Greenwich Hospital Price Master - CT.gov
Greenwich Hospital Price Master - CT.gov Greenwich Hospital Price Master - CT.gov
36000832 HC CHG TUBE NEPHROSTOMY/PYELOSTOMY 1,959.00 4/1/2013 36000842 HC INJ CYSTOGRAM/VOIDING URETHROCYSTOGRAM 1,880.00 4/1/2013 36000843 HC INJ URETHROCYSTOGRAM RETROGRADE 1,880.00 4/1/2013 36000845 HC CATH BLADDER NON-INDWELLING 404.00 4/1/2013 36000846 HC CATH BLADDER SMPL 143.00 4/1/2013 36000847 HC CATH BLADDER COMPLICATED 194.74 4/1/2013 36000857 HC MEASURE POST-VOID URINE BY US 121.00 4/1/2013 36000866 HC CIRCUM W/CLAMP/OTHER DEVICE/RING BLOCK 984.00 4/1/2013 36000896 HC COLPOSCOPY CERVIX/VAGINA 235.83 4/1/2013 36000897 HC COLPOSCOPY W/BX & CURETTAGE 391.00 4/1/2013 36000906 HC BX ENDOMETRIAL SAMP W/O DILATATION 232.00 4/1/2013 36000908 HC INS DEVICE INTRAUTERINE IUD 568.00 4/1/2013 36000910 HC CATH/INTRO SALINE/CONTR FOR SIS 508.00 4/1/2013 36000913 HC LIGATE/TRANSECT TUBE FALLOPIAN W/C-SECT 2,132.00 4/1/2013 36000920 HC CHORIONIC VILLUS SAMP 1,214.00 4/1/2013 36000922 HC TEST NON STRESS FETAL 1,071.00 4/1/2013 36000930 HC DEL VAG W/ANTEPARTUM/POSTPARTUM CARE 3,984.00 4/1/2013 36000932 HC VERSION CEPHALIC EXTERNAL 3,032.00 4/1/2013 36000935 HC DEL C-SECT W/HYSTERECTOMY TOTAL/SUBTOTAL 1,115.00 4/1/2013 36000942 HC REM SUTURE CERCLAGE UNDER ANESTHESIA 5,699.70 4/1/2013 36000959 HC LUMBAR PUNCT DIAG 1,719.00 4/1/2013 36000961 HC INJ EPIDURAL BL/CLOT PATCH 1,129.00 4/1/2013 36000998 HC DEST NRV NEUROLYTIC MSCL EXTREM/TRUNK 862.74 4/1/2013 36001000 HC SUTURE NRV DIGITAL HAND OR FT 1 NRV 3,114.66 4/1/2013 36001004 HC REM FB EYE EXT CONJUCTIVAL SUPERFICIAL 174.30 4/1/2013 36001006 HC REM FB CORNEAL W/O SLIT LAMP 374.02 4/1/2013 36001007 HC REM FB CORNEAL W/SLIT LAMP 153.00 4/1/2013 36001039 HC DRAIN ABSC/HEMATOMA EXT EAR SMPL 397.40 4/1/2013 36001042 HC REM FB CANAL AUD EXTERNAL W/O GEN ANES 164.00 4/1/2013 36001043 HC REM CERUMEN IMPACTED 1 OR BOTH EARS 260.00 4/1/2013 36001046 HC INTRO NDL/INTRACATH VEIN 775.27 4/1/2013 36001054 HC ASPIRAT BONE MARROW W/BX ON SAME DAY 107.00 4/1/2013 36001086 HC ADD C-SECTION DEL TWIN/TRIPLET 989.00 4/1/2013 36001105 HC OPERATING ROOM MINUTE LEVEL 1 54.00 4/1/2013 36001106 HC OPERATING ROOM MINUTE LEVEL 2 116.42 4/1/2013 36001109 HC PAIN MNGMNT PROC PER MINUTE 29.00 4/1/2013 36001111 HC POC 3,324.60 4/1/2013 36001124 HC C/SECTION 10,176.00 4/1/2013 36001149 HC STRAPPING UNNA BOOT BILAT 409.49 4/1/2013 36001151 HC GFT SKIN SUB T/A/L 14 WEEKS SNGL/FIRST GEST 1,267.00 4/1/2013 40000018 HC US PREGNANCY DETAILED SNGL/FIRST GEST 1,234.00 4/1/2013 40000019 HC US PREGNANCY DETAILED EA ADDL GEST 885.00 4/1/2013 40000020 HC US PREGNANCY 1 OR MORE FETUSES LTD 549.00 4/1/2013 40000021 HC US PREGNANCY FOLLOWUP PER FETUS 575.00 4/1/2013 40000022 HC US PREGNANCY TRANSVAG 611.00 4/1/2013 40000024 HC US FETAL BIOPHYSICAL PROFILE W/O NST 771.00 4/1/2013 40000025 HC US FETAL DOPLER VELOCIM UMBILICAL ART 465.00 4/1/2013 40000027 HC US FETAL HEA ECHO 2D W/ OR W/O M-MODE 1,217.00 4/1/2013 40000028 HC US FETAL ECHO 2D W/ OR W/O M-MODE F/U 628.90 4/1/2013 40000029 HC US DOPPLER ECHOCARDIOGRAPHY FETAL COMPL 559.00 4/1/2013 40000030 HC US FETAL HEA DOPPLER ECHO F/U 393.00 4/1/2013 40000031 HC US TRANSVAG 1,185.00 4/1/2013 40000032 HC US SALINE INF SONOHYSTERO COLOR FLOW 728.00 4/1/2013 40000033 HC US PELVIS NON OB 1,220.00 4/1/2013 40000034 HC US PELVIS NON OB LTD 462.00 4/1/2013 40000035 HC US SCROTUM 879.00 4/1/2013 40000038 HC US GUIDED NDL PL S&I 1,192.00 4/1/2013 40000039 HC US GUIDED CHORIONIC VILLUS SAMP S&I 1,100.00 4/1/2013 40000040 HC US GUIDED AMNIO S&I 599.00 4/1/2013
40000043 HC US GUIDANCE INTRAOPERATIVE 802.00 4/1/2013 40000050 HC PET W/CT TUMOR IMAG SKULL TO MID-THIGH 7,634.24 4/1/2013 40000051 HC PET W/CT TUMOR IMAG WHOLE BODY 8,827.00 4/1/2013 40000053 HC MAMMOGRAM SCRN W/DIGITAL IMAGES 463.00 4/1/2013 40000054 HC MAMMOGRAM DIAG W/DIGITAL IMAGES 549.00 4/1/2013 40000055 HC MAMMOGRAM DIAG UNI W/DIGITAL IMAGE 389.00 4/1/2013 40200002 HC US PREGNANCY NUCHAL MEAS SNGL OR 1ST GES 743.06 4/1/2013 40200003 HC US PREGNANCY NUCHAL MEAS EA ADDL GES 492.00 4/1/2013 40200005 HC US EXTREM NON VASCULAR COMPL 2,073.45 4/1/2013 40200006 HC US EXTREM NON VASCULAR LTD ANATOMIC SPEC 2,073.45 4/1/2013 40200008 HC US HIPS INFANT LTD STATIC 2,132.00 4/1/2013 41000001 HC VENT MANGMNT INPT/OBS INIT DAY 1,489.87 4/1/2013 41000004 HC CPAP INITIATION/MGMT 1,508.11 4/1/2013 41000005 HC CHEST PHYSIOTHPY INIT 214.00 4/1/2013 41000006 HC CHEST PHYSIOTHPY SUBSEQ 61.00 4/1/2013 41000007 HC PULSE OXIMETRY OVERNIGHT CONTINUOUS 890.00 4/1/2013 41000008 HC PULM UNLISTED SVC/PROC 459.00 4/1/2013 41000017 HC WEANING 185.00 4/1/2013 41000018 HC EXTUBATION 978.62 4/1/2013 41200001 HC VENTILATOR MGMT INPAT/OBS SUBSEQ DAY 1,393.00 4/1/2013 41300002 HC HYPERBARIC O2 1,130.72 4/1/2013 42000001 HC APPLICATION TENS 149.00 4/1/2013 42000002 HC EVALUATION SPEECH CMPLX 563.00 4/1/2013 42000003 HC PT TX SPEECH LTD 193.00 4/1/2013 42000004 HC EVALUATION SWALLOWING CMPLX 383.00 4/1/2013 42000005 HC FLURO EVAL SWALLOWING 703.74 4/1/2013 42000012 HC EVALUATION 45 MIN 644.73 4/1/2013 42000013 HC RE-EVALUATION 30 MIN 279.00 4/1/2013 42000015 HC TRACTION MECHANICAL 135.00 4/1/2013 42000016 HC ELECTRICAL STIMULATION UNATTENDED 118.00 4/1/2013 42000018 HC PARAFFIN BATH THPY 108.00 4/1/2013 42000019 HC WHIRLPOOL 109.00 4/1/2013 42000020 HC ELECTRICAL STIMULATION ATTENDED 15 MIN 173.00 4/1/2013 42000021 HC IONTOPHORESIS 15 MIN 158.00 4/1/2013 42000022 HC CONTR BATH 15 MIN 114.60 4/1/2013 42000023 HC ULTRASOUND 15 MIN 123.00 4/1/2013 42000025 HC EXERCISE PROPH 15 MIN 181.95 4/1/2013 42000026 HC NEUROMUSCULAR RE-ED 15 MIN 144.00 4/1/2013 42000027 HC AQUATIC THPY/EXERCISE 15 MIN 169.00 4/1/2013 42000028 HC GAIT TRN 15 MIN 153.38 4/1/2013 42000029 HC MASSAGE 15 MIN 129.00 4/1/2013 42000031 HC MANUAL THPY 15 MIN 181.95 4/1/2013 42000033 HC PROPH ACT 15 MIN 190.14 4/1/2013 42000035 HC SENSORY INTEGRATIVE TECHNIQUE 15 MIN 210.58 4/1/2013 42000036 HC HOME INSTRUCTION/PROGRAM 15 MIN 178.00 4/1/2013 42000039 HC DEBR OPEN WOUND PER SESSION
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- 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 and 14: 30600038 HC PAPILLOMAVIRUS, HUMAN:A
- Page 15 and 16: 32000101 HC XR ANKLE 2 VIEWS 406.00
- Page 17: 36000178 HC BX BREAST NDL PERC W/GU
- 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
36000832 HC CHG TUBE NEPHROSTOMY/PYELOSTOMY 1,959.00 4/1/2013<br />
36000842 HC INJ CYSTOGRAM/VOIDING URETHROCYSTOGRAM 1,880.00 4/1/2013<br />
36000843 HC INJ URETHROCYSTOGRAM RETROGRADE 1,880.00 4/1/2013<br />
36000845 HC CATH BLADDER NON-INDWELLING 404.00 4/1/2013<br />
36000846 HC CATH BLADDER SMPL 143.00 4/1/2013<br />
36000847 HC CATH BLADDER COMPLICATED 194.74 4/1/2013<br />
36000857 HC MEASURE POST-VOID URINE BY US 121.00 4/1/2013<br />
36000866 HC CIRCUM W/CLAMP/OTHER DEVICE/RING BLOCK 984.00 4/1/2013<br />
36000896 HC COLPOSCOPY CERVIX/VAGINA 235.83 4/1/2013<br />
36000897 HC COLPOSCOPY W/BX & CURETTAGE 391.00 4/1/2013<br />
36000906 HC BX ENDOMETRIAL SAMP W/O DILATATION 232.00 4/1/2013<br />
36000908 HC INS DEVICE INTRAUTERINE IUD 568.00 4/1/2013<br />
36000910 HC CATH/INTRO SALINE/CONTR FOR SIS 508.00 4/1/2013<br />
36000913 HC LIGATE/TRANSE<strong>CT</strong> TUBE FALLOPIAN W/C-SE<strong>CT</strong> 2,132.00 4/1/2013<br />
36000920 HC CHORIONIC VILLUS SAMP 1,214.00 4/1/2013<br />
36000922 HC TEST NON STRESS FETAL 1,071.00 4/1/2013<br />
36000930 HC DEL VAG W/ANTEPARTUM/POSTPARTUM CARE 3,984.00 4/1/2013<br />
36000932 HC VERSION CEPHALIC EXTERNAL 3,032.00 4/1/2013<br />
36000935 HC DEL C-SE<strong>CT</strong> W/HYSTERE<strong>CT</strong>OMY TOTAL/SUBTOTAL 1,115.00 4/1/2013<br />
36000942 HC REM SUTURE CERCLAGE UNDER ANESTHESIA 5,699.70 4/1/2013<br />
36000959 HC LUMBAR PUN<strong>CT</strong> DIAG 1,719.00 4/1/2013<br />
36000961 HC INJ EPIDURAL BL/CLOT PATCH 1,129.00 4/1/2013<br />
36000998 HC DEST NRV NEUROLYTIC MSCL EXTREM/TRUNK 862.74 4/1/2013<br />
36001000 HC SUTURE NRV DIGITAL HAND OR FT 1 NRV 3,114.66 4/1/2013<br />
36001004 HC REM FB EYE EXT CONJU<strong>CT</strong>IVAL SUPERFICIAL 174.30 4/1/2013<br />
36001006 HC REM FB CORNEAL W/O SLIT LAMP 374.02 4/1/2013<br />
36001007 HC REM FB CORNEAL W/SLIT LAMP 153.00 4/1/2013<br />
36001039 HC DRAIN ABSC/HEMATOMA EXT EAR SMPL 397.40 4/1/2013<br />
36001042 HC REM FB CANAL AUD EXTERNAL W/O GEN ANES 164.00 4/1/2013<br />
36001043 HC REM CERUMEN IMPA<strong>CT</strong>ED 1 OR BOTH EARS 260.00 4/1/2013<br />
36001046 HC INTRO NDL/INTRACATH VEIN 775.27 4/1/2013<br />
36001054 HC ASPIRAT BONE MARROW W/BX ON SAME DAY 107.00 4/1/2013<br />
36001086 HC ADD C-SE<strong>CT</strong>ION DEL TWIN/TRIPLET 989.00 4/1/2013<br />
36001105 HC OPERATING ROOM MINUTE LEVEL 1 54.00 4/1/2013<br />
36001106 HC OPERATING ROOM MINUTE LEVEL 2 116.42 4/1/2013<br />
36001109 HC PAIN MNGMNT PROC PER MINUTE 29.00 4/1/2013<br />
36001111 HC POC 3,324.60 4/1/2013<br />
36001124 HC C/SE<strong>CT</strong>ION 10,176.00 4/1/2013<br />
36001149 HC STRAPPING UNNA BOOT BILAT 409.49 4/1/2013<br />
36001151 HC GFT SKIN SUB T/A/L 14 WEEKS SNGL/FIRST GEST 1,267.00 4/1/2013<br />
40000018 HC US PREGNANCY DETAILED SNGL/FIRST GEST 1,234.00 4/1/2013<br />
40000019 HC US PREGNANCY DETAILED EA ADDL GEST 885.00 4/1/2013<br />
40000020 HC US PREGNANCY 1 OR MORE FETUSES LTD 549.00 4/1/2013<br />
40000021 HC US PREGNANCY FOLLOWUP PER FETUS 575.00 4/1/2013<br />
40000022 HC US PREGNANCY TRANSVAG 611.00 4/1/2013<br />
40000024 HC US FETAL BIOPHYSICAL PROFILE W/O NST 771.00 4/1/2013<br />
40000025 HC US FETAL DOPLER VELOCIM UMBILICAL ART 465.00 4/1/2013<br />
40000027 HC US FETAL HEA ECHO 2D W/ OR W/O M-MODE 1,217.00 4/1/2013<br />
40000028 HC US FETAL ECHO 2D W/ OR W/O M-MODE F/U 628.90 4/1/2013<br />
40000029 HC US DOPPLER ECHOCARDIOGRAPHY FETAL COMPL 559.00 4/1/2013<br />
40000030 HC US FETAL HEA DOPPLER ECHO F/U 393.00 4/1/2013<br />
40000031 HC US TRANSVAG 1,185.00 4/1/2013<br />
40000032 HC US SALINE INF SONOHYSTERO COLOR FLOW 728.00 4/1/2013<br />
40000033 HC US PELVIS NON OB 1,220.00 4/1/2013<br />
40000034 HC US PELVIS NON OB LTD 462.00 4/1/2013<br />
40000035 HC US SCROTUM 879.00 4/1/2013<br />
40000038 HC US GUIDED NDL PL S&I 1,192.00 4/1/2013<br />
40000039 HC US GUIDED CHORIONIC VILLUS SAMP S&I 1,100.00 4/1/2013<br />
40000040 HC US GUIDED AMNIO S&I 599.00 4/1/2013
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