Supply Charges Part 3

Our Commitment to Quality

Helping ensure our patients receive the highest level of care, delivered with dignity and compassion, is our goal with every patient and family member, every time. Our Board challenges us to remain in the Top 10 percent of hospitals in the country in quality scores, and they meet monthly with physicians and clinical staff to analyze the data and develop a plan to better serve our patients. It is this goal-driven mindset that has earned us recognition in key areas for our quality strides. Learn more about our quality awards and recognition.

NOTE: Costs displayed on these documents include: procedure, anesthesia and recovery time if applicable, some medications and supplies, laboratory tests and room & board). Not included are physician fees.

Charge Code Supply Description Charge
27000653 HC TUBING PRESSURE 84IN 0111 $34
27000654 HC CHEST DRAINAGE BOTTLE 90CC $121
27000655 HC IAP TRANSDUCER PRESS INTRA-ABD 013358 $62
27000656 HC IAP MONITOR KIT 013364 $407
27000657 HC WIRE-GUIDE-35-80-7/5 $102
27000658 HC PROBE ESOPHAGEAL TEMP 013387 $495
27000659 HC VAC CANISTER ABthera 013490 $80
27000660 HC BANDAGE PROFORE 4 LAYER SYS 013121 $98
27000661 HC FEMORAL BIOPSY SHEATH 7FR-CORD $199
27000662 HC CATHETER HOLDER---COLOSTOMY $44
27000663 HC SWAN-GANZ CATH 93A731H-7.5FR $970
27000664 HC HEART BIOPSY TRAY $95
27000665 HC CUTDOWN CATH PED-18 $50
27000666 HC HYPOTHERMIA BLANKET KOOL KIT 013386 $1,000
27000667 HC IAP DEVICE PRESS MONITOR INTRA 013357 $370
27000668 HC DENTAL WIRE SET $124
27000669 HC NASAL PACK 2 PER PKG $27
27000670 HC ENDOMETRIAL BIOPSY TRAY $77
27000671 HC BIOPTONE-BIOPSY-104 CM-LONG $714
27000672 HC PACEMAKER TRAY-EXTERNAL- $134
27000673 HC ANGIOGRAPHIC CATHETER $107
27000674 HC COOK DIALATOR $36
27000675 HC NDL JAMSHIDI 18GA BONE MAR 810014 $65
27000676 HC NDL ILL 15G 3/8X1 7/8 BON 804326 $65
27000677 HC BIOPTONE SHEATH 104 CM-LONG 7F $199
27000678 HC BIOPTONE-BIOPSY-50 CM-SHORT $693
27000679 HC DUAL LUMEN CV CATH SET PED 5CM $162
27000680 HC PRESSURE MONITOR TRAY 3.0-8CM $243
27000681 HC PRESSURE MONITOR TRAY 4.0-12CM $243
27000682 HC DUAL LUMEN CV CATH SET 15CM $162
27000683 HC TROCAR CATHETER 24FR $116
27000684 HC FEMORAL BIOPSY FORCEP-CORDIS- $714
27000685 HC SWAN-GANZ CATH-THE-93A931H 7.5 $815
27000686 HC BIOPTONE SHEATH 50CM SHORT 8F $162
27000687 HC INTRODUCER-CORDIS CATH 9 FR $131
27000688 HC RT-CIRCUIT BIPAP $107
27000689 HC TRAY QUICK TAP PARACENTESI 000616 $411
27000690 HC RT-MASL CPAP MED $299
27000691 HC RT-MASK CPAP LARGE $299
27000692 HC KIDNEY DIALYZER NT150 $143
27000693 HC RT-MASK NASAL SMALL $158
27000694 HC CATH LUTHER MIDLINE 20G PE 24580 $187
27000695 HC VINYL CONN TUBE $104
27000696 HC RT-HUMIDIFIER BOTTLE $30
27000697 HC RT-CIRCUIT IPPB $30
27000698 HC CIRCUIT VENT UNIVERSAL 301215 $150
27000699 HC RT-MASK CPAP SMALL $299
27000700 HC TENT CANOPIES RT 301196 $71
27000701 HC RT-LARGE FULL CPAP MASK $299
27000702 HC RT-SMALL FULL CPAP MASK $299
27000703 HC RT-LARGE NASAL MASK - BIPAP $158
27000704 HC RT-ISOTHERMAL CIRCUIT $64
27000705 HC RT-BIPAP CIRCUIT $107
27000706 HC RT-MED FULL CPAP MASK $299
27000707 HC RT-MASK NASAL MED $158
27000708 HC RT-MASK NASAL LARGE $158
27000709 HC RT-HEADSTRAP BIPAP $70
27000710 HC HEMO CATH DBL LUMEN 11.5X20CM $699
27000711 HC 6.5 SILICONE FEEDING TUBE 010822 $167
27000712 HC SURG-O-PAK HIP PACK $236
27000713 HC COLPOSCOPETRAY $77
27000714 HC NEEDLE-HUBER 19X1 W-TUBING $28
27000715 HC DUAL LUMEN CVP TRAY PED 8CM 5F $295
27000716 HC ILEAL CONDUIT SAMPLING CATH $33
27000717 HC CENTRAL CATH SINGLE LUMEN $361
27000718 HC WIRES GUIDE CSCF-18-50-2-J $84
27000719 HC WIRES GUIDE-CSF-18-50-STR $69
27000720 HC TROCAR-SURGIPORT 10MM $555
27000721 HC TUBE FEEDING CAP-ABBOT-IRR-BOT $51
27000722 HC PD TRANSFER SET EXCHANGE KIT $450
27000723 HC PRESSURE MONITORING SET 2-1/2F $89
27000724 HC DUAL LUMEN CVP TRAY PED 10C 5F $295
27000725 HC NEEDLE-SURGINEEDLE 120MM $153
27000726 HC OVERHEAD IRR SET-BAG-USE CYSTO $32
27000727 HC KIDNEY AV FISTULA NEEDLE 16GA $20
27000728 HC VENOUS PRESSURE SET B/P $64
27000729 HC RENAL BIOPSY TRAY W/NEEDLE-DIS $168
27000730 HC POLYETHYLENE TUBE 12 PE 205 $27
27000731 HC POLYETHYLENE TUBE 12 PE 50 $27
27000732 HC TRAY CATH CV MLMEN 7X20 AN 000891 $485
27000733 HC SUT 3-0 SILK FS-1 684H 300701 $27
27000734 HC POLYETHYLENE TUBE 12 PE 240 $27
27000735 HC ET ANTIMICROB ROLL $23
27000736 HC ET ANTIMICROB SPONGE $21
27000737 HC COMPRESSOR DISC DISP [5302] 5302 $116
27000738 HC POLYETHYLENE TUBE 12 PE 190 $27
27000739 HC POLYETHYLENE TUBE 12 PE 90 $27
27000740 HC CATH BARDEX SELF RETA 34F 5414 $70
27000741 HC CATH MALECOT 32FR LTX STR 805413 $70
27000742 HC CATH MALECOT 30FR LTX STRY 000826 $70
27000743 HC SOUND SET $77
27000744 HC LIVER BIOPSY TRAY $77
27000745 HC I AND D TRAY REUSABLE $88
27000746 HC CATH MALECOT 22FR LTX STR 5409 $50
27000747 HC CATH MALECOT 12FRLTX STR 800367 $50
27000748 HC CATHETER MALECOT WINGTIP 20 $50
27000749 HC CATHETER MALECOT WINGTIP 18 $50
27000750 HC CATH MALECOT 24FR LTX STR 5410 $70
27000751 HC CUFF BP NEONATAL SIZE 4 $34
27000752 HC CUFF BP NEONATAL SIZE 3 $34
27000753 HC CUFF BP NEONATAL SIZE 1 $34
27000754 HC SCALP VEIN 20GX1 BD SAFT I 004302 $41
27000755 HC SCALP VEIN 18GX1 BD SAFT I 004301 $41
27000756 HC RT-MED. NASAL MASK - BIPAP $158
27000757 HC RT-SM. NASAL MASK - BIPAP $158
27000758 HC #5 UNICATH FOLEY SET CLOSED SY 010629 $252
27000759 HC CUFF BP NEONATAL SIZE 2 $51
27000760 HC #8 UNICATH FOLEY SET CLOSED SY 010630 $252
27000761 HC INTRO CATH 1.9 FR 010819 $251
27000762 HC SHEATH PEEL AWAY 20G 010595 $219
27000763 HC HUBERLOC HUBER NDL REMOVAL 003332 $39
27000764 HC FEMORAL ART CATH 20GA $71
27000765 HC PACING 7FR ELECTRODE $530
27000766 HC DIALATOR JCD 6.3-38-20 $60
27000767 HC CATH IV 14X1-1/4 INTROCAN 004787 $25
27000768 HC CATH MULTI LUMEN CV COATED 000836 $443
27000769 HC CANNULA INNER DISP XLT 8.00MM 011098 $43
27000770 HC TUBE TRACH XLT 011821 $248
27000771 HC CUFF CRYO KNEE LG W/COOLER 012200 $336
27000772 HC STERILE SLEEVE NEEDLE GUIDE 011853 $101
27000773 HC 5FR PICC MICRO EZ SHEATH 011852 $253
27000774 HC CANNULA INNER DISP XLT 7.00MM 011099 $37
27000775 HC CANNULA INNER DISP XLT 6.0 MM 011714 $37
27000776 HC TUBE TRACH XLT PROXIMAL CUFF 7.0MM 011100 $264
27000777 HC TUBE FEED 55 IN FOR CORTRA 010568 $259
27000778 HC TUBE FEED 43 IN FOR CORTRA 010567 $259
27000779 HC SET IV EXT 3ML W/LUER T P 007868 $17
27000780 HC SLEEVE SCD THIGH MED $249
27000781 HC BAG DRAIN BEDSIDE LATEX FR 001005 $55
27000782 HC CATH FOLEY 18FR 2W 5CC LAT 001004 $99
27000783 HC CATH FOLEY 16FR LX-FREE 001003 $99
27000784 HC GEL IODOSORB CADEXOMER IOD 003591 $324
27000785 HC SET GEM V/NVQS MC .2MF 3VS 60D 005032 $89
27000786 HC SET GEM PED SYRINGE DEH 000992 $53
27000787 HC KIT CATH RADIAL ARTERIAL S 006524 $181
27000788 HC DRESSING SILVER 4 IN X 4IN 004798 $66
27000789 HC CATH IV 16X1-1/4 PROTECT 301507 $25
27000790 HC CATH TRACH CARE 5FR NEONAT 003889 $155
27000791 HC CUFF BP ADULT THIGH $85
27000792 HC CUFF BP ADULT LARGE $57
27000793 HC CUFF BP ADULT MED $57
27000794 HC CUFF BP ADULT SMALL $57
27000795 HC TRACH PERC PORTEX KIT 7.00 $1,570
27000796 HC CANNULA TRACH 7.00 mm POR 003970 $47
27000797 HC SET EXTENSION MINIVOLUME 1C8 003887 $59
27000798 HC MIDLINE INTRO KIT 010624 $350
27000799 HC BANDAGE HIGH COMPRESSION 000701 $143
27000800 HC CATH MAHURKAR11.5X24 800447 $627
27000801 HC CATH MAHURKAR 11.5X16CM Q 800887 $638
27000802 HC CATH MAHURKAR11.5X13 800886 $638
27000803 HC CATH TRACH CARE SX 14FR 12in S 301676 $97
27000804 HC SET IV ADM EXT 43IN 2SITE 005020 $25
27000805 HC BAG DRAIN 4000CC 000308 $45
27000806 HC SET PUMP FEED and FLUSH KANGRO 003189 $47
27000807 HC SET PUMP SPIKE FEED and FLUSH 003191 $33
27000808 HC BAG VENTRICULA DRAIN 000020 $252
27000809 HC DRAIN SYSTEM WITH BAG VENT 000088 $508
27000810 HC PAD TELFA 3X4 DRESS STR 301085 $8
27000811 HC DRESSING BIAFINE WOUND 801625 $150
27000812 HC IV INFUSION EXT HBO $154
27000813 HC SET TUR IRRIGATION Y LATEX FR 8132 $79
27000814 HC SET IV EXT 5IN MICRBR W MI 010513 $27
27000815 HC TRAY URINMETER 18FR LTX SL 301588 $158
27000816 HC TRAY URINMETER FOLEY 16FR 301587 $158
27000817 HC POUCH BONGORT URINARY 301565 $264
27000818 HC SET PUMP AMB 101 IN 800013 $114
27000819 HC TRAY PERCUTANEOUS 800426 $236
27000820 HC POUCH DRN W/2 3/4 FLAN 12 000780 $89
27000821 HC POUCH DRN W/1 3/4 FLAN 12 000782 $89
27000822 HC SET IV W/Y LL MICRO 800510 $19
27000823 HC SET IV VIAL ADAPTER 005028 $18
27000824 HC SET IV 3 PORT ADAPTER 005023 $32
27000825 HC SET IV PRIM 110IN 10DROP 005012 $37
27000826 HC SET IV MINIDROP 108IN 60D 005013 $11
27000827 HC SET IV BLD ADMINISTRATION 005019 $25
27000828 HC SET IV EXT 15CM [6in] P V 313115 $36
27000829 HC SET IV EXT W/2Y LL 005022 $25
27000830 HC SET IV EXT IV W/FIL 16IN H 005024 $18
27000831 HC SET IV EXT 15 24cm [6 in] 005085 $13
27000832 HC SET IV EXT 30IN W/LL 313106 $11
27000833 HC SET IV BASIC 100 15 DROP 005014 $19
27000834 HC SET IV BURR W/FIL 150ML 005018 $32
27000835 HC IV SET BASIC 80IN 10 DROP $30
27000836 HC SET IV SEC W/CANN GRAVITY 005015 $13
27000837 HC SET IV GEMINI VENTED 005026 $69
27000838 HC CANNULA INNER DISP 10 DIC 805400 $23
27000839 HC CANNULA 8 DISP 301310 $23
27000840 HC CANNULA 6 DISP 301309 $23
27000841 HC TRACH INNER CANNULA SIZE 4 $23
27000842 HC CATH COUDE FOLE SILCONE-5C-16F $82
27000843 HC CATH IV 20X1-1/4 PROTECT 301509 $30
27000844 HC SYSTEM LOOP OSTOMY 4 IN 800262 $82
27000845 HC TUBING PRESSURE 12 IN 808254 $33
27000846 HC TUBE TRACH SIZE 10 15160 $219
27000847 HC TRAY CENTRAL LINE DRESS CH 004720 $112
27000848 HC IV START KIT W/CHLORAPREP 004869 $82
27000849 HC TUBE TRACH LOPRO 5.5 22F 301165 $32
27000850 HC TUBE TRACH LOPRO 5.0 20F 301166 $32
27000851 HC STOCKINET TUB 6X5 300920 $33
27000852 HC VALVE HEIMLICH CHEST DRAI 800086 $50
27000853 HC TUBE TRACH PED 2.5MM 10FR 300848 $32
27000854 HC TUBE TRACH PED 3.5MM 14F 300850 $32
27000855 HC TUBE TRACH PED 3.0MM 12F 300849 $32
27000856 HC CORD CLAMP UMBILICAL ST 300836 $23
27000857 HC BIOPSY NEEDLE TRU CUT ADULT $129
27000858 HC TUBE TRACH LO PRESCUFF SIZ 301261 $219
27000859 HC TUBE TRACH LO PRESSCUF SIZ 301262 $219
27000860 HC TUBE TRACH SIZE 4 0248 $219
27000861 HC KIT TRACH CARE W/FCP and GL 300783 $32
27000862 HC TUBE SAL SUMP 18F 48IN 300831 $32
27000863 HC DEVICE MALE EXTERNAL CATH 000732 $27
27000864 HC DRAIN PENROSE 3/4 X 18 300939 $21
27000865 HC KIT HEMOVAC MASECTOMY 1/4 300845 $271
27000866 HC KIT HEMOVAC MASECTOMY 1/8 300846 $271
27000867 HC BELT OSTOMY MEDIUM 26in - 810601 $37
27000868 HC CATH ROBINSON 20FR RED RUB 301597 $27
27000869 HC CATH ROBINSON 18FR RED RUB 301596 $27
27000870 HC CATH ROBINSON 16FR RED RUB 301595 $27
27000871 HC CATH ROBINSON 14FR RED RUB 301070 $27
27000872 HC CATH ROBINSON 12FR RED RUB 301594 $27
27000873 HC CATH FOLEY 8F 3CC PED SILI 000912 $77
27000875 HC VENESECTION CUTDOWN ADULT 007130 $108
27000876 HC ELASTOMER INFUSION CATH 18 GA $37
27000877 HC TRAY HEMO-CATH 11.5FRX20CM 001221 $714
27000878 HC TUBE TRACH BIG BOY SZ 9 004209 $266
27000879 HC PACING ELECTRODE INSERT KIT $282
27000880 HC L-CATH BLUNT CATH REPAIR KIT $321
27000881 HC UT CATH TRAY $324
27000882 HC TUBE FEEDING SET W/DYE $62
27000883 HC CANNULA TRACH 8.00mm PORTE 003971 $47
27000884 HC TUBE TRACH BIG BOY SZ 8 004206 $266
27000885 HC TRACH PERC PORTEX KIT 8.00 $1,570
27000886 HC TUBE TRACH BIG BOY SZ 6 004205 $266
27000887 HC CENTRAL LINE INSERTION KIT $123
27000888 HC LARYNGECTOMY TUBE SIZE 36 EA $337
27000889 HC LARYNGECTOMY TUBE SIZE 8 EA $337
27000890 HC LARYNGECTOMY TUBE SIZE 10 EA $337
27000891 HC LARYNGECTOMY TUBE SIZE 40 EA $337
27000892 HC TROCATH IV SET $70

See Part 4 of this list.