	" $2,066.50 "	" $1,997.62 "	 $551.07 	" $1,756.52 "	" $1,928.73 "	" $1,928.73 "	 $567.60 	" $1,446.55 "	" $1,951.69 "	" $1,584.32 "	" $1,836.89 "	 $551.07 	" $2,066.50 "	" $1,866.74 "	" $1,951.69 "	 $546.47 	" $1,866.74 "	 $551.07 
308307	HCHG BMH/CVMC DEBRIDE BONE/TISS 1ST 20 SQCM	0510	CLINIC - GENERAL CLASSIFICATION	11044	" $2,939.97 "	" $2,057.98 "	 $699.71 	" $2,645.97 "	" $2,557.77 "	 $705.59 	" $2,249.08 "	" $2,469.57 "	" $2,469.57 "	 $726.76 	" $1,852.18 "	" $2,498.97 "	" $2,028.58 "	" $2,351.98 "	 $705.59 	" $2,645.97 "	" $2,390.20 "	" $2,498.97 "	 $699.71 	" $2,390.20 "	 $705.59 
310394	HCHG MED TEAM CONF W/INTERDISCIPLINARY	0510	CLINIC - GENERAL CLASSIFICATION	99366	 $137.00 	 $95.90 	 $32.61 	 $123.30 	 $119.19 	 $32.88 	 $104.81 	 $115.08 	 $115.08 	 $32.88 	 $86.31 	 $116.45 	 $94.53 	 $109.60 	 $32.88 	 $123.30 	 $111.38 	 $116.45 	 $32.61 	 $111.38 	 $32.88 
338901	HCHG CVMC WC NEW PATIENT LEVEL 2	0510	CLINIC - GENERAL CLASSIFICATION	99202	 $175.00 	 $122.50 	 $41.65 	 $157.50 	 $152.25 	 $42.00 	 $133.88 	 $147.00 	 $147.00 	 $43.26 	 $110.25 	 $148.75 	 $120.75 	 $140.00 	 $42.00 	 $157.50 	 $142.28 	 $148.75 	 $41.65 	 $142.28 	 $42.00 
338902	HCHG CVMC WC NEW PATIENT LEVEL 3	0510	CLINIC - GENERAL CLASSIFICATION	99203	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $74.16 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
338903	HCHG CVMC WC NEW PATIENT LEVEL 4	0510	CLINIC - GENERAL CLASSIFICATION	99204	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $86.52 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
338904	HCHG CVMC WC NEW PATIENT LEVEL 5	0510	CLINIC - GENERAL CLASSIFICATION	99205	 $472.75 	 $330.93 	 $112.51 	 $425.48 	 $411.29 	 $113.46 	 $361.65 	 $397.11 	 $397.11 	 $116.86 	 $297.83 	 $401.84 	 $326.20 	 $378.20 	 $113.46 	 $425.48 	 $384.35 	 $401.84 	 $112.51 	 $384.35 	 $113.46 
338905	HCHG CVMC WC ESTABLISHED PATIENT LEVEL 1	0510	CLINIC - GENERAL CLASSIFICATION	99211	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
338906	HCHG CVMC WC ESTABLISHED PATIENT LEVEL 2	0510	CLINIC - GENERAL CLASSIFICATION	99212	 $200.00 	 $140.00 	 $47.60 	 $180.00 	 $174.00 	 $48.00 	 $153.00 	 $168.00 	 $168.00 	 $49.44 	 $126.00 	 $170.00 	 $138.00 	 $160.00 	 $48.00 	 $180.00 	 $162.60 	 $170.00 	 $47.60 	 $162.60 	 $48.00 
338907	HCHG CVMC WC ESTABLISHED PATIENT LEVEL 3	0510	CLINIC - GENERAL CLASSIFICATION	99213	 $250.00 	 $175.00 	 $59.50 	 $225.00 	 $217.50 	 $60.00 	 $191.25 	 $210.00 	 $210.00 	 $61.80 	 $157.50 	 $212.50 	 $172.50 	 $200.00 	 $60.00 	 $225.00 	 $203.25 	 $212.50 	 $59.50 	 $203.25 	 $60.00 
338908	HCHG CVMC WC ESTABLISHED PATIENT LEVEL 4	0510	CLINIC - GENERAL CLASSIFICATION	99214	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $252.00 	 $252.00 	 $74.16 	 $189.00 	 $255.00 	 $207.00 	 $240.00 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
338909	HCHG CVMC WC ESTABLISHED PATIENT LEVEL 5	0510	CLINIC - GENERAL CLASSIFICATION	99215	 $350.00 	 $245.00 	 $83.30 	 $315.00 	 $304.50 	 $84.00 	 $267.75 	 $294.00 	 $294.00 	 $86.52 	 $220.50 	 $297.50 	 $241.50 	 $280.00 	 $84.00 	 $315.00 	 $284.55 	 $297.50 	 $83.30 	 $284.55 	 $84.00 
357220	HCHG ONL DGTL E/M SVC <7DYS 5-10MIN	0510	CLINIC - GENERAL CLASSIFICATION	99421	 $81.00 	 $56.70 	 $19.28 	 $72.90 	 $70.47 	 $19.44 	 $61.97 	 $68.04 	 $68.04 	 $19.44 	 $51.03 	 $68.85 	 $55.89 	 $64.80 	 $19.44 	 $72.90 	 $65.85 	 $68.85 	 $19.28 	 $65.85 	 $19.44 
357221	HCHG ONL DGTL E/M SVC <7DYS 11-20MIN	0510	CLINIC - GENERAL CLASSIFICATION	99422	 $167.00 	 $116.90 	 $39.75 	 $150.30 	 $145.29 	 $40.08 	 $127.76 	 $140.28 	 $140.28 	 $40.08 	 $105.21 	 $141.95 	 $115.23 	 $133.60 	 $40.08 	 $150.30 	 $135.77 	 $141.95 	 $39.75 	 $135.77 	 $40.08 
357222	HCHG ONL DGTL E/M SVC <7DYS 21+MIN	0510	CLINIC - GENERAL CLASSIFICATION	99423	 $265.00 	 $185.50 	 $63.07 	 $238.50 	 $230.55 	 $63.60 	 $202.73 	 $222.60 	 $222.60 	 $63.60 	 $166.95 	 $225.25 	 $182.85 	 $212.00 	 $63.60 	 $238.50 	 $215.45 	 $225.25 	 $63.07 	 $215.45 	 $63.60 
503413	HCHG PULMONARY STRESS TESTING	0510	CLINIC - GENERAL CLASSIFICATION	94618	 $636.00 	 $445.20 	 $151.37 	 $572.40 	 $553.32 	 $152.64 	 $486.54 	 $534.24 	 $534.24 	 $152.64 	 $400.68 	 $540.60 	 $438.84 	 $508.80 	 $152.64 	 $572.40 	 $517.07 	 $540.60 	 $151.37 	 $517.07 	 $152.64 
4400107	HCHG CARDIAC MRI MORPHOLOGY & FUNC*	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	75557	" $5,048.34 "	" $3,533.84 "	" $1,201.50 "	" $4,543.51 "	" $4,392.06 "	" $1,211.60 "	" $3,861.98 "	" $3,786.00 "	" $3,283.00 "	" $1,247.95 "	" $3,180.45 "	" $4,291.09 "	" $3,331.90 "	" $4,341.57 "	" $1,211.60 "	" $4,543.51 "	" $4,104.30 "	" $4,291.09 "	" $1,201.50 "	" $4,104.30 "	" $1,211.60 "
4400108	HCHG CARDIAC MRI W/W/O CONTRAST & *	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	75561	" $5,048.34 "	" $3,533.84 "	" $1,201.50 "	" $4,543.51 "	" $4,392.06 "	" $1,211.60 "	" $3,861.98 "	" $3,786.00 "	" $3,283.00 "	" $1,247.95 "	" $3,180.45 "	" $4,291.09 "	" $3,331.90 "	" $4,341.57 "	" $1,211.60 "	" $4,543.51 "	" $4,104.30 "	" $4,291.09 "	" $1,201.50 "	" $4,104.30 "	" $1,211.60 "
4400422	HCHG MR ANGIO UPPER EXTREMITY W/CONT	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73225	" $3,496.91 "	" $2,447.84 "	 $832.26 	" $3,147.22 "	" $3,042.31 "	 $839.26 	" $2,675.14 "	" $2,937.40 "	" $2,937.40 "	 $839.26 	" $2,203.05 "	" $2,972.37 "	" $2,307.96 "	" $3,007.34 "	 $839.26 	" $3,147.22 "	" $2,842.99 "	" $2,972.37 "	 $832.26 	" $2,842.99 "	 $839.26 
4400430	"HCHG MRA W/O CONT, ABD"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	C8901	" $3,975.00 "	" $2,782.50 "	 $946.05 	" $3,577.50 "	" $3,458.25 "	 $954.00 	" $3,040.88 "	" $3,339.00 "	" $3,283.00 "	 $954.00 	" $2,504.25 "	" $3,378.75 "	" $2,623.50 "	" $3,418.50 "	 $954.00 	" $3,577.50 "	" $3,231.68 "	" $3,378.75 "	 $946.05 	" $3,231.68 "	 $954.00 
4400436	"HCHG MRA W/O FOL W/CONT, LWR EXT"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	C8914	" $3,980.00 "	" $2,786.00 "	 $947.24 	" $3,582.00 "	" $3,462.60 "	 $955.20 	" $3,044.70 "	" $3,343.20 "	" $3,283.00 "	 $955.20 	" $2,507.40 "	" $3,383.00 "	" $2,626.80 "	" $3,422.80 "	 $955.20 	" $3,582.00 "	" $3,235.74 "	" $3,383.00 "	 $947.24 	" $3,235.74 "	 $955.20 
4400443	"HCHG MRI LOWER EXTREM JT, W/O CONT*"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73721	" $2,529.00 "	" $1,770.30 "	 $601.90 	" $2,276.10 "	" $2,200.23 "	 $606.96 	" $1,934.69 "	" $2,124.36 "	" $2,124.36 "	 $606.96 	" $1,593.27 "	" $2,149.65 "	" $1,669.14 "	" $2,174.94 "	 $606.96 	" $2,276.10 "	" $2,056.08 "	" $2,149.65 "	 $601.90 	" $2,056.08 "	 $606.96 
4400445	"HCHG MRI UPPER EXTR, W/CONTRAST"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73220	" $3,379.00 "	" $2,365.30 "	 $804.20 	" $3,041.10 "	" $2,939.73 "	 $810.96 	" $2,584.94 "	" $2,838.36 "	" $2,838.36 "	 $810.96 	" $2,128.77 "	" $2,872.15 "	" $2,230.14 "	" $2,905.94 "	 $810.96 	" $3,041.10 "	" $2,747.13 "	" $2,872.15 "	 $804.20 	" $2,747.13 "	 $810.96 
4400446	"HCHG MRI W/CONT, BREAST, BI"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	C8906	" $4,744.08 "	" $3,320.86 "	" $1,129.09 "	" $4,269.67 "	" $4,127.35 "	" $1,138.58 "	" $3,629.22 "	" $3,786.00 "	" $3,283.00 "	" $1,138.58 "	" $2,988.77 "	" $4,032.47 "	" $3,131.09 "	" $4,079.91 "	" $1,138.58 "	" $4,269.67 "	" $3,856.94 "	" $4,032.47 "	" $1,129.09 "	" $3,856.94 "	" $1,138.58 "
4400451	"HCHG MRI, ABDOMEN (MRI)"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	74181	" $2,541.00 "	" $1,778.70 "	 $604.76 	" $2,286.90 "	" $2,210.67 "	 $609.84 	" $1,943.87 "	" $2,134.44 "	" $2,134.44 "	 $609.84 	" $1,600.83 "	" $2,159.85 "	" $1,677.06 "	" $2,185.26 "	 $609.84 	" $2,286.90 "	" $2,065.83 "	" $2,159.85 "	 $604.76 	" $2,065.83 "	 $609.84 
4400452	"HCHG MRI, ABDOMEN, COMBO"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	74183	" $2,981.00 "	" $2,086.70 "	 $709.48 	" $2,682.90 "	" $2,593.47 "	 $715.44 	" $2,280.47 "	" $2,504.04 "	" $2,504.04 "	 $715.44 	" $1,878.03 "	" $2,533.85 "	" $1,967.46 "	" $2,563.66 "	 $715.44 	" $2,682.90 "	" $2,423.55 "	" $2,533.85 "	 $709.48 	" $2,423.55 "	 $715.44 
4400453	"HCHG MRI, BONE MARROW"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	77084	" $5,048.34 "	" $3,533.84 "	" $1,201.50 "	" $4,543.51 "	" $4,392.06 "	" $1,211.60 "	" $3,861.98 "	" $3,786.00 "	" $3,283.00 "	" $1,211.60 "	" $3,180.45 "	" $4,291.09 "	" $3,331.90 "	" $4,341.57 "	" $1,211.60 "	" $4,543.51 "	" $4,104.30 "	" $4,291.09 "	" $1,201.50 "	" $4,104.30 "	" $1,211.60 "
4400457	"HCHG MRI, CHEST"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	71550	" $2,231.00 "	" $1,561.70 "	 $530.98 	" $2,007.90 "	" $1,940.97 "	 $535.44 	" $1,706.72 "	" $1,874.04 "	" $1,874.04 "	 $535.44 	" $1,405.53 "	" $1,896.35 "	" $1,472.46 "	" $1,918.66 "	 $535.44 	" $2,007.90 "	" $1,813.80 "	" $1,896.35 "	 $530.98 	" $1,813.80 "	 $535.44 
4400458	"HCHG MRI, CHEST, COMBO"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	71552	" $2,981.00 "	" $2,086.70 "	 $709.48 	" $2,682.90 "	" $2,593.47 "	 $715.44 	" $2,280.47 "	" $2,504.04 "	" $2,504.04 "	 $715.44 	" $1,878.03 "	" $2,533.85 "	" $1,967.46 "	" $2,563.66 "	 $715.44 	" $2,682.90 "	" $2,423.55 "	" $2,533.85 "	 $709.48 	" $2,423.55 "	 $715.44 
4400465	"HCHG MRI, JOINT OF LEG W/CONTRAST"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73722	" $2,840.00 "	" $1,988.00 "	 $675.92 	" $2,556.00 "	" $2,470.80 "	 $681.60 	" $2,172.60 "	" $2,385.60 "	" $2,385.60 "	 $681.60 	" $1,789.20 "	" $2,414.00 "	" $1,874.40 "	" $2,442.40 "	 $681.60 	" $2,556.00 "	" $2,308.92 "	" $2,414.00 "	 $675.92 	" $2,308.92 "	 $681.60 
4400466	"HCHG MRI, JOINT OF LEG. COMBO"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73723	" $3,379.00 "	" $2,365.30 "	 $804.20 	" $3,041.10 "	" $2,939.73 "	 $810.96 	" $2,584.94 "	" $2,838.36 "	" $2,838.36 "	 $810.96 	" $2,128.77 "	" $2,872.15 "	" $2,230.14 "	" $2,905.94 "	 $810.96 	" $3,041.10 "	" $2,747.13 "	" $2,872.15 "	 $804.20 	" $2,747.13 "	 $810.96 
4400467	"HCHG MRI, JOINT UPPER EXTREM"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73221	" $2,529.00 "	" $1,770.30 "	 $601.90 	" $2,276.10 "	" $2,200.23 "	 $606.96 	" $1,934.69 "	" $2,124.36 "	" $2,124.36 "	 $606.96 	" $1,593.27 "	" $2,149.65 "	" $1,669.14 "	" $2,174.94 "	 $606.96 	" $2,276.10 "	" $2,056.08 "	" $2,149.65 "	 $601.90 	" $2,056.08 "	 $606.96 
4400468	"HCHG MRI, JOINT UPPER EXTREM COMBO"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73223	" $3,379.00 "	" $2,365.30 "	 $804.20 	" $3,041.10 "	" $2,939.73 "	 $810.96 	" $2,584.94 "	" $2,838.36 "	" $2,838.36 "	 $810.96 	" $2,128.77 "	" $2,872.15 "	" $2,230.14 "	" $2,905.94 "	 $810.96 	" $3,041.10 "	" $2,747.13 "	" $2,872.15 "	 $804.20 	" $2,747.13 "	 $810.96 
4400469	"HCHG MRI, JOINT UPPER EXTREM W/CON*"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73222	" $2,831.00 "	" $1,981.70 "	 $673.78 	" $2,547.90 "	" $2,462.97 "	 $679.44 	" $2,165.72 "	" $2,378.04 "	" $2,378.04 "	 $679.44 	" $1,783.53 "	" $2,406.35 "	" $1,868.46 "	" $2,434.66 "	 $679.44 	" $2,547.90 "	" $2,301.60 "	" $2,406.35 "	 $673.78 	" $2,301.60 "	 $679.44 
4400470	"HCHG MRI, LOWER EXTR, W/O CONTRAST*"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73720	" $3,739.00 "	" $2,617.30 "	 $889.88 	" $3,365.10 "	" $3,252.93 "	 $897.36 	" $2,860.34 "	" $3,140.76 "	" $3,140.76 "	 $897.36 	" $2,355.57 "	" $3,178.15 "	" $2,467.74 "	" $3,215.54 "	 $897.36 	" $3,365.10 "	" $3,039.81 "	" $3,178.15 "	 $889.88 	" $3,039.81 "	 $897.36 
4400471	"HCHG MRI, LOWER EXTREM"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73718	" $2,580.00 "	" $1,806.00 "	 $614.04 	" $2,322.00 "	" $2,244.60 "	 $619.20 	" $1,973.70 "	" $2,167.20 "	" $2,167.20 "	 $619.20 	" $1,625.40 "	" $2,193.00 "	" $1,702.80 "	" $2,218.80 "	 $619.20 	" $2,322.00 "	" $2,097.54 "	" $2,193.00 "	 $614.04 	" $2,097.54 "	 $619.20 
4400472	"HCHG MRI, LOWER EXTREM W/CONTRAST"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73719	" $3,576.26 "	" $2,503.38 "	 $851.15 	" $3,218.63 "	" $3,111.35 "	 $858.30 	" $2,735.84 "	" $3,004.06 "	" $3,004.06 "	 $858.30 	" $2,253.04 "	" $3,039.82 "	" $2,360.33 "	" $3,075.58 "	 $858.30 	" $3,218.63 "	" $2,907.50 "	" $3,039.82 "	 $851.15 	" $2,907.50 "	 $858.30 
4400476	"HCHG MRI, PELVIS W/CONTRAST"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	72196	" $3,750.00 "	" $2,625.00 "	 $892.50 	" $3,375.00 "	" $3,262.50 "	 $900.00 	" $2,868.75 "	" $3,150.00 "	" $3,150.00 "	 $900.00 	" $2,362.50 "	" $3,187.50 "	" $2,475.00 "	" $3,225.00 "	 $900.00 	" $3,375.00 "	" $3,048.75 "	" $3,187.50 "	 $892.50 	" $3,048.75 "	 $900.00 
4400477	"HCHG MRI, PELVIS, COMBO"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	72197	" $2,981.00 "	" $2,086.70 "	 $709.48 	" $2,682.90 "	" $2,593.47 "	 $715.44 	" $2,280.47 "	" $2,504.04 "	" $2,504.04 "	 $715.44 	" $1,878.03 "	" $2,533.85 "	" $1,967.46 "	" $2,563.66 "	 $715.44 	" $2,682.90 "	" $2,423.55 "	" $2,533.85 "	 $709.48 	" $2,423.55 "	 $715.44 
4400478	"HCHG MRI, PELVIS, W/O CONTRAST"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	72195	" $2,231.00 "	" $1,561.70 "	 $530.98 	" $2,007.90 "	" $1,940.97 "	 $535.44 	" $1,706.72 "	" $1,874.04 "	" $1,874.04 "	 $535.44 	" $1,405.53 "	" $1,896.35 "	" $1,472.46 "	" $1,918.66 "	 $535.44 	" $2,007.90 "	" $1,813.80 "	" $1,896.35 "	 $530.98 	" $1,813.80 "	 $535.44 
4400480	"HCHG MRI, UPPER EXTREM"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73218	" $2,529.00 "	" $1,770.30 "	 $601.90 	" $2,276.10 "	" $2,200.23 "	 $606.96 	" $1,934.69 "	" $2,124.36 "	" $2,124.36 "	 $606.96 	" $1,593.27 "	" $2,149.65 "	" $1,669.14 "	" $2,174.94 "	 $606.96 	" $2,276.10 "	" $2,056.08 "	" $2,149.65 "	 $601.90 	" $2,056.08 "	 $606.96 
4400481	"HCHG MRI, UPPER EXTREM W/CONTRAST"	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	73219	" $3,495.00 "	" $2,446.50 "	 $831.81 	" $3,145.50 "	" $3,040.65 "	 $838.80 	" $2,673.68 "	" $2,935.80 "	" $2,935.80 "	 $838.80 	" $2,201.85 "	" $2,970.75 "	" $2,306.70 "	" $3,005.70 "	 $838.80 	" $3,145.50 "	" $2,841.44 "	" $2,970.75 "	 $831.81 	" $2,841.44 "	 $838.80 
4400647	HCHG UNLISTED MR PROCEDURE	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	76498	" $2,867.24 "	" $2,007.07 "	 $682.40 	" $2,580.52 "	" $2,494.50 "	 $688.14 	" $2,193.44 "	" $2,408.48 "	" $2,408.48 "	 $688.14 	" $1,806.36 "	" $2,437.15 "	" $1,892.38 "	" $2,465.83 "	 $688.14 	" $2,580.52 "	" $2,331.07 "	" $2,437.15 "	 $682.40 	" $2,331.07 "	 $688.14 
4400883	HCHG MR ANGIO LOWER EXTREM (MRA)W/O CONT	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	C8912	" $3,495.00 "	" $2,446.50 "	 $831.81 	" $3,145.50 "	" $3,040.65 "	 $838.80 	" $2,673.68 "	" $2,935.80 "	" $2,935.80 "	 $838.80 	" $2,201.85 "	" $2,970.75 "	" $2,306.70 "	" $3,005.70 "	 $838.80 	" $3,145.50 "	" $2,841.44 "	" $2,970.75 "	 $831.81 	" $2,841.44 "	 $838.80 
4400900	HCHG MRI CHEST WITH CONTRAST	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	71551	" $3,495.00 "	" $2,446.50 "	 $831.81 	" $3,145.50 "	" $3,040.65 "	 $838.80 	" $2,673.68 "	" $2,935.80 "	" $2,935.80 "	 $838.80 	" $2,201.85 "	" $2,970.75 "	" $2,306.70 "	" $3,005.70 "	 $838.80 	" $3,145.50 "	" $2,841.44 "	" $2,970.75 "	 $831.81 	" $2,841.44 "	 $838.80 
4410671	HCHG MR ANGIO PELVIS W/O & W/DYE	0610	MAGNETIC RESONANCE TECHNOLOGY (MRT) - GENERAL CLASSIFICATION	72198	" $1,260.75 "	 $882.53 	 $300.06 	" $1,134.68 "	" $1,096.85 "	 $302.58 	 $964.47 	" $1,059.03 "	" $1,059.03 "	 $302.58 	 $794.27 	" $1,071.64 "	 $832.10 	" $1,084.25 "	 $302.58 	" $1,134.68 "	" $1,024.99 "	" $1,071.64 "	 $300.06 	" $1,024.99 "	 $302.58 
4400423	"HCHG MR ANGIO, HEAD"	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70544	" $2,540.00 "	" $1,778.00 "	 $604.52 	" $2,286.00 "	" $2,209.80 "	 $609.60 	" $1,943.10 "	" $2,133.60 "	" $2,133.60 "	 $609.60 	" $1,600.20 "	" $2,159.00 "	" $1,676.40 "	" $2,184.40 "	 $609.60 	" $2,286.00 "	" $2,065.02 "	" $2,159.00 "	 $604.52 	" $2,065.02 "	 $609.60 
4400424	"HCHG MR ANGIO, HEAD W/CONTRAST"	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70545	" $3,750.00 "	" $2,625.00 "	 $892.50 	" $3,375.00 "	" $3,262.50 "	 $900.00 	" $2,868.75 "	" $3,150.00 "	" $3,150.00 "	 $900.00 	" $2,362.50 "	" $3,187.50 "	" $2,475.00 "	" $3,225.00 "	 $900.00 	" $3,375.00 "	" $3,048.75 "	" $3,187.50 "	 $892.50 	" $3,048.75 "	 $900.00 
4400425	"HCHG MR ANGIO, HEAD, COMBO"	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70546	" $3,975.00 "	" $2,782.50 "	 $946.05 	" $3,577.50 "	" $3,458.25 "	 $954.00 	" $3,040.88 "	" $3,339.00 "	" $3,283.00 "	 $954.00 	" $2,504.25 "	" $3,378.75 "	" $2,623.50 "	" $3,418.50 "	 $954.00 	" $3,577.50 "	" $3,231.68 "	" $3,378.75 "	 $946.05 	" $3,231.68 "	 $954.00 
4400438	HCHG MRI BRAIN	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70551	" $2,200.00 "	" $1,540.00 "	 $523.60 	" $1,980.00 "	" $1,914.00 "	 $528.00 	" $1,683.00 "	" $1,848.00 "	" $1,848.00 "	 $528.00 	" $1,386.00 "	" $1,870.00 "	" $1,452.00 "	" $1,892.00 "	 $528.00 	" $1,980.00 "	" $1,788.60 "	" $1,870.00 "	 $523.60 	" $1,788.60 "	 $528.00 
4400439	HCHG MRI BRAIN COMBO	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70553	" $2,981.00 "	" $2,086.70 "	 $709.48 	" $2,682.90 "	" $2,593.47 "	 $715.44 	" $2,280.47 "	" $2,504.04 "	" $2,504.04 "	 $715.44 	" $1,878.03 "	" $2,533.85 "	" $1,967.46 "	" $2,563.66 "	 $715.44 	" $2,682.90 "	" $2,423.55 "	" $2,533.85 "	 $709.48 	" $2,423.55 "	 $715.44 
4400440	HCHG MRI BRAIN CONTRAST	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70552	" $2,500.00 "	" $1,750.00 "	 $595.00 	" $2,250.00 "	" $2,175.00 "	 $600.00 	" $1,912.50 "	" $2,100.00 "	" $2,100.00 "	 $600.00 	" $1,575.00 "	" $2,125.00 "	" $1,650.00 "	" $2,150.00 "	 $600.00 	" $2,250.00 "	" $2,032.50 "	" $2,125.00 "	 $595.00 	" $2,032.50 "	 $600.00 
4400462	"HCHG MRI, FACE, NECK"	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70540	" $3,400.00 "	" $2,380.00 "	 $809.20 	" $3,060.00 "	" $2,958.00 "	 $816.00 	" $2,601.00 "	" $2,856.00 "	" $2,856.00 "	 $816.00 	" $2,142.00 "	" $2,890.00 "	" $2,244.00 "	" $2,924.00 "	 $816.00 	" $3,060.00 "	" $2,764.20 "	" $2,890.00 "	 $809.20 	" $2,764.20 "	 $816.00 
4400464	"HCHG MRI, FACE, NECK, COMBO"	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70543	" $3,640.00 "	" $2,548.00 "	 $866.32 	" $3,276.00 "	" $3,166.80 "	 $873.60 	" $2,784.60 "	" $3,057.60 "	" $3,057.60 "	 $873.60 	" $2,293.20 "	" $3,094.00 "	" $2,402.40 "	" $3,130.40 "	 $873.60 	" $3,276.00 "	" $2,959.32 "	" $3,094.00 "	 $866.32 	" $2,959.32 "	 $873.60 
4400479	"HCHG MRI, TMJ"	0611	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - BRAIN/BRAINSTEM	70336	" $4,394.95 "	" $3,076.47 "	" $1,046.00 "	" $3,955.46 "	" $3,823.61 "	" $1,054.79 "	" $3,362.14 "	" $3,691.76 "	" $3,283.00 "	" $1,054.79 "	" $2,768.82 "	" $3,735.71 "	" $2,900.67 "	" $3,779.66 "	" $1,054.79 "	" $3,955.46 "	" $3,573.09 "	" $3,735.71 "	" $1,046.00 "	" $3,573.09 "	" $1,054.79 "
4400454	"HCHG MRI, CERV SPINE"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72141	" $2,189.00 "	" $1,532.30 "	 $520.98 	" $1,970.10 "	" $1,904.43 "	 $525.36 	" $1,674.59 "	" $1,838.76 "	" $1,838.76 "	 $525.36 	" $1,379.07 "	" $1,860.65 "	" $1,444.74 "	" $1,882.54 "	 $525.36 	" $1,970.10 "	" $1,779.66 "	" $1,860.65 "	 $520.98 	" $1,779.66 "	 $525.36 
4400455	"HCHG MRI, CERV SPINE COMBO"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72156	" $3,379.00 "	" $2,365.30 "	 $804.20 	" $3,041.10 "	" $2,939.73 "	 $810.96 	" $2,584.94 "	" $2,838.36 "	" $2,838.36 "	 $810.96 	" $2,128.77 "	" $2,872.15 "	" $2,230.14 "	" $2,905.94 "	 $810.96 	" $3,041.10 "	" $2,747.13 "	" $2,872.15 "	 $804.20 	" $2,747.13 "	 $810.96 
4400456	"HCHG MRI, CERV SPINE CONTRAST"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72142	" $3,750.00 "	" $2,625.00 "	 $892.50 	" $3,375.00 "	" $3,262.50 "	 $900.00 	" $2,868.75 "	" $3,150.00 "	" $3,150.00 "	 $900.00 	" $2,362.50 "	" $3,187.50 "	" $2,475.00 "	" $3,225.00 "	 $900.00 	" $3,375.00 "	" $3,048.75 "	" $3,187.50 "	 $892.50 	" $3,048.75 "	 $900.00 
4400459	"HCHG MRI, DORSAL SPINE"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72146	" $3,010.00 "	" $2,107.00 "	 $716.38 	" $2,709.00 "	" $2,618.70 "	 $722.40 	" $2,302.65 "	" $2,528.40 "	" $2,528.40 "	 $722.40 	" $1,896.30 "	" $2,558.50 "	" $1,986.60 "	" $2,588.60 "	 $722.40 	" $2,709.00 "	" $2,447.13 "	" $2,558.50 "	 $716.38 	" $2,447.13 "	 $722.40 
4400460	"HCHG MRI, DORSAL SPINE COMBO"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72157	" $3,379.00 "	" $2,365.30 "	 $804.20 	" $3,041.10 "	" $2,939.73 "	 $810.96 	" $2,584.94 "	" $2,838.36 "	" $2,838.36 "	 $810.96 	" $2,128.77 "	" $2,872.15 "	" $2,230.14 "	" $2,905.94 "	 $810.96 	" $3,041.10 "	" $2,747.13 "	" $2,872.15 "	 $804.20 	" $2,747.13 "	 $810.96 
4400461	"HCHG MRI, DORSAL SPINE CONTRAST"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72147	" $3,750.00 "	" $2,625.00 "	 $892.50 	" $3,375.00 "	" $3,262.50 "	 $900.00 	" $2,868.75 "	" $3,150.00 "	" $3,150.00 "	 $900.00 	" $2,362.50 "	" $3,187.50 "	" $2,475.00 "	" $3,225.00 "	 $900.00 	" $3,375.00 "	" $3,048.75 "	" $3,187.50 "	 $892.50 	" $3,048.75 "	 $900.00 
4400473	"HCHG MRI, LUMBAR SPINE"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72148	" $2,189.00 "	" $1,532.30 "	 $520.98 	" $1,970.10 "	" $1,904.43 "	 $525.36 	" $1,674.59 "	" $1,838.76 "	" $1,838.76 "	 $525.36 	" $1,379.07 "	" $1,860.65 "	" $1,444.74 "	" $1,882.54 "	 $525.36 	" $1,970.10 "	" $1,779.66 "	" $1,860.65 "	 $520.98 	" $1,779.66 "	 $525.36 
4400474	"HCHG MRI, LUMBAR SPINE COMBO"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72158	" $3,379.00 "	" $2,365.30 "	 $804.20 	" $3,041.10 "	" $2,939.73 "	 $810.96 	" $2,584.94 "	" $2,838.36 "	" $2,838.36 "	 $810.96 	" $2,128.77 "	" $2,872.15 "	" $2,230.14 "	" $2,905.94 "	 $810.96 	" $3,041.10 "	" $2,747.13 "	" $2,872.15 "	 $804.20 	" $2,747.13 "	 $810.96 
4400475	"HCHG MRI, LUMBAR SPINE CONTRAST"	0612	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRI - SPINAL CORD/SPINE)	72149	" $3,000.00 "	" $2,100.00 "	 $714.00 	" $2,700.00 "	" $2,610.00 "	 $720.00 	" $2,295.00 "	" $2,520.00 "	" $2,520.00 "	 $720.00 	" $1,890.00 "	" $2,550.00 "	" $1,980.00 "	" $2,580.00 "	 $720.00 	" $2,700.00 "	" $2,439.00 "	" $2,550.00 "	 $714.00 	" $2,439.00 "	 $720.00 
4400426	"HCHG MR ANGIO, NECK"	0615	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK	70547	" $2,700.00 "	" $1,890.00 "	 $642.60 	" $2,430.00 "	" $2,349.00 "	 $648.00 	" $2,065.50 "	" $2,268.00 "	" $2,268.00 "	 $648.00 	" $1,701.00 "	" $2,295.00 "	" $1,782.00 "	" $2,322.00 "	 $648.00 	" $2,430.00 "	" $2,195.10 "	" $2,295.00 "	 $642.60 	" $2,195.10 "	 $648.00 
4400428	"HCHG MR ANGIO, NECK, COMBO"	0615	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK	70549	" $3,700.00 "	" $2,590.00 "	 $880.60 	" $3,330.00 "	" $3,219.00 "	 $888.00 	" $2,830.50 "	" $3,108.00 "	" $3,108.00 "	 $888.00 	" $2,331.00 "	" $3,145.00 "	" $2,442.00 "	" $3,182.00 "	 $888.00 	" $3,330.00 "	" $3,008.10 "	" $3,145.00 "	 $880.60 	" $3,008.10 "	 $888.00 
4400921	"HCHG MR ANGIO, NECK W/CONTRAST"	0615	MAGNETIC RESONANCE TECHNOLOGY (MRT) - MRA - HEAD AND NECK	70548	" $3,200.00 "	" $2,240.00 "	 $761.60 	" $2,880.00 "	" $2,784.00 "	 $768.00 	" $2,448.00 "	" $2,688.00 "	" $2,688.00 "	 $768.00 	" $2,016.00 "	" $2,720.00 "	" $2,112.00 "	" $2,752.00 "	 $768.00 	" $2,880.00 "	" $2,601.60 "	" $2,720.00 "	 $761.60 	" $2,601.60 "	 $768.00 
303215	HCHG APLIGRAF-COM	0636	PHARMACY	Q4101	 $210.45 	 $147.32 	 $50.09 	 $189.41 	 $183.09 	 $50.51 	 $160.99 	 $-   	 $-   	 $52.02 	 $132.58 	 $178.88 	 $138.90 	 $170.46 	 $50.51 	 $189.41 	 $171.10 	 $178.88 	 $50.09 	 $171.10 	 $50.51 
303216	HCHG DERMAGRAF	0636	PHARMACY	Q4106	 $224.56 	 $157.19 	 $53.45 	 $202.10 	 $195.37 	 $53.89 	 $171.79 	 $-   	 $-   	 $55.51 	 $141.47 	 $190.88 	 $148.21 	 $181.89 	 $53.89 	 $202.10 	 $182.57 	 $190.88 	 $53.45 	 $182.57 	 $53.89 
303217	HCHG NUSHIELD NO-1160C	0636	PHARMACY	Q4160	" $1,143.08 "	 $800.16 	 $272.05 	" $1,028.77 "	 $994.48 	 $274.34 	 $874.46 	 $-   	 $-   	 $282.57 	 $720.14 	 $971.62 	 $754.43 	 $925.89 	 $274.34 	" $1,028.77 "	 $929.32 	 $971.62 	 $272.05 	 $929.32 	 $274.34 
303218	HCHG NUSHIELD NO-1230	0636	PHARMACY	Q4160	 $766.87 	 $536.81 	 $182.52 	 $690.18 	 $667.18 	 $184.05 	 $586.66 	 $-   	 $-   	 $189.57 	 $483.13 	 $651.84 	 $506.13 	 $621.16 	 $184.05 	 $690.18 	 $623.47 	 $651.84 	 $182.52 	 $623.47 	 $184.05 
303219	HCHG NUSHIELD NO-1240	0636	PHARMACY	Q4160	 $862.42 	 $603.69 	 $205.26 	 $776.18 	 $750.31 	 $206.98 	 $659.75 	 $-   	 $-   	 $213.19 	 $543.32 	 $733.06 	 $569.20 	 $698.56 	 $206.98 	 $776.18 	 $701.15 	 $733.06 	 $205.26 	 $701.15 	 $206.98 
303220	HCHG NUSHIELD NO-1330	0636	PHARMACY	Q4160	 $766.59 	 $536.61 	 $182.45 	 $689.93 	 $666.93 	 $183.98 	 $586.44 	 $-   	 $-   	 $189.50 	 $482.95 	 $651.60 	 $505.95 	 $620.94 	 $183.98 	 $689.93 	 $623.24 	 $651.60 	 $182.45 	 $623.24 	 $183.98 
303221	HCHG NUSHIELD NO-1340	0636	PHARMACY	Q4160	 $832.16 	 $582.51 	 $198.05 	 $748.94 	 $723.98 	 $199.72 	 $636.60 	 $-   	 $-   	 $205.71 	 $524.26 	 $707.34 	 $549.23 	 $674.05 	 $199.72 	 $748.94 	 $676.55 	 $707.34 	 $198.05 	 $676.55 	 $199.72 
303222	HCHG NUSHIELD NO-1440	0636	PHARMACY	Q4160	 $646.81 	 $452.77 	 $153.94 	 $582.13 	 $562.72 	 $155.23 	 $494.81 	 $-   	 $-   	 $159.89 	 $407.49 	 $549.79 	 $426.89 	 $523.92 	 $155.23 	 $582.13 	 $525.86 	 $549.79 	 $153.94 	 $525.86 	 $155.23 
303223	HCHG NUSHIELD NO-1460	0636	PHARMACY	Q4160	 $70.86 	 $49.60 	 $16.86 	 $63.77 	 $61.65 	 $17.01 	 $54.21 	 $-   	 $-   	 $17.52 	 $44.64 	 $60.23 	 $46.77 	 $57.40 	 $17.01 	 $63.77 	 $57.61 	 $60.23 	 $16.86 	 $57.61 	 $17.01 
303224	HCHG NUSHIELD NO-1660	0636	PHARMACY	Q4160	 $502.32 	 $351.62 	 $119.55 	 $452.09 	 $437.02 	 $120.56 	 $384.27 	 $-   	 $-   	 $124.17 	 $316.46 	 $426.97 	 $331.53 	 $406.88 	 $120.56 	 $452.09 	 $408.39 	 $426.97 	 $119.55 	 $408.39 	 $120.56 
303225	HCHG PURAPLYAM-COM 1.6 DISC	0636	PHARMACY	Q4196	" $1,302.24 "	 $911.57 	 $309.93 	" $1,172.02 "	" $1,132.95 "	 $312.54 	 $996.21 	 $-   	 $-   	 $321.91 	 $820.41 	" $1,106.90 "	 $859.48 	" $1,054.81 "	 $312.54 	" $1,172.02 "	" $1,058.72 "	" $1,106.90 "	 $309.93 	" $1,058.72 "	 $312.54 
303226	HCHG PURAPLYAM-COM 2X2	0636	PHARMACY	Q4196	" $1,085.20 "	 $759.64 	 $258.28 	 $976.68 	 $944.12 	 $260.45 	 $830.18 	 $-   	 $-   	 $268.26 	 $683.68 	 $922.42 	 $716.23 	 $879.01 	 $260.45 	 $976.68 	 $882.27 	 $922.42 	 $258.28 	 $882.27 	 $260.45 
303227	HCHG PURAPLYAM-COM 2X4	0636	PHARMACY	Q4196	 $817.03 	 $571.92 	 $194.45 	 $735.33 	 $710.82 	 $196.09 	 $625.03 	 $-   	 $-   	 $201.97 	 $514.73 	 $694.48 	 $539.24 	 $661.79 	 $196.09 	 $735.33 	 $664.25 	 $694.48 	 $194.45 	 $664.25 	 $196.09 
303228	HCHG PURAPLYAM-COM 5X5	0636	PHARMACY	Q4196	 $755.29 	 $528.70 	 $179.76 	 $679.76 	 $657.10 	 $181.27 	 $577.80 	 $-   	 $-   	 $186.71 	 $475.83 	 $642.00 	 $498.49 	 $611.78 	 $181.27 	 $679.76 	 $614.05 	 $642.00 	 $179.76 	 $614.05 	 $181.27 
303229	HCHG PURAPLYAM-COM 6X9	0636	PHARMACY	Q4196	 $689.93 	 $482.95 	 $164.20 	 $620.94 	 $600.24 	 $165.58 	 $527.80 	 $-   	 $-   	 $170.55 	 $434.66 	 $586.44 	 $455.35 	 $558.84 	 $165.58 	 $620.94 	 $560.91 	 $586.44 	 $164.20 	 $560.91 	 $165.58 
303230	HCHG PURAPLYAM-COM 8X16	0636	PHARMACY	Q4196	 $726.25 	 $508.38 	 $172.85 	 $653.63 	 $631.84 	 $174.30 	 $555.58 	 $-   	 $-   	 $179.53 	 $457.54 	 $617.31 	 $479.33 	 $588.26 	 $174.30 	 $653.63 	 $590.44 	 $617.31 	 $172.85 	 $590.44 	 $174.30 
303232	HCHG PURAPLY XT 5X5	0636	PHARMACY	Q4197	 $868.16 	 $607.71 	 $206.62 	 $781.34 	 $755.30 	 $208.36 	 $664.14 	 $-   	 $-   	 $214.61 	 $546.94 	 $737.94 	 $572.99 	 $703.21 	 $208.36 	 $781.34 	 $705.81 	 $737.94 	 $206.62 	 $705.81 	 $208.36 
303233	HCHG PURAPLY XT 6X9	0636	PHARMACY	Q4197	 $868.16 	 $607.71 	 $206.62 	 $781.34 	 $755.30 	 $208.36 	 $664.14 	 $-   	 $-   	 $214.61 	 $546.94 	 $737.94 	 $572.99 	 $703.21 	 $208.36 	 $781.34 	 $705.81 	 $737.94 	 $206.62 	 $705.81 	 $208.36 
303235	HCHG AFFINITY 2.5 X 2.5 (7 UNITS)	0636	PHARMACY	Q4159	" $1,637.11 "	" $1,145.98 "	 $389.63 	" $1,473.40 "	" $1,424.29 "	 $392.91 	" $1,252.39 "	 $-   	 $-   	 $404.69 	" $1,031.38 "	" $1,391.54 "	" $1,080.49 "	" $1,326.06 "	 $392.91 	" $1,473.40 "	" $1,330.97 "	" $1,391.54 "	 $389.63 	" $1,330.97 "	 $392.91 
303252	HCHG PURAPLYAM-COM 3X4	0636	PHARMACY	Q4196	 $666.75 	 $466.73 	 $158.69 	 $600.08 	 $580.07 	 $160.02 	 $510.06 	 $-   	 $-   	 $164.82 	 $420.05 	 $566.74 	 $440.06 	 $540.07 	 $160.02 	 $600.08 	 $542.07 	 $566.74 	 $158.69 	 $542.07 	 $160.02 
303253	HCHG PURAPLYAM-COM 4X4	0636	PHARMACY	Q4196	 $666.75 	 $466.73 	 $158.69 	 $600.08 	 $580.07 	 $160.02 	 $510.06 	 $-   	 $-   	 $164.82 	 $420.05 	 $566.74 	 $440.06 	 $540.07 	 $160.02 	 $600.08 	 $542.07 	 $566.74 	 $158.69 	 $542.07 	 $160.02 
303254	HCHG PURAPLY XT 4.91 X 4.91 (25 UNITS)	0636	PHARMACY	Q4197	" $10,733.53 "	" $7,513.47 "	" $2,554.58 "	" $9,660.18 "	" $9,338.17 "	" $2,576.05 "	" $8,211.15 "	" $4,830.09 "	" $4,508.08 "	" $2,653.33 "	" $6,762.12 "	" $9,123.50 "	" $7,084.13 "	" $8,694.16 "	" $2,576.05 "	" $9,660.18 "	" $8,726.36 "	" $9,123.50 "	" $2,554.58 "	" $8,726.36 "	" $2,576.05 "
303255	HCHG AFFINITY 1.5 X1.5 (3 UNITS)	0636	PHARMACY	Q4159	" $1,922.25 "	" $1,345.58 "	 $457.50 	" $1,730.03 "	" $1,672.36 "	 $461.34 	" $1,470.52 "	 $-   	 $-   	 $475.18 	" $1,211.02 "	" $1,633.91 "	" $1,268.69 "	" $1,557.02 "	 $461.34 	" $1,730.03 "	" $1,562.79 "	" $1,633.91 "	 $457.50 	" $1,562.79 "	 $461.34 
303301	HCHG SOLU-MEDROL PER 125 MG	0636	PHARMACY	J2930	 $38.25 	 $26.78 	 $9.10 	 $34.43 	 $33.28 	 $9.18 	 $29.26 	 $-   	 $-   	 $9.46 	 $24.10 	 $32.51 	 $25.25 	 $30.98 	 $9.18 	 $34.43 	 $31.10 	 $32.51 	 $9.10 	 $31.10 	 $9.18 
304802	HCHG PNEUMOCOCCAL CONJUGATE VALENT 13	0636	PHARMACY	90670	" $1,106.25 "	 $774.38 	 $263.29 	 $995.63 	 $962.44 	 $265.50 	 $846.28 	 $-   	 $-   	 $273.47 	 $696.94 	 $940.31 	 $730.13 	 $896.06 	 $265.50 	 $995.63 	 $899.38 	 $940.31 	 $263.29 	 $899.38 	 $265.50 
304806	HCHG PNEUMOCOCCAL VACCINE VALENT 23	0636	PHARMACY	90732	 $640.75 	 $448.53 	 $152.50 	 $576.68 	 $557.45 	 $153.78 	 $490.17 	 $-   	 $-   	 $158.39 	 $403.67 	 $544.64 	 $422.90 	 $519.01 	 $153.78 	 $576.68 	 $520.93 	 $544.64 	 $152.50 	 $520.93 	 $153.78 
305513	HCHG FLUZONE HD VACCINE (SPLIT VIRUS PF)	0636	PHARMACY	90662	 $326.50 	 $228.55 	 $77.71 	 $293.85 	 $284.06 	 $78.36 	 $249.77 	 $-   	 $-   	 $80.71 	 $205.70 	 $277.53 	 $215.49 	 $264.47 	 $78.36 	 $293.85 	 $265.44 	 $277.53 	 $77.71 	 $265.44 	 $78.36 
305514	HCHG FLU VACCINE QUAD (SPLIT VIRUS PF)	0636	PHARMACY	90686	 $144.75 	 $101.33 	 $34.45 	 $130.28 	 $125.93 	 $34.74 	 $110.73 	 $-   	 $-   	 $35.78 	 $91.19 	 $123.04 	 $95.54 	 $117.25 	 $34.74 	 $130.28 	 $117.68 	 $123.04 	 $34.45 	 $117.68 	 $34.74 
307090	HCHG TDAP VACCINE(AGE>=7)	0636	PHARMACY	90715	 $280.00 	 $196.00 	 $66.64 	 $252.00 	 $243.60 	 $67.20 	 $214.20 	 $-   	 $-   	 $69.22 	 $176.40 	 $238.00 	 $184.80 	 $226.80 	 $67.20 	 $252.00 	 $227.64 	 $238.00 	 $66.64 	 $227.64 	 $67.20 
357503	HCHG PCV20 VACCINE INTRAMUSCULAR USE	0636	PHARMACY	90677	 $810.92 	 $567.64 	 $193.00 	 $729.83 	 $705.50 	 $194.62 	 $620.35 	 $-   	 $-   	 $200.46 	 $510.88 	 $689.28 	 $535.21 	 $656.85 	 $194.62 	 $729.83 	 $659.28 	 $689.28 	 $193.00 	 $659.28 	 $194.62 
4410133	HCHG NON-IONIC CONTRAST 200-299MG/ML PER ML	0636	PHARMACY	Q9963	 $30.68 	 $21.48 	 $7.30 	 $27.61 	 $26.69 	 $7.36 	 $23.47 	 $-   	 $-   	 $7.58 	 $19.33 	 $26.08 	 $20.25 	 $24.85 	 $7.36 	 $27.61 	 $24.94 	 $26.08 	 $7.30 	 $24.94 	 $7.36 
4410254	HCHG NON-IONIC CONTRAST 150-199MG/ML PER ML	0636	PHARMACY	Q9965	 $5.27 	 $3.69 	 $1.25 	 $4.74 	 $4.58 	 $1.26 	 $4.03 	 $-   	 $-   	 $1.30 	 $3.32 	 $4.48 	 $3.48 	 $4.27 	 $1.26 	 $4.74 	 $4.28 	 $4.48 	 $1.25 	 $4.28 	 $1.26 
4410255	HCHG NON-IONIC CONTRAST 300-349MG/ML PER ML	0636	PHARMACY	Q9967	 $2.56 	 $1.79 	 $0.61 	 $2.30 	 $2.23 	 $0.61 	 $1.96 	 $-   	 $-   	 $0.63 	 $1.61 	 $2.18 	 $1.69 	 $2.07 	 $0.61 	 $2.30 	 $2.08 	 $2.18 	 $0.61 	 $2.08 	 $0.61 
4410256	HCHG NON-IONIC CONTRAST 350-399MG/ML PER ML	0636	PHARMACY	Q9967	 $2.56 	 $1.79 	 $0.61 	 $2.30 	 $2.23 	 $0.61 	 $1.96 	 $-   	 $-   	 $0.63 	 $1.61 	 $2.18 	 $1.69 	 $2.07 	 $0.61 	 $2.30 	 $2.08 	 $2.18 	 $0.61 	 $2.08 	 $0.61 
503439	HCHG EPICORD 2X3 CM	0636	PHARMACY	Q4187	" $4,293.41 "	" $3,005.39 "	" $1,021.83 "	" $3,864.07 "	" $3,735.27 "	" $1,030.42 "	" $3,284.46 "	" $1,932.03 "	" $1,803.23 "	" $1,061.33 "	" $2,704.85 "	" $3,649.40 "	" $2,833.65 "	" $3,477.66 "	" $1,030.42 "	" $3,864.07 "	" $3,490.54 "	" $3,649.40 "	" $1,021.83 "	" $3,490.54 "	" $1,030.42 "
503442	HCHG EPIFIX 2X2	0636	PHARMACY	Q4186	" $3,529.44 "	" $2,470.61 "	 $840.01 	" $3,176.50 "	" $3,070.61 "	 $847.07 	" $2,700.02 "	" $1,588.25 "	 $-   	 $872.48 	" $2,223.55 "	" $3,000.02 "	" $2,329.43 "	" $2,858.85 "	 $847.07 	" $3,176.50 "	" $2,869.43 "	" $3,000.02 "	 $840.01 	" $2,869.43 "	 $847.07 
503851	HCHG EPIFIX MESH 4X4.5CM 11 UNITS	0636	PHARMACY	Q4186	" $4,623.31 "	" $3,236.32 "	" $1,100.35 "	" $4,160.98 "	" $4,022.28 "	" $1,109.59 "	" $3,536.83 "	" $2,080.49 "	" $1,941.79 "	" $1,142.88 "	" $2,912.69 "	" $3,929.81 "	" $3,051.38 "	" $3,744.88 "	" $1,109.59 "	" $4,160.98 "	" $3,758.75 "	" $3,929.81 "	" $1,100.35 "	" $3,758.75 "	" $1,109.59 "
503852	HCHG EPIFIX 2X4 CM 8 UNITS	0636	PHARMACY	Q4186	" $4,476.51 "	" $3,133.56 "	" $1,065.41 "	" $4,028.86 "	" $3,894.56 "	" $1,074.36 "	" $3,424.53 "	" $2,014.43 "	" $1,880.13 "	" $1,106.59 "	" $2,820.20 "	" $3,805.03 "	" $2,954.50 "	" $3,625.97 "	" $1,074.36 "	" $4,028.86 "	" $3,639.40 "	" $3,805.03 "	" $1,065.41 "	" $3,639.40 "	" $1,074.36 "
503855	HCHG EPICORD 1X2 (EC-5120) 2 UNITS	0636	PHARMACY	Q4187	" $3,671.00 "	" $2,569.70 "	 $873.70 	" $3,303.90 "	" $3,193.77 "	 $881.04 	" $2,808.32 "	" $1,651.95 "	 $-   	 $907.47 	" $2,312.73 "	" $3,120.35 "	" $2,422.86 "	" $2,973.51 "	 $881.04 	" $3,303.90 "	" $2,984.52 "	" $3,120.35 "	 $873.70 	" $2,984.52 "	 $881.04 
503856	HCHG EPICORD 3X5 (EC-5350) 15 UNITS	0636	PHARMACY	Q4187	" $10,640.40 "	" $7,448.28 "	" $2,532.42 "	" $9,576.36 "	" $9,257.15 "	" $2,553.70 "	" $8,139.91 "	" $4,788.18 "	" $4,468.97 "	" $2,630.31 "	" $6,703.45 "	" $9,044.34 "	" $7,022.66 "	" $8,618.72 "	" $2,553.70 "	" $9,576.36 "	" $8,650.65 "	" $9,044.34 "	" $2,532.42 "	" $8,650.65 "	" $2,553.70 "
160046	HCHG PACU - 1ST 60 MINS PHASE II	0710	RECOVERY ROOM - GENERAL CLASSIFICATION	160046	 $660.00 	 $462.00 	 $157.08 	 $594.00 	 $574.20 	 $158.40 	 $504.90 	 $554.40 	 $554.40 	 $158.40 	 $415.80 	 $561.00 	 $455.40 	 $528.00 	 $158.40 	 $594.00 	 $536.58 	 $561.00 	 $157.08 	 $536.58 	 $158.40 
160049	HCHG PACU  - EA ADDL 15 MINS PHASE II	0710	RECOVERY ROOM - GENERAL CLASSIFICATION		 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $55.20 	 $64.00 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
310091	HCHG CVMC PHASE II (EXTENDED) RECOVERY	0710	RECOVERY ROOM - GENERAL CLASSIFICATION		 $950.00 	 $665.00 	 $226.10 	 $855.00 	 $826.50 	 $228.00 	 $726.75 	 $798.00 	 $798.00 	 $234.84 	 $598.50 	 $807.50 	 $655.50 	 $760.00 	 $228.00 	 $855.00 	 $772.35 	 $807.50 	 $226.10 	 $772.35 	 $228.00 
5260005	HCHG CVMC RECOVERY 1/4HR FRACT	0710	RECOVERY ROOM - GENERAL CLASSIFICATION		 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.72 	 $63.00 	 $85.00 	 $69.00 	 $80.00 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
5260006	HCHG CVMC POST OP CARE 3 TO 4 HOURS	0710	RECOVERY ROOM - GENERAL CLASSIFICATION		 $598.50 	 $418.95 	 $142.44 	 $538.65 	 $520.70 	 $143.64 	 $457.85 	 $502.74 	 $502.74 	 $147.95 	 $377.06 	 $508.73 	 $412.97 	 $478.80 	 $143.64 	 $538.65 	 $486.58 	 $508.73 	 $142.44 	 $486.58 	 $143.64 
5260008	HCHG POST OP CARE 1ST HOUR	0710	RECOVERY ROOM - GENERAL CLASSIFICATION		 $660.00 	 $462.00 	 $157.08 	 $594.00 	 $574.20 	 $158.40 	 $504.90 	 $554.40 	 $554.40 	 $158.40 	 $415.80 	 $561.00 	 $455.40 	 $528.00 	 $158.40 	 $594.00 	 $536.58 	 $561.00 	 $157.08 	 $536.58 	 $158.40 
5260009	HCHG CVMC POST OP CARE 1 TO 2 HOURS	0710	RECOVERY ROOM - GENERAL CLASSIFICATION		 $700.00 	 $490.00 	 $166.60 	 $630.00 	 $609.00 	 $168.00 	 $535.50 	 $588.00 	 $588.00 	 $173.04 	 $441.00 	 $595.00 	 $483.00 	 $560.00 	 $168.00 	 $630.00 	 $569.10 	 $595.00 	 $166.60 	 $569.10 	 $168.00 
5400191	HCHG CVMC GI POST OP CARE <6HR	0710	RECOVERY ROOM - GENERAL CLASSIFICATION		 $567.12 	 $396.98 	 $134.97 	 $510.41 	 $493.39 	 $136.11 	 $433.85 	 $476.38 	 $476.38 	 $140.19 	 $357.29 	 $482.05 	 $391.31 	 $453.70 	 $136.11 	 $510.41 	 $461.07 	 $482.05 	 $134.97 	 $461.07 	 $136.11 
303560	HCHG ELECTROCARDIOGRAM	0730	EKG/ECG (ELECTROCARDIOGRAM) - GENERAL CLASSIFICATION	93005	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $84.05 	 $214.20 	 $289.00 	 $234.60 	 $272.00 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
303630	HCHG ER EKG	0730	EKG/ECG (ELECTROCARDIOGRAM) - GENERAL CLASSIFICATION	93005	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $285.60 	 $285.60 	 $84.05 	 $214.20 	 $289.00 	 $234.60 	 $272.00 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
307911	HCHG CVMC UNLISTED CARDIO SERVICES	0730	EKG/ECG (ELECTROCARDIOGRAM) - GENERAL CLASSIFICATION	93799	 $966.83 	 $676.78 	 $230.11 	 $870.15 	 $841.14 	 $232.04 	 $739.62 	 $812.14 	 $812.14 	 $239.00 	 $609.10 	 $821.81 	 $667.11 	 $773.46 	 $232.04 	 $870.15 	 $786.03 	 $821.81 	 $230.11 	 $786.03 	 $232.04 
330915	HCHG BMH/CVMC RHYTHM ECG 93041	0730	EKG/ECG (ELECTROCARDIOGRAM) - GENERAL CLASSIFICATION	93041	 $156.97 	 $109.88 	 $37.36 	 $141.27 	 $136.56 	 $37.67 	 $120.08 	 $131.85 	 $131.85 	 $38.80 	 $98.89 	 $133.42 	 $108.31 	 $125.58 	 $37.67 	 $141.27 	 $127.62 	 $133.42 	 $37.36 	 $127.62 	 $37.67 
330959	HCHG CVMC ECG MONITOR/REPORT UP TO 48 HRS	0731	EKG/ECG (ELECTROCARDIOGRAM) - HOLTER MONITOR	93225	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
343141	HCHG BMH ECG MONIT/REPRT UP TO 48 HRS	0731	EKG/ECG (ELECTROCARDIOGRAM) - HOLTER MONITOR	93225	 $428.00 	 $299.60 	 $101.86 	 $385.20 	 $372.36 	 $102.72 	 $327.42 	 $359.52 	 $359.52 	 $105.80 	 $269.64 	 $363.80 	 $295.32 	 $342.40 	 $102.72 	 $385.20 	 $347.96 	 $363.80 	 $101.86 	 $347.96 	 $102.72 
303522	HCHG EEG AWAKE AND ASLEEP	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95819	 $757.00 	 $529.90 	 $180.17 	 $681.30 	 $658.59 	 $181.68 	 $579.11 	 $635.88 	 $635.88 	 $187.13 	 $476.91 	 $643.45 	 $522.33 	 $605.60 	 $181.68 	 $681.30 	 $615.44 	 $643.45 	 $180.17 	 $615.44 	 $181.68 
303523	HCHG EEG AWAKE	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95816	 $479.00 	 $335.30 	 $114.00 	 $431.10 	 $416.73 	 $114.96 	 $366.44 	 $402.36 	 $402.36 	 $118.41 	 $301.77 	 $407.15 	 $330.51 	 $383.20 	 $114.96 	 $431.10 	 $389.43 	 $407.15 	 $114.00 	 $389.43 	 $114.96 
303524	HCHG EEG CEREBRAL DEATH EVAL	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95824	 $819.00 	 $573.30 	 $194.92 	 $737.10 	 $712.53 	 $196.56 	 $626.54 	 $687.96 	 $687.96 	 $202.46 	 $515.97 	 $696.15 	 $565.11 	 $655.20 	 $196.56 	 $737.10 	 $665.85 	 $696.15 	 $194.92 	 $665.85 	 $196.56 
303525	HCHG EEG EXTENDED MONITORING 41-60 MIN	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95812	 $816.00 	 $571.20 	 $194.21 	 $734.40 	 $709.92 	 $195.84 	 $624.24 	 $685.44 	 $685.44 	 $201.72 	 $514.08 	 $693.60 	 $563.04 	 $652.80 	 $195.84 	 $734.40 	 $663.41 	 $693.60 	 $194.21 	 $663.41 	 $195.84 
303526	HCHG EEG EXTENDED MONITORING 61-119 MIN	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95813	" $1,054.00 "	 $737.80 	 $250.85 	 $948.60 	 $916.98 	 $252.96 	 $806.31 	 $885.36 	 $885.36 	 $260.55 	 $664.02 	 $895.90 	 $727.26 	 $843.20 	 $252.96 	 $948.60 	 $856.90 	 $895.90 	 $250.85 	 $856.90 	 $252.96 
303528	HCHG EEG SLEEP OR COMA	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95822	 $809.00 	 $566.30 	 $192.54 	 $728.10 	 $703.83 	 $194.16 	 $618.89 	 $679.56 	 $679.56 	 $199.98 	 $509.67 	 $687.65 	 $558.21 	 $647.20 	 $194.16 	 $728.10 	 $657.72 	 $687.65 	 $192.54 	 $657.72 	 $194.16 
305070	HCHG SLP STDY UNATTENDED W/HRT RATE/O2 SAT/RESP/SLP TIME	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95800	 $679.50 	 $475.65 	 $161.72 	 $611.55 	 $591.17 	 $163.08 	 $519.82 	 $570.78 	 $570.78 	 $163.08 	 $428.09 	 $577.58 	 $468.86 	 $543.60 	 $163.08 	 $611.55 	 $552.43 	 $577.58 	 $161.72 	 $552.43 	 $163.08 
309084	HCHG BMH/CVMC MSLT	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95805	" $4,000.00 "	" $2,800.00 "	 $952.00 	" $3,600.00 "	" $3,480.00 "	 $960.00 	" $3,060.00 "	" $3,360.00 "	" $3,283.00 "	 $988.80 	" $2,520.00 "	" $3,400.00 "	" $2,760.00 "	" $3,200.00 "	 $960.00 	" $3,600.00 "	" $3,252.00 "	" $3,400.00 "	 $952.00 	" $3,252.00 "	 $960.00 
309085	"HCHG BMH/CVMC POLYSOMNOGRAPHY, 4 OR MORE"	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95810	" $4,000.00 "	" $2,800.00 "	 $952.00 	" $3,600.00 "	" $3,480.00 "	 $960.00 	" $3,060.00 "	" $3,360.00 "	" $3,283.00 "	 $988.80 	" $2,520.00 "	" $3,400.00 "	" $2,760.00 "	" $3,200.00 "	 $960.00 	" $3,600.00 "	" $3,252.00 "	" $3,400.00 "	 $952.00 	" $3,252.00 "	 $960.00 
309086	HCHG BMH/CVMC POLYSOMNOGRAPHY/CPAP	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95811	" $5,500.00 "	" $3,850.00 "	" $1,309.00 "	" $4,950.00 "	" $4,785.00 "	" $1,320.00 "	" $4,207.50 "	" $3,786.00 "	" $3,283.00 "	" $1,359.60 "	" $3,465.00 "	" $4,675.00 "	" $3,795.00 "	" $4,400.00 "	" $1,320.00 "	" $4,950.00 "	" $4,471.50 "	" $4,675.00 "	" $1,309.00 "	" $4,471.50 "	" $1,320.00 "
309168	HCHG SLEEP STUDY UNATT & RESP EFFT	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95806	" $1,200.00 "	 $840.00 	 $285.60 	" $1,080.00 "	" $1,044.00 "	 $288.00 	 $918.00 	" $1,008.00 "	" $1,008.00 "	 $288.00 	 $756.00 	" $1,020.00 "	 $828.00 	 $960.00 	 $288.00 	" $1,080.00 "	 $975.60 	" $1,020.00 "	 $285.60 	 $975.60 	 $288.00 
309169	HCHG POLYSOMNOGRAPHY <6 YRS SLEEP STAGING 4>	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95782	" $5,200.00 "	" $3,640.00 "	" $1,237.60 "	" $4,680.00 "	" $4,524.00 "	" $1,248.00 "	" $3,978.00 "	" $3,786.00 "	" $3,283.00 "	" $1,248.00 "	" $3,276.00 "	" $4,420.00 "	" $3,588.00 "	" $4,160.00 "	" $1,248.00 "	" $4,680.00 "	" $4,227.60 "	" $4,420.00 "	" $1,237.60 "	" $4,227.60 "	" $1,248.00 "
309170	HCHG POLYSOM <6 YRS SLEEP STAGING 4> W/CPAP/BILVL	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95783	" $5,400.00 "	" $3,780.00 "	" $1,285.20 "	" $4,860.00 "	" $4,698.00 "	" $1,296.00 "	" $4,131.00 "	" $3,786.00 "	" $3,283.00 "	" $1,296.00 "	" $3,402.00 "	" $4,590.00 "	" $3,726.00 "	" $4,320.00 "	" $1,296.00 "	" $4,860.00 "	" $4,390.20 "	" $4,590.00 "	" $1,285.20 "	" $4,390.20 "	" $1,296.00 "
5200177	HCHG CVMC EEG DURING SURGERY	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95955	" $1,190.73 "	 $833.51 	 $283.39 	" $1,071.66 "	" $1,035.94 "	 $285.78 	 $910.91 	" $1,000.21 "	" $1,000.21 "	 $294.35 	 $750.16 	" $1,012.12 "	 $821.60 	 $952.58 	 $285.78 	" $1,071.66 "	 $968.06 	" $1,012.12 "	 $283.39 	 $968.06 	 $285.78 
5200178	"HCHG CVMC ELECTRODE STIMULATION,BRAIN"	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95961	" $1,128.01 "	 $789.61 	 $268.47 	" $1,015.21 "	 $981.37 	 $270.72 	 $862.93 	 $947.53 	 $947.53 	 $278.84 	 $710.65 	 $958.81 	 $778.33 	 $902.41 	 $270.72 	" $1,015.21 "	 $917.07 	 $958.81 	 $268.47 	 $917.07 	 $270.72 
5200179	"HCHG CVMC ELECTRODE STIM, BRAIN ADD-ON"	0740	EEG (ELECTROENCEPHALOGRAM) - GENERAL CLASSIFICATION	95962	 $847.92 	 $593.54 	 $201.80 	 $763.13 	 $737.69 	 $203.50 	 $648.66 	 $712.25 	 $712.25 	 $209.61 	 $534.19 	 $720.73 	 $585.06 	 $678.34 	 $203.50 	 $763.13 	 $689.36 	 $720.73 	 $201.80 	 $689.36 	 $203.50 
110356	HCHG SMALL BOWEL ENDOSCOPY J TUBE PLACE	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	44372	" $3,559.95 "	" $2,491.97 "	 $847.27 	" $3,203.96 "	" $3,097.16 "	 $854.39 	" $2,723.36 "	" $2,990.36 "	" $2,990.36 "	 $854.39 	" $2,242.77 "	" $3,025.96 "	" $2,456.37 "	" $2,847.96 "	 $854.39 	" $3,203.96 "	" $2,894.24 "	" $3,025.96 "	 $847.27 	" $2,894.24 "	 $854.39 
111010	HCHG SMALL BOWEL ENDOSCOPY BRUSH/WASH	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	44360	" $2,955.80 "	" $2,069.06 "	 $703.48 	" $2,660.22 "	" $2,571.55 "	 $709.39 	" $2,261.19 "	" $2,482.87 "	" $2,482.87 "	 $709.39 	" $1,862.15 "	" $2,512.43 "	" $2,039.50 "	" $2,364.64 "	 $709.39 	" $2,660.22 "	" $2,403.07 "	" $2,512.43 "	 $703.48 	" $2,403.07 "	 $709.39 
111330	HCHG SIGMOIDOSCOPY W/BALLOON DILATION	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	45340	" $2,698.57 "	" $1,889.00 "	 $642.26 	" $2,428.71 "	" $2,347.76 "	 $647.66 	" $2,064.41 "	" $2,266.80 "	" $2,266.80 "	 $647.66 	" $1,700.10 "	" $2,293.78 "	" $1,862.01 "	" $2,158.86 "	 $647.66 	" $2,428.71 "	" $2,193.94 "	" $2,293.78 "	 $642.26 	" $2,193.94 "	 $647.66 
111560	HCHG COLORECTAL CANCER SCN-FLEX SIG	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	G0104	" $2,046.00 "	" $1,432.20 "	 $486.95 	" $1,841.40 "	" $1,780.02 "	 $491.04 	" $1,565.19 "	" $1,718.64 "	" $1,718.64 "	 $505.77 	" $1,288.98 "	" $1,739.10 "	" $1,411.74 "	" $1,636.80 "	 $491.04 	" $1,841.40 "	" $1,663.40 "	" $1,739.10 "	 $486.95 	" $1,663.40 "	 $491.04 
111570	HCHG COLORECTAL CANCER SCN-COLON HR	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	G0105	" $2,430.00 "	" $1,701.00 "	 $578.34 	" $2,187.00 "	" $2,114.10 "	 $583.20 	" $1,858.95 "	" $2,041.20 "	" $2,041.20 "	 $600.70 	" $1,530.90 "	" $2,065.50 "	" $1,676.70 "	" $1,944.00 "	 $583.20 	" $2,187.00 "	" $1,975.59 "	" $2,065.50 "	 $578.34 	" $1,975.59 "	 $583.20 
111580	HCHG CANCER SCN-COLONOSCOPY-NON HR	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	G0121	" $2,890.00 "	" $2,023.00 "	 $687.82 	" $2,601.00 "	" $2,514.30 "	 $693.60 	" $2,210.85 "	" $2,427.60 "	" $2,427.60 "	 $714.41 	" $1,820.70 "	" $2,456.50 "	" $1,994.10 "	" $2,312.00 "	 $693.60 	" $2,601.00 "	" $2,349.57 "	" $2,456.50 "	 $687.82 	" $2,349.57 "	 $693.60 
302313	HCHG COLONOSCOPY FLX W/RMVL TUMOR W/FRCP	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	45384	" $3,250.00 "	" $2,275.00 "	 $773.50 	" $2,925.00 "	" $2,827.50 "	 $780.00 	" $2,486.25 "	" $2,730.00 "	" $2,730.00 "	 $803.40 	" $2,047.50 "	" $2,762.50 "	" $2,242.50 "	" $2,600.00 "	 $780.00 	" $2,925.00 "	" $2,642.25 "	" $2,762.50 "	 $773.50 	" $2,642.25 "	 $780.00 
342757	HCHG COLONOSCOPY W/ABLATION	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	45388	" $1,351.09 "	 $945.76 	 $321.56 	" $1,215.98 "	" $1,175.45 "	 $324.26 	" $1,033.58 "	" $1,134.92 "	" $1,134.92 "	 $333.99 	 $851.19 	" $1,148.43 "	 $932.25 	" $1,080.87 "	 $324.26 	" $1,215.98 "	" $1,098.44 "	" $1,148.43 "	 $321.56 	" $1,098.44 "	 $324.26 
342758	HCHG COLONOSCOPY W/ABLATION 2 OR 3	0750	GASTRO-INTESTINAL (GI) - GENERAL CLASSIFICATION	45388	" $3,299.37 "	" $2,309.56 "	 $785.25 	" $2,969.43 "	" $2,870.45 "	 $791.85 	" $2,524.02 "	" $2,771.47 "	" $2,771.47 "	 $815.60 	" $2,078.60 "	" $2,804.46 "	" $2,276.57 "	" $2,639.50 "	 $791.85 	" $2,969.43 "	" $2,682.39 "	" $2,804.46 "	 $785.25 	" $2,682.39 "	 $791.85 
302260	HCHG REM IMPACTED CERUMEN IRR/LVG UNILAT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	69209	 $100.00 	 $70.00 	 $23.80 	 $90.00 	 $87.00 	 $24.00 	 $76.50 	 $84.00 	 $84.00 	 $24.00 	 $63.00 	 $85.00 	 $69.00 	 $80.00 	 $24.00 	 $90.00 	 $81.30 	 $85.00 	 $23.80 	 $81.30 	 $24.00 
302932	HCHG BLADDER SCAN PROCEDURE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	51798	 $170.00 	 $119.00 	 $40.46 	 $153.00 	 $147.90 	 $40.80 	 $130.05 	 $142.80 	 $142.80 	 $42.02 	 $107.10 	 $144.50 	 $117.30 	 $136.00 	 $40.80 	 $153.00 	 $138.21 	 $144.50 	 $40.46 	 $138.21 	 $40.80 
303332	"HCHG CVC, NON TUNNELED >AGE 5"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36556	" $2,140.00 "	" $1,498.00 "	 $509.32 	" $1,926.00 "	" $1,861.80 "	 $513.60 	" $1,637.10 "	" $1,797.60 "	" $1,797.60 "	 $529.01 	" $1,348.20 "	" $1,819.00 "	" $1,476.60 "	" $1,712.00 "	 $513.60 	" $1,926.00 "	" $1,739.82 "	" $1,819.00 "	 $509.32 	" $1,739.82 "	 $513.60 
303339	HCHG DEBRIDEMENT NON-SELECTIVE RN	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97602	 $299.27 	 $209.49 	 $71.23 	 $269.34 	 $260.36 	 $71.82 	 $228.94 	 $251.39 	 $251.39 	 $73.98 	 $188.54 	 $254.38 	 $206.50 	 $239.42 	 $71.82 	 $269.34 	 $243.31 	 $254.38 	 $71.23 	 $243.31 	 $71.82 
303342	HCHG DEBRIDE-SELECTIVE FIRST 20 CM RN	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97597	 $550.00 	 $385.00 	 $130.90 	 $495.00 	 $478.50 	 $132.00 	 $420.75 	 $462.00 	 $462.00 	 $135.96 	 $346.50 	 $467.50 	 $379.50 	 $440.00 	 $132.00 	 $495.00 	 $447.15 	 $467.50 	 $130.90 	 $447.15 	 $132.00 
303344	HCHG DECLOTTING OF VASCULAR DEVICE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36593	 $980.00 	 $686.00 	 $233.24 	 $882.00 	 $852.60 	 $235.20 	 $749.70 	 $823.20 	 $823.20 	 $242.26 	 $617.40 	 $833.00 	 $676.20 	 $784.00 	 $235.20 	 $882.00 	 $796.74 	 $833.00 	 $233.24 	 $796.74 	 $235.20 
303347	HCHG DEEP LINE INSERTION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36425	" $1,341.34 "	 $938.94 	 $319.24 	" $1,207.21 "	" $1,166.97 "	 $321.92 	" $1,026.13 "	" $1,126.73 "	" $1,126.73 "	 $331.58 	 $845.04 	" $1,140.14 "	 $925.52 	" $1,073.07 "	 $321.92 	" $1,207.21 "	" $1,090.51 "	" $1,140.14 "	 $319.24 	" $1,090.51 "	 $321.92 
303462	HCHG FNA WO GUIDE 1ST LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10021	 $990.00 	 $693.00 	 $235.62 	 $891.00 	 $861.30 	 $237.60 	 $757.35 	 $831.60 	 $831.60 	 $244.73 	 $623.70 	 $841.50 	 $683.10 	 $792.00 	 $237.60 	 $891.00 	 $804.87 	 $841.50 	 $235.62 	 $804.87 	 $237.60 
303481	HCHG DRESS/DEBRIDE LARGE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	16030	" $1,060.00 "	 $742.00 	 $252.28 	 $954.00 	 $922.20 	 $254.40 	 $810.90 	 $890.40 	 $890.40 	 $262.03 	 $667.80 	 $901.00 	 $731.40 	 $848.00 	 $254.40 	 $954.00 	 $861.78 	 $901.00 	 $252.28 	 $861.78 	 $254.40 
303482	HCHG DRESS/DEBRIDE MEDIUM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	16025	 $433.84 	 $303.69 	 $103.25 	 $390.46 	 $377.44 	 $104.12 	 $331.89 	 $364.43 	 $364.43 	 $107.25 	 $273.32 	 $368.76 	 $299.35 	 $347.07 	 $104.12 	 $390.46 	 $352.71 	 $368.76 	 $103.25 	 $352.71 	 $104.12 
303483	HCHG DRESS/DEBRIDE-SMALL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	16020	 $510.00 	 $357.00 	 $121.38 	 $459.00 	 $443.70 	 $122.40 	 $390.15 	 $428.40 	 $428.40 	 $126.07 	 $321.30 	 $433.50 	 $351.90 	 $408.00 	 $122.40 	 $459.00 	 $414.63 	 $433.50 	 $121.38 	 $414.63 	 $122.40 
303606	HCHG ENDOTRACHEAL INTUBATION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	31500	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
303979	"HCHG I&D ABSCESS,COMPLICATED/MULT."	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10061	" $1,220.00 "	 $854.00 	 $290.36 	" $1,098.00 "	" $1,061.40 "	 $292.80 	 $933.30 	" $1,024.80 "	" $1,024.80 "	 $301.58 	 $768.60 	" $1,037.00 "	 $841.80 	 $976.00 	 $292.80 	" $1,098.00 "	 $991.86 	" $1,037.00 "	 $290.36 	 $991.86 	 $292.80 
304104	HCHG INJ/ASPIR-INTERMED JT/BURSA W/O US GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20605	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $197.76 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
304111	HCHG INJ(S) ANES OTHER PERIPHERAL NERVE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64450	" $1,950.00 "	" $1,365.00 "	 $464.10 	" $1,755.00 "	" $1,696.50 "	 $468.00 	" $1,491.75 "	" $1,638.00 "	" $1,638.00 "	 $482.04 	" $1,228.50 "	" $1,657.50 "	" $1,345.50 "	" $1,560.00 "	 $468.00 	" $1,755.00 "	" $1,585.35 "	" $1,657.50 "	 $464.10 	" $1,585.35 "	 $468.00 
304116	HCHG INJ(S) ANES TRIGEMINAL NERVE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64400	" $1,380.00 "	 $966.00 	 $328.44 	" $1,242.00 "	" $1,200.60 "	 $331.20 	" $1,055.70 "	" $1,159.20 "	" $1,159.20 "	 $341.14 	 $869.40 	" $1,173.00 "	 $952.20 	" $1,104.00 "	 $331.20 	" $1,242.00 "	" $1,121.94 "	" $1,173.00 "	 $328.44 	" $1,121.94 "	 $331.20 
304128	HCHG APPLICATION ON-BODY INJECTOR	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	96377	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
304140	HCHG INJ(S) ANES SUPRASCAPULAR NERVE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64418	" $1,074.00 "	 $751.80 	 $255.61 	 $966.60 	 $934.38 	 $257.76 	 $821.61 	 $902.16 	 $902.16 	 $265.49 	 $676.62 	 $912.90 	 $741.06 	 $859.20 	 $257.76 	 $966.60 	 $873.16 	 $912.90 	 $255.61 	 $873.16 	 $257.76 
304169	HCHG INJ(S) ANES INTERCOSTAL NERVE SINGLE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64420	" $1,102.00 "	 $771.40 	 $262.28 	 $991.80 	 $958.74 	 $264.48 	 $843.03 	 $925.68 	 $925.68 	 $272.41 	 $694.26 	 $936.70 	 $760.38 	 $881.60 	 $264.48 	 $991.80 	 $895.93 	 $936.70 	 $262.28 	 $895.93 	 $264.48 
304214	HCHG REMOVAL IMPACTED CERUMEN INSTR UNILAT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	69210	 $290.00 	 $203.00 	 $69.02 	 $261.00 	 $252.30 	 $69.60 	 $221.85 	 $243.60 	 $243.60 	 $69.60 	 $182.70 	 $246.50 	 $200.10 	 $232.00 	 $69.60 	 $261.00 	 $235.77 	 $246.50 	 $69.02 	 $235.77 	 $69.60 
304227	HCHG IV START	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36000	 $167.36 	 $117.15 	 $39.83 	 $150.62 	 $145.60 	 $40.17 	 $128.03 	 $140.58 	 $140.58 	 $41.37 	 $105.44 	 $142.26 	 $115.48 	 $133.89 	 $40.17 	 $150.62 	 $136.06 	 $142.26 	 $39.83 	 $136.06 	 $40.17 
304441	HCHG NEG PRESS WND THERAPY <50CM RN DISP	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97607	" $1,060.00 "	 $742.00 	 $252.28 	 $954.00 	 $922.20 	 $254.40 	 $810.90 	 $890.40 	 $890.40 	 $254.40 	 $667.80 	 $901.00 	 $731.40 	 $848.00 	 $254.40 	 $954.00 	 $861.78 	 $901.00 	 $252.28 	 $861.78 	 $254.40 
304442	HCHG NEG PRESS WND THERAPY >50CM RN DISP	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97608	 $783.00 	 $548.10 	 $186.35 	 $704.70 	 $681.21 	 $187.92 	 $599.00 	 $657.72 	 $657.72 	 $187.92 	 $493.29 	 $665.55 	 $540.27 	 $626.40 	 $187.92 	 $704.70 	 $636.58 	 $665.55 	 $186.35 	 $636.58 	 $187.92 
304792	HCHG REPLACE PICC WO SUBQ PORT W IMAGING	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36584	" $5,022.97 "	" $3,516.08 "	" $1,195.47 "	" $4,520.67 "	" $4,369.98 "	" $1,205.51 "	" $3,842.57 "	" $3,786.00 "	" $3,283.00 "	" $1,205.51 "	" $3,164.47 "	" $4,269.52 "	" $3,465.85 "	" $4,018.38 "	" $1,205.51 "	" $4,520.67 "	" $4,083.67 "	" $4,269.52 "	" $1,195.47 "	" $4,083.67 "	" $1,205.51 "
305001	HCHG REPAIR-SMP-FEENL <2.5 CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	12011	 $430.00 	 $301.00 	 $102.34 	 $387.00 	 $374.10 	 $103.20 	 $328.95 	 $361.20 	 $361.20 	 $103.20 	 $270.90 	 $365.50 	 $296.70 	 $344.00 	 $103.20 	 $387.00 	 $349.59 	 $365.50 	 $102.34 	 $349.59 	 $103.20 
305002	HCHG REPAIR-SMP-FEENL 2.6-5.0 CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	12013	 $460.00 	 $322.00 	 $109.48 	 $414.00 	 $400.20 	 $110.40 	 $351.90 	 $386.40 	 $386.40 	 $110.40 	 $289.80 	 $391.00 	 $317.40 	 $368.00 	 $110.40 	 $414.00 	 $373.98 	 $391.00 	 $109.48 	 $373.98 	 $110.40 
305003	HCHG REPAIR-SMP-FEENL 5.1-7.5 CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	12014	 $790.00 	 $553.00 	 $188.02 	 $711.00 	 $687.30 	 $189.60 	 $604.35 	 $663.60 	 $663.60 	 $189.60 	 $497.70 	 $671.50 	 $545.10 	 $632.00 	 $189.60 	 $711.00 	 $642.27 	 $671.50 	 $188.02 	 $642.27 	 $189.60 
305004	HCHG REPAIR-SMP-SNAGTE <2.5 CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	12001	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $310.50 	 $360.00 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
305005	HCHG REPAIR-SMP-SNAGTE 2.6-7.5 CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	12002	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $378.00 	 $378.00 	 $108.00 	 $283.50 	 $382.50 	 $310.50 	 $360.00 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
305272	HCHG SPINAL BLOOD PATCH INJECTION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62273	" $1,500.00 "	" $1,050.00 "	 $357.00 	" $1,350.00 "	" $1,305.00 "	 $360.00 	" $1,147.50 "	" $1,260.00 "	" $1,260.00 "	 $360.00 	 $945.00 	" $1,275.00 "	" $1,035.00 "	" $1,200.00 "	 $360.00 	" $1,350.00 "	" $1,219.50 "	" $1,275.00 "	 $357.00 	" $1,219.50 "	 $360.00 
305273	"HCHG SPINAL PUNCTURE,LUMBAR,DIAG."	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62270	" $2,160.00 "	" $1,512.00 "	 $514.08 	" $1,944.00 "	" $1,879.20 "	 $518.40 	" $1,652.40 "	" $1,814.40 "	" $1,814.40 "	 $518.40 	" $1,360.80 "	" $1,836.00 "	" $1,490.40 "	" $1,728.00 "	 $518.40 	" $1,944.00 "	" $1,756.08 "	" $1,836.00 "	 $514.08 	" $1,756.08 "	 $518.40 
305533	HCHG TRACHEOTOMY TUBE CHANGE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	31502	 $808.70 	 $566.09 	 $192.47 	 $727.83 	 $703.57 	 $194.09 	 $618.66 	 $679.31 	 $679.31 	 $194.09 	 $509.48 	 $687.40 	 $558.00 	 $646.96 	 $194.09 	 $727.83 	 $657.47 	 $687.40 	 $192.47 	 $657.47 	 $194.09 
305560	HCHG TRANSVENOUS TEMP PACER SNGL CH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	33210	" $6,202.00 "	" $4,341.40 "	" $1,476.08 "	" $5,581.80 "	" $5,395.74 "	" $1,488.48 "	" $4,744.53 "	" $3,786.00 "	" $3,283.00 "	" $1,488.48 "	" $3,907.26 "	" $5,271.70 "	" $4,279.38 "	" $4,961.60 "	" $1,488.48 "	" $5,581.80 "	" $5,042.23 "	" $5,271.70 "	" $1,476.08 "	" $5,042.23 "	" $1,488.48 "
305836	"HCHG INJ,EPI CERV/THOR SINGLE W/O IG"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62320	" $1,496.44 "	" $1,047.51 "	 $356.15 	" $1,346.80 "	" $1,301.90 "	 $359.15 	" $1,144.78 "	" $1,257.01 "	" $1,257.01 "	 $369.92 	 $942.76 	" $1,271.97 "	" $1,032.54 "	" $1,197.15 "	 $359.15 	" $1,346.80 "	" $1,216.61 "	" $1,271.97 "	 $356.15 	" $1,216.61 "	 $359.15 
305837	"HCHG INJ,EPI CERV/THOR SINGLE W IG"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62321	" $1,950.00 "	" $1,365.00 "	 $464.10 	" $1,755.00 "	" $1,696.50 "	 $468.00 	" $1,491.75 "	" $1,638.00 "	" $1,638.00 "	 $482.04 	" $1,228.50 "	" $1,657.50 "	" $1,345.50 "	" $1,560.00 "	 $468.00 	" $1,755.00 "	" $1,585.35 "	" $1,657.50 "	 $464.10 	" $1,585.35 "	 $468.00 
305838	"HCHG INJ,EPI LUMB/SAC SINGLE W/O IG"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62322	" $1,405.82 "	 $984.07 	 $334.59 	" $1,265.24 "	" $1,223.06 "	 $337.40 	" $1,075.45 "	" $1,180.89 "	" $1,180.89 "	 $347.52 	 $885.67 	" $1,194.95 "	 $970.02 	" $1,124.66 "	 $337.40 	" $1,265.24 "	" $1,142.93 "	" $1,194.95 "	 $334.59 	" $1,142.93 "	 $337.40 
305839	"HCHG INJ,EPI LUMB/SAC SINGLE W IG"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62323	" $1,950.00 "	" $1,365.00 "	 $464.10 	" $1,755.00 "	" $1,696.50 "	 $468.00 	" $1,491.75 "	" $1,638.00 "	" $1,638.00 "	 $482.04 	" $1,228.50 "	" $1,657.50 "	" $1,345.50 "	" $1,560.00 "	 $468.00 	" $1,755.00 "	" $1,585.35 "	" $1,657.50 "	 $464.10 	" $1,585.35 "	 $468.00 
306528	HCHG INJ PARA FACET L/S 2D LVL W/IG	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64494	" $1,420.00 "	 $994.00 	 $337.96 	" $1,278.00 "	" $1,235.40 "	 $340.80 	" $1,086.30 "	" $1,192.80 "	" $1,192.80 "	 $351.02 	 $894.60 	" $1,207.00 "	 $979.80 	" $1,136.00 "	 $340.80 	" $1,278.00 "	" $1,154.46 "	" $1,207.00 "	 $337.96 	" $1,154.46 "	 $340.80 
306644	"HCHG TRIM NONDYSTROPHIC NAILS,ANY NUM"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11719	 $99.14 	 $69.40 	 $23.60 	 $89.23 	 $86.25 	 $23.79 	 $75.84 	 $83.28 	 $83.28 	 $23.79 	 $62.46 	 $84.27 	 $68.41 	 $79.31 	 $23.79 	 $89.23 	 $80.60 	 $84.27 	 $23.60 	 $80.60 	 $23.79 
306645	"HCHG DEBRIDE NAIL,ANY METHOD 1 TO 5"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11720	 $242.07 	 $169.45 	 $57.61 	 $217.86 	 $210.60 	 $58.10 	 $185.18 	 $203.34 	 $203.34 	 $59.84 	 $152.50 	 $205.76 	 $167.03 	 $193.66 	 $58.10 	 $217.86 	 $196.80 	 $205.76 	 $57.61 	 $196.80 	 $58.10 
306646	"HCHG DEBRIDE NAIL,ANY METHOD 6/MORE"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11721	 $238.69 	 $167.08 	 $56.81 	 $214.82 	 $207.66 	 $57.29 	 $182.60 	 $200.50 	 $200.50 	 $59.00 	 $150.37 	 $202.89 	 $164.70 	 $190.95 	 $57.29 	 $214.82 	 $194.05 	 $202.89 	 $56.81 	 $194.05 	 $57.29 
306656	HCHG APPLY MULTILAYER COMPRESSION SYSTEM LOWER LEG BILATERAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	29581	 $630.00 	 $441.00 	 $149.94 	 $567.00 	 $548.10 	 $151.20 	 $481.95 	 $529.20 	 $529.20 	 $155.74 	 $396.90 	 $535.50 	 $434.70 	 $504.00 	 $151.20 	 $567.00 	 $512.19 	 $535.50 	 $149.94 	 $512.19 	 $151.20 
306732	HCHG APPLICATION OF PASTE BOOT BILATERAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	29580	 $830.00 	 $581.00 	 $197.54 	 $747.00 	 $722.10 	 $199.20 	 $634.95 	 $697.20 	 $697.20 	 $205.18 	 $522.90 	 $705.50 	 $572.70 	 $664.00 	 $199.20 	 $747.00 	 $674.79 	 $705.50 	 $197.54 	 $674.79 	 $199.20 
306792	HCHG CVC TUNNEL WO PORT REMOVAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36589	" $2,219.21 "	" $1,553.45 "	 $528.17 	" $1,997.29 "	" $1,930.71 "	 $532.61 	" $1,697.70 "	" $1,864.14 "	" $1,864.14 "	 $548.59 	" $1,398.10 "	" $1,886.33 "	" $1,531.25 "	" $1,775.37 "	 $532.61 	" $1,997.29 "	" $1,804.22 "	" $1,886.33 "	 $528.17 	" $1,804.22 "	 $532.61 
306805	HCHG APP SKN GRAFT TAL<100CM 1ST25	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15271	" $5,250.00 "	" $3,675.00 "	" $1,249.50 "	" $4,725.00 "	" $4,567.50 "	" $1,260.00 "	" $4,016.25 "	" $3,786.00 "	" $3,283.00 "	" $1,297.80 "	" $3,307.50 "	" $4,462.50 "	" $3,622.50 "	" $4,200.00 "	" $1,260.00 "	" $4,725.00 "	" $4,268.25 "	" $4,462.50 "	" $1,249.50 "	" $4,268.25 "	" $1,260.00 "
306806	HCHG APP SKN GRAFT TAL<100CM ADD25	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15272	" $1,060.00 "	 $742.00 	 $252.28 	 $954.00 	 $922.20 	 $254.40 	 $810.90 	 $890.40 	 $890.40 	 $262.03 	 $667.80 	 $901.00 	 $731.40 	 $848.00 	 $254.40 	 $954.00 	 $861.78 	 $901.00 	 $252.28 	 $861.78 	 $254.40 
306807	HCHG APP SKN GRAFT TAL>100 1ST100	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15273	" $1,590.19 "	" $1,113.13 "	 $378.47 	" $1,431.17 "	" $1,383.47 "	 $381.65 	" $1,216.50 "	" $1,335.76 "	" $1,335.76 "	 $393.09 	" $1,001.82 "	" $1,351.66 "	" $1,097.23 "	" $1,272.15 "	 $381.65 	" $1,431.17 "	" $1,292.82 "	" $1,351.66 "	 $378.47 	" $1,292.82 "	 $381.65 
306808	HCHG APP SKN GRAFT TAL>100 ADD100	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15274	" $1,590.19 "	" $1,113.13 "	 $378.47 	" $1,431.17 "	" $1,383.47 "	 $381.65 	" $1,216.50 "	" $1,335.76 "	" $1,335.76 "	 $393.09 	" $1,001.82 "	" $1,351.66 "	" $1,097.23 "	" $1,272.15 "	 $381.65 	" $1,431.17 "	" $1,292.82 "	" $1,351.66 "	 $378.47 	" $1,292.82 "	 $381.65 
306809	HCHG APP SKN GRAFT FNHFG<100 1ST25	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15275	" $5,250.00 "	" $3,675.00 "	" $1,249.50 "	" $4,725.00 "	" $4,567.50 "	" $1,260.00 "	" $4,016.25 "	" $3,786.00 "	" $3,283.00 "	" $1,297.80 "	" $3,307.50 "	" $4,462.50 "	" $3,622.50 "	" $4,200.00 "	" $1,260.00 "	" $4,725.00 "	" $4,268.25 "	" $4,462.50 "	" $1,249.50 "	" $4,268.25 "	" $1,260.00 "
306810	HCHG APP SKN GRAFT FNHFG<100ADD25	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15276	" $1,590.19 "	" $1,113.13 "	 $378.47 	" $1,431.17 "	" $1,383.47 "	 $381.65 	" $1,216.50 "	" $1,335.76 "	" $1,335.76 "	 $393.09 	" $1,001.82 "	" $1,351.66 "	" $1,097.23 "	" $1,272.15 "	 $381.65 	" $1,431.17 "	" $1,292.82 "	" $1,351.66 "	 $378.47 	" $1,292.82 "	 $381.65 
306811	HCHG APP SKN GRAFT FNHFG>100 1ST100	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15277	" $1,590.19 "	" $1,113.13 "	 $378.47 	" $1,431.17 "	" $1,383.47 "	 $381.65 	" $1,216.50 "	" $1,335.76 "	" $1,335.76 "	 $393.09 	" $1,001.82 "	" $1,351.66 "	" $1,097.23 "	" $1,272.15 "	 $381.65 	" $1,431.17 "	" $1,292.82 "	" $1,351.66 "	 $378.47 	" $1,292.82 "	 $381.65 
306812	HCHG APP SKN GRAFT FNHFG>100ADD100	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	15278	" $1,590.19 "	" $1,113.13 "	 $378.47 	" $1,431.17 "	" $1,383.47 "	 $381.65 	" $1,216.50 "	" $1,335.76 "	" $1,335.76 "	 $393.09 	" $1,001.82 "	" $1,351.66 "	" $1,097.23 "	" $1,272.15 "	 $381.65 	" $1,431.17 "	" $1,292.82 "	" $1,351.66 "	 $378.47 	" $1,292.82 "	 $381.65 
306826	"HCHG PARACENTESIS,ABD W/O IMAGING"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49082	" $2,520.00 "	" $1,764.00 "	 $599.76 	" $2,268.00 "	" $2,192.40 "	 $604.80 	" $1,927.80 "	" $2,116.80 "	" $2,116.80 "	 $604.80 	" $1,587.60 "	" $2,142.00 "	" $1,738.80 "	" $2,016.00 "	 $604.80 	" $2,268.00 "	" $2,048.76 "	" $2,142.00 "	 $599.76 	" $2,048.76 "	 $604.80 
307088	HCHG DEBRIDE SUBQ TISSUE 20SQCM<	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11042	" $1,500.00 "	" $1,050.00 "	 $357.00 	" $1,350.00 "	" $1,305.00 "	 $360.00 	" $1,147.50 "	" $1,260.00 "	" $1,260.00 "	 $370.80 	 $945.00 	" $1,275.00 "	" $1,035.00 "	" $1,200.00 "	 $360.00 	" $1,350.00 "	" $1,219.50 "	" $1,275.00 "	 $357.00 	" $1,219.50 "	 $360.00 
308401	HCHG AVULSION OF NAIL PLATE ADD-ON	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11732	 $625.84 	 $438.09 	 $148.95 	 $563.26 	 $544.48 	 $150.20 	 $478.77 	 $525.71 	 $525.71 	 $154.71 	 $394.28 	 $531.96 	 $431.83 	 $500.67 	 $150.20 	 $563.26 	 $508.81 	 $531.96 	 $148.95 	 $508.81 	 $150.20 
308938	HCHG CVMC CHANGE OF BLADDER TUBE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	51710	" $2,640.63 "	" $1,848.44 "	 $628.47 	" $2,376.57 "	" $2,297.35 "	 $633.75 	" $2,020.08 "	" $2,218.13 "	" $2,218.13 "	 $652.76 	" $1,663.60 "	" $2,244.54 "	" $1,822.03 "	" $2,112.50 "	 $633.75 	" $2,376.57 "	" $2,146.83 "	" $2,244.54 "	 $628.47 	" $2,146.83 "	 $633.75 
310125	HCHG INJ/ASPIR-LARGE JT/BURSA W/O US GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20610	" $1,160.00 "	 $812.00 	 $276.08 	" $1,044.00 "	" $1,009.20 "	 $278.40 	 $887.40 	 $974.40 	 $974.40 	 $286.75 	 $730.80 	 $986.00 	 $800.40 	 $928.00 	 $278.40 	" $1,044.00 "	 $943.08 	 $986.00 	 $276.08 	 $943.08 	 $278.40 
330930	HCHG CVMC REMOVAL OF PICC-SIMPLE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	99211	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
330931	HCHG CVMC FLUSH (CATH CARE)	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	99211	 $150.00 	 $105.00 	 $35.70 	 $135.00 	 $130.50 	 $36.00 	 $114.75 	 $126.00 	 $126.00 	 $37.08 	 $94.50 	 $127.50 	 $103.50 	 $120.00 	 $36.00 	 $135.00 	 $121.95 	 $127.50 	 $35.70 	 $121.95 	 $36.00 
330932	HCHG CVMC WOUND CARE W/O SHARP DEBRIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	99211	 $209.90 	 $146.93 	 $49.96 	 $188.91 	 $182.61 	 $50.38 	 $160.57 	 $176.32 	 $176.32 	 $51.89 	 $132.24 	 $178.42 	 $144.83 	 $167.92 	 $50.38 	 $188.91 	 $170.65 	 $178.42 	 $49.96 	 $170.65 	 $50.38 
330933	HCHG CVMC STAPLE/SUTURE REMOVAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	99211	 $209.90 	 $146.93 	 $49.96 	 $188.91 	 $182.61 	 $50.38 	 $160.57 	 $176.32 	 $176.32 	 $51.89 	 $132.24 	 $178.42 	 $144.83 	 $167.92 	 $50.38 	 $188.91 	 $170.65 	 $178.42 	 $49.96 	 $170.65 	 $50.38 
330961	HCHG CVMC WOUND CARE W/O DEBRIDEMENT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	99211	 $391.53 	 $274.07 	 $93.18 	 $352.38 	 $340.63 	 $93.97 	 $299.52 	 $328.89 	 $328.89 	 $96.79 	 $246.66 	 $332.80 	 $270.16 	 $313.22 	 $93.97 	 $352.38 	 $318.31 	 $332.80 	 $93.18 	 $318.31 	 $93.97 
338910	HCHG DEBRIDE BONE FIRST 20 SQ CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11044	" $2,690.00 "	" $1,883.00 "	 $640.22 	" $2,421.00 "	" $2,340.30 "	 $645.60 	" $2,057.85 "	" $2,259.60 "	" $2,259.60 "	 $664.97 	" $1,694.70 "	" $2,286.50 "	" $1,856.10 "	" $2,152.00 "	 $645.60 	" $2,421.00 "	" $2,186.97 "	" $2,286.50 "	 $640.22 	" $2,186.97 "	 $645.60 
338911	HCHG CVMC DEB SUBQ TISSUE 20 SQ CM /<	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11042	" $1,810.72 "	" $1,267.50 "	 $430.95 	" $1,629.65 "	" $1,575.33 "	 $434.57 	" $1,385.20 "	" $1,521.00 "	" $1,521.00 "	 $447.61 	" $1,140.75 "	" $1,539.11 "	" $1,249.40 "	" $1,448.58 "	 $434.57 	" $1,629.65 "	" $1,472.12 "	" $1,539.11 "	 $430.95 	" $1,472.12 "	 $434.57 
338912	HCHG DEBRIDE MUSC/FASCIA FIRST 20 SQ CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11043	" $1,810.72 "	" $1,267.50 "	 $430.95 	" $1,629.65 "	" $1,575.33 "	 $434.57 	" $1,385.20 "	" $1,521.00 "	" $1,521.00 "	 $447.61 	" $1,140.75 "	" $1,539.11 "	" $1,249.40 "	" $1,448.58 "	 $434.57 	" $1,629.65 "	" $1,472.12 "	" $1,539.11 "	 $430.95 	" $1,472.12 "	 $434.57 
338913	HCHG CVMC NEG PRESS WND TX <50 CM DME	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97605	 $390.00 	 $273.00 	 $92.82 	 $351.00 	 $339.30 	 $93.60 	 $298.35 	 $327.60 	 $327.60 	 $96.41 	 $245.70 	 $331.50 	 $269.10 	 $312.00 	 $93.60 	 $351.00 	 $317.07 	 $331.50 	 $92.82 	 $317.07 	 $93.60 
338914	HCHG CVMC NEG PRESS WND TX >50 CM DME	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97606	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $103.82 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
338915	HCHG CVMC REMOVAL DEVITALIZED TISSUE 20 CM /<	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97597	 $359.00 	 $251.30 	 $85.44 	 $323.10 	 $312.33 	 $86.16 	 $274.64 	 $301.56 	 $301.56 	 $88.74 	 $226.17 	 $305.15 	 $247.71 	 $287.20 	 $86.16 	 $323.10 	 $291.87 	 $305.15 	 $85.44 	 $291.87 	 $86.16 
338916	HCHG CVMC REMOVAL DEVITALOZED TISSUE ADD'L 20 CM /<	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97598	 $276.09 	 $193.26 	 $65.71 	 $248.48 	 $240.20 	 $66.26 	 $211.21 	 $231.92 	 $231.92 	 $68.25 	 $173.94 	 $234.68 	 $190.50 	 $220.87 	 $66.26 	 $248.48 	 $224.46 	 $234.68 	 $65.71 	 $224.46 	 $66.26 
338917	HCHG CVMC WOUND/ S CARE NON-SELECTIVE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	97602	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $66.74 	 $170.10 	 $229.50 	 $186.30 	 $216.00 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
338918	HCHG CVMC DEBRIDE INFECTED SKIN	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11000	" $1,810.72 "	" $1,267.50 "	 $430.95 	" $1,629.65 "	" $1,575.33 "	 $434.57 	" $1,385.20 "	" $1,521.00 "	" $1,521.00 "	 $447.61 	" $1,140.75 "	" $1,539.11 "	" $1,249.40 "	" $1,448.58 "	 $434.57 	" $1,629.65 "	" $1,472.12 "	" $1,539.11 "	 $430.95 	" $1,472.12 "	 $434.57 
338919	HCHG CVMC DEBRIDE INFECTED SKIN ADD-ON	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11001	 $293.60 	 $205.52 	 $69.88 	 $264.24 	 $255.43 	 $70.46 	 $224.60 	 $246.62 	 $246.62 	 $72.58 	 $184.97 	 $249.56 	 $202.58 	 $234.88 	 $70.46 	 $264.24 	 $238.70 	 $249.56 	 $69.88 	 $238.70 	 $70.46 
338920	HCHG DEBRIDE MUSC/FASCIA ADD 20 SQ CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11046	" $1,810.72 "	" $1,267.50 "	 $430.95 	" $1,629.65 "	" $1,575.33 "	 $434.57 	" $1,385.20 "	" $1,521.00 "	" $1,521.00 "	 $447.61 	" $1,140.75 "	" $1,539.11 "	" $1,249.40 "	" $1,448.58 "	 $434.57 	" $1,629.65 "	" $1,472.12 "	" $1,539.11 "	 $430.95 	" $1,472.12 "	 $434.57 
338921	HCHG DEBRIDE SUBQ TISSUE ADD 20 SQ CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11045	" $1,810.72 "	" $1,267.50 "	 $430.95 	" $1,629.65 "	" $1,575.33 "	 $434.57 	" $1,385.20 "	" $1,521.00 "	" $1,521.00 "	 $447.61 	" $1,140.75 "	" $1,539.11 "	" $1,249.40 "	" $1,448.58 "	 $434.57 	" $1,629.65 "	" $1,472.12 "	" $1,539.11 "	 $430.95 	" $1,472.12 "	 $434.57 
338922	HCHG DEBRIDE BONE ADD 20 SQ CM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11047	" $2,687.72 "	" $1,881.40 "	 $639.68 	" $2,418.95 "	" $2,338.32 "	 $645.05 	" $2,056.11 "	" $2,257.68 "	" $2,257.68 "	 $664.40 	" $1,693.26 "	" $2,284.56 "	" $1,854.53 "	" $2,150.18 "	 $645.05 	" $2,418.95 "	" $2,185.12 "	" $2,284.56 "	 $639.68 	" $2,185.12 "	 $645.05 
338923	HCHG CVMC APPLY MULTILAYER COMPRESSION SYSTEM LOWER LEG	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	29581	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $103.82 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
338924	HCHG CVMC APPLICATION OF PASTE BOOT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	29580	 $420.00 	 $294.00 	 $99.96 	 $378.00 	 $365.40 	 $100.80 	 $321.30 	 $352.80 	 $352.80 	 $103.82 	 $264.60 	 $357.00 	 $289.80 	 $336.00 	 $100.80 	 $378.00 	 $341.46 	 $357.00 	 $99.96 	 $341.46 	 $100.80 
342760	HCHG PERQ CERIVICOTHORACIC INJECT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	22510	" $6,700.00 "	" $4,690.00 "	" $1,594.60 "	" $6,030.00 "	" $5,829.00 "	" $1,608.00 "	" $5,125.50 "	" $3,786.00 "	" $3,283.00 "	" $1,608.00 "	" $4,221.00 "	" $5,695.00 "	" $4,623.00 "	" $5,360.00 "	" $1,608.00 "	" $6,030.00 "	" $5,447.10 "	" $5,695.00 "	" $1,594.60 "	" $5,447.10 "	" $1,608.00 "
342762	HCHG VERTEBROPLASTY ADDL INJECT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	22512	" $6,700.00 "	" $4,690.00 "	" $1,594.60 "	" $6,030.00 "	" $5,829.00 "	" $1,608.00 "	" $5,125.50 "	" $3,786.00 "	" $3,283.00 "	" $1,608.00 "	" $4,221.00 "	" $5,695.00 "	" $4,623.00 "	" $5,360.00 "	" $1,608.00 "	" $6,030.00 "	" $5,447.10 "	" $5,695.00 "	" $1,594.60 "	" $5,447.10 "	" $1,608.00 "
342763	HCHG PERQ VERTEBRAL AUGMENT THORACIC	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	22513	" $19,370.00 "	" $13,559.00 "	" $3,283.00 "	" $17,433.00 "	" $16,851.90 "	" $4,648.80 "	" $14,818.05 "	" $3,786.00 "	" $3,283.00 "	" $4,648.80 "	" $12,203.10 "	" $16,464.50 "	" $13,365.30 "	" $15,496.00 "	" $4,648.80 "	" $17,433.00 "	" $15,747.81 "	" $16,464.50 "	" $4,610.06 "	" $15,747.81 "	" $4,648.80 "
342764	HCHG PERQ VERTEBRAL AUGMENT LUMBAR	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	22514	" $14,900.00 "	" $10,430.00 "	" $3,283.00 "	" $13,410.00 "	" $12,963.00 "	" $3,576.00 "	" $11,398.50 "	" $3,786.00 "	" $3,283.00 "	" $3,576.00 "	" $9,387.00 "	" $12,665.00 "	" $10,281.00 "	" $11,920.00 "	" $3,576.00 "	" $13,410.00 "	" $12,113.70 "	" $12,665.00 "	" $3,546.20 "	" $12,113.70 "	" $3,576.00 "
342765	HCHG PERQ VERTEBRAL AUG EACH ADDL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	22515	" $9,000.00 "	" $6,300.00 "	" $2,142.00 "	" $8,100.00 "	" $7,830.00 "	" $2,160.00 "	" $6,885.00 "	" $3,786.00 "	" $3,283.00 "	" $2,160.00 "	" $5,670.00 "	" $7,650.00 "	" $6,210.00 "	" $7,200.00 "	" $2,160.00 "	" $8,100.00 "	" $7,317.00 "	" $7,650.00 "	" $2,142.00 "	" $7,317.00 "	" $2,160.00 "
343204	HCHG BMH/CVMC ASPIRATE PLEURA W/O IMAGING	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	32554	" $1,680.02 "	" $1,176.01 "	 $399.84 	" $1,512.02 "	" $1,461.62 "	 $403.20 	" $1,285.22 "	" $1,411.22 "	" $1,411.22 "	 $415.30 	" $1,058.41 "	" $1,428.02 "	" $1,159.21 "	" $1,344.02 "	 $403.20 	" $1,512.02 "	" $1,365.86 "	" $1,428.02 "	 $399.84 	" $1,365.86 "	 $403.20 
343277	HCHG CVMC REMOVAL OF CENTRAL LINE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	99211	 $209.90 	 $146.93 	 $49.96 	 $188.91 	 $182.61 	 $50.38 	 $160.57 	 $176.32 	 $176.32 	 $51.89 	 $132.24 	 $178.42 	 $144.83 	 $167.92 	 $50.38 	 $188.91 	 $170.65 	 $178.42 	 $49.96 	 $170.65 	 $50.38 
360855	HCHG INJ PERQ  CHOLANGIO EXIST W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47531	 $879.28 	 $615.50 	 $209.27 	 $791.35 	 $764.97 	 $211.03 	 $672.65 	 $738.60 	 $738.60 	 $217.36 	 $553.95 	 $747.39 	 $606.70 	 $703.42 	 $211.03 	 $791.35 	 $714.85 	 $747.39 	 $209.27 	 $714.85 	 $211.03 
360856	HCHG INJ PERQ  CHOLANGIO NEW W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47532	" $5,442.78 "	" $3,809.95 "	" $1,295.38 "	" $4,898.50 "	" $4,735.22 "	" $1,306.27 "	" $4,163.73 "	" $3,786.00 "	" $3,283.00 "	" $1,345.46 "	" $3,428.95 "	" $4,626.36 "	" $3,755.52 "	" $4,354.22 "	" $1,306.27 "	" $4,898.50 "	" $4,424.98 "	" $4,626.36 "	" $1,295.38 "	" $4,424.98 "	" $1,306.27 "
360857	HCHG PERQ BIL CATH PLACE EXT W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47533	" $5,442.78 "	" $3,809.95 "	" $1,295.38 "	" $4,898.50 "	" $4,735.22 "	" $1,306.27 "	" $4,163.73 "	" $3,786.00 "	" $3,283.00 "	" $1,306.27 "	" $3,428.95 "	" $4,626.36 "	" $3,755.52 "	" $4,354.22 "	" $1,306.27 "	" $4,898.50 "	" $4,424.98 "	" $4,626.36 "	" $1,295.38 "	" $4,424.98 "	" $1,306.27 "
360858	HCHG PERQ BIL CATH PLACE INT-EXT W R/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47534	" $5,442.78 "	" $3,809.95 "	" $1,295.38 "	" $4,898.50 "	" $4,735.22 "	" $1,306.27 "	" $4,163.73 "	" $3,786.00 "	" $3,283.00 "	" $1,306.27 "	" $3,428.95 "	" $4,626.36 "	" $3,755.52 "	" $4,354.22 "	" $1,306.27 "	" $4,898.50 "	" $4,424.98 "	" $4,626.36 "	" $1,295.38 "	" $4,424.98 "	" $1,306.27 "
360859	HCHG BILIARY EXT CATH CONV INT-EXT RS&I	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47535	" $5,442.78 "	" $3,809.95 "	" $1,295.38 "	" $4,898.50 "	" $4,735.22 "	" $1,306.27 "	" $4,163.73 "	" $3,786.00 "	" $3,283.00 "	" $1,345.46 "	" $3,428.95 "	" $4,626.36 "	" $3,755.52 "	" $4,354.22 "	" $1,306.27 "	" $4,898.50 "	" $4,424.98 "	" $4,626.36 "	" $1,295.38 "	" $4,424.98 "	" $1,306.27 "
360860	HCHG BIL CATH EX/ CV TO EXT  W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47536	" $5,442.78 "	" $3,809.95 "	" $1,295.38 "	" $4,898.50 "	" $4,735.22 "	" $1,306.27 "	" $4,163.73 "	" $3,786.00 "	" $3,283.00 "	" $1,345.46 "	" $3,428.95 "	" $4,626.36 "	" $3,755.52 "	" $4,354.22 "	" $1,306.27 "	" $4,898.50 "	" $4,424.98 "	" $4,626.36 "	" $1,295.38 "	" $4,424.98 "	" $1,306.27 "
360861	HCHG BIL CATH REMOVAL REQ FLUORO GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47537	" $1,207.08 "	 $844.96 	 $287.29 	" $1,086.37 "	" $1,050.16 "	 $289.70 	 $923.42 	" $1,013.95 "	" $1,013.95 "	 $298.39 	 $760.46 	" $1,026.02 "	 $832.89 	 $965.66 	 $289.70 	" $1,086.37 "	 $981.36 	" $1,026.02 "	 $287.29 	 $981.36 	 $289.70 
360862	HCHG PERQ BIL STENT PLACE EXIST W R/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47538	" $10,295.58 "	" $7,206.91 "	" $2,450.35 "	" $9,266.02 "	" $8,957.15 "	" $2,470.94 "	" $7,876.12 "	" $3,786.00 "	" $3,283.00 "	" $2,470.94 "	" $6,486.22 "	" $8,751.24 "	" $7,103.95 "	" $8,236.46 "	" $2,470.94 "	" $9,266.02 "	" $8,370.31 "	" $8,751.24 "	" $2,450.35 "	" $8,370.31 "	" $2,470.94 "
360863	HCHG PERQ BIL STENT PLACE EXIST WO CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47539	" $10,295.58 "	" $7,206.91 "	" $2,450.35 "	" $9,266.02 "	" $8,957.15 "	" $2,470.94 "	" $7,876.12 "	" $3,786.00 "	" $3,283.00 "	" $2,470.94 "	" $6,486.22 "	" $8,751.24 "	" $7,103.95 "	" $8,236.46 "	" $2,470.94 "	" $9,266.02 "	" $8,370.31 "	" $8,751.24 "	" $2,450.35 "	" $8,370.31 "	" $2,470.94 "
360864	HCHG PERQ BIL STENT PLACE EXIST W CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47540	" $10,295.58 "	" $7,206.91 "	" $2,450.35 "	" $9,266.02 "	" $8,957.15 "	" $2,470.94 "	" $7,876.12 "	" $3,786.00 "	" $3,283.00 "	" $2,470.94 "	" $6,486.22 "	" $8,751.24 "	" $7,103.95 "	" $8,236.46 "	" $2,470.94 "	" $9,266.02 "	" $8,370.31 "	" $8,751.24 "	" $2,450.35 "	" $8,370.31 "	" $2,470.94 "
360865	HCHG ACCESS BIL TREE TO SB NEW  W R/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47541	" $5,442.78 "	" $3,809.95 "	" $1,295.38 "	" $4,898.50 "	" $4,735.22 "	" $1,306.27 "	" $4,163.73 "	" $3,786.00 "	" $3,283.00 "	" $1,345.46 "	" $3,428.95 "	" $4,626.36 "	" $3,755.52 "	" $4,354.22 "	" $1,306.27 "	" $4,898.50 "	" $4,424.98 "	" $4,626.36 "	" $1,295.38 "	" $4,424.98 "	" $1,306.27 "
360866	HCHG PERQ DILATION BIL DUCT W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47542	" $3,500.00 "	" $2,450.00 "	 $833.00 	" $3,150.00 "	" $3,045.00 "	 $840.00 	" $2,677.50 "	" $2,940.00 "	" $2,940.00 "	 $840.00 	" $2,205.00 "	" $2,975.00 "	" $2,415.00 "	" $2,800.00 "	 $840.00 	" $3,150.00 "	" $2,845.50 "	" $2,975.00 "	 $833.00 	" $2,845.50 "	 $840.00 
360867	HCHG ENDOLUML BX(S) BIL TREE W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47543	" $3,500.00 "	" $2,450.00 "	 $833.00 	" $3,150.00 "	" $3,045.00 "	 $840.00 	" $2,677.50 "	" $2,940.00 "	" $2,940.00 "	 $865.20 	" $2,205.00 "	" $2,975.00 "	" $2,415.00 "	" $2,800.00 "	 $840.00 	" $3,150.00 "	" $2,845.50 "	" $2,975.00 "	 $833.00 	" $2,845.50 "	 $840.00 
360868	HCHG REM BIL CALCULI/DEBRIS W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47544	" $3,500.00 "	" $2,450.00 "	 $833.00 	" $3,150.00 "	" $3,045.00 "	 $840.00 	" $2,677.50 "	" $2,940.00 "	" $2,940.00 "	 $840.00 	" $2,205.00 "	" $2,975.00 "	" $2,415.00 "	" $2,800.00 "	 $840.00 	" $3,150.00 "	" $2,845.50 "	" $2,975.00 "	 $833.00 	" $2,845.50 "	 $840.00 
360909	HCHG PERQ NEPH CATH NEW ACCESS W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50432	" $3,766.05 "	" $2,636.24 "	 $896.32 	" $3,389.45 "	" $3,276.46 "	 $903.85 	" $2,881.03 "	" $3,163.48 "	" $3,163.48 "	 $903.85 	" $2,372.61 "	" $3,201.14 "	" $2,598.57 "	" $3,012.84 "	 $903.85 	" $3,389.45 "	" $3,061.80 "	" $3,201.14 "	 $896.32 	" $3,061.80 "	 $903.85 
360910	HCHG PERQ URET CATH NEW ACCESS W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50433	" $3,766.05 "	" $2,636.24 "	 $896.32 	" $3,389.45 "	" $3,276.46 "	 $903.85 	" $2,881.03 "	" $3,163.48 "	" $3,163.48 "	 $903.85 	" $2,372.61 "	" $3,201.14 "	" $2,598.57 "	" $3,012.84 "	 $903.85 	" $3,389.45 "	" $3,061.80 "	" $3,201.14 "	 $896.32 	" $3,061.80 "	 $903.85 
360911	HCHG CONV PERQ NEPH-URET CATH W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50434	" $1,311.20 "	 $917.84 	 $312.07 	" $1,180.08 "	" $1,140.74 "	 $314.69 	" $1,003.07 "	" $1,101.41 "	" $1,101.41 "	 $324.13 	 $826.06 	" $1,114.52 "	 $904.73 	" $1,048.96 "	 $314.69 	" $1,180.08 "	" $1,066.01 "	" $1,114.52 "	 $312.07 	" $1,066.01 "	 $314.69 
360912	HCHG EXCHANGE PERQ NEPH CATH W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50435	" $1,311.20 "	 $917.84 	 $312.07 	" $1,180.08 "	" $1,140.74 "	 $314.69 	" $1,003.07 "	" $1,101.41 "	" $1,101.41 "	 $324.13 	 $826.06 	" $1,114.52 "	 $904.73 	" $1,048.96 "	 $314.69 	" $1,180.08 "	" $1,066.01 "	" $1,114.52 "	 $312.07 	" $1,066.01 "	 $314.69 
360913	HCHG ENDOLUMINAL BX PELVIS W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50606	" $3,000.00 "	" $2,100.00 "	 $714.00 	" $2,700.00 "	" $2,610.00 "	 $720.00 	" $2,295.00 "	" $2,520.00 "	" $2,520.00 "	 $741.60 	" $1,890.00 "	" $2,550.00 "	" $2,070.00 "	" $2,400.00 "	 $720.00 	" $2,700.00 "	" $2,439.00 "	" $2,550.00 "	 $714.00 	" $2,439.00 "	 $720.00 
360914	HCHG PERQ URTRL STENT EXIST W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50693	" $5,608.73 "	" $3,926.11 "	" $1,334.88 "	" $5,047.86 "	" $4,879.60 "	" $1,346.10 "	" $4,290.68 "	" $3,786.00 "	" $3,283.00 "	" $1,346.10 "	" $3,533.50 "	" $4,767.42 "	" $3,870.02 "	" $4,486.98 "	" $1,346.10 "	" $5,047.86 "	" $4,559.90 "	" $4,767.42 "	" $1,334.88 "	" $4,559.90 "	" $1,346.10 "
360915	HCHG PERQ URTRL STENT NEW WO CATH W RGDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50694	" $5,608.73 "	" $3,926.11 "	" $1,334.88 "	" $5,047.86 "	" $4,879.60 "	" $1,346.10 "	" $4,290.68 "	" $3,786.00 "	" $3,283.00 "	" $1,346.10 "	" $3,533.50 "	" $4,767.42 "	" $3,870.02 "	" $4,486.98 "	" $1,346.10 "	" $5,047.86 "	" $4,559.90 "	" $4,767.42 "	" $1,334.88 "	" $4,559.90 "	" $1,346.10 "
360916	HCHG PERQ URTRL STENT NEW W CATH W RGDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50695	" $5,608.73 "	" $3,926.11 "	" $1,334.88 "	" $5,047.86 "	" $4,879.60 "	" $1,346.10 "	" $4,290.68 "	" $3,786.00 "	" $3,283.00 "	" $1,346.10 "	" $3,533.50 "	" $4,767.42 "	" $3,870.02 "	" $4,486.98 "	" $1,346.10 "	" $5,047.86 "	" $4,559.90 "	" $4,767.42 "	" $1,334.88 "	" $4,559.90 "	" $1,346.10 "
360921	HCHG INJ THRU KIDNEY TUBE NEW W RGDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50430	" $1,311.20 "	 $917.84 	 $312.07 	" $1,180.08 "	" $1,140.74 "	 $314.69 	" $1,003.07 "	" $1,101.41 "	" $1,101.41 "	 $324.13 	 $826.06 	" $1,114.52 "	 $904.73 	" $1,048.96 "	 $314.69 	" $1,180.08 "	" $1,066.01 "	" $1,114.52 "	 $312.07 	" $1,066.01 "	 $314.69 
360922	HCHG INJ THRU KIDNEY TUBE EXIST W RGDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50431	" $1,311.20 "	 $917.84 	 $312.07 	" $1,180.08 "	" $1,140.74 "	 $314.69 	" $1,003.07 "	" $1,101.41 "	" $1,101.41 "	 $324.13 	 $826.06 	" $1,114.52 "	 $904.73 	" $1,048.96 "	 $314.69 	" $1,180.08 "	" $1,066.01 "	" $1,114.52 "	 $312.07 	" $1,066.01 "	 $314.69 
360933	HCHG PERQ SOFT TISSUE DEV PLACE 1ST GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10035	" $1,201.60 "	 $841.12 	 $285.98 	" $1,081.44 "	" $1,045.39 "	 $288.38 	 $919.22 	" $1,009.34 "	" $1,009.34 "	 $288.38 	 $757.01 	" $1,021.36 "	 $829.10 	 $961.28 	 $288.38 	" $1,081.44 "	 $976.90 	" $1,021.36 "	 $285.98 	 $976.90 	 $288.38 
360934	HCHG PERQ SOFT TISSUE DEV PLACE ADDL GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10036	 $800.00 	 $560.00 	 $190.40 	 $720.00 	 $696.00 	 $192.00 	 $612.00 	 $672.00 	 $672.00 	 $192.00 	 $504.00 	 $680.00 	 $552.00 	 $640.00 	 $192.00 	 $720.00 	 $650.40 	 $680.00 	 $190.40 	 $650.40 	 $192.00 
360935	HCHG URETERAL EMB/OCCL W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50705	" $3,000.00 "	" $2,100.00 "	 $714.00 	" $2,700.00 "	" $2,610.00 "	 $720.00 	" $2,295.00 "	" $2,520.00 "	" $2,520.00 "	 $720.00 	" $1,890.00 "	" $2,550.00 "	" $2,070.00 "	" $2,400.00 "	 $720.00 	" $2,700.00 "	" $2,439.00 "	" $2,550.00 "	 $714.00 	" $2,439.00 "	 $720.00 
360936	HCHG BALLOON DILAT URET W RAD/GDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50706	" $3,000.00 "	" $2,100.00 "	 $714.00 	" $2,700.00 "	" $2,610.00 "	 $720.00 	" $2,295.00 "	" $2,520.00 "	" $2,520.00 "	 $741.60 	" $1,890.00 "	" $2,550.00 "	" $2,070.00 "	" $2,400.00 "	 $720.00 	" $2,700.00 "	" $2,439.00 "	" $2,550.00 "	 $714.00 	" $2,439.00 "	 $720.00 
362172	HCHG PICC LINE PLACE WO GUIDANCE < AGE 5	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36568	" $1,710.75 "	" $1,197.53 "	 $407.16 	" $1,539.68 "	" $1,488.35 "	 $410.58 	" $1,308.72 "	" $1,437.03 "	" $1,437.03 "	 $410.58 	" $1,077.77 "	" $1,454.14 "	" $1,180.42 "	" $1,368.60 "	 $410.58 	" $1,539.68 "	" $1,390.84 "	" $1,454.14 "	 $407.16 	" $1,390.84 "	 $410.58 
362173	HCHG PICC LINE PLACE WO GUIDANCE > AGE 5	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36569	" $1,800.67 "	" $1,260.47 "	 $428.56 	" $1,620.60 "	" $1,566.58 "	 $432.16 	" $1,377.51 "	" $1,512.56 "	" $1,512.56 "	 $432.16 	" $1,134.42 "	" $1,530.57 "	" $1,242.46 "	" $1,440.54 "	 $432.16 	" $1,620.60 "	" $1,463.94 "	" $1,530.57 "	 $428.56 	" $1,463.94 "	 $432.16 
362174	HCHG PICC LINE PLACE W GUIDANCE < AGE 5	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36572	" $1,551.00 "	" $1,085.70 "	 $369.14 	" $1,395.90 "	" $1,349.37 "	 $372.24 	" $1,186.52 "	" $1,302.84 "	" $1,302.84 "	 $372.24 	 $977.13 	" $1,318.35 "	" $1,070.19 "	" $1,240.80 "	 $372.24 	" $1,395.90 "	" $1,260.96 "	" $1,318.35 "	 $369.14 	" $1,260.96 "	 $372.24 
362175	HCHG PICC LINE PLACE W GUIDANCE > AGE 5	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36573	" $2,820.00 "	" $1,974.00 "	 $671.16 	" $2,538.00 "	" $2,453.40 "	 $676.80 	" $2,157.30 "	" $2,368.80 "	" $2,368.80 "	 $676.80 	" $1,776.60 "	" $2,397.00 "	" $1,945.80 "	" $2,256.00 "	 $676.80 	" $2,538.00 "	" $2,292.66 "	" $2,397.00 "	 $671.16 	" $2,292.66 "	 $676.80 
362178	HCHG MIDLINE NON-ROUTINE BL DRAW > AGE 3	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36410	 $767.25 	 $537.08 	 $182.61 	 $690.53 	 $667.51 	 $184.14 	 $586.95 	 $644.49 	 $644.49 	 $184.14 	 $483.37 	 $652.16 	 $529.40 	 $613.80 	 $184.14 	 $690.53 	 $623.77 	 $652.16 	 $182.61 	 $623.77 	 $184.14 
362266	HCHG TENOTOMY ELBOW LATERAL OR MEDIAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	24357	" $4,092.75 "	" $2,864.93 "	 $974.07 	" $3,683.48 "	" $3,560.69 "	 $982.26 	" $3,130.95 "	" $3,437.91 "	" $3,283.00 "	 $982.26 	" $2,578.43 "	" $3,478.84 "	" $2,824.00 "	" $3,274.20 "	 $982.26 	" $3,683.48 "	" $3,327.41 "	" $3,478.84 "	 $974.07 	" $3,327.41 "	 $982.26 
362277	"HCHG TRIM DYSTROPHIC NAILS,ANY NUM"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	G0127	 $78.91 	 $55.24 	 $18.78 	 $71.02 	 $68.65 	 $18.94 	 $60.37 	 $66.28 	 $66.28 	 $18.94 	 $49.71 	 $67.07 	 $54.45 	 $63.13 	 $18.94 	 $71.02 	 $64.15 	 $67.07 	 $18.78 	 $64.15 	 $18.94 
372761	HCHG PERQ LUMBOSACRAL INJECTION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	22511	" $6,700.00 "	" $4,690.00 "	" $1,594.60 "	" $6,030.00 "	" $5,829.00 "	" $1,608.00 "	" $5,125.50 "	" $3,786.00 "	" $3,283.00 "	" $1,608.00 "	" $4,221.00 "	" $5,695.00 "	" $4,623.00 "	" $5,360.00 "	" $1,608.00 "	" $6,030.00 "	" $5,447.10 "	" $5,695.00 "	" $1,594.60 "	" $5,447.10 "	" $1,608.00 "
4400102	HCHG ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	51102	" $4,105.72 "	" $2,874.00 "	 $977.16 	" $3,695.15 "	" $3,571.98 "	 $985.37 	" $3,140.88 "	" $3,448.80 "	" $3,283.00 "	" $1,014.93 "	" $2,586.60 "	" $3,489.86 "	" $2,832.95 "	" $3,284.58 "	 $985.37 	" $3,695.15 "	" $3,337.95 "	" $3,489.86 "	 $977.16 	" $3,337.95 "	 $985.37 
4400114	HCHG CONTRAST INJECTION PERCUTANEOUOS RADIOLOGIC EVAL GI TUBE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49465	 $306.24 	 $214.37 	 $72.89 	 $275.62 	 $266.43 	 $73.50 	 $234.27 	 $257.24 	 $257.24 	 $75.70 	 $192.93 	 $260.30 	 $211.31 	 $244.99 	 $73.50 	 $275.62 	 $248.97 	 $260.30 	 $72.89 	 $248.97 	 $73.50 
4400121	HCHG RF ABLATE LIVER TUMOR(S) PERQ	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47382	" $6,115.36 "	" $4,280.75 "	" $1,455.46 "	" $5,503.82 "	" $5,320.36 "	" $1,467.69 "	" $4,678.25 "	" $3,786.00 "	" $3,283.00 "	" $1,467.69 "	" $3,852.68 "	" $5,198.06 "	" $4,219.60 "	" $4,892.29 "	" $1,467.69 "	" $5,503.82 "	" $4,971.79 "	" $5,198.06 "	" $1,455.46 "	" $4,971.79 "	" $1,467.69 "
4400127	"HCHG AMNIOCENTESIS,DIAGNOSTIC"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	59000	" $1,167.08 "	 $816.96 	 $277.77 	" $1,050.37 "	" $1,015.36 "	 $280.10 	 $892.82 	 $980.35 	 $980.35 	 $288.50 	 $735.26 	 $992.02 	 $805.29 	 $933.66 	 $280.10 	" $1,050.37 "	 $948.84 	 $992.02 	 $277.77 	 $948.84 	 $280.10 
4400179	"HCHG BIOPSY OF KIDNEY,PERCUTANEOUS"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50200	" $2,463.49 "	" $1,724.44 "	 $586.31 	" $2,217.14 "	" $2,143.24 "	 $591.24 	" $1,884.57 "	" $2,069.33 "	" $2,069.33 "	 $608.97 	" $1,552.00 "	" $2,093.97 "	" $1,699.81 "	" $1,970.79 "	 $591.24 	" $2,217.14 "	" $2,002.82 "	" $2,093.97 "	 $586.31 	" $2,002.82 "	 $591.24 
4400181	"HCHG BIOPSY OF THYROID,PERCUT"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	60100	" $1,910.00 "	" $1,337.00 "	 $454.58 	" $1,719.00 "	" $1,661.70 "	 $458.40 	" $1,461.15 "	" $1,604.40 "	" $1,604.40 "	 $472.15 	" $1,203.30 "	" $1,623.50 "	" $1,317.90 "	" $1,528.00 "	 $458.40 	" $1,719.00 "	" $1,552.83 "	" $1,623.50 "	 $454.58 	" $1,552.83 "	 $458.40 
4400183	HCHG BIOPSY SOFT TISSUE NECK/CHEST	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	21550	" $4,228.00 "	" $2,959.60 "	" $1,006.26 "	" $3,805.20 "	" $3,678.36 "	" $1,014.72 "	" $3,234.42 "	" $3,551.52 "	" $3,283.00 "	" $1,045.16 "	" $2,663.64 "	" $3,593.80 "	" $2,917.32 "	" $3,382.40 "	" $1,014.72 "	" $3,805.20 "	" $3,437.36 "	" $3,593.80 "	" $1,006.26 "	" $3,437.36 "	" $1,014.72 "
4400185	"HCHG BONE BIOPSY,TROCAR/NEEDLE DEEP"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20225	" $2,110.00 "	" $1,477.00 "	 $502.18 	" $1,899.00 "	" $1,835.70 "	 $506.40 	" $1,614.15 "	" $1,772.40 "	" $1,772.40 "	 $521.59 	" $1,329.30 "	" $1,793.50 "	" $1,455.90 "	" $1,688.00 "	 $506.40 	" $1,899.00 "	" $1,715.43 "	" $1,793.50 "	 $502.18 	" $1,715.43 "	 $506.40 
4400186	"HCHG BONE BIOPSY,TROCAR/NEEDLE SUPERF"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20220	" $1,040.00 "	 $728.00 	 $247.52 	 $936.00 	 $904.80 	 $249.60 	 $795.60 	 $873.60 	 $873.60 	 $257.09 	 $655.20 	 $884.00 	 $717.60 	 $832.00 	 $249.60 	 $936.00 	 $845.52 	 $884.00 	 $247.52 	 $845.52 	 $249.60 
4400192	HCHG DX BONE MARROW BIOPSIES	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	38221	 $840.00 	 $588.00 	 $199.92 	 $756.00 	 $730.80 	 $201.60 	 $642.60 	 $705.60 	 $705.60 	 $207.65 	 $529.20 	 $714.00 	 $579.60 	 $672.00 	 $201.60 	 $756.00 	 $682.92 	 $714.00 	 $199.92 	 $682.92 	 $201.60 
4400206	HCHG CATH/INJECT HYSTEROSALPINGOGRAM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	58340	 $236.91 	 $165.84 	 $56.38 	 $213.22 	 $206.11 	 $56.86 	 $181.24 	 $199.00 	 $199.00 	 $58.56 	 $149.25 	 $201.37 	 $163.47 	 $189.53 	 $56.86 	 $213.22 	 $192.61 	 $201.37 	 $56.38 	 $192.61 	 $56.86 
4400207	HCHG NEPHROURETERAL STENT CHANGE W/ FLUORO	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50387	" $3,371.58 "	" $2,360.11 "	 $802.44 	" $3,034.42 "	" $2,933.27 "	 $809.18 	" $2,579.26 "	" $2,832.13 "	" $2,832.13 "	 $809.18 	" $2,124.10 "	" $2,865.84 "	" $2,326.39 "	" $2,697.26 "	 $809.18 	" $3,034.42 "	" $2,741.09 "	" $2,865.84 "	 $802.44 	" $2,741.09 "	 $809.18 
4400221	"HCHG CHOLECYSTOSTOMY,PERCUT"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47490	" $5,261.40 "	" $3,682.98 "	" $1,252.21 "	" $4,735.26 "	" $4,577.42 "	" $1,262.74 "	" $4,024.97 "	" $3,786.00 "	" $3,283.00 "	" $1,300.62 "	" $3,314.68 "	" $4,472.19 "	" $3,630.37 "	" $4,209.12 "	" $1,262.74 "	" $4,735.26 "	" $4,277.52 "	" $4,472.19 "	" $1,252.21 "	" $4,277.52 "	" $1,262.74 "
4400223	HCHG CISTERNAL/LAT (C1-C2) CERV PUNCTURE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	61055	" $1,519.05 "	" $1,063.34 "	 $361.53 	" $1,367.15 "	" $1,321.57 "	 $364.57 	" $1,162.07 "	" $1,276.00 "	" $1,276.00 "	 $375.51 	 $957.00 	" $1,291.19 "	" $1,048.14 "	" $1,215.24 "	 $364.57 	" $1,367.15 "	" $1,234.99 "	" $1,291.19 "	 $361.53 	" $1,234.99 "	 $364.57 
4400224	"HCHG CONTRAST INJ CENT VEN CATH, INC FLOURO"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36598	 $670.00 	 $469.00 	 $159.46 	 $603.00 	 $582.90 	 $160.80 	 $512.55 	 $562.80 	 $562.80 	 $165.62 	 $422.10 	 $569.50 	 $462.30 	 $536.00 	 $160.80 	 $603.00 	 $544.71 	 $569.50 	 $159.46 	 $544.71 	 $160.80 
4400287	HCHG DRAIN SKIN ABSCESS SIMPLE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10060	 $618.42 	 $432.89 	 $147.18 	 $556.58 	 $538.03 	 $148.42 	 $473.09 	 $519.47 	 $519.47 	 $152.87 	 $389.60 	 $525.66 	 $426.71 	 $494.74 	 $148.42 	 $556.58 	 $502.78 	 $525.66 	 $147.18 	 $502.78 	 $148.42 
4400289	HCHG INJ/ASPIR-INTERMED JT/BURSA W/O US GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20605	 $955.26 	 $668.68 	 $227.35 	 $859.73 	 $831.08 	 $229.26 	 $730.77 	 $802.42 	 $802.42 	 $236.14 	 $601.81 	 $811.97 	 $659.13 	 $764.21 	 $229.26 	 $859.73 	 $776.63 	 $811.97 	 $227.35 	 $776.63 	 $229.26 
4400290	HCHG INJ/ASPIR-LARGE JT/BURSA W/O US GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20610	" $1,160.00 "	 $812.00 	 $276.08 	" $1,044.00 "	" $1,009.20 "	 $278.40 	 $887.40 	 $974.40 	 $974.40 	 $286.75 	 $730.80 	 $986.00 	 $800.40 	 $928.00 	 $278.40 	" $1,044.00 "	 $943.08 	 $986.00 	 $276.08 	 $943.08 	 $278.40 
4400291	HCHG INJ/ASPIR-SMALL JT/BURSA W/O US GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20600	 $931.60 	 $652.12 	 $221.72 	 $838.44 	 $810.49 	 $223.58 	 $712.67 	 $782.54 	 $782.54 	 $230.29 	 $586.91 	 $791.86 	 $642.80 	 $745.28 	 $223.58 	 $838.44 	 $757.39 	 $791.86 	 $221.72 	 $757.39 	 $223.58 
4400292	HCHG DRAINAGE CATHETER EXCHANGE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49423	" $2,482.00 "	" $1,737.40 "	 $590.72 	" $2,233.80 "	" $2,159.34 "	 $595.68 	" $1,898.73 "	" $2,084.88 "	" $2,084.88 "	 $613.55 	" $1,563.66 "	" $2,109.70 "	" $1,712.58 "	" $1,985.60 "	 $595.68 	" $2,233.80 "	" $2,017.87 "	" $2,109.70 "	 $590.72 	" $2,017.87 "	 $595.68 
4400294	HCHG DRAINAGE OF HEMATOMA/FLUID	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10140	" $3,015.00 "	" $2,110.50 "	 $717.57 	" $2,713.50 "	" $2,623.05 "	 $723.60 	" $2,306.48 "	" $2,532.60 "	" $2,532.60 "	 $745.31 	" $1,899.45 "	" $2,562.75 "	" $2,080.35 "	" $2,412.00 "	 $723.60 	" $2,713.50 "	" $2,451.20 "	" $2,562.75 "	 $717.57 	" $2,451.20 "	 $723.60 
4400346	HCHG IDENTIFY SENTINEL NODE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	38792	" $2,130.00 "	" $1,491.00 "	 $506.94 	" $1,917.00 "	" $1,853.10 "	 $511.20 	" $1,629.45 "	" $1,789.20 "	" $1,789.20 "	 $526.54 	" $1,341.90 "	" $1,810.50 "	" $1,469.70 "	" $1,704.00 "	 $511.20 	" $1,917.00 "	" $1,731.69 "	" $1,810.50 "	 $506.94 	" $1,731.69 "	 $511.20 
4400350	HCHG INJ PROC SHOULDER ARTHROGRAPHY/CT/MRI	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	23350	 $830.00 	 $581.00 	 $197.54 	 $747.00 	 $722.10 	 $199.20 	 $634.95 	 $697.20 	 $697.20 	 $205.18 	 $522.90 	 $705.50 	 $572.70 	 $664.00 	 $199.20 	 $747.00 	 $674.79 	 $705.50 	 $197.54 	 $674.79 	 $199.20 
4400353	"HCHG INJ,FORAMEN C/T,1 LEVEL"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64479	" $2,743.11 "	" $1,920.18 "	 $652.86 	" $2,468.80 "	" $2,386.51 "	 $658.35 	" $2,098.48 "	" $2,304.21 "	" $2,304.21 "	 $678.10 	" $1,728.16 "	" $2,331.64 "	" $1,892.75 "	" $2,194.49 "	 $658.35 	" $2,468.80 "	" $2,230.15 "	" $2,331.64 "	 $652.86 	" $2,230.15 "	 $658.35 
4400354	"HCHG INJ,FORAMEN C/T,ADDL LEVELS"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64480	" $2,244.36 "	" $1,571.05 "	 $534.16 	" $2,019.92 "	" $1,952.59 "	 $538.65 	" $1,716.94 "	" $1,885.26 "	" $1,885.26 "	 $554.81 	" $1,413.95 "	" $1,907.71 "	" $1,548.61 "	" $1,795.49 "	 $538.65 	" $2,019.92 "	" $1,824.66 "	" $1,907.71 "	 $534.16 	" $1,824.66 "	 $538.65 
4400355	"HCHG INJ,FORAMEN,L/S,1 LEVEL"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64483	" $2,520.00 "	" $1,764.00 "	 $599.76 	" $2,268.00 "	" $2,192.40 "	 $604.80 	" $1,927.80 "	" $2,116.80 "	" $2,116.80 "	 $622.94 	" $1,587.60 "	" $2,142.00 "	" $1,738.80 "	" $2,016.00 "	 $604.80 	" $2,268.00 "	" $2,048.76 "	" $2,142.00 "	 $599.76 	" $2,048.76 "	 $604.80 
4400356	"HCHG INJ,FORAMEN,L/S,ADDL LEVELS"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	64484	" $2,240.00 "	" $1,568.00 "	 $533.12 	" $2,016.00 "	" $1,948.80 "	 $537.60 	" $1,713.60 "	" $1,881.60 "	" $1,881.60 "	 $553.73 	" $1,411.20 "	" $1,904.00 "	" $1,545.60 "	" $1,792.00 "	 $537.60 	" $2,016.00 "	" $1,821.12 "	" $1,904.00 "	 $533.12 	" $1,821.12 "	 $537.60 
4400358	"HCHG INJECT CORPORA CAVERN,PHARM AGNT"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	54235	" $1,190.00 "	 $833.00 	 $283.22 	" $1,071.00 "	" $1,035.30 "	 $285.60 	 $910.35 	 $999.60 	 $999.60 	 $294.17 	 $749.70 	" $1,011.50 "	 $821.10 	 $952.00 	 $285.60 	" $1,071.00 "	 $967.47 	" $1,011.50 "	 $283.22 	 $967.47 	 $285.60 
4400359	"HCHG INJECT DISCOGRAM,LUMBAR,EA LEVEL"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62290	 $236.91 	 $165.84 	 $56.38 	 $213.22 	 $206.11 	 $56.86 	 $181.24 	 $199.00 	 $199.00 	 $58.56 	 $149.25 	 $201.37 	 $163.47 	 $189.53 	 $56.86 	 $213.22 	 $192.61 	 $201.37 	 $56.38 	 $192.61 	 $56.86 
4400360	HCHG INJECT FOR RETROGRADE URETHOCYSTO	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	51610	 $236.91 	 $165.84 	 $56.38 	 $213.22 	 $206.11 	 $56.86 	 $181.24 	 $199.00 	 $199.00 	 $58.56 	 $149.25 	 $201.37 	 $163.47 	 $189.53 	 $56.86 	 $213.22 	 $192.61 	 $201.37 	 $56.38 	 $192.61 	 $56.86 
4400361	HCHG INJECT FOR SACROILIAC JOINT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	27096	" $1,310.00 "	 $917.00 	 $311.78 	" $1,179.00 "	" $1,139.70 "	 $314.40 	" $1,002.15 "	" $1,100.40 "	" $1,100.40 "	 $323.83 	 $825.30 	" $1,113.50 "	 $903.90 	" $1,048.00 "	 $314.40 	" $1,179.00 "	" $1,065.03 "	" $1,113.50 "	 $311.78 	" $1,065.03 "	 $314.40 
4400364	HCHG INJECT SINUS TRACT FOR DX W XRAY	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20501	 $236.91 	 $165.84 	 $56.38 	 $213.22 	 $206.11 	 $56.86 	 $181.24 	 $199.00 	 $199.00 	 $58.56 	 $149.25 	 $201.37 	 $163.47 	 $189.53 	 $56.86 	 $213.22 	 $192.61 	 $201.37 	 $56.38 	 $192.61 	 $56.86 
4400368	"HCHG INJECT,MYELOGRAPHY &/OR CT SCAN,SPINAL"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62284	" $1,030.00 "	 $721.00 	 $245.14 	 $927.00 	 $896.10 	 $247.20 	 $787.95 	 $865.20 	 $865.20 	 $254.62 	 $648.90 	 $875.50 	 $710.70 	 $824.00 	 $247.20 	 $927.00 	 $837.39 	 $875.50 	 $245.14 	 $837.39 	 $247.20 
4400369	HCHG INJECTION FOR ANKLE ARTHROGRAM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	27648	 $544.14 	 $380.90 	 $129.51 	 $489.73 	 $473.40 	 $130.59 	 $416.27 	 $457.08 	 $457.08 	 $134.51 	 $342.81 	 $462.52 	 $375.46 	 $435.31 	 $130.59 	 $489.73 	 $442.39 	 $462.52 	 $129.51 	 $442.39 	 $130.59 
4400370	HCHG INJECTION FOR BLADDER X-RAY	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	51600	 $236.91 	 $165.84 	 $56.38 	 $213.22 	 $206.11 	 $56.86 	 $181.24 	 $199.00 	 $199.00 	 $58.56 	 $149.25 	 $201.37 	 $163.47 	 $189.53 	 $56.86 	 $213.22 	 $192.61 	 $201.37 	 $56.38 	 $192.61 	 $56.86 
4400371	HCHG INJECTION FOR ELBOW ARTHROGRAM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	24220	 $342.12 	 $239.48 	 $81.42 	 $307.91 	 $297.64 	 $82.11 	 $261.72 	 $287.38 	 $287.38 	 $84.57 	 $215.54 	 $290.80 	 $236.06 	 $273.70 	 $82.11 	 $307.91 	 $278.14 	 $290.80 	 $81.42 	 $278.14 	 $82.11 
4400373	HCHG INJECTION FOR SALIVARY X-RAY	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	42550	 $610.73 	 $427.51 	 $145.35 	 $549.66 	 $531.34 	 $146.58 	 $467.21 	 $513.01 	 $513.01 	 $150.97 	 $384.76 	 $519.12 	 $421.40 	 $488.58 	 $146.58 	 $549.66 	 $496.52 	 $519.12 	 $145.35 	 $496.52 	 $146.58 
4400375	HCHG INJECTION FOR WRIST ARTHROGRAM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	25246	 $540.00 	 $378.00 	 $128.52 	 $486.00 	 $469.80 	 $129.60 	 $413.10 	 $453.60 	 $453.60 	 $133.49 	 $340.20 	 $459.00 	 $372.60 	 $432.00 	 $129.60 	 $486.00 	 $439.02 	 $459.00 	 $128.52 	 $439.02 	 $129.60 
4400376	HCHG INJECTION HIP ARTHROGRAM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	27093	 $720.00 	 $504.00 	 $171.36 	 $648.00 	 $626.40 	 $172.80 	 $550.80 	 $604.80 	 $604.80 	 $177.98 	 $453.60 	 $612.00 	 $496.80 	 $576.00 	 $172.80 	 $648.00 	 $585.36 	 $612.00 	 $171.36 	 $585.36 	 $172.80 
4400378	HCHG EXTREMITY VENOGRAPHY INJECTION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36005	 $214.84 	 $150.39 	 $51.13 	 $193.36 	 $186.91 	 $51.56 	 $164.35 	 $180.47 	 $180.47 	 $53.11 	 $135.35 	 $182.61 	 $148.24 	 $171.87 	 $51.56 	 $193.36 	 $174.66 	 $182.61 	 $51.13 	 $174.66 	 $51.56 
4400383	"HCHG INSERT ABDOM DRAIN/CATH,PERMAN"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49421	" $7,265.00 "	" $5,085.50 "	" $1,729.07 "	" $6,538.50 "	" $6,320.55 "	" $1,743.60 "	" $5,557.73 "	" $3,786.00 "	" $3,283.00 "	" $1,795.91 "	" $4,576.95 "	" $6,175.25 "	" $5,012.85 "	" $5,812.00 "	" $1,743.60 "	" $6,538.50 "	" $5,906.45 "	" $6,175.25 "	" $1,729.07 "	" $5,906.45 "	" $1,743.60 "
4400384	HCHG INSERT NON-TUNNEL CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36556	" $3,060.00 "	" $2,142.00 "	 $728.28 	" $2,754.00 "	" $2,662.20 "	 $734.40 	" $2,340.90 "	" $2,570.40 "	" $2,570.40 "	 $756.43 	" $1,927.80 "	" $2,601.00 "	" $2,111.40 "	" $2,448.00 "	 $734.40 	" $2,754.00 "	" $2,487.78 "	" $2,601.00 "	 $728.28 	" $2,487.78 "	 $734.40 
4400385	HCHG INSERT NON-TUNNEL CV CATH < 5 Y/O	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36555	" $1,500.48 "	" $1,050.34 "	 $357.11 	" $1,350.43 "	" $1,305.42 "	 $360.12 	" $1,147.87 "	" $1,260.40 "	" $1,260.40 "	 $370.92 	 $945.30 	" $1,275.41 "	" $1,035.33 "	" $1,200.38 "	 $360.12 	" $1,350.43 "	" $1,219.89 "	" $1,275.41 "	 $357.11 	" $1,219.89 "	 $360.12 
4400388	HCHG INSERT PICC W/ SUB-Q PORT <5 Y/O	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36570	" $14,400.00 "	" $10,080.00 "	" $3,283.00 "	" $12,960.00 "	" $12,528.00 "	" $3,456.00 "	" $11,016.00 "	" $3,786.00 "	" $3,283.00 "	" $3,559.68 "	" $9,072.00 "	" $12,240.00 "	" $9,936.00 "	" $11,520.00 "	" $3,456.00 "	" $12,960.00 "	" $11,707.20 "	" $12,240.00 "	" $3,427.20 "	" $11,707.20 "	" $3,456.00 "
4400390	HCHG INSERT TRANSVEN INTRAHEP PORTOSYS SHUNT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37182	" $25,395.69 "	" $17,776.98 "	" $3,283.00 "	" $22,856.12 "	" $22,094.25 "	" $6,094.97 "	" $19,427.70 "	" $3,786.00 "	" $3,283.00 "	" $6,277.81 "	" $15,999.28 "	" $21,586.34 "	" $17,523.03 "	" $20,316.55 "	" $6,094.97 "	" $22,856.12 "	" $20,646.70 "	" $21,586.34 "	" $6,044.17 "	" $20,646.70 "	" $6,094.97 "
4400391	HCHG INSERT TUNNELED CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36561	" $7,500.00 "	" $5,250.00 "	" $1,785.00 "	" $6,750.00 "	" $6,525.00 "	" $1,800.00 "	" $5,737.50 "	" $3,786.00 "	" $3,283.00 "	" $1,854.00 "	" $4,725.00 "	" $6,375.00 "	" $5,175.00 "	" $6,000.00 "	" $1,800.00 "	" $6,750.00 "	" $6,097.50 "	" $6,375.00 "	" $1,785.00 "	" $6,097.50 "	" $1,800.00 "
4400393	HCHG INSERT TUNNELED CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36571	" $7,000.00 "	" $4,900.00 "	" $1,666.00 "	" $6,300.00 "	" $6,090.00 "	" $1,680.00 "	" $5,355.00 "	" $3,786.00 "	" $3,283.00 "	" $1,730.40 "	" $4,410.00 "	" $5,950.00 "	" $4,830.00 "	" $5,600.00 "	" $1,680.00 "	" $6,300.00 "	" $5,691.00 "	" $5,950.00 "	" $1,666.00 "	" $5,691.00 "	" $1,680.00 "
4400394	HCHG INSERT TUNNELED CV CATH <5 Y/O	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36557	" $4,566.00 "	" $3,196.20 "	" $1,086.71 "	" $4,109.40 "	" $3,972.42 "	" $1,095.84 "	" $3,492.99 "	" $3,786.00 "	" $3,283.00 "	" $1,128.72 "	" $2,876.58 "	" $3,881.10 "	" $3,150.54 "	" $3,652.80 "	" $1,095.84 "	" $4,109.40 "	" $3,712.16 "	" $3,881.10 "	" $1,086.71 "	" $3,712.16 "	" $1,095.84 "
4400395	HCHG INSERT TUNNELED CV CATH WITH PORT <5 Y/O	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36560	" $6,820.15 "	" $4,774.11 "	" $1,623.20 "	" $6,138.14 "	" $5,933.53 "	" $1,636.84 "	" $5,217.41 "	" $3,786.00 "	" $3,283.00 "	" $1,685.94 "	" $4,296.69 "	" $5,797.13 "	" $4,705.90 "	" $5,456.12 "	" $1,636.84 "	" $6,138.14 "	" $5,544.78 "	" $5,797.13 "	" $1,623.20 "	" $5,544.78 "	" $1,636.84 "
4400419	HCHG MECH REMOV TUNNELED CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36595	" $4,916.94 "	" $3,441.86 "	" $1,170.23 "	" $4,425.25 "	" $4,277.74 "	" $1,180.07 "	" $3,761.46 "	" $3,786.00 "	" $3,283.00 "	" $1,180.07 "	" $3,097.67 "	" $4,179.40 "	" $3,392.69 "	" $3,933.55 "	" $1,180.07 "	" $4,425.25 "	" $3,997.47 "	" $4,179.40 "	" $1,170.23 "	" $3,997.47 "	" $1,180.07 "
4400420	HCHG MECH REMOV TUNNELED CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36596	" $2,512.66 "	" $1,758.86 "	 $598.01 	" $2,261.39 "	" $2,186.01 "	 $603.04 	" $1,922.18 "	" $2,110.63 "	" $2,110.63 "	 $603.04 	" $1,582.98 "	" $2,135.76 "	" $1,733.74 "	" $2,010.13 "	 $603.04 	" $2,261.39 "	" $2,042.79 "	" $2,135.76 "	 $598.01 	" $2,042.79 "	 $603.04 
4400490	HCHG NEEDLE BIOPSY LIVER	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47000	" $2,730.00 "	" $1,911.00 "	 $649.74 	" $2,457.00 "	" $2,375.10 "	 $655.20 	" $2,088.45 "	" $2,293.20 "	" $2,293.20 "	 $655.20 	" $1,719.90 "	" $2,320.50 "	" $1,883.70 "	" $2,184.00 "	 $655.20 	" $2,457.00 "	" $2,219.49 "	" $2,320.50 "	 $649.74 	" $2,219.49 "	 $655.20 
4400491	"HCHG NEEDLE BIOPSY LIVER,W OTHR PROC"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47001	" $4,880.25 "	" $3,416.18 "	" $1,161.50 "	" $4,392.23 "	" $4,245.82 "	" $1,171.26 "	" $3,733.39 "	" $3,786.00 "	" $3,283.00 "	" $1,171.26 "	" $3,074.56 "	" $4,148.21 "	" $3,367.37 "	" $3,904.20 "	" $1,171.26 "	" $4,392.23 "	" $3,967.64 "	" $4,148.21 "	" $1,161.50 "	" $3,967.64 "	" $1,171.26 "
4400492	HCHG NEEDLE BIOPSY OF PANCREAS	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	48102	" $3,127.15 "	" $2,189.01 "	 $744.26 	" $2,814.44 "	" $2,720.62 "	 $750.52 	" $2,392.27 "	" $2,626.81 "	" $2,626.81 "	 $750.52 	" $1,970.10 "	" $2,658.08 "	" $2,157.73 "	" $2,501.72 "	 $750.52 	" $2,814.44 "	" $2,542.37 "	" $2,658.08 "	 $744.26 	" $2,542.37 "	 $750.52 
4400493	HCHG NEEDLE BIOPSY PLEURA	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	32400	 $843.37 	 $590.36 	 $200.72 	 $759.03 	 $733.73 	 $202.41 	 $645.18 	 $708.43 	 $708.43 	 $202.41 	 $531.32 	 $716.86 	 $581.93 	 $674.70 	 $202.41 	 $759.03 	 $685.66 	 $716.86 	 $200.72 	 $685.66 	 $202.41 
4400494	"HCHG NEEDLE BIOPSY, LYMPH NODE(S)"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	38505	" $2,310.00 "	" $1,617.00 "	 $549.78 	" $2,079.00 "	" $2,009.70 "	 $554.40 	" $1,767.15 "	" $1,940.40 "	" $1,940.40 "	 $554.40 	" $1,455.30 "	" $1,963.50 "	" $1,593.90 "	" $1,848.00 "	 $554.40 	" $2,079.00 "	" $1,878.03 "	" $1,963.50 "	 $549.78 	" $1,878.03 "	 $554.40 
4400495	"HCHG NEEDLE BIOPSY,MUSCLE"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20206	" $1,150.00 "	 $805.00 	 $273.70 	" $1,035.00 "	" $1,000.50 "	 $276.00 	 $879.75 	 $966.00 	 $966.00 	 $276.00 	 $724.50 	 $977.50 	 $793.50 	 $920.00 	 $276.00 	" $1,035.00 "	 $934.95 	 $977.50 	 $273.70 	 $934.95 	 $276.00 
4400512	HCHG RF ABLATE RENAL TUMOR(S) PERQ	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50592	" $20,991.05 "	" $14,693.74 "	" $3,283.00 "	" $18,891.95 "	" $18,262.21 "	" $5,037.85 "	" $16,058.15 "	" $3,786.00 "	" $3,283.00 "	" $5,037.85 "	" $13,224.36 "	" $17,842.39 "	" $14,483.82 "	" $16,792.84 "	" $5,037.85 "	" $18,891.95 "	" $17,065.72 "	" $17,842.39 "	" $4,995.87 "	" $17,065.72 "	" $5,037.85 "
4400516	"HCHG PERCUT BIOPSY, ABDOMINAL MASS"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49180	" $1,400.00 "	 $980.00 	 $333.20 	" $1,260.00 "	" $1,218.00 "	 $336.00 	" $1,071.00 "	" $1,176.00 "	" $1,176.00 "	 $336.00 	 $882.00 	" $1,190.00 "	 $966.00 	" $1,120.00 "	 $336.00 	" $1,260.00 "	" $1,138.20 "	" $1,190.00 "	 $333.20 	" $1,138.20 "	 $336.00 
4400520	HCHG PERCUT DRAIN SPINAL CORD CYST	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62268	" $1,901.00 "	" $1,330.70 "	 $452.44 	" $1,710.90 "	" $1,653.87 "	 $456.24 	" $1,454.27 "	" $1,596.84 "	" $1,596.84 "	 $456.24 	" $1,197.63 "	" $1,615.85 "	" $1,311.69 "	" $1,520.80 "	 $456.24 	" $1,710.90 "	" $1,545.51 "	" $1,615.85 "	 $452.44 	" $1,545.51 "	 $456.24 
4400521	HCHG PERCUT DRAIN/INJECT RENAL CYST	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	50390	" $1,858.00 "	" $1,300.60 "	 $442.20 	" $1,672.20 "	" $1,616.46 "	 $445.92 	" $1,421.37 "	" $1,560.72 "	" $1,560.72 "	 $445.92 	" $1,170.54 "	" $1,579.30 "	" $1,282.02 "	" $1,486.40 "	 $445.92 	" $1,672.20 "	" $1,510.55 "	" $1,579.30 "	 $442.20 	" $1,510.55 "	 $445.92 
4400528	HCHG PERCUT PORTAL VEIN CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36481	" $4,918.70 "	" $3,443.09 "	" $1,170.65 "	" $4,426.83 "	" $4,279.27 "	" $1,180.49 "	" $3,762.81 "	" $3,786.00 "	" $3,283.00 "	" $1,180.49 "	" $3,098.78 "	" $4,180.90 "	" $3,393.90 "	" $3,934.96 "	" $1,180.49 "	" $4,426.83 "	" $3,998.90 "	" $4,180.90 "	" $1,170.65 "	" $3,998.90 "	" $1,180.49 "
4400536	HCHG PLACE CATH EA ADDL 2ND+ ORDER BELOW DIAPHRAGM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36248	 $559.76 	 $391.83 	 $133.22 	 $503.78 	 $486.99 	 $134.34 	 $428.22 	 $470.20 	 $470.20 	 $134.34 	 $352.65 	 $475.80 	 $386.23 	 $447.81 	 $134.34 	 $503.78 	 $455.08 	 $475.80 	 $133.22 	 $455.08 	 $134.34 
4400538	HCHG PLACE CATH AORTA	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36200	" $1,026.41 "	 $718.49 	 $244.29 	 $923.77 	 $892.98 	 $246.34 	 $785.20 	 $862.18 	 $862.18 	 $246.34 	 $646.64 	 $872.45 	 $708.22 	 $821.13 	 $246.34 	 $923.77 	 $834.47 	 $872.45 	 $244.29 	 $834.47 	 $246.34 
4400540	HCHG INTRO NEEDLE CATH UE/LE ARTERY	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36140	" $1,296.38 "	 $907.47 	 $308.54 	" $1,166.74 "	" $1,127.85 "	 $311.13 	 $991.73 	" $1,088.96 "	" $1,088.96 "	 $320.47 	 $816.72 	" $1,101.92 "	 $894.50 	" $1,037.10 "	 $311.13 	" $1,166.74 "	" $1,053.96 "	" $1,101.92 "	 $308.54 	" $1,053.96 "	 $311.13 
4400541	HCHG PLACE CATH IN RT OR LT PULM ART	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36014	" $1,243.55 "	 $870.49 	 $295.96 	" $1,119.20 "	" $1,081.89 "	 $298.45 	 $951.32 	" $1,044.58 "	" $1,044.58 "	 $298.45 	 $783.44 	" $1,057.02 "	 $858.05 	 $994.84 	 $298.45 	" $1,119.20 "	" $1,011.01 "	" $1,057.02 "	 $295.96 	" $1,011.01 "	 $298.45 
4400544	HCHG PLACE CATH IN VEIN 1ST ORDER BRANCH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36011	 $214.92 	 $150.44 	 $51.15 	 $193.43 	 $186.98 	 $51.58 	 $164.41 	 $180.53 	 $180.53 	 $51.58 	 $135.40 	 $182.68 	 $148.29 	 $171.94 	 $51.58 	 $193.43 	 $174.73 	 $182.68 	 $51.15 	 $174.73 	 $51.58 
4400545	HCHG PLACE CATH IN VEIN 2ND & HIGHER BRANCH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36012	 $214.92 	 $150.44 	 $51.15 	 $193.43 	 $186.98 	 $51.58 	 $164.41 	 $180.53 	 $180.53 	 $51.58 	 $135.40 	 $182.68 	 $148.29 	 $171.94 	 $51.58 	 $193.43 	 $174.73 	 $182.68 	 $51.15 	 $174.73 	 $51.58 
4400546	HCHG PLACE CATH IN SVC/IVC	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36010	" $2,506.34 "	" $1,754.44 "	 $596.51 	" $2,255.71 "	" $2,180.52 "	 $601.52 	" $1,917.35 "	" $2,105.33 "	" $2,105.33 "	 $601.52 	" $1,578.99 "	" $2,130.39 "	" $1,729.37 "	" $2,005.07 "	 $601.52 	" $2,255.71 "	" $2,037.65 "	" $2,130.39 "	 $596.51 	" $2,037.65 "	 $601.52 
4400547	HCHG PLACE CATH EA 1ST ORDER BELOW DIAPHRAGM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36245	" $1,538.53 "	" $1,076.97 "	 $366.17 	" $1,384.68 "	" $1,338.52 "	 $369.25 	" $1,176.98 "	" $1,292.37 "	" $1,292.37 "	 $369.25 	 $969.27 	" $1,307.75 "	" $1,061.59 "	" $1,230.82 "	 $369.25 	" $1,384.68 "	" $1,250.82 "	" $1,307.75 "	 $366.17 	" $1,250.82 "	 $369.25 
4400548	HCHG PLACE CATH EA 1ST ORDER ABOVE DIAPHRAGM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36215	" $2,069.96 "	" $1,448.97 "	 $492.65 	" $1,862.96 "	" $1,800.87 "	 $496.79 	" $1,583.52 "	" $1,738.77 "	" $1,738.77 "	 $496.79 	" $1,304.07 "	" $1,759.47 "	" $1,428.27 "	" $1,655.97 "	 $496.79 	" $1,862.96 "	" $1,682.88 "	" $1,759.47 "	 $492.65 	" $1,682.88 "	 $496.79 
4400549	HCHG PLACE CATH INITIAL 2ND ORDER BELOW DIAPHRAGM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36246	" $1,600.81 "	" $1,120.57 "	 $380.99 	" $1,440.73 "	" $1,392.70 "	 $384.19 	" $1,224.62 "	" $1,344.68 "	" $1,344.68 "	 $384.19 	" $1,008.51 "	" $1,360.69 "	" $1,104.56 "	" $1,280.65 "	 $384.19 	" $1,440.73 "	" $1,301.46 "	" $1,360.69 "	 $380.99 	" $1,301.46 "	 $384.19 
4400550	HCHG PLACE CATH INITIAL 2ND ORDER ABOVE DIAPHRAGM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36216	" $2,674.42 "	" $1,872.09 "	 $636.51 	" $2,406.98 "	" $2,326.75 "	 $641.86 	" $2,045.93 "	" $2,246.51 "	" $2,246.51 "	 $641.86 	" $1,684.88 "	" $2,273.26 "	" $1,845.35 "	" $2,139.54 "	 $641.86 	" $2,406.98 "	" $2,174.30 "	" $2,273.26 "	 $636.51 	" $2,174.30 "	 $641.86 
4400551	HCHG PLACE CATH INITIAL 3RD+ ORDER BELOW DIAPHRAGM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36247	" $1,894.27 "	" $1,325.99 "	 $450.84 	" $1,704.84 "	" $1,648.01 "	 $454.62 	" $1,449.12 "	" $1,591.19 "	" $1,591.19 "	 $454.62 	" $1,193.39 "	" $1,610.13 "	" $1,307.05 "	" $1,515.42 "	 $454.62 	" $1,704.84 "	" $1,540.04 "	" $1,610.13 "	 $450.84 	" $1,540.04 "	 $454.62 
4400552	HCHG PLACE CATH INITIAL 3RD+ ORDER ABOVE DIAPHRAGM	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36217	" $3,105.90 "	" $2,174.13 "	 $739.20 	" $2,795.31 "	" $2,702.13 "	 $745.42 	" $2,376.01 "	" $2,608.96 "	" $2,608.96 "	 $745.42 	" $1,956.72 "	" $2,640.02 "	" $2,143.07 "	" $2,484.72 "	 $745.42 	" $2,795.31 "	" $2,525.10 "	" $2,640.02 "	 $739.20 	" $2,525.10 "	 $745.42 
4400558	"HCHG PLACEMENT, BILE DUCT STENT"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	47801	" $6,075.45 "	" $4,252.82 "	" $1,445.96 "	" $5,467.91 "	" $5,285.64 "	" $1,458.11 "	" $4,647.72 "	" $3,786.00 "	" $3,283.00 "	" $1,458.11 "	" $3,827.53 "	" $5,164.13 "	" $4,192.06 "	" $4,860.36 "	" $1,458.11 "	" $5,467.91 "	" $4,939.34 "	" $5,164.13 "	" $1,445.96 "	" $4,939.34 "	" $1,458.11 "
4400564	"HCHG PUCT/ASPIR BREAST CYST,EACH A*"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	19001	" $1,197.02 "	 $837.91 	 $284.89 	" $1,077.32 "	" $1,041.41 "	 $287.28 	 $915.72 	" $1,005.50 "	" $1,005.50 "	 $287.28 	 $754.12 	" $1,017.47 "	 $825.94 	 $957.62 	 $287.28 	" $1,077.32 "	 $973.18 	" $1,017.47 "	 $284.89 	 $973.18 	 $287.28 
4400565	HCHG PUNC/ASPIR BREAST CYST	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	19000	" $1,910.00 "	" $1,337.00 "	 $454.58 	" $1,719.00 "	" $1,661.70 "	 $458.40 	" $1,461.15 "	" $1,604.40 "	" $1,604.40 "	 $458.40 	" $1,203.30 "	" $1,623.50 "	" $1,317.90 "	" $1,528.00 "	 $458.40 	" $1,719.00 "	" $1,552.83 "	" $1,623.50 "	 $454.58 	" $1,552.83 "	 $458.40 
4400569	HCHG REMOVAL TUNNELED CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36589	" $2,219.21 "	" $1,553.45 "	 $528.17 	" $1,997.29 "	" $1,930.71 "	 $532.61 	" $1,697.70 "	" $1,864.14 "	" $1,864.14 "	 $532.61 	" $1,398.10 "	" $1,886.33 "	" $1,531.25 "	" $1,775.37 "	 $532.61 	" $1,997.29 "	" $1,804.22 "	" $1,886.33 "	 $528.17 	" $1,804.22 "	 $532.61 
4400570	HCHG REMOVAL TUNNELED CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36590	" $2,890.00 "	" $2,023.00 "	 $687.82 	" $2,601.00 "	" $2,514.30 "	 $693.60 	" $2,210.85 "	" $2,427.60 "	" $2,427.60 "	 $693.60 	" $1,820.70 "	" $2,456.50 "	" $1,994.10 "	" $2,312.00 "	 $693.60 	" $2,601.00 "	" $2,349.57 "	" $2,456.50 "	 $687.82 	" $2,349.57 "	 $693.60 
4400572	HCHG REMOVE PERM CANNULA/CATHETER	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49422	" $5,338.31 "	" $3,736.82 "	" $1,270.52 "	" $4,804.48 "	" $4,644.33 "	" $1,281.19 "	" $4,083.81 "	" $3,786.00 "	" $3,283.00 "	" $1,281.19 "	" $3,363.14 "	" $4,537.56 "	" $3,683.43 "	" $4,270.65 "	" $1,281.19 "	" $4,804.48 "	" $4,340.05 "	" $4,537.56 "	" $1,270.52 "	" $4,340.05 "	" $1,281.19 "
4400584	HCHG REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERCUTANEOUS	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49451	" $2,742.00 "	" $1,919.40 "	 $652.60 	" $2,467.80 "	" $2,385.54 "	 $658.08 	" $2,097.63 "	" $2,303.28 "	" $2,303.28 "	 $658.08 	" $1,727.46 "	" $2,330.70 "	" $1,891.98 "	" $2,193.60 "	 $658.08 	" $2,467.80 "	" $2,229.25 "	" $2,330.70 "	 $652.60 	" $2,229.25 "	 $658.08 
4400585	HCHG REPLACE TUNNELED CVC WO SUBQ PORT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36581	" $6,297.88 "	" $4,408.52 "	" $1,498.90 "	" $5,668.09 "	" $5,479.16 "	" $1,511.49 "	" $4,817.88 "	" $3,786.00 "	" $3,283.00 "	" $1,511.49 "	" $3,967.66 "	" $5,353.20 "	" $4,345.54 "	" $5,038.30 "	" $1,511.49 "	" $5,668.09 "	" $5,120.18 "	" $5,353.20 "	" $1,498.90 "	" $5,120.18 "	" $1,511.49 "
4400586	HCHG REPLACE TUNNELED CVC W SUBQ PORT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36582	" $10,546.25 "	" $7,382.38 "	" $2,510.01 "	" $9,491.63 "	" $9,175.24 "	" $2,531.10 "	" $8,067.88 "	" $3,786.00 "	" $3,283.00 "	" $2,531.10 "	" $6,644.14 "	" $8,964.31 "	" $7,276.91 "	" $8,437.00 "	" $2,531.10 "	" $9,491.63 "	" $8,574.10 "	" $8,964.31 "	" $2,510.01 "	" $8,574.10 "	" $2,531.10 "
4400587	HCHG REPLACE PICC WO SUBQ PORT W IMAGING	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36584	" $5,022.97 "	" $3,516.08 "	" $1,195.47 "	" $4,520.67 "	" $4,369.98 "	" $1,205.51 "	" $3,842.57 "	" $3,786.00 "	" $3,283.00 "	" $1,205.51 "	" $3,164.47 "	" $4,269.52 "	" $3,465.85 "	" $4,018.38 "	" $1,205.51 "	" $4,520.67 "	" $4,083.67 "	" $4,269.52 "	" $1,195.47 "	" $4,083.67 "	" $1,205.51 "
4400588	HCHG REPLACE PICC W SUBQ PORT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36585	" $6,297.88 "	" $4,408.52 "	" $1,498.90 "	" $5,668.09 "	" $5,479.16 "	" $1,511.49 "	" $4,817.88 "	" $3,786.00 "	" $3,283.00 "	" $1,511.49 "	" $3,967.66 "	" $5,353.20 "	" $4,345.54 "	" $5,038.30 "	" $1,511.49 "	" $5,668.09 "	" $5,120.18 "	" $5,353.20 "	" $1,498.90 "	" $5,120.18 "	" $1,511.49 "
4400591	HCHG REPOSITION VENOUS CATHETER	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36597	" $2,425.06 "	" $1,697.54 "	 $577.16 	" $2,182.55 "	" $2,109.80 "	 $582.01 	" $1,855.17 "	" $2,037.05 "	" $2,037.05 "	 $582.01 	" $1,527.79 "	" $2,061.30 "	" $1,673.29 "	" $1,940.05 "	 $582.01 	" $2,182.55 "	" $1,971.57 "	" $2,061.30 "	 $577.16 	" $1,971.57 "	 $582.01 
4400595	HCHG TIPS REVISION W IMAGING	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37183	" $16,366.74 "	" $11,456.72 "	" $3,283.00 "	" $14,730.07 "	" $14,239.06 "	" $3,928.02 "	" $12,520.56 "	" $3,786.00 "	" $3,283.00 "	" $3,928.02 "	" $10,311.05 "	" $13,911.73 "	" $11,293.05 "	" $13,093.39 "	" $3,928.02 "	" $14,730.07 "	" $13,306.16 "	" $13,911.73 "	" $3,895.28 "	" $13,306.16 "	" $3,928.02 "
4400608	"HCHG SPINAL PUNCTURE,DIAGNOSTIC"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	62270	" $1,660.00 "	" $1,162.00 "	 $395.08 	" $1,494.00 "	" $1,444.20 "	 $398.40 	" $1,269.90 "	" $1,394.40 "	" $1,394.40 "	 $398.40 	" $1,045.80 "	" $1,411.00 "	" $1,145.40 "	" $1,328.00 "	 $398.40 	" $1,494.00 "	" $1,349.58 "	" $1,411.00 "	 $395.08 	" $1,349.58 "	 $398.40 
4400631	HCHG TRANSCATHETER BIOPSY	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37200	" $6,823.53 "	" $4,776.47 "	" $1,624.00 "	" $6,141.18 "	" $5,936.47 "	" $1,637.65 "	" $5,220.00 "	" $3,786.00 "	" $3,283.00 "	" $1,637.65 "	" $4,298.82 "	" $5,800.00 "	" $4,708.24 "	" $5,458.82 "	" $1,637.65 "	" $6,141.18 "	" $5,547.53 "	" $5,800.00 "	" $1,624.00 "	" $5,547.53 "	" $1,637.65 "
4400637	HCHG TUBE THORACOSTOMY INCLUDES WATER SEAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	32551	" $1,280.00 "	 $896.00 	 $304.64 	" $1,152.00 "	" $1,113.60 "	 $307.20 	 $979.20 	" $1,075.20 "	" $1,075.20 "	 $307.20 	 $806.40 	" $1,088.00 "	 $883.20 	" $1,024.00 "	 $307.20 	" $1,152.00 "	" $1,040.64 "	" $1,088.00 "	 $304.64 	" $1,040.64 "	 $307.20 
4400760	HCHG INJ/ASPIR-SMALL JT/BURSA WITH US GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20604	 $931.60 	 $652.12 	 $221.72 	 $838.44 	 $810.49 	 $223.58 	 $712.67 	 $782.54 	 $782.54 	 $230.29 	 $586.91 	 $791.86 	 $642.80 	 $745.28 	 $223.58 	 $838.44 	 $757.39 	 $791.86 	 $221.72 	 $757.39 	 $223.58 
4400807	HCHG INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERCUTANEOUS	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49441	" $5,012.05 "	" $3,508.44 "	" $1,192.87 "	" $4,510.85 "	" $4,360.48 "	" $1,202.89 "	" $3,834.22 "	" $3,786.00 "	" $3,283.00 "	" $1,238.98 "	" $3,157.59 "	" $4,260.24 "	" $3,458.31 "	" $4,009.64 "	" $1,202.89 "	" $4,510.85 "	" $4,074.80 "	" $4,260.24 "	" $1,192.87 "	" $4,074.80 "	" $1,202.89 "
4400808	HCHG INSERT GASTROSTOMY TUBE PERCUTANEOUS	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49440	" $7,217.34 "	" $5,052.14 "	" $1,717.73 "	" $6,495.61 "	" $6,279.09 "	" $1,732.16 "	" $5,521.27 "	" $3,786.00 "	" $3,283.00 "	" $1,784.13 "	" $4,546.92 "	" $6,134.74 "	" $4,979.96 "	" $5,773.87 "	" $1,732.16 "	" $6,495.61 "	" $5,867.70 "	" $6,134.74 "	" $1,717.73 "	" $5,867.70 "	" $1,732.16 "
4400809	HCHG INSERT TUNNELED CV CATH W/O PORT OR PUMP	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36558	" $4,093.26 "	" $2,865.28 "	 $974.20 	" $3,683.93 "	" $3,561.14 "	 $982.38 	" $3,131.34 "	" $3,438.34 "	" $3,283.00 "	" $1,011.85 "	" $2,578.75 "	" $3,479.27 "	" $2,824.35 "	" $3,274.61 "	 $982.38 	" $3,683.93 "	" $3,327.82 "	" $3,479.27 "	 $974.20 	" $3,327.82 "	 $982.38 
4400810	HCHG INSERTION INDWELLING TUNNELED PLEURAL CATHETER	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	32550	" $6,295.00 "	" $4,406.50 "	" $1,498.21 "	" $5,665.50 "	" $5,476.65 "	" $1,510.80 "	" $4,815.68 "	" $3,786.00 "	" $3,283.00 "	" $1,556.12 "	" $3,965.85 "	" $5,350.75 "	" $4,343.55 "	" $5,036.00 "	" $1,510.80 "	" $5,665.50 "	" $5,117.84 "	" $5,350.75 "	" $1,498.21 "	" $5,117.84 "	" $1,510.80 "
4400811	HCHG OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49460	" $1,399.47 "	 $979.63 	 $333.07 	" $1,259.52 "	" $1,217.54 "	 $335.87 	" $1,070.59 "	" $1,175.55 "	" $1,175.55 "	 $335.87 	 $881.67 	" $1,189.55 "	 $965.63 	" $1,119.58 "	 $335.87 	" $1,259.52 "	" $1,137.77 "	" $1,189.55 "	 $333.07 	" $1,137.77 "	 $335.87 
4400818	HCHG REPLACE NONTUNNELED CVC WO SUBQ PORT	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36580	" $6,297.88 "	" $4,408.52 "	" $1,498.90 "	" $5,668.09 "	" $5,479.16 "	" $1,511.49 "	" $4,817.88 "	" $3,786.00 "	" $3,283.00 "	" $1,511.49 "	" $3,967.66 "	" $5,353.20 "	" $4,345.54 "	" $5,038.30 "	" $1,511.49 "	" $5,668.09 "	" $5,120.18 "	" $5,353.20 "	" $1,498.90 "	" $5,120.18 "	" $1,511.49 "
4400835	HCHG ANGIO FEMORAL/POPLITEAL ARTERY UNILATERAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37224	" $13,230.63 "	" $9,261.44 "	" $3,148.89 "	" $11,907.57 "	" $11,510.65 "	" $3,175.35 "	" $10,121.43 "	" $3,786.00 "	" $3,283.00 "	" $3,270.61 "	" $8,335.30 "	" $11,246.04 "	" $9,129.13 "	" $10,584.50 "	" $3,175.35 "	" $11,907.57 "	" $10,756.50 "	" $11,246.04 "	" $3,148.89 "	" $10,756.50 "	" $3,175.35 "
4400855	"HCHG PARACENTESIS, ABD WITH IMAGING"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49083	" $3,500.00 "	" $2,450.00 "	 $833.00 	" $3,150.00 "	" $3,045.00 "	 $840.00 	" $2,677.50 "	" $2,940.00 "	" $2,940.00 "	 $840.00 	" $2,205.00 "	" $2,975.00 "	" $2,415.00 "	" $2,800.00 "	 $840.00 	" $3,150.00 "	" $2,845.50 "	" $2,975.00 "	 $833.00 	" $2,845.50 "	 $840.00 
4400858	HCHG RENAL SELECTIVE UNILATERAL W/WO AORTA	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36251	" $3,863.31 "	" $2,704.32 "	 $919.47 	" $3,476.98 "	" $3,361.08 "	 $927.19 	" $2,955.43 "	" $3,245.18 "	" $3,245.18 "	 $927.19 	" $2,433.89 "	" $3,283.81 "	" $2,665.68 "	" $3,090.65 "	 $927.19 	" $3,476.98 "	" $3,140.87 "	" $3,283.81 "	 $919.47 	" $3,140.87 "	 $927.19 
4400859	HCHG RENAL SELECTIVE BILATERAL W/WO AORTA	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36252	" $4,829.16 "	" $3,380.41 "	" $1,149.34 "	" $4,346.24 "	" $4,201.37 "	" $1,159.00 "	" $3,694.31 "	" $3,786.00 "	" $3,283.00 "	" $1,159.00 "	" $3,042.37 "	" $4,104.79 "	" $3,332.12 "	" $3,863.33 "	" $1,159.00 "	" $4,346.24 "	" $3,926.11 "	" $4,104.79 "	" $1,149.34 "	" $3,926.11 "	" $1,159.00 "
4400860	HCHG RENAL SUPERSELECTIVE UNILATERAL W/WO AORTA	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36253	" $3,863.31 "	" $2,704.32 "	 $919.47 	" $3,476.98 "	" $3,361.08 "	 $927.19 	" $2,955.43 "	" $3,245.18 "	" $3,245.18 "	 $927.19 	" $2,433.89 "	" $3,283.81 "	" $2,665.68 "	" $3,090.65 "	 $927.19 	" $3,476.98 "	" $3,140.87 "	" $3,283.81 "	 $919.47 	" $3,140.87 "	 $927.19 
4400861	HCHG RENAL SUPERSELECTIVE BILATERAL W/WO AORTA	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36254	" $4,829.16 "	" $3,380.41 "	" $1,149.34 "	" $4,346.24 "	" $4,201.37 "	" $1,159.00 "	" $3,694.31 "	" $3,786.00 "	" $3,283.00 "	" $1,159.00 "	" $3,042.37 "	" $4,104.79 "	" $3,332.12 "	" $3,863.33 "	" $1,159.00 "	" $4,346.24 "	" $3,926.11 "	" $4,104.79 "	" $1,149.34 "	" $3,926.11 "	" $1,159.00 "
4400863	HCHG INSERT VENA CAVA FILTER SVC/IVC	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37191	" $7,500.00 "	" $5,250.00 "	" $1,785.00 "	" $6,750.00 "	" $6,525.00 "	" $1,800.00 "	" $5,737.50 "	" $3,786.00 "	" $3,283.00 "	" $1,854.00 "	" $4,725.00 "	" $6,375.00 "	" $5,175.00 "	" $6,000.00 "	" $1,800.00 "	" $6,750.00 "	" $6,097.50 "	" $6,375.00 "	" $1,785.00 "	" $6,097.50 "	" $1,800.00 "
4400882	HCHG INJ/ASPIR-INTERMED JT/BURSA WITH US GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	20606	" $1,950.00 "	" $1,365.00 "	 $464.10 	" $1,755.00 "	" $1,696.50 "	 $468.00 	" $1,491.75 "	" $1,638.00 "	" $1,638.00 "	 $482.04 	" $1,228.50 "	" $1,657.50 "	" $1,345.50 "	" $1,560.00 "	 $468.00 	" $1,755.00 "	" $1,585.35 "	" $1,657.50 "	 $464.10 	" $1,585.35 "	 $468.00 
4400884	HCHG VESSEL INJECTION PROCEDURE UNLISTED	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36299	 $559.76 	 $391.83 	 $133.22 	 $503.78 	 $486.99 	 $134.34 	 $428.22 	 $470.20 	 $470.20 	 $134.34 	 $352.65 	 $475.80 	 $386.23 	 $447.81 	 $134.34 	 $503.78 	 $455.08 	 $475.80 	 $133.22 	 $455.08 	 $134.34 
4400888	"HCHG ENDOVENOUS LASER, 1ST VEIN"	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36478	" $9,205.73 "	" $6,444.01 "	" $2,190.96 "	" $8,285.16 "	" $8,008.99 "	" $2,209.38 "	" $7,042.38 "	" $3,786.00 "	" $3,283.00 "	" $2,275.66 "	" $5,799.61 "	" $7,824.87 "	" $6,351.95 "	" $7,364.58 "	" $2,209.38 "	" $8,285.16 "	" $7,484.26 "	" $7,824.87 "	" $2,190.96 "	" $7,484.26 "	" $2,209.38 "
4400889	HCHG ENDOVENOUS LASER VEIN ADDON	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36479	" $9,205.73 "	" $6,444.01 "	" $2,190.96 "	" $8,285.16 "	" $8,008.99 "	" $2,209.38 "	" $7,042.38 "	" $3,786.00 "	" $3,283.00 "	" $2,275.66 "	" $5,799.61 "	" $7,824.87 "	" $6,351.95 "	" $7,364.58 "	" $2,209.38 "	" $8,285.16 "	" $7,484.26 "	" $7,824.87 "	" $2,190.96 "	" $7,484.26 "	" $2,209.38 "
4400890	HCHG INSERT TUNNELED CV CATH	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	36563	" $6,275.94 "	" $4,393.16 "	" $1,493.67 "	" $5,648.35 "	" $5,460.07 "	" $1,506.23 "	" $4,801.09 "	" $3,786.00 "	" $3,283.00 "	" $1,551.41 "	" $3,953.84 "	" $5,334.55 "	" $4,330.40 "	" $5,020.75 "	" $1,506.23 "	" $5,648.35 "	" $5,102.34 "	" $5,334.55 "	" $1,493.67 "	" $5,102.34 "	" $1,506.23 "
4400926	HCHG DX BONE MARROW ASPIRATIONS	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	38220	 $720.00 	 $504.00 	 $171.36 	 $648.00 	 $626.40 	 $172.80 	 $550.80 	 $604.80 	 $604.80 	 $177.98 	 $453.60 	 $612.00 	 $496.80 	 $576.00 	 $172.80 	 $648.00 	 $585.36 	 $612.00 	 $171.36 	 $585.36 	 $172.80 
4400928	HCHG INSERT CATH PLEURA W/IG	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	32557	" $1,910.00 "	" $1,337.00 "	 $454.58 	" $1,719.00 "	" $1,661.70 "	 $458.40 	" $1,461.15 "	" $1,604.40 "	" $1,604.40 "	 $472.15 	" $1,203.30 "	" $1,623.50 "	" $1,317.90 "	" $1,528.00 "	 $458.40 	" $1,719.00 "	" $1,552.83 "	" $1,623.50 "	 $454.58 	" $1,552.83 "	 $458.40 
4401628	HCHG BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	27040	" $2,178.00 "	" $1,524.60 "	 $518.36 	" $1,960.20 "	" $1,894.86 "	 $522.72 	" $1,666.17 "	" $1,829.52 "	" $1,829.52 "	 $538.40 	" $1,372.14 "	" $1,851.30 "	" $1,502.82 "	" $1,742.40 "	 $522.72 	" $1,960.20 "	" $1,770.71 "	" $1,851.30 "	 $518.36 	" $1,770.71 "	 $522.72 
4401629	HCHG BIOPSY SOFT TISSUE PELVIS&HIP AREA DEEP/SUBFSCAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	27041	" $3,641.00 "	" $2,548.70 "	 $866.56 	" $3,276.90 "	" $3,167.67 "	 $873.84 	" $2,785.37 "	" $3,058.44 "	" $3,058.44 "	 $900.06 	" $2,293.83 "	" $3,094.85 "	" $2,512.29 "	" $2,912.80 "	 $873.84 	" $3,276.90 "	" $2,960.13 "	" $3,094.85 "	 $866.56 	" $2,960.13 "	 $873.84 
4410488	HCHG THORACENTESIS WITH IMAGING GUIDANCE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	32555	" $2,160.00 "	" $1,512.00 "	 $514.08 	" $1,944.00 "	" $1,879.20 "	 $518.40 	" $1,652.40 "	" $1,814.40 "	" $1,814.40 "	 $518.40 	" $1,360.80 "	" $1,836.00 "	" $1,490.40 "	" $1,728.00 "	 $518.40 	" $1,944.00 "	" $1,756.08 "	" $1,836.00 "	 $514.08 	" $1,756.08 "	 $518.40 
4410539	HCHG ARTERIAL STENT OPEN PERQ INITIAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37236	" $21,642.05 "	" $15,149.44 "	" $3,283.00 "	" $19,477.85 "	" $18,828.58 "	" $5,194.09 "	" $16,556.17 "	" $3,786.00 "	" $3,283.00 "	" $5,349.91 "	" $13,634.49 "	" $18,395.74 "	" $14,933.01 "	" $17,313.64 "	" $5,194.09 "	" $19,477.85 "	" $17,594.99 "	" $18,395.74 "	" $5,150.81 "	" $17,594.99 "	" $5,194.09 "
4410541	HCHG ARTERIAL STENT OPEN PERQ EA ADDL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37237	" $10,821.02 "	" $7,574.71 "	" $2,575.40 "	" $9,738.92 "	" $9,414.29 "	" $2,597.04 "	" $8,278.08 "	" $3,786.00 "	" $3,283.00 "	" $2,674.96 "	" $6,817.24 "	" $9,197.87 "	" $7,466.50 "	" $8,656.82 "	" $2,597.04 "	" $9,738.92 "	" $8,797.49 "	" $9,197.87 "	" $2,575.40 "	" $8,797.49 "	" $2,597.04 "
4410542	HCHG VENOUS STENT OPEN PERQ INITIAL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37238	" $21,642.05 "	" $15,149.44 "	" $3,283.00 "	" $19,477.85 "	" $18,828.58 "	" $5,194.09 "	" $16,556.17 "	" $3,786.00 "	" $3,283.00 "	" $5,194.09 "	" $13,634.49 "	" $18,395.74 "	" $14,933.01 "	" $17,313.64 "	" $5,194.09 "	" $19,477.85 "	" $17,594.99 "	" $18,395.74 "	" $5,150.81 "	" $17,594.99 "	" $5,194.09 "
4410544	HCHG VENOUS STENT OPEN PERQ EA ADDL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37239	" $10,821.02 "	" $7,574.71 "	" $2,575.40 "	" $9,738.92 "	" $9,414.29 "	" $2,597.04 "	" $8,278.08 "	" $3,786.00 "	" $3,283.00 "	" $2,597.04 "	" $6,817.24 "	" $9,197.87 "	" $7,466.50 "	" $8,656.82 "	" $2,597.04 "	" $9,738.92 "	" $8,797.49 "	" $9,197.87 "	" $2,575.40 "	" $8,797.49 "	" $2,597.04 "
4410545	HCHG VASC EMBOLIZE/OCCLUDE VENOUS	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37241	" $7,259.40 "	" $5,081.58 "	" $1,727.74 "	" $6,533.46 "	" $6,315.68 "	" $1,742.26 "	" $5,553.44 "	" $3,786.00 "	" $3,283.00 "	" $1,742.26 "	" $4,573.42 "	" $6,170.49 "	" $5,008.99 "	" $5,807.52 "	" $1,742.26 "	" $6,533.46 "	" $5,901.89 "	" $6,170.49 "	" $1,727.74 "	" $5,901.89 "	" $1,742.26 "
4410546	HCHG VASC EMBOLIZE/OCCLUDE ARTERY	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37242	" $7,259.40 "	" $5,081.58 "	" $1,727.74 "	" $6,533.46 "	" $6,315.68 "	" $1,742.26 "	" $5,553.44 "	" $3,786.00 "	" $3,283.00 "	" $1,742.26 "	" $4,573.42 "	" $6,170.49 "	" $5,008.99 "	" $5,807.52 "	" $1,742.26 "	" $6,533.46 "	" $5,901.89 "	" $6,170.49 "	" $1,727.74 "	" $5,901.89 "	" $1,742.26 "
4410547	HCHG VASC EMBOLIZE/OCCLUDE ORGAN	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37243	" $7,259.40 "	" $5,081.58 "	" $1,727.74 "	" $6,533.46 "	" $6,315.68 "	" $1,742.26 "	" $5,553.44 "	" $3,786.00 "	" $3,283.00 "	" $1,742.26 "	" $4,573.42 "	" $6,170.49 "	" $5,008.99 "	" $5,807.52 "	" $1,742.26 "	" $6,533.46 "	" $5,901.89 "	" $6,170.49 "	" $1,727.74 "	" $5,901.89 "	" $1,742.26 "
4410548	HCHG VASC EMBOLIZE/OCCLUDE BLEED	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	37244	" $7,259.40 "	" $5,081.58 "	" $1,727.74 "	" $6,533.46 "	" $6,315.68 "	" $1,742.26 "	" $5,553.44 "	" $3,786.00 "	" $3,283.00 "	" $1,742.26 "	" $4,573.42 "	" $6,170.49 "	" $5,008.99 "	" $5,807.52 "	" $1,742.26 "	" $6,533.46 "	" $5,901.89 "	" $6,170.49 "	" $1,727.74 "	" $5,901.89 "	" $1,742.26 "
4410550	HCHG IMAGE CATH FLUID COLXN VISC	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49405	" $2,594.00 "	" $1,815.80 "	 $617.37 	" $2,334.60 "	" $2,256.78 "	 $622.56 	" $1,984.41 "	" $2,178.96 "	" $2,178.96 "	 $641.24 	" $1,634.22 "	" $2,204.90 "	" $1,789.86 "	" $2,075.20 "	 $622.56 	" $2,334.60 "	" $2,108.92 "	" $2,204.90 "	 $617.37 	" $2,108.92 "	 $622.56 
4410551	HCHG IMAGE CATH FLUID PERI/RETRO	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49406	" $3,999.04 "	" $2,799.33 "	 $951.77 	" $3,599.14 "	" $3,479.16 "	 $959.77 	" $3,059.27 "	" $3,359.19 "	" $3,283.00 "	 $988.56 	" $2,519.40 "	" $3,399.18 "	" $2,759.34 "	" $3,199.23 "	 $959.77 	" $3,599.14 "	" $3,251.22 "	" $3,399.18 "	 $951.77 	" $3,251.22 "	 $959.77 
4410552	HCHG IMAGE CATH FLUID TRNS/VGNL	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	49407	" $4,910.50 "	" $3,437.35 "	" $1,168.70 "	" $4,419.45 "	" $4,272.14 "	" $1,178.52 "	" $3,756.53 "	" $3,786.00 "	" $3,283.00 "	" $1,213.88 "	" $3,093.62 "	" $4,173.93 "	" $3,388.25 "	" $3,928.40 "	" $1,178.52 "	" $4,419.45 "	" $3,992.24 "	" $4,173.93 "	" $1,168.70 "	" $3,992.24 "	" $1,178.52 "
4410574	HCHG FNA BIOPSY W US GUIDE 1ST LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10005	" $1,910.00 "	" $1,337.00 "	 $454.58 	" $1,719.00 "	" $1,661.70 "	 $458.40 	" $1,461.15 "	" $1,604.40 "	" $1,604.40 "	 $472.15 	" $1,203.30 "	" $1,623.50 "	" $1,317.90 "	" $1,528.00 "	 $458.40 	" $1,719.00 "	" $1,552.83 "	" $1,623.50 "	 $454.58 	" $1,552.83 "	 $458.40 
4410575	HCHG FNA BIOPSY W US GUIDE EA ADD LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10006	 $730.00 	 $511.00 	 $173.74 	 $657.00 	 $635.10 	 $175.20 	 $558.45 	 $613.20 	 $613.20 	 $180.46 	 $459.90 	 $620.50 	 $503.70 	 $584.00 	 $175.20 	 $657.00 	 $593.49 	 $620.50 	 $173.74 	 $593.49 	 $175.20 
4410576	HCHG FNA BIOPSY W FLUORO 1ST LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10007	" $1,449.00 "	" $1,014.30 "	 $344.86 	" $1,304.10 "	" $1,260.63 "	 $347.76 	" $1,108.49 "	" $1,217.16 "	" $1,217.16 "	 $358.19 	 $912.87 	" $1,231.65 "	 $999.81 	" $1,159.20 "	 $347.76 	" $1,304.10 "	" $1,178.04 "	" $1,231.65 "	 $344.86 	" $1,178.04 "	 $347.76 
4410577	HCHG FNA BIOPSY W FLUORO EA ADD LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10008	 $725.00 	 $507.50 	 $172.55 	 $652.50 	 $630.75 	 $174.00 	 $554.63 	 $609.00 	 $609.00 	 $179.22 	 $456.75 	 $616.25 	 $500.25 	 $580.00 	 $174.00 	 $652.50 	 $589.43 	 $616.25 	 $172.55 	 $589.43 	 $174.00 
4410578	HCHG FNA BIOPSY W CT GUIDE 1ST LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10009	" $1,449.00 "	" $1,014.30 "	 $344.86 	" $1,304.10 "	" $1,260.63 "	 $347.76 	" $1,108.49 "	" $1,217.16 "	" $1,217.16 "	 $358.19 	 $912.87 	" $1,231.65 "	 $999.81 	" $1,159.20 "	 $347.76 	" $1,304.10 "	" $1,178.04 "	" $1,231.65 "	 $344.86 	" $1,178.04 "	 $347.76 
4410579	HCHG FNA BIOPSY W CT GUIDE EA ADD LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10010	 $725.00 	 $507.50 	 $172.55 	 $652.50 	 $630.75 	 $174.00 	 $554.63 	 $609.00 	 $609.00 	 $179.22 	 $456.75 	 $616.25 	 $500.25 	 $580.00 	 $174.00 	 $652.50 	 $589.43 	 $616.25 	 $172.55 	 $589.43 	 $174.00 
4410580	HCHG FNA BIOPSY W MRI 1ST LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10011	" $1,449.00 "	" $1,014.30 "	 $344.86 	" $1,304.10 "	" $1,260.63 "	 $347.76 	" $1,108.49 "	" $1,217.16 "	" $1,217.16 "	 $358.19 	 $912.87 	" $1,231.65 "	 $999.81 	" $1,159.20 "	 $347.76 	" $1,304.10 "	" $1,178.04 "	" $1,231.65 "	 $344.86 	" $1,178.04 "	 $347.76 
4410581	HCHG FNA BIOPSY W MRI EA ADD LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	10012	 $725.00 	 $507.50 	 $172.55 	 $652.50 	 $630.75 	 $174.00 	 $554.63 	 $609.00 	 $609.00 	 $179.22 	 $456.75 	 $616.25 	 $500.25 	 $580.00 	 $174.00 	 $652.50 	 $589.43 	 $616.25 	 $172.55 	 $589.43 	 $174.00 
4410621	HCHG CORE BX LUNG MEDIASTINUM W/GUIDE	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	32408	" $1,300.00 "	 $910.00 	 $309.40 	" $1,170.00 "	" $1,131.00 "	 $312.00 	 $994.50 	" $1,092.00 "	" $1,092.00 "	 $321.36 	 $819.00 	" $1,105.00 "	 $897.00 	" $1,040.00 "	 $312.00 	" $1,170.00 "	" $1,056.90 "	" $1,105.00 "	 $309.40 	" $1,056.90 "	 $312.00 
503414	HCHG DX BONE MARROW BIOPSIES & ASPIRATIONS	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	38222	" $2,229.75 "	" $1,560.83 "	 $530.68 	" $2,006.78 "	" $1,939.88 "	 $535.14 	" $1,705.76 "	" $1,872.99 "	" $1,872.99 "	 $551.19 	" $1,404.74 "	" $1,895.29 "	" $1,538.53 "	" $1,783.80 "	 $535.14 	" $2,006.78 "	" $1,812.79 "	" $1,895.29 "	 $530.68 	" $1,812.79 "	 $535.14 
503427	HCHG TANGENTIAL SKIN BX SINGLE LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11102	 $442.00 	 $309.40 	 $105.20 	 $397.80 	 $384.54 	 $106.08 	 $338.13 	 $371.28 	 $371.28 	 $106.08 	 $278.46 	 $375.70 	 $304.98 	 $353.60 	 $106.08 	 $397.80 	 $359.35 	 $375.70 	 $105.20 	 $359.35 	 $106.08 
503429	HCHG PUNCH BIOPSY OF SKIN SINGLE LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11104	 $442.00 	 $309.40 	 $105.20 	 $397.80 	 $384.54 	 $106.08 	 $338.13 	 $371.28 	 $371.28 	 $106.08 	 $278.46 	 $375.70 	 $304.98 	 $353.60 	 $106.08 	 $397.80 	 $359.35 	 $375.70 	 $105.20 	 $359.35 	 $106.08 
503431	HCHG INCISIONAL BX OF SKIN SINGLE LESION	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	11106	" $1,600.00 "	" $1,120.00 "	 $380.80 	" $1,440.00 "	" $1,392.00 "	 $384.00 	" $1,224.00 "	" $1,344.00 "	" $1,344.00 "	 $395.52 	" $1,008.00 "	" $1,360.00 "	" $1,104.00 "	" $1,280.00 "	 $384.00 	" $1,440.00 "	" $1,300.80 "	" $1,360.00 "	 $380.80 	" $1,300.80 "	 $384.00 
503452	HCHG INJ CONTRAST KNEE RAD CT MRI ARTHO	0761	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - TREATMENT ROOM	27369	 $630.00 	 $441.00 	 $149.94 	 $567.00 	 $548.10 	 $151.20 	 $481.95 	 $529.20 	 $529.20 	 $155.74 	 $396.90 	 $535.50 	 $434.70 	 $504.00 	 $151.20 	 $567.00 	 $512.19 	 $535.50 	 $149.94 	 $512.19 	 $151.20 
309191	HCHG DIRECT ADMIT HOSPITAL OBSERV	0762	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - OBSERVATION ROOM (A)	G0379	 $297.36 	 $208.15 	 $70.77 	 $267.62 	 $258.70 	 $71.37 	 $227.48 	 $249.78 	 $249.78 	 $73.51 	 $187.34 	 $252.76 	 $205.18 	 $237.89 	 $71.37 	 $267.62 	 $241.75 	 $252.76 	 $70.77 	 $241.75 	 $71.37 
770025	HCHG ROOM/CARE - OBSERVATION HOUR *	0762	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - OBSERVATION ROOM (A)	G0378	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $28.80 	 $75.60 	 $102.00 	 $86.40 	 $97.20 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
770026	HCHG CVMC ROOM/CARE - OBS 1ST HR	0762	SPECIALTY ROOM - TREATMENT/OBSERVATION ROOM - OBSERVATION ROOM (A)	G0378	 $310.00 	 $217.00 	 $73.78 	 $279.00 	 $269.70 	 $74.40 	 $237.15 	 $260.40 	 $260.40 	 $76.63 	 $195.30 	 $263.50 	 $223.20 	 $251.10 	 $74.40 	 $279.00 	 $252.03 	 $263.50 	 $73.78 	 $252.03 	 $74.40 
306479	HCHG PAP SMEAR OBTAIN/PREP	0770	PREVENTIVE CARE SERVICES - GENERAL CLASSIFICATION	Q0091	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.20 	 $50.40 	 $68.00 	 $55.20 	 $64.00 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
304032	HCHG PFIZER COVID ADMIN 1ST DOSE	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	0001A	 $50.82 	 $35.57 	 $12.10 	 $45.74 	 $44.21 	 $12.20 	 $38.88 	 $42.69 	 $42.69 	 $12.20 	 $32.02 	 $43.20 	 $35.07 	 $40.66 	 $12.20 	 $45.74 	 $41.32 	 $43.20 	 $12.10 	 $41.32 	 $12.20 
304033	HCHG PFIZER COVID ADMIN 2ND DOSE	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	0002A	 $85.17 	 $59.62 	 $20.27 	 $76.65 	 $74.10 	 $20.44 	 $65.16 	 $71.54 	 $71.54 	 $20.44 	 $53.66 	 $72.39 	 $58.77 	 $68.14 	 $20.44 	 $76.65 	 $69.24 	 $72.39 	 $20.27 	 $69.24 	 $20.44 
304034	HCHG MODERNA COVID ADMIN 1ST DOSE	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	0011A	 $50.82 	 $35.57 	 $12.10 	 $45.74 	 $44.21 	 $12.20 	 $38.88 	 $42.69 	 $42.69 	 $12.20 	 $32.02 	 $43.20 	 $35.07 	 $40.66 	 $12.20 	 $45.74 	 $41.32 	 $43.20 	 $12.10 	 $41.32 	 $12.20 
304035	HCHG MODERNA COVID ADMIN 2ND DOSE	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	0012A	 $85.17 	 $59.62 	 $20.27 	 $76.65 	 $74.10 	 $20.44 	 $65.16 	 $71.54 	 $71.54 	 $20.44 	 $53.66 	 $72.39 	 $58.77 	 $68.14 	 $20.44 	 $76.65 	 $69.24 	 $72.39 	 $20.27 	 $69.24 	 $20.44 
304057	HCHG PFIZER COVID ADMIN 3RD DOSE	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	0003A	 $85.17 	 $59.62 	 $20.27 	 $76.65 	 $74.10 	 $20.44 	 $65.16 	 $71.54 	 $71.54 	 $20.44 	 $53.66 	 $72.39 	 $58.77 	 $68.14 	 $20.44 	 $76.65 	 $69.24 	 $72.39 	 $20.27 	 $69.24 	 $20.44 
304058	HCHG MODERNA COVID ADMIN 3RD DOSE	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	0013A	 $85.17 	 $59.62 	 $20.27 	 $76.65 	 $74.10 	 $20.44 	 $65.16 	 $71.54 	 $71.54 	 $20.44 	 $53.66 	 $72.39 	 $58.77 	 $68.14 	 $20.44 	 $76.65 	 $69.24 	 $72.39 	 $20.27 	 $69.24 	 $20.44 
304081	HCHG INFLUENZA ADMINISTRATION	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	90471	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $82.80 	 $96.00 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
304130	HCHG TIXAGEVIMAB/CILGAVIMAB ADMINISTRATION	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	M0220	 $900.00 	 $630.00 	 $214.20 	 $810.00 	 $783.00 	 $216.00 	 $688.50 	 $756.00 	 $756.00 	 $216.00 	 $567.00 	 $765.00 	 $621.00 	 $720.00 	 $216.00 	 $810.00 	 $731.70 	 $765.00 	 $214.20 	 $731.70 	 $216.00 
304805	HCHG PNEUMOCOCCAL ADMINISTRATION	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	90471	 $50.00 	 $35.00 	 $11.90 	 $45.00 	 $43.50 	 $12.00 	 $38.25 	 $42.00 	 $42.00 	 $12.00 	 $31.50 	 $42.50 	 $34.50 	 $40.00 	 $12.00 	 $45.00 	 $40.65 	 $42.50 	 $11.90 	 $40.65 	 $12.00 
306375	HCHG IMMUNIZATION ADMINISTRATION	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	90471	 $120.00 	 $84.00 	 $28.56 	 $108.00 	 $104.40 	 $28.80 	 $91.80 	 $100.80 	 $100.80 	 $29.66 	 $75.60 	 $102.00 	 $82.80 	 $96.00 	 $28.80 	 $108.00 	 $97.56 	 $102.00 	 $28.56 	 $97.56 	 $28.80 
309027	"HCHG BMH/CVMC IMMUNIZATION ADMIN, EACH ADD"	0771	PREVENTIVE CARE SERVICES - VACCINE ADMINISTRATION	90472	 $80.00 	 $56.00 	 $19.04 	 $72.00 	 $69.60 	 $19.20 	 $61.20 	 $67.20 	 $67.20 	 $19.78 	 $50.40 	 $68.00 	 $55.20 	 $64.00 	 $19.20 	 $72.00 	 $65.04 	 $68.00 	 $19.04 	 $65.04 	 $19.20 
309536	HCHG TELEHEALTH ORIGINATING SITE FACILITY FEE	0780	TELEMEDICINE - GENERAL CLASSIFICATION	Q3014	 $90.00 	 $63.00 	 $21.42 	 $81.00 	 $78.30 	 $21.60 	 $68.85 	 $75.60 	 $75.60 	 $21.60 	 $56.70 	 $76.50 	 $62.10 	 $72.00 	 $21.60 	 $81.00 	 $73.17 	 $76.50 	 $21.42 	 $73.17 	 $21.60 
310390	HCHG PSYTX COMPLEX INTERACTIVE	0900	BEHAVIORAL HEALTH TREATMENTS/SERVICES - GENERAL CLASSIFICATION	90785	 $89.00 	 $62.30 	 $16.56 	 $80.10 	 $77.43 	 $21.36 	 $68.09 	 $17.69 	 $17.69 	 $21.36 	 $62.30 	 $75.65 	 $16.56 	 $16.56 	 $21.36 	 $80.10 	 $72.36 	 $75.65 	 $21.18 	 $72.36 	 $21.36 
343249	HCHG CVMC PSYCH DIAGNOSTIC EVALUATION	0900	BEHAVIORAL HEALTH TREATMENTS/SERVICES - GENERAL CLASSIFICATION	90791	 $440.00 	 $308.00 	 $104.72 	 $396.00 	 $382.80 	 $105.60 	 $336.60 	 $166.92 	 $166.92 	 $108.77 	 $240.00 	 $374.00 	 $188.91 	 $188.91 	 $105.60 	 $396.00 	 $357.72 	 $374.00 	 $104.72 	 $357.72 	 $105.60 
343246	HCHG CVMC PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES	0900	BEHAVIORAL HEALTH TREATMENTS/SERVICES - GENERAL CLASSIFICATION	90792	 $410.00 	 $287.00 	 $97.58 	 $369.00 	 $356.70 	 $98.40 	 $313.65 	 $187.34 	 $187.34 	 $101.35 	 $300.00 	 $348.50 	 $282.90 	 $328.00 	 $98.40 	 $369.00 	 $333.33 	 $348.50 	 $97.58 	 $333.33 	 $98.40 
310092	HCHG PSYCHIATRIC SERVICE/THERAPY	0900	BEHAVIORAL HEALTH TREATMENTS/SERVICES - GENERAL CLASSIFICATION	90899	 $165.00 	 $115.50 	 $-   	 $148.50 	 $143.55 	 $39.60 	 $126.23 	 $-   	 $-   	 $39.60 	 $115.50 	 $140.25 	 $115.50 	 $115.50 	 $39.60 	 $148.50 	 $134.15 	 $140.25 	 $39.27 	 $134.15 	 $39.60 
304684	HCHG IOP FAMILY THERAPY W/O PT	0905	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INTENSIVE OUTPATIENT SERVICES - PSYCHIATRIC	90846	 $410.00 	 $287.00 	 $97.58 	 $369.00 	 $356.70 	 $98.40 	 $313.65 	 $130.64 	 $130.64 	 $101.35 	 $125.00 	 $348.50 	 $119.33 	 $119.33 	 $98.40 	 $369.00 	 $333.33 	 $265.00 	 $97.58 	 $333.33 	 $98.40 
306349	HCHG IOP GROUP THERAPY-CD	0906	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INTENSIVE OUTPATIENT SERVICES - CHEMICAL DEPENDENCY	90853	 $290.00 	 $203.00 	 $29.31 	 $265.00 	 $252.30 	 $69.60 	 $221.85 	 $32.66 	 $32.66 	 $71.69 	 $100.00 	 $246.50 	 $29.31 	 $29.31 	 $69.60 	 $261.00 	 $235.77 	 $265.00 	 $69.02 	 $235.77 	 $69.60 
304782	HCHG PHP FAMILY THERAPY W/ PATIENT	0912	BEHAVIORAL HEALTH TREATMENTS/SERVICES - PARTIAL HOSPITALIZATION - LESS INTENSIVE	90847	 $390.00 	 $273.00 	 $92.82 	 $351.00 	 $339.30 	 $93.60 	 $298.35 	 $135.63 	 $135.63 	 $93.60 	 $150.00 	 $331.50 	 $124.40 	 $124.40 	 $93.60 	 $351.00 	 $317.07 	 $331.50 	 $92.82 	 $317.07 	 $93.60 
343248	"HCHG CVMC PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY MEM"	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	90832	 $410.00 	 $287.00 	 $81.20 	 $369.00 	 $356.70 	 $98.40 	 $313.65 	 $81.20 	 $81.20 	 $101.35 	 $85.00 	 $348.50 	 $282.90 	 $328.00 	 $98.40 	 $369.00 	 $333.33 	 $348.50 	 $97.58 	 $333.33 	 $98.40 
331004	HCHG PSYCHOTHERAPY PT&/FAM W/E&M 30 MIN	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	90833	 $190.00 	 $133.00 	 $45.22 	 $171.00 	 $165.30 	 $45.60 	 $145.35 	 $84.37 	 $84.37 	 $45.60 	 $85.00 	 $161.50 	 $77.76 	 $77.76 	 $45.60 	 $171.00 	 $154.47 	 $161.50 	 $45.22 	 $154.47 	 $45.60 
343247	"HCHG CVMC PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY MEM"	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	90834	 $300.00 	 $210.00 	 $71.40 	 $270.00 	 $261.00 	 $72.00 	 $229.50 	 $107.96 	 $107.96 	 $74.16 	 $125.00 	 $255.00 	 $110.39 	 $110.39 	 $72.00 	 $270.00 	 $243.90 	 $255.00 	 $71.40 	 $243.90 	 $72.00 
331009	HCHG PSYCHOTHERAPY PT&/FAM W/E&M 45 MIN	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	90836	 $240.00 	 $168.00 	 $57.12 	 $216.00 	 $208.80 	 $57.60 	 $183.60 	 $106.60 	 $106.60 	 $57.60 	 $135.00 	 $204.00 	 $98.60 	 $98.60 	 $57.60 	 $216.00 	 $195.12 	 $204.00 	 $57.12 	 $195.12 	 $57.60 
343250	"HCHG CVMC PSYCHOTHERAPY, 60 MINUTES WITH PATIENT AND/OR FAMILY MEM"	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	90837	 $450.00 	 $315.00 	 $107.10 	 $405.00 	 $391.50 	 $108.00 	 $344.25 	 $161.94 	 $161.94 	 $111.24 	 $160.00 	 $382.50 	 $162.15 	 $162.15 	 $108.00 	 $405.00 	 $365.85 	 $382.50 	 $107.10 	 $365.85 	 $108.00 
302795	HCHG PSYCHOTHERAPY CRISIS 60 MIN (AT)	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	90839	 $410.00 	 $287.00 	 $97.58 	 $369.00 	 $356.70 	 $98.40 	 $313.65 	 $169.19 	 $169.19 	 $98.40 	 $190.00 	 $348.50 	 $156.73 	 $156.73 	 $98.40 	 $369.00 	 $333.33 	 $348.50 	 $97.58 	 $333.33 	 $98.40 
302797	HCHG PSYCHOTHERAPY CRISIS ADD 30 MN (AT)	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	90840	 $175.00 	 $122.50 	 $41.65 	 $157.50 	 $152.25 	 $42.00 	 $133.88 	 $80.74 	 $80.74 	 $42.00 	 $85.00 	 $148.75 	 $78.70 	 $78.70 	 $42.00 	 $157.50 	 $142.28 	 $148.75 	 $41.65 	 $142.28 	 $42.00 
305185	HCHG PRVNT MED COUNSEL/RISK FACTR 60MIN	0914	BEHAVIORAL HEALTH TREATMENTS/SERVICES - INDIVIDUAL THERAPY	99404	 $195.00 	 $136.50 	 $46.41 	 $175.50 	 $169.65 	 $46.80 	 $149.18 	 $142.43 	 $142.43 	 $46.80 	 $150.00 	 $165.75 	 $136.50 	 $136.50 	 $46.80 	 $175.50 	 $158.54 	 $165.75 	 $46.41 	 $158.54 	 $46.80 
343149	HCHG COGNITIVE TEST BY HC PRO	0918	BEHAVIORAL HEALTH TREATMENTS/SERVICES - TESTING	96125	 $340.00 	 $238.00 	 $80.92 	 $306.00 	 $295.80 	 $81.60 	 $260.10 	 $148.78 	 $148.78 	 $84.05 	 $306.00 	 $289.00 	 $129.45 	 $129.45 	 $81.60 	 $306.00 	 $276.42 	 $289.00 	 $80.92 	 $276.42 	 $81.60 
503472	HCHG PSYCH NEUR TEST AUTOMATED	0918	BEHAVIORAL HEALTH TREATMENTS/SERVICES - TESTING	96146	 $260.00 	 $182.00 	 $2.72 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $2.72 	 $2.72 	 $62.40 	 $182.00 	 $221.00 	 $3.01 	 $3.01 	 $62.40 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $62.40 
304300	HCHG LE ARTERIAL STRESS EXAM	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93924	" $1,466.24 "	" $1,026.37 "	 $348.97 	" $1,319.62 "	" $1,275.63 "	 $351.90 	" $1,121.67 "	" $1,231.64 "	" $1,231.64 "	 $351.90 	 $923.73 	" $1,246.30 "	" $1,011.71 "	" $1,172.99 "	 $351.90 	" $1,319.62 "	" $1,192.05 "	" $1,246.30 "	 $348.97 	" $1,192.05 "	 $351.90 
309110	HCHG CVMC INJ THERAPUTIC/PROPHLACTIC/DX	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	96379	 $179.55 	 $125.69 	 $42.73 	 $161.60 	 $156.21 	 $43.09 	 $137.36 	 $150.82 	 $150.82 	 $44.38 	 $113.12 	 $152.62 	 $123.89 	 $143.64 	 $43.09 	 $161.60 	 $145.97 	 $152.62 	 $42.73 	 $145.97 	 $43.09 
310111	HCHG CVMC ARTERIAL PUNCTURE FLOOR	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	36600	 $176.46 	 $123.52 	 $42.00 	 $158.81 	 $153.52 	 $42.35 	 $134.99 	 $148.23 	 $148.23 	 $43.62 	 $111.17 	 $149.99 	 $121.76 	 $141.17 	 $42.35 	 $158.81 	 $143.46 	 $149.99 	 $42.00 	 $143.46 	 $42.35 
343163	HCHG SLEEP STUDY UNATND W/ANALYSIS	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95801	 $660.00 	 $462.00 	 $157.08 	 $594.00 	 $574.20 	 $158.40 	 $504.90 	 $554.40 	 $554.40 	 $158.40 	 $415.80 	 $561.00 	 $455.40 	 $528.00 	 $158.40 	 $594.00 	 $536.58 	 $561.00 	 $157.08 	 $536.58 	 $158.40 
4400297	"HCHG DUPLEX ABD/PEL VASC STUDY,COMPLETE"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93975	" $1,470.00 "	" $1,029.00 "	 $349.86 	" $1,323.00 "	" $1,278.90 "	 $352.80 	" $1,124.55 "	" $1,234.80 "	" $1,234.80 "	 $363.38 	 $926.10 	" $1,249.50 "	" $1,014.30 "	" $1,176.00 "	 $352.80 	" $1,323.00 "	" $1,195.11 "	" $1,249.50 "	 $349.86 	" $1,195.11 "	 $352.80 
4400299	"HCHG DUPLEX EXTREM VENOUS,BILAT"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93970	" $1,270.00 "	 $889.00 	 $302.26 	" $1,143.00 "	" $1,104.90 "	 $304.80 	 $971.55 	" $1,066.80 "	" $1,066.80 "	 $313.94 	 $800.10 	" $1,079.50 "	 $876.30 	" $1,016.00 "	 $304.80 	" $1,143.00 "	" $1,032.51 "	" $1,079.50 "	 $302.26 	" $1,032.51 "	 $304.80 
4400300	"HCHG DUPLEX EXTREM VENOUS,UNI OR LTD"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93971	" $1,000.00 "	 $700.00 	 $238.00 	 $900.00 	 $870.00 	 $240.00 	 $765.00 	 $840.00 	 $840.00 	 $247.20 	 $630.00 	 $850.00 	 $690.00 	 $800.00 	 $240.00 	 $900.00 	 $813.00 	 $850.00 	 $238.00 	 $813.00 	 $240.00 
4400301	HCHG DUPLEX HEMODIALYSIS ACCESS	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93990	 $894.72 	 $626.30 	 $212.94 	 $805.25 	 $778.41 	 $214.73 	 $684.46 	 $751.56 	 $751.56 	 $221.17 	 $563.67 	 $760.51 	 $617.36 	 $715.78 	 $214.73 	 $805.25 	 $727.41 	 $760.51 	 $212.94 	 $727.41 	 $214.73 
4400302	"HCHG DUPLEX LARGE VESSEL(S),COMPLETE"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93978	" $2,200.00 "	" $1,540.00 "	 $523.60 	" $1,980.00 "	" $1,914.00 "	 $528.00 	" $1,683.00 "	" $1,848.00 "	" $1,848.00 "	 $543.84 	" $1,386.00 "	" $1,870.00 "	" $1,518.00 "	" $1,760.00 "	 $528.00 	" $1,980.00 "	" $1,788.60 "	" $1,870.00 "	 $523.60 	" $1,788.60 "	 $528.00 
4400303	"HCHG DUPLEX LARGE VESSEL(S),LIMITED"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93979	 $670.00 	 $469.00 	 $159.46 	 $603.00 	 $582.90 	 $160.80 	 $512.55 	 $562.80 	 $562.80 	 $165.62 	 $422.10 	 $569.50 	 $462.30 	 $536.00 	 $160.80 	 $603.00 	 $544.71 	 $569.50 	 $159.46 	 $544.71 	 $160.80 
4400304	HCHG DUPLEX LO EXTREM ART BILAT	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93925	" $1,120.00 "	 $784.00 	 $266.56 	" $1,008.00 "	 $974.40 	 $268.80 	 $856.80 	 $940.80 	 $940.80 	 $276.86 	 $705.60 	 $952.00 	 $772.80 	 $896.00 	 $268.80 	" $1,008.00 "	 $910.56 	 $952.00 	 $266.56 	 $910.56 	 $268.80 
4400305	HCHG DUPLEX LO EXTREM ART UNILAT/LTD	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93926	 $910.00 	 $637.00 	 $216.58 	 $819.00 	 $791.70 	 $218.40 	 $696.15 	 $764.40 	 $764.40 	 $224.95 	 $573.30 	 $773.50 	 $627.90 	 $728.00 	 $218.40 	 $819.00 	 $739.83 	 $773.50 	 $216.58 	 $739.83 	 $218.40 
4400306	"HCHG DUPLEX SCAN EXTRACRANIAL,BILAT"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93880	" $1,200.00 "	 $840.00 	 $285.60 	" $1,080.00 "	" $1,044.00 "	 $288.00 	 $918.00 	" $1,008.00 "	" $1,008.00 "	 $296.64 	 $756.00 	" $1,020.00 "	 $828.00 	 $960.00 	 $288.00 	" $1,080.00 "	 $975.60 	" $1,020.00 "	 $285.60 	 $975.60 	 $288.00 
4400308	HCHG DUPLEX UP EXTREM ART BILAT	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93930	" $2,580.00 "	" $1,806.00 "	 $614.04 	" $2,322.00 "	" $2,244.60 "	 $619.20 	" $1,973.70 "	" $2,167.20 "	" $2,167.20 "	 $637.78 	" $1,625.40 "	" $2,193.00 "	" $1,780.20 "	" $2,064.00 "	 $619.20 	" $2,322.00 "	" $2,097.54 "	" $2,193.00 "	 $614.04 	" $2,097.54 "	 $619.20 
4400309	HCHG DUPLEX UP EXTREM ART UNILAT/LTD	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93931	 $900.00 	 $630.00 	 $214.20 	 $810.00 	 $783.00 	 $216.00 	 $688.50 	 $756.00 	 $756.00 	 $222.48 	 $567.00 	 $765.00 	 $621.00 	 $720.00 	 $216.00 	 $810.00 	 $731.70 	 $765.00 	 $214.20 	 $731.70 	 $216.00 
4400497	"HCHG NONINVASV EXTREM EXAM,1LEVEL,BILAT"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93922	 $630.00 	 $441.00 	 $149.94 	 $567.00 	 $548.10 	 $151.20 	 $481.95 	 $529.20 	 $529.20 	 $151.20 	 $396.90 	 $535.50 	 $434.70 	 $504.00 	 $151.20 	 $567.00 	 $512.19 	 $535.50 	 $149.94 	 $512.19 	 $151.20 
4400498	"HCHG NONINVASV EXTREM EXAM,MULT,BILAT"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93923	" $1,087.00 "	 $760.90 	 $258.71 	 $978.30 	 $945.69 	 $260.88 	 $831.56 	 $913.08 	 $913.08 	 $260.88 	 $684.81 	 $923.95 	 $750.03 	 $869.60 	 $260.88 	 $978.30 	 $883.73 	 $923.95 	 $258.71 	 $883.73 	 $260.88 
4401005	"HCHG NONINVASV EXTREM EXAM, 1-2 LVLS, BILAT"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	93922	 $20.00 	 $14.00 	 $4.76 	 $18.00 	 $17.40 	 $4.80 	 $15.30 	 $16.80 	 $16.80 	 $4.80 	 $12.60 	 $17.00 	 $13.80 	 $16.00 	 $4.80 	 $18.00 	 $16.26 	 $17.00 	 $4.76 	 $16.26 	 $4.80 
5200171	"HCHG CVMC SOMATOSENSORY TESTING,UPPER LIMBS"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95925	" $1,185.44 "	 $829.81 	 $282.13 	" $1,066.90 "	" $1,031.33 "	 $284.51 	 $906.86 	 $995.77 	 $995.77 	 $293.04 	 $746.83 	" $1,007.62 "	 $817.95 	 $948.35 	 $284.51 	" $1,066.90 "	 $963.76 	" $1,007.62 "	 $282.13 	 $963.76 	 $284.51 
5200172	"HCHG CVMC SOMATOSENSORY TESTING,LOWER LIMBS"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95926	" $1,185.44 "	 $829.81 	 $282.13 	" $1,066.90 "	" $1,031.33 "	 $284.51 	 $906.86 	 $995.77 	 $995.77 	 $293.04 	 $746.83 	" $1,007.62 "	 $817.95 	 $948.35 	 $284.51 	" $1,066.90 "	 $963.76 	" $1,007.62 "	 $282.13 	 $963.76 	 $284.51 
5200173	"HCHG CVMC SOMATOSENSORY TESTING,TRUNK/HEAD"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95927	" $1,185.44 "	 $829.81 	 $282.13 	" $1,066.90 "	" $1,031.33 "	 $284.51 	 $906.86 	 $995.77 	 $995.77 	 $293.04 	 $746.83 	" $1,007.62 "	 $817.95 	 $948.35 	 $284.51 	" $1,066.90 "	 $963.76 	" $1,007.62 "	 $282.13 	 $963.76 	 $284.51 
5200174	"HCHG CVMC CENTRAL MOTOR EVOKED POTENTIAL STUDY, UPPER LIMBS"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95928	 $773.48 	 $541.44 	 $184.09 	 $696.13 	 $672.93 	 $185.64 	 $591.71 	 $649.72 	 $649.72 	 $191.20 	 $487.29 	 $657.46 	 $533.70 	 $618.78 	 $185.64 	 $696.13 	 $628.84 	 $657.46 	 $184.09 	 $628.84 	 $185.64 
5200175	"HCHG CVMC CENTAL MOTOR EVOKED POTENTIAL STUDY, LOWER LIMBS"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95929	 $773.48 	 $541.44 	 $184.09 	 $696.13 	 $672.93 	 $185.64 	 $591.71 	 $649.72 	 $649.72 	 $191.20 	 $487.29 	 $657.46 	 $533.70 	 $618.78 	 $185.64 	 $696.13 	 $628.84 	 $657.46 	 $184.09 	 $628.84 	 $185.64 
5200176	HCHG CVMC NEUROMUSCULAR JUNCTION TEST	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95937	 $402.66 	 $281.86 	 $95.83 	 $362.39 	 $350.31 	 $96.64 	 $308.03 	 $338.23 	 $338.23 	 $99.54 	 $253.68 	 $342.26 	 $277.84 	 $322.13 	 $96.64 	 $362.39 	 $327.36 	 $342.26 	 $95.83 	 $327.36 	 $96.64 
5200180	"HCHG CVMC ANALYZE NEUROSTIMULATOR ,W/O REPROGRAMMING"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95970	 $615.92 	 $431.14 	 $146.59 	 $554.33 	 $535.85 	 $147.82 	 $471.18 	 $517.37 	 $517.37 	 $152.26 	 $388.03 	 $523.53 	 $424.98 	 $492.74 	 $147.82 	 $554.33 	 $500.74 	 $523.53 	 $146.59 	 $500.74 	 $147.82 
5200181	"HCHG CVMC ANALYZE NEUROSTIM, WITH REPROGRAMMING"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95971	" $1,584.24 "	" $1,108.97 "	 $377.05 	" $1,425.82 "	" $1,378.29 "	 $380.22 	" $1,211.94 "	" $1,330.76 "	" $1,330.76 "	 $391.62 	 $998.07 	" $1,346.60 "	" $1,093.13 "	" $1,267.39 "	 $380.22 	" $1,425.82 "	" $1,287.99 "	" $1,346.60 "	 $377.05 	" $1,287.99 "	 $380.22 
5200182	"HCHG CVMC ANALYZE IMPLANTED NEUROSTIMULATOR, COMPLEX"	0920	OTHER DIAGNOSTIC SERVICES - GENERAL CLASSIFICATION	95972	" $1,265.24 "	 $885.67 	 $301.13 	" $1,138.72 "	" $1,100.76 "	 $303.66 	 $967.91 	" $1,062.80 "	" $1,062.80 "	 $312.77 	 $797.10 	" $1,075.45 "	 $873.02 	" $1,012.19 "	 $303.66 	" $1,138.72 "	" $1,028.64 "	" $1,075.45 "	 $301.13 	" $1,028.64 "	 $303.66 
306662	HCHG ARTERIAL EXTREMITY W/STRESS	0921	OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB	93924	" $1,466.24 "	" $1,026.37 "	 $348.97 	" $1,319.62 "	" $1,275.63 "	 $351.90 	" $1,121.67 "	" $1,231.64 "	" $1,231.64 "	 $362.45 	 $923.73 	" $1,246.30 "	" $1,011.71 "	" $1,172.99 "	 $351.90 	" $1,319.62 "	" $1,192.05 "	" $1,246.30 "	 $348.97 	" $1,192.05 "	 $351.90 
4400307	"HCHG DUPLEX SCAN EXTRACRANIAL,LIMITED"	0921	OTHER DIAGNOSTIC SERVICES - PERIPHERAL VASCULAR LAB	93882	 $670.00 	 $469.00 	 $159.46 	 $603.00 	 $582.90 	 $160.80 	 $512.55 	 $562.80 	 $562.80 	 $165.62 	 $422.10 	 $569.50 	 $462.30 	 $536.00 	 $160.80 	 $603.00 	 $544.71 	 $569.50 	 $159.46 	 $544.71 	 $160.80 
343252	HCHG BMH/CVMC NEEDLE ELECTROMYOGRAPHY 4 EXTREMITIES W/WO PARASPINAL	0922	OTHER DIAGNOSTIC SERVICES - ELECTROMYELGRAM	95864	" $1,027.22 "	 $719.05 	 $244.48 	 $924.50 	 $893.68 	 $246.53 	 $785.82 	 $862.86 	 $862.86 	 $253.93 	 $647.15 	 $873.14 	 $708.78 	 $821.78 	 $246.53 	 $924.50 	 $835.13 	 $873.14 	 $244.48 	 $835.13 	 $246.53 
5200184	"HCHG CVMC MUSCLE TEST, ONE LIMB"	0922	OTHER DIAGNOSTIC SERVICES - ELECTROMYELGRAM	95860	 $519.29 	 $363.50 	 $123.59 	 $467.36 	 $451.78 	 $124.63 	 $397.26 	 $436.20 	 $436.20 	 $128.37 	 $327.15 	 $441.40 	 $358.31 	 $415.43 	 $124.63 	 $467.36 	 $422.18 	 $441.40 	 $123.59 	 $422.18 	 $124.63 
5200185	"HCHG CVMC MUSCLE TEST, 2 LIMBS"	0922	OTHER DIAGNOSTIC SERVICES - ELECTROMYELGRAM	95861	 $675.20 	 $472.64 	 $160.70 	 $607.68 	 $587.42 	 $162.05 	 $516.53 	 $567.17 	 $567.17 	 $166.91 	 $425.38 	 $573.92 	 $465.89 	 $540.16 	 $162.05 	 $607.68 	 $548.94 	 $573.92 	 $160.70 	 $548.94 	 $162.05 
5200186	"HCHG CVMC MUSCLE TEST, 3 LIMBS"	0922	OTHER DIAGNOSTIC SERVICES - ELECTROMYELGRAM	95863	 $815.14 	 $570.60 	 $194.00 	 $733.63 	 $709.17 	 $195.63 	 $623.58 	 $684.72 	 $684.72 	 $201.50 	 $513.54 	 $692.87 	 $562.45 	 $652.11 	 $195.63 	 $733.63 	 $662.71 	 $692.87 	 $194.00 	 $662.71 	 $195.63 
5200187	HCHG CVMC MUSCLE TEST CRANIAL NERVE SUPPLIED MUSCLE(S) UNILATERAL	0922	OTHER DIAGNOSTIC SERVICES - ELECTROMYELGRAM	95867	 $552.09 	 $386.46 	 $131.40 	 $496.88 	 $480.32 	 $132.50 	 $422.35 	 $463.76 	 $463.76 	 $136.48 	 $347.82 	 $469.28 	 $380.94 	 $441.67 	 $132.50 	 $496.88 	 $448.85 	 $469.28 	 $131.40 	 $448.85 	 $132.50 
5200188	HCHG CVMC MUSCLE TEST CRANIAL NERVE SUPPLIED MUSCLES BILATERAL	0922	OTHER DIAGNOSTIC SERVICES - ELECTROMYELGRAM	95868	 $552.09 	 $386.46 	 $131.40 	 $496.88 	 $480.32 	 $132.50 	 $422.35 	 $463.76 	 $463.76 	 $136.48 	 $347.82 	 $469.28 	 $380.94 	 $441.67 	 $132.50 	 $496.88 	 $448.85 	 $469.28 	 $131.40 	 $448.85 	 $132.50 
5200189	"HCHG CVMC MUSCLE TEST, NONPARASPINAL"	0922	OTHER DIAGNOSTIC SERVICES - ELECTROMYELGRAM	95870	 $269.08 	 $188.36 	 $64.04 	 $242.17 	 $234.10 	 $64.58 	 $205.85 	 $226.03 	 $226.03 	 $66.52 	 $169.52 	 $228.72 	 $185.67 	 $215.26 	 $64.58 	 $242.17 	 $218.76 	 $228.72 	 $64.04 	 $218.76 	 $64.58 
304777	"HCHG PHLEBOTOMY,THERAPEUTIC"	0940	OTHER THERAPEUTIC SERVICES - GENERAL CLASSIFICATION	99195	 $270.00 	 $189.00 	 $64.26 	 $243.00 	 $234.90 	 $64.80 	 $206.55 	 $226.80 	 $226.80 	 $64.80 	 $170.10 	 $229.50 	 $186.30 	 $216.00 	 $64.80 	 $243.00 	 $219.51 	 $229.50 	 $64.26 	 $219.51 	 $64.80 
309111	HCHG PORTABLE PUMP REFILL & MAINT	0940	OTHER THERAPEUTIC SERVICES - GENERAL CLASSIFICATION	96521	 $630.00 	 $441.00 	 $149.94 	 $567.00 	 $548.10 	 $151.20 	 $481.95 	 $529.20 	 $529.20 	 $151.20 	 $396.90 	 $535.50 	 $434.70 	 $504.00 	 $151.20 	 $567.00 	 $512.19 	 $535.50 	 $149.94 	 $512.19 	 $151.20 
338958	HCHG CVMC MNT SUBS TX FOR CHANGE DX-MCAR	0942	OTHER THERAPEUTIC SERVICES - EDUCATION/TRAINING	G0270	 $50.00 	 $35.00 	 $11.90 	 $45.00 	 $43.50 	 $12.00 	 $38.25 	 $42.00 	 $42.00 	 $12.36 	 $31.50 	 $42.50 	 $34.50 	 $40.00 	 $12.00 	 $45.00 	 $40.65 	 $42.50 	 $11.90 	 $40.65 	 $12.00 
308807	PR TREAT STERNUM FRACTURE	0972	PROFESSIONAL FEES - RADIOLOGY - DIAGNOSTIC	21820	 $375.35 	 $262.75 	 $89.33 	 $337.82 	 $326.55 	 $90.08 	 $287.14 	 $181.44 	 $181.44 	 $90.08 	 $236.47 	 $319.05 	 $200.29 	 $200.29 	 $154.07 	 $337.82 	 $305.16 	 $319.05 	 $89.33 	 $305.16 	 $154.07 
342759	PR ULTRASOUND BREAST LIMITED	0972	PROFESSIONAL FEES - RADIOLOGY - DIAGNOSTIC	76642	 $265.90 	 $186.13 	 $63.28 	 $239.31 	 $231.33 	 $63.82 	 $203.41 	 $79.69 	 $79.69 	 $63.82 	 $167.52 	 $226.02 	 $-   	 $-   	 $-   	 $239.31 	 $216.18 	 $226.02 	 $63.28 	 $216.18 	 $-   
4400599	PR ECHO GUIDE FOR BIOPSY	0972	PROFESSIONAL FEES - RADIOLOGY - DIAGNOSTIC	76942	 $195.33 	 $136.73 	 $46.49 	 $175.80 	 $169.94 	 $46.88 	 $149.43 	 $79.69 	 $79.69 	 $46.88 	 $123.06 	 $166.03 	 $-   	 $-   	 $-   	 $175.80 	 $158.80 	 $166.03 	 $46.49 	 $158.80 	 $-   
308426	PR CVMC PF RPR FE/E/EN/L/M 12.6-20.0 CM	0981	PROFESSIONAL FEES - EMERGENCY ROOM	12016	 $461.00 	 $322.70 	 $109.72 	 $414.90 	 $401.07 	 $110.64 	 $352.67 	 $262.64 	 $262.64 	 $110.64 	 $414.90 	 $391.85 	 $169.61 	 $169.61 	 $130.47 	 $414.90 	 $374.79 	 $391.85 	 $109.72 	 $374.79 	 $130.47 
343147	HCHG PF TREAT HUMERUS FRACTURE CLOSED	0981	PROFESSIONAL FEES - EMERGENCY ROOM	23605	" $1,209.82 "	 $846.87 	 $287.94 	" $1,088.84 "	" $1,052.54 "	 $290.36 	 $925.51 	 $598.30 	 $598.30 	 $290.36 	" $1,088.84 "	" $1,028.35 "	 $580.14 	 $580.14 	 $446.26 	" $1,088.84 "	 $983.58 	" $1,028.35 "	 $287.94 	 $983.58 	 $446.26 
308707	PR CVMC PF TREATMENT OF TIBIA FRACTURE	0981	PROFESSIONAL FEES - EMERGENCY ROOM	27752	" $1,098.00 "	 $768.60 	 $261.32 	 $988.20 	 $955.26 	 $263.52 	 $839.97 	 $694.92 	 $694.92 	 $263.52 	 $988.20 	 $933.30 	 $664.04 	 $664.04 	 $510.80 	 $988.20 	 $892.67 	 $933.30 	 $261.32 	 $892.67 	 $510.80 
503370	HCHG CVMC PF STRAPPING UNNA BOOT	0981	PROFESSIONAL FEES - EMERGENCY ROOM	29580	 $93.72 	 $65.60 	 $22.31 	 $84.35 	 $81.54 	 $22.49 	 $71.70 	 $67.59 	 $67.59 	 $27.46 	 $84.35 	 $79.66 	 $34.66 	 $34.66 	 $26.66 	 $84.35 	 $76.19 	 $79.66 	 $22.31 	 $76.19 	 $26.66 
308947	PR CVMC PF DRAINAGE OF SCROTUM	0981	PROFESSIONAL FEES - EMERGENCY ROOM	54700	 $938.00 	 $656.60 	 $214.95 	 $844.20 	 $816.06 	 $225.12 	 $717.57 	 $279.87 	 $279.87 	 $225.12 	 $844.20 	 $797.30 	 $279.44 	 $279.44 	 $214.95 	 $844.20 	 $762.59 	 $797.30 	 $223.24 	 $762.59 	 $214.95 
343053	HCHG PF REVISE/RMV PN/GASTR STIMUL	0981	PROFESSIONAL FEES - EMERGENCY ROOM	64595	 $650.60 	 $455.42 	 $129.26 	 $585.54 	 $566.02 	 $156.14 	 $497.71 	 $317.52 	 $317.52 	 $156.14 	 $585.54 	 $553.01 	 $168.04 	 $168.04 	 $129.26 	 $585.54 	 $528.94 	 $553.01 	 $154.84 	 $528.94 	 $129.26 
309133	PR CVMC PF CVER PRO FEE-LEVEL I	0981	PROFESSIONAL FEES - EMERGENCY ROOM	99281	 $128.00 	 $89.60 	 $11.99 	 $115.20 	 $111.36 	 $30.72 	 $97.92 	 $27.22 	 $27.22 	 $30.72 	 $115.20 	 $108.80 	 $29.38 	 $29.38 	 $11.99 	 $115.20 	 $104.06 	 $108.80 	 $30.46 	 $104.06 	 $11.99 
309134	PR CVMC PF CVER PRO FEE-LEVEL II	0981	PROFESSIONAL FEES - EMERGENCY ROOM	99282	 $173.00 	 $121.10 	 $41.17 	 $155.70 	 $150.51 	 $41.52 	 $132.35 	 $53.07 	 $53.07 	 $41.52 	 $155.70 	 $147.05 	 $103.76 	 $103.76 	 $42.35 	 $155.70 	 $140.65 	 $147.05 	 $41.17 	 $140.65 	 $42.35 
309135	PR CVMC PF CVER PRO FEE-LEVEL III	0981	PROFESSIONAL FEES - EMERGENCY ROOM	99283	 $260.00 	 $182.00 	 $61.88 	 $234.00 	 $226.20 	 $62.40 	 $198.90 	 $79.38 	 $79.38 	 $62.40 	 $234.00 	 $221.00 	 $178.31 	 $178.31 	 $72.78 	 $234.00 	 $211.38 	 $221.00 	 $61.88 	 $211.38 	 $72.78 
309136	PR CVMC PF CVER PRO FEE-LEVEL IV	0981	PROFESSIONAL FEES - EMERGENCY ROOM	99284	 $388.00 	 $271.60 	 $92.34 	 $349.20 	 $337.56 	 $93.12 	 $296.82 	 $150.60 	 $150.60 	 $93.12 	 $349.20 	 $329.80 	 $299.41 	 $299.41 	 $122.21 	 $349.20 	 $315.44 	 $329.80 	 $92.34 	 $315.44 	 $122.21 
309137	PR CVMC PF CVER PRO FEE-LEVEL V	0981	PROFESSIONAL FEES - EMERGENCY ROOM	99285	 $578.00 	 $404.60 	 $137.56 	 $520.20 	 $502.86 	 $138.72 	 $442.17 	 $222.26 	 $222.26 	 $138.72 	 $520.20 	 $491.30 	 $435.98 	 $435.98 	 $177.95 	 $520.20 	 $469.91 	 $491.30 	 $137.56 	 $469.91 	 $177.95 
302444	HCHG PF EXCISION PILONIDAL CYST/SINUS COMPLICATED	0983	PROFESSIONAL FEES - CLINIC	11772	" $2,463.00 "	" $1,724.10 "	 $586.19 	" $2,216.70 "	" $2,142.81 "	 $591.12 	" $1,884.20 "	 $895.86 	 $895.86 	 $591.12 	" $2,216.70 "	" $2,093.55 "	 $772.60 	 $772.60 	 $594.31 	" $2,216.70 "	" $2,002.42 "	" $2,093.55 "	 $586.19 	" $2,002.42 "	 $594.31 
302439	HCHG PF SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN	0983	PROFESSIONAL FEES - CLINIC	99307	 $134.13 	 $93.89 	 $31.92 	 $120.72 	 $116.69 	 $32.19 	 $102.61 	 $57.15 	 $57.15 	 $32.19 	 $120.72 	 $114.01 	 $47.74 	 $47.74 	 $39.78 	 $120.72 	 $109.05 	 $114.01 	 $31.92 	 $109.05 	 $39.78 
302440	HCHG PF SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN	0983	PROFESSIONAL FEES - CLINIC	99308	 $211.17 	 $147.82 	 $50.26 	 $190.05 	 $183.72 	 $50.68 	 $161.55 	 $88.45 	 $88.45 	 $50.68 	 $190.05 	 $179.49 	 $89.86 	 $89.86 	 $74.88 	 $190.05 	 $171.68 	 $179.49 	 $50.26 	 $171.68 	 $74.88 
302442	HCHG PF SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN	0983	PROFESSIONAL FEES - CLINIC	99309	 $277.71 	 $194.40 	 $66.09 	 $249.94 	 $241.61 	 $66.65 	 $212.45 	 $117.03 	 $117.03 	 $66.65 	 $249.94 	 $236.05 	 $128.57 	 $128.57 	 $107.14 	 $249.94 	 $225.78 	 $236.05 	 $66.09 	 $225.78 	 $107.14 
302443	HCHG PF SBSQ NURS FACIL CARE/DAY UNSTABL/NEW PROB 45 MIN	0983	PROFESSIONAL FEES - CLINIC	99310	 $411.84 	 $288.29 	 $98.02 	 $370.66 	 $358.30 	 $98.84 	 $315.06 	 $174.19 	 $174.19 	 $98.84 	 $370.66 	 $350.06 	 $184.97 	 $184.97 	 $154.14 	 $370.66 	 $334.83 	 $350.06 	 $98.02 	 $334.83 	 $154.14 
309147	"PR CVMC PF SMOKING CESSATION COUNSELING, > 10 MIN"	0983	PROFESSIONAL FEES - CLINIC	99407	 $35.00 	 $24.50 	 $8.33 	 $35.84 	 $30.45 	 $8.40 	 $26.78 	 $35.84 	 $35.84 	 $8.40 	 $31.50 	 $29.75 	 $30.25 	 $30.25 	 $25.21 	 $31.50 	 $28.46 	 $29.75 	 $8.33 	 $28.46 	 $25.21 
503685	HCHG PF PROLONGED OUTPATIENT EM	0983	PROFESSIONAL FEES - CLINIC	99417	 $96.00 	 $67.20 	 $-   	 $86.40 	 $83.52 	 $23.04 	 $73.44 	 $42.18 	 $42.18 	 $23.04 	 $86.40 	 $81.60 	 $5.31 	 $5.31 	 $-   	 $86.40 	 $78.05 	 $81.60 	 $22.85 	 $78.05 	 $-   
503686	HCHG PF VISIT COMPLEXITY EM W/MED SERV	0983	PROFESSIONAL FEES - CLINIC	G2211	 $47.64 	 $33.35 	 $-   	 $42.88 	 $41.45 	 $11.43 	 $36.44 	 $-   	 $-   	 $11.43 	 $42.88 	 $40.49 	 $-   	 $-   	 $-   	 $42.88 	 $38.73 	 $40.49 	 $11.34 	 $38.73 	 $-   
309046	PR BMH/CVMC PF CARDIOVASCULAR STRESS TEST-PRO FEE	0985	PROFESSIONAL FEES - EKG	93016	 $46.00 	 $32.20 	 $10.95 	 $41.40 	 $40.02 	 $11.04 	 $35.19 	 $28.58 	 $28.58 	 $11.04 	 $41.40 	 $39.10 	 $25.25 	 $25.25 	 $21.04 	 $41.40 	 $37.40 	 $39.10 	 $10.95 	 $37.40 	 $21.04 
330962	PR CVMC STRESS INTERPRETATION	0985	PROFESSIONAL FEES - EKG	93018	 $399.03 	 $279.32 	 $13.93 	 $359.13 	 $347.16 	 $95.77 	 $305.26 	 $19.05 	 $19.05 	 $95.77 	 $359.13 	 $339.18 	 $16.72 	 $16.72 	 $13.93 	 $359.13 	 $324.41 	 $339.18 	 $94.97 	 $324.41 	 $13.93