Serv Cd lacrimal puncta by MikeJenny

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									PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML      CPT
AMBULATORY    5110010 0 NEW LEV I 0-15 MIN                    LOC        54.84                       99201
AMBULATORY    5110020 0 NEW LEV W/ PROC I 0-15 MIN            LOC        54.84                       9920125
AMBULATORY    5110011 0 NEW LEV II 15-30 MIN                  LOC        54.84                       99202
AMBULATORY    5110021 0 NEW LEV W/ PROC II 15-30 MIN          LOC        54.84                       9920225
AMBULATORY    5110012 0 NEW LEV III 30-45 MIN                 LOC        63.10                       99203
AMBULATORY    5110022 0 NEW LEV W/ PROC III 30-45 MIN         LOC        63.10                       9920325
AMBULATORY    5110013 0 NEW LEV IV 45-60 MIN                  LOC        91.81                       99204
AMBULATORY    5110023 0 NEW LEV W/ PROC IV 45-60 MIN          LOC        91.81                       9920425
AMBULATORY    5110014 0 NEW LEV V > 1 HR                      LOC        91.81                       99205
AMBULATORY    5110024 0 NEW LEV W/ PROC V >1HR                LOC        91.81                       9920525
AMBULATORY    5110015 0 EST LEV I 0-15 MIN                    LOC        40.00                       99211
AMBULATORY    5110025 0 EST LEV W/ UNREL PROC I 0-15 MIN      LOC        40.00                       9921125
AMBULATORY    5110016 0 EST LEV II 15-30 MIN                  LOC        40.00                       99212
AMBULATORY    5110026 0 EST LEV W/ UNREL PROC II 15-30 MIN    LOC        40.00                       9921225
AMBULATORY    5110017 0 EST LEV III 30-45 MIN                 LOC        63.10                       99213
AMBULATORY    5110027 0 EST LEV W/ UNREL PROC III 30-45 MIN   LOC        63.10                       9921325
AMBULATORY    5110018 0 EST LEV IV 45-60 MIN                  LOC        91.81                       99214
AMBULATORY    5110028 0 EST LEV W/ UNREL PROC IV 45-60 MIN    LOC        91.81                       9921425
AMBULATORY    5110019 0 EST LEV V > 1 HR                      LOC        91.81                       99215
AMBULATORY    5110029 0 EST LEV W/ UNREL PROC V >1 HR         LOC        91.81                       9921525
AMBULATORY    5110031 0 CONFERENCE INTERDISCIPLINARY          LOC        91.81                       G0175
AMBULATORY    5180162 0 ABSOLUTE ALCOHOL 1ML INJ              MED        12.80
AMBULATORY    5181201 0 ACCUZYME 30 GM OINT                   MED        92.80
AMBULATORY    5180170 0 ACETAMINOPHEN / CODEINE #3 TAB        MED        3.30
AMBULATORY    5180169 0 ACETAMINOPHEN 325 MG TAB              MED        3.30
AMBULATORY    5180165 0 ACETAMINOPHEN 325MG ELIX              MED        3.30
AMBULATORY    5181237 0 ACETAMINOPHEN 80 MG SUPP              MED        2.50
AMBULATORY    5180164 0 ACETAMINOPHEN DROPS (100MG)           MED        3.20
AMBULATORY    5180166 0 ACETAMINOPHEN PEDS DROPS              MED        3.30
AMBULATORY    5180167 0 ACETAMINOPHEN SUPP (650MG)            MED        3.30
AMBULATORY    5180168 0 ACETAMINOPHEN SUSP (80MG)             MED        3.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5181288 0 ACETAZOLAMIDE 250 MG TAB                          MED        10.30
AMBULATORY    5181263 0 ACETIC ACID 2% 60CC OTIC SOLN                     MED        16.50
AMBULATORY    5181228 0 ACETIC ACID 5% 10 ML TOP SOLN                     MED        3.30
AMBULATORY    5181261 0 ACETYLCYSTEINE 20% 6 GM IVPB (200 MG/ML, 30 ML VIAMED        36.50
AMBULATORY    5181021 0 ALBUTEROL 0.083% INHALATION SOLN                  MED        17.50
AMBULATORY    5180194 0 ALBUTEROL INHALER                                 MED        25.00
AMBULATORY    5181256 0 ALEFACEPT 0.5 MG INJ                              MED        66.40                       J0215
AMBULATORY    5181166 0 ALPHA-1 PROTEINASE INHIB IVPB 10 MG               MED        13.00                       J0256
AMBULATORY    5181177 0 ALTEPLASE INJ 1 MG FOR CATH CLEAR                 MED        56.20                       J2997
AMBULATORY    5181246 0 ALUM / MG HYDROX 15 ML PO SUSP                    MED        2.50
AMBULATORY    5181260 0 AMIKACIN 100 MG INJ / IVPB                        MED        35.20                       J0278
AMBULATORY    5181239 0 AMOXICILLIN 250 MG CAP                            MED        2.50
AMBULATORY    5180219 0 AMOXICILLIN CAP 500MG                             MED        3.30
AMBULATORY    5180250 0 AMPICILLIN / SULBACTAM 1.5 GM INJ                 MED        19.00                       J0295
AMBULATORY    5180570 0 AMPICILLIN 500MG INJ                              MED        7.60                        J0290
AMBULATORY    5180334 0 AMPICILLIN 500MG IVPB                             MED        31.70                       J0290
AMBULATORY    5180248 0 AMPICILLIN CAP (500MG)                            MED        3.30
AMBULATORY    5181191 0 AMPICILLIN CAP 250 MG                             MED        2.50
AMBULATORY    5181135 0 ARGININE IVPB 30 GM (300 ML)                      MED        217.00
AMBULATORY    5180256 0 AROMATIC AMMONINA AMP (.33ML)                     MED        3.30
AMBULATORY    5180260 0 ASPIRIN 325 MG ENT COAT TAB                       MED        3.30
AMBULATORY    5180262 0 ASPIRIN 325 MG TAB                                MED        3.30
AMBULATORY    5180158 0 ASPIRIN 81 MG PEDS CHEW TAB                       MED        3.30
AMBULATORY    5181179 0 AZITHROMYCIN 1 GM CAP                             MED        55.60                       Q0144
AMBULATORY    5181278 0 AZITHROMYCIN 500 MG INJ/IVPB                      MED        84.10                       J0456
AMBULATORY    5181167 0 AZTREONAM 1 GM IVPB                               MED        35.70
AMBULATORY    5180271 0 BACITRACIN 1 OZ OINT                              MED        14.20
AMBULATORY    5180460 0 BACITRACIN 3.5 GM OPHT OINT                       MED        3.30
AMBULATORY    5181091 0 BACLOFEN 2000 MCG/ML 20 ML SYRINGE IT KIT INJ     MED        1,487.50
AMBULATORY    5181093 0 BACLOFEN 50 MCG 1 AMP TRIAL KIT IT INJ            MED        210.00                      J0476
AMBULATORY    5181090 0 BACLOFEN 500 MCG/ML 20 ML SYRINGE IT KIT INJ      MED        632.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5180463 0 BENZOCAINE 20% TOPICAL SPRAY 56G             MED        33.00
AMBULATORY    5180469 0 BENZOIN COMPOUND 2OZ.                        MED        7.60
AMBULATORY    5180279 0 BETAMETHASONE 0.1% 15 GM CRM                 MED        3.15
AMBULATORY    5181082 0 BETAMETHASONE NA P04 3MG INJ                 MED        8.70                        J0702
AMBULATORY    5181279 0 BEVACIZUMAB (AVASTIN) 3 MG OPHT INJ          MED        40.44
AMBULATORY    5180562 0 BOTULINUM TOX TYP A INJ 1 UNIT               MED        12.00                       J0585
AMBULATORY    5181290 0 BRIMONIDINE TARTRATE 0.2% 5 ML OPHT SOLN     MED        34.25
AMBULATORY    5180195 0 BSS (BALANCED SALT SOLN) 15 ML OPHT SOLN     MED        17.20
AMBULATORY    5181222 0 BUDESONIDE 0.5 MG/2ML NEB INH SOLN           MED        14.15
AMBULATORY    5180291 0 BUPIVACAINE .5% W/EPI INJ 30ML               MED        10.20
AMBULATORY    5180289 0 BUPIVACAINE 0.25% W/O EPI INJ 30 ML          MED        9.80
AMBULATORY    5180295 0 BUPIVACAINE 0.75% W/EPI INJ 30ML             MED        13.20
AMBULATORY    5180290 0 BUPIVICAINE 0.5% W/O EPI INJ 30 ML           MED        8.70
AMBULATORY    5180292 0 BUPIVICAINE 0.75% W/O EPI INJ 30 ML          MED        11.90
AMBULATORY    5181023 0 CALCIUM GLUC 10% INJ 1GM                     MED        31.70                       J0610
AMBULATORY    5181168 0 CALCIUM GLUC IVPB 1 GM                       MED        4.50                        J0610
AMBULATORY    5180345 0 CANDIDA ALBICANS 0.1 ML SKIN TEST INJ        MED        18.00                       86485
AMBULATORY    5181274 0 CASPOFUNGIN 5 MG INJ / IVPB                  MED        80.00                       J0637
AMBULATORY    5181074 0 CEFAZOLIN 500 MG INJ                         MED        8.70                        J0690
AMBULATORY    5181075 0 CEFAZOLIN 500 MG IVPB                        MED        32.80                       J0690
AMBULATORY    5180355 0 CEFOTAXIME 1000 MG INJ                       MED        22.90                       J0698
AMBULATORY    5180357 0 CEFOXITIN 1000 MG INJ                        MED        20.80                       J0694
AMBULATORY    5181024 0 CEFTAZIDIME 500 MG IVPB                      MED        19.10                       J0713
AMBULATORY    5181104 0 CEFTRIAXONE 125 MG INJ                       MED        14.40
AMBULATORY    5180588 0 CEFTRIAXONE 250 MG INJ                       MED        28.80                       J0696
AMBULATORY    5181118 0 CEFTRIAXONE 250 MG IVPB                      MED        27.80                       J0696
AMBULATORY    5181264 0 CEPACOL LOZENGES 9 PER PCKE                  MED        2.50
AMBULATORY    5181240 0 CEPHALEXIN 500 MG CAP                        MED        4.50
AMBULATORY    5181275 0 CIDOFOVIR 375 MG INJ                         MED        1,750.50                    J0740
AMBULATORY    5181265 0 CIPRO HC 0.2% HYDROCORT 1% 10 ML OTIC SOLN   MED        215.00
AMBULATORY    5180391 0 CIPROFLOXACIN 500 MG TAB                     MED        9.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5180398 0 CLINDAMYCIN 150 MG CAP                          MED        4.50
AMBULATORY    5181169 0 CLINDAMYCIN 300 MG IVPB                         MED        4.70
AMBULATORY    5181211 0 CLONIDINE 0.1 MG TAB                            MED        3.30
AMBULATORY    5180299 0 CLONIDINE 0.2 MG TAB                            MED        3.30
AMBULATORY    5181131 0 CMV IMMUNE GLOB 2.5 GM VIAL INJ                 MED        1,852.70                    J0850
AMBULATORY    5180421 0 COLYTE SOLN 4 LITERS                            MED        10.90
AMBULATORY    5181259 0 CORTICORELIN 1 MCG INJ                          MED        10.65                       J0795
AMBULATORY    5180452 0 COSYNTROPIN 0.25MG INJ                          MED        72.00                       J0835
AMBULATORY    5180107 0 CYANOCOBALAMIN 1000 MCG INJ                     MED        7.60                        J3420
AMBULATORY    5180200 0 CYCLOPHOSPHAMIDE (NON-LYO) 100 MG IVPB          MED        15.60                       J9070
AMBULATORY    5180915 0 DACLIZUMAB 25 MG IVPB                           MED        908.70                      J7513
AMBULATORY    5181136 0 DARBEPOETIN 1 MCG (NON-ESRD PT) INJ             MED        13.55                       J0881
AMBULATORY    5181221 0 DEXAMETHASONE 2 MG TAB                          MED        2.50
AMBULATORY    5180510 0 DEXAMETHASONE 4 MG TAB                          MED        3.30
AMBULATORY    5181077 0 DEXAMETHASONE NA P04 1 MG INJ                   MED        3.30                        J1100
AMBULATORY    5181185 0 DEXTROSE 5% 100 ML INJ                          MED        5.00
AMBULATORY    5181184 0 DEXTROSE 5% 50 ML INJ                           MED        5.00
AMBULATORY    5180482 0 DEXTROSE 50% 50 ML INJ                          MED        7.60
AMBULATORY    5180514 0 DIAZEPAM 5 MG INJ                               MED        7.60                        J3360
AMBULATORY    5181032 0 DIAZEPAM 5 MG TAB                               MED        3.30
AMBULATORY    5180620 0 DILTIAZEM 240 MG CD CAP                         MED        4.70
AMBULATORY    5180277 0 DIPHENHYDRAMINE 50 MG INJ                       MED        7.60                        J1200
AMBULATORY    5180628 0 DIPHENHYDRAMINE 12.5 MG PO ELIX                 MED        5.30
AMBULATORY    5181180 0 DIPHENHYDRAMINE 25 MG CAP                       MED        2.50
AMBULATORY    5181236 0 DIPHENHYDRAMINE 25 MG INJ                       MED        1.60                        J1200
AMBULATORY    5180627 0 DIPHENHYDRAMINE 50 MG CAP                       MED        3.30
AMBULATORY    5181247 0 DMSO 10 ML / ANESTACON 10 ML MIXTURE TOP SOLN REMED        56.00
AMBULATORY    5180042 0 DMSO DIMETHYL SULFOXIDE 50% SOLN 50 ML          MED        105.50                      J1212
AMBULATORY    5180653 0 EMLA 5 GM CRM                                   MED        13.80
AMBULATORY    5180654 0 EMLA 5 GM CRM W/TEGADERM DRSG                   MED        16.50
AMBULATORY    5181203 0 ENALAPRIL 10 MG TAB                             MED        4.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5181164 0 ENOXAPARIN 10 MG INJ                         MED        20.00                       J1650
AMBULATORY    5180658 0 EPHEDRINE 50 MG INJ                          MED        7.60
AMBULATORY    5181266 0 EPI PEN 0.3 MG INJ                           MED        161.30
AMBULATORY    5181291 0 EPI PEN JR 0.15 MG INJ                       MED        161.30
AMBULATORY    5180127 0 EPINEPHRINE 1 ML AMP INJ                     MED        6.60                        J0170
AMBULATORY    5181187 0 ERTAPENUM 500 MG IVPB                        MED        48.95                       J1335
AMBULATORY    5181096 0 ERYTHROMYCIN 0.5% OPHT OINT                  MED        22.20
AMBULATORY    5180487 0 ERYTHROMYCIN OINT 3.5G                       MED        5.60
AMBULATORY    5181011 0 ERYTHROPOETIN 1000 UNITS (NON-ESRD PT) INJ   MED        46.40                       J0885
AMBULATORY    5181218 0 ETHANOLAMINE OLEATE INJ 100 MG               MED        150.00                      J1430
AMBULATORY    5180676 0 ETHYL CHLORIDE SPRAY                         MED        19.70
AMBULATORY    5181033 0 FENTANYL 100 MCG INJ                         MED        6.60                        J3010
AMBULATORY    5181284 0 FENTANYL 25 MCG/HR PATCH                     MED        39.40
AMBULATORY    5181283 0 FENTANYL 50 MCG/HR PATCH                     MED        58.50
AMBULATORY    5181282 0 FENTANYL 75 MCG/HR PATCH                     MED        120.00
AMBULATORY    5181186 0 FERRLECIT (IRON) IVPB 12.5 MG                MED        12.50                       J2916
AMBULATORY    5181001 0 FIBRIN SEALANT 5.0ML                         MED        1,854.00
AMBULATORY    5180575 0 FILGRASTIM 300 MCG INJ                       MED        516.00                      J1440
AMBULATORY    5181120 0 FILGRASTIM 480 MCG INJ                       MED        781.10                      J1441
AMBULATORY    5181141 0 FLOSEAL HEMOSTATIC SEAL 5 ML                 MED        440.00
AMBULATORY    5180488 0 FLOURESCEIN 1 MG OPHTH STRIP                 MED        3.30
AMBULATORY    5181018 0 FLUMAZENIL 0.1 MG INJ                        MED        20.00
AMBULATORY    5181116 0 FUROSEMIDE 20 MG INJ                         MED        3.80                        J1940
AMBULATORY    5180712 0 FUROSEMIDE 20 MG IVPB                        MED        30.80                       J1940
AMBULATORY    5181034 0 FUROSEMIDE 20 MG TAB                         MED        3.30
AMBULATORY    5180718 0 GELATIN SPONGE (SIZE 100)                    MED        63.30
AMBULATORY    5180722 0 GENTAMICIN 0.1% 15 GM TOP OINT               MED        3.30
AMBULATORY    5180723 0 GENTAMICIN 0.1% CRM                          MED        3.30
AMBULATORY    5180051 0 GENTAMICIN 80 MG INJ                         MED        6.60                        J1580
AMBULATORY    5180634 0 GENTAMICIN 80 MG IVPB                        MED        30.60                       J1580
AMBULATORY    5181267 0 GENTAMYCIN 0.3% 5 ML OPHT SOLN               MED        5.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5181241 0 GENTAMYCIN 40 MG INJ                    MED        2.50                        J1580
AMBULATORY    5181268 0 GENTIAN VIOLET 1% 30 ML TOP SOLN        MED        11.60
AMBULATORY    5181036 0 GLUCAGON 1 MG DIAGNOSTIC INJ            MED        122.60                      J1610
AMBULATORY    5181035 0 GLUCAGON 1 MG EMERG KIT                 MED        161.30                      J1610
AMBULATORY    5180727 0 GLUCOSE INSTANT                         MED        6.20
AMBULATORY    5181269 0 GLYCERIN 99% PEROX 30 ML TOP SOLN       MED        10.90
AMBULATORY    5181133 0 GOSERELIN 3.6 MG IMPLANT INJ            MED        975.00                      J9202
AMBULATORY    5180738 0 HALOPERIDOL 5 MG INJ                    MED        16.90                       J1630
AMBULATORY    5181017 0 HCG 10,000 UNITS INJ                    MED        128.80                      J0725
AMBULATORY    5181037 0 HEP LOCK 10 UNITS INJ                   MED        7.60                        J1642
AMBULATORY    5181010 0 HEPARIN 1000 UNITS INJ                  MED        3.30                        J1644
AMBULATORY    5181130 0 HEPATITIS B IMMUN GLOB 1 ML INJ         MED        264.70                      90371
AMBULATORY    5181171 0 HEPATITIS B IMMUNE GLOB PER 1 ML IVPB   MED        264.70                      90371
AMBULATORY    5180758 0 HISTOPLASMIN 0.1 ML SKIN TEST INJ       MED        13.20
AMBULATORY    5181142 0 HYALURONATE SOD 20-25 MG INJ            MED        362.60                      J7317
AMBULATORY    5180298 0 HYDRALAZINE 20 MG INJ                   MED        21.40                       J0360
AMBULATORY    5180914 0 HYDROCODONE W/ACETOMIN 5MG TAB          MED        3.30
AMBULATORY    5180768 0 HYDROCORTISONE 0.5% 30 GM CRM           MED        3.30
AMBULATORY    5180769 0 HYDROCORTISONE 1% 30 GM CRM             MED        3.30
AMBULATORY    5180094 0 HYDROCORTISONE 100 MG INJ               MED        7.60                        J1720
AMBULATORY    5180095 0 HYDROCORTISONE 100 MG IVPB              MED        31.70                       J1720
AMBULATORY    5181094 0 HYDROMORPHONE 2 MG INJ                  MED        7.60                        J1170
AMBULATORY    5180776 0 HYDROXYZINE 25 MG INJ                   MED        6.60                        J3410
AMBULATORY    5181117 0 HYLAN G-F INJ 16 MG                     MED        529.00                      J7320
AMBULATORY    5180331 0 IBANDRONATE 1 MG INJ / IVPB             MED        362.30                      C9229
AMBULATORY    5180779 0 IBUPROFEN 100 MG/5ML PO SUSP            MED        3.30
AMBULATORY    5181242 0 IBUPROFEN 200 MG CAP                    MED        2.50
AMBULATORY    5180780 0 IBUPROFEN 400 MG TAB                    MED        3.30
AMBULATORY    5181257 0 IMIPENEM CILASTIN 250 MG IVPB           MED        40.43                       J0743
AMBULATORY    5180787 0 INDIGO CARMINE 0.8% 5 ML INJ            MED        31.70
AMBULATORY    5181038 0 INFLIXIMAB 10 MG INJ                    MED        133.50                      J1745
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5181176 0 INFLIXIMAB 10 MG IVPB                      MED        133.50                      J1745
AMBULATORY    5181150 0 INSULIN (ALL TYPES) 5 UNITS INJ            MED        1.50                        J1815
AMBULATORY    5181039 0 INSULIN LISPRO INJ 50 UNITS                MED        11.90
AMBULATORY    5180607 0 INTERFERON ALFA 2A RCMB 3MU                MED        437.60                      J9213
AMBULATORY    5181220 0 IPRATROP BROM 0.02% 2.5MG/3ML INH SOLN     MED        3.30
AMBULATORY    5180809 0 IPRATROPRIUM BROMIDE INHALER               MED        84.40
AMBULATORY    5181040 0 IRON DEXTRAN 50MG INJ                      MED        56.10                       J1751
AMBULATORY    5181160 0 IT PUMP REFILL SYR DILAUD / BUPIV / CLON   MED        570.00
AMBULATORY    5181159 0 IT PUMP REFILL SYR DILAUDID / BUPIV        MED        570.00
AMBULATORY    5181158 0 IT PUMP REFILL SYR DILAUDID / CLON         MED        570.00
AMBULATORY    5181155 0 IT PUMP REFILL SYR MORPH / BUPIV           MED        570.00
AMBULATORY    5181156 0 IT PUMP REFILL SYR MORPH / CLON            MED        570.00
AMBULATORY    5181161 0 IT PUMP REFILL SYR MORPHINE                MED        161.00
AMBULATORY    5181157 0 IT PUMP REFILL SYR MS / BUPIV / CLON       MED        570.00
AMBULATORY    5181249 0 IV 0.45% NACL 1000 ML                      MED        2.00                        J7030
AMBULATORY    5180435 0 IV 0.9% NACL 1000ML                        MED        30.90                       J7030
AMBULATORY    5181212 0 IV 0.9% NACL 150 CC                        MED        30.90
AMBULATORY    5180427 0 IV 0.9% NACL 250ML                         MED        30.90                       J7050
AMBULATORY    5180434 0 IV 0.9% NACL 500ML                         MED        30.90                       J7040
AMBULATORY    5180454 0 IV D10W 1000ML                             MED        30.90
AMBULATORY    5180447 0 IV D5W / 0.2% NACL 1000 ML                 MED        30.90
AMBULATORY    5180446 0 IV D5W / 0.2% NACL 500 ML                  MED        30.90
AMBULATORY    5180451 0 IV D5W / 0.45% NACL 1000 ML                MED        30.90
AMBULATORY    5181031 0 IV D5W / 0.9% NACL 500 ML                  MED        30.90                       J7042
AMBULATORY    5180445 0 IV D5W / LR 1000 ML                        MED        30.90
AMBULATORY    5180438 0 IV D5W 1000 ML                             MED        30.90                       J7070
AMBULATORY    5181215 0 IV D5W 150 CC                              MED        30.90
AMBULATORY    5180437 0 IV D5W 500ML                               MED        30.90                       J7060
AMBULATORY    5180439 0 IV LR 1000ML                               MED        30.90                       J7120
AMBULATORY    5181041 0 KETOROLAC 15 MG INJ                        MED        4.90                        J1885
AMBULATORY    5181277 0 LABETALOL 300 MG TAB                       MED        2.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5180553 0 LEUPROLIDE SUSP DEPO INJ 7.5MG                  MED        1,400.00                    J9217
AMBULATORY    5180593 0 LEUPROLIDE SUSP INJ 3.75MG                      MED        1,120.00                    J1950
AMBULATORY    5181042 0 LIDOCAIN VISCOUS SOLN 2%/100ML                  MED        6.20
AMBULATORY    5181153 0 LIDOCAINE 0.5% W/ EPI 50 ML                     MED        12.90
AMBULATORY    5181165 0 LIDOCAINE 0.5% W/O EPI INJ 50 ML                MED        11.70
AMBULATORY    5181229 0 LIDOCAINE 1% PF 2 ML AMP INJ                    MED        2.50
AMBULATORY    5181139 0 LIDOCAINE 1% W/ EPI INJ 10 CC                   MED        5.40
AMBULATORY    5180517 0 LIDOCAINE 1% W/EPI 20 ML INJ                    Med        3.60
AMBULATORY    5181137 0 LIDOCAINE 1% W/O EPI 10 ML INJ                  MED        6.10
AMBULATORY    5181270 0 LIDOCAINE 1% W/O EPI 20 ML INJ                  MED        10.70
AMBULATORY    5181044 0 LIDOCAINE 1% W/O EPI 50 ML INJ                  MED        10.70
AMBULATORY    5180841 0 LIDOCAINE 2% TOPICAL JELLY 10 CC (URETH SOLN)   MED        11.50
AMBULATORY    5181140 0 LIDOCAINE 2% W/ EPI INJ 10 CC                   MED        6.70
AMBULATORY    5180530 0 LIDOCAINE 2% W/O EPI 20 ML INJ                  MED        13.50
AMBULATORY    5181138 0 LIDOCAINE 2% W/O EPI INJ 10 ML                  MED        7.40
AMBULATORY    5180531 0 LIDOCAINE 4% TOPICAL 50ML                       MED        6.30
AMBULATORY    5180842 0 LIDOCAINE JELLY 2% 30 ML TOP SOLN               MED        44.10
AMBULATORY    5181238 0 LISINOPRIL 20 MG TAB                            MED        3.10
AMBULATORY    5181286 0 LORAZEPAM 0.5 MG TAB                            MED        2.50
AMBULATORY    5181285 0 LORAZEPAM 1 MG TAB                              MED        2.50
AMBULATORY    5180854 0 MAALOX MG HYDROX / ALUM 30 ML PO SUSP           MED        2.50
AMBULATORY    5181173 0 MAGNESIUM SULF IVPB 500 MG                      MED        21.60                       J3475
AMBULATORY    5181276 0 MASTISOL ADHESIVE 1 CC TOPICAL                  MED        3.60
AMBULATORY    5181151 0 MEDROXYPROGEST ACET INJ 50 MG                   MED        41.20                       J1051
AMBULATORY    5181079 0 MEDROXYPROGESTERONE 150 MG INJ                  MED        81.40
AMBULATORY    5180533 0 MEDROXYPROGESTERONE 40 MG INJ                   MED        31.90
AMBULATORY    5180862 0 MEDROXYPROGESTERONE TAB 10MG                    MED        3.30
AMBULATORY    5181224 0 MEPERIDINE 100 MG INJ                           MED        2.50                        J2175
AMBULATORY    5181048 0 MEPERIDINE 25MG INJ                             MED        7.60
AMBULATORY    5180865 0 MEPERIDINE 50 MG INJ                            MED        4.50
AMBULATORY    5180867 0 MEPERIDINE TAB 50MG                             MED        3.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5181199 0 MEROPENEM INJ / IVPB 100 MG               MED        107.10                      J2185
AMBULATORY    5180875 0 METHERGINE 0.2 MG INJ                     MED        12.10                       J2210
AMBULATORY    5181049 0 METHOTREXATE 400 MCG OPHT INJ             MED        175.00
AMBULATORY    5181103 0 METHOTREXATE INJ 5 MG                     MED        10.70                       J9250
AMBULATORY    5181174 0 METHOTREXATE IVPB 5 MG                    MED        10.70                       J9250
AMBULATORY    5181192 0 METHOXSALEN 0.01% SOLN 10ML               MED        200.00
AMBULATORY    5180882 0 METHYLENE BLUE 1% 10 ML INJ               MED        16.50
AMBULATORY    5181162 0 METHYLPRED DEPOMEDROL INJ 20 MG           MED        10.70                       J1020
AMBULATORY    5181152 0 METHYLPRED DEPOMEDROL INJ 40 MG           MED        28.50                       J1030
AMBULATORY    5180038 0 METHYLPRED DEPOMEDROL INJ 80MG            MED        30.00                       J1040
AMBULATORY    5180490 0 METHYLPRED SOLUMEDROL 40 MG IVPB          MED        11.00                       J2920
AMBULATORY    5180884 0 METHYLPRED SOLUMEDROL INJ 125 MG          MED        28.50                       J2930
AMBULATORY    5181121 0 METHYLPRED SOLUMEDROL INJ 40 MG           MED        11.00                       J2920
AMBULATORY    5180885 0 METHYLPRED SOLUMEDROL IVPB 125 MG         MED        43.70                       J2930
AMBULATORY    5181281 0 METHYLPREDNISOLONE SOLUMEDROL 10 MG INJ   MED        2.50                        J2920
AMBULATORY    5180886 0 METHYLPREDNISOLONE TAB 4MG                MED        3.30
AMBULATORY    5180294 0 METOCLOPRAMIDE 10 MG INJ                  med        11.70                       J2765
AMBULATORY    5181294 0 METOPROLOL 25 MG TAB                      MED        2.50
AMBULATORY    5181204 0 METOPROLOL 50 MG TAB                      MED        2.50
AMBULATORY    5181207 0 METOPROLOL XL TAB 25 MG                   MED        2.50
AMBULATORY    5181206 0 METOPROLOL XL TAB 50 MG                   MED        2.60
AMBULATORY    5181050 0 MIDAZOLAM 1 MG INJ                        MED        7.80                        J2250
AMBULATORY    5181051 0 MIDAZOLAM 1 MG IVPB                       MED        10.20                       J2250
AMBULATORY    5181059 0 MITOXANTRONE 5 MG IVPB                    MED        889.39                      J9293
AMBULATORY    5181289 0 MOXIFLOXACIN 0.5% 3 ML OPHT SOLN          MED        104.00
AMBULATORY    5181052 0 MUPIROCIN 2% 22 GM OINT                   MED        76.90
AMBULATORY    5181248 0 NAFCILLIN 2 GM IVPB                       MED        39.66
AMBULATORY    5180920 0 NALOXONE 1 MG INJ                         MED        14.00                       J2310
AMBULATORY    5180461 0 NEOMYC / BACIT / POLYMX 30 GM OINT        MED        20.90
AMBULATORY    5181243 0 NIFEDIPINE 10 MG CAP                      MED        2.50
AMBULATORY    5180927 0 NIFEDIPINE 20 MG CAP                      MED        3.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5181197 0 NITROFURANTOIN 100 MG CAP                   MED        8.20
AMBULATORY    5180560 0 NITROGLYCERIN 0.4 MG SL TAB                 MED        2.50
AMBULATORY    5180933 0 NITROGLYCERIN 0.6 MG SL TAB                 MED        3.30
AMBULATORY    5181244 0 NYSTATIN 15 GM BTLE TOP POWDER              MED        47.95
AMBULATORY    5181132 0 OCTREOTIDE (SANDO LAR DEP) INJ 1 MG         MED        154.50                      J2353
AMBULATORY    5181271 0 OFLOXACIN 0.3% 10 ML OTIC SOLN              MED        159.20
AMBULATORY    5181254 0 OMALIZUMAB 5 MG INJ                         MED        29.20                       J2357
AMBULATORY    5181080 0 ONDANSETRON 1 MG INJ                        MED        10.30                       J2405
AMBULATORY    5180944 0 ONDANSETRON 8 MG TAB                        MED        51.20                       Q0179
AMBULATORY    5180293 0 OXYTOCIN 10 UNITS INJ                       MED        3.70                        J2590
AMBULATORY    5181056 0 PALIVIZUMAB 50 MG INJ                       MED        1,275.50                    C9003
AMBULATORY    5180957 0 PAMIDRONATE 30 MG IVPB                      MED        197.00                      J2430
AMBULATORY    5181250 0 PEGAPTANIB SODIUM 0.3 MG INTRAVITREAL INJ   MED        2,200.00                    J2503
AMBULATORY    5181073 0 PENICILL G BENZO 1.2 MU INJ                 MED        28.50                       J0570
AMBULATORY    5181145 0 PENICILL G BENZO 600,000 UNITS INJ          MED        16.30                       J0560
AMBULATORY    5181057 0 PENICILL G POT 600,000 UNIT INJ             MED        11.80                       J2540
AMBULATORY    5181058 0 PENICILL G POT 600,000 UNIT IVPB            MED        19.00                       J2540
AMBULATORY    5180013 0 PENICILLIN PROCAINE 1.2 MU INJ              MED        25.30                       J0540
AMBULATORY    5180966 0 PENTAMIDINE 300 MG INH                      MED        113.05                      J2545
AMBULATORY    5180971 0 PHENAZOPYRIDINE 100 MG TAB                  MED        3.30
AMBULATORY    5181060 0 PHYTONADIONE 1 MG INJ                       MED        7.60                        J3430
AMBULATORY    5180034 0 PIPERACILN/TAZOBAC 1.125 GM IVPB            MED        39.90                       J2543
AMBULATORY    5180995 0 PODOPHYLLUM 25% 15 ML LIQ                   MED        140.00
AMBULATORY    5180020 0 POTASSIUM CHLOR 20 MEQ SR TAB               MED        3.30
AMBULATORY    5180103 0 PREDNISOLONE 5 MG TAB                       MED        3.30
AMBULATORY    5181002 0 PREDNISOLONE 5 ML PO SOLN                   MED        3.30
AMBULATORY    5180561 0 PREDNISONE 10 MG TAB                        MED        2.50
AMBULATORY    5180104 0 PREDNISONE 20 MG TAB                        MED        3.30
AMBULATORY    5181245 0 PREDNISONE 50 MG TAB                        MED        2.50
AMBULATORY    5180023 0 PROCHLORPERAZINE 10 MG INJ                  MED        9.90                        J0780
AMBULATORY    5180302 0 PROCHLORPERAZINE 10 MG TAB                  MED        3.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5180022 0 PROCHLORPERAZINE 25 MG SUPP               MED        4.80
AMBULATORY    5180088 0 PROGESTERONE 50 MG INJ                    MED        20.10                       J2675
AMBULATORY    5180558 0 PROPARACAINE 0.5% 15 ML OPHT SOLN         MED        22.55
AMBULATORY    5181227 0 RACEMIC EPINEPH 1.25% 15 ML INJ           MED        33.80
AMBULATORY    5181172 0 RADIESSE VOICE GEL 1 CC VOCAL CORD INJ    MED        548.25
AMBULATORY    5181292 0 RANIBIZUMAB 20 MG IN 2 ML VIAL OPHT INJ   MED        3,412.50                    C9399
AMBULATORY    5181293 0 RESTYLANE 1 CC VOCAL CORD INJ             MED        660.00
AMBULATORY    5180594 0 RHO D IMMUNE GLOB ROPHYLAC 300 MCG INJ    MED        234.00                      J2790
AMBULATORY    5181081 0 RITUXIMAB 100 MG IVPB                     MED        902.10                      J9310
AMBULATORY    5181262 0 SECRETIN 1 MCG INJ                        MED        55.90                       J2850
AMBULATORY    5181226 0 SILVER NITRATE STICK TOP EA               MED        2.50
AMBULATORY    5180128 0 SILVER SULFADIAZINE 1% 400 GM CRM         MED        49.00
AMBULATORY    5180050 0 SILVER SULFADIAZINE 1%CRM 25GM            MED        5.60
AMBULATORY    5181272 0 SILVER SULFADIAZINE 20 GM CRM             MED        14.60
AMBULATORY    5181105 0 SODIUM BICARB 150 MEQ INJ / IVPB          MED        27.00
AMBULATORY    5181124 0 SODIUM BICARB 4.2% INJ 1 ML               MED        3.30
AMBULATORY    5181064 0 SODIUM BICARB 50MEQ INJ                   MED        7.60
AMBULATORY    5181223 0 SODIUM BICARB 8.4% 50ML INJ               MED        20.00
AMBULATORY    5181125 0 SODIUM CHLOR 0.9% INJ 2 ML                MED        2.00                        J2912
AMBULATORY    5181251 0 SODIUM TETRADECYL SULF 1% 10 ML INJ       MED        292.00
AMBULATORY    5181252 0 SODIUM TETRADECYL SULF 3% 10 ML INJ       MED        488.00
AMBULATORY    5181255 0 SULFAMETH / TRIMETH 160 MG IVPB           MED        10.00
AMBULATORY    5181066 0 SUMATRIPTAN 6 MG INJ                      MED        97.20                       J3030
AMBULATORY    5180449 0 TERBUTALINE 1MG INJ                       MED        7.20                        J3105
AMBULATORY    5180296 0 TERBUTALINE 2.5 MG TAB                    MED        2.50
AMBULATORY    5180105 0 TESTOSTERONE CYPIONAT 100 MG INJ          MED        15.50                       J1070
AMBULATORY    5181069 0 TESTOSTERONE CYPIONAT 200 MG INJ          MED        31.00                       J1080
AMBULATORY    5181068 0 TESTOSTERONE CYPIONAT 50 MG INJ           MED        8.00                        J1070
AMBULATORY    5180033 0 TESTOSTERONE ENAN 200 MG INJ              MED        52.00                       J3130
AMBULATORY    5181198 0 TESTOSTERONE ENAN 300 MG INJ              MED        77.70
AMBULATORY    5181217 0 TESTOSTERONE ENAN 50 MG INJ               MED        13.00                       J3120
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY    OUTPT)          LML/RML     CPT
AMBULATORY    5181067 0 TESTOSTERONE PROPION 100 MG INJ                  MED         15.00                       J3150
AMBULATORY    5180109 0 TETANUS IMM GLOB (BAYTET) 250 UNITS INJ          MED         200.00                      J1670
AMBULATORY    5189005 0 TETANUS IMM GLOB INJ                             MED         164.70                      90389
AMBULATORY    5181273 0 TETRACAINE (PONTOCAINE) 2% 5 ML TOP SPR          MED         3.90
AMBULATORY    5180579 0 TETRACAINE 1/2% DROPPERETE 1ML                   MED         3.50
AMBULATORY    5180606 0 TETRADISOL SULF 2 ML VIAL INJ                    MED         90.00
AMBULATORY    5180691 0 THYROTROPIN 0.9 MG IN 1.1 MG VIAL INJ            MED         2,537.50                    J3240
AMBULATORY    5181287 0 TIMOLOL 0.5% 5 ML OPHT SOLN                      MED         24.20
AMBULATORY    5180589 0 TOBRAMYCIN 0.3 / DEXAMETH 0.1% 2.5 ML OPHT SUSP MED          97.20
AMBULATORY    5180586 0 TOBRAMYCIN 0.3 / DEXAMETH 0.1% 3.5 GM TUBE OPHT OMED         187.30
AMBULATORY    5180307 0 TOBRAMYCIN 80 MG INJ                             MED         19.30                       J3260
AMBULATORY    5180303 0 TOBRAMYCIN 80MG IVPB                             MED         35.00                       J3260
AMBULATORY    5181214 0 TRIAMCINOLONE 0.1% 15 GM CRM                     MED         5.00
AMBULATORY    5180063 0 TRIAMCINOLONE ACET (KENALOG) INJ 10MG            MED         18.50                       J3301
AMBULATORY    5181280 0 TRIAMCINOLONE HEX (ARISTOSPAN) 1 MG INJ          MED         2.80
AMBULATORY    5181195 0 TRIAMCINOLONE HEX (ARISTOSPAN) INJ 5 MG          MED         14.00                       J3303
AMBULATORY    5180320 0 TRICHOPHYTIN 0.1 ML SKIN TEST INJ                MED         53.00                       86586
AMBULATORY    5181225 0 TROPICAMIDE 1% 15 ML OPHT SOLN                   MED         88.60
AMBULATORY    5189042 0 TUBERCULIN SKIN TEST INTRADERMAL INJ             MED         24.90                       86580
AMBULATORY    5180263 0 TUMESCENT LOCAL ANES INJ 500 CC                  MED         297.00
AMBULATORY    5180347 0 VANCOMYCIN 500 MG INJ                            MED         13.20                       J3370
AMBULATORY    5180333 0 VANCOMYCIN 500 MG IVPB                           MED         37.20                       J3370
AMBULATORY    5189021 0 VARICELLA ZOST IMMUN GLOB 125U                   MED         258.60                      90396
AMBULATORY    5181200 0 VERAPAMIL 5 MG INJ                               MED         20.60
AMBULATORY    5181219 0 VERTEPORFIN (VISUDYNE) 0.1 MG INJ                MED         15.45                       J3396
AMBULATORY    5180414 0 WARFARIN 10 MG TAB                               MED         3.30
AMBULATORY    5181127 0 WARFARIN 5 MG TAB                                MED         3.30
AMBULATORY    5181175 0 ZOLEDRONIC ACID INJ / IVPB 1 MG                  MED         865.00                      J3487
AMBULATORY    5189040 0 COMVAX VACCINE 0.5ML INJ                         MED IMMUN   102.90                      90748
AMBULATORY    5189024 0 DIPHTH / TET TOX < 7 Y/O IM INJ                  MED IMMUN   46.20                       90702
AMBULATORY    5189026 0 DIPHTH/TET TOX INJ > 7 Y/O & ADLT                MED IMMUN   36.00                       90718
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                                   CHARGE        PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                     CATEGORY    OUTPT)          LML/RML     CPT
AMBULATORY    5189025 0 DIPHTH/TETNUS/ACELL PERTUS VAC INJ (DTAP)              MED IMMUN   94.50                       90700
AMBULATORY    5189048 0 DTAP - HIB VACC INJ IM                                 MED IMMUN   93.03                       90721
AMBULATORY    5189027 0 HAEMOPHILUS VAC 0.5ML INJ                              MED IMMUN   75.60                       90647
AMBULATORY    5189030 0 HEPATITIS A VAC Inj 50 UNITS Adult                     MED IMMUN   139.20                      90632
AMBULATORY    5189003 0 HEPATITIS A VACC 0.5 ML PEDS INJ                       MED IMMUN   69.60                       90633
AMBULATORY    5189049 0 HEPATITIS B 40 MCG VACC INJ (for Dialysis or immunocompMED IMMUN   295.90                      90740
AMBULATORY    5189029 0 HEPATITIS B ADLT VAC 10MCG INJ                         MED IMMUN   115.60                      90746
AMBULATORY    5189028 0 HEPATITIS B VAC Inj 5 mcg Ped/Adoles                   MED IMMUN   31.25                       90744
AMBULATORY    5189060 0 HPV QUADRAVALENT 3 DOSE SCHED VACC IM INJ              MED IMMUN   323.00                      90649
AMBULATORY    5189063 0 INFLUENZA VACC AGE 18 & ABV INJ                        MED IMMUN   15.00                       90658
AMBULATORY    5189061 0 INFLUENZA VACC AGE 3-4 PF INJ (0.5 ML TOTAL)           MED IMMUN   15.00                       90656
AMBULATORY    5189062 0 INFLUENZA VACC AGE 4-17 INJ                            MED IMMUN   15.00                       90658
AMBULATORY    5189053 0 INFLUENZA VACC PF 6-35 MOS INJ                         MED IMMUN   15.00                       90655
AMBULATORY    5189033 0 MEASLES VIRUS VACC LIVE SQ INJ                         MED IMMUN   45.80                       90705
AMBULATORY    5189038 0 MENINGOCOCCAL MENIMMUNE VACC SQ INJ                    MED IMMUN   239.20                      90733
AMBULATORY    5189052 0 MENINGOCOCCAL VACC (MENACTRA) IM INJ                   MED IMMUN   242.10                      90734
AMBULATORY    5189034 0 MMR LIVE SQ INJ                                        MED IMMUN   124.70                      90707
AMBULATORY    5189059 0 MMR WITH VARICELLA VACC INJ                            MED IMMUN   325.30                      90710
AMBULATORY    5189035 0 MUMPS VIRUS VACC LIVE SQ INJ                           MED IMMUN   59.10                       90704
AMBULATORY    5189046 0 PEDIARIX INJ VACC (DTAP, HEP B, POLIO)                 MED IMMUN   161.00                      90723
AMBULATORY    5189023 0 PNEUMOCOCCAL 23-VAL (PNEUMOVAX) ADULT INJ              MED IMMUN   75.00                       90732
AMBULATORY    5189039 0 PNEUMOCOCCAL POLYVAL (PREVNAR) < 5 Y/O INJ             MED IMMUN   182.70                      90669
AMBULATORY    5189036 0 POLIO VIRUS 0.5ML INJ                                  MED IMMUN   73.70                       90713
AMBULATORY    5189012 0 RABIES VACC 1.0 ML INJ/IM                              MED IMMUN   356.70                      90675
AMBULATORY    5189057 0 ROTAVIRUS LIVE PENTAVALENT 2 ML ORAL VACC              MED IMMUN   185.75                      90680
AMBULATORY    5189002 0 RUBELLA VIRUS VACC LIVE SQ INJ                         MED IMMUN   50.50                       90706
AMBULATORY    5189056 0 TDAP (ADACEL) AGE 11-67 IM INJ                         MED IMMUN   119.00                      90715
AMBULATORY    5189055 0 TDAP (BOOSTRIX) AGE 10-18 IM INJ                       MED IMMUN   119.00                      90715
AMBULATORY    5189008 0 TETANUS TOXOID IM INJ                                  MED IMMUN   47.90                       90703
AMBULATORY    5189014 0 TYPHOID VACC (ViCP) IM INJ                             MED IMMUN   141.70                      90691
AMBULATORY    5189017 0 VARICELLA VIRUS VACC LIVE SQ INJ                       MED IMMUN   180.50                      90716
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY    OUTPT)          LML/RML     CPT
AMBULATORY    5189058 0 ZOSTER (SHINGLES) LIVE VACC SQ INJ     MED IMMUN   240.00                      90736
AMBULATORY    5121241 0 FINE NDLE ASP (FNA) W/O IMAG GUID      PROCED      300.15                      10021
AMBULATORY    5121093 0 ACNE SURGERY                           PROCED      164.70                      10040
AMBULATORY    5120432 0 I & D ABSCESS SIMPLE                   PROCED      300.00                      10060
AMBULATORY    5120433 0 I & D ABSCESS COMP                     PROCED      350.00                      10061
AMBULATORY    5123050 0 INCIS/REM FORGN BDY SQ TISS            PROCED      300.00                      10120
AMBULATORY    5121081 0 INCIS/REM FORGN BDY SQ TISS COMP       PROCED      936.00                      10121
AMBULATORY    5120431 0 I & D SEROMA / HEMATOMA / CYST         PROCED      1,165.47                    10140
AMBULATORY    5123001 0 I & D PUNCT ASP ABSCESS/HEMATOMA       PROCED      220.19                      10160
AMBULATORY    5123049 0 I & D COMP POSTOP WND INFECT           PROCED      1,397.12                    10180
AMBULATORY    5123046 0 DEBRDMNT INFECTED SKIN UP TO 10% BSA   PROCED      313.61                      11000
AMBULATORY    5121211 0 DEBRDMT INFECT SKN EA ADD'L 10% BSA    PROCED      230.00                      11001
AMBULATORY    5125154 0 DEBRDMT SKIN PARTIAL THICKNESS         PROCED      334.80                      11040
AMBULATORY    5121152 0 DEBRDMNT SKIN FULL THICKNESS           PROCED      604.80                      11041
AMBULATORY    5123053 0 DEBRDMNT SKIN & SQ TISS                PROCED      711.84                      11042
AMBULATORY    5120854 0 DEBRDMNT SKIN / SQ TISS & MUSC         PROCED      425.00                      11043
AMBULATORY    5121234 0 DEBRDMNT SQ TISS, MUSC, BONE           PROCED      1,314.90                    11044
AMBULATORY    5121020 0 PARING/CUTTING, HYPERKER 1 LES         PROCED      287.33                      11055
AMBULATORY    5125178 0 PARING/CUT HYPERKERATOT LES 2-4 LES    PROCED      297.41                      11056
AMBULATORY    5125179 0 PARING/CUT HYPERKERATOT LES > 4 LES    PROCED      210.33                      11057
AMBULATORY    5121018 0 BIOP SKN/SQ TISS SING LES              PROCED      199.60                      11100
AMBULATORY    5121017 0 BIOP SKN/SQ TISS EA ADDL LES           PROCED      91.17                       11101
AMBULATORY    5121021 0 SKIN TAG REMOVAL 1-15                  PROCED      200.00                      11200
AMBULATORY    5123038 0 SKIN TAG REMOVAL EA ADDTL 10           PROCED      145.44                      11201
AMBULATORY    5123030 0 SHV TK/AR/LG .5CM                      PROCED      67.33                       11300
AMBULATORY    5123031 0 SHV TK/AR/LG .6-1.0CM                  PROCED      150.00                      11301
AMBULATORY    5123032 0 SHV TK/AR/LG 1.1-2CM                   PROCED      159.84                      11302
AMBULATORY    5123033 0 SHV TK/AR/LG > 2CM                     PROCED      103.36                      11303
AMBULATORY    5123034 0 SHV LES SCP/NK/HN/FT .5CM              PROCED      87.45                       11305
AMBULATORY    5123035 0 SHV SCP/NK/HN/FT .6-1.0CM              PROCED      68.21                       11306
AMBULATORY    5123036 0 SHV SCP/NK/HN/FT 1.1-2CM               PROCED      213.00                      11307
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5123037 0 SHV SCP/NK/HN/FT > 2CM                       PROCED     213.00                      11308
AMBULATORY    5123026 0 SHV LES FC/ER/LP .5CM                        PROCED     164.00                      11310
AMBULATORY    5123027 0 SHV LES FC/ER/LP .6-1CM                      PROCED     164.00                      11311
AMBULATORY    5123028 0 SHV LES FC/ER/LP 1.1-2CM                     PROCED     213.00                      11312
AMBULATORY    5123029 0 SHV LES FC/ER/LP > 2CM                       PROCED     169.76                      11313
AMBULATORY    5121019 0 EXC BEN LES TK/AR/LG < 0.6 CM                PROCED     685.18                      11400
AMBULATORY    5123009 0 EXC BEN LES TK/AR/LG 0.6-1.0 CM              PROCED     687.29                      11401
AMBULATORY    5123010 0 EXC BEN LES TK/AR/LG 1.1-2 CM                PROCED     721.33                      11402
AMBULATORY    5123011 0 EXC BEN LES TK/AR/LG 2.1-3 CM                PROCED     890.93                      11403
AMBULATORY    5123012 0 EXC BEN LES TK/AR/LG 3.1-4 CM                PROCED     1,145.20                    11404
AMBULATORY    5123013 0 EXC BEN LES TK/AR/LG > 4 CM                  PROCED     1,461.76                    11406
AMBULATORY    5123014 0 EXC BEN LES SCP/NK/HN/FT/GEN < 0.6 CM        PROCED     782.89                      11420
AMBULATORY    5123015 0 EXC BEN LES SCP/NK/HN/FT/GEN 0.6-1 CM        PROCED     750.96                      11421
AMBULATORY    5123016 0 EXC BEN LES SCP/NK/HN/FT/GEN 1.1-2 CM        PROCED     762.21                      11422
AMBULATORY    5123017 0 EXC BEN LES SCP/NK/HN/FT/GEN 2.1-3 CM        PROCED     936.00                      11423
AMBULATORY    5123018 0 EXC BEN LES SCP/NK/HN/FT/GEN 3.1-4 CM        PROCED     1,086.08                    11424
AMBULATORY    5123019 0 EXC BEN LES SCP/NK/HN/FT/GEN > 4 CM          PROCED     1,636.61                    11426
AMBULATORY    5123020 0 EXC BEN LES FC < 0.6 CM                      PROCED     668.20                      11440
AMBULATORY    5123021 0 EXC BEN LES FC 0.6-1 CM                      PROCED     611.11                      11441
AMBULATORY    5123022 0 EXC BEN LES FC 1.1-2 CM                      PROCED     578.34                      11442
AMBULATORY    5123023 0 EXC BEN LES FC 2.1-3 CM                      PROCED     1,038.25                    11443
AMBULATORY    5123024 0 EXC BEN LES FC 3.1-4 CM                      PROCED     1,059.18                    11444
AMBULATORY    5123025 0 EXC BEN LES FC > 4 CM                        PROCED     1,512.27                    11446
AMBULATORY    5121273 0 EXC SKIN / SQ TISS HIDRAD AX SIMP/INTERMED   PROCED     1,250.00                    11450
AMBULATORY    5121274 0 EXC SKIN / SQ TISS HIDRAD AX COMPLEX         PROCED     1,250.00                    11451
AMBULATORY    5121111 0 EXC MAL LES T/AR/LG < 0.5 CM                 PROCED     880.48                      11600
AMBULATORY    5121110 0 EXC MAL LES T/AR/LG 0.6-1 CM                 PROCED     380.10                      11601
AMBULATORY    5121109 0 EXC MAL LES T/AR/LG 1.1-2 CM                 PROCED     1,012.41                    11602
AMBULATORY    5121108 0 EXC MAL LES T/AR/LG 2.1-3 CM                 PROCED     1,325.45                    11603
AMBULATORY    5121107 0 EXC MAL LES T/AR/LG 3.1-4 CM                 PROCED     1,571.45                    11604
AMBULATORY    5121106 0 EXC MAL LES T/AR/LG > 4 CM                   PROCED     1,858.01                    11606
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5123058 0 EXC MAL LES NK/HN/FT SCP<0.5CM          PROCED     1,024.83                    11620
AMBULATORY    5123059 0 EXC MAL LES NK/HN/FT/SCP.6-1CM          PROCED     929.34                      11621
AMBULATORY    5123060 0 EXC MAL LES NK/HN/FT/SCP 1.1-2          PROCED     543.24                      11622
AMBULATORY    5123061 0 EXC MAL LES NK/HN/FT/SCP 2.1-3          PROCED     936.00                      11623
AMBULATORY    5123062 0 EXC MAL LES NK/HN/FT/SCP 3.1-4          PROCED     1,774.99                    11624
AMBULATORY    5123063 0 EXC MAL LES NK/HN/FT/SCP >4CM           PROCED     2,438.64                    11626
AMBULATORY    5123064 0 EXC MAL LES FC/ER/EY/LP <.5CM           PROCED     1,073.17                    11640
AMBULATORY    5123065 0 EXC MAL LES FC/ER/EY/LP .6-1CM          PROCED     1,063.13                    11641
AMBULATORY    5123066 0 EXC MAL LES FC/ER/EY/LP 1.1-2           PROCED     1,313.01                    11642
AMBULATORY    5123067 0 EXC MAL LES FC/ER/EY/LP 2.1-3           PROCED     1,038.25                    11643
AMBULATORY    5123068 0 EXC MAL LES FC/ER/EY/LP 3.1-4           PROCED     1,785.20                    11644
AMBULATORY    5123069 0 EXC MAL LES FC/ER/EY/LP >4CM            PROCED     2,270.16                    11646
AMBULATORY    5121064 0 TRIM NAILS NONDYSTROPHIC (ANY #)        PROCED     47.00                       11719
AMBULATORY    5121151 0 DEBRDMNT NAILS ANY METHOD 1-5 NAILS     PROCED     69.70                       11720
AMBULATORY    5121065 0 DEBRDMNT NAILS ANY METHOD > 5           PROCED     47.00                       11721
AMBULATORY    5125175 0 REMOVAL NAIL PLATE SINGLE               PROCED     164.01                      11730
AMBULATORY    5125177 0 REM NAIL PLATE EA ADD'L NAIL            PROCED     100.00                      11732
AMBULATORY    5120731 0 EVAC SUBUNGUAL HEMATOMA                 PROCED     47.00                       11740
AMBULATORY    5123039 0 NAIL EXCIS PARTIAL/COMPLT               PROCED     506.10                      11750
AMBULATORY    5121112 0 BIOPSY NAIL UNIT                        PROCED     420.50                      11755
AMBULATORY    5120174 0 REPAIR NAIL BED                         PROCED     115.00                      11760
AMBULATORY    5125217 0 WEDGE EXC SKIN NAIL FOLD INGROWN NAIL   PROCED     102.00                      11765
AMBULATORY    5120790 0 EXC PILONIDAL CYST / SINUS SIMP         PROCED     1,221.00                    11770
AMBULATORY    5125168 0 INTRALESIONAL INJ 1-7 LES               PROCED     117.40                      11900
AMBULATORY    5121215 0 INTRALESIONAL INJ 8+ LES                PROCED     53.00                       11901
AMBULATORY    5123051 0 TATOOING < 6.0 SQ CM                    PROCED     106.35                      11920
AMBULATORY    5120791 0 TATOOING 6.1-20.0 SQ CM                 PROCED     150.00                      11921
AMBULATORY    5123040 0 COLLAGEN INJ 1CC OR LESS                PROCED     133.00                      11950
AMBULATORY    5123041 0 COLLAGEN INJ 1.1-5CC                    PROCED     133.00                      11951
AMBULATORY    5122012 0 INSERTION DRUG DELIVERY IMPLANT         PROCED     39.00                       11981
AMBULATORY    5122013 0 REMOVAL DRUG DELIVERY IMPLANT           PROCED     39.00                       11982
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5122014 0 REM & REINSERT DRUG DELIVERY IMPLANT     PROCED     39.00                       11983
AMBULATORY    5125123 0 WND REP SIMP SC/NK/AX/TK < 2.6 CM        PROCED     273.25                      12001
AMBULATORY    5125124 0 WND REP SIMP SC/NK/AX/TK 2.6-7.5 CM      PROCED     273.25                      12002
AMBULATORY    5121113 0 WND REP SIMP FC/ER/EY/N/L < 2.6 CM       PROCED     273.25                      12011
AMBULATORY    5121095 0 WND REP SIMP FC/ER/EY/N/L 2.6-5CM        PROCED     249.84                      12013
AMBULATORY    5121096 0 WND REP SIMP FC/ER/EY/N/L 5.1-7.5 CM     PROCED     230.50                      12014
AMBULATORY    5121105 0 LYR CLS WND SC/TK/EX < 2.6 CM            PROCED     334.80                      12031
AMBULATORY    5121104 0 LYR CLS WND SC/TR/EX 2.6-7.5CM           PROCED     273.25                      12032
AMBULATORY    5121103 0 LYR CLS WND SC/TR/EX 7.6-12.5CM          PROCED     268.92                      12034
AMBULATORY    5121102 0 LYR CLS WND SC/TR/EX 12.6-20CM           PROCED     267.84                      12035
AMBULATORY    5120881 0 LYR CLS WND SC/TK/EX 20.1-30 CM          PROCED     270.00                      12036
AMBULATORY    5120882 0 LYR CLS WND SC/TK/EX > 30 CM             PROCED     360.00                      12037
AMBULATORY    5121101 0 LYR CLOS WND NK/HN/FT/GEN < 2.6 CM       PROCED     263.52                      12041
AMBULATORY    5121100 0 LYR CLOS WND NK/HN/FT/GEN 2.6-7.5 CM     PROCED     233.66                      12042
AMBULATORY    5121099 0 LYR CLOS WND NK/HN/FT/GEN 7.6-12.5 CM    PROCED     287.28                      12044
AMBULATORY    5121098 0 LYR CLOS WND NK/HN/FT/GEN 12.6-20 CM     PROCED     106.35                      12045
AMBULATORY    5120883 0 LYR CLOS WND NK/HN/FT/GEN 20.1-30 CM     PROCED     235.00                      12046
AMBULATORY    5120884 0 LYR CLOS WND NK/HN/FT/GEN > 30 CM        PROCED     360.00                      12047
AMBULATORY    5122011 0 LYR CLS WND F/ER/EY/N/L <2.6CM           PROCED     273.25                      12051
AMBULATORY    5121083 0 LYR CLS WND F/ER/EY/N/L 2.6-5 CM         PROCED     249.08                      12052
AMBULATORY    5121084 0 LYR CLS WND F/ER/EY/N/L 5.1-7.5 CM       PROCED     273.25                      12053
AMBULATORY    5120885 0 LYR CLS WND F/ER/EY/N/L 12.6-20 CM       PROCED     300.00                      12055
AMBULATORY    5120886 0 LYR CLS WND F/ER/EY/N/L 20.1-30 CM       PROCED     300.00                      12056
AMBULATORY    5120887 0 LYR CLS WND F/ER/EY/N/L > 30 CM          PROCED     360.00                      12057
AMBULATORY    5121142 0 REP COMP TRNK 2.6-7.5 CM                 PROCED     331.00                      13101
AMBULATORY    5121173 0 REP COMP TRNK EA ADD 5 CM                PROCED     600.12                      13102
AMBULATORY    5121092 0 REP COMPLX SC/AR/LG 2.6-7.5 CM           PROCED     406.08                      13121
AMBULATORY    5121140 0 REP COMP FC/NK/GEN/HN/FT 1.1-2.5 CM      PROCED     421.00                      13131
AMBULATORY    5121141 0 REP COMP FC/NK/GEN/HN/FT 2.6-7.5 CM      PROCED     624.79                      13132
AMBULATORY    5120835 0 REP COMP FC/NK/GEN/HN/FT EA ADD < 5 CM   PROCED     546.08                      13133
AMBULATORY    5121115 0 REP COMP EY/N/ER/L < 1.1 CM              PROCED     700.65                      13150
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                                CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                  CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5121116 0 REP COMP EY/N/ER/L 1.1-2.5CM                        PROCED     503.55                      13151
AMBULATORY    5121117 0 REP COMP EY/N/ER/L 2.6-7.5CM                        PROCED     867.43                      13152
AMBULATORY    5125091 0 TISS TRANSFR SCP/AR/LG < 10 SQ CM                   PROCED     1,370.75                    14020
AMBULATORY    5125098 0 TISS TRNSFR SCP/AR/LG 10.1-30 SQ CM                 PROCED     1,135.00                    14021
AMBULATORY    5125090 0 TISS TRANSFR FC/NK/HN/FT < 10 SQ CM                 PROCED     1,406.21                    14040
AMBULATORY    5121209 0 TISS TRNS FC/NK/HN/FT 10.1 - 30 SQ CM               PROCED     1,771.35                    14041
AMBULATORY    5125089 0 TISS TRANSFR EY/NS/ER/LP < 10 SQ CM                 PROCED     1,740.47                    14060
AMBULATORY    5125094 0 SURG PREP RECIP SITE UP TO 100 SQ CM                PROCED     1,430.70                    15000
AMBULATORY    5125170 0 STSG PEDS 1ST 100 SQ CM (FC/SC/EY/NK/ER/HN/FT)      PROCED     1,950.84                    15120
AMBULATORY    5125169 0 STSG PEDS EA ADD'L 100 SQ CM (FC/SC/EY/NK/ER/HN/FT) PROCED     1,135.00                    15121
AMBULATORY    5121292 0 ACEL DERM REPL FC/SC/HN/FT 1ST 100 SQ CM PEDS       PROCED     110.00                      15175
AMBULATORY    5125162 0 FTSG FC/AX/GEN/HN 20 SQ CM OR LESS                  PROCED     2,215.51                    15240
AMBULATORY    5125163 0 FTSG FC/AX/GEN/HN EA ADD'L 20 SQ CM                 PROCED     331.00                      15241
AMBULATORY    5125092 0 FTSG N/ER/EY/LP 20 SQ CM OR LESS                    PROCED     1,009.12                    15260
AMBULATORY    5125157 0 FTSG N/ER/EY/LP EA ADD'L 20 SQ CM                   PROCED     350.00                      15261
AMBULATORY    5125218 0 ALLOGRAFT SKIN WND CLOS PEDS TR/AR/LG 1ST 100 SQ PROCED        1,300.00                    15300
AMBULATORY    5125219 0 ALLOGRAFT SKIN WND CLOS PEDS TR/AR/LG EA ADDL 1 PROCED         400.00                      15301
AMBULATORY    5125220 0 ALLOGRAFT SKIN WND CLOS PEDS F/EY/ER/HN/FT 1ST 10PROCED        400.00                      15320
AMBULATORY    5125221 0 ALLOGRAFT SKIN WND CLOS PEDS F/EY/ER/HN/FT EA ADPROCED         400.00                      15321
AMBULATORY    5125222 0 ALLOGRAFT ACELL DERM PEDS TR/AR/LG 1ST 100 SQ CMPROCED         400.00                      15330
AMBULATORY    5125223 0 ALLOGRAFT ACELL DERM PEDS TR/AR/LG EA ADDL 100 PROCED          400.00                      15331
AMBULATORY    5125224 0 ALLOGRAFT ACELL DERM PEDS F/ER/EY/HN/FT 1ST 100 SPROCED        400.00                      15335
AMBULATORY    5125225 0 ALLOGRAFT ACELL DERM PEDS F/ER/EY/HN/FT EA ADDLPROCED          400.00                      15336
AMBULATORY    5125152 0 XENOGRAFT TR/AR/LG 1ST 100 SQ CM                    PROCED     559.00                      15400
AMBULATORY    5125153 0 XENOGRAFT TR/AR/LG EA ADDL 100 SQ CM                PROCED     350.00                      15401
AMBULATORY    5121213 0 DERMABRASION SEGMENTAL FACE                         PROCED     259.00                      15781
AMBULATORY    5120814 0 DERMABRASION SUPERFIC ANY SITE                      PROCED     157.00                      15783
AMBULATORY    5120108 0 ABRASION SING LESION                                PROCED     75.00                       15786
AMBULATORY    5122249 0 BLEPHAROPLASTY LOWER EYELID W/ EXT FAT PAD          PROCED     1,191.75                    15821
AMBULATORY    5122250 0 BLEPHAROPLASTY UPPER EYELID W/ EXC SKIN             PROCED     1,191.75                    15823
AMBULATORY    5125031 0 DESTR BEN/PREMAL LES 1ST LES                        PROCED     70.07                       17000
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5125041 0 DSTR BEN/PREMAL LES EA (2 THRU 14 LES)   PROCED     37.19                       17003
AMBULATORY    5125042 0 DSTR BEN/PREMAL LESION 15+               PROCED     218.60                      17004
AMBULATORY    5121202 0 DSTR VASC PROLIF LES < 10 SQ CM          PROCED     268.80                      17106
AMBULATORY    5121204 0 DSTR VASC PROLIF LES > 50 SQ CM          PROCED     274.75                      17108
AMBULATORY    5123047 0 DESTR FLAT WARTS 1-14 LES                PROCED     67.00                       17110
AMBULATORY    5123048 0 DSTR FLAT WARTS 15+ LES                  PROCED     237.38                      17111
AMBULATORY    5125165 0 CHEM CAUTERY GRANULATN TISSUE            PROCED     168.70                      17250
AMBULATORY    5123070 0 DESTR MAL LES AR/LG/TK <.5CM             PROCED     110.70                      17260
AMBULATORY    5123071 0 DESTR MAL LES AR/LG/TK .6-1CM            PROCED     140.81                      17261
AMBULATORY    5123072 0 DEST MAL LES AR/LG/TK 1.1-2CM            PROCED     187.49                      17262
AMBULATORY    5123073 0 DEST MAL LES AR/LG/TK 2.1-3CM            PROCED     216.30                      17263
AMBULATORY    5123074 0 DEST MAL LES AR/LG/TK 3.1-4CM            PROCED     103.38                      17264
AMBULATORY    5123075 0 DEST MAL LES AR/LG/TK >4CM               PROCED     169.76                      17266
AMBULATORY    5121125 0 DSTR MAL LES SC/NK/HN/FT < 0.5 CM        PROCED     135.27                      17270
AMBULATORY    5121126 0 DSTR MAL LES SC/NK/HN/FT 0.6-1 CM        PROCED     141.21                      17271
AMBULATORY    5121127 0 DSTR MAL LES SC/NK/HN/FT 1.1-2 CM        PROCED     198.72                      17272
AMBULATORY    5121128 0 DSTR MAL LES SC/NK/HN/FT 2.1-3 CM        PROCED     216.30                      17273
AMBULATORY    5121129 0 DSTR MAL LES SC/NK/HN/FT 3.1-4 CM        PROCED     169.76                      17274
AMBULATORY    5121130 0 DSTR MAL LES SC/NK/HN/FT > 4 CM          PROCED     281.61                      17276
AMBULATORY    5121073 0 DSTR MAL LES FC/ER/EY/N/L < 0.5CM        PROCED     148.79                      17280
AMBULATORY    5121074 0 DSTR MAL LES FC/ER/EY/N/L 0.6-1CM        PROCED     236.79                      17281
AMBULATORY    5121075 0 DSTR MAL LES FC/ER/EY/N/L 1.1-2CM        PROCED     199.10                      17282
AMBULATORY    5121076 0 DSTR MAL LES FC/ER/EY/N/L 2.1-3CM        PROCED     103.38                      17283
AMBULATORY    5121077 0 DSTR MAL LES FC/ER/EY/N/L 3.1-4CM        PROCED     315.63                      17284
AMBULATORY    5121078 0 DSTR MAL LES FC/ER/EY/N/L > 4CM          PROCED     103.38                      17286
AMBULATORY    5120817 0 CRYOTHERAPY FOR ACNE                     PROCED     60.00                       17340
AMBULATORY    5120813 0 CHEM EXFOLIATION FOR ACNE                PROCED     67.00                       17360
AMBULATORY    5120434 0 BREAST CYST ASP SINGL                    PROCED     295.37                      19000
AMBULATORY    5120430 0 BREAST CYST ASP EA ADDL                  PROCED     204.66                      19001
AMBULATORY    5121054 0 BREAST BX PERCUT CORE                    PROCED     632.48                      19100
AMBULATORY    5120036 0 BREAST BX INCISIONAL                     PROCED     1,944.00                    19101
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120852 0 BREAST BX PERC CORE NEEDLE W/ IMAG GUID        PROCED     712.45                      19102
AMBULATORY    5121240 0 PLACEMENT MAMMOSITE CATH AFTR MASTECT          PROCED     3,418.48                    19296
AMBULATORY    5121293 0 NIPPLE / AREOLA RECONSTRUCTION                 PROCED     2,500.00                    19350
AMBULATORY    5120493 0 BONE BX SUPERFICIAL NEEDLE                     PROCED     411.66                      20220
AMBULATORY    5120818 0 REMOVAL FORGN BDY MUSC/TEND SHEATH SIMP        PROCED     275.00                      20520
AMBULATORY    5120856 0 CARPAL TUNNEL INJ THERAPEUTIC                  PROCED     142.00                      20526
AMBULATORY    5120110 0 INJ SING TENDON SHEATH OR LIG                  PROCED     201.00                      20550
AMBULATORY    5125106 0 INJ SINGLE TENDON ORIGIN/INSERTION             PROCED     296.28                      20551
AMBULATORY    5125105 0 TRIGR PNT INJ 1-2 MUSC SING / MULT             PROCED     189.00                      20552
AMBULATORY    5125107 0 TRIGR PNT INJ =/> 3 MUSC SING / MULT           PROCED     270.54                      20553
AMBULATORY    5120136 0 ARTHROCENTESIS ASP/INJ; SM JNT/BURSA           PROCED     204.07                      20600
AMBULATORY    5120311 0 ARTHROCENTESIS ASP/INJ; INTRMD JNT/BURSA       PROCED     201.13                      20605
AMBULATORY    5120312 0 ARTHROCENTESIS ASP/INJ; LG MAJ JNT/BURSA       PROCED     249.60                      20610
AMBULATORY    5121207 0 ASP / INJ GANGLION CYST                        PROCED     142.00                      20612
AMBULATORY    5125166 0 BONE CYST TX - ASP/INJ                         PROCED     285.14                      20615
AMBULATORY    5125176 0 REMOV WIRE/PIN/ROD SUPERFICIAL                 PROCED     1,194.24                    20670
AMBULATORY    5120733 0 REMOVAL IMPLANT DEEP                           PROCED     1,460.00                    20680
AMBULATORY    5120805 0 MONITR INTERST FLUID PRESS MUSC COMP SYN       PROCED     100.00                      20950
AMBULATORY    5121143 0 NASAL FX CLSED TX W/ STABILZATN                PROCED     531.30                      21320
AMBULATORY    5121267 0 CLOSED TX NASAL SEPTAL FX W/WO STABILIZATION   PROCED     1,003.00                    21337
AMBULATORY    5120846 0 I & D DEEP ABS / HEM SFT TISS NECK / THORAX    PROCED     1,218.28                    21501
AMBULATORY    5121190 0 EXC TUMOR SOFT TISSUE NECK / THORAX            PROCED     1,314.81                    21555
AMBULATORY    5121231 0 EXC TUMOR SOFT TISS NECK / THORAX DEEP         PROCED     2,030.08                    21556
AMBULATORY    5121269 0 CLOSED TX RIB FX UNCOMPLICATED EA              PROCED     120.00                      21800
AMBULATORY    5121230 0 EXC TUMOR SOFT TISS BACK / FLANK               PROCED     1,377.81                    21930
AMBULATORY    5125207 0 EXC SOFT TISS TUMOR SHOULDER SQ                PROCED     950.00                      23075
AMBULATORY    5125208 0 EXC SOFT TISS TUMOR SHOULDER DEEP              PROCED     1,225.00                    23076
AMBULATORY    5120734 0 CLOSED TX CLAVIC FX W/O MANIP                  PROCED     115.00                      23500
AMBULATORY    5120855 0 CLOSED TX STERN CLAVIC DISLOC W/O MANIP        PROCED     120.00                      23520
AMBULATORY    5121251 0 CLOSED TX ACROMCLAVIC DISLOCATION W/O MANIP    PROCED     115.00                      23540
AMBULATORY    5120853 0 CLOSED TX SCAP FX W/O MANIP                    PROCED     120.00                      23570
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120735 0 CLOSED TX PROX HUMRUS FX W/O MANIP             PROCED     230.00                      23600
AMBULATORY    5120843 0 CLOSED TX PROX HUMERAL FX W/ MANIP             PROCED     120.00                      23605
AMBULATORY    5121280 0 CLOSED TX HUMERAL TUBEROSITY FX W/O MANIP      PROCED     120.00                      23620
AMBULATORY    5120170 0 CLOSED TX SHOULDER DISLOC W/ MANIP             PROCED     120.00                      23650
AMBULATORY    5125226 0 EXC OLECRANON BURSA                            PROCED     1,300.00                    24105
AMBULATORY    5120736 0 REM FORGN BDY UPPER ARM/ELB SQ                 PROCED     259.00                      24200
AMBULATORY    5120737 0 CLOSED TX HUMERL SHFT FX W/O MANIP             PROCED     115.00                      24500
AMBULATORY    5120877 0 CLOSED TX HUMERAL SHFT FX WITH MANIP           PROCED     120.00                      24505
AMBULATORY    5121246 0 CLOSED TX SUPRA/TRANS CONDYLAR HUMERAL FX W/O  PROCED     115.00                      24530
AMBULATORY    5120829 0 PERC SKEL FIXATN HUMERAL FX                    PROCED     2,362.00                    24538
AMBULATORY    5120840 0 CLOSED TX HUM EPICOND FX W/O MANIP             PROCED     115.00                      24560
AMBULATORY    5121260 0 CLOSED TX HUM CONDYL FX W/O MANIP              PROCED     120.00                      24576
AMBULATORY    5120834 0 CLOSED TX ELBOW DISLOCATION W/O ANES           PROCED     115.00                      24600
AMBULATORY    5120738 0 CLOSED TX RAD HEAD SUBLUX CHILD NURSEMAID ALBPROCED       115.00                      24640
AMBULATORY    5121244 0 CLOSED TX RADIAL HEAD / NECK FX W/O MANIP      PROCED     115.00                      24650
AMBULATORY    5121281 0 CLOSED TX RADIAL HEAD / NECK FX W/ MANIP       PROCED     120.00                      24655
AMBULATORY    5120857 0 CLOSED TX ULNAR FX PROX END W/O MANIP          PROCED     120.00                      24670
AMBULATORY    5121233 0 EXC TUMOR SOFT TISS FOREARM / WRIST            PROCED     1,846.80                    25075
AMBULATORY    5120739 0 EXCIS GANGLION WRIST                           PROCED     976.00                      25111
AMBULATORY    5121282 0 CLOSED TX RADIAL SHFT FX W/O MANIP             PROCED     120.00                      25500
AMBULATORY    5125227 0 CLOSED TX RADIAL SHFT FX W/ MANIP              PROCED     120.00                      25505
AMBULATORY    5120844 0 CLOSED TX ULNAR SHAFT FX W/O MANIP             PROCED     120.00                      25530
AMBULATORY    5120741 0 CLOSED TX RADIAL / ULNR SHFT FX W/O MANIP      PROCED     115.00                      25560
AMBULATORY    5120801 0 CLOSED TX RAD/ULNR SHFT FX WITH MANIP          PROCED     115.00                      25565
AMBULATORY    5120742 0 CLOSED TX DIST RADIAL FX W/O MANIP             PROCED     160.00                      25600
AMBULATORY    5120743 0 CLOSED TX DIST RAD FX W/ MANIP                 PROCED     365.00                      25605
AMBULATORY    5120858 0 CLOSED TX CARPAL SCAPHOID (NAVIC) FX W/O MANIP PROCED     120.00                      25622
AMBULATORY    5120806 0 CLOSED TX CARP BONE FX W/O MANIP               PROCED     115.00                      25630
AMBULATORY    5120875 0 DRNGE FINGER ABSCESS SIMPLE                    PROCED     100.00                      26010
AMBULATORY    5120744 0 TENDON SHEATH INCISION                         PROCED     976.00                      26055
AMBULATORY    5120745 0 EXC TUMOR SOFT TISS HAND/FINGER SQ             PROCED     1,300.00                    26115
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5125228 0 EXC LES TEND SHEATH / JOINT CAP HAND/FINGER     PROCED     1,325.00                    26160
AMBULATORY    5120748 0 CLOSED TX METACARP FX SING W/O MANIP EA BONE PROCED        115.00                      26600
AMBULATORY    5120802 0 CLOSED TX PHAL SHFT FX W/O MANIP                PROCED     115.00                      26720
AMBULATORY    5120803 0 CLOSED TX PHALANGL SHFT FX WITH MANIP           PROCED     115.00                      26725
AMBULATORY    5120878 0 CLOSED TX ARTIC FX W/ MP, IP JOINT W/O MANIP EA PROCED     120.00                      26740
AMBULATORY    5120494 0 CLOSED TX DIST PHALANGEAL FX FINGER / THUMB W/OPROCED      120.00                      26750
AMBULATORY    5121283 0 CLOSED TX INTERPHAL JOINT DISLOC SINGL W/ MANIP PROCED     120.00                      26770
AMBULATORY    5120749 0 CLOSED TX PELVIC RING FX/DISLOC W/O MANIP       PROCED     115.00                      27193
AMBULATORY    5120750 0 CLOSED TX ACETAB FX W/O MANIP                   PROCED     115.00                      27220
AMBULATORY    5120167 0 CLOSED TX TROCHAN FEM FX W/O MANIP              PROCED     115.00                      27238
AMBULATORY    5121268 0 CLOSED TX TROCHANTER FX W/O MANIP               PROCED     120.00                      27246
AMBULATORY    5120751 0 CLOSED TX HIP DISLOC TRAUM W/O ANES             PROCED     115.00                      27250
AMBULATORY    5121259 0 I & D DEEP ABSCESS / BURS / HEM THIGH OR KNEE   PROCED     1,175.00                    27301
AMBULATORY    5121291 0 EXC TUMOR THIGH / KNEE SQ                       PROCED     1,250.00                    27327
AMBULATORY    5120752 0 EXC TUMOR THIGH / KNEE DEEP                     PROCED     1,250.00                    27328
AMBULATORY    5121258 0 CLOSED TX FEM SHFT FX W/O MANIP                 PROCED     120.00                      27500
AMBULATORY    5121284 0 CLOSED TX CONDYL FEM FX W/O MANIP               PROCED     120.00                      27501
AMBULATORY    5121285 0 CLOSED TX FEM SHFT FX W/ MANIP                  PROCED     120.00                      27502
AMBULATORY    5120820 0 CLOSED TX PATELLAR FX W/O MANIP                 PROCED     115.00                      27520
AMBULATORY    5120807 0 CLOSED TX TIB FX PROX W/O MANIP                 PROCED     115.00                      27530
AMBULATORY    5120842 0 CLOSED TX TUBEROSITY FX KNEE                    PROCED     120.00                      27538
AMBULATORY    5120890 0 CLOSED TX PATELLAR DISLOCATION W/O ANES         PROCED     120.00                      27560
AMBULATORY    5120753 0 CLOSED TX TIB SHFT FX W/O MANIP                 PROCED     115.00                      27750
AMBULATORY    5120163 0 CLOSED TX TIB SHFT FX WITH MANIP                PROCED     115.00                      27752
AMBULATORY    5120754 0 CLOSED TX MED MALLEOLUS FX W/O MANIP            PROCED     115.00                      27760
AMBULATORY    5120831 0 CLOSED TX PROX FIB / SHFT FX W/O MANIP          PROCED     115.00                      27780
AMBULATORY    5120845 0 CLOSED TX PROX FIB / SHFT FX W/ MANIP           PROCED     120.00                      27781
AMBULATORY    5121294 0 CLOSED TX DIST FIB FX W/O MANIP                 PROCED     236.80                      27786
AMBULATORY    5121245 0 CLOSED TX DIST FIB FX WITH MANIP                PROCED     115.00                      27788
AMBULATORY    5120164 0 CLOSED TX BIMALL ANKLE FX W/O MANIP             PROCED     115.00                      27808
AMBULATORY    5120492 0 CLOSED TX TRIMALLEOLAR ANKLE FX W/O MANIP       PROCED     120.00                      27816
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                               CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                 CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120830 0 CLOSED TX FX WT BEAR DIST TIB W/O MANIP            PROCED     115.00                      27824
AMBULATORY    5121191 0 REM FORGN BDY FOOT SQ                              PROCED     259.00                      28190
AMBULATORY    5123085 0 REM FORGN BDY FOOT DEEP                            PROCED     950.00                      28192
AMBULATORY    5120756 0 CLOSED TX CALCANEAL FX W/O MANIP                   PROCED     115.00                      28400
AMBULATORY    5120757 0 CLOSED TX TALUS FX W/O MANIP                       PROCED     115.00                      28430
AMBULATORY    5120782 0 TREATMNT TARSAL FX W/O MANIP EA                    PROCED     115.00                      28450
AMBULATORY    5120758 0 CLOSED TX METATARSL FX W/O MANIP                   PROCED     115.00                      28470
AMBULATORY    5120759 0 CLOSED TX FX GREAT TOE / PHAL W/O MANIP            PROCED     115.00                      28490
AMBULATORY    5121154 0 TOE FX CLOSED TX (EXC GREAT TOE)                   PROCED     143.50                      28510
AMBULATORY    5120888 0 CLOSED TX FX PHAL EXCEPT GREAT TOE W/ MANIP EA PROCED         143.50                      28515
AMBULATORY    5120760 0 CLOSED TX SESAMOID FX                              PROCED     115.00                      28530
AMBULATORY    5120109 0 CLOSED TX TARSMETATARS JNT DISLOC W/O ANES         PROCED     120.00                      28600
AMBULATORY    5120200 0 CAST APPLICATION LONG ARM                          PROCED     288.43                      29065
AMBULATORY    5120201 0 CAST APPLICATION SHORT ARM                         PROCED     246.13                      29075
AMBULATORY    5121287 0 CAST APPLICATION GAUNTLET HAND / LOWER FOREARM     PROCED     199.89                      29085
AMBULATORY    5125137 0 SPLINT APPLICATN LONG ARM                          PROCED     230.07                      29105
AMBULATORY    5125138 0 SPLINT APPLICATN SHORT ARM                         PROCED     199.89                      29125
AMBULATORY    5120761 0 APPLICATN FINGER SPLINT STATIC                     PROCED     105.00                      29130
AMBULATORY    5121250 0 CAST APPLICATION HIP SPICA 1 1/2 SPICA OR BOTH LEGSPROCED     494.00                      29325
AMBULATORY    5120202 0 CAST APPLICATION LONG LEG                          PROCED     379.03                      29345
AMBULATORY    5120203 0 CAST APPLICATION LONG LEG WT BEARING               PROCED     403.74                      29355
AMBULATORY    5120821 0 CAST APPLICATION CYLINDER THIGH TO ANKLE           PROCED     139.00                      29365
AMBULATORY    5120204 0 CAST APPLICATION SHORT LEG                         PROCED     269.21                      29405
AMBULATORY    5120205 0 CAST APPLICATION SHORT LEG WT BEARING              PROCED     374.12                      29425
AMBULATORY    5120762 0 CAST APPLICATION PATELLAR TENDON BEARING           PROCED     215.00                      29435
AMBULATORY    5121079 0 CAST APPLICATION LEG RIGID TOTAL CONTACT           PROCED     412.25                      29445
AMBULATORY    5121080 0 CAST APPLICATION CLUBFOOT W/ MLD- LNG OR SHRT L PROCED        138.37                      29450
AMBULATORY    5125139 0 SPLINT APPLICATN LONG LEG                          PROCED     203.63                      29505
AMBULATORY    5125140 0 SPLINT APPLICATN SHORT LEG                         PROCED     205.99                      29515
AMBULATORY    5120165 0 STRAPPING HIP                                      PROCED     120.00                      29520
AMBULATORY    5120763 0 STRAPPING ANKLE                                    PROCED     95.00                       29540
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML      CPT
AMBULATORY    5120105 0 UNNA BOOT APPLICATION BILAT                   PROCED     162.57                      2958050
AMBULATORY    5120004 0 UNNA BOOT APPLICATION LT                      PROCED     152.31                      29580LT
AMBULATORY    5120104 0 UNNA BOOT APPLICATION RT                      PROCED     152.31                      29580RT
AMBULATORY    5120823 0 REMOV/BIVALV GAUNTLET BOOT OR BODY CAST       PROCED     70.00                        29700
AMBULATORY    5121286 0 REMOV/BIVALV GAUNTLET FULL ARM/LEG CAST       PROCED     125.00                       29705
AMBULATORY    5125136 0 CAST WINDOWING                                PROCED     112.32                       29730
AMBULATORY    5125141 0 CAST WEDGING XCPT CLUBFOOT                    PROCED     162.18                       29740
AMBULATORY    5125142 0 CAST WEDGING CLUBFOOT                         PROCED     168.55                       29750
AMBULATORY    5120227 0 BIOPSY INTRANASAL                             PROCED     506.00                       30100
AMBULATORY    5120090 0 EXC / DSTR INTRANASAL LES INTERNAL APPROACH   PROCED     1,050.00                     30117
AMBULATORY    5120091 0 EXC / DSTR INTRANASAL LES EXTERNAL APPROACH   PROCED     1,460.00                     30118
AMBULATORY    5121037 0 SUBMUCOUS RESECTION TURBINATE                 PROCED     1,526.91                     30140
AMBULATORY    5125167 0 REMOVE FORGN BDY INTRANASAL                   PROCED     183.60                       30300
AMBULATORY    5120224 0 LYSIS INTRANASL SYNECH                        PROCED     215.80                       30560
AMBULATORY    5120800 0 CAUT/ABLATN MUC TURBINATES SUPERFIC           PROCED     506.00                       30801
AMBULATORY    5121036 0 NASAL CAUT/ABLATN (SOMNOPLSTY)                PROCED     875.13                       30802
AMBULATORY    5121002 0 NASAL PACKNG/CAUTERIZ                         PROCED     198.19                       30901
AMBULATORY    5121180 0 CAUTERY NASAL COMPLEX                         PROCED     177.40                       30903
AMBULATORY    5120225 0 CAUT NASAL PCK/POST W/PCK INTL                PROCED     177.40                       30905
AMBULATORY    5120226 0 SINUSOT MAXILLRY INTRANAS                     PROCED     2,431.82                     31020
AMBULATORY    5120243 0 NASAL ENDO DIAG UNILAT/BILAT                  PROCED     157.50                       31231
AMBULATORY    5120247 0 NASAL ENDO W/POLYPEC UNILAT                   PROCED     1,390.20                     31237
AMBULATORY    5120827 0 TRACH TUBE CHANGE PRIOR TO FISTULA TRACT      PROCED     140.00                       31502
AMBULATORY    5121007 0 LARYNGOS W/INT VOC INJ                        PROCED     101.08                       31513
AMBULATORY    5120221 0 LARYNGO DIAG EXPT NEWBRN                      PROCED     1,836.00                     31525
AMBULATORY    5120222 0 LARYNGO DIRCT OPER W/BIOP                     PROCED     1,324.00                     31535
AMBULATORY    5121012 0 THER VOCAL CORD INJ                           PROCED     1,683.63                     31570
AMBULATORY    5121057 0 THER VOCAL CORD INJ (MED SEP)                 PROCED     1,715.22                    3157052
AMBULATORY    5121010 0 FLEX FIBEROPTIC SCOPE                         PROCED     202.50                       31575
AMBULATORY    5121008 0 VIDEOSTROBOSCOPY                              PROCED     557.92                       31579
AMBULATORY    5120176 0 LARYNGEAL LESION LASER TREATMENT              PROCED     1,300.00                     31599
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5123087 0 TRACHEOSCOPY VIA EXISTING TRACHEOSTOMY INCIS PROCED          600.00                      31615
AMBULATORY    5121055 0 THORACENTESIS PUNC PLEURAL CAV FOR ASP            PROCED     471.73                      32000
AMBULATORY    5121205 0 INTRO NEEDLE/CATH INTO VEIN (IV START)            PROCED     118.23                      36000
AMBULATORY    5121183 0 LASER PV CATH PLC VENOUS 1ST ORD BRANCH           PROCED     395.28                      36011
AMBULATORY    5125062 0 BLOOD DRAW VENOUS PUNCTURE                        PROCED     19.69                       36415
AMBULATORY    5121086 0 BLOOD DRAW CAPILLARY - FINGER, EAR, HEEL STICK PROCED        15.50                       36416
AMBULATORY    5110301 0 TRANSFUSION BLD PRODUCT                           PROCED     627.92                      36430
AMBULATORY    5120440 0 SCLEROSING INJ SPIDER VEIN LIMB / TRUNK (SING OR MPROCED     221.67                      36468
AMBULATORY    5123007 0 SCLEROTHERAPY SINGLE VEIN                         PROCED     80.46                       36470
AMBULATORY    5123006 0 SCLEROTHER MULTIVEIN SAME LIMB                    PROCED     1,240.92                    36471
AMBULATORY    5120847 0 ENDOVEN ABLATION THER INCOM VEIN EXT; 1ST VEIN PROCED        1,801.00                    36478
AMBULATORY    5120851 0 ENDOVEN ABLATION THER INCOM VEIN EXT; 2ND & SUB   PROCED     1,801.00                    36479
AMBULATORY    5121185 0 BLOOD DRAW IMPLANTABLE VAD                        PROCED     91.26                       36540
AMBULATORY    5120035 0 DECLOT VAD BY THROMBOLYTIC AGT                    PROCED     293.00                      36550
AMBULATORY    5120160 0 REM TUNNLD CVC W/O PORT/PUMP                      PROCED     514.00                      36589
AMBULATORY    5120161 0 REM TUNNLD CVC W/ PORT OR PUMP                    PROCED     514.00                      36590
AMBULATORY    5121094 0 ARTERIAL BLOOD GAS DRAW                           PROCED     127.00                      36600
AMBULATORY    5121182 0 LASER PV VEIN OBLITERATION                        PROCED     2,733.48                    37204
AMBULATORY    5120033 0 TEMPORAL ARTERY BIOPSY                            PROCED     1,448.90                    37609
AMBULATORY    5120849 0 STAB PHLEBECTOMY VARICOS VEIN 1 EXT; 10-20 INCIS PROCED      1,801.00                    37765
AMBULATORY    5120850 0 STAB PHLEBECTOMY VARICOS VEIN 1 EXT; > 20 INCIS PROCED       1,801.00                    37766
AMBULATORY    5125150 0 VARICOSE VEIN LIG/EXC RECURING (1 LEG)            PROCED     2,255.31                    37785
AMBULATORY    5120159 0 LIP BIOPSY                                        PROCED     450.00                      40490
AMBULATORY    5120809 0 LIP SHAVE W/ MUCOSAL ADV                          PROCED     1,003.00                    40500
AMBULATORY    5120824 0 EXC LIP V-EXC W/ PRIM LINEAR CLSR                 PROCED     1,003.00                    40520
AMBULATORY    5121208 0 REP LIP FULL THICK VERMILLION ONLY                PROCED     506.00                      40650
AMBULATORY    5120228 0 BIOPSY, ORAL CAVITY                               PROCED     452.18                      40808
AMBULATORY    5120229 0 BIOPSY TONGUE, ANT 2/3                            PROCED     946.11                      41100
AMBULATORY    5120230 0 BIOPSY TONGUE, POST 1/3                           PROCED     1,456.92                    41105
AMBULATORY    5120231 0 BIOPSY FLOOR OF MOUTH                             PROCED     506.00                      41108
AMBULATORY    5121035 0 GLOSSECTOMY PARTIAL (< 1/2 TONGUE)                PROCED     2,283.51                    41120
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5121242 0 UVULECTOMY, EXCIS UVULA                     PROCED     778.20                      42140
AMBULATORY    5121005 0 LASER ASST UVULOPLASTY 1 SESS               PROCED     2,377.14                    42145
AMBULATORY    5121225 0 REMOVAL SALIVARY STONE INTRAORAL            PROCED     1,003.00                    42330
AMBULATORY    5120236 0 I & D PERITONSILLAR ABSCESS                 PROCED     180.36                      42700
AMBULATORY    5120232 0 BIOPSY OROPHARYNX                           PROCED     1,003.00                    42800
AMBULATORY    5120233 0 BIOPSY HYPOPHARYNX                          PROCED     1,003.00                    42802
AMBULATORY    5120234 0 BIOPSY NASOPHARYNX                          PROCED     1,478.60                    42804
AMBULATORY    5120237 0 EXCISION/DESTR LESION, PHARYN               PROCED     1,822.50                    42808
AMBULATORY    5120251 0 TONSILECTMY PRIM/SECND > AGE 11             PROCED     1,365.00                    42826
AMBULATORY    5121216 0 EXCIS OR DSTR LINGUAL TONSIL (ANY METHOD)   PROCED     1,365.00                    42870
AMBULATORY    5121060 0 ESOPHAGOSCPY DIAG W/ OR W/O SPEC            PROCED     939.60                      43200
AMBULATORY    5121061 0 ESOPHAGOSCPY W/ REM FORGN BDY               PROCED     1,352.25                    43215
AMBULATORY    5121062 0 ESOPHAGOSCPY W/ BALLOON DILATN (< 30 MM)    PROCED     944.00                      43220
AMBULATORY    5121263 0 DILATION ESOPHAGUS                          PROCED     408.50                      43450
AMBULATORY    5125076 0 GASTROS TUBE CHG 20-24 FR KIT               PROCED     333.53                      43760
AMBULATORY    5125077 0 GASTROS TUBE CHG 14-18 FR KIT               PROCED     333.53                      43760
AMBULATORY    5120016 0 PROCTOSIGMOIDOSCOPY DIAG RIGID              PROCED     405.00                      45300
AMBULATORY    5120017 0 PROCTOSIGMOIDOSCOPY W/ BX                   PROCED     498.00                      45305
AMBULATORY    5120024 0 FLEX SIG W/ BX SING/MULT                    PROCED     625.36                      45331
AMBULATORY    5120765 0 FELX SIG W/ ABLATION LES                    PROCED     604.00                      45339
AMBULATORY    5120764 0 COLONOSCOPY FLEX W/ ABLATION LES            PROCED     1,383.00                    45383
AMBULATORY    5120812 0 PLACEMENT OF SETON                          PROCED     1,489.00                    46020
AMBULATORY    5120811 0 REMOVAL ANAL SETON / OTHR MARKER            PROCED     250.00                      46030
AMBULATORY    5120828 0 I & D PERIRECTAL / ISCHREC ABSCESS          PROCED     1,128.00                    46040
AMBULATORY    5120808 0 I & D PERIANAL ABSCESS SUPERFIC             PROCED     250.00                      46050
AMBULATORY    5121082 0 SPHINCTEROTOMY ANAL                         PROCED     1,128.00                    46080
AMBULATORY    5125174 0 INCIS THROMBOSED HEMORRHOID, EXTRNL         PROCED     228.00                      46083
AMBULATORY    5123005 0 ANAL FISSURECTOMY                           PROCED     1,489.00                    46200
AMBULATORY    5125149 0 PAPILLECTOMY / EXCIS SING TAG ANUS          PROCED     2,133.83                    46220
AMBULATORY    5121029 0 HEMORRHOID BANDING                          PROCED     804.78                      46221
AMBULATORY    5121175 0 EXC EXTRNL HEMORRHOID TAGS / MULT PAPIL     PROCED     2,057.40                    46230
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5121028 0 HEMORRHOIDECT EXT COMPLT                 PROCED     1,883.52                    46250
AMBULATORY    5121275 0 HEMORRHOIDECT INT/EXT SIMP               PROCED     1,500.00                    46255
AMBULATORY    5120166 0 HEMORRHOIDECT INT/EXT W/ FISSURECTMY     PROCED     1,489.00                    46257
AMBULATORY    5121026 0 ANAL FISTULECTOMY/FISTULOTOMY            PROCED     1,489.00                    46270
AMBULATORY    5121114 0 ENUC/EXC EXT THROMB HEMORRHOID           PROCED     462.55                      46320
AMBULATORY    5121027 0 ANOSCOPY DIAG W/OR W/O SPEC COL          PROCED     275.12                      46600
AMBULATORY    5125084 0 ANOSCOPY W/ TUMOR ABLATION               PROCED     1,315.65                    46615
AMBULATORY    5121276 0 REPAIR ANAL FISTULA W/ FIBRIN GLUE       PROCED     1,500.00                    46706
AMBULATORY    5121277 0 DSTR LES ANUS ELECTRODESSICTN            PROCED     1,732.00                    46910
AMBULATORY    5121219 0 DSTR LESION ANUS CRYOSURGERY             PROCED     68.21                       46916
AMBULATORY    5121178 0 DSTR LES ANUS EXTENSIVE                  PROCED     1,949.94                    46924
AMBULATORY    5121278 0 HEMORRHOID LIGATION INTERNAL SINGLE      PROCED     1,000.00                    46945
AMBULATORY    5125027 0 ASP BLADDER BY CATH INCL STOMA           PROCED     136.50                      51005
AMBULATORY    5125017 0 ASP BLADR W/INS SUPRAPVB CATH            PROCED     1,428.98                    51010
AMBULATORY    5121015 0 BLADDER IRRIG LAV/INSTILLATION           PROCED     300.00                      51700
AMBULATORY    5125129 0 CATHETERIZTN URETHR STRAIT CATH          PROCED     50.00                       51701
AMBULATORY    5125019 0 CATHETERIZTN SIMP URETHR INDWELL FOLEY   PROCED     137.06                      51702
AMBULATORY    5121016 0 CATHETERIZTN COMP URETHR INDWELL FOLEY   PROCED     170.00                      51703
AMBULATORY    5125016 0 CYSTOSTOMY TUBE CHANGE SIMPL             PROCED     220.08                      51705
AMBULATORY    5125117 0 COLLAGEN IMPLANT URETH / BLAD NECK       PROCED     1,758.00                    51715
AMBULATORY    5125034 0 CYSTOMETROGRAM SIMPLE                    PROCED     1,217.36                    51725
AMBULATORY    5125033 0 CYSTOMETROGRAM COMPLEX                   PROCED     965.80                      51726
AMBULATORY    5125015 0 UROFLOW SIMPL MECHAN                     PROCED     208.97                      51736
AMBULATORY    5120022 0 UROFLOW COMPLX W/CALIB EQUIP             PROCED     285.95                      51741
AMBULATORY    5125037 0 URETH PRESS PROF STUDY (UPP)             PROCED     441.91                      51772
AMBULATORY    5125035 0 EMG ANAL/URETH SPHINC W/O NEED           PROCED     452.90                      51784
AMBULATORY    5125036 0 EMG ANAL/URETH SPHINCT W/NEED            PROCED     269.63                      51785
AMBULATORY    5125044 0 STIM EVOKED RESPONSE                     PROCED     212.40                      51792
AMBULATORY    5121014 0 VOIDING PRESSURE STUDY (VP)              PROCED     363.08                      51795
AMBULATORY    5125038 0 VOIDING PRESS STUDIES AP                 PROCED     314.82                      51797
AMBULATORY    5121072 0 PVR BY ULTRASOUND                        PROCED     39.00                       51798
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120020 0 CYSTOSCOPY                                   PROCED     1,395.61                    52000
AMBULATORY    5120889 0 CYTOSCOPY W/ BLADDER IRRIG                   PROCED     1,655.60                    52000
AMBULATORY    5125111 0 CYSTOSCPY W/ URETH CATH                      PROCED     1,474.46                    52005
AMBULATORY    5125008 0 CYSTOSCOPY W/BX                              PROCED     1,535.60                    52204
AMBULATORY    5125005 0 CYSTO W/CALIB/DILTN/URETH STRC               PROCED     1,440.24                    52281
AMBULATORY    5125003 0 CYSTO W/REM FORGN BDY OR STENT               PROCED     1,504.67                    52310
AMBULATORY    5120260 0 CYSTOSCPY W/ INS URETERAL STENT              PROCED     1,669.80                    52332
AMBULATORY    5120255 0 CYSTOSCPY W/ URETEROSCPY URETERAL STRICT     PROCED     1,521.59                    52344
AMBULATORY    5125097 0 MEATOTOMY OTHER THAN INFANT                  PROCED     1,210.68                    53020
AMBULATORY    5125096 0 MEATOTOMY INFANT                             PROCED     1,108.00                    53025
AMBULATORY    5120435 0 I & D SKENE'S GLAND                          PROCED     1,108.00                    53060
AMBULATORY    5120766 0 URETHRA BIOPSY                               PROCED     1,100.00                    53200
AMBULATORY    5125025 0 DILATION MALE URETHRA INITL                  PROCED     346.50                      53600
AMBULATORY    5125026 0 DILATION MALE URETHRA SUBS                   PROCED     134.43                      53601
AMBULATORY    5125023 0 DILATION FEMAL URETHRA INITL                 PROCED     140.40                      53660
AMBULATORY    5125024 0 DILATION FEMAL URETHRA SUBS                  PROCED     122.10                      53661
AMBULATORY    5125018 0 TRANSURETH MICROWV TX PROSTATE               PROCED     2,831.89                    53850
AMBULATORY    5121243 0 TRANSURETH DST PROSTATE RADFREQ THERMOTHER ( PROCED     2,831.89                    53852
AMBULATORY    5120059 0 SLITTING OF PREPUCE NOT NEWBORN              PROCED     1,100.00                    54001
AMBULATORY    5125002 0 DESTR LES PENIS CHEMICAL SIMPL               PROCED     75.80                       54050
AMBULATORY    5121176 0 DSTR LES PENIS CRYOSURGERY                   PROCED     109.08                      54056
AMBULATORY    5121174 0 PENIS BIOPSY                                 PROCED     1,117.00                    54100
AMBULATORY    5125030 0 CIRCUMCIS NWBRN W/CLAMP,OTHR                 PROCED     1,233.00                    54150
AMBULATORY    5120258 0 CIRCUMCISION NO CLMP NBN                     PROCED     1,233.00                    54160
AMBULATORY    5120257 0 CIRCUMCISION NO CLMP EXCPT NBN               PROCED     1,910.92                    54161
AMBULATORY    5120825 0 INJ PROCED FOR PEYRONIE DISEASE              PROCED     163.00                      54200
AMBULATORY    5125127 0 INTRACAVERNOSAL INJECTION                    PROCED     154.50                      54235
AMBULATORY    5125014 0 NOCTURNAL PENILE TUMESCENCE                  PROCED     680.00                      54250
AMBULATORY    5120256 0 FORESKIN MANIPULATION                        PROCED     300.30                      54450
AMBULATORY    5120021 0 BIOPSY PROSTATE, SING/MULT                   PROCED     800.00                      55700
AMBULATORY    5120436 0 I & D VULVA/PERINL ABSCESS                   PROCED     343.90                      56405
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120437 0 I&D BARTHOLIN GLAND                             PROCED     327.37                      56420
AMBULATORY    5120012 0 VULVA / PERINEUM BIOP 1 LES                     PROCED     738.75                      56605
AMBULATORY    5120421 0 VULVAR BIOP EA ADDL LES                         PROCED     573.08                      56606
AMBULATORY    5121264 0 COLPOSCOPY VULVA                                PROCED     131.00                      56820
AMBULATORY    5121265 0 COLPOSCOPY VULVA W/ BX                          PROCED     195.00                      56821
AMBULATORY    5120424 0 VAGINAL LESION DSTR                             PROCED     1,570.69                    57061
AMBULATORY    5120425 0 VAGINAL MUCOSA BX SIMP                          PROCED     603.74                      57100
AMBULATORY    5120041 0 PESSARY INSERTION/FIT                           PROCED     123.57                      57160
AMBULATORY    5121266 0 COLPOSCOPY ENTIRE VAGINA W/ CERVIX IF PRESENT PROCED       312.00                      57420
AMBULATORY    5120795 0 COLPOSCOPY ENTIRE VAG W/ BX                     PROCED     350.00                      57421
AMBULATORY    5120008 0 COLPOSCOPY CERVIX W/ UP / ADJ VAG               PROCED     380.00                      57452
AMBULATORY    5120420 0 COLPOSCOPY CERV / UP VAG W/ BX CERV / CURRETAGE PROCED     586.20                      57454
AMBULATORY    5120796 0 COLPOSCPY CER/UP VAG W/ BX CERV                 PROCED     500.00                      57455
AMBULATORY    5120772 0 COLPOSCOPY W/ ENDOCERV CURETTAGE                PROCED     500.00                      57456
AMBULATORY    5120038 0 COLPOSCOPY W/LEEP                               PROCED     1,619.38                    57460
AMBULATORY    5121248 0 COLPOSCOPY W/ LOOP ELECTRD CONIZATN CERVX       PROCED     1,619.38                    57461
AMBULATORY    5120422 0 CERVIX BX OR EXCIS LESION                       PROCED     843.30                      57500
AMBULATORY    5120040 0 CRYOCAUTERY CERVIX                              PROCED     272.80                      57511
AMBULATORY    5120428 0 CONIZATN CERVIX LOOP EXC                        PROCED     1,671.00                    57522
AMBULATORY    5120009 0 ENDOMET BX W/O CERV DILATN                      PROCED     318.67                      58100
AMBULATORY    5121249 0 DILATION & CURRETTAGE DIAG/THER NON-OB          PROCED     1,639.00                    58120
AMBULATORY    5120797 0 REMOVAL INTRAUTERINE DEVICE                     PROCED     149.00                      58301
AMBULATORY    5120773 0 ARTIFIC INSEMINATION INTRACERVICAL              PROCED     290.00                      58321
AMBULATORY    5120011 0 INTRAUTERINE INSEMINATION                       PROCED     285.83                      58322
AMBULATORY    5125028 0 INSEMINATION SPERM WASHING                      PROCED     285.83                      58323
AMBULATORY    5120470 0 INTRO SALINE / CONTRAST HYSTEROSALPINOGRAPHY PROCED        299.42                      58340
AMBULATORY    5120798 0 HYSTEROSCPY W/ BX ENDOMET &/OR POLYPEC          PROCED     1,600.00                    58558
AMBULATORY    5121256 0 DRNGE OVARIAN CYST VAG APPROACH                 PROCED     913.00                      58800
AMBULATORY    5121257 0 DRNGE OVARIAN ABSCESS VAG APPROACH              PROCED     1,671.00                    58820
AMBULATORY    5121254 0 DRNGE PELVIC ABSCESS PERC                       PROCED     1,135.76                    58823
AMBULATORY    5120010 0 AMNIOCENTESIS                                   PROCED     438.84                      59000
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5121156 0 AMNIO FLUID REDUCTION                           PROCED     260.00                      59001
AMBULATORY    5121157 0 CORDOCENTESIS                                   PROCED     85.00                       59012
AMBULATORY    5121158 0 CHORION VILLUS BX                               PROCED     85.00                       59015
AMBULATORY    5120173 0 FETAL CONTRACTION STRESS TEST                   PROCED     260.00                      59020
AMBULATORY    5120005 0 NST FETAL                                       PROCED     261.12                      59025
AMBULATORY    5121159 0 CERVICAL DILATOR PLCMT                          PROCED     149.00                      59200
AMBULATORY    5121160 0 EXTERNAL CEPHALIC VERSIONS                      PROCED     258.00                      59412
AMBULATORY    5120013 0 THYROID BX, PERC NEEDLE                         PROCED     339.80                      60100
AMBULATORY    5120495 0 PUNCTURE SHUNT TUBING / RESERVOIR FOR ASP/INJ   PROCED     176.61                      61070
AMBULATORY    5120496 0 REPROGRAMMING CEREBROSPINAL SHUNT               PROCED     175.00                      62252
AMBULATORY    5121123 0 RACZ LYSIS EPIDURAL ADHESION 1 DAY              PROCED     666.59                      62264
AMBULATORY    5120018 0 LUMBAR PUNCTURE DIAGNOSTIC                      PROCED     303.93                      62270
AMBULATORY    5120113 0 EPIDURAL INJ BLOOD CLOT PATCH                   PROCED     349.65                      62273
AMBULATORY    5120860 0 SUBARACHNOID INJ NEUROLYT AGNT                  PROCED     375.00                      62280
AMBULATORY    5120111 0 EPID/CERV/THOR INJ/INF NEU AGT                  PROCED     595.08                      62281
AMBULATORY    5120859 0 LUMB / SACRAL INJ NEURO AGNT                    PROCED     392.32                      62282
AMBULATORY    5120132 0 EPIDURAL INJ CERV / THORACIC SINGL              PROCED     375.00                      62310
AMBULATORY    5120134 0 EPID INJ LUMBAR/CAUDAL SINGLE                   PROCED     375.00                      62311
AMBULATORY    5120705 0 RACZ CATH INJ CERV/THOR                         PROCED     638.25                      62318
AMBULATORY    5120135 0 EPID INJ LUMB/CAUD CONT TNNLLD                  PROCED     637.73                      62319
AMBULATORY    5120116 0 INSERT/REVIS/REPOS TUNNEL CATH                  PROCED     1,781.00                    62350
AMBULATORY    5121193 0 ANALYSIS PROG PUMP EPID INF W/O REPRG           PROCED     214.92                      62367
AMBULATORY    5121194 0 ANALYSIS PROG PUMP EPID INF W/ REPRG            PROCED     179.00                      62368
AMBULATORY    5120861 0 PERC NEUROSTIM ELECTRODE EPID                   PROCED     3,169.00                    63650
AMBULATORY    5120862 0 REVIS / REMOV PERC NEUROSTIM ELECTRODE          PROCED     1,250.00                    63660
AMBULATORY    5120863 0 REVIS / REMOV SPINAL NEUROSTIM GENERATOR        PROCED     2,672.00                    63688
AMBULATORY    5120117 0 TRIGEM NRVE INJ BY ANEST AGNT                   PROCED     388.26                      64400
AMBULATORY    5120118 0 FACIAL NRVE INJ ANEST AGNT                      PROCED     250.34                      64402
AMBULATORY    5120119 0 GREATR OCCIP NRV INJ ANEST AGT                  PROCED     266.21                      64405
AMBULATORY    5120864 0 VAGUS NERVE INJ ANES AGNT                       PROCED     250.00                      64408
AMBULATORY    5120865 0 PHRENIC NERVE INJ ANES AGNT                     PROCED     350.00                      64410
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120866 0 SPINAL ACCESS NERVE INJ ANES AGNT      PROCED     350.00                      64412
AMBULATORY    5120120 0 CERVICAL PLEX INJ ANESTH AGNT          PROCED     387.16                      64413
AMBULATORY    5120121 0 BRACHIAL PLEXUS INJ ANEST AGNT         PROCED     169.02                      64415
AMBULATORY    5121270 0 BRACHIAL PLEXUS LASER BLOCK INJ        PROCED     169.02                      64415
AMBULATORY    5120867 0 BRACHIAL PLEX CONTIN INFUS ANES AGNT   PROCED     250.00                      64416
AMBULATORY    5120868 0 AXILLARY NERVE INJ ANES AGNT           PROCED     250.00                      64417
AMBULATORY    5120122 0 SUPRASCAP NERV INJ ANEST AGNT          PROCED     188.46                      64418
AMBULATORY    5120708 0 INTERCOSTL NRVE INJ SINGLE             PROCED     371.06                      64420
AMBULATORY    5120709 0 INTERCOSTL NRVE INJ MULT               PROCED     370.47                      64421
AMBULATORY    5120710 0 ILIO-INGUIN NRVE INJ                   PROCED     411.75                      64425
AMBULATORY    5125116 0 INJ ANES AGNT PUDENDAL NRVE            PROCED     142.00                      64430
AMBULATORY    5120774 0 INJ ANES AGNT PARACERV (UTERIN) NRV    PROCED     142.00                      64435
AMBULATORY    5121137 0 SCIATIC NRVE INJ ANEST AGNT SINGL      PROCED     175.98                      64445
AMBULATORY    5120869 0 SCIATIC NERVE CONTIN INFUS ANES AGNT   PROCED     350.00                      64446
AMBULATORY    5121237 0 INJ ANES AGNT FEMORAL NRVE SING        PROCED     142.00                      64447
AMBULATORY    5120870 0 FEMORAL NERVE CONTIN INFUS ANES AGNT   PROCED     250.00                      64448
AMBULATORY    5121222 0 INJ ANES AGT LUMB PLEX POST CONTIN     PROCED     142.00                      64449
AMBULATORY    5120711 0 PERIPH NRVE (OTHER) INJ                PROCED     291.60                      64450
AMBULATORY    5120707 0 FACET/NRV INJ CERV/THOR,SINGLE         PROCED     466.56                      64470
AMBULATORY    5120142 0 FACET JNT/INJ CERV/THOR EA ADD         PROCED     405.88                      64472
AMBULATORY    5120143 0 FACT JNT/NRVE INJ.LMB/SAC SING         PROCED     585.90                      64475
AMBULATORY    5120144 0 FCT JNT/NRVE INJ LMB/SAC EA AD         PROCED     515.55                      64476
AMBULATORY    5120137 0 TRSFRM EPID INJ CRV/THR SINGL          PROCED     597.94                      64479
AMBULATORY    5120138 0 TRNSFRM EPID INJ CRV/THR EA AD         PROCED     375.00                      64480
AMBULATORY    5120147 0 TRNSFRM EPID INJ LUMB/SAC SNGL         PROCED     608.70                      64483
AMBULATORY    5120148 0 TRANFRM EPID INJ LMB/SAC EA AD         PROCED     440.00                      64484
AMBULATORY    5120124 0 SPHENOPAL GANGLION INJ                 PROCED     272.87                      64505
AMBULATORY    5120871 0 CAROTID SINUS INJ ANES AGNT            PROCED     250.00                      64508
AMBULATORY    5120712 0 STELLATE GANG INJ BY ANES AGNT         PROCED     400.01                      64510
AMBULATORY    5121223 0 INJ ANES AGT SUP HYPOGAST PLEX         PROCED     142.00                      64517
AMBULATORY    5120713 0 LUMB/THOR INJ BY ANEST AGNT            PROCED     522.00                      64520
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120714 0 CELIAC PLEX INJ ANEST AGNT                 PROCED     375.00                      64530
AMBULATORY    5120150 0 TRIGEM NRVE DESTR BY NEUR AGNT             PROCED     665.54                      64600
AMBULATORY    5120721 0 CRYO TRIGEM NRVE DESTR                     PROCED     665.54                      64600
AMBULATORY    5120127 0 TRIGEM NEU AGT FORAMEN OVL 2&3             PROCED     2,043.90                    64605
AMBULATORY    5120722 0 CRYO TRGM DST,FORAMEN OVAL 2&3             PROCED     2,043.90                    64605
AMBULATORY    5120128 0 TRIGEM NEU AGNT FORAMEN 2&3RAD             PROCED     2,033.00                    64610
AMBULATORY    5122022 0 CHEMODENERVATION MUSC; FACIAL NRVE         PROCED     218.00                      64612
AMBULATORY    5124003 0 CHEMODENERV MUSC CERV/SPIN                 PROCED     497.58                      64613
AMBULATORY    5125121 0 CHEMODENERVATION MUSCLE                    PROCED     326.33                      64614
AMBULATORY    5125126 0 CHEMODENERV MUSC EXTREM / TRNK             PROCED     326.33                      64614
AMBULATORY    5120151 0 INTERCSTL NRV DESTR BY NEU AGT             PROCED     665.54                      64620
AMBULATORY    5120723 0 CRYO INTERCSTL NRVE DESTR                  PROCED     665.54                      64620
AMBULATORY    5120152 0 LUMB/SAC DESTR NEU ANGT SING               PROCED     665.54                      64622
AMBULATORY    5120724 0 CRYO LUMB/SAC DESTR SING                   PROCED     665.54                      64622
AMBULATORY    5120153 0 LUMB/SAC DESTR NEU AGT EA ADD              PROCED     665.54                      64623
AMBULATORY    5120725 0 CRYO LUMB/SAC DESTR EACH ADD               PROCED     665.54                      64623
AMBULATORY    5121238 0 CERV / THOR DSTR BY NEUR AGT SINGL         PROCED     686.28                      64626
AMBULATORY    5121239 0 CERV / THOR DSTR NEUR AGT EA ADD'L         PROCED     665.54                      64627
AMBULATORY    5120872 0 PUDENDAL NERVE DESTRUCTION NEUROLYT AGNT   PROCED     350.00                      64630
AMBULATORY    5120141 0 PERIPH NERV DESTR BY NEUR AGNT             PROCED     752.22                      64640
AMBULATORY    5120726 0 CRYO PERIPH NRVE(OTHER) DESTR              PROCED     752.22                      64640
AMBULATORY    5120149 0 CELIAC PLEX DESTR BY NEUR AGNT             PROCED     665.54                      64680
AMBULATORY    5120727 0 CRYO CELIAC PLEX DESTR                     PROCED     665.54                      64680
AMBULATORY    5121224 0 DSTR NEUROLYT AGT SUP HYPOGAST PLEX        PROCED     665.54                      64681
AMBULATORY    5120775 0 REM FORGN BDY EXT EYE CONJUNC SUPERFIC     PROCED     110.00                      65205
AMBULATORY    5122023 0 FOREIGN BODY REM CONJUNCT                  PROCED     148.45                      65210
AMBULATORY    5122024 0 FOREIGN BODY REM CRNA SLIT LMP             PROCED     250.00                      65222
AMBULATORY    5123086 0 REP LACERATION APPLIC TISSUE GLUE          PROCED     827.59                      65286
AMBULATORY    5122025 0 CORNEAL BIOPSY                             PROCED     915.00                      65410
AMBULATORY    5122026 0 CULTURE CORNEA                             PROCED     233.28                      65430
AMBULATORY    5122027 0 REMOVAL CORNEAL EPITHELIUM                 PROCED     1,312.50                    65435
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5122028 0 CORNEA LESION DESTRUCT                         PROCED     692.58                      65450
AMBULATORY    5122029 0 ANT STROMAL PUNC                               PROCED     1,125.00                    65600
AMBULATORY    5122031 0 CORRECT ASTIG-CORNL RELAX INCI                 PROCED     915.00                      65772
AMBULATORY    5123084 0 OCULAR SURFACE REONST AMM MEMB TRNSPLNT        PROCED     3,500.00                    65780
AMBULATORY    5125186 0 PARACENTES ANT EYE W/ ASP AQUEOUS              PROCED     1,346.76                    65800
AMBULATORY    5122032 0 PARACENTESIS, ANTERIOR EYE                     PROCED     1,443.27                    65805
AMBULATORY    5120098 0 LASER TRABECULOPLASTY                          PROCED     948.46                      65855
AMBULATORY    5122033 0 INJ ANTER CHAM (AIR OR LIQ)                    PROCED     2,467.44                    66020
AMBULATORY    5121252 0 REVIS / REP OP WOUND ANT SEGMENT               PROCED     1,981.17                    66250
AMBULATORY    5122034 0 CYCLOPHOTOCOAG CIL BOD DEST                    PROCED     1,425.00                    66710
AMBULATORY    5120096 0 LASER IRIDOTOMY                                PROCED     845.55                      66761
AMBULATORY    5122035 0 IRIDOPLASTY BY PHOTOCOAGULATIO                 PROCED     630.00                      66762
AMBULATORY    5120097 0 YAG, CAPSULOTOMY                               PROCED     845.64                      66821
AMBULATORY    5121272 0 INTRAVITREAL INJ AVASTIN (CHARGE MED SEPARATEL PROCED     167.00                      67028
AMBULATORY    5122037 0 INTRAVITREAL INJ OTHER THAN AVASTIN            PROCED     1,107.34                    67028
AMBULATORY    5121253 0 VITRECTOMY W/ ENDO LASER PANRET PHOTOCOAG      PROCED     4,200.00                    67040
AMBULATORY    5122038 0 RET DETCH REP CRYO/DIATHERMY                   PROCED     2,514.30                    67101
AMBULATORY    5122039 0 RET DETACH REP PHOTOCOAG                       PROCED     891.58                      67105
AMBULATORY    5122040 0 RET DETACH REP BY AIR                          PROCED     2,477.52                    67110
AMBULATORY    5122041 0 CRYOTHERAPY PROPHY RETINAL DE                  PROCED     1,007.64                    67141
AMBULATORY    5122042 0 RET DET PROPHY PHOTOCOAG                       PROCED     972.00                      67145
AMBULATORY    5120100 0 PHOTOCOAGULATION, RETINA LASER                 PROCED     885.58                      67210
AMBULATORY    5121122 0 PHOTOCOAG DST CHOROID LES                      PROCED     911.74                      67220
AMBULATORY    5125081 0 PDT-PHOTODYN THER DEST LES CHOROID             PROCED     625.00                      67221
AMBULATORY    5125187 0 PDT 2ND EYE                                    PROCED     917.28                      67225
AMBULATORY    5121066 0 DSTR RETINOPATHY PHOTOCOAG                     PROCED     972.00                      67228
AMBULATORY    5122044 0 ADJ SUTURE PLACEMENT (STRABIS)                 PROCED     1,375.00                    67335
AMBULATORY    5120755 0 CHEMODENERVATION EXTRAOCULAR MUSC              PROCED     200.00                      67345
AMBULATORY    5121226 0 ORBITOTOMY W/ OR W/O BX                        PROCED     2,875.88                    67400
AMBULATORY    5122045 0 INJ TENON'S CAPSULE                            PROCED     690.00                      67515
AMBULATORY    5122251 0 BLEPHAROTOMY EYELID DRNGE ABSCESS              PROCED     385.71                      67700
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML      CPT
AMBULATORY    5122252 0 CANTHOTOMY                                  PROCED     2,498.43                    67715
AMBULATORY    5120058 0 CHALAZ EXCIS SINGLE                         PROCED     496.99                      67800
AMBULATORY    5122047 0 CHALAZION EXCIS MULT SAME LI                PROCED     675.00                      67801
AMBULATORY    5122049 0 CHALAZION EXCIS MULT DIFF LI                PROCED     350.00                      67805
AMBULATORY    5122253 0 BIOPSY EYELID                               PROCED     418.88                      67810
AMBULATORY    5122050 0 EPILATION MANUAL (TRICHIA)                  PROCED     153.00                      67820
AMBULATORY    5122051 0 EPILATION OTH THN FRCP TRICHIA              PROCED     350.00                      67825
AMBULATORY    5122254 0 EXC LES EYELID XCEPT CHALAZ                 PROCED     758.80                      67840
AMBULATORY    5122055 0 TARSORRHAP BY SUTURE                        PROCED     577.80                      67875
AMBULATORY    5120068 0 TARSORRHAPHY                                PROCED     1,696.68                    67880
AMBULATORY    5122056 0 TARSORRHAP W/TRANSPO TARS PLT               PROCED     1,766.88                    67882
AMBULATORY    5121134 0 REPAIR BROW PTOSIS UNILAT                   PROCED     1,154.85                    67900
AMBULATORY    5121135 0 REPAIR BROW PTOSIS BILAT                    PROCED     1,154.85                    6790050
AMBULATORY    5122057 0 PTOSIS REP LEVAT RESECT                     PROCED     2,078.46                    67904
AMBULATORY    5122058 0 PTOSIS REP CONJ/TARS/MULER MUS              PROCED     2,401.46                    67908
AMBULATORY    5122059 0 REDUCTION OVERCORRECT PTOSIS                PROCED     1,125.00                    67909
AMBULATORY    5122063 0 ECTROPION REP BY SUTURE                     PROCED     1,410.41                    67914
AMBULATORY    5122065 0 ECTROP REP BLEPHAR TRSEL WDG                PROCED     1,711.80                    67916
AMBULATORY    5122070 0 ECTROP REP BLEPHARO,EXT                     PROCED     2,465.07                    67917
AMBULATORY    5120057 0 ENTROP REP BY SUTURE                        PROCED     1,239.53                    67921
AMBULATORY    5120056 0 ENTROP REP EXCIS                            PROCED     2,685.20                    67924
AMBULATORY    5122255 0 SUTURE WND EYELID PARTIAL THICKNESS         PROCED     1,125.00                    67930
AMBULATORY    5122256 0 SUTURE WND EYELID FULL THICKNESS            PROCED     1,900.00                    67935
AMBULATORY    5122081 0 FOREIGN BODY REM EYELID                     PROCED     321.30                      67938
AMBULATORY    5121279 0 EXC / REPAIR EYELID UP TO 1/4 LID MARGIN    PROCED     1,200.00                    67961
AMBULATORY    5120053 0 BIOPSY CONJUNCTIVA                          PROCED     432.00                      68100
AMBULATORY    5121059 0 EXC LES CONJUNCTIVA UP TO 1 CM              PROCED     840.00                      68110
AMBULATORY    5122092 0 EXCIS LES CONJUNCTIVA >1CM                  PROCED     1,125.00                    68115
AMBULATORY    5122094 0 LACR PUNC SNIP INCISION                     PROCED     763.71                      68440
AMBULATORY    5121288 0 REM FOREIGN BODY / DACRYOLITH LAC PASSAGE   PROCED     1,500.00                    68530
AMBULATORY    5125148 0 CORRECT EVERTD PUNCTUM CAUTERY              PROCED     183.38                      68705
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120062 0 CLOSUR LACR PUNC BY CAUTERY                     PROCED     248.40                      68760
AMBULATORY    5122095 0 LACR PUNC PLUG EA                               PROCED     392.23                      68761
AMBULATORY    5125188 0 DILATN LAC PUNCTUM W/ OR W/O IRRIG              PROCED     525.00                      68801
AMBULATORY    5121289 0 PROBE NASOLACRIMAL DUCT W/ INSERT TUBE/STENT    PROCED     1,500.00                    68815
AMBULATORY    5125093 0 PROBING LACRIMAL CANALIC W/ OR W/O IRRIG        PROCED     787.50                      68840
AMBULATORY    5120238 0 DRAINAGE EAR ABSCESS SIMPLE                     PROCED     199.50                      69000
AMBULATORY    5125209 0 DRAINAGE EAR ABSCESS COMPLICATED                PROCED     1,020.00                    69005
AMBULATORY    5120777 0 DRNGE EXTERNL AUDITORY CANAL ABSCESS            PROCED     95.00                       69020
AMBULATORY    5120235 0 BIOPSY EXTERNAL EAR                             PROCED     259.00                      69100
AMBULATORY    5120239 0 REM FOREIGN BODY EAR                            PROCED     128.79                      69200
AMBULATORY    5120240 0 REM IMPACTED CERUMEN                            PROCED     90.72                       69210
AMBULATORY    5120241 0 DEBRDMNT MASTOIDCTMY CVTY SIMP                  PROCED     57.91                       69220
AMBULATORY    5121034 0 DEBRDMNT MASTOIDCTMY CVTY COMPLEX               PROCED     1,100.00                    69222
AMBULATORY    5120242 0 MYRINGOTOMY W/ASP AND/OR TUBE INFLA             PROCED     390.71                      69420
AMBULATORY    5125065 0 TYMPANOSTOMY W/TUBE                             PROCED     670.43                      69433
AMBULATORY    5125195 0 LABRYNTHOTOMY TRANSCANAL (INCLUDES INFUS)       PROCED     2,307.00                    69801
AMBULATORY    5125022 0 URETHROCYSTOGRAPHY RETROGRADE                   PROCED     384.70                      74450
AMBULATORY    5120471 0 URETHROCYSTOGRAPHY VOIDING                      PROCED     380.00                      74455
AMBULATORY    5121206 0 EMBOLIZTN TRANSCATH RAD S/I                     PROCED     2,723.26                    75894
AMBULATORY    5121255 0 RAD GUID (FLUORO, U/S) FOR PERC DRNGE ABSCESS   PROCED     1,051.92                    75989
AMBULATORY    5121201 0 FLUOROSCOPY 0-60 MIN                            PROCED     350.00                      76000
AMBULATORY    5121200 0 FLUOROSCOPY > 60 MIN                            PROCED     574.66                      76001
AMBULATORY    5121118 0 FLUORO GUIDANCE NDLE PLCMT NON-SPINAL           PROCED     342.09                      76003
AMBULATORY    5120728 0 FLUORO GUID NDLE PLCMT SPINAL / SI INJ          PROCED     452.00                      76005
AMBULATORY    5121290 0 ULTRASOUND OPHTHAL QUANT A SCAN ONLY            PROCED     288.15                      76511
AMBULATORY    5120093 0 ULTRASOUND OPHTHAL B-SCAN W/WO A                PROCED     288.15                      76512
AMBULATORY    5121229 0 U/S CORNEAL PACHYMETRY UNILAT OR BILAT          PROCED     59.05                       76514
AMBULATORY    5120069 0 ULTRASOUND OPHTHAL A SCAN                       PROCED     241.12                      76516
AMBULATORY    5120491 0 ULTRASOUND A SCAN W/ IOL CALCULATION            PROCED     241.54                      76519
AMBULATORY    5120411 0 U/S BREAST UNILAT / BILAT                       PROCED     282.97                      76645
AMBULATORY    5121161 0 U/S ABDOMINAL COMPLETE                          PROCED     674.84                      76700
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5121162 0 U/S ABDOMINAL LTD                               PROCED     503.36                      76705
AMBULATORY    5125059 0 U/S BLADDER                                     PROCED     400.91                      76775
AMBULATORY    5125190 0 U/S PREG < 14 WKS SING GEST                     PROCED     100.00                      76801
AMBULATORY    5125232 0 U/S PREG < 14 WKS SING GEST W/ NUC TRANSULC     PROCED     200.00                      76801
AMBULATORY    5125191 0 U/S PREG < 14 WKS EA ADD'L GEST                 PROCED     197.35                      76802
AMBULATORY    5125233 0 U/S PREG < 14 WKS EA ADDL GEST W/ NUCH TRANSULC PROCED     197.35                      76802
AMBULATORY    5120025 0 U/S PREG > 14 WKS SING GEST                     PROCED     394.70                      76805
AMBULATORY    5120042 0 U/S PREG > 14 WKS EA ADD'L GEST                 PROCED     414.44                      76810
AMBULATORY    5125192 0 U/S PREG DETAILED 1ST GEST                      PROCED     435.10                      76811
AMBULATORY    5125193 0 U/S PREG DETAILED EA ADD'L GEST                 PROCED     274.00                      76812
AMBULATORY    5120426 0 U/S PREG LTD ONE OR MORE FETUSES                PROCED     350.71                      76815
AMBULATORY    5125133 0 U/S PREG F/U PER FETUS                          PROCED     237.57                      76816
AMBULATORY    5125194 0 U/S PREG TRANSVAGINAL                           PROCED     100.00                      76817
AMBULATORY    5120423 0 FETAL BIOPHYS PROFILE W/ NST                    PROCED     419.50                      76818
AMBULATORY    5121163 0 FETAL BIOPHYS PROFILE W/O NST                   PROCED     100.00                      76819
AMBULATORY    5120171 0 DOPPLER VELOCIMETRY FETAL UMBIL ARTERY          PROCED     120.00                      76820
AMBULATORY    5120172 0 DOPPLER VELOCIMETRY FETAL MID CEREBRAL ARTERY   PROCED     120.00                      76821
AMBULATORY    5121164 0 U/S TRANSVAGINAL                                PROCED     308.22                      76830
AMBULATORY    5121032 0 HYSTEROSONOGRAM                                 PROCED     446.90                      76831
AMBULATORY    5121033 0 ULTRASOUND FOLLIC DVLPT COMPLT                  PROCED     513.64                      76856
AMBULATORY    5121165 0 U/S PELVIC GYN COMPLETE                         PROCED     513.64                      76856
AMBULATORY    5121030 0 ULTRASOUND FOLLIC DVLPT LIMIT                   PROCED     260.00                      76857
AMBULATORY    5121169 0 U/S PELVIC GYN LTD OR F/U                       PROCED     260.00                      76857
AMBULATORY    5125135 0 ULTRASOUND PROSTATE                             PROCED     482.32                      76872
AMBULATORY    5125088 0 U/S PROSTATE W/ SEED MAPPING                    PROCED     496.80                      76873
AMBULATORY    5121166 0 U/S GUIDANCE NEEDLE PLCMT                       PROCED     478.88                      76942
AMBULATORY    5121167 0 U/S GUIDANCE FOR CHOR VILLUS SAMPL              PROCED     173.00                      76945
AMBULATORY    5121168 0 U/S GUIDANCE FOR AMNIOCENTESIS                  PROCED     368.20                      76946
AMBULATORY    5125125 0 ULTRASOUND RECTUM / ANUS                        PROCED     506.58                      76975
AMBULATORY    5125050 0 SWEAT CHLORIDE                                  PROCED     284.50                      89230
AMBULATORY    5125029 0 POST COITAL TST SEMEN ANALYSIS                  PROCED     164.00                      89300
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5110004 0 INJ FEE VACC < 8 Y/O MD COUNSEL (1) SINGL         PROCED     0.00                        90465
AMBULATORY    5110005 0 INJ FEE VACC < 8 Y/O MD COUNSEL EA ADDL           PROCED     0.00                        90466
AMBULATORY    5110006 0 ADMIN FEE VACC PO / NASL < 8 Y/O MD COUNSEL SINGL PROCED     0.00                        90467
AMBULATORY    5110007 0 ADMIN FEE VACC PO / NASL < 8 Y/O MD COUNSEL EA ADPROCED      0.00                        90468
AMBULATORY    5110062 0 INJ FEE VACCINE (1) SINGLE                        PROCED     25.00                       90471
AMBULATORY    5110300 0 VFC INJ FEE VACC SINGLE                           PROCED     25.00                       90471
AMBULATORY    5110059 0 VFC INJ FEE VACC EA ADD'L VACC                    PROCED     25.00                       90472
AMBULATORY    5110063 0 INJ FEE VACCINE EA ADDL                           PROCED     25.00                       90472
AMBULATORY    5110057 0 ADMIN FEE ORAL VACC SINGLE                        PROCED     16.00                       90473
AMBULATORY    5110058 0 ADMIN FEE ORAL VACC EA ADDL                       PROCED     16.00                       90474
AMBULATORY    5110032 0 INJ FEE SQ, IM, ID (PT PURCH OWN MED)             PROCED     60.36                       90772
AMBULATORY    5110064 0 INJ FEE THER / DIAG / PROPHY SQ,IM,ID             PROCED     60.36                       90772
AMBULATORY    5110068 0 INJ FEE EPOGEN / ARANESP                          PROCED     60.36                       90772
AMBULATORY    5110069 0 INJ FEE FILGRASTIM (NEUPOGEN)                     PROCED     60.36                       90772
AMBULATORY    5110106 0 OPHTH EXAM W/ANESTHESIA COMPL                     PROCED     559.00                      92018
AMBULATORY    5110107 0 GONIOSCOPY                                        PROCED     51.78                       92020
AMBULATORY    5122096 0 SENSORIMOTOR EVAL                                 PROCED     172.00                      92060
AMBULATORY    5110108 0 CONTACT LENS FIT TX DISEASE                       PROCED     20.00                       92070
AMBULATORY    5122097 0 VISUAL FIELD 2 ISOP                               PROCED     110.00                      92082
AMBULATORY    5120095 0 VISUAL FIELD HVF OR 3 ISOP                        PROCED     136.27                      92083
AMBULATORY    5125155 0 TOMOGRPHY-SCAN COMP OPH IMAG UNILAT               PROCED     95.65                       92135
AMBULATORY    5121271 0 OPTICAL BIOMETRY FOR IOL CALC                     PROCED     121.00                      92136
AMBULATORY    5110109 0 OPHTHALMOSCPY EXTD INITL                          PROCED     183.14                      92225
AMBULATORY    5110110 0 OPHTHALMOSCPY EXTD SUBS                           PROCED     144.10                      92226
AMBULATORY    5120050 0 ANGIOGRAPHY FLUORESCEIN                           PROCED     368.23                      92235
AMBULATORY    5120065 0 FUNDUS PHOTOGRAPHY                                PROCED     95.85                       92250
AMBULATORY    5120064 0 PHOTOG EXT OCULAR                                 PROCED     90.00                       92285
AMBULATORY    5110117 0 CONT LENS PRES NON-APHAK 2EYES                    PROCED     45.78                       92310
AMBULATORY    5110118 0 CONT LENS PRES APHAK 1 EYE                        PROCED     154.86                      92311
AMBULATORY    5120780 0 PRESCRIP/FIT CONTACT LENS APHAKIA BOTH EYES       PROCED     310.00                      92312
AMBULATORY    5120244 0 BINOCULAR MICROSCOPY                              PROCED     26.00                       92504
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5121006 0 NASOPHARYNG W/SCOPE                       PROCED     150.00                      92511
AMBULATORY    5123057 0 EKG 12-LEAD - OP                          PROCED     130.36                      93005
AMBULATORY    5120048 0 BLOOD PRESSURE 24HR MONITOR               PROCED     167.10                      93786
AMBULATORY    5120880 0 ABI ANKLE BRACHIAL INDEX                  PROCED     374.90                      93922
AMBULATORY    5125020 0 DOPPLER PENILE VESSEL COMPLT              PROCED     580.05                      93980
AMBULATORY    5125021 0 DOPPLER PENILE VESSEL LTD                 PROCED     256.90                      93981
AMBULATORY    5120045 0 SPIRO-PRE & POST BRONCHODILATR            PROCED     306.28                      94060
AMBULATORY    5120046 0 FLOW VOLUME LOOP (FVC)                    PROCED     159.80                      94375
AMBULATORY    5120779 0 BREATHING RESPONSE TO HYPOXIA             PROCED     200.00                      94450
AMBULATORY    5121131 0 MDI TREATMENT                             PROCED     92.29                       94640
AMBULATORY    5121132 0 NEBULIZER TREATMENT                       PROCED     92.29                       94640
AMBULATORY    5120034 0 CPAP MANAGEMENT FOLLOW-UP                 PROCED     225.00                      94660
AMBULATORY    5123079 0 CPAP INITIATION/MANAGEMENT                PROCED     440.57                      94660
AMBULATORY    5125052 0 DEMO / EVAL PT USE OF MDI                 PROCED     93.47                       94664
AMBULATORY    5125053 0 DEMO / EVAL PT USE NEBULIZER              PROCED     93.47                       94664
AMBULATORY    5125048 0 CHEST PHYSIO INTERM INI 10-30M            PROCED     87.48                       94667
AMBULATORY    5125049 0 CHEST PHYSIO SIMP INIT 0-10MIN            PROCED     87.48                       94667
AMBULATORY    5120044 0 PULSE OXIM SING CHECK 02 SAT              PROCED     94.01                       94760
AMBULATORY    5125051 0 DESATURATION SCREENING                    PROCED     124.61                      94761
AMBULATORY    5120084 0 PERC ALLERGEN EXT SKIN TEST EA            PROCED     57.00                       95004
AMBULATORY    5120085 0 PERC SKIN TEST EA (Drg,Biolog,Ven)        PROCED     57.91                       95010
AMBULATORY    5120086 0 INTRADRM SKIN TST EA (Drg, Biolo,Venom)   PROCED     57.91                       95015
AMBULATORY    5120087 0 INT DERM ALLERG EXT SKIN TEST EA          PROCED     57.00                       95024
AMBULATORY    5125115 0 COLLAGEN SKIN TEST EA                     PROCED     52.80                       95028
AMBULATORY    5120089 0 PATCH OR APPLICATION TEST                 PROCED     57.91                       95044
AMBULATORY    5120815 0 PHOTO PATCH TEST (SPECIFY #)              PROCED     60.00                       95052
AMBULATORY    5120070 0 ALLERGN ADM SING INJ NON VENOM            PROCED     42.12                       95120
AMBULATORY    5120071 0 ALLERGN ADM > 1 INJ NON VENOM             PROCED     70.20                       95125
AMBULATORY    5120072 0 ALLERGN ADM SING INJ VENOM                PROCED     47.80                       95130
AMBULATORY    5120073 0 ALLERGN ADM 2 INJ VENOM                   PROCED     55.60                       95131
AMBULATORY    5120074 0 ALLERGN ADM 3 INJ VENOM                   PROCED     63.40                       95132
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5120092 0 IMMUNOTHER SING/MULT ALLERG (Spec # dose)        PROCED     31.93                       95165
AMBULATORY    5120730 0 RAPID DESENSITIZATION EA HR                      PROCED     176.00                      95180
AMBULATORY    5125082 0 CMGS ( CONTIN GLUC MON SYS)                      PROCED     550.80                      95250
AMBULATORY    5124001 0 TENSILON TST MYASTHENIA GRAVI                    PROCED     105.34                      95857
AMBULATORY    5125201 0 EMG 1 EXTREM W/ OR W/O PARASPINAL                PROCED     223.00                      95860
AMBULATORY    5125202 0 EMG 2 EXTREM W/ OR W/O PARASPINAL                PROCED     273.03                      95861
AMBULATORY    5125203 0 EMG 3 EXTREM W/ OR W/O PARASPINAL                PROCED     321.50                      95863
AMBULATORY    5125204 0 EMG 4 EXTREM W/ OR W/O PARASPINAL                PROCED     316.94                      95864
AMBULATORY    5121227 0 EMG NDLE CRAN NRV SUPP MUSC UNILAT               PROCED     163.90                      95867
AMBULATORY    5125120 0 NEEDL EMG CRAN NRVE SUPPLD MUSC BILAT            PROCED     305.19                      95868
AMBULATORY    5125045 0 EMG NEEDL THOR/SPIN MUSC                         PROCED     140.94                      95869
AMBULATORY    5125200 0 EMG 1 EXTREM LTD MUSC                            PROCED     112.48                      95870
AMBULATORY    5125215 0 EMG SINGLE FIBER EA MUSC                         PROCED     339.24                      95872
AMBULATORY    5125216 0 EMG NDLE W/ CHEMODENERVATION                     PROCED     112.48                      95874
AMBULATORY    5125046 0 NRV CONDCTN MOTOR W/O F WAVE                     PROCED     107.63                      95900
AMBULATORY    5125199 0 NRV CONDCTN MOTOR W/ F-WAVE                      PROCED     121.85                      95903
AMBULATORY    5125047 0 NRV CONDCTN SENSORY/MIXD                         PROCED     129.00                      95904
AMBULATORY    5125212 0 AUTONOM TEST VASOMOTOR ADRENERG INNERV           PROCED     70.00                       95922
AMBULATORY    5125211 0 AUTONOM TEST SUDOMOTOR                           PROCED     328.32                      95923
AMBULATORY    5125119 0 H-REFLX GASTROCNEM/SOLEUS MUSC                   PROCED     308.20                      95934
AMBULATORY    5125214 0 H REFLEX OTHER THAN GASTROCNEM / SOLEUS MUSC PROCED         163.90                      95936
AMBULATORY    5125213 0 NM JUNCT TEST REPETITIVE EA NRVE                 PROCED     152.29                      95937
AMBULATORY    5120261 0 ELEC ANALY W/O REPROGRM IMPLNT NS SYS            PROCED     210.00                      95970
AMBULATORY    5120873 0 ELEC ANALYS W/ REPROGRAM IMPLANT NS SYS          PROCED     200.00                      95971
AMBULATORY    5125114 0 NEUROSTIM SYS ELEC ANALY W/ PROG 1ST HR          PROCED     1,326.61                    95972
AMBULATORY    5120252 0 NEUROSTIM SYS ELEC ANALY PROG EA ADD'L 30 MIN PROCED        210.00                      95973
AMBULATORY    5121181 0 REFIL/MAINT IMPLANT PUMP SPINAL DRUG DELIV       PROCED     172.90                      95990
AMBULATORY    5120720 0 REFILL/MAINT IMPLANT PUMP IV DRUG DELIVERY       PROCED     181.76                      96522
AMBULATORY    5120876 0 IRRIG IMPLNTED VAD (PORT FLUSH) FOR DRUG DELIV S PROCED     100.00                      96523
AMBULATORY    5120158 0 UVB                                              PROCED     82.93                       96910
AMBULATORY    5120026 0 PUVA or UVA                                      PROCED     101.41                      96912
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5121042 0 BLEOMYCIN TREATMENT-DERM                        PROCED     37.19                       96999
AMBULATORY    5123082 0 ACUPUNCTURE W/O ELEC STIM 1ST 15 MIN            PROCED     25.00                       97810
AMBULATORY    5123083 0 ACUPUNCTURE W/O ELEC STIM EA ADD'L 15 MIN       PROCED     17.00                       97811
AMBULATORY    5123080 0 ACUPUNCTURE W/ ELEC STIM 1ST 15 MIN             PROCED     33.00                       97813
AMBULATORY    5123081 0 ACUPUNCTURE W/ ELEC STIM EA ADD'L 15 MIN        PROCED     17.00                       97814
AMBULATORY    5121087 0 OSTEOPATH MANIP TX 1-2 REGIONS                  PROCED     50.00                       98925
AMBULATORY    5121088 0 OSTEOPATH MANIP TX 3-4 REGIONS                  PROCED     50.00                       98926
AMBULATORY    5121089 0 OSTEOPATH MANIP TX 5-6 REGIONS                  PROCED     50.00                       98927
AMBULATORY    5121090 0 OSTEOPATH MANIP TX 7-8 REGIONS                  PROCED     50.00                       98928
AMBULATORY    5125210 0 CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 30 MIN   PROCED     170.00                      99143
AMBULATORY    5125205 0 CONSCIOUS SEDATION SAME MD 5 Y/O & ABV 1ST 30 MIN
                                                                        PROCED     170.00                      99144
AMBULATORY    5125206 0 CONSCIOUS SEDATION SAME MD EA ADDL 15 MIN (ALL APROCED     85.00                       99145
AMBULATORY    5120874 0 ANOGENITAL EXAM CHILD SUSP ABUSE                PROCED     11.00                       99170
AMBULATORY    5121155 0 VISUAL ACUITY SCREENING                         PROCED     14.85                       99173
AMBULATORY    5120879 0 LAP BANDING ADJUSTMENT                          PROCED     125.00                      99213
AMBULATORY    5110408 0 CONSULT NP 15 MIN                               PROCED     78.80                       99241
AMBULATORY    5110409 0 CONSULT NP 30 MIN                               PROCED     75.65                       99242
AMBULATORY    5110410 0 CONSULT NP 40 MIN                               PROCED     114.00                      99243
AMBULATORY    5110405 0 PREVENTV RE-EVAL NP COUNSELING AGE 18-39        PROCED     89.20                       99395
AMBULATORY    5110406 0 PREVENTV RE-EVAL NP COUNSELING AGE 40-64        PROCED     115.02                      99396
AMBULATORY    5110407 0 PREVENTV RE-EVAL NP COUNSELING AGE >64          PROCED     114.05                      99397
AMBULATORY    5125230 0 SCREEN PRENATAL POST PARTUM DEPRESSION          PROCED     40.00                       99420
AMBULATORY    5125231 0 SCREEN POST PARTUM DEPRESSION                   PROCED     40.00                       99420
AMBULATORY    5120168 0 INFUSION THER NON-CHEMO 1ST HR                  PROCED     236.00                      C8950
AMBULATORY    5120169 0 INFUSION THER NON-CHEMO EA ADD'L HR             PROCED     142.00                      C8951
AMBULATORY    5110302 0 INJ FEE IV PUSH THER / DIAG / PROPHY            PROCED     150.00                      C8952
AMBULATORY    5121261 0 INFUSION THER CHEMO 1ST HR                      PROCED     264.00                      C8954
AMBULATORY    5121262 0 INFUSION THER CHEMO EA ADD'L HR                 PROCED     158.00                      C8955
AMBULATORY    5110061 0 INJ FEE INFLUENZA                               PROCED     15.00                       G0008
AMBULATORY    5110060 0 INJ FEE PNEUMOCOCCAL                            PROCED     25.00                       G0009
AMBULATORY    5110067 0 INJ FEE HEPATITIS B                             PROCED     25.00                       G0010
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                               CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY      OUTPT)           LML/RML    CPT
AMBULATORY    5120439 0 BREAST/PELVIC EXAM HIGH RISK                    PROCED        90.00                       G0101
AMBULATORY    5110403 0 DIETITIAN DIABETES SELF-MGMT TRAINING 30 MIN    PROCED        70.00                       G0108
AMBULATORY    5110404 0 RN DIABETES SELF-MGMT TRAINING 30 MIN IND       PROCED        70.00                       G0108
AMBULATORY    5104003 0 DIABETES SELF-MGMT TRAINING GRP CLASS PER 30 MINPROCED        35.00                       G0109
AMBULATORY    5125181 0 GLAUCOMA SCREEN, HIGH RISK PT BY MD             PROCED        50.00                       G0117
AMBULATORY    5125182 0 GLAUCOMA SCREEN, HIGH RISK PT, SUPERVS MD       PROCED        50.00                       G0118
AMBULATORY    5120162 0 TRIM NAILS DYSTROPHIC (ANY #)                   PROCED        47.00                       G0127
AMBULATORY    5121136 0 PEP THERAPY, INDIVID, PER 15 MIN                PROCED        67.90                       G0238
AMBULATORY    5125183 0 FOOT EXAM INIT DIAB PT W/ NEUROP                PROCED        55.00                       G0245
AMBULATORY    5125184 0 FOOT EXAM F/U DIAB PT W/ NEUROP                 PROCED        55.00                       G0246
AMBULATORY    5125185 0 FOOT CARE ROUTIN DIAB PT W/ NEUROP              PROCED        47.00                       G0247
AMBULATORY    5121120 0 SACROILIAC JOINT INJ                            PROCED        337.00                      G0260
AMBULATORY    5120799 0 REMOVAL IMPACT CERUMEN SAME DAY AS ADUIOL TE PROCED           39.00                       G0268
AMBULATORY    5121177 0 CATHETERIZTN URETH FOR COLLECTN SPEC            PROCED        67.68                       P9612
AMBULATORY    5121058 0 PAP SMEAR SCREENING                             PROCED        50.40                       Q0091
AMBULATORY    5110120 2 REFRACTION                                      PROCED        STATISTICAL ITEM
AMBULATORY    5125080 2 TOPOGRAPHY CORNEAL                              PROCED        STATISTICAL ITEM
AMBULATORY    5125229 2 VAD PICC REMOVAL AMB                            PROCED        STATISTICAL ITEM
AMBULATORY    5140062 0 PARENTING CLASS > 60 MIN SESSION                PROCED-CASH CO15.00
AMBULATORY    5140059 0 PHOTOGRAPHY LOYOLA MOLE EVAL PER SESSION        PROCED-CASH CO250.00
AMBULATORY    5140110 0 BLEPHAROPLASTY LOWER EYELID                     PROCED-COSMETI250.00                      15820
AMBULATORY    5140111 0 BLEPHAROPLASTY UPPER EYELID                     PROCED-COSMETI250.00                      15822
AMBULATORY    5140061 0 BODY PIERCING MISC EXCEPT EAR                   PROCED-COSMETI15.00
AMBULATORY    5140045 0 BOTOX 100 UNITS FACIAL INJ COSMETIC             PROCED-COSMETI520.00
AMBULATORY    5140041 0 BOTOX 20 UNITS FACIAL INJ COSMETIC              PROCED-COSMETI120.00
AMBULATORY    5140105 0 BOTOX 30 UNITS FACIAL INJ COSMETIC              PROCED-COSMETI160.00
AMBULATORY    5140042 0 BOTOX 40 UNITS FACIAL INJ COSMETIC              PROCED-COSMETI190.00
AMBULATORY    5140043 0 BOTOX 60 UNITS FACIAL INJ COSMETIC              PROCED-COSMETI315.00
AMBULATORY    5140044 0 BOTOX 80 UNITS FACIAL INJ COSMETIC              PROCED-COSMETI415.00
AMBULATORY    5140085 0 COSMETIC DSTR BENIGN LES 1ST LES                PROCED-COSMETI62.00
AMBULATORY    5140086 0 COSMETIC DSTR BENIGN LES 2-14                   PROCED-COSMETI50.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY       OUTPT)          LML/RML     CPT
AMBULATORY    5140090 0 COSMETIC SCLEROTHER 1 THIGH MULT VEIN          PROCED-COSMETI165.00
AMBULATORY    5140092 0 COSMETIC SCLEROTHER LOWER LEG MULT VEIN        PROCED-COSMETI128.00
AMBULATORY    5140091 0 COSMETIC SCLEROTHER SAME THIGH/LEG MULT VEIN   PROCED-COSMETI240.00
AMBULATORY    5140089 0 COSMETIC SCLEROTHER SING VEIN                  PROCED-COSMETI105.00
AMBULATORY    5140087 0 COSMETIC SKIN TAG REMOV 1-15                   PROCED-COSMETI35.00
AMBULATORY    5140088 0 COSMETIC SKIN TAG REMOV EA ADDL 10             PROCED-COSMETI20.00
AMBULATORY    5140049 0 COSMODERM INJ 1 CC                             PROCED-COSMETI225.00
AMBULATORY    5140050 0 COSMODERM INJ 2 CC                             PROCED-COSMETI425.00
AMBULATORY    5140051 0 COSMODERM INJ 3 CC                             PROCED-COSMETI600.00
AMBULATORY    5140052 0 COSMOPLAST INJ 1 CC                            PROCED-COSMETI250.00
AMBULATORY    5140053 0 COSMOPLAST INJ 2 CC                            PROCED-COSMETI475.00
AMBULATORY    5140054 0 COSMOPLAST INJ 3 CC                            PROCED-COSMETI675.00
AMBULATORY    5140055 0 EAR PIERCING                                   PROCED-COSMETI10.00                        69090
AMBULATORY    5140071 0 FACIAL CONTOUR 10 THREADS                      PROCED-COSMETI1,060.00
AMBULATORY    5140072 0 FACIAL CONTOUR 12 THREADS                      PROCED-COSMETI1,260.00
AMBULATORY    5140073 0 FACIAL CONTOUR 14 THREADS                      PROCED-COSMETI1,460.00
AMBULATORY    5140074 0 FACIAL CONTOUR 16 THREADS                      PROCED-COSMETI1,660.00
AMBULATORY    5140067 0 FACIAL CONTOUR 2 THREADS                       PROCED-COSMETI250.00
AMBULATORY    5140068 0 FACIAL CONTOUR 4 THREADS                       PROCED-COSMETI450.00
AMBULATORY    5140069 0 FACIAL CONTOUR 6 THREADS                       PROCED-COSMETI650.00
AMBULATORY    5140070 0 FACIAL CONTOUR 8 THREADS                       PROCED-COSMETI850.00
AMBULATORY    5140109 0 FACIAL REJUVENATION ACUPUNCTURE 1 SESSION      PROCED-COSMETI20.00
AMBULATORY    5140094 0 GLYTONE PEEL GEL 30 FULL FACE / NECK           PROCED-COSMETI60.00
AMBULATORY    5140093 0 GLYTONE PEEL GEL 30 PARTIAL FACE / NECK        PROCED-COSMETI50.00
AMBULATORY    5140096 0 GLYTONE PEEL GEL 40 FULL FACE / NECK           PROCED-COSMETI70.00
AMBULATORY    5140095 0 GLYTONE PEEL GEL 40 PARTIAL FACE / NECK        PROCED-COSMETI54.00
AMBULATORY    5140098 0 GLYTONE PEEL GEL 50 FULL FACE / NECK           PROCED-COSMETI71.00
AMBULATORY    5140097 0 GLYTONE PEEL GEL 50 PARTIAL FACE / NECK        PROCED-COSMETI62.00
AMBULATORY    5140100 0 GLYTONE PEEL GEL 60 FULL FACE / NECK           PROCED-COSMETI71.00
AMBULATORY    5140099 0 GLYTONE PEEL GEL 60 PARTIAL FACE / NECK        PROCED-COSMETI62.00
AMBULATORY    5140102 0 GLYTONE PEEL GEL 70 FULL FACE / NECK           PROCED-COSMETI71.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE        PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY      OUTPT)          LML/RML     CPT
AMBULATORY    5140101 0 GLYTONE PEEL GEL 70 PARTIAL FACE / NECK         PROCED-COSMETI62.00
AMBULATORY    5140104 0 GLYTONE REJUVENATING PEEL PAD 40 FULL FACE / NECPROCED-COSMETI70.00
AMBULATORY    5140103 0 GLYTONE REJUVENATING PEEL PAD 40 PARTIAL FACE / PROCED-COSMETI55.00
AMBULATORY    5140056 0 HYALAFORM COSMETIC INJ 1 CC                     PROCED-COSMETI200.00
AMBULATORY    5140057 0 HYALAFORM COSMETIC INJ 2 CC                     PROCED-COSMETI325.00
AMBULATORY    5140058 0 HYALAFORM COSMETIC INJ 3 CC                     PROCED-COSMETI450.00
AMBULATORY    5140165 0 IPL TX 1/2 FACE                                 PROCED-COSMETI175.00
AMBULATORY    5140164 0 IPL TX 1/4 FACE                                 PROCED-COSMETI150.00
AMBULATORY    5140163 0 IPL TX CHEST                                    PROCED-COSMETI225.00
AMBULATORY    5140161 0 IPL TX DORSAL HAND 1                            PROCED-COSMETI150.00
AMBULATORY    5140162 0 IPL TX DORSAL HAND 2                            PROCED-COSMETI225.00
AMBULATORY    5140167 0 IPL TX FOCAL                                    PROCED-COSMETI175.00
AMBULATORY    5140166 0 IPL TX FULL FACE                                PROCED-COSMETI225.00
AMBULATORY    5140160 0 IPL TX PHOTOFACIAL                              PROCED-COSMETI225.00
AMBULATORY    5140181 0 IPL TX SMALL FOCAL AREA                         PROCED-COSMETI100.00
AMBULATORY    5140084 0 LASER KTP > 5 COSMETIC UNITS                    PROCED-COSMETI262.50
AMBULATORY    5140081 0 LASER KTP 1 COSMETIC UNIT                       PROCED-COSMETI87.50
AMBULATORY    5140082 0 LASER KTP 2-3 COSMETIC UNITS                    PROCED-COSMETI157.50
AMBULATORY    5140083 0 LASER KTP 4-5 COSMETIC UNITS                    PROCED-COSMETI192.50
AMBULATORY    5140132 0 LASER MGL HAIR REM 1/2 FACE                     PROCED-COSMETI175.00
AMBULATORY    5140131 0 LASER MGL HAIR REM 1/4 FACE                     PROCED-COSMETI150.00
AMBULATORY    5140124 0 LASER MGL HAIR REM ABDOMEN                      PROCED-COSMETI250.00
AMBULATORY    5140121 0 LASER MGL HAIR REM AXILLA                       PROCED-COSMETI225.00
AMBULATORY    5140122 0 LASER MGL HAIR REM BACK                         PROCED-COSMETI400.00
AMBULATORY    5140120 0 LASER MGL HAIR REM BEARD AREA                   PROCED-COSMETI225.00
AMBULATORY    5140127 0 LASER MGL HAIR REM BIKINI                       PROCED-COSMETI225.00
AMBULATORY    5140130 0 LASER MGL HAIR REM BILAT LOW EXTREM             PROCED-COSMETI900.00
AMBULATORY    5140123 0 LASER MGL HAIR REM CHEST                        PROCED-COSMETI300.00
AMBULATORY    5140117 0 LASER MGL HAIR REM CHIN                         PROCED-COSMETI150.00
AMBULATORY    5140134 0 LASER MGL HAIR REM FOCAL                        PROCED-COSMETI125.00
AMBULATORY    5140126 0 LASER MGL HAIR REM FOREARMS                     PROCED-COSMETI250.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY       OUTPT)          LML/RML     CPT
AMBULATORY    5140133 0 LASER MGL HAIR REM FULL FACE                    PROCED-COSMETI250.00
AMBULATORY    5140128 0 LASER MGL HAIR REM LEGS                         PROCED-COSMETI450.00
AMBULATORY    5140119 0 LASER MGL HAIR REM NECK                         PROCED-COSMETI200.00
AMBULATORY    5140125 0 LASER MGL HAIR REM SHOULDERS                    PROCED-COSMETI250.00
AMBULATORY    5140129 0 LASER MGL HAIR REM THIGHS                       PROCED-COSMETI450.00
AMBULATORY    5140118 0 LASER MGL HAIR REM UP LIP & CHIN                PROCED-COSMETI200.00
AMBULATORY    5140116 0 LASER MGL HAIR REM UPPER LIP                    PROCED-COSMETI150.00
AMBULATORY    5140186 0 LASER PHOTODYNAM THER EXT FC, NK, SHLDR, BACK   PROCED-COSMETI555.00
AMBULATORY    5140182 0 LASER PHOTODYNAM THER FOCAL FACE ACNE           PROCED-COSMETI260.00
AMBULATORY    5140183 0 LASER PHOTODYNAM THER FULL FACE                 PROCED-COSMETI300.00
AMBULATORY    5140184 0 LASER PHOTODYNAM THER FULL FACE & NECK          PROCED-COSMETI335.00
AMBULATORY    5140185 0 LASER PHOTODYNAM THER SHOULDERS                 PROCED-COSMETI360.00
AMBULATORY    5140169 0 LASER PULSE DYE TX 1/2 FACE                     PROCED-COSMETI200.00
AMBULATORY    5140168 0 LASER PULSE DYE TX 1/4 FACE                     PROCED-COSMETI150.00
AMBULATORY    5140172 0 LASER PULSE DYE TX CHEST                        PROCED-COSMETI250.00
AMBULATORY    5140171 0 LASER PULSE DYE TX DORSAL HANDS                 PROCED-COSMETI250.00
AMBULATORY    5140179 0 LASER PULSE DYE TX FOCAL AREA                   PROCED-COSMETI150.00
AMBULATORY    5140170 0 LASER PULSE DYE TX FULL FACE                    PROCED-COSMETI250.00
AMBULATORY    5140173 0 LASER PULSE DYE TX PORT WINE STAIN < 10 CM2     PROCED-COSMETI250.00
AMBULATORY    5140174 0 LASER PULSE DYE TX PORT WINE STAIN > 10 CM2     PROCED-COSMETI400.00
AMBULATORY    5140177 0 LASER PULSE DYE TX SCAR < 10 CM2                PROCED-COSMETI150.00
AMBULATORY    5140178 0 LASER PULSE DYE TX SCAR > 10 CM2                PROCED-COSMETI200.00
AMBULATORY    5140180 0 LASER PULSE DYE TX SMALL FOCAL AREA             PROCED-COSMETI100.00
AMBULATORY    5140175 0 LASER PULSE DYE TX STRIAE < 10 CM2              PROCED-COSMETI200.00
AMBULATORY    5140176 0 LASER PULSE DYE TX STRIAE > 10 CM2              PROCED-COSMETI250.00
AMBULATORY    5140151 0 LASER YAG HAIR REM 1/2 FACE                     PROCED-COSMETI175.00
AMBULATORY    5140150 0 LASER YAG HAIR REM 1/4 FACE                     PROCED-COSMETI150.00
AMBULATORY    5140143 0 LASER YAG HAIR REM ABDOMEN                      PROCED-COSMETI250.00
AMBULATORY    5140140 0 LASER YAG HAIR REM AXILLA                       PROCED-COSMETI225.00
AMBULATORY    5140141 0 LASER YAG HAIR REM BACK                         PROCED-COSMETI400.00
AMBULATORY    5140139 0 LASER YAG HAIR REM BEARD AREA                   PROCED-COSMETI225.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                               CHARGE        PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY      OUTPT)           LML/RML    CPT
AMBULATORY    5140146 0 LASER YAG HAIR REM BIKINI                        PROCED-COSMETI225.00
AMBULATORY    5140149 0 LASER YAG HAIR REM BILAT LOW EXTREM              PROCED-COSMETI900.00
AMBULATORY    5140142 0 LASER YAG HAIR REM CHEST                         PROCED-COSMETI300.00
AMBULATORY    5140136 0 LASER YAG HAIR REM CHIN                          PROCED-COSMETI150.00
AMBULATORY    5140153 0 LASER YAG HAIR REM FOCAL                         PROCED-COSMETI125.00
AMBULATORY    5140145 0 LASER YAG HAIR REM FOREARMS                      PROCED-COSMETI250.00
AMBULATORY    5140152 0 LASER YAG HAIR REM FULL FACE                     PROCED-COSMETI250.00
AMBULATORY    5140147 0 LASER YAG HAIR REM LEGS                          PROCED-COSMETI450.00
AMBULATORY    5140138 0 LASER YAG HAIR REM NECK                          PROCED-COSMETI200.00
AMBULATORY    5140144 0 LASER YAG HAIR REM SHOULDERS                     PROCED-COSMETI250.00
AMBULATORY    5140148 0 LASER YAG HAIR REM THIGHS                        PROCED-COSMETI450.00
AMBULATORY    5140137 0 LASER YAG HAIR REM UP LIP & CHIN                 PROCED-COSMETI200.00
AMBULATORY    5140135 0 LASER YAG HAIR REM UPPER LIP                     PROCED-COSMETI150.00
AMBULATORY    5140159 0 LASER YAG SKIN TIGHTENING DORSAL HANDS           PROCED-COSMETI150.00
AMBULATORY    5140157 0 LASER YAG SKIN TIGHTENING FACE                   PROCED-COSMETI188.00
AMBULATORY    5140158 0 LASER YAG SKIN TIGHTENING FACE & NECK            PROCED-COSMETI225.00
AMBULATORY    5140155 0 LASER YAG VEIN REM 1 LEG                         PROCED-COSMETI250.00
AMBULATORY    5140156 0 LASER YAG VEIN REM 2 LEGS                        PROCED-COSMETI350.00
AMBULATORY    5140154 0 LASER YAG VEIN REM FOCAL VEIN                    PROCED-COSMETI125.00
AMBULATORY    5140108 0 LIPIVAGE SYSTEM FAT ASP / INJ                    PROCED-COSMETI273.00
AMBULATORY    5140106 0 PILLAR IMPLANT PROCEDURE                         PROCED-COSMETI850.00
AMBULATORY    5140063 0 RADIESSE COSMETIC INJ 1.3 CC                     PROCED-COSMETI400.00
AMBULATORY    5140064 0 RADIESSE COSMETIC INJ 2.6 CC                     PROCED-COSMETI600.00
AMBULATORY    5140065 0 RADIESSE COSMETIC INJ 3.9 CC                     PROCED-COSMETI800.00
AMBULATORY    5140066 2 RADIESSE COSMETIC INJ TOUCH-UP (WITHIN 2 MOS OF OPROCED-COSMETISTATISTICAL ITEM
AMBULATORY    5140115 0 RESTYLANE 0.4 CC COSMETIC INJ                    PROCED-COSMETI217.00
AMBULATORY    5140112 0 RESTYLANE 1 CC COSMETIC INJ                      PROCED-COSMETI288.00
AMBULATORY    5140113 0 RESTYLANE 2 CC COSMETIC INJ                      PROCED-COSMETI576.00
AMBULATORY    5140114 0 RESTYLANE 3 CC COSMETIC INJ                      PROCED-COSMETI864.00
AMBULATORY    5190234 0 ABDOMINAL BINDER EA ALL SIZES                    SUPPLY        53.05
AMBULATORY    5190556 0 ACE BANDAGE WRAP 2 IN                            SUPPLY        14.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190537 0 ACE BANDAGE WRAP 3 IN                 SUPPLY     14.00
AMBULATORY    5190538 0 ACE BANDAGE WRAP 4 IN                 SUPPLY     14.00
AMBULATORY    5190548 0 ACE BANDAGE WRAP 6 IN                 SUPPLY     14.00
AMBULATORY    5180187 0 AEROCHAMBER NO MASK                   SUPPLY     30.90
AMBULATORY    5180189 0 AEROCHAMBER W/LARGE MASK              SUPPLY     68.00
AMBULATORY    5180190 0 AEROCHAMBER W/MEDIUM MASK             SUPPLY     68.00
AMBULATORY    5180188 0 AEROCHAMBER W/SMALL MASK              SUPPLY     68.00
AMBULATORY    5190778 0 AMNIOTIC MEMBREANE TISS (PROKERA)     SUPPLY     1,675.00                    V2790
AMBULATORY    5190501 0 ANKLE ACTIVE BRACE (SPORTS MED)       SUPPLY     60.80                       L1906
AMBULATORY    5190054 0 ANKLE AIR CAST                        SUPPLY     78.00                       L4350
AMBULATORY    5190005 0 ANKLE BRACE VELCRO CANVAS             SUPPLY     38.30
AMBULATORY    5190119 0 ANKLE GEL BRACE                       SUPPLY     64.20                       L1902
AMBULATORY    5190003 0 ANKLE SLEEVE ELASTIC                  SUPPLY     12.30
AMBULATORY    5190502 0 ANKLE SLEEVE GEL MALLEOTRAIN          SUPPLY     106.40                      L1906
AMBULATORY    5190006 0 ARM BAND PNEUMATIC                    SUPPLY     79.30
AMBULATORY    5190153 0 ARM ELEVATOR-GARDNER SLING            SUPPLY     12.30                       L3908
AMBULATORY    5190709 0 ARM IMMOBIL NEWBRN 1 PR OPHTH         SUPPLY     35.00
AMBULATORY    5190192 0 ASPIRATOR OB/GYN                      SUPPLY     187.80
AMBULATORY    5190047 0 BAG DRAINAGE LARGE                    SUPPLY     10.10
AMBULATORY    5190046 0 BAG DRAINAGE MED                      SUPPLY     10.10
AMBULATORY    5190727 0 BAG NEPHROSTOMY EA                    SUPPLY     25.80
AMBULATORY    5190736 0 BAG OVERNIGHT URINE BAG               SUPPLY     5.60
AMBULATORY    5190783 0 BELLY BAG URINARY DRNGE BAG 1000 CC   SUPPLY     49.90
AMBULATORY    5190015 0 BONE SPUR PAD (EA)                    SUPPLY     22.50
AMBULATORY    5190283 0 BRA FORESTER SUPPORT                  SUPPLY     112.89
AMBULATORY    5190011 0 BRA SLEEP POST RECONSTR / REDUCT EA   SUPPLY     18.20
AMBULATORY    5190762 0 BRACE ELBOW MAYO CLINIC               SUPPLY     1,050.30                    L3760
AMBULATORY    5190530 0 BRACE HIP ABDUCTION (PEDS)            SUPPLY     148.60
AMBULATORY    5190529 0 BRACE HUMERAL FRACTURE (EA)           SUPPLY     202.60
AMBULATORY    5190758 0 BRACE THUMB COLLUM CMC                SUPPLY     50.00
AMBULATORY    5190134 0 BRACE TIBIA FRACTURE EA               SUPPLY     403.10                      L2114
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190541 0 BRACE TIBIA MIAMI ABOVE KNEE             SUPPLY     281.40                      L2116
AMBULATORY    5190638 0 BRACE TIBIA MIAMI BELOW KNEE             SUPPLY     281.40                      L2114
AMBULATORY    5190425 0 BRACE ULTRASLING ER (DON JOY) EA         SUPPLY     177.90                      L3670
AMBULATORY    5190235 0 BREAST SHIELDS (2)                       SUPPLY     14.01
AMBULATORY    5190017 0 BUNION SPLINT EACH                       SUPPLY     14.60
AMBULATORY    5190040 0 BUTTON SEPTAL                            SUPPLY     406.20
AMBULATORY    5190020 0 BUTTON TRACH (OLYMPIC) ALL SIZES         SUPPLY     324.70
AMBULATORY    5190500 0 CANE METAL ADJUSTABLE                    SUPPLY     20.30
AMBULATORY    5190554 0 CAST LINER GORTEX                        SUPPLY     61.20
AMBULATORY    5190551 0 CAST SHIELD SHOWER                       SUPPLY     45.90
AMBULATORY    5190550 0 CAST TAPE ROLL SINGLE                    SUPPLY     17.50
AMBULATORY    5190549 0 CAST WEDGE                               SUPPLY     32.80
AMBULATORY    5190058 0 CATH URETHRAL COUDE-ALL SIZES            SUPPLY     10.70
AMBULATORY    5190355 0 CATH URETHRAL FOLEY ALL SIZES            SUPPLY     3.40
AMBULATORY    5190060 0 CATH URETHRAL SELF CATH ALL SZ           SUPPLY     3.40
AMBULATORY    5190745 0 CATHETER EPIDURAL DUPENS                 SUPPLY     1,100.00                    C1755
AMBULATORY    5190302 0 CATHETER TRIPLE LUMEN KIT                SUPPLY     92.70                       C1751
AMBULATORY    5190618 0 CAUTERY DISP STERILE EACH                SUPPLY     15.20
AMBULATORY    5190160 0 CLAVICLE STRAP                           SUPPLY     10.20                       L3660
AMBULATORY    5190540 0 COBAN - SELF ADHESIVE WRAP               SUPPLY     6.80
AMBULATORY    5190751 0 COLLAGEN INJ 2.5CC URINARY TRACT         SUPPLY     741.70                      L8603
AMBULATORY    5190050 0 COLLAR CERV ASPEN ADLT REG               SUPPLY     75.80
AMBULATORY    5190049 0 COLLAR CERV ASPEN ADLT SHRT              SUPPLY     75.80
AMBULATORY    5190051 0 COLLAR CERV ASPEN ADLT TALL              SUPPLY     75.80
AMBULATORY    5190052 0 COLLAR CERV ASPEN ADLT X-TALL            SUPPLY     80.00
AMBULATORY    5190028 0 COLLAR CERVICAL FOAM                     SUPPLY     8.96
AMBULATORY    5190303 0 CONTIGEN SKIN TEST KIT EA                SUPPLY     123.60                      Q3031
AMBULATORY    5190737 0 CONVATEC WAFER W/ BAG EA (ACTIVE LIFE)   SUPPLY     5.40
AMBULATORY    5190032 0 CRUTCH ADULT EACH                        SUPPLY     40.50                       E0114
AMBULATORY    5190516 0 CRUTCH HANDGRIP (EACH)                   SUPPLY     11.20
AMBULATORY    5190514 0 CRUTCH TIPS (EACH)                       SUPPLY     9.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190515 0 CRUTCH UNDERARM PADS (EA)                  SUPPLY     12.30
AMBULATORY    5190031 0 CRUTCH YOUTH EACH                          SUPPLY     40.50                       E0114
AMBULATORY    5190787 0 CYSTOGRAFFIN CONTRAST 300 ML VIA BLADDER   SUPPLY     117.60
AMBULATORY    5190658 0 DECANN STOPPER                             SUPPLY     28.90
AMBULATORY    5190995 0 DERMAGRAFT PER SQ CM                       SUPPLY     33.60                       J7342
AMBULATORY    5190647 0 DIAB ORTHO ANTISHX CNFM NO-GEL             SUPPLY     13.10
AMBULATORY    5190646 0 DIAB ORTHO ANTISHX CNFRM GEL               SUPPLY     16.30
AMBULATORY    5190065 0 DILATOR VAGINAL                            SUPPLY     120.20
AMBULATORY    5190729 0 DOME PASTE BANDAGE EA                      SUPPLY     19.10
AMBULATORY    5190048 0 DRAIN RESERVOIR 100CC (JP BULB)            SUPPLY     14.00
AMBULATORY    5190066 0 DRESSING FIBRA COLLAGEN ALGIN              SUPPLY     37.69
AMBULATORY    5190730 0 DRSG ABD PAD 5X9 EA                        SUPPLY     3.10
AMBULATORY    5190763 0 DRSG ACTISORB SILVER 2X3 EA                SUPPLY     10.50                       A6206
AMBULATORY    5190764 0 DRSG ACTISORB SILVER 4X4 EA                SUPPLY     17.00                       A6207
AMBULATORY    5190718 0 DRSG ADAPTIC 3 X 8 EA                      SUPPLY     4.10
AMBULATORY    5190719 0 DRSG ADAPTIC 3X16 EA                       SUPPLY     3.60
AMBULATORY    5190717 0 DRSG ADAPTIC 3X3 EA                        SUPPLY     3.10
AMBULATORY    5190521 0 DRSG ALGISITE 3/4 X 12" ROPE EA            SUPPLY     14.75
AMBULATORY    5190772 0 DRSG AQUOCEL AG 6 X 6 EA                   SUPPLY     64.15
AMBULATORY    5190557 0 DRSG BIOPATCH ANTIMICROB EA                SUPPLY     14.00
AMBULATORY    5190733 0 DRSG BURN ACTICOAT 16X16                   SUPPLY     210.20
AMBULATORY    5190734 0 DRSG BURN ACTICOAT 4X48                    SUPPLY     214.10
AMBULATORY    5190732 0 DRSG BURN ACTICOAT 8X16                    SUPPLY     104.40
AMBULATORY    5190622 0 DRSG CHANGE KIT CNTR LINE PEDS             SUPPLY     8.70
AMBULATORY    5190621 0 DRSG CHNG KIT CNTR LINE ADULT              SUPPLY     4.80
AMBULATORY    5190199 0 DRSG EAR POPE OTOWICK (MEROCEL)            SUPPLY     16.65
AMBULATORY    5190722 0 DRSG GAUZE VASELINE 1X8 EA                 SUPPLY     3.10
AMBULATORY    5190724 0 DRSG GAUZE VASELINE 3X18 EA                SUPPLY     10.00
AMBULATORY    5190723 0 DRSG GAUZE VASELINE 3X9 EA                 SUPPLY     3.10
AMBULATORY    5190774 0 DRSG POLYMEM 4 X 12 ROLL EA                SUPPLY     34.45
AMBULATORY    5190775 0 DRSG POLYMEM 4 X 24 ROLL EA                SUPPLY     67.65
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190739 0 DRSG PROMOGRAN HEAVY EXUD EA       SUPPLY     50.50
AMBULATORY    5190740 0 DRSG PROMOGRAN LITE/MED EXUD EA    SUPPLY     19.00
AMBULATORY    5190769 0 DRSG SILVERCELL 3 X 4 EA           SUPPLY     42.00
AMBULATORY    5190113 0 DRSG SORBSAN TOPICAL 4X4 EA        SUPPLY     16.50                       A6196
AMBULATORY    5190742 0 DRSG SURGICEL 3 X 5 EA             SUPPLY     33.00
AMBULATORY    5190743 0 DRSG SURGICEL 4 X 8 EA             SUPPLY     128.10
AMBULATORY    5190761 0 DRSG TELFA 3 X 6 EA                SUPPLY     2.50
AMBULATORY    5190055 0 DRSG VIGILON 4X4 EA                SUPPLY     13.68
AMBULATORY    5190558 0 DRSG WOUND MATRIX OASIS 3 X 3 EA   SUPPLY     60.00
AMBULATORY    5190746 0 DRSG WOUND MATRIX OASIS 3 X 7 EA   SUPPLY     116.20
AMBULATORY    5190410 0 DRSG WOUND PRISMA EA               SUPPLY     34.30
AMBULATORY    5190721 0 DRSG XEROFORM 1 X 8 EA             SUPPLY     3.10
AMBULATORY    5190720 0 DRSG XEROFORM 5X9 EA               SUPPLY     3.10
AMBULATORY    5190614 0 DUODERM (6X6) EACH                 SUPPLY     16.50
AMBULATORY    5190615 0 DUODERM (8X8) EACH                 SUPPLY     27.40
AMBULATORY    5181188 0 DURASPHERE-EXP 1 ML VIAL INJ       SUPPLY     426.00                      L8606
AMBULATORY    5190648 0 ELBOW ORTHOSIS FLEX CUFF           SUPPLY     213.00                      L3760
AMBULATORY    5190773 0 ELTA 2.8 OZ SKIN CREAM             SUPPLY     11.15
AMBULATORY    5190635 0 ENEMA FLEETS                       SUPPLY     7.31
AMBULATORY    5190776 0 FILTER LEUKOCYTE PLATELET          SUPPLY     69.16
AMBULATORY    5190777 0 FILTER LEUKOCYTE RED CELL          SUPPLY     45.20
AMBULATORY    5125039 0 FLUTTER VALVE EA                   SUPPLY     225.20
AMBULATORY    5190602 0 FOIL EYE                           SUPPLY     6.80
AMBULATORY    5190996 0 FOOT DROP STOP HEEL PROTECTOR      SUPPLY     76.00
AMBULATORY    5190525 0 FOOT INSERT TOTL VISCOPED (EA)     SUPPLY     111.50
AMBULATORY    5190645 0 FOOT POD METATARSAL FELT EA        SUPPLY     3.30
AMBULATORY    5190607 0 GAUZE 1 BOX 2X2'S (PKG OF 75)      SUPPLY     3.30
AMBULATORY    5190606 0 GAUZE 1BOX 4X4'S (PKG OF 30)       SUPPLY     3.30
AMBULATORY    5190605 0 GAUZE IODAFORM (1 BTLE)            SUPPLY     7.10
AMBULATORY    5190604 0 GAUZE NU PLAIN (1 BTLE)            SUPPLY     9.90
AMBULATORY    5190095 0 GEL FOAM SPONGE PAD EA ALL SIZES   SUPPLY     30.55
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190081 0 GELFOAM STERILE POWDER              SUPPLY     120.70
AMBULATORY    5190738 0 GUIDEWIRE UROLOGY PROC              SUPPLY     40.20                       C1769
AMBULATORY    5190162 0 HARNESS PAVLIK PEDS                 SUPPLY     103.50
AMBULATORY    5190559 0 HEEL INSERT GEL VISCOHEEL K         SUPPLY     53.20
AMBULATORY    5190524 0 HEEL INSERT GEL VISCOSPOT EA        SUPPLY     63.00
AMBULATORY    5190102 0 HEEL LIFT CLOTH EA                  SUPPLY     3.40
AMBULATORY    5190782 0 HEEL LIFT FOAM EA                   SUPPLY     4.00
AMBULATORY    5190636 0 HIBICLENS 4OZ BTLE                  SUPPLY     11.20
AMBULATORY    5190767 0 HORIZONTAL PRISM BAR REG            SUPPLY     233.40
AMBULATORY    5190757 0 HOT PACK (INSTANT) EA - ALL SIZES   SUPPLY     10.95
AMBULATORY    5190627 0 HYDROGEN PEROX 3% BTLE 470ML        SUPPLY     3.30
AMBULATORY    5190023 0 HYPAFIX ROLL 2 IN X 10 YD EA        SUPPLY     32.20
AMBULATORY    5190021 0 HYPAFIX ROLL 4 IN X 10 YD EA        SUPPLY     45.00
AMBULATORY    5190022 0 HYPAFIX ROLL 6 IN X 10 YD EA        SUPPLY     57.30
AMBULATORY    5190033 0 IMMOBILIZER SHOULDER                SUPPLY     47.40                       L3670
AMBULATORY    5190770 0 INSOLES APEX 1 PR                   SUPPLY     35.30
AMBULATORY    5190528 0 INSOLES SHOCK ABS W/RAISE HEEL      SUPPLY     36.10
AMBULATORY    5190527 0 INSOLES SHOCK ABSORB (EA)           SUPPLY     33.80
AMBULATORY    5180545 0 IV 0.45% NACL 500 ML                SUPPLY     30.90                       J7042
AMBULATORY    5190609 0 KERLIX ROLL EACH                    SUPPLY     3.30
AMBULATORY    5190409 0 KIT STOOL COLLECTION                SUPPLY     45.73
AMBULATORY    5190209 0 KLING GAUZE 2 INCH OR 3 INCH EA     SUPPLY     2.00
AMBULATORY    5190637 0 KNEE BRACE HINGE STAB SLEEVE        SUPPLY     281.40                      L1815
AMBULATORY    5190506 0 KNEE BRACE HINGE STABILIZ LONG      SUPPLY     222.80                      L1880
AMBULATORY    5190510 0 KNEE BRACE HINGE STABILIZE          SUPPLY     281.40
AMBULATORY    5190090 0 KNEE BRACE MULTIFUNCTIONAL          SUPPLY     225.20                      L1880
AMBULATORY    5190639 0 KNEE BRACE PULLS                    SUPPLY     90.20                       L2800
AMBULATORY    5190164 0 KNEE IMMOBILIZER (ANY ADULT SZ)     SUPPLY     186.83                      L1845
AMBULATORY    5190545 0 KNEE IMMOBILIZER PEDS ONLY          SUPPLY     186.83                      L1830
AMBULATORY    5190503 0 KNEE SLEEVE GEL GENUTRAIN           SUPPLY     106.40                      L1815
AMBULATORY    5190504 0 KNEE SLEEVE GEL W/DOUBLE STAY       SUPPLY     211.20                      L1815
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190507 0 KNEE SLEEVE OPEN PATELLA                    SUPPLY     134.03                      L1825
AMBULATORY    5190157 0 KNEE STRAP                                  SUPPLY     17.00
AMBULATORY    5190753 0 KNEE SUPPORT ACTIVE GENUTRAIN P3            SUPPLY     136.00
AMBULATORY    5190509 0 KNEE SUPPORT NO HING XXXL ONLY              SUPPLY     96.80
AMBULATORY    5190508 0 KNEE SUPPORT NO HINGE                       SUPPLY     231.51                      L1810
AMBULATORY    5190505 0 KNEE WRAP PORTION                           SUPPLY     142.15                      L1800
AMBULATORY    5190731 0 LAC - SOFT FEEDER                           SUPPLY     30.00
AMBULATORY    5190694 0 LAC-BREAST PUMP MANUAL                      SUPPLY     45.98                       E0602
AMBULATORY    5190692 0 LAC-BREAST SHELLS                           SUPPLY     26.10
AMBULATORY    5190691 0 LAC-DOUBL PUMP ADAPTR KIT                   SUPPLY     70.14
AMBULATORY    5190690 0 LAC-DOUBLE PUMP KIT                         SUPPLY     55.00
AMBULATORY    5190695 0 LAC-NIPPLE SHIELD NEWBORN                   SUPPLY     10.00
AMBULATORY    5190688 0 LAC-NIPPLE SHIELD SMALL                     SUPPLY     10.00
AMBULATORY    5190685 0 LAC-REGULAR SUPPLEMENT NSG SYS              SUPPLY     62.86
AMBULATORY    5190754 0 LASER PV ABLATION CATH VEIN OBLIT           SUPPLY     340.00                      C1888
AMBULATORY    5190755 0 LASER PV GUIDEWIRE VEIN OBLIT               SUPPLY     340.00
AMBULATORY    5190756 0 LASER PV SHEATH/INTRODUC VEIN OBLIT         SUPPLY     340.00
AMBULATORY    5190110 0 LEG BAG URINE                               SUPPLY     17.50
AMBULATORY    5190111 0 LEG STRAP FOR URINARY CATH (PT TAKE HOME)   SUPPLY     15.20
AMBULATORY    5190381 0 LIMB STAT                                   SUPPLY     657.60
AMBULATORY    5190112 0 MARKER SURGICAL                             SUPPLY     7.93
AMBULATORY    5190207 0 MASK DISP 1 BOX (PT TAKE HOME)              SUPPLY     11.00
AMBULATORY    5190747 0 MICROWICK SILVERSTEIN EA                    SUPPLY     152.00
AMBULATORY    5190608 0 MONTGOMERY STRAP (EA)                       SUPPLY     3.30
AMBULATORY    5190759 0 NEEDLE 18G FOR DURASPHERE INJ EA            SUPPLY     47.30
AMBULATORY    5190780 0 NEEDLE 25G FOR TEGRESS INJ                  SUPPLY     70.00
AMBULATORY    5190619 0 NEEDLE 90 DEG NON-KOR (EACH)                SUPPLY     7.60
AMBULATORY    5190007 0 NEEDLE WOLF 22G UROGYNE                     SUPPLY     87.00
AMBULATORY    5190167 0 NRSER BTL CLEFT LP/PAL (PER BOX OF 6)       SUPPLY     30.90
AMBULATORY    5190784 0 OMNIPAQUE 180 MG IODINE/ML 1 ML INJ         SUPPLY     4.45                        Q9946
AMBULATORY    5190643 0 ORTHOTIC ANTISHX CNFRM GEL EA               SUPPLY     16.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190644 0 ORTHOTIC ANTISHX CNFRM NO-GEL             SUPPLY     13.10
AMBULATORY    5120208 0 ORTHOTIC FOOT MOLDS                       SUPPLY     281.40
AMBULATORY    5190526 0 ORTHOTIC INSERT STYROFOAM (EA)            SUPPLY     15.70
AMBULATORY    5190552 0 ORTHOTICS REFURBISH                       SUPPLY     105.00
AMBULATORY    5190010 0 OSTOMY SURFIT IRRIG SLEEVE 1 3/4"         SUPPLY     10.10
AMBULATORY    5190009 0 OSTOMY SURFIT WAFER 1 3/4" EA             SUPPLY     6.00
AMBULATORY    5190008 0 OSTOMY SURFIT WAFER 1 3/4" PER BX OF 10   SUPPLY     46.30
AMBULATORY    5190360 0 OVU STICK                                 SUPPLY     138.60
AMBULATORY    5120043 0 OXYGEN ADMINISTRATION                     SUPPLY     44.50
AMBULATORY    5190601 0 PATCH SOFT EYE                            SUPPLY     4.40
AMBULATORY    5190306 0 PATIENT PROGRAMMER NEUROSTIMULATOR        SUPPLY     1,532.12
AMBULATORY    5190206 0 PEAK FLOW METER EA (ALL SIZES)            SUPPLY     23.40
AMBULATORY    5190130 0 PESSARY NON RUBBER ANY TYPE               SUPPLY     117.40                      A4562
AMBULATORY    5190765 0 PLEURAL CATH DRNGE LINE SET REPLCMT       SUPPLY     50.00
AMBULATORY    5190630 0 POLYMEM DRESSING PER SHEET                SUPPLY     16.50
AMBULATORY    5190600 0 PRISM FRESNEL                             SUPPLY     31.50
AMBULATORY    5190131 0 RACZ CATHETER W/ INTRODUCER               SUPPLY     180.75
AMBULATORY    5190625 0 SALINE 0.9% POUR BOTTLE 1000ML            SUPPLY     3.30
AMBULATORY    5190725 0 SALINE 0.9% POUR BTLE 500 CC              SUPPLY     3.30
AMBULATORY    5190120 0 SCROTAL SUPPORT ANY SIZE EA               SUPPLY     13.39
AMBULATORY    5190624 0 SHIELD EYE METAL (EA)                     SUPPLY     3.30
AMBULATORY    5190519 0 SHOE ADULT CANVAS CAST (EA)               SUPPLY     17.00
AMBULATORY    5190025 0 SHOE CAST EACH                            SUPPLY     12.30
AMBULATORY    5190518 0 SHOE DIABETIC PRESS Ea Non-Custom         SUPPLY     112.60
AMBULATORY    5190520 0 SHOE PED CANVAS CAST (EA)                 SUPPLY     17.00
AMBULATORY    5190640 0 SHOE POST OP FEMALE                       SUPPLY     13.60
AMBULATORY    5190523 0 SHOE POST-OP MALE                         SUPPLY     13.60
AMBULATORY    5190546 0 SHOE POST-OP PEDS ONLY                    SUPPLY     14.60
AMBULATORY    5190517 0 SHOE WEDGE POSTOP (EA)                    SUPPLY     20.30
AMBULATORY    5190236 0 SILICONE REINFORCED SHEET Ea              SUPPLY     55.62
AMBULATORY    5190536 0 SLEEVE ELBOW GEL EPITRAIN                 SUPPLY     106.40
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190237 0 SLEEVES PEDIFORM                    SUPPLY     8.44
AMBULATORY    5190038 0 SLING ARM ADULT                     SUPPLY     11.20
AMBULATORY    5190533 0 SLING ARM PED MEDIUM                SUPPLY     19.10
AMBULATORY    5190210 0 SLIPPER SOCK MOLD EA PODIATRY       SUPPLY     27.40
AMBULATORY    5190238 0 SMELL IDENTIFICATION KIT            SUPPLY     58.00
AMBULATORY    5180062 0 SODIUM CHLORIDE .9% BTL 1000ML      SUPPLY     27.40
AMBULATORY    5180067 0 SODIUM CHLORIDE .9% BTL 500ML       SUPPLY     27.40
AMBULATORY    5190169 0 SOFT SIPP BOTTLE EA                 SUPPLY     14.60
AMBULATORY    5190241 0 SPECULUM VAGINAL DISP MED           SUPPLY     3.10
AMBULATORY    5190242 0 SPECULUM VAGINAL DISP SM            SUPPLY     3.10
AMBULATORY    5190532 0 SPLINT CARPAL TUNNEL                SUPPLY     40.50
AMBULATORY    5190553 0 SPLINT FINGER                       SUPPLY     6.60
AMBULATORY    5190285 0 SPLINT NASAL                        SUPPLY     13.50
AMBULATORY    5190544 0 SPLINT PEDS FOREARM & WRIST         SUPPLY     36.00
AMBULATORY    5190531 0 SPLINT TENNIS ELBOW                 SUPPLY     46.10
AMBULATORY    5190535 0 SPLINT WRIST PEDS                   SUPPLY     28.20                       L3908
AMBULATORY    5190266 0 SPLINT WRIST PROFLEX                SUPPLY     28.20                       L3908
AMBULATORY    5190617 0 STAPLE REMOVER SET DISP EA          SUPPLY     7.80
AMBULATORY    5190620 0 STERISTRIP (1PKG) ALL SIZES         SUPPLY     3.30
AMBULATORY    5190766 0 STOCKINETTE PER PIECE EA            SUPPLY     3.00
AMBULATORY    5190168 0 STOCKING EMBOLISM (TEDS) 1 PAIR     SUPPLY     11.31
AMBULATORY    5190208 0 STOMAHESIVE PASTE                   SUPPLY     20.30
AMBULATORY    5190786 0 STRAINER URINE (PT TAKE HOME)       SUPPLY     10.50
AMBULATORY    5190616 0 SUTURE REMOVAL SET EACH             SUPPLY     4.30
AMBULATORY    5190555 0 TAPE PAPER 1 ROLL ANY SIZE          SUPPLY     3.30
AMBULATORY    5190012 0 TEF-CATH FOR TRIAL TRANSFER (REI)   SUPPLY     42.00
AMBULATORY    5190610 0 TEGADERM (1X1) EACH                 SUPPLY     3.30
AMBULATORY    5190611 0 TEGADERM (2X2) EACH                 SUPPLY     3.30
AMBULATORY    5190612 0 TEGADERM (4X4) EACH                 SUPPLY     3.30
AMBULATORY    5190613 0 TEGADERM (8X12) EACH                SUPPLY     5.60
AMBULATORY    5190779 0 TEGRESS 1 ML URETH IMPLANT INJ      SUPPLY     502.00                      L8606
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
AMBULATORY    5190628 0 THERABITE (JAW MOTION REHAB)     SUPPLY     708.00
AMBULATORY    5190696 0 TISSUE EXPANDER (CYMETRA) 1ML    SUPPLY     569.59
AMBULATORY    5190251 0 TOE SEPARATOR                    SUPPLY     30.50
AMBULATORY    5120007 0 TRACH BUTTON, OLYMPIC            SUPPLY     116.70
AMBULATORY    5190781 0 TRACH CANNULA SET LONG TERM      SUPPLY     229.00
AMBULATORY    5190659 0 TRACH CUSTOM                     SUPPLY     560.00
AMBULATORY    5190291 0 TRACH FENESTRATED CUFFED         SUPPLY     70.00
AMBULATORY    5190656 0 TRACH FENESTRATED CUFFLESS       SUPPLY     59.70
AMBULATORY    5190254 0 TRACH METAL                      SUPPLY     288.60
AMBULATORY    5190256 0 TRACH STOMA BIB                  SUPPLY     36.20
AMBULATORY    5190657 0 TRACH TUBE PEDS (ALL SIZES)      SUPPLY     53.60
AMBULATORY    5190768 0 TRACH TUBE SHILEY ALL SIZES      SUPPLY     90.80
AMBULATORY    5190408 0 TRACTION CERV OVER DOOR          SUPPLY     26.57
AMBULATORY    5190094 0 TRAY IRRIG W/PISTON SYRINGE      SUPPLY     7.93
AMBULATORY    5190760 0 TRAY PUDENDAL                    SUPPLY     19.30
AMBULATORY    5190092 0 TRAY URINARY CATH KIT W/FOLEY    SUPPLY     53.40
AMBULATORY    5190093 0 TRAY URINARY STRGHT CATH KIT     SUPPLY     14.60
AMBULATORY    5190632 0 URINAL (EA)                      SUPPLY     3.60
AMBULATORY    5190631 0 URINE HAT (FEMALE)               SUPPLY     3.30
AMBULATORY    5190989 0 VAD REPL BATTERY CLIP EA         SUPPLY     380.00                      Q0497
AMBULATORY    5190990 0 VAD REPL BATTERY HOLSTER EA      SUPPLY     417.00                      Q0498
AMBULATORY    5190984 0 VAD REPL DISPLAY MODULE          SUPPLY     5,908.00                    Q0484
AMBULATORY    5190987 0 VAD REPL EMERG HAND PUMP         SUPPLY     528.00                      Q0494
AMBULATORY    5190986 0 VAD REPL EMERG POWER PACK        SUPPLY     1,794.00                    Q0491
AMBULATORY    5190988 0 VAD REPL HEARTMATE BATTERY EA    SUPPLY     317.00                      Q0496
AMBULATORY    5190993 0 VAD REPL NIGHT BELT EA           SUPPLY     475.00                      Q0505
AMBULATORY    5190994 0 VAD REPL POCKET PAK EA           SUPPLY     242.00                      Q0505
AMBULATORY    5190985 0 VAD REPL POWER BASE UNIT         SUPPLY     26,375.00                   Q0489
AMBULATORY    5190991 0 VAD REPL STABILIZATION BELT EA   SUPPLY     139.00                      Q0499
AMBULATORY    5190983 0 VAD REPL SYSTEM CONTROLLER       SUPPLY     7,385.00                    Q0482
AMBULATORY    5190992 0 VAD REPL VENT FILTER EA          SUPPLY     76.00                       Q0500
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY       OUTPT)          LML/RML     CPT
AMBULATORY    5190511 0 WALKER BODY ARMOR                   SUPPLY         134.69                      L4386
AMBULATORY    5190512 0 WALKER BODY ARMOUR (EQUALIZER)      SUPPLY         134.69                      L4386
AMBULATORY    5190513 0 WALKER LINERS (EA)                  SUPPLY         22.50
AMBULATORY    5190543 0 WALKER PNEUMATIC AIRCAST            SUPPLY         273.20                      L4360
AMBULATORY    5190261 0 WALKER SHORTIE                      SUPPLY         134.69                      L4386
AMBULATORY    5190265 0 WALKER SLIM LINE                    SUPPLY         207.60                      L4386
AMBULATORY    5190547 0 WALKER WEE (PEDS)                   SUPPLY         101.40                      L2116
AMBULATORY    5190539 0 WALKING HEELS FOR CAST (EA)         SUPPLY         11.20
AMBULATORY    5190726 0 WATER STERIL POUR BTL 500 CC        SUPPLY         3.30
AMBULATORY    5190626 0 WATER STERILE POUR BTLE 1000ML      SUPPLY         3.30
AMBULATORY    5190678 0 WOUND ADHESIVE (DERMABOND) 1VIAL    SUPPLY         54.07
AMBULATORY    5140048 0 ANKLE THERAPY KIT                   SUPPLY-CASH CO 132.00
AMBULATORY    5140060 0 FACIAL COMPRESSION BAND             SUPPLY-CASH CO 40.00
AMBULATORY    5140001 0 AHA LIP CONDIT 4% SPF 15            SUPPLY-COSMETI 7.60
AMBULATORY    5140002 0 AHA SKIN SMOOTH CRM 8% 1.75 OZ      SUPPLY-COSMETI 22.10
AMBULATORY    5140003 0 AHA SKIN SMOOTH LOTN 10% 6.8 OZ     SUPPLY-COSMETI 24.80
AMBULATORY    5140004 0 DAILY SUN DEFENSE SPF 20            SUPPLY-COSMETI 32.40
AMBULATORY    5140005 0 DAILY UV DEFENSE SPF 30             SUPPLY-COSMETI 38.90
AMBULATORY    5140006 0 DAY PROTECT CRM 4% SPF 15 1.75 OZ   SUPPLY-COSMETI 32.40
AMBULATORY    5140007 0 DLY UV DEFENSE SPRT SPF 45          SUPPLY-COSMETI 38.90
AMBULATORY    5140008 0 FOAMING CLEANSER                    SUPPLY-COSMETI 28.60
AMBULATORY    5140009 0 GLYCOL ACID CREAM PLUS 10% 1 OZ     SUPPLY-COSMETI 30.20
AMBULATORY    5140010 0 GLYCOL ACID ESTERFIED 60%           SUPPLY-COSMETI 45.40
AMBULATORY    5140011 0 GLYCOL ACID ESTERFIED 70%           SUPPLY-COSMETI 45.40
AMBULATORY    5140012 0 GLYCOL ACID ESTERFIED APPL 20%      SUPPLY-COSMETI 45.40
AMBULATORY    5140013 0 GLYCOL ACID ESTERFIED APPL 30%      SUPPLY-COSMETI 45.40
AMBULATORY    5140014 0 GLYCOL ACID ESTERFIED APPL 40%      SUPPLY-COSMETI 45.40
AMBULATORY    5140015 0 GLYCOL ACID ESTERFIED APPL 50%      SUPPLY-COSMETI 45.40
AMBULATORY    5140016 0 GLYCOL ACID GENTL EYE CREAM         SUPPLY-COSMETI 35.90
AMBULATORY    5140017 0 GLYCOL ACID HYDRAT EYE CRM 1OZ      SUPPLY-COSMETI 24.80
AMBULATORY    5140018 0 GLYCOL ACID HYDROTON LITE 1-16      SUPPLY-COSMETI 145.80
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY       OUTPT)          LML/RML     CPT
AMBULATORY    5140019 0 GLYCOL ACID HYDROTON LITE 2OZ             SUPPLY-COSMETI 27.00
AMBULATORY    5140020 0 GLYCOL ACID HYDROTONE 1-16                SUPPLY-COSMETI 145.80
AMBULATORY    5140021 0 GLYCOL ACID HYDROTONE 20Z                 SUPPLY-COSMETI 27.00
AMBULATORY    5140022 0 GLYCOL ACID HYDROTONE MAX 1OZ             SUPPLY-COSMETI 27.00
AMBULATORY    5140023 0 GLYCOL ACID LOTN LITE 5% 4 OZ             SUPPLY-COSMETI 27.00
AMBULATORY    5140024 0 GLYCOL ACID LOTN LITE PLUS 10% 4 OZ       SUPPLY-COSMETI 30.20
AMBULATORY    5140025 0 GLYCOL ACID LOTN LITE PLUS 12% 4 OZ       SUPPLY-COSMETI 32.40
AMBULATORY    5140026 0 GLYCOL ACID LOTN PLUS 12% 4 OZ            SUPPLY-COSMETI 32.40
AMBULATORY    5140027 0 GLYCOL ACID PRD LOTION PLS 12%            SUPPLY-COSMETI 56.40
AMBULATORY    5140028 0 GLYCOL ACID PROD CREAM PLS 12%            SUPPLY-COSMETI 56.40
AMBULATORY    5140029 0 GLYCOL ACID PROD GLYMIST 2%               SUPPLY-COSMETI 29.50
AMBULATORY    5140030 0 GLYCOL ACID PROD GNTL CLNSR 2%            SUPPLY-COSMETI 39.90
AMBULATORY    5140031 0 GLYCOL ACID PROD SOL PLUS 10%             SUPPLY-COSMETI 49.50
AMBULATORY    5140032 0 GLYCOL ACID PROD SOL PLUS 12%             SUPPLY-COSMETI 56.40
AMBULATORY    5140033 0 GLYMIST 8 OZ                              SUPPLY-COSMETI 17.30
AMBULATORY    5140034 0 HAND / NAIL CONDIT CRM 1.75 OZ            SUPPLY-COSMETI 21.10
AMBULATORY    5140035 0 HYDRATING B5 GEL 1 FL OZ                  SUPPLY-COSMETI 61.60
AMBULATORY    5140077 0 KINERASE C6 PEPTIDE INTENSIVE TX 30 ML    SUPPLY-COSMETI 96.00
AMBULATORY    5140079 0 KINERASE CREAM 40 GM                      SUPPLY-COSMETI 72.00
AMBULATORY    5140076 0 KINERASE GENTLE DAILY CLEANSER 200 ML     SUPPLY-COSMETI 30.00
AMBULATORY    5140080 0 KINERASE INTENSIVE EYE CREAM 20 GM        SUPPLY-COSMETI 59.00
AMBULATORY    5140078 0 KINERASE LOTION 40 ML                     SUPPLY-COSMETI 72.00
AMBULATORY    5140075 0 KINERASE UNDER EYE RESCUE 20 GM           SUPPLY-COSMETI 75.00
AMBULATORY    5140036 0 NAIL CONDIT SOLN 0.25 oz                  SUPPLY-COSMETI 18.40
AMBULATORY    5140046 0 NEOSTRAT AHA GEL AGE SPOT / LITE 1.6 OZ   SUPPLY-COSMETI 25.90
AMBULATORY    5140037 0 NEOSTRAT-15 AHA BDY / FCE LOTN            SUPPLY-COSMETI 27.00
AMBULATORY    5140038 0 NEOSTRAT-15 FACE CRM 1.75 OZ              SUPPLY-COSMETI 28.10
AMBULATORY    5140039 0 PHYTO PLUS 1 OZ                           SUPPLY-COSMETI 72.40
AMBULATORY    5140040 0 SERUM 10 - 1 FL OZ                        SUPPLY-COSMETI 67.00
AMBULATORY    5140047 0 ULTRA MOIST FACE CRM 10% 1.75 OZ          SUPPLY-COSMETI 27.00
AMBULATORY    5125060 0 BLOOD GLUCOSE ACCUCHECK - OP                            23.37
                                                                  WAIVED TEST DON                            82962
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY       OUTPT)          LML/RML     CPT
AMBULATORY    5125056 0 COAGU CHECK FOR PROTHROM TIME - OP                   50.49
                                                               WAIVED TEST DON                            85610
AMBULATORY    5120154 0 FECAL OCC BLOOD - CANCER SCREEN - OP                 29.87
                                                               WAIVED TEST DON                            G0107
AMBULATORY    5120429 0 FECAL OCC BLOOD - NON CANCER - OP                    26.20
                                                               WAIVED TEST DON                            82270
AMBULATORY    5125180 0 HEMOCUE - OP                                         34.56
                                                               WAIVED TEST DON                            85018
AMBULATORY    5125032 0 HEMOGLOBIN A1C TEST - OP                             93.58
                                                               WAIVED TEST DON                            83036
AMBULATORY    5120155 0 KOH - OP                                             12.96
                                                               WAIVED TEST DON                            Q0112
AMBULATORY    5125104 0 PH BODY FLUID XCEPT BLOOD - OP                       33.16
                                                               WAIVED TEST DON                            83986
AMBULATORY    5120839 0 PREGNANCY TEST URINE QUICKVUE - OP                   70.18
                                                               WAIVED TEST DON                            81025
AMBULATORY    5125067 0 RAPID STREP TEST - OP                                72.23
                                                               WAIVED TEST DON                            87880
AMBULATORY    5120841 0 RSV SCREEN NASAL WASH - OP                           65.00
                                                               WAIVED TEST DON                            87807
AMBULATORY    5125085 0 U/A BY CLINITEK (100 macine) - OP                    39.83
                                                               WAIVED TEST DON                            81003
AMBULATORY    5125198 0 U/A BY CLINITEK (50 MACHINE) - OP                    39.83
                                                               WAIVED TEST DON                            81003
AMBULATORY    5120427 0 URINALYSIS, DIPSTICK - OP                            28.20
                                                               WAIVED TEST DON                            81002
AMBULATORY    5121179 0 URINE MICROALBUMIN BY CLINITEK - OP                  46.50
                                                               WAIVED TEST DON                            82044
AMBULATORY    5120156 0 WET MOUNT - OP                                       6.00
                                                               WAIVED TEST DON                            Q0111
AUDIOLOGY     4704134 0 ENG / SPONTANEOUS NYSTAGMUS            PROCED         155.00                      92541
AUDIOLOGY     4704133 0 ENG / POSITONAL NYSTAGMUS TEST         PROCED         155.00                      92542
AUDIOLOGY     4704126 0 ENG / CAL RT EAR WARM                  PROCED         187.39                      92543
AUDIOLOGY     4704127 0 ENG / CAL RT EAR COOL                  PROCED         187.39                      92543
AUDIOLOGY     4704128 0 ENG / CAL LT EAR WARM                  PROCED         187.39                      92543
AUDIOLOGY     4704129 0 ENG / CAL LT EAR COOL                  PROCED         187.39                      92543
AUDIOLOGY     4704136 0 ENG / CAL RT EAR ICE                   PROCED         187.39                      92543
AUDIOLOGY     4704137 0 ENG / CAL LT EAR ICE                   PROCED         187.39                      92543
AUDIOLOGY     4704131 0 ENG / OPTOKINETIC                      PROCED         155.00                      92544
AUDIOLOGY     4704132 0 ENG / OSCIL TRACKING                   PROCED         155.00                      92545
AUDIOLOGY     4701114 0 ROTARY CHAIR SINUSOIDAL                PROCED         200.00                      92546
AUDIOLOGY     4703409 0 VESTIBULAR AUTOROTATION                PROCED         125.94                      92546
AUDIOLOGY     4704135 0 VERTICAL ELECTRODES                    PROCED         55.00                       92547
AUDIOLOGY     4703410 0 COMPUTER DYNAMIC POSTUROGRAPHY         PROCED         434.30                      92548
AUDIOLOGY     4702654 0 SCREENING TEST PURE TONE AIR ONLY      PROCED         45.00                       92551
AUDIOLOGY     4702655 0 AIR-ONLY PURE TONE AUDIOMETRY          PROCED         70.00                       92552
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML      CPT
AUDIOLOGY     4702118 0 PURE TONE AUDIOMETRY                           PROCED     97.90                        92553
AUDIOLOGY     4701654 0 SPEECH THRESHOLD                               PROCED     85.00                        92555
AUDIOLOGY     4701655 0 SPEECH THRESHOLD & RECOGNITION                 PROCED     85.00                        92556
AUDIOLOGY     4702102 0 COMPREHENSIVE AUDIO EVAL                       PROCED     182.12                       92557
AUDIOLOGY     4702122 0 TONE DECAY TEST                                PROCED     83.98                        92563
AUDIOLOGY     4702113 0 MFT-MULTI FREQ TYMPANOMETRY                    PROCED     123.60                       92567
AUDIOLOGY     4702123 0 TYMPANOMETRY DIAGNOSTIC                        PROCED     64.66                        92567
AUDIOLOGY     4702120 0 TAR-REFLEX THRESHOLD                           PROCED     77.92                        92568
AUDIOLOGY     4702101 0 ACOUSTIC REFLEX DECAY                          PROCED     61.75                        92569
AUDIOLOGY     4702119 0 STENGER TEST                                   PROCED     125.00                       92577
AUDIOLOGY     4702115 0 VRA-VIS REIM AUDIOM                            PROCED     97.90                        92579
AUDIOLOGY     4702116 0 CONDITIONING PLAY AUDIOM                       PROCED     139.10                       92582
AUDIOLOGY     4701113 0 SELECT PICTURE AUDIO WIPI                      PROCED     85.00                        92583
AUDIOLOGY     4701104 0 ECG-ELECTROCOCHLEOGRAPHY                       PROCED     303.82                       92584
AUDIOLOGY     4701260 0 PROMONTARY STIMULATION                         PROCED     303.82                       92584
AUDIOLOGY     4701250 0 AUD BRAINSTEM RESPONSE DX                      PROCED     457.25                       92585
AUDIOLOGY     4701252 0 ABR / ASSR / AEP COMPREHENSIVE                 PROCED     566.50                       92585
AUDIOLOGY     4701653 0 ABR NEONATAL SCREENING                         PROCED     145.80                       92586
AUDIOLOGY     4702114 0 AEP LIMITED (VESTIB ELECTROMYOGEN POTENTIAL)   PROCED     150.00                       92586
AUDIOLOGY     4702700 0 OTOACOUSTIC EMISSION LIMITED                   PROCED     94.16                        92587
AUDIOLOGY     4702702 0 OTOACOUSTIC EMISSN COMPREHENS                  PROCED     309.00                       92588
AUDIOLOGY     4703110 0 HEARING AID EVAL BINAURAL                      PROCED     205.67                       92591
AUDIOLOGY     4701120 0 EARMOLD MEASUREMENT                            PROCED     80.00                        92596
AUDIOLOGY     4701261 0 COCHLR IMPLNT W/ PRGRM DIAG ANALYS             PROCED     300.00                       92603
AUDIOLOGY     4701263 0 COCHLR IMPLNT SUBSEQ REPROGRM                  PROCED     300.00                       92604
AUDIOLOGY     4701106 0 EVAL CENTRAL AUD FUNCTION 1ST 60 MIN           PROCED     150.00                       92620
AUDIOLOGY     4701107 0 EVAL CENTRAL AUD FUNCTION EA ADD'L 15 MIN      PROCED     40.00                        92621
AUDIOLOGY     4701105 0 TINNITUS ASSMT (PITCH LOUDNESS & MASKING)      PROCED     150.00                       92625
AUDIOLOGY     4701118 0 EVAL AUD REHAB STATUS 1ST HR                   PROCED     125.00                       92626
AUDIOLOGY     4701119 0 EVAL AUD REHAB STATUS EA ADDL 15 MIN           PROCED     30.00                        92627
AUDIOLOGY     4701116 0 FACIAL NRVE EMG NDLE UNILAT LT                 PROCED     163.90                      95867LT
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE          PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY        OUTPT)             LML/RML      CPT
AUDIOLOGY     4701115 0 FACIAL NRVE EMG NDLE UNILAT RT       PROCED          163.90                         95867RT
AUDIOLOGY     4701117 0 FACIAL NRVE EMG NDLE BILAT           PROCED          305.19                          95868
AUDIOLOGY     4701121 0 IOM - FACIAL NERVE MONITOR PER HR    PROCED          461.30                          95920
AUDIOLOGY     4701122 0 IOM - HEARING NERVE MONITOR PER HR   PROCED          461.30                          95920
AUDIOLOGY     4702136 2 M00-AUD SVC N/C                      PROCED          STATISTICAL ITEM
AUDIOLOGY     4702138 2 PPD-MISC PREPAID                     PROCED          STATISTICAL ITEM
AUDIOLOGY     4705109 0 EARMOLD MODIFICATION PER 15 MIN      PROCED-CASH CO30.00
AUDIOLOGY     4705002 0 ELECTRACOUST HEAR EVAL MONAURAL      PROCED-CASH CO47.96                             92594
AUDIOLOGY     4705003 0 HAC REAL EAR ELECT MEAS MONAURAL     PROCED-CASH CO68.85                             92592
AUDIOLOGY     4705001 0 HAC-TROUBL SHOOT AID MONAURAL        PROCED-CASH CO68.85                             92592
AUDIOLOGY     4705018 0 AD EAR WAX GUARDS                    SUPPLY-CASH CO 7.00
AUDIOLOGY     4705028 0 AIR BLOWER                           SUPPLY-CASH CO 6.00
AUDIOLOGY     4705027 0 AUDIO WIPES                          SUPPLY-CASH CO 15.00
AUDIOLOGY     4705096 0 BAHA ACTIVATION                      SUPPLY-CASH CO 300.00
AUDIOLOGY     4705111 0 BAHA CORDELLE II                     SUPPLY-CASH CO 3,700.00
AUDIOLOGY     4705112 0 BAHA DIVINO                          SUPPLY-CASH CO 3,500.00
AUDIOLOGY     4705114 0 BAHA GOLD WARRANTY                   SUPPLY-CASH CO 1,500.00
AUDIOLOGY     4705113 0 BAHA PLATINUM WARRANTY               SUPPLY-CASH CO 4,000.00
AUDIOLOGY     4705110 0 BAHA SOFTBAND KIT                    SUPPLY-CASH CO 150.00
AUDIOLOGY     4705033 0 BATTERY LEVEL 10                     SUPPLY-CASH CO 10.00
AUDIOLOGY     4705032 0 BATTERY LEVEL 5                      SUPPLY-CASH CO 5.00
AUDIOLOGY     4705022 0 BATTERY TESTER                       SUPPLY-CASH CO 11.00
AUDIOLOGY     4705029 0 CLEAN AID                            SUPPLY-CASH CO 6.00
AUDIOLOGY     4705035 0 COMPLY WRAPS                         SUPPLY-CASH CO 7.00
AUDIOLOGY     4705020 0 CUSTOM MUSICIANS MOLDS EA            SUPPLY-CASH CO 65.00
AUDIOLOGY     4705021 0 CUSTOM SWIM PLUGS EA                 SUPPLY-CASH CO 30.00
AUDIOLOGY     4705025 0 DESSICANT BLOCK                      SUPPLY-CASH CO 3.00
AUDIOLOGY     4705098 0 DRI & STORE GLOBAL                   SUPPLY-CASH CO 100.00
AUDIOLOGY     4705023 0 DRI-AID KIT                          SUPPLY-CASH CO 7.00
AUDIOLOGY     4705024 0 DRY & STORE KIT                      SUPPLY-CASH CO 150.00
AUDIOLOGY     4705087 0 FM SYS LEXIS W/ RECEIVR              SUPPLY-CASH CO 3,200.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE          PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY        OUTPT)          LML/RML     CPT
AUDIOLOGY     4705089 0 FM SYS LEXIS W/ RECEIVR LUMC EMP DIS          SUPPLY-CASH CO 2,880.00
AUDIOLOGY     4705088 0 FM SYS LEXIS W/ RECEIVR REFER DIS             SUPPLY-CASH CO 3,040.00
AUDIOLOGY     4705084 0 FM SYS LEXIS W/O RECEIVR                      SUPPLY-CASH CO 2,200.00
AUDIOLOGY     4705086 0 FM SYS LEXIS W/O RECEIVR LUMC EMP DIS         SUPPLY-CASH CO 1,980.00
AUDIOLOGY     4705085 0 FM SYS LEXIS W/O RECEIVR REFER DIS            SUPPLY-CASH CO 2,090.00
AUDIOLOGY     4705093 0 FM SYS PHONAK W/ RECEIVR                      SUPPLY-CASH CO 3,500.00
AUDIOLOGY     4705095 0 FM SYS PHONAK W/ RECEIVR LUMC EMP DIS         SUPPLY-CASH CO 3,150.00
AUDIOLOGY     4705094 0 FM SYS PHONAK W/ RECEIVR REFER DIS            SUPPLY-CASH CO 3,325.00
AUDIOLOGY     4705090 0 FM SYS PHONAK W/O RECEIVR                     SUPPLY-CASH CO 2,500.00
AUDIOLOGY     4705092 0 FM SYS PHONAK W/O RECEIVR LUMC EMP DIS        SUPPLY-CASH CO 2,250.00
AUDIOLOGY     4705091 0 FM SYS PHONAK W/O RECEIVR REFER DIS           SUPPLY-CASH CO 2,375.00
AUDIOLOGY     4705017 0 HEAD BANDS                                    SUPPLY-CASH CO 17.00
AUDIOLOGY     4705068 0 HEAR AID DISP ADV BINAUR LUMC EMP DIS         SUPPLY-CASH CO 3,780.00
AUDIOLOGY     4705067 0 HEAR AID DISP ADV BINAUR REFER DIS            SUPPLY-CASH CO 3,990.00
AUDIOLOGY     4705066 0 HEAR AID DISP ADV BINAURAL                    SUPPLY-CASH CO 4,200.00
AUDIOLOGY     4705059 0 HEAR AID DISP ADV MONAUR LUMC EMP DIS         SUPPLY-CASH CO 1,980.00
AUDIOLOGY     4705058 0 HEAR AID DISP ADV MONAUR REFER DIS            SUPPLY-CASH CO 2,090.00
AUDIOLOGY     4705057 0 HEAR AID DISP ADV MONAURAL                    SUPPLY-CASH CO 2,200.00
AUDIOLOGY     4705071 0 HEAR AID DISP ESSENTIAL BINAUR LUMC EMP DIS   SUPPLY-CASH CO 2,880.00
AUDIOLOGY     4705070 0 HEAR AID DISP ESSENTIAL BINAUR REFER DIS      SUPPLY-CASH CO 3,040.00
AUDIOLOGY     4705069 0 HEAR AID DISP ESSENTIAL BINAURAL              SUPPLY-CASH CO 3,200.00
AUDIOLOGY     4705056 0 HEAR AID DISP ESSENTIAL MONAUR LUMC EMP DIS   SUPPLY-CASH CO 1,530.00
AUDIOLOGY     4705055 0 HEAR AID DISP ESSENTIAL MONAUR REFER DIS      SUPPLY-CASH CO 1,615.00
AUDIOLOGY     4705054 0 HEAR AID DISP ESSENTIAL MONAURAL              SUPPLY-CASH CO 1,700.00
AUDIOLOGY     4705065 0 HEAR AID DISP PREM BINAUR LUMC EMP DIS        SUPPLY-CASH CO 4,680.00
AUDIOLOGY     4705064 0 HEAR AID DISP PREM BINAUR REFER DIS           SUPPLY-CASH CO 4,940.00
AUDIOLOGY     4705063 0 HEAR AID DISP PREM BINAURAL                   SUPPLY-CASH CO 5,200.00
AUDIOLOGY     4705062 0 HEAR AID DISP PREM MONAUR LUMC EMP DIS        SUPPLY-CASH CO 2,430.00
AUDIOLOGY     4705061 0 HEAR AID DISP PREM MONAUR REFER DIS           SUPPLY-CASH CO 2,565.00
AUDIOLOGY     4705060 0 HEAR AID DISP PREM MONAURAL                   SUPPLY-CASH CO 2,700.00
AUDIOLOGY     4705080 0 HEAR AID ECON BINAUR LUMC EMP DIS             SUPPLY-CASH CO 1,620.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE          PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY        OUTPT)          LML/RML     CPT
AUDIOLOGY     4705079 0 HEAR AID ECON BINAUR REFER DIS            SUPPLY-CASH CO 1,710.00
AUDIOLOGY     4705078 0 HEAR AID ECON BINAURAL                    SUPPLY-CASH CO 1,800.00
AUDIOLOGY     4705081 0 HEAR AID ECON CROS/BI-CROS                SUPPLY-CASH CO 1,800.00
AUDIOLOGY     4705083 0 HEAR AID ECON CROS/BI-CROS LUMC EMP DIS   SUPPLY-CASH CO 1,620.00
AUDIOLOGY     4705082 0 HEAR AID ECON CROS/BI-CROS REFER DIS      SUPPLY-CASH CO 1,710.00
AUDIOLOGY     4705077 0 HEAR AID ECON MONAUR LUMC EMP DIS         SUPPLY-CASH CO 900.00
AUDIOLOGY     4705076 0 HEAR AID ECON MONAUR REFER DIS            SUPPLY-CASH CO 950.00
AUDIOLOGY     4705075 0 HEAR AID ECON MONAURAL                    SUPPLY-CASH CO 1,000.00
AUDIOLOGY     4705072 0 HEAR AID SURCHG FOR CIC                   SUPPLY-CASH CO 300.00
AUDIOLOGY     4705074 0 HEAR AID SURCHG FOR CIC LUMC EMP DIS      SUPPLY-CASH CO 270.00
AUDIOLOGY     4705073 0 HEAR AID SURCHG FOR CIC REFER DIS         SUPPLY-CASH CO 285.00
AUDIOLOGY     4705101 0 HEAR AID WESTONE CONVERSOR                SUPPLY-CASH CO 900.00
AUDIOLOGY     4705039 0 HEARING AID REMOTE CONTROL                SUPPLY-CASH CO 250.00
AUDIOLOGY     4705040 0 HEARING AID REPAIR ANALOG OTICON          SUPPLY-CASH CO 150.00
AUDIOLOGY     4705044 0 HEARING AID REPAIR ANALOG PHONAK          SUPPLY-CASH CO 150.00
AUDIOLOGY     4705042 0 HEARING AID REPAIR DIG OTICON             SUPPLY-CASH CO 200.00
AUDIOLOGY     4705046 0 HEARING AID REPAIR DIG PHONAK             SUPPLY-CASH CO 230.00
AUDIOLOGY     4705051 0 HEARING AID REPAIR DIG RESOUND            SUPPLY-CASH CO 230.00
AUDIOLOGY     4705048 0 HEARING AID REPAIR DIG WIDEX              SUPPLY-CASH CO 200.00
AUDIOLOGY     4705041 0 HEARING AID REPAIR PROGRM OTICON          SUPPLY-CASH CO 175.00
AUDIOLOGY     4705045 0 HEARING AID REPAIR PROGRM PHONAK          SUPPLY-CASH CO 200.00
AUDIOLOGY     4705050 0 HEARING AID REPAIR PROGRM RESOUND         SUPPLY-CASH CO 230.00
AUDIOLOGY     4705053 0 HEARING AID REPAIR SURCHG > 5 Y/O         SUPPLY-CASH CO 40.00
AUDIOLOGY     4705043 0 HEARING RECASE OTICON                     SUPPLY-CASH CO 30.00
AUDIOLOGY     4705047 0 HEARING RECASE PHONAK                     SUPPLY-CASH CO 200.00
AUDIOLOGY     4705049 0 HEARING RECASE WIDEX (TYPE 1)             SUPPLY-CASH CO 30.00
AUDIOLOGY     4705052 0 HEARING RECASE WIDEX (TYPE 2)             SUPPLY-CASH CO 50.00
AUDIOLOGY     4705034 0 HUGGIE AIDS                               SUPPLY-CASH CO 50.00
AUDIOLOGY     4705026 0 LISTENING STETHOSCOPE                     SUPPLY-CASH CO 25.00
AUDIOLOGY     4705099 0 MFG FEE FOR LOST / DAMAGED AID            SUPPLY-CASH CO 150.00
AUDIOLOGY     4705105 0 NO WAX                                    SUPPLY-CASH CO 6.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY       OUTPT)          LML/RML     CPT
AUDIOLOGY     4705030 0 OTO-FERM / OTO-EASE                         SUPPLY-CASH CO 3.50
AUDIOLOGY     4705037 0 POCKET TALKER                               SUPPLY-CASH CO 200.00
AUDIOLOGY     4705038 0 STEREO AMPLIFIED LISTENER                   SUPPLY-CASH CO 50.00
AUDIOLOGY     4705007 0 SWIM PLUGS (DOC'S PRO) 1 PR                 SUPPLY-CASH CO 10.00
AUDIOLOGY     4705031 0 TELEPHONE PADS                              SUPPLY-CASH CO 2.00
BMTP (NMDP)   5801041 0 TRNSPLNT PREP HEMAT CELLS THAW W/O WASH     PROCED         200.00                      38208
BMTP (NMDP)   5801042 0 TRNSPLNT PREP CELLS RBC REMOVAL             PROCED         900.00                      38212
BMTP (NMDP)   5801043 0 TRNSPLNT PREP CELL PLASMA VOL DEPLETN       PROCED         300.00                      38214
BMTP (NMDP)   5801044 0 BONE MARR / PERIPH STM CELL TRANS ALLOGEN   PROCED         1,527.00                    38240
BMTP (NMDP)   5801047 0 BONE MARR / PERIPH STM CEL TRANS AUTOLOG    PROCED         1,527.00                    38241
BMTP (NMDP)   5801048 0 BONE MARR TRANS ALLOGEN DONOR LYMPH INFUS   PROCED         770.00                      38242
BMTP (NMDP)   5801023 0 STS                                         PROCED         53.00                       86592
BMTP (NMDP)   5801029 0 CMV ANTIBODY (IGG)                          PROCED         128.67                      86644
BMTP (NMDP)   5801028 0 ANTI HLV-1                                  PROCED         123.93                      86687
BMTP (NMDP)   5801027 0 ANTI HIV 1,2, SINGL ASSAY                   PROCED         91.53                       86703
BMTP (NMDP)   5801024 0 ANTI HBC TOTAL                              PROCED         103.17                      86704
BMTP (NMDP)   5801025 0 ANTI HCV                                    PROCED         129.06                      86803
BMTP (NMDP)   5801013 0 CORD BLOOD TYPING ROUTINE                   PROCED         201.96                      86807
BMTP (NMDP)   5801015 0 CORD BLOOD TYPING URGENT                    PROCED         255.10                      86808
BMTP (NMDP)   5801017 0 CORD HLA-C TYPING                           PROCED         174.95                      86812
BMTP (NMDP)   5801020 0 HLA-C TYPING                                PROCED         174.95                      86812
BMTP (NMDP)   5801002 0 HLA DR PROCUREMENT & TYPE                   PROCED         208.44                      86816
BMTP (NMDP)   5801018 0 CORD HLA-DQ TYPING                          PROCED         208.44                      86816
BMTP (NMDP)   5801021 0 HLA-DQ TYPING                               PROCED         208.44                      86816
BMTP (NMDP)   5801009 0 AUTOLOGOUS BLOOD UNITS                      PROCED         236.18                      86890
BMTP (NMDP)   5801022 0 HBS AG                                      PROCED         97.42                       87340
BMTP (NMDP)   5801026 0 HIV-1 ANTIGEN (P-24)                        PROCED         94.08                       87390
BMTP (NMDP)   5801001 0 ACTIVATION DONOR SEARCH                     PROCED         952.30                      99244
BMTP (NMDP)   5801007 0 DONOR INFO SESSIONS                         PROCED         539.70                      99245
BMTP (NMDP)   5801008 0 DONOR PHYSICAL EXAM                         PROCED         1,545.00                    99245
BMTP (NMDP)   5801040 0 TRNSPLNT PREP PROGEN CRYO PRES / STOR       PROCED         1,250.00                    G0265
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)             LML/RML     CPT
BMTP (NMDP)     5801003 0 SAMPLE PROCUR CONFIRMATORY TYPING US          PROCED     400.00
BMTP (NMDP)     5801011 2 PRELIMINARY DONOR SEARCH                      PROCED     STATISTICAL ITEM
BMTP (NMDP)     5801052 0 ADDL / PRECOLLECT SAMPLE INTERNATL            SUPPLY     1,000.00
BMTP (NMDP)     5801004 0 ADDL / PRECOLLECT SAMPLE US                   SUPPLY     400.00
BMTP (NMDP)     5801046 0 BONE MARR PRODUCT ALLOGEN INTERNATL           SUPPLY     57,400.00
BMTP (NMDP)     5801045 0 BONE MARR PRODUCT ALLOGEN US                  SUPPLY     37,404.00
BMTP (NMDP)     5801012 0 CORD BLOOD PROCUREMENT                        SUPPLY     36,000.00
BMTP (NMDP)     5801014 0 PERIPH BLD STM CELL PROCUR PRIMARY            SUPPLY     36,177.00
BMTP (NMDP)     5801019 0 PERIPH BLD STM CELL PROCUR SECONDARY          SUPPLY     36,177.00
BMTP (NMDP)     5801049 0 SAMPLE PROCUR CONFIRMATORY TYPING INTERNATL   SUPPLY     1,000.00
BMTP (NMDP)     5801051 0 SAMPLE PROCUR INFECT DIS INTERNATL            SUPPLY     380.00
BMTP (NMDP)     5801050 0 SAMPLE PROCUR INFECT DIS US                   SUPPLY     380.00
BMTU            6901005 0 ALLOGEN CFU-GM, BFU-E ASSAY                   PROCED     476.00
BMTU            6920004 2 IP - DRESSING CHANGE CENTRAL LINE             PROCED     STATISTICAL ITEM
BMTU            6920001 0 IP - VAD DECLOTTING                           PROCED     293.00                         36550
BMTU            6920002 0 IP PICC CATH PLACEMENT                        PROCED     659.44                         36569
BMTU            6920009 0 IP VENOUS ACCESS LINE REPAIR                  PROCED     514.00                         36575
BMTU            6920008 2 OP DRSG CHANGE CENTRAL LINE                   PROCED     STATISTICAL ITEM
BMTU            6920006 0 OP PICC CATH PLACEMENT                        PROCED     1,007.00                       36569
BMTU            6920010 0 OP VENOUS ACCESS LINE REPAIR                  PROCED     514.00                         36575
BURN / TRAUMA   5211080 0 FLUMAZENIL 1 MG INJ                           MED        116.39
BURN / TRAUMA   5211086 0 ACETAMINOPHEN W/ COD 12.5 ML PO ELIX          MED        8.06
BURN / TRAUMA   5211089 0 HYDROCODONE 7.5MG / ACETAMIN 500MG TAB        MED        5.15
BURN / TRAUMA   5211092 0 MORPHINE IMMED RELEASE TAB 15 MG              MED        2.56
BURN / TRAUMA   5211093 0 COLLAGENASE (SANTYL) TOP OINT 30 GM           MED        147.80
BURN / TRAUMA   5211094 0 DERMAIDE ALOE 70% CRM 120 GM                  MED        31.80
BURN / TRAUMA   5211096 0 BACITRACIN ZINC 400 GM JAR TOP OINT           MED        68.46
BURN / TRAUMA   5211097 0 TRIPLE ATB (NEO, BAC, POLY) 30 GM OINT        MED        8.00
BURN / TRAUMA   5211128 0 SILVER SULFADIAZINE CRM 1% 400 GM             MED        49.00
BURN / TRAUMA   5211130 0 GENTAMYCIN CREAM 0.1% 15 GM                   MED        58.20
BURN / TRAUMA   5211131 0 MORPHINE 4 MG INJ                             MED        15.10
PARTIAL CHARGEMASTER - 12/13/06

                        Svc                                             CHARGE      PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)             LML/RML     CPT
BURN / TRAUMA   5211137 0 PAPAIN UREA (ACCUZYME) 1 ML TOP LIQ SPRAY      MED        4.00
BURN / TRAUMA   5211064 0 I&D ABSCESS SIMPL                              PROCED     375.13                         10060
BURN / TRAUMA   5211068 0 INCIS/REM FOREIGN BDY SQ TISS                  PROCED     924.80                         10120
BURN / TRAUMA   5211066 0 I&D HEMATOMA/CYST                              PROCED     1,165.47                       10140
BURN / TRAUMA   5211067 0 I&D PUNC ASP ABSCES/HEMAT/CYST                 PROCED     220.19                         10160
BURN / TRAUMA   5211065 0 I&D COMP POSTOP WND INFECT                     PROCED     1,397.12                       10180
BURN / TRAUMA   5211124 0 DEBRDMNT INFECTD SKIN UP TO 10% BSA            PROCED     313.60                         11000
BURN / TRAUMA   5211125 0 DEBRDMNT INFECTD SKIN EA ADD 10% BSA           PROCED     230.00                         11001
BURN / TRAUMA   5211063 0 DEBRDMT SKIN PARTIAL THCKNESS                  PROCED     334.80                         11040
BURN / TRAUMA   5211121 0 DEBRDMNT SKIN FULL THICKNESS                   PROCED     604.80                         11041
BURN / TRAUMA   5211122 0 DEBRDMNT SKIN & SQ TISSUE                      PROCED     711.84                         11042
BURN / TRAUMA   5211123 0 DEBRDMNT SKIN SQ TISS & MUSCLE                 PROCED     425.00                         11043
BURN / TRAUMA   5211061 0 BIOP SKIN/SQ TISS SINGL LES                    PROCED     419.04                         11100
BURN / TRAUMA   5211062 0 DEBRDMT NAILS ANY METHOD 1-5                   PROCED     69.70                          11720
BURN / TRAUMA   5211126 0 NAIL EXCIS PARTIAL / COMPLETE                  PROCED     951.66                         11750
BURN / TRAUMA   5211127 0 WEDG EXC SKIN NAIL FOLD (INGRWN NAIL)          PROCED     102.00                         11765
BURN / TRAUMA   5211041 0 EXC PILONIDAL CYST / SINUS EXTENSIVE           PROCED     1,221.00                       11771
BURN / TRAUMA   5211050 0 INIT TX 1ST DEG BURN LOCAL TX                  PROCED     180.09                         16000
BURN / TRAUMA   5211051 0 BURN DRSG / DEBRDMNT PART THICK BURN SMALL < 5%PROCED     189.99                         16020
BURN / TRAUMA   5211052 0 BURN DRSG / DEBRDMNT PART THICK BURN MED 5-10% PROCED     432.00                         16025
BURN / TRAUMA   5211053 0 BURN DRSG / DEBRDMNT PART THICK BURN LARGE >10%PROCED     500.00                         16030
BURN / TRAUMA   5211046 0 REM FORGN BDY SHOULDER SQ                      PROCED     433.00                         23330
BURN / TRAUMA   5211044 0 REM FORGN BDY UP ARM / ELB DEEP                PROCED     936.00                         24201
BURN / TRAUMA   5211045 0 REM FORGN BDY THIGH / KNEE DEEP                PROCED     1,221.00                       27372
BURN / TRAUMA   5211079 0 INJ FEE THER / DIAG / PROPHY SQ,IM,ID          PROCED     60.36                          90772
BURN / TRAUMA   5211055 2 NON BURN DRSG CHANGE SMALL                     PROCED     STATISTICAL ITEM
BURN / TRAUMA   5211056 2 NON BURN DRSG CHANGE MED                       PROCED     STATISTICAL ITEM
BURN / TRAUMA   5211057 2 NON BURN DRSG CHANGE LARGE                     PROCED     STATISTICAL ITEM
BURN / TRAUMA   5211132 0 TUBIGRIP PER FOOT                              SUPPLY     16.60
BURN / TRAUMA   5211133 0 DRSG EXUDRY BURN 9 X 15 EA                     SUPPLY     16.60
BURN / TRAUMA   5211134 0 DRSG EXUDRY BURN 6 X 9 EA                      SUPPLY     9.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
BURN / TRAUMA 5211135  0 DRSG EXUDRY BURN 15 X 24 EA           SUPPLY     32.40
BURN / TRAUMA 5211136  0 DRSG WOUND VEIL 12 X 12               SUPPLY     6.90
CANCER        5003105 0 FINE NEEDLE ASP (FNA) W/O IMAG GUID    PROCED     300.15                      10021
CANCER        5003264 0 I & D ABSCESS SIMPLE                   PROCED     375.13                      10060
CANCER        5003195 0 I & D ABSCESS COMP                     PROCED     584.24                      10061
CANCER        5003197 0 I & D HEMATOMA OR CYST                 PROCED     1,165.47                    10140
CANCER        5003198 0 I & D PUNCT ASP ABSCESS/HEMATOMA       PROCED     220.19                      10160
CANCER        5003259 0 DEBRDMNT INFECTED SKIN UP TO 10% BSA   PROCED     313.61                      11000
CANCER        5003260 0 DEBRDMNT SKIN PART THCK                PROCED     334.80                      11040
CANCER        5003428 0 DEBRDMNT SKIN FULL THCK                PROCED     604.80                      11041
CANCER        5003261 0 PARNG/CUT BEN HYPRKER 1 LES            PROCED     287.33                      11055
CANCER        5003262 0 PARNG/CUT BEN HYPRKER 2-4 LES          PROCED     297.41                      11056
CANCER        5003265 0 PARNG/CUT BEN HYPRKER >4 LES           PROCED     210.33                      11057
CANCER        5003266 0 BIOP SKN/SQ TISS SING LES              PROCED     419.04                      11100
CANCER        5003267 0 BIOP SKN/SQ TISS EA ADDL LES           PROCED     91.17                       11101
CANCER        5003268 0 SKIN TAG REMOVAL 1-15                  PROCED     446.91                      11200
CANCER        5003269 0 SKN TAG REM EA ADDTL 10 LES            PROCED     145.44                      11201
CANCER        5003270 0 SHAV EP/DERM 1 LES<.5CM T,A,L          PROCED     67.33                       11300
CANCER        5003271 0 SHAV EP/DERM 1 LES .6-1CM              PROCED     273.66                      11301
CANCER        5003272 0 SHAV EP/DERM 1 LES 1.1-2CM             PROCED     159.84                      11302
CANCER        5003273 0 SHAV EP/DERM 1 LES >2CM                PROCED     103.38                      11303
CANCER        5003274 0 SHAV EP/DERM S,N,H,FT,G<0.5CM          PROCED     87.45                       11305
CANCER        5003275 0 SHAV EP/DERM S,N,H,FT,G,.6-1CM         PROCED     68.21                       11306
CANCER        5003276 0 SHAV EP/DERM S,N,H,FT,G1.1-2CM         PROCED     1,125.36                    11307
CANCER        5003277 0 SHAV EP/DRM LES S,N,H,FT,G>2CM         PROCED     417.96                      11308
CANCER        5003278 0 SHAV EP/DERM F,E,EY,N,L<.5CM           PROCED     463.73                      11310
CANCER        5003279 0 SHAV EP/DERM F,E,EY,N,L,.6-1CM         PROCED     334.80                      11311
CANCER        5003280 0 SHAV EP/DRM F,E,EY,N,L,1.1-2CM         PROCED     648.00                      11312
CANCER        5003281 0 SHAV EP/DERM F,E,EY,N,L >2CM           PROCED     169.76                      11313
CANCER        5003282 0 EX BEN EXPT SK TG T,A,L<.5CM           PROCED     685.18                      11400
CANCER        5003283 0 EXC BEN EXPT SK TG T/A/L 0.6-1 CM      PROCED     687.29                      11401
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5003284 0 EXC BEN EXPT SK TG T/A/L 1.1-2 CM        PROCED     721.33                      11402
CANCER        5003285 0 EXC BEN LES EXCP SK TG T/A/L 2.1-3 CM    PROCED     890.93                      11403
CANCER        5003286 0 EXC BEN LES EXPT SK TAG T/A/L 3.1-4 CM   PROCED     1,145.20                    11404
CANCER        5003287 0 EXC BEN LES EXPT SK TAG T/A/L > 4 CM     PROCED     1,461.76                    11406
CANCER        5003288 0 EX BN EXPT SK TG < 0.5CM                 PROCED     782.89                      11420
CANCER        5003289 0 EX BN EXPT SK TG 0.6-1CM                 PROCED     750.96                      11421
CANCER        5003290 0 EX BN EXPT SK TG 1.1-2CM                 PROCED     762.21                      11422
CANCER        5003291 0 EX BN EXPT SK TG 2.1-3CM                 PROCED     936.00                      11423
CANCER        5003292 0 EX BN EXPT SK TG 3.1-4CM                 PROCED     1,086.08                    11424
CANCER        5003293 0 EX BN EXPT SK TG >4CM                    PROCED     1,636.61                    11426
CANCER        5003294 0 EX BN F, E, EY, N, L, MM < 0.5 CM        PROCED     668.20                      11440
CANCER        5003295 0 EX BN F, E, EY, N, L, MM 0.6 - 1 CM      PROCED     611.11                      11441
CANCER        5003296 0 EXC BEN LES F/E/EY/N/L/MM 1.1-2 CM       PROCED     578.34                      11442
CANCER        5003297 0 EXC BEN LES F/E/EY/N/L/MM 2.1-3 CM       PROCED     1,210.95                    11443
CANCER        5003298 0 EXC BEN LES F/E/EY/N/L/MM 3.1-4 CM       PROCED     1,059.18                    11444
CANCER        5003299 0 EXC BEN LES F/E/EY/N/L/MM > 4 CM         PROCED     1,512.27                    11446
CANCER        5003300 0 EXC MAL LES T/A/L/ < 0.5 CM              PROCED     880.48                      11600
CANCER        5003301 0 EXC MAL LES T/A/L/ 0.6 - 1 CM            PROCED     380.10                      11601
CANCER        5003302 0 EXC MAL LES T/A/L/ 1.1 - 2 CM            PROCED     1,012.41                    11602
CANCER        5003303 0 EXC MAL LES T/A/L 2.1-3 CM               PROCED     1,325.45                    11603
CANCER        5003304 0 EXC MAL LES T/A/L 3.1-4 CM               PROCED     1,571.45                    11604
CANCER        5003305 0 EXC MAL LES T/A/L > 4 CM                 PROCED     1,858.01                    11606
CANCER        5003306 0 EXC MAL LES S/N/H/FT/G < 0.5 CM          PROCED     1,024.83                    11620
CANCER        5003307 0 EXC MAL LES S/N/H/FT/G 0.6-1 CM          PROCED     929.34                      11621
CANCER        5003308 0 EXC MAL LES S/N/H/FT/G 1.1-2 CM          PROCED     543.24                      11622
CANCER        5003309 0 EXC MAL LES S/N/H/FT/G 2.1-3 CM          PROCED     936.00                      11623
CANCER        5003310 0 EXC MAL LES S/N/H/FT/G 3.1-4 CM          PROCED     1,774.99                    11624
CANCER        5003311 0 EXC MAL LES S/N/H/FT/G > 4 CM            PROCED     2,438.64                    11626
CANCER        5003312 0 EXC MAL LES F/E/EY/N/L 0.5 CM OR LESS    PROCED     1,073.17                    11640
CANCER        5003313 0 EXC MAL LES F/E/EY/N/L 0.6-1 CM          PROCED     1,063.13                    11641
CANCER        5003314 0 EXC MAL LES F/E/EY/N/L 1.1-2 CM          PROCED     1,313.01                    11642
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5003315 0 EXC MAL LES F/E/EY/N/L 2.1-3 CM         PROCED     1,355.93                    11643
CANCER        5003316 0 EXC MAL LES F/E/EY/N/L 3.1-4 CM         PROCED     2,320.11                    11644
CANCER        5003317 0 EXC MAL LES F/E/EY/N/L > 4 CM           PROCED     2,270.16                    11646
CANCER        5003318 0 INTRALESIONAL INJ 1-7 LES               PROCED     117.45                      11900
CANCER        5003319 0 INTRALESIONAL INJ 8+LES                 PROCED     53.00                       11901
CANCER        5003078 0 INSERTION DRUG DELIVERY IMPLANT         PROCED     39.00                       11981
CANCER        5003080 0 REM W/ REINSERT DRUG DELIVERY IMPLANT   PROCED     39.00                       11983
CANCER        5003324 0 SIM REP SC/AX/TK/EXT < 2.6 CM           PROCED     273.25                      12001
CANCER        5003325 0 SIM REP SC/AX/TR/2.6-7.5CM              PROCED     273.25                      12002
CANCER        5003121 0 SIM REP S/N/AX/T/E 7.6-12.5CM           PROCED     273.89                      12004
CANCER        5003326 0 SIM REP FC/EY/MM <2.5CM                 PROCED     273.25                      12011
CANCER        5003327 0 SIM REP FC/EY/MM 2.6-5CM                PROCED     249.84                      12013
CANCER        5003122 0 SIM REP F/EY/E/N/L 5.1-7.5CM            PROCED     230.50                      12014
CANCER        5003123 0 SIM REP F/EY/E/N/L 7.6-12.5CM           PROCED     196.56                      12015
CANCER        5003328 0 LYR CLS WND SC/TR/EX < 2.5 CM           PROCED     334.80                      12031
CANCER        5003329 0 LYR CLS WND SC/TR/EX 2.6-7.5 CM         PROCED     273.25                      12032
CANCER        5003066 0 LYR CLOS WND SC/TR/EX 7.6-12.5CM        PROCED     268.92                      12034
CANCER        5003330 0 LYR CLOS WND NK/HN/FT/GEN < 2.6 CM      PROCED     263.52                      12041
CANCER        5003331 0 LYR CLOS WND NK/HN/FT/GEN 2.6-7.5 CM    PROCED     233.66                      12042
CANCER        5003124 0 LYR CLOSURE N/H/FT 7.6-12.5CM           PROCED     287.28                      12044
CANCER        5003332 0 LYR CLS WND F/E/NO/L<2.5CM              PROCED     273.25                      12051
CANCER        5003333 0 LYR CLS WND F/E/NO/L/2.6-5CM            PROCED     249.08                      12052
CANCER        5003125 0 LYR CLOSURE F/E/N/L 5.1-7.5CM           PROCED     273.25                      12053
CANCER        5003126 0 LYR CLOSURE F/E/N/L 7.6-12.5CM          PROCED     282.69                      12054
CANCER        5003127 0 REP COMP TRNK 1.1-2.5CM                 PROCED     331.00                      13100
CANCER        5003128 0 REP COMP TRNK 2.6-7.5CM                 PROCED     331.00                      13101
CANCER        5003129 0 REP COMP TRNK EA AD L 5CM               PROCED     600.12                      13102
CANCER        5003130 0 REP COMP S,A,L 1.1-2.5CM                PROCED     317.25                      13120
CANCER        5003131 0 REP COMP S,A,L 2.6-7.5CM                PROCED     406.08                      13121
CANCER        5003132 0 REP COMP S,A,L EA AD <5CM               PROCED     622.35                      13122
CANCER        5003133 0 REP COMP F,N,H 1.1-2.5CM                PROCED     420.65                      13131
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5003134 0 REP COMP F,N,H 2.6-7.5CM                    PROCED     624.79                      13132
CANCER        5003135 0 REP COMP F,N,H EA AD <5CM                   PROCED     546.08                      13133
CANCER        5003138 0 REP COMP EY,N,E,EA AD <5CM                  PROCED     106.35                      13153
CANCER        5003334 0 TISS TRNSFR TRNK < 10.1 SQ CM               PROCED     1,866.46                    14000
CANCER        5003455 0 TISS TRNSFR TRUNK 10.1-30 SQ CM             PROCED     1,827.70                    14001
CANCER        5003335 0 TISS TRNSFR SCP/AR/LG < 10.1 SQ CM          PROCED     1,370.75                    14020
CANCER        5003336 0 TISS TRNSFR F/NK/HND/G < 10.1 SQ CM         PROCED     1,406.21                    14040
CANCER        5003337 0 TISS TRNSFR EY/N/ER/LP < 10.1 SQ CM         PROCED     1,740.47                    14060
CANCER        5003409 0 TISS TRNSFR EY/N/ER/LP 10.1-30 SQ CM        PROCED     1,827.00                    14061
CANCER        5003456 0 TISS TRNSFR / REARR > 30 SQ CM COMPLICATD   PROCED     1,900.00                    14300
CANCER        5003338 0 SURG PREP RECIP SITE 1ST 100 SQ CM          PROCED     1,430.70                    15000
CANCER        5003423 0 SURG PREP RECIP SITE EA ADDL 100 SQ CM      PROCED     331.00                      15001
CANCER        5003339 0 SPL GRFT T/A/L PEDS 1ST 100 SQ CM           PROCED     2,048.41                    15100
CANCER        5003424 0 SPL GRFT T/A/L PEDS EA ADD'L 100 SQ CM      PROCED     1,366.74                    15101
CANCER        5003340 0 SPL GRFT INF/CHLD 1ST 100SQ CM              PROCED     1,950.84                    15120
CANCER        5003140 0 FULL THCK GRAFT TRNK< 20SQ CM               PROCED     1,495.62                    15200
CANCER        5003141 0 FULL THCK GRAFT S/A/L <20SQ CM              PROCED     1,461.58                    15220
CANCER        5003341 0 FULL THCK GRFT F/N/G/H<20SQ CM              PROCED     2,215.51                    15240
CANCER        5003342 0 FTSG N/ER/EY/LIP < 20 SQ CM                 PROCED     1,009.12                    15260
CANCER        5003471 0 FTSG N/ER/EY/LIP EA ADD'L 20 SQ CM          PROCED     350.00                      15261
CANCER        5003438 0 FOR DIR/TUB PEDICL EY/N/ER/LP/OR            PROCED     1,828.00                    15576
CANCER        5003112 0 FLAP ISLAND PEDICLE                         PROCED     1,100.00                    15740
CANCER        5003458 0 ABRASION SINGLE LESION                      PROCED     75.00                       15786
CANCER        5003459 0 ABRASION EA ADDL 4 LESIONS OR LESS          PROCED     75.00                       15787
CANCER        5003113 0 EXCIS EXCESSIVE SKIN / SQ TISS OTHER        PROCED     1,000.00                    15839
CANCER        5003343 0 DESTR BEN/PREMAL LES 1ST LES                PROCED     516.78                      17000
CANCER        5003344 0 DSTR BEN/PREMAL LES EA (2 THRU 14 LES)      PROCED     37.19                       17003
CANCER        5003345 0 DSTR BEN/PREMAL LES 15+ LES                 PROCED     218.60                      17004
CANCER        5003346 0 DSTR FLAT WARTS 1-14 LES                    PROCED     67.00                       17110
CANCER        5003347 0 DSTR FLAT WARTS 15+ LES                     PROCED     237.38                      17111
CANCER        5003348 0 CHEM CAUTER GRANIR TISSUE                   PROCED     168.70                      17250
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5003349 0 DSTR MAL LES T/A/L < 0.5 CM                PROCED     110.70                      17260
CANCER        5003350 0 DSTR MAL LES T/A/L 0.6-1 CM                PROCED     140.81                      17261
CANCER        5003351 0 DSTR MAL LES T/A/L 1.1-2 CM                PROCED     187.49                      17262
CANCER        5003352 0 DSTR MAL LES T/A/L 2.1-3 CM                PROCED     236.79                      17263
CANCER        5003353 0 DSTR MAL LES T/A/L 3.1-4 CM                PROCED     103.38                      17264
CANCER        5003354 0 DSTR MAL LES T/A/L > 4 CM                  PROCED     169.76                      17266
CANCER        5003355 0 DSTR MAL LES S/H/FT/G < .5CM               PROCED     135.27                      17270
CANCER        5003356 0 DSTR MAL LES S/H/FT/G .6-1CM               PROCED     141.21                      17271
CANCER        5003357 0 DSTR MAL LES S/H/FT/G 1.1-2CM              PROCED     198.72                      17272
CANCER        5003358 0 DSTR MAL LES S/H/FT/G 2.1-3 CM             PROCED     880.74                      17273
CANCER        5003359 0 DSTR MAL LES S/H/FT/G 3.1-4 CM             PROCED     169.76                      17274
CANCER        5003360 0 DSTR MAL LES S/H/FT/G > 4 CM               PROCED     281.61                      17276
CANCER        5003361 0 DSTR MAL LES F/E/EY/N/L<0.5CM              PROCED     148.79                      17280
CANCER        5003362 0 DSTR MAL LES F/E/EY/N/L .6-1CM             PROCED     236.79                      17281
CANCER        5003363 0 DSTR MAL LES F/E/EY/N/L 1.1-2              PROCED     199.10                      17282
CANCER        5003364 0 DSTR MAL LES F/E/EY/N/L 2.1-3              PROCED     103.38                      17283
CANCER        5003365 0 DSTR MAL LES F/E/EY/N/L 3.1-4              PROCED     315.63                      17284
CANCER        5003366 0 DSTR MAL LES F/E/EY/N/L>4CM                PROCED     103.38                      17286
CANCER        5003021 0 MOHS SURGERY-1 STAGE                       PROCED     558.16                      17304
CANCER        5003022 0 MOHS SURGERY-2 STAGES                      PROCED     477.07                      17305
CANCER        5003023 0 MOHS SURGERY-3 STAGES                      PROCED     327.10                      17306
CANCER        5003142 0 MOHS ADDL STGE 1-5 SPEC EA STG             PROCED     251.93                      17307
CANCER        5003143 0 MOHS >5 SPEC ANY STAGE                     PROCED     251.93                      17310
CANCER        5003200 0 ASP BREAST CYST SINGL                      PROCED     295.37                      19000
CANCER        5003202 0 BIOPSY, BREAST PERCUT CORE                 PROCED     632.48                      19100
CANCER        5003461 0 MUSCLE BX SUPERFICIAL                      PROCED     1,100.00                    20200
CANCER        5003462 0 MUSCLE BX DEEP                             PROCED     1,900.00                    20205
CANCER        5003207 0 INJ SING TENDON SHEATH OR LIG              PROCED     201.00                      20550
CANCER        5003019 0 INJ SING TENDON ORIGIN/INSERTION           PROCED     296.28                      20551
CANCER        5003071 0 TRIGR PNT INJ 1-2 MUSC SING/MULT           PROCED     189.00                      20552
CANCER        5003208 0 ARTHROCENTESIS ASP/INJ; LG MAJ JNT/BURSA   PROCED     249.60                      20610
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML      CPT
CANCER        5003451 0 BX SOFT TISS BACK / FLANK SUPERFICIAL         PROCED     800.00                       21920
CANCER        5003452 0 BX SOFT TISS BACK / FLANK DEEP                PROCED     2,160.00                     21925
CANCER        5003463 0 BX SOFT TISS UP ARM / ELBOW SUPERFICIAL       PROCED     1,000.00                     24065
CANCER        5003464 0 BX SOFT TISS UP ARM / ELBOW DEEP              PROCED     1,200.00                     24066
CANCER        5003442 0 EXC TUMOR SFT TISS UP ARM / ELB SQ            PROCED     1,651.00                     24075
CANCER        5003468 0 BX SOFT TISS THIGH / KNEE SUPERFICIAL         PROCED     950.00                       27323
CANCER        5003469 0 BX SOFT TISS THIGH / KNEE DEEP                PROCED     1,250.00                     27324
CANCER        5003443 0 BX SFT TISS LEG/ANK SUPERFIC                  PROCED     814.00                       27613
CANCER        5003437 0 UNNA BOOT APPLICATION BILAT                   PROCED     162.57                      2958050
CANCER        5003416 0 UNNA BOOT APPLICATION LT                      PROCED     152.30                      29580LT
CANCER        5003436 0 UNNA BOOT APPLICATION RT                      PROCED     152.30                      29580RT
CANCER        5003145 0 BIOPSY INTRANASAL                             PROCED     506.00                       30100
CANCER        5003146 0 NASL PCK/CAUT (FOR EPISTAX)                   PROCED     198.19                       30901
CANCER        5003148 0 CAUT NASL PCK/POST W/PCK INIT                 PROCED     266.76                       30905
CANCER        5003149 0 NASL ENDO DIAG UNIL/BILAT                     PROCED     1,077.14                     31231
CANCER        5003063 0 NASL ENDO W/POLYPEC UNIL                      PROCED     2,343.10                     31237
CANCER        5003213 0 THER VOCAL CORD INJ                           PROCED     2,086.00                     31570
CANCER        5003214 0 FLEX FIBEROPTIC SCOPE                         PROCED     202.50                       31575
CANCER        5003065 0 VIDEOSTROBOSCOPY                              PROCED     557.92                       31579
CANCER        5003445 0 BRONCHOSCPY DIAG                              PROCED     1,420.00                     31622
CANCER        5003457 0 SURG CLOSURE TRACH / FIST W/ PLASTIC REPAIR   PROCED     1,454.00                     31825
CANCER        5003150 0 THORACENTESIS INIT/SUB                        PROCED     471.73                       32000
CANCER        5003086 0 THORACENTESIS W/ INSERT TUBE                  PROCED     1,078.11                     32002
CANCER        5003084 0 INSRT INDWELLING TUN PLEURAL CATH W/ CUFF     PROCED     850.00                       32019
CANCER        5003085 0 THORACOSTOMY TUBE PLCMT PLEURA                PROCED     1,154.52                     32020
CANCER        5003215 0 BLOOD DRAW ROUTN VENIPUNC                     PROCED     19.69                        36415
CANCER        5030025 0 TRANSFUS BLOOD PROD 0-2HR                     PROCED     627.92                       36430
CANCER        5043026 0 TRANSFUS BLOOD PROD 2-4HR                     PROCED     627.92                       36430
CANCER        5043027 0 TRANSFUS BLOOD PROD 4-6HR                     PROCED     627.92                       36430
CANCER        5043028 0 TRANSFUS BLOOD PROD 6-8HR                     PROCED     627.92                       36430
CANCER        5003368 0 INJ SCLER SNG/MULT VEIN LIM/TR                PROCED     221.67                       36468
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5030020 0 BLOOD DRAW IMPLANTABLE VAD                      PROCED     91.26                       36540
CANCER        5003101 0 DECLOT BY THROMOBOLYTIC AGEN                    PROCED     293.00                      36550
CANCER        5003446 0 INSRT TUN CVC W/ PORT AGE 5 & ABV               PROCED     2,948.00                    36561
CANCER        5030015 0 PICC CATH PLCMT W/O PORT/PUMP AGE 5 & ABV       PROCED     1,027.61                    36569
CANCER        5003431 0 REPAIR TUNN / NON-TUN CVC W/O PORT / PUMP       PROCED     514.00                      36575
CANCER        5003432 0 REPLAC NON-TUN CVC NO PORT / PUMP               PROCED     659.44                      36580
CANCER        5003434 0 REMOVE TUNNLD CVC NO PORT / PUMP                PROCED     514.00                      36589
CANCER        5003103 0 BONE MARROW ASPIRATION                          PROCED     267.00                      38220
CANCER        5003104 0 BONE MARROW BIOPSY                              PROCED     267.00                      38221
CANCER        5003111 0 BM/STM CELL TRANSPLANT ALLOGEN                  PROCED     1,527.00                    38240
CANCER        5003193 0 BM/STM CELL TRANSPLANT AUTOLOG                  PROCED     1,527.00                    38241
CANCER        5060017 0 ALLOGEN DONOR LYMPHCYT INFUSION                 PROCED     1,514.20                    38242
CANCER        5003217 0 LYMPH NDE BIOP SUPERFIC                         PROCED     1,796.85                    38500
CANCER        5003404 0 BIOPSY OF LIP                                   PROCED     929.34                      40490
CANCER        5003151 0 BIOPSY ORAL CAVITY                              PROCED     1,828.09                    40808
CANCER        5003447 0 EXC LES VESTIBUL MOUTH W/O REPAIR               PROCED     1,750.00                    40810
CANCER        5003152 0 BIOPSY TONGUE, ANT 2/3                          PROCED     946.11                      41100
CANCER        5003425 0 DILATION SALIVARY DUCT                          PROCED     506.00                      42650
CANCER        5003155 0 I&D PERITONSILR ABSCESS                         PROCED     180.36                      42700
CANCER        5003156 0 BIOPSY OROPHARYNX                               PROCED     1,003.00                    42800
CANCER        5003157 0 BIOPSY HYPOPHARYNX                              PROCED     1,003.00                    42802
CANCER        5003158 0 BIOPSY NASOPHARYNX                              PROCED     1,478.60                    42804
CANCER        5003072 0 ESOPHAGOSCOPY DIAG W/ OR W/O SPEC               PROCED     939.60                      43200
CANCER        5003073 0 ESOPHAGOSCPY W/ BX SING OR MULT                 PROCED     1,143.44                    43202
CANCER        5003074 0 ESOPHAGOSCPY W/ REM FORGN BDY                   PROCED     1,352.25                    43215
CANCER        5003075 0 ESOPHAGOSCPY W/ INSERT TUBE/STENT               PROCED     2,637.39                    43219
CANCER        5003054 0 ESOPHAGOSCPY DIAG W/ INSERT GIDEWIRE & DILATN   PROCED     1,000.00                    43226
CANCER        5003076 0 DILATION ESOPHAGUS                              PROCED     1,195.49                    43450
CANCER        5003077 0 DILATION ESOPHAGUS OVER GUIDE WIRE              PROCED     1,195.49                    43453
CANCER        5003220 0 PROCTOSIGMOIDOSCOPY                             PROCED     405.00                      45300
CANCER        5003221 0 PROCTOSIGMOIDOSC W/BIOP                         PROCED     498.00                      45305
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5003222 0 FLEX SIGMOIDOSCOPY                    PROCED     579.38                      45330
CANCER        5003223 0 FLEX SIGMOIDOSCPY W/BX                PROCED     625.36                      45331
CANCER        5003224 0 SIGMOIDOSCOPY W/ POLYPECTOMY          PROCED     805.84                      45333
CANCER        5003225 0 COLONOSCPY FLEX DIAGNOS               PROCED     1,078.18                    45378
CANCER        5003226 0 COLONOSCPY W/BIOP                     PROCED     1,600.00                    45380
CANCER        5003227 0 COLONOSCPY W/POLYPEC SNAR             PROCED     1,317.15                    45385
CANCER        5003372 0 DSTR LES ANUS SIMPL CHEM              PROCED     169.76                      46900
CANCER        5003229 0 PARACENTESIS INITIAL                  PROCED     558.03                      49080
CANCER        5003230 0 PARACENTESIS SUBSEQUENT               PROCED     421.40                      49081
CANCER        5003376 0 BLADDR IRRIG SIMP LAVGE               PROCED     681.24                      51700
CANCER        5003400 0 CATHETRZTN URETH STRAIGHT CATH        PROCED     50.00                       51701
CANCER        5003382 0 CATHETRZTN URETH INDWELL FOLEY SIMP   PROCED     137.06                      51702
CANCER        5003383 0 CATHETRZTN URETH INDWELL FOLEY COMP   PROCED     170.00                      51703
CANCER        5030016 0 BLADDER INSTILLATION CHEMO            PROCED     366.39                      51720
CANCER        5003040 0 UROFLOW SIMPL MECHAN                  PROCED     208.97                      51736
CANCER        5003402 0 UROFLOW COMPLX W/CALIB EQUIP          PROCED     285.95                      51741
CANCER        5003427 0 PVR BY ULTRASOUND                     PROCED     39.00                       51798
CANCER        5003417 0 CYSTOSCOPY                            PROCED     1,395.61                    52000
CANCER        5003418 0 CYSTOSCOPY W/ BX                      PROCED     1,535.60                    52204
CANCER        5003419 0 CYSTOSCPY W/ FULGURATION              PROCED     1,705.32                    52214
CANCER        5003420 0 CYSTOSCPY W/ FULGURATN / TX LES       PROCED     1,684.11                    52224
CANCER        5003380 0 DILTN OF FEM URETH INIT               PROCED     140.40                      53660
CANCER        5003381 0 DILTN OF FEM URETH SUBS               PROCED     122.10                      53661
CANCER        5003386 0 DSTR LES PENIS CRYOSURG               PROCED     109.08                      54056
CANCER        5003231 0 BIOPSY PENIS                          PROCED     1,117.00                    54100
CANCER        5003160 0 I & D VULVA/PERINEAL ABSCESS          PROCED     343.90                      56405
CANCER        5003162 0 DSTR LES VULVA SIMPL                  PROCED     1,881.90                    56501
CANCER        5003164 0 BIOP VULVA/PERINEUM 1 LES             PROCED     738.75                      56605
CANCER        5003232 0 BIOPSY VULVA EA ADDL                  PROCED     573.08                      56606
CANCER        5003460 0 VULVECTOMY SIMPLE PARTIAL             PROCED     1,671.00                    56620
CANCER        5003165 0 DESTR VAG LESION SIM                  PROCED     1,570.69                    57061
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY       OUTPT)          LML/RML     CPT
CANCER        5003167 0 BIOPSY VAG MUCOSA SIMPL                     PROCED         603.74                      57100
CANCER        5003233 0 EXCISION VAGINAL CYST / TUMOR               PROCED         1,628.10                    57135
CANCER        5003234 0 PESSARY INSERT FIT                          PROCED         123.57                      57160
CANCER        5003450 0 COLPOSCPY ENTIRE VAG W/ CERV IF PRESENT     PROCED         312.00                      57420
CANCER        5003235 0 COLPOSCOPY (VAGINOSCOPY)                    PROCED         380.00                      57452
CANCER        5003168 0 COLPOSCOPY W/BIOPSY                         PROCED         586.20                      57454
CANCER        5003236 0 COLPOSCOPY LEEP                             PROCED         1,619.38                    57460
CANCER        5003237 0 BIOP,SING OR MULT,CERVIX                    PROCED         843.30                      57500
CANCER        5003238 0 ENDOCERVICAL CUTTERAGE                      PROCED         604.08                      57505
CANCER        5003241 0 CONIZATION CERVIX                           PROCED         1,815.84                    57520
CANCER        5003242 0 DILAT CERVIX CANL INSTRMNT                  PROCED         1,074.74                    57800
CANCER        5003243 0 ENDOMET BX W/O CERV DILATN                  PROCED         318.67                      58100
CANCER        5003102 0 LUMBAR PUNCTURE DIAGNOSTIC                  PROCED         303.93                      62270
CANCER        5003170 0 INJ INFUS ANESTH LUMB/SACRAL                PROCED         375.00                      62311
CANCER        5003185 0 CELIAC PLEX INJ,ANES AGT                    PROCED         375.00                      64530
CANCER        5003250 0 TENS APPLICATION & INSTRUCTION              PROCED         74.61                       64550
CANCER        5003406 0 EXCIS EXTERNL EAR PARTIAL                   PROCED         1,952.00                    69110
CANCER        5003411 0 EXCIS EXTERN EAR COMPLT AMP                 PROCED         1,454.00                    69120
CANCER        5003254 0 REM IMPACTED CERUMEN                        PROCED         90.72                       69210
CANCER        5003189 0 TYPANOST W/TUBE                             PROCED         892.96                      69433
CANCER        5003414 0 ULTRASOUND BLADDER                          PROCED         400.91                      76775
CANCER        5003043 0 U/A BY CLINITEK                                           39.83
                                                                    WAIVED TEST DON                            81003
CANCER        5003401 0 BLOOD GLUCOSE ACCUCHECK                                   23.37
                                                                    WAIVED TEST DON                            82962
CANCER        5010604 0 TUBERCULIN SKIN TEST INTRADERM              MED            18.40                       86580
CANCER        5003429 0 TISSUE EXAM KOH - FUNGI, OVA                PROCED         44.62                       87220
CANCER        5003454 0 FROZEN SECTION SINGL SPEC; 1ST TISS BLOCK   PROCED         151.40                      88331
CANCER        5010241 0 VARICELLA IMMUNE GLOBULIN INJ               MED            404.80                      90396
CANCER        5002220 0 INJ FEE VACCINE (1) SINGLE                  PROCED         25.00                       90471
CANCER        5003258 0 INJ FEE VACCINE EA ADDL                     PROCED         25.00                       90472
CANCER        5010626 0 HAEMOPHILUS B VACC INJ                      MED IMMUN      48.40                       90647
CANCER        5010084 0 INFLUENZA VACC INJ AGE 3 & ABV              MED IMMUN      15.00                       90656
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY    OUTPT)          LML/RML     CPT
CANCER        5010625 0 DIPHTH / TETANUS TOX INJ ADULT                  MED IMMUN   34.00                       90718
CANCER        5010131 0 PNEUMOCOCCAL VACC INJ 0.5 ML                    MED IMMUN   75.00                       90732
CANCER        5010628 0 MENINGOCOCCAL VACC INJ SQ                       MED IMMUN   123.70                      90733
CANCER        5010627 0 HEPATITIS B INJ 10 MCG ADULT                    MED IMMUN   75.00                       90746
CANCER        5002050 0 INJ FEE FILGRASTIM (NEUPOGEN)                   PROCED      60.36                       90772
CANCER        5003020 0 INJ FEE THER / DIAG / PROPHY SQ,IM,ID           PROCED      60.36                       90772
CANCER        5003257 0 INJ FEE EPOGEN / ARANESP                        PROCED      60.36                       90772
CANCER        5003190 0 NASOPHARYN W/SCOPE                              PROCED      163.33                      92511
CANCER        5003030 0 PULSE OXIM FOR 02 SAT SINGL                     PROCED      94.01                       94760
CANCER        5030026 0 INJ FEE CHEMO SQ/IM ANTINEOPLAS, NON-HORMONE PROCED         155.25                      96401
CANCER        5030027 0 INJ FEE CHEMO SQ/IM ANTINEOPLAS, HORMONAL       PROCED      155.25                      96402
CANCER        5003405 0 LUMB PUNC W/CHEMO ADMIN                         PROCED      164.00                      96450
CANCER        5003435 0 REFILL / MAINT PORTABLE PUMP                    PROCED      129.78                      96521
CANCER        5003470 0 CHEMO INJ INTRAVENTRICULAR VIA SQ RESERVOIR (OM PROCED      100.00                      96542
CANCER        5003466 0 CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 30 MIN   PROCED      170.00                      99143
CANCER        5003467 0 CONSCIOUS SEDATION SAME MD 5 Y/O & ABV 1ST 30 MIN
                                                                        PROCED      170.00                      99144
CANCER        5003465 0 CONSCIOUS SEDATION SAME MD ALL AGES EA ADDL 15 PROCED       85.00                       99145
CANCER        5070003 0 GENETICS ASSESSMENT 15 MIN                      PROCED      79.60                       99401
CANCER        5070004 0 GENETICS ASSESSMENT 30 MIN                      PROCED      175.00                      99402
CANCER        5070002 0 GENETICS ASSESSMENT 60 MIN                      PROCED      278.51                      99404
CANCER        5001180 0 PESSARY,NON RUBBER, ANY TYPE                    SUPPLY      120.90                      A4562
CANCER        5043029 0 INFUSION THER NON-CHEMO 1ST HR                  PROCED      236.00                      C8950
CANCER        5060018 0 HDT INFUSION THER NON-CHEMO 1ST HR              PROCED      236.00                      C8950
CANCER        5043030 0 INFUSION THER NON-CHEMO EA ADD'L HR             PROCED      142.00                      C8951
CANCER        5060019 0 HDT INFUSION THER NON-CHEMO EA ADD'L HR         PROCED      142.00                      C8951
CANCER        5003053 0 INJ FEE IV PUSH THER / DIAG / PROPHY            PROCED      150.00                      C8952
CANCER        5030017 0 INJ FEE CHEMO IVP                               PROCED      155.25                      C8953
CANCER        5030076 0 INFUSION THER CHEMO 1ST HR                      PROCED      264.00                      C8954
CANCER        5030078 0 HDT INFUSION THER CHEMO 1ST HR                  PROCED      264.00                      C8954
CANCER        5030077 0 INFUSION THER CHEMO EA ADD'L HR                 PROCED      158.00                      C8955
CANCER        5030079 0 HDT INFUSION THER CHEMO EA ADD'L HR             PROCED      158.00                      C8955
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5002230 0 INJ FEE INFLUENZA                            PROCED     15.00                       G0008
CANCER        5002235 0 INJ FEE PNEUMOCOCCAL                         PROCED     25.00                       G0009
CANCER        5002240 0 INJ FEE HEPATITIS B                          PROCED     25.00                       G0010
CANCER        5010582 0 CASPOFUNGIN ACET IVPB 5 MG                   MED        62.40                       J0637
CANCER        5010921 0 DAPTOMYCIN INJ / IVPB 1 MG                   MED        0.70                        J0878
CANCER        5010621 0 DARBEPOETIN 1 MCG (NON-ESRD PT) INJ          MED        13.55                       J0881
CANCER        5010491 0 ERYTHROPOIETIN 1000 UNIT (NON-ESRD PT) INJ   MED        46.40                       J0885
CANCER        5010655 0 TESTOSTERONE CYPIONATE INJ 200 MG            MED        31.00                       J1080
CANCER        5010672 0 HYDROMORPHONE INJ 2 MG                       MED        7.60                        J1170
CANCER        5010225 0 FILGRASTIM INJ (300MCG)                      MED        516.00                      J1440
CANCER        5010902 0 FILGRASTIM 480 MCG INJ                       MED        781.10                      J1441
CANCER        5010209 0 GENTAMYCIN INJ 80MG                          MED        6.80                        J1580
CANCER        5010506 0 ENOXAPARIN 10MG INJ                          MED        20.00                       J1650
CANCER        5010072 0 HYDROCORTISONE INJ (100MG)                   MED        17.50                       J1720
CANCER        5010664 0 INSULIN INJ 5 UNITS ALL TYPES                MED        1.00                        J1815
CANCER        5010203 0 LEUPROLIDE DEPOT 3.75 MG INJ                 MED        1,120.00                    J1950
CANCER        5010096 0 LORAZEPAM INJ (2MG)                          MED        34.30                       J2060
CANCER        5010464 0 OCTREOTIDE ACET INJ (1MG) LAR                MED        308.00                      J2353
CANCER        5010870 0 PEGFILGRASTIM 6 MG INJ                       MED        5,160.40                    J2505
CANCER        5010246 0 PENTAMIDINE INH 300MG                        MED        113.05                      J2545
CANCER        5010476 0 TRIAMCINOLON Acet INJ 10MG                   MED        5.80                        J3301
CANCER        5010212 0 HYDROXYZINE 25 MG INJ                        MED        11.90                       J3410
CANCER        5010022 0 CYANOCOBALAMIN INJ 100MCG                    MED        11.00                       J3420
CANCER        5010023 0 CYANOCOBALAMIN INJ 1000MCG                   MED        16.60                       J3420
CANCER        5010496 0 MAGNESIUM SULFATE INJ 500 mg                 MED        21.60                       J3475
CANCER        5010657 0 ZOLEDRONIC ACID INJ / IVPB 1 MG              MED        865.00                      J3487
CANCER        5020002 0 IV 0.9% NACL IV BAG 500ML                    MED        64.80                       J7040
CANCER        5020001 0 IV 0.9% NACL IV BAG 250ML                    MED        64.80                       J7050
CANCER        5010635 0 HYALURONAT INJ 20-25 MG (JOINT INJ)          MED        352.00                      J7317
CANCER        5010457 0 THYMOGLOBULIN 25MG INJ                       MED        536.80                      J7511
CANCER        5010430 0 DACLIZUMAB (ZENAPAX)IVPB 25MG                MED        941.20                      J7513
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5010331 0 BUSULFAN 2 MG TAB                   MED        6.61                        J8510
CANCER        5010618 0 ARSENIC TRIOXIDE IVPB 1 MG          MED        56.70                       J9017
CANCER        5010005 0 BCG VACCINE INTRABLADDER (1AMP      MED        367.90                      J9031
CANCER        5010254 0 GOSERELIN 3.6 MG INJ                MED        975.00                      J9202
CANCER        5010095 0 LEUPROLIDE DEPOT 7.5 MG INJ         MED        1,400.00                    J9217
CANCER        5010622 0 LEUPROLIDE ACET IMPLNT 65 MG        MED        8,928.00                    J9219
CANCER        5010501 0 METHOTREXATE INTRATHECAL 5MG        MED        11.00                       J9250
CANCER        5010872 0 FULVESTRANT INJ 25 MG               MED        290.60                      J9395
CANCER        5003422 0 PAP SMEAR SCREENING                 PROCED     95.82                       Q0091
CANCER        5010135 0 PROCHLORPERAZINE TAB 10MG           MED        2.50                        Q0165
CANCER        5010125 0 ONDANSETRON TAB 8MG                 MED        59.00                       Q0179
CANCER        5010554 0 ONDANSETRON 8MG ODT                 MED        49.80                       Q0179
CANCER        5060014 0 BAG DRAINAGE URINARY                SUPPLY     10.10
CANCER        5001112 0 TRACH CLEANING KIT                  Supply     9.70
CANCER        5001004 0 BAG URINARY LEG BAG ALL SIZES       SUPPLY     27.19
CANCER        5001006 0 BANDAGE ACE WRAP 2 IN               SUPPLY     6.60
CANCER        5001007 0 BANDAGE GAUZE KLING                 SUPPLY     7.20
CANCER        5001008 0 BANDAGE ACE WRAP 4 IN               SUPPLY     6.60
CANCER        5001009 0 BANDAGE COBAN SELF ADHES WRAP       SUPPLY     7.20
CANCER        5001014 0 BIVONA TRACH VENT                   SUPPLY     39.90
CANCER        5001029 0 CATH MALE EXTERNL INCONT TEXAS      SUPPLY     5.60
CANCER        5001044 0 KERLIX ROLL EACH                    SUPPLY     2.00
CANCER        5001050 0 GAUZE 1 BOX 2X2'S STERILE           SUPPLY     14.00
CANCER        5001051 0 GAUZE 1 BOX 4X4'S UNSTERILE         SUPPLY     16.50
CANCER        5001052 0 GAUZE 1 BOX 4X4'S STERILE           SUPPLY     8.20
CANCER        5001055 0 DRSG CHNG KIT CENT LINE ADULT       SUPPLY     10.95
CANCER        5001065 0 TRACH TUBE SHILEY LGT ALL SIZES     SUPPLY     103.40
CANCER        5001085 0 CATH SUCTION SET PLASTIC 10-14 FR   SUPPLY     2.00
CANCER        5001087 0 TRAY IRRIG W/PISTON SYRNG           SUPPLY     13.95
CANCER        5001097 0 SUTURE REMOVAL SET EA               SUPPLY     2.00
CANCER        5001099 0 STAPLE REM SET DISP EA              SUPPLY     4.64
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5001102 0 LEG STRAP FOR URINARY CATH          SUPPLY     12.05
CANCER        5001110 0 TEGADERM 2X2 EACH                   SUPPLY     3.00
CANCER        5001113 0 TRACH TIE VELCRO ALL SIZES          SUPPLY     2.00
CANCER        5001130 0 WATER STERILE POUR BTL 1000 ML      SUPPLY     2.00
CANCER        5001137 0 TEGADERM 4X4 EACH                   SUPPLY     5.10
CANCER        5001138 0 WATER STERIL POUR BTL 500 ML        SUPPLY     3.30
CANCER        5001139 0 STERISTRIP 1 PKGE ALL SIZES         SUPPLY     2.00
CANCER        5001149 0 SALINE 0.9% POUR BTLE 1000ML        SUPPLY     2.00
CANCER        5001151 0 NEEDLE 90 DEG NON-KOR EA            SUPPLY     15.20
CANCER        5001153 0 URINE HAT FEMALE EA                 SUPPLY     3.30
CANCER        5001165 0 IV KIT PERIPHERAL                   SUPPLY     13.90
CANCER        5001168 0 DILATOR,VAGINAL SMALL               SUPPLY     31.80
CANCER        5001169 0 DILATOR,VAGINAL LARGE               SUPPLY     41.60
CANCER        5001170 0 DILATOR,VAGINAL MEDIUM              SUPPLY     36.20
CANCER        5001171 0 IRRIGATION SET BLADDER              SUPPLY     11.79
CANCER        5001172 0 TRAY URETHRAL CATH - STRAIT CATH    SUPPLY     6.68
CANCER        5001173 0 SYRINGE IRRIGATION PISTON           SUPPLY     2.00
CANCER        5001174 0 IRRIGATION SET W/ PISTON SYRINGE    SUPPLY     4.45
CANCER        5001175 0 CATH URETHRAL SELF-CATH ALL SIZES   SUPPLY     3.00
CANCER        5001176 0 ENEMA FLEET                         SUPPLY     7.30
CANCER        5001177 0 BANDAGE ACE WRAP 3"                 SUPPLY     2.00
CANCER        5001178 0 BANDAGE ACE WRAP 6"                 SUPPLY     3.65
CANCER        5001179 0 WATER STERILE POUR BTL 1500 ML      SUPPLY     3.76
CANCER        5001182 0 WATER STERILE POUR BTL 500 ML       SUPPLY     2.00
CANCER        5001183 0 THERABITE STYROFOAM CUSHION EA      SUPPLY     7.45
CANCER        5001184 0 FEEDING TUBE CAP EA                 SUPPLY     27.40
CANCER        5001187 0 THERABITE (JAW MOTION REHAB)        SUPPLY     708.00
CANCER        5001188 0 DRSG XEROFORM 5 X 9                 SUPPLY     2.00
CANCER        5001189 0 GAUZE IODAFORM 1 INCH               SUPPLY     10.69
CANCER        5001190 0 GAUZE IODAFORM 1/2 INCH             SUPPLY     9.45
CANCER        5001191 0 DRSG TEGADERM 6 X 7                 SUPPLY     2.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5001192 0 DRSG TEGADERM 8 X 12                         SUPPLY     7.77
CANCER        5001193 0 GAUZE VASELINE 3 X 9                         SUPPLY     2.00
CANCER        5001194 0 GAUZE VASELINE 3 X 18                        SUPPLY     2.00
CANCER        5001195 0 DRSG ADAPTIC 3 X 3                           SUPPLY     2.00
CANCER        5001196 0 DRSG ADAPTIC 3 X 6                           SUPPLY     6.64
CANCER        5001197 0 DRSG ADAPTIC 3 X 8                           SUPPLY     6.02
CANCER        5001198 0 CATH RED RUBBER SIZE 14-20                   SUPPLY     2.00
CANCER        5001199 0 CATH RED RUBBER COUDE SIZE 14-20             SUPPLY     14.16
CANCER        5001201 0 CATH FOLEY COUDE SIZE 14, 16                 SUPPLY     34.20
CANCER        5001202 0 CATH FOLEY COUDE SIZE 18                     SUPPLY     35.70
CANCER        5001203 0 CATH FOLEY 3-WAY W/ 5CC BALLOON SIZE 20-24   SUPPLY     33.32
CANCER        5001204 0 CATH FOLEY W/ 5CC BALLOON SIZE 14-22         SUPPLY     12.56
CANCER        5001206 0 TRAY FOLEY W/ CATH & URIMETER BAG            SUPPLY     35.76
CANCER        5001207 0 GAUZE NU GAUZE PLAIN 1/4"                    SUPPLY     8.14
CANCER        5001208 0 GAUZE NU GAUZE PLAIN 1/2"                    SUPPLY     8.10
CANCER        5001209 0 GAUZE NU GAUZE PLAIN 1"                      SUPPLY     9.20
CANCER        5001210 0 GEL FOAM SPONGE EA ALL SIZES                 SUPPLY     30.55
CANCER        5001211 0 TUBE SUCTION YANKAUER                        SUPPLY     2.00
CANCER        5001220 0 NASAL FX SPLINT DENVER                       SUPPLY     108.25
CANCER        5001221 0 PLEURAL CATH DRNGE LINE SET REPLCMNT         SUPPLY     50.00
CANCER        5001234 0 NASAL PCKNG EPISTAXIS(MEROCEL)               SUPPLY     17.00
CANCER        5001235 0 TRACH STOMA BIB                              SUPPLY     34.67
CANCER        5001236 0 TRACH TUBE SHILEY SIZE 4-10                  SUPPLY     91.76
CANCER        5001238 0 TRAY FOLEY W/ CATH & DRNG BAG                SUPPLY     27.27
CANCER        5010042 0 DEXAMETHASONE TAB 4MG                        MED        3.60
CANCER        5010043 0 DIPHENHYDRAMINE CAP 25MG                     MED        2.50
CANCER        5010134 0 PROCHLORPERAZINE SUP 25MG                    MED        4.50
CANCER        5010154 0 EMLA CREAM TOPICAL 5GM                       MED        19.90
CANCER        5010163 0 MEPERIDINE INJ (25MG)                        MED        11.00
CANCER        5010173 0 LORAZEPAM TAB 1MG                            MED        2.50
CANCER        5010177 0 ACETAMINOPHEN DROPS 100MG                    MED        15.80
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION              CATEGORY   OUTPT)          LML/RML     CPT
CANCER        5010275 0 FENTANYL PATCH 25MCG/HR         MED        39.40
CANCER        5010276 0 FENTANYL PATCH 75MCG/HR         MED        60.70
CANCER        5010277 0 FENTANYL PATCH 50MCG/HR         MED        58.50
CANCER        5010283 0 FOLIC ACID TAB 1MG              MED        2.50
CANCER        5010291 0 MILK OF MAGNESIA 30ML           MED        4.50
CANCER        5010297 0 MORPHINE ORAL CONC (20MG/1ML)   MED        10.50
CANCER        5010357 0 BUPIVACAINE 0.25% INJ 30ML      MED        33.30
CANCER        5010358 0 BUPIVACAINE 0.5% INJ 30ML       MED        33.30
CANCER        5010366 0 LOPERAMIDE CAP 2MG              MED        2.50
CANCER        5010368 0 PREDNISONE 20MG TAB             MED        2.50
CANCER        5010371 0 HYDROCORTISONE 1% CR 30GM       MED        11.20
CANCER        5010374 0 CLOTRIMAZOLE 1% CR 30G          MED        17.40
CANCER        5010375 0 TRIAMCINOLONE 0.5% CR 15G       MED        7.80
CANCER        5010387 0 ACYCLOVIR 5% OINT 15G           MED        141.00
CANCER        5010399 0 MAGNESIUM OXIDE CAP 400MG       MED        2.50
CANCER        5010404 0 MICONAZOLE 2% VAG CREAM 45G     MED        22.90
CANCER        5010408 0 OMEPRAZOLE SR CAP 20MG          MED        11.40
CANCER        5010427 0 ACETAMINOPHEN TAB 325MG         MED        3.70
CANCER        5010470 0 DIAZEPAM 5MG TAB                MED        2.50
CANCER        5010509 0 TRIAMCINOLNE CRM 0.1% 80GM      MED        37.30
CANCER        5010511 0 IBUPROFEN 200MG TAB             MED        2.50
CANCER        5010550 0 CEFEPIME 1GM IVPB               MED        34.50
CANCER        5010555 0 SIMETHICONE 80MG TAB            MED        2.50
CANCER        5010564 0 GATIFLOXACIN 400MG TAB          MED        15.20
CANCER        5010571 0 LIDOCAINE 2% VISC SOLN 20 ML    MED        4.50
CANCER        5010573 0 LIDOCAINE 2% GEL 30 ML          MED        44.10
CANCER        5010578 0 PANTOPRAZOLE TAB 40 MG          MED        2.60
CANCER        5010586 0 NYSTATIN CREAM 15 GM TUBE       MED        3.10
CANCER        5010605 0 ARTIFICIAL TEARS 15 ML GTTS     MED        15.50
CANCER        5010630 0 AMINOCAPROIC ACID TAB 500 MG    MED        3.20
CANCER        5010676 0 NYSTATIN TALC 15 GM             MED        49.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE        PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                            CATEGORY      OUTPT)           LML/RML     CPT
CANCER         5010848 0 METFORMIN TAB 500 MG                          MED           2.50
CANCER         5010917 0 MEPERIDINE 50 MG INJ                          MED           15.30
CANCER         5010925 0 RADIESSE 1 CC INJ (INJ TO VOCAL CORD)         MED           811.25
CANCER         5041046 0 FILTER LEUKOCYTE DEPLETN PRBC                 SUPPLY        57.20
CANCER         5041140 0 NEEDLE HUBER 20G X 1"                         SUPPLY        12.65
CANCER         5041141 0 NEEDLE HUBER 20G X 3/4"                       SUPPLY        12.65
CANCER         5041148 0 FILTER LEUKOCYTE PLTLET                       SUPPLY        134.20
CANCER         5041152 0 FILTER, 22 MICRON                             SUPPLY        10.75
CANCER         5060009 0 STETHOSCOPE DISP EA (ADLT/PED)                SUPPLY        25.70
CANCER         5060016 0 HOT PACK EA (INSTANT)ALL SIZES                SUPPLY        10.95
CANCER         5060020 0 STAT LOCK FOR PICC LINE                       SUPPLY        36.50
CANCER         5002216 2 LEVEL OF CARE NO CHARGE - CANCER USE ONLY     LOC           STATISTICAL ITEM
CANCER COLEM   5080010 0 BIOFEEDBACK TRAINING 30 MIN                   PROCED-CASH CO107.60                       90901
CANCER COLEM   5080011 0 BIOFEEDBACK TRAINING 60 MIN                   PROCED-CASH CO187.80                       90901
CANCER COLEM   5080006 0 ACUPUNCTURE W/O ELEC STIM 1ST 15 MIN          PROCED        25.00                        97810
CANCER COLEM   5080007 0 ACUPUNCTURE W/O ELEC STIM EA ADD'L 15 MIN     PROCED        17.00                        97811
CANCER COLEM   5080004 0 ACUPUNCTURE W/ ELEC STIM 1ST 15 MIN           PROCED        33.00                        97813
CANCER COLEM   5080005 0 ACUPUNCTURE W/ ELEC STIM EA ADD'L 15 MIN      PROCED        17.00                        97814
CANCER COLEM   5080008 0 MASSAGE THERAPY 60 MIN SESSION                PROCED-CASH CO65.00
CANCER COLEM   5080009 0 MASSAGE THERAPY 30 MIN SESSION                PROCED-CASH CO35.00
CARD CATH      4801126 0 ENDOTRACH INTUBATION EMERGENCY ONLY           PROCED        580.45                       31500
CARD CATH      4801038 0 PERICARDIOCENTESIS-INITIA                     PROCED        1,009.40                     33010
CARD CATH      4801065 0 PERICARDIOCENTESIS-SUBSEQUENT                 PROCED        1,009.40                     33011
CARD CATH      4801066 0 PERICARDIAL WINDOW                            PROCED        1,087.70                     33025
CARD CATH      4801550 0 PACER INSERT TEMP SING CHAMB                  PROCED        6,779.40                     33210
CARD CATH      4801028 0 PACER INSERT TEMP DUAL CHAMB                  PROCED        6,779.40                     33211
CARD CATH      4801542 0 TRICUSPID VALVULOPLASTY                       PROCED        6,806.18                     33463
CARD CATH      4801673 0 ENDVASC REP DESC THORACIC AORTA COV SUBCLAV PROCED          5,000.00                     33880
CARD CATH      4801674 0 ENDVASC REP DESC THORACIC AORTA W/O COV SUBCL PROCED        5,000.00                     33881
CARD CATH      4801675 0 ENDVASC REP PLCMT PROX EXT PROS INITIAL       PROCED        650.00                       33883
CARD CATH      4801676 0 ENDVASC REP PLCMT PROX EXT PROS EA ADDL       PROCED        650.00                       33884
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY   OUTPT)          LML/RML      CPT
CARD CATH     4801677 0 ENDVASC REP PLCMT DIST EXT PROS DELAY            PROCED     650.00                       33886
CARD CATH     4801678 0 ENDVASC REP OPEN SUBCL TRANSPO NECK INCIS UNILA  PROCED     5,000.00                     33889
CARD CATH     4801551 0 INTRA-AORTIC BALLOON INSERTION                   PROCED     2,115.40                     33967
CARD CATH     4802755 0 AAA STENT IMPLANT                                PROCED     4,696.40                     34802
CARD CATH     4801669 0 OPEM FEM ART EXPOS GROIN INCIS UNILAT            PROCED     5,000.00                     34812
CARD CATH     4801670 0 OPEN ILIAC ART EXPOS ABD/RETROPERIT INCIS UNILAT PROCED     2,400.00                     34820
CARD CATH     4802757 0 AAA EXT CUFF PLACEMENT                           PROCED     602.20                       34825
CARD CATH     4802756 0 AAA ADD'L CUFF PLACEMENT                         PROCED     602.20                       34826
CARD CATH     4801671 0 OPEN ILIAC ART EXPOS CREATE CONDUIT ABD/RET INCIPROCED      2,400.00                     34833
CARD CATH     4801672 0 OPEN BRACHIAL ART EXPOS ASST DEPLOY ARM INCIS UPROCED       2,400.00                     34834
CARD CATH     4801637 0 PTA TIBIOPERONL TRUNK EA VES                     PROCED     4,822.10                     35470
CARD CATH     4801638 0 PTA RENAL OR VISCERAL ART                        PROCED     4,822.10                     35471
CARD CATH     4802733 0 PTA AORTIC ARTERY                                PROCED     4,822.10                     35472
CARD CATH     4802732 0 PTA ILIAC ARTERY                                 PROCED     4,822.10                     35473
CARD CATH     4802731 0 PTA-FEMORAL/POP ARTERY                           PROCED     4,822.10                     35474
CARD CATH     4802730 0 PTA-BRACHIOCEPHALIC ARTER                        PROCED     4,822.10                     35475
CARD CATH     4802751 0 PTA-VENOUS                                       PROCED     4,822.10                     35476
CARD CATH     4801684 0 ATHERECTOMY TRANSLUM RENAL / VISC ART            PROCED     532.00                       35480
CARD CATH     4802742 0 ATHERECT PER AORTIC AR                           PROCED     4,822.10                     35491
CARD CATH     4802743 0 ATHERECT PERIPH ILIAC                            PROCED     4,822.10                     35492
CARD CATH     4802744 0 ATHERECT PERI FEM/POP                            PROCED     4,822.10                     35493
CARD CATH     4802745 0 ATHERECT BRACHIOCEPHAL                           PROCED     4,822.10                     35494
CARD CATH     4802746 0 ATHERECT TIBIOPERONEAL                           PROCED     4,822.10                     35495
CARD CATH     4801050 0 EXTREM VENOGRAM INJ PROC                         PROCED     888.80                       36005
CARD CATH     4801209 0 SVC / IVC INTRO CATH                             PROCED     320.85                       36010
CARD CATH     4801234 0 RENAL BILAT VEIN SELEC CATH PL 1ST BRANCH        PROCED     270.07                      3601150
CARD CATH     4801235 0 JUGULAR BILAT VEIN SELEC CATH PL 1ST BRANCH      PROCED     270.07                      3601150
CARD CATH     4801231 0 RENAL LT VEIN SELEC CATH PL 1ST BRANCH           PROCED     270.07                      36011LT
CARD CATH     4801233 0 JUGULAR LT VEIN SELEC CATH PL 1ST BRANCH         PROCED     270.07                      36011LT
CARD CATH     4801230 0 RENAL RT VEIN SELEC CATH PL 1ST BRANCH           PROCED     270.07                      36011RT
CARD CATH     4801232 0 JUGULAR RT VEIN SELEC CATH PL 1ST BRANCH         PROCED     270.07                      36011RT
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML      CPT
CARD CATH     4801196 0 RT HRT / PULM ART INTRO CATH          PROCED     392.51                       36013
CARD CATH     4801177 0 PULM LT ART CATH PLC SELECTV          PROCED     258.84                      36014LT
CARD CATH     4801180 0 PULM RT ART CATH PLC SELECTV          PROCED     258.84                      36014RT
CARD CATH     4801176 0 PULM LT ART CATH PLC SEGMNT           PROCED     298.29                      36015LT
CARD CATH     4801179 0 PULM RT ART CATH PLC SEGMNT           PROCED     298.29                      36015RT
CARD CATH     4801051 0 CAROTID ART INTRO NDL / CATH          PROCED     1,323.49                     36100
CARD CATH     4801227 0 VERTEBR ART INTRO NDL / CATH          PROCED     1,323.49                     36100
CARD CATH     4801473 0 BRACH/AX ART INTRO NDL/CATH           PROCED     1,321.80                     36120
CARD CATH     4801636 0 EXTREM ART INTRO NDL / CATH           PROCED     1,321.80                     36140
CARD CATH     4801098 0 AV DIALYSIS SHUNT INTRO NDL / CATH    PROCED     996.40                       36145
CARD CATH     4801087 0 AORTA TRANSLUMBAR INTRO NDL / CATH    PROCED     981.75                       36160
CARD CATH     4801079 0 AORTA INTRO CATH                      PROCED     919.50                       36200
CARD CATH     4801076 0 BRACHCEPH ART CATH PLC 1ST ORD        PROCED     734.54                       36215
CARD CATH     4801077 0 BRACHCEPH ART CATH PLC 2ND ORD        PROCED     864.90                       36216
CARD CATH     4801078 0 BRACHCEPH ART CATH PLC 3RD ORD        PROCED     517.68                       36217
CARD CATH     4801102 0 BRACHCEPH ART ADD CATH PL 2/3 ORD     PROCED     90.02                        36218
CARD CATH     4801048 0 ABD/PELV/LE ART CATH PLC 1ST ORD      PROCED     855.42                       36245
CARD CATH     4801236 0 RENAL ART CATH PLC 1ST ORD            PROCED     855.42                       36245
CARD CATH     4801113 0 ABD/PELV/LE ART CATH PLC 2ND ORD      PROCED     542.30                       36246
CARD CATH     4801237 0 RENAL ART CATH PLC 2ND ORD            PROCED     542.30                       36246
CARD CATH     4801114 0 ABD/PELV/LE ART CATH PLC 3RD ORD      PROCED     1,108.60                     36247
CARD CATH     4801238 0 RENAL ART CATH PLC 3RD ORD            PROCED     1,108.60                     36247
CARD CATH     4801115 0 ABD/PELV/LE ADD ART CATH 2/3 ORD      PROCED     90.02                        36248
CARD CATH     4801239 0 RENAL ADD'L ART CATH PLC 2/3 ORD      PROCED     90.02                        36248
CARD CATH     4801217 0 VENIPUNCTURE < AGE 3, FEM OR JUG      PROCED     20.00                        36400
CARD CATH     4801218 0 VENIPUNCTURE < AGE 3, SCALP VEIN      PROCED     20.00                        36405
CARD CATH     4801226 0 VENIPUNCTURE ROUTN BLD DRAW           PROCED     19.69                        36415
CARD CATH     4801156 0 PORTAL VEIN CATH PERC ANY METH        PROCED     509.00                       36481
CARD CATH     4802761 0 CV LINE INS NON-TUNNL < 5 YRS         PROCED     1,367.50                     36555
CARD CATH     4802762 0 CV LINE INS NON-TUNNL AGE 5 & ABOVE   PROCED     1,367.50                     36556
CARD CATH     4801581 0 ARTERIAL PUNC FOR BLOOD DRAW          PROCED     127.00                       36600
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML      CPT
CARD CATH     4801212 0 THROMBCTMY AV SHUNT MECH                    PROCED     3,452.64                     36870
CARD CATH     4801100 0 BIOPSY TRANSCATH                            PROCED     525.71                       37200
CARD CATH     4801047 0 INFUS PER TRANSCATH THROMB                  PROCED     1,241.80                     37201
CARD CATH     4801139 0 INFUS THER TRANSCATH NON-THRMBOLYT          PROCED     495.43                       37202
CARD CATH     4801471 0 TRANSCATH RETRIEVAL FORGN BDY               PROCED     2,002.40                     37203
CARD CATH     4801060 0 TRANSCATH OCCLUS / EMBOL                    PROCED     5,880.30                     37204
CARD CATH     4801062 0 TRANSCATHETER OCCULUSION PERC               PROCED     4,306.90                     37204
CARD CATH     4801080 0 PDA CLOSURE                                 PROCED     4,782.00                     37204
CARD CATH     4802728 0 PERIPH STENT INITIAL VESS                   PROCED     7,272.50                     37205
CARD CATH     4802727 0 PERIPHERAL STENT ADDL VES                   PROCED     7,272.50                     37206
CARD CATH     4801127 0 EXCHG ART CATH DUR THRMBOLYT THRPY          PROCED     1,335.86                     37209
CARD CATH     4801242 0 CAROTID STENT W/ EMBOL PROTECT DEV          PROCED     10,000.00                    37215
CARD CATH     4801243 0 CAROTID STENT W/O EMBOL PROTEC DEV          PROCED     9,518.50                     37216
CARD CATH     4801667 0 U/S INTRAVASC (NON COR) INIT                PROCED     3,351.84                     37250
CARD CATH     4801666 0 U/S INTRAVASC (NON COR) EA ADD VES          PROCED     3,351.84                     37251
CARD CATH     4801061 0 IVC FILTER PLACEMENT                        PROCED     3,314.60                     37620
CARD CATH     4801123 0 EMBOLIZTN PERC TRANSCATH INTRACRAN / SPIN   PROCED     1,722.06                     61624
CARD CATH     4801124 0 EMBOLIZTN PERC TRANSCATH NEURO              PROCED     4,026.88                     61626
CARD CATH     4801132 0 FLUORO FOR PACEMAKER INSERTION              PROCED     190.89                       71090
CARD CATH     4801211 0 THORACIC AORTOGRAM                          PROCED     2,195.90                     75605
CARD CATH     4801084 0 ABD AORTOGRAPHY                             PROCED     2,195.90                     75625
CARD CATH     4801083 0 ABD AORTOGRAPHY W/ RUNOFF                   PROCED     2,195.90                     75630
CARD CATH     4801072 0 AORTIC ARCH / GRT VES ANGIOGM               PROCED     2,195.90                     75650
CARD CATH     4801103 0 BRACHIAL RETRO ANGIOGM                      PROCED     2,195.90                     75658
CARD CATH     4801225 0 CAROTID EXTERN ANGIOGM UNIL LT              PROCED     1,464.19                    75660LT
CARD CATH     4801074 0 CAROTID EXTERN ANGIOGM UNIL RT              PROCED     1,464.19                    75660RT
CARD CATH     4801075 0 CAROTID EXTERN ANGIOGM BILAT                PROCED     1,466.29                     75662
CARD CATH     4801109 0 CAROTID CEREB UNILAT ANGIOGM                PROCED     2,195.90                     75665
CARD CATH     4801108 0 CAROTID CEREB BILAT ANGIOGM                 PROCED     2,195.90                     75671
CARD CATH     4801111 0 CAROTID CERVICAL UNILAT ANGIOGM             PROCED     2,195.90                     75676
CARD CATH     4801110 0 CAROTID CERVICAL BILAT ANGIOGM              PROCED     2,195.90                     75680
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML      CPT
CARD CATH     4801073 0 VERTEBRAL EA ANGIOGM                       PROCED     1,445.50                     75685
CARD CATH     4803094 0 EXTREM UNILAT LT ANGIOGM                   PROCED     2,195.90                    75710LT
CARD CATH     4803095 0 EXTREM UNILAT RT ANGIOGM                   PROCED     2,195.90                    75710RT
CARD CATH     4803096 0 EXTREM BILAT ANGIOGM                       PROCED     2,195.90                     75716
CARD CATH     4801192 0 RENAL UNILAT LT ANGIOGM                    PROCED     2,195.90                    75722LT
CARD CATH     4801194 0 RENAL UNILAT RT ANGIOGM                    PROCED     2,195.90                    75722RT
CARD CATH     4801183 0 RENAL BILAT ANGIOGM                        PROCED     2,195.90                     75724
CARD CATH     4801224 0 VISCERAL SELECTV EA VES ANGIOGM            PROCED     2,195.90                     75726
CARD CATH     4801154 0 PELVIC SELECTV ANGIOGM                     PROCED     2,195.90                     75736
CARD CATH     4801181 0 PULM UNILAT LT ANGIOGM                     PROCED     1,464.19                    75741LT
CARD CATH     4801182 0 PULM UNILAT RT ANGIOGM                     PROCED     1,464.19                    75741RT
CARD CATH     4801175 0 PULM BILAT ANGIOGM                         PROCED     2,559.96                     75743
CARD CATH     4801178 0 PULM NONSELECTIVE ANGIOGM                  PROCED     1,464.19                     75746
CARD CATH     4801143 0 INTERNAL MAMM ANGIOGM                      PROCED     1,421.54                     75756
CARD CATH     4801085 0 ADDL EA SELECTV VES AFT BASC ANGIOGM       PROCED     1,180.18                     75774
CARD CATH     4801099 0 AV SHUNT ANGIOGM                           PROCED     965.42                       75790
CARD CATH     4801130 0 EXTREM UNILAT LT VENOGRAM                  PROCED     887.30                      75820LT
CARD CATH     4801131 0 EXTREM UNILAT RT VENOGRAM                  PROCED     887.30                      75820RT
CARD CATH     4801129 0 EXTREM BILAT VENOGRAM                      PROCED     985.20                       75822
CARD CATH     4801149 0 IVC VENOGRAM                               PROCED     1,464.19                     75825
CARD CATH     4801210 0 SVC VENOGRAM                               PROCED     1,357.19                     75827
CARD CATH     4801193 0 RENAL UNILAT LT VENOGRAM                   PROCED     1,464.19                    75831LT
CARD CATH     4801195 0 RENAL UNILAT RT VENOGRAM                   PROCED     1,464.19                    75831RT
CARD CATH     4801184 0 RENAL BILAT VENOGRAM                       PROCED     1,466.29                     75833
CARD CATH     4801125 0 EMBOLIZTN TRANSCATH THRPY S & I            PROCED     2,723.30                     75894
CARD CATH     4801138 0 INFUS PER TRANSCATH THROMB S & I           PROCED     2,367.90                     75896
CARD CATH     4801086 0 ANGIOGRPH F/U W/ EXIST CATH                PROCED     693.90                       75898
CARD CATH     4801128 0 EXCHG ART CATH DUR THRMBOLYT THRPY S & I   PROCED     2,532.90                     75900
CARD CATH     4801148 0 IVC FILTER PLCMT S & I                     PROCED     1,964.50                     75940
CARD CATH     4801216 0 U/S INTRAVASC (NON COR) INIT S & I         PROCED     515.90                       75945
CARD CATH     4801215 0 U/S INTRAVASC (NON COR) EA ADD VES S & I   PROCED     387.30                       75946
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4801579 0 ENDOVASC REP INF-REN AAA RAD S/I               PROCED     2,514.54                    75952
CARD CATH     4801082 0 AAA EXT CUFF PLCMT S & I                       PROCED     2,514.54                    75953
CARD CATH     4801679 0 RAD S/I ENDVASC REP DESC THORACIC AORTA COV SUBPROCED     2,195.00                    75956
CARD CATH     4801680 0 RAD S/I ENDVASC REP DESC THORACIC AORTA W/O COVPROCED     2,195.00                    75957
CARD CATH     4801681 0 RAD S/I PLCMT PROX EXT PROS REP THOR AORTA     PROCED     2,195.00                    75958
CARD CATH     4801682 0 RAD S/I ENDVASC REP PLCMT DIST EXT PROS DELAY  PROCED     2,195.00                    75959
CARD CATH     4801155 0 PERIPH STENT EA VESSL S & I                    PROCED     2,514.54                    75960
CARD CATH     4801213 0 TRANSCATH RETRIEVAL FORGN BDY S & I            PROCED     2,195.90                    75961
CARD CATH     4801164 0 PTA BRACHIOCEPH S & I                          PROCED     2,195.90                    75962
CARD CATH     4801167 0 PTA FEM / POP S & I                            PROCED     2,195.90                    75962
CARD CATH     4801168 0 PTA ILIAC ART S & I                            PROCED     2,195.90                    75962
CARD CATH     4801171 0 PTA TIBIOPERONL TNK S & I                      PROCED     2,195.90                    75962
CARD CATH     4801163 0 PTA BRACHIOCEPH EA ADD S & I                   PROCED     2,195.90                    75964
CARD CATH     4801166 0 PTA FEM / POP EA ADD S & I                     PROCED     2,195.90                    75964
CARD CATH     4801169 0 PTA ILIAC EA ADD ART S & I                     PROCED     2,195.90                    75964
CARD CATH     4801172 0 PTA TIBIOPERONL TNK EA ADD S & I               PROCED     2,195.90                    75964
CARD CATH     4801161 0 PTA AORTIC ART S & I                           PROCED     2,195.90                    75966
CARD CATH     4801170 0 PTA RENAL OR VISCERAL ART S & I                PROCED     2,195.90                    75966
CARD CATH     4801162 0 PTA AORTIC EA ADD ART S & I                    PROCED     2,195.90                    75968
CARD CATH     4801165 0 PTA EA ADD VISCERAL ART S & I                  PROCED     2,195.90                    75968
CARD CATH     4801101 0 BIOPSY TRANSCATH S & I                         PROCED     2,195.90                    75970
CARD CATH     4801173 0 PTA VENOUS S & I                               PROCED     1,863.69                    75978
CARD CATH     4801089 0 ATHERECT BRACHIOCEPH S & I                     PROCED     2,195.90                    75992
CARD CATH     4801091 0 ATHERECT PER AORTIC ART S & I                  PROCED     2,195.90                    75992
CARD CATH     4801093 0 ATHERECT PERI FEM / POP S & I                  PROCED     2,195.90                    75992
CARD CATH     4801095 0 ATHERECT PERIPH ILIAC S & I                    PROCED     2,195.90                    75992
CARD CATH     4801097 0 ATHERECT TIBIOPERONL S & I                     PROCED     2,195.90                    75992
CARD CATH     4801088 0 ATHERECT BRACHIOCEPH EA ADD ART S & I          PROCED     2,195.90                    75993
CARD CATH     4801090 0 ATHERECT PER AORTIC ART EA ADD ART S & I       PROCED     2,195.90                    75993
CARD CATH     4801092 0 ATHERECT PERI FEM/POP EA ADD ART S & I         PROCED     2,195.90                    75993
CARD CATH     4801094 0 ATHERECT PERIPH ILIAC EA ADD ART S & I         PROCED     2,195.90                    75993
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4801096 0 ATHERECT TIBIOPERONL EA ADD ART S & I           PROCED     2,195.90                    75993
CARD CATH     4801683 0 RAD S/I ATHERECTOMY TRANSLUM RENAL / VISC ART   PROCED     1,084.00                    75994
CARD CATH     4801133 0 FLUORO GUID FOR NDL PLCMT                       PROCED     342.10                      76003
CARD CATH     4801541 0 DEVICE CINE                                     PROCED     209.60                      76120
CARD CATH     4801245 0 U/S GUID PERICARDIOCENTESIS S/I                 PROCED     172.62                      76930
CARD CATH     4801214 0 U/S GUID ENDOMYOCARD BX                         PROCED     172.62                      76932
CARD CATH     4801582 0 U/S GUID NEEDLE PLACEMENT                       PROCED     478.88                      76942
CARD CATH     4803552 0 ARTERIAL BLOOD GASES                            PROCED     147.60                      82805
CARD CATH     4801059 0 GASES, BLOOD, O2 SAT DIRECT MEAS (COAXIMETRY)   PROCED     55.60                       82810
CARD CATH     4801058 0 ACTIVATED CLOTTING TIME (ACT)                   PROCED     40.40                       85347
CARD CATH     4801122 0 CPR IN CARDIAC ARREST                           PROCED     565.40                      92950
CARD CATH     4802735 0 CARDIOVERSION, EXTERNAL                         PROCED     657.80                      92960
CARD CATH     4802548 0 CARDIOVERSION INTERNAL                          PROCED     657.80                      92961
CARD CATH     4801668 0 THROMBECTOMY CORONARY                           PROCED     2,277.00                    92973
CARD CATH     4801665 0 BRACHYTHERAPY CATH PLCMT                        PROCED     4,782.00                    92974
CARD CATH     4802734 0 THROMBOLYTIC TX INTRACOR                        PROCED     1,396.70                    92975
CARD CATH     4801556 0 THROMBOLYSIS BY IV INFUSION                     PROCED     1,241.80                    92977
CARD CATH     4802729 0 U/S INTRAVASC INIT VESL                         PROCED     3,351.84                    92978
CARD CATH     4801064 0 U/S INTRAVASC EA ADD VESL                       PROCED     3,351.84                    92979
CARD CATH     4801033 0 TRANSCATH STENT SINGL VES                       PROCED     9,518.50                    92980
CARD CATH     4801032 0 TRANSCATH STENT ADDL VESS                       PROCED     9,518.50                    92981
CARD CATH     4801529 0 COR ANGIOPLASTY, SINGLE VESSEL                  PROCED     6,806.18                    92982
CARD CATH     4801522 0 COR ANGIOPLASTY, ADDL VESSEL                    PROCED     6,806.18                    92984
CARD CATH     4801653 0 AORTIC VALVULOPLASTY                            PROCED     6,806.18                    92986
CARD CATH     4801657 0 AORTIC VALVULOPLASTY PEDS                       PROCED     6,806.18                    92986
CARD CATH     4801530 0 MITRAL VALVULOPLASTY                            PROCED     6,806.18                    92987
CARD CATH     4802508 0 MITRAL VALVULPLASTY PEDS                        PROCED     6,806.18                    92987
CARD CATH     4801036 0 PULMONIC VALVULOPLASTY                          PROCED     6,806.18                    92990
CARD CATH     4801655 0 PULMONIC VALVULOPLASTY PEDS                     PROCED     6,806.18                    92990
CARD CATH     4802726 0 ATRL SEPTECT/SEPTOST (RSHKD)                    PROCED     3,767.20                    92992
CARD CATH     4802747 0 ATRL SEPTECT/SEPTOST (BLADE)                    PROCED     3,767.20                    92993
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4802740 0 ATHERECT COR SING VESL                        PROCED     12,670.84                   92995
CARD CATH     4802741 0 ATHERECT COR ADDL VESL                        PROCED     12,670.84                   92996
CARD CATH     4801651 0 PULM ART ANGPLSTY SING VES                    PROCED     4,822.10                    92997
CARD CATH     4802510 0 PULM ART ANGPLSTY PEDS SING VES               PROCED     4,822.10                    92997
CARD CATH     4801174 0 PULM ART ANGPLSTY PEDS EA ADD VES             PROCED     4,822.10                    92998
CARD CATH     4801652 0 PULM ART ANGPLSTY EA ADD VES                  PROCED     4,822.10                    92998
CARD CATH     4801555 0 METHERGINE STUDY                              PROCED     703.50                      93024
CARD CATH     4801241 0 ECHO TRANSTHORACIC LIMITED                    PROCED     250.00                      93308
CARD CATH     4801574 0 CATH RT HRT (RA,RV,PA,PCW)                    PROCED     4,140.40                    93501
CARD CATH     4802725 0 SWAN GANZ CATHETER INSERT                     PROCED     2,021.50                    93503
CARD CATH     4801067 0 BIOPSY ENDOMYCARDIAL                          PROCED     2,230.50                    93505
CARD CATH     4801650 0 CORONARY ANGIO ONLY                           PROCED     4,140.40                    93508
CARD CATH     4801576 0 CATH LFT HRT (AO,LV) PERC                     PROCED     4,140.40                    93510
CARD CATH     4801037 0 CATH LFT HRT BY CUTDWN                        PROCED     4,140.40                    93511
CARD CATH     4802750 0 CATH LFT HRT BY LV PUNCT                      PROCED     4,140.40                    93514
CARD CATH     4802749 0 COMB TRANSSEPTL/RETRO LHC                     PROCED     5,244.10                    93524
CARD CATH     4801578 0 CATH R&L HRT (RA,RV,PA,PCW                    PROCED     4,171.20                    93526
CARD CATH     4801656 0 CATH PEDS RT HRT RETRO LT                     PROCED     4,140.40                    93526
CARD CATH     4803558 0 CATH TRANSSEPTAL RHC/LHC                      PROCED     5,521.80                    93527
CARD CATH     4802515 0 CATH RT HRT CONG ANOM                         PROCED     4,140.40                    93530
CARD CATH     4802505 0 CATH RHC/TRANS LHC INT SEPTUM -CONG           PROCED     5,091.40                    93532
CARD CATH     4802643 0 CATH RHC/TRANS LHC SEPTUM OPEN-CONG           PROCED     5,091.40                    93533
CARD CATH     4801476 0 GRAFT LIMA/RIMA INJ PROC CARD CATH            PROCED     293.70                      93539
CARD CATH     4802754 0 GRAFT SVG INJ PROC CARD CATH                  PROCED     266.20                      93540
CARD CATH     4801641 0 PULM ANGIOGM INJ PROC CARD CATH               PROCED     749.30                      93541
CARD CATH     4801660 0 RA/RV ANGIOG INJ PROC CARD CATH               PROCED     374.60                      93542
CARD CATH     4801659 0 LA/LV ANGIOGRAPHY                             PROCED     700.78                      93543
CARD CATH     4801663 0 LA/LV ANGIOGRAPHY PEDS                        PROCED     700.78                      93543
CARD CATH     4801642 0 AORTOGRAPHY INJ PROC CARD CATH                PROCED     247.80                      93544
CARD CATH     4801658 0 CORONARY ANGIOGRAM                            PROCED     683.92                      93545
CARD CATH     4801219 0 VENTRC &/OR ATRI ANGIOGM INJ PROC CARD CATH   PROCED     374.60                      93555
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4801662 0 COR/GRAFT/PA/AO ANGIO S & I             PROCED     636.80                      93556
CARD CATH     4801121 0 CORONARY FLOW INITIAL VESSEL            PROCED     1,821.08                    93571
CARD CATH     4801240 0 CORONARY FLOW EA ADD'L VESSEL           PROCED     1,026.00                    93572
CARD CATH     4801068 0 PFO CLOSURE                             PROCED     8,085.00                    93580
CARD CATH     4801069 0 ASD CLOSURE                             PROCED     8,085.00                    93580
CARD CATH     4801081 0 VSD CLOSURE                             PROCED     8,085.00                    93581
CARD CATH     4803764 0 U/S INTRACARDIAC                        PROCED     3,351.84                    93662
CARD CATH     4803660 0 ROTABLATOR ADVANCER                     SUPPLY     2,240.00                    C1724
CARD CATH     4803674 0 ROTOBLATOR BURR                         SUPPLY     2,688.10                    C1724
CARD CATH     4801017 0 COOK VP BALLOON                         SUPPLY     530.00                      C1725
CARD CATH     4803028 0 CORDIS RAPTOR                           SUPPLY     600.00                      C1725
CARD CATH     4803031 0 SCIMED QUANTUM RANGER                   SUPPLY     645.60                      C1725
CARD CATH     4803044 0 CORDIS POWERFLEX                        SUPPLY     581.60                      C1725
CARD CATH     4803047 0 CUTTING BALLOON                         SUPPLY     1,720.00                    C1725
CARD CATH     4803062 0 CATH QUICK CROSS 0.035 X 135 CM         SUPPLY     1,505.00                    C1725
CARD CATH     4803100 0 PTA BALLOON CATHETER                    SUPPLY     707.35                      C1725
CARD CATH     4803159 0 CATH BALLOON SPRINTER MX 1.5MM X 12MM   SUPPLY     408.50                      C1725
CARD CATH     4803160 0 CATH BALLOON SPRINTER MX 2.0MM X 12MM   SUPPLY     408.50                      C1725
CARD CATH     4803161 0 CATH BALLOON SPRINTER MX 2.5MM X 12MM   SUPPLY     408.50                      C1725
CARD CATH     4803162 0 CATH BALLOON SPRINTER MX 3.0MM X 12MM   SUPPLY     408.50                      C1725
CARD CATH     4803163 0 CATH BALLOON SPRINTER MX 3.5MM X 12MM   SUPPLY     408.50                      C1725
CARD CATH     4803164 0 CATH BALLOON SPRINTER MX 2.0MM X 15MM   SUPPLY     408.50                      C1725
CARD CATH     4803165 0 CATH BALLOON SPRINTER MX 2.5MM X 15MM   SUPPLY     408.50                      C1725
CARD CATH     4803166 0 CATH BALLOON SPRINTER MX 3.0MM X 15MM   SUPPLY     408.50                      C1725
CARD CATH     4803167 0 CATH BALLOON SPRINTER MX 2.0MM X 20MM   SUPPLY     408.50                      C1725
CARD CATH     4803168 0 CATH BALLOON SPRINTER MX 2.5MM X 20MM   SUPPLY     408.50                      C1725
CARD CATH     4803169 0 CATH BALLOON SPRINTER MX 3.0MM X 20MM   SUPPLY     408.50                      C1725
CARD CATH     4803170 0 CATH BALLOON SPRINTER MX 2.0MM X 30MM   SUPPLY     408.50                      C1725
CARD CATH     4803171 0 CATH BALLOON SPRINTER MX 3.0MM X 30MM   SUPPLY     408.50                      C1725
CARD CATH     4803172 0 CATH BALLOON SAVVY 2.5 X 6              SUPPLY     674.90                      C1725
CARD CATH     4803173 0 CATH BALLOON SAVVY 2.5 X 10             SUPPLY     674.90                      C1725
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION             CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803174 0 CATH BALLOON SAVVY 3 X 6       SUPPLY     674.90                      C1725
CARD CATH     4803175 0 CATH BALLOON SAVVY 3 X 10      SUPPLY     674.90                      C1725
CARD CATH     4803620 0 SCI MED PTCA BALLOONS          SUPPLY     807.50                      C1725
CARD CATH     4803621 0 MEDTRONIC PTCA BALLOONS        SUPPLY     807.50                      C1725
CARD CATH     4803706 0 CORDIS BALLOON                 SUPPLY     766.90                      C1725
CARD CATH     4803721 0 PE-MT CATHETER                 SUPPLY     312.30                      C1725
CARD CATH     4803759 0 MEDITECH BALLOON               SUPPLY     875.50                      C1725
CARD CATH     4803801 0 BALLOON MAVERICK 1.5 X 20      SUPPLY     430.00                      C1725
CARD CATH     4803802 0 BALLOON MAVERICK 2.0 X 20      SUPPLY     430.00                      C1725
CARD CATH     4803803 0 BALLOON MAVERICK 2.25 X 20     SUPPLY     430.00                      C1725
CARD CATH     4803804 0 BALLOON MAVERICK 2.5 X 20      SUPPLY     430.00                      C1725
CARD CATH     4803805 0 BALLOON MAVERICK 2.75 X 20     SUPPLY     430.00                      C1725
CARD CATH     4803806 0 BALLOON MAVERICK 3.0 X 20      SUPPLY     430.00                      C1725
CARD CATH     4803807 0 BALLOON MAVERICK 3.25 X 20     SUPPLY     430.00                      C1725
CARD CATH     4803808 0 BALLOON MAVERICK 3.5 X 20      SUPPLY     430.00                      C1725
CARD CATH     4803809 0 BALLOON MAVERICK 3.75 X 20     SUPPLY     430.00                      C1725
CARD CATH     4803810 0 BALLOON MAVERICK 4.0 X 20      SUPPLY     430.00                      C1725
CARD CATH     4801034 0 INOUE BALLOON                  SUPPLY     5,170.80                    C1726
CARD CATH     4803738 0 BRAUN/TYSHAK BALLOON           SUPPLY     704.80                      C1726
CARD CATH     4801020 0 TRANSFER CATHETER              SUPPLY     775.80                      C1751
CARD CATH     4803593 0 CORONARY INFUSON CATHETER      SUPPLY     475.00                      C1751
CARD CATH     4803718 0 PERIPHERAL INFUSION CATHETER   SUPPLY     469.90                      C1751
CARD CATH     4803755 0 PULSESPRAY CATHETER            SUPPLY     406.90                      C1751
CARD CATH     4803756 0 MEWISSION INFUSION CATH        SUPPLY     176.10                      C1751
CARD CATH     4803020 0 IVUS CATHETER ULTRA ICE        SUPPLY     1,813.40                    C1753
CARD CATH     4803021 0 IVUS CATHETER ULTRA CROSS      SUPPLY     1,813.40                    C1753
CARD CATH     4803049 0 CATH ATLANTIS PV IVUS          SUPPLY     1,343.80                    C1753
CARD CATH     4803690 0 IVUS CATHETER                  SUPPLY     1,609.30                    C1753
CARD CATH     4803060 0 ANGIOJET CATHETER-COR          SUPPLY     3,063.75                    C1757
CARD CATH     4803065 0 ANGIOJET CATHETER-PERIPHERAL   SUPPLY     3,214.25                    C1757
CARD CATH     4803106 0 CATH EXPORT ASPIRATION         SUPPLY     1,494.30                    C1757
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803766 0 ACUNAV CATHETER                   SUPPLY     6,250.00                    C1759
CARD CATH     4803075 0 PERCLOSE SYSTEM                   SUPPLY     731.60                      C1760
CARD CATH     4803705 0 ANGIOSEAL                         SUPPLY     441.00                      C1760
CARD CATH     4801018 0 PLATINUM PLUS WIRE                SUPPLY     133.50                      C1769
CARD CATH     4803176 0 WIRE SUPRACORE 300CM              SUPPLY     236.50                      C1769
CARD CATH     4803177 0 GUIDEWIRE STEER-IT                SUPPLY     731.00                      C1769
CARD CATH     4803178 0 GUIDEWIRE STABILIZER PLUS         SUPPLY     180.30                      C1769
CARD CATH     4803504 0 GUIDEWIRE ASAHI MIRACLE BROS 3    SUPPLY     268.80                      C1769
CARD CATH     4803505 0 GUIDEWIRE ASAHI MIRACLE BROS 6    SUPPLY     268.80                      C1769
CARD CATH     4803506 0 GUIDEWIRE ASAHI MIRACLE BROS 12   SUPPLY     268.80                      C1769
CARD CATH     4803507 0 GUIDEWIRE ASAHI CONFIANZA 9       SUPPLY     268.80                      C1769
CARD CATH     4803508 0 GUIDEWIRE ASAHI CONFIANZA 12      SUPPLY     268.80                      C1769
CARD CATH     4803509 0 GUIDEWIRE V-18 CONTROL WIRE       SUPPLY     243.00                      C1769
CARD CATH     4803542 0 WHOLEY WIRE                       SUPPLY     177.70                      C1769
CARD CATH     4803563 0 GUIDEWIRES DIAGNOSTIC             SUPPLY     33.70                       C1769
CARD CATH     4803596 0 AMPLATZ WIRES                     SUPPLY     64.80                       C1769
CARD CATH     4803627 0 ACS PTCA GUIDEWIRES               SUPPLY     232.40                      C1769
CARD CATH     4803645 0 FLEX T WIRE                       SUPPLY     193.90                      C1769
CARD CATH     4803649 0 TERUMO GUIDEWIRE                  SUPPLY     94.00                       C1769
CARD CATH     4803659 0 ROTABLATOR GUIDEWIRE              SUPPLY     361.90                      C1769
CARD CATH     4803670 0 COOK DEFLECTING WIRE              SUPPLY     101.70                      C1769
CARD CATH     4803672 0 LOC EXTENSION WIRE                SUPPLY     103.80                      C1769
CARD CATH     4803688 0 STORQ GUIDEWIRE                   SUPPLY     155.10                      C1769
CARD CATH     4803703 0 TRAPPER WIRE                      SUPPLY     219.60                      C1769
CARD CATH     4803704 0 SCIMED GUIDEWIRE                  SUPPLY     218.30                      C1769
CARD CATH     4803725 0 MEDTRONIC GUIDEWIRE               SUPPLY     246.70                      C1769
CARD CATH     4803728 0 MAGIC TORQUE GUIDEWIRE            SUPPLY     425.10                      C1769
CARD CATH     4803730 0 CORDIS PERIPHERAL GUIDEWIRE       SUPPLY     141.00                      C1769
CARD CATH     4803731 0 CORDIS GUIDEWIRE                  SUPPLY     234.90                      C1769
CARD CATH     4803757 0 SV-8 WIRE                         SUPPLY     244.10                      C1769
CARD CATH     4803763 0 LUNDERQUIST WIRE                  SUPPLY     157.00                      C1769
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION             CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803679 0 GOOSENECK SNARE                SUPPLY     582.50                      C1773
CARD CATH     4803682 0 MICRO SNARE                    SUPPLY     1,163.80                    C1773
CARD CATH     4803087 0 CARDIOSEAL DEVICE              SUPPLY     9,282.90                    C1817
CARD CATH     4803760 0 AMPLATZER BALLOON              SUPPLY     753.00                      C1817
CARD CATH     4803761 0 AMPLATZER DEL CATH             SUPPLY     753.00                      C1817
CARD CATH     4803762 0 AMPLATZER DEVICE               SUPPLY     7,095.00                    C1817
CARD CATH     4803092 0 HEPACOAT STENT                 SUPPLY     3,072.60                    C1874
CARD CATH     4803097 0 COVERED STENT PERIPHERAL       SUPPLY     6,010.00                    C1874
CARD CATH     4803107 0 STENT CYPHER 2.5 X 8 MM RE     SUPPLY     6,480.00                    C1874
CARD CATH     4803108 0 STENT CYPHER 3.0 X 8 MM RE     SUPPLY     6,480.00                    C1874
CARD CATH     4803109 0 STENT CYPHER 3.5 X 8 MM RE     SUPPLY     6,480.00                    C1874
CARD CATH     4803110 0 STENT CYPHER 2.5 X 13 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803111 0 STENT CYPHER 2.75 X 13 MM RE   SUPPLY     6,480.00                    C1874
CARD CATH     4803112 0 STENT CYPHER 3.0 X 13 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803113 0 STENT CYPHER 3.5 X 13 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803114 0 STENT CYPHER 2.5 X 18 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803115 0 STENT CYPHER 2.75 X 18 MM RE   SUPPLY     6,480.00                    C1874
CARD CATH     4803116 0 STENT CYPHER 3.0 X 18 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803117 0 STENT CYPHER 3.5 X 18 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803118 0 STENT CYPHER 2.5 X 23 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803119 0 STENT CYPHER 2.75 X 23 MM RE   SUPPLY     6,480.00                    C1874
CARD CATH     4803120 0 STENT CYPHER 3.0 X 23 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803121 0 STENT CYPHER 3.5 X 23 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803122 0 STENT CYPHER 2.5 X 28 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803123 0 STENT CYPHER 3.0 X 28 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803124 0 STENT CYPHER 3.5 X 28 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803125 0 STENT CYPHER 2.75 X 33 MM RE   SUPPLY     6,480.00                    C1874
CARD CATH     4803126 0 STENT CYPHER 3.0 X 33 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803127 0 STENT CYPHER 3.5 X 33 MM RE    SUPPLY     6,480.00                    C1874
CARD CATH     4803128 0 STENT CYPHER 2.5 MM X 13 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803129 0 STENT CYPHER 2.5 MM X 18 MM    SUPPLY     6,480.00                    C1874
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION             CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803130 0 STENT CYPHER 2.5 MM X 23 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803131 0 STENT CYPHER 2.5 MM X 28 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803132 0 STENT CYPHER 2.5 MM X 8 MM     SUPPLY     6,480.00                    C1874
CARD CATH     4803133 0 STENT CYPHER 2.75 MM X 13 MM   SUPPLY     6,480.00                    C1874
CARD CATH     4803134 0 STENT CYPHER 2.75 MM X 18 MM   SUPPLY     6,480.00                    C1874
CARD CATH     4803135 0 STENT CYPHER 2.75 MM X 23 MM   SUPPLY     6,480.00                    C1874
CARD CATH     4803136 0 STENT CYPHER 2.75 MM X 28 MM   SUPPLY     6,480.00                    C1874
CARD CATH     4803137 0 STENT CYPHER 2.75 MM X 33 MM   SUPPLY     6,480.00                    C1874
CARD CATH     4803138 0 STENT CYPHER 2.75 MM X 8 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803139 0 STENT CYPHER 3.0 MM X 13 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803140 0 STENT CYPHER 3.0 MM X 18 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803141 0 STENT CYPHER 3.0 MM X 23 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803142 0 STENT CYPHER 3.0 MM X 28 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803143 0 STENT CYPHER 3.0 MM X 33 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803144 0 STENT CYPHER 3.0 MM X 8 MM     SUPPLY     6,480.00                    C1874
CARD CATH     4803145 0 STENT CYPHER 3.5 MM X 13 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803146 0 STENT CYPHER 3.5 MM X 18 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803147 0 STENT CYPHER 3.5 MM X 23 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803148 0 STENT CYPHER 3.5 MM X 28 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803149 0 STENT CYPHER 3.5 MM X 33 MM    SUPPLY     6,480.00                    C1874
CARD CATH     4803150 0 STENT CYPHER 3.5 MM X 8 MM     SUPPLY     6,480.00                    C1874
CARD CATH     4801031 0 CORDIS CORONARY STENT          SUPPLY     3,059.60                    C1876
CARD CATH     4803032 0 CORDIS BX SONIC STENT          SUPPLY     3,131.80                    C1876
CARD CATH     4803066 0 CAROTID STENT                  SUPPLY     4,838.00                    C1876
CARD CATH     4803082 0 CORDIS CORINTHIAN STENT        SUPPLY     4,174.10                    C1876
CARD CATH     4803083 0 MEDTRONIC BRIDGE STENT         SUPPLY     3,068.00                    C1876
CARD CATH     4803179 0 STENT SMART 6 X 100MM          SUPPLY     3,524.40                    C1876
CARD CATH     4803180 0 STENT SMART 7 X 100MM          SUPPLY     3,524.40                    C1876
CARD CATH     4803181 0 STENT SMART 8 X 100MM          SUPPLY     3,524.40                    C1876
CARD CATH     4803182 0 STENT SMART 6 X 120MM          SUPPLY     4,237.80                    C1876
CARD CATH     4803183 0 STENT SMART 7 X 120MM          SUPPLY     4,237.80                    C1876
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803184 0 STENT SMART 8 X 120MM            SUPPLY     4,237.80                    C1876
CARD CATH     4803676 0 MEDTRONIC CORONARY STENT         SUPPLY     3,347.90                    C1876
CARD CATH     4803677 0 SCIMED CORONARY STENT            SUPPLY     3,632.70                    C1876
CARD CATH     4803727 0 MEDTRONIC/AVE PERIPHERAL STENT   SUPPLY     3,277.40                    C1876
CARD CATH     4803729 0 CORDIS SMART STENT               SUPPLY     2,985.40                    C1876
CARD CATH     4803732 0 CORDIS PERIPHERAL STENT          SUPPLY     2,184.90                    C1876
CARD CATH     4803739 0 MEDTRONIC/AVE BILIARY STENT      SUPPLY     3,512.30                    C1876
CARD CATH     4803811 0 STENT LIBERTE 4.5 X 12MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803812 0 STENT LIBERTE 4.5 X 16MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803813 0 STENT LIBERTE 4.5 X 20MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803814 0 STENT LIBERTE 4.5 X 24MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803815 0 STENT LIBERTE 4.5 X 28MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803816 0 STENT LIBERTE 4.5 X 32MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803817 0 STENT LIBERTE 5.0 X 12MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803818 0 STENT LIBERTE 5.0 X 16MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803819 0 STENT LIBERTE 5.0 X 20MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803820 0 STENT LIBERTE 5.0 X 24MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803821 0 STENT LIBERTE 5.0 X 28MM         SUPPLY     1,881.30                    C1876
CARD CATH     4803822 0 STENT LIBERTE 5.0 X 32MM         SUPPLY     1,881.30                    C1876
CARD CATH     4801002 0 CORDIS PALMAZ STENT              SUPPLY     2,250.40                    C1877
CARD CATH     4803153 0 STENT BILIARY 10ML 50ML LONG     SUPPLY     3,047.60                    C1877
CARD CATH     4803154 0 STENT BILIARY 10ML 30ML LONG     SUPPLY     2,673.20                    C1877
CARD CATH     4803155 0 STENT RENAL 6-8ML 15ML LONG      SUPPLY     1,715.40                    C1877
CARD CATH     4803156 0 STENT 8-12ML 30ML LONG           SUPPLY     1,715.40                    C1877
CARD CATH     4803157 0 STENT BILIARY 5-8ML 12ML LONG    SUPPLY     1,828.60                    C1877
CARD CATH     4803158 0 STENT BILIARY 5-8ML 24ML LONG    SUPPLY     1,898.20                    C1877
CARD CATH     4803736 0 CORDIS BILIARY STENT             SUPPLY     1,762.00                    C1877
CARD CATH     4803680 0 VENA CAVA FILTER                 SUPPLY     2,575.00                    C1880
CARD CATH     4803765 0 EMBOLIC PROTECTION DEVICE        SUPPLY     3,387.00                    C1884
CARD CATH     4803503 0 CATH VENTURE STEERABLE CATH      SUPPLY     1,398.00                    C1887
CARD CATH     4803511 0 CATH GUIDE IM 6FR 125CM          SUPPLY     236.50                      C1887
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803570 0 PTCA GUIDING CATHETER            SUPPLY     194.40                      C1887
CARD CATH     4803602 0 GUIDE H-STICK SH                 SUPPLY     144.30                      C1887
CARD CATH     4803683 0 PERIPHERAL GUIDE CATHETER        SUPPLY     194.30                      C1887
CARD CATH     4803701 0 CATH GUIDE 8FR Z2 MPA1           SUPPLY     130.00                      C1887
CARD CATH     4803702 0 CATH GUIDE 8FR Z2 HIS            SUPPLY     130.00                      C1887
CARD CATH     4803708 0 CATH GUIDE 8FR Z2 AR1O           SUPPLY     130.00                      C1887
CARD CATH     4803771 0 CATH GUIDE SIDEWINDER 2          SUPPLY     75.00                       C1887
CARD CATH     4803772 0 CATH GUIDE SIDEWINDER 1          SUPPLY     75.00                       C1887
CARD CATH     4803773 0 CATH GUIDE SLIPCATH VTK 5FR      SUPPLY     137.00                      C1887
CARD CATH     4803775 0 CATH GUIDE LAUNCHER JL 3.5       SUPPLY     137.50                      C1887
CARD CATH     4803776 0 CATH GUIDE LAUNCHER JL 3.5 SH    SUPPLY     137.50                      C1887
CARD CATH     4803777 0 CATH GUIDE LAUNCHER JL 4.0       SUPPLY     137.50                      C1887
CARD CATH     4803778 0 CATH GUIDE LAUNCHER JL 4.0 SH    SUPPLY     137.50                      C1887
CARD CATH     4803779 0 CATH GUIDE LAUNCHER JL 4.5       SUPPLY     137.50                      C1887
CARD CATH     4803780 0 CATH GUIDE LAUNCHER AL 1.0       SUPPLY     137.50                      C1887
CARD CATH     4803781 0 CATH GUIDE LAUNCHER AL 1.5       SUPPLY     137.50                      C1887
CARD CATH     4803782 0 CATH GUIDE LAUNCHER AL 2.0       SUPPLY     137.50                      C1887
CARD CATH     4803783 0 CATH GUIDE LAUNCHER AL 2.0 SH    SUPPLY     137.50                      C1887
CARD CATH     4803784 0 CATH GUIDE LAUNCHER EBU 3.0      SUPPLY     137.50                      C1887
CARD CATH     4803785 0 CATH GUIDE LAUNCHER EBU 3.0 SH   SUPPLY     137.50                      C1887
CARD CATH     4803786 0 CATH GUIDE LAUNCHER EBU 3.5      SUPPLY     137.50                      C1887
CARD CATH     4803787 0 CATH GUIDE LAUNCHER EBU 3.5 SH   SUPPLY     137.50                      C1887
CARD CATH     4803788 0 CATH GUIDE LAUNCHER EBU 4.0      SUPPLY     137.50                      C1887
CARD CATH     4803789 0 CATH GUIDE LAUNCHER EBU 4.0 SH   SUPPLY     137.50                      C1887
CARD CATH     4803790 0 CATH GUIDE LAUNCHER EBU 4.5      SUPPLY     137.50                      C1887
CARD CATH     4803791 0 CATH GUIDE LAUNCHER JR 3.5       SUPPLY     137.50                      C1887
CARD CATH     4803792 0 CATH GUIDE LAUNCHER JR 4.0       SUPPLY     137.50                      C1887
CARD CATH     4803793 0 CATH GUIDE LAUNCHER JR 4.0 SH    SUPPLY     137.50                      C1887
CARD CATH     4803794 0 CATH GUIDE LAUNCHER AR 1.0       SUPPLY     137.50                      C1887
CARD CATH     4803795 0 CATH GUIDE LAUNCHER AR 2.0       SUPPLY     137.50                      C1887
CARD CATH     4803796 0 CATH GUIDE LAUNCHER HS 1         SUPPLY     137.50                      C1887
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803797 0 CATH GUIDE LAUNCHER HS 1 SH                  SUPPLY     137.50                      C1887
CARD CATH     4803798 0 CATH GUIDE LAUNCHER HS 2                     SUPPLY     137.50                      C1887
CARD CATH     4803799 0 CATH GUIDE LAUNCHER IMA 90CM                 SUPPLY     137.50                      C1887
CARD CATH     4803800 0 CATH GUIDE LAUNCHER IMA 90CM SH              SUPPLY     137.50                      C1887
CARD CATH     4803767 0 INFUSION THER NON-CHEMO 1ST HR               PROCED     236.00                      C8950
CARD CATH     4803768 0 INFUSION THER NON-CHEMO EA ADD'L HR          PROCED     142.00                      C8951
CARD CATH     4801057 0 CLOSURE DEVICE PLACMENT                      PROCED     100.00                      G0269
CARD CATH     4801055 0 RENAL ANGIOGM W/ CARD CATH NON-SELECTV       PROCED     1,466.29                    G0275
CARD CATH     4801056 0 ILIAC/FEM ANGIOGM W/ CARD CATH NON-SELCTV    PROCED     1,951.33                    G0278
CARD CATH     4801053 0 STENT PLC DRUG ELUT SING VESL                PROCED     11,897.30                   G0290
CARD CATH     4801054 0 STENT PLC DRUG ELUT ADD VESL                 PROCED     11,897.30                   G0291
CARD CATH     4803770 0 VISIPAQUE 320 MG IODINE/ML - 1 ML INJ        SUPPLY     2.65                        Q9949
CARD CATH     4803769 0 NICM OMNIPAQUE 350 MG IODINE/ML - 1 ML INJ   SUPPLY     4.75                        Q9950
CARD CATH     4801001 0 TRI ADAPTOR                                  SUPPLY     40.40
CARD CATH     4801005 0 COOK SHEATH                                  SUPPLY     101.70
CARD CATH     4801006 0 Y ADAPTOR                                    SUPPLY     33.70
CARD CATH     4801016 0 TRANSEPTAL INTRODUCER                        SUPPLY     234.90
CARD CATH     4801019 0 FINGER PROBE-SA02                            SUPPLY     31.20
CARD CATH     4801244 0 THROMBECTOMY PERIPHERAL                      PROCED     532.00
CARD CATH     4802511 0 PEDS DIL OF AORTIC COAR                      PROCED     3,767.20
CARD CATH     4803005 0 RX ACCUNET 45 190                            SUPPLY     3,332.50
CARD CATH     4803006 0 RX ACCUNET 55 190                            SUPPLY     3,332.50
CARD CATH     4803007 0 RX ACCUNET 65 190                            SUPPLY     3,332.50
CARD CATH     4803008 0 RX ACCUNET 75 190                            SUPPLY     3,332.50
CARD CATH     4803009 0 STENT ACCULINK II 6-30                       SUPPLY     4,837.50
CARD CATH     4803010 0 STENT ACCULINK II 7-30                       SUPPLY     4,837.50
CARD CATH     4803011 0 STENT ACCULINK II 7-40                       SUPPLY     4,837.50
CARD CATH     4803012 0 STENT ACCULINK II 8-30                       SUPPLY     4,837.50
CARD CATH     4803013 0 STENT ACCULINK II 8-40                       SUPPLY     4,837.50
CARD CATH     4803014 0 STENT ACCULINK II 10-30                      SUPPLY     4,407.50
CARD CATH     4803015 0 STENT ACCULINK II 6-8-30                     SUPPLY     4,837.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                            CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION            CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803016 0 STENT ACCULINK II 6-8-40      SUPPLY     4,837.50
CARD CATH     4803017 0 STENT ACCULINK II 7-10-30     SUPPLY     4,837.50
CARD CATH     4803018 0 STENT ACCULINK II 7-10-40     SUPPLY     4,837.50
CARD CATH     4803048 0 EMBOLIC GLUE                  SUPPLY     4,290.00
CARD CATH     4803061 0 DILATOR SET                   SUPPLY     303.00
CARD CATH     4803063 0 BALLOON RELIANT RE 146        SUPPLY     956.80
CARD CATH     4803067 0 COIL EMBOLIZ 3/2 TORNADO      SUPPLY     219.00
CARD CATH     4803068 0 COIL EMBOLIZ 5/2 TORNADO      SUPPLY     219.00
CARD CATH     4803069 0 COIL EMBOLIZ 6/2 TORNADO      SUPPLY     219.00
CARD CATH     4803070 0 ANGIOJET PUMP SET             SUPPLY     537.50
CARD CATH     4803071 0 CATH INFUSION 3.0 FR 100 CM   SUPPLY     144.30
CARD CATH     4803076 0 SHEATH SHUTTLE                SUPPLY     290.30
CARD CATH     4803084 0 MEDTRONIC BRIDGE X3 STENT     SUPPLY     3,296.00
CARD CATH     4803086 0 INTRA AORTIC BALLOON          SUPPLY     1,551.10
CARD CATH     4803088 0 EMBOLIZATION COIL             SUPPLY     148.50
CARD CATH     4803089 0 BIOPSY FORCEPS                SUPPLY     418.69
CARD CATH     4803091 0 MARKER PIGTAIL                SUPPLY     243.60
CARD CATH     4803098 0 PROCEDURE PACK                SUPPLY     162.63
CARD CATH     4803099 0 GENSINI CATHETER              SUPPLY     176.30
CARD CATH     4803101 0 CARDIAC OUTPUT SET            SUPPLY     40.37
CARD CATH     4803102 0 SHEATH LONG 45 CM             SUPPLY     182.92
CARD CATH     4803103 0 SHEATH LONG 98 CM             SUPPLY     126.69
CARD CATH     4803104 0 SHEATH KIT BARD STERILE       SUPPLY     24.10
CARD CATH     4803105 0 VESSEL DILATOR                SUPPLY     21.73
CARD CATH     4803151 0 CATH SIM 2                    SUPPLY     38.70
CARD CATH     4803152 0 CATH SIM 3                    SUPPLY     38.70
CARD CATH     4803510 0 CATH TWIN PASS                SUPPLY     698.80
CARD CATH     4803532 0 SWAN GANZ CATHETER            SUPPLY     94.00
CARD CATH     4803533 0 LONG INTRODUCERS              SUPPLY     83.70
CARD CATH     4803537 0 ARROW PACING CATHETER         SUPPLY     194.40
CARD CATH     4803538 0 EMBOLIZATION COIL TRU FILL    SUPPLY     2,999.25
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
CARD CATH     4803543 0 AAA AORTIC / ILIAC CUFF          SUPPLY     4,354.00
CARD CATH     4803544 0 AAA STENT GRAFT                  SUPPLY     13,213.00
CARD CATH     4803545 0 AAA ILIAC LIMB                   SUPPLY     5,214.00
CARD CATH     4803561 0 THERMODILUTION KITS              SUPPLY     194.40
CARD CATH     4803565 0 DIAGNOSTIC CATHETER              SUPPLY     33.70
CARD CATH     4803597 0 SHORT INTRODUCERS                SUPPLY     55.72
CARD CATH     4803600 0 CATH SIM 1                       SUPPLY     7.70
CARD CATH     4803601 0 CATH BERNSTEIN                   SUPPLY     8.40
CARD CATH     4803604 0 CATH INT MAMM                    SUPPLY     7.70
CARD CATH     4803606 0 CATH GLIDECATH STR 4 FR 65 CM    SUPPLY     150.00
CARD CATH     4803607 0 CATH GLIDECATH ANG 4 FR 65 CM    SUPPLY     150.00
CARD CATH     4803608 0 CATH GLIDECATH STR 4 FR 100 CM   SUPPLY     150.00
CARD CATH     4803609 0 CATH GLIDECATH ANG 4 FR 100 CM   SUPPLY     150.00
CARD CATH     4803610 0 TUOHY BORST ADAPTER              SUPPLY     18.40
CARD CATH     4803611 0 HOLE PUNCH 0.25                  SUPPLY     62.50
CARD CATH     4803612 0 VASCULAR RETRIEVAL FORCEP        SUPPLY     846.60
CARD CATH     4803633 0 PERICARDIOCENTESIS TRAY          SUPPLY     188.00
CARD CATH     4803634 0 INTUBATION TRAY                  SUPPLY     104.10
CARD CATH     4803652 0 INFLATION DEVICE                 SUPPLY     103.40
CARD CATH     4803656 0 SMART NEEDLE                     SUPPLY     219.60
CARD CATH     4803657 0 FLOW WIRE                        SUPPLY     1,228.20
CARD CATH     4803658 0 CORDIS UNMOUNTED PALMAZ STENT    SUPPLY     1,814.90
CARD CATH     4803671 0 ARROW DOUBLE LUMEN               SUPPLY     230.50
CARD CATH     4803681 0 USCI FEM STOP                    SUPPLY     179.70
CARD CATH     4803687 0 IVUS PULLBACK DEVICE             SUPPLY     125.00
CARD CATH     4803689 0 TRANS-SEPTAL NEEDLE              SUPPLY     194.00
CARD CATH     4803710 0 ARROW WEDGE CATHETER             SUPPLY     69.90
CARD CATH     4803711 0 ARROW ANGIO CATHETER             SUPPLY     85.30
CARD CATH     4803714 0 STEERING HANDLE                  SUPPLY     15.50
CARD CATH     4803719 0 ATHERECTOMY CATH                 SUPPLY     6,439.00
CARD CATH     4803726 0 R2 DEFIB PADS                    SUPPLY     176.20
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML      CPT
CARD CATH     4803733 0 ROTOBLATOR C-CLIP                              SUPPLY     23.50
CARD CATH     4803740 0 THERMAL SWAN GANZ CATHETER                     SUPPLY     121.70
CARD CATH     4803753 0 BALKIN SHEATH                                  SUPPLY     104.40
CARD CATH     4803774 0 BALLOON CROSS SAIL 40X30 RX                    SUPPLY     645.00
CARD REHAB    9401002 0 PHASE I REHAB VISIT                            PROC       57.90                       93798
CARD REHAB    9401508 0 COUNSELING RISK FCTR REDUC IND 1 HR            PROCED     35.00                       99404
CARD REHAB    9401509 0 OP SMOKING CESSATION IND 3-10 MIN              PROCED     35.00                       G0375
CARD REHAB    9401511 0 IP SMOKING CESSATION IND 3-10 MIN              PROCED     35.00                       G0375
CARD REHAB    9401510 0 OP SMOKING CESSATION IND > 10 MIN              PROCED     40.00                       G0376
CARD REHAB    9401512 0 IP SMOKING CESSATION IND > 10 MIN              PROCED     40.00                       G0376
CARD REHAB    9401513 0 OP SMOKING CESSATION GRP > 10 MIN              PROCED     40.00                       G0376
CARDIOGRAPHIC 3861604  0 INTRO CATH INTO PERIPH VEIN (IV START)        PROCED     121.00                      36000
CARDIOGRAPHIC 3831509  0 ECG 12-LEAD WITH RHYTHM STRIP                 PROCED     130.36                      93005
CARDIOGRAPHIC 3851713  0 VECTORCARDIOGRAM / EKG                        PROCED     115.00                      93005
CARDIOGRAPHIC 3861602  0 EVENT MONITR RECORDING NON-LOOPING            PROCED     175.00                      93012
CARDIOGRAPHIC 3851581  0 TREADMILL EXERCISE TEST W/ O2 CONSUMPTION     PROCED     500.00                      93017
CARDIOGRAPHIC 3851582  0 TREADMILL EXERCISE TEST (NO IMAGING)          PROCED     500.00                      93017
CARDIOGRAPHIC 3851712  0 STRESS ECG TRACING                            PROCED     500.00                      93017
CARDIOGRAPHIC 3831510  0 TREADMILL LIMITED (LIFE STUDY)                PROCED     250.00                      9301752
CARDIOGRAPHIC 3841550  0 HOLTER MONITOR 24 HR ECG RECORDING            PROCED     232.00                      93231
CARDIOGRAPHIC 3841516  0 HOLTER MNTRING ANAL/REPRT 24 H                PROCED     450.00                      93232
CARDIOGRAPHIC 3841636  0 EVENT MONITOR RECORDING LOOPING 30 DAY PERIOD PROCED     190.00                      93270
CARDIOGRAPHIC 3831704  0 SIGNAL AVERAGE ECG                            PROCED     360.72                      93278
CARDIOGRAPHIC 3861703  0 TRANSTHOR ECHO CCA COMPLT                     PROCED     545.00                      93303
CARDIOGRAPHIC 3861702  0 TRANSTHOR ECHO CCA F/U                        PROCED     491.00                      93304
CARDIOGRAPHIC 3831512  0 ECHOCARDIOGRAM 2D M-MODE WITH AORTIC PROTOCO  PROCED     602.51                      93307
CARDIOGRAPHIC 3831513  0 ECHOCARDIOGRAM 2D M-MODE WITH PVI PROTOCOL (P PROCED     602.51                      93307
CARDIOGRAPHIC 3861603  0 ECHOCARDIOGRAM WITH SALINE CONTRAST           PROCED     602.51                      93307
CARDIOGRAPHIC 3861707  0 ECHOCARDIOGRAM 2D M-MODE                      PROCED     602.51                      93307
CARDIOGRAPHIC 3861708  0 ECHOCARDIOGRAM 2D M-MODE FOLLOW-UP / LTD      PROCED     250.00                      93308
CARDIOGRAPHIC 3861705  0 TRANSESOPHAGEAL ECHO COMPLETE                 PROCED     1,102.68                    93312
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML      CPT
CARDIOGRAPHIC 3861722  0 TRANSESOPHAGEAL ECHO FOLLOW-UP, LIMITED   PROCED     1,000.00                    9331252
CARDIOGRAPHIC 3861704  0 TRANS ESOPH ECHO CCA                      PROCED     1,720.00                    93315
CARDIOGRAPHIC 3861710  0 CARDIAC DOPPLER COMPLETE                  PROCED     356.87                      93320
CARDIOGRAPHIC 3861709  0 CARDIAC DOPPLER FOLLOW-UP/ LTD            PROCED     240.00                      93321
CARDIOGRAPHIC 3861721  0 COLOR FLOW MAPPING                        PROCED     264.87                      93325
CARDIOGRAPHIC 3861720  0 COLOR FLOW (LIMITED)                      PROCED     170.00                      9332552
CARDIOGRAPHIC 3851710  0 TREADMILL STRESS ECHOCARDIOGRAM           PROCED     1,082.31                    93350
CARDIOGRAPHIC 3851711  0 DOBUTAMINE STRESS ECHOCARDIOGRAM          PROCED     1,082.31                    93350
CARDIOGRAPHIC 3851002  0 ANAEROBIC THRESHOLD                       PROCED     277.00                      94680
CARDIOGRAPHIC 3851001  0 AEROBIC CAPACITY                          PROCED     277.00                      94681
CARDIOGRAPHIC 3851715  0 OPTISON 1 ML INJ                          SUPPLY     84.00                       Q9956
CARDIOGRAPHIC 3851714  0 DEFINITY INJ 1 ML                         SUPPLY     157.50                      Q9957
CARDIOGRAPHIC 3831511  0 AORTIC FAMILIAL SCREENING ECHO            PROCED     200.00
CNU(CLIN NUTR 9510053  0 OP VAD PERIPH IV INSERT                   PROCED     118.23                      36000
CNU(CLIN NUTR 9515002  0 OP - PERIPHERAL PHLEBOTOMY                PROCED     19.69                       36415
CNU(CLIN NUTR 9510079  0 OP VAD PHLEBOTOMY                         PROCED     91.26                       36540
CNU(CLIN NUTR 9510081  0 IP VAD PHLEBOTOMY                         PROCED     91.26                       36540
CNU(CLIN NUTR 9510021  0 OP VAD DECLOTTING                         PROCED     293.00                      36550
CNU(CLIN NUTR 9510080  0 IP VAD DECLOTTING                         PROCED     293.00                      36550
CNU(CLIN NUTR 9510088  0 IP - VAD DECLOT W/ DRSG CHANGE            PROCED     293.00                      36550
CNU(CLIN NUTR 9515006  0 OP VAD DECLOT W/ DRSG CHANGE              PROCED     293.00                      36550
CNU(CLIN NUTR 9510052  0 OP VAD PICC PLCMT                         PROCED     659.44                      36569
CNU(CLIN NUTR 9510083  0 IP VAD PICC PLACMT                        PROCED     659.44                      36569
CNU(CLIN NUTR 9510071  0 OP - VAD PICC PLCMT TERMINATED            PROCED     1,040.00                    3656952
CNU(CLIN NUTR 9510082  0 IP VAD PICC PLCMT TERMINATED              PROCED     659.44                      3656952
CNU(CLIN NUTR 9511029  0 IP - VAD REPAIR                           PROCED     514.00                      36575
CNU(CLIN NUTR 9511030  0 OP - VAD REPAIR                           PROCED     254.17                      36575
CNU(CLIN NUTR 9510092  0 IP - VAD PICC EXCHANGE                    PROCED     659.44                      36584
CNU(CLIN NUTR 9510093  0 OP - VAD PICC EXCHANGE                    PROCED     659.44                      36584
CNU(CLIN NUTR 9510051  0 OP GASTROS CHGE W/ REPL TUBE              PROCED     333.53                      43760
CNU(CLIN NUTR 9510086  0 IP GASTROST CHGE W/ BUTTON                PROCED     333.53                      43760
PARTIAL CHARGEMASTER - 12/13/06

                        Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
CNU(CLIN NUTR   9510087 0 IP GASTROS CHGE W/ REPL TUBE            PROCED     333.53                      43760
CNU(CLIN NUTR   9515003 0 OP GASTROST CHGE W/ BUTTON              PROCED     333.53                      43760
CNU(CLIN NUTR   9510020 0 OP DUODENAL FDG TUBE PLAMT              PROCED     432.00                      43761
CNU(CLIN NUTR   9510085 0 IP DUODENAL FDG TUBE PLCMT              PROCED     432.00                      43761
CNU(CLIN NUTR   9510094 0 OP - U/S GUIDANCE FOR VASCULAR ACCESS   PROCED     75.00                       76937
CNU(CLIN NUTR   9510095 0 IP - U/S GUIDANCE FOR VASCULAR ACCESS   PROCED     75.00                       76937
CNU(CLIN NUTR   9510090 0 IP - U/S GUIDED NEEDLE PLCMNT           PROCED     478.88                      76942
CNU(CLIN NUTR   9510091 0 OP - U/S GUIDED NEEDLE PLCMNT           PROCED     478.88                      76942
CNU(CLIN NUTR   9515001 0 INJ FEE THER / DIAG / PROPHY SQ,IM,ID   PROCED     60.36                       90772
CNU(CLIN NUTR   9510015 0 INDIRECT CALORIMETRY / Hood             PROCED     535.14                      94681
CNU(CLIN NUTR   9510084 0 INDIRECT CALORIM / VENT                 PROCED     535.14                      94681
CNU(CLIN NUTR   9515004 0 OP MNT INDIV INIT EA 15 MIN             PROCED     33.04                       97802
CNU(CLIN NUTR   9515005 0 OP MNT INDIV REASSES EA 15 MIN          PROCED     27.36                       97803
CNU(CLIN NUTR   9512001 0 NEW LEV I 0-15 MIN                      LOC        54.84                       99201
CNU(CLIN NUTR   9512002 0 NEW LEV II 15-30 MIN                    LOC        54.84                       99202
CNU(CLIN NUTR   9512003 0 NEW LEV III 30-45 MIN                   LOC        63.10                       99203
CNU(CLIN NUTR   9512004 0 NEW LEV IV 45-60 MIN                    LOC        91.81                       99204
CNU(CLIN NUTR   9512005 0 NEW LEV V > 1 HR                        LOC        91.81                       99205
CNU(CLIN NUTR   9512006 0 EST LEV I 0-15 MIN                      LOC        40.00                       99211
CNU(CLIN NUTR   9512007 0 EST LEV II 15-30 MIN                    LOC        40.00                       99212
CNU(CLIN NUTR   9512008 0 EST LEV III 30-45 MIN                   LOC        63.10                       99213
CNU(CLIN NUTR   9512009 0 EST LEV IV 45-60 MIN                    LOC        91.81                       99214
CNU(CLIN NUTR   9512010 0 EST LEV V > 1 HR                        LOC        91.81                       99215
CNU(CLIN NUTR   9510066 0 DRSG TRANSPAR 4X4 EA                    SUPPLY     3.20
CNU(CLIN NUTR   9510078 0 NASOENTERIC FEEDING TUBE                SUPPLY     30.00
CNU(CLIN NUTR   9510054 0 DUAL GROSHONG PICC                      SUPPLY     290.00                      C1751
CNU(CLIN NUTR   9510055 0 DUAL GROSH PICC TRAY                    SUPPLY     370.00                      C1751
CNU(CLIN NUTR   9510056 0 SINGLE GROSHONG PICC                    SUPPLY     182.00                      C1751
CNU(CLIN NUTR   9510057 0 SGL GROSHONG PICC TRAY                  SUPPLY     270.00                      C1751
CNU(CLIN NUTR   9513005 0 INFUSION THER NON-CHEMO 1ST HR          PROCED     236.00                      C8950
CNU(CLIN NUTR   9513006 0 INFUSION THER NON-CHEMO EA ADD'L HR     PROCED     142.00                      C8951
PARTIAL CHARGEMASTER - 12/13/06

                        Svc                                      CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)             LML/RML     CPT
CNU(CLIN NUTR   9510089 0 INJ FEE IV PUSH THER / DIAG / PROPHY   PROCED     150.00                         C8952
CNU(CLIN NUTR   9512011 0 CONFERENCE,INTERDISCIPLINARY T         LOC        91.81                          G0175
CNU(CLIN NUTR   9510010 0 SLEEVE ULTRASOUND EA                   SUPPLY     13.00
CNU(CLIN NUTR   9510011 0 PEG FEEDING ADAPTER EA                 SUPPLY     27.00
CNU(CLIN NUTR   9510058 0 STOMA MEASURE DEVICE                   SUPPLY     14.00
CNU(CLIN NUTR   9510059 0 DUAL PICC INTRODUCER                   SUPPLY     65.00
CNU(CLIN NUTR   9510060 0 BUTTON G TUBE KIT                      SUPPLY     275.00
CNU(CLIN NUTR   9510061 0 REPLACMENT G TUBE EA                   SUPPLY     85.00
CNU(CLIN NUTR   9510062 0 SPECIALTY TUBE/CATH                    SUPPLY     220.00
CNU(CLIN NUTR   9510063 0 IV EXTENSION SET 6" LUERLOCK           SUPPLY     8.50
CNU(CLIN NUTR   9510067 0 VAD DRSG KIT                           SUPPLY     17.50
CNU(CLIN NUTR   9510077 0 MICRO-INTRODUCER W/ SLEEVE             SUPPLY     82.00
CNU(CLIN NUTR   9511001 2 IP-VAD DRESSING CHANGE                 PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511003 2 IP PERIPH PHLEBOTOMY                   PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511004 2 IP VAD PERIPH IV INSERT                PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511005 2 IP ENT ACC DEV CARE                    PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511006 2 IP ACCESS DEVICE ASSMT                 PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511007 2 IP MNT INDIV INIT EA 15 MIN            PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511008 2 IP MNT INDIV REASSES EA 15 MIN         PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511009 2 IP - NASOGASTRIC FDG TUBE PLCMT        PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511010 2 IP - VAD PICC REMOVAL                  PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511011 2 IP - VAD PORT ACCESS / DEACCESS        PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511012 2 IP - BODY COMP MEASUREMENT             PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511013 2 IP - INFUS THPY NON CHEMO 0-2 HR       PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511014 2 IP - INFUS THPY NON CHEMO 2-4 HR       PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511015 2 IP - INFUS THPY NON CHEMO 4-6 HR       PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511016 2 IP - INFUS THPY NON CHEMO 6-8 HR       PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511017 2 IP - G-TUBE REMOVAL                    PROCED     STATISTICAL ITEM
CNU(CLIN NUTR   9511018 2 IP - PATIENT EDUCATION                 PROC       STATISTICAL ITEM
CNU(CLIN NUTR   9511019 2 OP - PATIENT EDUCATION                 PROC       STATISTICAL ITEM
CNU(CLIN NUTR   9511020 2 OP - BODY COMP MEASUREMENT             PROCED     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                                  CHARGE         PRICE (INPT /    LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                                   CATEGORY      OUTPT)           LML/RML    CPT
CNU(CLIN NUTR 9511021   2 OP - ACCESS DEVICE ASSMT                            PROCED        STATISTICAL ITEM
CNU(CLIN NUTR 9511022   2 OP - VAD PICC REMOVAL                               PROCED        STATISTICAL ITEM
CNU(CLIN NUTR 9511023   2 OP - VAD DRESSING CHANGE                            PROCED        STATISTICAL ITEM
CNU(CLIN NUTR 9511025   2 OP - VAD PORT ACCESS / DEACCESS                     PROCED        STATISTICAL ITEM
CNU(CLIN NUTR 9511026   2 OP - NASOGASTRIC FEDG TUBE PLCMT                    PROCED        STATISTICAL ITEM
CNU(CLIN NUTR 9511027   2 OP - G-TUBE REMOVAL                                 PROCED        STATISTICAL ITEM
CNU(CLIN NUTR 9511028   2 OP - ENT ACC DEV CARE                               PROCED        STATISTICAL ITEM
DIALYSIS INPT 8000120   0 HEMODIALYSIS NON-ROUTINE ESRD OP                    PROCED        444.90                      G0257
DIALYSIS INPT 8000100   0 HEMODIALYSIS ESRD ACUTE IP                          PROCED        1,153.20
DIALYSIS INPT 8000110   0 HEMODIALYSIS ESRD ROUTINE IP                        PROCED        470.00
DIALYSIS INPT 8001002   0 HEMODIALYSIS ARF ACUTE IP                           PROCED        1,262.50
DIALYSIS INPT 8001003   0 HEMODIALYSIS ARF ROUTINE IP                         PROCED        470.00
DIALYSIS INPT 8002100   0 CAPD IP TREATMENT                                   PROCED        195.30
DIALYSIS INPT 8002110   0 CCPD IP TREATMENT                                   PROCED        195.30
DIALYSIS INPT 8002121   0 RENAL CRRT TREATMENT                                PROCED        1,300.00
DIALYSIS INPT 8002140   0 ISOLATED ULTRAFILTRATION (IUF)                      PROCED        445.60
DIALYSIS INPT 8003100   0 CAPD IP ESRD W/TRAINING                             PROCED        370.00
DIALYSIS OUTPT 8006143  0 BLOOD GLUCOSE ACCUCHECK                                           23.37
                                                                              WAIVED TEST DON                           82962
DIALYSIS OUTPT 8006160  0 TUBERCULIN SKIN TEST INTRADERMAL                    MED           24.90                       86580
DIALYSIS OUTPT 8006159  0 INFLUENZA VACC INJ 6-35 MOS                         MED IMMUN     15.00                       90655
DIALYSIS OUTPT 8006158  0 INFLUENZA VACC INJ 3 Y/O & ABV                      MED IMMUN     15.00                       90656
DIALYSIS OUTPT 8006157  0 PNEUMOCOCCAL POLYVAL (PREVNAR) VACC INJ             MED IMMUN     182.70                      90669
DIALYSIS OUTPT 8006156  0 PNEUMOCOCCAL VACC INJ 0.5ML                         MED IMMUN     75.00                       90732
DIALYSIS OUTPT 8006155  0 HEPATITIS B 40 MCG INJ (4-DOSE SCH FOR DIALY / IMMU MED IMMUN     254.90                      90747
DIALYSIS OUTPT 8006105  0 INJ FEE THER / DIAG / PROPHY SQ,IM,ID               PROCED        60.36                       90772
DIALYSIS OUTPT 8005100  0 HEMODIALYSIS ARF OP                                 PROCED        1,113.21                    90935
DIALYSIS OUTPT 8006151  0 CPR IN CARDIAC ARREST                               PROCED        565.42                      92950
DIALYSIS OUTPT 8006144  0 EKG 12-LEAD                                         PROCED        130.36                      93005
DIALYSIS OUTPT 8006101  0 DIAG NON-INVASIVE VASCULAR STUDIES                  PROCED        456.44                      93990
DIALYSIS OUTPT 8006141  0 INFUSION THER NON-CHEMO 1ST HR                      PROCED        236.00                      C8950
DIALYSIS OUTPT 8006142  0 INFUSION THER NON-CHEMO EA ADD'L HR                 PROCED        142.00                      C8951
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
DIALYSIS OUTPT 8006106  0 INJ FEE IV PUSH THER / DIAG / PROPHY       PROCED     150.00                      C8952
DIALYSIS OUTPT 8006104  0 INJ FEE INFLUENZA                          PROCED     15.00                       G0008
DIALYSIS OUTPT 8006103  0 INJ FEE PNEUMOCOCCAL                       PROCED     25.00                       G0009
DIALYSIS OUTPT 8006102  0 INJ FEE HEPATITIS B                        PROCED     25.00                       G0010
DIALYSIS OUTPT 8006162  0 CALCIUM GLUCONATE 10% 10ML IVPB            MED        4.50                        J0610
DIALYSIS OUTPT 8006107  0 CALCITRIOL (CALCIJEX) INJ 0.1MCG           MED        3.09                        J0636
DIALYSIS OUTPT 8006163  0 CEFAZOLIN 500 MG IVPB                      MED        21.00                       J0690
DIALYSIS OUTPT 8006164  0 CEFTAZIDIME 500 MG IVPB                    MED        19.10                       J0713
DIALYSIS OUTPT 8006108  0 DARBEPOETIN 1 MCG INJ (ESRD ON DIALYSIS)   MED        13.55                       J0882
DIALYSIS OUTPT 8006154  0 ERYTHROPOETIN 1000 UNITS INJ (ESRD PT)     MED        46.40                       J0886
DIALYSIS OUTPT 8006166  0 GENTAMYCIN 80 MG IVPB                      MED        19.25                       J1580
DIALYSIS OUTPT 8006167  0 LEVOCARNITINE 1 GM IVPB                    MED        134.60                      J1955
DIALYSIS OUTPT 8006165  0 FERRLECIT 12.5 MG IVPB                     MED        13.00                       J2916
DIALYSIS OUTPT 8006168  0 METHYLPREDNISOLONE SOLUMEDROL 40 MG IVPB   MED        22.50                       J2920
DIALYSIS OUTPT 8006161  0 ALTEPLASE INJ 1 MG                         MED        56.20                       J2997
DIALYSIS OUTPT 8006169  0 VANCOMYCIN 500 MG IVPB                     MED        48.20                       J3370
DIALYSIS OUTPT 8006153  0 IV 0.9% NS 250 ML                          MED        40.00                       J7050
DIALYSIS OUTPT 8005110  0 HEMODIALYSIS OP ESRD                       PROCED     444.90
DIALYSIS OUTPT 8005120  0 ISOLATED ULTRAFILTRATION (IUF)             PROCED     445.60
DIALYSIS OUTPT 8006100  0 CAPD ESRD OP                               PROCED     195.30
DIALYSIS OUTPT 8006110  0 CCPD ESRD OP                               PROCED     195.30
DIALYSIS OUTPT 8006120  0 HEMODIALYSIS ESRD HOME                     PROCED     432.60
DIALYSIS OUTPT 8006130  0 SUPPORT SERVICES, CAPD                     PROCED     79.60
DIALYSIS OUTPT 8006140  0 SUPPORT SERVICES,CCPD                      PROCED     79.60
DIALYSIS OUTPT 8006150  0 SUPPORT SERVICES,HEMODIALYSIS              PROCED     79.60
DIALYSIS OUTPT 8006170  0 PHOPHASODA FLEET DIALYSIS SOLN 45 ML       MED        3.50
DIALYSIS OUTPT 8006171  0 KAYEXALATE SUSP 15 GM ORAL                 MED        12.80
DIALYSIS OUTPT 8006200  0 SERVICE CHARGE,RUSH DELIVERY               PROCED     106.10
DIALYSIS OUTPT 8006201  0 IV 0.9% NACL 100 ML                        MED        20.00
DIALYSIS OUTPT 8008100  0 CAPD ESRD W/TRAINING                       PROCED     370.00
DIALYSIS OUTPT 8008110  0 CCPD ESRD W/TRAINING                       PROCED     552.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
DIALYSIS OUTPT 8008120  0 HEMODIALYSIS ESRD W/TRAINING        PROCED     516.00
EP LAB         3801597 0 INCIS / DRNGE WOUND THORAX           PROCED     2,239.78                    21501
EP LAB         3811575 0 PERICARDIOCENTESIS, INITIAL          PROCED     495.54                      33010
EP LAB         3811522 0 IMPLANT PPM W/LEAD ATRIAL            PROCED     16,177.70                   33206
EP LAB         3811521 0 IMPLANT PPM W/LEAD VENTRICULAR       PROCED     16,177.70                   33207
EP LAB         3811520 0 IMPLANT PPM W/LEADS DCM              PROCED     16,177.70                   33208
EP LAB         3811585 0 INSERT TEMP PM/SCM                   PROCED     6,779.40                    33210
EP LAB         3811590 0 INSERT TEMP PM/DCM                   PROCED     6,779.40                    33211
EP LAB         3811528 0 IMPLANT PPM PG ONLY SCM              PROCED     12,717.54                   33212
EP LAB         3811527 0 IMPLANT PPM PG ONLY DCM              PROCED     12,955.50                   33213
EP LAB         3811513 0 UPGRADE PPM FR SCM TO DCM            PROCED     16,405.24                   33214
EP LAB         3801533 0 REPOSITN PREV IMPLNTED PPM OR AICD   PROCED     2,206.06                    33215
EP LAB         3811563 0 IMPLANT PPM/ICD LEAD-SCM             PROCED     6,779.40                    33216
EP LAB         3811523 0 IMPLANT PPM/ICD LEADS-DCM            PROCED     6,779.40                    33217
EP LAB         3811517 0 REPAIR PPM/ICD LEAD SCM              PROCED     6,779.40                    33218
EP LAB         3811516 0 REPAIR P PM/ICD LEAD DCM             PROCED     6,779.40                    33220
EP LAB         3811514 0 REVISE/RELOC POCKET PPM              PROCED     1,827.74                    33222
EP LAB         3811515 0 REVISE/RELOC POCKET ICD              PROCED     1,827.74                    33223
EP LAB         3801611 0 UPGRADE TO BI-V                      PROCED     10,555.00                   33224
EP LAB         3801612 0 LEAD BI-VENT NEW INSERT              PROCED     10,555.00                   33225
EP LAB         3801613 0 BI VENT REPOSITIONING                PROCED     2,206.06                    33226
EP LAB         3811518 0 REMOVE PPM PG SCM/DCM                PROCED     3,000.00                    33233
EP LAB         3801599 0 REMOVAL PACEMAKER LEAD SINGLE        PROCED     2,206.06                    33234
EP LAB         3801598 0 REMOVAL PACEMAKER LEAD DUAL          PROCED     2,206.06                    33235
EP LAB         3811519 0 REMOVE ICD PG SCM/DCM                PROCED     3,000.00                    33241
EP LAB         3822003 0 LEAD EXTRACTION TRANSVENOUS          PROCED     3,200.00                    33244
EP LAB         3802420 0 IMPLANT EVENT RECORDER               PROCED     7,222.38                    33282
EP LAB         3811540 0 REMOVE EVENT RECORDER                PROCED     1,236.60                    33284
EP LAB         3801591 0 INSERT CENTRAL LINE                  PROCED     1,367.62                    36556
EP LAB         3801592 0 INSERT ARTERIAL LINE                 PROCED     174.93                      36620
EP LAB         3801602 0 INSERT PACER / DEFIB FLUOROSCOPY     PROCED     190.90                      71090
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML      CPT
EP LAB        3801583 0 VENOGRAPHY-SINGLE                 PROCED     887.30                      75820
EP LAB        3801604 0 VENOGRAPHY SINUS OR JUGULAR       PROCED     1,744.00                    75860
EP LAB        3801503 0 CARDIOVERSION, EXTERNAL           PROCED     657.84                      92960
EP LAB        3822004 0 CARDIOVERSION EXTERN TERMINATED   PROCED     657.78                      9296073
EP LAB        3801580 0 INTERNAL CARDIOVERSION            PROCED     637.40                      92961
EP LAB        3801562 0 SWAN GANZ INSERTION               PROCED     1,335.86                    93503
EP LAB        3801532 0 LEFT HEART CATH                   PROCED     4,140.40                    93510
EP LAB        3801584 0 TRANSSEPTAL APPROACH              PROCED     4,140.40                    93527
EP LAB        3801605 0 INJ PROC CORONARY ANGIOGRAPHY     PROCED     375.30                      93545
EP LAB        3801510 0 SWAN GANZ/CARDIAC OUTPUT          PROCED     371.30                      93561
EP LAB        3801519 0 HIS ELECTROGRAM RECORDING         PROCED     5,676.04                    93600
EP LAB        3801517 0 INTRA-ATRIAL RECORDING            PROCED     5,676.04                    93602
EP LAB        3801520 0 R V RECORDING                     PROCED     5,676.04                    93603
EP LAB        3801501 0 VENT TACH MAPPING                 PROCED     5,676.04                    93609
EP LAB        3801518 0 INTRA-ATRIAL PACING               PROCED     5,676.04                    93610
EP LAB        3801521 0 R V PACING                        PROCED     5,676.04                    93612
EP LAB        3821525 0 INTRACARDIAC MAPPING              PROCED     4,577.26                    93613
EP LAB        3801581 0 INDUCTION OF ARRHYTHMIA           PROCED     5,676.04                    93618
EP LAB        3801600 0 EP STUDY W/O INDUCTION            PROCED     4,624.48                    93619
EP LAB        3801507 0 EP STUDY-COMPREHENSIVE            PROCED     4,624.48                    93620
EP LAB        3822002 0 EP STUDY COMP TERMINATED          PROCED     4,624.48                    9362073
EP LAB        3801513 0 EP STUDY-W/LA RECORDINGS          PROCED     4,624.48                    93621
EP LAB        3801585 0 LV RECORDING                      PROCED     4,624.48                    93622
EP LAB        3801514 0 PROG. STIM & PCNG AFTER IV DRU    PROCED     4,577.26                    93623
EP LAB        3801526 0 EP STUDY-FOLLOW UP                PROCED     5,676.04                    93624
EP LAB        3801601 0 EP EVALUATION OF ICD              PROCED     5,000.00                    93640
EP LAB        3801500 0 EP EVAL DEFIB PG/LEADS            PROCED     5,000.00                    93641
EP LAB        3801523 0 EP EVAL OF ICD (NIPS)             PROCED     5,000.00                    93642
EP LAB        3801508 0 CATHETER ABLATION-AVJ             PROCED     7,868.12                    93650
EP LAB        3801603 0 SVT ABLATION                      PROCED     7,868.12                    93651
EP LAB        3801531 0 CATHETER ABLATION-VT              PROCED     7,868.12                    93652
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3801506 0 TILT TABLE TEST                   PROCED     1,500.00                    93660
EP LAB        3822005 0 U/S INTERNAL CARDIAC              PROCED     3,352.00                    93662
EP LAB        3811605 0 ANALYSIS LOOP RECORDER            PROCED     146.00                      93727
EP LAB        3811530 0 ANALYSIS PPM DCM W/O REPROGRAM    PROCED     180.00                      93731
EP LAB        3811531 0 ANALYSIS PPM DCM W/REPROGRAM      PROCED     260.00                      93732
EP LAB        3811571 0 TRANSTEL PPM ANALYSIS DCM         PROCED     120.00                      93733
EP LAB        3811529 0 ANALYSIS PPM-SCM W/O REPROGRAM    PROCED     150.00                      93734
EP LAB        3811532 0 ANALYSIS PPM SCM W/REPROGRAM      PROCED     220.00                      93735
EP LAB        3811570 0 TRANSTEL PPM ANALYSIS SCM         PROCED     120.00                      93736
EP LAB        3811610 0 ANALYSIS DEFIB SCM W/O REPRGRM    PROCED     200.00                      93741
EP LAB        3811615 0 ANALYSIS DEFIB SCM W/REPROGRM     PROCED     260.00                      93742
EP LAB        3811620 0 ANALYSIS DEFIB DCM W/O REPRGRM    PROCED     220.00                      93743
EP LAB        3811625 0 ANALYSIS DEFIB DCM W/REPROGRAM    PROCED     300.00                      93744
EP LAB        3801589 0 WOUND EVALUATION                  PROCED     15.00                       99211
EP LAB        3821101 0 DEFIB VITALITY DS DR T125         SUPPLY     36,312.50                   C1721
EP LAB        3821245 0 DEFIB VENTAK PRIZM HE DR 1853     SUPPLY     44,800.00                   C1721
EP LAB        3821280 0 DEFIB V-235 EPIC DR               SUPPLY     36,750.00                   C1721
EP LAB        3821281 0 DEFIB V-236 EPIC + DR             SUPPLY     40,250.00                   C1721
EP LAB        3821285 0 DEFIB V-240 ATLAS DR SPLIT FLEX   SUPPLY     36,750.00                   C1721
EP LAB        3821402 0 DEFIB VIRTUOSO DR                 SUPPLY     43,400.00                   C1721
EP LAB        3821552 0 DEFIB VITALITY HE                 SUPPLY     31,979.50                   C1721
EP LAB        3821750 0 DEFIB VENTAK PRIZM DR II          SUPPLY     40,105.60                   C1721
EP LAB        3821753 0 DEFIB MARQUIS DR                  SUPPLY     39,375.00                   C1721
EP LAB        3821770 0 DEFIB MAXIMO DR DUAL CHM 7278     SUPPLY     35,612.50                   C1721
EP LAB        3821811 0 DEFIB VITALITY 2 DR T165          SUPPLY     39,217.50                   C1721
EP LAB        3821812 0 DEFIB VITALITY 2 DR EL T167       SUPPLY     41,580.00                   C1721
EP LAB        3821931 0 DEFIB LEXOS DR-T #349838          SUPPLY     30,625.00                   C1721
EP LAB        3821932 0 DEFIB LEXOS DR-T #347001          SUPPLY     29,750.00                   C1721
EP LAB        3821933 0 DEFIB LEXOS DR                    SUPPLY     27,125.00                   C1721
EP LAB        3821937 0 DEFIB BELOS DR-T HE               SUPPLY     30,625.00                   C1721
EP LAB        3822031 0 DEFIB INTRINSIC 7288              SUPPLY     39,462.50                   C1721
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3822049 0 DEFIB EPIC PLUS DR                  SUPPLY     31,500.00                   C1721
EP LAB        3822103 0 DEFIB LUMOS DR-T                    SUPPLY     32,375.00                   C1721
EP LAB        3822107 0 DEFIB ENTRUST DR                    SUPPLY     41,212.50                   C1721
EP LAB        3821003 0 DEFIB MARQUIS VR                    SUPPLY     33,075.00                   C1722
EP LAB        3821102 0 DEFIB VITALITY DS VR T135           SUPPLY     35,437.50                   C1722
EP LAB        3821246 0 DEFIB VENTAK PRIZM HE VR 1852       SUPPLY     33,687.50                   C1722
EP LAB        3821277 0 DEFIB V-196 EPIC                    SUPPLY     36,750.00                   C1722
EP LAB        3821278 0 DEFIB V-197EPIC VR                  SUPPLY     35,875.00                   C1722
EP LAB        3821279 0 DEFIB V-199 ATLAS VR                SUPPLY     35,000.00                   C1722
EP LAB        3821304 0 DEFIB V-194                         SUPPLY     33,250.00                   C1722
EP LAB        3821408 0 DEFIB VIRTUOSO SINGLE CHAMBER       SUPPLY     43,400.00                   C1722
EP LAB        3821764 0 DEFIB GEM III VR                    SUPPLY     32,550.00                   C1722
EP LAB        3821771 0 DEFIB MAXIMO VR SING CHM 7232CX     SUPPLY     33,705.00                   C1722
EP LAB        3821813 0 DEFIB VITALITY 2 VR T175            SUPPLY     36,277.50                   C1722
EP LAB        3821814 0 DEFIB VITALITY 2 VR EL T177         SUPPLY     38,640.00                   C1722
EP LAB        3821934 0 DEFIB LEXOS VR-T #349839            SUPPLY     27,125.00                   C1722
EP LAB        3821935 0 DEFIB LEXOS VR-T #346999            SUPPLY     26,250.00                   C1722
EP LAB        3821936 0 DEFIB LEXOS VR                      SUPPLY     21,875.00                   C1722
EP LAB        3822104 0 DEFIB LUMOS VR-T                    SUPPLY     25,375.00                   C1722
EP LAB        3822108 0 DEFIB ENTRUST VR                    SUPPLY     35,455.00                   C1722
EP LAB        3821536 0 CATH QUADRIPOLAR                    SUPPLY     420.30                      C1730
EP LAB        3821550 0 CATH QUAD 6 FR LARGE CURL           SUPPLY     967.50                      C1730
EP LAB        3821779 0 CATH OCTAPOLAR 6FR STEERABLE        SUPPLY     849.30                      C1730
EP LAB        3821780 0 CATH QUADRAPOLAR 6FR STEERABLE      SUPPLY     612.80                      C1730
EP LAB        3821781 0 CATH OCTAPOLAR 7FR STEERABLE        SUPPLY     849.30                      C1730
EP LAB        3821782 0 CATH QUADRAPOLAR 7FR STEERABLE DR   SUPPLY     612.80                      C1730
EP LAB        3821786 0 CATH QUADRAPOLAR 7FR STEERABLE DL   SUPPLY     958.90                      C1730
EP LAB        3821800 0 CATH LASSO 10 POLE 12MM             SUPPLY     2,042.50                    C1730
EP LAB        3821801 0 CATH LASSO 10 POLE 20MM             SUPPLY     2,042.50                    C1730
EP LAB        3821802 0 CATH LASSO 10 POLE 25MM             SUPPLY     2,042.50                    C1730
EP LAB        3821807 0 CATH EP-XT STEERABLE OCTAPOLAR      SUPPLY     849.30                      C1730
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821858 0 CATH RESPONSE CSL CATH 65CM                  SUPPLY     935.30                      C1730
EP LAB        3821859 0 CATH RESPONSE CSL CATH 120CM                 SUPPLY     935.30                      C1730
EP LAB        3822113 0 CATH LASSO 10 POLE 15 MM                     SUPPLY     2,042.50                    C1730
EP LAB        3821551 0 CATH DUO-DECA MD CURL                        SUPPLY     2,365.00                    C1731
EP LAB        3821784 0 CATH HALO FLAT CURVE                         SUPPLY     2,085.50                    C1731
EP LAB        3821785 0 CATH HALO FIXED CURVE                        SUPPLY     2,085.50                    C1731
EP LAB        3821666 0 CATH NAVISTAR THERM/COOL DIAG/ABLATN (IDE)   SUPPLY     3,750.00                    C1732
EP LAB        3821776 0 CATH NOGA STAR 2MM DL                        SUPPLY     3,870.00                    C1732
EP LAB        3821777 0 CATH NOGA STAR 2MM FL                        SUPPLY     3,870.00                    C1732
EP LAB        3821778 0 CATH NAVISTAR DS 8MM FL                      SUPPLY     3,655.00                    C1732
EP LAB        3821787 0 CATH NAVISTAR 4MM JL                         SUPPLY     3,870.00                    C1732
EP LAB        3821788 0 CATH NAVISTAR 4MM DL                         SUPPLY     3,870.00                    C1732
EP LAB        3821789 0 CATH NAVISTAR 4MM FL                         SUPPLY     3,870.00                    C1732
EP LAB        3821792 0 CATH NAVISTAR THERMACOOL D NS75TC DCT        SUPPLY     3,225.00                    C1732
EP LAB        3821793 0 CATH NAVISTAR THERMACOOL F NS75TC FCT        SUPPLY     3,225.00                    C1732
EP LAB        3821797 0 CATH NAVISTAR DS 8MM DL                      SUPPLY     3,655.00                    C1732
EP LAB        3821798 0 CATH NAVISTAR 4MM EL                         SUPPLY     3,870.00                    C1732
EP LAB        3822051 0 CATH NAVISTAR THERMACOOL D N175TCDH          SUPPLY     5,052.50                    C1732
EP LAB        3822052 0 CATH NAVISTAR THERMACOOL F N175TCFH          SUPPLY     5,052.50                    C1732
EP LAB        3822053 0 CATH NAVISTAR THERMACOOL J N175TCJH          SUPPLY     5,052.50                    C1732
EP LAB        3821664 0 CATH BLAZER II ABLATN XP, 6F, HI TORQ        SUPPLY     1,644.80                    C1733
EP LAB        3821393 0 CATH CRYOCATH FREEZOR 1 207F1                SUPPLY     3,225.00                    C1733
EP LAB        3821394 0 CATH CRYOCATH FREEZOR 3 207F3                SUPPLY     3,225.00                    C1733
EP LAB        3821395 0 CATH CRYOCATH FREEZOR 5 207F5                SUPPLY     3,225.00                    C1733
EP LAB        3821396 0 CATH CRYOCATH FREEZOR XTRA 1 227F1           SUPPLY     3,010.00                    C1733
EP LAB        3821397 0 CATH CRYOCATH FREEZOR XTRA 3 227F3           SUPPLY     3,010.00                    C1733
EP LAB        3821398 0 CATH CRYOCATH FREEZOR XTRA 5 227F5           SUPPLY     3,010.00                    C1733
EP LAB        3821399 0 CATH CRYOCATH FREEZOR MAX 3 117888           SUPPLY     4,300.00                    C1733
EP LAB        3821400 0 CATH CRYOCATH FREEZOR MAX 5 117888           SUPPLY     4,300.00                    C1733
EP LAB        3821608 0 CATH BLAZER II HT RFA CATH                   SUPPLY     1,738.40                    C1733
EP LAB        3821772 0 CATH BLAZER II XP STD 8MM CATH               SUPPLY     2,784.30                    C1733
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821773 0 CATH BLAZER II XP LG 8MM CATH               SUPPLY     2,784.30                    C1733
EP LAB        3821774 0 CATH BLAZER II XP STD 10MM CATH             SUPPLY     2,999.30                    C1733
EP LAB        3821775 0 CATH BLAZER II XP LG 10MM CATH              SUPPLY     2,999.30                    C1733
EP LAB        3821790 0 CATH CELSIUS 4MM DL                         SUPPLY     1,236.30                    C1733
EP LAB        3821791 0 CATH CELSIUS 7FR EG                         SUPPLY     1,236.30                    C1733
EP LAB        3821794 0 CATH CELSIUS 4MM DG                         SUPPLY     1,236.30                    C1733
EP LAB        3821795 0 CATH CELSIUS 4MM EL                         SUPPLY     1,236.30                    C1733
EP LAB        3821796 0 CATH CELSIUS 4MM FL                         SUPPLY     1,236.30                    C1733
EP LAB        3822114 0 CATH E CURVE ABLATION                       SUPPLY     971.80                      C1733
EP LAB        3822115 0 CATH CELSIUS DS 8MM D                       SUPPLY     1,935.00                    C1733
EP LAB        3822116 0 CATH CELSIUS DS 8MM F                       SUPPLY     1,935.00                    C1733
EP LAB        3821549 0 CATH ACUNAV 8 FR                            SUPPLY     4,837.50                    C1759
EP LAB        3821620 0 REVEAL PLUS LOOP RECORDER                   SUPPLY     7,515.00                    C1764
EP LAB        3821346 0 GUIDEWIRE HI-TORQUE BALANCE EXTRA SPORT     SUPPLY     301.00                      C1769
EP LAB        3821347 0 GUIDEWIRE HI-TORQUE BALANCE HEAVYWEIGHT     SUPPLY     301.00                      C1769
EP LAB        3821348 0 GUIDEWIRE HI-TORQUE BALANCE IRON MAN        SUPPLY     301.00                      C1769
EP LAB        3821349 0 GUIDEWIRE HI-TORQUE BALANCE MIDWEIGHT       SUPPLY     301.00                      C1769
EP LAB        3821350 0 GUIDEWIRE HI-TORQUE BALANCE TREK            SUPPLY     301.00                      C1769
EP LAB        3821351 0 GUIDEWIRE HI-TORQUE WHISPER DS              SUPPLY     301.00                      C1769
EP LAB        3821352 0 GUIDEWIRE HI-TORQUE WHISPER DS CS-J         SUPPLY     301.00                      C1769
EP LAB        3821353 0 GUIDEWIRE HI-TORQUE WHISPER EDS             SUPPLY     301.00                      C1769
EP LAB        3821354 0 GUIDEWIRE HI-TORQUE WHISPER EDS CS-J        SUPPLY     301.00                      C1769
EP LAB        3821355 0 GUIDEWIRE HI-TORQUE WHISPER ES              SUPPLY     301.00                      C1769
EP LAB        3821356 0 GUIDEWIRE HI-TORQUE WHISPER ES CS-J         SUPPLY     301.00                      C1769
EP LAB        3821357 0 GUIDEWIRE HI-TORQUE WHISPER LS              SUPPLY     301.00                      C1769
EP LAB        3821358 0 GUIDEWIRE HI-TORQUE WHISPER MS              SUPPLY     301.00                      C1769
EP LAB        3821359 0 GUIDEWIRE HI-TORQUE WHISPER MS CS-J         SUPPLY     301.00                      C1769
EP LAB        3821409 0 GUIDEWIRE ZINGER LIGHT SUPPORT STRAIT TIP   SUPPLY     311.80                      C1769
EP LAB        3821410 0 GUIDEWIRE ZINGER LIGHT SUPPORT J-TIP        SUPPLY     311.80                      C1769
EP LAB        3821411 0 GUIDEWIRE ZINGER MED SUPPORT STRAIT TIP     SUPPLY     311.80                      C1769
EP LAB        3821412 0 GUIDEWIRE ZINGER MED SUPPORT J-TIP          SUPPLY     311.80                      C1769
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821413 0 GUIDEWIRE ZINGER X-SUPPORT STRAIT TIP       SUPPLY     311.80                      C1769
EP LAB        3821414 0 GUIDEWIRE ZINGER X-SUPPORT J-TIP            SUPPLY     311.80                      C1769
EP LAB        3821415 0 GUIDEWIRE THUNDER MED SUPPORT STRAIT TIP    SUPPLY     311.80                      C1769
EP LAB        3821416 0 GUIDEWIRE COUGAR LIGHT SUPPORT STRAIT TIP   SUPPLY     311.80                      C1769
EP LAB        3821417 0 GUIDEWIRE COUGAR LIGHT SUPPORT J-TIP        SUPPLY     311.80                      C1769
EP LAB        3821418 0 GUIDEWIRE COUGAR X-SUPPORT STRAIT TIP       SUPPLY     311.80                      C1769
EP LAB        3821419 0 GUIDEWIRE COUGAR X-SUPPORT J-TIP            SUPPLY     311.80                      C1769
EP LAB        3821502 0 GUIDEWIRE TRANSEPTAL                        SUPPLY     250.00                      C1769
EP LAB        3821503 0 GUIDEWIRE WHOLLY                            SUPPLY     215.00                      C1769
EP LAB        3821504 0 GUIDEWIRE GENERAL                           SUPPLY     150.00                      C1769
EP LAB        3821891 0 GUIDEWIRE FLOPPY LIGHT 185                  SUPPLY     161.30                      C1769
EP LAB        3821892 0 GUIDEWIRE FLOPPY LIGHT 300                  SUPPLY     161.30                      C1769
EP LAB        3821893 0 GUIDEWIRE FLOPPY LIGHT "J" TIP 185          SUPPLY     161.30                      C1769
EP LAB        3821894 0 GUIDEWIRE FLOPPY LIGHT "J" TIP 300          SUPPLY     161.30                      C1769
EP LAB        3821895 0 GUIDEWIRE FLOPPY STANDARD 185               SUPPLY     161.30                      C1769
EP LAB        3821896 0 GUIDEWIRE FLOPPY STANDARD 300               SUPPLY     161.30                      C1769
EP LAB        3821897 0 GUIDEWIRE FLOPPY STANDARD W/J TIP 185       SUPPLY     161.30                      C1769
EP LAB        3821898 0 GUIDEWIRE FLOPPY STANDARD "J" TIP 300       SUPPLY     161.30                      C1769
EP LAB        3821899 0 GUIDEWIRE FLOPPY FIRM 185                   SUPPLY     161.30                      C1769
EP LAB        3821900 0 GUIDEWIRE FLOPPY FIRM 300                   SUPPLY     161.30                      C1769
EP LAB        3821910 0 GUIDEWIRE 0.032 J TIP                       SUPPLY     53.30                       C1769
EP LAB        3821260 0 LEAD 1582/60 RIATA                          SUPPLY     10,491.30                   C1777
EP LAB        3821261 0 LEAD 1582/65 RIATA                          SUPPLY     10,491.30                   C1777
EP LAB        3821315 0 LEAD ENDOTAK RELIANCE SG MODEL 170          SUPPLY     11,375.00                   C1777
EP LAB        3821384 0 LEAD ENDOTAK RELIANCE SG 59CM #180          SUPPLY     11,375.00                   C1777
EP LAB        3821385 0 LEAD ENDOTAK RELIANCE SG 64CM #181          SUPPLY     11,375.00                   C1777
EP LAB        3821909 0 LEAD SPRINT SINGLE COIL                     SUPPLY     12,250.00                   C1777
EP LAB        3821940 0 LEAD KENTROX 65 ACTIVE STER                 SUPPLY     8,170.00                    C1777
EP LAB        3821947 0 LEAD KENTROX 65 PASSV STER                  SUPPLY     8,170.00                    C1777
EP LAB        3821948 0 LEAD KENTROX 75 PASSV STER                  SUPPLY     8,170.00                    C1777
EP LAB        3821010 0 PACEMAKER INSIGNIA ENTRA DR                 SUPPLY     11,891.25                   C1785
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821137 0 PACEMAKER INSIGNIA ENTRA DDDR 1295     SUPPLY     11,891.30                   C1785
EP LAB        3821138 0 PACEMAKER INSIGNIA ENTRA DDDR 1296     SUPPLY     11,891.30                   C1785
EP LAB        3821141 0 PACEMAKER INSIGNIA PLUS DDDR 1297      SUPPLY     11,812.50                   C1785
EP LAB        3821272 0 PACEMAKER 5380 IDENTITY ADX DR         SUPPLY     11,191.30                   C1785
EP LAB        3821273 0 PACEMAKER 5386 IDENTITY ADX XL DR      SUPPLY     11,191.30                   C1785
EP LAB        3821284 0 PACEMAKER 5376 IDENTITY XL DR          SUPPLY     10,491.30                   C1785
EP LAB        3821324 0 PACEMAKER ENPULSE DR MODEL E1DR01      SUPPLY     11,593.80                   C1785
EP LAB        3821326 0 PACEMAKER ENPULSE DR MODEL E1SR21      SUPPLY     11,593.80                   C1785
EP LAB        3821378 0 PACEMAKER ADAPTA DR                    SUPPLY     12,425.00                   C1785
EP LAB        3821379 0 PACEMAKER VERSA DR                     SUPPLY     10,850.00                   C1785
EP LAB        3821403 0 PACEMAKER SENSIA DR                    SUPPLY     10,150.00                   C1785
EP LAB        3821611 0 PACEMAKER SIGMA 300 DR                 SUPPLY     11,750.00                   C1785
EP LAB        3821624 0 PACEMAKER PULSAR MAX DR                SUPPLY     13,900.00                   C1785
EP LAB        3821700 0 PACEMAKER KAPPA 400 DR                 SUPPLY     14,750.00                   C1785
EP LAB        3821755 0 PACEMAKER KAPPA 900 DR                 SUPPLY     11,366.25                   C1785
EP LAB        3821808 0 PACEMAKER INSIGNIA ULTRA DR 1290       SUPPLY     11,978.80                   C1785
EP LAB        3821809 0 PACEMAKER INSIGNIA ULTRA DR 1291       SUPPLY     11,978.80                   C1785
EP LAB        3821816 0 PACEMAKER 2 CHM ENPULSE IS-1 E1DR01    SUPPLY     11,593.80                   C1785
EP LAB        3821817 0 PACEMAKER 2 CHM ENPULSE IS-1 EIDR21    SUPPLY     11,593.80                   C1785
EP LAB        3821818 0 PACEMAKER 2 CHM ENPULSE 3.2MM EIDR03   SUPPLY     11,593.80                   C1785
EP LAB        3821819 0 PACEMAKER 2 CHM ENPULSE 5/6MM E1DR06   SUPPLY     11,593.80                   C1785
EP LAB        3821820 0 PACEMAKER 2 CHM ENPULSE IS-1 E2DR01    SUPPLY     11,593.80                   C1785
EP LAB        3821821 0 PACEMAKER 2 CHM ENPULSE IS-1 E2DR21    SUPPLY     11,593.80                   C1785
EP LAB        3821822 0 PACEMAKER 2 CHM ENPULSE 3.2MM E2DR03   SUPPLY     11,593.80                   C1785
EP LAB        3821823 0 PACEMAKER 2 CHM ENPULSE 5/6MM E2DR06   SUPPLY     11,593.80                   C1785
EP LAB        3821911 0 PACEMAKER PHILOS II DR-T               SUPPLY     10,150.00                   C1785
EP LAB        3821912 0 PACEMAKER PHILOS II DR                 SUPPLY     9,275.00                    C1785
EP LAB        3822010 0 PACEMAKER INSIGNIA PLUS DR             SUPPLY     13,116.25                   C1785
EP LAB        3822044 0 PACEMAKER ENRHYTHM                     SUPPLY     12,766.30                   C1785
EP LAB        3822125 0 PACEMAKER CYLOS DR                     SUPPLY     9,275.00                    C1785
EP LAB        3822126 0 PACEMAKER CYLOS DR-T                   SUPPLY     11,025.00                   C1785
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821009 0 PACEMAKER INSIGNIA ENTRA SR              SUPPLY     10,937.50                   C1786
EP LAB        3821011 0 PACEMAKER 5172 IDENTITY SR               SUPPLY     9,966.30                    C1786
EP LAB        3821139 0 PACEMAKER INSIGNIA ENTRA SSIR 1195       SUPPLY     11,016.30                   C1786
EP LAB        3821140 0 PACEMAKER INSIGNIA ENTRA SSIR 1198       SUPPLY     11,016.30                   C1786
EP LAB        3821268 0 PACEMAKER 5157 M/S VERITY ADX            SUPPLY     9,616.30                    C1786
EP LAB        3821325 0 PACEMAKER ENPULSE SR MODEL E2SR01        SUPPLY     9,528.80                    C1786
EP LAB        3821404 0 PACEMAKER ADAPTA SR                      SUPPLY     8,925.00                    C1786
EP LAB        3821405 0 PACEMAKER SENSIA SR                      SUPPLY     10,320.00                   C1786
EP LAB        3821737 0 PACEMAKER SIGMA 200 SR                   SUPPLY     9,500.00                    C1786
EP LAB        3821740 0 PACEMAKER INTEGRITY SR 5142              SUPPLY     10,613.00                   C1786
EP LAB        3821756 0 PACEMAKER KAPPA 900 SR                   SUPPLY     9,616.25                    C1786
EP LAB        3821810 0 PACEMAKER INSIGNIA ULTRA SR 1190         SUPPLY     11,200.00                   C1786
EP LAB        3821824 0 PACEMAKER SNG CHM ENPULSE IS-1 E1SR01    SUPPLY     9,528.80                    C1786
EP LAB        3821825 0 PACEMAKER SNG CHM ENPULSE 3.2MM E1SR03   SUPPLY     9,528.80                    C1786
EP LAB        3821826 0 PACEMAKER SNG CHM ENPULSE 5/6MM E1SR06   SUPPLY     9,528.80                    C1786
EP LAB        3821827 0 PACEMAKER SNG CHM ENPULSE IS-1 E2SR01    SUPPLY     9,528.80                    C1786
EP LAB        3821828 0 PACEMAKER SNG CHM ENPULSE 3.2MM E2SR03   SUPPLY     9,528.80                    C1786
EP LAB        3821829 0 PACEMAKER SNG CHM ENPULSE 5/6MM E2SR06   SUPPLY     9,528.80                    C1786
EP LAB        3821913 0 PACEMAKER PROTOS DR                      SUPPLY     10,150.00                   C1786
EP LAB        3821914 0 PACEMAKER PHILOS II SR                   SUPPLY     9,890.00                    C1786
EP LAB        3822105 0 PACEMAKER PROTOS VR                      SUPPLY     10,212.50                   C1786
EP LAB        3822124 0 PACEMAKER CYLOS VR                       SUPPLY     8,750.00                    C1786
EP LAB        3821014 0 DEFIB CONTAK RENEWAL 3 H170              SUPPLY     45,762.50                   C1882
EP LAB        3821015 0 DEFIB CONTAK RENEWAL 3 HE H177           SUPPLY     46,637.50                   C1882
EP LAB        3821019 0 DEFIB CONTAK RENEWAL 3 HE H179           SUPPLY     46,637.50                   C1882
EP LAB        3821020 0 DEFIB CONTAK RENEWAL 3 H175              SUPPLY     45,762.50                   C1882
EP LAB        3821021 0 DEFIB INSYNC MARQUIS 2                   SUPPLY     44,187.50                   C1882
EP LAB        3821401 0 DEFIB CONCERTO                           SUPPLY     51,450.00                   C1882
EP LAB        3821834 0 DEFIB INSYNC MAXIMO 7303                 SUPPLY     45,587.50                   C1882
EP LAB        3821905 0 DEFIB EPIC HF V-338                      SUPPLY     41,125.00                   C1882
EP LAB        3821906 0 DEFIB ATLAS PLUS HF V-340                SUPPLY     42,000.00                   C1882
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821907 0 DEFIB INSYNC SENTRY 7297                 SUPPLY     50,837.50                   C1882
EP LAB        3822111 0 DEFIB RENEWAL 3HE RF                     SUPPLY     45,850.00                   C1882
EP LAB        3822112 0 DEFIB RENEWAL 3 RF                       SUPPLY     44,712.50                   C1882
EP LAB        3822136 0 DEFIB KRONOS LV-T CRT                    SUPPLY     38,500.00                   C1882
EP LAB        3821077 0 CATH MB2 GUIDE CATHETER FOR LEFT-HE      SUPPLY     430.00                      C1887
EP LAB        3821078 0 CATH MULTI-PURPOSE GUIDE CATHETER F      SUPPLY     430.00                      C1887
EP LAB        3821157 0 CATH RAPIDO GUIDING CATH 6775            SUPPLY     268.80                      C1887
EP LAB        3821158 0 CATH RAPIDO GUIDING CATH 6776            SUPPLY     268.80                      C1887
EP LAB        3821159 0 CATH RAPIDO GUIDING CATH 6777            SUPPLY     268.80                      C1887
EP LAB        3821160 0 CATH RAPIDO GUIDING CATH 6779            SUPPLY     268.80                      C1887
EP LAB        3821327 0 CATH ATTAIN PREVAIL                      SUPPLY     752.50                      C1887
EP LAB        3821340 0 CATH EASYTRAK GUIDE CS-W                 SUPPLY     268.80                      C1887
EP LAB        3821360 0 CATH RAPIDO CE-EH                        SUPPLY     268.80                      C1887
EP LAB        3821361 0 CATH RAPIDO CS- EH CAT# 6778             SUPPLY     268.80                      C1887
EP LAB        3821362 0 CATH RAPIDO CS- EH CAT# 7551             SUPPLY     268.80                      C1887
EP LAB        3821363 0 CATH RAPIDO CS- EH R CAT# 7592           SUPPLY     268.80                      C1887
EP LAB        3821364 0 CATH RAPIDO CS-EH R CAT# 7519            SUPPLY     268.80                      C1887
EP LAB        3821365 0 CATH RAPIDO CS-EH R CAT# 7563            SUPPLY     268.80                      C1887
EP LAB        3821366 0 CATH RAPIDO CS-EH ST R CAT# 7521         SUPPLY     268.80                      C1887
EP LAB        3821367 0 CATH RAPIDO CS-EH ST R CAT# 7564         SUPPLY     268.80                      C1887
EP LAB        3821368 0 CATH RAPIDO CS-EH ST R CAT# 7593         SUPPLY     268.80                      C1887
EP LAB        3821369 0 CATH RAPIDO CS-H CAT# 7556               SUPPLY     268.80                      C1887
EP LAB        3821370 0 CATH RAPIDO CS-H CAT# 7557               SUPPLY     268.80                      C1887
EP LAB        3821371 0 CATH RAPIDO CS-IC 50C                    SUPPLY     268.80                      C1887
EP LAB        3821372 0 CATH RAPIDO CS-MP CAT# 7554              SUPPLY     268.80                      C1887
EP LAB        3821373 0 CATH RAPIDO CS-MP CAT# 7555              SUPPLY     268.80                      C1887
EP LAB        3821374 0 CATH RAPIDO CS-MPH CAT# 7558             SUPPLY     268.80                      C1887
EP LAB        3821375 0 CATH RAPIDO CS-MPH CAT# 7559             SUPPLY     268.80                      C1887
EP LAB        3821376 0 CATH RAPIDO CS-W CAT# 7516               SUPPLY     268.80                      C1887
EP LAB        3821377 0 CATH RAPIDO CS-W CAT# 7560               SUPPLY     268.80                      C1887
EP LAB        3821406 0 CATH GUIDE ATTAIN SELECT II 130 DEGREE   SUPPLY     430.00                      C1887
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821407 0 CATH GUIDE ATTAIN SELECT II 90 DEGREE        SUPPLY     430.00                      C1887
EP LAB        3821636 0 CATH ATTAIN LEAD DELIVERY SYS                SUPPLY     1,290.00                    C1887
EP LAB        3821875 0 CATH SEAL-AWAY CS INTRO KIT 45 X 115         SUPPLY     967.50                      C1887
EP LAB        3821876 0 CATH SEAL-AWAY CS INTRO KIT 45 X 60          SUPPLY     967.50                      C1887
EP LAB        3821877 0 CATH SEAL-AWAY CS INT KIT 45CM STR           SUPPLY     967.50                      C1887
EP LAB        3822020 0 CATH CS-EH 7711                              SUPPLY     268.80                      C1887
EP LAB        3822023 0 CATH CS-EH 7712                              SUPPLY     268.80                      C1887
EP LAB        3822026 0 CATH CS-EH 7713                              SUPPLY     268.80                      C1887
EP LAB        3822028 0 CATH CS-EH ST R 7719                         SUPPLY     268.80                      C1887
EP LAB        3822120 0 CATH SELECT SITE STEERABLE CATH              SUPPLY     1,075.00                    C1887
EP LAB        3822123 0 CATH ATTAIN SELECT TELE CATH                 SUPPLY     408.50                      C1887
EP LAB        3822128 0 RAPIDO CUT-AWAY CUTTER                       SUPPLY     62.50                       C1887
EP LAB        3822129 0 RAPIDO BLEEDBACK CONTROL VALVE               SUPPLY     125.00                      C1887
EP LAB        3821008 0 SHEATH WORLEY SHEATH                         SUPPLY     629.95                      C1892
EP LAB        3821081 0 INTRODUCER SAFESHTH LEAD INTRODC HLS1007M    SUPPLY     162.50                      C1892
EP LAB        3821082 0 INTRODUCER SAFESHTH LEAD INTRODC HLS 1009M   SUPPLY     162.50                      C1892
EP LAB        3821083 0 INTRODUCER SAFSHTH LEAD INTRODC HLS10105M    SUPPLY     162.50                      C1892
EP LAB        3821084 0 INTRODUCER SAFESHEATH LEAD INTRODUCER,9FR    SUPPLY     162.50                      C1892
EP LAB        3821568 0 INTRODUCER PEEL AWAY                         SUPPLY     82.50
EP LAB        3821844 0 INTRODUCER SAFE SHEATH INTRODUCER VALVE 09MM SUPPLY     137.50                      C1892
EP LAB        3821845 0 INTRODUCER SAFE SHEATH INTRODUCR VALV EXTEND SUPPLY     150.00                      C1892
EP LAB        3821873 0 SHEATH 12FR 405152                           SUPPLY     100.00                      C1892
EP LAB        3821545 0 INTRODUCER LONG SHEATH                       SUPPLY     354.30                      C1893
EP LAB        3822062 0 SHEATH SL-1 8.5 FR 406849                    SUPPLY     387.00                      C1893
EP LAB        3822109 0 INTRODUCER / SHEATH RAMP 406898              SUPPLY     387.00                      C1893
EP LAB        3822110 0 INTRODUCER / SHEATH SAFL 406871              SUPPLY     397.80                      C1893
EP LAB        3822117 0 CATH INTRODUCER FAST CATH 7 FR               SUPPLY     45.00                       C1894
EP LAB        3822118 0 CATH INTRODUCER FAST CATH 8 FR               SUPPLY     45.00                       C1894
EP LAB        3821072 0 LEAD QUADRIPOLAR,RV/SVC,65CM,U               SUPPLY     11,200.00                   C1895
EP LAB        3821249 0 LEAD 1055K/75 LV UNIPOLAR IDE                SUPPLY     6,009.30                    C1895
EP LAB        3821256 0 LEAD 1570/65 RIATA                           SUPPLY     10,491.30                   C1895
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821258 0 LEAD 1580/65 RIATA                   SUPPLY     10,491.30                   C1895
EP LAB        3821259 0 LEAD 1581/65 RIATA                   SUPPLY     10,491.30                   C1895
EP LAB        3821309 0 LEAD ENDOTAK RELIANCE 59 CM          SUPPLY     10,500.00                   C1895
EP LAB        3821311 0 LEAD ENDOTAK RELIANCE G MODEL 174    SUPPLY     11,375.00                   C1895
EP LAB        3821312 0 LEAD ENDOTAK RELIANCE G MODEL 175    SUPPLY     11,375.00                   C1895
EP LAB        3821313 0 LEAD ENDOTAK RELIANCE G MODEL 176    SUPPLY     11,375.00                   C1895
EP LAB        3821314 0 LEAD ENDOTAK RELIANCE G MODEL 177    SUPPLY     11,375.00                   C1895
EP LAB        3821320 0 LEAD ENDOTAK RELIANCE MODEL 145      SUPPLY     10,500.00                   C1895
EP LAB        3821386 0 LEAD ENDOTAK RELIANCE G 59CM #184    SUPPLY     11,375.00                   C1895
EP LAB        3821387 0 LEAD ENDOTAK RELIANCE G 64CM # 185   SUPPLY     11,375.00                   C1895
EP LAB        3821390 0 LEAD SPRINT FIDELIS 58CM             SUPPLY     12,241.30                   C1895
EP LAB        3821391 0 LEAD SPRINT FIDELIS 65CM             SUPPLY     12,241.30                   C1895
EP LAB        3821392 0 LEAD SPRINT FIDELIS 75CM             SUPPLY     12,241.30                   C1895
EP LAB        3821908 0 LEAD SPRINT QUATTRO TINED            SUPPLY     12,250.00                   C1895
EP LAB        3821938 0 LEAD KENTROX 65/16 ACTV STER         SUPPLY     8,170.00                    C1895
EP LAB        3821939 0 LEAD KENTROX 65/18 ACTV STER         SUPPLY     8,170.00                    C1895
EP LAB        3821941 0 LEAD KENTROX 65/16 PASSV STER        SUPPLY     8,170.00                    C1895
EP LAB        3821942 0 LEAD KENTROX 65/18 PASSV STER        SUPPLY     8,170.00                    C1895
EP LAB        3821943 0 LEAD KENTROX 75/16 PASSV STER        SUPPLY     8,170.00                    C1895
EP LAB        3821944 0 LEAD KENTROX 75/18 PASSV STER        SUPPLY     8,170.00                    C1895
EP LAB        3821945 0 LEAD KENTROX 100/16 PASSV STER       SUPPLY     8,170.00                    C1895
EP LAB        3821946 0 LEAD KENTROX 100/18 PASSV STER       SUPPLY     8,170.00                    C1895
EP LAB        3821949 0 LEAD KENTROX 65/16 PASSIVE           SUPPLY     8,170.00                    C1895
EP LAB        3821950 0 LEAD KENTROX 65/18 PASSIVE           SUPPLY     8,170.00                    C1895
EP LAB        3822127 0 LEAD LINOX SD                        SUPPLY     9,245.00                    C1895
EP LAB        3821067 0 LEAD-DEFIB SUBQ 41CM U               SUPPLY     5,375.00                    C1896
EP LAB        3821118 0 LEAD ENDOTAK SQ ARRAY 0049           SUPPLY     5,375.00                    C1896
EP LAB        3821119 0 LEAD ENDOTAK SQ ARRAY 0048           SUPPLY     5,375.00                    C1896
EP LAB        3821644 0 LEAD TENDRIL 1488TC-46               SUPPLY     1,773.80                    C1898
EP LAB        3821628 0 LEAD SELUTE PICOTIP MODEL 4034       SUPPLY     1,881.30                    C1898
EP LAB        3801593 0 LEAD CAPSURE FIX NOVUS 5076 (110)    SUPPLY     2,580.00                    C1898
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821040 0 LEAD CAPSR FX BI SCR-IN 556845         SUPPLY     1,397.50                    C1898
EP LAB        3821099 0 LEAD 5076 CAPSRE FX NOVUS 52CM         SUPPLY     1,720.00                    C1898
EP LAB        3821100 0 LEAD 5076 CAPSRE FX NOVUS 58CM         SUPPLY     1,720.00                    C1898
EP LAB        3821133 0 LEAD FINELINE II STEROX 4456           SUPPLY     1,763.00                    C1898
EP LAB        3821134 0 LEAD FINELINE II STEROX 4458           SUPPLY     1,763.00                    C1898
EP LAB        3821136 0 LEAD FLEXTEND MODEL 4086               SUPPLY     1,720.00                    C1898
EP LAB        3821170 0 LEAD SELUTE PICOTIP MODEL 4035         SUPPLY     1,720.00                    C1898
EP LAB        3821253 0 LEAD 1388K/46 TENDRL DX                SUPPLY     1,773.80                    C1898
EP LAB        3821254 0 LEAD 1488T/40 TENDRIL SDX              SUPPLY     1,773.80                    C1898
EP LAB        3821255 0 LEAD 1488TC/58 TENDRIL                 SUPPLY     1,773.80                    C1898
EP LAB        3821282 0 LEAD 1488TC / 52 TENDRIL               SUPPLY     1,773.80                    C1898
EP LAB        3821288 0 LEAD CAPSURE Z NOVUS 5054-52           SUPPLY     1,709.30                    C1898
EP LAB        3821292 0 LEAD 6216                              SUPPLY     1,290.00                    C1898
EP LAB        3821330 0 LEAD FLEXTEND MODEL 4088               SUPPLY     1,720.00                    C1898
EP LAB        3821333 0 LEAD FINELINE II STEROX 4470           SUPPLY     1,773.80                    C1898
EP LAB        3821759 0 LEAD 5076 CAPSRE FX NOVUS 45CM         SUPPLY     1,720.00                    C1898
EP LAB        3821835 0 LEAD BI STEROID TRANSVEN IS-1 ATRIUM   SUPPLY     1,505.00                    C1898
EP LAB        3821837 0 LEAD TRANSVEN CS/SVC COIL              SUPPLY     2,580.00                    C1898
EP LAB        3821916 0 LEAD SELOX ST 53 PASSV STER            SUPPLY     1,505.00                    C1898
EP LAB        3821917 0 LEAD SELOX ST-60 PASSV STER            SUPPLY     1,505.00                    C1898
EP LAB        3821918 0 LEAD SELOX JT 45 PASSV STER            SUPPLY     1,505.00                    C1898
EP LAB        3821919 0 LEAD SELOX JT 53 PASSV STER            SUPPLY     1,505.00                    C1898
EP LAB        3821920 0 LEAD SELOX SR 45 ACTV STER             SUPPLY     1,505.00                    C1898
EP LAB        3821921 0 LEAD SELOX SR 53 ACTV STER             SUPPLY     1,505.00                    C1898
EP LAB        3821922 0 LEAD SELOX SR 60 ACTV STER             SUPPLY     1,505.00                    C1898
EP LAB        3821923 0 LEAD AROX 53 PASSIVE 338023            SUPPLY     1,505.00                    C1898
EP LAB        3821924 0 LEAD AROX 60 PASSIVE                   SUPPLY     1,505.00                    C1898
EP LAB        3821925 0 LEAD AROX 45 PASSIVE                   SUPPLY     1,505.00                    C1898
EP LAB        3821926 0 LEAD AROX 53 PASSIVE 338025            SUPPLY     1,505.00                    C1898
EP LAB        3821927 0 LEAD SYNOX 53/15 PASSIVE               SUPPLY     1,505.00                    C1898
EP LAB        3821928 0 LEAD SYNOX 60/15 PASSIVE               SUPPLY     1,505.00                    C1898
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821929 0 LEAD SYNOX 45 PASSIVE            SUPPLY     1,505.00                    C1898
EP LAB        3821930 0 LEAD SYNOX 53 PASSIVE            SUPPLY     1,505.00                    C1898
EP LAB        3822006 0 LEAD FLEXTEND MODEL 4087         SUPPLY     1,720.00                    C1898
EP LAB        3822046 0 LEAD TENDRIL 1688-46             SUPPLY     1,505.00                    C1898
EP LAB        3822047 0 LEAD TENDRIL 1688-52             SUPPLY     1,505.00                    C1898
EP LAB        3822048 0 LEAD TENDRIL 1688-58             SUPPLY     1,505.00                    C1898
EP LAB        3822119 0 LEAD SELECT SECUREPACING         SUPPLY     1,720.00                    C1898
EP LAB        3822133 0 LEAD SETROX S 45 CM              SUPPLY     1,505.00                    C1898
EP LAB        3822134 0 LEAD SETROX S 53 CM              SUPPLY     1,505.00                    C1898
EP LAB        3822135 0 LEAD SETROX S 60 CM              SUPPLY     1,505.00                    C1898
EP LAB        3801594 0 LEAD ATTAIN OVER WIRE 4193-78    SUPPLY     4,246.25                    C1900
EP LAB        3821069 0 LEAD PACE,PU,UNI,4FR,LV,STEROI   SUPPLY     4,138.80                    C1900
EP LAB        3821124 0 LEAD EZTRK 4513 CORONARY VEN     SUPPLY     8,600.00                    C1900
EP LAB        3821322 0 LEAD EASYTRACK MODEL 4537        SUPPLY     9,800.00                    C1900
EP LAB        3821323 0 LEAD EASYTRACK MODEL 4538        SUPPLY     9,800.00                    C1900
EP LAB        3821637 0 LEAD ATTAIN 2188                 SUPPLY     2,688.00                    C1900
EP LAB        3821638 0 LEAD ATTAIN 2187                 SUPPLY     3,225.00                    C1900
EP LAB        3821758 0 LEAD EZ TRACK                    SUPPLY     10,500.00                   C1900
EP LAB        3821854 0 LEAD ATTAIN 4194-78              SUPPLY     5,364.30                    C1900
EP LAB        3821855 0 LEAD ATTAIN 4194-88              SUPPLY     5,364.30                    C1900
EP LAB        3821888 0 LEAD QUICKSITE 72CM              SUPPLY     8,600.00                    C1900
EP LAB        3821889 0 LEAD QUICKSITE 86CM              SUPPLY     8,600.00                    C1900
EP LAB        3822011 0 LEAD EASYTRAK 3 80CM             SUPPLY     6,966.00                    C1900
EP LAB        3822012 0 LEAD EASYTRAK 3 90CM             SUPPLY     6,966.00                    C1900
EP LAB        3822013 0 LEAD EASYTRAK 3 100CM            SUPPLY     6,966.00                    C1900
EP LAB        3822014 0 LEAD EASYTRAK 2 80CM             SUPPLY     6,966.00                    C1900
EP LAB        3822015 0 LEAD EASYTRAK 2 90CM             SUPPLY     6,966.00                    C1900
EP LAB        3822016 0 LEAD EASYTRAK 2 100CM            SUPPLY     6,966.00                    C1900
EP LAB        3822017 0 LEAD EASYTRAK 2 IS-1 80CM        SUPPLY     6,966.00                    C1900
EP LAB        3822018 0 LEAD EASYTRAK 2 IS-1 90CM        SUPPLY     6,966.00                    C1900
EP LAB        3822019 0 LEAD EASYTRAK 2 IS-1 100CM       SUPPLY     6,966.00                    C1900
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3822137 0 LEAD COROX OTW 75-UP                      SUPPLY     4,300.00                    C1900
EP LAB        3822138 0 LEAD COROX OTW 85                         SUPPLY     4,300.00                    C1900
EP LAB        3822139 0 SCOUTPRO LEAD DELIVERY SYSTEM             SUPPLY     1,935.00                    C1900
EP LAB        3821148 0 PACEMAKER MERIDIAN DDD #0976              SUPPLY     9,266.30                    C2619
EP LAB        3821388 0 PACEMAKER CONTAK RENEWAL TR H120          SUPPLY     15,750.00                   C2621
EP LAB        3821768 0 PACEMAKER IN SYNC III CRT-P 8042          SUPPLY     17,150.00                   C2621
EP LAB        3822050 0 PACEMAKER FRONTIER II                     SUPPLY     11,891.30                   C2621
EP LAB        3821506 0 SHEATH LASER                              SUPPLY     4,461.25
EP LAB        3811541 0 INSERT SING CHAMB DEFIB PG                PROCED     41,056.60                   G0297
EP LAB        3811542 0 INSERT DUAL CHAMB DEFIB PG                PROCED     41,056.60                   G0298
EP LAB        3801563 0 INSERT / REPOS LEAD SCD & INSERT PG       PROCED     49,812.14                   G0299
EP LAB        3801564 0 INSERT / REPOS LEAD DCD & INSERT PG       PROCED     49,812.14                   G0300
EP LAB        3821560 0 VISIPAQUE 320 MG IODINE / ML - 1 ML INJ   SUPPLY     2.65                        Q9949
EP LAB        3821559 0 OMNIPAQUE 350 MG IODINE / ML - 1 ML INJ   SUPPLY     4.75                        Q9950
EP LAB        3821094 0 TAPRD BAL TIP STYLT KIT 605458            SUPPLY     100.00
EP LAB        3821043 0 FINAL PACK 6726 DF-1 ADAPTOR/E            SUPPLY     215.00
EP LAB        3821044 0 FINAL PACK TUNNELING TOOL US M            SUPPLY     1,075.00
EP LAB        3821878 0 APEEL CS STRAIGHT 47CM 8FR                SUPPLY     752.50
EP LAB        3821025 0 CATH AMPLATZ GUIDE CATHETER FOR LEF       SUPPLY     1,182.50
EP LAB        3821027 0 BALL TIP STYLET KIT 605758                SUPPLY     100.00
EP LAB        3821028 0 BAL TIP STYL KIT GR KNB 608252            SUPPLY     100.00
EP LAB        3821029 0 BAL TIP STYL KIT GR KNB 608258            SUPPLY     100.00
EP LAB        3821031 0 BAL TIP STYL KIT GR KNB 608245            SUPPLY     100.00
EP LAB        3821038 0 CABLE-SURG DISP 12FT 5833L                SUPPLY     62.50
EP LAB        3821039 0 CABLE-SURG DISP 12FT 5833SL               SUPPLY     62.50
EP LAB        3821042 0 FINAL PACK-6725,PIN PLUG,CONNE            SUPPLY     215.00
EP LAB        3821057 0 IS1 LEAD END CAP KIT                      SUPPLY     62.50
EP LAB        3821059 0 J STYLET KIT 609452                       SUPPLY     100.00
EP LAB        3821060 0 J STYLET KIT W/GREY KNOB                  SUPPLY     100.00
EP LAB        3821065 0 LEAD ANCHORING SLEEVE                     SUPPLY     62.50
EP LAB        3821066 0 LEAD SPLICE KIT                           SUPPLY     161.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821079 0 PINCH ON TOOL FOR SCREWIN LEAD   SUPPLY     100.00
EP LAB        3821085 0 SERVICE INSTALLATION KIT         SUPPLY     112.50
EP LAB        3821093 0 TAPRD BAL TIP STYLT KIT 605465   SUPPLY     100.00
EP LAB        3821103 0 WRENCH #2 HEX MODEL 6563         SUPPLY     87.50
EP LAB        3821107 0 ANCHOR SLEEVE MODEL 6830         SUPPLY     75.00
EP LAB        3821108 0 BI-DIRECT TORQUE WRENCH 6942     SUPPLY     125.00
EP LAB        3821142 0 LEAD CAP KIT 6504                SUPPLY     87.50
EP LAB        3821172 0 SQ ARRAY KT W/SHEATH/TUNNELER    SUPPLY     215.00
EP LAB        3821177 0 STYLET 6601 / 59 CM              SUPPLY     125.00
EP LAB        3821188 0 STYLET 6048 / 52 CM              SUPPLY     125.00
EP LAB        3821213 0 STYLET 6585 / 52 CM              SUPPLY     125.00
EP LAB        3821214 0 STYLET 6586 / 52 CM              SUPPLY     125.00
EP LAB        3821231 0 STYLET 6971 / 64 CM              SUPPLY     125.00
EP LAB        3821232 0 STYLET 6972 / 64 CM              SUPPLY     125.00
EP LAB        3821242 0 VEIN PICK MODEL 6541             SUPPLY     45.00
EP LAB        3821289 0 SERVICE KIT 5873                 SUPPLY     87.50
EP LAB        3821298 0 WRENCH HEX 442-2                 SUPPLY     75.00
EP LAB        3821301 0 LEAD CAPS                        SUPPLY     87.50
EP LAB        3821302 0 CABLE 6697                       SUPPLY     66.00
EP LAB        3821307 0 STYLET KIT 6082-65               SUPPLY     100.00
EP LAB        3821334 0 COPILOT                          SUPPLY     62.50
EP LAB        3821341 0 FINISHING WIRE 65 CM             SUPPLY     365.50
EP LAB        3821343 0 FINISHING WIRE 80 CM             SUPPLY     365.50
EP LAB        3821344 0 FINISHING WIRE 90 CM             SUPPLY     365.50
EP LAB        3821345 0 GUIDEWIRE ACCESSORY KIT          SUPPLY     87.50
EP LAB        3821380 0 ROTATING HEMOSTATIC VALVE        SUPPLY     62.50
EP LAB        3821381 0 D-STAT                           SUPPLY     225.80
EP LAB        3821383 0 FIXATION TOOL                    SUPPLY     75.00
EP LAB        3821507 0 SCOUTPRO KIT                     SUPPLY     1,935.00
EP LAB        3821508 0 ACCESSORY GALEO HYDRO ES 014     SUPPLY     301.00
EP LAB        3821530 0 TOPICAL SKIN ADHESIVE            SUPPLY     48.20
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821641 0 ATTAIN VENOGRAM BALLOON              SUPPLY     215.00
EP LAB        3821657 0 FIXED CURVE (DECA, HEX, OCT, QUAD)   SUPPLY     363.00
EP LAB        3821762 0 WRENCH KIT                           SUPPLY     112.50
EP LAB        3821783 0 DECAPOLAR 6FR STEERABLE              SUPPLY     860.00
EP LAB        3821799 0 TUBING COOL FLOW                     SUPPLY     87.50
EP LAB        3821803 0 REF STAR                             SUPPLY     430.00
EP LAB        3821840 0 ATTAIN UNIVERSAL SLITTER             SUPPLY     62.50
EP LAB        3821848 0 BI LEAD EXTENDER KIT 6984M           SUPPLY     397.80
EP LAB        3821853 0 UPSIZING SLEEVE 5866-45              SUPPLY     62.50
EP LAB        3821882 0 APEEL CS 115 DEG 47CM                SUPPLY     967.50
EP LAB        3821883 0 APEEL CS 115 DEG 52CM                SUPPLY     967.50
EP LAB        3821915 0 PACEMAKER STRATOS LV BIV             SUPPLY     11,900.00
EP LAB        3821951 0 ELOX/SELOX FIXATION TOOL             SUPPLY     137.50
EP LAB        3821952 0 ADAPTOR FOR PK-44 CABLE              SUPPLY     322.50
EP LAB        3821953 0 ADAPTOR SET FOR PK-44 CABLE          SUPPLY     322.50
EP LAB        3821954 0 ADAPTOR PK-44 CABLE                  SUPPLY     322.50
EP LAB        3821955 0 ADAPTOR 2X UNI/BIP IS-1              SUPPLY     268.80
EP LAB        3821956 0 BLIND PLUG FOR DF-CONNECTORS         SUPPLY     62.50
EP LAB        3821957 0 ADAPTOR FROM 6.1 MM HV TO DF-1       SUPPLY     322.50
EP LAB        3821958 0 PLUG IS-1                            SUPPLY     62.50
EP LAB        3821959 0 UPSIZING SLEEVE 5 MM - 6 MM          SUPPLY     137.50
EP LAB        3821960 0 UNIPOLAR ADAPTER 5 MM TO IS-1        SUPPLY     322.50
EP LAB        3821961 0 UNIPOLAR ADAPTER 6 MM TO IS-1        SUPPLY     322.50
EP LAB        3821962 0 UNI-BIPOLAR ADAPTER 3.2 MM TO IS-1   SUPPLY     322.50
EP LAB        3821963 0 Y-ADAPTER UNIPOLAR RECEPTACLES       SUPPLY     322.50
EP LAB        3821964 0 Y-ADAPTER BIPOLAR RECEPTACLES        SUPPLY     67.50
EP LAB        3821965 0 PIN CONNECTOR CAP 3.2 MM LEAD        SUPPLY     67.50
EP LAB        3821966 0 PIN CONNECTOR CAP FOR 5 MM LEAD      SUPPLY     67.50
EP LAB        3821967 0 PIN CONNECTOR CAP FOR 6 MM LEAD      SUPPLY     67.50
EP LAB        3821968 0 LEAD WIRE CAP                        SUPPLY     67.50
EP LAB        3821969 0 LEAD SUTURE SLEEVES #330489          SUPPLY     67.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3821970 0 LEAD SUTURE SLEEVES #107622          SUPPLY     67.50
EP LAB        3821971 0 LEAD SUTURE SLEEVES #119964          SUPPLY     67.50
EP LAB        3821972 0 LEAD SUTURE SLEEVES #119965          SUPPLY     67.50
EP LAB        3821973 0 LEAD SUTURE SLEEVES #342381          SUPPLY     67.50
EP LAB        3821974 0 MEDICAL ADHESIVE 5 GMS               SUPPLY     67.50
EP LAB        3821975 0 SILICONE OIL                         SUPPLY     67.50
EP LAB        3821976 0 TORQUE WRENCH                        SUPPLY     67.50
EP LAB        3821977 0 PULSE GENERATOR POUCH 6 MM           SUPPLY     301.00
EP LAB        3821978 0 PULSE GENERATOR POUCH > 6 MM         SUPPLY     301.00
EP LAB        3821979 0 FIRM BLUNT 45 CM LEAD STYLET         SUPPLY     67.50
EP LAB        3821980 0 FIRM BLUNT 53 CM LEAD STYLET         SUPPLY     67.50
EP LAB        3821981 0 FIRM BLUNT 60 CM LEAD STYLET         SUPPLY     67.50
EP LAB        3821982 0 MEDIUM BALL 45 CM LEAD STYLET        SUPPLY     67.50
EP LAB        3821983 0 MEDIUM BALL 53 CM LEAD STYLET        SUPPLY     67.50
EP LAB        3821984 0 MEDIUM BALL 60 CM LEAD STYLET        SUPPLY     67.50
EP LAB        3821985 0 SOFT 45 CM LEAD STYLET               SUPPLY     67.50
EP LAB        3821986 0 SOFT 53 CM LEAD STYLET               SUPPLY     67.50
EP LAB        3821987 0 SOFT 60 CM LEAD STYLET               SUPPLY     67.50
EP LAB        3821988 0 ATRIAL J 45 CM LEAD STYLET           SUPPLY     67.50
EP LAB        3821989 0 ATRIAL J 53 CM LEAD STYLET           SUPPLY     67.50
EP LAB        3821990 0 X-FIRM TPRD 0.40 MM / 65 CM STYLET   SUPPLY     75.00
EP LAB        3821991 0 X-FIRM TPRD 0.45 MM / 75 CM STYLET   SUPPLY     75.00
EP LAB        3821992 0 X-FIRM TPRD 0.36 MM / 65 CM STYLET   SUPPLY     75.00
EP LAB        3821993 0 X-FIRM TPRD 0.36 MM / 75 CM STYLET   SUPPLY     75.00
EP LAB        3821994 0 FIRM TPRD 0.40 MM / 65 CM STYLET     SUPPLY     75.00
EP LAB        3821995 0 FIRM TPRD 0.40 MM / 75 CM STYLET     SUPPLY     75.00
EP LAB        3821996 0 MED TPRD 0.38 MM / 65 CM STYLET      SUPPLY     75.00
EP LAB        3821997 0 MED TPRD 0.38 MM / 75 CM STYLET      SUPPLY     75.00
EP LAB        3821998 0 SOFT TPRD 0.36 MM / 65 CM STYLET     SUPPLY     75.00
EP LAB        3821999 0 SOFT TPRD 0.36 MM / 75 CM STYLET     SUPPLY     75.00
EP LAB        3822032 0 LEAD CABLE TMS 1000 PROGRAMMER       SUPPLY     430.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3822033 0 PATIENT CABLE TMS 1000 / EPR PROG     SUPPLY     430.00
EP LAB        3822034 0 CABLE 1.5 M FOR 1.7-2.2 MM PINS       SUPPLY     322.50
EP LAB        3822035 0 CABLE 3.0 M FOR 1.7-2.2 MM PINS       SUPPLY     322.50
EP LAB        3822036 0 CABLE 1.5 M UNIV CONNECTIONS          SUPPLY     268.80
EP LAB        3822037 0 CABLE 1.5 M FOR < 2.3 MM PINS         SUPPLY     537.50
EP LAB        3822038 0 CABLE 18" FOR ERA 300                 SUPPLY     483.80
EP LAB        3822039 0 CABLE 6 FT DISP ERA 300               SUPPLY     100.00
EP LAB        3822040 0 CABLE 6 FT DISP ERA 300 MDTR STY      SUPPLY     100.00
EP LAB        3822041 0 CABLE 6 FT DISP ERA 300W / ALL CLP    SUPPLY     100.00
EP LAB        3822042 0 CABLE 6 FT NON-STER ERA 300           SUPPLY     376.30
EP LAB        3822043 0 ECG TRANSMITTER                       SUPPLY     376.30
EP LAB        3822045 0 CATH ATTAIN HOOK                      SUPPLY     430.00
EP LAB        3822054 0 SHEATH ELGAMAL 8 FR                   SUPPLY     156.30
EP LAB        3822055 0 SHEATH MULLANS 8 FR                   SUPPLY     258.00
EP LAB        3822056 0 SHEATH 8 FR SL-2                      SUPPLY     344.00
EP LAB        3822057 0 SHEATH SL-1                           SUPPLY     365.50
EP LAB        3822058 0 SHEATH 8 FR SL-3                      SUPPLY     365.50
EP LAB        3822059 0 SHEATH 8 FR SL-4                      SUPPLY     365.50
EP LAB        3822060 0 SHEATH 8 FR SR-2                      SUPPLY     365.50
EP LAB        3822061 0 SHEATH 8 FR SR-4                      SUPPLY     365.50
EP LAB        3822063 0 SHEATH CSTA 8 FR                      SUPPLY     365.50
EP LAB        3822064 0 SHEATH FLUTTER 8 FR AT                SUPPLY     365.50
EP LAB        3822065 0 NEEDLE TS 89 CM LENGTH                SUPPLY     483.80
EP LAB        3822066 0 SHEATH 80 CM 8 FR SL-1                SUPPLY     408.50
EP LAB        3822067 0 SHEATH 8 FR SR-0                      SUPPLY     365.50
EP LAB        3822068 0 SHEATH 8 FR SR-1                      SUPPLY     365.50
EP LAB        3822069 0 SHEATH 8 FR SR-3                      SUPPLY     365.50
EP LAB        3822070 0 SHEATH 7 FR 24 CM LONG METAL          SUPPLY     112.50
EP LAB        3822071 0 SHEATH 8 FR 24 CM LONG METAL          SUPPLY     112.50
EP LAB        3822072 0 CATH BLAZER 5 MM TIP 8 FR STD CURVE   SUPPLY     1,687.80
EP LAB        3822073 0 CATH BLAZER 5 MM TIP 8 FR LG CURVE    SUPPLY     1,687.80
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
EP LAB        3822074 0 CATH INTERNAL CV TZ MEDCL                SUPPLY     2,139.30
EP LAB        3822075 0 CATH BLAZER STD 7 FR                     SUPPLY     1,644.80
EP LAB        3822076 0 CATH BLAZER 4 MM TIP 7 FR LG CURVE       SUPPLY     1,644.80
EP LAB        3822077 0 CATH 4 MM TIP 6 FR STD CURVE             SUPPLY     1,644.80
EP LAB        3822078 0 CATH BLAZER 4 MM TIP 6 FR LG CURVE       SUPPLY     1,644.80
EP LAB        3822079 0 CATH DUO-DECA 95 CM 7 FR                 SUPPLY     365.50
EP LAB        3822080 0 SHEATH LASER 12 FR                       SUPPLY     2,687.50
EP LAB        3822081 0 SHEATH LASER 14 FR                       SUPPLY     2,687.50
EP LAB        3822082 0 SHEATH LASER 16 FR                       SUPPLY     2,687.50
EP LAB        3822083 0 LLD # 1                                  SUPPLY     894.40
EP LAB        3822084 0 LLD PAK # 2                              SUPPLY     894.40
EP LAB        3822085 0 LLD PAK # 3                              SUPPLY     894.40
EP LAB        3822086 0 CATH NON STEERABLE QUAD 6 FR             SUPPLY     408.50
EP LAB        3822088 0 DECAPOLAR                                SUPPLY     473.00
EP LAB        3822089 0 SHEATH 10.5 FR BARD SSV                  SUPPLY     137.50
EP LAB        3822090 0 SHEATH 7 FR BARD SSV                     SUPPLY     137.50
EP LAB        3822091 0 SHEATH 9.5 FR BARD SSV                   SUPPLY     137.50
EP LAB        3822092 0 SAFE SHEATH SPLITTABLE VALVED HLS-1007   SUPPLY     150.50
EP LAB        3822093 0 SAFE SHEATH SPLITTABLE VALVED HLS-1009   SUPPLY     150.50
EP LAB        3822094 0 SHEATH SPLIT WITH VALVE 23 CM            SUPPLY     150.50
EP LAB        3822095 0 SHEATH SPLIT WITH VALVE 8 FR             SUPPLY     150.50
EP LAB        3822096 0 SAFE SHEATH WITH VALVE & SIDE            SUPPLY     150.50
EP LAB        3822097 0 SUT V20 SOFSILK                          SUPPLY     187.30
EP LAB        3822098 0 SUT 3-0 POLY SORB                        SUPPLY     203.40
EP LAB        3822099 0 SUT 4-0 POLY SORB                        SUPPLY     204.30
EP LAB        3822100 0 SUT SOFSILK 0                            SUPPLY     117.90
EP LAB        3822101 0 SUT DEXON S 4-0 CV-23                    SUPPLY     297.20
EP LAB        3822102 0 SUT POLY SORB 0                          SUPPLY     210.70
EP LAB        3822121 0 ATTAIN 6 FR SLITTER                      SUPPLY     75.00
EP LAB        3822122 0 ATTAIN 4 FR SLITTER                      SUPPLY     75.00
EP LAB        3822130 0 WIRE SUPPORTTRAK FINISHING WIRE 6667     SUPPLY     301.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML        CPT
EP LAB        3822131 0 WIRE SUPPORTTRAK FINISHING WIRE 6675            SUPPLY     301.00
EP LAB        3822132 0 WIRE SUPPORTTRAK FINISHING WIRE 6668            SUPPLY     301.00
ER            4503058 0 INCISION AND DRAINAGE, SIMPLE                   PROCED     375.13                         10060
ER            4503210 0 I&D ABSCESS MULT/COMPLICATED                    PROCED     584.24                         10061
ER            4503200 0 BURN DRSG / DEBRDMNT PART THICK BURN SMALL < 5% PROCED     189.99                         16020
ER            4503201 0 BURN DRSG / DEBRDMNT PART THICK BURN MED 5-10% PROCED      432.00                         16025
ER            4503203 0 BURN DRSG / DEBRDMNT PART THICK BURN LGE > 10% TPROCED     234.59                         16030
ER            4503132 0 JOINT ASPIRATION                                PROCED     132.40                      20600 - 20610
ER            4503018 0 SKEL TRACT APPLIC/STEINMAN PIN                  PROCED     1,272.00                       20650
ER            4503050 0 HALO APPLICATION                                PROCED     71.79                          20661
ER            4503051 0 COMPARTMENT PRESSURE TEST                       PROCED     101.02                         20950
ER            4503006 0 CAST LA APPLICATION                             PROCED     288.43                         29065
ER            4503005 0 CAST SA APPLICATION                             PROCED     246.13                         29075
ER            4503204 0 SPLINT LA APPLICATION                           PROCED     230.07                         29105
ER            4503009 0 SPLINT SA APPLICATION                           PROCED     199.89                         29125
ER            4503017 0 FINGER SPLINT APPLICATION                       PROCED     190.89                         29130
ER            4503008 0 CAST LL APPLICATION                             PROCED     379.03                         29345
ER            4503007 0 CAST SL APPLICATION                             PROCED     269.21                         29405
ER            4503042 0 NASAL PACKING, SIMPLE                           PROCED     198.19                         30901
ER            4503043 0 NASAL PACKING, POST. COMPLEX                    PROCED     266.76                         30905
ER            4503029 0 ENDOTRACHEAL INTUBATION, EMER.                  PROCED     322.92                         31500
ER            4503024 0 TRACHEOSTOMY                                    PROCED     506.00                         31603
ER            4503056 0 CRICHOTHYROTOMY                                 PROCED     875.13                         31605
ER            4503033 0 BRONCHOSCOPY (ED)                               PROCED     1,420.00                       31622
ER            4503026 0 THORACENTESIS W/ INSERT TUBE                    PROCED     1,078.11                       32002
ER            4503036 0 CHEST TUBE INSERTION                            PROCED     1,154.52                       32020
ER            4503025 0 THORACOTOMY W/CARD MASSAGE                      PROCED     894.44                         32160
ER            4503068 0 PERICARDIOCENTESIS                              PROCED     429.59                         33010
ER            4503028 0 TEMP PACEMAKER INSERTION                        PROCED     3,487.00                       33210
ER            4502005 0 BLOOD DRAW VENIPUNCTURE                         PROCED     19.69                          36415
ER            4502003 0 BLOOD DRAW CAPILLARY - FINGR, EAR, HEEL         PROCED     15.50                          36416
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY       OUTPT)          LML/RML     CPT
ER            4503052 0 BLOOD TRANSFUSION PER VISIT                PROCED         627.92                      36430
ER            4504031 0 CENTRAL LINE INSERT NON-TUNN > AGE 4       PROCED         1,027.61                    36556
ER            4502001 0 ARTERIAL BLOOD GAS DRAW                    PROCED         127.00                      36600
ER            4503067 0 ARTERIAL LINE INSERTION                    PROCED         295.92                      36620
ER            4503045 0 INTRAOSSEOUS IV INSERTION                  PROCED         198.72                      36680
ER            4502035 0 GASTROSTOMY TUBE CHANGE                    PROCED         333.53                      43760
ER            4503064 0 ANOSCOPY                                   PROCED         275.12                      46600
ER            4503054 0 PERITONEAL LAVAGE DIAG                     PROCED         558.03                      49080
ER            4503215 0 PARACENTESIS                               PROCED         558.03                      49080
ER            4503222 0 CATHETRZTN URETH STRAIGHT CATH             PROCED         50.00                       51701
ER            4503032 0 CATHETERIZATN URETH INDWELL FOLEY SIMPLE   PROCED         137.06                      51702
ER            4503221 0 CATHETERIZATN URETH INDWELL FOLEY COMP     PROCED         170.00                      51703
ER            4503205 0 DIL URETHRAL STRICTURE MALE                PROCED         1,031.00                    53620
ER            4503131 0 DILATION FEMALE URETHRA                    PROCED         140.40                      53660
ER            4503207 0 VAGINAL DELIVERY EMERGENCY                 PROCED         1,288.00                    59409
ER            4503208 0 DELIVERY OF PLACENTA                       PROCED         1,145.73                    59414
ER            4503047 0 BURRHOLE EVAC/DRAIN HEMATOMA               PROCED         320.63                      61154
ER            4503049 0 BURRHOLE VENTRIC CATHETER                  PROCED         320.63                      61210
ER            4503037 0 LUMBAR PUNCTURE DIAGNOSTIC                 PROCED         303.93                      62270
ER            4505113 0 SLIT LAMP EXAM                             PROCED         369.82                      65222
ER            4504018 0 URINE DIPSTICK                                           39.83
                                                                   WAIVED TEST DON                            81003
ER            4504016 0 PREGNANCY TEST URINE QUICKVUE                            70.18
                                                                   WAIVED TEST DON                            81025
ER            4504023 0 HEMOCULT                                                 26.20
                                                                   WAIVED TEST DON                            82270
ER            4504024 0 GASTROCCULT                                              22.93
                                                                   WAIVED TEST DON                            82271
ER            4504020 0 BLOOD GLUCOSE ACCUCHECK                                  23.37
                                                                   WAIVED TEST DON                            82962
ER            4504019 0 HEMOCUE                                                  34.56
                                                                   WAIVED TEST DON                            85018
ER            4501112 0 INJ FEE VACCINE (1) SINGLE                 PROCED         44.04                       90471
ER            4501113 0 INJ FEE VACCINE EA ADDL                    PROCED         25.00                       90472
ER            4501109 0 INJ FEE THER / DIAG / PROPHY SQ,IM,ID      PROCED         60.36                       90772
ER            4503063 0 NG INSERTION W/O LAVAGE                    PROCED         100.21                      91055
ER            4503062 0 NG INSERTION W/ LAVAGE                     PROCED         189.30                      91105
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML     CPT
ER            4503225 0 CPR IN CARDIAC ARREST                             PROCED     565.42                      92950
ER            4503066 0 TRANSCUTANEOUS PACING                             PROCED     526.77                      92953
ER            4503137 0 CARDIOVERSION EXTERNAL ELECTIVE                   PROCED     657.80                      92960
ER            4503136 0 CARDIOVERSION INTERNAL ELECTIVE                   PROCED     637.40                      92961
ER            4503226 0 EKG 12-LEAD                                       PROCED     130.36                      93005
ER            4503027 0 SWAN GANZ INSERTION                               PROCED     938.00                      93503
ER            4503227 0 ER CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 30 MIN PROCED      170.00                      99143
ER            4503228 0 ER CONSCIOUS SEDATION SAME MD 5 Y/O & ABV 1ST 30 PROCED      170.00                      99144
ER            4503229 0 ER CONSCIOUS SEDATION SAME MD EA ADDL 15 MIN PROCED          85.00                       99145
ER            4503230 0 ER CONSCIOUS SEDATION DIFF MD < 5 Y/O 1ST 30 MIN PROCED      170.00                      99148
ER            4503231 0 ER CONSCIOUS SEDATION DIFF MD 5 Y/O & ABV 1ST 30 MPROCED     170.00                      99149
ER            4503232 0 ER CONSCIOUS SEDATION DIFF MD EA ADDL 15 MIN      PROCED     85.00                       99150
ER            4503213 0 ANOGENITAL ABUSE EXAM CHILD                       PROCED     11.00                       99170
ER            4503211 0 TEST VISUAL ACUITY BILAT                          PROCED     14.85                       99173
ER            4501001 0 ED VISIT LEVEL I                                  LOC        154.14                      99281
ER            4503301 0 TRIAGE ONLY FEE                                   PROCED     78.00                       99281
ER            4501106 0 ED VISIT LEVEL II                                 LOC        253.34                      99282
ER            4501002 0 ED VISIT LEVEL III                                LOC        422.12                      99283
ER            4501003 0 ED VISIT LEVEL IV                                 LOC        792.27                      99284
ER            4501004 0 ED VISIT LEVEL V                                  LOC        1,354.96                    99285
ER            4501007 0 ED-EXTEND CARE ICU                                PROCED     740.38                      99285
ER            4501105 0 CRITICAL CARE 1ST 30-74 MIN                       PROCED     1,966.88                    99291
ER            4501117 0 CRITICAL CARE EA ADD'L 30 MIN                     PROCED     250.00                      99292
ER            4503223 0 INFUSION THER NON-CHEMO 1ST HR                    PROCED     236.00                      C8950
ER            4503224 0 INFUSION THER NON-CHEMO EA ADD'L HR               PROCED     142.00                      C8951
ER            4501110 0 INJ FEE IV PUSH THER / DIAG / PROPHY              PROCED     160.91                      C8952
ER            4503219 0 AIR ANKLE BRACE MED LEFT                          SUPPLY     80.34                       L4350
ER            4503220 0 AIR ANKLE BRACE MED RIGHT                         SUPPLY     80.34                       L4350
ER            4503217 0 AIR SPLINT LGE RIGHT                              SUPPLY     138.73                      L4360
ER            4503218 0 AIR SPLINT LGE LEFT                               SUPPLY     138.73                      L4360
ER            4502002 0 CATHETERIZTN URETH FOR COLLECTN SPEC              PROCED     67.70                       P9612
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML         CPT
ER            4503133 0 FRACT UPPER/LOWER EXTREMITY TX     PROCED     148.94                      Various Ranges
ER            4503134 0 FRACT RIB/CLAV/SPN/SCAP/STERN TX   PROCED     239.44                      Various Ranges
ER            4503135 0 FRACTURE FACE TX                   PROCED     49.65                       Various Ranges
ER            4503138 0 REDUCTION DISLOCATED JOINT         PROCED     669.70                      Various Ranges
ER            4503139 0 LACERATION REPAIR COMPLEX          PROCED     723.57                      Various Ranges
ER            4503140 0 LACERATION REPAIR INTERMED         PROCED     382.45                      Various Ranges
ER            4503141 0 LACERATION REPAIR SIMPLE           PROCED     132.40                      Various Ranges
ER            4503093 0 SUT DERMALON 4-0 18PRE 2           SUPPLY     16.54
ER            4503099 0 SUT DERMALON 6-0 18PRE302          SUPPLY     11.45
ER            4503109 0 SUT PROLENE 5-0 18 IN              SUPPLY     18.19
ER            4503118 0 SUT VICRYL 5-0 18 IN PRE 3         SUPPLY     11.56
ER            4501114 0 TRAUMA RED LEVEL 3                 PROC       5,150.00
ER            4501115 0 TRAUMA CONSULT LEVEL 1             PROC       3,090.00
ER            4501116 0 TRAUMA YELLOW LEVEL 2              PROC       4,120.00
ER            4503041 0 ED-OB KIT SUPPLIES                 SUPPLY     52.31
ER            4503079 0 C02 DETECTORS                      SUPPLY     41.46
ER            4503080 0 DISP SCALP CLIP APPLIER            SUPPLY     68.74
ER            4503085 0 MINIPUNCT HI INFUSN SET 6.0        SUPPLY     81.11
ER            4503086 0 NOSEBLEED KITS                     SUPPLY     58.66
ER            4503087 0 POSTERIOR MOLD 3X260               SUPPLY     199.76
ER            4503088 0 POSTERIOR MOLD 4X260               SUPPLY     244.32
ER            4503089 0 PEDS CATH KIT 5FR W/SURGILUBE      SUPPLY     10.50
ER            4503090 0 PEDS PERIPH HI VOL INF SET         SUPPLY     59.94
ER            4503091 0 QUICK COMBO PADS                   SUPPLY     90.88
ER            4503092 0 QUICK STRAP ET TUBE HOLDER         SUPPLY     43.95
ER            4503094 0 SUT DERMALON 4-0 PE5 1593-33       SUPPLY     13.79
ER            4503095 0 SUT DERMALON 4-0 PRE2 1807-3       SUPPLY     10.29
ER            4503096 0 SUT DERMALON 5-0 18PRE302          SUPPLY     12.09
ER            4503097 0 SUT DERMALON 5-0 PE3 1594-23       SUPPLY     13.04
ER            4503098 0 SUT DERMALON 5-0 SBE2 1607-2       SUPPLY     12.20
ER            4503100 0 SUT DERMALON 6-0 PRE302 1807       SUPPLY     12.09
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                              CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION              CATEGORY   OUTPT)             LML/RML     CPT
ER            4503101 0 SUT DERMALON 6-0 SBE2 1607-1    SUPPLY     21.24
ER            4503102 0 SUT ETHILON 3-0 FSL (1671H)     SUPPLY     13.45
ER            4503103 0 SUT MONOCRYL 3-0 PS1 Y936       SUPPLY     18.24
ER            4503104 0 SUT MONOCRYL 5-0 PC1 Y834G      SUPPLY     19.94
ER            4503105 0 SUT MONOCRYL 5-0 PC3 Y844G      SUPPLY     19.94
ER            4503106 0 SUT MONOCRYL 6-0 PC1 Y833G      SUPPLY     19.94
ER            4503107 0 SUT PROLENE 1 CT1 (8425H)       SUPPLY     8.91
ER            4503108 0 SUT PROLENE 3-0 FSL (8675H)     SUPPLY     8.91
ER            4503110 0 SUT SILK CS1 1097-61            SUPPLY     1.69
ER            4503111 0 SUT SILK 0 KS (624H)            SUPPLY     6.25
ER            4503112 0 SUT SURGILENE 4-0 PRE4 3416     SUPPLY     19.97
ER            4503113 0 SUT SURGILENE 5-0 PE3 3414-2    SUPPLY     18.20
ER            4503114 0 SUT SURGILENE 6-0 SBE2 3411     SUPPLY     21.24
ER            4503115 0 SUT VICRYL 0 UR4 (J603H)        SUPPLY     9.33
ER            4503116 0 SUT VICRYL 2-0 PS12 J428H       SUPPLY     15.27
ER            4503117 0 SUT VICRYL 3-0 FS1 (J442H)      SUPPLY     8.37
ER            4503119 0 SUT VICRYL 5-0 J844G            SUPPLY     18.04
ER            4503120 0 SUT VICRYL 5-0 J845G            SUPPLY     18.78
ER            4503121 0 SUT VICRYL 5-0 PC1 J834G        SUPPLY     18.04
ER            4503122 0 SUT VICRYL RAPIDE 4-0 PC3 VR    SUPPLY     19.84
ER            4503123 0 SUT VICRYL RAPIDE 5-0 PC3 VR    SUPPLY     19.84
ER            4503124 0 FORCEP SPLINTER DISP ST         SUPPLY     6.79
ER            4503125 0 FORCEP HARTMAN ALLIGATOR DISP   SUPPLY     47.95
ER            4503126 0 SUT ETHILON 4-0 18 PRE          SUPPLY     17.50
ER            4503127 0 SUT ETHILON 6-0 18 PRE          SUPPLY     14.32
ER            4504006 0 MORGAN LENS IRRIGATION          SUPPLY     58.03
ER            4504022 0 AMBU                            SUPPLY     81.37
ER            4505200 0 RAPID INFUSER                   SUPPLY     358.15
ER            4510020 0 TRACH SHILEY                    SUPPLY     84.36
ER            4510021 0 TRACH METAL                     SUPPLY     77.23
ER            4501006 2 ED-NO CHARGE                    LOC        STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)             LML/RML     CPT
ER              4504017 2 PREGNANCY TEST URINE QUICKVUE         PROCED     STATISTICAL ITEM
FOOD / NUTRITIO 9504011  0 NUTRITION METABOLIC STUDY            PROCED     60.00                          94690
FOOD / NUTRITIO 9504004  0 OP NUTR ASSMT / ED INIT IND 15 MIN   PROCED     33.04                          97802
FOOD / NUTRITIO 9504007  0 RENAL EDUC INITIAL IND 15 MIN        PROCED     33.04                          97802
FOOD / NUTRITIO 9504003  0 OP NUTR ASSMT / ED F/U IND 15 MIN    PROCED     27.36                          97803
FOOD / NUTRITIO 9504008  0 RENAL EDUC F/U IND 15 MIN            PROCED     27.36                          97803
FOOD / NUTRITIO 9502005  0 NUTR EDUC MAT LEVEL 2                SUPPLY     13.20                          99071
FOOD / NUTRITIO 9502214  0 NUTR EDUC MAT LEVEL 1                SUPPLY     9.50                           99071
FOOD / NUTRITIO 9502222  0 NUTR SERV ONSITE EARLY INTV          PROC       23.95                          W8761
FOOD / NUTRITIO 9502221  0 ASSESSMENT-ONSITE EARLY INTV         PROC       23.95                          W8772
FOOD / NUTRITIO 9502213  0 MICRONTRNT INTAKE ANAL               PROCED     139.07
FOOD / NUTRITIO 9502216  0 KANANA BANANA FLAKES                 SUPPLY     2.75
FOOD / NUTRITIO 9502217  0 NUTRIHEP 8 OZ                        SUPPLY     38.50
FOOD / NUTRITIO 9503002  0 MIGHTYSHAKE 6 OZ                     SUPPLY     5.50
FOOD / NUTRITIO 9503003  0 BENEFIBER 1 PKT                      SUPPLY     4.50
FOOD / NUTRITIO 9503007  0 BOOST PUDDING 6 OZ                   SUPPLY     4.50
FOOD / NUTRITIO 9503008  0 GLUCERNA SHAKE                       SUPPLY     8.25
FOOD / NUTRITIO 9503010  0 PEDS SPECIAL INFANT FORMULA          SUPPLY     46.85
FOOD / NUTRITIO 9503011  0 BOOST 8 OZ                           SUPPLY     4.50
FOOD / NUTRITIO 9503012  0 PROPASS PACKET EA                    SUPPLY     5.50
FOOD / NUTRITIO 9503212  0 MACRONTRNT INTAKE ANAL               PROCED     110.66
FOOD / NUTRITIO 9503213  0 PEPTAMEN JR                          SUPPLY     31.18
FOOD / NUTRITIO 9503216  0 REPLETE                              SUPPLY     4.50
FOOD / NUTRITIO 9503219  0 PEPTINEX DT EA CAN                   SUPPLY     13.55
FOOD / NUTRITIO 9503220  0 2 CAL HN EA CAN                      SUPPLY     2.00
FOOD / NUTRITIO 9503221  0 GLYTROL EA CAN                       SUPPLY     2.10
FOOD / NUTRITIO 9503222  0 NUTREN RENAL EA CAN                  SUPPLY     2.30
FOOD / NUTRITIO 9503223  0 PEPTAMIN EA CAN                      SUPPLY     11.90
FOOD / NUTRITIO 9503225  0 ENSURE PLUS EA CAN                   SUPPLY     2.00
FOOD / NUTRITIO 9503226  0 RENAL CAL EA CAN                     SUPPLY     24.30
FOOD / NUTRITIO 9503227  0 RESOURCE BREEZE EA                   SUPPLY     3.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)             LML/RML      CPT
FOOD / NUTRITIO 9503300  0 PEDIASURE 8 OZ                         SUPPLY     8.25
FOOD / NUTRITIO 9503302  0 THICK-IT                               SUPPLY     2.20
FOOD / NUTRITIO 9503307  0 OSMOLITE                               SUPPLY     6.41
FOOD / NUTRITIO 9503321  0 NUTREN 1.5 8 OZ                        SUPPLY     8.35
FOOD / NUTRITIO 9503323  0 ULTRACAL 8 OZ                          SUPPLY     4.50
FOOD / NUTRITIO 9503930  0 OXEPA 8 OZ                             SUPPLY     30.88
FOOD / NUTRITIO 9503968  0 OSMOLITE 1 CAL                         SUPPLY     7.50
FOOD / NUTRITIO 9503975  0 SUPLENA                                SUPPLY     10.50
FOOD / NUTRITIO 9503976  0 IMPACT PER CAN                         SUPPLY     45.80
FOOD / NUTRITIO 9504005  2 IP NUTR ASSMT / ED INIT IND 15 MIN     PROCED     STATISTICAL ITEM
FOOD / NUTRITIO 9504006  2 IP NUTR ASSMT / ED F/U IND 15 MIN      PROCED     STATISTICAL ITEM
FOOD / NUTRITIO 9504009  2 DIALYSIS NUTR ED ASSMT INIT 15 MIN     PROCED     STATISTICAL ITEM
FOOD / NUTRITIO 9504010  2 DIALYSIS NUTR ED ASSMT F/U 15 MIN      PROCED     STATISTICAL ITEM
FOOD / NUTRITIO 9504012  2 BPD - NUTR ASSMT / ED IND 15 MIN       PROCED     STATISTICAL ITEM
GI LAB          7501112 0 FNA W/ IMAGING GUIDANCE                 PROCED     623.87                         10022
GI LAB          7501285 0 TRANSFUSION BLOOD / BLOOD PRODUCTS      PROCED     627.92                         36430
GI LAB          7501806 0 ESOPHAGEAL ABLATION                     PROCED     2,000.00                       43228
GI LAB          7501627 0 EGD PROCEDURE                           PROCED     1,033.23                       43235
GI LAB          7501210 0 EGD TERMINATION                         PROCED     1,033.23                       4323552
GI LAB          7501628 0 EGD WITH BIOPSY                         PROCED     1,287.18                       43239
GI LAB          7501273 0 EGD W/ U/S GUIDED FNA                   PROCED     1,843.41                       43242
GI LAB          7501666 0 EGD w/ SCLEROTHERAPY                    PROCED     1,306.68                       43243
GI LAB          7501223 0 EGD W/BANDING                           PROCED     1,345.75                       43244
GI LAB          7501224 0 EGD W/GASTRIC DILITATION                PROCED     1,069.56                       43245
GI LAB          7501671 0 PEG TUBE PLACEMENT                      PROCED     950.00                         43246
GI LAB          7503002 0 PEG TUBE INSERTION PEDS                 PROCED     1,125.00                       43246
GI LAB          7501225 0 EGD W/FOREIGN BODY REMOVAL              PROCED     1,100.00                       43247
GI LAB          7501636 0 ENDOSCOPY W/ SAVARY DILITATION          PROCED     1,198.64                       43248
GI LAB          7501653 0 EGD W/BALLOON DILATATION                PROCED     1,224.97                       43249
GI LAB          7501623 0 EGD POLYPECTOMY BY SNARE W/ OR W/O BX   PROCED     1,400.15                       43251
GI LAB          7501226 0 EGD W/COAGULATION                       PROCED     1,449.63                       43255
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                              CATEGORY   OUTPT)          LML/RML      CPT
GI LAB        7501610 0 EGD W/ ENDOSCOPIC US                            PROCED     2,001.28                    43259
GI LAB        7501367 0 ERCP                                            PROCED     1,582.92                    43260
GI LAB        7501257 0 ERCP TERMINATION                                PROCED     1,582.92                    4326052
GI LAB        7501221 0 ERCP W/BIOPSY                                   PROCED     1,910.17                    43261
GI LAB        7501248 0 ERCP W/BIOPSY, COMBO                            PROCED     1,910.17                    43261
GI LAB        7501667 0 ERCP W/PAPPILOTOMY                              PROCED     2,155.75                    43262
GI LAB        7501241 0 ERCP W/MANOMETRY                                PROCED     2,123.24                    43263
GI LAB        7501249 0 ERCP W/ MANOMETR COMBO                          PROCED     2,500.00                    43263
GI LAB        7501242 0 ERCP W/STONE EXT.                               PROCED     1,849.77                    43264
GI LAB        7501250 0 ERCP W/STONE EXT., COMBO                        PROCED     1,849.77                    43264
GI LAB        7501243 0 ERCP W/LITHOTRIPSY                              PROCED     3,084.21                    43265
GI LAB        7501251 0 ERCP W/LITHOTRIPSY, COMBO                       PROCED     3,084.21                    43265
GI LAB        7501244 0 ERCP W/NASOBILIARY TUBE                         PROCED     1,715.40                    43267
GI LAB        7501252 0 ERCP W/NASOBILIARY TUBE, COMBO                  PROCED     1,715.40                    43267
GI LAB        7501668 0 ERCP W/STENT PLACEMENT                          PROCED     2,386.94                    43268
GI LAB        7501245 0 ERCP W/STENT CHANGE                             PROCED     1,677.00                    43269
GI LAB        7501253 0 ERCP W/STENT CHANGE, COMBO                      PROCED     1,677.00                    43269
GI LAB        7501246 0 ERCP W/DILITATION                               PROCED     2,500.00                    43271
GI LAB        7501254 0 ERCP W/DILATION, COMBO                          PROCED     2,500.00                    43271
GI LAB        7501247 0 ERCP W/ABLATION                                 PROCED     1,970.19                    43272
GI LAB        7501255 0 ERCP W/ABLATION, COMBO                          PROCED     1,970.19                    43272
GI LAB        7501286 0 GASTRIC RESTRICTIVE PROC REVIS SQ PORT          PROCED     350.00                      43886
GI LAB        7501287 0 GASTRIC RESTRICTIVE PROC REMOV SQ PORT          PROCED     350.00                      43887
GI LAB        7501288 0 GASTRIC RESTRICTIVE PROC REM & REPLAC SQ PORT   PROCED     850.00                      43888
GI LAB        7501234 0 ENTEROSCOPY SMALL BOWEL                         PROCED     1,068.36                    44360
GI LAB        7501235 0 ENTEROSCOPY W/BIOPSY                            PROCED     1,383.89                    44361
GI LAB        7501236 0 ENTEROSCOPY W/COAGULATION                       PROCED     1,733.60                    44366
GI LAB        7501237 0 ENTEROSCOPY W/J TUBE PLACEMENT                  PROCED     1,059.03                    44373
GI LAB        7501238 0 ILEUM ENTEROSCOPY                               PROCED     816.21                      44376
GI LAB        7501211 0 ILEUM ENTEROSCOPY W/BIOPSY                      PROCED     1,136.77                    44377
GI LAB        7501239 0 ILEUM ENTEROSCOPY W/COAGULATIO                  PROCED     1,586.52                    44378
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY   OUTPT)          LML/RML      CPT
GI LAB        7501212 0 ILEOSCOPY THRU STOMA                             PROCED     1,172.48                    44380
GI LAB        7501213 0 ILEOSCOPY W/BIOPSY                               PROCED     1,650.00                    44382
GI LAB        7501214 0 STOMAL COLONOSCOPY                               PROCED     998.19                      44388
GI LAB        7501215 0 STOMAL COLONOSCOPY W/BIOPSY                      PROCED     1,190.29                    44389
GI LAB        7501216 0 STOMAL COLONOSCPY W/COAGULATIO                   PROCED     534.00                      44391
GI LAB        7501649 0 FLEX SIGMOIDOSCOPY                               PROCED     579.38                      45330
GI LAB        7501801 0 FLEX SIG POLYPEC HOT BX FORCP/CAUT               PROCED     805.84                      45333
GI LAB        7501803 0 FLEX SIG W/ COAGULATION                          PROCED     913.28                      45334
GI LAB        7501802 0 FLEX SIG POLYPEC BY SNARE                        PROCED     825.12                      45338
GI LAB        7501274 0 COLONOSCOPY TRANSABD VIA COLOTOMY                PROCED     1,641.06                    45355
GI LAB        7501629 0 COLONOSCOPY                                      PROCED     1,078.18                    45378
GI LAB        7501227 0 COLONOSCOPY TERMINATED                           PROCED     1,078.18                    4537874
GI LAB        7501228 0 COLONOSCOPY W/FRGN BDY REMOV                     PROCED     1,244.09                    45379
GI LAB        7501229 0 COLONOSCOPY W/BIOPSY                             PROCED     1,600.00                    45380
GI LAB        7501230 0 COLONOSCOPY W/COAGULATION                        PROCED     1,331.75                    45382
GI LAB        7501231 0 COLONOSCOPY W/FORCP POLYPECT                     PROCED     1,295.55                    45384
GI LAB        7501232 0 COLONOSCOPY W/SNARE POLYPECT                     PROCED     1,317.15                    45385
GI LAB        7501233 0 COLONOSCOPY W/SNARE POLYPECT COMB                PROCED     1,317.15                    45385
GI LAB        7501283 0 COLONOSCOPY FLEX W/ ENDOSC U/S                   PROCED     750.00                      45391
GI LAB        7501284 0 COLONOSCOPY FLEX W/ TRANSEND U/S GUID ASP / BX   PROCED     900.00                      45392
GI LAB        7501290 0 ANORECTAL EXAM W/ ANES DIAG                      PROCED     250.00                      45990
GI LAB        7501256 0 HEMORRHOID INJECTION                             PROCED     995.00                      46500
GI LAB        7501279 0 ANOSCOPY DIAG                                    PROCED     275.12                      46600
GI LAB        7502001 0 PERCUTANEOUS LIVER BIOPSY                        PROCED     641.50                      47000
GI LAB        7501676 0 PARACENTESIS INIT                                PROCED     558.03                      49080
GI LAB        7501677 0 PARACENTESIS SUBSEQ                              PROCED     421.40                      49081
GI LAB        7501368 0 CELIAC PLEXUS INJ ANES AGENT                     PROCED     375.00                      64530
GI LAB        7501266 0 RAD S/I REM FORGN BDY ESOPH W/ BAL               PROCED     553.89                      74235
GI LAB        7501264 0 RAD EXAM UGI TRACT W/ KUB W/ OR W/O FILM         PROCED     358.26                      74241
GI LAB        7501275 0 LAP BANDING ADJ RAD EXAM UGI W/ KUB              PROCED     358.26                      74241
GI LAB        7501268 0 RAD S/I ENDOSC CATH BILIARY DUCT                 PROCED     447.63                      74328
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                               CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY      OUTPT)         LML/RML      CPT
GI LAB        7501269 0 RAD S/I ENDOSC CATH PANC DUCT                    PROCED        585.23                     74329
GI LAB        7501240 0 PANCREATOGRAM (ERCP) RAD S/I                     PROCED        649.02                     74330
GI LAB        7501270 0 RAD S/I ENDOSC CATH BILIARY & PANC DUCT          PROCED        649.02                     74330
GI LAB        7501265 0 RAD S/I PERC PLCMT GASTROS TUBE                  PROCED        506.62                     74350
GI LAB        7501261 0 FLUOROSCOPY 0-60 MIN                             PROCED        350.00                     76000
GI LAB        7501262 0 FLUOROSCOPY > 60 MIN                             PROCED        574.66                     76001
GI LAB        7501271 0 FLUORO GUID NDL PLCM NON-SPINAL                  PROCED        342.09                     76003
GI LAB        7501611 0 TRANSRECTAL ULTRASOUND                           PROCED        482.32                     76872
GI LAB        7501263 0 U/S GUIDANCE NEEDLE PLCMT                        PROCED        478.88                     76942
GI LAB        7501267 0 U/S S/I GI ENDOSCOPIC U/S                        PROCED        506.58                     76975
GI LAB        7501276 0 BLOOD GLUCOSE ACCUCHECK                                        23.37
                                                                         WAIVED TEST DON                          82962
GI LAB        7501673 0 H PYLORI ANALYS NON RADIOACT ISOTPE              PROCED        150.00                     83013
GI LAB        7501674 0 H PYLORI DRUG ADMIN / SAMPL COLLCTN              PROCED        256.13                     83014
GI LAB        7501620 0 ESOPHAGEAL MOTILITY                              PROCED        746.09                     91010
GI LAB        7501289 0 DUODENAL MOTILITY (MANOMETRIC) STUDY             PROCED        250.00                     91022
GI LAB        7501282 0 GASTROESOPH REFLUX TEST W/ NASAL CATH            PROCED        600.00                     91034
GI LAB        7501281 0 GASTROESOPH REFLUX TEST W/ MUC ATT TELEM PH EL PROCED          800.00                     91035
GI LAB        7501669 0 BREATH HYDROGEN TEST LACTOS, FRUC, LACTULOS PROCED             366.52                     91065
GI LAB        7501805 0 CAPSULE ENTEROSCOPY SM BOWEL W/ ILEUM            PROCED        683.70                     91110
GI LAB        7501804 0 CAPSULE ENTEROSCOPY SM BOWEL NO ILEUM            PROCED        683.70                     9111052
GI LAB        7501648 0 ANORECTAL MANOMETRY                              PROCED        467.44                     91122
GI LAB        7501291 0 CONSCIOUS SED SAME MD > OR = 5 Y/O 1ST 30 MIN    PROCED        170.00                     99144
GI LAB        7501292 0 CONSCIOUS SED SAME MD EA ADD'L 15 MIN (ALL AGES) PROCED        85.00                      99145
GI LAB        7504006 0 NEW LEV I 0-15 MIN                               LOC           54.84                      99201
GI LAB        7504007 0 NEW LEV II 15-30 MIN                             LOC           54.84                      99202
GI LAB        7504008 0 NEW LEV III 30-45 MIN                            LOC           63.10                      99203
GI LAB        7504009 0 NEW LEV IV 45-60 MIN                             LOC           91.81                      99204
GI LAB        7504010 0 NEW LEV V > 1 HR                                 LOC           91.81                      99205
GI LAB        7504001 0 EST LEV I 0-15 MIN                               LOC           40.00                      99211
GI LAB        7504002 0 EST LEV II 15-30 MIN                             LOC           40.00                      99212
GI LAB        7504003 0 EST LEV III 30-45 MIN                            LOC           63.10                      99213
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
GI LAB        7504004 0 EST LEV IV 45-60 MIN                  LOC        91.81                       99214
GI LAB        7504005 0 EST LEV V > 1 HR                      LOC        91.81                       99215
GI LAB        7502033 0 HOWELL NEEDLE                         SUPPLY     354.75
GI LAB        7501113 0 GASTROVIEW CONTRAST SOLN PER 30 ML    SUPPLY     45.00
GI LAB        7502017 0 JEJUNAL TUBE                          SUPPLY     312.00
GI LAB        7502016 0 PEG TUBE                              SUPPLY     190.90
GI LAB        7502028 0 RAPID EXCHANGE RETRIEVL BALLOON       SUPPLY     309.60                      C1726
GI LAB        7502029 0 RAPID EXCHNGE DILATION BALLOON        SUPPLY     535.35                      C1726
GI LAB        7501639 0 STENT PANCREATIC                      SUPPLY     282.50                      C1875
GI LAB        7503005 0 INFUSION THER NON-CHEMO 1ST HR        PROCED     236.00                      C8950
GI LAB        7503006 0 INFUSION THER NON-CHEMO EA ADD'L HR   PROCED     142.00                      C8951
GI LAB        7501258 0 CA SCREEN FLEX SIG                    PROCED     525.92                      G0104
GI LAB        7501621 0 CA SCREEN COLONOSCOPY HIGH-RISK PT    PROCED     999.90                      G0105
GI LAB        7501622 0 CA SCREEN COLONOSCOPY                 PROCED     1,500.00                    G0121
GI LAB        7501133 0 EPINEPHRINE 1:1000 INJ 1 ML           MED        45.00                       J0170
GI LAB        7501117 0 AMPICILLIN IVPB 500 MG                MED        23.20                       J0290
GI LAB        7501118 0 UNASYN IVPB 1.5 GM                    MED        50.00                       J0295
GI LAB        7501219 0 BOTULINUM TOXIN A INJ PER UNIT        MED        40.00                       J0585
GI LAB        7501130 0 PROCHLORPERAZINE INJ 10 MG            MED        30.63                       J0780
GI LAB        7501128 0 DIPHENHYDRAMINE INJ 50 MG             MED        25.00                       J1200
GI LAB        7501116 0 GENTAMYCIN IVPB 80 MG                 MED        35.00                       J1580
GI LAB        7501136 0 GLUCAGON INJ 1 MG                     MED        127.00                      J1610
GI LAB        7501139 0 HYDROCORTISONE INJ 100 MG             MED        25.00                       J1720
GI LAB        7501143 0 MIDAZOLAM INJ 2 MG                    MED        30.00                       J2250
GI LAB        7501137 0 NALOXONE INJ 0.4 MG                   MED        32.00                       J2310
GI LAB        7501147 0 SECRETIN 1 MCG INJ                    MED        55.90                       J2850
GI LAB        7501218 0 FENTANYL INJ 100 MCG                  MED        50.00                       J3010
GI LAB        7501141 0 CHLORPROMAZINE INJ 25 MG              MED        55.00                       J3230
GI LAB        7501120 0 TRIAMCINOLONE ACET INJ 10 MG          MED        36.25                       J3301
GI LAB        7501142 0 DIAZEPAM INJ 10 MG                    MED        16.00                       J3360
GI LAB        7501121 0 IV 0.9% NS 1000 ML                    SUPPLY     70.00                       J7030
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION             CATEGORY   OUTPT)          LML/RML     CPT
GI LAB        7501122 0 IV 0.9% NS 500 ML              SUPPLY     70.00                       J7040
GI LAB        7501123 0 IV 0.9% NS 250 ML              SUPPLY     60.00                       J7050
GI LAB        7501124 0 IV D5W 500 ML                  SUPPLY     80.00                       J7060
GI LAB        7501125 0 IV D5W 1000 ML                 SUPPLY     70.00                       J7070
GI LAB        7501126 0 IV LR 1000 ML                  SUPPLY     70.00                       J7120
GI LAB        7501114 0 CATH NASOBILIARY DRNGE SET     SUPPLY     282.00
GI LAB        7501115 0 CLINDAMYCIN IVPB 600 MG        MED        22.00
GI LAB        7501119 0 LIDOCAINE 2% INJ 20 ML         MED        25.50
GI LAB        7501127 0 ATROPINE INJ 0.4 MG            MED        15.00
GI LAB        7501129 0 CETACAINE SPRAY                MED        40.00
GI LAB        7501131 0 MEPERIDINE INJ 50 MG           MED        20.00
GI LAB        7501134 0 EPINEPHRINE 1:10,000 SYRINGE   MED        40.50
GI LAB        7501135 0 ETHAMOLIN INJ 2 ML             MED        100.00
GI LAB        7501138 0 FLUMAZENIL INJ 1 MG            MED        170.00
GI LAB        7501140 0 BUTORPHANOL INJ 2 MG           MED        50.00
GI LAB        7501144 0 LIDOCAINE JELLY 2% 5 ML        MED        45.50
GI LAB        7501145 0 IV D5W 250 ML                  MED        65.00
GI LAB        7501260 0 OXYGEN PER HOUR                SUPPLY     50.00
GI LAB        7501280 0 PILL CAM (ESO)                 SUPPLY     1,000.00
GI LAB        7501633 0 WALL STENT BILIARY             SUPPLY     3,281.90
GI LAB        7501634 0 WALLSTENT 60                   SUPPLY     3,750.00
GI LAB        7501635 0 STENT ESOPHAGEAL               SUPPLY     4,062.50
GI LAB        7501637 0 WALLSTENT 90                   SUPPLY     3,750.00
GI LAB        7501700 0 GI RECOVERY 1ST 30MIN          TIME       200.00
GI LAB        7501701 0 GI RECOVERY ADD'L 15MIN        TIME       20.00
GI LAB        7502004 0 CYTOLOGY BRUSH                 SUPPLY     88.10
GI LAB        7502005 0 PROBE BICAP (GOLD PROBE)       SUPPLY     454.40
GI LAB        7502006 0 CRE (BALLOON)                  SUPPLY     587.75
GI LAB        7502007 0 BICAP(GOLD PRB & SCLERO NDL)   SUPPLY     631.20
GI LAB        7502008 0 FORCEPS-DISP                   SUPPLY     63.40
GI LAB        7502009 0 SNARE-DISP                     SUPPLY     52.80
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
GI LAB        7502010 0 HOT BIOPSY-DISP                        SUPPLY     117.40
GI LAB        7502011 0 NEEDLE SCLERO                          SUPPLY     120.00
GI LAB        7502013 0 BANDING KIT                            SUPPLY     506.25
GI LAB        7502014 0 ERBE PROBE                             SUPPLY     475.00
GI LAB        7502015 0 DECOMPRESSION TUBE                     SUPPLY     282.50
GI LAB        7502018 0 ERCP CATHETER                          SUPPLY     115.00
GI LAB        7502019 0 DBL LUMEN SPHINCTEROTOMY               SUPPLY     295.00
GI LAB        7502021 0 EXTRACTION BALLOON                     SUPPLY     295.00
GI LAB        7502022 0 STENT BILIARY                          SUPPLY     297.50
GI LAB        7502023 0 STENT PIGTAIL                          SUPPLY     282.50
GI LAB        7502024 0 STENT DOUBLE PIGTAIL                   SUPPLY     272.50
GI LAB        7502025 0 BILIARY BALLOON DIALATOR               SUPPLY     697.50
GI LAB        7502026 0 STENT COLON/RECTAL                     SUPPLY     3,450.00
GI LAB        7502027 0 RAPID EXCHANGE AUTOTOME                SUPPLY     860.00
GI LAB        7502030 0 NEEDLE KNIFE SPHINCTER TOME            SUPPLY     301.00
GI LAB        7502031 0 LITHOTRIPTOR STONE CRUSHER             SUPPLY     650.00
GI LAB        7502032 0 CODE BLUE LAVAGE                       SUPPLY     196.87
GI LAB        7502034 0 CYTOMAX DOUBLE LUMEN BRUSH             SUPPLY     347.50
GI LAB        7502035 0 WEB BASKET                             SUPPLY     387.00
GI LAB        7502036 0 CAPSULE ENDOSCOPE DEVICE (DISP)        SUPPLY     1,000.00
GI LAB        7502037 0 TRIPOD FORCEP (CAESER GRASP)           SUPPLY     282.00
GI LAB        7502038 0 NEEDLE (ACCESS PORT NDL) 20G x 89 MM   SUPPLY     40.00
GI LAB        7502039 0 NEEDLE ECHOTIP (US FNA NDLE)           SUPPLY     418.75
GI LAB        7502040 0 ENDOCLIP                               SUPPLY     225.00
GI LAB        7502041 0 NEEDLE QUICKCORE (US FNA NDLE)         SUPPLY     665.00
GI LAB        7502042 0 SPOT ENDOSCOPIC MARKER                 SUPPLY     47.00
GI LAB        7502043 0 SITZ MARKS CAPSULE EA                  SUPPLY     15.00
GI LAB        7502044 0 ENDOSCOPY OVERTUBE EA                  SUPPLY     268.75
GI LAB        7502045 0 MUCOSECTOMY BAND KIT DUETT             SUPPLY     569.75
GI LAB        7502046 0 TRICLIP                                SUPPLY     225.00
GI LAB        7503001 0 PEDS PEG KIT                           SUPPLY     810.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY       OUTPT)          LML/RML     CPT
L&D           7202715 0 FETAL PULSE OXIMETRY (OXI-FIRST)        PROCED         318.27                      0021T
L&D           7205732 0 ART LINE INSERTION                      PROCED         174.93                      36620
L&D           7205746 0 AMNIOCENTESIS                           PROCED         438.84                      59000
L&D           7203722 0 AMNIO FLUID REDUCTION                   PROCED         260.00                      59001
L&D           7207740 0 CONTRACTION STRESS TEST (NON U/S)       PROCED         260.00                      59020
L&D           7205753 0 NST MULTI (NON-STRESS TEST)             PROCED         261.20                      59025
L&D           7207741 0 NST SINGL (NON STRESS TEST)             PROCED         261.20                      59025
L&D           7207750 0 FETAL MONITR DURING LABOR W/ REPORT     PROCED         303.18                      59050
L&D           7203723 0 EXTERNAL CEPHALIC VERSION               PROCED         258.00                      59412
L&D           7205760 0 EPIDURAL INJ BLOOD / CLOT PATCH         PROCED         349.65                      62273
L&D           7205733 0 US PREG < 14 WKS SINGL GEST             PROCED         100.00                      76801
L&D           7205734 0 US PREG < 14 WKS EA ADD'L GEST          PROCED         197.35                      76802
L&D           7205735 0 US PREG > 14 WKS SING GEST              PROCED         394.70                      76805
L&D           7205736 0 US PREG > 14 WKS EA ADD'L GEST          PROCED         682.25                      76810
L&D           7205737 0 US PREG DETAILED 1ST GEST               PROCED         435.10                      76811
L&D           7205738 0 US PREG DETAILED EA ADD'L GEST          PROCED         274.00                      76812
L&D           7205739 0 US PREG LTD, ONE OR MORE FETUS          PROCED         350.71                      76815
L&D           7205741 0 US PREG TRANSVAGINAL                    PROCED         100.00                      76817
L&D           7205745 0 BIOPHYSICAL PROFILE SING W/ NST         PROCED         419.50                      76818
L&D           7205752 0 BIOPHYSICAL PROFILE MULTI W/ NST        PROCED         419.50                      76818
L&D           7205730 0 BIOPHYSICAL PROFILE W/O NST             PROCED         100.00                      76819
L&D           7205748 0 AMNIOCENTESIS ULTRASONIC GUIDANCE       PROCED         368.20                      76946
L&D           7202770 0 FETAL FIBRONECTIN (FFIB)                              296.55
                                                                WAIVED TEST DON                            82731
L&D           7205759 0 INJ FEE MTX MED SQ / IM                 PROCED         155.25                      90772
L&D           7205749 0 DOPPLER PREGNANCY COMPLETE              PROCED         611.59                      93975
L&D           7205750 0 DOPPLER PREGNANCY LTD                   PROCED         405.22                      93976
L&D           7205758 0 ASSESSMENT / COUNSELING MTX TREATMENT   PROCED         100.00                      99242
L&D           7201710 0 DELIVERY ROOM 1ST 1/2 HR                TIME           966.86
L&D           7201711 0 DELIVERY ROOM ADD'L 1/4 HR              TIME           274.77
L&D           7201713 0 SUT CHROMIC 2-0*54 TIE (S113H)          SUPPLY         14.11
L&D           7201714 0 SUT PDS LOOP 0*60 CTX                   SUPPLY         9.89
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
L&D           7201715 0 SUT ETHICON 1 PROXIMT PXW 35       SUPPLY     33.58
L&D           7201716 0 NEEDLES MAYO 1/2 TAPER             SUPPLY     8.86
L&D           7201717 0 SUT GORTEX EA CV2 #2 NO5B THX 26   SUPPLY     5.15
L&D           7201718 0 SUT GORTEX EA CV2 #2NO6B THX 26    SUPPLY     5.36
L&D           7201719 0 SUT PDS 1*36 CT                    SUPPLY     18.03
L&D           7201720 0 BAG ISOLATION CONVERTOR            SUPPLY     1.64
L&D           7201721 0 HANDLE EZ LIGHT DISP               SUPPLY     1.85
L&D           7201722 0 SYRINGE CONTROL 10 CC              SUPPLY     2.58
L&D           7201723 0 PACK PERI-GYN                      SUPPLY     23.07
L&D           7201724 0 DRSG TELFA                         SUPPLY     0.51
L&D           7201725 0 PACK C/S                           SUPPLY     271.20
L&D           7201726 0 PACK OB                            SUPPLY     51.76
L&D           7201727 0 PBDS CUSTOM URO-GYNE               SUPPLY     630.67
L&D           7202712 0 LD/PULSE OXIMETER                  SUPPLY     82.22
L&D           7202713 0 VACUUM EXTRACTOR                   SUPPLY     80.84
L&D           7202766 0 L&D SUPPLIES TYPE 1                SUPPLY     421.71
L&D           7202768 0 SUCTION CURETTAGE                  SUPPLY     92.91
L&D           7203717 0 RECOVERY ROOM ADDL 1/2 HR          TIME       265.53
L&D           7203721 0 RECOVERY ROOM 1ST 2 HRS            TIME       1,163.49
L&D           7206734 0 DELIVERY RM EMERGENCY SURGERY      PROCED     310.75
L&D           7207720 0 L & D LOCAL                        PROCED     76.70
L&D           7207742 0 HIGH RISK CARE 0-4 HOURS           PROC       734.98
L&D           7207743 0 HIGH RISK CARE 4-8 HOURS           PROC       970.20
L&D           7207744 0 HIGH RISK CARE 8-12 HRS            PROC       1,103.02
L&D           7207745 0 HIGH RISK CARE 12-24 HOURS         PROC       1,469.99
L&D           7207751 0 LABOR/DELIVERY SVCS 0-4 HRS        PROC       492.90
L&D           7207752 0 LABOR/DELIVERY SVCS 4-8 HRS        PROC       650.55
L&D           7207753 0 LABOR/DELIVERY SVCS 8-12HRS        PROC       738.39
L&D           7207754 0 LABOR/DELIVERY SVCS 12-24HRS       PROC       984.83
L&D           7207755 0 BIRTHING ROOM DEL/REC              PROCED     2,061.61
L&D           7207758 0 L&D PRE-SURGERY HOLDING            PROCED     207.44
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /      LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)             LML/RML     CPT
L&D            7209760 0 PERCUT UMBILICAL BLOOD                    PROCED     388.62
L&D            7202711 2 PREEMIE RESUSCITATION PACK                SUPPLY     STATISTICAL ITEM
L&D            7202714 2 NEWBORN RES PACK                          SUPPLY     STATISTICAL ITEM
L & D LACTATIO 7210764  0 OP - LACTATION FOLLOW-UP (15 MIN)        PROCED     55.00                          99241
L & D LACTATIO 7210762  0 OP - LACTATION SERV FEE RT (30 MIN)      PROCED     75.65                          99242
L & D LACTATIO 7210763  0 OP - LACTATION SERV FEE COMP (1 HR)      PROCED     222.49                         99245
L & D LACTATIO 7210765  0 BREAST SHIELDS REGULAR                   SUPPLY     11.54
L & D LACTATIO 7210768  2 IP - LACTATION SERV FEE RT (30 MIN)      PROC       STATISTICAL ITEM
L & D LACTATIO 7210769  2 IP - LACTATION FOLLOW-UP (15 MIN)        PROC       STATISTICAL ITEM
LAB APHERESIS 9520002   0 DUAL LUMEN CATH INSERT (DLCATH           PROCED     1,027.60                       36489
LAB APHERESIS 9520001   0 LEUKAPHERESIS                            PROCED     762.79                         36511
LAB APHERESIS 9520021   0 ERYTHROCYTPHERESIS                       PROCED     1,231.80                       36512
LAB APHERESIS 9520022   0 PLATELET PHERESIS                        PROCED     1,315.20                       36513
LAB APHERESIS 9520023   0 PLASMA PHERESIS                          PROCED     1,049.50                       36514
LAB APHERESIS 9520010   0 THERAPEU APHEU;W/COLUM(PROSRB)           PROCED     2,237.65                       36516
LAB APHERESIS 9520020   0 LDL PHERESIS                             PROCED     4,048.40                       36516
LAB APHERESIS 9520008   0 PHOTOPHERESIS                            PROCED     2,237.65                       36522
LAB APHERESIS 9520005   0 PERIPH STEM CELL HARV, ALLOG (STMALLO)   PROCED     1,691.80                       38205
LAB APHERESIS 9520014   0 PERIPH STEM CELL HARV, AUTOL (STMAUT)    PROCED     1,691.80                       38206
LAB APHERESIS 9520035   0 INFUSION THER NON-CHEMO 1ST HR           PROCED     236.00                         C8950
LAB APHERESIS 9520036   0 INFUSION THER NON-CHEMO EA ADD'L HR      PROCED     142.00                         C8951
LAB APHERESIS 9520037   0 INFUSION THER CHEMO 1ST HR               PROCED     264.00                         C8954
LAB APHERESIS 9520038   0 INFUSION THER CHEMO EA ADD'L HR          PROCED     158.00                         C8955
LAB BLOOD BAN 3001489   0 LAB ABSCN                                PROCED     85.00              21.63       86850
LAB BLOOD BAN 3001800   0 LAB ELU                                  PROCED     76.33              94.68       86860
LAB BLOOD BAN 3001343   0 LAB ABI                                  PROCED     179.96             97.30       86870
LAB BLOOD BAN 3001804   0 LAB PANEL                                PROCED     179.96             64.67       86870
LAB BLOOD BAN 3001490   0 LAB DAT                                  PROCED     54.38              8.57        86880
LAB BLOOD BAN 3001496   0 COOMBS INDIRECT,QL EACH (FBS)            PROCED     64.10              17.60       86885
LAB BLOOD BAN 3001345   0 LAB ABTR                                 PROCED     125.82             8.70        86886
LAB BLOOD BAN 3002106   0 AUTOL BLD, COLL PROC STOR                PROCED     236.18             154.00      86890
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
LAB BLOOD BAN 3001350  0 LAB BLOOD TYPING,ABO                   PROCED     41.72           7.63        86900
LAB BLOOD BAN 3001480  0 LAB BLOOD TYPING,RH                    PROCED     37.61           7.25        86901
LAB BLOOD BAN 3001234  0 RBC ANTIGENS, NOT ABO/RH EA (AO/AGI)   PROCED     50.22           6.33        86905
LAB BLOOD BAN 3001492  0 COMPATIBILITY TEST, EA, IMM SPN (XM)   PROCED     131.94          10.11       86920
LAB BLOOD BAN 3004710  0 FRESH FROZEN PLASMA THAW               PROCED     16.00           9.51        86927
LAB BLOOD BAN 3004809  0 RBC FREEZE (FREEZE)                    PROCED     76.20           76.20       86930
LAB BLOOD BAN 3004721  0 BLOOD PRODUCT IRRADIATION,EA           PROCED     75.00           27.40       86945
LAB BLOOD BAN 3004720  0 BLOOD PRODUCT POOLING (POOL)           PROCED     50.30           35.08       86965
LAB BLOOD BAN 3004811  0 SPLITTING OF BLOOD PROD (SPLIT         PROCED     14.00           9.70        86985
LAB BLOOD BAN 3002108  0 LAB THERA                              PROCED     155.47          69.80       99195
LAB BLOOD BAN 3003494  0 LAB BWB                                PROCED     151.10          151.10      P9010
LAB BLOOD BAN 3004702  0 RBC SPLIT UNIT < OR = 200 ML           SUPPLY     87.11           68.00       P9011
LAB BLOOD BAN 3003578  0 CRYOT                                  SUPPLY     106.30          53.00       P9012
LAB BLOOD BAN 3003678  0 BLOOD,LEUKOREDUCED                     SUPPLY     324.00          237.00      P9016
LAB BLOOD BAN 3002009  0 LAB SDFFP                              PROCED     158.00          158.00      P9017
LAB BLOOD BAN 3002010  0 FRESH FROZ PLASMA,PEDS                 SUPPLY     123.40          45.90       P9017
LAB BLOOD BAN 3003577  0 FP                                     SUPPLY     123.40          81.00       P9017
LAB BLOOD BAN 3003575  0 PL                                     SUPPLY     267.60          69.00       P9019
LAB BLOOD BAN 3003495  0 PC                                     SUPPLY     287.14          197.00      P9021
LAB BLOOD BAN 3003680  0 WASHED RED CELLS                       SUPPLY     429.30          200.00      P9022
LAB BLOOD BAN 3003676  0 PLATELET,IRRAD,EA UNIT                 SUPPLY     94.00           94.00       P9032
LAB BLOOD BAN 3002007  0 PLATELETS PHERESIS, EA (SDP1,SDP5)     PROCED     1,063.26        523.00      P9034
LAB BLOOD BAN 3003671  0 PLATELETS PHERESIS-XM COMPATIB         PROCED     1,063.26        1,052.70    P9034
LAB BLOOD BAN 3004700  0 HLA MATCH/SING DON PLT PROC FE         PROCED     1,482.00        1,482.00    P9034
LAB BLOOD BAN 3003674  0 PLATELET APH,LR,UNIT                   SUPPLY     1,233.20        545.00      P9035
LAB BLOOD BAN 3003673  0 PLATELET APH,IRRAD                     PROCED     577.80          530.00      P9036
LAB BLOOD BAN 3003675  0 PLT,APH,LR,IRRAD,UNIT                  SUPPLY     1,898.30        550.00      P9037
LAB BLOOD BAN 3003677  0 RED CELLS,IRRAD,EA UNIT                SUPPLY     627.00          198.00      P9038
LAB BLOOD BAN 3003679  0 BLOOD,LR,IRRAD                         SUPPLY     240.00          240.00      P9040
LAB BLOOD BAN 3002012  0 PLASMA,CRYO REDUCED                    PROCED     149.00          89.60       P9044
LAB BLOOD BAN 3002008  0 GRANULOPHERESIS PROCESS (GR)           PROCED     1,313.39        1,313.39    P9050
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
LAB BLOOD BAN 3003672  0 PLATELET APH,HLA-MATCH LR           PROCED     639.00          639.00      P9052
LAB BLOOD BAN 3004237  0 MISC BLOOD BANK                     PROCED     0.00            0.00
LAB CHEM      3028685 0 BASIC METABOLIC PANEL (BMPP)         PROCED     115.35          11.19       80048
LAB CHEM      3025266 0 ELECTROLYTE PANEL (LYT)              PROCED     74.55           4.44        80051
LAB CHEM      3028686 0 COMP METABOLIC PANEL (CMPP)          PROCED     169.50          12.65       80053
LAB CHEM      3026249 0 LIPID PANEL (LPR)                    PROCED     120.63          6.48        80061
LAB CHEM      3028688 0 RENAL FUNCTION PANEL (RFPP)          PROCED     149.86          11.19       80069
LAB CHEM      3028687 0 LIVER FUNCTION PANEL (LFPP)          PROCED     117.92          10.09       80076
LAB CHEM      3020597 0 DRUG SCRN EA DRG CLASS EIA (DRUGU)   PROCED     25.50           4.42        80101
LAB CHEM      3020130 0 AMIKACIN RANDOM (AMIKAR)             PROCED     122.24          9.35        80150
LAB CHEM      3020579 0 AMIKACIN TROUGH (AMITR)              PROCED     122.24          9.35        80150
LAB CHEM      3020580 0 AMIKACIN PEAK (AMIKAP)               PROCED     122.24          9.35        80150
LAB CHEM      3020581 0 CARBAMAZEPINE (CARB)                 PROCED     136.02          9.35        80156
LAB CHEM      3024737 0 DIGOXIN (DIG)                        PROCED     108.00          14.57       80162
LAB CHEM      3020592 0 VALPROIC ACID (VAL)                  PROCED     115.45          14.52       80164
LAB CHEM      3020131 0 GENTAMICIN, RANDOM (GENTAR)          PROCED     123.20          9.35        80170
LAB CHEM      3020583 0 GENTAMICIN, PEAK (GENTAP)            PROCED     123.20          9.35        80170
LAB CHEM      3020596 0 GENTAMYCIN TROUGH (GENTTR)           PROCED     123.20          9.35        80170
LAB CHEM      3020814 0 LIDOCAINE (LIDO)                     PROCED     106.50          24.58       80176
LAB CHEM      3024357 0 LITHIUM (LI)                         PROCED     70.86           21.49       80178
LAB CHEM      3020584 0 PHENOBARBITAL (PHENO)                PROCED     120.80          9.35        80184
LAB CHEM      3020585 0 PHENYTOIN, TOTAL (PHENY)             PROCED     120.16          9.35        80185
LAB CHEM      3020039 0 FREE PHENYTOIN (FPHY)                PROCED     67.77           51.50       80186
LAB CHEM      3026283 0 SALICYLATE (SALIC)                   PROCED     82.17           5.32        80196
LAB CHEM      3020589 0 THEOPHYLLINE (THEO)                  PROCED     115.57          9.35        80198
LAB CHEM      3020132 0 TOBRAMYCIN, RANDOM (TOBRAR)          PROCED     133.92          9.35        80200
LAB CHEM      3020590 0 TOBRAMYCIN TROUGH (TOBTR)            PROCED     133.92          9.35        80200
LAB CHEM      3020591 0 TOBRAMYCIN PEAK (TOBRAP)             PROCED     133.92          9.35        80200
LAB CHEM      3020133 0 VANCOMYCIN, RANDOM (VANCR)           PROCED     124.00          9.35        80202
LAB CHEM      3020593 0 VANCOMYCIN TROUGH (VANCTR)           PROCED     124.00          9.35        80202
LAB CHEM      3020594 0 VANCOMYCIN PEAK (VANCOP)             PROCED     124.00          9.35        80202
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
LAB CHEM      3020150 0 METHOTREXATE, DRUG QT (MTX)      PROCED     136.05          121.76      80299
LAB CHEM      3020600 0 VOL MEASURE/TIMED COLLEC(VOLM)   PROCED     21.06           13.92       81050
LAB CHEM      3020009 0 ACETAMINOPHEN (ACETAM)           PROCED     143.55          21.85       82003
LAB CHEM      3020204 0 KETONE, QT, BETAHYDROXYBU (BHB   PROCED     47.66           27.51       82010
LAB CHEM      3024228 0 ACETONE, QT, (ACET)              PROCED     41.10           5.50        82010
LAB CHEM      3026936 0 ALBUMIN, SERUM (ALB)             PROCED     37.26           3.71        82040
LAB CHEM      3026006 0 ALBUMIN,ASCITES FL (AALB)        PROCED     46.98           5.54        82042
LAB CHEM      3026232 0 ETHANOL, NOT BREATH (ETOH)       PROCED     122.96          23.00       82055
LAB CHEM      3024291 0 ALDOLASE (ALD)                   PROCED     83.30           56.35       82085
LAB CHEM      3026290 0 AMMONIA (AMON)                   PROCED     89.40           5.23        82140
LAB CHEM      3024202 0 AMYLASE (AMY)                    PROCED     80.84           5.77        82150
LAB CHEM      3024271 0 BILIRUBIN, TOTAL (TBIL)          PROCED     27.00           3.71        82247
LAB CHEM      3024620 0 BILIRUBIN, DIRECT (DBIL)         PROCED     35.10           3.71        82248
LAB CHEM      3024206 0 CALCIUM TOTAL (CA, RUCA)         PROCED     44.23           3.71        82310
LAB CHEM      3020095 0 CALCIUM, IONIZED (ICAL)          PROCED     104.39          7.14        82330
LAB CHEM      3024440 0 CALCIUM, URINE, QT, TIMED (UCA   PROCED     55.43           8.05        82340
LAB CHEM      3024615 0 BICARBONATE (BICARB)             PROCED     29.70           6.91        82374
LAB CHEM      3025702 0 CARBON DIOXIDE (C020)            PROCED     29.70           5.50        82374
LAB CHEM      3025208 0 CHLORIDE, BLOOD (CL)             PROCED     40.90           5.50        82435
LAB CHEM      3025668 0 CHLORIDE, URINE                  PROCED     39.38           8.89        82436
LAB CHEM      3025136 0 CHLORIDE OTHER (FCL)             PROCED     39.38           8.89        82438
LAB CHEM      3026209 0 CHOLESTEROL, SERUM, TOTAL(CHOL   PROCED     38.18           3.71        82465
LAB CHEM      3024237 0 CREATINE KINASE, TOTAL (CK)      PROCED     53.47           3.71        82550
LAB CHEM      3024445 0 CK, MB FRACTION (CKMB)           PROCED     101.40          19.29       82553
LAB CHEM      3025212 0 CREATININE, BLOOD (CR)           PROCED     40.06           3.71        82565
LAB CHEM      3025432 0 CREATININE, OTHER SOURCE (DUCR   PROCED     50.87           8.89        82570
LAB CHEM      3025801 0 CREATININE CLEARANCE (CRCL)      PROCED     104.33          10.81       82575
LAB CHEM      3025703 0 GASES, BLOOD, PH ONLY (PH)       PROCED     39.70           6.86        82800
LAB CHEM      3020010 0 GASES, BLOOD, MX VEN (MVBG)      PROCED     184.85          98.60       82803
LAB CHEM      3025390 0 GASES, BLOOD, ARTERIAL (ABG)     PROCED     184.85          7.14        82803
LAB CHEM      3025800 0 ABG W 02 SAT (ABGCOX)            PROCED     152.48          10.37       82805
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
LAB CHEM      3024099 0 LAB SAT                          PROCED     51.70           51.69       82810
LAB CHEM      3026234 0 GLUCOSE BODY FLUID (UGLU)        PROCED     44.24           8.10        82945
LAB CHEM      3025214 0 GLUCOSE, QUANTITATIVE (GLU)      PROCED     39.49           3.71        82947
LAB CHEM      3025238 0 GLUCOSE, POST GLUCOSE DOSE(2PP   PROCED     46.44           18.60       82950
LAB CHEM      3027301 0 GTT,3 SPECIMENS (GT3)            PROCED     112.86          51.50       82951
LAB CHEM      3027300 0 TOL TEST,EA ADDL>3(ADDGLU)       PROCED     28.35           18.60       82952
LAB CHEM      3024909 0 GGT (GT)                         PROCED     37.73           3.71        82977
LAB CHEM      3024340 0 PLASMA FREE HEMOGLOBIN (PFHGB)   PROCED     69.80           15.75       83051
LAB CHEM      3026239 0 IRON (FE)                        PROCED     56.65           7.84        83540
LAB CHEM      3026380 0 LACTIC ACID (LA)                 PROCED     61.20           5.23        83605
LAB CHEM      3024215 0 LDH (LDH)                        PROCED     42.00           3.71        83615
LAB CHEM      3026280 0 LIPASE (LIPAS)                   PROCED     78.29           11.95       83690
LAB CHEM      3026210 0 LIPO HIGH DENS CHOL (HDLC)       PROCED     45.00           11.50       83718
LAB CHEM      3026141 0 DIRECT LDL                       PROCED     47.42           19.50       83721
LAB CHEM      3024217 0 MAGNESIUM (MG/UMG/RUMG)          PROCED     53.95           3.46        83735
LAB CHEM      3020813 0 MYOGLOBIN (MYO/MGB)              PROCED     84.24           10.54       83874
LAB CHEM      3026937 0 B-NATRIURETIC PEPTID (BNP)       PROCED     75.00           30.77       83880
LAB CHEM      3024218 0 OSMOLALITY, BLOOD (OSMO)         PROCED     66.80           8.71        83930
LAB CHEM      3024148 0 OSMOLALITY, URINE (UOSMO)        PROCED     68.50           10.38       83935
LAB CHEM      3025391 0 PH BODY FLUID (FPH)              PROCED     33.16           6.86        83986
LAB CHEM      3024201 0 ALKALINE PHOSPHATASE             PROCED     39.68           3.71        84075
LAB CHEM      3024409 0 PHOSPHORUS INORGANIC (PHOS)      PROCED     37.43           3.71        84100
LAB CHEM      3024134 0 PHOSPHOROUS UR (UPHOS, RUPHOS)   PROCED     51.83           5.50        84105
LAB CHEM      3025395 0 POTASSIUM, SERUM (K)             PROCED     37.10           3.71        84132
LAB CHEM      3025135 0 POTASSIUM, URINE                 PROCED     42.70           8.89        84133
LAB CHEM      3024223 0 PROTEIN TOTAL SERUM              PROCED     49.46           3.71        84155
LAB CHEM      3024136 0 PROTEIN TOTAL UR (UP, RUP)       PROCED     39.40           6.37        84156
LAB CHEM      3024069 0 PROT, TTL, FLD (CP, FP, ASCP)    PROCED     39.40           6.37        84157
LAB CHEM      3025225 0 SODIUM, SERUM (NA)               PROCED     40.00           5.50        84295
LAB CHEM      3025133 0 SODIUM, URINE                    PROCED     42.70           8.89        84300
LAB CHEM      3025206 0 SODIUM, OTHER (FNA, FENA)        PROCED     42.70           5.50        84302
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
LAB CHEM       3024996 0 THIOCYANATE (THIOCY)                  PROCED     104.20          32.40       84430
LAB CHEM       3024071 0 THYROXINE (T4)                        PROCED     63.96           8.34        84436
LAB CHEM       3024072 0 THYROID STIM HORMONE (TSH)            PROCED     131.93          9.10        84443
LAB CHEM       3024226 0 AST / SGOT (SGOT)                     PROCED     43.33           3.60        84450
LAB CHEM       3024227 0 ALT / SGPT (SGPT)                     PROCED     42.34           3.71        84460
LAB CHEM       3026233 0 TRANSFERRIN (TRAN)                    PROCED     80.55           14.21       84466
LAB CHEM       3026356 0 TRIGLYCERIDES                         PROCED     39.40           3.71        84478
LAB CHEM       3024070 0 TRIIODOTHYRONINE (T3)                 PROCED     121.68          9.91        84480
LAB CHEM       3024736 0 TROPONIN, QUANTITATIVE (TROPI)        PROCED     111.11          11.71       84484
LAB CHEM       3025205 0 UREA NITROGEN, QT (BUN)               PROCED     37.59           3.71        84520
LAB CHEM       3024142 0 UREA NITROGEN UR (UUN/RUUN)           PROCED     46.44           5.37        84540
LAB CHEM       3026231 0 URIC ACID (URIC)                      PROCED     36.94           3.71        84550
LAB CHEM       3026147 0 URIC ACID OTHER (UURIC, RUURIC)       PROCED     53.31           4.80        84560
LAB CHEM       3024386 0 BETA HCG, QUANT (BHCG)                PROCED     141.00          6.41        84702
LAB CHEM       3020001 0 STAT COURIER CHARGE                   PROCED     0.00            0.00
LAB CHEM       3020002 0 LAB STATOS (LAB OUTSIDE TEST)         PROCED     17.00           16.30
LAB CHEM       3024067 0 LAB SPINH                             PROCED     14.00           14.00
LAB CHEM       3024068 0 LAB FRZ                               PROCED     28.00           28.00
LAB CHEM       3024093 0 LAB SPNO                              PROCED     5.00            5.00
LAB CYTOGENE   3070690 0 TISSUE CULT NON-NEO,LYMP(TSCUL        PROCED     518.77          190.30      88230
LAB CYTOGENE   3071200 0 TISSUE CULT NON-NEO, LYMP (FISHTEL)   PROCED     518.80          206.60      88230
LAB CYTOGENE   3070691 0 TISS CUL NON-NEO,SKI/TIS(TCULT        PROCED     305.28          305.28      88233
LAB CYTOGENE   3070693 0 TISSUE CULT NON-NEO,AF(TCULTA)        PROCED     721.50          270.40      88235
LAB CYTOGENE   3070689 0 TISSUE CULT NEOPLA,B/BM(TCULTB        PROCED     618.90          193.88      88237
LAB CYTOGENE   3070688 0 TISSUE CULT NEOPL,TISSU(TCULTT        PROCED     363.82          259.50      88239
LAB CYTOGENE   3070706 0 CRYOPRESERVATION,PER CELL LINE        PROCED     169.10          28.70       88240
LAB CYTOGENE   3070708 0 CHROM,ANL,5 CELLS,1 KAR(CHR5K1        PROCED     414.65          271.29      88261
LAB CYTOGENE   3070709 0 CHROM ANL,15 CELLS,2 KA(CH15K2        PROCED     610.80          191.32      88262
LAB CYTOGENE   3070710 0 CHROM ANL,INSITU, 1 KAR(CINSIT        PROCED     815.00          270.40      88269
LAB CYTOGENE   3070711 0 MOL CYTOGENETICS,DNA PR(CYGDNA        PROCED     143.38          90.00       88271
LAB CYTOGENE   3071199 0 MOL CYTOGEN, DNA PRB, EA (FISHTEL)    PROCED     99.20           25.66       88271
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML        CPT
LAB CYTOGENE   3070714 0 CHROM INSITU 10-30 CELLS                   PROCED     222.22          199.80         88273
LAB CYTOGENE   3071198 0 MOL CYT; CHRM INSIT, 10-30 CLS (FISHTEL)   PROCED     222.20          57.00          88273
LAB CYTOGENE   3070713 0 INTERPHAS INSITU 100-300 CELLS             PROCED     318.32          199.80         88275
LAB CYTOGENE   3071211 0 CHROM ANAL, AD KARYOTYPE(KARYO             PROCED     57.24           57.24          88280
LAB CYTOGENE   3070019 0 LAB MISC TEST ACC                          PROCED     0.00            0.00
LAB CYTOLOGY   3101121 0 STAIN INCLUSION BODIES (TZANCK             PROCED     68.60           15.80          87207
LAB CYTOLOGY   3101664 0 CYTOPATH NONGYN (PAPNG)                    PROCED     122.30          95.40          88104
LAB CYTOLOGY   3101666 0 CYTOPATH CONCENTR TECH (SPCYP)             PROCED     146.60          56.20          88108
LAB CYTOLOGY   3101009 0 CYTOPATH NONGYNTP (PAPTPNG)                PROCED     100.00          56.20          88112
LAB CYTOLOGY   3101008 0 PAP THIN PREP DIAG (PAPTPD)                PROCED     77.71           37.90          88142
LAB CYTOLOGY   3101668 0 CYTOPATH SM OTHER SOURCE(CYSCR             PROCED     61.90           56.20          88161
LAB CYTOLOGY   3101663 0 PAP BETHESDA (PPDIAG)                      PROCED     45.90           12.00          88164
LAB CYTOLOGY   3101006 0 PAP DIAG RESCREEN (PPDIAR)                 PROCED     14.80           12.00          88165
LAB CYTOLOGY   3101678 0 FNA IMMED EVAL (CYADEQ)                    PROCED     134.80          92.60          88172
LAB CYTOLOGY   3101669 0 FNA INTERP AND REPORT (CYASP)              PROCED     247.50          56.20          88173
LAB CYTOLOGY   3101672 0 SURG PATH LEV 4 CELL BLOCK(YBK             PROCED     216.30          48.70          88305
LAB CYTOLOGY   3101671 0 SPECIAL STAIN GROUP I (CYSTN)              PROCED     86.30           27.10          88312
LAB CYTOLOGY   3101660 0 MORPHOMETRIC ANAL TUMOR(DNALSC             PROCED     218.60          218.60         88358
LAB CYTOLOGY   3101007 0 HPV IN SITU                                PROCED     191.50          191.50         88365
LAB CYTOLOGY   3101003 0 PAP THIN PREP (PAPTP)                      PROCED     77.71           37.90         G0123
LAB CYTOLOGY   3101004 0 PAP THINPREP RESCREEN (PAPTPR)             PROCED     77.71           37.90         G0143
LAB CYTOLOGY   3101675 0 PAPSCREEN/RESCREEN (PAPSCR)                PROCED     98.30           12.00       P3000 / 88164

LAB CYTOLOGY   3103236 0 LAB MISC CYTOLOGY                          PROCED     0.00            0.00
LAB HEME       3012100 0 UA W MICRO AUTOMATED (UA)                  PROCED     49.19           5.57           81001
LAB HEME       3012102 0 UA AUTO W/OMICRO (DIPSTK)                  PROCED     39.83           3.09           81003
LAB HEME       3011012 0 SPECIFIC GRAVITY, FLUID (FLSG)             PROCED     28.08           8.70           84315
LAB HEME       3012685 0 URINE REDUCING SUBSTANC (UREDS             PROCED     33.30           10.80          84376
LAB HEME       3012468 0 HCG, QUALITATIVE (PREG)                    PROCED     64.25           6.99           84703
LAB HEME       3011020 0 BLEEDING TIME (IVBYT)                      PROCED     68.30           40.80          85002
LAB HEME       3010081 0 MANUAL DIFFERENTIAL (DIFF)                 PROCED     49.92           8.55           85007
LAB HEME       3010038 0 BUFFY COAT WBC DIFF (BCD)                  PROCED     21.60           15.70          85009
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
LAB HEME      3010062 0 BLOOD COUNT NOT SPUN HCT(HCT)     PROCED     32.45           5.11        85014
LAB HEME      3011050 0 HEMOGLOBIN (HH)                   PROCED     34.56           3.96        85018
LAB HEME      3010015 0 CBC W AUTOMATED DIFF (CBCDF)      PROCED     74.26           6.49        85025
LAB HEME      3010810 0 CBC AUTOMATED W PLATELET (CBC)    PROCED     54.26           5.23        85027
LAB HEME      3010437 0 RETICULOCYTE CT, MANUAL (RETIC    PROCED     41.90           10.80       85044
LAB HEME      3010233 0 RETIC, FLOW CYTOMETRY (ARETIC)    PROCED     39.11           10.39       85045
LAB HEME      3012232 0 WBC COUNT (WBCO)                  PROCED     39.78           4.02        85048
LAB HEME      3012231 0 PLATELET COUNT, AUTO (PLTO)       PROCED     35.70           5.11        85049
LAB HEME      3011382 0 FIBRIN DEGREDATION PRODUC (FSP    PROCED     71.20           17.53       85362
LAB HEME      3012003 0 D-DIMER QUANT (DDIM)              PROCED     65.75           17.68       85379
LAB HEME      3011213 0 FIBRINOGEN ACTIVITY               PROCED     49.10           7.05        85384
LAB HEME      3011021 0 KLEIHAUER-BETKE (HGBFS)           PROCED     83.16           83.16       85460
LAB HEME      3011436 0 PROTHROMBIN TIME (PT)             PROCED     50.50           5.62        85610
LAB HEME      3010438 0 SEDIMENTATION RATE (ESR)          PROCED     41.14           4.16        85651
LAB HEME      3010439 0 SICKLE CELL (SIC)                 PROCED     50.79           7.00        85660
LAB HEME      3011435 0 PARTIAL THROMBOPLASTIN TI (PTT    PROCED     65.00           5.62        85730
LAB HEME      3010421 0 SMEAR, MALARIA (MAL)              PROCED     68.61           38.40       87207
LAB HEME      3013450 0 CELL CT, FLUID, W DIFF (FLCT)     PROCED     96.18           38.89       89051
LAB HEME      3012103 0 LEUKOCYTE CNT, FECAL (STLWBC)     PROCED     27.70           15.80       89055
LAB HEME      3013091 0 CRYSTAL ID FLUID (CRYSTALS)       PROCED     42.39           28.60       89060
LAB HEME      3012112 0 FAT STAIN, FECES                  PROCED     52.20           7.32        89125
LAB HEME      3010540 0 NASAL SMEAR FOR EOS (EOSM)        PROCED     37.40           5.10        89190
LAB HEME      3012630 0 OCCULT BLOOD;FECES 1-3(OBST)      PROCED     29.87           5.36        G0107
LAB HEME      3010065 0 CBC W/ DIFF NO PLT (CBDFNP)       PROCED     50.40           3.30        G0306
LAB HEME      3010066 0 CBC W/O PLT (CBCNP)               PROCED     50.40           3.30        G0307
LAB HISTOLOGY 3110001  0 STONE ANALYSIS, QUAL (STONE)     PROCED     123.30          25.40       82355
LAB HISTOLOGY 3110007  0 LAB OSLB                         PROCED     500.20          1,081.50    88025
LAB HISTOLOGY 3110070  0 OSL COMPLETE AUTOPSY             PROCED     655.60          2,163.00    88027
LAB HISTOLOGY 3110030  0 OSLBRAINS FRESH FIXED (OSLBFF)   PROCED     515.00          540.80      88037
LAB HISTOLOGY 3110069  0 FNA IMMED EVAL (PRBXA)           PROCED     134.80          82.80       88172
LAB HISTOLOGY 3113102  0 MOL CYTGN; DNA PRB (HER2NF)      PROCED     99.20           44.60       88271
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML     CPT
LAB HISTOLOGY 3113101  0 MOL CYG; ANLYZ25-99 (HER2NF)                 PROCED     183.10          72.40       88274
LAB HISTOLOGY 3110656  0 SURG PATH LEVEL 1(LEVEL1)                    PROCED     60.50           21.60       88300
LAB HISTOLOGY 3110017  0 SURG PATH LEVEL 2 (LEVEL2)                   PROCED     117.00          48.70       88302
LAB HISTOLOGY 3110657  0 SURG PATH LEVEL 3 (LEVEL3)                   PROCED     160.88          48.70       88304
LAB HISTOLOGY 3110072  0 SURG PATH LEVEL 4 (OSLBX)                    PROCED     216.30          64.90       88305
LAB HISTOLOGY 3110660  0 SURG PATH LEVEL 4 (LEVEL4)                   PROCED     216.27          76.50       88305
LAB HISTOLOGY 3110010  0 SURG PATH LEVEL 5 (LEVEL5)                   PROCED     349.50          129.80      88307
LAB HISTOLOGY 3110011  0 SURG PATH LEVEL 6 (LEVEL6)                   PROCED     464.30          500.20      88309
LAB HISTOLOGY 3110015  0 DECALCIFICATION (DECAL)                      PROCED     55.30           27.10       88311
LAB HISTOLOGY 3110014  0 SPECIAL STAIN GROUP I (STN1)                 PROCED     86.30           27.10       88312
LAB HISTOLOGY 3110103  0 SPECIAL STAIN GROUP II (STN2)                PROCED     72.53           61.80       88313
LAB HISTOLOGY 3112115  0 STAIN HISTOCHEM FROZEN (STFROZ               PROCED     134.10          98.50       88314
LAB HISTOLOGY 3112112  0 DETERMINATIVE HISTOCH ENZ(STN4               PROCED     135.80          125.00      88319
LAB HISTOLOGY 3112120  0 CONSLT & RPRT ON REF SLIDES (CONSLI)         PROCED     88.40           35.00       88321
LAB HISTOLOGY 3112111  0 CONSULT ON REFER MATER(CONSLP)               PROCED     159.90          121.70      88323
LAB HISTOLOGY 3112121  0 CNSLT COMP W/ RCRD/SPEC REV & RPT (CONCOM)   PROCED     259.20          50.00       88325
LAB HISTOLOGY 3110661  0 FROZEN SECTION SINGLE (FROZ)                 PROCED     123.90          130.60      88331
LAB HISTOLOGY 3110013  0 FROZEN SECTION EA ADD (FROZAD)               PROCED     87.10           79.00       88332
LAB HISTOLOGY 3110019  0 IMMUNOCYTOCHEM EA ABODY(IMPERX               PROCED     176.60          54.10       88342
LAB HISTOLOGY 3110121  0 ERIP IMMUNOCYTOC EA ABODY(ERIP)              PROCED     164.40          54.10       88342
LAB HISTOLOGY 3110122  0 PRIP IMMUNOCYTOC EA ABODY(PRIP)              PROCED     164.60          54.10       88342
LAB HISTOLOGY 3110018  0 IMMUNOFLUORESCENT EA AB(IMFLOR               PROCED     65.60           68.00       88346
LAB HISTOLOGY 3112116  0 IMMUNOFLUORES INDIRECT(IMFLID)               PROCED     168.00          44.50       88347
LAB HISTOLOGY 3110073  0 ELECTRON MICRO LIMITED (EMEBPR               PROCED     196.70          0.00        88348
LAB HISTOLOGY 3111064  0 ELECTRON MICRO COMPLETE (EMTEC               PROCED     765.60          589.20      88348
LAB HISTOLOGY 3111065  0 ELECTRN MICR TEC ONLY (EMTECO)               PROCED     235.68          235.68      88348
LAB HISTOLOGY 3110125  0 MORPHOMETRIC ANAL TUMOR(DNACAS               PROCED     218.60          218.60      88358
LAB HISTOLOGY 3110126  0 MORPHOMETRIC ANAL TUMOR(QCAS)                PROCED     218.60          218.60      88358
LAB HISTOLOGY 3110127  0 MORPHOMETRIC ANAL TUMOR(QLSC)                PROCED     218.60          218.60      88358
LAB HISTOLOGY 3113100  0 TISS INSITU EA PRB (HER2NF)                  PROCED     164.10          164.10      88365
LAB HISTOLOGY 3113238  0 LAB MISC SURG PATH                           PROCED     0.00            0.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML          CPT
LAB HLA       3055383 0 MOL DIAG; ISO/EXT (CHIMRSM)               PROCED     106.26          48.30            83891
LAB HLA       3055389 0 MOL DIAG; ISO/EXT (HRABC)                 PROCED     18.46           4.20             83891
LAB HLA       3055388 0 MOL DIAG; ENZ DIG (HRABC)                 PROCED     4.20            4.20             83892
LAB HLA       3055384 0 MOL DIAG; GEL ELP (HRDR)                  PROCED     78.54           48.30            83894
LAB HLA       3055382 0 MDIAG; NUC ACD AMP (HRDR)                 PROCED     118.15          118.15           83898
LAB HLA       3055390 0 MDIAG; NUC ACD AMP (HRABC)                PROCED     118.15          17.50            83898
LAB HLA       3055385 0 MOL DIAG; MUT ID (HRABC)                  PROCED     23.42           17.50            83904
LAB HLA       3055378 0 MDIAG SEP & ID HI RES (HRABC)             PROCED     23.42           4.20             83909
LAB HLA       3055381 0 MOL DIAG; INTRP & RPT (HRDR)              PROCED     85.00           48.30            83912
LAB HLA       3055387 0 MOL DIAG; INTRP & RPT (HRABC)             PROCED     57.23           4.20             83912
LAB HLA       3053482 0 LYMPHOCYTX EA SER(HLAXMD/HLAX)            PROCED     392.81          54.10            86805
LAB HLA       3053472 0 HLA AB SCRN STANDARD (HASM)               PROCED     201.96          92.00            86807
LAB HLA       3054472 0 HLA AB SCREEN QUICK (HASQ)                PROCED     255.10          146.10           86808
LAB HLA       3053476 0 HLA B27 (HB27)                            PROCED     299.70          135.20           86812
LAB HLA       3053475 0 HLA ABC TYPING (HLA)                      PROCED     707.49          335.30           86813
LAB HLA       3053479 0 HLA DR MULTIPLE AGS (HLADR)               PROCED     747.80          335.30           86817
LAB HLA       3053063 0 HLA FLOW XM, 1ST MARK (HLFXM1)            PROCED     171.90          171.90           88184
LAB HLA       3053064 0 HLA FLOW XM, ADD MRK (HLFXM2)             PROCED     69.70           69.70            88185
LAB HLA       3055377 0 MISC TISSUE TYPING (X15)                  PROCED     0.00            0.00
LAB MICRO     3041011 0 MDIAG NUC ACD ISO (RESPCR)                PROCED     24.40           $         7.50   83891
LAB MICRO     3041014 0 MDIAG NUC ACD AMP 1ST 2 (RESPCR)          PROCED     79.90           $        46.84   83900
LAB MICRO     3041015 0 MDIAG INTRP & RPT (RESPCR)                PROCED     24.40           $         7.50   83912
LAB MICRO     3040103 0 CONCENT,INF AG (CONCE)                    PROCED     38.07           10.80            87015
LAB MICRO     3040084 0 CULT BACT; BLD AER, ISOL/PRE ID (BCHPC)   PROCED     147.20          54.10            87040
LAB MICRO     3040504 0 BLOOD CULTURE (BLD)                       PROCED     147.20          15.25            87040
LAB MICRO     3041009 0 CULTURE, BRUCELLA (BRUCC)                 PROCED     171.48          111.40           87040
LAB MICRO     3040605 0 STOOL CULTURE (STL)                       PROCED     139.56          16.98            87045
LAB MICRO     3040604 0 CULT STOOL PATH (STPATH)                  PROCED     24.56           9.00             87046
LAB MICRO     3040083 0 LAB GENITAL CULTURE (GENCUL)              PROCED     122.83          15.75            87070
LAB MICRO     3040090 0 CATH TIP CULTURE (CATHC)                  PROCED     122.83          13.99            87070
LAB MICRO     3040500 0 CSF CULTURE (CSFC)                        PROCED     122.83          17.35            87070
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
LAB MICRO     3040732 0 THROAT OR NOSE CULTURE (RESP)        PROCED     122.83          9.30        87070
LAB MICRO     3040795 0 AEROBIC CULTURE (AER)                PROCED     122.83          17.90       87070
LAB MICRO     3041101 0 LAB ENVR CULT                        PROCED     122.83          10.80       87070
LAB MICRO     3041617 0 CULT BACT QNT OTHR (BALC)            PROCED     135.00          135.00      87071
LAB MICRO     3040012 0 ANAEROBIC CULTURE EXC BLOOD (ANO2)   PROCED     131.36          37.90       87075
LAB MICRO     3040102 0 CULT BACT ANAER ID (ANAID)           PROCED     59.23           24.29       87076
LAB MICRO     3041010 0 CUL BAC AER EA ISO (ISOID)           PROCED     64.50           64.50       87077
LAB MICRO     3041202 0 CULT BAC AER DEF ID,EA ISO           PROCED     37.45           17.11       87077
LAB MICRO     3040009 0 CULTURE, GC (GCC)                    PROCED     53.09           7.00        87081
LAB MICRO     3040020 0 CULTURE STAPHYLOCOCCUS (STAPH)       PROCED     53.09           33.00       87081
LAB MICRO     3040039 0 H PYLORI SCREEN (HPYSCR)             PROCED     53.09           10.80       87081
LAB MICRO     3040061 0 CULTURE, BETA STREP A                PROCED     53.09           14.31       87081
LAB MICRO     3040429 0 CULT,SING,LEGIONELLA (LEGC)          PROCED     53.09           44.83       87081
LAB MICRO     3040799 0 CULT,VANC RES ENTEROCOCI(VRES)       PROCED     53.09           17.72       87081
LAB MICRO     3041036 0 CULTURE, GRP B SCREEN (PNGBS)        PROCED     53.09           32.40       87081
LAB MICRO     3041615 0 CULTURE, DIPHTHERIA (DIPHC)          PROCED     131.10          100.20      87081
LAB MICRO     3040776 0 CULT, URINE W CC (URIN)              PROCED     77.63           12.26       87086
LAB MICRO     3043012 0 FUGAL CULT,SKIN (FUNGSK)             PROCED     120.93          35.68       87101
LAB MICRO     3043737 0 FUNGAL CULTURE (FUNG)                PROCED     102.44          26.79       87102
LAB MICRO     3040038 0 CULTURE, FUNGUS BLOOD (FBLD)         PROCED     130.82          19.88       87103
LAB MICRO     3043011 0 CULT DEF ID,YEAST (YSTID)            PROCED     16.00           16.00       87106
LAB MICRO     3043010 0 CULT DEF ID,MOLD (MOLDID)            PROCED     41.65           26.09       87107
LAB MICRO     3046606 0 CULTURE,CHLAMYDIA (CLAM)             PROCED     119.97          27.10       87110
LAB MICRO     3040037 0 CULTURE,ACID FAST BACILL(AFBC)       PROCED     162.88          19.58       87116
LAB MICRO     3044738 0 CULT,ACID FAST,ISO                   PROCED     162.88          30.06       87116
LAB MICRO     3044007 0 CULT MYCO,DEF ID EA (AFBID)          PROCED     173.69          37.19       87118
LAB MICRO     3046430 0 CULT TYPING, IMFLOR, EA ANTISER      PROCED     34.44           22.06       87140
LAB MICRO     3041699 0 CULT TYPING, IMMUNOLOGIC, EA         PROCED     34.05           14.40       87147
LAB MICRO     3040505 0 MYCOBACTERIA DIRECT PROBE AFBP       PROCED     158.99          40.10       87149
LAB MICRO     3040092 0 MACROSCOPIC PARASITE (MACPAR)        PROCED     43.70           43.70       87169
LAB MICRO     3045587 0 PINWORM (PINWORM)                    PROCED     50.76           26.40       87172
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML         CPT
LAB MICRO     3046660 0 TISSUE HOMOGEN (TISSUE)          PROCED     34.83           13.00           87176
LAB MICRO     3045603 0 OVA & PARASITES,CONC &ID(OVAP)   PROCED     117.00          15.70           87177
LAB MICRO     3042798 0 SENSITIVITY, E-TEST (ETEST)      PROCED     20.00           8.20            87181
LAB MICRO     3040104 0 SUSC,DISK,PER PLT (KBSUSC)       PROCED     46.73           14.16           87184
LAB MICRO     3040100 0 BETALACTAMASE (BLACT)            PROCED     15.82           6.89            87185
LAB MICRO     3040791 0 SENSITIVITY MIC (SUSC)           PROCED     87.63           23.48           87186
LAB MICRO     3042795 0 MICRO OR AGAR DIL,MIC            PROCED     87.63           21.60           87186
LAB MICRO     3043009 0 SENSITIVITY,FUNGAL(FSUSC)        PROCED     170.00          71.61           87186
LAB MICRO     3042018 0 SENSITIVITY MBC (MBCMI)          PROCED     14.48           13.40           87187
LAB MICRO     3040790 0 SMEAR,PRIM SOUR W/INTERP(GRAM)   PROCED     44.97           9.26            87205
LAB MICRO     3043007 0 SMEAR,FUNGAL,FLUORESCE (FUNGS)   PROCED     62.88           7.00            87206
LAB MICRO     3044006 0 SMEAR,FLUOR W INTERP             PROCED     62.88           14.24           87206
LAB MICRO     3045608 0 SPECIAL STAIN,MICROS(MICSMR)     PROCED     68.61           26.73           87207
LAB MICRO     3045606 0 SPEC STN GRP II,TRICHROM(OVAP)   PROCED     72.53           3.80            87209
LAB MICRO     3042796 0 WET PREP (GWET)                  PROCED     55.22           54.60           87210
LAB MICRO     3046424 0 VIRUS ID,TSS CULT,CMV (CMV)      PROCED     128.00          26.26           87252
LAB MICRO     3046657 0 VIRUS ID,TSS CULT,(VIRU)         PROCED     120.42          26.94           87252
LAB MICRO     3046659 0 VIRUS CULT DEF ID (VIDENT)       PROCED     70.86           41.17           87253
LAB MICRO     3046658 0 VIRUS ISO,SHELL VIAL (SV)        PROCED     90.32           22.89           87254
LAB MICRO     3046423 0 VIRUS ID,TSS CULT,HERP (HERP)    PROCED     120.42          16.08           87255
LAB MICRO     3045607 0 DFA,GIARDIA (GIARDIA)            PROCED     86.30           62.50           87269
LAB MICRO     3041022 0 CRYPTOSPORIDIUM DFA (CRYP)       PROCED     85.86           27.10           87272
LAB MICRO     3040024 0 PNEUMOCYS CARINII SMEAR(PCSMR)   PROCED     47.30           47.30           87281
LAB MICRO     3040042 0 V ZOSTER DVA (VZVSCR)            PROCED     92.14           13.50           87290
LAB MICRO     3040041 0 INF AG, IMFLR EA PV ANTISER      PROCED     118.67          13.50           87300
LAB MICRO     3040428 0 CLOSTRIDIUM TOXIN A, EIA (CDT)   PROCED     143.19          15.05           87324
LAB MICRO     3042797 0 IMM ASSAY,RSV (RSVSCR)           PROCED     93.96           28.24           87420
LAB MICRO     3042019 0 SHIGA-LIKE TOXIN (STOX)          PROCED     15.00           15.00           87427
LAB MICRO     3040094 0 BETA STREP A SCREEN (BSASC)      PROCED     57.74           15.59           87430
LAB MICRO     3040434 0 LEGIONELLA ANTIGEN (LEGAG)       PROCED     95.89           84.28           87450
LAB MICRO     3041016 0 INF AG AMP PRB EA ORG (RESPCR)   PROCED     83.70           $       50.00   87798
PARTIAL CHARGEMASTER - 12/13/06

                        Svc                                   CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)             LML/RML     CPT
LAB MICRO       3041013 0 INFCT AG NUC ACD, PCR (BPCR)        PROCED     15.00              15.00       87801
LAB MICRO       3042051 0 IMM ASSY,DIR OPT,ROTA (ROTASC)      PROCED     76.68              26.28       87899
LAB MICRO       3047234 0 LAB MISC MICRO INP                  PROCED     0.00               0.00
LAB MICRO       3047432 2 LAB SRVCUL                          PROCED     STATISTICAL ITEM   0.00
LAB MOLEC PAT   3080004 0 MOL DIAG, ISOLAT OR EXTRACT (N      PROCED     113.10             71.40       83890
LAB MOLEC PAT   3080019 0 MOL DIAG ISO/EXT (VDJP)             PROCED     12.00              7.65        83890
LAB MOLEC PAT   3080068 0 MOL DIAG; ISOL / EXT (CHIM)         PROCED     50.70              28.00       83890
LAB MOLEC PAT   3080022 0 MOL DIAG, ISO/EXT. PUR NUC ACD      PROCED     23.65              12.30       83891
LAB MOLEC PAT   3080002 0 MOL DIAG, ENZYME DIGEST (NDGEST)    PROCED     52.03              12.30       83892
LAB MOLEC PAT   3080010 0 MOL DIAG, ENZYME DIGEST (UNG)       PROCED     52.03              22.10       83892
LAB MOLEC PAT   3080008 0 MOL DIAG, SEPARATION BY GEL ELP     PROCED     78.54              28.00       83894
LAB MOLEC PAT   3080005 0 MOL DIAG; NUC ACID PRB EA           PROCED     23.65              12.30       83896
LAB MOLEC PAT   3080006 0 MOL DIAG, AMP NUC ACID EA PR (      PROCED     118.15             74.10       83898
LAB MOLEC PAT   3080027 0 MOL DIAG, PCR EA (VDJP)             PROCED     50.10              32.05       83898
LAB MOLEC PAT   3080032 0 M DIAG; AMP MLTPLX 1ST 2NA (CHIM)   PROCED     232.90             116.00      83900
LAB MOLEC PAT   3080033 0 M DIAG; AMP MLTPLX 1ST 2NA (VDJP)   PROCED     100.20             64.10       83900
LAB MOLEC PAT   3080021 0 MUTATION SCANNING                   PROCED     99.00              51.50       83903
LAB MOLEC PAT   3080028 0 MOL DIAG MUT ID SEQ EA (VDJP)       PROCED     50.10              32.05       83904
LAB MOLEC PAT   3080035 0 MOL DIAG LYSIS OF CELLS (TCRP)      PROCED     93.30              93.30       83907
LAB MOLEC PAT   3080034 0 MDIAG SEP & ID, HI RES (CHIM)       PROCED     75.60              28.00       83909
LAB MOLEC PAT   3080017 0 LAB INTERPRET & REPORT (IRT)        PROCED     85.00              12.30       83912
LAB MOLEC PAT   3080029 0 MOL DIAG INT & RPT (VDJP)           PROCED     12.00              7.65        83912
LAB MOLEC PAT   3080066 0 MOL DIAG; INTRP / RPT (CHIM)        PROCED     55.70              28.00       83912
LAB MOLEC PAT   3080030 0 CHLAMYD, AMPL PRB (AMPGCC)          PROCED     125.00             60.00       87491
LAB MOLEC PAT   3080025 0 CMV AMPLIFIED PROBE (CMVDIG)        PROCED     261.16             103.30      87496
LAB MOLEC PAT   3080018 0 HBV DNA PCR LIV TIS (HBVQL)         PROCED     178.47             95.80       87516
LAB MOLEC PAT   3080065 0 HEPATITIS C AMPLIF PROBE(HCVQL      PROCED     237.60             116.80      87521
LAB MOLEC PAT   3080070 0 HEPATITIS C QUANT (HCVQT)           PROCED     289.83             235.50      87522
LAB MOLEC PAT   3080020 0 HIV 1 QUANTIFICATION (HIVULT)       PROCED     287.88             179.00      87536
LAB MOLEC PAT   3080031 0 N GONRH, AMPL PRB (AMPGCC)          PROCED     125.00             60.00       87591
LAB MOLEC PAT   3080001 0 INFECT AG DETECT, AMPLIF PROBE      PROCED     234.60             48.70       87798
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)             LML/RML     CPT
LAB MOLEC PAT   3080090 0 HCV GENOTYPING (HCGENB)           PROCED     529.20             360.50      87902
LAB MOLEC PAT   3080011 0 MISC MOLECULAR PATH               PROCED     0.00               0.00
LAB NEO         6701009 0 IONIZED CALCIUM (NICA)            PROCED     104.39                         82330
LAB NEO         6701021 0 CHLORIDE (NCL)                    PROCED     40.90                          82435
LAB NEO         6701001 0 BLOOD GASES (NABG, PABG)          PROCED     184.85                         82803
LAB NEO         6701011 0 GLUCOSE QUANT (NGLU)              PROCED     39.49                          82947
LAB NEO         6701005 0 GLUCOSE, BLD RGT STRIP (GLUCRN    PROCED     39.00                          82948
LAB NEO         6701020 0 POTASSIUM (NK)                    PROCED     37.11                          84132
LAB NEO         6701019 0 SODIUM (NNA)                      PROCED     40.00                          84295
LAB NEO         6701006 0 HEMATOCRIT, SPUN (NHCT)           PROCED     20.00                          85013
LAB NEO         6701027 0 ACTIVATED CLOTTING TIME (ACT)     PROCED     40.40                          85347
LAB NEO         6701003 2 FINGERSTICK GLUCOSE               PROCED     STATISTICAL ITEM
LAB PHLEB PRO   3121002 0 BLOOD DRAW ROUTN VENIPUNCTURE     PROCED     19.69              19.69       36415
LAB PHLEB PRO   3121004 0 BLEEDING TIME (IVYBT)             PROCED     68.30              40.80       85002
LAB PHLEB PRO   3121001 0 EKG 12-LEAD (EKG12)               PROCED     130.36             130.36      93005
LAB SEND OUT    3029208 0 DRUG SCR QL SINGLE (SULF/SULFU)   PROCED     138.61             100.75      80101
LAB SEND OUT    3029430 0 AMITRIPTYLINE (AMITRP)            PROCED     108.07             19.50       80152
LAB SEND OUT    3029069 0 BENZODIAZEP, CLONAZEPAM (CLON)    PROCED     101.52             40.40       80154
LAB SEND OUT    3029263 0 BENZODIAZEPINE (ALPRA)            PROCED     101.52             51.90       80154
LAB SEND OUT    3029695 0 TRANXENE (TRANX)                  PROCED     101.52             42.76       80154
LAB SEND OUT    3029777 0 BENZODIAZEPI, DIAZEPAM (DZNR)     PROCED     101.52             21.75       80154
LAB SEND OUT    3029612 0 DOXEPIN (DOXP)                    PROCED     81.25              18.75       80166
LAB SEND OUT    3029115 0 ETHOSUXIMIDE (ETHOS)              PROCED     44.23              26.70       80168
LAB SEND OUT    3029245 0 HALOPERIDOL (HALOP)               PROCED     20.34              43.50       80173
LAB SEND OUT    3029400 0 IMIPRAMINE (IMIP)                 PROCED     75.10              39.00       80174
LAB SEND OUT    3029009 0 NORTRIPTYLINE (NORTRP)            PROCED     91.15              19.50       80182
LAB SEND OUT    3029385 0 PHENOBARB                         PROCED     120.80             14.80       80184
LAB SEND OUT    3029383 0 PRIMIDONE-MYSOLINE                PROCED     113.90             14.80       80188
LAB SEND OUT    3029438 0 PROCAINAMIDE (PROC)               PROCED     154.71             32.50       80192
LAB SEND OUT    3029439 0 QUINIDINE (QUIN)                  PROCED     117.47             27.50       80194
LAB SEND OUT    3029381 0 RAPAMUNE / SIROL CORR (RAPAM)     PROCED     101.36             62.83       80195
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029174 0 TOPIRAMATE (TOPIR)                PROCED     102.32          53.90       80201
LAB SEND OUT   3029048 0 FLECAINIDE (FLEC)                 PROCED     101.36          36.25       80299
LAB SEND OUT   3029049 0 DISOPYRAMIDE (DISO)               PROCED     101.36          24.50       80299
LAB SEND OUT   3029050 0 PHENACEMIDE (PHNA)                PROCED     77.70           77.70       80299
LAB SEND OUT   3029053 0 SULFAMETHOXAZOLE (SULFMX)         PROCED     101.36          80.00       80299
LAB SEND OUT   3029131 0 QUANT DRUG, GABA (GABAP)          PROCED     101.36          31.75       80299
LAB SEND OUT   3029134 0 QUANT DRUG , (KEPPRA)             PROCED     101.36          90.75       80299
LAB SEND OUT   3029136 0 QUANT DRUG, LAMO (LAMOT)          PROCED     101.36          34.50       80299
LAB SEND OUT   3029149 0 QT DRUG, PROTRIPTYLIN (PTRIP)     PROCED     101.36          49.60       80299
LAB SEND OUT   3029163 0 MEXILETINE (MEXIL)                PROCED     101.36          43.90       80299
LAB SEND OUT   3029167 0 TOCAINIDE (TOC)                   PROCED     101.36          87.00       80299
LAB SEND OUT   3029212 0 QT DRUG, OXCARBAZPN (OXCAR)       PROCED     101.36          61.00       80299
LAB SEND OUT   3029239 0 QT DRUG, ZONISAMIDE (ZON)         PROCED     101.36          100.80      80299
LAB SEND OUT   3029262 0 QT DRUG, AMANTADINE (AMANT)       PROCED     101.36          79.40       80299
LAB SEND OUT   3029366 0 QUAN OF DRUG NOT SPEC (DOXP)      PROCED     18.75           18.75       80299
LAB SEND OUT   3029367 0 QUAN OF DRUG NOT SPEC (METHSX)    PROCED     18.75           18.75       80299
LAB SEND OUT   3029375 0 QUAN OF DRUG NOT SPEC (AMIOD)     PROCED     20.51           20.51       80299
LAB SEND OUT   3029379 0 QUAN OF DRUG NOT SPEC (MYPA)      PROCED     57.11           57.11       80299
LAB SEND OUT   3029979 0 ITRACONAZOLE (ITRA)               PROCED     101.36          95.30       80299
LAB SEND OUT   3029453 0 VOLUME MEAS (URORSK)              PROCED     21.06           21.06       81050
LAB SEND OUT   3029474 0 VOLUME MEASURE (RSTONE)           PROCED     21.06           21.06       81050
LAB SEND OUT   3029286 0 ACETYLCHOLINS (AMNACH)            PROCED     72.36           79.00       82013
LAB SEND OUT   3029389 0 ACYLCARN, QL, EA (ACARND)         PROCED     23.57           195.00      82017
LAB SEND OUT   3029988 0 ACYLCARNITINE (CARN)              PROCED     23.57           27.00       82017
LAB SEND OUT   3029154 0 CYCLIC AMP, PLASMA (PCAMP)        PROCED     31.67           42.00       82030
LAB SEND OUT   3029554 0 CYCLIC AMP, RANDOM UR (RAMP)      PROCED     31.67           39.00       82030
LAB SEND OUT   3029310 0 ALB, SERUM, QT (IGGIDX, OBANDS)   PROCED     37.26           7.00        82040
LAB SEND OUT   3029308 0 ALB OTHER, QT (IGGIDX, OBANDS)    PROCED     46.98           7.00        82042
LAB SEND OUT   3029309 0 ALB, OTHER (CSFALB, CIM)          PROCED     46.98           14.55       82042
LAB SEND OUT   3029428 0 ALDOSTERONE, URINE (UALDOS)       PROCED     224.59          28.10       82088
LAB SEND OUT   3029450 0 ALDOSTERONE (ALDOST)              PROCED     224.59          25.50       82088
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029126 0 A1ANTITRYPSN, TOTAL (A1ATPH)        PROCED     94.38           18.80       82103
LAB SEND OUT   3029189 0 ALPHA 1 ANTITRYPSN (A1ATFE)         PROCED     94.38           84.25       82103
LAB SEND OUT   3029066 0 A1 ANTITRYPSIN, PHENO (A1ATPH)      PROCED     106.23          18.80       82104
LAB SEND OUT   3029003 0 AFP, MATERNAL (MSAFP)               PROCED     121.56          47.40       82105
LAB SEND OUT   3029401 0 ALPHA FETOPROTEIN,SERUM (AFPT)      PROCED     121.56          15.10       82105
LAB SEND OUT   3029236 0 ALUMINUM (ALUMN)                    PROCED     112.76          25.50       82108
LAB SEND OUT   3029038 0 AMINOLEVULINIC ACID , DELTA (ALA)   PROCED     145.89          42.60       82135
LAB SEND OUT   3029190 0 AMINO ACIDS >5, QT (AACSF)          PROCED     489.65          120.75      82139
LAB SEND OUT   3029275 0 AMINO ACIDS > 6 QT, PLAS (AAUR)     PROCED     489.65          90.00       82139
LAB SEND OUT   3029475 0 AMMONIA (RSTONE)                    PROCED     113.28          113.28      82140
LAB SEND OUT   3029150 0 AMYLASE ISOENZYMES (AMYISO)         PROCED     80.84           12.45       82150
LAB SEND OUT   3029094 0 ANDROSTANEDIOL GLUCURONI (3AAAG)    PROCED     40.29           36.50       82154
LAB SEND OUT   3029030 0 ANDROSTENEDIONE (D4A)               PROCED     40.90           26.50       82157
LAB SEND OUT   3029228 0 ANDROSTENEDIONE, PEDS (PANDR)       PROCED     154.06          58.70       82157
LAB SEND OUT   3029388 0 ANDROSTENEDIONE (ANDRP)             PROCED     40.90           215.00      82157
LAB SEND OUT   3029194 0 ANGIOT CONV ENZ (ACECSF)            PROCED     86.94           64.60       82164
LAB SEND OUT   3029534 0 ANGIOTENSIN 1 CONVERT ENZ(A1CE      PROCED     86.94           31.60       82164
LAB SEND OUT   3029281 0 APOLIPOPROTEIN A                    PROCED     81.16           23.50       82172
LAB SEND OUT   3029282 0 APOLIPOPROTEIN B (APOB)             PROCED     81.16           23.50       82172
LAB SEND OUT   3029047 0 ARSEN, HVY MET PNL (HMPNLU)         PROCED     75.71           15.50       82175
LAB SEND OUT   3029623 0 ARSENIC (ARSEN)                     PROCED     75.71           25.50       82175
LAB SEND OUT   3029015 0 VITAMIN C (VITC)                    PROCED     58.35           39.10       82180
LAB SEND OUT   3029945 0 PENTOBARBITAL (PENT)                PROCED     121.50          96.75       82205
LAB SEND OUT   3029269 0 BILE ACIDS TOTAL (BILACT)           PROCED     70.20           26.05       82239
LAB SEND OUT   3029176 0 BIOTINADASE (BIOTIN)                PROCED     64.67           54.00       82261
LAB SEND OUT   3029171 0 CALCIFEDIOL (HYD)                   PROCED     91.80           30.57       82306
LAB SEND OUT   3029913 0 CALCITONIN (CALCIT)                 PROCED     129.60          39.00       82308
LAB SEND OUT   3029926 0 TOTAL CALCIUM (PTHC)                PROCED     44.23           19.80       82310
LAB SEND OUT   3029454 0 CALCIUM URINE (URORSK)              PROCED     55.43           55.43       82340
LAB SEND OUT   3029476 0 CALCIUM URINE (RSTONE)              PROCED     55.43           55.43       82340
LAB SEND OUT   3029233 0 CALCULUS, QUANT (TSTONE)            PROCED     241.20          241.20      82355
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029092 0 CARNITINE, QT (CARN)               PROCED     188.54          54.00       82379
LAB SEND OUT   3029392 0 CARN TOT & FR, QT (CARND)          PROCED     23.57           130.00      82379
LAB SEND OUT   3029393 0 CARNIT UR, TOT & FR DUKE (UCARD)   PROCED     23.57           107.00      82379
LAB SEND OUT   3029018 0 CAROTENE (CAROT)                   PROCED     77.97           30.00       82380
LAB SEND OUT   3029930 0 CATECHOLAMINES, FRACTIONA(PCAT     PROCED     162.79          54.10       82384
LAB SEND OUT   3029177 0 CHEMLUMNSCNT ASSY (IGFBP3)         PROCED     129.06          37.50       82397
LAB SEND OUT   3029181 0 IMMUNOASSAY NOT SPEC (IL6)         PROCED     136.05          129.65      82397
LAB SEND OUT   3029051 0 CHLORAMPHENICOL (CHLORM)           PROCED     46.10           46.10       82415
LAB SEND OUT   3029004 0 CHOLINESTERASE, SERUM (PCHE)       PROCED     60.48           20.55       82480
LAB SEND OUT   3029316 0 CHOLINESTERASE, RBC (RCHOL)        PROCED     10.74           41.40       82482
LAB SEND OUT   3029052 0 FLUOROCYTOSINE, 5 (FLC5)           PROCED     138.61          86.00       82491
LAB SEND OUT   3029065 0 CHRM QT COL SINGL (TPMTE)          PROCED     138.61          138.61      82491
LAB SEND OUT   3029204 0 CHRM QT COL SINGL (DILT)           PROCED     138.61          142.16      82491
LAB SEND OUT   3029983 0 GAS/LIQ CHROMATOG QT (PROPRD)      PROCED     138.61          155.25      82491
LAB SEND OUT   3029132 0 CHROM QT COL MULTI (DIURET)        PROCED     103.35          111.65      82492
LAB SEND OUT   3029257 0 CHROMIUM (CHROM)                   PROCED     35.85           30.00       82495
LAB SEND OUT   3029195 0 CITRIC ACID, UR (CITRCU)           PROCED     78.76           23.55       82507
LAB SEND OUT   3029455 0 CITRATE (URORSK)                   PROCED     78.76           78.76       82507
LAB SEND OUT   3029472 0 CITRATE (RSTONE)                   PROCED     78.76           78.76       82507
LAB SEND OUT   3029029 0 DEOXYPYRIDIN X-LINKS (DX PYXL)     PROCED     91.80           54.90       82523
LAB SEND OUT   3029173 0 COLLAGEN XLINKS (NTXU)             PROCED     91.80           51.95       82523
LAB SEND OUT   3029211 0 COLLAGEN XLINKS, SER (NTEL)        PROCED     91.80           110.00      82523
LAB SEND OUT   3029036 0 COPPER, URINE (UCU)                PROCED     83.21           21.80       82525
LAB SEND OUT   3029210 0 COPPER, LIVER TISSUE (LTCU)        PROCED     83.21           125.00      82525
LAB SEND OUT   3029984 0 COPPER (CU)                        PROCED     83.21           25.50       82525
LAB SEND OUT   3029420 0 CORTISOL,URINE FREE (UFF)          PROCED     139.95          24.70       82530
LAB SEND OUT   3029731 0 CORTISOL, FREE, SERUM (FCORT)      PROCED     139.95          166.00      82530
LAB SEND OUT   3029446 0 SALIVARY CORTISOL (SALCOR)         PROCED     77.40           59.00       82533
LAB SEND OUT   3029001 0 CREATINE KINASE,TTL (CKSO)         PROCED     53.47           12.85       82550
LAB SEND OUT   3029005 0 CREATINE KINASE, ISOENZY (CISO     PROCED     58.61           26.15       82552
LAB SEND OUT   3029394 0 CREAT UR, DUKE (UCARD)             PROCED     14.88           33.00       82570
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029456 0 CREATININE OTHER (URORSK)          PROCED     50.87           50.87       82570
LAB SEND OUT   3029473 0 CREATININE OTHER (RSTONE)          PROCED     50.87           50.87       82570
LAB SEND OUT   3029153 0 CYANIDE (CYAN)                     PROCED     27.11           46.25       82600
LAB SEND OUT   3029576 0 DHEA (DHEA)                        PROCED     145.60          26.60       82626
LAB SEND OUT   3029973 0 DHEA (PDHEA)                       PROCED     145.60          70.00       82626
LAB SEND OUT   3029220 0 DHEA-S (PDHEAS)                    PROCED     170.21          46.50       82627
LAB SEND OUT   3029397 0 DHEA-SULFATE (DHEASP)              PROCED     66.96           49.80       82627
LAB SEND OUT   3029224 0 DEOXYCORTISOL, 11 (PCPS)           PROCED     243.36          68.10       82634
LAB SEND OUT   3029905 0 11-DEOXYCORTISOL (DEOXC)           PROCED     243.36          41.40       82634
LAB SEND OUT   3029085 0 DIBUCAINE NUMBER (DIBUCN)          PROCED     17.11           47.00       82638
LAB SEND OUT   3029071 0 DIHYDROTESTOSTERONE (DHT           PROCED     135.82          36.80       82651
LAB SEND OUT   3029222 0 DIHYDROTESTOSTERONE (PDHT)         PROCED     135.82          85.90       82651
LAB SEND OUT   3029172 0 DIHYDROXYVITAMIN D, 1,25(DIHYD     PROCED     135.08          43.40       82652
LAB SEND OUT   3029063 0 ENZ ACTIVITY IN RBCS (TPMTE)       PROCED     138.31          138.31      82657
LAB SEND OUT   3029080 0 UROPORPHYRINOGEN-1-SYNTHAS (UPS)   PROCED     138.31          60.00       82657
LAB SEND OUT   3029962 0 ERYTHROPOIETIN (EPO)               PROCED     145.33          38.78       82668
LAB SEND OUT   3029917 0 ESTROGENS, FRAC (ESTRGN)           PROCED     35.73           52.80       82671
LAB SEND OUT   3029418 0 ESTRIOL (ESTRT)                    PROCED     91.94           15.10       82677
LAB SEND OUT   3029919 0 ESTRIOL (EST3)                     PROCED     91.94           42.00       82677
LAB SEND OUT   3029186 0 ESTRONE (ESTRN)                    PROCED     118.53          23.90       82679
LAB SEND OUT   3029943 0 ETHYLENE GLYCOL (EGLY)             PROCED     88.02           54.00       82693
LAB SEND OUT   3029426 0 FAT,FECAL,QT (FFAT)                PROCED     150.12          57.17       82710
LAB SEND OUT   3029329 0 FATTY ACIDS, NONESTERIFIED(FFA     PROCED     219.58          60.80       82725
LAB SEND OUT   3029235 0 V LONG CHAIN FATTY AC (VLCFAC)     PROCED     378.00          224.25      82726
LAB SEND OUT   3029019 0 FLUORIDE (FLORD)                   PROCED     57.93           98.95       82735
LAB SEND OUT   3029248 0 GAL1PHOS URID TRAN (G1PUT)         PROCED     24.77           86.85       82775
LAB SEND OUT   3029311 0 GAMMAGLOB IGG (OBANDS)             PROCED     93.93           9.15        82784
LAB SEND OUT   3029341 0 GAMMAGLOBULIN IGA (CELACA)         PROCED     30.60           25.50       82784
LAB SEND OUT   3029440 0 TOTAL IMMUNOGLOBULIN (IGG)         PROCED     93.93           19.15       82784
LAB SEND OUT   3029234 0 IGG SUBCLASSES (SUBIGG)            PROCED     54.18           18.50       82787
LAB SEND OUT   3029452 0 GASTRIN (GASTRN)                   PROCED     83.25           25.10       82941
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029551 0 GLUCAGON (GLUG)                    PROCED     101.08          25.55       82943
LAB SEND OUT   3029017 0 G6PD SCREEN (G6PD)                 PROCED     81.36           34.30       82960
LAB SEND OUT   3029251 0 GLYCATED PROTEIN (FRUCTO)          PROCED     51.23           27.65       82985
LAB SEND OUT   3029408 0 A1 ACID GLYCOPROTEIN (AAG)         PROCED     51.23           45.40       82985
LAB SEND OUT   3029260 0 BERRYLLIUM QT (BERYL)              PROCED     88.60           88.60       83018
LAB SEND OUT   3029327 0 HGB FRAC & QT, HPLC (BTHAL)        PROCED     124.62          24.84       83021
LAB SEND OUT   3029010 0 FETAL ABT,QUAL (ABT)               PROCED     8.33            20.10       83033
LAB SEND OUT   3029312 0 HEMOSIDERIN, URINE (UHEMSD)        PROCED     43.47           26.20       83070
LAB SEND OUT   3029421 0 B-HEXOSAMINIDASE,EA ASY(HEXOA)     PROCED     139.63          82.60       83080
LAB SEND OUT   3029033 0 HISTAMINE, URINE (UHIST)           PROCED     113.40          35.80       83088
LAB SEND OUT   3029572 0 HISTAMINE (HIST)                   PROCED     113.40          53.40       83088
LAB SEND OUT   3029237 0 HOMOCYSTINE, UR QT (HCYST)         PROCED     125.82          33.80       83090
LAB SEND OUT   3029423 0 HOMOVANILLIC ACID (HVA)            PROCED     39.81           29.70       83150
LAB SEND OUT   3029231 0 17-OHCS (17OH)                     PROCED     115.56          55.05       83491
LAB SEND OUT   3029422 0 5HIAA (U5HIAA)                     PROCED     75.79           29.80       83497
LAB SEND OUT   3029227 0 HYDROXYPROGESTERONE, 17-D (POHP)   PROCED     86.40           58.70       83498
LAB SEND OUT   3029898 0 HYDROXYPROGESTERONE, 17- D(OHP     PROCED     86.40           25.40       83498
LAB SEND OUT   3029867 0 HYDROXYPROLINE, TOTAL (HP)         PROCED     99.90           43.55       83505
LAB SEND OUT   3029011 0 IMMUNAS NON INFECT (GM1)           PROCED     84.86           71.00       83516
LAB SEND OUT   3029020 0 IMMUNAS NON INFECT (MAGM)          PROCED     84.86           39.96       83516
LAB SEND OUT   3029058 0 GLIADIN AB (GLIADP)                PROCED     84.86           15.00       83516
LAB SEND OUT   3029059 0 IMMUNOASSAY, ANTI GBM (AGBM)       PROCED     84.86           42.58       83516
LAB SEND OUT   3029109 0 IMMUNAS NON INFCT (TTRANS)         PROCED     84.86           35.19       83516
LAB SEND OUT   3029112 0 HETEROLOGOUS PROTEIN (HPRO)        PROCED     84.86           127.00      83516
LAB SEND OUT   3029168 0 IMMUNAS NON INFECT (ENDTTG)        PROCED     84.86           9.00        83516
LAB SEND OUT   3029338 0 IMMUNOASSA NON-INF (ANNAIB)        PROCED     132.89          132.89      83516
LAB SEND OUT   3029340 0 IMMUNOASSAY (TTG-CELACA)           PROCED     16.12           43.84       83516
LAB SEND OUT   3029382 0 ANTI-MYELOPEROXIDASE               PROCED     84.86           39.45       83516
LAB SEND OUT   3029384 0 ANTI-PROTEINASE 3 (PR3AB)          PROCED     84.86           39.45       83516
LAB SEND OUT   3029922 0 FLUOR AB, HISTONE (HIS)            PROCED     113.35          37.50       83516
LAB SEND OUT   3029002 0 ACETYLCHOLINE RECEPT AB (ACHRA)    PROCED     191.20          56.35       83519
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029093 0 IMMUNOASY, PANCREATIC POLY (PPP)   PROCED     129.06          246.90      83519
LAB SEND OUT   3029113 0 IMMUNAS ANLYT, QT (TSHAB)          PROCED     129.06          57.00       83519
LAB SEND OUT   3029116 0 IMMUNAS ANLYT, QT (TLIR)           PROCED     129.06          35.35       83519
LAB SEND OUT   3029130 0 IMMUNOASSAY ANALY QT (GADAB)       PROCED     129.06          74.50       83519
LAB SEND OUT   3029229 0 PTH REL PEPTIDE (PTHRPP)           PROCED     129.06          52.25       83519
LAB SEND OUT   3029396 0 IMMUNASY, ANLYT QT (IGFB3P)        PROCED     18.88           101.10      83519
LAB SEND OUT   3029183 0 IMMUNOAS NOT SPEC (TRYPT)          PROCED     136.05          96.50       83520
LAB SEND OUT   3029200 0 IMMU,IGG,ANTI IAG ANTIBOD SERU     PROCED     136.05          81.70       83520
LAB SEND OUT   3029978 0 IMMUN ASSAY NOT SPEC (IBDSCR)      PROCED     136.05          40.25       83520
LAB SEND OUT   3029369 0 IRON LIVER (LVIRON)                PROCED     145.00          145.00      83540
LAB SEND OUT   3029232 0 KETOSTEROIDS, 17-KS (17KETO)       PROCED     102.60          44.75       83586
LAB SEND OUT   3029941 0 LDH SENDOUT (LDHSO)                PROCED     42.00           10.00       83615
LAB SEND OUT   3029942 0 LDH ISOENZYMES (LISO)              PROCED     63.40           20.00       83625
LAB SEND OUT   3029278 0 LEAD UR, HVY MET PNL(HMPNLU)       PROCED     73.87           15.50       83655
LAB SEND OUT   3029436 0 LEAD, URINE (ULEAD)                PROCED     73.87           25.50       83655
LAB SEND OUT   3029350 0 LEUCINE AMINO PPTDS (LEU)          PROCED     74.52           49.45       83670
LAB SEND OUT   3029214 0 MAGNESIUM, FECAL (FMG)             PROCED     53.95           29.25       83735
LAB SEND OUT   3029457 0 MAGNESIUM (URORSK)                 PROCED     53.95           53.95       83735
LAB SEND OUT   3029471 0 MAGNESIUM (RSTONE)                 PROCED     53.95           53.95       83735
LAB SEND OUT   3029213 0 MANGANESE (MANG)                   PROCED     62.75           25.50       83785
LAB SEND OUT   3029026 0 MERCURY (MERC/MERCU)               PROCED     87.05           25.50       83825
LAB SEND OUT   3029279 0 MERC UR, HVY MET PNL(HMPNLU)       PROCED     87.05           15.50       83825
LAB SEND OUT   3029355 0 METANEPRINES (PMETA)               PROCED     23.67           177.50      83835
LAB SEND OUT   3029016 0 METHEMALBUMIN (MHALB)              PROCED     15.01           41.20       83857
LAB SEND OUT   3029924 0 METHSUXIMIDE (METHSX)              PROCED     122.26          18.75       83858
LAB SEND OUT   3029185 0 MUCOPOLYSACCHARIDES, QT (GAGS)     PROCED     27.82           139.90      83864
LAB SEND OUT   3029918 0 MYELIN BASIC PROTEIN (MBP)         PROCED     107.46          42.85       83873
LAB SEND OUT   3029128 0 NEPHELOM EA ANLYT (RETBP)          PROCED     51.63           30.00       83883
LAB SEND OUT   3029963 0 LIGHT CHAINS (KAPLAM)              PROCED     19.00           23.25       83883
LAB SEND OUT   3029135 0 NICOTINE (NICOT)                   PROCED     28.71           82.70       83887
LAB SEND OUT   3029289 0 MOL DIAG; ISOL/EXT (APOE)          PROCED     85.29           8.65        83890
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029354 0 MOL ISOLATION (FRAGX)                 PROCED     12.40           13.60       83890
LAB SEND OUT   3029982 0 MOL DIAG; ISOL OR EXT (HHFE)          PROCED     85.29           11.60       83890
LAB SEND OUT   3029023 0 MOL ISOL PUR NUC ACD (TPMTG)          PROCED     24.37           24.37       83891
LAB SEND OUT   3029040 0 CF NUCLEIC ACID EXTRACTION            PROCED     106.26          20.60       83891
LAB SEND OUT   3029298 0 MDIAG; ISO/EXT PUR NA(PML)            PROCED     106.26          8.95        83891
LAB SEND OUT   3029322 0 MOL DIAG; ISO/EXT DNA (CHMPCR)        PROCED     106.26          28.75       83891
LAB SEND OUT   3029342 0 MOL ISOL PUR NUC ACD (FRAGX)          PROCED     5.60            13.60       83891
LAB SEND OUT   3029371 0 MOL DIAG ISO/EXT (JAK2)               PROCED     24.37           24.37       83891
LAB SEND OUT   3029344 0 MOL ENZYME DIG (FRAGX)                PROCED     5.60            13.60       83892
LAB SEND OUT   3029043 0 MOL DIAG DOT/SLOT BLOT(CYSFIB)        PROCED     86.40           20.60       83893
LAB SEND OUT   3029981 0 MOL DIAG DOT/SLOT BLOT (HHFE)         PROCED     86.40           11.60       83893
LAB SEND OUT   3029041 0 MOLECUL DIAG SEPARATION(CYSFIB        PROCED     78.54           20.60       83894
LAB SEND OUT   3029299 0 MOL DIAG; GEL ELP (PML)               PROCED     78.54           8.95        83894
LAB SEND OUT   3029321 0 MOL DIAG; GEL ELP (CHMPCR)            PROCED     78.54           28.75       83894
LAB SEND OUT   3029346 0 MOL GEL ELP (FRAGX)                   PROCED     5.60            13.60       83894
LAB SEND OUT   3029042 0 MOLEC DIAG, NUC A PROBE(CYSFIB        PROCED     52.75           20.60       83896
LAB SEND OUT   3029056 0 MOL DIAG NUC AC PRB (TPMTG)           PROCED     23.65           23.65       83896
LAB SEND OUT   3029145 0 NUCLEIC ACID PROBE (HHFE)             PROCED     52.75           11.60       83896
LAB SEND OUT   3029290 0 MOL DIAG; NUC AC PRB(APOE)            PROCED     52.75           8.65        83896
LAB SEND OUT   3029347 0 MOL NUC ACD PRB, EA (FRAGX)           PROCED     5.60            13.60       83896
LAB SEND OUT   3029348 0 MOL NUC ACD TRANS (FRAGX)             PROCED     5.60            13.60       83897
LAB SEND OUT   3029060 0 MDIAG NUC ACD AMP (TPMTG)             PROCED     84.98           84.98       83898
LAB SEND OUT   3029301 0 MOL DIAG; PCR (PML)                   PROCED     84.98           37.55       83898
LAB SEND OUT   3029351 0 MOL AMPLIFICATN, EA (FRAGX)           PROCED     79.36           57.00       83898
LAB SEND OUT   3029359 0 MDIAG; AMP MLTPLX 1ST 2NA (METHFR)    PROCED     50.60           50.60       83900
LAB SEND OUT   3029364 0 M DIAG; AMP MLTPLX 1ST 2NA (APOE)     PROCED     68.90           68.90       83900
LAB SEND OUT   3029373 0 M DIAG; AMP MLTPLX 1ST 2NA (JAK2)     PROCED     176.25          176.25      83900
LAB SEND OUT   3029045 0 MOLE DIAG AMP MULTIPLEX(CYSFIB        PROCED     88.83           85.80       83901
LAB SEND OUT   3029326 0 MOL DIAG; AMPL MULTI (CHMPCR)         PROCED     88.83           120.30      83901
LAB SEND OUT   3029980 0 MOL DIAG; AMP NUC ACD, MULTI (HHFE)   PROCED     88.83           48.50       83901
LAB SEND OUT   3029302 0 MOL DIAG; RVRS TRANS (PML)            PROCED     56.96           32.00       83902
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029365 0 MDIAG; SEP & ID, HI RES (FRAGLX)   PROCED     27.20           27.20       83909
LAB SEND OUT   3029044 0 MOLECUL DIAGN INTER&REP(CYSFIB     PROCED     85.00           20.60       83912
LAB SEND OUT   3029061 0 MOL DIAG INTRP & RPT (TPMTG)       PROCED     61.52           61.52       83912
LAB SEND OUT   3029148 0 HFE INTERP & REPORT                PROCED     85.00           11.60       83912
LAB SEND OUT   3029292 0 MOL DIAG; INTRP/RPT (APOE)         PROCED     85.00           8.65        83912
LAB SEND OUT   3029303 0 MOL DIAG; INTRP/RPT (PML)          PROCED     85.00           8.95        83912
LAB SEND OUT   3029325 0 MOL DIAG; INTRP & RPT (CHMPCR)     PROCED     85.00           28.75       83912
LAB SEND OUT   3029349 0 MOL INTRP & RPRT (FRAGX)           PROCED     38.44           13.60       83912
LAB SEND OUT   3029374 0 MOL DIAG INTRP & RPT (JAK2)        PROCED     24.37           24.37       83912
LAB SEND OUT   3029372 0 MUT ID, ENZ LIG EA (JAK2)          PROCED     90.00           90.00       83914
LAB SEND OUT   3029012 0 NUCLEOTIDASE 5- (5NUC)             PROCED     93.96           30.00       83915
LAB SEND OUT   3029435 0 OLIGOCLONAL BANDS (OBAND)          PROCED     121.10          20.00       83916
LAB SEND OUT   3029164 0 ORGANIC ACIDS, QT, URINE (UORG     PROCED     64.80           107.25      83918
LAB SEND OUT   3029985 0 ORGANIC ACD SINGLE QT (MMA)        PROCED     101.09          52.07       83921
LAB SEND OUT   3029138 0 OSTEOCALCIN (OSTCAL)               PROCED     118.93          45.00       83937
LAB SEND OUT   3029432 0 OXALATE, URINE (OX)                PROCED     89.35           28.36       83945
LAB SEND OUT   3029458 0 OXALATE (URORSK)                   PROCED     89.35           89.35       83945
LAB SEND OUT   3029470 0 OXALATE (RSTONE)                   PROCED     89.35           89.35       83945
LAB SEND OUT   3029357 0 HER-2 / NEU (HER2)                 PROCED     65.40           110.00      83950
LAB SEND OUT   3029610 0 PARATHORMONE-C TERMINAL (PTHC      PROCED     204.61          184.10      83970
LAB SEND OUT   3029157 0 PH, BODY FLD NON BLD(FPH)          PROCED     33.16           27.22       83986
LAB SEND OUT   3029459 0 PH BODY FLUID (URORSK)             PROCED     33.16           33.16       83986
LAB SEND OUT   3029469 0 PH (RSTONE)                        PROCED     33.16           33.16       83986
LAB SEND OUT   3029165 0 PROLIXIN (PROLIX)                  PROCED     21.76           42.45       84022
LAB SEND OUT   3029843 0 PKU (PKUT4)                        PROCED     41.65           21.45       84030
LAB SEND OUT   3029032 0 ACID PHOSPHATASE, TOTAL (ACP)      PROCED     48.24           17.00       84060
LAB SEND OUT   3029024 0 ACID PHOS, PROSTATIC (ACPP)        PROCED     77.40           17.00       84066
LAB SEND OUT   3029027 0 BONE SPECIFIC ALK PHOS (ALPBS)     PROCED     79.92           73.30       84080
LAB SEND OUT   3029014 0 ALKALINE PHOSPHATA ISO (ALPISO     PROCED     79.92           25.75       84080
LAB SEND OUT   3029460 0 PHOSPHATE URINE (URORSK)           PROCED     51.83           51.83       84105
LAB SEND OUT   3029468 0 PHOSPHATE URINE (RSTONE)           PROCED     51.83           51.83       84105
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029202 0 PORPHOBILINOGEN QT (PBGQT)        PROCED     70.56           45.00       84110
LAB SEND OUT   3029427 0 PORPHYRINS,QT & FRACT (PORQT)     PROCED     115.92          131.10      84120
LAB SEND OUT   3029461 0 POTASSIUM URINE (URORSK)          PROCED     49.26           49.26       84133
LAB SEND OUT   3029467 0 POTASSIUM URINE (RSTONE)          PROCED     49.26           49.26       84133
LAB SEND OUT   3029424 0 PREGNANETRIOL (PTRIOL)            PROCED     26.46           195.70      84138
LAB SEND OUT   3029223 0 17-HYDROXYPREGNENOLONE (POHPN)    PROCED     128.52          59.80       84143
LAB SEND OUT   3029399 0 17OH PREGNENOLONE (PPRGN)         PROCED     31.89           150.00      84143
LAB SEND OUT   3029273 0 WESTERN BLOT, I&R (ANNAWB)        PROCED     99.00           99.00       84181
LAB SEND OUT   3029548 0 PROTOPORPHYRIN, RBC, QT (FEP)     PROCED     68.90           79.60       84202
LAB SEND OUT   3029054 0 PROINSULIN (PINSUL)               PROCED     223.85          45.00       84206
LAB SEND OUT   3029090 0 VITAMIN B6 (VB6)                  PROCED     157.82          30.09       84207
LAB SEND OUT   3029006 0 PYRUVATE (PYRU)                   PROCED     135.25          36.80       84210
LAB SEND OUT   3029443 0 THYRTRP BIND INHIB IG (TBIIP)     PROCED     51.49           223.95      84235
LAB SEND OUT   3029441 0 IMMUNO ASSY; SOL TRANSFRN (STR)   PROCED     193.87          56.20       84238
LAB SEND OUT   3029300 0 PLASMA RENIN (RENACT)             PROCED     139.01          30.00       84244
LAB SEND OUT   3029574 0 SEROTONIN (SEROT)                 PROCED     186.14          69.00       84260
LAB SEND OUT   3029462 0 SODIUM URINE (URORSK)             PROCED     52.18           52.18       84300
LAB SEND OUT   3029466 0 SODIUM URINE (RSTONE)             PROCED     52.18           52.18       84300
LAB SEND OUT   3029395 0 SOMATOMEDIN (IGF1P)               PROCED     69.96           63.10       84305
LAB SEND OUT   3029914 0 SOMATOMEDIN (SOMATO)              PROCED     159.67          35.40       84305
LAB SEND OUT   3029155 0 BETA GLUCURONIDASE (BETAG)        PROCED     120.37          124.20      84311
LAB SEND OUT   3029264 0 SPECTROPHOTOM (ADDEAF)            PROCED     120.37          105.00      84311
LAB SEND OUT   3029156 0 SUGARS, SNGL QL EA (FREDS)        PROCED     7.69            25.60       84376
LAB SEND OUT   3029465 0 SULFATE URINE (RSTONE)            PROCED     52.12           52.12       84392
LAB SEND OUT   3029386 0 TESTOSTERONE, FREE (TSTNP)        PROCED     75.64           96.50       84402
LAB SEND OUT   3029225 0 TESTOSTERONE, TOTAL               PROCED     155.85          70.00       84403
LAB SEND OUT   3029387 0 TESTOSTERONE, TOT (TSTNP)         PROCED     76.88           96.50       84403
LAB SEND OUT   3029067 0 VITAMIN B1, THIAMINE (VITB1)      PROCED     126.17          34.40       84425
LAB SEND OUT   3029378 0 THIOCYANATE (THIOCY)              PROCED     45.00           45.00       84430
LAB SEND OUT   3029324 0 THYROGLOBULIN (TGSENS)            PROCED     75.87           47.50       84432
LAB SEND OUT   3029179 0 FREE T4 (FT4ED)                   PROCED     85.80           63.60       84439
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029166 0 THYROID STIMUL IMMUNOGLOB (TSI      PROCED     181.44          144.05      84445
LAB SEND OUT   3029908 0 VITAMIN E (VITE)                    PROCED     104.89          32.00       84446
LAB SEND OUT   3029573 0 REVERSE T3 (RT3)                    PROCED     138.42          39.00       84482
LAB SEND OUT   3029175 0 TRYPSPIN FECES (TRYPF)              PROCED     10.20           28.90       84488
LAB SEND OUT   3029307 0 TYROSINE (PKUT4)                    PROCED     14.53           40.55       84510
LAB SEND OUT   3029463 0 URIC OTHER (URORSK)                 PROCED     53.31           53.31       84560
LAB SEND OUT   3029464 0 URIC OTHER (RSTONE)                 PROCED     53.31           53.31       84560
LAB SEND OUT   3029169 0 VASOACTIVE INTESTINAL PEPT(VIP      PROCED     186.84          41.65       84586
LAB SEND OUT   3029152 0 VASOPRESSIN (ADH)                   PROCED     111.64          40.40       84588
LAB SEND OUT   3029170 0 VITAMIN A (VITA)                    PROCED     108.54          32.00       84590
LAB SEND OUT   3029101 0 VITAMIN K1 (VITK)                   PROCED     205.20          72.00       84597
LAB SEND OUT   3029117 0 VOLATILES (ALCID)                   PROCED     109.76          44.00       84600
LAB SEND OUT   3029944 0 METHANOL (METHAN)                   PROCED     109.76          79.00       84600
LAB SEND OUT   3029034 0 XYLOSE ABSORPTION, URINE (UXYL)     PROCED     122.02          63.90       84620
LAB SEND OUT   3029008 0 ZINC (ZINC)                         PROCED     58.41           23.20       84630
LAB SEND OUT   3029304 0 ZINC, URINE (UZN)                   PROCED     25.50           25.50       84630
LAB SEND OUT   3029972 0 C-PEPTIDE (CPE)                     PROCED     98.82           21.30       84681
LAB SEND OUT   3029411 0 GONADOTROPIN QUANT (BHCGT)          PROCED     119.15          15.10       84702
LAB SEND OUT   3029358 0 HEMOLYSIN, ACID (HAM)               PROCED     12.40           50.74       85475
LAB SEND OUT   3029874 0 MURAMIDASE (LYSO)                   PROCED     97.32           27.95       85549
LAB SEND OUT   3029398 0 OSMO FRAG, RBC UNINC (OSFRAG)       PROCED     9.34            80.10       85555
LAB SEND OUT   3029362 0 VISCOSITY, SERUM (VISSER)           PROCED     16.32           24.61       85810
LAB SEND OUT   3029363 0 VISCOSITY, BLOOD (VISBLD)           PROCED     16.32           24.61       85810
LAB SEND OUT   3029974 0 ALLERGN SPEC IGE QT/SEM (ZONE 10)   PROCED     49.54           2.70        86003
LAB SEND OUT   3029319 0 B2 GLYCOPRT I IGA (B2GPA)           PROCED     140.62          85.80       86146
LAB SEND OUT   3029320 0 B2 GLYCOPRT I IGG/M (B2GPGM)        PROCED     140.62          24.90       86146
LAB SEND OUT   3029412 0 CARDIOLIPIN ANTIBODY (CLIPIN)       PROCED     101.95          25.50       86147
LAB SEND OUT   3029070 0 ANTIPHOSPHATI/SERINE AB(APHSAB      PROCED     61.20           27.50       86148
LAB SEND OUT   3029971 0 COLD AGGLUTININ (COLDAG)            PROCED     55.05           21.40       86157
LAB SEND OUT   3029256 0 COMPLEMNT ANTG (COMPC2)             PROCED     136.00          47.15       86160
LAB SEND OUT   3029265 0 COMPLEMNT; ANTG (C1EST)             PROCED     136.00          23.05       86160
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029102 0 C 1 ESTERASE INHIBITOR (C1ESTI   PROCED     105.93          41.90       86161
LAB SEND OUT   3029031 0 TOTAL HEM COMPLEMENT (CH50)      PROCED     142.80          28.80       86162
LAB SEND OUT   3029219 0 COMPLEMNT FIX (LISTAB)           PROCED     189.71          80.70       86171
LAB SEND OUT   3029391 0 IMMN ASY NON-INF AB (CCPG)       PROCED     16.12           40.50       86200
LAB SEND OUT   3029057 0 DEOXYRIBONUCLEASE AB (DNB)       PROCED     84.51           25.40       86215
LAB SEND OUT   3029802 0 DNA AB CRITHIDIA IFA (DNAAB)     PROCED     132.39          31.54       86225
LAB SEND OUT   3029417 0 SINGLE STRANDED DNA (SSDNA)      PROCED     39.99           39.00       86226
LAB SEND OUT   3029127 0 SCLERODERMA AB (SCLER)           PROCED     113.35          31.50       86235
LAB SEND OUT   3029477 0 EXTRACT NUC AG AB TO (J01AB)     PROCED     113.40          113.40      86235
LAB SEND OUT   3029478 0 EXTRACT NUC AG AB TO (ENE5AB)    PROCED     113.40          19.50       86235
LAB SEND OUT   3029055 0 FLUORESCENT AB, SCR (ADREN)      PROCED     122.69          60.60       86255
LAB SEND OUT   3029062 0 IMFLUOR ASAY OV AB (ANOV)        PROCED     122.69          97.15       86255
LAB SEND OUT   3029108 0 FLUOR AB, STR MUSCL (STMUS)      PROCED     122.69          31.50       86255
LAB SEND OUT   3029271 0 IMFLUOR ASAY HU/RI (ANNA12)      PROCED     122.69          33.10       86255
LAB SEND OUT   3029353 0 FLUOR NON INF, EA AB (IBDA)      PROCED     35.96           34.60       86255
LAB SEND OUT   3029413 0 FLUOR AB INDIR,SKIN AB(SKINAB)   PROCED     122.69          33.30       86255
LAB SEND OUT   3029203 0 FLUORESCENT AB, TIT (ENDBL)      PROCED     101.51          33.00       86256
LAB SEND OUT   3029272 0 FLUORESCENT AB, TIT (ANNAT)      PROCED     101.51          56.14       86256
LAB SEND OUT   3029276 0 FLUORESCENT AB, TIT (STMUBL)     PROCED     33.00           33.00       86256
LAB SEND OUT   3029193 0 IMMUN ASSY QT CA15-3 (C153)      PROCED     103.67          27.50       86300
LAB SEND OUT   3029620 0 CANCER AG 19-9 (CA199)           PROCED     86.40           33.40       86301
LAB SEND OUT   3029201 0 IMMUNOASSAY TUMOR AG (NSE)       PROCED     116.82          70.65       86316
LAB SEND OUT   3029103 0 ANTIBODY, RABIES VIRUS (RABIES   PROCED     93.84           71.25       86317
LAB SEND OUT   3029246 0 IMMUNAS INF, AB QT (HFLUAB)      PROCED     93.84           23.90       86317
LAB SEND OUT   3029252 0 IMMUNAS INF, AB QT (DIPHAB)      PROCED     93.84           45.00       86317
LAB SEND OUT   3029416 0 IMMUNOASY,PNEUMOCO AB (PNEUMO)   PROCED     93.84           5.50        86317
LAB SEND OUT   3029110 0 IMMUNODIF,TEICHOIC ACID(TEICHO   PROCED     107.35          29.45       86329
LAB SEND OUT   3029084 0 IMMUNOD, HYPER PNEUM (HYPSEN)    PROCED     34.56           146.00      86331
LAB SEND OUT   3029075 0 CIRCULATING IMMUNOGLOBULIN(CIC   PROCED     161.33          0.00        86332
LAB SEND OUT   3029305 0 IMMUNE COMPLEX ASSY (C1Q)        PROCED     161.33          21.35       86332
LAB SEND OUT   3029261 0 IMMUNO ELP, FLUID (B2TRAN)       PROCED     247.04          79.95       86335
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029330 0 INHIBIN A (QUAD4)                PROCED     21.77           59.92       86336
LAB SEND OUT   3029068 0 INSULIN ANTIBODY (INSLAB)        PROCED     113.29          56.60       86337
LAB SEND OUT   3029332 0 INSULIN ANTIBODIES (DIABA)       PROCED     29.92           83.56       86337
LAB SEND OUT   3029087 0 INTRINSIC FACTOR AB (INTAB)      PROCED     121.91          25.60       86340
LAB SEND OUT   3029088 0 ISLET CELL AB (ISLET)            PROCED     181.72          39.20       86341
LAB SEND OUT   3029331 0 ISLET CELL ANTIBODY (DIABA)      PROCED     27.65           77.22       86341
LAB SEND OUT   3029337 0 PART AGGLUT SCR, EA (STPZYM)     PROCED     14.88           24.07       86403
LAB SEND OUT   3029336 0 PART AGGLUT TITER (STPZBL)       PROCED     14.87           25.19       86406
LAB SEND OUT   3029801 0 QUANTIFERON TB GOLD (QFTG)       PROCED     86.60           86.60       86480
LAB SEND OUT   3029335 0 SYPHILIS TEST, QL (VDRLSF)       PROCED     12.40           22.24       86592
LAB SEND OUT   3029808 0 SYPHILIS QUAL (SCIDM)            PROCED     5.96            5.96        86592
LAB SEND OUT   3029249 0 SYPHILIS TEST, QNT (FTAIGM)      PROCED     58.51           54.65       86593
LAB SEND OUT   3029013 0 ADENOVIRUS AB (ADENO)            PROCED     37.80           18.00       86603
LAB SEND OUT   3029283 0 ASPERGILLUS                      PROCED     75.60           27.84       86606
LAB SEND OUT   3029196 0 BARTONELLA QUIN (BQUIN)          PROCED     14.22           19.80       86611
LAB SEND OUT   3029197 0 BARTONELLA HENS (BHENS)          PROCED     14.22           16.50       86611
LAB SEND OUT   3029267 0 AB BLASTOMYCES (BLASO)           PROCED     54.00           27.30       86612
LAB SEND OUT   3029198 0 BORDETELLA PERTUS (PERTAB)       PROCED     18.43           30.50       86615
LAB SEND OUT   3029259 0 AB B BURGDF CONFRM (LYMAB)       PROCED     78.84           30.20       86617
LAB SEND OUT   3029258 0 AB BRUCELLA (BRUAB)              PROCED     38.01           22.50       86622
LAB SEND OUT   3029159 0 ANTIBODY, CANDIDA (CANDAB)       PROCED     92.34           25.88       86628
LAB SEND OUT   3029073 0 CHLAMYDIA ANTIBODY (CLMPN)       PROCED     67.97           38.30       86631
LAB SEND OUT   3029100 0 CHLAMYDIA PSITTACOSIS AB(PSIT)   PROCED     67.97           69.80       86631
LAB SEND OUT   3029445 0 CHLAM TRACH IGG (CTRACH)         PROCED     67.97           38.30       86631
LAB SEND OUT   3029072 0 CHLAMYDIA ANTIBODY,IGM (CLMPNM   PROCED     41.85           41.30       86632
LAB SEND OUT   3029268 0 AB CHLAMYDIA (CHLABM)            PROCED     41.85           24.25       86632
LAB SEND OUT   3029444 0 CHLAM TRACH IGM (CTRACH)         PROCED     41.85           41.30       86632
LAB SEND OUT   3029199 0 COCCIDIOIDES ABS (COCCSF)        PROCED     50.61           12.75       86635
LAB SEND OUT   3029481 0 CMV ABS IGG QT (CMVGQ)           PROCED     82.50           82.50       86644
LAB SEND OUT   3029809 0 CYTOMEGALOVIRUS AB (SCIDM)       PROCED     20.11           20.11       86644
LAB SEND OUT   3029480 0 CMV ABS IGM QT (CMVMQ)           PROCED     82.50           82.50       86645
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029313 0 ENCEPH AB, CALIF (ARBOVM/G)      PROCED     27.54           6.25        86651
LAB SEND OUT   3029314 0 ENCEPH AB, E.EQUIN (ARBOVM/G)    PROCED     18.43           6.25        86652
LAB SEND OUT   3029315 0 ENCEPH AB, STL (ARBOVM/G)        PROCED     18.43           6.25        86653
LAB SEND OUT   3029318 0 ENCEPH AB, W.EQUIN (ARBOVM/G)    PROCED     18.43           6.25        86654
LAB SEND OUT   3029076 0 ENTEROVIRU AB,COXSACKIE A(COXA   PROCED     115.19          170.80      86658
LAB SEND OUT   3029077 0 ENTEROVIRU AB,COXSACKIE B(COXB   PROCED     115.19          100.40      86658
LAB SEND OUT   3029079 0 ENTEROVIRUS AB,ECHOVIRUS(ECHOV   PROCED     115.19          18.60       86658
LAB SEND OUT   3029099 0 ENTEROVIRUS AB, POLIO (POLIO)    PROCED     115.19          20.65       86658
LAB SEND OUT   3029414 0 EBV EA (EBVPAN)                  PROCED     80.78           9.90        86663
LAB SEND OUT   3029402 0 EPSTEIN BARR NUCLEAR AG(EBVNA)   PROCED     120.96          11.50       86664
LAB SEND OUT   3029403 0 EPSTEIN BARR VCA (EBVCA)         PROCED     93.41           13.70       86665
LAB SEND OUT   3029352 0 FUNGUS AB (IBDA)                 PROCED     17.13           35.20       86671
LAB SEND OUT   3029247 0 GIARDIA LAMBLIA (GIARAB)         PROCED     87.48           83.40       86674
LAB SEND OUT   3029244 0 H. PYLORI AB IGM (HPYLIM)        PROCED     114.28          34.50       86677
LAB SEND OUT   3029119 0 AB HELMINTH,TOXOCAR (TOXC)       PROCED     85.91           62.00       86682
LAB SEND OUT   3029254 0 AB HELMINTH (CYSTAB)             PROCED     85.91           58.15       86682
LAB SEND OUT   3029025 0 HTLVI/II WESTERN BLOT (HTLVC)    PROCED     131.49          75.10       86689
LAB SEND OUT   3029404 0 HEPATITIS,DELTA AGENT (HDAB)     PROCED     52.01           34.70       86692
LAB SEND OUT   3029284 0 HISTOPLASMA                      PROCED     61.56           29.90       86698
LAB SEND OUT   3029803 0 HIV 1/2 AB (SCIDM)               PROCED     19.17           19.17       86703
LAB SEND OUT   3029806 0 HEPATITIS B CORE AB (SCIDM)      PROCED     16.84           16.84       86704
LAB SEND OUT   3029409 0 HEPATITIS BE ANTIBODY (HBEAB)    PROCED     55.00           29.18       86707
LAB SEND OUT   3029081 0 INFLUENZA AB (FLUAB)             PROCED     87.48           11.85       86710
LAB SEND OUT   3029415 0 LEPTOSPIRA AB (LEPTO)            PROCED     18.43           41.60       86720
LAB SEND OUT   3029425 0 MUMPS IGG/IGM AB (MUMPSG/M)      PROCED     103.95          18.35       86735
LAB SEND OUT   3029226 0 MYCOPLASMA TITER (MYCO)          PROCED     77.76           18.90       86738
LAB SEND OUT   3029097 0 PARVOVIRUS AB (PARVO)            PROCED     40.84           21.40       86747
LAB SEND OUT   3029270 0 PROTOZOA NOT SPEC (EAMOEB)       PROCED     48.05           40.50       86753
LAB SEND OUT   3029104 0 RESPIRATORY SYNCYTIAL VI(RSVAB   PROCED     81.54           18.30       86756
LAB SEND OUT   3029277 0 AB RICKETTSIA (ROCKY)            PROCED     27.05           23.80       86757
LAB SEND OUT   3029106 0 RUBELLA IGM (RUBEM)              PROCED     76.76           25.30       86762
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
LAB SEND OUT   3029091 0 RUBEOLA IGM (MEASM)               PROCED     68.58           28.40       86765
LAB SEND OUT   3029111 0 TETANUS AB (TETAB)                PROCED     99.23           31.80       86774
LAB SEND OUT   3029334 0 TOXOPLASMA IGM (TOXABM)           PROCED     20.12           22.42       86778
LAB SEND OUT   3029125 0 AB TRICHENELLA (TRAB)             PROCED     17.55           54.80       86784
LAB SEND OUT   3029086 0 VARICELLA ZOSTER IGM (VZV)        PROCED     78.20           24.60       86787
LAB SEND OUT   3029804 0 HTLV I/II (SCIDM)                 PROCED     18.00           18.00       86790
LAB SEND OUT   3029923 0 PARAINFLUENZA AB (PARFLU)         PROCED     89.78           15.10       86790
LAB SEND OUT   3029323 0 THYROGLOB AB (TGSENS)             PROCED     92.27           47.50       86800
LAB SEND OUT   3029805 0 HEPATITIS C VIRUS AB (SCIDM)      PROCED     19.94           19.94       86803
LAB SEND OUT   3029035 0 HEPATITIS C AB CONF (CHCVAB)      PROCED     156.60          122.74      86804
LAB SEND OUT   3029360 0 HEMLYSIN & AGLTN, INCU (SUCROS)   PROCED     16.92           44.53       86941
LAB SEND OUT   3029807 0 HEPATITIS B SURF AG (SCIDM)       PROCED     14.43           14.43       87340
LAB SEND OUT   3029410 0 HEPATITIS BE ANTIGEN (HBEAG)      PROCED     63.61           28.08       87350
LAB SEND OUT   3029238 0 HISTOPLASMA AG (HISTAG)           PROCED     147.46          110.00      87385
LAB SEND OUT   3029096 0 HIV P24 AG (P24AG)                PROCED     94.08           88.75       87390
LAB SEND OUT   3029390 0 INFECT AG, EIA (ASPERG)           PROCED     16.76           215.00      87449
LAB SEND OUT   3029266 0 B BURDORFERI PCR (LYMPCR)         PROCED     178.23          84.40       87476
LAB SEND OUT   3029253 0 CYTOMEG VIRUS PCR (CMVPCR)        PROCED     261.16          74.22       87496
LAB SEND OUT   3029140 0 HBV,AMPLIF PROBE (LIVER TISSUE    PROCED     178.47          217.70      87516
LAB SEND OUT   3029370 0 HBV DNA PCR QUANT (HBQPCR)        PROCED     93.00           93.00       87517
LAB SEND OUT   3029810 0 HEP C AMP PRB (SCIDM)             PROCED     49.04           49.04       87521
LAB SEND OUT   3029161 0 HSV VIRUS PCR (HSVPCR)            PROCED     170.64          76.85       87529
LAB SEND OUT   3029812 0 HIV AMP PRB (SCIDM)               PROCED     49.04           49.04       87535
LAB SEND OUT   3029368 0 HPV DNA PROBE (HPVIR)             PROCED     70.00           70.00       87621
LAB SEND OUT   3029133 0 INF AGT AMPLF PRB (EBVCSF)        PROCED     234.60          100.40      87798
LAB SEND OUT   3029206 0 INF AG DET; AMP PRB (VZPCR)       PROCED     234.60          71.50       87798
LAB SEND OUT   3029207 0 INF AG DET; AMP PRB (TOXG)        PROCED     234.60          111.15      87798
LAB SEND OUT   3029209 0 INF AG DET; AMP PRB (PARV)        PROCED     234.60          91.55       87798
LAB SEND OUT   3029811 0 INF AG NOS AMP PRB (SCIDM)        PROCED     6.00            6.00        87798
LAB SEND OUT   3029333 0 INF AG DET DNA PCR, QT (BKV)      PROCED     59.85           289.30      87799
LAB SEND OUT   3029317 0 HIV GENOTYPE (HIVGNO)             PROCED     756.00          488.75      87901
PARTIAL CHARGEMASTER - 12/13/06

                        Svc                                 CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)             LML/RML     CPT
LAB SEND OUT    3029442 0 NEUT OXID BRST, 1ST MARK (NOB)    PROCED     100.45             86.25       88184
LAB SEND OUT    3029946 0 NEUT OXID BRST, ADD MARK (NOB)    PROCED     28.37              86.25       88185
LAB SEND OUT    3029977 0 IMFLUOR INDIR EA AB (IBDCON)      PROCED     167.96             175.40      88347
LAB SEND OUT    3029328 0 FAT STAIN, URINE (UFAT)           PROCED     52.20              27.14       89125
LAB SEND OUT    3029158 0 SPERM ANTIBODIES (SPRMAB)         PROCED     14.91              35.30       89325
LAB SEND OUT    3029037 0 MISC SENDOUT                      PROCED     0.00               0.00
LAB SEND OUT    3029479 0 MISC LAB GENETIC TESTING (X12G)   PROCED     0.00               0.00
LAB SEND OUT    3029356 2 CYS FIB RLBILL (CFRLB)            PROCED     STATISTICAL ITEM   0.00
LAB SEND OUT    3029448 2 FIRST TRIMESTER SCR (FTS)         PROCED     STATISTICAL ITEM   0.00
LAB SPEC CHEM   3032035 0 ACUTE HEPATITIS PANEL (ACUTEH)    PROCED     454.50             46.45       80074
LAB SPEC CHEM   3030004 0 LAB COKEM                         PROCED     60.90              60.90       80101
LAB SPEC CHEM   3030050 0 CYCLOSPORINE A BLD (CYSAB)        PROCED     163.16             22.84       80158
LAB SPEC CHEM   3030941 0 CSA 2 HR PEAK (CSA2P)             PROCED     163.16             133.50      80158
LAB SPEC CHEM   3032806 0 TACROLIMUS (FK506B)               PROCED     182.30             26.33       80197
LAB SPEC CHEM   3064896 0 LAB ACTH                          PROCED     210.87             89.90       82024
LAB SPEC CHEM   3031010 0 MICROALBUMIN (MALB)               PROCED     62.18              16.30       82043
LAB SPEC CHEM   3030783 0 LAB A1AT                          PROCED     94.38              15.55       82103
LAB SPEC CHEM   3033640 0 LAB AFP                           PROCED     121.56             15.01       82105
LAB SPEC CHEM   3033641 0 AFP,AMNIOTIC FLUID                PROCED     111.24             24.90       82106
LAB SPEC CHEM   3033607 0 AMNIOTIC FLD SCAN (GSOD)          PROCED     82.60              54.10       82143
LAB SPEC CHEM   3030042 0 LAB BETA 2 MICROGLOBULIN          PROCED     143.00             43.30       82232
LAB SPEC CHEM   3030017 0 LAB CEA                           PROCED     158.79             14.02       82378
LAB SPEC CHEM   3031123 0 CATECHOLAMINES, UR (CAT)          PROCED     174.48             32.40       82382
LAB SPEC CHEM   3032788 0 LAB CERULO                        PROCED     84.20              11.98       82390
LAB SPEC CHEM   3060285 0 LAB CORT                          PROCED     159.05             10.05       82533
LAB SPEC CHEM   3037273 0 CRYOGLOBULIN (CRYO)               PROCED     61.02              19.23       82595
LAB SPEC CHEM   3063287 0 LAB B12                           PROCED     124.86             21.60       82607
LAB SPEC CHEM   3060026 0 LAB DHEAS                         PROCED     208.90             21.90       82627
LAB SPEC CHEM   3060618 0 ESTRADIOL (E2)                    PROCED     171.90             33.40       82670
LAB SPEC CHEM   3030200 0 LAB FERRITIN (FER)                PROCED     108.25             6.18        82728
LAB SPEC CHEM   3063286 0 LAB FOL                           PROCED     117.12             9.28        82746
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
LAB SPEC CHEM   3038015 0 FRUCTOSE,SEMEN (SEMFRC)          PROCED     81.30           71.60       82757
LAB SPEC CHEM   3032792 0 LAB IGG                          PROCED     93.93           9.79        82784
LAB SPEC CHEM   3032793 0 LAB IGA/IGACB                    PROCED     93.93           10.13       82784
LAB SPEC CHEM   3032794 0 LAB IGM/IGMCB                    PROCED     93.93           10.70       82784
LAB SPEC CHEM   3032032 0 GAMMAGLOBULIN IGE (IGE2)         PROCED     75.00           75.00       82785
LAB SPEC CHEM   3064875 0 LAB FSH                          PROCED     149.90          11.00       83001
LAB SPEC CHEM   3064688 0 LAB LH                           PROCED     160.98          10.86       83002
LAB SPEC CHEM   3062941 0 LAB HGH                          PROCED     94.09           73.70       83003
LAB SPEC CHEM   3032796 0 LAB HAPTO                        PROCED     116.59          11.36       83010
LAB SPEC CHEM   3038007 0 HGB ELECTROPHORESIS (HGBELP)     PROCED     109.64          35.47       83020
LAB SPEC CHEM   3033115 0 LAB GLYC HGB                     PROCED     93.58           12.71       83036
LAB SPEC CHEM   3031005 0 HOMOCYSTEIN (HCY)                PROCED     125.82          20.43       83090
LAB SPEC CHEM   3039005 0 IMMUNOASSAY,FACTOR X AG(FXAG)    PROCED     136.05          73.90       83520
LAB SPEC CHEM   3039007 0 IMMUNOASSAY,PT FRAG1.2 (PFRAG)   PROCED     136.05          104.10      83520
LAB SPEC CHEM   3039008 0 IMMUNOASSAY,THROM/ANTITHR(TAT)   PROCED     136.05          90.20       83520
LAB SPEC CHEM   3039009 0 TISS FAC PATH INH AG (TFPIAG)    PROCED     136.05          47.60       83520
LAB SPEC CHEM   3062943 0 LAB INS                          PROCED     120.61          54.10       83525
LAB SPEC CHEM   3030349 0 LAB BLEAD                        PROCED     73.87           15.00       83655
LAB SPEC CHEM   3033200 0 L/S RATIO QUANT (LS)             PROCED     132.70          21.60       83661
LAB SPEC CHEM   3036016 0 LAB FLM                          PROCED     100.00          48.70       83661
LAB SPEC CHEM   3032811 0 LAB LIPOPROTEIN A (LPA)          PROCED     136.05          16.30       83695
LAB SPEC CHEM   3031185 0 LAB META/PED META                PROCED     131.90          32.40       83835
LAB SPEC CHEM   3032900 0 NEPHELOM EA ANAL (KAPLAM/CIM)    PROCED     51.63           21.81       83883
LAB SPEC CHEM   3060368 0 LAB PTH                          PROCED     204.61          11.58       83970
LAB SPEC CHEM   3060395 0 INTRAOPERATIVE PTH (IOPTH)       PROCED     218.60          218.60      83970
LAB SPEC CHEM   3030051 0 BONE SPEC ALK PHOS (ALPBS)       PROCED     79.92           27.49       84080
LAB SPEC CHEM   3033201 0 PHOSPHATIDYLGLYCEROL (PG)        PROCED     132.70          21.60       84081
LAB SPEC CHEM   3032797 0 LAB PAB                          PROCED     82.18           9.65        84134
LAB SPEC CHEM   3060877 0 LAB PROGEST                      PROCED     137.81          21.50       84144
LAB SPEC CHEM   3062878 0 PROLACTIN (HPR)                  PROCED     147.71          16.30       84146
LAB SPEC CHEM   3030045 0 PSA DIAGNOSTIC (PSAD)            PROCED     120.35          16.30       84153
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
LAB SPEC CHEM   3030040 0 FREE PSA (TFPSA)                 PROCED     191.66          32.60       84154
LAB SPEC CHEM   3032801 0 LAB SPE                          PROCED     111.70          17.92       84165
LAB SPEC CHEM   3032033 0 PROT ELP, CSF / URIN W CONC      PROCED     116.80          28.60       84166
LAB SPEC CHEM   3060018 0 SEX HORM BINDING GLOBULIN        PROCED     88.43           82.60       84270
LAB SPEC CHEM   3060365 0 LAB TSTN                         PROCED     155.85          10.39       84403
LAB SPEC CHEM   3063201 0 THYROGLOBULIN (TG)               PROCED     92.50           60.80       84432
LAB SPEC CHEM   3063366 0 LAB FREE T4                      PROCED     115.70          9.14        84439
LAB SPEC CHEM   3063871 0 THYROXIN BINDNG GLOB (TBG)       PROCED     113.54          11.95       84442
LAB SPEC CHEM   3063393 0 LAB FREE T3                      PROCED     158.18          9.98        84481
LAB SPEC CHEM   3031125 0 LAB VMA/PED VMA                  PROCED     96.60           30.30       84585
LAB SPEC CHEM   3038021 0 BONE MARROW ASSIST (BMAA)        PROCED     114.50          114.50      85097
LAB SPEC CHEM   3039017 0 FACTOR II (FII)                  PROCED     179.43          81.20       85210
LAB SPEC CHEM   3039018 0 FACTOR V (FV)                    PROCED     189.81          29.40       85220
LAB SPEC CHEM   3039019 0 FACTOR VII (FII)                 PROCED     202.82          73.50       85230
LAB SPEC CHEM   3039020 0 FACTOR VIII (FVIII)              PROCED     168.90          54.46       85240
LAB SPEC CHEM   3039021 0 FACTOR VIII RELATED AG(F8RAG)    PROCED     282.04          108.20      85244
LAB SPEC CHEM   3039038 0 RISTOCETIN COFACTOR (RCOF)       PROCED     212.22          112.00      85245
LAB SPEC CHEM   3039042 0 FACTOR 8 VONWILLEBRAND(VWMULT)   PROCED     229.00          151.40      85247
LAB SPEC CHEM   3039023 0 FACTOR IX (FIX)                  PROCED     223.87          24.71       85250
LAB SPEC CHEM   3039024 0 FACTOR X (FX)                    PROCED     180.20          73.50       85260
LAB SPEC CHEM   3039025 0 FACTOR XI (FXI)                  PROCED     246.62          24.71       85270
LAB SPEC CHEM   3039026 0 FACTOR FXII (FXII)               PROCED     168.90          24.71       85280
LAB SPEC CHEM   3039027 0 FACTOR XIII SCRN SOLU (FXIII)    PROCED     71.20           30.30       85291
LAB SPEC CHEM   3039014 0 ANTITHROMBIN 3 ACTIVITY (AT3F)   PROCED     165.94          73.50       85300
LAB SPEC CHEM   3039035 0 PROTEIN C ANTIGEN (PROTC)        PROCED     208.30          86.50       85302
LAB SPEC CHEM   3039036 0 PROTEIN C ACTIVITY (PROTCA)      PROCED     172.80          110.30      85303
LAB SPEC CHEM   3039044 0 PROTEIN S ANTIGEN TOTAL(TPSAG)   PROCED     150.22          64.90       85305
LAB SPEC CHEM   3039006 0 PROTEIN S ACTIVITY (PSACT)       PROCED     213.17          117.90      85306
LAB SPEC CHEM   3039043 0 PROTEIN S ANTIGEN FREE (FPSAG)   PROCED     213.17          69.20       85306
LAB SPEC CHEM   3039032 0 ACTIVATED PROT C RES (APCRES)    PROCED     121.26          88.70       85307
LAB SPEC CHEM   3039022 0 FACTOR INHIBITOR TEST (F8INHB)   PROCED     117.54          117.54      85335
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML          CPT
LAB SPEC CHEM   3039033 0 PLASMINOGEN,EXC ANTIG (PMGF)     PROCED     175.69          86.50            85420
LAB SPEC CHEM   3039010 0 PLASMINOGEN AGEN ASSAY(TPAAG)    PROCED     170.90          164.20           85421
LAB SPEC CHEM   3039012 0 HEPARIN ASSAY (AXA)              PROCED     120.50          102.80           85520
LAB SPEC CHEM   3038009 0 LEUKOCYTE ALKALINE PHOS (LAP)    PROCED     99.00           84.40            85540
LAB SPEC CHEM   3039034 0 PLATELET AGG,EA AGENT (PLTAGR)   PROCED     107.37          46.80            85576
LAB SPEC CHEM   3039050 0 PLATELET AGGREGATION EA AGNT     PROCED     287.10          173.00           85576
LAB SPEC CHEM   3039051 0 PLATELET AGGREGATION (HIT2)      PROCED     287.10          21.55            85576
LAB SPEC CHEM   3039046 0 MIXING STUDY-PT                  PROCED     94.74           44.40            85611
LAB SPEC CHEM   3039039 0 RUSSEL VIPER VENOM,DIL (DRVVT)   PROCED     94.40           92.00            85613
LAB SPEC CHEM   3039047 0 THROMBIN TIME                    PROCED     61.73           27.10            85670
LAB SPEC CHEM   3039015 0 PTT SUBSTITUTION FRA,EA(CIRCIN   PROCED     101.84          32.40            85732
LAB SPEC CHEM   3039048 0 MIXING STUDY PTT (MIXSTD)        PROCED     101.84          44.40            85732
LAB SPEC CHEM   3033009 0 LATEX SPECIFIC IGE               PROCED     49.54           31.70            86003
LAB SPEC CHEM   3061930 0 LAB ALLERGEN, IGE (ALRGN)        PROCED     49.54           15.00            86003
LAB SPEC CHEM   3039011 0 PLT ANTIBODIES,HEPARIN (SRA)     PROCED     277.90          216.30           86022
LAB SPEC CHEM   3037192 0 LAB ANA                          PROCED     131.90          21.61            86038
LAB SPEC CHEM   3037194 0 LAB ASO                          PROCED     91.40           54.10            86060
LAB SPEC CHEM   3037200 0 LAB CRPRO                        PROCED     69.67           15.07            86140
LAB SPEC CHEM   3037279 0 C REACT PROT, HI SENS (CRPHS)    PROCED     81.95           81.95            86141
LAB SPEC CHEM   3037270 0 ANTI-CARDIOLIPIN ABS (ACL)       PROCED     112.60          22.50            86147
LAB SPEC CHEM   3037207 0 LAB C3                           PROCED     136.00          9.15             86160
LAB SPEC CHEM   3037209 0 LAB C4                           PROCED     136.00          9.65             86160
LAB SPEC CHEM   3037190 0 CYCLIC CITRUL PEP AB (CCPG)      PROCED     50.00           $        50.00   86200
LAB SPEC CHEM   3037189 0 LAB DNA                          PROCED     132.39          54.10            86225
LAB SPEC CHEM   3037274 0 EXTRACTABLE NUC AG,EA AB (ENA)   PROCED     113.40          27.30            86235
LAB SPEC CHEM   3037196 0 ANTI-NEUT CYTOPLASMIC AB         PROCED     122.69          13.68            86255
LAB SPEC CHEM   3037271 0 FLUORESCENT AB SCRN,AMA (AMA)    PROCED     122.69          31.68            86255
LAB SPEC CHEM   3037272 0 FLUORESCENT AB SCRN,ASMA(ASMA)   PROCED     122.69          31.68            86255
LAB SPEC CHEM   3037275 0 FLUORESCENT AB SCRN,APCA(APCA)   PROCED     122.69          105.00           86255
LAB SPEC CHEM   3030044 0 CA27-29                          PROCED     103.67          37.90            86300
LAB SPEC CHEM   3030046 0 CANCER AG 19-9 (CA199)           PROCED     33.30           33.30            86301
PARTIAL CHARGEMASTER - 12/13/06

                        Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
LAB SPEC CHEM   3030043 0 CA125                                 PROCED     133.90          47.60       86304
LAB SPEC CHEM   3037228 0 LAB MONO                              PROCED     55.30           6.00        86308
LAB SPEC CHEM   3032256 0 LAB IFES                              PROCED     213.21          75.69       86334
LAB SPEC CHEM   3032034 0 IMMUNFIX ELP, FLD W CONC              PROCED     157.30          81.20       86335
LAB SPEC CHEM   3034121 0 B CELLS, TTL CNT (TBSC)               PROCED     82.44           30.62       86355
LAB SPEC CHEM   3034124 0 NAT KILL CELLS, TTL CT (TBSC)         PROCED     82.44           30.62       86357
LAB SPEC CHEM   3034119 0 T CELLS TOTAL CNT (CD48)              PROCED     65.45           30.65       86359
LAB SPEC CHEM   3034122 0 T CELLS TOTAL CNT (TBSC)              PROCED     82.44           30.62       86359
LAB SPEC CHEM   3034120 0 T CELLS ABS CNT / RATIO (CD48)        PROCED     81.55           38.15       86360
LAB SPEC CHEM   3034123 0 T CELLS ABS CNT / RATIO (TBSC)        PROCED     102.68          38.14       86360
LAB SPEC CHEM   3034112 0 ABSOLUTE CD4 COUNT (CD4ABS)           PROCED     132.00          60.00       86361
LAB SPEC CHEM   3034117 0 STEM CELLS, TTL COUNT (CD34)          PROCED     147.20          64.90       86367
LAB SPEC CHEM   3037257 0 LAB LIVER KIDNEY MICRO AB(LKM)        PROCED     86.56           22.80       86376
LAB SPEC CHEM   3037262 0 MICROSOMAL AB, EA (TPOAB)             PROCED     86.56           37.90       86376
LAB SPEC CHEM   3037235 0 LAB RAF                               PROCED     91.40           9.24        86431
LAB SPEC CHEM   3037238 0 LAB RPR                               PROCED     46.04           10.77       86592
LAB SPEC CHEM   3037226 0 LAB LYMEAB                            PROCED     112.01          48.32       86618
LAB SPEC CHEM   3037212 0 LAB CRYPTO                            PROCED     89.76           21.06       86641
LAB SPEC CHEM   3037201 0 LAB CMV                               PROCED     128.67          8.81        86644
LAB SPEC CHEM   3037203 0 LAB CMVM                              PROCED     147.30          11.41       86645
LAB SPEC CHEM   3037213 0 LAB EBV                               PROCED     201.90          9.27        86665
LAB SPEC CHEM   3037214 0 LAB EBVM                              PROCED     201.90          18.26       86665
LAB SPEC CHEM   3037259 0 LAB HPYLOR                            PROCED     114.28          12.59       86677
LAB SPEC CHEM   3037254 0 HTLV/HIV AB CONF, WEST BLT (ROUTWB)   PROCED     131.49          95.20       86689
LAB SPEC CHEM   3037219 0 LAB HSV                               PROCED     128.10          28.10       86694
LAB SPEC CHEM   3037221 0 LAB HSVM                              PROCED     147.30          55.20       86694
LAB SPEC CHEM   3037263 0 HIV 1 ANTIBODIES                      PROCED     82.03           20.08       86701
LAB SPEC CHEM   3037224 0 HIV1, HIV2 (HIVAB)                    PROCED     91.53           12.60       86703
LAB SPEC CHEM   3032580 0 LAB CORAB                             PROCED     103.17          9.31        86704
LAB SPEC CHEM   3030033 0 LAB CORABM                            PROCED     123.01          21.60       86705
LAB SPEC CHEM   3032810 0 LAB HBSABQ (ANTI HBS, QUANT)          PROCED     92.10           11.41       86706
PARTIAL CHARGEMASTER - 12/13/06

                        Svc                                  CHARGE     PRICE (INPT /      LAB PRICE
CDM Area        Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)             LML/RML     CPT
LAB SPEC CHEM   3032581 0 LAB HAVAB                          PROCED     83.16              10.76       86708
LAB SPEC CHEM   3032031 0 LAB HAVAB M                        PROCED     97.87              12.93       86709
LAB SPEC CHEM   3037225 0 LAB LEGION                         PROCED     84.11              27.10       86713
LAB SPEC CHEM   3037239 0 LAB RUBELA                         PROCED     76.76              9.80        86762
LAB SPEC CHEM   3037278 0 RUBEOLA, IGG AB (MEASLE)           PROCED     68.58              52.40       86765
LAB SPEC CHEM   3037247 0 LAB TOXO                           PROCED     97.20              16.30       86777
LAB SPEC CHEM   3037218 0 LAB FTA                            PROCED     99.60              64.90       86781
LAB SPEC CHEM   3037252 0 LAB VZV                            PROCED     109.20             32.40       86787
LAB SPEC CHEM   3037258 0 VIRUS AB NOS (HTLV12)              PROCED     89.78              18.00       86790
LAB SPEC CHEM   3063200 0 THYROGLOBULIN ANTIBODY (TGSCN)     PROCED     92.27              60.80       86800
LAB SPEC CHEM   3035017 0 ANTI-HEPATITIS C VIRUS             PROCED     129.06             18.68       86803
LAB SPEC CHEM   3032001 0 LAB CHBSAG                         PROCED     97.42              32.65       87340
LAB SPEC CHEM   3032691 0 LAB HBSAG                          PROCED     97.42              8.93        87340
LAB SPEC CHEM   3034114 0 FLOW CYT, CELL SURF MRK, 1ST       PROCED     100.45             30.60       88184
LAB SPEC CHEM   3034115 0 FLOW CYT, 1ST MARKER (CYTOP)       PROCED     218.60             135.40      88184
LAB SPEC CHEM   3034118 0 FLOW CYT, 1ST MARKER (TDT)         PROCED     248.80             219.40      88184
LAB SPEC CHEM   3034110 0 ADDL CELL SURFACE MARK(ADMARK)     PROCED     100.45             30.60       88185
LAB SPEC CHEM   3038001 0 GRP II STN,ACID PHOSPHAT (ACD)     PROCED     72.53              72.53       88313
LAB SPEC CHEM   3038010 0 GRP II STN, GIEMSA (MCG)           PROCED     78.00              52.20       88313
LAB SPEC CHEM   3038014 0 GRP II STN, SUDANBLACK (SBB)       PROCED     72.53              72.53       88313
LAB SPEC CHEM   3038022 0 IRON STAIN, RBC, BM (IRONST)       PROCED     86.29              72.00       88313
LAB SPEC CHEM   3038002 0 DETERMIN HISTOCH ENZ AEST,BEST     PROCED     107.30             107.30      88319
LAB SPEC CHEM   3038012 0 IMMUNOPEROXIDASE (PEROX)           PROCED     176.55             111.20      88342
LAB SPEC CHEM   3038016 0 SEMEN ANALYSIS COMPLETE (SMN)      PROCED     164.16             106.30      89320
LAB SPEC CHEM   3038013 0 SEMEN ANALYS, PRES/MOTIL (PVSMN)   PROCED     38.10              38.10       89321
LAB SPEC CHEM   3030041 0 LAB PSA (PROSTRATE SPCF ANTIG)     PROCED     105.57             13.70       G0103
LAB SPEC CHEM   3034233 0 LAB MISC SP CHEM                   PROCED     0.00               0.00
LAB SPEC CHEM   3034113 2 LEUKOREDUCED WBC (LRWBCO)          PROCED     STATISTICAL ITEM   0.00
MAT MGMT        2729066 0 CATH TRAY FOLEY 16FR W/ BAG        SUPPLY     27.30
MAT MGMT        2710020 0 SHOE DIABET SM EA (NON-CUSTOM)     SUPPLY     157.30
MAT MGMT        2710021 0 SHOE DIABET MED EA (NON-CUSTOM)    SUPPLY     164.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE        PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY      OUTPT)          LML/RML     CPT
MAT MGMT      2710022 0 SHOE DIABET LG EA (NON-CUSTOM)               SUPPLY        164.80
MAT MGMT      2710023 0 SHOE DIABET XL EA (NON-CUSTOM)               SUPPLY        164.76
MAT MGMT      2720663 0 WIRE J GUIDE TEFLON 0.38 IN                  SUPPLY        20.66                       C1769
MAT MGMT      2728220 0 WIRE GUIDE WIRE J .025 150CM                 SUPPLY        30.90                       C1769
MAT MGMT      2728221 0 WIRE GUIDEWIRE 0.035 J TIP 70C,              SUPPLY        28.90                       C1769
MAT MGMT      2740395 0 BED THERAPULSE II KCI                        SUPPLY MEMS   221.24
MAT MGMT      2740661 0 BED AIR FLUIDIZED THERAPY KCI                SUPPLY MEMS   161.00
MAT MGMT      2740402 0 BED FIRST STEP SELECT OVERLAY                SUPPLY        53.51
MAT MGMT      2740397 0 BED FIRST STEP HEAVY DUTY KCI                SUPPLY MEMS   75.46
MAT MGMT      2740062 0 BED BARIMAXX II KCI                          SUPPLY MEMS   208.25
MAT MGMT      2740392 0 BED BARIAIR THERAPY SYSTEM KCI               SUPPLY MEMS   377.32
MAT MGMT      2740393 0 WOUND ASST CLOSURE - WOUND VAC KCI           SUPPLY MEMS   162.00
MAT MGMT      2718200 0 DRSG ASSEMBLY SM VAC                         SUPPLY        73.90
MAT MGMT      2718201 0 DRSG ASSEMBLY MED VAC                        SUPPLY        87.00
MAT MGMT      2718202 0 DRSG ASSEMBLY LG VAC                         SUPPLY        105.00
MAT MGMT      2718203 0 CANNISTER ASSEMBLY VAC                       SUPPLY        97.00
MAT MGMT      2708028 0 COLLAR CERV SOFT                             SUPPLY        75.96                       L0120
MAT MGMT      2708029 0 COLLAR CERV SEMI RIGID ADJ MOLDED CHN        SUPPLY        236.24                      L0150
MAT MGMT      2708031 0 COLLAR CERV MIAMI J                          SUPPLY        312.55                      L0172
MAT MGMT      2708032 0 COLLAR CERV SUPP ADJ CERV BAR                SUPPLY        1,174.22                    L0190
MAT MGMT      2709103 0 COLLAR CERV SUP ADJ BAR & THOR               SUPPLY        1,362.03                    L0200
MAT MGMT      2708082 0 TLSO RIGID FRAME HYPEREX PREFAB              SUPPLY        1,051.11                    L0472
MAT MGMT      2742339 0 TLSO RIGID PLASTIC CUSTOM                    SUPPLY        3,333.32                    L0480
MAT MGMT      2708083 0 CTLSO CONTROL WITH INTERFACE                 SUPPLY        5,673.16                    L0710
MAT MGMT      2708034 0 HALO CERVICAL INTO JACKET VEST               SUPPLY        5,898.65                    L0810
MAT MGMT      2708035 0 HALO CERVICAL INTO BODY JACKET               SUPPLY        235.80                      L0820
MAT MGMT      2708036 0 HALO CERVICAL INTO MILWAUKEE TYPE ORTHOSIS   SUPPLY        7,100.11                    L0830
MAT MGMT      2708037 0 MAGNETIC RES IMAGE COMP ADD TO HALO          SUPPLY        2,513.82
MAT MGMT      2708038 0 TLSO - CORSET FRONT                          SUPPLY        235.81                      L0970
MAT MGMT      2708050 0 HO POST OP HIP ABDUCTION                     SUPPLY        2,067.90                    L1686
MAT MGMT      2708039 0 KO ADJ INT POS RIGID SUPPORT PREFAB          SUPPLY        1,520.11                    L1832
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2708057 0 AFO MOLD TO PT MODEL                           SUPPLY     1,111.60                    L1940
MAT MGMT      2708043 0 AFO POS SOLID ANKLE PLASTIC MOLD CUSTOM        SUPPLY     1,148.10                    L1960
MAT MGMT      2708055 0 AFO SOLID ANKLE PLASTIC                        SUPPLY     1,490.00                    L1960
MAT MGMT      2708058 0 AFO DOUBLE UPRIGHT                             SUPPLY     993.30                      L1990
MAT MGMT      2708045 0 KAFO PLASTIC CUSTOM                            SUPPLY     4,904.47
MAT MGMT      2708019 0 KAFO FEMORAL FX CAST RIGID PREFAB              SUPPLY     3,269.31                    L2136
MAT MGMT      2708046 0 DROP LOCK KNEE JOINT ADD LOW EXTREM TO ORTHOS SUPPLY      218.55                      L2182
MAT MGMT      2708062 0 LIMITED MOTION KNEE JOINT ADD LOW EXTREM FX OR SUPPLY     255.64                      L2184
MAT MGMT      2708063 0 ADJUSTABLE MOTION KNEE JOINT LERMAN            SUPPLY     340.00                      L2186
MAT MGMT      2708052 0 PROSTHESIS LOWER EXTREM QUAD BRIM              SUPPLY     618.00                      L2188
MAT MGMT      2742390 0 LIMITED MOTION ANKLE JOINT                     SUPPLY     134.75                      L2200
MAT MGMT      2708059 0 ADDITION TO LOWER EXTREMITY                    SUPPLY     176.40                      L2220
MAT MGMT      2742353 0 VARUS / VALGUS CORRECTION                      SUPPLY     236.50                      L2275
MAT MGMT      2708078 0 SHELL PRETIBIAL ADD LOWER EXTREM               SUPPLY     780.45                      L2340
MAT MGMT      2708067 0 EXTENDED STEEL SHANK ADD LOW EXTREM            SUPPLY     140.00                      L2360
MAT MGMT      2708064 0 PELVIC CONTROL HIP HEAVY DUTY                  SUPPLY     551.73                      L2620
MAT MGMT      2708051 0 HIP ADJ FLEX EXT ABD CON                       SUPPLY     861.10                      L2624
MAT MGMT      2742311 0 SOFT INTERFACE ORTHOSIS ADD LOWER EXTREM       SUPPLY     188.65                      L2820
MAT MGMT      2708079 0 SOCKS FX TIBIAL LENGTH EA                      SUPPLY     114.80                      L2840
MAT MGMT      2708084 0 SOCK FEMORAL LENGTH OR EQUAL ADD LOW EXT       SUPPLY     178.70                      L2850
MAT MGMT      2708080 0 FOOT INSERT MOLDED EA                          SUPPLY     236.50                      L3002
MAT MGMT      2708081 0 SHOE LIFT NEOPRENE HEEL / SOLE PER INCH        SUPPLY     159.25                      L3310
MAT MGMT      2708065 0 EO W/ ADJ JOINT PREFAB                         SUPPLY     870.49                      L3760
MAT MGMT      2708066 0 SEWHO AIRPLANE DESIGN ABDUCT POSN PREFAB       SUPPLY     1,601.84                    L3960
MAT MGMT      2708053 0 FOOT DROP SPLINT RECUMB                        SUPPLY     591.30                      L4398
MAT MGMT      2708070 0 IMMED POST SURG APPLICATN NON WT BEAR RIG DRSG SUPPLY     1,029.85                    L5450
MAT MGMT      2708071 0 PREPARATORY BELOW KNEE PREFAB                  SUPPLY     3,429.25                    L5535
MAT MGMT      2708073 0 ADD ENDOSKEL SYS BELOW KNEE ALIGN SYSTM        SUPPLY     698.75                      L5910
MAT MGMT      2708074 0 PROSTHESIS LOW EXTREM FOOT, EXT KEEL, SACH FOOTSUPPLY     449.35                      L5970
MAT MGMT      2708060 0 WU REMOVABLE BEL KNEE DRESS                    SUPPLY     793.40                      L5999
MAT MGMT      2708075 0 STOCKING GRADIENT COMP THIGH 18-30 MM EA       SUPPLY     215.60
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2708076 0 PROSTHETIC SHEATH BELOW KNEE EA       SUPPLY     54.75                       L8400
MAT MGMT      2708054 0 PROSTHETIC SHRINKER BELOW KNEE        SUPPLY     142.50                      L8440
MAT MGMT      2708077 0 PROSTHETIC SHRINKER ABOVE KNEE EA     SUPPLY     166.60                      L8460
MAT MGMT      2708061 0 STUMP SOCK SINGLE PLY                 SUPPLY     21.90                       L8470
MAT MGMT      2722159 0 STOCKINGS KNEE LG/LONG                SUPPLY     12.30
MAT MGMT      2708013 0 LUMBOSACRAL CORSET                    SUPPLY     309.70
MAT MGMT      2708014 0 TLSO - THOR LUMBO SAC ORTHOSIS        SUPPLY     4,515.80
MAT MGMT      2721311 0 CATH KIT SUBCLAVIAN 11.5FR X 19.5CM   SUPPLY     270.80
MAT MGMT      2722347 0 CATH VENTRICULAR EDM 35CM             SUPPLY     252.40
MAT MGMT      2722685 0 CATH UMBILICAL 5FR 2LM                SUPPLY     100.50
MAT MGMT      2722686 0 CATH UMBILICAL 3.5FR 2LM              SUPPLY     122.00
MAT MGMT      2723603 0 CATH FOLEY SILICONE 24FR 5CC          SUPPLY     20.02
MAT MGMT      2728825 0 CATH KIT CVC 3FR 8CM 1LM              SUPPLY     59.40
MAT MGMT      2701033 0 CATH KIT REPAIR BLUE HICKMAN          SUPPLY     196.00
MAT MGMT      2737703 0 NDL NON KOR 20G X 1 1/2 EA            SUPPLY     18.50
MAT MGMT      2722475 0 CATH TRAY RADIAL ART 3FR 5CM          SUPPLY     120.40
MAT MGMT      2729030 0 CATH KIT PERC INTRO SHEATH 9FR        SUPPLY     93.80
MAT MGMT      2738053 0 CAMINO VENTRICULAR CATH               SUPPLY     976.30
MAT MGMT      2724466 0 DRAIN SARATOGA SUMP 24FR 20IN         SUPPLY     28.70
MAT MGMT      2701004 0 TRANSDUCER KIT HEART BIOPSY           SUPPLY     29.40
MAT MGMT      2701467 0 HALO VEST LINER LGE                   SUPPLY     361.00
MAT MGMT      2701468 0 HALO VEST LINER MED                   SUPPLY     413.10
MAT MGMT      2708020 0 DARCO BODY ARMOR SM                   SUPPLY     138.10
MAT MGMT      2710863 0 STRAP CLAVICLE YOUTH MED              SUPPLY     23.15
MAT MGMT      2715128 0 IV D5W / 0.2% NACL 500 ML             SUPPLY     2.40
MAT MGMT      2715131 0 IV D5W / 0.2% NACL / 30 KCL 1000 ML   SUPPLY     4.30
MAT MGMT      2715134 0 IV D5W / 0.45% NACL 500 ML            SUPPLY     2.40
MAT MGMT      2715140 0 IV D5W / 0.9% NACL 250 ML             SUPPLY     2.40
MAT MGMT      2715141 0 IV D5W / 0.9% NACL 500 ML             SUPPLY     2.40
MAT MGMT      2715143 0 IV D5W 150 ML                         SUPPLY     2.20
MAT MGMT      2723178 0 CATH FOLEY TEMP SENSING 16 FR         SUPPLY     29.60
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE        PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY      OUTPT)          LML/RML     CPT
MAT MGMT      2723989 0 CATH FOLEY 28FR W/5CC BAL             SUPPLY        13.10
MAT MGMT      2730046 0 CATH SWAN GANZ THERM 7FR              SUPPLY        114.00
MAT MGMT      2733587 0 TUBE FEED MIC KEY 14FR 0.8CM          SUPPLY        225.75
MAT MGMT      2733588 0 TUBE FEED MIC KEY 14FR 1.0CM          SUPPLY        245.00
MAT MGMT      2733594 0 TUBE FEED MIC KEY 20FR 3.0CM          SUPPLY        232.75
MAT MGMT      2733595 0 TUBE FEED MIC KEY 20FR 2.7CM          SUPPLY        225.75
MAT MGMT      2733596 0 TUBE FEED MIC KEY 20FR 2.5CM          SUPPLY        225.75
MAT MGMT      2733598 0 TUBE FEED MIC KEY 20FR 2.0CM          SUPPLY        232.75
MAT MGMT      2733599 0 TUBE FEED MIC KEY 18FR 2.5CM          SUPPLY        232.75
MAT MGMT      2737582 0 BIOPSY KIT SKIN PUNCH 5MM             SUPPLY        5.50
MAT MGMT      2701086 0 TRACH STOPPER DECAN SZ 6 EA           SUPPLY        28.40
MAT MGMT      2728223 0 CATH KIT CVC INTO 8.5 FR              SUPPLY        138.40
MAT MGMT      2732247 0 TRACH TUBE CUFFED 4.5                 SUPPLY        5.30
MAT MGMT      2732248 0 TRACH TUBE CUFFED 5                   SUPPLY        5.30
MAT MGMT      2732249 0 TRACH TUBE CUFFED 5.5                 SUPPLY        5.30
MAT MGMT      2732250 0 TRACH TUBE CUFFED 6                   SUPPLY        5.30
MAT MGMT      2737584 0 BIOPSY KIT SKIN PUNCH 3MM             SUPPLY        17.20
MAT MGMT      2739093 0 LUMBAR DRAIN BAG                      SUPPLY        83.53
MAT MGMT      2740663 0 BED BIODYNE THERAPY KCI               SUPPLY MEMS   569.75
MAT MGMT      2701001 0 CATH SWAN GANZ CCO W/SVO2 NONHEP      SUPPLY        440.75
MAT MGMT      2701002 0 TRANSDUCER KIT DOUBLE                 SUPPLY        56.40
MAT MGMT      2701003 0 TRANSDUCER KIT TRIPLE                 SUPPLY        78.90
MAT MGMT      2701005 0 IV D5W / 0.9% NACL / 20 KCL 1000 ML   SUPPLY        4.70
MAT MGMT      2701006 0 BLOOD GAS KIT                         SUPPLY        5.10
MAT MGMT      2701010 0 SCISSORS BURN DISP STERIL             SUPPLY        5.73
MAT MGMT      2701019 0 EYE SHIELD PHOTOTHER SM PREMATURE     SUPPLY        9.66
MAT MGMT      2701020 0 EYE SHIELD PHOTOTHER PREMATUR         SUPPLY        10.00
MAT MGMT      2701028 0 REPAIR KIT F 0.7MM LUMEN              SUPPLY        225.00
MAT MGMT      2701029 0 REPAIR KIT F 1.0MM LUMEN              SUPPLY        172.50
MAT MGMT      2701030 0 REPAIR KIT F PED 9FR DBL LUMEN        SUPPLY        287.20
MAT MGMT      2701032 0 CATH KIT REPAIR LEONARD 10FR          SUPPLY        259.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2701039 0 PILLOW ABDUCTION MEDIUM                 SUPPLY     91.70
MAT MGMT      2701063 0 DIALYSIS FILTER RENAFLO II              SUPPLY     210.10
MAT MGMT      2701070 0 CAUTERY OPHTHAL STERL DISP              SUPPLY     44.60
MAT MGMT      2701074 0 OST SURFIT IRRIGATION 2 1/4 SLEEVE EA   SUPPLY     9.70
MAT MGMT      2701075 0 DIALYSATE PREMIX                        SUPPLY     41.70
MAT MGMT      2701076 0 TRACH ADAPTER SWIVEL 15MM               SUPPLY     19.80
MAT MGMT      2701077 0 BRUSH MICROBIOL 1650 EA                 SUPPLY     51.90
MAT MGMT      2701082 0 CATH KIT URICATH 5FR                    SUPPLY     57.00
MAT MGMT      2701083 0 CATH KIT URICATH 8FR                    SUPPLY     56.80
MAT MGMT      2701084 0 TRACH STOPPER DECAN SZ 4 EA             SUPPLY     26.40
MAT MGMT      2701085 0 TRACH STOPPER DECAN SZ 5 EA             SUPPLY     31.79
MAT MGMT      2701094 0 DELIVERY PACK PREMIE                    SUPPLY     68.90
MAT MGMT      2701095 0 DELIVERY PACK FULL TERM                 SUPPLY     72.10
MAT MGMT      2701104 0 BOWEL MGMT SYSTEM 4 CM                  SUPPLY     774.00
MAT MGMT      2701108 0 STAPLE REMOVER                          SUPPLY     4.40
MAT MGMT      2701117 0 SUTURE REMOVAL SET DISP                 SUPPLY     3.50
MAT MGMT      2701118 0 URINOMETER MIDGET                       SUPPLY     69.30
MAT MGMT      2701119 0 BOWEL MGMT SYSTEM 6 CM                  SUPPLY     773.20
MAT MGMT      2701120 0 PERICARDIOCENTESIS SET 8.3FR            SUPPLY     169.10
MAT MGMT      2701121 0 PERITONEAL LAVAGE KIT                   SUPPLY     67.15
MAT MGMT      2701177 0 CAMINO BOLT ADAPTER 045                 SUPPLY     171.50
MAT MGMT      2701182 0 TRACH STOPPER DECAN SZ 8 EA             SUPPLY     30.15
MAT MGMT      2701184 0 CATH KIT REPAIR DAVOL HICK              SUPPLY     173.30
MAT MGMT      2701192 0 REPAIR KIT WHITE ADPT LEG DAVOL CATH    SUPPLY     172.50
MAT MGMT      2701222 0 RENAL TRANSPLANT PRE-OP KIT             SUPPLY     18.25
MAT MGMT      2701224 0 RENAL TRANSPLANT BIOPSY KIT             SUPPLY     337.50
MAT MGMT      2701248 0 HEAD REST DISP SURG                     SUPPLY     9.18
MAT MGMT      2701249 0 TRACH INNER CANNULA SZ 6XL 1 BOX        SUPPLY     140.00
MAT MGMT      2701250 0 TRACH INNER CANNULA SZ 7XL 1 BOX        SUPPLY     140.00
MAT MGMT      2701251 0 TRACH INNER CANNULA SZ 8XL 1 BOX        SUPPLY     140.00
MAT MGMT      2701259 0 BAG FEEDING SET COR-PAK 1200 ML         SUPPLY     8.76
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2701261 0 TRACH INNER CANNULA SZ 4 1 BOX       SUPPLY     73.30
MAT MGMT      2701262 0 TRACH INNER CANNULA SZ 6 1 BOX       SUPPLY     73.50
MAT MGMT      2701263 0 TRACH INNER CANNULA SZ 8 1 BOX       SUPPLY     73.50
MAT MGMT      2701264 0 TRACH INNER CANNULA SZ 10 1 BOX      SUPPLY     72.60
MAT MGMT      2701266 0 BLOOD WARMING COIL                   SUPPLY     50.40
MAT MGMT      2701274 0 CATH KIT REPAIR LEIDER 9.5           SUPPLY     182.40
MAT MGMT      2701298 0 DRAIN THOR VALVE HEIMLICH            SUPPLY     49.00
MAT MGMT      2701299 0 CAMINO DRAIN VENTRICULAR             SUPPLY     233.90
MAT MGMT      2701308 0 LALLY ANORECTAL DILATOR SET          SUPPLY     210.70
MAT MGMT      2701329 0 DRAPE SLEEVE STERI                   SUPPLY     12.80
MAT MGMT      2701353 0 CRANIAL ACCESS KIT                   SUPPLY     498.50
MAT MGMT      2701354 0 CAMINO MONITOR KIT POST CRANIOTOMY   SUPPLY     1,194.70
MAT MGMT      2701355 0 EYE SHIELD OPTIGUARD ADLT            SUPPLY     17.48
MAT MGMT      2701361 0 PERICARDIOCENTESIS KIT               SUPPLY     334.90
MAT MGMT      2701375 0 FILTER LEUKOCYTE RED CELL            SUPPLY     45.20
MAT MGMT      2701378 0 POUCH PACEMAKER DISPOSABL            SUPPLY     13.90
MAT MGMT      2701379 0 IV SET BLOOD ADM SET W/ FILTER       SUPPLY     27.50
MAT MGMT      2701380 0 BOWEL MGMT COLLECTION BAG 3000 ML    SUPPLY     42.00
MAT MGMT      2701381 0 BOWEL MGMT COLLECTION BAG 2000 ML    SUPPLY     20.99
MAT MGMT      2701427 0 NDL NON KOR HUBER 20G X 3/4 IN       SUPPLY     18.50
MAT MGMT      2701429 0 NDL NON KOR HUBER 20G X 1 IN         SUPPLY     18.50
MAT MGMT      2701430 0 NDL NON KOR HUBER 22G X 3/4 IN       SUPPLY     18.40
MAT MGMT      2701459 0 CATH KIT FEMALE W/LUBE 8F            SUPPLY     9.13
MAT MGMT      2701463 0 DIALYSIS PERIT DIALY-NATE            SUPPLY     221.90
MAT MGMT      2701464 0 TUBE FEED BULLET TIP 10FRX43         SUPPLY     37.20
MAT MGMT      2701465 0 DIALYSIS SET ACUTE PERIT 9FR         SUPPLY     222.60
MAT MGMT      2701466 0 DIALYSIS SET ACUTE PERIT 11FR        SUPPLY     191.00
MAT MGMT      2701472 0 CATH FOLEY SILICONE 14FR 5CC KENDL   SUPPLY     17.00
MAT MGMT      2701474 0 HALO VEST LINER SM                   SUPPLY     376.30
MAT MGMT      2701478 0 PROBE OXIMETER INFANT EA             SUPPLY     41.00
MAT MGMT      2701479 0 PROBE OXIMETER ADULT EA              SUPPLY     32.85
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2701480 0 PROBE OXIMETER NEONATAL EA       SUPPLY     41.00
MAT MGMT      2701483 0 PROBE OXIMETER PED EA            SUPPLY     32.85
MAT MGMT      2701484 0 PROBE OXIMETER ADULT NASAL EA    SUPPLY     41.50
MAT MGMT      2701570 0 SEPTI-SOFT CONCENTRATE           SUPPLY     7.10
MAT MGMT      2701600 0 DRAIN JP RESERVOIR 100CC EVAC    SUPPLY     19.80
MAT MGMT      2701601 0 OST POUCH DRAINABLE BLUE         SUPPLY     102.40
MAT MGMT      2701602 0 OST POUCH URINE BLUE             SUPPLY     102.40
MAT MGMT      2701603 0 OST FLAT WAFER BLUE              SUPPLY     54.80
MAT MGMT      2701604 0 OST CONVEX WAFER DEEP BLUE       SUPPLY     54.80
MAT MGMT      2701605 0 OST CONVEX WAFER LITE RED        SUPPLY     65.20
MAT MGMT      2701606 0 OST CONVEX WAFER LITE BLUE       SUPPLY     65.20
MAT MGMT      2701632 0 STAPLE APPLIER STERILE DISP      SUPPLY     33.10
MAT MGMT      2701633 0 OST POUCH HI OUTPUT RED          SUPPLY     81.90
MAT MGMT      2701634 0 OST POUCH HI OUTPUT BLUE         SUPPLY     81.90
MAT MGMT      2701665 0 CATH KIT REPAIR HICKMAN 1.6MM    SUPPLY     172.50
MAT MGMT      2701666 0 AIRWAY NASOPHAR TRUMPET 6MM      SUPPLY     12.00
MAT MGMT      2701667 0 AIRWAY NASOPHAR TRUMPET 7MM      SUPPLY     12.00
MAT MGMT      2701668 0 AIRWAY NASOPHAR TRUMPET 8MM      SUPPLY     12.10
MAT MGMT      2701669 0 AIRWAY NASOPHAR TRUMPET 9MM      SUPPLY     12.00
MAT MGMT      2701670 0 FILTER REPLACMNT W/ SUMP         SUPPLY     24.15
MAT MGMT      2701671 0 DEBRIDER NORSEN                  SUPPLY     42.00
MAT MGMT      2701677 0 KIT VOIDING TRIAL                SUPPLY     36.50
MAT MGMT      2701693 0 CURETTE DERMAL DISP 4MM          SUPPLY     5.80
MAT MGMT      2701694 0 CURETTE DERMAL 5MM STERILE DIS   SUPPLY     5.80
MAT MGMT      2701695 0 CURETTE SKIN DISP 2MM            SUPPLY     5.70
MAT MGMT      2701706 0 CAUTERY SURG STERL FINE TIP      SUPPLY     28.50
MAT MGMT      2701725 0 LUMBAR DRAINAGE KIT EDM          SUPPLY     489.10
MAT MGMT      2701736 0 DEFIB PAD APEX R-2 ADLT          SUPPLY     82.20
MAT MGMT      2701737 0 DEFIB PAD PEDS MULTI FUNCTION    SUPPLY     70.00
MAT MGMT      2701738 0 BAG DECANTOR                     SUPPLY     3.90
MAT MGMT      2701740 0 SUPPORTER ATHLETIC MED           SUPPLY     20.80
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2701741 0 SUPPORTER ATHLETIC LGE                 SUPPLY     20.80
MAT MGMT      2701743 0 REPAIR KIT SINGLE LUMEN GRSHNG         SUPPLY     259.60
MAT MGMT      2701775 0 CLEANSER WOUND CARA-KLENZ              SUPPLY     14.05
MAT MGMT      2701801 0 DRAIN VENTRICULAR BECKER MONITOR       SUPPLY     360.00
MAT MGMT      2701802 0 DEFIB PAD (SAF-D-FIB) FOR PADDLE EA    SUPPLY     51.00
MAT MGMT      2701887 0 IMMOBILIZER ELBOW/WRIST XXS            SUPPLY     16.35
MAT MGMT      2701888 0 IMMOBILIZER ELBOW/WRIST SM             SUPPLY     21.50
MAT MGMT      2701890 0 CRITIC-AID CREAM (SWEEN)               SUPPLY     32.40
MAT MGMT      2701902 0 EYE PATCH CONVEX BLACK EA              SUPPLY     3.30
MAT MGMT      2701915 0 CAVR CONTIN ARTERIO VEN REWARM         SUPPLY     185.70
MAT MGMT      2701916 0 FILTER LEVEL 1 MICRO FILTER            SUPPLY     46.10
MAT MGMT      2701917 0 TUBING LEVEL 1 IV D 100                SUPPLY     161.90
MAT MGMT      2701931 0 FILTER LEUKOCYTE PLATELET              SUPPLY     69.16
MAT MGMT      2701953 0 DIALYSIS STERICAP ASSEMBLY             SUPPLY     2.00
MAT MGMT      2702002 0 CATH URO SELF CATH 8FR                 SUPPLY     3.30
MAT MGMT      2702003 0 CATH URO SELF CATH 10FR                SUPPLY     3.20
MAT MGMT      2702004 0 CATH URO SELF CATH 12FR                SUPPLY     3.00
MAT MGMT      2702005 0 CATH URO SELF CATH 14FR                SUPPLY     3.00
MAT MGMT      2702006 0 CATH URO SELF CATH 16FR                SUPPLY     3.00
MAT MGMT      2702007 0 CATH URO SELF CATH 18FR                SUPPLY     2.20
MAT MGMT      2702009 0 IV D10W / 0.2% NACL 250 ML             SUPPLY     12.80
MAT MGMT      2702011 0 CATH URO SELF CATH 5FR                 SUPPLY     3.20
MAT MGMT      2702014 0 HALO VEST RING SM / SM                 SUPPLY     3,246.50
MAT MGMT      2702015 0 BAG DRAIN DISP-A-BAG SM                SUPPLY     24.40
MAT MGMT      2702016 0 CATH SWAN GANZ CCO W/SVO2              SUPPLY     438.10
MAT MGMT      2702019 0 CATH SWAN GANZ PACEPORT 7.5FR NONHEP   SUPPLY     135.10
MAT MGMT      2702021 0 DRSG XEROFORM 1X8                      SUPPLY     2.00
MAT MGMT      2702022 0 DRSG ABDOMINAL KCI WOUND VAC           SUPPLY     649.30
MAT MGMT      2702025 0 CATH COUDE SELF CATH 8FR               SUPPLY     8.20
MAT MGMT      2702026 0 CATH MULTILUMEN ACCESS PRD             SUPPLY     200.00
MAT MGMT      2702027 0 PRESSURE MONITOR SET QUICK             SUPPLY     137.40
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2702028 0 CATH WORD BARTHOLIN GLAND                   SUPPLY     14.50
MAT MGMT      2702029 0 COLYTE KIT 1 GAL                            SUPPLY     24.65
MAT MGMT      2704008 0 BAG URIMETER                                SUPPLY     23.83
MAT MGMT      2704075 0 BAG AUTOTRANSFUSION REPLACEMENT             SUPPLY     80.20
MAT MGMT      2704108 0 OST CLAMP DRAIN POUCH                       SUPPLY     5.25
MAT MGMT      2704353 0 LEG STRAP FOR CATH ADULT                    SUPPLY     12.70
MAT MGMT      2704849 0 BAG URINE LEG LARGE                         SUPPLY     27.20
MAT MGMT      2704923 0 BAG URINE LEG MED                           SUPPLY     27.20
MAT MGMT      2704953 0 BAG BILE                                    SUPPLY     22.90
MAT MGMT      2704954 0 BAG FARRELL ENTERNAL VALVE                  SUPPLY     22.80
MAT MGMT      2706010 0 SKIN PROTECTANT PROSHIELD PLUS              SUPPLY     26.05
MAT MGMT      2706012 0 OST PASTE STRIP                             SUPPLY     21.60
MAT MGMT      2706013 0 DRSG AQUACEL AG ROPE                        SUPPLY     44.70
MAT MGMT      2706015 0 OST PERIWASH 8 OZ SPRAY                     SUPPLY     7.20
MAT MGMT      2706016 0 OST DRAIN POUCH W/ STOMA WAF                SUPPLY     23.90
MAT MGMT      2706037 0 OST WAFER SKIN BARRIER 4X4 EA               SUPPLY     5.30
MAT MGMT      2706078 0 OST POUCH COMBI INFANT                      SUPPLY     57.80
MAT MGMT      2706213 0 OST POUCH UROS PEDS LTL ONES 1 BOX          SUPPLY     87.90
MAT MGMT      2706214 0 OST POUCH DRAINABLE PEDS 1 BOX              SUPPLY     72.50
MAT MGMT      2706215 0 OST SURFIT POUCH 2 1/4 UROSTOMY 1 BOX       SUPPLY     46.75
MAT MGMT      2706216 0 OST INSERT CONVEX SURFIT 1 1/8 IN - 1 BOX   SUPPLY     24.50
MAT MGMT      2706217 0 OST WAFER STOMAHESIVE 6X6 4 IN FLAN 1 BOX   SUPPLY     56.80
MAT MGMT      2706268 0 OST WAFER SKIN BARRIER 8X8 EA               SUPPLY     26.80
MAT MGMT      2706271 0 OST POUCH NEWBRN 1 BOX                      SUPPLY     98.10
MAT MGMT      2706272 0 OST POUCH PREMIE CUT TO FIT 1 BOX           SUPPLY     84.40
MAT MGMT      2706275 0 OST INSERT CONVEX SURFIT 1 1/2 IN - 1 BOX   SUPPLY     20.30
MAT MGMT      2706277 0 OST INSERT CONVEX SURFIT 1 3/8 IN - 1 BOX   SUPPLY     36.20
MAT MGMT      2706278 0 OST POUCH PED 1 BOX                         SUPPLY     83.50
MAT MGMT      2706282 0 OST SURFIT POUCH 1 3/4 UROSTOMY 1 BOX       SUPPLY     50.60
MAT MGMT      2706297 0 OST SKIN PREP WIPE 1 BOX                    SUPPLY     23.90
MAT MGMT      2706321 0 OST WAFER DURAHESIVE 2 1/4IN FLANG 1 BOX    SUPPLY     50.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2706322 0 OST WAFER DURAHESIVE 1 3/4IN 1 BOX        SUPPLY     46.80
MAT MGMT      2706330 0 OST BELT APPLIANCE                        SUPPLY     15.30
MAT MGMT      2706335 0 OST SURFIT POUCH 1 3/4 DRAINABLE 1 BOX    SUPPLY     39.60
MAT MGMT      2706336 0 OST SURFIT POUCH 2 1/4 DRAINABLE 1 BOX    SUPPLY     39.60
MAT MGMT      2706374 0 COMFEEL WAFER 4 X 4                       SUPPLY     11.40
MAT MGMT      2706382 0 DRAIN JP FLAT SLCN 10MM X 20CM EA         SUPPLY     17.20
MAT MGMT      2706383 0 DRAIN KIT LUMBAR SUBARACH                 SUPPLY     406.35
MAT MGMT      2706384 0 DRAIN JP RESERVOIR 400 CC LGE             SUPPLY     36.15
MAT MGMT      2706385 0 DRAIN THOR PLEUROVAC                      SUPPLY     79.80
MAT MGMT      2706433 0 OST POUCH 1 PIECE DRAINABLE               SUPPLY     46.70
MAT MGMT      2706522 0 STOMAHESIVE POWDER                        SUPPLY     14.40
MAT MGMT      2706541 0 STOMAHESIVE PASTE                         SUPPLY     20.30
MAT MGMT      2706664 0 OST SKIN BOND CEMENT EA                   SUPPLY     35.59
MAT MGMT      2706732 0 WOUND MANAGER SM (WOUND DRAINAGE COLLECTORSUPPLY     41.00
MAT MGMT      2706733 0 WOUND DRAIN COLLECT MED                   SUPPLY     51.40
MAT MGMT      2706867 0 COMFEEL WAFER 8 X 8                       SUPPLY     25.10
MAT MGMT      2706869 0 OST WAFER DURAHESIVE 1 3/4IN FLANG 1 BOX  SUPPLY     48.40
MAT MGMT      2706874 0 OST IRRIGATOR W/ CONE                     SUPPLY     85.00
MAT MGMT      2706917 0 DRAIN COLLECTOR WOUND LG                  SUPPLY     68.90
MAT MGMT      2706918 0 CANNISTER TUBING CAP WOUND VAC EA         SUPPLY     6.40
MAT MGMT      2706934 0 OST SURFIT IRRIGATION 1 3/4 SLEEVE 1 BOX  SUPPLY     10.40
MAT MGMT      2706936 0 TRACH STOMA BIB EA                        SUPPLY     34.67
MAT MGMT      2707303 0 BINDER ABDOMINAL 9" 24-50"                SUPPLY     27.50
MAT MGMT      2707304 0 BINDER ABDOMINAL 9" 48-64"                SUPPLY     33.30
MAT MGMT      2707305 0 BINDER ABDOMINAL 12" 24-50"               SUPPLY     70.50
MAT MGMT      2707306 0 BINDER ABDOMINAL 12" 48-64"               SUPPLY     28.80
MAT MGMT      2708021 0 DARCO BODY ARMOR MEDIUM                   SUPPLY     145.10
MAT MGMT      2708022 0 DARCO BODY ARMOR LARGE                    SUPPLY     144.43
MAT MGMT      2708030 0 KNEE BRACE BILATERAL                      SUPPLY     283.50
MAT MGMT      2708047 0 SLING GARDNER                             SUPPLY     33.00
MAT MGMT      2708049 0 LSO WITH INTERFACE                        SUPPLY     3,651.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2708056 0 LSO CONTROL CUSTOM                            SUPPLY     2,859.00
MAT MGMT      2708068 0 SHOE MEN ORTHOPAEDIC FOOTWEAR DEPTH INLAY     SUPPLY     404.20
MAT MGMT      2708069 0 SHOE LIFT ELEVATION INSIDE SHOE               SUPPLY     84.00
MAT MGMT      2708072 0 SLEEVE SUSPENSION ADD LOW EXTREM BELOW KNEE   SUPPLY     176.40
MAT MGMT      2708085 0 LSO APL CONTROL WITH APRON                    SUPPLY     850.32
MAT MGMT      2708086 0 BRACE JEWETT                                  SUPPLY     893.70
MAT MGMT      2708087 0 PROSTHETIC SOCK WOOL BEL KNEE                 SUPPLY     61.60
MAT MGMT      2708088 0 ELBOW BLEDSOE RIGHT                           SUPPLY     1,104.00
MAT MGMT      2708493 0 HALO VEST LGE & RING XLG                      SUPPLY     3,246.50
MAT MGMT      2708494 0 RED CELL BAG ORTHOPAT                         SUPPLY     29.02
MAT MGMT      2708495 0 WASTE BAG ORTHOPAT                            SUPPLY     127.12
MAT MGMT      2709091 0 COLLAR CERV ASPEN ADLT SHRT                   SUPPLY     84.90
MAT MGMT      2709092 0 COLLAR CERV ASPEN ADLT REG                    SUPPLY     84.90
MAT MGMT      2709093 0 COLLAR CERV ASPEN ADLT TALL                   SUPPLY     84.90
MAT MGMT      2709094 0 COLLAR CERV ASPEN ADLT X-TALL                 SUPPLY     85.00
MAT MGMT      2709095 0 COLLAR CERV ASPEN PD-1 INF SHRT               SUPPLY     73.16
MAT MGMT      2709096 0 COLLAR CERV ASPEN PD-2 INF REG                SUPPLY     73.20
MAT MGMT      2709097 0 COLLAR CERV ASPEN PD-3 CHLD TOT               SUPPLY     73.20
MAT MGMT      2709098 0 COLLAR CERV ASPEN PD-4 CHLD SHRT              SUPPLY     73.20
MAT MGMT      2709099 0 COLLAR CERV ASPEN PD-5 CHLD REG               SUPPLY     73.20
MAT MGMT      2709100 0 COLLAR CERV ASPEN SM BACK PANEL               SUPPLY     30.35
MAT MGMT      2709101 0 COLLAR CERV ASPEN LGE BACK PANEL              SUPPLY     51.80
MAT MGMT      2709102 0 COLLAR CERV PAD UNIVERSAL ADULT               SUPPLY     34.30
MAT MGMT      2709104 0 TRACTION HALO OPEN BACK LG                    SUPPLY     1,882.05
MAT MGMT      2709105 0 TRACTION HALO OPEN BACK MED                   SUPPLY     1,476.70
MAT MGMT      2709106 0 TRACTION HALO OPEN BACK SM                    SUPPLY     1,709.70
MAT MGMT      2709437 0 HALO VEST RING MED / MED                      SUPPLY     3,254.00
MAT MGMT      2709438 0 HALO VEST RING LG / LG                        SUPPLY     3,246.50
MAT MGMT      2709727 0 COLLAR CERV PEDS 3IN                          SUPPLY     23.80
MAT MGMT      2709730 0 COLLAR CERV STIFNECK                          SUPPLY     25.70
MAT MGMT      2709870 0 COLLAR CERV FOAM SM                           SUPPLY     18.10
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2709871 0 COLLAR CERV FOAM MED                  SUPPLY     18.10
MAT MGMT      2709872 0 COLLAR CERV FOAM LG                   SUPPLY     18.10
MAT MGMT      2709916 0 COLLAR CERV BABY NO NECK              SUPPLY     23.80
MAT MGMT      2710001 0 WRIST SUPPORT LG LFT                  SUPPLY     62.90
MAT MGMT      2710002 0 WRIST SUPPORT X-LG RT                 SUPPLY     57.00
MAT MGMT      2710003 0 WRIST SUPPORT X-LG LFT                SUPPLY     62.00
MAT MGMT      2710004 0 SLING ARM X-SM                        SUPPLY     50.60
MAT MGMT      2710005 0 SLING ARM SM                          SUPPLY     54.00
MAT MGMT      2710009 0 SLING ARM ADJUSTABLE                  SUPPLY     19.30
MAT MGMT      2710013 0 SHOE POST OP FEMALE SM                SUPPLY     30.20
MAT MGMT      2710014 0 SHOE POST OP FEMALE MED               SUPPLY     30.20
MAT MGMT      2710015 0 SHOE POST OP FEMALE LG                SUPPLY     30.20
MAT MGMT      2710016 0 SHOE POST OP MALE SM                  SUPPLY     30.20
MAT MGMT      2710017 0 SHOE POST OP MALE MED                 SUPPLY     30.20
MAT MGMT      2710018 0 SHOE POST OP MALE LG                  SUPPLY     30.20
MAT MGMT      2710072 0 CAST SHOE LG                          SUPPLY     24.00
MAT MGMT      2710073 0 CAST SHOE MED                         SUPPLY     24.00
MAT MGMT      2710074 0 CAST SHOE SM                          SUPPLY     23.60
MAT MGMT      2710075 0 CAST SHOE XLG                         SUPPLY     24.02
MAT MGMT      2710076 0 CAST SHOE XS                          SUPPLY     24.00
MAT MGMT      2710098 0 STRAP CLAVICLE ADULT XL               SUPPLY     23.62
MAT MGMT      2710127 0 HEEL PROTECTOR FOOT PILLOW            SUPPLY     66.60
MAT MGMT      2710159 0 STOCKINETTE TUBULAR 3 IN X 25 YD EA   SUPPLY     49.60
MAT MGMT      2710160 0 STOCKINETTE TUBULAR 4 IN X 25 YD EA   SUPPLY     30.40
MAT MGMT      2710161 0 STOCKINETTE TUBULAR 6 IN X 25 YD EA   SUPPLY     94.08
MAT MGMT      2710162 0 STOCKINETTE TUBULAR 2 IN X 25 YD EA   SUPPLY     35.40
MAT MGMT      2710195 0 WRIST SUPPORT SM RT                   SUPPLY     62.80
MAT MGMT      2710196 0 WRIST SUPPORT SM LFT                  SUPPLY     60.80
MAT MGMT      2710197 0 WRIST SUPPORT MED RT                  SUPPLY     63.00
MAT MGMT      2710198 0 WRIST SUPPORT MED LFT                 SUPPLY     62.60
MAT MGMT      2710199 0 WRIST SUPPORT LG RT                   SUPPLY     63.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2710257 0 FOOT DROP STOP                         SUPPLY     76.00
MAT MGMT      2710440 0 IMMOBILIZER SHOULDER MENS SML          SUPPLY     31.60
MAT MGMT      2710441 0 IMMOBILIZER SHOULDER MENS MED          SUPPLY     35.40
MAT MGMT      2710442 0 IMMOBILIZER SHOULDER MENS LRG          SUPPLY     36.50
MAT MGMT      2710443 0 IMMOBILIZER SHOULDER MEN XLRG          SUPPLY     35.90
MAT MGMT      2710629 0 IMMOBILIZER SHOULDER XLG ELSTI         SUPPLY     32.60
MAT MGMT      2710711 0 IMMOBILIZER SHOULDER WOMEN MED         SUPPLY     36.00
MAT MGMT      2710712 0 IMMOBILIZER SHOULDER WOMEN LG          SUPPLY     36.40
MAT MGMT      2710713 0 IMMOBILIZER SHOULDER ELAST SM          SUPPLY     32.80
MAT MGMT      2710783 0 SPLINT ABDUCTION                       SUPPLY     259.40
MAT MGMT      2710865 0 STRAP CLAVICLE ADLT LG                 SUPPLY     23.62
MAT MGMT      2710889 0 FINGER PROTECTOR PADDED SMALL          SUPPLY     11.25
MAT MGMT      2710890 0 FINGER PROTECTOR PADDED MED            SUPPLY     11.60
MAT MGMT      2710891 0 FINGER PROTECTOR PADDED LARGE          SUPPLY     11.40
MAT MGMT      2710892 0 IMMOBILIZER SHOULDER X-SM              SUPPLY     37.40
MAT MGMT      2711867 0 SPLINT FINGER FOAM 1 IN X 18 IN EA     SUPPLY     5.49
MAT MGMT      2711868 0 SPLINT FINGER FOAM 3/4 IN X 18 IN EA   SUPPLY     5.25
MAT MGMT      2711869 0 SPLINT FINGER FOAM 1/2 IN X 9 IN EA    SUPPLY     3.90
MAT MGMT      2713531 0 ORTHO BOOT TRACTION FOAM               SUPPLY     37.30
MAT MGMT      2713563 0 DRSG MOLESKIN 12 IN X 4 YD             SUPPLY     73.00
MAT MGMT      2715005 0 IV D5W / 0.45% NACL / 10 KCL 1000 ML   SUPPLY     4.00
MAT MGMT      2715010 0 IV D5W / 0.2% NACL / 10 KCL 1000 ML    SUPPLY     4.10
MAT MGMT      2715011 0 IV D5W / 0.45% NACL 250 ML             SUPPLY     2.40
MAT MGMT      2715012 0 IV D5W 100 ML                          SUPPLY     3.00
MAT MGMT      2715013 0 IV D5W 100 ML SINGLE USE PA            SUPPLY     3.10
MAT MGMT      2715014 0 IV 0.9% NACL 100 ML SINGLE USE         SUPPLY     3.25
MAT MGMT      2715124 0 IV D10W 500 ML                         SUPPLY     2.30
MAT MGMT      2715125 0 IV D10W / 0.9% NACL 1000 ML            SUPPLY     2.70
MAT MGMT      2715126 0 IV D10W 1000 ML                        SUPPLY     2.80
MAT MGMT      2715127 0 IV D5W / 0.2% NACL 250 ML              SUPPLY     2.30
MAT MGMT      2715129 0 IV D5W / 0.2% NACL 1000 ML             SUPPLY     2.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2715130 0 IV D5W / 0.2% NACL / 20 KCL 1000 ML     SUPPLY     4.00
MAT MGMT      2715132 0 IV D5W / 0.2% NACL / 40 KCL 1000 ML     SUPPLY     4.10
MAT MGMT      2715135 0 IV D5W / 0.45% NACL 1000 ML             SUPPLY     2.00
MAT MGMT      2715136 0 IV D5W / 0.45% NACL / 20 KCL 1000 ML    SUPPLY     4.16
MAT MGMT      2715137 0 IV D5W / 0.45% NACL / 30 KCL 1000 ML    SUPPLY     4.00
MAT MGMT      2715138 0 IV D5W / 0.45% NACL / 40 KCL 1000 ML    SUPPLY     4.00
MAT MGMT      2715139 0 IV D5W / 0.9% NACL 1000 ML              SUPPLY     2.00
MAT MGMT      2715142 0 IV D5W 1000 ML                          SUPPLY     2.50
MAT MGMT      2715144 0 IV D5W 250 ML                           SUPPLY     2.10
MAT MGMT      2715145 0 IV D5W 500 ML                           SUPPLY     2.00
MAT MGMT      2715146 0 IV DEXTRAN 40 10% IN 0.9% NACL 500 ML   SUPPLY     48.90
MAT MGMT      2715147 0 IV DEXTRAN 40 10% IN D5W 500 ML         SUPPLY     48.90
MAT MGMT      2715148 0 IV LR 1000 ML                           SUPPLY     2.00
MAT MGMT      2715149 0 IV LR 500 ML                            SUPPLY     2.40
MAT MGMT      2715150 0 IV D5W / LR 1000 ML                     SUPPLY     2.00
MAT MGMT      2715151 0 IV D5W / LR 500 ML                      SUPPLY     2.50
MAT MGMT      2715157 0 IV 0.45% NACL 1000 ML                   SUPPLY     2.00
MAT MGMT      2715158 0 IV 0.45% NACL 500 ML                    SUPPLY     2.20
MAT MGMT      2715159 0 IV 0.9% NACL 1000 ML                    SUPPLY     2.00
MAT MGMT      2715160 0 IV 0.9% NACL 150 ML                     SUPPLY     2.10
MAT MGMT      2715161 0 IV 0.9% NACL 250 ML                     SUPPLY     2.00
MAT MGMT      2715162 0 IV 0.9% NACL 500 ML                     SUPPLY     2.00
MAT MGMT      2715163 0 SODIUM CHLOR 0.9% POUR BTLE 1000 ML     SUPPLY     2.00
MAT MGMT      2715164 0 IV 0.9% NACL IRRIG BAG 1000 ML          SUPPLY     8.29
MAT MGMT      2715165 0 SODIUM CHLOR 0.9% POUR BTLE 1500 ML     SUPPLY     4.00
MAT MGMT      2715166 0 IV 0.9% NACL IRRIG BAG 3000 ML          SUPPLY     17.20
MAT MGMT      2715167 0 IV 0.9% NACL IRRIG BTLE 500 ML          SUPPLY     2.50
MAT MGMT      2715168 0 IV WATER IRRIG BAG 3000 ML              SUPPLY     17.20
MAT MGMT      2715170 0 WATER STER IRRIG POUR BTLE 1000 ML      SUPPLY     2.70
MAT MGMT      2715171 0 WATER STER IRRIG POUR BTLE 1500 ML      SUPPLY     3.60
MAT MGMT      2715172 0 WATER STER IRRIG POUR BTLE 500 ML       SUPPLY     2.40
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION              CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2715173 0 WATER STER IRRIG 4 OZ           SUPPLY     2.00
MAT MGMT      2715182 0 SET ENTERAL EXTENSION 60"       SUPPLY     5.80
MAT MGMT      2715957 0 IV 0.9% NACL / 20 KCL 1000 ML   SUPPLY     4.20
MAT MGMT      2716006 0 IMMOBILIZER KNEE SMALL          SUPPLY     62.70
MAT MGMT      2716007 0 IMMOBILIZER KNEE MEDIUM         SUPPLY     62.70
MAT MGMT      2716008 0 IMMOBILIZER KNEE LARGE          SUPPLY     59.80
MAT MGMT      2716009 0 IMMOBILIZER KNEE X-LARGE        SUPPLY     62.70
MAT MGMT      2716010 0 PILLOW LEG ELEVATOR             SUPPLY     111.40
MAT MGMT      2716027 0 DRSG ABD COMBINE 5 X 9 EA       SUPPLY     2.00
MAT MGMT      2716050 0 PLAIN GAUZE PACKING 1/4 IN      SUPPLY     8.14
MAT MGMT      2716051 0 DRSG ADAPTIC SM 3X3             SUPPLY     2.00
MAT MGMT      2716052 0 DRSG ADAPTIC LGE 3X16           SUPPLY     5.80
MAT MGMT      2716053 0 ACE BANDAGE ELASTIC 6 IN        SUPPLY     3.50
MAT MGMT      2716054 0 ACE BANDAGE ELASTIC 4 IN        SUPPLY     2.30
MAT MGMT      2716055 0 ACE BANDAGE ELASTIC 3 IN        SUPPLY     2.50
MAT MGMT      2716056 0 ACE BANDAGE ELASTIC 2 IN        SUPPLY     2.50
MAT MGMT      2716059 0 MONTGOMERY STRAP                SUPPLY     4.90
MAT MGMT      2716063 0 DRSG GAUZE VASELINE 1X8         SUPPLY     2.00
MAT MGMT      2716068 0 DRSG GAUZE VASELINE 1X36        SUPPLY     2.00
MAT MGMT      2716069 0 DRSG GAUZE VASELINE 6X36        SUPPLY     4.80
MAT MGMT      2716074 0 BURN CARE CBI PK                SUPPLY     27.34
MAT MGMT      2716097 0 DRSG KLING 4 IN 2 PLY           SUPPLY     2.00
MAT MGMT      2716101 0 EYE SHIELD FOX METAL EA         SUPPLY     2.40
MAT MGMT      2716112 0 DRSG FOAM POLYMEN DISP          SUPPLY     21.90
MAT MGMT      2716180 0 DRAIN HEMOVAC SM 3/32 IN        SUPPLY     33.40
MAT MGMT      2716187 0 DRSG KIT TPN CHNGE PEDS         SUPPLY     8.30
MAT MGMT      2716195 0 DRSG XEROFORM 5X9               SUPPLY     2.50
MAT MGMT      2716196 0 DRSG KERLIX                     SUPPLY     2.00
MAT MGMT      2716217 0 DRSG BURN MESH 18 X 36          SUPPLY     6.85
MAT MGMT      2716235 0 DRSG WET 8X4 SALINE             SUPPLY     4.40
MAT MGMT      2716267 0 FEMORAL ARCH COMPRESSION        SUPPLY     173.80
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2716290 0 DRSG DUODERM SIGNAL BUTTERFLY 8 X 9   SUPPLY     36.60
MAT MGMT      2716291 0 DRSG DUODERM SIGNAL TRIANGL 8 X 9     SUPPLY     39.70
MAT MGMT      2716303 0 DRSG AQUACEL AG 6X6                   SUPPLY     67.30
MAT MGMT      2716314 0 DRSG BURN EXU DRY 9X15                SUPPLY     14.00
MAT MGMT      2716315 0 DRSG BURN EXU DRY 6X9                 SUPPLY     8.00
MAT MGMT      2716316 0 DRSG BURN ACTICOAT 16X16              SUPPLY     213.50
MAT MGMT      2716317 0 DRSG BURN ACTICOAT 8X16               SUPPLY     122.30
MAT MGMT      2716318 0 DRSG BURN ACTICOAT 4X48               SUPPLY     129.30
MAT MGMT      2716324 0 CAMINO KIT PRESSURE MONITOR           SUPPLY     1,084.40
MAT MGMT      2716374 0 DRSG BURN EXU-DRY 15X24               SUPPLY     27.65
MAT MGMT      2716452 0 DRSG COTTON ELASTIC 3 X 5             SUPPLY     2.70
MAT MGMT      2716453 0 DRSG COTTON ELASTIC 4 X 5             SUPPLY     9.70
MAT MGMT      2716483 0 DRSG ELASTOPLAST 3 IN                 SUPPLY     8.70
MAT MGMT      2716490 0 PNEUMOPERICARDIAL DRAINAGE SET        SUPPLY     171.40
MAT MGMT      2716492 0 DRAIN VENTRICULAR BECKER BAG          SUPPLY     71.10
MAT MGMT      2716494 0 DRSG VIGILON 4X4                      SUPPLY     13.68
MAT MGMT      2716503 0 NASAL TAMPON BALLOON LGE              SUPPLY     121.68
MAT MGMT      2716524 0 DRSG KIT TPN CHNGE ADULT              SUPPLY     12.41
MAT MGMT      2716525 0 NASAL BILIARY DRNGE SET 7 FR          SUPPLY     236.10
MAT MGMT      2716575 0 TRACH ALLEVYN DRSG                    SUPPLY     12.10
MAT MGMT      2716614 0 DRSG HEAVY DRAINAGE                   SUPPLY     5.90
MAT MGMT      2716700 0 DRSG TEGADERM 4X4                     SUPPLY     2.50
MAT MGMT      2716701 0 DRSG TEGADERM 2X2                     SUPPLY     2.00
MAT MGMT      2716710 0 DRSG BURN MESH 4 X 10                 SUPPLY     19.70
MAT MGMT      2716744 0 DRSG KERLIX SPONGE FLUFF BOX          SUPPLY     8.51
MAT MGMT      2716745 0 DRSG GLUCAN II 5 PER BOX              SUPPLY     129.85
MAT MGMT      2716776 0 DRSG WOUND GEL CARRASYN 3 OZ          SUPPLY     32.98
MAT MGMT      2716777 0 DRSG WOUND GEL CARRASYN 8 OZ          SUPPLY     51.00
MAT MGMT      2716784 0 DRSG ELASTOPLAST 4 IN                 SUPPLY     19.10
MAT MGMT      2716787 0 DRSG KLING 2 IN 2 PLY                 SUPPLY     2.00
MAT MGMT      2716788 0 DRSG KLING 3 IN 2 PLY                 SUPPLY     2.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION              CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2716829 0 DRAIN HEMOVAC MED 1/8 IN        SUPPLY     33.20
MAT MGMT      2716830 0 DRAIN HEMOVAC LGE 1/4 IN        SUPPLY     33.20
MAT MGMT      2716847 0 DRSG ADAPTIC MED 3X6            SUPPLY     6.70
MAT MGMT      2716918 0 DRSG TEGADERM 8X12              SUPPLY     7.50
MAT MGMT      2716921 0 STERI STRIPS 1/8 X 3            SUPPLY     2.10
MAT MGMT      2716922 0 STERI STRIPS 1/4 X 3            SUPPLY     2.10
MAT MGMT      2716923 0 STERI STRIPS 1/2 X 4            SUPPLY     3.40
MAT MGMT      2716926 0 IODOFORM GAUZE PACKING 2 IN     SUPPLY     14.56
MAT MGMT      2716927 0 IODOFORM GAUZE PACKING 1 IN     SUPPLY     10.99
MAT MGMT      2716928 0 IODOFORM GAUZE PACKING 1/2 IN   SUPPLY     10.00
MAT MGMT      2716929 0 IODOFORM GAUZE PACKING 1/4 IN   SUPPLY     8.61
MAT MGMT      2716930 0 PLAIN GAUZE PACKING 2 IN        SUPPLY     12.74
MAT MGMT      2716931 0 PLAIN GAUZE PACKING 1 IN        SUPPLY     9.20
MAT MGMT      2716932 0 PLAIN GAUZE PACKING 1/2 IN      SUPPLY     8.10
MAT MGMT      2716947 0 DRSG GAUZE VASELINE 3X36        SUPPLY     3.70
MAT MGMT      2716948 0 DRSG GAUZE VASELINE 3X18        SUPPLY     3.00
MAT MGMT      2716949 0 DRSG GAUZE VASELINE 3X9         SUPPLY     2.00
MAT MGMT      2716950 0 DRAIN THOR SENTINAL DUAL        SUPPLY     131.90
MAT MGMT      2716954 0 DRSG GAUZE VASELINE 1/2X72      SUPPLY     3.80
MAT MGMT      2716961 0 DRSG TELFA 3X6                  SUPPLY     2.00
MAT MGMT      2716962 0 ADHESIVE DERMABOND              SUPPLY     64.80
MAT MGMT      2716963 0 DRSG WOUND VEIL 12 X 12         SUPPLY     7.25
MAT MGMT      2717180 0 VAGINAL DILATOR SM              SUPPLY     33.50
MAT MGMT      2717201 0 SUPPLEMENTAL NURSING SYSTEM     SUPPLY     67.40
MAT MGMT      2717339 0 BREAST SHELL                    SUPPLY     25.00
MAT MGMT      2717566 0 PUMP BREAST MANUAL              SUPPLY     49.20
MAT MGMT      2717707 0 TUCKS PADS                      SUPPLY     3.60
MAT MGMT      2717785 0 BOTTLE PERITONEAL IRRIGATION    SUPPLY     2.10
MAT MGMT      2717928 0 PUMP BREAST DOUBLE              SUPPLY     70.10
MAT MGMT      2718029 0 DRAPE FOR VAC DRESSING          SUPPLY     23.90
MAT MGMT      2718069 0 EYE PAD OVAL 1 5/8 IN EA        SUPPLY     2.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2718101 0 HYPERTHERMIA PAD PED 22 X 30       SUPPLY     49.10
MAT MGMT      2718320 0 BED ALARM SENSOR PAD DISP          SUPPLY     79.80
MAT MGMT      2718322 0 MATTRESS PORTA WARM SING USE       SUPPLY     48.80
MAT MGMT      2718623 0 PAD HYPOTHERMIA ADULT              SUPPLY     59.20
MAT MGMT      2718624 0 PADS FOR CPM MACHINE               SUPPLY     31.40
MAT MGMT      2720168 0 STOCKINGS THIGH LG REG             SUPPLY     21.40
MAT MGMT      2720370 0 STOCKINGS KNEE SM / LONG           SUPPLY     21.16
MAT MGMT      2720371 0 STOCKINGS KNEE MED/REG             SUPPLY     12.30
MAT MGMT      2720372 0 STOCKINGS KNEE MED / LONG          SUPPLY     12.30
MAT MGMT      2720376 0 STOCKINGS KNEE LG/REG              SUPPLY     12.30
MAT MGMT      2720381 0 STOCKINGS KNEE XLG/REG             SUPPLY     12.30
MAT MGMT      2720383 0 STOCKINGS KNEE XLG/LONG            SUPPLY     21.16
MAT MGMT      2720385 0 STOCKINGS THIGH SM SHORT           SUPPLY     17.74
MAT MGMT      2720386 0 STOCKINGS THIGH SM REG             SUPPLY     17.74
MAT MGMT      2720387 0 STOCKINGS THIGH SM LONG            SUPPLY     28.04
MAT MGMT      2720388 0 STOCKINGS THIGH MED SHORT          SUPPLY     17.74
MAT MGMT      2720389 0 STOCKINGS THIGH MED LONG           SUPPLY     21.50
MAT MGMT      2720391 0 STOCKINGS THIGH LARGE SHORT        SUPPLY     17.74
MAT MGMT      2720398 0 STOCKINGS THIGH LARGE LONG         SUPPLY     17.74
MAT MGMT      2720635 0 STOCKINGS KNEE SM/REG              SUPPLY     12.50
MAT MGMT      2720662 0 STOCKINGS THIGH MED REG            SUPPLY     21.40
MAT MGMT      2720664 0 DRSG WOUND VAC XLGE                SUPPLY     189.60
MAT MGMT      2721032 0 CATH KIT CVC 7FR 20CM 2LM AGB      SUPPLY     136.40
MAT MGMT      2721033 0 CATH KIT CVC 7FR 30CM 3LM          SUPPLY     71.65
MAT MGMT      2721034 0 CATH KIT REPAIR HICKMAN 10FR       SUPPLY     376.25
MAT MGMT      2721035 0 CATH KIT MAHURKAR 11.5 X 16CM      SUPPLY     194.55
MAT MGMT      2721036 0 CATH 5FR WIRE VENT PACING          SUPPLY     232.75
MAT MGMT      2721037 0 CATH SUCTION GLOVE SET 12FR        SUPPLY     4.70
MAT MGMT      2721038 0 CATH FOLEY SILICONE 16FR 5CC BAL   SUPPLY     12.30
MAT MGMT      2721151 0 DIALYSIS PERITONEAL CAP            SUPPLY     5.60
MAT MGMT      2721152 0 DIALYSIS CATH PERITONEAL           SUPPLY     47.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2721293 0 DIALYSIS MANIFOLD SET 10 PRONG        SUPPLY     20.70
MAT MGMT      2721295 0 DIALYSIS CYCLER DRNGE SET             SUPPLY     28.80
MAT MGMT      2721296 0 TRAY ON-OFF                           SUPPLY     11.40
MAT MGMT      2721312 0 DILATOR 10FR                          SUPPLY     14.60
MAT MGMT      2721389 0 DIANEAL 1.5 DXT PD-2 2000 ML          SUPPLY     22.80
MAT MGMT      2721390 0 DIANEAL 2.5 DEXT PD-2 2000 ML         SUPPLY     22.80
MAT MGMT      2721391 0 DIANEAL 4.25 DEXT PD-2 2000 ML        SUPPLY     22.80
MAT MGMT      2721393 0 PERITONEAL OUTLET PORT CLAMP          SUPPLY     15.30
MAT MGMT      2721406 0 DIALYSIS ADAPTER SET IPD              SUPPLY     12.80
MAT MGMT      2721407 0 DIALYSIS PERI LOCKING CAP 5C41        SUPPLY     2.50
MAT MGMT      2721920 0 CATH KIT SUBCLAVIAN 11.5FR X 13.5CM   SUPPLY     194.40
MAT MGMT      2722025 0 CATH KIT REPAIR COOK 7.0FR 2LM        SUPPLY     181.20
MAT MGMT      2722026 0 CATH KIT REPAIR COOK 6.5 FR 1L        SUPPLY     135.30
MAT MGMT      2722027 0 CATH KIT REPAIR COOK 4.0FR 1LM        SUPPLY     159.30
MAT MGMT      2722028 0 SLEEVE SCD COMPRESS LG BARIATR EA     SUPPLY     57.20
MAT MGMT      2722059 0 CATH THOR TROCAR 8FR                  SUPPLY     45.10
MAT MGMT      2722104 0 NDL BIOPSY-CUT 14GA                   SUPPLY     74.20
MAT MGMT      2722105 0 NDL BIOPSY ASAP 15G                   SUPPLY     77.10
MAT MGMT      2722156 0 CATH FOGARTY EMB ART 6FR              SUPPLY     82.60
MAT MGMT      2722232 0 DIALYSIS TUBING UV FLASH              SUPPLY     7.30
MAT MGMT      2722233 0 DIALYSIS CAPS UV FLASH                SUPPLY     2.00
MAT MGMT      2722234 0 DIALYSIS TUBING ULTRA                 SUPPLY     5.80
MAT MGMT      2722235 0 DIALYSIS CAPS ULTRA                   SUPPLY     2.00
MAT MGMT      2722236 0 DIANEAL 2.5 DEXT PD-2 250 ML          SUPPLY     10.00
MAT MGMT      2722237 0 DIANEAL 1.5 DEXT PD-2 250 ML          SUPPLY     16.60
MAT MGMT      2722239 0 DEFIB PAD PACING                      SUPPLY     56.20
MAT MGMT      2722241 0 SLEEVE SCD COMPRESS 1 PR              SUPPLY     49.40
MAT MGMT      2722307 0 CATH KIT REPAIR COOK 5F2L             SUPPLY     183.80
MAT MGMT      2722308 0 CATH KIT CVC 7FR 20CM 2LM             SUPPLY     81.20
MAT MGMT      2722309 0 CATH KIT CVC 4FR 5CM 2LM              SUPPLY     234.90
MAT MGMT      2722310 0 CATH KIT CVC 5FR 12CM 2LM             SUPPLY     164.15
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2722311 0 CATH KIT CVC 5FR 15CM 2LM          SUPPLY     183.70
MAT MGMT      2722320 0 CATH IV TWIN 18G X 1 3/4           SUPPLY     29.90
MAT MGMT      2722323 0 CATH REPAIR KIT NEO PICC           SUPPLY     30.70
MAT MGMT      2722334 0 CATH KIT CVC 4FR 8CM 2LM           SUPPLY     234.90
MAT MGMT      2722336 0 CATH KIT CVC COOK 5FR 12CM 2LM     SUPPLY     240.35
MAT MGMT      2722338 0 CATH KIT CVC 5FR 12CM 3LM          SUPPLY     236.40
MAT MGMT      2722339 0 CATH KIT CVC 7FR 15CM 3LM          SUPPLY     253.30
MAT MGMT      2722340 0 CATH KIT CVC 7FR 35CM 3LM          SUPPLY     171.60
MAT MGMT      2722346 0 CATH KIT NEO PICC                  SUPPLY     161.70
MAT MGMT      2722350 0 CATH KIT CVC 7FR 20CM 3LM AGB      SUPPLY     168.40
MAT MGMT      2722366 0 CATH OXIMETRIX 8FR HEPARIN         SUPPLY     448.20
MAT MGMT      2722367 0 CATH SWAN GANZ PROBE V-PAC         SUPPLY     248.20
MAT MGMT      2722368 0 CATH SWAN GANZ PACEPORT 7.5FR      SUPPLY     134.40
MAT MGMT      2722375 0 CATH KIT CVC ARROW 16G 8IN         SUPPLY     49.00
MAT MGMT      2722379 0 CATH SWAN GANZ THERM 5FR           SUPPLY     218.30
MAT MGMT      2722395 0 CATH KIT CVC COOK 7FR 40CM 3LM     SUPPLY     158.30
MAT MGMT      2722396 0 CATH KIT CVC 5FR 25CM 2LM          SUPPLY     151.29
MAT MGMT      2722399 0 CATH KIT CVC COOK 3FR 15CM 1LM     SUPPLY     56.60
MAT MGMT      2722414 0 CATH SLEEVE SPETIISHIELD           SUPPLY     21.60
MAT MGMT      2722416 0 CATH KIT CVC 7FR 30CM 3LM AGB      SUPPLY     141.60
MAT MGMT      2722432 0 CATH CONTAMINATION SHEATH          SUPPLY     30.58
MAT MGMT      2722474 0 CATH KIT CVC 5FR 8CM 2LM           SUPPLY     238.40
MAT MGMT      2722523 0 CATH SWAN GANZ THERM 7.5FR         SUPPLY     114.00
MAT MGMT      2722683 0 CATH UMBILICAL 3.5FR               SUPPLY     45.40
MAT MGMT      2722684 0 CATH UMBILICAL 5FR                 SUPPLY     31.36
MAT MGMT      2722688 0 CATH KIT RADIAL ARTERY ARROW       SUPPLY     26.40
MAT MGMT      2722726 0 CATH TRIPLE LUMEN RT ART           SUPPLY     234.70
MAT MGMT      2722742 0 CATH GROSHONG OTG 3LM 8.5FR        SUPPLY     325.00
MAT MGMT      2722743 0 CATH TONOMETRY 18F                 SUPPLY     275.00
MAT MGMT      2722744 0 CATH KIT CVC ACCESS 9FR 10CM 2LM   SUPPLY     183.75
MAT MGMT      2722800 0 CATH OBTURATOR 7FR MULTILUMEN      SUPPLY     4.79
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2722801 0 CATH MULTI LUMEN CONTAM SHIELD         SUPPLY     7.90
MAT MGMT      2722802 0 CATH KIT CVC ACCESS 9FR 10CM 2LM AGB   SUPPLY     219.50
MAT MGMT      2722803 0 CATH 3 LM MAC COMPANION                SUPPLY     63.70
MAT MGMT      2723179 0 CATH FOLEY TEMP SENSING 18FR           SUPPLY     43.90
MAT MGMT      2723369 0 CATH FOLEY 6FR W/1.5CC BAL             SUPPLY     57.70
MAT MGMT      2723450 0 CATH FOLEY 2-WAY 8FR 3CC BAL           SUPPLY     24.40
MAT MGMT      2723451 0 CATH FOLEY SILICONE 10FR 3CC KENDL     SUPPLY     18.70
MAT MGMT      2723602 0 CATH FOLEY SILICONE 22FR 5CC KENDL     SUPPLY     20.02
MAT MGMT      2723604 0 CATH FOLEY 3-WAY 16FR W/30 CC BAL      SUPPLY     32.25
MAT MGMT      2723693 0 CATH FOLEY SILICONE 20FR 5CC KENDL     SUPPLY     20.00
MAT MGMT      2723694 0 CATH FOLEY SILICONE 18FR 5CC KENDL     SUPPLY     16.95
MAT MGMT      2723695 0 CATH FOLEY SILICONE 16FR 5CC KENDL     SUPPLY     16.60
MAT MGMT      2723807 0 CATH FOLEY 3-WAY 16FR W/5CC BAL        SUPPLY     33.40
MAT MGMT      2723850 0 CATH FOLEY COUDE 18FR W/5CC BAL        SUPPLY     34.20
MAT MGMT      2723966 0 CATH FOLEY 3-WAY 18FR W/5CC BAL        SUPPLY     33.40
MAT MGMT      2723968 0 CATH FOLEY 10FR W/3CC BAL PEDS         SUPPLY     24.40
MAT MGMT      2723969 0 CATH FOLEY 3-WAY 20FR W/5CC BAL        SUPPLY     33.40
MAT MGMT      2723970 0 CATH FOLEY 3-WAY 22FR W/5CC BAL        SUPPLY     33.40
MAT MGMT      2723971 0 CATH FOLEY 3-WAY 24FR W/5CC BAL        SUPPLY     33.40
MAT MGMT      2723972 0 CATH FOLEY 3-WAY 26FR W/5CC BAL        SUPPLY     33.40
MAT MGMT      2723973 0 CATH FOLEY 3-WAY 18FR W/30CC BAL       SUPPLY     32.20
MAT MGMT      2723974 0 CATH FOLEY 3-WAY 20FR W/30CC BAL       SUPPLY     32.20
MAT MGMT      2723975 0 CATH FOLEY 3-WAY 22FR W/30CC BAL       SUPPLY     32.20
MAT MGMT      2723976 0 CATH FOLEY 3-WAY 24FR W/30CC BAL       SUPPLY     32.20
MAT MGMT      2723977 0 CATH FOLEY 3-WAY 26FR W/30CC BAL       SUPPLY     33.60
MAT MGMT      2723978 0 CATH FOLEY 30FR W/30CC BAL             SUPPLY     14.40
MAT MGMT      2723979 0 CATH FOLEY 28FR W/30CC BAL             SUPPLY     14.40
MAT MGMT      2723980 0 CATH FOLEY 3-WAY 26FR W/30CC BAL       SUPPLY     32.20
MAT MGMT      2723981 0 CATH FOLEY 24FR W/30CC BAL             SUPPLY     14.40
MAT MGMT      2723982 0 CATH FOLEY 22FR W/30CC BAL             SUPPLY     14.40
MAT MGMT      2723983 0 CATH FOLEY 20FR W/30CC BAL             SUPPLY     14.40
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2723984 0 CATH FOLEY 18FR W/30CC BAL          SUPPLY     14.40
MAT MGMT      2723985 0 CATH FOLEY 16FR W/30CC BAL          SUPPLY     14.40
MAT MGMT      2723986 0 CATH FOLEY 14FR W/30CC BAL          SUPPLY     21.20
MAT MGMT      2723987 0 CATH FOLEY SILICONE 8FR 2CC KENDL   SUPPLY     29.50
MAT MGMT      2723988 0 CATH FOLEY 30FR W/5CC BAL           SUPPLY     12.75
MAT MGMT      2723990 0 CATH FOLEY 26FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723991 0 CATH FOLEY 24FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723992 0 CATH FOLEY 22FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723993 0 CATH FOLEY 20FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723994 0 CATH FOLEY 18FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723995 0 CATH FOLEY 16FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723996 0 CATH FOLEY 14FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723997 0 CATH FOLEY 12FR W/5CC BAL           SUPPLY     12.50
MAT MGMT      2723998 0 CATH FOLEY CARSON COUDE 14FR        SUPPLY     32.70
MAT MGMT      2723999 0 CATH FOLEY CARSON COUDE 16FR        SUPPLY     32.80
MAT MGMT      2724008 0 TUBE SUMP 6FR                       SUPPLY     35.00
MAT MGMT      2724009 0 TUBE SUMP 8FR LT                    SUPPLY     35.40
MAT MGMT      2724010 0 TUBE SUMP 10FR                      SUPPLY     35.48
MAT MGMT      2724101 0 CATH RECTAL ROBINSON 30FR           SUPPLY     12.80
MAT MGMT      2724138 0 DRAIN SALEM SUMP 10FR 36IN          SUPPLY     4.80
MAT MGMT      2724146 0 DRAIN SALEM SUMP 12FR 48IN          SUPPLY     4.80
MAT MGMT      2724147 0 DRAIN SALEM SUMP 14FR 48IN          SUPPLY     4.80
MAT MGMT      2724148 0 DRAIN SALEM SUMP 18FR 48IN          SUPPLY     4.80
MAT MGMT      2724464 0 DRAIN SARATOGA SUMP 16FR 20IN       SUPPLY     28.70
MAT MGMT      2724468 0 DRAIN SARATOGA SUMP 34FR 20IN       SUPPLY     33.00
MAT MGMT      2725009 0 CATH MALE EXTERN LGE STD            SUPPLY     4.70
MAT MGMT      2725010 0 CATH MALE EXTERN MED                SUPPLY     4.60
MAT MGMT      2725011 0 CATH MALE EXTERN SM                 SUPPLY     4.40
MAT MGMT      2725077 0 CATH PLUG W/ PROTECTOR              SUPPLY     2.00
MAT MGMT      2725417 0 CATH COUDE TIP 16FR 2 EYE           SUPPLY     14.15
MAT MGMT      2725418 0 CATH URETHRAL COUDE 12FR            SUPPLY     14.15
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2725419 0 CATH COUDE URETHRAL 14FR         SUPPLY     14.15
MAT MGMT      2725620 0 CATH COUDE TIP 18FR 2 EYE        SUPPLY     14.15
MAT MGMT      2725702 0 CATH COUDE TIP 20FR 2 EYE        SUPPLY     14.15
MAT MGMT      2726037 0 CATH SUCTION GLOVE SET 10FR      SUPPLY     2.00
MAT MGMT      2726074 0 CATH SUCTION GLOVE SET 14FR      SUPPLY     2.00
MAT MGMT      2726254 0 LUKENS TRAP MUCOUS SPEC          SUPPLY     3.70
MAT MGMT      2726291 0 MUCUS TRAP EXTRACTOR INF 10 FR   SUPPLY     13.60
MAT MGMT      2726420 0 CATH URETHRAL 20FR               SUPPLY     2.00
MAT MGMT      2726421 0 CATH URETHRAL 18FR               SUPPLY     2.00
MAT MGMT      2726422 0 CATH URETHRAL 12FR               SUPPLY     2.00
MAT MGMT      2726423 0 CATH URETHRAL 10FR               SUPPLY     2.00
MAT MGMT      2726424 0 CATH URETHRAL 8FR                SUPPLY     2.00
MAT MGMT      2726663 0 CATH SUCTION REPLOGLE 10FR       SUPPLY     32.40
MAT MGMT      2726714 0 CATH SUCTION GLOVE SET 8FR       SUPPLY     3.30
MAT MGMT      2726715 0 CATH SUCTION GLOVE SET 6FR       SUPPLY     3.30
MAT MGMT      2726854 0 CATH URETHRAL 16FR               SUPPLY     2.00
MAT MGMT      2726855 0 CATH URETHRAL 14FR               SUPPLY     2.00
MAT MGMT      2726940 0 CATH SUCTION CONTROL PEDS 14FR   SUPPLY     2.00
MAT MGMT      2726941 0 CATH SUCTION CONTROL PEDS 8FR    SUPPLY     2.00
MAT MGMT      2726942 0 CATH SUCTION CONTROL PEDS 10FR   SUPPLY     2.00
MAT MGMT      2726946 0 SUCTION YANKAUER EA              SUPPLY     2.70
MAT MGMT      2727094 0 CATH THOR TROCAR 10FR            SUPPLY     52.50
MAT MGMT      2727095 0 CATH THOR TROCAR 24FR            SUPPLY     45.10
MAT MGMT      2727243 0 CATH THOR SILICONE 36FR          SUPPLY     32.70
MAT MGMT      2727244 0 CATH THOR SILICONE 32FR          SUPPLY     32.60
MAT MGMT      2727245 0 CATH THOR SILICONE 28FR          SUPPLY     32.60
MAT MGMT      2727246 0 CATH THOR SILICONE 24FR          SUPPLY     31.80
MAT MGMT      2727247 0 CATH THOR SILICONE 20FR          SUPPLY     32.25
MAT MGMT      2727248 0 TUBE CHEST 16FR X 20             SUPPLY     19.60
MAT MGMT      2727610 0 CATH THOR SILICONE 40FR          SUPPLY     32.60
MAT MGMT      2727611 0 CATH THOR STRT 40FR              SUPPLY     32.10
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2727831 0 CATH THOR TROCAR 12FR                 SUPPLY     49.90
MAT MGMT      2727833 0 CATH THOR TROCAR 20FR                 SUPPLY     45.10
MAT MGMT      2727834 0 CATH THOR TROCAR 28FR                 SUPPLY     45.10
MAT MGMT      2728080 0 TRANSDUCER KIT BRIDGE                 SUPPLY     54.10
MAT MGMT      2728133 0 CATH SHEATH INTRODUCER 8FR 11CM       SUPPLY     32.40
MAT MGMT      2728189 0 WIRE ATRIAL J 5FR                     SUPPLY     250.00
MAT MGMT      2728218 0 CATH SHEATH INTRO 6 FR                SUPPLY     11.90
MAT MGMT      2728253 0 CATH KIT PERC INTRO SHEATH 5FR        SUPPLY     32.40
MAT MGMT      2728544 0 CATH GROSHONG CAP REPLACMNT           SUPPLY     39.60
MAT MGMT      2728659 0 CATH TEMP PACING BALLOON 5FR          SUPPLY     239.70
MAT MGMT      2728661 0 CATH PACING WIRE VENT 4FR             SUPPLY     216.80
MAT MGMT      2728836 0 CATH KIT CVC 5FR 40CM 3LM             SUPPLY     208.50
MAT MGMT      2728837 0 CATH KIT PICC LINE 20G                SUPPLY     172.10
MAT MGMT      2729029 0 TRAY PERC TRACH INTRODUCER            SUPPLY     662.50
MAT MGMT      2729052 0 CATH KIT FEM ART 4FR X 12             SUPPLY     67.00
MAT MGMT      2729060 0 CATH TRAY IRRIG W/ SYR                SUPPLY     4.30
MAT MGMT      2729062 0 AMNIOCENTESIS TRAY                    SUPPLY     55.30
MAT MGMT      2729064 0 CATH KIT URETHRAL 16FR                SUPPLY     6.70
MAT MGMT      2729083 0 TRACH CARE KIT EA                     SUPPLY     9.70
MAT MGMT      2729084 0 LUMBAR PUNCTURE KIT ADLT 20G          SUPPLY     46.90
MAT MGMT      2729085 0 LUMBAR PUNCTURE KIT ADLT 18G          SUPPLY     34.10
MAT MGMT      2729086 0 LUMBAR PUNCTURE KIT PEDS 22 X 1 1/2   SUPPLY     43.20
MAT MGMT      2729220 0 CATH KIT PERC INTRO 9FR AGB           SUPPLY     136.70
MAT MGMT      2729242 0 TRAY MINOR SUTURING                   SUPPLY     13.00
MAT MGMT      2729284 0 BONE MARROW TRAY 18G                  SUPPLY     47.88
MAT MGMT      2729313 0 CATH TRAY FOLEY 16FR W/ URIMETER      SUPPLY     44.70
MAT MGMT      2729323 0 LUMBAR PUNCTURE TRAY NEONATAL         SUPPLY     47.30
MAT MGMT      2729352 0 CATH FOLEY TRAY 18FR W/URIMETER       SUPPLY     44.70
MAT MGMT      2729448 0 BONE MARROW TRAY JAMSHIDI NDL         SUPPLY     51.10
MAT MGMT      2729689 0 CATH KIT PERC INTRO 8.5FR AGB         SUPPLY     136.70
MAT MGMT      2729690 0 CATH KIT PERC INTRO 8.5 FR            SUPPLY     97.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2729700 0 VALVE BIOPSY EA                     SUPPLY     11.00
MAT MGMT      2729727 0 MANOMETER KIT W/ STOPCOCK EA        SUPPLY     24.44
MAT MGMT      2729769 0 THORACENTESIS / PARACENTESIS KIT    SUPPLY     84.84
MAT MGMT      2729844 0 CATH TRAY FOLEY W/ 10CC SYR         SUPPLY     5.90
MAT MGMT      2729909 0 KIT TRAUMA 8.5FR                    SUPPLY     63.60
MAT MGMT      2729954 0 CATH KIT CVC 5FR 15CM 3LM           SUPPLY     234.50
MAT MGMT      2729955 0 CATH KIT CVC 4FR 15CM 2LM           SUPPLY     240.35
MAT MGMT      2730002 0 CATH SWAN GANZ MONITOR 5FR          SUPPLY     67.90
MAT MGMT      2730003 0 CATH SWAN GANZ MONITOR 7FR          SUPPLY     76.10
MAT MGMT      2730175 0 CATH AORTIC BAL 9.5FR 34CC          SUPPLY     1,247.00
MAT MGMT      2730176 0 CATH AORTIC BAL 8FR 34CC            SUPPLY     1,535.10
MAT MGMT      2730249 0 CATH AORTIC BAL 9.5FR 40CC          SUPPLY     1,247.00
MAT MGMT      2730250 0 CATH AORTIC BAL 8FR 40CC            SUPPLY     1,535.10
MAT MGMT      2730673 0 CATH SWAN GANZ PACEPORT 7FR         SUPPLY     595.20
MAT MGMT      2730674 0 CATH SWAN GANZ CCO W/SVO2 8FR       SUPPLY     484.20
MAT MGMT      2730675 0 CATH SWAN GANZ PACEPORT 8FR         SUPPLY     224.70
MAT MGMT      2730676 0 CATH SWAN GANZ PROBE A-PAC          SUPPLY     224.70
MAT MGMT      2731358 0 TRANSDUCER KIT SINGLE               SUPPLY     30.60
MAT MGMT      2731359 0 TRANSDUCER ADMIN SET 2 WAY EA       SUPPLY     10.10
MAT MGMT      2731409 0 TRANSDUCER ADMIN SET SING           SUPPLY     6.30
MAT MGMT      2731413 0 TUBING PRESSURE 36IN                SUPPLY     2.30
MAT MGMT      2731525 0 TRANSDUCER KIT NEONATAL             SUPPLY     30.60
MAT MGMT      2732243 0 TRACH TUBE UNCUFFED 2.5             SUPPLY     5.60
MAT MGMT      2732244 0 TRACH TUBE UNCUFFED 3               SUPPLY     5.80
MAT MGMT      2732245 0 TRACH TUBE UNCUFFED 3.5             SUPPLY     5.80
MAT MGMT      2732246 0 TRACH TUBE PORTEX 100 / 141 / 040   SUPPLY     4.93
MAT MGMT      2732251 0 TRACH TUBE CUFFED 6.5               SUPPLY     5.25
MAT MGMT      2732252 0 TRACH TUBE CUFFED 7                 SUPPLY     5.30
MAT MGMT      2732253 0 TRACH TUBE CUFFED 7.5               SUPPLY     5.25
MAT MGMT      2732254 0 TRACH TUBE CUFFED 8                 SUPPLY     5.40
MAT MGMT      2732255 0 TRACH TUBE CUFFED 8.5               SUPPLY     5.40
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                              CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION              CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2732257 0 TRACH TUBE LMA SZ 3 CHLD        SUPPLY     29.40
MAT MGMT      2732258 0 TRACH TUBE LMA SZ 1 NEO/INF     SUPPLY     29.40
MAT MGMT      2732259 0 TRACH TUBE LMA SZ 1.5 INF       SUPPLY     29.40
MAT MGMT      2732260 0 TRACH TUBE LMA SZ 2 INF/CHLD    SUPPLY     29.40
MAT MGMT      2732261 0 TRACH TUBE LMA SZ 2.5 CHLD      SUPPLY     29.40
MAT MGMT      2732262 0 TRACH TUBE LMA SZ 4 ADLT        SUPPLY     29.40
MAT MGMT      2732263 0 TRACH TUBE LMA SZ 5 ADLT        SUPPLY     29.40
MAT MGMT      2732264 0 TRACH TUBE CUFFED 4             SUPPLY     5.70
MAT MGMT      2732265 0 TRACH TUBE UNCUFFED 5.5         SUPPLY     10.60
MAT MGMT      2732448 0 TRACH TUBE HOLDER               SUPPLY     51.00
MAT MGMT      2733036 0 TUBE FEEDING KIT 5FR X 15IN     SUPPLY     5.40
MAT MGMT      2733121 0 BUTTON FEEDING TUBE BOLUS       SUPPLY     24.50
MAT MGMT      2733123 0 GASTROSTOMY BUTTON 18FR 1.2CM   SUPPLY     400.00
MAT MGMT      2733342 0 TUBE FEEDING 5FR 20IN           SUPPLY     18.30
MAT MGMT      2733343 0 TUBE FEEDING 5FR 36IN           SUPPLY     18.25
MAT MGMT      2733344 0 TUBE FEEDING 8FR 42IN           SUPPLY     18.30
MAT MGMT      2733348 0 GASTROSTOMY BUTTON 18FR 1.7CM   SUPPLY     300.00
MAT MGMT      2733349 0 TUBE FEEDING 8FR 20IN           SUPPLY     18.30
MAT MGMT      2733350 0 TUBE FEED MIC KEY 14FR 1.7CM    SUPPLY     221.60
MAT MGMT      2733351 0 TUBE FEED MIC KEY 14FR 2.0CM    SUPPLY     244.85
MAT MGMT      2733352 0 TUBE FEED MIC KEY 16FR 1.5CM    SUPPLY     234.80
MAT MGMT      2733353 0 TUBE FEED MIC KEY 16FR 2.0CM    SUPPLY     237.40
MAT MGMT      2733354 0 TUBE FEED MIC KEY 16FR 2.5CM    SUPPLY     232.75
MAT MGMT      2733355 0 TUBE FEED MIC KEY 18FR 3.0CM    SUPPLY     232.75
MAT MGMT      2733356 0 TUBE FEED MIC KEY 18FR 1.7CM    SUPPLY     232.75
MAT MGMT      2733357 0 TUBE FEEDING INDWELL 6.5FR      SUPPLY     18.30
MAT MGMT      2733358 0 TUBE FEED MIC KEY 14FR 2.3CM    SUPPLY     224.40
MAT MGMT      2733359 0 TUBE FEED MIC KEY 16FR 1.7CM    SUPPLY     240.90
MAT MGMT      2733360 0 TUBE FEED MIC KEY 16FR 2.3CM    SUPPLY     216.70
MAT MGMT      2733361 0 TUBE FEED MIC KEY 16FR 2.7CM    SUPPLY     232.75
MAT MGMT      2733362 0 TUBE FEED MIC KEY 16FR 3.0CM    SUPPLY     232.75
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2733363 0 TUBE FEED MIC KEY 20FR 1.5CM      SUPPLY     221.10
MAT MGMT      2733364 0 TUBE FEED MIC KEY 24FR 1.5CM      SUPPLY     232.75
MAT MGMT      2733365 0 TUBE FEED MIC KEY 24FR 2.0CM      SUPPLY     230.70
MAT MGMT      2733366 0 TUBE FEED MIC KEY 24FR 3.0CM      SUPPLY     232.75
MAT MGMT      2733367 0 TUBE GASTRONOMY 20FR              SUPPLY     105.30
MAT MGMT      2733386 0 TUBE GASTRONOMY 16FR              SUPPLY     105.28
MAT MGMT      2733387 0 TUBE GASTRONOMY 18FR              SUPPLY     107.50
MAT MGMT      2733521 0 TUBE ENTERAL FDG W/ STYLET 10FR   SUPPLY     43.80
MAT MGMT      2733577 0 TUBE BLAKEMORE 20FR ADULT         SUPPLY     579.40
MAT MGMT      2733578 0 TUBE BLAKEMORE-CHILD              SUPPLY     597.20
MAT MGMT      2733585 0 TUBE FEED MIC KEY 14FR 1.5CM      SUPPLY     237.50
MAT MGMT      2733586 0 TUBE FEEDING NASOGAST 6FR         SUPPLY     2.80
MAT MGMT      2733589 0 TUBE FEED MIC KEY 14FR 1.2CM      SUPPLY     237.50
MAT MGMT      2733590 0 TUBE FEED MIC KEY 18FR 1.5CM      SUPPLY     237.50
MAT MGMT      2733593 0 TUBE FEED MIC KEY EXT SET         SUPPLY     30.80
MAT MGMT      2733856 0 TUBE FEEDING KIT 8FR X 42IN       SUPPLY     23.40
MAT MGMT      2733857 0 TUBE FEEDING KIT 5FR X 40IN       SUPPLY     8.40
MAT MGMT      2733861 0 TUBE FEED MIC KEY 14FR 2.5CM      SUPPLY     237.40
MAT MGMT      2733875 0 TUBE FEED MIC KEY 20FR 1.7CM      SUPPLY     233.30
MAT MGMT      2734039 0 TRACH TUBE SHILEY FNSTRTD 4       SUPPLY     100.40
MAT MGMT      2734040 0 TRACH TUBE LPC FNSTRTD SZ 6       SUPPLY     99.30
MAT MGMT      2734041 0 TRACH TUBE LPC FNSTRTD SZ 8       SUPPLY     96.20
MAT MGMT      2734042 0 TRACH TUBE LPC FNSTRTD SZ 10      SUPPLY     96.00
MAT MGMT      2734079 0 TUBE LARYNGECTOMY METAL 10        SUPPLY     248.70
MAT MGMT      2734134 0 TRACH TUBE SHILEY LPC SZ 4        SUPPLY     94.50
MAT MGMT      2734135 0 TRACH TUBE SHILEY LPC SZ 6        SUPPLY     94.50
MAT MGMT      2734136 0 TRACH TUBE SHILEY LPT SZ 8        SUPPLY     94.10
MAT MGMT      2734137 0 TRACH TUBE SHILEY LPT SZ 10       SUPPLY     94.50
MAT MGMT      2734204 0 TRACH TUBE PEDS 3.5               SUPPLY     76.70
MAT MGMT      2734205 0 TRACH TUBE PEDS 3                 SUPPLY     74.80
MAT MGMT      2734206 0 TRACH TUBE PEDS 4                 SUPPLY     76.60
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML     CPT
MAT MGMT      2734207 0 TRACH TUBE PEDS 4.5                      SUPPLY     75.40
MAT MGMT      2734208 0 TRACH TUBE UNCUFFED PED 5                SUPPLY     76.90
MAT MGMT      2734209 0 TRACH TUBE TIE 14 CM 6-8 KILO            SUPPLY     7.30
MAT MGMT      2734210 0 TRACH TUBE CUFFED PEDS PDC 4             SUPPLY     106.32
MAT MGMT      2734211 0 TRACH TUBE CUFFED PEDS PDC 5.5           SUPPLY     81.20
MAT MGMT      2734212 0 TRACH TUBE CUFFED PEDS PDC 5             SUPPLY     93.16
MAT MGMT      2734213 0 TRACH TUBE CUFFED PEDS PDC 4.5           SUPPLY     102.60
MAT MGMT      2734217 0 TRACH TUBE KAMEN SZ 6                    SUPPLY     49.50
MAT MGMT      2734251 0 TRACH TUBE NEONATAL 4                    SUPPLY     76.30
MAT MGMT      2734282 0 TRACH TUBE KAMEN SZ 7                    SUPPLY     48.10
MAT MGMT      2734283 0 TRACH TUBE KAMEN SZ 8                    SUPPLY     48.90
MAT MGMT      2734284 0 TRACH TUBE KAMEN SZ 9                    SUPPLY     235.40
MAT MGMT      2734285 0 TRACH TUBE NEONATAL 3.5                  SUPPLY     77.10
MAT MGMT      2734641 0 TUBE LARYNGECTOMY #12 METAL              SUPPLY     248.70
MAT MGMT      2734642 0 TRACH TUBE UNCUFFED PED 5.5              SUPPLY     76.60
MAT MGMT      2734643 0 TRACH TUBE NEONATAL 3                    SUPPLY     77.10
MAT MGMT      2734770 0 TRACH TUBE UNCUFFED 4                    SUPPLY     85.70
MAT MGMT      2734771 0 TRACH TUBE UNCUFFED 6                    SUPPLY     85.70
MAT MGMT      2734772 0 TRACH TUBE UNCUFFED 8                    SUPPLY     83.20
MAT MGMT      2734773 0 TRACH TUBE SHILEY LGT SZ 10              SUPPLY     119.20
MAT MGMT      2735032 0 SUCTION TUBE CONNECT 1/4 IN X 72 IN EA   SUPPLY     2.60
MAT MGMT      2735074 0 IV SET DIAL-A-FLOW EXT EA                SUPPLY     13.32
MAT MGMT      2735110 0 IV SET EXT W/ 1.2 MICRON FILTER          SUPPLY     9.50
MAT MGMT      2735346 0 IV TUBING EXT LATEX 18 IN EA             SUPPLY     4.60
MAT MGMT      2737065 0 NDL JAMSHIDI 13G X 3.5 BONE MARROW       SUPPLY     74.00
MAT MGMT      2737066 0 NDL BIOPSY BONE MARROW 11G X 4           SUPPLY     68.80
MAT MGMT      2737067 0 NDL JAMSHIDI STERNAL ILL 15              SUPPLY     37.10
MAT MGMT      2737068 0 NDL JAMSHIDI STERNAL ILL                 SUPPLY     42.45
MAT MGMT      2737138 0 NDL BIOPSY LIVER JANSHIDI                SUPPLY     65.30
MAT MGMT      2737415 0 NDL BIOPSY TRUCUT 14G X 6                SUPPLY     58.60
MAT MGMT      2737457 0 NDL SPINAL 22G X 1 1/2 IN                SUPPLY     3.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE        PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY      OUTPT)          LML/RML     CPT
MAT MGMT      2737458 0 NDL SPINAL 20G 1 1/2"               SUPPLY        3.70
MAT MGMT      2737459 0 NDL SPINAL 25G X 3 1/2 IN           SUPPLY        3.70
MAT MGMT      2737460 0 NDL SPINAL 22G X 3 1/2 IN           SUPPLY        3.50
MAT MGMT      2737461 0 NDL SPINAL 20G X 3 1/2 IN           SUPPLY        3.70
MAT MGMT      2737463 0 NDL SPINAL 18G X 3 1/2 IN           SUPPLY        3.70
MAT MGMT      2737464 0 NDL SPINAL 20G X 2 1/2 IN           SUPPLY        3.90
MAT MGMT      2737583 0 BIOPSY KIT SKIN PUNCH 6MM           SUPPLY        5.26
MAT MGMT      2737585 0 BIOPSY KIT SKIN PUNCH 4MM           SUPPLY        16.80
MAT MGMT      2737586 0 BIOPSY KIT SKIN PUNCH 3.5MM         SUPPLY        5.50
MAT MGMT      2737771 0 NDL BIOPSY TRUCUT 14G X 4 1/2       SUPPLY        55.90
MAT MGMT      2737780 0 NDL SPINAL 20G X 1 1/2 IN           SUPPLY        3.70
MAT MGMT      2737789 0 NDL JAMSHIDI W/ SYR SOFT TI         SUPPLY        71.30
MAT MGMT      2737910 0 NDL NON KOR HUBER 19G X 1 IN        SUPPLY        18.20
MAT MGMT      2737915 0 NDL DIECKMANN INTRAOSS              SUPPLY        96.00
MAT MGMT      2738054 0 CATH CAMINO VP                      SUPPLY        957.50
MAT MGMT      2738055 0 CATH VENTRICULAR ANTIBIOTIC         SUPPLY        454.70
MAT MGMT      2738761 0 CYSTO SET IRRIG TUR Y-TYP           SUPPLY        12.10
MAT MGMT      2738837 0 DRAIN THOR PLEUROVAC W/ DRY         SUPPLY        81.40
MAT MGMT      2738955 0 BAG URINARY DRNGE 2000 ML LF        SUPPLY        10.00
MAT MGMT      2739092 0 CATH URETH FEMALE SELFCATH 14FR     SUPPLY        2.00
MAT MGMT      2740020 0 KIT TRACH MINI II                   SUPPLY        79.80
MAT MGMT      2740063 0 MAXX AIR ETS MATTRESS KCI           SUPPLY MEMS   123.20
MAT MGMT      2740175 0 CRASH CART ADULT                    SUPPLY        216.10
MAT MGMT      2740231 0 BED KINAIR III KCI                  SUPPLY MEMS   130.34
MAT MGMT      2740396 0 BED KINAIR IV KCI                   SUPPLY MEMS   173.95
MAT MGMT      2740398 0 BED PEDIDYNE KCI                    SUPPLY MEMS   344.00
MAT MGMT      2740408 0 BED DELTA ROTO REST KCI             SUPPLY MEMS   337.00
MAT MGMT      2740420 0 PASSIVE MOTION ELBOW/P DY           SUPPLY        73.30
MAT MGMT      2740662 0 BED BARIKARE KCI                    SUPPLY MEMS   230.69
MAT MGMT      2740664 0 BED ROTO REST KCI                   SUPPLY MEMS   344.00
MAT MGMT      2740665 0 TRACH TUBE SHILEY XLT DIST 7.0 EA   SUPPLY        135.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2740666 0 TRACH TUBE SHILEY XLT DIST 8.0 EA   SUPPLY     151.90
MAT MGMT      2740667 0 TRACH TUBE UNCUFFED XL DIST 6       SUPPLY     132.30
MAT MGMT      2740668 0 TRACH TUBE UNCUFFED XL DIST 7       SUPPLY     132.30
MAT MGMT      2740669 0 TRACH TUBE UNCUFFED XL DIST 8       SUPPLY     143.20
MAT MGMT      2740670 0 TRACHEOSTOMA VENT SZ 10 36 LONG     SUPPLY     149.65
MAT MGMT      2740671 0 TRACHEOSTOMA VENT SZ 9 55 LONG      SUPPLY     159.25
MAT MGMT      2740672 0 TRACHEOSTOMA VENT SZ 10 55 LONG     SUPPLY     149.45
MAT MGMT      2740745 0 TRACH TIE FOAM LARGE                SUPPLY     2.70
MAT MGMT      2740746 0 TRACH TIE FOAM MEDIUM               SUPPLY     2.50
MAT MGMT      2740747 0 TRACH TIE FOAM SMALL                SUPPLY     2.60
MAT MGMT      2740752 0 CATH TRAY PED 5FR                   SUPPLY     9.70
MAT MGMT      2740754 0 DRSG X-SPAN FINGER SZ1              SUPPLY     33.70
MAT MGMT      2740755 0 DRSG X-SPAN MULTIUSE SZ2            SUPPLY     35.40
MAT MGMT      2740756 0 DRSG X-SPAN ELBOW/ARM SZ4           SUPPLY     49.90
MAT MGMT      2740757 0 DRSG X-SPAN WAIST/HEAD SZ6          SUPPLY     63.80
MAT MGMT      2740758 0 DRSG X-SPAN HIP SZ8                 SUPPLY     128.40
MAT MGMT      2740759 0 IMMOBILIZER ELBOW/WRIST MED         SUPPLY     32.20
MAT MGMT      2740760 0 IRRIJET WOUND IRRIG SYS DISP.       SUPPLY     36.10
MAT MGMT      2740767 0 CATH SWAN GANZ CCO W/O SVO2 7.5FR   SUPPLY     391.90
MAT MGMT      2740768 0 OST VERT DRAIN TUBE                 SUPPLY     27.50
MAT MGMT      2740769 0 DRSG TEGADERM 1X1                   SUPPLY     2.00
MAT MGMT      2740777 0 CRASH CART NEWBORN                  SUPPLY     192.40
MAT MGMT      2740778 0 CRASH CART PEDS                     SUPPLY     216.10
MAT MGMT      2742301 0 STRAP REPLACEMENT FOR PRAFO         SUPPLY     78.40
MAT MGMT      2742310 0 LO SAGIT RIGID PANEL PREFAB         SUPPLY     1,080.74
MAT MGMT      2742313 0 TLSO FLEX PREFAB THORACIC           SUPPLY     358.64
MAT MGMT      2710530 2 CRUTCHES ALUM YOUTH                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2742145 2 ACTIVITY APRON                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2715169 2 IV WATER IRRIG BAG 1000 ML          SUPPLY     STATISTICAL ITEM
MAT MGMT      2729153 2 NEURO DRILL TRAY ER PROCESSED       SUPPLY     STATISTICAL ITEM
MAT MGMT      2729447 2 TRANSFUSION EXCHANGE TRAY           SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE        PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY      OUTPT)             LML/RML     CPT
MAT MGMT      2738874 2 ANOSCOPE FENESTRATED DISP                     SUPPLY        STATISTICAL ITEM
MAT MGMT      2701008 2 ICE PACK W/ VELCRO LGE EA                     SUPPLY        STATISTICAL ITEM
MAT MGMT      2701009 2 ICE PACK W/ VELCRO SM EA                      SUPPLY        STATISTICAL ITEM
MAT MGMT      2701012 2 COLD PACK PERINEAL PERI K 6/PK                SUPPLY        STATISTICAL ITEM
MAT MGMT      2701051 2 TOOTHBRUSH SUCTION                            SUPPLY        STATISTICAL ITEM
MAT MGMT      2701071 2 SUCTION TUBE FOR ORAL CARE KIT                SUPPLY        STATISTICAL ITEM
MAT MGMT      2701103 2 MARKER SURGICAL                               SUPPLY        STATISTICAL ITEM
MAT MGMT      2701111 2 SUCTION LINER & TUBING 6 FT KIT               SUPPLY        STATISTICAL ITEM
MAT MGMT      2701112 2 SUCTION LINER FOR CANNISTER 1500 CC EA        SUPPLY        STATISTICAL ITEM
MAT MGMT      2701113 2 ELECTRODE LEAD WIRE SET EKG 18 IN             SUPPLY        STATISTICAL ITEM
MAT MGMT      2701114 2 ELECTRODE LEAD WIRE SET EKG 36 IN             SUPPLY        STATISTICAL ITEM
MAT MGMT      2701122 2 PESSARY UTERINE SILICONE DONUT                SUPPLY        STATISTICAL ITEM
MAT MGMT      2701130 2 PAD K-PAD MODULE DISP                         SUPPLY        STATISTICAL ITEM
MAT MGMT      2701131 2 MONITOR CAMINO                                SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2701183 2 RESUSCITATION HYPERINFLATN BAG W/ 2 MASK EA   SUPPLY        STATISTICAL ITEM
MAT MGMT      2701189 2 COLLAR ICE                                    SUPPLY        STATISTICAL ITEM
MAT MGMT      2701225 2 DEFIB PAD QUICK COMBO ADLT REDIPACK           SUPPLY        STATISTICAL ITEM
MAT MGMT      2701230 2 BAG AMBU RESUSCITATOR ADT                     SUPPLY        STATISTICAL ITEM
MAT MGMT      2701231 2 BAG AMBU RESUSCITATOR PED                     SUPPLY        STATISTICAL ITEM
MAT MGMT      2701232 2 BLOOD COLLECT SET 21G X 3/4 IN - 1 PK         SUPPLY        STATISTICAL ITEM
MAT MGMT      2701233 2 BLOOD COLLECT SET 23G X 3/4 IN                SUPPLY        STATISTICAL ITEM
MAT MGMT      2701241 2 COLD PACK LARGE                               SUPPLY        STATISTICAL ITEM
MAT MGMT      2701242 2 COLD PACK SMALL                               SUPPLY        STATISTICAL ITEM
MAT MGMT      2701352 2 DIAPER ADULT SM EA                            SUPPLY        STATISTICAL ITEM
MAT MGMT      2701356 2 TAPE WATERPROOF ADHES 1 IN EA                 SUPPLY        STATISTICAL ITEM
MAT MGMT      2701377 2 BLANKET FULL BODY BAIR HUGGER EA              SUPPLY        STATISTICAL ITEM
MAT MGMT      2701424 2 NASAL TAMPON STAXI STAT                       SUPPLY        STATISTICAL ITEM
MAT MGMT      2701469 2 RSI SPRAY ATTACHMENT DISP.                    SUPPLY        STATISTICAL ITEM
MAT MGMT      2701513 2 DIAPER ADULT LARGE EA                         SUPPLY        STATISTICAL ITEM
MAT MGMT      2701912 2 RESUSCITATION KIT PED / INFANT                SUPPLY        STATISTICAL ITEM
MAT MGMT      2701913 2 ELECTRODE QUICK PACE ADULT                    SUPPLY        STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2701919 2 ELECTRODE FAST PATCH DEFIB         SUPPLY     STATISTICAL ITEM
MAT MGMT      2702017 2 OB PAD W/ BELT                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703001 2 A & D OINTMENT 2 OZ                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703002 2 ADAPTOR LUER MULTI SAMPLE          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703003 2 ADHESIVE MASTISOL PUMP 5 OZ        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703004 2 ADHESIVE REM DETACHOL              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703005 2 ADHESIVE REM UNISOLVE              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703006 2 AIRWAY OROPHAR GUEDEL 9CM          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703007 2 AIRWAY OROPHAR GUEDEL 10CM         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703008 2 AIRWAY OROPHAR 8CM                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703009 2 APPLICATOR COTTON TIP 6 IN         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703010 2 APPLICATOR SILVER NITRATE          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703011 2 ARMBOARD 18 IN                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703012 2 ARMBOARD 3 X 9 IN                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703013 2 ARMBOARD NEONATAL                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703014 2 ARMBOARD PEDS 2 X 5 IN             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703015 2 ARMBOARD PREEMIE                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703016 2 ARMBOARD SLEEVE 18 IN              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703017 2 ARMBOARD SLEEVE 9 IN               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703018 2 BABY POWDER                        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703019 2 BAG BEDSIDE W/ TWIN TAB            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703020 2 BAG LINER HAMPER W/ TIES 25 IN     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703021 2 BAG PAPER BROWN 12#                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703022 2 BAG PATIENT BELONGINGS             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703023 2 BAG ZIPLOCK 6 X 9 BIOHAZARD 1 PK   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703024 2 BASIN EMESIS 10 IN ROSE DISP       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703025 2 BASIN METAL STERILE SM             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703026 2 BASIN WASH 7 QT ROSE               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703027 2 BASIS SENSITIVE SKIN 4 OZ BAR      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703028 2 BEDPAN FRACTURE                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703029 2 BEDPAN W/ COVER WRAPPED            SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703030 2 BETADINE 144 X 0.9 GM OINT               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703031 2 BLADE TONGUE ADULT STER                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703032 2 BLADE TONGUE INFANT STER                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703033 2 BLEACH CHLORINE 1 GAL                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703034 2 BLOOD COLLECT SET 21G X 3/4 IN - 1 BOX   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703035 2 BLOOD COLLECT SET 25G X 3/4 IN           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703036 2 BLOOD CULT KIT FREPP SEPP                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703037 2 BLOOD PRESSURE BULB & VALVE              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703038 2 BLOOD SAMPLE SYRING HEPERANIZ            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703039 2 BORE EXTENSION SET                       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703040 2 BOTTLE ANAEROBIC                         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703041 2 BOTTLE AEROBIC PLASTIC                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703042 2 BOTTLE PEDI BACT                         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703043 2 TAPE BROSELOW PED                        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703044 2 BRUSH CLEANING CB-X2                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703045 2 BRUSH CYTOLOGY 1.7MM                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703046 2 BRUSH SCRUB IODOPHOR                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703047 2 BRUSH SCRUB PLAIN                        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703048 2 BRUSH SCRUB PLAIN NAIL CLEAN             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703049 2 CO2 DETECTOR PD1CAP                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703050 2 CABLE CONTIN CARDIAC OUTPUT              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703051 2 CABLE OM-2 OPTIC MODULE                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703052 2 CABLE PACING                             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703053 2 CABLE SURG FOR PACING DISP               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703054 2 CALDESENE MED 2.5 OZ                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703056 2 CANNULA TWIN PK                          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703057 2 CAP HOOD SURGEON BLUE                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703058 2 CAP NURSE BOUF BLUE LG                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703059 2 CAP SURGEON BLUE                         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703060 2 CARAFE INSERT                            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703061 2 CARAFE W/ SLIDE TOP 32 OZ                SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703062 2 CAST BUCKET PLASTER                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703063 2 CAST PADDING SYNTHETIC 2 IN X 4 YD   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703064 2 CAST PADDING SYNTHETIC 3 IN X 4 YD   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703065 2 CAST PADDING SYNTHETIC 4 IN X 4 YD   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703066 2 CAST PADDING SYNTHETIC 6 IN X 4 YD   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703072 2 CATH IV INSITE 20G X 1 IN SFTY       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703073 2 CATH IV INSITE 22G X 1 IN SFTY       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703074 2 CATH IV INSITE 18G X 1.88            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703075 2 CATH IV INSITE 20G X 1.88            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703076 2 CATH IV INSITE 24G X 3/4 IN          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703077 2 CATH ADAPTER                         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703078 2 CATH IV INSITE 14G X 1 3/4 IN        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703079 2 CATH IV INSITE 16G X 2 IN            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703080 2 CATH IV INSITE 16G X 1 1/4 IN        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703081 2 CATH IV INSITE 18G X 1 1/4 IN        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703082 2 CATH IV INSITE 18G X 2 IN            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703083 2 CATH IV INSITE 20G X 2 IN            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703085 2 CATH IV INTRODUCER                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703086 2 CATH KIT SPECIMEN                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703087 2 CAVIWIPES                            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703088 2 CHLORAPREP 1.5ML                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703089 2 CHLORAPREP 10.5ML                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703090 2 CHLORAPREP 3ML                       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703091 2 CLAMP CORD                           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703092 2 CLAMP DOUBLE SOFT JAW                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703093 2 CLAMP HOFFMAN SWING BAR              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703094 2 CLAMP UMBILICAL NONSTER              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703095 2 CLEANSER CETAPHIL 4OZ                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703096 2 CLEANSER SKIN HIBICLENS 4OZ          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703097 2 COLLECTION BAG W/DRAIN 3000 ML       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703098 2 COMB BLACK PLAST DISP 7IN            SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703099 2 CONNECTOR Y 1/4 IN STER             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703100 2 CONNECTOR Y 3/8 IN STER             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703101 2 CONNECTOR 6 IN 1 NON STER           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703102 2 CONNECTOR Y                         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703103 2 CONTAINER CHEMOTHER YELLOW          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703104 2 CONTAINER DENTURE NON STER          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703105 2 CONTAINER KIT MIDSTREAM URINE       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703106 2 CONTAINER OPEN TOP RED TRANSL       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703107 2 CONTAINER SHARPS 1 QT               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703108 2 CONTAINER SHARPS 3 GAL RED DOT      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703109 2 CONTAINER SHARPS 8 GAL ORANGE       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703110 2 CONTAINER SPECIMEN 32 OZ            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703111 2 CONTAINER SPECIMEN I & O 8 OZ       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703112 2 CONTAINER SPECIMEN SPUTUM           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703113 2 CONTAINER SPECIMEN TOP HAT          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703114 2 CONTAINER SPECIMEN URINE 5 OZ       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703115 2 CONTAINER SPECIMEN URINE COLLECTN   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703116 2 CORDSET HOSP GRD DETACH 10FT        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703117 2 COTTON BALL RAYON LG STER           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703118 2 PROBE COVER                         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703119 2 COVERS EASY 36 X 38                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703120 2 CPM PATIENT KIT                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703122 2 CREAM SHAVING 11 OZ LEMON LIME      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703123 2 CRYO PUMPS W/ PADS                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703124 2 CUFF BP NEO # 4                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703125 2 CUFF BP ADULT LG 2 TUBE             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703126 2 CUFF BP THIGH SZ 2 2 TUBE           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703127 2 CUFF BP ADULT 1 TUBE HP             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703128 2 CUFF BP ADULT 2 TUBE                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703129 2 CUFF BP ADULT 2 TUBE W/ BULB        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703130 2 CUFF BP CHILD 2 TUBE W/ BULB        SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703131 2 CUFF BP CHILD 2 TUBE WHITE        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703132 2 CUFF BP INFANT 2 TUBE W/ BULB     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703133 2 CUFF BP INFANT 2 TUBE WHITE       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703134 2 CUFF BP ADULT LG 2 TUBE W/ BULB   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703135 2 CUFF BP NEO #2 1 TUBE             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703136 2 CUFF BP NEO #3 1 TUBE             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703137 2 CUFF BP NEO #5 1 TUBE             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703138 2 CUFF BP ADULT SM 2 TUBE W/ BULB   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703139 2 CUFF BP ADULT SM 2 TUBE WHITE     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703140 2 CUFF BP THIGH 2 TUBE W/ BULB      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703141 2 CUFF PRESSURE ADMINISTRATION      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703142 2 CUP MEDICINE PLASTIC 1 OZ         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703143 2 CUP PLASTIC TRANSLUCENT 9 OZ      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703144 2 CURETTE PIPELLE ENDO SUCTION      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703145 2 DAILY PACKS                       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703146 2 DENTURE CLEANING TABS             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703147 2 DEODORANT 1.5 OZ ROLL ON          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703148 2 DEODORANT ROOM                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703149 2 DEODORIZER LYSOL SPRAY 19 OZ      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703150 2 DESITIN CREAM 4 OZ                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703152 2 DISH SOAP CLIP-ON ROSE            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703153 2 DISINFECTANT CAVICIDE SPR 24      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703154 2 DISINFECTANT CIDEX OPA 1 GAL      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703155 2 PENROSE DRAIN 1 X 18 IN STER      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703158 2 DRAPE BARRIER STER                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703159 2 DRAPE UTILITY 14 X 26             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703160 2 BAND AID 7/8 IN SPOT              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703161 2 BAND AID BUGS & DAFFY             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703162 2 BAND AID 1 X 3 IN LF              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703163 2 COTTON ROLL 16 OZ STER            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703164 2 DRSG GAUZE TUBE 1 IN SZ 12        SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703165 2 DRSG GAUZE TUBE 5/8 IN SZ 1            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703166 2 NURSING PAD                            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703167 2 DRSG SPONGE 2X2 8 PLY MIRA             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703168 2 DRSG SPONGE 2X2 NONSTER                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703169 2 DRSG SPONGE 3X4 TOPPER                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703170 2 DRSG SPONGE 4X4 12 PLY STER TUBE       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703171 2 DRSG SPONGE 4X4 12 PLY MIRASORB STER   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703172 2 DRSG SPONGE 4X4 SOFWICK                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703173 2 DRSG SPONGE 4X4 NONSTER                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703174 2 DYED TERRY 1 LB                        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703175 2 ECG PRINTER PAPER                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703176 2 ELECTRODE CLEAR TRACE ADULT            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703177 2 ELECTRODE PASTE REDUX                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703178 2 ELECTRODE SOFTRACE ADULT               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703179 2 ELECTRODE EKG DISPOZ-IT                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703180 2 ELTA 2.8 OZ CRM                        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703182 2 EXTENSION SET SM BORE T-POR            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703183 2 EYE SHIELD NEWBORN                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703184 2 FILTER 5 MICRON LG VOL                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703185 2 TRACH TUBE FLEXI SLIP                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703186 2 FORCEP CLAMP TUBE OCCLUDING            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703187 2 FORCEP HALSTED MOSQUITO 5 IN ST        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703188 2 FORCEP KELLY 5 1/2" CRV STER           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703189 2 FORCEP KELLY 5 1/2" STR                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703190 2 FORMALIN PREFILLED CH 30ML             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703191 2 GAIT BELT REG                          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703192 2 GAIT BELT XLONG LAVENDAR               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703193 2 GEL AQUASONIC ULTRASOUND               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703194 2 GLOVE DERMAPRENE LF SZ 6.5             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703195 2 GLOVE DERMAPRENE LF SZ 7               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703196 2 GLOVE DERMAPRENE LF SZ 7.5             SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703197 2 GLOVE DERMAPRENE LF SZ 8            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703198 2 GLOVE DERMAPRENE LF SZ 8.5          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703199 2 GLOVE EP MED UNSTER                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703200 2 GLOVE EXAM LATEX NONSTER MED PWDR   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703201 2 GLOVE EXAM LATEX NONSTER SM PWDR    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703202 2 GLOVE EXAM PWDR FREE LG             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703203 2 GLOVE EXAM PWDR FREE MED            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703204 2 GLOVE EXAM PWDR FREE SM             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703205 2 GLOVE EXAM STER MED                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703206 2 GLOVE EXAM VINYL NONSTER MED        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703207 2 GLOVE PROC STER SZ 7                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703208 2 GLOVE PROC STER SZ 7.5              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703209 2 GLOVE PROC STER SZ 8                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703210 2 GLOVE PROC STER SZ 6.5              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703211 2 GLOVE SURGEON PF SZ 5.5             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703212 2 GLOVE SURGEON PF SZ 6               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703213 2 GLOVE SURGEON PF SZ 6.5             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703214 2 GLOVE SURGEON PF SZ 7               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703215 2 GLOVE SURGEON PF SZ 7.5             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703216 2 GLOVE SURGEON PF SZ 8               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703217 2 GLOVE SURGEON SZ 6                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703218 2 GLOVE SURGEON SZ 6.5                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703219 2 GLOVE SURGEON SZ 7                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703220 2 GLOVE SURGEON SZ 7.5                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703221 2 GLOVE SURGEON SZ 8                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703222 2 GLUCOSE CTR SOLN ACCUCHK            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703223 2 GOGGLE RED                          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703224 2 GOGGLE SPECTACLE SFTY GLASS         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703225 2 GOWN BLUE THUMBLOOP                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703226 2 GOWN CONTROL COVER UNIV             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703227 2 GOWN FLUID RESIS XLG                SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703228 2 GOWN ISOLATION XL (PK)                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703230 2 GOWN SURGEON STER XLG                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703231 2 GRADUATE DISP 32 OZ                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703232 2 HEAD BED ADULT                          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703233 2 HIP ABDUCTION CHANGE                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703234 2 VACUTAINER HOLDER NEEDLE                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703235 2 HYDROGEN PEROXIDE 3% 470 ML BTLE        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703236 2 PROBE COVER INCUTEMP                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703237 2 INJECTION CAP LATEX FREE                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703238 2 INSTILLER VIAL NACL 0.9% 5 ML           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703239 2 ALCOHOL ISOPROP 70% 16 OZ               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703240 2 IV BAG EMPTY AUTOMIX 3000 ML            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703241 2 IV CONNECTOR LOOP                       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703242 2 IV FILTER INTERLINK 0.22 MIC 26C        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703243 2 SODIUM CHLOR 0.9% INJ UNIT DOSE 10 ML   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703244 2 SODIUM CHLOR 0.9% INJ UNIT DOSE 30 ML   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703245 2 IV SAF T EZ SET 19G X 088 IN            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703246 2 IV SAF T EZ SET 25G X 1/2 IN            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703247 2 IV SAF T EZ SET 23G X 3/4 IN            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703248 2 IV SAF T EZ SET 23G X 3/4 3 IN          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703249 2 IV SET 10 DROP SOLN SET                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703250 2 IV SET 60 DROP SOLN SET                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703251 2 IV SET BLOOD FILTER Y TYPE              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703252 2 IV SET BURETROL ADD ON 150 ML           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703253 2 IV SET BURETROL W/ FLASH 150 ML         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703254 2 IV SET BUTTERFLY INFUS 23G              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703255 2 IV SET EXT MINI VOL 36 IN               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703256 2 IV SET EXT ANESTHESIA                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703257 2 IV SET EXT LUER LOCK                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703258 2 IV SET INTERLINK 10 DROP VENTED         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703259 2 IV SET MCGAW HALF (MICRO) V740          SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703260 2 IV SET MCGAW NITRO ADMIN          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703261 2 IV SET MCGAW PED W/ BACK CHECK    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703262 2 IV SET MCGAW PIGGYBACK            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703263 2 IV SET MCGAW PRIMARY              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703264 2 IV SET MCGAW VENTED NON DEHP      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703265 2 IV SET Y-TYPE W/ FLASH            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703266 2 IV START KIT                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703267 2 WATER BACTERIOSTATIC 30ML INJ     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703268 2 JUG CAP PLASTIC                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703269 2 JUG GALLON FOR 24 HR URINE COLL   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703270 2 KIT KWIKWIPE                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703271 2 HEMOCULT DEVELOPER 15 ML          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703272 2 HEMOCULT SLIDES W/ DEVELOPER      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703273 2 LAB MICROTAINER W/ SERUM SEP      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703274 2 LAB TEST PARA PAK STOOL           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703275 2 LAB TUBE MICROTAINER W/ K2 EDTA   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703276 2 LAB VIROCULT CULTERETTE           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703278 2 LABSTIX REAGENT                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703279 2 LANCET BLOOD GREEN 1.4 MM         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703280 2 LANCET SAF T PRO 951              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703281 2 PILLOW PT DISP                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703282 2 PEPPERMINT LORANN 1 OZ            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703283 2 LOTION HAND FOR DISP 1000 ML      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703284 2 LOTION HAND W/ PUMP 1000 ML       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703285 2 LOTION HAND W/ PUMP 540 ML        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703286 2 LOTION SKIN ULTRACARE             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703287 2 LUBRICANT SURGILUBE 3 GM          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703288 2 LUBRICANT SURGILUBE 4 1/2 OZ      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703289 2 LUBRICANT SURGILUBE 5 GR TUBE     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703290 2 MARKER SURGICAL W/ LABEL STERL    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703291 2 MASK FACE HI PERF DUCK BILL       SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703292 2 MASK FACE ISOLATION EAR LOOP        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703293 2 MASK FACE W/ SHIELD                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703294 2 MASK PROCEDURE FLUIDSHIELD          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703295 2 MORTUARY PACK BODY WHITE ADLT       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703296 2 MORTUARY PACK PED                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703297 2 MOUTHWASH / GARGLE 4 OZ             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703298 2 MRI HEAD BLOCK                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703299 2 MULTISTIX 10 SG                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703300 2 NASAL RHINO GUARD                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703301 2 AIRWAY NASOPHAR 12 FR               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703302 2 AIRWAY NASOPHAR 16 FR               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703303 2 AIRWAY NASOPHAR 20 FR               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703304 2 AIRWAY NASOPHAR 24 FR               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703305 2 AIRWAY NASOPHAR 30 FR               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703306 2 NDL BLOOD COLLECT 21G X 1 - 1 BOX   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703307 2 NDL BLOOD COLLECT 22G X 2 - 1 BOX   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703308 2 NDL BIOPSY EASYCORE 18G X 21        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703309 2 NDL CARDIAC PROCESSED               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703310 2 NDL FILTER 5 MIC 18G X 1/2          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703311 2 NDL HYPO 16G X 1 1/2                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703312 2 NDL HYPO 20G X 1 1/2                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703313 2 NDL HYPO 18G X 1 1/2 SAFETY         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703314 2 NDL HYPO 21G X 1 1/2 SAFETY         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703315 2 NDL HYPO 21G X 1 SAFETY             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703316 2 NDL HYPO 22G X 1 1/2 SAFETY         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703317 2 NDL HYPO 25G X 1 1/2 SAFETY         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703318 2 NDL HYPO BD 23G X 1 SAFETY          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703319 2 NDL HYPO BD 27G X 1 1/4             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703320 2 NDL HYPO BD 27G X 1/2               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703321 2 NDL HOLDER WEBSTER 4 1/2 IN ST      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703322 2 NEEDLELESS INJECTION SITE           SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703323 2 NEEDLELESS LEVER LOCK                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703324 2 NEEDLELESS SET BURETROL W/ CHAM      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703325 2 NEEDLELESS SET EXTENSION             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703326 2 NEEDLELESS SYRINGE CANNULA           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703327 2 NEEDLELESS T CONNECTOR EXT SET       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703328 2 NEEDLELESS THREADED LOCK             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703329 2 NEEDLELESS VIAL ACCESS CANNULA       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703330 2 NEEDLELESS VIAL ADAPTER MULTI        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703331 2 NIVEA CREAM 2 OZ TUBE                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703332 2 ORAL Q CARE KIT                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703333 2 ORAL SWAB MOUTH CARE KIT             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703334 2 OST IRRIGATION CONE                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703335 2 ALCOHOL PREP PAD MED                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703336 2 BENZAL CHLORIDE PAD                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703337 2 BETADINE PAD                         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703338 2 CHAIR SENSOR PAD DISP                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703339 2 DEFIB PAD INFANT                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703340 2 PAD TUCKABLE INCONTINENT 5 PER PCK   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703341 2 PAD UNDERPAD CHUX 30X20              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703342 2 PAD UNDERPAD DRY FLOW KCI            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703343 2 PANT SANITARY LGE                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703344 2 PAPER DEFIB FOR LIFEPAK MON          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703345 2 PAPER ECG 1 CHANNEL                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703346 2 PAPER EXAM TABLE 1 ROLL              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703347 2 PAPER LENS CLEANING 4X6              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703348 2 PAPER THERMAL PHARMACY O CELL        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703349 2 DEFIB PADDLES PEDS CABLE             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703350 2 PETROLATUM 30GM WHT VASELINE         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703351 2 PILLOW NON DISP                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703352 2 PIN SAFETY LARGE                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703353 2 PIN SAFETY MED                       SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703354 2 PIN SAFETY SMALL                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703355 2 VALVE POSIFLOW                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703356 2 POUCH TELEMETRY PERSONAL         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703357 2 BETADINE PREP AEROSOL SPRAY      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703358 2 BETADINE PREP SOLN 32 OZ         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703359 2 PREP KIT SHAVE                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703360 2 PROBE SKIN TEMP INCUBATOR        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703361 2 PROBE TEMP RECTAL                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703362 2 PROBE TEMP RECTAL ICU            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703363 2 PROBE SKIN TEMP                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703364 2 VASCULAR SYSTEM PROSTAR 6 FR     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703365 2 PUREFLOW B SOLN BICARB           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703366 2 PWA CPU GENERIC PCA (CC)         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703367 2 RAZOR GILLETTE GOOD NEWS         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703368 2 RAZOR PREP                       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703369 2 CORD BOLUS CORD REMOTE           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703370 2 RESPIRATOR HOOD AIR MATE HEPA    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703371 2 RESTRAINT BELT SFT QR RL CHAIR   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703372 2 RESTRAINT LIMB INFANT            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703373 2 RESTRAINT MITT FINGER CONTROL    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703374 2 RESTRAINT ROLL BELT QR REL BED   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703375 2 RESTRAINT TATC ANKLE CUFF        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703376 2 RESTRAINT TATC WRIST CUFF        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703377 2 RESTRAINT VEST LG QT RELEASE     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703378 2 RESTRAINT VEST MED QT RELEASE    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703379 2 RESTRAINT VEST SM QT RELEASE     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703380 2 RESTRAINT VEST XLG QT RELEASE    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703381 2 RESTRAINT VEST XSM               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703382 2 RESTRAINT VEST XX LGE            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703383 2 RESTRAINT WRIST / LIMB QR        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703385 2 ADMISSION KIT RONALD MCDONALD    SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703386 2 SCALPEL DISP SZ 10 SAFETY         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703387 2 SCALPEL DISP SZ 11 SAFETY         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703388 2 SCALPEL DISP SZ 15 SAFETY         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703389 2 SCISSORS IRIS 4 1/2 STR STERIL    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703390 2 SCISSORS SUTURE 4 1/2 IN STERIL   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703391 2 SCRUB SURGICAL 2% CHZ             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703392 2 SHAMPOO RINSELESS 2 OZ            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703393 2 SHEETS STERILE PROCESSED          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703394 2 SHOE COVER XLGE NON SKID          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703395 2 SHOE COVERS                       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703396 2 SILK SKIN 2 OZ                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703397 2 TRACTION SKIN LG                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703398 2 TRACTION SKIN MED                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2703399 2 SLIDE COVER GLASS 24 X 40 MM      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703400 2 SLIDE FROSTED END 3 X 1 IN        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703401 2 SLIDE MICROSCOPE MAILER           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703402 2 SLIDE PLAIN 1.2MM 3 X 1 IN        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703403 2 SLIPPERS ADULT BLUE LGE           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703404 2 SLIPPERS ADULT TAN LGE            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703405 2 SLIPPERS PEDS WHITE AGE 1 -3      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703406 2 SLIPPERS PEDS YELLOW AGE 5 & UP   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703407 2 SOAP BABY WASH HEAD TO TOE        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703408 2 SOAP CASTILE CONCENTRATE          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703409 2 SOAP IODOPHOR 1 LITER             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703410 2 SOAP WATERLESS COUNTER TOP        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703411 2 SOAP WATERLESS COUNTER TOP SM     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703412 2 SPECULA OTOSCOPE 2.75MM           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703413 2 SPECULA OTOSCOPE 4MM              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703414 2 SPECULUM VAGINAL LGE PROCESSED    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703415 2 SPECULUM VAGINAL MED PROCESSED    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703416 2 SPECULUM VAGINAL MED DISP         SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE        PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY      OUTPT)             LML/RML     CPT
MAT MGMT      2703417 2 SPHYGMOMANOMETER BP GAUGE         SUPPLY        STATISTICAL ITEM
MAT MGMT      2703418 2 SPILL KIT CHEMOTHERAPY            SUPPLY        STATISTICAL ITEM
MAT MGMT      2703419 2 SPILL RED-Z T BAG                 SUPPLY        STATISTICAL ITEM
MAT MGMT      2703420 2 SPIROMETER INCENTIVE 2500ML       SUPPLY        STATISTICAL ITEM
MAT MGMT      2703421 2 SPIROMETER INCENTIVE PED          SUPPLY        STATISTICAL ITEM
MAT MGMT      2703423 2 SPLINT FINGER VELCRO 12 IN        SUPPLY        STATISTICAL ITEM
MAT MGMT      2703424 2 SPLINT FINGER VELCRO 9 IN         SUPPLY        STATISTICAL ITEM
MAT MGMT      2703425 2 SPLINT PLASTER FAST 5X30          SUPPLY        STATISTICAL ITEM
MAT MGMT      2703426 2 SPLINT PLASTER FAST 5X45          SUPPLY        STATISTICAL ITEM
MAT MGMT      2703427 2 DRSG SPONGE 2X2 SOFWICK STER      SUPPLY        STATISTICAL ITEM
MAT MGMT      2703428 2 STATLOCK PICC PLUS                SUPPLY        STATISTICAL ITEM
MAT MGMT      2703429 2 WATER STER FOR INJ                SUPPLY        STATISTICAL ITEM
MAT MGMT      2703430 2 STETHOSCOPE ADULT DISP DRK BLUE   SUPPLY        STATISTICAL ITEM
MAT MGMT      2703431 2 STETHOSCOPE PEDS DISP BLUE        SUPPLY        STATISTICAL ITEM
MAT MGMT      2703433 2 STOPCOCK 3 WAY W/ LUER LOCK       SUPPLY        STATISTICAL ITEM
MAT MGMT      2703434 2 STOPCOCK 4 WAY W/ LUER LOCK       SUPPLY        STATISTICAL ITEM
MAT MGMT      2703435 2 STRAW FLEX WHITE                  SUPPLY        STATISTICAL ITEM
MAT MGMT      2703436 2 SYTLET INTUBATION BL 5-7.5MM      SUPPLY        STATISTICAL ITEM
MAT MGMT      2703437 2 STYLET INTUBATION 14FR            SUPPLY        STATISTICAL ITEM
MAT MGMT      2703438 2 STYLET INTUBATION 6FR INFANT      SUPPLY        STATISTICAL ITEM
MAT MGMT      2703439 2 SUCTION CANNISTER PLASTIC CLEAR   SUPPLY        STATISTICAL ITEM
MAT MGMT      2703440 2 SUCTION REGULATOR                 SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2703442 2 TUBE SUMP 8FR                     SUPPLY        STATISTICAL ITEM
MAT MGMT      2703443 2 SURGICAL HAND PREP 800 ML BAG     SUPPLY        STATISTICAL ITEM
MAT MGMT      2703444 2 SUT SILK 2-0 STERILIZED           SUPPLY        STATISTICAL ITEM
MAT MGMT      2703445 2 BETADINE SWAB                     SUPPLY        STATISTICAL ITEM
MAT MGMT      2703446 2 CALGISWAB STERILE                 SUPPLY        STATISTICAL ITEM
MAT MGMT      2703447 2 COTTON SWAB 8IN SINGLE END        SUPPLY        STATISTICAL ITEM
MAT MGMT      2703448 2 COULTER SWAB COLLECTION MED       SUPPLY        STATISTICAL ITEM
MAT MGMT      2703449 2 SWAB ORA MOUTH                    SUPPLY        STATISTICAL ITEM
MAT MGMT      2703450 2 SWAB ORA-SUCTION SYSTEM           SUPPLY        STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703451 2 SWEEN CREAM 3 OZ TUBE                SUPPLY     STATISTICAL ITEM
MAT MGMT      2703452 2 SYRINGE 10CC W/ TWIN PACK            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703453 2 SYRINGE 10CC W/ BLUNT CANNULA        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703454 2 SYRINGE 10CC W/ VIAL ACC CANNULA     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703455 2 SYRINGE 3CC 21G X 1 1/2 SAFETY       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703456 2 SYRINGE 5CC W/ TWIN PACK             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703457 2 SYRINGE 5CC W/ BLUNT CANNULA         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703458 2 SYRINGE 5CC W/ VIAL ACC CANNULA      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703459 2 SYRINGE BULB IRRIGATION 50CC         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703460 2 SYRINGE INSULIN 1CC 28G X 1/2        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703461 2 SYRINGE INSULIN 28G X 1/2            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703462 2 SYRINGE LUER LOCK 10 CC              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703463 2 SYRINGE LUER LOCK 20 CC              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703464 2 SYRINGE LUER LOCK 30 CC              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703465 2 SYRINGE LUER LOCK 3 CC               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703466 2 SYRINGE LUER LOCK 5 CC               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703467 2 SYRINGE LUER LOCK 60 CC              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703468 2 SYRINGE PREFILLED SALINE 10 ML       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703469 2 SYRINGE PREFILLED SALINE 3 ML        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703470 2 SYRINGE TB 1CC 25G X 5/8 SAFETY      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703471 2 SYRINGE TB 1CC 27G X 1/2 ECLIPSE     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703472 2 TAPE ADHESIVE CLOTH 1 IN X 10 YD     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703473 2 TAPE ADHESIVE CLOTH 2 IN X 10 YD     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703474 2 TAPE CLOTH 3 IN                      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703475 2 TAPE MEASURE INFANT DISP             SUPPLY     STATISTICAL ITEM
MAT MGMT      2703476 2 TAPE MEASURE MULTI USE               SUPPLY     STATISTICAL ITEM
MAT MGMT      2703478 2 TAPE MICROPORE HYPO 1/2 IN X 10 YD   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703479 2 TAPE MICROPORE HYPO 1 IN X 10 YD     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703480 2 TAPE PAPER MICROPORE 2 IN            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703481 2 TAPE POROUS 1/2 IN                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703482 2 TAPE SILK DURAPORE 1 IN X 10 YD      SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2703483 2 TAPE SILK DURAPORE 2 IN X 10 YD      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703484 2 TAPE SILK DURAPORE 3 IN X 10 YD      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703485 2 TAPE TRANSPORE HYPO 1/2 IN X 10 YD   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703486 2 TAPE TRANSPORE HYPO 1 IN X 10 YD     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703487 2 TAPE UMBILICAL                       SUPPLY     STATISTICAL ITEM
MAT MGMT      2703488 2 TEST STRIP ACCUCHECK COMFT CV        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703489 2 THERMOMETER CELCIUS ORAL / RECT      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703490 2 THERMOMETER PROBE COVER              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703491 2 THORACOTOMY TRAY PROCESSED           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703492 2 TRACH / HERNIA TIE WHITE 1/2 IN      SUPPLY     STATISTICAL ITEM
MAT MGMT      2703493 2 TISSUE FACIAL WHITE                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2703494 2 TOOTH PASTE COLGATE 0.85 OZ          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703495 2 TOOTHBRUSH 5 TUFT NYLON              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703496 2 TOURNAQUET NON LATEX DISP            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703497 2 TOURNAQUET LATEX 1 X 18 IN NONSTER   SUPPLY     STATISTICAL ITEM
MAT MGMT      2703504 2 BEDSIDE TRAY 6X9                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703505 2 TRAY ED PLASTIC MIN MINER            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703506 2 TRAY EMERGENCY DELIVERY KIT          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703507 2 HAND & FOOT TRAY                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703508 2 TRAY PEDS TROCAR                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2703509 2 TRAY TRACTION PIN                    SUPPLY     STATISTICAL ITEM
MAT MGMT      2703510 2 TRACH TUBE CUFFED 3 W/ MURP          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703511 2 VACUTAINER TUBE 10ML GREEN           SUPPLY     STATISTICAL ITEM
MAT MGMT      2703512 2 VACUTAINER TUBE 3ML LAVENDER         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703513 2 VACUTAINER TUBE 4.5ML GREEN          SUPPLY     STATISTICAL ITEM
MAT MGMT      2703514 2 VACUTAINER TUBE 4.5ML LT BLUE        SUPPLY     STATISTICAL ITEM
MAT MGMT      2703515 2 VACUTAINER TUBE 6ML RED              SUPPLY     STATISTICAL ITEM
MAT MGMT      2703516 2 VACUTAINER TUBE 7ML LAVENDER         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703517 2 VACUTAINER TUBE SST 5ML GOLD         SUPPLY     STATISTICAL ITEM
MAT MGMT      2703518 2 VACUTAINER TUBE BLACK TOP            SUPPLY     STATISTICAL ITEM
MAT MGMT      2703519 2 TUBING CONNECTOR 6 IN 1              SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE        PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY      OUTPT)             LML/RML     CPT
MAT MGMT      2703520 2 TUBING OXYGEN W/ NASAL CANNULA         SUPPLY        STATISTICAL ITEM
MAT MGMT      2703521 2 SUCTION TUBING 3/16 IN X 8 IN          SUPPLY        STATISTICAL ITEM
MAT MGMT      2703522 2 SUCTION TUBING STER 7MM X 12 FT        SUPPLY        STATISTICAL ITEM
MAT MGMT      2703523 2 BAG URINE PEDS 24HR NONSTER            SUPPLY        STATISTICAL ITEM
MAT MGMT      2703524 2 BAG URINE PED NONSTER                  SUPPLY        STATISTICAL ITEM
MAT MGMT      2703525 2 URINAL MALE 1 QT CLEAR TOP             SUPPLY        STATISTICAL ITEM
MAT MGMT      2703526 2 WARMER INFANT HEEL 3X4                 SUPPLY        STATISTICAL ITEM
MAT MGMT      2703527 2 WIPE CHIX CLEANER                      SUPPLY        STATISTICAL ITEM
MAT MGMT      2703528 2 WIPE DIACHLOR TOWLETTE                 SUPPLY        STATISTICAL ITEM
MAT MGMT      2703529 2 DILATOR VAG MED                        SUPPLY        STATISTICAL ITEM
MAT MGMT      2703530 2 NASAL TAMPON DOYLE 5.5 CM              SUPPLY        STATISTICAL ITEM
MAT MGMT      2703531 2 NASAL TAMPON POSTERIOR POPE            SUPPLY        STATISTICAL ITEM
MAT MGMT      2703532 2 TUBE FEED KIT W/ SYRINGE 8FR X 15 IN   SUPPLY        STATISTICAL ITEM
MAT MGMT      2703540 2 SPECULUM VAGINAL SM PROCESSED          SUPPLY        STATISTICAL ITEM
MAT MGMT      2703541 2 CIRCUMCISION TRAY DISP                 SUPPLY        STATISTICAL ITEM
MAT MGMT      2703542 2 CO2 DETECTOR EZ-CAP                    SUPPLY        STATISTICAL ITEM
MAT MGMT      2703543 2 TRACTION CORD / ROPE                   SUPPLY        STATISTICAL ITEM
MAT MGMT      2704200 2 BAG URINE PREEMIE REG STER             SUPPLY        STATISTICAL ITEM
MAT MGMT      2704349 2 BAG URINE NEWBRN NON-STERL             SUPPLY        STATISTICAL ITEM
MAT MGMT      2704365 2 FECAL COLLECTOR INCONTINENCE           SUPPLY        STATISTICAL ITEM
MAT MGMT      2704705 2 BAG URINE PED STERILE                  SUPPLY        STATISTICAL ITEM
MAT MGMT      2705002 2 ENEMA FLEET (PHOSPHATE) ADULT          SUPPLY        STATISTICAL ITEM
MAT MGMT      2705064 2 ENEMA FLEET BAG                        SUPPLY        STATISTICAL ITEM
MAT MGMT      2705106 2 ENEMA BUCKET ADULT SOAP & PAD          SUPPLY        STATISTICAL ITEM
MAT MGMT      2705442 2 ENEMA FLEET PEDS                       SUPPLY        STATISTICAL ITEM
MAT MGMT      2705443 2 ENEMA OIL RETENTION                    SUPPLY        STATISTICAL ITEM
MAT MGMT      2710126 2 WALKER                                 SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2710391 2 PILLOW HEART ADULT                     SUPPLY        STATISTICAL ITEM
MAT MGMT      2710395 2 CANE ALUM ADJUSTABLE                   SUPPLY        STATISTICAL ITEM
MAT MGMT      2710528 2 CRUTCHES ALUM ADULT REG                SUPPLY        STATISTICAL ITEM
MAT MGMT      2710529 2 CRUTCHES ALUM ADULT TALL               SUPPLY        STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT      2710870 2 TRACTION THOMAS SETUP KIT                 SUPPLY     STATISTICAL ITEM
MAT MGMT      2710871 2 TRACTION HELPER                           SUPPLY     STATISTICAL ITEM
MAT MGMT      2712205 2 CAST TAPE SCOTCHCAST 2 IN X 4 YD 1 ROLL   SUPPLY     STATISTICAL ITEM
MAT MGMT      2712206 2 CAST TAPE SCOTCHCAST 3 IN X 4 YD 1 ROLL   SUPPLY     STATISTICAL ITEM
MAT MGMT      2712207 2 CAST TAPE SCOTCHCAST 4 IN X 4 YD 1 ROLL   SUPPLY     STATISTICAL ITEM
MAT MGMT      2712208 2 CAST TAPE SCOTCHCAST 5 IN X 4 YD 1 ROLL   SUPPLY     STATISTICAL ITEM
MAT MGMT      2712209 2 CAST PADDING WEBRIL 2 IN X 4 YD           SUPPLY     STATISTICAL ITEM
MAT MGMT      2712210 2 CAST PADDING WEBRIL 3 IN X 4 YD           SUPPLY     STATISTICAL ITEM
MAT MGMT      2712211 2 CAST PADDING WEBRIL 4 IN X 4 YD           SUPPLY     STATISTICAL ITEM
MAT MGMT      2712212 2 CAST PADDING WEBRIL 6 IN X 4 YD           SUPPLY     STATISTICAL ITEM
MAT MGMT      2712217 2 CAST PLASTER FAST ROLL 2IN                SUPPLY     STATISTICAL ITEM
MAT MGMT      2712218 2 CAST PLASTER FAST ROLL 3IN                SUPPLY     STATISTICAL ITEM
MAT MGMT      2712219 2 CAST PLASTER FAST ROLL 4IN                SUPPLY     STATISTICAL ITEM
MAT MGMT      2712220 2 CAST PLASTER FAST ROLL 5IN                SUPPLY     STATISTICAL ITEM
MAT MGMT      2712221 2 CAST PLASTER FAST ROLL 6IN                SUPPLY     STATISTICAL ITEM
MAT MGMT      2715015 2 IV WATER 1000 ML                          SUPPLY     STATISTICAL ITEM
MAT MGMT      2716228 2 STERIDRAPE 23 X 17 EA                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2716229 2 STERIDRAPE 13 X 13 EA                     SUPPLY     STATISTICAL ITEM
MAT MGMT      2716230 2 SHEET LAPAROTOMY                          SUPPLY     STATISTICAL ITEM
MAT MGMT      2717070 2 SYRINGE BULB EAR / ULCER 2 OZ EA          SUPPLY     STATISTICAL ITEM
MAT MGMT      2717071 2 ELECTRODE QUICK COMBO PEDS                SUPPLY     STATISTICAL ITEM
MAT MGMT      2717190 2 DIAPER NEWBRN 8-14 LB PK                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2717191 2 DIAPER TODDLER LGE 21-37 LB SZ 4 PK       SUPPLY     STATISTICAL ITEM
MAT MGMT      2717192 2 DIAPER TODDLER XLG >25 LB PK LB SZ 4 PK   SUPPLY     STATISTICAL ITEM
MAT MGMT      2717240 2 HOT PACK INSTANT                          SUPPLY     STATISTICAL ITEM
MAT MGMT      2717252 2 DIAPER NEWBRN 0-10 LB PK                  SUPPLY     STATISTICAL ITEM
MAT MGMT      2717772 2 ELECTRODE NEO/PED KLEAR TRACE 1 PK        SUPPLY     STATISTICAL ITEM
MAT MGMT      2717773 2 ELECTRODE PREMIE KLEAR TRACE 1 PK         SUPPLY     STATISTICAL ITEM
MAT MGMT      2717774 2 ELECTRODE NEONATAL 1 PK                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2717775 2 DIAPER PREMIE 0-5 LB PK                   SUPPLY     STATISTICAL ITEM
MAT MGMT      2717776 2 DIAPER PAMPER PREMIE 1-5 LB PK            SUPPLY     STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE        PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY      OUTPT)             LML/RML     CPT
MAT MGMT      2717777 2 DIAPER PAMPER MED SZ 3 PK          SUPPLY        STATISTICAL ITEM
MAT MGMT      2717799 2 SITZ BATH                          SUPPLY        STATISTICAL ITEM
MAT MGMT      2718028 2 SHEEPSKIN PAD                      SUPPLY        STATISTICAL ITEM
MAT MGMT      2718181 2 PAD HOT ICE                        SUPPLY        STATISTICAL ITEM
MAT MGMT      2718240 2 EGGCRATE MATTRESS PAD ADULT        SUPPLY        STATISTICAL ITEM
MAT MGMT      2718759 2 DRSG FOAM RESTON MD 7 7/8 EA       SUPPLY        STATISTICAL ITEM
MAT MGMT      2718891 2 PAD CHAIR FOAM STATIONARY          SUPPLY        STATISTICAL ITEM
MAT MGMT      2720001 2 WIRE J WHOLEY                      SUPPLY        STATISTICAL ITEM
MAT MGMT      2720004 2 PCA INFUSER                        SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2720005 2 INFUSION PUMP,MINI MED DA          SUPPLY        STATISTICAL ITEM
MAT MGMT      2720006 2 SUCTION CONTINUOUS DAILY           SUPPLY        STATISTICAL ITEM
MAT MGMT      2720010 2 HYPERTHERMIA UNIT                  SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2720011 2 INFUSION PUMP                      SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2720013 2 PAIN MANAGEMENT PUMP PCA           SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2720014 2 SEQUENTIAL COMPRES DEVICE          SUPPLY        STATISTICAL ITEM
MAT MGMT      2720015 2 FEEDING PUMP CORPAK                SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2720016 2 PASSIVE MOTION MACHINE             SUPPLY        STATISTICAL ITEM
MAT MGMT      2720017 2 BAIR HUGGER WARMING UNIT           SUPPLY MEMS   STATISTICAL ITEM
MAT MGMT      2720018 2 BED ALARM                          SUPPLY        STATISTICAL ITEM
MAT MGMT      2722243 2 MASK RESPIRATOR REG PFR 95 1 BOX   SUPPLY        STATISTICAL ITEM
MAT MGMT      2722244 2 EGGCRATE MATTRESS PAD PED          SUPPLY        STATISTICAL ITEM
MAT MGMT      2722245 2 MASK RESPIRATOR SM TECNO 1 BOX     SUPPLY        STATISTICAL ITEM
MAT MGMT      2729002 2 TRACH TRAY TRAUMA                  SUPPLY        STATISTICAL ITEM
MAT MGMT      2729041 2 TRAY SUTURE                        SUPPLY        STATISTICAL ITEM
MAT MGMT      2729050 2 BALLOON TRAY PUMP PERC INSERT      SUPPLY        STATISTICAL ITEM
MAT MGMT      2729051 2 TRAY PACEMAKER INSERTION           SUPPLY        STATISTICAL ITEM
MAT MGMT      2729068 2 COMBO TRAY ER                      SUPPLY        STATISTICAL ITEM
MAT MGMT      2729069 2 CHEST THORACOTOMY ER TRAY          SUPPLY        STATISTICAL ITEM
MAT MGMT      2729070 2 TRAUMA STERNAL SPLITTING TRAY ER   SUPPLY        STATISTICAL ITEM
MAT MGMT      2729073 2 CUTDOWN TRAY ADLT PROCESSED        SUPPLY        STATISTICAL ITEM
MAT MGMT      2729097 2 CIRCUMCISION TRAY PROCESSED        SUPPLY        STATISTICAL ITEM
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE     PRICE (INPT /      LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                           CATEGORY   OUTPT)             LML/RML     CPT
MAT MGMT       2729109 2 INTUBATION TRAY PEDS                         SUPPLY     STATISTICAL ITEM
MAT MGMT       2729151 2 INTUBATION TRAY ADULT                        SUPPLY     STATISTICAL ITEM
MAT MGMT       2729172 2 TRAY CAST CUTTER                             SUPPLY     STATISTICAL ITEM
MAT MGMT       2729212 2 LARYNGOSCOPE TRAY ADULT                      SUPPLY     STATISTICAL ITEM
MAT MGMT       2729255 2 UMBILICAL IV TRAY                            SUPPLY     STATISTICAL ITEM
MAT MGMT       2729302 2 TRAY PEDS I.V.                               SUPPLY     STATISTICAL ITEM
MAT MGMT       2729397 2 TRAY PROCTO EXAM                             SUPPLY     STATISTICAL ITEM
MAT MGMT       2729444 2 TRAY PARACENTESIS                            SUPPLY     STATISTICAL ITEM
MAT MGMT       2729446 2 ENT TRAY                                     SUPPLY     STATISTICAL ITEM
MAT MGMT       2729455 2 TRAY STEINMAN PIN K-WIRE                     SUPPLY     STATISTICAL ITEM
MAT MGMT       2729573 2 MINOR TRAY                                   SUPPLY     STATISTICAL ITEM
MAT MGMT       2729574 2 CUTDOWN TRAY PEDS PROCESSED                  SUPPLY     STATISTICAL ITEM
MAT MGMT       2729701 2 VALVE SUCTION EA                             SUPPLY     STATISTICAL ITEM
MAT MGMT       2729702 2 FORCEP ADSON THUMB 4 3/4 IN STER EA          SUPPLY     STATISTICAL ITEM
MAT MGMT       2729765 2 TRAY THORACOTOMY TUBE ADLT/PDS               SUPPLY     STATISTICAL ITEM
MAT MGMT       2730377 2 TRAY GYNE SMALL                              SUPPLY     STATISTICAL ITEM
MAT MGMT       2735226 2 TUBING EPIDURAL SPIKE SET                    SUPPLY     STATISTICAL ITEM
MAT MGMT       2735446 2 IV SET PCA PUMP                              SUPPLY     STATISTICAL ITEM
MAT MGMT       2738708 2 SYRINGE IRRIGATION CATH TIP                  SUPPLY     STATISTICAL ITEM
MAT MGMT       2738908 2 RESUSCITATION KIT ADULT                      SUPPLY     STATISTICAL ITEM
MAT MGMT       2740176 2 ISOLATION SUPPLIES (CART)                    SUPPLY     STATISTICAL ITEM
MAT MGMT       2740177 2 ISOLATION SUPPLIES (CABINET) OVER-THE-DOOR   SUPPLY     STATISTICAL ITEM
MAT MGMT       2740753 2 CLEANSER SHUR-CLENS 20ML                     SUPPLY     STATISTICAL ITEM
MAT MGMT       2742139 2 FUNNEL FILTER URINE 8OZ                      SUPPLY     STATISTICAL ITEM
MAT MGMT       2742192 2 COMMODE BEDSIDE                              SUPPLY     STATISTICAL ITEM
MAT MGMT       2742230 2 DRAPE PACK TOWEL PROCESSED                   SUPPLY     STATISTICAL ITEM
NEUROPHYS LA   7402653 0 EMG ANAL / URETH SPHINCTER OTHER THAN NDL    PROCED     795.30                         51784
NEUROPHYS LA   7402668 0 EMG ANAL / URETH SPHINCTER W/ NEEDLE         PROCED     269.63                         51785
NEUROPHYS LA   7407002 0 BOTULINUM INJECTION FACE                     PROCED     218.00                         64612
NEUROPHYS LA   7407003 0 BOTULINUM INJ CERVICAL SPINE                 PROCED     497.58                         64613
NEUROPHYS LA   7401780 0 BOTULINUM INJ EXT / TRNK MUSC                PROCED     326.33                         64614
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML      CPT
NEUROPHYS LA   7405203 0 BAER (BRAINSTM AUD EVK RESP)       PROCED     457.25                      92585
NEUROPHYS LA   7401741 0 MSLT/MWT                           PROCED     1,279.09                    95805
NEUROPHYS LA   7401745 0 POLYSOMNOGRAM +4 PARAMETERS        PROCED     1,828.44                    95810
NEUROPHYS LA   7401748 0 POLYSOMN 4 PARAMETERS W/CPAP       PROCED     1,852.58                    95811
NEUROPHYS LA   7401770 0 EEG EXTENDED 41-60 MIN             PROCED     615.87                      95812
NEUROPHYS LA   7401771 0 EEG EXTENDED > 1 HOUR              PROCED     608.80                      95813
NEUROPHYS LA   7401702 0 EEG AWAKE AND DROWSY               PROCED     393.69                      95816
NEUROPHYS LA   7403509 0 EEG AWAKE AND SLEEP                PROCED     424.74                      95819
NEUROPHYS LA   7401738 0 EEG COMA / SLEEP ONLY              PROCED     419.60                      95822
NEUROPHYS LA   7401704 0 EEG CEREBRAL SILENCE               PROCED     136.59                      95824
NEUROPHYS LA   7401705 0 ELECTROCORTICOGRAPHY AT SURGERY    PROCED     136.59                      95829
NEUROPHYS LA   7402671 0 TENSILON TEST/MYASTHENIA GRAV      PROCED     105.34                      95857
NEUROPHYS LA   7402604 0 TENSIL EMG TEST/MYASTHENIA GRV     PROCED     257.91                      95858
NEUROPHYS LA   7402651 0 EMG 1 EXTREMITY +/- PARASPINAL     PROCED     223.00                      95860
NEUROPHYS LA   7402663 0 EMG 2 EXTREMITY +/- PARASPINAL     PROCED     273.03                      95861
NEUROPHYS LA   7402664 0 EMG 3 EXTREMITY +/- PARASPINAL     PROCED     321.50                      95863
NEUROPHYS LA   7402665 0 EMG 4 EXTREMITY +/- PARASPINAL     PROCED     316.94                      95864
NEUROPHYS LA   7402672 0 EMG CRANIAL INNERV MUSCL UNIL      PROCED     163.90                      95867
NEUROPHYS LA   7402666 0 EMG CRANIAL INNERV MUSC BILAT      PROCED     305.19                      95868
NEUROPHYS LA   7402679 0 EMG NEEDLE THOR / SPINE MUSC       PROCED     140.94                      95869
NEUROPHYS LA   7402667 0 EMG 1 EXT,LIMITED MUSCLE           PROCED     112.48                      95870
NEUROPHYS LA   7402652 0 EMG SINGLE FIBER EA MUSCLE         PROCED     339.24                      95872
NEUROPHYS LA   7402601 0 NCV MOTOR & LATENCY W/O F-WAVE     PROCED     107.64                      95900
NEUROPHYS LA   7402670 0 NCV MOTOR & LATENCY W/F WAVE       PROCED     121.85                      95903
NEUROPHYS LA   7402611 0 EMG SENSORY NCV/LATENCY            PROCED     129.00                      95904
NEUROPHYS LA   7402673 0 EMG SENSORY NCV/LATENCY UNIL       PROCED     129.00                      9590452
NEUROPHYS LA   7403005 0 INTRA-OP NEUROPHYS TEST EA HR      PROCED     461.30                      95920
NEUROPHYS LA   7401779 0 VASOMOTOR ADRENERG INNERVTN TEST   PROCED     70.00                       95922
NEUROPHYS LA   7405215 0 SUDOMOTOR TEST,SYMP SKIN POTEN     PROCED     328.32                      95923
NEUROPHYS LA   7405209 0 SSEP PERIPH NERVE UP LIMB          PROCED     336.37                      95925
NEUROPHYS LA   7405219 0 SSEP PERPH NRV UP LMB UNIL         PROCED     336.37                      9592552
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE      PRICE (INPT /   LAB PRICE
CDM Area     Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML      CPT
NEUROPHYS LA 7405212  0 SSEP PERIPH NERVE LO LIMB                     PROCED     307.13                       95926
NEUROPHYS LA 7405220  0 SSEP PERPH NRV LO LMB UNIL                    PROCED     307.13                      9592652
NEUROPHYS LA 7405213  0 SSEP PERIPH NERVE TRUNK/HEAD                  PROCED     365.58                       95927
NEUROPHYS LA 7401773  0 TRANSCRAN MOTR EVOK POTEN UPPER LIMBS         PROCED     100.00                       95928
NEUROPHYS LA 7401774  0 TRANSCRAN MOTR EVOK POTEN LOWER LIMBS         PROCED     100.00                       95929
NEUROPHYS LA 7405202  0 VEP CHECKERBOARD OR FLASH                     PROCED     357.08                       95930
NEUROPHYS LA 7402669  0 EMG BLINK REFLEX                              PROCED     294.84                       95933
NEUROPHYS LA 7402662  0 H REFLEX LAT,GASTROCN/SOL MUSC                PROCED     308.20                       95934
NEUROPHYS LA 7405223  0 H REFLX LAT W/O GASTR/SOL MUSC                PROCED     163.90                       95936
NEUROPHYS LA 7405218  0 H REFLEX LAT,W/O GASTR BILAT                  PROCED     308.20                      9593650
NEUROPHYS LA 7405214  0 NM JUNCT / REPETITIVE STIM EA NRV             PROCED     152.29                       95937
NEUROPHYS LA 7401754  0 EEG VIDEO MONITORING 24 HR EA                 PROCED     1,227.00                     95951
NEUROPHYS LA 7401777  0 EEG VIDEO MONITORING 24 HR < 24 HR            PROCED     704.00                      9595152
NEUROPHYS LA 7401762  0 EEG AMBULATORY 24 HR                          PROCED     1,098.83                     95953
NEUROPHYS LA 7401778  0 EEG AMBULATORY 24 HR < 24HR                   PROCED     1,098.83                    9595352
NEUROPHYS LA 7401703  0 EEG PHARMACOL ACTIVATION                      PROCED     136.59                       95954
NEUROPHYS LA 7401739  0 EEG NONINTRACRANIAL SURGERY                   PROCED     413.30                       95955
NEUROPHYS LA 7401776  0 EEG W/O VIDEO MON > 16 CHAN 24 HR EA          PROCED     704.00                       95956
NEUROPHYS LA 7401775  0 WADA ACTIVATION EEG                           PROCED     1,386.37                     95958
NEUROPHYS LA 7403503  0 FUNCT CORT / SUBCORT MAP 1ST HR               PROCED     396.23                       95961
NEUROPHYS LA 7403504  0 FUNCT CORT / SUBCORT MAP EA ADD HR            PROCED     482.49                       95962
NEUROPHYS LA 7401001  0 BARI KARE BED                                 SUPPLY     325.20
NEUROPSYCHOL 7403000  0 DIAG PSYCHIATRIC EVAL / EXAM                  PROCED     170.80                       90801
NEUROPSYCHOL 7403001  0 NEUROBEHAVIOR STATUS EXAM PER HOUR            PROCED     181.65                       96116
NEUROPSYCHOL 7403007  0 NEUROPSYCH TESTING BY TECHNICIAN PER HOUR     PROCED     288.71                       96119
NEUROPSYCHOL 7403006  0 NEUROPSYCH TESTING BY TECHNICIAN PER HOUR TERMPROCED     288.71                      9611952
NEWBORN NURS 7211001  0 NEWBORN HEARING SCREENING                     PROCED     94.16                        92587
NEWBORN NURS 7211002  0 TRAY CIRCUMCISION DISP                        SUPPLY     33.25
OCC THER     4332002 0 SPL PREF AOA NEO WR WRAP OT                    SUPPLY     58.00
OCC THER     4360041 0 CAST APPLICATION LONG ARM OT                   PROCED     288.43                      29065GO
OCC THER     4360042 0 CAST APPLICATION SHORT ARM OT                  PROCED     246.13                      29075GO
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML      CPT
OCC THER      4360043 0 CAST APPLICATION LONG LEG OT            PROCED     379.03                      29345GO
OCC THER      4360044 0 CAST APPLICATION SHORT LEG OT           PROCED     269.21                      29405GO
OCC THER      4360046 0 CAST APPLICATION SHORT LEG WT BEAR OT   PROCED     374.12                      29425GO
OCC THER      4360045 0 CAST WINDOWING OT                       PROCED     112.32                      29730GO
OCC THER      4372001 0 BIOFEEDBACK 30 MIN OT                   PROCED     107.60                      90901GO
OCC THER      4372002 0 BIOFEEDBACK 60 MIN OT                   PROCED     187.80                      90901GO
OCC THER      4372010 0 BIOFEEDBACK PERINEAL-RECTAL W/ EMG OT   PROCED     235.00                      90911GO
OCC THER      4350001 0 NEW EVAL 15 MIN OT                      PROCED     154.98                      97003GO
OCC THER      4350002 0 NEW EVAL 30 MIN OT                      PROCED     181.86                      97003GO
OCC THER      4350003 0 NEW EVAL 45 MIN OT                      PROCED     200.00                      97003GO
OCC THER      4350004 0 NEW EVAL 60 MIN OT                      PROCED     266.60                      97003GO
OCC THER      4352002 0 COMPUTER HAND EVAL 15 MIN OT            PROCED     154.98                      97003GO
OCC THER      4351001 0 RE-EVAL 15 MIN OT                       PROCED     95.60                       97004GO
OCC THER      4351002 0 RE-EVAL 30 MIN OT                       PROCED     124.50                      97004GO
OCC THER      4351003 0 RE-EVAL 45 MIN OT                       PROCED     186.80                      97004GO
OCC THER      4351004 0 RE-EVAL 60 MIN OT                       PROCED     249.10                      97004GO
OCC THER      4371001 0 HOT/COLD PACK APPLICATION OT            PROCED     55.08                       97010GO
OCC THER      4371003 0 FLUIDOTHERAPY OT                        PROCED     71.65                       97022GO
OCC THER      4371005 0 WHIRLPOOL OT                            PROCED     71.65                       97022GO
OCC THER      4372003 0 E STIM MANUAL 15 MIN OT                 PROCED     79.93                       97032GO
OCC THER      4372004 0 IONTOPHORESIS 15 MIN OT                 PROCED     90.36                       97033GO
OCC THER      4372009 0 CONTRAST BATH 15 MIN OT                 PROCED     67.50                       97034GO
OCC THER      4372005 0 PHONOPHORESIS 15 MIN OT                 PROCED     70.90                       97035GO
OCC THER      4372006 0 ULTRASOUND 15 MIN OT                    PROCED     70.19                       97035GO
OCC THER      4372007 0 ULTRASOUND/HVG 15 MIN OT                PROCED     72.20                       97035GO
OCC THER      4360017 0 THER EXERCISE 15 MIN OT                 PROCED     71.23                       97110GO
OCC THER      4360018 0 NEUROMUSC RE-ED 15 MIN OT               PROCED     76.45                       97112GO
OCC THER      4360006 0 MANUAL THERAPY 15 MIN OT                PROCED     78.30                       97140GO
OCC THER      4360004 0 GRP TRMT THERA ACT 30 MIN OT            PROCED     95.49                       97150GO
OCC THER      4360005 0 GRP TRMT THERA ACT 60 MIN OT            PROCED     95.49                       97150GO
OCC THER      4360019 0 GRP TRMT THER ACT 15 MIN OT             PROCED     48.40                       97150GO
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML      CPT
OCC THER      4360003 0 FUNCT THER ACTIV 15 MIN OT                        PROCED     76.51                       97530GO
OCC THER      4360001 0 COGNITIVE TRAINING 15 MIN OT                      PROCED     67.00                       97532GO
OCC THER      4360021 0 SENSORY INTEGRATION EA 15 MIN OT                  PROCED     50.68                       97533GO
OCC THER      4360009 0 SELF CARE/HOME MGMT 15 MIN OT                     PROCED     67.00                       97535GO
OCC THER      4360002 0 COMM/WORK REINTG 15 MIN OT                        PROCED     67.00                       97537GO
OCC THER      4360012 0 JOB SITE VISIT 15 MIN OT                          PROCED     67.00                       97537GO
OCC THER      4360011 0 W/C MNGMT & TRAIN 15 MIN OT                       PROCED     63.72                       97542GO
OCC THER      4360013 0 WRK HARD/COND 2HR OT                              PROCED     328.30                      97545GO
OCC THER      4360014 0 WRK HARD/COND ADDL 1HR OT                         PROCED     255.00                      97546GO
OCC THER      4352001 0 FUNCT CAP EVAL (FCE) 15 MIN OT                    PROCED     82.00                       97750GO
OCC THER      4360010 0 SPLINT FAB/ADJUST 15 MIN OT                       PROCED     72.44                       97760GO
OCC THER      4360016 0 COMP GARM MEAS/FIT 15 MIN OT                      PROCED     72.44                       97760GO
OCC THER      4360008 0 PROSTHETIC TRAIN 15 MIN OT                        PROCED     67.00                       97761GO
OCC THER      4360007 0 ORTH/PROSTH CHKOUT 15 MIN OT                      PROCED     70.17                       97762GO
OCC THER      4371002 0 E STIM UNATTEN OTHER THAN WOUND CARE OT           PROCED     76.20                        G0283
OCC THER      4360022 0 EARLY INTERVENTION CONSLT / STAFF PER 15 MIN OT   PROCED     35.00                       W8746
OCC THER      4301030 0 OPPOCISER OT                                      SUPPLY     37.60
OCC THER      4301033 0 FOAM EXERCISE BALL OT                             SUPPLY     11.80
OCC THER      4301039 0 TUBULAR BANDAGE/IN OT                             SUPPLY     0.50
OCC THER      4301048 0 PALMAR BAR OT                                     SUPPLY     8.70
OCC THER      4301050 0 DRESSING STICK OT                                 SUPPLY     12.10
OCC THER      4301051 0 SERIAL CYLINDER CAST OT                           SUPPLY     4.00
OCC THER      4301055 0 GLOVE VIBRATION EACH OT                           SUPPLY     31.50
OCC THER      4301056 0 GLOVE ISOTONER OT                                 SUPPLY     159.30
OCC THER      4301058 0 FINGER/SLING/LINE/BAND OT                         SUPPLY     35.50
OCC THER      4301059 0 FINGER PULLEY/EA OT                               SUPPLY     18.80
OCC THER      4301060 0 O.T. TUBIPAD/FT                                   SUPPLY     7.50
OCC THER      4301063 0 NAIL HOOK/EA OT                                   SUPPLY     0.50
OCC THER      4301065 0 TENSION LOOP/EA OT                                SUPPLY     10.90
OCC THER      4301068 0 WALKER BAG OT                                     SUPPLY     59.60
OCC THER      4301075 0 SHOE LACES OT                                     SUPPLY     8.80
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML     CPT
OCC THER      4301078 0 BUTTON AID REG OT                SUPPLY     40.00
OCC THER      4301083 0 COBAN ROLL OT                    SUPPLY     10.10
OCC THER      4301084 0 COWRAP ROLL OT                   SUPPLY     54.70
OCC THER      4301086 0 PRISM GLASSES OT                 SUPPLY     155.80
OCC THER      4301093 0 HAND HELPER EXERCISER OT         SUPPLY     32.10
OCC THER      4301095 0 RELAXATION TRAINING TAPE/CD OT   SUPPLY     41.55
OCC THER      4301096 0 OTOFORM PER OZ OT                SUPPLY     8.50
OCC THER      4301098 0 ELBOW PROTECTOR OT               SUPPLY     38.90
OCC THER      4301099 0 OUTRGR 1ST FINGER OT             SUPPLY     80.20
OCC THER      4301100 0 OUTRIGGERS ADDL FINGER OT        SUPPLY     32.10
OCC THER      4301103 0 PLATE GUARD OT                   SUPPLY     34.50
OCC THER      4301104 0 SHOE HORN OT                     SUPPLY     23.40
OCC THER      4301105 0 LEG LIFTER OT                    SUPPLY     32.90
OCC THER      4301106 0 SOCK AID OT                      SUPPLY     40.20
OCC THER      4301107 0 REACHER OT                       SUPPLY     41.10
OCC THER      4301109 0 SLING OT                         SUPPLY     59.60
OCC THER      4301110 0 KNIFE ROCKER OT                  SUPPLY     19.70
OCC THER      4301111 0 ADAPTIC OT                       SUPPLY     8.80
OCC THER      4301112 0 GAUZE STERILE 2X2 OT             SUPPLY     0.40
OCC THER      4301113 0 GAUZE STERILE 4X4 OT             SUPPLY     0.50
OCC THER      4301114 0 KERLIX OT                        SUPPLY     4.20
OCC THER      4301116 0 PAPER TAPE OT                    SUPPLY     1.00
OCC THER      4301119 0 SILICONE GEL CAPS/TUBING OT      SUPPLY     5.80
OCC THER      4301120 0 SILCONE SES GEL SHEET 2" OT      SUPPLY     15.60
OCC THER      4301121 0 GAIT BELT 48" OT                 SUPPLY     33.40
OCC THER      4301122 0 GAIT BELT 60" OT                 SUPPLY     35.20
OCC THER      4301124 0 SCISSORS BLUNT BNDG 5.5" OT      SUPPLY     7.40
OCC THER      4301125 0 TOILET AID ECONOMY OT            SUPPLY     25.10
OCC THER      4301126 0 GLOVE NEOPRENE PEDS OT           SUPPLY     36.30
OCC THER      4301128 0 FINGER WRAP TRANSELAST BOX OT    SUPPLY     44.32
OCC THER      4301129 0 FINGER WRAP TRANSELAST EA OT     SUPPLY     1.51
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
OCC THER      4301130 0 COMPRILAN (ROSIDAL) SHORT STRETCH OT   SUPPLY     35.00
OCC THER      4301131 0 ARTIFLEX OT                            SUPPLY     21.00
OCC THER      4301132 0 ELASTOMULL BAG OT                      SUPPLY     30.64
OCC THER      4301133 0 STOCKINETTE TRICOFIX OT                SUPPLY     80.00
OCC THER      4301135 0 CUTTING BOARD OT                       SUPPLY     30.49
OCC THER      4301136 0 EGGERCIZERS OT                         SUPPLY     32.31
OCC THER      4301137 0 GLOVE DELUXE FLEXION OT                SUPPLY     60.80
OCC THER      4301138 0 BRACE ELBOW VISCOELASTIC               SUPPLY     48.45
OCC THER      4301600 0 DIGIFLEX OT                            SUPPLY     32.80
OCC THER      4301601 0 SILICONE GEL SHEET OT                  SUPPLY     81.00
OCC THER      4301660 0 DIGIS/COMP GRIP/IN OT                  SUPPLY     7.00
OCC THER      4301661 0 DYCEM 8X8 OT                           SUPPLY     15.70
OCC THER      4301665 0 FLEXION MITT OT                        SUPPLY     38.70
OCC THER      4301666 0 SPONGE LONG HANDLE OT                  SUPPLY     16.20
OCC THER      4301667 0 STOCKINETTE/FT OT                      SUPPLY     6.60
OCC THER      4301669 0 THERABAND/YD OT                        SUPPLY     32.30
OCC THER      4301670 0 THERAPUTTY THERAPLAST OT               SUPPLY     19.00
OCC THER      4301672 0 TUBIGRIP/FT OT                         SUPPLY     16.60
OCC THER      4301673 0 TUBULAR FOAM PER HANDL OT              SUPPLY     8.30
OCC THER      4301674 0 UNIVERSAL CUFF OT                      SUPPLY     33.70
OCC THER      4301675 0 VELCRO/BETAPILE-FT OT                  SUPPLY     7.30
OCC THER      4301676 0 VIBRATOR-MINI OT                       SUPPLY     47.40
OCC THER      4301677 0 WASH MITT OT                           SUPPLY     25.00
OCC THER      4301679 0 SUTURE REMOVAL DISP OT                 SUPPLY     8.10
OCC THER      4301737 0 HYPAFIX ROLL 4 IN X 10 YD EA - OT      SUPPLY     45.00
OCC THER      4301738 0 HYPAFIX ROLL 6 IN X 10 YD EA - OT      SUPPLY     57.30
OCC THER      4301739 0 HYPAFIX ROLL 2 IN X 10 YD EA - OT      SUPPLY     32.20
OCC THER      4301825 0 BUMPER BENDY POSITIONER EA OT          SUPPLY     83.10
OCC THER      4301826 0 CAST PADDING ROLL OT                   SUPPLY     7.15
OCC THER      4301827 0 CAST TAPE SEMI-RIGID ROLL OT           SUPPLY     12.20
OCC THER      4301828 0 COLLAR CERVICAL ZIMMER OT              SUPPLY     23.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
OCC THER      4301829 0 COLLAR T.O.T OT                           SUPPLY     132.90
OCC THER      4301832 0 IMMOBILIZER PREF ELB/WRIST MED OT         SUPPLY     31.75
OCC THER      4301833 0 IMMOBILIZER PREF ELB/WRIST SM OT          SUPPLY     21.20
OCC THER      4301834 0 KINESIOTAPE FOOT OT                       SUPPLY     3.60
OCC THER      4301835 0 KINESIOTAPE ROLL OT                       SUPPLY     39.20
OCC THER      4301836 0 LEUKOTAPE FOOT OT                         SUPPLY     3.60
OCC THER      4301837 0 LEUKOTAPE ROLL OT                         SUPPLY     48.45
OCC THER      4301838 0 PRAFO PREF OT                             SUPPLY     137.40
OCC THER      4301839 0 RESTRAINT PREF LEG PEDI-WRAP 13" OT       SUPPLY     60.95
OCC THER      4301840 0 RESTRAINT PREF LEG PEDI-WRAP 15 X 17 OT   SUPPLY     66.50
OCC THER      4301841 0 RESTRAINT PREF LEG PEDI-WRAP 7 X 11 OT    SUPPLY     55.40
OCC THER      4301842 0 TENSOWRAP MED 2 X 5 ROLL OT               SUPPLY     62.25
OCC THER      4301843 0 TENSOWRAP MED 3 X 5 ROLL OT               SUPPLY     85.75
OCC THER      4301844 0 TENSOWRAP NU BLUE 2 X 48 ROLL OT          SUPPLY     32.30
OCC THER      4301845 0 TENSOWRAP NU BLUE 6 X 18 ROLL OT          SUPPLY     32.30
OCC THER      4301846 0 TENSOWRAP NU BLUE 6 X 36 ROLL OT          SUPPLY     48.90
OCC THER      4301847 0 TENSOWRAP NU BLUE 6 X 48 ROLL OT          SUPPLY     70.15
OCC THER      4301848 0 TENSOWRAP SUPER 2 X 5 ROLL OT             SUPPLY     14.25
OCC THER      4301849 0 TENSOWRAP SUPER 3 X 5 ROLL OT             SUPPLY     17.30
OCC THER      4301850 0 TENSOWRAP SUPER 4 X 5 ROLL OT             SUPPLY     22.35
OCC THER      4301851 0 BUILT-UP UTENSIL WTD BENDABLE OT          SUPPLY     24.50
OCC THER      4301852 0 GLOVE PREF BENEK NEOPRN W/ THUMB OT       SUPPLY     30.30
OCC THER      4301853 0 HEMI-SLING SHOULDER UNILAT OT             SUPPLY     113.80
OCC THER      4301854 0 PENCIL FOAM GRIPPERS OT                   SUPPLY     1.05
OCC THER      4301855 0 SWIVEL SPOON / FORK OT                    SUPPLY     27.25
OCC THER      4301856 0 THERABAND TUBING OT                       SUPPLY     30.00
OCC THER      4301857 0 WALKER BASKET OT                          SUPPLY     45.90
OCC THER      4301858 0 STOCKINGS TED KNEE XL 1 PR                SUPPLY     67.17
OCC THER      4309412 0 CAST SHOE OT                              SUPPLY     36.50
OCC THER      4309413 0 ORTHOTIC CUSTM CAST SHOE OT               SUPPLY     334.26
OCC THER      4331001 0 SPL CUSTM AFO OT                          SUPPLY     321.30
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
OCC THER      4331002 0 SPL CUSTM KFO OT                  SUPPLY     699.80
OCC THER      4331003 0 SPL CUSTM AIRPLANE SPLINT OT      SUPPLY     1,130.20
OCC THER      4331004 0 SPL CUSTM ANT ELBOW OT            SUPPLY     277.70
OCC THER      4331005 0 SPL CUSTM CLAM/DOR EXT BLK OT     SUPPLY     191.30
OCC THER      4331006 0 SPL CUSTM DUPUYTRENES OT          SUPPLY     194.00
OCC THER      4331008 0 SPL CUSTM MALI-EXT OT             SUPPLY     138.60
OCC THER      4331009 0 SPL CUSTM MICROSTOMIA OT          SUPPLY     208.80
OCC THER      4331011 0 SPL CUSTM NECK OT                 SUPPLY     245.90
OCC THER      4331012 0 SPL CUSTM NEO UE OT               SUPPLY     86.10
OCC THER      4331013 0 SPL CUSTM NEO LE OT               SUPPLY     106.80
OCC THER      4331014 0 SPL CUSTM OPONENS LONG OT         SUPPLY     262.70
OCC THER      4331015 0 SPL CUSTM OPONENS SHORT OT        SUPPLY     266.60
OCC THER      4331016 0 SPL CUSTM PEDS UE OT              SUPPLY     126.20
OCC THER      4331017 0 SPL CUSTM PEDS LE OT              SUPPLY     214.60
OCC THER      4331018 0 SPL CUSTM POST ELBOW SHELL OT     SUPPLY     277.70
OCC THER      4331019 0 SPL CUSTM POST ELBOW W/WRIST OT   SUPPLY     339.15
OCC THER      4331021 0 SPL CUSTM RADIAL NERVE OT         SUPPLY     437.00
OCC THER      4331022 0 SPL CUSTM RESTING/INTRINS OT      SUPPLY     167.10
OCC THER      4331023 0 SPL CUSTM-SCROTAL SLING OT        SUPPLY     318.40
OCC THER      4331026 0 SPL CUSTM STATIC KNEE OT          SUPPLY     303.20
OCC THER      4331027 0 SPL CUSTM SUGAR TONG OT           SUPPLY     350.20
OCC THER      4331028 0 SPL CUSTM TH SPICA/FRM OT         SUPPLY     236.50
OCC THER      4331029 0 SPL CUSTM TH SPICA/HAND OT        SUPPLY     203.50
OCC THER      4331030 0 SPL CUSTM TRIGGER FINGER OT       SUPPLY     130.20
OCC THER      4331031 0 SPL CUSTM ULNAR/RAD GUTTER OT     SUPPLY     176.90
OCC THER      4331032 0 SPL CUSTM VOL/DOR COCK UP OT      SUPPLY     204.00
OCC THER      4331034 0 SPL CUSTM FNG/THMB VOL/DOR OT     SUPPLY     8.50
OCC THER      4331035 0 SPL CUSTM ELBOW PAD OT            SUPPLY     32.40
OCC THER      4331036 0 SPL CUSTM MERIT OT                SUPPLY     52.49
OCC THER      4331037 0 SPL CUSTM AIRPLANE ADULT OT       SUPPLY     800.00
OCC THER      4331038 0 SPL CUSTM AIRPLANE PED OT         SUPPLY     350.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
OCC THER      4332003 0 SPL PREF AOA TENNIS ELBOW OT      SUPPLY     53.20
OCC THER      4332005 0 SPL PREF BR COLLUM THUMB OT       SUPPLY     66.70
OCC THER      4332007 0 SPL PREF BUDDY OT                 SUPPLY     8.80
OCC THER      4332008 0 SPL PREF CAPENER OT               SUPPLY     69.10
OCC THER      4332009 0 SPL PREF D-RING WRAP OT           SUPPLY     45.30
OCC THER      4332010 0 SPL PREF ELB CNTR STRAP OT        SUPPLY     20.40
OCC THER      4332011 0 SPL PREF POSTERIOR ELBOW OT       SUPPLY     199.70
OCC THER      4332012 0 SPL PREF FOOT DROP ROLYN OT       SUPPLY     152.40
OCC THER      4332013 0 SPL PREF FREEDOM WRIST OT         SUPPLY     55.20
OCC THER      4332014 0 SPL PREF INFLATABLE HAND OT       SUPPLY     178.70
OCC THER      4332015 0 SPL PREF JOINT JACK OT            SUPPLY     77.20
OCC THER      4332016 0 SPL PREF LINER OT                 SUPPLY     39.60
OCC THER      4332018 0 SPL PREF LMB EXT OT               SUPPLY     42.50
OCC THER      4332019 0 SPL PREF LMB FLEXION OT           SUPPLY     42.50
OCC THER      4332020 0 SPL PREF LMB MP FLEXION OT        SUPPLY     105.60
OCC THER      4332022 0 SPL PREF TH NEOPRENE OT           SUPPLY     34.10
OCC THER      4332025 0 SPL PREF PIP/DIP STRAP OT         SUPPLY     10.60
OCC THER      4332026 0 SPL PREF PROFLEX WRIST OT         SUPPLY     51.90
OCC THER      4332027 0 SPL PREF RESTING PAN OT           SUPPLY     83.00
OCC THER      4332028 0 SPL PREF SPASTICITY OT            SUPPLY     155.10
OCC THER      4332029 0 SPL PREF STACK OT                 SUPPLY     8.40
OCC THER      4332030 0 SPL PREF TH SPICA/FRM OT          SUPPLY     133.60
OCC THER      4332031 0 SPL PREF TH SPICA/HAND OT         SUPPLY     35.90
OCC THER      4332032 0 SPL PREF TIP PROTECTOR OT         SUPPLY     39.10
OCC THER      4332034 0 SPL PREF GEL SHELL OT             SUPPLY     66.34
OCC THER      4332035 0 SPL PREF JOINT CINCH OT           SUPPLY     49.27
OCC THER      4332036 0 SPL PREF NEOPRENE SUPINATION OT   SUPPLY     77.42
OCC THER      4332037 0 SPL PREF NEOPRENE THUMB CMC OT    SUPPLY     31.85
OCC THER      4332038 0 SPL PREF JOE COOL CHILD OT        SUPPLY     33.10
OCC THER      4332039 0 SPL PREF JOE COOL PREM/INF OT     SUPPLY     30.30
OCC THER      4332040 0 SPL PREF JOE COOL TEEN/ADLT OT    SUPPLY     38.65
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
OCC THER      4332041 0 SPL PREF SOFT CONTOUR HAND OT     SUPPLY     121.90
OCC THER      4332042 0 SPL PREF SOFT RESTING HAND OT     SUPPLY     121.90
OCC THER      4332043 0 SPL PREF WALKER OT                SUPPLY     80.40
OCC THER      4332044 0 SPL THOMAS SUSPENSION             SUPPLY     66.34
OCC THER      4332045 0 SPL FINGER OVAL 8                 SUPPLY     35.87
OCC THER      4333001 0 SPL PADDING OT                    SUPPLY     14.80
OCC THER      4340001 0 JOBST BODYBRIEF SLEEVELESS OT     SUPPLY     386.00
OCC THER      4340002 0 JOBST BODYBRIEF SLEEVES OT        SUPPLY     433.80
OCC THER      4340003 0 JOBST CHIN STRAP OT               SUPPLY     138.70
OCC THER      4340004 0 JOBST CHIN STRAP MOD OT           SUPPLY     143.20
OCC THER      4340005 0 JOBST FACE MASK OT                SUPPLY     224.30
OCC THER      4340006 0 JOBST FOREARM SLEEVE OT           SUPPLY     106.20
OCC THER      4340007 0 JOBST FOREARM SLV GANT OT         SUPPLY     211.70
OCC THER      4340008 0 JOBST FULL ELBOW LINING OT        SUPPLY     24.60
OCC THER      4340009 0 JOBST GAUNTLET OT                 SUPPLY     101.40
OCC THER      4340010 0 JOBST GLOVE TO ELBOW OT           SUPPLY     268.50
OCC THER      4340011 0 JOBST GLOVE TO WRIST OT           SUPPLY     158.00
OCC THER      4340012 0 JOBST INSERTS OT                  SUPPLY     45.90
OCC THER      4340013 0 JOBST NOSE COVERING OT            SUPPLY     20.90
OCC THER      4340014 0 JOBST POCKET OT                   SUPPLY     69.00
OCC THER      4340015 0 JOBST SLEEVE GAUNTLET OT          SUPPLY     152.60
OCC THER      4340016 0 JOBST SLEEVE SHLD FL OT           SUPPLY     149.90
OCC THER      4340017 0 JOBST SUSPENDERS OT               SUPPLY     54.30
OCC THER      4340018 0 JOBST VELCRO TABS OT              SUPPLY     19.00
OCC THER      4340019 0 JOBST VEST SLEEVELESS OT          SUPPLY     260.90
OCC THER      4340020 0 JOBST VEST SLEEVES OT             SUPPLY     318.70
OCC THER      4340021 0 JOBST WEB SPACER OT               SUPPLY     137.30
OCC THER      4340022 0 JOBST ZIPPER OT                   SUPPLY     57.00
OCC THER      4340023 0 JOBST SLEEVE OT                   SUPPLY     153.00
OCC THER      4340028 0 JOBST GLOVE-PREFAB OT             SUPPLY     75.20
OCC THER      4340030 0 JOBST WAIST HT 1 LG OPEN PUB OT   SUPPLY     332.10
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML     CPT
OCC THER      4340031 0 JOBST WAIST HT 1 LG PANTY OT               SUPPLY     372.00
OCC THER      4340032 0 JOBST THIGH LENGTH OT                      SUPPLY     146.10
OCC THER      4340033 0 JOBST SOFT ENCLOSED TOE OT                 SUPPLY     13.10
OCC THER      4340034 0 JOBST SELF-ENCLOSED TOE OT                 SUPPLY     18.50
OCC THER      4340035 0 JOBST REINFORCED KNEE OT                   SUPPLY     38.10
OCC THER      4340036 0 JOBST REINFORCED HEEL OT                   SUPPLY     16.30
OCC THER      4340037 0 JOBST PANTY GIRDLE OT                      SUPPLY     227.40
OCC THER      4340038 0 JOBST FAST FIT KNEE OT                     SUPPLY     195.70
OCC THER      4340039 0 JOBST CHEST HEIGHT 2 LEG OT                SUPPLY     419.10
OCC THER      4340040 0 JOBST CHAP STYLE 2 LEGS OT                 SUPPLY     465.90
OCC THER      4340041 0 JOBST CHAP STYLE 1 LEG OT                  SUPPLY     376.20
OCC THER      4340042 0 JOBST BK STUMP SUPPRT OT                   SUPPLY     186.20
OCC THER      4340043 0 JOBST ANKLE SUPPRT OT                      SUPPLY     102.00
OCC THER      4340045 0 JOBST KNEE LENGTH OT                       SUPPLY     118.50
OCC THER      4340046 0 JOBST WAIST HT 2 LEG OT                    SUPPLY     414.90
OCC THER      4340053 0 JOBST 2" SILICONE BAND OT                  SUPPLY     11.47
OCC THER      4340054 0 JOBST REINFORCED HEEL W/ ANKLE LINING OT   SUPPLY     28.05
OCC THER      4340055 0 JOBST LINING VARIATION OT                  SUPPLY     63.54
OCC THER      4340056 0 JOBST HEADBAND OT                          SUPPLY     88.64
OCC THER      4340057 0 JOBST MEDI KNEE OT                         SUPPLY     154.21
OCC THER      4340058 0 JOBST MEDI SLEEVE OT                       SUPPLY     132.52
OCC THER      4340059 0 JOBST 2" ELASTIC BAND OT                   SUPPLY     11.47
OCC THER      4340060 0 JOBST MEDI GLOVE OT                        SUPPLY     240.97
OCC THER      4340061 0 JOBST WAIST HIGH 2 LEGS W/ PUBIS OT        SUPPLY     320.48
OCC THER      4340062 0 JOBST JUZO OT                              SUPPLY     132.52
OCC THER      4340063 0 JOBST CIRCUMFERENCE 60-69 OT               SUPPLY     70.10
OCC THER      4340064 0 JOBST CIRCUMFERENCE 50-59 OT               SUPPLY     121.24
OCC THER      4340065 0 JOBST GAUNTLET ATTACHED TO BODYBRIEF OT    SUPPLY     44.81
OCC THER      4340066 0 JOBST INTERIM GLOVE OT                     SUPPLY     137.44
OCC THER      4340067 0 JOBST FACIOPLASTY OT                       SUPPLY     110.35
OCC THER      4340068 0 JOBST MEDI GAUNTLET OT                     SUPPLY     132.93
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML      CPT
OCC THER      4340069 0 CIRC AID PREFAB UE OT                 SUPPLY     506.40
OCC THER      4340070 0 CIRC AID PREFAB LE OT                 SUPPLY     569.70
OCC THER      4340071 0 ELVAREX SLEEVE OT                     SUPPLY     317.66
OCC THER      4340072 0 ELVAREX GLOVE OT                      SUPPLY     516.52
OCC THER      4340073 0 ELVAREX KNEE OT                       SUPPLY     310.59
OCC THER      4340074 0 ELVAREX THIGH OT                      SUPPLY     457.44
OCC THER      4340075 0 JOBST MAMMORY SUPPORT OT              SUPPLY     238.40
OCC THER      4340076 0 CIRC AID CUSTM LE OT                  SUPPLY     1,000.00
OCC THER      4340077 0 CIRC AID CUSTM UE OT                  SUPPLY     1,100.00
OCC THER      4340078 0 TURTLENECK DETACHABLE                 SUPPLY     76.03
OCC THER      4340079 0 NECK SUPPORT EXTENSION COLLAR         SUPPLY     128.83
PEDS ECHO     3871385 0 3D RECON                              PROCED     618.00                       76376
PEDS ECHO     3871387 0 ECHO FETAL CV COMP MM                 PROCED     417.07                       76825
PEDS ECHO     3871401 0 ECHO, FETAL CVS F/U                   PROCED     370.80                       76826
PEDS ECHO     3871400 0 FETAL DOPPLER, CVS COMP               PROCED     235.80                       76827
PEDS ECHO     3871402 0 FETAL DOPPLER CVS F/U                 PROCED     370.80                       76828
PEDS ECHO     3871393 0 PEDS EKG                              PROCED     130.36                       93005
PEDS ECHO     3871403 0 ECHO TRANSTHOR CCA COMP               PROCED     744.00                       93303
PEDS ECHO     3871404 0 ECHO TRANSTHOR CCA F/U                PROCED     269.36                       93304
PEDS ECHO     3871384 0 ECHO TRANSTHOR COMP MM                PROCED     602.51                       93307
PEDS ECHO     3871386 0 ECHO TRANSTHOR LTD MM                 PROCED     388.21                       93308
PEDS ECHO     3871398 0 ECHO TRANSESOPH COMP MM               PROCED     1,102.68                     93312
PEDS ECHO     3871405 0 PEDS ECHO TRANSESOPH CONG CARD ANOM   PROCED     1,720.00                     93315
PEDS ECHO     3871389 0 ECHO DOPPLER COMP                     PROCED     356.87                       93320
PEDS ECHO     3871395 0 ECHO DOPPLER F/U                      PROCED     258.56                       93321
PEDS ECHO     3871396 0 ECHO DOPPLER COLOR MAPPING            PROCED     264.87                       93325
PHYS THER     4240022 0 FAST FIT THIGH PT                     SUPPLY     235.00
PHYS THER     4240038 0 JOBST INTERIM FACE MASK PT            SUPPLY     160.00
PHYS THER     4240021 0 JOBST FAST FIT WAIST PANTY PT         SUPPLY     265.00
PHYS THER     4260041 0 CAST APPLICATION LONG ARM PT          PROCED     288.43                      29065GP
PHYS THER     4260042 0 CAST APPLICATION SHORT ARM PT         PROCED     246.13                      29075GP
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML      CPT
PHYS THER     4260018 0 TAPING SHOULDER PT                      PROCED     108.00                      29240GP
PHYS THER     4260043 0 CAST APPLICATION LONG LEG PT            PROCED     379.03                      29345GP
PHYS THER     4260044 0 CAST APPLICATION SHORT LEG PT           PROCED     269.21                      29405GP
PHYS THER     4260046 0 CAST APPLICATION SHORT LEG WT BEAR PT   PROCED     374.12                      29425GP
PHYS THER     4260019 0 TAPING KNEE PT                          PROCED     140.01                      29530GP
PHYS THER     4260030 0 UNNA BOOT APPLICATION BILAT             PROCED     162.57                      2958050
PHYS THER     4260026 0 UNNA BOOT APPLICATION LT                PROCED     152.31                      29580LT
PHYS THER     4260029 0 UNNA BOOT APPLICATION RT                PROCED     152.31                      29580RT
PHYS THER     4260045 0 CAST WINDOWING PT                       PROCED     112.32                      29730GP
PHYS THER     4272001 0 BIOFEEDBACK 30 MIN PT                   PROCED     107.60                      90901GP
PHYS THER     4272002 0 BIOFEEDBACK 60 MIN PT                   PROCED     187.80                      90901GP
PHYS THER     4272010 0 BIOFEEDBACK PERINEAL-RECTAL W/ EMG PT   PROCED     235.00                      90911GP
PHYS THER     4280003 0 EMG 1 EXTREM W/ OR W/O PARASPINL        PROCED     223.00                       95860
PHYS THER     4280004 0 EMG 2 EXTREM W/ OR W/O PARASPNL         PROCED     273.03                       95861
PHYS THER     4280006 0 EMG 4 EXTREM W/ OR W/O PARASPNL         PROCED     316.94                       95864
PHYS THER     4280002 0 EMG 1 EXTREM LIMTD MUSC                 PROCED     112.48                       95870
PHYS THER     4260033 0 MOTOR NRVE CONDUCTION W/ F-WAVE         PROCED     121.85                       95903
PHYS THER     4250001 0 NEW EVAL 15 MIN PT                      PROCED     154.98                      97001GP
PHYS THER     4250002 0 NEW EVAL 30 MIN PT                      PROCED     181.86                      97001GP
PHYS THER     4250003 0 NEW EVAL 45 MIN PT                      PROCED     200.00                      97001GP
PHYS THER     4250004 0 NEW EVAL 60 MIN PT                      PROCED     266.60                      97001GP
PHYS THER     4252003 0 ISOKINETIC EVAL 15 MIN PT               PROCED     84.00                       97001GP
PHYS THER     4251001 0 RE-EVAL 15 MIN PT                       PROCED     95.60                       97002GP
PHYS THER     4251002 0 RE-EVAL 30 MIN PT                       PROCED     124.50                      97002GP
PHYS THER     4251003 0 RE-EVAL 45 MIN PT                       PROCED     186.80                      97002GP
PHYS THER     4251004 0 RE-EVAL 60 MIN PT                       PROCED     249.10                      97002GP
PHYS THER     4271001 0 HOT/COLD PACK APPL PT                   PROCED     55.08                       97010GP
PHYS THER     4271004 0 MECHANICAL TRACTION PT                  PROCED     76.50                       97012GP
PHYS THER     4271003 0 FLUIDOTHERAPY PT                        PROCED     71.65                       97022GP
PHYS THER     4271007 0 WHIRLPOOL PT                            PROCED     71.65                       97022GP
PHYS THER     4272003 0 E STIM MANUAL 15 MIN PT                 PROCED     79.93                       97032GP
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                       CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                       CATEGORY   OUTPT)          LML/RML      CPT
PHYS THER     4272005 0 IONTOPHORESIS 15 MIN PT                  PROCED     90.36                       97033GP
PHYS THER     4272006 0 PHONOPHORESIS 15 MIN PT                  PROCED     70.90                       97035GP
PHYS THER     4272007 0 ULTRASOUND 15 MIN PT                     PROCED     70.19                       97035GP
PHYS THER     4272008 0 ULTRASOUND/HVG 15 MIN PT                 PROCED     72.20                       97035GP
PHYS THER     4272004 0 ICE MASSAGE 15 MIN PT                    PROCED     133.52                      97039GP
PHYS THER     4260005 0 ISOKINETIC EXERCISE 15 MIN PT            PROCED     71.23                       97110GP
PHYS THER     4260009 0 THER EXERCISE 15 MIN PT                  PROCED     71.23                       97110GP
PHYS THER     4260007 0 NEUROMUSC RE-ED 15 MIN PT                PROCED     76.45                       97112GP
PHYS THER     4260040 0 AQUATIC THERAPY W/ EXERCISE PER 15 MIN   PROCED     85.00                       97113GP
PHYS THER     4260004 0 GAIT TRAINING 15 MIN PT                  PROCED     68.26                       97116GP
PHYS THER     4260006 0 MANUAL THERAPY 15 MIN PT                 PROCED     78.30                       97140GP
PHYS THER     4260022 0 GRP THER ACTIVITIES 30MIN PT             PROCED     95.49                       97150GP
PHYS THER     4260023 0 GRP THER ACTIVITIES 60 MIN PT            PROCED     95.49                       97150GP
PHYS THER     4260024 0 GRP THER ACTIV 15 MIN PT                 PROCED     48.40                       97150GP
PHYS THER     4260003 0 FUNCT THER ACTIV 15 MIN PT               PROCED     76.51                       97530GP
PHYS THER     4260027 0 SENSORY INTEGRATION EA 15 MIN PT         PROCED     50.68                       97533GP
PHYS THER     4260008 0 SLF CARE/HOME MNGMT 15 MIN PT            PROCED     67.00                       97535GP
PHYS THER     4260002 0 COMM/WK RE-INTEG 15 MIN PT               PROCED     67.00                       97537GP
PHYS THER     4260010 0 W/C MNGMT/TRAIN 15 MIN PT                PROCED     63.72                       97542GP
PHYS THER     4260012 0 WK HARD/COND 2HRS PT                     PROCED     328.30                      97545GP
PHYS THER     4260013 0 WK HARD/COND ADDL HR PT                  PROCED     255.00                      97546GP
PHYS THER     4260028 0 WOUND CARE SELECTV DEBRDMNT < 20 SQ CM   PROCED     122.40                      97597GP
PHYS THER     4260037 0 WOUND CARE SELECTV DEBRDMNT > 20 SQ CM   PROCED     150.00                      97598GP
PHYS THER     4260031 0 DEBRD WOUND NON-SELCTV PER SESSION       PROCED     66.73                       97602GP
PHYS THER     4260038 0 NEG PRESS WOUND THER < / = 50 SQ CM      PROCED     122.40                      97605GP
PHYS THER     4260039 0 NEG PRESS WOUND THER > 50 SQ CM          PROCED     150.00                      97606GP
PHYS THER     4252001 0 COMP GAIT ANALYSIS 15 MIN PT             PROCED     69.05                       97750GP
PHYS THER     4252002 0 FUNCT CAP EVAL (FCE) 15 MIN PT           PROCED     82.00                       97750GP
PHYS THER     4260014 0 COMP GARMT MEAS/FIT 15 MIN PT            PROCED     72.44                       97760GP
PHYS THER     4260015 0 ORTHOTIC FIT/TRAIN 15 MIN PT             PROCED     72.44                       97760GP
PHYS THER     4260017 0 PROSTH TRAIN PT                          PROCED     67.00                       97761GP
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML      CPT
PHYS THER     4260016 0 ORTHO/PROS CHECKOUT 15 MIN PT                     PROCED     70.17                       97762GP
PHYS THER     4271008 0 E-STIM UNATTEN WOUND ULCER (STG 3,4)              PROCED     67.00                       G0281
PHYS THER     4271009 0 E-STIM UNATTEN WOUND CARE                         PROCED     67.00                       G0282
PHYS THER     4271002 0 E-STIM UNATTEN OTHER THAN WOUND CARE PT           PROCED     76.20                       G0283
PHYS THER     4251005 0 EARLY INTERVENTION CONSLT / STAFF PER 15 MIN PT   PROC       35.00                       W8746
PHYS THER     4201128 0 FINGER WRAP TRANSELAST BOX PT                     SUPPLY     44.32
PHYS THER     4201129 0 FINGER WRAP TRANSELAST EA PT                      SUPPLY     1.51
PHYS THER     4201130 0 COMPRILAN (ROSIDAL) SHORT STRETCH PT              SUPPLY     35.00
PHYS THER     4201131 0 ARTIFLEX PT                                       SUPPLY     21.00
PHYS THER     4201132 0 ELASTOMULL BAG PT                                 SUPPLY     30.64
PHYS THER     4201133 0 STOCKINETTE TRICOFIX PT                           SUPPLY     80.00
PHYS THER     4201134 0 PULLEY WITH ATTACHMENT                            SUPPLY     52.60
PHYS THER     4201135 0 PULLEY WITHOUT ATTACHMENT                         SUPPLY     47.06
PHYS THER     4201733 0 ALUMINUM STRAIGHT CANE PT                         SUPPLY     97.30
PHYS THER     4201734 0 DRSG WOUND PRISMA EA - PT                         SUPPLY     34.30
PHYS THER     4201735 0 DRSG PROMOGRAN LITE/MED EXUD EA - PT              SUPPLY     19.00
PHYS THER     4201736 0 DRSG PROMOGRAN HEAVY EXUD EA - PT                 SUPPKY     50.50
PHYS THER     4201737 0 HYPAFIX ROLL 4 IN X 10 YD EA - PT                 SUPPLY     45.00
PHYS THER     4201738 0 HYPAFIX ROLL 6 IN X 10 YD EA - PT                 SUPPLY     57.30
PHYS THER     4201739 0 HYPAFIX ROLL 2 IN X 10 YD EA - PT                 SUPPLY     32.20
PHYS THER     4201825 0 BUMPER BENDY POSITIONER EA PT                     SUPPLY     83.10
PHYS THER     4201826 0 CAST PADDING ROLL PT                              SUPPLY     7.15
PHYS THER     4201827 0 CAST TAPE SEMI-RIGID ROLL PT                      SUPPLY     12.20
PHYS THER     4201828 0 COLLAR CERVICAL ZIMMER PT                         SUPPLY     23.30
PHYS THER     4201829 0 COLLAR T.O.T PT                                   SUPPLY     132.90
PHYS THER     4201832 0 IMMOBILIZER PREF ELB/WRIST MED PT                 SUPPLY     31.75
PHYS THER     4201833 0 IMMOBILIZER PREF ELB/WRIST SM PT                  SUPPLY     21.20
PHYS THER     4201834 0 KINESIOTAPE FOOT PT                               SUPPLY     3.60
PHYS THER     4201835 0 KINESIOTAPE ROLL PT                               SUPPLY     39.20
PHYS THER     4201836 0 LEUKOTAPE FOOT PT                                 SUPPLY     3.60
PHYS THER     4201837 0 LEUKOTAPE ROLL PT                                 SUPPLY     48.45
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML     CPT
PHYS THER     4201838 0 PRAFO PREF PT                             SUPPLY     137.40
PHYS THER     4201839 0 RESTRAINT PREF LEG PEDI-WRAP 13" PT       SUPPLY     60.95
PHYS THER     4201840 0 RESTRAINT PREF LEG PEDI-WRAP 15 X 17 PT   SUPPLY     66.50
PHYS THER     4201841 0 RESTRAINT PREF LEG PEDI-WRAP 7 X 11 PT    SUPPLY     55.40
PHYS THER     4201842 0 TENSOWRAP MED 2 X 5 ROLL PT               SUPPLY     62.25
PHYS THER     4201843 0 TENSOWRAP MED 3 X 5 ROLL PT               SUPPLY     85.75
PHYS THER     4201844 0 TENSOWRAP NU BLUE 2 X 48 ROLL PT          SUPPLY     32.30
PHYS THER     4201845 0 TENSOWRAP NU BLUE 6 X 18 ROLL PT          SUPPLY     32.30
PHYS THER     4201846 0 TENSOWRAP NU BLUE 6 X 36 ROLL PT          SUPPLY     48.90
PHYS THER     4201847 0 TENSOWRAP NU BLUE 6 X 48 ROLL PT          SUPPLY     70.15
PHYS THER     4201848 0 TENSOWRAP SUPER 2 X 5 ROLL PT             SUPPLY     14.25
PHYS THER     4201849 0 TENSOWRAP SUPER 3 X 5 ROLL PT             SUPPLY     17.30
PHYS THER     4201850 0 TENSOWRAP SUPER 4 X 5 ROLL PT             SUPPLY     22.35
PHYS THER     4201858 0 HIP ABDUCTION WEDGE PT                    SUPPLY     80.20
PHYS THER     4201859 0 LYMPHEDEMA KIT LOWER EXTREM               SUPPLY     341.71
PHYS THER     4205737 0 SORBOTHANE HEEL LIFTS PT                  SUPPLY     53.70
PHYS THER     4205738 0 INSOLES PT                                SUPPLY     34.10
PHYS THER     4207731 0 ATHLETIC TAPE ROLL PT                     SUPPLY     33.40
PHYS THER     4207732 0 PREWRAP ROLL PT                           SUPPLY     54.50
PHYS THER     4207734 0 NARROW BASED QUAD CANE PT                 SUPPLY     105.50
PHYS THER     4207735 0 WIDE BASED QUAD CANE PT                   SUPPLY     105.50
PHYS THER     4207736 0 WALKER PT                                 SUPPLY     196.10
PHYS THER     4208859 0 PREF LEG ROTATION CTRL LGE PT             SUPPLY     173.40
PHYS THER     4209401 0 ACE BANDAGE PT                            SUPPLY     6.50
PHYS THER     4209407 0 CERV ROLL                                 SUPPLY     55.70
PHYS THER     4209410 0 CRUTCHES                                  SUPPLY     96.00
PHYS THER     4209412 0 CAST SHOE PT                              SUPPLY     36.50
PHYS THER     4209413 0 ORTHOTIC CUSTM CAST SHOE PT               SUPPLY     334.26
PHYS THER     4209422 0 THERABAND/TUBING                          SUPPLY     8.30
PHYS THER     4209423 0 KOMPREX ROLL 8 X 2 X 0.5 CM EA            SUPPLY     42.00
PHYS THER     4209424 0 LUMBAR ROLL                               SUPPLY     55.70
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION             CATEGORY   OUTPT)          LML/RML     CPT
PHYS THER     4209425 0 LUMBO SACRAL SUPPORT           SUPPLY     100.00
PHYS THER     4209426 0 PILLOWS PAWS PT                SUPPLY     6.50
PHYS THER     4209427 0 SWISS BALL PT                  SUPPLY     45.00
PHYS THER     4209428 0 CRUTCH CUSHIONS PT             SUPPLY     12.10
PHYS THER     4209434 0 SILICONE GEL CAPS/TUBING PT    SUPPLY     5.80
PHYS THER     4209435 0 SILICONE SES GEL SHEET 2" PT   SUPPLY     15.60
PHYS THER     4209436 0 SILICONE GEL SHEET PT          SUPPLY     81.00
PHYS THER     4209438 0 COWRAP ROLL PT                 SUPPLY     55.10
PHYS THER     4209439 0 KERLIX PT                      SUPPLY     4.20
PHYS THER     4209440 0 OTOFORM PT                     SUPPLY     8.50
PHYS THER     4209441 0 GAUZE STERILE 2X2 PT           SUPPLY     0.40
PHYS THER     4209442 0 GAUZE STERILE 4X4 PT           SUPPLY     0.50
PHYS THER     4209443 0 PAPER TAPE PT                  SUPPLY     1.00
PHYS THER     4209445 0 COBAN ROLL PT                  SUPPLY     10.10
PHYS THER     4209446 0 ELASTOMER/OZ PT                SUPPLY     8.10
PHYS THER     4209447 0 STOCKINETTE/FT PT              SUPPLY     6.60
PHYS THER     4209450 0 HEEL LIFT PT                   SUPPLY     37.60
PHYS THER     4209453 0 GAIT BELT 48" PT               SUPPLY     33.40
PHYS THER     4209454 0 GAIT BELT 60" PT               SUPPLY     35.20
PHYS THER     4209455 0 PADDING 6"X6"                  SUPPLY     14.20
PHYS THER     4209456 0 CAST ROLL SERIAL               SUPPLY     3.90
PHYS THER     4209457 0 CAST ROLL FIBERGLASS           SUPPLY     28.80
PHYS THER     4209458 0 SCISSORS BLUNT BNDG 5.5" PT    SUPPLY     7.40
PHYS THER     4209459 0 SUTURE REMOVAL KIT             SUPPLY     7.90
PHYS THER     4209460 0 SURGI PADS                     SUPPLY     0.20
PHYS THER     4209461 0 MESH PANTY                     SUPPLY     5.40
PHYS THER     4209462 0 EXUDRY/SMALL                   SUPPLY     9.50
PHYS THER     4209465 0 TUBIGRIP / FT PT               SUPPLY     16.60
PHYS THER     4209466 0 FOOT ORTHOTIC PT               SUPPLY     220.00
PHYS THER     4209467 0 SI BELT PT                     SUPPLY     49.86
PHYS THER     4209468 0 WALKER WHEELS 3" PT            SUPPLY     44.95
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                    CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                    CATEGORY   OUTPT)          LML/RML     CPT
PHYS THER     4209469 0 WALKER PLATFORM                       SUPPLY     227.77
PHYS THER     4209470 0 DRSG ABD COMBINE PAD 5X9 EA - PT      SUPPLY     2.00
PHYS THER     4209471 0 DRSG TELFA 3X6 EA - PT                SUPPLY     2.00
PHYS THER     4209472 0 DRSG AQUACEL AG 6X6 EA - PT           SUPPLY     67.30
PHYS THER     4209473 0 DRSG AQUACEL AG ROPE - PT             SUPPLY     44.70
PHYS THER     4209474 0 DRSG WOUND MATRIX OASIS 3X3 EA - PT   SUPPLY     60.00
PHYS THER     4209475 0 DRSG WOUND MATRIX OASIS 3X7 EA - PT   SUPPLY     116.20
PHYS THER     4209476 0 ELTA 2.8 OZ SKIN CREAM - PT           SUPPLY     11.15
PHYS THER     4209477 0 BARRIER CREAM - PT                    SUPPLY     10.00
PHYS THER     4209478 0 DRSG SORBALGON 4X4 EA - PT            SUPPLY     14.80
PHYS THER     4209479 0 DRSG ADAPTIC 3X3 EA - PT              SUPPLY     3.10
PHYS THER     4209480 0 DRSG ADAPTIC 3X16 EA - PT             SUPPLY     5.80
PHYS THER     4209481 0 DRSG ADAPTIC 3X8 EA - PT              SUPPLY     6.70
PHYS THER     4209482 0 HYDROGEL LIQUID 1 OZ BTLE TOP - PT    SUPPLY     9.30
PHYS THER     4209483 0 DRSG STRATASORB 6X6 EA - PT           SUPPLY     17.60
PHYS THER     4209484 0 DRSG DUODERM 6X6 EA - PT              SUPPLY     16.50
PHYS THER     4209485 0 DRSG DUODERM 8X8 EA - PT              SUPPLY     27.40
PHYS THER     4210008 0 NEOPRENE SLEEVE PT                    SUPPLY     38.60
PHYS THER     4210009 0 POST OP BUNION BOOT PT                SUPPLY     100.00
PHYS THER     4210012 0 BRACE TIBIAL FRACTURE                 SUPPLY     376.63
PHYS THER     4230002 0 ANKLE FOOT ORTHOSIS PT                SUPPLY     167.60
PHYS THER     4230003 0 PLANTAR FASCIA NIGHT SPLINTS          SUPPLY     106.90
PHYS THER     4240002 0 JOBST ANKLE SUPPORT PT                SUPPLY     102.00
PHYS THER     4240003 0 JOBST CHAP STYLE 1 LEG - PT           SUPPLY     376.20
PHYS THER     4240004 0 JOBST CHAP STYLE 2 LEGS PT            SUPPLY     465.90
PHYS THER     4240005 0 JOBST CHEST HEIGHT 2 LEG PT           SUPPLY     419.10
PHYS THER     4240007 0 JOBST KNEE LENGTH PT                  SUPPLY     118.50
PHYS THER     4240008 0 JOBST PANTY GIRDLE PT                 SUPPLY     227.40
PHYS THER     4240009 0 JOBST REINFORCED HEEL PT              SUPPLY     16.30
PHYS THER     4240010 0 JOBST REINFORCED KNEE PT              SUPPLY     38.10
PHYS THER     4240011 0 JOBST SELF ENCLOSED TOE PT            SUPPLY     18.50
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                  CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
PHYS THER     4240012 0 JOBST SOFT ENCLOSED TOE PT          SUPPLY     13.10
PHYS THER     4240013 0 JOBST AK STUMP SUPPORT PT           SUPPLY     222.00
PHYS THER     4240014 0 JOBST BK STUMP SUPPORT PT           SUPPLY     186.20
PHYS THER     4240015 0 JOBST THIGH LENGTH PT               SUPPLY     146.10
PHYS THER     4240016 0 JOBST WAIST HGT 1 LEG PANTY PT      SUPPLY     372.00
PHYS THER     4240017 0 JOBST WAIST HGT 1LG OPEN PUB        SUPPLY     332.10
PHYS THER     4240018 0 JOBST WAIST HGT 2 LEGS PT           SUPPLY     414.90
PHYS THER     4240019 0 JOBST ZIPPER PT                     SUPPLY     60.90
PHYS THER     4240020 0 JOBST FAST-FIT KNEE PT              SUPPLY     195.70
PHYS THER     4240023 0 JOBST VAIROX KNEE LGT OPEN TOE PT   SUPPLY     226.10
PHYS THER     4240024 0 JOBST VAIROX THIGH PT               SUPPLY     296.30
PHYS THER     4240025 0 JOBST WEB SPACER PT                 SUPPLY     137.30
PHYS THER     4240026 0 JOBST VEST SLEEVES PT               SUPPLY     318.70
PHYS THER     4240027 0 JOBST VEST SLEEVELESS PT            SUPPLY     260.90
PHYS THER     4240028 0 JOBST VELCRO TABS PT                SUPPLY     19.00
PHYS THER     4240029 0 JOBST SUSPENDERS PT                 SUPPLY     54.30
PHYS THER     4240030 0 JOBST SLEEVE SHLD FL PT             SUPPLY     149.90
PHYS THER     4240031 0 JOBST SLEEVE PT                     SUPPLY     153.00
PHYS THER     4240032 0 JOBST SLEEVE GAUNTLET PT            SUPPLY     152.60
PHYS THER     4240033 0 JOBST POCKET PT                     SUPPLY     69.00
PHYS THER     4240034 0 JOBST NOSE COVERING PT              SUPPLY     20.90
PHYS THER     4240040 0 JOBST INSERTS PT                    SUPPLY     45.90
PHYS THER     4240041 0 JOBST GLOVE PREFAB PT               SUPPLY     75.20
PHYS THER     4240042 0 JOBST GLOVE TO WRIST PT             SUPPLY     158.00
PHYS THER     4240043 0 JOBST GLOVE TO ELBOW PT             SUPPLY     268.50
PHYS THER     4240044 0 JOBST GAUNTLET PT                   SUPPLY     101.40
PHYS THER     4240045 0 JOBST FULL ELBOW LINING PT          SUPPLY     24.60
PHYS THER     4240046 0 JOBST CHIN STRAP PT                 SUPPLY     138.70
PHYS THER     4240047 0 JOBST CHIN STRAP MOD PT             SUPPLY     143.20
PHYS THER     4240048 0 JOBST BODY BRIEF SLEEVES PT         SUPPLY     433.80
PHYS THER     4240049 0 JOBST BDY BRIEF SLEEVELESS PT       SUPPLY     386.00
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML     CPT
PHYS THER     4240050 0 JOBST FACE MASK PT                         SUPPLY     224.30
PHYS THER     4240051 0 JOBST FOREARM SLEEVE PT                    SUPPLY     106.20
PHYS THER     4240052 0 JOBST FOREARM SLEEVE GANT PT               SUPPLY     211.70
PHYS THER     4240053 0 JOBST 2" SILICONE BAND PT                  SUPPLY     11.47
PHYS THER     4240054 0 JOBST REINFORCED HEEL W/ ANKLE LINING PT   SUPPLY     28.05
PHYS THER     4240055 0 JOBST LINING VARIATION PT                  SUPPLY     63.54
PHYS THER     4240056 0 JOBST HEADBAND PT                          SUPPLY     88.64
PHYS THER     4240057 0 JOBST MEDI KNEE PT                         SUPPLY     154.21
PHYS THER     4240058 0 JOBST MEDI SLEEVE PT                       SUPPLY     132.52
PHYS THER     4240059 0 JOBST 2" ELASTIC BAND PT                   SUPPLY     11.47
PHYS THER     4240060 0 JOBST MEDI GLOVE PT                        SUPPLY     240.97
PHYS THER     4240061 0 JOBST WAIST HIGH 2 LEGS W/ PUBIS PT        SUPPLY     320.48
PHYS THER     4240062 0 JOBST JUZO PT                              SUPPLY     132.52
PHYS THER     4240063 0 JOBST CIRCUMFERENCE 60-69 PT               SUPPLY     70.10
PHYS THER     4240064 0 JOBST CIRCUMFERENCE 50-59 PT               SUPPLY     121.24
PHYS THER     4240065 0 JOBST GAUNTLET ATTACHED TO BODYBRIEF PT    SUPPLY     44.81
PHYS THER     4240066 0 JOBST INTERIM GLOVE PT                     SUPPLY     137.44
PHYS THER     4240067 0 JOBST FACIOPLASTY PT                       SUPPLY     110.35
PHYS THER     4240068 0 JOBST MEDI GAUNTLET PT                     SUPPLY     132.93
PHYS THER     4240069 0 CIRC AID PREFAB UE PT                      SUPPLY     506.40
PHYS THER     4240070 0 CIRC AID PREFAB LE PT                      SUPPLY     569.70
PHYS THER     4240071 0 ELVAREX SLEEVE PT                          SUPPLY     317.66
PHYS THER     4240072 0 ELVAREX GLOVE PT                           SUPPLY     516.52
PHYS THER     4240073 0 ELVAREX KNEE PT                            SUPPLY     310.59
PHYS THER     4240074 0 ELVAREX THIGH PT                           SUPPLY     457.44
PHYS THER     4240075 0 JOBST MAMMORY SUPPORT PT                   SUPPLY     238.40
PHYS THER     4240076 0 CIRC AID CUSTM LE PT                       SUPPLY     1,000.00
PHYS THER     4240077 0 CIRC AID CUSTM UE PT                       SUPPLY     1,100.00
PHYS THER     4240078 0 JOBST CONTRACTURE SEAMS                    SUPPLY     10.79
PHYS THER     4240079 0 JOBST CHAP MED SZ 4/5 PETIT                SUPPLY     168.68
PHYS THER     4240080 0 JOBST MEDI CLOSED TOE PANTYHOSE            SUPPLY     262.27
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE         PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                           CATEGORY       OUTPT)          LML/RML      CPT
PHYS THER     4240081 0 JOBST MEDI THIGH HIGH - PT                   SUPPLY         235.17
PSYCH         9101070 0 INJ FEE THER / DIAG / PROPHY SQ,IM,ID        PROCED         60.36                       90772
PSYCH         9101023 0 INDIVID PSYCHOTHERPY 20-30 MIN               PROCED         93.42                       90804
PSYCH         9101024 0 INDIVID PSYCHOTHERPY 45-50 MIN               PROCED         129.34                      90806
PSYCH         9101022 0 GROUP PSYCHOTHERPY                           PROCED         97.31                       90853
PSYCH         9103004 0 PSYCHOTHER W/ BIOFEEDBACK TRAIN 45-50 MIN    PROCED         50.00                       90876
PULM FUNCTION 4601343  0 BRONCHOSCOPY DIAGNOSITIC                    PROCED         1,420.00                    31622
PULM FUNCTION 4601370  0 BRONCHOSCOPY, BRUSHING                      PROCED         1,233.85                    31623
PULM FUNCTION 4601371  0 BRONCHOSCOPY, ALVEOLAR LAVAGE               PROCED         1,600.00                    31624
PULM FUNCTION 4601372  0 BRONCHOSCOPY, W/BIOPSY                      PROCED         1,600.00                    31625
PULM FUNCTION 4601376  0 BRONCHOSCOPY W/BIOPSY TERMIN                PROCED         1,386.27                    3162573
PULM FUNCTION 4601381  0 BRONCHOSCOPY NEEDL ASPIRATN BX              PROCED         1,423.44                    31629
PULM FUNCTION 4601386  0 BRONCH W/ TRACHEAL DILATION / STENT PLCMT   PROCED         1,600.00                    31631
PULM FUNCTION 4601373  0 BRONCHOSCOPY, W/REM FORGN BODY              PROCED         1,882.35                    31635
PULM FUNCTION 4601374  0 BRONCHOSCOPY, INITIAL ASPIR                 PROCED         1,024.38                    31645
PULM FUNCTION 4601377  0 BRONCHOSCOPY W/ASP TERMINATED               PROCED         1,024.38                    3164573
PULM FUNCTION 4601375  0 BRONCHOSCOPY, SUBSQ ASPIR                   PROCED         587.00                      31646
PULM FUNCTION 4601311  0 THORACENTESIS ASP INIT / SUB                PROCED         471.80                      32000
PULM FUNCTION 4601383  0 THORACENTESIS W/ INSERT TUBE                PROCED         1,078.11                    32002
PULM FUNCTION 4601331  0 ARTERIAL BLOOD GAS DRAW                     PROCED         127.00                      36600
PULM FUNCTION 4601382  0 PARACENTESIS INITIAL                        PROCED         558.03                      49080
PULM FUNCTION 4601384  0 LUMBAR PUNCTURE DIAG                        PROCED         303.93                      62270
PULM FUNCTION 4601302  0 BLOOD GLUCOSE ACCUCHECK                                   23.37
                                                                     WAIVED TEST DON                            82962
PULM FUNCTION 4601008  0 SWEAT CHLORIDE                              PROCED         284.50                      89230
PULM FUNCTION 4601307  0 ACID REFLUX STUDY                           PROCED         610.10                      91038
PULM FUNCTION 4601401  0 INFANT PH STUDY                             PROCED         510.10                      91038
PULM FUNCTION 4601356  0 SPIROMETRY                                  PROCED         157.45                      94010
PULM FUNCTION 4601309  0 SPIRO PRE/POST BRONCHODILATOR               PROCED         306.28                      94060
PULM FUNCTION 4601316  0 BRONCHOPROVOCATION                          PROCED         635.04                      94070
PULM FUNCTION 4601360  0 LUNG VOLUMES                                PROCED         173.29                      94240
PULM FUNCTION 4601306  0 THORACIC GAS VOLUME                         PROCED         155.10                      94260
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)             LML/RML      CPT
PULM FUNCTION 4601304  0 FLOW VOLUME LOOP                         PROCED     159.80                         94375
PULM FUNCTION 4601404  0 SIMPLE PULMONARY STRESS TEST             PROCED     439.38                         94620
PULM FUNCTION 4601380  0 COMPLEX PULMONARY STRESS TEST            PROCED     899.47                         94621
PULM FUNCTION 4601378  0 COMPLEX PULM STRESS TEST TERM            PROCED     899.47                         9462152
PULM FUNCTION 4601369  0 SPUTUM INDUCTION                         PROCED     92.29                          94640
PULM FUNCTION 4601394  0 MED NEBULIZER TREATMENT                  PROCED     94.71                          94640
PULM FUNCTION 4601310  0 PENTAMIDINE TREATMENT                    PROCED     136.70                         94642
PULM FUNCTION 4601017  0 ACAPELLA TX INITIAL                      PROCED     175.00                         94667
PULM FUNCTION 4601019  0 FLUTTER VALVE TX INITIAL                 PROCED     150.00                         94667
PULM FUNCTION 4601018  0 ACAPELLA TX SUBSEQUENT                   PROCED     105.00                         94668
PULM FUNCTION 4601020  0 FLUTTER VALVE TX SUBSEQUENT              PROCED     105.00                         94668
PULM FUNCTION 4601361  0 DIFFUSION CAPACITY                       PROCED     221.31                         94720
PULM FUNCTION 4601319  0 OXIMETRY INT CHK                         PROCED     94.01                          94760
PULM FUNCTION 4601362  0 DESATURATION SCREENING                   PROCED     124.61                         94761
PULM FUNCTION 4601397  0 INFANT SLEEP STUDY                       PROCED     169.00                         94772
PULM FUNCTION 4601314  0 MAX RESP PRESSURES                       PROCED     230.00                         95831
PULM FUNCTION 4601009  0 FLUTTER VALVE DEVICE ONLY EA             SUPPLY     114.00
PULM FUNCTION 4601016  0 ACAPELLA CHOICE DEVICE ONLY EA           SUPPLY     140.00
PULM FUNCTION 4601321  0 PORTABLE OXYGEN, PER HOUR                SUPPLY     47.57
PULM FUNCTION 4601392  0 PNEUMOTHORAX SET                         SUPPLY     290.00
PULM FUNCTION 4601411  0 REFLUX STUDY PROBE                       SUPPLY     123.00
PULM FUNCTION 4601408  2 EXTEND BRONCH RECOV 214-274MIN           TIME       STATISTICAL ITEM
PULM FUNCTION 4601409  2 SCORE INFNT SLEEP STDY 61-120            PROCED     STATISTICAL ITEM
PULM FUNCTION 4601410  2 SCORE INFNT SLEEP STDY 121-180           PROCED     STATISTICAL ITEM
PULM FUNCTION 4601412  2 SCORE INFNT SLEEP STUDY 181-240 MIN      PROCED     STATISTICAL ITEM
PULM FUNCTION 4601413  2 SCORE INFNT SLEEP STUDY 0-60 MIN         PROCED     STATISTICAL ITEM
PULM FUNCTION 4602004  2 PATIENT ASSIST 0-30MIN                   PROC       STATISTICAL ITEM
PV LAB        9201063 0 DUPLEX SCAN INTRAOP ULTRASONIC GUIDANCE   PROCED     521.64                         76986
PV LAB        9201048 0 CAROTID DUPLEX COMPLETE / BILAT           PROCED     633.19                         93880
PV LAB        9201049 0 CAROTID DUPLEX EXAM UNILAT / LIMITED      PROCED     389.69                         93882
PV LAB        9201055 0 ABI ANKLE BRACHIAL INDEX                  PROCED     374.90                         93922
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                           CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML     CPT
PV LAB        9201054 0 ARTERIAL SEGMENTAL PRESSURES                  PROCED     530.59                      93923
PV LAB        9201072 0 ARTERIAL ARM EXAM                             PROCED     530.59                      93923
PV LAB        9201074 0 ARTERIAL DIGIT (TOES) EXAM                    PROCED     530.40                      93923
PV LAB        9201075 0 ARTERIAL DIGIT (FINGERS) EXAM                 PROCED     530.40                      93923
PV LAB        9201053 0 ARTERIAL EXAM WITH TREADMILL                  PROCED     544.50                      93924
PV LAB        9201101 0 ARTERIAL DUPLEX LEG BILATERAL                 PROCED     588.35                      93925
PV LAB        9201071 0 ARTERIAL DUPLEX LEG UNILATERAL / LIMITED      PROCED     429.92                      93926
PV LAB        9201102 0 ARTERIAL DUPLEX ARM BILATERAL                 PROCED     605.41                      93930
PV LAB        9201073 0 ARTERIAL DUPLEX ARM UNILATERAL                PROCED     468.96                      93931
PV LAB        9201119 0 VENOUS DUPLEX ARM BILAT MAPPING               PROCED     615.93                      93970
PV LAB        9201120 0 VENOUS DUPLEX ARM BILAT DVT                   PROCED     615.93                      93970
PV LAB        9201124 0 VENOUS DUPLEX LEG BILAT DVT                   PROCED     615.93                      93970
PV LAB        9201125 0 VENOUS DUPLEX LEG BILAT REFLUX                PROCED     615.93                      93970
PV LAB        9201126 0 VENOUS DUPLEX LEG BILAT MAPPING               PROCED     615.93                      93970
PV LAB        9201117 0 VENOUS DUPLEX ARM UNILAT MAPPING              PROCED     425.26                      93971
PV LAB        9201118 0 VENOUS DUPLEX ARM UNILAT DVT                  PROCED     425.26                      93971
PV LAB        9201121 0 VENOUS DUPLEX LEG UNILAT DVT                  PROCED     425.26                      93971
PV LAB        9201122 0 VENOUS DUPLEX LEG UNILAT REFLUX               PROCED     425.26                      93971
PV LAB        9201123 0 VENOUS DUPLEX LEG UNILAT MAPPING              PROCED     425.26                      93971
PV LAB        9201059 0 RENAL FLOW DUPLEX SCAN COMPLETE               PROCED     611.59                      93975
PV LAB        9201060 0 MESENTERIC FLOW DUPLEX SCAN COMPLETE          PROCED     611.59                      93975
PV LAB        9201061 0 HEPATO PORTAL FLOW DUPLEX SCAN COMPLETE       PROCED     611.59                      93975
PV LAB        9201127 0 RENAL FLOW DUPLEX SCAN LTD                    PROCED     405.22                      93976
PV LAB        9201128 0 MESENTERIC FLOW DUPLEX SCAN LTD               PROCED     405.22                      93976
PV LAB        9201129 0 HEPATO PORTAL FLOW DUPLEX SCAN LTD            PROCED     405.22                      93976
PV LAB        9201111 0 ABD AORTA AND/OR ILIAC ART DUPLEX SCAN COMPLETPROCED     643.14                      93978
PV LAB        9201112 0 VENA CAVA AND/OR ILIAC VEINS DUPLEX SCAN COMPLPROCED     643.14                      93978
PV LAB        9201130 0 ABD AORTA AND/OR ILIAC ART DUPLEX SCAN LTD    PROCED     466.00                      93979
PV LAB        9201131 0 VENA CAVA AND/OR ILIAC VEINS DUPLEX SCAN LTD PROCED      466.00                      93979
PV LAB        9201110 0 DIALYSIS ACCESS DUPLEX SCAN                   PROCED     456.44                      93990
PV LAB        9201056 0 ENDO CT ANGIO AAA PLANNING                    PROCED     1,040.00                    G0288
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area       Serv Cd Type CDM DESCRIPTION                  CATEGORY   OUTPT)          LML/RML     CPT
RAD 3D IMAGING 3501591  0 3D REND PERF ON INDEP WS           PROCED     618.00                      76377
RAD 3D IMAGING 6101638  0 3D REND PERF ON INDEP WS           PROCED     618.00                      76377
RAD CT         3503262 0 CT CARD COR CAL W/O CONT            PROCED     1,851.89                    0144T
RAD CT         3503263 0 CT CARD STRUCT / MORPH W W/O CONT   PROCED     2,120.18                    0145T
RAD CT         3503264 0 CT CARD COR ART W W/O CONT          PROCED     2,320.18                    0146T
RAD CT         3503265 0 CT CARD COR ART W COR CAL           PROCED     2,420.18                    0147T
RAD CT         3503267 0 CT CARD STRUCT / MORPH + COR ART    PROCED     2,420.18                    0148T
RAD CT         3503268 0 CT CARD STR / MOR COR ART COR CAL   PROCED     2,520.18                    0149T
RAD CT         3503269 0 CT CARD STRUCT / MORPH CONG H D     PROCED     2,120.18                    0150T
RAD CT         3503272 0 CT CARD FUNCTIONAL EVAL             PROCED     2,379.61                    0151T
RAD CT         3503281 0 FINE NEEDL ASP W/O IM GD            PROCED     300.15                      10021
RAD CT         3503311 0 FINE NEEDL ASP W/ IM GUIDA          PROCED     623.87                      10022
RAD CT         3503241 0 BONE BIOPSY,NEEDLE SUPERFICIAL      PROCED     411.66                      20220
RAD CT         3503266 0 BONE BIOPSY,NEEDLE VERTEB/DEEP      PROCED     983.88                      20225
RAD CT         3503301 0 ASPIRATION BONE CYST                PROCED     423.33                      20615
RAD CT         3503261 0 THORACENTESIS                       PROCED     471.73                      32000
RAD CT         3501003 0 HEIMLICH CHEST TUBE INSERTION       PROCED     1,078.11                    32002
RAD CT         3503256 0 PLEURA BIOPSY, PERCUT NEEDLE        PROCED     740.34                      32400
RAD CT         3503236 0 LUNG BIOPSY, PERCUT NEEDLE          PROCED     766.35                      32405
RAD CT         3503251 0 LIVER BIOPSY, PERCUT NEEDLE         PROCED     641.50                      47000
RAD CT         3503226 0 BIOPSY PANCREAS                     PROCED     1,014.12                    48102
RAD CT         3503291 0 DRAINAGE,PERITONEAL ABS PERC        PROCED     1,239.30                    49021
RAD CT         3503286 0 DRAINAGE,SUBPHRENIC ABS PERCT       PROCED     736.04                      49041
RAD CT         3503276 0 DRAIN,RETROPERIT ABS PERCUT         PROCED     691.03                      49061
RAD CT         3503271 0 PARACENTESIS, INITIAL               PROCED     558.03                      49080
RAD CT         3503296 0 PARACENTESIS, SUBSEQUENT            PROCED     421.40                      49081
RAD CT         3503297 0 BIOPSY ABD/RETRO PERCUT NEEDLE      PROCED     686.96                      49180
RAD CT         3503306 0 ASPIRATION KIDNEY/PELVIS CYST       PROCED     493.56                      50390
RAD CT         3503246 0 DRAIN,PELVIC/OVARIAN ABS PERCU      PROCED     1,135.76                    58823
RAD CT         3503231 0 ASPIRATION, THYROID CYST            PROCED     168.21                      60001
RAD CT         3503221 0 THYROID BIOPSY, PERCUT NEEDLE       PROCED     339.80                      60100
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                         CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                         CATEGORY   OUTPT)          LML/RML      CPT
RAD CT        3501807 0 INJ LUMB SAC FACET JT SING                 PROCED     585.90                      64475
RAD CT        3502064 0 CT HEAD W/O CONTRAST                       PROCED     961.29                      70450
RAD CT        3502567 0 CT HEAD W/CONTRAST                         PROCED     1,212.71                    70460
RAD CT        3502065 0 CT HEAD W&W/O CONTRAST                     PROCED     1,529.65                    70470
RAD CT        3502822 0 CT ORB SE P/FOS EAR W/OC                   PROCED     1,180.91                    70480
RAD CT        3502827 0 CT ORB SE P/FOS EAR W/CON                  PROCED     1,197.47                    70481
RAD CT        3502815 0 CT HEAD CISTERNOGRAM W & W/O CON           PROCED     1,528.27                    70482
RAD CT        3501068 0 CT ORB SE P/FOS EAR WW/OC                  PROCED     1,528.27                    70482
RAD CT        3502830 0 CT MAXILLOFACIAL W/O CONTRAST              PROCED     1,063.86                    70486
RAD CT        3502004 0 CT TEMPOROMANDIBULAR JOINT                 PROCED     1,063.86                    70486
RAD CT        3504037 0 CT DENTA SCAN COMPLETE                     PROCED     447.80                      7048652
RAD CT        3504036 0 CT DENTA SCAN PLAN                         PROCED     1,063.86                    7048652
RAD CT        3504038 0 CT DENTA SIM-PLANT REFORMAT                PROCED     270.00                      7048652
RAD CT        3502066 0 CT SINUS SCREEN                            PROCED     604.69                      7048652
RAD CT        3502074 0 CT NASOPHARYNX / MAXILLOFACIAL W/ CON      PROCED     1,063.86                    70487
RAD CT        3502807 0 CT NASOPHARYNX / MAXILLOFACIAL W W/O CON   PROCED     1,432.08                    70488
RAD CT        3502824 0 CT NECK S.TISS/PARTID W/O CON              PROCED     1,102.52                    70490
RAD CT        3502073 0 CT LARYNX W/ CONTRAST                      PROCED     772.09                      70491
RAD CT        3502072 0 CT NECK SFT TISS W/CONTRAST                PROCED     1,315.04                    70491
RAD CT        3502835 0 CT LARYNX W&W/O CONTRAST                   PROCED     1,411.52                    70492
RAD CT        3502808 0 CT NECK S.TISS/PARTD,W&W/O CON             PROCED     1,411.52                    70492
RAD CT        3501906 0 CT ANGIO HEAD W W/O CONT                   PROCED     1,529.65                    70496
RAD CT        3501907 0 CT ANGIO NECK W W/O CONT                   PROCED     1,676.00                    70498
RAD CT        3501845 0 CT CHEST LUNG SCREENING                    PROCED     180.00                      71250
RAD CT        3501999 0 CT CHEST LUNG SCRN OCCH                    PROCED     180.00                      71250
RAD CT        3501800 0 CT THORAX W/O CONTRAST                     PROCED     1,233.89                    71250
RAD CT        3501075 0 CT THORAX W/CONTRAST                       PROCED     1,386.02                    71260
RAD CT        3501810 0 CT THORAX W&W/O CONTRAST                   PROCED     1,502.18                    71270
RAD CT        3501904 0 ANGIO CHEST W&W/O CONT                     PROCED     1,803.41                    71275
RAD CT        3502802 0 CT CERVICAL SPINE W/O CON                  PROCED     1,407.07                    72125
RAD CT        3502071 0 CT CERVICAL SP W/CONTRAST                  PROCED     1,553.38                    72126
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
RAD CT        3502812 0 CT CERVICAL SP W&W/O CONT         PROCED     2,106.81                    72127
RAD CT        3502838 0 CT THORACIC SPINE W/O CON         PROCED     1,310.27                    72128
RAD CT        3502069 0 CT THORACIC SP W/CONTRAST         PROCED     1,411.02                    72129
RAD CT        3502839 0 CT THORACIC SP W&W/O CON          PROCED     1,129.60                    72130
RAD CT        3502840 0 CT LUMBAR SPINE W/O CON           PROCED     1,505.93                    72131
RAD CT        3502070 0 CT LUMBAR SP W/CONTRAST           PROCED     1,546.29                    72132
RAD CT        3502841 0 CT LUMBAR SPINE W&W/O CON         PROCED     1,881.36                    72133
RAD CT        3501903 0 ANGIO PELVIS W&W/O CONT           PROCED     1,660.63                    72191
RAD CT        3501803 0 CT PELVIS W/O CONTRAST            PROCED     967.87                      72192
RAD CT        3501076 0 CT PELVIS W/CONTRAST              PROCED     1,333.31                    72193
RAD CT        3501813 0 CT PELVIS W&W/O CONTRAST          PROCED     1,479.72                    72194
RAD CT        3501804 0 CT UPPER EXT W/O CONTRAST         PROCED     1,285.09                    73200
RAD CT        3501080 0 CT UPPER EXT W/CONTRAST           PROCED     1,185.57                    73201
RAD CT        3501814 0 CT UPPER EXTREM W&W/O CON         PROCED     1,144.33                    73202
RAD CT        3501902 0 ANGIO UP EXT W&W/O CONT           PROCED     337.30                      73206
RAD CT        3501843 0 CT LOWER EXT W/O CONTRAST         PROCED     1,213.11                    73700
RAD CT        3501079 0 CT LOWER EXT W/CONTRAST           PROCED     1,222.63                    73701
RAD CT        3501844 0 CT LOWER EXT W/&W/O CONTRAST      PROCED     979.32                      73702
RAD CT        3501901 0 ANGIO LOW EXT W&W/O CONT          PROCED     337.30                      73706
RAD CT        3501801 0 CT ABDOMEN W/O CONTRAST           PROCED     1,205.77                    74150
RAD CT        3501078 0 CT ABDOMEN W/CONTRAST             PROCED     1,348.94                    74160
RAD CT        3501811 0 CT ABDOMEN W&W/O CONTRAST         PROCED     1,835.73                    74170
RAD CT        3501900 0 ANGIO ABDOM W&W/O CONT            PROCED     1,835.73                    74175
RAD CT        3502007 0 ANGIO AB AORTA/RUNOFF W WO CONT   PROCED     1,298.42                    75635
RAD CT        3501905 0 ANGIO AORTA W&W/O CONT            PROCED     1,298.42                    75635
RAD CT        3503206 0 RAD SPVN PERC THB DRAINAGE        PROCED     1,039.56                    75980
RAD CT        3503211 0 RAD SPVN PERC PLCMT DRAIN CATH    PROCED     885.60                      75982
RAD CT        3503216 0 RAD SPVN CHNG PERC DRAIN ABCES    PROCED     678.60                      75984
RAD CT        3503201 0 RAD GUIDANCE,PERC DRAINAGE        PROCED     1,051.92                    75989
RAD CT        3501081 0 CT BONE LENGTH SCANOGRAM          PROCED     267.40                      76040
RAD CT        3502806 0 CT GUIDE STEREOTACTIC LOC         PROCED     1,521.45                    76355
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML     CPT
RAD CT        3503005 0 CT GUIDANCE,NERVE BLOCK                           PROCED     1,459.43                    76360
RAD CT        3503831 0 GUIDANCE NEEDLE PLACEMENT                         PROCED     1,459.43                    76360
RAD CT        3501806 0 GUIDANCE VIS TISS ABLATION                        PROCED     1,459.43                    76362
RAD CT        3501805 0 CT RAD THERAPY PLAN                               PROCED     571.67                      76370
RAD CT        3501590 0 3D RENDERING PERF ON SCANNER                      PROCED     618.00                      76376
RAD CT        3503826 0 CT LTD OR FOLLOW-UP STUDY                         PROCED     458.96                      76380
RAD CT        3503827 0 CREATININE, ISTAT (ICR)                           PROCED     40.40                       82565
RAD CT        3503596 0 CT CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 30 MIN PROCED      170.00                      99143
RAD CT        3503597 0 CT CONSCIOUS SEDATION SAME MD 5 Y/O & ABV 1ST 30 PROCED      170.00                      99144
RAD CT        3503598 0 CT CONSCIOUS SEDATION SAME MD EA ADDL 15 MIN PROCED          85.00                       99145
RAD CT        3503599 0 CT CONSCIOUS SEDATION DIFF MD < 5 Y/O 1ST 30 MIN PROCED      170.00                      99148
RAD CT        3503600 0 CT CONSCIOUS SEDATION DIFF MD 5 Y/O & ABV 1ST 30 MPROCED     170.00                      99149
RAD CT        3503601 0 CT CONSCIOUS SEDATION DIFF MD EA ADDL 15 MIN      PROCED     85.00                       99150
RAD CT        3503010 0 AMPLATZ SUPER STIFF GUIDEWIRE                     SUPPLY     78.25                       C1769
RAD CT        3502009 0 GUIDEWIRE TEFLON 80 CM                            SUPPLY     67.52                       C1769
RAD CT        3503592 0 CONTRAST 240 MG IODINE/ML - 1 ML INJ              SUPPLY     2.00                        Q9947
RAD CT        3503595 0 VISIPAQUE 270 MG IODINE/ML - 1 ML INJ             SUPPLY     1.26                        Q9948
RAD CT        3503593 0 CONTRAST 300 MG IODINE/ML - 1 ML INJ              SUPPLY     2.25                        Q9949
RAD CT        3503603 0 VISIPAQUE 320 MG IODINE / ML 1 ML INJ             SUPPLY     1.40                        Q9949
RAD CT        3503594 0 CONTRAST 350 MG IODINE/ML - 1 ML INJ              SUPPLY     2.25                        Q9950
RAD CT        3503008 0 ALL PURPOSE DRAINAGE CATHETER                     SUPPLY     222.38
RAD CT        3503012 0 BULB SUCTION DEVICE                               SUPPLY     41.48
RAD CT        3503006 0 CHEST DRAINAGE CATHETER                           SUPPLY     222.38
RAD CT        3501001 0 CT 150ML PRSS SYRING                              SUPPLY     32.75
RAD CT        3503062 0 CT ASPIR BIOP NEEDLE                              SUPPLY     27.81
RAD CT        3503060 0 CT COAXIAL BIOP NDLE                              SUPPLY     52.22
RAD CT        3503059 0 CT CORE BIOP NDLE KIT                             SUPPLY     75.81
RAD CT        3503061 0 CT CORE BIOP NDLE/GN                              SUPPLY     30.39
RAD CT        3503007 0 CT DRAINAGE BAG                                   SUPPLY     29.15
RAD CT        3503202 0 CT GUIDED GRID MARKERS                            SUPPLY     17.15
RAD CT        3502006 0 DILATOR VESSEL 38 CM                              SUPPLY     14.85
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                             CATEGORY   OUTPT)          LML/RML      CPT
RAD CT        3503602 0 FIDUCIAL SURGICAL MARKERS                      SUPPLY     12.00
RAD CT        3501002 0 HEIMLICH CHEST DRAIN                           SUPPLY     222.38
RAD CT        3502008 0 LOCKING SYRINGE 10 CC                          SUPPLY     12.98
RAD CT        3503063 0 POWERLOC INFUSION NEEDLE 20G                   SUPPLY     27.73
RAD CT        3503009 0 VIT HEAD SET, DISPOSABLE                       SUPPLY     78.80
RAD CT        3503011 0 Y CONNECTOR                                    SUPPLY     30.80
RAD DIAG      3203237 0 INJ SINUS TRACT                                PROCED     171.36                       20501
RAD DIAG      3201042 0 INJ SING TENDON SHEATH OR LIG                  PROCED     201.00                       20550
RAD DIAG      3201043 0 INJ SING TENDON ORIGIN / INSERTION             PROCED     296.28                       20551
RAD DIAG      3201044 0 TRIGGER POINT INJ 1-2 MUSC SING / MULT         PROCED     189.00                       20552
RAD DIAG      3201045 0 TRIGGER POINT INJ 3 OR MORE MUSC SING / MULT   PROCED     270.54                       20553
RAD DIAG      3203238 0 INJ IMAG GUIDANC MAJOR JOINT                   PROCED     249.60                       20610
RAD DIAG      3203240 0 INJ SHOULDER ARTHROGRAM BILAT                  PROCED     200.00                      2335050
RAD DIAG      3203242 0 INJ SHOULDER ARTHROGRAM LT                     PROCED     162.20                      23350LT
RAD DIAG      3203241 0 INJ SHOULDER ARTHROGRAM RT                     PROCED     162.20                      23350RT
RAD DIAG      3208012 0 INJ HIP ARTHROGRAM BILAT                       PROCED     200.00                      2709350
RAD DIAG      3208014 0 INJ HIP ARTHROGRAM LT                          PROCED     118.14                      27093LT
RAD DIAG      3208013 0 INJ HIP ARTHROGRAM RT                          PROCED     118.14                      27093RT
RAD DIAG      3213486 0 CONTRAST VENOGRAPHY INJECTION                  PROCED     267.10                       36005
RAD DIAG      3208368 0 INJECTION CYSTOGRAM OR VOIDING                 PROCED     247.49                       51600
RAD DIAG      3208367 0 INJECTION AND PLACEMENT CONTRS                 PROCED     1,958.04                     51605
RAD DIAG      3208366 0 INJ PROC RETRO URETHROCYSTO                    PROCED     406.62                       51610
RAD DIAG      3213393 0 CONT INJ HYSTEROSALPINGOGRAPH                  PROCED     299.42                       58340
RAD DIAG      3216011 0 LUMBAR PUNCTURE THER DRNGE CSF                 PROCED     303.93                       62272
RAD DIAG      3216001 0 INJECTION PROC MYELOGRAM                       PROCED     423.11                       62284
RAD DIAG      3201015 0 XRAY MANDIBLE >/=4 VWS                         PROCED     253.80                       70110
RAD DIAG      3201020 0 XRAY MASTOIDS BILATERAL                        PROCED     276.54                       70130
RAD DIAG      3201027 0 XRAY FACIAL BONE < 3 VIEWS                     PROCED     209.70                       70140
RAD DIAG      3201026 0 XRAY FACIAL BONE, >/=3 VIEWS                   PROCED     275.80                       70150
RAD DIAG      3201030 0 XRAY NASAL BONE, >/=3 VIEWS                    PROCED     183.03                       70160
RAD DIAG      3201041 0 XRAY ORBITS, >/= 4 VIEWS                       PROCED     270.21                       70200
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML      CPT
RAD DIAG      3201051 0 XRAY SINUSES < 3 VIEWS           PROCED     191.37                       70210
RAD DIAG      3201050 0 XRAY SINUS PARANASAL >/=3 VIEW   PROCED     274.48                       70220
RAD DIAG      3201056 0 XRAY SKULL < 4 VIEWS             PROCED     199.20                       70250
RAD DIAG      3201062 0 XRAY SKULL >/= 4 VIEWS           PROCED     274.35                       70260
RAD DIAG      3201071 0 XRAY TMJ BILATERAL               PROCED     293.22                       70330
RAD DIAG      3201313 0 XRAY PANOREX                     PROCED     158.54                       70355
RAD DIAG      3201077 0 XRAY NECK SOFT TISS 2 VIEW       PROCED     200.64                       70360
RAD DIAG      3202101 0 XRAY CHEST 1 VIEW PA             PROCED     150.95                       71010
RAD DIAG      3202103 0 XRAY CHEST 1 VIEW PA PORTABLE    PROCED     215.27                       71010
RAD DIAG      3202998 0 CHEST 1 VIEW PA - OCCH           PROCED     150.95                       71010
RAD DIAG      3202102 0 XRAY CHEST 2 VIEW                PROCED     162.10                       71020
RAD DIAG      3202999 0 CHEST 2 VIEW OCCH                PROCED     162.10                       71020
RAD DIAG      3202104 0 XRAY CHEST 2 VIEWS W/OBL         PROCED     185.40                       71022
RAD DIAG      3202109 0 XRAY CHEST 1 VIEW LORD           PROCED     145.13                       71035
RAD DIAG      3202113 0 XRAY CHEST 1 VIEW DECUB          PROCED     145.13                       71035
RAD DIAG      3202149 0 XRAY RIBS LT UNILAT > 2 VIEWS    PROCED     248.40                      71101LT
RAD DIAG      3202150 0 XRAY RIBS RT UNILAT > 2 VIEWS    PROCED     248.40                      71101RT
RAD DIAG      3202151 0 XRAY RIBS BILAT, >/= 4 VIEWS     PROCED     379.08                       71111
RAD DIAG      3202170 0 XRAY STERNUM, >/=2 VIEWS         PROCED     208.27                       71120
RAD DIAG      3204175 0 XRAY STERNOCLAVICULAR JTS        PROCED     185.83                       71130
RAD DIAG      3203201 0 XRAY SPINE 1 VIEW                PROCED     173.15                       72020
RAD DIAG      3203209 0 XRAY SPINE THOR/LUMB 1 VIEW      PROCED     173.15                       72020
RAD DIAG      3203203 0 XRAY SPINE CERVICAL 2 VW         PROCED     196.81                       72040
RAD DIAG      3203205 0 XRAY SPINE CERVICAL >/= 4 VW     PROCED     301.75                       72050
RAD DIAG      3203206 0 XRAY SPINE CERVICAL 3 VIEWS      PROCED     301.75                      7205052
RAD DIAG      3203207 0 XRAY SPINE CERV.COMPL W/FE       PROCED     281.40                       72052
RAD DIAG      3203212 0 SPINE THORACIC-2VW               PROCED     196.32                       72070
RAD DIAG      3203210 0 XRAY SPINE THORACIC AP/LAT SWI   PROCED     251.93                       72072
RAD DIAG      3203208 0 XRAY SPINE THOR/LUMB 2 VIEWS     PROCED     199.21                       72080
RAD DIAG      3203216 0 XRAY SCOLIOSIS SERIES            PROCED     276.64                       72090
RAD DIAG      3203217 0 XRAY SPINE < 4 VIEWS             PROCED     203.22                       72100
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION               CATEGORY   OUTPT)          LML/RML      CPT
RAD DIAG      3203221 0 XRAY SPINE LUMBOSACRAL 5VW       PROCED     316.48                       72110
RAD DIAG      3203229 0 XRAY PELVIS 1 VIEW AP            PROCED     184.27                       72170
RAD DIAG      3203234 0 PELVIS >= 3 VIEWS                PROCED     322.39                       72190
RAD DIAG      3203235 0 XRAY SACROILIAC JTS 3 VW         PROCED     224.36                       72202
RAD DIAG      3203225 0 XRAY SACRUM/COCCYX 2 VIEW        PROCED     212.54                       72220
RAD DIAG      3216003 0 XRAY MYELOGRAM CERVICAL          PROCED     888.27                       72240
RAD DIAG      3216004 0 XRAY MYELOGRAM THORACIC          PROCED     785.17                       72255
RAD DIAG      3216005 0 XRAY MYELOGRAM LUMBAR            PROCED     763.77                       72265
RAD DIAG      3216006 0 XRAY MYELOGRAM COMPLETE SPINE    PROCED     1,232.28                     72270
RAD DIAG      3204253 0 XRAY CLAVICLE BILAT COMPL 2 VW   PROCED     187.51                      7300050
RAD DIAG      3204251 0 XRAY CLAVICLE LT COMPLT 2 VW     PROCED     187.51                      73000LT
RAD DIAG      3204250 0 XRAY CLAVICLE RT COMPLT 2VW      PROCED     187.51                      73000RT
RAD DIAG      3204263 0 XRAY SCAPULA BILAT COMPL 2 VW    PROCED     179.32                      7301050
RAD DIAG      3204256 0 XRAY SCAPULA LT COMPLT 2 VW      PROCED     179.32                      73010LT
RAD DIAG      3204255 0 XRAY SCAPULA RT COMPLT 2 VW      PROCED     179.32                      73010RT
RAD DIAG      3204264 0 XRAY SHOULDER BILAT 1 VW         PROCED     141.32                      7302050
RAD DIAG      3204261 0 XRAY SHOULDER LT 1 VW            PROCED     141.32                      73020LT
RAD DIAG      3204260 0 XRAY SHOULDER RT 1 VIEW          PROCED     141.32                      73020RT
RAD DIAG      3204266 0 XRAY SHOULDER BILAT > 1 VW       PROCED     208.27                      7303050
RAD DIAG      3204258 0 XRAY SHOULDER LT > 1 VW          PROCED     208.27                      73030LT
RAD DIAG      3204259 0 XRAY SHOULDER RT > 1 VW          PROCED     208.27                      73030RT
RAD DIAG      3216014 0 ARTHROGRAM BILAT SHOULDER        PROCED     526.30                      7304050
RAD DIAG      3216012 0 ARTHROGRAM LT SHOULDER           PROCED     526.30                      73040LT
RAD DIAG      3216007 0 ARTHROGRAM RT SHOULDER           PROCED     526.30                      73040RT
RAD DIAG      3204265 0 XRAY AC JOINTS BILATERAL         PROCED     227.99                       73050
RAD DIAG      3204279 0 XRAY HUMERUS BILAT 2 VW          PROCED     174.98                      7306050
RAD DIAG      3204271 0 XRAY HUMERUS LT 2 VW             PROCED     174.98                      73060LT
RAD DIAG      3204270 0 XRAY HUMERUS RT 2 VW             PROCED     174.98                      73060RT
RAD DIAG      3204299 0 XRAY ELBOW BILAT 2 VW            PROCED     150.07                      7307050
RAD DIAG      3204277 0 XRAY ELBOW LT 2 VW               PROCED     150.07                      73070LT
RAD DIAG      3204276 0 XRAY ELBOW RT 2 VW               PROCED     150.07                      73070RT
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML      CPT
RAD DIAG      3204323 0 XRAY ELBOW BILAT 3 VW                PROCED     164.85                      7308050
RAD DIAG      3204274 0 XRAY ELBOW LT 3 VW                   PROCED     164.85                      73080LT
RAD DIAG      3204275 0 XRAY ELBOW RT 3 VW                   PROCED     164.85                      73080RT
RAD DIAG      3204324 0 XRAY FOREARM BILAT 2 VW              PROCED     161.93                      7309050
RAD DIAG      3204281 0 XRAY FOREARM LT 2 VW                 PROCED     161.93                      73090LT
RAD DIAG      3204280 0 XRAY FOREARM RT 2 VW                 PROCED     161.93                      73090RT
RAD DIAG      3204325 0 XRAY UP EXT BILAT 2 VW INF / CHILD   PROCED     146.26                      7309250
RAD DIAG      3204321 0 XRAY UP EXT LT 2 VW INF / CHILD      PROCED     146.26                      73092LT
RAD DIAG      3204320 0 XRAY UP EXT RT 2 VW INF / CHILD      PROCED     146.26                      73092RT
RAD DIAG      3204326 0 XRAY WRIST BILAT 2 VW                PROCED     152.75                      7310050
RAD DIAG      3204284 0 XRAY WRIST LT 2 VW                   PROCED     152.75                      73100LT
RAD DIAG      3204285 0 XRAY WRIST RT 2 VW                   PROCED     152.75                      73100RT
RAD DIAG      3204327 0 XRAY WRIST BILAT > 2 VW              PROCED     166.55                      7311050
RAD DIAG      3204287 0 XRAY WRIST LT > 2 VW                 PROCED     166.55                      73110LT
RAD DIAG      3204286 0 XRAY WRIST RT > 2 VW                 PROCED     166.55                      73110RT
RAD DIAG      3204328 0 XRAY HAND BILAT 2 VW                 PROCED     131.12                      7312050
RAD DIAG      3204292 0 XRAY HAND LT 2 VW                    PROCED     131.12                      73120LT
RAD DIAG      3204291 0 XRAY HAND RT 2 VW                    PROCED     131.12                      73120RT
RAD DIAG      3204329 0 XRAY HAND BILAT > 2 VW               PROCED     166.99                      7313050
RAD DIAG      3204289 0 XRAY HAND LT > 2 VW                  PROCED     166.99                      73130LT
RAD DIAG      3204290 0 XRAY HAND RT > 2 VW                  PROCED     166.99                      73130RT
RAD DIAG      3204330 0 XRAY FINGER(S) BILAT 2 VW            PROCED     128.54                      7314050
RAD DIAG      3204296 0 XRAY FINGER(S) LT 2 VW               PROCED     128.54                      73140LT
RAD DIAG      3204300 0 XRAY FINGER(S) RT 2 VW               PROCED     128.54                      73140RT
RAD DIAG      3205302 0 XRAY HIP LT 1 VW                     PROCED     129.83                      73500LT
RAD DIAG      3205300 0 XRAY HIP RT 1 VW                     PROCED     129.83                      73500RT
RAD DIAG      3205303 0 XRAY HIPLT 2 VW                      PROCED     188.07                      73510LT
RAD DIAG      3205301 0 XRAY HIP RT 2 VW                     PROCED     188.07                      73510RT
RAD DIAG      3203233 0 XRAY HIP BILAT 2 VW W/ AP PELVIS     PROCED     234.05                       73520
RAD DIAG      3207551 0 FLUORO HIPPINNING                    PROCED     270.00                       73530
RAD DIAG      3205349 0 PELVIS / HIP 2 VW INF / CHILD        PROCED     196.83                       73540
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                 CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                 CATEGORY   OUTPT)          LML/RML      CPT
RAD DIAG      3205352 0 XRAY FEMUR BILAT 2 VW              PROCED     203.14                      7355050
RAD DIAG      3205305 0 XRAY FEMUR LT 2 VW                 PROCED     203.14                      73550LT
RAD DIAG      3205304 0 XRAY FEMUR RT 2 VW                 PROCED     203.14                      73550RT
RAD DIAG      3205353 0 XRAY PATELLA BILAT 1-2 VW          PROCED     171.90                      7356050
RAD DIAG      3205354 0 XRAY KNEE BILAT 1-2 VW             PROCED     171.90                      7356050
RAD DIAG      3205312 0 XRAY KNEE LT 1-2 VW                PROCED     171.90                      73560LT
RAD DIAG      3205313 0 XRAY PATELLA LT 1-2 VW             PROCED     171.90                      73560LT
RAD DIAG      3205306 0 XRAY KNEE RT 1-2 VW                PROCED     171.90                      73560RT
RAD DIAG      3205311 0 XRAY PATELLA RT 1-2 VW             PROCED     171.90                      73560RT
RAD DIAG      3205355 0 XRAY KNEE BILAT 3 VW               PROCED     193.03                      7356250
RAD DIAG      3205308 0 XRAY KNEE LT 3 VW                  PROCED     193.03                      73562LT
RAD DIAG      3205307 0 XRAY KNEE RT 3 VW                  PROCED     193.03                      73562RT
RAD DIAG      3205356 0 XRAY KNEE BILAT 4 VW               PROCED     257.56                      7356450
RAD DIAG      3205216 0 XRAY KNEE LT 4 VW                  PROCED     257.56                      73564LT
RAD DIAG      3205215 0 XRAY KNEE RT 4 VW                  PROCED     257.56                      73564RT
RAD DIAG      3205293 0 XRAY KNEE 1 VW AP / STAND          PROCED     156.06                       73565
RAD DIAG      3205358 0 XRAY TIB / FIB BILAT 2 VW          PROCED     162.20                      7359050
RAD DIAG      3205315 0 XRAY TIB / FIB LT 2 VW             PROCED     162.20                      73590LT
RAD DIAG      3205316 0 XRAY TIB / FIB RT 2 VW             PROCED     162.20                      73590RT
RAD DIAG      3205359 0 LOWER EXT 2 VW INF / CHILD BILAT   PROCED     221.00                      7359250
RAD DIAG      3205340 0 LOWER EXT 2VW INF/CHILD LT         PROCED     221.00                      73592LT
RAD DIAG      3205341 0 LOWER EXT 2VW INF/CHILD RT         PROCED     221.00                      73592RT
RAD DIAG      3205360 0 XRAY ANKLE BILAT 2 VW              PROCED     152.75                      7360050
RAD DIAG      3205317 0 XRAY ANKLE LT 2 VW                 PROCED     152.75                      73600LT
RAD DIAG      3205318 0 XRAY ANKLE RT 2 VW                 PROCED     152.75                      73600RT
RAD DIAG      3205361 0 XRAY ANKLE BILAT 3 VW              PROCED     176.16                      7361050
RAD DIAG      3205320 0 XRAY ANKLE LT 3 VW                 PROCED     176.16                      73610LT
RAD DIAG      3205319 0 XRAY ANKLE RT 3 VW                 PROCED     176.16                      73610RT
RAD DIAG      3205362 0 XRAY FOOT BILAT 2 VW               PROCED     156.46                      7362050
RAD DIAG      3205363 0 XRAY FOOT BILAT 2 VW STANDING      PROCED     153.73                      7362050
RAD DIAG      3205217 0 XRAY FOOT LT 2 VW STANDING         PROCED     153.73                      73620LT
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML      CPT
RAD DIAG      3205323 0 XRAY FOOT LT 2 VW                 PROCED     156.46                      73620LT
RAD DIAG      3205214 0 XRAY FOOT RT 2 VW STANDING        PROCED     153.73                      73620RT
RAD DIAG      3205321 0 XRAY FOOT RT 2 VW                 PROCED     156.46                      73620RT
RAD DIAG      3205364 0 XRAY FOOT BILAT 3 VW              PROCED     169.50                      7363050
RAD DIAG      3205326 0 XRAY FOOT LT 3 VW                 PROCED     169.50                      73630LT
RAD DIAG      3205322 0 XRAY FOOT RT 3 VW                 PROCED     169.50                      73630RT
RAD DIAG      3205365 0 XRAY CALCANEOUS BILAT < 3 VW      PROCED     156.96                      7365050
RAD DIAG      3205329 0 XRAY CALCANEOUS LT < 3 VW         PROCED     156.96                      73650LT
RAD DIAG      3205325 0 XRAY CALCANEOUS RT < 3 VW         PROCED     156.96                      73650RT
RAD DIAG      3205366 0 XRAY TOE(S) BILAT 2 VW            PROCED     152.75                      7366050
RAD DIAG      3205345 0 XRAY TOE(S) LT 2 VW               PROCED     152.75                      73660LT
RAD DIAG      3205330 0 XRAY TOE(S) RT 2 VW               PROCED     152.75                      73660RT
RAD DIAG      3206330 0 XRAY ABDOMEN 1 VIEW               PROCED     168.06                       74000
RAD DIAG      3206333 0 XRAY ABDOMEN 3 VW AP/OBLIQ/CONE   PROCED     238.75                       74010
RAD DIAG      3206331 0 XRAY ABDOMEN 2 VIEW               PROCED     252.10                       74020
RAD DIAG      3206332 0 XRAY ACUTE ABD SERIES             PROCED     295.60                       74022
RAD DIAG      3207336 0 ESOPHAGRAM                        PROCED     350.61                       74220
RAD DIAG      3207826 0 XRAY ESOPH VIDEO/FLUORO           PROCED     357.18                       74230
RAD DIAG      3216008 0 GI UPPER STOMACH W/O KUB          PROCED     378.45                       74240
RAD DIAG      3207346 0 GI UPPER STOMACH W/ KUB           PROCED     375.00                       74241
RAD DIAG      3207337 0 GI UPPER STOMACH AIR W/O KUB      PROCED     422.28                       74246
RAD DIAG      3207347 0 GI UPPER STOMACH AIR W/ KUB       PROCED     425.00                       74247
RAD DIAG      3207339 0 GI UPPER W SM BOWEL               PROCED     647.03                       74249
RAD DIAG      3207341 0 GI SMALL BOWEL                    PROCED     379.81                       74250
RAD DIAG      3207345 0 XRAY GI BARIUM ENEMA              PROCED     409.59                       74270
RAD DIAG      3207344 0 GI BARIUM ENEMA, AIR              PROCED     526.29                       74280
RAD DIAG      3207356 0 THERAPEUTIC ENEMA                 PROCED     290.40                       74283
RAD DIAG      3207349 0 XRAY CHOLECYSTO ORAL GB           PROCED     94.75                        74290
RAD DIAG      3211350 0 XRAY CHOLANGIOGRAM INTRAOP        PROCED     397.89                       74300
RAD DIAG      3216009 0 XRAY ADDL SURGICAL, CHOLANGIO     PROCED     157.59                       74301
RAD DIAG      3207351 0 CHOLANGIO T-TUBE- POST OP         PROCED     290.36                       74305
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML      CPT
RAD DIAG      3207825 0 XRAY ENTEROCLYSIS                                 PROCED     1,582.18                     74355
RAD DIAG      3208363 0 XRAY IVP W/O TOMOGRAPHY                           PROCED     427.59                       74400
RAD DIAG      3208398 0 XRAY IVP W/ TOMOGRAPHY                            PROCED     567.72                       74415
RAD DIAG      3211367 0 RETROGRADE PYELOGRAM                              PROCED     406.93                       74420
RAD DIAG      3208364 0 UROGRAPHY ANTEGRADE                               PROCED     524.60                       74425
RAD DIAG      3208369 0 XRAY CYSTOGRAM                                    PROCED     444.03                       74430
RAD DIAG      3208371 0 XRAY URETHROCYSTO RETRO                           PROCED     384.70                       74450
RAD DIAG      3208372 0 XRAY CYSTOURETHRO VOIDING                         PROCED     380.00                       74455
RAD DIAG      3213392 0 XRAY HYSTEROSALPINGOGRAM                          PROCED     1,303.57                     74740
RAD DIAG      3213487 0 VENOGRAM EXT UNILAT LT                            PROCED     887.30                      75820LT
RAD DIAG      3213484 0 VENOGRAM EXT UNILAT RT                            PROCED     887.30                      75820RT
RAD DIAG      3213485 0 XRAY VENOGRAM EXTREMITY BILAT                     PROCED     985.20                       75822
RAD DIAG      3207550 0 FLUOROSCOPY 0-60 MIN                              PROCED     350.00                       76000
RAD DIAG      3216010 0 FLUOROSCOPY 1-2 HRS                               PROCED     574.66                       76001
RAD DIAG      3216015 0 FLUOROSCOPY 2-4 HRS                               PROCED     574.66                       76001
RAD DIAG      3216016 0 FLUOROSCOPY 4-6 HRS                               PROCED     574.66                       76001
RAD DIAG      3216017 0 FLUOROSCOPY 6-8 HRS                               PROCED     574.66                       76001
RAD DIAG      3207884 0 FLUORO GUID NDLE PLCMT (BX, ASP, JOINT INJ, LOC DEV
                                                                          PROCED     342.09                       76003
RAD DIAG      3203202 0 FLUORO VERTEBRAL LOCALIZATION                     PROCED     452.00                       76005
RAD DIAG      3205344 0 STRESS VIEW OF ANY JOINT                          PROCED     150.66                       76006
RAD DIAG      3209554 0 XRAY SURVEY BONE AGE                              PROCED     191.50                       76020
RAD DIAG      3205328 0 BONE LENGTH SCANOGRAM                             PROCED     267.37                       76040
RAD DIAG      3209555 0 XRAY SURVEY BONE LENGTH                           PROCED     267.37                       76040
RAD DIAG      3205346 0 XRAY SURVEY BONE LONG                             PROCED     422.93                       76061
RAD DIAG      3209557 0 XRAY SURVEY BONE, COMPLETE                        PROCED     562.09                       76062
RAD DIAG      3209017 0 XRAY SURVEY SKELETAL-PED                          PROCED     83.26                        76065
RAD DIAG      3209556 0 XRAY SURVEY ARTHRITIS                             PROCED     215.30                       76066
RAD DIAG      3205310 0 XRAY KNEE RT 1 VW TUNNEL                          PROCED     215.30                      76066RT
RAD DIAG      3207563 0 XRAY FISTULAGRAM                                  PROCED     404.61                       76080
RAD DIAG      3208833 0 XRAY NEPHROTOMOGRAMS                              PROCED     398.52                       76100
RAD DIAG      3214533 0 XRAY TOMOGRAPY SINGLE PLANE                       PROCED     366.37                       76101
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                                CHARGE        PRICE (INPT /    LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                 CATEGORY      OUTPT)           LML/RML    CPT
RAD DIAG      3204331 0 RAD DIAG CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 3  PROCED        170.00                      99143
RAD DIAG      3204332 0 RAD DIAG CONSCIOUS SEDATION SAME MD 5 Y/O & ABVPROCED            170.00                      99144
RAD DIAG      3204333 0 RAD DIAG CONSCIOUS SEDATION SAME MD EA ADDL 15 PROCED            85.00                       99145
RAD DIAG      3204334 0 RAD DIAG CONSCIOUS SEDATION DIFF MD < 5 Y/O 1ST 30PROCED         170.00                      99148
RAD DIAG      3204335 0 RAD DIAG CONSCIOUS SEDATION DIFF MD 5 Y/O & ABV PROCED           170.00                      99149
RAD DIAG      3204336 0 RAD DIAG CONSCIOUS SEDATION DIFF MD EA ADDL 15 M   PROCED        85.00                       99150
RAD DIAG      3202172 0 INJ PROC SACROILIAC JOINT W/ ANES                  PROCED        337.00                      G0260
RAD DIAG      3212022 0 NONIONIC CONTRAST 180 MG IODINE/ML - 1 ML INJ      SUPPLY        9.96                        Q9946
RAD DIAG      3212023 0 NONIONIC CONTRAST 300 MG IODINE/ML - 1 ML INJ      SUPPLY        3.52                        Q9949
RAD DIAG      3202171 0 INJ HIP ARTHROGRAPHY W/ ANES                       PROCED        337.00
RAD DIAG      3212021 0 XRAY ADDL SUPPLIES                                 SUPPLY        27.81
RAD DIAG      3207342 2 ERCP - GI LAB                                      PROCED        STATISTICAL ITEM
RAD DIAG      3210601 2 XRAY PORTABLE SURGICAL                             PROCED        STATISTICAL ITEM
RAD INTERVENT 3260114  0 BLOOD DRAW VENIPUNCTURE                           PROCED        19.69                       36415
RAD INTERVENT 3260111  0 BLOOD DRAW IMPLANTABLE VAD                        PROCED        91.26                       36540
RAD INTERVENT 3260112  0 DECLOT VAD BY THROMBOLYTIC AGNT                   PROCED        293.00                      36550
RAD INTERVENT 3260113  0 REMOVE TUNLD CVC W/O PORT/PUMP                    PROCED        514.00                      36589
RAD INTERVENT 3260108  0 CATHETERIZATN URETH STRAIGHT CATH                 PROCED        50.00                       51701
RAD INTERVENT 3260109  0 CATHETERIZATN URETH INDWELL FOLEY SIMPLE          PROCED        137.06                      51702
RAD INTERVENT 3260117  0 URINALYSIS DIP                                                  28.20
                                                                           WAIVED TEST DON                           81002
RAD INTERVENT 3260116  0 CREATININE ISTAT (ICR)                            PROCED        40.40                       82565
RAD INTERVENT 3260115  0 BLOOD GLUCOSE ACCUCHECK                                         23.37
                                                                           WAIVED TEST DON                           82962
RAD INTERVENT 3260100  0 INT CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 30 MIN PROCED        170.00                      99143
RAD INTERVENT 3260101  0 INT CONSCIOUS SEDATION SAME MD 5 Y/O & ABV 1ST 30PROCED         170.00                      99144
RAD INTERVENT 3260102  0 INT CONSCIOUS SEDATION SAME MD EA ADDL 15 MIN PROCED            85.00                       99145
RAD INTERVENT 3260103  0 INT CONSCIOUS SEDATION DIFF MD < 5 Y/O 1ST 30 MIN PROCED        170.00                      99148
RAD INTERVENT 3260104  0 INT CONSCIOUS SEDATION DIFF MD 5 Y/O & ABV 1ST 30 M
                                                                           PROCED        170.00                      99149
RAD INTERVENT 3260105  0 INT CONSCIOUS SEDATION DIFF MD EA ADDL 15 MIN     PROCED        85.00                       99150
RAD INTERVENT 3260120  0 EST LEVEL I 0-15 MIN                              LOC           40.00                       99211
RAD INTERVENT 3260118  0 INFUSION THER NON CHEMO 1ST HR                    PROCED        236.00                      C8950
RAD INTERVENT 3260119  0 INFUSION THER NON-CHEMO EA ADDL HR                PROCED        142.00                      C8951
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                            CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML     CPT
RAD INTERVENT 3260110  0 CATHETERIZATN URETH FOR COLLECTION OF SPEC   PROCED     67.70                       P9612
RAD INTERVENT 3260106  0 INT OBS RECOVERY 1ST 30 MIN                  PROCED     200.00
RAD INTERVENT 3260107  0 INT OBS RECOVERY EA ADDL 15 MIN              PROCED     20.00
RAD MRI       6101499 0 MR SCAN TMJ                                   PROCED     1,558.08                    70336
RAD MRI       6101503 0 MR ORBIT/FACE NEC W/O CON                     PROCED     1,658.10                    70540
RAD MRI       6101607 0 MR ORBIT/FACE NEC W&W/O CON                   PROCED     2,162.91                    70543
RAD MRI       6101608 0 MR HEAD VASC MRA W/O CON                      PROCED     1,482.83                    70544
RAD MRI       6101609 0 MR HEAD VASC MRA W/CON                        PROCED     1,644.50                    70545
RAD MRI       6101610 0 MR HEAD VASC MRA W&W/O CON                    PROCED     2,033.46                    70546
RAD MRI       6101611 0 MR NECK VASC MRA W/O CON                      PROCED     1,644.50                    70547
RAD MRI       6101612 0 MR NECK VASC MRA W/CON                        PROCED     1,880.90                    70548
RAD MRI       6101613 0 MR NECK VASC MRA W&W/O CON                    PROCED     1,892.32                    70549
RAD MRI       6101497 0 MR SCAN BRAIN/HEAD WO/CONT                    PROCED     1,704.33                    70551
RAD MRI       6101701 0 MR STEREOTACTIC SURGICAL PLAN                 PROCED     1,761.50                    70552
RAD MRI       6101541 0 MR SCAN BRAIN-W/CONTRAST                      PROCED     1,761.50                    70552
RAD MRI       6101496 0 MR SCREENING IAC W/WO CON                     PROCED     2,810.59                    70553
RAD MRI       6101542 0 MR SCAN BRAIN-W/WO CONT                       PROCED     2,810.59                    70553
RAD MRI       6101543 0 MR SCAN CPA/IAC-W/WO CONT                     PROCED     2,810.59                    70553
RAD MRI       6101545 0 MR SCAN SELLA/PIT-W/WO CO                     PROCED     2,810.59                    70553
RAD MRI       6101518 0 MR CHEST/MEDIAST W/O CON                      PROCED     1,676.70                    71550
RAD MRI       6101614 0 MR CHEST/MEDIAST W/CON                        PROCED     1,996.92                    71551
RAD MRI       6101615 0 MR CHEST/MEDIAST W&W/O CON                    PROCED     2,125.44                    71552
RAD MRI       6101510 0 MR SCAN SPINE CERV-WO/CON                     PROCED     1,765.74                    72141
RAD MRI       6101558 0 MR SCAN SPINE CERV-W/CONT                     PROCED     1,981.70                    72142
RAD MRI       6101511 0 MR SCAN SPINE THOR-WO/CON                     PROCED     1,766.85                    72146
RAD MRI       6101560 0 MR SCAN SPINE THOR-W/CONT                     PROCED     1,931.99                    72147
RAD MRI       6101512 0 MR SCAN SPINE LUMB-WO/CON                     PROCED     1,787.67                    72148
RAD MRI       6101562 0 MR SCAN SPINE LUMB-W/CONT                     PROCED     1,899.78                    72149
RAD MRI       6101559 0 MR SCAN SPINE CERV-W/WO C                     PROCED     2,812.62                    72156
RAD MRI       6101561 0 MR SCAN SPINE THOR-W/WO C                     PROCED     2,812.62                    72157
RAD MRI       6101563 0 MR SCAN SPINE LUMB-W/WO C                     PROCED     2,810.59                    72158
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY   OUTPT)          LML/RML     CPT
RAD MRI       6101570 0 MR SCAN SPINAL MRA                               PROCED     1,405.29                    72159
RAD MRI       6101616 0 MR SCAN PELVIS/HIP W/O CON                       PROCED     1,647.52                    72195
RAD MRI       6101526 0 MR SCAN PELVIS/HIP W/CON                         PROCED     1,528.34                    72196
RAD MRI       6101617 0 MR SCAN PELVIS/HIP W&W/O CON                     PROCED     2,117.62                    72197
RAD MRI       6101618 0 MR UPPER EXTREMITY W/O CON                       PROCED     1,686.42                    73218
RAD MRI       6101619 0 MR UPPER EXTREMITY W/CON                         PROCED     2,063.88                    73219
RAD MRI       6101534 0 MR UP EXTREM W&W/O CON                           PROCED     1,734.48                    73220
RAD MRI       6101535 0 MR UP EXT JOINT W/O CON                          PROCED     1,714.68                    73221
RAD MRI       6101620 0 MR UP EXTREM JOINT W/CON                         PROCED     1,851.93                    73222
RAD MRI       6101621 0 MR UP EXT JOINT W&W/O CON                        PROCED     2,109.56                    73223
RAD MRI       6101575 0 MR SCAN UP EXT-MRA W/WO                          PROCED     1,265.17                    73225
RAD MRI       6101622 0 MR LOW EXTREM W/O CON                            PROCED     1,619.36                    73718
RAD MRI       6101623 0 MR LOWER EXTREM W/CON                            PROCED     1,561.68                    73719
RAD MRI       6101532 0 MR LOW EXTREM W&W/O CON                          PROCED     1,681.70                    73720
RAD MRI       6101533 0 MR LOW EXT JOINT W/O CON                         PROCED     1,661.15                    73721
RAD MRI       6101624 0 MR LOW EXTREM JOINT W/CON                        PROCED     1,720.50                    73722
RAD MRI       6101625 0 MR LOW EXT JOINT W&W/O CON                       PROCED     1,667.26                    73723
RAD MRI       6101519 0 MR SCAN ABDOMEN W/O CON                          PROCED     1,771.94                    74181
RAD MRI       6101626 0 MR SCAN ABDOMEN W/CON                            PROCED     1,683.35                    74182
RAD MRI       6101627 0 MR SCAN ABDOMEN W&W/O CON                        PROCED     2,059.71                    74183
RAD MRI       6101491 0 MR CARD MORPHOLOGY W/O CON                       PROCED     1,558.08                    75552
RAD MRI       6101492 0 MR CARD MORPHOLOGY W/ CON                        PROCED     1,761.61                    75553
RAD MRI       6101493 0 MR CARD FUNCTION COMPL ST                        PROCED     1,761.61                    75554
RAD MRI       6101494 0 MR CARD FUNCTION LTD ST                          PROCED     1,558.08                    75555
RAD MRI       6101495 0 MR CARD VELOCITY FLOW MAP                        PROCED     1,761.61                    75556
RAD MRI       6101637 0 3D RENDERING PERF ON SCANNER                     PROCED     618.00                      76376
RAD MRI       6101604 0 MRI SPECTROSCOPY                                 PROCED     876.56                      76390
RAD MRI       6101513 0 MR SCAN BONE MARROW WO/CN                        PROCED     1,265.17                    76400
RAD MRI       6101012 0 MRI CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 30 MINPROCED     170.00                      99143
RAD MRI       6101013 0 MRI CONSCIOUS SEDATION SAME MD 5 Y/O & ABV 1ST 3 PROCED     170.00                      99144
RAD MRI       6101014 0 MRI CONSCIOUS SEDATION SAME MD EA ADDL 15 MIN PROCED        85.00                       99145
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)          LML/RML     CPT
RAD MRI       6101015 0 MRI CONSCIOUS SEDATION DIFF MD < 5 Y/O 1ST 30 MIN PROCED     170.00                      99148
RAD MRI       6101016 0 MRI CONSCIOUS SEDATION DIFF MD 5 Y/O & ABV 1ST 30 PROCED     170.00                      99149
RAD MRI       6101017 0 MRI CONSCIOUS SEDATION DIFF MD EA ADDL 15 MIN PROCED         85.00                       99150
RAD MRI       6101633 0 MR SCAN ABDM MRA W/CON                            PROCED     1,053.45                    C8900
RAD MRI       6101523 0 MRA SCAN ABD VESSEL W/O CO                        PROCED     1,285.20                    C8901
RAD MRI       6101566 0 MR SCAN ABDM MRA W/O CON                          PROCED     1,285.20                    C8901
RAD MRI       6101573 0 MR SCAN ABDM-MRA W/WO CON                         PROCED     1,742.04                    C8902
RAD MRI       6101632 0 MR BREAST UNILAT W/CON                            PROCED     1,714.12                    C8903
RAD MRI       6101517 0 MR BREAST UNILAT W/O CON                          PROCED     1,713.89                    C8904
RAD MRI       6101631 0 MR BREAST UNILAT W W/O CON                        PROCED     1,961.45                    C8905
RAD MRI       6101630 0 MR BREAST BILAT W/CON                             PROCED     1,226.07                    C8906
RAD MRI       6101582 0 MR BREAST BILAT W/O CON                           PROCED     1,732.95                    C8907
RAD MRI       6101629 0 MR BREAST BILAT W W/O CON                         PROCED     1,961.45                    C8908
RAD MRI       6101628 0 MR SCAN CHEST MRA W/CON                           PROCED     1,339.47                    C8909
RAD MRI       6101564 0 MR SCAN CHEST MRA W/O CON                         PROCED     1,422.36                    C8910
RAD MRI       6101572 0 MR SCAN CHEST-MRA W/WO CO                         PROCED     1,783.14                    C8911
RAD MRI       6101634 0 MR LOW EXT MRA W/CON                              PROCED     408.41                      C8912
RAD MRI       6101576 0 MR LOW EXT MRA W/O CON                            PROCED     1,906.48                    C8913
RAD MRI       6101577 0 MR SCAN LOW EXT MRA W/WO                          PROCED     1,783.14                    C8914
RAD MRI       6101635 0 MR SCAN PELV - MRA W/ CON                         PROCED     408.41                      C8918
RAD MRI       6101636 0 MR SCAN PELV - MRA W/O CON                        PROCED     378.52                      C8919
RAD MRI       6101574 0 MR SCAN PELV-MRA W/WO CON                         PROCED     1,783.14                    C8920
RAD MRI       6101536 0 GADOLINUM CONTRAST PER 1 ML INJ                   SUPPLY     11.25                       Q9952
RAD MRI       6101007 0 CANNULA ADULT DISP 4707F                          SUPPLY     57.00
RAD MRI       6101008 0 CANNULA INFANT DISP 4200F                         SUPPLY     57.00
RAD MRI       6101009 0 CANNULA PEDS DISPOS 4100F                         SUPPLY     49.88
RAD MRI       6101010 0 CANNULA ADULT DISPOS 4000F                        SUPPLY     49.88
RAD MRI       6101011 0 ETC02 SAMPLING KIT 20FR                           SUPPLY     71.25
RAD MRI       6101700 0 FIDUCIAL SURGICAL MARKERS                         SUPPLY     12.00
RAD MRI       6101702 0 MRI 50ML PRESSURE SYRINGE                         SUPPLY     33.78
RAD MRI       6101703 0 POWERLOC INFUSION NEEDLE 20G                      SUPPLY     27.73
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE     PRICE (INPT /      LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                          CATEGORY   OUTPT)             LML/RML     CPT
RAD MRI       6101001 2 MRI BODY-OUTSIDE FILM REV                   PROCED     STATISTICAL ITEM
RAD MRI       6101002 2 MRI NEURO-OUTSIDE FILM                      PROCED     STATISTICAL ITEM
RAD NUC MED   3410413 0 INJ FOR CYSTOG OR VOID URETHCYST            PROCED     247.49                         51600
RAD NUC MED   3410405 0 SPINAL PUNCTURE, LUMBAR                     PROCED     303.93                         62270
RAD NUC MED   3410999 0 DEXA Scan -OCCH                             PROCED     351.32                         76075
RAD NUC MED   3412721 0 DEXA WITH MORPHOLOGY ANALYSIS               PROCED     400.00                         76075
RAD NUC MED   3412722 0 DEXA WITH BONE AGE                          PROCED     380.00                         76075
RAD NUC MED   3412726 0 SCAN DEXA, AXIAL SKELETON                   PROCED     380.00                         76075
RAD NUC MED   3412723 0 DEXA APPENDICULAR SKEL                      PROCED     195.00                         76076
RAD NUC MED   3410793 0 NM CLINICAL TREATMENT PLANNING              PROCED     500.00                         77261
RAD NUC MED   3410794 0 NM MEDICAL RADIATION DOSIMETRY              PROCED     294.20                         77300
RAD NUC MED   3410007 0 INFUS / INSTILL OF RAD SOLN                 PROCED     531.36                         77750
RAD NUC MED   3410795 0 NM INTERSTITIAL RADIATION SOURCE APPLICTN   PROCED     3,123.30                       77778
RAD NUC MED   3410008 0 SUPV / HANDLE RAD SOURCE                    PROCED     374.76                         77790
RAD NUC MED   3412537 0 RAI THYROID UPTAKE SINGLE                   PROCED     341.00                         78000
RAD NUC MED   3412538 0 RAI THYROID UPTAKE MULT                     PROCED     361.29                         78001
RAD NUC MED   3412264 0 RAI THYROID WASHOUT                         PROCED     220.00                         78003
RAD NUC MED   3412540 0 RAI THYROID UPTAKE W SUPP                   PROCED     220.00                         78003
RAD NUC MED   3412541 0 RAI THYROID UPTAKE W STIM                   PROCED     220.00                         78003
RAD NUC MED   3412539 0 RAI THYROID UPTAKE W SCAN                   PROCED     524.61                         78006
RAD NUC MED   3412568 0 SCAN THYROID                                PROCED     473.58                         78010
RAD NUC MED   3412579 0 SCAN I 131 WB THYROID MET.                  PROCED     945.28                         78018
RAD NUC MED   3412580 0 THYROID CA METASTASES UPTAKE                PROCED     115.00                         78020
RAD NUC MED   3412688 0 SCAN PARA THYROID                           PROCED     647.74                         78070
RAD NUC MED   3412588 0 SCAN ADRENAL                                PROCED     662.18                         78075
RAD NUC MED   3410689 0 SCAN BONE MARROW WB                         PROCED     1,072.98                       78104
RAD NUC MED   3401548 0 PLASMA VOLUME, SINGL SMPL                   PROCED     280.96                         78110
RAD NUC MED   3401549 0 RED CELL MASS, SNGL SAMPLING                PROCED     526.26                         78120
RAD NUC MED   3401578 0 TOTAL BLD VOL DETERMINATION                 PROCED     535.60                         78122
RAD NUC MED   3401544 0 NM RED CELL SURVIVAL                        PROCED     320.86                         78130
RAD NUC MED   3401545 0 NM RED CELL SURVIVAL SEQ                    PROCED     652.86                         78135
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                      CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                      CATEGORY   OUTPT)          LML/RML     CPT
RAD NUC MED   3410567 0 SCAN SPLEEN                             PROCED     469.23                      78185
RAD NUC MED   3401709 0 NM PLATELET SURVIVAL                    PROCED     645.78                      78190
RAD NUC MED   3416569 0 SCAN LYMPHOSCINTIGRAPHY                 PROCED     792.93                      78195
RAD NUC MED   3410796 0 NM LIVER IMAGING W/ VASCULAR FLOW       PROCED     676.08                      78202
RAD NUC MED   3411563 0 SCAN LIVER (SPLEEN) SPECT               PROCED     770.31                      78205
RAD NUC MED   3416686 0 SCAN LIVER BILIARY AGENT                PROCED     903.94                      78220
RAD NUC MED   3416722 0 GALLBLADDER FUNCTION                    PROCED     826.01                      78223
RAD NUC MED   3416575 0 SCAN PAROTID, SERIAL                    PROCED     993.60                      78231
RAD NUC MED   3416550 0 SCAN ESOPHAGEAL REFLUX STUDY            PROCED     650.70                      78262
RAD NUC MED   3416596 0 SCAN GASTRIC EMPTYING                   PROCED     763.13                      78264
RAD NUC MED   3410406 0 SCHILLINGS TEST W/O IF                  PROCED     436.14                      78270
RAD NUC MED   3401551 0 B12 ABSORP WIF (SCHILLINGS)             PROCED     461.77                      78271
RAD NUC MED   3401546 0 B12 ABSORP W/ AND W/O IF (SCHILLINGS)   PROCED     451.81                      78272
RAD NUC MED   3416551 0 SCAN GI BLEEDING LOCAL                  PROCED     840.33                      78278
RAD NUC MED   3416576 0 SCAN MECKELS                            PROCED     561.66                      78290
RAD NUC MED   3413696 0 LAVEEN SHUNT PATENCY                    PROCED     889.92                      78291
RAD NUC MED   3410485 0 BONE AND OR JOINT IMG/LIMITED           PROCED     769.50                      78300
RAD NUC MED   3410486 0 BONE AND OR JOINT IMG/MULTI AR          PROCED     832.15                      78305
RAD NUC MED   3411560 0 SCAN BONE WHOLE BODY                    PROCED     929.17                      78306
RAD NUC MED   3410570 0 SCAN BONE, TRIPLE PHASE                 PROCED     1,075.98                    78315
RAD NUC MED   3411340 0 SCAN BONE, TOMOGRAPHIC                  PROCED     738.58                      78320
RAD NUC MED   3410530 0 AMB CARDIAC LVEF,SS                     PROCED     481.29                      78414
RAD NUC MED   3413594 0 SCAN NON-CARD VASC FLOW                 PROCED     211.20                      78445
RAD NUC MED   3410447 0 SCAN ACUTE VEN THROMB PEPTIDE           PROCED     497.61                      78456
RAD NUC MED   3413584 0 SCAN ISOTOPE VENOGRAM                   PROCED     452.86                      78458
RAD NUC MED   3410752 0 NM PET MYO VIABILITY F/U INCON SPECT    PROCED     2,889.00                    78459
RAD NUC MED   3413562 0 MYOCARDIAL PERF REST SPECT              PROCED     824.00                      78464
RAD NUC MED   3410482 0 MYOCARDIAL PERF SPECT MULT              PROCED     1,558.40                    78465
RAD NUC MED   3413705 0 MYOCARDIAL PERF R & S                   PROCED     1,558.40                    78465
RAD NUC MED   3413726 0 MYOCARDIAL PERF IMAGING MULT            PROCED     1,558.40                    78465
RAD NUC MED   3410476 0 MYOCARDIAL IMAGING INFARCT AVI          PROCED     298.52                      78466
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                     CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                     CATEGORY   OUTPT)          LML/RML     CPT
RAD NUC MED   3413583 0 SCAN HEART INFARCT                     PROCED     298.52                      78466
RAD NUC MED   3411533 0 SCAN HEART SINGLE VIEW                 PROCED     993.45                      78472
RAD NUC MED   3413531 0 SCAN MUGA REST/STRESS W/EF             PROCED     1,333.99                    78473
RAD NUC MED   3413536 0 NM HEART SCAN MULT VIEWS               PROCED     1,333.99                    78473
RAD NUC MED   3413700 0 MYO-PERF W/WALL MOTION                 PROCED     432.37                      78478
RAD NUC MED   3410407 0 MYOCARDIAL PERF W/EF                   PROCED     350.14                      78480
RAD NUC MED   3410414 0 NM PET MYO SINGL F/U PET               PROCED     840.00                      78491
RAD NUC MED   3410416 0 NM PET MYO SINGL F/U R SPECT           PROCED     840.00                      78491
RAD NUC MED   3410418 0 NM PET MYO SINGL F/U S SPECT           PROCED     840.00                      78491
RAD NUC MED   3410420 0 NM PET MYO SINGL F/U C ANGIO           PROCED     840.00                      78491
RAD NUC MED   3410422 0 NM PET MYO SINGL F/U PL MCP            PROCED     840.00                      78491
RAD NUC MED   3410424 0 NM PET MYO SINGL F/U S ECHO            PROCED     840.00                      78491
RAD NUC MED   3410426 0 NM PET MYO SINGL F/U VENTRIC           PROCED     840.00                      78491
RAD NUC MED   3410428 0 NM PET MYO SINGL F/U R ECG             PROCED     840.00                      78491
RAD NUC MED   3410430 0 NM PET MYO SINGL F/U S ECG             PROCED     840.00                      78491
RAD NUC MED   3412004 0 NM PET HEART MUSC IMAGING SING STUDY   PROCED     840.00                      78491
RAD NUC MED   3410415 0 NM PET MYO MULT F/U PET                PROCED     2,603.00                    78492
RAD NUC MED   3410417 0 NM PET MYO MULT F/U R SPECT            PROCED     2,603.00                    78492
RAD NUC MED   3410419 0 NM PET MYO MULT F/U S SPECT            PROCED     2,603.00                    78492
RAD NUC MED   3410421 0 NM PET MYO MULT F/U C ANGIO            PROCED     2,603.00                    78492
RAD NUC MED   3410423 0 NM PET MYO MULT F/U PL MCP             PROCED     2,603.00                    78492
RAD NUC MED   3410425 0 NM PET MYO MULT F/U S ECHO             PROCED     2,603.00                    78492
RAD NUC MED   3410427 0 NM PET MYO MULT F/U VENTRIC            PROCED     2,603.00                    78492
RAD NUC MED   3410429 0 NM PET MYO MULT F/U R ECG              PROCED     2,603.00                    78492
RAD NUC MED   3410431 0 NM PET MYO MULT F/U S ECG              PROCED     2,603.00                    78492
RAD NUC MED   3410478 0 HRT BLD FLW GATED EQ R EF 1 PA         PROCED     689.31                      78496
RAD NUC MED   3413535 0 SCAN HEART RIGHT                       PROCED     689.31                      78496
RAD NUC MED   3410017 0 LUNG PERF PRE-LUNG CA TX               PROCED     845.00                      78580
RAD NUC MED   3413564 0 SCAN LUNG PERFUSION                    PROCED     665.28                      78580
RAD NUC MED   3410444 0 PULMONARY PERF. W/VENT                 PROCED     978.48                      78585
RAD NUC MED   3413694 0 AEROSOL LUNG VENTILATION               PROCED     316.80                      78587
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                   CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                   CATEGORY   OUTPT)          LML/RML     CPT
RAD NUC MED   3413690 0 SCAN LUNG VENTILATION                PROCED     675.36                      78593
RAD NUC MED   3413342 0 SCAN LUNG, QUANTITATIVE              PROCED     1,343.52                    78596
RAD NUC MED   3415561 0 SCAN BRAIN                           PROCED     381.78                      78605
RAD NUC MED   3415695 0 SCAN BRAIN COMP, W/VASC FLOW         PROCED     973.08                      78606
RAD NUC MED   3412720 0 CEREBRAL PERFUSION SPECT             PROCED     913.90                      78607
RAD NUC MED   3412724 0 CEREBRAL PERFUSION SEIZURE SPECT     PROCED     913.90                      78607
RAD NUC MED   3410759 0 NM PET BRAIN METABOLIC SEIZURES      PROCED     3,013.74                    78608
RAD NUC MED   3417732 0 NM PET BRAIN                         PROCED     3,013.74                    78608
RAD NUC MED   3410027 0 NM PET BRAIN ALZHEIMERS DIFF DX      PROCED     2,926.23                    78609
RAD NUC MED   3415580 0 SCAN, BRAIN VASC. FLOW ONLY          PROCED     323.00                      78610
RAD NUC MED   3415684 0 SCAN CISTERNOGRAM                    PROCED     1,157.76                    78630
RAD NUC MED   3410474 0 CISTERNOGRAPHY W/SHUNT EVAL          PROCED     633.42                      78645
RAD NUC MED   3410473 0 CSF LEAK DETECT AND LOCAL            PROCED     523.94                      78650
RAD NUC MED   3414566 0 SCAN RENAL W/VASC FLOW               PROCED     705.55                      78701
RAD NUC MED   3410403 0 RENAL IMAGING SING W/ FUNC STUDY     PROCED     834.55                      78704
RAD NUC MED   3414559 0 SCAN RENAL W/VASC FLOW AND FUN       PROCED     921.46                      78707
RAD NUC MED   3410475 0 SCAN RENAL SINGLE W/PHARM INTE       PROCED     830.13                      78708
RAD NUC MED   3410481 0 RENAL FNCTN, MULT W/PHRM INTRV       PROCED     1,221.18                    78709
RAD NUC MED   3414585 0 SCAN RENAL VASC. FLOW ONLY           PROCED     585.36                      78715
RAD NUC MED   3405715 0 GLOMERULAR RATE STUDY                PROCED     724.68                      78725
RAD NUC MED   3410432 0 URINARY BLADDER RESIDUAL STUDY       PROCED     214.08                      78730
RAD NUC MED   3414704 0 SCAN CYSTOGRAM, VOIDING              PROCED     425.39                      78740
RAD NUC MED   3414706 0 SCAN TESTICULAR W/VASC FLOW          PROCED     361.48                      78761
RAD NUC MED   3412702 0 TUMOR LOC. LTD (BREAST)              PROCED     734.26                      78800
RAD NUC MED   3410723 0 TUMOR LOC, MULTI ONCOSCINT           PROCED     675.19                      78801
RAD NUC MED   3410004 0 RAD LOC TUMOR WB (ZEVALIN) INITIAL   PROCED     1,065.23                    78802
RAD NUC MED   3410731 0 TUMOR SCAN, WHOLE BODY               PROCED     1,065.23                    78802
RAD NUC MED   3410742 0 TUMOR LOC. SPECT - GALLIUM           PROCED     739.20                      78803
RAD NUC MED   3410502 0 RADP BIODISTRIBUTION SCAN - FIRST    PROCED     683.70                      78804
RAD NUC MED   3411006 0 TUMOR LOC SPECT PROSTASCINT          PROCED     1,324.79                    78804
RAD NUC MED   3410412 0 ABSCESS LOC LTD GALLIUM              PROCED     721.20                      78805
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                        CHARGE     PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                        CATEGORY   OUTPT)          LML/RML      CPT
RAD NUC MED   3410009 0 ABSCESS LOC, WHOLE BODY (WBC)             PROCED     920.61                       78806
RAD NUC MED   3410025 0 ABSCESS LOC WHOLE BODY (PTHER)            PROCED     920.61                       78806
RAD NUC MED   3411685 0 ABSCESS LOC. WB - GALLIUM                 PROCED     920.61                       78806
RAD NUC MED   3410807 0 NM PET RE LTD                             PROCED     2,926.00                    78811QR
RAD NUC MED   3410026 0 NM PET WB OVARIAN RESTAGING               PROCED     2,926.23                     78812
RAD NUC MED   3410028 0 NM PET WB CERVICAL INITIAL DX             PROCED     2,926.23                     78812
RAD NUC MED   3410409 0 NM PET WB RSTAG COLORECTAL                PROCED     3,100.42                     78812
RAD NUC MED   3410411 0 NM PET SINGL LUNG NODULE                  PROCED     3,287.66                     78812
RAD NUC MED   3410487 0 NM PET WB NSCL CA RESTAGNG                PROCED     3,125.11                     78812
RAD NUC MED   3410488 0 NM PET WB NSCLA CA DX                     PROCED     2,926.23                     78812
RAD NUC MED   3410491 0 NM PET WB DX LYMPHOMA                     PROCED     2,926.23                     78812
RAD NUC MED   3410492 0 NM PET WB RSTG LYMPHOMA                   PROCED     3,079.43                     78812
RAD NUC MED   3410493 0 NM PET WB INIT STGNG COLOREC              PROCED     3,135.78                     78812
RAD NUC MED   3410494 0 NM PET WB DX COLORECTAL CA                PROCED     2,889.00                     78812
RAD NUC MED   3410495 0 NM PET THY CA FOL RSTG F/U NEG I-131 WB   PROCED     1,525.17                     78812
RAD NUC MED   3410753 0 NM PET WB RSTG ESOPHAGEAL CA              PROCED     3,351.36                     78812
RAD NUC MED   3410754 0 NM PET WB DX ESOPHAGEAL CA                PROCED     2,646.54                     78812
RAD NUC MED   3410755 0 NM PET WB INT STG ESOPHAGEAL CA           PROCED     2,926.23                     78812
RAD NUC MED   3410756 0 NM PET WB DX HEAD/NECK W/O THYR           PROCED     2,404.08                     78812
RAD NUC MED   3410757 0 NM PET WB INT STG HEAD/NECK W/O THYR      PROCED     2,922.38                     78812
RAD NUC MED   3410758 0 NM PET WB RSTG HEAD/NECK W/O THYR         PROCED     2,926.23                     78812
RAD NUC MED   3410760 0 NM PET WB INIT NSCL CA LUNG               PROCED     3,100.17                     78812
RAD NUC MED   3410783 0 NM PET BREAST DTCT / RECUR                PROCED     3,663.36                     78812
RAD NUC MED   3410784 0 NM PET BREAST EVAL TO TX                  PROCED     2,404.08                     78812
RAD NUC MED   3411001 0 NM PET WB INIT STG LYMPHOMA               PROCED     3,071.84                     78812
RAD NUC MED   3410808 0 NM PET RE STM                             PROCED     2,926.00                    78812QR
RAD NUC MED   3410410 0 NM PET WB RSTAG MELANOMA                  PROCED     3,195.77                     78813
RAD NUC MED   3410489 0 NM PET WB INIT MELANOMA                   PROCED     3,092.68                     78813
RAD NUC MED   3410490 0 NM PET WB DX MELANOMA                     PROCED     1,525.17                     78813
RAD NUC MED   3410809 0 NM PET RE WB                              PROCED     2,926.00                    78813QR
RAD NUC MED   3410018 0 GENERATION AUTO DATA SIMPLE               PROCED     288.36                       78890
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                              CHARGE      PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                               CATEGORY   OUTPT)          LML/RML     CPT
RAD NUC MED   3410024 0 NM RAI THER ORAL ADMIN                           PROCED     270.00                      79005
RAD NUC MED   3412703 0 NM RAI THER THYROID INITIAL                      PROCED     886.00                      79005
RAD NUC MED   3412708 0 NM RAI THER THYROID CA                           PROCED     721.71                      79005
RAD NUC MED   3412716 0 NM RAI THER THYROID SUBSEQ                       PROCED     552.06                      79005
RAD NUC MED   3410013 0 NM RAI THER P-32 IV THERAPY                      PROCED     636.88                      79101
RAD NUC MED   3410023 0 NM RAI THER BY IV ADMIN                          PROCED     270.00                      79101
RAD NUC MED   3410477 0 NM RAI THER NON-THYR / HEMAT                     PROCED     1,125.48                    79101
RAD NUC MED   3413697 0 NM RAI THER STRONTIUM 89                         PROCED     655.56                      79101
RAD NUC MED   3410012 0 NM RAI THER P-32 INTRACAVITARY THER              PROCED     602.64                      79200
RAD NUC MED   3410020 0 NM RAI THER INTRACAVITARY ADMIN                  PROCED     1,116.21                    79200
RAD NUC MED   3410021 0 NM RAI THER INTERSTIT RADACT COLLOID ADMIN       PROCED     573.00                      79300
RAD NUC MED   3410496 0 NM RAI THER YTRIUM 90 SIROSPHERES                PROCED     578.51                      79403
RAD NUC MED   3410497 0 NM RAI THER ZEVALIN                              PROCED     578.51                      79403
RAD NUC MED   3410498 0 NM RAI THER BEXXAR                               PROCED     578.51                      79403
RAD NUC MED   3410022 0 NM RAI THER INTRA-ARTERIAL PARTIC ADMIN          PROCED     300.00                      79445
RAD NUC MED   3413699 0 ELECTROCARD,TRACING ONLY                         PROCED     130.40                      93005
RAD NUC MED   3413698 0 STRESS TEST,TRACING ONLY                         PROCED     528.85                      93017
RAD NUC MED   3410505 0 NM CONSCIOUS SEDATION SAME MD < 5 Y/O 1ST 30 MIN PROCED     170.00                      99143
RAD NUC MED   3410506 0 NM CONSCIOUS SEDATION SAME MD 5 Y/O & ABV 1ST 30PROCED      170.00                      99144
RAD NUC MED   3410507 0 NM CONSCIOUS SEDATION SAME MD EA ADDL 15 MIN PROCED         85.00                       99145
RAD NUC MED   3410508 0 NM CONSCIOUS SEDATION DIFF MD < 5 Y/O 1ST 30 MIN PROCED     170.00                      99148
RAD NUC MED   3410509 0 NM CONSCIOUS SEDATION DIFF MD 5 Y/O & ABV 1ST 30 M
                                                                         PROCED     170.00                      99149
RAD NUC MED   3410510 0 NM CONSCIOUS SEDATION DIFF MD EA ADDL 15 MIN     PROCED     85.00                       99150
RAD NUC MED   3410453 0 I-131 IODOCHOLESTEROL PER DOSE                   SUPPLY     967.99                      A4641
RAD NUC MED   3410454 0 NP 59 PER DOSE                                   SUPPLY     478.33                      A4641
RAD NUC MED   3410460 0 CHROMIUM-51, 75UCI                               SUPPLY     350.00                      A4641
RAD NUC MED   3410461 0 I-125 HSA SYRING (HUM SERUM ALBUMIN)             SUPPLY     190.24                      A4641
RAD NUC MED   3410465 0 TC99M CERETEC-WBC LABELING                       SUPPLY     500.99                      A4641
RAD NUC MED   3410472 0 TC99M TCO4 1-25 mCi                              SUPPLY     144.30                      A4641
RAD NUC MED   3413529 0 MIBG I-123 UP TO 5 MCI                           SUPPLY     1,463.22                    A4641
RAD NUC MED   3410439 0 SATUMOMAB PENDETIDE PER VIAL                     SUPPLY     1,794.16                    A4642
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                               CHARGE       PRICE (INPT /   LAB PRICE
CDM Area      Serv Cd Type CDM DESCRIPTION                                 CATEGORY   OUTPT)          LML/RML     CPT
RAD NUC MED   3410442 0 TC99M SESTAMIBI PER DOSE                           SUPPLY     168.82                      A9500
RAD NUC MED   3410743 0 Tc99m TETROFOSMN, PER Dose                         SUPPLY     251.22                      A9502
RAD NUC MED   3410769 0 TC99M MEDRONATE UP TO 30 MCI                       SUPPLY     51.50                       A9503
RAD NUC MED   3410751 0 TC99M APCITUDE PER VIAL                            SUPPLY     677.53                      A9504
RAD NUC MED   3410449 0 THALLIUM-201 CHLORIDE PER 1 MILLICURIE             SUPPLY     30.00                       A9505
RAD NUC MED   3411005 0 INDIUM III CAPROMAB PEND DOSE                      SUPPLY     2,471.59                    A9507
RAD NUC MED   3410766 0 TC99M HEPATOLITE (DISOFENIN) PER VIAL              SUPPLY     103.00                      A9510
RAD NUC MED   3410450 0 I-123 CAP PER 100 UCI                              SUPPLY     45.32                       A9516
RAD NUC MED   3410787 0 I-131 SOD IODIDE CAP PER MCI                       SUPPLY     43.26                       A9517
RAD NUC MED   3410443 0 TC99M EXAMITAZ PER DOSE                            SUPPLY     818.47                      A9521
RAD NUC MED   3410790 0 I-131 SOD IODIDE DIAG SOLN PER MCI                 SUPPLY     54.59                       A9529
RAD NUC MED   3410789 0 I-131 SOD IODIDE THERAPEU SOLN PER MCI             SUPPLY     54.59                       A9530
RAD NUC MED   3410798 0 TC99M CHOLETEC (MEBROFENIN) PER DOSE UP TO 15 MC   SUPPLY     103.00                      A9537
RAD NUC MED   3410468 0 TC99M DTPA (PENTETATE) AEROSOL PER DOSE            SUPPLY     47.28                       A9539
RAD NUC MED   3410799 0 TC99M DTPA (PENTETATE) RENAL PER DOSE UP TO 25 M SUPPLY       38.32                       A9539
RAD NUC MED   3410800 0 TC99M ALBUM AGG PER DOSE UP TO 10 MCI              SUPPLY     46.14                       A9540
RAD NUC MED   3410801 0 TC99M SULF COLLOID INJ PER DOSE UP TO 20 MCI       SUPPLY     30.90                       A9541
RAD NUC MED   3410791 0 IN 111 IBRITUMOMAB (ZEVALIN) INJ PER DOSE UP TO 5 MSUPPLY     5,682.00                    A9542
RAD NUC MED   3410792 0 YTRIUM-90 (ZEVALIN) INJ PER DOSE UP TO 40 MCI      SUPPLY     30,918.00                   A9543
RAD NUC MED   3410501 0 I-131 TOSITUMOMAB PER DOSE DX 5 MCI                SUPPLY     4,000.00                    A9544
RAD NUC MED   3410504 0 I-131 TOSITUMOMAB PER DOSE THER                    SUPPLY     35,000.00                   A9545
RAD NUC MED   3410777 0 CYANOCOBAL CO 57/58 PER DOSE UP TO 1 UCI           SUPPLY     298.70                      A9546
RAD NUC MED   3410464 0 INDIUM 111 OXINE PER 0.5 MCI                       SUPPLY     489.25                      A9547
RAD NUC MED   3410774 0 INDIUM 111 PENTETATE PER 0.5 MCI                   SUPPLY     309.00                      A9548
RAD NUC MED   3410771 0 TC99M SOD GLUCEPTATE PER DOSE UP TO 25 MCI         SUPPLY     51.50                       A9550
RAD NUC MED   3410457 0 TC99M DMSA (SUCCIMER) PER DOSE UP TO 10 MCI        SUPPLY     164.80                      A9551
RAD NUC MED   3417701 0 FLOURODEOXYGLUCOSE 4-40 MCI INJ                    SUPPLY     892.50                      A9552
RAD NUC MED   3410776 0 GALLIUM 67 DIAG PER 1 MCI                          SUPPLY     30.90                       A9556
RAD NUC MED   3410772 0 TC99M BICISATE PER DOSE UP TO 25 MCI               SUPPLY     515.00                      A9557
RAD NUC MED   3410469 0 XENON XE133 PER 10 MCI                             SUPPLY     52.02                       A9558
RAD NUC MED   3410778 0 CYANOCOBAL CO 57 CAP PER DOSE UP TO 1 UCI          SUPPLY     185.40                      A9559
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                               CHARGE     PRICE (INPT /      LAB PRICE
CDM Area     Serv Cd Type CDM DESCRIPTION                                CATEGORY   OUTPT)             LML/RML     CPT
RAD NUC MED 3410779   0 CYANOCOBAL CO 57 SOLN PER DOSE UP TO 1 UCI       SUPPLY     103.00                         A9559
RAD NUC MED 3410806   0 TC99M ULTRATAG RBC LABEL PER DOSE UP TO 30 MCI   SUPPLY     416.43                         A9560
RAD NUC MED 3410805   0 TC99M OXIDRONATE HDP PER DOSE UP TO 30 MCI       SUPPLY     90.00                          A9561
RAD NUC MED 3410802   0 TC99M MAG 3 (MERTIATIDE) PER DOSE UP TO 15 MCI   SUPPLY     352.00                         A9562
RAD NUC MED 3410470   0 P-32 SODIUM PHOSPHATE PER MCI                    SUPPLY     578.55                         A9563
RAD NUC MED 3410775   0 P-32 CHROM PHOSPHAT SUSP PER MCI                 SUPPLY     175.10                         A9564
RAD NUC MED 3410803   0 IN 111 PENTETRETIDE PER 1 MCI                    SUPPLY     424.40                         A9565
RAD NUC MED 3410804   0 INDIUM 111 OCTREASCAN (PENTETREOTIDE) PER MCI    SUPPLY     199.60                         A9565
RAD NUC MED 3410019   0 TC 99M FANOLESOMAB PER DOSE 10-20 MCI            SUPPLY     1,400.00                       A9566
RAD NUC MED 3410471   0 STRONTIUM 89 SOLN THER PER MCI                   SUPPLY     3,819.96                       A9600
RAD NUC MED 3410448   0 SAMARIUM 153, 50MCI                              SUPPLY     4,051.81                       A9605
RAD NUC MED 3410797   0 NM YTRIUM-90 SEEDS                               SUPPLY     14,000.00                      C2616
RAD NUC MED 3410029   0 NM PET NOT ELSEWHERE DESCRIBED                   PROCED     2,926.23                       G0235
RAD NUC MED 3410030   0 NM PET CLINICAL TRIAL                            PROCED     2,926.23                       G0235
RAD NUC MED 3410782   0 NM PET BREAST INITIAL DX                         PROCED     2,926.23                       G0235
RAD NUC MED 3410500   0 NM TOSITUMOMAB 440MG INFUSION                    PROCED     2,366.64                       G3001
RAD NUC MED 3410011   0 LASIX INJ 5 MG                                   MED        20.00                          J1940
RAD NUC MED 3410010   0 CCK INJ PER DOSE                                 MED        186.43
RAD NUC MED 3410402   0 INDIUM CHLORIDE PER MCI                          SUPPLY     273.16
RAD NUC MED 3410765   0 I-123 SOD IODID PER 100 UCI INJ (Microcuries)    SUPPLY     0.72
RAD NUC MED 3410014   2 STRESS TEST PHYSCN SUPV ONLY                     PROCED     STATISTICAL ITEM
RAD NUC MED 3410016   2 RAD LOC TUMOR (ZEVALIN) SUBS                     PROCED     STATISTICAL ITEM
RAD NUC MED 3410483   2 SCAN NM EMERGENCY                                PROCED     STATISTICAL ITEM
RAD NUC MED 3410484   2 SCAN NM PORTABLE                                 PROCED     STATISTICAL ITEM
RAD NUC MED 3410503   2 RADP BIODISTRIBUTION SCAN - SUBS                 PROCED     STATISTICAL ITEM
RAD NUC MED 3412001   2 OUTSIDE FILM REVIEW,OTHER                        PROCED     STATISTICAL ITEM
RAD NUC MED 3412002   2 BONE SCAN WHOLE BODY-OFR                         PROCED     STATISTICAL ITEM
RAD NUC MED 3412003   2 MYOCA PERF R/S-SPECT, OFR                        PROCED     STATISTICAL ITEM
RAD ONCOLOGY 3307336  0 PLACEMENT MAMMOSITE CATH                         PROCED     3,418.48                       19296
RAD ONCOLOGY 3306502  0 IV START - INTRO CATH INTO PERIPH VEIN           PROCED     118.23                         36000
RAD ONCOLOGY 3306504  0 BLOOD DRAW VENIPUNCTURE                          PROCED     19.69                          36415
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                          CHARGE      PRICE (INPT /   LAB PRICE
CDM Area     Serv Cd Type CDM DESCRIPTION                            CATEGORY   OUTPT)          LML/RML     CPT
RAD ONCOLOGY 3306505  0 BLADDER IRRIG LAV / INSTILLATION             PROCED     300.00                      51700
RAD ONCOLOGY 3306509  0 CATHETERIZATN URETH STRAIGHT CATH            PROCED     50.00                       51701
RAD ONCOLOGY 3306510  0 CATHETERIZATN URETH INDWELL FOLEY SIMPLE     PROCED     137.06                      51702
RAD ONCOLOGY 3306511  0 CATHETERIZATN URETH INDWELL FOLEY COMP       PROCED     170.00                      51703
RAD ONCOLOGY 3304764  0 INSRT UTER TANDEM / VAG OVOID FOR BRACHYTHER PROCED     864.80                      57155
RAD ONCOLOGY 3304799  0 CT GUID PLCMT RADIATION THER FIELDS          PROCED     571.67                      76370
RAD ONCOLOGY 3301281  0 US TRNSRECT PROS VOL STDY BRACHY TX PLAN     PROCED     496.80                      76873
RAD ONCOLOGY 3301305  0 STEREO RADIO SURG PLANNING (LINEAR ACCELERATOR
                                                                     PROCED     1,527.60                    77263
RAD ONCOLOGY 3301280  0 SIMULATION - S                               PROCED     610.12                      77280
RAD ONCOLOGY 3301285  0 SIMULATION - I                               PROCED     902.37                      77285
RAD ONCOLOGY 3301290  0 SIMULATION - C                               PROCED     1,250.17                    77290
RAD ONCOLOGY 3301489  0 SIMULATION-3D TUM VOL REC                    PROCED     3,157.85                    77295
RAD ONCOLOGY 3302300  0 BASIC DOSIM CALC                             PROCED     294.20                      77300
RAD ONCOLOGY 3302316  0 TLTHPY DOSE PLAN-IMRT                        PROCED     1,902.96                    77301
RAD ONCOLOGY 3302305  0 TLTHPY DOSE PLAN-S                           PROCED     487.81                      77305
RAD ONCOLOGY 3302310  0 TLTHPY DOSE PLAN-I                           PROCED     640.08                      77310
RAD ONCOLOGY 3302315  0 TLTHPY DOSE PLAN-C                           PROCED     782.29                      77315
RAD ONCOLOGY 3302321  0 SPECIAL EXTENDED FIELD PLAN                  PROCED     741.24                      77321
RAD ONCOLOGY 3302326  0 BRCHYTPY DOSE PL-S                           PROCED     595.03                      77326
RAD ONCOLOGY 3302327  0 BRCHYTPY DOSE PL-I                           PROCED     700.80                      77327
RAD ONCOLOGY 3302328  0 BRCHYTPY DOSE PL-C                           PROCED     874.35                      77328
RAD ONCOLOGY 3302331  0 SPECIAL DOSIMETRY                            PROCED     440.45                      77331
RAD ONCOLOGY 3307329  0 TX DEVICE BOLUS/HAND BLOCK                   PROCED     319.91                      77332
RAD ONCOLOGY 3307345  0 TX DEVICE S INDEPENDENT JAW                  PROCED     319.91                      77332
RAD ONCOLOGY 3307351  0 TX DEVICE BREAST RING                        PROCED     319.91                      77332
RAD ONCOLOGY 3307330  0 TX DEVICE BITE BLOCK/STENT                   PROCED     500.52                      77333
RAD ONCOLOGY 3307346  0 TX DEVICE I INDEPENDENT JAW                  PROCED     500.52                      77333
RAD ONCOLOGY 3307348  0 BELLY BOARD                                  PROCED     500.52                      77333
RAD ONCOLOGY 3307352  0 TX DEVICE TESTICULAR SHIELD                  PROCED     500.52                      77333
RAD ONCOLOGY 3301267  0 TREATMENT DEVICE-BREAST BOARD                PROCED     683.96                      77334
RAD ONCOLOGY 3301268  0 TREATMENT DEVICE WEDGE                       PROCED     683.96                      77334
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                               CHARGE     PRICE (INPT /   LAB PRICE
CDM Area     Serv Cd Type CDM DESCRIPTION                CATEGORY   OUTPT)          LML/RML     CPT
RAD ONCOLOGY 3307331  0 TX DEVICE NOVALIS MASK           PROCED     683.96                      77334
RAD ONCOLOGY 3307332  0 TX DEVICE LEAD CUTOUT            PROCED     383.40                      77334
RAD ONCOLOGY 3307333  0 TX DEVICE LUCITE COMP FILTER     PROCED     683.96                      77334
RAD ONCOLOGY 3307334  0 TX DEVICE CERROBEND BLOCK        PROCED     683.96                      77334
RAD ONCOLOGY 3307335  0 TX DEVICE ELECTRON BEAM MASK     PROCED     683.96                      77334
RAD ONCOLOGY 3307337  0 TX DEVICE STEREOTACTIC-C         PROCED     683.96                      77334
RAD ONCOLOGY 3307338  0 TX DEVICE CHESTWALL MASK         PROCED     683.96                      77334
RAD ONCOLOGY 3307339  0 TX DEVICE THERMOPLASTIC-MLD      PROCED     683.96                      77334
RAD ONCOLOGY 3307340  0 MILLED COMP FILTER               PROCED     683.96                      77334
RAD ONCOLOGY 3307341  0 TX DEVICE ELLIS COMP FILTER      PROCED     683.96                      77334
RAD ONCOLOGY 3307342  0 TX DEVICE MULTI-LEAF COLLIMATO   PROCED     683.96                      77334
RAD ONCOLOGY 3307343  0 TX DEVICE ALPHA CRADLE           PROCED     683.96                      77334
RAD ONCOLOGY 3307344  0 TX DEVICE C INDEPENDENT JAW      PROCED     683.96                      77334
RAD ONCOLOGY 3307349  0 EXTENDED ALPHA CRADLE            PROCED     683.96                      77334
RAD ONCOLOGY 3307350  0 TREATMENT DEVICE BRACHYTHERAPY   PROCED     683.96                      77334
RAD ONCOLOGY 3302336  0 CONT RAD PHYSICS                 PROCED     349.09                      77336
RAD ONCOLOGY 3302370  0 SPEC RAD PHYSICS                 PROCED     776.83                      77370
RAD ONCOLOGY 3303465  0 SUPERFICIAL/ORTHO VOLTAGE TX     PROCED     192.12                      77401
RAD ONCOLOGY 3301473  0 DAILY MEGA RT C060 5MEV-S        PROCED     327.24                      77402
RAD ONCOLOGY 3301474  0 DAILY MEG RT 6-10 MEV S          PROCED     328.92                      77403
RAD ONCOLOGY 3301475  0 DAILY MEG RT 11-19 MEV S         PROCED     301.14                      77404
RAD ONCOLOGY 3301476  0 DAILY MEG RT > 19 MEV S          PROCED     314.42                      77406
RAD ONCOLOGY 3301477  0 DAILY MEGA RT CO60 MEV-I         PROCED     473.60                      77407
RAD ONCOLOGY 3301478  0 DAILY MEGA RT 6-10 MEV I         PROCED     375.90                      77408
RAD ONCOLOGY 3301479  0 DAILY MEG RT 11-19 MEV I         PROCED     426.86                      77409
RAD ONCOLOGY 3301480  0 DAILY MEGA RT >19 MEV-I          PROCED     336.96                      77411
RAD ONCOLOGY 3301481  0 DAILY MEG RT CO60 5 MEV C        PROCED     515.93                      77412
RAD ONCOLOGY 3301482  0 DAILY MEG RT 6-10 MEV C          PROCED     479.33                      77413
RAD ONCOLOGY 3301483  0 DAILY MEG RT 11-19 MEV C         PROCED     429.45                      77414
RAD ONCOLOGY 3301484  0 DAILY MEGA RT >19 MEV-C          PROCED     479.59                      77416
RAD ONCOLOGY 3303415  0 TREAT PORT FILMS                 PROCED     167.00                      77417
PARTIAL CHARGEMASTER - 12/13/06

                       Svc                                             CHARGE       PRICE (INPT /   LAB PRICE
CDM Area     Serv Cd Type CDM DESCRIPTION                               CATEGORY    OUTPT)          LML/RML     CPT
RAD ONCOLOGY 3301302  0 IMRT > 1 SESSION                                PROCED      2,066.62                    77418
RAD ONCOLOGY 3301306  0 IGRT - (NOVALIS) - IMAGE GUIDANCE RAD THER      PROCED      160.00                      77421
RAD ONCOLOGY 3301304  0 SPECIAL PROCEDURE                               PROCED      1,294.76                    77470
RAD ONCOLOGY 3303471  0 EXTENDED-TBI/HBI                                PROCED      1,294.76                    77470
RAD ONCOLOGY 3304761  0 INTRACAV RADIOELEMENT-SIMPL