SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 02050012 CARDIAC CARE UNIT 10-3115 210 $24,995.00 02050013 INTENSIVE CARE UNIT 10-3115 202 $21,995.00 2151010 HOURLY OBSERVATION 10-3170 762 $950.00 G0378 2159008 STRAIGHT CATHETER 10-3170 761 $384.23 51701 2159011 SLCTV WND DEBRIDEM ADDL 20 C 10-3170 761 $630.15 97597 2159013 ROUTINE VENIPUNCTURE, BLOOD D 10-3170 300 $50.00 36415 02200006 NURSERY LEVEL 1 10-3105 171 $9,995.00 02200007 NURSERY LEVEL 2 10-3105 172 $10,995.00 02200008 SEMI-PRIVATE GYNECOLOGY RM 10-3195 122 $9,995.00 2200010 EVOKED AUDITORY TEST LIMITED 10-3105 471 $769.30 92587 2200011 SPECIAL DERMATOLOGICAL SERV 10-3105 940 $1,389.80 96999 02300003 MED/SURGE ISOLATION 10-3200 121 $11,995.00 02300014 SEMI PRIVATE 3MEDSUR 331 10-3200 121 $9,995.00 2309004 INFUS THRAPY EA ADD HOUR UP T 10-3170 260 $219.03 96366 02450014 SEMI-PRIVATE PEDIATRIC 10-3085 123 $9,995.00 02500017 SEMI-PRIVATE OB POST PARTUM 10-3195 122 $9,995.00 7623085 PEDIATRICS TREAT/OBS RM OBSERV 10-3085 762 $500.00 G0378 7623115 MCU TREAT/OBS RM OBSERVATION 10-3115 762 $500.00 G0378 7623195 L&D TREAT/OBS RM OBSERVATION 10-3195 762 $500.00 7623200 3 M/S TREAT/OBS RM OBSERVATION 10-3200 762 $500.00 G0378 9999999 OUTPATIENT IN A BED - N/C 10-9999 120 $0.00 10000700 D&C DIAG OR THERAP NOT OB 10-3140 360 $16,333.80 58120 10000702 BX-SKIN SQ/MM,EA ADDTL 10-3140 360 $994.50 11200 10000707 LAPAROS,W LYSIS OF ADHESIONS 10-3140 360 $43,334.60 58660 10000803 RESECT INFEOR TURBINATE-BILTRL 10-3140 360 $22,083.40 30140 10000804 INJ FOR CYSTOGRAM 10-3140 360 $490.60 51600 10001128 AMPUTATION,TOE & METATARSAL 10-3140 360 $19,998.60 28810 10001130 APPENDECTOMY,LAPAROSCOPIC 10-3140 360 $43,334.60 44970 10001131 APPENDETOMY,OPEN 10-3140 360 $21,811.50 44950 10001138 COLOSTOMY 10-3140 360 $134,093.30 44320 10001147 GASRECTOMY TUBE,INSERT 10-3140 360 $12,032.40 49440 10001326 I&D OF BARTHOLINGLAND ABSCESS 10-3140 360 $1,504.50 56420 10001330 CERVICAL BX,LEEP 10-3140 360 $16,333.80 57460 10001337 HYSTERECTOMY,TOTAL ABDOMINAL 10-3140 360 $11,332.50 58150 10001604 SREP S/N/A/G/TR/E,2.5CM/< 10-3140 360 $1,473.00 12001 10001605 INJ AN/ST TRNS EPID CERV/TH RI 10-3140 360 $4,344.06 64479 10001722 THYROIDECTOMMY 10-3140 360 $47,194.00 60240 10001724 TRACHEOSTOMMY 10-3140 360 $22,083.40 31600 10001800 COLPOPEXY INTRAPERITONEAL 10-3140 360 $42,389.30 57283 10002100 CIRCUMSICISON-ADULT 10-3140 360 $20,610.70 54161 10002125 I&D HEMATOMA/FLUID 10-3140 360 $10,031.10 10140 10002301 ANGIOPLASTY WITH STENT 10-3140 360 $15,539.30 61635 10002309 INS PICC AGE 5 YRS/> 10-3140 360 $10,092.30 36569 10003012 NASAL ENDO,W BX POLYPECT/DEBD 10-3140 360 $14,446.50 31237 10003603 ANKLE,ARTHROTOMY 10-3140 360 $30,595.00 27620 10003620 OF,ANKLE FRACTURE 10-3140 360 $48,992.10 27766 10003622 OF ELBOW FRACTURE 10-3140 360 $63,949.60 24586 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10003626 OF HUMERUS FRACTURE 10-3140 360 $63,943.60 23615 10003629 OF TIBIA/FIBULA FRACTURE 10-3140 360 $48,992.10 27758 10003637 TOTAL HIP REPLCMNT(NO IMPT) 10-3140 360 $15,300.00 27130 10003801 HERNIA REPAIR-PEDIATC 10-3140 360 $30,877.00 49505 10004500 ACROMIOPL/ACROMIONECT,PRTL LT 10-3140 360 $44,916.00 23130 10004502 APLY BNE FIXATION DEVC>1PLANE 10-3140 360 $30,595.00 20692 10004503 APLY BNE FIXATION DEVC 1PLANE 10-3140 360 $30,595.00 20690 10004511 CRANIAL TONGS/ST FRAME 10-3140 360 $5,332.00 20660 10004532 INJ TGGER POINT 1/2 MUSCL 10-3140 360 $2,401.70 20552 10004534 INSRT SPN FIXATION DVC7-12SEGS 10-3140 360 $35,667.27 22845 10004537 LUMBAR SPINE FUSION 10-3140 360 $17,295.60 22558 10004548 RELEASE EXT TNDN HAND/FINGER 10-3140 360 $14,854.00 26445 10004554 TNDN SHEATH INCSN,RDL STYLOID 10-3140 360 $19,467.90 25000 10004555 TENDON SHEATH INCISION 10-3140 360 $14,854.00 26055 10004556 TA THORAX SPINE FUSION 10-3140 360 $14,222.30 22610 10004560 TREAT FX RAD EXTRA ARTICUL 10-3140 360 $63,943.60 25607 10004565 UNLISTED PROCEDURE,SPINE 10-3140 360 $859.60 22899 10004568 TREAT FINGER FRACTURE EACH 10-3140 360 $23,899.60 26765 10004596 SHOULDER,ARTHOSCOPY,DX 10-3140 360 $25,603.80 29805 10004599 ARTHROSCOPY,SHLDR W REM FB/LB 10-3140 360 $50,586.00 29819 10004601 ARTHROSCOPY SHLDR SYNOVEC CMPL 10-3140 360 $42,590.10 29821 10004602 ARTHROSCOPY SHLDR,DEBD LIMITED 10-3140 360 $25,603.80 29822 10004605 ARTHROSC,SHLDR,W LYSIS OF ADH 10-3140 360 $50,586.00 29825 10004611 ARTHROSCOPY WST EXC/REP CARTIL 10-3140 360 $25,603.80 29846 10004617 ARTHROSC HIP W REM FB W SYNVCT 10-3140 360 $50,586.00 29863 10004619 ARTHROSC,KNEE FR INF/LAVAGE/DR 10-3140 360 $25,603.80 29871 10004620 ARTHROSC,KNEE REM LOOSE OR FM 10-3140 360 $25,603.80 29874 10004627 ARTHROSC,KNEE,W MEN REP-MED&LA 10-3140 360 $32,775.00 29882 10004628 ARTHRSC KNEE,W MEN RPR-MED/LAT 10-3140 360 $25,603.80 29883 10004630 ARTHROSC,ANKLE,EXC OSCHON DFCT 10-3140 360 $50,586.00 29891 10004635 UNLISTED JNT ARTHROSC 10-3140 360 $859.60 29999 10004642 UGI W REMOVAL OF FB 10-3140 360 $7,963.40 43247 10004643 UGI REM T/P/LES-HOT BX/BP CAUT 10-3140 360 $12,032.40 43250 10004645 COLONOSCOPY,FLEX,DX 10-3140 360 $8,652.00 45378 10004650 HYSTEROSY,W BX ENDOM /POLYPECT 10-3140 360 $20,944.30 58558 10004660 EPID-INJ-CONT-CERV/THORACIC 10-3140 360 $7,956.80 62324 10004662 NECK SPINE DISK SURGERY 10-3140 360 $47,548.90 63020 10004664 SPINAL DISK SURGERY ADD-ON 10-3140 360 $46,926.01 63035 10004665 RMVL OF SPINL LAMINA SGL THRCC 10-3140 360 $47,548.90 63046 10004673 LAMINCT IMPL NS ELCTRDS,EPIDRL 10-3140 360 $88,183.60 63655 10004676 INJ ANESTH,CERVICAL PLEXUS 10-3140 360 $4,204.50 64413 10004677 SGL NBI BRACHIAL PLEXUS 10-3140 360 $4,204.50 64415 10004678 INJ ANESTH,SUPRASCAPULAR NERV 10-3140 360 $4,204.50 64418 10004704 NEUROPLSTY MA PEPH NRV A/L,NOS 10-3140 360 $16,437.00 64708 10004707 RNL NEUROLYSIS W USE OF OP MIC 10-3140 360 $7,922.15 64727 10004711 OPERATING MICROSCOPE ADD-ON 10-3140 360 $3,617.70 69990 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10004713 X-RAY C/T SPINE DISK 10-3140 320 $19,636.25 72285 10004735 TENODESIS LG TENDON BICEPTSLT 10-3140 360 $44,916.00 23430 10005680 MANIPULATE KNEE JNT UNDR ANES 10-3140 360 $32,127.31 27570 10005686 ADV POST TIBIAL TNDON W EXC NA 10-3140 360 $57,834.50 28238 10005692 MT TO SHORTEN,1ST MT - RT 10-3140 360 $57,834.50 28725 10005697 OPN TX BIMALLEOLAR ANKLE FRACT 10-3140 360 $48,992.10 27814 10005703 TREAT LOWER LEG JOINT 10-3140 360 $63,197.33 27829 10005718 ARTHRSC WST,W RLS TRNSV C RT 10-3140 360 $32,775.00 29848 10005751 HYSTEROSCOPY,W ENDOMETAL ABLTN 10-3140 360 $44,931.96 58563 10005796 COMB ANTEROPOSTEOR COLPORRHPHY 10-3140 360 $46,649.25 57260 10005811 SIJ ANESTH/STEROID INJ RT 10-3140 360 $9,499.05 G0260 10005817 INS TUNN CVAD W PORT AGE5YR/> 10-3140 360 $37,793.28 36561 10005931 EXC FOOT/TOE TUM SC >1.5CM BL 10-3140 360 $33,420.05 28039 10006045 EXC FOOT CYST/GANGLION LT 10-3140 360 $20,900.00 28090 10006072 NEURPLASTY,MEDN NRV AT CRP TNL 10-3140 360 $16,437.00 64721 10006135 RI MARSUPIALIZATION BARTHOLIN' 10-3140 360 $21,746.60 56440 10006141 LAP,ABD PET OMENTUM W BX 10-3140 360 $36,033.50 49321 10006198 OSTEOTOMY,CALCANEUS RT 10-3140 360 $57,834.50 28300 10006213 EXC TNDN SHTH LESIN LEG/ANK RT 10-3140 360 $21,417.75 27630 10006286 CARTILAGE FRAFT,N SEPTUM 10-3140 360 $26,848.40 20912 10006287 REPAIR NASAL STENOSIS 10-3140 360 $42,339.20 30465 10006309 REMOVE IN/EX HEM GROUPS 2+ 10-3140 360 $32,333.10 46260 10006952 LAP VENT/ABD HERN PROC COMP 10-3140 360 $66,436.16 49653 10006964 CYSTOSCOPY AND TREATMENT 10-3140 360 $15,511.63 52281 10006997 CONIZATION OF CERVIX 10-3140 360 $29,961.70 57520 10007240 THER/PROPH/DIAG ING, IV PUSH 10-3140 260 $691.65 96374 10007369 TREAT FINGER FRACTURE,EACH-F2 10-3140 360 $25,398.25 26735 10007387 EXPLORE/TREAT ANKLE JOINT-LT 10-3140 360 $32,127.31 27610 10007399 TXMENT OF ANKLE FRACTURE-RT 10-3140 360 $48,992.10 27822 10007411 AMPUTAION OF THE KNEE 10-3140 360 $19,503.55 27599 10007417 REMVAL OF ANKLE/HEEL LESION-R 10-3140 360 $20,900.00 28100 10007471 CORRECTION OF BUNION-LT 10-3140 360 $46,489.60 28298 10007495 ARTHRODESIS MT OR TME; SGL JOI 10-3140 360 $50,347.74 28740 10007564 SHOULDER ARTHROSCOPY/SURGRY-R 10-3140 360 $50,586.00 29806 10007711 N BLOCK INJ,SCIATIC,SNG-RT 10-3140 360 $7,956.80 64445 10007807 UNLSTD PROC DENTOALVEOLAR STRT 10-3140 360 $2,959.63 41899 10007808 BX DONE W/COLPOSCOPY 10-3140 360 $16,333.80 58110 10007810 TREAT BIG TOE FRACTURE TA 10-3140 360 $24,756.05 28505 10007813 CAPSULORRHAPHY,BANKART 10-3140 360 $82,959.70 23455 10007819 REMVAL OF SPINAL LMNA SGL LMBR 10-3140 360 $47,548.90 63047 10007822 REMOVE SPINAL LAMINA ADD-ON 10-3140 360 $47,548.90 63048 10007840 TREAT ANKLE FRACTURE 10-3140 360 $63,197.33 28445 10007885 CL TX SHLDR DISL W MAN,W ANSTH 10-3140 360 $19,539.46 23655 10007903 SUTURE LIGAMENT ANKLE,COLLAT 10-3140 360 $45,892.50 27695 10007954 TENODESIS OF BICEPS TNDNAT EL 10-3140 360 $44,916.00 24340 10007966 EXC SHOULDER TUM DEEP< 5 CM B 10-3140 360 $15,933.34 23076 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10008103 OPN TX DSTL FBLR FX LAT MALS 10-3140 360 $48,992.10 27792 10008107 PRP I/HERN INIT BLOCK 5+YR BL 10-3140 360 $54,380.28 49507 10008123 INJ FORAMEN EPIDURAL ADD-ON 10-3140 360 $7,655.73 64484 10008131 REPR FOOT FLEXOR TENDON EA BL 10-3140 360 $20,537.30 28200 10008134 CREP F/G/H/F,2.6-7.5CM 10-3140 360 $4,862.70 13132 10008135 REINSERT SPINAL FIXATION DEVIC 10-3140 360 $20,529.83 22849 10008146 LIGATE FLOPN TUBE W CESAAN SCT 10-3140 360 $12,887.02 58611 10008149 CESAREAN DELIVERY ONLY,INCL PP 10-3140 360 $14,333.80 59515 10008152 UGI PLACEM GASTROSTOMY TUBE 10-3140 360 $12,032.40 43246 10008157 UNLISTED LAPAROSCOPY ABD PERIT 10-3140 360 $26,932.08 49329 10008160 CARDIOVERSION ELECTRIC EXT 10-3140 360 $5,509.10 92960 10008392 DX BRONCHOSCOPE/LAVAGE 10-3140 360 $11,302.80 31624 10008395 BONE MARROW ASPIRATION BL 10-3140 360 $7,612.30 38220 10008405 I&D ABSC, COMPL OR MULTI 10-3140 360 $1,896.30 10061 10008410 SUBTOTAL ABD HYSTERECTOMY 10-3140 360 $15,145.47 58180 10008413 PARTIAL HIP REPL PROSTHESIS 10-3140 360 $17,961.84 27125 10008423 REPR FOOT FLEXOR TENDON EA 10-3140 360 $20,537.30 28200 10008425 COLONOSCOPY FLEX W BX,SGL/MULT 10-3140 360 $8,751.70 45380 10008429 1' SUTR BTH RPTR ANKLE CRL LIG 10-3140 360 $30,651.00 27696 10008433 PARIALEXCISIONPOSTERIOR VERTBR 10-3140 360 $48,449.80 22102 10008436 REP TS FA/WR W FGRAFT 10-3140 360 $30,651.00 25275 10008437 COCCYGECTOMY, PRIMARY 10-3140 360 $30,595.00 27080 10008440 CYSTO W STONE MANIP OR REM LT 10-3140 360 $24,549.90 52352 10008442 EXISE NURMA, HNDORFOTNOTDIGNRV 10-3140 360 $16,437.00 64782 10008449 LAP TX ECT PREG,W SALPIN/OOPHO 10-3140 360 $44,604.40 59151 10008450 TREATMENT OF FIBULA FRACTURE 10-3140 360 $49,807.20 27784 10008454 ARTHROT KNEE W SYNOV, ANT/POST 10-3140 360 $30,651.00 27334 10008457 SUBTALAR ARTHRO W/EXC 10-3140 360 $25,343.80 29905 10008462 CYSTO/URETERO W/LITHOTRIPSY 10-3140 360 $36,677.50 52356 10008500 SPINE FUSE&REMV CERV BEL C2,SG 10-3140 360 $44,286.00 22551 10008501 SPN FUSE&RMV CRV BLW C2,EA ADL 10-3140 360 $47,548.90 22552 10008503 TREAT METACARPAL FRACTURE 10-3140 360 $48,992.10 26615 10008507 REV /REM IMPL SPNL NS PG/REC 10-3140 360 $27,115.93 63688 10008513 RMVL OF SPNL LMNA LMBR,1-2VERT 10-3140 360 $47,548.90 63005 10008531 REMOVE ANKLE IMPLANT BL 10-3140 360 $21,418.70 27704 10008532 ENTEROLYSIS 10-3140 360 $17,050.84 44005 10008533 LAP ENTEROLYSIS 10-3140 360 $58,549.97 44180 10008545 REMOVE IUD 10-3140 360 $2,249.90 58301 10008546 INSERT CERVICAL DILATOR 10-3140 360 $2,249.90 59200 10008548 ROUTINE OB CR INCL AP C-SCT PP 10-3140 360 $26,768.15 59510 10008560 REMOVE SPINE ELTRD PERQ ARAY 10-3140 360 $20,319.50 63661 10008562 INJ ANESTH,OTH PEPRLL NRV/BRNC 10-3140 360 $4,204.50 64450 10008567 RESECT SM INTEST,SGL RESECT&AN 10-3140 360 $14,675.36 44120 10008569 LAP ING HERNIA REPAIR RECUR RT 10-3140 360 $44,604.55 49651 10008572 TOT KNEE ARTHROPLASTY 10-3140 360 $24,330.17 27447 10008574 OMENTECTOMY EPIPLOECTOMY 10-3140 360 $13,267.95 49255 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10008575 REPL TUNNELED VAD W PORT 10-3140 360 $28,691.63 36582 10008579 LUMBAR SPINE FUSION POSTEOR 10-3140 360 $25,747.95 22630 10008580 REM P SEGMENT INSTRUMENT 10-3140 360 $11,058.29 22852 10008591 DEB BONE 20 SQ CM/< 10-3140 360 $9,798.87 11044 10008599 RPR INIT INCISIONAL HRNI,INCRC 10-3140 360 $30,877.00 49561 10008603 OP/PERC TX TIB SHAFT FX BY IM 10-3140 360 $84,627.62 27759 10008613 INS TUNNELED CV CATH AGE 5/> 10-3140 360 $29,451.76 36558 10008614 FEM/POPL REVAS W/TLA 10-3140 360 $52,384.20 37224 10008622 CYSTOURETHROSCOPY W URETERA LT 10-3140 360 $24,549.79 52005 10008629 OVAAN CYSTECTOMY UL/BL 10-3140 360 $44,316.79 58925 10008631 SUTURE OF 1 NERVE,ULNAR MOTOR 10-3140 360 $34,749.94 64836 10008636 INSRT SPINE FIXATION DVC POSTR 10-3140 360 $26,643.14 22840 10008637 APLY SPINE PROSTH DEVICE 10-3140 360 $37,080.65 22853 10008638 BIPOLAR HIP REPLACEMENT 10-3140 360 $15,133.50 27236 10008639 VAGINAL DELIVERY ONLY,INCL PP 10-3140 360 $11,826.20 59410 10008656 TA SP BONE AGRFT LOCAL ADD-ON 10-3140 360 $32,597.51 20936 10008661 EXC ABD LES SC > 3 CM 10-3140 360 $23,455.00 22903 10008666 REPAIR KNEECAP TENDON 10-3140 360 $30,595.00 27380 10008669 SP BONE ALGRFT MORSEL ADD-ON 10-3140 360 $31,255.16 20930 10008670 AV ANASTOMOSIS OPEN,ANY SITE 10-3140 360 $38,857.60 36821 10008674 OPN TX FMRL FRAC DSTL M/L CNDY 10-3140 360 $15,278.28 27514 10008675 TX INTR/PR/S FEM FX IMED IMPLT 10-3140 360 $19,503.55 27245 10008678 INSRT SPINE FXTN DVC3-6SEGMNTS 10-3140 360 $21,725.43 22842 10008682 ARTHROSCOPY BICEPS TENODESS B 10-3140 360 $50,586.00 29828 10008688 ARTHRODESIS GREAT TOE,MTP JNT 10-3140 360 $57,834.50 28750 10008692 ADHESIOLYSIS TUBE OVARY 10-3140 360 $11,114.05 58740 10008694 LIGATE FALLOP TUBE ABD ORV RT 10-3140 360 $33,257.68 58600 10008697 LAMINOTOMY SINGLE LUMBAR-LT 10-3140 360 $63,107.55 63042 10008703 TENOMYOTOMY SHOULDER,SINGLE R 10-3140 360 $30,595.00 23405 10008708 LAPAROSCOPE PROCEDURE LIVER 10-3140 360 $36,033.35 47379 10008722 DX BRONCHOSCOPE/WASH 10-3140 360 $11,302.80 31622 10008724 PMARY REPAIR RUPT ACHILLES LT 10-3140 360 $44,916.00 27650 10008725 EXPLORE SPINAL FUSION 10-3140 360 $12,938.72 22830 10008727 DR CLOSED TX ULNAR FRACTURE PR 10-3140 360 $1,550.00 27650 10008730 SPINE FUSION EXTRA SEGMENT 10-3140 360 $26,738.90 22632 10008731 SP BONE AGRFT MORSEL ADD-ON 10-3140 360 $35,293.19 20937 10008739 PARTL EXC ANKLE OR HEEL BONELT 10-3140 360 $22,175.00 28120 10008742 REPAIR TOE DISLOCATION T1 10-3140 360 $24,756.05 28645 10008765 ELECTR BONE STIM,IV 10-3140 360 $3,724.95 20975 10008774 ARTHROD MT OR TMT MULTI/TRANSV 10-3140 360 $72,664.88 28730 10008775 ARTHROSC RPIR O.D. LESION O FX 10-3140 360 $82,959.70 29892 10008777 BIOPSY OF VULVA/PENEUM 1 LESN 10-3140 360 $8,751.70 56605 10008778 LAP VENT/ABD HERNIA REPAIR 10-3140 360 $66,282.45 49652 10008789 REMOVE FECAL IMPACTION OR FB 10-3140 360 $21,472.19 45915 10008791 MYOMECTMY ABDOM METHOD 1-4MYMS 10-3140 360 $14,539.99 58140 10008795 UNLSTD PROC FEMALE GENITAL SYS 10-3140 360 $17,050.84 58999 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10008815 UNLSTD PROCEDRE PELVIS/HIP JNT 10-3140 360 $19,503.55 27299 10008838 TA ARTHRODESIS P/PL- 1L,BLW C2 10-3140 360 $41,756.45 22600 10008854 NG TUBE PLC W FLUORO 10-3140 360 $1,796.20 43752 10008858 LAPAROSCPIC MYOMECTMY =<250 GM 10-3140 360 $34,812.50 58545 10008865 FEMORAL N BLOCK SGL RT 10-3140 360 $4,204.50 64447 10008871 ARTHROPLASTY WRIST 10-3140 360 $44,916.00 25332 10008872 PM RPR RUPT ACHLS TNDN W GRFT 10-3140 360 $65,621.54 27652 10008880 CARPECTOMY;ALL BONES PROXIMAL 10-3140 360 $25,274.60 25215 10008883 AMPUTATE TOE,MTP JOINT 10-3140 360 $19,998.60 28820 10008922 REM ANT SEGMENT INSTRUMENT 10-3140 360 $12,585.60 22855 10008929 ATT S/A/L,D 10 SQ CM/< 10-3140 360 $16,286.20 14020 10008939 LAPAROSCOPY W SALPINGOSTOMY LT 10-3140 360 $43,334.60 58673 10008946 REMOVAL OF SUPPORT IMPLANT 10-3140 360 $13,615.50 20670 10008948 DESTROY ANAL LESN SMP,SURG EXC 10-3140 360 $17,947.70 46922 10008963 VERTEBR CORPCTMY,CERV SGL SEGT 10-3140 360 $19,892.30 63081 10008967 CERV ARTIFIC DISKECTOMY 10-3140 360 $47,548.90 22856 10008975 EXC PILONID CYST,SMPL 10-3140 360 $20,625.50 11770 10008983 INSRT SPINE FXTN DVC4-7SEGMNTS 10-3140 360 $40,430.22 22846 10008995 DRAINAGE OF SCRTAL WLL ABSCSS 10-3140 360 $10,031.10 55100 10009000 SURG TX ECT PREG,TUB/OV REQ 10-3140 360 $9,050.20 59120 10009003 BONE GRFT,MINOR/SM 10-3140 360 $30,595.00 20900 10009008 EXC ABDL TUM DEEP < 5 CM 10-3140 360 $20,625.50 22900 10009012 REPAIR ELBOW DEB/ATTCH OPEN 10-3140 360 $30,595.00 24359 10009017 OPEN TX FRAC DISTAL TIBIA ONLY 10-3140 360 $63,943.60 27827 10009018 OPEN ANKLE JNT FUSION 10-3140 360 $77,285.80 27870 10009022 INS PICC DEVICE W PORT 5 YRS/> 10-3140 360 $22,851.90 36571 10009023 COLONOSCOPE SUBMUCOUS INJ 10-3140 360 $8,751.70 45381 10009030 INDUCED ABORTION BY D&C 10-3140 360 $16,333.80 59840 10009031 TTL THYROID LOBECTMY UNIL 10-3140 360 $47,194.00 60220 10009032 DRAIN CEREBRO SPINAL FLUID 10-3140 360 $4,204.50 62272 10009033 DURAL GRAFT SPINAL 10-3140 360 $12,447.50 63710 10009043 TEE FOR MONITORING 10-3140 360 $1,738.02 93318 10009049 NEUROPLASTY,ULNAR NERVE AT ELB 10-3140 360 $16,437.00 64718 10009058 REPAIR UA/ELBOW TENDON/MUSCLE 10-3140 360 $44,916.00 24341 10009060 COLECTOMY PARTIAL,W ANASTOMOSI 10-3140 360 $14,894.10 44140 10009062 REM VENTIL TUBE UNDER ANESTH 10-3140 360 $14,464.70 69424 10009066 OP AV FUSE UPPR ARM CEPHALIC 10-3140 360 $38,857.60 36818 10009085 BUNION CORRECT W JNT RESCTIMPL 10-3140 360 $31,049.10 28291 10009086 ARTHROSC KNEE,DRL FR OSTCHNDRT 10-3140 360 $50,586.00 29885 10009094 RECONSTR ANGLE TOE DEFORMITY S 10-3140 360 $19,998.60 28313 10009104 LAMINOTOMY ADDL LUMBAR 10-3140 360 $63,107.55 63044 10009105 I&D P-SPINE L/S/LS 10-3140 360 $10,113.70 22015 10009118 INC ANKLE - POST CAPSL RELEASE 10-3140 360 $30,595.00 27612 10009127 INS NON-TUNNEL CV CATH 5 YRS/> 10-3140 360 $10,092.30 36556 10009133 UNLSTD PROCEDURE UNARY SYSTEM 10-3140 360 $918.12 53899 10009136 TX INT/PR/SBTRN FM FXSCRW IMPL 10-3140 360 $13,871.80 27244 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10009137 1' REPR/SUTR LEG FLEXOR TENDON 10-3140 360 $19,467.90 27658 10009153 HYSTRCPY;W LYSIS INTRAUT ADHSN 10-3140 360 $20,944.30 58559 10009160 REP DURL/CSF LEAK WO LAMINCTMY 10-3140 360 $10,338.30 63707 10009196 CIRCUMCISION W/REGIONL BLOCK 10-3140 723 $4,952.46 54150 10009203 CALCANEUS REMOVAL 10-3140 360 $19,998.60 28118 10009220 SUTURE QUAD/HAMSTNG MSCL RUPT 10-3140 360 $30,595.00 27385 10009223 SALPINGECTOMY COMPL/PART UL/BL 10-3140 360 $8,767.70 58700 10009244 ARTHROTOMY ANKLE W SYNOVECTOMY 10-3140 360 $30,595.00 27625 10009246 GSTRCTMY P DIST,W GASTRJEJ 10-3140 360 $22,454.10 43632 10009270 EXC BACK TUM DEEP 5 CM/> 10-3140 360 $20,625.50 21933 10009306 2' REPR TORN COLLAT ANKL LIGAM 10-3140 360 $30,595.00 27698 10009314 WND PREP F/N/HF/G 100SQ CM/1%B 10-3140 360 $4,862.70 15004 10009315 DISTANCE TENDON GRAFT 10-3140 360 $30,595.00 20924 10009317 BX VULVA /PENEUM,EA ADDTL LESN 10-3140 360 $4,862.70 56606 10009318 TLH W/T/O 250 G OR LESS 10-3140 360 $43,334.60 58571 10009331 INC ACHILLES TENDON W GN ANSTH 10-3140 360 $19,467.90 27606 10009351 ORBITOTOMY,W REMOVAL OF LESION 10-3140 360 $17,221.30 67412 10009359 RESECT SM INTST,EA ADDTL RSCTN 10-3140 360 $14,675.36 44121 10009372 REVISE SPINE ELTRD PERQ ARAY 10-3140 360 $54,950.80 63663 10009374 EXPL LAPAROTOMY EXPL CELIOTOMY 10-3140 360 $8,578.30 49000 10009383 SPLENECTOMY,TOTAL 10-3140 360 $12,780.80 38100 10009385 EPIDUROGRAMS 10-3140 320 $697.34 72275 10009388 INSERTION OF CHEST TUBE 10-3140 360 $5,762.80 32551 10009389 NJX INTERLAMINAR LMBR/SAC 10-3140 360 $5,965.40 62322 10009392 INJECT SPINE C/T 10-3140 360 $3,466.32 62320 10009396 INJ PARAVERT F JNT L/S 2-LEV 10-3140 360 $6,666.60 64494 10009404 LAP,ADB PET OMENUTM W ASP CYST 10-3140 360 $45,838.40 49322 10009410 DECOPRESS SPINAL CORD LUMBARS 10-3140 360 $47,548.90 63056 10009414 KNEE ARTHROSCOP/SURG--RT 10-3140 360 $35,454.57 29879 10009416 INJ A/S TRNSF EPID C/TH EA-LT 10-3140 360 $2,073.00 64480 10009422 IDET,SINGLE LEVEL--LT 10-3140 360 $30,000.00 22526 10009423 KNEE ARTHROSCOP/SURGERY--RT 10-3140 360 $35,454.57 29876 10009427 SHOULDER ARTHROSCOPY/SURGER-RT 10-3140 360 $50,586.00 29807 10009428 HYSTEROSCOPY W REM IMPACTED FB 10-3140 360 $20,944.30 58562 10009432 TREAT METATARSAL FRACTURES 10-3140 360 $48,992.10 28485 10009434 INC/REPL SPINES NSTIM PG/RCVR 10-3140 360 $204,682.00 63685 10009446 NJX PLATELET PLASMA 10-3140 360 $9,053.98 0232T 10009449 INJECT SPINE DISK X-RAY LUMBAR 10-3140 360 $7,677.47 62290 10009453 INJ FORAMEN EPIDURAL L/S 10-3140 360 $7,956.80 64483 10009454 INJ FORAMEN EPIDURAL L/S - RT 10-3140 360 $4,344.06 64483 10009456 LAP W/EXC DESTR OVARY PELVIC W 10-3140 360 $58,549.97 58662 10009465 DESTROY L/S FACET JNT ADDL 10-3140 360 $11,722.37 64636 10009468 SURG TX INCOMPL ABORTION_ 10-3140 360 $24,422.22 59812 10009469 HYSTEROSCOPY DIAGNOSTIC_ 10-3140 360 $28,242.08 58555 10009472 SLING OP FOR STRESS INCONTINNC 10-3140 360 $57,179.55 57288 10009473 INJECT SACROILIAC JOINT--RT 10-3140 360 $12,825.00 27096 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10009476 PERCUTANEOUS DISKECTOMY- 10-3140 360 $16,003.26 62380 10009477 ARTHROSC,SHLDR DECOM SA SP WPA 10-3140 360 $50,586.00 29826 10009478 SP BONE ALGRFT STRUCT ADD - ON 10-3140 360 $36,299.35 20931 10009480 ARTHROSCOPY,SHLDR DEBD EXTENS 10-3140 360 $50,586.00 29823 10009481 SHOULDER MUMFORD PROC- 10-3140 360 $50,586.00 29824 10009483 DECOMPRESS SPINE CORD ADD--ON 10-3140 360 $47,548.90 63057 10009484 DESTROY C/TH FACET JNT ADDL 10-3140 360 $18,351.40 64634 10009487 INJECT TGGER POINTS =/> 3 10-3140 360 $4,088.04 20553 10009490 LOW BACK,DISK SURGERY 10-3140 360 $47,548.90 63030 10009493 IDET 1 OR MORE LEVELS 10-3140 360 $30,000.00 22527 10009494 ARTHROSC KNEE,LIM SYNOVECTMY 10-3140 360 $32,775.00 29875 10009495 DR ARTHROSCOPY SHLDR,SYNOVEC P 10-3140 360 $25,593.55 29820 10009496 REM IMPL DEEP 10-3140 360 $20,625.50 20680 10009497 TONSILLECTOMY - AGE 12 OR MORE 10-3140 360 $22,083.40 42826 10009505 LAP W DESTRUCTIONS OF OVIDUCT 10-3140 360 $58,549.97 58670 10009506 DESTROY LUMB/SAC FACET JNT 10-3140 360 $10,093.90 64635 10009507 INJ PARAVERT F JNT L/S 3 LEV 10-3140 360 $6,666.60 64495 10009510 LAPAROSCOPY CHOLECYSTECOMY 10-3140 360 $58,549.97 47562 10009511 INJ SPINE DISK X-R CERV/THOR 10-3140 360 $8,254.60 62291 10009514 INJ PARAVERT F JNT C/T 3 LEV 10-3140 360 $7,956.80 64492 10009516 INJ PARAVERT F JNT L/S 1 LEV 10-3140 360 $6,666.60 64493 10009518 INJ PARAVERT F JNT C/T LEV 10-3140 360 $7,956.80 64490 10009522 TRAN OR AVULSE OTH SPINAL NRV 10-3140 360 $16,437.00 64772 10009526 SURG TX MISSED ABRT,1ST TMEST 10-3140 360 $24,422.22 59820 10009527 DESTROY CERV/THOR FACET JNT 10-3140 360 $18,351.40 64633 10009528 LAP,CHOLCYSTMY W CHLNGIGR 10-3140 360 $43,334.60 47563 10009529 LAP,W REM ADNEXAL STRUCTURES 10-3140 360 $44,604.40 58661 10009531 CYSTOURETHROSCOPY 10-3140 360 $9,122.85 52000 10009532 REP INIT INCI/ VENTRAL HERNIA 10-3140 360 $30,877.00 49560 10009535 SHOULDER ARTHRSCOPY/SURGERY RT 10-3140 360 $50,586.00 29820 10009536 ARTHROSC,KNEE,W MENISC-MED&LAT 10-3140 360 $35,454.57 29880 10009537 ROTATOR CUFF,REP ARTHROSCOPY 10-3140 360 $50,586.00 29827 10009538 DIAG LAPARO,SEPARATE PROC 10-3140 360 $45,838.40 49320 10009547 ARTHRODESIS POST 1LEV LUMBAR 10-3140 360 $47,548.90 22612 10009551 DX- KNEE ARTHROSCOPY 10-3140 360 $25,603.80 29870 10009552 ENDOSCOPIC PLANTAR FASCITMY-LT 10-3140 360 $21,064.35 29893 10009554 EXC BEN LES T/A/L,2.1-3.0CM 10-3140 360 $7,918.25 11403 10009558 UNLSTD PROCEDURE,NERVOUS-SYSTM 10-3140 360 $7,070.85 64999 10009560 BUNION CORRECT W MTRSL BNE INC 10-3140 360 $13,593.45 28296 10009563 ARTHROSC ANT CRUC LIG REP/AUG 10-3140 360 $82,959.70 29888 10009564 ARTHROSC KNEE W/MENISC MED/LAT 10-3140 360 $35,454.57 29881 10009566 DRAIN /INJ MAJOR JNT BURSA 10-3140 360 $2,401.70 20610 10009571 RPR UMBIL HERN BLOCK 5+YR 10-3140 360 $30,877.00 49587 10009574 ARTHRDESIS_PSTER EA ADD'L LEVL 10-3140 360 $42,722.91 22614 10009575 SPN FSN WO DECMPR CERV BELW C2 10-3140 360 $47,548.90 22554 10009577 UGI,DIAGNOSTIC- 10-3140 360 $7,963.40 43235 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10009578 LIGATION / BIOPSY TEMPORAL ART 10-3140 360 $16,853.95 37609 10009579 NECK SPINE DISK SRGRY DSCTMY A 10-3140 360 $47,548.90 63076 10009582 LAP ING HERNIA REPAIR INIT--RT 10-3140 360 $43,334.60 49650 10009583 ARTHROSCOPY ANKLE,EXT DEBD 10-3140 360 $35,454.57 29898 10009584 ARTHROSCOPY,ANKLE,P_SYNOVECTOM 10-3140 360 $25,603.80 29895 10009585 UGI W BX_SGL/MULTIPLE 10-3140 360 $7,963.40 43239 10009590 CYSTOSCOPY W/BIOPSY (S) 10-3140 360 $23,841.70 52204 10009594 ARTHROSCOPY,ANKLE,SMPL DEBD 10-3140 360 $25,603.80 29897 10009595 PERC IMPL NS ELCTRD ARY,EPIDRL 10-3140 360 $54,950.80 63650 10009597 INCISION OF METATARSAL RT 10-3140 360 $19,998.60 28308 10009600 RPR UMBIL HERN REDUC 5+YR 10-3140 360 $30,877.00 49585 10009601 ADDITIONAL SPINAL- FUSION 10-3140 360 $33,934.91 22585 10009605 EXC&REP OF EYELID>1/4 LID MARG 10-3140 360 $17,221.30 67966 10009606 EXC EYLID LSN WO CLOSE/SML RPR 10-3140 360 $7,645.60 67840 10009607 REMOVE HARNGTON ROD 10-3140 360 $11,542.64 22850 10009608 2' REPR/SUTR LEG FLEXOR TENDON 10-3140 360 $19,467.90 27659 10009612 LUMBAR ARTIF DISKECTOMY 10-3140 360 $20,589.70 22857 10009613 ARTHRODESIS SACROILIAC JOINT 10-3140 360 $11,748.30 27280 10009615 AMPUTATE FOOT,TRANSMETATARSAL 10-3140 360 $19,998.60 28805 10009616 DEB SUBQ TISSUE 20 SQ CM/< 10-3140 360 $3,264.00 11042 10009627 ASPIRATE PLEURA W/ IMAGING 10-3140 360 $5,762.80 32555 10009637 NECK SPINE DISK SRGR DISCECTMY 10-3140 360 $47,548.90 63075 10009659 EXPL W DR/REM FB-MTP FOOT JNT 10-3140 360 $19,998.60 28022 10009665 SCNDRY REPR RUPT ACHILLES TNDN 10-3140 360 $44,916.00 27654 10009669 INTUBATION ET EMERGENT 10-3140 360 $1,896.20 31500 10009677 NASOLACR PROBE W TUBE/STNT INS 10-3140 360 $17,221.30 68815 10009678 VRTBR CRPCTMY,CERV EA ADTL SGM 10-3140 360 $19,892.30 63082 10009679 EXC TALUS/CALCAN CYST/TMR W AG 10-3140 360 $25,496.45 28103 10009708 CYSTOSCOPY IMPLANT STENT 10-3140 360 $34,504.00 52282 10009709 OP TX RDL&ULNR SHFT FX FIXJR/U 10-3140 360 $63,943.60 25575 10009711 INSRT HEART PM ATAL & VENT 10-3140 360 $125,762.70 33208 10009713 RMVL OF SPINAL LAMINA SGL CERV 10-3140 360 $47,548.90 63045 10009716 CYST W INS INDWELLING URTR ST 10-3140 360 $32,050.10 52332 10009723 ARTHROSC KNEE,W LYSIS OF ADHES 10-3140 360 $25,603.80 29884 10009729 LPR-VAG HYST INCL T/O =<250 GM 10-3140 360 $43,337.60 58552 10009733 OPN BX/EXC LN,DEEPCERV NODE(S) 10-3140 360 $24,074.90 38510 10009738 OPEN TX RADIAL SHAFT FRACTURE 10-3140 360 $48,992.10 25515 10009750 CESAREAN DELIVERY ONLY 10-3140 360 $10,428.50 59514 10009752 INJ PARAVERT F JNT C/T 2 LEV 10-3140 360 $7,956.80 64491 10009793 NS CATH - EXTREMITY ARTERY 10-3140 360 $2,125.91 36140 10009795 FRENOPLASTY 10-3140 360 $42,339.20 41520 10009797 IMPLANT SPINE INFUSION PUMP 10-3140 360 $174,001.20 62361 10009799 SPINE FUSION EXTRA SEGMENT 10-3140 360 $20,251.12 22634 10009800 LUMBAR SPINE FUSION COMBINED 10-3140 360 $20,318.30 22633 10009806 ARTHROSCOPY KNEE,DEBD/SHV AC 10-3140 360 $25,603.80 29877 10009810 CONJUNCTIVORHINSTMY,W INS TUBE 10-3140 360 $23,599.20 68750 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10009812 REP NU/MU,METATARSAL 10-3140 360 $57,824.50 28322 10009821 VAG DELIVERY AFTER PREV CESAAN 10-3140 360 $16,333.80 59612 10009826 OP TX TRMLELR ANKL W FX PSTLIP 10-3140 360 $63,943.60 27823 10009827 CERCLAGE CERVIX PREGNANT,VAG 10-3140 360 $16,333.80 59320 10009835 OP TX NASAL SEPTAL FX 10-3140 360 $23,899.60 21336 10009838 OP TX HUMERS SHFT FX,PLT/SCRW 10-3140 360 $63,943.60 24515 10009840 CREP E/N/E/L,1.1-2.5 CM 10-3140 360 $4,862.70 13151 10009847 GASTROSTMY OP,WO GASTC TUBECRE 10-3140 360 $28,383.60 43830 10009849 BONE MARROW BIOPSY 10-3140 360 $7,612.30 38221 10009852 SKIN SUB GRAFT FACE/NK/HF/G 10-3140 360 $16,286.20 15275 10009900 INS TEMP BLADDER CATH 10-3140 360 $1,167.00 51702 10009901 DEB SKIN BONE AT FX SITE 10-3140 360 $7,612.30 11012 10009916 CURETTAGE POSTPARTUM 10-3140 360 $16,333.80 59160 10009932 COLNSCPY FLX W REM LES HBF/BPC 10-3140 360 $8,751.70 45384 10009947 CYSTO W FULG OF MINOR LESIONS 10-3140 360 $24,567.50 52224 10009961 CL TX METATARSAL FX; W MANIP 10-3140 360 $2,519.70 28475 10009963 REPR FOOT EXTENSOR TENDON EA 10-3140 360 $19,998.60 28208 10009977 ERCP DUCT STENT PLACEMENT 10-3140 360 $22,967.20 43274 10009997 SPL AVULSE NP,SGL 10-3140 360 $1,750.60 11730 10010000 LARYNGOSCOPY W/FB REMOVAL 10-3140 360 $15,521.20 31530 10010001 INJ INTERLAMINAR CRV/THRC 10-3140 360 $7,881.70 62325 10010016 OP TX ULNAR STYL FX 10-3140 360 $49,826.60 25652 10010037 REPAIR FIBULA NONUNION 10-3140 360 $58,610.40 27726 10010044 CL TX SESAMOID FRACTURE 10-3140 360 $2,932.60 28530 10010054 UNLISTED PROCEDURE FOOT OR TOE 10-3140 360 $859.60 28899 10010059 DEB MUSC/FASCIA 20 SQ CM/< 10-3140 360 $5,056.00 11043 10010066 CLNSCPY FLX W REM LESN BY SNA 10-3140 360 $8,878.50 45385 10010068 DEB SUBQ TISSUE ADD-ON =<20 SQ 10-3140 360 $2,727.52 11045 10010071 EGD CONTROL BLEEDING ANY 10-3140 360 $12,832.50 43255 10010072 INCISION OF TIBIA 10-3140 360 $28,255.00 27705 10010081 INS PICC AGE 5 YRS/> 10-3200 761 $10,092.30 36569 10010094 ERCP W/SPECIMEN COLLECTION 10-3140 360 $10,176.05 43260 10010095 ARTHRODESIS SACROILIAC JOINT 10-3140 360 $124,290.30 27279 10010101 TX TARSAL BONE FX ; WO MANIPU 10-3140 360 $2,833.00 28450 10010110 COLONOSCOPY W/FB REMOVAL 10-3140 360 $13,705.00 45379 10010111 TX TARSAL BONE FX; W MANIP 10-3140 360 $2,936.50 28455 10010125 CREP H/A/G/EXTR; EA ADD 5 CM/< 10-3140 360 $3,895.95 13133 10010129 BONE MARROW HARVEST AUTOLOG 10-3140 360 $37,494.00 38232 10010132 DEBRIDE SKIN AT FX SITE 10-3140 360 $7,612.30 11010 10010134 INCISION & DRAINING, PERNIAL ABSCESS 10-3140 360 $5,965.40 46050 10010139 INSJ BIOMECHANICAL DEVICE 10-3140 360 $34,767.33 22853 10010146 NJX INTERLAMINAR LMBR/SAC 10-3140 360 $5,965.40 62323 10010147 NJX INTERLAMINAR CRV/THRC 10-3140 360 $5,965.40 62321 10011005 SECOND LEVEL CER DISKECTOMY 10-3140 360 $47,548.90 22858 10011006 INCISION ST ABSC; DEEP 10-3140 360 $15,806.60 20005 10011007 KNEE ARTHROSCOPY W LAT RLS 10-3140 360 $31,016.90 29873 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10011008 SPINA LAMINA 1/2 CRVL 10-3140 360 $23,080.70 63001 10011009 SCRN COLONOSCPY PT NOT HI RISK 10-3140 360 $8,652.00 45378 10011010 REPAIR LIVER WOUND 10-3140 360 $14,703.50 47361 10011011 PERCUTANEOUS DISKECTOMY 10-3140 360 $29,089.64 62287 10011012 REPAIR DEFECT OF ARTERY 10-3140 360 $10,526.30 35011 10011013 TRANSPLT ALLO HCT/DONOR 10-3140 360 $2,347.20 38240 10011014 CLTX ANKLE DISLOC W ANSTH 10-3140 360 $14,397.50 27842 10011015 REMOVE LUMB ARTIF DISC 10-3140 360 $4,017.10 64837 10011016 DEBRIDE SKIN MUSC AT FX SITE 10-3140 360 $3,609.90 11011 10011017 ARTHRO, LOOSE BODY + CHONDRO 10-3140 360 $1,043.50 G0289 10011018 REMOVE DIGIT NERVE LESION 10-3140 360 $4,643.50 64776 10011019 RELEASE PALM/FINGER TENDON 10-3140 360 $7,359.90 26440 10011020 REMOVE/TRANSPLANT TENDON 10-3140 360 $9,043.00 23440 10011021 REMOVE LUMB ARTIF DISC 10-3140 360 $24,839.20 22865 10011022 PROCTOSIGMOIDOSCOPY W/BX 10-3140 360 $884.70 45305 10011023 N BLOCK INJ PARACERVICAL 10-3140 360 $958.10 64435 10011024 REMOVE SPINE FIXATION DEVICE 10-3140 360 $13,677.00 22859 10011025 INSJ BIOMECHANICAL DEVICE 10-3140 360 $3,957.50 22854 10011026 REVISE LUMBAR ARTIF DISC 10-3140 360 $29,391.50 22862 10011027 EXCISE INTRSPINL LESION LMBR 10-3140 360 $17,022.20 63267 10011028 HERNIA REPAIR W/MESH 10-3140 360 $3,248.50 49568 10011029 SMALL BOWEL ENDOSCOPY 10-3140 360 $3,420.50 44376 10011030 REPAIR BLOOD VESSEL UPPER EXTR 10-3140 360 $9,488.60 35206 10011031 REVISION OF TOTAL KNEE ARTH 10-3140 360 $21,142.50 27487 10011032 REMOVE VERT BODY DCMPRN LMBR 10-3140 360 $23,970.90 63090 10011033 INCISE TENDON(S) & MUSCLE(S) 10-3140 360 $9,222.50 23406 10011034 CPTR-ASST DIR MS PX 10-3140 360 $1,772.70 20985 10011041 INSJ STABLJ DEV W/DCMPRN 10-3140 360 $92,226.00 22867 10011043 PERQ VERTEBRAL AUGMENTATION 10-3140 360 $33,638.52 22514 10011045 Remove knee joint lining 10-3140 360 $33,638.52 27335 10011046 Aspirate/inj ganglion cyst 10-3140 360 $1,468.20 20612 10011047 Bone marrow aspir bone grfg 10-3140 360 $1,468.20 20939 10011048 Amputation of midfoot 10-3140 360 $15,871.38 28800 10011049 Skin sub graft f/n/hf/g addl 10-3140 360 $9,410.58 15276 10011050 REPAIR LIVER WOUND 10-3140 360 $13,705.32 47360 10011051 N BLOCK INJ LUMBAR PLEXUS 10-3140 360 $6,721.80 64449 10011052 REMOVE VERTEBRAL BODY ADD-ON 10-3140 360 $19,892.30 63091 10011055 REMOVAL OF COLON 10-3140 360 $30,380.00 44150 10011057 BIOPSY THIGH SOFT TISSUES 10-3140 360 $9,299.48 27324 10011059 ARTHROPLASY, ANKLE W/IMPLANT 10-3140 360 $11,481.10 27702 10011061 TREAT SPINAL CANAL LESION 10-3140 360 $4,033.08 62282 10011063 ABDOMEN SURGERY PROCEDURE 10-3140 360 $4,460.94 49999 10011064 SP BONE AGRFT STRUCT ADD-ON 10-3140 360 $16,262.88 20938 10011065 REVISE LOWER LEG TENDON 10-3140 360 $33,638.52 27690 10011066 INCISION OF COLLARBONE JOINT 10-3140 360 $15,871.38 23106 10011067 EXPLORATORY SHOULDER SURGERY 10-3140 360 $15,871.38 23044 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 10011070 OPEN TX NOSE FX W/SKELE FIXJ 10-3140 360 $17,355.16 21330 10011071 TREAT DISLOCATION/FRACTURE 10-3140 360 $22,425.68 23670 10011072 REMOVE WRIST/FOREARM LESION 10-3140 360 $10,580.92 25116 10011074 ABLATE BONE TUMOR(S) PERQ 10-3140 360 $22,425.68 20982 10011075 VASCULAR SURGERY PROCEDURE 10-3140 360 $2,450.28 37799 10011077 REPAIR FINGER/HAND TENDON 10-3140 360 $10,580.92 26426 10011078 ANALYZE NEUROSTIM COMPLEX 10-3140 360 $460.72 95972 10011079 GENITAL SURGERY PROCEDURE 10-3140 360 $642.80 58999 10011083 REMOVAL OF ARM FOREIGN BODY 10-3140 360 $9,299.48 24201 10011084 SHOULDER SURGERY PROCEDURE 10-3140 360 $859.60 23929 10011085 N BLOCK CONT INFUSE B PLEX 10-3140 360 $2,688.72 64416 10011086 HIP ARTHRO W/FEMOROPLASTY 10-3140 360 $22,425.68 29914 10011087 HIP ARTHRO ACETEBULOPLASTY 10-3140 360 $22,425.68 29915 10011088 DRAINAGE OF SCROTUM 10-3140 360 $6,782.72 54700 10011089 REPAIR TESTIS INJURY 10-3140 360 $6,782.72 54670 10011091 HIP ARTHRO W/LABRAL REPAIR 10-3140 360 $22,425.68 29916 10011092 REPAIR HAND JOINT 10-3140 360 $10,580.92 26540 10011093 DECOMPRESS FOREARM 1 SPACE 10-3140 360 $5,399.78 25020 10011094 REVISE FINGER JOINT EACH 10-3140 360 $10,580.92 26135 10011095 CORRECT METACARPAL FLOW 10-3140 360 $10,580.92 26565 10011096 RECONSTRICTION KNEE 10-3140 360 $22,425.68 27427 10011097 REMOVE EXTRA SPINE SEGMENT 10-3140 360 $22,425.68 22103 10011098 COLONOSCOPY W/BALLOON DILAT 10-3140 360 $3,745.56 45386 10011099 NEUROVASCULAR PEDICLE FLAP 10-3140 360 $10,841.92 15750 10011100 HARVEST AUTO STEM CELLS 10-3140 360 $4,886.96 38206 10011101 EXC SYNOVIUAL CYST POPLTEAL SP 10-3140 360 $105,850.92 27345 10011102 CMPLX REPAIR TRUNK 2.6-7.5 cm 10-3140 360 $5,105.84 13101 10011103 TLH W/T/O UTERUS OVER 250 G 10-3140 360 $30,381.68 58573 10011104 SELECTIVE CATH LT/RT PUL ARTY 10-3140 360 $815.10 36014 10011105 SCAN PROC SPINAL 10-3140 360 $2,265.10 61783 10011106 COLOTOMY EXPLORE BX FB REM 10-3140 360 $9,477.40 44025 10011107 ABDOMEN SURGERY PROCEDURE 10-3140 360 $859.60 22999 10011108 TISSUE TRX ANY 30.1-60CM 10-3140 360 $10,841.92 14301 10011109 TISSUE TRX ADDL 30 SQ CM 10-3140 360 $10,841.92 14302 10011110 AUTOCHONDROCYTE IMPLANT KNEE 10-3140 360 $22,425.68 27412 10011111 REMOVAL OF FOOT FOREIGN BODY 10-3170 450 $5,392.12 28192 10013048 REPR TORN CRUCIATE KNEE LIGAM 10-3140 360 $82,959.70 27407 10013079 IRRIGATION OF BLADDER 10-3140 360 $25,410.00 51700 10013087 PERQ VERTEBRAL AUGMENTATION 10-3140 360 $47,526.41 22514 10020002 GUIDE CATHET FLUID DRAINAGE 10-3710 360 $1,145.70 10030 10020021 THRMBC/NFS DIALYSIS CIRCUIT 10-3710 360 $20,340.00 36904 10020037 TIB/PER REVASC W/TLA 10-3710 360 $42,041.84 37228 10020046 VASC EMBOLIZE/OCCLUDE ORGAN 10-3710 360 $42,041.84 37243 10020085 PLMT NEPHROSTOMY CATHETER 10-3710 360 $6,782.72 50432 10020086 PLMT NEPHROURETERAL CATHETER 10-3710 360 $6,782.72 50433 12000001 ANESTH .75 HRS 10-3140 379 $3,526.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 12000002 ANESTH 1.25 HRS. 10-3140 379 $4,808.00 12000003 ANESTH 1.75 HRS. 10-3140 379 $6,094.00 12000004 ANESTH 2.25 HRS. 10-3140 379 $7,360.00 12000005 ANESTH 2.75 HRS. 10-3140 379 $8,628.00 12000006 ANESTH 3.25 HRS. 10-3140 379 $9,928.00 12000007 ANESTH 3.75 HRS. 10-3140 379 $11,208.00 12000008 ANESTH 4.25 HRS. 10-3140 379 $12,456.00 12000009 ANESTH 4.75 HRS. 10-3140 379 $13,416.00 12000010 ANESTH 5.25 HRS. 10-3140 379 $14,372.00 12000011 ANESTH 5.75 HRS. 10-3140 379 $14,990.00 12000012 ANESTH 6.25 HRS. 10-3140 379 $14,990.00 12000013 ANESTH 6.5 HRS. 10-3140 379 $17,564.00 12000015 ANESTH 7 HRS. 10-3140 379 $18,850.00 12000018 ANESTH 7.75 HRS. 10-3140 379 $20,736.00 12000019 ANESTH 8 HRS. 10-3140 379 $21,392.00 12000020 ANESTHESIA - 0.15 10-3140 379 $1,441.00 12000021 ANESTHESIA - 0.5 HR. 10-3140 379 $2,882.00 12000022 ANESTHESIA - 1 HR. 10-3140 379 $4,168.00 12000023 ANESTHESIA - 1.5 HRS. 10-3140 379 $5,450.00 12000024 ANESTHESIA - 2 HRS. 10-3140 379 $6,724.00 12000025 ANESTHESIA - 2.5 HRS. 10-3140 379 $7,998.00 12000026 ANESTHESIA - 3 HRS. 10-3140 379 $9,272.00 12000027 ANESTHESIA - 3.5 HRS. 10-3140 379 $10,558.00 12000028 ANESTHESIA - 4 HRS. 10-3140 379 $11,806.00 12000029 ANESTHESIA - 4.5 HRS. 10-3140 379 $13,098.00 12000030 ANESTHESIA - 5 HRS. 10-3140 379 $13,750.00 12000031 ANESTHESIA - 5.5 HRS. 10-3140 379 $14,990.00 12000032 ANESTHESIA - 6 HRS. 10-3140 379 $14,990.00 12000056 INTUBATION 10-3140 379 $1,233.00 13000002 RR 30MIN to 1 hour 10-3160 710 $5,865.00 13000005 RR 1 hour to 1.5 hour 10-3160 710 $7,035.00 13000006 RR 1.5 hours to 2 hours 10-3160 710 $7,629.00 13000007 RR 2 hours to 2.5 hours 10-3160 710 $7,629.00 13000008 RR 2.5 hours to 3 hours 10-3160 710 $12,183.00 13000010 RR 3 hours to 3.5 hours 10-3160 710 $14,238.00 13000011 RR 3.5 hours to 4 hours 10-3160 710 $16,176.00 13000012 RR 4 hours to 4.5 hours 10-3160 710 $17,346.00 13000014 RR 5 hours to 5.5 hours 10-3160 710 $19,692.00 13000015 RR 5.5 TO 6.0 HRS. 10-3160 710 $22,038.00 13000021 RR UP TO 30 MINUTES 10-3160 710 $1,382.00 13000042 ANESTHESIA VAGINAL DELIVERY 10-3325 370 $4,637.60 01960 13000043 ANESTH/ANALG VAG DELIVERY 10-3325 370 $3,312.50 01967 13000044 ANESTHESIA CESAREAN DELIVERY 10-3325 370 $5,125.50 01961 15000018 HOSPITAL OBSERV L/D UP TO 8HR 10-3195 721 $10,200.00 G0378 15000070 VENIPUNCTURE 10-3195 300 $50.00 36415 15001001 NUR- CIRCUMCISION 10-3195 361 $4,952.46 54160 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 21001007 GLUCOSE, BLOOD REAGENT STRIP 10-3140 301 $21.75 82948 24000038 DRAIN/INJ INTERM JNT/BURSA 10-3170 450 $2,521.79 20605 24000039 DRAIN/INJ MAJOR JNT/BURSA 10-3170 450 $2,521.79 20610 24000073 EMERGENCY DEPT VISIT LEVEL II 10-3170 450 $2,686.74 99282 24000089 CPR 10-3170 450 $994.88 92950 24000181 EMERGENCY DEPT VISIT LEVEL I 10-3170 450 $1,815.45 99281 24000195 CNTRL POST EPISTAX INIT 10-3170 450 $1,049.06 30905 24000247 CRITICAL CARE 1ST HOUR 10-3170 450 $6,621.18 99291 24000266 CREP F/G/H/F; 1-2.5CM 10-3170 450 $2,721.18 13131 24000268 REM FB MUSCLE; SMPL 10-3170 360 $7,992.92 20520 24000280 INS TEMP BLADDER CATH 10-3170 450 $1,225.35 51702 24000332 EMERGENCY DEPT VISIT LEVEL IV 10-3170 450 $4,256.60 99284 24000336 INTUBATION ET EMERGENT 10-3170 450 $1,985.74 31500 24000353 SREP F/E/N/L/MM; 2.6-5.0CM 10-3170 450 $1,831.41 12013 24000354 INTMD WND RPR FACE/MM2.6-5.0CM 10-3170 450 $2,482.20 12052 24000355 SREPS/N/A/G/TR/E; 2.6-7.5CM 10-3170 450 $2,088.72 12002 24000356 SREP F/E/N/L/MM; 5.1-7.5CM 10-3170 450 $2,090.76 12014 24000359 SREP F/E/N/L/MM; 7.6-12.5CM 10-3170 450 $1,795.50 12015 24000360 SREP S/N/A/G/TR/E; 7.6-12.5CM 10-3170 450 $2,685.27 12004 24000392 EMERGENCY DEPT VISIT LEVEL III 10-3170 450 $3,547.32 99283 24000417 CLTX MCP DISLOC SGL W MANIP 10-3170 450 $2,285.27 26700 24000478 CLTX NURSEMAID ELBW" W MANIP" 10-3170 450 $2,285.27 24640 24000496 CLTX SHLDR DISL W MNP;WO ANSTH 10-3170 450 $2,522.68 23650 24000497 INSERTION CATHETER ARTERY 10-3170 450 $14,956.44 36640 24000617 SPL AVULSE NP; SGL 10-3170 450 $1,838.13 11730 24000620 REPAIR NAIL BED 10-3170 450 $2,482.20 11760 24000627 CLTX SHLDR DISL W M;W ANSTH 10-3170 450 $14,397.50 23655 24000639 CLTX D PHAL FX FGRR/THMB;W M 10-3170 450 $2,285.27 26755 24000676 REP LAC2.5CM/<;FLR-MTH/ANT 2/3 10-3170 450 $1,049.06 41250 24000682 IM RABIES VACCINE 10-3170 636 $1,035.65 90675 24000686 THER/PROPH/DIAG INJ SC/IM 10-3170 450 $499.80 96372 24000704 SREP F/E/N/L/MM; 2.5CM/< 10-3170 450 $1,199.99 12011 24000709 CREP E/N/E/L; 2.6-7.5CM 10-3170 450 $5,105.84 13152 24000724 EMERGENCY DEPT VISIT LEVEL V 10-3170 450 $4,807.83 99285 24000725 TREAT HIP DISLOCATION 10-3170 450 $5,399.76 27252 24000726 CRITICAL CARE ADDL 30MIN 10-3170 450 $7,918.47 99292 24000747 PUNCT ASP - ABSC HEMAT CYST 10-3170 450 $1,991.12 10160 24000749 I&D ABSC; SMPL/SGL 10-3170 450 $1,991.12 10060 24000757 I&D BARTHOLIN'S GLND ABSCESS 10-3170 450 $1,872.73 56420 24000791 THER/PROPH/DIAG IV INIT<1HR 10-3170 450 $2,147.36 96365 24000801 THER/PROPH/DIAG IV INF ADDON 10-3170 450 $861.55 96366 24000802 REMOVAL OF NAIL BED 10-3170 450 $4,151.00 11750 24000891 INJ ANSTH;PERIPHERL NRV/BRANCH 10-3170 450 $4,414.73 64450 24000895 I&D ABSCESS; PERITONSILLAR 10-3170 450 $3,256.16 42700 24000897 THER/PROPH/DIAG INJ IV PUSH 10-3170 450 $1,320.69 96374 24000901 HYDRTN IV INFUSN INIT 31-60MIN 10-3170 260 $637.80 96360 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 24000902 HYDRATE IV INFUSION ADD-ON 10-3170 450 $166.49 96361 24001111 THROMBOLYSIS CERBRL IV INFUSN 10-3170 450 $2,291.73 37195 24001624 TX/PRO/DX INJ NEW DRUG ADDON 10-3170 450 $242.08 96375 24009003 THER/PROPH/DIAG IV INF INIT =< 10-3170 260 $861.55 96365 24009908 TX/PRO/DX INJ SAME DRUG ADDON 10-3170 260 $454.00 96376 24009917 IMMUNIZATION ADMIN 1 VACCINE 10-3170 771 $230.55 90471 24009918 ASPIRATE PLEURA W/O IMAGING 10-3170 450 $6,050.94 32554 24009930 SREP S/N/A/G/TR/E; 2.5CM/< 10-3140 450 $1,217.93 12001 24009950 TREAT FRACTURE OF RADIUS 10-3170 450 $5,332.00 25505 30000113 INCENTIVE SPIROMETRY INITIAL 10-3410 460 $708.00 94010 30000114 INCENTIVE SPIROMETRY SUBSEQU 10-3410 460 $708.00 94010 30000122 PEAK FLOW 10-3410 460 $481.80 94150 30000130 P.F.T. MVV 10-3410 460 $481.80 94200 30000131 P.F.T. SPIROMETRY 10-3410 460 $708.00 94010 31000002 ABG PUNCTURE 10-3410 410 $1,386.48 36600 31000004 AEROSOL THERAPY CONTINS -INITI 10-3410 410 $341.10 94664 31000005 AEROSOL THERAPY CONTINUOS -SUB 10-3410 410 $341.10 94640 31000010 CPR 10-3410 480 $947.50 92950 31000011 CHEST PHYSICAL THERAPY-INTIAL 10-3410 410 $341.10 94667 31000012 CHEST PT, SUBSEQUENT 10-3410 410 $206.75 94668 31000017 CPAP/BIPAP - INITIAL 10-3410 410 $1,170.90 94660 31000018 CPAP/BIPAP-SUBSEQUENT 10-3410 410 $1,170.90 94660 31000030 NEBULIZER THERAPY - INITIAL 10-3410 410 $370.55 94664 31000031 NEBULIZER THERAPY - SUBSEQUENT 10-3410 410 $341.10 94640 31000035 PED AEROSOL TENT INITIAL 10-3410 410 $370.55 94664 31000036 PED AEROSOL TENT SUBSEQT DAY 10-3410 410 $341.10 94640 31000043 VENTILATOR MGMT ADULT -INITIAL 10-3410 410 $2,375.50 94002 31000044 VENTILATOR MGMT ADULT - SUBSEQ 10-3410 410 $2,375.50 94003 36000005 BRONCHOSCOPY DX W/WO CELL WASH 10-3065 761 $6,293.60 31622 36000035 EGD W/ SCLEROTHERAPY 10-3065 750 $5,978.70 43243 36000120 COLONOSCOPY-HI RISK CANCER SCR 10-3065 750 $5,605.00 36000146 CARDIOVERSION ELECTRIC EXT 10-3065 480 $2,354.70 92960 48001057 FLUOROSCOPE EXAM EXTENSIVE 10-3320 320 $189.70 76001 48001103 X-RAY C/T SPINE DISK 10-3720 320 $6,593.09 72285 48001289 NASAL/ORGASTRIC W/TUBE PLCMT 10-3325 361 $1,796.20 43752 52000200 EVALUATE SWALLOWING FUNCTION 10-3475 444 $364.40 92610 52000237 SPEECH/HEARING EVALUATION 10-3475 440 $1,267.25 92506 52000255 SPEECH LANGUAGE EVAL 10-3475 444 $4,148.00 92506 52000272 TREAT SWALLOWING DYSFUNCTION 10-3475 449 $423.95 92526 53000018 DIGOXIN INJ TO 0.5 MG 10-3460 636 $22.00 J1160 53000024 NUBAIN INJ PER 10 MG 10-3460 636 $12.85 53000026 UNCLASSIFIED DRUG 10-3460 636 $20.92 53000030 PHENERGAN INJ TO 50 MG 10-3460 636 $5.00 J2550 53000032 EPHEDRINE SULFATE50MG/MLAMPUL 10-3460 259 $158.92 53000038 METOPROLOL TARTRATE1MG/MLAMPUL 10-3460 259 $21.00 53000040 NARCAN INJ PER 1 MG 10-3460 636 $62.84 J2310 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53000044 VITAMIN K INJ PER 1 MG 10-3460 636 $16.00 J3430 53000053 PRESERV FREE MORPHINE PER 10MG 10-3460 636 $24.56 J2274 53000054 INJ HALOPERIDOL TO 5 MG 10-3460 636 $75.00 J1630 53000055 NOREPINEPHRINE BITART1MG/MLAMP 10-3460 259 $73.00 53000058 VITAMIN K INJ PER 1 MG 10-3460 636 $15.99 J3430 53000061 DIGOXIN INJ TO 0.5 MG 10-3460 636 $292.50 53000064 TERBUTALINE SULFATE INJ TO 1MG 10-3460 636 $54.00 J3105 53000067 PHENYTOIN SODIUM INJ PER 50MG 10-3460 636 $2.18 J1165 53000068 SUFENTASUFENTANIL 50MCG/MLAMP 10-3460 259 $17.00 53000073 INJ LOVENOX 10 MG 10-3460 636 $25.00 53000075 AMIODARONE HCL INJ 30MG 10-3460 636 $2.66 J0282 53000089 METHERGINE INJ TO 0.2 MG 10-3460 636 $89.00 53000090 INDIGO CARMINE0.8%AMP 10-3460 259 $26.00 53000094 NEOSPORIN G.U. IRRNEOPOLYBAMP 10-3460 259 $372.00 53000099 AMMONIA AROMATICAMPULE 10-3460 259 $3.00 53000103 DEPAKOTE SPRINKDIVALPROEX125MG 10-3460 259 $5.28 53000106 CARDIZEM CDDILTIAZEM 120MGCAP 10-3460 259 $3.00 53000107 CARDIZEM CDDILTIAZEM180MGCAP 10-3460 259 $4.00 53000108 CARDIZEM CDDILTIAZEM240MGCAP 10-3460 259 $128.00 53000113 TEMAZEPAM15MGCAPSULE 10-3460 259 $3.00 53000115 ORAL PRESCRIP DRUG NON CHEMO 10-3460 636 $3.00 53000116 NIFEDIPINE10MGCAPSULE 10-3460 259 $3.00 53000124 BENZONATATE100MGCAPSULE 10-3460 259 $3.00 53000126 INDOMETHACIN25MGCAPSULE 10-3460 259 $3.00 53000127 INDOMETHACIN50MGCAPSULE 10-3460 259 $3.00 53000128 LOPERAMIDE HCL2MGCAPSULE 10-3460 259 $3.00 53000129 CEPHALEXIN MH500MGCAPSULE 10-3460 259 $2.95 53000139 DICYCLOMINE HCL10MGCAPSULE 10-3460 259 $3.00 J0500 53000144 CLINDAMYCIN HCL150MGCAPSULE 10-3460 259 $3.00 53000146 DOCUSATE SODIUM100MGCAPSULE 10-3460 259 $3.00 53000164 ORAL PRESCRIPTION DRUG CHEMO 10-3460 636 $5.00 53000167 HYTRINTERAZOSIN HCL5MGCAPSULE 10-3460 259 $3.00 53000168 LITHIUM CARBONATE300MGCAPSULE 10-3460 259 $3.00 53000172 DIPHENHYDRAMINE HCL 50 MG ORAL 10-3460 636 $3.00 J1200 53000173 DIPHENHYDRAMINE HCL 50 MG ORAL 10-3460 636 $3.00 Q0163 53000179 CHLORDIAZEPOXIDE HCL25MGCAP 10-3460 259 $3.00 53000180 DOXYCYCLINE HYCLATE100MGCAP 10-3460 259 $4.00 53000182 NEURONTINGABAPENTIN100MGCAP 10-3460 259 $6.38 53000183 NEURONTINGABAPENTIN300MGCAP 10-3460 259 $16.66 53000184 NEURONTINGABAPENTIN400MGCAP 10-3460 259 $19.51 53000186 PROZACFLUOXETINE HCL20MGCAP 10-3460 259 $3.00 53000196 ROCALTROLCALCITRIOL0.25MCGCAP 10-3460 259 $3.63 J0636 53000199 AMOXICILLIN TRIHYDRATE500MGCAP 10-3460 259 $3.00 53000205 LIBRIUMCHLORDIAZEPOXIDE 5MGCAP 10-3460 259 $3.00 53000214 NITROFURANTOIN MACRO100MGCAP 10-3460 259 $12.00 53000220 DILANTINPHENYT SODEXT100MGCAP 10-3460 259 $3.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53000221 HYDROMORPHONE 0.5 MG/0.5ML 10-3460 259 $13.47 J1170 53000231 PRILOSECOMEPRAZOLE10MGCAP DR 10-3460 259 $20.00 53000232 PRILOSECOMEPRAZOLE20MGCAP DR 10-3460 259 $3.00 53000236 PANCRELIPASEAM/LIP/PROTCAP EC 10-3460 259 $8.51 53000243 CLOTRIMAZOLE1%CREAM 10-3460 259 $41.00 53000245 NYSTATIN100MU/GCREAM 10-3460 259 $42.00 53000246 HYDROCORTISONE1%CREAM 10-3460 259 $18.00 53000247 FLUOCINONIDE0.05%CREAM 10-3460 259 $110.00 53000248 HYDROCORTISONE0.5%CREAM 10-3460 259 $9.00 53000252 NIZORALKETOCONAZOLE2%CREAM 10-3460 259 $125.62 53000257 TRIAMCINOLONE ACETONIDE0.1%CRE 10-3460 259 $14.00 53000262 THERMAZENESILVER SULFAD1%CREAM 10-3460 259 $38.00 53000265 LOTRISONECLOTRIM/BETA DIPCREAM 10-3460 259 $176.00 53000266 NYSTATIN W/TRIAMCINOLONECREAM 10-3460 259 $202.00 53000275 LIDOCAINE HCL INJ FOR IV 10 MG 10-3460 636 $12.00 53000279 DEXTROSE 50% INJ 50ML SYRINGE 10-3460 636 $29.94 53000280 DEMEROL HCL INJ PER 100 MG 10-3460 636 $22.39 53000281 DEMEROL HCL INJ PER 100 MG 10-3460 636 $25.20 53000282 DEMEROL HCL INJ PER 100 MG 10-3460 636 $21.00 53000289 MORPHINE SULFATE INJ TO 10 MG 10-3460 636 $5.24 J2270 53000293 CALCIUM CHLORIDE100MG/MLSYRIN 10-3460 259 $31.00 53000302 PHENOBARBITAL SOD30MG/ML SYRIN 10-3460 259 $3.00 53000317 INJ LOVENOX 10 MG 10-3460 636 $24.90 J1650 53000337 ATROPINE SULFATE1%DROPS 10-3460 259 $41.00 53000340 TETRACAINE HCL0.5%DROPS 10-3460 259 $26.00 53000349 GENTAMICIN SULFATE0.3%DROPS 10-3460 259 $47.00 53000350 TOBRAMYCIN SULFATE0.3%DROPS 10-3460 259 $289.00 53000359 XALATANLATANOPROST0.005%DROPS 10-3460 259 $569.60 53000370 CILOXANCIPROFLOXACIN0.3%DROPS 10-3460 259 $27.00 53000375 GENASYMESIMETH40MG/0.6MLDROPS 10-3460 259 $5.80 53000386 ALPHAGANBRIMONIDINE0.2%DROPS 10-3460 259 $135.00 53000390 NEO-SYNEPHRINEPHENYL HCL1%DRPS 10-3460 259 $12.00 53000392 DEXAMETHASONE SODPHOSPH0.1%DRP 10-3460 259 $214.00 53000402 ARTIFICL TEARSPOLYVINOL1.4%DRP 10-3460 259 $7.00 53000419 PREDNISOLONE ACET1%DROPS SUSP 10-3460 259 $417.00 J2650 53000427 CORTISPORINDROPS SUSP 10-3460 259 $340.00 53000429 SILVER NITRATE APPLICATOREACH 10-3460 259 $180.92 53000432 ACETAMINOPHEN160MG/5MLELIXIR 10-3460 259 $3.95 53000440 FLEET MINERAL OIL ENEMAENEMA 10-3460 259 $5.83 53000445 FLEET ENEMA 10-3460 259 $3.00 53000447 TUCKS WITCH HAZEL EXTRACT 10-3460 259 $3.00 53000458 NITROGLYCERIN 50MG/D5W INJ BT 10-3460 636 $59.20 53000466 HYPERTONIC SALINE SOL 1 ML 10-3460 636 $8.00 53000476 RINGERS LACTATE INF TO 1000CC 10-3460 636 $7.97 J7120 53000479 DOBUTREX INJ PER 250 MG 10-3460 636 $63.00 J1250 53000483 5%DEXTROSE/NRMLSALINE500ML=1UT 10-3460 636 $8.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53000485 POTASSIUM CHLRD5W/NACL2B2434IV 10-3460 259 $9.00 53000487 RINGERS LACTATE INF TO 1000CC 10-3460 636 $8.00 53000490 SURGILUBECHLORHEX JELLY 10-3460 259 $3.64 53000492 EMLALIDO/PRILOCAINE2.5-2.5%KIT 10-3460 259 $25.00 53000502 ULTANESEVOFLURANELIQUID 10-3460 259 $400.19 53000506 FERROUS SULFATE300MG/5MLLIQUID 10-3460 259 $3.00 53000507 DOCUSATE SOD150MG/15MLLIQUID 10-3460 259 $10.97 53000510 DIPHENHYDRAMINE HCL 50 MG ORAL 10-3460 636 $5.00 J1200 53000538 LANOLIN OINTMENT 30GM TUBE 10-3460 259 $6.00 53000542 NITROGLYCERIN2%OINT.(GM) 10-3460 259 $93.00 53000549 HYDROCORTISONE2.5%OINT.(GM) 10-3460 259 $210.00 53000552 BACTROBANMUPIROCIN2%OINT.(GM) 10-3460 259 $378.75 53000554 SANTYLCOLLAGENASE250U/GOINT(GM 10-3460 259 $615.00 53000560 NEO/POLY SULF/DEXAMETHOINT(GM) 10-3460 259 $552.00 53000561 GENTAKGENTAMICIN0.3%OINT.(GM) 10-3460 259 $45.00 53000598 MOTRINIBUPROFEN100MG/5ML SUSP 10-3460 259 $10.00 53000610 TEGRETOLCARBAMAZE100MG/5MLSUSP 10-3460 259 $212.99 53000615 SODIUM POLYSTYRENE 15G/60MLSUS 10-3460 259 $27.00 53000621 MILK OF MAGNESIA SUSP 10-3460 259 $5.27 53000629 BACITRACIN ZINC500U/GPACKET 10-3460 259 $3.00 53000635 NICOTINE 21MG/24HRPATCH TD24 10-3460 259 $10.00 53000636 DURAGESICFENTANYL25MCG/HPATCH 10-3460 259 $22.00 53000639 DURAGESICFENTANYL100MCG/HPATCH 10-3460 259 $83.00 53000645 CIPROFLOXACIN IV 200 MG 10-3460 636 $5.49 J0744 53000646 INJ LEVOFLOXACIN 250 MG 10-3460 636 $39.00 J1956 53000647 INJ LEVOFLOXACIN 250 MG 10-3460 636 $11.48 J1956 53000649 DIFLUCAN INJ 200 MG 10-3460 636 $26.42 53000650 DIFLUCAN INJ 200 MG 10-3460 636 $22.75 53000651 UNCLASSIFIED DRUG 10-3460 636 $41.46 53000660 AVITENEMICROFI COLLAGENPOWDER 10-3460 259 $570.00 53000667 COLYTESOLN RECON 10-3460 259 $39.00 53000669 COCAINE HCL4%SOL 10-3460 259 $1,339.00 53000677 FUROSEMIDE40MG/5MLSOL 10-3460 259 $5.00 53000693 ALBUTEROL NON-COMP UNIT 1 MG 10-3460 636 $0.94 53000697 IPRATROPIUM BRM NON-CMP PER1MG 10-3460 636 $3.00 53000711 BSSPLUSSOD/POT/CAL/MAG/BAKSOL 10-3460 259 $24.00 53000713 ADRENALIN NASALEPINE1-1000SOL 10-3460 259 $336.00 53000714 LIDOCAINE HCL VISCOUS20MGMLSOL 10-3460 259 $2.92 53000720 NEOMYCIN/POLYMYXIN/HCSOL 10-3460 259 $182.50 53000727 GELFOAM COMPRESSED100CMSPONGE 10-3460 259 $125.00 53000731 OXYMETAZOLINE HCL0.05%SPRAY 10-3460 259 $2.84 53000735 FLONASEFLUTICASONE 50MCGSPRAY 10-3460 259 $282.00 53000742 MIACALCINCALCITON200USPRYPUMP 10-3460 259 $225.00 J0630 53000743 FLUOR-I-STRIPFLUORESC9MGSTRIP 10-3460 259 $3.00 53000745 ASPIRIN300MGSUPP.RECT 10-3460 259 $4.00 53000746 BISACODYL10MGSUPP.RECT 10-3460 259 $3.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53000751 ACEPHENACETAMINO120MGSUPP.RECT 10-3460 259 $3.00 53000754 FEVERALLACETAMINO650MGSUPP 10-3460 259 $3.00 53000777 AMOXICILLIN TRIHY250MG/5MLSUSP 10-3460 259 $10.00 53000781 CEPHALEXIN 250MG/5ML SUSP100ML 10-3460 259 $69.00 53000795 LACTULOSE10G/15MLSYRUP 10-3460 259 $3.99 53000804 PROMETHAZINE HCL 12.5 MG ORAL 10-3460 636 $33.60 Q0169 53000806 PRELONEPREDNISOLO15MG/5MLSYRUP 10-3460 636 $64.69 J7510 53000808 ZANTACRANITIDINE15MG/MLSYRUP 10-3460 259 $54.00 53000821 PHENERGAN W/CODEINESYRUP 10-3460 259 $37.93 53000822 PROMETHAZINE W/DMSYRUP 10-3460 259 $8.00 53000828 GUAIFENESIW/DMHB100-10/5MLSYRU 10-3460 259 $3.00 53000829 ASPIRIN81MGTAB CHEW 10-3460 259 $3.00 53000830 SIMETHICONE80MGTAB CHEW 10-3460 259 $3.00 53000838 GLUCOTROL XLGLIPIZIDE5MGTABSA 10-3460 259 $3.00 53000842 THEOPHYLLINE 100MGTAB.SR 12H 10-3460 259 $3.00 J2810 53000844 THEOPHYLLINE 300MGTAB.SR 12H 10-3460 259 $3.00 J2810 53000846 IMDURISOSORBIDEMONONITR30MGTAB 10-3460 259 $3.00 53000847 IMDURISOSORBIDEMONONITR60MGTAB 10-3460 259 $3.00 53000848 SENNA187MGTABLET 10-3460 259 $3.00 53000850 DIAZEPAM5MGTABLET 10-3460 259 $3.00 J3360 53000852 ASPIRIN325MGTABLET 10-3460 259 $3.00 53000853 ATENOLOL25MGTABLET 10-3460 259 $15.00 53000854 ATENOLOL50MGTABLET 10-3460 259 $3.00 53000856 GLIPIZIDE5MGTABLET 10-3460 259 $3.00 53000857 GLYBURIDE5MGTABLET 10-3460 259 $3.00 53000858 LORAZEPAM1MGTABLET 10-3460 259 $3.00 53000859 SUCRALFATE1GTABLET 10-3460 259 $3.00 53000862 BUMETANIDE1MGTABLET 10-3460 259 $3.00 53000865 CLONAZEPAM1MGTABLET 10-3460 259 $3.00 53000866 DIGOXIN0.25MGTABLET 10-3460 259 $4.00 53000867 FOLIC ACID1MGTABLET 10-3460 259 $3.00 53000868 GLIPIZIDE10MGTABLET 10-3460 259 $9.19 53000869 MINOXIDIL10MGTABLET 10-3460 259 $3.00 53000874 PREDNISONE ORAL PER 5 MG 10-3460 636 $3.00 J7512 53000875 PREDNISONE ORAL PER 5 MG 10-3460 636 $0.60 J7512 53000878 ORAL PRESCRIP DRUG NON CHEMO 10-3460 636 $3.00 53000880 DIGOXIN0.125MGTABLET 10-3460 259 $4.00 53000881 FUROSEMIDE20MGTABLET 10-3460 259 $3.00 53000882 FUROSEMIDE40MGTABLET 10-3460 259 $3.00 53000885 HALOPERIDOL1MGTABLET 10-3460 259 $3.00 53000887 HALOPERIDOL5MGTABLET 10-3460 259 $3.00 53000888 IBUPROFEN400MGTABLET 10-3460 259 $3.00 53000889 IBUPROFEN600MGTABLET 10-3460 259 $2.99 53000891 ISONIAZID300MGTABLET 10-3460 259 $3.00 53000892 LORAZEPAM0.5MGTABLET 10-3460 259 $3.00 53000894 PREDNISONE ORAL PER 5 MG 10-3460 636 $3.00 J7512 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53000895 PREDNISONE ORAL PER 5 MG 10-3460 636 $3.00 J7512 53000897 ALPRAZOLAM0.5MGTABLET 10-3460 259 $3.00 53000902 CLONAZEPAM0.5MGTABLET 10-3460 259 $3.00 53000903 COLCHICINE0.6MGTABLET 10-3460 259 $20.87 53000912 ALLOPURINOL100MGTABLET 10-3460 259 $3.00 53000913 ALLOPURINOL300MGTABLET 10-3460 259 $3.00 53000914 ALPRAZOLAM0.25MGTABLET 10-3460 259 $3.46 53000916 ORAL DEXAMETHASONE 0.25 MG 10-3460 636 $3.15 53000920 GEMFIBROZIL600MGTABLET 10-3460 259 $20.66 53000924 DILTIAZEM HCL30MGTABLET 10-3460 259 $3.00 53000925 DILTIAZEM HCL60MGTABLET 10-3460 259 $3.00 53000926 MECLIZINE HCL25MGTABLET 10-3460 259 $3.00 53000934 TRAZODONE HCL50MGTABLET 10-3460 259 $3.00 53000937 ACETAMINOPHEN325MGTABLET 10-3460 259 $3.00 53000938 ACETAZOLAMIDE250MGTABLET 10-3460 259 $7.00 53000939 CARBAMAZEPINE200MGTABLET 10-3460 259 $3.00 53000941 CLONIDINE HCL0.1MGTABLET 10-3460 259 $3.00 53000942 CLONIDINE HCL0.2MGTABLET 10-3460 259 $3.00 53000943 CLONIDINE HCL0.3MGTABLET 10-3460 259 $3.00 53000949 METHOCARBAMOL750MGTABLET 10-3460 259 $3.00 53000951 METRONIDAZOLE500MGTABLET 10-3460 259 $3.00 53000953 SPIRONOLACTONE25MGTABLET 10-3460 259 $3.00 53000954 TRAZODONE HCL100MGTABLET 10-3460 259 $3.00 53000955 VERAPAMIL HCL120MGTABLET 10-3460 259 $3.00 53000960 COREGCARVEDILOL25MGTABLET 10-3460 259 $14.12 53000965 HYDRALAZINE HCL10MGTABLET 10-3460 259 $3.00 53000966 HYDRALAZINE HCL25MGTABLET 10-3460 259 $3.00 53000967 HYDRALAZINE HCL50MGTABLET 10-3460 259 $3.00 53000968 HYDROXYZINE HCL10MGTABLET 10-3460 259 $3.00 53000969 HYDROXYZINE PAMOATE 25 MG ORAL 10-3460 636 $3.00 53000970 HYDROXYZINE HCL50MGTABLET 10-3460 259 $9.00 53000971 MECLIZINE HCL12.5MGTABLET 10-3460 259 $3.00 53000976 ZOCORSIMVASTATIN5MGTABLET 10-3460 259 $3.00 53000985 FERROUS SULFATE325MGTABLET 10-3460 259 $3.00 53000991 HYDROMORPHONE HCL4MGTABLET 10-3460 259 $3.00 53000995 PEPCIDFAMOTIDINE20MGTABLET 10-3460 259 $3.00 53000999 ZESTRILLISINOPRIL5MGTABLET 10-3460 259 $3.00 53001001 ZOCORSIMVASTATIN20MGTABLET 10-3460 259 $3.00 53001003 AMITRIPTYLINE HCL10MGTABLET 10-3460 259 $3.00 J1320 53001004 AMITRIPTYLINE HCL25MGTABLET 10-3460 259 $3.00 J1320 53001005 AMITRIPTYLINE HCL50MGTABLET 10-3460 259 $3.00 J1320 53001007 AVAPROIRBESARTAN150MGTABLET 10-3460 259 $3.00 53001009 COREGCARVEDILOL12.5MGTABLET 10-3460 259 $14.39 53001010 COREGCARVEDILOL6.25MGTABLET 10-3460 259 $14.10 53001012 CYPROHEPTADINE HCL4MGTABLET 10-3460 259 $3.00 53001018 ORAL PRESCRIPTION DRUG CHEMO 10-3460 636 $3.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53001019 METHYLPREDNISOLONE ORAL PER4MG 10-3460 636 $9.61 53001023 NEOMYCIN SULFATE500MGTABLET 10-3460 259 $4.40 53001024 PROSCARFINASTERIDE5MGTABLET 10-3460 259 $3.00 53001026 ZESTRILLISINOPRIL10MGTABLET 10-3460 259 $3.00 53001027 ZESTRILLISINOPRIL20MGTABLET 10-3460 259 $3.00 53001030 BUSPARBUSPIRONE HCL5MGTABLET 10-3460 259 $3.00 53001032 CALCIUM GLUCONATE500MGTABLET 10-3460 259 $3.00 53001035 CHLORPROMAZINE HCL25MGTABLET 10-3460 259 $19.20 53001038 CIPROFLOXACIN HCL500MGTABLET 10-3460 259 $3.00 53001042 COREGCARVEDILOL3.125MGTABLET 10-3460 259 $14.37 53001045 FERROUS GLUCONATE325MGTABLET 10-3460 259 $3.00 53001048 METOCLOPRAMIDE HCL10MGTABLET 10-3460 259 $3.00 53001049 OXYBUTYNIN CHLORIDE5MGTABLET 10-3460 259 $3.00 53001051 TAPAZOLEMETHIMAZOLE5MGTABLET 10-3460 259 $3.00 53001054 ULTRAMTRAMADOL HCL50MGTABLET 10-3460 259 $3.00 53001055 ZAROXOLYNMETOLAZONE5MGTABLET 10-3460 259 $10.00 53001058 ARICEPTDONEPEZIL HCL5MGTABLET 10-3460 259 $3.00 53001059 BENZTROPINE MESYLATE1MGTABLET 10-3460 259 $3.00 J0515 53001061 BETAPACESOTALOL HCL80MGTABLET 10-3460 259 $5.00 53001063 BUSPARBUSPIRONE HCL10MGTABLET 10-3460 259 $3.00 53001066 CYCLOBENZAPRINE HCL10MGTABLET 10-3460 259 $3.00 53001070 HYDROCHLOROTHIAZIDE25MGTABLET 10-3460 259 $3.00 53001072 LAMICTALLAMOTRIGINE25MGTABLET 10-3460 259 $3.00 53001077 METOPROLOL TARTRATE50MGTABLET 10-3460 259 $3.00 53001078 PAXILPAROXETINE HCL20MGTABLET 10-3460 259 $3.00 53001079 PSEUDOEPHEDRINE HCL30MGTABLET 10-3460 259 $3.00 53001081 RISPERDALRISPERIDONE1MGTABLET 10-3460 259 $29.85 53001082 RISPERDALRISPERIDONE2MGTABLET 10-3460 259 $50.54 53001085 TAB-A-VITEMULTIVITAMINSTABLET 10-3460 259 $3.00 53001089 BETHANECHOL CHLORIDE10MGTABLET 10-3460 259 $3.00 J0520 53001090 BETHANECHOL CHLORIDE25MGTABLET 10-3460 259 $3.00 53001092 CYTOTECMISOPROSTOL100MCGTABLET 10-3460 259 $11.00 53001094 DIFLUCANFLUCONAZOLE100MGTABLET 10-3460 259 $103.90 53001097 ISOSORBIDE DINITRATE20MGTABLET 10-3460 259 $3.00 53001099 LAMICTALLAMOTRIGINE100MGTABLET 10-3460 259 $41.80 53001103 PHENAZOPYRIDINE HCL100MGTABLET 10-3460 259 $3.28 53001104 PHENAZOPYRIDINE HCL200MGTABLET 10-3460 259 $7.00 53001108 SODIUM BICARBONATE 650MGTABLET 10-3460 259 $3.00 53001110 ONDANSETRON ORAL 1 MG 10-3460 636 $3.00 Q0162 53001111 ZOLOFTSERTRALINE HCL50MGTABLET 10-3460 259 $30.51 53001119 LEVAQUINLEVOFLOXACIN250MGTAB 10-3460 259 $3.00 53001120 LEVAQUINLEVOFLOXACIN500MGTAB 10-3460 259 $90.85 53001123 ZOLOFTSERTRALINE HCL100MGTAB 10-3460 259 $30.06 53001124 AMBIENZOLPIDEM TARTRATE5MGTAB 10-3460 259 $3.00 53001125 CARBIDOPA/LEVODOPA25-100MGTAB 10-3460 259 $3.00 53001126 CARBIDOPA/LEVODOPA25-250MGTAB 10-3460 259 $3.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53001127 COUMADINWARFARIN SODIUM1MGTAB 10-3460 259 $6.00 53001128 COUMADINWARFARIN SODIUM2MGTAB 10-3460 259 $7.00 53001129 COUMADINWARFARIN SODIUM5MGTAB 10-3460 259 $7.00 53001130 KETOROLAC TROMETHAMINE10MGTAB 10-3460 259 $3.55 53001132 ROXICODONEOXYCODONE HCL5MGTAB 10-3460 259 $3.00 53001139 TRANDATELABETALOL HCL200MGTAB 10-3460 259 $3.00 53001140 ORAL AZITHROMYCIN DIHYDRTE 1GM 10-3460 636 $97.01 53001143 ORAL AZITHROMYCIN DIHRT 1GM 10-3460 259 $10.00 53001145 COUMADINWARFARIN SODIUM10MGTAB 10-3460 259 $10.00 53001150 NORMODYNELABETALOL HCL100MGTAB 10-3460 259 $3.00 53001152 PENICILLIN V POTASSIUM500MGTAB 10-3460 259 $3.00 53001153 PROCHLORPERAZINE MALEATE 5MG 10-3460 636 $3.00 Q0164 53001155 VASOTECENALAPRIL MALEATE5MGTAB 10-3460 259 $3.00 53001157 VITAMIN CASCORBIC ACID500MGTAB 10-3460 259 $3.00 53001161 CARDURADOXAZOSIN MESYLAT2MGTAB 10-3460 259 $13.55 53001162 CARDURADOXAZOSIN MESYLAT4MGTAB 10-3460 259 $15.00 53001166 CORDARONEAMIODARONE200MGTAB 10-3460 259 $3.84 J0282 53001167 COUMADINWARFARIN 2.5MGTABLET 10-3460 259 $7.00 53001168 COUMADINWARFARIN 7.5MGTABLET 10-3460 259 $9.00 53001169 COZAARLOSARTAN POTASS25MGTAB 10-3460 259 $2.97 53001170 GLUCOPHAGEMETFORMIN500MGTAB 10-3460 259 $3.00 53001171 GLUCOPHAGEMETFORMIN850MGTAB 10-3460 259 $3.00 53001175 VASOTECENALAPRIL MAL10MGTAB 10-3460 259 $3.00 53001176 VASOTECENALAPRIL MAL20MGTAB 10-3460 259 $3.00 53001177 VITAMIN B-1THIAMINE100MGTAB 10-3460 259 $3.20 J3411 53001182 NORVASCAMLODIPINE 5MGTABLET 10-3460 259 $18.24 53001185 RITALINMETHYLPHENIDATE5MGTAB 10-3460 259 $3.00 53001186 VASOTECENALAPRIL2.5MGTABLET 10-3460 259 $3.00 53001187 VITAMIN B-6PYRIDOXINE50MGTAB 10-3460 259 $3.00 53001189 ISMOISOSORBIDE MONONITR20MGTAB 10-3460 259 $3.00 53001190 NORVASCAMLODIPINE 10MGTABLET 10-3460 259 $24.55 53001191 HYDROXYCHLOROQUINE200MGTABLET 10-3460 259 $9.00 53001192 LIPITORATORVASTATIN 0MGTABLET 10-3460 259 $28.67 53001193 LIPITORATORVASTATIN 20MGTABLET 10-3460 259 $42.38 53001194 NORVASCAMLODIPINE2.5MGTABLET 10-3460 259 $18.20 53001195 PLAVIXCLOPIDOGREL75MGTABLET 10-3460 259 $19.92 53001198 SINGULAIRMONTELUKAST 10MGTAB 10-3460 259 $3.33 53001202 MAGONATEMAG GLUCONATE500MGTAB 10-3460 259 $3.00 53001204 SEROQUELQUETIAPINE 100MGTABLET 10-3460 259 $3.00 53001209 LEVOXYLLEVOTHYROXINE112MCGTAB 10-3460 259 $3.00 53001210 LEVOXYLLEVOTHYROXINE150MCGTAB 10-3460 259 $4.00 53001216 ACCUPRILQUINAPRIL 20MGTABLET 10-3460 259 $13.50 53001218 MESTINONPYRIDOSTIGMINE 60MGTAB 10-3460 259 $43.40 53001221 SYNTHROIDLEVOTHYROXIN50MCGTAB 10-3460 259 $3.00 53001222 LEVOTHROIDLEVOTHYROXIN25MCGTAB 10-3460 259 $3.00 53001223 LEVOTHROIDLEVOTHYROXIN88MCGTAB 10-3460 259 $3.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53001229 LEVOTHROIDLEVOTHYROX100MCGTAB 10-3460 259 $3.00 53001236 SULFAMETHOX/TRIMET800-160MGTAB 10-3460 259 $3.00 53001241 ACETAMINOPHEN W/COD30-300MGTAB 10-3460 259 $3.00 53001244 PERCOCETOXYCODONEACET5-325MGTB 10-3460 259 $3.00 53001245 THERAPEUTIC-M W-MINERALSTAB 10-3460 259 $3.00 53001250 FIORPAPACETAMIN/CAFF/BUTTAB 10-3460 259 $14.35 53001254 AUGMENTINAMOX TR/500-125MGTAB 10-3460 259 $29.00 53001255 AUGMENTINAMOX TR/875-125MGTAB 10-3460 259 $5.96 53001256 K-DUR .POTASSIUM CH20 MEQTAB 10-3460 259 $3.00 53001257 DIPHENOXYLATE W/ATROPINEABLET 10-3460 259 $3.00 53001260 MEDROXYPROGESTERONE ACE10MGTAB 10-3460 259 $3.00 53001266 ASPIRIN81MGTABLET EC 10-3460 259 $3.00 53001267 ASPIRIN325MGTABLET EC 10-3460 259 $3.00 53001268 BISACODYL5MGTABLET EC 10-3460 259 $3.00 53001274 DEPAKOTEDIVALPROEX 250MGTAB EC 10-3460 259 $3.00 53001275 DEPAKOTEDIVALPROEX 500MGTAB EC 10-3460 259 $3.00 53001281 ADALAT CCNIFEDIPINE30MGTAB SA 10-3460 259 $18.39 53001294 ISOPTIN S.R.VERAPAMIL240MGTAB 10-3460 259 $7.00 53001295 MAG DELAYMAGNESIUM64MGTAB SA 10-3460 259 $3.00 53001298 TOPROL XLMETOPROLOL 50MGTAB SA 10-3460 259 $4.00 53001302 BENZOIN COMPOUNDTINCTURE 10-3460 259 $9.00 53001304 INJ GLUCAGON HCL PER 1 MG 10-3460 259 $618.00 53001308 TRIMETHOBENZAMIDE HCL TO 200MG 10-3460 636 $49.50 53001309 OXYTOCIN INJECTION TO 10 UNITS 10-3460 636 $5.62 J2590 53001310 UNCLASSIFIED DRUG 10-3460 636 $162.98 53001312 ADRENALIN EPINEPHRINE INJ0.1MG 10-3460 636 $63.00 53001313 FUROSEMIDE INJ UPTO 20MG 10-3460 636 $14.99 J1940 53001315 AZTREONAM 1GM/VI INJ 10-3460 636 $118.56 53001316 UNCLASSIFIED DRUG 10-3460 636 $120.75 53001317 CEFAZOLIN SODIUM INJ 500 MG 10-3460 636 $2.94 J0690 53001319 UNCLASSIFIED DRUG 10-3460 636 $39.66 53001320 AMPICILLIN 500 MG INJ 10-3460 636 $9.00 J0290 53001322 AMPICILLIN SODIUM INJ 500 MG 10-3460 636 $7.21 J0290 53001323 UNCLASSIFIED DRUG 10-3460 636 $8.00 53001325 DOPAMINE INJECTION 40 MG 10-3460 636 $12.00 J1265 53001327 KETAMINE HCL50MG/MLVIAL 10-3460 259 $22.00 53001331 NON-INHALATION DRUG FOR DME 10-3460 636 $45.00 53001333 LIDOCAINE HCL INJ FOR IV 10 MG 10-3460 636 $10.99 J2001 53001337 LIDOCAINE HCL INJ FOR IV 10 MG 10-3460 636 $10.00 53001340 LORAZEPAM INJ 2 MG 10-3460 636 $3.00 53001351 VERAPAMIL HCL2.5MG/MLVIAL 10-3460 259 $59.53 53001354 TPA INJ 1 MG 10-3460 636 $312.63 J2997 53001355 ACYCLOVIR INJ 5MG 10-3460 636 $0.63 J0133 53001357 AMPICILLIN 500 MG INJ 10-3460 636 $13.22 J0290 53001359 AMPICILLIN SODIUM500MGVIAL 10-3460 636 $8.73 J0290 53001360 BACITRACIN 50000 UNT/VIL INJ 10-3460 636 $40.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53001365 INJ HYDRALAZINE HCL TO 20 MG 10-3460 636 $54.00 J0360 53001367 CEFEPIME HCL INJ 500 MG 10-3460 636 $10.96 J0692 53001377 BUPIVACAINE HCL 0.25% INJ 30ML 10-3460 636 $6.00 53001379 INJ DOBUTAMINE HCL250 MG 10-3460 636 $19.00 J1250 53001385 PENICILLIN G BENZ INJ 100000UN 10-3460 636 $47.25 53001386 FAMOTIDINE 10MG/ML INJ 2ML 10-3460 636 $3.00 53001390 THROMBIN-JMITHROMBIN5MUVIAL 10-3460 259 $215.91 53001397 VITAMIN B-12 INJ TO 1000MCG 10-3460 636 $15.70 J3240 53001400 UNCLASSIFIED DRUG 10-3460 636 $1.12 53001406 INJ MAGNESIUM SULFATE/500 MG 10-3460 636 $0.70 53001410 POLYMYXIN B SULFATE500MUVIAL 10-3460 259 $40.40 53001414 NRML SALINE INFUSION 1000 CC 10-3460 636 $10.19 53001420 CALCIUM GLUCONATE INJ TO 10ML 10-3460 636 $25.93 J0610 53001424 GARAMYCIN GENTAMICIN INJTO80MG 10-3460 636 $14.81 J1580 53001427 CEFOXITIN SODIUM INJ 1 GM 10-3460 636 $18.00 J0694 53001432 INJ POTASSIUM CHL PER 2 MEQ 10-3460 636 $1.10 J3480 53001433 SODIUM BICARBONATE1MEQ/MLVIAL 10-3460 259 $171.98 53001436 VERSED INJ PER 1 MG 10-3460 636 $1.42 53001437 VERSED INJ PER 1 MG 10-3460 636 $0.83 53001443 DIPHENHYDRAMINE INJ HCL50MG 10-3460 636 $10.00 J1200 53001445 LEVOTHYROXINE SODIUM200MCGVIAL 10-3460 259 $761.00 53001455 INJECTION ADENOSINE 6 MG 10-3460 636 $6.63 J0150 53001456 BREVIBLOCESMOLOL10MG/MLVIAL 10-3460 259 $26.00 53001468 UNCLASSIFIED DRUG 10-3460 636 $24.95 53001472 UNCLASSIFIED DRUG 10-3460 636 $12.40 53001475 VANCOMYCIN HCL 500 MG INJ 10-3460 636 $28.97 J3370 53001477 ZOFRAN INJ PER 1 MG 10-3460 636 $0.98 J2405 53001483 INJ HEPARIN SODIUM PER 1000U 10-3460 636 $1.99 J1644 53001492 ROCEPHIN INJ PER 250 MG 10-3460 636 $1.47 J0696 53001493 ROCEPHIN INJ PER 250 MG 10-3460 636 $7.92 J0696 53001509 GLYCOPYRROLATE COMP UN PER 1MG 10-3460 636 $46.99 53001510 SULFAMETH 80/TRIMETH 16MG/ML I 10-3460 636 $39.69 53001517 BAYRHO-DRHO(D) IMMUNE GLOBVIAL 10-3460 259 $425.00 53001524 METOCLOPRAMIDE HCL TO 10 MG 10-3460 636 $4.00 53001526 THIAMINE HCL 100 MG INJ 10-3460 636 $18.00 53001530 ACETAZOLAMID SOD INJ UPTO500MG 10-3460 636 $150.00 J1120 53001538 ROCEPHIN INJ PER 250 MG 10-3460 636 $1.89 J0696 53001540 AZITHROMYCIN 500 MG INJ 10-3460 636 $21.93 J0456 53001544 INJ CEFTAZIDIME PER 500 MG 10-3460 636 $7.74 J0713 53001550 BUPIVACAINE HCL 10-3460 636 $13.47 53001553 ZEMURONROCURONIUM10MG/MLVIAL 10-3460 259 $76.73 53001554 DEXAMETHASONE SODIUM PHOS 1MG 10-3460 636 $2.00 53001560 ZOSYN INJ 1 GM/0.125 GM 10-3460 636 $11.78 J2543 53001561 DEXAMETHASONE SODIUM PHOS 1MG 10-3460 636 $1.90 J1100 53001562 LIDOCAINE HCL W/EPI1-0.001VIAL 10-3460 259 $8.00 53001563 LIDOCAINE HCL W/EPI2-0.001VIAL 10-3460 259 $11.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53001565 NIMBEXCISATRACURIUM 2MG/MLVIAL 10-3460 259 $56.60 53001569 HEPAGAM B IM INJECTION 0.5 ML 10-3460 636 $251.80 90371 53001581 INSULIN REG 100U/ML (3ML) HUM 10-3460 636 $26.83 J1815 53001584 INSULIN INJ PER 5 UNITS 10-3460 636 $26.78 53001585 IMITREX INJ 6 MG 10-3460 636 $537.66 J3030 53001599 INJ AMPICILLIN SODM PER 1.5GM 10-3460 636 $6.51 J0295 53001604 NORMAL SALINE SOL INFUS 250CC 10-3460 636 $5.81 53001609 TRIAMCINOLONE ACET INJ NOS10MG 10-3460 259 $8.34 53001613 INJ AMPICILLIN SODM PER 1.5GM 10-3460 636 $6.56 J0295 53001621 METHOTREXATE LPF25MG/MLVIAL 10-3460 250 $26.00 J9250 53001623 ENALAPRILAT 1.25MG/ML INJ 1ML 10-3460 259 $11.00 53001626 CELESTONEBETAMET ACET3-3MG/ML 10-3460 250 $26.57 J0702 53001630 METHYLPREDNISOLONE INJTO 125MG 10-3460 636 $33.47 53001632 SQ LIVE VARICELLA VACCINE 10-3460 636 $364.00 53001633 DEPO-MEDROLMETHYLPRED40MG/ML 10-3460 636 $37.07 53001634 METHYLPREDNISOLONE INJ TO 40MG 10-3460 636 $36.43 53001635 HEP B VACC ADOL 2 DOSE IM 10-3460 636 $79.00 53001639 HYDROCORSONE NA SCCNINJTO100MG 10-3460 636 $36.64 J1720 53001644 RECOMBIVAX HB VACCINE5MCG/ML 10-3460 636 $84.23 53001645 TUBERSOLTUBERCULIN5TU/0.1ML 10-3460 259 $880.25 53001646 CLINDAMYCIN PO4 600MG INJ VIAL 10-3460 636 $10.83 53001649 SUCCINYCHOLINE CHL INJ to 20MG 10-3460 636 $11.00 J0330 53001661 IM RABIES VACCINE 10-3460 636 $1,222.00 90675 53001663 METHYLPREDNISOLONE INJTO 125MG 10-3460 636 $18.87 53001670 MARCAINE W/EP0.25-.0005 10-3460 259 $31.78 53001671 MARCAINE W/EP0.5-0.0005 10-3460 259 $30.00 53001675 ACETYLCYSTEINE100MGMLVIAL-NEB. 10-3460 250 $39.00 J7608 53001677 SODIUM CHLORIDE INHAL0.9%-NEB. 10-3460 259 $3.00 53001678 ACYCLOVIR INJ 5MG 10-3460 636 $0.67 J0133 53001681 AMIKACIN SULFATE INJ 100 MG 10-3460 636 $6.03 J0278 53001689 CITROMA,MAGNESIUM CITRATE SOL 10-3460 259 $6.00 53001703 ADRENALIN EPINEPHRINE INJ0.1MG 10-3460 636 $6.91 J0171 53001706 KETOROLAC TROMETHAMINE INJ 10-3460 636 $10.50 53001708 LIDOCAINE HCL2%JEL 10-3460 259 $31.97 53001709 VISUALIZATION ADJUNCT 1 MG 10-3460 636 $65.00 53001711 MYDRIACYLTROPICAMIDE1%DROPS 10-3460 259 $90.00 53001716 OXYCONTINOXYCODONE 10MG.SR 12H 10-3460 259 $11.31 53001717 OXYCONTINOXYCODONE 20MG.SR 12H 10-3460 259 $21.03 53001719 NEO-SYNEPHRINE INJ TO 1 ML 10-3460 636 $20.45 J2370 53001720 PHENYTOIN SODIUM INJ PER 50MG 10-3460 636 $1.20 J1165 53001722 PNEUMOVAX23PNEUMOCOCCALVAC,SZ1 10-3460 250 $341.00 90732 53001724 PROCHLORPERAZINE INJ UPTO10MG 10-3460 636 $17.00 53001728 TOBRAMYCIN SULFATE INJ TO 80MG 10-3460 636 $8.00 J3260 53001731 TRIPLE ANTIBIOTIBOINT(GM),SZ14 10-3460 259 $12.00 53001733 VANCOMYCIN HCL 500 MG INJ 10-3460 636 $29.00 J3370 53001734 UNCLASSIFIED DRUG 10-3460 636 $548.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53001735 UNCLASSIFIED DRUG 10-3460 636 $56.00 53001743 5% DEXTROSE/NRML SAL500ML=1UN 10-3460 636 $7.66 53001744 5% DEXTROSE/NRML SAL500ML=1UN 10-3460 636 $18.00 53001745 INJ POTASSIUM CHL PER 2 MEQ 10-3460 636 $3.10 53001746 NON-INHALATION DRUG FOR DME 10-3460 636 $19.00 53001748 5% DEXTROSE/WATER(500ML = 1UN) 10-3460 636 $18.03 J7060 53001749 5% DEXTROSE/WATER(500ML=1UN) 10-3460 636 $7.24 53001750 5% DEXTROSE/WATER(500ML=1UN) 10-3460 636 $12.18 J7060 53001751 5% DEXTROSE/WATER(500ML=1UN) 10-3460 636 $15.11 J7060 53001752 5% DEXTROSE/WATER(500ML=1UN) 10-3460 636 $8.33 J7060 53001753 5%DEXTROSE/NRMLSALINE500ML=1UT 10-3460 636 $13.76 53001754 5%DEXTROSE/NRMLSALINE500ML=1UT 10-3460 636 $19.00 53001755 INJ HEPARIN SODIUM PER 1000U 10-3460 636 $1.20 53001759 NON-INHALATION DRUG FOR DME 10-3460 636 $19.00 53001760 SODIUM CHLORIDE 0.45%,SZ1000 10-3460 259 $7.49 53001780 NITRO-DUR PATCH(ALL STRENGTHS) 10-3460 259 $14.00 53001800 OXYCODONEHCL 10MG 68084004801 10-3460 250 $3.00 53002077 CEPACOL LOZENGE 10-3460 259 $3.00 53002600 CERVIDIL VAGINAL SUPP 10MG 10-3460 259 $919.00 53002605 WELLBUTRIN TABLET 150MG 10-3460 259 $126.04 S0106 53002802 STERILE WATER FOR INJ.10ML VL 10-3460 259 $3.85 53002811 INJ, PROPOFOL, 10 MG 10-3460 636 $1.08 53002822 LEVOTHYROXINE 75MCG TAB 10-3460 259 $3.00 53002825 TOPAMAX 25MG TAB 10-3460 259 $3.00 53002840 CEPHALEXIN 250MG CAP 10-3460 259 $3.00 53002843 DEPACON 500MG/5ML VIAL 10-3460 259 $107.00 53002846 ZINC SULFAT 220MG CAP 10-3460 259 $3.00 53002849 PRANDIN 1MG TAB 10-3460 259 $19.00 53002851 ARICEPT 10MG TAB 10-3460 259 $51.00 53002864 FLORINEF 0.1MG TAB 10-3460 259 $3.00 53002873 WELLBUTRIN 75MG TAB 10-3460 259 $7.70 53002875 CELEXA 20MG TAB 10-3460 259 $26.29 53002880 ZYPREXA 10MG TABLET 10-3460 259 $3.00 53002889 INSULIN ASPART 100U/ML VIAL 10-3460 636 $41.35 J1815 53002899 SEROQUEL 25MG TAB 10-3460 259 $3.00 53002903 RISPERDAL 0.25MG TAB 10-3460 259 $27.84 53002904 RISPERDAL 0.5MG TAB 10-3460 259 $28.65 53002911 UNCLASSIFIED DRUG 10-3460 636 $63.00 53002912 UNCLASSIFIED DRUG 10-3460 636 $77.00 53002914 SINEMET 10-100 TAB 10-3460 259 $3.00 53002916 FUROSEMIDE INJ UPTO 20MG 10-3460 636 $5.48 53002928 LIDOCAINE 2% JELLY 5ML 10-3460 259 $14.00 53002933 ERYTHROMYCIN 0.5 OPHOINT 1 GR 10-3460 259 $30.00 53002936 DILTIAZEM HCL 5MG/ML INJ 10ML 10-3460 636 $11.69 53002968 FENTANYL CITRATE INJ 0.1 MG 10-3460 636 $5.95 J3010 53003007 ATROPINE SULFATE0.4MG/ML 1MLVL 10-3460 259 $0.65 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53003008 ATROPINE SULFATE INJ 0.01 MG 10-3460 636 $0.15 J0461 53003029 NON-INHALATION DRUG FOR DME 10-3460 636 $19.00 53003044 INJ GARAMYCIN GENTAMICINTO80MG 10-3460 636 $11.87 J1580 53003052 IM ADULT HEP-A VACCINE 10-3460 636 $237.50 53003058 INTRALIPIDFATEMULSN 20% 500ML 10-3460 259 $131.00 53003061 KEPPRALEVETIRACETAM500MG TAB 10-3460 259 $3.00 53003066 INJ LOVENOX 10 MG 10-3460 636 $24.87 J1650 53003086 POTASSIUMCL10/D5-0.45NS1000ML 10-3460 259 $28.08 J3480 53003089 POTASSIUMCL20/5-0.45NS1000ML 10-3460 259 $10.00 53003090 UNCLASSIFIED DRUG 10-3460 636 $29.50 J3480 53003092 INJ POTASSIUM CHL PER 2 MEQ 10-3460 636 $3.10 53003100 POTASSIUM 40 / D5NS 1000ML 10-3460 250 $26.00 J3480 53003102 INJ POTASSIUM CHL PER 2 MEQ 10-3460 636 $11.00 53003108 QUESTRANCHOLESTYRRAMINE4GMPACK 10-3460 259 $6.33 53003132 WELLBUTRINBUPROION 100MG TAB 10-3460 259 $9.88 53003158 ERYTHROMYCIN EYE OINTMENT 3.5 10-3460 259 $46.00 53003168 SURGILUBE LUBRICANT 3GM PACKET 10-3460 259 $1.83 53003170 CATAPRES-TTS 1 PATCH 10-3460 259 $80.00 53003173 GENTEAL EYE DROPS 15ML 10-3460 259 $21.80 53003181 LEVOTHROID 137MCG TABLET 10-3460 259 $3.00 53003187 NEOPOLYMYXINBEXAMETHDRP 5ML 10-3460 259 $54.00 53003212 MYDRIACYL 0.5% EYE DROPS-15ML 10-3460 259 $24.00 53003215 VITAMIN A & D OINTMENT 5GM 10-3460 259 $3.00 53003222 INJ POTASSIUM CHL PER 2 MEQ 10-3460 636 $0.75 53003231 TPN ADULT FORMULA 1000ML 10-3460 259 $120.00 53003246 5% DEXTROSE/NRML SAL 500ML=1UN 10-3460 636 $13.50 J7042 53003251 Hemophilus influenza b vaccine 10-3460 636 $54.00 90648 53003263 METHADONE 10MG TABLET 10-3460 250 $3.00 53003278 VALTREX VALACYCOVIR 500MG TAB 10-3460 259 $3.00 53003281 ADVAIR 500/50 INHALER-28 10-3460 259 $49.00 53003284 TPA INJ 1 MG 10-3460 636 $265.12 J2997 53003290 ERTAPENEM SODIUM 500 MG INJ 10-3460 636 $232.00 53003291 INJ LOVENOX 10 MG 10-3460 636 $24.97 J1650 53003294 MEROPENEM 100 MG INJ 10-3460 636 $24.17 J7042 53003295 MEROPENEM 100 MG INJ 10-3460 636 $24.20 J2185 53003298 DOPAMINE INJ 40MG 10-3460 636 $4.70 53003304 PANTOPRAZOLE SODIUM INJPER VL 10-3460 636 $7.27 C9113 53003305 PROTONIXANTIOPRAZOLE 40MGTAB 10-3460 259 $41.33 53003307 IM RABIES VACCINE 10-3460 636 $1,278.50 53003313 VANCERIL INHALER 42MCG 10-3460 259 $134.00 53003315 ZYVOXLINEZOLID 600MCGCAP 10-3460 259 $511.00 53003316 LINEZOLID INJ 200 MG 10-3460 636 $163.93 J2020 53003320 ZANAFLEX 2MG TABLET 10-3460 259 $3.00 53003321 ZANAFLEX 4MG TABLET 10-3460 259 $3.00 53003322 EXELON 1.5MG CAPSULE 10-3460 259 $7.00 53003326 KLOR 20MEQ PACKET ORAL 10-3460 259 $14.97 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53003329 HUNABID LA TABLET 10-3460 259 $3.00 53003335 DRISDOL 1.25MG (50,000U) CAPSU 10-3460 259 $4.20 53003339 ALTACE 2.5MG CAPSULE 10-3460 259 $17.00 53003340 ALTACE 5MG CAPSULE 10-3460 259 $3.00 53003341 ALTACE 10MG CAPSULE 10-3460 259 $21.20 53003342 LEXAPRO 10MG TABLET 10-3460 259 $30.20 53003343 LEXAPRO 20MG TABLET 10-3460 259 $30.63 53003344 MYCOPHENOLATE MOFETIL ORL250MG 10-3460 636 $27.00 J7517 53003345 CELEBREX 100MG CAPSULE 10-3460 259 $21.61 53003346 CELEBREX 200MG CAPSULE 10-3460 259 $36.50 53003353 PAXIL CR 25MG TAB 10-3460 259 $10.00 53003356 TRILEPTAL 300MG TABLETS 10-3460 259 $24.22 53003359 ULTRACET TABLETS 10-3460 259 $3.00 53003362 TOPROL XL 25MG TAB 10-3460 259 $4.00 53003363 TOPROL XL 100MG TAB 10-3460 259 $5.88 53003364 ZYRTEC 5MG TAB 10-3460 259 $3.00 53003365 ZYRTEC 10MG TAB 10-3460 259 $3.00 53003367 TORADOL 60MG INJ (KETORALAC) 10-3460 250 $5.74 J1885 53003370 ZEBETA 5MG TABLET 10-3460 259 $3.00 53003371 TRANS-DERM SCOPOLAMINE PATCH 10-3460 259 $54.00 53003375 VIOXX 12.5MG TAB 10-3460 250 $26.66 53003376 AMARYL 1MG 10-3460 259 $4.00 53003377 AMARYL 2MG 10-3460 259 $3.00 53003378 AMARYL 4MG 10-3460 259 $13.00 53003379 REMURON 15MG TAB 10-3460 259 $18.00 53003385 FLU VACCINE NO PRESERV 3 & > 10-3460 636 $67.00 53003388 NYSTATIN ORAL SUSPENSION 60ML 10-3460 259 $3.00 53003389 INDERAL LA 60MG CAPSULE 10-3460 259 $6.00 53003390 INDERAL LA 80MG CAPSULE 10-3460 259 $6.00 53003391 ZOCOR 10MG TAB 10-3460 259 $3.00 53003395 NYSTATIN POWDER 10-3460 259 $59.00 53003401 MOBIC 7.5MG TAB 10-3460 250 $22.97 53003403 REQUIP 0.25MG TAB 10-3460 259 $3.00 53003408 DEMADEX 10MG TAB 10-3460 259 $3.00 53003411 COSOPT OPTHALMIC DROPS 5ML 10-3460 259 $150.00 53003412 STARLIX 60MG TAB 10-3460 259 $11.00 53003413 STARLIX 120MG TAB 10-3460 259 $12.00 53003419 D5-1/2NS KCL 30MEQ 1000ML 10-3460 259 $10.00 J3480 53003423 SYNTHROID 0.125MG TABLET 10-3460 259 $4.00 53003440 TAMIFLU 75MG TAB 10-3460 259 $46.00 53003442 ZETIA 10MG TAB 10-3460 259 $33.16 53003445 PENTASA 250MG CAPS 10-3460 259 $8.67 53003447 CALCIUM CARBONATE CHEWABLE TUM 10-3460 259 $3.00 53003448 MAGNESIUMHYROXIDE400MG5ML 10-3460 259 $6.28 53003449 IRONPOLYSACCHARIDESCMPLX150MG 10-3460 259 $3.00 53003451 SIMVASTATINZOCOR 40MG TABLET 10-3460 259 $3.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53003460 DESFLURANE (SUPRANE) 10-3460 259 $481.00 53003467 SODIUM CHLORIDE 500MG TABLET 10-3460 259 $3.00 53003480 LOTENSIN 10MG TABLETS 10-3460 259 $3.00 53003729 ONDANSETRON ORAL 1 MG 10-3460 636 $3.47 Q0162 53003821 DEPAKOTE ER 250MG TABLET 10-3460 259 $9.00 53003865 INJ POTASSIUM CHL PER 2 MEQ 10-3460 636 $2.16 53003938 QUININE SULFATE 324MG CAPSULE 10-3460 259 $19.66 53004069 ACIDOPHILUS CAPSULE 10-3460 259 $3.00 53004075 KEPPRA 250MG TAB 10-3460 259 $3.00 53004083 OXYBUTNIN CHLORIDE 5MG TAB SA 10-3460 259 $8.93 53004089 MVI COMBO PKG 10-3460 259 $24.66 53004095 HYDROCODONEBIT/ACETMINPHN5-500 10-3460 259 $3.00 53004101 TYLENOL 325MG SUPP 10-3460 250 $3.00 53004104 ALBL TO2.5MG IPRATROP TO0.5MG 10-3460 636 $2.96 53004106 FOSAMAX 70MG TAB 10-3460 250 $5.00 53004114 AMOXIL 400MG/5ML 10-3460 259 $10.00 53004118 ABILIFY 5MG TAB 10-3460 259 $89.30 53004119 ABILIFY 10MG TAB 10-3460 259 $89.40 53004121 LOTENSIN 20MG TAB 10-3460 259 $3.00 53004129 BUDSNIDE NON-CMP UN UPTO 0.5MG 10-3460 636 $23.00 53004130 MARCAIN 0.75% VIAL 10-3460 259 $13.52 53004136 DEBROS 6.5% EAR DROPS 10-3460 259 $13.00 53004149 PLETAL 50MG 10-3460 259 $5.50 53004151 SURGICAL 4X8 10-3460 259 $376.60 53004156 DESITIN OINTMENT 10-3460 259 $11.00 53004159 VITAMIN B12 1000MCG TAB 10-3460 259 $3.00 53004162 5%DEXTROSE/NRMLSALINE500ML=1UT 10-3460 636 $8.00 53004163 DEXTROSE 5% 1/2NS 10-3460 259 $15.65 53004177 S-2 2.25% SOL/NEPHRON 10-3460 259 $4.00 53004188 TRICOR 54MG TAB 10-3460 259 $3.00 53004210 HYDROMORPHONE INJ UPTO 4MG 10-3460 636 $6.66 53004213 GENTEAL EYE OINT 10-3460 259 $11.00 53004214 HYDROXYZINE PAMOATE 25 MG ORAL 10-3460 636 $3.00 53004216 MOTRIN 200MG TAB 10-3460 250 $3.00 53004218 IC GREEN 25MG DYE 10-3460 259 $306.00 53004222 IRON SUCROSE INJ 1 MG 10-3460 636 $1.73 J1756 53004226 UNCLASSIFIED DRUG 10-3460 636 $73.50 53004232 LIDODERM PATCH 5% 10-3460 259 $43.83 53004235 CLARITIN 10MG TAB 10-3460 259 $3.00 53004236 COZAAR 100MG TAB 10-3460 259 $3.00 53004245 GLUCOPHAGE XR 500MG TAB 10-3460 259 $3.64 53004258 MS CONTIN 15MG TAB 10-3460 259 $3.00 53004265 RELAFEN 500MG TAB 10-3460 259 $3.00 53004267 NADOLOL 20MG TAB 10-3460 259 $15.50 53004272 PROSTIGMIN INJ TO 0.5 MG 10-3460 636 $307.42 53004276 MYCOLOG OINT 10-3460 259 $42.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53004300 MIRALAX PACKET 10-3460 259 $5.00 53004305 BETADINE 10% SOLUTION 10-3460 259 $10.00 53004330 SENAKOT S TAB 10-3460 259 $3.00 53004335 AK-RINSE EYE SOLUTION 10-3460 259 $84.00 53004337 SULFATRIM PED SUSP 10-3460 259 $538.57 53004354 DEPO-MEDROL 20 MG INJ 10-3460 636 $22.50 53004355 DEMADEX 20MG TAB 10-3460 250 $3.00 53004369 UNCLASSIFIED DRUG 10-3460 636 $22.00 53004376 INJ DAPTOMYCIN 1 MG 10-3460 636 $3.20 53004379 NICODERM 7MG TAB 10-3460 250 $6.00 53004389 RESTASIS 0.05% EYE EMULSION 10-3460 259 $23.58 53004398 ZADITOR 0.025% EYE DROPS 10-3460 259 $27.71 53004402 MELATONIN 3MG TABLET 10-3460 250 $3.00 53004403 REGLAN 5MG TABLET 10-3460 259 $2.25 53004405 PROAMATINE 10MG TABLET 10-3460 259 $3.82 53004406 PROAMATINE 5MG TAB 10-3460 259 $4.00 53004420 EFFEXOR 37.5MG TABLET 10-3460 259 $3.00 53004424 NAMENDA 10MG TAB 10-3460 259 $21.40 53004429 PRANDIN(REPAGLINIDE) 2MG TAB 10-3460 259 $19.00 53004455 METOPROLOL 25MG TABLET 10-3460 259 $3.00 53004464 NOVOLOG MIX 70/30 10ML VIAL 10-3460 259 $4.29 53004466 SENSIPAR 30MG TABLET 10-3460 259 $81.00 53004483 DIPROLENE AF CREAM 15 GM 10-3460 259 $106.00 53004484 DIPROLENE AF OINTMENT 15 GM 10-3460 259 $271.50 53004486 PULMICORT 0.5MG/2ML NEBULIZER 10-3460 259 $31.00 53004503 CYMBALTA 30MG TABLET 10-3460 259 $22.87 53004538 METHOCARBAMOL 500MG TABLET 10-3460 259 $3.00 53004551 PROTONIX 20MG TABLET 10-3460 259 $42.07 53004562 DAKINS 0.25% SOLUTION 480ML 10-3460 259 $29.00 53004563 PREPARATION H OINTMENT 30G 10-3460 250 $8.00 53004579 DEPAKOTE ER TABLET 10-3460 259 $16.00 53004580 ADRENALIN EPINEPHRINE INJ0.1MG 10-3460 636 $16.93 53004588 METHYLPREDNISOLONE ORAL PER4MG 10-3460 636 $3.00 53004596 NAMENDA 5MG TABLET 10-3460 259 $21.40 53004597 DILAUDID 2MG TABLET 10-3460 259 $3.00 53004598 TRICOR 48MG TABLET 10-3460 259 $3.00 53004599 TRICOR 145MG TABLET 10-3460 250 $4.00 53004604 INJ LEVOFLOXACIN 250 MG 10-3460 636 $17.33 J1956 53004606 MORPHINE SULFATE INJ TO 10 MG 10-3460 636 $58.40 J2270 53004608 KEPPRAORL SOL.100MG/ML480ML 10-3460 259 $180.00 53004609 METFORMIN 1000MG TABLET 10-3460 259 $3.00 53004612 ROBINUL 1MG TABLET 10-3460 259 $23.50 53004616 VALIUM 2MG TABLET 10-3460 259 $3.00 J3360 53004626 TIGECYCLINE INJECTION 1 MG 10-3460 636 $11.27 53004628 LYRICA 50MG CAPSULE 10-3460 259 $22.51 53004630 MICAFUNGIN SODIUM INJ 1MG 10-3460 636 $6.73 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53004650 ACETAZOLAMIDE 500MG INJVIAL 10-3460 250 $34.33 53004654 UNCLASSIFIED DRUG 10-3460 636 $15.88 53004680 PYRIDOXINE 25MG TABLET 10-3460 259 $3.00 53004689 DEPO-MEDROL 20 MG INJ 10-3460 636 $63.06 J1040 53004691 HYDROMORPHONE INJ UPTO 4MG 10-3460 636 $7.00 J1170 53004692 CITALOPRAM HBR 10MG TABLET 10-3460 259 $3.00 53004715 FLUCONAZOLE 150MG TABLET 10-3460 259 $9.00 53004728 LIDOCAINE 2% PRESERVAT.FREE AM 10-3460 636 $14.00 53004732 LEVETIRACETAM INJ 10MG 10-3460 636 $28.98 53004749 COLISTIMETHATESODIUMINJTO150MG 10-3460 636 $101.00 53004754 SODIUM BICARBONATE 325MG TAB 10-3460 259 $3.00 53004758 DESMOPRESSIN ACETATE0.1MG TAB 10-3460 259 $21.00 53004763 PIOGLITAZONE HCL 15MG TABLET 10-3460 259 $39.00 53004790 SOLIFENACIN SUCCINATE 5MG TABL 10-3460 259 $31.72 53004791 DULOXETINE HCL 20MG CAPSULE DR 10-3460 259 $4.00 53004816 AA 4.25%/CAL/LYTES/D5W IV SOL 10-3460 250 $135.96 53004831 BENZOCAINE 20% SPRAY 10-3460 259 $84.00 53004833 FAT EMULSIONS 20% EMULSION 10-3460 259 $137.41 53004838 ATORVASTATIN CALCIUM 40MG TABL 10-3460 259 $3.00 53004845 ROPINIROLE HCL 1 MG TABLET 10-3460 259 $3.00 53004850 DUTASTERIDE 0.5MG CAPSULE 10-3460 259 $19.76 53004852 ALBUTEROL SULFAT105MCG AER 10-3460 259 $64.00 53004855 BENZOCAINE/METHOL 20-0.5% 10-3460 250 $15.00 53004859 MENINGOCOCCAL VACCINE IM 10-3460 636 $411.50 53004860 AMITIZA CAPSULE 24MCG 10-3460 259 $18.00 53004861 INJ POTASSIUM CHL PER 2 MEQ 10-3460 636 $0.99 J3480 53004868 AMINO ACIDS4.25%D5W4.25% IVSOL 10-3460 250 $117.80 53004870 JANUVIA 100MG TABLET 10-3460 259 $40.00 53004900 EXPAREL BUPIVACAINE LIPO INJ S 10-3460 636 $1,134.00 53005219 PROTONIX GRANULES 40MG/PKT 10-3460 259 $41.53 53005220 BACTROBAN NASAL TUBE 10-3460 259 $51.58 53005224 STROVITE TABLETS 10-3460 250 $3.00 53005225 JANUVIA 25MG (SITAGLIPTIN) 10-3460 259 $41.00 53005226 JANUVIA 50MG (SITALIPTIN) 10-3460 259 $41.67 53005230 RENVELA 800MG TAB 10-3460 259 $17.00 53006005 HYDROCORTISONE 2.5% CREAM 10-3460 250 $10.00 53006015 SODIUM BICARB 8.4% ABBOJECT 10-3460 259 $38.80 53006017 TD VACCINE NO PRSRV >= 7 IM 10-3460 636 $137.77 90714 53006018 INJ LOVENOX 10 MG 10-3460 636 $6.00 53006023 ACETAMINOPHEN160MG/5ML SOL 10-3460 250 $4.89 53006024 TYLENOL WITH CODENE ELIXIR 10-3460 259 $4.66 53006029 DIPHENHYDRAMINE HCL 50 MG ORAL 10-3460 636 $2.87 53006031 AMLACTIN 12% CREAM 10-3460 250 $32.00 53006035 CARAFATE 1GM/10ML SUSP 10-3460 250 $27.67 53006038 NICOTINE 14MG/24HR PATCH 10-3460 250 $6.00 53006039 METRONIDAZOLE 500MG INJ 100ML 10-3460 636 $5.39 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53006042 METOCLOPRAMIDE 5MG/ML SYRP 10-3460 259 $3.00 53006044 AYR SALINE 0.65% NOSE SPRAY 10-3460 250 $6.00 53006048 NAPROXEN 500MG TABLET 10-3460 259 $3.00 53006049 ROBITUSSIN 100MG/5ML SYRUP 10-3460 259 $2.70 53006051 DEPAKENE 250MG/5ML SYRUP 10-3460 250 $2.56 53006055 ROBITUSSIN DM SYRUP 10-3460 250 $16.00 53006057 SAFE TUSSIN 30 LIQUID 10-3460 259 $3.00 53006058 NITROSTAT 0.4MG TABLET SL 10-3460 250 $3.00 53006063 ALDOMET 250MG TABLET 10-3460 250 $3.00 53006064 ZYPREXA 2.5MG TABLET 10-3460 250 $3.00 53006068 PAXIL 10MG TABLET 10-3460 259 $3.00 53006073 PHOSLO 667MG GEL CAPSULE 10-3460 259 $3.00 53006074 COUMADIN 3MG TABLET 10-3460 250 $7.00 53006075 COUMADIN 4MG TABLET 10-3460 250 $7.00 53006082 K-DUR 10MEQ TABLET SA 10-3460 250 $3.00 53006084 LASIX INJ TO 20 MG 10-3460 636 $5.44 J1940 53006087 MAXIPIME 2G VIAL 10-3460 636 $8.25 53006088 ALBUMIN (HUMAN) 25% 20 ML 10-3460 636 $69.42 53006090 SODIUM CHLORIDE 0.9% SOLN 10-3460 250 $13.41 53006091 SODIUM CHLORIDE 0.9% IV SOLN 10-3460 250 $7.73 53006092 NACL 0.9% SOLN 10-3460 250 $7.12 53006093 NACL 0.9% IV SOLUTION 10-3460 250 $12.09 53006094 MIDAZOLAM HCL 1MG/ML VIAL 10-3460 250 $0.80 J2250 53006100 FORTAZ 2GM ADD-VANTAGE VIAL 10-3460 636 $10.00 J0713 53006102 UNCLASSIFIED DRUG 10-3460 636 $12.90 53006105 CLINDAMYCIN PH 900 MG/6 ML VL 10-3460 258 $17.85 53006106 IM RABIES VACCINE 10-3460 636 $1,197.60 90675 53006110 TRIDIL 5MG/ML VIAL 10-3460 636 $41.50 53006113 ZITHROMAX 200MG/5ML SUSP 10-3460 250 $437.00 53006114 FEVERALL 80MG SUPPOSITORY 10-3460 250 $3.00 53006115 DEPONIT 0.2MG/HR PATCH 10-3460 259 $3.00 53006117 NITROGLYCERIN 0.4MG/HR PATCH 10-3460 259 $3.00 53006122 METAMUCIL PACKET S/F 10-3460 259 $5.66 53006124 VITAMIN E 400 UNITS CAP 10-3460 250 $3.00 53006129 ADVAIR 250/50 DISKUS 10-3460 250 $31.00 53006133 5% DEXTROSE/NRML SAL 500ML=1UN 10-3460 636 $8.02 53006135 FLOMAX 0.4MG CAPSULE SA 10-3460 250 $22.82 53006137 HYDRODIURIL 12.5MG CAPSULE 10-3460 259 $4.00 53006145 EFFEXOR 75MG TABLET 10-3460 259 $4.00 53006148 CIPROFLOXACIN IV 200 MG 10-3460 636 $9.39 53006156 TORSEMIDE 100MG TABLET 10-3460 250 $3.00 53006160 MYLANTA LIQUID 10-3460 250 $6.25 53006167 CEFAZOLIN SODIUM INJ 500 MG 10-3460 636 $2.82 53006172 INJ HEPARIN SODIUM PER 1000U 10-3460 636 $14.00 J1644 53006175 ORAMORPH SR 30MG TABLET SA 10-3460 250 $3.00 53006188 CHLORPROPAMIDE 100MG TABLET 10-3460 259 $5.75 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53007020 VANCOMYCIN HCL 500 MG INJ 10-3460 636 $32.04 53007043 NEUTRA-PHOS K PWD PACKET 10-3460 259 $3.00 53007062 SPIRONOLACTONE 50MG TABLET 10-3460 259 $13.00 53007097 INSULIN DETEMIR PEN 100U/ML 10-3460 259 $583.61 53007202 INJ HEPARIN SODIUM PER 1000U 10-3460 636 $1.23 53007206 ULORIC FEBUXOSTAT 40MG TAB 10-3460 259 $30.92 53007208 BYSTOLIC 5MG TABLET 10-3460 259 $13.10 53008015 RANEXA 500MG (RANOLAZINE) 10-3460 259 $18.00 53008020 MEGESTROL ACETATE 400MG/10ML 10-3460 259 $108.00 53008024 NACL IRRIGATION 0.9% 3000ML 10-3460 259 $9.69 53008032 LOTRISONE CREAM 0.5% CRM 45GM 10-3460 259 $378.00 53008036 ABILIFY(ARIPIPRAZOLE) 2MG TAB 10-3460 259 $90.00 53008038 DAKINS 0.125% SOL 473ML BTL 10-3460 259 $28.62 53008042 VOLTAREN 1% GEL 100GM TUBE 10-3460 259 $116.00 53008044 FISH OIL 500MG SOFTGEL 10-3460 259 $3.00 53008046 COLACE PEDIATRIC SUPPOSITORY 10-3460 259 $3.00 53008047 LYRICA (PREGABALIN) 75MG CAPSU 10-3460 250 $23.11 53008048 FENTANYL CITRATE INJ 0.1MG 10-3460 636 $2.30 J3010 53008049 MORPHINE SULFATE INJ TO 10 MG 10-3460 636 $8.04 J2270 53008050 MORPHINE SULFATE INJ TO 10 MG 10-3460 636 $7.05 J2270 53008064 INJ MAGNESIUM SULFATE/500 MG 10-3460 636 $53.00 53008066 INJ MAGNESIUM SULFATE/500 MG 10-3460 636 $52.98 53008067 EXELON 9.5MG/24HR PATCH 10-3460 250 $65.00 53008070 GAVISCON ES CALCIUMCARBONATE 10-3460 259 $3.00 53008071 VANCOMYCIN HCL 500 MG INJ 10-3460 636 $23.33 J3370 53008075 INJ MAGNESIUM SULFATE/500 MG 10-3460 636 $21.00 53008185 OXYTOCIN INJECTION TO 10 UNITS 10-3460 636 $6.05 J2590 53008197 CARDENE 20MG/200ML SOLUTION 10-3460 259 $366.00 53008221 ACETYLCYSTEINE NON-COMP UNIT 10-3460 250 $24.00 53008227 VITAMIN D 400U TAB 10-3460 259 $3.00 53008228 VITAMIN D CHOLELCIFERL 1000UT 10-3460 259 $3.00 53008230 AMPHOTERICIN B LIPID COMPLEX 10-3460 636 $69.13 J0287 53008239 CHOLESTYRAMINE 4GM/5.5 GM 10-3460 259 $7.00 53008248 SEROQUEL XR 300MG 10-3460 250 $64.00 53008251 HYDROCORTISONE ACETATE 25MG SU 10-3460 250 $34.50 53008254 ANTARA 130 MG CAPS 10-3460 259 $17.00 53008275 LIORESAL 10MG INJ 10-3460 250 $3.00 J0745 53008284 LOVAZA CAPSULES 10-3460 259 $5.59 53008288 CEFTAROLINE FOSAMIL INJ 10MG 10-3460 636 $0.99 C9282 53008290 NITROFURANTOIN MACROCR 50MG 10-3460 259 $7.00 53008293 ACETAMINOPHEN INJ 10 MG 10-3460 636 $135.98 53008317 AMITIZA(LUBIPROSTONE)8MCG CAP 10-3460 259 $19.00 53008318 SEROQUEL(QUETIAPINE)XR 50MG UN 10-3460 250 $24.85 53008321 FENTANYL CITRATE INJ250MCG/5ML 10-3460 250 $3.02 53008322 DEXTROSE 5%/LR 500ML 10-3460 259 $7.50 53008325 VIMPAT 200MG TABLET 10-3460 259 $43.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 53008326 VIMPAT 50MG TABLET 10-3460 259 $24.33 53008327 UNCLASSIFIED DRUG 10-3460 636 $21.00 53008330 LIDOCAINEHYDROCHLORIDE 2% 20ML 10-3460 250 $15.78 53008331 RENAL CAPS 10-3460 259 $3.00 53008333 XARELTO 15 MG TAB 10-3460 259 $39.64 53008334 XARELTO 120 MG TAB 10-3460 259 $39.94 53008335 TETRAVISC FORTE OPHTHALMIC SOL 10-3460 259 $76.00 53008341 OSEL TAMIVIR 6MG/ML 60ML SUSP 10-3460 259 $420.92 53008344 LIDOCAINE HCL INJ FOR IV 10 MG 10-3460 636 $12.77 53008347 PROPOFOL 10MG/ML EMULSION 20ML 10-3460 636 $1.08 J2704 53008350 BACLOFEN 20MG TAB 10-3460 250 $3.00 53008351 PNEUMOCOCCAL VACC 13 VAL IM 10-3460 636 $636.25 90670 53008352 DTAP-HEPB-IPV INACTIV IM 10-3460 636 $258.66 90723 53008354 ROPIVACAINE HCL INJ 1 MG 10-3460 636 $0.52 53008355 ROTAVIRUS VACC 3 DOSE ORAL 10-3460 636 $247.00 90680 53008361 AMIKACIN SULFATE INJ 100 MG 10-3460 636 $8.90 53008362 MYCAMINE (MICAFUNGIN) 100MG VI 10-3460 250 $6.73 J2248 53008365 PEDIARIX 10-3460 259 $256.00 90723 53008366 TDAP VACCINE >7 IM 10-3460 636 $151.68 90715 53008377 ALBUTEROL SUL 1.25 MG/3 ML SOL 10-3460 250 $2.00 53008385 DARBEPOETIN ALFA ESRD.40MCG 10-3460 636 $27.87 53008386 DARBEPOETN ESRD60MCG5551300230 10-3460 636 $27.86 53008387 COZAAR/LOSARTAN50MG00904639061 10-3460 250 $3.00 53008388 ISENTRESS 400MG 00006022761 10-3460 250 $75.00 53008389 TORADOL INJ PR 15MG00409379301 10-3460 636 $10.00 53008392 FAMOTIDINE 20MG/2ML63323073809 10-3460 636 $6.88 J3490 53008393 BREVIBLOC IN NACL 10019005561 10-3730 636 $1,545.00 53008396 HYDROMOROPHONE 1MG/1ML 10-3460 636 $9.06 J1170 53008403 Ketamine 500mg/5ml 10-3460 250 $30.00 53008404 OXYCODONE 20MG IR TAB 10-3460 259 $3.00 53008405 PRAMIPEXOLE DIHCL 0.75MG TAB 10-3460 259 $18.87 53008407 LORAZEPAM INJ 2 MG 10-3460 636 $3.32 55000101 12 LEAD EKG, TRACING ONLY 10-3715 730 $323.70 93005 59000002 EEG AWAKE & DROWSY 10-3715 740 $1,016.90 95816 61000006 CYTOPATH, CONCEN., SMEAR 10-3640 311 $128.00 88108 61000015 CYTP DX EVAL FNA 1ST EA SITE 10-3640 311 $138.05 88172 61000023 CP SMR OTHR, SCRN & INT 10-3640 311 $74.90 88160 61011010 HOURLY OBSERVATION 10-3240 762 $500.00 62000502 SURG PATH LEVEL-I GROSS ONLY 10-3640 312 $74.90 88300 62000507 TISSUE EXAM BY PATHOLGST LVL 6 10-3640 312 $925.25 88309 62000508 SPECIAL STAINS GROUP 1 10-3640 312 $138.05 88312 62000509 SPECIAL STAINS GROUP 2 10-3640 312 $138.05 88313 62000510 IHC EACH ANTIBODY 10-3640 312 $224.45 88342 62000512 SP CONSULT, 1ST TB W FS SGL SP 10-3640 312 $138.05 88331 62000517 B 5 FIXATIVE 10-3640 312 $50.00 88311 62000600 SURG PATH LVL 2 10-3640 312 $138.05 88302 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 62000601 TISSUE EXAM BY PATHOLGST LVL 3 10-3640 312 $138.05 88304 62000602 TISSUE EXAM BY PATHOLGST LVL 4 10-3640 312 $245.30 88305 62000603 TISSUE EXAM BY PATHOLGST LVL 5 10-3640 312 $356.15 88307 62000607 INTRAOP CYTO PATH CONSULT 1 10-3640 312 $138.05 88333 62000609 CYTP FNA EVAL EA ADDL 10-3640 312 $74.90 88177 62060008 CPR 10-3410 480 $947.50 92950 62060015 EMERGENCY AIRWAY/PMR 10-3410 469 $1,935.80 31500 62060018 ENDOTRACHEAL INTUBATION 10-3410 361 $1,935.80 31500 62080333 PT-THER ACT/MOBILITY/TRANS TR 10-3425 429 $938.69 97530 62080340 PT EVAL LOW COMPLEX 20 MIN 10-3425 424 $3,276.00 97161 62080341 PT EVAL MOD COMPLEX 30 MIN 10-3425 424 $3,603.60 97162 63001002 TRANSFERASE, ALANINE AMINO 10-3625 301 $36.35 84460 63001003 ST OR SGOT 10-3625 301 $35.55 84450 63001004 DRUG CONFIRM BLD ACETAMINOPHEN 10-3625 301 $139.10 G0659 63001005 ALBUMIN 10-3625 301 $50.00 82040 63001006 DRUG CONF BLD,ETHANOL, ALCOHOL 10-3625 301 $75.68 G0659 63001008 AMMONIA 10-3625 301 $100.15 82140 63001009 AMYLASE 10-3625 301 $50.00 82150 63001010 UREA NITROGEN, QUAN 10-3625 301 $27.15 84520 63001011 DIRECT BILIRUBIN 10-3625 301 $34.50 82248 63001012 TOTAL BILIRUBIN 10-3625 301 $34.50 82247 63001016 CPK, TOTAL 10-3625 301 $107.58 82550 63001017 GLUCOSE, QUAN BLOOD 10-3625 301 $26.95 82947 63001019 TOTAL PROTEIN OTHER SPECIMEN 10-3625 301 $25.20 84157 63001020 CALCIUM, TOTAL 10-3625 301 $35.45 82310 63001021 CARBAMAZEPINE, TOTAL 10-3625 301 $100.10 80156 63001025 SERUM/WB TOT CHOLEST 10-3625 301 $29.90 82465 63001026 CREATININE, BLOOD 10-3625 301 $35.20 82565 63001029 DIGOXIN QUANTITATIVE 10-3625 301 $91.25 80162 63001030 PHENYTOIN, TOTAL 10-3625 301 $91.10 80185 63001031 ELECTROLYTE PANEL 10-3625 301 $36.30 80051 63001032 FERRITIN 10-3625 301 $92.50 82728 63001035 GLUCOSE, QUAN BLOOD 10-3650 301 $26.95 82947 63001039 FOLIC ACID, SERUM 10-3625 301 $99.55 82746 63001040 FREE THYROXINE 10-3625 301 $62.00 84439 63001041 GLUTAMYLTRANSFERASE GAMMA 10-3625 301 $49.25 82977 63001044 GENTAMICIN 10-3625 301 $112.65 80170 63001048 HCG, QUAN 10-3625 301 $103.50 84702 63001051 IRON 10-3625 301 $43.95 83540 63001052 IRON BINDING CAPACITY 10-3625 301 $60.10 83550 63001054 ACETONE ASSAY 10-3625 301 $56.15 82010 63001057 LIPASE 10-3625 301 $134.00 83690 63001058 LIPID PANEL 10-3625 301 $513.05 80061 63001060 MAGNESIUM 10-3625 301 $63.79 83735 63001061 BLOOD OSMOLALITY 10-3625 301 $40.90 83930 63001062 PHENOBARBITAL 10-3625 301 $78.70 80184 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 63001063 PHOSPHATE 10-3625 301 $31.56 84100 63001065 ASSAY OF SERUM POTASSIUM 10-3625 301 $31.60 84132 63001067 PROTEIN TOTAL 10-3625 301 $117.00 84155 63001069 DRUG CONF BLD SALICYLATE 10-3625 301 $54.48 G0659 63001070 ASSAY OF SERUM SODIUM 10-3625 301 $30.05 84295 63001071 FAT/LIPIDS FECES, QUAL 10-3650 301 $34.95 82705 63001072 OCCULT BLOOD FECES 10-3625 301 $22.40 82270 63001076 T3, TOTAL 10-3625 301 $97.45 84480 63001077 T3 OR T4 OR THBR 10-3625 301 $44.45 84479 63001078 THYROXINE, TOTAL 10-3625 301 $47.20 84436 63001079 TSH 10-3625 301 $149.76 84443 63001082 TRIGLYCERIDES 10-3625 301 $31.75 84478 63001083 TROPONIN QUAN 10-3625 301 $98.68 84484 63001084 URIC ACID, BLOOD 10-3625 301 $31.05 84550 63001085 AUTOM URINE DIP W MICRO 10-3625 307 $134.00 81001 63001090 URINE CREATININE 10-3625 301 $45.38 82570 63001091 URINE CREATNINE 24 HR 10-3625 301 $50.00 82570 63001093 HCG, QUAL 10-3625 301 $51.65 84703 63001097 OSMOLALITY, URINE 10-3625 301 $42.52 83935 63001098 URINE POTASSIUM 10-3625 301 $21.37 84133 63001100 URINE PROTEIN 24 HR 10-3625 301 $50.00 84156 63001102 SODIUM, URINE 10-3625 301 $46.22 84300 63001104 URINE TOTAL PROTEIN 10-3625 301 $25.20 84156 63001106 DIPROPYLACETIC ACID 10-3625 301 $67.20 80164 63001107 VANCOMYCIN 10-3625 301 $93.15 80202 63001108 VANCOMYCIN 10-3625 301 $92.84 80202 63001109 VITAMIN B-12 LEVEL 10-3625 301 $102.52 82607 63001113 GENTAMICIN 10-3625 301 $112.65 80170 63001119 GLUCOSE, QUAN BLOOD 10-3625 301 $26.95 82947 63001121 VANCOMYCIN 10-3625 301 $93.15 80202 63001123 BILIRUBIN NEONATAL 10-3625 301 $50.00 84999 63001125 T3; FREE 10-3625 301 $115.55 84481 63001145 GLUCOSE TOLERNCE TST(GT)3SPECM 10-3625 301 $88.45 82951 63001160 METABOLIC PANEL TOTAL CA 10-3625 301 $99.74 80048 63001162 COMPREHENSIVE METABOLIC PANEL 10-3625 301 $149.59 80053 63001163 HEPATIC FUNCTION PANEL 10-3625 301 $56.15 80076 63001172 INFLUENZA A/B AG EIA 10-3630 306 $75.65 87400 63001184 CPK- MB FRACTION ONLY 10-3625 301 $99.07 82553 63001190 JAK 2 GENE (V617F) VARIANT 10-3625 301 $135.80 81270 63004046 CEA 10-3625 301 $130.40 82378 63004117 PSA, TOTAL 10-3625 301 $125.07 84153 63004241 RESPIRATORY PANEL (26) 10-3650 302 $892.55 86003 63005049 TB TEST CELL IMMUN MEASURE 10-3625 301 $426.00 86480 63005066 MONO TEST 10-3630 302 $21.84 86308 63005067 AB- THYROGLOBULIN 10-3625 302 $109.30 86800 63005072 BACTERIAL CULTURE -OTHR SOURCE 10-3650 306 $59.20 87070 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 63005075 IA INFECTIOUS AGENT AB QUAN 10-3650 302 $103.05 86317 63005077 HIV-1 QUANT&REVRSE TRNSCRPJ 10-3650 306 $584.80 87536 63005149 ALPHA-FETOPROTEIN SERUM 10-3625 301 $115.30 82105 63005177 ALLERGY PROFILE,FOOD 10-3625 302 $744.75 86003 63005250 ASSAY OF IGE 10-3625 301 $113.20 82785 63005263 GLUCOSE, POST GLUCOSE DOSE 10-3625 301 $32.65 82950 63010029 CULT FUNGUS W P ID, SKIN HR NL 10-3650 306 $53.00 87101 63010035 ANGIOTENSIN I - CONVRTNG ENZME 10-3650 301 $100.35 82164 63010050 VOLTAGE-GATED CALCIM CHANL ANT 10-3650 301 $228.00 63010059 PROTEIN ELECTROPHORESIS W INTE 10-3650 301 $62.00 84155 63010064 URINE PREGNANCY VISUAL COLOR 10-3140 307 $86.30 81025 63010065 URINE DRUG SCREEN PANEL 9 10-3625 301 $972.63 80307 63010066 URINALYSIS;QUAL NOT IA 10-3625 307 $44.40 81005 63011070 URINE DRUG CONF 8-14 DRUG CL 10-3650 301 $1,565.90 G0481 63011071 URINE DRUG SCREEN CUPS 10-3625 301 $179.46 80305 64001502 CBC W PLT W AUTOM DIFF 10-3615 305 $146.63 85025 64001505 FIBRIN DEGRADATION PRODUCTS 10-3615 305 $47.35 85362 64001506 FIBRINOGEN, ACTIVITY 10-3615 305 $58.40 85384 64001507 DIFF CELL COUNT NOT BLOOD 10-3615 300 $37.85 89051 64001512 SMEAR SPECIAL STAIN 10-3615 306 $70.40 87207 64001513 BL SMEAR W/DIFF WBC COUNT 10-3615 305 $25.00 85007 64001517 PTT, PLASMA OR WHOLE BLOOD 10-3615 305 $146.30 85730 64001518 PROTHROMBIN TIME, 10-3615 305 $142.35 85610 64001521 MANUAL RETICULOCYTE COUNT 10-3615 305 $29.55 85044 64001522 NONAUTO ERYTHROCYTE SED RATE 10-3615 305 $24.40 85651 64001525 PROTEIN E-PHORESIS/URINE/CSF 10-3650 301 $109.40 84166 64001526 ELL COUNT NOT BLOOD 10-3615 300 $32.50 89050 64001543 HEMATOCRIT 10-3615 305 $16.30 85018 64001544 HEMOGLOBIN 10-3615 305 $16.30 85014 64001545 BABESIA & OTHER BLOOD PARASITE 10-3650 306 $44.40 87207 64001546 ANAPLASMA PHAG Ab IgG,M 10-3650 302 $150.72 86666 64001547 RICKETTSIA Ab IgG IgM Ref tit 10-3650 302 $286.80 86757 64001549 ASSAY OF LD LDH ENZYME 10-3650 301 $94.80 83625 64001550 INSECT VENOM PANEL 10-3650 302 $234.60 86001 64002001 RUSSELL VIPER VENOM TIME, DILU 10-3650 305 $65.80 85613 65000301 ANAEROB BACT CULTURE W ID 10-3630 306 $65.05 87075 65000303 BACT CULTURE URINE,QUAN COUNT 10-3630 306 $212.00 87086 65000305 BACTERIAL CULTURE -OTHR SOURCE 10-3630 306 $59.20 87070 65000306 MR-STAPH DNA AMP PROBE 10-3630 306 $241.40 87641 65000312 CELL COUNT NOT BLOOD 10-3615 306 $32.50 89055 65000316 BACTERIAL CULTURE -OTHR SOURCE 10-3630 306 $59.20 87070 65000321 ASO , TITER 10-3650 306 $50.15 86060 65000325 DIR NA PROBE MULTI ORGANISMS 10-3650 306 $275.70 87800 65002501 CULTURE AFB - ISOL & ID 10-3650 306 $74.25 87116 65002503 BACTERIAL CULTURE - OTHR SOU 10-3630 306 $59.20 87070 65002505 CULTURE P PATHOG - SCREEN 10-3630 306 $45.60 87081 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 65002506 BACTERIAL CULTURE -OTHR SOURCE 10-3630 306 $59.20 87070 65002509 EROB BACTERIA CULTURE STOOL 10-3630 306 $69.85 87045 65002511 BACT CULTURE - URINE, QUAN CO 10-3630 306 $212.00 87086 65002512 ANAEROB BACT CULTURE W ID 10-3630 306 $65.05 87075 65002513 SMEAR - GRAM OR GIEMSA 10-3630 306 $29.35 87205 65002515 TA MICROBE SUSCEPTIBLE MIC 10-3630 306 $59.40 87186 65002516 OVA & PARASITES DIR SMR W ID 10-3630 306 $61.15 87177 65002518 STREP B IA W DOA 10-3630 306 $75.65 87802 65003000 NEISSERIA AMPLIF NA PROBE 10-3630 306 $241.20 87591 65003022 BC - ANAEROBE - ADDTL ID 10-3630 306 $110.00 87076 65003023 BC - AEROBIC - ADDTL ID 10-3630 306 $110.00 87077 65003101 FUNGUS CULTURE DEF I.D YEAST 10-3630 306 $70.95 87106 65003103 AEROB BACTERIAL BLOOD CULTURE 10-3630 306 $270.00 87040 65003123 AEROB BACTERIAL BLOOD CULTURE 10-3630 306 $270.00 87040 65003124 AEROB BACTERIAL BLOOD CULTURE 10-3630 306 $270.00 87040 65003125 BACTERIAL CULTURE - OTHR SOU 10-3630 306 $59.20 87070 65003126 AGENT NOS ASSAY W/OPTIC 10-3630 306 $75.65 87899 65003127 IA BY EIA - MULTI STEP 10-3630 306 $75.65 87449 65003129 CHLAMYDIA T AG BY DFA 10-3630 306 $75.65 87270 65003133 AEROB BACTERIAL BLOOD CULTURE 10-3630 306 $270.00 87040 65003135 AB; LYME'S DISEASE (IgG & IgM) 10-3630 302 $116.00 86618 65004180 ANESTHESIA - 0.5 HR. 10-3140 379 $2,882.00 66003009 AB, HIV-1 10-3625 302 $60.52 86701 66003010 HEPATITIS B SURFACE AG EIA 10-3625 306 $71.00 87340 66003011 AB- HBSAB 10-3625 302 $69.17 86706 66003014 AB, RSV 10-3630 302 $88.60 86756 66003015 QUAN RHEUM FACTOR 10-3625 302 $39.00 86431 67003564 TRANSFUSION BLD/BLD COMPONENTS 10-3645 391 $1,534.35 36430 67003571 THAWED FFP (BILL ONLY) 10-3645 390 $310.00 P9017 67003588 LEUKOCYTE POOR BLOOD EA UNIT 10-3645 381 $965.12 P9016 67003589 PLATELETS PHERESIS LR EA UNIT 10-3645 384 $2,213.58 P9035 68001056 LACTATE DEHYDROGENASE (LD/LDH) 10-3650 301 $41.50 83615 68003053 AB, RUBELLA 10-3630 302 $83.84 86762 68004006 ALDOLASE 10-3650 301 $66.70 82085 68004007 ALDOSTERONE 10-3650 301 $280.10 82088 68004009 ALPHA-1-ANTITRYPSIN, TOTAL 10-3650 301 $92.35 82103 68004013 AMIKACIN 10-3650 301 $103.60 80150 68004023 DNA AB, NATIVE OR DS 10-3650 302 $94.40 86225 68004025 VASOPRESSIN 10-3625 301 $233.30 84588 68004027 FLUORESCENT AB, SCRN EA AB 10-3650 302 $82.85 86255 68004029 ANTINUCLEAR AB (ANA), 10-3625 302 $83.10 86038 68004031 FLUORESCENT AB, SCRN EA AB 10-3650 302 $82.85 86255 68004034 COMPLEMENT, AG EA 10-3625 302 $82.50 86160 68004035 COMPLEMENT, AG EA 10-3625 302 $82.50 86160 68004037 AB, CMV 10-3630 302 $98.95 86644 68004044 IA QUANT, CA 125 10-3625 302 $143.05 86304 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 68004045 IA QUANT, CA 19-9 10-3625 302 $143.05 86301 68004055 COMPLEMENT, TOT HEMOLYTIC (CH 10-3650 302 $139.65 86162 68004056 COPPER 10-3650 301 $85.30 82525 68004057 CORTISOL, TOTAL 10-3625 301 $112.05 82533 68004061 DHEA-S 10-3615 301 $152.80 82627 68004066 AB, EB VCA 10-3650 302 $124.70 86665 68004070 ESTRADIOL 10-3625 301 $192.05 82670 68004071 FLUID AMINO DELTA OD 10-3625 301 $50.00 82040 68004073 GONADOTROPIN, FSH 10-3625 301 $127.70 83001 68004079 GLYCOSYLATED HEMOGLOBIN TEST 10-3625 301 $66.57 83036 68004084 HLA TYPE, A B C SGL AG 10-3650 302 $177.40 86812 68004086 HAPTOGLOBIN, QUAN 10-3625 301 $86.45 83010 68004096 INSULIN, TOTAL 10-3650 301 $78.55 83525 68004101 GONADOTROPIN, LUTEINIZING HORM 10-3625 301 $127.30 83002 68004106 MICROALBUMIN, URINE QUAN 10-3625 301 $39.75 82043 68004111 PARATHORMONE 10-3625 301 $283.70 83970 68004114 PROGESTERONE ASSAY 10-3625 301 $143.40 84144 68004115 PROLACTIN ASSAY 10-3625 301 $133.20 84146 68004119 CLOTTING INHIBITOR, PROTEIN C 10-3650 305 $82.60 85302 68004123 RENIN 10-3650 301 $151.20 84244 68004124 AB, RUBEOLA 10-3630 302 $61.63 86765 68004144 TRANSFERRIN 10-3625 301 $87.75 84466 68004172 AB, VARICELLA-ZOSTER 10-3630 302 $82.13 86787 68004173 VIT D 1 25-DIHYDROXY 10-3650 301 $264.60 82652 68004174 VITAMIN D 25 HYDROXY 10-3625 301 $221.25 82306 68004175 ZINC 10-3650 301 $78.25 84630 68004180 CLOSTRIDIUM AG EIA 10-3630 306 $75.65 87324 68004197 AB, HBCAB - TOTAL 10-3625 302 $82.85 86704 68004198 AB- HBCAB - IGM AB 10-3625 302 $80.90 86705 68004202 AB, HAAB - TOTAL 10-3625 302 $85.15 86708 68004203 AB- HAAB - IGM 10-3625 302 $77.35 86709 68004206 AB, HSV 1 10-3625 302 $90.65 86695 68004225 IA QUANT, CA 15-3 (27.29) 10-3625 302 $143.05 86300 68004229 HCG, QUAL 10-3625 301 $51.65 84703 68004230 TESTOSTERONE, FREE 10-3625 301 $175.00 84402 68004236 SRM IMMUNOFIXATION ELECTROPHO 10-3650 302 $153.55 86334 68004242 C PEPTIDE 10-3650 301 $100.00 84681 68004258 MYOGLOBIN 10-3625 301 $88.75 83874 68004274 VITAMIN A 10-3650 301 $79.75 84590 68004320 HEPATITIS C REVRS TRNSCRPJ 10-3650 306 $294.40 87522 68004367 CLOTTING, FACTOR V 10-3650 305 $121.30 85220 68004369 ASSAY OF HOMOCYSTINE 10-3625 301 $115.95 83090 68004371 HERPES S AMPLIF NA PROBE 10-3650 306 $241.20 87529 68004375 ACUTE HEPATITIS PANEL 10-3625 301 $327.35 80074 68004395 ASSAY OF THIAMINE (VITAMIN B 10-3650 301 $145.95 84425 68004400 D-DIMER- QUAL/SEMIQUAN 10-3625 305 $42.95 85378 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 68004406 CORBIC ACID BLOOD 10-3650 301 $67.95 82180 68004410 ORGANIC ACID SINGLE QUANT 10-3650 301 $113.10 83921 68004412 EXAM SYNOVIAL FLUID CRYSTALS 10-3650 300 $107.35 89060 68004414 AB, MUMPS 10-3630 302 $83.18 86735 68004418 MICROSOMAL AB EACH 10-3625 302 $99.95 86376 68004423 THYROGLOBULIN 10-3625 301 $110.40 84432 68004429 OLIGOCLONAL BANDS CSF 10-3625 301 $51.00 83916 68004437 TREPONEMA PALLIDUM 10-3625 302 $91.00 86780 68004444 CALCIUM, IONIZED 10-3650 301 $93.95 82330 68004453 CHLAMYDIA T AMPLIF NA PROBE 10-3630 306 $241.20 87491 68004461 COLD AGGLUTININ, TITER 10-3650 302 $55.45 86157 68004469 CARDIOLIPIN AB EA IG CLASS 10-3650 302 $174.85 86147 68004475 MICROALBUMIN, URINE QUAN 10-3625 301 $39.75 82043 68004481 GLYCATED PROTEIN 10-3650 301 $103.60 82985 68004482 PREALBUMIN 10-3625 301 $58.64 84134 68004485 C-REACTIVE PROTEIN HS 10-3625 302 $89.00 86141 68004488 AB, EBNA 10-3625 302 $105.15 86664 68004491 TOCOPHEROL ALPHA (VIT E) 10-3650 301 $97.45 84446 68004603 ANTITHROMBIN III ACTIVITY AS 10-3650 305 $81.45 85300 68004609 HEPATITIS C AB 10-3625 302 $98.10 86803 68004627 AChR Binding Abs, Serum 10-3650 311 $0.00 68004632 COMPLEMENT, AG EA 10-3650 302 $82.50 86160 68004636 CCP ANTIBODY 10-3650 302 $89.00 86200 68004637 T CELLS, ABSOL CD4 AND CD8 10-3650 302 $322.95 86360 68004643 C-REACTIVE PROTEIN 10-3625 301 $50.00 86140 68004659 SUGARS, SINGLE QUAN EA SPECI 10-3650 301 $79.20 84378 68004663 IMMUNOGLOBULIN G,QUANT,CSF 10-3650 301 $75.00 82784 68004672 MACROSCOPIC EXAM ARTHROPOD 10-3650 306 $39.85 87168 68004675 IA NONANTIBODY 10-3650 301 $92.85 83519 68004696 PROTEIN WB, IM ID FOR BANDS 10-3650 300 $99.30 84182 68004697 AB, LYME'S (WB) CONFIRM 10-3650 300 $106.50 86617 68004699 MYCOPLASMA AMPLIF NA PROBE 10-3650 300 $241.20 87581 68004711 ANCA Panel 10-3650 300 $165.60 86021 68004719 Factor II, DNA Analysis 10-3650 301 $0.00 68004741 PROTEIN E-PHORESIS/URINE/CSF 10-3650 301 $109.40 84166 68004751 SMEAR - GRAM OR GIEMSA 10-3650 309 $29.35 87205 68004769 ADRENOCORTICOTROPIC HORMONE 10-3650 309 $652.00 82024 68004775 LACTATE 10-3625 309 $73.22 83605 68004781 TOTAL PROTEIN OTHER SPECIMEN 10-3650 301 $25.20 84157 68004801 STONE, IR SPECTROSCOPY 10-3650 301 $88.60 82365 68004804 VITAMIN B6, PYRIDOXINE, PLASMA 10-3650 301 $193.10 84207 68004830 ALBUMIN, QUAN 10-3650 301 $70.60 82042 69008004 BLOOD TYPING, ABO 10-3645 305 $56.95 86900 69008005 COOMBS, DIRECT 10-3645 302 $56.95 86880 69008006 COMPATIBILITY TEST ANTIGLOB 10-3645 302 $147.20 86922 69008008 ANTIBODY ID (BILL ONLY) 10-3645 302 $332.00 86870 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 69008009 RBC AB SCRN EA TECHIQ 10-3645 302 $105.80 86850 69008011 BLD TYPE, RBC AG NOT ABO/RHD 10-3645 302 $105.80 86905 69008014 FETAL SCREEN (BILL ONLY) 10-3645 305 $65.00 85461 69008029 BLD TYPE, AG SCRN W PT SERUM 10-3645 399 $132.37 86904 69008031 COMPATIBILITY TEST SPIN 10-3645 300 $104.57 86920 73000020 GAIT TRAINING THERAPY EA 15 M 10-3475 429 $157.55 97116 73000033 PHYS THER EXER 0-30 MIN 10-3475 420 $400.00 97110 77000018 INJ NEUROLYTIC,EPIDRL LUMB/CAU 10-3330 360 $5,046.95 62282 80000001 ACJ BILATERAL W/WO WEIGHTS 10-3720 320 $681.20 73050 80000007 CONTRAST X-RAY EXAM OF COLON 10-3720 320 $1,447.10 74270 80000009 SMALL BOWEL XR 10-3720 320 $974.70 74250 80000011 UGI W AIR & BARIUM W SB 10-3720 320 $2,170.65 74249 80000012 UGI W AIR W KUB 10-3720 320 $1,447.10 74247 80000016 FLUOROSCOPE EXAM EXTENSIVE 10-3720 320 $189.70 76001 80000017 FLUOROSCOPE EXAMINATION 10-3720 320 $1,346.30 76000 80000028 SGL VW SPINE XR 10-3720 320 $681.20 72020 80000029 COMPL ACUTE ABDOMEN 10-3720 320 $834.70 74022 80000032 ABD SGL AP VW 10-3720 320 $541.40 74018 80000038 X-RAY EXAM OF BREASTBONE 2+ VI 10-3720 324 $541.40 71120 80000039 X-RAY EXAM NECK SPINE 2-3 VW 10-3720 320 $681.20 72040 80000040 SGL VW SPINE XR 10-3720 320 $681.20 72020 80000041 X-RAY EXAM NECK SPINE 4/5VWS 10-3720 320 $834.70 72050 80000042 CHEST X-RAY 2 VIEWS FR&LAT 10-3720 324 $541.40 71046 80000043 CHEST X-RAY 2 VIEWS FR&LAT 10-3720 324 $541.40 71046 80000045 CHEST FRONTAL SINGLE VIEW 10-3720 324 $541.40 71045 80000046 CHEST FRONTAL SINGLE VIEW 10-3720 324 $541.40 71045 80000048 CHEST X-RAY 2 VIEWS FR&LAT 10-3720 324 $541.40 71046 80000051 ESOPHOGRAM 10-3720 320 $974.70 74220 80000053 X-RAY EXAM OF FACIAL BONES 3+ 10-3720 320 $834.70 70150 80000061 CHOLANGIOGRAM INTRAOP 10-3720 320 $0.00 74300 80000068 X-RAY EXAM OF HIPS 2+ VIEWS PE 10-3720 320 $834.70 73523 80000085 X-RAY EXAM OF JAW 4+ VIEWS 10-3720 320 $1,079.50 70110 80000086 X-RAY EXAM OF LOWER SPINE 4+ V 10-3720 320 $834.70 72110 80000088 XR NECK SOFT TISSUE 10-3720 320 $681.20 70360 80000089 X-RAY EXAM OF NASAL BONES 3+ V 10-3720 320 $541.40 70160 80000090 X-RAY EXAM OF EYE SOCKETS 4+ V 10-3720 320 $834.70 70200 80000092 X-RAY EXAM OF PELVIS 3+ VIEWS 10-3720 320 $771.50 72190 80000093 X-RAY EXAM OF PELVIS 1-2 VIEWS 10-3720 320 $681.20 72170 80000094 X-RAY EXAM OF RIBS 3 VIEWS BIL 10-3720 324 $1,252.05 71110 80000097 X-RAY EXAM SACROILIAC JOINTS 3 10-3720 320 $541.40 72202 80000100 X-RAY EXAM OF SINUSES 3+ VIEWS 10-3720 320 $834.70 70220 80000101 X-RAY EXAM OF SKULL 4+ VIEWS 10-3720 320 $834.70 70260 80000105 SWALLOWING FCN W CINE/VIDEO 10-3720 320 $974.70 74230 80000106 X-RAY EXAM OF TAILBONE 2+ VIEW 10-3720 320 $541.40 72220 80000108 X-RAY EXAM OF THORACIC SPINE 2 10-3720 320 $541.40 72070 80000123 COMPLETE ABDOMEN, 2 VIEWS 10-3720 320 $541.40 74019 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 80000139 HYSTEROSALPINGOGRAM 10-3720 320 $3,010.00 74740 80000151 MYELOGRAM LUMBOSACRAL 10-3720 320 $5,980.80 72265 80000166 X-RAY EXAM OF LWR SPINE 2-3VI 10-3720 324 $270.70 72100 80000214 CONTRAST X-RAY BLADDER 3+ VIEW 10-3720 320 $2,469.00 74430 80000348 MR GUIDANCE FOR NEEDLE PLACE 10-3140 360 $3,812.00 77021 80000362 REPLACE TUNNELED CV CATH 10-3710 360 $9,970.96 36578 80000500 X-RAY EXAM OF ANKLE 3+ VIEWS 10-3720 320 $812.10 73610 80000501 X-RAY EXAM OF ANKLE 3+ VIEWS 10-3720 320 $812.10 73610 80000502 CLAVICLE COMPLETE 10-3720 320 $541.40 73000 80000503 CLAVICLE COMPLETE 10-3720 320 $541.40 73000 80000504 X-RAY EXAM OF ELBOW 2 VIEWS 10-3720 320 $541.40 73070 80000505 X-RAY EXAM OF ELBOW 2 VIEWS 10-3720 320 $541.40 73070 80000506 X-RAY EXAM OF THIGH 2 VIEW 10-3720 320 $812.10 73552 80000507 X-RAY EXAM OF THIGH 2 VIEWS 10-3720 320 $812.10 73552 80000508 X-RAY EXAM OF FINGER(S) 2+ VIE 10-3720 320 $541.40 73140 80000509 X-RAY EXAM OF FINGER(S) 2+ VIE 10-3720 320 $541.40 73140 80000510 X-RAY EXAM OF FOOT; 3+ VIEWS 10-3720 320 $541.40 73630 80000511 X-RAY EXAM OF FOOT; 3+ VIEWS 10-3720 320 $541.40 73630 80000512 X-RAY EXAM OF FOREARM 2 VIEWS 10-3720 320 $541.40 73090 80000513 X-RAY EXAM OF FOREARM 2 VIEWS 10-3720 320 $541.40 73090 80000514 X-RAY EXAM OF HAND 3+ VIEWS 10-3720 320 $812.10 73130 80000515 X-RAY EXAM OF HAND 3+ VIEWS 10-3720 320 $812.10 73130 80000516 X-RAY EXAM OF HEEL 2+ VIEWS 10-3720 320 $541.40 73650 80000517 X-RAY EXAM OF HEEL 2+ VIEWS 10-3720 320 $834.70 73650 80000518 X-RAY EXAM OF HIP 2+ VIEWS UNI 10-3720 320 $541.40 73502 80000519 X-RAY EXAM OF HIP 2+ VIEWS UNI 10-3720 320 $541.40 73502 80000520 X-RAY EXAM OF KNEE 1 OR 2 10-3720 320 $541.40 73560 80000521 X-RAY EXAM OF KNEE 1 OR 2 10-3720 320 $541.40 73560 80000522 X-RAY EXAM KNEE 4 OR MORE 10-3720 320 $834.70 73564 80000523 X-RAY EXAM KNEE 4 OR MORE 10-3720 320 $834.70 73564 80000530 X-RAY EXAM OF RIBS 2 VIEWS UNI 10-3720 324 $541.40 71100 80000531 X-RAY EXAM OF RIBS 2 VIEWS UNI 10-3720 324 $541.40 71100 80000534 X-RAY EXAM OF SHOULDER 2+ VIEW 10-3720 320 $541.40 73030 80000535 X-RAY EXAM OF SHOULDER 2+ VIEW 10-3720 320 $541.40 73030 80000536 SCAPULA COMPLETE 10-3720 320 $541.40 73010 80000538 X-RAY EXAM OF LOWER LEG 2 VIEW 10-3720 320 $541.40 73590 80000539 X-RAY EXAM OF LOWER LEG 2 VIEW 10-3720 320 $541.40 73590 80000540 X-RAY EXAM OF HUMERUS 2+ VIEWS 10-3720 320 $541.40 73060 80000541 X-RAY EXAM OF HUMERUS 2+ VIEWS 10-3720 320 $541.40 73060 80000542 X-RAY EXAM OF WRIST 3+ VIEWS 10-3720 320 $541.40 73110 80000543 X-RAY EXAM OF WRIST 3+ VIEWS 10-3720 320 $541.40 73110 80000552 X-RAY EXAM OF WRIST 2 VIEWS 10-3720 320 $541.40 73100 80000553 X-RAY EXAM OF WRIST 2 VIEWS 10-3720 320 $541.40 73100 80000554 X-RAY EXAM OF HAND 2 VIEWS 10-3720 320 $541.40 73120 80000555 X-RAY EXAM OF HAND 2 VIEWS 10-3720 320 $812.10 73120 80000556 X-RAY EXAM OF ANKLE 2 VIEWS 10-3720 320 $812.10 73600 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 80000557 X-RAY EXAM OF ANKLE 2 VIEWS 10-3720 320 $812.10 73600 80000558 X-RAY EXAM OF FOOT; 2 VIEWS 10-3720 320 $541.40 73620 80000559 X-RAY EXAM OF FOOT; 2 VIEWS 10-3720 320 $541.40 73620 80000564 X-RAY EXAM OF HIP 1 VIEW UNILA 10-3720 320 $541.40 73501 80000565 X-RAY EXAM OF HIP 1 VIEW UNILA 10-3720 320 $541.40 73501 80000567 X-RAY EXAM OF TOE(S) 2+ VIEWS 10-3720 320 $326.00 73660 80000572 X-RAY EXAM OF TOE(S) 2+ VIEWS 10-3720 320 $541.40 73660 80000573 X-RAY EXAM OF TOE(S) 2+ VIEWS 10-3720 320 $270.70 73660 80000574 X-RAY EXAM OF TOE(S) 2+ VIEWS 10-3720 320 $541.40 73660 80000575 X-RAY EXAM OF TOE(S) 2+ VIEWS 10-3720 320 $541.40 73660 80000587 NEEDLE LOCALIZATION BY XRAY 10-3720 320 $0.00 77002 80000588 X-RAY C/T SPINE DISK 10-3720 320 $33,786.17 72285 80000589 X-RAY OF LOWER SPINE DISK 10-3720 320 $26,326.42 72295 80000593 X-RAY EXAM OF ELBOW 3+ VIEWS 10-3720 320 $541.40 73080 80000596 X-RAY EXAM OF ELBOW 3+ VIEWS 10-3720 320 $541.40 73080 80000605 ENDO CATH - BIL & PANCR D 10-3720 320 $528.00 74330 80000615 BX BREAST 1ST LESION US IMAG 10-3720 761 $8,338.90 19083 80000650 ISOVUE 300á15ML vl 10-3720 255 $22.79 81008001 MEG FOR SBMA 10-3740 860 $27,745.50 95965 81008002 MEG EVOKED SINGLE 10-3740 860 $13,000.00 95966 81008004 EEG AWAKE & ASLEEP 10-3720 740 $2,156.69 95819 82001001 US PV RESIDUAL URINE 10-3725 761 $634.70 51798 82001003 ECHO EXAM OF ABDOMEN 10-3725 402 $1,170.20 76705 82001004 US XTR NON-VASC COMPLETE 10-3725 402 $1,170.20 76881 82001007 ECHO EXAM OF ABDOMEN 10-3725 402 $1,170.20 76705 82001011 ECHO EXAM OF ABDOMEN 10-3725 402 $1,170.20 76705 82001012 US EXAM ABDO BACK WALL LIM 10-3725 402 $1,170.20 76775 82001015 ECHO EXAM OF ABDOMEN 10-3725 402 $1,170.20 76705 82001018 US EXAM ABDOM COMPLETE 10-3725 402 $1,170.20 76700 82001027 US SCROTUM AND CONTENTS 10-3725 402 $1,170.20 76870 82001028 US EXAM ABDO BACK WALL COMP 10-3725 402 $1,170.20 76770 82001031 US EXAM OF HEAD AND NECK 10-3725 402 $1,170.20 76536 82001032 OB US < 14 WKS SINGLE FETUS 10-3725 402 $1,170.20 76801 82001033 OB US >= 14 WKS SNGL FETUS 10-3725 402 $1,170.20 76805 82001052 US GUIDED NEEDLE PLACEMENT 10-3725 402 $1,042.85 76942 82001076 US GUIDED NEEDLE PLACEMENT 10-3725 402 $521.42 76942 82001085 US GUIDED NEEDLE PLACEMENT 10-3725 402 $0.00 76942 82001140 FBP W NON-STRESS TEST 10-3725 402 $1,598.30 76818 82001149 US EXAM PELVIC COMPLETE 10-3725 402 $1,170.20 76856 82001151 NON-OB TRANSVAG US 10-3725 402 $1,170.20 76830 82001154 TRANSVAGINAL US OBSTETRIC 10-3725 402 $760.80 76817 82001176 DUPLEX LE ART/BPG; BILAT 10-3720 920 $2,266.70 93925 82001178 DUPLEX UE ART/BPG; BILAT 10-3720 920 $2,266.70 93930 82001180 DUPLEX EXT VEINS; BILAT 10-3720 920 $1,823.20 93970 82001192 US GUIDE VASCULAR ACCESS 10-3725 402 $594.16 76937 82001195 DUPLEX EXT VEINS; BILAT 10-3720 920 $1,823.20 93970 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 82001702 ULTRASOUND BREAST COMPLETE 10-3725 402 $760.80 76641 82001706 DUPLEX LE ART/BPG; UNIL/LIMIT 10-3720 920 $1,598.30 93926 82001707 DUPLEX LE ART/BPG; UNIL/LIMIT 10-3720 920 $1,598.30 93926 82001709 DUPLEX UE ART/BPG; UNIL/LIMIT 10-3720 920 $1,598.30 93931 82001710 DUPLEX EXT VEINS; UNIL/LIMIT 10-3720 920 $1,598.30 93971 82001711 DUPLEX EXT VEINS; UNIL/LIMIT 10-3720 920 $1,598.30 93971 82001712 DUPLEX EXT VEINS; UNIL/LIMIT 10-3720 920 $1,598.30 93971 82001713 DUPLEX EXT VEINS; UNIL/LIMIT 10-3720 920 $1,598.30 93971 82001720 US XTR NON-VASC LMTD 10-3725 402 $1,069.60 76882 82001721 US XTR NON-VASC LMTD 10-3725 402 $1,069.60 76882 82001730 DUPLEX ARTERIAL FLOW; COMPL 10-3720 920 $1,811.40 93975 82001733 US XTR NON-VASC LMTD 10-3725 402 $760.80 76882 82001736 ECHO TRANSESOPHAGEAL COMPLETE 10-3720 483 $23,127.09 93312 82001737 STRESS TTE COMPLETE 10-3720 483 $6,582.50 93351 82001738 ABD PARACENTESIS W/US IMAGING 10-3725 402 $5,762.80 49083 82001739 ECHO EXAM OF HEAD 10-3725 402 $1,598.30 76506 82001740 CAROTID DUPLEX SCAN; BILAT 10-3720 920 $2,266.70 93880 82001750 TTE W/DOPPLER COMPLETE 10-3725 483 $5,074.90 93306 82001751 CVSLR STRESS TEST; TRACING 10-3725 482 $2,900.60 93017 82001801 US ULTRASOUND BRST COMPLETE LT 10-3725 402 $760.80 76641 82001802 US ULTRASOUND BRST COMPLETE RT 10-3725 402 $760.80 76641 82020019 TRACHEOSTOMMY 10-3410 361 $22,083.40 31600 84003001 HT MUSCLE IMAGE SPECT SING 10-3730 341 $8,008.84 78451 84003002 ZZNM CERETEC WBC 10-3720 349 $5,242.00 84003008 ZZNM DTPA AEROSOL 10-3720 343 $108.00 84003020 ZZNM MAA 10-3720 343 $108.00 84003021 NM MDP 45567004002 10-3720 343 $144.00 84003028 BONE IMAGING 3 PHASE 10-3730 341 $3,083.30 78315 84003030 BONE/JOINT; WB 10-3730 341 $3,847.60 78306 84003036 HT MUSCLE IMAGE SPECT MULT 10-3730 341 $13,702.00 78452 84003046 ACUTE GI BLEED STUDY 10-3730 341 $3,025.30 78278 84003047 HEPATOBILIARY SYSTEM IMAGING 10-3730 341 $4,425.20 78226 84003056 LUNG PERFUSION IMAGING 10-3730 341 $3,634.60 78580 84003057 LUNG VENTILATION IMAGING 10-3730 341 $3,634.60 78579 84003064 HT MUSCLE IMAGE SPECT MULT 10-3730 341 $13,702.00 78452 84003067 K FLOW/FUNCT IMAGE W/O DRUG 10-3730 341 $4,953.10 78707 84003080 ZZNM PYP 45567006002 10-3720 343 $180.00 84003102 NM TC99M MEBROFENIN 10-3720 636 $276.00 84003108 ZZNM MYOVIEW 10-3460 250 $8,244.00 A4641 84003156 THYROID IMAGING W/BLOOD FLOW 10-3720 341 $2,774.60 78014 84003208 LOCALIZ INFLAMM; LIMITED AREA 10-3730 341 $5,921.20 78805 85005001 CT PELVIS; W CONTR 10-3735 352 $5,251.80 72193 85005002 CT ABD & PELVIS 10-3735 352 $3,600.10 74176 85005003 CT ABD & PELV W/CONTRAST 10-3735 352 $5,686.00 74177 85005028 RENAL BIOPSY PERQ 10-3735 360 $3,098.00 50200 85005031 CT CERV SPINE WO CONTR 10-3735 352 $1,022.60 72125 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 85005033 CT CERV SPINE W & WO CONTR 10-3735 352 $3,067.80 72127 85005036 CT - MF WO CONTR 10-3735 351 $3,067.80 70486 85005037 CT - MF W CONTR 10-3735 351 $3,501.20 70487 85005038 CT - MF W&WO CONTR 10-3735 351 $3,880.50 70488 85005040 CT - HEAD/BRAIN WO CONTRAST 10-3735 351 $3,067.80 70450 85005041 CT - HEAD/BRAIN W CONTRAST 10-3735 351 $3,501.20 70460 85005042 CT - HEAD/BRAIN W & WO CONTRAS 10-3735 351 $5,820.75 70470 85005043 CT L EXTR WO CONTRAST 10-3735 352 $3,067.80 73700 85005054 CT LS WO CONTRAST 10-3735 352 $4,090.40 72131 85005055 CT LS W CONTRAST 10-3735 352 $5,251.80 72132 85005056 CT LS W & WO CONTRAST 10-3735 352 $5,820.75 72133 85005057 CT THORAX; WO CONTRAST 10-3735 352 $4,090.40 71250 85005058 CT THORAX; W CONTRAST 10-3735 352 $5,251.80 71260 85005059 CT THORAX; W & WO CONTRASTCT T 10-3735 352 $5,820.75 71270 85005060 CT - ST NECK WO CONTR 10-3735 350 $3,067.80 70490 85005061 CT - ST NECK W CONTR 10-3735 350 $3,501.20 70491 85005062 CT - ST NECK W&WO CONTR 10-3735 350 $3,880.50 70492 85005063 CT PELVIS; WO CONTR 10-3735 352 $4,090.40 72192 85005064 CT - ORBIT SELLA MID/INNER EAR 10-3735 351 $3,067.80 70480 85005065 CT - ORBIT SELLA MID/INNER EAR 10-3735 351 $3,501.20 70481 85005081 CT - MF WO CONTR 10-3735 351 $3,067.80 70486 85005087 CT THORACIC SPINE WO CONTR 10-3735 352 $4,090.40 72128 85005088 CT THORACIC SPINE W CONTR 10-3735 352 $5,251.80 72129 85005178 CT ANGIOGRAPHY HEAD 10-3735 351 $3,997.10 70496 85005179 CT ANGIOGRAPHY NECK 10-3735 350 $3,997.10 70498 85005182 CT ANGIOGRAPHY CHEST 10-3735 352 $3,997.10 71275 85005183 CT ANGIO ABDOMINAL ARTERIES 10-3735 352 $3,997.10 75635 85005194 CT ABD WO CONTRAST 10-3735 352 $2,045.20 74150 85005306 CT L EXTR W AND WO CONTRAST 10-3735 352 $3,067.80 73700 85005307 CT L EXTR W AND WO CONTRAST 10-3735 352 $3,067.80 73700 85005308 CT L EXTR W CONTRAST 10-3735 352 $3,501.20 73701 85005309 CT L EXTR W CONTRAST 10-3735 352 $3,501.20 73701 85005310 CT; U EXTR WO CONTRAST 10-3735 352 $3,067.80 73200 85005311 CT; U EXTR WO CONTRAST 10-3735 352 $3,067.80 73200 85005312 CT; U EXTR WO CONTRAST 10-3735 352 $3,067.80 73200 85005313 CT; U EXTR WO CONTRAST 10-3735 352 $3,067.80 73200 85005315 CT: U EXTR W AND WO CONTRAST 10-3735 352 $3,501.20 73201 85005319 CT ANGIO LWR EXTR W/O&W/DYE 10-3735 352 $1,998.55 73706 85005320 CT ANGIO ABDOMINAL ARTERIES 10-3735 352 $3,997.70 75635 85005322 CT ABD & PELVIS 10-3735 352 $3,600.10 74176 85005324 CT ABD & PELV 1/> REGNS 10-3735 352 $5,686.00 74178 85005325 CT ABD & PELV W/CONTRAST 10-3735 352 $5,686.00 74177 85005327 CT ABD & PELV 1/> REGNS 10-3735 352 $5,686.00 74178 85005331 CT ABD W AND WO CONTRAST 10-3735 352 $5,820.75 74170 85005332 SHOULDER ARTHROGRAM INJ 10-3735 360 $272.05 23350 85005333 ROBOTIC SURGICAL SYSTEM 10-3140 360 $17,070.41 S2900 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 85005335 THORACIC AORTOGRAM W SERIALOGR 10-3735 323 $26,155.30 75605 85005339 ISOVUE 370áIOPAMIDOL 100ML vl 10-3735 636 $4.34 85005340 VISIPAQUEá320-100ML vial 10-3735 255 $3.82 86004002 SURGICAL SPECIMEN XR 10-3720 320 $3,794.50 76098 86004017 SCRN MAMMO DIR DIGITAL - BIL 10-3720 403 $2,468.60 77067 86004021 DX MAMMO DIR DIGITAL - BILAT 10-3720 401 $2,985.00 77066 86004022 DX MAMMO DIR DIGITAL - UNIL 10-3720 401 $2,339.40 77065 86004023 DX BREAST TOMOSYNTHESIS,UNL 10-3705 401 $304.00 G0279 86004024 TM BREAST TOMOSYNTHESIS BI 10-3705 403 $304.00 77063 86004025 DX BREAST TOMOSYNTHSIS DIG ,BL 10-3705 401 $608.00 G0279 86004109 BX BREAST 1ST LEASION STRTCTC 10-3705 360 $8,338.90 19081 87002025 EXTREMITY ANGIO - BILAT 10-3720 323 $30,601.40 75716 87002082 EXTREMITY ANGIO - UNIL 10-3720 323 $30,601.40 75710 87002136 SHOULDER ARTHROGRAM 10-3720 322 $3,159.10 73040 87002182 PERC DR OR STENT PLACEMENT URE 10-3720 360 $11,245.65 50694 87009003 INS PICC AGE 5 YRS/> 10-3720 320 $10,092.30 36569 87009007 SPINAL PUNCTURE LUMBAR DIAGNOS 10-3207 761 $3,437.50 62270 89006014 MRI ABDOMEN WO CONTRAST 10-3207 610 $3,988.30 74181 89006016 MRI BRAIN WO CONTRAST 10-3207 611 $6,769.80 70551 89006017 MRI BRAIN W CONTRAST 10-3207 611 $8,033.85 70552 89006018 MRI BRAIN W & WO CONTRAST 10-3207 611 $9,711.30 70553 89006021 MRI SPINE CERV; WO CONTR 10-3207 612 $5,982.45 72141 89006022 MRI SPINE CERVICAL W CONTR 10-3207 612 $8,033.85 72142 89006023 MRI CERV SPINE W & WO CONTR 10-3207 612 $12,948.40 72156 89006025 MRI SPINE THORACIC WO CONTR 10-3207 612 $5,978.76 72146 89006027 MRI THORAC SPINE W & WO CONTR 10-3207 612 $3,237.10 72157 89006030 MRI SPINE LUMBAR WO CONTR 10-3207 612 $7,976.60 72148 89006031 MRI SPINE LUMBAR W CONTR 10-3207 612 $8,030.85 72149 89006032 MRI LUMB SPINE W & WO CONTR 10-3207 612 $12,948.40 72158 89006033 MRI ORBIT/FACE/NECK W/O DYE 10-3207 610 $3,988.30 70540 89006050 MRI ORBIT/FACE/NECK W/O DYE 10-3207 610 $3,988.30 70540 89006081 MRA; HEAD; WO CONTRAST 10-3207 615 $5,982.45 70544 89006084 MRA; NECK WO CONTRAST 10-3207 610 $5,982.45 70547 89006086 MRA; NECK W & WO CONTRAST 10-3207 610 $9,711.30 70549 89006092 MRI ORBT/FAC/NCK W/O & W/DYE 10-3207 610 $6,474.20 70543 89006097 MRI ABDOMEN W & WO CONTRAST 10-3207 610 $6,474.30 74183 89006099 MRI PELVIS W & WO CONTRAST 10-3207 610 $6,474.20 72197 89006117 MRI UE ANY JOINT W & WO CONTR 10-3207 614 $6,474.20 73223 89006133 MRI ORBT/FAC/NCK W/O & W/DYE 10-3207 610 $6,474.20 70543 89006135 GAD-BASE MR/PROHANCE 5-15ML VL 10-3207 255 $22.72 89006218 MRI - LE JNT WO CONTR 10-3207 610 $3,988.30 73721 89006219 MRI - LE JNT WO CONTR 10-3207 610 $3,988.30 73721 89006220 MRI - LE JNT WO CONTR 10-3207 610 $3,988.30 73721 89006221 MRI - LE JNT WO CONTR 10-3207 610 $3,988.30 73721 89006222 MRI U EXTR; ANY JOINT WO CONTR 10-3207 610 $3,988.30 73221 89006223 MRI U EXTR; ANY JOINT WO CONTR 10-3207 610 $3,988.30 73221 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 89006224 MRI U EXTR; ANY JOINT WO CONTR 10-3207 610 $3,988.30 73221 89006225 MRI U EXTR; ANY JOINT WO CONTR 10-3207 610 $3,988.30 73221 89006226 MRI U EXTR; ANY JOINT WO CONTR 10-3207 610 $3,988.30 73221 89006227 MRI U EXTR; ANY JOINT WO CONTR 10-3207 610 $3,988.30 73221 89006228 MRI - LE JNT WO CONTR 10-3207 610 $3,988.39 73721 89006229 MRI - LE JNT WO CONTR 10-3207 610 $3,988.30 73721 89006234 MRI - LEXTREM WO CONTR 10-3207 610 $3,988.30 73718 89006235 MRI - LEXTREM WO CONTR 10-3207 610 $3,988.30 73718 89006244 MRI - LEXTREM WO CONTR 10-3207 610 $3,988.30 73718 89006248 MRI LEXTREM W&WO CONTR 10-3207 610 $6,474.20 73720 89006249 MRI LEXTREM W&WO CONTR 10-3207 610 $6,474.20 73720 89006252 MRI LE JNT W&WO CONTR 10-3207 610 $6,474.20 73723 89006253 MRI LE JNT W&WO CONTR 10-3207 610 $6,474.20 73723 89006254 MRI - LEXTREM WO CONTR 10-3207 610 $3,988.30 73718 89006255 MRI - LEXTREM WO CONTR 10-3207 610 $3,988.30 73718 89006258 MRI LEXTREM W&WO CONTR 10-3207 610 $6,474.20 73720 89006259 MRI LEXTREM W&WO CONTR 10-3207 610 $6,474.20 73720 89006263 MRI UE ANY JOINT W & WO CONTRA 10-3207 610 $6,474.20 73223 89006265 MRI U EXT NOT JOINT WO CONTRAS 10-3207 610 $1,401.00 73218 89006282 MRI UE ANY JOINT W & WO CONTRA 10-3207 610 $6,474.20 73223 89006324 MRA; HEAD; WO CONTRAST 10-3207 615 $5,982.45 70544 89006326 MULTIHANCEáGAD BASE 15ml vl 10-3207 255 $22.03 89006328 MRA LEXTREM W/WO CONTR 10-3207 616 $5,016.60 C8914 90000004 7MM CURVED DISPOSABLE 10-3140 279 $9.50 90000005 8MM CURVED DISPOSABLE 10-3140 279 $9.50 90000006 9MM CURVED DISPOSABLE 10-3140 279 $9.50 90000009 ANTI FOG SOLUTION 10-3140 279 $3.53 90000010 ARM CRADLE POSITIONER FOAM 10-3140 279 $10.07 90000012 ARTHROWAND RF COVAC 50 10-3140 279 $650.00 90000013 ARTHROWAND SHORT BEVEL 2.3MM 10-3140 279 $1,157.95 90000018 BLADE AVERAGE MEDIUM 10-3140 279 $87.64 90000022 BLADE FULL RADIUS 4.5MM 10-3140 279 $92.50 90000024 BLADE INCISOR PLUS 4.5MM 10-3140 279 $92.50 90000025 BLADE LONG MEDIUM 10-3140 279 $87.64 90000027 BLADE MEDIUM NARROW AGGRESSIVE 10-3140 279 $70.04 90000028 BLADE POWERMINI INCISOR 10-3140 279 $112.50 90000029 BLADE RAZORCUT 3.5MM 10-3140 279 $92.50 90000030 BLADE SAGITTAL 13MM X 60MM 10-3140 279 $123.62 90000032 BLADE SAGITTAL 18MM X 90MM 10-3140 279 $123.63 90000033 BLADE SAGITTAL 25MM X 90MM 10-3140 279 $123.63 90000038 BLADE SYNOVATOR CONCAVE 4.5MM 10-3140 279 $137.50 90000039 BLADE XX LONG WIDE 10-3140 279 $99.43 90000041 BONE HARVESTER 10MM 10-3140 279 $1,375.00 90000042 BONE HARVESTER 10MM SHORT 10-3140 279 $1,512.50 90000043 BONE PLATINUM SERIES 5.5MM 10-3140 279 $239.25 90000044 BRA POST SURGICAL SUPPORT 10-3140 279 $121.22 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90000048 BRUSH SCRUB IMPREGNATED 4% CHG 10-3140 279 $3.20 90000049 BRUSH SCRUB POVIDONE IODINE 10-3140 279 $0.82 90000051 BURR ACROMIONIZER 5.5MM 10-3140 279 $92.50 90000052 BURR CARBIDE LEGEND TOOL 10-3140 279 $371.25 90000053 BURR CARBIDE LEGEND TOOL 10-3140 279 $349.65 90000054 BURR CARBIDE LEGEND TOOL 10-3140 279 $385.87 90000055 BURR CARBIDE LEGEND TOOL 10-3140 279 $355.25 90000056 BURR CARBIDE LEGEND TOOL 6MM 10-3140 279 $393.73 90000057 BURR CERVICAL 5MM, 14AM 10-3140 279 $384.65 90000058 BURR LONG OVAL SOLID CARBIDE 10-3140 279 $60.18 90000059 BURR MATCHEAD 3MM 14-AM 10-3140 279 $376.89 90000063 BURR ROUND CUTTING BALL 10-3140 279 $494.27 90000064 BURR ROUND CUTTING BALL 10-3140 279 $415.80 90000065 BURR ROUND CUTTING BALL 10-3140 279 $372.97 90000066 BURR ROUND CUTTING BALL 10-3140 279 $409.15 90000067 BURR ROUND DIAMOND 10CM X 1MM 10-3140 279 $377.30 90000068 BURR ROUND DIAMOND 10CM X 2MM 10-3140 279 $396.00 90000070 BURR ROUND DIAMOND 10CM X 4MM 10-3140 279 $377.30 90000071 BURR ROUND DIAMOND 10CM X 5MM 10-3140 279 $409.50 90000072 BURR ROUND DIAMOND 10CM X 6MM 10-3140 279 $428.34 90000074 BURR ROUND FAST CUTTING 10-3140 279 $91.16 90000088 CANCELLOUS CHIPS 30CC 10-3140 279 $1,196.25 90000091 CANNULA INTRODUCER CRAWFORD 10-3140 279 $105.05 90000093 CANNULA SPINAL 1.25MM X 150MM 10-3140 279 $120.17 90000094 CANNULA SPINAL 1.25MM X 250MM 10-3140 279 $109.25 90000095 CANNULA SYSTEM 5MM ID X 76MM 10-3140 279 $35.23 90000096 CANNULA SYSTEM CLEAR-TRAC 10-3140 279 $68.20 90000100 C-ARM COVER FULL OEC/GE 9800 10-3140 279 $16.10 90000101 C-ARM COVER OEC MINIVIEW 6800 10-3140 279 $37.12 90000102 C-ARM SNAP COVER 40X30 10-3140 279 $6.56 90000103 C-ARMOR DRAPE 10-3140 279 $94.51 90000112 CAUTERY TIP MEGADYNE 10-3140 279 $141.25 90000114 CELLULOSE POINTS AND STRIPS 10-3140 279 $6.47 90000115 CELLULOSE SPEARS SURGICAL 10-3140 279 $0.60 90000117 CEMENT BONE MIXER MIXEVAC 3 10-3140 279 $102.47 90000120 CHLORAPREP APPLICATOR 26ML 10-3140 279 $20.46 90000122 CLIP APPLIER AUTOMATIC LARGE 10-3140 270 $370.56 90000123 CLIP APPLIER AUTOMATIC MEDIUM 10-3140 270 $314.82 90000124 CLIP APPLIER AUTOMATIC SMALL 10-3140 270 $313.42 90000127 CLIP APPLIER ENDOSCOPIC III 10-3140 279 $1,197.26 90000131 CLIPPER BLADE ASSEMBLY PURPLE 10-3140 279 $5.09 90000132 COAGULATOR SUCTION 12FR 6"HAN 10-3140 279 $24.70 90000138 COBAN 4" 10-3140 279 $5.77 90000139 COBAN 6" 10-3140 279 $8.35 90000140 COLLECTION SET DISPOSABLE W 10-3140 279 $27.10 90000141 CORD BIPOLAR FORCEP 12FT 10-3140 279 $7.32 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90000142 COTTON BALLS LARGE STERILE 10-3140 279 $0.88 90000143 COUNTER,NEEDLE FOAM-MAGNET 10C 10-3140 279 $1.68 90000145 CYSTO BLADDER IRRIG SET 81 IN 10-3140 279 $14.41 90000146 DECANTER BAG 9" 10-3140 279 $1.66 90000147 DEPUY CONTROL CABLE 10-3140 279 $780.00 90000149 DISCOGRAPHY PROBE DISCMONITOR 10-3140 279 $1,028.72 90000150 DISPOSABLE ACTIVE CORD CABLE 10-3140 279 $37.50 90000151 DISSECTOR LAPAROSCOPIC 5MM 10-3140 279 $535.41 90000153 DRAIN PENROSE 1/2" X 18" 10-3140 279 $1.45 90000154 DRAPE IOBAN 2 10-3140 279 $45.02 90000155 DRAPE IOBAN 2 INCISE 10-3140 279 $14.30 90000156 DRAPE IOBAN 2 INCISE 10-3140 272 $10.14 90000157 DRAPE SHOULDER BEACH CHAIR 10-3140 279 $35.69 90000159 DURASEAL EXACT SPINE SEALANT 10-3140 278 $3,283.39 90000160 DURASEAL EXTENDED TIP 10-3140 279 $616.81 90000163 ELECTRODE BLADE 1.1" 10-3140 279 $10.37 90000164 ELECTRODE BLADE 2.75 10-3140 279 $9.93 90000165 ELECTRODE BLADE 4" 10-3140 279 $11.90 90000166 ELECTRODE BLADE 6.5" 10-3140 279 $7.90 90000168 ELECTRODE NEEDLE 2.84" 10-3140 279 $18.50 90000176 EPIDURAL TRAY 18G PERIFIX 10-3140 279 $36.21 90000177 EPIDURAL TRAY 20G PERIFIX 10-3140 279 $36.22 90000178 ESMARK BANDAGE ELASTIC 4" X 9 10-3140 279 $8.55 90000179 ESMARK BANDAGE ELASTIC 4" X9' 10-3140 279 $6.79 90000182 EVACUATOR KIT, 3-SPRING, 400CC 10-3140 279 $19.70 90000183 EVACUATOR KIT, 3-SPRING, 400CC 10-3140 279 $19.70 90000184 EVACUATOR KIT, 3-SPRING,400CC 10-3140 279 $19.54 90000185 EVACUATOR SMOKE PLUME AWAY 4.0 10-3140 279 $40.33 90000186 EVICEL FIBRIN SEALANT 2ML 10-3140 278 $815.95 90000187 EVICEL FIBRIN SEALANT 5ML 10-3140 278 $1,876.74 90000188 FACE MASK DISPOSABLE 10-3140 279 $55.38 90000189 FAST FIX 360 CV NEEDLE DEL SYS 10-3140 279 $1,175.20 90000199 GENESYS HTA PROCERVA 10-3140 279 $3,312.50 90000201 GLIDEWIRE STRAIGHT 10-3140 279 $109.25 90000219 HIP POSITIONER LATERAL 10-3140 279 $64.58 90000224 INSUFFLATION TUBING 10-3140 279 $19.88 90000225 INSUFFLATION TUBING PNEUMO 10-3140 279 $23.37 90000226 INTELLISYSTEM PROBE INFLATION 10-3140 279 $122.76 90000227 INTERCEED ABSORBABLE ADHESION 10-3140 279 $638.14 90000228 INTERPULSE HANDPIECE SET 10-3140 279 $79.25 90000230 K-WIRE 0.045" X 6" 10-3140 278 $9.27 90000232 K-WIRE 0.062" X 6" 10-3140 278 $9.27 90000233 LACRIMAL INTUBATION SET CVD 10-3140 279 $96.58 90000237 LEEP ELECTRODE RADIUS 10-3140 279 $59.33 90000239 LEEP ELECTRODE RADIUS 10-3140 279 $59.33 90000240 LEEP ELECTRODE RADIUS 10-3140 279 $59.33 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90000243 LIGACLIP CARTRIDGE MEDIUM 10-3140 279 $6.32 90000244 LIGACLIP CARTRIDGE MEDIUM/LARG 10-3140 279 $8.17 90000245 LIGACLIP CARTRIDGE SMALL 10-3140 279 $4.97 90000249 LMA SIZE 3 10-3140 279 $15.87 90000250 LMA SIZE 4 10-3140 279 $15.87 90000251 LMA SIZE 5 10-3140 279 $15.88 90000252 LOOP VESSEL MAXI RED ST 10-3140 279 $2.47 90000253 LOOP VESSEL MINI WHITE ST 10-3140 279 $2.55 90000255 MARKER SKIN WITH RULER 10-3140 279 $0.95 90000256 MATRIX DURAL REGENERATION 10-3140 278 $1,799.21 90000257 MATRIX DURAL REGENERATION 10-3140 278 $2,675.36 90000264 MESH 4"X6" 3D MAX LEFT LARGE 10-3140 278 $626.73 90000265 MESH 4"X6" 3D MAX RIGHT LARG 10-3140 278 $626.73 90000285 NEEDLE INSUFLATION 150MM 10-3140 279 $21.25 90000286 NEEDLE INTRODUCER GEN III 10-3140 279 $350.00 90000287 NEEDLE SPINAL 18G X 3.5" 10-3140 279 $2.94 90000295 OPEN-ENDED URETHERAL CATHETER 10-3140 279 $29.88 90000297 OPTI-GARD EYE PROTECTION ST 10-3140 279 $11.85 90000300 ORTHO-GLASS 3" X 15' 10-3140 279 $118.10 90000307 OSTEOSTRUX PUTTY 15CC 10-3140 278 $3,016.75 90000309 OUTSIDE-IN MENISCAL REPAIR SYS 10-3140 278 $275.98 90000310 PACKING VAGINAL GAUZE 2" X 72 10-3140 279 $8.85 90000311 PAD SHOULDER FOAM 10-3140 279 $66.64 90000315 PATCH PROLENE 3D MEDIUM MESH 10-3140 279 $1,108.50 90000316 PEANUT ENDO SPONGE 5MM 10-3140 279 $177.89 90000317 PIN COVERS SMALL 10-3140 279 $1.87 90000318 PINS SAFETY STERILE 10-3140 272 $0.45 90000324 PREP-IN ENCHANCED TOTAL 10-3140 278 $880.00 90000325 PRESSURE INFUSOR 1000CC 10-3140 279 $54.93 90000326 PRESSURE INFUSOR 500CC 10-3140 279 $24.38 90000329 PROBE PERCUTANEOUS DISCECTOMY 10-3140 279 $3,750.00 90000330 PROBE PERCUTANEOUS DISCECTOMY 10-3140 279 $3,958.92 90000332 PRONE VIEW CUSHION INSERTS 10-3140 279 $66.10 90000333 PTFE WIRE GUIDE 0.35"- 145CM 10-3140 279 $50.40 90000334 PUNCTURE CLOSURE DEVICE 10MM 10-3140 279 $133.36 90000337 RELOAD 45-3.5MM 10-3140 270 $429.95 90000338 RELOAD ARTICULATING ENDO GIA 10-3140 270 $994.88 90000339 RELOAD ARTICULATING ENDO GIA 10-3140 270 $1,018.50 90000346 RELOAD ARTICULATING ENDO GIA 10-3140 270 $1,247.98 90000351 RELOAD EGIA 45MM 10-3140 270 $1,118.85 90000356 RELOAD ENDO HERNIA 10-3140 270 $311.50 90000358 RELOAD GIA 60MM - 3.8MM 10-3140 279 $479.87 90000359 RELOAD GIA 60MM - 4.8MM 10-3140 270 $470.45 90000360 RELOAD GIA 80MM - 3.8 10-3140 279 $709.08 90000361 RELOAD GIA 80MM - 4.8MM 10-3140 270 $721.22 90000362 RELOAD TA 30-3.5MM 10-3140 270 $338.14 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90000366 RELOAD TA 60-3.5MM 10-3140 270 $399.91 90000368 RELOAD TA 90-3.5MM 10-3140 270 $401.37 90000370 RESERVOIR SILICONE 100CC 10-3140 279 $26.66 90000373 RETRIEVAL ENDO POUCH 12-15MM 10-3140 279 $437.50 90000376 RF CANNULA 20G X 10CM X 5MM 10-3140 279 $60.00 90000379 RF CANNULA 20G X 10MM X 150MM 10-3140 279 $116.55 90000395 RF WHIRLWIND 90DEG 10-3140 279 $522.50 90000398 SCISSOR LAPAROSCOPIC EPIX 10-3140 279 $112.50 90000399 SCISSOR LAPAROSCOPIC EPIX 10-3140 279 $112.29 90000400 12MM SCREW DISTRACTION 10-3140 279 $60.50 90000401 SCREW DISTRACTION 14MM 10-3140 279 $60.50 90000403 SHOULDER SUSPENSION KIT 10-3140 279 $133.46 90000412 SOFT URETERAL STENT & 10-3140 279 $367.62 90000413 SOFT URETERAL STENT SET 10-3140 279 $367.62 90000416 SPINEWAND PERCUTANEOUS 3" 10-3140 279 $4,935.00 90000419 SPONGE NEURO 1" X 1" 10-3140 279 $10.35 90000420 SPONGE NEURO 1" X 3" 10-3140 279 $8.60 90000422 SPONGE NEURO 1/2" X 1" 10-3140 279 $10.30 90000423 SPONGE NEURO 1/2" X 1/2" 10-3140 279 $9.62 90000424 SPONGE NEURO 1/2" X 3" 10-3140 279 $8.99 90000426 SPONGE TONSIL DOUBLE STRING 10-3140 279 $1.70 90000431 STAPLER GIA SINGLE 60MM 3.8MM 10-3140 270 $904.20 90000432 STAPLER HERNIA ABSORBATACK 5MM 10-3140 270 $1,091.73 90000434 STAPLER HERNIA PROTACK 5MM 10-3140 270 $1,079.93 90000437 STAPLER PREMIUM PLUS CEEA 10-3140 270 $2,881.45 90000439 STAPLER PURSTRING 65 10-3140 270 $475.23 90000440 STAPLER RELOADABLE 90-3.5MM 10-3140 270 $899.00 90000441 STAPLER RELOADABLE TA 30-3.5MM 10-3140 270 $834.08 90000442 STAPLER RELOADABLE TA 45-3.5MM 10-3140 270 $934.97 90000443 STAPLER RELOADABLE TA 60-3.5MM 10-3140 270 $834.75 90000445 STAPLER UNIV EGIA 12MM 10-3140 270 $974.93 90000447 STERI-DRAPE IRRIGATION 10-3140 279 $0.85 90000448 STERILLIUM SCRUB SURGICAL RUB 10-3140 279 $115.15 90000449 STRAIGHT TIP NITINOL WIRE W/ 10-3140 279 $138.46 90000450 SUCTION IRRIGATION STRYKERFLOW 10-3140 279 $143.99 90000452 SUCTION POOLE TIP 10-3140 279 $2.05 90000456 SURGICEL FIBRILLAR HEMOSTATIC 10-3140 278 $522.03 90000457 SURGIFLO ENDOSCOPIC APPLICATOR 10-3140 279 $183.15 90000458 SURGIFLO HEMOSTATIC MATRIX 10-3140 279 $973.72 90000463 SUTURE CAPROSYN 3-0 P-12 10-3140 279 $7.12 90000464 SUTURE CAPROSYN 4-0 V-20 10-3140 279 $3.87 90000468 SUTURE CHROMIC GUT 1, GS-21 10-3140 270 $3.30 90000471 SUTURE CHROMIC GUT 2-0, GS-21 10-3140 270 $3.20 90000473 SUTURE CHROMIC GUT 2-0, V-20 10-3140 270 $3.30 90000476 SUTURE CHROMIC GUT 3-0, P-12 10-3140 270 $7.30 90000477 SUTURE CHROMIC GUT 3-0, V-20 10-3140 270 $3.30 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90000480 SUTURE CHROMIC GUT 4-0, P-12 10-3140 270 $7.10 90000490 SUTURE ETHILON 6-0 P-1 CUTTING 10-3140 279 $17.27 90000491 SUTURE MAXON 0 GS-26 TAPER 10-3140 279 $14.05 90000501 SUTURE MONOCRYLE 4-0 P-3 10-3140 279 $18.88 90000502 SUTURE MONOSOF 2-0 C-15 10-3140 279 $3.05 90000503 SUTURE MONOSOF 3-0 P-14 10-3140 279 $5.98 90000504 SUTURE MONOSOF 4-0 P-12 10-3140 279 $5.97 90000511 SUTURE PDS II 0 CT-1 TAPER 10-3140 279 $10.01 90000512 SUTURE PDS II 2-0 SH TAPER 10-3140 279 $8.65 90000515 SUTURE PLAIN GUT 2-0 GS-11 10-3140 279 $3.52 90000516 SUTURE PLAIN GUT 3-0 C-13 10-3140 279 $4.07 90000525 SUTURE POLYSORB 0 GS-21 10-3140 279 $12.62 90000526 SUTURE POLYSORB 0 GS-24 TAPER 10-3140 279 $4.20 90000527 SUTURE POLYSORB 0 GU-45 TAPER 10-3140 279 $4.01 90000528 SUTURE POLYSORB 0 GU-46 TAPER 10-3140 279 $4.02 90000529 SUTURE POLYSORB 0 REEL 60" 10-3140 270 $9.93 90000530 SUTURE POLYSORB 0, GS-11 10-3140 270 $4.52 90000531 SUTURE POLYSORB 0, GS-21 TAPER 10-3140 270 $3.87 90000532 SUTURE POLYSORB 1, GS-11 10-3140 270 $4.77 90000533 SUTURE POLYSORB 1, GS-21 TAPER 10-3140 270 $4.88 90000536 SUTURE POLYSORB 2-0 C-14 10-3140 279 $4.19 90000538 SUTURE POLYSORB 2-0 GS-11 10-3140 279 $4.00 90000539 SUTURE POLYSORB 2-0 GS-21 10-3140 279 $3.20 90000540 SUTURE POLYSORB 2-0 GS-21 10-3140 279 $12.30 90000542 SUTURE POLYSORB 2-0 GS-22 10-3140 279 $12.40 90000543 SUTURE POLYSORB 2-0 GU-45 10-3140 279 $4.20 90000544 SUTURE POLYSORB 2-0 REEL 60" 10-3140 279 $8.27 90000546 SUTURE POLYSORB 3-0 GS-10 10-3140 279 $15.20 90000550 SUTURE POLYSORB 3-0 V-20 10-3140 279 $3.35 90000553 SUTURE POLYSORB 4-0 REEL 0-12 10-3140 279 $5.57 90000560 SUTURE POLYSORB V-20 TAPER 10-3140 279 $3.20 90000561 SUTURE PROLENE 1 TP-1 TAPER 10-3140 279 $95.50 90000567 SUTURE PROLENE 6-0 BV-1 10-3140 279 $40.70 90000568 SUTURE PROLENE 6-0 C-1 TAPER 10-3140 279 $37.22 90000573 SUTURE SOFSILK 0 PRECUT 10-3140 270 $3.13 90000578 SUTURE SOFSILK 2-0 10-3140 270 $4.13 90000579 SUTURE SOFSILK 2-0, GS-21 10-3140 270 $2.43 90000580 SUTURE SOFSILK 2-0, P-14 10-3140 270 $6.19 90000582 SUTURE SOFSILK 2-0, V-20 10-3140 270 $2.52 90000583 SUTURE SOFSILK 3-0 10-3140 270 $3.65 90000586 SUTURE SOFSILK 3-0, V-20 10-3140 270 $2.48 90000587 SUTURE SOFSILK 4-0 10-3140 270 $3.83 90000594 SUTURE SOFSILK 6-0, SE-140-8 10-3140 270 $35.95 90000596 SUTURE SURGIPRO 0 GS-21 10-3140 279 $3.55 90000597 SUTURE SURGIPRO 0 GS-22 TAPER 10-3140 279 $3.43 90000598 SUTURE SURGIPRO 1 GS-21 10-3140 279 $3.92 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90000601 SUTURE SURGIPRO 2-0 GS-22 10-3140 279 $4.12 90000603 SUTURE SURGIPRO 5-0 P-11 10-3140 279 $7.15 90000605 SUTURE SURGIPRO 6-0 P-10 10-3140 279 $6.88 90000607 SUTURE TICRON 0, GS-21 10-3140 270 $5.92 90000608 SUTURE TICRON 0, GS-22 10-3140 270 $5.93 90000615 SUTURE TICRON 2-0, V-20 D/A 10-3140 270 $7.53 90000627 T5 HOOD, PEEL AWAY FACE SHIELD 10-3140 279 $63.45 90000630 TISSEEL FIBRIN SEALANT 2ML 10-3140 278 $585.80 90000631 TISSEEL FIBRIN SEALANT 4ML 10-3140 278 $691.54 90000635 TOURNIQUET CUFF SINGLE BLADDER 10-3140 279 $81.85 90000636 TRAP TISSUE BERKELEY SAFETOUCH 10-3140 279 $32.99 90000637 TRIGGER FLEX BIPOLAR SYST 40CM 10-3140 279 $1,468.91 90000638 TRIGGER FLEX BI-TIP 23CM 10-3140 279 $1,351.25 90000639 TROCAR BLADELESS ENDOPATH XCEL 10-3140 279 $284.71 90000640 TROCAR BLADELESS ENDOPATH XCEL 10-3140 279 $366.82 90000641 TROCAR KII BALLON TIP 10-3140 279 $88.67 90000642 TROCAR KII FIOS ENTRY 10-3140 279 $74.25 90000643 TROCAR KII FIOS FIRST ENTRY 10-3140 279 $96.25 90000644 TROCAR KII FIOS FIRST ENTRY 10-3140 279 $101.23 90000646 TROCAR KII FIOS FIRST ENTRY 10-3140 279 $112.50 90000650 TROCAR KII FIRST ENTRY 10-3140 279 $63.26 90000651 TROCAR KII FIRST ENTRY 10-3140 279 $107.50 90000653 TROCAR KII SHIELDED BLADED 10-3140 279 $57.24 90000654 TROCAR SITE ENDO CLOSE 10-3140 279 $192.05 90000658 TROCAR THREADED KII OPTICAL 10-3140 279 $162.50 90000661 TUBING ARTHROSCOPY PUMP 10-3140 279 $115.47 90000662 TUBING BOTTLE TO BOTTLE 10-3140 279 $6.76 90000665 TUBING SYSTEM WOLF DISPOSABLE 10-3140 279 $123.75 90000681 V-LOC 90 ABSORBABLE WOUND 10-3140 279 $68.75 90000683 V-PATCH C-QUR 2.5"X2.5" MEDI 10-3140 278 $1,280.13 90000685 WILSON SPINAL FRAME KIT 10-3140 279 $82.78 90000686 WILSON TABLE FOAM KIT 10-3140 279 $97.79 90000689 WOUND RETRACTOR MEDIUM ALEXIS 10-3140 279 $137.48 90000691 ZUMI UTERINE MANIPULATOR 4.5 10-3140 279 $119.10 90000977 TOWEL OR DISP BLUE 10-3140 279 $1.14 90000978 GOWN SIRUS NONREINF STERILE XL 10-3140 279 $5.28 90000979 DRAPE SHEET STERILE 3/4 10-3140 279 $3.10 90000980 DRAPE T ARTHROSCOPY STERILE 10-3140 279 $53.85 90000982 DRAPE CHEST/BREAST 15X10 10-3140 279 $13.42 90000983 DRAPE HAND STERILE 10-3140 279 $14.99 90000984 DRAPE U IMPERVIOUS SPLIT 10-3140 279 $4.09 90000985 DRAPE LAP CHOLE W/TROUGHS 10-3140 279 $19.80 90000986 DRAPE T LAPAROTOMY 10-3140 279 $11.47 90000987 DRAPE T EXTREMITY STERILE 10-3140 279 $14.47 90000988 COVER MAYO STAND STERILE 10-3140 279 $2.09 90000990 DRAPE U ORTHOMAX 10-3140 279 $25.52 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90000991 DRAPE T THYROID 10-3140 279 $12.37 90000992 DRAPE TOP SHEET 102X53 10-3140 279 $7.56 90000993 DRAPE T LAPARO TRANSVERSE 10-3140 279 $12.21 90000994 DRAPE UTILITY W/ TAPE 15X26 10-3140 279 $0.66 90000995 PACK ARTHROSCOPY CDS-LF 10-3140 279 $271.29 90000996 PACK BASIC 10-3140 279 $18.87 90000997 PACK CYSTO/GYN/LITHO CDS 10-3140 279 $249.59 90000998 PACK LAPAROTOMY CDS-LF 10-3140 279 $383.98 90000999 PACK MINOR CDS 10-3140 279 $257.62 90001000 PACK PODIATRY CDS 10-3140 279 $226.54 90001001 PACK SHOULDER 10-3140 279 $86.09 90001002 PACK UNIVERSAL 10-3140 279 $69.68 90001003 GOWN SLEEVE 10-3140 279 $1.54 90001004 PACK GENERAL LAPAROSCOPY 10-3140 279 $718.66 90001006 LEICA DRAPE 46 X 120"" 10-3140 279 $82.18 90001007 TRAY GAUZE SPONGE 4X4"" 10-3140 279 $0.08 90001008 3MM, T14CM TOOL LEGEND MH 3 10-3140 279 $468.42 90001011 COVER,LIGHT HANDLE,FLEXIBLE 10-3140 279 $0.77 90001013 CATHETER IV AUTOGUARD 22GX1.00 10-3140 279 $11.54 90001014 KIT IV START CHLOROSCRUB 10-3140 279 $2.25 90001015 IV TUBING ADMIN SETS 2Y 10-3140 279 $7.86 90001016 MASK ANESTHESIA ADULT SIZE 5 10-3140 279 $5.36 90001017 SURGIFOAM GELATIN SPONGE 10-3140 279 $86.26 90001019 STRIP CLOSURE SKIN 1/2 X 4"" 10-3140 279 $2.36 90001020 CIRCUIT ADULT BREATHING 10-3140 279 $15.84 90001026 RF WHIRLWIND 90DEG 10-3140 279 $522.50 90001030 IV TUBING Y TYPE BLOOD SET 10-3140 279 $13.50 90001032 SOLUTION .9 NACL 3000ML BAG 10-3140 279 $23.97 90001038 ENDO POCKET DETACHABLE 10-3140 279 $112.75 90001043 SOLUTION LACT RINGERS 1000ML 10-3140 279 $4.60 90001047 12MM X 100MM TROCAR,KII BLADED 10-3140 279 $102.09 90001048 TUBE SALEM SUMP AR VALVE 16FR 10-3140 279 $10.70 90001050 SPONGE PEANUT W/TAIL XR 3/8IN 10-3140 279 $1.12 90001051 TUBING SUCTION 1/4 X 12' STRL" 10-3140 279 $2.00 90001054 PAD NON-ADHERENT 3X4"" 10-3140 279 $0.11 90001060 LAP SPONGE 18X18", RING, XR" 10-3140 279 $3.74 90001135 GAUZE SPONGE 4X4" 16PLY XRAY" 10-3140 279 $1.34 90001136 CARBIDE BURS RA 8 8 10-3140 279 $5.50 90001137 CARBIDE BURS FGSS 557 557 SS 10-3140 279 $4.65 90001138 IV TUBING BURETROL 60 DROP 10-3140 279 $18.56 90001139 SOLUTION STERILE WATER 1000 ML 10-3140 279 $4.07 90001141 CANNISTER SUCTION 1500CC LINER 10-3140 279 $5.28 90001142 CONTAINER SPECIMEN STERILE 10-3140 279 $0.49 90001146 PADDING UNDERCAST SYNTHETIC 10-3140 279 $6.26 90001149 LACTATED RINGERS 500ML 10-3140 279 $2.61 90001150 DRAIN WOUND FLAT 7MM 10-3140 279 $36.18 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90001151 DRESSING TEGADERM TRANSPARENT 10-3140 279 $1.71 90001152 BANDAGE ELASTIC MATRIX 6X 5YD" 10-3140 279 $2.64 90001154 BANDAGE ELASTIC MATRIX 4X 5YD" 10-3140 279 $2.20 90001155 TUBING SUCTION STRL 1/4X10"" 10-3140 279 $1.95 90001156 K-WIRE 0.045 X 9 TROCAR POINT" 10-3140 272 $9.27 90001157 STRATOSPHERE CAPS FAST-SET 2 10-3140 279 $4.37 90001159 SYRINGE IRRIGATION BULB 60 ML 10-3140 279 $1.21 90001162 PACK CYSTOCSCOPY PK I 10-3140 279 $13.25 90001163 BAIR HUGGER UPPER BODY 10-3140 279 $14.11 90001170 SODIUM CHLORIDE .9% 500ML BT 10-3140 279 $2.31 90001171 APPLICATOR COTTON TIPPED 10-3140 279 $0.08 90001173 PENCIL CAUTERY ROCKERSWITCH 10-3140 279 $15.81 90001174 PAD ABDOMINAL 5X9" STRL" 10-3140 279 $0.19 90001175 GAUZE XEROFORM 4IN 4IN 10-3140 279 $1.37 90001177 60 MICROBORE EXT SET" 10-3140 279 $7.50 90001178 ORTHO-GLASS, 3X12" PRE-CUT" 10-3140 279 $12.52 90001180 ORTHO-GLASS, 4X30" PRE-CUT" 10-3140 279 $30.44 90001181 LOOP,VSSL MINI 8X406MM WHT 10-3140 279 $5.20 90001182 6.5 ELECTRODE BLADE,INSULATED" 10-3140 279 $11.66 90001186 CULTURE SWAB SINGLE LIQUID 10-3140 279 $1.22 90001187 DRAPE TOWELS 17X23 10-3140 279 $2.31 90001188 CATHETER URETHRAL 10FR 10-3140 279 $1.51 90001189 TEGADERNM 4X4.75 10-3140 279 $1.89 90001190 TEGADREEM 2.375X2.75 10-3140 279 $0.57 90001191 DRESSING AQUACEL AG EXTRA 10-3140 279 $20.02 90001192 DRESSING AQUACEL EXTRA 10-3140 279 $7.26 90001193 PADDING, CAST, SPEC, 100 COTTO 10-3140 279 $1.81 90001194 ELECTRODE ECG 450FOAM 10-3140 279 $0.25 90001195 COMPRESSION BOOTS 10-3140 279 $30.85 90001196 3MM, 10AM BURR MATCHEAD 10-3140 279 $377.38 90001197 19FR BLAKE DRAIN R / F 10-3140 279 $283.17 90001198 TRAY FOLEY 16 FR 100% SILCONE 10-3320 279 $23.92 A4355 90001208 AR-7500 SUTURE TAPE, 1.3MM 10-3140 279 $87.50 90001209 AR-8400DC 4.0MMX13CM SHAVER 10-3140 279 $104.70 90001210 COAGULATOR SUCTION 10FR 6' 10-3140 279 $25.38 90001211 AR-6068-90 SUTURE LASSO 90DEG 10-3140 279 $437.33 90001212 AR-1923PK 2.9MM PERC KIT 10-3140 279 $550.00 90001213 MICROPUNCTURE INTRODUCER SET 2 10-3140 279 $73.31 90001214 AR-7276T LABRAL TAPE 1.5MM 10-3140 279 $178.75 90001215 5.75MMX7CM CRYSTAL CANNULA 10-3140 279 $62.50 90001217 AR-4068-30 SUTURE LASSO 30DEG 10-3140 279 $385.00 90001219 AR-6068-45R LASSO 45DEG RIGHT 10-3140 279 $440.00 90001221 JACKSON SPINAL CARE KIT, LF 10-3140 279 $71.75 90001223 AR-7235 #2 FIBERWIRE,FIBERLINK 10-3140 279 $125.00 90001224 AR-6068-25TR LASSO 25DEG TIGHT 10-3140 279 $400.00 90001225 AR-6068-25TL LASSO 25DEG TIGHT 10-3140 279 $400.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90001226 AR-2324BCT-2 4.75MM ANCHOR DBL 10-3140 278 $1,168.75 90001228 AR-2923DSR 2.9 SHAVER DRILL SH 10-3140 279 $237.50 90001230 AR-6068-30 SUTURE LASSO 30DEG 10-3140 279 $400.00 90001231 DIGIT TRAP, SMALL, LF 10-3140 279 $55.33 90001232 AR-8400CDC 4.0MMX13CM SHAVER C 10-3140 279 $100.00 90001233 AR-8400BC 4.0MMX13CM BONECUTTE 10-3140 279 $100.00 90001234 AR-8550BC 5.5MMX13CM BONECUTTR 10-3140 279 $100.00 90001235 AR-8400CTD 4MX13C TORPEDO CRVD 10-3140 279 $227.50 90001236 AR-8400TD 4.0MMX13CM TORPEDO 10-3140 279 $202.50 90001237 AR-8400RBE 4.0X13CM ROUND BUR 10-3140 279 $100.00 90001238 AR-8550RBE 5.5X13CM ROUND BURR 10-3140 279 $100.00 90001242 AR-8400OBE 4.0X13CM OVAL BURR 10-3140 279 $100.00 90001243 AR-8550OBT 5.5X13CM OVAL BURR 10-3140 279 $100.00 90001244 AR-8150PP-30 30DEG PWRPICK 10-3140 279 $277.75 90001245 AR-8150PP-45 45DEG POWERPICK 10-3140 279 $273.54 90001246 AR-8400PR 4.0X13CM POWERASP 10-3140 279 $358.88 90001247 AR-6411 8 PUMP TUBING W/CONN" 10-3140 279 $136.34 90001248 AR-6421 8 PATIENT TUBING W/CO" 10-3140 279 $58.71 90001249 AR-9821 APOLLORF XL90,ABLATOR 10-3140 279 $342.27 90001260 AR-7237-7 FIBERTAPE 2MM 10-3140 278 $123.75 90001261 AR-2923BC 2.9X12.5MM ANCHOR 10-3140 278 $1,066.66 90001264 AR-9300DS 3.0X7CM DISSECTOR 10-3140 279 $178.96 90001265 AR-9300OBT 3.0MM OVAL BURR 10F 10-3140 279 $165.00 90001266 AR-7235T FIBERLINK,#2 FIBRWIRE 10-3140 279 $137.50 90001267 AR-8400CRE 4.0X13CM ROUND BURR 10-3140 279 $110.00 90001268 AR-8550FOE 5.5X13 FLUSHCT OVAL 10-3140 279 $122.94 90001270 CB6007 ONQ PUMP 600ML,1-7ML/HR 10-3140 279 $1,152.00 90001271 SILVERSOAKER 2.5 CATHETER" 10-3140 279 $89.00 90001276 SUTURE CAPROSYN 5-0, P-13 10-3140 279 $7.15 90001277 SUTURE POLYSORB 2-0, GU-46 10-3140 279 $4.35 90001278 SUTURE SOFSILK 2-0, C-15 10-3140 279 $3.05 90001280 AR7234 SUTURE FIBERLOOP 2,40'' 10-3140 279 $112.50 90001282 AR-2290 PROX TENODESIS IMP KIT 10-3140 278 $2,700.00 90001283 AR-2324PSLM 4.75X24.5MM ANCHOR 10-3140 278 $1,600.00 90001286 AR-7234C #2 FIBERLOOP,CRV NEED 10-3140 279 $123.75 90001287 AR-7242 2-0 FIBERWIRE,T5 TAPER 10-3140 279 $48.75 90001288 GLOVE, COTTON, STERILE 10-3140 279 $10.37 90001292 TUBE TRACH CUFFED SZ 8.0 10-3140 279 $80.11 90001293 SUTURE CHROMIC 2-0, CT-2 10-3140 279 $13.67 90001295 15CC CANCELLOUS CHIPS, 1-4MM 10-3140 278 $1,120.00 90001296 30CC CANCELLOUS CHIPS, 1-4MM 10-3140 278 $2,000.00 90001297 SUTURE PROL 6/0 BV-1,BV-1 10-3140 279 $207.02 90001300 MASTISOL LIQUID ADHESIVE VIAL 10-3140 279 $4.56 90001301 SUTURE CAPROSYN 3-0, V-20 10-3140 279 $5.03 90001304 COVER PROBE W/GEL 24'' 10-3140 279 $14.98 90001401 AR-8926SS SYNDESMOSIS TIGHTROP 10-3140 279 $3,520.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90001402 ACCU-PASS SUTURE SHUTTLE 70D 10-3140 279 $270.00 90001403 AR-2324PSLC-2 4.75X19.1 PEEK 10-3140 278 $1,580.00 90001404 AR-6572 GEMINI SR8 TROCAR 10-3140 279 $88.00 90001405 AR-2600SBS-6 4.75x24 SPEEDBRG 10-3140 278 $6,400.00 90001406 AR-2923PS 2.9x12.5 PEEK ANCHO 10-3140 278 $1,440.00 90001411 YANKAUER,REG CAPACITY,FLEXIBLE 10-3140 279 $1.34 90001412 4.0MM NEURO MATCH HEAD 10-3140 279 $290.62 90001413 1.5MM ROUND FLUTED BURR 10-3140 279 $290.58 90001502 14MH30T 14-AM DISSECTING TOOL 10-3140 279 $530.62 90001503 SUTURE VICRYL 1, S-6 10-3140 279 $10.81 90001504 SUTURE VICRYL 2-0, PSL 10-3140 279 $20.68 90001505 SUTURE POLYSORB 3-0, GS-21 10-3140 279 $3.15 90001506 SUTURE POLYSORB 4-0, CVF-23 10-3140 279 $4.98 90001510 SUTURE,4-0 CHROMIC, RB-1 10-3140 279 $13.05 90001516 IOBAN2 DRAPE,INCISE, 23 X 33"" 10-3140 279 $27.47 90001517 AR-1644 TRMANO BEACH CHAIR KIT 10-3140 279 $206.25 90001521 SUTURE POLYSORB 3-0, GS-21 10-3140 279 $14.36 90001522 SEQUENT DISPOSABLE KIT 10-3140 279 $212.19 90001524 MENISCAL REPAIR DEV 3 IMPLANTS 10-3140 278 $2,144.92 90001525 MENISCAL REPAIR DEV 4 IMPLANTS 10-3140 278 $3,379.36 90001595 AR-8500OBE 5.0X13CM OVAL BURR 10-3140 279 $110.00 90001596 AR-7300DS 3.0X7CM DISSECTOR,SJ 10-3140 279 $181.50 90001599 22GX8/18GX5" NEEDLE SET" 10-3140 279 $38.14 90001603 FLOOR PAD 46 X 40 10-3140 279 $40.42 90001613 COVER BOOT KNEE HIGH 10-3140 279 $20.77 90002000 CANNISTER SUCTION 3000CC LINER 10-3140 279 $6.13 90002001 YANKAUER BULB TIP STRL 10-3140 279 $1.26 90002002 TUBE ENDOTRACH INTERMED HI/LO 10-3140 279 $3.88 90002003 SOLUTION .9% 1000 INJ 10-3140 279 $4.07 90002004 BRONCH PACK 10-3065 279 $150.21 90002005 CANNISTER 1000CC SUCTION 10-3065 279 $4.12 90002007 MUCUS TRAP 40CC LATEX FREE 10-3065 279 $1.59 90002012 COLONOSCOPY PACK 10-3065 279 $58.42 90002015 FORCEPS ENDO NDL 10-3065 279 $19.61 90002016 SOLUTION FORMALIN 10% 15ML 10-3065 279 $0.73 90002017 BONE WAX 10-3140 279 $21.70 90002018 TABLE COVER, REINFORCED 10-3140 279 $4.18 90002022 25G X 6 NEEDLE SPINAL,QUINCKE" 10-3140 279 $30.50 90002023 NEXIVA 22G ANGIO CATH 10-3065 279 $13.99 90002024 5.1 INSULATED BLADE ELECTRODE" 10-3140 279 $11.79 90002026 TRAY BLOCK UNIVERSAL 10-3140 279 $38.20 90002028 3FRX80CM EMBOLECTOMY CATHETER 10-3140 279 $222.39 90002030 LIGASURE,BLUNT TIP,LAPAROSCOPI 10-3140 279 $1,555.98 90002032 DEVICE LOCK BIOPSY CAP RX DISP 10-3140 279 $24.75 90002033 DREAMTOME RX 4.9F 260CM 30MM 10-3140 279 $1,072.50 90002034 DREAMWIRE ST GW 450CM ST RD 10-3140 279 $453.75 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90002037 ADVX DUODENAL BEND 7FR X 5CM 10-3140 279 $354.75 90002038 SNARE LG OVL 240CM X 2.4 10-3140 279 $45.54 90002039 INJECTION NEEDLE 25G 2.3MM 10-3140 279 $79.75 90002040 ENDO CRE WIRE 8-10MM 6FR 10-3140 279 $473.00 90002042 20FR SAFETY PEG KIT, PULL 10-3140 279 $240.63 90002092 CATHETER IV AUTOGUARD 16GX1.16 10-3140 279 $4.23 90002110 DRAPE STERIDRAPE INCISE 13X13" 10-3140 279 $4.55 90002121 MAZOR MINIMALLY INVASIVE KIT 10-3140 279 $3,300.00 90002126 SYRINGE LUER LOCK 30ML 10-3140 279 $0.47 90002130 3MM, DIAMOND MATCH HEAD, 14AM 10-3140 279 $475.86 90002222 PACK ANTERIOR CERVICAL -LF 10-3140 279 $185.46 90002325 AR-1688-CP INTERNAL BRACE IMPL 10-3140 278 $2,956.25 90002345 AR-2323PSLC-2 5.5X19.1 PEEK 10-3140 278 $1,086.25 90002349 AR-1897S TRANSTIBIAL ACL KIT 10-3140 279 $562.50 90002355 AR-8850 ENDOSCOPIC SOFT TISSUE 10-3140 279 $500.00 90002357 AR-3602-2 1.3MM FIBERTAK ANCHO 10-3140 278 $1,017.50 90002388 SUTURE POLYSORB 1, GS-24 10-3140 279 $4.72 90002429 22G X 2 STIMUPLEX NEEDLE" 10-3140 279 $22.58 90002430 5023-132 5.5X25.5X.4 SAGGITAL 10-3140 279 $14.38 90002431 5023-143 9.5X25.5X.4 SAGITTAL 10-3140 279 $14.38 90002432 5023-249 9X31X.4 SAGITTAL BLAD 10-3140 279 $74.25 90002433 5071-161 25.4X90X1.27 OSCILLAT 10-3140 279 $72.77 90002434 5071-267 19.5X95X1.27 OSCILLAT 10-3140 279 $96.25 90002435 5071-582 13X90X1.27 OSCILLATIN 10-3140 279 $134.06 90002589 AR-1288-90 10-3140 279 $2,780.00 90002652 4 WAY STOPCOCK 10-3140 279 $4.87 90002669 SOF-FORM 2X75 STRL LF BANDAGE" 10-3140 279 $0.30 90002709 BL-1600-003 VIVIGEN FORMABLE 10-3140 278 $12,012.00 90002805 STERILE SKIN STAPLE REMOVER 10-3140 279 $1.78 90002821 5092-236 4X8MM BUR OVAL,LONG 10-3140 279 $25.18 90002895 AR-5028C-10 10X28M DELTA SCREW 10-3140 278 $940.00 90002899 AR-6215 Y TUBING, DOUBLE SPIKE 10-3140 279 $57.75 90003123 VERSASTEP EXPANDABLE SLEEVE 10-3140 279 $253.43 90003133 10MM ENDO CATCH SPECIMEN 10-3140 279 $484.50 90003185 STRAPS, SUSPENSORY W/LEG LARGE 10-3140 279 $20.85 90003235 ENFLOW CARTRIDGE DISP 3 EXT" 10-3140 279 $33.11 90003280 HOLDER LIMB SECURE 10-3140 279 $11.74 90003490 12 EXTENSION SET,MINIBORE" 10-3140 279 $5.98 90003839 GLOVE SENSICARE PI 7.5 10-3140 279 $3.55 90003841 GLOVE SURG SENSICARE 6.5 10-3140 279 $3.37 90003842 GLOVE SURG SENSICARE 9.0 10-3140 279 $3.37 90004153 AR-1322BCNF 2.4X8.5MM ANCH SUT 10-3140 278 $893.75 90004443 ARTHROSCOPY DAY TUBING 10K/24K 10-3140 279 $112.45 90004445 ARTHROSCOPY TUBING IN/OUT FLOW 10-3140 279 $92.40 90004446 ARTHROSCOPIC ENERGY PROBE 50DE 10-3140 279 $299.82 90004447 4.2MM GATOR, STEALTH SHAVER 10-3140 279 $112.50 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90004448 ARTHROSCOPIC ENERGY PROBE 90 D 10-3140 279 $287.50 90004451 5.5X70MM CANNULA SET UNIVERSAL 10-3140 279 $30.68 90004454 4.2MM ULTRAFRR, STEALTH 10-3140 279 $150.00 90004455 6.0MM STERLING OVAL BUR 10-3140 279 $90.00 90004456 4.5MM STERLING SPHERICAL BUR 10-3140 279 $90.00 90004457 4.2MM X 13CM LANZA 10-3140 279 $150.00 90004458 FLOSEAL HEMOSTATIC MATRIX 10MM 10-3140 278 $1,232.32 90004492 4.2MM STERLING GATOR, SHAVER 10-3140 279 $90.00 90004579 ASHA4830-01 AMB SUP MULT 50IFS 10-3140 279 $695.43 90004647 6F 22-30CM URETERAL STENT 10-3140 278 $496.97 90004659 BLADE SURGICAL STAINLESS #10 10-3140 279 $0.55 90004662 3/32 X 9" STEINMANN PIN" 10-3140 279 $31.85 90004667 TRAY FOLEY 16FR SILICONE 10-3140 279 $36.72 90004677 ADULT/PED SENSOR,ADHES,TRUSIG 10-3140 279 $28.28 90004678 GAUZE PACKING STRIP 1/2X5YD" 10-3140 279 $3.92 90004679 DRESSING FOAM 4 CIRCLE 10-3140 279 $4.75 90004680 SINGLE-USE SYRING/GAUGE ASSEM 10-3140 279 $73.00 90004682 PERFIX PLUG SURG 1.3'' 10-3140 278 $944.00 90004683 SWANSON SUTURE 1-7/16 LOOP 10-3140 279 $313.50 90004685 PILLOW ABDUCTION MEDIUM DISP 10-3140 279 $56.38 90004687 STEINMANN PIN, 5/64, 2.0MM" 10-3140 279 $31.85 90004690 15F X 27CM RETGR RADIO POLY CA 10-3140 278 $2,238.12 90004691 11.5F X 15CM STR TRI-FLOW CATH 10-3140 279 $180.00 90004702 30MM-3.5MM RELOAD ARTICULATING 10-3140 279 $1,006.26 90004703 45MM-2.5MM RELOAD ARTICULATING 10-3140 279 $1,085.55 90004704 45MM-3.5MM RELOAD ARTICULATING 10-3140 279 $1,131.26 90004710 BANDAGE ELASTIC 3X5 YDS 10-3140 279 $0.80 90004715 GAUZE SOF-FORM 3X75 STRL 10-3140 279 $0.35 90004717 SOLUTION .45% NACL 1000ML 10-3140 279 $6.27 90004718 SUSPENSORY STRAPS LRG 10-3140 279 $20.85 90004721 CAUTERY TIP CLEANER 2X2 10-3140 279 $0.77 90004725 GLOVES ORTHO BIOGEL SZ 8 10-3140 279 $4.33 90004727 GLOVES INDICATOR BIOGEL SIZE 8 10-3140 279 $3.37 90004728 SOLUTION FORMALIN 10% 120ML 10-3140 279 $2.67 90004729 SOLUTION FORMALIN 10% 480 ML 10-3140 279 $13.84 90004733 DRESSING TEGADERM FILM 8X 12"" 10-3140 279 $4.55 90004734 CANNULA SET 5.5MM 10-3140 279 $43.83 90004736 SUTURE MAXON 1, GS-26, TAPER 10-3140 279 $14.80 90004742 SUPPORT TRAY, NO DRUGS 10-3140 279 $13.98 90004748 TUBE ENDOTRACH INTERMED 8.0 MM 10-3140 279 $3.53 90004751 STOPCOCK 3 WAY MED OFF 10-3140 279 $3.95 90004752 EXTENSION SET 37 5.0 ML MALE" 10-3140 279 $2.68 90004753 SUTURE,PROLENE 2-0,SH, 30'' 10-3140 279 $9.87 90004754 FORCEPS ENDO 240CM 3.2MM RF 10-3140 279 $80.50 90004760 TAPE CAST DELTA LITE 2X4YD" 10-3140 279 $4.93 90004764 16FR COUNCIL RADIOPAQUE ANTI- 10-3140 279 $39.90 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90004769 PFISTER-SCHWARTZ STONE RETRIEV 10-3140 279 $140.20 90004774 16FR 5CC 2-WAY FOLEY CATH 10-3140 279 $23.58 90004775 GLOVE BIOGEL SURG PI IND 7.5 10-3140 279 $3.37 90004779 CATHETER SUCTION 10FR WHISTLE 10-3140 279 $0.55 90004782 PADDING UNDERCAST 3X4YD 10-3140 279 $3.50 90004785 TAPE CAST DELTA LITE 3X4YD" 10-3140 279 $5.70 90004787 BANDAGE BULKEE 2 4.5 X 4.1YD 10-3140 279 $1.17 90004789 GAUZE SPONGE 4X4 STRL 10-3140 279 $0.07 90004792 GAUZE PACKING STRIP 1X5YD" 10-3140 279 $4.30 90004793 DRESSING GAUZE XEROFORM 5X9"" 10-3140 279 $1.25 90004795 PACKING STRIP 1X5YD IOD" 10-3140 279 $4.93 90004796 FOLEY HOLDER UNIV TUBE 10-3140 279 $4.80 90004797 DRESSING FOAM COPA FENESTRATED 10-3140 279 $5.75 90004800 TAPE MEDIPORE ROLL 4 X 10 YD" 10-3140 279 $17.13 90004801 POSITIONER HEAD RING CUSHION 10-3140 279 $5.30 90004802 AMBU BAG ADULT 10-3140 279 $17.03 90004803 CATHETER URETHRAL 18FR 10-3140 279 $1.65 90004804 CATHETER URETHRAL 14FR 10-3140 279 $1.58 90004805 CATHETER URETHRAL 12FR 10-3140 279 $2.08 90004807 BLANKET COVER FULL BODY WARM 10-3140 279 $12.25 90004809 CANNULA ADULT 7' CO2/O2 10-3140 279 $7.81 90004810 AMBU BAG TODDLER/PEDI MASK 10-3140 279 $18.18 90004811 SIZE4 MASK ANESTHESIA SM ADULT 10-3140 279 $7.10 90004815 SET IV EXTENSION ULTRASITE 7'' 10-3140 279 $3.30 90004817 CATHETER SUCTION 5/6 FR 10-3140 279 $5.05 90004819 GLOVE BIOGEL PI INDICATOR 5.5 10-3140 279 $3.67 90004821 GLOVE BIOGEL ULTRATOUCH G SZ 6 10-3140 279 $3.50 90004822 GLOVE BIOGEL PI IND SZ 6 10-3140 279 $3.37 90004823 GLOVE BIOGEL ULTRATOUCH G SZ 7 10-3140 279 $3.90 90004824 GLOVE BIOGEL PI INDICAT SZ 8.5 10-3140 279 $3.37 90004825 GLOVE ULTRATOUCH G SZ 8.5 10-3140 279 $3.52 90004826 CATHETER IV 18G X 1.25'' 10-3140 279 $12.73 90004827 25G X 5 NEEDLE SPINAL PENCAN" 10-3140 279 $12.40 90004828 TRAY SPINAL PENCAN 25GX3.5'' 10-3140 279 $34.95 90004849 BINDER ABD 12 4 PAN XXL" 10-3140 279 $25.73 90004852 PUTTY DBM GRAFT 5CC 10-3140 278 $1,691.25 90004853 PUTTY DBM GRAFT 2.5CC 10-3140 278 $893.75 90004854 PUTTY DBM GRAFT 10CC 10-3140 278 $3,135.00 90004900 SINGLE ACTION PUMPING SYSTEM 10-3140 279 $133.00 90004901 STERILE WATER 3LBAG IRRG 10-3140 279 $11.37 90004902 SURGIFLO (NO THROMBIN) HEMOSTA 10-3140 279 $450.12 90004910 MESH CQUR 3.54 ROUND" 10-3140 278 $744.56 90004958 INFUSE BONE GRAFT SMALL 10-3140 278 $14,780.00 90004980 HERNIA PATCH 1.7X1.7" CIRCLE" 10-3140 278 $2,800.16 90005051 BONE CEMENT W/ANTIBIOTIC STRY 10-3140 279 $618.12 90005156 AR-1662PSL-7 7MM TENO PEEK 10-3140 278 $1,620.00 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90005254 BLADE SURGICAL STAINLESS #15 10-3140 279 $0.17 90005454 NEEDLE, EPIDURAL 20GX6 OBESE," 10-3140 279 $79.08 90005455 NEEDLE, 22GX5, BLACK, BEVEL S" 10-3140 279 $35.90 90005456 NEEDLE,SPINAL 25GX3.5 SHORT" 10-3140 279 $6.22 90005458 EXTENSION SET, 20 MINIBORE" 10-3140 279 $5.58 90005459 20G SINGLE SHOT EPIDURAL TRAY 10-3140 279 $54.60 90005461 RF CANNULA 100X10MM,18G CURVED 10-3140 279 $450.95 90005547 18G X 3 1/2 EPIDURAL NEEDLE EX 10-3140 279 $9.60 90005548 20G PERIFIX EPIDURAL TRAY 10-3140 279 $27.90 90005554 BOOTIE SUTURE AID YLW STD 10-3140 279 $5.90 90005555 RF CANNULA 20G X 10CM X 10MM 10-3140 279 $60.00 90005556 DRAIN PENROSE 5/8 X 18"" 10-3140 279 $1.68 90005557 AIRWAY NASOPHARYNGEAL 34 FR 10-3140 279 $6.27 90005558 SUTURE SOFSILK 3-0,PRECUT,128Q 10-3140 279 $3.30 90005559 EXTENSION TUBE EXTENDABLE 10-3140 279 $3.17 90005560 SUTURE POLYSORB 3-0, C-13 10-3140 279 $4.95 90005561 REPOSITIONABLE CLIIP 1650MM 10-3140 279 $16.20 90005562 MINI-SPIKE DISPENSING PIN 10-3140 279 $16.10 90005563 SUTURE PDS 3-0, SH 10-3140 279 $9.65 90005565 SUTURE POLYSORB 3-0, V-20 10-3140 279 $12.67 90005566 SUTURE CAPROSYN 4-0, P-12 10-3140 279 $7.15 90005567 20G X 1 IV ANGIOCATHS INSYTE" 10-3140 279 $103.32 90005656 MC254 7.6CM,25.4 DIAM WHEEL 10-3140 279 $534.60 90006052 RF NEEDLES 22G X 5MM X 10CM CV 10-3140 279 $146.60 90006263 RF NEEDLES 22G X 10MM X 10CM S 10-3140 279 $319.40 90007000 PACK GYN LAPAROSCOPY CDS 10-3140 270 $382.91 90007005 PACK LAMINECTOMY CDS 10-3140 279 $476.24 90007006 22G X 5 NEEDLE SPINAL,QUINCKE" 10-3140 279 $7.50 90007008 BIOGEL ULTRATOUCH SIZE 8 GLOVE 10-3140 270 $3.90 90007009 20G X 3.5 NEEDLE SPINAL,QUINC" 10-3140 279 $3.02 90007011 GLOVE BIOGEL PI INDICATOR SZ 7 10-3140 270 $3.55 90007015 22G X 8 NEEDLE CHIBA, BIOPSY" 10-3140 279 $11.35 90007017 GROUNDING PAD ADULT 10-3140 270 $9.21 90007022 OSTEOCEL PRO SM BONE G 5016001 10-3140 278 $1,612.87 90007023 OSTEOCEL PRO ME BONE G 5016005 10-3140 278 $7,421.56 90007025 LIGASURE IMPACT 10-3140 279 $2,267.93 90007026 4.34X5.5" KUGEL HERNIA PATCH" 10-3140 279 $952.05 C1781 90007027 3.0X4.6" KUGEL HERNIA PATCH" 10-3140 279 $780.45 C1781 90007272 CATHETER, CVC, TRI LUMEN, 7FR, 10-3140 279 $317.53 36569 90007320 CATHETER FOLEY 10FR, 3CC 10-3140 272 $15.80 C1729 90007326 CATHETER FOLEY 3-WAY 20FR,30CC 10-3140 272 $20.40 C1729 90007333 CATHETER FOLEY 2-WAY 18FR,10CC 10-3140 272 $24.87 C1729 90007334 CATHETER FOLEY 2-WAY 22FR,10CC 10-3140 272 $25.48 C1729 90007338 CATHETER FOLEY 3-WAY 20FR, 5CC 10-3140 272 $20.27 C1729 90007346 STYLET INTUBATING 6 FR 10-3140 270 $4.20 C1894 90007348 CATHETER FOLEY 2-WAY 24 FR 10-3140 272 $4.68 C1729 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90007362 CATHETER FOLEY, 16FR, LATEXFRE 10-3140 272 $15.15 C1729 90007367 15FRX28CM HEMODIALYSIS KIT,2-L 10-3140 279 $2,287.94 C1752 90007372 9.6F XCELA POWER INJECT PORT 10-3140 278 $2,300.00 C1788 90007373 8F XCELA POWER INJECTA PORT 10-3140 278 $2,000.00 C1788 90007376 20G X 1-3/4 CATHETER RADIAL" 10-3140 761 $23.87 36620 90007379 .035X150CM ZIPWIRE ANG STANDAR 10-3140 272 $109.25 C1769 90007442 THE MILL DISPOSABLE-MEDIUM 10-3140 279 $770.71 90007443 GUHL ANKLE DISTRACTOR FOOT 10-3140 279 $78.18 90007444 NEPTUNE 2 SPECIMEN COLLECTION 10-3140 279 $75.71 90007447 YANKAUER, FLANGE TIP RIGID STN 10-3140 279 $0.65 90007448 CATHETER IV AUTOGUARD 14GX1.75 10-3140 279 $4.27 90007449 DERMABOND ADHESIVE,TOPIC,.25ML 10-3140 279 $38.75 90007450 CATHETER URETHRAL 16FR 10-3140 279 $2.08 90007451 MASK OXYGEN ADULT 7' TUBE 10-3140 279 $4.35 90007453 BOTTLE, SOLIDIFIER, 3000CC 10-3140 279 $4.95 90007454 GASTROSTOMY FEEDING TUBE 10-3140 272 $151.31 90007455 18X4" CUFF,TOURNIQUET,RED,LF" 10-3140 279 $65.97 90007456 24X4" CUFF,TOURNIQUET,YELLOW" 10-3140 279 $113.10 90007457 34X4" CUFF,TOURNIQUET,PURPLE" 10-3140 279 $125.00 90007458 SUCTION VALVE VISERA FLX 10-3140 279 $14.63 90007459 BIOPSY VALVE STRL DISP 10-3140 279 $7.05 90007467 8.0 X-RAY GLOVE, SENSICARE 10-3140 279 $22.25 90007471 15FR BLAKE DRAIN R / F 10-3140 279 $154.45 90007472 PEDIATRIC CIRCUIT 10-3140 279 $19.83 90007473 PICO DRESSING 4X8 (10X20CM)" 10-3140 279 $798.20 90007474 ENDOJAW ALLIGATOR NEEDLE 230CM 10-3140 279 $16.57 90007475 DISPOSABLE INJECTION NEEDLES 10-3140 279 $70.13 90007476 TIGER TAPE,2MM,#2 TIGERWIRE BW 10-3140 279 $112.50 90007477 FIBERWIRE SIZE2 BLUE W/NEEDLE 10-3140 279 $55.00 90007478 DERMABOND SKIN ADHESIVE, 0.7ML 10-3140 279 $63.17 90007479 DRAIN WOUND FLAT 10MM 10-3140 279 $24.77 90007480 18G ANGIOGRAPHIC NEEDLE 10-3140 279 $4.88 90007481 BLANKET WARM LOWER BODY 10-3140 279 $12.82 90007483 GLIDESCOPE, GVL STAT 3 10-3140 279 $39.20 90007484 GLIDESCOPE, GVL STAT 4 10-3140 279 $39.20 90007486 SNARE OVL 230CM 2.8X15MM 10-3140 279 $22.28 90007487 SNARE OVL 230CM 2.8X.25MM 10-3140 279 $22.28 90007490 10CM X 3MM BURR ROUND DIAMOND 10-3140 279 $387.20 90007492 DRESSING AQUACEL AG HYDROFIBER 10-3140 279 $22.75 90007495 ELECTROHYDRAULIC LITHOTRIPSY 10-3140 279 $276.25 90007498 CATHETER IV 20 G X 1IN 10-3140 279 $12.73 90007500 SILVERSOAKER 5 CATHETER ON Q" 10-3140 279 $127.60 90007504 SCORPION NEEDLE MULTIFIRE 10-3140 279 $387.50 90007505 10MM CLIP APPLIER ENDO 10-3140 279 $961.43 90007506 8.25MM X 7CM CANNULA TWIST IN 10-3140 279 $62.50 90007508 VERESS NEEDLE 120MM 10-3140 279 $18.53 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90007510 22G X 7 NEEDLE SPINAL, QUINCK" 10-3140 279 $6.82 90007511 PENCIL CAUTERY PERFECT TEMP 10-3140 279 $18.85 90007512 U-DRAPE STERI-DRAPE 10-3140 279 $7.20 90007513 EYE SHIELD UNIV 7.5CM X 6.5XCM 10-3140 279 $1.70 90007514 BANDAGE EYE GUIBOR BUBBLE S 10-3140 279 $16.92 90007515 PACK SHOULDER CDS 10-3140 279 $345.70 90007516 CATH IV AUTOGD 20G X 1.16 10-3140 279 $4.18 90007517 DRESSING GAUZE OIL EMULSION 10-3140 279 $0.45 90007518 NASSAL CANNULA 10-3140 279 $0.75 90007519 GIA 80 STAPLER SINGLE USE 10-3140 279 $1,366.15 90007520 GLOVE RADIATION SZ.8 10-3140 279 $82.50 90007521 22GX8/18GX5" NEEDLE SET" 10-3140 279 $33.63 90007523 BURETTE 60 PUMPS SET 10-3140 279 $18.84 90007526 CARTER THOMASON SG SYSTEM 10-3140 279 $259.37 90007530 8.0 FR. DILATOR,COONS TAPER 10-3140 279 $49.50 90007531 SURGICLIP M - 11.5 TITANIUM 10-3140 279 $484.87 90007533 CARBIDE BURS FG 330 33O 10-3140 279 $4.65 90007536 POLY PAD MIX PAD 3 X 3"" 10-3140 279 $5.48 90007537 GEL ETCH SYRINGE W/25 TIP,12GM 10-3140 279 $56.07 90007540 POSITIONER,COMFORT TOUCH,2-LYR 10-3140 279 $24.74 90007541 TUBE ENDOTRACH INTERMED 7.5MM 10-3140 279 $3.53 90007542 EPIDURAL PULSATOR, 7ML, LL 10-3140 279 $8.35 90007543 CATH 30CC 3WAY 24FR 10-3140 279 $19.98 90007545 270ML ONQ PUMP W/2.5 CATHETER" 10-3140 279 $917.25 90007546 2.4MM ROUND FAST CUTTING BURR 10-3140 279 $82.88 90007547 7510400 INFUSE BONE GRAFT MED 10-3140 278 $20,580.00 90007550 SKIN STAPLER 35 WIDE ULC 10-3140 279 $68.93 90007551 EXTENSION SET,SMLLBR 7-1/2IN 10-3140 279 $4.50 90007553 2.5MM AGGRESSIVE PLUS SMALL 10-3140 279 $92.50 90007555 14G VERSASTEP INSUFFLATION 10-3140 279 $94.45 90007556 11MM VERSASTEP PLUS CANNULA 10-3140 279 $364.80 90007557 GAUZE PACKING STRIP IODOFORM 10-3140 279 $3.97 90007558 STICK SPONGE PRESAT PVP 10-3140 279 $5.15 90007559 ZUMI 4.5MM 33CM ZINN UTERINE 10-3140 279 $67.70 90007560 PROBE COVER KIT WITH GEL 10-3140 279 $31.75 90007561 V.A.C. SIMPLACE MEDIUM DRESING 10-3140 279 $105.41 90007565 STOCKINETTE IMPERVIOUS 12X48 10-3140 279 $8.17 90007569 JACKSON TABLE ORTHO KITS 10-3140 279 $56.40 90007570 STRIP CLOSURE SKIN 1/4 X 4"" 10-3140 279 $2.12 90007571 72202467 FAST-FIX 360 STR NDL 10-3140 279 $1,175.20 90007572 72202674 FAST-FIX 360 KPSC 10-3140 279 $317.20 90007574 GAUZE PACKING STRIP 1/4 X 5 YA 10-3140 279 $3.60 90007576 7MMX7CM, CANNULA DISPOSABLE 10-3140 279 $62.50 90007577 18CM TRIGGER-FLEX 10-3140 279 $972.50 90007578 IV EXTENSION SMALL BORE 10-3140 279 $2.07 90007579 DRESSING AQUACEL FOAM 5X5 10-3140 279 $6.35 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90007580 FULL BONE CUTTER RADIUS 3.5MM 10-3140 279 $92.50 90007581 LOOPS, RED, MAXI, STRL, 1X406M 10-3140 279 $4.72 90007587 ALEXIS O RETRACTOR SMALL 10-3140 279 $137.48 90007589 GAUZE BULKEE LITE 4X4 1YD STRL 10-3140 279 $0.73 90007591 DENVER SPLINT,LARGE, 1500 SERI 10-3140 279 $115.83 90007592 25G X 3.5 NEEDLE SPINAL,QUINC" 10-3140 279 $2.87 90007594 2.0M WIRE PASS DRILL MEDIUM 10-3140 279 $62.82 90007595 20G X 6 NEEDLE SPINAL,QUINCKE" 10-3140 279 $6.57 90007597 DRAIN PENROSE 1/4 X 18"" 10-3140 279 $1.45 90007612 12MM VERSASTEP PLUS CANNULA 10-3140 279 $375.73 90007625 DRESSING AQUACEL FOAM 4X4 10-3140 279 $4.87 90007626 GAUZE SPONGE AVANT 2X2"" 10-3140 279 $0.02 90007645 FRAZIER SUCTION, 12FR 10-3140 279 $4.60 90007646 4.8F X 22-30CM URETERAL STENT 10-3140 278 $589.00 90007647 MICROSCOPE OPMI DRAPE,52X154'' 10-3140 279 $181.97 90007648 14MH40 14-AM BUR 10-3140 279 $528.26 90007649 GLOVE RADIATION SZ7 PROGUARD 10-3140 279 $88.68 90007650 GLOVE RADIATION SZ7.5 PROGUARD 10-3140 279 $82.50 90007651 GLOVE RADIATION SZ8.5 PROGUARD 10-3140 279 $82.50 90007652 FLOSEAL HEMOSTATIC MATRIX 5ML 10-3140 279 $402.53 90007653 414702 BONE CEMENT MIXING & DE 10-3140 279 $686.13 90007861 NEEDLE BLUNT FILL 18GX1.5'' 10-3140 279 $0.17 90007875 BAXTER .9% SODIUM CHLO 1000ML 10-3140 279 $8.75 90007883 5CC GLASS SYRINGE, LUER SLIP 10-3140 279 $16.04 90007887 ABS-10011 ACP KIT SERIES 1 10-3140 279 $437.50 90007967 AR-1380E 8X20MM SCREW W/SHEATH 10-3140 278 $460.00 90008067 AR-8350DS 3.5MMX13CM DISSECTOR 10-3140 279 $100.00 90008104 CARPOSYN UD 3/0 30 P-12" 10-3140 279 $6.50 90008152 ANGIO-SEAL VIP 6F .035 WIRE 10-3140 279 $562.50 90008230 URETERAL STENT 8.5F 26CM 0.35' 10-3140 279 $292.17 90008263 AR-9815 50 DEGREE WAND 10-3140 279 $343.75 90008275 VCARE MEDM UTERINE MANIPULATOR 10-3140 279 $198.27 90008316 AR-1400F-90 9MM FLEXBLE REAMER 10-3140 279 $875.00 90008320 AR-5028P-10 10X28 SCREW DELTA 10-3140 278 $687.50 90008321 AR-5028P-9 9X28 SCREW DELTA 10-3140 278 $687.50 90008322 AR-1400FLX FLEXIBLE GUIDE PIN 10-3140 279 $387.50 90008326 ATP-101 ACHILLES PRE-SHAPED 10-3140 278 $8,525.00 90008371 AR-8400DS 4MM X 13CM DISSECTOR 10-3140 279 $110.00 90008372 AR-8400CDS 4X13 CURVED DISECTR 10-3140 279 $110.00 90008373 AR-8550RFOE 5.5MM OVAL BURR 10-3140 279 $277.75 90008375 GUIDEWIRE, SPRING,.018 10-3140 279 $27.50 90008376 BEACH CHAIR,ERIN MASK,LTX FRE 10-3140 279 $45.80 90008381 AR-1320BCNF 2.4X6.5SUTURETAK, 10-3140 278 $893.75 90008382 AR-1320DSC SutureTak INSTR KIT 10-3140 278 $481.25 90008387 AR-1300CST-CP MPFL KIT 10-3140 278 $4,639.25 90008411 492206112 90mm wolf needles 10-3140 279 $120.17 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 90008505 10-12MM CRE BALLON DILATOR 10-3140 279 $758.63 90008556 AR-9811 APOLLO 90, MULTIPORT 10-3140 279 $312.50 90008589 AR-3650DS RTC SOFT ANCHORS 10-3140 279 $536.25 90008590 AR-3632 2.7FIBERTAK 1.3 SUTURE 10-3140 278 $1,017.50 90008592 AR-8925SS SYNDESMOSIS TIGHT 10-3140 278 $4,111.25 90008595 30X4" CUFF,TOURNIQUET,RYL BLU" 10-3140 279 $125.00 90008623 400180 TIP COVER ACCESSORY 10-3140 279 $50.00 90008624 470359 8MM OBTURATOR BLADELESS 10-3140 279 $75.00 90008626 470361 5-8MM SEAL,IS4000 PORTS 10-3140 279 $45.00 90008629 470015 INSTRUMENT ARM DRAPE 10-3140 279 $130.00 90008633 18G X 3.5 NEEDLE TUOHY,NO WNG" 10-3140 279 $8.70 90008636 PICO DRESSING 4X12 (10X30CM)" 10-3140 279 $798.20 90008678 VCARE SMALL UTERINE MANIPULATO 10-3140 279 $198.27 90008690 DYNJP9103 STERILE LAVH DRAPE 10-3140 279 $25.23 90008694 AR-3290-1007 HEATED TUBESET 10-3140 279 $202.50 90008701 5FRX70CM OPENEND URETERAL CATH 10-3140 279 $35.00 90008766 .038X150CM SENSOR GUIDEWIRE ST 10-3140 279 $101.05 90008772 UROLOK II SCOPE ADAPTOR 10-3140 279 $34.33 90008791 1.7F NGAGE RETRIEVL BASKT,11MM 10-3140 279 $767.50 90008855 HERNIA PATCH BIO-A 7X10CM 10-3140 278 $1,795.75 90008858 STAPLER XL UNIV EGIA 12MM 10-3140 279 $1,413.23 90008859 LIGASURE MARYLAND JAW SEALER 10-3140 279 $1,712.45 90008865 B-COLLECTOR-1 BONE COLLECTOR 10-3140 279 $350.00 90008866 SUTURE VICRYL 2-0,CT-2 UNDYED 10-3140 279 $6.68 90008932 SUTURE QUILL MONODERM 0, VLT 10-3140 279 $48.95 90008933 SUTURE QUILL PDO 0,T9,VIOLET 10-3140 279 $45.83 90008961 10165 GRANEE NEEDLE 10-3140 279 $135.00 90008968 ENTRUST STENT 6X150MM X 120CM 10-3140 278 $4,009.50 90008991 HIP DRAPE 10-3140 279 $16.05 90008992 AR-8928BCJ-CP ACHILLES SPEEDB. 10-3140 278 $7,980.00 90008998 ABS-4200-033 AMNION MATRIX 10-3140 278 $9,800.00 90009874 FLOSEAL MALLEABLE APPLIC TIP 10-3140 279 $0.00 91004107 HEARING SCREENING-(HS) 10-3085 471 $186.00 92551 93000108 DEBR EXZ/INF SKIN, 10% BS 10-3270 361 $1,235.10 11000 100110968 CORRECT SKIN COLOR 6.0 CM/< 10-3140 360 $1,952.80 11920 100111001 REVISION OF CALF TENDON 10-3140 360 $10,580.92 27687 240002916 NG TUBE PLC W FLUORO 10-3170 450 $1,796.20 43752 630011069 URINE DRUG CONF 1-7 DRUG CL 10-3650 301 $1,144.30 G0480 630011072 URINE DRUG CONF 22+ DRUG CL 10-3650 301 $2,616.49 G0483 630011074 URINE CONFIRM OPIATES 10-3650 301 $263.28 80361 630011075 OXYCODONE CONFIRMATION 10-3650 301 $263.28 80365 630011076 URINE CONFIRM BUPRENORPHINE 10-3650 301 $263.28 80348 630011077 URINE CONFIRM NALOXONE&MEPER 10-3650 301 $525.66 80362 630011078 URINE CONFIRM METHADONE EDDP0 10-3650 301 $263.28 80358 630011079 URINE CONFIRM FENTANYL 10-3650 301 $263.28 80354 630011080 URINE CONFIRM HEROIN 10-3650 301 $263.28 80361 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com SERVICE CODE DESCRIPTION DEPT REV PRICE CPT-4 630011081 URINE CONFIRM 6-MONACETYL 10-3650 301 $263.28 80356 630011082 URINE CONFIRM MDMA&METABOLITE 10-3650 301 $263.28 80359 630011083 URINE CONFIRM SERTRALINE 10-3650 301 $263.28 80332 630011084 URINE CONFIRM TAPENTADOL 10-3650 301 $263.28 80372 630011085 URINE CONFIRM TRAMADOL 10-3650 301 $263.28 80373 630011086 URINE CONFIRM BENZODIAZEPINES 10-3650 301 $263.28 80346 630011087 URINE CONFIRM AMPHETAMINES 10-3650 301 $263.28 80324 630011088 URINE CONFIRM METHYLPHENIDATE 10-3650 301 $263.28 80360 630011089 URINE CONFIRM BARBITUATES 10-3650 301 $263.28 80345 630011090 URINE CONFIRM GABAPENTIN 10-3650 301 $263.28 80355 630011091 URINE CONFIRM PREGABALIN 10-3650 301 $263.28 80366 630011092 URINE CONFIRM ZOLPIDEM 10-3650 301 $263.28 80368 630011093 URINE CONFIRM CARISOPRODOL 10-3650 301 $263.28 80369 630011094 URINE CONFIRM AMIT & NORT 10-3650 301 $264.14 80335 Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com Building a HEALTHIER COMMUNITY 55 Meadowlands Parkway Secaucus, NJ 07094 201-392-3100 201-392-3527 info@hudsonregionalhospital.com www.HudsonRegionalHospital.com