tvrh item description primary price rehab …...tvrh item description primary price iv infus...

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TVRH Item Description Primary Price REHAB PRIVATE ROOM 1,673.00 SEMI PRIVATE ROOM 1,028.00 ICU ROOM CHARGE 1,889.00 PCU ROOM 1,364.00 SOLUTION IV .9%SOD CHLOR MINI 100 12.75 SOLUTION IV .9%SOD CHLOR MINI 50M 12.75 SOLUTION IRRIG .9% SOD CHL 500ML 14.30 SOLUTION IRRIG WTR PLSTC 1000ML 14.80 SOLUTION IRRIG .9% SOD CH 1000ML 14.90 SOLUTION IV 10%DEX PLSTC CON 1000 16.20 MR ZZ EOVIST PER ML 38.31 SOLUTION IRRIG LACTD RNGR LF 5000 62.60 SOLUTION IRRIG 3% SORB 3000ML 73.10 SOLUTION IV .9%SOD CHLOR 250ML 9.40 SOLUTION IV .9%SOD CHLOR 500ML 9.90 SOLUTION IV 5%DEX 250ML 10.35 SOLUTION IV .9%SOD CHLOR 1000ML 10.95 SOLUTION IV 5%DEX 1000ML 11.80 SOLUTION INFSN 5%DEX .45%SO 1000M 12.30 SOLUTION INFSN 5%DEX LACTD R 1000 12.30 SOLUTION INFSN 5%DEX .9%SOD 1000M 12.75 SOLUTION IV 5%DEX 50ML 12.75 SOLUTION INJ .45%SOD CHLOR 1000ML 13.15 SOLUTION IV LACTD RNGR BG 1000ML 16.26 IV INFUS THPY/PRO/DX CONCURREN 124.65 IV INFUS THERAPY/DX EA ADD HOUR 167.10 IV INFUS THERAPY/DX ADDL HR 167.10 IV INFUS THPY FLUID ADDL HOUR 168.30 IV INFUS THPY HYDRAT ADDL HR 168.30 THERAPEUT/PROPH/DX INJ SQ/IM (59) 212.00 THERAPYPRO//DX IV PSH ADD SQ (59) 213.25 THERAPYPRO//DX IV PUSH ADD SEQ 213.25 THERAPYPRO//DX IV PUSH ADDL 213.25 THERAPYPRO//DX IV PUSH INITIA 213.25 THERAPYPRO//DX IV PUSH INITIAL 213.25 THERAPYPRO//DX IV PUSH INITL (59) 213.25 THERAPYPRO//DX IV PUSH SAME DRG 213.25 THERAPYPRO//DX IV PUSH SAME DRG 213.25 THERAPYPRO//DX IVP SAME DRG (59) 213.25 IV INFUS THPYPRO//DX ADD SEQUENT 270.80 IV INFUS THPYPRO//DX ADDL SEQ 270.80 IV INFUS THPYPRO//DX CONCUR 270.80 IV INFUS THPY HYDRA FLUID INITL 554.60 IV INFUS THPY HYDRAT INITIAL HR 554.60 IV INFUS THPY INITIAL HR SDPM 699.80

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Page 1: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceREHAB PRIVATE ROOM 1,673.00SEMI PRIVATE ROOM 1,028.00ICU ROOM CHARGE 1,889.00PCU ROOM 1,364.00SOLUTION IV .9%SOD CHLOR MINI 100 12.75SOLUTION IV .9%SOD CHLOR MINI 50M 12.75SOLUTION IRRIG .9% SOD CHL 500ML 14.30SOLUTION IRRIG WTR PLSTC 1000ML 14.80SOLUTION IRRIG .9% SOD CH 1000ML 14.90SOLUTION IV 10%DEX PLSTC CON 1000 16.20MR ZZ EOVIST PER ML 38.31SOLUTION IRRIG LACTD RNGR LF 5000 62.60SOLUTION IRRIG 3% SORB 3000ML 73.10SOLUTION IV .9%SOD CHLOR 250ML 9.40SOLUTION IV .9%SOD CHLOR 500ML 9.90SOLUTION IV 5%DEX 250ML 10.35SOLUTION IV .9%SOD CHLOR 1000ML 10.95SOLUTION IV 5%DEX 1000ML 11.80SOLUTION INFSN 5%DEX .45%SO 1000M 12.30SOLUTION INFSN 5%DEX LACTD R 1000 12.30SOLUTION INFSN 5%DEX .9%SOD 1000M 12.75SOLUTION IV 5%DEX 50ML 12.75SOLUTION INJ .45%SOD CHLOR 1000ML 13.15SOLUTION IV LACTD RNGR BG 1000ML 16.26IV INFUS THPY/PRO/DX CONCURREN 124.65IV INFUS THERAPY/DX EA ADD HOUR 167.10IV INFUS THERAPY/DX ADDL HR 167.10IV INFUS THPY FLUID ADDL HOUR 168.30IV INFUS THPY HYDRAT ADDL HR 168.30THERAPEUT/PROPH/DX INJ SQ/IM (59) 212.00THERAPYPRO//DX IV PSH ADD SQ (59) 213.25THERAPYPRO//DX IV PUSH ADD SEQ 213.25THERAPYPRO//DX IV PUSH ADDL 213.25THERAPYPRO//DX IV PUSH INITIA 213.25THERAPYPRO//DX IV PUSH INITIAL 213.25THERAPYPRO//DX IV PUSH INITL (59) 213.25THERAPYPRO//DX IV PUSH SAME DRG 213.25THERAPYPRO//DX IV PUSH SAME DRG 213.25THERAPYPRO//DX IVP SAME DRG (59) 213.25IV INFUS THPYPRO//DX ADD SEQUENT 270.80IV INFUS THPYPRO//DX ADDL SEQ 270.80IV INFUS THPYPRO//DX CONCUR 270.80IV INFUS THPY HYDRA FLUID INITL 554.60IV INFUS THPY HYDRAT INITIAL HR 554.60IV INFUS THPY INITIAL HR SDPM 699.80

Page 2: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceIV INFUS THPYPROPH//DX (59) 699.80IV INFUS THPYPROPH//DX INITL UP 699.80IV INFUS THPYPROPH//DX INTL HR 699.80CATHETER SUCTION 12FR LATEX/F 9.25CLAMP TAIL CLOSR OSTMY PCH 9.25NEEDLE SUT MAYO CATGT HLF CR SZ5 9.25POUCH OSTMY DRNBL TRANS 4IN 14IN 9.25SLIPPERS PTNT FEM BLU SZ5-SZ9 9.25SLIPPERS PTNT MAL SZ10-SZ13 ADLT 9.25SLIPPERS PTNT TRRY X-LG SZ9-SZ16 9.25SPLINT CASTG PLSTR XTRA 3INX15IN 9.25CATH EXTERNAL MALE 21MM 9.62CATH EXTERNAL MALE 40MM 10.51TRACHEOSTOMY MASKS 10.85BANDAGES COMP 3INX5YD TAN 11.84SLING ARM LARGE CLINIC COTTON/POL 14.10SLING ARM MEDIUM CLINIC COTTON/PO 14.10SUTURE ETHLN 4-0 FS-2 18 IN NON 15.95DRESSING BURN ANTI SHEAR 4INX6IN 16.40SUTURE VICRYL 3-0 CP-1 (J471H) 18.35MESALT RIBBON 18.75DRESSING BURN ANTI SHEAR 3INX4IN 19.35BAG URINARY DRAIN 4000 19.50BARRIER OSTMY WAFR ADHSV 6INX6IN 21.00BAG LEG URINARY LATEX FREE 21.85VENTI MASK 22.85SLING ARM UNIVERSAL 7X18IN 23.68BAG URINARY DRAIN 23.75SLING ARM LARGE 24.80SLING ARM MEDIUM 24.80SLING ARM SMALL 24.80DRESSING BURN ANTI SHEAR 6INX9IN 24.95BAG URINARY DRAIN 2000 26.30ADHESIVE APLNC OSTMY PWDR 1OZ 26.60CANNULA INR TRACH DISP SZ6 27.60CANNULA INR TRACH DISP SZ8 27.60OXYGEN HUMIDIFIER 27.65OXYGEN STAND-BY 28.25SUTURE CHRMC 3-0 FSL 36 IN ABSRB 31.20AIRWAY NASO DISP LF NS 7MM 31.95IMMOBILIZER SHLDR VELP ELSTC LG 32.10IMMOBILIZER SHLDR VELP ELSTC MED 32.10IMMOBILIZER SHLDR VELP ELSTC SM 32.10SHOE CST RCKR SOLE MED 36.90DRESSING BURN ANTI SHEAR 3INX9IN 40.95

Page 3: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceER-EAR TRAY 41.60DRESSING BURN ANTI SHEA 9INX15IN 41.80BINDER ABD 3 PNL S 9INX30IN-45IN 43.40SPLINT CASTG PLSTR CONF 4INX15IN 45.50CANNULA INR TRACH DISP SZ10 45.65CATH FEMALE EXTERNAL 45.79ADULT C02 DETECTORS 46.95TRANSPORT OXYGEN 47.85BAG DRNG BILE REG LTX STRL 19OZ 50.30IMMOBILIZER SHOULDER UNIV 50.70SHOE SQUARE TOE POST OP MED 51.80ER-CUTDOWN TRAY 53.60SOLUTION IRRIG WTR FLXBL 3000ML 58.00ER-PELVIC EXAM TRAY 63.70MASK LARYNGEAL #3 DISPOSABLE 64.80MASK LARYNGEAL #4 DISPOSABLE 64.80MASK LARYNGEAL #5 64.80BINDER ABD 3 PNL S 9INX60IN-75IN 65.70TELEMETRY FLAT RATE 65.70IMMOBILIZER KNEE FOAM 14IN MED 67.25INFUSOR PRESSURE DISPOSABLE 500ML 73.82PEAK FLOW METER 75.10BINDER ABD 4 PNL 12INX46IN-62IN 76.70COLLAR CERV 3.25IN LG W/TRCTN 83.15COLLAR CERV 3.25IN SM W/TRCTN 83.15CATH URTHRL FOL RN 22FR 30ML 88.85SPLINT WRIST/FOREARM UNIVRSAL RT 91.60SUTURE VCRYL 0 CT-1 27 IN ABSRBL 101.20SLEEVE ANTI THRMBS ALTERNATG REG 126.00IMMOBILIZER KNEE FOAM 24IN SM 127.70LARYNGOSCOPE GLIDESCPE STATS GVL4 144.00STOCK COMPRESSION SMALL (ALP3-SM) 144.00INCENTIVE SPIROMETRY SETUP/NS 150.10SPLINT FREEDOM MEDIUM 150.85STOCK COMPRESSION LARGE (ALP4-LAR 158.40ELECTRODE ELECTRCRDOGRM MUL ADLT 161.55PROSETHTIC SOCK MULTI PLY BK 180.00DEFIB/PACING/CARDIO ELECTRODES 181.85NEEDLE BPSY BNE MRW JAM 11GAX4IN 186.75RETAINER VISCRL SURG RADPAQ MED 204.95CATH URTHRL FOL CO 22FR 30ML 206.70DRAIN SYS CHST WTR SCTN CONTR 229.20LT LIMITED ANKLE MOTION EA JNT 232.35TUBE GASTROSTOMY FEEDING 20FR 241.50TUBE GASTRO ENTRL FEDG 22FR ADLT 262.90

Page 4: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceOSSUR EXOFORM WRIST BRACE SM R 286.50PACEMAKER MEDTRONIC WRENCH KIT 302.40STOCKING COMPRESSION BK3040 308.95TUBE TRACH CFFD LO PRESSR DI SZ8 312.55CATHETER PUSH 7FR 323.75SHRINKER BELOW KNEE 325.10SLEEVE SEQTL CMPRSN DEVC SC X-LG 358.25BIT DRL QCK CPLG 85 2.5MMX110MM 390.60DIAB SHOE FOR DENSITY INSERT 408.83KIT DRSG FOAM VAC ASISTD CLOS LG 415.85BK WAIST BELT WEBRING 417.14CARTRIDGE STPL RELOADING LNE 55MM 420.00SHRINKER ABOVE KNEE 420.00SOFT INTERFACE BELOW KNEE SE 420.00WOUND VAC ATS DAILY 420.00SLING ULTRA ABDUCTION L 421.74SLING ULTRA ABDUCTION M 421.74PACK MAJOR EXTREMITY 439.85KO IMMOBILIZER CANVAS LONGIT 463.80TORSION ANK & HALF SOLID STI 483.10KX RT DORSI & PLANTAR FLEX ASSRES 502.15RETRACTOR ENDOSCPC DISP 10MM 525.10SHOE HEEL WEDGE 557.42PLASTIC MOD LOW EXT PAD/LINE 558.75KX RT BK WAIST BELT PADDED 591.09GLOVE LT HFO FLEXION PRE OTS 595.30ACROMIO/CLAVICULAR CANVAS&WE 599.40BOOT TCC-EZ LARGE 627.70NET POLY RETRIEVAL 661.50PORT PRCUTAN ENDOSCPC GASTR 20FR 661.50SP PEG TUBE KIT 719.15TUBE FASTENER ENDOTRACHEAL 764.62STATIC AFO 771.70CATH CNTRAL VENS H 62CM ADLT 812.70CAST TCC-EZ TOTAL CONTACT W/BOOT 840.80CAST TCC-EZ TOTAL CONTACT 4INW/BT 879.55CAST TCC-EZ TOTAL CONTACT 3 IN 929.95CAST TCC-EZ TOTAL CONTACT 4 IN 929.95CARTRIDGE STPL RELOADING LNE 45MM 938.85ANTERIOR THORACIC EXTENSION 947.25RT AFO PLASTIC 1,011.50MULTI DEN INSERT CUSTOM MOLD 1,032.01WHFO NO JOINT PREFABRICATED 1,046.35NDL KNIFE HUIBREGTSE TRIPLE LUMEN 1,069.00CERV COL FOAM 2 PIECE W THOR 1,102.00

Page 5: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceKX PNEUMATI WALKING BOOT PREFAB 1,102.00UPP EXT FX ORTHOSIS HUMERAL 1,102.00BASKET STNE RET 12MM 2.4FRX120CM 1,171.80KIT CATH CNTRAL VENS DBL LU 40CM 1,406.30UPPER EXT FRACT ORTHOTIC WRIST 1,438.90HIP ADJ FLEX EXT ABDUCT CONT 1,503.60ADAPTER CELLULAR SERVICE 1,550.00TLSO RIGID FRAME HYPEREX PRE 1,660.85CER POST COL OCCMAN SUP ADJ 1,786.72EO WITH JOINT PREFAB 1,872.77POSTOP APP NONWGT BEAR DSG L5460 1,931.79LT AFO MOLDED TO PATIENT PLASTI 2,045.81POSTOP APP NOWGT BEAR DSG 2,057.10ABD SEWHO ERBS PALSEY DESIGN 2,064.56FORCEPS BPSY FLXBL URT 3FRX115CM 2,081.65COLLAR CERV SUPP ADJ BAR & THOR 2,442.86KIT TISS FIBRIN SEALNT VALUPAK10M 2,732.60AFO POS SOLID ANK PLASTIC MO 2,827.55KO ADJ POS RIGID SUPPORT 2,923.75AFO PLASTIC MOLDED W/ANKLE J 3,100.00BONE PRESS WITH TUBING HENSLER 3,100.00LSO SAG-CORO RIGID FRAME PRE 3,100.00LSO SAG-CORONAL PANEL PREFAB 3,100.00LT HO POST-OP HIP ABDUCTION 3,100.00PLATE BNE GRTR TRCHNTR 6 H 187MM 3,100.00TLSO 4 MOD SACRO-SCAP PRE 3,100.00TLSO FLEX TRNK SJ-SS PRE CST 3,100.00KIT BG ENM 1500ML W/CASTIL SOAP 9.25NAPKIN SANITARY MAXI PED 9.25NAPLIN SANITARY LATEX FREE 9.25PACK ICE DISP LG 6INX14IN 15.10PACK ICE SM 5INX12IN 15.85TAPE SCOTCHCAST PLUS PURPLE 3X4 23.05SPLINT CASTG PLSTR CONF 3INX12IN 30.40BAG COLLECTION STOOL MNGMT 33.75SHOE CST RCKR SOLE LG 36.90ADHESIVE APLNC OSTMY PSTE TU 2OZ 37.45SHOE PST OPERTV WMEN MED SZ6-SZ8 40.05SHOE PST OPERTV WMEN SM W/VLCRO 40.05BRIEF INCONT ADLT LG 57.90ADHESIVE RELEASER STNG FREE 50ML 78.60SPLINT CASTG PLSTR CONF 3INX35IN 88.50SPLINT CASTG PLSTR CONF 4INX30IN 91.10DRAPE COLUMN 162.00PILLOW ABDUCTN SM 6INX12INX18IN 162.00

Page 6: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceSEAL UNIVERSAL 5-8MM 162.00SENSOR PTNT NEUROLGCL STD F/BISP 162.00PILLOW ABDUCTN MED 14INX22INX6IN 168.75FRACTURE SOCK LT 175.25TIP COVER SCISSORS CURVED 180.00SPLINT CASTG PLSTR 1 ST 5INX45IN 181.60PILLOW ABDUCTN LG 6INX16INX25IN 197.75OBTURATOR BLADELESS 210.00TOURNIQUET SINGLE BLADDER 42IN 219.85CUFF COLD THERAPY KNEE MEDIUM 247.95TOURNIQUET DUAL PORT BLADDER 18IN 268.15SLING RT ULTIMATE AVE ADULT 327.60TOURNIQUET DUAL BLADDER 24IN 401.50DRAPE ARM 420.00HIGH FLOW INITIAL 467.05KX ANKLE CONTROL ORTHO PRE OTS 681.49DARCO SHOE 999.60KIT STOOL MANAGEMENT SYSTEM 1,021.65VESSEL SEALER 3,100.00DRESSING IV TEGADERM 2X2IN 5.64CANNULA IV ACCESS NEEDLELESS 15GA 9.25CAP PROTCTV PIN BLU .035IN 9.25CAP PROTCTV PIN K WRE & .045IN 9.25CLEANER TIP ELECTRODE ELECTROSURG 9.25CLOSURE WOUND STRIP R1/2 INX4IN 9.25CONNECTOR DISPLACEMENT CLEAR 9.25COVER PIN YELLOW 045-062 338942 9.25CREAM NUTRASHIELD SKIN 4OZ 9.25DRESSING FLM TRANSPRN 4INX4.75IN 9.25DRESSING SPNG GAU 6INX6.75IN MED 9.25DRESSING TELFA 4X5 9.25DRESSING TELFA ISLAND 2 X 3 1/2 9.25DRSG TEGADERM HP 4X4.75IN 9.25DRSG TEGADERM HP IV 2.375X2.75IN 9.25GAUZE SPONGE 10'S 4X4 9.25IV START KIT 9.25IV START KIT 9.25NEEDLE SUT KEITH ABD STRT SZ 2.5 9.25PADDING CST UNDR CST COT 2INX4YD 9.25POUCH OSTMY 2 PC DRN 1.75IN 12IN 9.25POUCH OSTMY 2 PC DRN 2.25IN 12IN 9.25POUCH OSTMY 2 PC DRN 2.75IN 12IN 9.25SET ADMIN IV SECNDARY 15 DRP 37IN 9.25SLEEVE-STERILE 9.25SLIPPER DBL THREAD GY XXL 9.25

Page 7: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceSOL IV .9% NACL NO-PVC 500ML 9.25SOLUTION IV .9%SOD CHLOR 100ML 9.25SPONGE GAUZE XRAY DETCT 4X4 16PLY 9.25STAPLE REMOVER SURGICAL 9.25STOPCOCK 3 WAY LF SWVEL MLE LUER 9.25SUCTION FRAZIER 12F 9.25SYR BULB IRR DISP STR 50ML 9.25TIP SUCTION YANKAUER WO CTRL VENT 9.25TUBE CONNECTING SUCTN .25INX10FT 9.25TUBE STOMACH 18FR 9.25TUBE SUCTION YANKAUER 12FR 9.25TRAP SPECIMEN 40CC 9.34SOL IV .9 % SOD CHL 250ML 9.40POUCH OSTMY 1 PC DRNBL TRAN 12IN 9.50TIP SCTN FRAZIER SURG STRL 8FR 9.85SOL IV .9 % SOD CHL 500ML 9.90TIP SCTN FRAZIER SURG STRL 10FR 9.90IV PUMP SET SECONDARY 10.35DRAIN WND PENRS RBBR 5/8INX12IN 10.75POUCH UROSTOMY ACCUSEAL 1 3/4 10.90POUCH UROSTOMY ACCUSEAL 2 1/4 10.90SET EXT IV SB MCLAV RMV VALVE 7IN 10.92SET EXT PRES INFUS MICRO PRPL 7IN 10.92SOL IV .9 % SOD CHL 1000ML 10.95TRAY SUT RMVL 11.20DRESSING FILM FRAME STYLE 4INX10I 11.30BANDAGE CMPRSN ELSTC POL 4INX5YD 11.40SOLUTION IV 5% DEXTROSE LR 500ML 11.75NEEDLE SPNL QNCK SNGL 25GAX3.5IN 11.80NEEDLE SPNL QNCK SNGL 18GAX3.5IN 11.85NEEDLE SPNL QNCK SNGL 22GAX3.5IN 11.85INSERT TOOL ENDOSCOPIC 12.05SUTURE SILK 0 30 NON-ABSRB BR BLK 12.15SUTURE SLK 2-0 SH 30 IN NON ABSR 12.55SUTURE SLK 3-0 SH 30 IN NON ABSR 12.60SOL IV .9 % SOD CHL MIN BAG 100ML 12.75SOL IV .9 % SOD CHL MINI BAG 50ML 12.75SUTURE SILK 0 SH 30IN BLK 12.80SUTURE SLK 0 SH 30 IN NON ABSRBL 12.80SOLUATION IRRIG LACTD RNGR 1000ML 12.85SUTURE SLK 0 MH 30 IN NON ABSRBL 12.85DRAIN PENROSE 1/2 X 18 12.95DRAIN WND PENRS RBBR .25INX18IN 12.95DRESSING FLM TRANSPRNT O 6INX8IN 13.00TRAY URETHRAL CATH 13.05

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TVRH Item Description Primary PricePUNCH BPSY DISP 2MM 13.20SUTURE SILK 2-0 KS 30 BR BLK 13.45BARRIER WAFER DUR W HYDRO 1.75 13.50BARRIER WAFER DURA W HYDRO 2.25 13.50BARRIER WAFER DURA W HYDRO 2.75 13.50IV SET EXTENSION 40IN 2-Y 13.60SET EXT IV 36IN NDLLESS VLVE PORT 13.60TUBE ENDO LO PRO 6.5 13.70TUBE ENDOTRACHEAL 9.0MM 86055 13.70TUBE ET NSL OR ORL CFFD MR 8.5MM 13.70TUBE ET NSL OR ORL CFFD MRP 10MM 13.70DRAIN PENROSE 3/4 13347 13.90TRACHESOTOMY CARE KIT 14.00TUBE ET NSL OR ORL CFFD MR 7.5MM 14.25TUBE ET NSL OR ORL CFFD MRPH 7MM 14.25TUBE ET NSL OR ORL CFFD MRPH 8MM 14.25SOLUTION IRRIG WTR PLSTC P 500ML 14.30SPLINT FINGER ALUM/FOAM 9115-03 14.50CATHETER IV 18GAX1.25IN 14.80CATHETER IV 22GAX1IN 14.80SUTURE VICRYL 4-0 SH 27 IN 14.81SUTURE VCRYL 2-0 CT-1 27IN ABSR 14.85SUTURE VCRYL 2-0 SH 27 IN ABSRBL 14.85SUTURE VCRYL 2-0 SH 27IN ABSRBL 14.85SUTURE VCRYL 3-0 CT-1 27IN ABSR 14.90SUTURE VCRYL 3-0 SH 27 IN ABSRBL 14.90SUTURE VCRYL 0 CT-1 27 IN ABSRBL 14.95SUTURE VICRYL BRD 2.0 CT-3 27IN 14.99BLADE MINI RNDED TIP SURG 15.15WIRE K .062X9IN SMOOTH TROCAR 15.25ROD COLOSTOMY LOOP 90MM 15.30SPONGE LAP PRE WSHD STD LF 18X18 15.47SUTURE VCRYL 1 CT-1 27 IN ABSRBL 15.50SUTURE VICRYL 0 CT-2 27 BR 910 15.50SUTURE ETHLN 2-0 KS 30 MONO NYLN 15.60SUTURE VCRYL 0 CT-1 36 IN ABSRBL 15.70SUTURE SILK 2-0 FS 18IN NON ABSOR 15.80SUTURE SLK 2-0 FS 18 IN NON ABSR 15.80SUTURE VCRYL 2-0 CT-2 27 IN ABSR 15.85CLEANER SAF CLENS SPRAY 12OZ 15.95DRESSING DUODERM CGF XTHIN 4X4 15.95SUTURE ETHLN 4-0 FS 2 18 IN NON 15.95SUTURE VCRYL 3-0 CT-1 36 IN ABSR 15.95SUTURE VCRYL 2-0 CT-1 36IN 16.00SUTURE VICRYL 2-0 CT-1 16.05

Page 9: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceSUTURE VICRYL 2-0 CT-1 16.05SUTURE VICRYL 2-0 SH 16.05SUTURE VICRYL 3-0 SH 27IN UD 16.09SUTURE VCRYL 2-0 CP-1 27 IN ABSR 16.10SUTURE VICRYL 0 CT-1 16.10SUTURE VICRYL PLUS 3-0 27IN CT-1 16.10SUTURE VICRYL PLUS 3-0 SH 27IN 16.10SUTURE ETHLN 3-0 FS-1 30 IN NON 16.20SUTURE VCRYL 0 CT 36 IN ABSRBLE 16.20CONNECTOR Y WOUND CARE VAC 16.25SUTURE VCRYL 0 CP-1 27 IN ABSRBL 16.25SUTURE SLK 3-0 KS 30 IN NON ABSR 16.30SUTURE VCRYL 1 CP 27 IN ABSRBLE 16.30TRAY-URETHRAL CATH 16.30SUTURE VCRYL 1 CT-1 36 IN ABSRBL 16.35SUTURE VCRYL 2-0 CP-2 27 IN ABSR 16.35SUTURE SILK 0 FSL 30IN BLK 16.40SUTURE SILK 3-0 FS-1 18 BR BLK 16.40SUTURE SLK 0 FSL 30 IN NON ABSRB 16.40SUTURE VCRYL 0 CP-2 27 IN ABSRBL 16.45SUTURE ETHIBOND EXC 0T-1 30IN PB 16.53SUTURE 4-0 VICRYL SH 4-0 ETHICON 16.55SUTURE ETHBND EXCL 0 CT-1 30 IN 16.55SUTURE ETHBND EXCL 2-0 CT-1 30 I 16.55SUTURE ETHLN 2-0 FS 18 IN NON AB 16.55SUTURE VCRYL 1 CTX 36 IN ABSRBLE 16.55SUTURE ETHLN 2-0 FSLX 30 IN NON 16.60SUTURE VCRYL 1 CP-1 27 IN ABSRBL 16.60SUTURE VICRYL UD BR C4-0 27IN RB1 16.60SUTURE ETHLN 3-0 FS-1 18 NYLN BLK 16.65SUTURE VCRYL 0 CPX 27 IN ABSRBLE 16.70SUTURE VICRYL 1 CT-1 16.70SUTURE VICRYL 0 CT-2 27IN 16.75SUTURE ETHLN 4-0 FS-1 18 IN NON 16.90SUTURE VICRYL 2-0 CT-2 17.15SUTURE VICRYL 2-0 27IN CP-1 17.40SUTURE VICRYL 0 17.50SUTURE VICRYL 0 27IN CP-1 17.55SUTURE VICRYL 20 27IN CP-2 17.65SUTURE VICRYL 1 CP 17.65SUTURE VICRYL 0 VIO 54 IN 17.70SUTURE VICRYL 2-0 SH 27 IN 70CM 17.75SUTURE VICRYL PLUS 3-0 27INCH CP1 17.80SUTURE VICRYL CTD 1 27IN CP-1 17.90SUTURE VICRYL CTD ANTIBAC 1 36IN 17.90

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TVRH Item Description Primary PriceSUTURE VCRYL 0 REEL 54 IN ABSRBL 18.00SUTURE VICRYL 0 CP 18.00SUTURE VCRYL 3-0 REEL 54 IN ABSR 18.05SUTURE VICRYL PLUS CTD1 27IN CPX 18.10SUTURE VICRYL 2-0 CP 27IN 18.15DRESSING FLM TRANSPRNT 8INX12IN 18.20SUTURE VCRYL 0 UR-6 27 IN ABSRBL 18.35SUTURE VCRYL 2-0 REEL 54 IN ABSR 18.40SUTURE MONCRYL 3-0 SH 27 IN ABSR 18.85SUTURE MONOCRYL 2-0 MH 18.85REMOVER STPL SKN 18.90CATHETER FOLEY 14FR 30CC 2WAY 19.20SUTURE MONOCRYL 2-0 SH Y417H 19.40SUTURE VICRYL 0 UND 54 IN 19.45SUTURE VICRYL 2 CP NEEDLE 19.60SUTURE SLK 1 STRND 10 IN NON ABS 19.85SUTURE VICRYL 0 UR-6 19.85SUTURE VICRYL 2-0 REEL 19.85CLIP LIGATION TITANIUM SM 19.95SUTURE VICRYL 2-0 UR-6 20.10SUT MONOCRYL PLUS UD 2-0 27 SH 20.40SUTURE MONOCRYL PLUS UD 3-0 27 SH 20.40SUR MONOCRYL PLUS VIO 2-0 27 CT-2 20.55BLADE CLIPPERS SURGICAL DISPSBLE 20.88BLADE CLIPPING SINGLE USE 20.88BANDAGE CMPRSN ELSTC SLF 4INX5YD 20.90SUTURE MONCRYL 3-0 CT-1 36 IN AB 20.90STYLET INTUBTN ET TUBE 14FR ADLT 21.05SUTURE MONCRYL 2-0 CT-1 36 IN AB 21.10SUTURE MONOCRYL 4-0 27 PLUS RB-1 21.25SUTURE PROLN 1 CTX 30 IN NON ABS 21.35DRAPE ANGIO BRACHIAL SURG 38X44IN 21.55SUTURE ETHLN 2 LR 20 IN NON ABSR 21.70SUTURE VICRYL 1 CTX 21.70SUTURE VICRYL 0 CPX 27 IN 22.00NEEDLE SUT MRTN UTER HLF CRC SZ5 22.30SUT MONOCRYL PLUS UD 0 36 CT-1 22.35TUBE SALEM SUMP 10FR 22.40SUTURE VICRYL 2-0 FS-1 22.55PUNCH BPSY DISP 3MM 22.60SUT MONOCRYL PLUS UD 3-0 36 CT-1 22.60SUTURE PROLN 0 CT 30 IN NON ABSR 22.60SUTURE PROLN 2-0 CT-2 30 IN NON 22.60COLLAR CERV MED 22.65SUTURE PDS II 0 CT-1 27 IN ABSRB 22.65

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TVRH Item Description Primary PriceSUT MONOCRYL PLUS UD 2-0 36 CT-1 22.80SUTURE PROLN 1 CT-1 30 IN NON AB 22.80SUTURE PROLN 2-0 FS 18 IN NON AB 22.85SUTURE MONCRYL VIO MONO 0UR-6 27I 22.90SUTURE PDS II 1 CT-1 27 IN ABSRB 23.10DRESSING LYOFOAM MAX T 3.5X3.5 23.26DRESSING ABSRBNT NON ADH 3INX8IN 23.35CLIP LIGTG TI MED 24.05SUTURE PROLN 5-0 FS-2 18 IN NON 24.05SUTURE PDS II 0 CT-2 27 IN ABSRB 24.15SUTURE PDS II 0 CTX 36 IN ABSRBL 24.15SUTURE SLK 2-0 STRND 30 IN NON A 24.25SUTURE ETHLN 1 TP-1 60 IN NON AB 24.35SUTURE PDS II 2-0 CT-2 27 IN ABS 24.40SUTURE ETHBND EXCL 0 OS-4 30 IN 24.55SUTURE ETHBND EXCL 1 OS-4 30 IN 24.55SUTURE ETHBND EXCL 1 OS-6 30 IN 24.55DRESSNG SAF-GEL HYDRATNG W ALGINA 24.65SUTURE PDS PLUS3/0 27 CLR MONO SH 24.95ELECTRODE ELECTROSURGCL BLAD 6IN 25.15SUTURE PROLN 2-0 SH 30 IN NON AB 25.20ELECTRODE ELECTRO GROUND PAD 25.25SUTURE SLK 3-0 STRND 30 IN NON A 25.55SUTURE VICRYL 2-0 OS-6 25.70ELECTRODE ELECTROSURGCL PNCL RCK 25.81SUTURE SLK 4-0 STRND 30 IN NON A 25.90SUTURE PROLN 3-0 SH 30 IN NON AB 26.00SUTURE PROLN 4-0 SH 30 IN NON AB 26.05SUT PDS PLUS ANTIBCTERIAL 0 CT-2 26.10CATHETER FOLEY SILCONE 30CC 18FR 26.15TUBE NG SLEM SUMP DBL LUMN 18FR 26.25TUBE SALEM SUMP 12 FR 26.25SUT PDS PLUS 0 27 VIO MONO CP-1 26.35DRESSING VERSIVA XC 4 X 4 27.15SUTURE PROLN 0 SH 30 IN NON ABSR 27.15WATER IRR BAG 1000 2B7114 (12) 27.65CATH URTHRL FOL RND 14FR 5ML 27.75CATHETER URTHRL FOL STR 12FR 5ML 27.75WIRE FIXTN KRSCHNR .9MMX140MM W/ 27.75TUBE NG SLEM SUMP DBL LUMN 14FR 28.00TUBE NG SLEM SUMP DBL LUMN 16FR 28.00SUTURE PDS II 1 CTX 36 IN ABSRBL 28.10SUTURE SLK 5-0 STRND 30 IN NON A 28.15SUTURE PDS PLUS 1 36 VIO MONO CTX 28.20POUCH COLOST ILOSTMY PST OP 70MM 28.25

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TVRH Item Description Primary PriceCATHETER FOLEY 2WAY 5CC 22FR 28.75CATHETER URTHRL FOL RND 24FR 5ML 28.75SUTURE CHRMC 2-0 CT-1 27 IN ABSR 28.95SUTURE PROLN 0 MO-6 30 IN NON AB 29.20NEEDLE SPNL QNCK 22GAX4.75IN 29.25SUTURE CHRMC 2-0 SH 27 IN ABSRBL 29.35CATH FOLEY SILICONE 2W 5CC 16F 29.55SUTURE CHROMIC GUT 3-0 CT-2 27IN 29.60SYRINGE ANGIO 3 RING CRTL 12ML 29.70SUTURE CHRMC 0 CT-1 27 IN ABSRBL 29.80SUTURE CHRMC 3-0 SH 27 IN ABSRBL 29.80NEEDLE PERCUTANEOUS ENTRY 18G 9CM 30.06NEEDLE SMOOTH TIP 21GX4CM 30.06POUCH COLOST ILOSTMY PST OP 45MM 30.10CATHETER FOLEY 2WAY 5CC 14FR 30.65CATHETER FOLEY 2WAY 5CC 16FR 30.65CATHETER FOLEY 2WAY 5CC 20FR 30.65CATHETR FOLEY 2WAY 5CC 18FR 30.65DRESSING FOAM SLF ADHERN 4INX4IN 30.75SUTURE CHRMC 3-0 SH-1 27 IN ABSR 30.90SUTURE VICRYL 0 OS-6 31.00CRM SKIN ZINC OXIDE INV BARRIER 4 31.05CLIP LIGTG TI M/L 31.15SUTURE ETHLN 5-0 PS-2 18 IN NON 31.20SUTURE ETHL 4-0 P-3 18 IN NON A 31.30SUTURE MRSLN 5-0 S-24 18 IN NON 31.30SUTURE ETHLN 6-0 P-3 18 IN NON A 31.35SHOE POST-OP XTRA-LARGE 31.45BARRIER OSTMY WAF ADHSV ML 45MM M 31.80DRESSING DUODERM CGF XTHIN 6X6 31.85SUTURE SLK 3-0 PS-1 18 IN NON AB 32.20NEEDLE HUBER 20G X 1 1/2 32.40SUTURE ETHL 4-0 PS-2 18 IN NON 32.40SUTURE ETHLN 3-0 PS-2 18 IN NON 32.60SUTURE ETHLN 4-0 PS-2 18 IN NON 32.75SUTURE CHRMC 2-0 UR-6 27 IN ABSR 32.85IV PUMP SET PRIMARY 33.05IV PUMP SET PRIMARY 33.05CANNULA FENESTRATED DISPOSABLE 6 33.20SUTURE ETHILON 1 LR 33.20SUTURE ETHLN 2-0 LR 30 IN NON AB 33.20SUTURE VCRYL 2-0 PS-2 27 IN ABSR 33.30CATH URTHRL FOL RN 18FR 30ML 33.40CATHETER URTHRL FOL RN 22FR 30ML 33.40CATHETER URTHRL FOL RN 24FR 30ML 33.40

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TVRH Item Description Primary PriceCATHETER FOLEY 12FR 5CC SILICONE 33.50CATHETER COUDE STRT 12FR LATFR 33.55SUTURE PROLENE 0 XLH 8845G 34.00SUTURE ETHLN 3-0 PS-1 18 IN NON 34.05SUTURE VCRYL 3-0 PS-2 27 IN ABSR 34.05SUTURE VCRYL 3-0 PS-2 18 IN ABSR 34.10SUTURE VCRYL 4-0 PS-2 27 IN ABSR 34.25TUBE NASAL RAE UNCUFFED 7.0 34.40SUTURE VCRYL 5-0 P-3 18IN ABSRB 34.55SUTURE VCRYL 4-0 PS-2 18IN ABSR 34.70SUTURE SLK 2-0 PS 18 IN NON ABSR 35.00SUTURE VCRYL 3-0 PS-1 18 IN ABSR 35.40WAX BNE HEMOSTC NON BOIILBL 2.5GR 35.65CANNULA FENESTRATED DISPOSABLE 8 35.90SUTURE 2-0 PS-2 UD 35.95DRESSING AQUACEL HYDROFIBER 4 X 4 36.10SUTURE VICRYL 4-0 PS-2 36.23CATHETER DRNG THOR STR 24FRX22IN 36.35HEMSTAT SPNG SRGIFOM 2CMX6CMX7MM 36.57SUTURE VICRYL 3-0 18IN PS-2 36.80SPLINT WRIST FOREARM LEFT MEDIUM 36.90RESERVOIR DRNG WND BLB SCT 100ML 37.35SUTURE VICRYL 4-0 PS-2 37.50SUTURE VICRYL PLUS 3-0 18 IN 38.25SUTURE VICRYL 4-0 18 IN 45CM 38.45SUTURE PROLN 5-0 PS-2 18 38.90DRSG GAUZ XEROFORM 4INX3YD NONSTK 39.88SUTURE VICRYL 4-0 PS-5 39.95SECURING DEVICE PERIPHLY INSRTD 40.60SUTURE PROL 4-0 FS-2 18 IN NON 41.20CONTRAST INJECTOR LINE 20IN 41.55NEEDLE EZ HUB INFUS 20GA 1IN W YS 41.65DRESSING VERSIVA XC 5.5 X 5.5 41.85SUTURE PROLN 5-0 P-3 18 IN NON A 41.95VALVE BIOPSY SUCT ENDO FLEX 41.95SUTURE PROLN 4-0 P-3 18 IN NON A 42.20SUTURE PDS II 1 TP-1 96 IN ABSRB 43.35NEEDLE EZ HUB INFUS 20GA 3/4IN 44.35SLING ARM UNIVERSAL LG 79-84167 44.50DRAIN JACKSON PRATT FLAT 7MM 44.85DRAIN WND FLAT CLSD SC 10MMX20CM 44.85NEEDLE EZ HUBER INFUSION 20GA 1IN 44.85BANDAGE PSTE UNNA BOOT 4INX10YD 44.95SUTURE MONCRYL 4-0 PS-2 18 IN AB 45.85SUTURE MONCRYL 3-0 PS-2 27 IN AB 46.25

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TVRH Item Description Primary PriceSUTURE MONCRYL 5-0 PS-2 18 IN AB 46.25TUBE ENDO RAE CUFF 6.0 46.35SUTURE MONOCRYL 4-0 PS1 (Y935H) 46.39SUTURE MONCRYL 3-0 PS-1 27 IN AB 46.40SUTURE MONCRYL 4-0 PS-1 27 IN AB 46.40SUTURE MONCRYL 5-0 P-3 18 IN ABS 46.40SUTURE MONOCRYL 4-0 PS2 46.40DRESSING MEPITEL STR 3X4 SILICONE 46.45DRESSNG RIBBON AQUACEL HYDR3/4X18 46.65CLIP LIGTG TI LG 46.95CATHETER URTHRL FOL 8FR 3ML PED 47.20WAX BNE HEMOSTC 2.5GR 47.65CATHETER THORACIC 36FR 8888570564 48.05SUTURE PROLN 3-0 PC-5 18 IN NON 48.30DRAPE ANTIMICROBIAL IOBAN2 23X17 48.38COVER PROBE 6 X 48 48.55COVER PROBE 6 X 48 48.56SUTURE PROLN 2-0 SH 36 IN NON AB 48.70CATH THORACIC 32 FR 8888570556 49.05SUTURE PROLN 3-0 CH 36 IN NON AB 49.25IMBOLIZER MED SHOULDER 7984035 49.30IMMOBILIXER XL SHOULD 7984038 49.30IMMOBILIZER LG SHLD 7984037 49.30SUTURE PROLN 3-0 SH 8 IN NON ABS 49.45IMMOBILZER WRIST LT LRG 346149 49.50IMMOBILZER WRIST LT MED 346148 49.50IMMOBILZER WRIST RT LRG 346145 49.50IMMOBILZER WRIST RT MED 346144 49.50SUT MONOCRYL PLUS UD 4-0 18 PS-2 49.55TRAY LACERATION 49.55SUT MONOCRYL PLUS UD 5-0 18 PS-2 49.95SUT MONOCRYL PLUS UD 3-0 27 PS-1 50.10SUT MONOCRYL PLUS UD 4-0 18 P-3 50.10SUT MONOCRYL PLUS UD 4-0 27 PS-1 50.10SUT MONOCRYL PLUS UD 4-0 27 PS-2 50.10SUT MONOCRYL PLUS UD 5-0 18 P-3 50.10SUTURE PROLN 4-0 RB-1 36 IN NON 50.10CATHETER THROACIC 28FR CHEST TUBE 50.15SUTURE CHRMC 2-0 SH 36 IN ABSRBL 50.30SUTURE PROLN 5-0 RB-1 36 IN NON 50.30SUTURE PROLN 2-0 SH 8 DOUBLE ARM 50.35KIT DRESSING MIDLINE 50.90DRESSING PAD NA 5V5IN 51.37SUTURE PROLN 3-0 MH 36 IN NON AB 51.50SHOE SQUARED TOE POST OP LRG 51.80

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TVRH Item Description Primary PriceSHOE SQUARED TOE POST OP XLRG 51.80SUTURE PDS II 0 TP-1 60 ABSRB MON 52.65PUNCH BPSY SKN SURG DISP 4MM 52.95SP ZZ FOGARTY BALLOON CATHETER 53.20CAP PIN PROTECTIVE BALL .045 YELL 53.95BLADE MINI SHRP ALL ARND 180DEG 54.00CERVICAL COLLAR IMBLZR ADJ 55.05KIT NATURA POST OP 4 55.15TUBING SMART MAC SAMPLING 02 55.40POUCH URSTMY PST OPERTV STR 35MM 56.20DRESSING ANTIMICROBIAL BIOPATCH 56.35DRESSING MAXORB POST OP 1 X 2 56.65GW VISE MULTITORQ .010 .03 56.65SUT PDS PLUS 0 60 VIO MONO TP-1 56.90SUTURE ETHIBOND V-5(X916H) 57.35SODIUM CHLORIDE IRR BAG 3000 2B71 58.00WATER IRRIGATION URO 3000 58.00SUTURE CHRMC 4-0 P-3 18 IN ABSRB 58.05KWIRE .045 STERILE 58.85SUTURE CHRMC 5-0 P-3 18 IN ABSRB 59.40TRAY CATHETER FOLEY 16FR LATEX FR 60.15TRAY-URINE METER 60.20SUTURE CHRMC 4-0 PS-2 18 IN ABSR 60.50PIN GDE SMTH SHFT TROC 1.6MMX9MM 60.70SLING/SWTH UNIV 7984230 60.95BLADE SAGGITAL 9.5MM X 25.5MMX4MM 61.98BLADE SAW FINE 9.5MMX25.5MMX.4MM 61.98BLADE SAW OSCI 5.5MMX18.5MMX.4MM 61.98BLADE SAW OSCIL 10MMX18.5MMX.4MM 61.98BLADE SAW OSCILLTG FI 5.5MMX12MM 61.98BLADE SAW OSCILLTG FIN 10MMX35MM 61.98TUBING INSUF ENDOSCPC DISP W/0.2 62.45WATER IRRIGATION URO 2000 63.35DRESSNG VERSIVA XC NON-ADHES 6X6 63.85TUBING INSUF ENDOSCPC 64.10SUTURE PROLN 4-0 TF 24 IN NON AB 64.70STAPLER SKIN FIXED HEAD 64.75STAPLER SKIN FIXED HEAD 64.75STAPLER SKN FIXD HEAD WD 64.75IV PUMP SET BLOOD 66.40WIRE FIXTN KRSCHNR TRO 2MMX150MM 66.60TRAY BIOPSY SURGICAL 66.97TRAY BIOPSY SURGICAL 66.97IMMOBILIZER MED SHOULDER 410181 67.90CANNULA INNER SIZE 6 SIC 68.10

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TVRH Item Description Primary PriceDIFFUSER MAESTRO DRILL 68.40KIT ADAPTER CATH Y PTCA 69.30CATH ANGIO DIAGNS 6FRX100CM 69.38CATH ANGIO DIAGNS 6FRX110CM 69.38CATH ANGIO DIAGNSTC PIG 6FR 69.38CATH DIAG F6 ST JR 4 100CM 69.38CATH DIAG F6 ST+ JR 4 100CM 69.38CATH DIAG ST CAS2 6F 100CM 69.38CATH DIAG ST+ AL I 6F 100CM 69.38CATH DIAG ST+ AL II 6F 100CM 69.38CATH DIAG ST+ AL MOD 6F 100CM 69.38CATH DIAG ST+ LCB 6F 100CM 69.38CATH DIAG ST+ MPA1 6F 125CM 69.38CATH DIAG ST CAS1 6F 100CM 69.40NEEDLE NON ECHOGENIC TIP 21GX7CM 69.40WIRE K-9IN .035 90MM 407186046 70.50CATHETER FOLEY 18FR 3WAY 30CC 71.50CATHETER FOLEY 3WAY 30CC 20FR 71.50CATHETER FOLEY 3WAY 30CC 22FR 71.50CATHETER URTHRL FOL RN 22FR 30ML 71.50KIT CATH ARTE 20GAX1.75IN 4.45CM 72.05CATHETER TROCAR RT ANGLE 28FR 20I 72.40CATH DIAG 5F FL3.5 125CM 72.52CATH DIAG 5F FR4 125CM 72.52CATH DIAG 5F IM 125CM 72.52CATH DIAG 5F MPA2 125CM 72.52CATHETER PIGTAIL 6FR X 125CM 72.52GUIDEWIRE 0.035INX260CM 72.61GUIDEWIRE ANGIO ST .035INX260CM 72.61GW EMERALD FIX CORE J .025X150 72.61GW EMERLD FIX CORE J FRM .035X125 72.61SOL IRRG 1.5 % GLYCINE 3000ML 73.72DEVICE TROCAR WOUND CLOSURE 73.80KIT TRNSDUCR PRESSR STD 2/FLSH D 73.80K WIRE ACUMED WS-1607ST 74.00TUBE EVACUATED STERILE 15CC TET 74.00WIRE ACUMED .059 WS-1505ST 74.00KIT TRANS PRESS STND FLUSH 60IN 75.15POUCH WOUND/EKIN FISTULA 2.4X3.14 75.55CATHETER FOLEY 3WAY 5CC 18FR 75.65CATHETER URTHRL FOL CON 22FR 5ML 75.65FORCEP MAGILL ADULT STRL 10IN 75.94CATHETER FOLEY 3WAY 30CC 24FR 76.15CATHETER FOLEY 3WAY 30CC 26FR 76.15SET BRSH CANLA FEMRL W/SCTN & IR 76.30

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TVRH Item Description Primary PriceKIT CLOSE WOUND SUCTION EVACUATOR 76.65DRAIN WND SURG 1.25INX6IN 400ML 76.75TRACTION BOOT BUCKS FOAM MEDIUM 77.05IMMOBILIZER KNEE 16IN MED 77.80NEEDLE NERVE BLOCK 22G X 2 IN 77.80SUTURE SILK 3-0 CO13D 77.80CATH ANGIO 6FR X 125CM 78.15CATH ANGIO DIAGNS 5FRX100CM 78.16CATH ANGIO DIAGNS 6FRX125CM 78.16CATH DIAG INF A1MOD 5F 100CM 78.16CATH DIAG INF A2MOD 5F 100CM 78.16CATH DIAG INF AL I 5F 100CM 78.16CATH DIAG INF AL III 5F 100CM 78.16CATH DIAG INF AL MOD 5F 100CM 78.16CATH DIAG INF JL 5 5F 100CM 78.16CATH DIAG INF JL 6 5F 100CM 78.16CATH DIAG INF JR 4 5F 100CM 78.16CATH DIAG INF JR 5 5F 100CM 78.16CATH DIAG INF LCB 5F 100CM 78.16CATH DIAG INF MPA2 5F 2SH 100CM 78.16CATH DIAG INF PIG145D 5F 6SG 110 78.16CATH DIAG INF RCB 5F 100CM 78.16IMMOBILIZER KNEE CONTR SM 20IN 78.25SUTURE SILK 2-0 SH 78.30BIT DRL TWIST 1/8INX5IN 79.55SUTURE STL 26 GA STRND 18 IN NON 79.60GEL LIDOCAINE HYDRO PRE SYR 20ML 80.80CATHETER FOLEY TRAY 16FR 80.85TRAY CATHETER FOLEY 16FR 80.85TRAY CATH URTHRL FOL 18FR 5ML W/ 80.90BLADE SAW SAG MICRO 10 MM STP 80.94TRAY LUMBAR ADULT 81.35WIRE K-9IN .045 1.10MM 470186062 81.40DRESSING COMBIDERM ACD 6 X 7 81.45TVRH URETH CATH CONE TIP 8FR LRAS 82.50CATHETER 18FR 30CC 3WAY 82.60CATH DIAG ST+ MULTIPAC PIG 145 83.16BLADE MICRO SAG 4.5X25.5X4MM 5023 83.25SNARE MINI ACU ASM-1 83.25CATH FOLEY LUBRICATH TC 5ML 20FR 84.36CATH DIAG INF JL4 4F 100CM 85.50SUTURE TICR 5-0 C-20 30 IN NON A 86.10DRESS PRISMA MATRIX 28CM 2 4.34SQ 86.70SUTURE SLK 3-0 SH 30 IN NON ABS 86.80GUIDEWIRE ANGIOGRPH .035INX150CM 86.95

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TVRH Item Description Primary PriceGW ANGIO TFE 3MM J TIP .035INX150 86.95INTRODUCER PINNACLE 6F 16035-06 86.95CATH DIAG INF IM 4F 100CM 87.88CATH DIAG INF JL4.5 4F 100CM 87.88CATH DIAG INF MPA2 AF 100CM 25H 87.88CATH DIAG INFINITI AL1 AF 100CM 87.88CATH F4 INF 3DRC 100CM 87.88CATH F4 INF AR I MOD 100CM 87.88SUTURE SLK 2-0 SH 30 IN NONABSR 87.90DIGIT TRAP MEDIUM 9906 89.75CATHETER COUDE 18FR 5CC 89.85CATHETER COUDE STRAIGHT 14FR 5CC 89.85CATHETER COUDE STRAIGHT 16FR 5CC 89.85PIN GDE SMTH SHFT TROC 1.6MMX6IN 91.00SLING ARM IMOBILIZING DLX LG W/SW 91.20SLING ARM IMOBILIZING DLX MED W/S 91.20BUR CTTG RND CARBD 2MM MED 91.50STOCK COMPRESSION MEDIUM(APL3-ME 92.05BLADE SAGITTAL THIN 2108-197-00 92.50BLADE SAW SAGITTAL WIDE MEDIUM 92.50CATH URETERAL OPEN END 5FRX70CM 92.50CATH URETHRAL CONE TIP 8FR 92.50CATHETER URETHRAL OLIVE TIP 4FR 92.50CATHETER URTHRL FOL 3 18FR 30ML 92.50CATHETER URTHRL FOL IR 22FR 30ML 92.50DRESSING AQUACEL HYDROFB SIL4X4.7 92.50GUIDEWIRE ORTHO .035INX4IN 92.50KWIRE DBL TROCAR .035X4IN 92.50K-WIRE STANDARD TIP 1.5MM X 100MM 92.50TUBNG CAPNOLINE PLUS OXYGEN ADULT 92.50TUBNG CAPNOLINE PLUS OXYGEN ADULT 92.50VALVE BIOPSY SUCT ENDO FLEXIBLE S 92.50TRAY CATH URTHRL FOL CTR EN 14FR 93.45SUTURE PROLENE 5-0 C-1 24 NONABS 93.63SUTURE PROLENE 6-0 C1 DA 24IN 93.96SP CATHETER DIAGNOSTIC 94.00SUTURE PROLN 5-0 C-1 36 IN NON A 94.10ETRAP POLYP TRAP 94.50FORCEPS BIOPSY ALLICATOR ENDOS DI 95.40SUTURE VCRYL 2-0 CT-2 18 IN ABSR 95.55TUBE ENTERAL FEEDING 12FR 95.60MASK AIRWAY LARYNGEAL SUPREME SZ3 95.85MASK AIRWAY LARYNGEAL SUPREME SZ4 95.85MASK AIRWAY LARYNGEAL SUPREME SZ5 95.85SPLINT KNEE IMMOBIL LRG 401190 96.40

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TVRH Item Description Primary PriceDRESSNG AQUACEL AG RIBBON2.0X45.0 96.95SPLINT KNEE IMMOBIL XL 380275 97.40SUTURE VCRYL 1 CTX 18 IN ABSRBLE 98.05SUTURE VCRYL 0 CT-2 18 IN ABSRBL 98.25SUTURE ETHBND EXCL 0 CT-1 18 IN 98.65TUBING CAPNOLINE PLUS 02 LONG 98.65SUTURE CTD VCRYL 0 UND BR CR/CT-1 98.69SUTURE VCRYL 3-0 SH 18IN ABSRBL 98.90IMMOBILIZER KNEE 12U 380225 100.15SUTURE PROLEN 5-0 C-1 8321H 100.50SLEEVE ALTERNATING PRESSURE LRG 100.80SLEEVE ALTERNATING PRESSURE LRG 100.80CATHETER FOLEY COUNCIL 18F 5CC 101.25CATHETER URTHRL FOL COU 16FR 5ML 101.25KIT GDE NDL 21GA 102.60SUTURE VICRYL 2-0 8X18 PLUS CT-2 103.20CATHETER DRNG MALECT 4 WNG 20FR 103.50CATHETER DRNG MALECT 4 WNG 34FR 103.50DRAIN MALECOT 26FR 103.50DRESSING HEMOSTAT CELOX STR 2X2 104.19DRESSING HEMOSTAT CELOX STR 2X2 104.20NEEDLE NERVE BLOCK 21G X 4 IN 105.00CLOSURE WOUND STRIP 1INX5IN 105.25SUT VICRYL 2-0 8/18IN 45CMVCP751D 105.35SUTURE VICRYL CTD ANTIBAC 1 CTX 105.85DRESSING ANTIMICROBL SILVR C 5GR 106.35SUTURE VICRYL 2-0 SH 27 IN VIL 106.45NEEDLE INSULTD PRPH N/B 21GA X3.5 106.60SUTURE VICRYL UD BR 3-0 SH 8X18IN 106.85NEEDLE INSULTD PERIPH N/B 22GA X2 107.65BLADE SAW RECLM THCK HVY DUT LNG 108.00CATH INF PIG145 4F 6SH 110CM 108.00DRAIN 19FR RND FULL FLUT 2190 108.00MONITOR PERCEPTOR PRESSURE 108.00DRESSING VERSAFOAM LARGE 108.95DRAIN BLAKE FLAT 10MM 110.05DRAIN BLAKE ROUND 15FR 110.05CATHETER DRNG MALECT 4 WNG 28FR 110.25DRAIN MALECOT 24FR 110.25IMMOBILIZER KNEE 20 U 410245 110.50WIRE K-9IN 0.62 1.60MM 470186078 110.60CATH DIAG ST TEMPO 5F 5SH 65CM 112.50CATHETER FOLEY 16FR 5CC 113.75SUTURE PROLN 6-0 BV-1 18 IN NON 113.90COMPRESSION WRAP COBAN2LR MM2094 114.85

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TVRH Item Description Primary PriceSUTURE PROLN 6-0 BV 30 IN NON AB 115.30SUTURE PROLN 6-0 BV-1 30 IN NON 115.45LOCKING DEVICE FUSION 115.85SUTURE ETHBND EXCL 0 MO-7 18 IN 116.00IMMOBILIZER KNEE 24U 410247 116.20SUTURE PROLN 7-0 BV-1 18 116.40NEEDLE INSUF PNEUMPERTNM D 150MM 117.00NEEDLE INSUF PNEUMPRTNM D 150MM 117.00DRAPE GYN/URO LITHO W/ POUCH 117.20POUCH WOUND/EKIN FISTULA6.9X4.3IN 117.35SUTURE VICRYL 2-0-SH 117.85SUTURE PROLN 7-0 BV-1 24 IN NON 118.00PIN GDE SMTH SHFT TROC 2.4MMX9IN 118.80PIN GDE SMTH SHFT TROC 3.2MMX9IN 118.80COVER PRB ULTRSND T SHAP LG 119.25GUIDEWIRE BENTSON .035 150CM 119.75IMMOBILIZER KNEE FOAM 20IN UNIV 120.35DRAIN BLAKE FULL FLUT 7MM 2210 125.90HEMOVAC JADKPRATT 19FR SU1301010 125.90SUTURE VICRYL 1 CUTTING NEEDLE 127.05SUTURE VCRYL 2-0 CP-2 18IN ABSR 127.20IMMOBILIZER KNEE FOAM 24IN SMALL 127.71DISSECTOR ENDOSCPC BLNT TIP 10MM 129.10SUTURE PROLN 10-0 STC-6 8 IN NON 129.20MANIFOLD 4 PORT NEPTUNE SYSTEM 129.60PIN GDE SMTH SHFT TRO 3.2MMX12IN 129.60CATHETER TROCAR 28FR 16IN 130.10CATHETER TROCAR STR 20FR 16IN 130.10CATHETER TROCAR STR 24FR 16IN 130.10DRAPE VERTICAL CS/14 130.77BRUSH CYTOL ENDO CCB72403 131.75DRESSING BACTERIOSTATIC FOAM 6X6 133.45TRAY SPNL ANESTH PNCN W/27 GA 134.70CABLE PACG CRDIAC TEMPRY DIS 6FT 135.00CABLE PACING CARDIAC TEMP 8FT 135.00PACEMAKER MEDT SLEEVE STR 135.00PIN GDE PARTL THRD TR 3.2MMX12IN 135.00PIN GDE PARTL THRD TRO 1.6MMX9IN 135.00PIN GDE THRDD TIP 1.6MMX6IN 135.00DISSECTOR ENDOSCPC BLNT TIP 5MM 135.95DRAIN WOUND RND W 1/4 TROCAR 19F 136.45SUTURE ETHLN 8-0 BV130-4 30 IN N 136.70CATHETER ANGIOGRAPH DIA 5FRX65CM 139.05CATHETER ANGIOGRPHC DIA 5FRX65CM 139.05SUTURE VICRYL 0 MO-4 139.50

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TVRH Item Description Primary PriceIMMOBILIZER KNEE 26 U 410265 142.10BRUSH CYTOLOGY WILSON COOK 143.90GUIDEWIRE ANGIO FI .035INX150CM 146.25TRAY URINE METER 146.70SUTURE ETHBND EXCL 2-0 V-37 30 I 146.85BLADE MICRO SAGITAL 5.5X18.5X4MM 147.40CATHETER TROCAR STR 32FR 16IN 148.05SUTURE ETHIBOND#5 V-37 #MB66G 148.25CATHETER ANGIOGRAPHC DIA 5FRX80CM 149.40DERMABOND WITH TIP DNX12 150.66DERMABOND WITH TIP DNX12 150.66HMSTAT SPNG SRGFOM 8CMX6.25CMX10M 151.30SP GELFOAM 152.00CANNISTER SUCTION OMNI-JUG 16000C 152.10DRAIN LINE PLEURX CATH 507225 153.35TROCAR ENDOSCPC THOR 12MM 154.40KIT TRNSDUCR PRESSR SNGL LN 157.50SET INTRDCR CATH MID 5FRX23CM 157.50SUTURE CHRMC 5-0 S-14 18 IN ABSR 158.70PROBE SMAA T SHAPED 160.20TUBING SCTN ANTICOAGLATN 160.20BIOSEAL CVC PRO QR 160.40SNARE POLYP OVL S 1.5CMX3CM JMBO 162.00SUTURE ETIBOND 5MB46G 163.45GW ROSEN CVD TIP .035INX260CM 163.80KIT TRNSDUCR PRESSR W/FLSH DEVC 164.70FORCEPS BIOPSY ALLIGATOR ENDO DIS 165.19SUTURE FIBRWIR 2 TPR NDL 38 IN N 166.50INSERT AORTIC CLAMP EVERGRIP 33CM 167.65SUTURE MYO WR II 65MM 4X18IN SZ5 168.20SUTURE PROLN 5-0 BV-1 24 IN NON 168.60SUTURE PDS II 1 CTX 18 IN ABSRBL 169.10ELECTRODE ELECTROSURGCL FRCP 172.55WIRE KIRSCHNER 2.0MM 172.80MEDIA CONTRAST VISIPAQUE 320X50ML 173.00DVC STRATAFIX PDSPLUS CT2 0 45CM 173.11HEMSTAT SPNG SRGIFOM 8CMX12CMX10M 173.70PAD CLD THRPY SHLDR WRP ON X-LG 175.95PAD KNEE WRAPON POLAR XLARGE 175.95DRESSING HYDRGRL ANTIMICRO 1.5OZ 176.95CLAMP BPSY MSCL RAYPRT 12MM MED 177.20SHIELD RADIAL SORBX 179.37BLADE MICRO SAGITAL 5044-145 180.00BLADE SAGITTAL 2108-318-000 180.00CONTROL VALVE BLDBCK BLN CATH 180.00

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TVRH Item Description Primary PriceINSERT AORTIC CLAMP EVERGRIP 61MM 180.00KIT LEAD END CAP PACEMAKER 180.00PIN STEINMANN DMND 3.2X229MM 180.00ROTATION TOOL MEDTR 6056 180.00SEAL CANN ENDOWRST STAPLER 10/BX 180.00SHEATH ENDOWRIST STAPLER 10/BX 180.00SLEEVE UNIVERSAL TROCAR 5MMX100MM 180.00SUTURE PRLN 5-0 RB-1 36 IN NON 180.00SUTURE QUILL SRS PDO 00 TAPER 180.00SUTURE QUILL SRS PDO 2 REVERSE 180.00SUTURE VLOC 90 V30 2 0 9IN 180.00SUTURING DEVIC SURGDAC ENDO STC 180.00SUTURING DEVICE SURGDA ENDO STC 180.00TOURNIQUET SINGLE BLADDER 24IN 180.00SUTURE VLOC 180 V20 2 0 12IN 180.26INTRO CATH VAS W/O GW 6FRX10CM 180.60DRAIN WND RND HUBLS SIL SUR 15FR 182.80DRAIN WND RND HUBLS SIL SUR 19FR 182.80PAD SHOULDER WRAPON POLAR 184.80PIN GDE SMTH SHFT DRL 3.2MMX9IN 184.80TRAY EPIDURAL CE18HKCD 185.40SUTURING DEVCE SURGDAC ENDO STC 185.55SUTURE GORE TEX CV-3 PH-24 24 IN 188.30KIT INJ COLLAGEN IMPLT URIN INCON 189.00SHIELD FEMORAL ANGIO SORBX 189.25SET INTRO SHTH VASC PERC 6FX11CM 189.63INTRDCR SYS ARROWFLEX STD 7FRX13 190.68KWIRE .035 STERILE 9IN 191.50KWIRE .045 STERILE 9IN 191.50SUTURE GORE TEX CV-0 THX-26 36 I 193.20SUTURE GORE TEX CV-2 THX-26 36 I 193.20SAW BLADE STRYKER 0277-096-278 194.40SYSTM SMOKE EVACUATION LAPAROSCOP 195.55CANISTER PREVENA 45ML 198.25ADHESIVE LEADWIRE PACEMAKER 201.60TOURNIQUET SINGLE BLADDER 34IN 202.30FORCEPS BPSY PULM EN 1.8MMX100CM 204.20CATHETER IRRIGTG CONTRS 4FRX80CM 209.65CATHETER IRRIGTG CONTRST MED 6FR 209.65BLADE OSC AND SAGIT 2296-033-520 210.00CANNULA ARTHROSCPC TWST IN 7MMX7C 210.00CANNULA TWST IN ARTHROSC 6MMX7CM 210.00CANNULAR ARTHROSCOPIC 8.25MM 210.00PACEMAKER MEDT CABLE PACING 12FT 210.00REDUCER ENDOWRIST STAPLER 12MM 210.00

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TVRH Item Description Primary PriceCATH MLTIPK 3FR 145 ANGL 6SH JL4 210.84KIT CATH ANGIO DIAGNSTC JDK 6FR 210.84ELECTRODE ELECTROSURGCL RT A 5MM 211.70KWIRE 1.2MM X 100MM 213.45WRAP KNEE COMPRESSION 214.60INTRODUCER SET 5FRX7CM 216.70GW AMPLATZ SS STR .035X75 218.00CATHETER BEACON TIP 5F X 65MM 218.40FIXATION TOOL BSCI 6616 218.40TUBE GASTRO REPLCMNT TRI FNN 20FR 218.40UTERINE MANIPULATOR CLEAN VIEW 219.25SLEEVE STABILITY XCEL 12MM 220.21TRAY THORACENTESIS 221.15GUIDEWIRE NON-THREADED 1.25X150MM 221.35DEVICE ENDO CLOSE 223.65SUTURE QUILL 24CM X 24CM 2-0 226.65BLADE NEXGEN 18MM X 90MM X 1.27MM 226.80BLADE SAG SAW SYS 6 BR11290-50 226.80BLADE SAG SYSTEM 6 BR11990-47 226.80BLADE SAW SAG AGRESV TOO MED LNG 226.80SAGITTAL BLADE 13.0X0.89X90MM 226.80SAGITTAL BLADE 18.0X1.27X100MM 226.80SAGITTAL BLADE 21.0X90X1.27MM 226.80SAGITTAL BLADE 25.0X1.27X90MM 226.80WRAP BOOT WLKR LO PROFL BLU MED 227.70BOOT POST OP WALK LRG SLB200107 228.15BOOT POST OP WALK SM SLB200103 228.15BOOT POST OP WALKER MED SLB200105 228.15SET INTRO CTH PERC 6FX41/8IN 10 228.38KIT INTRODCR SHE 6FRX41/8IN 10CM 228.40DRAIN SYSTEM CHST DRY SCTN CONTR 229.50MASK FACE DISP 231.60BRA SURGI LARGE 231.85BRA SURGI MEDIUM 231.85BRA SURGI XL 231.85BOOT PREVNTN DECUB INFLAT MED 233.05TRAY PARA/THORA - ULTRAOUND 234.00TRAY THORACEN/PARACEN 234.00TRAY THORACENTESIS PARA 8FR 4 3/4 234.00PACEMAKER MEDT ADJ SLITTER 235.20PACEMAKER MEDT UNI SLITTER 235.20BUR OVL HALL DNTL 5.5MM 235.45WALKER MAXTRAX BOOT LARGE 235.70WALKER MAXTRAX BOOT MEDIUM 235.70WALKER MAXTRAX BOOT SMALL 235.70

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TVRH Item Description Primary PriceWALKER MAXTRAX BOOT SMALL 235.70CATHETER FOLEY COUDE 22FR 30CC 238.30KIT CANSTR VAC ASISTD CLOS 500ML 238.60WALKER MAXTRAX BOOT XLARGE 238.75TUBE GASTROSTOMY 18FR 241.50SCISSOR TIP LOGICUT 243.60SUTURE FIBERLOOP 4-0 243.60TACK PLATE 243.60ELECTRODE BAYONET BLADE 246.10MARKER TATOG ENDOSCPC MUCSL W/SY 247.80GW GLIDEWIRE STR 3CM 035X150 248.64BLADE SAW GIGLI 249.20SPLINT BULK 4IN X 15YDS 250.25DRAIN EVACTNG RND TROC TIP 7FR 252.00KIT LEAD CAP 252.00WRAP HIP COMPRESSION 253.30WRAP SHOULDER COMPRESSION 253.30TUBE GASTROSTOMY 24FR 253.59GW AMPLATZ SS J .035X145 255.00SET CATH ARTRY RADL 3FRX5CM PED 255.85MICROPUNCTURE ACS SET MNK MOD 255.96SUTURE PDS II 1 TP-1 60 IN ABSRB 257.25SUTURE QUILL SRS 36CMX36CM 48M 259.05SP CATHETER PIGTAIL 4FR 260.00PAD COLD THPY SHLDR WRAP ON LG-RH 260.40KIT INFSN GALCTGRPHY RAD BRS 31GA 261.40CATHETER KUMPE ACCESS 5FR X 65CM 261.75SP CATHETER MICHELSON 5FR 261.75SUTURE PDS 0 FOR CAPIO DEVICE 263.20DRAIN WND SURG 10FR W/TROC 264.60NEEDLE INJ BUNG AGNT U 18GAX15IN 264.60GUIDEWIRE ANGIOGRAPH .035INX150CM 264.80GW GLIDEWIRE ANG 3CM 035X150 264.80MANIPULATOR UTER ENDOSCPC 266.15MICROINTRODUCER PICC KIT 4.0FR 266.45SET INTRODCR CATH COAXL 4FRX10CM 266.45STYLET KIT MEDTR 52CM 268.80STYLET KIT MEDTR 6054-58 268.80STYLET KIT MEDTR 6056M 268.80STYLET KIT MEDTR 6057-52 268.80STYLET KIT MEDTR 6057-58 268.80STYLET KIT MEDTR 6082-55 268.80STYLET KIT MEDTR 6093-58 268.80STYLET KIT MEDTR 6094-52 268.80STYLET KIT MEDTRNIC 6082-58 268.80

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TVRH Item Description Primary PriceDRAIN BLAKE WOUND 24FR RD 2234 269.95CLIP LIGATING HEM-O-LOK LARGE 270.00BOOT PREVNTN ANKL CONTRCTUR MED 274.45GW GLIDEWIRE ANG 8CM 035X150 274.68BLADE MICRO SAGITAL S5023-244 277.20INTRO SYS SAFESHTHII STD 8FRX13 277.20KIT IRRIG AHTO STUBE W/ TIP 33CM 277.20CATHETER CHOLANG ENDO 7.5FRX18IN 277.75TROCAR ENDOSCPC FLXBL 15MM 278.45KIT INFLATION ENCORE 26 ADVANTAGE 279.90KIT INFLATN DILATN BALLN ANGIOPL 279.90VALVE DRNG CHST HEIMLC 1 WAY STR 283.25CATH ANGIO SPECIAL SUPER TORGUE 283.50BAG RETRVL SPECI ENDOSCP 4INX6IN 285.60INTRODUCER LDWR PACEMKR 7FRX13CM 285.60INTRODUCER SHETH HEMSTA 9FRX13CM 285.60CATHETER CHOLANGIOGRAM TAUT 287.85TROCAR ENDOSCPC BLADLS 5MM 289.90BLADE SAW BONE SMAL 5023-243 290.65CATH CRNRY DIAG 4.0X100 CM 294.00CATH CRNRY DIAG 4.5X100 CM 294.00CATH OPTITORQUE 5FR JACKAY RADIAL 294.00CATH OPTITORQUE 6FR JACKAY RADIAL 294.00LARYNGOSCOPE DISP LOPRO S3 294.00PIN BALL .035 294.00CLIP HEMOLOK XL 294.25KIT PORT ANGIOGRAPHIC RED 296.39KIT PORT ANGIOGRAPHIC WHITE 296.39TUBE TRACH UNCUFF FEN SZ4 300.30DRESSING AQUA HYDROFIBER 3.5X10 301.75INJECTOR VARICES DISP 302.40PACEMAKER MEDT WRENCH KIT 302.40PIN GDE SMTH SHFT DRL 3.2MMX12IN 302.40SUTURE FIBRWIR 5 CTTG NDL 38 IN 302.40IDOSORB GEL 4OZ TUBE 303.83SHIELD PERIPHERAL SORBX 307.44TUBE TRACH CFFD LO PRESSR DI SZ6 312.55GLIDEWIRE ANGLED .035 315.00SET VASC ACCS VSTICK 4400E 315.80KIT HANA BED 319.40BLADE DERMTM 323.40SUTURING DEVICE PDS II ENDOLP 0 324.75SUTURING DEVICE VCRYL ENDOLP 0 S 324.75OXYGEN DAILY 325.60OXYGEN NEW 325.60

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TVRH Item Description Primary PriceGUIDE DRILL AIMING 1.5MM 326.76SCREWDRIVER SQUARE TIP 2.0MM 326.76SCREWDRIVER UNIVERSAL T10 326.76KIT D HELP STERILE 327.20RETACTOR WOUND ALEXIS O MED 327.60RETRACTOR WOUND MEDIUM 5CM - 9CM 327.60RELOAD ENDO UNIVERSAL 4.0 328.20GW AMPLATZ SS STR .035X180 329.00GUIDEWIRE ANGIO.035INX180CM 329.10BAND TR STANDARD WITH INFLATOR 330.96GUIDEWIRE ORTHO THRD 2.8MMX300MM 332.72SET VASC STIFF 4FX10CM 335.20GLIDEWIRE STRAIGHT .035 335.50CATH 6FR 3DRC [G6703DRC] 336.00CATH 6FR AR1SH [G667636] 336.00CATH 7FR JR4 VISTA 778-082-00 336.00CATH GDE XBLAD3.5 6FRX100CM W/SH 336.00CATH GDG 5FR JR4 LBT 100CM 336.00CATH GDG 6FR 3DRC [G6723DRC] 336.00CATH GDG AMPLTZ LFT .7 6FRX100CM 336.00CATH GDG AMPLTZ LFT 1 6FRX100CM 336.00CATH GDG AMPLTZ LFT 1 7FRX100CM 336.00CATH GDG AMPLTZ LFT 1 8FRX100CM 336.00CATH GDG AMPLTZ LFT 2 6FRX100CM 336.00CATH GDG AMPLTZ LFT 3 6FRX100CM 336.00CATH GDG AMPLTZ RT 1 C 6FRX100CM 336.00CATH GDG AMPLTZ RT 2 C 6FRX100CM 336.00CATH GDG AMPLTZ RT 2 C 7FRX100CM 336.00CATH GDG HCKEY STIK CR 6FRX100CM 336.00CATH GDG INTRNL MAMRY 6FRX100CM 336.00CATH GDG INTRNL MAMRY A 6FRX90CM 336.00CATH GDG JDKNS LFT 3.5 6FRX100CM 336.00CATH GDG JDKNS LFT 4 C 6FRX100CM 336.00CATH GDG JDKNS LFT 4 C 7FRX100CM 336.00CATH GDG JDKNS LFT 4 C 8FRX100CM 336.00CATH GDG JDKNS LFT 4.5 6FRX100CM 336.00CATH GDG JDKNS LFT 5 C 6FRX100CM 336.00CATH GDG JDKNS LFT 5 C 7FRX100CM 336.00CATH GDG JDKNS RT 3.5 6FRX100CM 336.00CATH GDG JDKNS RT 4 CR 6FRX100CM 336.00CATH GDG JDKNS RT 5 CR 6FRX100CM 336.00CATH GDG LFT 4 C 6FRX100CM 336.00CATH GDG LFT CRNRY BYP 6FRX100CM 336.00CATH GDG MULT PRPS A1 6FRX100CM 336.00CATH GDG MULT PRPS A1 7FRX100CM 336.00

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TVRH Item Description Primary PriceCATH GDG RT CRNRY BYPS 6FRX100CM 336.00CATH GDG RT CRNRY BYPS 7FRX100CM 336.00CATH GDG TRNSRADIAL XT 6FRX100CM 336.00CATH GDG V 6FR JL3 667-000-00 336.00CATH GDG XTRA BCKUP 3 6FRX100CM 336.00CATH GDG XTRA BCKUP 3 7FRX100CM 336.00CATH GDG XTRA BCKUP 3. 6FRX100CM 336.00CATH GDG XTRA BCKUP 3. 7FRX100CM 336.00CATH GDG XTRA BCKUP 3. 8FRX100CM 336.00CATH GDG XTRA BCKUP 4 6FRX100CM 336.00CATH GDG XTRA BCKUP 4 7FRX100CM 336.00CATH GDG XTRA BCKUP 4 8FRX100CM 336.00CATH GDG XTRA BCKUP 4. 6FRX100CM 336.00CATH GDG XTRA BCKUP LA 6FRX100CM 336.00CATH GDG XTRA BCKUP LA 7FRX100CM 336.00CATH GUIDE AL.75 6FRX100CM W/ SH 336.00CATH GUIDE AL1 6FRX100CM W/ SH 336.00CATH GUIDE AR2 6FRX100CM W/ SH 336.00CATH GUIDE HS SH 6FRX100CM W/ SH 336.00CATH GUIDE JL3.5 7FRX100CM W/ SH 336.00CATH GUIDE JR3.5 6FRX100CM W/ SH 336.00CATH GUIDE JR4SH 6FRX100CM W/ SH 336.00CATH GUIDE JR4SH 8FRX100CM W/ SH 336.00CATH GUIDE LCB 6FRX100CM W/ SH 336.00CATH GUIDE MPA1 6FRX100CM W/ SH 336.00CATH GUIDE XB2 6FRX100CM W/ SH 336.00CATH GUIDE XB3.5 6FRX100CM W/ SH 336.00CATH GUIDE XBLAD3 6FRX100CM 336.00CATH GUIDE XBLAD4 6FRX100CM 336.00CATH GUIDE XBRCA 6FRX100CM 336.00GUIDEWIRE SPNL TUBE DISP MIN MED 336.00HEMOSTAT ABSO SURG 2X3 1953 336.00SET DRL DISP W/PIN 336.00DRESSING AQUA HYDROFIBER 3.5X14 336.25TROCAR 5MM LONG 125MM 336.30DRAIN WOUND CLOSED SUCTION 400ML 342.70GW AMPLATZ SS J .035X260 344.00GW AMPLATZ SS STR .035X260 344.00GW AMPLATZ SS STR .035X260 344.00CARTRIDGE STPL RELOAD 30MMX3.5MM 344.40CARTRIDGE STPL RELOAD 30MMX4.8MM 344.40CATH BALLOON 6FR 110CM 344.40SUTURE MAXON 1 TT20 649171 344.40WRENCH TORQUE BIDIRECTIONAL BSCI 344.40GW ANGIO 3 MM AMPLATZ .035INX260 344.42

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TVRH Item Description Primary PriceDRESSING MEDIUM KIT VAC 344.60CATH SLIPCATH STR .035 4FX150 350.20SP ZZ CATH SUPRAPUB FOLEY 350.90GUIDEWIRE ANGIO ANGLED .035X180 355.15GW GLIDEWIRE ANG 3CM 035X180 355.15GW AMPLATZ SS ST .035X260 359.00GW AMPLATZ SS ST .035X260 359.05KIT SCTN PLSED LAV 360.10BLADE KNEE 6118-119-090 361.20CATHETER BALLOON 6714 361.20SAGITTAL BLADE 25.0X0.89X90MM 361.20STYLET BSCI SOFT STRAIGHT 45CM 361.20SUTURE STEEL D SPECIAL 5-0 20 IN 362.00SHEATH SAFE II LONG 10FR 23CM 369.00ADAPTER PACING SEALING 369.60SHEATH INTRO INTRA ARTC BLLN PMP 369.60SET TBG INSUF HTD ENDOSCPC 369.95ADAPTOR DISP HAND SWITCHING 370.50CARTRIDGE STPL RELOAD 60MMX3.5MM 370.90CARTRIDGE STPL RELOAD 60MMX4.8MM 370.90SP GLIDEWIRE 372.00TROCAR ENDOSCPC BLADLS 11MM 372.35GUIDE DRILL TIP 1.6MM 372.95GUIDEWIRE ANGIOGRAPH .035INX260CM 372.95GW GLIDEWIRE STR 3CM 035X260 372.95GW GLDEWRE ANG 3CM .038INX260CM 372.96GW GLIDEWIRE ANG 3CM 035X260 372.96FORCEP GRASPING CARTRIDGE 5MMX38C 375.75CATHETER SLIP BEACON 4FR ANGLED 376.74CATHETER ENDOSCPC RETROGRD 5.5FR 378.00SUTURE FIBERLOOP 2 20IN 76MM 7MM 378.00GUIDEWIRE DBL STRT .035INX150CM 378.40GUIDEWIRE ANGIOGRPH .035INX150CM 379.25GW GLIDEWIRE SS ANG 3 035X150 379.26SHEATH PERFORM GUIDE CFLO G08024 382.20TROCAR ENDOSCPC BLADLS 12MM 383.70BIT DRL QCK RLS 2.8MMX5IN 386.40BIT DRL QCK RLS 2MM 386.40TRAY PACEMAKER (CVP138) 389.40GW GLIDEWIRE SS ANG 3CM 035X180 392.28BLADE SHVR FUNCTNL ENDOSCP 4.2MM 394.80KIT ACCSS ARTRY TRNS 6FX43/8IN 11 399.84CATH MIDLINE 20GX6CM BASIC KIT 403.20CATHETER EMBLCTMY 3FRX80CM 403.20SET ZIMMER DRILL PIN 200100000 403.20

Page 29: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceELECTRODE ELECTROSURGCL HNDL PNC 404.80CARTRIDG STPL RELOADNG LNE 55MM 406.35CATH ANGIO PERIPHL 5FRX65CM 407.40CATH ANGIOGRPHC PERIPH 4FRX100CM 407.40CATH ANGIOGRPHC PERIPH 5FX100CM 407.40CATH GDE GLIDECTH SIM2 100CM 5FR 407.40CATH GLIDECATH ANGLE 120CM 4FR 407.40CATH GLIDECATH ANGLE 65CM 4FR 407.40CATH GLIDECATH STRAIGHT 100CM 4FR 407.40CATHETER ANGIOGRPHC DI 5FRX100CM 407.40CATHETER ANGIOGRPHC PE 5FRX100CM 407.40SP CATHETER VERTEBRAL GLIDE 4FR 407.40TUBE GASTRO REPLACE TRFUNNEL 18FR 407.40DRESSING VAC GRANDUFOAM MEDIUM 408.40CATH ANGIOGRPHC PERIPH 5FRX100CM 410.13BLADE 3.5MM GATOR C9962 411.60CATHETER PER-Q-CATH SINGLE 4.0FR 411.60SHEATH FLEXOR ANSEL RDC 6F 45 411.60CATH GDG HCKEY STIK CR 7FRX100CM 415.80GUIDEWRE ANGIOGRPH .035INX150CM 417.90GW GLIDEWIRE SS ANG 3 035X260 417.90GW SS ANG 5CM 035INX260CM 417.90GWIRE CRNRY HI PER .035INX260CM 417.90APPLIER CLP LIGTG MULT LG 420.00APPLIER CLP LIGTG MULT MED 420.00APPLIER CLP LIGTG MULT MED SH 420.00APPLIER LIGACLIP DISP SMALL(MCS20 420.00BLADE SAW STRYKER SAG 13.2X63.5MM 420.00BUR HOLLOW FLUTE BARREL 4.0MM 6 420.00BUR HOLLOW FLUTE BARREL 5.5MM 6 420.00BUR HOODED ABRAISION 3.0MM 420.00BUR STRYKER BARRELL 375-941-012 420.00BURR DIAMOND 3.0 LONG 420.00CATH FEMORAL SWANGANZ CC AMC 7F 420.00CLAMP BPSY MSCL RAYPRT 16MM LG 420.00CUTTER AGGR PLUS JOINT 2.5MM 420.00CUTTER AGGRESSIVE PLUS 3.5MM 420.00CUTTER AGGRESSIVE PLUS 4.0MM 420.00CUTTER AGGRESSIVE PLUS 5.5MM 420.00CUTTER ANGLED 4.0MM 420.00CUTTER ANGLED 4.5MM 420.00CUTTER RESECTOR 5.0MM 420.00CUTTER RESECTOR 5.5MM 420.00CUTTER TOMCAT 4.0MM 420.00CUTTER TOMCAT ANGLED 4.5MM 420.00

Page 30: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceDRAIN KIT PLEURX CATH 507500 420.00DRILL ACUMED 2.0 80-0318 420.00DRILL BIT NON CANN 1.7MM 420.00ELECTRODE ELECGTROSURGCL NDL 3CM 420.00FORCEPS GRSPG 3 PRON 2.3MMX240CM 420.00GLIDEWIRE .035 STIFF TYPE 630117 420.00PIN DISTRACTION 14MM 420.00POWDER GELATIN GELFOAM ABSORBABLE 420.00SIMULATOR NRV DISP 420.00SPLINT BULK 3IN X 15YDS 420.00STAY ELSTC RETRCTR SHRP SURG 5MM 420.00TUBE ENDOBRONCH DBL LUMEN LFT 37F 420.00TUBE ENDOBRONCH DBL LUMEN LFT 39F 420.00TUBE ENDOBRONCH DBL LUMEN LFT 41F 420.00CATHETER ANGIOGRPHC DI 5FRX110CM 420.40INTRODUCER PEEL OPTISEAL 13CM 8F 421.89INTRODUCER PEEL OPTISEAL 7F 25CM 421.89SET TUBE PUMP DISP FLOSTEADY 422.90DILATOR FOLLOWER 12FR 427.20DILATOR FOLLOWER 14FR 427.20DILATOR FOLLOWER 18FR 427.20DILATOR FOLLOWER 20FR 427.20GUIDEWIRE ANGIO 5 .018INX190CM 430.56GUIDEWIRE ANGIO 5 .018INX300CM 430.56GUIDEWIRE ANGIO ST .035INX190CM 430.56GW ANGIO ST .035INX300 1002703-02 430.56GW SPARTACORE .014X300 1005203 430.56SP CATHETER VERTEBRAL 4FR 431.00CATHETER EMBLCTMY ARTER 3FRX80CM 431.45TROCAR ENDOSCPC BLNT T 10MM-12MM 432.20PAD PRESSURE PROTECTOR SET 907-P 439.55CATH 6F IM [670-190-55] 441.00CATH GDG HCKEY STIK CRV 7FRX55CM 441.00DRILL BIT 2.5MM X 40MM 442.54DRILL BIT 2MM X 4MM 442.54BIT DRILL 2.0 X 100MM 442.55GW ANGIO J SHAPE TIP .035INX145CM 445.90GWIRE MANDREL SS .018X80CM 446.90HEMOSTATIC AGENT OXDZD C 4INX8IN 450.60LOOP CUTTING 24FR 452.05PROBE BALLOON FOGARTY BILIARY 6FR 453.95PACK TOTAL KNEE 454.45CHITO SEAL 457.00LO GLEX W/O RIGID STAYS/PRE 459.30BLADE SHAVER DUAL EDGE 3.5MM 459.82

Page 31: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceRETRIEVER SUT HWSON ARTHROSCPC 461.35BIT DRL QCK CONC 2.5MMX110MM STD 463.05BIT DRL QCK CONCT 3.5MMX110MM SH 463.05TIP TROCAR DILATING 5X100 473.11SHEATH INRODUCER LONG 12 FR 477.75PIN GDE THRDD TIP 3.5MM 486.70VALVE PASSY MUIR 492.80STAPLE DRILL BIT SMALL 1.8MM 496.15POWER RASP 5053-082 496.25TUBE TRACH UNCUFF FEN SZ6 499.35GUIDE PIN 3.2MM 01000100 499.80TUBE GASTRO REPLACE TRFUNNEL 16FR 499.80CATH URETERAL DUAL LUMEN 10FR 504.43MEDIA CONTRST OMNIPAQUE 300 100ML 512.30CATH IKARI LEFT 3.5 6FR 100CM 514.50CATH IKARI LEFT 4.0 6FR 100CM 514.50CATH IKARI LEFT 4.5 6FR 100CM 514.50CATH IKARI RIGHT 1.0 6FR 100CM 514.50CATH IKARI RIGHT 1.5 6FR 100CM 514.50GW CHOICE PT .014X182 514.50GW CHOICE PT XS .014X182 514.50GW HITPRQUE J .014X190 514.50GW TURN TRAC FLEX 190 CM 514.50GW VERSA TURN F 190 CM 514.50SYSTEM PRINEO SKIN CLOSURE 517.81RASP HELIOCOIDAL LONG 3.2MMX18.3M 519.80GUIDEWIRE CRNRY .014INX182CM 525.82GW CHOICE EXTRA SUPPRT J .014X182 525.82GW CHOICE PT J TIP .014X600 525.82GW CHOICE PT XTR SUPPRT J 014X300 525.82GW CHOICE XTRA SUPPRT J 014X300 525.82GWIRE CRNRY HYDROPH .014INX182CM 525.82GWIRE CRNRY HYDROPH .014INX300CM 525.82SHEATH FLEXOR ANSEL 6FR 55CM 526.26SHEATH FLEXOR ANSEL STR 6F 70 526.26STAPLER INTRNL PURSTRNG SUT 65MM 526.75CARTRIDG STPL RELOADNG LNE 75MM 527.95KIT POWERPULSE ULTRA 529.20SHEATH INTRDCR VSCLR 7FRX45CM 529.20SHEATH PINN DESTIN CC ST 6F 45 529.20GW BALL TIP STRL 02.5X850MM 532.51ELECTRODE ELECTROSURGICAL LOOP 24 536.30CARTRIDGE STPL RELOADNG LNE 75MM 538.30BIT DRILL 2.0 540.22BIT DRILL 2.5 540.22

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TVRH Item Description Primary PriceBIT DRILL 2.8 540.22BIT DRILL 3.0 540.22SP COIL TORNADO EMBO 4X8MM 541.70SP ZZ COIL TORNADO 3X2 MM 541.70GWIRE ANGLED .018 INX260X3 CM 543.90GUIDEWIRE ANGIO 3 .014INX190CM 547.94GUIDEWIRE ANGIO CR .014INX300CM 547.94GUIDEWIRE ANGIO J SHAP TI 190CM 547.94GUIDEWIRE WHISPER HT J .014 X 300 547.94GW ANGIO 3 .014INX190 547.94GW ANGIO 3 .014INX300 547.94GW ANGIOGRPHC CR .014INX190CM 547.94GW ASAHI GRANDSLAM .014INX180 547.94GW ASAHI GRANDSLAM .014X300 547.94GW ASAHI PROWATER .014X180 547.94GW HI-TORQUE MIDLEWGHT J 014X190 547.94GWIRE .014 190 CM 547.94GWIRE .014 300 CM 547.94GWIREHT STRAIGHT .014X190 547.94GUIDEWIRE ANGIO ST .014INX300CM 547.95BIT DRL QCK CPLG 75 MM 2MMX100MM 549.05BRUSH CYTO BILRY DBL L 8FRX200CM 551.25NEEDLE BIOP AUTO 18GAX20CM A1820 558.60CATHETER INDWELLING INTRA PRESSUR 567.50DRILL BIT 2.5MM X 180MM Q/C 573.30POUCH LAPSAC SURGICAL TISSUE 10X8 573.30ELECTRODE HF HOOP 24FR.35W 30D 574.92SP ZZ CATHETER URETHRAL 578.45GWIRE FLOPPY TIP .014 180CM 580.65GWIRE FLOPPY TIP .014 300CM 580.65GUIDEWIRE ANGIO J .035INX260CM 583.10ADAPTER LDWR PACG CRDIAC PIN PLG 588.00ANTENNA DETACHABLE 588.00TIP APPLICATOR SPRAY EXT 6IN 588.00TIP APPLICATOR SPRAY EXTEND 11IN 588.00KIT PNEUMTHRX RADPAQ 18GA W/CATH 591.95BLADE SHVR XTRA SHRP ARTHR 5.5MM 602.70CATH MIDLINE 20G X 8CM 602.70ELECTRODE PACG CRDIAC TEMPRY 5FR 602.70TUBE J INTESTINE 9FR 609.02DRILL BIT ACUMED 2.3MM 80-0627 610.05K WIRE GUIDE .054IN 610.05SYSTEM MIXER BONE CEMENT 612.50SHTH CAROTID 6FRX90CM 617.40LOOP DETACH LIGATING DEV POLYLOOP 621.80

Page 33: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceBIT DRILL ARTHREX 2.5MM AR8943-30 624.75POUCH SPECI RETRVL ENDOSCPC 15MM 624.75TROCAR BLUNT TIP WITH BALLOON 626.20STAPLER INTRNL LNEAR 30MMX4.8MM 627.70DRILL BIT TWIST 2.6 X 122MM 628.45APPLIER CLP LIGTG ROTATG SHF M/L 631.70COMPRESSOR ARTRY FEMRL DISP STRL 632.10COMPRESSOR ARTRY FEMRL DISP STRL 632.10DRILL BIT ACUMED 2.8MM 80-0387 632.10CERVICAL CUP VCARE LARGE 638.70DRILL ZIM HAND FREE 4.3 X 152.5MM 639.45STAPLER INTRNL LNEAR 30MMX3.5MM 639.90CATH DIAG WHOLEY FLOPPY .035X15 640.19CATHETER ANGIOGRAPHC CM 5FRX70CM 640.70HEMOSTAT ABSORB SNOW 2X4IN 641.27HEMOSTAT ABSORB SNOW 2X4IN 641.27GDEWIRE VERSACORE MODIFIED J 641.88DRILL SHORT 2.7 644.00CATHETER EMBOLECTOMY 5F X 8MM 646.80CATHETER OCLUD IRRIG DBL LUM 4FR 646.80TRAY CATH SUPRAPUB FOL 646.95STAPLER INTERNAL LINEAR CUTTER 60 649.15STAPLER INTRNL LNEAR 60MMX4.8MM 649.15RETRIEVER STRL FOREIGN BODY ROTH 654.15APPLICATOR DUPLOSPRAY MIS 30CM 655.60APPLIER CLIP LIGTG ROTATG SHFT LG 656.00KWIRE STRYKER 3 X 285MM 657.85SP ZZ DRAINAGE CATHETER 661.95STAPLER INTRNL LNEAR CTTR T 55MM 663.40DRESSING ABSRBNT FBROUS 4INX4IN 664.55DRILL BIT NCB 4.3MM X 195MM 683.55K WIRE 03.0 X 450MM 683.55GUIDEWIRE UNTHREADED 1.5X150MM 685.02GW V-18 CONTROL STR 8CM .018X300 689.36DRILL BIT 3.5MM SHRT BRAD POINT 690.40BLADE ORAL OSCIL 11.5 X 7 X 0.4 690.90BRACE KNEE POST OP T ROM FUL FOAM 692.30BIT DRILL ARTHREX 3.0 AR8943-16 698.25CATH RESPON QUAD CRD 5MM 5F 120 698.25CATH RESPON QUAD CRD 5MM 6F 120 698.25STAPLER INTRNL LNEAR CTTR V 55MM 704.00CATHETER OMNI FLUSH SF .035 70CM 705.60GUIDEWIRE ANGIOGRPH .035INX260CM 712.95DRILL BIT 2.7 2142-27-070 727.65GUIDEWIRE EXTRA STIFF 0.35X260 727.65

Page 34: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceTUBING DOLPH HYSTEROSCOPY DOLTUB 730.80KIT BPSY BNE SPNL 732.65BALLOON MEDT PACE VENOGRAM ATTAIN 735.00GUIDEWIRE FUSION SHORT .035 735.00INTRODUCER CHECK FLO 18 X 38 X 30 738.70SET INTRODCR CATH 16FRX35CM W/.0 738.70SHEATH ACCESS URETERAL 15X36CM 745.44BRACE KN/POST OP T ROM F/FOAM XL 746.05DRILL BIT NCB 3.3 195MM 749.70GUIDEWIRE ZIM SMOOTH BULLET 749.70POWDER TALC VI STRL 5GR 757.05CARTRIDGE STPL RELOADNG LNE 35MM 764.30DRILL BIT 2.7MM 771.90HEMOSTATIC AGENT OXDZD C 2INX4IN 772.35CARTRIDGE STPL RELOADNG LN 100MM 795.65BUR MTCH HEAD 3MMX9CM 801.65GDWIRE VERSACORE MOD J 035X260 806.25NEEDLE VASCULAR ACCESS 18GA 808.50RESERVOIR COLL AUTOTRNSFUS 250ML 808.50DRILL 2.7MM 815.85SUCTION IRRIGATOR DEVICE LIGHTED 830.55SET STNT URTRL MON 6FRX22CM-30CM 837.90CATHETER B 36FRX240CM 12MMX5.5CM 845.25CATHETER B 42FRX240CM 14MMX5.5CM 845.25CATHETER B 60FRX240CM 20MMX5.5CM 845.25DILTR BALLOON QUANTIUM10X5.5X240C 845.25DILTR BALLOON QUANTIUM16X5.5X240C 845.25DLTR BALLOON QUANTIUM18X5.5X240CM 845.25G/WIRE ENDO ST BIL EXT .025INX450 845.25TROCAR ENDOSCOPIC BLADELESS 15MM 858.95SEALANT THROMBIN TOPICAL FLOWABLE 861.05SUTURING DEVICE SURGDAC END 10MM 862.55SET TBG LAV SYS CO2 GS 871.00SPHINC CLEVER CUT 3 4FR 7MMX20MM 874.30CATH LANGSTON PIGTAIL 6F 145 874.65GUIDEWIRE BALL NOSE 3.0MMX100CM 882.00CATH FOLEY 3W 30CC 20FR 884.86STAPEL RELOAD 60MM GRAY 885.35ELECT FULGUR SHRT TIP 3FR 105CM 888.00GUIDEWIRE TRACER TN 480A 889.05K WIRE NITINOL SHARP 20-0124 911.40CATH INF CRAGMCNAMAR 30C 5FX135 918.75CONNECTOR SMARTSTITCH PERFECTPASS 918.75CEMENT BNE TOTL HIP MAX CAPCTY 933.45CARTRDGE STPL RELOADNG LNE 45MM 938.85

Page 35: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceSTAPLE ECHELON RELOAD 45 BLUE 938.85STAPLE ECHELON RELOAD 45 GREY 938.85STAPLE ECHELON RELOAD 45 WHITE 938.85STAPLE ECHOLON RELOAD 45 GREEN 938.85CATHETER SUPPRT RUBICON 35 135CM 943.30ELECTRODE ROLLER BAR 24FR 947.20DRILL AO 04.20X340MM 951.85DRILL STRYKER 1806-4250S 951.85DRILL STRYKER 1806-4280S 951.85BIT DRILL SHORT 4.3X152MM 955.50CATH PTA POWERFLEX P3 12X40X80 955.50CATH PTA POWERFLEX P3 12X60X80 955.50CATH PTA POWERFLEX P3 8X40X80 955.50CATH PTA POWERFLEX P3 9X20X80 955.50SHEATH INTRODUCER 18FR 955.50GUIDEWIRE ANGIOGRPH .018INX480CM 958.30BURR BARREL 5MM 967.63STENT CONTOUR 6 X 20 968.35SUT CART SMART PERFECTP CO-BRAID 970.20SUT CART SMART PERFECTPASS WHITE 970.20SET INTRO PERFORMER RCF-16.0-38-J 977.55GUIDE WIRE BALL TIP 3 X 800MM 984.90KIT MXG BNE CEMT SPNL W/MXR 986.30POWDER TALC AEROSL 4GR 986.35KIT CENTRAL LINE BUNDLE DWARDS 988.60STAPLER INTRNL LNEAR CTTR T 75MM 990.00CATH SUPPORT ANG CXI 2.6FX150CM 992.00CATH SUPPORT DAV CXI 4FX150 992.00CATH PTA ARMADA 35 7X100X135 992.25CATH SUPPORT QUICKCROSS .018X150 992.25CATH SUPPORT QUICKCROSS .035X150 992.25GW ASHAHI FIELDER XT .009X190 992.25DRILL BIT SGL USE STRL 04.2X300MM 996.03DRILL OA 04.2 X 180MM 1,003.30SAVARY GILLIARD GUIDEWIRE 1,006.50TIP FAN SPRAY COAXIAL RETRACT 1,006.95INTRO HEMO SWARTZ SR0 8.5F 60CM 1,012.46INTRO HEMO SWARTZ SR0 8.5F 60CM 1,012.46INTRO HEMO SWARTZ SR0 8F 60CM 1,012.46WIRE GUIDE TRACER .021 X 480 1,018.55STAPLE ECHELON RELOAD 60 BLUE 1,024.50STAPLE ECHELON RELOAD 60 GREEN 1,024.50STAPLE ECHELON RELOAD 60 WHITE 1,024.50SENSOR CEREBRAL OXIMETER 1,029.00GUIDE WIRE BALL TIPPED 03X1000MM 1,047.40

Page 36: TVRH Item Description Primary Price REHAB …...TVRH Item Description Primary Price IV INFUS THPYPROPH//DX (59) 699.80 IV INFUS THPYPROPH//DX INITL UP 699.80 IV INFUS THPYPROPH//DX

TVRH Item Description Primary PriceDRILL PILOT AO SHORT 4.0MM 1,049.75GWIRE CRNRY 9 .014 X300CM 1,056.75GWIRE CRNRY ASAHI 3 .014X180 CM 1,056.75GWIRE CRNRY ASAHI 6 .014X300 CM 1,056.75GW HITORQUE COMMAND .014X300 1,065.75NEEDLE XPAK TRCAR ASSY DISPSBL 1,066.11BIT DRILL 310.509 1,067.60DRILL BIT 2.0MM W/DEPTH MARK 1,067.60KIT PICC XCELA WPV 5F D LUM 1,077.05STAPLR INTRNL LNEAR CTTR T 75MM 1,078.20PUMP PAIN DISP ON-Q SINGLE LEAD 1,081.90DRIL DISTAL GRAD 4.3MM 2112-01-40 1,087.80KIT PERICARDIO 8.3FR CATH 1,090.23KIT PERICARDIO 8.3FR CATH 1,090.25WIRE CTO VCTRY 14 300 CM 12G TIP 1,091.48WIRE CTO VCTRY 14 300 CM 18G TIP 1,091.48KIT PEG 15FR 1,100.59APPLIER CLP LIGTG ROTATG MED 5MM 1,102.00BALLN DIALATING WIRE GUIDED 20X5. 1,102.00BALLOON 4 STAGE STONE EXTRACTION 1,102.00BASKET STNE RETRVL BILRY 2CMX4CM 1,102.00BUR ROUND PRECISION 7.0MM 1,102.00CATH DIL BALL ESOPH 42F 14MMX5.5C 1,102.00CATH DIL ESOPH 16MMX5.5CM 1,102.00CATH NAVICROSS 30DEG ANGLE 150CM 1,102.00CATH NAVICROSS STRAIGHT 135CM 1,102.00CATH SUPPORT CXI 2.6FR X 150CM 1,102.00CATH SUPPORT SEEKER .018X135 1,102.00CATH SUPPORT SEEKER .018X150 1,102.00CATH SUPPORT SEEKER .035X135 1,102.00CATH SUPPORT SEEKER .035X150 1,102.00CATH SUPPORT SEEKER CTO .014X150 1,102.00CATH VISTA BRITE TIP XBRCA 7FR 1,102.00CATH VISTA BRITE XBRCA SH 6F 100 1,102.00CATHETER MPA 1 120CM 5FR.LBT 1,102.00CATHETER SUPPORT CXI 4FR 1,102.00COUNTER SINK CANN 3MM 1,102.00DILATOR BALL ECLIPSE COLON ECL-10 1,102.00DRILL BIT ADV ORTHO 0219 1,102.00DRILL BIT CANN CANN 1.7MM 1,102.00DRILL BIT CANNULATED 2.7MM 1,102.00DRILL DISTAL GRAD LNG 2112-01-405 1,102.00DRILL ZIM 4.3 LONG 1,102.00ELECTRODE ELECTROSURGCL COAG 7FR 1,102.00ELECTRODE ELECTROSURGCL WA 90DEG 1,102.00

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TVRH Item Description Primary PriceGW ASAHI ASTATO 30 300CM 1,102.00GW ASAHI TREASURE .45 X 300CM 1,102.00GWIRE ASAHI ASTATO 20 17X300 CM 1,102.00LARYNGOSCOPE GLIDESCOPE DISP#3 1,102.00LEADWIRE PACG ENDCARDL 6FR 1,102.00LIGATOR CLIP ENDO 7FRX205CM 1,102.00NEEDLE MULTIFIRE SCORPION 1,102.00ON Q PAINBUSTER W/5IN CATHETER 1,102.00RELOAD ENDOWRST STAPLER 30 GREEN 1,102.00RELOAD ENDOWRST STAPLER 30 WHITE 1,102.00STAPLER ENDO HERNIA UNIV 173054 1,102.00SYS EXOSEAL VASCULAR CLOSURE 6F 1,102.00SYSTEM EXOSEAL VASCLR CLOSURE 5F 1,102.00SYSTEM EXOSEAL VASCLR CLOSURE 6F 1,102.00WAND RF SERFAS ENERGY SUPER 90-S 1,102.00WAND SABER 30 W/INTEGRATED CABLE 1,102.00WAND SERFAS ENERGY 30-S STRYKER 1,102.00WAND SERFAS ENERGY 50-S STRYKER 1,102.00WIRES DIAMONDBACK FIRM .014X35CM 1,102.00CATHETER DRNG CYSTC DCT RDDCK 1,102.15BIT 2.0 DRILL 1,116.00RELOAD ENDOWRST STAPLER 45 BLUE 1,116.00RELOAD ENDOWRST STAPLER 45 GREEN 1,116.00SP ZZ OCCLUSION BALLOON STENT 1,119.00ROD GDE BALL TIP DISP 3MMX1000MM 1,124.05SP ZZ VASOSEAL 1,141.75CATH BAL ANGIO MUSTANG 7X40X75 1,147.00CLOSURE VASCULAR MECHANICAL 8FR 1,147.00COUNTER SINK CANN 2MM 1,159.40CLOSURE VASCULAR MECHANICAL 6FR 1,178.00WAND SUPER TURBOVAC 50 IFS 1,178.00WAND SUPER TURBOVAC 90 IFS 1,178.00ELECTRODE HF BAND 24FR 30D 1,195.55CATH CPS AIM SL 90D 59CM 1,209.00CATH CPS AIM SL ALII 65CM 1,209.00CATH CPS AIM SL CSL 65CM 1,209.00CATH CPS AIM SL OBTUSE 59CM 1,209.00CATH CPS AIM SL SUB-ACU 59CM 1,209.00GW CONFIDA CURVED .035X260CM 1,209.00DRILL COMPRESSION 7.0MM 1,215.20DRILL PILOT AO LONG 4.0MM 1,220.40HEMOSTATIC PARTICLES ABS 3GM 1,222.02BLADE PLNTR FASOTOMY ENDOSCPC HK 1,227.60KIT CATH TEMP PACING BALLOON 1,230.08DRILL BIT 2.9 8290-30-070 1,230.10

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TVRH Item Description Primary PriceTRAY HEYMAN UROLOGIST 1,234.40BLADE CARPEL TUNNEL (81010) 1,240.00BLADE CARPEL TUNNEL SLIMLINE 1,240.00CATH PTA XXL 14X40X75 1,240.00CATHETER BAL 12MMX4CM 5.8FRX75CM 1,240.00SP ZZ INFUSION CATHETER 1,246.65KIT PICC XCELA WPV 6F 3LUM IR 1,251.65SP ZZ GUIDEWIRE 1,269.40STAPLER INTRNL LNEAR CTTR 100MM 1,275.55BASKT STONE RETRIEVAL NITINOL 1.9 1,302.00MCRSPHR BEAD BLOCK 500-700 2ML 1,302.00PROBE ARGON BEAM STRAIGHT FIRE 1,313.45CLOSURE VASCULAR SUTURE 6FR 1,320.60REAMER SHAFT MOD TRINKLE 08.0X448 1,333.00PROBE ARGON BEAM CIRCUMFRENTIAL 1,348.50ELECTRODE CYLINDER 24-28FR .35W 1,356.75DRILL STRYKER 702449 1,360.90STAPLR INTRNL LNEAR CTTR THK TISS 1,362.30SP ZZ Closure Device 1,362.55DRILL BIT ADV ORTHO 0209 1,364.00BLADE SAW PRECISION 6525-127-105 1,395.00CABLE CERCLG GRTR TRCH 1.8MM LNG 1,413.60STAPLER INT LIN CUTTR ARTICUL 45M 1,418.85CATHETER RIGHTSITE 1,438.40FIBER LASER MICRON 270 1,450.80NEEDLE MEDTRONIC 8670015 1,457.00STAPLER INTRNL LNEAR CTTR A 35MM 1,496.60CATH GUIDE ATTAIN SELECT II 1,500.40CATHETER BALL 12FRX180CM 4MMX3CM 1,515.05DEVICE FIXATION PERMANENT CAPSURE 1,519.00KIT SNARE INTRVS RETRL 10MMX120 1,537.60STAPLER LINR CUTTR FLEX SHAFT 45M 1,559.30DRILL CANLTD DISP 2MM-2.4MM 1,560.85LIGATOR MULT BND SAEED X-SM 1,565.85CARTRIDGE STPL RELOADNG CRVD BLU 1,569.25CARTRIDGE STPL RELOADNG CRVD GRN 1,569.25CATHETER ENDOSCPC RE 5.5FRX200CM 1,572.30SP ZZ PERCLOSE 1,584.00SPHINCTEROTOME ENDOSC 25MM 480CM 1,597.10HEMOSTATIC PARTICLES ABSORBABLE 1,612.60CATH PTA SLEEK OTW 2.0X20X150 1,635.25BALLOON DILATOR 21FR URETHERAL 1,660.05BIT DRILL TWST COLE RADIOLUCENT 4 1,663.60KIT CATH UROMAX ULTRA 24FRX8CM 1,670.60KIT DIL HIGH PRES HYDRPLS 24FX8CM 1,670.60

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TVRH Item Description Primary PriceKIT BALLOON 18FRX10CM 1,677.16SYS INCISION WND MNGMT PRE1055US 1,682.68CATH EXTRACTION PRONTO LP 1,705.00CATHETER THROM VASC EXTRAC 6FR 1,705.00DEVICE FIXATION PERM CAPSURE 30 1,705.00FILM ADHESION BARRIER 5 X 6 1,717.85CATH GUIDE ATTAIN COMMAND 1,721.10KIT LEAD INTRODUCER 1,736.00BURR MATCH HEAD MIS 2.5MM 1,739.10STAPLER INTERNL HERNIA LAV 5MM 1,746.05KIT CATH DILATN BA 15FRX4CMX75CM 1,765.45RETRACTOR WOUND PROTECTOR 1,798.00CATH GUIDING ATTAIN SELECT 90 1,810.40ADAPTER POWER DRIVE 4.0 MV SCREW 1,822.80FORCEP RAT TOOTH 3FR 1,830.75WC GRAFT EPIFIX 14MM 1,853.80CATH DIAG TORQR 2-5-2 65CM 1,860.00CATH LIVEWIRE DECA MED 2-5-2 6F 1,860.00STAPLER INTRNL LNEAR CT 45MM LNG 1,882.85STAPLER INTRNL CIRCULR 21MM 1,904.40STAPLER INTRNL CIRCULR 25MM 1,904.40STAPLER INTRNL CIRCULR 29MM 1,904.40STAPLER INTRNL CIRCULR CRVD 33MM 1,904.40SPINCTORTOME FS OMNI.035 W WIRE 1,946.30CABLE CERCLAGE W/GRIP 1.8 X 22IN 1,971.60STAPLER ECHELON 60 LAP 1,986.70CATH WEBSTER QUAD DEFL D6DR005RT 1,996.40SHEARS HARMONIC ACE+7 36CM 2,002.60STAPLR PWRD LAPRSCPIC CUTTER 45MM 2,028.50KIT TRACH PERC 8 2,081.55REAMER CANNULATED 2.7MM 2,110.48TUBE ESPHGL BLAKMOR GS 20FR ADLT 2,127.90TUBE ET EMG NRV INTGRTY MNTR 7MM 2,163.80CAPTURING DEVICE SUT OPN AC 25CM 2,165.35CATH CPS DIRECT PL OC-R 47CM 2,170.00CATH CPS DIRECT SL II RS 47CM 2,170.00CATH CPS DIRECT SL II WIDE 47CM 2,170.00CATH CPS DIRECT SL II XWIDE 47CM 2,170.00KIT DYEVERT PLUS DISPOSABLE 2,170.00SHEARS HARMONIC FOCUS 9CM 2,204.72CABLE WCLAMP ACC 2.0MM 71340007 2,260.85CABLE CERCLG STNLS S 1.8MMX914MM 2,269.20CANNISTER MAX W/TUBE AND FILTER 2,294.00REAMER CONCAVE 22 2,296.48CATHETER BALLOON CODA 120CM 14F 2,312.60

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TVRH Item Description Primary PriceSTAPLER ECHLON FLX ENDOPATH 280MM 2,340.30STAPLER POWER FLEX 60MM 2,340.30DRILL BIT SYN CAN 5.0MM 2,346.58SUTURING DEVICE BARD SD105 2,356.00TROCAR BLUNT TIP W OVAL DISS BALL 2,374.45TROCAR BLUNT TIP W ROUND DISS BAL 2,374.45CATH GDG LINER 6F 25X150CM 2,449.00CATH GUIDELINER V3 7F 150CM 2,449.00ELECTRODE ULTRSNC SHR ENDOS 23CM 2,460.30STAPLER INTRNL CIRCULR HEMR 15IN 2,464.70HANDPIECE LIGASURE OPEN LS1120 2,476.15LIGASURE LAPROSCOPIC ATLAS 10MM 2,476.15DRILL BIT CANNULTD 2.0MM 310.221 2,495.80FIBER LSR HI TRANSMSN STD 200MH 2,497.35ELECTRODE ULTRSNC SHR COAGL 14MM 2,502.55DRESSING ABDOMINAL VAC SYS 2,504.80CEMEX CEMENT FAST SETSYSTEM 70G 2,511.00ANCHOR MITEK 1.3MM 2,523.40SCPL HARMNC HAND ACTVTD 23CM 2,533.95CATH WEBSTER DECA D610DR005RT 2,573.00BAL OCCLUSION CODE-10.0-35-100-32 2,585.40HANDPIECE LIGASURE LAPROSCOPIC 2,624.70COUNTERSINK SURG CANNULATED 4MM 2,631.28ENSEAL TRIO 3MM CURVE TIP 35CM 2,643.80ELECTRODE INSTRUMENT SMALL JAW 2,666.00MARKER TISSUE BIOZORB 2X2CM 2,681.25MARKER TISSUE BIOZORB 2X3CM 2,681.25CATHETER BALLOON PLUS STENT GRAFT 2,697.00GRAFT BONE CONNEXUS PUTTY 2.5CC 2,703.20KIT VERT AUGMENT CEMENT KIVA 2,755.58CATH STENT GRAFT BALLOON 12FR 2,759.00STAPLER INTRNL CONTR BLU 2,789.05STAPLER INTRNL CRVD CTTR CTHCK TI 2,789.05TUBING ASPIRATION PENUMBRA LRG 2,790.00SYS INCISION WND MNGMT PRE1001US 2,823.48DEVICE SUTURE CAPTURNG CAPIO SLIM 2,835.76ELECTRODE ULTRSNC SHR ENDOS 36CM 2,880.60LIGASURE IMPACT 18CM 2,898.38SCPL HARMNC HAND ACTVTD 36CM 2,966.80DEVICE FIXATION SECURE STRAP 2,977.20TISSEEL FIBRIN SEALANT FROZEN 10M 3,009.05SYSTEM LAPARASCOPIC GELPORT 3,030.25LIGASURE IMPACT REPROCESSED 3,043.17SEALER DIVIDER LIGASURE 5MM TIP 3,044.00KIT MINI TIGHTROPE REPAIR AR-8911 3,069.00

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TVRH Item Description Primary PriceABLATIION DEVICE ENDOMTRL DISP 3,100.00BALLOON FIBER OPTIC 40CC 3,100.00BALLOON FIBER OPTIC 50CC 3,100.00CATH SAFIRE MED SWP 4MM 7F 3,100.00CATHET PLEURX KIT PLURAL 507000 3,100.00DRILL SCREW INTERTAN LAG 3,100.00FBR LASER PVP 3,100.00FIBER LASER MICRON 1000 3,100.00GW PRESSURE VERRATA STRT 185CM 3,100.00HEMOSTAT ABSORB SNOW 1X2IN 3,100.00KIT INTRODUCER IMPELLA CP 14FR 3,100.00KIT PROGEL PLEURAL AIRLEAK SEALAN 3,100.00LIGASURE IMPACT HANDPIECE 3,100.00MONOTORING SSEP INTRA OP 3,100.00PACEMAKER STJUDE CPS IMPLANT KIT 3,100.00PROBE CYBER WAND CW-RBPBX 3,100.00PROBE SINGLE USE 3.76MM 3,100.00PUTTY GRAFTON DBM 10CC 3,100.00SEALER AQUAMANTY BIPOLAR MALLEABL 3,100.00SEPARATOR PENUMBRA 6 .055 3,100.00SHEARS HARMONIC FOCUS 9CM CURVED 3,100.00SHUNT CAROTD OUTLYG W/O T SH 9FR 3,100.00SP ZZ GOOSENECK SNARE 3,100.00STAPLER PWRD ARTCLTN LINEAR 45MM 3,100.00TRAY PROCEDURE AVAMAX PLUS 3,100.00MASTERGRAFT STRIP 3,465.00CATH PTA LUTONIX 5MMX100MMX130CM 3,850.00CATH PTA LUTONIX 5MMX60MMX130CM 3,850.00CATH PTA LUTONIX 6MMX100MMX130CM 3,850.00CATH PTA DCB ADMIRAL 6X40X130 3,877.50CATH PTA DCB ADMIRAL 6X80X130 3,877.50KIT EXTRNL FIXATR WRST 3,946.25CATH PTA DCB ADMIRAL 4X120X130 4,290.00CATH PTA DCB ADMIRAL 5X120X130 4,290.00CATH PTA DCB ADMIRAL 6X120X130 4,290.00STNT 20MM BDY 25MM FLNGE DIA 10CM 4,389.00CATH ABLAT FLEXABILITY BI-D D-F 4,537.50KIT VALVULTM EXPANDBL ANGIOS 2MM 5,167.25CATHETER INDIGO RX W/ASP TUBE 5,335.00CATH CTO CROSSER OTW 14P 146CM 5,431.25DERMIS AFLEX 101 4X7CM 1.5MM 5,657.44PLATE BNE GRTR TRCHNTR LNG W/4 C 5,725.50TRAY 1 STEP FRACT W 15CC BALLOON 5,784.30TRAY 1 STEP FRACT W 20CC BALLOON 5,784.30TIP ENDOWRIST STAPLER 30 CURVED 7,200.00

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TVRH Item Description Primary PriceCATHETER INDIGO D 50CM 7,397.00INFUSION SYSTEM EKOSONIC 50X106 7,686.25INFUSION SYSTEM LYSUS 40X106 7,686.25DERMIS AFLEX201 1.76X2.25MM 7,763.25ANTENNA PERCUTANEOUS 15CM 7,975.00ANTENNA REIN PERCUTANEOUS 15 CM 7,975.00GRFT CONTRA EXCLUDER 18MMX13.5CM 10,972.50GRFT CONTRA EXCLUDER 20MMX13.5CM 10,972.50GRFT CONTRA EXCLUDER 20MMX9.5CM 10,972.50GRFT CONTRA EXCLUDER 23MMX12CM 10,972.50GRFT CONTRA EXCLUDER 27MMX10CM 10,972.50GRFT CONTRA EXCLUDER 27MMX12CM 10,972.50GRFT CONTRA EXCLUDER 27MMX14CM 10,972.50INTEGRAL 180 PRIMARY REV 166015 15,892.80GRFT BIFUR ENDURANT IIS 28X14X103 26,059.00GRFT BIFUR ENDURANT IIS 32X14X103 26,059.00GRFT BIFUR ENDURANT IIS 36X14X103 26,059.00CATH HEART ASSIST IMPELLA 2.5 55,000.00PACEMAKER BSCI VALITUDE CRT-P IS1 283.50ACUITY BSCI PRO IC90 1,302.00LEAD BSCI 7FR 60CM CS-IC 130 1,339.20LEAD PACING MRI 46CM 2,790.00LEAD PACING MRI 46CM 2,790.00LEAD PACING MRI 52CM 2,790.00LEAD PACING MRI 52CM 2,790.00LEAD PACING TENDRIL MRI 58CM 2,790.00LEAD PACING TENDRIL MRI 58CM 2,790.00LEAD BSCI 9FR 45CM CS-EH 2,808.60ENVELOPE PACEMAKER TYRX ABSORB 3,100.00ENVELOPE PACEMAKER TYRX MED 3,100.00LEAD INGEVITY MRI 45CM 3,100.00LEAD INGEVITY MRI 52CM 3,100.00LEAD INGEVITY MRI 59CM 3,100.00LEAD SELECT SECURE 3830 69 3,100.00LEAD ST JUDE QUARTET TRAD S 86CM 5,282.75LEAD ACUITY X 4 SPIRALL L 86CM 6,432.25LEAD ACUITY X4 STRAIGHT 86CM 6,432.25LOOP RECORDER ST JUDE 7,837.50PACEMAKER ESSENTIO SR MRI 8,635.00PMAKER ACCOLADE SR 8,937.50PACEMAKER ESSENTIO DR MRI 9,044.75PACEMAKER ESSENTIO DR MRI 9,044.75PACEMAKER ASSURITY SR IS1 9,344.28PACEMAKER ASSURITY SR IS1 9,344.28P/MAKER MEDTRONIC SNGL GEN ADAPTA 9,344.60

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TVRH Item Description Primary PricePACEMKR MED ADAPT SINGLE GEN 9,344.60PACEMKR MED VERSA DUAL GEN 9,344.60PACEMAKER BSCI ACCOLADE DR 9,570.00PACEMAKER MRI PM 1272 9,900.00PACEMAKER MRI PM 1272 9,900.00PACEMKR STJUD ACCENT DL CH GEN 9,925.95PACEMAKER XT SR MRI SURESCAN 10,023.75PACEMAKER ASSURITY DR IS1 10,242.05PACEMKR MED ADAPT DUAL GEN 10,319.65PACEMAKER XT DR MRI SURESCAN 10,604.13PACEMAKER XT DR MRI SURESCAN 10,604.13PACEMKR MED ADAPT DL GEN 10,862.80PACEMAKER MEDT ADVISA SR MRI 11,000.00PACEMKR MED ADVISA DR MRI 11,121.40PACEMAKER MRI PM 2272 11,137.50PACEMAKER MRI PM 2272 11,137.50PACEMKR MED ADAPTA SINGLE SYS 11,448.25PACEMAKER BSCI INGENIO DR 1LD SYS 13,563.00PACEMAKER ASSURITY DR IS1 13,649.60PACEMAKER STJUDE ALLURE RF CRT-P 16,500.00PACMKR STJUD ALLURE QUADRA CRT-P 17,875.00PACEMAKER MEDT VIVA CRT-P 18,975.00PACEMAKER MRI QUAD CRT-P 20,350.00PACEMAKER ELLIPSE VR ICD DF1 29,082.35PACEMKR STJUD ELLP VR ICD DF4 29,082.35PACEMKR STJUD FORT AS VR IC DF4 29,082.35PMAKER DYNAGEN EL ICD VR 31,471.00PMAKER DYNAGEN EL ICD VR DF4 31,471.00PMAKER DYNAGEN MINI ICD VR DF4 33,000.00PACEMAKER ICD ITREVIA 7 HF-T 33,396.00PACEMAKER ASSURA DR ICD DF4 34,140.15PACEMKR STJUD ELLP DR ICD DF4 34,140.15PACEMKR STJUD FORT AS DR IC DF4 34,140.15PACEMAKER VISIA AF VR DVAB1D4 34,650.00PMAKER MEDT PROTECTA XT DR 34,916.05PMAKER DYNAGEN EL ICD DR 36,025.00PMAKER DYNAGEN EL ICD DR DF4 36,025.00PACEMKR MED EVERA XT ICD IS1 DF1 36,364.45PACEMKR MED EVERA XT ICD IS1 DF4 36,364.45PACEMAKER ELLIPSE DR ICD DF1 37,125.00PACEMKR STJUD ASSUR DR DL ICDDF4 37,125.00PACEMKR STJUD ELLP DR ICD DF1 37,125.00PMAKER DYNAGEN MINI ICD DR DF4 37,675.00PACEMAKER VISIA AF MRI S-SCAN VR 38,087.50PACEMKR MEDT ICD EVERA MRI XT VR 38,087.50

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TVRH Item Description Primary PricePACEMAKER EVERA MRI XT DR 40,667.00PACEMAKER EVERA MRI XT DR 40,667.00PACEMKR STJUD UNI AS CRTD DF4 42,978.65PACEMKR STJUD UNI ASSURA CRT-D 42,978.65PACEMKR MEDT ICD EVERA MRI XT DR 43,202.50PACEMAKER DYNAGEN CRT-D 44,550.00PACEMKR MED VIVA XT CRT-D DF4 45,261.55PACEMKR MED VIVA XT CRTD IS1 DF1 45,261.55PACEMAKER BSCI DYNAGEN X4 CRT-D 45,925.00PMAKER DYNAGEN X4 CRT-D DF4 45,925.00PACEMAKER VIVA QUAD XT CRT-D 47,201.35PACEMAKER VIVA QUAD XT CRT-D DF4 47,201.35PACEMAKER MRI SURESCAN DTMB1D1 49,500.00PACEMAKER MRI SURESCAN DTMB1D4 49,500.00PACEMAKER ST JUDE CD3369-40C 50,737.50PACEMKR ST JUDE ASSURA QUADRA 50,737.50PACEMKR MEDT SURSCN MRI QD CRT-D 54,725.00BURR BONE MICRO 3.0 13.90NEEDLE ARTERL ANGLOG 18GA X.038IN 27.65SUTURE ETHLN 4-0 P-3 18 IN 38.25SHEATH INTRDCR CATH VASC 8FRX10CM 46.30KWIRE .035 STERILE (TVRH) 58.30KWIRE .062 STERILE (TVRH) 58.85WIRE FIXTN KRSCHNR STY 2MMX152MM 59.20WIRE FIXTN KRSCHNR T 1.6MMX150MM 66.60CATH DIAG ST PLUS MPB2 6F 100CM 69.38CATH ST PLUS AR1 MOD 6F 100CM 69.38CATH ST PLUS AR2 MOD 6F 100CM 69.38CATH ST PLUS JL3.5 6F 100CM 69.38CATH ST PLUS JL4 6F 100CM 69.38CATH ST PLUS JL4.5 6F 100CM 69.38CATH ST PLUS JL5 6F 100CM 69.38CATH ST PLUS JR3.5 6F 100CM 69.38CATH ST PLUS MPA2 6F 100CM 69.38GUIDEWIRE ORTHO STNLS .045INX6IN 74.00GUIDEWIRE ORTHO STNLS .054INX6IN 74.00SHEATH INTRODCR CATH V 11FRX10CM 74.00CATH DIAG INFINI JL4 5F 100CM 78.16CATH DIAG INFINI PIG 5F 6SH 110CM 78.16CATH DIAG INFINITI 3DRC 5F 100CM 78.16CATH DIAG INFINITI AL II 5F 100CM 78.16CATH DIAG INFINITI IM 5F 100CM 78.16CATH DIAG INFINITI IM 6F 100CM 78.16CATH DIAG INFNI JL 3.5 5F 100CM 78.16CATH DIAG MULTI MPB 5FR X 100CM 78.16

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TVRH Item Description Primary PriceCATH INF 3DRC 6F 100CM 78.16CATH INF JL4.5 5F 100CM 78.16INTRODUCER SHEATH PINNACLE 10C7F 83.50INTRODUCER PINNACLE 5F 86.95SHEATH INTRDCR VASC 10FRX10CM 86.95SHEATH PER PINNACLE GW 6F 10CM 86.95CATH DIAG INF AR2MOD 4F 100CM 87.88CATH DIAG INF JL5 4F 100CM 87.88CATH DIAG INF JR4 4F 100CM 87.88SHEATH INTRDCR CATH VASC 7FRX10CM 92.50SHEATH INTRO CATH VAS 7FRX10CM 92.50CATH DIAG ST TEMPO H1 5F 100CM 112.50GUIDE WIRE .078 X 9 126.00K WIRE 1.4MM 144.00KWIRE .8MM X 100MM 144.00SHEATH INTRO CARDIO 4FRX10CM 144.00CATH DIAG SOS OMNI 1 4FRX80CM 149.40K WIRE 1.2MM 45-30015S 157.50SHEATH INTRDCR CATH MID 8FRX23CM 157.50K WIRE .062 162.00KIT CATH CNTRAL VE 20GAX5IN 12CM 166.00SUTURE 4-0 FIBERWIRE AR7228 175.50K WIRE 1.6MM X 107MM 180.00INTRODUCER SHEATH PINNACLE 10CM8F 180.60SHEATH INTRODCR CATH VS 6FRX10CM 180.60SNARE SPIRAL 20MM 181.00DVC STRATIFIX PDSPLUS 1 CTX 183.54SCREW CORTEX 4.5MM 36MM 185.64SCREW BNE CORT SLF TP 3.5MMX14MM 186.50SCREW BNE CORT SLF TP 3.5MMX16MM 186.50SCREW BNE CORT SLF TP 3.5MMX18MM 186.50SCREW BNE CORT SLF TP 3.5MMX20MM 186.50SCREW BNE CORT SLF TP 3.5MMX22MM 186.50SCREW BNE CORT SLF TP 3.5MMX24MM 186.50SCREW BNE CORT SLF TP 3.5MMX26MM 186.50SCREW BNE CORT SLF TP 3.5MMX28MM 186.50SCREW BNE CORT SLF TP 3.5MMX30MM 186.50SCREW BNE CORT SLF TP 3.5MMX32MM 186.50GUIDE PIN THREADED 3.2MM 201.60K WIRE SMOOTH 1.6MM 201.60SET INTRO SHEATH VASC 7FRX11CM 205.50BONE LOCKING THREADED 2.3 X 18 207.06PEG BONE LOCKING 2.7 X 20 207.06PEG BONE LOCKING THREADED 2.3X20 207.06PMAKER MEDTR CABLE PACING 12FT 210.00

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TVRH Item Description Primary PriceK-WIRE THREADED 1.25 215.46GUID WIRE NONTHREAD 1.1MM 292.623 223.10K-WIRE PERI-LOC 2.0MM 234.35GUIDE WIRE THREADED 1.1MM 292.622 237.05SCREW BNE PERIARTCLR 4.5MMX34MM 246.95SCREW BNE PERIARTCLR 4.5MMX36MM 246.95SCREW BNE PERIARTCLR 4.5MMX40MM 246.95CATHETER BALLN ANGIOPLSTY CRNRY 252.00INTRO SHEATH TEAR AWAY VALVE 8FR 252.00CATH DIAG OMNI 5FRX65CM W/6SH 259.56SCREW BNE PERIARTCL 3.5MMX12MM 262.10SCREW BNE PERIARTCL 3.5MMX16MM 262.10SCREW BNE PERIARTCL 3.5MMX18MM 262.10SCREW BNE PERIARTCL 3.5MMX20MM 262.10SCREW BNE PERIARTCL 3.5MMX24MM 262.10SCREW BNE PERIARTCL 3.5MMX26MM 262.10SCREW BNE PERIARTCL 3.5MMX30MM 262.10SCREW BNE PERIARTCL 3.5MMX50MM 262.10SCREW BNE PERIARTCLR 3.5MMX14MM 262.10SCREW BNE PERIARTCLR 3.5MMX22MM 262.10CREW CORTEX 3.5MMX18MM 267.12SCREW CORTEX 3.5MMX16MM 267.12INTRDCR SHTH SAFESHEATH 6FR 277.20INTRDCR SHTH SAFESHEATH BLACK 9FR 277.20INTRO SHEATH SAFESHEATH II 7F 277.20SP SHEATH FILTER DELIVER 278.00INTRODUCER SHETH CATH ST 7FRX35CM 278.96SHEATH INTRDCR CATH INT 6FRX55CM 278.96SHEATH INTRODCR CATH CV 6FRX23CM 278.96SHEATH INTRODCR CATH CV 6FRX35CM 278.96WIRE CERLAGE COIL 1.25MMX10MM 279.30WASHER F/3.5 MM & 4 MM CANLTD SC 282.25WASHER F/4.5 MM CANLTD SCRW 282.25WASHER F/CANC SCRW 5.5MM 282.25LOOP WRE SPNL BD 1.22MMX30CM 284.75INTRO SYS SAFESHEATH STD 9FRX13 285.60INTRODUCER SYS SAFESHEATH 7FX13 285.60SHEATH SAFE 8FR 285.60GLIDESHEATH 6FR 100MM .021 302.40GLIDESHEATH 6FR 100MM .021 302.40MESH SFT TISS HRNIA REPR 3INX6IN 311.45SHEATH INTRDCR CATH INT 8FRX55CM 312.98GLIDWIRE RG BODY ANG .038INX.3CM 315.00GLIDESHEATH 5FR X10CM 322.15SCREW BNE HND CORT MINI 2MMX18MM 327.70

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TVRH Item Description Primary PriceBAND TR LONG WITH INFLATOR 330.96INTRO SHEATH FEMORAL 4FRX45CM 331.80CATH GUIDE IM 5FR 336.00CATH GUIDE JL4 5FR 336.00CATH GUIDE XB3 5FR 336.00GUIDE CATH XB3.5 5FR 336.00CATH FEMORAL SWANGANZ STIP 7FR 344.48SCREW CORTEX STANDRV 2.7X16 353.30MESH SFT TISS HRNIA REPR 6INX6IN 359.60INTRDCR SAFESHEATH II LNG 7FRX23 369.60INTRDCR SAFESHEATH II LNG 7FRX23 369.60INTRDCR SAFESHEATH II LNG 9FRX23 369.60SCREW BONE T10 3.5X14MM 382.20SCREW BONE T10 3.5X16MM 382.20FIBERSTICK2 FIBERWIRE2 50IN 386.40SHEATH INTRDCR VASC PR 6FRX35CM 394.21SCREW BONE NON LOCKING 3.5 X 14 399.84SCREW CORTICAL 2.7 X 10 399.85SCREW CORTICAL 2.7 X 12 399.85SCREW CORTICAL 2.7 X 14 399.85SCREW CORTICAL 2.7 X 18 399.85SCREW CORTICAL 2.7 X 22 399.85SCREW CORTICAL 2.7 X 24 399.85CATHETER EMBLCTMY ARTER 3FRX40CM 420.00CATHETER EMBLCTMY ARTER 4FRX40CM 420.00GLIDESHEATH SLENDER SS .021 6FX10 420.00GLIDESHEATH SLENDER SS .021 6FX16 420.00KIT CATH PLEURX INDWELL PLEURAL 420.00SCREW LOCKING HEAD 3.5X14MM 420.00SCREW NON LOCKING SHAFT 3.5X14 420.00SCREW NON LOCKING SHAFT 3.5X16 420.00SCREW NON LOCKING SHAFT 3.5X20 420.00SHEATH CHECKFLO ANSEL 7FR X 45CM 420.00SHEATH INTRODUCER 4FR 420.00SP ZZ PLEURX KIT 420.00STENT BILARY COTTON LEUNG 10-10 420.00STENT BILIARY 10MM X 12CM 420.00STENT BILRY ENDOSCPC 10FR W/5 CM 420.00STENT BILRY ENDOSCPC 10FR W/9 CM 420.00STENT BILRY ENDOSCPC 8.5FRX12CM 420.00INTRDCR SHEATH TR AWY VLV BLK 9F 421.89INTRDCR SHTH OPTISEAL GREEN 6FR 421.89INTRO SHEATH OPTISEAL ORANGE 7F 421.89STENT BILIARY 10 X 7 427.90CATHETER EMBLCTMY ARTER 5FRX80CM 428.45

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TVRH Item Description Primary PriceCATHETER EMBLCTMY ARTER 6FRX80CM 428.45CATHETER EMBLCTMY ARTER 7FRX80CM 428.45SCREW BONE LOCKING 3.5 X 12 431.10CATHETER EMBLCTMY ARTER 4FRX80CM 431.45INTRODUCER CHECK-FLO14FR X 30CM 437.33OCCLUDERS COLPO PNEUMO STERILE 440.05SP ZZ DECLOT CATHETER 454.30SCREW ACUMED CORTICAL 3.5 X 14MM 463.05SCREW ACUMED CORTICAL 3.5 X 18MM 463.05SCREW ACUMED CORTICAL 3.5 X 22MM 463.05SCREW ACUMED CORTICAL 3.5 X 24 463.05SCREW ACUMED CORTICAL 3.5 X 28MM 463.05SCREW ACUMED NON LOCKING 3.5 X 20 463.05SCREW ACUMED NON-LOCKING 3.5X45MM 463.05SCREW HEX NON-LOCKING 3.5X10MM 463.05SCREW HEX NON-LOCKING 3.5X12MM 463.05SCREW HEX NON-LOCKING 3.5X16MM 463.05SCREW NON-LOCK HEXALOBE 2.7X20MM 463.05SCREW NON-LOCK HEXALOBE 3.5X32MM 463.05SCREW NON-LOCK HEXALOBE 3.5X36MM 463.05SCREW NON-LOCK HEXALOBE 3.5X40MM 463.05SCREW BONE T10 3.5X12MM 464.10SCREW BONE T10 3.5X18MM 464.10PEG FIXTN DISTL RAD LC 23MMX18MM 470.40PEG FIXTN DISTL RAD LC 23MMX20MM 470.40PEG FIXTN DISTL RAD LC 23MMX22MM 470.40SCREW BNE DIST RAD N 2.3MMX16MM 470.40SCREW BNE DISTL RAD N 2.3MMX14MM 470.40SCREW BNE DISTL RAD N 2.3MMX20MM 470.40SCREW BNE DISTL RAD N 2.3MMX22MM 470.40SCREW BNE DISTL RAD N 2.3MMX24MM 470.40SCREW BNE DISTL RAD N 2.3MMX26MM 470.40SCREW BNE DISTL RAD NO 23MMX14MM 470.40SCREW BNE DISTL RAD NO 23MMX18MM 470.40SCREW BNE DISTL RAD NO 23MMX20MM 470.40SCREW BNE DISTL RAD NO 23MMX22MM 470.40SCREW BNE DISTL RAD NO 23MMX24MM 470.40SCREW CORTICAL LOCKING 2.3 X 10MM 470.40SCREW CORTICAL LOCKING 2.3 X 12MM 470.40SCREW CORTICAL LOCKING 2.3 X 8MM 470.40LAG SCREW K-WIRE 450MM 472.97GUIDE WIRE BALL NOSE 499.80SET INTR 10FRX200CM .035INX480CM 500.25SHEATH DESTINATION 6FR X 45 CM 529.20SHEATH PINNACLE DEST TB ST 7F 45 529.20

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TVRH Item Description Primary PriceCOIL EMB TORNADO .035 8/4MM 541.70COIL EMBOLZTN DETCHBL E 10MMX5CM 541.70INTRO SHEATH SET 6FRX45CM 543.30COIL EMB NESTER .035 14CMX10MM 549.78DRILL-BIT 2.5 588.00SHEATH RTRVL EMBOLIC PRTCT SYS CV 588.00SP ZZ SHUTTLE SHEATH 600.10GUIDEWIRE 3.2MM 604.32WIRE FIXTN KRSCHNR 1.25MMX150MM 616.15SCREW PERI CANN CON 3.5 X 40MM 617.40SCREW PERI CANNUL CNCL 3.5X45MM 617.40SCREW ZIMMER CONICAL 3.5 X 35 617.40SHEATH DESTINATION 6FR X 90CM 617.40SHEATH GUIDE DILATION 7FRX90CM 617.40SHEATH ACCSS URTRL 35CM 624.75STENT FUSION OASIS INTRO SYSTEM 626.80SCREW BONE LOCKING 3.5 X 14 634.65BOLT LOCK TGT GUIDE RDLCNT 639.45SCREW LCKING 2.7MM HEAD 3.5X24MM 639.45SCREW LCKING 2.7MM HEAD 3.5X30MM 639.45SCREW ZIM LOCKING 3.5 MM X 18 MM 639.45SCREW ZIM LOCKING 3.5 MM X 20 MM 639.45SCREW ZIM LOCKING 3.5 MM X 22 MM 639.45SCREW ZIM LOCKING 3.5 X 16MM 639.45SCREW ZIM LOCKING 3.5MM X 40MM 639.45SCREW ZIMMER LOCKING SS 3.5 X 10 639.45SCREW ZIMMER LOCKING SS 3.5 X 12 639.45SCREW ZIMMER LOCKING SS 3.5 X 14 639.45SET SCREW 4.75 TI NS SXT BRK OFF 639.45CATH SHEATH 6FR 65X35X2.5CM 646.80BLN CATH PTA .035 4X200X135 661.50BLN CATH PTA .035 5X150X135 661.50BLN CATH PTA .035 8X40X80 661.50CATH EVERCROSS 4X40X135 661.50PEG PULL SAFETY KIT 20FR W/VIAL 661.50PEG PULL SAFETY KIT 24FR W/VIAL 661.50SCREW 3.5 X 28 LOCKING 661.50SCREW 3.5 X 32 LOCKING 661.50SCREW LOCKING 3.5 X 30MM 661.50SCREW LOCKING CANNULA 3.5 X 42CM 661.50SCREW NCB CORT SELF-TAPNG 4X36MM 661.50SCREW PERI CANN LOCKN 3.5X30MM 661.50SCREW ZIM CAN LOCK 3.5 X 40MM 661.50SCREW ZIM CAN LOCK 3.5 X 45MM 661.50SCREW ZIM LOCKING 3.5 X 26MM 661.50

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TVRH Item Description Primary PriceSCREW ZIM LOCKING 3.5 X 35MM 661.50K WIRE OLIVE 676.20SCREW NON LOCKING 3.5 X 18MM 676.20SCREW ZIM LOCKING 2.7 X 12MM 683.55SCREW ZIMMER LOCKING 2.7 X 18MM 683.55SCREW ZIMMER LOCKING SS 2.7 X 14 683.55SCREW ZIMMER LOCKING SS 2.7 X 16 683.55SCREW LOCKIG HEAD 2.5X20 694.58SCREW LOCKING HEAD 2.5X16 694.58SCREW LOCKING HEAD 2.5X18 694.58SCREW LOCKING HEAD 2.5X22 694.58SCREW LOCKING HEAD 2.7X16 694.58SCREW LOCKING HEAD 2.7X18 694.58SCREW LOCKING HEAD 2.8X14 694.58SCREW LOCKING SHAFT 3.5X14 694.58SCREW LOCKING SHAFT 3.5X16 694.58CATH FEMORAL SWANGANZ CTIP 6FR 698.70GUIDEWIRE LONG SHARP 699.70LOCKING CAN SCREW 3.0 X 16 699.70LOCKING CAN SCREW 3.0 X 18 699.70LOCKING CAN SCREW 3.0 X 20 699.70LOCKING CAN SCREW 3.0 X 24 699.70LOCKING CAN SCREW 3.0 XX 22 699.70CATHETER TRIPLE LUMEN CVC KIT 7FR 712.95SCREW CORTICAL 4.3X40 712.95SCREW ACUMED 30-0236 720.30SCREW ACUMED 30-0239 720.30SCREW ACUMED 30-0326 720.30SCREW ACUMED LOCKING 2.7 X 10MM 720.30SCREW ACUMED LOCKING 2.7 X 14 720.30SCREW ACUMED LOCKING 2.7 X 16 720.30SCREW ACUMED LOCKING 2.7 X 18 720.30SCREW ACUMED LOCKING 3.0 X 45MM 720.30SCREW ACUMED LOCKING 3.5 X 12MM 720.30SCREW ACUMED LOCKING 3.5 X 14MM 720.30SCREW ACUMED LOCKING 3.5 X 20 720.30SCREW ACUMED LOCKING 3.5 X 26MM 720.30SCREW ACUMED LOCKING 3.5 X 45MM 720.30SCREW HEX LOCKING 3.5X10MM 720.30SCREW HEX LOCKING 3.5X18MM 720.30SCREW LOCKING HEXALOBE 2.7X20MM 720.30SCREW LOCKING HEXALOBE 3.5X32MM 720.30SCREW LOCKING HEXALOBE 3.5X38MM 720.30STNT CONTOUR VL 4.8FX22-30CM 735.01SHEATH INTRDCR MLTPRPSE 5FRX90CM 746.03

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TVRH Item Description Primary PriceCATHETR MULTI LUMEN BLUE FLEX TIP 748.35MESH SFT TISS HRNIA RE 10INX14IN 749.70SCREW LOCKING T10 3.5X12MM 753.40SCREW LOCKING T10 3.5X14MM 753.40SCREW LOCKING T10 3.5X16MM 753.40SCREW CORTICL LK 28MM 8161-35-028 764.40SCREW CORTICL LK 32MM 8161-35-032 764.40CEMENT BNE RADPAQ HI VSCSTY 40GR 771.75SCREW NON LOCKING 3X14MM 771.75SCREW NON LOCKING 3X16MM 771.75STENT BIL 10X5 OACL 10-5 784.10STENT BIL 8.5X12MM OACL8.5-12 784.10SP ZZ HICKMAN CATH TRIPLE LUMEN 789.80PIN GOLD TIP LONG PIN THREADED 793.80REAMING ROD W/BALL TIP 25MM 799.17CATH PTA OPTA PRO 7X10X110 808.50CATH TREK MINI 1.2MM X 12 MM 808.50CATH TREK MINI II 2.00X8MM 808.50CATH ULTRAVERSE 035 10X40X75 808.50CATH ULTRAVERSE 035 4X40X75 808.50CATH ULTRAVERSE 035 5X100X130 808.50CATH ULTRAVERSE 035 5X100X75 808.50CATH ULTRAVERSE 035 5X40X75 808.50CATH ULTRAVERSE 035 6X100X130 808.50CATH ULTRAVERSE 035 6X40X130 808.50CATH ULTRAVERSE 035 6X40X75 808.50CATH ULTRAVERSE 035 7X40X130 808.50CATH ULTRAVERSE 035 7X40X75 808.50CATH ULTRAVERSE 035 8X40X130 808.50CATH ULTRAVERSE 035 8X40X75 808.50CATHETER BALLOON OPTA PRO 808.50GW RUNTHRU NS HYPERCOAT 180CM 808.50SCREW NCB CORT SLF-TAP 4.0 X 32MM 827.90SCREW NCB CORT SLF-TAP 4.0 X 38MM 827.90SP ZZ PICC LINE TRAY SNGL LUMEN 832.25STENT CONTOUR 7X30 837.90STENT PERCUFLEX PLUS 4.8X24 837.90STENT PERCUFLEX PLUS 4.8X26 837.90STENT URETERAL 7R X 22CM 837.90STENT URETERAL CONTOUR 7FRX24CM 837.90BALLOON MINI TREK 1.20MM X 08MM 861.05BALLOON MINI TREK 1.20MM X 12MM 861.05BALLOON MINI TREK 1.20MM X 15MM 861.05BALLOON OTW MINI 1.20MM X 12MM 861.05BALLOON OTW MINI 1.20MM X 15MM 861.05

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TVRH Item Description Primary PriceBALLOON OTW SMALL 1.50MM X 08MM 861.05BALLOON OTW SMALL 1.50MM X 12MM 861.05BALLOON OTW SMALL 1.50MM X 15MM 861.05BALLOON OTW SMALL 2.0MM X 08MM 861.05BALLOON OTW SMALL 2.0MM X 12MM 861.05BALLOON OTW SMALL 2.0MM X 15MM 861.05BALLOON OTW SMALL 2.25MM X 12MM 861.05BALLOON OTW SMALL 2.5MM X 15MM 861.05BALLOON OTW SMALL 3.0MM X 12MM 861.05BALLOON RX SMALL 1.50MM X 08MM 861.05BALLOON RX SMALL 1.50MM X 12MM 861.05BALLOON RX SMALL 1.50MM X 15MM 861.05BALLOON RX SMALL 1.50MM X 20MM 861.05BALLOON RX SMALL 2.0MM X 08MM 861.05BALLOON RX SMALL 2.0MM X 12MM 861.05BALLOON RX SMALL 2.0MM X 15MM 861.05BALLOON RX SMALL 2.0MM X 20MM 861.05BALLOON RX SMALL 2.0MM X 30MM 861.05BALLOON RX SMALL 2.25MM X 08MM 861.05BALLOON RX SMALL 2.25MM X 12MM 861.05BALLOON RX SMALL 2.25MM X 15MM 861.05BALLOON RX SMALL 2.25MM X 20MM 861.05BALLOON RX SMALL 2.50MM X 08MM 861.05BALLOON RX SMALL 2.50MM X 12MM 861.05BALLOON RX SMALL 2.50MM X 15MM 861.05BALLOON RX SMALL 2.50MM X 20MM 861.05BALLOON RX SMALL 2.50MM X 30MM 861.05BALLOON RX SMALL 2.75MM X 08MM 861.05BALLOON RX SMALL 2.75MM X 12MM 861.05BALLOON RX SMALL 2.75MM X 15MM 861.05BALLOON RX SMALL 2.75MM X 20MM 861.05BALLOON RX SMALL 3.0MM X 08MM 861.05BALLOON RX SMALL 3.0MM X 12MM 861.05BALLOON RX SMALL 3.0MM X 20MM 861.05BALLOON RX SMALL 3.0MM X 30MM 861.05BALLOON RX SMALL 3.50MM X 08MM 861.05BALLOON RX SMALL 3.50MM X 12MM 861.05BALLOON RX SMALL 3.50MM X 15MM 861.05BALLOON RX SMALL 3.50MM X 20MM 861.05BALLOON RX SMALL 3.50MM X 30MM 861.05BALLOON RX SMALL 30.MM X 15MM 861.05BALLOON RX SMALL 4.0MM X 08MM 861.05BALLOON RX SMALL 4.0MM X 12MM 861.05BALLOON RX SMALL 4.0MM X 15MM 861.05BALLOON RX SMALL 4.0MM X 20MM 861.05

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TVRH Item Description Primary PriceBALLOON RX SMALL 5.0MM X 12MM 861.05BALLOON RX SMALL 5.0MM X 15MM 861.05CATH BLN CRNRY ANGIO PTCA 1.5X12 861.05CATH BLN CRNRY ANGIO PTCA 2.0X12 861.05CATH BLN CRNRY ANGIO PTCA 2.0X15 861.05CATH BLN CRNRY ANGIO PTCA 2.0X8 861.05CATH BLN CRNRY ANGIO PTCA 2.25X8 861.05CATH BLN CRNRY ANGIO PTCA 2.5X12 861.05CATH BLN CRNRY ANGIO PTCA 2.5X15 861.05CATH BLN CRNRY ANGIO PTCA 2.5X20 861.05CATH BLN CRNRY ANGIO PTCA 2.5X8 861.05CATH BLN CRNRY ANGIO PTCA 2.75X8 861.05CATH BLN CRNRY ANGIO PTCA 3.00X8 861.05CATH BLN CRNRY ANGIO PTCA 3.25X8 861.05CATH BLN CRNRY ANGIO PTCA 3.5X12 861.05CATH BLN CRNRY ANGIO PTCA 3.5X15 861.05CATH BLN CRNRY ANGIO PTCA 3.5X20 861.05CATH BLN CRNRY ANGIO PTCA 3.5X8 861.05CATH BLN CRNRY ANGIO PTCA 4.0X12 861.05CATH BLN CRNRY ANGIO PTCA 4.0X15 861.05CATH BLN CRNRY ANGIO PTCA 4.0X20 861.05CATH BLN CRNRY ANGIO PTCA 4.0X8 861.05CATH BLN CRNRY ANGIO PTCA 4.5X12 861.05CATH BLN CRNRY ANGIO PTCA 4.5X15 861.05CATH BLN CRNRY ANGIO PTCA 4.5X8 861.05CATH BLN CRNRY ANGIO PTCA 5.0X12 861.05CATH BLN CRNRY ANGIO PTCA 5.0X15 861.05CATH BLN CRNRY PTCA 2.25X12 861.05CATH BLN CRNRY PTCA 2.25X15 861.05CATH BLN CRNRY PTCA 2.75X12 861.05CATH BLN CRNRY PTCA 2.75X15 861.05CATH BLN CRNRY PTCA 2.75X20 861.05CATH BLN CRNRY PTCA 3.00X12 861.05CATH BLN CRNRY PTCA 3.00X15 861.05CATH BLN CRNRY PTCA 3.00X20 861.05CATH BLN CRNRY PTCA 3.25X12 861.05CATH BLN CRNRY PTCA 3.25X15 861.05CATH BLN CRNRY PTCA 3.25X20 861.05CATH BLN CRNRY PTCA 3.75X08 861.05CATH BLN CRNRY PTCA 3.75X12 861.05CATH BLN CRNRY PTCA 3.75X15 861.05CATH TREK RX 3.75X8 861.05SCREW LOCKING HEXALOBE 3.0X50MM 867.30SCREW CANC NCB 5.0 X 55 882.00SCREW CANC NCB 70 X 5.0 X 3.5MM 882.00

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TVRH Item Description Primary PriceSCREW CANC PRTL THRD 5.0MMX50MM 882.00SCREW CANN THREAD P 4 MM X 46 MM 882.00SCREW CANN THREAD P 4 MM X 50 MM 882.00WIRE GUIDE BALL NOSE 3.0MMX80CM 882.00VASCUGUARD PATCH 894.15KIT PREP CEMT BNE HIP 894.40STENT BIL 10X9 OACL 10-9 898.00STENT BIL 7-10MM 0ACL 10-7 898.00STENT BIL 8.5X9MM OACL8.5-9 898.00SCREW DRIVER 1.5MM 918.75SCREW VA LOCKING 2.7MMX16MM 926.10KIT PICC XCELA WPV 4F SGL LUM 935.66SCREW LOCKING 3.5 X 16MM 945.50SCREW LOCKING 3X16MM 945.50SCREW LOCKING CAP NCB 8X3.5MM 948.15SCREW FULL THREADED LCKN 5X32.5MM 970.20SCREW FULL THREADED LCKN 5X374.5M 970.20SCREW FULL THREADED LCKN 5X42.5MM 970.20SCREW FULL THREADED LCKN 5X47.5MM 970.20SCREW LOCKING FULL THREAD 05X30MM 970.20SCREW LOCKING FULL THREAD 05X35MM 970.20SCREW LOCKING STRYKER 1896-5040S 970.20SCREW CAN HEADLESS 2.0MM X 10MM 980.85SCREW CAN HEADLESS 2.0MM X 20MM 980.85BLN ARMADA 35 WH 3 X 20 X 135 CM 992.25BLN ARMADA 35 WH 3 X 40 X 135 CM 992.25BLN ARMADA 35 WH 4 X 100 X 135 CM 992.25BLN ARMADA 35 WH 4 X 40 X 135 CM 992.25BLN ARMADA 35 WH 4 X 60 X 135 CM 992.25BLN ARMADA 35 WH 5 X 100 X 135 CM 992.25BLN ARMADA 35 WH 8 X 80 X 135 CM 992.25BLN ARMADA 35 WH 9 X 40 X 135 CM 992.25CATH FOX PLUS BLN 4.0 X 20 MM 992.25CATH FOX PLUS BLN 8.0X 20MM 992.25CATH PTA ARMADA 35 10X20X135 992.25CATH PTA ARMADA 35 5X20X135 992.25CATH PTA ARMADA 35 6X40X135 992.25CATH PTA ARMADA 35 6X80X135 992.25CATH PTA ARMADA 35 7X40X135 992.25CATH PTA ARMADA 35 8X40X135 992.25CATH PTA ARMADA 5.0X40MM 992.25CATH PTA ARMADA 5.0X60MM 992.25CATH PTA ARMADA 5.0X80MM 992.25CATH PTA ARMADA 6.0X100MM 992.25GW ASAHI FIELDER XT 190CM 992.25

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TVRH Item Description Primary PriceGW CONFIANZA PRO 12 180CM 992.25PIN PF 3.5MMX40MM 71173325 999.60SCREW 32MM 3.0 40-30232S 1,018.00SCREW STRYKER CANN 2 MM X 10 MM 1,018.00SCREW STRYKER CANN 2 MM X 12 MM 1,018.00SCREW STRYKER CANN 2 MM X 13 MM 1,018.00SCREW STRYKER CANN 2 MM X 14 MM 1,018.00SCREW STRYKER CANN 2 MM X 15 MM 1,018.00SCREW STRYKER CANN 2 MM X 16 MM 1,018.00SCREW STRYKER CANN 2 MM X 18 MM 1,018.00SCREW STRYKER CANN 2 MM X 9 MM 1,018.00SCREW STRYKER CANN 3 MM X 15 MM 1,018.00SCREW STRYKER CANN 3 MM X 16 MM 1,018.00SCREW STRYKER CANN 3 MM X 17 MM 1,018.00SCREW STRYKER CANN 3 MM X 19 MM 1,018.00SCREW STRYKER CANN 3 MM X 22 MM 1,018.00SCREW STRYKER CANN 3 MM X 24 MM 1,018.00SCREW STRYKER CANN 3 MM X 26 MM 1,018.00SCREW STRYKER CANN 3 MM X 30 MM 1,018.00SCREW STRYKER CANN 3 MM X 34 MM 1,018.00PIN PF 2.7X14MM 1,020.47MESH SFT TISS HRNI 1INX1.35IN SM 1,024.75SCREW CORTICAL ST 5MMX40MM 1,036.35SCREW CORTICAL ST 5MMX46MM 1,036.35SCREW CORTICAL ST 5MMX50MM 1,036.35SCREW CORTICAL ST 5MMX55MM 1,036.35SCREW NCB CORT SLF-TAP 5.0 X 38MM 1,036.35SCREW NCB SELFTAPPING 36MM X 3.5 1,036.35BLADE ANCHORAGE SELF RETAINING 1,037.82MESH SFT TISS H 1.3INX1.55IN MED 1,046.25K-WIRE 1.6MM 1,055.75PIN QUICK RELEASE WITH COLLAR 40M 1,058.40MESH SFT TISS HRN 1.6INX1.9IN LG 1,067.75SCREW BNE LAG CANLTD 2.4MMX20MM 1,082.30SCREW BNE LAG CANLTD 2.4MMX22MM 1,082.30SCREW CANNULATED 2.4 X 28MM 1,082.30SCREW 4X13MM 1,087.80SCREW MEDT VARIABLE 14MM 3120314 1,087.80SCREW VARIABLE 4X11MM 1,087.80SCREW VARIABLE SELF TAP 4X12MM 1,087.80BLN ARMADA 35 LL 5.0 X 150 X 135 1,102.00BLN ARMADA 35 WH 4 X 120 X 135 CM 1,102.00BUR ACRN 6MMX26CM 1,102.00BUR TPRD 3MM X 21CM 1,102.00CATH PTA PACIFIC PLUS 3X40X130 1,102.00

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TVRH Item Description Primary PriceCATH PTA PACIFIC PLUS 5X40X130 1,102.00CATHETER BALLN E 54FR 18MMX5.5CM 1,102.00CATHETER BALN E 36FR 12MMX5.5CM 1,102.00ELECTRODE LOOP 24FR .35W 12D 1,102.00MESH 3DMAX LEFT MEDIUM 1,102.00MESH 3DMAX RIGHT MEDIUM 1,102.00MESH SFT TISS HRN 1.6INX2IN X-LG 1,102.00MESH ULTRAPRO PLUG AND PATCH LARG 1,102.00MESH ULTRAPRO PLUG AND PATCH MED 1,102.00PUTTY GRAFTON DBM 1CC T43102 1,102.00ROD LORDOTIC PHOENIX 40MM 1,102.00SCREW BNE CANLT 1/2 TH 4MMX36MM 1,102.00SCREW BNE CANLTD 1/2 TH 4MMX30MM 1,102.00SCREW BNE CANLTD 1/2 TH 4MMX40MM 1,102.00SCREW BNE CANLTD 1/3 4.5MMX36MM 1,102.00SCREW BNE CANLTD 1/3 4.5MMX46MM 1,102.00SCREW BNE CANLTD 1/3 TH 4MMX50MM 1,102.00SCREW BNE CANLTD PART 3.5MMX34MM 1,102.00SCREW BNE CANLTD PART 3.5MMX38MM 1,102.00SCREW CANC NCB 65 X 5.0 X 3.5MM 1,102.00SCREW CANNULTD 1/2 THD 4.0MM 60MM 1,102.00SCREW CNLTD 1/3 THREAD 4.0MMX46MM 1,102.00SCREW CNNULTD 1/3 THRD 4.0MMX40MM 1,102.00SCREW CORTICAL 5.0X36 8145-50-036 1,102.00SCREW DRIVER BIT CAN 2MM 1,102.00SCREW DRIVER BIT CAN 3MM 1,102.00SCREW ZIM CORTICAL 3.5 X 32.5MM 1,102.00SCREW ZIM CORTICAL 5.0 X 40MM 1,102.00BONE CHIPS CANCELLOUS 5CC 1,109.80GUIDE PIN THREADED 3.2MMX444MM 1,109.80SCREW DRIVER CANNULATED 45-30005S 1,147.00MESH 3DMAX LEFT LARGE 1,162.00MESH SFT TISS HRN 10.8CMX16CM LG 1,162.00MESH 3-D MAX RIGHT XLARGE 1,172.75PUTTY DBM PROGENIX PLUS 1CC 1,175.50CATH GUIDE ATTAIN COMMAND 9FR 1,190.40CATH CPS AIM SL ACUTE 59CM 1,209.00SCREW BNE CMPRSN LAG 3.15MMX80MM 1,210.25SP ZZ CATHETER BALLOON DIL NONVAS 1,233.30GRAFT VASCULAR PATCH .8CMX8CM 1,233.80CATH PTA NANOCROSS 2.5X120X150 1,240.00CATH PTA NANOCROSS 2.5X210X150 1,240.00CATH PTA NANOCROSS 2.5X40X120 1,240.00CATH PTA NANOCROSS 2X210X150 1,240.00CATH PTA PACIFIC PLUS 2.5X120X130 1,240.00

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TVRH Item Description Primary PriceCATH PTA PACIFIC PLUS 2.5X40X130 1,240.00CATH PTA PACIFIC PLUS 2X40X130 1,240.00CATH PTA XXL 14X40X75 1,240.00CATH PTA XXL 16X40X75 1,240.00CATH PTA XXL 18X40X75 1,240.00CATHETER BAL 14MMX4CM 5.8FRX75CM 1,240.00MESH 3-D MAX LEFT XLARGE 1,246.20SCREW BNE CANLTD 16 MM 7MMX100MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX105MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX110MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX115MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX70MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX75MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX80MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX85MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX90MM 1,283.40SCREW BNE CANLTD 16 MM 7MMX95MM 1,283.40SCREW BNE CANLTD 32 MM 7MMX105MM 1,283.40SCREW CAN 16MM THREAD 7.0MMX65MM 1,283.40SCREW BNE CANLTD 16 M 7.3MMX95MM 1,299.60SP ZZ INTRODUCER/SHEATH 1,301.20DRILL PIN TRIM-IT 1.5MMX100MM 1,302.00KIT APPLICATOR PRP 1,302.00CATH ULTRAVERSE 018 5X40X130 1,364.00CATH ULTRAVERSE 018 6X40X130 1,364.00MESH VENTRALIGHT ECHO 4X6IN 1,388.75BALLOON SAVVY 3X2150 [435-302X] 1,395.00CATH DIL PTA BLN LG 6X100X150 CM 1,395.00CATH PTA SABER 2.5X10X150 1,395.00CATH PTA SABER 2X3X150 1,395.00CATH PTA SABER 3X6X150 1,395.00CATH PTA SABER 4X15X150 1,395.00CATH PTA SABER 5X6X150 1,395.00SCREW CANN LCK 5.7MM X 65MM 1,412.35DURASHERE INJECTION 1,450.80CATH PTA ARMADA 18 5.0X40X150 1,457.00CATH PTA ARMADA 18 5.0X60X150 1,457.00CATH PTA ARMADA 18 5.5X40X150 1,457.00MESH VENTRALIGHT ECHO CIRCLE 4.5 1,512.50CATH PTA ARMADA 14 1.5X20X150 1,550.00CATH PTA ARMADA 14 2.5X80X150 1,550.00CATH PTA ARMADA 14 2X80X150 1,550.00CATH PTA ARMADA 14 3X60X150 1,550.00CATH PTA ARMADA 14 3X80X150 1,550.00CATH PTA ARMADA 14 4X20X150 1,550.00

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TVRH Item Description Primary PriceCATH PTA ARMADA 14 4X40X150 1,550.00CATH PTA ARMADA 14 4X60X150 1,550.00CATH PTA ARMADA 14 4X80X150 1,550.00CATH PTA ARMADA 18 2.0X200X150 1,550.00CATH PTA ARMADA 18 2.5X100X150 1,550.00CATH PTA ARMADA 18 2.5X150X150 1,550.00CATH PTA ARMADA 18 3.0X100X150 1,550.00CATH PTA ARMADA 18 3.0X150X150 1,550.00CATH PTA ARMADA 18 3.0X200X150 1,550.00CATH PTA ARMADA 18 4.0X100X150 1,550.00CATH PTA ARMADA 18 4.0X150X150 1,550.00CATH PTA ARMADA 18 4.0X200X150 1,550.00CATH PTA ARMADA 18 5.0X150X150 1,550.00CATH PTA ARMADA 18 5.0X200X150 1,550.00CATH PTA ARMADA 18 5.0X80X150 1,550.00CATH PTA ARMADA 18 6.0X100X150 1,550.00CATH PTA ARMADA 18 6.0X150X150 1,550.00CATH PTA ARMADA 18 6.0X200X150 1,550.00CATH PTA FOX SV 2.0X120 1,550.00ROD MEDT SEXTANT 4.75 CCM X 55MM 1,550.00ROD MEDTRONIC 45MM 1,550.00ROD SEXTANT 4.75 CM X 40 MM 1,550.00ROD SOLERA 30MM 1,550.00ROD SOLERA 35 MM 1,550.00ROD SOLERA 60 MM 1,550.00ROD SOLERA 65MM 1,550.00ROD SOLERA 70MM 1,550.00SHEATH DRYSEAL 12FR 1,550.00SHEATH DRYSEAL 16 FR 1,550.00MESH SFT TISS HRNIA REPR POL MED 1,550.30MESH SFT TISS HRNIA REPR POLY LG 1,550.30CATH UROMAX ULTRA 6.4/5.8/75 1,581.00SUTURE ANCHOR CORKSCREW FTII 1,581.00SCREW CANN LCK 5.7MM X 70MM 1,600.20SCREW CANN LCK 5.7MM X 75MM 1,600.20PATCH BIOLOGIC 2CMX9CM 1,643.00SP ZZ PERIPERAL BALLOON CATHETER 1,663.80CATH CORONARY SINUS BVCS6180 1,705.00CATH PTA SABER 6X15X150 1,705.00KIT CATH DILA 7FRX55CM 30FRX12CM 1,712.75CATH PTA SLEEK OTW 1.5X2X150 1,736.00PORT POWER INJECT PLASTIC TIT 8FR 1,756.15KIT CATH BAL 18FRX4CM 5.8FRX75CM 1,765.45PLATE BNE CMPRSN 16 3.5MMX194MM 1,804.20SUTURE BIO CORKSC 5.55MMX15MM W/N 1,829.00

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TVRH Item Description Primary PricePORT POWER INJECT LOW PRO TIT 8FR 1,853.80PATCH DURAGEN PLUS 1 X 1 1,853.85ANCHOR SUTURE PITON BLACK 3.5 1,860.00ANCHOR SUTURE PITON BLUE 3.5 1,860.00CATH PTA ARMADA 14 1.5X120X150 1,860.00CATH PTA ARMADA 14 2.5X120X150 1,860.00CATH PTA ARMADA 14 2.5X200X150 1,860.00CATH PTA ARMADA 14 2X120X150 1,860.00CATH PTA ARMADA 14 2X200X150 1,860.00CATH PTA ARMADA 14 3X120X150 1,860.00CATH PTA ARMADA 14 3X200X150 1,860.00CATH PTA ARMADA 14 4X120X150 1,860.00CATH PTS ARMADA 14 4X200X150 1,860.00CATH PTA AMPHIRION 2X40X120 1,922.00CATH PTA AMPHIRION 3X40X150 1,922.00SNARE SYSTEM STANDARD 7F 120CM 1,922.00PLATE CERVICAL 19MM 1,922.25CATH ASPIRATION PRIORITYONE 7F 1,953.00PUTTY BIOLOGICAL CS 3CC 1,963.80SCREW HEADLS COMP LNG 3.0 X 34 1,965.75CABLE ASSEMBLY 1.8 X 635MM 1,971.60CABLE CERCLG GRTR TRCHNTR 1.8MM 1,971.60SP ZZ TESSIO CATHETER 1,982.40PUTTY DBM OSTEOSURGE 100 2.5CC 2,015.00SHEATH AFX 17FR 2,015.00SP ZZ URETERAL STENT 2,040.80SCREW FIXOS MV 4.0X36MM 2,060.88SP ZZ X-PORT CHEST PORT 2,076.75SUTURE ANCHOR MINI LOCK BIO 2-0 2,077.00MESH COMPOSIX LP 10.8CM X 15.9CM 2,157.00ANCHOR KNOTLESS REELX 2,170.00MESH VENTRALIGHT ECHO CIRCLE 6IN 2,200.00PUTTY GRAFTON DBM 2.5CC T43103 2,213.40CATH PTA AMPHIRION 2.5X150X150 2,232.00CATH PTA AMPHIRION 3/3.5X210X150 2,232.00SUTURE ANC SWIVELOCK 4.75X19.1MM 2,325.00SP ZZ INFERIOR VENA CAVA FILTER 2,384.05SUTURE ANCHOR QUATRO X 5.5MM 2,405.60MESH SFT TISS HRN 4.3CMX4.3CM SM 2,426.60PUTTY DBM PROGENIX PLUS 2.5CC 2,440.30SCREW LAG SCREW 010.5 X 100MM 2,445.90SCREW LAG SCREW TI 10.5X95MM 2,445.90SCREW LAG TI 10.5 X 105MM 2,445.90SCREW LAG TI 10.5 X 85MM 2,445.90SCREW LAG TI 10.5 X 90MM 2,445.90

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TVRH Item Description Primary PriceSCREW COMP HEADLESS 3.0MM X 32MM 2,447.75ANCHOR SUTURE 2/0 MINI V-5 2,449.00CATH GUIDELINER V3 5FR 2,449.00CATH PTCA GLIDER 2.5X12X135 2,449.00LEAD ST JUDE TENDRIL ST 2088TC46 2,565.70LEAD ST JUDE TENDRIL ST 2088TC52 2,565.70LEAD STJUDE TENDRIL ST 2088TC46 2,565.70LEAD STJUDE TENDRIL ST 2088TC52 2,565.70LEAD STJUDE TENDRIL ST 2088TC58 2,565.70SP ZZ PORT-A-CATH BRACHIAL PORT 2,591.20BONE CANC CHP 30ML 2,604.00SCREW 5.5X45MM 2,612.50SUTURE ANCHOR MITEK 3/0 MINI BIO 2,622.60PLATE DISTAL LATERAL FIBULA 4HOLE 2,625.70STENT NIRXCELL 2.75X8X135 2,635.00STENT NIRXCELL 3.5X12X135 2,635.00STENT NIRXCELL 3.5X17X135 2,635.00STENT NIRXCELL 3.5X33X135 2,635.00STENT NIRXCELL 3X17X135 2,635.00SYSTEM ANCHORSURE 2,635.00PLATE RECON LCK 3.5MM 8H 105MM 2,697.00MESH VENTRALEX ST MED CIRCLE 2,728.00GRFT BNE CORTICAL STRUT 10CMX2CM 2,732.95SP ZZ SCHON CATHETER 2,747.05SP ZZ STENT 2,748.50INTRODUCER SAFESHEATH CSG 9FX40CM 2,765.20STNT CRNRY SML VSL2.25X18MM 2,777.60ACUITY BSCI PRO 9 FR X 45CM 2,808.60ACUITY BSCI PRO EXT HK 9FR X 45CM 2,808.60ACUITY BSCI PRO HOOK 9FR X 45CM 2,808.60MESH KUGEL COMPOSITE OVAL14X18LG 2,871.70ANCHOR SUT SFT TISS BIOABSRB 2,895.40LAG SCREW 10.5MM X 100MM 2,901.60SCREW ZIM LAG 10.5MM X 80MM 2,901.60MESH SFT TISS HR 6.4CMX6.4CM MED 2,905.45STNT CORONARY RX 3.5X12MM 2,958.14STNT CORONARY RX 3.5X15MM 2,958.14STNT CORONARY RX 3.5X23MM 2,958.14STNT CORONARY RX 3.5X28MM 2,958.14STNT CORONARY RX 3X12MM 2,958.14STNT CORONARY RX 3X15MM 2,958.14STNT CORONARY RX 3X18MM 2,958.14STNT CORONARY RX 3X23MM 2,958.14STNT CORONARY RX 4X12MM 2,958.14STNT CORONARY RX 4X15MM 2,958.14

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TVRH Item Description Primary PriceSTNT CORONARY RX 4X18MM 2,958.14STNT CORONARY RX 4X28MM 2,958.14STNT CRNRY BLN EXPND 4.5X18MM 2,958.14STNT CRNRY BLN EXPND 4.5X38MM 2,958.14STNT CRNRY BLN EXPND 5X18MM 2,958.14STNT CRNRY BLN EXPNDBL 5X38MM 2,958.14STNT CRNRY RX VISION 2.75X12 MM 2,958.14STNT CRNRY RX VISION 2.75X15 MM 2,958.14STNT CRNRY RX VISION 2.75X18 MM 2,958.14STNT CRNRY RX VISION 2.75X23 MM 2,958.14STNT CRNRY RX VISION 2.75X28 MM 2,958.14STNT CRNRY SML VSL RX 2.25X12MM 2,958.14STNT CRNRY SML VSL RX 2.25X23MM 2,958.14STNT CRNRY SML VSL RX 2.25X8MM 2,958.14STNT CRNRY SML VSL RX 2.5X12MM 2,958.14STNT CRNRY SML VSL RX 2.5X15MM 2,958.14STNT CRNRY SML VSL RX 2.5X18MM 2,958.14STNT CRNRY SML VSL RX 2.5X23MM 2,958.14STNT CRNRY SML VSL RX 2.5X28MM 2,958.14STNT CRNRY SML VSL RX 2.5X8MM 2,958.14STNT CRNRY SML VSL RX 2X12MM 2,958.14STNT CRNRY SML VSL RX 2X15MM 2,958.14STNT CRNRY SML VSL RX 2X18MM 2,958.14STNT CRNRY SML VSL RX 2X28MM 2,958.14STNT CRNRY SML VSL RX 2X8MM 2,958.14STNT MLT LNK VISION 3X18 2,958.14STNT CRNRY BLN EXPND 5X13MM 2,958.15APERFIX II CAN TIBIAL PK 10MMX30M 3,069.00BLOCK FEM POST AUGMT SZ F 5MM 3,100.00CAP END PEEK CAGE 6 X 14 X 11MM 3,100.00CAP END PEEK CAGE 7X14X11MM 3,100.00CAP END PEEK CAGE 8X14X11MM 3,100.00CATH BLN INTRA ARTC P 7.5FR 40ML 3,100.00CATH CRNRY RX PTCA TT 2.0X10MM 3,100.00CATH CRNRY RX PTCA TT 2.0X15MM 3,100.00CATH CRNRY RX PTCA TT 2.0X6MM 3,100.00CATH CRNRY RX PTCA TT 2.5X6MM 3,100.00CATH CRNRY RX PTCA TT 3.0X6MM 3,100.00CATH CRNRY RX PTCA TT 3.5X10MM 3,100.00CATH EAGLE EYE PLATINUM 3,100.00CATH IVUS PV .018 3,100.00CATHETER BALLN PTV .035 28MMX6CM 3,100.00CATHETER IVUS VISIONS PV .035X135 3,100.00CATHETHER MEDT DEFLECTABLE 3,100.00CEMENT BNE RADPAQ 40GR W/GNTMYCN 3,100.00

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TVRH Item Description Primary PriceDEVICE EMBO PROTCT SPIDR FX 4X320 3,100.00FEMORAL HEAD COCR 12/14 32MM +7 3,100.00FILTER OPTEASE RETRVL 30MM 8FX55 3,100.00FILTER VENA CAVA IVC CELECT 3,100.00FILTER VENA CAVA OPTION ELITE 70C 3,100.00FINGER JOINT IMPLANT SZ0 470-0010 3,100.00GARFT VASC NAT COLLAGEN 6MMX15CM 3,100.00GRAFT 4.5MMX6.5MMX70CM 4.5MMTO6 3,100.00GRAFT VASCLR THIN WALL RING8MMX70 3,100.00GRAFT VSCLR NATRL COLAGN 8MM 3,100.00GRAFT VSCLR THIN WALL H 6MMX80CM 3,100.00HEAD FEMRL MDLR COBLT CHRM 28MM 3,100.00HIP PARTIAL CEMENTED STELKAST H2 3,100.00KIT SCREW LAG 90MM 3,100.00LEAD BSCI DEXTRUS 4136 3,100.00LEAD MDT CAPSURE FIX 6.2 FR 45CM 3,100.00LEAD MDT CAPSURE FIX 6.2FR 52CM 3,100.00LEAD MDT CAPSURE FIX 6.2FR 58CM 3,100.00LEAD MDT MRI 45CM 3,100.00LEAD MDT MRI 52CM 3,100.00LEAD MDT MRI 58CM 3,100.00LEAD MEDT CAPSURE FIX 45CM 3,100.00LEAD MEDT CAPSURE FIX 52CM 3,100.00LEAD MEDT CAPSURE FIX 58CM 3,100.00MATRIX MASTERGRAFT 10CC 3,100.00MESH COMPOSIX LP 15.9 X 21.0CM 3,100.00MESH COMPOSIX LP CIRCLE 4.5IN 3,100.00MESH PATCH VENTRALEX LG 3,100.00MESH SFT TISS HRNI 11CMX14CM MED 3,100.00MESH VENTRALIGHT 6X8 ELLIPSE 3,100.00NAIL KIT TROCH TI 11X160MMX125 3,100.00NERVE PROTECTOR 7MMX10MM 3,100.00ORTHOBLEND DEFGRAFT DBM 5CC 3,100.00OSTEOSET ABSORBABLE MINI-BEAD KIT 3,100.00PLATE 2 VDR NARROW LNG RT 70-0371 3,100.00PLATE 2 VDR NARROW LT 70-0358 3,100.00PLATE 2 VDR NARROW RT 70-0359 3,100.00PLATE 2 VDR STANDARD LT 70-0356 3,100.00PLATE 2 VDR STANDARD RT 70-0357 3,100.00PLATE 2 VDR STD LONG LT 70-0368 3,100.00PLATE 2 VDR STD LONG RT 70-0369 3,100.00PLATE 2 VDR WIDE LT 70-0360 3,100.00PLATE ACUMED CLAVICAL 10 HOLE RT 3,100.00PLATE ANCHORAGE MTP V1 RIGHT 3,100.00PLATE BONE ANTERIOR CERVICAL 40MM 3,100.00

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TVRH Item Description Primary PricePLATE BONE WRIST LEFT 3 HOLE 3,100.00PLATE CERVICAL 35MM 3,100.00PLATE DIST MED HUM 5H RT 100MM 3,100.00PLATE DIST POST HUM 5H RT 98MM 3,100.00PLATE DISTAL FIBULA RIGHT 3,100.00PLATE DISTAL LATERAL FIBULA 5HOLE 3,100.00PLATE DISTAL RADIUS 3 HOLE 3,100.00PLATE ELITE 23 MM 3,100.00PLATE EXTENSION 2 VDR NEUTRAL 3,100.00PLATE OLECRANON EXT RT 5 HOLE 3,100.00PLATE OLECRANON STD LT 3 HOLE 3,100.00PLATE OLECRANON STD LT 5 HOLE 3,100.00PLATE OLECRANON STD RT 5 HOLE 3,100.00PLATE PROX ULNAR 5H LT 103MM 3,100.00PLATE RADIAL 4HOLE LG LT 32MM 3,100.00PLATE RADIAL 6HOLE SM RT 25MM 3,100.00PLATE VDR 3H LT NRRW 3,100.00PLATE VDU LONG LT 70-0047 3,100.00PLATE ZIM DISTAL LEFT 801MM 3,100.00PLATE ZIM LAT FIB LOCK 106MM L6H 3,100.00PLATE ZIM LAT FIB LOCK 106MM R6H 3,100.00PLATE ZIM LAT FIB LOCK 80MM R4H 3,100.00PLATELOCKING 8HOLE MEDIAL HUMERUS 3,100.00PLT HUMERUS POST-LAT LT 11 HOLE 3,100.00PLT HUMERUS POST-LAT LT 5 HOLE 3,100.00PLT VDR ACU-LOC 2 STNADARD RT 3,100.00PLUG VASCULAR AMPLATZER 12MM 3,100.00PLUG VASCULAR AMPLATZER 16MM 3,100.00PUTTY DBM OSTEOSURGE 100 5CC 3,100.00PUTTY DMB 5CC 3,100.00PUTTY GRAFTON DBM 5CC 3,100.00SCREW 4.5X45MM 3,100.00SCREW CANN 8.5MM X 50MM 3,100.00SCREW CANN MAS 6.5 X 40 CC 3,100.00SCREW CANN MAS 6.5 X 45MM 3,100.00SCREW CANN MAS 6.5 X 50 CM 3,100.00SCREW CANN MAS 7.5X45 CM 3,100.00SCREW CANN MAS 7.5X50 CM 3,100.00SCREW CANN SOLERA 8.5X45MM 3,100.00SCREW MEDT CANN 7.5 X 40MM 3,100.00SHUNT CAROTID PRUIT W TPORT 8FR 3,100.00SLING SYSTEM OBTRYX II CURVED 3,100.00SPACER JNT TOE FLXBL HNG SZ2 SH 3,100.00SPACER PSR LAT PORTS 5X14X11 3,100.00SPACER PSR LAT PORTS 9X14X11 3,100.00

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TVRH Item Description Primary PriceSTENT BIL SMART FLEX 5X80X120 3,100.00STENT BIL SMART FLEX 6X100X120 3,100.00STENT BIL SMART FLEX 6X120X120 3,100.00STENT BIL SMART FLEX 6X60X120 3,100.00STENT BIL SMART FLEX 7X80X120 3,100.00STENT BIL SMART FLEX 8X120X120 3,100.00STENT DES RESOLUTE RX 2.00X12MM 3,100.00STENT DES RESOLUTE RX 2.00X15MM 3,100.00STENT DES RESOLUTE RX 2.00X18MM 3,100.00STENT DES RESOLUTE RX 2.00X22MM 3,100.00STENT DES RESOLUTE RX 2.00X26MM 3,100.00STENT DES RESOLUTE RX 2.00X30MM 3,100.00STENT DES RESOLUTE RX 2.00X8MM 3,100.00STENT DES RESOLUTE RX 2.25X08MM 3,100.00STENT DES RESOLUTE RX 2.25X12MM 3,100.00STENT DES RESOLUTE RX 2.25X15MM 3,100.00STENT DES RESOLUTE RX 2.25X18MM 3,100.00STENT DES RESOLUTE RX 2.25X22MM 3,100.00STENT DES RESOLUTE RX 2.25X26MM 3,100.00STENT DES RESOLUTE RX 2.25X34MM 3,100.00STENT DES RESOLUTE RX 2.25X38MM 3,100.00STENT DES RESOLUTE RX 2.50X12MM 3,100.00STENT DES RESOLUTE RX 2.50X15MM 3,100.00STENT DES RESOLUTE RX 2.50X18MM 3,100.00STENT DES RESOLUTE RX 2.50X22MM 3,100.00STENT DES RESOLUTE RX 2.50X26MM 3,100.00STENT DES RESOLUTE RX 2.50X30MM 3,100.00STENT DES RESOLUTE RX 2.50X34MM 3,100.00STENT DES RESOLUTE RX 2.50X38MM 3,100.00STENT DES RESOLUTE RX 2.75X08MM 3,100.00STENT DES RESOLUTE RX 2.75X12MM 3,100.00STENT DES RESOLUTE RX 2.75X15MM 3,100.00STENT DES RESOLUTE RX 2.75X18MM 3,100.00STENT DES RESOLUTE RX 2.75X22MM 3,100.00STENT DES RESOLUTE RX 2.75X26MM 3,100.00STENT DES RESOLUTE RX 2.75X30MM 3,100.00STENT DES RESOLUTE RX 2.75X38MM 3,100.00STENT DES RESOLUTE RX 3.0X08MM 3,100.00STENT DES RESOLUTE RX 3.0X12MM 3,100.00STENT DES RESOLUTE RX 3.0X15MM 3,100.00STENT DES RESOLUTE RX 3.0X18MM 3,100.00STENT DES RESOLUTE RX 3.0X22MM 3,100.00STENT DES RESOLUTE RX 3.0X26MM 3,100.00STENT DES RESOLUTE RX 3.0X30MM 3,100.00STENT DES RESOLUTE RX 3.0X34MM 3,100.00

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TVRH Item Description Primary PriceSTENT DES RESOLUTE RX 3.0X38MM 3,100.00STENT DES RESOLUTE RX 3.5X08MM 3,100.00STENT DES RESOLUTE RX 3.5X12MM 3,100.00STENT DES RESOLUTE RX 3.5X15MM 3,100.00STENT DES RESOLUTE RX 3.5X18MM 3,100.00STENT DES RESOLUTE RX 3.5X22MM 3,100.00STENT DES RESOLUTE RX 3.5X26MM 3,100.00STENT DES RESOLUTE RX 3.5X30MM 3,100.00STENT DES RESOLUTE RX 3.5X38MM 3,100.00STENT DES RESOLUTE RX 4.0X12MM 3,100.00STENT DES RESOLUTE RX 4.0X15MM 3,100.00STENT DES RESOLUTE RX 4.0X18MM 3,100.00STENT DES RESOLUTE RX 4.0X22MM 3,100.00STENT DES RESOLUTE RX 4.0X30MM 3,100.00STENT DES RESOLUTE RX 4.0X34MM 3,100.00STENT DES RESOLUTE RX 4.0X38MM 3,100.00STENT DES RESOLUTE RX 4.5X12MM 3,100.00STENT DES RESOLUTE RX 4.5X15MM 3,100.00STENT DES RESOLUTE RX 4.5X18MM 3,100.00STENT DES RESOLUTE RX 4.5X22MM 3,100.00STENT DES RESOLUTE RX 4.5X26MM 3,100.00STENT DES RESOLUTE RX 5.0X12MM 3,100.00STENT DES RESOLUTE RX 5.0X15MM 3,100.00STENT DES RESOLUTE RX 5.0X18MM 3,100.00STENT DES RESOLUTE RX 5.0X26MM 3,100.00STENT DES RESOLUTE RX 5.0X30MM 3,100.00STENT EVERFLEX 6X100X120 3,100.00STENT EVERFLEX 6X150X120 3,100.00STENT EVERFLEX 6X60X120 3,100.00STENT EVERFLEX 7X60X80 3,100.00STENT EVERFLEX 8X40X120 3,100.00STENT EVERFLEX 8X60X120 3,100.00STENT EVERFLEX 8X80X120 3,100.00STENT OMNILINK ELITE 10X39X135 3,100.00STENT PALMZ GENESIS 9X29X80 3,100.00STENT PROTEGE GPS 10X80X120 3,100.00STENT PROTEGE GPS 9X40X80 3,100.00STENT PROTEGE GPS 9X60X120 3,100.00STENT PROTEGE GPS 9X60X120 3,100.00STENT PROTGE EVRFLX 6FR .035 7X80 3,100.00STENT VISIPRO 5X17X80 3,100.00STENT VISIPRO 5X27X80 3,100.00STENT VISIPRO 6X27X135 3,100.00STENT VISIPRO 6X27X80 3,100.00STENT VISIPRO 7X17X135 3,100.00

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TVRH Item Description Primary PriceSTENT VISIPRO 7X17X80 3,100.00STENT VISIPRO 7X27X135 3,100.00STENT VISIPRO 7X27X80 3,100.00STENT VISIPRO 7X37X135 3,100.00STENT VISIPRO 8X37X80 3,100.00STENT VISIPRO 9X37X135 3,100.00STENT VISIPRO 9X57X135 3,100.00STENT WALLSTENT 16X60X75 3,100.00STENT WALLSTENT 18X60X75 3,100.00STNT .035 7.0X29X135CM 3,100.00STNT .035 8.0X19X135CM 3,100.00STNT .035 8.0X29X135CM 3,100.00STNT .035 8.0X39X135CM 3,100.00STNT 6FR .035 5X100MM 120CM 3,100.00STNT ABSOLUT PRO VASC 6X100X135CM 3,100.00STNT ABSOLUT PRO VASC 7X100X135CM 3,100.00STNT BLRY SLF EXPN 10X80X120CM 3,100.00STNT DESXIENCE SIERRA 2.25X08MM 3,100.00STNT DESXIENCE SIERRA 2.25X12MM 3,100.00STNT DESXIENCE SIERRA 2.25X15MM 3,100.00STNT DESXIENCE SIERRA 2.25X18MM 3,100.00STNT DESXIENCE SIERRA 2.25X23MM 3,100.00STNT DESXIENCE SIERRA 2.25X28MM 3,100.00STNT DESXIENCE SIERRA 2.25X33MM 3,100.00STNT DESXIENCE SIERRA 2.25X38MM 3,100.00STNT DESXIENCE SIERRA 2.50X12MM 3,100.00STNT DESXIENCE SIERRA 2.50X15MM 3,100.00STNT DESXIENCE SIERRA 2.50X18MM 3,100.00STNT DESXIENCE SIERRA 2.50X23MM 3,100.00STNT DESXIENCE SIERRA 2.50X28MM 3,100.00STNT DESXIENCE SIERRA 2.50X33MM 3,100.00STNT DESXIENCE SIERRA 2.50X38MM 3,100.00STNT DESXIENCE SIERRA 2.75X08MM 3,100.00STNT DESXIENCE SIERRA 2.75X12MM 3,100.00STNT DESXIENCE SIERRA 2.75X15MM 3,100.00STNT DESXIENCE SIERRA 2.75X18MM 3,100.00STNT DESXIENCE SIERRA 2.75X23MM 3,100.00STNT DESXIENCE SIERRA 2.75X28MM 3,100.00STNT DESXIENCE SIERRA 2.75X33MM 3,100.00STNT DESXIENCE SIERRA 2.75X38MM 3,100.00STNT DESXIENCE SIERRA 3.00X12MM 3,100.00STNT DESXIENCE SIERRA 3.00X15MM 3,100.00STNT DESXIENCE SIERRA 3.00X18MM 3,100.00STNT DESXIENCE SIERRA 3.00X23MM 3,100.00STNT DESXIENCE SIERRA 3.00X28MM 3,100.00

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TVRH Item Description Primary PriceSTNT DESXIENCE SIERRA 3.00X33MM 3,100.00STNT DESXIENCE SIERRA 3.00X38MM 3,100.00STNT DESXIENCE SIERRA 3.25X08MM 3,100.00STNT DESXIENCE SIERRA 3.25X12MM 3,100.00STNT DESXIENCE SIERRA 3.25X15MM 3,100.00STNT DESXIENCE SIERRA 3.25X18MM 3,100.00STNT DESXIENCE SIERRA 3.25X23MM 3,100.00STNT DESXIENCE SIERRA 3.25X28MM 3,100.00STNT DESXIENCE SIERRA 3.25X38MM 3,100.00STNT DESXIENCE SIERRA 3.50X08MM 3,100.00STNT DESXIENCE SIERRA 3.50X12MM 3,100.00STNT DESXIENCE SIERRA 3.50X15MM 3,100.00STNT DESXIENCE SIERRA 3.50X18MM 3,100.00STNT DESXIENCE SIERRA 3.50X23MM 3,100.00STNT DESXIENCE SIERRA 3.50X28MM 3,100.00STNT DESXIENCE SIERRA 3.50X33MM 3,100.00STNT DESXIENCE SIERRA 3.50X38MM 3,100.00STNT DESXIENCE SIERRA 4.00X08MM 3,100.00STNT DESXIENCE SIERRA 4.00X12MM 3,100.00STNT DESXIENCE SIERRA 4.00X15MM 3,100.00STNT DESXIENCE SIERRA 4.00X18MM 3,100.00STNT DESXIENCE SIERRA 4.00X23MM 3,100.00STNT DESXIENCE SIERRA 4.00X28MM 3,100.00STNT DESXIENCE SIERRA 4.00X33MM 3,100.00STNT DESXIENCE SIERRA 4.00X38MM 3,100.00STNT FILTER PRB 06X60X120 3,100.00STNT FILTER PRB 07X150X120 3,100.00STNT FILTER PRB-07X120X120 3,100.00STNT FILTER PROTEGE 8X40X120 3,100.00STNT GENESIS AVIATOR 7X24X80 3,100.00STNT HURCULINK ELITE 6X18X135 3,100.00STNT INTEGRITY 2.25 MM X 14MM 3,100.00STNT INTEGRITY 2.25MM X 12MM 3,100.00STNT INTEGRITY 2.50 MM X 14MM 3,100.00STNT INTEGRITY 2.50 MM X 26MM 3,100.00STNT INTEGRITY 2.50MM X 12MM 3,100.00STNT INTEGRITY 2.50MM X 18MM 3,100.00STNT INTEGRITY 2.75 MM X 14MM 3,100.00STNT INTEGRITY 2.75 MM X 18MM 3,100.00STNT INTEGRITY 3.00 MM X 15MM 3,100.00STNT INTEGRITY 3.00MM X 12MM 3,100.00STNT INTEGRITY 3.00MM X 18MM 3,100.00STNT INTEGRITY 3.00MM X 22MM 3,100.00STNT INTEGRITY 3.00MM X 30MM 3,100.00STNT INTEGRITY 3.50 MM X 15MM 3,100.00

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TVRH Item Description Primary PriceSTNT INTEGRITY 3.50MM X 18MM 3,100.00STNT INTEGRITY 3.50MM X 22MM 3,100.00STNT INTEGRITY 4.00 MM X 15MM 3,100.00STNT INTEGRITY 4.0MM X 12MM 3,100.00STNT INTEGRITY 4.0MM X 18MM 3,100.00STNT PROTEGE 6 X 40 X 120 3,100.00STNT SPIDER FX 5.0MM 3,100.00SUTURE ANCHOR QUATRO LINK 5.5MM 3,100.00SYS IMPL MINI THIGHTROPE 1.1 3,100.00TOE GREAT MP JOINT MEDIUM 3,100.00WIRE FILTER EMBLC PRTCT 6.0MM 3,100.00DERMIS FLEXHD THICK 6X8CM 3,137.05CATH INDIGO 5 STR TIP 132CM 5.0F 3,198.25GRAFT VSCLR NATRL COLAGN 7MM 3,214.75PLATE PROX TIBIA 5H RT 132MM 3,217.50STENT BILIARY XPERT 4X20X135 3,221.65PATIENT PROGRAMMER INTERSIM 3,272.50STENT PALMZ GENESIS 6.0X12X135 3,285.55HIP FRACTURE STRYKER H4 3,300.00PLATE DISTAL FEMUR 5H RIGHT 167MM 3,300.00MESH COMPOSIX LP 21.0CM X 26.1CM 3,341.80ORTHOBLEND DEFGRAFT DBM 10CC 3,345.40PLATE PROX LAT HUM 4H RT 90MM 3,349.50GRAFT PROPATEN STD 4?7MM 45CM 3,390.75STENT XIENCE ALPINE 2.25X12 3,412.00STENT XIENCE ALPINE 2.25X15 3,412.00STENT XIENCE ALPINE 2.25X18 3,412.00STENT XIENCE ALPINE 2.25X23 3,412.00STENT XIENCE ALPINE 2.25X28 3,412.00STENT XIENCE ALPINE 2.25X8 3,412.00STENT XIENCE ALPINE 2.5X12 3,412.00STENT XIENCE ALPINE 2.5X15 3,412.00STENT XIENCE ALPINE 2.5X18 3,412.00STENT XIENCE ALPINE 2.5X23 3,412.00STENT XIENCE ALPINE 2.5X28 3,412.00STENT XIENCE ALPINE 2.5X33 3,412.00STENT XIENCE ALPINE 2.5X38 3,412.00STENT XIENCE ALPINE 2.5X8 3,412.00STENT XIENCE ALPINE 2.75X12 3,412.00STENT XIENCE ALPINE 2.75X15 3,412.00STENT XIENCE ALPINE 2.75X18 3,412.00STENT XIENCE ALPINE 2.75X23 3,412.00STENT XIENCE ALPINE 2.75X28 3,412.00STENT XIENCE ALPINE 2.75X33 3,412.00STENT XIENCE ALPINE 2.75X38 3,412.00

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TVRH Item Description Primary PriceSTENT XIENCE ALPINE 2.75X8 3,412.00STENT XIENCE ALPINE 3.0X12 3,412.00STENT XIENCE ALPINE 3.0X15 3,412.00STENT XIENCE ALPINE 3.0X18 3,412.00STENT XIENCE ALPINE 3.0X23 3,412.00STENT XIENCE ALPINE 3.0X28 3,412.00STENT XIENCE ALPINE 3.0X33 3,412.00STENT XIENCE ALPINE 3.0X38 3,412.00STENT XIENCE ALPINE 3.0X8 3,412.00STENT XIENCE ALPINE 3.25X12 3,412.00STENT XIENCE ALPINE 3.25X15 3,412.00STENT XIENCE ALPINE 3.25X18 3,412.00STENT XIENCE ALPINE 3.25X23 3,412.00STENT XIENCE ALPINE 3.25X28 3,412.00STENT XIENCE ALPINE 3.25X33 3,412.00STENT XIENCE ALPINE 3.25X38 3,412.00STENT XIENCE ALPINE 3.5X12 3,412.00STENT XIENCE ALPINE 3.5X15 3,412.00STENT XIENCE ALPINE 3.5X18 3,412.00STENT XIENCE ALPINE 3.5X23 3,412.00STENT XIENCE ALPINE 3.5X28 3,412.00STENT XIENCE ALPINE 3.5X33 3,412.00STENT XIENCE ALPINE 3.5X38 3,412.00STENT XIENCE ALPINE 3.5X8 3,412.00STENT XIENCE ALPINE 4.0X12 3,412.00STENT XIENCE ALPINE 4.0X15 3,412.00STENT XIENCE ALPINE 4.0X18 3,412.00STENT XIENCE ALPINE 4.0X23 3,412.00STENT XIENCE ALPINE 4.0X28 3,412.00STENT XIENCE ALPINE 4.0X33 3,412.00STENT XIENCE ALPINE 4.0X38 3,412.00STENT XIENCE ALPINE 4.0X8 3,412.00SLING SYSTEM ALTIS 7.75CM 3,437.50NAIL PROXIMAL FEMUR 11/180 3,439.15STNT INTEGRITY DES 2.25X12MM 3,506.25STNT INTEGRITY DES 2.25X14MM 3,506.25STNT INTEGRITY DES 2.25X26MM 3,506.25STNT INTEGRITY DES 2.50X12MM 3,506.25STNT INTEGRITY DES 2.50X14MM 3,506.25STNT INTEGRITY DES 2.50X18MM 3,506.25STNT INTEGRITY DES 2.50X26MM 3,506.25STNT INTEGRITY DES 2.75X14MM 3,506.25STNT INTEGRITY DES 3.00X12MM 3,506.25STNT INTEGRITY DES 3.00X18MM 3,506.25STNT INTEGRITY DES 3.00X22MM 3,506.25

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TVRH Item Description Primary PriceSTNT INTEGRITY DES 3.50X15MM 3,506.25STNT INTEGRITY DES 3.50X22MM 3,506.25STNT RES INTEGRITY DES 2.50X22 MM 3,506.25STNT RES INTEGRITY DES 2.50X30 MM 3,506.25STNT RX 2.25X8MM 3,506.25STNT RX 3.50X9MM 3,506.25PLATE PROX LAT HUM 8H RT 138MM 3,531.00NAIL INTERTAN 10X18MM 130 DEGREE 3,540.90NAIL FEM SHORT RT 13MM DIA 21.5CM 3,547.50PLATE ZIMMER LOCKING 14 HOLE R 3,613.50PLATE PROX LAT HUM 16H RT 234MM 3,696.00TOTAL KNEE EXACTECH K1 3,700.00MONARC C SUBFASCIAL HAMMOCK 3,709.75STENT SIDE BRANCH 15MM 3.0-3.5MM 3,712.50STENT SIDE BRANCH 19MM 2.5-3.0MM 3,712.50STENT SIDE BRANCH 2.5MM 3,712.50GRAFT VSCLR NATRL COLAGN 6MM 3,737.25STENT XCEED NITINOL 8 X 120 X 120 3,790.55FILTER VENA CAVA ENDOVASCULAR FEM 3,850.00SP ATHERECTOMY CATHETER 4,003.90FILTER BSKET EMBOLC PROTCTN 4,070.00FILTER EMBOLIC PRTCT 3.5MM 190CM 4,070.00BONE GRAFT PUTTY CONNEXUS 10CC 4,086.50PRIMARY EXTENSION STEM L11MM 65MM 4,111.25GRAFT ACUSEAL 4-7MMX45CM 4,122.25TISSUE TENDON TIBIALIS POSTER 4,122.25GRAFT ALLOMAX 4X16 CM 4,166.65NAIL 13MM X 180MM 8143-13-180 4,180.00GRAFT VASC NTRL COLLAGEN 7MMX45CM 4,259.75STENT WALLSTENT 18X90X75 4,262.50STENT WALLSTENT 20X80X75 4,262.50MATRIX SOFT TISSUE 200 3CM X 3CM 4,279.00MESH SFT TISS 22.1CMX17.1CM X-LG 4,317.50STENT SUPERA PERIPH 4.5X120X120 4,386.25SP ZZ DURAFLOW CATHETER 4,403.25GRAFT ALLOMAX 7X10 CM 4,566.20LEAD MDT ATTAIN ABILITY 88CM 4,655.50CATH PTA DCB INPACT 150X130 4,702.50CATH PTA DCB INPACT 5X150X130 4,702.50GRAFT BONE INFUSE X SMALL 1.4CC 4,746.50DERMIS AFLEX 100 1.26-1.75MM 4,758.19SP ZZ ANGIOJET CATHETER 4,764.00GRAFT PROPATEN TW RR 6MM 40-50CM 4,878.50STENT SUPERA 6.0X150X120 4,936.25STNT SUPERA VERI SYS 5X100X120CM 4,936.25

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TVRH Item Description Primary PriceLEAD MDT LEFT VENTRICAL 4296 4,950.00LEAD STJUDE QUARTET 86CM 5,057.80SHEATH DILATOR TIGHTRAIL 9F 5,211.25MESH SFT TISS HRNI 15CMX20CMX2MM 5,238.75GRAFT JACKET EXPRESS PER 2CC 5,329.50NERVE PROTECTOR 7MMX40MM 5,362.50MESH TISS ALLOMAX 6X12CM 5,469.75CATH INDIGO 6 STR TIP 135CM 6.0F 5,472.50LEAD MEDT ATTAIN PERF 88CM 5,500.00LEAD MEDT ATTAIN PERFORMA 78CM 5,500.00LEAD MEDT ATTAIN PERFORMA S 88CM 5,500.00LEAD STJUDE QUARTET 75CM 5,500.00SYS POST SPINE 22X9 0DEG 10X8.5MM 5,720.00SYS POST SPINE 22X9 0DEG 6MM 5,720.00SYS POST SPINE 22X9 0DEG 8MM 5,720.00SYS POST SPINE 22X9 0DEG 8X6.5MM 5,720.00SYS POST SPINE 26X9 0DEG 10MM 5,720.00SYS POST SPINE 26X9 0DEG 10X8.1MM 5,720.00SYS POST SPINE 26X9 0DEG 6MM 5,720.00SYS POST SPINE 26X9 0DEG 8MM 5,720.00SYS POST SPINE 26X9 0DEG 8X6.1MM 5,720.00SYS PST SPINE 22X9 0DEG 12X10.5MM 5,720.00SYS PST SPINE 26X9 0DEG 12X10.1MM 5,720.00SYS PST SPINE 26X9 0DEG 14X12.1MM 5,720.00PLATE INTEGRAL GTR LONG W/4 CBLS 5,725.50MATRIX SOFT TISSUE 200 5CM X 5CM 5,819.00TOTAL HIP CORIN HSPLIT H2 5,984.00HIP FRAC TRAUMA DPY SHRT T1A 6,050.00NAIL IMHS CP 125 X 10 X 36L 6,072.00SP ZZ PERIPHERAL STENT GRAFT 6,121.20TOTAL HIP HSPLIT 6,187.50BONE MATRIX TRINITY MCB 5CC 6,338.75LEAD BSCI ACUITY X 4 6,432.25STENT GRAFT VBC VIABAHN 7X5X120 6,462.50JOSTNT GRAFTMASTER 2.8X16 6,586.25STNT TRACH ICAST 7F 8X38X120MM 6,727.20HIP BIPOLAR CEMENTED BIOMET H3 6,875.00HIP BIPOLAR CEMENTED SMITHNEPH H3 6,875.00HIP BIPOLAR CEMENTED ZIMMER H3 6,875.00HIP FRAC TRAUMA DPY LNG T1 6,875.00CAGE CAPSTONE 7X26MM 7,152.75CAGE CAPSTONE 8X22MM 7,152.75CAGE CAPSTONE 9X22MM 7,152.75SPACER CAPSTONE 10X22MM 7,152.75SPACER CAPSTONE 10X26MM 7,152.75

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TVRH Item Description Primary PriceSPACER CAPSTONE PEEK 11X26 7,152.75SPACER CAPSTONE PEEK INTERBODY 7,152.75SPACER PEEK CAPSTONE 12X22MM 7,152.75MESH TISS ALLOMAX 6CM X 16CM 7,548.75SPACER CAPSTONE PEEK 09/26 7,590.00SPACER CAPSTONE PEEK 13X22 7,590.00STENT GRAFT VIABAHN VBJ 8X5 7,603.75STNT CVRD HEPARIN 6X5CMX120CM 7,603.75STNT CVRD HEPARIN 8X5CMX120CM 7,603.75CATH INFUSION SYS LYSUS 12X106CM 7,686.25CATH INFUSION SYS LYSUS 18X106CM 7,686.25CATH INFUSION SYS LYSUS 50X135CM 7,686.25INFUSION SYSTEM LYSUS 6X106 7,686.25GFT VASC ILIAC EXTNDR 14.5X7CM 7,708.25GRAFT ILIAC EXTENSION 16X12X7 7,708.25GRFT AORTIC EXT EXCLUDER 28.5X3.3 7,708.25GRFT LIMB EXT FLEX AFX I-20X13 88 7,823.75PLATE EXT 4HOLE W/4CBLS 23X232MM 7,837.50OPTEFORM ALLOGRAFT DBM RT 10CC 7,983.25CATH PLAQUE EXCISION 8FRX9.0CM 8,236.25CATH DIAMONDBACK 2.00MMX135CM 8,236.25HIP BIPOLAR POROUS BIOMET H2 8,250.00HIP BIPOLAR POROUS DEPUY ORTHO H2 8,250.00HIP BIPOLAR POROUS MEDACTA H2 8,250.00HIP BIPOLAR POROUS ODI H2 8,250.00HIP BIPOLAR POROUS SMITH NEPH H2 8,250.00HIP BIPOLAR POROUS ZIMMER H2 8,250.00STENT GRAFT VIABAHN VBH 6X10 8,398.50STNT CVRD HEPARIN 7X10X120 8,665.25CATHETER HAWKONE M 6FR 8,786.25CATHETER HAWKONE S 6FR 8,786.25LEAD ST JUDE ICD DURATA 65CM 8,851.15LEAD ST JUDE ICD DURATA 65CM 8,851.15LEAD STJUDE ICD DURATA SJ4 58CM 8,851.15LEAD STJUDE ICD SJ4 DURATA 52CM 8,851.15LEAD STJUDE ICD SJ4 DURATA 58CM 8,851.15LEAD STJUDE ICD SJ4 DURATA58CM 8,851.15LEAD UROLOGICAL NEURO STIMULATOR 9,033.75CATHETER JETSTREAM 2.5MMX135CM 9,047.50GRFT AORTIC EXT ENDURANT 32X32X49 9,281.25CATH STEALTH MICRO 1.25X145 9,336.25CATH STEALTH SOLID CROWN 1.25X45 9,336.25CATH STEALTH SOLID CROWN 1.5X145 9,336.25CATH STEALTH SOLID CROWN 2.0X145 9,336.25CATH STLTH CLASSIC CROWN 1.5X145 9,336.25

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TVRH Item Description Primary PriceGRFT SUPRA AFX A-28X28 95 9,336.25KIT BONE GRAFT INFUSION SMALL 9,490.25ST JUDE ESI INSITE ARRAY 9,555.00STENT GRAFT VBH VIABAHN 6X15X120 9,724.00STENT GRAFT VIABAHN VBH 6X15 9,724.00TOTAL SHOULDER HEMI EXACTECH S2 9,900.00STENT GRAFT VIABAHN 5X15X120 9,988.00TOTAL KNEE FUSION ORTHO K1 10,175.00TOTAL KNEE PRIMARY CONFORMIS K1 10,175.00TOTAL KNEE PRIMARY DEPUY ORTH K1 10,175.00TOTAL KNEE PRIMARY ZIMMER K1T 10,175.00LEAD BSCI ENDOTK RELINC 64 DF4 10,419.75LEAD BSCI ENDOTK RELINC SG59 DF4 10,419.75LEAD BSCI ENDOTK RELINC SG64 DF4 10,419.75SYSTEM DIAMONDBACK 360 1.25MM 10,436.25TOTAL KNEE PRIMARY BIOMET K1 10,450.00TOTAL KNEE PRIMARY SMITH NEPH K1 10,450.00TOTAL KNEE PRIMARY ZIMMER K1 10,450.00LEAD MDTR SPRINT QUA DF4 55CM 10,604.15LEAD MDTR SPRNT QUA DF4 62CM 10,604.15LEAD MEDT SPRNT QUATTRO S 62CM 10,604.15GRFT ILIAC EXT ENDURANT 20X20X82 10,931.25EXCLUDER CONTRA LEG 18 X 9.5 10,972.50GFT VASC CNTRLAT LEG14.5X14.0CM 10,972.50GRAFT CONTRA LTRL LEG 16MM/11.5CM 10,972.50GRFT CONTRA EXCLUDER 16MMX13.5CM 10,972.50GRFT CONTRA EXCLUDER 20MMX11.5CM 10,972.50TOTAL SHOULDER CORIN S1 11,000.00TOTAL SHOULDER DJ ORTO S1T 11,000.00TOTAL SHOULDER FX SOLUTIONS S1 11,000.00TOTAL SHOULDER HEMI EXACTECH S1H 11,000.00TOTAL SHOULDER TORNIER S1T 11,000.00LEAD MDT SPRNT QUA DUAL 62CM 11,275.00LEAD MEDT SPRNT QUATTRO S 55CM 11,275.00TOTAL KNEE HYBRID EXACTECHK2 11,275.00TOTAL KNEE HYBRID SMITH NEPH K2 11,275.00TOTAL KNEE PRIMARY ZIMMER K1TA 11,275.00GRAFT STENT CONTRALTRL 16X13X93 11,481.25RECORDER LOOP CONFIRM RX ICM 11,495.00GRAFT EXTENSION PROXIMAL 34X100MM 11,536.25COMPONENT TIBIAL PRECOAT SIZE 4 11,632.50TOTAL SHOULDER BIOMET S2 11,825.00TOTAL SHOULDER DEPUY ORTH S1 11,825.00GRFT LIMB ENDURANT II 16X24X93 11,893.75TOTAL HIP CORIN H1 12,375.00

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TVRH Item Description Primary PriceTOTAL HIP DEPUY ORTHO H1 12,375.00TOTAL HIP EXACTECH H1 12,375.00TOTAL HIP FUSION ORTHO H1 12,375.00TOTAL HIP HYBRID SMITH NEPH H1 12,375.00TOTAL HIP HYBRID ZIMMER H1 12,375.00TOTAL HIP ODI H1 12,375.00RECORDER LOOP MEDT LINQ 12,531.00STENT VIATORR TIPS 12,749.00GRAFT STENT LIMB 16X10X93MM 12,856.25GRAFT CONTRALATRL LIMB 16X16X124M 12,866.55GRFT LIMB ENDURANT II 16X10X124 12,997.19GRAFT STENT CNTRALTRL 16X13CX124E 12,997.20GRAFT STENT CNTRALTRL 16X20CX124E 12,997.20TOTAL HIP BIOMET H1 13,750.00TOTAL SHOULDER HEMI DEPUY ORT S2 13,750.00DERMIS FLEXHD ULTRA THICK 12X20CM 16,532.60STENT GRAFT VIABAHN 5X25X120 16,816.25STENT GRAFT VIABAHN 6X25X120 16,816.25STENT GRAFT VIABAHN VBJ 8X25 16,816.25GRAFT STENT CONTRALTRL16X16CX156E 17,600.00GRFT LIMB ENDURANT II 16X20X156 17,600.00GRAFT STENT LIMB 16X20X199MM 17,861.25GRFT LIMB ENDURANT II 16X10X199 17,861.25VEIN CRYO SAPHENEOUS 71-80CM 20,374.00TOTAL SHOULDER REV EXACTECHS3 20,625.00TOTAL SHOULDER REV ZIMMER S3 20,625.00TOTAL SHOULDER FX SOLUTIONS S3 20,625.00TOTAL SHOULDER REV BIOMET S3 20,625.00TOTAL SHOULDER REV CORIN S3 20,625.00TOTAL SHOULDER REV DEPUY ORTH S3 20,625.00TOTAL SHOULDER REV LIMA S3 20,625.00TOTAL SHOULDER REVERSE DJO S3 20,625.00TOTAL SHOULDER REVERSE MEDACTA S3 20,625.00TOTAL SHOULDER REVERSE TORNIER S3 20,625.00GRAFT BIF ENDURANT IIS 25X12X103 26,059.00GRFT TRNK EXCLUDER 23X14.5MMX18CM 27,486.25GRFT TRNK EXCLUDER 26X12MMX16CM 27,486.25GRFT TRNK EXCLUDER 26X12MMX18CM 27,486.25GRFT TRNK EXCLUDER 26X14.5MMX12CM 27,486.25GRFT TRNK EXCLUDER 26X14.5MMX18CM 27,486.25GRFT TRNK EXCLUDER 28X14.5MMX12CM 27,486.25GRFT TRNK EXCLUDER 28X14.5MMX14CM 27,486.25GRFT TRNK EXCLUDER 28X14.5MMX16CM 27,486.25GRFT TRNK EXCLUDER 31X14.5MMX13CM 27,486.25GRFT TRNK EXCLUDER 31X14.5MMX15CM 27,486.25

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TVRH Item Description Primary PriceGRFT BIFUR AFX A-28X90 I-16X30 28,270.00STMLTR NEURO VERSITIREL INTERSTIM 30,868.75DERMIS FLEXHD ULTRA THICK 20X25CM 32,228.65PUMP IMPELLA CP 14FR W/ 9FR CATH 55,000.00VENIPUNCTURE - CHARGE ONLY 10.50VENIPUNCTURE SPECIMEN COLLECTION 10.50VENIPUNCTURE SPECIMEN COLLECTION 10.50HEMOGLOBIN ELECTROPHORESIS CASCAD 40.95CREATININE RANDOM URINE (CHG ONLY 55.50IEF CONFIRMS 71.00ANTIBODY SCREEN 73.50ANTIBODY SCREEN-RBC-CHARGE ONLY 73.50ANTIBODY SCREEN-TUBE METHODS 73.50INDUCE SPUTUM SUBSEQUENT 85.85INDUCED SPUTUM TVRH 85.85ACTIVATED CLOTTING TIME 105.20URINALYSIS (ROUTINE UA) 137.60URINALYSIS W/ REFLEX CULTURE 148.70JAK2 V617F MUTATION QN 250.00JAK2 V617F MUTATION 297.25FRUCTOSAMINE BLD 6.00CERULOPLASMIN BLD 7.00MITOCHONDRIAL (M2) AB IGG 7.00INSULIN LEVEL 8.00COPPER (CU) BLD 9.00ESTRADIOL (E2) BLD 9.00ALPHA FETOPROTEIN (AFP) 10.00ALPHA-1-ANTITRYPSIN QUANTITATION 10.00GASTRIC OCCULT BLOOD 13.30OCCULT BLOOD 1 RANDOM SPEC 13.30CYCLOSPOINE A TROUGH 13.86OLIGOCLONAL BANDS CSF 14.00RENIN ACTIVITY PLASMA 14.00VITAMIN B6 PLASMA 14.00METHYLMALONIC ACID (MMA) 15.00TESTOSTERONE FREE & TOTAL BLD 15.00ZINC LEVEL 15.76ACTH (CORTICOTROPIN) 16.00PSA FREE & TOTAL BLD 16.00ALDOSTERONE BLD 19.00C PEPTIDE BLD 20.00LEVETIRACETAM LVL 21.50OCCULT BLOOD STOOL-3 CARD 21.65ZINC 24.65KAPPA/LAMBDA LT CHAINS TOTAL 25.00

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TVRH Item Description Primary PriceLATEX IGE SERUM 25.70ALDOLASE-BLOOD 26.05MITOCHONDRIAL AB 26.15BETA 2 MICROGLOBULIN SERUM 26.65CELIAC DISEASE CASCADE 27.205-HIAA 24 HR URINE 28.20INSULIN SERUM 28.80I STAT-GLUCOSE(BLD REAGENT STRIP) 29.15ALPHA-1-ANTITRYPSIN SERUM 29.35TISSUE TRANGLUTAMINASE AB IGG 30.15TISSUE TRANSGLUTAMINASE IGA AB 30.15RENIN ACTIVITY 30.20METANEPHRINES FRAC 24H URINE 30.25GLUCOSE 30.45GLUCOSE-BODY FLUID 30.45GLUCOSE-CSF 30.45GASTRIN BLD 30.55CERULOPLASMIN SERUM 31.05LDL CHOLESTEROL-DIRECT 31.25ALPHA-1-ANTITRYPSIN PHENOTYPE 31.60CALCIUM IONIZED SERUM 31.65POTASSIUM-URINE (24 HOUR) 31.75POTASSIUM-URINE (RANDOM) 31.75VMA 24 HR URINE 31.85VMA RANDOM URINE 31.85GROWTH HORMONE (HGH) 31.95GBM IGG AB 32.00CATECHOLAMINE FRAC FREE URINE 32.45PROLACTIN-BLOOD 32.55ERYTHROPOIETIN (EPO) 32.65LITHIUM 32.65PSA FREE & TOTAL 33.10PSA 33.15FRUCTOSAMINE 33.45POTASSIUM 34.10SIROLIMUS (RAPAMYCIN) LVL 34.25LAMOTRIGINE BLOOD 34.65CRYOGLOBULIN BLOOD 35.10INSULIN-LIKE GROWTH FACTOR 1 35.50CYCLOSPORINE BLOOD 36.00ANGIOTENSIN CONVERT ENZYME (ACE) 36.70COPPER BLOOD 36.90CATECHOLAMINE FREE FRAC BLD 37.00CORTISOL FREE 24H URINE 37.05METHYLMALONIC ACID SERUM 37.05

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TVRH Item Description Primary PriceMYELIN BASIC PROTEIN 37.15GLIADIN IGG & IGA ANTIBODIES 37.40BLOOD UREA NITROGEN (BUN) 37.55CALCITONIN 37.70IRON 38.05PHOSPHORUS-URINE (24 HOUR) 38.20I STAT-PH (BODY FLUID) 38.80ALKALINE PHOS ISOENZYMES 39.10TACROLIMUS 39.50DEAMIDATED GLIADIN IGA AB 40.15DEAMIDATED GLIADIN IGG AB 40.15BHCG TUMOR MARKER 40.20CALCIUM 41.20CALCIUM-URINE(RANDOM) 41.20VITAMIN E SERUM 41.30IGG SYNTHESIS INDEX CSF 41.35BILIRUBIN FRACTIONATED 41.40FSH 42.10LUTEINIZING HORMONE (LH) BLOOD 42.35THYROXINE-BINDING GLOB (TBG) 42.65ALKALINE PHOSPHATASE 43.05IGE QUANT IMMUNOGLOB 43.30CELIAC DZ SEROLOGY 43.50ACETONE (SERUM) QUALITATIVE 43.65PHOSPHORUS 43.75CALCIUM-URINE (24 HR) 44.55VARICELLA ZOSTER IGG AB SERUM 44.70AFP TUMOR MARKER 44.90THYROID STIM IMMUNOGLOBULIN 45.00PROT ELECTROPHORESIS 24H URINE 45.40PROTEIN ELECTROPHORESIS, URINE 45.40AMIODARONE BLOOD 45.55CHROMOGRANIN A 45.60BILIRUBIN-TOTAL 45.70MYELOPEROXIDASE IGG AB 45.70C PEPTIDE 46.60C1 ESTERASE INHIBITOR AG 46.60GBM AB IGG 47.40IGG SUBCLASSES PANEL 48.10BETA HYDROXYBUTYRATE 48.15AMIKACIN PEAK SERUM 48.60AMIKACIN TROUGH SERUM 48.60OLIGOCLONAL BANDING CSF & SERUM 48.90T3 REVERSE 49.00IGG SUBCLASSES SERUM 49.70

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TVRH Item Description Primary PriceIMMUNOGLOBULIN A 50.25IMMUNOGLOBULIN G 50.25IMMUNOGLOBULIN M 50.25IMMUNOGLOBULIN PANEL 50.25MONOCLONAL PROTEIN 24H URINE 50.30MONOCLONAL PROTEIN STUDY URINE 50.30ALBUMIN 50.35ALBUMIN-BODY FLUID 50.35HEAVY METALS SCRN 24HR URINE 50.50SELENIUM 50.75LEVETIRACETAM BLOOD 51.60ACETYLCHOLINE REC BINDING AB 51.65ETHYLENE GLYCOL BLOOD 52.05PROGESTERONE SERUM 52.20ACTH PLASMA 52.60PHOSPHOLIPIDS SERUM 52.85FECAL FAT (LIPIDS) 53.30VITAMIN D 125 DIHYDROXY 53.45BILIRUBIN-DIRECT 53.55CREATININE 55.50CREATININE-BODY FLUID 55.50CREATININE-URINE (24 HOUR) 55.50CREATININE-URINE (RANDOM) 55.50THYROGLOBULIN PANEL BLD 55.75URIC ACID-BODY FLUID 56.10HISTONE AUTOANTIBODY 57.20HEAVY METAL PROFILE RANDOM URINE 57.90TRIGLYCERIDE-BODY FLUID 58.15TRIGLYCERIDES 58.15TRANSFERRIN 58.35PROTEIN ELECTROPHORESIS CSF \ BF 58.45SODIUM-URINE (24 HOUR) 59.15SODIUM-URINE (RANDOM) 59.15COMPLEMENT C1Q 59.20CHOLESTEROL 59.35CHOLESTEROL-BODY FLUID 59.35TESTOSTERONE FREE TOT & BIO 59.75T4 FREE DIRECT DIALYSIS 60.15I STAT-6+ 60.45SODIUM 60.45METHOTREXATE SERUM 60.50SIROLIMUS 60.70PROTEIN ELECTROPHORESIS 60.85HEAVY METALS SCRN BLOOD 60.95MAGNESIUM 61.15

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TVRH Item Description Primary PriceFREE T4 (THYROXINE) 61.80IMMUNOGLOBULIN D 62.60IONIZED CALCIUM 63.55OXCARBAZEPINE METAB (MHC) 63.70TESTOSTERONE FREE & TOTAL 63.75LACTATE (LACTIC ACID) 63.80TOTAL PROTEIN 64.25ALT (SGPT) 64.50VITAMIN B6 SERUM 64.65GLUCOSE-POST GLUCOSE(1 HR PP) 65.60PROBNP N-TERMINAL SERUM 66.05CHLORIDE-URINE (RANDOM) 66.30T3 TOTAL 68.15VITAMIN B-12 68.95METANEPHRINES FRAC FREE PLASMA 69.40PROTEIN RANDOM URINE 69.50PROTEIN-URINE (24 HOUR) 69.50PROTEIN-CSF 70.65PROTEN-TOTAL (BODY FLUID) 70.65ESTRADIOL SERUM 70.90FERRITIN 71.80THYROID STIM IMMUNOGLOB 72.65FOLATE 73.70IRON BINDING CAPACITY (TOTAL) 74.80LDH 75.70LDH-BODY FLUID 75.70CREATININE CLEARANCE 24HR URINE 76.10VITAMIN B1 (THIAMINE) WB 78.60PTH RELATED PROTEIN BLD 79.35MICROALBUMIN RANDOM URINE 79.55CARBON MONOXIDE 79.90DIGOXIN 82.15MULTIPLE SCLEROSIS PROFILE 82.50AST (SGOT) 82.80T3 FREE (TRI-IODOTHYRONINE FREE) 83.80URIC ACID 88.00PRE ALBUMIN 93.30PANCREATIC ELASTASE STOOL 96.75ACETYLCHOLINE RECEPTOR BLOCKING A 97.00ACETYLCHOLINE RECEPTOR MODULATING 97.00CORTISOL 98.50OSMOLALITY BLOOD 99.40HIV-1/HIV-2 AB CONF AND DIFF 100.00TESTOSTERONE 102.40THEOPHYLLINE 103.35

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TVRH Item Description Primary PriceHGB VARIANT BY MASS SPEC 103.55PHENOBARBITAL 103.65OSMOLALITY URINE 104.40TOTAL T4 (THYROXINE) 107.20LACOSAMIDE 108.05T3 UPTAKE(THYROID HORMONE) 108.50KAPPA/LAMBDA FREE LIGHT CHAINS 110.60CALCULUS ANALYSIS QUALITATIVE 111.15GGT 112.00ADULT FOOD ALLERGY PROF 114.15TSH (THYROID STIMULATING HORMONE) 116.40HAPTOGLOBIN QUANTITATIVE 117.40PHENYTOIN (TOTAL) 118.05CYSTIC FIBROSIS MUTATION PANEL 118.45ACE CSF 118.70CK (CPK) 119.15ISTAT CHEM8+ 122.40KAPPA & LAMBDA QNT LT CHAINS UR 122.45RENAL FUNCTION PANEL 123.75CARBAMAZEPINE 124.30IMMUNOFIXATION URINE 124.30GQ1B AB IGG 125.25HEMOGLOBIN A1C 128.05GONADOTROPIN CHORIONIC(HCG-QUAL) 129.35IFE 24H URINE 130.00IMMUNOFIX CRYOGLOBULIN 130.00AMMONIA 130.25DRUG SCREEN URINE MEDICAL 131.00CEA 132.05BRAIN NATURIETIC PEPTIDE (BNP) 133.00HEMOCHROMATOSIS GENE ANALYSIS 133.50ELECTROLYTE PANEL 134.00PTH INTACT W/CA 136.70IMMUNOFIXATION 137.00AMYLASE 148.90AMYLASE-BODY FLUID 148.90TOBRAMYCIN-PEAK 154.30TOBRAMYCIN-TROUGH 154.30ALPHA-FETOPROTEIN & AFP L3% 156.25MTHFR MUTATION BY PCR 159.55VANCOMYCIN NOT PEAK OR TROUGH 159.65VANCOMYCIN PEAK 159.65VANCOMYCIN TROUGH 159.65VAPOR ACID (DEPAKOTE) 159.75PROCALCITONIN 164.35

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TVRH Item Description Primary PriceLIPASE 165.60VITAMIN D 25 HYDROXY 173.00VITAMIN D 25-OH TOTAL 180.15GENTAMICIN (NOT PEAK OR TROUGH) 200.20GENTAMICIN-PEAK 200.20GENTAMICIN-TROUGH 200.20ALDOSTERONE SERUM 208.15LIPID PANEL 209.05PROBNP 209.50CALPROTECTIN STOOL 238.00HEPATIC FUNCTION PANEL 238.15GASES-BLOOD (ABG) ISG3+ 252.15ANTI-TSH AUTOANTIBODY 262.75DRUG SCREEN SERUM COMPRHENSIVE 264.10ALCOHOL (ETHANOL) 289.25BASIC METABOLIC PANEL 294.85SALICYLATE 301.95ACETAMINOPHEN 334.85ISTAT TROPONIN 336.30TROPONIN (QUANT) 336.30HEPATITIS PANEL ACUTE 347.60COMPREHENSIVE METABOLIC PANEL 359.20NMDA-R AB CBA CSF 425.00GONADOTROPIN CHORIONIC(HCG-QUANT) 494.95LYME AB IGG & IGM REFL BLOT 7.00CARDIOLIPIN AB IGG & IGM 7.40ACTIN (SMOOTH MUSCLE) AB 8.00CH50 TOTAL COMPLEMENT 9.00THYROID PEROXIDASE ANTIBODIES 9.00CA 27.29 BLD 9.55LYME DZ ABS BY BLOT 14.00MYELOPEROXIDASE ANTIBODY (MPO) 14.50BETA-2 GP1 IGG & IGM ABS 18.00MYCOPLASMA PNEUM ABS IGG/IGM 21.00ANCA VASCULITIDES ABS 22.50CMV IGG ANTIBODIES 22.50HEPATITIS A TOTAL ABS 24.85RHEUMATOID FACTOR-(RA QUAL) 25.50SMOOTH MUSCLE ANTIBODY 25.70LYME DISEASE ABS W/REFLEX WB 27.50CA 27.29 27.80DNA DS IGG AB 27.95CMV IGM ANTIBODIES 30.40VDRL (CSF) 30.70HEPATITIS B CORE TOTAL ABS 31.45

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TVRH Item Description Primary PriceHSV TYPES 1&2 IGG AB BLD 31.50CA 15-3 SERUM 32.25CMV IGG & IGM ANTIBODIES CSF 33.00HYPERSENSITIVITY PNEUMONITIS PANL 33.10PARVO B19 AB IGG & IGM 33.90COMPLEMENT TOTAL CH50 35.75HSV TYPE 1 & 2 IGG ABS 37.05CARDIOLIPIN ANTIBODIES 37.40CENTROMERE IGG AB 37.55INSTRINSIC FACTOR BLOCKING AB 38.85THYROID PEROXIDASE ABS 40.75ANCA VASCULITIS 40.95ANCA-RFLX 41.35CHG ONLY RPR TITER 42.20CYCLIC CITRULLINATED PEPTIDE IGG 42.25BLD TYPNG-RBC-NON ABO-CHRG ONLY 42.75RNP IGG ANTIBODIES 43.65SM IGG ANTIBODIES 43.65INDIRECT PLATELET ANTIBODY 43.70LYME DZ AB W/REF WB CSF 43.85INFLUENZA A IGG & IGM ABS 43.90INFLUENZA B IGG & IGM ABS 43.90MYCOPLASMA PNEUMO IGG & IGM 43.90LYME DISEASE IGM & IGG WB 45.55EPSTEIN BARR IGG&IGM AB SCR 46.25CRYPTOCOCCAL ANTIGEN CSF 47.25BARTONELLA IGG & IGM ANTIBODIES 49.60BRUCELLA AB IGG & IGM 49.85SCLERODERMA (SCL 70) ABS 49.90QUANTIFERON(R)-TB GOLD 50.00ANA COMPREHENSIVE CASCADE 50.90ASO TITER PROFILE 51.15C-REACTIVE PROTEIN 52.30RH CHARGE ONLY 53.25RH TUBE METHOD 53.25DNA (DS) IGG ANTIBODIES 55.00HEPATITIS BE PROFILE 55.10HTLV I / II AB SCREEN 55.75HEPATITIS B CORE AB TOTAL 56.00JO 1 AB IGG 56.15ENDOMYSIAL IGA ANTIBODIES 57.05SJOGREN'S ANTIBODIES 57.45LYME DZ AB BY WB CSF 57.60COLD AGGLUTININS BLD 58.10COCCIDIODES ANTIBODY SERUM 58.25

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TVRH Item Description Primary PriceABO TUBE METHOD 59.80BLOOD TYPING - ABO 59.80ENA ANTIBODIES 61.00ASPERGILLUS AG BLOOD 61.40FTA-ABS IGG 62.35Q FEVER AB IGG & IGM 62.50BETA-2 GLYCOPROTEIN AB PANEL 64.45QUANTIFERON GOLD PLUS MTB 69.00L/K MICROSOME TYPE 1 ABS 69.30INFLUENZA A&B ANTIGEN 70.55ANA TITER-CHARGE ONLY 70.65ANTIBODY-CMV-CHARGE ONLY 71.35DIRECT COOMBS 71.60TOXOPLASMA IGG / IGM ABS 72.25CRP HIGH SENSITIVITY (CARDIO) 77.45RPR-(SYPHILIS TEST-QUAL) 79.40STRIATED MUSCLE ABS 79.40HEPATITIS A VIRUS ANTIBODY IGM 80.70C3 COMPLEMENT 80.75C4 COMPLEMENT 80.75HEPATITIS B CORE ANTIBODY IGM 86.40CHG ONLY RA TITER 86.65HIV 1 /HIV II SCREEN 87.45COXSACKIE A ABS 89.25COXSACKIE B (1-6) ABS 89.25HIV AB CONFIRMATION PROFILE 89.30CCP AB IGG 90.00SJOGRENS ANTIBODIES (SSA & SSB) 90.34T-CELL & B-CELL QUANT BY FLOW 94.55TISSUE TRANGLUTAMINASE AB IGA&IGG 98.95EHRLICHIA AB PANEL 100.20WEAK D 101.00HISTOPLASMA AG URINE (MVISTA) 101.80CA 125 (CANCER ANTIGEN 125) 107.95CA 19-9 (CANCER ANTIGEN 19-9) 107.95GAD65 AB ASSAY BLD 111.75GAD65 AB ASSAY CSF 111.75CO FICIN/ENZ PANEL EA 117.20WEST NILE VIRUS ABS BLD 120.45ANCA C&P INFLAM BOWEL 121.45INVEST.TRANSF.RXN-INT. 128.50QUANTIFERON GOLD MTB 131.90HETEROPHILE AB (MONO SCREEN) 133.55HTLV I / II CONFIRMATION 142.85ARBOVIRUS ABS IGG/IGM CSF 144.00

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TVRH Item Description Primary PriceNMO IGG BLD 156.50NMO IGG CSF 156.50CO CELL SEPARATION 160.05HEPATITIS B SURFACE ANTIBODY 174.35M PNEUMONIAE IGM AB IFA 179.65ANA SCREEN 179.70HEPATITIS C ANTIBODY 256.55PARANEOPLASTIC AUTOAB EVAL CSF 315.35PARANEOPLASTIC AUTOAB EVAL BLOOD 330.45BLOOD TYP.ANTGN SCRN.-CHRG ONLY 364.15PROTEIN S ACTIVITY FUNCTIONAL 16.50PROTEIN C ACTIVITY FUNCTIONAL 18.00HEMOGLOBIN 26.60INFUSION CENTER H & H 26.60CHG ONLY PLATELET CNT 27.65PLATELET CLUMPING TEST 27.65ANTITHROMBIN 3 ACTIVITY 31.50WBC COUNT 32.30DIFFERENTIAL MANUAL 35.05PROTEIN S ANTIGEN TOTAL 35.75FACTOR VIII ACTIVITY LVL 40.00HEMATOCRIT 41.45PROTEIN S ACTIVITY BLOOD 41.85PROTEIN S ANTIGEN PLASMA 42.35PROTEIN C ANTIGEN PLASMA 42.90THROMBIN TIME 43.00PROTEIN C ACTIVITY-BLOOD 45.70INFUSION CENTER PT/INR 47.85ISTAT PT/INR 47.85PROTHROMBIN TIME 47.85FACTOR VIII ACTIVITY 59.20COAG FACTOR II ACTIVITY 64.40COAG FACTOR V ACTIVITY 64.40COAG FACTOR VII ACTIVITY 64.40COAG FACTOR XII ACTIVITY 64.40FIBRIN DEGRADATION PRODUCTS 67.75ANTI-XA 68.15HEPERIN PROTOCOL PTT 72.30PARTIAL THROMBOPLASTIN TIME 72.30SED RATE 77.90RETICULOCYTE (AUTO) 78.10INFUSION CENTER PLATELET CNT 78.45PLATELET COUNT AUTO 78.45VON WILLIBRAND FACTOR AG 89.80PROTHROMBIN G20210A MUTATION 92.05

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TVRH Item Description Primary PriceCBC W/DIFF 93.45CBC (HEMOGRAM) 93.70FIBRINOGEN 97.45PFA PLAVIX ASSAY 99.65ISTAT ACT CELITE 105.20PLATELET FUNCTION ASSAY 106.35HEPARIN PF4 ANTIBODY (HIT) 108.35COAG FACTOR X ACTIVITY 120.35VON WILLEBRAND FAC AG 137.45RISTOCETIN COFACTOR 137.95COAG FACTOR VIII INHIBITOR 145.85VON WILLEBRAND FACT ACT 156.25D-DIMER (QUANTITATIVE) 176.40SEROTONN RELES ASSAY UNFRAC HEPAR 317.55FACTOR V LEIDEN MUTATION G1691A 319.80VON WILLEBRAND FACTOR PROTEASE AC 339.25VON WILLEBRAND PROFILE 347.45GIARDIA AG EIA STOOL 8.00HELICOBACTER PYLORI AG FECES 10.00CULTURE & SMEAR FUNGUS 24.50SMEAR PRIMARY WET MOUNT 27.60AEROBIC ISOLATE DEF ID CHG ONLY 31.45LEGIONELLA CULTURE 32.70OVA & PARASITE 33.85HOMOGENIZATION TISSU CULT CHG ONL 34.45RSV ANTIGEN 38.50CONCENTRATION- CHRG ONLY 42.20GIARDIA ANTIGEN STOOL 44.95VIRAL CULTURE NON-RESPIRATORY 48.35VIRAL CULTURE RESPIRATORY 48.35SHIGA TOXINS - CHRG ONLY 55.15HELICOBACTER PYLORI AG STOOL 56.90MOLD ISOLATE DEF ID CHARGE ONLY 56.95YEAST ISOLATE DEF ID CHARGE ONLY 56.95SENSITIVITY KIRBY-BOW - CHRG ONLY 58.70FUNGAL BLOOD CULUTRE 61.85VZV PCR CSF 64.90ANAEROBIC CULTURE CHARGE ONLY 67.25ACID FAST BACILLI BLOOD CULTURE 74.10LEGIONELLA URINARY ANTIGEN 74.95STREP PNEUMONIAE URINARY ANTIGEN 74.95ANAEROBIC CULTURE W/ GRAM STAIN 76.95HERPES SIMPLEX VIRUS 1&2 PCR 79.65ENTEROVIRUS PCR 82.45CAMPYLOBACTER ANTIGEN CHG ONLY 83.20

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TVRH Item Description Primary PriceJC VIRUS PCR CSF 86.75SENSITIVITY MIC - CHRG ONLY 88.10GRAM STAIN CHARGE ONLY 88.50SMEAR-PRIMARY (GRAM STAIN) 88.50EOSINOPHL-URINE 89.70CMV PCR FLUIDS 95.25CRYPTOSPORIDIUM PARVUM ANTIGEN 98.65PARASITE PANEL I 98.65ANAEROBIC ISOLATE DEF ID CHG ONLY 108.25BABESIA MICROTI PCR 111.20HEPATITIS B SURFACE ANTIGEN 114.90EBV PCR FLUIDS 120.05LYME DZ PCR BLOOD 120.05LYME DZ PCR CSF 120.05AFB STAIN 121.35HEP C RNA DETECTION & QN RTPCR 122.85ROTAVIRUS ANTIGEN 123.85HSV TYPE 1&2 RT PCR CSF 125.00CULTURE URINE 125.55CULTURE MRSA SCREEN 137.60CULTURE VRE SCREEN 137.60STREP SCREEN GROUP A 137.60HIV-1 RNA QUANT VIRAL LOAD 148.70HHV-6 CSF 159.75CMV QUANT PCR PLASMA 160.95GC GENPROBE-CHARGE ONLY 180.40GC/CHLAMYDIA GENPROBE 180.40HEPATITIS B QUAL TO QUANT RT PCR 183.65C DIFFICILE TOXIN A AND B 188.60CULTURE & GRAM STAIN SPUTUM 207.00CULTURE & SMEAR BODY FLUID 207.00CULTURE & SMEAR RESPIRATORY 207.00CULTURE & SMEAR ROUTINE 207.00C DIFFICILE TOXIN B BY PCR 240.80MRSA PCR ASSAY 251.85CULTURE & SMEAR AFB 262.25CSF CULTURE W/GRAM STAIN 275.95ENVIRONMENTAL CULTURE 275.95THROAT CULTURE 275.95CULTURE BLOOD 278.55CATHETER TIP CULTURE 278.95EAR CULTURE W/ GRAM STAIN 278.95EYE CULTURE W/ GRAM STAIN 278.95MEDICAL DEVICE CULTURE 278.95WOUND/MISC CULT W/GRAM STAIN 278.95

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TVRH Item Description Primary PriceCULTURE STOOL 279.35HIV 1 GENOTYPIC DRUG RESISTANCE 350.70HEPATITIS C GENOTYPE BLD 1,347.35VOLUME MEASURE CHARGE ONLY 14.35URINE-CHEMISTRIES ONLY 43.90POINT OF CARE HCG 183.00URINE PREGNANCY TEST(HCG-QUAL) 183.00CRYSTAL ID BODY FLUID 61.80FECAL LEUKOCYTES BY LACTOFERRIN 112.80CELL COUNT-BODY FLUID 114.95CELL COUNT-CSF 114.95DECALCIFICATION 110.40IMMUNOCYTOCHEMISTRY ADDL SLIDE 154.60SPECIAL STAINS GRP II 182.85HER2/NEU ERA/PRA EA AB MANUAL 215.95SPECIAL STAINS GRP I MICROOGNSMS 216.25IMMUNOCYTOCHEMISTRY 1ST SLIDE 251.25CYT EXAM TOUCH SQUASH EA ADDL 68.80CYT EXAM TOUCH SQUASH IST SITE 68.80FLOW CYTOMETRY EA ADD MARKER 95.85THINPREP 120.10SMEAR SCREENING & INTERPRETATION 130.20FNA ADEQUATE SMEARS 144.95FLOW CYTO SURFACE MRKR 1ST MRKR 214.20LEVEL I GROSS ONLY 84.40IMMUNOFLUORESCENT STAIN EA AB 141.90ADD FROZEN SECTION (SAME SITE) 151.80LEVEL II GROSS & MICRO 284.45LEVEL III GROSS & MICRO 284.45FROZEN SECTION EA DISTINCT SITE 296.60LEVEL IV GROSS & MICRO 303.05LEVEL V GROSS & MICRO 487.30LEVEL VI GROSS & MICRO 568.35ELECTRON MICROSCOPY 813.30XR ERCP BILIARY 104.70XR SACROILIAC JOINTS 112.55XR L-SPINE FLEX/EXT ONLY 120.85XR STERNOCLAVICULAR JTS BIL 182.65XR EYE BIL FOREIGN BODY 191.65XR L-SPINE COMP FLEX/EXT 203.45XR HIP OPERATIVE LT 204.20XR HIP OPERATIVE RT 204.20XR UGI AIR CONTRAST 251.00XR ERCP PANCREATIC 251.10XR SPINE ENTIRE AP AND LAT 259.45

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TVRH Item Description Primary PriceFLUORO GUIDE/LOC(L/P) 273.65SP BIOPSY FLUORO S & I 273.65SP FL/GUIDE/NEEDL/PLA/SPINE 273.65SP FLUOROSCOPIC GUIDANCE 273.65SP LUNG BIOPSY S & I 273.65XR FLUOROSCOPIC GUID NDLE PLC 273.65XR GI TRACT UPPR/FLMS W/KUB 285.40XR STERNUM 288.85XR VIDEO SWALLOW 293.80SP CYSTOGRAM CONT COMP S&I 299.30XR CYSTOGRAPHY 299.30XR CLAVICLE LT 301.00XR CLAVICLE RT 301.00SP FLUORO GUIDANCE 303.30XR HIP BIL COMPLETE 306.05XR TM JOINTS BIL 308.75XR HIP LT COMPLETE 313.60XR HIP POST FEM PROS LT 313.60XR HIP POST FEM PROS RT 313.60XR HIP POST REDUCTION LT 313.60XR HIP POST REDUCTION RT 313.60XR HIP POST TOTAL HIP LT 313.60XR HIP POST TOTAL HIP RT 313.60XR HIP RT COMPLETE 313.60XR MOBILE HIP LT 73501 313.60XR MOBILE HIP RT 73501 313.60FL SNIFF TEST 342.80XR BONE SURVEY INFANT COMPLETE 346.75SP NG/ J-TUBE INSERTION S&I 353.70XR UGI W/SM BOWEL 363.00SP FL GUIDAN VENOUS ACCESS DEVICE 368.85XR FL GUIDED VENOUS ACCESS DEVICE 368.85XR CHOLANG/PNCR INTRAOP 375.30XR URETHROCYSTO VOIDING S&I 383.65XR RIBS LT 389.10XR RIBS RT 389.10XR FEMUR LT 391.00XR FEMUR RT 391.00XR MOBILE FEMUR LT 2 VIEW 391.00XR ARTHROGRAM SHOULDER LT S&I 391.15XR ARTHROGRAM SHOULDER RT S&I 391.15SP INJ FACET JOINT LUMB. S&I 393.00XR RIBS BILATERAL 413.05XR FACIAL BONES LIMITED 416.20XR OSSEOUS SURVEY COMPLETE 417.00

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TVRH Item Description Primary PriceXRAY ABDOMEN 1 VIEW 421.70SP CYSTOGRAM CONT COMP 434.25XR FL CYSTOGRAM CONTRAST COMPLETE 434.25XR FINGER LT 2ND DIGIT 445.40XR FINGER LT 3RD DIGIT 445.40XR FINGER LT 4TH DIGIT 445.40XR FINGER LT 5TH DIGIT 445.40XR FINGER LT THUMB 445.40XR FINGER RT 2ND DIGIT 445.40XR FINGER RT 3RD DIGIT 445.40XR FINGER RT 4TH DIGIT 445.40XR FINGER RT 5TH DIGIT 445.40XR FINGER RT THUMB 445.40XR TOE LT 5TH DIGIT 448.80XR TOE LT GREAT TOE 448.80XR TOE RT 2ND DIGIT 448.80XR TOE RT 3RD DIGIT 448.80XR TOE RT 4TH DIGIT 448.80XR TOE RT 5TH DIGIT 448.80XR TOE RT GREAT TOE 448.80XR FOOT LT AP/LAT 450.60XR FOOT LT COMPLETE 450.60XR FOOT RT AP/LAT 450.60XR FOOT RT COMPLETE 450.60XR MOBILE FOOT LT 450.60XR MOBILE FOOT RT 450.60XR ELBOW L POST REDUCTION 450.90XR ELBOW LT TWO VIEWS 450.90XR ELBOW R POST REDUCTION 450.90XR ELBOW RT TWO VIEWS 450.90XR MOBILE ELBOW LT 450.90SP DILATATION NEPHROSTOMY S&I 458.40SP URETER STENT/DILITATION S&I 458.40SP URETERAL DILATATION S&I 458.40SP EXT/VEIN INJ/VENOG 460.50VENOGRAM EXTREMTY UNILATERAL 460.50XR PELVIS 3+ VIEWS COMPLETE 461.30XR SKULL LIMITED 467.80XR ANKLE LT AP/LAT 469.15XR ANKLE RT AP/LAT 469.15XR MOBILE ANKLE LT 469.15XR MOBILE ANKLE RT 469.15ANGIOGRAM FOLLOW-UP STUDY 480.00XR FOREARM LT 486.45XR FOREARM RT 486.45

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TVRH Item Description Primary PriceXRAY ABDOMEN 2 VIEW 488.00XR SPINE ENTIRE 4/5 VIEWS 72083 488.65XR MOBILE PELVIS 500.10XR PELVIS AP 500.10XR NECK SOFT TISSUE 501.60XR SCAPULA LT 507.05XR SCAPULA RT 507.05XR HAND LT AP/LAT 513.45XR HAND RT AP/LAT 513.45XR C-SPINE AP/LAT 514.70XR MOBILE CERVICAL SPINE 514.70XR HUMERUS LT 522.70XR HUMERUS RT 522.70XR MOBILE HUMERUS LT 522.70XR ORBITS COMPLETE 529.85SP CHANGE CYSTOSTOMY TUBE S&I 530.05SP NEPHROSTOMY TUBE CHANGE S&I 530.05SP PERC DRAINGE CATH EXCHANGE S&I 530.05SP URETEROSTOMY CTH CHANGE S&I 530.05XR FLURO TUBE CHECK 530.35XR UROGRAPHY RETROGRADE/KUB 535.10XR SACRUM AND COCCYX 537.60XR FACIAL BONES COMPLETE 540.00SP ABSCESSOGRAM (TUBE CHECK) S&I 540.05SP FISTULA/SINUS TRACT S&I 540.05XR NASAL BONES 540.05XR MOBILE WRIST LT 540.90XR MOBILE WRIST RT 540.90XR WRIST L POST REDUCTION 540.90XR WRIST LT AP/LAT 540.90XR WRIST LT COMPLETE 540.90XR WRIST R POST REDUCTION 540.90XR WRIST RT AP/LAT 540.90XR WRIST RT COMPLETE 540.90XR ACROMCLAV JTS BILAT/WTD DIST 547.25XR PERITONEOGRAM S & I 547.60XR HAND LT 549.60XR HAND RT 549.60XR CALCANEUS LT 550.20XR CALCANEUS RT 550.20SP LLEOCONDUIT INJECTION S&I 557.70SP URETEROGRAPHY EXIST CATH S&I 557.70XR SHOULDER LT COMPLETE 558.85XR SHOULDER RT COMPLETE 558.85XR MOBILE SHOULDER LT 563.50

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TVRH Item Description Primary PriceXR MOBILE SHOULDER RT 563.50XR SHOULDER LT ONE VIEW 563.50XR SHOULDER LT POST REDUCTION 563.50XR SHOULDER RT ONE VIEW 563.50XR SHOULDER RT POST REDUCTION 563.50XR SINSUSES COMPLETE 568.10XR ANKLE LT COMPLETE 572.15XR ANKLE RT COMPLETE 572.15XR ELBOW BIL COMPLETE 576.50XR ELBOW LT COMPLETE 576.50XR ELBOW RT COMPLETE 576.50XR ABDOMEN 3 OR MORE VIEWS 585.60XR MANDIBLE COMPLETE 589.85XR MOBILE TIB/FIB LT 591.85XR MOBILE TIB/FIB RT 591.85XR TIB/FIB LT 591.85XR TIB/FIB RT 591.85XR L-SPINE AP/LAT 612.85XR MOBILE LUMBAR SPINE 612.85XR KNEE LT COMPLETE 650.30XR KNEE RT COMPLETE 650.30XR C-SPINE W/FLEX-EXT 658.45XR KNEE LT AP/LAT 661.00XR KNEE RT AP/LAT 661.00XR MOBILE KNEE LT 661.00XR MOBILE KNEE POST TKA LT 661.00XR MOBILE KNEE POST TKA RT 661.00XR MOBILE KNEE POST UNI LT 661.00XR MOBILE KNEE POST UNI RT 661.00XR MOBILE KNEE RT 661.00XR BARIUM SWALLOW 743.45XR C-SPINE COMPLETE 744.90XR THORACOLUMBAR SPINE 770.50XR ABDOMEN SERIES W/PA CHEST 775.10XR RIBS BIL W/PA CHEST 779.75XR MOBILE THORACIC SPINE 781.90XR T-SPINE W/SWIMMERS VIEW 781.90XR UPPER GI 792.45XR RIBS LT W/PA CHEST 803.70XR RIBS RT W/PA CHEST 803.70UGI W/AIR CONTRAST 829.45XR ARTHROGRAM SHOULDER LFT 842.20XR ARTHROGRAM SHOULDER RT 842.20XR L-SPINE COMPLETE 868.95XR SMLL INTEST INCLUD SERI FLMS 879.80

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TVRH Item Description Primary PriceSP VISCERAL S&I 964.85VISCERAL SELECTIVE S&I 964.85XR SKULL COMPLETE 975.00XR KNEE BIL STANDING 975.35SP ABSCESS DRAINAGE S&I 1,012.65CL VENOGRAM BILAT S & I 1,035.40SP VENOGRAM BILAT S & I 1,035.40SP PORTAL VEIN CATH S&I 1,065.00PELVIC SELECTIVE S&I 1,104.00XR CLN AIR CNTR W/HD BARI/GLUC 1,114.50XR COLON BARIUM ENEMA/KUB 1,114.50SP HYSTEROSALPINGOGRAM S&I 1,118.25SP CHOLEDOCHAL STENT S&I 1,226.80XR ERCP BILIARY/PANCREATIC 1,244.95SP PULMONARY ANGIO-BILATERAL S&I 1,301.15VENA CAVA INFERIOR S&I 1,374.15ABD AO+BIL ILEOFEM LO SERGRA S&I 1,562.00ABDOMINAL AO S&I 1,562.00SP ABDOMINAL ANGIOGRAPHY S&I 1,562.00SP ABDOMINAL RUNOFF S &I 1,562.00EA ADD VES AFTER BASIC EXAM S&I 1,587.65SP ANGIO SEL EA VESS AFTER BASIC 1,587.65SP TRANSPORT WO HEMODYNAMIC S&I 2,099.90EXTREMITY BILATERAL SELEC S&I 2,125.40EXTREMITY UNILATERAL SELEC S&I 2,125.40SP EXTREMITY ANGIO-BILATERAL S&I 2,125.40SP EXTREMITY ANGIO-UNILAT S & I 2,125.40SP CHOLANGIO PERC NEW 47532 6,050.00SP EA ADDL VESSEL AFTER BASIC 1,587.65CHEST X RAY ONE VIEW FRONTAL 390.00CHEST XRAY 2VW FRONTAL&LATL 472.00CHEST XRAY FRNT LAT LORDOTC 529.00CHEST X-RAY 4/> VIEWS 621.00SP CHEMO ADMIN CNS 643.00HI COMPLX IV PUSH ADDITIONAL DRUG 294.90HI COMPLX IV INFUS ADDITIONAL HR 177.75HI COMPLX IV INFUS EA ADD DRUG<1H 177.75HI COMPLX IV INFUS SGL/INITIAL HR 752.90NM THYROID IMAGING 424.25NM RADIOPH INFLM TOMGR (SPECT) 668.75NM PULMONARY QUANT PERF/VENT 813.55NM HIDA W/ PHARM INTERVEN 838.30NM HIDA W/MORPHIN 838.30NM HIDA W/O PHARM INTERVEN 838.30NM CEREBROSPINAL FLOW CISTERNOGR 419.60

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TVRH Item Description Primary PriceNM RADIOPH LOC INFLM PRCS WHL BD 668.75NM RADPHARM LOC INFLM PROCS LIM 668.75NM GI BLOOD LOSS 695.45NM THYROID CA WHOLE BODY 793.15NM TUMOR LOCALIZATION TOTAL BODY 840.10NM PULMONARY (QUANT) (PERFUSION) 849.35NM PULMONARY PERFUSIO IMAG PARTI 849.35NM BONE &/OR JT IMAGING WHOL BOD 950.65NM GASTRIC EMPTYING STUDY 984.20NM BONE SPECT 1,157.85NM KIDNEY IMAGING WITH FUNCTION 1,166.45NM TRIPLE RENAL IMAGE 1,435.70NM BONE SCAN 3 PHASE 1,470.80NM MYOCAR PERF IMAG SPECT SINGLE 1,472.50NM RENAL SCAN AND FLOW 1,543.70NM LYMPHATICS/LYMPH NODES IMAGIN 1,604.65NM LYMPHOSCINTIGRAPHY LEFT 1,604.65NM PULMONARY PERFUSION AND AEROSO 1,710.95NM GATED WALL MOTION RESTING 1,761.05NM BRAIN IMAG COMPL W/VASCU FLOW 1,826.40NM THYROID CA THERAPY 2,123.05NM LIVER/SPLEEN IMAG STATIC ONLY 2,243.80NM MYO PERF MULTI SPECT W EF/WM 5,000.65NM ZZ IDOINE 1 131 OVER 6 MCI 74.15NM ZZ THALLOUS CHLORIDEI 201 82.70NM ZZ 1-131 PER MCI 83.35NM ZZ TECH TC99 LBL RBC P/ST (30M 98.90NM ZZ TC99M DTPA 103.30NM ZZ GALLIUM PER MCI 116.70NM ZZ TC99M MAA 151.95NM ZZ LABEL RED BLOOD CELL PE MCI 187.20NM ZZ CHOLETEC PER VIAL 232.25NM ZZ TC99M TETROFSMIN 321.20NM ZZ MDP PER UP TO 30 MCI 330.85NM ZZ TC99M PERTECHNETATE 331.25NM ZZ SULFUR COLLOID PER DOSE 346.45NM ZZ MYOVIEW PER DOSE 519.15NM ZZ TC 99M MERTIATIDE (MAG 3) 628.55NM ZZ IN-111 DTPA 1,917.25NM ZZ IN-111 WBC 2,013.95CTA HEART W/WO 3D/ART/STR/MOR 318.95CTA HEART WO EVAL COR CAL 870.85CTA HRT W/O -EVAL CORN CAL 870.85CT GUIDANCE ABALATION 1,224.75SP RADIO ABLATION-CT GUIDE S&I 1,224.75

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TVRH Item Description Primary PriceCT GUID FOR NEEDLE BIOPSY 1,349.55CTA ABDOM/PELVIS/ W/CONTRAST 1,646.10CT CYSTOGRAM 2,536.85CT THORAX W CONTRAST 2,671.25CT ABDOMEN & PELVIS WO CONTRAST 3,398.35CT ABDOMEN/PELVIS (ORAL ONLY) 3,398.35CT ABDOMEN/PELVIS (STONE) 3,398.35CT ABDOMEN & PELVIS WITH CONTRAST 3,848.10CT ABDOMEN/PELVIS (IV ONLY) 3,848.10CT ENTEROGRAPHY W/ IV CONTRAST 3,848.10CT ABDOMEN & PELVIS W/WO CONTRAST 5,897.10CT ANGIOGRAM NECK W/O & W CONT 1,010.35CT SOFT TISSUE NECK W/O CONTRAST 1,578.25CT ORBIT SELLA/FOSSA/MID/INNR 1,701.45CT TEMPORAL BONES W/O CONTRAST 1,701.45CT MASTOIDS W CONTRAST 1,713.60CT SOFT TISSUE NECK W CONTRAST 1,713.60CT MAXILLOFACIAL AREA W/O CONTR 1,851.95CT SINUS 1,851.95CT ORBITS SELLA OR IACS W/CONT 1,859.75CT MAXILLOFACIAL W/CONT. 1,907.60CTA BRAIN W/O & W/CONT. 2,095.00CT HEAD OR BRAIN W/O CONTRAST 2,101.05CT HEAD OR BRAIN W CONTRAST 2,491.60CT HD/BRN W/O CONTRST/CONTR/SEXT 3,242.25CT ANGIO LOWER EXTREMITY LEFT 909.30CT ANGIO UPPER EXTREMITY LEFT 909.30CT ANGIL AORTO-FEM RUN OFF W/O&W 1,009.85CT ANGIO LOWER EXTREMITY RIGHT 1,010.35CT ANGIO UPPER EXTREMITY RIGHT 1,010.35CT THORACIC SPINE W/O CONTRAST 1,274.55CT ANKLE LT W/O CONTRAST 1,372.30CT ANKLE RT W/O CONTRAST 1,372.30CT FEMUR LT W/O CONTRAST 1,372.30CT FEMUR RT W/O CONTRAST 1,372.30CT FOOT LT W/O CONTRAST 1,372.30CT FOOT RT W/O CONTRAST 1,372.30CT HIP LT W/O CONTRAST 1,372.30CT HIP RT W/O CONTRAST 1,372.30CT KNEE LT W/O CONTRAST 1,372.30CT KNEE RT W/O CONTRAST 1,372.30CT LOW EXTREMITY W/O CONTR BILAT 1,372.30CT LOW EXTREMITY W/O CONTRAST-LT 1,372.30CT LOW EXTREMITY W/O CONTRAST-RT 1,372.30CT TIB/FIB LT W/O CONTRAST 1,372.30

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TVRH Item Description Primary PriceCT ELBOW LT W/O CONTRAST 1,508.75CT ELBOW RT W/O CONTRAST 1,508.75CT HAND LT W/O CONTRAST 1,508.75CT HAND RT W/O CONTRAST 1,508.75CT HUMERUS RT W/O CONTRAST 1,508.75CT SHOULDER LT W/O CONTRAST 1,508.75CT SHOULDER RT W/O CONTRAST 1,508.75CT UPPER EXTREM W/O CONTR-LT 1,508.75CT UPPER EXTREMITY W/O CONTR-RT 1,508.75CT WRIST LT W/O CONTRAST 1,508.75CT WRIST RT W/O CONTRAST 1,508.75CT CTA AAA 1,577.50CT PULMONARY ANGIOGRAM W/O & W/CO 1,777.25CTA CHEST W/CONTRAST 1,777.25CT ANKLE LT W/ CONTRAST 1,815.05CT FEMUR RT W/ CONTRAST 1,815.05CT FOOT LT W/ CONTRAST 1,815.05CT FOOT RT W/ CONTRAST 1,815.05CT HIP LT W/ CONTRAST 1,815.05CT HIP RT W/ CONTRAST 1,815.05CT KNEE LT W/ CONTRAST 1,815.05CT KNEE RT W/ CONTRAST 1,815.05CT LOWER EXTREMITY W CONTRAST-LT 1,815.05CT LOWER EXTREMITY W CONTRAST-RT 1,815.05CT TIB/FIB LT W/ CONTRAST 1,815.05CT THORACIC SPINE W/CONT. 1,822.15CT T-SPINE POST MYELO 1,822.15CT PELVIS W/O CONTRAST 1,902.70CT ELBOW LT W/ CONTRAST 1,995.60CT FOREARM RT W/ CONTRAST 1,995.60CT HAND LT W/ CONTRAST 1,995.60CT HAND RT W/ CONTRAST 1,995.60CT HUMERUS RT W/ CONTRAST 1,995.60CT SHOULDER LT W/ CONTRAST 1,995.60CT SHOULDER RT W/ CONTRAST 1,995.60CT UPPER EXTREMITY W CONTRAST-LT 1,995.60CT UPPER EXTREMITY W CONTRAST-RT 1,995.60CT LUMBAR SPINE W/O CONTRAST 2,182.65CT PELVIS W CONTRAST 2,406.10CT CERVICAL SPINE W/O CONTRAST 2,425.30CT L-SPINE POST MYELO 2,466.00CT LUMBAR SPINE W/CONT. 2,466.00CT THORAX HIGH RESOLUTION 2,502.20CT THORAX W/O CONTRAST 2,502.20CT ABDOMEN W/O CONTRAST 2,865.45

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TVRH Item Description Primary PriceCT ABDOMEN W CONTRAST 3,128.40CT HIP RT WO/W CONTRAST 3,185.85CT CERVICAL SPINE W/CONT. 3,292.05CT C-SPINE POST MYELO 3,292.05CT PELVIS W/O CONTR/W CONTR 3,416.35CT UPPR EXTRMY W/ W/O CONTR-RT 3,504.35CT LUMBAR SPINE W/O & W/CONT. 3,611.40CT THORAX W/O CONTRAST/CONTR 4,075.65CT CERVICAL SPINE W/O & W/ CONT. 4,354.45CT ABDN W/O CONTRST/CNTR/SEXT 4,920.70OPERATING ROOM TIME 104.10COLLECT BLOOD PORT/ACCESS DVC 106.90BLADDER INSTILLATION 259.75XR FL JOINT INJECTION LT 359.20XR FL JOINT INJECTION RT 359.20DECLOT PORT W/THROMB AGENT 379.45DECLOT VENOUS DEVICE W/THROMBOLYT 379.45INTRO NEEDLE EXTR ART 502.20INJ PROCEDURE EXTREM VENOGRAPHY 503.40PERICARDIOCENTESIS 545.10INTRO CATHETER AO 726.85FL CV CATH INJ/CHECK 863.25US PSEUD ANEURYSM THROMBIN INJ 876.20XR FL LUMBAR PUNCTURE THERA 896.50US THORACENTESIS LEFT 917.60US THORACENTESIS W/TUBE INSERT LT 917.60XR FL MYELOGRAM 2+ LEVELS 954.70XR FL MYELOGRAM CERVICAL SPI 954.70XR FL MYELOGRAM LUMBOSACRAL 954.70IAB PERCUTANEOUS INSERTION 1,044.65REPAIR CVAD CATH W/O PORT/PUMP 1,093.00VENA CAVA INFERIOR/SUPERIOR 1,303.00POST-OP PAIN BLOCKS 1,368.60PRIMARY ART MECH THROMB ADL VES 1,420.65XR FL LUMBAR PUNCTURE DIAGNOSTIC 1,535.801ST ORD BRANC-RENAL/JUG/HEP 1,652.85XR FL BLOOD PATCH 1,819.30DRAINAGE HEMATOMA FLUID 2,031.051ST ORDER THOR/BRACHIOCEPHALIC BR 2,210.10SP THROMBOLYSIS ART NON-COR 2,222.80ADD 2ND/3RD ORD ABD/PEL/LWR EXT A 2,350.40REVISE/RELOCATE SKIN POCKET DEFIB 2,450.602ND ORDER BRANCH 2,557.95REPOSITION DUAL LEAD >15DAYS 2,612.751ST ORD ABD/PEL/LOWER EXTR ART BR 2,638.00

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TVRH Item Description Primary PriceREMOVE TRNVNS PCMKR SNGL LEAD 2,663.30RMVL SNGL/DUAL DEFIB ELEC TRNSVEN 2,663.30RMVL TRNSVEN ELEC DUAL LEAD 2,663.30SUBQ RMVL SNGL/DUAL DEFIB PLS GEN 2,663.30INSERT NON-TUNNEL CV >5 YRS 2,836.90REPLACE PICC W/O PORT 2,836.90REPLACE PICC W/O PORT 2,836.90INSERTION PICC OVER 5 YEARS 2,839.65INSERTION PICC OVER 5 YEARS 2,839.652ND ORD ABD/PEL/LOWER EXTR ART BR 2,840.50SEC PERC THROMB EA ADD VESSEL 2,993.803RD ORD ABD/PEL/LOWER EXTR ART BR 3,212.45PRIMARY ART MECH THROMB 1ST VES 3,529.30TIB/PER REVASC ADD-ON 4,469.65RENAL ANGIO SEL 4,512.10THROMBOLYSIS NON-COR DC 4,960.15ILIAC REVASC 5,605.00FEM/POPL REVAS W/TLA 5,936.25TIB/PER REVASC W/TLA 5,936.25INSERT TRANS ELEC SGL CHAMBER PAC 7,067.20TRLUML PERIP ATHRC ILIAC ART 9,302.25TIBPER REVASC W/ATHER ADD-ON 9,492.85LITHOTRIPSY USE 9,529.70UPGRADE SINGLE CHAMBER TO DUAL 10,004.65TIB/PER REVASC W/STENT 10,253.80SEL CATH PL COM CAR IN ART EX 11,376.15SEL CATH PL COM CAR IN ART IN 11,376.15SEL CATH PL INT CAROTID UNI 11,376.15FEM/POPL REVAS W/ATHERECTOMY 11,569.90TIB/PER REVASC W/ATHER 11,569.90REVSC OPN/PRQ TIB/PERO STENT 11,647.70ILIAC REVASC W/STENT 12,783.00FEM/POPL REVASC W/STENT 13,114.25INSERT/REPOS DEFIB LEAD/GEN 13,431.55TRANSCATH INTRAVASC STENT ADD 15,507.50TIB/PER REVASC STENT & ATHER 15,887.45TIB/PER REVASC STNT & ATHER 16,670.85FEM/POPL REVASC STNT & ATHER 18,747.85TRANSCATH INTRVSC STNT OPN/PER 20,857.40VASC EMBOLIZATION/OCCLSN ART 31,186.25TRANSCATH INTRVASC STENT 32,066.25SP URETEROGRAPHY THRU EXIST CATH 101.65MINOR ASC ROOM USE 168.10SP LLEOCONDUIT INJECTION 196.05SP INJ TRIGGER PT 1-2 MUSCLE(S) 197.05

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TVRH Item Description Primary PriceSP NEPHROSTOGRAM EXISTING 216.20SP T-TUBE CHOLANGIO EXISTING 223.30SP ASP BONE MARROW W/BX SAME DAY 257.60SP BIOPSY LIVER W/PROCEDURE 270.00SP BIOPSY BILIARY ENDOLUMINAL 292.50SP CHANGE CYSTOSTOMY TUBE SIMPLE 301.25SP HYSTEROSALPINGOGRAM 305.40SP ABSCESSOGRAM (TUBE CHECK) 321.60SP BX BONE MARROW 340.25REMOVAL OF IMPLANT EVENT RECORDER 354.90SP JOINT (MAJOR) INJECTION RT 359.20SP JOINT(MAJOR) INJECTION LT 359.20SP DILATATION NEPHOSTOMY TRACT 369.50SP NEPHROSTOMY PERCUTANEOUS COMP 369.50SP CHOLANGIO PERC EXISTING 375.15SP RADIO ABLATION LIVER TUMOR EXT 377.90SP DECLOT THROMBOLYTIC VASCULAR A 379.45SP LYMPH NODE BIOPSY 383.65SP BIOPSY NEEDLE PLEURA PERCUTANE 411.40SP BONE BIOPSY SUPERFICIAL 420.35SP ASPIRATION OF ABSCESS OR CYST 426.55SP URETERAL BALLOON DILATION 432.95SP INJ CNTR W/FLUOR EVAL G/D/J TB 439.30SP FINE NEEDLE ASP W/O IMAGING 475.45SP FISTULA/SINUS TRACT 502.60SP ABSCESS DRAINAGE LIVER 516.30SP ARTHROCENTESIS INT US 535.85SP ARTHROCENTESIS LG US 535.85SP INTRO LONG GI TUBE 547.15SP BIOPSY LUNG LT 557.85SP BIOPSY LUNG RT 557.85SP GASTROSTOMY TUBE EXC. 576.75SP BIOPSY MUSCLE 588.30SP RADIOFREQUENCY ABLATION RENAL 638.20SP CHEST TUBE INSERTION 641.70SP FACET JT INJ L/S FIRST 646.25SP RENAL CYST ASPIRATION 693.40SP FINE NEEDLE ASP W/ IMAGING 704.80SP INJ AIR/CONTR PERITONEAL CAV 733.85SP ASP PUNC ABSC/CYST/HEMA/BULLA 746.00SP PARACENTESIS 749.70SP BONE BIOPSY DEEP 753.90SP J/G TUBE INSERTION 767.60SP NEPHROSTOMY TUBE CHANGE 774.30SP THYROID BIOPSY 797.65

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TVRH Item Description Primary PriceSP BIOPSY LIVER 830.95SP BIOPSY RENAL 830.95SP PERC BIOPSY/FL 830.95SP CV CATH INJ/CHECK 863.25SP PSEUDOANEURYSM THROM INJ 876.20SP LUMBAR PUNCTURE THERAPEUTIC 896.50SP NEPHROSTOMY TUBE REMOVAL 909.10SP MECH REM OBS MAT G/D/J/G-J/CEC 916.05SP THORACENTESIS BILAT 917.60SP THORACENTESIS LEFT 917.60SP THORACENTESIS RIGHT 917.60SP REPOSITIONING OF CV CATHETER 934.30SP DISKOGRAPHY LUMBAR (EA LEVEL) 954.70SP CHANGE URETEROSTOMY CATHETER 975.15SP RPLC GASTRO-JEJUN TB FLUORO 1,027.30US THORACENTESIS RIGHT 1,029.40US THORACENTESIS W/TUBE INSERT RT 1,029.40SP URETERAL STENT PL EXIST 1,039.40SP PLEURAL DRAINAGE/CATH/IMAGING 1,039.50SP RPLC DUODEN/JEJUN TB FLUORO 1,053.40SP GUIDANCE CATHET FLUID DRAINAGE 1,078.50SP REMOVE TUNNEL CATH WO PORT/PUM 1,093.00SP RPLC G/CEC/OTH TB UNDER FLUORO 1,106.40SP CHANGE CYSTOSTOMY TUBE COMPLEX 1,131.60*PU TRNSBRONC BX ADD LOBE W/31828 1,171.35SP BIOPSY SALIVARY GLAND NEEDLE 1,195.15SP BILIARY CRAIN CATH EXCH COMP 1,237.30SP ADD THORA/LUM VERTEBRAL BODY 1,272.15SP PERC J/G TUBE INSERTION 1,371.70SP CHANGE EXT/INT URETER STENT 1,379.25*PU BRONCHOSCOPY 1,417.00SP PULMONARY ARTERY PLACE LT/RT 1,445.30*PU TRNSBRONC BX ADD LOBE W/31828 1,452.80SP PLACEMENT CLOSURE DEVICE 1,464.40SP INTERDISCAL PERC ASPIR DX 1,467.40SP PERC ASPIR NUCLEUS PULPOSUS 1,467.40SP BILIARY DRAIN CATH PL EXT 1,492.30SP BILIARY DRAIN STENT PL NEW 1,492.30SP CHOLEDOCHAL STENT PL EXIST 1,492.30SP T-TUBE POST OP INSERTION 1,492.30SP SCLEROTHERAPY 1,514.28SP VENA CAVA INFERIOR/SUPERIOR 1,532.95SP LUMBAR PUNCTURE DIAG W/O INJ 1,535.80SP LUMBAR VERTEBRAL PLASTY 1,538.10SP THORACIC VERTEBRAL PLASTY 1,538.10

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TVRH Item Description Primary PriceSP CHANGE OF ABSCESS DRAIN 1,587.30SP PERC CHOLECYSTOSTOMY 1,604.05*PU TRANSBRONC BIOPSY SINGLE LOBE 1,626.30SP VENOUS SEL FIRST ORDER 1,652.85*PU BRONCHOSCOPY INCLUD BRUSHING 1,707.65*PU BRONCHOSCOPY BEDSIDE 1,757.45SP INJ EPIDUR CERV/THOR W/ IMAGE 1,773.55SP INJ EPIDUR LUM/SAC W/ IMAGE 1,773.55SP INJ EPIDUR LUM/SAC W/O IMAGE 1,773.55SP BLOOD PATCH 1,819.30SP FOREIGN BODY REMOVAL 1,840.20SP REMOVE TUNNEL CATH W PORT/PUMP 1,844.30SP ABSCESS DRAINAGE RENAL/PERIREN 1,852.65BRONCH EBUS IVNTJ PERPH LES 1,854.45EBUS W/BRONCH/INTERVENT 1,854.45*PU TRANSBRONC NEEDLE ASP BIOPSY 1,863.10SP INJ FORAMEN EPIDURAL SGL 1,863.55SP INJ ANES CELIAC PLEXUS 1,911.30SP AV FISTULOGRAM 1,921.00*PU BRONCH ALVEOLAR LAVAGE-BAL 1,956.20*PU BRONCHOSCOPY WITH BRUSHING 1,956.20*PU BRONCHOSCOPY WITH BIOPSY 2,038.55SP ABSCESS DRAINAGE PEROTINEAL 2,106.60SP ABSCESS DRAINAGE RETROPERITONE 2,106.60SP BIOPSY NECK/THORAX SOFT TISSUE 2,184.20SP ARTERY CAROTID UNILAT 1ST ORDE 2,210.10SP SEL THOR/BRACH 1ST ORDER 2,210.10SP THROMBOLYSIS ART NON-COR 2,222.80SP THROMBOLYSIS VENOUS 2,222.80SP INTERCOSTAL NERVE INJECTION 2,261.35INSERT IMPELLA ART&VEIN ACCESS 2,344.50INSERT IMPELLA ARTERY ACCESS 2,344.50SP SELE THORA/BRACHIOCEP 3 OR >VE 2,349.40SP SELECT ABD/PELVIS ADD VESSEL 2,350.40*PU REMOVAL OF FOREIGN BODY 2,421.55SP REPLAC TUNNEL CATH WO PORT/PUM 2,450.80SP INS CATH DRAIN RENAL PELVIS 2,500.25SP TIPS VENOGRAM 2ND ORDER 2,557.95SP VENOUS SEL SECOND ORDER+ 2,557.95SP ARTER VISCERAL SUPRASELECT CP 2,638.00SP ARTERIOGRAM AORTA ABDOMINAL 2,638.00SP SELEC ABDOMEN/PELVIC 1ST ORDER 2,638.00SP TIPS REVISION 2,694.40SP CHG G-TB TO GJ-TB PERC FLUORO 2,696.85SP INSERT DUODEN/JEJUN TBE FLUORO 2,696.85

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TVRH Item Description Primary Price*PU BRNCHS W/CPTR-ASST IMAGE-GUID 2,741.35NON-TUNNEL CENTRAL LINE PLCMT 2,836.90SP INSERT/NON-TUNNEL CV CATH >5 2,836.90SP INSERT/TUNNEL/CV W/O PORT/PUMP 2,836.90SP REPLACE NON-TUNN CATH W/O PORT 2,836.90SP REPLACE PICC W/O PORT/PUMP 2,836.90SP PICC LINE INSERTION > 5 YEARS 2,839.65SP SELEC ABD/PELVIC EXTR 2 VESSEL 2,840.50SP DRAIN ABSC SUBDIAPHRAGM PERC 2,899.05SP ENDO BILIARY DIL DUCT W/STENT 2,948.15SP SEC PERC THROMB EA ADD VESSEL 2,993.80SP SELEC ABD/PELVIC EXTR 3/4 VESS 3,212.45SP PRIMRY ART MECH THROMB 1ST VES 3,529.30SP BONE MARROW BX & ASPIR 3,790.05SP PERCUTANEOUS CYSTOSTOMY 3,901.75SP REMOVAL & REPLACE URETERL STNT 3,911.35IVUS INT US NONCOR AE ADTL VES 4,250.00BRONCH EBUS SAMPLING 1/2 NODE 4,463.60BRONCH EBUS SAMPLING 3/> NODE 4,463.60SP REVASC TIB/PER ADD-ON 4,469.65SP ABSCESS PELVIC TRV PERC 4,471.00SP RENAL ANGIO SEL BIL 4,512.10SP RENAL ANGIO SEL L 4,512.10SP RENAL ANGIO SEL R 4,512.10SP INSRT CECOSTOMY/OTHR COLN TUB 4,530.80SP NEPHROURETERAL CATH PLCMT 4,767.50SP REVASC ILIAC ADD ON 4,906.05IMPLANT EVENT RECORDER 4,911.70SP THROMBOLYSIS NON-COR DC 4,960.15SP THROMBOLYSIS NON-COR NXT DAY 4,960.15SP VENA CAVA FILTER REMOVAL 5,119.70SP KYPHOPLASTY THORACIC 5,422.90SP REVASC ILIAC UNI 5,605.00THROMBECTOMY VENOUS MECHAN 5,643.90SP TUNNEL PLEURAL CATH W/CUFF 5,771.65SP REVAS FEM/POPL W/TLA 5,936.25SP REVASC TIB/PER W/TLA 5,936.25SP TIPS PORTAL VEIN CATHERIZATION 6,042.65SP INSERT TUNN CV CATH WITH PRT/P 6,330.25SP REPLACE TUNNEL CATH WITH PORT 6,330.25SP SACROPLASTY BILATERAL 6,488.25SP SACROPLASTY UNILATERAL 6,597.00SP AV FIST W/ CENTRAL PTA 6,774.00SP PTA RENAL OR VISCERAL ADDL 6,774.00SP PTA VENOUS ADDL 6,774.00

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TVRH Item Description Primary PriceSP EACH ADDAL VASCULAR STENT ARTY 6,780.00SP THROMBECTOMY VENOUS MECHAN 7,033.50SP BILIARY DRAIN CATH INT-EXT 7,173.70SP DRAIN CATH CONV EXT-INT/EXT 7,173.70SP URETERAL STENT PL NEW WO 7,189.20SP VENA CAVA FILTER INSERT 7,460.50SP TIPS COMPLETE PROCEDURE 9,376.30SP EMBOLIZATION UTERINE FIBROID 9,982.30SP REVASC TIB/PER W/STENT 10,253.80SP KYPHOPL PERC LUMB 1 BDY UN/BI 10,569.25SP REVASC FEM/POP W ATHERECTOMY 11,569.90SP REVASC TIB/PER W/ATHER 11,569.90SP REVAS W STENT ILIAC ART ADD 12,084.05SP REVAS W STENT ILIAC ARTY 12,783.00SP REVASC FEM/POP W/STENT 13,114.25IVUS INTRVASC US NONCORONARY 1ST 13,350.00AV FISTULAGRAM W/ PTA 13,547.00PTA RENAL OR VISCERAL 13,547.00PTA VENOUS INITAL 13,547.00SP AV FIST W/ EMBOLIZATION 13,547.00SP AV FIST W/ THROMBECT/LYTIC INF 13,547.00SP AV FISTULOGRAM W/ PTA 13,547.00SP PTA RENAL OR VISCERAL 13,547.00SP PTA VENOUS INITIAL 13,547.00SP AV FIST W/ CENT STENT PLCMNT 13,691.00SP TRANSCATH INTRAVASC STENT ADD 15,507.50SP INTRAVASCULAR STENT PLACE ARTY 20,957.40SP NON-SEL CATH PL THOR AORTA 24,479.25SP AV FIST THROM/INF W/ PTA 27,381.00SP AV FIST W/ STENT PLCMNT 27,381.00SP EMBOL ART/VEN/LYMPH 31,186.25SP EMBOLIZATION ORGAN ART 31,186.25SP TRANSCATH INTRVASC STENT 32,066.25SP AV FIST THROM/INF W/ STENT 41,503.00ANESTHESIA TIME 17.45SEDATION SAME MD ADDITION 15 MIN 280.95SEDATION SAME MD ADDITION 15 MIN 280.95SEDATION SAME MD INIT 15 MIN >5YR 561.80SEDATION SAME MD INIT 15 MIN >5YR 561.80ELECTRONIC CROSSMATCH 42.10CRYOPR-1 UNIT CHARGE ONLY 57.20COMPAT.TST-1 UNIT-ANG-CHRG ONLY 128.20ANTIBODY ELUTION(RBC) CHARGE ONLY 135.60ANTIBODY IDENTIFICATION 146.40COMPAT.TEST-1 UNIT-IS-CHRG ONLY 177.20

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TVRH Item Description Primary PriceFFP-1 UNIT-CHARGE ONLY 200.00RBC-LEUKOREDUCED 1UNIT CHARGE ONL 385.70RBC-IRRADITE-LEUKO REDUC 1UNIT 390.65PLATELET PHERESIS LEUKOREDUCED 1,292.80PLATELET PHER L/R IRR EA 1,461.10BLOOD/BLOOD COMPONENT TRANSFUSION 529.55BLOOD TRANSFUSION 588.40GUIDANCE VENOUS ACCESS DVCE 155.75SP US GUIDANCE VENOUS ACCESS DVCE 155.75ULTRASOUND GUIDANCE PICC PLACE 155.75ULTRASOUND GUIDANCE PICC PLACE 155.75US OB < 14 WEEKS ADDITIONAL FETUS 179.25US EXTREMITY NON-VASCULAR LTD LT 215.30US EXTREMITY NON-VASCULAR LTD RT 215.30S&I US GUIDANCE PERICARDIOCENTESI 239.30US PRGNT UTRS B-SCN/RL TM IMG IM 282.45US OB < 14 WEEKS 286.70US OB TRANSVAGINAL 286.70US EXTREMITY NON-VASCULAR LEFT 357.30SP US CHEST 393.95US CHEST 393.95US PELVIC LIMITED/FU 432.80US OB COMPLETE 491.20ULTRASONIC GUIDANCE INTROP 534.40US BREAST RT 560.05US RENAL 576.25US EXTREMITY NON-VASCULAR RT 634.65US OB >14 WKS 650.15US AORTA 670.85US SFT TSSUS HD/NCK B-SCN/RL TM 725.50US SOFT TISSUE HEAD/NECK 725.50SP RFA PARENCHYMAL TISSUE S & I 792.45SP RADIO ABLATION-U/S GUIDE S&I 902.65SP US GUIDANCE 902.65US GUIDED NEEDLE PLACEMENT 902.65US BLADDER VOLUME 927.00US PELVIC 927.00SP U/S ABDOMEN LIMITED 1,004.70US ABDOM B-SCN/RL TIM W/IMG LIM 1,004.70US ABDOMEN LIMITED 1,004.70US APPENDIX 1,004.70US HEPATIC 1,004.70US SPLEEN 1,004.70US TRANSVAGINAL 1,007.90US ABDOMINAL COMPLETE 1,317.65

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TVRH Item Description Primary PriceIMPROVE RESP FUNCTION PER UNIT 69.25INC STRENGTH RESP MUSCLE 15 MIN 69.25CHEST PHYSIO SUBSEQUENT 84.90AIRWAY INHALATION TREATMENT 89.35AIRWAY INHALATION TREATMENT 89.35AIRWAY INHALATION TREATMENT 89.35DEMO-EVAL USE BRONCH DEVICE ONCE 89.35ER AIRWAY INHALATION TREATMENT 89.35ER EVAL PATIENT USE OF INHALER 89.35EVAL PATIENT USE OF INHALER 89.35MDI INSTRUCTION 89.35CHEST PHYSIO INITIAL 91.30SUCTIONING TVRH 271.65PUNCTURE ARTERIAL 290.65CPAP/BIPAP INITIAL 430.05CPAP/BIPAP OVERNIGHT 430.05CPAP/BIPAP SUBSEQUENT 430.05INTUBATION ENDOTRACHEAL 544.15VENTILATOR SHORT TERM 1-4 HOURS 954.90VENTILATOR FIRST DAY 1,390.40VENTILATOR SUBSEQUENT 1,390.40HYPERBARIC 02 PER 30 MIN 402.50HYPERBARIC O2 THERAPY PER SESSION 1,610.00PT ORTHOTIC/PROSTHET SUBSQ 15MIN 135.00PT HOME MANAGEMENT TRAIN PER UNIT 71.35PT GROUP THERAPY 71.85PT COMNTY/WORK RE-INTEGR 15 MIN 82.35PT WHEELCHAIR MANAGEMENT PER UNIT 84.15PT WHEELCHAIR MGMT TRAIN 15 MIN 84.15PT PROSTHETIC TRAINING 15 MIN 90.00PT GROUP THERAPEUTIC PROCEDURE 90.90PT GAIT TRAINING THERAPY 15 MIN 92.70PT AQUATIC THERAPY PER UNIT 95.25PT SELF CARE MGMT TRAINING 15 MIN 98.10PT THERAPEUTIC ACTIVITIES 15 MIN 100.80PT THERAPY EXERCISE 15 MIN 103.50PT COMMUNITY/WK INTEGRATION/UNIT 113.85PT GAIT TRAINING PER UNIT 113.85PT MASSAGE PER UNIT 113.85PT THERAPEUTIC ACTIVITIES/UNIT 113.85PT THERAPY EXERCISE PER UNIT 113.85PT IONTOPHORESIS PER UNIT 115.80PT ELECTRICAL STIMULATION 15 MIN 121.95PT FUNCTION CAPACITY W0RKUP/UNIT 126.50PT ORTHOTIC/PROSTHET SUBSQ 15MIN 135.00

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TVRH Item Description Primary PricePT APPLY NEUROSTIMULATOR 135.25PT NEUROMUSCL RE-EDUCATION 15 MIN 142.50JOINT MOBILIZATION ONE/MORE AREAS 158.15MYOFASCIAL RELEASE PER UNIT 158.15PT JT MOBILIZA ONE/MORE AREA/UNIT 158.15PT MYOFASCIAL RELEASE PER UNIT 158.15PT NEUROMUSCULAR RE-ED PER UNIT 158.15PT TRACTION PER UNIT 158.15PT ULTRASOUND PER UNIT 158.15PT ULTRASOUND THERAPY 15 MIN 158.15PT ELEC STIM MANUAL PER UNIT 168.00PT E-STIM UNATTENDED 205.95PT RE-EVAL EST PLAN CARE 204.30PT RE-EVAL EST PLAN CARE 204.30PT EVAL LOW COMPLEX 20 MIN 245.70PT EVAL LOW COMPLEX 20 MIN 245.70PT EVAL MOD COMPLEX 30 MIN 333.90PT EVAL MOD COMPLEX 30 MIN 333.90PT EVAL HIGH COMPLEX 45 MIN 459.90PT EVAL HIGH COMPLEX 45 MIN 459.90SELF CARE/HOME TRAINING PER UNIT 71.35THERAPEUTIC ACTIVITIES PER UNIT 71.35OT COMNTY/WORK RE-INTEGR 15 MIN 82.35OT PROSTHETIC TRAINING 15 MIN 90.00OT GROUP THERAPEUTIC PROCEDURE 90.90OT SELF CARE/HOME TRAIN PER UNIT 98.10OT THERAPEUTIC ACTIVITIES/UNIT 100.80OT THERAPY EXERCISE 15 MIN 103.50OT THERAPY EXERCISE PER UNIT 103.50OT WHIRLPOOL THERAPY 112.00OT COGNITIVE SKLL PER 15 141.20OT COGNITIVE SKLL PER 15 141.20OT NEUROMUSCL RE-EDUCATION 15 MIN 142.50OT NEUROMUSCULAR PROCEDURE/ UNIT 142.50OT ULTRASOUND THERAPY 15 MIN 158.15OT RE-EVAL EST PLAN CARE 207.00OT RE-EVAL EST PLAN CARE 207.00OT EVAL LOW COMPLEX 30 MIN 251.10OT EVAL LOW COMPLEX 30 MIN 251.10OT EVAL MOD COMPLEX 45 MIN 337.50OT EVAL MOD COMPLEX 45 MIN 337.50OT EVAL HIGH COMPLEX 60 MIN 466.20OT EVAL HIGH COMPLEX 60 MIN 466.20ST GROUP SPEECH/HEARING THERAPY 115.00ST ORAL FUNCTION THERAPY 217.80

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TVRH Item Description Primary PriceST SLP SWALLOWING TREATMENT 217.80ST MODIFICATION OF VOICE PROSTHE 225.55ST SLP TREATMENT 225.55ST SPEECH/HEARING THERAPY 225.55ST SWALLOW EVAL BEDSIDE 236.75ST SWALLOW EVAL W/RADIO-OPAQUE 236.75ST BEHAVIORAL & QUAL VOICE ANALYS 243.00SWALLOW EVAL-BEDSIDE 465.00ST BEHAV QUALIT ANALYS VOICE 243.00ST EVAL SOUND PRODUCTION 280.70ST EVALUATE SPEECH PRODUCTION 280.70ST EVAL LANG COMP/EXPRESSI 346.35ST SPEECH SOUND LANG COMP 346.35ER AVULSION NAIL PLATE EA ADD 21.80ER IMMUN ADMIN EA ADD VACC 31.25ER FEMALE GENITAL UNLSTD PROC 38.75FB REMOVAL EXT EAR 61.10DRAIN/INJECT INTERM JOINT/BURSA 73.15REMOVAL NASAL FOREIGN BODY 80.05EVAC SUBUNGUAL HEMATOMA 85.65ED-BLADDER SCAN 92.05INSERTION NON-INDWELLING CATHTER 116.15REMOVE IMPACTED EAR WAX UNILAT 140.90ER IMMUN ADMIN ANY ROUTE 1ST 148.85ER CATHETERIZATION 154.40IV THERAPY EACH ADD HOUR 167.10HYDRATION EACH ADD HOUR 168.30CLOSED TRMT JAW DISLOCATION 178.10STRAPPING SHLDR 185.10NAIL AVUL/PARTIAL COMP SIM SINGLE 189.65INI TR FIRST DEGREE BURN 192.00INJECTION TRIGGER MUSCLE 1OR2 197.05CLSD TX SHOULDER DISLOC 197.90ER TX DISL SHLDR W/MAN CLSD LT 197.90ER TX DISL SHLDR W/MAN CLSD RT 197.90IRRIG/LAVG/INSTL BLADDER 198.00TX DISL KNEE W/O ANES CLSD 205.45ER THER/PRO/DX INJ SQ/IM DPSS 212.00INJECT SC/IM 212.00ER THERAPYPRO//DX IV PSH SM 213.25ER THPY/PRO/DX IV PUSH ADD SQ 213.25ER THPY/PRO/DX IV PUSH INI DPSS 213.25IV INJECT INITIAL 213.25IV INJECTION ADD SEQUENTL 213.25THERAPYPRO//DX IV PUSH SAME DRG 213.25

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TVRH Item Description Primary PriceER APPL SPLINT ARM SHORT 219.60ER APPL SPLINT ARM SHORT STAT LT 219.60ER APPL SPLINT ARM SHORT STAT RT 219.60ER CNTRL NOSEBLEED ANT SMP BIL 224.75ER CNTRL NOSEBLEED POST SUBSEQ 224.75ER RPR LAC MOUTH/TONGUE <2.5CM 229.25ER APPL SPLINT FINGER 233.60CONTROL N/BLEED W/PACKS CAUTERIZE 235.95CONTROL NASAL HEMORRHAGE 235.95STRAPPING TOES 238.90FB REMOVAL EXT EYE 243.95APPL SPLINT LEG SHORT 248.00ER APPL SPLINT LEG SHORT LT 248.00ER APPL SPLINT LEG SHORT RT 248.00FB REMOVAL CORNEA W/SLIT 261.50IV THERAPY ADD SEQUENTL 270.80IV THERAPY CONCURRNT 270.80SEDATION MD ADDITION 15 MIN 280.95TREAT HIP SOCKET FX W/O MANIP 282.65ER APPL SPLINT LEG LONG 285.00INJECT NERVE BLOCK-PERI NERVE 285.10INJECT NERVE BLOCK-TRIGEMINAL 294.30I&D PILONIDAL CYST SIMPLE 297.00ED VISIT LEVEL 1 297.45CHANGE CYSTOSTOMY TUBE SIMPLE 301.25TX DISL (M-P) W/O ANES CLSD 306.05INSERT EMERGENCY AIRWAY 311.90ER CLSD TX POST MALL FX W/MAN RT 314.70CLOSED TRMT KNEECAP DISLOCATION 315.85CLSD TX RADIUS/ULNA FX 318.75ER APPL SPLINT ARM LONG LT 319.15CLOSED TRMT HIP PROTH DISLO 328.55ER TX DISL HIP POST W/O ANES LT 328.55ER TX DISL HIP POST W/O ANES RT 328.55LAYER CLOSE WOUND(FEENL)<=2.5CM 332.70LAYER CLOSE WOUND(FEENL)2.6-5.0CM 332.70LAYER CLOSE WOUND(FEENL)5.1-7.5CM 332.70LAYER CLOSE WOUND(NHF6)<=2.5CM 332.70LAYER CLOSE WOUND(NHF6)2.6-7.5CM 332.70LAYER CLOSE WOUND(NHFG)12.6-20CM 332.70LAYER CLOSE WOUND(SNAT)<=2.5CM 332.70LAYER CLOSE WOUND(SNAT)12.5-20CM 332.70LAYER CLOSE WOUND(SNAT)7.6-12.5CM 332.70LAYER CLOSEWOUND(SNAT)2.6-7.5CM 332.70REPAIR SUP WOUND(FEENL)<=2.5CM 332.70

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TVRH Item Description Primary PriceREPAIR SUP WOUND(FEENL)2.6-7.5CM 332.70REPAIR SUP WOUND(FEENL)5.1-7.5CM 332.70REPAIR SUP WOUND(FEENL)7.6-12.5CM 332.70REPAIR SUP WOUND(S N A T)<=2.5CM 332.70REPAIR SUP WOUND(SNAT)12.6-20CM 332.70REPAIR SUP WOUND(SNAT)2.6-7.6CM 332.70REPAIR SUP WOUND(SNAT)7.6-12.5CM 332.70WOOUND REPAIR SIMPLE OVER 30.0 CM 332.70CLSD TX RADIUS/ULNA FX W/MANIP 354.80ER TX FX RADIUS/ULNA W/MAN CL LT 354.80ER DRESS/DEBR BURN >10% TTL LG 356.05DRAIN/INJECT MAJOR JOINT/BURSA 359.20ER INTUBTN GASTRIC TREATMENT 362.55SIMPLE REPAIR SUPERFICIAL WOUNDS 365.15INCISION & DRAIN BARTHOLIN 366.50ER TX FX RADUS/ULNA W/O MAN C BL 368.70INJECT ANESTHETIC FACIAL NERVE 371.50CLSD TX TOE FX/NOT GREAT 381.10CLSD TX FINGER DISLOC 394.85CLSD TX FINGER FX EACH 394.85ER CAUT CHEM TISSUE GRNLTN 397.95PLACE TUBE NASOGASTRIC 399.20I&D ABSCESS COMP/MULT 421.05INC&REMOVAL FB SUBQ TISSUE SIMPLE 421.05I&D ABSCESS 426.55EXC WEDGE SKIN NAIL FOLD 430.15ER RPR LAC CPLX SCALP ADD 5.0C 435.65ER TX FX FEM DIST W/MAN CLSD BIL 435.95ER DRAIN ABSC FINGER SIMPLE 453.55ED VISIT LEVEL 2 456.30ED VISIT LEVEL 2 W PROC 456.30APPL SPLINT ARM SHORT 473.00STRAPPING ELBOW/WRIST 473.00STRAPPING UNNA BOOT 473.00ER ASP FINE NDL W/O IMGNG GUID 475.45ED-CRITICAL CARE ADDL 30MIN 478.50TX DISL WRIST W/MANIP CLOSED 495.05ER TX FX BIMALLEOLAR W/O MAN BIL 504.60ER TX FX FIB DIST W/MAN CLSD BIL 504.60ER INC HEMORRHOID EXTERNAL 525.30ER ARTHROCENT ASP/INJ JT SMALL 544.15CLSD TX ELBOW DIS-CHILD 549.85ER IV INFS THPY FLD INTL 1H DPSS 554.60HYDRATION INITIAL HR 554.60SEDATION MD INIT 15 MIN >5YR 561.80

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TVRH Item Description Primary PriceER CATH BLADDER CPLX 568.15EXCISION NAIL/NAIL MATRIX 573.05CHANGE GASTROSOMY TUBE 576.75RPR LAC CPLX FOREHD 1.1-2.5CM 584.20RPR LAC CPLX FOREHD 2.6-7.5CM 584.20RPR LAC CPLX SCALP 2.6-7.5CM 584.20ER TX RAD/ULNA SHFT W/MAN CL BL 591.25ER TX RAD/ULNA SHFT W/MAN CL LT 591.25ER TX DISL RADIOULNAR W/MAN CL BL 591.25REM FB FOOT SUBQ 610.55ER TX FX PHALANX W/MAN CLSD T9 611.10STRAPPING KNEE 612.30ER TX FX HUMER PRX W/O MAN CL BIL 623.75ER TX FX RADIL HD/NCK W/MAN C BL 623.75ER TX FX ULNA PROX W/MAN CLSD BIL 623.75CLSD TX PHAL SHAFT FX W/MANIP 633.15ER TX DISL (M-P) W/ANES/MAN CL BL 633.15ER TX DISL HAND W/ANES/MAN CL BL 633.15ER TX DISL THUMB W/MAN CLSD BIL 633.15ER TX FX METACARP W/MAN CLSD BIL 633.15ER TX FX THUMB W/MAN CLSD BIL 633.15THORACOSTOMY W/TUBE INSRT 641.70ER IV INFUS THY/PROP/DX INTL DPSS 699.80IV THERAPY INITIAL HR 699.80ER TX FX TIB DIST TRACT W/MAN 727.00PARACENTESIS 749.70ER RPR LAC CPLX FOREHD ADD 5CM 792.05EXPL PENTR WOUND EXTREMITY 792.40ER THORACENTESIS W/O IMAGING G 797.90OCCIPITAL NERVE INJECTION 825.00ED VISIT LEVEL 3 841.80ED VISIT LEVEL 3 W PROC 841.80DRAIN CEREBRO SPINAL FLUID 896.50ER I&D ABSC ISCHIO/PERIRECTAL 1,080.95TX ARTICULAR FINGER FX W/MANIP 1,089.30ER RPLC G/CEC/OTH TB UNDER FLU 1,106.40ER PLEUR DRN W/INSRT CATH WO G 1,297.45ER TX DISL TIB/FIB PROX W/ANES RT 1,305.95ER TX FX BIMALLEOLAR W/MAN CLS BL 1,305.95ER TX FX FIB SHFT PROX W/MAN C BL 1,305.95ER TX FX TRIMALLEOLAR W/MAN CL BL 1,305.95ER PERICARDIOCENTESIS INITIAL 1,310.05ER TRACHEOSTOMY CRICOTHYROID 1,318.60ER PERITONEAL LAVAGE W/ IMAGIN 1,455.55ER TX DISL HIP SPONT W/ANES/MA BL 1,469.85

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TVRH Item Description Primary PriceER TX DISL HIP SPONT W/ANES/MA LT 1,469.85ER TX DISL HIP TRAUMA W/ANES BIL 1,469.85ER TX DISL HIP TRAUMA W/ANES RT 1,469.85ER RPR LAC CPLX EYE 2.6-7.5CM 1,534.55ER RPR LAC CPLX TRNK 2.6-7.5CM 1,534.55ER RPR LAC CPLX TRUNK 1.1-2.5C 1,534.55SPINAL TAP DIAGNOSTIC 1,535.80ER RECTUM UNLSTD PROC 1,560.45ED VISIT LEVEL 4 1,670.80ED VISIT LEVEL 4 W PROC 1,670.80ER I&D ABSC PERIANAL SUPERFIC 1,722.45ED VISIT LEVEL 5 1,903.80ED VISIT LEVEL 5 W PROC 1,903.80ER LARYNGOSC DIRECT DX 2,189.95ER TX DISL HIP POST W/ANES 2,352.40ER INS CATH CV NON-TUNL <5 YRS 2,549.15ER TX DISL SHLDR W/MAN/ANES CL 2,735.60ER TX DISL SHLDR W/MAN/ANES CL LT 2,735.60ER TX DISL SHLDR W/MAN/ANES CL RT 2,735.60ER FIX DISL (I-P) W/MANIP PERC F7 2,776.75ER TX DISL (I-P) HND W/ANES/MN 2,776.75ER TX DISL (I-P) HND W/ANES/MN F6 2,776.75ER INS PER CV CATH W/O PORT 5> 2,839.65ER I&D HEMATOMA/SEROMA/FLUID 2,979.10ER TX FX FEM SHAFT W/MAN CLSD BIL 3,146.85DEL PLACENTA 3,338.35ER TX DISL ANKLE W/ANES CLSD BIL 3,358.45ER TX FX MALLEOLUS W/MAN CLSD BIL 3,642.70ER TX FX TIB SHAFT W/MAN CLSD BIL 3,642.70ER DEL VAGINAL ONLY 3,713.05ER TX DISL HIP POST W/ANES RT 3,779.85ED CRITICAL CARE 30-74 3,810.30ED CRITICAL CARE 30-74 W PROC 3,810.30ER TX DISL ELBOW W/ANES CLSD BIL 4,151.40ER TX FX HUMER PRX W/MAN CD RT 4,502.75*PU-FLOW VOLUME LOOP 68.55ENDTIDAL CO2 MONITOR 93.95VITAL CAPACITY 123.70PULSE OXIMETER-MULTI ONCE PER DAY 147.85*PU-RESIDUAL VOLUME 179.25PFT DLCO ADD ON 184.80*PULMONARY FUNCTION PRE-POST 314.55O2 SATURATION/CONT 382.85OR CODE BLUE 353.35CPR ED 453.00

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TVRH Item Description Primary PriceCPR/CODE 453.00EK DOPPLER ECHO COLOR FLOW MAPING 510.45EK DOPPLER FLW UP ECHO/LIMITED 510.45EK TT ECHO FOLLOWUP/LMT STUDY 510.45EK DOPPLER ECHO COMPLETE 943.85EK ECHO TT INCLUDING STRESS 943.85EK ECHO TRANS ESOPHAGEAL 971.70CARDIOVERSION ELECTIVE 1,014.25CARDIOVERSION EXTERNAL 1,014.25CARDIOVERSION EXTERNAL 1,014.25EK CARDIOVERSION EXTERNAL 1,014.25VIS CARDIOVERSION 1,014.25EP EVAL CD W/GENERATOR TEST 1,119.65INTRA-ATRIAL RECORDING 1,220.90INTRAVENTRICULAR PACING 1,676.25EK TILT TABLE PROCEDURE 1,724.00INTRA-ATRIAL PACING 1,805.85ARRHYTHMIA INDUCTION 1,871.55EK ECHO COMPLETE STDY (3PTS) 2,398.05BUNDLE OF HIS RECORDING 3,490.20EP IV DRUG INFUSION PACING 4,791.65ICC ABL AV NODE CREATE CHB 7,518.20COMP EP EVAL W INDUCTION 9,273.60COMP EP EVAL W LV RECORDING 9,273.60COMP EP W RA RECORDING 9,273.60RIGHT VENTRICULAR RECORDING 10,170.55IVUS ADDITIONAL VESSEL 361.75WAVEWIRE ADDITIONAL VESSEL 436.35VCA-CPR 453.00EVAL CARDIO/DEFIB SGL/DUAL 957.15VCA-CARDIOVERSION 1,014.25PACER SKIN POCKET REVISION 1,039.80PERM PACER GENERATOR REMOVAL 1,179.60WAVEWIRE INITIAL VESSEL 1,525.00PERCUTANEOUS CORONARY THRMBCTY 2,258.25IVUS INITIAL VESSEL 2,280.85REPOSITION TRANSVENOUS ELECTRODE 2,324.35INSERT PACE ELEC CVS LFT VEN PACE 2,756.45CORONARY ARTERY ANGIO S&I 3,140.15ILLIAC ARTERY ANGIO DURING CATH 3,283.55CORONARY ART/GRFT ANGIO S&I 4,212.50RENAL ANGIO SEL BIL 4,512.10RIGHT HEART CATH 5,494.25INSERTION TEMPORARY PACEMAKER 6,353.30RHRT CORONARY ARTERY ANGIO 6,774.65

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TVRH Item Description Primary PriceVENA CAVA FILTER INSERT 7,460.50RHRT ART/GRFT ANGIO 7,842.55LHRT ARTERY/VENTRICLE ANGIO 7,851.05LHRT ART/GRFT ANGIO 8,918.90REMOVE&REPLACE PM GEN SGL 9,330.90REMV&REPLC PM GEN DUAL LD 9,330.90REMV&REPLC PM GEN MULT LDS 9,330.90R&L HRT ART/VENTRICLE ANGIO 9,936.15PERMANENT PACER ATRIAL W/LEADS 10,004.65PERMANENT PACER DUAL W/LEADS 10,004.65PERMANENT PACER VENTR W/LEADS 10,004.65R&L HRT ART/VENTRIC GRFT ANGIO 11,004.00REMV&REPLC CVD GEN DUAL LD 12,472.40REMV&REPLC CVD GEN MULT LDS 12,472.40REMV&REPLC CVD GEN SGL LD 12,472.40INSRT PULSE GEN W/DUAL LDS 13,431.55INSRT PULSE GEN W/MULT LDS 13,431.55PRQ CARDIAC ANGIO ADDL ART 14,220.20PRQ CARDIAC ANGIOPLAST 1 ART 14,220.20PRQ CARD REVASC MI 1 VSL 15,529.10PRQ CARD STENT W/ANGIO 1 VSL 15,529.10PRQ CARD STENT W/ANGIO ADDL 15,529.10PRQ REVASC BYP GRAFT 1 VSL 15,529.10PERC D-E COR REVASC CHRO SIN 21,952.25PERC D-E COR REVASC T CABG B 21,952.25PERC D-E COR REVASC T CABG S 21,952.25PERC D-E COR REVASC W AMI S 21,952.25PERC DRUG-EL COR STENT BRAN 21,952.25PERC DRUG-EL COR STENT SING 21,952.25EK CARDIOVAS STRESS TEST 1,662.00ECHO TEE PROBE PLACEMENT 1,084.95VISIT WOUND ESTAB LEVEL I 194.50VISIT WOUND ESTAB LEVEL II 232.70VISIT WOUND NEW LEVEL II 232.70VISIT WOUND ESTAB LEVEL III 277.45VISIT WOUND ESTAB LEVEL IV 322.00VISIT WOUND NEW LEVEL III 322.00VISIT WOUND ESTAB LEVEL V 403.60VISIT WOUND NEW LEVEL IV 403.60MRI CHEST/HILAR/MEDIAS WO CONTRA 1,449.25MRI SACRUM WO CONTRAST 1,449.25MRI ANKLE LT W/O CONTRAST 1,706.15MRI ANKLE RT W/O CONTRAST 1,706.15MRI FOOT LT W/O CONTRAST 1,706.15MRI FOOT RT W/O CONTRAST 1,706.15

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TVRH Item Description Primary PriceMRI HIP LT W/O CONTRAST 1,706.15MRI HIP RT W/O CONTRAST 1,706.15MRI HIPS BIL W/O CONTRAST 1,706.15MRI KNEE LT W/O CONTRAST 1,706.15MRI KNEE RT W/O CONTRAST 1,706.15MRI NECK W/O CONTRAST 1,896.35MRI ORBITS/FACE/NECK WO CONTRAST 1,896.35MRI ABDOMEN MRCP 2,369.40MRI ABDOMEN WO CONTRAST 2,369.40MRI SACRUM WO W CONTRAST 2,898.35MRI ANKLE LT WO/W CONTRAST 3,220.40MRI ANKLE RT WO/W CONTRAST 3,220.40MRI HIP LT WO/W CONTRAST 3,220.40MRI HIP RT WO/W CONTRAST 3,220.40MRI KNEE RT WO/W CONTRAST 3,220.40MRI FEMUR LT WO/W CONTRAST 3,361.70MRI FEMUR RT WO/W CONTRAST 3,361.70MRI FOOT LT WO/W CONTRAST 3,361.70MRI FOOT RT WO/W CONTRAST 3,361.70MRI LOWER EXTREM W/WO CONTRAST 3,361.70MRI TIB FIB LT WO/W CONTRAST 3,361.70MRI TIB FIB RT WO/W CONTRAST 3,361.70MRI ABDOMEN W/WO CONTRAS 3,652.25MRI BRAIN WO CONTRAST 1,896.35MRI BRACHIAL PLEXUS WO W CONTRAST 2,923.25MRI BRAIN WITH/WO CONTRAST 2,923.25MRI PITUITARY 2,923.25MRI THORACIC SPINE WO CONTRAST 2,101.40MRI LUMBAR SPINE WO CONTRAST 2,332.55MRI CERVICAL SPINE WO CONTRAST 2,844.05MRI THORACIC SPINE W/WO CONTRAST 3,238.85MRI CERVICAL SPINE W CONTRAST 3,553.55MRI LUMBAR SPINE W/WO CONTRAST 3,595.75MRI CERVICAL SPINE W/WO CONTRA 4,384.20MRI PELVIS WO CONTRAST 1,449.25MRI FEMUR LT W/O CONTRAWT 1,706.15MRI FEMUR RT W/O CONTRAST 1,706.15MRI TIB FIB LT W/O CONTRAST 1,706.15MRI TIB FIB RT W/O CONTRAST 1,706.15MRI ELBOW LT W/O CONTRAST 2,076.95MRI ELBOW RT W/O CONTRAST 2,076.95MRI SHOULDER LEFT W/O CONTRAST 2,076.95MRI SHOULDER RT W/O CONTRAST 2,076.95MRI WRIST LT W/O CONTRAST 2,076.95MRI WRIST RT W/O CONTRAST 2,076.95

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TVRH Item Description Primary PriceMRI HAND LT W/O CONTRAST 2,180.80MRI HAND RT W/O CONTRAST 2,180.80MRI HUMERUS RT W/O CONTRAST 2,180.80MRI SHOULDER LEFT W/CONTRAST 2,594.85MRI PELVIS W/WO CONTRAS 2,898.35MRI NECK WO/W CONTRAST 2,923.25MRI ORBITS/FACE/NECK W/WO CONTRAS 2,923.25MRI FOREARM LT WO/W CONTRAST 3,278.70MRI FOREARM RT WO/W CONTRAST 3,278.70MRI HAND LT WO/W CONTRAST 3,278.70MRI HAND RT WO/W CONTRAST 3,278.70MRI HUMERUS RT WO/W CONTRAST 3,278.70MRI ELBOW RT WO/W CONTRAST 3,361.70MRI SHOULDER LEFT WO/W CONTRAST 3,361.70MRI SHOULDER RT WO/W CONTRAST 3,361.70MRI WRIST LT WO/W CONTRAST 3,361.70MRI WRIST RT WO/W CONTRAST 3,361.70MRA HEAD WO CONTRAST 1,896.35MRA NECK WO CONTRAST 1,896.35MRV HEAD W/O CONTRAST 1,896.35MRA NECK W CONTRAST 2,369.45MRA NECK WITH/WO CONTRAST 2,923.25MRV HEAD WO/W CONTRAST 2,923.25MRA LOWER EXTR W/WO CONTRAST 2,421.65MRA ABDOMEN WITH/WO CONTRST 3,652.25ICU OBSERVATION PER MINUTE 0.90XR ZZ ISOVUE 300-M PER ML 0.70OMNIPAQUE 350 PER ML 1.05VISIPAQUE 270 PER ML 1.10OMNIPAQUE 300 PER ML 1.30VISIPAQUE 320 PER ML 1.30OMNIPAQUE 240 PER ML 5.60OMNIPAQUE 180 PER ML 7.20MULTIHANCE PER ML 7.26MRI ZZ MAGNEVIST PER ML 11.10DSG OASIS FENESTRATED PER SQ CM 17.75MEDIA CONTRAST OMNI 300 50 47.08APLIGRAF PER SQ CM 82.60RHOGAM ISSUE (ONE DOSE) 171.00EK OPTISON INJECTION 508.70NM ZZ CCK 643.12NM ZZ IODINE I 131 PER 1-6 MCI 721.65GRAFT NUSHIELD 1.6 SQ CM DISC 2,449.00GRAFT NUSHIELD 2X3 8 SQ CM 3,100.00DERMIS FLEXHD ULTRA THICK 16X20CM 21,471.45

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TVRH Item Description Primary PriceSURGICAL RECOVERY ROOM TIME 12.95PT STAGING CATH RECOVERY 2 HRS 307.10DSC AMBULATORY ROOM CHARGE 514.20ASU RECOVERY ROOM CHARGE 540.00TE ECHO RECOVERY 618.50CARDIAC CATH RECOVERY 794.50RHYTHM ECG TRACING & MONITOR 123.95EKG 12 LEADS 288.55ER-EKG 288.55EVENT MONITORING 171.00EK HOLTER MONITOR 858.00EXT EEG <1 367.45EXT EEG >1 HOUR 427.55EEG AWAKE & ASLEEP 470.25EEG AWAKE & DROWSY 470.25EEG ALL NIGHT RECORDING 954.15ENDO TIME 25.50IRRIGATE IMPLANTED VENOUS ACCESS 89.10BX LESN SKIN/SUBQ/MUCOUS SGL 182.30DEBR/REM DEV TISS W/O ANES <20 185.20PARING/CUTTING LESION BENIGN 1 205.50DRESS/DEB BURN <5% TOTAL SM 238.60REM DEVITAL TISS W/O ANES >20 238.60CAUT CHEM TISSUE GRANULATION 265.00NEG PRESS WOUND THRPY <50 285.45GFT SKIN SUB T/A/L <=100CM ADD 296.10NEG PRESS WOUND THRPY >50 SQ CM 297.75PICC LINE CARE BASIC LEVEL 1 313.85APPL MULTILYR VEN WD CMPRES 336.80BONE MARROW BX NEEDLE OR TROCAR 340.25DRESS/DEB BURN 5-10% TOTAL MED 374.25STRAPPING BOOT UNNA 473.00DEBRID BONE ADDL 20 SQ CM 581.40DEBRID MUSC/FASCIA ADDL 20 SQ CM 581.40DEBRID SUBQ TISSUE ADDL 20 SQ CM 581.40I&D ABSCES SIMPLE 597.80APPL CAST LEG RIGID CONTACT 630.15DEBRID MUSCLE/FASCIA 1ST 20 SQ CM 678.45DEBRIDE SUBQ TISSUE 1ST 20 SQ CM 678.45GFT SKIN LOW SUB T/A/L <=100CM 807.10GFT SKIN SUB T/A/L <=100CM 807.10GFT SKN LOWSB F/S/E <=100CM 25 SC 807.10GFT SKN SUB F/S/E <=100CM 25 SC 807.10FOLEY PLCMT W/ CYSTO 1,543.29DEBRIDE BONE 1ST 20 SQ CM 1,744.60

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TVRH Item Description Primary PriceI&D HEMATOMA/SEROMA/FLUID 1,856.90OBSERVATION PER MINUTE 0.70DIRECT ADMIT OBSERVATION CARE 115.75DIRECT ADMIT OBSERVATION CARE PRO 115.75ADMIN INFLUENZA VACCINE 69.90ADMIN INFLUENZA VACCINE 110.65ER IMMUNIZATION 153.95IMMUNIZATION ADMIN 153.95INPATIENT RENAL DIALYSIS 568.15HEMODIALYSIS INPATIENT DAILY 911.75PERITONEAL INPATIENT DAILY 625.20PERITONEAL INPATIENT SET UP 625.20HEMODIALYSIS OUTPATIENT 911.75PERITONEAL DIALYSIS OUTPATIENT 477.80NERVE CONDUCTION 2 STUDIES 120.70NERVE CONDUCTION 4 STUDIES 146.05NERVE CONDUCTION 5 STUDIES 160.60NERVE CONDUCTION 6 STUDIES 176.65NERVE CONDUCTION 8 STUDIES 213.80NERVE CONDUCTION 9 STUDIES 223.50NERVE CONDUCTION 10 STUDIES 245.85NERVE CONDUCTION 11 STUDIES 270.40NERVE CONDUCTION 12 STUDIES 297.45NERVE CONDUCTION 13 STUDIES 327.20US CAROTID LEFT 468.15US CAROTID RIGHT 468.15US INGUINAL FOR PSEUDOANEURYSM 717.20US TESTICULAR ART/VEN FLOW 1,107.20US ANKLE/BRACHIAL PRESSURES (ABI) 327.90US ARTERIAL UPPER EXTREMITY L 551.05US ARTERIAL UPPER EXTREMITY R 551.05US ARTERIAL LOWER EXT LT 717.20US ARTERIAL LOWER EXT RT 717.20US DIALYSIS GRAFT RIGHT 874.60US VEIN MAPPING LOWER EXT LT 874.60US VEIN MAPPING LOWER EXT RT 874.60US VEIN MAPPING UPPER EXT LT 874.60US VEIN MAPPING UPPER EXT RT 874.60US VENOUS LOWER EXTREMITY LT 874.60US VENOUS LOWER EXTREMITY RT 874.60US VENOUS UPPER EXTREMITY LT 874.60US VENOUS UPPER EXTREMITY RT 874.60US CAROTID BIL 899.45US VEIN MAPPING LOWER EXT BIL 1,024.50US VEIN MAPPING UPPER EXT BIL 1,024.50

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TVRH Item Description Primary PriceUS VENOUS INSUFFICIENCY 1,024.50US VENOUS LOWER EXTREMITY BIL 1,024.50US VENOUS UPPER EXTREMITY BIL 1,024.50US ARTERIAL LOWER EXT BIL 1,033.25US ARTERIAL UPPER BIL 1,069.60US DUPLEX SCN ART/VEN LIVER LMTD 1,107.20US DUPLEX SCN ART/VEN LIVER 1,297.20EMG W/NC COMPLETE 202.65THERAPEUT/PROPH/DX INJ SQ/IM 212.65ARTERIAL CATH A-LINE 315.95SP PERCUTANEOUS FILLING OF PUMP 408.85ER SMOK CESS COUN INTER >3MIN 61.65SMOKING CESSATION COUNSELING INTE 61.65SMOKNG CESSATION COUNS 3-10 MINS 61.65CARD REHAB ASSESS EDUCATE SD 118.60CARDIAC REHAB PHASE II 237.20PULMON REHAB W EXRCISE 1 HR SES 245.35