Greenwich Hospital Price Master - CT.gov

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31000344 HC IMMUNOCYTOCHEMISTRY, EA AB - TECHNICAL 198.00 4/1/2013 31000345 HC IMMUNOCYTOCHEMISTRY, ADD'L - TECHNICAL 198.00 4/1/2013 31000347 HC IHC ADDITIONAL - GLOBAL 502.00 4/1/2013 31000353 HC MORPHOMET ANAL QUANT EA AB MAN - TECHNIC 397.00 4/1/2013 31000354 HC QUANT IMMUNOHISTOCHEMISTRY ADD - TECHNIC 314.58 4/1/2013 31000355 HC MORPHOMET ANAL QUANT EA AB MAN - GLOBAL 604.00 4/1/2013 31000356 HC QUANTITATIVE IHC ADD'L - GLOBAL 604.00 4/1/2013 31000358 HC ISH - TECHNICAL 221.00 4/1/2013 31000359 HC ISH ADDITIONAL - TECHNICAL 174.68 4/1/2013 31000360 HC ISH - GLOBAL 793.00 4/1/2013 31000361 HC ISH ADDITIONAL - GLOBAL 793.00 4/1/2013 31000395 HC TISSUE CULTURE NEOPLASTIC (CLL/LPD) 764.00 4/1/2013 31000396 HC FLOW CYTOMETRY, MARKER 1 (ZAP-70) 151.41 4/1/2013 31000397 HC FLOW CYTOMETRY EA ADD'L (ZAP-70) 151.41 4/1/2013 31000398 HC FLOW INTERP 2-8 MARKERS (ZAP-70) 92.39 4/1/2013 31000399 HC FLOW CYTOMETRY EA ADD'L (PNH W FLAER) 75.57 4/1/2013 31000406 HC FLOW CYTO, MARKER 1 (CD57,CD3,CD8) 273.00 4/1/2013 31000407 HC FLOW CYTO EA ADD'L (CD57,CD3,CD8) 161.48 4/1/2013 31100013 HC CYTOPATHOLOGY FLUIDS, ADD'L - TECHNICAL 194.00 4/1/2013 31100015 HC CYTOPATHOLOGY FLUIDS - TECHNICAL 194.00 4/1/2013 31100016 HC CYTO FLUID FILTER METHOD - TECHNICAL 194.00 4/1/2013 31100019 HC CYTOPATH FLUIDS - GLOBAL 508.00 4/1/2013 31100020 HC CYTOPATH URINE - GLOBAL 508.00 4/1/2013 31100021 HC MD INTERPRETATION - PAP SMEAR - GLOBAL 134.00 4/1/2013 31100022 HC C/V CYTOLOGY THIN PREP - GLOBAL 134.00 4/1/2013 31100027 HC ADEQUACY FINE NEEDLE ASPIRATE - TECHNICA 159.00 4/1/2013 31100029 HC FNA ADEQUACY - GLOBAL 262.00 4/1/2013 31100031 HC FINE NEEDLE ASPIRATE - TECHNICAL 249.00 4/1/2013 31100033 HC FNA - GLOBAL 667.00 4/1/2013 31100035 HC CYTOPATH C/V AUTO FLUID REDO - TC ONLY 147.13 4/1/2013 31100036 HC CYTOPATH C/V AUTO IN FLUID RED - GLOBAL 186.24 4/1/2013 31100039 HC SCREENING THIN-LAYER PAP 69.39 4/1/2013 31100040 HC SCR C/V CYTO, F/P + MAN RESCR 138.00 4/1/2013 31200001 HC FISH,HER-2/NEU 258.75 4/1/2013 32000008 HC XR NASAL BONES COMPL 3+ VIEWS 506.00 4/1/2013 32000013 HC XR SINUSES COMPL 3+ VIEWS 598.00 4/1/2013 32000015 HC XR SKULL < 4 VIEWS 565.00 4/1/2013 32000016 HC XR SKULL COMPL 4+ VIEWS 698.00 4/1/2013 32000020 HC XR ORTHOPANTOGRAM 253.00 4/1/2013 32000021 HC XR NECK SOFT TISS 393.39 4/1/2013 32000026 HC XR CHEST 1 VIEW 358.88 4/1/2013 32000027 HC XR CHEST 2 VIEWS 455.00 4/1/2013 32000028 HC XR CHEST 2 VIEWS W/APICAL LORDOTIC 509.00 4/1/2013 32000029 HC XR CHEST W/OBLIQUES 669.45 4/1/2013 32000030 HC XR CHEST 2 VIEWS W/FLUORO 1,006.50 4/1/2013 32000031 HC XR CHEST COMPL 4+ VIEWS 607.33 4/1/2013 32000033 HC XR CHEST SPECL VIEWS 386.00 4/1/2013 32000035 HC XR RIBS UNI 2 VIEWS 546.00 4/1/2013 32000036 HC XR RIBS UNI W/CHEST 3+ VIEWS 583.20 4/1/2013 32000039 HC XR STERNUM 2+ VIEWS 541.00 4/1/2013 32000041 HC XR SPINE ENTIRE AP & LATERAL 340.50 4/1/2013 32000042 HC XR C-SPINE 1 VIEW 319.00 4/1/2013 32000043 HC XR C-SPINE 2 OR 3 VIEWS 578.60 4/1/2013 32000044 HC XR C-SPINE 4+ VIEWS 849.00 4/1/2013 32000045 HC XR C-SPINE COMPL W/OBLIQUE/FLEX/EXT 914.00 4/1/2013 32000047 HC XR THOR SPINE 2 VIEWS 510.00 4/1/2013 32000049 HC XR THOR SPINE 4+ VIEWS 771.00 4/1/2013 32000051 HC XR SPINE SCOLIOSIS STDY SUPINE/ERECT 488.88 4/1/2013 32000052 HC XR LUMBAR SPINE 2 OR 3 VIEWS 510.71 4/1/2013 32000053 HC XR LUMBAR SPINE 4+ VIEWS 833.00 4/1/2013 32000054 HC XR LUMBAR SPINE COMPL W/BENDING VIEWS 940.90 4/1/2013 32000056 HC XR PELVIS 1 OR 2 VIEWS 479.00 4/1/2013 32000059 HC XR SACROILIAC JTS 3+ VIEWS 338.00 4/1/2013 32000060 HC XR SACRUM/COCCYX 2+ VIEWS 466.00 4/1/2013 32000061 HC XR MYELOGRAM C-SPINE S&I 1,239.97 4/1/2013 32000066 HC XR FLUORO VEEBROP PERC OR SAC AUG 1,249.00 4/1/2013 32000069 HC XR CLAVICLE COMPL 432.00 4/1/2013 32000070 HC XR SCAPULA COMPL 436.00 4/1/2013 32000071 HC XR SHOULDER 1 VIEW 388.00 4/1/2013 32000072 HC XR SHOULDER COMPL 2+ VIEWS 462.40 4/1/2013 32000075 HC XR HUMERUS 2+ VIEWS 420.00 4/1/2013 32000076 HC XR ELBOW 2 VIEWS 418.00 4/1/2013 32000077 HC XR ELBOW COMPL 3+ VIEWS 447.47 4/1/2013 32000079 HC XR FOREARM 2 VIEWS 437.00 4/1/2013 32000081 HC XR WRIST 2 VIEWS 369.00 4/1/2013 32000082 HC XR WRIST COMPL 3+ VIEWS 474.00 4/1/2013 32000084 HC XR HAND LTD 2 VIEWS 367.00 4/1/2013 32000085 HC XR HAND COMPL 3+ VIEWS 474.00 4/1/2013 32000086 HC XR FINGER(S) 2+ VIEWS 320.00 4/1/2013 32000087 HC XR HIP UNI 1 VIEW 355.00 4/1/2013 32000088 HC XR HIP UNI COMPL 2+ VIEWS 523.39 4/1/2013 32000089 HC XR HIPS W/PELVIS 4+ VIEWS 879.00 4/1/2013 32000090 HC XR AHROGRAM HIP S&I 1,328.57 4/1/2013 32000091 HC XR HIP INTRAOPERATIVE 379.58 4/1/2013 32000093 HC XR FEMUR 2 VIEWS 514.00 4/1/2013 32000094 HC XR KNEE 1 OR 2 VIEWS 366.96 4/1/2013 32000095 HC XR KNEE 3 VIEWS 498.00 4/1/2013 32000096 HC XR KNEE COMPL 4+ VIEWS 550.00 4/1/2013 32000099 HC XR TIB/FIB 2 VIEWS 419.00 4/1/2013 32000100 HC XR LWR EXTREM INFANT 2+ VIEWS 256.53 4/1/2013
32000101 HC XR ANKLE 2 VIEWS 406.00 4/1/2013 32000102 HC XR ANKLE COMPL 3+ VIEWS 474.00 4/1/2013 32000104 HC XR FT 2 VIEWS 484.00 4/1/2013 32000105 HC XR FT COMPL 3+ VIEWS 580.90 4/1/2013 32000106 HC XR CALCANEUS 2+ VIEWS 349.00 4/1/2013 32000107 HC XR TOE(S) 2+ VIEWS 400.29 4/1/2013 32000108 HC XR ABD 1 VIEW 450.00 4/1/2013 32000110 HC XR ABD AP/DECUB/ERECT 549.82 4/1/2013 32000113 HC XR ESOPHAGUS 811.00 4/1/2013 32000114 HC XR SWALLOWING FUNCTION CINE/VIDEO 753.00 4/1/2013 32000116 HC XR UGI W/O KUB 972.00 4/1/2013 32000118 HC XR UGI W/SMALL INTESTINE 1,409.08 4/1/2013 32000121 HC XR SMALL INTESTINE 953.00 4/1/2013 32000128 HC XR CHOLANGIO THRU CATH S&I 819.00 4/1/2013 32000133 HC XR CATH BILIARY & PANCREATIC (ERCP) S&I 1,316.00 4/1/2013 32000141 HC XR UROGRAM RETROGRADE 1,129.00 4/1/2013 32000142 HC XR UROGRAM ANTEGRADE S&I 887.00 4/1/2013 32000143 HC XR CYSTOGRAM 3+ VIEWS S&I 1,098.00 4/1/2013 32000144 HC XR CYSTOURETHROGRAM RETROGRADE S&I 1,202.00 4/1/2013 32000145 HC XR CYSTOURETHROGRAM VOIDING S&I 945.00 4/1/2013 32000147 HC XR INTRODUCTION CATH RENAL PELVIS S&I 2,508.72 4/1/2013 32000148 HC XR INTRODUCTION CATH/STENT URETERAL S&I 2,260.27 4/1/2013 32000150 HC XR HYSTEROSALPINGOGRAM S&I 905.00 4/1/2013 32000222 HC XR CHG TUBE/DRAIN CATH S&I 1,051.00 4/1/2013 32000223 HC XR FLUORO ABSC DRAIN/SPECIMEN COLL S&I 1,219.27 4/1/2013 32000224 HC XR FLUORO < 1 HR 0.00 4/1/2013 32000225 HC XR FLUORO > 1 HR 0.00 4/1/2013 32000227 HC XR ABSC FISTULA/SINUS TRACT STDY S&I 695.93 4/1/2013 32000228 HC XR SURGICAL SPECIMEN 355.00 4/1/2013 32000236 HC XR FLUORO CV ACCESS DEVICE PLACEMENT 783.35 4/1/2013 32000237 HC XR FLUORO NDL PLACEMENT 1,025.00 4/1/2013 32000238 HC XR FLUORO NDL LOACALIZ 842.00 4/1/2013 32000239 HC XR STEREOTACTIC LOACALIZ GUIDE EA S&I 2,090.03 4/1/2013 32000240 HC MAMMO GUIDE PL NDL BREAST EA S&I 1,038.00 4/1/2013 32000241 HC MAMMOGRAM COMPUTER AIDED DETECTION DIAG 95.23 4/1/2013 32000242 HC MAMMOGRAM COMPUTER AIDED DETECTION SCRN 100.58 4/1/2013 32000244 HC DIAG MAMMO,UNILATE 389.00 4/1/2013 32000245 HC MAMMOGRAM DIAG BILATERAL 549.00 4/1/2013 32000246 HC MAMMOGRAM SCRN BILATERAL 463.00 4/1/2013 32000247 HC XR BONE AGE STDY 414.00 4/1/2013 32000250 HC XR BONE SURVEY COMPL 1,011.00 4/1/2013 32000253 HC XR BONE DENSITY DUAL ENERGY (DXA) AXIAL 602.00 4/1/2013 33000001 HC SIM SMPL 1,032.00 4/1/2013 33000003 HC SIM CMPLX 2,764.00 4/1/2013 33000004 HC SIM 3-D/CT GUIDED 7,062.54 4/1/2013 33000005 HC DOSIMETRY CALCULATION BASIC 841.00 4/1/2013 33000006 HC INTENSITY MODULATED TX PLAN 10,353.00 4/1/2013 33000009 HC ISODOSE TELETHPY CMPLX 3,306.00 4/1/2013 33000010 HC PO PLAN SPECL PAICLES/HEMI/TOTAL BODY 1,676.00 4/1/2013 33000017 HC TX DEVICE CMPLX 1,257.25 4/1/2013 33000018 HC MEDICAL PHYSICS CONTINUING 936.30 4/1/2013 33000019 HC MLC DEVICE(S) FOR IM 1,934.00 4/1/2013 33000020 HC MEDICAL PHYSICS SPECL 1,192.00 4/1/2013 33000022 HC MED PHYSICS DOSIMETRY UNLISTED PROC 410.00 4/1/2013 33000026 HC RAD THPY TREAT SMPL 11-19 MEV 801.75 4/1/2013 33000029 HC RAD THPY TREAT CMPLX 6-10 MEV 1,447.00 4/1/2013 33000030 HC RAD THPY TREAT CMPLX 11-19 MEV 1,457.00 4/1/2013 33000032 HC RAD THPY PO FILM(S) 378.00 4/1/2013 33000033 HC RAD THPY TREAT INTENSITY MOD SNGL/MULT 3,203.47 4/1/2013 33000034 HC STEREOTACTIC XR GUIDANCE 680.95 4/1/2013 33000035 HC RAD THPY TREAT SPECL HEMI/TOTAL BODY 3,051.00 4/1/2013 33000048 HC CHEMO SC/IM NONHORMONAL ANTI-NEOPLASTIC 382.00 4/1/2013 33000049 HC CHEMO SC/IM HORMONAL ANTI-NEOPLASTIC 308.00 4/1/2013 33000051 HC CHEMO IV PUSH SNGL/INIT DRUG 671.00 4/1/2013 33000052 HC CHEMO IV PUSH ADDL DRUG 662.00 4/1/2013 33000053 HC CHEMO IV INF SNGL/INIT DRUG < 1HR 873.00 4/1/2013 33000054 HC CHEMO IV INF ADDL HR 708.00 4/1/2013 33000055 HC CHEMO IV INF PROLONG W/PBLE/IMPL PUMP 996.00 4/1/2013 33000056 HC CHEMO IV INF EA ADD DRUG < 1HR 807.00 4/1/2013 33000058 HC PUMP POABLE REFILLING AND MAINTENANCE 519.00 4/1/2013 33300006 HC STEREOTACTIC FIRST SESSION TOTAL 16,149.51 4/1/2013 33300007 HC LINEAR ACCELERATOR SRS DEL/SESSION
Page 1 and 2: Greenwich Hospital Price Master as
Page 3 and 4: 27200017 HC ELECTRODE TRANSVENOUS P
Page 5 and 6: 27800067 HC STAPLER SKIN ROYAL 35 2
Page 7 and 8: 30000464 HC ACTIVATED PROTEIN C RES
Page 9 and 10: 30001771 HC CYSTIC FIBROSIS NEWBORN
Page 11 and 12: 30100318 HC MOL DIA;SEP BY GEL E4,E
Page 13: 30600038 HC PAPILLOMAVIRUS, HUMAN:A
Page 17 and 18: 36000178 HC BX BREAST NDL PERC W/GU
Page 19 and 20: 40000043 HC US GUIDANCE INTRAOPERAT
Page 21 and 22: 61000039 HC MRI UPR EXTREM JT W/O C
Page 23 and 24: 98100016 HCPR REPAIR LAC SIMPLE SCA
Page 25 and 26: 27250001628 SUTURE SILK 6-0 S1769K
Page 27 and 28: 250000051465 CEFUROXIME SODIUM 750
Page 29 and 30: 270500013282 INDERMIL TISSUE ADHESI
Page 31 and 32: 272500012059 BLANKET WARMER BAIR HU
Page 33 and 34: 272500015138 BLADE DIEGO SERRATED 4
Page 35 and 36: 276500023575 LENSE SN60WF18.5 569.1
Page 37 and 38: 278500015237 CUP BIPOLAR 5001-53-28
Page 39 and 40: 278500232831 POLARIS STENT KIT 7FR
Page 41 and 42: 637000017753 TEMAZEPAM 15 MG CAPSUL
Page 43 and 44: 2500000433512 ESCITALOPRAM 10 MG TA
Page 45 and 46: 2705000126822 TUBE VACUUM AQUILEX H
Page 47 and 48: 6370000111218 PSYLLIUM ORAL PACKET
Page 49 and 50: 6370000129858 METOPROLOL SUCCINATE
Page 51 and 52: 25000005113667 SODIUM CHLORIDE 0.9

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