Supply Charges Part 7

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
27800189 HC IMPLANTED PLEURAL CATHETER $1,403
27800193 HC VASCULAR CLOSURE DEVICE $1,203
27800197 HC GENERATOR NEURO NON-RECHARGE (#015838) $19,430
27800231 HC LEAD NEUROSTIMULATOR $3,794
27800232 HC HICKMAN POWERCATH $1,790
27800233 HC STENT DRUG ELUTING PERIPHERAL 80 - 100mm $6,578
27800234 HC PICC 1.4 FR POLYURETHANE $385
27800236 HC STENT DRUG ELUTING PERIPHERAL 40mm $6,278
27800237 HC STENT DRUG ELUTING PERIPHERAL 60mm $5,978
27800238 HC STENT DRUG ELUTING PERIPHERAL 140mm $7,378
73140243 HC .035 INTERLOCK COIL - LONG $3,732
73140244 HC .035 INTERLOCK COIL - MEDIUM $3,483
73140245 HC .035 INTERLOCK COIL - SHORT $2,322
27800239 HC LEAD, CARDIOVERTER-DEFIBRILLATOR $8,418
27001665 HC WIRELESS AICD KIT $0
27001666 HC SINGLE SILICONE LUMEN $254
27001667 HC AERONEB NEBULIZER CONVENIENCE KIT $243
27001668 HC BRIEF ADULT XXL 60-69IN $97
27001669 HC INFANT GROUNDING PAD $76
27001670 HC CANNULA NASAL NEONATAL $76
27001671 HC RFA CATHETER $600
27001672 HC PRE OP CLEANSING CLOTHS $48
27200417 HC G26563 LEAD EXTRACTOR $954
27200418 HC G26550 LEAD EXTRACTOR $2,092
27200419 HC G20001 LEAD EXTRACTOR $324
27200420 HC G46542 LEAD EXTRACTOR $1,072
27200421 HC G15052 LEAD EXTRACTOR $3,717
27200422 HC G31000 LEAD EXTRACTOR $551
27200423 HC G26517 LEAD EXTRACTOR $3,118
27200424 HC G26505 LEAD EXTRACTOR $882
27001673 HC KIT CENTRAL VENOUS TWO LUMEN $413
27001674 HC POST INTUBATION INLINE ETCO2 DETECTOR $65
27200425 HC ARTIC CRYO CATHETER $4,500
27400030 HC BAHA IMPLANT W/ABUTMENT $4,282
27001675 HC PEDIATRIC IO NEEDLE EA $115
27001676 HC ADULT OXYGEN SENSOR (COVIDIEN 015245A) $68
27001677 HC XTRASORB DRESSING (6X9) $38
27001678 HC AQUACEL AG DRESSING (007937) $39
27001679 HC ENLUXTRA DRESSING (2X2 OR 4X4) $57
27001680 HC ENLUXTRA DRESSING (6X9) $146
27001681 HC PROMOGRAN 2.25X2 (J-JPG004H) $100
27001682 HC PROMOGRAN 19.1 SQ IN (J-JPG019H) $229
27001683 HC PREVENA INCISION MGMT SYSTEM (015203) $1,900
27001684 HC PREVENA CANISTER ASSEMBLY (015204) $456
27001685 HC PREVENA DRESSING (015240) $1,129
27200426 HC ANGIOVAC KIT-VTX 4000 (015282) $17,420
27100693 HC WARRIOR KNEE BRACE $395
27001686 HC STRAIGHT SUTURE KS (Y523H) $30
27001687 HC MERISLENE SUTURE (RS 21 BP-1) EA $50
27001688 HC PDS #1 SUTURE TP-1 (Z880G) EA $18
27001689 HC TYRX ABSORBABLE ANTIBACTERIAL ENVELOPE $3,850
27001690 HC CIRCA S-CATH ESOPHAGEAL TEMPERATURE PROBE $2,535
27001691 HC CLIP SUT ENDO ABSORBABLE (#004797A) $355
27001692 HC TROCAR ADV FIX 5 X 100 MM (#014639) $152
27001693 HC URINAL FEMALE (5915) $13
27001694 HC RETRACT ENDO II, COVIDIEN (16729) $563
27001695 HC NITRIC OXIDE (HOURLY CHARGE) $744
27001696 HC ENSITE VELOCITY SURFACE ELECTRODE KIT $4,665
27001697 HC LUNG BX PLUG W/DELIVERY SYST (7680220196) $1,243
27001698 HC POWERGLIDE BASIC KIT $312
27001699 HC POWERGLIDE FULL KIT $528
27200427 HC DRUG COATED TRANSLUMINAL ANGIO CATH, NON LASER $6,643
27200428 HC QUICK-CROSS SELECT SUPPORT CATH (518-093) $800
27001700 HC MIDLINE DRESSING KIT (#015767) $84
27001701 HC STAY SAFE LUER LOK ADAPTER 4 IN (#015769) EA $160
27001702 HC PICC WIRE GUIDE 68 CM (#015448) $80
27001703 HC NEEDLE BREAST KOPANS $113
27001704 HC NEEDLE BREAST W/ GUIDEWIRE $113
27001705 HC ENEMA KIT CT CAT PAK $48
27001706 HC ADAPTIC TOUCH 3 X 4.25 (#015843A) EA $17
27001707 HC ENDOFORM 2 X 2 FENESTRATED (015495) EA $87
27001708 HC ENDOFORM 4 X 4 FENESTRATED (015496) EA $229
27001709 HC MEPILEX 4 X 4 DRESSING (294199) EA $133
27001710 HC UNNA W/CALAMINE (15844) $49
27001711 HC WALKER PACESETTER OPEN HEEL BOOT $254
27001712 HC HYDROFERA BLUE 2.5 X 2.5 (015421) EA $34
27001713 HC HYDROFERA BLUE 4 X 4 (015496) EA $45
27800240 HC LOOP RECORDER $10,230
27200429 HC MITRACLIP STEERABLE CATH (015827) $40,200
42000054 HC PT HEEL WEDGE SMALL $16
42000055 HC PT HEEL WEDGE MEDIUM $14
42000055 HC PT HEEL WEDGE LARGE $14
42000056 HC PT HEAT PACKS CERVICAL $27
42000057 HC PT HEAT PACKS STD $31
42000058 HC PT WRIST BRACE MEDIUM $25
42000059 HC PT KINESIO BBEG/GLD 2X2.73" $6
27001714 HC FOLEY TRAY I.C. COMPLETE CARE (000926) $112
27001715 HC ACTICOAT 7 SILVER DRESSING (020647) $127
27100694 HC ANKLE RESTRAINT (UH016385) $162
27100695 HC WRIST RESTRAINT (UH016386) $162
27100696 HC NEBULIZER LCD DISP (EA) $14
27100697 HC OXISENSOR CABLE INFANT $0
27002687 HC HIP ASSIST KIT (016475) $57
27100698 HC COMPLIANCE ENDO KIT (016379) $5
27800241 HC SEPTAL DEFECT IMPLANT SYSTEM $21,833
27002688 HC HIBICLENS 4% CHG FOAM (016575) $56
27002689 HC PERQ GASTROSTOMY SET (G08417) $670
27002690 HC KET ENEMA RAPIFIL SNAPCAP (300625) $49
27002691 HC RING E BARIUM DISP (300626) $60
27002522 HC CATARACT EYE KIT WITH LENS (TELESCOPIC) $1,722
27002758 HC NEBULIZER IV PORT/MASK/O2 TUBING (016193) $25
27002759 HC DRESSING ACTICOAT 4x5 INCH EA (014329) $45
27002760 HC GECKO NASAL PADS (016719) EA $80
27002761 HC EMMA DISP ADAPTERS $72
27002762 HC DILATOR SERIAL SINGLE $435
27002763 HC CLEARLINK BURETROL ADD ON SET (015567) $46
27002764 HC GRIPPER PORTACATH 19G X 1IN (015168) $11
27200430 HC THROMBECTOMY/EMBOLECTOMY CATHETER $9,284
27002765 HC AQUAPHOR (HYDROPHOR) OINTMENT #012768 $20
27002766 HC GLIDESCOPE TITANIUM S3 OR S4 $98
27002767 HC COMBAT APPLICATION TOURNIQUET (C-A-T) $74
27002768 HC SMOKE EVAC ELECTROSURGICAL PLUME PEN $119
27002769 HC GLIDESCOPE GVL 1 OR 2 STAT $66
27002770 HC SKIN TEMP PROBE, SINGLE USE $19
27800296 HC CORNEAL TISSUE PROCESSING $4,288
27002771 HC CATARACT EYE KIT WITH LENS (NON-TELESCOPIC) $1,722
27800297 HC WIRELESS PRESSURE SENSOR (CARDIOMEMS) $23,450
27800298 HC AMNIOTIC MEMBRANE (OCULAR) $475
27002772 HC ETRAP POLYP TRAP #017007 $22
27002773 HC BREATHING KIT CIRCUIT W/T-PIECE #013254 $60
27002774 HC MINERVA DISP HANDPIECE #017116 $1,555
27002775 HC FLOSHIELD $172
27800299 HC ABSORB BIOREABSORBABLE STENT $4,354
27002776 HC ONCONTROL BONE MARROW BX TRAY/KIT(017256) $520
27002777 HC EXSALT AG (SILVER) 4X5 IN DRESSING $47
27002778 HC EAKIN SEAL RING (014268) $120
27002779 HC POWERGLIDE PRO CATH FULL KIT (015584) $404
27002780 HC PREVENA PLUS INCISION SYSTEM (017480) $2,390
27002781 HC TISSEEL SPRAY SET (015592) $142
27100699 HC STERILE PANNUS RETENTION SYS (017603) $238
27002782 HC OPTI FLOW JR CANNULA (NEO/INFANT/PED) $270
27002784 HC SAFETY THORAPERA TRAY (017688) $341
27002785 HC CYSTOSURE SILICONE ACCESS CATH EA $65
27800301 HC LAA CLOSURE DEVICE $16,000
27002786 HC LAA ACCESS DEVICE (SHEATH) $2,000
27002787 HC OPTI FLOW JR CIRCUIT W/CHAMBER $194
27400031 HC VAD POWER MODULE, REPLACEMENT $28,000
27400032 HC VAD BATTERY/POWER PACK CHRGR, REP $25,200
27400033 HC VAD SYSTEM CONTROLLER, REP $19,250
27400034 HC VAD 14 VOLT LI-ION BATT EA, REP $8,750
27400035 HC VAD 11 VOLT LI-ION BACK UP BATT (PC) EA, REP $1,750
27400036 HC VAD 14 VOLT BATTERY CLIP, REP $3,850
27400037 HC VAD TRAVEL BAG, REP $560
27400038 HC VAD HOLSTER VEST SMALL, REP $1,383
27400039 HC VAD HOLSTER VEST MEDIUM, REP $1,383
27400040 HC VAD HOLSTER VEST LARGE, REP $1,383
27400041 HC VAD SHOWER BAG, REP $1,575
27400042 HC VAD STABILIZATION BELT MED/LG, REP $350
27400043 HC VAD BELT/VEST/BAG COMBO, REP $1,138
27002788 HC DRESSING SACRUM LG ALLEVYN $29
27100699 HC STERILE PANNUS RETENTION SYS (017603) $238
27100700 HC HUMERUS OVER THE SHOULDER BRACE (017859) $380
27100701 HC CERVICAL SOFT FOAM COLLAR $192
27100702 HC CERVICAL RIGID FOAM COLLAR $38
27100703 HC KNEE IMMOBILIZER $136
27100704 HC KNEE BRACE ADJUSTABLE $1,019
27100705 HC ARM/SHOULDER IMMOBILIZER $74
27100706 HC WRIST /HAND COCK-UP SPLINT $74
27100707 HC WALKING BOOT PNEUMA/VAC PREFAB $370
27100708 HC CLAVICULAR SPLINT $74
27100709 HC FINGER SPLINT $43
27100710 HC AFO ANKLE GAUNLET (BRACE) $103
27100711 HC METACARPAL BRACE $130
27100712 HC HUMERAL BRACE $380
27100713 HC SLEEVE NEOPRENE $45
27100714 HC SHOULDER SLING ULTRA $75
27100715 HC SHOE POST OP $33
27100716 HC ARM SLING $27
27400044 HC VAD 12 VOLT LI-ION BACK UP BATT EA, REP $1,750
27400045 HC VAD MOBILE POWER UNIT (MPU) $28,000
27200500 HC MIRENA IUD $1,716
27400046 HC VAD MPU AC POWER CABLE, EA $123
27002789 HC THORACOTOMY TROCAR TRAY DISP (017916) $175
27002790 HC INTRANASAL MUCOSAL ATOMIZATION DEVICE (017946) $374
27400047 HC VAD 12 V BACK UP BATTERY EA, REP $315
27400048 HC VAD BATTERY HOLSTER (SET OF 2) $1,383
27002791 HC TRUCLEAR ULTRA PLUS DEVICE (018120) $1,205
27002792 HC TRUCLEAR ULTRA MINI DEVICE (018121) $1,470
27002793 HC TRUCLEAR INCISOR PLUS DEVICE (018122) $1,080
27002794 HC TRUCLEAR INCISOR DEVICE (018123) $1,310
27002795 HC PROCEDURE KIT HYSTER. (018124) $640
27002796 HC 3000CC HI-FLOW CANISTER (018125) $18
27002797 HC FULL MAX BARRIER INSERT KIT (4FR PICC) 018062 $928
27002798 HC APPLICATOR TIP (ARISTA) $31
27002799 HC PUREWICK FEMALE CATH $26
27200501 HC PTA .035 BALLOON CATH $323
27200502 HC PTA .018 BALLOON CATH $629
27200503 HC PTA .014 BALLOON CATH $663
27200504 HC SX ILIAC STENT (E-LUMIXEXX) $2,720
27200505 HC BALLOON EXPANDABLE STENT (VALEO) $2,465
27200506 HC LIFE STENT 20MM-120MM $1,500
27200507 HC LIFE STENT 150MM $2,500
27200508 HC LIFE STENT 170MM $3,150
27200509 HC LIFE STENT 200MM $4,800
27200510 HC PTA SPECIALTY BALLOON (VASCUTRAK) $2,040
27002800 HC OXIMIZER PENDANT NASAL CANNULA $72
27002801 HC NEOBAR TUBE HOLDER MICRO $72
27002802 HC NEOBAR TUBE HOLDER SMALL $72
27002803 HC NEOBAR TUBE HOLDER LARGE $72
27002804 HC NEOBAR TUBE HOLDER X LARGE $72
27002805 HC CUSHION INVALID RING W/COVER $58
27002806 HC LEG HOLDER PAD (016317) $51
27002807 HC CASTILLE SOAP UNSCENTED 4OZ (018485) $31
27002808 HC ARCTIC GEL PAD SET SMALL $2,055
27002809 HC ARCTIC GEL PAD SET LARGE $2,055
27002810 HC ARCTIC GEL PAD UNIVERSAL PAD $618
27002811 HC BACTISURE WOUND LAVAGE $1,340
27002812 HC 12 FR TPIECE INLINE SUCTION CATH #21513511 $54
27002813 HC ONESTEP RESUSC ELECTRODE PAD #018867 $332
27002814 HC SWAB SKIN AND NASAL ANTISEPTIC $103
27002815 HC LVAD WEEKLY DRESSING CHANGE KIT $153
27002816 HC LVAD DAILY DRESSING CHANGE KIT $215
27002817 HC NOZIN PRE OP PACKS $51
27002818 HC LUMI BEADS $4,690
27002819 HC NEPHROMAX SET $656
27002820 HC SACRUM DRESSING-LARGE $36
27002821 HC TUBE EVAC 15-19FR DRAIN $42
27800302 HC STENT LIFESTREAM $7,500
27400049 HC VAD GO GEAR ACCESSORIES $595
27400050 HC VAD BATTERY CHRGR AC POWER CORD $123
27002822 HC DISPOSABLE SCOPE SMALL $628
27002823 HC DISPOSABLE SCOPE LARGE $722
27002824 HC CYCLER DRAINAGE BAG 15 LITER $45
27002825 HC AMIA PERITONEAL DIALYSIS $165
27002826 HC DRAIN MANIFOLD $41
27002827 HC 5FRVTK CATHETER 125CM $126
27002828 HC ABSORBANT DRY SHEET $39
27002829 HC ACTICOAT 4 X 4 3/4 $62
27002830 HC ACTICOAT 4 X 8 $98
27002831 HC ACTICOAT 4 X 10 $130
27002832 HC ACTICOAT 4 X 13 3/4 $146
27002833 HC BARRIER SKIN STING FREE $102
27002834 HC RESECTION DEVICE $2,867
27002835 HC FLUID MANAGEMENT $1,197
27002836 HC GENESYS PROCEDURE SET $3,081
27002837 HC GELPOINT MINI ACCESS PLATFORM $650
27002838 HC GELPOINT ACCESS PLATFORM $950
27002839 HC NEUWAVE MICRO-ABLATION PROBE $2,546
27002840 HC SOLERO MICRO-ABLATION PROBE $4,824
27002841 HC PRECIPITOUS DELIVERY TRAY $471