BG MANUAL RESUSC NEO PEEP VALV $69.00 IOL TORIC ZCT300 26.0D $572.00 STNT VIABAHN 0.018 6MM 5X120CM $5,676.00 ... Page 5 of 458 Bozeman Health Deaconess Hospital 2020 pricing. Drugs&Supplies PROCEDURE NAME UNIT PRICE KIT FULL 4FR SL PWRMDLN CATH $790.00 SUT 4/0 18 PDS II CLR MONO PS $22.00
Drugs&Supplies PROCEDURE NAME SELF DRILL CANNULA 4.0MM X 37 1.4MM GUIDE WIRE TUBE FEED 20FRX4.0 STOMA LO-PRO NEEDLE 25G BIOPSY FNA DRILL LONG AO 3.6X160MM LEGION SCW LWDG S3 5D X 5P ONE-THIRD TUBULAR PLATE 10 HOLE / L119MM DRSG SPANDAGE SZ8 GDWIRE MAGIC TORQ 0.035 180CM GDWIRE MAGIC TORQ 0.035 260CM HNDL RUBY COIL DETACHMENT CATH INDIGO 3.4FR 150CM COIL RUBY POD 4MMX30CM COIL RUBY POD 5MMX30CM COIL RUBY POD 6MMX50CM COIL RUBY POD 8MMX60CM ENV ABSORB TYRX ANTIBACT MD COIL RUBY POD PKNG J-SOFT 15CM COIL RUBY POD PKNG J-SOFT 30CM COIL RUBY POD PKNG J-SOFT 45CM COIL RUBY POD PKNG J-SOFT 60CM CATH SIZING 20MM PIGT 5FR 70CM COIL RUBY COMPLEXSOFT10MMX35CM PPM AZURE XT DR MRI STNT XIENCE SIERRA RX2.25X08MM STNT XIENCE SIERRA RX2.25X12MM STNT XIENCE SIERRA RX2.25X15MM STNT XIENCE SIERRA RX2.25X18MM STNT XIENCE SIERRA RX2.25X23MM STNT XIENCE SIERRA RX2.25X28MM STNT XIENCE SIERRA RX2.50X08MM STNT XIENCE SIERRA RX2.50X12MM STNT XIENCE SIERRA RX2.50X15MM STNT XIENCE SIERRA RX2.50X18MM STNT XIENCE SIERRA RX2.50X23MM STNT XIENCE SIERRA RX2.50X28MM STNT XIENCE SIERRA RX2.50X33MM STNT XIENCE SIERRA RX2.50X38MM STNT XIENCE SIERRA RX2.75X08MM STNT XIENCE SIERRA RX2.75X12MM STNT XIENCE SIERRA RX2.75X15MM STNT XIENCE SIERRA RX2.75X18MM STNT XIENCE SIERRA RX2.75X23MM STNT XIENCE SIERRA RX2.75X28MM STNT XIENCE SIERRA RX2.75X33MM STNT XIENCE SIERRA RX2.75X38MM Page 1 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,015.00 $72.00 $516.00 $1,120.00 $959.00 $5,251.00 $1,369.00 $1,071.36 $466.32 $466.32 $996.00 $3,173.00 $5,370.00 $5,370.00 $3,565.90 $3,565.90 $2,567.10 $3,465.00 $3,059.20 $3,059.20 $3,059.20 $689.00 $3,104.61 $8,560.00 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 2020 pricing Drugs&Supplies PROCEDURE NAME STNT XIENCE SIERRA RX3.00X08MM STNT XIENCE SIERRA RX3.00X12MM STNT XIENCE SIERRA RX3.00X15MM STNT XIENCE SIERRA RX3.00X18MM STNT XIENCE SIERRA RX3.00X23MM STNT XIENCE SIERRA RX3.00X28MM STNT XIENCE SIERRA RX3.00X33MM STNT XIENCE SIERRA RX3.00X38MM STNT XIENCE SIERRA RX3.50X12MM STNT XIENCE SIERRA RX3.50X15MM STNT XIENCE SIERRA RX3.50X18MM STNT XIENCE SIERRA RX3.50X23MM STNT XIENCE SIERRA RX3.50X28MM STNT XIENCE SIERRA RX3.50X33MM STNT XIENCE SIERRA RX3.50X38MM STNT XIENCE SIERRA RX4.00X08MM STNT XIENCE SIERRA RX4.00X12MM STNT XIENCE SIERRA RX4.00X15MM STNT XIENCE SIERRA RX4.00X18MM STNT XIENCE SIERRA RX4.00X23MM STNT XIENCE SIERRA RX4.00X28MM STNT XIENCE SIERRA RX4.00X33MM STNT XIENCE SIERRA RX4.00X38MM GDWIRE MAGICTORQ0.035180-260CM GDWIRE CONFIANZA 300CM HNDL MICROCATH DETACHMENT POD GDWIRE SENTAI SAMURAI 190CM GDWIRE SENTAI MARVEL 190CM GDWIRE GT STD 0.018 45D 180CM GDWIRE GT 0.018 90/60D 180CM SHEATH MULLINS 12FR 63CM INTR PERFORMER RADPQ 14FR 45CM INTR FLEXOR CHECK-FLO 12FR45CM PPM AZURE S DR MRI OCCLUDER 30MM SEPTAL CARDIOFORM SHEATH MULLINS 16FR 85CM .038"" BAND LT RDL DSTL ACCSS HEMOSTATIC BAND RT RDL DSTL ACCSS HEMOSTATIC SLITTER ADJUSTABLE LEAD-PACE CATH DELIV 4FR 38 CATH RIGHTSIDE IPG AZURE S SR MRI SHEATH RADIAL ACCESS 6FR GDWIRE EMERALD J3 0.035 180CM TRAPPER EXCHANGE DEVICE PALMAZ BLUE STENT 4 X 17 Page 2 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $2,463.90 $466.32 $600.00 $1,170.56 $1,091.20 $1,091.20 $930.00 $930.00 $585.00 $775.00 $440.00 $8,412.00 $15,822.00 $635.00 $193.00 $193.00 $193.00 $1,435.00 $725.00 $6,640.00 $275.00 $137.00 $1,733.00 $2,538.00 2020 pricing Drugs&Supplies PROCEDURE NAME PALMAZ BLUE STENT 6 X 17 PALMAZ BLUE STENT 7 X 17 PALMAZ BLUE STENT 4 X 25 PALMAZ BLUE STENT 5 X 25 PALMAZ BLUE STENT 6 X 25 PALMAZ BLUE STENT 7 X 25 BALLOON PACIFIC PLUS 2.0 X 40 BALLOON PACIFIC PLUS 3.0 X 40 BALLOON PACIFIC PLUS 4.0 X 40 BALLOON PACIFIC PLUS 5.0 X 40 KIT VENA CAVA FILTER PALMAZ BLUE STENT 5 X 15 PRELUDE IDEAL 5F 11CM 21GX4CM SEPTAL OCCLUDER CARDIOFORM KIT SYNCHROWAVE LT ANTENNA 4.1CM 14GX15CM CATH ASPIRATION 8F INDIGO SYSTEM PACEMAKER EDORA 8 DR-T CABLE REMINGTON 12FT TW TORQUE WRENCH KIT ACCESS 10G DIAMOND & BEVEL CMNT DLVRY GUN 10G SZ2 SET CATH RAD ART 20GX1.75 DRSG HYDRCOLL DUODERM 8.5X8.75 DEV TORQ OLCOTT OTD-100 TB GAST DCOMP DL SIL 18FRX48 CATH FOLEY IC 2WAY 16FR 5CC GDWIRE DOC EXT GDWIRE HT PILOT 150 ST 190CM GDWIRE HT PILOT 50 ST 190CM SYS CLSR PERCLOSE PROGLIDE 6FR GDWIRE HT PILOT 50 ST 300CM GDWIRE STD 0.035 180CM GDWIRE STD 0.035 260CM SUT FBRTAPE TAPER BLU 2MM 36 SUT FBRWIRE 2-0 MENISC NDLE NDLE SET EZ-IO AD 15GX25MM BLU SHLDR GLENOBASEHYBRIDMODULARSM SUT FBRTAPE TAPER BLU 2MM 7 SUT TIGERTAPE WHT/BLK 2MM 7 CATH RAD SARAH CURV 5FR 110CM KT TORQ WRENCH AND BOOT COIL INTRLK 5MMX8CM SHLDR STEM CMPRHNSV MINI 10X83 SYS STARCLOSE SE VASC 5-6FR CATH BLN APEX PUSHOTW1.50X15MM CATH BLN APEX PUSH RX1.50X15MM Page 3 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,538.00 $2,538.00 $2,538.00 $2,538.00 $2,538.00 $2,538.00 $800.00 $800.00 $800.00 $800.00 $4,288.00 $2,538.00 $55.00 $15,822.00 $5,100.00 $5,380.00 $8,826.00 $272.00 $242.00 $3,600.00 $1,733.00 $59.00 $47.00 $71.00 $58.00 $39.00 $385.00 $385.00 $385.00 $1,189.00 $385.00 $235.00 $264.00 $580.00 $342.00 $637.00 $2,917.00 $244.00 $360.00 $257.00 $310.00 $1,214.00 $5,908.00 $1,063.00 $531.00 $531.00 2020 pricing Drugs&Supplies PROCEDURE NAME EMBOL PVA FM PUR 300-500MCRN CATH BLN APEX OTWFLEX1.50X15MM CATH BLN APEX RX FLEX1.50X15MM BLN MINI TREK OTW 1.5X15MM BLN MINI TREK OTW 2X8MM BLN MINI TREK OTW 2X15MM BLN TREK OTW 2.50X8MM BLN TREK OTW 2.50X15MM BLN MINI TREK RX 1.50X12MM BLN MINI TREK RX 2X8MM BLN MINI TREK RX 2X12MM BLN MINI TREK RX 2X15MM BLN MINI TREK RX 2X20MM BLN TREK RX 2.25X8MM BLN TREK RX 2.25X15MM BLN TREK RX 2.25X20MM BLN TREK RX 2.50X8MM BLN TREK RX 2.50X12MM BLN TREK RX 2.50X15MM BLN TREK RX 2.50X20MM BLN TREK RX 2.75X8MM BLN TREK RX 2.75X15MM BLN TREK RX 2.75X20MM BLN TREK RX 3X8MM BLN TREK RX 3X15MM BLN TREK RX 3X20MM BLN TREK RX 3.25X8MM BLN TREK RX 3.25X15MM BLN TREK RX 3.25X20MM BLN TREK RX 3.50X8MM BLN TREK RX 3.50X15MM BLN TREK RX 3.50X20MM BLN TREK RX 3.75X8MM BLN TREK RX 3.75X15MM BLN TREK RX 3.75X20MM BLN TREK RX 4X8MM BLN TREK RX 4X15MM BLN TREK RX 4X20MM BLN TREK RX 4.5X15MM BLN TREK RX 5.0X15MM BLN NC TREK RX 2X08MM BLN NC TREK RX 2X12MM BLN NC TREK RX 2.5X08MM BLN NC TREK RX 2.5X15MM BLN NC TREK RX 2.75X08MM BLN NC TREK RX 2.75X15MM Page 4 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $407.00 $531.00 $531.00 $778.00 $669.50 $778.00 $669.50 $669.50 $778.00 $778.00 $778.00 $778.00 $778.00 $669.50 $778.00 $778.00 $669.50 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $669.50 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLN NC TREK RX 3X8MM BLN NC TREK RX 3X15MM BLN NC TREK RX 3.25X15MM BLN NC TREKRX 3.50X8MM BLN NC TREK RX 3.50X15MM BLN NC TREK RX 3.75X8MM BLN NC TREK RX 3.75X12MM BLN NC TREK RX 3.75X15MM BLN NC TREK RX 4X8MM BLN NC TREK RX 4X15MM BLN NC TREK RX 4.50X8MM BLN NC TREK RX 4.50X12MM BLN NC TREK RX 5X12MM COIL INTRLK 3MMX6CM TB IRG OLYMPUS*CIP* COIL DETACH INTRLK 8MM20CM GDWIRE GT DBL ANG 45D 180CM CNTRST EZ ENTEROVU 24% 600ML SCREW FIXED LK MINIMAXLK2.7X14 SCREW FIXED LK MINIMAXLK2.7X16 BIT DRILL MINI MAXLK 1.9MM SCREW FIXED LK MINIMAXLK2.7X12 GDWIRE ANG JTIP 0.035 180CM CATH SWAN GANZ VIP 5LUM 7.5FR BG MANUAL RESUSC NEO PEEP VALV IOL TORIC ZCT300 26.0D STNT VIABAHN 0.018 6MM 5X120CM STNT VIABAHN 0.018 6MM10X120CM STNT VIABAHN0.018 7MM2.5X120CM STNT VIABAHN 0.018 7MM 5X120CM STNT VIABAHN 0.018 7MM10X120CM CATH SLIP-CATH VERT 5FR 100CM ALLO MTX GRAFIXCOREDISC16MM2SQ CANN ADLT NASAL HI-FLOW MD CATH DXTERITY TRAN3.5SH 5FR100 CATH CLSD DBL ELBOW WETPAK14FR L0648 LUMBAR SACRAL ORTHOSIS KT VAPREVENT ORALCARE W/CHG INVALID RING FOAM 14IN TRAY FOLEY 16FR TTLVENT SIL TRAY FOLEY TMP 16FR TTLVENT SIL TRAY FOLEY DB 16FR TTLVENT SIL TRAY FOLEY C UM 16FR TTLVENT SIL CAPSLR TNSN RING 13.0-11.0MM R CAPSLR TNSN RNG 14.5-12.0MM R TRAY CATH NURSE 4FR DUAL MAX Page 5 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $669.50 $778.00 $778.00 $778.00 $778.00 $778.00 $1,214.00 $64.00 $2,076.00 $953.00 $160.00 $585.00 $585.00 $1,022.00 $585.00 $235.00 $221.00 $69.00 $572.00 $5,676.00 $6,227.00 $5,676.00 $5,676.00 $6,227.00 $173.00 $3,998.45 $112.23 $1,313.00 $57.01 $0.00 $172.00 $52.00 $99.00 $134.00 $73.00 $25.00 $600.00 $600.00 $825.00 2020 pricing Drugs&Supplies PROCEDURE NAME UNIT PRICE KIT FULL 4FR SL PWRMDLN CATH $790.00 SUT 4/0 18 PDS II CLR MONO PS $22.00 SPACER SOVRN MD 18DGR 18MM $10,534.00 PAD FOAM EGGCRATE 32X73X3IN $103.00 BOOT WLK GNSS 4 STRP GRY L $248.00 DRESSING VAC VERAFLO MED $690.00 KIT IV MONITOR TRANSPAC $111.00 BINDER ABDOMINAL 28-44IN $94.00 BINDER ABDOMINAL 44-60IN $100.00 KT INPATIENT PORT ACCESS $80.00 SLV COMPRESSION DVT MED $64.00 SLV COMPRESSION DVT LG $105.00 SLV COMPRESSION DVT XL $126.00 ADH SKIN AFFIX SURG .4ML $61.00 THMB SPIKA QC LEFT/LG $95.00 SPLINT THUMB SPICA QC LFT/MD $95.00 SPLINT THUMB SPICA QC RT/LG $95.00 SPLINT THUMB SPICA QC RT/MD $95.00 STNT DUODEN RX 10FR12CM $488.00 STNT WLLFLX RXFULL8.5FR10X40MM $3,998.45 AGENT SUBMUCOSAL INJ ELEVIEW $434.16 RETRIEVER FRGN BDY 160CM X1.8MM $605.00 DVC GRASPER - MINI 200CM X1.9MM $743.00 SYSTM PADLOCK CLIP DEFECT CLSR $2,097.00 NEEDLEMASTER 6MM X 23G LOWER $198.00 KIT SPINNER ENDO $302.00 KIT LOWER ENDO $224.00 KIT UPPER ENDO $259.00 ACUSNARE POLYPECTOMY SNARE $59.00 ACUSNARE POLYPECTOMY SNARE $59.00 ACUSNARE POLYPECTOMY SNARE $59.00 6 SHOOTER MULTIBAND LIGATOR $1,130.00 DILATION SYRINGE $157.00 SPHERE INFLATION DEVICE $237.00 INSTINCT ENDOSCOPIC HEMOCLIP $723.00 FUSION WIRE GUIDE LOCKING DEVICE $71.00 FUSION CYTOLOGY BRUSH $530.00 HERCULES 3 STAGE BALLOON ESOPHAGEAL $865.00 HERCULES 3 STAGE BALLOON ESOPHAGEAL $865.00 HERCULES 3 STAGE BALLOON ESOPHAGEAL $865.00 HERCULES 3 STAGE BALLOON ESOPHAGEAL $865.00 HERCULES 3 STAGE WIREGUIDED BALLOON ESOPHAGEAL-PYLORIC-COLO$N1,070.00 HERCULES 3 STAGE WIREGUIDED BALLOON ESOPHAGEAL-PYLORIC-COLO$N1,070.00 HERCULES 3 STAGE WIREGUIDED BALLOON ESOPHAGEAL-PYLORIC-COLO$N1,070.00 HERCULES 3 STAGE WIREGUIDED BALLOON ESOPHAGEAL-PYLORIC-COLO$N1,070.00 HERCULES 3 STAGE WIREGUIDED BALLOON ESOPHAGEAL-PYLORIC-COLO$N1,070.00 Page 6 of 458 Bozeman Health Deaconess Hospital 2020 pricing Drugs&Supplies PROCEDURE NAME FUSION TITAN DILATION BALLOON FUSION TITAN DILATION BALLOON FUSION TITAN DILATION BALLOON FUSION OMNI-TOME PRE-LOADED SPHINCTEROTOME FUSION OMNI-TOME PRE-LOADED SPHINCTEROTOME FUSION QUATTRO EXTRACTION BALLOON 8.5-10-12-15 ACROBAT 2 CALIBRATED TIP WIRE GUIDE ACROBAT 2 CALIBRATED TIP WIRE GUIDE FUSION LITHOTRIPSY EXTRACTION BASKET FUSION LITHOTRIPSY EXTRACTION BASKET SNAREMASTER SNARE 2.8 MM 230 CM 15 MM SNAREMASTER SNARE 2.8 MM 230 CM 25 MM SMARTBAND LIGATION KIT INFLATION DEVICE FOR ENDOSCOPIC BALLOON DILATION B-V243Q-A (OAI) VN G-240-2527S VISIGLIDE GUIDEWIRE .025,27 G-240-2545S VISIGLIDE GUIDEWIRE .025, 45 CD-B620LA BICOAG BIPOLAR HEMO PROB 2.3 MM CLEVERCUT 3 VDW V1 4.5 FR 7 MM TIP 20 MM WIRE CLEVERCUT 3 VDW V2 2.9 FR 7 MM TIP 20 MM WIRE MAXPASS BILIARY BALLOON DILATOR MAXPASS INFLATION DEVICE BILIARY EZ DILATE BALLOON DILATOR 2.8 CHNL 19 11-12-13 EZ DILATE BALLOON DILATOR 2.8 CHNL 13.5-14.5-15.5 EZ DILATE BALLOON DILATOR 2.8 CHNL 16-17-18 EZ DILATE BALLOON DILATOR 2.8 CHNL 18-19-20 HANAROSTENT ESO FULLY COVERED 22DM 15CM MAXPASS BILIARY BALLOON DILATOR 4 X 20MM QUICKSILVER BIPOLAR COAGULATION PROBE QUICKSILVER BIPOLAR COAGULATION PROBE ACUJECT VARIABLE INJECTION NEEDLE HUIBREGTSE TRIPLE LUMEN NEEDLE KNIFE CAPTURA PRO BIOPSY FORCEPS WITH SPIKE GEENEN PANCREATIC STENT FUSION PUSHING CATHETER OASIS ONE ACTION STENT INTRODUCTION SYSTEM OASIS ONE ACTION STENT INTRODUCTION SYSTEM OASIS ONE ACTION STENT INTRODUCTION SYSTEM OASIS ONE ACTION STENT INTRODUCTION SYSTEM ADVANTIX PLASTIC DUODENAL STENTS 7 FR 7 CM DUODENAL STENT INSERTION KIT PLASTIC BILLIARY STENT DUODENAL BEND 10 FRENCH X 5 CM PLASTIC BILLIARY STENT DUODENAL BEND 10 FRENCH X 7 CM BILIARY STENT INSERTION KIT ACUSNARE POLYPECTOMY SNARE SOFT 13MM FUSION QUATTRO EXTRACTION BALLOON 8.5-10-12-15 Page 7 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,050.00 $1,050.00 $1,050.00 $1,117.00 $1,190.00 $790.00 $890.00 $890.00 $1,019.00 $1,047.00 $101.00 $101.00 $720.00 $193.00 $525.00 $750.00 $750.00 $630.00 $1,208.00 $1,208.00 $665.00 $435.00 $665.00 $665.00 $665.00 $665.00 $4,275.00 $202.00 $1,150.00 $865.00 $209.00 $960.00 $63.00 $358.00 $341.00 $645.00 $645.00 $645.00 $645.00 $202.00 $291.00 $202.00 $202.00 $291.00 $72.00 $890.00 2020 pricing Drugs&Supplies PROCEDURE NAME UNIT PRICE SET CO2 TUBING/CAP - OLYMPUS SCOPES & UCR $143.00 ADVANCE DELIVERY DEVICE-CAPSULE ENDOSCOPE $925.00 STENT SYS EPIC BILIARY 6X60MM $4,485.00 STENT SET BIL - 10FR 5CM B/W FLAPPS $555.00 STENT SET BIL - 10FR 7CM B/W FLAPPS $555.00 STENT SET BIL - 10FR 9CM B/W FLAPPS $555.00 STENT SET BIL - 7FR 7CM B/W FLAPPS $555.00 STENT SET BIL - 7FR 9CM B/W FLAPPS $555.00 FORCEPS BIOPSY 1.8MM CUP 160CM MINI $172.00 BALLOON DILATOR - 8MM WIRE-GUIDED PYLORIC/COLONIC $760.00 STNT BIL BD 10MMXFD 11CMXL 6CM $5,142.00 STNT BIL BD 10MMXFD 11CMXL 8CM $5,142.00 ESOPHAGEAL STNT BDIA 20MM FDIA 25MM STNT L 15CM $4,566.00 DUODENAL STNT 22MM BD 27MM FD 6CM STNT L 10FR 230CM L $5,235.00 DUODENAL STNT 22MM BD 27MM FD 9CM STNT L 10FR 230CM L $5,235.00 STNT 25MM BD 30MM FD 6CM L -10FR D 230CM L $5,235.00 STNT 25MM BD 30MM FD 8CM L -10FR D 230CM L $5,235.00 FLOW 20 PERC ENDO GAST SETPULL 20FR PULL-SAFETY $495.00 FUSION OMNI ERCP CATH 7FR 200 CM $424.00 FUSION PRE-LOADED WITH ACROBAT WIRE .035 INCH 260CM L $1,208.00 DISP VARICES INJECTOR 23GA 240CM $237.00 DISP VARICES INJECTOR 25GA 240CM $237.00 ZIMMON PANCREATIC STNT 4FR 4CM B/W CURL & FLAP $303.00 ZILVER 635 BILIARY SLF-EXPAND METAL STNT $4,350.00 NDL ASPIRATION 22G L80MM $1,043.00 NDL ENDO ASPIRATION 25G L140MM $763.00 SNAREMASTER PLUS 15MM $87.00 ESUCTION ESOPHAGEAL $1,024.00 WIRE STONE REMOVER L115CM W11MM $1,026.00 NDL BIOPSY 21GA L15CM CHIBA DISP $61.00 NDL BIOPSY 21GA L20CM CHIBA DISP $61.00 BIOPSY VALVE 140-AL5/160-OL5 $54.00 EUS SUCTION VALVE AUTOCLAVE $1,060.00 EUS AIR/WATER FALVE AUTOCLAVE $924.00 BALLOON APPLICATOR $291.00 BALLOON APLICATOR FOR GF-UC30P $300.00 BALLOON FOR GF-UM30P $138.00 KIT ERCP CUSTOM $172.00 KIT BRONCH CUSTOM $312.00 BALLOON GF/JF-UM2/3 $133.00 BRUSH BRONCH CYTOLOGY 2MM DIA $5,850.00 STENT GASTRO PANC EXT PIGTAIL W/LEAD FLAP 5FR 3CM $71.00 STENT GASTRO PANC EXT PIGTAIL W/O LEADING FLAP 5FR 3CM $358.00 STENT GASTRO PANC STRT W/ EXT AND LEAD FLAP 5FR 3CM $358.00 STENT GASTRO PANC SOFT STRT W/ EXT AND LEAD FLAP 5FR 3CM $303.00 STENT GASTRO PANC STRT W/ EXT W/O INT FLAP 5FR 3CM $303.00 Page 8 of 458 Bozeman Health Deaconess Hospital 2020 pricing Drugs&Supplies PROCEDURE NAME STENT GASTRO PANC SOFT STRT W/ EXT W/O INT FLAP 5FR 3CM BRUSH CYTOLOGY BRONCH&COLON 3MMX240CM IOL TORIC ZCT600 5.0D TITAN BALLOON 6MMX4CM FORCEP BIOPSY 2.2MMX160CM FORCEP BRONCH 1.8MMX110CM NEEDLE 22G ENDO FNB PROCORE NEEDLE 25G ENDO FNB PROCORE NEEDLE 22G BIOPSY FNA 4MM LOCKING SCREW 4.0MM / L48MM REAG VIDAS LYMES LGG II REAG VIDAS LYMES LGM II TB VENT TRIUNE SIL 1.35X5MM CASSETTE VAC VERALINK REAG INFLUENZA A/B COBAS LIAT REAG STREP A COBAS LIAT CTRL KT COBAS FLU A/B 3SET CTRL KT COBAS FLU A/B & RSV CTRL KT COBAS STREP A REAG INFLUENZA A/B RSV COBAS ALLO MTX GRAFIXPLPRIME16MM=2CM ALLO MTXGRAFIXPLPRIME1.5X2=3SQ ALLO MTXGRAFIXPLPRIME2X3CM=6SQ ALLO MTXGRAFIXPLPRIME3X3CM=9SQ ALLOMTXGRAFIXPLPRIME3X4CM=12SQ ALLOMTXGRAFIXPLPRIME5X5CM=25SQ BG PRSS INFUSER W HOOK 1000ML DISC RING CUT CARB GLD SLVR DISC RING CUT DIMND HARD MTL BLN CATH EPISTAX PK 120MM PAPER TEST PH NITRATESTINVITRO TRANSD SET SGL DTXPLUS DISP LEAD 3WIRE ECG SGL PIN DISP BLADE SPECTRUM LOPRO DISP S4 BLADE SPECTRUM LOPRO DISP S3 BLADE MYRINGOTOMY SPEARANGDOWN SPECULUM VAG SGL USE W LT SM SPECULUM VAG SGL USE W LT MD SPECULUM VAG SGL USE W LT LG NDLE BX DISP 18GX20CM BLADE LARYNSCP DISP MAC SZ1 INTR SUPRAFOLEY 12FR SET INFUS TB FILLING FOR NPU PESSARY DISH INCONTINENCE SZ3 PF L0623 SIO PANEL PREFAB PF L1820 KO ELAS W/ CONDYLE PADS & JOINTS PREFAB UNIT PRICE $303.00 $303.00 $71.00 $530.00 $1,050.00 $47.00 $172.00 $1,236.00 $1,131.00 $1,120.00 $1,190.00 $1,910.00 $152.64 $308.00 $378.70 $382.90 $521.00 $521.00 $521.00 $405.75 $1,663.20 $2,367.20 $2,987.50 $2,987.50 $3,145.50 $5,760.00 $70.94 $188.31 $521.00 $196.05 $304.15 $139.30 $575.10 $224.40 $224.40 $80.62 $68.01 $68.01 $68.01 $183.96 $68.84 $501.60 $73.77 $246.84 $113.00 $170.00 Page 9 of 458 Bozeman Health Deaconess Hospital 2020 pricing Drugs&Supplies PROCEDURE NAME GLOVE CARPEL TUNNEL THMO RT MD GLOVE CARPEL TUNNEL THMO LFT LG GLOVE CARPEL TUNNEL THMO RT LG GLOVE CARPEL TUNNEL THMO LFT XL SPLT THB ROLN SUPP MD SPLT HAND BASED THB SPICA GLOVE CARPAL TUNNEL THMO LFT MD SPLT RAD HNGULNARDEVTN LFT SM SPLT RAD HNG ULNAR DEVTN RT SM SPLT PERFD SPECTRUM BGE18X24 DRAPE FEN CL RD 4 SET TUOHY CONTIPLEX NDLE 18GX6 STRAP HD BACK MULLIGAN SLFSNAG BELT SEROLA SACROILIAC SM CATH PICC TURBOJECT DLSS5FR130 NDLE BX ACHIEVE COAX 14GX11CM KT GASTRO MIC LOPRO 16FR 3.0CM PORT POWERPORT DL 9.5FR KT CATH TRIALYSIS CURV EXT24CM TB GJ G-JET 14FR 1.5 30CM BG DRN ASPIRA 1000ML TB AMT MINIONE NONBLN24FR4.4CM BTN NON BLN MINIONE 24FR 5.4CM BTN MINIONE 18FR 2.4CM BTN MINIONE 18FR 3.4CM TRAY ACCUCATH BASIC 20G 2.25"" TRAY ACCUCATH INTRMDT 20G 2.25"" TRAY ACCUCATH INTRMDT 22G 1.25"" TRAY ACCUCATH INTRMDT 22G 2.25"" SYNCHROWAVE ANT ACT TIP 2.0CM 14GX15CM CRYOPROBE 2.4MM VARIABLE ICE CATHETER SECUREMENT DEVICE SET ENDOBRONCH BLOCK 5FR 50CM SET ENDOBRONCH BLOCK 7FR 65CM SET ENDOBRONCH BLOCK 9FR 78CM DILATOR PLMNRY BALLOON CRE 8X9X10MM DILATOR PLMNRY BALLOON CRE 10X11X12MM JAGWIRE PULMONARY .035IN X 180CM KIT CATH DRAINAGE PLEURX 500ML KIT CATH DRAINAGE PLEURX 1000ML MINI ROTH NET RETRIEVER AEROSIZER 90CM STENT TRACHEOBRONCHIAL 40MM STR 6FR STENT TRACHEOBRONCHIAL 60MM STR 6FR STENT TRACHEOBRONCHIAL 80MM STR 6FR CATH 9.6FR 90CM SNGL-LMN HICKMAN Page 10 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $123.86 $123.86 $123.86 $123.86 $119.90 $129.26 $123.86 $295.30 $295.30 $360.74 $68.00 $129.00 $78.06 $169.07 $546.00 $290.65 $485.97 $1,487.00 $468.73 $1,433.85 $165.00 $1,147.30 $1,193.60 $814.40 $814.40 $236.00 $1,214.00 $811.00 $1,158.00 $5,100.00 $4,200.00 $80.00 $942.00 $942.00 $942.00 $1,033.00 $1,033.00 $598.00 $571.00 $525.00 $575.00 $875.00 $4,173.00 $4,173.00 $4,173.00 $567.00 2020 pricing Drugs&Supplies PROCEDURE NAME WALLSTENT ENDOPROSTH 6X60MM 75CM KIT CATH 3FR INFUSE PROVENA MIDLINE KIT CATH 4FR INFUSE PROVENA MIDLINE BTL DRAIN EVOLUTION EVAC 1000ML DENNY PEEL AWAY INTRODUCER SET KT GASTRO MIC LOPRO 24FR 3.5CM CIRCUIT W MR290 DUAL HEAT ADLT KT NEB CONVENIENCE MASK AF531EE NEB 1ELBOW SM MASK AF531EE NEB 1ELBOW MD MASK AF531EE NEB 1ELBOW LG BUBBLE CPAP SYSTEM NASAL TUBING UNIVERSAL 50MM NASAL TUBING UNIVERSAL 70MM NASAL TUBING UNIVERSAL 100MM NASAL MASK (SMALL) NASAL MASK (MEDIUM) NASAL MASK (LARGE) NASAL MASK (EXTRA LARGE) INFANT BONNET 17-22 CM INFANT BONNET 22-25 CM INFANT BONNET 25-29 CM INFANT BONNET 29-36 CM HEAD GEAR 29-36 CM HEAD GEAR 35-40 CM HEAD GEAR 40-45 CM VPEP/BRONCHIAL HYGIENE IOL MULTI 3PC ZMA00 15.0D IOL MULTI 3PC ZMA00 14.0D IOL MULTI 3PC ZMA00 22.5D IOL MULTI 3PC ZMA00 16.5D IOL MULTI 3PC ZMA00 13.5D IOL MULTI 3PC ZMA00 21.5D IOL MULTI 3PC ZMA00 11.0D IOL MULTI 3PC ZMA00 10.0D IOL MULTI 3PC ZMA00 10.5D IOL MULTI 3PC ZMA00 11.5D IOL MULTI 3PC ZMA00 12.0D IOL MULTI 3PC ZMA00 12.5D IOL MULTI 3PC ZMA00 13.0D IOL MULTI 3PC ZMA00 14.5D IOL MULTI 3PC ZMA00 15.5D IOL MULTI 3PC ZMA00 16.0D IOL MULTI 3PC ZMA00 17.0D IOL MULTI 3PC ZMA00 17.5D IOL MULTI 3PC ZMA00 18.0D Page 11 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,173.00 $966.00 $1,086.00 $140.00 $432.00 $507.00 $140.00 $298.00 $578.00 $578.00 $578.00 $750.00 $358.00 $358.00 $358.00 $509.00 $509.00 $509.00 $509.00 $303.00 $303.00 $303.00 $303.00 $535.00 $535.00 $535.00 $181.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL MULTI 3PC ZMA00 18.5D IOL MULTI 3PC ZMA00 19.0D IOL MULTI 3PC ZMA00 19.5D IOL MULTI 3PC ZMA00 20.0D IOL MULTI 3PC ZMA00 20.5D IOL MULTI 3PC ZMA00 21.0D IOL MULTI 3PC ZMA00 22.0D IOL MULTI 3PC ZMA00 23.0D IOL MULTI 3PC ZMA00 23.5D IOL MULTI 3PC ZMA00 24.0D IOL MULTI 3PC ZMA00 24.5D IOL MULTI 3PC ZMA00 25.0D IOL MULTI 3PC ZMA00 26.0D IOL MULTI 3PC ZMA00 26.5D IOL MULTI 3PC ZMA00 27.0D IOL MULTI 3PC ZMA00 27.5D IOL MULTI 3PC ZMA00 28.0D IOL MULTI 3PC ZMA00 28.5D IOL MULTI 3PC ZMA00 29.0D IOL MULTI 3PC ZMA00 29.5D IOL MULTI 3PC ZMA00 30.0D IOL MULTI 3PC ZMA00 30.5D IOL MULTI 3PC ZMA00 31.0D IOL MULTI 3PC ZMA00 31.5D IOL MULTI 3PC ZMA00 32.0D IOL MULTI 3PC ZMA00 32.5D IOL MULTI 3PC ZMA00 33.0D IOL MULTI 3PC ZMA00 33.5D IOL MULTI 3PC ZMA00 34.0D IOL MULTI 3PC ZMA00 5.0D IOL MULTI 3PC ZMA00 5.5D IOL MULTI 3PC ZMA00 6.0D IOL MULTI 3PC ZMA00 6.5D IOL MULTI 3PC ZMA00 7.0D IOL MULTI 3PC ZMA00 7.5D IOL MULTI 3PC ZMA00 8.0D IOL MULTI 3PC ZMA00 8.5D IOL MULTI 3PC ZMA00 9.5D IOL MULTI 3PC ZMA00 25.5D IOL 1PC ZCB00 ACRYL 18.5D IOL 1PC ZCB00 ACRYL 19.0D IOL 1PC ZCB00 ACRYL 19.5D IOL 1PC ZCB00 ACRYL 20.0D IOL 1PC ZCB00 ACRYL 20.5D IOL 1PC ZCB00 ACRYL 21.0D IOL 1PC ZCB00 ACRYL 21.5D Page 12 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL 1PC ZCB00 ACRYL 22.5D IOL 1PC ZCB00 ACRYL 23.0D IOL 1PC ZCB00 ACRYL 24.0D IOL MULT 3PC ZMA0U 9.0D IOL 1PC ZCB00 ACRYL 18.0D IOL 1PC ZCB00 ACRYL 22.0D IOL 1PC ZCB00 ACRYL 23.5D IOL 1PC ZCB00 ACRYL 24.5D IOL 1PC ZCB00 ACRYL 12.0D IOL 1PC ZCB00 ACRYL 12.5D IOL 1PC ZCB00 ACRYL 13.0D IOL 1PC ZCB00 ACRYL 13.5D IOL 1PC ZCB00 ACRYL 14.0D IOL 1PC ZCB00 ACRYL 14.5D IOL 1PC ZCB00 ACRYL 15.0D IOL 1PC ZCB00 ACRYL 15.5D IOL 1PC ZCB00 ACRYL 25.0D IOL 1PC ZCB00 ACRYL 25.5D IOL 1PC ZCB00 ACRYL 26.0D IOL 1PC ZCB00 ACRYL 26.5D IOL 1PC ZCB00 ACRYL 16.0D IOL 1PC ZCB00 ACRYL 16.5D IOL 1PC ZCB00 ACRYL 17.0D IOL 1PC ZCB00 ACRYL 17.5D IOL 1PC ZCB00 ACRYL 27.0D IOL 1PC ZCB00 ACRYL 27.5D IOL 1PC ZCB00 ACRYL 28.0D IOL 1PC ZCB00 ACRYL 28.5D IOL 1PC ZCB00 ACRYL 29.0D IOL 1PC ZCB00 ACRYL 29.5D IOL 1PC ZCB00 ACRYL 30.0D IOL 1PC ZCB00 ACRYL 9.5D IOL 1PC ZCB00 ACRYL 32.0D IOL 1PC ZCB00 ACRYL 31.0D IOL MULT 1PC ZMB00 ACRYL 21.0D IOL MULT 1PC ZMB00 ACRYL 20.5D IOL 1PC ZCB00 ACRYL 8.5D IOL MULT 1PC ZMB00 ACRYL 15.0D IOL MULT 1PC ZMB00 ACRYL 18.5D IOL MULT 1PC ZMB00 ACRYL 17.5D IOL MULT 1PC ZMB00 ACRYL 22.0D IOL MULT 1PC ZMB00 ACRYL 15.5D IOL 1PC ZCB00 ACRYL 7.0D IOL MULT 1PC ZMB00 ACRYL 8.5D IOL MULT 1PC ZMB00 ACRYL 20.0D IOL MULT 1PC ZMB00 ACRYL 10.0D Page 13 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $900.00 $900.00 $900.00 $1,034.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $900.00 $1,034.00 $1,034.00 $900.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $900.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL MULT 1PC ZMB00 ACRYL 10.5D IOL MULT 1PC ZMB00 ACRYL 11.0D IOL MULT 1PC ZMB00 ACRYL 11.5D IOL MULT 1PC ZMB00 ACRYL 12.0D IOL MULT 1PC ZMB00 ACRYL 12.5D IOL MULT 1PC ZMB00 ACRYL 13.0D IOL MULT 1PC ZMB00 ACRYL 13.5D IOL MULT 1PC ZMB00 ACRYL 14.0D IOL MULT 1PC ZMB00 ACRYL 14.5D IOL MULT 1PC ZMB00 ACRYL 16.0D IOL MULT 1PC ZMB00 ACRYL 16.5D IOL MULT 1PC ZMB00 ACRYL 17.0D IOL MULT 1PC ZMB00 ACRYL 18.0D IOL MULT 1PC ZMB00 ACRYL 19.0D IOL MULT 1PC ZMB00 ACRYL 19.5D IOL MULT 1PC ZMB00 ACRYL 21.5D IOL MULT 1PC ZMB00 ACRYL 22.5D IOL MULT 1PC ZMB00 ACRYL 23.0D IOL MULT 1PC ZMB00 ACRYL 23.5D IOL MULT 1PC ZMB00 ACRYL 24.0D IOL MULT 1PC ZMB00 ACRYL 24.5D IOL MULT 1PC ZMB00 ACRYL 25.0D IOL MULT 1PC ZMB00 ACRYL 25.5D IOL MULT 1PC ZMB00 ACRYL 26.0D IOL MULT 1PC ZMB00 ACRYL 26.5D IOL MULT 1PC ZMB00 ACRYL 27.0D IOL MULT 1PC ZMB00 ACRYL 27.5D IOL MULT 1PC ZMB00 ACRYL 28.0D IOL MULT 1PC ZMB00 ACRYL 28.0D IOL MULT 1PC ZMB00 ACRYL 29.0D IOL MULT 1PC ZMB00 ACRYL 29.5D IOL MULT 1PC ZMB00 ACRYL 30.0D IOL 1PC ZCB00 ACRYL 11.5D IOL MULT 1PC ZMB00 ACRYL 5.0D IOL MULT 1PC ZMB00 ACRYL 7.0D IOL MULT 1PC ZMB00 ACRYL 5.5D IOL MULT 1PC ZMB00 ACRYL 7.5D IOL 1PC ZCB00 ACRYL 6.0D STNT TRABEC BYPASS ISTENT RT STNT TRABEC BYPASS ISTENT LFT IOL 1PC ZCB00 ACRYL 8.0D IOL MULT 1PC ZMB00 ACRYL 6.5D IOL TORIC ZCT150 16.0D IOL TORIC ZCT225 25.0D IOL TORIC ZCT150 19.5D IOL TORIC ZCT150 16.5D Page 14 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $900.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $900.00 $3,498.00 $3,498.00 $900.00 $1,034.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TORIC ZCT225 16.0D IOL TORIC ZCT225 12.5D IOL TORIC ZCT225 10.0D IOL TORIC ZCT225 19.0D IOL TORIC ZCT225 20.5D IOL TORIC ZCT300 20.5D IOL TORIC ZCT150 20.0D IOL TORIC ZCT150 19.0D IOL TORIC ZCT225 17.5D IOL TORIC ZCT300 20.0D IOL TORIC ZCT400 18.5D IOL TORIC ZCT150 22.0D IOL TORIC ZCT150 23.5D IOL TORIC ZCT225 25.5D IOL TORIC ZCT150 10.5D IOL TORIC ZCT300 15.0D IOL TORIC ZCT150 17.0D IOL TORIC ZCT225 11.0D IOL TORIC ZCT300 15.5D IOL TORIC ZCT225 18.5D IOL TORIC ZCT300 18.0D IOL TORIC ZCT150 24.0D IOL TORIC ZCT150 20.5D IOL TECNIS MULT ZKB00 16.5D IOL TECNIS MULT ZKB00 21.0D IOL TECNIS MULT ZKB00 21.5D IOL TECNIS MULT ZKB00 22.0D IOL TECNIS MULT ZKB00 22.5D IOL TECNIS MULT ZKB00 24.5D MICROSTNT CYPASS CAUT LIGASURE MARYLANDOPEN37CM IOL TORIC ZCT225 10.5D IOL TORIC ZCT300 19.5D STNT TRABEC BYPASS ISTENT INJ IOL ACRYSOFIQ TORIC 4.50D 23.5 MICROSTNT CYPASS ULT OPHT IOL 1PC ZCB00 ACRYL 32.5D IOL TORIC ASPHERIC 6.00D 14.0 D IOL TORIC ZCT150 5.0D IOL TORIC ZCT150 5.5D IOL TORIC ZCT150 6.0D IOL TORIC ZCT150 7.0D IOL TORIC ZCT150 7.5D IOL TORIC ZCT150 8.0D IOL TORIC ZCT225 5.0D IOL TORIC ZCT225 5.5D Page 15 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $3,376.00 $2,227.00 $572.00 $572.00 $4,583.50 $851.00 $3,376.00 $900.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TORIC ZCT225 6.0D IOL TORIC ZCT225 7.0D IOL TORIC ZCT225 7.5D IOL TORIC ZCT225 8.0D IOL AKREOS AO 8.5D IOL AKREOS AO 9.0D IOL AKREOS AO 9.5D IOL AKREOS AO60 7.0D IOL RESTOR +3D 11.0 IOL RESTOR +3D 11.5 IOL RESTOR +3D 12.0 IOL RESTOR +2.5 18.0 IOL ACTFOC NAT +2.5D 13.5 IOL ACTFOC NAT +2.5D 14.0 IOL ACTFOC NAT +2.5D 14.5 IOL NAT TORIC SND1T3 13.5 IOL NAT TORIC SND1T3 14.0 IOL NAT TORIC SND1T3 14.5 IOL NAT NON TORIC SV25T0 20.5 IOL NAT NON TORIC SV25T0 21.0 IOL NAT NON TORIC SV25T0 21.5 IOL NAT TORIC SV25T3 20.5 IOL NAT TORIC SV25T3 21.0 IOL NAT TORIC SV25T3 21.5 IOL NAT TORIC SV25T4 20.5 IOL NAT TORIC SV25T4 21.0 IOL NAT TORIC SV25T4 21.5 IOL RESTOR +2.5D 12.0 IOL RESTOR +2.5D 12.5 IOL RESTOR +2.5D 13.0 IOL RESTOR +2.5D 14.5 IOL RESTOR +2.5D 15.0 IOL RESTOR +2.5D 15.5 IOL RESTOR TORIC +2.5D 12.0 IOL RESTOR TORIC +2.5D 12.5 IOL RESTOR TORIC +2.5D 13.0 IOL RESTOR TORIC +2.5D 14.5 IOL RESTOR TORIC +2.5D 15.0 IOL RESTOR TORIC +2.5D 15.5 IOL RESTOR +2.5D 17.5 IOL ACTVFCS NAT NON TORIC 6.0 IOL ACTVFCS NAT NON TORIC 6.5 IOL ACTVFCS NAT NON TORIC 7.0 IOL ACTVFCS NAT NON TORIC 7.5 IOL ACTVFCS NAT NON TORIC 8.0 IOL ACTVFCS NAT NON TORIC 8.5 Page 16 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $923.00 $923.00 $923.00 $923.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS NAT NON TORIC 9.0 IOL ACTVFCS NAT NON TORIC 9.5 IOL ACTVFCS NAT NON TORIC 10.0 IOL ACTVFCS NAT NON TORIC 10.5 IOL ACTVFCS NAT NON TORIC 11.0 IOL ACTVFCS NAT NON TORIC 11.5 IOL ACTVFCS NAT NON TORIC 12.0 IOL ACTVFCS NAT NON TORIC 12.5 IOL ACTVFCS NAT NON TORIC 13.0 IOL ACTVFCS NAT NON TORIC 15.0 IOL ACTVFCS NAT NON TORIC 15.5 IOL ACTVFCS NAT NON TORIC 16.0 IOL ACTVFCS NAT NON TORIC 16.5 IOL ACTVFCS NAT NON TORIC 17.0 IOL ACTVFCS NAT NON TORIC 17.5 IOL ACTVFCS NAT NON TORIC 18.0 IOL ACTVFCS NAT NON TORIC 18.5 IOL ACTVFCS NAT NON TORIC 19.0 IOL ACTVFCS NAT NON TORIC 19.5 IOL ACTVFCS NAT NON TORIC 20.0 IOL ACTVFCS NAT NON TORIC 20.5 IOL ACTVFCS NAT NON TORIC 21.0 IOL ACTVFCS NAT NON TORIC 21.5 IOL ACTVFCS NAT NON TORIC 22.0 IOL ACTVFCS NAT NON TORIC 22.5 IOL ACTVFCS NAT NON TORIC 23.0 IOL ACTVFCS NAT NON TORIC 23.5 IOL ACTVFCS NAT NON TORIC 24.0 IOL ACTVFCS NAT NON TORIC 24.5 IOL ACTVFCS NAT NON TORIC 25.0 IOL ACTVFCS NAT NON TORIC 25.5 IOL ACTVFCS NAT NON TORIC 26.0 IOL ACTVFCS NAT NON TORIC 26.5 IOL ACTVFCS NAT NON TORIC 27.0 IOL ACTVFCS NAT NON TORIC 27.5 IOL ACTVFCS NAT NON TORIC 28.0 IOL ACTVFCS NAT NON TORIC 28.5 IOL ACTVFCS NAT NON TORIC 29.0 IOL ACTVFCS NAT NON TORIC 29.5 IOL ACTVFCS NAT NON TORIC 30.0 IOL ACTVFCS NAT NON TORIC 30.5 IOL ACTVFCS NAT NON TORIC 31.0 IOL ACTVFCS NAT NON TORIC 32.0 IOL ACTVFCS NAT NON TORIC 33.0 IOL ACTVFCS NAT NON TORIC 34.0 IOL ACTVFCS CLR NON TORIC 6.0 Page 17 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS CLR NON TORIC 6.5 IOL ACTVFCS CLR NON TORIC 7.0 IOL ACTVFCS CLR NON TORIC 7.5 IOL ACTVFCS CLR NON TORIC 8.0 IOL ACTVFCS CLR NON TORIC 8.5 IOL ACTVFCS CLR NON TORIC 9.0 IOL ACTVFCS CLR NON TORIC 9.5 IOL ACTVFCS CLR NON TORIC 10.0 IOL ACTVFCS CLR NON TORIC 10.5 IOL ACTVFCS CLR NON TORIC 11.0 IOL ACTVFCS CLR NON TORIC 11.5 IOL ACTVFCS CLR NON TORIC 12.0 IOL ACTVFCS CLR NON TORIC 12.5 IOL ACTVFCS CLR NON TORIC 13.0 IOL ACTVFCS CLR NON TORIC 13.5 IOL ACTVFCS CLR NON TORIC 14.0 IOL ACTVFCS CLR NON TORIC 14.5 IOL ACTVFCS CLR NON TORIC 15.0 IOL ACTVFCS CLR NON TORIC 15.5 IOL ACTVFCS CLR NON TORIC 16.0 IOL ACTVFCS CLR NON TORIC 16.5 IOL ACTVFCS CLR NON TORIC 17.0 IOL ACTVFCS CLR NON TORIC 17.5 IOL ACTVFCS CLR NON TORIC 18.0 IOL ACTVFCS CLR NON TORIC 18.5 IOL ACTVFCS CLR NON TORIC 19.0 IOL ACTVFCS CLR NON TORIC 19.5 IOL ACTVFCS CLR NON TORIC 20.0 IOL ACTVFCS CLR NON TORIC 20.5 IOL ACTVFCS CLR NON TORIC 21.0 IOL ACTVFCS CLR NON TORIC 21.5 IOL ACTVFCS CLR NON TORIC 22.0 IOL ACTVFCS CLR NON TORIC 22.5 IOL ACTVFCS CLR NON TORIC 23.0 IOL ACTVFCS CLR NON TORIC 23.5 IOL ACTVFCS CLR NON TORIC 24.0 IOL ACTVFCS CLR NON TORIC 24.5 IOL ACTVFCS CLR NON TORIC 25.0 IOL ACTVFCS CLR NON TORIC 25.5 IOL ACTVFCS CLR NON TORIC 26.0 IOL ACTVFCS CLR NON TORIC 26.5 IOL ACTVFCS CLR NON TORIC 27.0 IOL ACTVFCS CLR NON TORIC 27.5 IOL ACTVFCS CLR NON TORIC 28.0 IOL ACTVFCS CLR NON TORIC 28.5 IOL ACTVFCS CLR NON TORIC 29.0 Page 18 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS CLR NON TORIC 29.5 IOL ACTVFCS CLR NON TORIC 30.0 IOL ACTVFCS CLR NON TORIC 30.5 IOL ACTVFCS CLR NON TORIC 31.0 IOL ACTVFCS CLR NON TORIC 32.0 IOL ACTVFCS CLR NON TORIC 33.0 IOL ACTVFCS CLR NON TORIC 34.0 IOL ACTVFCS NAT TORIC 6.0 IOL ACTVFCS NAT TORIC 6.5 IOL ACTVFCS NAT TORIC 7.0 IOL ACTVFCS NAT TORIC 7.5 IOL ACTVFCS NAT TORIC 8.0 IOL ACTVFCS NAT TORIC 8.5 IOL ACTVFCS NAT TORIC 9.0 IOL ACTVFCS NAT TORIC 9.5 IOL ACTVFCS NAT TORIC 10.0 IOL ACTVFCS NAT TORIC 10.5 IOL ACTVFCS NAT TORIC 11.0 IOL ACTVFCS NAT TORIC 11.5 IOL ACTVFCS NAT TORIC 12.0 IOL ACTVFCS NAT TORIC 12.5 IOL ACTVFCS NAT TORIC 13.0 IOL ACTVFCS NAT TORIC 13.5 IOL ACTVFCS NAT TORIC 14.0 IOL ACTVFCS NAT TORIC 14.5 IOL ACTVFCS NAT TORIC 15.0 IOL ACTVFCS NAT TORIC 15.5 IOL ACTVFCS NAT TORIC 16.0 IOL ACTVFCS NAT TORIC 16.5 IOL ACTVFCS NAT TORIC 17.0 IOL ACTVFCS NAT TORIC 17.5 IOL ACTVFCS NAT TORIC 18.0 IOL ACTVFCS NAT TORIC 18.5 IOL ACTVFCS NAT TORIC 19.0 IOL ACTVFCS NAT TORIC 19.5 IOL ACTVFCS NAT TORIC 20.0 IOL ACTVFCS NAT TORIC 20.5 IOL ACTVFCS NAT TORIC 21.0 IOL ACTVFCS NAT TORIC 21.5 IOL ACTVFCS NAT TORIC 22.0 IOL ACTVFCS NAT TORIC 22.5 IOL ACTVFCS NAT TORIC 23.0 IOL ACTVFCS NAT TORIC 23.5 IOL ACTVFCS NAT TORIC 24.0 IOL ACTVFCS NAT TORIC 24.5 IOL ACTVFCS NAT TORIC 25.0 Page 19 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS NAT TORIC 25.5 IOL ACTVFCS NAT TORIC 26.0 IOL ACTVFCS NAT TORIC 26.5 IOL ACTVFCS NAT TORIC 27.0 IOL ACTVFCS NAT TORIC 27.5 IOL ACTVFCS NAT TORIC 28.0 IOL ACTVFCS NAT TORIC 28.5 IOL ACTVFCS NAT TORIC 29.0 IOL ACTVFCS NAT TORIC 29.5 IOL ACTVFCS NAT TORIC 30.0 IOL ACTVFCS NAT TORIC 30.5 IOL ACTVFCS NAT TORIC 31.0 IOL ACTVFCS NAT TORIC 32.0 IOL ACTVFCS NAT TORIC 33.0 IOL ACTVFCS NAT TORIC 34.0 IOL ACTVFCS NAT TORIC 6.0 IOL ACTVFCS NAT TORIC 6.5 IOL ACTVFCS NAT TORIC 7.0 IOL ACTVFCS NAT TORIC 7.5 IOL ACTVFCS NAT TORIC 8.0 IOL ACTVFCS NAT TORIC 8.5 IOL ACTVFCS NAT TORIC 9.0 IOL ACTVFCS NAT TORIC 9.5 IOL ACTVFCS NAT TORIC 10.0 IOL ACTVFCS NAT TORIC 10.5 IOL ACTVFCS NAT TORIC 11.0 IOL ACTVFCS NAT TORIC 11.5 IOL ACTVFCS NAT TORIC 12.0 IOL ACTVFCS NAT TORIC 12.5 IOL ACTVFCS NAT TORIC 13.0 IOL ACTVFCS NAT TORIC 13.5 IOL ACTVFCS NAT TORIC 14.0 IOL ACTVFCS NAT TORIC 14.5 IOL ACTVFCS NAT TORIC 15.0 IOL ACTVFCS NAT TORIC 15.5 IOL ACTVFCS NAT TORIC 16.0 IOL ACTVFCS NAT TORIC 16.5 IOL ACTVFCS NAT TORIC 17.0 IOL ACTVFCS NAT TORIC 17.5 IOL ACTVFCS NAT TORIC 18.0 IOL ACTVFCS NAT TORIC 18.5 IOL ACTVFCS NAT TORIC 19.0 IOL ACTVFCS NAT TORIC 19.5 IOL ACTVFCS NAT TORIC 20.0 IOL ACTVFCS NAT TORIC 20.5 IOL ACTVFCS NAT TORIC 21.0 Page 20 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS NAT TORIC 21.5 IOL ACTVFCS NAT TORIC 22.0 IOL ACTVFCS NAT TORIC 22.5 IOL ACTVFCS NAT TORIC 23.0 IOL ACTVFCS NAT TORIC 23.5 IOL ACTVFCS NAT TORIC 24.0 IOL ACTVFCS NAT TORIC 24.5 IOL ACTVFCS NAT TORIC 25.0 IOL ACTVFCS NAT TORIC 25.5 IOL ACTVFCS NAT TORIC 26.0 IOL ACTVFCS NAT TORIC 26.5 IOL ACTVFCS NAT TORIC 27.0 IOL ACTVFCS NAT TORIC 27.5 IOL ACTVFCS NAT TORIC 28.0 IOL ACTVFCS NAT TORIC 28.5 IOL ACTVFCS NAT TORIC 29.0 IOL ACTVFCS NAT TORIC 29.5 IOL ACTVFCS NAT TORIC 30.0 IOL ACTVFCS NAT TORIC 30.5 IOL ACTVFCS NAT TORIC 31.0 IOL ACTVFCS NAT TORIC 32.0 IOL ACTVFCS NAT TORIC 33.0 IOL ACTVFCS NAT TORIC 34.0 IOL ACTVFCS NAT TORIC 6.0 IOL ACTVFCS NAT TORIC 6.5 IOL ACTVFCS NAT TORIC 7.0 IOL ACTVFCS NAT TORIC 7.5 IOL ACTVFCS NAT TORIC 8.0 IOL ACTVFCS NAT TORIC 8.5 IOL ACTVFCS NAT TORIC 9.0 IOL ACTVFCS NAT TORIC 9.5 IOL ACTVFCS NAT TORIC 10.0 IOL ACTVFCS NAT TORIC 10.5 IOL ACTVFCS NAT TORIC 11.0 IOL ACTVFCS NAT TORIC 11.5 IOL ACTVFCS NAT TORIC 12.0 IOL ACTVFCS NAT TORIC 12.5 IOL ACTVFCS NAT TORIC 13.0 IOL ACTVFCS NAT TORIC 13.5 IOL ACTVFCS NAT TORIC 14.0 IOL ACTVFCS NAT TORIC 14.5 IOL ACTVFCS NAT TORIC 15.0 IOL ACTVFCS NAT TORIC 15.5 IOL ACTVFCS NAT TORIC 16.0 IOL ACTVFCS NAT TORIC 16.5 IOL ACTVFCS NAT TORIC 17.0 Page 21 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS NAT TORIC 17.5 IOL ACTVFCS NAT TORIC 18.5 IOL ACTVFCS NAT TORIC 19.0 IOL ACTVFCS NAT TORIC 19.5 IOL ACTVFCS NAT TORIC 20.0 IOL ACTVFCS NAT TORIC 20.5 IOL ACTVFCS NAT TORIC 21.0 IOL ACTVFCS NAT TORIC 21.5 IOL ACTVFCS NAT TORIC 22.0 IOL ACTVFCS NAT TORIC 22.5 IOL ACTVFCS NAT TORIC 23.0 IOL ACTVFCS NAT TORIC 23.5 IOL ACTVFCS NAT TORIC 24.0 IOL ACTVFCS NAT TORIC 24.5 IOL ACTVFCS NAT TORIC 25.0 IOL ACTVFCS NAT TORIC 25.5 IOL ACTVFCS NAT TORIC 26.0 IOL ACTVFCS NAT TORIC 26.5 IOL ACTVFCS NAT TORIC 27.0 IOL ACTVFCS NAT TORIC 27.5 IOL ACTVFCS NAT TORIC 28.0 IOL ACTVFCS NAT TORIC 28.5 IOL ACTVFCS NAT TORIC 29.0 IOL ACTVFCS NAT TORIC 29.5 IOL ACTVFCS NAT TORIC 30.0 IOL ACTVFCS NAT TORIC 30.5 IOL ACTVFCS NAT TORIC 31.0 IOL ACTVFCS NAT TORIC 32.0 IOL ACTVFCS NAT TORIC 33.0 IOL ACTVFCS NAT TORIC 34.0 IOL ACTVFCS NAT TORIC 6.0 IOL ACTVFCS NAT TORIC 6.5 IOL ACTVFCS NAT TORIC 7.0 IOL ACTVFCS NAT TORIC 7.5 IOL ACTVFCS NAT TORIC 8.0 IOL ACTVFCS NAT TORIC 8.5 IOL ACTVFCS NAT TORIC 9.0 IOL ACTVFCS NAT TORIC 9.5 IOL ACTVFCS NAT TORIC 10.0 IOL ACTVFCS NAT TORIC 10.5 IOL ACTVFCS NAT TORIC 11.0 IOL ACTVFCS NAT TORIC 11.5 IOL ACTVFCS NAT TORIC 12.0 IOL ACTVFCS NAT TORIC 12.5 IOL ACTVFCS NAT TORIC 13.0 IOL ACTVFCS NAT TORIC 13.5 Page 22 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS NAT TORIC 14.0 IOL ACTVFCS NAT TORIC 14.5 IOL ACTVFCS NAT TORIC 15.0 IOL ACTVFCS NAT TORIC 15.5 IOL ACTVFCS NAT TORIC 16.0 IOL ACTVFCS NAT TORIC 16.5 IOL ACTVFCS NAT TORIC 17.0 IOL ACTVFCS NAT TORIC 17.5 IOL ACTVFCS NAT TORIC 18.0 IOL ACTVFCS NAT TORIC 18.5 IOL ACTVFCS NAT TORIC 19.0 IOL ACTVFCS NAT TORIC 19.5 IOL ACTVFCS NAT TORIC 20.0 IOL ACTVFCS NAT TORIC 20.5 IOL ACTVFCS NAT TORIC 21.0 IOL ACTVFCS NAT TORIC 21.5 IOL ACTVFCS NAT TORIC 22.0 IOL ACTVFCS NAT TORIC 22.5 IOL ACTVFCS NAT TORIC 23.0 IOL ACTVFCS NAT TORIC 23.5 IOL ACTVFCS NAT TORIC 24.0 IOL ACTVFCS NAT TORIC 24.5 IOL ACTVFCS NAT TORIC 25.0 IOL ACTVFCS NAT TORIC 25.5 IOL ACTVFCS NAT TORIC 26.0 IOL ACTVFCS NAT TORIC 26.5 IOL ACTVFCS NAT TORIC 27.0 IOL ACTVFCS NAT TORIC 27.5 IOL ACTVFCS NAT TORIC 28.0 IOL ACTVFCS NAT TORIC 28.5 IOL ACTVFCS NAT TORIC 29.0 IOL ACTVFCS NAT TORIC 29.5 IOL ACTVFCS NAT TORIC 30.0 IOL ACTVFCS NAT TORIC 30.5 IOL ACTVFCS NAT TORIC 31.0 IOL ACTVFCS NAT TORIC 32.0 IOL ACTVFCS NAT TORIC 33.0 IOL ACTVFCS NAT TORIC 34.0 IOL ACTVFCS CLR TORIC 6.0 IOL ACTVFCS CLR TORIC 6.5 IOL ACTVFCS CLR TORIC 7.0 IOL ACTVFCS CLR TORIC 7.5 IOL ACTVFCS CLR TORIC 8.0 IOL ACTVFCS CLR TORIC 8.5 IOL ACTVFCS CLR TORIC 9.0 IOL ACTVFCS CLR TORIC 9.5 Page 23 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS CLR TORIC 10.0 IOL ACTVFCS CLR TORIC 10.5 IOL ACTVFCS CLR TORIC 11.0 IOL ACTVFCS CLR TORIC 11.5 IOL ACTVFCS CLR TORIC 12.0 IOL ACTVFCS CLR TORIC 12.5 IOL ACTVFCS CLR TORIC 13.0 IOL ACTVFCS CLR TORIC 13.5 IOL ACTVFCS CLR TORIC 14.0 IOL ACTVFCS CLR TORIC 14.5 IOL ACTVFCS CLR TORIC 15.0 IOL ACTVFCS CLR TORIC 15.5 IOL ACTVFCS CLR TORIC 16.0 IOL ACTVFCS CLR TORIC 16.5 IOL ACTVFCS CLR TORIC 17.0 IOL ACTVFCS CLR TORIC 17.5 IOL ACTVFCS CLR TORIC 18.0 IOL ACTVFCS CLR TORIC 18.5 IOL ACTVFCS CLR TORIC 19.0 IOL ACTVFCS CLR TORIC 19.5 IOL ACTVFCS CLR TORIC 20.0 IOL ACTVFCS CLR TORIC 20.5 IOL ACTVFCS CLR TORIC 21.0 IOL ACTVFCS CLR TORIC 21.5 IOL ACTVFCS CLR TORIC 22.0 IOL ACTVFCS CLR TORIC 22.5 IOL ACTVFCS CLR TORIC 23.0 IOL ACTVFCS CLR TORIC 23.5 IOL ACTVFCS CLR TORIC 24.0 IOL ACTVFCS CLR TORIC 24.5 IOL ACTVFCS CLR TORIC 25.0 IOL ACTVFCS CLR TORIC 25.5 IOL ACTVFCS CLR TORIC 26.0 IOL ACTVFCS CLR TORIC 26.5 IOL ACTVFCS CLR TORIC 27.0 IOL ACTVFCS CLR TORIC 27.5 IOL ACTVFCS CLR TORIC 28.0 IOL ACTVFCS CLR TORIC 28.5 IOL ACTVFCS CLR TORIC 29.0 IOL ACTVFCS CLR TORIC 29.5 IOL ACTVFCS CLR TORIC 30.0 IOL ACTVFCS CLR TORIC 30.5 IOL ACTVFCS CLR TORIC 31.0 IOL ACTVFCS CLR TORIC 32.0 IOL ACTVFCS CLR TORIC 33.0 IOL ACTVFCS CLR TORIC 34.0 Page 24 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS CLR TORIC 6.0 IOL ACTVFCS CLR TORIC 6.5 IOL ACTVFCS CLR TORIC 7.0 IOL ACTVFCS CLR TORIC 7.5 IOL ACTVFCS CLR TORIC 8.0 IOL ACTVFCS CLR TORIC 8.5 IOL ACTVFCS CLR TORIC 9.0 IOL ACTVFCS CLR TORIC 9.5 IOL ACTVFCS CLR TORIC 10.0 IOL ACTVFCS CLR TORIC 10.5 IOL ACTVFCS CLR TORIC 11.0 IOL ACTVFCS CLR TORIC 11.5 IOL ACTVFCS CLR TORIC 12.0 IOL ACTVFCS CLR TORIC 12.5 IOL ACTVFCS CLR TORIC 13.0 IOL ACTVFCS CLR TORIC 13.5 IOL ACTVFCS CLR TORIC 14.0 IOL ACTVFCS CLR TORIC 14.5 IOL ACTVFCS CLR TORIC 15.0 IOL ACTVFCS CLR TORIC 15.5 IOL ACTVFCS CLR TORIC 16.0 IOL ACTVFCS CLR TORIC 16.5 IOL ACTVFCS CLR TORIC 17.0 IOL ACTVFCS CLR TORIC 17.5 IOL ACTVFCS CLR TORIC 18.0 IOL ACTVFCS CLR TORIC 18.5 IOL ACTVFCS CLR TORIC 19.0 IOL ACTVFCS CLR TORIC 19.5 IOL ACTVFCS CLR TORIC 20.0 IOL ACTVFCS CLR TORIC 20.5 IOL ACTVFCS CLR TORIC 21.0 IOL ACTVFCS CLR TORIC 21.5 IOL ACTVFCS CLR TORIC 22.0 IOL ACTVFCS CLR TORIC 22.5 IOL ACTVFCS CLR TORIC 23.0 IOL ACTVFCS CLR TORIC 23.5 IOL ACTVFCS CLR TORIC 24.0 IOL ACTVFCS CLR TORIC 24.5 IOL ACTVFCS CLR TORIC 25.0 IOL ACTVFCS CLR TORIC 25.5 IOL ACTVFCS CLR TORIC 26.0 IOL ACTVFCS CLR TORIC 26.5 IOL ACTVFCS CLR TORIC 27.0 IOL ACTVFCS CLR TORIC 27.5 IOL ACTVFCS CLR TORIC 28.0 IOL ACTVFCS CLR TORIC 28.5 Page 25 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS CLR TORIC 29.0 IOL ACTVFCS CLR TORIC 29.5 IOL ACTVFCS CLR TORIC 30.0 IOL ACTVFCS CLR TORIC 30.5 IOL ACTVFCS CLR TORIC 31.0 IOL ACTVFCS CLR TORIC 32.0 IOL ACTVFCS CLR TORIC 33.0 IOL ACTVFCS CLR TORIC 34.0 IOL ACTVFCS CLR TORIC 6.0 IOL ACTVFCS CLR TORIC 6.5 IOL ACTVFCS CLR TORIC 7.0 IOL ACTVFCS CLR TORIC 7.5 IOL ACTVFCS CLR TORIC 8.0 IOL ACTVFCS CLR TORIC 8.5 IOL ACTVFCS CLR TORIC 9.0 IOL ACTVFCS CLR TORIC 9.5 IOL ACTVFCS CLR TORIC 10.0 IOL ACTVFCS CLR TORIC 10.5 IOL ACTVFCS CLR TORIC 11.0 IOL ACTVFCS CLR TORIC 11.5 IOL ACTVFCS CLR TORIC 12.0 IOL ACTVFCS CLR TORIC 12.5 IOL ACTVFCS CLR TORIC 13.0 IOL ACTVFCS CLR TORIC 13.5 IOL ACTVFCS CLR TORIC 14.0 IOL ACTVFCS CLR TORIC 14.5 IOL ACTVFCS CLR TORIC 15.0 IOL ACTVFCS CLR TORIC 15.5 IOL ACTVFCS CLR TORIC 16.0 IOL ACTVFCS CLR TORIC 16.5 IOL ACTVFCS CLR TORIC 17.0 IOL ACTVFCS CLR TORIC 17.5 IOL ACTVFCS CLR TORIC 18.0 IOL ACTVFCS CLR TORIC 18.5 IOL ACTVFCS CLR TORIC 19.0 IOL ACTVFCS CLR TORIC 19.5 IOL ACTVFCS CLR TORIC 20.0 IOL ACTVFCS CLR TORIC 20.5 IOL ACTVFCS CLR TORIC 21.0 IOL ACTVFCS CLR TORIC 21.5 IOL ACTVFCS CLR TORIC 22.0 IOL ACTVFCS CLR TORIC 22.5 IOL ACTVFCS CLR TORIC 23.0 IOL ACTVFCS CLR TORIC 23.5 IOL ACTVFCS CLR TORIC 24.0 IOL ACTVFCS CLR TORIC 24.5 Page 26 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS CLR TORIC 25.0 IOL ACTVFCS CLR TORIC 25.5 IOL ACTVFCS CLR TORIC 26.0 IOL ACTVFCS CLR TORIC 26.5 IOL ACTVFCS CLR TORIC 27.0 IOL ACTVFCS CLR TORIC 27.5 IOL ACTVFCS CLR TORIC 28.0 IOL ACTVFCS CLR TORIC 28.5 IOL ACTVFCS CLR TORIC 29.0 IOL ACTVFCS CLR TORIC 29.5 IOL ACTVFCS CLR TORIC 30.0 IOL ACTVFCS CLR TORIC 30.5 IOL ACTVFCS CLR TORIC 31.0 IOL ACTVFCS CLR TORIC 32.0 IOL ACTVFCS CLR TORIC 33.0 IOL ACTVFCS CLR TORIC 34.0 IOL ACTVFCS CLR TORIC 6.0 IOL ACTVFCS CLR TORIC 6.5 IOL ACTVFCS CLR TORIC 7.0 IOL ACTVFCS CLR TORIC 7.5 IOL ACTVFCS CLR TORIC 8.0 IOL ACTVFCS CLR TORIC 8.5 IOL ACTVFCS CLR TORIC 9.0 IOL ACTVFCS CLR TORIC 9.5 IOL ACTVFCS CLR TORIC 10.0 IOL ACTVFCS CLR TORIC 10.5 IOL ACTVFCS CLR TORIC 11.0 IOL ACTVFCS CLR TORIC 11.5 IOL ACTVFCS CLR TORIC 12.0 IOL ACTVFCS CLR TORIC 12.5 IOL ACTVFCS CLR TORIC 13.0 IOL ACTVFCS CLR TORIC 13.5 IOL ACTVFCS CLR TORIC 14.0 IOL ACTVFCS CLR TORIC 14.5 IOL ACTVFCS CLR TORIC 15.0 IOL ACTVFCS CLR TORIC 15.5 IOL ACTVFCS CLR TORIC 16.0 IOL ACTVFCS CLR TORIC 16.5 IOL ACTVFCS CLR TORIC 17.0 IOL ACTVFCS CLR TORIC 17.5 IOL ACTVFCS CLR TORIC 18.0 IOL ACTVFCS CLR TORIC 18.5 IOL ACTVFCS CLR TORIC 19.0 IOL ACTVFCS CLR TORIC 19.5 IOL ACTVFCS CLR TORIC 20.0 IOL ACTVFCS CLR TORIC 20.5 Page 27 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACTVFCS CLR TORIC 21.0 IOL ACTVFCS CLR TORIC 21.5 IOL ACTVFCS CLR TORIC 22.0 IOL ACTVFCS CLR TORIC 22.5 IOL ACTVFCS CLR TORIC 23.0 IOL ACTVFCS CLR TORIC 23.5 IOL ACTVFCS CLR TORIC 24.0 IOL ACTVFCS CLR TORIC 24.5 IOL ACTVFCS CLR TORIC 25.0 IOL ACTVFCS CLR TORIC 25.5 IOL ACTVFCS CLR TORIC 26.0 IOL ACTVFCS CLR TORIC 26.5 IOL ACTVFCS CLR TORIC 27.0 IOL ACTVFCS CLR TORIC 27.5 IOL ACTVFCS CLR TORIC 28.0 IOL ACTVFCS CLR TORIC 28.5 IOL ACTVFCS CLR TORIC 29.0 IOL ACTVFCS CLR TORIC 29.5 IOL ACTVFCS CLR TORIC 30.0 IOL ACTVFCS CLR TORIC 30.5 IOL ACTVFCS CLR TORIC 31.0 IOL ACTVFCS CLR TORIC 32.0 IOL ACTVFCS CLR TORIC 33.0 IOL ACTVFCS CLR TORIC 34.0 IOL RSTR NAT NON TORIC 6.0 IOL RSTR NAT NON TORIC 6.5 IOL RSTR NAT NON TORIC 7.0 IOL RSTR NAT NON TORIC 7.5 IOL RSTR NAT NON TORIC 8.0 IOL RSTR NAT NON TORIC 8.5 IOL RSTR NAT NON TORIC 9.0 IOL RSTR NAT NON TORIC 9.5 IOL RSTR NAT NON TORIC 10.0 IOL RSTR NAT NON TORIC 10.5 IOL RSTR NAT NON TORIC 12.5 IOL RSTR NAT NON TORIC 13.0 IOL RSTR NAT NON TORIC 13.5 IOL RSTR NAT NON TORIC 14.0 IOL RSTR NAT NON TORIC 14.5 IOL RSTR NAT NON TORIC 15.0 IOL RSTR NAT NON TORIC 15.5 IOL RSTR NAT NON TORIC 16.0 IOL RSTR NAT NON TORIC 16.5 IOL RSTR NAT NON TORIC 17.0 IOL RSTR NAT NON TORIC 17.5 IOL RSTR NAT NON TORIC 18.0 Page 28 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RSTR NAT NON TORIC 18.5 IOL RSTR NAT NON TORIC 19.0 IOL RSTR NAT NON TORIC 19.5 IOL RSTR NAT NON TORIC 20.0 IOL RSTR NAT NON TORIC 20.5 IOL RSTR NAT NON TORIC 21.0 IOL RSTR NAT NON TORIC 21.5 IOL RSTR NAT NON TORIC 22.0 IOL RSTR NAT NON TORIC 22.5 IOL RSTR NAT NON TORIC 23.0 IOL RSTR NAT NON TORIC 23.5 IOL RSTR NAT NON TORIC 24.0 IOL RSTR NAT NON TORIC 24.5 IOL RSTR NAT NON TORIC 25.0 IOL RSTR NAT NON TORIC 25.5 IOL RSTR NAT NON TORIC 26.0 IOL RSTR NAT NON TORIC 26.5 IOL RSTR NAT NON TORIC 27.0 IOL RSTR NAT NON TORIC 27.5 IOL RSTR NAT NON TORIC 28.0 IOL RSTR NAT NON TORIC 28.5 IOL RSTR NAT NON TORIC 29.0 IOL RSTR NAT NON TORIC 29.5 IOL RSTR NAT NON TORIC 30.0 IOL RSTR NAT NON TORIC 30.5 IOL RSTR NAT NON TORIC 31.0 IOL RSTR NAT NON TORIC 32.0 IOL RSTR NAT NON TORIC 33.0 IOL RSTR NAT NON TORIC 34.0 IOL RSTR NAT TORIC 6.0 IOL RSTR NAT TORIC 6.5 IOL RSTR NAT TORIC 7.0 IOL RSTR NAT TORIC 7.5 IOL RSTR NAT TORIC 8.0 IOL RSTR NAT TORIC 8.5 IOL RSTR NAT TORIC 9.0 IOL RSTR NAT TORIC 9.5 IOL RSTR NAT TORIC 10.0 IOL RSTR NAT TORIC 10.5 IOL RSTR NAT TORIC 11.0 IOL RSTR NAT TORIC 11.5 IOL RSTR NAT TORIC 12.0 IOL RSTR NAT TORIC 12.5 IOL RSTR NAT TORIC 13.0 IOL RSTR NAT TORIC 13.5 IOL RSTR NAT TORIC 14.0 Page 29 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RSTR NAT TORIC 14.5 IOL RSTR NAT TORIC 15.0 IOL RSTR NAT TORIC 15.5 IOL RSTR NAT TORIC 16.0 IOL RSTR NAT TORIC 16.5 IOL RSTR NAT TORIC 17.0 IOL RSTR NAT TORIC 17.5 IOL RSTR NAT TORIC 18.0 IOL RSTR NAT TORIC 18.5 IOL RSTR NAT TORIC 19.0 IOL RSTR NAT TORIC 19.5 IOL RSTR NAT TORIC 20.0 IOL RSTR NAT TORIC 20.5 IOL RSTR NAT TORIC 21.0 IOL RSTR NAT TORIC 21.5 IOL RSTR NAT TORIC 22.0 IOL RSTR NAT TORIC 22.5 IOL RSTR NAT TORIC 23.0 IOL RSTR NAT TORIC 23.5 IOL RSTR NAT TORIC 24.0 IOL RSTR NAT TORIC 24.5 IOL RSTR NAT TORIC 25.0 IOL RSTR NAT TORIC 25.5 IOL RSTR NAT TORIC 26.0 IOL RSTR NAT TORIC 26.5 IOL RSTR NAT TORIC 27.0 IOL RSTR NAT TORIC 27.5 IOL RSTR NAT TORIC 28.0 IOL RSTR NAT TORIC 28.5 IOL RSTR NAT TORIC 29.0 IOL RSTR NAT TORIC 29.5 IOL RSTR NAT TORIC 30.0 IOL RSTR NAT TORIC 30.5 IOL RSTR NAT TORIC 31.0 IOL RSTR NAT TORIC 32.0 IOL RSTR NAT TORIC 33.0 IOL RSTR NAT TORIC 34.0 IOL RSTR NAT TORIC 6.0 IOL RSTR NAT TORIC 6.5 IOL RSTR NAT TORIC 7.0 IOL RSTR NAT TORIC 7.5 IOL RSTR NAT TORIC 8.0 IOL RSTR NAT TORIC 8.5 IOL RSTR NAT TORIC 9.0 IOL RSTR NAT TORIC 9.5 IOL RSTR NAT TORIC 10.0 Page 30 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RSTR NAT TORIC 10.5 IOL RSTR NAT TORIC 11.0 IOL RSTR NAT TORIC 11.5 IOL RSTR NAT TORIC 12.0 IOL RSTR NAT TORIC 12.5 IOL RSTR NAT TORIC 13.0 IOL RSTR NAT TORIC 13.5 IOL RSTR NAT TORIC 14.0 IOL RSTR NAT TORIC 14.5 IOL RSTR NAT TORIC 15.0 IOL RSTR NAT TORIC 15.5 IOL RSTR NAT TORIC 16.0 IOL RSTR NAT TORIC 16.5 IOL RSTR NAT TORIC 17.0 IOL RSTR NAT TORIC 17.5 IOL RSTR NAT TORIC 18.0 IOL RSTR NAT TORIC 18.5 IOL RSTR NAT TORIC 19.0 IOL RSTR NAT TORIC 19.5 IOL RSTR NAT TORIC 20.0 IOL RSTR NAT TORIC 20.5 IOL RSTR NAT TORIC 21.0 IOL RSTR NAT TORIC 21.5 IOL RSTR NAT TORIC 22.0 IOL RSTR NAT TORIC 22.5 IOL RSTR NAT TORIC 23.0 IOL RSTR NAT TORIC 23.5 IOL RSTR NAT TORIC 24.0 IOL RSTR NAT TORIC 24.5 IOL RSTR NAT TORIC 25.0 IOL RSTR NAT TORIC 25.5 IOL RSTR NAT TORIC 26.0 IOL RSTR NAT TORIC 26.5 IOL RSTR NAT TORIC 27.0 IOL RSTR NAT TORIC 27.5 IOL RSTR NAT TORIC 28.0 IOL RSTR NAT TORIC 28.5 IOL RSTR NAT TORIC 29.0 IOL RSTR NAT TORIC 29.5 IOL RSTR NAT TORIC 30.0 IOL RSTR NAT TORIC 30.5 IOL RSTR NAT TORIC 31.0 IOL RSTR NAT TORIC 32.0 IOL RSTR NAT TORIC 33.0 IOL RSTR NAT TORIC 34.0 IOL RSTR NAT TORIC 6.0 Page 31 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RSTR NAT TORIC 6.5 IOL RSTR NAT TORIC 7.0 IOL RSTR NAT TORIC 7.5 IOL RSTR NAT TORIC 8.0 IOL RSTR NAT TORIC 8.5 IOL RSTR NAT TORIC 9.0 IOL RSTR NAT TORIC 9.5 IOL RSTR NAT TORIC 10.0 IOL RSTR NAT TORIC 10.5 IOL RSTR NAT TORIC 11.0 IOL RSTR NAT TORIC 11.5 IOL RSTR NAT TORIC 12.0 IOL RSTR NAT TORIC 12.5 IOL RSTR NAT TORIC 13.0 IOL RSTR NAT TORIC 13.5 IOL RSTR NAT TORIC 14.0 IOL RSTR NAT TORIC 14.5 IOL RSTR NAT TORIC 15.0 IOL RSTR NAT TORIC 15.5 IOL RSTR NAT TORIC 16.0 IOL RSTR NAT TORIC 16.5 IOL RSTR NAT TORIC 17.0 IOL RSTR NAT TORIC 17.5 IOL RSTR NAT TORIC 18.0 IOL RSTR NAT TORIC 18.5 IOL RSTR NAT TORIC 19.0 IOL RSTR NAT TORIC 19.5 IOL RSTR NAT TORIC 20.0 IOL RSTR NAT TORIC 20.5 IOL RSTR NAT TORIC 21.0 IOL RSTR NAT TORIC 21.5 IOL RSTR NAT TORIC 22.0 IOL RSTR NAT TORIC 22.5 IOL RSTR NAT TORIC 23.0 IOL RSTR NAT TORIC 23.5 IOL RSTR NAT TORIC 24.0 IOL RSTR NAT TORIC 24.5 IOL RSTR NAT TORIC 25.0 IOL RSTR NAT TORIC 25.5 IOL RSTR NAT TORIC 26.0 IOL RSTR NAT TORIC 26.5 IOL RSTR NAT TORIC 27.0 IOL RSTR NAT TORIC 27.5 IOL RSTR NAT TORIC 28.0 IOL RSTR NAT TORIC 28.5 IOL RSTR NAT TORIC 29.0 Page 32 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RSTR NAT TORIC 29.5 IOL RSTR NAT TORIC 30.0 IOL RSTR NAT TORIC 30.5 IOL RSTR NAT TORIC 31.0 IOL RSTR NAT TORIC 32.0 IOL RSTR NAT TORIC 33.0 IOL RSTR NAT TORIC 34.0 IOL RSTR NAT TORIC 6.0 IOL RSTR NAT TORIC 6.5 IOL RSTR NAT TORIC 7.0 IOL RSTR NAT TORIC 7.5 IOL RSTR NAT TORIC 8.0 IOL RSTR NAT TORIC 8.5 IOL RSTR NAT TORIC 9.0 IOL RSTR NAT TORIC 9.5 IOL RSTR NAT TORIC 10.0 IOL RSTR NAT TORIC 10.5 IOL RSTR NAT TORIC 11.0 IOL RSTR NAT TORIC 11.5 IOL RSTR NAT TORIC 12.0 IOL RSTR NAT TORIC 12.5 IOL RSTR NAT TORIC 13.0 IOL RSTR NAT TORIC 13.5 IOL RSTR NAT TORIC 14.0 IOL RSTR NAT TORIC 14.5 IOL RSTR NAT TORIC 15.0 IOL RSTR NAT TORIC 15.5 IOL RSTR NAT TORIC 16.0 IOL RSTR NAT TORIC 16.5 IOL RSTR NAT TORIC 17.0 IOL RSTR NAT TORIC 17.5 IOL RSTR NAT TORIC 18.0 IOL RSTR NAT TORIC 18.5 IOL RSTR NAT TORIC 19.0 IOL RSTR NAT TORIC 19.5 IOL RSTR NAT TORIC 20.0 IOL RSTR NAT TORIC 20.5 IOL RSTR NAT TORIC 21.0 IOL RSTR NAT TORIC 21.5 IOL RSTR NAT TORIC 22.0 IOL RSTR NAT TORIC 22.5 IOL RSTR NAT TORIC 23.0 IOL RSTR NAT TORIC 23.5 IOL RSTR NAT TORIC 24.0 IOL RSTR NAT TORIC 24.5 IOL RSTR NAT TORIC 25.0 Page 33 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RSTR NAT TORIC 25.5 IOL RSTR NAT TORIC 26.0 IOL RSTR NAT TORIC 26.5 IOL RSTR NAT TORIC 27.0 IOL RSTR NAT TORIC 27.5 IOL RSTR NAT TORIC 28.0 IOL RSTR NAT TORIC 28.5 IOL RSTR NAT TORIC 29.0 IOL RSTR NAT TORIC 29.5 IOL RSTR NAT TORIC 30.0 IOL RSTR NAT TORIC 30.5 IOL RSTR NAT TORIC 31.0 IOL RSTR NAT TORIC 32.0 IOL RSTR NAT TORIC 33.0 IOL RSTR NAT TORIC 34.0 FLEXIBLE HINGE TOE IMPLANT W SWANSON FLEX TOE REGULAR #6 W SWANSON FLEX TOE REGULAR #7 W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W FLEXIBLE HINGE TOE IMPLANT W ISO PLATE 2.4MM X 14MM NON-LOCKING SCRE 2.4MM X 16MM NON-LOCKING SCRE 2.4MM X 14MM LOCKING SCREW KIT TROCAR 23GA ESA WITH VALVE OMNI SURGICAL SYSTEM IOL TORIC ZCT225 9.0D IOL 1PC ZCB00 ACRYL 33.0D IOL 1PC ZCB00 ACRYL 34.0D IOL TORIC ZCT225 9.0D IOL TORIC ASPHERIC 1.5D 9.5D IOL TORIC ZCT400 13.5D IOL TORIC ZCT400 15.0D IOL TORIC ZCT450 14.0D IOL TORIC ZCT450 15.0D IOL TORIC ZCT525 13.5D IOL TORIC ZCT525 14.0D Page 34 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,206.00 $3,657.00 $565.00 $565.00 $565.00 $640.00 $4,497.00 $572.00 $900.00 $900.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TORIC ZCT525 14.5D IOL TORIC ZCT525 15.0D IOL MONOFOCAL LI61AO +24.0 IOL TORIC ZCT400 10.5D IOL TORIC ZCT400 17.5D IOL TORIC ZCT400 18.0D IOL TORIC ZCT400 19.0D IOL TORIC ASPHERIC 4.0D 20.0D IOL TORIC ASPHERIC 4.0D 20.5D IOL TORIC ZCT450 16.5D IOL TORIC ZCT450 17.0D IOL TORIC ZCT450 17.5D IOL TORIC ZCT450 19.0D IOL TORIC ZCT450 19.5D IOL TORIC ZCT450 20.0D IOL TORIC ZCT525 16.5D IOL TORIC ZCT525 17.0D IOL TORIC ZCT525 17.5D IOL TORIC ZCT525 19.0D IOL TORIC ZCT525 19.5D IOL TORIC ZCT525 20.0D IOL TORIC ZCT600 16.5D IOL TORIC ZCT600 17.0D IOL TORIC ZCT600 19.0D IOL TORIC ZCT600 20.0D IOL ACRYSOFIQ TORIC 4.50D 14.0D IOL CT LUCIA 3PC MONO 18.0 IOL SENSAR MENISC -7.0 IOL TORIC ZCT300 31.0D KIT TROCAR 25GA ESA W/ VALVE IOL PANOPTIX +0 6.0D CLR IOL PANOPTIX +0 6.5D CLR IOL PANOPTIX +0 7.0D CLR IOL PANOPTIX +0 7.5D CLR IOL PANOPTIX +0 8.0D CLR IOL PANOPTIX +0 8.5D CLR IOL PANOPTIX +0 9.0D CLR IOL PANOPTIX +0 9.5D CLR IOL PANOPTIX +0 10.0D CLR IOL PANOPTIX +0 10.5D CLR IOL PANOPTIX +0 11.0D CLR IOL PANOPTIX +0 11.5D CLR IOL PANOPTIX +0 12.0D CLR IOL PANOPTIX +0 12.5D CLR IOL PANOPTIX +0 13.0D CLR IOL PANOPTIX +0 13.5D CLR Page 35 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $782.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $778.00 $912.00 $572.00 $640.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PANOPTIX +0 14.0D CLR IOL PANOPTIX +0 14.5D CLR IOL PANOPTIX +0 15.0D CLR IOL PANOPTIX +0 15.5D CLR IOL PANOPTIX +0 16.0D CLR IOL PANOPTIX +0 16.5D CLR IOL PANOPTIX +0 17.0D CLR IOL PANOPTIX +0 17.5D CLR IOL PANOPTIX +0 18.0D CLR IOL PANOPTIX +0 18.5D CLR IOL PANOPTIX +0 19.0D CLR IOL PANOPTIX +0 19.5D CLR IOL PANOPTIX +0 20.0D CLR IOL PANOPTIX +0 20.5D CLR IOL PANOPTIX +0 21.0D CLR IOL PANOPTIX +0 21.5D CLR IOL PANOPTIX +0 22.0D CLR IOL PANOPTIX +0 22.5D CLR IOL PANOPTIX +0 23.0D CLR IOL PANOPTIX +0 23.5D CLR IOL PANOPTIX +0 24.0D CLR IOL PANOPTIX +0 24.5D CLR IOL PANOPTIX +0 25.0D CLR IOL PANOPTIX +0 25.5D CLR IOL PANOPTIX +0 26.0D CLR IOL PANOPTIX +0 26.5D CLR IOL PANOPTIX +0 27.0D CLR IOL PANOPTIX +0 27.5D CLR IOL PANOPTIX +0 28.0D CLR IOL PANOPTIX +0 28.5D CLR IOL PANOPTIX +0 29.0D CLR IOL PANOPTIX +0 29.5D CLR IOL PANOPTIX +0 30.0D CLR IOL PANOPTIX +0 31.0D CLR IOL PANOPTIX +0 32.0D CLR IOL PANOPTIX +0 33.0D CLR IOL PANOPTIX +0 34.0D CLR IOL PANOPTIX +1.5 6.0D CLR IOL PANOPTIX +1.5 6.5D CLR IOL PANOPTIX +1.5 7.0D CLR IOL PANOPTIX +1.5 7.5D CLR IOL PANOPTIX +1.5 8.0D CLR IOL PANOPTIX +1.5 8.5D CLR IOL PANOPTIX +1.5 9.0D CLR IOL PANOPTIX +1.5 9.5D CLR IOL PANOPTIX +1.5 10.0D CLR Page 36 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PANOPTIX +1.5 10.5D CLR IOL PANOPTIX +1.5 11.0D CLR IOL PANOPTIX +1.5 11.5D CLR IOL PANOPTIX +1.5 12.0D CLR IOL PANOPTIX +1.5 12.5D CLR IOL PANOPTIX +1.5 13.0D CLR IOL PANOPTIX +1.5 13.5D CLR IOL PANOPTIX +1.5 14.0D CLR IOL PANOPTIX +1.5 14.5D CLR IOL PANOPTIX +1.5 15.0D CLR IOL PANOPTIX +1.5 15.5D CLR IOL PANOPTIX +1.5 16.0D CLR IOL PANOPTIX +1.5 16.5D CLR IOL PANOPTIX +1.5 17.0D CLR IOL PANOPTIX +1.5 17.5D CLR IOL PANOPTIX +1.5 18.0D CLR IOL PANOPTIX +1.5 18.5D CLR IOL PANOPTIX +1.5 19.0D CLR IOL PANOPTIX +1.5 19.5D CLR IOL PANOPTIX +1.5 20.0D CLR IOL PANOPTIX +1.5 20.5D CLR IOL PANOPTIX +1.5 21.0D CLR IOL PANOPTIX +1.5 21.5D CLR IOL PANOPTIX +1.5 22.0D CLR IOL PANOPTIX +1.5 22.5D CLR IOL PANOPTIX +1.5 23.0D CLR IOL PANOPTIX +1.5 23.5D CLR IOL PANOPTIX +1.5 24.0D CLR IOL PANOPTIX +1.5 24.5D CLR IOL PANOPTIX +1.5 25.0D CLR IOL PANOPTIX +1.5 25.5D CLR IOL PANOPTIX +1.5 26.0D CLR IOL PANOPTIX +1.5 26.5D CLR IOL PANOPTIX +1.5 27.0D CLR IOL PANOPTIX +1.5 27.5D CLR IOL PANOPTIX +1.5 28.0D CLR IOL PANOPTIX +1.5 28.5D CLR IOL PANOPTIX +1.5 29.0D CLR IOL PANOPTIX +1.5 29.5D CLR IOL PANOPTIX +1.5 30.0D CLR IOL PANOPTIX +1.5 31.0D CLR IOL PANOPTIX +1.5 32.0D CLR IOL PANOPTIX +1.5 33.0D CLR IOL PANOPTIX +1.5 34.0D CLR IOL PANOPTIX +2.25 6.0D CLR IOL PANOPTIX +2.25 6.5D CLR Page 37 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PANOPTIX +2.25 7.0D CLR IOL PANOPTIX +2.25 7.5D CLR IOL PANOPTIX +2.25 8.0D CLR IOL PANOPTIX +2.25 8.5D CLR IOL PANOPTIX +2.25 9.0D CLR IOL PANOPTIX +2.25 9.5D CLR IOL PANOPTIX +2.25 10.0D CLR IOL PANOPTIX +2.25 10.5D CLR IOL PANOPTIX +2.25 11.0D CLR IOL PANOPTIX +2.25 11.5D CLR IOL PANOPTIX +2.25 12.0D CLR IOL PANOPTIX +2.25 12.5D CLR IOL PANOPTIX +2.25 13.0D CLR IOL PANOPTIX +2.25 13.5D CLR IOL PANOPTIX +2.25 14.0D CLR IOL PANOPTIX +2.25 14.5D CLR IOL PANOPTIX +2.25 15.0D CLR IOL PANOPTIX +2.25 15.5D CLR IOL PANOPTIX +2.25 16.0D CLR IOL PANOPTIX +2.25 16.5D CLR IOL PANOPTIX +2.25 17.0D CLR IOL PANOPTIX +2.25 17.5D CLR IOL PANOPTIX +2.25 18.0D CLR IOL PANOPTIX +2.25 18.5D CLR IOL PANOPTIX +2.25 19.0D CLR IOL PANOPTIX +2.25 19.5D CLR IOL PANOPTIX +2.25 20.0D CLR IOL PANOPTIX +2.25 20.5D CLR IOL PANOPTIX +2.25 21.0D CLR IOL PANOPTIX +2.25 21.5D CLR IOL PANOPTIX +2.25 22.0D CLR IOL PANOPTIX +2.25 22.5D CLR IOL PANOPTIX +2.25 23.0D CLR IOL PANOPTIX +2.25 23.5D CLR IOL PANOPTIX +2.25 24.0D CLR IOL PANOPTIX +2.25 24.5D CLR IOL PANOPTIX +2.25 25.0D CLR IOL PANOPTIX +2.25 25.5D CLR IOL PANOPTIX +2.25 26.0D CLR IOL PANOPTIX +2.25 26.5D CLR IOL PANOPTIX +2.25 27.0D CLR IOL PANOPTIX +2.25 27.5D CLR IOL PANOPTIX +2.25 28.0D CLR IOL PANOPTIX +2.25 28.5D CLR IOL PANOPTIX +2.25 29.0D CLR IOL PANOPTIX +2.25 29.5D CLR Page 38 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PANOPTIX +2.25 30.0D CLR IOL PANOPTIX +2.25 31.0D CLR IOL PANOPTIX +2.25 32.0D CLR IOL PANOPTIX +2.25 33.0D CLR IOL PANOPTIX +2.25 34.0D CLR IOL PANOPTIX +3.0 6.0D CLR IOL PANOPTIX +3.0 6.5D CLR IOL PANOPTIX +3.0 7.0D CLR IOL PANOPTIX +3.0 7.5D CLR IOL PANOPTIX +3.0 8.0D CLR IOL PANOPTIX +3.0 8.5D CLR IOL PANOPTIX +3.0 9.0D CLR IOL PANOPTIX +3.0 9.5D CLR IOL PANOPTIX +3.0 10.0D CLR IOL PANOPTIX +3.0 10.5D CLR IOL PANOPTIX +3.0 11.0D CLR IOL PANOPTIX +3.0 11.5D CLR IOL PANOPTIX +3.0 12.0D CLR IOL PANOPTIX +3.0 12.5D CLR IOL PANOPTIX +3.0 13.0D CLR IOL PANOPTIX +3.0 13.5D CLR IOL PANOPTIX +3.0 14.0D CLR IOL PANOPTIX +3.0 14.5D CLR IOL PANOPTIX +3.0 15.0D CLR IOL PANOPTIX +3.0 15.5D CLR IOL PANOPTIX +3.0 16.0D CLR IOL PANOPTIX +3.0 16.5D CLR IOL PANOPTIX +3.0 17.0D CLR IOL PANOPTIX +3.0 17.5D CLR IOL PANOPTIX +3.0 18.0D CLR IOL PANOPTIX +3.0 18.5D CLR IOL PANOPTIX +3.0 19.0D CLR IOL PANOPTIX +3.0 19.5D CLR IOL PANOPTIX +3.0 20.0D CLR IOL PANOPTIX +3.0 20.5D CLR IOL PANOPTIX +3.0 21.0D CLR IOL PANOPTIX +3.0 21.5D CLR IOL PANOPTIX +3.0 22.0D CLR IOL PANOPTIX +3.0 22.5D CLR IOL PANOPTIX +3.0 23.0D CLR IOL PANOPTIX +3.0 23.5D CLR IOL PANOPTIX +3.0 24.0D CLR IOL PANOPTIX +3.0 24.5D CLR IOL PANOPTIX +3.0 25.0D CLR IOL PANOPTIX +3.0 25.5D CLR IOL PANOPTIX +3.0 26.0D CLR Page 39 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PANOPTIX +3.0 26.5D CLR IOL PANOPTIX +3.0 27.0D CLR IOL PANOPTIX +3.0 27.5D CLR IOL PANOPTIX +3.0 28.0D CLR IOL PANOPTIX +3.0 28.5D CLR IOL PANOPTIX +3.0 29.0D CLR IOL PANOPTIX +3.0 29.5D CLR IOL PANOPTIX +3.0 30.0D CLR IOL PANOPTIX +3.0 31.0D CLR IOL PANOPTIX +3.0 32.0D CLR IOL PANOPTIX +3.0 33.0D CLR IOL PANOPTIX +3.0 34.0D CLR IOL PANOPTIX +3.75 6.0D CLR IOL PANOPTIX +3.75 6.5D CLR IOL PANOPTIX +3.75 7.0D CLR IOL PANOPTIX +3.75 7.5D CLR IOL PANOPTIX +3.75 8.0D CLR IOL PANOPTIX +3.75 8.5D CLR IOL PANOPTIX +3.75 9.0D CLR IOL PANOPTIX +3.75 9.5D CLR IOL PANOPTIX +3.75 10.0D CLR IOL PANOPTIX +3.75 10.5D CLR IOL PANOPTIX +3.75 11.0D CLR IOL PANOPTIX +3.75 11.5D CLR IOL PANOPTIX +3.75 12.0D CLR IOL PANOPTIX +3.75 12.5D CLR IOL PANOPTIX +3.75 13.0D CLR IOL PANOPTIX +3.75 13.5D CLR IOL PANOPTIX +3.75 14.0D CLR IOL PANOPTIX +3.75 14.5D CLR IOL PANOPTIX +3.76 15.0D CLR IOL PANOPTIX +3.75 15.5D CLR IOL PANOPTIX +3.75 16.0D CLR IOL PANOPTIX +3.75 16.5D CLR IOL PANOPTIX +3.75 17.0D CLR IOL PANOPTIX +3.75 17.5D CLR IOL PANOPTIX +3.75 18.0D CLR IOL PANOPTIX +3.75 18.5D CLR IOL PANOPTIX +3.75 19.0D CLR IOL PANOPTIX +3.75 19.5D CLR IOL PANOPTIX +3.75 20.0D CLR IOL PANOPTIX +3.75 20.5D CLR IOL PANOPTIX +3.75 21.0D CLR IOL PANOPTIX +3.75 21.5D CLR IOL PANOPTIX +3.75 22.0D CLR IOL PANOPTIX +3.75 22.5D CLR Page 40 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PANOPTIX +3.75 23.0D CLR IOL PANOPTIX +3.75 23.5D CLR IOL PANOPTIX +3.75 24.0D CLR IOL PANOPTIX +3.75 24.5D CLR IOL PANOPTIX +3.75 25.0D CLR IOL PANOPTIX +3.75 25.5D CLR IOL PANOPTIX +3.75 26.0D CLR IOL PANOPTIX +3.75 26.5D CLR IOL PANOPTIX +3.75 27.0D CLR IOL PANOPTIX +3.75 27.5D CLR IOL PANOPTIX +3.75 28.0D CLR IOL PANOPTIX +3.75 28.5D CLR IOL PANOPTIX +3.75 29.0D CLR IOL PANOPTIX +3.75 29.5D CLR IOL PANOPTIX +3.75 30.0D CLR IOL PANOPTIX +3.756 31.0D CLR IOL PANOPTIX +3.75 32.0D CLR IOL PANOPTIX +3.756 33.0D CLR IOL PANOPTIX +3.75 34.0D CLR IOL ACRYSOF PANOPTIX +0 6.0D IOL ACRYSOF PANOPTIX +0 6.5D IOL ACRYSOF PANOPTIX +0 7.0D IOL ACRYSOF PANOPTIX +0 7.5D IOL ACRYSOF PANOPTIX +0 8.0D IOL ACRYSOF PANOPTIX +0 8.5D IOL ACRYSOF PANOPTIX +0 9.0D IOL ACRYSOF PANOPTIX +0 9.5D IOL ACRYSOF PANOPTIX +0 10.0D IOL ACRYSOF PANOPTIX +0 10.5D IOL ACRYSOF PANOPTIX +0 11.0D IOL ACRYSOF PANOPTIX +0 11.5D IOL ACRYSOF PANOPTIX +0 12.0D IOL ACRYSOF PANOPTIX +0 12.5D IOL ACRYSOF PANOPTIX +0 13.0D IOL ACRYSOF PANOPTIX +0 13.5D IOL ACRYSOF PANOPTIX +0 14.0D IOL ACRYSOF PANOPTIX +0 14.5D IOL ACRYSOF PANOPTIX +0 15.0D IOL ACRYSOF PANOPTIX +0 15.5D IOL ACRYSOF PANOPTIX +0 16.0D IOL ACRYSOF PANOPTIX +0 16.5D IOL ACRYSOF PANOPTIX +0 17.0D IOL ACRYSOF PANOPTIX +0 17.5D IOL ACRYSOF PANOPTIX +0 18.0D IOL ACRYSOF PANOPTIX +0 18.5D IOL ACRYSOF PANOPTIX +0 19.0D Page 41 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF PANOPTIX +0 19.5D IOL ACRYSOF PANOPTIX +0 20.0D IOL ACRYSOF PANOPTIX +0 20.5D IOL ACRYSOF PANOPTIX +0 21.0D IOL ACRYSOF PANOPTIX +0 21.5D IOL ACRYSOF PANOPTIX +0 22.0D IOL ACRYSOF PANOPTIX +0 22.5D IOL ACRYSOF PANOPTIX +0 23.0D IOL ACRYSOF PANOPTIX +0 23.5D IOL ACRYSOF PANOPTIX +0 24.0D IOL ACRYSOF PANOPTIX +0 24.5D IOL ACRYSOF PANOPTIX +0 25.0D IOL ACRYSOF PANOPTIX +0 25.5D IOL ACRYSOF PANOPTIX +0 26.0D IOL ACRYSOF PANOPTIX +0 26.5D IOL ACRYSOF PANOPTIX +0 27.0D IOL ACRYSOF PANOPTIX +0 27.5D IOL ACRYSOF PANOPTIX +0 28.0D IOL ACRYSOF PANOPTIX +0 28.5D IOL ACRYSOF PANOPTIX +0 29.0D IOL ACRYSOF PANOPTIX +0 29.5D IOL ACRYSOF PANOPTIX +0 30.0D IOL ACRYSOF PANOPTIX +0 31.0D IOL ACRYSOF PANOPTIX +0 32.0D IOL ACRYSOF PANOPTIX +0 33.0D IOL ACRYSOF PANOPTIX +0 34.0D IOL ACRYSOF PANOPTIX +1.5 6.0D IOL ACRYSOF PANOPTIX +1.5 6.5D IOL ACRYSOF PANOPTIX +1.5 7.0D IOL ACRYSOF PANOPTIX +1.5 7.5D IOL ACRYSOF PANOPTIX +1.5 8.0D IOL ACRYSOF PANOPTIX +1.5 8.5D IOL ACRYSOF PANOPTIX +1.5 9.0D IOL ACRYSOF PANOPTIX +1.5 9.5D IOL ACRYSOF PANOPTIX +1.5 10.0D IOL ACRYSOF PANOPTIX +1.5 10.5D IOL ACRYSOF PANOPTIX +1.5 11.0D IOL ACRYSOF PANOPTIX +1.5 11.5D IOL ACRYSOF PANOPTIX +1.5 12.0D IOL ACRYSOF PANOPTIX +1.5 12.5D IOL ACRYSOF PANOPTIX +1.5 13.0D IOL ACRYSOF PANOPTIX +1.5 13.5D IOL ACRYSOF PANOPTIX +1.5 14.0D IOL ACRYSOF PANOPTIX +1.5 14.5D IOL ACRYSOF PANOPTIX +1.5 15.0D IOL ACRYSOF PANOPTIX +1.5 15.5D Page 42 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF PANOPTIX +1.5 16.0D IOL ACRYSOF PANOPTIX +1.5 16.5D IOL ACRYSOF PANOPTIX +1.5 17.0D IOL ACRYSOF PANOPTIX +1.5 17.5D IOL ACRYSOF PANOPTIX +1.5 18.0D IOL ACRYSOF PANOPTIX +1.5 18.5D IOL ACRYSOF PANOPTIX +1.5 19.0D IOL ACRYSOF PANOPTIX +1.5 19.5D IOL ACRYSOF PANOPTIX +1.5 20.0D IOL ACRYSOF PANOPTIX +1.5 20.5D IOL ACRYSOF PANOPTIX +1.5 21.0D IOL ACRYSOF PANOPTIX +1.5 21.5D IOL ACRYSOF PANOPTIX +1.5 22.0D IOL ACRYSOF PANOPTIX +1.5 22.5D IOL ACRYSOF PANOPTIX +1.5 23.0D IOL ACRYSOF PANOPTIX +1.5 23.5D IOL ACRYSOF PANOPTIX +1.5 24.0D IOL ACRYSOF PANOPTIX +1.5 24.5D IOL ACRYSOF PANOPTIX +1.5 25.0D IOL ACRYSOF PANOPTIX +1.5 25.5D IOL ACRYSOF PANOPTIX +1.5 26.0D IOL ACRYSOF PANOPTIX +1.5 26.5D IOL ACRYSOF PANOPTIX +1.5 27.0D IOL ACRYSOF PANOPTIX +1.5 27.5D IOL ACRYSOF PANOPTIX +1.5 28.0D IOL ACRYSOF PANOPTIX +1.5 28.5D IOL ACRYSOF PANOPTIX +1.5 29.0D IOL ACRYSOF PANOPTIX +1.5 29.5D IOL ACRYSOF PANOPTIX +1.5 30.0D IOL ACRYSOF PANOPTIX +1.5 31.0D IOL ACRYSOF PANOPTIX +1.5 32.0D IOL ACRYSOF PANOPTIX +1.5 33.0D IOL ACRYSOF PANOPTIX +1.5 34.0D IOL ACRYSOF PANOPTIX +2.25 6.0D IOL ACRYSOF PANOPTIX +2.25 6.5D IOL ACRYSOF PANOPTIX +2.25 7.0D IOL ACRYSOF PANOPTIX +2.25 7.5D IOL ACRYSOF PANOPTIX +2.25 8.0D IOL ACRYSOF PANOPTIX +2.25 8.5D IOL ACRYSOF PANOPTIX +2.25 9.0D IOL ACRYSOF PANOPTIX +2.25 9.5D IOL ACRYSOF PANOPTIX +2.25 10.0D IOL ACRYSOF PANOPTIX +2.25 10.5D IOL ACRYSOF PANOPTIX +2.25 11.0D IOL ACRYSOF PANOPTIX +2.25 11.5D IOL ACRYSOF PANOPTIX +2.25 12.0D Page 43 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF PANOPTIX +2.25 12.5D IOL ACRYSOF PANOPTIX +2.25 13.0D IOL ACRYSOF PANOPTIX +2.25 13.5D IOL ACRYSOF PANOPTIX +2.25 14.0D IOL ACRYSOF PANOPTIX +2.25 14.5D IOL ACRYSOF PANOPTIX +2.25 15.0D IOL ACRYSOF PANOPTIX +2.25 15.5D IOL ACRYSOF PANOPTIX +2.25 16.0D IOL ACRYSOF PANOPTIX +2.25 16.5D IOL ACRYSOF PANOPTIX +2.25 17.0D IOL ACRYSOF PANOPTIX +2.25 17.5D IOL ACRYSOF PANOPTIX +2.25 18.0D IOL ACRYSOF PANOPTIX +2.25 18.5D IOL ACRYSOF PANOPTIX +2.25 19.0D IOL ACRYSOF PANOPTIX +2.25 19.5D IOL ACRYSOF PANOPTIX +2.25 20.0D IOL ACRYSOF PANOPTIX +2.25 20.5D IOL ACRYSOF PANOPTIX +2.25 21.0D IOL ACRYSOF PANOPTIX +2.25 21.5D IOL ACRYSOF PANOPTIX +2.25 22.0D IOL ACRYSOF PANOPTIX +2.25 22.5D IOL ACRYSOF PANOPTIX +2.25 23.0D IOL ACRYSOF PANOPTIX +2.25 23.5D IOL ACRYSOF PANOPTIX +2.25 24.0D IOL ACRYSOF PANOPTIX +2.25 24.5D IOL ACRYSOF PANOPTIX +2.25 25.0D IOL ACRYSOF PANOPTIX +2.25 25.5D IOL ACRYSOF PANOPTIX +2.25 26.0D IOL ACRYSOF PANOPTIX +2.25 26.5D IOL ACRYSOF PANOPTIX +2.25 27.0D IOL ACRYSOF PANOPTIX +2.25 27.5D IOL ACRYSOF PANOPTIX +2.25 28.0D IOL ACRYSOF PANOPTIX +2.25 28.5D IOL ACRYSOF PANOPTIX +2.25 29.0D IOL ACRYSOF PANOPTIX +2.25 29.5D IOL ACRYSOF PANOPTIX +2.25 30.0D IOL ACRYSOF PANOPTIX +2.25 31.0D IOL ACRYSOF PANOPTIX +2.25 32.0D IOL ACRYSOF PANOPTIX +2.25 33.0D IOL ACRYSOF PANOPTIX +2.25 34.0D IOL ACRYSOF PANOPTIX +3.0 6.0D IOL ACRYSOF PANOPTIX +3.0 6.5D IOL ACRYSOF PANOPTIX +3.0 7.0D IOL ACRYSOF PANOPTIX +3.0 7.5D IOL ACRYSOF PANOPTIX +3.0 8.0D IOL ACRYSOF PANOPTIX +3.0 8.5D Page 44 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF PANOPTIX +3.0 9.0D IOL ACRYSOF PANOPTIX +3.0 9.5D IOL ACRYSOF PANOPTIX +3.0 10.0D IOL ACRYSOF PANOPTIX +3.0 10.5D IOL ACRYSOF PANOPTIX +3.0 11.0D IOL ACRYSOF PANOPTIX +3.0 11.5D IOL ACRYSOF PANOPTIX +3.0 12.0D IOL ACRYSOF PANOPTIX +3.0 12.5D IOL ACRYSOF PANOPTIX +3.0 13.0D IOL ACRYSOF PANOPTIX +3.0 13.5D IOL ACRYSOF PANOPTIX +3.0 14.0D IOL ACRYSOF PANOPTIX +3.0 14.5D IOL ACRYSOF PANOPTIX +3.0 15.0D IOL ACRYSOF PANOPTIX +3.0 15.5D IOL ACRYSOF PANOPTIX +3.0 16.0D IOL ACRYSOF PANOPTIX +3.0 17.0D IOL ACRYSOF PANOPTIX +3.0 17.5D IOL ACRYSOF PANOPTIX +3.0 18.0D IOL ACRYSOF PANOPTIX +3.0 18.5D IOL ACRYSOF PANOPTIX +3.0 19.0D IOL ACRYSOF PANOPTIX +3.0 19.5D IOL ACRYSOF PANOPTIX +3.0 20.0D IOL ACRYSOF PANOPTIX +3.0 20.5D IOL ACRYSOF PANOPTIX +3.0 21.0D IOL ACRYSOF PANOPTIX +3.0 21.5D IOL ACRYSOF PANOPTIX +3.0 22.0D IOL ACRYSOF PANOPTIX +3.0 22.5D IOL ACRYSOF PANOPTIX +3.0 23.0D IOL ACRYSOF PANOPTIX +3.0 23.5D IOL ACRYSOF PANOPTIX +3.0 24.0D IOL ACRYSOF PANOPTIX +3.0 24.5D IOL ACRYSOF PANOPTIX +3.0 25.0D IOL ACRYSOF PANOPTIX +3.0 25.5D IOL ACRYSOF PANOPTIX +3.0 26.0D IOL ACRYSOF PANOPTIX +3.0 26.5D IOL ACRYSOF PANOPTIX +3.0 27.0D IOL ACRYSOF PANOPTIX +3.0 27.5D IOL ACRYSOF PANOPTIX +3.0 28.0D IOL ACRYSOF PANOPTIX +3.0 28.5D IOL ACRYSOF PANOPTIX +3.0 29.0D IOL ACRYSOF PANOPTIX +3.0 29.5D IOL ACRYSOF PANOPTIX +3.0 30.0D IOL ACRYSOF PANOPTIX +3.0 31.0D IOL ACRYSOF PANOPTIX +3.0 32.0D IOL ACRYSOF PANOPTIX +3.0 33.0D IOL ACRYSOF PANOPTIX +3.0 34.0D Page 45 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF PANOPTIX +3.75 6.0D IOL ACRYSOF PANOPTIX +3.75 6.5D IOL ACRYSOF PANOPTIX +3.75 7.0D IOL ACRYSOF PANOPTIX +3.75 7.5D IOL ACRYSOF PANOPTIX +3.75 8.0D IOL ACRYSOF PANOPTIX +3.75 8.5D IOL ACRYSOF PANOPTIX +3.75 9.0D IOL ACRYSOF PANOPTIX +3.75 9.5D IOL ACRYSOF PANOPTIX +3.75 10.0D IOL ACRYSOF PANOPTIX +3.75 10.5D IOL ACRYSOF PANOPTIX +3.75 11.0D IOL ACRYSOF PANOPTIX +3.75 11.5D IOL ACRYSOF PANOPTIX +3.75 12.0D IOL ACRYSOF PANOPTIX +3.75 12.5D IOL ACRYSOF PANOPTIX +3.75 13.0D IOL ACRYSOF PANOPTIX +3.75 13.5D IOL ACRYSOF PANOPTIX +3.75 14.0D IOL ACRYSOF PANOPTIX +3.75 14.5D IOL ACRYSOF PANOPTIX +3.76 15.0D IOL ACRYSOF PANOPTIX +3.75 15.5D IOL ACRYSOF PANOPTIX +3.75 16.0D IOL ACRYSOF PANOPTIX +3.75 16.5D IOL ACRYSOF PANOPTIX +3.75 17.0D IOL ACRYSOF PANOPTIX +3.75 17.5D IOL ACRYSOF PANOPTIX +3.75 18.0D IOL ACRYSOF PANOPTIX +3.75 18.5D IOL ACRYSOF PANOPTIX +3.75 19.0D IOL ACRYSOF PANOPTIX +3.75 19.5D IOL ACRYSOF PANOPTIX +3.75 20.0D IOL ACRYSOF PANOPTIX +3.75 20.5D IOL ACRYSOF PANOPTIX +3.75 21.0D IOL ACRYSOF PANOPTIX +3.75 21.5D IOL ACRYSOF PANOPTIX +3.75 22.0D IOL ACRYSOF PANOPTIX +3.75 22.5D IOL ACRYSOF PANOPTIX +3.75 23.0D IOL ACRYSOF PANOPTIX +3.75 23.5D IOL ACRYSOF PANOPTIX +3.75 24.0D IOL ACRYSOF PANOPTIX +3.75 24.5D IOL ACRYSOF PANOPTIX +3.75 25.0D IOL ACRYSOF PANOPTIX +3.75 25.5D IOL ACRYSOF PANOPTIX +3.75 26.0D IOL ACRYSOF PANOPTIX +3.75 26.5D IOL ACRYSOF PANOPTIX +3.75 27.0D IOL ACRYSOF PANOPTIX +3.75 27.5D IOL ACRYSOF PANOPTIX +3.75 28.0D IOL ACRYSOF PANOPTIX +3.75 28.5D Page 46 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF PANOPTIX +3.75 29.0D IOL ACRYSOF PANOPTIX +3.75 29.5D IOL ACRYSOF PANOPTIX +3.75 30.0D IOL ACRYSOF PANOPTIX +3.756 31.0D IOL ACRYSOF PANOPTIX +3.75 32.0D IOL ACRYSOF PANOPTIX +3.756 33.0D IOL ACRYSOF PANOPTIX +3.75 34.0D IOL ACRYSOF PANOPTIX +3.0 16.5D CONTOUR GOLD WEIGHT 1.8G IOL RXSIGHT 10.0D IOL RXSIGHT 11.0D IOL RXSIGHT 12.0D IOL RXSIGHT 13.0D IOL RXSIGHT 14.0D IOL RXSIGHT 15.0D IOL RXSIGHT 16.0D IOL RXSIGHT 16.5D IOL RXSIGHT 17.0D IOL RXSIGHT 17.5D IOL RXSIGHT 18.0D IOL RXSIGHT 18.5D IOL RXSIGHT 19.0D IOL RXSIGHT 19.5D IOL RXSIGHT 20.0D IOL RXSIGHT 20.5D IOL RXSIGHT 21.0D IOL RXSIGHT 21.5D IOL RXSIGHT 22.0D IOL RXSIGHT 22.5D IOL RXSIGHT 23.0D IOL RXSIGHT 23.5D IOL RXSIGHT 24.0D IOL RXSIGHT 25.0D IOL RXSIGHT 26.0D IOL RXSIGHT 27.0D IOL TORIC ZCT150 8.5D IOL TORIC ZCT150 9.0D IOL TORIC ZCT225 9.5D LEGION PS OXIN FEM SZ7 RT RING MULTI-SITE ADAPTER SCREW VOYAGER EXT TAB 5.5X45MM SCREW VOYAGER EXT TAB 5.5X50MM CNTRST VARIBAR PUDDING 230ML CNTRST VARIBAR HONEY THIN250ML TRNQT STERICUFF WO SLV 18IN SCREW PEG NL ALPS 2.5X22MM Page 47 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,348.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $1,323.00 $572.00 $572.00 $572.00 $572.00 $70.00 $2,464.00 $2,436.00 $273.00 $289.00 $111.00 $561.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW PEG NL ALPS 2.5X24MM SCREW PEG NL ALPS 2.5X28MM MESH 3D MAX RT MD MESH 3D MAX RT LG TAMP BONE INFL XPANDER 15MM STNT DUODEN RX 7FR5CM STNT DUODEN RX 7FR12CM STNT DUODEN RX 8.5FR12CM STAPLER ENDO GIAL ULT GEN XL SCREW CANN SYNT 6.5X16X80MM SCREW CANN SYNT 6.5X32X100MM SCREW CANN SYNT 6.5X16X55MM BIT DRILL FLUTED QK CPL 3.2MM SCREW PLLA BIOINTERFER 7X23MM STNT DUODEN RX 8.5FR5CM SYS DEL 9FR 45/80 ALLO ALLOD 6X12CM=72SQ PUNCH CRKSCRW SWIVEL K 5.5MM BLN DILATOR CRE 18-20MM SET INFUS QUICK-SET 6MM 23IN NAIL GAMMA RT LNG 125D11X360MM STNT DUODEN RX 10FR15CM STNT DUODEN RX 8.5FR7CM SCREW CANN SYNT 6.5X32X60MM KNEE TIB BASE OFFSET ZIMM 75MM INTR PICC INTROSYTE-N26GX1.9CM GDWIRE HT PILOT 200 ST 190CM ALLO ALLOD CYMETRA 2CC HIP STEM SUMMIT POR HIGH SZ3 SCREW PEG NL ALPS 2.5X20MM NAIL GAMMA RT LNG 125D11X300MM NAIL GAMMA RT LNG 125D11X340MM NAIL GAMMA RT LNG 125D11X380MM NAIL GAMMA RT LNG 125D11X400MM NAIL GAMMA RT LNG 125D11X420MM NAIL GAMMA RT LNG 125D11X440MM GDWIRE GT ANG 0.018 45D 180CM BIT DRILL HAMMERLOCK 1.8MM BIT DRILL FLUTED QK CPL 4.2MM BIT DRILL FAST 2MM KNEE TIB BASE OFFSET ZIMM 71MM SHLDR HUMRSTEM STD COMPL14X130 CAGE PEEK VBS MDTR 11X30MM ILLUM ENDO ALCON 25G SHLDR HUMR HD COPELAND HA SZ6 GDWIRE ANG 0.018 150CM Page 48 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $561.00 $561.00 $625.20 $695.25 $3,002.00 $487.00 $487.00 $487.00 $848.00 $1,117.19 $1,118.06 $1,118.06 $569.00 $706.00 $487.00 $2,132.00 $4,104.00 $923.00 $821.83 $60.00 $3,766.00 $487.00 $487.00 $1,118.06 $4,730.00 $288.00 $387.00 $1,138.00 $4,078.63 $561.00 $3,766.00 $3,766.00 $3,766.00 $3,747.00 $3,766.00 $3,766.00 $959.00 $927.00 $569.00 $641.00 $4,730.00 $5,118.00 $5,350.00 $361.02 $6,551.00 $315.00 2020 pricing Drugs&Supplies PROCEDURE NAME MOLD CMNT KNEE SPACER TIB 70MM SCREW CORT LK ACUM 2.3X24MM CATH BLN RELIANT MDTR 12FR GDWIRE STIFF ANG 3CM 150CM ALLO ALLOD 16X20CM=320SQ SHLDR HUMRSTEM STD COMPL13X130 PIN STEINMAN STRY 5/64X9 BIT DRILL CANN ARTX 1.7MM SCREW PLLA BIOCOMP 3X20MM SHLDR HUMRSTEM STD COMPL16X130 SHLDR KT TORQ SCREW DEFINE SHLDR GLENOBASEHYBRIDMODULARMD SHLDR HD VERSA-DIAL 42X18X46MM HEMO SEAL FLOSEAL 5ML SCREW PEG NL ALPS 2.5X10MM NDLE BREAST LOCAL 20GX6.4CM SUT ENDOLOOP PDS II 0 MOLD CMNT KNEE SPACER FEM 75MM SUT TIGERSTICK2 STIFFWHT/BLK50 DRN JP RD PVC W TROC 10FR ELTD ELECSURG RT ANG LOOP 26FR HIP LNR E1 PE MROM 36X24MM SCREW CORT SLFTP T6 2X22MM CATH BLN BILI FOGARTY 5FRX23CM ALLO ALLOD 8X16CM=128SQ NAIL TIB T2 STRY STD 11X360MM PROBE LITHO CYBERWAND GONIOMETER EZ READ JAMA 12.5IN KNEE TIB BASE OFFSET ZIMM 79MM SUT FBRWIRE 3-0 TAPER BLU 18 SCREW CANN THRD ASNIS6.5X20X75 SCREW INTERFER BIOCOMP 8X23MM SCREW INTERFER BIOCOMP 8X28MM SCREW CORT STAR T15 3.5X20MM SCREW LK SYNT 2X6MM SCREW INTERFER BIOCOMP 7X23MM RETR STAY LONESTAR 2FINGER 7MM PLATE ADPTN MD TI 20HL 0.7MM SCREW INTERFER BIOCOMP 9X23MM BIT DRILL ACUTRAK2 MINI LNG ANCHOR BIOCOMP SUTTAK 2FBR 3MM HIP LNR E1 PE MROM +3 40X24MM PLATE HUMR DIST LCP XTRLFT10HL SCREW CORT SLFTP T6 2X24MM SCREW CORT SLFTP T6 2X26MM KNEE TIB INSRTCRZIMM10X71/75MM Page 49 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,123.46 $583.52 $1,578.00 $269.00 $18,105.00 $5,118.00 $81.66 $880.25 $1,382.00 $5,118.00 $284.00 $2,932.00 $3,786.00 $941.50 $561.00 $68.00 $210.00 $3,477.72 $261.00 $72.00 $356.00 $3,240.00 $173.40 $249.00 $7,298.00 $3,070.47 $1,876.00 $95.00 $4,730.00 $126.28 $1,051.42 $1,127.00 $1,127.00 $124.27 $521.03 $1,127.00 $72.34 $1,557.09 $1,127.00 $1,300.96 $1,168.00 $3,240.00 $3,094.40 $173.40 $173.40 $3,520.00 2020 pricing Drugs&Supplies PROCEDURE NAME CAUT BIPOLR CORD IRG 1000*CIP* CANN BTN PASSPORT 8MMX3CM CANN BTN PASSPORT 8MMX4CM CANN BTN PASSPORT 8MMX5CM CATH RAD JACKY3.5 6FR 100CM CATH RAD TIG 4.0 5FR 100CM CATH RAD TIG 4.0 6FR 100CM PROS PENILE AMS700 LGX MS 15CM SCREW PLLA BIOCOMP 3X18MM CANN BTN PASSPORT 8MMX2CM SCREW CORT STAR T15 3.5X26MM SCREW LK VA T8 STAR 2.4X20MM SCREW LK VA T8 STAR 2.4X12MM SCREW LK VA T8 STAR 2.4X16MM SCREW LK VA T8 STAR 2.4X22MM SCREW LK VA T8 STAR 2.4X24MM ANCHOR SUT PLK BIOCOMP2.9X15.5 ANCHOR BIOCOMP SWVLK 4.75X19.1 SCREW TENODESIS BIOCOMP 8X23MM SCREW LK T15 STARDR 3.5X52MM SCREW LK SYNT 2X8MM SET SCREW SOLERA MDTR SHLDR HD VERSA-DIAL 50X21X57MM SHLDR STEM CMPRHNSV MINI 12X83 CLIP LIGACLIP LIGATING TIMD-LG SHLDR STEM CMPRHNSV MINI 11X83 ANCHOR BIOCOMPSUTTAK 1FBR2 2.4 HIP LNR E1 PE MROM +3 36X23MM KNEE TIB INSRTCRZIMM12X71/75MM GDWIRE BEAD ZIMM 2.6MMX80CM SCREW CANN LOPRO ARTX 3.0X34MM STAPLER ENDOCUTTER ARTIC 45 MM SCREW MTXMID SYNT BLU 6MM SHLDR HD VERSA-DIAL 46X18X53MM SHLDR STEM CMPRHNSV MINI 9X83 CATH ABL COOL POINT*CIP* SHLDR HD VERSA-DIAL 50X24X52MM SHLDR STEM CMPRHNSV MINI 14X83 ANCHOR BIOCOMP CRKSCRW 3FBR5.5 BLN RETRV RX PRO ABOVE 9-12MM BLN RETRV RX PRO ABOVE 12-15MM SHLDR GLENOBASEHYBRIDMODULARLG FORCEPS CAUT HALO PKS 5MM 33CM PLATE DIST RAD 2COL LFT 6/5HL PLATE DIST RAD 2COL LFT 7/5HL CMNT BONE CMW2 DEPU 20GM Page 50 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $172.00 $174.00 $174.00 $174.00 $258.00 $258.00 $258.00 $20,186.00 $1,433.85 $174.00 $124.27 $592.64 $592.64 $592.64 $592.64 $592.64 $1,401.00 $1,400.00 $1,245.00 $561.22 $521.03 $400.34 $3,786.00 $5,937.00 $68.00 $5,937.00 $1,168.00 $3,240.00 $3,520.00 $625.20 $625.20 $1,864.00 $329.07 $3,786.00 $5,937.00 $3,053.00 $3,786.00 $5,937.00 $1,268.20 $764.00 $764.00 $2,932.00 $1,778.00 $2,239.98 $2,339.97 $410.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLN NC TREK RX 2.25X08MM BLN NC TREK RX 2.25X12MM DRN JP RD SIL W TROC 15FR DRN JP RD SIL W TROC 10FR ELTD CAUT FULGUR 5FR 58CM SCREW MTX SYNT SGL 1.85X6MM WRENCH TORQ JUDE ROD CC MDTR 3.5X240MM SCREW SWVLK BIO 6.25X19.1MM SUT V-LOC ABSORB 3-0 V20 VIO 6 SHLDR STEM CMPRHNSV MINI 15X83 HIP LNR E1 PE MROM +3 40X25MM HIP LNR G7 ARTICU E1 PE28X42MM MESH VENTRALIGHT ECHO 7X9 MESH VENTRALIGHT ECHO 8X10 MESH VENTRALIGHT ECHO 6X8 SYS IMPLT SPEEDBRIDGE BIOCOMP SCREW CORT LK ACUM 2.3X28MM SUT SILK 3-0 FS1 18 MESH VENTRALIGHT ECHO 10X13 TONGUE ADV BONE SYS REPOS CATH BLN Q50 10-50MM 65CM PLATE DIST RAD 2COL RT 6/2HL SIZER MAM 68MP DISP 300-330CC BLADE MINI LEMELLAR ANG KNEE TIB INSRTGII CNSTND3-4 15 PLATE OLEC ACUM STD LFT 5HL HIP LNR E1 PE MROM +3 32X22MM HIP LNR G7 ARTICU E1 PE28X40MM HIP HD EZE TSCER12/14 28MM+8.5 ELTD EMG PATHWAY VAG GD CATH LAUNCH MAC4 5FR 100CM PLATE HUMR PROX LFT 8HL 3.5MM ALLO ALLOD THICK 4X16CM=64SQ SCREW LO PRO LNG THRD 4X30MM SCREW LK T15 STARDR 3.5X35MM SCREW CORT LOPRO ARTX 3.5X40MM SCREW CORT LOPRO ARTX 3.5X44MM SCREW ACUTRAK2 MINI 18MM ANCHOR BIOCOMP SWVLKCTIGER4.75 TRNQT CUFF DUAL DUAL 24 SCREW CNCLS ARTX 3X20MM SCREW CNCLS ARTX 3X26MM PLATE LK TUBLR SS ARTX 10HL BIT DRILL QC SYNT 7.3X300MM KNEE FEM LGN PS OXIN RT SZ5 Page 51 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $781.00 $781.00 $109.00 $110.00 $331.00 $635.00 $133.00 $945.64 $1,434.00 $204.58 $5,937.00 $3,240.00 $4,120.00 $3,378.70 $3,671.40 $2,695.00 $3,591.00 $583.52 $9.00 $4,532.00 $5,255.00 $1,512.02 $2,180.38 $258.00 $85.00 $4,532.00 $2,974.85 $3,240.00 $4,120.00 $3,164.00 $242.00 $230.01 $3,386.18 $3,648.00 $197.75 $561.22 $328.20 $328.20 $1,735.58 $1,609.00 $218.00 $197.75 $197.75 $1,083.60 $1,162.45 $4,917.00 2020 pricing Drugs&Supplies PROCEDURE NAME WASHER ASNIS III STRY 6.5/8MM ROD EXTL FIX CBN MR 11X450MM HIP STEM SYNRG CMNT STD SZ11 HIP STEM SYNRG CMNT STD SZ12 HIP STEM SYNRG CMNT STD SZ16 HIP STEM SYNRG CMNT STD SZ17 CBL TORQ TIGER2 ST 170CM KNEE FEM WEDGE LGN 5-6 5MM SCREW CORT LEAD DBL 5X36MM SCREW QUICKFIX ARTX 2X13MM BIT DRILL STRY 3.5X130MM NAIL TIB T2 STRY STD 9X285MM KNEE TIB BASE JOURNEY LFT SZ3 KNEE PSN TIB STEM 5D LFT SZC ENDOL TRUNK C3 31X14.5MMX17CM KNEE PSN FEM CRCMNT STD LFTSZ4 SCREW CNCLS SHRTTHRD TI 4.0X48 SCREW CNCLS SHRTTHRD TI 4.0X60 ENDOL EXTNDR 32MMX4.5CM NAIL GAMMA STRY LFTLNG11X320MM NAIL GAMMA STRY LFTLNG11X360MM NAIL GAMMA3 LFT LNG 125D11X440 KNEE STEM LGN PRESSFIT16X160MM ENDOL EXCLUDER 27MMX14CM ENDOL EXCLUDER 32MMX12CM GDWIRE ST 0.035 150CM KNEE FEM LGN CNSTND LFT SZ7 SIZER MAM 410MF RPSB 470CC ALLO TRINITY ELITE MTF MD ANK INBONE STEIN PIN 2.4MM KNEE TIB INSRTCRZIMM14X63/67MM TAMP BONE INFL EXPRESS 10MM SUT BOOT SHOD YEL STD 10PK CATH FOLEY COUNCIL 20FR 5CC SHLDR HD VERSA-DIAL 54X27X55MM ALLO ALLOD THIN 4X7CM=28SQ KNEE STEM LGN PRESSFIT18X160MM KNEE FEM LGN PS OXIN LFT SZ7 MESH VENTRALIGHT ECHO 4X6 KNEE FEM LGN CNSTND LFT SZ5 HIP HD OXIN MTL 12/14 36MM +12 HIP LNR R3 XLPE PE 20D 36X52 ANCHOR BIOCOMP SWVLK3.5X15.8MM PIN STEINMAN WRIT 2.5MM KNEE FEM LGN PS OXIN LFT SZ6 KNEE KT CUT BLOCK LGNP RT Page 52 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $177.98 $959.02 $2,643.03 $2,643.03 $8,930.00 $2,643.03 $207.00 $2,868.00 $1,052.64 $1,190.40 $471.14 $3,070.47 $3,351.00 $2,203.11 $23,114.00 $3,229.54 $839.85 $839.85 $6,670.00 $3,583.45 $3,583.45 $4,079.00 $6,063.95 $9,478.00 $9,478.00 $177.00 $13,835.00 $992.00 $4,061.75 $197.75 $3,520.00 $3,420.00 $37.00 $68.21 $3,786.00 $1,035.00 $3,063.95 $4,917.00 $1,562.40 $13,835.00 $2,117.82 $1,972.08 $4,074.00 $180.80 $4,917.00 $1,974.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE CALC STEP ARTX 7.5MM SUT V-LOC ABSORB 0 GS21 GRN 9 SCREW CORT LEAD DBL 5X75MM NAIL ANK PHOE LK 10X210MM PLATE TIB ANT LAT VALCP 8HL RT PLATE META LCP 8HL 3.5MM HIP STEM ANTHOLOGY STD SZ10 KNEE FEM LGN CR OXIN RT SZ7 KNEE FEM LGN CR OXIN LFTSZ7 KNEE INSRT XLPE DISHSZ5-6 11MM KNEE FEM LGN PS OXIN LFT SZ3 SCREW CANN TRIL 2.4X18MM SHLDR GLENOID PEG CORTILOC S30 SHLDR GLENOID PEG CORTILOC L60 SHLDR GLENOID KEEL AEGU S35 SHLDR HUMR STEM STD 3C 74MM SHLDR HUMR STEM STD 7C 90MM TRIAL CBL MULTLEAD SUT TIGERLINK 2 CLSD WHT/BLK26 PLATE PROX RAD SM 2.5MM LT SOURCE WIDE FLAT DISP SCREW CORT LEAD DBL 5X50MM HIP STEM SYNRG POR STD SZ14 SCREW NL HEXALOBE 2.7X18MM CAUT LIGASURE MARY 37CM REPROCESSED ANCHOR ENDOBTN CL ULT 20MM ENDOL TRUNK LP 23X14MMX18CM KNEE INSRT XLPE DISHSZ5-6 13MM HIP STEM SYNRG POR STD SZ9 ELITE FBR ENT OMGD ANCHOR ENDOBTN CL ULT 25MM ANCHOR ENDOBTN CL ULT 15MM ANCHOR ICONIX 2 #2FBR 2.3MM SCREW VAL TI 3.0X12.0MM SCREW VAL TI 3.0X18.0MM SCREW LAG TI STER 105MM SHLDR HUMR HD STB LOW 54X21 SCREW LK GORILLA 2.7X12MM KNEE TIB INSRTGII CNSTND 3-4 9 KNEE INSRT XLPE DISHSZ5-6 15MM MEP/EMG NDLE MODULE CAP VANTAGE ALTITUDE 2MM HIP STEM POLARSTEM135D STD SZ2 SCREW POST BI CORT 4.5X50MM SCREW POST BI CORT 4.5X52.5MM SCREW POST BI CORT 4.5X55MM Page 53 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,528.40 $171.47 $1,052.64 $6,944.00 $1,540.56 $2,194.91 $4,078.65 $3,542.69 $3,542.69 $2,353.75 $3,542.69 $880.25 $3,285.00 $3,285.00 $4,919.28 $8,478.00 $8,478.00 $905.40 $1,897.00 $2,445.00 $1,064.25 $1,052.64 $4,078.63 $485.76 $1,435.00 $1,000.00 $21,208.00 $2,343.75 $4,078.63 $2,322.00 $1,000.00 $1,000.00 $1,150.00 $729.40 $729.40 $1,868.13 $3,285.00 $1,034.16 $8,930.00 $2,353.75 $3,842.31 $1,339.47 $4,078.63 $521.00 $521.00 $521.00 2020 pricing Drugs&Supplies PROCEDURE NAME REAMER METATARSAL 20MM BLADE HIGHTORQ 12.5MM KNEE TIB INSRT HNG POSTSZC12MM KNEE TIB INSRT HNG POSTSZD12MM KNEE TIB INSRT HNG POSTSZD14MM KNEE TIB INSRT HNG POSTSZD17MM KNEE TIB INSRT HNG POSTSZE12MM SUT FBRWIRE 2-0 MENISC NDLE SM SUT FBRWIRE 2 LOOP NDLE10GRN26 KT SUT TIGER/FBRWIRE 5 2 NDLE PLATE LCP META 3.5/4.5MM 12HL HANDPC PROBREATH 1.1X10MM SCREW NL HEXALOBE 2.7X32MM KWIRE SGL TROC SMTHPRGN2.3X230 HIP STEM SYNRG POR HIGH SZ11 KNEE FEM LGN CNSTND RT SZ7 KNEE TIB BASE CMNT LGNREVRTSZ4 HIP SCREW CNCLS RFLCT 40MM SOL VISCOAT LG 0.75ML PLATE TI MTXWAVE SYNT SCREW TI MTXWAVE 1.85X6MM SCREW TI MTXWAVE 1.85X8MM HIP STEM POLARSTEM135D STD SZ8 SUT FBRLOOP FBRTAG ST NDLE SYS EXTR ALEXIS CONTAINED 17CM GRSPR FEN TIP-UP ROB XI RPSB BIT DRILL CANN ZIMM 7X200MM DRIV NDLE ROB XI MEGA RPSB SHLDR HUMR HD UNIV II 56X22 SIZER MAM 410MM RPSB 360CC SYS CHARGING PRODIGY SCREW NL GORILLA 3.5X22MM SCREW LK LOPRO TI 4.5X44MM KNEE PSN ASFMCVELFT10MM 4-5CD KNEE PSN ASF MCVELFT10MM8-11GH KNEE PSN ASF MC VERT11MM6-7 EF SCREW LK TI SLFTP 5.0X36MM HIP LNR DURALOC PE +4 0D 36X62 END CAP TFNA TI STER 5MM HIP SHELL OSSEOTI 3HL E 52MM TREPHINE EYEPTADJVACUUM 8.50MM HIP SUCT CUP STER SGL DISP BREAST SMTH RESPONSE FULL450CC FLIPCUTTER II ARTX SHRT 10.5MM HIP LNR G7 PE DUAL 42MM SZ E HIP LNR ARCOMXL PE 0D 28X46MM Page 54 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,512.00 $2,999.00 $5,002.00 $5,002.00 $5,002.00 $5,002.00 $5,002.00 $343.00 $303.00 $1,311.00 $2,647.09 $908.62 $485.76 $167.89 $4,078.63 $13,834.00 $5,530.00 $6,549.95 $270.00 $1,072.95 $496.59 $496.59 $4,078.63 $656.00 $1,212.25 $4,532.00 $1,145.52 $4,532.00 $273.74 $992.00 $3,145.50 $1,268.20 $980.85 $2,903.85 $2,903.85 $2,903.85 $935.93 $4,180.23 $1,105.83 $6,948.00 $525.00 $371.96 $2,241.90 $1,212.25 $4,140.00 $2,775.85 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE INSRT JII BSCRTSZ3-4 12MM KNEE INSRT JIIBCSLFTSZ3-4 13MM BLADE DERMATOME ZIMM STER KNEE STEM LGN PRESSFIT20X160MM HIP SHELL OSSEOTI 4HL G 60MM BREAST SMTH RD MODER 445CC BREAST SMTH RESPONSEXFULL400CC LENS VITRECTOMY DIRECT FLAT PLATE CALC PERC ARTX RT STD PLATE CALC PERC ARTX RT LNG KNEE INSRT JII BCS RT SZ7-8 9 NEBULIZER FINITY LG VOL 240ML SCREW LK T8 FULL THRD 2.7X14MM SCREW VARIAX NL T8FULL2.7X12MM KNEE INSRT JIIBCSLFTSZ7-8 10MM KNEE FEM JII BCS OXIN LFT SZ9 DEV TISS REMOV MYOSURE REACH KNEE INSRT JII BCSRTSZ5-6 9MM SCREW MULTLOC FULL TI 4.5X44MM MESH ALLODERM 21.5X107CM=164SQ SCREW LK LOPRO TI 4.5X46MM RELOAD RAD MDTHK PUR 2.0 SCREW BONE T10FULLTHRD3.5X30MM DEV FUSN SM INTRLK 7D6X17X14MM SCREW COROENT SI SLFTP 4X12MM SCREW COROENT SI SLFTP 4X14MM ALLO SPNG OSTEOAMP 50X20X7MM SCREW MINI SHRT THRD 3.0X28MM CAUT LIGASURE IMPACT CURV 14D SCREW VARIAX LK T8 2.4X14MM END CAP OFFSET 0MM GRSPR ROB XI SMGRAPTOR RPSB8MM KNIFE DUAL BEVEL CLEARCUT2.4MM SCREW LK T8 FULL THRD 2.7X12MM BLADE SCREWDRIVER T10 AO BREAST SIL 410MODER XFULL550CC STNT SINUS CONT PROPEL 8MM BREAST SIL 410MODER XFULL520CC BG LAVAGE WOUND BACTISURE 1L KNEE FEM JII BCS OXIN RT SZ10 NDLE CYSTO INJETAK 4.8FR 35CM NAIL GAMMA LNG LFT11X440X130MM NAIL GAMMA LNG LFT11X400X130MM ALLO EVANS WEDGE SUBTLR 10MM ROD CP4 CURV TI 5.5X40MM KNEE INSRT JIIBCSLFTSZ3-4 12MM Page 55 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,353.75 $2,353.75 $257.00 $3,063.95 $6,984.00 $2,241.90 $2,241.90 $171.00 $2,748.45 $2,748.45 $2,353.75 $85.23 $81.69 $656.63 $2,353.75 $4,317.76 $3,067.16 $2,353.75 $850.23 $10,064.00 $908.85 $1,335.91 $453.99 $5,154.00 $710.70 $710.70 $9,094.00 $1,153.20 $1,833.98 $835.01 $1,031.68 $4,944.00 $137.81 $81.69 $707.61 $2,682.75 $2,115.00 $2,748.45 $625.00 $4,317.76 $252.45 $3,427.65 $3,427.65 $5,325.00 $844.94 $2,353.75 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB BASE JOURNEY LFT SZ2 PLATE T LCP 2/7HL 2.0X53MM SCREW SOLERA MAS 4.5X50MM SCREW SOLERA MAS 5.5X30MM ROD CP4 CURV TI 5.5X30MM BTN ABS TIGHTROPE CONCAVE 20MM SCREW BONE T10FULLTHRD2.7X14MM CUTTER HD IOL DISP 19G FORCEPS MICRO-HOLDING DISP 23G KNEE FEM JII BCS OXIN LFT SZ3 SCREW FEM PERFD TFNA TI 90MM SCREW FEM PERFD TFNA TI 110MM STIM NEURO EXTL EVAL MDTR SYS SPACEOAR HYDROGEL 10ML SCREW COMP FT LG ARTX 5.0X55MM SCREW BONE T10FULLTHRD2.7X20MM SCREW VARIAX NL T8PART2.7X16M SCREW VARIAX LK T8 2.4X10MM SCREW VARIAX LK T8 2.4X12MM KWIRE PHALINX 1.1X102MM SCREW CANN TOE PHALINX 0D SM SCREW CANN TOE PHALINX 0D MD SEAL VESS DISP EXT ROB XI 8MM SCREW RELINE-O PA 4.5X50MM PLATE ANT TLIFCOROENT8D12X9X30 SYR HEALON5 PRO OVD 0.6ML SCREW ASNIS III CANN 6.5X95MM BIT DRILL CANN DISTCUT2.7X70MM PLATE BASE ASSY IJS SCREW IJS NL TI 3.5X22MM SCREW IJS NL TI 3.5X24MM SCREW IJS NL TI 3.5X34MM KWIRE STD 4.5X127MM BIT DRILL SOLID SIDECUT 2.5X80 KT PT SFTY BED SET UP LG ALLO MTX CELL BONE V92 5CC DRILL CANNULATED WRIT 2.55MM DRILL CANNULATED ARTX 6MM SCREW MNSTR CANN SHRT 7.0X82MM SCREW MNSTR CANN SHRT 7.0X74MM ARCHON PLATE LVL2 34MM KNEE INSRT JIIBCS RTSZ1-2 10MM HIP POLARSTEM VALGUS 145D SZ4 KNEE INSRT JIIBCS RTSZ7-8 15MM GDWIRE PROWATERFLEX PTCA 18CM MESH VENTRALIGHT ECHO 15CM Page 56 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,901.46 $1,224.76 $1,865.16 $1,865.16 $844.94 $1,111.04 $75.40 $542.00 $524.73 $4,317.76 $1,959.46 $1,959.46 $1,400.00 $5,930.00 $1,596.00 $453.99 $656.62 $81.69 $81.69 $81.20 $3,099.83 $3,099.83 $2,188.00 $2,394.24 $5,950.00 $286.00 $1,051.52 $1,435.90 $11,404.00 $773.68 $773.69 $773.68 $180.80 $1,156.30 $1,610.00 $5,980.00 $1,003.37 $980.85 $1,663.94 $1,663.94 $2,510.00 $2,353.75 $4,078.63 $2,353.75 $385.00 $2,216.56 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW RELINE-O PA 7.5X50MM SUT V-LOC ABSORB 0 GS21 GRN 6 ALLO HAMMERGRAFT 2.8X21MM 10D NAIL TIB T2 STD 10X420MM ELBOW RAD STEM ALIGN 9X0MM ELBOW RAD STEM ALIGN 8X0MM PLATE BONE ANT MID 8H 97MM KT INTERSTIM SMART PROGRAMMER CATH BLN MOLD OCCL 10-37MM ROD RELINE-O TI ST 535X300MM SCREW RELINE-O PA 7.5X35MM SCREW PRECEPT 8.5X70MM SCREW PRECEPT 8.5X80MM DEV FUSN MONOLITH CORE 12X10MM SCREW MA VUEPOINT II 4.0X30MM SCREW MA VUEPOINT II 3.5X16MM SCREW MA VUEPOINT II 3.5X12MM SCREW BONE T10FULLTHRD3.5X46MM KNEE FEM HNG NEXGEN SZD 14MM REAMER CONE MALE 17MM REAMER CONE SLV FEMALE 17MM ROD RELINE-O TI LORD 5.5X70MM KNEE INSRT JIIBCSLFTSZ7-8 13MM GENERATOR PRODIGY MRI RECHARGE CNTRLR PRODIGY MRI PT JUDE KNEE STEM LGN PRESSFIT16X220MM KNEE FEM LGN CONE SHRT ID24 KNEE TIB LGN CONE SHRT ID20 SCREW TSRH OSTEOGRIP 8.5X50MM SCREW QK SNAP 2.7X12MM DEV FUSN COROENTXL+10D10X18X45 SUT V-LOC ABSORB 2-0GS22VIO9 PLATE ANTTLIFCOROENT12D10X9X30 SCREW PA PRECEPT 9.5X80MM SCREW QK SNAP 2.0X12MM HIP POLARSTEM VALGUS 145D SZ2 KNEE INSRTXRXLPE LATRT SZ7-5-6 KNEE TIB BASE JII XR RT SZ6 KNEE INSRT XRMEDLXLPELFT SZ5-6 HIP CENTRALIZER DIST INVIS 9MM MESH VENTRALIGHTST ECHO2 15X20 GDWIRE TROC TIP THRD 2.4X235MM SCREW COMP FT ARTX XL 7.0X75MM KNEE INSRT JIIBCSLFTSZ5-6 11MM SCREW LK LOPRO TI 4.5X55MM PLATE SAG MTX CURV 1.0 6HL 8MM Page 57 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,394.24 $203.69 $3,099.23 $3,070.47 $4,264.20 $4,264.20 $2,369.73 $5,850.00 $1,512.02 $1,135.84 $2,394.24 $2,391.41 $2,391.41 $10,682.00 $2,286.50 $2,286.50 $2,286.50 $453.99 $4,781.77 $1,260.00 $1,260.00 $1,639.68 $2,535.75 $63,850.00 $3,428.75 $3,339.15 $9,400.00 $8,930.00 $1,318.01 $1,219.85 $10,000.00 $0.01 $5,950.00 $2,391.41 $1,144.16 $4,078.63 $2,353.75 $2,901.46 $2,353.75 $7,540.00 $2,231.70 $169.50 $2,064.15 $2,353.75 $980.85 $2,062.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW MTX SYNT SGL 1.85X6MM HIP STEM POLARSTEM COLAR SZ2 PLATE ST STAPLE ASSY 8MMX8MM HIP LNR TANDEM BIPOLRPE28X50MM SCREW PA RELINE-O 6.5X40MM SCREW PA RELINE-O 5.5X40MM ROD RELINE-O TI LORD 5.5X40MM KNEE INSRT XLPE CRHFSZ1-2 12MM KNEE TIB LGN CONE SHRT ID18 EXPAND MAM MENT ARTOURA 375CC ROD PRECEPT TI PREBENT 95MM ROD PRECEPT TI PREBENT 90MM SCREW MINI SHRT THRD 3.0X14MM SCREW LK TI SLFTP 5X32MM SCREW PRECEPT PA 7.5X80MM SCREW PRECEPT PA 4.5X40MM SCREW SOVEREIGN ANG 5.5X30MM SPACER INTERBODY12D 32X23X18MM HIP STEM POLARSTEM COLAR SZ1 ROD RELINE-O TI LORD 5.5X35MM SCREW TSRH OSTEOGRIP 8.5X45MM EMG NVM5 NDLE MODULE BREAST MODER+XTREMEMORYGEL755CC SCREW MNSTR CANN MD 7.0X74MM BREAST HIPRO XTRMEMORYGEL450CC BIT DRILL MINI ACUTRAK 2 PLATE LEVERAGE C-C 9.5MM SCREW LEVERAGE LAAMINAR2.6X5MM SCREW LEVERAGE LAT MASS2.6X5MM PLATE LEVERAGE M-L 9.5MM PLATE LEVERAGE M-L 8MM SCREW LEVERAGE LAT MASS2.6X7MM SCREW LEVERAGE LAT MASS2.6X8MM SPACER CRST PEEK 8X36MM BONE SCREW T10 FULL THRD3.5X10 PLATE ANT TLIF COROENT 8D9X11X30 KNEE FEM JII BCS OXIN LFT SZ2 KNEE INSRT JII BCSLFTSZ1-2 11MM KNEE FEM JII PATELLO LG RT KNEE INSRT JII BCSRTSZ3-4 15MM PLATE INTRMD SHRT RT 10HL 58MM ALLO HAMMERGRAFT 0D 2.8X21MM KWIRE INSRT HAMMERTUBE1.0X70MM TB DISP 3/8IN TIP FORCEPS ILM GRIESHABER 25G BRA COMPRESSION MULTI SZ Page 58 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,897.83 $4,078.63 $3,224.45 $1,189.87 $3,394.24 $3,394.24 $844.94 $7,376.00 $8,930.00 $5,200.00 $1,071.99 $1,071.99 $880.43 $903.93 $2,391.41 $2,391.41 $1,813.83 $10,534.00 $4,078.63 $4,783.32 $1,318.02 $3,247.62 $2,554.20 $1,572.48 $2,554.20 $1,286.85 $3,510.57 $1,439.36 $1,153.26 $4,783.32 $4,783.32 $1,153.26 $1,153.26 $5,350.00 $453.99 $5,950.00 $4,317.00 $2,818.00 $5,420.00 $2,818.00 $3,920.38 $3,099.23 $592.64 $56.84 $159.00 $87.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE VOLAR DISTRAD NARW XSHRT PLATE VARIAX SLIM Y 3HL BIT DRILL LNG CANN 3.2MM STAPLE DYNAMITE NIT INST 15X15 STAPLE DYNAMITE NIT INST 20X20 STAPLE NIT COMP 20X15 STAPLE NIT COMP 15X15 BEAM SALVATION 7.0X125 SUT PLAIN GUT 6-0 G6/G6 18 WEDGE COTTON ALLOSYNC 16X65MM DRAIN MID-PREF PVC 10FR EVACUATOR 400CC PVC 10FR PLATE LCP META3.5-425-5.0 18HL SCREW CORT 110/40 6.0/5.0MM SCREW CORT 100/40 4.5/3.5MM KNEE TIB BASE CMNT LGNREVRTSZ5 KNEE TIB FULLSTEPWEDGE5-6 10MM KNEE TIB INSRTGII CNSTND5-6 13 PIN SCHANZ ARTX 5.0MM PLATE CALC PERIMETER RT MD SCREW CORT LK LOPRO TI3.5X14MM SCREW CANN AS3 STRY 4.0X55MM ARTICULAR INSERT SZ 5-6 11MM ARTICULAR INSERT SZ 5-6 12MM WEDGE SZ8 5X5MM SCREW COROENT XLR-F 4.5X27.5MM BRIGADE IMPLANT 12X38X28MM 8D VISION UNILATERAL ANKLE FIXATOR DRILL BIT 4.8MM 280MM SIZER HIPROMEMORYXTRA RPSB 465 NAIL FEMORAL RIGHT 11X440MM CANCELLOUS CUBES - BONE IMPLANT PLATE META LCP 7HL 3.5MM SCREW SOLERA MAS 6.5X60MM NAIL FEMORAL LEFT 11X420 MM PLATE INTER RIGHT 11HL SHORT SCREW RELINE-O 4.0X35MM 2S POLY SCREW RELINE-O 4.0X40MM 2S POLY SCREW RELINE-O 4.0X45MM 2S POLY TI ROD RELINE-O 5.5X500MM STRAIGHT SCREW CANN SHORT THRD 7.0X86MM PLATE CALC PERIMETER RT LG CLIP ANESTHESIA PEACH DRAPE CLAMPS TB ET LASER CUFF MURPHY 6.0MM VEST MALE COMPRESSION LARGE DRILL BIT PARAGON C Page 59 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,239.64 $3,536.36 $880.25 $5,738.00 $5,738.00 $5,685.00 $3,998.45 $3,924.60 $116.23 $4,800.00 $71.00 $93.00 $4,675.00 $1,000.00 $1,000.00 $5,530.00 $4,755.00 $5,500.00 $1,050.00 $3,285.00 $468.00 $680.00 $3,063.00 $3,063.00 $5,708.00 $1,003.00 $10,650.00 $14,304.00 $886.00 $875.00 $5,142.00 $965.00 $3,159.00 $2,198.00 $5,142.00 $2,780.00 $3,248.00 $3,248.00 $3,248.00 $1,145.00 $1,638.00 $3,285.00 $48.00 $220.00 $182.00 $2,017.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE MTP RT SHRT 0D SCREW NL COMP TUFFNEK 4.2X20MM SCREW CANN SYNT 6.5X16X105MM SCREW FEN TFNA TI STER 90MM INSERT RETENTIVE AEQ REVSD SPACER AEQ REVSD FRACTURE WEDGE ANAT COTTON 20X6.5MM PLATE 1/3 TUBLR 6HL 71MM PIN HALF APEX 3X80 20C/THR PIN HALF HYBRID APEX3X120X20MM PLATE SM FRAG LOCKING HS Y KNEE INSRT JII BCSRTSZ5-6 9MM SHLDR BASEPLATE THRD 25X25MM MESH 3D MAX LFT MD PLT DIST TIB ANTLAT LEFT NRW 6H PLATE FIBULA COMP LOCK 6H SCREW CORT LK 3.5 X10MM SCREW 2.7MM CORT FT 16MM SCREW 3.5MM MULTIDIRECT 26MM SCREW 3.5MM LW PROF CORT 32MM SCREW 3.5MM CORT LOCK 20MM NS SCREW 3.5MM LW PROF CORT 26MM SCREW 3.5MM LW PROF CORT 36MM POLARSTEM SZ STD3 TI/HA COLLAR BIT DRILL AO SCALED 02.6X220MM TROCH COMP SM RT JOURNEY PFJ SCREW SOLERA MAS 5.5X60MM SCREW 11X28MM RD DELTAPR SHTH SCREW PLATE R3CON NLCK 2.7X14MM SCREW PLATE R3CON NLCK 3.5X26MM PLATE 30MM SCREW VARIAX NL T8 2.4X18MM SCREW VARIAX NL T8 2.4X16MM PLATE VARIAX FIB DIST LAT 6HL SCREW BONE T10FULLTHRD3.5X60MM SCREW BONE T10FULLTHRD3.5X50MM SCREW VARIAX NL T8 2.4X26MM SCREW BONE T10FULLTHRD3.5X55MM SHLDR BASEPLATE THRD 29X25MM SHLDR BASEPLATE THRD 29X30MM SUT PLAIN GUT6-0 TG1408/TG1408 ILLUM ENDO ALCON 25G SUT MERSILENE WHT 4/0 18"" P-3 SCREW CANN AS3 STRY 4.0X42MM PLATE TI MTXWAVE SYNT BIT DRILL SYNT 6MM STOP 1.1MM Page 60 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,612.00 $927.00 $1,084.00 $3,434.00 $3,379.00 $4,170.00 $5,985.00 $1,225.00 $400.00 $652.00 $2,520.00 $3,063.00 $5,478.00 $3,075.00 $5,616.00 $1,064.00 $880.00 $352.00 $1,240.00 $440.00 $880.00 $440.00 $440.00 $5,799.00 $545.00 $5,420.00 $2,198.00 $875.00 $780.00 $780.00 $5,465.00 $638.00 $638.00 $1,974.00 $466.00 $466.00 $638.00 $466.00 $5,478.00 $5,478.00 $104.00 $59.00 $20.00 $680.00 $1,558.00 $1,205.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT STAR T15 3.5X14MM BIT DRILL SYNT 1.5X125MM SCREW TI MTXWAVE 1.85X6MM HUMERAL STEM INSERT SMALL SOCKET KNEE INSRT JII BCSRTSZ7-8 11MM SZR BRST XTRMEMORYGEL465CC KT COMMON BILE DUCT EXPLOR SET SCREW CANN SHRT THRD 3.0X10MM SCREW CANN SHRT THRD 3.0X36MM SCREW PLATE LOCKING 3.5X28MM SCREW PLATE NON-LCK 3.5X20MM REAMER FEMALE 19MM MTP SCREW FIXED ANGLE 5.5X20MM NAIL FEM LEFT 9X360MM IMPLANT BREAST 295CC TIGHT ROPE DOUBLE LOADED STONE EXTRACTOR 1.9FR HYDRA GUIDE WIRE QUICK SNAP SCREW BRIGADE IMPLANT 16X34X24MM SCREW VARIAX LK T8 2.4X14MM SCREW VARIAX NL T8FULL2.7X12MM 2.4X122MM OVER DRILL SCREW 2X12MM SCREW 2X5MM SCREW 2X6MM SCREW 2X8MM SCREW 2X10MM IMF SCREW 2X12MM DRILL BIT 1.3X0.4MM 2.5X25MM MULTIDIRECT PEG 2.5X26MM MULTIDIRECT PEG 4.0X46MM CANN SCREW DUAL SYSTEM TIGHTROPE 2.7X14MM LK SCREW 3.5X36MM LK SCREW 3.5X32MM LK SCREW 3.5X38MM SCREW 3.5X40MM SCREW 2.7X38MM VARIAX SCREW 2.7X30MM VARIAX SCREW 2.7X32MM VARIAX SCREW 2.7X34MM VARIAX SCREW 2.7X40MM VARIAX SCREW 4HL STD PLATE Page 61 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $164.00 $1,050.00 $970.00 $12,659.00 $3,777.00 $3,063.00 $1,200.00 $3,238.00 $1,138.00 $1,138.00 $1,008.00 $780.00 $1,183.00 $2,055.00 $5,142.00 $2,785.00 $2,433.00 $1,272.00 $748.00 $1,035.00 $10,650.00 $821.00 $638.00 $398.00 $525.00 $980.00 $980.00 $980.00 $980.00 $3,126.00 $1,210.00 $1,000.00 $1,000.00 $680.00 $5,875.00 $821.00 $1,212.00 $466.00 $435.00 $435.00 $638.00 $638.00 $638.00 $638.00 $638.00 $4,778.00 2020 pricing Drugs&Supplies PROCEDURE NAME 21MM MDLE REAMER 5D RT MD MTP PLATE 2.4MM DRILL BIT 1.4MM OLIVE WIRE BONE PERFERATOR 3.5X12MM LK GORILLA SCREW 3.5X18MM LK GORILLA SCREW 3.5X22MM LK GORILLA SCREW 3.5X24MM LK GORILLA SCREW 2.5X12MM BABY GORILLA SCREW 1.3MM SOLID DRILL BIT 3.5X24MM RECON GORILLA SCREW CELLULAR BONE MATRIX 2.5CC CARPOMETACARPAL FIXATION SYSTEM CORTILOC PEGGED GLENOID L40 SHOULDER BASE PLATE 25X30MM LATERAL STEM NAIL GAMMA 11X360 RT LNG NAIL GAMMA 11X420 RT LNG CURVED SCISSORS 25G 295CC SMTH SOFT BREAST BRA COMPRESSION MULTI SZ 7X11X30MM 8DG TLIF COROENT 8X11X30MM 8DG TLIF PEEK COROENT 9X11X30MM 8DG TLIF PEEK COROENT SCREW 2.5MM HEADLESS 24MM SCREW 2.5MM HEADLESS 26MM SCREW 2.5MM HEADLESS 30MM DRILL BIT 1.9 CANN WIRE 2.5MM NON THREADED GUIDEWIRE 1.3MM TROC TIP SCREW 7.0X CMPRSSN LG 80MM SCREW 7.0X CMPRSSN LG 85MM SCREW 3.5X16MM CORT LK LOPRO SCREW 4.0X26MM LOPRO PLATE 3.5MM LFT MEDL CVS PICK PAC 25G THREADED POST BASEPLATE 30X30 MACROPOROUS MESH X-SMALL ALEXIS WOUND PROTECTOR SCP 3CC FOOT AND ANKLE KIT 11G SIDE DELIVERY CANNULA SCP 3CC FOOT AND ANKLE KIT 11G END DELIVERY CANNULA ACCUFILL BONE SUBSTITUTE MATERIAL 3CC ACCUPORT END DELIVERY CANNULA 8G X 200MM ACCUPORT SIDE DELIVERY CANNULA 8G X 200MM ACCUPORT MULTI DELIVERY CANNULA 8G X 200MM Page 62 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,183.00 $4,612.00 $959.00 $520.00 $959.00 $1,008.00 $1,008.00 $1,008.00 $1,008.00 $780.00 $959.00 $780.00 $4,875.00 $3,234.00 $2,388.00 $5,478.00 $5,799.00 $5,095.00 $5,095.00 $932.00 $3,285.00 $187.00 $5,950.00 $5,950.00 $5,950.00 $1,960.00 $1,960.00 $1,960.00 $943.00 $212.00 $93.50 $2,797.00 $2,797.00 $865.00 $380.00 $5,157.00 $2,375.00 $5,478.00 $1,159.00 $176.00 $5,598.00 $5,598.00 $5,558.00 $1,733.00 $1,733.00 $1,733.00 2020 pricing Drugs&Supplies PROCEDURE NAME ACCUPORT ZONE DELIVERY CANNULA 8G X 200MM ACCUPORT END DELIVERY CANNULA 15G X 60MM SUTURE 6-0 PROLENE RB1 BLADE CRESCENTIC 15X0.51X30MM FRACTURE TRAY SZ2 16MM URETERAL IRISKT 12X14X19MM SPNL CAGE PLATE ARCHON LVL3 58MM DRILL BIT 2X30MM DRILL ORTHOLOC 2.5X60MM DRILL ORTHOLOC 2.8X60MM CLAW II PLATE TACK 4X45MM SELF DRILL CANNULA 4X50MM SELF DRILL CANNULA 2.7 DRILL BIT MTP PLATE LFT ORTHOLOC SCREW 2.7X12MM ORTHOLOC SCREW 3.5X14MM LOPRO ORTHOLOC SCREW 3.5X18MM LOPRO ORTHOLOC SCREW 3.5X20MM LOPRO ORTHOLOC SCREW 3.5X22MM LOPRO ORTHOLOC SCREW 3.5X18MM LK ORTHOLOC SCREW 3.5X16MM LK ORTHOLOC SCREW 3.5X12MM LK ORTHOLOC SCREW 3.5X20MM LK ORTHOLOC KWIRE SINGLE 1.4MM SUTURE PASING DOUBLE LOADED 8X12MM TIGHTROPE BUTTON SEMI TENDINOSUS TENDON SEMI TENDINOSUS TENDON 1.85X8MM MTXWAVE SCREW 1.5X125MM CALIB DRILL BIT 2XHL 1.5MM MTXMAND PLATE 475 CC BREAST EXPANDERS 4.5 MM STEINMAN PIN JII KNEE INSERT 10MM PROBE LSR 25G ILLUM FLEX CRVD RFID X2 20X20 FIRM MESH 39X14 HUMRND SIMPLICITI SHLDR SINGLE TROCAR WIRE 1.6X150MM C CLAW II 2 HOLE 20MM ORTHOLOC LOCKING CORT SCREW 3.5 X 24MM LOCKING CORT SCREW 3.5 X 28MM LISFRANC SCREW 4.5 X 30MM CHA STEINMANN PIN 2.5MMX150MM LOCKING SCREW 3.5 X 14MM ORTHO Page 63 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,733.00 $1,733.00 $3.00 $508.00 $6,180.00 $5,443.00 $7,200.00 $3,300.00 $960.00 $960.00 $960.00 $534.00 $1,015.00 $505.00 $840.00 $4,236.00 $264.00 $534.00 $534.00 $534.00 $534.00 $1,025.00 $1,025.00 $1,025.00 $1,025.00 $116.00 $1,488.00 $825.00 $5,551.00 $5,551.00 $3,392.00 $907.00 $3,427.00 $5,200.00 $72.00 $3,063.00 $189.00 $27,748.00 $5,124.00 $138.00 $3,894.00 $1,025.00 $1,025.00 $1,478.00 $160.00 $1,025.00 2020 pricing Drugs&Supplies PROCEDURE NAME LOW-PRO CORT SCREW 3.5 X 12MM MTP FUSION MEDIUM 5DG RT ORTHO DRILL 2.45MM CANNULATED PHALIN K-WIRE 0.9MM X 102MM PHALINX SALVATION BEAM 7.0 X 125MM RETRACTOR STERILE PLASTIC 25.0 CM X 25.0 CM 5MM 2-FINGER ELASTIC STAYS. ONE PACK OF 4 STAYS ADVINCULA DELINEATOR 3.0CM ULTEM PLASTIC CUP ADVINCULA DELINEATOR 3.5CM ULTEM PLASTIC CUP ADVINCULA DELINEATOR 4.0CM ULTEM PLASTIC CUP (3 PER BOX) NEEDLE TIP INJETAK 70CM ADJUSTABLE MUSCULOSKELETAL TRNSPLNT FDN ELITE 46-65MM X-CONN RELINE 5.5X12MM IORDOTIC TI ROD - RELINE 6X16 SPIR PLUS RELIEVA KT 10CC N-FORCE BLUE BONE MAT 36MM ACETABULAR UNER NEUTRAL LG BONE CMNT SYS N-FORCE 23MM X 10CM ENDOL EXCLUDER 31 X 14.5MM X 13 ENDOL TRUNK 23MM X14CM ENDOL EXCLUDER 19X190 SLEEVELESS STEM INSERT 13MM SZ 5-6 LEFT ARTICULAR SCREW SZ5 LGNL WEDGE INSERT TIB KNEE 16MM SCREW 4.5X55MM LOPRO JONES SCREW 5.5X55MM LOPRO JONES 2MM GDWIRE TROCAR 3.5MM CANN DRILL BIT 4.5MM CAN TAP XP TIGHTROAP KNOTLESS PK CONSTELATION 25G SET DILATOR STIM NIM SCINTILLANT LIGHT SOURCE PROBE 23CM BALL TIP KIT NEEDLE ELECTRODE KNIFE BAYONET 188MM LONG BIPOLAR BAYONET 190MM CAGE 12X60MM CLYDESDALE SCREW 7.5MMX50MM MULTIAX SCREW 6.5MMX50MM MULTIAX SCREW 7.5MMX45MM MULTIAX SCREW 5.5MMX50MM MULTIAX BURR 4MM HI SPEED CUT SCREW BONE 2.7X16MM NAIL RT LNG GAMMA 11X400MM 125DG UNIT PRICE $520.00 $3,876.00 $725.00 $110.00 $4,674.00 $356.00 $291.00 $1,050.00 $1,050.00 $1,050.00 $377.00 $5,757.00 $2,125.00 $830.00 $5,438.00 $11,488.00 $6,000.00 $1,120.00 $9,714.00 $23,692.00 $9,714.00 $16,282.50 $2,625.00 $5,708.00 $2,464.00 $2,783.00 $2,783.00 $138.00 $875.00 $875.00 $5,157.00 $2,203.00 $1,444.00 $1,022.00 $555.00 $1,040.00 $912.00 $1,586.00 $6,820.00 $4,650.00 $4,650.00 $4,650.00 $4,650.00 $1,218.00 $466.00 $5,095.00 Page 64 of 458 Bozeman Health Deaconess Hospital 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LCK 4MM X 65MM NAIL RECON 11X440MMX125 SCREW 100MM TFNA FEN SCREW 1.85X8MM MTXWAVE SIZER MAM SRF RPSB 240CC SIZER MAM SRF RPSB 265CC SIZER MAM SRF RPSB 325CC SIZER MAM SRF RPSB 335CC SIZER MAM SRF RPSB 345CC SIZER MAM SRF RPSB 365CC SIZER MAM SRF RPSB 385CC SIZER MAM SRF RPSB 415CC IMPLANT BREAST 240CC IMPLANT BREAST 265CC IMPLANT BREAST 325CC IMPLANT BREAST 335CC IMPLANT BREAST 345CC IMPLANT BREAST 365CC IMPLANT BREAST 385CC IMPLANT BREAST 415CC EXPANDER BREAST ARTOURA 600CC ENDOBRONCH KT 180 CATH EDG TIP ENDOBRONCH KT 90 CATH EDG TIP ENDOBRONCH KT 45 EDG KT ENDOBRONCH KT MEDIAL CATH TP ENDOBRONCH KT 190 CATHETER EDG BRONCHSCOPE ADPTR OLYMPUS EDG BRONCHSCOPE ADPTR OLYMPUS EDG BRONCHSCOPE ADPTR 190 OLYM EDG BRONCHSCOPE ADPTR 190 OLYM EDGE LOCATABLE GUIDE EXTND WRK CHNL 180 CATH EDG TP EXTND WRK CHNL 90 CATH EDG TIP EXTND WRK CHNL 45 CATH EDG TIP EXTND WRK CHNL MED CATH TIP EXTND WRK CHNL 190 CATH EDG TP EXTND WRK CHNL STR EDG TIP SUPERDIMENSION BIOPSY FORCEPS SUPERDIMENSION PRE-MARKED BIOPSY FORCEPS ARCPOINT PULMONARY NEEDLE 18 G ARCPOINT PULMONARY NEEDLE 21 G SUPERDIMENSION ASPIRATING NEEDLE 21 G SUPERDIMENSION PRE-MARKED ASPIRATING NEEDLE 21 G SUPERDIMENSION PRE-MARKED ASPIRATING NEEDLE 19 G SUPERDIMENSION TRIPLE NEEDLE CYTOLOGY BRUSH 10MM SUPERDIMENSION TRIPLE NEEDLE CYTOLOGY BRUSH 15MM Page 65 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,004.00 $4,538.00 $3,434.00 $970.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $3,285.00 $3,285.00 $3,285.00 $3,285.00 $3,285.00 $3,285.00 $3,285.00 $3,285.00 $5,200.00 $3,882.00 $3,882.00 $3,882.00 $3,882.00 $3,882.00 $413.00 $2,625.00 $413.00 $2,625.00 $3,217.00 $1,806.00 $1,806.00 $1,806.00 $1,806.00 $1,806.00 $1,806.00 $1,610.00 $1,768.00 $3,325.00 $3,325.00 $2,013.00 $2,146.00 $2,146.00 $4,404.00 $4,404.00 2020 pricing Drugs&Supplies PROCEDURE NAME UNIT PRICE SUPERDIMENSION NEEDLE-TIPPED CYTOLOGY BRUSH ASPIRATING PORT $2,807.00 SUPERDIMENSION CYTOLOGY BRUSH $1,029.00 GENCUT CORE BIOPSY SYSTEM $1,351.00 SUPERDIMENSION FIDUCIAL MARKER 2-BAND 0.9MM X 13MM $3,168.00 SUPERLOCK FIDUCIAL MARKER NITINOL COIL 4MM X 7MM $3,021.00 SUPERDIMENSION MARKER DELIVERY KIT $1,785.00 SUPERDIMENSION PATIENT SENSOR PATCH $1,185.00 CORECATH 2.7S ELECTROSURGICAL $4,125.00 SCREW RELINE-O 7.5X80MM 2S POLY ILLIAC $3,084.00 ROD RELINE-O 5.5X300MM STRAIGHT COCR $1,022.00 SCREW MA VUEPNT II 4.5X40MM $2,975.00 SCREW MA VUEPNT II 4.5X30MM $2,975.00 SCREW SET ROD-ROD CON VP II $413.00 SCREW RELINE-O 7.5X70MM 2S POLY ILLIAC $3,084.00 ROD RELINE-O 5.5X500MM STRAIGHT COCR $1,022.00 NAIL HUMR T2 7X230MM $3,987.00 NAIL GAMMA RT LNG 11X400MMX130 $5,095.00 WOUND MATRIX THIN 54101T $16,000.00 WOUND MATRIX THIN 54051T $9,200.00 KNEE INSRT ART XLPE CRHF SZ1-2 11MM $3,063.00 KNEE INSRT ART JII BCS RT SZ1-2 9MM $3,063.00 KNEE KIT SZ F3/T2 RT VIS ADPT GUIDE $5,250.00 SCREW SET INFINITY $563.00 ROD TAPERED 3.5-5.5 X420MM $3,000.00 SCREW INFINITY 4X26MM $3,063.00 SCREW INFINITY 3.5X18MM $3,063.00 SCREW INFINITY 4.5X34MM $3,063.00 SCREW INFINITY 4.5X30MM $3,063.00 BUR BULLET DIAMOND 30K 3MM 70DEG $1,372.00 BUR BULLET CUTTING 30K 3MM 70DEG $1,372.00 IMPLANT SPEED 15X12X12MM $5,068.00 CYSTO PACK CUST BZN $116.00 ROBOTIC PACK CUST BZN $841.00 LEGION CR OXIN FEM SZ2 RT $4,635.00 LEGION CR OXIN FEM SZ7 RT $4,635.00 LGN PS HIGH FLEX XLPE SZ 5-6 15MM $5,037.00 LEGION PS OXIN FEM SZ5 LT $4,635.00 LGN PS HIGH FLEX XLPE SZ 3-4 9MM $2,818.00 LGN SCRW DIS FEM WDG SZ5 10MM $3,063.00 LGN XLPE DISHED ISRT SZ 3-4 15MM $2,818.00 JRNY II BCS FEMORAL OXIN RT SZ 9 $5,785.00 JRNY II BCS CNSTRD ART ISRT 7-8 LT 9M $3,063.00 JRNY II BCS XLPE ART ISRT SZ 1-2 RT 11MM $2,818.00 JRNY II BCS XLPE ART ISRT SZ 3-4-RT 13MM $3,063.00 JRNY II BCS XLPE ART ISRT SZ 7-8 RT 12MM $3,063.00 JRNY II BCS XLPE ART ISRT SZ 7-8 RT 13MM $2,818.00 Page 66 of 458 Bozeman Health Deaconess Hospital 2020 pricing Drugs&Supplies PROCEDURE NAME JRNY II ISRT XLPE DD LT SZ 1-2 10MM JRNY II ISRT XLPE DD RT SZ 7-8 15MM LGN OX CONSTRAINED FEM 5 LT LGN OX CONSTRAINED FEM 3 RT GNS II CON INS SZ5-6 18MM G2 CONST INSRT SZ1-2 13MM LGN PRESSFIT STEM 10MM X 120MM LGN PRESSFIT STEM 11MM X 120MM LGN REV TIBIA BASE SZ 2 RT LGN SCRW DIS FEM WDG SZ3 5MM BROAD Y-PLATE 6 SHAFT HOLES (T10) LGN HM ST 1-2 5MM LTLA-RTMED SYN POR HO FEM COM SZ 17 SYN CEM HO FEM COMP SZ 11 SYN CEM HO FEM COMP SZ 12 R3 0 DEG +4 XLPE ACET LNR 36MM X 62MM R3 0 DEG XLPE ACET LNR 40MM X 62MM IMPLANT BREAST 195CC NATRELLE INSPIRA R3 0 DEG +4 XLPE ACET LNR 40MM ID X 56OD POLARSTEM STEM STD TI/HA 8 NON-CEM POLARSTEM STEM STD TI/HA 9 NON-CEM POLARSTEM VALGUS TI/HA 3 HEMOSPRAY 7FR CATH HEMOSTAT POLARSTEM COLLAR STD. TI/HA 0 POLARSTEM COLLAR STD. TI/HA 4 POLARSTEM COLLAR STD. TI/HA 5 POLARSTEM COLLAR LAT. TI/HA 1 POLARSTEM COLLAR LAT. TI/HA 5 PLATE 2.7MM RT VA-LCP 11HL PLATE 3.5MM RT LCP 10HL 187MM ELITE FIBER ENT ENT HAND PIECE SUTURE 5-0 VICRYL RELOAD 35MM VASCULAR WHT TIP STAPLER 35MM ENDO VASCULAR FLEX WEDGE 16X4.5MM ALLOSYNC COTTON X-PLATE SMALL 2.4MM TI SCREW 2.4X12MM LOPRO CORT SCREW 4.0X38MM LOPRO WEDGE 18X18X6.5MM ALLOSYNC SCREW 5.5X30MM LOPRO TI SCREW 3.5X30MM LK PLATE CALCANEUS STD MED PIN 3.0X80X30MM APEX CORT SCREW 3.5X34MM LK SCREW 3.5X36MM BONE Page 67 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,818.00 $2,818.00 $13,835.00 $12,729.00 $5,060.00 $5,060.00 $3,533.00 $3,840.00 $5,088.00 $3,588.00 $3,900.00 $4,051.00 $5,336.00 $3,391.00 $3,391.00 $2,139.00 $2,139.00 $2,324.00 $2,139.00 $5,336.00 $5,799.00 $5,799.00 $5,799.00 $5,799.00 $5,336.00 $5,336.00 $5,336.00 $5,336.00 $3,781.00 $5,151.00 $3,750.00 $1,000.00 $8.44 $744.00 $1,132.00 $4,800.00 $2,433.00 $550.00 $330.00 $4,650.00 $413.00 $808.00 $2,409.00 $570.00 $808.00 $466.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW 3.5X44MM BONE NAIL 8X250MM HUMERAL CANN 25G SOFT TIP NEEDLE CONSTELLATION 25G W/ VISCOAT SUTURE 3-0 SILK 8X30IN SH CR SUTURE 3-0 MONOCRYL SH EEA CIRCULAR STAPLER 28 EEA CIRCULAR STAPLER 31 HEMOSTAT 2X4 ABSORB FIBRULLAR SCREW 4.5X50MM POLYAXIAL ROD 5.5X90MM RELINE-O TLIF PEEK ANT 10X9X30MM 8DEG CANN 11G X 200MM ACCUPORT PLATE 5HL 2.7MM RT DISTAL FIBULA DRILL BIT 2.8X248MM PLATE 2HL FORCEPS BB PNCLE DRAIN 19FR CHANNEL ROUND IMPLANT BREAST 695CC NATRELLE IMPLANT LG TISSUE ALLODERM 2-2.8MM COBLATOR COAG SUCT 12FR 6IN KT DRSG VAC VIA 7 DAY DILATOR URETRL SET SCURV8-20FR KT PT XL POSITIONING PINK PAD TRIAD CR ALLOGRAFT 5X14X11MM LORDOTIC TRIAD CR ALLOGRAFT 7X14X11MM LORDOTIC TRIAD CR ALLOGRAFT 8X14X11MM LORDOTIC COROENT ANT TLIF 11X9X30MM 8DG ARCHON SCREW 4.0X15MM SELF-TAP FIXED ARCHON SCREW 4.0X19MM SELF-TAP FIXED ARCHON PLATE 54MM 3-LEVEL ARCHON PLATE 60MM 3-LEVEL ARCHON PLATE 68MM 4-LEVEL ASF15T ROD CONNECTOR 5.5MM PARALLEL ATTRAX PUTTY 1CC US BRIGADE IMPLANT 14X34X24MM 8DEG BRIGADE IMPLANT 16X34X24MM 12DEG BRIGADE PLATE SCREW 5.5X22.5MM COROENT XL 12X18X50MM 10DEG BULLETED LEVERAGE SCREW 2.6X6MM LATERAL MASS MONOLITH ENDCAP PARALLEL 14 ROUND MONOLITH CORE 12X12MM MONOLITH CORE 12X14MM PRECEPT REDUCTION SCREW 5.5X40MM PRECEPT REDUCTION SCREW 5.5X45MM PRECEPT REDUCTION SCREW 5.5X50MM Page 68 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $466.00 $3,987.00 $99.00 $2,375.00 $58.00 $14.00 $1,149.00 $1,149.00 $535.00 $3,112.00 $830.00 $5,950.00 $1,733.00 $3,133.00 $958.00 $3,423.00 $114.00 $130.00 $3,285.00 $13,408.00 $53.00 $2,534.00 $902.00 $535.00 $2,730.00 $2,730.00 $2,730.00 $5,950.00 $690.00 $690.00 $3,300.00 $3,300.00 $3,600.00 $2,076.00 $1,260.00 $10,650.00 $10,650.00 $917.00 $9,800.00 $1,043.00 $4,479.00 $10,682.00 $10,682.00 $4,485.00 $4,485.00 $4,485.00 2020 pricing Drugs&Supplies PROCEDURE NAME PRECEPT REDUCTION SCREW 5.5X55MM PRECEPT REDUCTION SCREW 6.5X40MM PRECEPT REDUCTION SCREW 6.5X45MM PRECEPT REDUCTION SCREW 6.5X55MM PRECEPT REDUCTION SCREW 7.5X40MM PRECEPT TI ROD 35MM PREBENT LORDOTIC PRECEPT TI ROD 40MM PREBENT LORDOTIC PRECEPT TI ROD 130MM PREBENT LORDOTIC PRECEPT TI ROD 180MM STRAIGHT TRAY NATURAL TIB 2PEG RT SZ:H PRECEPT SCREW 8.5X90MM POLYAXIAL RELINE-O SCREW 6.0X50MM 2S POLYAXIAL RELINE-O SCREW 5.5X60MM 2S POLY ILIAC ROD TI UNID 5.5MM - 08 RELINE-O SCREW 5.0X45MM 2S POLYAXIAL RELINE-O SCREW 8.5X50MM 2S POLYAXIAL RELINE-O SCREW 8.5X55MM 2S POLYAXIAL RELINE-O TI ROD 5.5X50MM LORDOTIC RELINE-O TI ROD 5.5X55MM LORDOTIC RELINE-O TI ROD 5.5X60MM LORDOTIC RELINE-O TI ROD 5.5X100MM LORDOTIC VUEPOINT II KEEL PLATE ADJUSTABLE VUEPOINT II SCREW 3.5X20MM MA VUEPOINT II SCREW 3.5X22MM MA VUEPOINT II SCREW 3.5X32MM MA VUEPOINT II SCREW 4.0X12MM MA VUEPOINT II SCREW 4.0X14MM MA VP II SCREW 3.5X30MM FA PART THREAD VUEPOINT II ROD 3.5X60MM VUEPOINT II ROD 240MM 45DEG PRECURVED VP II SCREW 4.5X6MM OCCIPITAL VP II SCREW 4.5X8MM OCCIPITAL NCB CORT SCREW 4.0 X 34MM SELFTAPPING NCB CORT SCREW 4.0X36MM SELFT APPING NCB CORT SCREW 4.0X50MM SELFT APPLNG NCB CORT SCREW 4.0X55MM SELFT APPLNG NCB TROC PLT RIGHT NARROW NCB CORT SCREW 5.0 X 22MM SELFTAPPING NCB CORT SCREW 5.0 X 24MM SELFTAPPING NCB CANC SCREW 5.0 X 65MM NCB DISTAL FEMUR PLATE LEFT 9H 246MM NCB SPACER 2MM NCB 5.0 UNICORTICAL SCR L=16MM NCB PP PROX FEM PLATE R L. 324MM NCB PP DIST FEM PLATE R L 355MM HIP TROCHANT 2CBI 23X53MM REATTACH Page 69 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,485.00 $4,485.00 $4,485.00 $4,485.00 $4,485.00 $970.00 $970.00 $970.00 $1,190.00 $1,190.00 $3,112.00 $3,248.00 $3,248.00 $3,248.00 $3,084.00 $3,248.00 $3,248.00 $830.00 $830.00 $830.00 $830.00 $5,625.00 $2,975.00 $2,975.00 $2,975.00 $2,975.00 $2,975.00 $2,975.00 $1,120.00 $1,120.00 $1,125.00 $1,125.00 $840.00 $840.00 $840.00 $840.00 $4,080.00 $1,160.00 $1,160.00 $1,000.00 $5,880.00 $760.00 $1,080.00 $5,140.00 $5,400.00 $5,380.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT PDS II 4-0 SH DYE SHLDR BASEPLATE THRD 29X35MM SCREW MULTI AXIAL 3.5X16MM SCREW MULTI AXIAL 3.5X24MM SCREW MULTI AXIAL 4.0X28MM SCREW MULTI AXIAL 4.0X32MM SET SCREW STANDARD SCREW CORTEX 2.4X13MM PLATE 2.4MM 5HL DISTAL CUSHION ACCUFORM 20X35CM WASHER T8 & T10 SCREWS 2.4MM / 2.7MM / 3.5MM T2 SUPRACONDYLAR NAIL 11X440MM STENT TRACH AEROMINI 8MM X 10MM T2 FEMORAL NAIL R1500 12MMX380MM T2 HUMERAL NAIL 7MMX230MM FEMORAL NAIL LEFT 11X400 MM FEMORAL NAIL RIGHT 10X400 MM CROSSFLOW DAY USE TUBING T2 F/T LOCKING SCREW 4MMX50MM T2 F/T LOCKING SCREW 4MMX55MM TI-SET SCREW 8X17.5MM FEMORAL NAIL RIGHT 11X420 MM ASNIS III SS CANNULATED SCR 6.5X110MM ASNIS III SS CANNULATED SCR 6.5X120MM LONG NAIL KIT R1/5 TI LEFT11X380MM X 125 LONG NAIL KIT R1/5 TI LEFT11X420MM X 125 LONG NAIL KIT R1/5 TI LEFT11X340MM X 130 LONG NAIL KIT R1/5 TI LEFT11X460MM X 130 EGR-D 5X250 APEX S/D HALF PIN 70 THR GRAY PT DRILL 3.2MMX200MM STERILE MODIFIED HALL SHAFT 885MM 4.0 X24MM TI CANNULATED SCREW 4.0 X38MM TI CANNULATED SCREW TI ASNIS III CANNULATED SCR 4X44MM DISTAL MEDIAL TIBIA PLATE FOR RIGHT TIBIA 6 HOLE / L123MM ONE-THIRD TUBULAR PLATE 5 HOLE / L59MM ONE-THIRD TUBULAR PLATE 14 HOLE / L167MM L-PLATE LEFT SLIM STRAIGHT PLATE 7 HOLES (T8) SLIM Y-PLATE 2 SHAFT HOLES (T8) SLIM Y-PLATE 4 SHAFT HOLES (T8) LOCKING SCREW T8 FULL THREAD 2.7MM / L20MM MICRO BONE SCREW 24MM ACUTRAK DISTAL MEDIAL TIBIA PLATE FOR LEFT TIBIA 6 HOLE / L123MM 4MM LOCKING SCREW 4.0MM / L20MM UNIT PRICE $13.00 $5,478.00 $3,063.00 $3,063.00 $3,063.00 $3,063.00 $563.00 $354.00 $2,409.00 $325.00 $1,232.00 $3,508.00 $3,074.00 $3,074.00 $3,082.00 $3,441.00 $3,441.00 $3,441.00 $564.00 $560.00 $579.00 $2,965.00 $864.00 $864.00 $4,079.00 $4,079.00 $4,079.00 $4,079.00 $1,294.00 $622.00 $264.00 $847.00 $554.00 $554.00 $550.00 $155.00 $1,021.00 $1,894.00 $2,333.00 $2,333.00 $2,556.00 $2,556.00 $3,001.00 $5,483.00 $4,327.00 $5,409.00 Page 70 of 458 Bozeman Health Deaconess Hospital 2020 pricing Drugs&Supplies PROCEDURE NAME UNIT PRICE SUPERIOR PLATE DECREASED - 6 HOLE / RIGHT $2,894.00 OLECRANON PLATE 4 HOLE / LEFT $3,079.00 OLECRANON PLATE 6 HOLE / RIGHT $3,079.00 BONE SCREW T8 FULL THREAD 2.4MM / L22MM $638.00 BONE SCREW T8 FULL THREAD 2.4MM / L32MM $638.00 LOCKING SCREW T8 FULL THREAD 2.7MM / L18MM $821.00 LOCKING SCREW T8 FULL THREAD 2.7MM / L22MM $821.00 LOCKING SCREW T10 FULL THREAD 2.7MM / L14MM $821.00 BONE SCREW T8 FULL THREAD 2.7MM / L22MM $638.00 BONE SCREW T8 FULL THREAD 2.7MM / L26MM $638.00 BONE SCREW T8 FULL THREAD 2.7MM / L36MM $638.00 SLIM STRAIGHT PLATE 5 HOLES (T8) $806.00 BONE SCREW T10 FULL THREAD 2.7MM / L10MM $466.00 LOCKING SCREW T10 FULL THREAD 3.5MM / L26MM $806.00 LOCKING SCREW T10 FULL THREAD 3.5MM / L55MM $1,212.00 BONE SCREW T10 FULL THREAD 3.5MM / L42MM $537.00 BONE SCREW T10 FULL THREAD 3.5MM / L65MM $537.00 4MM LOCKING SCREW 4.0MM / L14MM $1,004.00 3.5MM CORTEX TI SCREW 3.5MM / L28MM $1,004.00 4MM LOCKING SCREW 4.0MM/L24MM $1,004.00 4MM LOCKING SCREW 4.0MM / L38MM $1,004.00 4MM LOCKING SCREW 4.0MM / L46MM $1,004.00 PROXIMAL LATERAL HUMERUS PLATE FOR RIGHT HUMERUS 4 HOLE / L9 $1,004.00 3.5MM CORTEX TI SCREW 3.5MM / L40MM $1,004.00 4MM LOCKING SCREW 4.0MM / L60MM $176.00 T2 FEMORAL NAIL R1500 11MMX420MM $176.00 OVERDRILL AO DIA 2.7MM X 122MM $451.00 STEM MINI HUMERAL 13X83MM $8,800.00 SCREW NON-LCK 475X35X3.5 $333.00 CALCANEUS STEP PLATE 7.5 MM STEP $3,285.00 INTSCRW RD DELTATPR W/DISP SHTH 12X28MM $875.00 BTB TIGHTROPE W/ DEPLOYING SUTURE $1,558.00 SCREW INFINITY 3.5X26MM $3,063.00 SPONGE OSTEOAMP SM TALL COMPRESSIBLE $10,700.00 AL 2.0 CATHETER $226.00 ALLOGRAFT 10X69MM $6,160.00 PLATE BONE L242MM 10 HOLE RT $5,871.00 PLATE BONE W22XL 54MM STANDARD 6X3 HOLE RT DIST $3,327.00 PLATE BONE L62MM 3 HOLE STAINLESS STEEL $2,247.00 PLATE LCP RT 2.7MM 6H L 188MM $3,292.00 PLATE BONE L163MM 6HOLE RIGHT PERIARTICULAR PROX $5,949.00 PLT 3.5MM 6HL LCP LFT PERIART PROX HUM $5,949.00 SCRW LCK 3.5MM SELF TAP $907.00 DRILL BIT CANN 13MM FLEX LRG CPLNG $2,787.00 BIT DRILL L310MM DIAL 15MM CANNULATED FLEX $2,733.00 SCREW BONE L58MM D4MM CANNULATED $1,176.00 Page 71 of 458 Bozeman Health Deaconess Hospital 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW BONE L60MM D4MM CANNULATED SCREW BONE L76MM DIA4.5MM THREAD PLATE BONE L237MM 16 HOLE RIGHT LATERAL PROXIMAL STAPLE BONE FIXATION W13XL10MM WIRE OD1.5X1.5MM GRASPER LAPAROSCOPIC 5MM X 35MM KIT OR TURNOVER BZ CUSTOM SET HEYMAN FOLLOWER STRGHT 10-24FR SUT PDS II 2-0 SH SUT PDS+ 3-0 SH SUT VICRYL+ 3-0 SH MESH PARIETENE 15X15CM PIVOT GUARDIAN PT SFTY KIT SZ SM PATCH .6MM 5X7.5CM GORETEX CV DX SWIVELOCK SL, 3.5X8.5MM W/FORK EYELET SPACER INTERBODY 12DEG 32X23X14MM CAGE SLYDESDALE 0DEG 12X45MM ALLOMAX SURGICAL GRAFT 12X20CM ALLODERM 10X16CM SPACER 9X16X14MM DYNANITE NITI STAPLE W/INSTRS 13WX10L COMPR FT SCRW 5.0 LG 60MM LGTH G-WIRE W/TRCR TIP .062IN X 9.25IN ALLOSYNC EVANS WEDGE 18MM X 18MM X 10MM BLADE TENDON STRIPPER 9MM 4.0MM CANN DRILL BIT BONE TAP CANNULATED 5.5MM GUIDE PIN 3.2X343MM ROD GUIDE BALL TIP 3X100MM NAIL TRIGEN RT 10MMX38CMX130D SCRW TRIGEN L-P 5MMX47.5MM ADPTR EDGE PENTAX BRNCHOSCOPE ADPTR EDGE FUJINON BRNCHOSCOPE S1S HIP HEAD CEMENT MOLD 52MM HIP MOLD STEM W/REI NF 13X145 S1S HIP NECK ADAPTER +6MM BLADE THIN PREC 16.5 X .38 X 34.5MM ORTHOGNATHIC KIT/SPLINT CUSTOM 1.4 CALIBRATED DRILL BIT 1.4 DRILL BIT 3X14.5MM BIOCOMPOSITE SUTURE ANCHOR ALLODERM 6X12CM THICK 9X80MM ALLO GRAFT LINK AAA ENDOPROSTHESIS 26MMX14.5MMX18CM 6FR FOAM BUMP 12X7X7IN STERILE ASSEMBLY KIT TITAN STANDARD CL RESERVOIR TITAN CLOVERLEAF 125CC Page 72 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,176.00 $1,196.00 $5,604.00 $3,660.00 $1,082.00 $47.00 $50.00 $12.00 $13.00 $9.00 $314.00 $834.00 $1,127.00 $1,488.00 $9,460.00 $6,820.00 $12,792.00 $12,720.00 $3,465.00 $5,685.00 $1,663.00 $83.00 $4,650.00 $875.00 $875.00 $875.00 $964.00 $1,225.00 $5,537.00 $962.00 $413.00 $413.00 $5,655.00 $5,900.00 $1,663.00 $163.00 $5,886.00 $1,210.00 $1,210.00 $1,138.00 $5,414.00 $5,795.00 $23,692.00 $71.00 $2,149.00 $5,603.00 2020 pricing Drugs&Supplies PROCEDURE NAME CYLINDER TOUCH SCOTAL 16CM W/PUMP PROSTHESIS PENILE 14CM X 9.5MM PLATE 2.4 LCP STRT WRIST SIZER MAM SRF RPSB 220CC BASEPLATE GLENOID NON HA CONV COMP E1 CONVERTIBLE GLENOID LINER STEM HUMERAL MINI COMP 8MM HEAD HUMERAL VERSA-DIAL 42X21X43 URETERAL ACCESS SHEATH 9.5FR 35CM URETERAL ACCESS SHEATH 9.5FR 45CM STRATAFIX TISSUE CTRL 3-0 PG A PCL SUT 3/0 27 PDS II MONO SH RELOAD ENDOPATH STAPLER 45MM STAPLER 45MM ESCHELON ENDO ROBOT SUCTION IRRIGATOR WASHER FOR 3.75 MM SCREW TITANIUM SCRW CANN 4X30MM SHRT THD MODULAR HEAD 54X21X64MM HUM VERSA-DIAL LINER ACETABULAR 36MM F HIP SHELL OSSEOTI 4HL E 56MM LINER ACETABULAR 36MM G GUIDE PIN 2.5X220MM AEQUALIS PERFORM DRAPE LAVH STRL PLATE LEFT 2X3 HOLE OBLIQUE PLATE MTX CURV SAG 6HL 10ML STAPLER 60MM FLEX POWERED RELOAD ENDOPATH STAPLER 60MM SUTURE STRATAFIX 36X36 DBLE AR SCREWS 95MM LAG 90MM CMPRSSN INTRLCK DRL BIT 3.2MM CANN. SMALLJOINT SUTURE KIT PLATE LK TUBLR SS 12HL PENILE PROSTHESIS MALLEABLE SCREW 3.5X14MM LK GORILLA SCREW 3.5X16MM NON-LK GORILLA SCREW 3.5X18MM NON-LK GORILLA DVC LIGASURE EXACT DISSECTOR SCREW CANN SHRT THRD 3.0X16MM SCREW CANN SHRT THRD 3.0X20MM BIT DRILL MTX J-LATCH 1.4X12MM SCREW MTX SYNT SGL 1.85X12MM SCREW MTX SYNT SGL 1.85X8MM SCREW MTX TI SGL 2.1X8MM PLATE CHIN DBLCURV 0.7 5HL 6MM PLATE L MTX OBLIQ 3HL0.7MMSHRT SCREW MTX SYNT SGL 1.85X14MM Page 73 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $20,404.00 $21,250.00 $5,754.00 $1,000.00 $5,225.00 $5,775.00 $8,800.00 $5,280.00 $650.00 $650.00 $124.00 $12.00 $783.00 $1,130.00 $928.00 $275.00 $825.00 $5,280.00 $6,000.00 $8,804.00 $6,000.00 $1,140.00 $66.00 $1,635.00 $2,062.00 $1,304.00 $784.00 $131.00 $3,229.00 $875.00 $725.00 $1,050.00 $17,416.00 $1,008.00 $780.00 $780.00 $1,892.00 $1,138.00 $1,138.00 $1,220.00 $635.00 $635.00 $670.00 $1,936.00 $1,481.00 $635.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW MTX SYNT 1.85X18MM SCREW MTX SYNT SGL 1.85X4MM SCREW MTX TI SGL 2.1X4MM PLATE L MTX 90D 2HL 0.5MM SHRT SCREW MTX TI 1.85X4MM SELF-DRILLING BRONCHOSCOPE FLEX L23.6IN OD0.15IN ASCOPE 4 CLEARIFY VISURALIZATION KIT GUIDEWIRE FIXED CORE 0.38IN EXPANDER BREAST 750CC ARTOURA PLATE MTX 15MM 12HL SCREW MTX LK 2X14MM SCREW MTX LK 2.4X8MM PLT MTX MAND TEMPLATE 1.5MM THICK LINER ACETABULAR 36MM SCREW CORTICAL 5X95MM ELBOW RAD HD ANATOM LFT 22MM ELBOW RAD STEM ANATOM 9X2MM SCREW SOLERA MULTIAX 9.5X40MM SCREW SOLERA MULTIAX 9.5X45MM SPACER INTERBODY 8D 32X23X14MM SCREW CMAS BALLAST 8.5X70MM CATH SHEATH URETRL 7FR 70MM FLEXOR PARALLEL BRIGADE LATERAL 10X34X24MM 10D CAGE VERTE-STACK 14X11X14MM BREAST NATRELLE SOFT 295CC ALLO BONE PUTTY OSTEOAMP 0.5CC NEEDLE VIZISHOT2 21G 700MM NEEDLE VIZISHOT2 22G 700MM SCISSORS DAVINCI POTTS OSTEOAMP SELECT FIBERS 2.5CC CLIP APPL LARGE DAVINCI XI ANGEL C PRP + BMA TRAY STAPLE DYNANITE 18W X 15L SCREW COMPRESSION LG 5X36MM SCREW COMPRESSION LG 5X40MM SCREW COMPRESSION LG 5X55MM SCREW COMPRESSION LG 7X35MM IMPLANT SYSTEM PARS W/ SUTURE TAPE V-LOC SZ0 GS21 12IN SCREW INFINITY 4.5X32MM SCREW INFINITY 4.5X26MM SCREW INFINITY 4.0X24MM SCREW INFINITY 4.0X16MM SCREW INFINITY 3.5X32MM ROD STND 3.5X240MM DBL LUMEN BALLOON 11MM DIA 2.0 Page 74 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $635.00 $635.00 $670.00 $1,428.00 $670.00 $1,047.00 $297.00 $149.00 $5,200.00 $3,768.00 $980.00 $1,210.00 $540.00 $5,132.00 $1,120.00 $7,110.00 $5,413.00 $3,238.00 $3,238.00 $9,460.00 $4,236.00 $62.00 $15,000.00 $3,465.00 $3,285.00 $1,663.00 $1,190.00 $1,190.00 $975.00 $5,169.00 $700.00 $3,430.00 $5,738.00 $1,663.00 $1,663.00 $1,663.00 $2,433.00 $4,485.00 $450.00 $3,063.00 $3,063.00 $3,063.00 $3,063.00 $3,063.00 $875.00 $622.00 2020 pricing Drugs&Supplies PROCEDURE NAME MESH PHASIX ST 7X10CM SCREW INFINITY 3.5X14MM GUIDEWIRE .035IN SAFE-T J-TIP TUBING PNEUMOCLEAR HEATED HUMIDIFIED SMOKE SCREW QUICKFIX TITAN 2X12MM ANCHOR SUT TAK KNOTLESS 3X12.7MM ALLOSYNC DMB GEL 5CC SCORING CUTTER FOR 20X25MM OBLONG CARTIFORM CARTIFORM 20X25MM DISC ALLOGRAFT KIT DISP 3.0MM KNOTLESS SUT TAK OPEN FEMORAL HEAD 28MM +8 BIOLOX DELTA 12/14 SCREW 1.85MM MTX SELF-TAP 8MM DRILL BIT 1.4 X 110MM WASHER 13.0MM TISSEEL FIBRIN SEALANT 10ML VHSD FRZ 2.3 CANN SCREW 22MM 2.3 CANN SCREW 23MM DRILL CANN 1.6MM COUNTERSINK HEADLESS 2.3MM STENT TRACHEAL/BRONCHIAL SUT RELOAD V-LOC 180 SZ 2-0 ENDOSTITCH LOOP V-LOC 180 ABS 06 FLUENT INFLOW OUTFLOW TUBING SHEATH PRLL RAPID REL 12FR 45CM ALLO COTTON WEDGE 5MM SCREW MINI MONSTER CANN 3X18MM HAMMER TUBE 2.75MM 10DEG CANN SCREW MINI HDLSS CANN 3.0X24MM KWIRE DBL BLNT SMOOTH 1.4X30MM SCREW GORILLA R3CON LK2 2.7X8MM SCREW GORILLA R3CON NONLK 3.5X14MM PLT MTP GORILLA LFT SHRT 10DEG KWIRE SGL TROC SMTH 2X150MM KWIRE DBL TROC SMTH 1.4X150MM IMPLANT SYS FOREFOOT INTERNAL BRACE SUT FIBERSNARE/FIBERWIRE #2 TRIM-IT CUSTOME HIP CANNULA FLIPCUTTER II SHORT 11.5MM BTN ABS TIGHTROPE CONCAVE 11MM OSTEOAMP SELECT FIBERS 10CC SUT MONOCRYL+ VIO 2-0 CT-2 STNT UNIVERSA FIRM 6FR 18CM KT STNT 14FR 26CM ENDOURETEROTOMY TRI-LUMEN FILTERED TUBE SET AIRSEAL ACCESS PORT - 5X120MM AIRSEAL ACCESS PORT - 8X120MM Page 75 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,567.00 $3,063.00 $79.00 $520.00 $1,200.00 $1,488.00 $2,800.00 $1,125.00 $22,000.00 $725.00 $5,830.00 $635.00 $907.00 $391.00 $2,067.00 $1,029.00 $1,029.00 $710.00 $600.00 $6,238.00 $197.00 $197.00 $1,208.00 $650.00 $5,288.00 $1,138.00 $5,685.00 $1,453.00 $231.00 $1,085.00 $780.00 $5,073.00 $143.00 $143.00 $4,185.00 $116.00 $358.00 $1,138.00 $1,120.00 $5,169.00 $50.00 $307.00 $625.00 $528.00 $509.00 $518.00 2020 pricing Drugs&Supplies PROCEDURE NAME AIRSEAL ACCESS PORT - 12X120MM SEMI TENDINOSIS TENDON PLT TI MATRIX 8HL 1MM THICK BEAD TIP GD WIRE 26X80CM ANKLE LOCKING NAIL 11X150 SCREW CORT LEAD DBL 5X28MM SCREW CORT LEAD DBL 5X40MM SCREW CORT LEAD DBL 5X36MM SCREW CORT LEAD DBL 5X65MM CALIBRATED DRILL 4.3MM DRILL 2.8X140MM SOLID SCREW PLATE R3CON NLCK 4.2X24MM REAMER MALE 9MM GORILLA R3CON DRILL INSERT TROCAR TIP 104X70MM STENT TRACHEAL/BRONCHIAL 12X30 SHLDR HUMR HD TI 46X18X53MM DRAIN FLUTED 19FR .25IN TROCAR GELPOINT MINI ADVANCED ACCESS PLATFORM DRSG KIT PICO 10X30CM 2X DRSG KIT PICO 10X40CM 2X DRSG ACTICOAT 1X24IN ANTIMICROBIAL BARRIER SYS WOUND DEBRID IRRISEPT PALAMIX UNO CEMENT MIXING SYSTEM PALABOWL VACUUM MIXING BOWL PLATE MTP 5D SHORT SHORT RIGHT SCREW 3.5X16MM LK GORILLA SCREW 3.5X20MM LK GORILLA SCREW PLATE R3CON NLCK 4.2X34MM FOAM BUMP 10X6X6IN RELOAD ENDO GIA 30MM CVD TIP ARCTIC SHLDR GLENOID PEG CORTILOC M35 DRN CATH 16FR MULTIPURPOSE SCREW 6.5MMX45MM MULTIAX SCREW 5.5MMX45MM MULTIAX CAGE CLYDESDALE 6D 10X45MM DRILL BIT 2.4MM BONE BIOPSY DEVICE SCREW INFINITY 3.5X30MM SCREW INFINITY 4.0X30MM BONE ANCHOR W/ ARTH DELIV SYST TENDON ANCHOR IMPLANT ARTH BIOINDUCTIVE MED ANCHOR ICONIX 2.3MM 2.0MM BRAID FLEXIGRAFT ANTERIOR TIB TENDON GRAFTLINK TS 9.5X73MM SPACER PLATE 8D 37X27X12MM Page 76 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $537.00 $5,550.00 $3,056.00 $680.00 $7,744.00 $1,064.00 $1,064.00 $1,064.00 $1,064.00 $1,160.00 $959.00 $813.00 $1,183.00 $569.00 $6,238.00 $5,280.00 $70.00 $2,363.00 $1,103.00 $1,103.00 $102.00 $462.00 $600.00 $385.00 $4,612.00 $1,008.00 $1,008.00 $813.00 $63.00 $1,764.00 $5,970.00 $475.00 $4,650.00 $4,650.00 $6,820.00 $573.00 $700.00 $3,063.00 $3,063.00 $3,325.00 $2,100.00 $5,700.00 $504.00 $5,756.00 $6,160.00 $9,460.00 2020 pricing Drugs&Supplies PROCEDURE NAME G7 OSSEOTI ACET SHELL 52MM CEMENTLESS G7 ACET LINER NEU +5MM 36MM SCREW NON-LCK 4.75X30MM 3.5HEX SCREW CENTRAL 6.5X30MM WHITE RELOAD INTENDED FOR USE IN VASCULAR/THIN TISSUE ECHLN ENDO STPLR RLD (GST), 60M, GRN ECHLN FLEX PWRD PLUS STPLR, 340M DRSG KIT PICO 15X20CM FIBERTAK DX SUTURE ANCHOR 1.3MM SCREW PLATE R3CON NLCK 4.2X26MM PLATE COMP INTEGRA 2HL 30MM SCREW INFINITY 4.5X28MM IMP ENDOSKEL TT 4D 35X11MM 9MM COMPR FT SCRW 5.0MM LG 32MM LGTH COMPR FT SCRW 5.0MM LG 34MM LGTH COMPR FT SCRW 4.0MM 32MM LGTH COMPR FT SCRW 4.0MM 40MM LGTH DRILL BIT CANN 3.2MM CALIB GUIDEWIRE DBLE TROC .045IN LASER DRILL FLIPCUTTER III SUTURELASSO CRESCENT IMP ENDOSKEL TT 4D 35X11MM 10MM ENDOSCOPIC HEX SNARE MINI 2.3MMX240CM SCREW LK GORILLA 4.2X20MM MEDSURG POSTOP SHOE M LG NVY SCREW SOLERA MULTI-AX 8.5X55MM IMPLANT BRST XTRA MEMORY GEL 350CC SCREW 2.3 CANN 20MM NS VIS ADPT GUIDE JII KIT RT SZ F8/T7 SIZER MOD NATRELLE INSPIRA 375CC SIZER MOD NATRELLE INSPIRA 405CC SIZER MOD NATRELLE INSPIRA 445CC SIZER MOD NATRELLE INSPIRA 175CC MTP PLATE 0DEG MED LEFT SCREW PLATE R3CON NLCK 4.2X28MM JRNY II FEMORAL COMP SZ7 JRNY II UNI LAT TIB BASEPLATE LFT SZ5 JRNY II UNI LAT TIB INSERT SZ4-5 9MM INTRBDY SPCR + CVRPLT 32X23X18MM 18D CENTER SCREW 6.5X28MM REUNION RSA PERIPHERAL SCREW 4.5X32MM REUNION RSA PERIPHERAL SCREW 4.5X20MM REUNION RSA PERIPHERAL SCREW 4.5X28MM REUNION RSA CONCENTRIC GLENO 32X2MM REUNION RSA X3 HUMERAL INSERT 32X4MM REUNION RSA HUMERAL CUP 32X4MM REUNION RSA Page 77 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $10,635.00 $5,132.00 $333.00 $333.00 $783.00 $847.00 $1,245.00 $1,103.00 $1,628.00 $813.00 $4,464.00 $3,063.00 $8,970.00 $1,663.00 $1,663.00 $1,225.00 $1,225.00 $975.00 $165.00 $1,670.00 $700.00 $5,738.00 $875.00 $2,783.00 $76.00 $3,238.00 $3,465.00 $1,029.00 $5,513.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $4,612.00 $813.00 $5,200.00 $4,020.00 $2,233.00 $11,500.00 $275.00 $275.00 $275.00 $275.00 $3,750.00 $3,750.00 $3,750.00 2020 pricing Drugs&Supplies PROCEDURE NAME MOD HUMERAL STEM SZ10 123MM REUNION TSA DRILL BIT 3.1MM REUNION RSA NITINOL PILOT WIRE REUNION PIN FLUTED HDLSS STRL 32X89MM DISP MICRO BONE SCREW 28MM ACUTRAK MICRO DRILL ACUTRAK 2 MICRO DRILL LONG ACUTRAK 2 SINGLE TROCAR WIRE GUIDE .035X6IN DERMASPAN MID-HT EXPANDER 380-450CC CLIP HEM-O-LOK XL PROXIMATE LINEAR CUTTER 100MM REG TISSUE SIZER MAM SRF RPSB 605CC IMPLANT BREAST 605CC SOFTTOUCH SCREW LK 3.5X34MM HEXALOBE SCREW INFINITY 4.0X18MM OMNI LOK CERVICAL SEAL FLUENT TISSUE TRAP FLUENT WASTE BAG DYNANITE NITI STAPLE W/INSTRS 20WX15L R3 0 DEG XLPE ACET LNR 40MM X 64MM PUMP PENILE AMS 700 LGX 12CM X 12MM RELINE-O SCREW 7.5X90MM 2S POLY ILIAC TI ASNIS III CANNULATED SCR 6.5X75MM POLARSTEM VALGUS TI/HA 5 CROSSFLOW OUTFLOW TUBING CROSSFLOW PATIENT USE TUBING DRAPE HIP CHECK STERILE LINER G7 ACETAB NEUT 36MM F ARCOM 4.5X14MM CORKSCREW FT DISPS MICRO ACUTRAK DRILL EXT LONG GUIDE WIRE DBL TROC .035X6IN ACUTRAK LO-PRO SCRWPT THDTI5.5MMX 45MM SCREW LK GORILLA 4.2X30MM SCREW LK GORILLA 4.2X22MM DRILL LONG AO 2.8X160MM ANT TT PLATE STAND CONT LEFT SCREW 7.0X55MM PLATE SCREW LK 5.2X34MM PLATE SCREW LK 5.2X36MM PLATE SCREW NON-LK 5.2X30MM KWIRE SINGLE END 2.0X200MM KWIRE SINGLE END 2.0X200MM SUT PROLENE 5-0 TF/TF 24 SCREW NL HEXALOBE 2.7X28MM EXPAND TISS AEROFORM MD SCREW ARCHON 4.5X13MM SELF-TAP Page 78 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $6,500.00 $427.00 $160.00 $1,573.00 $1,887.00 $1,208.00 $1,348.00 $121.00 $4,485.00 $190.00 $857.00 $1,000.00 $3,285.00 $750.00 $3,063.00 $600.00 $55.00 $330.00 $5,225.00 $8,970.00 $2,783.00 $21,000.00 $4,500.00 $5,875.00 $479.00 $303.00 $137.00 $500.00 $3,600.00 $1,887.00 $1,344.00 $130.00 $1,008.00 $1,008.00 $1,008.00 $959.00 $5,842.00 $1,638.00 $1,120.00 $1,120.00 $927.00 $143.00 $37.00 $485.76 $0.01 $690.00 2020 pricing Drugs&Supplies PROCEDURE NAME CARTRDG NEG PRSS SNAP 60 ML KT DRSG ADV SNAP FM 15X15CM ALLO MTX STRAVIX 2X2CM = 4SQ ALLO MTX STRAVIX 2X4CM = 8SQ ALLO MTX STRAVIX 3X6CM = 18SQ PROBE ABL COOLCUT CALIBRATOR CELL SAVER HIGH SPEED ANCHOR BIO-SUTTAK 3.7 *DISC* GDWIRE HT WIGGLE ST .014 190CM STNT MULTLINK RX 4.50X13MM STNT MULTLINK RX 4.50X18MM STNT MULTLINK RX 4.50X28MM GDWIRE HIWIRE STDANG.035 150CM SHEATH PEELAWAY MDTR SGL 9FR INTER GD JR4 6FR INTER GD PINCH ON TOOL STNT MULTLINK RX 4.50X38MM STNT MULTLINK RX 5.00X13MM STNT MULTLINK RX 5.00X18MM STNT MULTLINK RX 5.00X28MM STNT MULTLINK RX 5.00X38MM COIL MWCE-35-14-12-NESTER GDWIRE AMPLZ XSTIFF 0.035 145 GDWIRE ROSEN PTFE 0.035 180CM BLN SPRINTER OTW 2.5X12MM BLN SPRINTER OTW 3.0X12MM BLN SPRINTER OTW 3.0X15MM BLEEDBACK CTRL VALV COPILOT GDWIRE HT BMW HC ST .014 300CM STNT ULTRFX COV DIST 18MM 15CM KT POWER PULSE FOR ULT GDWIRE PLAT +ST .018 180CM GDWIRE PLAT +ST .018 260CM CATH SLIP-CATH KMP 5FR 40CM STNT COPE NEPHUROST 10.2FR24CM COIL MWCE-35-14-6-NESTER COIL MWCE-35-14-8-NESTER CATH KUMPE 0.038 5FR *CIP* SHEATH ANSEL RENALDBLSIDE6FR55 CATH VISTA JL4.5 7FR 100CM CATH VISTA XBLAD4 7FR 100CM CATH VISTA XBLAD4SH 7FR 100CM CATH VISTA IM 7FR 100CM CATH VISTA HSTICK 7FR 100CM SHEATH AVANTI 6FR 11CM PPM ADAPTA DR MVP IS1 BI/UNI Page 79 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $642.00 $265.00 $1,182.00 $1,188.00 $931.00 $875.00 $456.00 $1,169.00 $368.00 $1,658.00 $1,658.00 $1,658.00 $174.00 $192.00 $209.00 $78.00 $1,610.00 $1,610.00 $1,658.00 $1,610.00 $1,610.00 $567.00 $103.00 $45.58 $741.00 $741.00 $738.00 $147.00 $385.00 $3,542.00 $197.00 $593.94 $695.25 $174.00 $485.00 $567.00 $567.00 $77.00 $242.00 $207.00 $207.00 $207.00 $207.00 $207.00 $36.00 $6,498.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHEATH CROSSCUT ST 6FR 45CM SHEATH CROSSCUT ST 7FR 45CM SHEATH ANSEL MULTPRP SIDE6FR55 COIL MWCE-35-14-10-NESTER HIP LNR ACS PE 20D 28MM SHEATH PNCLE PERIPH 9FR 10CM COIL MWCE-18S-5/2-TORNADO SHEATH 8FR 55CM*CIP* KNEE MOD TIB BASEPLATE LFT SZ2 KT EKOSONIC INFUS 106CM 6CM HIP RING LK DYNAMIC DEPU 48MM SHEATH DI-LOCK 10FR SCREW TENODESIS PEEK 5.5X15MM MESH FLT 2X12 BLN NANOCROSS 2.0X 210MM 150CM BLN NANOCROSS 2.5X210MM 150CM PPM ZEPHYR XL SR ANCHOR BIO PLK SP 4.5MM GDWIRE SILVERSPEED .014X200CM CATH IMPULSE BS FL3.5 5FR CATH IMPULSE BS FL4 5FR CATH IMPULSE BS FL5 5FR CATH IMPULSE BS FL6 5FR CATH IMPULSE BS FR4 5FR CATH IMPULSE BS FR5 5FR CATH IMPULSE PIGT 5FR 110CM CATH IMPULSE BS AL1 5FR CATH IMPULSE BS IM 5FR CATH IMPULSE BS LCB 5FR CATH IMPULSE BS MPA1 5FR CATH IMPULSE BS MPA2 5FR CATH IMPULSE BS RCB 5FR CATH TRELLIS-8 15X80CM*DISC* CATH TREL*DISC NO REPLACEMENT* STNT COPE NEPHUROST 10.2FR26CM CATH GLIDE C2 4FR 65CM WIRE PRIME 185CM DIRECT SUT VICRYL+ 3-0 FS1 BLN NC TREK RX 3.50X20MM SCREW MILAGRO BR DEPU 9X35MM STNT COPE NEPHUROST 10.2FR22CM KT CATH DRN PERITON ASPIRA SCREW ADVANTAGE 7X20 SCREW ADVANTAGE 7X25 SCREW ADVANTAGE 9X20 SCREW ADVANTAGE 9X25 Page 80 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $529.00 $529.00 $254.00 $567.00 $3,503.00 $65.00 $591.00 $531.00 $2,423.00 $5,312.00 $1,223.00 $203.00 $1,178.00 $265.00 $992.00 $1,012.00 $6,653.00 $1,367.00 $991.00 $56.00 $59.00 $47.00 $70.00 $47.00 $47.00 $57.00 $71.00 $47.00 $47.00 $47.00 $47.00 $47.00 $4,515.00 $4,515.00 $485.00 $287.00 $2,120.00 $13.00 $824.00 $1,545.00 $485.00 $2,815.00 $1,162.00 $1,157.00 $1,162.00 $1,157.00 2020 pricing Drugs&Supplies PROCEDURE NAME CATH EMBOL 3FR 80CM CATH EMBOL 4FR 80CM CATH GLIDE C2 4FR 100CM CATH CXI SUPP TUNG 4FR 135CM STNT PROTEGE 12X80MM 80CM SHEATH CROSSCUT ST 6FR 65CM SHEATH CROSSCUT ST 7FR 65CM HIP STEM PRESS FIT 12/14 9.0 HIP STEM EXCEL 12/14 120MM SZ1 HIP STEM EXCEL 12/14 120MM SZ2 HIP STEM EXCEL 12/14 120MM SZ3 PPM ZEPHYR DR CMNT BONE KYPHON XPEDE W MIXER CATH SOLENT OMNI 6FR 120CM STNT RESOLUTE 2.25X12MM STNT RESOLUTE 2.25X14MM STNT RESOLUTE 2.25X18MM STNT RESOLUTE 2.25X22MM STNT RESOLUTE 2.25X30MM STNT RESOLUTE 2.50X12MM STNT RESOLUTE 2.50X14MM STNT RESOLUTE 2.75X12MM STNT RESOLUTE 2.75X14MM STNT RESOLUTE 2.75X18MM STNT RESOLUTE 2.75X22MM STNT RESOLUTE 2.75X30MM STNT RESOLUTE 3.00X12MM STNT RESOLUTE 3.00X15MM STNT RESOLUTE 3.50X12MM STNT RESOLUTE 3.50X15MM KT RX CATH 8FR SCREW COV BAHA CONIC HIP STEM FITMORE B PRIM SZ4 CATH SOLENT PROXI 6FR 90CM COCHLEAR BAHA BI300 3MM TAPE RADIOPQ MARKING 270MM COIL RUBY COMPLEX STD10MMX35CM COIL RUBY COMPLEX STD12MMX40CM COIL RUBY COMPLEX SOFT 2MMX1CM COIL RUBY COMPLEX SOFT 2MMX2CM COIL RUBY COMPLEX SOFT 3MMX5CM COIL RUBY COMPLEX SOFT3MMX15CM COIL RUBY COMPLEX SOFT 4MMX6CM COIL RUBY COMPLEX SOFT4MMX15CM COIL RUBY COMPLEX SOFT6MMX20CM COIL RUBY COMPLEX SOFT6MMX30CM Page 81 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $278.00 $280.00 $286.00 $814.40 $2,251.00 $629.00 $587.00 $2,216.00 $2,205.00 $2,216.00 $2,205.00 $7,405.00 $1,113.00 $3,484.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $2,923.00 $62.00 $725.00 $4,971.00 $3,443.00 $2,895.00 $321.00 $3,108.00 $3,083.10 $2,227.80 $2,227.80 $2,227.80 $2,554.20 $2,227.80 $2,554.20 $2,554.20 $3,083.10 2020 pricing Drugs&Supplies PROCEDURE NAME COIL RUBY COMPLEX SOFT8MMX35CM COIL RUBY COMPLEX SOFT8MMX60CM COIL 400 COMPLEX SOFT10M*CIP* COIL 400 COMPLEX SOFT12MM*CIP* SET INTR MICRO PEDAL 2.9-4FR COIL MWCE-35-7-5-NESTER COIL MWCE-35-7-6-NESTER SCREW COV CONIC VISTAFIX GDWIRE COONS ST PTFE.035 145CM INFL DEV ENCORE 26 20ML GDWIRE AMPLZ XSTIFF 0.035 260 GDWIRE CHOICE XSUPP 300CM GDWIRE ROSEN PTFE 0.035 260CM SCREW GLD UNIGRIP KT GLIDESHEATH SLENDER.021 6FR GDWIRE VERRATA FFR J 185CM CATH PRO INFUS 5FR 135X20CM SNARE ENSNARE 7FR 18-30MM COIL MWCE-35-7-8-NESTER SEP INDIGO 3 190CM FLTR VENA CAVA DENALI JUGULAR COIL MWCE-18-3-2-NESTER COIL MWCE-18-3-3-NESTER STNT VIABAHN 0.018 5MM10X120CM STNT VIABAHN .018 5X5CM 120CM STNT VIABAHN 0.035 7X5 120CM STNT VIABAHN 0.035 7X10 120CM STNT XIENCE ALPINE RX 3.5X38MM STNT XIENCE ALPINE RX 4.0X8MM STNT XIENCE ALPINE RX 4.0X12MM STNT XIENCE ALPINE RX 4.0X15MM STNT XIENCE ALPINE RX 4.0X18MM STNT XIENCE ALPINE RX 4.0X23MM COIL MWCE-18-5-3-NESTER COIL MWCE-18S-10/4-TORNADO DILATOR VESS 9FR 0.038 20CM STNT VIABAHN 0.035 7X2.5120CM BLN INPACT ADMRL DCB4X40X130CM BLN INPACT ADMRL DCB4X80X130CM BLN INPACT ADMRLDCB4X120X130CM BLN INPACT ADMRL DCB5X40X130CM BLN INPACT ADMRL DCB5X80X130CM BLN INPACT ADMRLDCB5X120X130CM BLN INPACT ADMRL DCB6X40X130CM BLN INPACT ADMRLDCB6X120X130CM CATH TURBOHAWK 1 LS Page 82 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,083.10 $1,823.10 $3,108.00 $3,592.00 $224.40 $567.00 $567.00 $725.00 $103.00 $210.00 $104.00 $390.00 $163.00 $131.00 $490.00 $2,161.00 $863.00 $996.00 $567.00 $2,309.00 $2,562.00 $538.00 $538.00 $6,296.00 $5,676.00 $5,551.00 $6,107.00 $2,635.50 $326.00 $326.00 $326.00 $326.00 $326.00 $538.00 $392.00 $58.00 $5,551.00 $3,074.00 $3,074.00 $3,257.00 $3,074.00 $3,074.00 $3,257.00 $3,074.00 $3,257.00 $6,784.00 2020 pricing Drugs&Supplies PROCEDURE NAME CATH TURBOHAWK 1 LX KT INDEFLATOR*DISC 6275515* COIL MWCER-35-7-6 COIL MWCER-35-14-8 COIL MWCER-35-14-10 COIL MWCER-35-14-112 GDWIRE INQWIRE J 0.035 3X150CM PK CATH LAB CUST BZ PK PACEMAKER CUST BZ ADPTR AIRW SET H DRAPE RAD RADPAD FEM YEL PPM ADVISA MRI SURESCAN SR CATH INDIGO 6 135CM CATH INDIGO 8 TORQ 85CM CATH INDIGO 8 XTORQ 115CM SEP INDIGO 6 175CM SEP INDIGO 8 150CM TB INDIGO ASPIR CATH BLN FORTREX6FR6X40MM80CM CATH BLN PTAOTW6FR10X40MMX80CM CATH BLN PTAOTW7FR12X40MMX80CM LOOP REC LINQ MON DEV ICM SYS KT GLIDESHEATHSLENDERSS5FR10CM CANN CAPNOLINE+ W TB ADLT LNG SHLDR SIMPLICITI NUCLEUS SZ1 SHLDR HUMRHD SIMPLICITI43X16 GDWIRE SUP STIFF J 260CM KT GLIDESHEATH SLENDER.021 7FR SYS GAS MGMT ANGIOASSIST DISP CATH TURNPIKE SPIRAL TIP 135CM STNT PARAMOUNTMINI6X17MM 0.018 CATH ANGIOJET ZELANTEDVT ADH SKIN LIQUIBAND MICROCATH LANTERN ST TIP 115CM MICROCATH LANTERN 45D TIP115CM MICROCATH LANTERN ST TIP 150CM MICROCATH LANTERN 45D TIP150CM CATH RIM HT 0.038 5FR 65CM CATH SOS2 5FR CATH KUMPE 0.038 5FR 65CM CATH KUMPE 0.038 5FR 100CM CATH OMNIFLUSH 0.038 5FR 70CM ELTD DEFIB RADIOTRNSPARQKCOMBO CATH SLIP-CATH ANG MPA 5FR 100 SHEATH ANSEL HI FLEX MULT6FR70 FLTR TULIP FEM W NAVALIGN DELV Page 83 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $6,784.00 $216.00 $1,906.00 $2,058.00 $2,058.00 $2,058.00 $36.00 $243.00 $287.00 $93.00 $142.00 $6,993.00 $4,319.00 $6,156.00 $6,156.00 $3,019.00 $4,330.00 $1,553.00 $777.00 $1,776.75 $1,776.75 $9,976.00 $310.00 $73.00 $9,256.00 $5,142.00 $217.00 $454.00 $541.00 $1,787.00 $2,727.00 $5,794.00 $109.00 $1,823.10 $1,823.10 $2,179.00 $1,823.10 $75.40 $78.00 $78.00 $78.00 $621.00 $214.00 $174.00 $340.00 $2,964.00 2020 pricing Drugs&Supplies PROCEDURE NAME FLTR TULIP JUGULAR CANN NASAL CO2/O2 LOFLO ADLT KT BONE ACCESS 100 13G CATH TORCON C2 0.038 5FR 65CM CATH TORCON RIM 0.038 5FR 65CM CATH VERT 0.035 5FR 130CM CATH MIKAELSSON .038 5FR 80CM CATH HDHUNTER1 0.038 5FR 100CM CATH SIDEWINDER1 .038 5FR100CM CATH SIDEWINDER2 .038 5FR100CM CATH HDHUNTER3 0.038 5FR 100CM CATH LEVIN1 0.038 5FR 65CM CATH RC2 0.038 5FR 65CM CATH SIDEWINDER1 .038 5FR 65CM CATH SIDEWINDER2 .038 5FR 65CM CATH MPA 0.038 5FR 100CM CATH VERTEBRAL .038 5FR100CM CATH SIDEWINDER20.038 5FR100CM CATH PRO INFUS 5FR 90X10CM CATH PRO INFUS 5FR 90X20CM CATH PRO INFUS 5FR 90X40CM CATH PRO INFUS 5FR 135X30CM CATH PRO INFUS 5FR 135X40CM CATH PRO INFUS 5FR 135X50CM COIL MWCER-35-14-16 COIL MWCER-35-7-8 COIL MWCER-35-7-10 COIL MWCER-35-14-14 COIL MWCER-35-14-16 COIL MWCE-35-14-5-NESTER COIL MWCE-35-20-5-NESTER COIL MWCE-35-20-6-NESTER COIL MWCE-35-20-8-NESTER COIL MWCE-35-20-10-NESTER COIL MWCE-35-20-12-NESTER CANISTER MAX INDIGO SYS CATH CXI SUPP PLAT 2.3FR 135CM TRANSMITTER MERLIN AT HOME LEAD PACE OPTEASE 7FR 40CM SET LIVER ACCESS BX 18G DEV RAD COMP TR BAND DEV RAD COMP TR BAND LNG SET LIVER ACCESS CATH CXI SUPP TUNG 4FR 90CM ADPTR NAMIC INFL DEV W/OPT 125 SHEATH RB RCFW 16FR 45CM Page 84 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,964.00 $90.00 $1,639.00 $61.00 $61.00 $644.00 $78.00 $78.00 $130.00 $130.00 $113.00 $130.00 $130.00 $78.00 $130.00 $130.00 $130.00 $243.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $1,906.00 $1,906.00 $1,906.00 $1,906.00 $1,906.00 $567.00 $567.00 $567.00 $567.00 $567.00 $567.00 $1,380.00 $814.40 $1,305.00 $1,425.00 $1,457.00 $147.00 $147.00 $1,435.00 $814.40 $204.00 $522.72 2020 pricing Drugs&Supplies PROCEDURE NAME INTR FASTCATH DUO HEMO12FR12CM CATH RIM HT 0.038 5FR 65CM CATH TURNPIKE LP 135CM STNT VIABAHN VBX 7X59MM135CM GDWIRE VERRATA+ FFR ST 185CM CATH SOFT VU HIGH5FR0.035 65CM CATH PRO INFUS 5FR 135X20CM GDWIRE VERRETA+ J TIP 185CM GD SHERPA APMLZ RT 6FR 100CM CANN ORAL NASAL CO2/O2 ADLT ADPTR AIRW SET H ET>4.0MM CATH IAB FIBEROPTIX 8FR 40CC CATH IAB FIBEROPTIX 8 FR 30CC STNT RESOLUTE ONYX RX2.25X12MM STNT RESOLUTE ONYX RX2.25X15MM STNT RESOLUTE ONYX RX2.25X18MM STNT RESOLUTE ONYX RX2.25X22MM STNT RESOLUTE ONYX RX2.25X26MM STNT RESOLUTE ONYX RX2.25X30MM STNT RESOLUTE ONYX RX2.25X34MM STNT RESOLUTE ONYX RX2.25X38MM STNT RESOLUTE ONYX RX2.50X12MM STNT RESOLUTE ONYX RX2.50X15MM STNT RESOLUTE ONYX RX2.50X18MM STNT RESOLUTE ONYX RX2.50X22MM STNT RESOLUTE ONYX RX2.50X26MM STNT RESOLUTE ONYX RX2.50X30MM STNT RESOLUTE ONYX RX2.50X34MM STNT RESOLUTE ONYX RX2.50X38MM STNT RESOLUTE ONYX RX2.75X12MM STNT RESOLUTE ONYX RX2.75X15MM STNT RESOLUTE ONYX RX2.75X18MM STNT RESOLUTE ONYX RX2.75X22MM STNT RESOLUTE ONYX RX2.75X26MM STNT RESOLUTE ONYX RX2.75X30MM STNT RESOLUTE ONYX RX2.75X34MM STNT RESOLUTE ONYX RX2.75X38MM STNT RESOLUTE ONYX RX 3.0X12MM STNT RESOLUTE ONYX RX 3.0X15MM STNT RESOLUTE ONYX RX 3.0X18MM STNT RESOLUTE ONYX RX 3.0X22MM STNT RESOLUTE ONYX RX 3.0X26MM STNT RESOLUTE ONYX RX 3.0X30MM STNT RESOLUTE ONYX RX 3.0X34MM STNT RESOLUTE ONYX RX 3.0X38MM STNT RESOLUTE ONYX RX 3.5X12MM Page 85 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $97.00 $77.00 $2,037.00 $5,657.00 $1,890.00 $210.00 $856.00 $1,890.00 $258.00 $86.00 $90.94 $2,626.00 $2,626.00 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,428.00 $2,386.50 $2,386.50 2020 pricing Drugs&Supplies PROCEDURE NAME STNT RESOLUTE ONYX RX 3.5X15MM STNT RESOLUTE ONYX RX 3.5X18MM STNT RESOLUTE ONYX RX 3.5X22MM STNT RESOLUTE ONYX RX 3.5X26MM STNT RESOLUTE ONYX RX 3.5X30MM STNT RESOLUTE ONYX RX 3.5X34MM STNT RESOLUTE ONYX RX 3.5X38MM STNT RESOLUTE ONYX RX 4.0X12MM STNT RESOLUTE ONYX RX 4.0X15MM STNT RESOLUTE ONYX RX 4.0X18MM STNT RESOLUTE ONYX RX 4.0X22MM STNT RESOLUTE ONYX RX 4.0X26MM STNT RESOLUTE ONYX RX 4.0X30MM STNT RESOLUTE ONYX RX 4.0X34MM STNT RESOLUTE ONYX RX 4.0X38MM STNT RESOLUTE ONYX RX 4.5X15MM STNT RESOLUTE ONYX RX 4.5X18MM STNT RESOLUTE ONYX RX 4.5X22MM STNT RESOLUTE ONYX RX 5.0X15MM STNT RESOLUTE ONYX RX 5.0X18MM STNT RESOLUTE ONYX RX 5.0X22MM PAD TOP RADIAL RUNAWAY DISP DEV CATH STBL STATLOCK CBL THERMISTOR PSA DISP 3FT KT CMNT V OSTOE INTR BEVEL 13G TRANSD PRSS COMPASS UNIV STNT VIATORR TIPS 8-10MM 5X2CM STNT VIATORR TIPS 8-10MM 7X2CM CATH CXI SUPP PLAT 2.3FR 150CM STNT RESOLUTE ONYX RX2.00X8MM STNT RESOLUTE ONYX RX2.00X12MM STNT RESOLUTE ONYX RX2.00X15MM STNT RESOLUTE ONYX RX2.00X18MM STNT RESOLUTE ONYX RX2.00X22MM STNT RESOLUTE ONYX RX2.00X26MM STNT RESOLUTE ONYX RX2.00X30MM STNT VIABAHN 0.018 5MM 7X120CM CATH PIGT GROLLMAN 5FR0.035X90 CATH MOD UTERINEART5FR0.035X90 CATH PERFORMA SPIRAL 6FR0.038X100 KT INTR KYPHON TROC BEVEL 13G SET GORE TIPS ACCESS 16G 10FR LEAD MRI TENDRIL 8FR 46CM LEAD MRI TENDRIL 8FR 58CM LEAD MRI TENDRIL 8FR 52CM KT GLIDESHEATH SLENDER.021 6FR Page 86 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,386.50 $2,386.50 $2,386.50 $2,428.00 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,386.50 $2,428.00 $2,756.25 $2,756.25 $2,756.25 $2,756.25 $2,756.25 $2,756.25 $117.00 $95.00 $1,113.00 $2,363.00 $303.87 $8,826.00 $8,826.00 $814.40 $2,756.25 $2,756.25 $2,756.25 $2,756.25 $2,756.25 $2,756.25 $2,756.25 $6,296.00 $154.98 $154.98 $154.98 $992.00 $1,636.32 $1,384.00 $1,425.52 $1,425.52 $475.20 2020 pricing Drugs&Supplies PROCEDURE NAME KT GLIDESHEATHSLENDERSS5FR10CM KT GLIDESHEATHSLENDERSS6FR10CM PLS-2508 MERIT PRELUDE 8FR 25CM GD CATH SHERPA NX EBU 6FR PKNG NASAL RHINO RCKT SM PKNG NASAL RHINO RCKT MD BRC WRIST BREG THB SPI LFT LG BRC WRIST BREG THB SPI RT MD BRC WRIST BREG THB SPI RT LG CRUTCHES ADLT 5FT2IN-5FT10IN CRUTCHES ADLT TALL 5FT10IN-6FT CRUTCHES YTH 4FT6IN-5FT2IN ELTD QK COMBO REDI PK EDGE ELTD QK COMBO EDGE PED SET CATH ART 20G 10.8CM INJ SYS CLSD CO-SET+ RM TEMP OPTICHAMBER DIMND IN BG MASK AEROCHAMBER MD DRN CHEST UNIT ADLT SPIROMETER INCENT ADLT BZ ONLY DETECTOR CO2 EASYCAP II ADLT DETECTOR CO2 PEDICAP PED SENS OXISENSOR OXIMAX INFANT MASK AEROCHAMBER SM CATH FOLEY COUDE RB 14 *CIP* CATH FOLEY COUDE RB 16FR*CIP* CATH FOLEY COUDE RB 18 *CIP* CATH FOLEY LUBRI-SIL IC14*CIP* CATH FOLEY LUBRI-SIL IC16*CIP* TRAY FOLEY 2L W STATLK *CIP* CNTRCPT IUD PARAGARD FLTR NG PREVENT ANTIREFLX COLAR CERV SERP FM 2.5X16.5 TRAY CHEST THAL QK 12FR 22CM DRN BG DEPOT 600ML KT PARACENTESIS ABD LG SYR STELLANT DUAL QUAD PAK SUT ETHILON 6-0 P3 18 BLK PROTECT CAST SHOWER FULL LEG KT CATH TROC 28FR SUT ETHILON 4-0 P3 18 SLV SCD KNEE EXPRESS REG SLV SCD KNEE EXPRESS LG DRSG GEL MEPITEL ONE 4X7 CYL REPL F INTOXIL TRAY CHEST THAL QK 28FR 41CM Page 87 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $276.50 $276.50 $1,116.00 $269.28 $78.00 $78.00 $67.00 $67.00 $67.00 $60.00 $60.00 $60.00 $146.00 $147.00 $79.00 $61.00 $29.00 $69.00 $156.00 $14.00 $54.00 $54.00 $57.00 $69.00 $76.00 $72.00 $72.00 $53.00 $53.00 $77.00 $2,209.00 $260.00 $21.00 $688.00 $46.00 $291.00 $74.00 $17.00 $88.00 $172.00 $17.00 $55.47 $128.00 $48.00 $744.00 $774.00 2020 pricing Drugs&Supplies PROCEDURE NAME MOUTHPIECE DISP INTOXILYZER 20 CATH THORACIC PVC ST 28FR TRAY FOLEY W URINMET *CIP* NDLE EXELON TRANSBRONC ASP 21G EAR PLUG HOWARD LEIGHT SET WARM BLD FLUID W PORT 18ML TRAY CATH SPINAL PENCAN 25G DRSG SPANDAGE SZ7 RESUSC MANUAL RSVR BG PEDS KT DUAL SYR W LG SALINE SPIKE SPLT CAST PRE CUT 3X35IN BOOT WLK PNEUMATIC DJOR MD BRC WRIST BREG THB SPI LFT SM BRC WRIST BREG THB SPI RT SM RESUSC MANUAL MANOMETER INFANT SPLT CAST PRE CUT 5X30IN COLAR PHILADEL TRACH HL 3.25LG COLAR PHILADEL TRACH HL 3.25MD COLAR PHILADEL TRACH HL 4.25MD TRAY THORACENTESI*CIP* CATH THORACIC FIRM PVC ST 16FR CANISTER INFOVAC W GEL 1000ML LANCET SAFE T PL*DISC 6117736* CATH FOLEY LUBRI-SIL 6FR*CIP* BG FLEXISEAL PRIVACY W FLTR TRAY LUMBAR STD ADLT 22GX3.5 EXTR KATZ OTO-RHINO NDLE DCOMPR 14GX3.25 IMMOB KNEE DELUX TRI PNL 16IN KT DRSG PORT IN PT SUT VICRYL+ 3-0 PS2 MASK AEROCHAMBER LG ELTD AED ADLT*CIP*VAT 6115371* BRC WRIST BREG THB SPI RT XS BRC WRIST BREG THB SPI LFT XS BRC ANK AIRCAST AIRSPORT BRC ANK STIRRUP KOOLAIR UNIV IMMOB KNEE QK WRAP UNIV 20IN IMMOB KNEE QK WRAP UNIV 24IN IMMOB KNEE UNI-VERSATIL23*CIP* SUPP SHLDR STBL LG BRC SHLDR STBL MD BRC SHLDR STBL XL IMMOB SHLDR ST SM BRC WRIST APOLLO UNIV RT 10IN BOOT WLK SHELL AIR TALL LG Page 88 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $169.00 $21.00 $104.00 $364.00 $208.00 $59.00 $78.00 $63.00 $61.00 $75.00 $46.00 $411.00 $67.00 $67.00 $101.00 $60.00 $96.00 $96.00 $96.00 $152.00 $21.00 $347.00 $103.00 $131.00 $36.00 $44.00 $293.00 $184.00 $91.00 $76.00 $21.00 $72.00 $242.00 $67.00 $67.00 $266.00 $82.00 $105.00 $104.00 $104.00 $62.00 $62.00 $62.00 $62.00 $32.00 $287.00 2020 pricing Drugs&Supplies PROCEDURE NAME BOOT WLK SHELL AIR TALL MD BOOT WLK SHELL AIR TALL SM BRC WRIST APOLLO UNIV LFT 10IN REMOV CONTACT LENS SOFT SUCT CLSD DBL ELBOW WETPAK14FR TRAY FOLEY TEMP SENS 16FR*CIP* BELT GAIT WLK 60IN TB CAPNOLINE H PLUS ADLT TRAY LUMBAR PUNC PEDS 21GX2.5 KT CATH RAD ART KT CATH FEM ART TRAY AVA HI FLOW CVC INSERT BODY BG 36X90 *CIP* KT CENTVEN CATH TL 7.0FR SET CONTIPLEX ECHO CT TUOHY 2 TRAY EPIDURAL TUOHY17G/19GX3.5 TRAY FOLEY TEMP SENS 16FR TRAY FOLEY COUDE URN METER16FR TRAY SURESTEP IC COMPL BG 16FR TRAY SURESTEP IC COMPL 16FR GLOVE RADIATION INBM PF 7.5 RSVR WOUND JP SIL 100ML KT OSTOMY CONE IRG MATTRESS EGGCRATE 2.5IN VACUUM OB KIWI OMNI CUP DRSG FM WHT VAC SM DRSG VAC SM DRSG VAC MD DRSG VAC LG CANISTER INFOVAC W GEL 500ML DRSG VAC TRAC PAD PKNG NASAL TAMPON PKNG NASAL W AIRW BINDER ABD 4PNL 2XLNG 12X60-75 SUT TICRON 2 HGS21 SUT CHROMIC GUT 3-0 FS2 SUT SILK 4-0 PS2 18 SUT SILK 6-0 TG140-8 SUT PLAIN GUT 5-0 PC1 18 SUT PLAIN GUT 6-0 PC1 18 SUT ETHILON 9-0 BV1004 5 SUT PROLENE 4-0 PS2 18 SUT PROLENE 5-0 P3 18 SUT CHROMIC GUT 3-0 SH SUT VICRYL 5-0 RB1 UNDY SUT VICRYL 0 CT2 DYE Page 89 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $58.00 $287.00 $32.00 $79.00 $58.00 $170.00 $20.00 $95.00 $47.00 $242.00 $623.00 $789.00 $57.00 $632.00 $230.00 $121.00 $171.00 $153.00 $117.00 $89.00 $281.00 $62.00 $51.00 $70.00 $195.00 $208.00 $207.00 $259.00 $301.00 $222.00 $115.00 $58.00 $97.00 $104.00 $37.00 $16.00 $17.00 $60.00 $35.00 $35.00 $103.00 $22.00 $23.00 $17.00 $9.00 $9.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT VICRYL 4-0 PS2 UNDY SUT VICRYL 3-0 FS1 UNDY SUT VICRYL 5-0 P3 18 UNDY SUT SILK 5-0 RB1 30 SUT CHROMIC GUT 4-0 RB1 SUT CHROMIC GUT 3-0 RB1 SUT VICRYL 9-0 BV1003 5 DYE SUT VICRYL 10-0 CSB6 4 DYE SUT VICRYLRAPIDE 4-0 PS2 UNDY SUT MONOCRYL 5-0 RB1 UNDY SUT GORETEX CV2 THX26 1/2CIR TRAY ARTHROGRAM STD KT THORACENTESIS PLEURA-SEAL TRAY AMNIO 20GX3.5 KT CATH KOALA INTRAUTERINE KT REFRACTIVE EYE VTC ONLY BUR SIDE CUT TAPER 1.2X44.8MM CATH SWAN GANZ FEM PACING PPM ADAPTA SR IS1 PPM SENSIA SR LEAD CAPSUREFIX NOVUS MRI 45CM LEAD CAPSUREFIX NOVUS MRI 52CM ANGIOSEAL VIP 6FR FLTR BLD PALL Y SET 40MCRN FLTR BLD TRANSFUSION Y SET KT BASIN DBL LABEL MEDICTN ADDED RED2.5X1.5 BP CUFF 1TB LS DISP NEO SZ2 SOL BSS PLUS 500ML SET PRIM PLUM 1Y 104 NDLE HYPO REG BEVEL BD 25GX5/8 NDLE ECHOGENIC PTC 22GX152MM NDLE BX ILLINOIS ADJ 15G RESUSC NEO DISP 0.5L RESUSC MANUAL MASK RSVR ADLT TB TRACH CUFF DISP CANN FEN 10 VALV SPEAKING PASSY-MUIR CL CATH CLSD MULTACCESS 2.5-3.5 SENS OXISENSOR OXIMAX NEO/ADLT SENS OXISENSOR OXIMAX PEDS CATH SUCT CLSD Y ADPTR PEDS6FR CATH SUCT CLSD Y ADPTR PEDS8FR SENS OXISENSOR OXIMAX ADLT CATH UMBILICAL SL PU 5FR CATH UMBILICAL SL PU 3.5FR DRN CATH MALECOT 4WING 24FR Page 90 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $20.00 $13.00 $19.00 $8.00 $17.00 $17.00 $97.00 $70.00 $27.00 $12.00 $143.00 $56.00 $1,898.00 $56.00 $167.00 $419.00 $50.00 $324.00 $5,696.00 $4,299.00 $1,448.00 $1,448.00 $1,000.00 $45.00 $71.00 $63.00 $82.00 $7.00 $284.00 $58.00 $0.00 $47.00 $51.00 $66.00 $39.00 $222.00 $425.00 $77.00 $54.29 $41.76 $79.00 $79.00 $52.37 $101.00 $104.00 $56.00 2020 pricing Drugs&Supplies PROCEDURE NAME DRN CATH MALECOT 4WING 28FR CATH FOLEY IC 3WAY 22 *CIP* CATH FOLEY IC 2WAY 16FR*CIP* CATH FOLEY IC 2WAY 18FR *CIP* CATH FOLEY IC 2WAY 20FR *CIP* CATH FOLEY IC 2WAY 22FR *CIP* CATH FOLEY IC 2WAY 24FR*CIP* CATH FOLEY IC 3WAYCLSD22 *CIP* CATH FOLEY IC 3WAYCLSD26 *CIP* CATH FOLEY COUDE RB 22 *CIP* CATH FOLEY IC 2WAY 12FR *CIP* CATH FOLEY IC 2WAY 14FR *CIP* CATH FOLEY IC 2WAY *CIP* CATH FOLEY IC 2WAY 20 *CIP* CATH FOLEY IC 2WAY 22FR *CIP* CATH FOLEY IC 2WAY 24 *CIP* CATH FOLEY SIL 2WAY 8FR 3CC CATH FOLEY SIL 2WAY 10FR 3CC CATH FOLEY LUBRI-SIL IC12FR5CC CATH FOLEY LUBRI-SIL IC18*CIP* CATH FOLEY LUBRI-SIL IC20*CIP* CATH FOLEY LUBRI-SIL IC22*CIP* CATH FOLEY LUBRI-SIL IC24*CIP* DRN CATH MALECOT 4WING 14FR CATH UMBILICAL DL PU 5FR ENDOSTITCH SURGIDAC 0 120CM ENDO NDLE VERSASTEP 14G PK PHACO TIPLESS ALCON SUT FBRWIRE 2 TAPER BLU 38 SUT FBRWIRE 5 CUT BLU 38 SUT FBRWIRE 2-0 TAPER BLU 18 KT LEAD INTERSTIM 28CM NDLE INTERSTIM FORAMEN 20GX5 PK INFINITI ANT VITRECTOMY SCREW CANN ACE 4X*DUP 6149242* SCREW CANN SYNT 6.5X16X100MM SUT FBRWIRE 4-0 TAPER BLU 18 DRAPE MINI C-ARM GDWIRE HT WHISPER MS ST 190CM GDWIRE CROSSIT 100XT.014 190CM CATH SILVERHAWK MS-M SET FEED EXT MIC SECUR-LOK12IN GDWIRE AMPLZ SUPSTIFF J260CM SUT MONOCRYL 4-0 RB1 UNDY SUT FBRSTICK/WIRE 2 BLU 50 SLV IRR INFUSCOAXANTVITRECTOMY Page 91 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $56.00 $79.00 $46.00 $46.00 $46.00 $46.00 $46.00 $72.00 $74.00 $72.00 $39.00 $39.00 $39.00 $39.00 $39.00 $39.00 $15.00 $15.00 $53.00 $53.00 $53.00 $53.00 $53.00 $56.00 $246.00 $1,038.00 $133.00 $497.00 $109.00 $208.00 $116.00 $6,966.00 $437.00 $708.00 $327.00 $1,139.00 $116.00 $24.00 $385.00 $385.00 $5,490.00 $47.00 $216.00 $12.00 $276.00 $213.00 2020 pricing Drugs&Supplies PROCEDURE NAME CATH FOLEY IC 2WAY 14FR *CIP* CATH FOLEY IC 2WAY 26FR *CIP* SCREW CANN SYNT 6.5X16X85MM SCREW CANN SYNT 6.5X16X90MM SCREW CANN SYNT 6.5X32X90MM SCREW CANN SYNT 6.5X32X95MM SCREW CANN SYNT 6.5X32X65MM SCREW CANN SYNT 6.5X32X70MM SCREW CANN SYNT 6.5X32X80MM DRILL PIN TRIMIT 2X100MM GDWIRE HT WHISPER MS ST 300CM STNT MINI-VISION RX 2.00X8MM STNT MINI-VISION RX 2.00X12MM STNT MINI-VISION RX 2.00X15MM STNT MINI-VISION RX 2.00X18MM STNT MINI-VISION RX 2.00X23MM STNT MINI-VISION RX 2.25X8MM STNT MINI-VISION RX 2.25X12MM STNT MINI-VISION RX 2.25X18MM STNT MINI-VISION RX 2.25X23MM STNT MINI-VISION RX 2.50X8MM STNT MINI-VISION RX 2.50X12MM STNT MINI-VISION RX 2.50X15MM STNT MINI-VISION RX 2.50X18MM STNT MINI-VISION RX 2.50X23MM STNT MINI-VISION RX 2.50X28MM STNT VISION RX 2.75X8 STNT VISION RX 2.75X12 STNT VISION RX 2.75X15 STNT VISION RX 2.75X18 STNT VISION RX 2.75X28 STNT VISION RX 3.00X8 STNT VISION RX 3.00X12 STNT VISION RX 3.00X15 STNT VISION RX 3.00X18 STNT VISION RX 3.00X23 STNT VISION RX 3.00X28 STNT VISION RX 3.50X8 STNT VISION RX 3.50X15 STNT VISION RX 4.00X12 STNT VISION RX 4.00X15 STNT VISION RX 4.00X18 STNT VISION RX 4.00X23 GDWIRE SENS ST 0.035 150CM CATH INFUS CRAGG 5FR 100/20CM CATH VERT 4FR*USE 6256551* Page 92 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $46.00 $47.00 $1,139.00 $1,139.00 $1,139.00 $1,139.00 $1,139.00 $1,139.00 $1,139.00 $1,015.00 $385.00 $1,610.00 $1,813.00 $1,813.00 $1,610.00 $1,610.00 $1,610.00 $1,610.00 $1,813.00 $1,610.00 $1,610.00 $1,813.00 $1,610.00 $1,813.00 $1,610.00 $1,813.00 $1,813.00 $1,610.00 $1,813.00 $1,813.00 $1,813.00 $1,610.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,610.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $396.00 $485.00 $301.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHEATH ARROW FLEX 6FR 45CM L2200 AFO ADD LOWER EXT ANK L2210 AFO ADD LOWER EXT DORSI L2270 AFO VARUS/VALGUS T STRAP L1990 AFO DBL UPRIGHT FREE MOT L1970 AFO PLST MOLDED WANK JOI L1907 AFO SUPRAMELLELOAR CUST L8480 SOCK STUMP SGL PLY AKKD L8430 SOCK STUMP MULT PLY AKKD L4360 BOOT WLK ORTHOTIC PNEU CATH INFUS CRAGG 5FR 135/40CM TB VINYL DRN BG STOPCOCK 30CM GDWIRE 260CM L1686 HO ABDUCTION CTRL POSTOP L2624 HO ADD TO LOWER EXT PELV SPRAY ADH OSTOMY MEDICAL 3.2OZ LOOP REC ICM REVEAL DX FLTR TULIP FEM*DISC 6271014* FLTR TULIP JUGULAR*CIP* INTER GD AL1 7FR INTER GD AL2 7FR INTER GD AR1 7FR INTER GUIDE AR1 SH GUIDWIRE CBL INTER GD CATH VISTA IM 7FR 90CM INTER GD JL35 7FR INTER GD JL4 7FR INTER GD JL5 7FR CATH VISTA JL4SH 7FR 100CM INTER GD JR4 7FR INTER GD JR4 SH 7FR INTER GD LCB 7FR INTER GD MPA1 7FR INTER GD XB35 7FR INTER GD XB35 SH 7FR INTER GD XB4 7FR INTER GD XB 4 SH 7F INTER GD XB3 7FR STNT VISION RX 2.75X23 STNT VISION RX 3.50X12 STNT VISION RX 3.50X18 STNT VISION RX 3.50X23 STNT VISION RX 3.50X28 STNT VISION RX 4.00X28 PROBE ANT VITRECTOMY SGL SHEATH ANSEL MULTPRP 6FR 45CM Page 93 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $407.00 $94.00 $0.00 $0.00 $0.00 $1,108.00 $902.00 $0.00 $0.00 $0.00 $734.00 $59.00 $299.00 $0.00 $0.00 $59.00 $6,773.00 $2,930.00 $2,930.00 $207.00 $207.00 $207.00 $207.00 $216.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $744.00 $239.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHEATH ANSEL RENAL DBL6FR 45CM SHEATH ANSEL RENAL DBL7FR 45CM SHEATH BALKIN CHECK 7FR 40CM SHEATH BALKIN CHECK 8FR 40CM L1832 KO ADJ KNEE SET LIVER ACCESS BX 18GX60CM COIL MWCE-35-8/4-TORNADO COIL MWCE-35-8/5-TORNADO TRAC OVERDOOR W WATER BG BLANKET WARM UNDERBODY PEDS STNT PROTEGE 10X40MM 80CM STNT PROTEGE 12X60MM 80CM STNT PROTEGE 14X40MM 80CM STNT PROTEGE 14X60MM 80CM STNT PROTEGE 14X80MM 80CM GDWIRE COIL PUSHER .016 177CM BELT GAIT QK RELEASE 72IN SET ACCESS RING TRANSJGLR 16FR SCREW CANN SYNT 6.5X32X45MM SCREW CANN SYNT 6.5X32X50MM SCREW CANN ACE 4X60*DISC* OCCL SEPTAL ASD 15MM OCCL SEPTAL ASD 12MM OCCL SEPTAL ASD 11MM L3221 SHOE MALE DEPTH BLN SIZING 24MM STOPCOCK SQEEZE BULB 4WAY SUT PDS II 1 CT1 CR8-18 DYE COIL MWCE-35-7/3-TORNADO GDWIRE LUNDERQUIST CURV 260MM SET NDLE PAKTER CURV 25G 15CM CATH BEACON ANG VERT 5FR 125 CATH BEACON H1 0.038 5FR 100CM CATH BEACON MIK 5FR 80CM 0.038 CATH BEACON ANG KMP5FR40CM.038 STNT GRAFTMASTER 3.50X16MM STNT GRAFTMASTER 3.50X19MM GDWIRE ASAHI GRANDSLAM 180CM GDWIRE ASAHI PROWATER 300CM GDWIRE ASAHI GRANDSLAM 300CM GDWIRE ASAHI CONFIANZA 300CM GDWIRE HT BMW HC ST .014 190CM HNDL ALLIANCE INFL BITEBLOCK PEDS SUT SUPRAMID 4-0 HOOK LEGACY PEDICLE TI MD Page 94 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $239.00 $239.00 $239.00 $239.00 $0.00 $1,430.00 $392.00 $392.00 $80.00 $75.00 $1,813.00 $1,776.75 $1,776.75 $1,776.75 $1,776.75 $708.00 $63.00 $1,423.00 $1,139.00 $1,139.00 $299.00 $12,852.00 $12,852.00 $12,852.00 $0.00 $1,180.00 $55.00 $127.00 $392.00 $534.00 $274.00 $60.00 $60.00 $60.00 $60.00 $5,018.00 $5,018.00 $385.00 $385.00 $385.00 $681.00 $385.00 $1,549.00 $105.00 $76.00 $2,018.00 2020 pricing Drugs&Supplies PROCEDURE NAME HOOK LEGACY WIDE TI MD GDWIRE ROSEN HEP 0.035 180CM STAPLE FIX S&N XS NDLE EPIDURAL WEISS TUOHY18GX5 SYR EMBOSPHERES 500-700UM SYR EMBOSPHERES 700-900UM INTR PERFORMER RADPQ 12FR 30CM INTR FLEXOR RAABE 8FR 70CM SHEATH BALKIN CHECK 6FR 40CM SHEATH ANSEL MULTPRP 7FR 45CM INTR FLEXOR RAABE 7FR 70CM SET INTR CHECK-FLO 10FR 38.5CM SET ACCESS HASKAL TRANSJGLR16G GDWIRE ROSEN HEP 0.035 260CM GDWIRE FIX CORE ST 0.018 145CM RETRV FLTR IVC GUNTHER TULIP SET NDLE PAKTER CURV 25G 20CM COIL MWCE-35-6/3-TORNADO STNT VIATORR 10MMX8CMX2CM 75CM STNT VIATORR 10MMX6CMX2CM 75CM CATH INFUS CRAGG 5FR 100/10CM CATH INFUS CRAGG 5FR 100/40CM CATH INFUS CRAGG 5FR 135/20CM HEMO BNDG D-STAT SLV SYS DEL 10FR 45/80 BLN SIZING 34MM CATH WEDGE BERMAN 5FR 110CM SHEATH ARRO 7FR 45CM ENDOL ICAST 5X22MM 120CM INTR FLEXOR LG CHECKFLO 10FR80 SHEATH SHUTTLE SELECT 6FR 90CM CATH VISTA JR4 8FR 100CM CATH VISTA XB4 8FR 100CM STYLET LEAD ST BLNT .014 58CM KT WRENCH MDTR GDWIRE ADDWIRE 145CM FLTRWIRE EZ LG 3.5-5.5MMX190CM RETRV TIP EZ BENT 150CM HEMO GPS APPL DUAL TIP 20GX4 SUT FBRLOOP 2 ST BLU 20 BLN FLEXTOME MONO 2.00X6MM BLN FLEXTOME MONO 2.50X6MM BLN FLEXTOME MONO 3.0X6MM BLN FLEXTOME MONO 3.50X6MM BLN FLEXTOME MONO 2.00X10MM BLN FLEXTOME MONO 2.50X10MM Page 95 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,018.00 $58.00 $1,021.00 $56.00 $1,215.00 $994.00 $315.00 $266.00 $239.00 $239.00 $266.00 $405.00 $1,796.00 $82.00 $62.00 $1,257.00 $274.00 $392.00 $8,771.00 $8,771.00 $485.00 $760.00 $485.00 $333.00 $2,121.00 $1,180.00 $362.00 $505.00 $5,124.00 $410.00 $553.00 $207.00 $207.00 $118.00 $134.00 $44.00 $3,006.00 $436.00 $196.00 $257.00 $2,018.00 $2,018.00 $2,018.00 $2,018.00 $2,018.00 $2,018.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLN FLEXTOME MONO 3.0X10MM BLN FLEXTOME MONO 3.50X10MM SHEATH ANSEL MULTPRP 5FR 45CM BLN BERN OCCL 6FR 80CM ENDOL ICAST 6X22MM 120CM GLIDEWIRE STIFF ANG 3CM 180CM GLIDEWIRE STIFF ANG 3CM 260CM SHEATH ARRO 6FR 45CM FLTR IVC RETRV SET G2 STIM PT PROGRAMM ANTENNA MDTR NEUROSTIMULATOR INTERSTIM II PROGRAMMER PT MDTR INTERSTIM OCCL MULT-FEN 18MM OCCL MULT-FEN 25MM OCCL MULT-FEN 35MM BIT DRILL QK ACUM 2MM BIT DRILL QK ACUM 2.8MM LNG SNARE GOOSENECK 10MM OATS HARVESTER ARTX 10MM DEV CAPSULE DEL 2.5MMX180CM BLADE SCLEROTOME MULTISIDE TB GJ MIC ENDO 16FR 30CM TB GJ MIC LOPRO 18FR 2.5 45CM SHEATH PNCLE RO HIFLO 6FR 4CM COIL MWCE-18S-3/2-TORNADO COIL MWCE-18S-4/2-TORNADO COIL MWCE-18S-7/3-TORNADO COIL MWCE-18S-8/4-TORNADO COIL MWCE-35-10/5-TORNADO SHEATH 7FR 55CM ALLO FEM HEMI COND MEDL RT DRSG INTERDRY AG 10X12FT SUT MERSILENE 4-0 P3 18 BIT DRILL ZIMM 3.5X70MM CATH 3DRC 5FR 100CM TRAY EPIDURAL CONTINUOUSCE18TK SYS EXER DIGI-FLEX BLU 7LB BLADE SAG FINE 9.5 ELTD PRASS INCREMENT PROTECT CAST SHOWER FULL ARM TRANSD DTXPLUS POLE MOUNT 72IN DRN CATH BARTHOLIN WORD 10FR HOOD OXY DISP INFANT MD HOOD OXY DISP INFANT LG TEST STRIPS ONE TOUCH ULTRA PAD COOLING ARCTICGEL UNIV Page 96 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,018.00 $2,018.00 $239.00 $1,200.00 $5,124.00 $277.00 $291.00 $539.00 $1,810.00 $431.00 $23,003.00 $2,978.00 $12,852.00 $12,852.00 $12,852.00 $660.00 $664.00 $1,145.00 $1,675.00 $845.00 $57.00 $1,078.00 $1,222.00 $149.00 $392.00 $392.00 $392.00 $392.00 $392.00 $531.00 $23,354.00 $275.00 $21.00 $697.00 $53.00 $118.00 $74.00 $327.00 $872.00 $81.00 $124.00 $132.00 $37.00 $40.00 $384.00 $1,149.77 2020 pricing Drugs&Supplies PROCEDURE NAME PAD COOLING ARCTICGEL LG FLTR SPIDERFX 6.0MM STNT VISI-PRO 8X27MM 80CM ROD REAMING OFFSET 3X950MM STNT WLLFLX DUODEN 22X120MM DTERG INST ENZYCLN PRESOAK SUT MERSILENE 5MM BP1/BP1 12 ELTD ZOLL STAT AD HEARING TEST ALGO PK DRN T TB WHELAN MOSS 12FR STNT EVERFLEX 6X60MM 120CM STNT EVERFLEX 7X60MM 120CM FLTR IVC CELECT *DISC 6250768* FLTR IVC CELECT JGLR 7FR CATH SET HSG 5FR SPLT BUCK TRACTION UNIV SUT SILK 2-0 MO7 CR8-18 *DISC* SUT ETHIBOND 1 OS4 30 KT FILSHIE TROCAR WO BLADE 8MM KT INTR MIC GASTR*USE 6261456* STNT EVERFLEX 6X40MM 120CM STNT EVERFLEX 7X40MM 120CM OCCL MULT-FEN 30MM METER PEAK FLOW ASTHMA CHECK CATH ACUNAV ULTRSND 8FR TB TRACH BIVONA UNCUF NEO3.5MM SUT VICRYL 6-0 P3 18 UNDY BIT DRILL CANN SYNT 10X190MM DEV STATLOCK IAB MAQU CATH LANCET NICU ONE TOUCH BODY BG W/KT SNARE EXPRO ELITE 15MM CIRCUIT T-PC WO MASK DISP NEO BTL & CAP BERKELYSAFE TOUCH TABLESPOON BENDABLE SURE GRIP STNT PARAMOUNTMINI5X14MM 0.018 STNT PARAMOUNTMINI6X14MM 0.018 STNT PARAMOUNTMINI7X14MM 0.018 FLTR SPIDERFX 3MM FLTR SPIDERFX 7MM FLTR SPIDERFX 5MM SUT SILK 4-0 FS2 18 FLTR SPIDERFX 4.0MM BIT DRILL BRASSELER 1/16X5 BIT DRILL BRAS 5/64X5 BIT DRILL BRASSELER 3/32X5 Page 97 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,591.57 $2,497.00 $1,776.75 $446.00 $4,085.00 $317.00 $173.00 $273.00 $79.00 $45.00 $1,776.75 $1,776.75 $3,374.00 $3,374.00 $144.00 $54.00 $50.00 $14.00 $293.00 $1,078.00 $1,776.75 $1,776.75 $12,852.00 $42.28 $5,248.00 $283.00 $19.00 $1,450.00 $104.00 $295.00 $67.00 $1,500.00 $81.00 $49.00 $11.00 $1,776.75 $1,776.75 $1,776.75 $2,497.00 $2,497.00 $2,497.00 $9.00 $2,497.00 $49.00 $49.00 $49.00 2020 pricing Drugs&Supplies PROCEDURE NAME BIT DRILL BRASSELER 9/64X5 BIT DRILL BRASSELER 1/8X5 BIT DRILL BRAS 7/64X5 BIT DRILL BRASSELER 5/32X5 BIT DRILL BRASSELER 3/16X5 SUT ETHILON 5-0 RD1/RD1 18 SUT VICRYL 2-0 CP1 UNDY STKNT SYN 3X25YD TIP ABS PHACO SAND ALONE PK C-PAK EYE SURG BLN EVERCROSS 8X40MM 135CM BLN EVERCROSS 4X40MM 135CM BLN EVERCROSS 5X40MM 135CM BLN EVERCROSS 7X40MM 135CM BLN EVERCROSS 8X80MM 135CM BLN EVERCROSS 6X30MM 135CM BLN NANOCROSS 2.0X40MM 150CM BLN NANOCROSS 2.5X40MM 150CM BLN NANOCROSS 3.0X40MM 150CM BLN NANOCROSS 3.5X40MM 150CM NDLE BX ACKERMANN 14GX9.6CM REAR TIP EXT AMS 1CM ELTD BIPHASIC PEDS ENDOSTITCH SURGIDAC 2-0 ES-9 SNARE OVAL CAPTIFLEX SM 13MM NDLE ECHOGENIC PTC 20GX152MM BIT DRILL TWIST CANN AS3 6.5M DEV SUCT KURTIS MECONIUM 3.0MM DEV VISCOELAS HEALON5 OVD0.6ML TOILET AID EASYWIPE NDLE BX ACKERMANN 14GX17.1CM DRAPE LAP ABD MOLD CMNT KNEE SPACER TIB 80MM SNARE MICRO 014 4MM 180CM CATH TURBOHAWK LS-C CATH TURBOHAWK LX-C CATH TURBOHAWK LS-M CATH TURBOHAWK LX-M CATH TRAILBLAZER .035 135CM PAD COOLING ARCTICGEL MD TIP IRG SIL ST 0.3MM ALLO ZIMMEND EXT 20X30MM TIP POLYMER I&A ALCO 35D REAR TIP EXT AMS 2CM REAR TIP EXT AMS 4CM CATH OMNIFLUSH W *USE 6269912* Page 98 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $49.00 $49.00 $49.00 $49.00 $49.00 $56.00 $9.00 $70.00 $436.00 $1,061.00 $414.00 $414.00 $414.00 $414.00 $414.00 $531.00 $1,012.00 $1,012.00 $1,012.00 $1,012.00 $1,073.00 $0.00 $287.00 $118.00 $54.00 $47.00 $1,101.00 $52.00 $257.00 $245.00 $1,073.00 $65.00 $2,170.00 $4,080.00 $6,306.00 $6,306.00 $6,306.00 $6,306.00 $708.00 $2,591.57 $456.00 $1,154.00 $59.00 $0.00 $0.00 $622.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT MICROSMTH ULT PARTS 0.9MM UNFOLDER MONARCH III C GRN CATH TRELLIS-8 30X80CM*DISC* CATH TRELLIS-8 15X120*DISC* HEMO HEMADERM ENT 2GM COAGULATOR SUCT MONOPOLAR 10FR PUPIL DILATOR MALYUGIN RING7MM SCREW LK STRY 3.5X18MM GAS CO2 NOVASURE KT ORAL SUCT Q2 W CATH PORT BIT DRILL STRY 2.7MM SCREW BONE STRY 2.7X24MM CATH INFUS SL 7FR 20CM ENDO CANN Z THRD 5X100MM CATH FOGARTY TL EMBOL 5FR 40CM NDLE ULTRSND ECHOSTIM 21GX50MM DETECTOR CO2 STATCO2 >15KG ENDO TROC BLADE Z 12X100MM GDWIRE ASAHI FIELDER XT 190CM BLADE HOCKEYSTICK ALCON PK VITRECTOMY ACURUS TOTALPLUS ILLUM SAPPHIRE WIDE ANG 20G KT PERFLUORON VITREO 7ML PHACO SOVEREIGN SLV PUR PHACO TIP CURV 30D 20GA OIL SIL ADATOSIL 10ML GDWIRE SENS FLEX ST0.035 150CM TENSIONER SE GRAFT W PINS DISP DILATOR COONS TAPER 16FR 20CM EMBOL PVA FM BLU 710-1000MCRN PESSARY GELLHORN SHRT 2.75 PESSARY RING W SUPP SZ4 2.75 PESSARY RING W SUPP SZ5 3.00 ELTD LEEP MD RAD 1.0X1.0CM ELTD LEEP MD RAD 1.5X0.7CM ELTD LOOP LG LEEP DISP 2CM EAR WASHER ELEPHANT CATH INFUS CRAGG 5FR 135/50CM SNARE AMPLZ GOOSENECK 20CM ADD SOFT INNERFACE PAD CUST CATH ABD RECT/VAG NO LUM 7FR HLDR CATH PERCUSTAY CATH HSG 5FR CATH HSG 7FR KT ESSENTIALS RL CERV MCKENZIE Page 99 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $138.00 $118.00 $4,515.00 $4,515.00 $530.00 $56.00 $655.00 $781.00 $61.00 $185.00 $458.00 $415.00 $47.00 $47.00 $466.00 $57.00 $54.00 $164.00 $681.00 $95.00 $1,265.00 $480.00 $1,565.00 $637.00 $436.00 $1,525.00 $407.00 $238.00 $61.00 $407.00 $253.00 $253.00 $253.00 $59.00 $59.00 $59.00 $172.00 $734.00 $1,161.00 $246.00 $161.00 $50.00 $106.00 $106.00 $196.00 $59.00 2020 pricing Drugs&Supplies PROCEDURE NAME RL LUMBAR MCKENZIE SUP CATH THORACIC PVC ST 12FR CATH THORACIC PVC ST 16FR CATH THORACIC PVC ST 20FR CATH THORACIC PVC ST 32FR CATH THORACIC PVC ST 36FR CATH THORACIC PVC RT ANG 20FR CATH THORACIC PVC RT ANG 24FR CATH THORACIC PVC RT ANG 28FR CATH THORACIC PVC RT ANG 32FR CATH THORACIC PVC RT ANG 36FR CANN GUARDED TROC 5.5MM STAPLER ENDO GIA MULT 30 3.5MM CATH FOLEY RDTIP 3WAY 16 *CIP* CATH FOLEY LUBRI-SIL 22FR 5CC CATH FOLEY LUBRI-SIL 22FR 30CC SUT CHROMIC GUT 4-0 PS5 18 SUT MERSILENE 4-0 S2/S2 18 SUT PROLENE 2-0 FS 18 SUT VICRYL 0 CP1 UNDY SUT VICRYL 0 UR6 DYE SUT SILK 0 SH 30 SUT MONOCRYL 6-0 P3 18 UNDY DRAPE OPTHALMIC OCUART W POUCH IMMOB SHLDR ELAS *VAT 6258698* IMMOB SHLDR ELAS *VAT 6258697* CATH GLIDE ANG 4FR 65CM KT RET GAS UNIV CATH LANGSTON DL 145D 110CM CATH RENEGADE STC ST 30X130CM DRSG RAPIDRHINO TAMPONADE7.5CM NDLE SPINAL WHITACRE 27GX3.5 SHNT MINI GLAUCOMA EX-PRESSP50 OIL SILIKON 1000 8.5ML BUR RD MDTR 3.2MM SPLT ORTHOGLS PRECUT 4X30SHT CASSETTE ULT SONIC 1.1MM AIRW LMA *VAT 6180502 6214618* GDWIRE CHOICE XSUPP .014 300CM SUT SILK 2-0 PS2 18 TRAY FOLEY URIMETER STTLK*CIP* FORCEPS MAXGRIP 25GA SUT VICRYL+ 0 CP1 SCREW VA LK T8 STAR 2.7X18MM SUT VICRYL+3-0 CT1 CP1 SHEATH PNCLE 10FR 10CM Page 100 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $103.00 $21.00 $21.00 $21.00 $21.00 $21.00 $34.00 $34.00 $34.00 $34.00 $34.00 $261.00 $1,074.00 $71.00 $21.00 $44.00 $36.00 $65.00 $13.00 $9.00 $13.00 $7.00 $25.00 $61.00 $50.00 $50.00 $286.00 $117.00 $755.00 $1,239.00 $202.00 $1,159.00 $2,615.00 $1,373.00 $1,112.00 $67.00 $310.00 $46.00 $257.00 $17.00 $118.00 $676.00 $9.00 $629.00 $20.00 $61.00 2020 pricing Drugs&Supplies PROCEDURE NAME FEE RENT P500 OVERLAY FEE RENT ENVISION MRS OVERLAY FEE RENT TOTALCARE SPO2RT FEE RENT TOTALCARE BARI+ AIR BRC WRIST UNIV NEOP BLK CATH INFUS CRAGG 5FR 100/50CM SUT VICRYL+ 1 CP1 SCREW VA LK T8 STAR 2.7X32MM SUT VICRYL + 2-0 CP1 SUT VICRYL+ 3-0 SH1 SUT VICRYL+3-0 CT1 SUT VICRYL+ 0 UR6 BLN MINI TREK RX 1.50X15MM PPM REVO MRI SURESCAN LEAD CAPSUREFIX MRI 45CM LEAD CAPSUREFIX MRI 52CM KT HISTOFREEZER CRYO 2MM-5MM 1 CATH GUIDELINER 6FR LOOP REC ICM REVEAL XT CATH TURBOHAWK SS-C CATH TURBOHAWK SS-CL CATH TURBOHAWK SX-C STNT VIABAHN 5MMX5.0CM 12*CIP* STNT VIABAHN 6MM*DISC 6248300* STNT *7/29/14 DISC 6248301 KR* STNT VIABAHN 6MM*DISC 6248302* STNT VIABAHN 7MM*USE 6248303* STNT VIABAHN 7MMX10.0CM 1*CIP* TRAY SPINAL EPIDURAL 18GX3.5 GDWIRE ASAHI PROWATER FLEX GLIDEWIRE ADVANTAGE.035 260CM GLOVE COMP OVRWRST OPEN BGE MD GLOVE COMP OVRWRST OPEN BGE LG MASK CPAP FITLIFE SM MASK CPAP FITLIFE LG BRC WRIST WIDGET STNT WLLFLX ESOPHCOV18MM15.3CM GLOVE COMP OVRWRST OPEN BGE SM SUT VICRYL+ 4-0 FS2 UNDY SLING SHLDR SUPP GIVMOHR LG TB ET NIM EMG 7MM STNT WLLFLX DUODEN 22X90MM SUT VICRYL+ 3-0 FS2 BLN EVERCROSS 5X40MM 80CM BLN EVERCROSS 6X40MM 80CM BLN EVERCROSS 7X40MM 80CM Page 101 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $177.00 $274.00 $585.00 $708.00 $45.00 $734.00 $9.00 $629.00 $11.00 $11.00 $11.00 $11.00 $778.00 $9,099.00 $1,866.00 $1,866.00 $1,650.00 $1,476.00 $7,587.00 $6,306.00 $6,306.00 $6,306.00 $6,313.00 $6,313.00 $6,313.00 $6,313.00 $6,313.00 $6,313.00 $188.00 $385.00 $1,163.00 $69.00 $70.00 $778.00 $778.00 $224.00 $3,859.00 $70.00 $13.00 $284.00 $1,351.00 $4,193.00 $13.00 $414.00 $414.00 $414.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLN EVERCROSS 8X40MM 80CM CIRCUIT ADLT PT W O PEEP OCCL SEPTAL HELEX PFO *CIP* ENDOL ICAST 6X38MM 120CM CATH EAGLE EYE PLAT 3.3FR CUTTER VITRECTOMY HIGHSPEED20G OCCL SEPTAL HELEX PFO *OBS* OCCL SEPTAL HELEX PFO *OBS* SUT VICRYL 3-0 CT1 36 DYE ANCHOR SUT PITON BLK WHT 3.5MM CANN KII ADV FIX 5X100MM FORCEPS MAXGRIP ALCON 25GA+ SYR LL CTRL MALE ROTATOR 12ML PLATE CLAV DIST LFT 9HL 3.5MM SCREW CORT NON TOGGLE 2.3X20MM GDWIRE SENS FLEX ST0.038 150CM SET CANN SHLDR WO FEN 70MM STAPLER PRXMT PLU*VAT 6122029* SUT VICRYL 3-0 CT3 DYE BIT DRILL JC SYNT 3.2X130MM BNDG TUBLR TENSOGRIP BGE SZ D PHACO TIP ST 30D 20GA RL THERAPY FM CYL 36X6 MASSAGER MINI W 3HD BLN EVERCROSS 8X80MM 80CM BLN EVERCROSS 9X40MM 80CM BLN EVERCROSS 10X40MM 80CM BLN EVERCROSS 12X40MM 80CM PLATE RAD HD ACUM CURV 3HL IV SAFESET TRANSPAC KT FLEXI SEAL SIGNAL CONCHAPAK VERTICAL PORT 1650ML DTERG INST ENZYMATIC PREM GA BLN BLU MAX 6X4MM 75CM*CIP* CANN RX RAPID EXCHANGE XL195CM CASSETTE KELMAN ABS BG ACCUGRID SPECMN 4.65IN STNT PROTEGE 9X40MM 80CM STNT EVERFLEX 8X40MM 80CM STNT VISI-PRO 5X17MM 80CM STNT VISI-PRO 6X27MM 80CM STNT VISI-PRO 7X27MM 80CM STNT VISI-PRO 9X27MM 80CM STNT VISI-PRO 10X37MM 80CM STNT EVERFLEX 8X60MM 80CM STNT EVERFLEX 5X60MM 120CM Page 102 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $414.00 $60.00 $14,052.00 $5,247.00 $2,162.00 $898.00 $14,052.00 $14,256.00 $8.00 $1,458.00 $47.00 $814.00 $19.00 $2,712.00 $574.00 $407.00 $91.00 $369.00 $27.00 $279.00 $254.00 $436.00 $76.00 $117.00 $414.00 $414.00 $898.00 $414.00 $2,763.00 $77.19 $761.00 $59.00 $284.00 $771.00 $281.00 $229.00 $127.00 $1,776.75 $1,776.75 $1,776.75 $1,776.75 $1,776.75 $1,961.00 $1,776.75 $1,776.75 $1,776.75 2020 pricing Drugs&Supplies PROCEDURE NAME STNT EVERFLEX 5X40MM 120CM CAUT ACCUTEMP LOW TEMP FINE0.5 GLIDEWIRE ST 0.035 180CM WIRE COMP 1.6X20X150MM IOL TECNIS 1PC ASPHERIC 11.0D KT BREAST PUMP LACTINA CONVERS SENS SPO2 LNCS ADTX ADLT 18IN SENS SPO2 LNCS PDTX PEDS 18IN CAUT BIPOLR BRUSH ST 18GA NDLE SPINAL WEISS 17X5 NDLE DURASPHERE INJ GDWIRE KINETIX ST 185CM SHEATH PNCLE RO NO GD 7FR 25CM STNT VISI-PRO 6X37MM 80CM STNT VISI-PRO 7X37MM 80CM STNT VISI-PRO 8X37MM 80CM STNT VISI-PRO 9X37MM 80CM BLN POWERCROSS 90CM 6X40MM REAR TIP EXT AMS 1.5CM FEE RENT TOTALCARE SPORT MCM FEE RENT EXCEL ESBARIFOAMSCALE FEE RENT EXCEL BARI AIR TRAPEZ GDWIRE FATHOM .016 25X180CM IOL ELASTIMIDE SIL 2.0 IOL ACRYSOFIQ TORIC 6.00D 13.5 ENDOL ICAST 7X38MM 80CM BLN BLU MAX 8X4MM 75CM*CIP* SCREW NL STRY 3.5X24MM SNARE EXACTO COLD .09X1.9CM STNT RESOLUTE 2.50X18MM STNT RESOLUTE 2.50X22MM STNT RESOLUTE 2.50X30MM STNT RESOLUTE 3.00X18MM STNT RESOLUTE 3.00X22MM STNT RESOLUTE 3.00X30MM STNT RESOLUTE 3.50X18MM STNT RESOLUTE 3.50X22MM STNT RESOLUTE 3.50X30MM GLOVE COMP OVRWRST FULL RT SM GLOVE COMP OVRWRST FULL RT MD GLOVE COMP OVRWRST FULL LFT MD GLOVE COMP OVRWRST FULL LFT LG GLOVE COMP WRIST FULL RT XS SCREW VA LK T8 STAR 2.7X36MM SUT VICRYL 3-0 STD/SHRT 3-1 SUT VICRYL+ 1 CT2 Page 103 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,776.75 $65.00 $235.00 $217.00 $900.00 $473.00 $47.00 $41.76 $56.00 $56.00 $129.00 $444.00 $191.00 $1,776.75 $1,776.75 $1,776.75 $1,776.75 $1,857.00 $0.00 $697.00 $458.00 $585.00 $1,132.00 $1,138.00 $572.00 $5,247.00 $771.00 $397.00 $77.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $98.00 $98.00 $98.00 $98.00 $98.00 $629.00 $11.00 $11.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT MONOCRYL 6-0 TF UNDY GOWN BAIR PAWS ADLT SM GLOVE COMP OVRWRST OPEN BGE XS MAMM ST PROBE 8G*VAT MULT* TB MEDIHONEY W APPL 1.5OZ BRC WRIST FORMFIT 10IN LFT SM BRC WRIST FORMFIT 10IN RT SM BRC WRIST FORMFIT 10IN RT MD BRC WRIST FORMFIT 10IN RT LG SCREW VA LK T8 STAR 2.7X42MM SCREW VA LK T8 STAR 2.7X46MM SCREW VA LK T8 STAR 2.7X48MM SCREW VA LK T8 STAR 2.7X56MM GD DRILL BAHA 3+4X2.3MM GD DRILL BAHA WIDENING DISP4MM DRAPE TBL TWO TIER 72IN KT SUPPL NURS SYS INTR PERFORMER RADPQ 16FR 30CM PK INFINITI KELMAN 45D 0.9MM NDLE SPINAL SHRT BEVEL 22GX5 BLADE A-OK ANG BEVEL UP 2.3MM LEAD SETROX S 45CM LEAD SETROX S 53CM LEAD SETROX S 60CM SCREW LK HEXALOBE 3X20MM SUT MONOCRYL+ 4-0 PS2 18 UNDY SCREW CORTNLARTX 3.5X60MM MARKER FIDUCIAL 14GX20 1.6X3MM IOL ACRYSOFIQ TORIC 3.75D 29.5 IOL ACRYSOFIQ TORIC 3.75D 29.0 PIN STEINMAN HDLSS 3 CATH VIANCE CROSSING STD 150CM CATH ENTEER REENTRY ATK3.75X20 GDWIRE ENTEER STD .014 300CM GDWIRE ENTEER STIFF .014 300CM KNIFE CLEARCUT HP DUALBEVEL2.6 GLIDEWIRE ST 0.035 260CM SYR EMBOSPHERES 300-500UM CAP HEALING EAR 20MM CATH GD ENVOY MPD 6FR 100CM SHEATH ANSEL RENAL DBL5FR 45CM PPM EVIA DR-T*DISC* DRSG RAPID RHINO PSTR 9CM BAT BAHA BP100 POWERONE P13 SCREW NL HEXALOBE 3X22MM TB FUSN FLUIDICS DUAL PUMP SGL Page 104 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $14.00 $58.00 $70.00 $1,088.00 $66.00 $47.00 $47.00 $51.00 $47.00 $629.00 $629.00 $629.00 $629.00 $863.00 $863.00 $179.00 $121.00 $486.00 $485.00 $57.00 $143.00 $1,412.00 $1,412.00 $1,412.00 $765.00 $27.00 $190.00 $1,037.00 $572.00 $572.00 $102.00 $4,080.00 $4,599.00 $987.00 $987.00 $141.00 $264.00 $994.00 $75.00 $1,176.00 $239.00 $7,587.00 $362.00 $1,113.00 $485.00 $226.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOFIQ TORIC 3.75D 21.0 PRSS MON INTRA ABD EDWARDS THORACO LUMBAR SACRAL ORTHOSIS SCREW VA LK STAR T15 3.5X50 ENDOL ICAST 10X38MM 80CM BLN 2XL 16FR 4X75CM*CIP* SCREW VA LK STAR T15 3.5X30 SCREW VA LK STAR T15 3.5X32 SCREW VA LK STAR T15 3.5X34 SCREW VA LK STAR T15 3.5X38 BAT DOOR BAHA BP100 TAMPER PNK BAT DOOR BAHA BP100 PUR CUSH WHLCHR WAFFLE 19X19 SCREW BONE STRY 3.5X18MM SCREW BONE STRY 3.5X20MM COIL DETACH INTERLOCK10MMX20CM COIL DETACH INTERLOCK 6MMX10CM CATH VISIONS PV .035 GDWIRE TROC THRD ARTX 2.4MMX12 EXT LEG ORTHO MTOR DROP LK ORTHO MTOR VEST HALO ORTHO MTOR KNIFE XSTAR SGL BEVEL 45D2.4MM COLAR CERV PHIL LG 2.25 INTR PEEL OPTISEAL 7FR SUT ZIPLINE #2 BLK KNEE PSN FEM CRCMNT NARW RTSZ7 KNEE PSN TIB STEM 5D RT SZD SENS SPO2 LNCS NEO 18IN PESSARY GELLHORN FLEX 2.50 PESSARY GELLHORN FLEX 2.75 PESSARY RING W SUPP SZ2 2.25 PESSARY RING W SUPP SZ3 2.50 PESSARY GELLHORN SHRT 2.25 PESSARY DONUT 3.25 PESSARY CUBE W HL SZ2 1-3/8 PESSARY CUBE W HL SZ3 1.50 PESSARY CUBE W HL SZ4 1-5/8 PESSARY CUBE W HL SZ5 1.75 PESSARY CUBE SZ 2 1-3/8 CATH THORACIC FIRM PVC ST 28FR CATH THORACIC FIRM PVC ST 12FR KNEE PSN ASF UCVELFT11MM7-12GH KNEE PSN ASF UC VE RT12MM-7 CD KNEE PSN PTLA ALL PE VE 29MM KNEE PSN PTLA ALL PE VE 35MM Page 105 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $477.00 $0.00 $741.00 $5,247.00 $1,130.00 $740.00 $740.00 $740.00 $741.00 $414.00 $310.00 $128.00 $415.00 $415.00 $2,076.00 $1,621.00 $2,523.00 $166.00 $1,437.00 $475.00 $5,195.00 $86.00 $44.00 $188.00 $117.00 $5,028.00 $2,461.00 $71.00 $253.00 $253.00 $253.00 $253.00 $253.00 $242.00 $253.00 $253.00 $253.00 $253.00 $253.00 $21.00 $21.00 $2,396.00 $2,399.00 $1,644.00 $1,644.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLADE BAHA SGL USE SUT ZIPLINE #2 GRN IOL ACRYSOFIQ TORIC 5.25D 14.5 CATH GUIDELINER 7FR KT PT CARE WILSON TABLE INTR PEEL OPTISEAL LNG 7FR23CM ADPTR THAL-QK CHEST TB KT HYPER/HYPO VEST/LEG*CIP* KT HYPER/HYPO VEST/LEG LG PPM ADVISA MRI SURESCAN DR PEN WEIGHTED GDWIRE ASAHI FIELDER XT 300CM SYS DIGNISHIELD ADV RECTAL TB SPLT FINGER LMB SPRING SZ A STNT PROS SPANNER 20FR SZ7 STAPLE ENDO VASC *CIP* VALV SPEAKING PASSY-MUIR PUR MASK AF531 EE NEB ELBOW SM COLAR CERV PHIL MD 4.25 CATH FOLEY COUDE 2WAY 12FR 5CC CATH FOLEY COUDE 2WAY *CIP* PLATE FIB LAT DIST 2.7 LFT 7HL CANN CAPNOLINE SMART PLUS*CIP* GDWIRE ST PT2 TIP .014X188CM CATH INFINITI AL2 5FR 100CM CATH INFINITI AR2 MOD 5FR100CM CATH INFINITI AR1 MOD 5FR100CM DRAPE SOL WARMER DEV EXTR CONIC THRD WASH CAP HEALING EAR 14MM FEE RENT EXCELBARIAIRCLRT TRAP KNEE PSN FEM CRCMNT STD LFTSZ1 CATH ADROIT XB3 6FR 100CM CATH ADROIT XB3.5 6FR 100CM GD ADROIT XB4 6FR CATH ADROIT JR4 6FR 100CM CATH ADROIT IM 6FR 100CM CATH ADROIT JL4 6FR 100CM GD PIN VISTAFIX 20MM BAR GLD VISTAFIX 2X50MM CLIP ATTACH VISTAFIX 02MM IMPRESSION COPING VXA300 CYL GLD VISTAFIX VXA300 4MM REPLICA ABUTMENT VXA300 STNT GRAFTMASTER 2.80X16MM STNT GRAFTMASTER 2.80X19MM Page 106 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $313.00 $117.00 $572.00 $1,476.00 $202.00 $211.00 $300.99 $618.00 $645.00 $9,762.00 $172.00 $681.00 $533.00 $83.00 $1,726.00 $770.00 $423.00 $137.00 $44.00 $48.00 $48.00 $2,403.00 $1,260.00 $385.00 $44.00 $44.00 $44.00 $198.00 $781.00 $338.00 $776.00 $5,027.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $79.00 $428.00 $180.00 $173.00 $338.00 $97.00 $5,018.00 $5,018.00 2020 pricing Drugs&Supplies PROCEDURE NAME STNT GRAFTMASTER 4.0X16MM STNT GRAFTMASTER 4.5X16MM SCREW CORT LOPRO T15 3.5X30MM SCREW CORT LOPRO T15 3.5X34MM CATH RENEGADE HIFLO 20X135CM STNT MULTLINK 8LL 3.5X33*DISC* STNT MULTLINK 8LL 3.5X3*DISC* CAST SYS TCC-EZ W 2 BOOT 3IN STAPLER SKIN MULT*USE 6122029* STAPLER SKIN MU35*USE 6121829* SET Y-TYPE TUR-BLADDER IRR BOOT CAST TCC-EZ CHARCOT LG CANN OPTIFLOW JUNIOR NEO CANN OPTIFLOW JUNIOR INFANT CANN OPTIFLOW JUNIOR PEDS CIRCUIT OPTIFLOW JUNIOR BOOT CAST TCC-EZ LG PPM EVIA SR-T W HOME MON CATH SLIP-CATH SIM2 5FR 100CM BINDER ABD UNIV 2*VAT 6258796* CATH CLSD DBL SWIVEL 12FR 21.3 HUMIDIFIER COOLMIST SUT VICRYL+ 4-0 PS2 SHEATH ANSEL COBRA 6FR 45CM BRC THB WTO UNIV LFT BRC THB WTO UNIV RT KNIFE S SLIT SGL BEVEL ANG 2.4 KNIFE SSIDEPORT DBLBEVELANG1.0 STRAP FOREARM TRAC TOWER TB GASTRO REPL RT ANG 20FR SUT MONOCRYL+ 4-0 RB1 SUT MONOCRYL+ 3-0 PS2 SUT MONOCRYL+ 3-0 PS1 SUT PDS+ 0 CT2 SUT PDS+ 2-0 C1 SUT PDS+ 2-0 FS1 SUT PDS+ 6-0 P1 SUT VICRYL+ 0 CT2 SUT VICRYL+ 5-0 P1 SUT VICRYL+2-0 CT1 CR81 SUT VICRYL+3-0 SH SUT VICRYL+ 2-0 CP2 SUT VICRYL+ 3-0 PS1 SUT VICRYL+ 0 CT FLTR PRE 0.45MCRN EX WATER KWIRE TROC TIP ARTX 0.078 Page 107 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,018.00 $5,018.00 $160.00 $160.00 $1,150.00 $1,813.00 $1,813.00 $2,748.00 $104.00 $104.00 $67.00 $497.00 $255.00 $255.00 $255.00 $282.00 $437.00 $5,705.00 $173.00 $69.00 $54.00 $120.00 $23.00 $239.00 $81.00 $81.00 $305.00 $83.00 $248.00 $225.00 $13.00 $28.00 $87.00 $15.00 $14.00 $18.00 $28.00 $9.00 $22.00 $62.00 $63.00 $9.00 $24.00 $11.00 $777.00 $57.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT MONOCRYL+ 4-0 PS2 SUT VICRYL+ 4-0 TIE 18 SUT VICRYL+ 1 CT1 SCREW CORT LOPRO T15 3.5X36MM RESUSC NEO-TEE W MASK INFANT PLATE TIB ANT LAT VALCP 4HL RT PLATE TIB ANT LAT VALCP 6HLLFT WIRE COMP 2.8X30MM CAP HEALING EAR W PLUG 20MM STNT EVERFLEX 6X40MM 80CM STNT EVERFLEX 7X40MM 80CM STNT EVERFLEX 7X80MM 80CM BLN DIL CRE 7.5FR 240CM 8-10MM CATH VISTA AL1 SH 7FR 100CM CATH VISTA RCB 7FR 100CM SENS FLOW VENTADL*USE 6259523* LOOP REC LINQ SHEATH VAG SPECULUM 590 DISP DILATOR VESS 10FR 0.038 20CM COCHLEAR MAGNET BAHA BIM400 BTL THERMO LG CAPACITY WIDE 2L DRSG RAPIDRHINO W AIRW 5.5CM MASK AF531 EE NEB ELBOW MD MASK AF531 EE NEB ELBOW LG BOOT CAST TCC-EZ REG KT BREAST PUMP SYMPHONY DBL PORT CLEARVUE 8FR KT INTR MIC 16FR*USE 6259398* BLADE QUADCUT M4 3.4MMX13CM PPM ENTOVIS DR-T W LANDLINE PPM ENTOVIS SR-T W LANDLINE EMBOL PVA FM RED 500-710MCRN SOL VISCOELASTIC VISCOAT 0.5ML PPM ENDURITY DR STNT VIABAHN0.018 5MM2.5X120CM STNT VIABAHN0.018 6MM2.5X120CM STNT VIABAHN 0.035 8X5 120CM STNT VIABAHN 0.035 8X10 120CM PROCESSOR CP910 W PORT MAIZE STNT VIABAHN 0.035 9X5 120CM STNT VIABAHN 0.035 10X5 120CM STNT VIABAHN 0.035 13X5 120CM STNT VIABAHN 0.035 11X5 120CM SPLT WRIST THB CMFTCOOL LFT MD SPLT WRIST THB CMFTCOOL LFT LG SPLT WRIST THB CMFT COOL RT MD Page 108 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $27.00 $50.00 $68.00 $160.00 $98.00 $3,397.00 $3,435.00 $318.00 $75.00 $1,776.75 $1,776.75 $1,776.75 $1,088.00 $207.00 $207.00 $111.00 $9,871.00 $145.00 $55.00 $3,665.00 $116.00 $202.00 $137.00 $137.00 $376.00 $167.00 $1,458.00 $1,083.00 $1,238.00 $10,954.00 $7,131.00 $407.00 $317.00 $8,150.00 $5,676.00 $5,676.00 $5,493.00 $6,043.00 $26,181.00 $5,493.00 $5,493.00 $5,506.00 $5,493.00 $175.00 $162.00 $162.00 2020 pricing Drugs&Supplies PROCEDURE NAME SPLT WRIST THB CMFT COOL RT LG ATTACH FINGER FLEXION LOOP PROCESSOR BAHA 4 SOFT BLK MICROPHONE WRLSS COCHLEAR MINI KT PEDS SOUND PROCESSOR MAGNET IOL TORIC ASPHERIC 1.5D 15.0D NAIL TFNA TI LFT 130D 11X400MM SCREW LAG TI STER 100MM KT BX MISSION 20GX10CM INFUS POWERLOC MAX SFTY20GX1.5 CUSH DONU*DISC NO REPLACEMENT* CBL TWIST LK MDTR 25CM NEUROSTIMULATOR MDTR EXTL EVAL NIPPER NAIL SS CONCAVE ANG 5.5 FLTR IVC CELECT PLAT UNISET DRSG HEMO QUIKCLOT 4X4 BRC WRIST PRO W THB SPI LFT MD STNT XIENCE ALPINE RX 2.25X8MM STNT XIENCE ALPINE RX2.25X12MM STNT XIENCE ALPINE RX2.25X15MM STNT XIENCE ALPINE RX2.25X18MM STNT XIENCE ALPINE RX2.25X23MM STNT XIENCE ALPINE RX2.25X28MM STNT XIENCE ALPINE RX 2.5X8MM STNT XIENCE ALPINE RX 2.5X12MM STNT XIENCE ALPINE RX 2.5X15MM STNT XIENCE ALPINE RX 2.5X18MM STNT XIENCE ALPINE RX 2.5X23MM STNT XIENCE ALPINE RX 2.5X28MM STNT XIENCE ALPINE RX 2.5X33MM STNT XIENCE ALPINE RX 2.5X38MM STNT XIENCE ALPINE RX 2.75X8MM STNT XIENCE ALPINE RX2.75X12MM STNT XIENCE ALPINE RX2.75X15MM STNT XIENCE ALPINE RX2.75X18MM STNT XIENCE ALPINE RX2.75X23MM STNT XIENCE ALPINE RX2.75X28MM STNT XIENCE ALPINE RX2.75X33MM STNT XIENCE ALPINE RX2.75X38MM STNT XIENCE ALPINE RX 3.0X8MM STNT XIENCE ALPINE RX 3.0X12MM STNT XIENCE ALPINE RX 3.0X15MM STNT XIENCE ALPINE RX 3.0X18MM STNT XIENCE ALPINE RX 3.0X23MM STNT XIENCE ALPINE RX 3.0X28MM STNT XIENCE ALPINE RX 3.0X33MM Page 109 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $175.00 $75.00 $5,277.00 $898.00 $949.00 $572.00 $4,254.00 $2,103.00 $240.00 $49.00 $104.00 $437.00 $1,418.00 $319.00 $2,751.00 $110.00 $50.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $2,635.50 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 2020 pricing Drugs&Supplies PROCEDURE NAME STNT XIENCE ALPINE RX 3.0X38MM STNT XIENCE ALPINE RX 3.5X12MM STNT XIENCE ALPINE RX 3.5X15MM STNT XIENCE ALPINE RX 3.5X18MM STNT XIENCE ALPINE RX 3.5X23MM STNT XIENCE ALPINE RX 3.5X28MM STNT XIENCE ALPINE RX 3.5X33MM STNT XIENCE ALPINE RX 4.0X28MM STNT XIENCE ALPINE RX 4.0X33MM STNT XIENCE ALPINE RX 4.0X38MM SPLT FOREARM RAD NERVE PROBE SERFAS ENERGY 50-S XL PLATE CALC VA RT LNG 2.7X56MM HEMO CONN MIXING W SPRAY TIP STBL BNDG NDLE EZ-10 STNT REBEL MR 4.00X12MM STNT REBEL MR 4.00X16MM STNT REBEL MR 4.00X20MM STNT REBEL MR 4.00X24MM STNT REBEL MR 4.00X28MM STNT REBEL MR 4.00X32MM STNT REBEL MR 4.50X12MM STNT REBEL MR 4.50X16MM STNT REBEL MR 4.50X20MM STNT REBEL MR 4.50X24MM STNT REBEL MR 4.50X28MM PILLCAM SB-3 8HR TB TRACH FLEXTEND PED 4.5MM BRC ANK ULT HIGH 5 MD BRC WRIST PRO W THB SPI LFT SM BRC WRIST PRO W THB SPI LFT LG STKNG ANTIEMB THIGH REG XL GRSPR SLINGSHOT 45D KT BAHA ATTRACT MAGNET WATER CHAMBER CPAP AIRSENSE 10 HNDL EGG QK CONN RETR BYNT PENFIELD CURETTE 30D ANG SZ0 CURETTE 0D ST SZ0 ELTD TWST PAIR 8CH ELTD SGL 27G 13MM ELTD DUAL 27G 13MM ELTD CORKSCREW STIM ELTD NDLE REC REAMER HAND SYNT 6.0X450MM REAMER HAND SYNT 7.0X450MM Page 110 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $3,039.00 $702.00 $799.00 $2,602.00 $257.00 $95.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $2,471.00 $1,785.00 $1,050.00 $274.00 $50.00 $50.00 $54.00 $1,194.00 $949.00 $150.00 $2,201.00 $1,787.00 $2,457.00 $2,201.00 $1,948.00 $1,257.00 $226.00 $1,257.00 $1,779.00 $1,004.00 $1,004.00 2020 pricing Drugs&Supplies PROCEDURE NAME HD RDCTN ANG 7.0MM HD RDCTN ST 7.0MM REAMER HAND SYNT 8.0X450MM AIMING ARM TI LK SCREW 6.0MM TEMPLATE BENDING GLD 12HL3.5MM TEMPLATE BENDING GRN 9HL 3.5MM TEMPLATE BENDING PROX TIB3.5MM TEMPLATE BENDING PROX TIB4.5MM BROACH TI FEM NAIL CONN SCREW FOR FEM NAIL EXTR SCREW TI FEM TIB NA EXTR SCREW TI TIB NAIL AWL REV LG G MEDULLARY CANAL LENGTH CATH TRAY CENT*USE 6258542* CATH TRAY CENT *USE 6263665* CATH TRAY CENTV *USE 6263671* CATH TRAY CENT *USE 6263677* DILATOR FEM COPE SADDEKNI 5FR CATH BEACON C2 0.035 5FR 65CM INTR FLEXOR SM CHECKFLO7FR40CM GDWIRE MCNAMARA 90D0.018 180CM SHEATH BALKIN CHECK 5.5FR 40CM CATH BEACON LEVI0.038 5FR 65CM GDWIRE MCNAMARA 90D0.018 260CM CATH BEACON RCD 0.038 5FR 65CM CATH BEACON RIM 0.035 5FR 65CM CATH BEACON SIM2 0.038 5FR65CM CATH BEACON SIM1 0.038 5FR65CM ADPTR TUOHY-BORST SIDE ARM FORCEPS VASC RETRV 3.0FR 120CM DILATOR VESS 14FR 0.038 20CM DILATOR VESS 16FR 0.038 20CM DILATOR VESS STD0.025 4FR 20CM DILATOR VESS 6FR 0.035 20CM GDWIRE FIX ST HEP 0.035 145CM SCREW LK HEXALOBE 3X24MM BLN BILI CRE 7.5FRX180CM 6-8MM BLN BILI CRE 7.5FRX180CM8-10MM ADPTR FEED BOLUS BS ST 18FR CATH URETRL CONN 3-6FR CATH URETRL CONN 7-10FR COIL INTERLOCK 2D 12MMX20CM COIL VORTEX DIMND 0.75MMX2.3CM GDWIRE ZIPWIRE ANG 035 150CM CATH RENEGADE STC ANG 20X130CM Page 111 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $428.00 $428.00 $1,023.00 $1,548.00 $238.00 $174.00 $284.00 $284.00 $1,712.00 $1,773.00 $950.00 $950.00 $1,321.00 $443.00 $372.00 $372.00 $372.00 $372.00 $80.00 $60.00 $289.00 $497.00 $239.00 $60.00 $497.00 $60.00 $60.00 $60.00 $60.00 $60.00 $1,455.00 $56.00 $56.00 $56.00 $56.00 $68.00 $765.00 $1,093.00 $1,093.00 $47.00 $48.00 $48.00 $2,048.00 $2,048.00 $141.00 $1,297.00 2020 pricing Drugs&Supplies PROCEDURE NAME CATH BLN DIL 7FR 7X4X40CM*CIP* CATH BLN DIL 8FR 9X4X75CM*CIP* CATH BLN DIL XXL 12X40CM CATH BLN DIL XXL/12X6X75C CATH BLN DIL XXL 16X6X75C CATH EXPO WRP 5FR 100CM GLS SFTY LASER HOLMIUM LASER STRIPPER SLIMLINE 200MCR LASER STRIPPER SLIMLINE 365MCR LASER STRIPPER SLIMLINE 550MCR LASER STRIPPER SLIMLINE1000MCR GDWIRE CHOICE PT ST 182CM KWIRE STYLE7 0.9X229MM KWIRE STYLE1 0.7X127MM KWIRE STYLE6 2.0X152MM SCREW LK AXSOS 4.0X38MM PLATE 1/3 TUBLR 7HL SCREW CORT SLFTP 3.5X12MM SCREW CORT SLFTP 3.5X14MM SCREW ASNIS III CANN 6.5X80MM LEAD TMPR PACING TV 6FR 140CM PLUG VASC AMPLZ 4 5MM PLUG VASC AMPLZ 4 6MM PLUG VASC AMPLZ 4 7MM PLUG VASC AMPLZ 4.8MM PROBE HOOK W 5MM MARKING 5.4MM BIT DRILL ARTX*USE 6184741* PUNCH PLK REUS 3.5MM BIT DRILL CALIB 3.0MM BIT DRILL CANN 4.0MM PLATE FUSN ANK ANT TT LFT SLING THUMSLING GRY LFT MD/LG HNG ELBOW ADJ RT SPLT ANTISPAS VOLAR LFT SM SPLT ANTISPAS W/SLOT LOOP RT SPLT RESTING PAN AQUAPLAST LFT SPLT RAD NERVE W-711 LFT MD/LG SPLT RAD NERVE W-711 LFT SM/MD BRC WRIST W THB SPI LFT LG BRC WRIST W THB SPI LFT MD BRC WRIST W THB SPI RT MD BRC WRIST W THB SPI LFT SM BRC WRIST W THB SPI RT SM BRC WRIST W THB SPI LFT XSM BRC WRIST W THB SPI RT XSM SPLT ARM THERMOPLASTIC LFT SM Page 112 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $771.00 $771.00 $1,130.00 $1,130.00 $1,130.00 $47.00 $1,762.00 $1,118.00 $1,118.00 $1,118.00 $1,118.00 $385.00 $57.00 $57.00 $57.00 $688.00 $349.00 $159.00 $159.00 $1,078.00 $1,106.00 $2,497.00 $2,497.00 $2,497.00 $2,497.00 $821.00 $379.00 $919.00 $943.00 $943.00 $4,213.00 $174.00 $438.00 $215.00 $348.00 $174.00 $605.00 $605.00 $57.00 $57.00 $57.00 $57.00 $57.00 $57.00 $57.00 $206.00 2020 pricing Drugs&Supplies PROCEDURE NAME SPLT COMFORTER LFT MD SPLT COMFORTER RT MD SLING CUFF ADPTR HEMI LG KT DAILY CARE DIABETIC FT SPLT BALL ANTISPASTTY DORSAL SPLT ELAS THB RT SM BELT GAIT W BUCKLE 60 SLING SHLDR SUPP GIVMOHR SM SUPP WRIST GRASPING CUFF SPLT HAND ANTI SPASTITY RT MD SPLT HAND ANTI SPASTITY RT SM SPLT HAND ANTI SPASTITY RT LG SLING SHLDR HEMI LFT LG BAND COMP WRAP PRO-TEC SPLT TENNIS ELBOW IMAK SPLT SOFT HAND ULNAR LFT MD SPLT SOFT HAND ULNAR RT MD KT REHAB HIP KNEE PAD HOT MOIST HOTPAC 10X20 SPLT KNUCKLE BENDER LG SPLT KNUCKLE BENDER MD SPLT KNUCKLE BENDER SM GLOVE COMP OPEN BGE 15-20LFTMD GLOVE COMP OPEN BGE 15-25 XL SPLT FINGER LMB SPRING EXT B SPLT FINGER LMB SPRING EXT C SPLT FINGER LMB SPRING EXT AA SPLT LYNX WHFO LFT LG SPLT LYNX WHFO LFT MD BOWL MELAMINE SCOOPER WHT SPLT MODABBER THB ORTHOSIS STD SPLT MODABBER THB ORTHOSIS XL SPLT MODABBER THB ORTHOSIS XS SPLT CARVE-IT HAND POSITION XL SPLT CARVE-IT HAND POSITION SM PK COLD GEL UNI-PATCH 11X21 HNG ELBOW PHOE MD 4.5IN SPLT ULNAR POLYCENTRIC LFT MD SUPP POSTURE CORRECTOR SM/MD PD PRSS RELIEF 3/16X4X36 SPLT PLANTAR FASCITTIS SM SPLT BIODYNAMIC FLEXION EXT SPLT AQUAPLAST OPTIPERF BLU PUMP SCAR PLST SLING ARM HEMI II LFT LNG LG SPLT FINGER EXT SHRT BLK XS Page 113 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $381.00 $381.00 $66.00 $91.00 $240.00 $75.00 $65.00 $285.00 $209.00 $193.00 $193.00 $193.00 $246.00 $75.00 $87.00 $65.00 $65.00 $56.00 $197.00 $106.00 $106.00 $106.00 $260.00 $259.00 $83.00 $83.00 $83.00 $344.00 $344.00 $75.00 $154.00 $148.00 $148.00 $146.00 $140.00 $155.00 $264.00 $370.00 $122.00 $166.00 $252.00 $109.00 $321.00 $88.00 $251.00 $75.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT SOFT TOUCH SPLT HAND WRIST E-Z RT SPLT PALM PROTECT RT 90D SPLT THB CMFT COOL TODDLER LFT SPLT THB CMFT COOL LFT LG PLUS SPLT THB CMFT COOL LFT SM PLUS SPLT THB CMFT COOL RT SM PLUS SPLT ULNAR DEVTN WIRE FM LFTMD SPLT ULNAR DEVTN WIRE FM RT SM COMP SUPP WRAP STD KNEE BELT SUPP BACK MD SPLT TENNIS ELBOW GEL HOT/COLD SPLT THERMOFORM THB LNG LFT SPLT THERMOFORM THB LNG SM 8 SPLT THERMOFORM THB RT LNG MD SPLT THERMOFORM THB RT LNG SM SPLT THERMOFORM THB MID LFT LG SPLT THERMOFORM THB MID RT MD SPLT THERMOFORM THB MID RT SM SPLT THERMOFORM THB SHRT LFT L SPLT THERMOFORM THB SHRT LFT M SPLT THERMOFORM THB SHRT LFT S SPLT THERMOFORM THB SHRT RT LG SPLT THERMOFORM THB SHRT RT MD SPLT THERMOFORM THB SHRT RT SM POUCH STRL SLF SEAL 12X18 BINDER ABD 12IN *DISC 6263634* STRAP TENNIS ELBOW VOLLEY BRC WRIST PRO W THB SPI RT SM BRC WRIST PRO W THB SPI RT LG BRC WRIST PRO W THB SPI RT MD SPLT ARM COLLES RT MD BRC WRIST PEDS W THB SPI RT BINDER A*DISC 6115326 6114862* BLADE OXFORD RESECTION *CIP* HANDPC CENTURION ULTRAVIT PK PHACO CENTURION FMS ACTIVE CANN CAPNOLINE+ W TB ADLT LNG PANTYHOSE MATERNITYBGE20-30SZ3 DRSG MEPILEX BORD 4X8 CATH PRONTO V4 BLADE MVR ST 20G GDWIRE BENTSON PTFE .035 150CM CATH OMNIFLUSH 5FR .038 65CM CATH KUMPE 0.038 5FR 65CM CATH SOFTVU STR 5FR .038 65CM Page 114 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $104.00 $294.00 $205.00 $192.00 $142.00 $142.00 $142.00 $134.00 $134.00 $1,362.00 $213.00 $83.00 $134.00 $134.00 $134.00 $134.00 $104.00 $104.00 $104.00 $88.00 $88.00 $88.00 $88.00 $88.00 $88.00 $313.00 $49.00 $69.00 $50.00 $50.00 $50.00 $58.00 $83.00 $61.00 $536.00 $974.00 $264.00 $66.00 $411.00 $28.00 $1,293.00 $47.00 $65.00 $86.00 $240.00 $86.00 2020 pricing Drugs&Supplies PROCEDURE NAME CATH OMNIFLUSH 4FR 65CM SET FILTERLINE ADLT/PED KT MICINTR NIT STIFF 5FR 21GX7 HEMO D-STAT DRY FLOWABLE CATH PRONTO EXTR LP SNARE EXPRO ELITE 10MM CATH SUPP MINNIE .018X150CM MICROCATH SUPCROSS BRD ST 130 MICROCATH SUPCROSS COIL120D130 CATH PRONTO EXTR V4 6FR MICROCATH SUPCROSS COIL 90D130 CATH TWIN PASS DUAL ACCESS CATH SUPP MINNIE .014X150CM BIT DRILL STOP 1.5X50 9MM VAC WOUND ULTA NDLE SPINAL STELLATE 22GX2 ENDOL ICAST 8X38MM 80CM SUPP SHLDR THERMOSKIN BLN NANOCROSS 5.0X100MM 150CM BLN NANOCROSS 6.0X100MM 150CM MAGNET PROCESSOR STRENGTH 1 MAGNET PROCESSOR STRENGTH 2 MAGNET PROCESSOR STRENGTH 3 MAGNET PROCESSOR STRENGTH 4 MAGNET PROCESSOR STRENGTH 5 MAGNET PROCESSOR STRENGTH 6 SUT PROLENE 5-0 MONO PS5 18 DRSG MEPILEX BORD SACRUM 9X9 SHEARS ENDO ACE+7 5MM 36CM PK SHANFELD CUST BEMIDJI STNT VIATORR 10MMX4CMX2CM 75CM VACUUM EXTR CUP W TB SHEATH PNCLE .038 5FR 10CM SHEATH PNCLE 5FR 25CM SHEATH PNCLE 7FR 25CM SHEATH PNCLE .038 9FR 10CM SHEATH PNCLE .038 6FR 10CM SHEATH PNCLE .038 8FR 10CM SHEATH PNCLE .038 7FR 10CM SHEATH PNCLE .038 11FR 10CM SHEATH PNCLE PERIPH 11FR 25CM GLIDEWIRE ADVANTAGE.035 180CM SHEATH PNCLE PERIPH 6FR 25CM BUR SIDE CUT TAPER 1.6X44.8MM EXCHANGE SYS CURV 12FR 45D GDWIRE J3 FX .035 260CM Page 115 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $219.00 $69.00 $196.00 $771.00 $1,691.00 $1,500.00 $676.00 $1,458.00 $1,691.00 $1,691.00 $1,691.00 $1,292.00 $676.00 $478.00 $335.00 $57.00 $5,247.00 $335.00 $1,012.00 $1,012.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $29.00 $57.00 $1,557.00 $974.00 $8,771.00 $128.00 $61.00 $128.00 $128.00 $61.00 $61.00 $61.00 $61.00 $61.00 $139.00 $1,063.00 $28.00 $50.00 $2,121.00 $95.00 2020 pricing Drugs&Supplies PROCEDURE NAME GDWIRE JTIP PTFE .025 150CM GDWIRE JTIP PTFE .025 *OBS* TB TRACH AIRE-CUF XLNG 9.0MM BRUSH CYTOLOGY ERCP DISP1950MM SET CNTRST BURETTE SPIKE SET CNTRST CO2 DEL KT BG CUST CO2 WASTE DRAPE STERIDRAPE SHLDR U POUCH GOWN BAIR PAWS W BOOTIES SM GOWN BAIR PAWS PLUS ADLT STD CANN VERSAPORT THRD 5MM DRAPE CSECTION W POUCH PK ARTHROGRAM TRAY CUST BZ PK DEL CUST BZ HOLDER ET TB QUICKSTRAP ADLT CATH FOLEY IC 3WAY 18 *CIP* CATH FOLEY IC 3WAY 24 *CIP* CATH FOLEY IC 2WAY 28FR *CIP* CATH FOLEY IC 2WAY 30FR*CIP* DRN CATH MALECOT 4WING 36FR DRN CATH MALECOT 4WING 38FR POUCH WOUND EAKIN TAP 4.3X3 SENS SYS SPO2 RAINBOW R2-25 SENS SPO2 RAINBOW ADLT R1 25L BLN IABP LINEAR 7.5FR 40CC BLN IABP LINEAR 7.5FR 34CC CATH VISTA IMSH 7FR 100CM CATH VISTA MPA1SH 7FR 100CM CATH VISTA XBLAD3.5 7FR 100CM CATH VISTA XBLAD4.5 7FR 100CM CATH VISTA XB3SH 7FR 100CM CATH VISTA XBLAD3.5SH 7FR100CM CATH VISTA XBLAD3.5 8FR 100CM CATH VISTA XBLAD4 8FR 100CM CATH VISTA IMSH 7FR 90CM CATH VISTA LCBSH 7FR 100CM CATH ADRIOT XBLAD3 6FR 100CM CATH ADRIOT XBLAD3.5 6FR 100CM CATH ADRIOT XBLAD4 6FR 100CM CATH ADRIOT 3DRC SH 6FR 100CM CATH ADRIOT NR4 6FR 100CM CATH ADRIOT JR4 SH 6FR 100CM CATH ADRIOT AL1 6FR 100CM CATH ADRIOT AL1 SH 6FR 100CM CATH ADRIOT AL2 6FR 100CM CATH ADRIOT AR1 6FR 100CM Page 116 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $68.00 $95.00 $486.00 $400.00 $59.00 $243.00 $132.00 $58.00 $138.00 $69.00 $239.00 $70.00 $239.00 $146.00 $54.00 $76.00 $79.00 $46.00 $46.00 $56.00 $56.00 $56.00 $260.00 $777.00 $2,224.00 $2,224.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 2020 pricing Drugs&Supplies PROCEDURE NAME CATH ADRIOT XB3.5 SH 6FR 100CM CATH ADRIOT XB4 SH 6FR 100CM CATH ADRIOT JL3.5 6FR 100CM CATH ADRIOT JL4 SH 6FR 100CM CATH ADRIOT JL4.5 6FR 100CM CATH ADRIOT JL5 6FR 100CM CATH ADRIOT LCB 6FR 100CM CATH ADRIOT MPA1 6FR 100CM CATH ADRIOT MPA1 SH 6FR 100CM CATH ADRIOT RCB 6FR 100CM CATH ADRIOT HOCKEY 6FR 100CM CATH ADRIOT XBLAD4.5 6FR 100CM CATH ADRIOT XB3 SH 6FR 100CM CATH ADRIOT XBLAD4 SH 6FR100CM CATH ADRIOT XBLAD3.5SH6FR100CM CATH ADRIOT IM 6FR 90CM CATH ADRIOT IM SH 6FR 100CM CATH ADRIOT LCB SH 6FR 100CM SET INFUS STD MRI SET VENTED SYR ADPTR MRI NDLE ULTRSND ECHOSTIM 21GX80MM GDWIRE WHOLEY MOD J .035 175CM CATH MICRO REBAR 18 2.4FR130CM CATH INFUS CRAGG 5FR 100/30CM CATH SILVERHAWK EXL XS SNARE AMPLZ MICRO 4MM 200CM GDWIRE PROSTREAM .035 .89MM TB CAPNOLINE ADLT LONG OR*CIP* CANN CAPNOLINE W TB PEDS CANN GUARDIAN NON-INTUB CATH CONTAMINATION SHIELD WIRE LIGATURE 18G 0.040 675FT WIRE LIGATURE 22G 0.025 120FT WIRE LIGATURE 24G 0.020 184FT WIRE LIGATURE 30G 0.010 675FT CATH TREROTOLA PTD 5FR 65CM SPLT NASAL THERMOPLAS ENDOCARE SLIMLINE 1.7MM GDWIRE BMW ELITE .014 190CM MARKER FIDUCIAL 18GX20 0.9X3MM KT FIDUCIAL MARKE*USE 6216940* EVAC BLADDER ELLIK W BULB MD SYS PEP ACAPELLA DH GRN SUT GORETEX CV2 THX26 1/2CIR SUT PROLENE 5-0 RB1 18 SUT PDS II 4-0 ST4 DYE Page 117 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $207.00 $92.00 $92.00 $59.00 $1,157.00 $1,125.00 $512.00 $5,212.00 $1,934.00 $1,012.00 $55.00 $62.00 $82.00 $62.00 $293.00 $293.00 $345.00 $293.00 $2,244.00 $46.00 $2,917.00 $385.00 $1,037.00 $1,037.00 $294.00 $246.00 $154.00 $46.00 $25.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT ETHIBOND 2-0 SH ENV NON-ABSORB TYRX ANTIBACTMD CANN ORAL NASAL CO2/O2 ADLT CANN NASAL CO2/O*DISC 6271342* GLOVE LNR FLEX-GARD PF 2XL BLN POWERCROSS 90CM 5X40MM STNT VISI-PRO 5X27MM 80CM BLN EVERCROSS PTA 12X60X80CM STNT PROTEGE 6F 1*USE 6207464* BLN POWERCROSS 90CM 4X40MM KT ENDO CHOICE STD PPM EVIA DR PPM ESTELLA DR-T PPM ESTELLA SR-T PPM ESTELLA DR TB BUTTON GASTRO 24FR 1.2CM TB BUTTON GASTRO 24FR 1.7CM TB BUTTON GASTRO 24FR 4.4CM KT MANIFOLD 3 VALV CUST NDLE HYFRECATOR ANG 5 KT MASK HYBRID CPAP SET INFANT NASAL CPAP ASSY12FR SET INFANT NASAL CPAP ASSY15FR NDLE SPINAL TUOHY 18GX3.5 GDWIRE SPRING TIP MARKED 210CM SUT MAXBRAID HC5 #2 SUT NYLON BLK AU-8 10-0 20CM TIP IRG ULTRAFLOW CURV 0.3MM TIP IRG ULTRAFLOW 45D 0.3MM TIP IRG ULTRAFLOW ST 0.3MM HANDPC I/A THRD ULTRAFLOW FORCEPS MONARCH LOADING RESUSC MANUAL ADLT COLAR INFANT 6-8IN BB TAK SYS ARTX LG SUT VICRYL 1 MO-4 8-18 SUT VICRYL SH 2-0 8X27 SUT VICRYL TIE 0 6-18 SUT VICRYL TIE 4-0 12-18 SUT PDS PC-5 CLR 3-0 18 DRAP LAP W POUCH 100X72X124 TB ET ORAL SEALGUARD EVAC7.0MM TB ET ORAL SEALGUARD EVAC7.5MM CIRCUIT T PC WO MASK*CIP* RESUSC MANUAL MASK RSVR BGADLT PK MON MYCARELINK Page 118 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $50.00 $2,291.00 $89.00 $89.00 $162.00 $830.00 $1,776.75 $414.00 $2,234.00 $830.00 $56.00 $4,191.00 $7,587.00 $5,094.00 $4,191.00 $1,129.00 $1,129.00 $1,129.00 $106.00 $233.00 $1,260.00 $142.00 $142.00 $57.00 $611.00 $182.00 $204.00 $1,280.00 $1,163.00 $1,016.00 $1,257.00 $1,037.00 $77.00 $89.00 $668.00 $74.00 $56.00 $23.00 $41.00 $26.00 $57.00 $188.00 $188.00 $59.00 $44.00 $987.00 2020 pricing Drugs&Supplies PROCEDURE NAME PPM ELUNA 8 SR-T KT MATERNITY OB CUST BZ BINDER ABD 12IN UNIV*CIP* IMMOB KNEE UNI-VERSATIL 23IN BED KCI ROTO REST DELTA KT AUTOTRANFUSN AUTOVAC BG AUTOVAC BLD CATH SWAN GANZ CCOMBO V VIP8FR NDLE KNEE SCORPION KT RAPIDINFUSOR UNIV BG3-SPIKE TRAY EPIDURAL ANES 19G DRSG MEPILEX FM AG 6X6 BZ ELTD STD SPATULA CATH 3WAY 75ML 20FR GDWIRE CVC .032 60CM SUCT TB IRG PROBE 5MMX33CM TRANSD DTX PLUS DBLE LINE KT CUTIMED OFF-LOADER SELECT DRSG TUBLR XSPAN 25YD SZ1 PAD GEL METATARSAL MD 5/16 BLADE TREPHINE LNG 8.50MM BLADE TREPHINE LNG 8.00MM BLADE TREPHINE LNG 7.00MM SHEATH ANSEL HI FLEX ST12FR 45 GDWIRE AMPLZXSTIFFFIX0.035 260 CATH BEACON TEGT0.038 5FR 65CM CATH BEACON VTK 0.038 5FR 100 CATH BEACON VS2 0.038 5FR 80CM BLN DIL ADV ATB 14X4 80CM COIL MWCE-18-7-5-NESTER COIL MWCE-18-14-5-NESTER BLN NANOCROSS 4X100MM 150CM BLN NANOCROSS 3X100MM 150CM GD 6FR XB 2.5 100CM SHEATH BRITE TIP 5FR 23CM ENDOL ICAST 6X38MM 80CM ENDOL ICAST 6X59MM 80CM CATH TIG MOD 4.0CM 6FR 100CM COIL AZUR CX .018 4MM 13CM INTR T/O HIFLO 7FR ALLO GRAFIX PRIM14MM=2SQ*DISC* PLATE HUMR DIST LCP XTR LFT 6H SUT STRFX PDO 2-0 14CM DYE TB OUTFLOW W/PT TB BUR RD LONG 5.5MM BUR AGGR +LONG HIP 4.0MM Page 119 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $7,359.00 $58.00 $107.00 $105.00 $830.00 $1,639.00 $397.00 $163.00 $1,005.00 $646.00 $170.00 $97.00 $219.00 $160.00 $50.00 $242.00 $123.00 $414.00 $69.00 $59.00 $356.00 $356.00 $356.00 $335.00 $204.00 $80.00 $77.00 $77.00 $830.00 $558.00 $558.00 $1,196.00 $1,196.00 $414.00 $183.00 $5,247.00 $5,654.00 $512.00 $2,332.00 $131.00 $520.00 $2,965.00 $1,193.00 $335.00 $438.00 $240.00 2020 pricing Drugs&Supplies PROCEDURE NAME BONE MID FUSN BLU 2.8X6MM BONE MID FUSN BLU 3.8X6MM BONE MID FUSN GRY 5X5MM ANCHOR INTRALINE 5.5MM SCREW LK HEXALOBE 2.7X8MM SCREW LK HEXALOBE 2.7X28MM PLATE LOPRO ARTX FLAT PLATE FLAT COTTON SYS LAT ANK RECON NAIL RECON RT 10X360MM SCREW RECON LAG T2 6.5X85MM SCREW SOLERA BREAKOFF SCREW SOLERA FA TI 6.5X35MM SCREW SOLERA FA TI 6.5X40MM FORCEPS ACL/PCL GRAFT PASSING SCREW SOLERA MAS 5.5X50MM SCREW SOLERA MAS 6.5X40MM SCREW SOLERA MAS 6.5X45MM SCREW SOLERA MAS 6.5X50MM SCREW SOLERA MAS 7.5X40MM SCREW SOLERA MAS 7.5X45MM SCREW SOLERA MAS 7.5X50MM SCREW SOLERA MAS 4.0X40MM SCREW SOLERA MAS 4.0X45MM SCREW SOLERA MAS 4.5X25MM SCREW SOLERA MAS 4.5X30MM SCREW SOLERA MAS 4.5X35MM SCREW SOLERA MAS 4.5X40MM SCREW SOLERA MAS 4.5X45MM SCREW SOLERA MAS 5.0X35MM SCREW SOLERA MAS 5.0X40MM SCREW SOLERA MAS 5.0X45MM SCREW SOLERA MAS 5.0X50MM GRAFT FEM HD NECK BLADE SAG DUALCUT 18X.89X90MM SPACER CERV 7X16X14MM NDLE SLIDER CRST LG XL NDLE SLIDER NIT SHUTTLE BUR PEAR HIP 5.5MM PIN COLAR 8MM SYS IMPLT PROX TENODESIS BAT SMARTLIFE SM SCREW SOLERA MAS 8.5X40MM SCREW SOLERA MAS 8.5X45MM SCREW SOLERA MAS 8.5X50MM SCREW SOLERA MAS 5.5X35MM Page 120 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,026.00 $1,026.00 $1,026.00 $1,029.00 $765.00 $765.00 $2,162.00 $2,783.00 $3,553.00 $3,379.00 $1,069.00 $574.00 $2,195.00 $2,195.00 $2,462.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $4,001.00 $246.00 $2,917.00 $1,121.00 $424.00 $1,063.00 $943.00 $1,925.00 $1,581.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW SOLERA MAS 5.5X40MM SCREW SOLERA MAS 5.5X45MM SCREW SOLERA FA TI 5.5X30MM SCREW SOLERA FA TI 5.5X35MM SCREW SOLERA FA TI 5.5X40MM SCREW SOLERA FA TI 5.5X45MM SCREW SOLERA FA TI 5.5X50MM SCREW SOLERA FA TI 6.5X45MM SCREW SOLERA FA TI 6.5X50MM SHLDR REV INSRT 36MM +6 A SHLDR REV INSRT 36MM +9 A NAIL FLEX T2 PEDS 2.5X450MM NAIL FLEX T2 PEDS 3.0X450MM KT JUGGERKNOTLESS DISP ANCHOR JUGGERKNOT SOFT 2.1MM CLIP QUICK PRO 230CM CAGE PERIMETER MD 8D 14MM SUT STRFX PDO 2-0 36CM DYE SCREW LNG THRD 4.0X42MM SCREW LNG THRD 4.0X44MM PLATE PEANUT ARCH 12MM SCREW CANN 4.5X24MM GDWIRE SMTH 8 WIRE DBLE SIDED ROD EXTL FIX H3 11X350MM BLADE OSTEO PELVIC 15X304MM BLADE OSTEO PELVIC 20X304MM SCREW CANN 4.5X16MM NAIL RECON LFT 9X400MM PLATE OLECRANON EXT 5HL RT SCREW LK HEXALOBE 3X30MM SCREW LK HEXALOBE 2.7X10MM SCREW SHRT THRD 4.0X32MM BLADE DIEGO CURV 4MM 90D SHLDR HUMR STEM LNG 7B 120MM SHLDR HUMR HD HIGH 54X23MM CLAMP PIN HOFFMAN 5L ROD EXTL FIX H3 11X150MM ROD EXTL FIX H3 11X250MM ROD EXTL FIX H3 11X400MM ROD EXTL FIX H3 11X450MM CPLE PIN/ROD INVERTED HOFFMAN3 POST ANG HOFFMAN 90D ROD EXTL FIX SEMICIR 11X220MM CPLE ROD HOFFMAN 30D DISECT SONICISION 5MM 13CM Page 121 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,274.00 $2,274.00 $2,197.00 $2,197.00 $2,195.00 $2,195.00 $2,195.00 $2,195.00 $2,195.00 $4,872.00 $4,872.00 $1,219.00 $1,252.00 $1,158.00 $1,381.00 $1,005.00 $6,112.00 $118.00 $190.00 $190.00 $739.00 $739.00 $264.00 $210.00 $1,127.00 $1,530.00 $1,530.00 $739.00 $3,379.00 $2,737.00 $765.00 $765.00 $190.00 $659.00 $6,112.00 $3,352.00 $1,870.00 $1,070.00 $1,098.00 $1,244.00 $1,244.00 $1,683.00 $707.00 $1,341.00 $1,870.00 $1,486.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW PT THRD 8X115MM SCREW LOPRO TI 4.5X55MM PLATE FUSN ANT RT SCREW CANN 4.0X42MM KNEE TIB INSRT MHR 20MM SHLDR REV TRAY +6 1.5MM AIRW SUPRAGLOTTIC IGEL SZ4 CATH MOTARJEME AMIR 5FR KNIFE SIDEPORT CLEARCUT ANG1.2 CBL SURG DISP 12FT LEAD TMPR PACING 6FR 200CM ENDOL ICAST 9X38MM 80CM COIL INTERLOCK 2D 12MMX40CM COIL INTERLOCK 2D 15MMX20CM COIL INTERLOCK 2D 15MMX40CM TB VENT TRIUNE PC SIL 1.35X5MM SUT PDS+ 0 CT1 SUT PDS+ 3-0 PC5 SUT PDS+ 4-0 P3 SUT PDS+ 4-0 ST4 SUT VICRYL+ 0 CP2 SUT VICRYL+ 0 CT3 SUT VICRYL+ 0 CTX SUT VICRYL+ 0 TIE 18 SUT VICRYL+ 0 TIE SUT VICRYL+ 1 MO4 SUT VICRYL+ 2-0 SH SUT VICRYL+ 2-0 TIE ADH SKIN HISTOACRYL 0.5ML SCREW LOPRO TI 5.5X55MM CATH EMBOL PYTHON OTW 39FR13MM STNT REBEL MR 2.75X12MM STNT REBEL MR 2.75X16MM STNT REBEL MR 2.75X24MM STNT REBEL MR 2.75X8MM STNT REBEL MR 3.00X16MM STNT REBEL MR 3.00X20MM STNT REBEL MR 3.00X28MM STNT REBEL MR 3.00X32MM STNT REBEL MR 3.00X8MM STNT REBEL MR 3.50X12MM STNT REBEL MR 3.50X16MM STNT REBEL MR 3.50X20MM STNT REBEL MR 3.50X24MM STNT REBEL MR 3.50X28MM STNT REBEL MR 3.50X32MM Page 122 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,072.00 $390.00 $4,348.00 $806.00 $2,482.00 $3,352.00 $55.00 $82.00 $77.00 $114.00 $1,106.00 $5,247.00 $2,372.00 $2,048.00 $2,372.00 $174.00 $15.00 $28.00 $27.00 $27.00 $9.00 $9.00 $9.00 $25.00 $9.00 $79.00 $60.00 $9.00 $191.00 $390.00 $436.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 $1,813.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE CLX CALC LG LFT PLATE CLX CALC LG RT CANN TRNSPRT 1-2-3 8MM CANN TRNSPRT 4-5-6 8MM CANN FLOWPORT II W OBRTR CANN FLOWPORT 2 NDLE ULTRSND ECHOBLOCK 21GX4 TRAY EPIDURAL PEDS 18G MESH MACROPOROUS 45X30CM SCREW NL 3.5X32.5MM SCREW LK FIXED ANG 3.5X35MM SCREW NL 3.5X35MM SCREW NL 3.5X26MM SCREW LK FIXED ANG 3.5X37.5MM DEV ENDORING SLIM PCF-H190I/L DEV ENDORING SLIM PCF-H180AI/L SCREW PT THRD 8X160MM SPACER VERTESTACK LORD SM 18MM PLATE MINI MAXLOCK MTP LFT SCREW NL 2.7X14MM SCREW NL 2.7X30MM REAMER CONV 16MM REAMER CONCAVE 16MM HIP HD SROM CER 11/13 28MM +3 SCREW PT THRD 6.5X85MM SCREW PT THRD 6.5X90MM SUT MERSILENE 5-0 S-24 PLATE PROX FEM RT 12HL 285MM SPACER NCB 1MM SCREW CORT SLFTP NCB 5.0X36MM SCREW CORT SLFTP NCB 4.0X32MM SCREW CORT SLFTP NCB 4.0X26MM SCREW PT THRD 6.5X85MM SCREW LK LOPRO TI 4.5X20MM SCREW LOCK SLFTP 4.0X55MM SCREW LK SLFTP 4.0X60MM PLATE DIST TIB LFT 8HL SCREW NL HEXALOBE 2.7X20MM SCREW PT THRD 6.5X75MM PLATE POLYAXIAL LOCK LFT HIP STEM INTEGRAL LAT 19X175MM GDWIRE BENTSON ST .035 180CM PROTECT RADIATION COLARTHYROID CAR SEAT SNUG FOR SPICA TURBINE FLOWMIR DISP W MOUTHPC SHLDR REV INSRT 36MM +9 C Page 123 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,348.00 $4,348.00 $442.00 $442.00 $1,313.00 $1,313.00 $59.00 $365.00 $1,324.00 $1,214.00 $1,214.00 $1,214.00 $1,214.00 $1,214.00 $95.00 $95.00 $1,072.00 $10,590.00 $3,545.00 $760.00 $531.00 $1,167.00 $1,167.00 $2,365.00 $1,072.00 $1,072.00 $65.00 $3,904.00 $504.00 $1,092.00 $758.00 $758.00 $1,072.00 $943.00 $592.00 $592.00 $2,767.00 $485.00 $1,072.00 $2,673.00 $4,652.00 $65.00 $386.00 $19,355.00 $11.00 $4,872.00 2020 pricing Drugs&Supplies PROCEDURE NAME ROD SOLERA CURV COCR 5.5X30MM PLATE CLAV STD LFT SHLDR CMNT HUMR STEM15X150MM PUNCH RELIEVA ETHMOID DISP KT CENTVEN CATH DL 8.5FR CATH THORACIC PVC ST 40FR CATH THORACIC PVC RT ANG 16FR CATH THORACIC PVC RT ANG 40FR CATH THORACIC PVC ST 10FR BREAST SIL 410 FULL MODER440CC KT BONE GRAFT CONVENIENCE MINI SET PRIM PLUM CLAVE 2Y 103 CATH MAGLINTE ENTEROCLYSIS13FR SET INFUS BYPASS MRI MRIDIUM LINE SAMP STD FLOW ETCO2 CANN ADLT DIV ETC02 TRAY CATH TRIALYSIS ST 24CM CATH POWERLINE FL TUNNEL 5FR NDLE BX BIOPINCE 18GX20CM CATH PARACENTESES VALV 5FR 7CM DEV BX PREC CORE 18G 10CM DEV BX PREC CORE 20G 10CM CATH SIL HSG CLSD 7FR 30CM TRAP WATER STD FLOW CL TB BP RENAISSANCE II CUSH HYBRID LG RESPCARE CPAP ELTD DEFIB RADIOTRNSLUC ADLT CBL TEST STIMULATOR MINI-HOOK KT FALL RISK PUR BZ ONLY*NLU* DRAPE MICROSCOPE ZEISS 40.5X80 CATH ROYAL HI PIGT0.035 5FR100 STENCIL CATH DIALY TENCKHOFF CONCENTRATOR SIMPLYGO MINI SLING PT HIGHBACK POLY XL HEADGEAR CPAP WISP REDUCED BACK PK SIMPLYGO MINI BRN TB LAB HELIXMARK 0.375X.625 CONSERVER SMARTDOSE GAS 310G CARTRDG CO2 BZ RENT FIRST STEP ADVANTAGE CATH URETRL 6EYE RD TIP 26FR CATH URETRL 6EYE RD TIP*CIP* SET EXT RAPID INFUS PT LN 4FT DEV SUCT KURTIS MECONIUM 3.5MM SUPP POSITION DONUT2.5X12X14.5 SPNG STER ENDO 2X2 Page 124 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,571.00 $2,291.00 $3,255.00 $1,077.00 $625.00 $21.00 $34.00 $34.00 $21.00 $3,204.00 $3,499.00 $60.00 $1,146.00 $87.00 $131.00 $101.00 $1,022.00 $1,173.00 $229.00 $133.00 $229.00 $229.00 $208.00 $352.00 $285.00 $175.00 $87.00 $229.00 $89.00 $60.00 $60.00 $75.00 $4,318.00 $1,332.00 $176.00 $336.00 $1,160.00 $1,052.00 $180.00 $168.00 $61.00 $61.00 $79.00 $149.00 $58.00 $55.00 2020 pricing Drugs&Supplies PROCEDURE NAME BINDER ABD SURG *DISC 6271394* FLTR EVAC SMOKE ASSY DISP CATH BLADDER 7FR BRA SURG CHMPGN 34 BRA SURG CHMPGN 36 BRA SURG CHMPGN 38 BRA SURG CHMPGN 40 PESSARY RING W SUPP SZ1 2.00 BOOT HEEL ORTHOTIC REG GDWIRE THRD AS3 STRY 3.2X300MM KNEE PSN ASF CPS VERT14MM6-9CD BLN DIL CRE 7.5FR 240CM 6-8MM BLN DIL CRE 7.5FR 240CM10-12MM BLN DIL CRE 7.5FR 240CM12-15MM BLN DIL CRE 7.5FR 240CM15-18MM BLN DIL CRE 7.5FR 240CM18-20MM AIRW SUPRAGLOTTIC IGEL SZ3 AIRW SUPRAGLOTTIC IGEL SZ5.0 BLN BILI CRE 7.5FR180CM12-15MM TRAP MUCOUS SPEC 12FR KT MINI TRACH II SCISSORS KINESIO W HOLSTER RL MATTING DYCEM BLU 8INX10YD HNDL METRO CAR BAR HANDY FOR CAR DOOR LATCH HOOK VELCRO NON ADH BLK 2IN HOOK SELF ADH BLK 1X25 TB ENDOBRONCH SHILEY LFT 32FR SYS AEROSOL W HEPA FLTR KT TEST METHACHOLINE CHALLENGE KT FALL MGMT DELX YEL NDLE ICEPEARL 2.1CX WHT ANG90D KT HYPER/HYPO VEST/LEG SM/MD SIZER MAM GELMODPRO RPSB200CC SIZER MAM GELMODPRO RPSB225CC SIZER MAM GELMODPRO RPSB250CC SIZER MAM GELMODPRO RPSB275CC SIZER MAM GELMODPRO RPSB300CC SIZER MAM GELMODPRO RPSB325CC SIZER MAM GELMODPRO RPSB350CC SIZER MAM GELMODPRO RPSB375CC SIZER MAM GELMODPRO RPSB400CC SIZER MAM GELMODPRO RPSB425CC SIZER MAM GELMODPRO RPSB450CC SIZER MAM GELMODPRO RPSB475CC SIZER MAM GELMODPRO RPSB500CC Page 125 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $98.00 $269.00 $240.00 $212.00 $212.00 $212.00 $212.00 $253.00 $440.00 $341.00 $2,396.00 $1,088.00 $1,088.00 $1,088.00 $1,088.00 $1,088.00 $53.65 $53.65 $1,088.00 $54.00 $101.00 $261.00 $400.00 $193.00 $219.00 $198.00 $233.00 $274.00 $656.00 $779.00 $89.00 $3,821.00 $606.44 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 2020 pricing Drugs&Supplies PROCEDURE NAME SIZER MAM GEL HIPRO RPSB200CC SIZER MAM GEL HIPRO RPSB225CC SIZER MAM GEL HIPRO RPSB250CC SIZER MAM GEL HIPRO RPSB275CC SIZER MAM GEL HIPRO RPSB300CC SIZER MAM GEL HIPRO RPSB325CC SIZER MAM GEL HIPROR PSB350CC SIZER MAM GEL HIPRO RPSB 375CC SIZER MAM GEL HIPRO RPSB 400CC SIZER MAM GEL HIPRO RPSB 425CC SIZER MAM GEL HIPRO RPSB 450CC SIZER MAM GEL HIPRO RPSB 475CC SIZER MAM GEL HIPRO RPSB 500CC SYS UTERINE TAMPONADE RING BARR CERARING ADAPT 2IN CATH SWAN GANZ OXMTR 7.5FR L0120 CERV SOFT COLAR L0160 CERV SUPP WIRE FRAME L0172 CERV COLAR SEMIRIGIDPLAS L0174 CERV COLAR 2PC THOR EXT L0180 CERV COLAR MULTIPOST ADJ L0190 CERV COLAR SUPP ADJ L0200 CERV COLAR T-SPINE EX L0456 TLSO FLEX PREFAB L0464 TLSO SPINAL BRCTRIPLANER L0466 TLSO SPINAL BRC SAG L0472 TLSO SPINAL BRC HYPREXT L0482 1 PIECE TLSO L0486 TLSO SPINALBRCTRIPLANER2 L0621 SACROILIAC ORTHOSIS FLEX L0625 BINDER ADDED TO TLSO L0626 LO SAG RIG PNL STAYS L0626 LUMBAR ORTHOSIS SAG POST L0627 LUMBAR ORTHOSIS SAG ANT L0628 LUMBAR SACRAL ORTHOSISFA L0629 LUMBAR SACRAL ORTHOSISFT L0630 LUMBAR SACRALORTHOSISSAG L0631 LSO SAG-CORO RIGID FRAME L0637 LUMBAR SACRALORTHOSISSAG L0638 LUMBAR SACRALORTHOSISSAG L0639 LUMBAR SACRALORTHOSISSAG L0710 CTLSO APL CTRL W INTER L0810 CERV HALO THORACIC ORTH L0820 CERV HALO INTO BODY JACK L0859 MRI COMPATIBLE SYS L0861 HALO REPL LNR INTERFACE Page 126 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,086.00 $1,386.00 $13.00 $1,138.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,593.00 $0.00 $0.00 $0.00 $0.00 $0.00 $169.00 $0.00 $126.00 $0.00 $0.00 $135.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 2020 pricing Drugs&Supplies PROCEDURE NAME L0974 TLSO FULL CORSET L0976 LSO FULL CORSET L1220 EXT ANT THORACIC L1499 LNR REPL L1680 PELVIC HIP CTRL THIGH L1685 POSTOP HIP ABDUCT CUSTFA L1686 LT HO POSTOP HIP ABDUCT L1820 KO ELAS W CONDYLE PADS L1830 KO IMMOB CANVAS LNG PRE L1832 KO ADJ JOINT POS SUP PRE L1834 KO W/O JOINT MOLDED L1834 MC KNEE GUTTER L1836 KO RIGID W/O JOINT PRE L1846 LT KO W ADJ FLEX EXT ROT L1902 AFO PREFAB L1904 AFO MOLDED ANK GAUNTLET L1906 ASO ANK FT ORTHOSIS PRE L3906 CUST WRIST COCKUP SPLNT L1930 AFO PLST L1932 AFO RT ANT TIB PREFABTCF L1940 AFO MOLD PT MODEL PLST L1940 MC DORSAL AFO L1940 MC NIGHT RESTING AFO L1945 AFO MOLDED RT ANT TIB L1951 AFO SPIRAL PREFABRICATED L1960 AFO POLY SOLID ANK L1960 AFO SOLID ANK CUST FAB L1970 AFO PLST MOLDED JOINT L2036 KAFO PLST DBL FREE KNEE L2108 AFO TIB FX CAST MOLDED L2126 KAFO FEM FX CAST THERMO L2190 WAIST BELT POST OP L2210 DORSI ASSIST ANK L2220 LT DORSI & PLANTAR FLEX L2232 AFO CUST FITTED L2250 RT FT PLATE MOLD STIRRUP L2275 VALGUS CORRECT POLY L2275 VARUS/VALGUS PLST MOD L2385 ST KNEE JOINT HD L2405 KNEE JOINT DROP LOCK L2425 KNEE DISC/DIAL LOCK/ADJ L2540 THIGH WT BEAR LACER MOLD L2580 PELVIC SLING L2610 HIP CLEVISTHRUST BEARING L2622 CLEVIS HIP JOINT ADJUST L2624 LT HIP ADJ FLEX EXT ABD Page 127 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $211.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $119.00 $697.00 $238.00 $0.00 $383.00 $0.00 $733.00 $0.00 $0.00 $1,411.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $158.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 2020 pricing Drugs&Supplies PROCEDURE NAME L2755 CARBON GRAPHITE LAM L2780 NON-CORROSIVE FINISH L2810 KNEE CTRL CONDYLAR PD L2820 INTERFACE SOFT KNEE L2840 SOCK TIBIAL LENGTH L2999 CUST STERNAL SHIELD L3000 C ORTHOTICS NEW EA L3000 LIFT HEELTAPERMETATARSAL L3002 FT INSRT PLASTAZOTE L3010 FT LONGITUDINAL ARCHSUPP L3020 MOLD FT INSRT DRESS XLNG L3020 MOLD FT INSRT L3020 ORTHOTIC DRESS FULL L3030 MC GREAT TOE SPLNT L3030 ORTHOTICS ATHLETIC L3030 ORTHOTICS DRESS L3030 ORTHOTICS REG L3040 C CONTOUR ORTHOTIC EA L3100 HALLUS VAGUS NT DYNAMIC L3216 SHOE ORTHOPEDLADY LFT/RT L3332 SHOE LIFT TAPERED TO .50 L3650 SHLDR ORTHOSIS FIGURE 8 L3660 FIG 8 ABDUCTIONRESTRAINT L3671 SHLDR ORTHOIC (SO) JOINT L3671 SHLDR JOINT DSN W/OSPLNT L3674 SO AIRPLANE WO JOINT CF L3677 SO W/O JOINT PREFAB L3702 ELBOW ORTHOSIS L3702 EO RIGID SPLNT CUST L3702 MC ELBOW STATIC SHRT L3720 MC ELBOW STATIC FOREARM L3730 MC DYNAMIC ELBOW L3740 EO PROG SPLNT DYN/STAT L3760 ELBOW ARTHROSIS W JOINT L3762 ELBOW ARTHROSIS WO JOINT L3763 EWHO RIGID SPLNT L3763 EWHO STATIC W/O JOINT L3764 EWHO PROG SPLNT DYN/STAT L3764 EWHO W/JOINTS L3765 MC PSTR ELBOW SPLNT SHRT L3765 RIGID EWHFO L3766 EWHFO W/JOINTS L3806 MC WHFO ADDN FLEX CTRL L3806 MC WHFO ADDN FLX CTRL IP L3806 MC WHFO DYNAMIC FINGER L3806 MC WHFO MP EXT ASSIST Page 128 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $0.00 $0.00 $0.00 $0.00 $0.00 $503.00 $503.00 $0.00 $0.00 $280.00 $0.00 $318.00 $0.00 $0.00 $0.00 $0.00 $123.00 $0.00 $0.00 $0.00 $0.00 $86.00 $195.00 $0.00 $0.00 $1,723.00 $133.00 $0.00 $421.00 $0.00 $0.00 $0.00 $0.00 $729.00 $157.00 $0.00 $979.00 $0.00 $1,120.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 2020 pricing Drugs&Supplies PROCEDURE NAME L3806 WHFO W/JOINTS L3807 PREFAB WHFO L3807 WHFO W/O JOINTS PRE CAST L3808 GAME KEEPERS SPLNT L3808 RESTING HAND SPLNT L3808 THUMB SPICA SOFT W/STAY L3808 THUMB SPICA SPLNT HFO L3808 THUMB SPICA SPLNT WHFO L3808 WHFO L3808 MC DORSAL BLOCK L3808 MC WHFO LNG OPPONENS L3808 MC WHFO SHRT OPPONENS L3808 MC WHFO WRST GAUNT THUMB L3808 MC WRIST BASED THUMB L3808 MC WRIST BASEULNARGUTTER L3808 WHFO RIGID WO JOINT L3809 ORTHOWHFO WO JOINTPREFAB L3900 WHFO DYN FLX HINGE L3900 MC DYNAMIC WRIST L3900 MC HAND BASE FINGERTHUMB L3900 MC WHFO FLEXOR HNG EXT L3900 MC WRIST BASEFINGERTHUMB L3900 WHFO DYNA JOINT DRIVEN L3901 WHFO DYNA CBL DRIVEN L3904 WHFO ELECTIC L3905 WHO W NONTORSION JOINT L3905 WHO W/JOINTS L3906 ULNAR GUTTER SPLNT L3906 MC CHILD WHO/WRST GNT L3906 MC WHO WRIST GAUNT MOLD L3906 MC WHO WRST GAUNT MOLDED L3906 MC WRIST COCK-UP L3906 WHO W/O JOINTS L3906 WHO WRISTCOCKUP GAUNTLET L3908 WHO COCK-UP NONMOLD L3912 HFO FLEXION GLOVE PREFAB L3913 TRIGGER FINGER SPLINT L3913 HFO L3913 HFO W/O JOINT L3913 MC HAND BASED THUMBSPICA L3913 MC HAND BASIC STATIC L3915 WHO NONTORSION JOINTS L3916 ORTHO WHO W/NONTORSION L3917 HO FX ORTH PREFAB L3918 ORTHO HO FRAC METACARPAL L3919 HO CUST Page 129 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $663.00 $0.00 $365.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $529.00 $0.00 $1,876.00 $0.00 $0.00 $0.00 $0.00 $0.00 $2,985.00 $0.00 $1,446.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $593.00 $0.00 $87.00 $138.00 $0.00 $0.00 $395.00 $0.00 $0.00 $775.00 $0.00 $154.00 $0.00 $395.00 2020 pricing Drugs&Supplies PROCEDURE NAME L3921 HAND FINGERORTHOTICS HFO L3921 HFO W JOINT L3923 HFO NO JOINT PREFAB L3923 MC FINGER GUTTER L3924 ORTHO HFO W/O JOINTS L3925 FO W/JOINT PREFAB L3927 FO PIP/DIP W/O JOINT L3927 FO W/O JOINT PREFAB L3929 HFO NONTORSION JNT PF L3930 ORTHO HFO W/NONTORSION L3931 WHFO NONTORSION JOINT PF L3933 FINGER GUTTER SPLNT L3933 FO W/O JOINT L3935 FO W/JOINT L3935 MC FINGER ORTHOSIS L3960 SEWHO AIRPLAN DESIG ABDU L3980 EXOS HUMR FRAC BRC L3980 MC HUMR FX L3980 UPP EXT FX ORTHOSIS HUMR L3980 UPPER EXT FX ORTH L3982 MC SHORT ARM FX BRC L3982 UPPER EXT FX ORTH L3984 MC WRIST BRC/THUMB SPICA L3995 SOCK FRAC OR EQUAL EA L3995 SOCK FRAC OR EQUAL EA L3999 MC BUBBLE SPLNT LG L3999 MC BUBBLE SPLNT MD L3999 MC BUBBLE SPLNT SM L3999 MC ELBOW SPLNT L3999 UPPER LIMB ORTHOSIS NOS L4002 REPL STRAP ANY ORTHOSIS L4205 ORTHO DEV REPAIR 15 MIN L4205 ORTHO REPAIR DEV 15MIN L4210 C ORTHOTICS REPAIR EA L4210 ORTHO PARTS REPAIR/PLACE L4350 ANK ORTHOSIS RIGD PREFAB L4360 PNEUMAT WALK BOOT PRECST L4361 PNEUMA/VAC WALK BOOT OTS L4370 PNEUM FULL LEG SPLNT OTS L4386 NONPNEUM WALK BOOTPREFAB L4387 NONPNEUM WALK BOOTPREOTS L4396 AFO STATIC L4396 STATIC DYNAMIC AFOPRECST L4398 FOOT DROP SPLIT PRE OTS L5400 BK POST SURG RIGID DRESS L5450 LT POSTOP APP NONWGT BEAR Page 130 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $0.00 $469.00 $127.00 $0.00 $0.00 $72.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $311.00 $323.00 $0.00 $0.00 $0.00 $0.00 $449.00 $0.00 $0.00 $554.00 $574.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $47.00 $37.00 $0.00 $0.00 $63.00 $133.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $264.00 $122.00 $0.00 $0.00 2020 pricing Drugs&Supplies PROCEDURE NAME L5535 PREP BKPTB OPENENDSOCKET L5637 BELOW KNEE TOTAL CONTACT L5646 BELOW KNEE CUST SOCKET L5668 BK MOLDED DISTAL CUSHION L5684 BK FORK STRAP L5688 LT BK WAIST BELT WEBBING L5910 ENDO BELOW KNEE ALIGN L5940 ENDO BK ULTRALT MATERIAL L5974 FT SGL AXIS ANK FT L7520 LABOR ADJ PROSTH 15MIN L8010 C MASECT SLV20-30M 0-100 L8010 C MASECTSLV20-30M101-200 L8010 C MASECT SLV30-40M 0-100 L8420 PROSTH SOCK MULTI PLY BK L8440 LT SHRINKER BELOW KNEE L8460 LT SHRINKER ABOVE KNEE L8470 SOCK SGL PLY PROSTH BK L8499 MC COMPRESSION SPLING LG L8499 MC COMPRESSION SPLNT MD L8499 MC COMPRESSION SPLINT SM TB TRACH BIVONA UNCUF NEO2.5MM TB TRACH BIVONA UNCUF NEO3.0MM TRAY SPINAL CUST BZ L0460 TLSO 2 SHL SYMPHYSSTERN TRAY EPIDURAL CUSTOM ANES AIRW SUPRALARYNGEAL SZ4 L0650 LSO SC R ANTPOSPNLPREOTS L0120 CERV SOFT COLAR PREFAB FEE IONM HOURLY CODE FEE IONM BASELINE FEE IONM SUPPLIES PER CA L5685 BELOW KNEE SUSSEAL SLV IMMOB KNEE SGL PNL 20IN IMMOB KNEE SGL PNL 24IN GLIDESHEATH PNCLE TIF TIP 7FR TRAY LUBRISIL URNMETER 16FR AIRW SUPRALARYNGEAL SZ3 AIRW SUPRALARYNGEAL SZ5 L8465 SHRINKER UPPER LIMB DEV STATLOCK UNIV 6-8.5FR KT PRO-NOXMEDIUM DISP L2340 MOLD SHELL PRE-LABIAL L1833 KO ADJ JNL POS R SUP PRE CATH EXTL PUREWICK FEMALE KT AIRW SUPRAGLOTTIC LTS-D SZ2 L1810 KO ELAS W JOINT Page 131 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $279.00 $279.00 $96.00 $0.00 $166.00 $78.42 $0.00 $40.00 $927.00 $927.00 $534.00 $0.00 $104.00 $105.00 $143.00 $132.00 $78.42 $78.42 $0.00 $64.00 $100.00 $0.00 $0.00 $37.70 $199.21 $150.00 2020 pricing Drugs&Supplies PROCEDURE NAME L1900 AFO SPR WIR DFLX CALF BD L3060 SUPP FT ARCH LNG/META COLAR CERV PHILADEL MD 4.25IN L0454 TLSO TRNK SJ-T9 PRE CST L0623 RIG PNL PLV/SAC PRE OTS KT HYPER/HYPO VEST/LEG RAPR LG AIRW SUPRALARYNGEAL SZ2.5 L0830 CERV HALO MILWAUKEE ORTH L2280 MOLDED INNER BOOT PROBE COOLTIP REMOTE TEMP 20CM ER O2 OXYGEN DAILY SUT ETHILON 3-0 PS2 18 SUT PROLENE 4-0 PS2 18 CANN NASAL OPTIFL*VAT 6275797* SUT CHROMIC GUT 6-0 G1 18 SUT ETHILON 4-0 PS2 18 SUT ETHILON 5-0 C-2 BLK 18 CANN NASAL OXYGEN THERAPY PEDS DRSG HEMO QUIKCLOT 2X2 TB ESOPH BLAKEMORE ADLT 20FR BLN DILATOR CRE 15-18MM BSKT RX TRAPEZOID RETRV 2.5CM STNT WLLFLX COLON 25X90MM230CM FORCEPS RADJAW4 HOT 240CM PROBE SPYGLASS DIRECT VIS STNT WLLFLX ESOPH18MM15.3X12CM STNT WLLFLX COLON25X120MM230CM FORCEPS RADJAW4 LC NDLE 240CM SYS WATER BTL AQUASHIELD DISP SNARE SPIRAL 20MM BRUSH CYTOLOGY GASTROSCOPE DEV RESOLUTION CLIP 11MMX235CM STNT ADVANIX DBLPIGT 10FR 5CM STNT ADVANIX DUODEN RX7FR5CM STNT ADVANIX DUODEN RX10FR5CM STNT WLLFLX ESOPH23MM15.3X12CM STNT WLLFLX DUODEN 22X60MM STNT WLLFLX COLON 25X60MM230CM STNT WLLFLX COLON 22X60MM230CM STNT WLLFLX COLON 22X90MM230CM OVERTUBE GARDUS 8.6-10MMX50CM TB IRG TORRENT 305CM PROBE ERBE W FLTR 2200C TB ESOPH MINNESOTA 4L 18FR BLN DILATOR CRE ESOPH 18-20MM Page 132 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $436.00 $119.00 $45.76 $556.00 $46.00 $631.71 $199.21 $0.00 $0.00 $1,694.00 $28.00 $312.00 $20.00 $25.00 $119.00 $44.00 $20.00 $9.00 $47.00 $54.00 $1,327.00 $821.52 $1,023.00 $4,213.00 $203.00 $7,333.00 $3,667.00 $4,213.00 $193.00 $57.00 $152.00 $95.00 $587.00 $294.00 $664.35 $664.35 $3,667.00 $4,114.50 $4,213.00 $4,114.50 $4,114.50 $902.00 $62.00 $1,095.00 $1,595.33 $791.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLN DILATOR CRE ESOPH 15-18MM BLN DILATOR ESOPH CRE 12-15MM GDWIRE JAGWIRE HYDRA ST 260CM TB GASTRO REPL ST 20FR INFL DEV ENCORE 26 20CC KT COMPLIANCE SPINNER DBL TB GASTRO REPL ST 24FR MICROBIOTA FECAL PREP 250ML MICROBIOTA FECAL UPPER 30ML SNARE HISTOLOCK 2.4MX230CM BUTTON BLN LOPRO 20FR 1.2CM BUTTON BLN LOPRO 20FR 1.7CM BUTTONBLN20FR2.3*DISC 6141091* BUTTON BLN LOPRO 20FR 2.5CM BUTTON BLN LOPRO 20FR 2.7CM BUTTON BLN LOPRO 20FR 3.0CM BUTTON BLN LOPRO 20FR 3.5CM BUTTON BLN LOPRO 20FR 4.4CM BUTTON BLN LOPRO 24FR 1.5CM BUTTON BLN LOPRO 24FR 1.7CM BUTTON BLN LOPRO 24FR 2.0CM BUTTON BLN LOPRO 24FR 2.3CM BUTTON BLN LOPRO 24FR 2.5CM BUTTON BLN LOPRO 24FR 2.7CM BUTTON BLN LOPRO 24FR 3.0CM BUTTON BLN LOPRO 24FR 3.5CM BUTTON BLN LOPRO 24FR 4.0CM BUTTON BLN LOPRO 24FR 4.4CM BRUSH CYTOLOGY INFINITY DEV CLIP RESOLUTION360 11MMX235CM CIRCUIT ANES 10IN TB 2L KT STNT ADVANIX NOBARB 4FR 3CM STNT ADVANIX ST PANCR 4FR 3CM DEV ENDORING SLIM ADLT DEV ENDORING ADLTOD12.8-14.5MM GDWIRE NAVIPRO ST 0.018 260CM STNT WLLFLX RXFULL8.5FR10X60MM STNT WLLFLX RXFULL8.5FR10X80MM VALV SUCT AIR/WATER ORCA SYS WATER BTL CAP CO2 4IN MARKER GI SPOT EX ENDO TATTOO SET ANCHOR GASTRO SAF-T-PEXY PUSHER NAVIFLEX RX 4-5FR KT ENDO COMPLIANCE STD KT ENDO COMPLIANCE SPINNER TB GJ MIC ENDO 16FR 45CM Page 133 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $791.00 $791.00 $788.00 $205.00 $209.00 $78.00 $205.00 $4,785.00 $1,629.60 $466.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $487.00 $174.00 $1,113.00 $90.00 $885.00 $387.00 $95.00 $95.00 $538.00 $4,079.00 $4,079.00 $50.39 $60.16 $203.40 $576.00 $293.09 $102.37 $159.57 $1,138.00 2020 pricing Drugs&Supplies PROCEDURE NAME OXYGEN/HOUR TRAY BX JAMSHIDI TEMP CTRL ANCILLARY USER FILLABLE #1 PKNG NASAL RHINO RCKT LG SUT MONOCRYL+ 5-0 P3 UNDY BLADE LARYNSCP DISP MAC SZ4 PKNG NASAL RHINO RCKT XL PESSARY CUBE W HL SZ4 1-5/8 PESSARY CUBE W HL SZ2 1-3/8 STYLET INTUB 6FR Y90 BRACYTX NONSTRANDED PER SOURCE KT RADIOAEROSOL VERTI-SCAN24IN PAD WARMGEL NICU 10X16 SPLT FINGER EXT SHRT BLK LG SET UTENSIL BENDABLE SURE GRIP SPLT THB SPI LFT LG/XL PEN GRIP PENAGAIN ERGO-SOF LIFTER SAFETYSURE LEG UP SLV HEEL ELBOW XXL GLOVE COMP WRIST OPEN LOOP MD GLOVE COMP WRIST OPEN BLK XL GLOVE COMP OVRWRST FULL REG LG CUP INSULATED WEIGHTED UTENSILS WEIGHTED SET SOCK AID ROPE ADLT 30IN EASYWIPE FOLDING GLOVE ANTIVIB GEL FULL430-30MD MITT MOIST HEAT EXER HAND DIGI-FLEX YEL 1.5LB FINGER EXTENSOR EXER GLOVE COMP OVRWRST FULL LG BRC STBL ELBOW ADLT SPLT WRIST EPX AMBIFLEX MD SPLT WRIST EPX AMBIFLEX MD/LG SPLT ULNAR NERVE RT MD BRC WRIST D RING BLK LFT LG BRC WRIST D RING BLK RT LG BRC WRIST D RING BLK LFT MD BRC WRIST D RING BLK LFT SM BRC WRIST D RING BLK RT SM BRC WRIST D RING BLK LFT XL BRC WRIST D RING BLK RT XL BRC WRIST D RING BLK LFT XS BRC WRIST DRING BLK RIGHT XS BRC ELBOW SUPP IMAK UNIV GLOVE COMP WRIST OPEN GRY SM Page 134 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $17.00 $132.00 $129.00 $90.57 $27.00 $114.37 $90.57 $281.80 $281.80 $97.00 $32,881.00 $155.00 $72.00 $72.00 $149.00 $66.00 $65.00 $122.00 $107.00 $145.00 $137.00 $204.00 $273.00 $284.00 $72.00 $285.00 $256.00 $111.00 $71.00 $263.00 $69.00 $243.00 $99.00 $99.00 $339.00 $93.00 $93.00 $93.00 $92.00 $92.00 $92.00 $92.00 $92.00 $92.00 $132.00 $103.00 2020 pricing Drugs&Supplies PROCEDURE NAME GLOVE COMP OVRWRST OPEN RT XS SPLT HAND W STRAP LFT SM SPLT HAND W STRAP RT MD SPLT HAND W STRAP RT LG SPLT WRIST IN-LINE RT SM SPLT ARM THERMOPLASTIC RT SM GLOVE COMP WRIST OPEN SLIPONLG GLOVE COMP WRIST OPEN LOOP LG GLOVE ANTIVIB AIR OPEN LOOP MD SPLT HAND DYNAPRO FLEX RT BRC WRIST ORTHOSIS DYNAMIC MD SPLT HAND ANTIMIC WHFO RT SM SPLT ULNAR DEV RADIAL LFT MD HAND GAUNTLET FABRIFOAM RT WRITING CLAW SET OF 4 SM BRC THB SPICA RT LG PEN WEIGHTED BLK INK BRC TRIGGER FINGER SOL SM BRC TRIGGER FINGER SOL LG BRC TRIGGER FINGER SOL XL PEN EZ GRIP GLOVE COMP OVRWRST FULL MD STRAP MATERIAL NEOP 1.5X3.5YD GONIOMETER ST JAMAR EZ READ GLOVE COMP OPEN FINGER LFT SM AID STKNG SUPREME AID STKNG MBOSS W RIDGES PCKT UTENSIL RT ANG BAR THERABAND FLEXBAR GRN 15LB BRC WRIST D-RING BLK RT XSM GLOVE COMP OPEN FINGER LFT XSM GRIP PEN WANCHIK WRITER LFT SM GRIP PEN WANCHIK WRITER LFT LG GRIP PEN WANCHIK WRITER RT LG LIFTER LEG ADJ SZ 22 GRIPPER KEY TURNER 2KEY GRIPPER KEY TURNER 1KEY TRAY CONTIPLEX TUOHY NDLE 4IN SET TUOHY INSULATE NDLE 18GX2 ADH SKIN DERMABOND 0.7ML PK TX1 PRCD TRAY PAIN DR AYLOR CUST BZ NDLE ECHOBLOCK 21GX2.00 NDLE ECHOBLOCK 21GX3 1/8 COV TRANSD SHEATH 4-5.5 KT COOL RF COOLIEF 17G 75X4MM Page 135 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $95.00 $185.00 $185.00 $185.00 $204.00 $206.00 $138.00 $145.00 $249.00 $454.00 $203.00 $347.00 $294.00 $63.00 $79.00 $56.00 $226.00 $61.00 $61.00 $61.00 $55.00 $88.00 $124.00 $253.00 $96.00 $107.00 $89.00 $77.00 $100.00 $94.00 $96.00 $138.00 $138.00 $138.00 $85.00 $60.00 $47.00 $172.00 $149.00 $104.00 $2,201.00 $46.57 $48.43 $48.43 $65.00 $2,158.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT COOL RF COOLIEF 17G 100X4MM PK TX2 PRCD NDLE ULTRSND ECHOBLOCK 21GX6 KT COOL RF COOLIEF 17G 50X4MM KT COOL RF COOLIEF 17G 150X4MM INTRO RF COOLED COOLIEF4X100MM INTRO RF COOLED COOLIEF 4X50MM BRC ANK AIRCASTAIRSPORT LFT LG BRC ANK AIRCASTAIRSPORT LFT MD BRC ANK AIRCASTAIRSPORT LFT SM SUPP RL NIGHT MCKENZIE LG/XL BRC AFO SWEDISH MEN WHT LFT BRC AFO SWEDISH MEN WHT RT PK HOT COLD CORPAK SOFT 10X13 PK HOT COLD CORPAK SOFT 6X20 ROLLER THERABAND MASSAGER TAPING BASE CRAMER TUF-SKIN 8O BELT GAIT BARIATRIC 96IN BELT GAIT 6 HNDLD PAD CRUTCH UNDERARM BELT GAIT PASTEL 60IN BRC ANK AIRCAST AIRSPORT RT LG BRC ANK AIRCAST AIRSPORT RT SM DISC CANDO BALANCE BLU 14IN TRACTION SUPINE CTRAX W HALTER BRC AFO SWEDISH WOMEN WHT RT BRC AFO SWEDISH WOMEN WHT LFT WARMER GEL SGL BTL CANE OFSET BARIATRIC TALL37-46 PK COLD GEL UNI-PATCH CERV 23 LADDER AGIL FLAT RUNG 15FT SPLT PLANTAR FASCITIS MD CUP MASSAGE FACIAL SIL STD SUPP RL NIGHT MCKENZIE XS PAD SWELL SPOT PALMAR SM BNDG KOMPREY-BINDE 10X2CM KT CIRCAID ARM RDCTN PAD SWELL SPOT PALMAR LG PAD SWELL SPOT FULL BRA LG PAD SWELL SPOT FULL BRA MD PAD LYMPH RB 8X12 PAD LYMPH FINELY NAPPED 8X12 PAD LYMPH COARSELY NAPPED 8X12 PAD SWELL SPOT LAT BRA NDLE ACUPNC L 25X60MM NDLE ACUPNC L 25X40MM Page 136 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,158.00 $2,316.00 $59.00 $2,329.00 $2,329.00 $452.00 $452.00 $259.00 $259.00 $259.00 $161.00 $145.00 $145.00 $54.00 $48.00 $131.00 $62.00 $218.00 $161.00 $35.00 $316.00 $259.00 $259.00 $127.00 $212.00 $145.00 $145.00 $477.00 $221.00 $98.00 $259.00 $246.00 $53.00 $141.00 $114.00 $111.00 $730.00 $113.00 $183.00 $175.00 $61.00 $65.00 $65.00 $114.00 $83.00 $83.00 2020 pricing Drugs&Supplies PROCEDURE NAME NDLE ACUPNC L 25X30MM ELTD STIM EMG VAG RL FM AXIS BLK FIRM BALL EXER REFLEX GRN ELTD EASYTRODE PREGELLED SUPP BACK AIRBACK SLFINFL 16X8 SUPP NECK AIRBACK INFL 14X5IN STRAP LUMBAR MULLIGAN SLF SNAG COV TERRY HYDROCOLLATOR 24X36 BRACHY THERAPY NEEDLE BRACHY SOURCE STRAND IODINE-125 PER SOURCE NDLE BRACHY SEED IMPLT18GX20CM MARKER FIDUCIAL 18GX20 0.9X3MM CLAMP INCONT BAUMRUCKER CATH CENTVEN HICK DL 9FR 90CM CRYOPROBE SLIMLINE 2.4MM GLOVE RADIATION EPIM PF 8.5 TB GASTRO ENTUIT BR BLN 18FR SET FEED ENTUIT START MD CATH PICC TURBOJECT ONT 5FR CATH PICC TURBOJECT 4FR 17G SYR ALLIANCE INFL KT GASTRO MIC LOPRO 14FR 1.0CM KT GASTRO MIC LOPRO 14FR 1.2CM KT GASTRO MIC LOPRO 14FR1.5CM PK CMNT HV-R BONE KYPHX KT GASTRO MIC LOPRO 16FR 2.0CM KT GASTRO MIC LOPRO 20FR 3.5CM TRAY CHEST THAL QK 24FR 41CM DRN DAWSON MUELLER 10.2FR25CM DRN DAWSON MUELLER 12FR 25CM CATH DRN MULTPRP LK 14FR 45CM CATH DRN BILI 18FR 61CM CATH DRN BILI 20FR 61CM KT GASTRO MIC LOPRO 16FR 2.5CM SET CHEST TB THAL QK 20FR 41CM TB JEJ MIC BLN 7-10ML 14FR TB GJ MIC ENDO 16FR 45CM TRAY 1ST FRAC EXPRESS 15/2 NDLE KOPANS BREAST 20GX9CM TB JEJ MIC BLN 7-10ML 18FR STNT VIABIL WO HL 10X80MM 40CM PLEURA VAC MOBILE MINI DRN DAWSON MUELLER 14FR 25CM SHEATH PEELAWAY8FR0.038 15.5CM NDLE GD W COV 14X91.5CM Page 137 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $83.00 $210.00 $105.00 $108.00 $623.00 $96.00 $58.00 $73.00 $158.00 $20.00 $113.00 $21.00 $435.00 $246.00 $754.00 $3,600.00 $173.00 $256.00 $428.00 $856.00 $865.30 $173.00 $523.00 $533.00 $533.00 $979.00 $523.00 $512.79 $688.00 $352.00 $353.00 $413.87 $527.00 $534.00 $521.00 $602.00 $705.00 $1,069.00 $7,359.00 $129.00 $711.00 $5,257.00 $337.00 $353.00 $216.00 $99.00 2020 pricing Drugs&Supplies PROCEDURE NAME DRN SYS SAFE-T-CENTESIS 6FR DEV BX BONE KYPHON 3.4MM 10G KT ASPIRA DRSG TB GJ G-JET 14FR 1.0 15CM TB GJ G-JET 14FR 1.5 15CM TB GJ G-JET 14FR 1.5 22CM SUT PROLENE 3-0 FSL 30 BG DRN W PORT URES 500ML SUCT MANIFOLD NEPTUNE2 1 PORT KT CATH TRIALYSIS CURV EXT20CM STNT VIABIL HL 8X60MM 40CM NDLE SPINAL SPROTTE 20GX3.5 TB JEJ MIC BLN 3-5ML 12FR CATH GLIDE ANG 5FR 65CM DRAPE PROBE COV GELULTRSND6X96 HOOD O2 BRIAN HUT TODDLER CATH CONN TITAN 2PC CATH DIALYS PERITON ADLT STD SET INTR DENNY 4.5FR 65CM TB GJ G-JET 14FR 2.0 22CM KT BX MISSION 18GX20CM ANTENNA EMPRINT SHRT 15CM ANTENNA EMPRINT LNG 30CM SCREW T20 CORT SLFTP 3.5X22MM SHEATH PEELAWAY 10FR0.038 15.5 SHEATH INTR PEELAWAY12FR15.5CM SHEATH INTR PEELAWAY14FR15.5CM SHEATH PEELAWAY 16FR0.038 15.5 SHEATH PEELAWAY 5FR .035 13CM SHEATH PEELAWAY9FR0.038 15.5CM GDWIRE TORQFLEX ST MOD130 .018 TRAY BONE BX 13G 14CM TRAY BONE BX 13G 19CM CATH KUMPE 0.038 5FR 40CM CATH POWERGLIDE BASIC 18GX8CM CATH POWERGLIDE BASIC 20GX8CM CATH POWERGLIDE BASIC 20GX10CM CATH POWERGLIDE BASIC 22GX8CM HEMO SEAL TISSEEL FIBRIN 10ML TB GJ G-JET 16FR 2.0 22CM TB GASTRO MIC BLN 7-10ML 30FR CATH H/S KRATON 5FR CATH PICC TURBOJECT DLNIT5FR60 CATH PICC TURBOJECT SL OTW 4FR CATH PICC TURBOJECT SL NIT 4FR CATH PICC TURBOJECT OTWTL6FR60 Page 138 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $289.00 $683.00 $111.00 $153.00 $1,379.00 $1,492.00 $14.00 $199.00 $68.00 $468.73 $5,180.00 $74.00 $711.00 $284.00 $28.00 $153.00 $783.00 $903.00 $242.00 $1,492.00 $239.00 $6,508.00 $6,508.00 $236.00 $214.00 $216.00 $214.00 $249.00 $214.00 $214.00 $270.00 $1,379.00 $4,690.00 $77.00 $294.00 $294.00 $297.00 $280.00 $1,785.00 $1,492.00 $176.00 $163.00 $561.00 $537.00 $545.00 $886.00 2020 pricing Drugs&Supplies PROCEDURE NAME CAP DIST ATTACH REVEAL ADLT CAP DIST ATTACH REVEAL PED ANTENNA EMPRINT 20CM NDLE BX ACHIEVE COAX 18GX11CM FORCEP BX MYOCARDIAL 5.2FR60CM NDLE TUOHY HUBER TIP 14G PROBE KT SGL 20MM PROBE KT DUAL 10MM KT BONE ACCESS 090 10G CATH SPG BLOCK SPHENOCATH KT CATH TRIALYSIS CURV EXT15CM TRAY THORA-PARA 5FR STNT VIABIL HL 10MMX10CM 40CM CATH DIL VAN ANDEL 8FR 50CM TRAY BX BONE 12G 14CM TRAY BX BONE 12G 19CM TB GASTRO MIC BLN 7-10ML 30FR KT POWERGLIDE PRO BASIC22G 8CM KT POWERGLIDE PRO BASIC20G 8CM KT POWERGLIDE PROBASIC20G 10CM KT POWERGLIDE PRO BASIC18G 8CM KT POWERGLIDE PROBASIC18G 10CM SET STNT URETRL AMPLZ8.5FR10CM TIP COLOSTOMY ENEMA NIPPLE CATH HEMODIAL HICK 13.5FR 40CM CATH HEMODIAL HICK 13.5FR 45CM NDLE ICEPEARL 2.1CX 90D KT PERITON DIAYS WO CATH KT INTR MINI-NV SS/PT 6FR 60CM CATH PICC TURBOJECT DLSS5FR150 DEV BX BONE KYPHON V 15G KT POWERGLIDE GUARDIVA 18G 8CM KT POWERGLIDE GUARDIVA 18G10CM KT POWERGLIDE GUARDIVA 20G 8CM KT POWERGLIDE GUARDIVA 20G10CM KT DRN STARTER PERITON ASPIRA KT DRN VALV REPAIR ASPIRA ADPTR TB DRN UNIV ASPIRA KT DRN STARTER PLEURAL ASPIRA KT DRSG ASPIRA DRN INTR SHEATH TEARAWAY 8FR 30CM O2 USE INITIAL DAY O2 USE SUBSEQ DAY INCENTIVE SPIROMETER HELIOX PER HOUR CIRCUIT VENTILATOR SGL HEATED Page 139 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $118.00 $118.00 $6,508.00 $290.66 $2,160.82 $764.00 $7,882.00 $10,076.00 $1,639.00 $683.00 $468.73 $166.00 $5,434.00 $91.00 $1,447.00 $1,447.00 $879.00 $332.00 $332.00 $332.00 $332.00 $332.00 $633.00 $79.00 $778.00 $778.00 $3,567.00 $897.00 $1,996.00 $882.00 $778.00 $392.22 $392.22 $392.22 $392.22 $2,812.60 $230.01 $230.01 $2,812.60 $132.59 $311.56 $327.00 $327.00 $66.00 $84.00 $139.00 2020 pricing Drugs&Supplies PROCEDURE NAME EXTR STONE NCIRCLE NIT 2.2FR BRUSH CYTOLOGY ENDO HLDR ET TB ANCHOR CATH CLSD DBL SWIVEL 14FR 12 CATH DRN MULTPRP 16.0FR 25CM ROTH NET PEDS 1.8MM 160CM SEAL FM SLC PETITE ZEST MASK FORCEPS BX BROCHOSCOPY CANN OPTIFLOW JUNIOR PREIME CIRCUIT SPU METANEB W NEB CIRCUIT EVAQUA II VENT TB ET MICROCUFF SUBGLOT 8.0MM NDLE ASPIR EBUS TBNA 21GX40MM NDLE ASPIR EBUS TBNA 22GX40MM ADPTR SWIVEL Y BODAI PEEP SCOPE ASCOPE 3 REG 5.0/2.2MM CHAMBER HUMIDIFICATION TB HEATED BREATHING MYAIRVO ADPTR MASK INTERFACE GUARD TRACH TILSON RSVR WATER REFILLABLE MYAIRVO CONVERTER DCNADC AIRSENSE 10 COV SIDE AIRSENSE 10 CHARCOAL CUSH CPAP NASAL KIDSTA REPL SM CUSH CPAP MOUTH LIBERTY SM MASK SYS SWIFT FX NANO WIDE CUSH EASYLIFE MD HEADGEAR FITLIFE SM CHAMBER WATER MASK ONLY FITLIFE LG MASK CPAP NASAL ESON HDGEAR SM MASK CPAP NASAL ESON HDGEAR MD MASK CPAP NASAL ESON HDGEAR LG MASK CPAP SIMPLUS FULL MD MASK QUATTRO FX HER FULL SM MASK QUATTRO FX HER FULL MD MASK QUATTRO AIR HER FULL XS MASK TOTAL FACE W HDGEAR HDGEAR ASSY AIRFIT P10 STD MASK CPAP NASAL W HEADGEAR CUSH REPL MASK CPAP NASALSM/MD CUSH REPL MASK CPAP NASAL LG MASK CPAP NASAL PILLOW NUANCE MASK CPAP NASAL W HEADGEAR YTH CUSH REPL MASK CPAP NASAL XL MASK CPAP NASAL DREAMWEAR SM Page 140 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,036.00 $65.00 $42.00 $49.00 $354.00 $515.00 $117.00 $155.00 $260.00 $402.00 $207.63 $104.00 $595.00 $419.00 $170.24 $1,180.00 $67.00 $769.00 $158.00 $62.00 $225.00 $355.00 $59.00 $76.00 $129.00 $258.00 $105.00 $117.00 $83.00 $709.00 $280.00 $280.00 $280.00 $413.00 $464.00 $656.00 $656.00 $683.00 $99.00 $310.00 $106.00 $106.00 $89.00 $485.00 $117.00 $275.00 2020 pricing Drugs&Supplies PROCEDURE NAME MASK CPAP DREAMWEAR MD CUSH SM FITPAK CPAP DREAMWEAR HDGEARMD CUSH CPAP NASAL DREAMWEAR SM CUSH CPAP NASAL DREAMWEAR MD CUSH CPAP NASAL DREAMWEAR LG WATER CHAMBER DREAMSTATION CUSH CPAP NASAL ESON SM CUSH CPAP NASAL ESON MD CUSH CPAP NASAL ESON LG CUSH SEAL CPAP FLEXIFIT 406PET SEAL SIMPLUS CUSH MD CPAP DREAMSTATION W HUMIDIFIER STRAP CHIN HALO HDGEAR MASK FLEXIFIT 406 MASK FLEXIFIT 407 TB DREAMSTATION HEATED TB SYS ONE HEATED NDLE BX VIZISHOT 2 FLEX 19G TISS WHOLE CORNEA TISS CORNEA PRECUT ENDOTHEL SUT PLAIN GUT 6-0 G1/G1 18 SUT CHROMIC GUT 4-0 G2/G2 18 SUT VICRYL 5-0 S14 18 DYE BLADE SAG SM COARSE ST5.5X25.7 BLADE SAG SM FINE ST 9.5X25.7 IOL PMMA ANT 5.5X12.5 10.0 IOL PMMA ANT 5.5X12.5 11.0 IOL PMMA ANT 5.5X12.5 12.0 IOL PMMA ANT 5.5X12.5 13.0 IOL PMMA ANT 5.5X12.5 14.0 IOL PMMA ANT 5.5X12.5 15.0 IOL PMMA ANT 5.5X12.5 16.0 IOL PMMA ANT 5.5X12.5 17.0 IOL PMMA ANT 5.5X12.5 18.0 IOL PMMA ANT 5.5X12.5 20.0 IOL PMMA ANT 5.5X12.5 21.0 IOL PMMA ANT 5.5X12.5 22.0 IOL PMMA ANT 5.5X12.5 23.0 IOL PMMA ANT 5.5X12.5 24.0 IOL PMMA ANT 5.5X12.5 25.0 IOL PMMA ANT 5.5X12.5 26.0 IOL PMMA ANT 5.5X12.5 27.0 IOL PMMA ANT 5.5X12.5 28.0 IOL PMMA ANT 5.5X12.5 29.0 IOL PMMA ANT 5.5X13MM 10.0 IOL PMMA ANT 5.5X13MM 11.0 Page 141 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $275.00 $310.00 $105.00 $105.00 $105.00 $82.00 $76.00 $76.00 $77.00 $111.00 $173.00 $1,189.00 $117.00 $310.00 $310.00 $173.00 $173.00 $1,113.00 $5,771.00 $9,590.00 $92.00 $89.00 $68.00 $40.00 $40.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PMMA ANT 5.5X13MM 12.0 IOL PMMA ANT 5.5X13MM 13.0 IOL PMMA ANT 5.5X13MM 14.0 IOL PMMA ANT 5.5X13MM 15.0 IOL PMMA ANT 5.5X13MM 16.0 IOL PMMA ANT 5.5X13MM 17.0 IOL PMMA ANT 5.5X13MM 18.0 IOL PMMA ANT 5.5X13MM 19.0 IOL PMMA ANT 5.5X13MM 20.0 IOL PMMA ANT 5.5X13MM 21.0 IOL PMMA ANT 5.5X13MM 22.0 IOL PMMA ANT 5.5X13MM 24.0 IOL PMMA ANT 5.5X13MM 25.0 IOL PMMA ANT 5.5X13MM 26.0 IOL PMMA ANT 5.5X13MM 27.0 IOL PMMA ANT 5.5X13MM 28.0 IOL PMMA ANT 5.5X13MM 29.0 IOL PMMA ANT 5.5X13MM 6.0 IOL PMMA ANT 5.5X13MM 7.0 IOL PMMA ANT 5.5X13MM 8.0 IOL PMMA ANT 5.5X13MM 9.0 IOL PMMA ANT 5.5X13.5 10.0 IOL PMMA ANT 5.5X13.5 11.0 IOL PMMA ANT 5.5X13.5 12.0 IOL PMMA ANT 5.5X13.5 13.0 IOL PMMA ANT 5.5X13.5 14.0 IOL PMMA ANT 5.5X13.5 15.0 IOL PMMA ANT 5.5X13.5 16.0 IOL PMMA ANT 5.5X13.5 17.0 IOL PMMA ANT 5.5X13.5 18.0 IOL PMMA ANT 5.5X13.5 19.0 IOL PMMA ANT 5.5X13.5 20.0 IOL PMMA ANT 5.5X13.5 21.0 IOL PMMA ANT 5.5X13.5 22.0 IOL PMMA ANT 5.5X13.5 23.0 IOL PMMA ANT 5.5X13.5 24.0 IOL PMMA ANT 5.5X13.5 25.0 IOL PMMA ANT 5.5X13.5 26.0 IOL PMMA ANT 5.5X13.5 27.0 IOL PMMA ANT 5.5X13.5 28.0 IOL PMMA ANT 5.5X13.5 29.0 IOL PMMA ANT 5.5X13.5 6.0 IOL PMMA ANT 5.5X13.5 7.0 IOL PMMA ANT 5.5X13.5 8.0 IOL PMMA ANT 5.5X13.5 9.0 IOL SENSAR 13.0MM 10.0 Page 142 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $912.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SENSAR 13.0MM 11.0 IOL SENSAR 13.0MM 12.0 IOL SENSAR 13.0MM 12.5 IOL SENSAR 13.0MM 13.0 IOL SENSAR 13.0MM 13.5 IOL SENSAR 13.0MM 14.0 IOL SENSAR 13.0MM 14.5 IOL SENSAR 13.0MM 15.0 IOL SENSAR 13.0MM 15.5 IOL SENSAR 13.0MM 16.0 IOL SENSAR 13.0MM 16.5 IOL SENSAR 13.0MM 17.0 IOL SENSAR 13.0MM 17.5 IOL SENSAR 13.0MM 18.0 IOL SENSAR 13.0MM 18.5 IOL SENSAR 13.0MM 19.0 IOL SENSAR 13.0MM 19.5 IOL SENSAR 13.0MM 20.0 IOL SENSAR 13.0MM 20.5 IOL SENSAR 13.0MM 21.0 IOL SENSAR 13.0MM 21.5 IOL SENSAR 13.0MM 22.0 IOL SENSAR 13.0MM 23.5 IOL SENSAR 13.0MM 24.0 IOL SENSAR 13.0MM 24.5 IOL SENSAR 13.0MM 25.0 IOL SENSAR 13.0MM 25.5 IOL SENSAR 13.0MM 26.0 IOL SENSAR 13.0MM 27.0 IOL SENSAR 13.0MM 28.0 IOL SENSAR 13.0MM 29.0 IOL SENSAR 13.0MM 30.0 IOL RESTOR IQ MULT 4.0D 10.0 IOL RESTOR IQ MULT 4.0D 10.5 IOL RESTOR IQ MULT 4.0D 11.0 IOL RESTOR IQ MULT 4.0D 11.5 IOL RESTOR IQ MULT 4.0D 12.0 IOL RESTOR IQ MULT 4.0D 12.5 IOL RESTOR IQ MULT 4.0D 13.0 IOL RESTOR IQ MULT 4.0D 13.5 IOL RESTOR IQ MULT 4.0D 14.0 IOL RESTOR IQ MULT 4.0D 14.5 IOL RESTOR IQ MULT 4.0D 15.0 IOL RESTOR IQ MULT 4.0D 15.5 IOL RESTOR IQ MULT 4.0D 16.0 IOL RESTOR IQ MULT 4.0D 16.5 Page 143 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RESTOR IQ MULT 4.0D 17.0 IOL RESTOR IQ MULT 4.0D 17.5 IOL RESTOR IQ MULT 4.0D 18.0 IOL RESTOR IQ MULT 4.0D 18.5 IOL RESTOR IQ MULT 4.0D 19.0 IOL RESTOR IQ MULT 4.0D 19.5 IOL RESTOR IQ MULT 4.0D 20.0 IOL RESTOR IQ MULT 4.0D 20.5 IOL RESTOR IQ MULT 4.0D 21.0 IOL RESTOR IQ MULT 4.0D 21.5 IOL RESTOR IQ MULT 4.0D 22.0 IOL RESTOR IQ MULT 4.0D 22.5 IOL RESTOR IQ MULT 4.0D 23.0 IOL RESTOR IQ MULT 4.0D 23.5 IOL RESTOR IQ MULT 4.0D 24.0 IOL RESTOR IQ MULT 4.0D 24.5 IOL RESTOR IQ MULT 4.0D 25.0 IOL RESTOR IQ MULT 4.0D 25.5 IOL RESTOR IQ MULT 4.0D 26.0 IOL RESTOR IQ MULT 4.0D 26.5 IOL RESTOR IQ MULT 4.0D 27.0 IOL RESTOR IQ MULT 4.0D 27.5 IOL RESTOR IQ MULT 4.0D 28.0 IOL RESTOR IQ MULT 4.0D 28.5 IOL RESTOR IQ MULT 4.0D 29.0 IOL RESTOR IQ MULT 4.0D 29.5 IOL RESTOR IQ MULT 4.0D 30.0 IOL PMMA ANT 5.5X12.5 5.0 IOL PMMA ANT 5.5X12.5 6.0 IOL PMMA ANT 5.5X12.5 7.0 IOL PMMA ANT 5.5X12.5 8.0 IOL PMMA ANT 5.5X12.5 9.0 IOL PMMA ANT 5.5X12.5 21.5 IOL PMMA ANT 5.5X12.5 30.0 IOL PMMA ANT 5.5X13MM 5.0 IOL PMMA ANT 5.5X13MM 21.5 IOL PMMA ANT 5.5X13MM 30.0 IOL PMMA ANT 5.5X13.5 5.0 IOL PMMA ANT 5.5X13.5 21.5 IOL PMMA ANT 5.5X13.5 30.0 IOL ACRYSOF SGL 0D 35.0 IOL ACRYSOF IQ 0D NAT 6.0 IOL ACRYSOF IQ 0D NAT 7.0 IOL ACRYSOF IQ 0D NAT 8.0 IOL ACRYSOF IQ 0D NAT 9.0 IOL ACRYSOF IQ 0D NAT 10.0 Page 144 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $464.00 $464.00 $464.00 $693.00 $782.00 $782.00 $782.00 $782.00 $782.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF IQ 0D NAT 10.5 IOL ACRYSOF IQ 0D NAT 11.0 IOL ACRYSOF IQ 0D NAT 11.5 IOL ACRYSOF IQ 0D NAT 12.0 IOL ACRYSOF IQ 0D NAT 12.5 IOL ACRYSOF IQ 0D NAT 13.0 IOL ACRYSOF IQ 0D NAT 13.5 IOL ACRYSOF IQ 0D NAT 14.0 IOL ACRYSOF IQ 0D NAT 14.5 IOL ACRYSOF IQ 0D NAT 15.0 IOL ACRYSOF IQ 0D NAT 15.5 IOL ACRYSOF IQ 0D NAT 16.0 IOL ACRYSOF IQ 0D NAT 16.5 IOL ACRYSOF IQ 0D NAT 17.0 IOL ACRYSOF IQ 0D NAT 17.5 IOL ACRYSOF IQ 0D NAT 18.0 IOL ACRYSOF IQ 0D NAT 18.5 IOL ACRYSOF IQ 0D NAT 19.0 IOL ACRYSOF IQ 0D NAT 19.5 IOL ACRYSOF IQ 0D NAT 20.0 IOL ACRYSOF IQ 0D NAT 20.5 IOL ACRYSOF IQ 0D NAT 21.0 IOL ACRYSOF IQ 0D NAT 21.5 IOL ACRYSOF IQ 0D NAT 22.0 IOL ACRYSOF IQ 0D NAT 22.5 IOL ACRYSOF IQ 0D NAT 23.0 IOL ACRYSOF IQ 0D NAT 23.5 IOL ACRYSOF IQ 0D NAT 24.0 IOL ACRYSOF IQ 0D NAT 24.5 IOL ACRYSOF IQ 0D NAT 25.0 IOL ACRYSOF IQ 0D NAT 25.5 IOL ACRYSOF IQ 0D NAT 26.0 IOL ACRYSOF IQ 0D NAT 26.5 IOL ACRYSOF IQ 0D NAT 27.0 IOL ACRYSOF IQ 0D NAT 27.5 IOL ACRYSOF IQ 0D NAT 28.0 IOL ACRYSOF IQ 0D NAT 28.5 IOL ACRYSOF IQ 0D NAT 29.0 IOL ACRYSOF IQ 0D NAT 29.5 IOL ACRYSOF IQ 0D NAT 30.0 IOL PMMA ANT 5.5X12MM 16.5 IOL PMMA ANT 5.5X13MM 16.5 IOL PMMA ANT 5.5X13.5 17.5 IOL TECNIS 3PC 5D 10.0 IOL TECNIS 3PC 5D 10.5 IOL TECNIS 3PC 5D 11.0 Page 145 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $531.00 $457.00 $464.00 $782.00 $869.00 $782.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TECNIS 3PC 5D 11.5 IOL TECNIS 3PC 5D 12.0 IOL TECNIS 3PC 5D 12.5 IOL TECNIS 3PC 5D 13.0 IOL TECNIS 3PC 5D 13.5 IOL TECNIS 3PC 5D 14.0 IOL TECNIS 3PC 5D 14.5 IOL TECNIS 3PC 5D 15.0 IOL TECNIS 3PC 5D 15.5 IOL TECNIS 3PC 5D 16.0 IOL TECNIS 3PC 5D 16.5 IOL TECNIS 3PC 5D 17.0 IOL TECNIS 3PC 5D 17.5 IOL TECNIS 3PC 5D 18.0 IOL TECNIS 3PC 5D 18.5 IOL TECNIS 3PC 5D 19.0 IOL TECNIS 3PC 5D 19.5 IOL TECNIS 3PC 5D 20.0 IOL TECNIS 3PC 5D 20.5 IOL TECNIS 3PC 5D 21.0 IOL TECNIS 3PC 5D 21.5 IOL TECNIS 3PC 5D 22.0 IOL TECNIS 3PC 5D 22.5 IOL TECNIS 3PC 5D 23.0 IOL TECNIS 3PC 5D 23.5 IOL TECNIS 3PC 5D 24.0 IOL TECNIS 3PC 5D 24.5 IOL TECNIS 3PC 5D 25.0 IOL TECNIS 3PC 5D 25.5 IOL TECNIS 3PC 5D 26.0 IOL TECNIS 3PC 5D 26.5 IOL TECNIS 3PC 5D 27.0 IOL TECNIS 3PC 5D 27.5 IOL TECNIS 3PC 5D 28.0 IOL TECNIS 3PC 5D 28.5 IOL TECNIS 3PC 5D 29.0 IOL TECNIS 3PC 5D 29.5 IOL TECNIS 3PC 5D 30.0 IOL PMMA ANT 5.5X12.5 19.0 IOL PMMA ANT 5.5X13MM 23.0 IOL SENSAR 13.0MM 22.5 IOL SENSAR 13.0MM 23.0 IOL ACRYSOF MULT 10D 6.0 IOL ACRYSOF MULT 10D 6.5 IOL ACRYSOF MULT 10D 7.0 IOL ACRYSOF MULT 10D 7.5 Page 146 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $782.00 $869.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $457.00 $457.00 $912.00 $912.00 $659.00 $659.00 $659.00 $659.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF MULT 10D 8.0 IOL ACRYSOF MULT 10D 8.5 IOL ACRYSOF MULT 10D 9.0 IOL ACRYSOF MULT 10D 9.5 IOL ACRYSOF MULT 10D 10.5 IOL ACRYSOF MULT 10D 11.0 IOL ACRYSOF MULT 10D 11.5 IOL ACRYSOF MULT 10D 12.0 IOL ACRYSOF MULT 10D 12.5 IOL ACRYSOF MULT 10D 13.0 IOL ACRYSOF MULT 10D 13.5 IOL ACRYSOF MULT 10D 14.0 IOL ACRYSOF MULT 10D 14.5 IOL ACRYSOF MULT 10D 15.0 IOL ACRYSOF MULT 10D 15.5 IOL ACRYSOF MULT 10D 16.0 IOL ACRYSOF MULT 10D 16.5 IOL ACRYSOF MULT 10D 17.0 IOL ACRYSOF MULT 10D 17.5 IOL ACRYSOF MULT 10D 18.0 IOL ACRYSOF MULT 10D 18.5 IOL ACRYSOF MULT 10D 19.0 IOL ACRYSOF MULT 10D 19.5 IOL ACRYSOF MULT 10D 20.0 IOL ACRYSOF MULT 10D 20.5 IOL ACRYSOF MULT 10D 21.0 IOL ACRYSOF MULT 10D 21.5 IOL ACRYSOF MULT 10D 22.0 IOL ACRYSOF MULT 10D 22.5 IOL ACRYSOF MULT 10D 23.0 IOL ACRYSOF MULT 10D 23.5 IOL ACRYSOF MULT 10D 24.0 IOL ACRYSOF MULT 10D 24.5 IOL ACRYSOF MULT 10D 25.0 IOL ACRYSOF MULT 10D 25.5 IOL ACRYSOF MULT 10D 26.0 IOL ACRYSOF MULT 10D 26.5 IOL ACRYSOF MULT 10D 27.0 IOL ACRYSOF MULT 10D 27.5 IOL ACRYSOF MULT 10D 28.0 IOL ACRYSOF MULT 10D 28.5 IOL ACRYSOF MULT 10D 29.0 IOL ACRYSOF MULT 10D 29.5 IOL ACRYSOF MULT 10D 30.0 IOL ACRYSOF SGL 0D 33.0 IOL ACRYSOF SGL 0D 31.0 Page 147 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $659.00 $693.00 $693.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SENSAR MENISC -5.0 IOL ACRYSOF SGL 0D NAT 22.5 IOL SENSAR MENISC -4.0 IOL ACRYSOF SGL 0D NAT 20.0 IOL ACRYSOF SGL 0D 40.0 IOL SENSAR 13.0MM 26.5 IOL SENSAR 13.0MM 6.5 IOL ACRYSOF SGL 0D NAT 16.5 IOL ACRYSOF SGL 0D NAT 19.5 IOL ACRYSOF SGL 0D NAT 32.0 IOL PMMA ANT 5.5X13MM 17.5 IOL ACRYSOF SGL 0D NAT 33.0 IOL SENSAR MENISC 1.0 IOL ACRYSOF SGL 0D NAT 34.0 IOL SENSAR 13.5MM 3.0 GLAUCOMA VALV AHMED FLEX PLATE IOL SENSAR 13.5MM 3.5 IOL ACRYSOF SGL 0D NAT 23.5 IOL RESTOR IQ MULT 3.0D 21.0 IOL SENSAR 13.0MM 10.5 IOL SENSAR 13.0MM 11.5 IOL SENSAR 13.5MM 2.0 IOL SENSAR 13.5MM 2.5 IOL SENSAR 13.0MM 27.5 IOL SENSAR 13.0MM 28.5 IOL SENSAR 13.0MM 29.5 IOL SENSAR 13.5MM 4.0 IOL SENSAR 13.5MM 4.5 IOL SENSAR 13.5MM 5.0 IOL SENSAR 13.5MM 5.5 IOL SENSAR 13.0MM 6.0 IOL ACRYSOF SGL 0D 6.0 IOL ACRYSOF SGL 0D 6.5 IOL ACRYSOF SGL 0D 7.0 IOL ACRYSOF SGL 0D 7.5 IOL ACRYSOF SGL 0D 8.0 IOL ACRYSOF SGL 0D 8.5 IOL ACRYSOF SGL 0D 9.0 IOL ACRYSOF SGL 0D 9.5 IOL ACRYSOF SGL 0D 10.0 IOL ACRYSOF SGL 0D 10.5 IOL ACRYSOF SGL 0D 11.0 IOL ACRYSOF SGL 0D 11.5 IOL ACRYSOF SGL 0D 12.0 IOL ACRYSOF SGL 0D 12.5 IOL ACRYSOF SGL 0D 13.0 Page 148 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $912.00 $782.00 $912.00 $782.00 $693.00 $912.00 $912.00 $782.00 $782.00 $782.00 $457.00 $782.00 $912.00 $782.00 $912.00 $2,450.00 $912.00 $782.00 $1,034.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF SGL 0D 13.5 IOL ACRYSOF SGL 0D 14.0 IOL ACRYSOF SGL 0D 14.5 IOL ACRYSOF SGL 0D 15.0 IOL ACRYSOF SGL 0D 15.5 IOL ACRYSOF SGL 0D 16.0 IOL ACRYSOF SGL 0D 16.5 IOL ACRYSOF SGL 0D 17.0 IOL ACRYSOF SGL 0D 17.5 IOL ACRYSOF SGL 0D 18.0 IOL ACRYSOF SGL 0D 18.5 IOL ACRYSOF SGL 0D 19.0 IOL ACRYSOF SGL 0D 19.5 IOL ACRYSOF SGL 0D 20.0 IOL ACRYSOF SGL 0D 20.5 IOL ACRYSOF SGL 0D 21.0 IOL ACRYSOF SGL 0D 21.5 IOL ACRYSOF SGL 0D 22.0 IOL ACRYSOF SGL 0D 22.5 IOL ACRYSOF SGL 0D 23.0 IOL ACRYSOF SGL 0D 23.5 IOL ACRYSOF SGL 0D 24.0 IOL ACRYSOF SGL 0D 24.5 IOL ACRYSOF SGL 0D 25.0 IOL ACRYSOF SGL 0D 25.5 IOL ACRYSOF SGL 0D 26.0 IOL ACRYSOF SGL 0D 26.5 IOL ACRYSOF SGL 0D 27.0 IOL ACRYSOF SGL 0D 27.5 IOL ACRYSOF SGL 0D 28.0 IOL ACRYSOF SGL 0D 28.5 IOL ACRYSOF SGL 0D 29.0 IOL ACRYSOF SGL 0D 29.5 IOL ACRYSOF SGL 0D 30.0 IOL ACRYSOF SGL 0D 30.5 IOL ACRYSOF SGL 0D 32.0 IOL ACRYSOF SGL 0D 34.0 IOL RESTOR IQ MULT 3.0D 11.5 IOL SENSAR MENISC 0.0 IOL SENSAR 13.0MM 7.0 IOL ACRYSOFIQ TORIC 1.50D 19.5 IOL ACRYSOFIQ TORIC 3.00D 11.0 IOL RESTOR IQ MULT 3.0D 17.0 IOL ACRYSOFIQ TORIC 3.00D 10.5 IOL RESTOR IQ MULT 3.0D 13.5 IOL ACRYSOFIQ TORIC 3.00D 10.0 Page 149 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $693.00 $1,034.00 $912.00 $912.00 $572.00 $572.00 $1,034.00 $572.00 $1,034.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RESTOR IQ MULT 3.0D 10.0 IOL RESTOR IQ MULT 3.0D 10.5 IOL RESTOR IQ MULT 3.0D 11.0 IOL RESTOR IQ MULT 3.0D 12.0 IOL RESTOR IQ MULT 3.0D 12.5 IOL RESTOR IQ MULT 3.0D 13.0 IOL RESTOR IQ MULT 3.0D 14.0 IOL RESTOR IQ MULT 3.0D 14.5 IOL RESTOR IQ MULT 3.0D 15.0 IOL RESTOR IQ MULT 3.0D 15.5 IOL RESTOR IQ MULT 3.0D 16.0 IOL RESTOR IQ MULT 3.0D 16.5 IOL RESTOR IQ MULT 3.0D 17.5 IOL RESTOR IQ MULT 3.0D 18.0 IOL RESTOR IQ MULT 3.0D 18.5 IOL RESTOR IQ MULT 3.0D 19.0 IOL RESTOR IQ MULT 3.0D 19.5 IOL RESTOR IQ MULT 3.0D 20.0 IOL RESTOR IQ MULT 3.0D 20.5 IOL RESTOR IQ MULT 3.0D 21.5 IOL RESTOR IQ MULT 3.0D 22.0 IOL RESTOR IQ MULT 3.0D 22.5 IOL RESTOR IQ MULT 3.0D 23.0 IOL RESTOR IQ MULT 3.0D 23.5 IOL RESTOR IQ MULT 3.0D 24.0 IOL RESTOR IQ MULT 3.0D 24.5 IOL RESTOR IQ MULT 3.0D 25.0 IOL RESTOR IQ MULT 3.0D 25.5 IOL RESTOR IQ MULT 3.0D 26.0 IOL RESTOR IQ MULT 3.0D 26.5 IOL RESTOR IQ MULT 3.0D 27.0 IOL RESTOR IQ MULT 3.0D 27.5 IOL RESTOR IQ MULT 3.0D 28.0 IOL RESTOR IQ MULT 3.0D 28.5 IOL RESTOR IQ MULT 3.0D 29.0 IOL RESTOR IQ MULT 3.0D 29.5 IOL RESTOR IQ MULT 3.0D 30.0 IOL ACRYSOFIQ TORIC 1.50D 20.5 IOL ACRYSOF SGL 0D NAT 30.0 IOL ACRYSOFIQ TORIC 2.25D 22.5 IOL ACRYSOFIQ TORIC 1.50D 12.0 IOL ACRYSOFIQ TORIC 1.50D 15.5 IOL ACRYSOFIQ TORIC 3.00D 29.0 IOL ACRYSOFIQ TORIC 1.50D 26.5 IOL ACRYSOFIQ TORIC 2.25D 24.5 IOL ACRYSOFIQ TORIC 2.25D 27.0 Page 150 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $572.00 $782.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOFIQ TORIC 3.00D 20.0 IOL ACRYSOFIQ TORIC 3.00D 29.5 IOL ACRYSOFIQ TORIC 1.50D 24.0 IOL ACRYSOFIQ TORIC 2.25D 12.0 IOL ACRYSOFIQ TORIC 3.00D 19.5 IOL ACRYSOFIQ TORIC 1.50D 12.5 IOL ACRYSOFIQ TORIC 2.25D 9.0 IOL ACRYSOFIQ TORIC 3.00D 9.5 IOL ACRYSOFIQ TORIC 2.25D 9.5 IOL ACRYSOFIQ TORIC 3.00D 11.5 IOL ACRYSOFIQ TORIC 3.00D 12.0 IOL ACRYSOFIQ TORIC 3.00D 12.5 IOL ACRYSOFIQ TORIC 3.00D 13.0 IOL ACRYSOFIQ TORIC 3.00D 13.5 IOL ACRYSOFIQ TORIC 3.00D 14.0 IOL ACRYSOFIQ TORIC 3.00D 14.5 IOL ACRYSOFIQ TORIC 3.00D 15.0 IOL ACRYSOFIQ TORIC 3.00D 15.5 IOL ACRYSOFIQ TORIC 3.00D 16.0 IOL ACRYSOFIQ TORIC 3.00D 16.5 IOL ACRYSOFIQ TORIC 3.00D 17.0 IOL ACRYSOFIQ TORIC 3.00D 17.5 IOL ACRYSOFIQ TORIC 3.00D 18.0 IOL ACRYSOFIQ TORIC 3.00D 18.5 IOL ACRYSOFIQ TORIC 3.00D 19.0 IOL ACRYSOFIQ TORIC 3.00D 20.5 IOL ACRYSOFIQ TORIC 3.00D 21.0 IOL ACRYSOFIQ TORIC 3.00D 21.5 IOL ACRYSOFIQ TORIC 3.00D 22.0 IOL ACRYSOFIQ TORIC 3.00D 22.5 IOL ACRYSOFIQ TORIC 3.00D 23.0 IOL ACRYSOFIQ TORIC 3.00D 23.5 IOL ACRYSOFIQ TORIC 3.00D 24.0 IOL ACRYSOFIQ TORIC 3.00D 24.5 IOL ACRYSOFIQ TORIC 3.00D 25.0 IOL ACRYSOFIQ TORIC 3.00D 25.5 IOL ACRYSOFIQ TORIC 3.00D 26.0 IOL ACRYSOFIQ TORIC 3.00D 26.5 IOL ACRYSOFIQ TORIC 3.00D 27.0 IOL ACRYSOFIQ TORIC 3.00D 27.5 IOL ACRYSOFIQ TORIC 3.00D 28.0 IOL ACRYSOFIQ TORIC 3.00D 28.5 IOL ACRYSOFIQ TORIC 3.00D 30.0 IOL ACRYSOFIQ TORIC 3.00D 6.0 IOL ACRYSOFIQ TORIC 3.00D 6.5 IOL ACRYSOFIQ TORIC 3.00D 7.0 Page 151 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOFIQ TORIC 3.00D 7.5 IOL ACRYSOFIQ TORIC 3.00D 8.0 IOL ACRYSOFIQ TORIC 3.00D 8.5 IOL ACRYSOFIQ TORIC 3.00D 9.0 IOL ACRYSOFIQ TORIC 2.25D 6.0 IOL ACRYSOFIQ TORIC 2.25D 6.5 IOL ACRYSOFIQ TORIC 2.25D 7.0 IOL ACRYSOFIQ TORIC 2.25D 7.5 IOL ACRYSOFIQ TORIC 2.25D 8.0 IOL ACRYSOFIQ TORIC 2.25D 8.5 IOL ACRYSOFIQ TORIC 2.25D 10.0 IOL ACRYSOFIQ TORIC 2.25D 10.5 IOL ACRYSOFIQ TORIC 2.25D 11.0 IOL ACRYSOFIQ TORIC 2.25D 11.5 IOL ACRYSOFIQ TORIC 2.25D 12.5 IOL ACRYSOFIQ TORIC 2.25D 13.0 IOL ACRYSOFIQ TORIC 2.25D 13.5 IOL ACRYSOFIQ TORIC 2.25D 14.0 IOL ACRYSOFIQ TORIC 2.25D 14.5 IOL ACRYSOFIQ TORIC 2.25D 15.0 IOL ACRYSOFIQ TORIC 2.25D 15.5 IOL ACRYSOFIQ TORIC 2.25D 16.0 IOL ACRYSOFIQ TORIC 2.25D 16.5 IOL ACRYSOFIQ TORIC 2.25D 17.0 IOL ACRYSOFIQ TORIC 2.25D 17.5 IOL ACRYSOFIQ TORIC 2.25D 18.0 IOL ACRYSOFIQ TORIC 2.25D 18.5 IOL ACRYSOFIQ TORIC 2.25D 19.0 IOL ACRYSOFIQ TORIC 2.25D 19.5 IOL ACRYSOFIQ TORIC 2.25D 20.0 IOL ACRYSOFIQ TORIC 2.25D 20.5 IOL ACRYSOFIQ TORIC 2.25D 21.0 IOL ACRYSOFIQ TORIC 2.25D 21.5 IOL ACRYSOFIQ TORIC 2.25D 22.0 IOL ACRYSOFIQ TORIC 2.25D 23.0 IOL ACRYSOFIQ TORIC 2.25D 23.5 IOL ACRYSOFIQ TORIC 2.25D 24.0 IOL ACRYSOFIQ TORIC 2.25D 25.0 IOL ACRYSOFIQ TORIC 2.25D 25.5 IOL ACRYSOFIQ TORIC 2.25D 26.0 IOL ACRYSOFIQ TORIC 2.25D 26.5 IOL ACRYSOFIQ TORIC 2.25D 27.5 IOL ACRYSOFIQ TORIC 2.25D 28.0 IOL ACRYSOFIQ TORIC 2.25D 28.5 IOL ACRYSOFIQ TORIC 2.25D 29.0 IOL ACRYSOFIQ TORIC 2.25D 29.5 Page 152 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOFIQ TORIC 2.25D 30.0 IOL ACRYSOFIQ TORIC 1.50D 6.0 IOL ACRYSOFIQ TORIC 1.50D 6.5 IOL ACRYSOFIQ TORIC 1.50D 7.0 IOL ACRYSOFIQ TORIC 1.50D 7.5 IOL ACRYSOFIQ TORIC 1.50D 8.0 IOL ACRYSOFIQ TORIC 1.50D 8.5 IOL ACRYSOFIQ TORIC 1.50D 9.0 IOL ACRYSOFIQ TORIC 1.50D 9.5 IOL ACRYSOFIQ TORIC 1.50D 10.0 IOL ACRYSOFIQ TORIC 1.50D 10.5 IOL ACRYSOFIQ TORIC 1.50D 11.0 IOL ACRYSOFIQ TORIC 1.50D 11.5 IOL ACRYSOFIQ TORIC 1.50D 13.0 IOL ACRYSOFIQ TORIC 1.50D 13.5 IOL ACRYSOFIQ TORIC 1.50D 14.0 IOL ACRYSOFIQ TORIC 1.50D 14.5 IOL ACRYSOFIQ TORIC 1.50D 15.0 IOL ACRYSOFIQ TORIC 1.50D 16.0 IOL ACRYSOFIQ TORIC 1.50D 16.5 IOL ACRYSOFIQ TORIC 1.50D 17.0 IOL ACRYSOFIQ TORIC 1.50D 17.5 IOL ACRYSOFIQ TORIC 1.50D 18.0 IOL ACRYSOFIQ TORIC 1.50D 18.5 IOL ACRYSOFIQ TORIC 1.50D 19.0 IOL ACRYSOFIQ TORIC 1.50D 20.0 IOL ACRYSOFIQ TORIC 1.50D 21.0 IOL ACRYSOFIQ TORIC 1.50D 21.5 IOL ACRYSOFIQ TORIC 1.50D 22.0 IOL ACRYSOFIQ TORIC 1.50D 22.5 IOL ACRYSOFIQ TORIC 1.50D 23.0 IOL ACRYSOFIQ TORIC 1.50D 23.5 IOL ACRYSOFIQ TORIC 1.50D 24.5 IOL ACRYSOFIQ TORIC 1.50D 25.0 IOL ACRYSOFIQ TORIC 1.50D 25.5 IOL ACRYSOFIQ TORIC 1.50D 26.0 IOL ACRYSOFIQ TORIC 1.50D 27.0 IOL ACRYSOFIQ TORIC 1.50D 27.5 IOL ACRYSOFIQ TORIC 1.50D 28.0 IOL ACRYSOFIQ TORIC 1.50D 28.5 IOL ACRYSOFIQ TORIC 1.50D 29.0 IOL ACRYSOFIQ TORIC 1.50D 29.5 IOL ACRYSOFIQ TORIC 1.50D 30.0 IOL RESTOR IQ MULT 3.0D 9.5 IOL PMMA ANT 5.5X13MM 15.5 IOL AKREOS AO 22.5 Page 153 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $1,034.00 $457.00 $923.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL RESTOR IQ MULT 3.0D 34.0 IOL AKREOS AO 28.5 IOL RESTOR IQ MULT 3.0D 6.0 IOL RESTOR IQ MULT 3.0D 6.5 IOL RESTOR IQ MULT 3.0D 7.0 IOL RESTOR IQ MULT 3.0D 7.5 IOL RESTOR IQ MULT 3.0D 8.0 IOL RESTOR IQ MULT 3.0D 8.5 IOL RESTOR IQ MULT 3.0D 9.0 IOL RESTOR IQ MULT 3.0D 31.0 IOL RESTOR IQ MULT 3.0D 32.0 IOL RESTOR IQ MULT 3.0D 33.0 IOL ACRYSOF SGL 0D 36.0 IOL ACRYSOF SGL 0D 37.0 IOL ACRYSOF SGL 0D 38.0 IOL ACRYSOF SGL 0D 39.0 IOL ACRYSOF SGL 0D NAT 6.0 IOL ACRYSOF SGL 0D NAT 6.5 IOL ACRYSOF SGL 0D NAT 7.0 IOL ACRYSOF SGL 0D NAT 7.5 IOL ACRYSOF SGL 0D NAT 8.0 IOL ACRYSOF SGL 0D NAT 8.5 IOL ACRYSOF SGL 0D NAT 9.0 IOL ACRYSOF SGL 0D NAT 9.5 IOL ACRYSOF SGL 0D NAT 10.0 IOL ACRYSOF SGL 0D NAT 10.5 IOL ACRYSOF SGL 0D NAT 11.0 IOL ACRYSOF SGL 0D NAT 11.5 IOL ACRYSOF SGL 0D NAT 12.0 IOL ACRYSOF SGL 0D NAT 12.5 IOL ACRYSOF SGL 0D NAT 13.0 IOL ACRYSOF SGL 0D NAT 13.5 IOL ACRYSOF SGL 0D NAT 14.0 IOL ACRYSOF SGL 0D NAT 14.5 IOL ACRYSOF SGL 0D NAT 15.0 IOL ACRYSOF SGL 0D NAT 15.5 IOL ACRYSOF SGL 0D NAT 16.0 IOL ACRYSOF SGL 0D NAT 17.0 IOL ACRYSOF SGL 0D NAT 17.5 IOL ACRYSOF SGL 0D NAT 18.0 IOL ACRYSOF SGL 0D NAT 18.5 IOL ACRYSOF SGL 0D NAT 19.0 IOL ACRYSOF SGL 0D NAT 20.5 IOL ACRYSOF SGL 0D NAT 21.0 IOL ACRYSOF SGL 0D NAT 21.5 IOL ACRYSOF SGL 0D NAT 22.0 Page 154 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $923.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $693.00 $693.00 $693.00 $693.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF SGL 0D NAT 23.0 IOL ACRYSOF SGL 0D NAT 24.0 IOL ACRYSOF SGL 0D NAT 24.5 IOL ACRYSOF SGL 0D NAT 25.0 IOL ACRYSOF SGL 0D NAT 25.5 IOL ACRYSOF SGL 0D NAT 26.0 IOL ACRYSOF SGL 0D NAT 26.5 IOL ACRYSOF SGL 0D NAT 27.0 IOL ACRYSOF SGL 0D NAT 27.5 IOL ACRYSOF SGL 0D NAT 28.0 IOL ACRYSOF SGL 0D NAT 28.5 IOL ACRYSOF SGL 0D NAT 29.0 IOL ACRYSOF SGL 0D NAT 29.5 IOL ACRYSOF SGL 0D NAT 31.0 IOL ACRYSOF SGL 0D NAT 35.0 IOL ACRYSOF SGL 0D NAT 36.0 IOL ACRYSOF SGL 0D NAT 37.0 IOL ACRYSOF SGL 0D NAT 38.0 IOL ACRYSOF SGL 0D NAT 39.0 IOL ACRYSOF SGL 0D NAT 40.0 IOL PMMA ANT 5.5X12.5 5.5 IOL PMMA ANT 5.5X12.5 6.5 IOL PMMA ANT 5.5X12.5 7.5 IOL PMMA ANT 5.5X12.5 8.5 IOL PMMA ANT 5.5X12.5 9.5 IOL PMMA ANT 5.5X12.5 10.5 IOL PMMA ANT 5.5X12.5 11.5 IOL PMMA ANT 5.5X12.5 12.5 IOL PMMA ANT 5.5X12.5 13.5 IOL PMMA ANT 5.5X12.5 14.5 IOL PMMA ANT 5.5X12.5 15.5 IOL PMMA ANT 5.5X12.5 17.5 IOL PMMA ANT 5.5X12.5 18.5 IOL PMMA ANT 5.5X12.5 19.5 IOL PMMA ANT 5.5X12.5 20.5 IOL PMMA ANT 5.5X12.5 22.5 IOL PMMA ANT 5.5X12.5 23.5 IOL PMMA ANT 5.5X12.5 24.5 IOL PMMA ANT 5.5X12.5 25.5 IOL PMMA ANT 5.5X12.5 26.5 IOL PMMA ANT 5.5X12.5 27.5 IOL PMMA ANT 5.5X12.5 28.5 IOL PMMA ANT 5.5X12.5 29.5 IOL PMMA ANT 5.5X13MM 5.5 IOL PMMA ANT 5.5X13MM 6.5 IOL PMMA ANT 5.5X13MM 7.5 Page 155 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL PMMA ANT 5.5X13MM 8.5 IOL PMMA ANT 5.5X13MM 9.5 IOL PMMA ANT 5.5X13MM 10.5 IOL PMMA ANT 5.5X13MM 11.5 IOL PMMA ANT 5.5X13MM 12.5 IOL PMMA ANT 5.5X13MM 13.5 IOL PMMA ANT 5.5X13MM 14.5 IOL PMMA ANT 5.5X13MM 18.5 IOL PMMA ANT 5.5X13MM 19.5 IOL PMMA ANT 5.5X13MM 20.5 IOL PMMA ANT 5.5X13MM 22.5 IOL PMMA ANT 5.5X13MM 23.5 IOL PMMA ANT 5.5X13MM 24.5 IOL PMMA ANT 5.5X13MM 25.5 IOL PMMA ANT 5.5X13MM 26.5 IOL PMMA ANT 5.5X13MM 27.5 IOL PMMA ANT 5.5X13MM 28.5 IOL PMMA ANT 5.5X13MM 29.5 IOL SENSAR MENISC 1.5 IOL SENSAR 13.0MM 7.5 IOL SENSAR 13.0MM 8.0 IOL SENSAR 13.0MM 8.5 IOL SENSAR 13.0MM 9.0 IOL SENSAR 13.0MM 9.5 IOL PMMA ANT 5.5X13.5 5.5 IOL PMMA ANT 5.5X13.5 6.5 IOL PMMA ANT 5.5X13.5 7.5 IOL PMMA ANT 5.5X13.5 8.5 IOL PMMA ANT 5.5X13.5 9.5 IOL PMMA ANT 5.5X13.5 10.5 IOL PMMA ANT 5.5X13.5 11.5 IOL PMMA ANT 5.5X13.5 12.5 IOL PMMA ANT 5.5X13.5 13.5 IOL PMMA ANT 5.5X13.5 14.5 IOL PMMA ANT 5.5X13.5 15.5 IOL PMMA ANT 5.5X13.5 18.5 IOL PMMA ANT 5.5X13.5 19.5 IOL PMMA ANT 5.5X13.5 20.5 IOL PMMA ANT 5.5X13.5 22.5 IOL PMMA ANT 5.5X13.5 23.5 IOL PMMA ANT 5.5X13.5 24.5 IOL PMMA ANT 5.5X13.5 25.5 IOL PMMA ANT 5.5X13.5 27.5 IOL PMMA ANT 5.5X13.5 28.5 IOL PMMA ANT 5.5X13.5 29.5 IOL ACRYSOF IQ 0D NAT 6.5 Page 156 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $457.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $464.00 $782.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF IQ 0D NAT 7.5 IOL ACRYSOF IQ 0D NAT 8.5 IOL ACRYSOF IQ 0D NAT 9.5 SUT PROLENE 3-0 PS1 18 SUT VICRYL 4-0 FS2 UNDY IOL SENSAR MENISC -10.0 SUT VICRYL 2-0 CT2 DYE IOL CRYSTALENS AO 11.5MM 31.5 IOL AKREOS AO 26.0 IOL CRYSTALENS FIVE21.75*DISC* IOL AKREOS AO 20.5 IOL AKREOS AO 16.5 IOL AKREOS AO 18.5 IOL ACRYSOFIQ TORIC 5.25D 26.0 IOL ACRYSOFIQ TORIC 3.75D 6.0 IOL AKREOS AO 21.0 IOL TECNIS 1PC ASPHERIC 9.0D IOL SENSAR MENISC -1.0 IOL AKREOS AO 27.0 IOL SENSAR MENISC -2.5 IOL ACRYSOFIQ TORIC 4.50D 22.0 SUT ETHILON 3-0 FS1 18 IOL ACRYSOFIQ TORIC 5.25D 23.0 IOL ACRYSOFIQ TORIC 3.75D 23.0 IOL ACRYSOFIQ TORIC 3.75D 22.0 IOL TECNIS 1PC ASPHERIC 7.5D IOL SOFTEC HD 30.0 IOL ACRYSOFIQ TORIC 3.75D 22.5 IOL ACRYSOFIQ TORIC 6.00D 22.5 IOL ACRYSOFIQ TORIC 3.75D 17.5 SUT ETHILON 4-0 FS1 18 IOL TECNIS 1PC ASPHERIC 10.0D IOL ACRYSOFIQ TORIC 5.25D 21.0 IOL ACRYSOFIQ TORIC 3.75D 24.0 IOL ACRYSOFIQ TORIC 6.00D 13.0 IOL ACRYSOFIQ TORIC 4.50D 8.5 IOL ACRYSOFIQ TORIC 6.00D 20.5 IOL ACRYSOFIQ TORIC 4.50D 17.0 IOL ACRYSOFIQ TORIC 4.50D 6.0 IOL ACRYSOFIQ TORIC 3.75D 18.5 IOL TECNIS 1PC ASPHERIC 10.5D IOL ACRYSOFIQ TORIC 6.00D 23.0 IOL AKREOS AO 14.0 IOL AKREOS AO 23.0 IOL ACRYSOFIQ TORIC 4.50D 18.0 IOL AKREOS AO 19.5 Page 157 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $782.00 $782.00 $782.00 $25.00 $13.00 $912.00 $9.00 $2,457.00 $923.00 $1,731.00 $923.00 $923.00 $923.00 $572.00 $572.00 $923.00 $900.00 $912.00 $923.00 $734.00 $572.00 $10.00 $572.00 $572.00 $572.00 $900.00 $949.00 $572.00 $572.00 $572.00 $10.00 $900.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $900.00 $572.00 $923.00 $923.00 $572.00 $923.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOFIQ TORIC 5.25D 16.5 IOL AKREOS AO 10.0 IOL AKREOS AO 10.5 IOL AKREOS AO 11.0 IOL AKREOS AO 11.5 IOL AKREOS AO 12.0 IOL AKREOS AO 12.5 IOL AKREOS AO 13.0 IOL AKREOS AO 13.5 IOL AKREOS AO 14.5 IOL AKREOS AO 15.0 IOL AKREOS AO 15.5 IOL AKREOS AO 16.0 IOL AKREOS AO 17.0 IOL AKREOS AO 17.5 IOL AKREOS AO 18.0 IOL AKREOS AO 19.0 IOL AKREOS AO 20.0 IOL AKREOS AO 21.5 IOL AKREOS AO 22.0 IOL AKREOS AO 23.5 IOL AKREOS AO 24.0 IOL AKREOS AO 24.5 IOL AKREOS AO 25.0 IOL AKREOS AO 25.5 IOL AKREOS AO 26.5 IOL AKREOS AO 27.5 IOL AKREOS AO 28.0 IOL AKREOS AO 29.0 IOL AKREOS AO 29.5 IOL AKREOS AO 30.0 IOL ACRYSOFIQ TORIC 6.00D 17.0 IOL ACRYSOFIQ TORIC 6.00D 6.5 IOL SENSAR MENISC 0.5 IOL ELAS SIL 6.0 13.0/+3.5 IOL ELAS SIL 6.0 11.5/+3.5 IOL ACRYSOFIQ TORIC 6.00D 11.0 IOL TECNIS 1PC ASPHERIC 5.5D IOL ACRYSOFIQ TORIC 3.75D 19.5 IOL SENSAR MENISC -6.0 IOL ACRYSOFIQ TORIC 3.75D 20.5 IOL ACRYSOFIQ TORIC 4.50D 10.0 IOL ACRYSOFIQ TORIC 4.50D 8.0 IOL ACRYSOFIQ TORIC 6.00D 14.0 IOL ELASTIMIDE SIL -4 14MM IOL ACRYSOFIQ TORIC 3.75D 13.5 Page 158 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $900.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $923.00 $900.00 $923.00 $572.00 $572.00 $912.00 $1,138.00 $1,138.00 $572.00 $900.00 $572.00 $912.00 $572.00 $572.00 $572.00 $572.00 $1,138.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOFIQ TORIC 4.50D 15.5 IOL ACRYSOFIQ TORIC 4.50D 17.5 IOL ACRYSOFIQ TORIC 6.00D 21.5 IOL STAAR -3.0 IOL ACRYSOFIQ TORIC 6.00D 30.0 SUT VICRYL+ 3-0 CT3 SUT ETHIBOND 2-0 CT2 30 IOL ACRYSOFIQ TORIC 4.50D 25.5 IOL ACRYSOFIQ TORIC 4.50D 14.5 IOL PMMA SGL PC POST 17.0D IOL ACRYSERT C 21.0 IOL ACRYSERT C 21.5 IOL ELAS SIL 6.0 14.5/+2.0 IOL ACRYSOFIQ TORIC 6.00D 23.5 IOL TECNIS 1PC ASPHERIC 30.5D IOL ACRYSOFIQ TORIC 4.50D 28.0 IOL CRYSTALENS AO 12.0MM 5.0 IOL ACRYSOFIQ TORIC 4.50D 12.0 IOL ACRYSOFIQ TORIC 4.50D 12.5 IOL ACRYSOFIQ TORIC 5.25D 23.5 IOL ACRYSOFIQ TORIC 3.75D 14.0 IOL CRYSTALENS AO 12.0MM 4.0 IOL ACRYSOFIQ TORIC 4.50D 28.5 IOL ACRYSOFIQ TORIC 3.75D 18.0 IOL ACRYSOFIQ TORIC 6.00D 10.0 IOL ACRYSOFIQ TORIC 6.00D 10.5 IOL ACRYSOFIQ TORIC 6.00D 11.5 IOL ACRYSOFIQ TORIC 6.00D 12.0 IOL ACRYSOFIQ TORIC 6.00D 12.5 IOL ACRYSOFIQ TORIC 6.00D 14.5 IOL ACRYSOFIQ TORIC 6.00D 15.0 IOL ACRYSOFIQ TORIC 6.00D 15.5 IOL ACRYSOFIQ TORIC 6.00D 16.0 IOL ACRYSOFIQ TORIC 6.00D 16.5 IOL ACRYSOFIQ TORIC 6.00D 17.5 IOL ACRYSOFIQ TORIC 6.00D 18.0 IOL ACRYSOFIQ TORIC 6.00D 18.5 IOL ACRYSOFIQ TORIC 6.00D 19.0 IOL ACRYSOFIQ TORIC 6.00D 19.5 IOL ACRYSOFIQ TORIC 6.00D 20.0 IOL ACRYSOFIQ TORIC 6.00D 21.0 IOL ACRYSOFIQ TORIC 6.00D 22.0 IOL ACRYSOFIQ TORIC 6.00D 24.0 IOL ACRYSOFIQ TORIC 6.00D 24.5 IOL ACRYSOFIQ TORIC 6.00D 25.0 IOL ACRYSOFIQ TORIC 6.00D 25.5 Page 159 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $1,138.00 $572.00 $11.00 $10.00 $572.00 $572.00 $464.00 $830.00 $830.00 $1,138.00 $572.00 $900.00 $572.00 $2,457.00 $572.00 $572.00 $572.00 $572.00 $2,457.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOFIQ TORIC 6.00D 26.0 IOL ACRYSOFIQ TORIC 6.00D 26.5 IOL ACRYSOFIQ TORIC 6.00D 27.0 IOL ACRYSOFIQ TORIC 6.00D 27.5 IOL ACRYSOFIQ TORIC 6.00D 28.0 IOL ACRYSOFIQ TORIC 6.00D 28.5 IOL ACRYSOFIQ TORIC 6.00D 29.0 IOL ACRYSOFIQ TORIC 6.00D 29.5 IOL ACRYSOFIQ TORIC 5.25D 15.0 IOL ACRYSOFIQ TORIC 3.75D 13.0 IOL ACRYSOFIQ TORIC 3.75D 14.5 IOL ACRYSOFIQ TORIC 3.75D 15.0 IOL ACRYSOFIQ TORIC 3.75D 15.5 IOL ACRYSOFIQ TORIC 3.75D 16.0 IOL ACRYSOFIQ TORIC 3.75D 16.5 IOL ACRYSOFIQ TORIC 3.75D 17.0 IOL ACRYSOFIQ TORIC 3.75D 19.0 IOL ACRYSOFIQ TORIC 3.75D 20.0 IOL ACRYSOFIQ TORIC 3.75D 23.5 IOL ACRYSOFIQ TORIC 3.75D 24.5 IOL ACRYSOFIQ TORIC 3.75D 25.0 IOL ACRYSOFIQ TORIC 3.75D 26.0 IOL ACRYSOFIQ TORIC 3.75D 27.0 IOL ACRYSOFIQ TORIC 3.75D 27.5 IOL ACRYSOFIQ TORIC 3.75D 28.0 IOL ACRYSOFIQ TORIC 3.75D 28.5 IOL ACRYSOFIQ TORIC 3.75D 30.0 IOL ACRYSOFIQ TORIC 3.75D 10.0 IOL ACRYSOFIQ TORIC 3.75D 10.5 IOL ACRYSOFIQ TORIC 3.75D 11.0 IOL ACRYSOFIQ TORIC 3.75D 11.5 IOL ACRYSOFIQ TORIC 3.75D 12.0 IOL ACRYSOFIQ TORIC 3.75D 12.5 IOL SENSAR MENISC -3.0 IOL SENSAR MENISC -3.5 SUT SILK 4-0 C1 18 SUT SILK 5-0 C1 30 IOL SENSAR MENISC -2.0 IOL ACRYSOFIQ TORIC 4.50D 23.0 IOL ACRYSOFIQ TORIC 6.00D 9.0 IOL PMMA SGL PC POST 21.0D IOL ACRYSOFIQ TORIC 6.00D 6.0 IOL ACRYSOFIQ TORIC 5.25D 6.0 IOL ACRYSOFIQ TORIC 6.00D 8.0 IOL ACRYSOFIQ TORIC 5.25D 17.5 IOL ACRYSOFIQ TORIC 4.50D 9.0 Page 160 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $912.00 $912.00 $18.00 $18.21 $912.00 $572.00 $572.00 $464.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL AKREOS AO 8.0 IOL ACRYSOFIQ TORIC 5.25D 10.5 IOL ACRYSOFIQ TORIC 4.50D 16.0 IOL ACRYSOFIQ TORIC 6.00D 9.5 IOL TECNIS 1PC ASPHERIC 6.5D IOL ACRYSOFIQ TORIC 5.25D 14.0 IOL ACRYSOFIQ TORIC 3.75D 21.5 IOL PMMA SGL PC POST 20.0D SUT MONOCRYL+ 4-0 P3 UNDY IOL PMMA SGL PC POST 25.0D IOL ACRYSOFIQ TORIC 5.25D 21.5 IOL TORIC ASPHERIC 1.5D 18.5D IOL TORIC ASPHERIC 3.0D 22.5D IOL TORIC ASPHERIC 4.0D 13.0D IOL TORIC ASPHERIC 3.0D 11.5D IOL ACRYSOFIQ TORIC 4.50D 7.5 IOL PMMA SGL PC POST 19.0D IOL TORIC ASPHERIC 2.25D 15.5D IOL TORIC ASPHERIC 2.25D 21.5D IOL TORIC ASPHERIC 2.25D 14.5D IOL TORIC ASPHERIC 3.0D 22.0D IOL TORIC ASPHERIC 3.0D 19.0D IOL TORIC ASPHERIC 3.0D 27.5D IOL TORIC ASPHERIC 4.0D 17.0D IOL TORIC ASPHERIC 4.0D 21.5D IOL TORIC ASPHERIC 3.0D 21.5D IOL TORIC ASPHERIC 4.0D 22.5D IOL TORIC ASPHERIC 4.0D 16.5D IOL TORIC ASPHERIC 2.25D 21.0D IOL TORIC ASPHERIC 1.5D 21.5D IOL TORIC ASPHERIC 4.0D 7.5D IOL TORIC ASPHERIC 2.25D 14.0D IOL TORIC ASPHERIC 2.25D 28.5D IOL TORIC ASPHERIC 3.0D 5.5D IOL TORIC ASPHERIC 2.25D 5.5D IOL ACRYSOFIQ TORIC 4.50D 16.5 IOL ELASTIMIDE SIL -1.5 IOL ELASTIMIDE SIL -2.5 IOL ELASTIMIDE SIL +2.5 IOL TORIC ASPHERIC 3.0D 13.0D IOL TORIC ASPHERIC 1.5D 12.0D IOL TORIC ASPHERIC 1.5D 12.5D IOL TORIC ASPHERIC 2.25D 13.5D IOL TORIC ASPHERIC 4.0D 19.5D IOL ACRYSOFIQ TORIC 5.25D 13.5 IOL ACRYSOFIQ TORIC 4.50D 18.5 Page 161 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $923.00 $572.00 $572.00 $572.00 $900.00 $572.00 $572.00 $464.00 $31.00 $783.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $464.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $1,138.00 $1,138.00 $1,138.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TORIC ASPHERIC 2.25D 24.0D IOL TORIC ASPHERIC 2.25D 24.5D IOL TORIC ASPHERIC 3.0D 6.5D IOL TORIC ASPHERIC 2.25D 20.0D IOL TORIC ASPHERIC 1.5D 14.5D IOL TORIC ASPHERIC 2.25D 8.0D IOL TORIC ASPHERIC 1.50D 11.0D IOL TECNIS MULT 1PC 3.25D 19.0 IOL TORIC ASPHERIC 4.0D 14.5D IOL TORIC ASPHERIC 3.0D 17.0D IOL TORIC ASPHERIC 3.0D 16.5D IOL TORIC ASPHERIC 3.0D 14.5D IOL TORIC ASPHERIC 2.25D 23.0D SUT ETHILON 5-0 FS2 18 PK LOWER EXTREMITY CUST BZ IOL TORIC ASPHERIC 3.0D 14.0D IOL TECNIS MULT 1PC 3.25D 21.0 IOL SENSAR MENISC -1.50 IOL TORIC ASPHERIC 2.25D 22.0D IOL TORIC ASPHERIC 1.50D 11.5D IOL TECNIS MULT 1PC 3.25D 20.5 IOL TECNIS MULT 1PC 3.25D 20.0 IOL TORIC ASPHERIC 2.25D 16.5D IOL TECNIS MULT 1PC 3.25D 19.5 IOL TORIC ASPHERIC 2.25D 12.0D IOL TORIC ASPHERIC 2.25D 13.0D IOL TORIC ASPHERIC 1.5D 21.0D IOL TECNIS MULT 1PC 3.25D 11.0 TREPHINE EYE PTADJ VACUUM7.0MM TREPHINE EYE PTADJVACUUM7.25MM TREPHINE EYE PTADJVACUUM8.75MM ALLO AMNIOGRAFT 5.0X5.0CM BNDG CORNEAPLUSBIOLOGICPROKERA IOL TORIC ASPHERIC 3.0D 25.0D IOL TORIC ASPHERIC 2.25D 17.0D IOL TORIC ASPHERIC 3.0D 17.5D IOL TORIC ASPHERIC 2.25D 19.5D IOL TORIC ASPHERIC 1.5D 17.5D IOL TORIC ASPHERIC 3.0D 24.5D IOL TORIC ASPHERIC 6.0D 16.5D IOL TORIC ASPHERIC 2.25D 27.0 IOL ACRYSOF NAT MULT 10D 22.5 IOL TECNIS 1PC ASPHERIC 33.5D IOL TORIC ASPHERIC 4.5D 14.5D IOL TECNIS MULT 1PC 3.25D 17.0 IOL TORIC ASPHERIC 1.5D 18.0D Page 162 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $1,034.00 $572.00 $572.00 $572.00 $572.00 $572.00 $10.00 $364.00 $572.00 $1,034.00 $912.00 $572.00 $572.00 $1,034.00 $1,034.00 $572.00 $1,034.00 $572.00 $572.00 $572.00 $1,034.00 $525.00 $525.00 $525.00 $3,310.00 $2,645.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $782.00 $900.00 $572.00 $1,034.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TORIC ASPHORIC 3.0D 10.5D IOL ACRYSOF NAT MULT 10D 13.5 IOL ACCRYSOFIQ TORIC 4.5D 19.0 IOL TORIC ASPHERIC 2.25D 26.5D IOL TORIC ASPHERIC 6.0D 15.5D IOL TORIC ASPHERIC 1.5D 25.0D IOL PMMA SGL PC POST 22.0D IOL TECNIS 1PC ASPHERIC 31.5D IOL ACRYSOF NAT MULT 10D 28.0 IOL ACRYSOF NAT MULT 10D 10.0 IOL ACRYSOFIQ TORIC 6.00D 7.0 IOL ACRYSOFIQ TORIC 6.00D 7.5 IOL TORIC ASPHERIC 1.5D 24.5D IOL TORIC ASPHERIC 3.0D 13.5D IOL TORIC ASPHERIC 1.5D 22.5D IOL TORIC ASPHERIC 1.5D 23.0D IOL SYMFONY EXT REACH 20.5 IOL TORIC ASPHERIC 1.5D 25.5D IOL ACRYSOF 6.0 IOL ACRYSOF 6.5 IOL ACRYSOF 7.0 IOL ACRYSOF 7.5 IOL ACRYSOF 8.0 IOL ACRYSOF 8.5 IOL ACRYSOF 9.0 IOL ACRYSOF 9.5 IOL ACRYSOF 10.0 IOL ACRYSOF 10.5 IOL ACRYSOF 11.0 IOL ACRYSOF 11.5 IOL ACRYSOF 12.0 IOL ACRYSOF 12.5 IOL ACRYSOF 13.0 IOL ACRYSOF 13.5 IOL ACRYSOF 14.0 IOL ACRYSOF 14.5 IOL ACRYSOF 15.0 IOL ACRYSOF 15.5 IOL ACRYSOF 16.0 IOL ACRYSOF 16.5 IOL ACRYSOF 17.0 IOL ACRYSOF 17.5 IOL ACRYSOF 18.0 IOL ACRYSOF 18.5 IOL ACRYSOF 19.0 IOL ACRYSOF 19.5 Page 163 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $782.00 $572.00 $572.00 $572.00 $572.00 $464.00 $900.00 $782.00 $782.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $1,034.00 $572.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF 20.0 IOL ACRYSOF 20.5 IOL ACRYSOF 21.0 IOL ACRYSOF 21.5 IOL ACRYSOF 22.0 IOL ACRYSOF 22.5 IOL ACRYSOF 23.0 IOL ACRYSOF 23.5 IOL ACRYSOF 24.0 IOL ACRYSOF 24.5 IOL ACRYSOF 25.0 IOL ACRYSOF 25.5 IOL ACRYSOF 26.0 IOL ACRYSOF 26.5 IOL ACRYSOF 27.0 IOL ACRYSOF 27.5 IOL ACRYSOF 28.0 IOL ACRYSOF 28.5 IOL ACRYSOF 29.0 IOL ACRYSOF 29.5 IOL ACRYSOF 30.0 IOL ACRYSOF NAT MULT 10D 6.0 IOL ACRYSOF NAT MULT 10D 6.5 IOL ACRYSOF NAT MULT 10D 7.0 IOL ACRYSOF NAT MULT 10D 7.5 IOL ACRYSOF NAT MULT 10D 8.0 IOL ACRYSOF NAT MULT 10D 8.5 IOL ACRYSOF NAT MULT 10D 9.0 IOL ACRYSOF NAT MULT 10D 9.5 IOL ACRYSOF NAT MULT 10D 10.5 IOL ACRYSOF NAT MULT 10D 11.0 IOL ACRYSOF NAT MULT 10D 11.5 IOL ACRYSOF NAT MULT 10D 12.0 IOL ACRYSOF NAT MULT 10D 12.5 IOL ACRYSOF NAT MULT 10D 13.0 IOL ACRYSOF NAT MULT 10D 14.0 IOL ACRYSOF NAT MULT 10D 14.5 IOL ACRYSOF NAT MULT 10D 15.0 IOL ACRYSOF NAT MULT 10D 15.5 IOL ACRYSOF NAT MULT 10D 16.0 IOL ACRYSOF NAT MULT 10D 16.5 IOL ACRYSOF NAT MULT 10D 17.0 IOL ACRYSOF NAT MULT 10D 17.5 IOL ACRYSOF NAT MULT 10D 18.0 IOL ACRYSOF NAT MULT 10D 18.5 IOL ACRYSOF NAT MULT 10D 19.0 Page 164 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL ACRYSOF NAT MULT 10D 19.5 IOL ACRYSOF NAT MULT 10D 20.0 IOL ACRYSOF NAT MULT 10D 20.5 IOL ACRYSOF NAT MULT 10D 21.0 IOL ACRYSOF NAT MULT 10D 21.5 IOL ACRYSOF NAT MULT 10D 22.0 IOL ACRYSOF NAT MULT 10D 23.0 IOL ACRYSOF NAT MULT 10D 23.5 IOL ACRYSOF NAT MULT 10D 24.0 IOL ACRYSOF NAT MULT 10D 24.5 IOL ACRYSOF NAT MULT 10D 25.0 IOL ACRYSOF NAT MULT 10D 25.5 IOL ACRYSOF NAT MULT 10D 26.0 IOL ACRYSOF NAT MULT 10D 26.5 IOL ACRYSOF NAT MULT 10D 27.0 IOL ACRYSOF NAT MULT 10D 27.5 IOL ACRYSOF NAT MULT 10D 28.5 IOL ACRYSOF NAT MULT 10D 29.0 IOL ACRYSOF NAT MULT 10D 29.5 IOL ACRYSOF NAT MULT 10D 30.0 IOL SYMFONY EXT REACH 13.0 IOL SYMFONY EXT REACH 11.5 IOL TORIC ASPHERIC 6.0D 17.5D IOL SYMFONY EXT REACH 21.5 IOL TORIC ASPHERIC 3.0D 26.5D IOL TORIC ASPHERIC 3.0D 27.0D IOL SYMFONY TORIC 2.25D 22.5 IOL SYMFONY EXT REACH 22.5 IOL SYMFONY EXT REACH 17.0 IOL SYMFONY EXT REACH 17.5 IOL SYMFONY TORIC 3.75D 20.5 IOL SYMFONY EXT REACH 23.0 IOL TORIC ASPHERIC 2.25D 18.0D IOL SYMFONY TORIC 3.00D 21.0 IOL SYMFONY TORIC 1.50D 19.5 IOL TORIC ASPHERIC 6.00D 19.5D IOL SYMFONY EXT REACH 5.0 IOL SYMFONY EXT REACH 5.5 IOL SYMFONY EXT REACH 6.0 IOL SYMFONY EXT REACH 6.5 IOL SYMFONY EXT REACH 7.0 IOL SYMFONY EXT REACH 7.5 IOL SYMFONY EXT REACH 8.0 IOL SYMFONY EXT REACH 8.5 IOL SYMFONY EXT REACH 9.0 IOL SYMFONY EXT REACH 9.5 Page 165 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $1,034.00 $1,034.00 $572.00 $1,034.00 $572.00 $572.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $572.00 $1,034.00 $1,034.00 $572.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SYMFONY EXT REACH 10.0 IOL SYMFONY EXT REACH 10.5 IOL SYMFONY EXT REACH 11.0 IOL SYMFONY EXT REACH 12.0 IOL SYMFONY EXT REACH 12.5 IOL SYMFONY EXT REACH 13.5 IOL SYMFONY EXT REACH 14.0 IOL SYMFONY EXT REACH 14.5 IOL SYMFONY EXT REACH 15.0 IOL SYMFONY EXT REACH 15.5 IOL SYMFONY EXT REACH 16.0 IOL SYMFONY EXT REACH 16.5 IOL SYMFONY EXT REACH 18.0 IOL SYMFONY EXT REACH 18.5 IOL SYMFONY EXT REACH 19.0 IOL SYMFONY EXT REACH 19.5 IOL SYMFONY EXT REACH 20.0 IOL SYMFONY EXT REACH 21.0 IOL SYMFONY EXT REACH 22.0 IOL SYMFONY EXT REACH 23.5 IOL SYMFONY EXT REACH 24.0 IOL SYMFONY EXT REACH 24.5 IOL SYMFONY EXT REACH 25.0 IOL SYMFONY EXT REACH 25.5 IOL SYMFONY EXT REACH 26.0 IOL SYMFONY EXT REACH 26.5 IOL SYMFONY EXT REACH 27.0 IOL SYMFONY EXT REACH 27.5 IOL SYMFONY EXT REACH 28.0 IOL SYMFONY EXT REACH 28.5 IOL SYMFONY EXT REACH 29.0 IOL SYMFONY EXT REACH 29.5 IOL SYMFONY EXT REACH 30.0 IOL SYMFONY EXT REACH 30.5 IOL SYMFONY EXT REACH 31.0 IOL SYMFONY EXT REACH 31.5 IOL SYMFONY EXT REACH 32.0 IOL SYMFONY EXT REACH 32.5 IOL SYMFONY EXT REACH 33.0 IOL SYMFONY EXT REACH 33.5 IOL SYMFONY EXT REACH 34.0 IOL TORIC ASPHERIC 4.5D 13.5D IOL TORIC ASPHERIC 1.5D 15.5D CLIP IPRISM DISP TISS CORNEA PRECUT FOR IEK IOL SYMFONY TORIC 1.50D 17.0 Page 166 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $572.00 $572.00 $282.00 $8,352.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SYMFONY TORIC 1.5D 17.5 IOL SYMFONY TORIC 2.25D 17.0 IOL SYMFONY TORIC 1.50D 5.0 IOL SYMFONY TORIC 1.50D 5.5 IOL SYMFONY TORIC 1.50D 6.0 IOL SYMFONY TORIC 1.50D 6.5 IOL SYMFONY TORIC 1.50D 7.0 IOL SYMFONY TORIC 1.50D 7.5 IOL SYMFONY TORIC 1.50D 8.0 IOL SYMFONY TORIC 1.50D 8.5 IOL SYMFONY TORIC 1.50D 9.0 IOL SYMFONY TORIC 1.50D 9.5 IOL SYMFONY TORIC 1.50D 10.0 IOL SYMFONY TORIC 1.50D 10.5 IOL SYMFONY TORIC 1.50D 11.0 IOL SYMFONY TORIC 1.50D 11.5 IOL SYMFONY TORIC 1.50D 12.0 IOL SYMFONY TORIC 1.50D 12.5 IOL SYMFONY TORIC 1.50D 13.0 IOL SYMFONY TORIC 1.50D 13.5 IOL SYMFONY TORIC 1.50D 14.0 IOL SYMFONY TORIC 1.50D 14.5 IOL SYMFONY TORIC 1.50D 15.0 IOL SYMFONY TORIC 1.50D 15.5 IOL SYMFONY TORIC 1.50D 16.0 IOL SYMFONY TORIC 1.50D 16.5 IOL SYMFONY TORIC 1.50D 18.0 IOL SYMFONY TORIC 1.50D 18.5 IOL SYMFONY TORIC 1.50D 19.0 IOL SYMFONY TORIC 1.50D 20.0 IOL SYMFONY TORIC 1.50D 20.5 IOL SYMFONY TORIC 1.50D 21.0 IOL SYMFONY TORIC 1.50D 21.5 IOL SYMFONY TORIC 1.50D 22.0 IOL SYMFONY TORIC 1.50D 22.5 IOL SYMFONY TORIC 1.50D 23.0 IOL SYMFONY TORIC 1.50D 23.5 IOL SYMFONY TORIC 1.50D 24.0 IOL SYMFONY TORIC 1.50D 24.5 IOL SYMFONY TORIC 1.50D 25.0 IOL SYMFONY TORIC 1.50D 25.5 IOL SYMFONY TORIC 1.50D 26.0 IOL SYMFONY TORIC 1.50D 26.5 IOL SYMFONY TORIC 1.50D 27.0 IOL SYMFONY TORIC 1.50D 27.5 IOL SYMFONY TORIC 1.50D 28.0 Page 167 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SYMFONY TORIC 1.50D 28.5 IOL SYMFONY TORIC 1.50D 29.0 IOL SYMFONY TORIC 1.50D 29.5 IOL SYMFONY TORIC 1.50D 30.0 IOL SYMFONY TORIC 1.50D 30.5 IOL SYMFONY TORIC 1.50D 31.0 IOL SYMFONY TORIC 1.50D 31.5 IOL SYMFONY TORIC 1.50D 32.0 IOL SYMFONY TORIC 1.50D 32.5 IOL SYMFONY TORIC 1.50D 33.0 IOL SYMFONY TORIC 1.50D 33.5 IOL SYMFONY TORIC 1.50D 34.0 IOL SYMFONY TORIC 2.25D 5.0 IOL SYMFONY TORIC 2.25D 5.5 IOL SYMFONY TORIC 2.25D 6.0 IOL SYMFONY TORIC 2.25D 6.5 IOL SYMFONY TORIC 2.25D 7.0 IOL SYMFONY TORIC 2.25D 7.5 IOL SYMFONY TORIC 2.25D 8.0 IOL SYMFONY TORIC 2.25D 8.5 IOL SYMFONY TORIC 2.25D 9.0 IOL SYMFONY TORIC 2.25D 9.5 IOL SYMFONY TORIC 2.25D 10.0 IOL SYMFONY TORIC 2.25D 10.5 IOL SYMFONY TORIC 2.25D 11.0 IOL SYMFONY TORIC 2.25D 11.5 IOL SYMFONY TORIC 2.25D 12.0 IOL SYMFONY TORIC 2.25D 12.5 IOL SYMFONY TORIC 2.25D 13.0 IOL SYMFONY TORIC 2.25D 13.5 IOL SYMFONY TORIC 2.25D 14.0 IOL SYMFONY TORIC 2.25D 14.5 IOL SYMFONY TORIC 2.25D 15.0 IOL SYMFONY TORIC 2.25D 15.5 IOL SYMFONY TORIC 2.25D 16.0 IOL SYMFONY TORIC 2.25D 16.5 IOL SYMFONY TORIC 2.25D 17.5 IOL SYMFONY TORIC 2.25D 18.0 IOL SYMFONY TORIC 2.25D 18.5 IOL SYMFONY TORIC 2.25D 19.0 IOL SYMFONY TORIC 2.25D 19.5 IOL SYMFONY TORIC 2.25D 20.0 IOL SYMFONY TORIC 2.25D 20.5 IOL SYMFONY TORIC 2.25D 21.0 IOL SYMFONY TORIC 2.25D 21.5 IOL SYMFONY TORIC 2.25D 22.0 Page 168 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SYMFONY TORIC 2.25D 23.0 IOL SYMFONY TORIC 2.25D 23.5 IOL SYMFONY TORIC 2.25D 24.0 IOL SYMFONY TORIC 2.25D 24.5 IOL SYMFONY TORIC 2.25D 25.0 IOL SYMFONY TORIC 2.25D 25.5 IOL SYMFONY TORIC 2.25D 26.0 IOL SYMFONY TORIC 2.25D 26.5 IOL SYMFONY TORIC 2.25D 27.0 IOL SYMFONY TORIC 2.25D 27.5 IOL SYMFONY TORIC 2.25D 28.0 IOL SYMFONY TORIC 2.25D 28.5 IOL SYMFONY TORIC 2.25D 29.0 IOL SYMFONY TORIC 2.25D 29.5 IOL SYMFONY TORIC 2.25D 30.0 IOL SYMFONY TORIC 2.25D 30.5 IOL SYMFONY TORIC 2.25D 31.0 IOL SYMFONY TORIC 2.25D 31.5 IOL SYMFONY TORIC 2.25D 32.0 IOL SYMFONY TORIC 2.25D 32.5 IOL SYMFONY TORIC 2.25D 33.0 IOL SYMFONY TORIC 2.25D 33.5 IOL SYMFONY TORIC 2.25D 34.0 IOL SYMFONY TORIC 3.0D 5.0 IOL SYMFONY TORIC 3.0D 5.5 IOL SYMFONY TORIC 3.0D 6.0 IOL SYMFONY TORIC 3.0D 6.5 IOL SYMFONY TORIC 3.0D 7.0 IOL SYMFONY TORIC 3.0D 7.5 IOL SYMFONY TORIC 3.0D 8.0 IOL SYMFONY TORIC 3.0D 8.5 IOL SYMFONY TORIC 3.0D 9.0 IOL SYMFONY TORIC 3.0D 9.5 IOL SYMFONY TORIC 3.0D 10.0 IOL SYMFONY TORIC 3.0D 10.5 IOL SYMFONY TORIC 3.0D 11.0 IOL SYMFONY TORIC 3.0D 11.5 IOL SYMPHONY TORIC 12.0 IOL SYMFONY TORIC 3.0D 12.5 IOL SYMFONY TORIC 3.0D 13.0 IOL SYMFONY TORIC 3.0D 13.5 IOL SYMFONY TORIC 3.0D 14.0 IOL SYMFONY TORIC 3.0D 14.5 IOL SYMFONY TORIC 3.0D 15.0 IOL SYMFONY TORIC 3.0D 15.5 IOL SYMFONY TORIC 3.0D 16.0 Page 169 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SYMFONY TORIC 3.0D 16.5 IOL SYMFONY TORIC 3.0D 17.0 IOL SYMFONY TORIC 3.0D 17.5 IOL SYMFONY TORIC 3.0D 18.0 IOL SYMFONY TORIC 3.0D 18.5 IOL SYMFONY TORIC 3.0D 19.0 IOL SYMFONY TORIC 3.0D 19.5 IOL SYMFONY TORIC 3.0D 20.0 IOL SYMFONY TORIC 3.0D 20.5 IOL SYMFONY TORIC 3.0D 21.5 IOL SYMFONY TORIC 3.0D 22.0 IOL SYMFONY TORIC 3.0D 22.5 IOL SYMFONY TORIC 3.0D 23.0 IOL SYMFONY TORIC 3.0D 23.5 IOL SYMFONY TORIC 3.0D 24.0 IOL SYMFONY TORIC 3.0D 24.5 IOL SYMFONY TORIC 3.0D 25.0 IOL SYMFONY TORIC 3.0D 25.5 IOL SYMFONY TORIC 3.0D 26.0 IOL SYMFONY TORIC 3.0D 26.5 IOL SYMFONY TORIC 3.0D 27.0 IOL SYMFONY TORIC 3.0D 27.5 IOL SYMFONY TORIC 3.0D 28.0 IOL SYMFONY TORIC 3.0D 28.5 IOL SYMFONY TORIC 3.0D 29.0 IOL SYMFONY TORIC 3.0D 29.5 IOL SYMFONY TORIC 3.0D 30.0 IOL SYMFONY TORIC 3.0D 30.5 IOL SYMFONY TORIC 3.0D 31.0 IOL SYMFONY TORIC 3.0D 31.5 IOL SYMFONY TORIC 3.0D 32.0 IOL SYMFONY TORIC 3.0D 32.5 IOL SYMFONY TORIC 3.0D 33.0 IOL SYMFONY TORIC 3.0D 33.5 IOL SYMFONY TORIC 3.0D 34.0 IOL SYMFONY TORIC 3.75D 5.0 IOL SYMFONY TORIC 3.75D 5.5 IOL SYMFONY TORIC 3.75D 6.0 IOL SYMFONY TORIC 3.75D 6.5 IOL SYMFONY TORIC 3.75D 7.0 IOL SYMFONY TORIC 3.75D 7.5 IOL SYMFONY TORIC 3.75D 8.0 IOL SYMFONY TORIC 3.75D 8.5 IOL SYMFONY TORIC 3.75D 9.0 IOL SYMFONY TORIC 3.75D 9.5 IOL SYMFONY TORIC 3.75D 10.0 Page 170 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SYMFONY TORIC 3.75D 10.5 IOL SYMFONY TORIC 3.75D 11.0 IOL SYMFONY TORIC 3.75D 11.5 IOL SYMFONY TORIC 3.75D 12.0 IOL SYMFONY TORIC 3.75D 12.5 IOL SYMFONY TORIC 3.75D 13.0 IOL SYMFONY TORIC 3.75D 13.5 IOL SYMFONY TORIC 3.75D 14.0 IOL SYMFONY TORIC 3.75D 14.5 IOL SYMFONY TORIC 3.75D 15.0 IOL SYMFONY TORIC 3.75D 15.5 IOL SYMFONY TORIC 3.75D 16.0 IOL SYMFONY TORIC 3.75D 16.5 IOL SYMFONY TORIC 3.75D 17.0 IOL SYMFONY TORIC 3.75D 17.5 IOL SYMFONY TORIC 3.75D 18.0 IOL SYMFONY TORIC 3.75D 18.5 IOL SYMFONY TORIC 3.75D 19.0 IOL SYMFONY TORIC 3.75D 19.5 IOL SYMFONY TORIC 3.75D 20.0 IOL SYMFONY TORIC 3.75D 21.0 IOL SYMFONY TORIC 3.75D 21.5 IOL SYMFONY TORIC 3.75D 22.0 IOL SYMFONY TORIC 3.75D 22.5 IOL SYMFONY TORIC 3.75D 23.0 IOL SYMFONY TORIC 3.75D 23.5 IOL SYMFONY TORIC 3.75D 24.0 IOL SYMFONY TORIC 3.75D 24.5 IOL SYMFONY TORIC 3.75D 25.0 IOL SYMFONY TORIC 3.75D 25.5 IOL SYMFONY TORIC 3.75D 26.0 IOL SYMFONY TORIC 3.75D 26.5 IOL SYMFONY TORIC 3.75D 27.0 IOL SYMFONY TORIC 3.75D 27.5 IOL SYMFONY TORIC 3.75D 28.0 IOL SYMFONY TORIC 3.75D 28.5 IOL SYMFONY TORIC 3.75D 29.0 IOL SYMFONY TORIC 3.75D 29.5 IOL SYMFONY TORIC 3.75D 30.0 IOL SYMFONY TORIC 3.75D 30.5 IOL SYMFONY TORIC 3.75D 31.0 IOL SYMFONY TORIC 3.75D 31.5 IOL SYMFONY TORIC 3.75D 32.0 IOL SYMFONY TORIC 3.75D 32.5 IOL SYMFONY TORIC 3.75D 33.0 IOL SYMFONY TORIC 3.75D 33.5 Page 171 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL SYMFONY TORIC 3.75D 34.0 IOL ACRYSOF EXPAND 6.0 5.0D TISS CORNEA WHOLE IOL ACRFSOF EXPAND 6.0 -1.0D IOL TORIC ASPHERIC 3.0D 16.0 IOL ACRYSOF NAT MULTI 4.0D 6.0 IOL TORIC ASPHERIC 1.5D 14.0D IOL ACRYSOFIQ TORIC 5.25D 8.5 IOL ACRYSOFIQ TORIC 6.00D 8.5 SYS GLAUCOMA XEN 45 GEL STNT IOL TORIC ASPHORIC 1.5D 13.0D IOL TORIC ASPHORIC 1.5D 13.5D IOL ACRYSOFIQ TORIC 6.0D 21.5 IOL TORIC ASPHERIC 2.25D 27.5 IOL TORIC 21.0 IOL ACRFSOF EXPAND 6.0 2.0D IOL ACRFSOF EXPAND 6.0 3.0D IOL SOFTEC HD 24.5 IOL ARRIS ADAPTIV 3PC 23.0D SUT VICRYL+ 5-0 PC1 13MM 18 SUT PROLENE 5-0 SM1/SM1 BLU 12 IOL ARRIS ADAPTIV 3PC 9.5D SUT VICRYL 6-0 PC1 UNDY IOL TORIC ASPHERIC 2.25D 6.0D IOL TORIC ASPHERIC 3.0D 23.5D IOL TORIC ASPHERIC 3.0D 10.0D IOL TORIC ASPHERIC 3.0D 11.0D IOL TORIC ASPHERIC 3.0D 12.0D IOL TORIC ASPHERIC 3.0D 12.5D IOL TORIC ASPHERIC 3.0D 18.5D IOL TORIC ASPHERIC 3.0D 19.5D IOL TORIC ASPHERIC 3.0D 21.0D IOL TORIC ASPHERIC 3.0D 23.0D IOL TORIC ASPHERIC 3.0D 28.0D IOL TORIC ASPHERIC 3.0D 28.5D IOL TORIC ASPHERIC 3.0D 29.0D IOL TORIC ASPHERIC 3.0D 29.5D IOL TORIC ASPHERIC 3.0D 30.0D IOL TORIC ASPHERIC 3.0D 24.0D IOL TORIC ASPHERIC 2.25D 10.5D IOL TORIC ASPHERIC 2.25D 11.5D IOL TORIC ASPHERIC 2.25D 15.0D IOL TORIC ASPHERIC 2.25D 22.5D IOL TORIC ASPHERIC 2.25D 23.5D IOL TORIC ASPHERIC 2.25D 26.0D IOL TORIC ASPHERIC 2.25D 28.0D Page 172 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $782.00 $6,417.00 $782.00 $572.00 $782.00 $572.00 $572.00 $572.00 $4,305.00 $572.00 $572.00 $572.00 $572.00 $572.00 $782.00 $782.00 $512.00 $778.00 $25.00 $73.00 $778.00 $23.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TORIC ASPHERIC 2.25D 29.0D IOL TORIC ASPHERIC 2.25D 29.5D IOL TORIC ASPHERIC 2.25D 30.0D IOL TORIC ASPHERIC 1.50D 10.0D IOL TORIC ASPHERIC 1.50D 26.0D IOL TORIC ASPHERIC 1.50D 26.5D IOL TORIC ASPHERIC 1.50D 27.0D IOL TORIC ASPHERIC 1.50D 27.5D IOL TORIC ASPHERIC 1.50D 28.0D IOL TORIC ASPHERIC 1.50D 28.5D IOL TORIC ASPHERIC 1.50D 29.0D IOL TORIC ASPHERIC 1.50D 29.5D IOL TORIC ASPHERIC 1.50D 30.0D IOL TECNIS MULT 1PC3.25D 10.0D IOL TECNIS MULT 1PC3.25D 10.5D IOL TECNIS MULT 1PC3.25D 11.5D IOL TECNIS MULT 1PC3.25D 12.0D IOL TECNIS MULT 1PC3.25D 12.5D IOL TECNIS MULT 1PC3.25D 13.0D IOL TECNIS MULT 1PC3.25D 13.5D IOL TECNIS MULT 1PC3.25D 14.0D IOL TECNIS MULT 1PC3.25D 14.5D IOL TECNIS MULT 1PC3.25D 15.0D IOL TECNIS MULT 1PC3.25D 15.5D IOL TECNIS MULT 1PC3.25D 16.0D IOL TECNIS MULT 1PC3.25D 16.5D IOL TECNIS MULT 1PC3.25D 17.5D IOL TECNIS MULT 1PC3.25D 18.0D IOL TECNIS MULT 1PC3.25D 18.5D IOL TECNIS MULT 1PC3.25D 21.5D IOL TECNIS MULT 1PC3.25D 22.0D IOL TECNIS MULT 1PC3.25D 22.5D IOL TECNIS MULT 1PC3.25D 23.0D IOL TECNIS MULT 1PC3.25D 23.5D IOL TECNIS MULT 1PC3.25D 24.0D IOL TECNIS MULT 1PC3.25D 24.5D IOL TECNIS MULT 1PC3.25D 25.0D IOL TECNIS MULT 1PC3.25D 25.5D IOL TECNIS MULT 1PC3.25D 26.0D IOL TECNIS MULT 1PC3.25D 26.5D IOL TECNIS MULT 1PC3.25D 27.0D IOL TECNIS MULT 1PC3.25D 27.5D IOL TECNIS MULT 1PC3.25D 28.0D IOL TECNIS MULT 1PC3.25D 28.5D IOL TECNIS MULT 1PC3.25D 29.0D IOL TECNIS MULT 1PC3.25D 29.5D Page 173 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 $1,034.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL TECNIS MULT 1PC3.25D 30.0D IOL TECNIS 1PC ASPHERIC 5.0D IOL ACRYSOFIQ TORIC 3.75D 6.5 IOL ACRYSOFIQ TORIC 3.75D 7.0 IOL ACRYSOFIQ TORIC 3.75D 7.5 IOL ACRYSOFIQ TORIC 3.75D 8.0 IOL ACRYSOFIQ TORIC 3.75D 8.5 IOL ACRYSOFIQ TORIC 3.75D 9.0 IOL ACRYSOFIQ TORIC 3.75D 9.5 IOL ACRYSOFIQ TORIC 3.75D 25.5 IOL ACRYSOFIQ TORIC 3.75D 26.5 IOL ARRIS ADAPTIV 3PC 20.5D IOL ACRYSOFIQ TORIC 5.25D 6.5 IOL ARRIS ADAPTIV 3PC 18.0D IOL ARRIS ADAPTIV 3PC 29.5D IOL SENSAR MENISC -9.0 IOL ACRYSOFIQ TORIC 4.5D 19.5 IOL ACRYSOFIQ TORIC 4.5D 20.0 IOL ACRYSOFIQ TORIC 4.5D 20.5 IOL ACRYSOFIQ TORIC 5.25D 19.0 IOL ACRYSOFIQ TORIC 5.25D 19.5 IOL ACRYSOFIQ TORIC 5.25D 20.0 IOL ACRYSOFIQ TORIC 5.25D 20.5 TISS CORNEA HALO HALFTHICKNESS IOL ACRYSOFIQ TORIC 4.50D 15.0 IOL ACRFSOF EXPAND 6.0 +1.0D IOL SENSAR MENISC -0.5 LENS GOINIO IPRISM S DISP RT LENS GOINIO IPRISM S DISP LFT IOL CT LUCIA 3PC MONO 17.5D IOL CT LUCIA 3PC MONO 22.0D IOL TECNIS 1PC ASPHERIC 34.5D IOL TECNIS 1PC ASPHERIC 35.5D IOL TECNIS 1PC ASPHERIC 36.0D IOL CT LUCIA 3PC MONO 21.5D IOL ACRYSOFIQ TORIC 5.25D 11.0 IOL ACRYSOFIQ TORIC 5.25D 11.5 IOL CT LUCIA 3PC MONO 20.0D IOL CT LUCICA 3PC MONO 18.0D IOL CT LUCIA 3PC MONO 10.0D IOL CT LUCIA 3PC MONO 10.5D IOL CT LUCIA 3PC MONO 11.0D IOL CT LUCIA 3PC MONO 11.5D IOL CT LUCIA 3PC MONO 12.0D IOL CT LUCIA 3PC MONO 12.5D IOL CT LUCIA 3PC MONO 13.0D Page 174 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,034.00 $900.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $173.00 $572.00 $778.00 $778.00 $912.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $572.00 $1,596.00 $572.00 $782.00 $912.00 $378.70 $378.70 $778.00 $778.00 $857.00 $857.00 $857.00 $778.00 $572.00 $572.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL CT LUCIA 3PC MONO 13.5D IOL CT LUCIA 3PC MONO 14.0D IOL CT LUCIA 3PC MONO 14.5D IOL CT LUCIA 3PC MONO 15.0D IOL CT LUCIA 3PC MONO 15.5D IOL CT LUCIA 3PC MONO 16.0D IOL CT LUCIA 3PC MONO 16.5D IOL CT LUCIA 3PC MONO 17.0D IOL CT LUCIA 3PC MONO 18.5D IOL CT LUCIA 3PC MONO 19.0D IOL CT LUCIA 3PC MONO 19.5D IOL CT LUCIA 3PC MONO 20.0D IOL CT LUCIA 3PC MONO 20.5D IOL CT LUCIA 3PC MONO 21.0D IOL CT LUCIA 3PC MONO 21.5D IOL CT LUCIA 3PC MONO 22.5D IOL CT LUCIA 3PC MONO 23.0D IOL CT LUCIA 3PC MONO 23.5D IOL CT LUCIA 3PC MONO 24.0D IOL CT LUCIA 3PC MONO 24.5D IOL CT LUCIA 3PC MONO 25.0D IOL CT LUCIA 3PC MONO 25.5D IOL CT LUCIA 3PC MONO 26.0D IOL CT LUCIA 3PC MONO 26.5D IOL CT LUCIA 3PC MONO 27.0D IOL CT LUCIA 3PC MONO 27.5D IOL CT LUCIA 3PC MONO 28.0D IOL CT LUCIA 3PC MONO 28.5D IOL CT LUCIA 3PC MONO 29.0D IOL CT LUCIA 3PC MONO 29.5D IOL CT LUCIA 3PC MONO 30.0D IOL CT LUCIA 3PC MONO 30.5D IOL CT LUCIA 3PC MONO 31.0D IOL CT LUCIA 3PC MONO 31.5D IOL CT LUCIA 3PC MONO 32.0D IOL CT LUCIA 3PC MONO 32.5D IOL CT LUCIA 3PC MONO 33.0D IOL CT LUCIA 3PC MONO 33.5D IOL CT LUCIA 3PC MONO 34.0D IOL CT LUCIA 3PC MONO 4.0D IOL CT LUCIA 3PC MONO 4.5D IOL CT LUCIA 3PC MONO 5.0D IOL CT LUCIA 3PC MONO 5.5D IOL CT LUCIA 3PC MONO 6.0D IOL CT LUCIA 3PC MONO 6.5D IOL CT LUCIA 3PC MONO 7.0D Page 175 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $778.00 $778.00 $763.50 $763.50 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 2020 pricing Drugs&Supplies PROCEDURE NAME IOL CT LUCIA 3PC MONO 7.5D IOL CT LUCIA 3PC MONO 8.0D IOL CT LUCIA 3PC MONO 8.5D IOL CT LUCIA 3PC MONO 9.0D IOL CT LUCIA 3PC MONO 9.5D IOL CT LUCIA 3PC MONO 8.5D IOL CT LUCIA 3PC MONO 9.0D IOL CT LUCIA 3PC MONO 9.5D BRC WRIST BREG THB SPI LFT MD IRG MORGAN THERAPEUTIC LENS SUT ETHILON 5-0 P3 18 SUT CHROMIC GUT 4-0 PS2 18 SUT ETHILON 3-0 PS1 18 BIT DRILL TPS RASP METAL CUT FORCEPS BX RADJAW4 1.8MM 160CM SUT VICRYL+ 2-0 CP2 CR8 18 CANN CAPNOLINE SMART PLUS PROCALCITONIN RGT VIDAS 60T ANES OXYGEN PER MINUTE DRN T TB JP SIL 19FR RSVR WOUND JP SIL 400ML DRN HEIMLICH CHEST VALV SET IRG VISI-FLOW W CONE HOOK LEGACY RAMP NARW MD HOOK LEGACY THORACIC ANG RT HOOK LEGACY OFFSET TI LFT5.5MM SCREW LEGACY MA TI 5.5X4X30MM SCREW LEGACY MA TI 5.5X4X35MM SCREW LEGACY MA TI 5.5X4X40MM SCREW LEGACY MA TI 5.5X4X45MM SCREW LEGACY MA TI5.5X4.5X25MM SCREW LEGACY MA TI5.5X4.5X30MM SCREW LEGACY MA TI5.5X4.5X35MM SCREW LEGACY MA TI5.5X4.5X40MM SCREW LEGACY MA TI 5.5X5X30MM SCREW LEGACY MA TI 5.5X5X35MM SCREW LEGACY MA TI 5.5X5X40MM SCREW LEGACY MA TI 5.5X5X45MM SCREW LEGACY MA TI 5.5X5X50MM SCREW LEGACY MA TI5.5X5.5X45MM SCREW LEGACY MA TI5.5X5.5X50MM SCREW LEGACY MA TI5.5X6.5X50MM SCREW LEGACY MA TI5.5X7.5X40MM SCREW LEGACY MA TI5.5X7.5X45MM SCREW LEGACY MA TI5.5X7.5X50MM SCREW LEGACY MA TI5.5X8.5X40MM Page 176 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $778.00 $67.00 $145.00 $17.00 $34.00 $19.00 $555.00 $235.00 $86.00 $57.00 $3,291.00 $3.00 $71.00 $72.00 $164.00 $65.00 $2,028.00 $2,332.00 $2,332.00 $2,285.00 $2,285.00 $2,285.00 $2,285.00 $2,285.00 $2,423.00 $2,423.00 $2,423.00 $2,285.00 $2,423.00 $2,423.00 $2,423.00 $2,285.00 $2,285.00 $2,285.00 $2,285.00 $2,285.00 $2,423.00 $2,285.00 $2,285.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LEGACY MA TI5.5X8.5X45MM SCREW LEGACY MA TI5.5X8.5X50MM SCREW RDCTN MDTR 4.5X40MM ROD ST LEGACY MDTR 5.5X500MM ROD LEGACY MDTR 5.5X500MM PK COLD EYE SWISS THERAPY VACUUM OB KIWI PROCUP PATCH SYN WITTMAN 20X40CM ROD LNGTDII ST COCR+4.75X220MM BOOT HEEL PREVALON W WEDGE BOOT ROOKE VASC *DISC 6183020* BOOT ROOKE VASC *DISC 6183020* ELTD BIS XP QUATTRO SENS CLIP APPL ENDO CLIP II MD 10MM SUT PLAIN GUT 5-0 P3 18 SUT RETENTION BRIDGE SUT VICRYL 4-0 RB1 DYE SUT NYLON BLK CU-8 10-0 20CM PK FRAG ACC DRAPE ARTHRO SHT DRAPE IOBAN 320X213CM KT CATH CRICOTHYROTOMY 6.0MM CAUT ELTD ROLLERBALL BLK LIGASURE ELTD SNAP IN STD LIGASURE ATLAS 20CM LIGASURE ELTD SEAL ATLAS LIGASURE ELTD SNAP IN MAX LIGASURE ELTD SNAP IN EXT LIGASURE VESS SEAL CAUT PENCIL HAND ARGON CAUT ELTD BALL 24FR 3MM CAUT PENCIL ROCKER EDGE SMOKE CORD ACMI BOVIE ELTD VAPORTRODE VAPORIZATION BLADE DYONICS ABRADER 4.0MM BLADE DYONICS ACRO 4.0MM BLADE DYONICS ACRO 5.5MM BLADE DYONICS INCIS 4.5MM BLADE TRICUT 3.5MMX11CM BLADE RADENOIDPED CURV4MMX11CM BLADE HEL FIX NAIL TI 11X95MM BLADE DYONICS FULL RAD 2.9MM BLADE DYONICS FULL RAD 3.5MM BLADE DYONICS FULL RAD 4.5MM BLADE DERMA *CIP*DISC 6271020* CAUT ELTD CUT LOOP 24FR Page 177 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,423.00 $2,285.00 $2,764.00 $28.00 $1,240.00 $72.00 $180.00 $4,843.00 $1,228.00 $306.00 $465.00 $465.00 $97.00 $443.00 $36.00 $35.00 $8.00 $160.00 $324.00 $90.00 $100.00 $841.00 $522.00 $690.00 $1,349.00 $1,349.00 $1,042.00 $1,042.00 $1,454.00 $646.00 $533.00 $80.00 $105.00 $757.00 $230.00 $230.00 $230.00 $230.00 $815.00 $791.00 $1,466.00 $230.00 $230.00 $230.00 $200.00 $518.00 2020 pricing Drugs&Supplies PROCEDURE NAME CASSETTE IRG DISP STRY CORE BLADE ZIMM TRUNCATED 52MM BLADE ZIMM TRUNCATED 54MM BLADE ZIMM TRUNCATED 56MM BIT DRILL SYNT 1.1X55MM BIT DRILL QK SYNT 1.5X65MM BIT DRILL SYNT 2X100MM BIT DRILL QK SYNT 2.5X110MM BIT DRILL QK SYNT 2.8X165MM BIT DRILL QK SYNT 3.2X145MM BIT DRILL QK SYNT 3.5X110MM BIT DRILL QK SYNT 4.3X180MM BIT DRILL W DM 1.8X110MM BIT DRILL SYNT 1.8X100MM BIT DRILL CANN SYNT 3.2X170MM BIT DRILL CANN DISP 2.7MM160MM BIT DRILL W 6M STOP 44.5X1.1MM BIT DRILL J-LATCH 1.5X110MM BIT DRILL MINIQK CPLE 1.8X80MM BIT DRILL SYNT 4X215MM BLADE THIN OSTEO ZIMM 8MM BLADE THIN OSTEO ZIMM 10MM BLADE OSTEO LNG THIN 10MM BLADE ZIMM FULL 52MM BLADE ZIMM FULL 54MM BLADE ZIMM FULL 56MM BLADE ZIMM FULL 58MM BLADE ZIMM FULL 64MM BLADE ZIMM TRUNCATED 58MM BLADE ZIMM TRUNCATED 64MM GRAFT GORE REMOV RING RRT GRAFT BIF HEMA 24X12MM MASK TB DUCKBILL REG CATH SWAN GANZ ANTECUB PACING DEV FEM COMP GDWIRE SPRING ST 0.025 33CM GDWIRE SPRING ST J 0.035 45CM GDWIRE SPRING ST J 0.035 68CM CELL SAVER RSVR TB ASPIR ANTICOAG CELL SAVER PPM VERSA DR W SAV PPM SENSIA DR W SAV LEAD CAPSUREFIX NOVUS MRI 58CM ANGIOSEAL VIP 8FR CBL ATLAS SGL W CRIMP SUT RETRIEVER SM Page 178 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $250.00 $2,371.00 $2,371.00 $2,371.00 $293.00 $293.00 $310.00 $293.00 $358.00 $287.00 $310.00 $469.00 $568.00 $541.00 $1,780.00 $1,191.00 $541.00 $541.00 $293.00 $790.00 $818.00 $818.00 $480.48 $2,371.00 $2,371.00 $2,371.00 $2,371.00 $2,371.00 $2,371.00 $2,371.00 $3,405.00 $2,240.00 $87.00 $322.00 $460.00 $62.00 $57.00 $59.00 $303.00 $105.00 $5,628.00 $5,004.00 $1,455.00 $1,005.00 $1,512.00 $278.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT RETRIEVER MD SUT RETRIEVER LG SCRWDRVR CRUCIFM SHFT/SLV DEV SUTLASSO BANANA ARTX DURAPREP TINTED 26ML CONN TI 2 PORT SCREW CANN PART THRD 4.5X64MM TRAY CATH DL ST 11.5FR 19.5CM KT CATH CENTVEN DL 4FR 8CM CATH IV ANGIOCATH 16GX5.25 NDLE BX TRU-CUT 14GX6 DRN CHEST UNIT INFANT TB TRACH XLT PROX CUFF 6.0MM TB TRACH XLT PROX CUFF 7.0MM TB TRACH XLT PROX CUFF 8.0MM TB TRACH UNCUF PED 3.0 TB TRACH UNCUF PED 3.5 TB TRACH UNCUF PED 4.0 TB TRACH UNCUF PED 4.5 TB TRACH UNCUF PED 5.0 TB TRACH CUFF PED 5 TB TRACH CUFF PED 5.5 TB TRACH CUFF DISP CANN FEN 6 TB TRACH CUFF DISP CANN FEN 8 TB TRACH UNCUF DISP CANN 4 TB TRACH UNCUF DISP CANN 6 TB TRACH UNCUF DISP CANN 8 TB TRACH UNCUF DISP CANN FEN 4 TB TRACH UNCUF DISP CANN FEN 6 VALV SPEAKING PASSY-MUIR AQUA TB TRACH UNCUF DISP CANN FEN10 SET INTR CIAGLIA W EZ-PASS CATH SUCT ELBOW PEDS 8FR 14 TB ET CUFF REINF MURPHY 7.0MM KT GASTRO MIC LOPRO 18FR 1.0CM KT GASTRO MIC LOPRO 18FR 1.5CM KT GASTRO MIC LOPRO 18FR 2.0CM TB GJ MIC ENDO 22FR 45CM CATH INTR CHOLANGIO 4.5FR 18IN KT BLN DIL UROMAX ULT 18FR 4CM CATH FOLEY IC 3WAYCLSD18 *CIP* CATH FOLEY IC 3WAYCLSD20 *CIP* CATH FOLEY IC 3WAYCLSD24 *CIP* CATH FOLEY COUDE RB 20 *CIP* CATH PAIN PUMP INTH MDTR 2PC SET IRG TUR LG BORE 100 Page 179 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $278.00 $278.00 $1,848.06 $655.00 $21.00 $721.00 $907.00 $604.00 $165.00 $71.00 $159.00 $230.00 $348.00 $340.00 $348.00 $179.00 $179.00 $179.00 $179.00 $179.00 $236.00 $236.00 $222.00 $224.00 $197.00 $197.00 $197.00 $209.00 $209.00 $425.00 $209.00 $1,148.00 $85.00 $107.00 $526.00 $526.00 $526.00 $1,078.00 $297.00 $1,549.00 $71.00 $73.00 $71.00 $74.00 $1,807.00 $57.00 2020 pricing Drugs&Supplies PROCEDURE NAME TB JEJ BAKER CATH 15ML 16FR CATH UMBILICAL DL PU 3.5FR CATH BLN BILI FOGARTY 6FRX40CM SET CONTR NIGHT DRN KT BLN DIL UROMAX ULT 18FR10CM SET INTR APPEL-BERCI 12FR15CM CATH EMBOL IRG 4FR BLN OPTA PRO 10X4 80CM BLN OPTA PRO 7X4 80CM BLN OPTA PRO 8X4 80CM BLN OPTA PRO 9X4 80CM CATH URETRL OPEN END 4FR 70CM CATH URETRL FLEXTIP CLSD RT7FR STAPLE RELOAD GIA 60 3.8MM STAPLER TA 60 4.8MM STAPLE RELOAD TA 60 4.8MM STAPLER LDS POWERED 15W STAPLER ROTIC 55 4.8MM STAPLER CEEA 28MM STAPLER CEEA 31MM CLIP APPL SURGICLIP MD 11.5MM STAPLE RELOAD TA 60 3.5MM STAPLER CEEA 25MM STAPLER ROTIC 55 3.5MM STAPLER ENDO GIA ULT UNIV STD STAPLER CEEA 21MM CLIP APPL SURGICLIP SM 9MM STAPLE RELOAD GIA 30 2.5MM CLIP LIGACLIP LIGATING TI LG ENDO PROTACK 5MM STAPLER TA 90 4.8MM CLIP HEM-O-LOK LG STAPLER ROTIC 30 V3 STAPLER ENDO GIA ULT UNIV SHRT STAPLER CONT CURV BLU 40MM STAPLER CONT CURV GRN 40MM ENDO POUCH ENDOCATCH 10MM ENDO BABCOCK 10MM ENDO PADDLE RETR 12MM CLIP APPL LIGAMAX MG/LG 10MM ENDO STITCH DEV 10MM STAPLER ENDO HERNIA MULT 4MM TROC VERSASTEP W SLV 5MM ENDOSHEARS LAP DISP 5MM ENDO NDLE SHRT 120MM DISECT ENDO KITTNER SGL TIP Page 180 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,263.00 $247.00 $249.00 $89.00 $1,549.00 $507.00 $150.00 $523.00 $523.00 $523.00 $523.00 $58.00 $65.00 $267.00 $460.00 $231.00 $849.00 $928.00 $1,045.00 $1,045.00 $317.00 $231.00 $1,045.00 $928.00 $560.00 $1,045.00 $280.00 $509.00 $103.00 $1,259.00 $485.00 $190.00 $1,031.00 $517.00 $1,751.00 $1,751.00 $374.00 $379.00 $553.00 $1,138.00 $588.00 $269.00 $834.00 $332.00 $86.00 $130.00 2020 pricing Drugs&Supplies PROCEDURE NAME ENDO POUCH ENDOCATCH 15MM STNT ADVANIX DUODEN RX10FR5CM CANN ERCP RX TAPERED 210CM BLN CRE DILATE 10-12MM 24*CIP* BLN CRE DILATE 15-18MM 24*CIP* BLN CRE DILATE 18-20MM 24*CIP* DEV RF NOVASURE DISP ENDO TROC VERSAP*DISC 6271996* STAPLE RELOAD TA PREM 30 3.5MM STAPLER TA 30 3.5MM STAPLE RELOAD TA PREM 55 3.5MM STAPLE RELOAD TA PREM 55 4.8MM CANN TWIST-IN 6X70MM CANN TWIST-IN 8.25X70MM CMNT BONE SIMPLEX P STRY CMNT HI VAC MIXING BOWL SUCT IRG STRYKEFLOW2 10FT TB NERVE LOCATOR VARI-STEM 3 PAIN PUMP SYNCROMED MDTR 20CC PAIN PUMP SYNCROMED MDTR 40CC ARTHOWAND 35D ICW 2.3MM WIRE SUT PASSING ANCHOR SUT CRKSCRW 3.5X12MM ANCHOR SUT CRKSCRW 5X15.5MM DEV SUTLASSO CRKSCRW 45D LFT DEV SUTLASSO SD TIGHT RT 25D DEV SUTLASSO SD TIGHT LFT 25D CANN TWIST-IN 7X70MM ARTHROWAND ULT VAC BARR ADHESION INTERCEED 3X4 MANIP INJ UTERINE KRONNER CMNT BONE PALACOS R 1X40 SGL BOWL MIXEVAC II*USE 6174616* NOZZLE CMNT THIN FLEX TIP FAN LOW SPLASH INTERPULSE CBL CERLAGE W CRIMP 1.7X750MM RETR LONESTAR RING 3304 RETR STAYS LONESTAR 5MM KT INTR LEAD INTERSTIM SEPRAFILM BIORESORB MEMB 5X6 HEMO GPS SPRAY APPL HEMO GPS PLATELET SYS SGL MANIP INJ UTERINE ZUMI 4.5MM TB IRG STRAIGHTSHOT XPS MDTR SHEATH BRITE TIP 8FR 23CM BONE PLUG ZIMM LG Page 181 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $545.00 $487.00 $378.00 $1,132.00 $1,029.00 $1,029.00 $2,975.00 $666.00 $259.00 $444.00 $285.00 $285.00 $140.00 $140.00 $324.00 $416.00 $239.00 $312.00 $20,778.00 $20,778.00 $1,164.00 $415.00 $949.00 $949.00 $655.00 $738.00 $738.00 $140.00 $1,164.00 $1,073.00 $179.00 $420.00 $1,471.00 $77.00 $59.00 $1,671.00 $334.00 $343.00 $2,576.00 $1,099.00 $203.00 $1,545.00 $168.00 $149.00 $184.00 $834.00 2020 pricing Drugs&Supplies PROCEDURE NAME ALLO ASR CORNERSTONE 7MM ALLO ASR CORNERSTONE 8MM ALLO ASR CORNERSTONE 9MM BONE GRAFT INFUSE SM 2.8CC BONE GRAFT INFUSE MD 5.6CC MTX MASTERGRAFT CU 20CC ALLO PUTTY ALLOMATRIX 5CC ALLO PUTTY ALLOMATRIX 10CC ALLO DBM PUTTY DBX MTF 10ML ALLO DBM PUTTY DBX MTF 2.5ML ALLO DBM PUTTY DBX MTF 5ML BONE GRAFT INFUSE LG 8.0CC PROS GOLDENBERG PORP 5.5MM HIP HD ENDOII MTL UNIPOLR SZ43 HIP HD ENDOII MTL UNIPOLR SZ44 HIP HD ENDOII MTL UNIPOLR SZ45 HIP HD ENDOII MTL UNIPOLR SZ46 HIP HD ENDOII MTL UNIPOLR SZ47 HIP HD ENDOII MTL UNIPOLR SZ48 HIP HD ENDOII MTL UNIPOLR SZ54 HIP ADPTR ENDOII TAPER +3MM HIP ADPTR ENDOII TAPER STD HIP ADPTR ENDOII TAPER -3MM HIP CENTRALIZER ECHO ZIMM 13MM HIP CENTRALIZER ECHO ZIMM 9MM HIP SHELL MALLORY 3HL 52MM HIP HD G7 TYPE 1 MTL 32MM -6 HIP HD G7 TYPE 1 MTL 32MM -3 HIP HD G7 TYPE 1 MTL 32MM +0 HIP HD G7 TYPE 1 MTL 32MM +3 HIP HD G7 TYPE 1 MTL 32MM +9 HIP HD G7 TYPE 1 MTL 32MM +12 HIP HD EZE MTL 12/14 28MM +5 HIP HD EZE MTL 12/14 28MM +8.5 HIP HD EZE MTL 12/14 28MM +12 HIP HD EZE MTL 12/14 28MM+15.5 HIP HD EZE MTL 12/14 32MM +9 HIP HD EZE MTL 12/14 32MM +13 HIP CEMENTRALIZER DEPU 10.5MM HIP CEMENTRALIZER DEPU 12MM HIP CEMENTRALIZER DEPU 13MM HIP STEM SUMMIT CMNT SZ2 HIP STEM SUMMIT POR HIGH SZ4 HIP STEM SUMMIT POR HIGH SZ5 HIP STEM SUMMIT POR HIGH SZ6 HIP STEM SUMMIT POR HIGH SZ7 Page 182 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,172.00 $2,712.00 $2,712.00 $7,610.00 $10,231.00 $3,157.00 $1,778.00 $2,296.00 $2,389.00 $1,221.00 $1,863.00 $11,401.00 $1,282.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $834.00 $834.00 $834.00 $658.00 $658.00 $2,205.00 $1,790.00 $1,790.00 $1,790.00 $1,790.00 $1,790.00 $1,790.00 $1,419.00 $1,419.00 $1,419.00 $1,419.00 $1,419.00 $1,419.00 $284.00 $284.00 $284.00 $3,240.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SHELL TRID PSL CLUSTER52MM HIP SHELL TRID PSL CLUSTER56MM HIP SHELL TRID PSL CLUSTER58MM HIP SHELL VERS BIPOLR ZIMM44MM HIP SHELL VERS BIPOLR ZIMM45MM HIP SHELL VERS BIPOLR ZIMM47MM HIP SHELL VERS BIPOLR ZIMM48MM HIP SHELL VERS BIPOLR ZIMM49MM HIP SHELL VERS BIPOLR ZIMM50MM HIP SHELL VERS BIPOLR ZIMM51MM HIP SHELL VERS BIPOLR ZIMM52MM HIP SHELL VERS BIPOLR ZIMM53MM HIP SHELL VERS BIPOLR ZIMM54MM HIP SHELL VERS BIPOLR ZIMM55MM HIP SHELL VERS BIPOLR ZIMM57MM HIP SHELL VERS BIPOLR ZIMM58MM HIP SHELL VERS BIPOLR ZIMM60MM HIP LNR VERS BIPOLR PE 0D50X28 HIP LNR VERS BIPOLR PE 0D53X28 HIP LNR VERS BIPOLR PE 0D57X28 HIP LNR VERS BIPOLR PE 0D60X28 HIP LNR TRILOGY PE 20D 60X28MM HIP LNR TRILOGY PE 10D 48X28MM HIP LNR TRILOGY PE 10D 50X28MM HIP LNR TRILOGY PE 10D 56X28MM HIP LNR TRILOGY PE 10D 58X28MM HIP LNR TRILOGY PE 10D 60X28MM HIP LNR TRILOGY PE 10D 62X28MM HIP LNR TRILOGY PE 10D 64X28MM HIP LNR TRILOGY PE 10D 66X28MM HIP LNR TRILOGY PE 10D 68X28MM HIP LNR TRILOGY PE 10D 70X28MM HIP LNR TRILOGY PE 20D 48X28MM HIP LNR TRILOGY PE 20D 50X28MM HIP LNR TRILOGY PE 20D 58X28MM HIP LNR TRILOGY PE 20D 60X28MM HIP LNR TRILOGY PE 20D 62X28MM HIP LNR TRILOGY PE 20D 64X28MM HIP LNR TRILOGY PE 20D 66X28MM HIP LNR TRILOGY PE 20D 70X28MM HIP SHELL TRILOGY CLUSTER 48MM HIP SHELL TRILOGY CLUSTER 50MM HIP SHELL TRILOGY CLUSTER 52MM HIP SHELL TRILOGY CLUSTER 54MM HIP SHELL TRILOGY CLUSTER 56MM HIP SHELL TRILOGY CLUSTER 58MM Page 183 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,303.00 $2,303.00 $2,303.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $1,178.00 $2,847.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SHELL TRILOGY CLUSTER 60MM HIP SHELL TRILOGY CLUSTER 62MM HIP SHELL TRILOGY CLUSTER 64MM HIP SHELL TRILOGY CLUSTER 66MM HIP SHELL TRILOGY CLUSTER 68MM HIP SHELL TRILOGY CLUSTER 70MM HIP STEM VERS CMNT 12X125MM HIP CENTRALIZER DIST VERS 10MM HIP CENTRALIZER DIST VERS 11MM HIP CENTRALIZER DIST VERS 13MM HIP CENTRALIZER DIST VERS 14MM HIP CENTRALIZER DIST VERS 15MM HIP CENTRALIZER DIST VERS 16MM HIP CENTRALIZER DIST VERS 17MM HIP CENTRALIZER DIST VERS 18MM HIP CENTRALIZER DIST VERS 19MM HIP HD VERS UNIPOLR MTL 43MM HIP STEM VERS CMNT 11X120MM HIP STEM VERS CMNT 12X125MM HIP STEM VERS CMNT 13X130MM HIP STEM VERS CMNT X-OFF13X130 HIP STEM VERS CMNT 14X135MM HIP STEM VERS CMNT 15X140MM HIP STEM VERS CMNT 16X145MM HIP STEM VERS CMNT 17X150MM HIP HD VERS MTL 12/14 28MM-3.5 HIP HD VERS MTL 12/14 28MM+3.5 HIP HD VERS MTL12/14 28MM+10.5 HIP STEM LD/FX PRESSFIT 11X120 KNEE TIB INSRT ZIMM10X71/75MM KNEE TIB INSRT ZIMM10X79/83MM KNEE TIB BASE CCCR ZIMM 63MM KNEE TIB BASE CCCR ZIMM 67MM KNEE TIB BASE CCCR ZIMM 71MM KNEE TIB BASE CCCR ZIMM 75MM KNEE TIB BASE CCCR ZIMM 79MM KNEE TIB BASE CCCR ZIMM 83MM KNEE TIB STEM FINNED ZIMM 40MM KNEE TIB BASE ILOK ZIMM 59MM KNEE TIB BASE ILOK ZIMM 63MM KNEE TIB BASE ILOK ZIMM 67MM KNEE TIB BASE ILOK ZIMM 71MM KNEE TIB BASE ILOK ZIMM 75MM KNEE TIB BASE ILOK ZIMM 79MM KNEE TIB BASE ILOK ZIMM 83MM KNEE TIB BASE ILOK ZIMM 87MM Page 184 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,274.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $1,469.00 $3,298.00 $3,298.00 $3,298.00 $4,868.00 $3,298.00 $3,298.00 $3,298.00 $3,298.00 $1,657.00 $1,657.00 $1,657.00 $2,890.00 $2,042.00 $2,042.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 $1,167.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 $2,458.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB BASE ILOK ZIMM 91MM KNEE FEM CR NONPOR DEPU LFT 2 KNEE FEM CR NONPOR DEPU LFT 3 KNEE FEM CR NONPOR DEPU LFT 4 KNEE FEM CR NONPOR DEPU LFT 5 KNEE FEM CR NONPORDEPU LFT2.5 KNEE FEM CR NONPOR DEPU RT 2 KNEE FEM CR NONPOR DEPU RT 3 KNEE FEM CR NONPOR DEPU RT 4 KNEE FEM CR NONPOR DEPU RT 5 KNEE FEM CR NONPOR DEPU RT2.5 KNEE FEM CRUC SUB SIGMA LFT 2 KNEE FEM CRUC SUB SIGMA LFT 3 KNEE FEM CRUC SUB SIGMA LFT 4 KNEE FEM CRUC SUB SIGMA LFT 5 KNEE FEM CRUC SUB SIGMA LFT 6 KNEE FEM CRUC SUB SIGMA LFT2.5 KNEE FEM CRUC SUB SIGMA RT 2 KNEE FEM CRUC SUB SIGMA RT 3 KNEE FEM CRUC SUB SIGMA RT 4 KNEE FEM CRUC SUB SIGMA RT 5 KNEE FEM CRUC SUB SIGMA RT 6 KNEE FEM CRUC SUB SIGMA RT 2.5 KNEE FEM CR POR DEPU LFT SZ2 KNEE FEM CR POR DEPU LFT SZ3 KNEE FEM CR POR DEPU LFT SZ4 KNEE FEM CR POR DEPU LFT SZ5 KNEE FEM CR POR DEPULFT 2.5 KNEE FEM CR POR DEPU RT SZ2 KNEE FEM CR POR DEPU RT SZ3 KNEE FEM CR POR DEPU RT SZ4 KNEE FEM CR POR DEPU RT 2.5 KNEE PTLA PFC SIGMA DEPU 25MM KNEE PTLA PFC SIGMA DEPU 28MM KNEE PTLA PFC SIGMA DEPU 32MM KNEE PTLA DOME 3PEG DEPU 32MM KNEE PTLA DOME 3PEG DEPU 35MM KNEE PTLA DOME 3PEG DEPU 41MM KNEE TIB BASE PFC POR DEPUSZ2 KNEE TIB BASE PFC POR DEPUSZ3 KNEE TIB BASE PFC POR DEPUSZ4 KNEE TIB BASE PFC POR DEPUSZ5 KNEE TIB BASE PFC POR DEPUSZ6 KNEE TIB BASE PFC POR SZ2.5 KNEE FEM NEX CR PRECOAT LFTSZC KNEE FEM NEX CR PRECOAT RT C Page 185 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,458.00 $4,665.00 $2,764.00 $2,764.00 $4,665.00 $4,665.00 $4,665.00 $2,764.00 $2,764.00 $2,764.00 $2,764.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,356.00 $3,356.00 $3,356.00 $3,357.00 $3,356.00 $3,356.00 $3,356.00 $3,356.00 $3,356.00 $1,299.00 $1,299.00 $1,299.00 $1,299.00 $1,299.00 $1,299.00 $5,814.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,479.00 $3,479.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE FEM NEX CR PRECOAT LFTSZD KNEE FEM NEX CR PRECOAT RT SZD KNEE FEM NEX CR PRECOAT LFTSZE KNEE FEM NEX CR PRECOAT RT SZE KNEE FEM NEX CR PRECOAT LFTSZF KNEE FEM NEX CR PRECOAT RT SZF KNEE FEM NEX CR PRECOAT LFTSZG KNEE FEM NEX CR PRECOAT RT SZG KNEE PTLA NEX ZIMM 29MM KNEE PTLA NEX ZIMM 32MM KNEE PTLA NEX ZIMM 35MM KNEE PTLA NEX ZIMM 38MM KNEE PTLA NEX ZIMM 41MM KNEE TIB INSRT 3-4 YEL 12MM KNEE TIB INSRT 5-6 GRN 12MM KNEE TIB INSRT CH 3-4 10MM KNEE TIB BASE NEX PRECOATSZ3 KNEE TIB BASE NEX PRECOATSZ4 KNEE TIB BASE NEX PRECOATSZ5 KNEE TIB BASE NEX PRECOAT SZ6 KNEE TIB BASE NEX PRECOAT SZ7 KNEE TIB BASE NEX PRECOAT SZ8 KNEE TIB BASE PEGGED ZIMM SZ7 EXPAND MAM ALLE LOW 400CC EXPAND MAM ALLE MODER 500CC BREAST COHESIVEHIPRO 500CC BREAST COHESIVEHIPRO 550CC BREAST COHESIVEHIPRO 600CC NAIL GAMMA RT LNG 130D 340MM TRANSFIX IMPLT ARTX 3X50MM ANCHOR MITEK ROTATOR SZ2 36 ANCHOR SUP QK PLUS 2 CP2 ETHI PLATE COMP TENSION TI 2.4 4HL PLATE LCDCP CRST TI 4HL 2.4MM PLATE LCDCP CRST TI 6HL 2.4MM PLATE ST LC DCP TI 5HL 2.4MM PLATE COMP TENSION TI 2.4 6HL PLATE ANG UNIVFRAC TI2.4 3X3HL PLATE ANG UNIVFRAC TI2.4 4X4HL PLATE ST UNIV FRAC TI 8HL 2.4 PLATE ST UNIV FRAC TI 10HL 2.4 KWIRE CANN ZIMM 1.6MMX6IN KWIRE GAMMA 3.2X450MM KWIRE THRD TIP 5X1.6X150MM KWIRE TROC SGL END 1.6MM PIN ORTHOSORB 1.3X40MM*CIP* Page 186 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,479.00 $3,479.00 $3,479.00 $3,479.00 $3,479.00 $3,479.00 $3,479.00 $3,479.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,829.00 $1,829.00 $1,829.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $3,164.00 $3,278.00 $2,274.00 $2,274.00 $2,274.00 $3,195.00 $786.00 $1,584.00 $1,558.00 $1,235.00 $1,405.00 $1,458.00 $1,405.00 $1,035.00 $1,913.00 $2,065.00 $1,405.00 $1,433.00 $235.00 $352.00 $69.00 $60.00 $1,191.00 2020 pricing Drugs&Supplies PROCEDURE NAME PIN ORTHOSORB KT 1.3X40 *DISC* PLATE CALCANEAL ZIMM LG PLATE CALCANEAL ZIMM SM PLATE COMP ZIMM10HL PLATE COMP ZIMM 5HL PLATE COMP ZIMM 6HL PLATE COMP ZIMM 7HL PLATE COMP ZIMM 8HL PLATE COMP ZIMM 9HL PLATE RAD DORSAL ZIMM LFT NARW PLATE RAD ZIMM LFT WD PLATE RAD ZIMM RT NARW PLATE RAD DORSAL ZIMM RT WIDE PLATE FIB ZIMM 5HL PLATE FIB ZIMM 7HL PLATE FIB ZIMM 9HL PLATE FIB ZIMM 11HL PLATE MEDL PILON ZIMM 3HL PLATE MEDL PILON ZIMM 5HL PLATE MEDL PILON ZIMM 7HL PLATE META ZIMM LG 3HL PLATE META ZIMM LG 5HL PLATE META ZIMM SM 3HL PLATE META ZIMM SM 5HL PLATE HUMR PROX ZIMM LFT 6HL PLATE HUMR PROX ZIMM RT 6HL PLATE ZIMM SPIDER 16MM PLATE ZIMM SPIDER 20MM PLATE ZIMM SPIDER OFFSET PLATE TUBLR SM 100D 10HL PLATE TUBLR SM 100D 3HL PLATE TUBLR SM 100D 5HL PLATE TUBLR SM 100D 7HL PLATE TUBLR SM 100D 8HL PLATE VOLAR ZIMM LFT NARW PLATE VOLAR ZIMM LFT WIDE PLATE VOLAR ZIMM RT NARW PLATE RAD VOLAR ZIMM RT WIDE BIT DRILL MDTR 4.0MM PLATE DVR ZIMM STD LFT PLATE DVR ZIMM STD RT PLATE T LCP LG 4HL 4.5X83MM PLATE LCP BROAD 4.5/5 9HL 170 PLATE LCP BROAD 4.5/5 14HL 260 PLATE LCP BROAD 4.5/5 16HL 296 PLATE LCP NARW 11HL 4.5X206MM Page 187 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,606.00 $1,851.00 $1,810.00 $1,000.00 $834.00 $834.00 $834.00 $891.00 $943.00 $1,111.00 $1,182.00 $1,182.00 $1,182.00 $927.00 $1,037.00 $1,098.00 $1,159.00 $1,377.00 $1,441.00 $1,554.00 $1,441.00 $1,572.00 $1,282.00 $1,421.00 $1,175.00 $1,175.00 $641.00 $641.00 $641.00 $641.00 $465.00 $531.00 $582.00 $582.00 $1,182.00 $1,372.00 $1,182.00 $1,182.00 $2,114.00 $2,543.00 $2,543.00 $1,744.00 $1,693.00 $2,104.00 $2,326.00 $1,693.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE LCP NARW 14HL 4.5X260MM PLATE TIB PROX LCP RT 4HL 4.5 PLATE TIB PROX LCP LFT 8HL 4.5 PLATE TIB PROX LCP RT 10HL 4.5 PLATE TIB PROX LCP LFT 10HL4.5 PLATE TIB PROX LCP RT 12HL 4.5 PLATE TIB PROX LCP LFT 12HL4.5 PLATE TIB PROX LCP RT 14HL 4.5 PLATE TIB PROX LCP LFT 14HL4.5 PLATE T TI SYNT 1.3MM 1X3HL PLATE X TI SYNT 1.3MM 4HL PLATE Y TI SYNT 1.3MM 1X3HL PLATE BOX TI SYNT 4HL 13X8MM PLATE DBL Y TI 1.3MM 6HL 15MM PLATE DBL Y TI 1.3MM 6HL 18MM PLATE L OBLIQ TI 1.3MMLFT3X4HL PLATE L OBLIQ TI 1.3MM RT3X4HL PLATE ORB RIM TI 9HL 1.3X35MM PLATE X TI 1.5 4HL 15X15MM PLATE DBL Y TI 6HL 1.5X18MM PLATE DBL Y TI 6HL 1.5X21MM PLATE L OBLIQ TI 100D RT 5HL PLATE L OBLIQ TI 100D LFT 7HL PLATE L OBLIQ TI 100D RT 7HL PLATE L OBLIQ 2.0 LFT 2HL 19MM PLATE L OBLIQ 2.7MM LFT 3HL PLATE L OBLIQ 2.0 RT 2HL 19MM PLATE L OBLIQ 2.7MM RT 3HL PLATE T 2.0MM 2HL 18MM PLATE T 3HL 2.7X32MM PLATE ST 2.0MM 3HL 17MM PLATE ST 2.0MM 5HL 29MM PLATE 1/4TUBLR W COLAR 2.7 5HL PLATE T TI 3HL 1.3X35MM PLATE T TI 4HL 1.3X35MM PLATE Y TI 3HL 1.3X37MM PLATE H EXT TI LFT 1.3X19MM PLATE ST TI 6HL 1.3X23MM PLATE ST TI 12HL 1.3X47MM PLATE T TI 3/8HL 1.5X44MM PLATE T TI 4/8HL 1.5X44MM PLATE COND TI 7HL LFT 1.5X36MM PLATE COND TI 7HL RT 1.5X36MM PLATE H EXT TI RT 8HL 1.5MM PLATE H EXT TI LFT 8HL 1.5MM PLATE ST TI 6HL 1.5X29MM Page 188 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,875.00 $3,010.00 $3,082.00 $3,115.00 $3,115.00 $3,150.00 $3,150.00 $3,109.00 $3,109.00 $793.00 $727.00 $728.00 $712.00 $786.00 $788.00 $792.00 $793.00 $793.00 $849.00 $848.00 $849.00 $848.00 $897.00 $897.00 $279.00 $306.00 $279.00 $306.00 $279.00 $306.00 $279.00 $324.00 $429.00 $1,009.00 $1,037.00 $1,009.00 $1,037.00 $883.00 $1,084.00 $1,009.00 $1,037.00 $998.00 $998.00 $1,037.00 $1,037.00 $883.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE ST TI 12HL 1.5X59MM PLATE T TI 3/8HL 2.0X53MM PLATE Y TI 2.0 3X8HL 55MM PLATE MINICOND TI 7HL LFT2.0MM PLATE MINICOND TI 7HL RT 2.0MM PLATE LC-DCP HAND TI 8HL 2.0MM PLATE ST TI 6HL 2.0X35MM PLATE ST TI 12HL 2.0X71MM PLATE T HAND TI 12HL 2.4 3X8HL PLATE Y HAND TI 12HL 2.4 3X8HL PLATE CONDHAND TI RT 8HL 2.4MM PLATE CONDHAND TI LFT8HL 2.4MM PLATE ST HAND TI 12HL 2.4X72MM PLATE 3.5 LC-DCP 6HL 77MM PLATE 3.5 LC-DCP 7HL 90MM PLATE 3.5 LC-DCP 8HL 103MM PLATE 3.5 LC-DCP 9HL 116MM PLATE T LCP OBLIQ LFT3HL3.5X52 PLATE T LCP OBLIQ LFT4HL3.5X63 PLATE T LCP OBLIQ LFT7HL3.5X96 PLATE T LCP OBLIQ RT 3HL3.5X52 PLATE T LCP OBLIQ RT 4HL3.5X63 PLATE T LCP OBLIQ RT 5HL3.5X74 PLATE T LCP OBLIQ RT 7HL3.5X96 PLATE T LCP RTANG 4HD4HL3.5X56 PLATE T LCP RTANG4HD6HL 3.5X78 PLATE 3.5 LCP 12HL 163MM PLATE 3.5 LCP 14HL 189MM PLATE CLOVERLF THIN BLADE 3HL PLATE CLOVERLF THIN BLADE 4HL PLATE RECON LCP 3.5MM12HL168MM PLATE T RT ANG 3HD3HL 3.5X50MM PLATE T RT ANG 3HD5HL 3.5X67MM PLATE T OBLIQ RT 3HL 3.5X53MM PLATE T OBLIQ RT 4HL 3.5X63MM PLATE T OBLIQ RT 5HL 3.5X75MM PLATE 1/3TUBLR COLAR 2HL 25MM PLATE 1/3TUBLR COLAR 3HL 37MM PLATE 1/3TUBLR COLAR 4HL 49MM PLATE 1/3TUBLR COLAR 5HL 61MM PLATE 1/3TUBLR COLAR 6HL 73MM PLATE 1/3TUBLR COLAR 7HL 85MM PLATE TIB DIST ZIMM RT 6HL PLATE TIB DIST ZIMM RT 14HL PLATE TIB PLATEAU ZIMM LFT 10H PLATE TIB PLATEAU ZIMM RT 8HL Page 189 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,084.00 $1,133.00 $1,133.00 $1,046.00 $1,046.00 $1,085.00 $959.00 $1,133.00 $1,241.00 $1,202.00 $1,061.00 $1,061.00 $1,225.00 $683.00 $707.00 $742.00 $782.00 $1,208.00 $1,265.00 $1,389.00 $1,205.00 $1,260.00 $1,315.00 $1,386.00 $1,151.00 $1,372.00 $1,330.00 $1,779.00 $1,043.00 $1,114.00 $1,811.00 $580.00 $659.00 $966.00 $1,021.00 $1,042.00 $279.00 $284.00 $329.00 $329.00 $338.00 $338.00 $2,477.00 $2,589.00 $2,524.00 $2,437.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE TIB PLATEAU ZIMM RT 12HL ROD RUSH 1/8X10 SZM ROD RUSH 1/8X4.5 SZB ROD RUSH 1/8X4 SZA ROD RUSH 1/8X6 SZE ROD RUSH 1/8X7.5 SZH ROD RUSH 1/8X7 SZG ROD RUSH 1/8X8.5 SZJ ROD RUSH 1/8X8 SZI ROD RUSH 1/8X9.5 SZL ROD RUSH 1/8X9 SZK SCREW CANN CNCLS ZIMM 14MM SCREW CANN CNCLS ZIMM 16MM SCREW CANN CNCLS ZIMM 18MM SCREW CANN CNCLS ZIMM 20MM SCREW CANN CNCLS ZIMM 22MM SCREW CANN CNCLS ZIMM 24MM SCREW CANN CNCLS ZIMM 26MM SCREW CANN CNCLS ZIMM 28MM SCREW CANN CNCLS ZIMM 30MM SCREW CANN CNCLS ZIMM 34MM SCREW CANN CNCLS ZIMM 36MM SCREW CANN CNCLS ZIMM 38MM SCREW CANN CNCLS ZIMM 40MM 'SCREW CANN CNCLS ZIMM 42MM SCREW CANN CNCLS ZIMM 44MM SCREW CANN CNCLS ZIMM 46MM SCREW CANN CNCLS ZIMM 48MM SCREW CANN CNCLS ZIMM 50MM SCREW CANN CNCLS ZIMM 55MM SCREW CANN CNCLS ZIMM 60MM SCREW CANN CNCLS ZIMM 65MM SCREW CORT BONE 4.5X30MM SCREW CORT BONE 4.5X32MM SCREW CORT BONE 4.5X34MM SCREW CORT BONE 4.5X36MM SCREW CORT BONE 4.5X38MM SCREW CORT BONE 4.5X40MM SCREW CORT BONE 4.5X42MM SCREW CORT BONE 4.5X44MM SCREW CORT BONE 4.5X46MM SCREW CORT BONE 4.5X48MM SCREW CORT BONE 4.5X50MM SCREW CORT BONE 4.5X52MM SCREW CORT BONE 4.5X56MM SCREW CORT BONE 4.5X60MM Page 190 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,524.00 $653.00 $653.00 $653.00 $653.00 $653.00 $653.00 $653.00 $653.00 $653.00 $653.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,068.00 $1,195.00 $1,068.00 $1,068.00 $1,195.00 $1,195.00 $1,068.00 $284.00 $284.00 $284.00 $276.00 $276.00 $284.00 $284.00 $284.00 $284.00 $284.00 $284.00 $284.00 $284.00 $284.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREWCANNCNCLSZIMM6.5X22X100MM SCREWCANNCNCLSZIMM6.5X22X105MM SCREWCANNCNCLSZIMM6.5X22X110MM SCREWCANNCNCLSZIMM6.5X22X115MM SCREWCANNCNCLSZIMM6.5X22X120MM SCREW CANNCNCLSZIMM6.5X22X25MM SCREW CANNCNCLSZIMM6.5X22X30MM SCREW CANNCNCLSZIMM6.5X22X35MM SCREW CANNCNCLSZIMM6.5X22X40MM SCREW CANNCNCLSZIMM6.5X22X45MM SCREW CANNCNCLSZIMM6.5X22X50MM SCREW CANNCNCLSZIMM6.5X22X55MM SCREW CANNCNCLSZIMM6.5X22X60MM SCREW CANNCNCLSZIMM6.5X22X65MM SCREW CANNCNCLSZIMM6.5X22X70MM SCREW CANNCNCLSZIMM6.5X22X75MM SCREW CANNCNCLSZIMM6.5X22X90MM SCREW CANNCNCLSZIMM6.5X22X95MM SCREWCANNCNCLSZIMM6.5X40X100MM SCREWCANNCNCLSZIMM6.5X40X105MM SCREWCANNCNCLSZIMM6.5X40X110MM SCREWCANNCNCLSZIMM6.5X40X115MM SCREWCANNCNCLSZIMM6.5X40X120MM SCREW CANNCNCLSZIMM6.5X40X40MM SCREW CANNCNCLSZIMM6.5X40X45MM SCREW CANNCNCLSZIMM6.5X40X50MM SCREW CANNCNCLSZIMM6.5X40X55MM SCREW CANNCNCLSZIMM6.5X40X60MM SCREW CANNCNCLSZIMM6.5X40X65MM SCREW CANNCNCLSZIMM6.5X40X70MM SCREW CANNCNCLSZIMM6.5X40X75MM SCREW CANNCNCLSZIMM6.5X40X80MM SCREW CANNCNCLSZIMM6.5X40X85MM SCREW CANNCNCLSZIMM6.5X40X90MM SCREW CANNCNCLSZIMM6.5X40X95MM SCREW CNCLS NL PART THRD 4X14 SCREW CNCLS NL PART THRD 4X16 SCREW CNCLS NL PART THRD 4X18 SCREW CNCLS NL PART THRD 4X20 SCREW CNCLS NL PART THRD 4X22 SCREW CNCLS NL PART THRD 4X24 SCREW CNCLS NL PART THRD 4X26 SCREW CNCLS NL PART THRD 4X28 SCREW CNCLS NL PART THRD 4X30 SCREW CNCLS NL PART THRD 4X35 SCREW CNCLS NL PART THRD 4X40 Page 191 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $1,282.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CNCLS NL PART THRD 4X45 SCREW CNCLS NL PART THRD 4X50 SCREW CNCLS NL PART THRD 4X60 SCREW CANN ZIMM 4X10MM SCREW CANN ZIMM 4X12MM SCREW CANN ZIMM 4X14MM SCREW CANN ZIMM 4X16MM SCREW CANN ZIMM 4X18MM SCREW CANN ZIMM 4X20MM SCREW CANN ZIMM 4X22MM SCREW CANN ZIMM 4X24MM SCREW CANN ZIMM 4X26MM SCREW CANN ZIMM 4X28MM SCREW CANN ZIMM 4X30MM SCREW CANN ZIMM 4X32MM SCREW CANN ZIMM 4X34MM SCREW CANN ZIMM 4X36MM SCREW CANN ZIMM 4X38MM SCREW CANN ZIMM 4X40MM SCREW CANN ZIMM 4X42MM SCREW CANN ZIMM 4X44MM SCREW CANN ZIMM 4X46MM SCREW CANN ZIMM 4X48MM SCREW CANN ZIMM 4X50MM SCREW CANN ZIMM 4X55MM SCREW CORT ZIMM 4X10MM SCREW CORT ZIMM 4X12MM SCREW CORT ZIMM 4X14MM SCREW CORT ZIMM 4X16MM SCREW CORT ZIMM 4X18MM SCREW CORT ZIMM 4X20MM SCREW CORT ZIMM 4X22MM SCREW CORT ZIMM 4X24MM SCREW CORT ZIMM 4X26MM SCREW CORT ZIMM 4X28MM SCREW CORT ZIMM 4X30MM SCREW CORT ZIMM 4X32MM SCREW CORT ZIMM 4X34MM SCREW CORT ZIMM 4X36MM SCREW CORT ZIMM 4X38MM SCREW CORT ZIMM 4X40MM SCREW CORT ZIMM 4X42MM SCREW CORT ZIMM 4X44MM SCREW CORT ZIMM 4X46MM SCREW CORT ZIMM 4X48MM SCREW CORT ZIMM 4X50MM Page 192 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $214.00 $214.00 $214.00 $214.00 $214.00 $214.00 $214.00 $214.00 $214.00 $214.00 $281.00 $281.00 $281.00 $281.00 $281.00 $281.00 $281.00 $281.00 $281.00 $281.00 $281.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT ZIMM 4X60MM SCREW ACUTRAK STD 30MM SCREW BIO INTERFER FULL9X28MM SCREW BIO INTERFER 10X28MM SCREW BIO INTERFER 11X28MM SCREW CANN INTERFER 7X20MM SCREW CANN SHEATH 7X25MM SCREW CANN SHEATH 8X20MM SCREW CANN SHEATH 8X25MM SCREW CANN SHEATH 9X20MM SCREW CANN SHEATH 9X25MM SCREW ATLANTIS VA MDTR 4X18MM HIP SCREW C2A TAPER 6.5X15MM HIP SCREW C2A TAPER 6.5X20MM HIP SCREW C2A TAPER 6.5X25MM HIP SCREW C2A TAPER 6.5X30MM HIP SCREW C2A TAPER 6.5X40MM SCREW CROSS LK HEX ZIMM 20MM SCREW TRNVRS BIOM *DISC* SCREW TRNVRS BIOM *DISC* SCREW TRNVRS BIOM *DISC* SCREW TRNVRS BIOM *DISC* SCREW TRNVRS BIOM *DISC* SCREW ENDOFIX ZIMM PEG SMTH ZIMM 14MM PEG SMTH ZIMM 16MM PEG SMTH ZIMM LNG 20MM PEG SMTH ZIMM LNG 22MM PEG SMTH ZIMM LNG 24MM PEG SMTH ZIMM LNG 26MM PEG LK SMTH ZIMM2X28MM PEG PART THRD ZIMM 2.5X14MM PEG PART THRD ZIMM 2.5X16MM PEG PART THRD ZIMM 2.5X18MM PEG PART THRD ZIMM 2.5X20MM PEG PART THRD ZIMM 2.5X24MM PEG PART THRD ZIMM 2.5X26MM PEG PART THRD ZIMM 2.5X28MM HIP SCREW BONE HGPII 6.5X40MM HIP SCREW BONE HGPII 6.5X50MM HIP SCREW PNCLE CNCLS 6.5X25MM HIP SCREW PNCLE CNCLS 6.5X30MM HIP SCREW PNCLE CNCLS 6.5X35MM HIP SCREW PNCLE CNCLS 6.5X40MM HIP SCREW PNCLE CNCLS 6.5X45MM HIP SCREW PNCLE CNCLS 6.5X50MM Page 193 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $281.00 $1,418.00 $706.00 $706.00 $706.00 $579.00 $579.00 $579.00 $579.00 $579.00 $579.00 $855.00 $284.00 $284.00 $284.00 $284.00 $284.00 $984.00 $823.00 $823.00 $1,042.00 $1,042.00 $1,042.00 $700.00 $561.00 $561.00 $590.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $203.00 $203.00 $276.00 $276.00 $276.00 $276.00 $276.00 $276.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SCREW PNCLE CNCLS 6.5X55MM SCREW NUT 5MM HIP SCREW CNCLS TRIDENT 6.5X25 HIP SCREW CNCLS TRIDENT 6.5X30 SCREW SEXTANT 5.5X45MM SCREW SET SEXTANT MA SCREW LK CONIC HD 4X16MM SCREW LK CONIC HD 4X18MM SCREW LK CONIC HD 4X22MM SCREW LK CONIC HD 4X26MM SCREW LK CONIC HD 4X30MM SCREW LK CONIC HD 4X58MM SCREW LK CONIC HD 4X62MM SCREW LK SLFTP STAR T25 4X16 SCREW LK SLFTP STAR T25 4X18 SCREW LK SLFTP STAR T25 4X22 SCREW LK SLFTP STAR T25 4X58 SCREW LK SLFTP STAR T25 4X62 SCREW CORT SLFTP 4.5X18MM SCREW CORT SLFTP 4.5X66MM SCREW CORT SLFTP 4.5X68MM SCREW MALLEO SYNT 4.5X25MM SCREW MALLEO SYNT 4.5X35MM SCREW MALLEO SYNT 4.5X45MM SCREW MALLEO SYNT 4.5X55MM SCREW SHAFT SYNT 4.5X12X28MM SCREW SHAFT SYNT 4.5X12X32MM SCREW SHAFT SYNT 4.5X12X34MM SCREW SHAFT SYNT 4.5X12X36MM SCREW SHAFT SYNT 4.5X12X38MM SCREW SHAFT SYNT 4.5X12X42MM SCREW SHAFT SYNT 4.5X12X44MM SCREW SHAFT SYNT 4.5X12X46MM SCREW SHAFT SYNT 4.5X12X48MM SCREW CANN CONIC HEX SMTH 5X40 SCREW CANN CONIC HEX SMTH 5X45 SCREW CANN CONIC HEX SMTH 5X50 SCREW CANN CONIC HEX SMTH 5X55 SCREW CANN CONIC HEX SMTH 5X60 SCREW CANN CONIC HEX SMTH 5X80 SCREW CANN CONIC HEX SMTH 5X90 SCREW CANN CONIC HEX SMTH 5X95 SCREW CANN LK HEX THRD 5X90 SCREW CANN LK HEX THRD 5X95 SCREW LK T25 STARDR 5X70MM SCREW LK T25 STARDR 5X75MM Page 194 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $276.00 $747.00 $716.00 $484.00 $2,581.00 $576.00 $664.00 $664.00 $664.00 $664.00 $664.00 $664.00 $664.00 $664.00 $664.00 $664.00 $664.00 $664.00 $117.00 $117.00 $117.00 $166.00 $166.00 $166.00 $166.00 $89.00 $89.00 $89.00 $89.00 $89.00 $98.00 $98.00 $98.00 $98.00 $793.00 $793.00 $793.00 $793.00 $793.00 $793.00 $793.00 $793.00 $903.00 $903.00 $667.00 $667.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK T25 STARDR 5X80MM SCREW LK T25 STARDR 5X85MM SCREW LK T25 STARDR 5X90MM SCREW CNCLS SYNT 6.5X16X35MM SCREW CNCLS SYNT 6.5X16X45MM SCREW CNCLS SYNT 6.5X16X55MM SCREW CNCLS SYNT 6.5X16X95MM SCREW CNCLS SYNT 6.5X16X105MM SCREW CNCLS SYNT 6.5X32X55MM SCREW CNCLS SYNT 6.5X32X95MM SCREW CNCLS FULL THRD 6.5X25MM SCREW CNCLS FULL THRD 6.5X35MM SCREW CANN CONIC SYNT 7.3X55MM SCREW CANN CONIC SYNT 7.3X60MM SCREW CANN CONIC SYNT 7.3X70MM SCREW CANN CONIC SYNT 7.3X75MM SCREW CANN CONIC SYNT 7.3X80MM SCREW CANN CONIC SYNT 7.3X85MM SCREW CANN CONIC SYNT 7.3X90MM SCREW CANN CONIC SYNT 7.3X05MM SCREW CANN LK THRD HEX7.3X50 SCREW CANN LK THRD HEX7.3X55 SCREW CANN LK THRD HEX7.3X75 SCREW CANN LK THRD HEX7.3X80 SCREW CANN LK THRD HEX7.3X90 SCREW CANN LK THRD HEX7.3X95 SCREW CANN LNG THRD SS 3X14MM SCREW CANN LNG THRD SS 3X15MM SCREW CANN LNG THRD SS 3X16MM SCREW CANN LNG THRD SS 3X17MM SCREW CANN LNG THRD SS 3X19MM SCREW CANN LNG THRD SS 3X21MM SCREW CANN LNG THRD SS 3X22MM SCREW CANN LNG THRD SS 3X23MM SCREW CANN LNG THRD SS 3X24MM SCREW CANN LNG THRD SS 3X25MM SCREW CANN LNG THRD SS 3X26MM SCREW CANN LNG THRD SS 3X27MM SCREW CANN LNG THRD SS 3X28MM SCREW CANN LNG THRD SS 3X29MM SCREW CANN LNG THRD SS 3X32MM SCREW CANN LNG THRD SS 3X38MM SCREW CANN SHRT THRD SS 3X8MM SCREW CANN SHRT THRD SS 3X9MM SCREW CANN SHRT THRD SS 3X11MM SCREW CANN SHRT THRD SS 3X12MM Page 195 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $667.00 $667.00 $667.00 $172.00 $172.00 $172.00 $184.00 $184.00 $172.00 $184.00 $172.00 $172.00 $1,160.00 $1,160.00 $1,160.00 $1,160.00 $1,160.00 $1,267.00 $1,160.00 $1,160.00 $1,015.00 $1,015.00 $1,015.00 $1,015.00 $1,015.00 $1,015.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN SHRT THRD SS 3X13MM SCREW CANN SHRT THRD SS 3X14MM SCREW CANN SHRT THRD SS 3X15MM SCREW CANN SHRT THRD SS 3X16MM SCREW CANN SHRT THRD SS 3X17MM SCREW CANN SHRT THRD SS 3X18MM SCREW CANN SHRT THRD SS 3X19MM SCREW CANN SHRT THRD SS 3X21MM SCREW CANN SHRT THRD SS 3X22MM SCREW CANN SHRT THRD SS 3X23MM SCREW CANN SHRT THRD SS 3X24MM SCREW CANN SHRT THRD SS 3X25MM SCREW CANN SHRT THRD SS 3X27MM SCREW CANN SHRT THRD SS 3X28MM SCREW CANN SHRT THRD SS 3X29MM SCREW CANN SHRT THRD SS 3X34MM SCREW CANN SHRT THRD SS 3X36MM SCREW CANN PART THRD 3.5X34MM SCREW CANN PART THRD 3.5X36MM SCREW CANN PART THRD 4.5X22MM SCREW CANN PART THRD 4.5X24MM SCREW CANN PART THRD 4.5X28MM SCREW CANN PART THRD 4.5X68MM SCREW CANN SYNT 7.3X16X115MM SCREW CANN SYNT 7.3X32X115MM SCREW CANN SYNT 7.3X16X125MM SCREW CANN SYNT 7.3X32X125MM SCREW CANN SYNT 7.3X16X35MM SCREW CANN SYNT 7.3X16X45MM SCREW CANN SYNT 7.3X32X55MM SCREW CANN SYNT 7.3X16X65MM SCREW CANN SYNT 7.3X32X65MM SCREW CRANFAC SYNT 2.4X18MM SCREW EMER SYNT 2.4X8MM SCREW EMER SYNT 2.7X12MM SCREW EMER SYNT 2.7X14MM SCREW CORT SYNT STD 2X12MM SCREW CORT SYNT STD 2X14MM SCREW CORT SYNT STD 2X16MM SCREW CORT SYNT STD 2X8MM SCREW CORT STD HEX 2.7X14MM SCREW CORT STD HEX 2.7X22MM SCREW CORT STD HEX 2.7X24MM SCREW CORT STD HEX 2.7X26MM SCREW CORT STD HEX 2.7X6MM SCREW CORT STD HEX 2.7X8MM Page 196 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $899.00 $852.00 $852.00 $907.00 $907.00 $907.00 $907.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $342.00 $377.00 $377.00 $377.00 $148.00 $148.00 $148.00 $148.00 $158.00 $158.00 $158.00 $158.00 $158.00 $158.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP TI 1X6MM SCREW CORT SLFTP TI 1X7MM SCREW CORT SLFTP TI 1X8MM SCREW CORT SLFTP TI 1X9MM SCREW CORT SLFTP TI 1X11MM SCREW CORT SLFTP TI 1X12MM SCREW CORT SLFTP TI 1X13MM SCREW CORT SLFTP TI 1X14MM SCREW CORT SLFTP TI 1.3X7MM SCREW CORT SLFTP TI 1.3X8MM SCREW CORT SLFTP TI 1.3X11MM SCREW CORT SLFTP TI 1.3X12MM SCREW CORT SLFTP TI 1.3X13MM SCREW CORT SLFTP TI 1.5X6MM SCREW CORT SLFTP TI 1.5X16MM SCREW CORT SLFTP TI 1.5X18MM SCREW CORT SLFTP TI 1.5X20MM SCREW CORT SLFTP TI 1.5X22MM SCREW CORT SLFTP TI 1.5X24MM SCREW CORT SLFTP TI 2.0X6MM SCREW CORT SLFTP TI 2.0X16MM SCREW CORT SLFTP TI 2.0X18MM SCREW CORT SLFTP TI 2.0X20MM SCREW CORT SLFTP TI 2.0X22MM SCREW CORT SLFTP TI 2.0X24MM SCREW CORT SLFTP TI 2.0X26MM SCREW CORT SLFTP TI 2.0X28MM SCREW CORT SLFTP TI 2.0X30MM SCREW CORT SLFTP TI 2.0X32MM SCREW CORT SLFTP TI 2.4X6MM SCREW CORT SLFTP TI 2.4X7MM SCREW CORT SLFTP TI 2.4X8MM SCREW CORT SLFTP TI 2.4X9MM SCREW CORT SLFTP TI 2.4X11MM SCREW CORT SLFTP TI 2.4X16MM SCREW CORT SLFTP TI 2.4X18MM SCREW CORT SLFTP TI 2.4X20MM SCREW CORT SLFTP TI 2.4X22MM SCREW CORT SLFTP TI 2.4X24MM SCREW CORT SLFTP TI 2.4X26MM SCREW CORT SLFTP TI 2.4X28MM SCREW CORT SLFTP TI 2.4X30MM SCREW CORT SLFTP TI 2.4X32MM SCREW CNCLS FULL THRD 4X55MM SCREW CNCLS PART THRD 4X12MM SCREW CNCLS PART THRD 4X14MM Page 197 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $351.00 $351.00 $351.00 $351.00 $351.00 $351.00 $351.00 $351.00 $368.00 $368.00 $368.00 $368.00 $368.00 $243.00 $243.00 $243.00 $243.00 $243.00 $243.00 $209.00 $209.00 $209.00 $209.00 $209.00 $209.00 $209.00 $209.00 $209.00 $209.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $391.00 $95.00 $90.00 $90.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CNCLS PART THRD 4X16MM SCREW TUNNELOC BONE MULCH 20MM WASHER TIMAX FLAT 6.5MM WASHER CUP SM FRAG 3.5X4MM WASHER 10MM WASHER 6.5MM DEV TIB WASHERLOC ZIMM 16MM PIN ATLANTIS PLATE HOLDING MESH FLT 1X4 MESH FLT 10X14 MESH SURGIPRO 3X5*USE 6128261* MESH VENTRALEX CIR MD MESH KUGEL COMPOSIX SM OVAL GRAFT BIF HEMA 14X7MM GRAFT HEMAGARD BIF KNIT 8X16MM GRAFT BIF HEMA 22X11MM GRAFT HEMA ST 16MMX30CM MESH 3D MAX LFT LG MESH ORB FLOOR SYNT 1.3MM GLD PATCH GORE 1X10X15MM PATCH GORE 2X10X15MM SHNT CATH LUMBAR CLSD TIP80CM GDWIRE CROSSIT 100XT.014 300CM ARM SUPP MCCONNELL CATH SILVERHAWK SX TRAY 1ST FRAC 1STEPXPANDER20/3 TRAY ADDL FRAC XPANDER 20/3 NDLE BX BONE KYPHON 11GX10CM SYR INFL KYPHX XPANDER KT DRN PLEURX 1000ML SHNT CAROTID JAVID 17FR 27.5CM BSKT RX TRAPEZOID RETRV 2CM CATH GLD PROBE ELECTRO HEMO 10 GRAFT SOFT RESTORE *DISC* GDWIRE FIX CORE FLEX.035 145CM GDWIRE FIX CORE FLEX 0.038 145 STNT ADVANIXDUODENRX11.5FR5CM STNT ADVANIXDUODENRX11.5FR7CM STNT ADVANIXDUODENRX11.5FR10CM STNT ADVANIXDUODENRX11.5FR12CM STNT ADVANIXDUODENRX11.5FR15CM DEV RESOLUTION CLIP 11MMX235CM BAND LIGATOR SUPERVIEW 7 BLN BILI RX DIL 5.8FR 6MMX4CM KT PT CARE ANDREW TBL SEAL SLF SEALING 7FR Page 198 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $90.00 $1,793.00 $214.00 $284.00 $134.00 $151.00 $1,447.00 $731.00 $159.00 $487.00 $230.00 $1,554.00 $1,810.00 $2,240.00 $2,240.00 $2,240.00 $1,670.00 $695.25 $2,035.00 $1,742.00 $2,630.00 $1,020.00 $387.00 $203.00 $6,745.00 $7,359.00 $5,844.00 $173.00 $641.00 $323.00 $438.00 $1,027.00 $1,093.00 $5,849.00 $80.00 $80.00 $487.00 $487.00 $487.00 $487.00 $487.00 $515.00 $1,180.00 $1,164.00 $176.00 $75.00 2020 pricing Drugs&Supplies PROCEDURE NAME SET INTR SUPRAPUBIC TB8-14FR14 INST BX MAX CORE 18GX20CM RETR GELPORT STAPLER GIA 60 3.8MM STAPLER TA 60 3.5MM SCREW CORT 3.5HD 2.4X18MM SCREW CORT 3.5HD 2.4X22MM SCREW CORT SLFTP 2X12MM PIN BTRS SS 1.8X18MM SCREW CORT STD HEX 2.7X12MM SCREW CORT STD HEX 2.7X16MM SCREW CORT STD HEX 2.7X18MM SCREW CANN SHRT THRD SS 3X20MM SCREW CANN SHRT THRD SS 3X26MM SCREW CANN LNG THRD SS 3X34MM SCREW CANN LNG THRD SS 3X36MM SCREW CANN LNG THRD SS 3X40MM SCREW CORT SLFTP HEX 2.7X10MM SCREW CORT SLFTP HEX 2.7X12MM SCREW CORT SLFTP HEX 2.7X14MM SCREW CORT SLFTP HEX 2.7X16MM SCREW CORT SLFTP HEX 2.7X18MM SCREW CORT SLFTP HEX 2.7X20MM SCREW CORT SLFTP HEX 2.7X22MM SCREW CORT SLFTP HEX 2.7X24MM SCREW CORT SLFTP HEX 2.7X26MM SCREW CORT SLFTP HEX 2.7X30MM SCREW SHAFT SYNT 3.5X16MM SCREW SHAFT SYNT 3.5X18MM SCREW SHAFT SYNT 3.5X20MM SCREW SHAFT SYNT 3.5X22MM SCREW SHAFT SYNT 3.5X24MM SCREW SHAFT SYNT 3.5X26MM SCREW SHAFT SYNT 3.5X28MM SCREW SHAFT SYNT 3.5X30MM SCREW SHAFT SYNT 3.5X32MM SCREW SHAFT SYNT 3.5X34MM SCREW SHAFT SYNT 3.5X36MM SCREW SHAFT SYNT 3.5X38MM SCREW CORT SLFTP 3.5X10MM SCREW CORT SLFTP 3.5X12MM SCREW CORT SLFTP 3.5X14MM SCREW CORT SLFTP 3.5X16MM SCREW CORT SLFTP 3.5X18MM SCREW CORT SLFTP 3.5X20MM SCREW CORT SLFTP 3.5X22MM Page 199 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $456.00 $169.00 $1,545.00 $483.00 $460.00 $238.00 $238.00 $162.00 $306.00 $158.00 $158.00 $158.00 $899.00 $899.00 $899.00 $899.00 $899.00 $170.00 $170.00 $242.00 $170.00 $242.00 $170.00 $242.00 $170.00 $170.00 $170.00 $102.00 $102.00 $102.00 $102.00 $102.00 $102.00 $102.00 $102.00 $102.00 $102.00 $102.00 $102.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP 3.5X24MM SCREW CORT SLFTP 3.5X26MM SCREW CORT SLFTP 3.5X28MM SCREW CORT SLFTP 3.5X30MM SCREW CORT SLFTP 3.5X32MM SCREW CORT SLFTP 3.5X34MM SCREW CORT SLFTP 3.5X36MM SCREW CORT SLFTP 3.5X38MM SCREW CORT SLFTP 3.5X40MM SCREW CORT SLFTP 3.5X42MM SCREW CORT SLFTP 3.5X45MM SCREW CORT SLFTP 3.5X50MM SCREW CORT SLFTP 3.5X55MM SCREW CORT SLFTP 3.5X60MM SCREW CNCLS FULL THRD 4X10MM SCREW CNCLS FULL THRD 4X12MM SCREW CNCLS FULL THRD 4X14MM SCREW CNCLS FULL THRD 4X16MM SCREW CNCLS FULL THRD 4X18MM SCREW CNCLS FULL THRD 4X20MM SCREW CNCLS FULL THRD 4X22MM SCREW CNCLS FULL THRD 4X24MM SCREW CNCLS FULL THRD 4X26MM SCREW CNCLS FULL THRD 4X28MM SCREW CNCLS FULL THRD 4X35MM SCREW CNCLS FULL THRD 4X40MM SCREW CNCLS FULL THRD 4X45MM SCREW CNCLS PART THRD 4X18MM SCREW CNCLS PART THRD 4X20MM SCREW CNCLS PART THRD 4X22MM SCREW CNCLS PART THRD 4X24MM SCREW CNCLS PART THRD 4X26MM SCREW CNCLS PART THRD 4X28MM SCREW CNCLS PART THRD 4X30MM SCREW CNCLS PART THRD 4X35MM SCREW CNCLS PART THRD 4X40MM SCREW CNCLS PART THRD 4X45MM SCREW CNCLS PART THRD 4X50MM SCREW CANN SHRT THRD SS 4X18MM SCREW CANN SHRT THRD SS 4X20MM SCREW CANN SHRT THRD SS 4X22MM SCREW CANN SHRT THRD SS 4X24MM SCREW CANN SHRT THRD SS 4X26MM SCREW CANN SHRT THRD SS 4X28MM SCREW CANN SHRT THRD SS 4X30MM SCREW CANN SHRT THRD SS 4X32MM Page 200 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $116.00 $116.00 $116.00 $165.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $95.00 $90.00 $90.00 $90.00 $90.00 $90.00 $90.00 $90.00 $90.00 $90.00 $90.00 $90.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN SHRT THRD SS 4X34MM SCREW CANN SHRT THRD SS 4X36MM SCREW CANN SHRT THRD SS 4X38MM SCREW CANN SHRT THRD SS 4X40MM SCREW CANN SHRT THRD SS 4X42MM SCREW CANN SHRT THRD SS 4X44MM SCREW CANN SHRT THRD SS 4X46MM SCREW CANN SHRT THRD SS 4X48MM SCREW CANN SHRT THRD SS 4X50MM SCREW CANN SYNT 6.5X16X60MM SCREW CANN SYNT 6.5X16X65MM SCREW CANN SYNT 6.5X16X70MM SCREW CANN SYNT 6.5X16X75MM SCREW CANN SYNT 6.5X32X105MM SCREW CANN SYNT 7.3X16X80MM SCREW CANN SYNT 7.3X16X85MM SCREW CANN SYNT 7.3X16X90MM SCREW CANN SYNT 7.3X16X95MM SCREW CANN SYNT 7.3X16X100MM SCREW CANN SYNT 7.3X16X105MM SCREW CANN SYNT 7.3X16X110MM SCREW CANN SYNT 7.3X16X75MM SCREW CANN SYNT 7.3X32X80MM SCREW CANN SYNT 7.3X32X85MM SCREW CANN SYNT 7.3X32X90MM SCREW CANN SYNT 7.3X32X95MM SCREW CANN SYNT 7.3X32X100MM SCREW CANN SYNT 7.3X32X105MM SCREW LK T15 STARDR 3.5X10MM SCREW LK T15 STARDR 3.5X12MM SCREW LK T15 STARDR 3.5X14MM SCREW LK T15 STARDR 3.5X16MM SCREW LK T15 STARDR 3.5X18MM SCREW LK T15 STARDR 3.5X20MM SCREW LK T15 STARDR 3.5X22MM SCREW LK T15 STARDR 3.5X24MM SCREW LK T15 STARDR 3.5X26MM SCREW LK T15 STARDR 3.5X28MM SCREW LK T15 STARDR 3.5X30MM SCREW LK T15 STARDR 3.5X32MM SCREW LK T15 STARDR 3.5X34MM SCREW LK T15 STARDR 3.5X36MM SCREW LK T15 STARDR 3.5X38MM SCREW LK T15 STARDR 3.5X40MM SCREW LK T15 STARDR 3.5X45MM SCREW LK T15 STARDR 3.5X50MM Page 201 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $1,140.00 $1,140.00 $1,086.00 $1,086.00 $1,146.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $671.00 $694.00 $575.00 $575.00 $575.00 $814.00 $814.00 $814.00 $575.00 $814.00 $814.00 $814.00 $814.00 $814.00 $814.00 $814.00 $575.00 $575.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK T25 STARDR 5X14MM SCREW LK T25 STARDR 5X16MM SCREW LK T25 STARDR 5X18MM SCREW LK T25 STARDR 5X20MM SCREW LK T25 STARDR 5X22MM SCREW LK T25 STARDR 5X24MM SCREW LK T25 STARDR 5X26MM SCREW LK T25 STARDR 5X28MM SCREW LK T25 STARDR 5X30MM SCREW LK T25 STARDR 5X32MM SCREW LK T25 STARDR 5X34MM SCREW LK T25 STARDR 5X36MM SCREW LK T25 STARDR 5X38MM SCREW LK T25 STARDR 5X40MM SCREW LK T25 STARDR 5X42MM SCREW LK T25 STARDR 5X44MM SCREW LK T25 STARDR 5X46MM SCREW LK T25 STARDR 5X48MM SCREW LK T25 STARDR 5X50MM SCREW LK T25 STARDR 5X55MM SCREW LK T25 STARDR 5X60MM SCREW LK T25 STARDR 5X65MM SCREW LK T8 STARDR 2.4X14MM SCREW LK T8 STARDR 2.4X16MM SCREW LK T8 STARDR 2.4X18MM SCREW LK T8 STARDR 2.4X22MM SCREW LK T8 STARDR 2.4X24MM SCREW LK T8 STARDR 2.4X26MM SCREW LK SM HEX 3.5X36MM SCREW CANN PART THRD 4.5X26MM SCREW CANN PART THRD 4.5X32MM SCREW CANN PART THRD 4.5X34MM SCREW CANN PART THRD 4.5X36MM SCREW CANN PART THRD 4.5X40MM SCREW CANN PART THRD 4.5X44MM SCREW CANN PART THRD 4.5X46MM SCREW CANN PART THRD 4.5X48MM SCREW CANN PART THRD 4.5X50MM SCREW CANN PART THRD 4.5X52MM SCREW CANN PART THRD 4.5X54MM SCREW CANN PART THRD 4.5X56MM SCREW CANN FULL THRD 4.5X40MM SCREW CANN FULL THRD 4.5X50MM SCREW CANN FULL THRD 4.5X54MM SCREW CANN FULL THRD 4.5X64MM SCREW CANN FULL THRD 4.5X68MM Page 202 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $667.00 $534.00 $534.00 $534.00 $534.00 $534.00 $506.22 $575.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP 4.5X14MM SCREW CORT SLFTP 4.5X16MM SCREW CORT SLFTP 4.5X20MM SCREW CORT SLFTP 4.5X22MM SCREW CORT SLFTP 4.5X24MM SCREW CORT SLFTP SYNT 4.5X26MM SCREW CORT SLFTP SYNT 4.5X28MM SCREW CORT SLFTP SYNT 4.5X30MM SCREW CORT SLFTP 4.5X32MM SCREW CORT SLFTP 4.5X34MM SCREW CORT SLFTP 4.5X36MM SCREW CORT SLFTP 4.5X38MM SCREW CORT SLFTP 4.5X40MM SCREW CORT SLFTP 4.5X42MM SCREW CORT SLFTP 4.5X44MM SCREW CORT SLFTP 4.5X46MM SCREW CORT SLFTP 4.5X48MM SCREW CORT SLFTP 4.5X50MM SCREW CORT SLFTP 4.5X52MM SCREW CORT SLFTP 4.5X54MM SCREW CORT SLFTP 4.5X56MM SCREW CORT SLFTP 4.5X58MM SCREW CORT SLFTP SYNT 4.5X60MM SCREW CORT SLFTP 4.5X62MM SCREW CORT SLFTP 4.5X64MM SCREW MALLEO SYNT 4.5X60MM SCREW MALLEO SYNT 4.5X65MM SCREW CNCLS SYNT 6.5X16X65MM SCREW CNCLS SYNT 6.5X16X70MM SCREW CNCLS SYNT 6.5X16X75MM SCREW CNCLS SYNT 6.5X16X80MM SCREW CNCLS SYNT 6.5X16X85MM SCREW CNCLS SYNT 6.5X32X45MM SCREW CNCLS SYNT 6.5X32X60MM SCREW CNCLS SYNT 6.5X32X65MM SCREW CNCLS SYNT 6.5X32X70MM SCREW CNCLS SYNT 6.5X32X75MM SCREW CNCLS SYNT 6.5X32X80MM SCREW CNCLS SYNT 6.5X32X85MM SCREW CNCLS FULL THRD 6.5X40MM SCREW CNCLS FULL THRD 6.5X45MM SCREW CNCLS FULL THRD 6.5X50MM SCREW CNCLS FULL THRD 6.5X55MM SCREW CNCLS FULL THRD 6.5X60MM WASHER 7MM WASHER 13MM Page 203 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $117.00 $117.00 $117.00 $117.00 $164.00 $167.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $117.00 $166.00 $166.00 $172.00 $172.00 $172.00 $172.00 $184.00 $172.00 $172.00 $172.00 $172.00 $172.00 $172.00 $184.00 $172.00 $172.00 $172.00 $172.00 $172.00 $128.00 $142.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN LK HEX THRD 5X65 SCREW CANN LK HEX THRD 5X75 SCREW CANN LK HEX THRD 5X80 SCREW CANN CONIC HEX SMTH 5X75 SCREW CANN CONIC HEX SMTH 5X85 SCREW CANN LK THRD HEX7.3X85 SCREW LK CONIC HD 4X38MM SCREW LK CONIC HD 4X42MM SCREW LK CONIC HD 4X46MM SCREW LK CONIC HD 4X54MM PLATE COND RT 8HL 4.5MM PLATE COND LFT 8HL 4.5MM PLATE COND LFT 10HL 4.5MM SCREW LK SLFTP STAR T25 4X26 SCREW LK SLFTP STAR T25 4X30 SCREW LK SLFTP STAR T25 4X34 SCREW LK SLFTP STAR T25 4X38 SCREW LK SLFTP STAR T25 4X42 SCREW LK SLFTP STAR T25 4X46 SCREW LK SLFTP STAR T25 4X54 PLATE 3.5 LCP 5HL 72MM PLATE 3.5 LCP 6HL 85MM PLATE 3.5 LCP 8HL 111MM PLATE 3.5 LCP 9HL 124MM PLATE 3.5 LCP 10HL 137MM PLATE LCP NARW 6HL 4.5X116MM PLATE LCP NARW 7HL 4.5X134MM PLATE LCP NARW 8HL 4.5X152MM PLATE LCP NARW 9HL 4.5X170MM PLATE LCP NARW 10HL 4.5X188MM PLATE LCP NARW 12HL 4.5X224MM PLATE LCP BROAD 4.5/5 10HL 186 PLATE LCP BROAD 4.5/5 11HL 206 PLATE TIB PROX LCP LFT 4HL 4.5 PLATE TIB PROX LCP RT 6HL 4.5 PLATE TIB PROX LCP LFT 6HL 4.5 PLATE T LCP RTANG3HD5HL 3.5X67 PLATE T LCP RTANG3HD7HL 3.5X87 PLATE 1/3TUBLR LCP COLAR 5HL57 PLATE 1/3TUBLR LCP COLAR 6HL69 PLATE 1/3TUBLR LCP COLAR 7HL81 PLATE 1/3TUBLR LCP COLAR 8HL93 PLATE 1/3TUBLR LCPCOLAR10HL117 PLATE 1/3TUBLR LCPCOLAR12HL141 PLATE 3.5 CALC SHRT RT 69MM PLATE 3.5 CALC SHRT LFT 69MM Page 204 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $903.00 $903.00 $903.00 $793.00 $793.00 $1,015.00 $664.00 $664.00 $664.00 $664.00 $3,242.00 $3,242.00 $3,262.00 $664.00 $664.00 $664.00 $929.00 $929.00 $664.00 $664.00 $1,031.00 $1,427.00 $1,161.00 $1,211.00 $1,245.00 $1,306.00 $1,465.00 $1,481.00 $1,553.00 $1,631.00 $1,817.00 $1,817.00 $1,854.00 $3,010.00 $3,047.00 $3,047.00 $1,214.00 $1,590.00 $790.00 $790.00 $797.00 $836.00 $836.00 $867.00 $1,897.00 $2,397.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE HUMR PROX LCP 3.5 3HL 90 PLATE T LCP OBLIQ LFT5HL3.5X74 PLATE 1/4TUBLR W COLAR 2.7 6HL PLATE DORSAL DIST RADIUS LFT PLATE VOLAR DIST RADIUS LFT PLATE ST 2.0MM 4HL 23MM PLATE RECON LCP 3.5MM 5HL 70MM PLATE RECON LCP 3.5MM 6HL 84MM PLATE RECON LCP 3.5MM 7HL 99MM PLATE RECON LCP 3.5MM 8HL113MM SCREW COMP DHS DCS 36MM PLATE DHS STD 135D 4HL 78MM GDWIRE THRD TROC 1.25X150MM GDWIRE THRD RECTANG TROC 1.1 GDWIRE NTHRD TRIANG TROC 1.1 GDWIRE SPADE BLU 2.0X230 GDWIRE THRD TRIANG TROC2.8X300 KWIRE THRD TIP 2.0X280MM GDWIRE THRD TROC TIP 1.6X150 SCREW SCHANZ 5.0 BLNT TIP200MM GDWIRE 3.2X400MM CLAMP EXTL FIX 6POSITION MR LG ROD ATTACH EXTL FIX MR LG CLAMP EXTL FIX COMB MR LG CLAMP EXTL FIX OPEN ADJ MR LG ROD EXTL FIX CBN MR 11X200MM ROD EXTL FIX CBN MR 11X350MM ROD EXTL FIX CBN MR 11X400MM SCREW CORT SLFTP TI 1.3X6MM SCREW CORT SLFTP TI 1.3X9MM SCREW CORT SLFTP TI 1.3X14MM SCREW CORT SLFTP TI 1.3X16MM SCREW CORT SLFTP TI 1.3X18MM PLATE T TI 2/8HL 2.0X53MM PLATE ST HAND TI 6HL 2.4X36MM PLATE T HAND TI 12HL 2.4 2X8HL PLATE LC-DCP HAND TI 4HL 2.4MM PLATE LC-DCP HAND TI 6HL 2.4MM PLATE LC-DCP HAND TI 4HL 2.0MM PLATE LC-DCP HAND TI 6HL 2.0MM END CAP TI GRN CANN TIB NAIL BOLT LK TI 3.9X30MM SCREW TI LK IM NAIL 5.0X32MM SCREW TI LK IM NAIL 5.0X34MM SCREW TI LK IM NAIL 5.0X36MM SCREW TI LK IM NAIL 5.0X38MM Page 205 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,170.00 $1,320.00 $462.00 $2,222.00 $2,016.00 $303.00 $1,426.00 $1,577.00 $1,602.00 $1,673.00 $207.00 $1,566.00 $122.00 $122.00 $116.00 $154.00 $183.00 $170.00 $138.00 $365.00 $630.00 $1,788.00 $1,159.00 $1,635.00 $1,455.00 $843.00 $903.00 $983.00 $368.00 $368.00 $368.00 $368.00 $368.00 $1,037.00 $1,037.00 $1,164.00 $1,132.00 $1,225.00 $1,037.00 $1,225.00 $503.00 $625.00 $639.00 $639.00 $639.00 $639.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW TI LK IM NAIL 5.0X40MM SCREW TI LK IM NAIL 5.0X44MM SCREW TI LK IM NAIL 5.0X46MM BOLT LK TI 4.9X32MM BOLT LK TI 4.9X34MM BLADE SPIRAL HUMR NAIL TI 40MM END CAP EXT SPIRAL HUMR 5MM NAIL ELAS TI GLD 3X440MM GDWIRE THRD SPADE 2.5X230MM PIN CERCLAGE THRD STER 4.5MM ROD REAMING BALL TIP 2.5X950MM ROD REAMING ST STR 3.0X950MM ENDOL CONTRLAT 14MMX12CM SCREW CANN SHRT THRD SS 3X30MM SCREW CANN SHRT THRD SS 3X32MM SCREW CANN SHRT THRD SS 3X38MM SCREW CANN SHRT THRD SS 3X40MM SCREW CANN LNG THRD SS 3X18MM SCREW CNCLS FULL THRD 4X30MM SCREW CNCLS FULL THRD 4X50MM SCREW CANN SHRT THRD SS 4X16MM SCREW CANN SYNT 6.5X32X75MM SCREW CANN SYNT 6.5X32X85MM SCREW CANN SYNT 7.3X16X50MM SCREW CANN SYNT 7.3X16X55MM ENDOL CONTRLAT 14.5MMX14CM SCREW LK T15 STARDR 3.5X55MM SCREW LK T15 STARDR 3.5X60MM SCREW CANN PART THRD 4.5X30MM SCREW CANN PART THRD 4.5X38MM SCREW CANN PART THRD 4.5X72MM SCREW CANN FULL THRD 4.5X28MM SCREW CANN FULL THRD 4.5X30MM SCREW CANN FULL THRD 4.5X60MM SCREW CNCLS SYNT 6.5X32X90MM SCREW CANN CONIC HEX SMTH 5X65 SCREW LK CONIC HD 4X34MM SCREW CANN CONIC SYNT 7.3X65MM PLATE COND RT 6HL 4.5MM PLATE COND LFT 6HL 4.5MM SCREW LK SLFTP STAR T25 4X14 PLATE T LCP RTANG 3HD3HL3.5X50 PLATE HUMR PROX LCP 3.5 5HL114 PLATE RECON LCP 3.5MM10HL140MM SCREW SCHANZ 6.0 SPADE 190MM SCREW CORT SLFTP TI 1.3X10MM Page 206 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $639.00 $639.00 $639.00 $625.00 $625.00 $1,424.00 $655.00 $1,040.00 $195.00 $731.00 $754.00 $590.00 $8,203.00 $899.00 $899.00 $899.00 $899.00 $899.00 $95.00 $95.00 $891.00 $1,140.00 $1,073.00 $1,145.00 $1,145.00 $8,602.00 $575.00 $575.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $184.00 $793.00 $664.00 $1,160.00 $3,182.00 $4,186.00 $664.00 $1,103.00 $3,269.00 $1,667.00 $316.00 $368.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP TI 1.5X7MM SCREW CORT SLFTP TI 1.5X8MM SCREW CORT SLFTP TI 1.5X9MM SCREW CORT SLFTP TI 1.5X10MM SCREW CORT SLFTP TI 1.5X11MM SCREW CORT SLFTP TI 1.5X12MM SCREW CORT SLFTP TI 1.5X13MM SCREW CORT SLFTP TI 1.5X14MM SCREW CORT SLFTP TI 2.4X10MM SCREW CORT SLFTP TI 2.4X12MM SCREW CORT SLFTP TI 2.4X13MM SCREW CORT SLFTP TI 2.4X14MM SCREW EMER SYNT 2.7X10MM SCREW EMER SYNT 2.7X16MM SCREW CORT SLFTP TI 2.0X10MM SCREW CORT SLFTP TI 2.0X12MM SCREW CORT SLFTP TI 2.0X14MM PLATE ORB RIM TI RIGID 12HL1.5 PLATE Y TI SYNT 5HL 1.5MM PLATE Y TI 3 HD 8 HL 1.5MM PLATE LC-DCP HAND TI 8HL 2.4MM SCREW LK T15 STARDR 3.5X65MM SCREW LK T15 STARDR 3.5X70MM SCREW LK T15 STARDR 3.5X75MM SCREW LK T15 STARDR 3.5X80MM SCREW LK T15 STARDR 3.5X85MM SCREW LK T15 STARDR 3.5X90MM SCREW LK T15 STARDR 3.5X95MM STNT MINI-VISION RX 2.25X15MM STNT VASC ZILVER 9X40MM 80CM STNT VASC ZILVER 10X40MM 80CM STNT VASC ZILVER 8X40MM 80CM CANN TWIST-IN 8.25X90MM CANN TWIST-IN 6X90MM ANCHOR SUT CRKSCRWII FIBER 5.5 NDLE SCORPION SHLDR GD WISEGUIDE VL4 7FR HIP HD M2A ZIMM MTL 52MM +0 HIP SHELL M2A ZIMM 58X52MM HIP LNR ULTAMET MTL 40X62MM HIP HD EZE MTL 12/14 44MM +5 SET SCREW LEGACY MDTR 4.5MM TRAP SM DIGIT LINVATEC SNARE AMPLZ GOOSENECK 25MM BREAST NATRELLE LOWFULL450 BREAST SPECTRUM SMTH RD270 Page 207 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $243.00 $243.00 $243.00 $243.00 $243.00 $243.00 $243.00 $243.00 $391.00 $391.00 $391.00 $391.00 $630.00 $377.00 $209.00 $209.00 $209.00 $1,043.00 $848.00 $1,009.00 $1,323.00 $671.00 $856.00 $730.00 $671.00 $671.00 $671.00 $671.00 $1,822.00 $2,993.00 $2,993.00 $2,993.00 $140.00 $140.00 $1,169.00 $738.00 $258.00 $1,790.00 $3,918.00 $3,100.00 $1,545.00 $833.00 $165.00 $1,150.00 $2,205.00 $2,274.00 2020 pricing Drugs&Supplies PROCEDURE NAME BREAST SILTEX SALINE 450CC GDWIRE ST ACUM 0.045X6 GDWIRE ST ACUM 0.035X6 KNIFE GREISHABER IRIS ST .05MM BIT DRILL QC 14MM STOP .76MM BIT DRILL QC 6MM STOP .76MM BIT DRILL QC 8MM STOP .76MM BIT DRILL QC 10MM STOP .76MM BIT DRILL QC 12MM STOP .76MM BIT DRILL QK SYNT 1X50MM BIT DRILL SYNT 1.3X14MM COUNTERSINK 1.3MM/1.5MM SCREW BIT DRILL ARTX 1.7MM GRAFT HEMA 10MMX60CM NDLE CATH YUEH ST 5FR 10CM NAIL FEM DIST CANN TI 10X340MM NAIL EX TIB CANN TI 10X330MM ROD EXTL FIX CBN MR 11X250MM ROD EXTL FIX CBN MR 11X300MM NAIL TROCHANT LNG130D RT11X380 NAIL TROCHANT LNG130D RT11X400 BLADE HEL FIX NAIL TI 11X100MM NAIL TIB TI CANN 11X400MM GRAFT HEMA MD 12MM 15CM CATH DRN FLEXIMA REG 12FR 35CM GRAFT HEMA PLAT 12MM 15CM GRAFT HEMA PLAT 12X6MM 40CM GRAFT HEMA MDV BIF 12X6MM 40CM GRAFT HEMA PLAT 14MM 15CM SCREW CORT LOPRO TI 2.3X14MM GRAFT HEMA PLAT 14X7MM 40CM PIN EXTL FIX THRD 40X5X150MM END CAP TI T40 EXT 15MM GRAFT HEMA MD 16MM 15CM KNEE TIB STEM REV ZIMM16X120MM GRAFT HEMA PLAT WDV 16MM 15CM SCREW CORT LOPRO TI 2.3X16MM GRAFT HEMA PLAT 16X8MM 40CM GRAFT HEMA MD 18MM 15CM RETR METRX BEVELED 5CM GRAFT HEMA PLAT WDV 18MM 15CM GRAFT HEMA PLAT 18X9MM 40CM GRAFT BIF HEMA 18X9MM BIT DRILL QK 2X140MM SCREW CORT NON TOGGLE 2.3X24MM SCREW CORT LK ACUM 2.3X26MM Page 208 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,952.00 $89.00 $284.00 $204.00 $551.00 $551.00 $551.00 $551.00 $551.00 $293.00 $293.00 $510.00 $413.00 $1,734.00 $86.00 $2,996.00 $2,543.00 $903.00 $903.00 $2,951.00 $2,951.00 $1,466.00 $2,337.00 $1,461.00 $352.00 $1,560.00 $2,264.00 $2,240.00 $1,560.00 $490.00 $2,265.00 $864.00 $734.00 $1,461.00 $3,178.00 $1,560.00 $490.00 $2,264.00 $1,461.00 $1,530.00 $1,560.00 $2,102.61 $2,240.00 $568.00 $576.00 $576.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT LOPRO TI 2.3X26MM BIT DRILL MINIQK CPLE 2.4X80MM SCREW CORT 3.5HD 2.4X16MM KWIRE TROC 2.5X285MM SCREW LK SYNT 2.7X38MM SCREW LK SYNT 2.7X16MM SCREW LK SYNT 2.7X18MM SCREW LK SYNT 2.7X26MM SCREW CRUCIFORM TI 2.7X10MM SCREW CRUCIFORM TI 2.7X16MM GRAFT HEMA MD 20MM 15CM GRAFT HEMA PLAT WDV 20MM 15CM SCREW CORT LOPRO TI 2.3X20MM GRAFT BIF HEMA 20X10MM GRAFT HEMA MD 22MM 15CM SCREW CORT LOPRO TI 2.3X22MM GRAFT HEMA MD 24MM 15CM IMMOB KNEE TRI PNL 24IN SCREW CORT LOPRO TI 2.3X24MM GD ROD SYNT SMTH STER 3X950MM GD PIN SHRT THRD 3.2X9MM BIT DRILL QK SYNT 3.2X330MM SCREW CORT STRY 3.5X40 SCREW CORT MATTA 3.5X50MM SCREW CORT MATTA 3.5X60MM PLATE HUMR MEDL DIST 3.5LFT5HL SCREW LK CORT ACUM 3.5X18MM BIT DRILL QK SYNT 3.5X195MM PLATE TIB PROX LCP LFT 4HL 3.5 PLATE TIB PROX LCP RT 6HL 3.5 PLATE HUMR DIST PSTRLAT LFT7HL HIP HD G7 TYPE 1 MTL 36MM +0 HIP LNR TRILOGY PE 0D 50X36MM SCREW LK TI NAIL 5X38MM COIL VORTEX DIMND 3MMX3.7CM SCREW LK TI NAIL 4X34MM SCREW LK TI NAIL 4X36MM SCREW LK TI NAIL 4X44MM SCREW VERTEX CNCLS VA 4X10MM SCREW SCHANZ SLFDR 4/3.0 20X80 BIT DRILL 3 FLUTE SYNT 4X150MM BUR EGG 4MM SCREW SCHANZ 4.0 SPADE 120MM SCREW CORT STD 4.5X42MM SCREW CORT SLFTP ZIMM 4.5X38MM SCREW CORT SLFTP ZIMM 4.5X40MM Page 209 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $490.00 $293.00 $238.00 $424.00 $547.00 $547.00 $547.00 $547.00 $284.00 $284.00 $1,461.00 $1,560.00 $490.00 $2,240.00 $1,461.00 $490.00 $1,461.00 $118.00 $490.00 $500.00 $207.00 $790.00 $152.00 $152.00 $152.00 $2,461.00 $690.00 $327.00 $3,025.00 $3,062.00 $2,594.00 $1,790.00 $2,847.00 $627.00 $288.00 $627.00 $627.00 $627.00 $1,263.00 $519.00 $849.00 $276.00 $291.00 $87.00 $234.00 $234.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP ZIMM 4.5X46MM BIT DRILL CANN SYNT 4.5MM SCREW CORT STD 4.5X44MM SCREW CORT STD 4.5X46MM SCREW CORT SLFTP ZIMM 4.5X44MM BOLT LK TI 4.9X38MM BLADE DIEGO CURV 4MM 40D PLATE VENTURE MDTR 40MM SCREW LK STRY 5X40MM SCREW ODONTOID MDTR 4X40MM SCREW LK TI NAIL 5X42MM SCREW LK TI NAIL 5X46MM ROD PREBENT LEGACY 5.5X40MM CATH BEACON SIM2 0.038 5FR 100 BIT DRILL 3FLUTE CALIB5.0X330M SCREW PERIPROSTHETIC 5X12MM SCREW TI LK IM NAIL 5.0X48MM SCREW LEGACY MA TI5.5X5.5X35MM SCREW LEGACY MA TI5.5X5.5X40MM SCREW VANTAGE THORACIC5.5X40MM SCREW VANTAGE THORACIC5.5X45MM PLATE LOPRO ARTX RT 5MM LIGATOR MULTIBAND MBL-6-OV SCREW LK TI SYNT 6X75MM SCREW LK TI SYNT 6X90MM SCREW LK TI SYNT 6X85MM SCREW LK TI SYNT 6X65MM SCREW LK TI SYNT 6X80MM SCREW CANNCNCLSZIMM6.5X22X80MM SCREW CORT SLFTP ZIMM 6.5X70MM SCREW LEGACY MA TI5.5X6.5X40MM SCREW LEGACY MA TI5.5X6.5X45MM SCREW CANNCNCLSZIMM6.5X22X85MM BLN URINARY AMS 800 61-70CM PLATE THORACIC MDTR 6.0CM PROBE INJ GLD STD 7FR SYS DEL 8FR 45/80 GRAFT HEMA PLAT FINE .8X15.2CM GRAFT HEMA PLAT FINE .8X7.6CM NAIL HUMR SOLID TI 9.5X20*OBS* ENDO CLIP LAPRA-TY HIP STEM ACLD TMZF 127D SZ3.5 HIP SHELL PNCLE SECT POR 62MM HIP SHELL TRABEC CLUSTER 50MM HIP LNR PNCLE PE LIP 28X56MM HIP LNR ARCOMXL PE 0D 36X24MM Page 210 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $234.00 $1,233.00 $87.00 $87.00 $234.00 $625.00 $576.00 $2,368.00 $842.00 $1,853.00 $627.00 $627.00 $1,240.00 $61.00 $977.00 $959.00 $639.00 $2,285.00 $2,285.00 $1,751.00 $1,751.00 $2,171.00 $1,195.00 $677.00 $677.00 $677.00 $677.00 $677.00 $1,282.00 $257.00 $2,285.00 $2,285.00 $1,282.00 $4,941.00 $5,886.00 $1,093.00 $2,132.00 $743.00 $641.00 $2,874.00 $1,013.00 $5,053.00 $2,376.00 $2,789.00 $2,172.00 $2,123.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR TRILOGY PE 10D 50X32MM HIP LNR PNCLE PE LIP 32X54MM HIP LNR PNCLE PE 0D 32X52 HIP HD ADPTR VERS ENDO +7MM STRAP ANK DISTRAC FT BLOCKER ENDOBRONCH ARNDT 9FR BLOCKER ENDOBRONCH ARNDT 7FR CATH PERITON LAVAGE ARRO 8FR KNEE TIB ART SURFACE SZF 9MM PLATE ATLANTIS STD 2LVL 40MM KNEE FEM PSTR AUG SZ3 8MM HIP PROS MOORE DEPU STD 44MM HIP PROS MOORE DEPU STD 47MM HIP PROS MOORE DEPU STD 46MM HIP PROS MOORE DEPU STD 45MM HIP PROS MOORE DEPU STD 49MM HIP HD EZE MTL 12/14 32MM +1 SCREW BIO INTERFER 10X23MM BONE DOWELS 18 X 23 HIP SCREW PNCLE CNCLS 6.5X20MM BONE SUB BSM 10CC*DISC* ROD CBN EXTL FIX STRY 8X200MM ROD CBN EXTL FIX STRY 8X300MM ROD CBN EXTL FIX STRY 8X150MM ROD CBN EXTL FIX STRY 8X250MM KT CATH ACCESS PORT PLATE LEGACY MULT TI 45-57MM HOOK LEGACY OFFSET TI RT 5.5MM SCREW LEGACY MA TI5.5X6.5X35MM PLATE LEGACY MULT TI 39-45MM MOLD CMNT KNEE SPACER TIB 75MM KNEE TIB STEM CMNT PFC 13X60MM HIP CEMENTRALIZER DEPU 11MM HIP CEMENTRALIZER DEPU 14MM CHONDRAL DART ARTX 1.3X18MM SPLT THB CMC COOL CMFT RT SM SPLT THB CMC COOL CMFT LFT SM SCREW VERTEX CONN MAX MENISC ARROW CONMED 13MM MENISC ARROW CONMED 16MM CAGE CORNERSTONE 6X14X11MM CAGE CORNERSTONE 7X1X11MM SCREW CORT BONE 4.5X54MM SCREW CORT BONE 4.5X58MM SCREW CORT ACUM 3.5X12MM SCREW CORT ACUM 3.5X14MM Page 211 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,847.00 $2,172.00 $2,172.00 $641.00 $186.16 $836.00 $916.00 $132.00 $8,416.00 $2,368.00 $2,660.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $1,419.00 $706.00 $7,353.00 $276.00 $3,263.00 $1,048.00 $1,048.00 $1,163.00 $1,220.00 $141.00 $2,022.00 $2,332.00 $2,285.00 $2,022.00 $2,181.00 $2,639.00 $284.00 $284.00 $610.00 $105.00 $110.00 $1,450.00 $783.00 $783.00 $2,620.00 $2,620.00 $284.00 $284.00 $438.00 $438.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT ACUM 3.5X16MM SCREW CORT 120/40 4.5/3.5MM SCREW CORT LOPRO TI 2.3X18MM BLN DILATOR CRE 10-12MM BLN DILATOR CRE 8-10MM BLN DILATOR CRE WIREGD 8-*CIP* SCREW EMER KLS 2.3X7MM SCREW EMER KLS 2.3X9MM SCREW MICRO KLS 1.5X9MM SCREW MICRO EMER KLS 1.8X5MM SCREW MICRO EMER KLS 1.8X7MM SCREW MINI KLS 2.0X11MM SCREW MINI KLS 2.0X13MM SCREW MINI KLS 2.0X15MM SCREW MINI KLS 2.0X17MM SCREW MINI KLS 2.0X19MM SCREW MINI KLS 2.0X9MM PLATE LEGACY MULT TI 36-39MM PLATE LEGACY MULT TI 34-36MM HIP SHELL PNCLE SECT POR 50MM HIP SHELL PNCLE SECT POR 54MM HIP SHELL PNCLE SECT POR 56MM HIP SHELL M2A ZIMM 52X46MM HIP SHELL M2A ZIMM 62X56MM NDLE BX MURPHY COAX 11GX10CM SUCT TB DIEGO IRG EXER HAND DIGI-FLEX GRN 5LB KNEE FEM DIST AUG LFT SZ4 4MM KNEE FEM DIST AUG RT SZ5 8MM BIT DRILL STRY 4.2X130MM BIT DRILL ZIMM 2.5X110MM BIT DRILL ZIMM 3.2X145MM SET SCREW VERTEX MDTR BIT DRILL CANN SYNT 13MM BIT DRILL CANN SYNT 17X300MM BIT DRILL CANN SYNT 11X280MM BIT DRILL QK SYNT 4X260MM BIT DRILL STD ZIMM 2.7MM BIT DRILL CALIB SYNT 2.8MM BIT DRILL SYNT CRANFAC BIT DRILL SYNT CRANFAC BIT DRILL SYNT CRANFAC BIT DRILL QK SYNT 2.7X125MM BIT DRILL SYNT QK COUPLING BIT DRILL MATTA 2.5X180MM BIT DRILL SYNT 2.7X125MM Page 212 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $438.00 $967.00 $490.00 $924.00 $924.00 $1,029.00 $229.00 $229.00 $194.00 $208.00 $208.00 $186.00 $186.00 $186.00 $186.00 $186.00 $186.00 $2,022.00 $2,022.00 $2,376.00 $2,376.00 $2,376.00 $3,918.00 $3,918.00 $476.00 $133.00 $74.00 $2,660.00 $2,718.00 $470.00 $516.00 $516.00 $523.00 $1,346.00 $1,687.00 $1,239.00 $668.00 $864.00 $691.00 $541.00 $541.00 $567.00 $449.00 $521.00 $477.00 $327.00 2020 pricing Drugs&Supplies PROCEDURE NAME BIT DRILL 32 31531 BIT DRILL 3.2X215MM BIT DRILL 3211 3FLUTED BIT DRILL MATTA 3.5X180MM BIT DRILL STRY JL2.4X75MM SCREW MICRO KLS 1.5X4MM SCREW MICRO KLS 1.5X5MM NDLE SPINAL 20G 15CM END CAP TI EXT GRN 0MM CNTRCPT FALLOP ESSURE 0.8MM RAD HD EVOLVE +2 24MM RAD HD STEM WRIT +4 6.5MM EXTR BOLT SCREW 3.5/4.0MM HIP HD EZEM MTL12/14 36MM +5 HIP HD G7 TYPE 1 MTL 36MM +6 HIP HD VERS MTL 12/14 36MM +0 HIP HD VERS MTL 12/14 36MM+3.5 HIP STEM TAPERLOC 10X140MM KNEE FEM TC3 DEPU RT 3 KNEE FEM TC3 DEPU RT 5 KNEE FEM ILOK ZIMM LFT 65.0MM KNEE FEM TC3 DEPU RT 4 KNEE FEM UNI OXFORD ZIMM SM KNEE FEM UNI OXFORD ZIMM MD KNEE FEM ILOK ZIMM RT 62.5MM KNEE FEM ILOK ZIMM RT 65.0MM KNEE FEM ILOK ZIMM LFT 62.5MM KNEE FEM ILOK ZIMM LFT 67.5MM KNEE FEM PFC RPF DEPU LFT 3 KNEE FEM ILOK ZIMM LFT 70.0MM HIP HD SROM MTL 11/13 32MM +0 HIP HD G7 TYPE 1 MTL 32MM +6 NAIL FEM DIST CANN TI 12X240MM HIP STEM SROM 36 +8L 13X18X160 RETRV ROTH FOOD BOLUS 160CM SCREW CANN INTERFEFULL 9X25MM TB GASTRO MIC BLN 7-10ML 22FR SET ANCHOR SUT COPE 17G 12CM ROD REAMING BALL W EXT 2.5X950 GDWIRE ST ACUM 0.054X6 GDWIRE CALIB 3.2X300MM GDWIRE THRD MDTR 24 GDWIRE BALL TIP STRY 3X800MM GDWIRE BALL TIP STRY 3X1000MM BIT DRILL GRY PT 4.0X200MM HIP HD EZEM MTL12/14 36MM +1.5 Page 213 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $361.00 $695.00 $623.00 $466.32 $526.68 $216.00 $216.00 $101.00 $557.00 $3,480.00 $5,122.00 $5,920.00 $487.00 $2,224.00 $1,790.00 $1,657.00 $1,657.00 $4,674.00 $12,347.00 $12,620.00 $4,005.00 $12,620.00 $3,444.00 $3,444.00 $4,005.00 $4,005.00 $4,005.00 $4,005.00 $4,111.00 $4,005.00 $1,419.00 $1,790.00 $2,773.00 $3,240.00 $533.00 $490.00 $214.00 $433.00 $623.00 $89.00 $366.00 $751.00 $489.00 $510.00 $281.00 $1,419.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP HD M2A ZIMM MTL 46MM +0 HIP HD G7 TYPE 1 MTL 36MM +9 HIP HD VERS MTL 12/14 32MM +0 HIP HD VERS MTL 12/14 36MM-3.5 KNEE SCREW M/G ZIMM 48MM BLADE HEL FIX NAIL TI 11X90MM HIP HD EZE MTL 12/14 32MM +5 HIP HD EZE MTL 12/14 32MM +17 HIP STEM ACLD TMZF 132D SZ2 ROD CBN EXTL FIX STRY 8X350MM ROD CBN EXTL FIX STRY 8X400MM ROD CBN EXTL FIX STRY 8X450MM HIP HL ELIMINATOR DEPU SHLDR HUMR HD DEPU 48X15MM SHLDR HUMR STEM DEPU 12MM SET INFUS SILHOUETTE 13MM 23IN INTER GD ART35 WISEGUIDE INTER GD ART4 WISEGUIDE 7 INTER GD VL35 7FR CATH VISTA XB3 6FR 100CM INTER GD XB35 6FR STNT EXPRESS2 MR FG 2.50X12MM STNT EXPRESS2 MR FG 2.50X16MM STNT INTER EXPRESS 2RX2.5X20MM STNT EXPRESS2 MR FG 2.25X24MM STNT EXPRESS2 MR FG 2.50X8MM BLN OPTA PRO 5X4 80CM BLN OPTA PRO 6X4 80CM GLOVE COMP OVRWRST OPEN LFT MD GLOVE COMP OVRWRST OPEN RT MD GLOVE COMP OVRWRST OPEN RT SM GDWIRE JAGWIRE ST .038 260CM TB JEJ MIC SURG 14/9FR KWIRE 1.1X160MM KWIRE THRD TIP ZIMM 1.6MM KNEE ELEV 25.5X19X8 SCREW LAG GAMMA3 10.5X85MM SCREW LAG DHSDCS SYNT12.7X85MM CLAMP EXTL FIX 4POSITION MR LG PLATE HUMR DIST PSTRLAT RT 3HL SLV CARPAL RT SM/MD HIP LNR PNCLE PE 0D 32X54 HIP LNR PNCLE PE LIP 32X52MM HIP LNR PNCLE PE LIP 32X56MM HIP LNR ARCOMXL PE 0D 32X23MM HIP LNR ARCOMXL PE 0D +5 36X26 Page 214 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,790.00 $1,790.00 $1,657.00 $1,657.00 $426.00 $1,466.00 $1,419.00 $1,630.00 $5,053.00 $1,310.00 $1,310.00 $1,310.00 $276.00 $2,932.00 $5,118.00 $60.00 $258.00 $258.00 $258.00 $208.00 $208.00 $1,652.00 $1,652.00 $1,652.00 $1,652.00 $1,652.00 $523.00 $523.00 $98.00 $98.00 $98.00 $488.00 $904.00 $66.12 $209.00 $197.00 $1,672.00 $1,114.00 $1,671.00 $2,218.00 $124.00 $2,172.00 $2,172.00 $2,172.00 $2,123.00 $2,123.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR VERS BIPOLR PE 0D44X28 HIP RING LK DYNAMIC DEPU 56MM SCREW CORT LK ACUM 2.3X16MM SCREW CORT LK ACUM 2.3X22MM SCREW LK TI NAIL 5X36MM SCREW LK TI NAIL 5X40MM SCREW LK TI NAIL 5X48MM SCREW LK STRY 5X35MM SCREW LK STRY 5X45MM SCREW LK STRY 5X65MM SLV LK TI BLADE 120D PLATE Y DBL KLS REG PLATE L KLS LFT LNG PLATE L KLS LFT MD PLATE L KLS RT LNG PLATE L KLS RT MD PLATE ST KLS REG 16HL PLATE T KLS REG 90D PLATE Y KLS REG PLATE Z KLS LFT LNG PLATE Z KLS RT LNG HIP SHELL M2A ZIMM 54X48MM HIP HD M2A ZIMM MTL 48MM +0 BREAST NATRELLE LOWFULL300 BREAST SPECTRUM SMTH RD210 GD LT FOR XLIF MAXCESS ANG KNEE TIB TRAY KEEL MBT CMNT 2 KNEE TIB TRAY KEEL MBT CMNT2.5 KNEE TIB TRAY KEEL MBT CMNT 3 KNEE TIB TRAY KEEL MBT CMNT 4 KNEE TIB TRAY KEEL MBT CMNT 5 KNEE TIB TRAY KEEL MBT CMNT 6 DEV THYROPLASTY MEASURING PLATE HUMR MEDL DIST 3.5RT 5HL SEAL NASAL FLEXIFIT SIL MD TB MEDULLARY IRG RIA DISP TB JEJ MIC LOPRO 14FR 2.5CM TB GJ MIC LOPRO 16FR 2.5 30CM TB GJ MIC ENDO 18FR 45CM PLATE MICRO 1.5MM 6HL DBLYSHRT PLATE MICRO 1.5MM 5HL L LFTLNG PLATE MICRO 1.5MM 5HL L RT LNG PLATE MICRO 1.5MM 4HL L LFTLNG PLATE MICRO 1.5MM 4HL L LFT MD PLATE MICRO 1.5MM 4HL L RT LNG PLATE MICRO 1.5MM 4HL L RT MD Page 215 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,178.00 $1,218.00 $576.00 $576.00 $627.00 $627.00 $627.00 $842.00 $842.00 $842.00 $1,218.00 $610.00 $570.00 $570.00 $570.00 $570.00 $517.00 $570.00 $570.00 $570.00 $570.00 $3,918.00 $1,790.00 $2,205.00 $2,274.00 $1,165.00 $3,367.00 $3,367.00 $3,367.00 $3,367.00 $3,367.00 $3,367.00 $540.00 $2,461.00 $197.00 $376.00 $912.00 $1,227.00 $1,078.00 $702.00 $610.00 $610.00 $610.00 $610.00 $610.00 $610.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE MICRO 1.5MM 10HL CURV PLATE MICRO 1.5MM 4HL ST SHRT PLATE MICRO 1.5MM 4HL ST PLATE MICRO 1.5MM 6HL ST SHRT PLATE MICRO 1.5MM 6HL ST PLATE MICRO 1.5MM 8HL ST PLATE MICRO 1.5MM 16HL ST PLATE MICRO 1.5MM 6HL T PLATE MICRO 1.5MM 4HL CROSS PLATE MICRO 1.5MM 5HL Y MD MINI MIIG 5CC PLATE MINI KLS 4HL LNG PLATE MINI KLS 4HL REG PLATE MINI KLS 8HL REG HIP HD M2A ZIMM MTL 38MM +6 HIP HD G7 TYPE 1 MTL 36MM +3 NAIL ELAS TI BLU 3.5X440MM GD NERVE NEURAGEN 2MMX2CM(2U) NDLE NIM PAK EXTR STONE NCOMPASS NIT 2.4FR SCREW LK NUT TI KNEE PTLA 3PEG STD 28X8MM KNEE PTLA 3PEG STD 31X8MM KNEE PTLA ARCOM ZIMM 37MM KNEE PTLA DOME I/B II KNEE PTLA DOME 3PEG DEPU 38MM SHEATH PEELAWAY MDTR SGL 7FR LEAD FLEXTEND BIPOLR *OBS* SHEATH PEELAWAY MDTR DUAL 7FR STNT PROTEGE 10X80MM 80CM SHEATH INTR MDTR SAFE 7FR CATH DRN PERITON PLEURX 71CM KNEE FEM WLUG DEPU LFT 2*DISC* KNEE TIB INSRT CURV SZ2 10MM KNEE INSRT CURV DEPU 2 12.5MM KNEE INSRT CURV DEPU 2 15MM KNEE INSRT CURV DEPU 2 17.5MM KNEE TIB INSRT CURV SZ3 10MM KNEE TIB INSRT CURV SZ3 12.5MM KNEE TIB INSRT CURV SZ3 15MM KNEE TIB INSRT CURV SZ3 17.5MM KNEE TIB INSRT CURV SZ4 10MM KNEE TIB INSRT CURV SZ4 12.5MM KNEE TIB INSRT CURV SZ4 15MM KNEE INSRT CURV DEPU 4 17.5MM KNEE TIB INSRT CURV SZ5 10MM Page 216 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $663.00 $294.00 $285.00 $380.00 $380.00 $414.00 $651.00 $610.00 $663.00 $611.00 $5,204.00 $294.00 $298.00 $363.00 $1,790.00 $1,790.00 $1,099.00 $3,176.00 $2,158.00 $1,118.00 $738.00 $1,476.00 $1,476.00 $1,476.00 $2,274.00 $1,299.00 $191.00 $2,095.00 $258.00 $1,822.00 $189.00 $1,820.00 $3,357.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT CURV SZ5 12.5MM KNEE TIB INSRT CURV SZ5 15MM KNEE INSRT CURV DEPU 5 17.5MM KNEE TIB INSRT CURV SZ2.5 10MM KNEE TIB INSRT CURV 2.5 12.5MM KNEE TIB INSRT CURV SZ2.5 15MM KNEE INSRT CURV DEPU 2.5 17.5 KNEE TIB INSRT STBL SZ2 10MM KNEE TIB INSRT STBL SZ2 12MM KNEE TIB INSRT STBL SZ2 15MM KNEE TIB INSRT STBL SZ2 17.5MM KNEE TIB INSRT STBL 2.5 12.5MM KNEE TIB INSRT STBL SZ2.5 15MM KNEE TIB INSRT STBL SZ2.5 17.5 KNEE TIB INSRT STBL SZ3 10MM KNEE TIB INSRT STBL SZ3 12.5MM KNEE TIB INSRT STBL SZ3 15MM KNEE TIB INSRT STBL SZ3 17.5MM KNEE TIB INSRT STBL SZ4 10MM KNEE TIB INSRT STBL SZ4 15MM KNEE TIB INSRT STBL SZ5 10MM KNEE TIB INSRT STBL SZ5 12.5MM KNEE TIB INSRT STBL SZ5 15MM KNEE TIB INSRT STBL SZ5 17.5MM KNEE TIB INSRT STBL SZ6 10MM KNEE TIB INSRT STBL SZ6 12.5MM KNEE TIB INSRT STBL SZ6 17.5MM KNEE FEM CR NONPOR DEPU LFT 6 CATH CENTVEN PICC SL 3FR 60CM FORCEP BIPOLR CUT PKS 5MMX33CM PLATE COND RT 10HL 4.5MM PLATE COND RT 12HL 4.5MM PLATE COND LFT 12HL 4.5MM PLATE COND RT 14HL 4.5MM PLATE COND LFT 18HL 4.5MM PLATE TIB PROX LCP RT 8HL 4.5 PLATE Y CALC PLATE CALC LK 60MM PLATE CALC LK 70MM PLATE 3.5 CALC RT LNG 76MM PLATE ADPTN TI 24HL 1.3X95MM PLATE STRUT TI 1.3MM 18HL 5X43 PLATE ADPTN TI 20HL 1.5X90MM PLATE L OBLIQ TI 100D LFT 5HL PLATE ADPTN TI 20HL 2.0X100MM PLATE COND 12HL 50MM Page 217 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,764.00 $738.00 $1,738.00 $3,262.00 $3,331.00 $3,331.00 $3,397.00 $3,428.00 $3,082.00 $1,608.00 $1,574.00 $1,608.00 $1,944.00 $1,418.00 $1,202.00 $1,153.00 $848.00 $1,110.00 $1,755.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE COND 12HL 60MM PLATE COND 12HL 70MM PLATE COND 12HL 80MM PLATE COND 5HL 50MM PLATE COND 5HL 60MM PLATE COND 5HL 70MM PLATE COND 5HL 80MM PLATE COND 7HL 50MM PLATE COND 7HL 60MM PLATE COND 7HL 70MM PLATE COND 7HL 80MM PLATE COND 9HL 50MM PLATE COND 9HL 60MM PLATE COND 9HL 70MM PLATE COND 9HL 80MM PLATE H EXT TI RT 1.3X19MM PLATE RECON 3.5MM 10HL 118MM PLATE RECON 3.5MM 12HL 142MM PLATE RECON 3.5MM 14HL 166MM PLATE RECON 3.5MM 16HL 190MM PLATE RECON 3.5MM 18HL 214MM PLATE RECON 3.5MM 5HL 58MM PLATE RECON 3.5MM 6HL 70MM PLATE RECON 3.5MM 7HL 82MM PLATE RECON 3.5MM 8HL 94MM PLATE RECON 3.5MM 9HL 106MM PLATE RECON 4HL 4.5X61MM PLATE RECON 9HL 4.5X141MM PLATE RECON CURV 3.5 14HL166MM PLATE RECON CURV 3.5 8HL 94MM PLATE 3.5 LC-DCP 10HL 129MM PLATE WRIST FUSN ST TI 8HL PLATE WRIST FUSN SHRTBENDTI8HL PLATE WRIST FUSN STDBEND TI8HL PLATE TUBLR SM 100D 6HL PLATE H 5HL 23MM CATH DRN PLEURAL PLEURX 66CM SET DRN LN PLEURX LOCKABLE INTR TRANSITIONLESS 16FR KNEE TIB INSRT STD 10X63/67MM KNEE TIB INSRT STD 12X63/67MM KNEE TIB INSRT STD 10X71/75MM HIP LNR TRILOGY PE 0D 58X36MM KNEE FEM PSTR AUG SZ5 4MM KNEE FEM PSTR AUG SZ5 8MM KNEE FEM PSTR AUG SZ4 4MM Page 218 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,755.00 $1,755.00 $1,755.00 $1,566.00 $1,566.00 $1,566.00 $1,566.00 $1,597.00 $1,597.00 $1,597.00 $1,597.00 $1,675.00 $1,675.00 $1,675.00 $1,675.00 $1,037.00 $1,394.00 $1,462.00 $1,588.00 $1,662.00 $1,675.00 $1,148.00 $1,274.00 $1,338.00 $1,350.00 $1,384.00 $1,202.00 $597.84 $1,652.00 $1,453.00 $785.00 $2,349.00 $2,413.00 $2,413.00 $597.84 $1,067.00 $1,820.00 $95.00 $277.00 $2,042.00 $2,432.00 $2,042.00 $2,847.00 $2,660.00 $2,718.00 $2,718.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE FEM PSTR AUG SZ4 8MM KNEE FEM PSTR AUG SZ3 4MM SET PRSS MON MESH PROCEED MESH 3X6CM NDLE BX BIOPTY CUT 18GX20CM TISS REPLIFORM 2X7CM NAIL FEM CANN TI GRN 11X360MM BREAST COHESIVEHIPRO 325CC BREAST COHESIVEHIPRO 350CC BREAST COHESIVEHIPRO 375CC BIT DRILL SYNT 4X245MM BOLT LK TI 4.9X54MM LIGASURE PRECISE CORD HANDPC TPS 10FT CATH DRN BILI MACLOC10.2FR40CM BREAST SPECTRUM SMTH RD450 BREAST SILTEX SALINE 350CC KT IMPLT THYROPLASTY FEMALE EXPAND MAM ALLE MODER 400CC EXPAND MAM ALLE FULL 400CC RING EXTL FIX HYBRID 3/4 140MM CLAMP EXTL FIX RING-TO-ROD CATH SIZING AUROUS PIGT5FR70CM SPHINCTER AUTOME CANN RX44 BRUSH CYTOLOGY RX COMBO CATH GDWIRE JAGWIREST EXT.035 260CM KNIFE NDLE RX STNT WLLSTNT RX 8FR 10X60MM STNT WLLSTNT RX 8FR 10X80MM NDLE SCLERO CNTRST 2.3MM 25G HIP SCREW PNCLE CNCLS 6.5X15MM SCREW CORT SLFTP ZIMM 6.5X80MM SCREW CORT TI SM HEX 2.7X10MM SCREW CORT TI SM HEX 2.7X12MM SCREW CORT TI SM HEX 2.7X14MM SCREW CORT TI SM HEX 2.7X16MM SCREW CORT TI SM HEX 2.7X18MM SCREW CORT TI SM HEX 2.7X20MM SCREW CORT TI SM HEX 2.7X22MM SCREW CORT TI SM HEX 2.7X24MM SCREW CORT SLFTP HEX TI 2.7X12 SCREW CORT SLFTP HEX TI 2.7X14 SCREW CORT SLFTP HEX TI 2.7X16 SCREW CORT SLFTP HEX TI 2.7X18 SCREW CORT SLFTP HEX TI 2.7X20 SCREW CORT SLFTP HEX TI 2.7X22 Page 219 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,660.00 $2,660.00 $479.00 $1,524.00 $87.00 $2,147.00 $2,570.00 $2,274.00 $2,274.00 $2,274.00 $804.00 $625.00 $1,083.00 $1,142.00 $378.00 $2,274.00 $2,952.00 $2,104.00 $3,278.00 $3,278.00 $1,197.00 $1,910.00 $533.00 $1,063.00 $550.00 $488.00 $902.00 $3,326.00 $3,326.00 $186.00 $692.00 $257.00 $158.00 $158.00 $158.00 $158.00 $158.00 $158.00 $158.00 $158.00 $170.00 $170.00 $170.00 $170.00 $170.00 $170.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP HEX TI 2.7X24 SCREW CORT STD HEX TI 3.5X12MM SCREW CORT STD HEX TI 3.5X14MM SCREW CORT STD HEX TI 3.5X16MM SCREW CORT STD HEX TI 3.5X18MM SCREW CORT STD HEX TI 3.5X20MM SCREW CORT STD HEX TI 3.5X22MM SCREW CORT STD HEX TI 3.5X24MM SCREW CORT STD HEX TI 3.5X26MM SCREW CORT STD HEX TI 3.5X28MM SCREW CORT TI SLFTP 3.5X14MM SCREW CORT TI SLFTP 3.5X16MM SCREW CORT TI SLFTP 3.5X18MM SCREW CORT TI SLFTP 3.5X20MM SCREW CORT TI SLFTP 3.5X22MM SCREW CORT TI SLFTP 3.5X28MM SCREW LK SM HEX 3.5X18MM SCREW LK SM HEX 3.5X30MM SCREW LK SM HEX 3.5X32MM SCREW LK SM HEX 3.5X34MM SCREW LK SM HEX 3.5X38MM SCREW LK SM HEX 3.5X40MM SCREW LK SM HEX 3.5X45MM SCREW LK CONIC HD 4X14MM SCREW LK CONIC HD 4X50MM SCREW CORT SLFTP 4.5X70MM SCREW MALLEO SYNT 4.5X30MM SCREW MALLEO SYNT 4.5X40MM SCREW MALLEO SYNT 4.5X50MM SCREW MALLEO SYNT 4.5X70MM SCREW SHAFT SYNT 4.5X12X30MM SCREW SHAFT SYNT 4.5X12X40MM SCREW SHAFT SYNT 4.5X12X50MM SCREW CANN CONIC HEX SMTH 5X70 SCREW CNCLS SYNT 6.5X16X30MM SCREW CNCLS SYNT 6.5X16X40MM SCREW CNCLS SYNT 6.5X16X50MM SCREW CNCLS SYNT 6.5X16X60MM SCREW CNCLS SYNT 6.5X16X90MM SCREW CNCLS SYNT 6.5X16X100MM SCREW CNCLS SYNT 6.5X16X110MM SCREW CNCLS SYNT 6.5X32X50MM SCREW CNCLS SYNT 6.5X32X100MM SCREW CNCLS SYNT 6.5X32X110MM SCREW CNCLS FULL THRD 6.5X30MM SCREW CANN CONIC SYNT 7.3X50MM Page 220 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $170.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $116.00 $116.00 $116.00 $116.00 $116.00 $116.00 $575.00 $575.00 $575.00 $575.00 $575.00 $575.00 $575.00 $664.00 $664.00 $117.00 $166.00 $166.00 $166.00 $166.00 $89.00 $89.00 $98.00 $793.00 $172.00 $172.00 $172.00 $172.00 $184.00 $184.00 $184.00 $172.00 $184.00 $184.00 $172.00 $1,160.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN LNG THRD SS 3X20MM SCREW CANN LNG THRD SS 3X30MM SCREW CANN SHRT THRD SS 3X10MM SCREW CANN SHRT THRD SS 4X10MM SCREW CANN SHRT THRD SS 4X12MM SCREW CANN SHRT THRD SS 4X14MM SCREW CANN SYNT LNG THRD 4X40 SCREW CANN SYNT LNG THRD 4X42 SCREW CANN SYNT LNG THRD 4X44 SCREW CANN SYNT LNG THRD 4X46 SCREW CANN SYNT LNG THRD 4X48 SCREW CANN SYNT LNG THRD 4X50 SCREW CANN PART THRD 4.5X20MM SCREW CANN FULL THRD 4.5X20MM SCREW CANN FULL THRD 4.5X22MM SCREW CANN FULL THRD 4.5X24MM SCREW CANN FULL THRD 4.5X26MM SCREW CANN FULL THRD 4.5X32MM SCREW CANN FULL THRD 4.5X34MM SCREW CANN FULL THRD 4.5X36MM SCREW CANN FULL THRD 4.5X38MM SCREW CANN PART THRD 4.5X42MM SCREW CANN FULL THRD 4.5X42MM SCREW CANN FULL THRD 4.5X44MM SCREW CANN FULL THRD 4.5X46MM SCREW CANN FULL THRD 4.5X48MM SCREW CANN FULL THRD 4.5X52MM SCREW CANN FULL THRD 4.5X56MM SCREW CANN PART THRD 4.5X60MM SCREW CANN FULL THRD 4.5X72MM SCREW CANN SYNT 6.5X32X55MM SCREW CANN SYNT 7.3X32X110MM SCREW CANN SYNT 7.3X16X120MM SCREW CANN SYNT 7.3X32X120MM SCREW CANN SYNT 7.3X16X130MM SCREW CANN SYNT 7.3X32X130MM SCREW CANN SYNT 7.3X16X30MM SCREW CANN SYNT 7.3X16X40MM SCREW CANN SYNT 7.3X32X50MM SCREW CANN SYNT 7.3X16X60MM SCREW CANN SYNT 7.3X32X60MM SCREW CANN SYNT 7.3X16X70MM SCREW CANN SYNT 7.3X32X70MM SCREW CANN SYNT 7.3X32X75MM SCREW CORT SLFTP TI 1X10MM SCREW CORT SLFTP TI 2.0X7MM Page 221 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $899.00 $899.00 $899.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $907.00 $1,140.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $1,145.00 $351.00 $209.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP TI 2.0X8MM SCREW CORT SLFTP TI 2.0X9MM SCREW CORT SLFTP TI 2.0X11MM SCREW CORT SLFTP TI 2.0X13MM SCREW CNCLS FULL THRD 4X60MM SCREW CNCLS PART THRD 4X10MM SCREW CORT STD HEX 3.5X10MM SCREW CORT STD HEX 3.5X12MM SCREW CORT STD HEX 3.5X14MM SCREW CORT STD HEX 3.5X16MM SCREW CORT STD HEX 3.5X18MM SCREW CORT STD HEX 3.5X20MM SCREW CORT STD HEX 3.5X22MM SCREW CORT STD HEX 3.5X24MM SCREW CORT STD HEX 3.5X26MM SCREW CORT STD HEX 3.5X28MM SCREW CORT STD HEX 3.5X30MM SCREW CORT STD HEX 3.5X32MM SCREW CORT STD HEX 3.5X34MM SCREW CORT STD HEX 3.5X36MM SCREW CORT STD HEX 3.5X40MM SCREW CORT STD HEX 3.5X50MM ANCHOR TI-SCREW WO NDLE 5MMSZ2 SCREW CRUCIFORM TI 2.1X12MM SCREW CRUCIFORM TI 2.1X14MM SCREW CRUCIFORM TI 2.1X16MM HEMO SEAL TISSEEL FIBRIN 50ML OCCL SEPTAL ASD 18MM OCCL SEPTAL ASD 16MM OCCL SEPTAL ASD 22MM HIP SHELL TRABEC CLUSTER 54MM TB TRACH XLT PROX UNCUF 5.0MM KNEE TIBTRAY GVF CMNT COCR 2MM KNEE TIBTRAY GVF CMNTCOCR2.5MM KNEE TIBTRAY GVF CMNT COCR 3MM KNEE TIBTRAY GVF CMNT COCR 4MM KNEE TIBTRAY GVF CMNT COCR 5MM KNEE TIBTRAY GVF CMNT COCR 6MM RETR SYS DEEP SCROTAL AMS HIP SLV PROX SROM 18D-SML SPLT FINGER EXT SHRT BLK MD SLING SPA*DISC NO REPLACEMENT* BLADE FEM NAIL SPIRAL TI 75MM BLADE FEM NAIL SPIRAL TI 80MM PLATE WRIST FUSN STD 8HL SHLDR TRAC STAR SLV W COBAN Page 222 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $209.00 $209.00 $209.00 $209.00 $95.00 $90.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $84.00 $1,301.00 $284.00 $284.00 $284.00 $1,802.00 $12,913.00 $12,913.00 $12,913.00 $2,789.00 $340.00 $2,508.00 $2,508.00 $2,508.00 $2,508.00 $2,508.00 $2,508.00 $1,297.00 $2,205.00 $63.00 $2,621.00 $1,577.00 $1,577.00 $2,409.00 $370.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB STEM CMNT PFC 13X30MM HIP STEM TAPERLOC 17.5X140MM NAIL TIB T2 STRY 9X135MM TAP CORT SCREW SYNT 27MM TAP CORT SCREW SYNT 3.5MM110MM HIP ADPTR TYPE1 M2A 42-50MMSTD BRC THB SPI LFT LG BRC THB SPI LFT SM BRC THB SPI RT SM NAIL TIB TI CANN 12X360MM END CAP 15MM TI EXT BLU 0MM END CAP TI EXT SOLID NAIL 15MM PLATE MAND LOCK SYNT 12HL 2MM PLATE MAND LK TI 6HL 2.0MM PLATE MAND LK TI LG12HL2.0MM PLATE MAND LK TI LG20HL2.0MM PLATE MAND LK TI LG 3X3HL2.0 PLATE MANDLOCK ANG TI2.0 3X3HL PLATE MANDLOCK CURV TI3X3HL2.0 PLATE MANDLOCK ANG TI2.0 4X4HL PLATE MAND LK TI LG 6HL2.0MM PLATE MAND LK TI RT6X21HL2.0 BOLT LK TI 3.9X32MM BOLT LK TI 3.9X44MM PLATE ADPTN MINI TI 20HL 2.0MM PLATE MINI MAND BROAD TI 4HL PLATE MINIMAND BROAD CURVTI4HL PLATE MINI MAND NARW TI 4HL2.0 PLATE MALLEA NARW TI 4HL 2.0MM PLATE MINI MAND NARW TI 6HL2.0 PLATE MALLEA NARW TI 6HL 2.0MM NAIL EX TIB CANN TI 11X330MM KNE STEM TIB BASEPLATE RT SZ2 KNEE TIB MONOBLOCK LPS 3EF10MM NAIL TIB TI STER 8X330MM KNEE TIB STEM CMNT PFC 15X30MM KNEE TIB SURFACE YEL SZCD 9MM KNEE TIB TRAY PFC MOD PLUS 3 KNEE TIB TRAY PFC MOD PLUS 5 KNEE TIB WEDGE HEMI PFC 3 20D KNEE TIB WEDGE HEMI PFC 3 10D EXPAND MAM ALLE LOW 500CC MESH MICRO MESH 1.5MM 84X53MM TB TRACH XLT DIST CUFF 7.0MM TB TRACH XLT PROX UNCUF 6.0MM HIP SHELL TRID PSL CLUSTER54MM Page 223 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,639.00 $4,674.00 $3,143.00 $543.00 $543.00 $1,419.00 $147.00 $147.00 $147.00 $2,337.00 $791.00 $843.00 $2,046.00 $1,394.00 $1,692.00 $2,060.00 $1,524.00 $1,872.00 $1,870.00 $1,945.00 $1,524.00 $2,818.00 $625.00 $625.00 $1,550.00 $1,135.00 $1,244.00 $1,133.00 $1,133.00 $1,234.00 $1,133.00 $2,543.00 $2,412.00 $5,322.00 $2,452.00 $2,639.00 $8,416.00 $6,820.00 $6,820.00 $3,604.00 $3,604.00 $3,326.00 $1,784.00 $340.00 $340.00 $2,303.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL TROCHANT TI 130D 10X170MM GDWIRE BENTSON HEP 0.035 145CM BIT DRILL 1.1MM DIAX50MM 5M BIT DRILL 1.1MM DIAX50MM WN BIT DRILL 1.5X115MM BIT DRILL 1.5MM DIAX50MM WN BIT DRILL 1.9MM DIAX70MM WN CATH DRN MULTPRP LK10.2FR 25CM CATH DRN BILI MACLOC 12FR 40CM DRN DAWSON MUELLER 8.5FR 25CM CATH DRN MULTPRP LK 8.5FR 25CM STAPLER ENDO GIA UNIV XL CATH PICC TURBOFLO SL 4FR 60CM HIP HD TRID V40 LFIT MTL36MM-5 PSTNR OLYMPIC VAC-PAC SZ30 PLATE THORACIC MDTR 5.5CM STAPLE VANTAGE ROSTRAL TI STAPLE VANTAGE CAUDAL TI RETAINER VISCERA MD CLAMP EXTL FIX ADJ WIRE-PIN PLATE WRIST FUSN HUB CAP COV SCREW WRIST HUB CAP NDLE CATH YUEH ST 5FR 7CM BLN SPRINTER OTW 1.5X12MM BLN SPRINTER OTW 2.0X6MM BLN SPRINTER OTW 2.0X12MM BLN SPRINTER OTW 2.0X15MM BLN SPRINTER OTW 2.0X20MM BLN SPRINTER OTW 2.5X6MM BLN SPRINTER OTW 2.5X15MM BLN SPRINTER OTW 3.0X6MM BLN SPRINTER OTW 3.0X20MM BLN SPRINTER OTW 3.0X25MM BLN SPRINTER OTW 3.0X30MM BLN SPRINTER OTW 3.5X6MM BLN SPRINTER OTW 3.5X12MM BLN SPRINTER OTW 3.5X15MM BLN SPRINTER OTW 3.5X20MM BLN SPRINTER OTW 4.0X6MM BLN SPRINTER OTW 4.0X12MM BLN SPRINTER OTW 4.0X15MM BLN SPRINTER OTW 4.0X20MM CATH GUIDE IM-C 90CM 6FR BLN MAVERICK OTW 2.00X15MM BLN MAVERICK RX 2.00X9MM BLN MAVERICK RX 2.25X9MM Page 224 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,459.00 $65.00 $478.00 $478.00 $478.00 $478.00 $478.00 $356.00 $378.00 $356.00 $356.00 $783.00 $834.00 $1,466.00 $1,801.00 $5,886.00 $2,989.00 $2,989.00 $140.00 $1,815.00 $2,586.00 $646.00 $86.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $738.00 $533.00 $533.00 $533.00 $533.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLN MAVERICK RX 1.50X15MM BLN MAVERICK RX 2.00X15MM BLN MAVERICK RX 2.50X15MM BLN MAVERICK RX 1.50X20MM BLN MAVERICK RX 2.00X20MM BLN MAVERICK RX 2.25X20MM BLN MAVERICK RX 2.50X20MM BLN MAVERICK RX 3.00X20MM BLN MAVERICK RX 3.50X20MM BLN MAVERICK RX 4.00X20MM PEG FULL THRD ZIMM 2.5X26MM PEG FULL THRD ZIMM 2.5X28MM PEG FULL THRD ZIMM 2.5X30MM PLATE DVR ZIMM EXT RT PLATE DVR ZIMM EXT LFT PLATE DVR ZIMM SHRT RT PLATE DVR ZIMMNARW SHRT LFT3HL PLATE DVR ZIMM WIDE RT PLATE DVR ZIMM WIDE LFT KNEE TIB INSRT XLK STBL 2 10MM KNEE TIB INSRT XLK CURV 2 8MM KNEE TIB INSRT XLK CURV 2 10MM KNEE TIBINSRT XLK CURV2 12.5MM KNEE TIB INSRT XLK CURV 2 15MM KNEE TIBINSRT XLK CURV2 17.5MM KNEE TIBINSRT XLK CURV2.5 8MM KNEE TIBINSRT XLK CURV2.5 12.5 KNEE TIBINSRT XLK CURV2.5 15MM KNEE TIBINSRT XLK CURV2.5 17.5 KNEE TIB INSRT XLK CURV 3 8MM KNEE TIB INSRT XLK CURV 3 10MM KNEE TIBINSRT XLK CURV3 12.5MM KNEE TIB INSRT XLK CURV 3 15MM KNEE TIBINSRT XLK CURV3 17.5MM KNEE TIB INSRT XLK CURV 4 8MM KNEE TIB INSRT XLK CURV 4 10MM KNEE TIBINSRT XLK CURV4 12.5MM KNEE TIB INSRT XLK CURV 4 15MM KNEE TIBINSRT XLK CURV4 17.5MM KNEE TIB INSRT XLK CURV 5 8MM KNEE TIB INSRT XLK CURV 5 10MM KNEE TIBINSRT XLK CURV5 12.5MM KNEE TIBINSRT XLK CURV5 17.5MM KNEE TIB INSRT XLK STBL 2 8MM KNEE TIB INSRT XLK STBL 2 12.5 KNEE TIB INSRT XLK STBL 2 15MM Page 225 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $533.00 $533.00 $533.00 $533.00 $533.00 $533.00 $533.00 $533.00 $533.00 $533.00 $561.00 $561.00 $561.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT XLK STBL 2 17.5 KNEE TIBINSRT GVF STBL2.5 17.5 KNEE TIB INSRT XLK STBL2.5 8MM KNEE TIBINSRT XLK STBL2.5 12.5 KNEE TIBINSRT XLK STBL2.5 15MM KNEE TIBINSRT XLK STBL2.5 17.5 KNEE TIBINSRT GVF STBL3 12.5MM KNEE TIB INSRT XLK STBL 3 8MM KNEE TIBINSRT XLK STBL3 12.5MM KNEE TIB INSRT XLK STBL 3 15MM KNEE TIBINSRT XLK STBL3 17.5MM KNEE TIB INSRT XLK STBL 4 8MM KNEE TIB INSRT XLK STBL 4 10MM KNEE TIBINSRT XLK STBL4 12.5MM KNEE TIBINSRT XLK STBL4 17.5MM KNEE TIB INSRT XLK STBL 5 8MM KNEE TIB INSRT XLK STBL 5 10MM KNEE TIB INSRT XLK STBL 5 12.5 KNEE TIB INSRT XLK STBL 5 15MM KNEE TIB INSRT XLK STBL 5 17.5 KNEE TIB INSRT CURV SZ2 8MM KNEE INSRT CURV DEPU 2 12.5MM KNEE INSRT CURV DEPU 2 15MM KNEE INSRT CURV DEPU 2 17.5MM KNEE TIB INSRT CURV SZ2.5 10MM KNEE TIB INSRT CURV 2.5 12.5MM KNEE TIB INSRT CURV SZ2.5 15MM KNEE TIB INSRT CURV 2.5 17.5MM KNEE TIB INSRT CURV SZ3 8MM KNEE TIB INSRT CURV SZ3 10MM KNEE TIB INSRT CURV SZ3 12.5MM KNEE TIB INSRT CURV SZ3 15MM KNEE TIB INSRT CURV SZ3 17.5MM KNEE TIB INSRT CURV SZ4 8MM KNEE TIB INSRT CURV SZ4 12.5MM KNEE TIB INSRT CURV SZ4 15MM KNEE INSRT CURV DEPU 4 17.5MM KNEE TIB INSRT CURV SZ5 8MM KNEE TIB INSRT CURV SZ5 10MM KNEE TIB INSRT CURV SZ5 12.5MM KNEE TIB INSRT CURV SZ5 15MM KNEE TIB INSRT CURV SZ5 17.5MM KNEE INSRT CURV DEPU 6 8MM KNEE INSRT CURV DEPU 6 10MM KNEE TIB INSRTCURV SZ6 12.5MM KNEE INSRT CURV DEPU 6 15MM Page 226 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,344.00 $1,722.70 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,172.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE INSRT CURV DEPU 6 17.5MM PLATE TENSION TI SYNT 4HL2.0MM NDLE STIMUPLEX A 21GX4 GD PIN OSTEOTOMY 2.4MM TRANSFIX IMPLT ARTX 3X40MM BIO-TRANSFIX ARTX 5X40MM KT TRANSTIB ACL DISP WO SAW SET BIT DRILL TRANSFIX II KT KNEE FLAP REPAIR SGL SHOT SCREW SET BREAKOFF MDTR SCREW LEGACY MA TI5.5X4.5X45MM PROBE VENTILATOR TEMP MR850 59 PIN EXTL FIX THRD 50X5X180MM PIN EXTL FIX APEX BLNT 5MM PIN EXTL FIX TRANSFIX 5X250MM HIP LNR TRID X3 PE 0D 36MM F HIP LNR TRID X3 PE 10D 36MM G SET FEED EXT BOLUS MIC RTANG12 KNEE TIB INSRT PFC RPFSZ3 12.5 KNEE TIB INSRT TC3 3 10MM KNEE TIB INSRT CURV SZ4 10MM CATH DIL VAN ANDEL 7FR 80CM CATH BEACON SIM1 0.038 5FR 100 CATH BEACON ANG KMP5FR65CM.038 SET DISP DRILL AND PIN ZIMM HIP LNR TRILOGY PE 0D 56X36MM HIP LNR TRILOGY PE 10D 58X36MM HIP LNR TRILOGY PE 20D 50X32MM SCREW CANN OSTE 3X20MM SCREW CANN OSTE 3X22MM SCREW CANN OSTE 3X28MM SCREW CANN OSTE 4X36MM PLATE 1/3TUBLR W COLAR 3.5 8HL STNT GRAFTMASTER 3.00X12*DISC* STNT GRAFTMASTER 3.00X16*DISC* STNT GRAFTMASTER 3.50X12*DISC* STNT GRAFTMASTER 4.00X12*DISC* STNT GRAFTMASTER 4.50X16*DISC* STNT GRAFTMASTER 5.00X16*DISC* BLN MAVERICK RX 2.25X15MM SCREW CORT 130/40 6.0/5.0MM CANN RADL POWERSHIELD 12MM WASHER THRD PORT MRI DL 10FR SCREW CANN CNCLS ZIMM 10MM SCREW CANN CNCLS ZIMM 12MM Page 227 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,344.00 $1,106.00 $69.00 $203.00 $786.00 $1,082.00 $723.00 $758.00 $996.00 $482.00 $2,285.00 $704.00 $864.00 $664.00 $450.24 $2,627.00 $2,627.00 $58.00 $2,700.00 $4,414.00 $2,344.00 $76.00 $61.00 $61.00 $415.00 $2,847.00 $2,847.00 $2,847.00 $721.00 $721.00 $721.00 $711.00 $351.00 $5,042.00 $5,042.00 $5,042.00 $5,042.00 $5,042.00 $5,042.00 $533.00 $876.00 $462.00 $635.00 $1,131.00 $1,068.00 $1,068.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN CNCLS ZIMM 32MM RETR METRX BEVELED 4CM PIN EXTL FIX THRD 35X5X120MM EXT FIX PIN APEX 4.0X120MM PIN EXTL APEX SLFTP 4X150MM PIN EXTL APEX SLFTP 4X150MM ROD ALUMI EXTL FIX CURV MD HIP PROS MOORE DEPU STD 41MM HIP PROS MOORE DEPU STD 42MM HIP PROS MOORE DEPU STD 43MM HIP PROS MOORE DEPU STD 50MM HIP PROS MOORE DEPU STD 51MM HIP PROS MOORE DEPU STD 52MM HIP PROS MOORE DEPU STD 54MM HIP PROS MOORE DEPU STD 53MM HIP PROS MOORE DEPU STD 55MM HIP PROS MOORE DEPU STD 48MM GLIDEWIRE ANG 0.035 150CM STNT ULTRFX COV DIST 18MM 12CM STNT POLYFLEX 21/25X90MM PLATE 1/4TUBLR W COLAR 2.7 8HL SCREW CORT STD 4.5X14MM SCREW CORT STD 4.5X16MM SCREW CORT STD 4.5X18MM SCREW CORT STD 4.5X20MM SCREW CORT STD 4.5X22MM SCREW CORT STD 4.5X24MM SCREW CORT STD 4.5X26MM SCREW CORT STD 4.5X28MM SCREW CORT STD 4.5X30MM SCREW CORT STD 4.5X32MM SCREW CORT STD 4.5X34MM SCREW CORT STD 4.5X36MM SCREW CORT STD 4.5X38MM SCREW CORT STD 4.5X40MM SCREW CORT STD 4.5X48MM SCREW CORT STD 4.5X50MM SCREW CORT STD 4.5X52MM SCREW CORT STD 4.5X54MM SCREW CORT STD 4.5X56MM SCREW CORT STD 4.5X58MM SCREW CORT STD 4.5X60MM SCREW CORT STD 4.5X64MM SCREW CORT STD 4.5X70MM HOOK LEGACY WIDE BLADE TI SM HOOK LEGACY WIDE TI LG Page 228 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,068.00 $1,530.00 $664.00 $664.00 $806.00 $806.00 $956.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $2,884.00 $177.00 $3,525.00 $4,305.00 $502.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $87.00 $2,453.00 $2,023.00 2020 pricing Drugs&Supplies PROCEDURE NAME ADPTR TUOHY-BORST 6FR GRAFT HEMA MD 14MM 15CM GDWIRE SEXTANT SHARP HIP SHELL VERS BIPOLR ZIMM46MM SCREW CORT ZIMM 3.5X24MM HIP SCREW BONE ZIMMSLFTP6.5X15 HIP SCREW BONE ZIMMSLFTP6.5X30 HIP LNR VERS BIPOLR PE 0D47X28 DRSG NASAL STD W AIRW 8CM CATH URETRL OPEN END 7FR 70CM BLN ENDO DISSECTION KDN CAUT ELTD VERSAPOINT BALL TIP CAUT ELTD VERSAPOINT TWIZZEL RETR FLEX IRIS ANCHOR GII QK PLUS 2 CP2 ETHI CLAMP EXTL FIX SM 4/2.5MM CLAMP EXTL FIX SM 4/4MM NUT EXTL FIX SPRING LOAD SM ROD EXTL FIX CBN SM 4X60MM ROD EXTL FIX CBN SM 4X80MM ROD EXTL FIX CBN SM 4X100MM ROD EXTL FIX CBN SM 4X120MM ROD EXTL FIX CBN SM 4X140MM ROD EXTL FIX CBN SM 4X160MM ROD EXTL FIX CBN SM 4X180MM ROD EXTL FIX CBN SM 4X200MM GDWIRE ST ACUM 0.028X6 HIP STEM SUMMIT POR STD SZ1 HIP STEM SUMMIT POR STD SZ2 HIP STEM SUMMIT POR STD SZ3 HIP STEM SUMMIT POR STD SZ4 HIP STEM SUMMIT POR STD SZ5 HIP STEM SUMMIT POR STD SZ6 HIP STEM SUMMIT POR STD SZ7 HIP STEM SUMMIT POR STD SZ8 HIP STEM SUMMIT POR STD SZ9 HIP STEM SUMMIT POR STD SZ10 HIP STEM SUMMIT POR HIGH SZ1 HIP STEM SUMMIT POR HIGH SZ2 HIP STEM SUMMIT POR HIGH SZ8 HIP STEM SUMMIT POR HIGH SZ9 HIP STEM SUMMIT POR HIGH SZ10 HIP STEM SUMMIT CMNT SZ3 HIP STEM SUMMIT CMNT SZ4 HIP STEM SUMMIT CMNT SZ5 HIP STEM SUMMIT CMNT SZ6 Page 229 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $86.00 $1,461.00 $517.00 $1,178.00 $248.00 $203.00 $203.00 $1,178.00 $116.00 $365.00 $1,226.00 $1,445.00 $1,389.00 $390.00 $1,187.00 $1,121.00 $1,121.00 $143.00 $163.00 $163.00 $163.00 $163.00 $218.00 $218.00 $218.00 $218.00 $77.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $3,240.00 $3,240.00 $3,240.00 $3,240.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP STEM SUMMIT CMNT SZ7 HIP STEM SUMMIT CMNT SZ8 HIP STEM SUMMIT CMNT HIGH SZ3 HIP STEM SUMMIT CMNT HIGH SZ4 HIP STEM SUMMIT CMNT HIGH SZ5 HIP STEM SUMMIT CMNT HIGH SZ6 HIP STEM SUMMIT CMNT HIGH SZ7 HIP STEM SUMMIT CMNT HIGH SZ8 KNEE FEM CR POR DEPU RT 5 HIP SHELL PNCLE100 POR 48MM HIP SCREW BONE HGPII 6.5X25MM HIP SCREW BONE HGPII 6.5X30MM SCREW CORT ZIMM 4X55MM SCREW CORT SYNT STD 2X6MM SCREW CORT SYNT STD 2X10MM SCREW CORT STD HEX 2.7X10MM SCREW CORT STD HEX 2.7X20MM SCREW SCHANZ 4.0/3.0 80MM SCREW SCHANZ 4.0 SPADE 100MM ROD RUSH ZIMM 1/8X5 ROD RUSH ZIMM 1/8X5.5 STAPLE FIX S&N SM STAPLE FIX S&N LG SCREW NUT 4.5MM CBL SONGER TI SGL MENISC ARROW CONMED 10MM BIT DRILL GAMMA NAIL 220MM BLN DILATOR CRE WIREGD 12*CIP* GDWIRE JAGWIRE ST .025 450CM ROTH NET 2.5MM DISP 230CM PIN BTRS SS 1.8X12MM PIN BTRS SS 1.8X14MM PIN BTRS SS 1.8X16MM PIN BTRS SS 1.8X20MM PIN BTRS SS 1.8X22MM PIN BTRS SS 1.8X24MM PIN BTRS SS 1.8X26MM PIN BTRS SS 1.8X28MM PIN BTRS SS 1.8X30MM SCREW CORT 3.5HD 2.4X12MM SCREW CORT 3.5HD 2.4X14MM SCREW CORT 3.5HD 2.4X20MM SCREW CORT 3.5HD 2.4X24MM SCREW CORT 3.5HD 2.4X26MM SCREW CORT 3.5HD 2.4X28MM SCREW CORT 3.5HD 2.4X30MM Page 230 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,240.00 $3,240.00 $3,240.00 $3,240.00 $3,240.00 $3,240.00 $3,240.00 $3,240.00 $3,356.00 $2,376.00 $203.00 $203.00 $281.00 $148.00 $148.00 $158.00 $158.00 $291.00 $291.00 $653.00 $653.00 $1,025.00 $1,025.00 $151.00 $1,700.00 $783.00 $369.00 $1,029.00 $488.00 $509.00 $306.00 $306.00 $306.00 $306.00 $306.00 $306.00 $306.00 $306.00 $306.00 $238.00 $238.00 $238.00 $238.00 $238.00 $238.00 $238.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE DORSAL DIST RAD RT PLATE VOLAR DIST RAD RT CONN DOMINO LEGACY MDTR 5.5MM SCREW FA LEGACY 5.5X25MM SCREW FA LEGACY 5.5X30MM SCREW FA LEGACY 5.5X35MM SCREW FA LEGACY 5.5X40MM SCREW FA LEGACY 5.5X45MM SCREW FA LEGACY 5.5X50MM SCREW FA LEGACY 6.5X40MM SCREW FA LEGACY 6.5X45MM SCREW FA LEGACY 6.5X50MM SYS NAIL GAMMA3 125D 11X180MM SYS NAIL GAMMA3 130D 11X180MM NAIL GAMMA RT LNG 130D11X380MM NAIL GAMMA RT LNG 130D11X400MM NAIL GAMMA RT LNG 130D11X420MM NAIL GAMMA3 LFT LNG 125D11X340 NAIL GAMMA3 LFT LNG 125D11X360 NAIL GAMMA3 LFT LNG 125D11X380 NAIL GAMMA3 LFT LNG 125D11X400 NAIL GAMMA3 LFT LNG 125D11X420 NAIL GAMMA STRY LNG LFT 340MM NAIL GAMMA STRY LNG LFT 360MM NAIL GAMMA STRY LNG LFT 380MM NAIL GAMMA STRY LNG LFT 400MM SCREW LAG GAMMA3 10.5X75MM SCREW LAG GAMMA3 10.5X80MM SCREW LAG GAMMA3 10.5X90MM SCREW LAG GAMMA3 10.5X95MM SCREW LAG GAMMA3 10.5X100MM SCREW LAG GAMMA3 10.5X105MM SCREW LAG GAMMA3 10.5X110MM SCREW LAG GAMMA3 10.5X115MM SCREW LAG GAMMA3 10.5X120MM SET SCREW GAMMA STRY END CAP GAMMA3 TI 11X0MM SCREW LK STRY 5X30MM SCREW LK STRY 5X50MM SCREW LK STRY 5X55MM SCREW LK STRY 5X60MM SCREW LK STRY 5X70MM SCREW LK STRY 5X75MM SCREW LK STRY 5X80MM SCREW LK STRY 5X85MM SCREW LK STRY 5X90MM Page 231 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,222.00 $2,016.00 $2,028.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $3,000.00 $3,000.00 $3,766.00 $5,009.00 $3,766.00 $3,766.00 $3,766.00 $3,766.00 $3,766.00 $3,766.00 $4,001.00 $4,001.00 $4,007.00 $4,007.00 $1,668.00 $1,672.00 $1,672.00 $1,672.00 $1,672.00 $1,672.00 $1,672.00 $744.00 $1,672.00 $908.00 $908.00 $842.00 $842.00 $842.00 $842.00 $842.00 $842.00 $842.00 $842.00 $842.00 2020 pricing Drugs&Supplies PROCEDURE NAME ENDO LAP SCISSORS TIP BINDER ABD 3PNL 2XLNG 9X60-75 CATH POWERLINE SL 5FR 40CM CATH DRN FLEXIMA REG 8FR 35CM CATH DRN FLEXIMA REG 10FR 35CM CATH DRN FLEXIMA REG 14FR 35CM INTR FLEXOR RAABE 5FR 55CM CATH ROYAL HI VCF 5FR 65CM .03 GDWIRE *DISC 6160215 6288671* CATH SLIP-CATH C2 5FR 65CM GDWIRE USTIFF ST HEP0.035 180 INTR TRANSITIONLESS 12FR SET ACCESS ROSCH TRANSJGLR10FR GDWIRE HIWIRE STDANG.018 180CM STNT URETRL DBL J 10.2FR 22CM CATH DRN MULTPRP LK10.2FR 45CM CATH DRN MULTPRP LK 12FR 25CM CATH DRN MULTPRP LK 12FR 45CM CATH DRN MULTPRP LK 14FR 25CM COIL MCWE-18-0.5-0-HILAL COIL MWCE-18-2.0-2-HILAL COIL MWCE-18S-6/2-TORNADO SHEATH PNCLE RO NO GD 6FR 10CM BLN SIZING 18MM OCCL SEPTAL ASD 8MM OCCL SEPTAL ASD 10MM OCCL SEPTAL ASD 20MM GDWIRE BENTSON HEP 0.035 260CM GDWIRE SV-5 .018 300CM STYLET LEAD ST BALL .016 58CM STYLET LEAD ST BALL .014 58CM LEAD END CAP MDTR 1-5MM CATH QUICKCROSS .035 135CM CATH PRONTO V3 KT ART CATH 20G 5IN MESH ALLOMAX 7X10CM BIT DRILL STRY 4.2X300MM CAP EXTL FIX PROTECT PIN 2.5MM CAP EXTL FIX PROTECT ROD 4.0MM SCREW CORT SLFTP 2X8MM SCREW CORT SLFTP 2X18MM SCREW CORT SLFTP SM HEX 4X56MM BIT DRILL QK 1.5X110MM BIT DRILL QK 2.4X100MM COUNTERSINK CORT SCREW 2.7MM SCREW CORT SLFTP 3.5X65MM Page 232 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $265.00 $89.00 $1,169.00 $352.00 $352.00 $352.00 $215.00 $61.00 $62.00 $173.00 $129.00 $277.00 $1,447.00 $860.00 $576.00 $423.00 $356.00 $423.00 $356.00 $203.00 $203.00 $393.00 $153.00 $1,187.00 $12,913.00 $12,913.00 $12,913.00 $82.00 $415.00 $118.00 $118.00 $77.00 $870.00 $1,699.00 $144.00 $3,684.00 $492.00 $68.00 $68.00 $162.00 $162.00 $138.00 $293.00 $541.00 $714.00 $116.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP 3.5X70MM SCREW CORT SLFTP 3.5X75MM BIT DRILL QK 2.9 X 150MM BIT DRILL QK 2.7X100MM COUNTERSINK 3.5 TAP CORT SCREW SYNT 3.5MM TAP CNCLS SCREW SYNT 4.0MM KNEE FEM NKII NONPOR RT SZ1 KNE STEM TIB BASEPLATE RT SZ1 SHLDR GLENOID KEEL DEPU 48MM BREAST MODER SMTH RD 125CC BREAST MODER SMTH RD 150CC BREAST MODER SMTH RD 475CC BREAST SPECTRUMSMTH RD150 BREAST SPECTRUM SMTH RD330 BREAST SPECTRUM SMTH RD390 BREAST SILTEX HIGHGEL600CC BREAST SILTEX HIGHGEL650CC HIP STEM SROM 30 +4L 16X11X150 HIP LNR PNCLE PE 0D 28X50 HIP HD SROM MTL 11/13 28MM +3 HIP SLV PROX SROM ZTT 16B-SM KNEE FEM ILOK ZIMM RT 67.5MM KNEE PTLA 3PEG STD 34X8.5MM KNEE TIB INSRT STD 12X79/83MM BIT DRILL STRY 4.2X180MM CATH SILVERHAWK DS HIP SHELL PNCLE SECT POR 52MM HIP HD EZE MTL 12/14 28MM +1.5 DEV POLYLOOP LIGATING HIP STEM SUMMIT BASIC CMNT SZ5 HIP HD CORAIL SLF CTR MTL28X47 KNEE FEM ILOK ZIMM RT 60.0MM HIP LNR TRID X3 PE 0D 36MM E BLADE HEL FIX NAIL TI 11X110MM BIT DRILL 3FLUTED SYNT 4X195MM HIP SCREW BONE ZIMMSLFTP6.5X20 HIP SCREW BONE ZIMMSLFTP6.5X25 HIP LNR TRILOGY PE 0D 58X32MM HIP SCREW BONE ZIMMSLFTP6.5X40 HIP HD VERS MTL 12/14 32MM+3.5 HIP LNR ULTAMET MTL 36X56MM BLN FLEXTOME MONO 2.25X6MM BLN FLEXTOME MONO 2.75X6MM BLN FLEXTOME MONO 3.25X6MM BLN FLEXTOME MONO 3.75X6MM Page 233 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $116.00 $116.00 $358.00 $293.00 $714.00 $543.00 $543.00 $3,479.00 $2,412.00 $4,841.00 $1,545.00 $1,545.00 $1,545.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $2,274.00 $3,240.00 $2,172.00 $1,419.00 $2,205.00 $4,005.00 $1,476.00 $2,432.00 $168.00 $5,158.00 $2,376.00 $1,419.00 $487.00 $2,205.00 $1,822.00 $4,005.00 $2,627.00 $1,466.00 $503.00 $203.00 $523.00 $2,847.00 $203.00 $1,657.00 $3,100.00 $2,028.00 $2,028.00 $2,028.00 $2,028.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLN FLEXTOME MONO 4.0X6MM BLN FLEXTOME MONO 2.75X10MM BLN FLEXTOME MONO 3.25X10MM BLN FLEXTOME MONO 3.75X10MM BLN FLEXTOME MONO 4.0X10MM BLN SOS BAKRI TAMPONADE HIP SHELL TRABEC MULTHL 60MM HIP LNR TRID PE CNSTND10D36MMF KNEE TIB INSRTSIGMACURV2.5 8MM KNEE PTLA 3PEG THIN 31X6.2MM HIP STEM SUMMIT BASIC CMNT SZ7 HIP HD CORAIL SLF CTR MTL28X49 PIN STEINMAN ZIMM 3/32IN SCREW CORT SLFTP 2X14MM SCREW CORT SLFTP 2X16MM BIT DRILL SYNT 1.5X85MM BIT DRILL QK SYNT 2X125MM NDLE CATH YUEH ST 5FR 15CM CATH SINUS GD S-0 CATH SINUS VORTEX IRG 2MM KNEE TIB INSRT PFC SZ4 10MM KNEE FEM PFC RPF DEPU LFT 4 HIP SHELL PNCLE SECT POR 60MM HIP STEM CORAIL2 BOW STD SZ14 HIP LNR PNCLE PE 0D 36X60 KNEE TIB TRAY PFC MOD PLUS 4 PLATE LCP COND CURV LFT 16HL SCREW EXTR CONIC CANN 7.3MM SET INTRSHEATH PEELAWAY7FR.038 GDWIRE DRILL TIP 2.5 200MM HIP STEM CORAIL2 BOW STD SZ13 PLATE TIB PROX LCP RT 4HL 3.5 PLATE TIB PROX LCP LFT 6HL 3.5 PLATE TIB PROX LCP RT 8HL 3.5 PLATE TIB PROX LCP LFT 8HL 3.5 PLATE TIB PROX LCP RT 10HL 3.5 PLATE TIB PROX LCP LFT 10HL3.5 PLATE TIB PROX LCP RT 12HL 3.5 PLATE TIB PROX LCP LFT 12HL3.5 PLATE HUMR PROX LCP 3.5 8HL196 HIP LNR ULTAMET MTL 36X62MM HIP HD EZEM MTL12/14 36MM+8.5 KNEE FEM TC3 DEPU LFT 3 KNEE FEM DIST AUG LFT SZ3 4MM NAIL EX TIB CANN TI 11X360MM SCREW LK TI NAIL 5X44MM Page 234 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,028.00 $2,028.00 $2,028.00 $2,028.00 $2,028.00 $1,215.00 $4,326.00 $5,345.00 $2,344.00 $1,476.00 $2,205.00 $1,822.00 $323.00 $162.00 $162.00 $293.00 $327.00 $86.00 $1,372.00 $658.00 $2,700.00 $4,111.00 $2,376.00 $4,527.00 $2,172.00 $6,820.00 $3,396.00 $1,247.00 $336.00 $267.00 $4,527.00 $3,025.00 $3,062.00 $3,096.00 $3,096.00 $3,130.00 $3,130.00 $3,170.00 $3,170.00 $3,460.00 $3,100.00 $1,419.00 $12,347.00 $2,660.00 $2,543.00 $627.00 2020 pricing Drugs&Supplies PROCEDURE NAME BIT DRILL CALIB SYNT 4.2MM BREAST HIPRO SALINE 320CC PIN EXTL FIX THRD 50X5X150MM BIT DRILL DVRA ZIMM 2.5MM SCREW BIOTENODESIS *DISC* KNEE TIB INSRT XLK STBL 4 15MM KNEE FEM LPS GENDER XL RT SZE KNEE TIB LK BAR ZIMM KNEE TIB BASE ADPTR ZIMM 2.5MM KNEE FEM AUG DIST LL/RM 5X65MM SCREW LK TI SLFTP 5.0X40MM SCREW LK TI SLFTP 5.0X44MM SCREW LK TI SLFTP 5.0X50MM SCREW LK TI SLFTP 5.0X55MM SCREW LK TI SLFTP 5.0X60MM SCREW LK TI SLFTP 5.0X65MM SCREW LK TI SLFTP 5.0X70MM SCREW LK TI SLFTP 5.0X75MM SCREW LK TI SLFTP 5.0X80MM SCREW LK TI SLFTP 5.0X85MM SCREW LK TI SLFDR 5.0X26MM PLATE FEM LAT DIST TI RT 4HL PLATE FEM LAT DIST TI LFT 4HL BIT DRIL QK SYNT 4.3X221MM BREAST NATRELLE LOWFULL370 EXPAND MAM ALLE MODER 250CC BLADE HEL FIX NAIL TI 11X115MM SCREW TI LK IM NAIL 5.0X42MM HEMO GPS MINI SEPARATION ZIMM BONE FILLER HYDROSET 10CC KNEE TIB INSRT PFC SZ5 12.5MM KNEE FEM PFC RPF SIGMA RT SZ5 BREAST HIPRO SIL RD 375CC BREAST HIPRO SIL RD 425CC BREAST HIPRO SIL RD 450CC BREAST HIPRO SIL RD 475CC SET BLN ULTRAXX NPHRSTMY 10MM HIP SHELL TRABEC MULTHL 56MM SCREW ODONTOID MDTR 4X36MM KNEE FEM PSTR AUG SZ2 4MM KNEE TIB TRAY PFC MOD PLUS 2.5 PLATE J CLAV ACUM LFT 9HL SCREW CORT ACUM 3.5X18MM SCREW CORT ACUM 3.5X20MM SCREW CORT ACUM 3.5X24MM SCREW CORT ACUM 3.5X26MM Page 235 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $790.00 $1,591.00 $990.00 $641.00 $1,178.00 $2,344.00 $3,933.00 $488.00 $2,155.00 $2,732.00 $959.00 $959.00 $959.00 $959.00 $959.00 $959.00 $959.00 $959.00 $959.00 $959.00 $959.00 $2,827.00 $2,827.00 $801.00 $2,205.00 $3,155.00 $1,466.00 $639.00 $1,545.00 $4,993.00 $2,700.00 $4,111.00 $2,245.00 $2,245.00 $2,245.00 $2,376.00 $1,258.00 $4,326.00 $1,853.00 $2,660.00 $6,820.00 $2,205.00 $438.00 $438.00 $438.00 $438.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CNCLS ACUM 4X20MM SCREW CNCLS ACUM 4X22MM ANCHOR PEEK PLK 3.5X19.5 SCREW CANN LK THRD HEX7.3X70 KNEE PTLA 3PEG STD 37X10MM KNEE FEM ILOK ZIMM LFT 75.0MM KNEE TIB INSRT STD 10X79/83MM KNEE FEM ILOK ZIMM RT 70.0MM KNEE TIB INSRT STD 12X71/75MM BIT DRILL QK ZIMM 1/8IN SHLDR HUMR STEM DEPU 12MM KNEE TIB INSRT PFC SZ3 17.5MM HIP LNR PNCLE PE 0D 36X58 HIP SHELL PNCLE SECT POR 58MM SHLDR HUMR HD OFF 21X52MM HIP CENTRALIZER DIST VERS 12MM HIP HD VERS MTL 12/14 28MM +0 HIP SHELL TRABEC MULTHL 62MM HIP LNR TRILOGY PE 0D 62X40MM PLATE HTO ARTX 12.5MM GD PIN OSTEOTOMY 3MM HIP STEM CORAIL2 BOW STD SZ12 NAIL TROCHANT LNG130DLFT11X380 END CAP TI EXT GRN 5MM SCREW TI LK IM NAIL 5.0X50MM NAIL TROCHANT TI 130D 12X170MM SCREW LK TI NAIL 5X32MM SCREW LK TI NAIL 5X34MM NAIL EX TIB CANN TI 12X315MM ANCHOR PEEK PLK 4.5MM KNEE FEM PFC RPF SIGMA RT SZ3 KNEE TIB INSRT SIGMACURV2 10MM HIP HD SROM MTL 11/13 36MM+0 HIP SHELL TRABEC MULTHL 58MM KNEE TIB BASE ADPTR ZIMM 5MM KNEE FEM AUG DIST RL/LM10X70MM PROS TESTICULAR COLOPLAST LG HIP STEM COXAVARA HIGH SZ13 HIP HD EZEM MTL 12/14 36MM -2 PLATE LOPRO ARTX LFT 4.5MM KNEE FEM ILOK ZIMM RT 75.0MM END CAP 12MM TI W EXT 5MM SCREW LK TI SYNT 6X50MM SCREW LK TI SYNT 6X60MM SCREW LK TI SYNT 6X70MM BIT DRILL CALIB SYNT 5MM Page 236 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $488.00 $488.00 $1,301.00 $1,015.00 $1,476.00 $4,005.00 $2,042.00 $4,005.00 $2,042.00 $408.00 $5,118.00 $2,700.00 $2,172.00 $2,376.00 $2,764.00 $587.00 $1,657.00 $4,326.00 $2,847.00 $1,683.00 $175.00 $4,527.00 $2,951.00 $557.00 $639.00 $2,459.00 $627.00 $627.00 $2,543.00 $1,301.00 $4,111.00 $2,629.00 $1,419.00 $4,326.00 $2,155.00 $2,732.00 $3,786.00 $4,527.00 $1,419.00 $2,171.00 $4,005.00 $579.00 $677.00 $677.00 $677.00 $790.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE TIB DIST ANTLAT RT 9HL HIP HD ZIMM MTL 6D 32MM +0 SCREW HDLSS COMP LNG TI 3X30MM BIT DRILL CANN SYNT 2MM KNEE FEM ILOK ZIMM LFT 60.0MM KNEE FEM TC3 DEPU LFT 5 KNEE FEM DIST AUG LFT SZ5 8MM RAD HD EVOLVE WRIT 24MM RAD HD STEM WRIT 7.5MM NAIL EX TIB CANN TI 10X345MM KNEE FEM PFC RPF SIGMA LFT SZ5 KNEE TIB INSRT PFC SZ5 10MM EXPAND MAM ALLE FULL 300CC EXPAND MAM ALLE FULL 600CC NAIL TROCHANT LNG130D RT11X440 BLADE HEL FIX NAIL TI 11X105MM PLATE ELBOW ACUM MEDL 16HL PLATE ELBOW ACUM MEDL 12HL PLATE ELBOW ACUM MEDL LONG 9HL PLATE ELBOW ACUM MEDL 8HL PLATE ELBOW ACUM MEDL 7HL PLATE ELBOW ACUM LFT 14HL PLATE ELBOW ACUM RT 14HL PLATE ELBOW ACUM LFT 10HL PLATE ELBOW ACUM RT 10HL PLATE ELBOW ACUM LFT 6HL PLATE ELBOW ACUM RT 6HL PLATE OLEC ACUM LFT 17HL PLATE OLEC ACUM RT 17HL PLATE OLEC ACUM LNG 13HL PLATE OLEC ACUM XLNG 13HL PLATE OLEC ACUM 11HL PLATE OLEC ACUM 9HL PLATE CORONOID ACUM LT PLATE CORONOID ACUM RT PLATE ELBOW ACUM PSTR SCREW CORT ACUM 2.7X12MM SCREW CORT ACUM 2.7X14MM SCREW CORT ACUM 2.7X16MM SCREW CORT ACUM 2.7X18MM SCREW CORT ACUM 2.7X20MM SCREW CORT ACUM 2.7X22MM SCREW CORT ACUM 2.7X24MM SCREW CORT ACUM 2.7X26MM SCREW CORT ACUM 2.7X34MM SCREW CORT ACUM 3.5X22MM Page 237 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,131.00 $1,657.00 $1,140.00 $1,169.00 $4,005.00 $12,347.00 $2,660.00 $5,122.00 $5,920.00 $2,543.00 $4,111.00 $2,700.00 $3,278.00 $3,155.00 $2,951.00 $1,466.00 $2,890.00 $2,609.00 $2,609.00 $2,609.00 $2,609.00 $2,890.00 $2,890.00 $2,609.00 $2,609.00 $2,609.00 $2,609.00 $2,890.00 $2,890.00 $2,609.00 $2,609.00 $2,609.00 $2,609.00 $2,609.00 $2,609.00 $2,609.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT ACUM 3.5X28MM SCREW CORT ACUM 3.5X30MM SCREW CORT ACUM 3.5X32MM SCREW CORT ACUM 3.5X34MM SCREW CORT ACUM 3.5X36MM SCREW CORT ACUM 3.5X38MM SCREW CORT ACUM 3.5X40MM SCREW CORT ACUM 3.5X45MM SCREW CORT ACUM 3.5X50MM SCREW CORT ACUM 3.5X55MM SCREW CORT ACUM 3.5X60MM SCREW CORT ACUM 3.5X65MM SCREW CNCLS ACUM 4X12MM SCREW CNCLS ACUM 4X14MM SCREW CNCLS ACUM 4X16MM SCREW CNCLS ACUM 4X18MM SCREW CNCLS ACUM 4X24MM SCREW CNCLS ACUM 4X26MM SCREW CNCLS ACUM 4X28MM SCREW CNCLS ACUM 4X30MM SCREW CNCLS ACUM 4X40MM SCREW CNCLS ACUM 4X45MM SCREW CNCLS ACUM 4X50MM SCREW CNCLS ACUM 4X55MM SCREW CNCLS ACUM 4X60MM SCREW LK TAP ACUM 3.5X36MM SCREW LK TAP ACUM 3.5X38MM SCREW LK TAP ACUM 3.5X45MM SCREW LK TAP ACUM 3.5X50MM SCREW LK TAP ACUM 3.5X55MM SCREW LK TAP ACUM 2.7X36MM SCREW LK TAP ACUM 2.7X45MM SCREW LK TAP ACUM 2.7X50MM SCREW LK TAP ACUM 2.7X60MM SCREW LK CORT ACUM 3.5X12MM SCREW LK CORT ACUM 3.5X14MM SCREW LK CORT ACUM 3.5X16MM SCREW LK CORT ACUM 3.5X20MM SCREW LK CORT ACUM 3.5X22MM SCREW LK CORT ACUM 3.5X24MM SCREW LK CORT ACUM 3.5X26MM SCREW LK CORT ACUM 3.5X28MM SCREW LK CORT ACUM 3.5X30MM SCREW LK CORT ACUM 3.5X32MM SCREW LK CORT ACUM 3.5X34MM SCREW LK CORT ACUM 3.5X36MM Page 238 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $571.00 $571.00 $571.00 $571.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $597.00 $597.00 $597.00 $834.00 $834.00 $834.00 $834.00 $834.00 $834.00 $834.00 $834.00 $834.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK CORT ACUM 3.5X38MM SCREW LK CORT ACUM 3.5X40MM SCREW LK CORT ACUM 3.5X45MM SCREW LK CORT ACUM 3.5X50MM SCREW LK CORT ACUM 2.7X12MM SCREW LK CORT ACUM 2.7X14MM SCREW LK CORT ACUM 2.7X16MM SCREW LK CORT ACUM 2.7X18MM SCREW LK CORT ACUM 2.7X20MM SCREW LK CORT ACUM 2.7X22MM BIT DRILL QK ACUM 3.5MM BIT DRILLQK ACUM 2MM BIT DRILL QK ACUM 2.8MM GDWIRE THRD ACUM TI 0.062X6 HIP STEM CORAIL2 BOW STD SZ11 HIP HD EZE MTL 12/14 40MM +5 HIP LNR ULTAMET MTL 40X56MM HIP HD CORAIL SLF CTR MTL28X46 TIP FOR SCRWDRVR ZIMM 2MM STNT URETRL DBL J 8.5FR 12CM SCREW CORT SLFTP 2X10MM HIP LNR ARCOMXL PE 0D 32X23MM KNEE PTLA 3PEG THIN 34X7.8MM HIP SHELL PNCLE SECT POR 66MM HIP LNR ULTAMET MTL 44X66MM HIP HD EZE MTL 12/14 44MM+15.5 NAIL EX TIB CANN TI 8X330MM SCREW LK TI NAIL 4X32MM SCREW LK TI NAIL 4X40MM PLATE TIB DIST LCP RT 6HL 3.5 NAIL TROCHANT TI 130D 11X170MM BIT DRILL CALIB SYNT 2.8X200MM NAIL TROCHANT LNG130DLFT11X400 PROBE ERBE W FLTR SIDEFIRE NAIL EX TIB CANN TI 10X360MM SCREW LK TI NAIL 5X50MM SCREW LK TI NAIL 4X24MM SCREW LK TI NAIL 4X26MM BLADE SPIRAL HUMR NAIL TI 48MM SCREW LK TI NAIL 4X38MM HIP LNR PNCLE PE 0D 36X56 KNEE TIB INSRT PFC RPFSZ3 10MM SCREW LK TI SLFTP 3.5X34MM SCREW CORT ORTHOFIX 3.2X32MM HIP SHELL M2A ZIMM 60X54MM HIP HD M2A ZIMM MTL 54MM +0 Page 239 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $690.00 $471.00 $471.00 $471.00 $284.00 $4,527.00 $1,545.00 $3,100.00 $1,822.00 $281.00 $573.00 $162.00 $2,123.00 $1,476.00 $2,376.00 $3,100.00 $1,545.00 $2,543.00 $627.00 $627.00 $2,990.00 $2,459.00 $649.00 $2,951.00 $1,106.00 $2,543.00 $627.00 $627.00 $627.00 $1,424.00 $627.00 $2,172.00 $2,700.00 $575.00 $855.00 $3,918.00 $1,790.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP ADPTR TYPE1 M2A 52-60MM -3 BLADE SPIRAL HUMR NAIL TI 36MM QUADRANT ILLUM MDTR BIT DRILL QK SYNT 4.5MM SCREW LK SYNT 2.7X10MM SCREW LK SYNT 2.7X20MM SCREW LK SYNT 2.7X44MM SCREW LK SYNT 2.7X50MM PLATE HUMR PSTRLAT WSUPPLFT5HL PLATE HUMR MEDL DIST 3.5LFT3HL CATH REPAIR TPN SL 6.5FR STNT BILI FORMULA 418 6X16MM ALLO WEDGE HATRIC *DISC* SCREW CORT LOPRO TI 2.3X12MM KNEE TIB INSRT STD 14X71/75MM MOLD CMNT KNEE SPACER FEM 65MM SHLDR HUMR HD ECCN 48X18MM HIP LNR PNCLE PE LIP 32X58MM KNEE FEM DIST AUG RT SZ5 4MM HIP HD V40 EXETER CER 36MM+2.5 SCREW CORT SLFTP 2X20MM RAD HD EVOLVE WRIT 26MM KNEE TIB STEM EXT ST 15X30MM KNEE TIB INSRT STD 14X63/67MM KNEE PTLA 3PEG THIN 28X6.2MM HIP LNR ULTAMET MTL 36X52MM HIP HD CORAIL SLF CTR MTL28X54 KNEE TIB INSRT XLK STBL 3 10MM BREAST HIPRO SIL RD 500CC BLADE SPIRAL HUMR NAIL TI 34MM BLADE SPIRAL HUMR NAIL TI 46MM SCREW CANN LK HEX THRD 5X70 SCREW LK TI NAIL 4X30MM RAD HD EVOLVE +4 28MM RAD HD STEM WRIT 6.5MM RAD HD STEM WRIT 8.5MM SHEATH PEELAWAY 7FR 14CM SCREW LK CORT ACUM 3.5X10MM ALLO WEDGE HATRIC*DISC* ANCHOR BIO PLK 4.5MM KNEE TIB STEM REV ZIMM18X120MM KNEE FEM PS INTL ZIMM RT60.0MM KNEE FEM INTLK ZIMM RT 70MM KNEE TIB INSRT PS VNGD14X71/75 SCREW INTRAFIX DEPU 9X30MM HIP CEMENTRALIZER DEPU 10MM Page 240 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,419.00 $1,424.00 $2,214.00 $287.00 $547.00 $547.00 $547.00 $547.00 $2,587.00 $2,218.00 $533.00 $2,613.00 $1,466.00 $490.00 $2,432.00 $3,565.00 $2,932.00 $2,172.00 $2,660.00 $2,627.00 $162.00 $5,122.00 $2,997.00 $2,432.00 $1,476.00 $3,100.00 $1,822.00 $2,344.00 $2,245.00 $1,424.00 $1,424.00 $903.00 $627.00 $5,122.00 $5,920.00 $5,920.00 $203.00 $690.00 $1,466.00 $1,301.00 $3,178.00 $4,005.00 $12,985.00 $4,366.00 $1,168.00 $284.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP STEM CORAIL ST HIGH SZ14 HIP HD V40 EXETER CER 36MM+7.5 NAIL EX TIB CANN TI 11X345MM HIP LNR HGPII PE NEUT SZE 52MM KNEE TIB INSRT PS+ 14X63/67MM HIP LNR ARCOMXL PE 0D 36X25MM SCREW LK SYNT 2.7X22MM SCREW LK SYNT 2.7X34MM SCREW LK SYNT 2.7X36MM KNEE TIBINSRT XLK STBL2.5 10MM HIP TROCHANT LNG 4CBL 23X121MM EXPAND MAM ALLE LOW 350CC BLADE SPIRAL HUMR NAIL TI 44MM SCREW LK TI NAIL 4X28MM BLADE DIEGO AGG HEMO W PK 3MM PLATE HUMR PSTRLAT WSUPPLFT3HL SCREW BIOTENODESIS *DISC* NAIL EX TIB CANN TI 11X375MM HIP STEM ACLD TMZF 132D SZ5 FINGER PIP DIST ASCENSION 30 CLAMP PIN/ROD EXTL FIX STRY FRM EXTL FIX DJD II BODY PIN EXTL FIX TRANSFIX 3X200MM HIP LNR TRID CER 0D 36X62 G HIP HD TRID V40 CER 36MM +0 BIT DRILL VENTURE MDTR 11MM SCREW VENTURE MDTR 4X15MM PLATE VENTURE MDTR 80MM HIP ADPTR TYPE1 M2A 42-50MM +3 SCREW LK KLS 2.7X7MM SCREW LK KLS 2.7X9MM SCREW LK KLS 2.7X11MM BIT DRILL KLS 2.2X70MM BIT DRILL KLS 2.2X105MM HIP STEM ACLD TMZF 132D SZ2.5 KNEE FEM ILOK ZIMM LFT 72.5MM PLATE DVR ZIMM SHRT LFT 3HL PLATE DVR ANATOM FAST SHRT RT RAD HD EVOLVE +4 26MM KNEE FEM LCCK OPT ZIMM RT SZE FINGER PIP DIST ASCENSION 10 FINGER PIP PROX ASCENSION 20 PLATE VENTURE MDTR 57.5MM CAGE PEEK LT MDTR 16X26MM SHEATH PNCLE PERIPH 5FR 10CM SHEATH PNCLE RO NO GD 7FR 10CM Page 241 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,527.00 $2,627.00 $2,543.00 $4,258.00 $2,432.00 $2,123.00 $547.00 $547.00 $547.00 $2,344.00 $6,089.00 $3,164.00 $1,424.00 $627.00 $933.00 $2,436.00 $1,066.00 $2,543.00 $5,053.00 $4,065.00 $1,168.00 $6,686.00 $652.00 $3,207.00 $2,627.00 $1,561.00 $855.00 $2,487.00 $1,419.00 $531.00 $531.00 $531.00 $478.00 $478.00 $5,053.00 $4,005.00 $2,543.00 $2,543.00 $5,122.00 $13,208.00 $4,065.00 $4,065.00 $2,376.00 $6,756.00 $64.00 $153.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHEATH PNCLE RO NO GD 8FR 10CM COIL MWCE-18-1.0-0-HILAL SHEATH PEELAWAY 6FR 14CM BREAST NATRELLE SIL MID 457CC SCREW CANN LK HEX THRD 5X50 SCREW CANN LK HEX THRD 5X55 KNEE TIB INSRT ZIMM LFT SM 4MM KNEE TIB BASE UNI LM ZIMM SZA HIP HD EZE MTL 12/14 40MM -2 NAIL EX TIB CANN TI 11X390MM SCREW LK TI NAIL 5X56MM SCREW LK TI NAIL 5X60MM SCREW CORT SLFTP ZIMM 4.5X32MM HIP HD V40 EXETER CER 36MM-2.5 SCREW HDLSS COMP T8 TI 3X26MM HIP STEM CORAIL2 BOW STD SZ9 SCREW SCHANZ SLFDR 5.0 60X150 SCREW CORT LK ACUM 2.3X20MM HIP RING REPL LK RINGLOC SZ24 HIP ADPTR TYPE1 M2A 42-50MM -3 HIP HD M2A ZIMM MTL 44MM +0 HIP SHELL M2A ZIMM 50X44MM CAGE LORD LPD DEPU 5D 10MM PLATE HUMR DIST LCP XTR LFT8HL ALLO FEM HEMI COND MEDL RT CAUT LIGASURE IMPACT *CIP* KNEE FEM TC3 DEPU LFT 4 KNEE FEM ADPTR DEPU 5D KNEE FEM ADPTR DEPU +2/2 KNEE TIB INSRT STBL SZ2.5 10MM CATH PAIN MDTR SUT LESS 2PC NAIL TROCHANT LNG130D RT12X400 KNEE TIB INSRT STBL SZ6 15MM KNEE TIB BASE CMNT REV MBT 4 PLATE 8-PLATE ORTHOFIX 16MM GDWIRE 3.2X290MM NAIL EX TIB CANN TI 9X360MM SCREW LK TI NAIL 4X46MM SCREW LK TI NAIL 4X54MM SCREW CORT LOPRO TI 2.3X10MM BLADE SPIRAL HUMR NAIL TI 50MM NAIL EX TIB CANN TI 9X315MM TB GJ MIC LOPRO 16FR 3.0 45CM SCREW CORT LK ACUM 2.3X18MM HIP STEM COXAVARA HIGH SZ11 SCREW SCHANZ SLFDR 5.0 60X175 Page 242 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $153.00 $203.00 $203.00 $2,245.00 $903.00 $903.00 $2,216.00 $3,248.00 $1,545.00 $2,543.00 $627.00 $627.00 $234.00 $2,627.00 $1,141.00 $4,527.00 $579.00 $576.00 $460.00 $1,419.00 $1,790.00 $3,918.00 $4,853.00 $3,065.00 $21,904.00 $1,914.00 $12,347.00 $4,744.00 $1,208.00 $2,700.00 $1,982.00 $2,951.00 $2,700.00 $10,324.00 $1,187.00 $540.00 $2,543.00 $627.00 $627.00 $488.00 $1,424.00 $2,543.00 $1,227.00 $576.00 $4,527.00 $579.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT INST BIOTENODESIS ARTX DISP KNEE FEM ILOK ZIMM RT 57.5MM KNEE FEM PFC RPF DEPU RT 6 KNEE TIB INSRT STBL SZ4 12.5MM HIP HD V40 EXETER CER 36MM +5 SCREW LK SYNT 2.7X12MM SCREW LK SYNT 2.7X14MM SCREW LK SYNT 2.7X24MM SCREW LK SYNT 2.7X28MM SCREW LK SYNT 2.7X30MM SCREW LK SYNT 2.7X32MM SCREW LK SYNT 2.7X40MM SCREW LK SYNT 2.7X42MM SCREW LK SYNT 2.7X46MM SCREW LK SYNT 2.7X48MM SCREW LK SYNT 2.7X55MM SCREW LK SYNT 2.7X60MM PLATE HUMR PSTRLAT WSUPP RT3HL SCREW CANN LK HEX THRD 5X35 SCREW CANN LK HEX THRD 5X40 SCREW CANN LK HEX THRD 5X45 SCREW CANN LK HEX THRD 5X60 NAIL TROCHANT LNG130DLFT11X420 NAIL TROCHANT LNG130D RT12X380 HIP SCREW BONE ZIMMSLFTP6.5X35 HIP SCREW BONE ZIMMSLFTP6.5X60 SCREW CORT ACUM 2.7X10MM HIP LNR ULTAMET MTL 40X58MM HIP HD EZE MTL 12/14 40MM +1.5 KNEE TIB INSRT PFC RPFSZ5 15MM SCREW CORT PELVIC 3.5X55MM SCREW CORT PELVIC 3.5X60MM SCREW CORT PELVIC 3.5X65MM SCREW CORT PELVIC 3.5X70MM SCREW CORT PELVIC 3.5X75MM SCREW CORT PELVIC 3.5X80MM SCREW CORT PELVIC 3.5X85MM SCREW CORT PELVIC 3.5X90MM SCREW CORT PELVIC 3.5X95MM CLAMP EXTL FIX TB-TO-TB MR LG PLATE LCP COND CURV RT 16HL SCREW CANN LK HEX THRD 5X85 NAIL EX TIB CANN TI 10X285MM SCREW LK TI NAIL 5X28MM RAD HD EVOLVE +4 24MM TB JEJ MIC BLN 7-10ML 16FR Page 243 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $949.00 $4,005.00 $4,111.00 $2,700.00 $2,627.00 $547.00 $547.00 $547.00 $547.00 $547.00 $547.00 $547.00 $547.00 $547.00 $547.00 $547.00 $547.00 $2,436.00 $996.00 $903.00 $903.00 $996.00 $2,951.00 $2,951.00 $203.00 $203.00 $438.00 $3,100.00 $1,545.00 $2,700.00 $145.00 $145.00 $145.00 $145.00 $145.00 $145.00 $145.00 $145.00 $145.00 $1,678.00 $3,396.00 $903.00 $2,543.00 $627.00 $5,122.00 $711.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP HD CORAIL SLF CTR MTL28X53 HIP HD CORAIL SLF CTR MTL28X55 HIP LNR PNCLE PE 0D 32X58 HIP STEM CORAIL2 BOW STD SZ16 SCREW ODONTOID LAG MDTR 4X40MM HIP STEM ACLD TMZF 132D SZ4 HIP HD V40 EXETER CER 36MM +0 NAIL EX TIB CANN TI 10X315MM SCREW LK TI NAIL 5X30MM KNEE FEM ILOK ZIMM RT 80.0MM KNEE TIB INSRT STD 10X87/91MM KNEE PTLA 3PEG STD 40X10MM NAIL FEM ANTERETROGRD TI10X380 HIP HD ZIMM MTL 6D 36MM +3.5 HIP HD M2A ZIMM MTL 50MM +0 HIP SHELL M2A ZIMM 56X50MM NDLE DEFLUX 3.7 FR 23G 350MM KNEE FEM TC3 DEPU LFT 2.5 KNEE TIB INSRT TC3 2 10MM GDWIRE MED SURG .059X5 SCREW CANN INTERFER FULL8X20MM KNEE TIB INSRT STBLZIMM10X83MM KNEE TIB INSRT STBLZIMM12X83MM BUR TPS ACORN LN*DISC 6276645* PLATE TIB DIST LCP RT 8HL 3.5 KNEE FEM INTLK ZIMM LFT 65MM HIP LNR PNCLE PE 0D 36X62 KNEE FEM PFC RPF DEPU RT 4 PLATE HUMR DIST PSTRLAT LFT5HL NAIL EX TIB CANN TI 10X375MM SCREW CORT LOPRO TI 2.3X28MM SCREW MINI KLS 2X7MM SCREW MMF/IMF KLS 2X13MM SCREW MMF/IMF KLS 2X15MM SCREW CRUCIFORM TI 2.7X12MM SCREW CRUCIFORM TI 2.7X14MM SCREW CANN INTERFER FULL7X35MM SCREW CANN INTERFER FULL8X25MM KNEE TIB INSRT TC3 3 20MM KT ACC AMS 800 HIP SPACER TAPERED DEPU 0 HIP HD CATHCART UNIPOLR MTL 48 SCREW CORT MATTA 3.5X36MM SCREW CORT MATTA 3.5X38MM SCREW LK STRY 4X75MM SCREW CORT T8 STARDR 2.4X10MM Page 244 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,822.00 $1,822.00 $2,172.00 $4,527.00 $1,853.00 $5,053.00 $2,627.00 $2,543.00 $627.00 $4,005.00 $2,432.00 $1,476.00 $2,827.00 $1,657.00 $1,790.00 $3,918.00 $303.00 $12,347.00 $4,319.00 $89.00 $515.00 $2,042.00 $2,042.00 $455.00 $3,020.00 $12,985.00 $2,172.00 $4,111.00 $2,461.00 $2,543.00 $490.00 $186.00 $498.00 $498.00 $284.00 $284.00 $490.00 $515.00 $4,319.00 $3,657.00 $641.00 $1,545.00 $152.00 $152.00 $554.00 $269.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT T8 STARDR 2.4X12MM SCREW CORT T8 STARDR 2.4X14MM SCREW CORT T8 STARDR 2.4X18MM SCREW CORT T8 STARDR 2.7X16MM SCREW CORT T8 STARDR 2.7X18MM SCREW LK T8 STARDR 2.4X10MM SCREW LK T8 STARDR 2.4X12MM PLATE LCP COND SS 7HL 2.4X50MM BIT DRILL SYNT 2X65MM BIT DRILL SYNT 1.5X96MM SCREW CORT SLFTP T6 2X8MM SCREW CORT SLFTP T6 2X10MM SCREW CORT SLFTP T6 2X12MM HIP HD EZE MTL 12/14 44MM +8.5 ALLO DBM PUTTY PROGENIX 5ML SCREW CORT T8 STARDR 2.7X14MM SCREW LK T8 STARDR 2.4X20MM NAIL EX TIB CANN TI 12X345MM KNEE TIB STEM EXT ST 16X100MM SUCT CATH FLEX 5FR SCREW CORT ACUM 3.5X8MM MANIFOLD ACIST WO TRANSD SHEAR TIP COV ACC DISP ROB SUCT CATH FLEX 4FR PLATE LEGACY MULT TI 30-34MM SCREW SET TSRH MDTR SCREW TSRH MDTR 5.5X40MM SCREW TSRH MDTR 5.5X45MM SCREW TSRH MDTR 6.5X40MM SCREW TSRH MDTR 6.5X45MM SCREW TSRH MDTR 6.5X50MM ROD TSRH MDTR 55X25MM HIP HD PCA MTL 36MM +5 SCREW CORT T8 STARDR 2.7X12MM NAIL EX TIB CANN TI 12X330MM SCREW LK TI NAIL STER 5X36MM PLATE TIB MEDL PROX 3.5 LFT6HL RAD HD EVOLVE +2 26MM KNEE TIB STEM EXT ST 10X100MM KNEE FEM AUG DIST ZIMM SZD 5MM HIP HD CORAIL SLF CTR MTL28X57 SCREW CORT 150/50 6.0/5.0MM HIP LNR ULTAMET MTL 40X60MM KNEE TIBINSRT XLK CURV2.5 10MM CAGE VERTE-STACK 14X11X7MM CAGE VERTE-STACK 14X11X8MM Page 245 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $269.00 $269.00 $269.00 $184.00 $184.00 $534.00 $534.00 $1,697.00 $293.00 $568.00 $177.00 $177.00 $177.00 $1,545.00 $2,128.00 $184.00 $534.00 $2,543.00 $2,997.00 $195.00 $438.00 $91.00 $114.80 $195.00 $2,022.00 $807.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,568.00 $3,229.00 $184.00 $2,543.00 $772.00 $3,150.00 $5,122.00 $2,997.00 $2,704.00 $1,822.00 $967.00 $3,100.00 $2,344.00 $2,591.00 $2,591.00 2020 pricing Drugs&Supplies PROCEDURE NAME CAGE VERTE-STACK 14X11X9MM STRUT ANATOM PEEK 5X14MM SCREW CORT T8 STARDR 2.7X20MM SCREW CORT T8 STARDR 2.7X32MM PLATE T LCP SS 2/3HL 2.7X32MM NUT TI SYNT 11MM COLAR TI W GROOVES SYNT NAIL EX TIB CANN TI 12X375MM HIP BODY MALLORY A STD 45MM BIT DRILL QK ZIMM 3.2X20MM BIT DRILL QK ZIMM 3.2X30MM MESH PARIETEX 25X20CM SHLDR HUMR HD DEPU 52X18MM BIT DRILL ZIMM 2.9X70MM ALLO DBM PUTTY PROGENIX 1ML SCREW LK T8 STARDR 2.4X8MM SCREW LK T8 STARDR 2.4X11MM SCREW LK T8 STARDR 2.4X13MM PLATE LCP SS 6HL 2.4X52MM SCREW HDLSS SHRT SYNT 3X28MM SCREW HDLSS SHRT SYNT 3X30MM SCREW HDLSS SHRT SYNT 3X32MM NAIL TROCHANT LNG130D RT11X360 SCREW LAG CANN ARTX 16MM SCREW LAG CANN ARTX 18MM SCREW CANN INTERFER FULL7X20MM TB IRG ULTDRV3 SGL DISP HIP HD EZE MTL 12/14 40MM +8.5 KNEE FEM DIST AUG LFT SZ3 8MM PLATE DVR ZIMM NARW RT PLATE HUMR PSTRLAT WSUPP RT5HL SHLDR GLENO KEEL BIGLIANI 46MM CATH SUCT ELBOW PEDS 6FR 12 CAGE VERTE-STACK 14X11X6MM BIT DRILL STRY 4.2X230MM NAIL TIB T2 STRY STD 9X345MM PLATE TIB DIST ANTLAT RT 11HL PIN STEINMAN MID THRD 5.0X200 BIT DRILL SYNT 5X300MM NAIL TROCHANT LNG130DLFT12X380 HIP STEM ACLD TMZF 127D SZ5.5 KNEE TIB STEM EXT ST 15X100MM SET FEED FREDERICKMILLER8FR120 SET FEED MCLEAN RING9.5FR130CM SCREW ODONTOID MDTR 4X34MM END CAP STRY +5 Page 246 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,591.00 $4,864.00 $184.00 $184.00 $1,907.00 $415.00 $943.00 $2,543.00 $13,249.00 $533.00 $533.00 $2,830.00 $2,932.00 $685.00 $1,005.00 $514.12 $534.00 $534.00 $1,308.00 $1,141.00 $1,141.00 $1,141.00 $2,951.00 $582.00 $582.00 $515.00 $818.00 $1,545.00 $2,660.00 $2,543.00 $2,587.00 $2,570.00 $85.00 $2,258.00 $498.00 $3,143.00 $3,162.00 $467.00 $1,176.00 $2,951.00 $5,053.00 $2,997.00 $242.00 $378.00 $1,853.00 $842.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL EX TIB CANN TI 12X360MM SHLDR HUMR HD OFF 24X52MM KT PERFLUORON 5ML HIP STEM CORAIL ST HIGH SZ11 KNEE PTLA RD 3 PEG DEPU 32MM SHLDR HUMR STEM EXAT 11MM KWIRE TEMP FIX SHARP 3X285MM BIT DRILL STRY 4.2X340MM LEAD DEXTRUS PPM 45CM LEAD DEXTRUS PPM 53CM DRSG DERMAGRAFT 2X3IN=39SQCM GDWIRE SGL TROC ACUM 2.0MMX9 ANCHOR SUT CRKSCRWII FIBER #2 KNEE TIB BASE UNI RM ZIMM SZB KNEE TIB INSRT ZIMM RT MD 4MM SHLDR GLENOID POST ZIMM CANN DRY DOC CONMED 8X85MM HIP HD CORAIL SLF CTR MTL28X45 HIP LNR ULTAMET MTL 36X50MM HIP LNR ULTAMET MTL 36X60MM KNEE TIB INSRT XLK CURV 5 15MM KNEE FEM DIST AUG RT 2.5 8MM SCREW ODONTOID MDTR 4X44MM SCREW CORT T8 STARDR 2.7X24MM SCREW CORT T8 STARDR 2.7X28MM PLATE TIB PROX 8HL LFT 3.5MM BLADE HEL FIX NAIL TI 11X120MM NAIL TROCHANT LNG130DLFT12X360 CTRL PUMP AMS 800 IZ CUFF URINARY AMS 800 4.5CM IZ KNEE TIB INSRT ZIMM RT MD 5MM TB TRACH XLT DIST CUFF 8.0MM KNEE TIB ROTATE STRY XS-XL KNEE AXLE STRY KNEE TIB SLV STRY SCREW CORT T8 STARDR 2.7X26MM PLATE ADPTN LCP 2.7MM 12HL PLATE DHS SHRT 135D 4HL 78MM BIT DRILL QK SYNT 2.5X180MM BLADE SPIRAL HUMR NAIL TI 54MM NAIL FEM ANTERETROGRD TI13X340 BIT DRILL FOR 3.5MM PUSHLOCK ANCHOR BIO CRKSCRWFT2TIGER 5.5 BIT DRILL SUTTAK 2.4MM WAND COBLATION ULT 55 BUTTON LOPRO ST ADPTR18FR3.4CM Page 247 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,543.00 $2,764.00 $1,395.00 $4,527.00 $1,299.00 $4,737.00 $335.00 $470.00 $1,545.00 $1,545.00 $3,053.00 $141.00 $1,245.00 $3,248.00 $2,088.00 $1,336.00 $151.00 $1,822.00 $3,100.00 $3,100.00 $2,344.00 $2,660.00 $1,853.00 $184.00 $184.00 $2,603.00 $1,466.00 $2,951.00 $10,365.00 $10,225.00 $2,216.00 $340.00 $5,102.00 $2,334.00 $1,509.00 $184.00 $1,476.00 $1,566.00 $327.00 $1,424.00 $2,827.00 $516.00 $1,141.00 $438.00 $1,245.00 $1,040.00 2020 pricing Drugs&Supplies PROCEDURE NAME BUTTON LOPRO ST ADPTR18FR2.4CM CLIP HEMOCLIP TI LG CLIP HEMOCLIP TANTALUM MD SCREW LK CORT ACUM 3.5X8MM DEV SUTLASSO ST 90D SHLDR ADPTR ZIMM STD HIP ADPTR TYPE1 M2A 52-60MMSTD KNEE TIB BASE UNI LM ZIMM SZC KNEE TIB INSRT ZIMM LFT LG 4MM KNEE FEM ILOK ZIMM LFT 57.5MM BONE PLUG DEPU SZ3 KNEE FEM DIST AUG LFT SZ5 4MM SHLDR PLATE EXAT 4.5MM BIT DRILL KLS 1.5X50MM PLATE HUMR PSTRLAT WSUPPLFT7HL NAIL EX TIB CANN TI 12X390MM SCREW LK TI NAIL 4X50MM SCREW CORT SLFTP T6 2X16MM HIP HD ZIMM MTL 6D 28MM +7 BLADE AGG + CUTTER STRY 4MM TB COLAR BUTTON VENT 1.27MM SPLT THB CMC COOL CMFT RT MD BRC WRIST CARPAL BLK RT SM EXER HAND DIGI-FLEX RED 3LB SPLT THB CMC COOL CMFT LFT LG SPLT THB CMC COOL CMFT RT LG SPLT THB CMC COOL CMFT LFT MD BLADE TOMCAT 4.0 BLADE TOMCAT 5.5 NDLE BX QKCORECOAX18GX15CM20MM NDLE BX QKCORECOAX20GX15CM20MM ROTH NET UNIV RETRV NDLE BX QKCORECOAX UT20GX9CM20 ELTD NDLE SUBDERM PR 2CH KT WOUND DRN 400CC 10FR BUR RD 6 FLUTE 4.0MM BLADE RESECTOR 3.5MM TB TRACH CUFF CANN 6 TB TRACH CUFF CANN 8 NDLE BX JAMSHIDI 11GX101MM INTR FROVA INTUB W CANN 14FR BRC WRIST ERGODYNE RT XSM/SM MARKER GI TRACT SPOT PLATE LOPRO ARTX RT 6MM KNEE TIB BASE UNI LM ZIMM SZE PLATE F3 HIGH STRENGTH RT Page 248 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,040.00 $182.00 $135.00 $690.00 $738.00 $1,016.00 $1,419.00 $3,248.00 $2,088.00 $4,005.00 $399.00 $2,660.00 $2,376.00 $478.00 $2,806.00 $2,543.00 $627.00 $177.00 $1,657.00 $242.00 $63.00 $110.00 $100.00 $74.00 $110.00 $110.00 $110.00 $242.00 $242.00 $231.00 $231.00 $561.00 $231.00 $483.00 $100.00 $242.00 $242.00 $281.00 $278.00 $91.00 $466.00 $83.00 $173.00 $2,171.00 $3,248.00 $2,095.00 2020 pricing Drugs&Supplies PROCEDURE NAME BONE PLUG DEPU SZ1 SHLDR HUMR STEM EXAT 13MM SHLDR HUM HD EXAT SHR 44MM SCREW CORT T8 STARDR 2.4X8MM SCREW CORT T8 STARDR 2.4X16MM SCREW LK TI NAIL 4X22MM CBL W TI CRIMP 1.7X750MM KWIRE SMTH TIP WRIT 2.0X228MM RAD HD EVOLVE +4 22MM BLADE SAG OSCL PREC 9X25MM SUT ETHILON 6-0 P1 18 SUT VICRYL 1 CP1 UNDY MESH PARIETEX RD 9CM BLN CERV RIPENING NO STYLET INTR FLEXOR RAABE 6FR 90CM SHEATH BRITE TIP 7FR 23CM NAIL TROCHANT LNG130D RT10X320 NAIL TROCHANT LNG130D RT10X340 NAIL TROCHANT LNG130D RT10X360 NAIL TROCHANT LNG130D RT10X380 NAIL TROCHANT LNG130D RT10X400 NAIL TROCHANT LNG130DLFT10X320 NAIL TROCHANT LNG130DLFT10X340 NAIL TROCHANT LNG130DLFT10X360 NAIL TROCHANT LNG130DLFT10X380 NAIL TROCHANT LNG130D RT11X320 NAIL TROCHANT LNG130D RT11X340 NAIL TROCHANT LNG130D RT11X420 NAIL TROCHANT LNG130DLFT11X320 NAIL TROCHANT LNG130DLFT11X340 NAIL TROCHANT LNG130DLFT11X360 NAIL TROCHANT LNG130DLFT11X440 NAIL TROCHANT LNG130D RT12X300 NAIL TROCHANT LNG130D RT12X320 NAIL TROCHANT LNG130D RT12X340 NAIL TROCHANT LNG130D RT12X360 NAIL TROCHANT LNG130D RT12X420 NAIL TROCHANT LNG130D RT12X440 NAIL TROCHANT LNG130DLFT12X300 NAIL TROCHANT LNG130DLFT12X320 NAIL TROCHANT LNG130DLFT12X340 NAIL TROCHANT LNG130DLFT12X400 NAIL TROCHANT LNG130DLFT12X420 NAIL TROCHANT LNG130DLFT12X440 BLADE HEL FIX NAIL TI 11X80MM BLADE HEL FIX NAIL TI 11X85MM Page 249 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $728.00 $4,737.00 $2,932.00 $269.00 $269.00 $627.00 $1,467.00 $186.00 $5,122.00 $173.00 $18.00 $9.00 $1,289.00 $233.00 $267.00 $184.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $2,951.00 $1,466.00 $1,466.00 2020 pricing Drugs&Supplies PROCEDURE NAME END CAP TI EXT GRN 10MM SCREW TI LK IM NAIL 5.0X26MM SCREW TI LK IM NAIL 5.0X28MM SCREW TI LK IM NAIL 5.0X30MM SCREW TI LK IM NAIL 5.0X52MM BOLT LK TI 4.9X26MM BOLT LK TI 4.9X28MM BOLT LK TI 4.9X36MM BOLT LK TI 4.9X40MM BOLT LK TI 4.9X42MM BOLT LK TI 4.9X44MM BOLT LK TI 4.9X46MM BOLT LK TI 4.9X48MM BOLT LK TI 4.9X50MM BOLT LK TI 4.9X52MM BOLT LK TI 4.9X56MM BOLT LK TI 4.9X58MM BOLT LK TI 4.9X60MM BOLT LK TI 4.9X64MM BOLT LK TI 4.9X68MM BOLT LK TI 4.9X72MM BOLT LK TI 4.9X76MM BOLT LK TI 4.9X80MM BOLT LK TI 4.9X85MM BOLT LK TI 4.9X90MM BOLT LK TI 4.9X95MM BOLT LK TI 4.9X100MM BIT DRILL CANN SYNT 6X10MM CAUT COBLATOR PROCISE EZ PLATE LOPRO ARTX LFT 4MM KNEE TIB INSRT PSC 10X79/83MM KNEE PTLA 3PEG THIN 37X8.6MM ENDO ABSORBATACK 5MM HIP LNR ALTRX PE 0D 36X56MM KNEE TIB BASE CMNT REV MBT 5 HIP HD EZE MTL 12/14 40MM +12 KNEE TIB INSRT TC3 SZ5 12.5MM HIP STEM CORAIL ST HIGH SZ13 HEMO SEAL EVICEL FIBRIN 5ML CAUT HARMONIC FO*DISC 6247926* PLATE HUMR PROX LCP 3.5 6HL160 NAIL EX TIB CANN TI 9X300MM CAUT SEALER AQUAMANTYS 6MM KNEE FEM PFC RPF DEPU LFT 2 KNEE FEM PFC RPF DEPU LFT 2.5 KNEE TIB INSRT PFC RPFSZ2 10MM Page 250 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $557.00 $639.00 $639.00 $639.00 $639.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $1,362.00 $1,217.63 $2,171.00 $4,365.00 $1,476.00 $1,414.00 $2,376.00 $10,324.00 $1,545.00 $5,543.00 $4,527.00 $1,658.00 $1,583.00 $3,331.00 $2,543.00 $1,801.00 $4,111.00 $4,111.00 $2,700.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT PFC RPFSZ2.5 10 KNEE TIB INSRT PFC RPFSZ4 12.5 KNEE TIB INSRT PFC RPFSZ4 15MM KNEE TIB INSRT PFC RPFSZ6 15MM KNEE PTLA RD 3 PEG DEPU 41MM ANCHOR SUT CRKSCRWII FIBER 6.5 HIP LNR ARCOMXL PE 0D 36X28MM HIP STEM CORAIL2 BOW STD SZ15 KNEE TIB INSRT TC3 3 17.5MM KNEE FEM DIST AUG RT SZ2.5 4MM MEMBRANE SCRAPER TANO STIFF25G SCREW LK TI NAIL 4X60MM RAD HD EVOLVE +2 22MM KNE STEM TIB BASEPLATE RT SZ3 KNEE TIB INSRT NEX ZIMM 12MM KNEE LPS-FLEX FIXED5-6GH 10MM SCREW LK CORT ACUM 2.7X10MM KNEE TIB INSRT TC3 SZ5 22.5MM SCREW HDLSS COMP T8 TI 3X22MM PIN TRIM-IT SPIN 2.0X100MM STNT WALLENDO 10X60MM*DISC* TVT Y GRAFT INTEPRO 4X23*DISC* OATS HARVESTOR ARTX 8MM BIT DRILL 2.5MM SCREW CORT LK LOPRO TI3.5X24MM SCREW CORT LK LOPRO TI3.5X26MM SCREW LOPRO ARTX TI 4.0X36MM PLATE LAPIDUS ARTX GDWIRE TROC TIP ARTX 1.6MM HIP SHELL REGENEREX LTD 23X54 HIP LNR ARCOMXL PE 0D 36X26MM BONE PLUG DEPU SZ5 KNEE FEM DIST AUG RT SZ4 4MM RETR DEXTRUS SEAL CAP ASSY RETR FIXED LENGTH ACCESS SM KWIRE COND STER 1.8X310MM BIT DRILL STRY 5X340MM END CAP STRY T2 NUT SCREW COND STRY 5MM BIT DRILL QK SYNT 1.8X100MM SCREW RECON THRD TI 6.5X30X90 NAIL EX TIB CANN TI 8X315MM SCREW LK TI NAIL 4X42MM NAIL FEM ANTERETROGRD TI13X360 KNEE TIB STEM EXT ST 14X100MM HIP HL PLUG STRY Page 251 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,700.00 $2,700.00 $2,700.00 $2,700.00 $1,299.00 $1,174.00 $2,123.00 $4,527.00 $4,319.00 $2,660.00 $728.00 $627.00 $5,122.00 $2,412.00 $2,271.00 $1,829.00 $690.00 $5,543.00 $1,141.00 $1,151.00 $3,581.00 $2,312.00 $1,683.00 $413.00 $441.00 $441.00 $321.00 $1,790.00 $83.00 $3,918.00 $2,123.00 $728.00 $2,718.00 $1,576.00 $279.00 $263.00 $474.00 $877.00 $860.00 $821.00 $646.00 $2,543.00 $627.00 $2,827.00 $2,997.00 $716.00 2020 pricing Drugs&Supplies PROCEDURE NAME INST BX MAX CORE 18GX16CM NDLE BX MAXCORE 16GX16CM NDLE BX MAXCORE 18GX10CM KT RETR SCREW REDDICK SAYE PKNG NASAL TAMPON 8CM SNARE OVAL CAPTIFLEX MD 27MM CLIP APPL SURGICLIP II MD 11.5 BLADE SAG OSCL PREC 5.5X25MM BUR BRL 6-FLUTE 5.5MM TROC VERSASTEP 5MM TROC VERSASTEP 11MM SET TB COLLT DISP NDLE SPINAL SPROTTE 24GX120MM NDLE BX TRUGUIDE 17GX7.8CM SINUS GD CATH HNDL SIDEKICK KNEE FEM ILOK ZIMM RT 72.5MM HIP SHELL REGENEREX LTD 23X52 HIP SHELL PNCLE SECT POR 64MM HIP LNR ALTRX PE 0D 36X64MM HIP STEM CORAIL2 BOW STD SZ10 SHLDR HUMR STEM EXAT 9MM SCREW CANN LK THRD HEX7.3X60 MESH PARIETEX SKIRT 15X10CM BLADE SAG OSCL AGGR 9X25MM PLATE LOPRO ARTX RT 3.5MM PAD PERINEAL POST SUPINE S&N PLATE RECON 14HL 4.5X221MM STAPLE RELOAD TA 30 V3 STAPLER TA 30 V3 KNEE TIB STEM EXT ST 17X100MM HIP HD G7 TYPE 1 MTL 36MM -3 BIT DRILL QK ZIMM 3.2X40MM HIP SHELL REGENEREX LTD 24X58 HIP STEM TAPERLOC STD 6X132 TB GASTRO MIC BLN 7-10ML 24FR ADPTR LUER ASPIRA KNEE TIB INSRT ZIMM LFT SM 5MM HIP STEM CORAIL ST HIGH SZ15 HIP SHELL TRID HA CLUSTER 54MM PLATE TIB DIST LCP LFT 6HL 3.5 SCREW LK TI NAIL 5X58MM SCREW LK TI NAIL 5X64MM SCREW LK TI NAIL 5X70MM BLADE IMPLT FEM SPIRAL TI 70MM BLADE IMPLT FEM SPIRAL TI 75MM NAIL TIB TI CANN 12X345MM Page 252 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $169.00 $186.00 $169.00 $1,164.00 $77.00 $95.00 $317.00 $180.00 $242.00 $557.00 $936.00 $60.00 $104.00 $62.00 $312.00 $4,005.00 $3,918.00 $2,376.00 $2,376.00 $4,527.00 $4,737.00 $1,015.00 $1,857.00 $173.00 $2,171.00 $465.00 $1,757.00 $230.00 $489.00 $2,997.00 $1,790.00 $379.00 $3,918.00 $4,674.00 $214.00 $203.00 $2,088.00 $4,527.00 $2,303.00 $2,990.00 $627.00 $627.00 $627.00 $1,352.00 $1,352.00 $2,337.00 2020 pricing Drugs&Supplies PROCEDURE NAME NDLE SET EZ-IO PD 15GX15M*CIP* KNEE TIB STEM REV ZIMM 20X80MM HIP HD CORAIL SLF CTR MTL28X44 HIP SHELL PNCLE SECT GRIPTN 48 HIP SHELL PNCLE SECT GRIPTN 56 HIP LNR ULTAMET MTL 28X48MM HIP HD V40 EXETER CER 36MM -5 KNEE FEM PS CMNT DEPU LFT 2 KNEE FEM PS CMNT DEPU LFT 2.5 KNEE FEM PS CMNT DEPU LFT 3 KNEE FEM PS CMNT DEPU LFT 4.5 KNEE FEM PS CMNT DEPU LFT 4 KNEE FEM PS CMNT DEPU LFT 5 KNEE FEM PS CMNT DEPU LFT 6 KNEE FEM PS CMNT DEPU RT 2 KNEE FEM PS CMNT DEPU RT 2.5 KNEE FEM PS CMNT DEPU RT 3 KNEE FEM PS CMNT DEPU RT 4 KNEE FEM PS CMNT DEPU RT 4 KNEE FEM PS CMNT DEPU RT 5 KNEE FEM PS CMNT DEPU RT 6 KNEE FEM PFC CR DEPU LFT 4 KNEE FEM PFC CR DEPU RT 4 HIP SHELL PNCLE SECT GRIPTN 54 GDWIRE THRD SPADE 2.0X230MM CANN EXPANULA ARTX 8.25MMX7CM HIP HD EZE MTL 12/14 40MM+15.5 PLATE CLAV ACUM RT 9HL NAIL EX TIB CANN TI 11X315MM SCREW LK TI NAIL 5X26MM KT INTR VASC GROSHONG 8FR 15CM CATH GLD PROBE EP HEMO 7F CLSR SYS CT STD NDLE MATCH RD TIP INTR 13GA BLADE SAW GIGLI ZIMM 300MM PROBE ERBE W FLTR ST FIRE FLEX SCREW ROCKWOOD*DISC* WASHER ROCKWOOD SHLD*DISC* BIT DRILL ZIMM 9/64X6 BIT DRILL ZIMM 3/16X6 HIP STEM MALLORY STD135D13X220 HIP BODY MALLORY A STD 34MM HIP SHELL TRID HA CLUSTER 60MM PIN EXTL FIX APEX 3X110MM PIN EXTL APEX SLFTP 4X120MM SHEATH RAABE 8FR 90CM Page 253 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $641.00 $3,178.00 $2,113.00 $3,240.00 $3,240.00 $3,096.00 $2,627.00 $2,764.00 $5,651.00 $2,764.00 $2,764.00 $5,651.00 $1,219.00 $2,764.00 $2,764.00 $2,764.00 $5,651.00 $2,764.00 $1,219.00 $2,764.00 $1,219.00 $2,764.00 $2,764.00 $3,240.00 $160.00 $213.00 $1,545.00 $2,205.00 $2,543.00 $627.00 $334.00 $834.00 $616.00 $292.00 $150.00 $1,077.00 $1,454.00 $1,454.00 $695.00 $695.00 $5,620.00 $13,249.00 $2,303.00 $364.00 $546.00 $711.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE FEM ILOK ZIMM LFT 80.0MM KNEE FEM DIST AUG RT SZ3 4MM FILLER GRAN MASTERGRAFT 5CC FILLER GRAN MASTERGRAFT 10CC ROD EXTL FIX CBN MR 11X150MM BLADE SPIRAL HUMR NAIL TI 42MM KNEE TIB STEM EXT ST 12X100MM KT EKOSONIC INFUS 106CM 12CM KT EKOSONIC INFUS 106CM 18CM KT EKOSONIC INFUS 106CM 24CM KT EKOSONIC INFUS 106CM 30CM KT EKOSONIC INFUS 135CM 40CM KT EKOSONIC INFUS 135CM 50CM HIP SHELL PNCLE SECT POR 48MM HIP STEM COXAVARA HIGH SZ9 ROD PREBENT MDTR 5.5MM 33CM SIZER MAM MODPRO+ DISP 175CC SIZER MAM MODPRO+ DISP 200CC SIZER MAM MODPRO+ DISP 225CC SIZER MAM MODPRO+ DISP 250CC SIZER MAM MODPRO+ DISP 275CC SIZER MAM MODPRO+ DISP 300CC SIZER MAM MODPRO+ DISP 325CC SIZER MAM MODPRO+ DISP 350CC SIZER MAM MODPRO+ DISP 375CC SIZER MAM MODPRO+ DISP 400CC SIZER MAM MODPRO+ DISP 700CC SCREW COND STRY 5X75MM HIP SHELL TRID HA CLUSTER 66MM SCREW LK TI NAIL 4X48MM STAPLER SUBCUTICULAR INSORB HIP ADPTR TYPE1 M2A 42-50MM -6 HIP HD M2A ZIMM MTL 38MM -6 HIP SHELL REGENEREX LTD 24X56 HIP LNR ARCOMXL PE 0D 28X22MM HIP STEM TRI-LOCK STD SZ4 SLV SCD KNEE EXPRESS XL SCREW CORT SLFTP 4.5X80MM NAIL FEM ANTERETROGRD TI12X360 KNEE PTLA FLEX PROLNG SZ1 8MM KNEE FEM CRFLEX NONPOR RT SZ3 SYS CMNT MIXING END CAP STRY T2 08MM KNEE FEM AUGDIST RL/LM 5X65MM KNEE FEM AUG DIST LL/RM 5X65MM HIP STEM TRI-LOCK HIGH SZ7 Page 254 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,005.00 $2,660.00 $1,205.00 $1,793.00 $843.00 $1,424.00 $2,997.00 $5,312.00 $5,312.00 $5,312.00 $5,312.00 $5,312.00 $5,312.00 $2,376.00 $4,527.00 $3,540.00 $230.00 $230.00 $230.00 $230.00 $230.00 $230.00 $230.00 $230.00 $230.00 $230.00 $230.00 $860.00 $2,303.00 $627.00 $285.00 $1,419.00 $1,790.00 $3,918.00 $2,123.00 $5,118.00 $285.00 $174.00 $2,765.00 $1,973.00 $3,933.00 $716.00 $842.00 $2,732.00 $2,732.00 $5,118.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP HD EZE CER 12/14 36MM +1.5 HIP HD EZE CER 12/14 36MM +5 CAGE VERTE-STACK 14X11X10MM CAGE VERTE-STACK 14X11X11MM BIT DRILL MDTR 2.4MM SCREW VERTEX MDTR 3.5X12MM SCREW VERTEX MDTR 14MM SCREW VERTEX MDTR 18MM SCREW VERTEX MDTR 20MM HIP STEM ACLD TMZF 132D SZ7.5 SCREW HDLSS COMP LNG TI 3X32MM CLIP APPL LIGAMAX MG/LG 5MM MASK PCKT GLOVE WIPE HARD CA CATH CHOLANGIO 4FR 23CM PKNG NASAL POPE EPISTAXIS CNTRCPT FALLOP CLIP FILSHIE HIP STEM TRI-LOCK STD SZ6 KT TRNSPRT CARTI*DISC 6270900* BOWL MIXEVAC III BELT MATERNITY SI-LOC LG/XL CUFF URINARY AMS 800 4.0CM IZ HIP STEM TRI-LOCK STD SZ7 SCREW CORT T8 STARDR 2.4X20MM SCREW LK TI NAIL STER 5X30MM STNT XIENCE RX 2.5X12*DISC* STNT XIENCE RX 2.5X15*DISC* STNT XIENCE RX 2.5X18*DISC* STNT XIENCE RX 2.5X23*DISC* STNT XIENCE RX 2.5X28*DISC* STNT XIENCE RX 2.75X12*DISC* STNT XIENCE RX 2.75X15*DISC* STNT XIENCE RX 2.75X18*DISC* STNT XIENCE RX 2.75X23*DISC* STNT XIENCE RX 2.75X28*DISC* STNT XIENCE RX 3.0X12*DISC* STNT XIENCE RX 3.0X15*DISC* STNT XIENCE RX 3.0X18*DISC* STNT XIENCE RX 3.0X23*DISC* STNT XIENCE RX 3.0X28*DISC* STNT XIENCE RX 3.5X12*DISC* STNT XIENCE RX 3.5X15*DISC* STNT XIENCE RX 3.5X18*DISC* STNT XIENCE RX 3.5X23*DISC* STNT XIENCE RX 3.5X28*DISC* PLATE VENTURE MDTR 21MM BLADE IMPLT FEM SPIRAL TI 80MM Page 255 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,376.00 $2,376.00 $2,591.00 $2,591.00 $1,460.00 $2,077.00 $2,346.00 $2,077.00 $2,077.00 $5,053.00 $1,140.00 $1,660.00 $68.00 $630.00 $142.00 $368.00 $5,118.00 $1,699.00 $245.00 $280.00 $10,225.00 $5,118.00 $269.00 $5,904.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $2,315.00 $1,352.00 2020 pricing Drugs&Supplies PROCEDURE NAME RING EXTL FIX HYBRID 3/4 205MM KWIRE SPADE 2X350MM SCREW CANN 3X24MM KWIRE STRY 1.2X100MM HIP HD CORAIL SLF CTR MTL28X51 HIP LNR ALTRX PE 0D 36X62MM BREAST NATRELLE MID 222CC BREAST NATRELLE MID 354CC END CAP TI T40 EXT 0MM SNARE EXPRO ELITE 25MM CATH SINUS GD M-110 110D HIP SHELL REGENEREX MULT 25X60 HIP HD EZE CER 12/14 32MM +5 SET SCREW LEGACY MDTR 4.5MM PLATE HUMR MEDL DIST 3.5LFT7HL SCREW LK TI NAIL 5X54MM HIP STEM TRI-LOCK STD SZ2 SCREW CANN THRD ASNIS6.5X20X80 FINGER IMPLT NEUFLEX MCP SZ1 FINGER IMPLT NEUFLEX MCP SZ3 FINGER IMPLT NEUFLEX MCP SZ4 FINGER IMPLT NEUFLEX MCP SZ5 BREAST NATRELLE SIL MID 659CC SPACER PERIMETER PEEK 8D 14MM HIP LNR TRID X3 PE 0D 40MM F PLATE LCP COND SS 7HL 2.7X66MM NAIL FEM RECON LAT TI RT11X380 NAIL FEM ANTERETROGRD TI11X420 HIP LNR TRILOGY PE 0D 48X32MM HIP HD ZIMM MTL 6D 32MM +10.5 HIP STEM TRI-LOCK STD SZ5 HIP LNR ALTRX PE 0D 36X58MM HIP STEM M/L STD SZ12.5 HIP BODY MALLORY C STD 34MM SYS MENISC MAXFIRE ZIMM HIP STEM TRI-LOCK HIGH SZ4 BONE PLUG DEPU SZ2 NAIL FEM ANTERETROGRD TI11X360 NAIL FEM ANTERETROGRD TI12X380 ROD LEGACY MDTR 5.5X500MM NAIL FEM RECON LAT TI RT11X340 HIP STEM M/L STD SZ13.5 KT MICPUNC NIT 5FR 21GX7CM HARNESS EZWAY SMART STAND MD ORTHOSIS SHLDR MFC UNIL LFT MD PLATE ELBOW ACUM MEDL SHRT 9HL Page 256 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,443.00 $294.00 $790.00 $152.00 $1,822.00 $2,376.00 $2,344.00 $2,344.00 $579.00 $1,466.00 $1,372.00 $5,699.00 $2,376.00 $488.00 $2,594.00 $627.00 $5,118.00 $1,073.00 $2,475.00 $2,475.00 $2,475.00 $2,475.00 $2,245.00 $6,141.00 $2,627.00 $1,770.00 $2,762.00 $2,827.00 $2,847.00 $1,657.00 $5,118.00 $2,376.00 $4,948.00 $13,249.00 $1,328.00 $5,118.00 $399.00 $2,827.00 $2,827.00 $1,240.00 $2,762.00 $4,948.00 $101.00 $1,029.00 $284.00 $2,609.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE LOPRO ARTX LFT 6MM SCREW BIOCOMP DELTA TAPER10X35 CANN INST ARTX 7MMX7CM STNT URETRL RESONANCE 6FR26CM HIP LNR ULTAMET MTL 36X58MM NAIL FEM RECON LAT TI RT13X420 HIP ADPTR TYPE1 M2A 52-60MM +6 SCREW SHLDR ROCKWO *DISC* PLATE OLEC LFT 4HL SCREW LK TI SLFTP 3.5X30MM FISTULA WOUND MGMT MINI CTF 1 FISTULA WOUND MGMT MIDI CTF 2 SUT FBRLINK/WIRE 2 CLSD BLU 26 KNEE TIB BASE UNI RM ZIMM SZC HIP HD M2A ZIMM MTL 42MM +0 HIP SHELL M2A ZIMM 48X42MM HIP STEM CORAIL BOW COLAR SZ11 BLADE SPIRAL HUMR NAIL TI 38MM STNT PARAMOUNTMINI7X18MM 0.018 MESH SOFT FLAT LG PORE 3X6 SCREW MICRO ASNIS 3X26MM FORCEPS ILM REVOLUTION 20G SCREW LK T15 STARDR 3.5X42MM PLATE HUMR MEDL DIST 3.5RT 7HL HIP HD SROM MTL 11/13 32MM +6 OVERTUBE GARDUS 8.6-10MMX25CM STNT WLLFLX RX 8FR 10X60MM KNEE FEM ILOK ZIMM LFT 55.0MM KNEE TIB INSRT STBLZIMM10X63MM HIP STEM CORAIL BOW COLAR SZ9 HIP STEM CORAIL BOW COLAR SZ10 KNEE BUMPER INSRT STRY NEUT TB TRACH RUSCH QUICKTRACH 4MM TROC VERSASTEP 12MM ANCHOR PEEK PLK 2.9X15.5MM SCREW LOPRO ARTX 3X24MM SHEATH DILATOR COAX HIP STEM TRI-LOCK STD SZ3 KNEE FEM PSTR AUG SZ2 8MM ALLO CERV LIFENET 6.75X22MM PLATE VENTURE MDTR 23MM PPM ZEPHYR XL DR LEAD TENDRIL ST OPTIM ST 52CM LEAD TENDRIL ST OPTIM ST 58CM MESH PARIETEX SKIRT 25X20CM TISS WEDGE PLEXUR 40X15MM Page 257 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,171.00 $1,127.00 $147.00 $2,423.00 $3,100.00 $2,762.00 $1,419.00 $1,454.00 $2,241.00 $575.00 $226.00 $238.00 $1,794.00 $3,248.00 $1,790.00 $3,918.00 $4,527.00 $1,424.00 $1,970.00 $677.00 $790.00 $754.00 $575.00 $2,594.00 $1,419.00 $849.00 $3,461.00 $4,005.00 $2,042.00 $4,527.00 $4,527.00 $1,679.00 $1,073.00 $665.00 $1,301.00 $604.00 $447.00 $5,118.00 $2,660.00 $3,217.00 $2,315.00 $7,370.00 $1,652.00 $1,652.00 $3,392.00 $1,910.00 2020 pricing Drugs&Supplies PROCEDURE NAME CINCH MENISC CURV TIP CUTTER FIBERWIRE ARTX 2-0 BLADE HEMOSTATIX #15 DRSG MTX BILYR 4X5IN=130SQCM BIT DRILL MDTR TRI FLT PLATE CENTERPIECE LAT HL 10MM SCREW CENTERPIECE FA 2.6X5MM SCREW CENTERPIECE FA 2.6X7MM SCREW CENTERPIECE FA 2.6X9MM SCREW CENTERPIECE FA 2.6X11MM BLADE IMPLT FEM SPIRAL TI 65MM SCREW CORT SYNT 1.5X16MM PLATE ST LCP 2.4MM 7HL 60MM HIP LNR TRILOGY PE 10D 60X36MM TROC CANN VERS W FIX 11MM TROC CANN VERS W FIX 5MM BLADE CARPAL TUNNEL CATH DILATATION COOK 5FR SCREW CORT T8 STARDR 2.7X40MM PLATE ST LCP 2.7MM 8HL 76MM KNEE TIB BASE UNI RM ZIMM SZA KNEE TIB INSRT ZIMM RT SM 5MM PLATE VENTURE MDTR 42.5MM BREAST COHESIVEHIPRO 650CC ALLO DBM PUTTY PROGENIX 10ML INFL DEV ENCORE CLIP ROTATABLE FIX DEV QCCLIP2 KT PEG PULL SFTY 20FR HIP STEM TRI-LOCK HIGH SZ8 HIP STEM COXAVARA HIGH SZ12 KNEE TIB INSRT TC3 2.5 17.5MM HIP HD CORAIL SLF CTR MTL28X48 SCREW LAG CANN ARTX 30MM DEL SYS DISTBICEP REPAIR SCREW CORT T8 STARDR 2.4X26MM LEAD TENDRIL ST OPTIM ST 46CM PPM VICTORY XL DR HNDL LECTROCORD DISP 10FT STAPLE RELOAD TA 30 4.8MM STAPLER EEA 4.8MM 25MM STAPLER EEA 4.8MM 28MM AIRW SUPRAGLOTTIC LTS-D SZ5 EXTR STONE HEL OCCL 3.2FR3WIRE DRSG RAPIDRHINO TAMPONADE5.5CM DRSG RAPIDRHINO ANT/PSTR 7.5CM SENS BIOSPECTORAL PEDS Page 258 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,066.00 $631.00 $275.00 $6,706.00 $1,126.00 $1,822.00 $364.00 $364.00 $364.00 $364.00 $1,352.00 $162.00 $1,308.00 $2,847.00 $636.00 $490.00 $1,088.00 $876.00 $184.00 $1,339.00 $3,248.00 $2,088.00 $2,368.00 $2,274.00 $2,997.00 $404.00 $1,357.00 $601.00 $5,118.00 $4,527.00 $4,319.00 $1,822.00 $582.00 $2,211.00 $269.00 $1,652.00 $6,653.00 $167.00 $206.00 $1,110.00 $1,110.00 $80.00 $849.00 $196.00 $203.00 $116.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW SHLDR ROCKWOOD*DISC* PLATE VENTURE MDTR 27.5MM HIP AUG TRABEC MTL ZIMM50X10MM SCREW CORT SLFTP ZIMM 4.5X36MM HIP HD ADPTR VERS ENDO +10.5MM CLIP APPL ENDO CLIP III 5MM HIP HD CORAIL SLF CTR MTL28X59 HIP RING LK DYNAMIC DEPU 54MM KNEE TRAY SLV MBT POR 61MM HIP STEM CORAIL BOW COLAR SZ13 KNEE FEM PSTR AUG 2.5 4MM KNEE FEM DIST AUG LFT SZ4 8MM KNEE TIB INSRT TC3 SZ4 15MM PLATE CENTERPIECE OPENDOOR10MM PLATE CENTERPIECE OPENDOOR12MM PLATE LCP SS 4HL 2.4X36MM CLIP HEM-O-LOK MD/LG MESH PARIETEX PROGRIP 15X9CM GLIDESCOPE GVL 3 SM GLIDESCOPE GVL 4 LG HIP LNR ALTRX PE 0D 36X60MM BLN EVERCROSS 4X200MM 135CM BLN EVERCROSS 5X200MM 135CM BLN EVERCROSS 6X200MM 135CM KNEE TIB INSRT ZIMM RT SM 4MM HIP STEM CORAIL ST HIGH SZ16 HIP STEM TRI-LOCK HIGH SZ6 MESH PROCEED VENTRAL 6.4X6.4CM MESH PROCEED VENTRAL 4.3X4.3CM PLATE VENTURE MDTR 30MM PLATE VENTURE MDTR 32MM PLATE VENTURE MDTR 35MM MESH PARIETEX PROGRIP RT14X9CM HIP STEM M/L EXT SZ11 HIP LNR TRILOGY PE 0D 58X40MM HIP HD VERS MTL 12/14 40MM +0 DEV THYROPLASTY MALE SZ8 HIP STEM CORAIL ST HIGH SZ18 PLATE ORB KLS 1.5X3MM SCREW LAG 1STEP 12.7X85MM SCREW LK TI SLFTP 3.5X14MM SCREW HDLSS COMP LNG TI 3X26MM DRSG VAC XL TB EAR ARMSTRONG GROMMETT STAPLE RELOAD GIA 30 3.5MM KT CONN QK AMS 700 Page 259 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,454.00 $2,315.00 $6,223.00 $234.00 $641.00 $865.00 $1,822.00 $1,218.00 $5,674.00 $4,527.00 $2,660.00 $2,660.00 $5,543.00 $1,822.00 $1,822.00 $1,308.00 $191.70 $1,077.29 $112.00 $95.00 $2,376.00 $415.00 $415.00 $415.00 $2,088.00 $4,527.00 $5,118.00 $1,959.00 $1,783.00 $2,315.00 $2,368.00 $2,368.00 $1,155.00 $4,948.00 $2,847.00 $1,657.00 $1,366.00 $4,527.00 $1,179.00 $1,114.00 $575.00 $1,140.00 $604.00 $90.00 $509.00 $2,101.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CNCLS 140/50 6.0/5.0MM MTX COLLAGEN FLOWABLE 3CC KT TB TDS-T BTL PLEURX DENVER 500ML HIP STEM TRI-LOCK HIGH SZ5 HIP LNR ULTAMET MTL 36X54MM HIP HD EZE CER 12/14 32MM +1 HIP STEM CORAIL BOW COLAR SZ12 NAIL FEM ANTERETROGRD TI12X380 BIT DRILL SYNT 3.5X180MM NAIL FEM RECON LAT TILFT11X400 KT ESSENTIALS CARTILAGE IMPLT SCREW CORT LK LOPRO TI3.5X18MM SCREW CORT LK LOPRO TI3.5X20MM SCREW LOPRO ARTX TI 4.0X28MM KNEE TIB INSRT ZIMM LFT MD 4MM KNEE TIBINSRT XLK STBL3 22.5MM PLATE VENTURE MDTR 60MM PLATE VENTURE MDTR 65MM KNEE TIB INSRT STD 14X79/83MM KNEE TIB BASE CMNT REV MBT 2 KNEE TRAY SLV MBT POR 29MM HIP STEM COXAVARA HIGH SZ18 KNEE TIB INSRT TC3 SZ3 10MM SCREW CANN THRD ASNIS6.5X20X85 SCREW CANN THRD ASNIS6.5X20X90 SCREW CANN THRD ASNIS6.5X20X90 SCREW CANN THRDASNIS6.5X20X100 SCREW CANN THRDASNIS6.5X20X105 MESH PARIETEX PROGRIPLFT14X9CM KNEE TIB LCCK YEL SZE/F 12MM PLATE CLAV ANT RT 7HL 3.5MM SCREW CANN LK HEX THRD 5X30MM SUCT DEV BIOVAC W Y 244CM RSVR PENILE AMS 700 65ML HIP HD G7 TYPE 1 MTL 36MM -6 HIP STEM TRI-LOCK STD SZ8 KNEE TIB BASE CMNT REV MBT 3 HIP SHELL PNCLE SECT GRIPTN 50 HIP STEM CORAIL2 BOW STD SZ8 HIP SLV PROX SROM ZTT 18B-SM HIP STEM SROM 30 13X18X160 KNEE TIB INSRT TC3 SZ4 25MM SCREW MTXMAND SYNT 2X6MM SCREW MTXMAND SYNT 2X8MM PLATE RD STRUT CURV MALLEA 8HL Page 260 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $969.00 $7,867.00 $107.00 $214.00 $5,118.00 $3,100.00 $2,376.00 $4,527.00 $2,827.00 $327.00 $2,762.00 $1,143.00 $441.00 $441.00 $321.00 $2,088.00 $2,344.00 $2,376.00 $2,376.00 $2,432.00 $10,324.00 $5,674.00 $4,527.00 $5,543.00 $1,073.00 $1,073.00 $1,073.00 $1,073.00 $1,051.52 $1,155.00 $4,514.00 $943.00 $903.00 $582.00 $4,569.00 $1,790.00 $5,118.00 $10,324.00 $3,240.00 $4,527.00 $2,205.00 $3,240.00 $5,543.00 $245.00 $245.00 $1,319.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT T8 STARDR 2.4X22MM SCREW CORT T8 STARDR 2.4X24MM SCREW CORT T8 STARDR 2.4X28MM SCREW CORT T8 STARDR 2.4X30MM SCREW CORT T8 STARDR 2.4X32MM SCREW CORT T8 STARDR 2.4X34MM SCREW CORT T8 STARDR 2.4X36MM SCREW CORT T8 STARDR 2.4X38MM SCREW CORT T8 STARDR 2.4X40MM SCREW CORT SLFTP T6 2X18MM PLATE FEM PROX 4.5/5 LFT 12HL DRSG MEPILEX TRANSFER 8X8 BUR SABER RD DIMND STRY 5MM BUR SABER RD DIMND STRY 4MM BUR SABER RD DIMND STRY 2MM HIP STEM CORAIL BOW COLAR SZ14 SCREW CORT ZIMM 3.5X12MM SCREW CORT NL ZIMM 3.5X14MM SCREW CORT NL ZIMM 3.5X16MM SCREW CORT NL ZIMM 3.5X26MM SCREW CORT NL ZIMM 3.5X30MM BIT DRILL ZIMM 2.5MM HIP LNR TRILOGY PE 0D 62X36MM SCREW CORT T8 STARDR 2.7X22MM SCREW DUALCORE 5X40MM BREAST RD SIL XTRHIGH800CC HIP HD CORAIL SLF CTR MTL28X56 TRAY 1ST FRAC ADV XPANDER 20/3 SCREW CORT T8 STARDR 2.7X30MM SCREW CANN LK HEX THRD 5X25 SCREW CANN LK HEX THRD 5X100 SCREW CANN LK HEX THRD 5X105 SCREW CANN LK HEX THRD 5X110 SCREW CANN LK HEX THRD 5X115 SCREW CANN LK HEX THRD 5X120 SCREW CANN LK HEX THRD 5X125MM SCREW CANN LK HEX THRD 5X130 SCREW CANN LK HEX THRD 5X135 SCREW CANN LK HEX THRD 5X140 SCREW CANN LK HEX THRD 5X145 ALLO GRAN CHRONOS LG 10CC SHLDR HUMR HD OFF 21X46MM KNEE TIB INSRT STD 16X79/83MM BIT DRILL MDTR 2.9MM SCREW VERTEX MDTR 4X12MM SCREW VERTEX MDTR 4X14MM Page 261 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $269.00 $269.00 $269.00 $269.00 $269.00 $269.00 $269.00 $269.00 $269.00 $177.00 $3,463.00 $60.00 $674.00 $674.00 $646.00 $4,527.00 $342.00 $342.00 $342.00 $342.00 $342.00 $685.00 $2,847.00 $184.00 $698.00 $2,245.00 $2,113.00 $8,840.00 $184.00 $903.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $912.00 $1,920.00 $2,764.00 $2,432.00 $1,460.00 $2,077.00 $2,077.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE OLEC LFT 6HL CAUT COBLATOR PROCIS LW PLATE WRIST SHRT BEND SCREW CORT SLFTP T6 2X14MM SCREW CORT SLFTP T6 2X20MM SCREW LK SYNT 2X10MM SCREW LK SYNT 2X14MM SCREW LK SYNT 2X16MM PLATE T LCP 2.0MM 3/7HL SCREW SCHANZ 4.5 SHRT BLNT 175 FINGER PIP PROX ASCENSION 30 SCREW LK SYNT 2X9MM SCREW LK SYNT 2X11MM PLATE ST LCP 4HL 2.0MM SHEATH PNCLE RO NO GD 5FR 10CM CATH PROGREAT W GLIDE GT 2.8FR SPHINCTEROTOME HYDRATOME RX 49 MESH ALLOMAX 13X15CM SCREW CANN ARTX 4.5X36MM SCREW CANN ARTX 4.5X40MM SCREW CANN ARTX 4.5X45MM ENDO TACKER 30 SORBAFIX 36CM KNEE TIB INSRT XLK STBL 6 8MM PLATE TIB DIST LCP LFT 8HL 3.5 PLATE TIB DIST LCP LFT10HL 3.5 PLATE TIB DIST LCP RT 12HL 3.5 PLATE TIB DIST LCP LFT12HL 3.5 PLATE TIB DIST LCP RT 14HL 3.5 PLATE TIB DIST LCP LFT14HL 3.5 SCREW CANN LK THRD HEX7.3X65 SCREW PERIPROSTHETIC 5X10MM TB TRACH XLT DIST CUFF 6.0MM TB LARYN SHILEY SZ6 TB LARYN SHILEY SZ8 TB TRACH HYPERFLEX ADJ 6.0MM TB TRACH HYPERFLEX ADJ 7.0MM TB TRACH HYPERFLEX ADJ 8.0MM BUR SOFT TOUCH RD STRY 4MM BUR SOFT TOUCH RD STRY 6MM CAUT COBLATOR REFLEX ULT HIP HD CORAIL SLF CTR MTL28X52 SCREW LK KLS 2.7X15MM PLATE LK STR KLS 20HL 3MM NAIL FEM RECON LAT TILFT12X380 CERV PEEK PREVAIL 2HL5X16X14MM CERV PEEK PREVAIL 2HL6X16X14MM Page 262 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,311.00 $1,545.00 $3,253.00 $177.00 $177.00 $534.00 $534.00 $534.00 $1,401.00 $349.00 $4,065.00 $534.00 $534.00 $1,084.00 $153.00 $1,771.00 $1,336.00 $9,707.00 $860.00 $860.00 $860.00 $1,515.00 $2,344.00 $3,020.00 $3,050.00 $3,084.00 $3,084.00 $3,125.00 $3,125.00 $1,015.00 $959.00 $340.00 $253.00 $253.00 $852.00 $852.00 $852.00 $674.00 $674.00 $1,022.00 $1,822.00 $531.00 $2,258.00 $2,762.00 $5,319.00 $5,319.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW MTXMID SYNT SLVR 5MM SCREW MTXMID SYNT BLU 5MM STNT WLLFLX ESOPH 18MM10.3X7CM HIP STEM SOL SYS BOW LG 16.5MM KNEE TIB INSRT PSC 14X71/75MM HIP STEM ECHO FX STD 13MM BREAST MEMORYGEL MODER 350 PLATE LCP SS 7HL 2.7X67MM MESH PERMACOL 15X20CM SCREW CROSSDRIV SIL 2.7X8MM SCREW CROSSDRIV SIL 2.7X12MM SCREW LK KLS 2.7X17MM SCREW LK KLS 2.7X19MM PLATE MAND RECON KLS ANGRT26HL PLATE RECON KLS ANG LFT 26HL PLATE RECON KLS ANG 32HL 3MM SCREW EMER SYNT 2.7X18MM SCREW CANN ASNIS STRY 3X20MM HIP STEM TRI-LOCK HIGH SZ3 SCREW CORT SYNT 1.5X6MM SCREW CORT SYNT 1.5X7MM SCREW CORT SYNT 1.5X8MM SCREW CORT SYNT 1.5X9MM SCREW CORT SYNT 1.5X10MM SCREW CORT SYNT 1.5X11MM SCREW CORT SYNT 1.5X12MM SCREW CORT SYNT 1.5X14MM SCREW CORT SLFTP 2X6MM SCREW CORT SLFTP HEX 2.7X6MM SCREW CORT SLFTP HEX 2.7X8MM STNT WLLFLX RXFULL8.5FR10X60MM STNT WLLFLX RXFULL8.5FR10X80MM BLN GASTRO TB 20FR BUTTON BICEP 2.6X12MM SCREW CORT T8 STARDR 2.7X36MM KNEE BUSHING FEM GMRS STRY GDWIRE DRILL TIP 1.6X150MM SCREW CANN LK FULL 3.7X36MM SCREW CANN LK FULL 3.7X38MM SCREW CANN LK FULL 3.7X40MM SCREW CANN LK FULL 3.7X42MM NAIL FEM ANTERETROGRD TI10X360 GDWIRE THRD AS3 STRY 1.4X150MM EXPAND MAM PMT TEARDROP 600CC NDLE SET EZ-IO LD 15GX45M*CIP* ENDO GATOR*CIP* Page 263 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $309.00 $309.00 $3,667.00 $16,270.00 $4,366.00 $2,172.00 $2,274.00 $1,339.00 $11,054.00 $390.00 $390.00 $531.00 $531.00 $3,096.00 $3,096.00 $3,252.00 $377.00 $790.00 $5,118.00 $162.00 $162.00 $162.00 $162.00 $162.00 $162.00 $162.00 $162.00 $162.00 $170.00 $170.00 $4,099.00 $4,099.00 $203.00 $1,170.00 $184.00 $1,014.00 $197.00 $856.00 $863.00 $863.00 $863.00 $2,827.00 $336.00 $3,786.00 $641.00 $106.00 2020 pricing Drugs&Supplies PROCEDURE NAME SYS FEM APERFIX PEEK 9X29MM SYS TIB APERFIX CANN 9X30MM HIP HD ASPHR MTL 12/14 36MM +5 PLATE DHS STD 135D 5HL 94MM PLATE DHS STD 135D 6HL 110MM PLATE DHS STD 150D 4HL 78MM SCREW CORT T8 STARDR 2.7X38MM HIP HD VERS MTL 12/14 36MM +7 HIP SHELL PNCLE MULT 62MM HIP HD ASPHR MTL 12/14 40MM -2 HIP STEM CORAIL BOW COLAR SZ6 HIP HD ASPHR MTL12/14 44MM+1.5 HIP HD BIOLOX CER ZIMM 36MM +0 SCREW CORT T8 STARDR 2.7X10MM SCREW CANN INTERFER FULL9X20MM KNEE TIB INSRT ZIMM RT MD 6MM PLATE LCP SS 4HL 2.7X40MM HAND DIGIT WIDGIT AGEE SCREW DUALCORE 5X50MM HIP STEM SROM 30 +4L 14X9X150 HIP SLV PROX SROM 14B-SML CATH CHAIT CECOSTOMY 10.2FR 20 KNE STEM TIB BASEPLATE RT SZ4 KNEE FLEX GSM NONPOR RT SZ4 KNEE UL ARTICU RT SZ3/4/5 9MM KNEE PTLA FLEX PROLNG SZ0 8MM DRSG TENDERWET CAVITY 3X8 EYELID IMPLT GLD THIN 1.2GM MESH PERMACOL 20X30CM HIP HD ASPHR MTL12/14 36MM+1.5 HIP HD ASPHR MTL12/14 36MM+8.5 KNEE FEM DIST AUG RT SZ2 4MM HIP STEM CORAIL ST HIGH SZ12 DEV FUSN CAPSTONE PEEK 14X26MM PLATE LCP SS 6HL 2.7X58MM BLADE IMPLT FEM SPIRAL TI 60MM CMNT BONE PALACOS R+GENTAMICIN HIP HD M2A ZIMM MTL 40MM +0 SMARTNAIL CONMED 1.5X20MM SMARTNAIL CONMED 1.5X25MM SCREW LK TI NAIL 4X52MM SCREW LK TI NAIL 4X56MM SCREW LK TI NAIL 4X58MM SCREW LK TI NAIL 4X62MM SCREW LK TI NAIL 4X64MM SCREW LK TI NAIL 4X66MM Page 264 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,247.00 $1,466.00 $2,373.00 $1,566.00 $1,566.00 $1,566.00 $184.00 $1,657.00 $4,762.00 $2,570.00 $4,527.00 $2,373.00 $2,610.00 $184.00 $490.00 $2,216.00 $1,339.00 $3,415.00 $698.00 $3,240.00 $2,205.00 $998.00 $2,412.00 $3,933.00 $2,271.00 $1,973.00 $59.00 $1,091.00 $24,320.00 $2,373.00 $2,373.00 $2,660.00 $4,527.00 $4,853.00 $1,339.00 $1,352.00 $1,176.00 $1,790.00 $920.00 $885.00 $627.00 $627.00 $627.00 $627.00 $627.00 $627.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK TI NAIL 4X68MM SCREW LK TI NAIL 4X70MM SCREW LK TI NAIL 4X72MM SCREW LK TI NAIL 4X74MM SCREW LK TI NAIL 4X76MM SCREW LK TI NAIL 4X78MM SCREW LK TI NAIL 4X80MM RAD HD EVOLVE WRIT 22MM RAD HD STEM WRIT +4 7.5MM SCREW DUALCORE 5X30MM SCREW DUALCORE 5X55MM SCREW DUALCORE 5X35MM SCREW DUALCORE 5X60MM SCREW DUALCORE 5X65MM SCREW DUALCORE 5X70MM SCREW DUALCORE 5X75MM SCREW DUALCORE 5X80MM SCREW DUALCORE 5X85MM SCREW DUALCORE 5X90MM GLIDESCOPE GLV 1 GLIDESCOPE GLV 2 KNEE AXLE GMRS STRY MOLD CMNT KNEE SPACER FEM 70MM SCREW PYRAMID PLUSMDTR6.5X30MM SCREW PYRAMID PLUSMDTR6.5X25MM PLATE HUMR DIST LCP XTR RT 8HL PLATE HUMR DIST LCP XTR RT10HL PLATE COND LCP 2.0MM 7HL PLATE TIB DIST ANTLAT RT 15HL SCREW CORT SLFTP T6 2X6MM HIP CAGE PROTRUSIO LFT 49X52MM HIP HD ASPHR MTL 12/14 40MM +5 HIP HD ASPHR MTL12/14 40MM+8.5 BONE FILLER HYDROSET 3CC ELEV SYS PSTR INTEPR*CIP* KNEE TIB INSRT PS+ 12X63/67MM KNEE FEM SLV UNIV FULLPOR 34MM KNEE TRAY SLV MBT POR 45MM HIP HD ASPHR MTL12/14 40MM+1.5 KNEE FEM ADPTR DEPU NEUT PLATE CLAV ANT LFT 7HL 3.5MM BREAST NATRELLE SIL MID 286CC BREAST HIPRO SIL RD 350CC ANCHOR SWIVELOCK PEEK 5.5MM CLIP EXTL FIX DYNAMIZATION LG COMP EXTL FIX OPEN LG Page 265 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $627.00 $627.00 $627.00 $627.00 $627.00 $627.00 $627.00 $5,122.00 $5,920.00 $698.00 $698.00 $698.00 $698.00 $698.00 $698.00 $698.00 $698.00 $698.00 $698.00 $123.00 $123.00 $2,337.00 $3,565.00 $1,224.00 $1,224.00 $3,065.00 $3,167.00 $2,044.00 $3,238.00 $177.00 $5,193.00 $2,570.00 $2,570.00 $2,225.00 $4,789.00 $2,042.00 $6,509.00 $5,674.00 $2,570.00 $1,208.00 $2,234.00 $2,245.00 $2,312.00 $1,400.00 $390.00 $1,453.00 2020 pricing Drugs&Supplies PROCEDURE NAME ROD EXTL FIX CBN MR 11X100MM PLATE HUMR DIST PSTRLAT LFT3HL COCHLEAR PROCES1 NUCLEUS5 SAND COCHLEAR PROCES2 NUCLEUS5 SAND COCHLEAR PROCES1 NUCLEUS5 BRN COCHLEAR PROCES2 NUCLEUS5 BRN COCHLEAR PROCES1 NUCLEUS5 CHAR COCHLEAR PROCES2 NUCLEUS5 CHAR COCHLEAR PROCES1 NUCLEUS5 WHT COCHLEAR PROCES2 NUCLEUS5 WHT HIP HD ASPHR MTL 12/14 36MM -2 NAIL FEM RECON LAT TILFT12X400 STNT WLLFLX RX 8FR 10X80MM STNT WLLFLX RX 8FR 10X100MM BIT DRILL VARIAX STRY 2.6MM SCREW LK STRY 3.5X30MM SCREW LK STRY 3.5X32MM SCREW LK STRY 3.5X36MM ALLO PTLA BTB HEMIBONE13X10X75 SPIKED WASHER ARTX 18MM SCREW BIOCOMP RD DELTA 9X28MM SCREW BIOCOMP RD DELTA 10X28MM DRSG SINUFOAM STAMMBERGER HIP SHELL PNCLE GRIPTN MULT 60 NDLE BX MAGNUM 18GX20CM BIT DRILL SYNT 4.3X200MM SCREW BIOCOMP RD DELTA 8X28MM BLADE SAG OSCL PREC 5.5X11.5MM BLADE SAG OSCL PREC 9X11.5MM PPM ACCENT DR RF KNEE FEM CMNT CR150 LFT SZ3 KNEE TIB INSRT TC3 4 25MM PLATE ST LCP 2.4MM 5HL 44MM NAIL FEM RECON LAT TI RT10X420 GDWIRE ARTX .086MM HIP STEM SROM 36 11X16X150 KNEE TIB INSRT TC3 SZ3 17.5MM HIP HD C-TAPER LFIT MTL 40MM+5 PLATE T LCP COND SS3/7HL2.4X58 DEV RAD COMP TR *DISC 6273631* CATH RADIAL JACKY CURV5FR100CM ENDO TROCAR BLN 12X100MM KNEE TIB INSRT TC3 4 10MM SCREW CANN LK THRDHEX7.3X105 NAIL FEM RECON LAT TI RT10X380 HIP HD BIOLOX CER ZIMM 32MM +0 Page 266 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $843.00 $2,218.00 $16,377.00 $4,211.00 $16,377.00 $4,211.00 $16,377.00 $4,211.00 $16,377.00 $4,211.00 $2,376.00 $2,762.00 $3,461.00 $3,461.00 $828.00 $754.00 $754.00 $754.00 $5,834.00 $510.00 $1,127.00 $1,127.00 $364.00 $6,444.00 $85.00 $1,247.00 $1,127.00 $173.00 $173.00 $8,189.00 $4,111.00 $4,319.00 $1,308.00 $2,762.00 $84.00 $3,240.00 $5,543.00 $1,466.00 $1,907.00 $258.00 $258.00 $165.00 $4,319.00 $1,040.00 $2,762.00 $2,613.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SHELL TRABEC MULTHL 64MM STNT WLLFLX ESOPH 18MM12.3X9CM BOOT HEEL PREVALON PET PEDS SPEEDSCREW OPUS ARTC BIT DRILL SYNT 1.25X125MM 4MM SCREW MTXMID SYNT SLVR 4MM PLATE CLAV SUPR RT 7HL 3.5MM NAIL FEM RECON LAT TI RT10X400 SCREW LK STRY 3.5X26MM SCREW NL STRY 3.5X34MM NDLE SCORPION MULTFIRE KNEE TIB BASE UNI RM ZIMM SZD KNEE FEM UNI OXFORD ZIMM LG KNEE TIB INSRT ZIMM RT LG 8MM HIP STEM KINECTIV SZ13.5 SCREW TENODESIS PEEK 5.5X12MM KNEE TIB INSRT STBLZIMM12X67MM KNEE STEM FLUTED DEPU 75X16MM PLATE CLAV SUPR RT 6HL 3.5MM NDLE BX PROBE FINESSE14GX105MM HIP LNR ALTRX PE +4 0D 40X56MM HIP LNR ALTRX PE +4 0D 40X58MM KNEE TIB INSRT XLK STBL 4 25MM KNEE TIB INSRT TC3 SZ4 17.5MM STAPLER SEPTAL ENTACT CAGE VERTE-STACK 16X14X6MM CAGE VERTE-STACK 16X14X7MM PLATE CLAV SUPR LFT 8HL 3.5MM BIT DRILL SYNT 5MM NAIL FEM RECON LAT TI RT11X400 SCREW LK TI NAIL STER 4X34MM BREAST HIPRO SMTH RD 380CC BREAST HIPRO SMTH RD 500CC PLATE ADPTN MINI TI 20HL 0.5MM SCREW CORT LEAD DBL 5X26MM SCREW CORT LEAD DBL 5X30MM SCREW CORT LEAD DBL 5X70MM HIP LNR ARCOMXL PE 0D 36X25MM ROD OCCIPITAL STR VERTEX 240MM ROD OCCIPITAL CURVVERTEX 270MM SCREW VERTEX OCCIPITAL4.5X12MM ROD OCCIPITAL ADJ VERTEX 220MM PLATE OCCIPITAL ADJ VERTEX PLATE CLAV SUPR LFT 6HL 3.5MM SET ANCHOR GASTRO SAF-T-PEXY KNEE FEM CMNT CR150 RT SZ5 Page 267 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,326.00 $3,667.00 $295.00 $1,299.00 $513.00 $318.36 $2,234.00 $2,762.00 $754.00 $399.00 $886.00 $3,248.00 $3,444.00 $2,216.00 $4,948.00 $1,068.00 $2,042.00 $3,561.00 $2,289.00 $1,220.00 $2,376.00 $2,376.00 $2,344.00 $5,543.00 $856.00 $2,591.00 $2,591.00 $2,292.00 $1,195.00 $2,762.00 $772.00 $1,545.00 $1,545.00 $1,534.37 $1,067.00 $1,067.00 $1,067.00 $2,123.00 $1,016.00 $1,016.00 $679.00 $1,199.00 $3,100.00 $2,289.00 $222.00 $4,111.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT T8 STARDR 2.7X34MM SCREW CORT T8 STARDR 2.7X42MM SCREW CORT T8 STARDR 2.7X44MM SCREW CORT T8 STARDR 2.7X46MM SCREW CORT T8 STARDR 2.7X48MM SCREW CORT T8 STARDR 2.7X50MM SCREW CORT T8 STARDR 2.7X55MM SCREW CORT T8 STARDR 2.7X60MM GD PIN DRILL TIP ARTX 2.4MM HIP HD EZE TSCER12/14 40MM+1.5 HIP HD EZE TS CER 12/14 40MM+5 KNEE FEM DIST AUG LFT 2.5 4MM STNT LACRIMAL MONOKA MD 3MM INSERTOR DILATOR MONOKA END CAP CORNERSTONE 6X14X11 BLADE IMPLT FEM SPIRAL TI 85MM HIP LNR TRILOGY PE 0D 68X40MM TROC VERSAPORT BLDLES 5MM STNT WLLFLX ESOPHCOV18MM10.3CM STNT WLLFLX ESOPHCOV18MM12.3CM STNT WLLFLX ESOPHCOV23MM10.3CM KNEE TIB WEDGE STEP PFC 4 10MM PLATE DIST RAD 2COL RT 7/3HL SCREW CORT STAR T15 3.5X16MM SCREW CORT STAR T15 3.5X18MM SCREW CORT STAR T15 3.5X22MM BREAST NATRELLE SIL MID 339CC CAUT ARGON LAP PROBE 5MM 36CM SCREW LK VA T8 STAR 2.4X18MM HIP LNR ALTRX PE +4 0D 36X54MM HIP HD EZE TSCER12/14 40MM+8.5 HIP HD EZE TS CER12/14 40MM+12 PPM ACCENT DR SYS INJ RAPID REFILL PLATE CLAV LOPRO LFT 10HL ELBOW RAD HD ANATOM RT 22MM KNEE TIB INSRT PS+ 16X63/67MM HIP SHELL PNCLE GRIPTN MULT 52 HIP LNR ALTRX PE +4 10D40X58MM KNEE TIBINSRT XLK STBL4 22.5MM SCREW CORT SLFTP 4.5X90MM SHLDR GLENO KEEL BIGLIANI 52MM PLATE CLAV LOPRO MD RT 8HL PLATE CLAV NARW ST RT 8HL ANCHOR SUT CRKSCRW 3.5X12MM MARKER FIDUCIAL 20CM 1.2X3MM Page 268 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $184.00 $184.00 $184.00 $184.00 $184.00 $184.00 $184.00 $184.00 $175.00 $4,843.00 $4,843.00 $2,660.00 $1,111.00 $174.00 $2,620.00 $1,352.00 $2,847.00 $306.00 $3,883.00 $3,883.00 $3,883.00 $3,604.00 $2,200.07 $127.00 $127.00 $127.00 $2,245.00 $1,120.00 $604.00 $2,376.00 $4,843.00 $4,843.00 $7,984.00 $127.00 $2,725.00 $6,040.00 $2,432.00 $6,444.00 $2,376.00 $2,344.00 $174.00 $2,570.00 $2,725.00 $2,725.00 $1,021.00 $295.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK SYNT 2X12MM SCREW LK SYNT 2X13MM PLATE HUMR DIST PSTRLAT RT 7HL PLATE ST LCP 5HL 2.0MM PLATE ST LCP 6HL 2.0MM PLATE ST LCP 7HL 2.0MM PLATE LCP SS 5HL 2.7X49MM LOCK DISTRAC SYNT BLN SPRINTER OTW 1.5X6MM BREAST HIPRO SIL RD 280CC BREAST HIPRO SIL RD 300CC BREAST HIPRO SIL RD 325CC BREAST HIPRO SIL RD 400CC BREAST HIPRO SIL RD 550CC BREAST HIPRO SIL RD 700CC HIP HD M2A ZIMM MTL 38MM -3 SUT V-LOC ABSORB 2-0 GS21 12 BONE GRAFT INFUSE XS 1.4CC DEV RAD COMP TR *DISC 6273630* BIT DRILL ACUM 2MM SLV ABSORB 5MM RAD HD STEM WRIT +4 8.5MM HIP PLUG DOME HL ZIMM SCREW LOPRO ARTX TI 3.5X28MM SCREW LOPRO ARTX TI 3.5X32MM TIP EXT DURASEAL 8CM MESH PROCEED 10X15CM HIP HD EZE CER 12/14 36MM +1.5 PLATE DIST RAD NARW RT 2X6HL PLATE CLAV SUPR EXTLFT6HL3.5MM SUT V-LOC ABSORB 2-0 V20 GRN12 HIP HD ZIMM MTL 6D 36MM +0 HIP SHELL PNCLE SECT GRIPTN 58 HIP SHELL PNCLE SECT GRIPTN 52 HIP STEM SROM 36 13X18X160 HIP SLV PROX SROM ZTT 18B-LG PLATE CLAV NARW RT 6HL GDWIRE ARTX 6 GDWIRE ARTX 7 PIN STEINMAN THRD 1/8X2.5 HIP LNR ALTRX PE +4 0D 36X52MM HIP LNR ALTRX PE +4 0D 40X60MM HIP LNR ALTRX PE +4 0D 44X62MM ALLO FEM HEMI COND LAT RT BREAST COHESIVEHIPRO 250CC SCREW CORT T8 STARDR 2.4X6MM Page 269 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $534.00 $534.00 $2,594.00 $1,084.00 $1,084.00 $1,084.00 $1,339.00 $1,946.00 $738.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $1,790.00 $180.00 $3,883.00 $258.00 $646.00 $683.00 $5,920.00 $364.00 $321.00 $321.00 $672.00 $2,083.00 $5,133.00 $2,221.00 $2,289.00 $180.00 $1,657.00 $3,240.00 $3,240.00 $3,240.00 $2,205.00 $2,725.00 $219.00 $219.00 $902.00 $2,376.00 $2,376.00 $2,376.00 $22,416.00 $2,274.00 $269.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK SYNT 2X18MM SCREW LK SYNT 2X20MM SCREW LK SYNT 2X22MM SCREW LK SYNT 2X24MM PLATE HUMR DIST PSTRLAT RT 5HL PLATE ST LCP 8HL 2.0MM PLATE ST LCP 10 HL 2.0MM PLATE ADPTN LCP 2.0MM 12HL PLATE ST LCP 2.4MM 10HL 84MM PLATE ADPTN LCP 2.4MM 12HL PLATE ST LCP 2.7MM 10HL 94MM PLATE LCP SS 8HL 2.4X68MM PLATE L OBLIQ LCPRT3HL2.7X35MM PLATE L OBLIQ LCP LFT3HL2.7X35 PLATE L LCP RT 3HL 2.7X32MM PLATE L LCP LFT 2/3HL 2.7X32MM SCREW CANN ASNIS STRY 3X28MM SCREW CANN ASNIS STRY 3X22MM HIP HD M2A ZIMM MTL 56MM +0 HIP STEM ECHO FX STD 11MM HIP HD CORAIL SLF CTR MTL28X50 KNEE TIB INSRT XLK STBL 4 20MM KNEE FEM CMNT CR150 LFT SZ4 BREAST NATRELLE SIL MID 533CC SCREW BONE STRY 3.5X16MM BIT DRILL STRY 2.6MM KNEE FEM NEX PRECOAT LFT SZE NDLE VAERSA-KATH 12IN KNEE TIB BASE CMNT REV MBT 2.5 KNEE FEM SLV UNIV DISTPOR 40MM BREAST COHESIVEI MODER+225 CATH FOLEY SIMP 24FR 30CC*CIP* PLATE CLAV NARW LG LFT 8HL MTX XENMTX RECTANG 19X28CM SHLDR GLENO VERSADIAL STD TI36 SHLDR GLENO BASE VERSADIAL28MM SCREW FIXED LK ZIMM 4.75X15MM SCREW FIXED LK ZIMM 4.75X25MM PIN STEINMAN ZIMM 3.2X9MM BIT DRILL PERIPH ZIMM 2.7MM BIT DRILL CENT ZIMM 3.2MM SHLDR HUMR BEARING STD 44-36MM HIP HD EZE TS CER 12/14 36MM+5 HIP LNR TRILOGY PE 0D 64X40MM HIP HD VERS MTL12/14 40MM+10.5 TB GJ MIC LOPRO 22FR 3.5 45CM Page 270 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $534.00 $534.00 $534.00 $534.00 $2,461.00 $1,084.00 $1,084.00 $1,342.00 $1,308.00 $1,476.00 $1,339.00 $1,308.00 $1,311.00 $1,311.00 $1,311.00 $1,311.00 $790.00 $790.00 $1,790.00 $2,172.00 $1,822.00 $2,344.00 $4,111.00 $2,312.00 $417.00 $400.00 $3,933.00 $353.00 $10,324.00 $6,509.00 $2,274.00 $127.00 $2,725.00 $24,406.00 $3,127.00 $2,749.00 $641.00 $641.00 $545.00 $679.00 $540.00 $2,426.00 $5,133.00 $2,402.00 $1,735.00 $1,227.00 2020 pricing Drugs&Supplies PROCEDURE NAME BOOT ROOKE HEEL LIFT OSFM BREAST NATRELLE SIL MID 575CC KNEE TIB INSRT STBLZIMM10X71MM HIP STEM CORAIL BOW COLAR SZ15 KNEE FEM DIST AUG LFT SZ2 4MM PLATE TIB PROX LCP 3.5MM 4HL SCREW CANN LK FULL 3.7X10MM SCREW CANN LK FULL 3.7X12MM SCREW CANN LK FULL 3.7X14MM SCREW CANN LK FULL 3.7X16MM SCREW CANN LK FULL 3.7X18MM SCREW CANN LK FULL 3.7X20MM SCREW CANN LK FULL 3.7X22MM SCREW CANN LK FULL 3.7X24MM SCREW CANN LK FULL 3.7X26MM SCREW CANN LK FULL 3.7X28MM SCREW CANN LK FULL 3.7X30MM SCREW CANN LK FULL 3.7X32MM SCREW CANN LK FULL 3.7X34MM SCREW CANN LK FULL 3.7X44MM SCREW CANN LK FULL 3.7X46MM SCREW CANN LK FULL 3.7X48MM SCREW CANN LK FULL 3.7X50MM SCREW CANN LK FULL 3.7X52MM SCREW CANN LK FULL 3.7X54MM SCREW CANN LK FULL 3.7X56MM SCREW CANN LK FULL 3.7X58MM SCREW CANN LK FULL 3.7X60MM SCREW CANN LK FULL 3.7X65MM SCREW CANN LK FULL 3.7X70MM SCREW CANN LK FULL 3.7X75MM SCREW CANN LK FULL 3.7X80MM SCREW CANN LK FULL 3.7X85MM SCREW CANN LK FULL 3.7X90MM SCREW CANN LK FULL 3.7X95MM SCREW CANN CONIC THRD 3.7X6X10 SCREW CANN CONIC THRD 3.7X8X12 SCREW CANN CONIC THRD 3.7X8X14 SCREW CANN CONIC THRD 3.7X8X16 SCREW CANN CONIC THRD 3.7X8X18 SCREW CANN CONIC THRD3.7X15X20 SCREW CANN CONIC THRD3.7X15X22 SCREW CANN CONIC THRD3.7X15X24 SCREW CANN CONIC THRD3.7X15X26 SCREW CANN CONIC THRD3.7X15X28 SCREW CANN CONIC THRD3.7X15X30 Page 271 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $465.00 $2,245.00 $2,042.00 $4,527.00 $2,660.00 $2,325.00 $863.00 $863.00 $883.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $863.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $2,289.00 $767.00 $767.00 $767.00 $767.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN CONIC THRD3.7X25X32 SCREW CANN CONIC THRD3.7X25X34 SCREW CANN CONIC THRD3.7X25X44 SCREW CANN CONIC THRD3.7X25X46 SCREW CANN CONIC THRD3.7X25X48 SCREW CANN CONIC THRD3.7X25X50 SCREW CANN CONIC THRD3.7X25X52 SCREW CANN CONIC THRD3.7X25X54 SCREW CANN CONIC THRD3.7X25X56 SCREW CANN CONIC THRD3.7X25X58 SCREW CANN CONIC THRD3.7X25X60 SCREW CANN CONIC THRD3.7X25X65 SCREW CANN CONIC THRD3.7X25X70 SCREW CANN CONIC THRD3.7X25X75 SCREW CANN CONIC THRD3.7X25X80 SCREW CANN CONIC THRD3.7X25X85 SCREW CANN CONIC THRD3.7X25X90 SCREW CANN CONIC THRD3.7X25X95 ADPTR UROLOK II SHLDR HUMR HD OFF 19X46MM BREAST NATRELLE SIL MID 492CC TVT MONARC SUBFASCIAL HA *CIP* KT INSRT SUTTAK ARTX 2.4MM HIP LNR ALTRX PE +4 10D44X62MM ENDO VERSAPORT W FIX 12MM ANCHOR BIOCOMP CRKSCRW4NDLE5.5 HIP SHELL PNCLE GRIPTN MULT 54 HIP LNR PNCLE PE +4 10D 28X54 KNEE TRAY SLV MBT POR 37MM KNEE TIB INSRT TC3 4 12.5MM KNEE TIB INSRT TC3 SZ5 25MM CATH TAL PALINDROME 55CM SLING MALE ADV SYS AMS KNEE FEM SLV UNIV FULLPOR 31MM KNEE TIB INSRT TC3 SZ3 12.5MM SCREW LK TI NAIL STER 4X38MM PLATE DIST RAD COL LFT 8/4HL PLATE CLAV W EXT RT 3HL 3.5MM PLATE CLAV W EXT LFT 3HL 3.5MM PLATE CLAV W EXT RT 6HL 3.5MM PLATE CLAV W EXT LFT 6HL 3.5MM PLATE CLAV W EXT RT 4HL 3.5MM PLATE CLAV W EXT LFT 4HL 3.5MM PLATE CLAV W EXT RT 5HL 3.5MM PLATE CLAV W EXT LFT 5HL 3.5MM PLATE CLAV W EXT RT 7HL 3.5MM Page 272 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $767.00 $140.00 $2,764.00 $2,245.00 $2,904.00 $949.00 $2,376.00 $636.00 $1,282.00 $6,444.00 $2,172.00 $5,674.00 $4,319.00 $5,543.00 $1,481.00 $11,587.00 $6,509.00 $5,543.00 $772.00 $2,186.00 $2,188.00 $2,188.00 $2,289.00 $2,289.00 $2,225.00 $2,225.00 $2,263.00 $2,263.00 $2,234.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE CLAV W EXT LFT 7HL 3.5MM PLATE CLAV W EXT RT 8HL 3.5MM PLATE CLAV W EXT LFT 8HL 3.5MM PLATE CLAV ANT RT 6HL 3.5MM PLATE CLAV ANT RT 8HL 3.5MM PLATE CLAV ANT LFT 8HL 3.5MM PLATE CLAV SUPR LFT 7HL 3.5MM PLATE CLAV SUPR RT 8HL 3.5MM PLATE CLAV SUPR EXT RT7HL3.5MM PLATE CLAV SUPR EXTLFT7HL3.5MM PLATE CLAV SUPR EXTRT 8HL3.5MM PLATE CLAV SUPR EXTLFT8HL3.5MM SCREW CANN LK THRDHEX7.3X100 SCREW CANN LK THRDHEX7.3X110 SCREW CANN LK THRDHEX7.3X115 SCREW CANN LK THRDHEX7.3X120 SCREW CANN LK THRDHEX7.3X125 SCREW CANN LK THRDHEX7.3X130 SCREW CANN LK THRDHEX7.3X135 SCREW CANN LK THRDHEX7.3X140 SCREW CANN LK THRDHEX7.3X145 SCREW PERIPROSTHETIC 5X8MM SCREW HDLSS SHRT SYNT3X10MM SCREW HDLSS SHRT SYNT3X12MM SCREW HDLSS SHRT SYNT3X14MM SCREW HDLSS SHRT SYNT3X16MM SCREW HDLSS SHRT SYNT3X18MM SCREW HDLSS SHRT SYNT3X20MM SCREW HDLSS SHRT SYNT3X21MM SCREW HDLSS SHRT SYNT3X22MM SCREW HDLSS SHRT SYNT3X23MM SCREW HDLSS SHRT SYNT3X24MM SCREW HDLSS SHRT SYNT3X26MM SCREW HDLSS SHRT SYNT3X27MM SCREW HDLSS SHRT SYNT3X29MM SCREW HDLSS SHRT SYNT3X34MM SCREW HDLSS SHRT SYNT3X36MM SCREW HDLSS SHRT SYNT3X38MM SCREW HDLSS SHRT SYNT3X40MM SCREW HDLSS LNG SYNT 3X16MM SCREW HDLSS LNG SYNT 3X18MM SCREW HDLSS LNG SYNT 3X20MM SCREW HDLSS LNG SYNT 3X22MM SCREW HDLSS LNG SYNT 3X24MM SCREW HDLSS LNG SYNT 3X26MM SCREW HDLSS LNG SYNT 3X28MM Page 273 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,234.00 $2,292.00 $2,292.00 $2,289.00 $2,292.00 $2,292.00 $2,234.00 $2,292.00 $2,234.00 $2,234.00 $2,292.00 $2,292.00 $1,040.00 $1,040.00 $1,040.00 $1,040.00 $1,040.00 $1,040.00 $1,040.00 $1,040.00 $1,040.00 $959.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 $1,141.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW HDLSS LNG SYNT 3X30MM SCREW HDLSS LNG SYNT 3X32MM SCREW HDLSS LNG SYNT 3X34MM SCREW HDLSS LNG SYNT 3X36MM SCREW HDLSS LNG SYNT 3X38MM SCREW HDLSS LNG SYNT 3X40MM BIT DRILL CANN QC SYNT 4.8MM NAIL FEM ANTERETROGRD TI11X300 NAIL FEM ANTERETROGRD TI13X400 SCREW CORT PELVIC 3.5X100MM SCREW CORT PELVIC 3.5X105MM SCREW CORT PELVIC 3.5X110MM SCREW CNCLS PART THRD 4X55MM SCREW CNCLS PART THRD 4X60MM SCREW CNCLS PART THRD 4X65MM SCREW CNCLS PART THRD 4X70MM SCREW CNCLS PART THRD 4X75MM SCREW CNCLS PART THRD 4X80MM SCREW CNCLS PART THRD 4X85MM SCREW CNCLS PART THRD 4X90MM SCREW CNCLS PART THRD 4X95MM SCREW CANN SYNT LNG THRD 4X16 SCREW CANN SYNT LNG THRD 4X18 SCREW CANN SYNT LNG THRD 4X20 SCREW CANN SYNT LNG THRD 4X22 SCREW CANN SYNT LNG THRD 4X24 SCREW CANN SYNT LNG THRD 4X26 SCREW CANN SYNT LNG THRD 4X28 SCREW CANN SYNT LNG THRD 4X30 SCREW CANN SYNT LNG THRD 4X32 SCREW CANN SYNT LNG THRD 4X34 SCREW CANN SYNT LNG THRD 4X36 SCREW CANN SYNT LNG THRD 4X38 WASHER SCREW SPIKED 4-4.5MM WASHER SCREW SPIKED 6.5-7MM PLATE 3.5 LC-DCP 12HL 155MM PLATE COND 16HL 60X267MM PLATE COND 16HL 70X267MM PLATE COND 16HL 80X267MM PLATE H 5HL 28MM PLATE T DIST RAD LCP 4HL2.4X49 PLATE X LK 2.4/2.7MM MD SCREW LAG DHSDCS SYNT 14X140MM PLATE DHS SHRT 150D 4HL 78MM SCREW SCHANZ 4.0 SPADE 60MM SCREW SCHANZ 4.0 SPADE 150MM Page 274 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,141.00 $1,141.00 $1,141.00 $1,142.00 $1,141.00 $1,141.00 $1,265.00 $2,827.00 $2,827.00 $145.00 $145.00 $145.00 $90.00 $90.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $100.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $891.00 $571.00 $559.00 $939.00 $2,322.00 $2,322.00 $2,322.00 $1,067.00 $1,470.00 $1,990.00 $3,127.00 $1,566.00 $291.00 $291.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW SCHANZ 5.0 BLNT TIP150MM SCREW SCHANZ 5.0 BLNT TIP170MM SCREW SCHANZ 4.5 SHRT BLNT 150 SCREW SCHANZ 4.5 SHRT BLNT 200 BIT DRILL QC SYNT 4.5X195MM BIT DRILL QC SYNT 5X200MM BIT DRILL QC SYNT 4.5X170MM COUNTERSINK 3.5-4.0MMCANNSCREW COUNTERSINK 1.5-2MM CORT SCREW TAP CORT SCREW SYNT 1.5MM TAP CORT SCREW SYNT 2MM TAP CORT SCREW SYNT 4.5MM TAP CANN SCREW SYNT 4.5MM TAP CANN SCREW SYNT 4MM TAP CNCLS SCREW SYNT 6.5MM BIT DRILL TRPL REAMER SYNT 8MM TAP DHS DCS SCREW SYNT 12.5MM SCREW CORT TI SLFTP 1.5X20MM SCREW CORT 3.5HD TI 2.4X24MM PIN BTRS TI 1.8X20MM SCREW CNCLS TI FULL THRD 4X14 SCREW CNCLS TI FULL THRD 4X16 SCREW CNCLS TI FULL THRD 4X30 SCREW CNCLS TI FULL THRD 4X35 SCREW CNCLS TI PART THRD 4X45 SCREW CORT TI SLFTP 4.5X32MM SCREW CORT TI SLFTP 4.5X36MM SCREW CORT TI SLFTP 4.5X40MM SCREW CORT TI SLFTP 4.5X44MM SCREW CORT TI SLFTP 4.5X48MM SCREW CORT TI SLFTP 4.5X50MM SCREW CORT TI SLFTP 4.5X52MM PLATE 1/3TUBLR TI COLAR 7HL 85 PLATE VOLAR TI DORSAL RAD RT PLATE VOLAR TI DORSAL RAD LFT PLATE VOLAR TI DIST RAD LFT PLATE COND TI LFT 7HL 1.5MM KWIRE TROC TI 2.0X150MM SCREW HDLSS SHRT SYNT 2.4X20MM SCREW HDLSS LNG SYNT 2.4X20MM SCREW HDLSS LNG SYNT 2.4X22MM SCREW HDLSS LNG SYNT 2.4X24MM SCREW LK TI NAIL 5X52MM BIT DRILL SYNT 2.5X230 205MM KNEE FEM SLV UNIV FULLPOR 46MM HIP LNR XLPE PE 0D 36X54MM Page 275 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $316.00 $365.00 $294.00 $349.00 $98.00 $1,247.00 $1,170.00 $1,208.00 $714.00 $475.00 $475.00 $539.00 $1,478.00 $1,465.00 $1,133.00 $1,445.00 $1,179.00 $243.00 $320.00 $306.00 $95.00 $95.00 $95.00 $95.00 $90.00 $117.00 $117.00 $117.00 $117.00 $117.00 $113.62 $117.00 $402.00 $2,222.00 $2,222.00 $2,016.00 $998.00 $394.00 $1,136.00 $1,136.00 $1,136.00 $1,141.00 $627.00 $705.00 $6,509.00 $2,015.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP HD OXIN MTL 12/14 36MM +0 HIP STEM ANTHOLOGY HIGH SZ9 PLATE TIB MEDL PROX 3.5 RT 6HL BIT DRILL ZIMM 1.1X100MM KNEE TIB INSRT ZIMM LFT MD 3MM KNEE TIB INSRT ZIMM LFT LG 8MM KNEE TIB INSRT ZIMM LFT LG 9MM KNEE TIB INSRT ZIMM RT SM 7MM HIP STEM TAPERLOC STD 7.5X135 HIP STEM TAPERLOC STD 11X142 HIP STEM TAPERLOC STD 12.5X145 KNEE TIB BASE UNI LM ZIMM SZB KNEE TIB BASE UNI LM ZIMM SZD KNEE TIB INSRT ZIMM LFT SM 3MM KNEE TIB INSRT ZIMM LFT MD 5MM KNEE TIB INSRT ZIMM LFT LG 3MM KNEE TIB INSRT ZIMM RT SM 3MM KNEE TIB INSRT ZIMM RT LG 4MM KNEE TIB INSRT ZIMM RT LG 5MM KNEE TIB INSRT ZIMM RT LG 6MM KNEE TIB INSRT STBLZIMM12X71MM BLADE OXFORD ZIMM KNEE TIB INSRT CURV SZ3 20MM HIP STEM TRI-LOCK HIGH SZ2 HIP STEM TRI-LOCK HIGH SZ9 HIP STEM TRI-LOCK HIGH SZ10 HIP STEM TRI-LOCK HIGH SZ11 HIP LNR ULTAMET MTL 28X44MM HIP LNR ULTAMET MTL 28X46MM HIP LNR ALTRX PE +4 0D 32X48MM HIP LNR ALTRX PE +4 0D 32X50MM HIP HD EZE TSCER12/14 28MM+1.5 HIP HD EZE TS CER 12/14 28MM+5 HIP HD EZE TS CER 12/14 32MM+1 SCREW CANN CONIC THRD3.7X25X36 SCREW CANN CONIC THRD3.7X25X38 SCREW CANN CONIC THRD3.7X25X40 HIP LNR TRILOGY PE 10D 70X36MM KNEE FLEX GSM NONPOR LFT SZ3 KNEE FLEX GSM NONPOR RT SZ3 KNEE FLEX GSM NONPOR LFT SZ4 KNEE FLEX GSM NONPOR LFT SZ5 KNEE FLEX GSM NONPOR RT5 KNEE FLEX GSF NONPOR RT SZ1 KNEE FLEX GSF NONPOR LFT SZ2 KNEE FLEX GSF NONPOR RT SZ2 Page 276 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,171.00 $4,161.00 $3,150.00 $227.00 $2,088.00 $2,216.00 $2,216.00 $2,216.00 $4,674.00 $4,674.00 $4,674.00 $3,248.00 $3,248.00 $2,088.00 $2,088.00 $2,216.00 $2,088.00 $2,088.00 $2,216.00 $2,216.00 $2,042.00 $1,047.00 $2,344.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $3,096.00 $3,096.00 $2,376.00 $2,376.00 $3,219.00 $3,219.00 $4,899.00 $767.00 $767.00 $767.00 $2,847.00 $3,933.00 $3,933.00 $3,933.00 $3,933.00 $3,933.00 $3,933.00 $3,933.00 $3,933.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE FLEX GSF NONPOR LFT SZ3 KNEE PTLA FLEX PROLNG SZ2 8MM KNEE PTLA FLEX PROLNG SZ3 8MM KNEE UL ARTICU LFT SZ1/2 9MM KNEE UL ARTICU LFT SZ1/2 11MM KNEE UL ARTICU LFT SZ1/2 13MM KNEE UL ARTICU LFT SZ1/2 16MM KNEE UL ARTICU LFT SZ3/4/5 9MM KNEE UL ARTICU LFT SZ3/4/5 11M KNEE UL ARTICU LFT SZ3/4/5 13M KNEE UL ARTICU LFT SZ3/4/5 16M KNEE UL ARTICU RT SZ00/0 11MM KNEE UL ARTICU RT SZ1/2 9MM KNEE UL ARTICU RT SZ1/2 11MM KNEE UL ARTICU RT SZ1/2 13MM KNEE UL ARTICU RT SZ1/2 16MM KNEE UL ARTICU RT SZ3/4/5 11MM KNEE UL ARTICU RT SZ3/4/5 13MM KNEE UL ARTICU RT SZ3/4/5 16MM WRENCH TORQUE HEX DRIV 2MM KNEE TIB STEMSMTHREV16.5X125MM KNE STEM TIB BASEPLATE LFT SZ1 KNE STEM TIB BASEPLATE LFT SZ2 KNE STEM TIB BASEPLATE LFT SZ3 KNE STEM TIB BASEPLATE LFT SZ4 KNE STEM TIB BASEPLATE RT SZ0 HIP LNR LNGVTY PE 0D LL 40MM ALLO TENDON SEMITENDIN 20-26CM BIT DRILL MDTR 11MM ANCHOR BIOCOMP CRKSCRW 2FBR5.5 GD PIN NIT ARTX 1.1MM ANCHOR SUT MICRO CRKSCRW 2-0 KNEE TIB INSRT TC3 SZ3 15MM FAST FIX ULT ST FAST FIX ULT CURV BIT DRILL ARTX 3.2MM SCREW CANN FULL ARTX 3.75X34MM SCREW CNCLS ARTX 6.5X50MM SCREW CORT ARTX 4.5X46MM SCREW CORT ARTX 4.5X40MM BONEFILL OSFERION 7X3X30X12MM BONEFILL OSFERION 10X3X30X12MM KNEE PTLA 3PEG THIN 25X6.2MM HIP STEM CORAIL ST HIGH SZ9 PLATE ORB RIM MD TI 12HL 0.7MM BIT DRILL STRY 2MM Page 277 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,933.00 $1,973.00 $1,973.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $438.00 $2,962.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $2,847.00 $2,807.00 $1,214.00 $1,243.00 $118.00 $1,066.00 $5,543.00 $1,164.00 $1,170.00 $380.00 $972.00 $441.00 $442.00 $441.00 $1,601.00 $1,602.00 $1,476.00 $4,527.00 $1,212.86 $400.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN CONIC THRD3.7X25X42 NAIL FEM RECON LAT TILFT10X420 SCREW BONE STRY 2.7X14MM KT SHEATH INTR PERC ARROW 6FR KT CATH CENTVEN TL 7FR 30CM KT CATH CENTVEN DL 7FR 20CM BREAST NATRELLE SIL MID 371CC ENDO TROC GELPORT BLN 12X130MM ENDO TROC BLADE ADV 5X100MM ENDO TROC BLDLES ADV 5X100MM ENDO TROC BLDLES FIOS 5X75MM ENDO TROC BLDLES ADV 12X100MM ENDO TROC BLADE Z 5X100MM ENDO TROC BLDLES FIOS 5X100MM HIP SHELL REGENEREX MULT 24X58 HIP HD M2A ZIMM MTL 40MM +6 GRASP SUT IDEAL MITEK 30D GRASP SUT IDEAL MITEK 60D BIT DRILL SYNT 1.5X90MM PLATE MINI TENSION BROAD 2X2HL CATH CHOLANGIO EDWA 4FR 40CM CATH CHOLANGIO EDWA 6FR 40CM PILLCAM SB 2 NDLE ULTRSND ECHOSTIM21GX100MM TB GASTRO MIC BLN 7-10ML 26FR TB LARYN SHILEY SZ10 NDLE BX JAMSHIDI 13GX50MM MATTRESS PORTA-WARM 9.25X16 SCREW CORT LEAD DBL 5X32MM HEMO BIOCUE PLATELET CONC ENDO TROC KII OPTICAL 15X100MM SCREW TENODESIS ARTX *DISC* BB TAK LOPRO SYS ARTX BIT DRILL ARTX 2MM BIT DRILL ARTX 3.5MM SCREW CORT LOPRO ARTX 3.0X14MM SCREW CORT LOPRO ARTX 3.0X16MM SCREW CANN LOPRO ARTX 3.0X18MM BIT DRILL CANN ARTX 2MM SCREW CANN LOPRO ARTX 3.0X22MM SCREW CANN LOPRO ARTX 3.0X26MM SCREW CANN LOPRO ARTX 3.0X28MM SCREW CANN LOPRO ARTX 3.0X30MM SCREW CANN LOPRO ARTX 3.0X32MM SCREW CANN LOPRO ARTX 3.0X36MM SCREW LK LOPRO ARTX 3.0X12MM Page 278 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $767.00 $2,762.00 $417.00 $171.00 $233.00 $166.00 $2,245.00 $165.00 $107.00 $107.00 $107.00 $165.00 $107.00 $107.00 $5,699.00 $1,790.00 $1,118.00 $1,118.00 $551.00 $1,135.33 $214.00 $630.00 $1,545.00 $69.00 $214.00 $253.00 $91.00 $92.00 $1,067.00 $2,940.00 $276.00 $1,271.00 $271.00 $413.00 $413.00 $573.10 $584.00 $604.00 $604.00 $604.00 $604.00 $604.00 $604.00 $604.00 $604.00 $553.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK LOPRO ARTX 3.0X14MM SCREW LK LOPRO ARTX 3.0X16MM SCREW LK LOPRO ARTX 3.0X18MM SCREW LK LOPRO ARTX 3.0X22MM SCREW LK LOPRO ARTX 3.5X28MM SCREW CNCLS ARTX 4X24MM BIT DRILL ARTX 2.2MM PLATE LOPRO MTP CONT SHRT LFT PLATE LOPRO MTP CONT SHRT RT HEMO SEAL COSEAL 4.0ML HIP STEM TAPERLOC 7.55X135MM GDWIRE V18 CTRLWIRE .018 150CM BLN DILATOR CRE WIREGD 6-*CIP* GDWIRE AMPLZ SUPSTIFF ST 7X180 BLN CATH NEPHROMAX 30FR 12CM STNT EXPRESS SD 6X18MM 90CM STONE CONE RETRV COIL 3FR 7MM CATH URETRL OPEN END 6FR 70CM CATH NPHRST MALECOT 24FR GDWIRE JAGWIREHYDRA STIFF450CM CATH BUR SYS ROTALINK 1.25MM CATH BUR SYS ROTALINK 1.50MM CATH BUR SYS ROTALINK 1.75MM ADV ROTABLATOR ROTALINK GDWIRE ROTAWIRE FLOPPY .014 HANDPC ABC BEND-A-BEAM 6IN GDWIRE BENTSON STD 0.038 145CM GDWIRE COONS ST PTFE.038 145CM TRAY CHEST THAL QK 20FR 41CM CATH DRN ULT 18FR 25CM NDLE BX QKCORECOAX20GX20CM20MM NDLE BX QKCORECOAX18GX20CM20MM CATH DRN BILI MACLOC 8.5FR35CM STNT URETRL DBL J 8.5FR 22CM STNT URETRL DBL J 8.5FR 24CM STNT URETRL DBL J 8.5FR 26CM STNT URETRL DBL J 10.2FR 26CM CATH DRN MULTPRP LK 8.5FR 45CM STNT COPE NEPHUROST 8.5FR 22CM CATH VTK 5FR 100CM SHEATH AMPLZ OPQ 30FR 30CM NDLE BX QK CORECOAX18GX9CM20MM STNT COPE NEPHUROST 8.5FR 24CM STNT COPE NEPHUROST 8.5FR 26CM CATH DRN BILI MACLOC 14FR 40CM CATH DIL VAN ANDEL 7FR 63*CIP* Page 279 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $553.00 $553.00 $553.00 $441.00 $441.00 $321.00 $464.00 $2,185.00 $2,185.00 $1,845.00 $4,674.00 $432.00 $1,029.00 $208.00 $1,397.00 $2,172.00 $1,437.00 $365.00 $605.00 $788.00 $2,412.00 $2,412.00 $2,412.00 $953.00 $817.00 $3,522.00 $65.00 $103.00 $774.00 $496.00 $231.00 $231.00 $378.00 $573.00 $573.00 $573.00 $573.00 $423.00 $483.00 $221.00 $141.43 $231.00 $483.00 $483.00 $378.00 $179.00 2020 pricing Drugs&Supplies PROCEDURE NAME GDWIRE HIWIRE STIFFANG.035 180 CATH ACCESS DL FLEX 6-10FR50CM EXTR STONE HEL FILIFORM 3.2FR3 EXTR STONE NCOMPASS 2.4FR 1CM CATH SUPRAPUBIC STAMEYPERC14FR CATH DRN APDL 6.3FR 25CM HIP PLUG CLEARCUT CMNT SZ12 SHLDR SCREW LK 5X14MM SHLDR HUMR INSRT RSP +0 32MM SHLDR GLENOID HD RSP 32MM SHLDR GLENOID BASEPLATE 30MM CATH INFUS CRAGG 5FR 135/30CM SNARE AMPLZ MICRO 7MM 175CM SUT GORETEX CV0 THX26 1/2CIR PPM ALTRUA 60 DR EL*OBS* LASER FBR HOLMIUM 1000 LASER FBR HOLMIUM 270 JM ONLY LASER FBR HOLMIUM*VAT 6249654* DRN T TB RICHARDS 12X9.8MM SOCK STUMP 18IN 8X6 SOCK STUMP 18IN 9X7 PROTECT NEURAWRAP 10MMX4CM(4U) GD NERVE NEURAGEN 3MMX3CM (3U) INTUB LACRIMAL CRAWFORD W/OSUT CAUT ELTD VERSAPOINT ANG LOOP ENDOPATH REDUCER ONSEAL 5*CIP* SHEATH BRITE TIP 6FR 23CM SUT ENDOLOOP VICRYL 0 W VCL NDLE ENDOPATH VERESS 120MM NDLE ENDOPATH VERESS 150MM GDWIRE SV-5 .018 180CM STAPLER PRXMT REG BLU 55MM STAPLE RELOAD ENDOPATH RED45MM PIN CROSS RIGIDFIX TENDON ELTD VAPR THML SIDE EF 3.5MM ELTD VAPR SUCT SHEATH 3.5MM GDWIRE NIT INTRAFIX 1.1MM SUT PASR CHIA PIERCPASSER ANCHOR SPIRALOK DEPU 5.0MM #2 SCREW MILAGRO BR DEPU 9X23MM SCREW MILAGRO BR DEPU 9X30MM GRSPR SUT MITEK 45D TB GJ MIC LOPRO 18FR 2.0 30CM CATH BLADDER SGL SENS 7 *CIP* SHNT CAROTID PRUITT-INAHARA 9 MARKER FIDUCIAL 17GX20 1.2X3MM Page 280 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $191.00 $227.00 $849.00 $1,048.00 $229.00 $370.00 $387.00 $438.00 $2,028.00 $2,591.00 $2,955.00 $488.00 $1,822.00 $144.00 $7,062.00 $2,220.00 $1,245.00 $1,174.00 $109.00 $96.00 $109.00 $4,219.00 $3,502.00 $449.00 $1,389.00 $374.00 $184.00 $680.00 $263.00 $272.00 $415.00 $1,177.00 $1,552.00 $1,355.00 $964.00 $380.00 $254.00 $757.00 $1,513.00 $1,537.00 $1,537.00 $1,118.00 $1,227.00 $186.00 $2,021.00 $526.00 2020 pricing Drugs&Supplies PROCEDURE NAME STYLET LEAD ST EXT BALL 52CM STYLET LEAD ST EXT BALL 58CM STYLET LEAD J EXT .014 45CM CATH PASR 8709 8709SC 38CM TRAY 1ST FRAC 1STEPXPANDER15/3 DRN VENTRIC EDMS BECKER BONE GRAFT INFUSE XXS 0.7CC SCREW ZEPHIR SLFTP 3.5X13MM PKNG NASAL MEROCEL STD 8CM ALLO CNCLS CHIP 1.7-10MM 15CC ALLO CNCLS CHIP 1.7-10MM 30CC ALLO TENDON ACHILLESCALC19.5CM ALLO TENDON ANT TIB20CMX6-12MM ALLO TENDON PSTR TIB 22-38CM CATH CHOLANGIO KUMAR 16G 76CM SNARE SOFT LG 25MM ENDO TROC SLV SEP 8MM STAPLER EEA 4.8MM 31MM STAPLE RELOAD TA 30 3.5MM COLAR CERV ADLT SM 3.25 DRSG AQUACEL AG XTRA 8X12 SUT PROLENE 5-0 RB2/RB2 24 SUT CHROMIC GUT 0 BP1 MESH PROLENE PMH 6X6 SUT RETENTION BOLSTER SUT ETHILON 2 LR/LR 30 SUT SILK 2-0 KS 30 SUT CHROMIC GUT 4-0 FS2 SUT ETHILON 5-0 FS2 18 SUT ETHILON 4-0 FS2 18 SUT ETHILON 5-0 P3 18 UNDY SUT ETHILON 4-0 P3 18 UNDY MESH VICRYL 12X12 SUT PLAIN GUT 3-0 PS2 18 SUT CHROMIC GUT 5-0 PS3 18 SUT CHROMIC GUT 4-0 PS4 18 SUT ETHILON 5-0 PS2 18 SUT ETHILON 4-0 PS2 18 SUT ETHILON 3-0 FSLX 30 SUT ETHILON 2-0 FSLX 30 SUT ETHILON 8-0 TG1758/TG1758 SUT CHROMIC GUT 5-0 S14/S14 SUT PLAIN GUT 4-0 SC1 18 SUT PROLENE 0 CT2 18 SUT PROLENE 2-0 CT1 30 SUT PROLENE 0 CT1 18 Page 281 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $118.00 $118.00 $118.00 $499.00 $7,359.00 $950.00 $2,476.00 $725.00 $97.00 $924.00 $1,162.00 $3,479.00 $3,462.00 $3,262.00 $630.00 $61.00 $107.00 $1,110.00 $206.00 $65.00 $143.00 $27.00 $57.00 $146.00 $11.00 $18.00 $7.00 $16.00 $9.00 $8.00 $19.00 $19.00 $3,029.00 $32.00 $32.00 $32.00 $19.00 $18.00 $9.00 $9.00 $63.00 $89.00 $17.00 $13.00 $13.00 $13.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT PROLENE 1 CT1 30 SUT PROLENE 4-0 SH/SH 36 SUT PROLENE 3-0 SH/SH 36 SUT PROLENE 5-0 RB1/RB1 36 SUT PROLENE 4-0 RB1/RB1 36 SUT PROLENE 2-0 TS/TS 14 SUT PROLENE 4-0 BB/BB 36 SUT PROLENE 6-0 PS3 18 SUT PROLENE 5-0 PS3 18 SUT PROLENE 3-0 PS2 18 SUT PROLENE 6-0 P1 18 SUT PROLENE 4-0 P3 18 SUT PROLENE 6-0 RB2/RB2 30 SUT PROLENE 7-0 BV1756/BV1756 SUT PROLENE 6-0 CC/CC 18 SUT PROLENE 2 TP1 60 SUT PROLENE 2-0 SH 30 SUT PROLENE 5-0 BV1/BV1 HS 18 SUT SILK TIE 4-0 12-30 SUT SILK TIE 3-0 12-30 SUT SILK TIE 2-0 12-30 SUT SILK TIE 0 6-30 SUT SILK 2-0 SH CR8-18 SUT SILK 3-0 SH CR8-18 SUT SILK 4-0 SH CR8-18 SUT ETHIBOND 0 CT1 CR8-18 SUT ETHIBOND 0 M06 CR8-18 SUT VICRYL 3-0 SH1 UNDY SUT VICRYL 0 CT2 18 UNDY SUT VICRYL 0 CT3 DYE SUT VICRYL 3-0 FS2 18 UNDY SUT VICRYL 3-0 CT1/CP1 54 DYE SUT VICRYL 7-0 TG1408 18 DYE SUT VICRYL8-0 TG1408/TG1408DYE SUT VICRYL 6-0 S24/S24 12 DYE SUT VICRYL 6-0 S14/S14 18 DYE SUT VICRYL 0 STD/SHRT 18 UNDY SUT VICRYL 6-0 S14/S14 18 UNDY SUT VICRYL 3-0 CR8-18 UNDY SUT VICRYL 0 CP2 18 UNDY SUT VICRYL 3-0 PS1 UNDY SUT SILK 3-0 SH 30 SUT SILK 2-0 SH 30 SUT SILK 4-0 RB1 30 SUT PLAIN GUT 0 STD/SHRT 54 SUT CHROMIC GUT 0 STD/SHRT 54 Page 282 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $13.00 $27.00 $27.00 $27.00 $27.00 $30.00 $30.00 $25.00 $23.00 $23.00 $25.00 $23.00 $27.00 $131.00 $70.00 $22.00 $14.00 $96.00 $15.00 $14.00 $14.00 $6.00 $43.00 $43.00 $43.00 $56.00 $73.00 $9.00 $8.00 $8.00 $13.00 $18.00 $77.00 $76.00 $65.00 $62.00 $9.00 $61.00 $56.00 $9.00 $20.00 $7.00 $7.00 $8.00 $16.00 $16.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT ETHIBOND TIE 2-0 12-30 SUT ETHIBOND 1 CT1 30 SUT ETHIBOND 2 OS4 30 SUT ETHIBOND 1 OS6 30 SUT ETHIBOND 0 SH 18 SUT ETHIBOND 0 CTX 30 SUT MONOCRYL 4-0 PS2 UNDY SUT MONOCRYL 4-0 P3 18 UNDY SUT PDS II 3-0 RB1 DYE SUT PDS II 4-0 P3 18 UNDY CATH MAHURK ST 11.5FR 16CM TB TRACH PERC DISP CANN 6 TB ET CUFF REINF MURPHY 8.0MM TB TRACH PERC DISP CANN 8 TB ENDOBRONCH SHILEY LFT 35FR TB ENDOBRONCH SHILEY LFT 37FR TB ENDOBRONCH SHILEY LFT 39FR TB ENDOBRONCH SHILEY RT 35FR TB ENDOBRONCH SHILEY RT 37FR TB ENDOBRONCH SHILEY RT 39FR PILLOW ABDUCTION HIP SM CMNT MIXEVAC II 3BONE SUCT IRG STRYKEFLOW2 W DISPTIP GEL DEFLUX INJ Q-MED DRAPE URO CATCHER STER POUC SCREW SURETAK II W SPIKES 8X16 BLADE SHAVER SYNO CURV SUT RETRIEVER HEWSON SET GENESIS PIN AND DRILL HIP SCREW CNCLS RFLCT 25MM KNEE TIB GENESIS II CMNTLFTSZ3 KNEE TIB GENESIS II CMNTLFTSZ4 KNEE TIB GENESIS IICMNT LFTSZ5 KNEE TIB GENESIS II CMNTLFTSZ6 KNEE TIB GENESIS IICMNT RT SZ3 KNEE TIB GENESIS II CMNT RTSZ4 KNEE TIB GENESIS IICMNT RT SZ5 KNEE TIB GENESIS II CMNT RTSZ6 KNEE TIB GENESISII CMNT RT SZ7 KNEE PTLA GSII W PEG 29MM KNEE PTLA GSII W PEG 32MM KNEE PTLA GSII W PEG 35MM KNEE PTLA GSII W PEG 26MM KNEE PTLA COMP S&N 38MM NOZZLE CMNT HUMR SAW BLADE LG BAT RECIP HVY Page 283 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $16.00 $9.00 $13.00 $14.00 $12.06 $9.00 $25.00 $25.00 $14.00 $22.00 $586.00 $236.00 $107.00 $236.00 $276.00 $276.00 $276.00 $319.00 $319.00 $319.00 $103.00 $245.00 $275.00 $4,110.00 $71.00 $1,215.00 $284.00 $616.00 $809.00 $684.95 $2,059.00 $2,059.00 $2,059.00 $2,055.00 $2,059.00 $2,055.00 $2,055.00 $2,259.00 $2,059.00 $1,111.00 $1,111.00 $1,111.00 $1,204.00 $1,111.00 $77.00 $193.00 2020 pricing Drugs&Supplies PROCEDURE NAME BUR EGG 6.0MM BIT DRILL WIRE PASS 1.1MM BLADE SAG NO OFF12.5X1.19X81.5 SAW BLADE LG BAT STRY ZM BUR FLUTED LNG 4MM BUR ACORN LNG 6.0MM STRY NAVIGATION INST BLADE SAG OSCL AGGR 9X31MM PLATE CALC MESH STRY MD SCREW NL STRY 3.5X36MM GLIDESCOPE GVL STAT3 CATH CLSR FAST 7FR 7X60CM TB JEJ PEG24 12FR 66CM SKIN GRAFT DERMACARRIER 1.5-1 SKIN GRAFT DERMACARRIER 3-1 SCREW LK MTXMAND TI 2.4X12MM SCREW LK MTXMAND TI 2.4X14MM PLATE CRST BROAD 3X3HL 2.0MM SCREW CORT ACUM 3.5X10MM SCREW LK SYNT 2.7X8MM PLATE CLAV NARW LG RT 8HL SCREW MTXMID SYNT SLVR 6MM PLATE L MD TI RT 2X3HL 0.7MM LASER FBR VERSIVA 550 LASER FBR VERSIVA 1000 BREAST HIPRO SMTH RD 460CC LIGACLIP MD 20CLIPS PLUG BIO-A FISTULA*DISC* SLV SCD FT EXPRESS LG SLV SCD FT EXPRESS REG BLADE DEPU STABLE CUT SCREW LAG OMEGA+ STRY 90MM TROC ENDOPATH BLDLES 5X100MM SUT CHROMIC GUT 2-0 SH SCREW TENODESIS PEEK 7X10MM INSERTOR BICEP BUTTON ARTX KNEE TIB INSRT XLK STBL 5 20MM SCREW HEX CLAW WRIT 3.5X22MM DRSG AQUACEL AG SURG COV3.5X10 CATH COUDE SIL 2WAY 16FR*CIP* NDLE BLOCK B BEVEL 23GX1.5 SUT VICRYL 1 CT2 DYE SUT PROLENE P3 18 PROBE ABL COOLCUT 90 ASPIR ANCHOR SUT CRKSCRWII NDLE 5.5 TB ENDOSCRUB 2 Page 284 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $276.00 $284.00 $154.00 $239.00 $460.00 $460.00 $154.00 $173.00 $2,088.00 $399.00 $95.00 $2,219.00 $488.00 $192.00 $192.00 $522.00 $522.00 $1,601.00 $438.00 $547.00 $2,725.00 $329.08 $964.00 $1,483.07 $2,141.17 $1,545.00 $817.00 $2,322.00 $107.00 $107.00 $642.00 $1,099.00 $716.00 $16.00 $1,178.00 $695.00 $2,344.00 $1,255.00 $170.00 $125.00 $65.00 $9.00 $25.00 $902.00 $1,224.00 $251.00 2020 pricing Drugs&Supplies PROCEDURE NAME FORCEPS ILM REVOLUTION 23G BIT DRILL QC 1.1X60MM SCREW FIXED MDTR 4X18MM PLATE DHS STD 150D 6HL 110MM PLATE CLAV ANT LFT 6HL 3.5MM PLATE CLAV SUPR EXT RT6HL3.5MM BIT DRILL ACUM 2.8MM GDWIRE SS ACUM 0.62X6 KNEE TIB INSRT STD 16X63/67MM KNEE FEM DIST AUG RT SZ4 8MM BLADE RECIP DBL SIDE 2.76X70MM PLATE BX TI 4HL 5X10X0.5MM PLATE X MINI TI SYNT 4HL 0.5MM CAGE VERTE-STACK 14X11X12MM KNEE TIB STEM REV ZIMM 22X80MM GD DRILL BAHA WIDENING DISP3MM COCHLEAR BAHA BIA300 3MM COCHLEAR BAHA BIA300 4MM CAP HEALING BAHA BP100 30MM PROCESSOR BAHA *DISC* SINUS ILLUM SYS LUMAB ALLO AMNIOGUARD 1.0X0.75CM HIP LNR TRILOGY PE 10D 56X32MM STNT EXPRESS SD 5X19MM 90CM KNEE STEM FLUTED DEPU 75X12MM KNEE STEM FLUTED DEPU 75X14MM KNEE TIB INSRT TC3 SZ4 22.5MM SCREW TI TFN NAIL 11X95MM BREAST HIPRO SALINE 750CC PLATE CLAV NARW LFT 6HL HIP HD BIOLOX CER STRY 40MM -0 LEAD TENDRIL ACTIVE FIX 52CM LEAD TENDRIL STS IS1 46CM LEAD TENDRIL STS IS1 52CM LEAD TENDRIL STS IS1 58CM STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2*DISC* Page 285 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $695.00 $293.00 $855.00 $1,566.00 $2,289.00 $2,289.00 $738.00 $89.00 $2,432.00 $2,718.00 $185.00 $1,011.00 $1,011.00 $2,216.56 $3,178.00 $867.00 $4,510.00 $4,510.00 $75.00 $2,799.00 $1,521.00 $1,026.00 $2,890.00 $2,172.00 $3,561.00 $3,561.00 $5,543.00 $1,327.00 $1,591.00 $2,725.00 $2,627.00 $1,652.00 $1,740.00 $1,740.00 $1,740.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 2020 pricing Drugs&Supplies PROCEDURE NAME STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2 *DISC* STNT TAXUS EXPRESS2*DISC* KT STYLET WHT 53CM STYLET LEAD ST BALL .014 52CM STYLET LEAD J EXT BALL 45CM KT STYLET BALL TIP EXT PUR 58 KT STYLET BALL TIP EXT PUR 65 PPM ALTRUA 60 DR*OBS* DEV SUTLASSO W WIRE LOOP 90D ANCHOR SUT CRKSCRW 3.5X10MM NAIL LABRAL CONT CONM 3.5X2 SUT VICRYL 5-0 P1 18 UNDY SUT ETHIBOND 4-0 PS2 18 WHT SUT CHROMIC GUT 5-0 FS2 SUT PROLENE 2-0 FSLX 30 SUT PDS II 2-0 CT1 DYE SUT SILK 2-0 FS 18 KNEE FEM SROM XS RT 66X58MM HIP STEM ANTHOLOGY STD SZ5 DRSG MEPILEX FM AG 8X8 STAPLE RELOAD PRXMT BLU 55MM TB VENT ST SHANK NDLE INJ 25GX5MM SUT PDS II 0 CT2 DYE MESH PROCEED 6X8CM END CAP 12MM TI EXT GRN 0MM END CAP 12MM TI EXT GRN 10MM END CAP 12MM TI EXT GRN 20MM BLADE SPIRAL HUMR NAIL TI 52MM SCREW LK TI NAIL 4X18MM SCREW LK TI NAIL 4X20MM SCREW MICRO ASNIS 3X38X8MM UTERINE MANIPULATOR V- *CIP* Page 286 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $118.00 $118.00 $118.00 $118.00 $118.00 $7,062.00 $655.00 $1,068.00 $1,257.00 $20.00 $19.00 $17.00 $14.00 $13.00 $8.00 $13,583.00 $4,161.00 $148.00 $859.00 $104.00 $154.00 $14.00 $3,035.00 $655.00 $655.00 $655.00 $1,424.00 $627.00 $627.00 $790.00 $462.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT TC3 SZ4 12.5MM SCREW CNCLS ARTX 6.5X60MM BONEFILL OSFERION 15X3X35X12MM SCREW CORT ARTX 4.5X42MM PLATE HTO ST WEDGE LFT 15MM KNEE TIB INSRT TC3 SZ3 20MM PLATE CLAV LOPRO ST RT 8HL HIP LNR ALTRX PE +4 10D40X56MM KNEE TIB INSRT TC3 SZ5 15MM STAPLE RELOAD ENDOPATH ETS45 PLATE VENTURE MDTR 25MM BREAST MODER SALINE 360CC BAR EXTL FIX CONN SS SM4X120MM BAR EXTL FIX CONN SS SM4X160MM BAR EXTL FIX CONN SS SM4X180MM BAR EXTL FIX CONN SS SM4X200MM HIP HD CORAIL SLF CTR MTL28X43 SLV LAT TRAC ARM ALLO DBM PUTTY DBX MTF 1ML SCREW VA LK T8 STAR 2.7X12MM SCREW VA LK T8 STAR 2.7X14MM SCREW VA LK T8 STAR 2.7X16MM SCREW VA LK T8 STAR 2.7X22MM BREAST HIPRO SALINE 350CC KNEE TIB INSRT TC3 SZ4 10MM SUT VICRYL 8-0 BV1304 5 DYE AIRW SUPRAGLOTTIC LTS-D SZ3 AIRW SUPRAGLOTTIC LTS-*CIP* DRSG MEPILEX BORD AG 4X8 SCREW MTXMID SYNT BLU 4MM PLATE ORB RIM MTXMID 12HL 0.5 PLATE Y MINI TI SYNT 3HL 0.5MM PLATE STRUT MD TI 18HL 0.7MM PLATE L MINI TI LFT2X3HL0.5MM PLATE L MINI TI RT2X3HL0.5MM PLATE L MD TI LFT 3X4HL 0.7MM PLATE L MINI TI RT3X4HL0.5MM PLATE L MD TI RT 3X4HL 0.7MM PLATE L MINI TI RT 4X6HL 0.5MM PLATE H MINI TI 11HL 0.5MM FEE RENT CLINITRON RITE HITE HIP LNR ALTRX PE +4 0D 44X64MM HIP HD ASPHR MTL 12/14 44MM +5 GDWIRE JAGWIRE STIFF.025 260CM ANCHOR SUT MINI CRKSCRW2.7X7MM DERMIS DECEL 1.5MM 4X7CM=28SQ Page 287 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,543.00 $441.00 $1,583.00 $441.00 $2,486.00 $5,543.00 $2,725.00 $2,376.00 $5,543.00 $1,180.00 $2,315.00 $1,591.00 $120.00 $158.00 $158.00 $158.00 $1,822.00 $276.00 $755.00 $631.00 $631.00 $631.00 $631.00 $1,591.00 $5,543.00 $82.00 $80.00 $80.00 $112.00 $317.97 $1,212.86 $992.01 $1,461.40 $964.00 $964.00 $1,017.79 $1,017.79 $1,039.00 $1,053.50 $992.34 $438.00 $2,376.00 $2,373.00 $488.00 $1,066.00 $4,742.00 2020 pricing Drugs&Supplies PROCEDURE NAME MTX MESH BILYR 4X5IN=130SQCM PLATE CLAV LOPRO LG RT 8HL SCREW VA LK T8 STAR 2.7X28MM SCREW VA LK T8 STAR 2.7X30MM SCREW VA LK T8 STAR 2.7X34MM SCREW HDLSS COMP T8 TI 3X30MM HIP SHELL TRABEC MULTHL 50MM SCREW VA LK T8 STAR 2.7X20MM SCREW VA LK T8 STAR 2.7X24MM SCREW LK TI NAIL 5X62MM SCREW LK TI NAIL 5X66MM SCREW LK TI NAIL 5X68MM SCREW LK TI NAIL 5X72MM SCREW LK TI NAIL 5X74MM SCREW LK TI NAIL 5X76MM SCREW LK TI NAIL 5X78MM SCREW LK TI NAIL 5X80MM SCREW DUALCORE 5X45MM END CAP TI T40 EXT 5MM SCREW LK STRY 3.5X12MM GD NERVE NEURAGEN 2MMX3CM (3U) SCREW POST BI CORT 4.5X30MM SCREW CORT ARTX 4.5X44MM BIT DRILL OK ZIMM 4MM KNEE FEM ILOK ZIMM RT 55.0MM HIP SLV TI MODULAR 12/14 +8 STNT PALMAZ BL 5X15 80CM ALLO AMNIOGRAFT 2.0X1.5CM TB GJ MIC ENDO 18FR 30CM BREAST NATRELLE SIL MID 213CC SCREW CANN THRD18 ARTX6.7X55MM SCREW CANN THRD18 ARTX6.7X60MM SCREW CANN THRD18 ARTX6.7X70MM SCREW CANN THRD28 ARTX6.7X70MM BIT DRILL ARTX 4MM GDWIRE NTHRD W TROC ARTX 2.4MM HIP HD M2A ZIMM MTL 38MM +0 KNEE TIBINSRT XLK STBL2.5 20MM SCREW TI TFN NAIL 11X100MM SUT MONOCRYL 2-0 CT1 DYE SUT ETHILON 2-0 KS 30 SUT PROLENE 5-0 FS2 18 SUT SILK TIE 2-0 10-30 SUT VICRYL+ 2-0 CT2 UNDY SUT VICRYL+ 3-0 CT2 UNDY SUT VICRYL+ 4-0 PS2 18 UNDY Page 288 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $7,716.00 $2,725.00 $631.00 $631.00 $631.00 $1,141.00 $4,379.00 $631.00 $631.00 $627.00 $627.00 $627.00 $1,133.00 $627.00 $627.00 $627.00 $627.00 $698.00 $734.00 $785.00 $3,502.00 $3,329.00 $441.00 $738.00 $4,005.00 $1,190.00 $2,538.00 $1,883.00 $1,078.00 $2,245.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $746.00 $84.00 $1,790.00 $2,344.00 $1,340.00 $11.00 $8.00 $14.00 $12.00 $9.00 $9.00 $21.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT GORETEX CV2 THX36 1/2CIR KNEE TIB INSRT TC3 4 17.5MM HIP STEM VERS 6BEAD FC STDSZ14 KNEE TIB INSRT TC3 SZ4 20MM SCREW ANT CERV REGENT 4X14MM SCREW HEX CLAW WRIT 3.5X20MM SCREW HEX CLAW WRIT 3.5X24MM TIGHTROPE ACL RT TI FLIPCUTTER II ARTX 7MM SUT ETHILON 2-0 PS 18 LEAD CAPSUREFIX MRI 58CM UTERINE MANIPULATOR V-CAR*CIP* DRSG WOUND MTX 2X2IN=26SQCM SCREW CORT DVRA ZIMM 3.5X20MM PEG PART THRD ZIMM 2.5X30MM FLIPCUTTER II ARTX 8MM SUT PK PARS ARTX #2 SCREW CNCLS SYNT 6.5X16X115MM SCREW CNCLS SYNT 6.5X16X120MM SCREW CNCLS SYNT 6.5X32X120MM BREAST MODER+SALINE 325+65 TENDON SEMI TENDINOSUS 4X230MM HIP HD CATHCART UNIPOLR MTL 47 HIP SPACER TAPER DEPU12 14 -3 SCREW CANN ARTX 4.5X50MM STNT ADVANIX DUODEN RX10FR7CM TRAY CHEST THAL QK 16FR 41CM STNT WLLFLX RXPART8.5FR10X60MM INTR PERFORMER RADPQ 14FR 30CM STAPLE RELOAD GIA VASC TAN45MM STAPLE ENDO VASC *CIP* STAPLE ENDO MDTHK PUR 45 STAPLE ENDO XTHK *CIP* SHAVER PLUS 4.0*C*USE 6250888* DRSG MEPILEX LITE 8X20 FLIPCUTTER II ARTX 9.0MM BIT DRILL SYNT 3.2X230MM SET NDLE WINGED TUOHY 17GA RETR ALEXIS O C-SECTION LG PLATE ATLANTIS VISION 19MM SCREW ATLANTIS SLFTP FIX4X13MM SCREW ATLANTIS SLFTP VAR4X13MM FLIPCUTTER II ARTX 7.5MM FLIPCUTTER II ARTX 8.5MM FLIPCUTTER II ARTX 9.5MM FLIPCUTTER II ARTX 10MM Page 289 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $144.00 $4,319.00 $5,589.00 $5,543.00 $855.00 $1,255.00 $1,255.00 $1,263.00 $1,173.00 $19.00 $1,874.00 $629.00 $4,248.00 $538.52 $561.00 $1,173.00 $1,699.00 $232.00 $232.00 $232.00 $1,545.00 $3,385.00 $1,545.00 $641.00 $860.00 $679.00 $709.00 $3,883.00 $489.00 $875.00 $1,031.00 $907.00 $1,041.00 $1,068.00 $99.00 $1,243.00 $842.00 $88.00 $354.00 $2,315.00 $855.00 $855.00 $1,173.00 $1,173.00 $1,173.00 $1,243.00 2020 pricing Drugs&Supplies PROCEDURE NAME FLIPCUTTER II ARTX 11MM GRAFTBOLT TIB ARTX 9MM HIP HD SROM MTL 11/13 32MM +9 HIP LNR ALTRX PE +4 10D32X50MM BIT DRILL SM FRAGMENT 4.0MM BREAST COHESIVEI MODER+350 RSVR PENILE CONCEAL AMS 100ML SCREW CNCLS ARTX 6.5X45MM PLATE FEM MEDL DIST TI LFT 4HL PLATE ATLANTIS VISION 40MM SCREW ATLANTIS SLFTP FIX4X14MM SCREW ATLANTIS SLFTP VAR4X14MM SCREW ATLANTIS SLFTP VAR4X15MM PLATE ATLANTIS VISION 42.5MM SCREW ATLANTIS SLFTP FIX4X15MM PLATE CLAV LAT ANT 9HL 2.7/3.6 KNEE TIB CONE FULL XS 48-15MM PLATE ATLANTIS VISION 21MM MOLD CMNT HIP SPACER STEM9X125 NAIL FEM RECON LAT TILFT11X360 DRSG AQUACEL AG SURG COV3.5X14 SCREW LK TI SYNT 6X45MM SCREW LK TI SYNT 6X55MM SCREW LK TI SYNT 6X95MM SCREW LK TI SYNT 6X100MM END CAP TI DIST FEM NAIL NDLE ASPIR STERNAL 16GX1-7/8 SCREW TI TFN NAIL 11X90MM KNEE TIB INSRT TC3 SZ5 20MM MARKER BREAST ULTRACOR SS 14G INST DISP CARPALTUNNEL RELEASE ENDOL ENDURANT 28X13X166MM ENDOL ENDURANT 32X16X145MM ENDOL ENDUR II 16X16X93MM ENDOL ENDUR II 16X20X93MM ENDOL ILIAC EXTNDR 24X24X82MM LIGASURE ADV PISTOL 44CM BLADE OSTEO ARTX LATERJET BIT DRILL CANN ARTX 2.75MM BIT DRILL ARTX 4MM SCREW CANN FULL ARTX 3.75X36MM SUT ETHIBOND 0 CT2 18 BREAST COHESIVEI MODER+400 BREAST COHESIVEI MODER+375 BREAST MODER+SALINE 275+55 BREAST MODER+SALINE 300+60 Page 290 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,388.00 $1,384.00 $1,419.00 $2,376.00 $851.00 $2,274.00 $4,501.00 $442.00 $2,827.00 $2,368.00 $1,447.00 $1,447.00 $855.00 $2,368.00 $855.00 $2,292.00 $10,371.00 $2,315.00 $3,060.00 $2,762.00 $189.00 $677.00 $677.00 $677.00 $677.00 $683.00 $60.00 $1,360.00 $5,543.00 $381.00 $972.00 $18,378.00 $18,398.00 $8,576.00 $9,084.00 $9,074.00 $1,958.00 $631.00 $1,263.00 $579.00 $972.00 $9.00 $2,274.00 $2,274.00 $1,545.00 $1,545.00 2020 pricing Drugs&Supplies PROCEDURE NAME BREAST MODER+SALINE 350+70 BREAST MODER+SALINE 375+75 BREAST MODER+SALINE 400+80 EXPAND MAM CPX2 6100 LO*DISC* STNT WLLFLX ESOPH 23MM10.3X7CM SHEATH COVERLOC TIB SCREW BONE STABILIS 4.5X36 SCREW BONE STABILIS 4.5X38 SCREW BONE STABILIS 4.5X40 SCREW BONE STABILIS 4.5X50 HIP LNR ALTRX PE 0D 32X50MM HIP STEM COXAVARA HIGH SZ10 ENDO TROC FIOS ZTHRD 12X100MM HIP HD CATHCART UNIPOLR MTL 46 SCREW CORT STAR T15 3.5X38MM SCREW CORT STAR T15 3.5X40MM KT STYLET BALL TIP EXT PUR 52 STYLET LEAD J WIDE SOFT 60CM TRACKER PT AXIEM ENT MDTR TRACKER INST AXIEM ENT MDTR BLADE RAD 40 M4 CURV 4MMX11CM BLADE RAD 60 M4 CURV 4MMX11CM BLADE RAD 90 M4 CURV3.5MMX11CM BLADE RAD 40 M4 CURV3.5MMX11CM BLADE QUADCUT 4.3MMX13CM BLADE TURBINATE M4 2MMX11CM BLADE RAD 40 M4 CURV 4MMX11CM HIP LNR ALTRX PE 0D 36X52MM HIP LNR ALTRX PE 0D 36X54MM NIM PROBE BALL TIP 23CM STNT XIENCE RX NANO 2.25X8 STNT XIENCE RX NANO 2.25X12 STNT XIENCE RX NANO 2.25X15 STNT XIENCE RX NANO 2.25X18 STNT XIENCE RX NANO 2.25X23 STNT XIENCE RX NANO 2.25X28 NDLE VERTEBROPLASTY 11G HIP HD CORAIL SLF CTR MTL28X42 BREAST COHESIVEHIPRO 300CC SCREW VERTEX OCCIPITAL4.5X14MM BIT DRILL CERV MDTR 2.4MM PUNCH CRKSCRW SWIVELKDISP5.5MM SUT ETHILON 5-0 PS3 18 GDWIRE AMPLZ SUPSTIFF FLEX 145 STAPLER ENDO ETS *USE 6187502* SUCT TB INTERPULSE SFT TISS Page 291 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,545.00 $1,545.00 $1,545.00 $3,159.00 $3,667.00 $834.00 $561.00 $561.00 $561.00 $561.00 $2,376.00 $4,527.00 $165.00 $1,545.00 $127.00 $127.00 $118.00 $284.00 $925.00 $740.00 $881.00 $886.00 $1,231.00 $908.00 $916.00 $1,046.00 $1,221.00 $2,376.00 $2,376.00 $1,072.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $247.00 $1,822.00 $2,274.00 $679.00 $1,483.00 $395.00 $18.00 $169.00 $1,822.00 $188.00 2020 pricing Drugs&Supplies PROCEDURE NAME SYS DRSG PEEL&PLACEPREVENA20CM CATH COUDE SIL 2WAY 14FR 5CC CATH FOLEY COUDE 3WAY 20FR30CC KNEE STEM FLUTED DEPU 75X18MM NAIL FEM ANTERETROGRD TI12X320 SCREW VERTEX MDTR 4X10MM SCREW VERTEX MDTR 4X16MM SCREW VERTEX MDTR 10MM SEALER LIGASURE CURV JAW SM HIP HD G7 BIOLOX OPT CER 40MM PLATE SEMI TUBLR 4HL 71MM PLATE SEMI TUBLR 5HL 87MM PLATE SEMI TUBLR 6HL 103MM PLATE SEMI TUBLR 7HL 119MM PLATE L BTRS ANG LFT 4HL 86MM PLATE L BTRS ANG RT 4HL 86MM SCREW CORT STD HEX TI 3.5X32MM SCREW CORT STD HEX TI 3.5X45MM DRIV CANN 2.5MM SCREW CORT LOPRO ARTX 3.0X10MM SCREW CANN LOPRO ARTX 3.0X20MM DRSG MTX BILYR 2X2IN=26SQCM SCREW MTXMAND SYNT 2X14MM HIP LNR ALTRX PE +4 0D 44X66MM GDWIRE HIWIRE STD ST.018 180CM GDWIRE HIWIRE NIT STD ST 0.035 GDWIRE HIWIRE NIT STIFF ST.038 FORCEPS BX BIGOPSY 2.4FR 115CM RETR ALEXIS O C-SECTION XL SCREW VA LK T8 STAR 2.7X26MM RASP SM TEAR 11X5MM BIT DRILL CANN 3MM COVERLOC LAT TALAS STABILIS KWIRE STABILIS 2.5X225MM BIT DRILL STABILIS 2.7MM SCREW MILAGRO BR DEPU 8X23MM SCREW MILAGRO BR DEPU 8X30MM SCREW MILAGRO BR DEPU 7X23MM SCREW MILAGRO BR DEPU 7X30MM SCREW MILAGRO BR DEPU 10X23MM SCREW MILAGRO BR DEPU 10X30MM SCREW MILAGRO BR DEPU 10X35MM SUT GRSPR MITEK 15D ENDOSCOPIC LINEAR CUTTER *CIP* CLIP LIGACLIP SM STAPLE RELOAD ENDOPATH VASC 35 Page 292 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,469.00 $125.00 $165.00 $3,561.00 $2,827.00 $2,045.00 $2,077.00 $2,077.00 $1,713.00 $2,691.00 $359.00 $380.00 $400.00 $415.00 $1,297.00 $1,297.00 $84.00 $84.00 $553.00 $573.10 $604.00 $4,248.00 $252.61 $2,376.00 $191.00 $175.00 $274.00 $1,336.00 $439.00 $631.00 $581.00 $533.00 $834.00 $230.00 $465.00 $1,537.00 $1,537.00 $1,537.00 $1,537.00 $1,537.00 $1,537.00 $1,537.00 $1,091.20 $1,822.00 $897.00 $1,321.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCISSORS CAUT MONO CURV 5MM HIP HD CATHCART UNIPOLR MTL 49 GD NERVE NEURAGEN 4MMX3CM (3U) GD NERVE NEURAGEN 5MMX3CM (3U) CATH SINUS GD F-70C CMNT NOZZLE REVOLUTION HUMR DRSG VAC SIL MD ENDO TROC BLADE ADV 12X150MM MESH VENTRALIGHT ST ELLIP 8X10 DRSG MEPILEX BORD AG 4X4 STNT ADVANIX DUODEN RX7FR7CM STNT ADVANIX DUODEN RX7FR9CM STNT ADVANIX DUODEN RX8.5FR9CM STNT ADVANIX DUODEN RX10FR9CM STNT ADVANIX DUODEN RX10FR12CM ANCHOR SUT PITON BLU 3.5MM BLADE FULL RAD CUTTER 3.5MM BLADE FULL RAD CUTTER 2.5MM SUT MAXBRAID PE 2-0 HIP HD CATHCART UNIPOLR MTL 45 SUT PROLENE 3-0 SH 30 SCREW LK TI NAIL STER 4X40MM BONE VOID FILLER STIMULAN 10CC PLATE FIB ANK ARTX LFT 5HL BIT DRILL ARTX 2MM BIT DRILL ARTX 2.5MM SCREW LK ARTX 2.7X14MM SCREW LK ARTX 2.7X16MM SCREW LK ARTX 2.7X18MM SCREW NL ARTX 3.5X16MM SCREW NL ARTX 3.5X28MM SCREW CORT LK ARTX 3.5X14MM GDWIRE AMPLZ SUPSTIFF BT 7X145 CATH AXXCESS URETRL 6FR 70CM TISS MACROPLASTIQUE 2.5ML KNEE TIB INSRT STBLZIMM20X75MM TB ARTHRO DUALWAVE OUTFLOW SCREW CANN THRD18 ARTX6.7X80MM KNEE TIB INSRT TC3 SZ5 30MM HIP SLV TYPE I OPT CER +6MM ARTHROWAND AMBIENT SUPTURBOVAC PLATE LC-CDP NARW 7HL 4.5X124 SCREW CANN LOPRO TI 6.7X40MM SCREW CANN LOPRO TI 6.7X45MM SCREW CANN LOPRO TI 6.7X50MM SCREW CANN LOPRO TI 6.7X65MM Page 293 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,026.00 $1,545.00 $3,472.00 $3,472.00 $1,372.00 $103.00 $395.00 $165.00 $2,938.00 $57.00 $679.00 $679.00 $679.00 $679.00 $679.00 $1,466.00 $242.00 $242.00 $143.00 $1,545.00 $15.00 $768.00 $2,205.00 $1,861.00 $490.00 $439.00 $579.00 $579.00 $579.00 $191.00 $191.00 $579.00 $242.00 $106.00 $1,699.00 $2,042.00 $209.00 $1,201.00 $5,543.00 $834.00 $1,164.00 $840.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN LOPRO TI 6.7X75MM SCREW CANN LOPRO TI 6.7X80MM SCREW CANN LOPRO TI 6.7X85MM SCREW CANN LOPRO TI 6.7X90MM SCREW CANN LOPRO TI 6.7X95MM SCREW CANN LOPRO TI 6.7X100MM SCREW CANN LOPRO TI 6.7X110MM SCREW LOPRO TI 6.7X75MM SCREW LOPRO TI 6.7X85MM SCREW LOPRO TI 6.7X110MM SCREW LOPRO TI 6.7X120MM SCREW CANN LOPRO TI 4.5X38MM SCREW CANN LOPRO TI 4.5X55MM SCREW CANN LOPRO TI 4.5X60MM SCREW CANN LOPRO TI 4.5X70MM KNEE TIB WEDGE STEP PFC 3 10MM BREAST HIPRO SMTH RD 420CC HIP SHELL CONTM CLUSTER II52MM HIP SHELL CONTM CLUSTER JJ54MM STNT WLLFLX RXPART8.5FR10X40MM STNT WLLFLX RXPART8.5FR10X80MM HIP STEM CORAIL ST HIGH SZ20 KNEE TIB INSRT PSC 14X63/67MM KNEE TIB COMP HNG NONMOD SZ2 BREAST HIPRO SMTH RD 270CC ENDO TROC BLDLES Z 5X55MM KNEE TIB INSRT XLK STBL 2 20MM HIP HD OXIN MTL 12/14 28MM +0 CONN DOMINO MDTR 5.5X5.5MM SET SCREW DOMINO MDTR MESH VENTRALEX ST CIR SM 1.7 BREAST MODER+SALINE 250+50 MESH VENTRALIGHT ST ELLIP 4X6 OCCL SEPTAL HELEX PFO 2.*CIP* SUT VICRYL 2-0 CT1 36 DYE HIP LNR TANDEM BIPOLRPE28X48MM HIP STEM CORAIL ST HIGH SZ10 BLADE OSCL CRST 18X0.51X30 BIT DRILL WIRE PASS 1.5MM MESH VENTRALEX ST CIR MD 2.5 HIP SHELL REGENEREX MULT 26X62 PLATE TIB PROX LCP 3.5MM 6HL STAPLE ENDO XTHK *CIP* STAPLE RELOAD GIA VASC MDTAN60 STAPLE RELOAD GIA MDTHK PUR 60 FACE SHIELD PEEL AWAY T-5 Page 294 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,201.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $1,201.00 $860.00 $860.00 $860.00 $860.00 $3,604.00 $1,545.00 $2,789.00 $2,789.00 $3,883.00 $3,883.00 $4,527.00 $4,366.00 $11,018.00 $1,545.00 $107.00 $2,344.00 $2,161.00 $1,949.00 $738.00 $1,373.00 $1,545.00 $1,300.00 $14,119.00 $8.00 $1,189.87 $4,527.00 $537.00 $284.00 $1,577.00 $5,699.00 $2,347.00 $1,143.00 $1,115.00 $1,164.00 $193.00 2020 pricing Drugs&Supplies PROCEDURE NAME MESH PROLENE 3X6 TB VENT TI MCRN BOBBIN .076 PLATE CLAV LOPRO RT 10HL MESH ALLOMAX 8X16CM HIP TROCHANT 4HL 4CBL 23X232MM BIT DRILL 2.0X175MM KNEE STEM FLUTED DEPU 75X20MM SHLDR SCREW CENT 6.5X25MM SCREW FIXED LK ZIMM 4.75X30MM SCREW BIOCOMP DELTA TAPER11X35 NAIL FEM RECON LAT TILFT10X380 MESH PERMACOL 10X15CM MESH VENTRIO ST CIR 4.5 BREAST COHESIVEI MODER+200 KNEE TIB BASE CMNTLGNREVLFTSZ3 KNEE STEM LGN PRESSFIT15X160MM KNEE OFFSET CPLE 4MM PLATE DIST CLAV RT 13HL 2.3MM SCREW CORT LK ACUM 2.3X10MM SCREW CORT LK ACUM 2.3X12MM SHLDR HUMR BEARING+3STD44-36MM KNEE TIB INSRT ZIMM LFT MD 7MM HIP STEM CORAIL2 BOW STD SZ18 FILLER STRIP MASTERGRAFT 10CM NAIL FEM ANTERETROGRD TI11X340 MESH VENTRIO ST OVAL 4.3X5.5 SCREW VERTEX MDTR 4.5X32MM SINUS BLN ACCLARENTW/IRG6X16MM SUT V-LOC ABSORB 3-0 V20 UNDY6 SCREW PEG NL ZIMM 2.5X26MM KWIRE ZIMM 1.6X127MM KT CATH CRICOTHYROTOMY 4.0MM KNEE TIB INSRT STBLZIMM14X79MM PLATE CLAV LOPRO MD LFT 8HL SCREW BIOCOMP DELTA TAPER 9X35 HIP HD OXIN MTL 12/14 28MM -3 PLATE CLAV DIST RT 12HL 3.5MM PLATE CLAV DIST LFT 12HL 3.5MM PLATE CLAV DIST RT 9HL 3.5MM PLATE CLAV LAT ANT ACUM 8HL PLATE CLAV MEDL ANT ACUM 8HL PLATE CLAV MEDL ANT ACUM 6HL PLATE CLAV LAT ANT ACUM 10HL PLATE CLAV LAT ANT ACUM 6HL PLATE CLAV DIST RT 16HL 2.3MM PLATE CLAV DIST LFT 16HL 2.3MM Page 295 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $573.00 $155.00 $2,725.00 $6,812.00 $8,334.00 $1,062.00 $3,561.00 $584.00 $333.00 $1,127.00 $2,762.00 $5,311.00 $1,821.00 $2,274.00 $5,530.00 $3,120.00 $3,115.00 $2,725.00 $576.00 $576.00 $2,426.00 $2,216.00 $4,527.00 $3,078.00 $2,827.00 $2,284.00 $2,077.00 $2,262.00 $195.26 $561.00 $152.00 $816.00 $2,042.00 $2,725.00 $1,127.00 $2,161.00 $2,725.00 $2,725.00 $2,725.00 $2,725.00 $2,725.00 $2,725.00 $2,725.00 $2,725.00 $2,916.00 $2,930.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE DIST CLAV LFT 13HL 2.3MM PLATE CLAV LOPRO ST LFT 8HL PLATE CLAV LOPRO LG LFT 8HL PLATE CLAV LOPRO SM LFT 8HL PLATE CLAV LOPRO SM RT 8HL PLATE CLAV NARW ST LFT 8HL PLATE CLAV J LOPRO LFT 8HL PLATE CLAV J LOPRO RT 8HL SCREW CORT ACUM 2.7X8MM SCREW LK CORT ACUM 2.7X8MM SCREW CORT NON TOGGLE 2.3X8MM SCREW CORT NON TOGGLE 2.3X10MM SCREW CORT NON TOGGLE 2.3X12MM SCREW CORT NON TOGGLE 2.3X18MM SCREW CORT NON TOGGLE 2.3X26MM SCREW CORT NON TOGGLE 2.3X16MM SCREW CORT LK ACUM 2.3X8MM SCREW CORT LK ACUM 2.3X14MM PLATE RAD DIST ACUM LFT WIDE KT INST PLK 2.9MM ALLO DBM PUTTY OSTEOSELECT 5CC FBR LASER FLEXIVA 200 RETR RING LONESTAR 28.3X18.3MM HIP STEM TRI-LOCK HIGH SZ1 HIP HD CORAIL SLF CTR MTL28X39 HIP HD CORAIL SLF CTR MTL28X40 HIP HD CORAIL SLF CTR MTL28X41 HIP HD CORAIL SLF CTR MTL28X61 HIP LNR PNCLE PE 0D 28X48 HIP LNR PNCLE PE +4 10D 28X48 HIP LNR PNCLE PE +4 10D 28X50 HIP LNR PNCLE PE LIP 28X48MM HIP LNR PNCLE PE LIP 28X50MM HIP LNR PNCLE PE 0D 32X66 HIP LNR PNCLE PE +4 10D 32X52 HIP LNR PNCLE PE +4 10D 32X54 HIP LNR PNCLE PE +4 0D 32X52 HIP LNR PNCLE PE +4 0D 32X54 HIP LNR PNCLE PE 0D 36X64 HIP LNR PNCLE PE 0D 36X66 HIP LNR PNCLE PE +4 10D 36X54 HIP LNR PNCLE PE +4 10D 36X56 HIP LNR PNCLE PE +4 10D 36X58 HIP LNR PNCLE PE +4 10D 36X60 HIP LNR PNCLE PE +4 10D 36X62 HIP LNR PNCLE PE +4 10D 36X64 Page 296 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,725.00 $2,725.00 $2,930.00 $2,725.00 $2,725.00 $2,725.00 $2,725.00 $2,725.00 $438.00 $690.00 $576.00 $576.00 $576.00 $576.00 $576.00 $576.00 $576.00 $576.00 $2,401.00 $860.00 $2,100.00 $1,398.20 $334.00 $5,118.00 $1,822.00 $1,822.00 $1,822.00 $1,822.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR PNCLE PE +4 10D 36X66 HIP LNR PNCLE PE +4 0D 36X52 HIP LNR PNCLE PE +4 0D 36X54 HIP LNR PNCLE PE +4 0D 36X56 HIP LNR PNCLE PE +4 0D 36X58 HIP LNR PNCLE PE +4 0D 36X60 HIP LNR PNCLE PE +4 0D 36X62 HIP LNR PNCLE PE +4 0D 36X64 HIP LNR PNCLE PE +4 0D 36X66 HIP LNR ALTRX PE +4 10D32X48MM HIP LNR ALTRX PE 0D 36X66MM HIP LNR ALTRX PE +4 10D36X52MM HIP LNR ALTRX PE +4 10D36X54MM HIP LNR ALTRX PE +4 10D36X56MM HIP LNR ALTRX PE +4 10D36X58MM HIP LNR ALTRX PE +4 10D36X60MM HIP LNR ALTRX PE +4 10D36X62MM HIP LNR ALTRX PE +4 10D36X64MM HIP LNR ALTRX PE +4 10D36X66MM HIP LNR ALTRX PE +4 0D 36X58MM HIP LNR ALTRX PE +4 0D 36X60MM HIP LNR ALTRX PE +4 0D 36X62MM HIP LNR ALTRX PE +4 0D 36X64MM HIP LNR ALTRX PE +4 0D 36X66MM HIP LNR ALTRX PE +4 10D40X60MM HIP LNR ALTRX PE +4 10D44X64MM HIP LNR ALTRX PE +4 10D44X66MM KNEE TIB TRAY KEEL MBT CMNT1.5 HIP HD EZE CER 12/14 32MM +9 HIP HD EZE TS CER 12/14 32MM+5 HIP HD EZE MTL 12/14 44MM -2 HIP HD EZE MTL 12/14 44MM +1.5 HIP HD EZE MTL 12/14 44MM +12 HIP CEMENTRALIZER DEPU 8.5MM HIP CEMENTRALIZER DEPU 9.25MM HIP STEM SUMMIT BASIC CMNT SZ2 HIP STEM SUMMIT BASIC CMNT SZ3 HIP STEM SUMMIT BASIC CMNT SZ4 HIP STEM SUMMIT BASIC CMNT SZ6 KNEE TIB INSRT XLK STBL 6 10MM KNEE TIBINSRT XLK STBL6 12.5MM KNEE TIB INSRT XLK STBL 6 15MM KNEE TIBINSRT XLK STBL6 17.5MM KNEE FEM PFC CMNT LFT SZ4 PIN THRD HD DEPU KNEE TIB INSRT PFC STBL 1.5 10 Page 297 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $3,367.00 $2,376.00 $4,899.00 $1,545.00 $1,545.00 $1,545.00 $284.00 $284.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $4,111.00 $322.00 $2,700.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT DVRA ZIMM 3.5X10MM SCREW CORT DVRA ZIMM 3.5X12MM SCREW CORT DVRA ZIMM 3.5X14MM SCREW CORT DVRA ZIMM 3.5X16MM SCREW CORT DVRA ZIMM 3.5X18MM BIT DRILL DVRA ZIMM 3.3MM PEG FULL THRD ZIMM 2.5X10MM PEG FULL THRD ZIMM 2.5X12MM PEG FULL THRD ZIMM 2.5X14MM PEG FULL THRD ZIMM 2.5X16MM PEG FULL THRD ZIMM 2.5X18MM PEG FULL THRD ZIMM 2.5X20MM PEG FULL THRD ZIMM 2.5X22MM PEG FULL THRD ZIMM 2.5X24MM PEG SMTH ZIMM 18MM SCREW PEG NL ZIMM 2.5X14MM SCREW PEG NL ZIMM 2.5X16MM SCREW PEG NL ZIMM 2.5X18MM PEG PART THRD ZIMM 2.5X22MM LMA CLASC SZ2 LMA CLASC SZ2.5 HEMO APPL ARISTA FLEXTIP XL GDWIRE RD TIP .062X14 NDLE INSUF 13GX120MM NDLE INSUF 13GX150MM RETR RIGID ALEXIS O 5-9CM MD STAPLE RELOAD ENDOPATH GRN45MM SUT STEEL 5 20G 18 SUT CHROMIC GUT 4-0 P3 18 SUT PLAIN GUT 2-0 STD/SHRT 54 SUT MONOCRYL 2-0 CP1 UNDY BLADE SHAVER INCIS CURV 4.5MM BIT DRILL ENDO BUTTON 4.5MM BLADE SAW SAG STRY 13X90MM SCREW CORT STD HEX 3.5X45MM WASHER 4.5MM PLATE T 4HL 4.5X84MM WIRE CERCLAGE COIL 1.25MM GDWIRE THRD TROC 2.0X230MM BIT DRILL CANN SYNT 4.5X233MM BIT DRILL QC SYNT 3.5X225MM BIT DRILL CANN 12.0MM END CAP TI T40 STER EXT 10MM ALLO DBM PASTE MTF 5ML HIP STEM VERS 6BEAD STD SZ12 HIP LNR TRILOGY PE 20D 56X32MM Page 298 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $561.00 $561.00 $561.00 $561.00 $561.00 $700.00 $548.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $1,063.00 $1,063.00 $86.00 $171.00 $72.00 $72.00 $233.00 $1,552.00 $36.00 $32.00 $17.00 $12.00 $376.00 $686.00 $289.00 $84.00 $111.00 $1,256.00 $274.00 $164.00 $1,170.00 $466.00 $1,243.95 $877.00 $1,863.00 $5,589.00 $2,847.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW FIXED LK ZIMM 4.75X20MM SHLDR GLENO VERSADIAL TI +3 36 MESH ALLODERM THIN 4X7CM=28SQ ALLO FEM CORT STRUT 250X10MM ALLO ILIAC CREST WEDGE 13-15MM PLATE STABILIS LAT TT HI TLR SCREW BONE STABILIS 4.5X34MM SCREW BONE STABILIS 4.5X28MM KWIRE STABILIS 2.0X150MM DEV BONE FILLER KYPHON SZ2 MESH VENTRALEX ST CIR LG 3.2 PLATE H MIDFOOT SM RT 28X16MM ENDOSERTER CORNEAL DEL INST MESH VENTRIO ST OVAL 5.4X7 MESH VENTRIO ST CIR 3 MESH VENTRIO ST OVAL 7.7X9.7 CATH EMBOL 5FR 80CM CATH EMBOL 6FR 80CM BONEFILL STIMULAN RAPID 10CC SHLDR ASCEND STEM ANG B SZ5 BRC ELBOW BANDIT THERAPEUTIC SCREW CORT ZIMM 3.5X10MM SCREW CORT NL ZIMM 3.5X18MM SCREW CORT NL ZIMM 3.5X20MM SCREW CORT NL ZIMM 3.5X22MM SCREW CORT NL ZIMM 3.5X24MM SCREW CORT NL ZIMM 3.5X28MM SCREW CORT NL ZIMM 3.5X32MM SCREW CORT NL ZIMM 3.5X34MM SCREW CORT NL ZIMM 3.5X36MM SCREW CORT NL ZIMM 3.5X38MM SCREW CORT NL ZIMM 3.5X40MM SCREW CORT NL ZIMM 3.5X42MM SCREW CORT NL ZIMM 3.5X44MM SCREW CORT NL ZIMM 3.5X46MM SCREW CORT NL ZIMM 3.5X48MM SCREW CORT NL ZIMM 3.5X50MM SCREW CORT NL ZIMM 3.5X60MM KNEE TIB INSRT TC3 SZ5 17.5MM SCREW VERTEX MDTR 3.5X16MM SCREW VERTEX MDTR 4.0X26MM SCREW VERTEX MDTR 4.5X30MM HIP HD ASPHR MTL 12/14 44MM -2 HIP HD M2A ZIMM MTL 40MM -3 SYS SPEEDBRIDGE ACHILLES SCREW BONE STABILIS 4.5X30MM Page 299 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $641.00 $3,133.00 $2,140.00 $2,787.00 $2,233.00 $2,890.00 $561.00 $561.00 $173.00 $614.00 $1,806.00 $1,792.00 $1,143.00 $2,570.00 $1,489.00 $3,241.00 $278.00 $278.00 $3,053.00 $5,266.00 $79.00 $353.36 $342.00 $342.00 $342.00 $342.00 $342.00 $362.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $342.00 $5,543.00 $2,077.00 $2,077.00 $2,077.00 $2,373.00 $1,790.00 $3,591.00 $561.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW BONE STABILIS 4.5X32MM GRAFTBOLT TIB ARTX 10MM PLATE SYS SUPP ARTX 2HL CAGE VERTE-STACK 14X11X24MM HIP HD CATHCART UNIPOLR MTL 50 PLATE FIB ANK ARTX RT 6HL SCREW NL ARTX 3.5X18MM SCREW NL ARTX 3.5X14MM BIT DRILL CANN ARTX 2.6MM BIT DRILLCALIB ARTX 2.5MM SHLDR AFFINITI 48 PEG GLENOID SHLDR ASCEND STEM ANG B SZ6 SHLDR AFFINITI 52 PEG GLENOID SHLDR ASCEND STEM ANG A SZ7 SHLDR ASCEND HUMRHD4.0 50X18 CATH CENTVEN GROSHONG SL 8FR BLN GASTRO TB 24FR RENT VAC UNIT ATS TB TRACH UNCUF CANN FEN 4 TB TRACH UNCUF CANN FEN 8 COIL MWCE18-14-10-NESTER KNEE FEM AUG DIST ONLY SZD10MM SCREW CANN LNG THRD 4X40MM HIP STEM TAPERLOC 15.0X150MM HIP HD SROM CER 11/13 36MM +0 HIP SLV PROX SROM 16D-SML HIP RING LK DYNAMIC DEPU 52MM KNEE HNG BUMPER DEPU SM/XSM STNT URETRL DBL J 8.5FR 28CM PEG THRD MULTDIRECT 2.5X16MM HIP SCREW CNCLS RFLCT 15MM HIP STEM SYNRG POR HIGH SZ12 SCREW VERTEX OCCIPITAL 4.5X8MM SCREW VERTEX OCCIPITAL4.5X10MM HIP STEM EPOCH COMP STD 15X160 BG ASPIRA DRN 1L KT ASPIRA VALV REPAIR CATH ANGIOFLUSH MGNMT SYS NDLE BX MAGNUM 18GX10CM NDLE BX MAGNUM 18GX16CM NDLE BX MAGNUM 20GX10CM NDLE BX MAGNUM 20GX16CM MARKER BREAST DUALWING17GX10CM NDLE BX TRUGUIDE 19GX7.8CM NDLE BX TRUGUIDE 17GX17.8CM NDLE BX TRUGUIDE 19GX13.8CM Page 300 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $561.00 $1,384.00 $1,790.00 $4,958.00 $1,545.00 $2,075.00 $191.00 $191.00 $579.00 $439.00 $2,932.00 $5,266.00 $2,932.00 $5,266.00 $2,932.00 $1,261.00 $203.00 $337.00 $226.00 $226.00 $393.00 $2,704.00 $811.00 $4,674.00 $2,376.00 $2,205.00 $1,218.00 $780.00 $573.00 $953.00 $698.00 $3,958.00 $679.00 $679.00 $5,589.00 $173.00 $192.00 $79.00 $85.00 $85.00 $85.00 $100.00 $387.00 $62.00 $62.00 $62.00 2020 pricing Drugs&Supplies PROCEDURE NAME INTR ACCUSTICK IIN CORD ENDO CAUT STNT WLLSTNT UNISTEP 16X40MM75 MALECOT NEPH SET 20FR KT BLN CATH NEPHROMAX30FR 12CM STNT VASC ZILVER 6X40MM 80CM GDWIRE ROSEN HEP 0.035 145CM STNT PROTEGE 8X80MM 80CM STNT PARAMOUNTMINI8X21MM 0.018 STNT PARAMOUNTMINI7X21MM 0.018 BUTTON NASAL SEPTAL 1PC SCREW LK STRY 3.4X14MM SCREW LK BONE 3.5X16MM SCREW LK STRY 3.5X20MM PLATE VARIAX FIB DIST LAT 3HL KNEE PTLA FLEX PROLNG SZ3 10MM KNEE TIB INSRT ANT STBL12X71MM HIP HD PFC MTL 10/12 32MM +0 GD DRILL THRD SS 1.5MM HIP CBL BONE PLATE 1.8X635MM KT EKOSONIC INFUS 135CM 12CM KT EKOSONIC INFUS 135CM 30CM PEG THRD MULTDIRECT 2.5X14MM PEG THRD MULTDIRECT 2.5X18MM PEG THRD MULTDIRECT 2.5X20MM PEG THRD MULTDIRECT 2.5X22MM PEG THRD MULTDIRECT 2.5X28MM PEG THRD MULTDIRECT 2.5X30MM PLATE HI STRENGTH LFT11.7X45.3 PLATE HI STRENGTH ST 5.6X50MM PLATE Y HI STRENGTH 12.9X43.7 PLATE LK FLEX ZIMM RT PLATE LK FLEX ZIMM LFT PLATE LK FLEX ZIMM ST PLATE LK FLEX ZIMM Y PLATE DVR ZIMM NARW LFT PLATE DVR ZIMM XTR EXT LFT PLATE DVR ZIMM XTR EXT RT SCREW PEG NL ZIMM 2.5X12MM SCREW PEG ZIMM 2.5X30MM STNT XIENCE PRIME 2.5X33 STNT XIENCE PRIME 2.5X38 STNT XIENCE PRIME 2.75X33 STNT XIENCE PRIME 2.75X38 STNT XIENCE PRIME 3.0X33 STNT XIENCE PRIME 3.0X38 Page 301 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $336.00 $432.00 $2,449.00 $637.00 $1,444.00 $2,993.00 $58.00 $1,822.00 $1,970.00 $1,970.00 $1,138.00 $754.00 $754.00 $751.00 $1,793.00 $1,973.00 $3,520.00 $2,379.00 $1,301.60 $1,576.00 $5,312.00 $5,312.00 $953.00 $953.00 $953.00 $1,054.00 $1,054.00 $1,054.00 $2,095.00 $2,095.00 $2,095.00 $2,095.00 $2,095.00 $2,095.00 $2,095.00 $2,543.00 $4,037.00 $4,037.00 $561.00 $561.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 2020 pricing Drugs&Supplies PROCEDURE NAME STNT XIENCE PRIME 3.5X33 STNT XIENCE PRIME 3.5X38 STNT XIENCE PRIME 4.0X33 STNT XIENCE PRIME 4.0X38 TB TRACH CUFF CANN 4 BOOT TRAC UNIV 30IN HIP RING LK DYNAMIC DEPU 60MM MESH ALLOMAX 16X20CM BLN DILATOR RIGIFLEX II 30X90 CATH BLN CATH FOR TI 4 BSKT STONE TI 2.4FR 15 INTR TAUT 10FR 20.3CM HIP SHELL CONTM CLUSTER LL58MM KNEE TIB INSRT STBL SZ4 17.5MM NAIL FEM ANTERETROGRD TI10X320 NAIL FEM ANTERETROGRD TI10X400 NAIL FEM RETROGRD TI 12X160MM NAIL FEM RETROGRD TI 13X200MM NAIL FEM RETROGRD TI 13X280MM NAIL FEM ANTERETROGRD TI13X320 HIP HD CATHCART UNIPOLR MTL 41 HIP HD CATHCART UNIPOLR MTL 42 HIP HD CATHCART UNIPOLR MTL 43 HIP HD CATHCART UNIPOLR MTL 44 HIP HD CATHCART UNIPOLR MTL 51 HIP HD CATHCART UNIPOLR MTL 52 HIP HD CATHCART UNIPOLR MTL 53 HIP HD CATHCART UNIPOLR MTL 54 HIP HD CATHCART UNIPOLR MTL 56 HIP HD CATHCART UNIPOLR MTL 58 HIP HD CATHCART UNIPOLR MTL 60 HIP STEM EXCEL 12/14 120MM SZ4 HIP STEM EXCEL 12/14 120MM SZ5 HIP SPACER UNIPOLR DEPU +5 HIP SPACER UNIPOLR DEPU +10 SUT CARTRDG PERFECTPASS CONN PERFECT PASR NAIL FEM ANTERETROGRD TI14X380 NAIL EX TIB CANN TI 10X300MM NAIL EX TIB CANN TI 10X390MM NAIL EX TIB CANN TI 11X285MM NAIL EX TIB CANN TI 11X300MM NAIL EX TIB CANN TI 12X285MM NAIL EX TIB CANN TI 12X300MM NAIL EX TIB CANN TI 9X285MM NAIL EX TIB CANN TI 9X330MM Page 302 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,053.00 $3,053.00 $3,053.00 $3,053.00 $278.00 $150.00 $1,218.00 $15,918.00 $1,973.00 $1,169.00 $1,217.00 $219.00 $2,789.00 $2,700.00 $2,827.00 $2,827.00 $2,827.00 $2,827.00 $2,827.00 $2,827.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $2,205.00 $2,205.00 $641.00 $641.00 $685.00 $747.00 $2,827.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL EX TIB CANN TI 9X345MM NAIL EX TIB CANN TI 9X375MM NAIL EX TIB CANN TI 9X390MM SCREW LK TI NAIL STER 4X30MM SCREW LK TI NAIL STER 4X44MM NAIL FEM RECON LAT TI RT10X320 NAIL FEM RECON LAT TILFT10X320 NAIL FEM RECON LAT TI RT10X340 NAIL FEM RECON LAT TILFT10X340 NAIL FEM RECON LAT TI RT10X360 NAIL FEM RECON LAT TILFT10X360 NAIL FEM RECON LAT TI RT11X320 NAIL FEM RECON LAT TILFT11X320 NAIL FEM RECON LAT TILFT11X340 NAIL FEM RECON LAT TI RT11X360 NAIL FEM RECON LAT TILFT11X380 NAIL FEM RECON LAT TI RT11X420 NAIL FEM RECON LAT TILFT11X420 NAIL FEM RECON LAT TI RT12X400 NAIL FEM RECON LAT TILFT12X420 NAIL FEM RECON LAT TI RT13X400 NAIL TIB CANN 10X300MM PLATE 1/3TUBLR W COLAR3.5 10HL KNEE GD NK FLEX ZIMM CUST HIP STEM PRODIGY12/14 13.5X160 HIP STEM PRODIGY12/14 13.5X155 PLATE VARIAX FIB DIST LAT 4HL SCREW NL STRY 3.5X20MM SCREW LK STRY 3.5X12MM SCREW LK STRY 3.5X18MM DRSG AQUACEL AG SURG 3.5X12 SCREW RECON THRD TI 6.5X30X70 FINGER PIP SIL ASCENSION SZ0 KNEE TIB INSRT CURV SZ4 20MM KNEE TIB CONE FULL SM 52-15MM KNEE TIB STEM REV ZIMM 90MM SCREW VERTEX MDTR 24MM HOOD STRY FLYTE PEELAWAY SET SCREW BREAK OFF M8 MDTR PLATE CLAV ANT ST 7HL 3.5MM HIP HD OXIN MTL 12/14 32MM +0 PLATE OLEC ACUM STD LFT 3HL SCREW NL ACUM 3.5X18MM SCREW NL ACUM 3.5X20MM SCREW NL ACUM 3.5X22MM SCREW NL ACUM 3.5X30MM Page 303 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,543.00 $2,543.00 $2,543.00 $772.00 $772.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,528.00 $351.00 $2,028.00 $4,526.00 $4,526.00 $1,749.74 $399.00 $754.00 $754.00 $189.00 $790.00 $3,319.00 $2,344.00 $10,371.00 $2,962.00 $2,077.00 $232.00 $488.00 $2,292.00 $2,117.82 $2,969.00 $488.00 $488.00 $488.00 $488.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK HEXALOBE 3X50MM SCREW LK HEXALOBE 2.7X12MM SCREW LK HEXALOBE 2.7X18MM SCREW LK HEXALOBE 2.7X20MM SCREW RESORB CORT 1.5X4MM SCREW RESORB CORT 1.5X5MM SCREW RESORB CORT 2.0X6MM NAIL TIB T2 STRY STD 11X315MM KNEE TIB INSRT TC3 3 12.5MM KNEE OFFSET CPLE 2MM HIP SCREW HL PLUG ZIMM KNEE TIB BASE CMNT LGNREVRTSZ3 HIP SHELL CONTM CLUSTER HH50MM HIP STEM KINECTIV SZ10 HIP NECK KINECTIV ST K AIRW CATH TRANSTRACH 6FR5CM15G CATH URETRL CONE TIP 6FR 70CM END CAP CORNERSTONE 7X14X11 SET SHEATH MICRO INTR 7FR 7CM SCREW NL ACUM 3.5X14MM SCREW LK ACUM 3.5X28MM SCREW LK HEXALOBE 2.7X16MM SCREW LK HEXALOBE 2.7X22MM KNEE TIB INSRT ANT STBL14X79MM KNEE TIB GENESISII CMNT LFTSZ7 HEMO DBL SYR ACP SER I ARTX SCREW VA LK T8 STAR 2.7X10MM BUR RD DIMND MD 4X54MM SCREW NL STRY 3.5X22MM HIP SHELL PNCLE SECT GRIPTN 60 HIP SHELL PNCLE SECT GRIPTN 62 HIP SHELL PNCLE SECT GRIPTN 66 PEG LK SMTH ZIMM 2X30MM MTX XENMTX RECTANG 15X20CM HIP HD M2A ZIMM MTL 40MM +3 HIP STEM TAPERLOC 9X137MM KNEE TIB INSRT STBLZIMM20X71MM HIP STEM TAPERLOC LAT 12.5X45 HIP LNR TRILOGY PE 10D 48X32MM HIP TROCHANT 1CBL 1.8X635MM HEMO DBL SYR ACP SER II ARTX SHEATH PNCLE RO NO GD 8FR 25CM SCREW VERTEX MDTR 3.5X26MM HIP RING LK DYNAMIC DEPU 58MM NDLE FAST FIX 360 CURV PUSHER KNOT CUTTER W SLOT CANN Page 304 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $912.00 $770.00 $770.00 $770.00 $1,194.46 $1,194.46 $1,194.46 $3,143.00 $4,319.00 $3,115.00 $641.00 $5,632.00 $2,789.00 $4,948.00 $1,973.00 $306.00 $65.00 $2,620.00 $176.00 $488.00 $781.00 $770.00 $770.00 $3,520.00 $2,259.00 $860.00 $631.00 $399.00 $378.00 $3,240.00 $3,240.00 $3,240.00 $561.00 $15,133.00 $1,790.00 $4,674.00 $2,042.00 $4,674.00 $2,847.00 $1,258.00 $1,201.00 $192.00 $2,077.00 $1,218.00 $1,508.00 $658.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT NON TOGGLE 2.3X14MM SCREW CORT NON TOGGLE 2.3X22MM STNT WLLSTNT UNISTEP 16X60MM75 STNT PARAMOUNTMINI5X21MM 0.018 HIP BLOCK VERS 30MM SZ13 HIP LNR TRILOGY PE 0D 68X36MM HIP LNR TRILOGY PE 0D 70X36MM HIP STEM VERS 6BEAD STD 13X160 HIP STEM BEAD FC+ EXT SZ13 HIP STEM BEAD FC+ EXT SZ14 HIP STEM BEAD FC+ EXT SZ15 HIP STEM BEAD FC+ EXT SZ17 HIP STEM VERS ZIMM 13X170MM HIP STEM VERS ZIMM 19X200MM STNT FLEXI PUSH CATH ST 5FR3CM STNT FLEXI PUSH CATH 5FR 3CM PROS PENILE AMS 700 CX MS 15CM HIP STEM SYNRG POR STD SZ15 SHLDR SCREW LK 5X22MM SHLDR SCREW LK 5X30MM SHLDR HUMR STEM SZ7 SHLDR HUMR SHELL RSP NEUT HIP PLUG CLEARCUT CMNT SZ10 COIL MWCE-18-14-8-NESTER COIL MWCE-18-14-6-NESTER PLATE LCP BROADCURV 4.5/5 13HL PLATE LCP BROADCURV 4.5/5 16HL SCREW HDLSS SHRT SYNT 3X25MM HIP HD VERS MTL 12/14 26MM+3.5 SUT STEEL 7 18G 18 SUT STEEL 2 24G 18 MESH PROLENE 12X12 MESH PROLENE EXT 10CM PRSSZR CMNT FEM CANAL BLU MD CBL CRIMP SS ZIMM 2.0X750MM SLV CBL CRIMP SS ZIMM 2.0MM TRAY 1ST FRAC EXPRESS 10/2 SCREW RECON LAG T2 6.5X90MM SCREW CROSSDRIVE 2.3X11MM HIP STEM SYNRG POR STD SZ16 HIP SLV ADPTR V40 STRYUNIV+4MM CONN TSRH MDTR MD 5.5MM CONN TSRH MDTR LG 5.5MM SCREW SET TSRH FLUSH BREAK 3DX SCREW TSRH OSTEOGRIP 5.5X40MM SCREW CANN LOPRO ARTX 3.0X16MM Page 305 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $576.00 $576.00 $2,449.00 $1,970.00 $1,533.00 $2,847.00 $2,847.00 $5,589.00 $5,589.00 $5,589.00 $5,589.00 $5,589.00 $10,917.00 $10,917.00 $284.00 $315.21 $17,161.00 $4,161.00 $438.00 $438.00 $5,546.00 $3,137.00 $387.00 $393.00 $393.00 $2,006.00 $2,332.00 $1,141.00 $1,657.00 $38.00 $35.00 $1,116.00 $1,545.00 $166.00 $828.00 $888.00 $7,152.00 $1,073.00 $236.00 $4,176.00 $1,187.00 $3,007.00 $3,007.00 $902.00 $1,973.00 $604.00 2020 pricing Drugs&Supplies PROCEDURE NAME GDWIRE LOPRO ARTX .045 HIP STEM TAPERLOC LAT 13.5X147 HIP HD M2A ZIMM MTL 40MM -6 KNEE FEM LCCK OPT ZIMM LFT SZG HIP LNR TRID X3 PE 10D 36MM H SCREW LAG CANN ARTX 24MM SCREW VERTEX MDTR 3.5X34MM SCREW VERTEX MDTR 4.0X24MM HIP LNR ARCOMXL PE 10D 28X22MM HIP LNR ARCOMXL PE 10D 32X23MM HIP SHELL M2A ZIMM 46X40MM CATH CENTVEN BROVIAC SL 4.2FR HIP HD EZE TS CER 12/14 32MM+9 HIP LNR ALTRX PE 0D 32X48MM NDLE FAST FIX 360 ST SCREW CROSSDRIV SIL 2.7X10MM SCREW CROSSDRIV SIL 2.7X14MM SCREW CROSSDRIV SIL 2.7X16MM SCREW CROSSDRIV SIL 2.7X18MM SCREW CROSSDRIV SIL 2.7X20MM SCREW CROSSDRIV EMER 3.2X16MM BONEFILL STIMULAN RAPID 5CC SCREW VERTEX PT MDTR 3.5X32MM SCREW VERTEX MAS MDTR 3.5X22MM SCREW VERTEX MAS MDTR 3.5X28MM SCREW VERTEX MAS MDTR 3.5X30MM SCREW VERTEX MAS MDTR 4X18MM SCREW VERTEX MAS MDTR 4X20MM SCREW VERTEX MAS MDTR 4X22MM SCREW VERTEX MAS MDTR 4X28MM SCREW VERTEX MAS MDTR 4X34MM SCREW VERTEX MAS MDTR 4X36MM SCREW VERTEX MAS MDTR 4X38MM SCREW VERTEX MAS MDTR 4.5X34MM KWIRE RECON STRY 3.2X400MM HIP STEM TRI-LOCK HIGH SZ12 SCREW NL STRY 3.5X18MM BIT DRILL VARIAX STRY 3.5MM HIP HD OXIN MTL 12/14 28MM +4 KNEE TIB OXFORD ZIMM RT SZ F KNEE TIB INSRT ZIMM RT LG 3MM HIP STEM TAPERLOC LAT 15X150 HIP STEM TRI-LOCK STD SZ10 DEV MYOSURE TISS REMOVAL*CIP* BREAST MODER SALINE 300CC ROD TI VERTEX MDTR 3.2X240MM Page 306 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $84.00 $4,674.00 $1,790.00 $13,208.00 $2,627.00 $582.00 $2,077.00 $2,077.00 $2,123.00 $2,123.00 $3,918.00 $781.00 $4,899.00 $2,376.00 $1,507.00 $390.00 $390.00 $390.00 $390.00 $390.00 $433.00 $2,376.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $2,077.00 $395.00 $5,118.00 $399.00 $790.00 $2,117.82 $3,248.00 $2,088.00 $4,674.00 $5,118.00 $3,426.00 $1,410.00 $1,016.00 2020 pricing Drugs&Supplies PROCEDURE NAME CONN DOMINO OFF3.2-5.5MM ROD OCCIPITAL ADJ3.2/3.5X220MM ROD TI VERTEX MDTR 5.5X360MM CONN VERTEX OPEN END 10MM CONN VERTEX CLSD END 10MM CONN VERTEX CLSD END 13MM HOOK VERTEX 6MM PLATE OCCIPMIDLINE VERTEX SM BIT DRILL OCC FLEX MDTR 3.2MM SCREW NL STRY 3.5X12MM SCREW NL STRY 3.5X14MM SCREW NL STRY 3.5X16MM SCREW NL STRY 3.5X26MM SCREW NL STRY 3.5X32MM SCREW NL STRY 3.5X38MM SCREW CORT ARTX 3.5X18MM SCREW CORT ARTX 3.5X20MM SCREW CORT ARTX 3.5X26MM SCREW CORT ARTX 3.5X30MM SCREW CORT LK ARTX 3.5X34MM SCREW CORT LK ARTX 3.5X36MM SCREW CORT LK ARTX 3.5X38MM KNEE TIB INSRT STBLZIMM16X79MM HIP STEM TAPERLOC 12.5X145MM KNEE TIB REV STEM ZIMM 155MM SCREW FIXED LK ZIMM 4.75X35MM NDLE SPINAL SPROTTE 24GX90MM TVT MONARC+ SUBFASCIALHA*DISC* TB GJ G-JET 16FR 2.0 30CM SCREW TSRH OSTEOGRIP 4.5X40MM PLATE VENTURE MDTR 37MM PLATE TIB WEDGE OPEN 12.5MM KNEE TIB INSRT TC3 SZ2.5 15MM KNEE FEM SLV UNIV CMNT 20MM PLATE HORIZ LOPRO TI5.5MM1.125 PLATE HORIZ LOPRO TI5.5MM1.375 PLATE HORIZ LOPRO TI5.5MM1.500 PLATE HORIZ LOPRO MULT TI 1.55 PLATE HORIZ LOPRO MULT TI 1.75 BLADE CARPAL SLIMLINE*CIP* LITHOTRIPTOR WIREGD 4.2X30MM KNEE FEM SROM MD RT 71X66MM CONN ROD LEGACY 5.5X5.5MM ANCHOR TI-SCREW W NDLE 5MM SZ2 GRAFTBOLT TIB ARTX 8MM PLATE VARIAX FIB DIST LAT 5HL Page 307 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,283.00 $945.64 $1,199.00 $1,567.00 $1,532.00 $1,532.00 $2,850.00 $3,029.00 $2,062.00 $399.00 $399.00 $399.00 $399.00 $399.00 $399.00 $321.00 $321.00 $321.00 $321.00 $319.00 $319.00 $328.20 $2,042.00 $4,674.00 $2,962.00 $584.00 $75.00 $2,904.00 $1,466.00 $1,973.00 $2,368.00 $1,683.00 $5,543.00 $5,523.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $1,195.00 $1,476.00 $13,583.00 $2,028.00 $1,301.00 $1,384.00 $1,786.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT TC3 SZ5 10MM KNEE UL ARTICU RT SZ3/4/5 19MM ENDO TROC BLDLES FIOS 11X100MM HIP LNR TRILOGY PE 10D 62X36MM HIP LNR TRILOGY PE 10D 64X36MM HIP HD PROTASUL MTL 32MM +4 BLADE SKIMMER ANG 3.5MMX22.5CM BUR DIMND HIGH SPEED 4.0MM SET SCREW SOLERA SEXTANT MDTR SCREW SOLERA MA CANN 6.5X50MM KNEE TIB INSRT STBLZIMM10X79MM HIP STEM TAPERLOC 11X142MM KNEE FEM CRFLEX NONPOR LFT SZ4 BIT DRILL 3MMX220MM HIP STEM TRI-LOCK STD SZ0 HIP STEM TRI-LOCK STD SZ1 HIP STEM TRI-LOCK STD SZ9 HIP STEM TRI-LOCK STD SZ11 HIP STEM TRI-LOCK STD SZ12 HIP LNR ALTRX PE +4 0D 36X56MM HIP HD EZE TSCER12/14 36MM+8.5 HIP HD EZE TS CER12/14 36MM+12 HIP HD EZEM MTL12/14 36MM +12 HIP HD ASPHR MTL 12/14 36MM+12 HIP HD ASPHR MTL12/14 44MM+8.5 PLATE VOLAR TRMI LFT 3HL7PEG SCREW CORT TRMI 2.3X20MM SCREW CORT TRMI 3.2X12MM SCREW CORT TRMI 3.2X14MM PEG VOLAR THRD TRMI 18MM BIT DRILL TRMI 1.75MM SPNG SHLDR KEEL SGL DISP ZIMM SCREW MTXMAND SYNT 2X15MM PLATE TRAPEZOID SUBCOND TI 1.0 KNEE TIB INSRT XLK CURV 5 20MM STNT XIENCE PRIME 2.5X28 STNT XIENCE PRIME 2.75X28 STNT XIENCE PRIME 3.0X28 STNT XIENCE PRIME 3.5X28 STNT XIENCE PRIME 4.0X28 EMBOL LC BEADS SZ300-500 SCREW LK ZIMM 3.5X10MM SCREW LK ZIMM 3.5X12MM PLATE LK TUBLR SS 6HL SCREW LO PRO TM SS 4.0X18MM SCREW LO PRO TM SS 4.0X16MM Page 308 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,543.00 $2,271.00 $165.00 $2,847.00 $2,847.00 $1,657.00 $1,456.00 $1,181.00 $408.00 $2,436.00 $2,042.00 $4,674.00 $3,933.00 $456.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $2,376.00 $5,133.00 $5,133.00 $1,419.00 $2,373.00 $2,373.00 $2,661.00 $438.00 $455.00 $455.00 $515.00 $641.00 $336.00 $245.00 $1,713.74 $2,344.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,053.00 $3,998.00 $686.00 $686.00 $1,150.00 $191.00 $191.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW NL ARTX 3.5X22MM PLATE FIB ANK ARTX LFT 4HL SCREW NL ARTX 3.5X12MM SCREW LK ARTX 2.7X20MM PLATE FIB ANK ARTX RT 5HL HIP STEM RX90 RT 13X200MM SCREW NL ARTX 3.5X20MM PLATE LK TUBLR SS 8HL KNEE TIB OXFORD UNI LFT SZAA SET GJ MARX-COPE 16FR 25CM EXPAND MAM MODER W TAB 600CC KT UNIV FILL ENDO TROC KII BLADE 11X100MM TIGHTROPE SYNDMSIS KNOTLESS HIP STEM ECHO LAT 10X130MM DEV GRASPING RAPTOR SUCT CATH FLEX 6FR BUR ANG 70D SCREW NL ACUM 3.5X24MM SCREW NL ACUM 3.5X16MM HIP STEMMICRPLSTYLAT13.5X112.5 SCREW LK STRY 5X32.5MM GDWIRE SMTH TIP STRY 3X1000MM SCREW LK ACUM 3.5X8MM SCREW LK ACUM 3.5X10MM SCREW LK ACUM 3.5X12MM SCREW LK ACUM 3.5X14MM SCREW LK ACUM 3.5X16MM SCREW LK ACUM 3.5X18MM SCREW LK ACUM 3.5X20MM SCREW LK ACUM 3.5X22MM SCREW LK ACUM 3.5X24MM SCREW LK ACUM 3.5X26MM SCREW LK ACUM 3.5X32MM SCREW LK ACUM 3.5X40MM SCREW LK ACUM 3.5X45MM SCREW LK ACUM 3.5X50MM SCREW NL ACUM 3.5X8MM SCREW NL ACUM 3.5X10MM SCREW NL ACUM 3.5X12MM SCREW NL ACUM 3.5X26MM SCREW NL ACUM 3.5X28MM SCREW NL ACUM 3.5X32MM SCREW NL ACUM 3.5X36MM SCREW NL ACUM 3.5X40MM SCREW NL ACUM 3.5X45MM Page 309 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $191.00 $1,714.00 $191.00 $579.00 $1,861.00 $13,032.00 $191.00 $1,271.00 $3,248.00 $1,387.00 $3,438.00 $59.00 $165.00 $2,412.00 $4,674.00 $537.00 $195.00 $1,282.00 $488.00 $488.00 $4,674.00 $842.00 $489.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $770.00 $912.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 $488.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW NL ACUM 3.5X55MM SCREW NL ACUM 3.5X65MM SCREW NL HEXALOBE 3X45MM BIT DRILL QK ACUM 2.3MM KNEE TIB INSRT ZIMM RT MD 3MM KNEE TIB INSRT ZIMM LFT SM 4MM KNEE OFFSET CPLE 6MM KNEE PTLA FLEX PROLNG SZ2 10MM BAND SCLERAL BUCKLE CIR 2MM SLV SCLERAL BUCKLE 1MM STRIP SCLERAL BUCKLE 3.5MM SHLDR ASCEND STEM ANG B SZ8 ENDO TROC BLDLES FIOS 5X150MM PLATE H MIDFOOT SM LFT 28X16MM HIP STEM MICRPLSTY LAT12.5X110 KNEE TIB INSRT ANT STBL12X75MM KNEE UL ARTICU LFT SZ1/2 19MM KNEE TIB INSRT ZIMM LFT SM 6MM HIP STEM TRI-LOCK HIGH SZ0 HIP LNR ULTAMET MTL 40X64MM BUR PED ANG 2.5MM PLATE TIB WEDGE OPEN 7.5MM BIT DRILL HTO MEDL 4.8X180MM KNEE TIB INSRT STBLZIMM16X71MM SHLDR ASCEND HUMRHD4.0 52X18 PLATE CENTERPIECE HINGED TIGHTROPE NO BTN ABS W UHMWPE KNEE TIB INSRT ANT STBL14X63MM SHLDR SCREW LK 5X18MM SHLDR SCREW LK 5X26MM SHLDR HUMR STEM SZ12 SHLDR ASCEND HUMRHD3.5 42X16 SHLDR ASCEND STEM ANG C SZ3 KNEE TIB OXFORD ZIMM LFT SZF HIP STEM M/L STD SZ10 SCREW LK STRY 5X27.5MM SCREW LK STRY 5X37.5MM SCREW LK STRY 5X42.5MM SCREW LK STRY 5X47.5MM SCREW LK STRY 5X52.5MM SCREW LK STRY 5X57.5MM END CAP GAMMA STRY 5MM +5 PLATE OLEC ACUM STD RT 5HL BLADE STERNAL SYS 6 STRY HD SUT FBRLOOP 4-0 TAPER BLU 6 CATH URETRL OPEN END FLEX 5FR Page 310 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $630.00 $630.00 $487.00 $717.00 $2,088.00 $2,088.00 $3,058.12 $1,973.00 $84.00 $66.00 $90.00 $5,266.00 $107.00 $1,792.00 $4,674.00 $3,520.00 $2,271.00 $2,216.00 $5,118.00 $3,100.00 $1,254.00 $1,683.00 $857.00 $2,042.00 $2,932.00 $1,822.00 $948.00 $3,520.00 $438.00 $438.00 $5,546.00 $2,932.00 $5,266.00 $3,248.00 $4,948.00 $842.00 $842.00 $842.00 $842.00 $842.00 $842.00 $908.00 $2,751.00 $124.00 $161.00 $65.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT LONESTAR GYNECOLOGY SUT CHROMIC GUT 2-0 CT3 SUT ETHIBOND 0 CT1 18 SUT SILK 4-0 KS 30 SUT VICRYL 6-0 PS6 18 UNDY SUT ETHIBOND 0 OS4 30 SUT CHROMIC GUT 4-0 J1 18 SUT VICRYL+ S0 CT1 CR8-18DYE SUT VICRYL+ 0 CT2 CR8-18DYE INTERPULSE HANDPC COAX HI FLOW PLATE LC-CDP NARW 6HL 4.5X105 CLAMP EXTL FIX ADJ LG 4-6MM SCREW TENODESIS PEEK 5.5X8MM SCREW QUICKFIX ARTX 3X15MM SCREW QUICKFIX ARTX 3X17MM SCREW QUICKFIX ARTX 3X19MM SCREW CORT LOPRO ARTX 3.5X42MM SCREW CORT LOCK ARTX 3.5X30MM SCREW CORT LK ARTX 3.5X32MM SCREW CORT LK ARTX 3.5X34MM SCREW CORT LK ARTX 3.5X36MM SCREW CORT LK ARTX 3.5X38MM PLATE H LOPRO TI LFT ARTX 6MM PLATE TIB MEDL PROX 3.5 RT 4HL PLATE TIB MEDL PROX 3.5LFT 4HL PLATE TIB MEDL PROX3.5 LFT 8HL PLATE RAD HD RT 3HL 2.4X46MM PLATE DHS STD 135D 10HL 174MM PLATE DHS STD 135D 12HL 206MM PLATE DHS STD 135D 8HL 142MM PLATE T TIB PSTR LCP 3.5MM12HL SCREW VA LK T8 STAR 2.7X38MM SCREW VA LK T8 STAR 2.7X40MM SCREW VA LK T8 STAR 2.7X44MM SCREW VA LK T8 STAR 2.7X50MM SCREW VA LK T8 STAR 2.7X52MM SCREW VA LK T8 STAR 2.7X54MM BIT DRILL 2.5MM BIT DRILL ZEBRA 4.0MM KNEE TIB AUG FULLBLOCKSZ3 10MM ALLO DENOVO NT ZIMM KNEE TIB COMP HNG NEXGEN SZ3 PK FINGER MCP STRY COMMAND II SCREW PERI FULL ZIMM 6.5X45MM SCREW PERI FULL ZIMM 6.5X50MM SCREW PERI FULL ZIMM 6.5X55MM Page 311 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $581.00 $17.00 $9.00 $7.00 $20.00 $14.00 $17.00 $60.00 $60.00 $184.00 $840.00 $1,158.00 $1,068.00 $1,150.00 $1,150.00 $1,150.00 $328.20 $441.00 $455.60 $455.60 $442.00 $455.60 $1,862.00 $3,018.00 $3,018.00 $3,093.00 $1,807.00 $1,856.00 $1,856.00 $1,856.00 $2,812.00 $631.00 $631.00 $631.00 $631.00 $631.00 $631.00 $364.00 $953.00 $4,205.00 $9,543.00 $11,018.00 $1,428.00 $257.00 $257.00 $257.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW ELBOW LK 2.7X10MM SCREW ELBOW LK 2.7X12MM BLADE CUBITAL TUNNEL KNEE FEM JII BCS OXIN RT SZ4 KNEE TIB BASE JOURNEY RT SZ3 KNEE INSRT JII BCSRTSZ3-4 11MM KNEE PTLA JII RESURF 32MM KNEE TIB INSRT TC3 2.5 12.5MM HIP SLV PROX SROM 16D-LRG KNEE TIB BLOCK ZIMM SZ6 5MM KNEE FEM AUG PSTR ZIMM SZG 5MM KNEE FEM AUG DIST ZIMM SZG10MM KNEE TIB LCCK YEL SZC/D 17MM BLADE RESECTOR 5.5MM BUR BRL 6 FLUTE 4.0MM BLADE AGG + ANG STRYK 4.5MM PLATE RESORB ORB RIM 1.5 10HL NAIL TIB T2 STRY STD 11X330MM HIP LNR LNGVTY PE ELEV HH 32MM HIP LNR LNGVTY PE ELEV 11 36MM HIP LNR LNGVTY PE ELEV JJ 36MM KNEE TIB INSRT GII SZ3-4 85MM HIP STEM MICRPLSTY STD11X107.5 BLADE SAG STRY 21X90X1.37MM MOLD CMNT HIP SPACERSTEM11X135 MOLD CMNT HIP SPACER HD 56MM MOLD CMNT HIP SPACER HD 60MM MOLD CMNT HIP SPACER NECK STD FIX EXTL FIX DIST RAD ADJ WPIN KT TRIMANO BEACH CHAIR SHLDR HUMR STEM SZ8 PLATE TIB MEDLPROXLCP RT6HL4.5 SCREW LK SLFTP STAR T25 4X28 SCREW LK SLFTP STAR T25 4X32 SHLDR SCREW LK 5X34MM SHLDR GLENOID HD RSP 36MM SHLDR HUMR INSRT RSP +0 36MM SHLDR HUMR STEM SZ10 SHLDR HUMR SHELL RSP +8MM SCREW ZEPHIR SLFTP 3.5X15MM NAIL FEM RECON LAT TI RT 9X400 HIP SCREW C2A TAPER 6.5X50MM KNEE TIB BASE UNI RM ZIMM SZE KNEE TIB INSRT ZIMM LFT MD 6MM KNEE TIB INSRT ZIMM LFT MD 8MM KNEE TIB INSRT ZIMM LFT MD 9MM Page 312 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $735.00 $735.00 $2,201.00 $4,192.00 $2,957.00 $2,353.75 $1,204.00 $4,319.00 $2,205.00 $2,704.00 $2,704.00 $2,704.00 $4,514.00 $242.00 $363.00 $372.00 $1,001.52 $3,143.00 $2,847.00 $2,847.00 $2,847.00 $2,373.00 $4,674.00 $282.00 $3,068.00 $2,572.00 $2,581.00 $1,000.00 $3,251.00 $415.00 $5,546.00 $3,065.00 $664.00 $664.00 $438.00 $2,582.00 $2,014.00 $5,546.00 $3,137.00 $5,319.00 $2,762.00 $284.00 $3,248.00 $2,216.00 $2,216.00 $2,216.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT ZIMM LFT LG 5MM KNEE TIB INSRT ZIMM LFT LG 6MM KNEE TIB INSRT ZIMM LFT LG 7MM KNEE TIB INSRT ZIMM RT SM 6MM KNEE TIB INSRT ZIMM RT SM 8MM KNEE TIB INSRT ZIMM RT SM 9MM KNEE TIB INSRT ZIMM RT MD 7MM KNEE TIB INSRT ZIMM RT MD 8MM KNEE TIB INSRT ZIMM RT MD 9MM KNEE TIB INSRT ZIMM RT LG 7MM KNEE TIB INSRT ZIMM RT LG 9MM HIP HD G7 TYPE 1 MTL 36MM +12 HIP STEM MICRPLSTY STD 9X102.5 HIP STEM MICRPLSTY STD 15X115 HIP HD G7 BIOLOX OPT CER 36MM HIP SLV TYPE I OPT CER +3MM KNEE TIB INSRT ANT STBL14X67MM KNEE TIB INSRT ANT STBL10X75MM KNEE TIB INSRT ANT STBL12X83MM HIP LNR G7 ARTICU E1 PE 28X44 HIP LNR G7 ARTICU E1 PE 28X46 HIP LNR G7 ARTICU E1 PE 28X50 HIP SHELL M2A ZIMM 64X56MM HIP SHELL M2A ZIMM 66X56MM BREAST NATRELLE SIL MID 234CC KNEE FEM OXFORD MD KNEE FEM OXFORD LG KNEE FEM ADPTR DEPU 7 KNEE TIB INSRT TC3 SZ3 22.5M SCREW CANN TI THRD16MM 7.3X110 SLV LK TI BLADE 110D SLV LK TI BLADE 130D BLADE FEM NAIL SPIRAL TI 100MM BLADE FEM NAIL SPIRAL TI 110MM BLADE FEM NAIL SPIRAL TI 115MM BLADE FEM NAIL SPIRAL TI 70MM BLADE FEM NAIL SPIRAL TI 85MM BLADE FEM NAIL SPIRAL TI 90MM BLADE FEM NAIL SPIRAL TI 95MM END CAP 15MM TI EXT BLU 10MM END CAP 15MM TI EXT BLU 20MM END CAP 130D 15MM TI EXT 0MM END CAP 15MM TI EXT 10MM END CAP 15MM TI EXT 20MM PLATE LK MEDL HOOK 3HL ENDO CANN KII ADV FIX 11X100MM Page 313 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,088.00 $2,216.00 $2,216.00 $2,088.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $1,790.00 $4,674.00 $4,674.00 $2,691.00 $834.00 $3,520.00 $3,520.00 $3,520.00 $4,200.00 $4,120.00 $4,200.00 $3,918.00 $3,918.00 $2,245.00 $3,444.00 $3,444.00 $4,744.00 $5,543.00 $1,145.00 $1,218.00 $1,218.00 $1,577.00 $1,577.00 $1,577.00 $1,577.00 $1,577.00 $1,577.00 $1,577.00 $719.00 $719.00 $674.00 $674.00 $674.00 $2,253.00 $83.00 2020 pricing Drugs&Supplies PROCEDURE NAME NDLE CATH YUEH PIGT 5FR 15CM ANCHOR BTB TIGHTROPE KNEE TIB GENESIS IICMNT LFTSZ2 SHLDR HUMR INSRT SEMICNSTND 32 HIP PLUG CLEARCUT CMNT SZ8 TB GJ MIC LOPRO 16FR 3.5 45CM KT GASTRO MIC LOPRO 12FR 2.0CM KT GASTRO MIC LOPRO 12FR 2.5CM KT GASTRO MIC LOPRO 12FR 3.0CM KT GASTRO MIC LOPRO 12FR 3.5CM TB GASTRO MIC BLN 3-5ML 18FR GDWIRE AMPLZ XSTIFF 0.038 80CM SCREW LO PRO TM SS 4.0X22MM SCREW CANN LNG ARTX 4.0X50MM PLATE ST LK SS ARTX 7HL PLATE ST LK SS ARTX 6HL STRAP ANK DISTRAC AIRW SUPRAGLOTTIC LT-D SZ2 HIP STEM PRODIGY12/14 18X160 ELTD PATHWAY RECTAL EMG STIM HIP HD C-TAPER LFIT MTL40MM+10 HIP HD C-TAPER LFITMTL40MM+7.5 KNIFE A-OK STD ANG 15D 1.52MM SCREW NL HEXALOBE 3X65MM SCREW NL HEXALOBE 3X50MM CAUT COBLATOR PROCISE MAX SCREW LK HEXALOBE 3X16MM SCREW LK HEXALOBE 3X22MM SCREW LK HEXALOBE 3X26MM SHLDR SCREW CENT 6.5X20MM SUT VICRYL 2-0 CT1 CR8-18 UNDY STAPLE RELOAD ENDOPATH BLU35MM SHLDR HUMR HD ZIMM 54X24X58MM HANDPC VERSAJETII EXACT 8MM NAIL FEM RECON LAT TI RT 9X380 NAIL SUPRA COND STRY 10X340MM SCREW VERTEX MAS MDTR 4X30MM SCREW CORT LOCK ARTX 3.5X18MM SCREW CORT SLFTP 3.5X20MM SHLDR RVRS HUMR ZIMM STD 44MM KNEE FEM OXFORD SM HIP STEM ACLDII 132D SZ11 PLATE ST LK SS ARTX 8HL MESH ALLOMAX 10X15CM PLATE LC-CDP NARW 4HL 4.5X70 PLATE LC-CDP NARW 5HL 4.5X88 Page 314 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $86.00 $1,424.00 $2,259.00 $2,028.00 $387.00 $1,227.00 $526.00 $526.00 $526.00 $526.00 $912.00 $103.00 $191.00 $811.00 $1,699.00 $1,589.00 $252.45 $69.00 $4,526.00 $242.00 $1,466.00 $1,466.00 $62.00 $630.00 $484.00 $1,148.00 $770.00 $770.00 $770.00 $641.00 $55.00 $1,321.00 $3,786.00 $2,071.00 $2,762.00 $3,826.63 $2,077.00 $579.00 $123.00 $3,240.00 $3,444.00 $3,582.06 $1,714.00 $7,463.00 $754.00 $754.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE LC-CDP NARW 8HL 4.5X142 PLATE LC-CDP NARW 9HL 4.5X160 PLATE LC-CDP NARW 10HL 4.5X188 PLATE LC-CDP NARW 11HL 4.5X196 PLATE LC-CDP NARW 12HL 4.5X214 PLATE LC-DCP BROAD 6HL 4.5X106 PLATE LC-DCP BROAD 7HL 4.5X124 PLATE LC-DCP BROAD 8HL 4.5X142 PLATE LC-DCP BROAD 9HL 4.5X160 PLATE LC-DCP BROAD 10HL4.5X178 PLATE LC-DCP BROAD 11HL4.5X196 PLATE LC-DCP BROAD 12HL4.5X214 PLATE LC-DCP BROAD 14HL4.5X250 PLATE T 6HL 4.5X116MM PLATE T 8HL 4.5X148MM SLV LK TI BLADE 100D END CAP TI SOLID TIB NAIL BOLT LK TROC SLFTP TI 4.9X30MM NAIL FEM CANN TI GRN 10X300MM NAIL FEM CANN TI GRN 10X320MM NAIL FEM CANN TI GRN 10X340MM NAIL FEM CANN TI GRN 10X360MM NAIL FEM CANN TI GRN 10X380MM NAIL FEM CANN TI GRN 10X400MM NAIL FEM CANN TI GRN 10X420MM NAIL FEM CANN TI GRN 10X440MM NAIL FEM CANN TI GRN 10X460MM NAIL FEM CANN TI GRN 10X480MM NAIL FEM CANN TI GRN 11X300MM NAIL FEM CANN TI GRN 11X320MM NAIL FEM CANN TI GRN 11X340MM NAIL FEM CANN TI GRN 11X380MM NAIL FEM CANN TI GRN 11X400MM NAIL FEM CANN TI GRN 11X420MM NAIL FEM CANN TI GRN 11X440MM NAIL FEM CANN TI GRN 11X460MM NAIL FEM CANN TI GRN 11X480MM NAIL FEM CANN TI GRN 12X300MM NAIL FEM CANN TI GRN 12X320MM NAIL FEM CANN TI GRN 12X340MM NAIL FEM CANN TI GRN 12X360MM NAIL FEM CANN TI GRN 12X380MM NAIL FEM CANN TI GRN 12X400MM NAIL FEM CANN TI GRN 12X420MM NAIL FEM CANN TI GRN 12X440MM NAIL FEM CANN TI GRN 12X460MM Page 315 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $840.00 $840.00 $1,068.00 $1,068.00 $1,068.00 $1,114.00 $1,206.00 $1,049.00 $1,049.00 $1,049.00 $1,127.00 $1,127.00 $1,127.00 $1,171.00 $1,445.00 $1,218.00 $615.00 $768.00 $2,570.00 $2,415.00 $2,415.00 $2,415.00 $2,570.00 $2,415.00 $2,570.00 $2,570.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,570.00 $2,570.00 $2,570.00 $2,570.00 $2,570.00 $2,570.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,570.00 $2,570.00 $2,415.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL FEM CANN TI GRN 12X480MM NAIL TIB TI STER 8X285MM NAIL TIB TI STER 8X300MM NAIL TIB TI STER 8X315MM NAIL TIB TI STER 8X345MM NAIL TIB TI STER 8X360MM NAIL TIB TI STER 8X380MM NAIL TIB TI STER 9X285MM NAIL TIB TI STER 9X300MM NAIL TIB TI STER 9X315MM NAIL TIB TI STER 9X330MM NAIL TIB TI STER 9X345MM NAIL TIB TI STER 9X360MM NAIL TIB TI STER 9X380MM NAIL TIB TI STER 9X400MM NAIL TIB TI CANN 10X255MM NAIL TIB TI CANN 10X270MM NAIL TIB TI CANN 10X285MM NAIL TIB TI CANN 10X300MM NAIL TIB TI CANN 10X315MM NAIL TIB TI CANN 10X330MM NAIL TIB TI CANN 10X345MM NAIL TIB TI CANN 10X360MM NAIL TIB TI CANN 10X380MM NAIL TIB TI CANN 10X400MM NAIL TIB TI CANN 10X420MM NAIL TIB TI CANN 11X255MM NAIL TIB TI CANN 11X270MM NAIL TIB TI CANN 11X285MM NAIL TIB TI CANN 11X300MM NAIL TIB TI CANN 11X315MM NAIL TIB TI CANN 11X330MM NAIL TIB TI CANN 11X345MM NAIL TIB TI CANN 11X360MM NAIL TIB TI CANN 11X380MM NAIL TIB TI CANN 11X420MM CATH GLIDE ANG 4FR 120CM DRSG ABTHERA WITH SENSATRAC SCREW CORT TRMI 2.3X18MM KWIRE SGL PREMARK TRMI 1.1MM SCREW BREAKOFF SOLERA TI MDTR SCREW LK ARTX 2.7X10MM SCREW LK ARTX 2.7X12MM SCREW LK SS ARTX 2.7X22MM SCREW LK SS ARTX 2.7X24MM SCREW LK SS ARTX 2.7X26MM Page 316 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,415.00 $2,304.00 $2,304.00 $2,452.00 $2,452.00 $2,452.00 $2,304.00 $2,304.00 $2,304.00 $2,304.00 $2,304.00 $2,304.00 $2,304.00 $2,304.00 $2,304.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $287.00 $1,365.00 $455.00 $95.00 $741.00 $579.00 $579.00 $579.00 $599.15 $579.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CNCLS ARTX 3X16MM SCREW CORTNLARTX 3.5X10MM SCREW CORTNLARTX 3.5X24MM SCREW CORTNLARTX 3.5X26MM SCREW CORTNLARTX 3.5X30MM SCREW CORTNLARTX 3.5X40MM SCREW CORTNLARTX 3.5X45MM SCREW CORTNLARTX 3.5X50MM SCREW CORTNLARTX 3.5X55MM SCREW CORT LK ARTX 3.5X10MM SCREW CORT LK ARTX 3.5X12MM SCREW CORT LK ARTX 3.5X16MM SCREW CORT LOCK ARTX 3.5X20MM SCREW LO PRO TM SS ARTX 4X12MM SCREW LO PRO TM SS ARTX 4X14MM SCREW LO PRO TM SS ARTX 4X20MM SCREW CANN SHRT THRD 4X30MM SCREW CANN SHRT THRD 4X40MM SCREW CANN SHT THRDARTX 4X50MM SCREW CANN SHRT THRD 4X55MM SCREW CANN SHT THRDARTX 4X60MM SCREW CANN LNG THRDARTX 4X55MM SCREW CANN LNG THRDARTX 4X60MM GDWIRE TROC TIP 1.35X150MM BIT DRILL 3MM BIT DRILL 2.5MM PLATE FIB ANK ARTX LFT 6HL PLATE FIB ANK ARTX LFT 8HL PLATE FIB ANK ARTX RT 4HL PLATE ST LK ST SS ARTX 4HL PLATE ST LK ST SS ARTX 10HL PLATE LK MEDL HOOK ARTX 5HL PLATE LK MEDL HOOK ARTX 7HL PLATE LK TUBLR SS ARTX 4HL PLATE LK TUBLR SS ARTX 7HL PLATE LK LAT HOOK ARTX 3HL PLATE LK LAT HOOK ARTX 5HL SHLDR AFFINITI 40 PEG GLENOID SHLDR AFFINITI 44 PEG GLENOID SHLDR AFFINITI 56 PEG GLENOID SHLDR ASCEND HUMRHD1.5 38X15 SHLDR ASCEND HUMRHD1.5 42X16 SHLDR ASCEND HUMRHD1.5 44X17 SHLDR ASCEND HUMRHD1.5 46X18 SHLDR ASCEND HUMRHD1.5 50X19 SHLDR ASCEND HUMRHD1.5 52X20 Page 317 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $191.00 $191.00 $191.00 $191.00 $191.00 $191.00 $191.00 $191.00 $191.00 $579.00 $579.00 $579.00 $579.00 $191.00 $191.00 $191.00 $811.00 $811.00 $811.00 $856.00 $811.00 $856.00 $811.00 $113.00 $579.00 $455.60 $2,075.00 $2,171.00 $1,714.00 $1,506.00 $1,874.00 $2,253.00 $2,340.00 $1,078.00 $1,222.00 $2,003.00 $2,003.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHLDR ASCEND HUMRHD3.5 38X15 SHLDR ASCEND HUMRHD3.5 40X15 SHLDR ASCEND HUMRHD4.0 46X18 SHLDR ASCEND STEM ANG A SZ1 SHLDR HUMR STEM SZ6 SHLDR SCREW LK 5X38MM SHLDR GLENOID HD OFFSET-4 32MM NDLE BX PROBE FINESSE10GX105MM SEAL MYOSURE LENS CAUT ENTCEPS HIP HD BIOLOX CER ZIMM32MM+3.5 SHLDR ASCEND STEM ANG A SZ4 SHLDR ASCEND STEM ANG B SZ4 SHLDR ASCEND STEM ANG C SZ4 SHLDR ASCEND STEM ANG A SZ5 SHLDR ASCEND STEM ANG A SZ6 SHLDR ASCEND STEM ANG B SZ7 SHLDR ASCEND STEM ANG A SZ8 SHLDR ASCEND STEM ANG C SZ8 HIP HD M2A ZIMM MTL 40MM +9 PLATE FEM OPEN WEDGE TI 7.5MM SCREW CORT ARTX 4.5X48MM SCREW CORT ARTX 4.5X56MM SCREW CNCLS ARTX 6.5X65MM SCREW CNCLS ARTX 6.5X70MM KNEE ADPTR SLV DEPU FEM +5MM KNEE FEM PS CMNT DEPU LFT 1.5 SUT VICRYL 5-0 PS2 18 UNDY SUT NUROLON 0 CT2 CR8-18 BIT DRILL NEUROSOFTTOUCH 2X3.1 PLATE CRST BROAD 2X2HL 2.0MM PLATE ANG BROAD TI 2.0MM 3X3HL KNEE TIB INSRT XLK STBL 3 20MM SCREW CANN AS3 STRY 4.0X60MM SCREW CANN TI AS3 STRY6.5X55MM NAIL ANK T2 STRY LFT 10X150MM NAIL ANK T2 STRY RT 10X200MM SCREW CENTERPIECE FA 3.0X7MM SCREW CENTERPIECE FA 3.0X9MM CATH GLIDE ANG 4FR 100CM ENDOL ENDUR II 16X13X124MM KNEE FEM DIST AUG RT SZ3 12MM KT BLN DIL UROMAX 21FR FORCEPS URETEROSCOPIC BX 115CM BLADE TURBINATE M4 2.9MMX11CM SCREW SCHANZ CALC WAVE 5MM Page 318 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,932.00 $2,932.00 $2,932.00 $5,266.00 $5,546.00 $438.00 $2,591.00 $1,169.00 $59.00 $931.80 $2,613.00 $5,266.00 $5,266.00 $5,266.00 $5,266.00 $5,266.00 $5,266.00 $5,266.00 $5,266.00 $1,790.00 $2,327.00 $441.00 $441.00 $441.00 $441.00 $2,439.00 $2,764.00 $20.00 $58.00 $674.00 $1,537.90 $2,004.39 $2,344.00 $714.00 $1,077.00 $4,240.00 $4,240.00 $364.00 $364.00 $287.00 $9,176.00 $2,660.00 $1,549.00 $1,707.00 $1,046.00 $387.00 2020 pricing Drugs&Supplies PROCEDURE NAME BIT DRILL CALC WAVE 2.7X160MM ELBOW RAD HD ANATOM RT 24MM EXPAND MAM MODER W TAB 400CC ENDOL ENDUR II 16X10X156MM SCREW EMER MTXMAND 2.7X8MM PLATE MINI TENSION NARW 2X2HL PLATE CRST TI 2X2HL 1.25MM PLATE ST DCP TI 3X3HL 1.25MM PLATE ANG DCP TI 3X3HL 1.25MM PLATE MTXMAND ANG3X3HL1.5MM PLATE MTXMANDTHICK3X3HL 1.5 PLATE MTXMAND 3X3HL 1.5MM DRSG OASIS MTX FEN 3X7CM=21SQ DRAPE MICROSCOPE LEICA 54X150 SUT DEV CAPRIO RP SUT CAPRIO TC 26MM HIP HD EZEM MTL12/14 36 +15.5 HIP STEM SUMMIT BASIC CMNT SZ8 SUT CHROMIC GUT 2-0 CT2 SUT STEEL 4 22G 18 SUT STEEL 1 25G 18 SUT STEEL 0 26G 18 SCREW CORT SLFTP 3.5X80MM SCREW CORT STD 4.5X66MM SCREW CORT STD 4.5X68MM PLATE DCP BROAD 4.5MM 7HL 119 PLATE DCP BROAD 4.5MM 8HL 135 PLATE DCP BROAD 4.5MM 9HL 151 PLATE DCP BROAD 4.5MM 10HL 167 PLATE TIB PROX RT 4HL 4.5MM PLATE TIB PROX LFT 4HL 4.5MM PLATE TIB PROX RT 6HL .5MM PLATE TIB PROX LFT 6HL 4.5MM PLATE T BTRS 5HL 4.5X96MM PLATE TIB BTRS RT 7HL 149MM PLATE TIB BTRS LFT 7HL 149MM PLATE FEM BTRS COND LFT 11HL PLATE FEM BUTTRESS COND R*CIP PLATE FEM BTRS COND LFT 7HL PLATE FEM BTRS COND LFT 9HL PLATE FEM BTRS COND RT 7HL PLATE FEM BTRS COND RT 9HL PLATE T RT ANG 6HL/4HL HD SCREW LAG DHS/DCS 12.7X100MM SCREW LAG DHS/DCS 12.7X105MM SCREW LAG DHS/DCS 12.7X110MM Page 319 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $364.00 $5,864.00 $3,438.00 $11,804.00 $368.00 $1,210.04 $2,031.48 $1,074.27 $1,303.29 $1,928.21 $1,928.21 $1,538.31 $1,020.00 $101.00 $206.00 $179.00 $1,419.00 $2,205.00 $17.00 $37.00 $37.00 $38.00 $116.00 $87.00 $87.00 $959.00 $1,179.00 $1,179.00 $1,179.00 $2,566.00 $2,566.00 $2,571.00 $2,571.00 $1,473.00 $1,860.00 $1,860.00 $2,064.00 $2,064.00 $1,852.00 $2,006.00 $1,852.00 $2,006.00 $767.00 $1,114.00 $1,114.00 $1,114.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LAG DHS/DCS 12.7X115MM SCREW LAG DHS/DCS 12.7X120MM SCREW LAG DHSDCS SYNT12.7X55MM SCREW LAG DHSDCS SYNT12.7X65MM SCREW LAG DHSDCS SYNT12.7X70MM SCREW LAG DHSDCS SYNT12.7X75MM SCREW LAG DHSDCS SYNT12.7X80MM SCREW LAG DHSDCS SYNT12.7X90MM SCREW LAG DHSDCS SYNT12.7X95MM PLATE DCS 25BRL 95D 10HL 114MM PLATE DCS 25BRL 95D 14HL 242MM PLATE DCS 25BRL 95D 16HL 274MM PLATE DCS 25BRL 95D 6HL 114MM PLATE DCS 25BRL 95D 8HL 146MM PLATE DCS 25BRL 95D 22HL 370MM SCREW SCHANZ 6.0 SPADE 160MM SIZER MAM STER 210-240CC SIZER MAM STER 240-270CC SIZER MAM STER 270-300CC SIZER MAM STER 330-360CC SIZER MAM STER 360-390CC SIZER MAM STER 390-420CC SIZER MAM STER 420-450CC SIZER MAM STER 450-480CC ROD TSRH MDTR 6.5X4.0MM ROD TSRH MDTR 6.5X5.0MM CORE FORT PEEK 20MM 26-32MM SCREW LK HEXALOBE 2.7X24MM GDWIRE TROCTIP ARTX 1.35X150MM GLIDESCOPE GLV 2.5 GDWIRE NTHRD 1.25X150MM SUT CHROMIC GUT 1 CT1 36 SUT CHROMIC GUT 2-0 CT1 36 NDLE EPIDURAL TUOHY 20GX127MM SCREW NL LP ARTX 4X34MM SCREW NL LP ARTX 4X40MM STNT URETRL RESONANCE 6FR24CM CATH TRAILBLAZER .035 90CM SHEATH PNCLE RO NO GD 6FR 25CM ENDOL ENDUR II 16X16X124MM PLATE HUMR PROX RT 5HL 3.5MM ENDO TROC KII FIOS 11X100MM SCREW LK HEXALOBE 2.7X26MM BREAST HIPRO SALINE 425CC ALLO LASR CORNERSTONE 7X14X11 ALLO LASR CORNERSTONE 6X14X11 Page 320 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,114.00 $1,114.00 $1,114.00 $1,114.00 $1,114.00 $1,114.00 $1,114.00 $1,114.00 $1,114.00 $2,258.00 $2,442.00 $2,604.00 $2,258.00 $2,258.00 $3,237.00 $316.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $1,568.00 $1,568.00 $13,409.00 $770.00 $113.00 $123.00 $111.82 $18.00 $18.00 $64.00 $191.00 $191.00 $2,254.00 $159.00 $192.00 $9,084.00 $3,225.00 $165.00 $781.00 $1,591.00 $2,890.00 $2,890.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT ETHILON 6-0 P1 18 UNDY SUT VICRYL 4-0 SH1 UNDY SUT PROLENE 4-0 FS2 18 SUT ETHIBOND 2-0 CT2 CR8-18 SUT SILK 5-0 P3 18 KT BLN RELIEVA SPIN F6X16*CIP* PLATE CLAV LAT ANT10HL 2.7/3.7 HIP SHELL TRABEC REV 66MM KNEE TIB GENESIS II CMNT RTSZ2 KT BLN RELIEVA SPINM6X16*CIP* CATH SINUS GD SPIN F70*CIP* CATH SINUS GD SPIN M110*CIP* CATH SINUS GD SPIN S-0*CIP* CATH IRG SINUS VORTEX 2 BREAST MODER SALINE 270CC KT GASTRO MIC LOPRO 12FR 1.5CM SCREW CORT STD HEX 3.5X38MM GLOVE ANTIVIB GEL OPEN LG BUR RD PREC 4MM CATH BEACON RC2 0.038 5FR 65CM SUCT MANIFOLD NEPTUNE2 4 PORT BUTTON CERCLAGE 3.5MM HIP STEM SYNRG POR STD SZ10 KNEE TIB FULLSTEPWEDGE3-4 10MM STNT BLN UTERINE 11.5X2.8X3CM HIP STEM SOL SYS ST LG 15MM PIN STEINMAN MID THRD 5.0X275 MAM IMPLT SILTEX GEL 700CC BREAST NATRELLE SIL MID 176CC BREAST NATRELLE SIL MID 194CC BREAST NATRELLE SIL MID 265CC BREAST NATRELLE SIL MID 304CC BREAST NATRELLE SIL MID 397CC BREAST NATRELLE SIL MID 421CC BREAST HIPRO SIL RD 230CC BREAST HIPRO SIL RD 260CC BREAST MODER SALINE 150CC BREAST MODER SALINE 180CC BREAST MODER SALINE 240CC BREAST MODER SALINE 330CC BREAST MODER SALINE 390CC BREAST MODER SALINE 420CC BREAST MODER SALINE 450CC BREAST MODER SALINE 480CC BREAST MODER SALINE 510CC BREAST MODER SALINE 550CC Page 321 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $19.00 $8.00 $13.00 $56.00 $18.00 $3,624.00 $2,292.00 $8,435.00 $2,259.00 $3,624.00 $1,224.00 $1,224.00 $1,224.00 $807.00 $1,410.00 $526.00 $84.00 $263.00 $895.00 $61.00 $91.00 $731.00 $4,161.00 $3,545.00 $209.00 $16,270.00 $465.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $2,312.00 $2,312.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 2020 pricing Drugs&Supplies PROCEDURE NAME EXPAND MAM XTR PROJ SHRT 400CC PLATE HUMR MEDL DIST MD LFT2HL PLATE HUMR LAT DIST 2HL LFT MD SCREW METAPHYSEAL SYNT2.7X34MM HIP ADPTR ENDOII TAPER -6MM SCREW NL STRY 3.5X65MM SCREW LK STRY 3.5X38MM HIP STEM SYNRG CMNT STD SZ10 HIP STEM SYNRG CMNT STD SZ13 HIP STEM SYNRG CMNT STD SZ14 HIP STEM SYNRG CMNT STD SZ15 HIP STEM SYNRG CMNT HIGH SZ13 HIP STEM SYNRG CMNT HIGH SZ14 HIP STEM SYNRG CMNT HIGH SZ15 MESH PARIETEX PROGRIPLFT12X8CM DRSG AQUACEL AG SURG 3.5X6 PLATE DCP NARW 5HL 4.5X87MM PLATE DCP NARW 6HL 4.5X103MM PLATE DCP NARW 10HL 4.5X167MM KNEE SEGMENT LPS DEPU 35MM PLATE HUMR MEDL EXT RT LNG 4HL PLATE OLEC PROX RT 2HL 73MM SCREW METAPHYSEAL SYNT2.7X50MM SCREW METAPHYSEAL SYNT2.7X60MM SCREW CORT TRMI 3.2X16MM SCREW CORT TRMI 3.2X18MM SCREW CORT TRMI 2.3X22MM SCREW CORT TRMI 2.3X24MM ALLO LASR CORNERSTONE 5X14X11 SHEATH FLEXOR 12FR 35CM SHEATH FLEXOR URETRL 12FR 45CM EXTR STONE NGAGE NIT 2.2FR 8MM BREAST RD SIL XTRHIGH400CC HIP STEM SYNRG CMNT HIGH SZ16 HIP STEM SYNRG CMNT HIGH SZ17 HIP STEM CONQUEST PRIM STDSZ14 HIP STEM CONQUEST PRIM STDSZ15 PLATE REPLANT MLOCK2.3 3D4X2H SCREW STRY BONE 2.3X11MM SCREW STRY BONE 2.3X12MM SCREW STRY BONE 2.3X13MM SCREW STRY BONE 2.3X14MM SCREW CANN SYNT 7X32X70MM SCREW CANN SYNT 7X32X75MM HIP BODY PROX RECLAIM 20X85MM BLADE RAD 120 CURV 3.5MMX11CM Page 322 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,164.00 $2,751.00 $4,121.00 $247.00 $834.00 $397.00 $754.00 $2,643.03 $2,643.03 $2,698.00 $2,698.00 $2,698.00 $2,643.03 $2,698.00 $1,121.00 $123.00 $655.00 $734.00 $947.00 $5,235.00 $2,775.00 $2,390.00 $247.00 $247.00 $455.00 $455.00 $438.00 $439.00 $2,890.00 $657.00 $657.00 $1,048.00 $2,205.00 $2,643.03 $2,698.00 $1,808.00 $1,773.66 $1,436.00 $417.00 $417.00 $417.00 $417.00 $1,172.00 $1,172.00 $9,203.00 $1,182.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE HUMR MEDL EXT MD RT 2HL PLATE HUMR LAT DIST 5HL RT LNG SCREW METAPHYSEAL SYNT2.7X28MM SCREW METAPHYSEAL SYNT2.7X42MM SCREW METAPHYSEAL SYNT2.7X46MM SCREW NL HEXALOBE 3X24MM SCREW LK HEXALOBE 3X28MM SCREW NL HEXALOBE 3X20MM BREAST RD SIL XTRHIGH500CC BIT DRILL WRIT CANN 3.2MM SCREW CORT MATTA 3.5X24MM SCREW CORT MATTA 3.5X32MM SCREW CORT MATTA 3.5X34MM SCREW CORT MATTA 3.5X45MM SCREW CORT MATTA 3.5X55MM SCREW CORT MATTA 3.5X65MM SCREW CORT MATTA 3.5X70MM SCREW CORT MATTA 3.5X75MM SCREW CORT MATTA 3.5X80MM SCREW CORT MATTA 3.5X85MM WASHER MATTA 9MM PLATE MATTA MPS ST 4HL 58.5MM PLATE MATTA MPS FLEX 4HL 46.5 PLATE MATTA MPS FLEX 8HL 94.5 BIT DRILL MATTA 2.5X230MM BIT DRILL MATTA 3.2X230MM CAGE EXPAND MDTR 22X31X41MM DISECT ETHICON CURV 5MM SCREW LK AXSOS 4.0X24MM SCREW LK AXSOS 4.0X28MM SCREW LK AXSOS 4.0X30MM SCREW LK AXSOS 4.0X36MM SCREW LK AXSOS 4.0X40MM SCREW CORT MATTA 3.5X28MM SCREW CORT MATTA 3.5X30MM PLATE VOLAR FA 5HL 7PEG LFT PLATE VOLAR FA 3HL 7PEG RT SCREW CORT TRMI 3.2X10MM SCREW CORT TRMI 3.2X20MM PEG VOLAR THRD TRMI 14MM PEG VOLAR UNTHRD TRMI 22MM PEG VOLAR UNTHRD TRMI 24MM BIT DRILL TRMI 2.30MM LEAD PENTA 3MMX60CM KT XLIF DISP KT MACXCESS DISP Page 323 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,775.00 $2,751.00 $247.00 $247.00 $247.00 $488.00 $778.00 $494.00 $2,205.00 $1,220.00 $152.00 $152.00 $152.00 $152.00 $152.00 $152.00 $152.00 $152.00 $152.00 $152.00 $159.00 $1,101.00 $1,151.92 $1,374.56 $477.00 $477.00 $14,023.00 $1,020.00 $655.00 $655.00 $655.00 $655.00 $655.00 $152.00 $152.00 $1,897.00 $1,897.00 $455.00 $455.00 $515.00 $533.00 $533.00 $641.00 $12,436.00 $2,740.00 $2,455.00 2020 pricing Drugs&Supplies PROCEDURE NAME EMG NDLE MODULE KNEE FEM LGN CNSTND RT SZ5 KNEE FEM WEDGE LGN 5-6 10MM ALLO LASR CORNERSTONE 8X14X11 BLADE BLITZER SICKLE MDTR SUT VICRYL 1 CT1 CR8-18 UNDY SCREW CNCLS PART TI 3.0X16MM SCREW CNCLS PART TI 3.0X18MM SHLDR GD RETROVERSION ROD SHLDR HEX SCREW DRIV BIT REVII BIT DRILL TORN SHLDR 3X220MM SHLDR CMNT RESTRICTOR SHLDR COMP SCREW 26MM SHLDR COMP SCREW 38MM SHLDR LK SCREW 4.5X23MM SHLDR GLENOID BASE PLATE SHLDR CMNT METAPHYSIS 36MM SHLDR CMNT HUMR STEM 15X100MM SHLDR LAT HUMR INSRT 36X9 KNEE TIB TRAY 360 ZIMM 83MM KNEE TIB CRUC WING 360 LG KNEE ADPTR OFFSET 360 ZIMM 5MM NDLE BX TRUGUIDE 17GX13.8CM KNEE TIB CONE STEPMD59 15/30MM WALKER PNEUMATIC *VAT 6258773* CASSETTE IRG DISP HUMMER 2 PLATE HUMR MEDL EXT XLNGLFT6HL PLATE HUMR LAT DIST 5HL LFTLNG PLATE HUMR LAT DIST 7HLLFTXLNG SCREW METAPHYSEAL SYNT2.7X30MM SCREW METAPHYSEAL SYNT2.7X38MM SCREW METAPHYSEAL SYNT2.7X44MM PLATE OLEC PROX LFT 2HL 73MM PLATE HUMR MEDL EXT MD LFT 2HL SCREW METAPHYSEAL SYNT2.7X20MM SCREW METAPHYSEAL SYNT2.7X58MM SCREW METAPHYSEAL SYNT2.7X64MM SCREW VA LK STAR T15 3.5X65 SCREW VA LK STAR T15 3.5X70 SCREW CANN SYNT 7X32X85MM SYS CPR MINI SCORPION DX GDWIRE ARCHER STIF.035*DISC* KNEE TIB INSRT HNG DEPU 16MM BLADE RAD 12 M4 CURV 4MMX11CM PLATE HUMR LAT DIST 2HL RT MD SCREW METAPHYSEAL SYNT2.7X22MM Page 324 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,012.00 $14,091.00 $2,923.00 $2,890.00 $319.00 $56.00 $746.00 $746.00 $373.00 $579.00 $394.00 $992.00 $289.00 $289.00 $558.00 $2,800.00 $2,932.00 $3,271.00 $1,822.00 $4,763.00 $1,933.00 $2,151.00 $62.00 $10,371.00 $411.00 $217.00 $2,775.00 $2,751.00 $2,751.00 $247.00 $247.00 $247.00 $2,390.00 $2,775.00 $247.00 $247.00 $247.00 $744.00 $744.00 $1,172.00 $2,471.00 $764.00 $5,819.00 $869.00 $2,752.00 $247.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW METAPHYSEAL SYNT2.7X36MM SCREW METAPHYSEAL SYNT2.7X52MM KNEE TIB TRAY PFC MOD PLUS 2 SCREW ANT LOPRO 6.5X30MM NDLE BX MURPHY COAX 13GX10CM NDLE BX MURPHY COAX 13GX15CM KNEE TIB INSRT STD 16X71/75MM PLATE PDS FLEX 0.15MM HIP LNR X3 STRY PE 28X48 G SIZER MAM STER 480-510CC SIZER MAM STER 510-540CC SIZER STYLE 68HP 320-340CC SIZER STYLE 68HP 350-380CC SIZER STYLE 68HP 425-455CC SIZER STYLE 68HP 465-505CC SIZER STYLE 68HP 500-540CC SHLDR HUMRSTEM CMPRHNSV MINI17 HIP BODY PROX RECLAIM 24X75MM PLATE OLEC LFT 2HL 90MM NAIL TIB T2 STRY STD 12X375MM HIP LNR ARCOMXL PE 10D 36X24MM CNTRCPT ARM NEXPLANON 68MG NAIL TIB T2 STRY 9X330MM KNEE FEM OXFORD XS PLATE TIB SM LFT 4HL 3.5X87MM SCREW VA LK STAR T15 3.5X22 SCREW VA LK STAR T15 3.5X24 SCREW VA LK STAR T15 3.5X26 SCREW VA LK STAR T15 3.5X28 SCREW VA LK STAR T15 3.5X36 SCREW VA LK STAR T15 3.5X40 SCREW VA LK STAR T15 3.5X54 SCREW VA LK STAR T15 3.5X75 SUPP KNEE ELAS BRC 16-20IN HIP STEM SROM 36 19X24X175 HIP SLV PROX SROM 24B-SML TB INSERTION TEFLON STRY GDWIRE BALL TIP STRY 2.5X800MM GDWIRE SMTH TIP STRY 2.2X800MM BIT DRILL STRY 3.5X230MM NAIL HUMR T2 7X250MM SCREW LK STRY 4X22MM SCREW LK STRY 4X40MM SCREW LK STRY 4X45MM PLATE OLEC RT 2HL 90MM PLATE OLEC RT 4HL 116MM Page 325 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $247.00 $247.00 $6,820.00 $2,123.00 $476.00 $476.00 $2,432.00 $1,142.00 $2,627.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $5,937.00 $9,203.00 $2,571.00 $3,143.00 $2,123.00 $2,231.00 $3,143.00 $3,444.00 $2,074.00 $706.00 $744.00 $744.00 $744.00 $744.00 $744.00 $744.00 $744.00 $123.00 $3,240.00 $2,205.00 $642.00 $471.14 $471.14 $471.14 $3,169.00 $809.05 $828.00 $828.00 $2,568.00 $2,568.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE OLEC RT 6HL 142MM PLATE OLEC STER RT 8HL 169MM PLATE OLEC LFT 4HL 116MM PLATE OLEC LFT 6HL 142MM PLATE OLEC LFT 8HL 169MM PLATE X ART PROX ULNA RT6HL131 PLATE X ART PROX ULNA RT8HL157 PLATE X ART PROX ULNART10HL184 PLATE X ART PROX ULNART12HL211 PLATE X ART PROX ULNALFT8HL157 PLATE XART PROX ULNALFT10HL184 PLATE XART PROX ULNALFT12HL211 PLATE HUMR MEDL DIST SHRTRT1HL PLATE HUMR MEDL DIST MD RT 2HL PLATE HUMR MEDL DIST RT LNG4HL PLATE HUMR MEDL DIST RTXLNG6HL PLATE HUMR MEDL DIST RT 8HL PLATE HUMR MEDL DIST RT 10HL PLATE HUMR MEDLDIST SHRTLFT1HL PLATE HUMR MEDL DIST LNGLFT4HL PLATE HUMR MEDLDIST XLNGLFT6HL PLATE HUMR MEDL DIST LFT 8HL PLATE HUMR MEDL DIST LFT 10HL PLATE HUMR MEDL EXT SHRT RT1HL PLATE HUMR MEDL EXT RT XLNG6HL PLATE HUMR MEDL EXT RT 8HL PLATE HUMR MEDL EXT RT 10HL PLATE HUMR MEDL EXT SHRTLFT1HL PLATE HUMR MEDL EXT LNG LFT4HL PLATE HUMR MEDL EXT LFT 8HL PLATE HUMR MEDL EXT LFT 10HL PLATE HUMR LAT DIST 1HL RTSHRT PLATE HUMR LAT DIST 7HL RTXLNG PLATE HUMR LAT DIST 9HL RT 173 PLATE HUMR LAT DIST 11HL RT199 PLATE HUMR LAT DIST 1HLLFTSHRT PLATE HUMR LAT DIST 9HL LFT173 PLATE HUMR LAT DIST 11HLLFT199 SCREW METAPHYSEAL SYNT2.7X10MM SCREW METAPHYSEAL SYNT2.7X12MM SCREW METAPHYSEAL SYNT2.7X14MM SCREW METAPHYSEAL SYNT2.7X16MM SCREW METAPHYSEAL SYNT2.7X18MM SCREW METAPHYSEAL SYNT2.7X24MM SCREW METAPHYSEAL SYNT2.7X26MM SCREW METAPHYSEAL SYNT2.7X32MM Page 326 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,568.00 $2,609.00 $2,568.00 $2,691.00 $2,609.00 $2,817.00 $2,817.00 $2,817.00 $2,817.00 $2,817.00 $2,817.00 $2,817.00 $2,752.00 $2,751.00 $2,751.00 $2,751.00 $2,985.00 $2,985.00 $2,751.00 $2,751.00 $2,751.00 $2,985.00 $2,985.00 $2,775.00 $2,775.00 $2,879.00 $2,879.00 $2,775.00 $2,773.00 $2,879.00 $2,879.00 $2,751.00 $2,751.00 $2,796.00 $2,796.00 $2,751.00 $2,796.00 $2,796.00 $247.00 $247.00 $247.00 $247.00 $247.00 $247.00 $247.00 $247.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW METAPHYSEAL SYNT2.7X40MM SCREW METAPHYSEAL SYNT2.7X48MM SCREW METAPHYSEAL SYNT2.7X54MM SCREW METAPHYSEAL SYNT2.7X56MM SCREW METAPHYSEAL SYNT2.7X62MM SCREW METAPHYSEAL SYNT2.7X66MM SCREW VA LK T8 STAR 2.7X58MM SCREW VA LK T8 STAR 2.7X60MM PLATE X ART PROX ULNALFT6HL131 NAIL TIB T2 STRY STD 10X390MM NAIL TIB T2 STRY STD 10X405MM END CAP T2 STRY 12X +10 FINGER SIL MSP SZ20 HIP HD SROM MTL 11/13 28MM +0 HIP STEM SROM 30 9X14X130 SCREW CANN SYNT 7X32X90MM PLATE HUMR DIST SHRT LFT 3HL CELL SAVE 5 BOWL 125ML MESH PARIETEX PLUG PATCH 6.0CM BONE VOID FILLER CERAMENT 10CC PIN EXTL FIX THRD 60X5X200MM MESH VENTRALIGHT ST CIR 6 SHLDR CMNT HUMR STEM 12X100MM SHLDR CMNT METAPHYSIS 42MM SHLDR LAT HUMR INSRT 42X9 SHLDR LK SCREW 4.5X29MM SHLDR LK SCREW 4.5X35MM SHLDR GLENOIDSPHERE CTR29X42MM SHLDR COMP SCREW 29MM SHLDR COMP SCREW 50MM SHLDR HUMR HD ZIMM 38X19X39MM GRAFTBOLT TIB ARTX 10MM HIP LNR ENDURANCE PE 28X44MM HIP LNR ARCOMXL PE 10D 36X25MM BREAST NATRELLE SIL MID 752CC SCREW CANN SYNT 7X32X80MM BUR M4 SM RD 10CMX2.9MM NAIL TIB T2 STRY STD 10X360MM TB INFLOW OUTFLOW AQUILEX SYS CMNT MIXING REVOLUTION HIP HD OXIN MTL 12/14 32MM -3 NAIL TIB T2 STRY STD 10X330MM PSTNR HD DISP UNIV SCREW LK STRY 3.5X14MM SCREW LK STRY 3.5X16MM DEV MYOSURE TISS REMOVAL*CIP* Page 327 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $247.00 $247.00 $247.00 $247.00 $247.00 $247.00 $631.00 $631.00 $2,817.00 $3,143.00 $3,143.00 $842.00 $3,319.00 $1,419.00 $3,240.00 $1,172.00 $2,751.00 $456.00 $602.00 $6,491.00 $570.00 $1,734.00 $3,271.00 $2,932.00 $1,822.00 $570.00 $570.00 $4,873.00 $289.00 $289.00 $3,786.00 $1,384.00 $2,376.00 $2,123.00 $2,245.00 $1,172.00 $793.00 $3,143.00 $658.00 $667.00 $2,171.00 $3,143.00 $118.00 $785.00 $785.00 $3,179.00 2020 pricing Drugs&Supplies PROCEDURE NAME COIL DETACH INTERLOCK10MMX40CM BIT DRILL CANN TRMI 1.6MM FINGER IMPLT NEUFLEX MCP SZ6 HIP STEM RECLAIM DIST ST17X140 SCREW CANN SYNT 7X16X70MM SCREW CORT LEAD DBL 5X34MM MESH ALLOMAX 2X4CM SHLDR LAT HUMR INSRT 36X12 SHLDR LK SCREW 4.5X38MM SHLDR LK SCREW 4.5X41MM SHLDR GLENOID BASE PLATE 25MM SHLDR GLENOIDSPERE TILT25X36MM SHLDR COMP SCREW 32MM CANN GEMINI SR8 ARTX PLATE OLECRANON RT 4HL 65MM BRC ANK ASO BLK LACE UP XL PLATE HUMR DIST SHRT SUPPRT3HL PLATE HUMR DIST MD SUPP RT 4HL PLATE HUMR DIST LNG SUPP RT7HL PLATE HUMR DISTXLNG SUPP RT9HL PLATE HUMR DIST SHRTSUPPLFT3HL PLATE HUMR DIST LNG SUPPLFT7HL PLATE HUMR DISTXLNG SUPPLFT9HL PLATE HUMR DIST SHRT RT 3HL PLATE HUMR DIST MD RT 4HL PLATE HUMR DIST RT LNG 7HL PLATE HUMR DIST RT XLNG 9HL PLATE HUMR DIST MD LFT 4HL PLATE HUMR DIST LNG LFT 7HL PLATE HUMR DIST XLNG LFT 9HL PLATE HUMR DIST MD SUPP LFT4HL CATH PROGREAT RO 2.4FR 130CM SHLDR LK SCREW 4.5X44MM SHLDR LAT HUMR INSRT 36X9MM SHLDR HUMR STEM 36X9MM SHLDR COMP SCREW 18MM SHLDR COMP SCREW 45MM WASHER ARTX TI 13MM BG BELLY W HIP BELT BRC BACK ASPEN VISTA LSO SUPP WRIST W SWIVEL CLIPLFTREG SCREW LK TI SLFTP 3.5X28MM SCREW LK TI SLFTP 3.5X40MM SCREW LK TI SLFTP 3.5X42MM SCREW LK TI SLFTP 3.5X45MM NAIL TIB T2 STRY STD 10X375MM Page 328 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,382.00 $744.00 $2,475.00 $7,694.00 $1,172.00 $1,067.00 $1,000.00 $1,822.00 $570.00 $558.00 $3,088.81 $4,873.00 $289.00 $175.00 $2,365.72 $116.00 $2,775.00 $2,775.00 $2,775.00 $2,775.00 $2,775.00 $2,775.00 $2,775.00 $2,751.00 $2,751.00 $2,751.00 $2,751.00 $2,751.00 $2,752.00 $2,751.00 $2,773.00 $1,301.00 $558.00 $1,822.00 $8,316.54 $289.00 $289.00 $420.00 $125.00 $3,107.00 $186.00 $575.00 $575.00 $575.00 $575.00 $3,143.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT LPS HNG SM 16MM KNEE FEM JII BCS OXIN LFT SZ4 KNEE INSRT JIIBCSLFTSZ3-4 10MM PLATE VARIAX FIB DIST LAT 7HL PLATE VARIAX FIB DIST LAT 9HL GDWIRE DBL ENDED ST .035 SPLT THB SPI RT LG/XL SET WARM BLD FLUID 65ML BREAST SIL MODER STYLE10 270CC SCREW LK STRY 3.5X10MM SCREW BONE STRY 2.7X12MM SCREW BONE STRY 3.5X10MM SCREW BONE STRY 3.5X12MM SCREW BONE STRY 3.5X14MM TB TRACH CUFF CANN 10 SCREW CANN SYNT 7X32X95MM SCREW CANN SYNT 7X32X105MM SCREW CORT SLFTP 2.7X30MM CARTRDG INJECTOR II NDLE FAST-FIX 360 RVRS CURV KNEE PSN FEM CRCMNT NARWLFTSZ5 KNEE PSN FEM CRCMNT NARWLFTSZ6 KNEE PSN FEM CRCMNT NARW RTSZ6 KNEE PSN FEM CRCMNT NARWLFTSZ8 KNEE PSN FEM CRCMNT NARW RTSZ8 KNEE PSN FEM CRCMNT NARWLFTSZ9 KNEE PSN FEM CRCMNT NARW RTSZ9 KNEE PSN FEM CRCMNT STD LFTSZ5 KNEE PSN FEM CRCMNT STD RT SZ5 KNEE PSN FEM CRCMNT STD LFTSZ6 KNEE PSN FEM CRCMNT STD RT SZ6 KNEE PSN FEM CRCMNT STD LFTSZ7 KNEE PSN FEM CRCMNT STD RT SZ7 KNEE PSN FEM CRCMNT STD LFTSZ8 KNEE PSN FEM CRCMNT STD RT SZ8 KNEE PSN FEM CRCMNT STD LFTSZ9 KNEE PSN FEM CRCMNT STD RT SZ9 SCREW PSN FEMALE 2.5X25MM KNEE PSN TIB STEM 5D RT SZC KNEE PSN TIB STEM 5D LFT SZD KNEE PSN TIB STEM 5D LFT SZE KNEE PSN TIB STEM 5D RT SZE KNEE PSN TIB STEM 5D LFT SZF KNEE PSN TIB STEM 5D RT SZF KNEE PSN TIB STEM 5D LFT SZG KNEE PSN TIB STEM 5D RT SZG Page 329 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $6,504.00 $4,317.76 $2,353.75 $1,851.00 $1,859.00 $112.00 $69.00 $370.00 $2,627.00 $784.00 $417.00 $417.00 $417.00 $417.00 $278.00 $1,172.00 $1,172.00 $129.00 $1,170.00 $1,582.00 $3,309.00 $3,136.00 $3,136.00 $5,052.00 $5,052.00 $3,309.00 $3,309.00 $5,304.00 $5,052.00 $5,053.00 $5,052.00 $5,052.00 $5,304.00 $5,053.00 $4,918.00 $5,164.00 $5,052.00 $781.00 $2,259.00 $2,473.00 $2,598.00 $2,474.00 $2,598.00 $2,474.00 $2,473.00 $2,474.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE PSN TIB STEM 5D LFT SZH KNEE PSN TIB STEM 5D RT SZH KNEE PSN PTLA ALL PE 32MM KNEE PSN PTLA ALL PE 35MM KNEE PSN PTLA ALL PE 38MM MESH ALLOMAX 6X16CM SHLDR CMNT HUMR STEM 9X100MM SHLDR LK SCREW 4.5X20MM SHLDR LK SCREW 4.5X26MM KNEE STEM FLUTED DEPU 75X10MM KNEE FEM AUG SROM DEPU 5MM TB TRACH UNCUF CANN FEN 6 GDWIRE ARTX 12 GDWIRE TROC TIP ARTX 1.1MM KNEE FEM LGN CNSTND RT SZ6 PESSARY RING WO SUPPSZ2 2.25 SCREW CANN SYNT 7X16X30MM SCREW CANN SYNT 7X16X35MM SCREW CANN SYNT 7X16X40MM SCREW CANN SYNT 7X16X45MM SCREW CANN SYNT 7X16X50MM SCREW CANN SYNT 7X16X55MM SCREW CANN SYNT 7X16X60MM SCREW CANN SYNT 7X16X65MM SCREW CANN SYNT 7X16X75MM SCREW CANN SYNT 7X16X80MM SCREW CANN SYNT 7X16X85MM SCREW CANN SYNT 7X16X90MM SCREW CANN SYNT 7X16X95MM SCREW CANN SYNT 7X16X100MM SCREW CANN SYNT 7X16X105MM SCREW CANN SYNT 7X16X110MM SCREW CANN SYNT 7X16X115MM SCREW CANN SYNT 7X16X120MM SCREW CANN SYNT 7X16X125MM SCREW CANN SYNT 7X16X130MM SCREW CANN SYNT 7X32X45MM SCREW CANN SYNT 7X32X50MM SCREW CANN SYNT 7X32X55MM SCREW CANN SYNT 7X32X60MM SCREW CANN SYNT 7X32X65MM SCREW CANN SYNT 7X32X100MM SCREW CANN SYNT 7X32X110MM SCREW CANN SYNT 7X32X115MM SCREW CANN SYNT 7X32X120MM SCREW CANN SYNT 7X32X125MM Page 330 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,474.00 $2,473.00 $1,148.00 $1,148.00 $1,204.00 $5,255.00 $3,271.00 $570.00 $570.00 $3,561.00 $2,290.00 $226.00 $257.00 $84.00 $14,091.00 $243.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 $1,172.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN SYNT 7X32X130MM BLADE CERV BX BEVI SEAL TROC VERSASEAL RT 5MM BLADE MINI MENISC CURV 4MM NDLE INSUF LL 120MM SLV TROC HOUSING 10/11MM*CIP* SLV TROC HOUSING 10/12MM*CIP* SLV TROC HOUSING 5MM*CIP* SUT ETHIBOND 2-0 SH 30 SUT ETHIBOND 5 CCS 4-30 SUT ETHILON 3-0 FSL 30 SUT PLAIN GUT 4-0 FS2 SUT PROLENE 3-0 FS2 18 SUT PROLENE 5-0 PS2 18 TROC REPOSB BLDLSS 10/11X*CIP* TROC REPOSB BLDLSS 5X100M*CIP* SHLDR ADPTR CMPRHNSV REV 25MM SHEATH DRYSEAL HC 18FR 28CM BREAST HIPRO SALINE 465CC CATH THORACIC FIRM PVC ST 20FR KNEE PSN ASF UC VELFT11MM3-7CD KNEE PSN ASF UC VELFT12MM3-7CD KNEE PSN ASF UCVELFT10MM4-11EF KNEE PSN ASF UCVELFT11MM4-11EF KNEE PSN ASF UCVELFT12MM4-11EF KNEE PSN ASF UCVELFT13MM4-11EF KNEE PSN ASF UCVELFT10MM7-12GH KNEE PSN ASF UCVELFT12MM7-12GH KNEE PSN ASF UCVELFT13MM7-12EF KNEE PSN ASF UCVELFT14MM7-12GH KNEE PSN ASF UCVELFT16MM7-12EF KNEE PSN ASF UC VE RT10MM-7 CD KNEE PSN ASF UC VE RT11MM-7 CD KNEE PSN ASF UC VE RT10MM-11EF KNEE PSN ASF UC VE RT11MM-11EF KNEE PSN ASF UC VE RT12MM-11EF KNEE PSN ASF UC VE RT13MM-11EF KNEE PSN ASF UC VE RT14MM-11EF KNEE PSN ASF UC VE RT11MM-12GH KNEE PSN ASF UC VE RT12MM-12GH KNEE PSN ASF UC VE RT14MM-12GH KNEE PSN PTLA ALL PE VE 32MM KNEE PSN PTLA ALL PE VE 38MM KNEE PSN PTLA ALL PE VE 41MM NAIL SUPRA COND STRY 12X380MM KNEE PSN FEM CR CMNTSTD RT SZ4 Page 331 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,172.00 $54.00 $165.00 $64.00 $318.00 $214.00 $214.00 $214.00 $12.00 $102.00 $9.00 $17.00 $13.00 $21.00 $583.00 $502.00 $2,932.00 $1,254.00 $1,591.00 $21.00 $2,411.00 $2,407.00 $2,527.00 $2,407.00 $2,527.00 $2,407.00 $2,411.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,407.00 $2,411.00 $2,407.00 $2,407.00 $1,652.00 $1,652.00 $1,651.00 $3,775.00 $1,674.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE PSN FEM CRCMNTNARWLFTSZ10 KNEE PSN FEM CRCMNT STDLFTSZ10 KNEE PSN FEM CRCMNTSTD LFTSZ11 KNEE PSN FEM CRCMNTNARW RTSZ11 KNEE PSN FEM CRCMNT STD RTSZ10 KNEE PSN FEM CRCMNT STD RTSZ11 NAIL HINDFT CANN RT TI 13X240 BIT DRILL QK RELEASE PERIPH PIN STEINMANN THRD 3.2MMX9IN KT INSRT SUTTAK ARTX 3.0MM KNEE STEM SPLINED V2 17X80MM KNEE TIB INSRT PSC 10X63/67MM KNEE ADPTR OFFSET 360ZIMM2.5MM KNEE TIB CRUC WING 360 SM NAIL FEM T2GTN STRY RT09X360MM TROC REPOSB BLDLES 10/12X*CIP* NAIL GAMMA STRY RT LNG11X340MM NAIL GAMMA STRY RT LNG11X380MM NAIL GAMMA STRY LFTLNG11X400MM HIP STEM ECHO PRESSFIT STD10MM MESH PARIETEX PROGRIP RT12X8CM MESH PARIETEX PLUG PATCH 8CM BOOT HEEL PREVALON BARIATRIC KNEE STEM LGN PRESSFIT14X160MM KNEE TIB INSRTGII CNSTND3-4 13 KNEE FEM DIST LPS DEPU LFT 2XS PROBE NIM BALL TIP 2.3MM SCREW LK LOPRO 2.4X20MM BIT DRILL SM BONE ARTX 1.7MM BLADE SAMURAI FULL RAD HIP CEMENTRALIZER DEPU 15MM SCREW CNCLS COMP WRIT 7.0X75MM KWIRE THRD TIP WRIT 2.5X230MM BIT DRILL WRIT 5MM PLATE CLAW II 4HL 20MM PLATE CLAW II 4HL 25MM SCREW LK WRIT 3.5X30MM BIT DRILL 2.8MM SCREW CORT LOPRO 2.4X14MM SUT PROLENE 2-0 MH/MH 48 NAIL SUPRA COND STRY 10X380MM BIT DRILL ILSC 2.7MM SCREW ILSC 3.5X30MM PLATE SURFIX INTERAXIS 2HL17MM SCREW LK ILSC BLADE DIEGO TURBINATE 2MM Page 332 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,918.00 $5,304.00 $5,052.00 $5,052.00 $5,052.00 $3,309.00 $2,633.00 $582.00 $545.00 $980.85 $3,045.00 $5,052.00 $2,151.00 $744.00 $3,708.00 $583.00 $3,656.00 $3,583.45 $3,583.45 $3,053.00 $1,121.00 $633.00 $487.00 $3,120.00 $4,620.00 $27,886.00 $891.00 $643.75 $435.00 $1,245.00 $284.00 $2,958.00 $186.00 $1,220.00 $5,216.00 $5,216.00 $1,255.00 $907.00 $584.00 $29.00 $3,780.00 $991.00 $1,410.00 $3,444.00 $880.00 $580.00 2020 pricing Drugs&Supplies PROCEDURE NAME BTN ABS TIGHTROPE RD 14MM KNEE TIB INSRTGII CNSTND3-4 1 HIP STEM BIMETRIC LAT45X13X150 RETR RIGID ALEXIS O 11-17CM XL ENDOL EXCLUDER 20MMX9.5CM ENDOL EXCLUDER 20MMX13.5CM ENDOL EXCLUDER 27MMX10CM BLN RAPIDCROSS 4.0X80MM 170CM CANN TRNSPRT 7-8-9 8MM KT SUT PASR UCL DISP ARTX SCREW CNCLS PART TI 3.0X28MM GDWIRE TROC TIPTHRD ARTX 1.1MM ABUTMENT IMPLT BIA300 4.0MM SCREW CANN PART ARTX 3.75X34MM SCREW CANN PART ARTX 3.75X36MM SCREW CORT LEAD DBL 5X24MM KNEE FEM CR NONPOR DEPU RT 1.5 SCREW CANN AS3 STER 4.0X40MM KNEE INSRT XLPE HIFLEX3-4 11MM SUT STEEL 3-0 30 18 ALLO LASR CORNERSTONE 9X14X11 ENDOL EXCLUDER 20MMX11.5CM ENDOL EXCLUDER 18MMX9.5CM SCREW LK 5X100MM NAIL SUPRA COND STRY 13X400MM ENDOL EXCLUDER 18MMX13.5CM SCREW ILSC 3.5X28MM HIP SLV ADPTR C-TAPER -2.5MM KNEE PSN FEM PSCMNT STD RT SZ6 KNEE PSN FEM PSCMNT STD LFTSZ8 KNEE PSN FEM PSCMNT STD LFTSZ9 PK BIOCOMP MPFL SCREW LK STRY 4.0X30MM SCREW LK STRY 4.0X36MM SCREW CORT ARTX 4.5X50MM KNEE TIB BASE CMNTLGNREVLFTSZ6 KNEE STEM LGN PRESSFIT13X120MM KNEE STEM LGN PRESSFIT14X120MM SCREW CORT LOPRO T15 3.5X32MM ALLO MENISC LAT W BONEBLOCKLFT SHLDR LK SCREW 4.5X32MM KWIRE GLENOID EXAT 2.0MM BIT DRILL CANN ARTX 4.5MM NDLE BX TRUGUIDE 19GX17.8CM MASSAGER MINI HIP SHELL R3 3HL 54MM Page 333 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,078.00 $4,400.00 $12,363.00 $339.14 $8,446.00 $8,446.00 $8,602.00 $1,016.00 $488.00 $2,064.15 $746.00 $117.00 $4,510.00 $972.00 $972.00 $1,067.00 $2,764.00 $714.00 $2,976.00 $39.00 $2,890.00 $7,702.00 $8,446.00 $842.00 $3,716.00 $8,446.00 $1,490.00 $284.00 $5,164.00 $3,309.00 $5,052.00 $3,247.00 $582.00 $582.00 $441.00 $5,632.00 $3,118.00 $3,118.00 $161.00 $9,724.00 $570.00 $330.00 $658.00 $62.00 $89.00 $2,773.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT TC3 SZ2 10MM KNEE FEM TC3 DEPU LFT SZ2 SCREW CANN AS3 STRY 4.0X50MM BIT DRILL ASNIS CANN 2.7MM PLATE FIB LAT DIST 2.7 RT 4HL KT COCHLEAR SGL USE KNEE PSN FEM PSCMNT NRWLFT SZ7 HIP HD OXIN MTL 12/14 32MM +4 SUT PDS II 0 CT1 36 DYE SUT VICRYL 2-0 CP2 UNDY BLN CATH URETRL DIL OPEN 7FR KNEE TIB INSRT STBLZIMM12X63MM PIN DRILL BUTTON ARTX 3.2MM SCREW CORT LK 3.5X12MM SCREW CORT LK 3.5X14MM SCREW CORT LK 3.5X18MM CLIP APPL ENDO CLIP ML 10MM KNEE FEM ATTUNE DEPU RT SZ8 KWIRE ANCHORAGE 1.2X70MM PLATE LAPIDUS LS STEP 0MM PLATE ANCHORAGE LSIFRANC MD LS SCREW ANCHORAGE LK 3.5X16 SCREW ANCHORAGE LK 3.5X18 SCREW ANCHORAGE LK 3.5X22 SCREW ANCHORAGE LK 3.5X24 SCREW ANCHORAGE LK 3.5X26 SCREW ANCHORAGE LK 3.5X28 SCREW ANCHORAGE LK 3.5X38 SCREW ANCHORAGE LK 3.5X40 SCREW ANCHORAGE STD 3.5X14MM SCREW ANCHORAGE STD 3.5X22MM SCREW ANCHORAGE STD 3.5X24MM SCREW ANCHORAGE STD 3.5X28MM BREAST SIL MODER STYLE10 390CC BREAST MODER CLASSIC 350CC SCREW CORT LK 3.5X16MM NAIL FEM RECON LAT TI LFT9X380 CAUT COBLATOR PROCISE XP WAND MARKER BREAST DUALCOIL17GX10CM ALLO DBM PASTE DBX MTF 1ML KNEE PTLA ATTUNE DEPU 29*NLU* KNEE PTLA ATTUNE DEPU 32MM KNEE PTLA ATTUNE DEPU 35MM HIP STEM SROM 42 13X18X160 SHLDR GLENDOID EXAT SM SUT PDS II 2 CCS1 DYE Page 334 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,543.00 $12,347.00 $716.00 $1,208.00 $2,230.53 $1,322.00 $4,918.00 $2,161.00 $14.00 $9.00 $564.00 $2,042.00 $614.00 $844.00 $844.00 $844.00 $443.00 $3,486.00 $257.00 $3,207.00 $3,207.00 $902.00 $902.00 $902.00 $902.00 $902.00 $902.00 $902.00 $902.00 $614.00 $614.00 $614.00 $614.00 $2,245.00 $2,627.00 $844.00 $2,762.00 $1,158.00 $387.00 $755.00 $2,345.00 $2,345.00 $2,345.00 $3,240.00 $2,932.00 $19.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE CLAW 20MM SCREW CLAW 2.7X20MM SCREW CLAW 2.7X22MM SCREW CLAW 2.7X16MM PLATE ATLANTIS VISION 23MM NAIL FEM T2GTN STRY RT10X360MM SHLDR COMP SCREW 41MM STNT URETRL DBL J 10.2FR 24CM PEG VOLAR THRD TRMI 20MM PEG VOLAR THRD TRMI 22MM PEG VOLAR THRD TRMI 24MM PLATE ULNAR OSTEO COMP KWIRE SGL TROC TRMI 1.6X65MM KWIRE SGL TROC TRMI 1.6X100MM SCREW LAG 3.2X16MM TRAY FOLEY DRN BG 16FR*CIP* ENDOL EXCLUDER 16MMX13.5CM ENDOL EXCLUDER 18MMX11.5CM PLATE FIB LAT DIST 2.7 LFT 4HL KNEE SPEEDPIN S&N NONRIM 65MM BLADE ST SS 35MM PIN AESCULAP DISTRAC 14MM KT THYROPLASTY MEASURE FEMALE KT CENTVEN CATH 16GX20CM APPL FLOSEAL ENDO SCREW WASHERLOC CNCLS 6X40MM SCREW WASHERLOC CNCLS 6X42MM SCREW WASHERLOC CNCLS 6X46MM SCREW WASHERLOC CNCLS 6X48MM SCREW WASHERLOC CNCLS 6X58MM GDWIRE JAGWIRE HYDRA ST 450CM BLN DILATOR ESOPH CRE 6 7 8 SET ART PRSS MON ST 3FR 5CM ELTD REDUCE ENERGY INFANTCHILD PKNG MEROCEL 2000 BARON 6CM KNIFE COLD ST BLADE BLADE DIEGO ST IRG AGGRES 4MM SET BLN CATH HEMORRHAGE SUT VICRYL+ 2-0 CT1 36 UNDY SUT VICRYL+ 1 CT1 36 UNDY SUT STEEL 2-0 28G 18 SUT VICRYL+ 2 TP1 2-27 UNDY SUT VICRYL+ 4-0 RB1 DYE SUT VICRYL+ 3-0 CT1 UNDY SUT VICRYL+ 2-0 UR6 DYE SUT VICRYL+ 2-0 UR5 DYE Page 335 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,446.00 $1,000.00 $1,000.00 $1,000.00 $2,315.00 $3,702.00 $289.00 $573.00 $515.00 $515.00 $515.00 $2,274.00 $89.00 $89.00 $533.00 $72.00 $9,020.00 $8,402.00 $220.53 $139.00 $86.00 $480.00 $566.00 $85.00 $341.00 $711.00 $711.00 $711.00 $711.00 $695.25 $788.00 $1,545.00 $186.00 $507.00 $147.00 $782.00 $580.00 $716.00 $9.00 $9.00 $37.00 $42.00 $9.00 $8.00 $12.00 $12.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT VICRYL+ 4-0 KS UNDY SUT VICRYL+ 0 MO4 CR8-18DYE SUT VICRYL+ 0 CT1 UNDY SUT VICRYL+ TIE 1 18 DYE SUT VICRYL+ 3-0 18 UNDY SUT VICRYL+ TIE 2-0 18 UNDY SUT VICRYL+ 1 STD/SHRT 54 DYE SUT PDS+ 1 XLH 96 DYE SUT PDS+ 0 CTX 36 DYE SUT VICRYL+ 2-0 CT2 CR8-18 DYE SUT ETHIBOND 2-0 CT1 CR8-18 SUT PDS+ 5-0 P3 18 CLR SUT VICRYL+ 5-0 P3 18 UNDY SUT VICRYL+ 4-0 P3 18 UNDY SUT PDS+ 4-0 PS2 18 CLR SUT MONOCRYL+ 3-0 PS2 18UNDY SUT VICRYL+ 2-0 CTB1 UNDY SUT VICRYL+ 3-0 RB1 CR8-18 DYE SUT VICRYL+ 3-0 CT1/CP1 UNDY SEAL TROC VERSASEAL PLUS5-12MM SUT PDS+ 0 CTX 60 DYE STNT GRAFTMASTER 3.5X16M*DISC* BREAST EXPAND FULL XTR450CC CONN RPLC GROSHONG CATH 4FR HIP STEM TAPERLOC 13.5X147MM HIP STEM TAPERLOC 12.5X145MM KNEE TIB INSRT ZIMM LFT XS 3MM KNEE TIB INSRT STBLZIMM10X67MM KNEE TIB INSRT STBLZIMM14X67MM KNEE TIB INSRT STBLZIMM16X67MM KNEE TIB INSRT STBLZIMM14X71MM KNEE TIB INSRT STBLZIMM10X75MM KNEE TIB INSRT STBLZIMM12X75MM KNEE TIB INSRT STBLZIMM14X75MM KNEE TIB INSRT STBLZIMM12X79MM KNEE TIB INSRT STBLZIMM16X83MM HIP HD BIOLOX CER ZIMM 36MM -3 HIP HD BIOLOX CER ZIMM 36MM +0 KNEE TIB OXFORD UNI RT SZAA HIP STEM TAPERLOC STD 5X130 HIP STEM TAPERLOC STD 10X140 HIP STEM TAPERLOC STD 13.5X147 HIP STEM TAPERLOC STD 15X150 HIP STEM TAPERLOC 13.5X147MM SHLDR HUMRSTEM CMPRHNSV MINI16 CANN ERCP FLUOROTIP ULT TAPER Page 336 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $11.00 $79.00 $9.00 $26.00 $42.00 $43.00 $9.00 $28.00 $15.00 $59.00 $55.00 $27.00 $22.00 $21.00 $29.34 $27.00 $12.00 $61.00 $19.00 $189.00 $34.00 $5,042.00 $3,145.50 $109.00 $4,674.00 $4,674.00 $2,088.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $2,691.00 $2,691.00 $3,248.00 $4,674.00 $4,674.00 $4,674.00 $4,674.00 $4,674.00 $5,937.00 $147.00 2020 pricing Drugs&Supplies PROCEDURE NAME GDWIRE KINETIX J TIP.014X185CM NDLE MYOJECT BLU 30GX25MM ANCHOR PANACRYL FASTIN RC ANCHOR FASTIN RC DUAL CH 6.5MM CATH VISTA XBLAD3.5 6FR 100CM CATH VISTA XBLAD4 6FR 100CM CATH VISTA 3DRC 6FR 100CM PLATE ATLANTIS STD 2LVL 35MM PLATE ATLANTIS STD 2LVL32.5MM PLATE ATLANTIS STD 2LVL 30MM PLATE ATLANTIS STD 1LVL27.5MM PLATE ATLANTIS STD 1LVL 23MM PLATE ATLANTIS STD 4LVL 65MM PLATE ATLANTIS STD 4LVL 80MM PLATE ATLANTIS STD 4LVL 77.5MM PLATE ATLANTIS STD 4LVL 75MM PLATE ATLANTIS STD 4LVL 72.5MM PLATE ATLANTIS STD 2LVL37.5MM PLATE ATLANTIS STD 4LVL 67.5MM PLATE ATLANTIS STD 4LVL 62.5MM PLATE ATLANTIS STD 3LVL 55MM PLATE ATLANTIS STD 3LVL52.5MM PLATE ATLANTIS STD 4LVL 70MM HEMO ARISTA AH 1GM BIT DRILL RFLCT FLEX 25MM PLATE META LCP 12HL 3.5MM TAP CANN SCREW SYNT 7.3MM SCREW TI LK IM NAIL 4.0X26MM SCREW TI LK IM NAIL 4.0X28MM SCREW TI LK IM NAIL 4.0X30MM SCREW TI LK IM NAIL 4.0X32MM SCREW TI LK IM NAIL 4.0X38MM SCREW TI LK IM NAIL 4.0X44MM SCREW TI LK IM NAIL 4.0X60MM END CAP EXT SPIRAL HUMR 0MM END CAP EXT SPIRAL HUMR 10MM END CAP EXT SPIRAL HUMR 15MM END CAP TI SOLID NAIL 0MM END CAP TI SOLID NAIL 5MM END CAP TI SOLID NAIL 10MM END CAP TI SOLID NAIL 15MM COUNTERSINK CANN SCREW 3.0MM NAIL EX TIB CANN TI 8X285MM NAIL EX TIB CANN TI 8X300MM NAIL EX TIB CANN TI 8X345MM NAIL EX TIB CANN TI 8X360MM Page 337 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $446.00 $153.00 $1,239.00 $1,467.00 $208.00 $208.00 $208.00 $2,368.00 $2,368.00 $2,368.00 $2,315.00 $2,315.00 $2,487.00 $2,487.00 $2,514.00 $2,487.00 $2,487.00 $2,368.00 $2,487.00 $2,487.00 $2,376.00 $2,376.00 $2,487.00 $1,510.00 $799.00 $2,647.09 $1,414.00 $639.00 $639.00 $639.00 $639.00 $639.00 $639.00 $639.00 $655.00 $655.00 $655.00 $817.00 $743.00 $743.00 $743.00 $1,335.00 $2,543.00 $2,543.00 $2,543.00 $2,543.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL EX TIB CANN TI 8X375MM NAIL EX TIB CANN TI 8X390MM NAIL HUMR SOLID TI 7.5X20*OBS* NAIL HUMR SOLID TI 7.5X22*OBS* BIT DRILL STEP LG4.5/6.5 485MM BIT DRILL 3FLUTE 3.9/4.2 331MM PLATE DIST RAD NARW RT 4X6HL SCREW HDLSS SHRT SYNT3X17MM SCREW HDLSS SHRT SYNT3X19MM SYR INFL HP BLN CATH TAUT ALLO GRAFTJKT1.0MM 5X5CM=25SQ PROBE MAMMOTOME ST 11G SCREW MTXMAND SYNT 2.4X10MM SCREW LK MTXMAND TI 2.0X12MM SCREW LK MTXMAND TI 2.0X16MM SIZER MAM 410MF RPSB 525CC STNT BLN UTERINE 11.5X4X4CM KNEE STEM LGN PRESSFIT13X160MM KNEE TIB INSRTGII CNSTND7-8 9 KNEE SPEEDPIN S&N RIMMED 45MM PLATE CLAV ANT ST 8HL 3.5MM KNEE PSN FEM CRCMNT STD RTSZ12 CATH AIR-CHARGED ABD CATH AIR-CHARGED DUAL SENS BIT DRILL SYNT 2.5X95MM BIT DRILL SYNT 3.5X95MM KNEE TIB INSRT TC3 SZ2 20MM SCREW IMF MAND SYNT 2X8MM COLAR CERV 2PC FM LG 5.25 BREAST HIPRO SMTH RD 310CC KT INTR SUPRAPUBIC ONESTEP18FR PLATE CLAV DIST RT LNG 8HL SCREW CORT ARTX 2.4X18MM SCREW CORT ARTX 2.4X20MM PLATE CLAV LAT ANT 7HL 2.7/3.5 HIP HD ZIMM MTL 6D 32MM +7 SCREW PYRAMIDPLUSMDTR6.5X35MM EXPAND MAM MODER W TAB 300CC HIP STEM ECHO PRESSFIT STD12MM BREAST SIL MODER STYLE10 360CC TB INFLOW AQUILEX PIN DRILL HDLSS TROC PLATE ATLANTIS VISION 35MM HIP HD EZE CER 12/14 36MM +8.5 KNEE FEM CR ZIMM RT 67.5MM ALLO TRINITY ELITE MTF SM Page 338 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,543.00 $2,543.00 $3,153.00 $3,153.00 $1,215.00 $790.00 $2,397.00 $1,141.00 $1,141.00 $397.00 $3,137.00 $3,007.00 $342.00 $449.11 $449.11 $146.00 $230.00 $3,120.00 $4,620.00 $392.00 $2,292.00 $5,053.00 $187.00 $191.00 $293.00 $293.00 $5,543.00 $401.00 $65.00 $1,545.00 $380.86 $1,714.00 $553.00 $553.00 $2,292.00 $1,657.00 $1,034.00 $3,378.70 $3,053.00 $2,312.00 $533.00 $1,307.00 $2,368.00 $2,376.00 $3,605.00 $1,701.00 2020 pricing Drugs&Supplies PROCEDURE NAME ALLO TRINITY ELITE MTF LG BREAST SIL 410 2FULL 475CC BREAST SIL 410 2FULL 535CC BREAST SIL SIEN HP 550CC KNEE STEM LGN PRESSFIT15X120MM BIT DRILL ENCR 3.2MM SCREW CNCLS PART TI 3.0X32MM GDWIRE J ROSEN .035 180CM PLATE CLAV LAT ANT11HL 2.7/3.8 ENDO ABSORBATACK W 30TACK 5MM KNEE PSN ASF UC VE RT10MM-12GH SCREW LK HEXALOBE 2.7X14MM SCREW TRMI 3.0X22MM HIP LNR E1 PE MROM 40X25 CAGE CLYDESDALE 6D 8X50MM CAGE CLYDESDALE 6D 12X55MM ALLO FEM HEMI COND MEDL LFT NAIL FEM RECON LAT TI RT 9X340 KNEE TIB INSRT TC3 2 20MM KNEE TIB INSRT STD 18X63/67MM BLN CATH URETRL DIL COUDE 9FR ENDOL EXCLUDER 27MMX12CM KNEE TIB INSRT CR ZIMM10X59MM SYS INTRL BRC AUG REPAIR TB W CONN REDEUCE PUMP 8IN TB W CONN REDEUCE PT 8IN TRAY BX SOFT TISS BASIC WONDLE SUT VICRYL 0 CT 36 UNDY TB EVAC SMOKE SEECLEAR 8.0L BIT DRILL CALIB ZIMM 2.7MM SCREW CORT LK 3.5X22MM SCREW CORT LK 3.5X24MM SCREW CORT LK 3.5X26MM SCREW CORT LK 3.5X30MM SCREW CORT LK 3.5X32MM SCREW CORT LK 3.5X34MM SCREW CORT LK 3.5X40MM KT SCP KNEE W ACCUPORT CANN SCP END TARGET BONE SUB SCP 5CC KNEE TIB TRAY 360 ZIMM 75MM SCREW CNCLS PART TI 3.0X30MM PLATE COMP INTEGRA 2HL 20MM MESH SOFT FLAT LG PORE 6X6 MESH SOFT FLAT LG PORE 12X12 PLATE CLAV LAT ANT12HL 2.7/3.9 Page 339 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $7,854.00 $2,570.00 $2,570.00 $2,627.00 $3,118.00 $587.00 $746.00 $75.00 $2,292.00 $1,676.00 $2,407.00 $770.00 $1,170.00 $3,240.00 $7,268.00 $6,820.00 $23,340.00 $2,762.00 $4,319.00 $2,432.00 $564.00 $8,203.00 $2,432.00 $2,428.00 $300.00 $159.00 $58.00 $8.00 $177.00 $733.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $6,507.00 $1,466.00 $6,426.00 $4,763.00 $746.00 $4,464.00 $319.00 $684.00 $2,292.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB STEM CMNT PFC 15X60MM BOOT CAST TCC-EZ XL BIT DRILL RFLCT FLEX 35MM HIP SHELL R3 3HL 62MM HIP STEM SYNRG POR STD SZ17 HIP SHELL R3 3HL 52MM BREAST SIL 410 MODER FULL470CC BREAST SIL 410 2FULL 255CC HIP HD ZIMM MTL 6D 36MM +7 HIP HD OXIN MTL 12/14 36MM +4 HIP STEM ANTHOLOGY STD SZ6 BOOT CAST TCC-EZ CHARCOT XL CAST SYS TCC-EZ NO BOOT 3IN CAST SYS TCC-EZ NO BOOT 4IN BARR NORMLGEL AG 45GM PLATE ATLANTIS VISION 45MM HIP SHELL R3 3HL 46MM HIP LNR R3 XLPE PE 0D 28X46MM HIP STEM ANTHOLOGY STD SZ2 PLATE TIB MEDL PROX 3.5 RT 8HL SCREW SET INNER DEPU SGL 4.5MM ROD SPINE DEPU 4.5X450MM SCREW RECON THRD TI 6.5X30X85 SCREW RECON THRD TI 6.5X30X105 KNEE TIB STEMSMTHREV14.5X125MM SUT MGR NANOPASS REACH CRST HIP SHELL R3 3HL 56MM HIP HD OXIN MTL 12/14 36MM -3 GD SIZING PODIATRY SURG BME STAPLE SPEED ARC BME11X10X10MM KT DRILL BME 2.0MM GRAFT BONE SYN GENEX10ML SHLDR GLENOIDSPHERE CTR29X36MM SHLDR COMP SCREW 20MM SCREW TRMI 3.0X25MM NAIL GAMMA3 LFT LNG 130D11X320 TB OUTFLOW AQUILEX CUFF URINARY AMS 800 5.0CM IZ HIP STEM CORAIL BOW COLAR SZ8 PLATE ATLANTIS VISION 55MM PLATE ATLANTIS VISION 57MM SHLDR GLENOIDSPERE TILT29X42MM SHLDR COMP SCREW 35MM STAPLE SPEED ARC BME13X10X10MM I PAS III BEVEL TIP NUVA SCREW CORT LOPRO T15 3.5X16MM Page 340 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,639.00 $461.00 $799.00 $2,708.29 $4,078.63 $2,773.00 $2,570.00 $2,993.00 $1,657.00 $3,461.00 $4,161.00 $526.00 $547.00 $547.00 $96.00 $2,368.00 $2,632.76 $1,912.32 $3,962.65 $3,109.00 $1,602.00 $2,565.00 $646.00 $646.00 $2,962.00 $1,147.00 $2,773.00 $2,161.00 $230.00 $2,377.00 $1,191.00 $3,586.00 $4,873.00 $289.00 $1,170.00 $3,583.45 $147.00 $10,225.00 $4,527.00 $2,376.00 $2,376.00 $4,873.00 $289.00 $2,377.00 $1,374.00 $156.70 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT LOPRO T15 3.5X24MM STAPLE ENDO VASC *CIP* BIT DRILL NANOTACK FLEX 1.4MM BIT DRILL TWIST LNG 2.30MM KNEE FEM DIST AUG RT SZ3 8MM CAUT SONICISION SCREW CORT LOPRO T15 3.5X14MM SCREW LAG NL ZIMM 4.75X15MM BIT DRILL CANN ZIMM 2.9X70MM SAW BLADE TRMI 0.4MM SIZER STYLE 68HP 650-700CC BONE VOID FILLER CERAMENT 5CC ENDO TROC BLADE Z 5X55MM ANCHOR ENDOBTN CL ULT 30MM INTR PICC MINI STICK II 4FR INTR PICC MINI STICK II 5FR NDLE BX MAGNUM 14GX10CM KNEE TIB BASE NEXGEN PEG SZ3 KNEE TIB BASE NEXGEN PEG SZ4 KNEE TIB BASE NEXGEN PEG SZ5 KNEE TIB BASE NEXGEN PEG SZ6 SUT ETHILON 5-0 PS2 18 SUT FBRWIRE 2 TAPERBLU WHT/BLK SUT MONOCRYL 3-0 PS2 UNDY SUT VICRYL 0 CTX 36 UNDY TIP AUTOLOGOUS THROMBIN MIXER SLING GYN OBTRYX HALO TRAY SPINAL 25G KWIRE BLNT TROC 0.9X150MM KWIRE SGL TROC 1.6X150MM SCREW HDLSS DARTFIRE 2.5X18MM SCREW HDLSS DARTFIRE 2.5X22MM BREAST SILTEX MODER 525+55 DEV SUTLASSO WIRE LOOP SD PLATE ATLANTIS VISION 72.5MM SIZER STYLE 68HP 280-300CC INTR CLASC JUDE 6FR MESH PHASIX 20.3X25.4CM GD SHLDR BONE MODEL ZIMM NDLE BX MAXCORE 20GX16CM NDLE BX MAXCORE 20GX10CM CATH DRN UNIV LK PIGT 8FR NDLE BX MURPHY COAX 11GX15CM KNEE TIB INSRT TC3 SZ2 15MM CAUT COBLATOR PROCISE EZ VIEW SUT CARTRDG SMARTSTITCH Page 341 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $161.00 $915.00 $1,063.00 $641.00 $2,660.00 $1,699.00 $161.00 $641.00 $1,198.00 $438.00 $258.00 $3,438.00 $186.00 $1,000.00 $110.00 $215.00 $132.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $17.00 $233.00 $25.00 $9.00 $242.00 $3,114.00 $89.00 $186.00 $186.00 $1,286.00 $1,286.00 $2,274.00 $155.00 $2,376.00 $258.00 $202.00 $13,320.00 $3,098.00 $169.00 $85.00 $370.00 $476.00 $5,543.00 $1,158.00 $685.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHLDR HUMRHD EXAT 47X22MM NDLE CATH YUEH ST 4FR 7CM TB EAR VENT PAPAR*USE 6262091* KT CMNT OPTIVAC DBL MIX 80GM DRSG SPLT DOYLE II INTRANASAL SCREW CORT TI CRANIO 1.7X3MM SCREW CORT TI CRANIO 1.3X3MM SCREW ILSC 3.5X32MM SCREW LAG 3.2X20MM BIT DRILL ZIMM 2.2MM SCREW DVR LK 2.7X20MM SCREW DVR LK 2.7X22MM ANCHOR MINI QK PLUS2-0 V5 CORD SUT PROLENE 8-0 BV1305 5 HIP SHELL VISION 24X56MM HIP SHELL VISION 25X58MM KNEE TIB INSRT CR ZIMM12X59MM KNEE TIB INSRT STBLZIMM16X63MM KNEE TIB INSRT STBLZIMM17X63MM KNEE TIB INSRT STBLZIMM20X63MM KNEE TIB INSRT STBLZIMM16X75MM HIP STEM TAPERLOC PRIM5X130MM HIP STEM TAPERLOC PRIM20X160MM KNEE TIB INSRT STBLZIMM14X63MM KNEE TIB INSRT STBLZIMM18X67MM BIT DRILL JLATCH 8MM STOP.70MM BIT DRILL JLATCH 4MM STOP1.1MM BIT DRILL JLATCH 8MM STOP1.1MM SCREW CRANFAC SYNT 1.5X4MM SCREW CRANFAC SYNT 1.5X5MM SCREW CRANFAC SYNT 1.5X6MM SCREW CRANFAC SYNT 2.0X4MM SCREW CRANFAC SYNT 2.0X5MM SCREW CRANFAC SYNT 2.0X6MM SCREW CORT SLFTP SYNT 1X6MM SCREW EMER CRANFAC SYNT1.2X3MM SCREW EMER CRANFAC SYNT1.2X4MM SCREW EMER CRANFAC SYNT1.2X5MM SCREW CORT ENT CRANIO 1.3X4MM SCREW CORT ENT CRANIO 1.3X5MM SCREW CORT ENT CRANIO 1.3X6MM SCREW CORT ENT CRANIO 1.7X4MM SCREW CORT ENT CRANIO 1.7X5MM SCREW CORT ENT CRANIO 1.7X6MM PLATE STRUT SYNT 6X30MM 16HL PLATE ADPTN 1X100MM 34HL Page 342 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,260.00 $86.00 $79.00 $802.00 $306.00 $307.00 $295.00 $1,410.00 $533.00 $607.20 $720.00 $720.00 $1,187.00 $103.00 $2,205.00 $2,205.00 $2,432.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $4,674.00 $4,674.00 $2,042.00 $2,042.00 $532.00 $541.00 $541.00 $263.00 $263.00 $263.00 $231.00 $231.00 $231.00 $310.00 $322.00 $322.00 $322.00 $295.00 $295.00 $295.00 $307.00 $307.00 $307.00 $1,184.00 $1,366.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE ORB RIM 11HL PLATE ORB MESH THICK 0.4MM PLATE ORB FLOOR TI SM 1.0MM PLATE ORB FLOOR TI LG 1.0MM PLATE ORB FLOOR TI MD 1.0MM PLATE Y TI SYNT 1MM 2X5HL PLATE Y TI SYNT 1MM 3X7HL PLATE X TI SYNT 1MM 11HL MESH CRANFAC RIGID 1.3 38X45MM KNEE TIB INSRT STBLZIMM20X67MM KNEE TIB INSRT STBLZIMM18X71MM KNEE TIB INSRT STBLZIMM18X75MM BIT DRILL JLATCH 3MM STOP.70MM INTRO PERC LEAD 7FR BUR ACORN LNG 7MM BUR ACORN LNG 8MM HIP STEM AUSTIN SOLID 145MM HIP STEM AUSTIN SOLID 165MM HIP HD UNIPOLR ZIMM MTL 6D42MM HIP HD UNIPOLR ZIMM MTL 6D45MM KNEE KT CUT BLOCK LGNP LFT SPEEDSCREW ARTC W HNDL 6.5 SUT CARTRDG SMARTSTITCHOPUS RING SIL XTRAFLG PROVOX 22.5FR HIP ADPTR TYPE1 M2A 42-50MM +9 BREAST HIPRO SMTH RD 250CC SCREW CORT LOPRO T15 3.5X26MM KNEE FEM PSTR UNIV AUG 10X70MM KNEE TIB TRAY 360 ZIMM 79MM KNEE STEM SPLINED V2 14X80MM KNEE FEM DIST AUG LL/RM 5X70MM KNEE FEM DIST AUG RL/LM 5X70MM KNEE FEM PSTR AUG UNIV 5X70MM SUT ETHILON 4-0 PS4 18 SUT ETHILON 5-0 PC1 18 SUT SILK 4-0 P3 18 SUT ETHILON 9-0 TG1408/TG1408 SUT PLAIN GUT 6-0 G1 18 SUT PROLENE 6-0 BV1/BV1 VB24 SUT PROLENE 3-0 SH1/SH1 30 SUT STEEL 6 V40 4-18 SUT MONOCRYL+ 2-0 CP1 UNDY SUT PDS+ 4-0 RB1 DYE SUT MONOCRYL 1 CT 36 DYE CMNT SIMPLEX HV W GENTAMICIN WIRE COMP 2.8X20MM Page 343 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $848.00 $2,203.00 $2,115.00 $2,118.00 $2,118.00 $778.00 $778.00 $813.00 $2,497.00 $2,042.00 $2,042.00 $2,042.00 $532.00 $180.00 $455.00 $455.00 $2,274.00 $2,274.00 $1,469.00 $1,469.00 $1,299.00 $1,299.00 $685.00 $197.00 $1,419.00 $1,545.00 $161.00 $2,616.00 $5,106.00 $744.00 $2,616.00 $2,616.00 $2,616.00 $18.00 $22.00 $19.00 $63.00 $44.00 $63.00 $26.00 $66.00 $13.00 $17.00 $12.00 $1,028.00 $319.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL GAMMA3 LFT LNG 130D11X360 SCREW EXTR CONIC FOR LG SCREW ARTHROWAND SUP MULTVAC IFS 50 KT BLN RELIEVASPINTIP5X16*CIP* SET MICPUNC STIFF NIT 4FR 7CM SCREW UNICORT 5X12MM SCREW UNICORT 5X16MM SCREW UNICORT 5X20MM SCREW CORT SLFTP NCB 4.0X40MM BIT DRILL ZIMM 2.5X180MM BIT DRILL ZIMM 3.3MM BIT DRILL ZIMM 4.3MM SCREW CORT SLFTP NCB 5.0X38MM SCREW CORT SLFTP NCB 5.X040MM SCREW CORT SLFTP NCB 5.0X44MM SCREW CAP LK CBL BUTTON HEX DRIVE 2.5MM SYR SYS ACP DBLE SUT PLAIN GUT 3-0 CT1 SUT PROLENE 4-0 KS 30 ALLO DBM PUTTY STAGRAFT 5CC SCREW CLAW 2.7X18MM TB INFILTRATION HK PUMP HIP HD TRID V40 LFIT MTL22MM+0 SCREW LAG 3.2X18MM SCREW LAG 3.2X22MM SCREW LK CORT TRMI 3.2X16MM SCREW LK CORT TRMI 3.2X18MM HIP SHELL R3 3HL 48MM HIP STEM SYNRG POR STD SZ13 SHEATH INTR SENTRANT 12FR 28CM SHEATH INTR SENTRANT 16FR 28CM HIP STEM SROM 30 11X16X150 PLATE HUMR DIST W SUPP RT 11HL PLATE HUMR DIST W SUPP RT 13HL PLATE HUMR DIST W SUPP LFT11HL PLATE HUMR DIST W SUPP LFT13HL PLATE HUMR DIST RT 11HL PLATE HUMR DIST RT 13HL PLATE HUMR DIST LFT 11HL PLATE HUMR DIST LFT 13HL PLATE TIB MEDL DIST 6HL LFT PLATE TIB MEDL DIST 10HL RT PLATE TIB MEDL DIST 10HL LFT PLATE TIB MEDL DIST 12HL LFT PLATE TIB ANT LAT VALCP 6HL RT Page 344 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,656.00 $338.00 $1,164.00 $3,624.00 $187.00 $1,054.00 $1,016.00 $1,054.00 $788.00 $585.00 $793.00 $730.00 $1,154.00 $1,097.00 $1,097.00 $1,016.00 $1,029.00 $695.00 $17.00 $14.00 $2,043.00 $1,000.00 $70.00 $1,466.00 $533.00 $533.00 $506.00 $506.00 $2,764.00 $3,958.00 $781.00 $1,016.00 $3,240.00 $2,879.00 $2,879.00 $2,879.00 $2,879.00 $2,796.00 $2,796.00 $2,796.00 $2,796.00 $3,242.00 $3,138.00 $3,231.25 $3,505.00 $3,451.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE FIB LAT DIST 2.7 LFT 3HL SCREW CORT LOPRO T15 3.5X10MM SCREW CORT LOPRO T15 3.5X12MM SCREW CORT LOPRO T15 3.5X22MM SCREW CORT LOPRO T15 3.5X28MM SCREW CORT LOPRO T15 3.5X42MM KNEE PSN FEM CR STD LFT SZ36 BLADE QUADCUT 3.4MMX13CM ROD TAPER MDTR 3.5X4.75MM SCREW CRUCIFORM TI 2.1X10MM BIT DRILL QK ACUM 1.5MM KNEE STEM SPLINED V2 15X40MM KNEE STEM SPLINED V2 13X80MM KNEE STEM SPLINED V2 16X80MM KNEE STEM SPLINED V2 14X120MM KNEE TIB TRAY 360 ZIMM 63MM KNEE FEM VNGD ZIMM RT 72.5MM KNEE FEM VNGDZIMMLFT 57.5MM KNEE FEM VNGD ZIMM LFT 67.5MM KNEE FEM VNGD ZIMM LFT70MM KNEE FEM DIST AUGRL/LM5X72.5MM KNEE FEM PSTR AUG UNIV5X67.5MM KNEE FEM PSTR AUG UNIV5X72.5MM SCREW DVR LK 2.7X14MM SCREW DVR NL 2.7X18MM GD BIPLANE BX NDLE ASPIR INJ 22G TRAY INTR BLU RHINO G2 PERC6 SHLDR GLENOID PEG AEQUALIS 35 SHLDR HUMR STEM STD 3A 74MM SHLDR HUMR HD HIGH 43X16MM CAGE WAVE OBLIQ 6D 10X26MM CAGE CLYDESDALE 6D 14X55MM PLATE RECON 3HL 4.5X45MM PLATE RECON CURV 3.5 6HL 70MM BIT DRILL CANN QC 17.0X280MM SCREW CRUCIFORM TI 2.1X6MM SCREW CRUCIFORM TI 2.7X6MM SCREW CRUCIFORM TI 2.7X8MM PLATE FUSN MCP TI ACUM RT CATH VISTA XBLAD3 6FR 100CM HIP SCREW CNCLS RFLCT 30MM EXTR TRIGEN DISP HIP STEM ANTHOLOGY STD SZ4 HIP SCREW CNCLS RFLCT 35MM BLADE QUADCUT M4 4.3MMX13CM Page 345 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,190.00 $161.00 $161.00 $161.00 $161.00 $161.00 $9,102.00 $948.00 $917.44 $284.00 $465.00 $3,138.00 $807.00 $3,240.00 $3,045.00 $4,365.00 $11,494.00 $744.00 $12,999.00 $12,120.00 $2,479.00 $2,732.00 $2,479.00 $720.00 $416.00 $96.00 $471.68 $1,671.02 $3,355.00 $6,141.00 $3,367.00 $8,730.00 $8,033.00 $1,153.00 $1,339.00 $1,464.00 $284.00 $284.00 $284.00 $1,586.00 $208.00 $701.00 $1,067.22 $4,078.63 $701.00 $1,243.00 2020 pricing Drugs&Supplies PROCEDURE NAME ELBOW RAD STEM ANATOM 9X4MM BLADE ARTHRO PLUS AGRESSIVE3.5 BLADE MINI FULL RAD BLU 2.0MM CATH EMBOL IRG 6FR KNEE TIB INSRT TC3 2 12.5MM KNEE FEM TC3 DEPU RT 2 SCREW ATLANTIS SLFTP FIX4X16MM SCREW ATLANTIS SLFTP VAR4X16MM SCREW ATLANTIS SLFTP FIX4X11MM SCREW ATLANTIS SLFTP FIX4X12MM SCREW ATLANTIS SLFTP FIX4X17MM SCREW ATLANTISSLFTPFIX4.5X11MM SCREW ATLANTISSLFTPFIX4.5X13MM SCREW ATLANTISSLFTPFIX4.5X15MM SCREW ATLANTISSLFTPFIX4.5X17MM SCREW ATLANTIS SLFTP VAR4X11MM SCREW ATLANTIS SLFTP VAR4X12MM SCREW ATLANTIS SLFTP VAR4X17MM SCREW ATLANTISSLFTPVAR4.5X11MM SCREW ATLANTISSLFTPVAR4.5X13MM SCREW ATLANTISSLFTPVAR4.5X15MM SCREW ATLANTISSLFTPVAR4.5X17MM ALLO WEDGE BICORT ALLOPURE 8MM STNT SINUS PROPEL 23MM STNT SINUS MINI PROPEL 16MM SCREW JONES LOPRO ARTX5.5X50MM CAUT LIGASURE BLNT LAP 5MM37CM DEL SYS PECTORAL REPAIR PLATE CLAW COMP 4HL 3.5X25MM SCREW PA LK CLAW II 3.5X16MM SCREW PA LK CLAW II 3.5X18MM SCREW PA LK CLAW II 3.5X20MM SCREW PA LK CLAW II 3.5X22MM SCREW PA LK CLAW II 3.5X28MM PLATE COMP PA CLAW II 2HL 30MM BIT DRILL JLATCH 5MM STOP.70MM KNEE INSRT XLPE DISHSZ5-6 9MM SHLDR HUMR STEM STD 6A 86MM SHLDR HUMR HD HIGH 52X19MM SCREW CANN TRMI 2.3X18MM KWIRE DBL TROC TRMI 0.8X120MM SCREW CANN LOPRO ARTX 3X26MM SHLDR HUMR STEM STD 6C 86MM BREAST SILTEX HI CONT450+50 BREAST SILTEX HI CONT550+50 BREAST SILTEX MODER 425+55 Page 346 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,880.29 $242.00 $247.00 $150.00 $4,319.00 $12,347.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $3,278.00 $2,115.00 $2,115.00 $2,171.00 $1,580.00 $2,796.00 $4,918.00 $1,255.00 $1,255.00 $1,255.00 $1,255.00 $1,255.00 $4,397.00 $532.00 $2,414.00 $6,141.00 $3,367.00 $511.00 $744.00 $746.00 $6,141.00 $2,088.00 $2,274.00 $2,274.00 2020 pricing Drugs&Supplies PROCEDURE NAME BREAST HIPRO SMTH RD 290CC KNEE TIB INSRT STBLZIMM20X79MM SHLDR GLENOID PEG CORTILOC S40 SHLDR GLENOID PEG CORTILOC M30 SHLDR GLENOID PEG CORTILOC M40 SHLDR GLENOID PEG CORTILOC L50 SHLDR GLENOID KEEL AEGU M35 SHLDR HUMR STEM STD 1A 66MM SHLDR HUMR STEM STD 1B 66MM SHLDR HUMR STEM STD 2A 70MM SHLDR HUMR STEM STD 2B 70MM SHLDR HUMR STEM STD 2C 70MM SHLDR HUMR STEM STD 3B 74MM SHLDR HUMR STEM STD 4A 78MM SHLDR HUMR STEM STD 4B 78MM SHLDR HUMR STEM STD 4C 78MM SHLDR HUMR STEM STD 5A 82MM SHLDR HUMR STEM STD 5B 82MM SHLDR HUMR STEM STD 5C 82MM SHLDR HUMR STEM STD 6B 86MM SHLDR HUMR STEM STD 7A 90MM SHLDR HUMR STEM STD 7B 90MM SHLDR HUMR STEM STD 8A 94MM SHLDR HUMR STEM STD 8B 94MM SHLDR HUMR STEM STD 8C 94MM SHLDR HUMR HD LOW 43X16MM SHLDR HUMR HD LOW 46X17MM SHLDR HUMR HD LOW 48X18MM SHLDR HUMR HD LOW 50X16MM SHLDR HUMR HD LOW 50X19MM SHLDR HUMR HD LOW 52X19MM SHLDR HUMR HD LOW 52X23MM SHLDR HUMR HD HIGH 39X14MM SHLDR HUMR HD HIGH 41X15MM SHLDR HUMR HD HIGH 46X17MM SHLDR HUMR HD HIGH 48X18MM SHLDR HUMR HD HIGH 50X16MM SHLDR HUMR HD HIGH 50X19MM SHLDR HUMR HD HIGH 52X23MM PLATE L TIB HIGH ZIMM RT HIP SCREW BONE ZIMM 6.5X60MM ANCHOR SWIFTLOCK KNEE FEM CR *USE 6147714* KNEE TIB INSRT CURV SZ6 15MM HIP STEM COXAVARA HIGH SZ15 HIP SCREW G7 LOPRODOME6.5X35MM Page 347 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,545.00 $2,042.00 $3,355.00 $3,355.00 $3,285.00 $3,355.00 $3,285.00 $6,141.00 $8,687.00 $6,455.00 $6,000.00 $6,000.00 $6,141.00 $6,141.00 $6,141.00 $6,141.00 $8,678.00 $6,141.00 $6,141.00 $6,141.00 $6,141.00 $8,478.00 $6,141.00 $6,141.00 $6,141.00 $3,367.00 $3,367.00 $5,047.00 $3,285.00 $4,249.00 $5,047.00 $3,373.00 $4,249.00 $3,367.00 $3,367.00 $3,367.00 $3,373.00 $3,367.00 $4,249.00 $1,823.00 $203.00 $711.00 $2,764.00 $2,700.00 $4,527.00 $197.75 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SCREW G7 LOPRODOME6.5X40MM STNT VISI-PRO 8X57MM 80CM ANCHOR CINCHLOCK KNOTLESS KNEE FEM LGN CR OXIN RT SZ6 KNEE FEM LGN CR OXIN LFTSZ6 HIP HD OXIN MTL 12/14 36MM +8 DRN EVAC 3SPRING 400ML 3/16IN SCREW CORT ARTX 2.4X16MM SCREW LK ARTX 2.4X14MM BIT DRILL PIVM 2.4MM KNEE STEM LGN PRESSFIT16X120MM KNEE TIB INSRTGII CNSTND3-4 11 TROC KII Z THRD 8X100MM SCREW CNCLS FULL THRD 6.5X65MM SCREW CNCLS FULL THRD 6.5X70MM SCREW CNCLS FULL THRD 6.5X75MM PLATE DCP NARW 9HL 4.5X151MM PLATE DCP NARW 12HL 4.5X199MM PLATE DCP BROAD 4.5MM 6HL 103 PLATE DCP BROAD 4.5MM 12HL 199 HIP HD UNIPOLR ZIMM MTL 6D38MM HIP HD UNIPOLR ZIMM MTL 6D40MM HIP HD UNIPOLR ZIMM MTL 6D41MM HIP HD UNIPOLR ZIMM MTL 6D43MM HIP HD UNIPOLR ZIMM MTL 6D44MM HIP HD UNIPOLR ZIMM MTL 6D47MM HIP HD UNIPOLR ZIMM MTL 6D48MM HIP HD UNIPOLR ZIMM MTL 6D49MM HIP HD UNIPOLR ZIMM MTL 6D50MM HIP HD UNIPOLR ZIMM MTL 6D51MM HIP HD UNIPOLR ZIMM MTL 6D52MM HIP HD UNIPOLR ZIMM MTL 6D54MM HIP HD UNIPOLR ZIMM MTL 6D55MM HIP HD UNIPOLR ZIMM MTL 6D57MM HIP HD UNIPOLR ZIMM MTL 6D60MM HIP HD UNIPOLR ZIMM MTL 6D63MM HIP STEM AUSTIN SOLID 175MM TRNQT STERICUFF W SLV 18IN HIP SCREW G7 LOPRODOME6.5X25MM GDWIRE AMPLZ XSTIFF 0.038 180 SUT VICRYL 4-0 PS2 18 UNDY SUT VICRYL 0 CTXB 36 UNDY SUT MONOCRYL 3-0 PS1 UNDY SUT PDS II 2-0 FS1 UNDY SUT PDS II 0 CTB1 36 DYE HIP STEM SROM 36 14X9X130 Page 348 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $202.00 $1,970.00 $1,667.00 $4,916.00 $4,916.00 $2,161.00 $79.00 $584.00 $643.75 $973.00 $3,118.00 $4,620.00 $107.00 $172.00 $172.00 $172.00 $734.00 $947.00 $959.00 $1,248.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $1,469.00 $2,274.00 $110.00 $202.00 $118.00 $19.00 $13.00 $25.00 $15.00 $18.00 $3,240.00 2020 pricing Drugs&Supplies PROCEDURE NAME SUT PDS II 6-0 P1 18 UNDY KNEE PSN STR HYB ST 14MM +30D CAUT COBLATOR PROCISE MLW SCREW CORT LEAD DBL 5X20MM SLING MINIARC PRO *DISC* ANCHOR W DRILL SHRT RIGID SZ2 PLATE CALC STEP ARTX 10MM HIP SHELL R3 3HL 60MM HIP STEM CORAIL BOW COLAR SZ18 HIP SCREW G7 LOPRODOME6.5X30MM HIP SLV PROX SROM 14D-SML PLATE DCP NARW 7HL 4.5X119MM END CAP T40 GLD 0MM PLATE ATLANTIS VISION 37.5MM HIP STEM POLARSTEM135D STD SZ5 STYLET GLIDERITE RIGID SCREW CANN INTERFERFTHRD10X25M SCREW CANN AS3 STRY 4.0X30MM SCREW CANN AS3 STRY 4.0X44MM KNEE TIB INSRT CURV SZ6 12.5MM DRSG WOUND DRAWTEX 6X8 PLATE DCP NARW 4HL 4.5X71MM KWIRE DBL TROC OSTE 0.035X4 WIRE CERCLAGE COIL 1.0MM HIP STEM SYNRG POR STD SZ11 HIP STEM SYNRG POR STD SZ12 INST CARPALTUNNELRELEASE MANOS KNEE INSRT XLPE DISHSZ3-4 11MM KNEE FEM LGN CR OXIN LFTSZ4 KNEE INSRT XLPE DISHSZ3-4 9MM MOLD CMNT SHLDR SPACER HD 6MM KT SYS DRSG PREVENA CUST SCREW DVR LK 2.7X18MM DEV BREAST BX EVIVA 9GX10CM MARKER BREAST HYDROMARK TI 3 SCREW LK STRY 5X95MM KT 2 MONOTB STER YEL PLATE DCP NARW 8HL 4.5X119MM PLATE DCP BROAD 4.5MM 16H*OBS* PLATE DCS 25BRL 95D 12HL*OBS* WIRE CERCLAGE W EYE 1.25X280MM GDWIRE THR*OBS NO REPLACEMENT* CMNT BONE SIMPLEX HV KNEE FEM LGN CR OXIN LFTSZ3 BIT DRILL 2X85MM PLATE ATLANTIS VISION 25MM Page 349 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $25.00 $2,766.00 $1,824.00 $1,067.00 $4,099.00 $1,460.00 $2,449.00 $2,773.00 $4,527.00 $202.00 $2,205.00 $734.00 $579.00 $2,368.00 $4,161.00 $203.00 $490.00 $714.00 $716.00 $2,700.00 $72.00 $655.00 $173.00 $274.00 $4,176.00 $4,176.00 $2,570.00 $2,288.00 $4,917.00 $2,414.00 $5,314.00 $1,874.00 $720.00 $1,118.00 $523.00 $842.00 $3,172.00 $734.00 $1,034.00 $1,692.00 $318.00 $387.00 $324.00 $3,627.00 $293.00 $2,315.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SHELL BURSTEIN LTD HL23X52 KNEE STEP WEDGE DEPU SZ4 5MM KNEE STEM FLUTED DEPU 115X15MM ADPTR UNIV ASPIRA HIP STEM TAPERLOC PRIM6X132MM GRSPR SLINGSHOT 70D UP PUSHER KNOT SUT CUTTER CTRX SCREW LK LOPRO 2.4X26MM PROTECT HOOD FOREIGN BODY SCREW LOPRO CORT 3.5X36MM SCREW CORT LK 3.5X36MM WASHER SCREW SPIKED 8.0/3.2MM SUCT CANISTER ACTIVAC 300ML DRSG WOUND DRAWTEX 8X8 DRSG WOUND DRAWTEX 3X39 DRSG WOUND DRAWTEX 4X39 DRSG WOUND DRAWTEX 8X39 END CAP TI T40 EXT 0MM END CAP 12MM TI W EXT 10MM END CAP 12MM TI W EXT 20MM SCREW LK TI NAIL 5X90MM SCREW LK TI NAIL 5X100MM BLADE IMPLT FEM SPIRAL TI100MM DEV MENISC CROSSFIXII CURV KNEE FEM LGN CR OXIN LFTSZ5 NDLE BX BIOPINCE 18GX10CM NDLE BX BIOPINCE 18GX15CM NDLE BX BIOPINCE COAX 17GX10CM NDLE BX BIOPINCE COAX 17GX15CM SYS TIGHTROPE MINI CMC1.1MM END CAP TIB TI T40 EXT 5MM END CAP TIB TI T40 EXT 10MM END CAP TIB TI T40 EXT 15MM SHEARS OPEN FOCUS PLUS CURV9CM FLTR DENALI VENA CAVA FEM KT GLIDESHEATHSLENDERSS6FR10CM STYLET PERITON ST 61CM BTL DRN WOUND ASEPT 1000ML BLADE BONE MILL COARSE 8MM ENDOL TRUNK LP 23X14MMX12CM ENDOL TRUNK LP 26X14MMX12CM ENDOL TRUNK LP 26X14MMX14CM ENDOL TRUNK LP 28X14MMX12CM ENDOL TRUNK LP 28X14MMX16CM ENDOL TRUNK LP 28X14MMX18CM ENDOL EXTNDR LP 26MMX3.3CM Page 350 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,205.00 $4,312.00 $3,561.00 $203.00 $4,674.00 $987.00 $638.00 $643.75 $122.00 $393.00 $890.00 $338.00 $223.00 $89.00 $139.00 $161.00 $261.00 $579.00 $579.00 $579.00 $627.00 $627.00 $1,352.00 $1,561.00 $4,917.00 $230.00 $230.00 $83.00 $83.00 $1,735.00 $734.00 $734.00 $734.00 $1,609.00 $2,575.00 $339.00 $708.00 $158.00 $1,168.00 $20,590.00 $20,483.00 $21,208.00 $20,971.00 $20,971.00 $19,998.00 $5,892.00 2020 pricing Drugs&Supplies PROCEDURE NAME ENDOL EXTNDR LP 28.5MMX3.3CM ENDOL EXTNDR LP 16MMX7CM RETR LT MAT LUMITEX DISP HEMO SEAL TISSEEL FIBRINRTU2ML ISOTOPE MICROSPHERE SIR SPHERE MOUTHPIECE W SALIVA TRAP WHT GLIDESCOPE GLV 0 PLATE CLAV CENT 1/3 RT 8HL KNEE TIB INSRT TC3 5 10MM PORT CLEARVUE SLIM INTRMD 6FR TB GASTRO MIC BLN 7-10ML 18FR KT INTR MIC GASTR*USE 6259398* SHLDR SCREW CMPRHNSV 6.5X30MM INFL DEV ENDOTEK BIG 60 KNEE FEM LGN CR OXIN RT SZ4 PLATE ATLANTIS VISION 60MM BIT DRILL ACUM 3MM SCREW NL HEXALOBE 3X16MM PPM ASSURITY DR-RF SCREW CORT LK ARTX 3.5MMX24M SCREW VANTAGE ATL 6.5X30MM SCREW VANTAGE ATL 6.5X40MM STAPLE VANTAGE ROSTRAL ATL TI STAPLE VANTAGE CAUDAL ATL TI SCREW NL HEXALOBE 3X12MM SCREW LK LOPRO 2.4X18MM SCREW LK LOPRO 2.4X28MM PLATE VANTAGE ATL 6.0CM KNEE FEM LGN CR OXIN RT SZ5 ALLO OSTEOAMP 5CC KNEE TIB INSRT ZIMM LFT SM 7MM KNEE TIB INSRT ZIMM LFT XS 5MM STAPLE SPEED ARC BME13X15X13MM SUT VICRYL+ 4-0 PS4 18 UNDY DEL SYS PECTORAL REPAIR HIP LNR ALTRX PE 0D 40X58MM HIP LNR ALTRX PE LIP 36X56MM GDWIRE THRD TROC TIP 1.6MM BIT DRILL SHRT 3.5MM SCREW CORT ARTX 2.4X22MM REAMER PILOT HEADED ARTX 7MM TB REAMER FOR HOLLOW REAMER SHT SILASTIC 8X6 NAIL TFNA TI 130D 10X170MM NAIL TFNA TI RT 130D 11X170MM NAIL TFNA TI RT 130D 11X360MM Page 351 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $6,032.00 $5,922.00 $384.00 $545.00 $32,754.00 $64.00 $123.00 $1,699.50 $4,319.00 $1,466.00 $174.00 $1,083.00 $641.00 $203.00 $4,916.00 $2,376.00 $717.00 $488.00 $8,700.00 $579.00 $1,751.00 $1,751.00 $2,989.00 $2,989.00 $488.00 $643.75 $643.75 $5,886.00 $3,970.00 $4,830.00 $2,216.00 $2,216.00 $2,379.00 $20.00 $3,501.00 $2,376.00 $2,373.00 $129.00 $618.00 $553.00 $1,038.00 $1,179.00 $1,068.00 $3,277.00 $3,522.00 $4,274.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL TFNA TI RT 130D 11X380MM NAIL TFNA TI RT 130D 11X400MM NAIL TFNA TI RT 130D 11X420MM NAIL TFNA TI LFT 130D 11X420MM SCREW LAG TI STER 85MM SCREW LAG TI STER 90MM SCREW LAG TI STER 95MM SCREW LAG TI STER 110MM BLADE HEL TFNA TI STER 80MM BLADE HEL TFNA TI STER 90MM BLADE HEL TFNA TI STER 100MM SCREW LK HEXALOBE 3X14MM SCREW LK HEXALOBE 3X10MM SCREW NL HEXALOBE 3X14MM KNEE SIG M PKA GDE/MDL PH3 LG ANCHOR NANOTACK FLEX PIVM SCREW TRMI 3.0X18MM BREAST HIPRO SALINE 200CC KT BX MISSION 20GX16CM HIP SCREW PERIPH 5.0X50MM HIP SHELL PNCLE DEEPGRIPTN56MM HIP SCREW PERIPH 5.0X45MM PLATE RAD HD NECK 2HL 2.4X28 KNEE INSRT XLPE DISHSZ3-4 13MM SHLDR SCREW CMPRHNSV 6.5X35MM SUCT VALV FLEX ENDO STER SUT CARTRDG SPEEDSTITCH BLU NDLE SPEEDSTITCH SCREW NL HEXALOBE 3X18MM SCREW LK LOPRO 2.4X30MM SCREW CORT ARTX 2.4X32MM HIP SHELL BURSTEIN LTD HL22X48 DEFIB HEARTSTART FRX BIT DRILL SYNT 3.2X195MM PLATE MTXMAND THICK 1.25MM NAILEX LAT ENTRY TI RT 9X360 PLATE WRIST FUSN SHRT 8HL SHLDR HUMR HD STB HIGH 45X17 SHLDR HUMR HD STB HIGH 48X16 SHLDR HUMR HD STB LOW 48X16 SHLDR HUMR HD STB HIGH 51X17 SHLDR HUMR HD STB LOW 51X17 SHLDR HUMR HD STB HIGH 51X23 SHLDR HUMR HD STB HIGH 54X18 SHLDR LAT HUMR INSRT 42MM +6MM KT BX MISSION 20GX20CM Page 352 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,274.00 $4,276.00 $4,488.00 $4,167.00 $2,002.00 $2,112.00 $2,002.00 $1,959.45 $2,206.00 $1,984.00 $2,101.00 $770.00 $770.00 $488.00 $2,432.00 $1,557.00 $1,031.00 $1,591.00 $242.00 $981.00 $7,903.00 $981.00 $1,714.90 $2,976.00 $641.00 $77.00 $1,093.00 $533.00 $488.00 $643.75 $573.10 $2,205.00 $3,242.00 $453.00 $1,245.89 $3,079.00 $2,413.00 $3,367.00 $4,027.00 $3,367.00 $3,367.00 $3,373.00 $3,285.00 $3,373.00 $2,932.00 $242.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT BX MISSION 18GX10CM KT BX MISSION 18GX16CM BIT DRILL SHRT S&N 2.7X155MM BIT DRILL LNG S&N 2.7X228MM HIP SHELL R3 3HL 58MM KWIRE SGL TROC SMTHPRGN1.6X150 SCREW LK GORILLA 2.7X18MM SCREW LK GORILLA 2.7X20MM SCREW NL GORILLA 3.5X16MM BIT DRILL SOLID MEASURE 2MM KWIRE SGL TROC SMTHPRGN1.2X150 SCREW LK GORILLA 3.5X16MM SCREW LK GORILLA 2.7X16MM HIP LNR R3 XLPE PE 0D 32X48 HIP STEM ANTHOLOGY HIGH SZ4 KNEE TIB GII CR PE RT SZ4 9MM LASER FBR FLAT TIP BLK SGL 550 STNT UNIVERSA FIRM 6FR 26CM PLATE ATLANTIS VISION 52.5MM KNEE STEM FLUTED DEPU 75X24MM SCREW CANN LOPRO ARTX 3X20MM ANCHOR ICONIX W#2FBR 1.4MM BIT DRILL ICONIX DISP 1.4MM FINGER SIL MSP SZ10 SCREW LK TRMI 2.4X8MM SCREW LK TRMI 2.4X10MM SCREW LK TRMI 2.4X12MM PLATE CUP XPODE TRMI SCREW LK TRMI 2.4X14MM KT KNEE CUT GD LGNP SZ F5/T CATH URETRL ACCESS DL 6/10FR50 SET DILATOR URETRL PE 6-18FR60 DILATOR URETRL LNG TAPER 6FR60 CATH ABD FIBEROPTIC 10FR BIT DRILL QUICKSET 3.8X25MM BIT DRILL QUICKSET 3.8X40MM BIT DRILL QUICKSET 3.8X70MM LASER FBR FLAT TIP BLK SGL 365 GDWIRE AMPLZUSTIFFFIX0.035 145 LASER FBR FLAT TIP BLK SGL 940 STNT UNIVERSA FIRM 6FR 28CM STNT UNIVERSA FIRM 6FR 24CM STNT UNIVERSA FIRM 6FR 22CM LASER FBR FLAT TIP BLK SGL 273 MESH PHASIX 10.2X15.2CM BONE PLUG ZIMM SM Page 353 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $242.00 $242.00 $452.00 $534.00 $2,773.00 $172.00 $1,061.00 $1,034.16 $1,022.00 $800.00 $132.00 $1,103.00 $1,055.00 $2,008.00 $4,161.00 $2,244.00 $1,414.00 $287.00 $2,376.00 $3,561.00 $746.00 $1,034.00 $693.00 $2,777.44 $465.00 $465.00 $465.00 $2,686.00 $465.00 $2,023.00 $198.00 $802.18 $116.17 $224.00 $922.00 $922.00 $922.00 $1,138.00 $159.00 $1,917.00 $311.00 $287.00 $287.00 $1,323.00 $4,213.00 $834.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLADE ARTHRO PLUS AGRESS ANG 4 MASK CPAP FORMA FULL MD/LG TB CPAP 600 THERMOSMART 6FT SCREW ASNIS III STRY 6.5X75MM SCREW ASNIS III STRY 6.5X80MM SCREW RECON THRD TI 6.5X30X80 FINGER IMPLT NEUFLEX PIP SZ1 HIP STEM TAPERLOC STD 9X137 HIP BODY PROX RECLAIM 20X75MM BLADE QUADCUT M4 3MMX13CM KT TOGGLELOC FIX ZIPLOOP ELBOW HIP SLV PROX SROM ZTT 16B-LG KNEE TIBDURASULLFTSZ3-4-5 11MM END CAP OFFSET 12X0MM SCREW LK CORT ACUM 3.5X6MM HIP STEM POLARSTEM135D STD SZ0 TRNQT STERICUFF W SLV 24IN PLATE CLAV DIST SHRT LFT 5HL KWIRE SMTH ARTX 0.062X3 HIP STEM COXAVARA HIGH SZ14 BED BARIATRIC EXCELCARE AIRMAT KT PERC INSRT PLK 2.9MM KNEE FEM CR NONPOR DEPU LFT1.5 PLATE ATLANTIS VISION 27MM SCREW CORT NL 3.5X38MM SCREW CORT LK ARTX 3.5X28MM SCREW CORT LK ARTX 3.5X30MM PLATE SUPERIOR CURV LFT8HL99MM SCREW CORT MATTA 3.5X18MM ALLO EPIFIX 2X2CM=4SQCM ALLO EPIFIX 2X4CM=8SQCM KT PROLARYN GEL 1CC KT PROLARYN PLUS 1CC ANCHOR FASTIN RC ETHIBOND KNEE STEM FLUTED DEPU 75X22MM PLATE CALC VA MD LFT 2.7X64MM ELTD STARBURST SE*USE 6269873* BIT DRILL RFLCT FLEX 15MM HIP STEM POLARSTEM135D STD SZ6 KNEE PLTA NKII ZIMM SZ1 7MM PLATE VANTAGE ATL 6.5CM SCREW VANTAGE ATL 6.5X45MM KNEE TIB INSRT PS VNGD10X71/75 BREAST HIPRO SIL RD 160CC HIP SHELL R3 3HL 64MM SCREW SURFIX ILSC 3.5X20MM Page 354 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $242.00 $515.00 $203.00 $1,077.00 $1,077.00 $646.00 $2,475.00 $4,674.00 $9,203.00 $2,868.00 $2,807.00 $2,205.00 $2,271.00 $1,052.00 $690.00 $4,078.63 $121.00 $1,699.50 $114.80 $4,527.00 $658.00 $1,057.00 $2,764.00 $2,315.00 $191.00 $579.00 $579.00 $2,421.00 $152.00 $2,735.00 $3,219.00 $1,856.25 $1,820.00 $1,388.00 $3,561.00 $2,730.00 $6,768.00 $796.00 $4,161.00 $1,148.00 $5,886.00 $1,751.00 $4,180.00 $2,245.00 $2,773.00 $1,410.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR ALTRX PE +4 0D 40X62MM KNEE FEM LGN CR OXIN RT SZ3 KNEE FEM TC3 DEPU RT 2.5 KNEE TIB INSRT TC3 2.5 20MM HIP LNR PNCLE PE +4 0D 32X62 HIP STEM ANTHOLOGY STD SZ9 KNEE DCM PRI LIPBEAR10X71/75MM KNEE PSN TIB STEM 5D RT SZJ NAIL FEM RECON LAT TI RT 9X420 SYS SPEEDBRIDGE MIDSUB HIP STEM POLARSTEM135D STD SZ4 GDWIRE PTFE GYRUS .035 50CM GDWIRE E-Z GLIDER ST.038 150CM COIL MWCE-18-7-6-NESTER COIL MWCE-18-7-8-NESTER COIL MWCE-18-7-10-NESTER MARKER MARGIN AND CORRECTCLIPS KT GI ENDO COMPLI*VAT 6276907* CAPSULE AGILE PATENCY NAILEX LAT ENTRY TI LFT 9X360 BUR CUT OTO-FLEX DIMND 1.0MM BUR RASP HELOCOIDAL 2.1MM SCREW CANN LOPRO ARTX 3X24MM REAMER CORING ARTX 8MM BELT SI EVERGRN 621 MD BOLT EXTR FOR SCREW 1.5MM BOLT EXTR FOR SCREW 2.0MM BOLT EXTR FOR SCREW 2.7MM BOLT EXTR FOR SCREW 4.5MM SCREW EXTR CONIC TIP 1.5/2.0MM SCREW EXTR CONIC TIP 2.7/3.5MM SCREW CNCLS 130/60 6.0/5.0MM NAIL ANK LK BIOM 10X150MM NAIL ANK LK BIOM 10X180MM SCREW CNCLS LK FT 4.0X75MM SCREW CNCLS LK FT 4.0X80MM SCREW CNCLS LK FT 4.0X85MM SCREW CNCLS LK FT 4.0X90MM SCREW CNCLS LK FT 4.0X10MM SCREW CNCLS LK FT 4.0X12MM SCREW CNCLS LK FT 4.0X16MM SCREW CNCLS LK FT 4.0X44MM SCREW CNCLS LK FT 4.0X48MM SCREW CNCLS LK FT 4.0X65MM SCREW CNCLS LK FT 4.0X70MM SCREW CORT LK 3.5X10MM Page 355 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,481.00 $3,970.00 $12,347.00 $4,319.00 $2,172.00 $4,161.00 $2,042.00 $2,141.00 $2,762.00 $2,423.00 $4,161.00 $133.00 $173.00 $376.00 $376.00 $376.00 $563.00 $78.00 $173.00 $3,094.00 $1,083.00 $707.00 $778.00 $996.00 $226.00 $487.00 $487.00 $487.00 $531.00 $338.00 $338.00 $967.00 $6,833.00 $6,833.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $889.00 $844.00 $844.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT LK 3.5X20MM SCREW CORT LK 3.5X28MM SCREW CORT LK 3.5X38MM SCREW CORT LK 3.5X42MM SCREW CORT LK 3.5X44MM SCREW CORT LK 3.5X46MM SCREW CORT LK 3.5X48MM SCREW CORT LK 3.5X50MM SCREW CORT LK 3.5X52MM SCREW CORT LK 3.5X58MM SCREW CORT LK 3.5X60MM SCREW CORT LK 3.5X65MM SCREW CORT LK 3.5X70MM SCREW CORT LK 3.5X75MM SCREW CORT LK 3.5X80MM SCREW CORT LK 3.5X85MM BIT DRILL ZIMM 2.0MM BIT DRILL 2.5X100MM BIT DRILL 2.7X100MM GDWIRE ENTRY 3.2X320MM PLATE FIB LK RT 4HL BIT DRILL I/N TWIST 3.6X180MM PLATE DIST TIB LK LFT 9HL PLATE DIST TIB LK RT 12HL SCREW LK MULTDIRECT 3.5X54MM SCREW LK MULTDIRECT 3.5X58MM SCREW LK MULTDIRECT 3.5X60MM SCREW PEG ZIMM 2.5X40MM WASHER FLAT TIMAX 4.2X11MM PLATE TIB PROX LK LFT 3HL STD PLATE TIB PROX LK LFT 5HL STD PLATE TIB PROX LK RT 11HLSTD SCREW SOLID CORT FT 2.7X20MM SCREW SOLID CORT FT 2.7X55MM SCREW CORT NL ZIMM 3.5X65MM SCREW CORT NL ZIMM 3.5X70MM WASHER LOPRO CORT 3.5MM SCREW LOPRO CORT 3.5X26MM SCREW LOPRO CORT 3.5X48MM SCREW LOPRO CORT 3.5X80MM SCREW LOPRO CORT 3.5X85MM SCREW HUMR DIST LAT RT 7HL64MM SCREW HUMR DIST LAT LFT7HL64MM SCREW DIST HUMPOSTLATRT9HL74MM SCREW DISTHUMPOSTLATRT11HL94MM SCREW HUMR DIST MD RT 9HL 88MM Page 356 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $844.00 $393.00 $685.00 $733.00 $711.00 $2,456.00 $807.00 $3,948.00 $3,974.00 $1,199.00 $1,199.00 $1,199.00 $561.00 $235.00 $3,466.00 $3,923.00 $3,607.00 $342.00 $342.00 $342.00 $342.00 $432.00 $393.00 $393.00 $393.00 $393.00 $3,131.00 $3,131.00 $3,131.00 $3,131.00 $3,131.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW HUMR DIST MD RT 10HL97MM SCREW DIST HUMR MD LFT9HL88MM GD PIN BYNT PT 2MM 3PK SLV CBL CRIMP COCR 2.0MM BLADE THIN OSTEO CURVEND 12MM CBL BMP COCR BIOM 2.0X750MM PRSSZR FEM CANAL CBL COCR TROCHGRIP MD 2.0MM KNEE PTLA 3PEG STD 25X8MM HIP ADPTR TYPE1 M2A 42-50MM +6 HIP ADPTR TYPE1 M2A 52-60MM -6 HIP ADPTR TYPE1 M2A 52-60MM +3 HIP ADPTR TYPE1 M2A 52-60MM +9 HIP HD M2A ZIMM MTL 58MM +0 HIP HD M2A ZIMM MTL 60MM +0 KNEE TIB INSRT STBLZIMM18X79MM KNEE TIB INSRT STBLZIMM14X83MM KNEE TIB INSRT STBLZIMM18X83MM KNEE TIB INSRT STBLZIMM20X83MM HIP LNR ARCOMXL PE 0D +5 36X25 KNEE TIB INSRT ZIMM RT XL 5MM KNEE TIB INSRT ZIMM LFT XS 6MM KNEE TIB INSRT ZIMM LFT XS 7MM KNEE TIB INSRT ZIMM LFT XS 8MM KNEE TIB INSRT ZIMM LFT XS 9MM KNEE TIB INSRT ZIMM RT XS 3MM KNEE TIB INSRT ZIMM RT XS 4MM KNEE TIB INSRT ZIMM RT XS 5MM KNEE TIB INSRT ZIMM RT XS 6MM KNEE TIB INSRT ZIMM RT XS 7MM KNEE TIB INSRT ZIMM RT XS 8MM KNEE TIB INSRT ZIMM RT XS 9M KNEE TIB INSRT ZIMM LFT SM 8MM KNEE TIB INSRT ZIMM LFT SM 9MM KNEE TIB INSRT ZIMM LFT XL 3MM KNEE TIB INSRT ZIMM LFT XL 4MM KNEE TIB INSRT ZIMM LFT XL 5MM KNEE TIB INSRT ZIMM LFT XL 6MM KNEE TIB INSRT ZIMM LFT XL 7MM KNEE TIB INSRT ZIMM LFT XL 8MM KNEE TIB INSRT ZIMM LFT XL 9MM KNEE TIB INSRT ZIMM RT XL 3MM KNEE TIB INSRT ZIMM RT XL 4MM KNEE TIB INSRT ZIMM RT XL 6MM KNEE TIB INSRT ZIMM RT XL 7MM KNEE TIB INSRT ZIMM RT XL 8MM Page 357 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,131.00 $3,131.00 $207.00 $597.00 $818.00 $953.00 $280.00 $1,454.00 $1,476.00 $1,419.00 $1,419.00 $1,419.00 $1,419.00 $1,790.00 $1,790.00 $2,042.00 $2,042.00 $2,042.00 $2,042.00 $2,123.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 $2,216.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT ZIMM RT XL 9MM ADPTR FEM CR STEM SZ70 KNEE TIB INSRT STD 14X59MM KNEE TIB INSRT STD 16X59MM KNEE TIB INSRT STD 18X59MM KNEE TIB INSRT STD 18X71/75MM KNEE TIB INSRT STD 18X79/83MM KNEE TIB INSRT STD 12X87/91MM KNEE TIB INSRT STD 14X87/91MM KNEE TIB INSRT STD 16X87/91MM KNEE TIB INSRT STD 18X87/91MM KNEE TIB STEM REV ZIMM22X120MM SHLDR SHELL BIPOLR 48MM KNEE FEM UNI OXFORD ZIMM XL HIP LNR RINGLOC PE 10D 26X28MM KNEE VNGD M UNI C4 LM/RL KNEE VNGD M UNI A6 RM/LL KNEE STEM SPLINED BOW 14X200MM KNEE FEM CR ZIMM LFT 67.5MM HIP STEM ANSWER LAT 9X125MM HIP SHELL M2A ZIMM 44X38MM HIP SHELL BURSTEIN MULT 22X46 HIP SHELL BURSTEIN MULT 22X48 HIP SHELL BURSTEIN MULT 23X50 HIP SHELL BURSTEIN MULT 23X52 HIP SHELL BURSTEIN MULT 24X54 HIP SHELL BURSTEIN MULT 24X56 HIP SHELL BURSTEIN MULT 25X58 HIP SHELL BURSTEIN MULT 25X60 HIP SHELL BURSTEIN MULT 26X62 HIP SHELL BURSTEIN MULT 26X64 HIP SHELL BURSTEIN MULT 27X66 HIP SHELL BURSTEIN MULT 27X68 HIP SHELL BURSTEIN MULT 28X70 PLATE LAT TROCH 159MM HIP STEM TAPERLOC STD 17.5X155 HIP STEM TAPERLOC STD 20X160 HIP STEM TAPERLOC STD 22.5X165 HIP STEM TAPERLOC STD 25X170 PLATE LAT TROCH 254MM SHLDR HUMR STEM 9.5X125MM HIP STEM REACH W COLAR 1X170MM HIP BODY MALLORY D STD 34MM HIP STEM REACH BOW RT 11X200MM HIP RING RETAINING RINGLOC II HIP HD M2A ZIMM MTL 38MM +3 Page 358 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,216.00 $2,268.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $3,178.00 $3,257.00 $3,444.00 $3,520.00 $3,570.00 $3,570.00 $3,589.00 $3,605.00 $3,894.00 $3,918.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,225.00 $4,417.00 $4,674.00 $4,674.00 $4,674.00 $4,674.00 $4,920.00 $5,937.00 $13,005.00 $13,249.00 $16,946.00 $1,078.00 $1,790.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP HD M2A ZIMM MTL 38MM +9 HIP LNR ARCOM PE 10D 23X32MM HIP LNR ARCOMXL PE 0D 36X27MM HIP LNR ARCOMXL PE 0D 36X28MM HIP LNR ARCOMXL PE 10D 28X22MM HIP LNR ARCOMXL PE 0D 36X26MM HIP LNR ARCOMXL PE 0D 36X27MM HIP LNR ARCOMXL PE 0D 36X28MM HIP LNR ARCOMXL PE 10D 36X26MM HIP LNR ARCOMXL PE 10D 36X27MM HIP LNR ARCOMXL PE 10D 36X28MM HIP LNR ARCOMXL PE 0D +5 32X22 HIP LNR ARCOMXL PE 0D +5 36X23 HIP LNR ARCOMXL PE 0D +5 36X24 HIP LNR ARCOMXL PE 0D +5 36X27 HIP LNR ARCOMXL PE 0D +5 36X28 HIP SHELL BURSTEIN LTD HL22X46 HIP SHELL BURSTEIN LTD HL23X50 HIP SHELL BURSTEIN LTD HL24X54 HIP SHELL BURSTEIN LTD HL24X56 HIP SHELL BURSTEIN LTD HL25X58 HIP SHELL BURSTEIN LTD HL25X60 HIP SHELL BURSTEIN LTD HL26X62 HIP SHELL BURSTEIN LTD HL26X64 HIP SHELL BURSTEIN LTD HL27X66 HIP SHELL BURSTEIN LTD HL27X68 HIP SHELL BURSTEIN LTD HL28X70 KNEE GD SIGNATURE MODEL04-05 HIP HD BIOLOX CER ZIMM 36MM +6 HIP HD FREEDOM 1 COCR STD 36MM HIP LNR E1 PE MROM +5 40X25 HIP LNR E1 PE MROM 40X27 HIP STEM TAPERLOC PRIM22.5X165 HIP STEM TAPERLOC PRIM25X170MM HIP STEM TAPERLOC LAT 20X160 HIP STEM TAPERLOC PRIM16X152MM HIP STEM MALRY LAT131.5D14X175 HIP LNR FREEDOM PE 10D SZ24 HIP STEM MALLORY STD135D11X220 SHLDR HUMR HD ZIMM SZ7 HIP STEM MALLORY STD135D15X300 HIP STEM BIMETRIC LAT 9X55X150 HIP STEM NECK COCR RT11X55X250 HIP STEM REACH STD 11X200MM HIP STEM PLR SPLINED 19X270MM NAIL FEM 12X28MM Page 359 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,790.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,123.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,432.00 $2,691.00 $3,319.00 $3,240.00 $3,240.00 $4,674.00 $4,674.00 $4,674.00 $4,674.00 $4,674.00 $4,787.00 $5,620.00 $6,551.00 $7,662.00 $12,363.00 $12,363.00 $16,946.00 $19,290.00 $4,104.00 2020 pricing Drugs&Supplies PROCEDURE NAME T-NUT LK TI 5MM BOLT LK TI 5X60MM SCREW WASHER TI 13MM BOLT LK TI 5X50MM CLAMP EXTL FIX ANK ROD EXTL FIX TELESCOPEARMSTDRT NAIL ANK ARTHODESIS DEV COMP/DISTR 1-5CM HIP CUST MALLORY HD MOD CALCAR SCREW CORT LEAD DBL 5X110MM SCREW STEM DIST BOW 15X250MM KT ACET CUP REMOV SYS BIOM HIP CAGE RECOVERY RT 67MM PLATE PROX TIB LK RT 7HL STD SCREW LK MULTDIRECT 3.5X65MM SCREW CORT LK 3.5X54MM SCREW FEM COMP LFT 67.5MM KNEE STEM FLUTED DEPU 115X18MM EXPAND MAM MODER W TAB 300CC TB REAMER SPARE 1.0/1.5MM TB REAMER SPARE 2.0MM TB REAMER SPARE 2.4/3.0MM TB REAMER SPARE 6.0/7.0MM TB REAMER SPARE 4.0/5.0MM ARTHROWAND MULTVAC 50 XL KT T3 AMZ DISP SCREW POST BI CORT 4.5X60MM HIP LNR ALTRX PE 0D 40X56MM HIP HD OXIN MTL 12/14 32MM +8 HIP STEM CORAIL BOW COLAR SZ20 HIP STEM COXAVARA HIGH SZ16 HIP STEM SROM 36 +8L 15X20X165 SHLDR HUMR HD GLOBAL MD 44MM HIP LNR DURALOC PE 0D 28X48 HIP LNR DURALOC PE 0D 28X50 HIP LNR DURALOC PE 20D 28X48 HIP LNR DURALOC PE 20D 28X50 HIP LNR DURALOC PE 20D 28X52 HIP LNR DURALOC PE 20D 28X54 HIP LNR DURALOC PE 20D 28X56 HIP LNR DURALOC PE 20D 28X58 HIP LNR DURALOC PE 20D 28X60 HIP LNR DURALOC PE 20D 28X62 HIP LNR DURALOC PE 20D 28X64 HIP LNR DURALOC PE 20D 28X66 HIP LNR DURALOC PE +4 0D 28X48 Page 360 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,127.00 $1,127.00 $465.00 $1,127.00 $3,495.00 $2,791.00 $4,320.00 $2,128.00 $18,194.00 $1,067.00 $11,247.00 $2,172.00 $9,356.00 $3,535.00 $1,199.00 $844.00 $13,962.00 $3,561.00 $3,145.50 $928.00 $928.00 $928.00 $1,179.00 $1,179.00 $1,554.00 $1,615.00 $531.00 $2,376.00 $2,161.00 $4,527.00 $4,527.00 $6,315.00 $5,467.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,589.00 $3,943.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR DURALOC PE +4 0D 28X50 HIP LNR DURALOC PE +4 0D 28X52 HIP LNR DURALOC PE +4 0D 28X54 HIP LNR DURALOC PE +4 0D 28X56 HIP LNR DURALOC PE +4 0D 28X58 HIP LNR DURALOC PE +4 0D 28X60 HIP LNR DURALOC PE +4 0D 28X62 HIP LNR DURALOC PE +4 0D 28X64 HIP LNR DURALOC PE +4 0D 28X66 HIP RING LK DYNAMIC DEPU 50MM HIP RING LK DYNAMIC DEPU 62MM HIP RING LK DYNAMIC DEPU 64MM HIP RING LK DYNAMIC DEPU 66MM HIP SLV PROX SROM ZTT 22B-SML HIP SLV PROX SROM ZTT 22B-LRG SCREW CANN ACET 5.0X55MM HIP HD SROM MTL 11/13 32MM +12 HIP STEM SROM 36 22X17X165 HIP STEM SROM 42 22X17X165 HIP STEM SROM LG 36 11X16X205L HIP STEM SROM LG 36 18X13X215L HIP STEM SROM LG 36 20X15X225L HIP STEM SROM LG 36 22X17X230L HIP STEM SROM LG 36 22X17X230R HIP STEM SROM 36+21CR16X11X150 HIP STEM SROM 36+21CR20X15X165 HIP STEM SROM 36+21CR22X17X165 HIP STEM SROM 36+21CR24X19X175 WASHER TROCHANTER DEPU 54X70MM HIP SLV PROX SROM 14B-LRG HIP SLV PROX SROM 14D-LRG HIP SLV PROX SROM 14F-LRG HIP SLV PROX SROM 22D-SML HIP SLV PROX SROM 22D-LRG HIP SLV PROX SROM 24B-LRG HIP SLV PROX SROM 24D-SML HIP SLV PROX SROM 24F-SML HIP SLV PROX SROM 24F-LRG HIP SLV PROX SROM 24F XX HIP SLV PROX SROM 18F-SML 16ID HIP SLV PROX SROM 18F-XXL 16ID HIP SLV PROX SROM 22F-SML 20ID HIP SLV PROX SROM 24F-SML 22ID HIP SLV PROX SROM 24F-XXL 22ID HIP SHELL MTL M28 51MM15MMNEUT HIP SHELL MTL M28 54MM15MMNEUT Page 361 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,943.00 $3,943.00 $3,943.00 $3,943.00 $3,943.00 $3,943.00 $3,943.00 $3,943.00 $3,943.00 $1,218.00 $1,218.00 $1,218.00 $1,218.00 $2,205.00 $2,205.00 $898.00 $1,419.00 $3,240.00 $3,240.00 $15,552.00 $15,552.00 $15,552.00 $15,552.00 $15,552.00 $13,270.00 $13,270.00 $13,270.00 $13,270.00 $1,428.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $10,893.00 $10,893.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SHELL MTL M28 51MM 25MMLFT HIP SHELL MTL M28 51MM 25MM RT HIP SHELL MTL M28 54MM 25MMLFT HIP SHELL MTL M28 54MM 25MM RT HIP SHELL MTL L32 57MM15MMNEUT HIP SHELL MTL L32 60MM15MMNEUT HIP SHELL MTL L32 63MM15MMNEUT HIP SHELL MTL L32 66MM15MMNEUT HIP SHELL MTL L32 57MM 25MMLFT HIP SHELL MTL L32 57MM 25MM RT HIP SHELL MTL L32 60MM 25MM RT HIP SHELL MTL L32 63MM 25MMLFT HIP SHELL MTL L32 63MM 25MM RT HIP SHELL MTL L32 66MM 25MMLFT HIP SHELL MTL L32 66MM 25MM RT SCREW CNCLS LG 6.5X50MM SCREW CNCLS LG 6.5X55MM PEG PLUG HL HIP STEMLNG36+21CR4L11X16X205L HIP STEMLNG36+21CR8L22X17X230L HIP STEMLNG36+21CR8L22X17X230R HIP STEMLNG36+21CR8L24X19X230L HIP STEMLNG36+21CR8L24X19X230R HIP STEM XL36+21CR4L16X11X240R HIP STEM XL36+21CR8L20X15X270L HIP STEM XL36+21CR8L20X15X275L HIP STEM XL36+21CR8L20X15X275R HIP STEM 2XL36+21+4L16X11X300L HIP STEM 2XL36+21+8L18X13X315R HIP STEM 2XL36+21+8L20X15X325L HIP STEM 2XL36+21+8L20X15X325R HIP STEM 2XL36+21+8L22X17X325L HIP STEM 2XL36+21+8L22X17X325R HIP STEM SROM 36 +8L17X22X230L HIP STEM SROM 36 +8L22X17X230R HIP STEM SROM 36 +8L19X24X230L HIP STEM SROM 36 +8L19X24X230R HIP STEM SROM 30 +4L16X11X205L HIP STEM SROM 30 +4L16X11X205R HIP CAGE PROTRUSIO LFT 56X53MM HIP HD AML MTL 14/16 28MM +5 HIP HD AML MTL 14/16 36MM +5 HIP SHELL PNCLE REV GRIPTN58MM HIP SHELL PNCLE REV GRIPTN68MM HIP SHELL PNCLE DEEPGRIPTN60MM HIP SHELL PNCLE DEEPGRIPTN62MM Page 362 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $11,596.00 $11,596.00 $11,596.00 $11,596.00 $10,893.00 $10,893.00 $10,893.00 $10,893.00 $11,596.00 $11,596.00 $11,596.00 $11,596.00 $11,596.00 $11,596.00 $11,596.00 $898.00 $898.00 $1,178.00 $13,019.00 $13,019.00 $13,019.00 $13,019.00 $13,019.00 $14,963.00 $14,963.00 $14,963.00 $14,963.00 $16,028.00 $16,028.00 $16,028.00 $16,028.00 $16,028.00 $16,028.00 $10,250.00 $10,250.00 $10,250.00 $10,250.00 $10,250.00 $10,250.00 $5,209.00 $3,304.00 $3,415.00 $7,512.00 $7,512.00 $7,903.00 $7,903.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SHELL PNCLE DEEPGRIPTN66MM HIP LNR ULTAMET MTL 36X64MM HIP LNR ULTAMET MTL 36X66MM HIP LNR PNCLE PE 0D 28X52 HIP LNR PNCLE PE 0D 28X54 HIP LNR PNCLE PE 0D 28X56 HIP LNR PNCLE PE 0D 28X58 HIP LNR PNCLE PE 0D 28X60 HIP LNR PNCLE PE 0D 28X62 HIP LNR PNCLE PE +4 10D 28X52 HIP LNR PNCLE PE +4 10D 28X56 HIP LNR PNCLE PE +4 10D 28X58 HIP LNR PNCLE PE +4 10D 28X60 HIP LNR PNCLE PE +4 10D 28X62 HIP LNR PNCLE PE LIP 28X52MM HIP LNR PNCLE PE LIP 28X54MM HIP LNR PNCLE PE LIP 28X58MM HIP LNR PNCLE PE 0D 32X56 HIP LNR PNCLE PE 0D 32X60 HIP LNR PNCLE PE 0D 32X62 HIP LNR PNCLE PE 0D 32X64 HIP LNR PNCLE PE +4 10D 32X56 HIP LNR PNCLE PE +4 10D 32X58 HIP LNR PNCLE PE +4 10D 32X60 HIP LNR PNCLE PE +4 10D 32X62 HIP LNR PNCLE PE +4 10D 32X64 HIP LNR PNCLE PE +4 10D 32X66 HIP LNR PNCLE PE LIP 32X60MM HIP LNR PNCLE PE LIP 32X62MM HIP LNR PNCLE PE LIP 32X64MM HIP LNR PNCLE PE LIP 32X66MM HIP LNR PNCLE PE +4 0D 32X48 HIP LNR PNCLE PE +4 0D 32X50 HIP LNR PNCLE PE +4 0D 32X56 HIP LNR PNCLE PE +4 0D 32X58 HIP LNR PNCLE PE +4 0D 32X60 HIP LNR PNCLE PE +4 0D 32X64 HIP LNR PNCLE PE +4 0D 32X66 HIP LNR SROM M PE 10D 28MM HIP LNR SROM M PE 10D 28MM +3 HIP LNR SROM L PE 10D 32MM HIP LNR SROM L PE 10D 32MM +3 HIP SCREW PERIPH 5.0X30MM HIP SCREW PERIPH 5.0X40MM HIP SCREW PERIPH 5.0X55MM HIP SCREW PERIPH 5.0X60MM Page 363 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $7,903.00 $3,100.00 $3,100.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $3,472.00 $3,700.00 $3,472.00 $3,700.00 $981.00 $981.00 $981.00 $981.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP HD SROM MTL 11/13 36MM -3 HIP HD ASPHR MTL 11/13 36MM -3 HIP HD SROM MTL 11/13 36MM+3 HIP HD SROM MTL 11/13 36MM +6 HIP HD SROM MTL 11/13 36MM +9 HIP HD EZE CER 12/14 36MM +12 HIP HD SROM MTL 11/13 40MM +0 HIP HD SROM MTL 11/13 40MM +3 HIP HD SROM MTL 11/13 40MM +6 HIP HD SROM MTL 11/13 40MM +9 HIP HD SROM MTL 11/13 40MM+12 HIP HD ASPHR MTL 12/14 44MM +6 HIP HD SROM MTL 11/13 44MM +12 HIP STEM PRESS FIT 12/14 10.5 HIP STEM PRESS FIT 12/14 12.0 HIP STEM PRESS FIT 12/14 13.5 HIP STEM PRESS FIT 12/14 15.0 HIP STEM PRESS FIT 12/14 16.5 HIP STEM SUMMIT DUOFIX STD SZ1 HIP STEM SUMMIT DUOFIX STD SZ2 HIP STEM SUMMIT DUOFIX STD SZ3 HIP STEM SUMMIT DUOFIX STD SZ4 HIP STEM SUMMIT DUOFIX STD SZ5 HIP STEM SUMMIT DUOFIX STD SZ6 HIP STEM SUMMIT DUOFIX STD SZ7 HIP STEM SUMMIT DUOFIX STD SZ8 HIP STEM SUMMIT DUOFIX STD SZ9 HIP STEM SUMMIT DUOFIX STDSZ10 HIP STEM SUMMIT PRESS FIT SZ2 HIP STEM SUMMIT PRESS FIT SZ3 HIP STEM SUMMIT PRESS FIT SZ4 HIP STEM SUMMIT PRESS FIT SZ5 HIP STEM SUMMIT PRESS FIT SZ6 HIP STEM SUMMIT PRESS FIT SZ7 HIP STEM SUMMIT PRESS FIT SZ8 HIP STEM SUMMIT DUOFIX HIGHSZ1 HIP STEM SUMMIT DUOFIX HIGHSZ2 HIP STEM SUMMIT DUOFIX HIGHSZ3 HIP STEM SUMMIT DUOFIX HIGHSZ4 HIP STEM SUMMIT DUOFIX HIGHSZ5 HIP STEM SUMMIT DUOFIX HIGHSZ6 HIP STEM SUMMIT DUOFIX HIGHSZ7 HIP STEM SUMMIT DUOFIX HIGHSZ8 HIP STEM SUMMIT DUOFIX HIGHSZ9 HIP STEM SUMMIT DUOFIXHIGHSZ10 HIP STEM SOL SYS BOW LFT16.5MM Page 364 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,419.00 $2,570.00 $1,419.00 $1,419.00 $1,419.00 $2,376.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $1,545.00 $2,376.00 $1,545.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $4,527.00 $16,885.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP STEM SOL SYS BOW LFT18.0MM HIP STEM SOL SYS BOW RT 15.0MM HIP STEM SOL SYS BOW RT 19.5MM HIP BODY PROX RECLAIM 20X95MM HIP STEM RECLAIM DISTANG15X190 HIP SLV PROX SROM ZTT 20B-SML HIP SLV PROX SROM ZTT 20B-LG HIP SCREW CNCLS 5.0X30MM HIP SCREW CNCLS 5.0X40MM HIP SCREW CNCLS 5.0X50MM HIP SCREW CNCLS 5.0X25MM HIP SCREW CNCLS 5.0X35MM HIP SCREW CNCLS 5.0X45MM HIP HD SROM MTL 11/13 28MM +6 HIP HD SROM MTL 11/13 28MM +12 HIP STEM SROM 36 20X15X165 HIP STEM SROM 42 24X19X175 HIP STEM SROM 36 +8L 22X17X165 HIP STEM SROM 36 +8L 24X19X175 HIP STEM SROM LG 36 16X11X205R HIP STEM SROM LG 36 18X13X215R HIP STEM SROM LG 36 20X15X225R HIP SLV PROX SROM SZ F 18X13MM WASHER TROCHANTER 40X31MM WASHER TROCHANTER 60X45MM SCREW TROCHANTER 42MM SCREW TROCHANTER 52MM SCREW TROCHANTER 62MM PEG PIN LK 3.5MM PEG PIN LK 5.0MM HIP SLV PROX SROM 14F-SML HIP SLV PROX SROM 16F-SML HIP SLV PROX SROM 16F-LRG HIP SLV PROX SROM 18D-LRG HIP SLV PROX SROM 18F-SML HIP SLV PROX SROM 18F-LRG HIP SLV PROX SROM 18F-2XL HIP SLV PROX SROM 20D-SML HIP SLV PROX SROM 20D-LRG HIP SLV PROX SROM 20F-SML HIP SLV PROX SROM 20F-LRG HIP SLV PROX SROM 20F-2XL HIP SLV PROX SROM 22F-SML HIP SLV PROX SROM 22F-LRG HIP SLV PROX SROM 22F-2XL HIP SLV PROX SROM 24D-LRG Page 365 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $16,885.00 $16,885.00 $16,885.00 $9,203.00 $7,694.00 $2,205.00 $2,205.00 $898.00 $898.00 $898.00 $898.00 $898.00 $898.00 $1,419.00 $1,419.00 $3,240.00 $3,240.00 $3,240.00 $3,240.00 $15,552.00 $15,552.00 $15,552.00 $2,205.00 $1,428.00 $1,428.00 $880.00 $880.00 $880.00 $852.00 $852.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $3,457.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP SLV PROX SROM 18F-LRG 16ID HIP SLV PROX SROM 20F-LRG 18ID HIP SLV PROX SROM 20F-XXL 18ID HIP SLV PROX SROM 22F-LRG 20ID HIP SLV PROX SROM 22F-XXL 20ID HIP SLV PROX SROM 24F-LRG 22ID HIP SHELL MTL L32 60MM 25MMLFT SCREW CNCLS LG 6.5X15MM SCREW CNCLS LG 6.5X20MM SCREW CNCLS LG 6.5X25MM SCREW CNCLS LG 6.5X30MM SCREW CNCLS LG 6.5X35MM SCREW CNCLS LG 6.5X40MM SCREW CNCLS LG 6.5X45MM HIP STEMLNG36+21CR4L16X11X205R HIP STEMLNG36+21CR8L13X18X215L HIP STEMLNG36+21CR8L18X13X215R HIP STEMLNG36+21CR8L15X20X225L HIP STEMLNG36+21CR8L20X15X225R HIP STEM XL36+21CR4L16X11X240L HIP STEM XL36+21CR8L18X13X255L HIP STEM XL36+21CR8L18X13X255R HIP STEM XL36+21CR8L20X15X270R HIP STEM 2XL36+21+4L16X11X300R HIP STEM 2XL36+21+8L18X13X315L HIP STEM SROM 36 +8L13X18X215L HIP STEM SROM 36 +8L20X15X225L HIP STEM SROM 36 +8L 22X17X230 HIP STEM 2XL 36 +8L 18X13X315L HIP STEM 2XL 36 +8L 15X20X325L HIP STEM SROM 30 +4L 18X13X160 HIP STEM SROM 36 +12L13X18X160 HIP HD ULTIMA UNIPOLR MTL 63MM HIP CENTRALIZER DEPU 10MM HIP CENTRALIZER DEPU 11MM HIP CENTRALIZER DEPU 12MM HIP CENTRALIZER DEPU 13MM HIP CENTRALIZER DEPU 14MM HIP CENTRALIZER DEPU 15MM HIP HD PFC MTL 10/12 28MM +0 HIP HD PFC MTL 10/12 28MM +10 HIP HD PFC MTL 10/12 28MM +5 HIP HD PFC MTL 10/12 32MM +5 HIP HD PFC MTL 10/12 32MM +10 HIP LNR PFC PE 10D 28X48-52MM HIP LNR PFC PE 10D 28X54-58MM Page 366 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $11,596.00 $898.00 $898.00 $898.00 $898.00 $898.00 $898.00 $898.00 $13,019.00 $13,019.00 $13,019.00 $13,019.00 $13,019.00 $14,963.00 $14,963.00 $14,963.00 $14,963.00 $16,028.00 $16,028.00 $10,250.00 $10,250.00 $10,250.00 $14,155.00 $14,155.00 $3,240.00 $3,240.00 $1,578.00 $782.00 $782.00 $782.00 $782.00 $782.00 $782.00 $2,405.00 $2,405.00 $2,405.00 $2,379.00 $2,379.00 $2,947.00 $2,947.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR PFC PE 10D 28X60-64MM HIP LNR PFC PE 10D 28X66-70MM HIP LNR SROM M PE 0D 28MM HIP LNR SROM L PE 0D 28MM HIP LNR SROM L PE 0D 32MM HIP STEM ULTIMA BIL SZ2 35MM HIP STEM ULTIMA BIL SZ2 45MM HIP STEM ULTIMA BIL SZ3 45MM HIP STEM ULTIMA BIL SZ3 55MM HIP STEM ULTIMA BIL SZ4 45MM HIP STEM ULTIMA BIL SZ4 55MM HIP HD SROM MTL 11/13 28MM +9 HIP HD SROM MTL 11/13 32MM +3 KNEE TIB PLAT ASSY XS 21MM KNEE TIB BASE CMNT REV DEPU1.5 KNEE FEM SLV UNIV DISTPOR 31MM KNEE STEP WEDGE SZ1 10MM KNEE TIB INSRT XLK CURV 2 20MM KNEE TIBINSRT XLK CURV2.5 20MM KNEE TIB INSRT XLK CURV 3 20MM KNEE TIB INSRT XLK CURV 4 20MM KNEE TIB INSRT XLK CURV 6 8MM KNEE TIB INSRT XLK CURV 6 10MM KNEE TIBINSRT XLK CURV6 12.5MM KNEE TIB INSRT XLK CURV 6 15MM KNEE TIBINSRT XLK CURV6 17.5MM KNEE TIB INSRT XLK CURV 6 20MM KNEE TIBINSRT XLK STBL2 22.5MM KNEE TIB INSRT XLK STBL 2 25MM KNEE TIBINSRT XLK STBL2.5 22.5 KNEE TIBINSRT XLK STBL2.5 25MM KNEE TIB INSRT XLK STBL 3 25MM KNEE TIBINSRT XLK STBL5 22.5MM KNEE TIB INSRT XLK STBL 5 25MM KNEE TIB INSRT XLK STBL 6 20MM KNEE TIBINSRT XLK STBL6 22.5MM KNEE TIB INSRT XLK STBL 6 25MM KNEE FEM PFC CMNT RT SZ4N KNEE FEM CMNT CR150 LFT SZ1.5 KNEE FEM CMNT CR150 LFT SZ2 KNEE FEM CMNT CR150 LFT SZ2.5 KNEE FEM CMNT CR150 LFT SZ4N KNEE FEM CMNT CR150 LFT SZ5 KNEE FEM CMNT CR150 LFT SZ6 KNEE FEM CMNT CR150 RT SZ1.5 KNEE FEM CMNT CR150 RT SZ2 Page 367 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,947.00 $2,947.00 $5,159.00 $5,159.00 $5,159.00 $6,981.00 $6,981.00 $6,981.00 $6,981.00 $6,981.00 $6,981.00 $1,419.00 $1,419.00 $7,689.00 $10,324.00 $5,523.00 $4,312.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $4,111.00 $4,111.00 $4,111.00 $4,111.00 $4,111.00 $4,111.00 $4,111.00 $4,111.00 $4,111.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE FEM CMNT CR150 RT SZ2.5 KNEE FEM CMNT CR150 RT SZ3 KNEE FEM CMNT CR150 RT SZ4 KNEE FEM CMNT CR150 RT SZ4N KNEE FEM CMNT CR150 RT SZ6 KNEE TIB INSRT HNG XXSM 18MM KNEE TIB PLAT ASSY XSM 12MM KNEE HNG BUMPER MOD MD KNEE FEM AUG SROM DEPU 10MM KNEE TIB TRAY PFC MOD PLUS 1.5 KNEE TIB WEDGE HEMI PFC 4 10D KNEE TIB WEDGE HEMI PFC 5 10D KNEE TIB WEDGE HEMI PFC2.5 10D KNEE TIB TRAY PFC KEEL CMNT2.5 KNEE TIB TRAY PFC KEEL CMNT 2 KNEE TIB TRAY PFC KEEL CMNT 3 KNEE TIB TRAY PFC KEEL CMNT 4 KNEE TIB TRAY PFC KEEL CMNT 5 KNEE TIB TRAY PFC KEEL CMNT 6 PIN/DRILL STEINMAN .25X3 KNEE STEM FLUTED DEPU 115X10MM KNEE STEM FLUTED DEPU 115X12MM KNEE STEM FLUTED DEPU 115X14MM KNEE STEM FLUTED DEPU 115X20MM KNEE STEM FLUTED DEPU 115X22MM KNEE STEM FLUTED DEPU 115X24MM KNEE FEM TC3 DEPU RT SZ1.5 KNEE TIB INSRT TC3 2 15MM KNEE TIB INSRT TC3 2 17.5MM KNEE TIB INSRT TC3 2 22.5MM KNEE TIB INSRT TC3 2 25MM KNEE TIB INSRT TC3 2.5 10MM KNEE TIB INSRT TC3 2.5 15MM KNEE TIB INSRT TC3 2.5 22.5MM KNEE TIB INSRT TC3 2.5 25MM KNEE TIB INSRT TC3 3 15MM KNEE TIB INSRT TC3 3 22.5MM KNEE TIB INSRT TC3 3 25MM KNEE TIB INSRT TC3 4 15MM KNEE TIB INSRT TC3 4 20MM KNEE TIB INSRT TC3 4 22.5MM KNEE TIB INSRT TC3 5 12.5MM KNEE TIB INSRT TC3 5 15MM KNEE TIB INSRT TC3 5 17.5MM KNEE TIB INSRT TC3 5 20MM KNEE TIB INSRT TC3 5 22.5MM Page 368 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,111.00 $4,111.00 $4,111.00 $4,111.00 $4,111.00 $5,819.00 $7,689.00 $780.00 $2,290.00 $6,820.00 $3,604.00 $3,604.00 $3,604.00 $2,570.00 $2,570.00 $2,570.00 $2,570.00 $2,570.00 $2,570.00 $1,428.00 $3,561.00 $3,561.00 $3,561.00 $3,561.00 $3,561.00 $3,561.00 $12,347.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 $4,319.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT TC3 5 25MM KNEE FEM DIST AUG RT SZ1.5 8MM KNEE TIB INSRT CURV SZ6 10.0MM KNEE TIB INSRT CURV SZ6 17.5MM KNEE TIB INSRT STBL SZ2.5 20MM KNEE TIB INSRT STBL SZ3 20MM KNEE TIB INSRT STBL SZ5 22.5MM KNEE TIB INSRT TC3 1.5 17.5MM KNEE TIB INSRT TC3 SZ2 12.5MM KNEE TIB INSRT TC3 SZ2 17.5MM KNEE TIB INSRT TC3 SZ2 22.5MM KNEE TIB INSRT TC3 SZ2 25.0MM KNEE TIB INSRT TC3 SZ2 30.0MM KNEE TIB INSRT TC3 SZ2.5 10MM KNEE TIB INSRT TC3 2.5 12.5MM KNEE TIB INSRT TC3 2.5 17.5MM KNEE TIB INSRT TC3 SZ2.5 20MM KNEE TIB INSRT TC3 2.5 22.5MM KNEE TIB INSRT TC3 SZ2.5 25MM KNEE TIB INSRT TC3 SZ2.5 30MM KNEE TIB INSRT TC3 SZ3 25.0MM KNEE TIB INSRT TC3 SZ3 30.0MM KNEE TIB INSRT TC3 SZ4 30.0MM KNEE TIB INSRT STBL SZ1.5 15MM KNEE TIB INSRTCURV SZ2 2 20MM KNEE TIB INSRT CURV SZ2.5 20MM KNEE TIB INSRT CURV SZ5 20MM KNEE TIB INSRT CURV SZ6 20MM KNEE TIB BASEOFFSETLM/RL SZ2.5 SHLDR HUMR STEM 12MM FINGER IMPLT NEUFLEX PIP SZ3 FINGER IMPLT NEUFLEX MCP SZ0 FINGER IMPLT NEUFLEX MCP SZ2 CMNT BONE SMARTSET GHV 40GM SUT CLEVERHOOK RT SUT CLEVERHOOK LFT SUT SIXTER RT SUT SIXTER LFT BIT DRILL TROC 3.8MM SCREW CANN LAG 10.5X100MM SCREW CANN LAG 10.5X105MM SCREW CANN LAG 10.5X110MM SCREW CANN LAG 10.5X115MM SCREW CANN LAG 10.5X120MM SCREW CANN LAG 10.5X125MM SCREW CANN LAG 10.5X130MM Page 369 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,319.00 $2,660.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $2,700.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $5,543.00 $4,264.00 $2,344.00 $2,344.00 $2,344.00 $2,344.00 $6,695.00 $5,118.00 $2,475.00 $2,475.00 $2,475.00 $991.00 $5,212.00 $5,212.00 $5,212.00 $5,212.00 $1,301.00 $1,849.00 $1,849.00 $1,849.00 $1,849.00 $1,849.00 $1,849.00 $1,849.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CANN LAG 10.5X80MM SCREW CANN LAG 10.5X85MM SCREW CANN LAG 10.5X90MM SCREW CANN LAG 10.5X95MM TAP CNCLS CANN 4.0X70MM TAP CNCLS ZIMM 4.5X70MM SCREW CNCLS LK SM 4.0X50MM SCREWDRIVER CRUC ASSY BIT DRILL 3.2MM BIT DRILL FAST LNG 4.0MM BIT DRILL FAST STEP 4.0MM BIT DRILL SNP 4.0MM GD PIN 2.5MM KWIRE SS DVR ZIMM 2.0X152MM PEG STD 4.0X25.0MM PEG STD 4.0X30.0MM PEG STD 4.0X32.5MM PEG STD 4.0X35.0MM PEG STD 4.0X37.5MM PEG STD 4.0X40.0MM SCREW SHLDR ROCKWOOD LK *DISC* PLATE SHLDR 3HL RT PLATE SHLDR 4HL LFT SCREW LK 90D 3.8X26MM SCREW LK 90D 3.8X28MM SCREW LK 90D 3.8X30MM SCREW DEPTH G LG *DISC* SCREW MULTDIRECTIONAL 3.8X26MM SCREW MULTDIRECTIONAL 3.8X30MM SHLDR GD PIN 2.0MM CAP END TROC 0MM TAP CORT S-CP 3.5X70MM GD PIN THRD 3.2MM MASK REGISTRATION INTELLECT SHLDR STEM FRAC 9X130MM 13 SHLDR STEM FRAC12X130MM 13 SHLDR HUMR REV FX 13X130MM SHLDR REV INSRT 36MM +6 B SHLDR REV INSRT 36MM +9 B SHLDR STEM FRAC 6.5X130MM1 SHLDR REV TRAY +0 0MM SHLDR REV TRAY +0 3.5MM SHLDR REV INSRT 36X12MM SHLDR REV TRAY +0 1.5MM SHLDR CANN REAMER PILOT SHLDR HD RESURF PIN 3X170MM Page 370 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,849.00 $1,849.00 $1,849.00 $1,849.00 $1,377.00 $1,201.00 $889.00 $1,441.00 $465.00 $651.00 $651.00 $597.00 $891.00 $214.00 $597.00 $597.00 $597.00 $597.00 $597.00 $597.00 $4,160.00 $3,540.00 $3,540.00 $711.00 $711.00 $711.00 $1,989.00 $711.00 $711.00 $217.00 $1,047.00 $1,201.00 $927.00 $1,065.00 $9,232.70 $12,651.00 $16,346.00 $3,367.00 $3,367.00 $12,651.00 $3,367.00 $3,367.00 $3,161.00 $3,367.00 $540.00 $550.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHLDR GLENOID PIN KT 200MM BIT DRILL 6MM SHLDR COMP SCREW 23MM SHLDR COMP SCREW 47MM SHLDR REV SPACER 36MM +9MM SHLDR REV SPACER 42MM +9MM SHLDR HUMR INSRT CNSTND36X12MM SHLDR HUMR INSRT CNSTND36X15MM SHLDR HUMR INSRT REV STD36X6MM SHLDR HUMR HD 37X13.5MM SHLDR HUMR HD 39X14MM SHLDR HUMR HD 41X15MM SHLDR HUMR HD 43X16MM SHLDR HUMR HD 46X17MM SHLDR HUMR HD 48X18MM SHLDR HUMR HD 50X16MM SHLDR HUMR HD 50X19MM SHLDR HUMR HD 52X19MM SHLDR HUMR HD 52X23MM SHLDR HUMR HD 54X23MM SHLDR HUMR HD 54X27MM SHLDR GLENOID KEELED LG SHLDR GLENOID PEG LG SHLDR GLENOID KEELED MD SHLDR GLENOID PEG MD SHLDR GLENOID KEELED SM SHLDR GLENOID PEG SM SHLDR GLENOID KEELED XLG SHLDR GLENOID PEG XLG SHLDR GLENOIDSPHERE 2MM25X36MM SHLDR GLENOID BASE PLATE 25MMT SHLDR GLENOIDSPHERE CTR25X36MM SHLDR GLENOIDSPHERE CTR25X42MM SHLDR CMNT HUMR STEM 9X180MM SHLDR CMNT HUMR STEM 9X210MM SHLDR CMNT HUMR STEM 6.5X100MM SHLDR STEM HUMR 7X115MM 125D SHLDR STEM HUMR 7X115MM 130D SHLDR STEM HUMR 7X115MM 135D SHLDR STEM HUMR 7X115MM 140D SHLDR STEM HUMR 9X115MM 125D SHLDR STEM HUMR 9X115MM 130D SHLDR STEM HUMR 9X115MM 135D SHLDR STEM HUMR 9X115MM 140D SHLDR CMNT HUMR 9X115MM 125D SHLDR CMNT HUMR 9X115MM 130D Page 371 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $576.00 $576.00 $781.00 $1,148.00 $2,205.00 $2,205.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $4,053.00 $2,932.00 $3,952.03 $2,932.00 $4,053.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $2,932.00 $3,462.00 $3,462.00 $6,628.00 $3,462.00 $4,211.00 $4,211.00 $4,211.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHLDR CMNT HUMR 9X115MM 135D SHLDR CMNT HUMR 9X115MM 140D SHLDR STEM HUMR 11X115MM 125D SHLDR STEM HUMR 11X115MM 130D SHLDR STEM HUMR 11X115MM 135D SHLDR STEM HUMR 11X115MM 140D SHLDR CMNT HUMR 12X115MM 125D SHLDR CMNT HUMR 12X115MM 130D SHLDR CMNT HUMR 12X115MM 135D SHLDR CMNT HUMR 12X115MM 140D SHLDR CMNT HUMR 12X157MM 130D SHLDR STEM HUMR 13X125MM 125D SHLDR STEM HUMR 13X125MM 130D SHLDR STEM HUMR 13X125MM 135D SHLDR STEM HUMR 13X125MM 140D SHLDR STEM HUMR 15X125MM 125D SHLDR STEM HUMR 15X125MM 130D SHLDR STEM HUMR 15X125MM 135D SHLDR STEM HUMR 15X125MM 140D SHLDR STEM HUMR 15X125MM 125D SHLDR CMNT HUMR 15X125MM 130D SHLDR CMNT HUMR 15X125MM 135D SHLDR CMNT HUMR 15X125MM 140D SHLDR CMNT HUMR 15X167MM 130D SHLDR STEM HUMR 17X125MM 125D SHLDR STEM HUMR 6.5X115MM 125D SHLDR STEM HUMR 6.5X115MM 130D SHLDR CMNT HUMR 6.5X115MM 135D SHLDR CMNT HUMR 6.5X115MM 140D SHLDR CMNT HUMR 6.5X147MM 130D SHLDR CMNT HUMR 9X157MM 130D SHLDR ADPTR 36MM SHLDR HD RESURF 41X15MM SHLDR HD RESURF 46X17MM SHLDR HD RESURF 48X18MM SHLDR HD RESURF 50X16MM SHLDR HD RESURF 52X19MM SHLDR HD RESURF 54X23MM ADPTR CHECKFLO SIDEARM 9FR SHEATH FLEXOR 12FR 55CM PUNCH FOLEY CATH TIP GDWIRE HIWIRE NIT STIFFANG.035 GDWIRE HIWIRE NIT STIFF ST.035 SET BLN KAYE TAMPONADE 17FR 25 EXTR STONE NCIRCLE NIT 10FR SET CATH MALECOT PERC PU 8.3FR Page 372 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $8,509.00 $8,509.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,118.00 $5,236.00 $9,826.00 $9,826.00 $9,826.00 $9,826.00 $9,826.00 $9,826.00 $70.00 $657.00 $355.00 $274.00 $274.00 $962.00 $617.00 $933.00 2020 pricing Drugs&Supplies PROCEDURE NAME CATH PERC NPHRSTMY 10FR SET CATH MALECOT PERC PU 12FR CATH PERC NPHRSTMY 14FR NDLE SKINNY CHIBA 22G 20CM NDLE NPHRSTMY CHIBA 22GX11CM CATH SUPRAPUBIC PERC 12FR SUCT CTRL LITHASSIST 38CM BLN CATH URETRL DILFILIFORM9FR DEV TISS REMOV MYOSURE XL SCREW CENTERPIECE FA 3.0X5MM SCREW CENTERPIECE FA 3.0X11MM CAGE CLYDESDALE 0D 10X55MM CAGE CENTERPIECE 16X17MM CAGE CENTERPIECE 19X23MM CAGE CENTERPIECE 22X25MM CAGE CENTERPIECE 25X25MM CAGE CENTERPIECE 25X31MM CAGE CENTERPIECE 25X37MM PLATE X10 MULT SS6.35MM39-45MM PLATE X10 MULT SS6.35MM45-57MM PLATE LEGACY MULT TI 28-30MM PLATE LEGACY MULT TI 58-81MM PLATE LEGACY FIX TI 6.35X16MM PLATE LEGACY FIX TI 6.35X19MM PLATE LEGACY FIX TI 6.35X22MM PLATE LEGACY FIX TI 6.35X25MM PLATE LEGACY MULT TI 34-36MM PLATE LEGACY MULT TI 36-39MM PLATE LEGACY MULT TI 39-45MM PLATE LEGACY MULT TI 45-57MM CAP END ALTITUDE 25MM 4D CAGE VERTE-STACK 16X14X10MM CAGE VERTE-STACK 16X14X11MM CAGE VERTE-STACK 16X14X12MM CAGE VERTE-STACK 16X14X13MM CAGE VERTE-STACK 16X14X8MM CAGE VERTE-STACK 16X14X9MM CAGE VERTE-STACK 18X16X9MM PLATE OD LAT 8MM PLATE ATLANTIS VISION 30MM PLATE ATLANTIS VISION 32.5MM PLATE ATLANTIS VISION 47.5MM PLATE ATLANTIS VISION 50MM PLATE ATLANTIS VISION 62.5MM PLATE ATLANTIS VISION 65MM PLATE ATLANTIS VISION 67.5MM Page 373 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $933.00 $821.00 $821.00 $79.00 $90.00 $275.00 $1,156.00 $564.00 $2,827.00 $364.00 $364.00 $8,033.00 $14,023.00 $14,023.00 $14,023.00 $14,023.00 $14,023.00 $14,023.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $2,022.00 $1,419.00 $2,591.00 $2,591.00 $2,591.00 $2,591.00 $2,591.00 $2,591.00 $2,591.00 $1,822.00 $2,315.00 $2,368.00 $2,368.00 $2,368.00 $2,376.00 $2,376.00 $2,376.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE ATLANTIS VISION 70MM PLATE ATLANTIS VISION 1 27.5MM PLATE ATLANTIS VISION 30MM PLATE ATLANTIS VISION 32MM PLATE ATLANTIS VISION 45MM PLATE ATLANTIS VISION 47.5MM PLATE ATLANTIS VISION 50MM PLATE ATLANTIS VISION 52.5MM PLATE ATLANTIS VISION 55MM PLATE CENTERPIECE LAT WIDE10MM PLATE CENTERPIECE LAT HL 12MM PLATE CENTERPIECE GRAFT 10MM PLATE CENTERPIECE GRAFTLAT10MM PLATE CENTERPIECE GRAFT 12MM PLATE CENTERPIECE GRAFTLAT12MM PLATE CENTERPIECE GRAFT 14MM PLATE ATLANTIS STD 1LVL 19MM PLATE ATLANTIS STD 1LVL 21MM PLATE VENTURE 19MM PLATE VENTURE 45MM PLATE VENTURE 47.5MM PLATE VENTURE 50MM PLATE VENTURE 52 5MM PLATE VENTURE 55MM PLATE VENTURE 62 5MM PLATE VENTURE 67 5MM PLATE VENTURE 70MM PLATE VENTURE 72 5MM PLATE VENTURE 75MM PLATE VENTURE 77 5MM ROD HEX END SS 5.5MM ROD TI ROD 5.5MM ROD HEX END TI 5.5MM ROD LEGACY HEX END TI 5.5MM SCREW VENTURE MDTR 4.0X13MM SCREW VENTURE MDTR 4.0X15MM SCREW VENTURE MDTR 4.0X17MM SCREW VENTURE MDTR 4.0X13MM SCREW VENTURE MDTR 4.0X17MM SCREW VENTURE MDTR 4.0X15MM SCREW VENTURE MDTR 4.5X13MM SCREW VENTURE MDTR 4.5X15MM SCREW VENTURE MDTR 4.5X17MM SCREW VENTURE MDTR 4.5X15MM SCREW VENTURE MDTR 4.5X13MM SCREW VENTURE MDTR 4.5X15MM Page 374 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,376.00 $2,368.00 $2,368.00 $2,315.00 $2,376.00 $2,376.00 $2,376.00 $2,368.00 $2,368.00 $1,822.00 $1,822.00 $1,822.00 $1,822.00 $1,822.00 $1,822.00 $1,822.00 $2,315.00 $2,315.00 $2,315.00 $2,368.00 $2,368.00 $2,368.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,487.00 $2,487.00 $1,220.00 $1,220.00 $1,240.00 $1,240.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 $855.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW VENTURE MDTR 4.5X17MM SPACER TELAMON 3.22X8MM SPACER TELAMON 3.22X12MM SPACER TELAMON 3.26X8MM SPACER TELAMON 3.26X10MM SPACER TELAMON 3.26X12MM PLATE OD 14MM SCREW VERTEX CORT 4.0X6MM SCREW VERTEX CORT 4.0X8MM SCREW VERTEX CORT 4.0X10MM SCREW VERTTEX CORT 4.5X6MM SCREW VERTEX CORT 4.5X8MM SCREW VERTEX CORT 4.5X10MM SCREW LEGACY MA TI 6.35X5.0X35 SCREW LEGACY MA TI 6.35X5.0X40 SCREW LEGACY MA TI 6.35X5.0X45 SCREW LEGACY MA TI 6.35X5.0X50 SCREW LEGACY MA TI 6.35X5.5X35 SCREW LEGACY MA TI 6.35X5.5X45 SCREW LEGACY MA TI 6.35X6.5X40 SCREW LEGACY MA TI 6.35X6.5X45 SCREW LEGACY MA TI 6.35X6.5X50 CONN PLATE VERTEX SM CONN PLATE VERTEX MD CONN PLATE VERTEX LG HOOK LEGACY RAMP NARW TI MD HOOK LEGACY OFFSET TI RT6.35MM HOOK LEGACY OFFSETTI LFT6.35MM HOOK LEGACY LIP PEDICLE TI SM HOOK LEGACY LIP PEDICLE TI MD HOOK LEGACY LIP PEDICLE TI LG HOOK LEGACY LIP WIDE TI LG HOOK LEGACY LIP NARW TI MD HOOK CD HORIZ SV WIDE GROVE SM HOOK CD HORIZ PEDICLE TI HOOK CD HORIZ WIDE TI HOOK CD HORIZ NARW TI HOOK CD HORIZ NARW GROOVE SM ROD VERTEX 3.2X240MM PLATE OCCIPITAL KEEL SM PLATE OCCIPITAL KEEL MD PLATE OCCIPITAL KEEL LG PLATE ATLANTIS VISION 75MM PLATE ATLANTIS VISION 77.5MM PLATE ATLANTIS VISION 80MM PLATE ATLANTIS VISION 67.5MM Page 375 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $855.00 $4,853.00 $4,853.00 $4,853.00 $4,853.00 $4,853.00 $1,822.00 $1,171.00 $1,171.00 $1,171.00 $1,171.00 $1,171.00 $1,171.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,283.00 $2,283.00 $2,283.00 $2,745.00 $3,114.00 $3,114.00 $3,114.00 $3,114.00 $3,114.00 $3,114.00 $3,114.00 $2,034.00 $2,034.00 $2,034.00 $2,034.00 $2,034.00 $377.00 $5,850.00 $5,850.00 $5,850.00 $2,514.00 $2,514.00 $2,514.00 $2,514.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE ATLANTIS VISION 70MM PLATE ATLANTIS VISION 72.5MM ROD VERTEX TI 3.2X120MM ROD VERTEX THRD 5.5X360MM ROD VERTEX TAPER 3.5MM/5.5MM ROD PRECURV VERTEX 3.5X200MM SCREW VERTEX CNCLS VA 3.5X12MM SCREW VERTEX CNCLS VA 3.5X14MM SCREW VERTEX CNCLS VA 4.0X6MM SCREW VERTEX CNCLS VA 4.0X8MM SCREW VERTEX CNCLS VA 4.0X12MM SCREW VERTEX CNCLS VA 4.0X14MM SCREW MULT 4.0X32MM SCREW LEGACY MA SS 6.35X5.5X45 SCREW LEGACY MA SS 6.35X6.5X45 SCREW LEGACY MA SS 6.35X6.5X50 SCREW LEGACY MA SS 6.35X6.5X55 SCREW LEGACY MA SS 6.35X7.5X45 SCREW LEGACY MA SS 6.35X7.5X50 SCREW LEGACY MA SS 6.35X7.5X55 SCREW M8 BREAKOFF SCREW FIXED ANG 6.5X40MM SCREW LEGACY BREAKOFF SCREW LEGACY RDCTN PLUG SPACER CORNERSTONE 8X14X11MM STRUT ANATOM PEEK 16X14X5MM STRUT ANATOM PEEK 16X14X24MM CONN TSRH LG 6.35MM SCREW LEGACY ILIAC 10D7.5X60MM SCREW LEGACY ILIAC 10D7.5X80MM SCREW LEGACY ILIAC 10D8.5X70MM SCREW LEGACY ILIAC 10D8.5X80MM SCREW MPA LNG 5.5X40MM SCREW MPA LNG 5.5X45MM SCREW MPA LNG 5.5X50MMI CONN LEGACY ILIAC 60MM CONN LEGACY ILIAC 10MM CONN LEGACY ILIAC 20MM CONN LEGACY ILIAC 30MM CONN AXIAL .25X5.5MM CONN AXIAL .25X.25MM CONN SIDE LOAD CLSD CONN CLSD 6.35X6.35MM CONN CLSD 5.5X6.35MM CONN TSRH HOOK TBOLT CONN TSRH 3DX SM 5.5MM Page 376 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,514.00 $2,514.00 $1,016.00 $1,657.00 $1,016.00 $1,199.00 $1,263.00 $1,263.00 $1,263.00 $1,263.00 $1,263.00 $1,263.00 $2,077.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $2,423.00 $488.00 $2,213.00 $587.00 $587.00 $2,620.00 $4,864.00 $4,864.00 $3,129.00 $3,285.00 $3,285.00 $3,285.00 $3,285.00 $2,479.00 $2,479.00 $2,479.00 $2,808.00 $2,808.00 $2,808.00 $2,808.00 $2,028.00 $2,028.00 $2,028.00 $2,028.00 $2,028.00 $2,306.00 $3,007.00 2020 pricing Drugs&Supplies PROCEDURE NAME CONN TSRH SM 6.5X3MM CONN TSRH MD 6.35MM CONN DOMINO 5.5X6.35MM CONN AXIAL 5.5X6.35MM CONN DOMINO 6.35X6.35MM CONN AXIAL 6.35X6.35MM PLATE HORIZ LOPRO SS5.5MM1.375 PLATE HORIZ LOPRO TI6.35MM.375 PLATE HORIZ LOPRO TI6.35MM.625 PLATE HORIZ LOPRO TI6.35MM.750 PLATE HORIZ LOPRO TI6.35MM.875 PLATE HORIZ LOPRO TI6.35MM1.00 PLATE HORIZ LOPROTI6.35MM1.125 PLATE HORIZ LOPROTI6.35MM1.250 PLATE HORIZ LOPROTI6.35MM1.375 PLATE HORIZ LOPROTI6.35MM1.500 PLATE HORIZ LOPRO MULT TI 1.55 PLATE HORIZ LOPRO MULT TI 1.75 PLATE HORIZ LOPRO MULT TI 2.15 HOOK VERTEX LAMINAR PUR 4.5MM HOOK VERTEX LAMINAR GRN 6.0MM HOOK VERTEX LAMINAR 4.5MM HOOK VERTEX LAMINAR 6.0MM HOOK TSRH LAMINAR LG ROD TSRH TEMPLATE 8.0MM LOOP CAGE T-LIF 7X32 5MM LOOP CAGE T-LIF 8X32 5MM PLATE VANTAGE ATL 4CM PLATE VANTAGE ATL 4.5CM PLATE VANTAGE ATL 5CM PLATE VANTAGE ATL 5.5CM PLATE VANTAGE ATL 7CM PLATE VANTAGE ATL 7.5CM PLATE VANTAGE ATL 8CM PLATE VANTAGE ATL 8.5CM PLATE VANTAGE ATL 9CM PLATE VANTAGE ATL 9.5CM PLATE VANTAGE ATL 10CM PLATE VANTAGE THORACIC 3.5CM PLATE VANTAGE THORACIC 4CM PLATE VANTAGE THORACIC 4.5CM PLATE VANTAGE THORACIC 5CM PLATE VANTAGE THORACIC 6.5CM PLATE VANTAGE THORACIC 7CM PLATE VANTAGE THORACIC 7CM PLATE VANTAGE THORACIC 8CM Page 377 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,129.00 $3,129.00 $2,028.00 $2,028.00 $2,028.00 $2,028.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,376.00 $2,727.00 $2,727.00 $2,727.00 $2,727.00 $2,764.00 $765.00 $9,212.00 $9,212.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 $5,886.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE PYRAMID 4HL 35MM ROD SAG TI 5.5X70MM ROD TSRH ALLOY 6.35X51MM ROD TRSH 6.35MM ROD TSRH 2D PREBENT 3.0CM ROD TSRH 2D PREBENT 6.0CM ROD TSRH 2D PREBENT 7.0CM ROD TSRH 2D PREBENT 8.0CM ROD TSRH 2D PREBENT 9.0CM ROD TSRH 2D PREBENT 10.0CM ROD TSRH 3D 25CM 6.35MM ROD COBALT 5.5X500MM SCREW LEGACY ILIAC VA 7.5X60MM SCREW LEGACY ILIAC 7.5X70MM SCREW LEGACY ILIAC 7.5X80MM SCREW LEGACY ILIAC 8.5X70MM SCREW LEGACY ILIAC 8.5X80MM SCREW LEGACY ILIAC VA 8.5X90MM SCREW HEX BREAK .25X32MM SET HORIZ SCREW LOPRO PLATE SCREW HORIZ LOPRO OFFSET PLATE SCREW DBL HEX LK BREAKOFF SCREW TSRH TOP TIGHT LK SCREW TSRH VA 7.5MM SCREW TSRH OSTEOGRIP 4.5X45MM SCREW TSRH OSTEOGRIP 5.5X35MM SCREW TSRH MPA SHRT 5.5X40MM SCREW TSRH MPA LNG 5.5X45MM SCREW TSRH OSTEOGRIP 5.5X45MM SCREW TSRH OSTEOGRIP 5.5X50MM SCREW TSRH OSTEOGRIP 6.5X30MM SCREW TSRH MPA SHRT 6.5X35MM SCREW TSRH OSTEOGRIP 6.5X35MM SCREW TSRH MPA SHRT 6.5X40MM SCREW TSRH OSTEOGRIP 6.5X40MM SCREW TSRH MPA SHRT 6.5X45MM SCREW TSRH OSTEOGRIP 6.5X45MM SCREW TSRH MPA SHRT 6.5X50MM SCREW TSRH OSTEOGRIP 6.5X50MM SCREW TSRH OSTEOGRIP 6.5X55MM SCREW TSRH OSTEOGRIP 7.5X30MM SCREW TSRH OSTEOGRIP 7.5X35MM SCREW TSRH MPA 7.5X40MM SCREW TSRH MPA SHRT 7.5X40MM SCREW TSRH OSTEOGRIP 7.5X40MM SCREW TSRH MPA SHRT 7.5X45MM Page 378 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $7,984.00 $2,550.00 $1,968.00 $1,968.00 $1,568.00 $1,568.00 $1,568.00 $1,568.00 $1,568.00 $1,568.00 $1,568.00 $1,740.00 $4,054.00 $4,054.00 $4,054.00 $4,054.00 $4,054.00 $4,054.00 $907.00 $671.00 $671.00 $891.00 $876.00 $3,171.00 $1,973.00 $1,973.00 $2,434.00 $2,804.00 $1,973.00 $1,973.00 $1,973.00 $2,434.00 $1,973.00 $2,434.00 $1,973.00 $2,434.00 $1,973.00 $2,434.00 $1,973.00 $1,973.00 $1,973.00 $1,973.00 $2,804.00 $2,434.00 $1,973.00 $2,434.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW TSRH OSTEOGRIP 7.5X45MM SCREW TSRH OSTEOGRIP 7.5X50MM SCREW TSRH OSTEOGRIP 7.5X55MM SCREW TSRH OSTEOGRIP 8.5X35MM SCREW TSRH OSTEOGRIP 8.5X40MM SCREW TSRH SHRT POST 4.5X45MM SCREW TSRH SHRT POST 4.5X50MM SCREW TSRH3D SHRT POST5.5X35MM SCREW TSRH3D SHRT POST5.5X50MM SCREW TSRH3D SHRT POST6.5X35MM SCREW TSRH3D SHRT POST6.5X55MM SCREW TSRH3D SHRT POST7.5X30MM SCREW TSRH3D SHRT POST7.5X35MM SCREW TSRH3D SHRT POST7.5X40MM SCREW TSRH3D SHRT POST7.5X45MM SCREW TSRH3D SHRT POST7.5X50MM SCREW TSRH3D SHRT POST7.5X55MM SCREW TSRH3D SHRT POST8.5X35MM SCREW TSRH3D SHRT POST8.5X40MM SCREW TSRH3D SHRT POST8.5X45MM SCREW TSRH3D SHRT POST8.5X50MM SCREW TSRH3D EXP POST 6.5X40MM SCREW TSRH3D EXP POST 6.5X45MM SCREW TSRH MPA SHRT 6 5X40MM SCREW VANTAGE THORACIC5.5X20MM SCREW VANTAGE THORACIC5.5X25MM SCREW VANTAGE THORACIC5.5X30MM SCREW VANTAGE THORACIC5.5X35MM SCREW VANTAGE THORACIC5.5X50MM SCREW VANTAGE ATL 6.5X35MM SCREW VANTAGE ATL 6.5X50MM SCREW VANTAGE ATL 6.5X55MM SET SCREW STD 1/4-32 SPACER PERIMETER PEEK 8D 8MM SPACER PERIMETER PEEK 8D 10MM SPACER PERIMETER PEEK 8D 12MM SPACER PERIMETER PEEK 8D 14MM SPACER PERIMETER PEEK12D 12MM SPACER PERIMETER PEEK12D 16MM SPACER PERIMETER PEEK12D 12MM SPACER PERIMETER PEEK12D 18MM SPACER VERTESTACK SM 10MM SPACER VERTESTACK SM 12MM SPACER VERTESTACK SM 14MM SPACER VERTESTACK SM 16MM SPACER VERTESTACK SM 18MM Page 379 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,973.00 $1,973.00 $1,973.00 $1,973.00 $1,973.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $1,886.00 $2,245.00 $1,751.00 $1,751.00 $1,751.00 $1,751.00 $1,751.00 $1,751.00 $1,751.00 $1,751.00 $738.00 $6,141.00 $6,141.00 $6,141.00 $6,141.00 $6,141.00 $6,141.00 $6,141.00 $6,141.00 $10,641.00 $10,641.00 $10,641.00 $10,641.00 $10,641.00 2020 pricing Drugs&Supplies PROCEDURE NAME SPACER VERTESTACK LORD SM 10MM SPACER VERTESTACK LORD SM 14MM SPACER VERTESTACK LORD SM 16MM SPACER VERTESTACK CTR SM5MM SPACER VERTESTACK CTR SM 10MM SPACER VERTESTACK CTR SM 20MM SPACER VERTESTACK CTR SM 30MM SPACER VERTESTACK CTR SM40M SPACER VERTESTACK LORD LG 12MM SPACER CRST PEEK 7X25MM SPACER CRST PEEK 8X25MM SPACER CRST PEEK 9X25MM SPACER CRST PEEK 10X25MM SPACER CRST PEEK 11X25MM SPACER CRST PEEK 12X25MM SPACER CRST PEEK 13X25MM SPACER CRST PEEK 14X25MM SPACER CRST PEEK 15X25MM SPACER CRST PEEK 12X36MM SPACER CRST PEEK 7X30MM SPACER CRST PEEK 8X30MM SPACER CRST PEEK 9X30MM SPACER CRST PEEK 10X30MM SPACER CRST PEEK 11X30MM SPACER CRST PEEK 12X30MM SPACER CRST PEEK 13X30MM SPACER CRST PEEK 14X30MM SPACER CRST PEEK 15X30MM TAP OSTEOGRIP THIN 3.75MM TAP OSTEOGRIP THIN 4.0MM TAP OSTEOGRIP THIN 5.0MM ROD TEMPLATE BL CBL DBL LEADER CBL CRIMP INTEGRAL BAR PLATE ATLANTIS VISION 80MM DISTRAC TIP T-HNDL DISTRAC TIP 7MM DISTRAC TIP 8MM DISTRAC TIP 9MM DISTRAC TIP 10MM DISTRAC TIP 11MM DISTRAC TIP 12MM DISTRAC TIP 13MM DISTRAC TIP 14MM DISTRAC TIP 15MM KT EVOLUTION SPINAL REMOV Page 380 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $10,641.00 $10,641.00 $10,641.00 $5,782.00 $5,782.00 $5,782.00 $5,782.00 $5,782.00 $10,641.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $5,350.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $6,756.00 $1,654.00 $1,654.00 $1,654.00 $1,181.00 $1,512.00 $1,068.00 $2,932.00 $2,036.00 $1,126.00 $1,126.00 $1,126.00 $1,126.00 $1,126.00 $1,126.00 $1,126.00 $1,126.00 $1,126.00 $37,457.00 2020 pricing Drugs&Supplies PROCEDURE NAME DRIV HEX MALE 7/64IN 2.78MM ALLO TENDON GRACILIS 230MM ALLO MTX GRAFIX CORE5X5CM=25SQ HIP SHELL R3 3HL 50MM REAMER PHALANGEAL 20MM BIT DRILL STOP 12MM BIT DRILL STOP 14MM BIT DRILL STOP 6MM BIT DRILL STOP 8MM BIT DRILL STOP 10MM KWIRE SPADE 1.8X400MM KWIRE SPADE 1.8X350MM RING EXTL FIX HYBRID 1/4 165MM REAMER HD 10.0MM REAMER HD 10.5MM SLV SPIRAL LK 100D STER NAIL FEM DIST CANN TI 10X160MM NAIL FEM DIST CANN TI 10X200MM NAIL FEM DIST CANN TI 10X240MM NAIL FEM DIST CANN TI 10X280MM NAIL FEM DIST CANN TI 10X300MM NAIL FEM DIST CANN TI 10X320MM NAIL FEM DIST CANN TI 10X360MM NAIL FEM DIST CANN TI 10X380MM NAIL FEM DIST CANN TI 10X400MM NAIL FEM DIST CANN TI 10X420MM NAIL FEM DIST CANN TI 10X440MM NAIL FEM DIST CANN TI 10X460MM NAIL FEM RECON LAT TILFT10X440 NAIL FEM RECON LAT TI RT10X440 BIT DRILL CANN 11X190MM REAMER HD SYNT 11.0MM REAMER HD SYNT 11.5MM SLV SPIRAL LK 110D STER NAIL FEM DIST CANN TI 11X160MM NAIL FEM DIST CANN TI 11X200MM NAIL FEM DIST CANN TI 11X240MM NAIL FEM DIST CANN TI 11X280MM NAIL FEM DIST CANN TI 11X300MM NAIL FEM DIST CANN TI 11X320MM NAIL FEM DIST CANN TI 11X340MM NAIL FEM DIST CANN TI 11X360MM NAIL FEM DIST CANN TI 11X380MM NAIL FEM DIST CANN TI 11X400MM NAIL FEM DIST CANN TI 11X420MM NAIL FEM DIST CANN TI 11X440MM Page 381 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,666.00 $3,282.00 $252.00 $2,773.00 $1,512.00 $551.00 $551.00 $551.00 $551.00 $551.00 $838.00 $294.00 $1,047.00 $1,033.00 $1,033.00 $1,065.00 $2,773.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,773.00 $2,773.00 $2,762.00 $2,762.00 $1,532.00 $1,033.00 $1,033.00 $1,065.00 $2,773.00 $2,773.00 $2,773.00 $2,996.00 $2,773.00 $2,773.00 $2,773.00 $2,996.00 $2,996.00 $2,773.00 $2,773.00 $2,773.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL FEM DIST CANN TI 11X460MM REAMER HD SYNT 12.0MM REAMER HD SYNT 12.5MM SLV SPIRAL LK 120D STER NAIL FEM DIST CANN TI 12X160MM NAIL FEM DIST CANN TI 12X200MM NAIL FEM DIST CANN TI 12X280MM NAIL FEM DIST CANN TI 12X300MM NAIL FEM DIST CANN TI 12X320MM NAIL FEM DIST CANN TI 12X340MM NAIL FEM DIST CANN TI 12X360MM NAIL FEM DIST CANN TI 12X380MM NAIL FEM DIST CANN TI 12X400MM NAIL FEM DIST CANN TI 12X420MM NAIL FEM DIST CANN TI 12X440MM NAIL FEM DIST CANN TI 12X460MM NAIL TIB TI CANN 12X255MM NAIL TIB TI CANN 12X270MM NAIL TIB TI CANN 12X285MM NAIL TIB TI CANN 12X300MM NAIL TIB TI CANN 12X315MM NAIL TIB TI CANN 12X330MM NAIL TIB TI CANN 12X380MM NAIL TIB TI CANN 12X400MM NAIL TIB TI CANN 12X420MM REAMER HD SYNT 13.0MM REAMER HD SYNT 13.5MM SLV SPIRAL LK 130D STER NAIL FEM DIST CANN TI 13X160MM NAIL FEM DIST CANN TI 13X200MM NAIL FEM DIST CANN TI 13X240MM NAIL FEM DIST CANN TI 13X280MM NAIL FEM DIST CANN TI 13X300MM NAIL FEM DIST CANN TI 13X320MM NAIL FEM DIST CANN TI 13X340MM NAIL FEM DIST CANN TI 13X360MM NAIL FEM DIST CANN TI 13X380MM NAIL FEM DIST CANN TI 13X400MM NAIL FEM DIST CANN TI 13X420MM NAIL FEM DIST CANN TI 13X440MM NAIL FEM DIST CANN TI 13X460MM NAIL FEM CANN TI GRN 13X300MM NAIL FEM CANN TI GRN 13X320MM NAIL FEM CANN TI GRN 13X340MM NAIL FEM CANN TI GRN 13X360MM NAIL FEM CANN TI GRN 13X380MM Page 382 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,773.00 $1,033.00 $1,033.00 $1,065.00 $2,773.00 $2,773.00 $2,996.00 $2,773.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,996.00 $2,773.00 $2,773.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $1,033.00 $1,033.00 $1,065.00 $2,773.00 $2,773.00 $2,773.00 $2,996.00 $2,773.00 $2,996.00 $2,773.00 $2,996.00 $2,773.00 $2,773.00 $2,996.00 $2,773.00 $2,773.00 $2,415.00 $2,415.00 $2,570.00 $2,570.00 $2,570.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL FEM CANN TI GRN 13X400MM NAIL FEM CANN TI GRN 13X420MM NAIL FEM CANN TI GRN 13X440MM NAIL FEM CANN TI GRN 13X460MM NAIL FEM CANN TI GRN 13X480MM NAIL TIB TI CANN 13X255MM NAIL TIB TI CANN 13X270MM NAIL TIB TI CANN 13X285MM NAIL TIB TI CANN 13X300MM NAIL TIB TI CANN 13X315MM NAIL TIB TI CANN 13X330MM NAIL TIB TI CANN 13X345MM NAIL TIB TI CANN 13X360MM NAIL TIB TI CANN 13X380MM NAIL TIB TI CANN 13X400MM NAIL TIB TI CANN 13X420MM REAMER HD SYNT 14.0MM REAMER HD SYNT 14.5MM NAIL FEM CANN TI GRN 14X300MM NAIL FEM CANN TI GRN 14X320MM NAIL FEM CANN TI GRN 14X340MM NAIL FEM CANN TI GRN 14X360MM NAIL FEM CANN TI GRN 14X380MM NAIL FEM CANN TI GRN 14X400MM NAIL FEM CANN TI GRN 14X420MM NAIL FEM CANN TI GRN 14X440MM NAIL FEM CANN TI GRN 14X460MM NAIL FEM CANN TI GRN 14X480MM REAMER HD SYNT 15.0MM REAMER HD SYNT 15.5MM NAIL FEM CANN TI GRN 15X300MM NAIL FEM CANN TI GRN 15X320MM NAIL FEM CANN TI GRN 15X340MM NAIL FEM CANN TI GRN 15X360MM NAIL FEM CANN TI GRN 15X380MM NAIL FEM CANN TI GRN 15X400MM NAIL FEM CANN TI GRN 15X420MM NAIL FEM CANN TI GRN 15X440MM NAIL FEM CANN TI GRN 15X460MM NAIL FEM CANN TI GRN 15X480MM END CAP TI EXT 15X0MM END CAP TI EXT 15X10MM END CAP TI EXT 15X20MM NAIL FEM UNIV SLOT 15X340MM REAMER HD SYNT 16.0MM REAMER HD SYNT 16.5MM Page 383 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,570.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,337.00 $2,487.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,337.00 $2,487.00 $2,337.00 $2,337.00 $2,337.00 $1,033.00 $1,033.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $1,033.00 $1,033.00 $2,415.00 $2,570.00 $2,415.00 $2,570.00 $2,415.00 $2,570.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $817.00 $817.00 $817.00 $2,297.00 $1,033.00 $1,033.00 2020 pricing Drugs&Supplies PROCEDURE NAME REAMER HD SYNT 17.5MM NAIL FEM UNIV SLOT 17X340MM REAMER HD SYNT 18.0MM REAMER HD SYNT 18.5MM REAMER HD SYNT 19.0MM KWIRE SPADE 2.0X400MM GDWIRE THRD DBL SPADE 2X230MM BIT DRILL SYNT JC 2.7X110MM BIT DRILL CALIB SHRT 2.8MM GD ROD FLAT ENDS 3.0X950*OBS* BIT DRILL JC SYNT 3.2X180MM BIT DRILL QC SYNT 3.2X225MM BIT DRILL QC CALIB 3FLUTED 3.2 BIT DRILL QC RADL 3FLUTED 3.2M PLATE BLADE LC ANG 90D 5HL40MM SCREW CORT STD HEX 3.5X55MM SCREW CORT STD HEX 3.5X60MM SCREW CORT STD HEX 3.5X65MM SCREW CORT STD HEX 3.5X70MM SCREW CORT SLFTP 3.5X100MM SCREW CORT SLFTP 3.5X85MM SCREW CORT SLFTP 3.5X90MM SCREW CORT SLFTP 3.5X95MM PLATE T TIB DIST LCP 3HL 3.5MM PLATE PILON LCP 7HL 3.5MM PLATE HUMR PROXLCP 3.5 10HL232 PLATE HUMR PROXLCP 3.5 12HL268 PLATE HUMR PROX LCP 3.5 5HL142 PLATE TIB DIST W TAB RT10HL3.5 PLATE TIB DIST W TAB RT 4HL3.5 PLATE TIB MEDL DIST10HL LFT3.5 PLATE TIB MEDL DIST 10HL RT3.5 PLATE TIB MEDL DIST14HL LFT3.5 PLATE TIB MEDL DIST 14HL RT3.5 PLATE TIB MEDL DIST18HL LFT3.5 PLATE TIB MEDL DIST 18HL RT3.5 PLATE TIB MEDL DIST 6HL LFT3.5 PLATE TIB MEDL DIST 6HL RT 3.5 PLATE TIB MEDL DIST 8HL LFT3.5 PLATE TIB MEDL DIST 8HL RT 3.5 PLATE TIB PROX 10HL LFT 3.5MM PLATE TIB PROX 10HL RT 3.5MM PLATE TIB PROX 12HL LFT 3.5MM PLATE TIB PROX 12HL RT 3.5MM PLATE TIB PROX 14HL LFT 3.5MM PLATE TIB PROX 14HL RT 3.5MM Page 384 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,033.00 $2,297.00 $1,033.00 $1,033.00 $1,033.00 $838.00 $183.00 $310.00 $615.00 $541.00 $351.00 $571.00 $689.00 $849.00 $2,184.00 $84.00 $84.00 $130.00 $130.00 $116.00 $116.00 $116.00 $116.00 $1,889.00 $3,313.00 $3,565.00 $3,553.00 $3,291.00 $3,122.00 $3,101.00 $1,912.00 $1,912.00 $2,271.00 $2,271.00 $2,484.00 $2,484.00 $1,625.00 $1,625.00 $1,742.00 $1,742.00 $2,616.00 $2,616.00 $2,715.00 $2,715.00 $2,773.00 $2,773.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE TIB PROX 16HL LFT 3.5MM PLATE TIB PROX 16HL RT 3.5MM PLATE TIB PROX 4HL LFT 3.5MM PLATE TIB PROX 4HL RT 3.5MM PLATE TIB PROX 6HL LFT 3.5MM PLATE TIB PROX 6HL RT 3.5MM PLATE TIB PROX 8HL RT 3.5MM BIT DRILL 3FLUTE BRAD PT RADL PLATE TIB DIST 7HL LFT 3.5MM PLATE T RT ANG TI 4HL 3.5MM WASHER 3.5MM/4.5MM BOLT LK TI 3.9X26MM BOLT LK TI 3.9X28MM BOLT LK TI 3.9X34MM BOLT LK TI 3.9X36MM BOLT LK TI 3.9X38MM BOLT LK TI 3.9X40MM BOLT LK TI 3.9X42MM BOLT LK TI 3.9X46MM BOLT LK TI 3.9X48MM BOLT LK TI 3.9X52MM BOLT LK TI 3.9X54MM BOLT LK TI 3.9X56MM BOLT LK TI 3.9X58MM BOLT LK TI 3.9X60MM BOLT LK TI 3.9X62MM BOLT LK TI 3.9X64MM BOLT LK TI 3.9X66MM BOLT LK TI 3.9X68MM BOLT LK TI 3.9X70MM BOLT LK TI 3.9X72MM BOLT LK TI 3.9X74MM BOLT LK TI 3.9X76MM BOLT LK TI 3.9X78MM BOLT LK TI 3.9X80MM RING EXTL FIX HYBRID 3/4 115MM RING EXTL FIX HYBRID 3/4 165MM PIN CTR 4.0X400MM BAR EXTL FIX CONN SS SM4X100MM BAR EXTL FIX CONN SS SM4X140MM BAR EXTL FIX CONN SS SM 4X60MM BAR EXTL FIX CONN SS SM 4X80MM BIT DRILL QC SYNT 4.0MM/4.5MM BIT DRILL 3FLUTE CALIB 4MM/4 BIT DRILL 3FLUTE CALIB NDL POI BIT DRILL QC SYNT 4.3X280MM Page 385 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,767.00 $2,767.00 $2,578.00 $2,578.00 $2,589.00 $2,589.00 $2,603.00 $849.00 $3,174.00 $1,151.00 $253.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $625.00 $1,135.00 $1,257.00 $185.00 $120.00 $158.00 $120.00 $120.00 $668.00 $804.00 $783.00 $1,051.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT STD 4.5X100MM SCREW CORT STD 4.5X220MM SCREW CORT STD 4.5X120MM SCREW CORT STD 4.5X62MM SCREW CORT STD 4.5X80MM SCREW CORT STD 4.5X90MM BIT DRILL JC 4.5X130MM BIT DRILL JC 4.5X180MM PLATE TIBMEDLPROXLCPLFT10HL4.5 PLATE TIB MEDLPROXLCPLFT4HL4.5 PLATE TIB MEDLPROXLCP RT4HL4.5 PLATE TIB MEDLPROXLCPLFT6HL4.5 PLATE FEM PROX 4.5/5 LFT 10HL PLATE FEM PROX 4.5/5 RT 10HL PLATE FEM PROX 4.5/5 RT 12HL PLATE FEM PROX 4.5/5 LFT 14HL PLATE FEM PROX 4.5/5 RT 14HL PLATE FEM PROX 4.5/5 LFT 16HL PLATE FEM PROX 4.5/5 RT 16HL PLATE FEM PROX 4.5/5 LFT 2HL PLATE FEM PROX 4.5/5 RT 2HL PLATE FEM PROX 4.5/5 LFT 4HL PLATE FEM PROX 4.5/5 RT 4HL PLATE FEM PROX 4.5/5 LFT 6HL PLATE FEM PROX 4.5/5 RT 6HL PLATE FEM PROX 4.5/5 LFT 8HL PLATE FEM PROX 4.5/5 RT 8HL PLATE TIB PROX LFT 10HL 4.5MM PLATE TIB PROX RT 10HL 4.5MM PLATE TIB PROX LFT 12HL 4.5MM PLATE TIB PROX RT 12HL 4.5MM PLATE TIB PROX LFT 14HL 4.5MM PLATE TIB PROX RT 14HL 4.5MM PLATE TIB PROX LFT 2HL 4.5MM PLATE TIB PROX RT 2HL 4.5MM PLATE TIB PROX LFT 8HL .5MM PLATE TIB PROX RT 8HL 4.5MM PLATE RECON 12HL 4.5X189MM PIN STEINMAN 4.5X180MM PIN STEINMAN 4.5X200MM BIT DRILL 3FLUTE RADLBRAD4.5MM PIN STEINMAN 5X150MM PIN STEINMAN 5X180MM SCREW TI ANG STABLE LK 5X56MM SCREW LK TI SLFTP 5.0X90MM SCREW SCHANZ SLFDR 5.0X175MM Page 386 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $142.00 $142.00 $142.00 $87.00 $142.00 $142.00 $281.00 $351.00 $3,133.00 $3,027.00 $3,027.00 $3,065.00 $3,376.00 $3,376.00 $3,463.00 $3,598.00 $3,598.00 $3,704.00 $3,704.00 $3,062.00 $3,062.00 $3,121.00 $3,121.00 $3,102.00 $3,102.00 $3,253.00 $3,253.00 $2,597.00 $2,597.00 $2,702.00 $2,702.00 $2,759.00 $2,759.00 $2,558.00 $2,558.00 $2,589.00 $2,589.00 $1,667.00 $284.00 $284.00 $849.00 $284.00 $284.00 $747.00 $959.00 $658.00 2020 pricing Drugs&Supplies PROCEDURE NAME WASHER SPACER TI 5.0/2MM BIT DRILL CANN QC 6X190MM BIT DRILL QC 6X195MM SCREW CNCLS FULL THRD 6.5X100M SCREW CNCLS FULL THRD 6.5X105M SCREW CNCLS FULL THRD 6.5X110M SCREW CNCLS FULL THRD 6.5X80MM SCREW CNCLS FULL THRD 6.5X85MM SCREW CNCLS FULL THRD 6.5X90MM SCREW CNCLS FULL THRD 6.5X95MM SCREW RECON THRD TI 6.5X30X100 SCREW RECON THRD TI 6.5X30X75 BIT DRILL QC LG 7X190MM BIT DRILL CANN QC LG 8X190MM REAMER HD SYNT 8.5MM BIT DRILL LG CANN QC 9X190MM REAMER HD SYNT 9MM REAMER HD SYNT 9.5MM PLATE COND 14HL 50MM PLATE COND 14HL 60MM PLATE COND 14HL 70MM PLATE COND 14HL 80MM PLATE COND 18HL 60MM PLATE COND 18HL 70MM PLATE COND 18HL 80MM NAIL FEM RECON LAT TI LFT9X320 NAIL FEM RECON LAT TI RT 9X320 NAIL FEM RECON LAT TI LFT9X340 NAIL FEM RECON LAT TI LFT9X360 NAIL FEM RECON LAT TI RT 9X360 NAIL FEM RECON LAT TI LFT9X400 NAIL FEM RECON LAT TI LFT9X420 NAIL FEM RECON LAT TI LFT9X440 NAIL FEM RECON LAT TI RT 9X440 NAIL FEM DIST TI 9X160MM NAIL FEM DIST TI 9X200MM NAIL FEM DIST TI 9X240MM NAIL FEM DIST TI 9X280MM NAIL FEM DIST TI 9X300MM NAIL FEM DIST TI 9X320MM NAIL FEM DIST TI 9X340MM NAIL FEM DIST TI 9X360MM NAIL FEM DIST TI 9X380MM NAIL FEM DIST TI 9X400MM NAIL FEM DIST TI 9X420MM NAIL FEM DIST TI 9X440MM Page 387 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $462.00 $1,457.00 $623.00 $184.00 $184.00 $184.00 $172.00 $184.00 $184.00 $184.00 $646.00 $646.00 $1,457.00 $1,457.00 $1,033.00 $1,457.00 $1,033.00 $1,033.00 $2,306.00 $2,306.00 $2,306.00 $2,306.00 $2,462.00 $2,462.00 $2,462.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,762.00 $2,773.00 $2,773.00 $2,996.00 $2,773.00 $2,996.00 $2,773.00 $2,773.00 $2,773.00 $2,773.00 $2,773.00 $2,773.00 $2,996.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL FEM DIST TI 9X460MM ALLO WEDGE CHRONOS 7D 7X25X35 ALLO GRAN CHRONOS MD 10CC PLATE CLOVERLF THIN BLADE 5HL COUNTERSINK CORT SCREW 4.5MM REAMING HD DCS REAMING HD SHRT DHS SCREW LAG DHSDCS SYNT12.7X60MM CAP DRIVING TI FEM NAILS REAMERS FLEX IM NAIL RING EXTL FIX HYBRID FULL115MM RING EXTL FIX HYBRID FULL165MM RING EXTL FIX HYBRID FULL205MM REAMER HOLLOW COMPL3.5MM/4.0MM REAMER HOLLOW COMPL6.5MM/7.0MM REAMER HOLLOW COMPL1.5MM REAMER HOLLOW COMPL 2.0MM REAMER HOLLOW COMPL 2.7MM PLATE TIB BTRS RT 13HL 240MM PLATE TIB BTRS LFT 5HL 118MM PLATE TIB BTRS RT 5HL 118MM PLATE TIB BTRS LFT 9HL 181MM PLATE TIB BTRS RT 9HL 181MM NUT LK UNIV FEM 9-12MM SLV STD LK TI FEM NAIL F13-1 TAP CORT SCREW 4.5MM 180MM BOLT THRD CONIC UNIV TIB NAIL BOLT THRD CONIC UNIV FEM NAIL END CAP TIB TI T40 EXT 0MM PLATE T ILSC 4HL SCREW SURFIX ILSC 3.5X12MM PLATE COMP INTE 4HL 20MM ELBOW HUMR SPOOL LFT MD ELBOW HUMR STEM LFT MD ELBOW HUMR STEM LFT MD 150MM ELBOW ULNA STEM LFT MD STD ELBOW ULNAR CAPS MD CMNT RESTRICTOR 5-8MM SUT PASR TORN SCREW CORT LK SLFTP 3.5X18MM HIP STEM POLARSTEM135D STD SZ3 SCREW NL HEXALOBE 3X26MM TRAY CENTVEN SL PEDS 3FR 5CM ROD TI HARD 6.0X100MM BUR DIMND 2MM BUR DIMND 4MM Page 388 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,773.00 $2,149.00 $1,920.00 $1,314.00 $954.00 $1,871.00 $1,871.00 $1,114.00 $796.00 $2,400.00 $1,219.00 $1,340.00 $1,494.00 $1,378.00 $1,378.00 $1,096.00 $1,096.00 $1,096.00 $2,095.00 $1,802.00 $1,802.00 $1,985.00 $1,985.00 $445.00 $1,203.00 $663.00 $956.00 $956.00 $579.00 $4,602.00 $1,410.00 $4,602.00 $2,806.00 $6,950.00 $6,824.00 $6,197.00 $2,335.00 $785.00 $348.00 $615.00 $4,161.00 $488.00 $248.00 $1,148.00 $526.00 $526.00 2020 pricing Drugs&Supplies PROCEDURE NAME BUR ACORN LNG 6.0MM BUR DRILL NEURO LNG 2.2X3.7MM BUR EGG 2.0MM BUR EGG 4.0MM BUR SHANNON SIDECUT 2.1MM BIT DRILL WIRE PASS 1.3MM BIT DRILL WIRE PASS 1.7MM SET MICPUNC ECHOGENIC NIT 4FR7 SET MICPUNC INTR PEDS NIT 4FR4 SET MICPUNC PEDS ECHOGENIC4FR4 SET MICPUNC STIFF NIT5FR10X7CM STNT URETRL AMPLZ 8.5FR 16CM CATH SIZING AUROUS VCF 5FR70CM GDWIRE COPE MANDRIL SS0.018X40 GDWIRE COPE MANDRIL NIT.018X60 DRN DAWSON MUELLER UT6.3FR25CM CATH ROYAL FLUSH PIGT 4FR 70CM CATH ROYAL FLUSH PIGT 5FR100CM CATH ROYAL FLUSH PIGT 5FR 70CM GDWIRE HIWIRE STDANG.018 150CM GDWIRE HIWIRE STDANG.035 180CM GDWIRE HIWIRE STDANG.038 180CM GDWIRE HIWIRE STD ST.038 180CM GDWIRE HIWIRE STIFF ST.035 180 INTR TRANSITIONLESS 14FR INTR PERFORMER RADPQ 5FR 13CM INTR PERFORMER RADPQ 7FR 13CM CATH MALECOT DRN 10.2FR 25CM CATH MALECOT DRN 12FR 25CM CATH DRN MULTPRP 8.5FR 25CM SET CATH DRN MULTPRP10.2FR25CM CATH DRN MULTPRP 12FR 25CM CATH DRN MULTPRP 14FR 25CM SET CATH DRN MULTPRP 8.5FR25CM NDLE CATH YUEH ST 4FR 10CM SET MICPUNC INTR NIT 4FR 7CM SHEATH INTR PEELAWAY11FR15.5CM SHEATH PEELAWAY7FR0.035 15.5CM SET INTR DENNY 5.0FR 65CM SET INTR DENNY NIT 5.5FR 65CM CATH RABINOV SIALOGRAPHY 0.032 DILATOR SALIVARY DUCT.022 15CM CATH SLIP-CATH ST 5FR 100CM CATH SLIP-CATH ANG KMP 5FR 65 DEV INFL SPHERE 20ML 30ATM KT MICPUNC ECHOGENIC5FR21GX7CM Page 389 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $455.00 $455.00 $674.00 $674.00 $674.00 $674.00 $674.00 $110.00 $111.00 $140.00 $187.00 $573.00 $533.00 $138.00 $150.00 $356.00 $61.00 $61.00 $61.00 $191.00 $134.00 $134.00 $134.00 $134.00 $277.00 $152.00 $151.00 $356.00 $293.00 $356.00 $719.00 $719.00 $719.00 $719.00 $86.00 $101.00 $193.00 $216.00 $242.00 $276.00 $176.00 $165.00 $173.00 $173.00 $170.00 $110.00 2020 pricing Drugs&Supplies PROCEDURE NAME GDWIRE FIX J HEP 3MMX145CM GDWIRE AMPLZ HEPXSTIFF.035 145 GDWIRE AMPLZ HEPXSTIFF.035 180 GDWIRE AMPLZ XSTIFF 0.035 180 GDWIRE AMPLZ XSTIFF ST.035 80 GDWIRE AMPLZ HEPXSTIFF.038 145 GDWIRE AMPLZ STIFF ST0.038 180 KNEE FEM OXFORD XL SCREW CORT SLFTP 1.0X3MM SCREW CORT SLFTP 1.0X4MM SCREW CORT SLFTP 1.0X5MM STNT BILI COTTON-LEUNG8.5FR5CM STNT BILI COTTON-LEUNG8.5FR9CM SET INTR STNT PUSH CATH 8.5FR STNT BILI COTTON-HUIBREG 10FR7 KT INTR STNT BILI OASIS10FR205 SET INTR STNT PUSH CATH 7FR STNT BILI COTTONLEUNG8.5FR12CM STNT BILI COTTONLEUNG 11.5FR12 ALLO PLEXUR M XLG 20CC FILLER GRAN MASTERGRAFT 15CC FILLER GRAN MASTERGRAFT 30CC MTX MASTERGRAFT CU 10CC FILLER STRIP MASTERGRAFT 20CM FILLER STRIP MASTERGRAFT 36CM BLADE RECIP PREC SHRT 27MM BUR SIDE CUT 1.0X51MM BUR SIDE CUT 1.5MM BUR RD XLNG 2.0MM BLADE SAG AGGR 29X1.24X83.5 BLADE SAG AGGR 25X0.89X73 BLADE SAG AGGR 21X0.89X84.5 BLADE SAG AGGR 25X1.27X81.5 BLADE SAG AGGR 25X0.89X89.5 BLADE AUTOPSY LG BLADE SAG AGGR 18.5X1.24X83.5 BLADE MICRO SAG.4X6.5MM BUR RD LNG 4MM BRUSH CLN BUR BROCA BUR RD DIMND FINE 2X54MM BUR RD DIMND MD 4.5X52.4MM BUR RD DIMND MD 3X54MM BUR RD 2.4X54MM BUR RD 3.2X54MM BUR RD 4X54MM BUR RD 4.8X51.2MM Page 390 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $62.00 $114.00 $61.00 $127.00 $103.00 $103.00 $61.00 $3,444.00 $310.00 $310.00 $310.00 $317.00 $317.00 $230.00 $317.00 $381.00 $230.00 $317.00 $317.00 $7,490.00 $2,064.00 $2,376.00 $2,376.00 $5,486.00 $8,827.00 $377.00 $111.00 $111.00 $176.00 $159.00 $159.00 $159.00 $159.00 $159.00 $467.00 $159.00 $99.00 $174.00 $215.00 $399.00 $399.00 $399.00 $235.00 $235.00 $235.00 $235.00 2020 pricing Drugs&Supplies PROCEDURE NAME BUR EGG 4X54MM BLADE HD RECIP 12.5MM BLADE HD SAG 12.5MM BLADE HD SAG 33.MM BLADE HD SAG 19.5MM BLADE SAG NO OFF12.5X1.19X61.5 BLADE MICRO SAG 14MM BLADE MICRO SAG 9.5MMX14CM BUR RD POLISHING 4MM BUR RD SOLID CARB XLNG 4.0MM RASP RIORDON SM 32X6.5MM BUR RD 1.6X54MM RASP SM DOWNSET 21.5X5.5MM SCREW POST BI CORT 4.5X40MM KNEE INSRT XLPE DISHSZ1-2 9MM SCREW LK HEXALOBE 3X18MM KNEE PSN TIB STEM 5D LFT SZJ AIRW SUPRAGLOTTIC LT-D SZ2.5 DEV THYROPLASTY FEMALE SZ7 NDLE SCLERO CL 2.3MM 23G 240CM STNT FLEXIMA DUODEN DEL7FR 7CM CANN TIP CONT CANN ERCP STD TIP .035 CANN ERCP TAPER TIP .035 PROBE GLD 10FR GDWIRE SUP STIFF .035 500CM SPHINCTER HYDRATOME RX44 260CM GDWIRE JAGWIRE STIFF.035 260CM BLN ERCP MAXFORCE 4-4/5X180MM BLN ERCP MAXFORCE 6-4/5X180MM BLN ESOPH MAXFORCE TTS45FR15MM BLN ESOPH MAXFORCE TTS54FR18MM KNIFE NDLE TL MICRO XL STNT WLLSTNT UNISTEP20X60MM230 STNT WLLSTNT UNISTEP20X90MM230 FORCEPS RADJAW4 JUMBONDLE240CM BLN BILI RX DIL 5.8FR 4MMX2CM STNT WLLSTNT RX 8FR 10X100MM DEV STONETOME BELOWCUT TIP20MM ULTRATOME XL TL SHRT 20MM STNT WLLFLX RX 8FR 8X60MM STNT WLLFLX RX 8FR 8X80MM STNT WLLFLX COLON 22X90MM135CM KT PEG PUSH SFTY 20FR KT PEG PUSH SFTY 24FR KT PEG PULL SFTY 24FR Page 391 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $276.00 $144.00 $148.00 $148.00 $144.00 $159.00 $99.00 $99.00 $235.00 $174.00 $1,026.00 $299.00 $581.00 $531.00 $2,414.00 $770.00 $2,474.00 $69.00 $1,434.00 $186.00 $487.00 $258.00 $147.00 $147.00 $834.00 $772.00 $1,336.00 $488.00 $1,143.00 $1,143.00 $415.00 $415.00 $711.00 $3,699.00 $3,699.00 $109.00 $1,164.00 $3,315.00 $1,067.00 $733.00 $3,461.00 $3,461.00 $4,219.00 $587.00 $587.00 $601.00 2020 pricing Drugs&Supplies PROCEDURE NAME BUTTON BLN LOPRO 20FR 1.0CM BUTTON BLN LOPRO 20FR 1.5CM BUTTON BLN LOPRO 20FR 2.0CM GDWIRE SENS .035 *USE 6186318" GDWIRE SENS .038 *USE 6205229* KT BLN DIL UROMAX 15FR KT BLN DIL UROMAX 21FR GDWIRE CYST .038 KT NEPHROMAX PERC GDWIRE CYST ANG .038 GDWIRE CYST ST .035 CATH NPHRSTMY MALECOT 20FR PROBE PNEUMATIC 1.0X570MM PROBE ULTRSND 3.8CMX403MM RENAL DILATOR SET AMPLZ E STNT RETROMAXX PLUS 7/14FR 26C STNT RETROMAXX PLUS 7/14FR 28C STONE CONE RETRV COIL 3FR 10MM STNT URETRL VARI 4.8FR 22CM BLN DILATOR CYST 30FR KT BLN DIL 12FR 10CM CATH BLN UROMAX DIL 18FR 4CM KT BLN DIL 24FR 4CM BLN DILATOR CYST 24FR GDWIRE ZEBRA ST .035 150CM SET ACCUSTICK II SYS ST .038 GDWIRE AMPLZ SUPSTIFF ST 6X260 GDWIRE ACCUSTICK .018G 7.5CM SLING GYN ADVANTAGE TVT TWIST MONO SYS SLING GYN LYNX SUPRAPUBIC CATH NPHRSTMY VTC 8FR CATH NPHRSTMY VTC 10FR CATH NPHRSTMY VTC 12FR GDWIRE TRANSC 0.014 165CM GDWIRE THRUWAY SHRT ST 130CM GDWIRE THRUWAY MARKER 130CM BLN QUANTUM MAVERICK 2.0X8MM BLN QUANTUM MAVERICK 4.0X8MM BLN QUANTUM MAVERICK 5.0X8MM BLN QUANTUM MAVERICK 3.75X15MM STNT URETRL PERCUFLEX 8FR 24CM BSKT GEMINI 3FR 90CM 11MM ELTD LEVEEN COACCESS 3.5CM ELTD LEVEEN SUPER SLIM 3CM SET GENESIS PRCD HTA Page 392 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $488.00 $488.00 $488.00 $390.00 $390.00 $1,549.00 $1,549.00 $275.00 $1,978.00 $275.00 $275.00 $605.00 $1,157.00 $2,100.00 $1,464.00 $1,202.00 $1,202.00 $1,437.00 $1,014.00 $1,464.00 $1,549.00 $1,464.00 $1,549.00 $1,464.00 $491.00 $322.00 $213.00 $113.00 $2,885.00 $3,277.00 $2,793.00 $356.00 $356.00 $356.00 $858.00 $449.00 $537.00 $533.00 $533.00 $533.00 $533.00 $1,009.00 $1,181.00 $3,862.00 $3,342.00 $3,480.00 2020 pricing Drugs&Supplies PROCEDURE NAME GDWIRE CHOICE FLOPPY 182CM GD WISEGUIDE FL4.5 7FR GD WISEGUIDE VR1 7FR GD WISEGUIDE FCL3.5 SH 7FR GD WISEGUIDE FCL4 SH 7FR GD WISEGUIDE FCR3.5 7FR GD WISEGUIDE FCR5 7FR GD WISEGUIDE Q4 7FR GD WISEGUIDE Q4 SH 7FR GD WISEGUIDE MP2 7FR GD WISEGUIDE FR3.5SH 7FR GD WISEGUIDE ART3.5SH 7FR GD WISEGUIDE FR4.5 7FR GD WISEGUIDE AL1SH 7FR GD WISEGUIDE VL4.5 7FR GD WISEGUIDE VL3.5 SH 7FR GD WISEGUIDE VL4 SH 7FR GD WISEGUIDE AL1.5 7FR KT DISP PLK 2.9MM SCREW COMP 7.0MM 65X16MM ALLO PUTTY OSTEOAMP 10CC HIP SCREW BONE ZIMM 6.5X50MM HIP SCREW BONE ZIMM 6.5X70MM HIP LNR DURASUL PE 38X57MM HIP LNR DURASUL PE 32X59MM HIP SHELL CONVERGE RIM 57MM HIP SHELL CONVERGE RIM 59MM HIP SHELL TRILOGY SOLID 48MM HIP SHELL TRILOGY SOLID 50MM HIP SHELL TRILOGY SOLID 52MM HIP SHELL TRILOGY SOLID 54MM HIP SHELL TRILOGY SOLID 56MM HIP SHELL TRILOGY SOLID 58MM HIP SHELL TRILOGY SOLID 62MM HIP SHELL TRILOGY SOLID 64MM HIP LNR TRILOGY PE 20D 58X32MM HIP LNR TRILOGY PE 7MM 50X28MM HIP LNR TRILOGY PE 7MM 56X32MM SCREW CORT ZIMM 4.5X30MM SCREW CORT ZIMM 4.5X32MM SCREW CORT ZIMM 4.5X34MM SCREW CORT ZIMM 4.5X36MM SCREW CORT ZIMM 4.5X38MM SCREW CORT ZIMM 4.5X40MM SCREW CORT ZIMM 4.5X42MM SCREW CORT ZIMM 4.5X44MM Page 393 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $387.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $860.00 $2,958.00 $5,920.00 $203.00 $203.00 $2,847.00 $2,847.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,247.00 $2,847.00 $2,847.00 $2,847.00 $203.00 $203.00 $203.00 $203.00 $203.00 $203.00 $203.00 $203.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT ZIMM 4.5X46MM SCREW CORT ZIMM 4.5X48MM SCREW CORT ZIMM 4.5X50MM SCREW CORT ZIMM 4.5X52MM SCREW CORT ZIMM 4.5X54MM SCREW CORT ZIMM 4.5X56MM SCREW CORT ZIMM 4.5X58MM SCREW CORT ZIMM 4.5X60MM HIP STEM KINECTIV SZ7.5 HIP NECK KINECTIV ANTEVERT P1 HIP NECK KINECTIV ANTEVERT G2 HIP HD ZIMM MTL 6D 36MM +10.5 PLATE PROX HUMR LFT 4.5MM 6HL PLATE PROX HUMR LFT 4.5MM 8HL SCREW CONIC ZIMM 2.7X10MM SCREW CORT SLFTP NCB 5.0X32MM SCREW CORT SLFTP NCB 5.0X34MM SCREW CORT SLFTP NCB 5.0X48MM SCREW CORT SLFTP NCB 5.0X65MM SCREW CORT SLFTP NCB 5.0X75MM SCREW CORT SLFTP NCB 5.0X80MM PLATE DIST FEM RT 15HL 317MM BIT DRILL ST 7.9MMX12.7CM BIT DRILL ST 4MMX12.7CM BIT DRILL ST 6.4MMX12.7CM BIT DRILL FINE ZIMM 3.5MM BIT DRILL ZIMM LNG 6.5MM TAP QK CONN ZIMM 4.0MM TAP QK CONN ZIMM XLNG 4.5MM PLATE DIST FEM RT 6HL 146MM PLATE DIST FEM LFT6HL 146MM SCREW FULL SLFTP ZIMM 4.0X60MM SCREW CORT SLFTP ZIMM 3.5X10MM SCREW CORT SLFTP ZIMM 3.5X16MM SCREW CORT SLFTP ZIMM 3.5X24MM SCREW CORT SLFTP ZIMM 3.5X38MM SCREW CORT SLFTP ZIMM 3.5X40MM SCREW CORT SLFTP ZIMM 3.5X42MM SCREW CORT SLFTP ZIMM 3.5X48MM SCREW CORT SLFTP ZIMM 3.5X50MM SCREW CANC THRD 4.0X30MM 20MM SCREW CANC THRD 4.0X40MM 20MM SCREW CANC THRD 4.0X45MM 20MM SCREW THRD SLFTP ZIMM 4.0X50MM SCREW CORT SLFTP ZIMM 4.5X26MM SCREW CORT SLFTP ZIMM 4.5X28MM Page 394 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $203.00 $203.00 $203.00 $203.00 $203.00 $203.00 $203.00 $203.00 $4,948.00 $1,973.00 $1,973.00 $1,657.00 $2,393.00 $2,459.00 $386.00 $1,097.00 $1,097.00 $1,097.00 $1,097.00 $1,097.00 $1,097.00 $4,158.00 $755.00 $227.00 $227.00 $597.00 $738.00 $407.00 $555.00 $2,455.00 $2,455.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $217.00 $234.00 $234.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP ZIMM 4.5X30MM SCREW CORT SLFTP ZIMM 4.5X60MM SCREW CORT SLFTP ZIMM 4.5X75MM SCREW CORT SLFTP ZIMM 4.5X90MM SCREW CANC THRD 6.5X45MM 32MM SCREW CANC THRD 6.5X50MM 32MM PLATE HUMR PROX 14HL LFT 3.5MM BIT DRILL QKCONN 2.5X125MM BIT DRILL QKCONN 2.5X220MM BIT DRILL QKCONN 3.2X195MM BIT DRILL QKCONN 3.5X110MM BIT DRILL QKCONN 3.5X195MM BIT DRILL QKCONN 4.5X195MM KNEE TIB NEX PEG BLU SZ7 KNEE TIB NEX PEG BLU SZ8 KNEE ASF YEL 10MM KNEE ASF YEL 12MM KNEE ASF YEL 14MM KNEE ASF YEL 17MM KNEE ASF YEL 20MM KNEE ASF GRN 10MM KNEE ASF GRN 12MM KNEE ASF GRN 14MM KNEE ASF GRN 17MM KNEE ASF GRN 20MM KNEE ASF BLU 10MM KNEE ASF BLU 12MM KNEE ASF BLU 14MM KNEE ASF BLU 17MM KNEE ASF BLU 20MM KNEE TIB NKII ULT RT SZ2 9MM KNEE TIB NKII ULT RT SZ2 16MM KNEE PTLA NKII ZIMM SZ2 7MM KNEE PTLA NKII ZIMM SZ1 10MM KNEE PTLA NKII ZIMM SZ2 10MM KNEE PTLA NKII ZIMM SZ3 10MM KNEE FEM NKII NONPOR LFT SZ2 KNEE FEM NKII NONPOR RT SZ4 KNEE MOD TIB BASEPLATE LFT SZ0 KNEE MOD TIB BASEPLATE LFT SZ1 KNEE MOD TIB BASEPLATE LFT SZ3 KNEE MOD TIB BASEPLATE RT SZ3 KNEE MOD TIB BASEPLATE RT SZ4 HIP LNR DURASUL PE CNSTND32X55 KNEE TIB TRABEC CONE RTLG51X34 KNEE FEM CONE RT SM 35MM Page 395 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $234.00 $234.00 $234.00 $234.00 $257.00 $257.00 $2,610.00 $438.00 $438.00 $438.00 $438.00 $438.00 $438.00 $2,412.00 $2,412.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $1,829.00 $2,570.00 $2,570.00 $1,148.00 $1,148.00 $1,148.00 $1,148.00 $3,479.00 $13,208.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $2,412.00 $8,678.00 $10,371.00 $11,815.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB COMP HNG NEXGEN SZ4 KNEE FEM HNG ROTATE LFT SZC KNEE FEM HNG ROTATE LFT SZD KNEE FEM HNG ROTATE RT SZD KNEE FEM HNG ROTATE RT SZE KNEE ACET SHELL TRILOGY 48MM KNEE ACET SHELL TRILOGY 50MM KNEE ACET SHELL TRILOGY 52MM KNEE ACET SHELL TRILOGY 54MM KNEE ACET SHELL TRILOGY 56MM KNEE ACET SHELL TRILOGY 58MM KNEE ACET SHELL TRILOGY 60MM KNEE ACET SHELL TRILOGY 62MM KNEE ACET SHELL TRILOGY 64MM KNEE FEM SPACER SZ2 4MM KNEE FEM SPACER SZ3 4MM KNEE FEM SPACER SZ4 8MM KNEE TIB NKII STEM REV 180MM KNEE TIB NKII STEM REV 215MM KNEE TIB STEMSMTHREV12.5X125MM KNEE TIB STEM SMTHREV14.5X75MM KNEE TIB STEM SMTHREV16.5X75MM KNEE TIB STEM SMTHREV18.5X75MM KNEE FEM NKII REV LFT SZ4 KNEE FEM NKII NONPOR LFT SZ1 KNEE FEM NKII NONPOR LFT SZ2 KNEE FEM NKII NONPOR LFT SZ4 KNEE FEM NKII NONPOR RT SZ1 KNEE FEM NKII NONPOR RT SZ3 KNEE TIB BASEPLATE +4MM LFT SZ KNEE TIB BASEPLATE +4MM LFT SZ KNEE TIB BASEPLATE +4MM RT SZ0 KNEE TIB BASEPLATE +4MM RT SZ2 KNEE TIB SPACER MEDL SZ3 4MM KNEE TIB SPACER MEDL SZ3 8MM KNEE TIB SPACER MEDL SZ4 8MM PLATE L TIB HIGH ZIMM LFT KNEE TIB INSRT LFT SZ1-2 9MM KNEE TIB INSRT LFT SZ3-4-5 9MM KNEE TIB INSRT RTSZ3-4-5 9MM KNEE TIB INSRT RT SZ1-2 11MM KNEE TIB INSRT RT SZ3-4-5 11MM KNEE TIB INSRT LFT SZ00-0 13MM KNEE TIB INSRT LFT SZ1-2 13MM KNEE TIB INSRT LFT SZ00-0 16MM KNEE TIB INSRT LFTSZ3-4-5 19MM Page 396 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $11,018.00 $22,201.00 $22,201.00 $22,201.00 $22,201.00 $2,622.00 $2,622.00 $2,622.00 $2,622.00 $2,622.00 $2,622.00 $2,622.00 $2,622.00 $2,622.00 $2,829.00 $2,829.00 $2,829.00 $2,963.00 $2,963.00 $2,963.00 $2,963.00 $2,963.00 $2,963.00 $13,208.00 $13,208.00 $13,208.00 $13,208.00 $13,208.00 $13,208.00 $6,227.00 $6,227.00 $6,227.00 $6,227.00 $2,945.00 $2,945.00 $2,945.00 $2,789.00 $4,514.00 $4,514.00 $4,514.00 $4,514.00 $4,514.00 $4,514.00 $4,514.00 $4,514.00 $4,514.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB INSRT RT SZ00-0 25MM KNEE TIB INSRT LFTSZ3-4-5 9MM KNEE TIB INSRT RT SZ3-4-5 9MM KNEE TIB INSRT RT SZ1-2 11MM KNEE TIB INSRT RT SZ3-4-5 11MM KNEE ST FLUTED REV 16.5X175MM KNEE ST FLUTED REV 18.5X175MM KNEE ST FLUTED REV 20.5X175MM HIP STEM ZMR POR BOW18.0X170MM HIP BODY ZMR SPOUT F 46X55MM TRNQT STERICUFF DUAL LL 12IN TRNQT STERICUFF ATS LL 18IN TRNQT STERICUFF ATS LL 24IN TRNQT STERICUFF ATS LL 30IN TRNQT STERICUFF ATS LL 34IN TRNQT STERICUFF ATS LL 42IN HIP HD ZIMM MTL 6D 28MM +10.5 HIP HD ZIMM MTL 6D 28MM +14 HIP HD ZIMM MTL 6D 36MM +14 KNEE TIB AUG 1/2 WEDGE 16D SZ3 KNEE TIB BASE A/P WEDGE SZ4 KNEE TIB BASE A/P WEDGE SZ6 KNEE ART MOLDED BLU 17MM KNEE STEM EXT 12X120MM KNEE STEM EXT 15X120MM KNEE TIB INSRT UNI 8MM HIP HD DURASUL MTL12/14 38MM+4 PIN BEATH 2.4X254MM HIP ADPTR UNIPOLR ZIMM 6D 7MM KNEE PTLA DOME 36MM CBL CERCLAGE 1.8X914MM KT HEMOVAC COMPONENT 400ML HIP LNR TRILOGY PE CNSTND80X32 HIP SHELL TRABEC MULTHL 80MM HIP LNR LNGVTY PE 10D 32X62MM BONE PLUG CMNT12MM/16MM BONE PLUG CMNT 20MM/24MM HIP AUG TRABEC MTL ZIMM50X20MM HIP AUG TRABEC MTL ZIMM54X15MM HIP LNR HGPII PE NEUT SZD 50MM HIP LNR HGPII PE ELEV SZG 56MM HIP LNR HGPII PE ELEV SZL 64MM PLATE SUPRAPECTINEAL QLS RT KWIRE STRY 3.2X150MM STNT ENDURANT LIMB SHEATH INTR SENTRANT 14FR 28CM Page 397 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,514.00 $4,514.00 $4,514.00 $4,514.00 $4,514.00 $3,624.00 $3,624.00 $3,624.00 $7,338.00 $8,559.00 $153.00 $93.00 $105.00 $112.00 $121.00 $130.00 $1,657.00 $1,657.00 $1,657.00 $2,704.00 $4,951.00 $4,951.00 $1,829.00 $2,861.00 $2,861.00 $2,172.00 $1,545.00 $738.00 $533.00 $3,520.00 $1,747.00 $242.00 $3,768.00 $4,379.00 $4,385.00 $886.00 $886.00 $6,379.00 $6,379.00 $4,258.00 $4,258.00 $4,258.00 $5,053.00 $604.00 $5,885.00 $1,016.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK 4.0X22MM SCREW LK 4.0X24MM SCREW LK 4.0X26MM SCREW LK 4.0X28MM SCREW LK 4.0X40MM SCREW LK 4.0X42MM SCREW LK 4.0X44MM SCREW LK 4.0X46MM SCREW LK 4.0X48MM SCREW CORT STRY 4.5X38MM CAP PROTECT TIP WHT 4.0MM SCREW CANN TI AS3 6.5X65MM SCREW CANN TI AS3 6.5X70MM SCREW CANN TI AS3 6.5X105MM SCREW CANN TI AS3 6.5X120MM SCREW CANN 6.5X130MM 16MM SCREW CANN 6.5X16MM PIN EXTL APEX 6X200MM SCREW CANN TI AS3 8.0X75MM SCREW CANN TI AS3 8.0X80MM SCREW CANN TI AS3 8.0X85MM SCREW CANN TI AS3 8.0X90MM BIT DRILL GRY 9/64 .140X5 PIN EXTL APEX SLFTP 3X80MM PIN EXTL APEX TRANSFIX 4X200MM SCREW CNCLS SS THRD 4.0X16MM SCREW CNCLS SS THRD 4.0X18MM SCREW CNCLS SS THRD 4.0X45MM ROD CONN CBN 8X100MM ROD CONN CBN 8X500MM ROD CONN CBN 8X65MM PLATE DIST ANT TIB LFT 6HL PLATE DIST ANT TIB RT 6HL PLATE DIST MEDL TIB LFT 10HL PLATE DIST MEDL TIB RT 10HL PLATE DIST MEDL TIB LFT 12HL PLATE DIST MEDL TIB RT4HL BIT DRILL 3.1X204MM BIT DRILL GLD 2.5X12MM BIT DRILL 3.5X125MM END CAP +0MM END CAP +10MM NAIL FEM LFT 10X400MM NAIL FEM T2 GTN LFT 12X360MM NAIL FEM T2GTN STRY RT10X420MM NAIL FEM T2GTN STRY RT12X380MM Page 398 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $582.00 $582.00 $582.00 $582.00 $582.00 $582.00 $582.00 $582.00 $582.00 $142.00 $219.00 $1,077.00 $1,077.00 $1,077.00 $1,077.00 $213.00 $197.00 $687.00 $1,077.00 $1,077.00 $1,077.00 $1,077.00 $330.00 $402.00 $920.00 $132.00 $132.00 $132.00 $978.00 $1,454.00 $978.00 $3,083.00 $2,969.00 $2,973.00 $2,973.00 $2,973.00 $2,973.00 $296.00 $336.00 $336.00 $802.00 $802.00 $3,708.00 $3,708.00 $3,708.00 $3,708.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE RECON 8HL 96MM SCREW LK AXSOS 4.0X16MM SCREW LK AXSOS 4.0X18MM SCREW LK AXSOS 4.0X32MM SCREW LK AXSOS 4.0X34MM SCREW LK AXSOS 4.0X42MM SCREW LK AXSOS 4.0X46MM SCREW LK AXSOS 4.0X50MM PIN EXTL APEX SLFTP 4X180MM PIN EXTL APEX 4X200MM PIN EXTL APEX 4X90MM PLATE 1/3 TUBLR 4HL PLATE 1/3 TUBLR 5HL PLATE 1/3 TUBLR 6HL PLATE 1/3 TUBLR 8HL PLATE PROX LAT HUMR LFT 3HL PLATE PROX LAT HUMR LFT 5HL NAIL RECON LFT 9X380MM NAIL RECON LFT 9X420MM NAIL RECON RT 11X380MM NAIL RECON RT 9X360MM NAIL RECON RT 9X380MM PIN RDCTN 5X180MM SCREW CNCLS PART THRD 4.0X45MM SCREW CORT SLFTP STRY3.5X100MM SCREW CORT SLFTP STRY3.5X105MM SCREW CORT SLFTP STRY 3.5X20MM SCREW CORT SLFTP 3.5X46MM SCREW CORT SLFTP STRY 3.5X48MM SCREW CORT SLFTP STRY 3.5X90MM SCREW CORT SLFTP STRY 3.5X95MM PLATE MATTA MPS FLEX 12HL142.5 PLATE MATTA MPS FLEX 16HL190.5 PLATE MATTA MPS FLEX 6HL 70.5 PLATE SUPERIOR CURV RT 7HL88MM END CAP T2 +15MM SCREW LK THRD 4X28MM SCREW LK THRD 4X32MM SCREW LK THRD 4X50MM NAIL FEM T2 10X340MM NAIL FEM T2 10X360MM NAIL FEM T2 10X380MM NAIL FEM T2 10X400MM NAIL FEM T2 10X420MM NAIL FEM T2 10X440MM NAIL FEM T2 11X340MM Page 399 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,576.00 $655.00 $655.00 $655.00 $655.00 $655.00 $655.00 $655.00 $806.00 $649.00 $806.00 $302.00 $302.00 $302.00 $370.00 $2,970.00 $2,970.00 $3,396.00 $3,396.00 $3,396.00 $3,396.00 $3,396.00 $447.00 $132.00 $152.00 $152.00 $152.00 $152.00 $152.00 $152.00 $152.00 $1,689.00 $1,828.00 $1,449.00 $2,279.00 $842.00 $828.00 $828.00 $828.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL FEM T2 11X360MM NAIL FEM T2 11X420MM NAIL FEM T2 12X400MM NAIL FEM T2 12X420MM NAIL FEM T2 12X440MM NAIL FEM T2 13X380MM NAIL FEM T2 14X420MM NAIL FEM T2 9X360MM NAIL FEM T2 9X380MM NAIL FEM T2 9X400MM NAIL FEM T2 9X420MM NAIL HUMR T2 7X260MM SCREW RECON LAG T2 6.5X65MM SCREW RECON LAG T2 6.5X70MM SCREW RECON LAG T2 6.5X75MM SCREW RECON LAG T2 6.5X80MM SCREW RECON LAG T2 6.5X95MM BIT DRILL SOLID STEP RECON T2 SCREW LK PART THRD 5X40MM NAIL TIB T2 STRY STD 10X270MM NAIL TIB T2 STRY STD 10X345MM NAIL TIB T2 STD 11X285MM NAIL TIB T2 STD 11X300MM NAIL TIB T2 STD 11X345MM NAIL TIB T2 STD 11X375MM NAIL TIB T2 STD 11X390MM NAIL TIB T2 STD 12X345MM NAIL TIB T2 STD 9X270MM NAIL TIB T2 STD 9X300MM NAIL TIB T2 STD 9X360MM NAIL TIB T2 STD 9X375MM NAIL TIB T2 STD 9X390MM SCREW ASNIS III CANN 6.5X110MM SCREW ASNIS III CANN 6.5X120MM WASHER ASNIS III 6.5/8.0MM SCREW ASNIS III CANN 4X70MM BLADE RAD 60S SINUS 2.9MM BLADE TRACH CURV TIP 37CM SCREW BONE W SUT SLFTP REPOSE DRSG NASAL MEROGEL INJECT TB VENT MORETX TAB TYTAN TB VENT HUNSAKER MON-JE LEAD CAPSUREFIX NOVUS MRI 35CM BLN SPRINTER OTW 3.5X30MM BLN SPRINTER OTW 4.0X30MM KT SURVIVAL EVEREST30 INFL Page 400 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,183.00 $3,169.00 $1,073.00 $1,073.00 $1,073.00 $1,073.00 $1,073.00 $591.00 $885.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $3,143.00 $1,077.00 $1,077.00 $173.00 $716.00 $1,005.00 $1,361.00 $1,331.00 $476.00 $272.00 $526.00 $1,455.00 $738.00 $738.00 $247.00 2020 pricing Drugs&Supplies PROCEDURE NAME GD SHERPA AL10 7FR 100CM GD SHERPA EB30 7FR 100CM GD SHERPA EB35 7FR 100CM GDSHERPA EB375 7FR 100CM GD SHERPA EBU40 7FR 100CM GD SHERPA EB45 7FR 100CM GDSHERPA JCL35 7FR 100CM GD SHERPA JCL40 7FR 100CM GD SHERPA JCL45 7FR 100CM GD SHERPA JL35 7FR 100CM GDSHERPA JL40 7FR 100CM GD SHERPA JL45 7FR 100CM GD SHERPA JL50 7FR 100CM GD SHERPA JR35 7FR 100CM GD SHERPA JR40 7FR 100CM GD SHERPA JR45 7FR 100CM GD SHERPA JR50 7FR 100CM GD SHERPA LCB 7FR 100CM GDWIRE ZINGER LS HYDRO LT180CM GDWIRE ZINGER MS HYDRO MD180CM GDWIRE ZINGER S HYDRO ST 180CM CATH PROGREAT 2.8FR 150CM ENDO GRASP MINIALLIGATOR TB EVAC SMOKENEPTUNE2 3/8X10FT KWIRE STABILIS 2.5X100MM SCREW NEXA 2.7X12MM SCREW NEXA 2.7X14MM SCREW NEXA 2.7X16MM SCREW NEXA 2.7X18MM SCREW NEXA 2.7X20MM SCREW NEXA 2.7X24MM SCREW NEXA 2.7X28MM SCREW NEXA 3.2X12MM SCREW NEXA 3.2X14MM SCREW NEXA 3.2X16MM SCREW NEXA 3.2X18MM SCREW NEXA 3.2X20MM BIT DRILL NEXA 2MM BIT DRILL NEXA 2.5MM KWIRE NEXA 1.6MM PLATE NEXA PRIM LFT SZ2 PLATE NEXA PRIM RT SZ2 PLATE NEXA PRIM RT SZ3 PLATE NEXA RECON RT SZ2 PLATE NEXA RECON LFT SZ3 SCREW NEXFIX COMP 6.5X40X14MM Page 401 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $258.00 $77.00 $77.00 $77.00 $1,364.00 $902.00 $173.00 $230.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $561.00 $641.00 $641.00 $641.00 $641.00 $641.00 $641.00 $641.00 $173.00 $2,956.00 $2,956.00 $2,956.00 $3,426.00 $3,426.00 $1,699.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW NEXFIX COMP 6.5X45X20MM SCREW NEXFIX COMP 6.5X50X20MM SCREW NEXFIX COMP 6.5X55X20MM SCREW NEXFIX COMP 6.5X60X20MM SCREW NEXFIX COMP 6.5X65X20MM SCREW NEXFIX COMP 6.5X70X20MM GDWIRE NEXFIX 2.5MM SCREW NEXA SNAPOFF 2.7X15MM ANCHOR SUT PITON 2.8MM GD OFFSET BIOSUTURE TAK KT INSRT SUTTAK ARTX SPEAR ALLO DBM PUTTY STIMUBLAST 1CC FLIPCUTTER II ARTX 12MM BIT DRILL GD PIN 3.58MM GD PIN BLNT 2.0MM GD PIN SHARP 2.4MM PLATE FEM OPEN WEDGE TI 15.0MM PLATE TIB WEDGE OPEN 5.0MM PLATE TIB WEDGE OPEN 9.0MM PLATE TIB WEDGE OPEN 11.0MM PLATE TIB WEDGE OPEN 15.0MM PLATE TIB WEDGE OPEN 17.5MM SCREW CORT TI 6.5X55MM SCREW CORT ARTX TI 4.5X36MM SCREW CANN THRD 8X30MM SCREW CANN THRD 10X20MM ANCHOR BTB TIGHTROPE FLIPCUT ANCHOR SUT BIO-CRKSCRW5X17.9MM ANCHOR BIO SUT TAK W WIRE3MM ANCHOR PEEK SUT TAK WIRE 3.0 OATS HARVESTER DISP 8MM BUTTON BICEP 2.6X10.9MM BLADE KNIFE PRLL 11MM ANCHOR PEEK SUT 4.75X24.5MM PLATE CLAV CENT 1/3 RT 8HL DEV SUTLASSO W WIRE LOOP 45D DEV SUTLASSO SD LFT 45D DEV SUTLASSO SD RT 45D DEV SUTLASSO SD LFT 90D DEV SUTLASSO SD RT 90D SCREW DELTA PEEK 8X28MM SCREW DELTA PEEK 9X28MM SCREW DELTA PEEK 10X28MM SCREW DELTA PEEK 9X35MM SCREW DELTA PEEK 10X35MM SCREW DELTA PEEK 11X35MM Page 402 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,699.00 $1,699.00 $1,699.00 $1,699.00 $1,699.00 $1,699.00 $173.00 $1,301.00 $1,436.00 $1,335.00 $1,506.00 $972.00 $1,173.00 $239.00 $118.00 $361.00 $2,327.00 $1,683.00 $1,683.00 $1,683.00 $1,683.00 $1,683.00 $441.00 $441.00 $490.00 $490.00 $2,050.00 $1,047.00 $1,224.00 $1,224.00 $1,105.00 $1,105.00 $256.00 $1,400.00 $1,714.00 $655.00 $738.00 $695.00 $695.00 $695.00 $1,198.00 $1,198.00 $1,198.00 $1,198.00 $1,198.00 $1,198.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW BIOCOMP DELTA 12X35MM CANN PART THRD 8.25X70MM SCREW CANN 3.75X32MM SUT FBRWIRE 2 BLU WHT/BLK 38 SUT FBRWIRE 2 2 NDLE BLU 38 DEV SUTLASSO MICRO SHRT 70D SCREW LPS 3.5X32MM SCREW LPS 3.5X34MM SCREW LPS 3.5X36MM SCREW LPS 3.5X42MM SCREW LPS 3.5X46MM SCREW LPS 3.5X48MM SCREW LK 3.5X22MM SCREW LK 3.5X26MM SCREW ARTX 4.0X26MM SCREW CANN SHRT THRD 4.0X32MM SCREW CANN SHRT THRD 4.0X34MM SCREW CANN SHRT THRD 4.0X36MM SCREW CANN SHRT THRD 4.0X38MM SCREW CANN SHRT THRD 4.0X42MM SCREW CANN SHRT THRD 4.0X44MM SCREW CANN SHRT THRD 4.0X48MM SCREW CANN 4.0X34MM SCREW CANN 4.0X36MM SCREW CANN 4.0X44MM SCREW CANN 4.0X46MM SCREW SHRT THRD 4.0X34MM SCREW SHRT THRD 4.0X36MM SCREW SHRT THRD 4.0X40MM SCREW SHRT THRD 4.0X46MM SCREW SHRT THRD 4.0X50MM SCREW LNG THRD 4.0X60MM SCREW LPS 3.0X10MM SCREW LPS 3.0X12MM SCREW LPS 3.0X14MM WASHER ARTX 10MM PLATE LP PRO COTTON 4MM PLATE LP PRO COTTON 6MM PLATE LP PRO COTTON 8MM SHLDR HUMR HD 43X15MM PROBE ABL COOLCUT 45 BALL REAMER CORING 14MM SHLDR HUMR STEM 9X146MM SCREW FIXED ANG 5.5X35MM SCREW FIXED ANG 6.5X35MM SCREW SACROILIAC 12X40MM Page 403 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,127.00 $140.00 $972.00 $172.00 $164.00 $695.00 $191.00 $191.00 $191.00 $191.00 $191.00 $191.00 $579.00 $579.00 $191.00 $811.00 $811.00 $811.00 $811.00 $811.00 $811.00 $811.00 $811.00 $811.00 $811.00 $811.00 $191.00 $191.00 $191.00 $191.00 $191.00 $191.00 $604.00 $604.00 $604.00 $420.00 $2,171.00 $2,171.00 $2,171.00 $2,833.00 $614.00 $996.00 $7,095.00 $2,213.00 $2,213.00 $9,007.00 2020 pricing Drugs&Supplies PROCEDURE NAME CMNT BONE HV-R KYPHON SET INTR SHEATH CURV 7FR 24CM NDLE BX CHIBA ECHOTIP 20GX20CM BLADE SAG OSCL 90D PLATE LCP META 3.5/4.5MM 10HL GLIDESCOPE LOPRO SGL USE #3 GLIDESCOPE LOPRO SGL USE #4 NAILEX LAT ENTRY TI RT 9X380 SCREW LOPRO TI 4.5X28MM SCREW LOPRO TI 4.5X34MM SCREW LOPRO TI 4.5X45MM SCREW LK LOPRO TI 4.5X32MM SCREW LK LOPRO TI 4.5X34MM SCREW LOPRO TI 5.5X75MM BB TAK SYS THRD LG HIP SCREW G7 LOPRODOME6.5X15MM HIP STEM ANTHOLOGY HIGH SZ6 STAPLER SKIN REFLEX 35W SCREW LK HEXALOBE 3X8MM SCREW LK HEXALOBE 3X12MM SYS ENTERAL DIL PEELAWAY 20FR BOOT CONTRACTURE ANK WRAP COLD BACK GAME READY GLOVE COMP WRIST OPEN SLIPONXL BRC WRIST D RING BLK RT MD BRC WRIST D RING THB LFT XLG BRC WRIST D RING THB RT XLG BRC WRIST D RING RT THB MD BRC CARPAL TUNNEL AIR LFT XLG BRC CARPAL TUNNEL AIR LFT 2XL BRC CARPAL TUNNEL AIR RT XLG BRC CARPAL TUNNEL AIR RT 2XL ELTD COLUMBIA SNAP600 1 PROTECT HEELELBOWSLIPOVERLG/XL PROTECT HEELELBOWSLIPOVERSM/MD SLING P*DUPLICATE USE 6163631* SLING P*DUPLICATE USE 6163630* SHLDR ORTHOSIS UNILAT RT MD SCREW LK TRMI 2.4X16MM SCREW LK TRMI 2.4X18MM SCREW LK TRMI 2.4X20MM KWIRE SGL TROC TRMI 0.8X80MM ANK FUSN CUP 10HL 18MM PATCH COMPOSITE VENTRAL 8.6CM CATH TRAY CENTVEN STD ST5FR8CM ALLO GRAN OSTEOAMP 2.5CC Page 404 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $641.00 $650.00 $61.00 $438.00 $2,214.00 $230.00 $230.00 $3,087.00 $392.00 $392.00 $392.00 $947.00 $947.00 $392.00 $749.00 $197.75 $4,161.00 $191.00 $770.00 $770.00 $538.00 $381.00 $1,497.00 $142.00 $96.00 $96.00 $96.00 $96.00 $134.00 $134.00 $134.00 $134.00 $63.00 $88.00 $88.00 $448.00 $448.00 $284.00 $465.00 $465.00 $465.00 $89.00 $2,686.00 $1,867.00 $490.00 $2,417.46 2020 pricing Drugs&Supplies PROCEDURE NAME BRC ANK LACE UP TIB STRAP SM BRC ANK LACE UP TIB STRAP MD BELT SI EVERGRN 621 LG DEV BX PREC CORE 18G 15CM20M MESH PROGRIP ANATOM LFT15X10CM SCREW LK GORILLA TUFF 3.5X18MM SCREW COMP GORILLA 4.2X18MM PLATE OLEC ACUM STD RT 3 HL SCREW LK HEXALOBE 3X40MM EXPAND MAM MODER W TAB 400CC KT INTR GASTRO MIC LOPRO 16FR MESH ALLODE9.6X19.3CM=185.28SQ SUCT CANISTER REVOLVE 700ML SCREW LK GORILLA 2.7X10MM SCREW NL HEXALOBE 2.7X30MM HIP STEM SYNRG POR HIGH SZ9 HIP STEM SYNRG POR HIGH SZ10 HIP STEM SYNRG POR HIGH SZ13 HIP STEM SYNRG POR HIGH SZ14 HIP STEM SYNRG POR HIGH SZ15 HIP STEM SYNRG POR HIGH SZ16 SCREW LK LOPRO 2.4X24MM KNEE TIB INSRTGII CNSTND5-6 11 KNEE TIB INSRT GII SZ1-2 18MM KNEE INSRT XLPE HIFLEX7-8 13MM KNEE INSRT XLPE DISHSZ1-2 11MM KNEE INSRT XLPE DISHSZ1-2 13MM KNEE INSRT XLPE DISHSZ1-2 15MM KNEE INSRT XLPE DISHSZ7-8 13MM KNEE FEM LGN CR OXIN RT SZ8 KNEE FEM LGN CR OXIN LFTSZ2 KNEE FEM LGN CR OXIN LFTSZ8 SPIKE BONE PROFIX SHRT KNEE FEM LGN CR NP RT SZ8 KNEE FEM LGN CNSTND LFTSZ6 KNEE FEM LGN CNSTND RT SZ8 KNEE TIB BASE CMNT LGNREVRTSZ7 KNEE FEM LGN PS NP RT SZ5 KNEE TIB GENESISII CMNT LFTSZ1 HIP SCREW CNCLS RFLCT 20MM KNEE PTLA FEM TROCHLEAR8.5X4MM KNEE PTLA DOME 9.0X30MM KNEE PTLA FEM POST 11X21.5MM ENDOL ENDUR II SHRT28X14X103MM HIP HD VERS BIOLOX CER28MM+3.5 KT LIGAMENT AUG REPAIRINTRLBRC Page 405 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $75.00 $75.00 $226.00 $260.00 $1,547.00 $1,103.00 $1,022.00 $2,751.00 $770.00 $3,281.00 $1,083.00 $8,103.00 $1,543.16 $1,034.16 $488.00 $4,176.00 $4,176.00 $4,161.00 $4,161.00 $4,176.00 $4,161.00 $643.75 $4,620.00 $1,734.00 $2,398.00 $2,398.00 $2,414.00 $2,353.75 $2,398.00 $3,970.00 $3,542.69 $3,627.00 $352.00 $2,641.00 $13,835.00 $14,091.00 $5,632.00 $5,632.00 $2,203.11 $701.00 $9,280.00 $1,781.00 $1,688.00 $18,398.00 $3,598.71 $2,606.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHLDR HUMR HD CTA DEPU 56*OBS* PK VERSAPACK EFFICIENCY 23G PK VERSAPACK EFFICIENCY 25G PK VERSAPACK EFFICIENCY 20G BIPOLR CAUT 23G BIPOLR CAUT 25G PROBE DIRECTIONAL LASER 25G HANDPC BACKFLUSH SOFT TIP 23G HANDPC BACKFLUSH SOFT TIP 25G CANN SOFT TIP 23G CANN SOFT TIP 25G MEMBRANE SCRAPER TANO 23G LENS VITRECTOMY *DISC 6272091* STEALTH PORT ENTRY SYS 25G STEALTH PORT ENTRY SYS 23G TB INFUS ADJ GAS PRSSD ENDOILLUMINATOR MIDFIELD 20G ENDOILLUMINATOR WIDEFIELD 23G ENDOILLUMINATOR MIDFIELD 25G LASER PROBE ILLUM 25G FORCEPS PICK HVY MEMBRANE 23G LASER PROBE TRU CURV 37D 23G KT VISCOUS OIL ACCURUS CANN INFUS DISP 23G 6MM PROBE DIRECTIONAL LASER 23GA SPLT NASAL REUTER BLADE ENT MICRO ST PROS HYDROXYLAPATITE BUR DCR CURV 4.0MM BUR HYDROBRADER RASP SUCT FINE 8MM BUR CURV DIMND DCR 2.9MM KT LINQ INSERTION TOOL SPLT NASAL GOLDSMITH COLLT SINUS SECRETION TB IRR POWERF*DISC NO RPLCMNT* SET PARADIGM QUICKSET 9MM 32IN CATH EMBOL 7FRX80CM CLIP SPRING FOGARTY 6MM CATH EMBOL 2FRX60CM BRA SURG HOOK MICHELLE BLK XL BINDER DBL PNL WHT 9 BRA SURG COMP VEST BLK SM BRA SURG COMP VEST BLK MD BRA SURG COMP VEST BLK LG BRA SURG COMP VEST BLK XL Page 406 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,209.00 $1,067.00 $1,067.00 $1,107.00 $438.00 $438.00 $928.00 $390.00 $390.00 $166.00 $166.00 $642.00 $185.00 $501.00 $501.00 $488.00 $390.00 $361.00 $471.00 $970.00 $519.00 $595.00 $531.00 $104.00 $928.00 $183.00 $131.00 $1,787.00 $1,160.00 $1,000.00 $1,328.00 $1,114.00 $515.00 $743.00 $200.00 $242.00 $60.00 $278.00 $60.00 $427.00 $263.00 $231.00 $231.00 $231.00 $231.00 $231.00 2020 pricing Drugs&Supplies PROCEDURE NAME BRA SURG HOOK MICHELLE BLK MD BRA SURG HOOK MICHELLE BLK LG BRA SURG HOOK MICHELLE BLK SM BRA SURG COMP VEST BLK XS BRA SURG HOOK MICHELLE BLK 3XL BRA SURG HOOK MICHELLE BLK 2XL VEST COMP MALE BLK CATH URETRL WHISTLE TIP 5FR CATH CYST URETRL WHISTLE 6FR CATH CYST URETRL WHISTLE 5FR CATH CYST URETRL WHISTLE 10FR GDWIRE AQUALINE ANG .035 180CM GDWIRE BENTSON PTFE .038 150CM CATH MARINER 5FR *DISC* FORCEPS ILM REVOLUTION 25G+ CATH KUMPE 0.038 4FR 65CM KT NEVERTOUCH FBR 21G 65CM PROS VOICE CLASC 20FR 6MM BLADE TENDON STRIPPER 10MM ALLO PUTTY OSTEOAMP 1CC RETR TRAXI PANNICULUS RETR EXTNDR TRAXI PANNICULUS CATH SUPP MINNIE .035X150CM KT MICINTR NIT STIFF 4FR 21GX7 KT MICINTR NIT 4FR ECHO21GX4CM CATH SKY WAY OTW*OBS* CATH PRONTO EXTR 0.035 KT INTR MICRO 5FR 20G 15CM GRAFT ADVANTA PTFE 8MM 50CM GRAFT ADVANTA PTFE 7MM 50CM GRAFT ADVANTA PTFE 6MM 50CM GRAFT PTFE VXT 6MM 40CM GRAFT PTFE VXT 4-6MM 45CM GRAFT BIF 18X9MM 40CM PLATE FRAC 4HL 35MM PLATE FRAC 4HL 40MM PLATE FRAC 6HL 50MM PLATE FRAC 8HL 60MM PLATE MAND ANG RT XLNG PLATE MAND ANG LFT XLNG PLATE MAND ANG RT SHRT PLATE MAND ANG LFT SHRT PLATE FRAC EDCP 4HL 35MM PLATE FRAC EDCP 4HL 40MM SCREW CROSSDRIV MICRO1.5X3.5MM SCREW CROSSDRIV MICRO 1.5X4MM Page 407 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $287.00 $287.00 $287.00 $231.00 $392.00 $339.00 $287.00 $237.00 $206.00 $231.00 $231.00 $364.00 $66.00 $242.00 $764.00 $242.00 $991.00 $1,108.00 $2,398.00 $2,058.60 $258.00 $416.00 $679.00 $270.00 $482.00 $902.00 $2,468.00 $537.00 $2,466.00 $2,466.00 $2,466.00 $1,411.00 $1,612.00 $2,542.00 $663.00 $702.00 $874.00 $903.00 $1,022.00 $1,022.00 $923.00 $923.00 $763.00 $795.00 $194.00 $194.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CROSSDRIV MICRO 1.5X5MM SCREW CROSSDRIV MICRO 1.5X7MM SCREW CROSSDRIV EMER 1.8X3.5MM SCREW CROSSDRIV EMER 3.2X12MM PLATE ORB 8HL 0.6MM PLATE LINDORF LFT 3MM PLATE LINDORF RT 3MM PLATE LINDORF LFT 0 FLAT PLATE LINDORF RT 0 FLAT PLATE LINDORF RT 5MM PLATE LINDORF LFT 7MM PLATE LINDORF RT 7MM PLATE LINDORF LFT 9MM PLATE LINDORF RT 9MM PLATE LINDORF LFT 11MM PLATE LINDORF RT 11MM PLATE CHIN LINDORF 1MM PLATE CHIN LINDORF 3MM PLATE CHIN LINDORF 5MM PLATE CHIN LINDORF 7MM PLATE LINDORF LFT 5MM TEMPLATE MAND RECON ANG 21HL PLATE MAND RECON ANG LK 13HL VAC MINI WOUND PUMP NDLE EPIDURAL TUOHY 20GX152MM CATH URETRL CONNECT ADPTR PATCH ULTRAMAX*DISC 6128279* PATCH ULTRAMAX*DISC 6227251* GRAFT ADVANTA PTFE 7MMX80CM GRAFT ULTRAMAX *DISC 6141133* GRAFT ULTRA *DISC 6128284* GRAFT ULTRA*DISC 6140778* GRAFT ULTRA*DISC 6128283* GRAFT ULTRA *DISC 6141106* GRAFT ULTRA*DISC 6140872* GRAFT ULTRA*DISC 6141155* GRAFT ULTRAMAX *DISC 6140926* GRAFT ULTRAMAX*DISC 6128291* GRAFT ULTRA *DISC 6117087* GRAFT ADVANTA PTFE 6MMX70CM GRAFT ADVANTA PTFE 7MMX70CM GRAFT ADVANTA PTFE 8MMX70CM GRAFT ULTRA *DISC 6128287* GRAFT HEMAGARD BIF 16X8MM50CM GRAFT FLIXENE 4-7MMX45CM HIP STEM ECHO LAT 9X125MM Page 408 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $194.00 $194.00 $194.00 $423.00 $590.00 $963.00 $963.00 $963.00 $963.00 $963.00 $963.00 $963.00 $963.00 $963.00 $963.00 $963.00 $702.00 $702.00 $702.00 $702.00 $963.00 $215.00 $2,187.00 $411.00 $64.00 $118.00 $524.00 $448.00 $3,205.00 $1,141.00 $1,737.00 $1,737.00 $1,737.00 $1,737.00 $1,141.00 $1,141.00 $1,737.00 $1,430.00 $1,737.00 $3,001.00 $1,657.00 $1,657.00 $1,737.00 $1,614.00 $2,955.00 $4,161.00 2020 pricing Drugs&Supplies PROCEDURE NAME BLADE TENDON STRIPPER 11MM ALLO BIOCARTILAGE 1CC SCREW LK GORILLA 2.7X14MM HIP STEM POLARSTEM135D STD SZ1 KT INTR GASTRO MIC LOPRO 18FR MESH PARIETEX PROGRIP SGL15X10 MESH PROGRIP ANATOM RT 15X10CM ALLO BIOMEND EXT*USE 6181040* GRAFT GORE-TEX STD TW 4MMX70CM GRAFT GORE-TEX STD TW 8MMX70CM KT PEG NON BLN RPLC 20FR *NLU* SNARE TRAXTION 2.4MX230CM SYS OPUS MAGNUM SYS OPUS MINI MAGNUM SUT CARTRDG OPUS SMARTSTITCH SHEATH PNCLE 6FR 25CM SHEATH PNCLE .035 4FR 10CM SHEATH PNCLE 8FR 25CM PLATE DHS SHRT 135D 5HL 94MM PLATE DHS SHRT 135D 6HL 110MM SCREW CORT TI SLFTP 1.5X22MM SCREW CORT TI SLFTP 1.5X24MM PIN BTRS TI 1.8X18MM PLATE DCS 25BRL 95D 20HL 338MM PLATE DCS 25BRL 95D 18HL 306MM NAIL HUMR SOLID TI 9.5X26*OBS* NAIL HUMR SOLID TI 9.5X25*OBS* PLATE DHS SHRT 150D 5HL 94MM PLATE LC-ANG 90D 5HL 4.5X40MM PLATE TIB MEDL HI TOMOFIXTI4HL NAIL TI HUMR 8X150MM*OBS* NAIL TI PROX HUMR 7.5X15*OBS* GDWIRE THRD 3.0X230MM SCREW TI DUAL USS 4.0X45MM SCREW TI DUAL USS 5.0X45MM CONN TI EXT 6.0MM ROD TEMPLATE CTD 6.0MM PLATE TIB MEDL HI TOMOFIX TISM SCREW HDLSS CANN SHRT TI2.4X24 KT CMNT PCD VERTEBROPLASTY 13G KT CMNT PCD VERTEBROPLASTY 11G BLADE SAG THIN WIDE35X64X.89MM BUR RD DIMND 5X50.8MM PRSSZR CMNT TIB 90D BIT DRILL GRY PT 2.2X150MM BIT DRILL GRY PT 3.2X200MM Page 409 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $880.85 $2,528.40 $1,061.00 $4,161.00 $1,083.00 $1,423.00 $1,619.00 $907.00 $2,233.00 $2,233.00 $201.00 $203.00 $1,148.00 $1,148.00 $764.00 $128.00 $62.00 $128.00 $1,566.00 $1,566.00 $243.00 $243.00 $306.00 $3,188.00 $3,165.00 $2,801.00 $2,801.00 $1,566.00 $2,251.00 $2,827.00 $2,775.00 $2,775.00 $77.00 $2,505.00 $2,505.00 $2,235.00 $943.00 $2,827.00 $1,141.00 $1,922.00 $1,922.00 $269.00 $399.00 $65.00 $300.00 $276.00 2020 pricing Drugs&Supplies PROCEDURE NAME BIT DRILL GRY PT 2.2X100MM BIT DRILL GRY PT 4.5X200MM BIT DRILL GRY .187X5 GDWIRE BALL TIP 3X1000MM HIP HD MORSE LFIT MTL 32MM +0 BIT DRILL CANN ASNIS 3MM BIT DRILL 3.2X300MM STRYKER TEMPLATE MPS FLEX MATTA 18HL PLATE MATTA MPS FLEX 10HL118.5 BIT DRILL AO 3.1X285MM BIT DRILL ASNIS AO CANN 5.6MM HIP HD BIOLOX CER STRY 44MM -0 ROD CBN 15X150MM TB DYNAMIC BLU 20MM ROD CBN 15X200MM CLAMP EXTL FIX PIN YEL 15MM ROD CBN 15X250MM ROD CBN 15X300MM POST EXTL FIX H2 ANG 30D CLAMP EXTL FIX ROD/ROD H2 8MM CLAMP EXTL FIX PIN/ROD H2 8MM T-ADPTR EXTL FIX YEL 15MM DISTRAC COMP EXTL FIX YEL 15MM CLAMP EXTL FIX TB/TB BLU 20MM TB EXTL FIX CBN BLU 20X250MM CLAMP EXTL FIX SGL PIN BLU20MM CLAMP EXTL FIX PIN BLU 20MM T-ADPTR EXTL FIX BLU 20MM TB EXTL FIX CBN 300MM POST EXTL FIX H2 ST 8MM EXTL FIX PIN CLAMP 5HL EXTL FIX CLAMP TB/ROD 8MM EXTL FIX TB CBN 20X350MM EXTL FIX TB CBN 20X300MM EXTL FIX CLAMP SGL 15MM EXTL FIX TB CBN 20X200MM EXTL FIX ROD COMP DISTRAC TB EXTL FIX THUMBWHEEL 7MM KNEE TIB COMP SM 8MM KNEE FEM COMP SM KNEE TIB COMP MD 8MM KNEE FEM COMP LG KNEE TIB COMP LG 8MM KNEE FEM AVON PROS SM KNEE PTLA PROS SM KNEE FEM AVON PROS MD Page 410 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $716.00 $281.00 $330.00 $423.00 $1,466.00 $1,027.00 $380.00 $194.00 $1,449.00 $525.00 $1,054.00 $2,627.00 $678.00 $3,628.00 $678.00 $1,682.00 $678.00 $742.00 $1,048.00 $1,692.00 $2,181.00 $1,332.00 $2,377.00 $3,628.00 $3,628.00 $3,628.00 $3,628.00 $3,628.00 $3,628.00 $1,048.00 $1,776.00 $1,048.00 $3,628.00 $3,628.00 $1,754.00 $3,628.00 $1,048.00 $3,628.00 $2,570.00 $3,786.00 $2,570.00 $3,786.00 $2,570.00 $3,894.00 $991.00 $3,894.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE PTLA PROS LG HIP LNR TRID X3 PE 0D 36MM F SCREW ASNIS III STRY 6.5X95MM SCREW ASNIS III STRY 6.5X105MM HLDR PLATE STRY REAMER SHAFT STRY 450MM SCREW ASNIS III CANN 4.0X46MM SCREW ASNIS III CANN 4.0X60MM SCREW ASNIS III CANN 4.0X65MM SCREW ASNIS III CANN 4.0X40MM SCREW ASNIS III CANN 6.5X45MM SCREW ASNIS III CANN 6.5X60MM SCREW ASNIS III CANN 6.5X70MM SCREW CORT SLFTP 3.5X44MM PLATE DIST MEDL TIB LFT 4HL SCREW LK STRY 4X24MM SCREW ASNIS III CANN 6.5X90MM SCREW ASNIS III CANN 6.5X100MM NAIL FEM LFT 9X380MM NAIL FEM T2 11X440MM NAIL RECON RT 10X440MM SCREW RECON SET SCREW CANN TI 8.0X95MM PLATE DIST ANT TIB RT 10HL SHT MEDPOR MICRO 38X50X0.45MM SHT MEDPOR UT 50X76X0.85MM CAUT NDLE COLORADO 45D 3/32 CAUT NDLE COLORADO 45D 3 CAUT NDLE COLORADO ST 2CM GRAFT DURA SUB ONLAY 2.5X2.5CM BLADE ANG RESECTOR 4.5MM BLADE SLOTTED WHISKER 4.0MM BLADE HLX LFT 5.5MM BLADE TOMCAT CUT 5.0MM ELTD BUGBEE 5FR 65CM TB CROSSFLOW INTEGRATED INTR CATH 10.5FR INTR PACER 8FR SHEATH PEELAWAY 8FR CAP PACER TERMINAL SHEATH PACER HLS 8.5FR CBL PACER PLUG CONN SHEATH INTR PEELAWAY 12FR SHEATH INTR PEELAWAY 14CM SHEATH INTR PEELAWAY 14CM 11FR SHEATH INTR PACER 11FR Page 411 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $991.00 $2,627.00 $525.00 $525.00 $525.00 $751.00 $525.00 $525.00 $525.00 $276.00 $525.00 $525.00 $525.00 $525.00 $525.00 $751.00 $751.00 $751.00 $751.00 $751.00 $751.00 $751.00 $525.00 $525.00 $1,548.00 $1,843.00 $323.00 $396.00 $357.00 $1,271.00 $242.00 $242.00 $336.00 $242.00 $716.00 $492.00 $203.00 $203.00 $173.00 $172.00 $202.00 $414.00 $173.00 $173.00 $173.00 $203.00 2020 pricing Drugs&Supplies PROCEDURE NAME PPM IDENTITY ADX XL DR LEAD TENDRIL SDX 46CM LEAD TENDRIL SDX 58CM KT STYLET REPOSIT 46CM SHEATH INTR 8.5FR EXT CBL DISP JUDE PPM VERITY ADX SR M/S ANGIOSEAL STS PLUS US 6FR PPM ZEPHYR SR IS1 LEAD OPTISENSE 46CM SHEATH INTR PEELAWAY 10FR CBL PLUG SGL CBL EXT SJ4 8FT DRAPE PLEXUR M 44X44 ALLO CENTERPIECE STRUT 10MM ALLO CENTERPIECE STRUT 12MM ALLO PLEXUR M REG 10CM TB TRACH AIRE-CUF XLNG 8.0MM TB TRACH AIRE-CUF XLNG 7.0MM STAPLE FIX SM 7.9*USE 6156358* STAPLE FIX XS 6.3*USE 6156357* STAPLE FIX 5MM STAPLE FIX 10MM STAPLE FIX 14MM GD PIN THRD SHARP 2.4X279MM ARTHROWAND 70D WAND VULCAN ABLAT 90D KNIFE HOOK 3.0MM CAUT SWITCHPEN ELTD FAST FIX ST RVRS CURV SCREW BIORCI-HA 7X30 7MM SCREW BIORCI-HA 10X25MM PROBE SAPHYRE 90D 3MM ENDOBTN CL ULT 35MM ENDOBTN CL ULT 40MM ENDOBTN CL ULT 45MM ENDOBTN CL ULT 50MM ENDOBTN CL ULT 55MM ENDOBTN CL ULT 60MM SCREW BIORCI-HA 8X25MM KT RAP-PAC CRUC ACC WASHER SPIKED 21X6MM SCREW BIORCI-HA 9X25MM SCREW BIORCI-HA 10X35MM SCREW BIORCI-HA 7X25MM 8MM SCREW BIORCI-HA 7X25MM 7MM Page 412 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,118.00 $1,652.00 $1,652.00 $280.00 $902.00 $116.00 $4,422.00 $1,042.00 $6,653.00 $1,740.00 $173.00 $607.00 $126.00 $415.00 $1,973.00 $1,973.00 $3,398.00 $488.00 $488.00 $1,163.00 $1,163.00 $1,056.00 $1,056.00 $1,056.00 $166.00 $1,508.00 $708.00 $221.00 $265.00 $1,135.00 $1,067.00 $1,164.00 $858.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,000.00 $1,086.00 $1,164.00 $1,216.00 $561.00 $1,164.00 $1,067.00 $1,164.00 $1,164.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW BIORCI-HA 7X20MM 7MM PLATE CLAV SUPERIOR MEDL 8HL SCREW CORT SLFTP S&N 3.5X14MM SCREW CORT SLFTP S&N 3.5X12MM SCREW CORT LK SLFTP 3.5X10MM SCREW CORT LK SLFTP 3.5X12MM PLATE DIST LAT FIB RT 5HL SCREW CORT LK SLFTP 3.5X6MM SCREW CORT LK SLFTP 3.5X10MM SCREW CORT LK SLFTP 3.5X16MM SCREW CORT SLFTP 3.5X18MM KWIRE TROC S&N 1.25X150MM BIT DRILL 2.0X190MM KNEE TIB GENESIS II LFT SZ7 11 DEV EXTENDOBUTTON FIX KNEE TIB INSRT GSII SZ7-8 11MM KNEE TIB INSRT GSII SZ5-6 15MM KNEE TIB INSRT SZ3-4 9MM ENDOBUTTON CRUC ACC PAC BIT DRILL TWIST COLE 4.0MM PROST EAR SHEA CAP 1.5MM PROS GOLDENBERG TORP 7.9M*OBS* DRSG SPLT DENVER NOSE SM ALLO TUTOPLASTPERICARDIUM2X5CM PROBE ENDO PH 10CM PROBE ENDO PH 15CM TRAY PARACENTESIS TURKEL TB JEJ VIVONEX CATH 5FR SET SGL ACTN IRRI-FLO PUMP BLADE DIEGO ANG IRG CURV 60D TB MYRINGOTOMY BOBBIN 1.27MM SPHINCTEROTOME CLEVERCUT 7MM KT EMR 10-11MM BSKT RETRIEVAL SGL USE FORCEPS GRASPING KNIFE ELECSURG ITKNIFE2 KNIFE ELECSURG DUALKNIFE DISP TB VENT RICHARDS 1.27MM STNT QUADRACOIL 4.5FR 22-28CM TB PAPARELLA 1MM CATH DL 10FR 60CM ELTD CUT RT ANG 3FR 115CM TB MORETZ TYPE VENT 1.27MM TB DURAVENT ULTRASIL 1.27MM SET IRG DEL SYS I*USE 6262078* CAUT THUNDERBEAT 35CM 5MM Page 413 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,164.00 $2,022.00 $122.00 $122.00 $636.00 $636.00 $1,860.00 $615.00 $615.00 $615.00 $123.00 $181.00 $459.00 $2,608.00 $706.00 $2,376.00 $2,376.00 $2,976.00 $1,442.00 $1,121.00 $1,189.00 $1,376.00 $235.00 $1,561.00 $348.00 $348.00 $364.00 $364.00 $209.00 $589.00 $63.00 $651.00 $1,004.00 $1,043.00 $1,495.00 $1,797.00 $1,797.00 $124.00 $440.00 $62.00 $141.00 $1,255.00 $59.00 $124.00 $209.00 $1,545.00 2020 pricing Drugs&Supplies PROCEDURE NAME BAND SCLERAL BUCKLING 3X6 BAND SCLERAL BUCKLING 2.6X6 KT PERICARDCENT PIGT 8.3FR40CM CATH REUTER .038 5FR 80CM SYR EMBOSPHERE 100-300UM SYR QUADRASPHERE 400-600UM ELTD E-Z CLN LAP BALL 33CM HOOK LEGACY THORACIC RAMP SM HOOK LEGACY NARW TI LG HOOK LEGACY PEDICLE TI LG HOOK LEGACY PEDICLE TI SM HOOK LEGACY NARW TI MD RETR METRX 22MMX5CM CAGE VANTAGE ALTITUDE 22X21MM CAGE CENTERPIECE 25X68MM RETR METRX WIDE SUCT CONN VERTEX OFFSET OPEN 13MM KWIRE SPINE MDTR 5INX1MM CONN VERTEX OFFSET OPEN 10MM BLADE BEVI CATARACT 1.7X20.5MM MESH PARIETEX W SUT 15X10CM TROC VERSAPORT BLDLES 12MM MESH PARIETEX RD 8CM MESH PARIETEX RD 12CM DRAPE SENTINAL NODE BX SUT ETHIBOND 2-0 UCL SUT ETHILON 6-0 P-1 BLK 18 SUT PROLENE 2-0 MO6 30 SUT SILK 0 FSL 18 SUT SILK 4-0 BB 30 SUT CHROMIC 5-0 PS4 18 SUT VICRYL TN 0 SUT PDS II CP 2 DYE SUT ETHILON 10-0 BV75-4 SUT PDS II 0 CR CTX 18 DYE SUT VICRYL RAP 2-0 CT-1 36 SUT MONOCRYL 3-0 CT-1 DYE MESH PROLENE HERNIA SYS EXT SUT VICRYL+ 3-0 CP1 SUT STEEL 7 CCS SET IRG WARM NORMOFLO 2Y PK ENT CUST BZ PK LAPAROTOMY CUST BZ PK LAP CUST BZ PK D&C CUST BZ PK GEN ORTHO CUST BZ Page 414 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $287.00 $302.00 $658.00 $363.00 $1,031.00 $3,480.00 $224.00 $1,572.00 $1,572.00 $1,572.00 $1,572.00 $1,572.00 $1,301.00 $14,023.00 $14,023.00 $711.00 $1,461.00 $123.00 $1,461.00 $110.00 $1,572.00 $380.00 $1,572.00 $1,572.00 $301.00 $16.00 $18.00 $16.00 $9.00 $11.00 $32.00 $516.00 $16.00 $119.00 $96.00 $17.00 $11.00 $1,593.00 $9.00 $78.00 $258.00 $227.00 $389.00 $254.00 $158.00 $385.00 2020 pricing Drugs&Supplies PROCEDURE NAME PK ARTHRO CUST BZ PK CSECTION CUST BZ PK LAP CHOLE CUST BZ PK UPPER EXTREMITY CUST BZ PK LAMINECTOMY CUST BZ PK HIP PINNING CUST BZ PK LOCAL BASIC CUST BZ PK EYE CUST BZ SUT SURGITIE POLYSORB 0 21 ENDO ABSORORBTACK SHRT 5MM CATH FOLEY IC 3WAY 20FR *CIP* TB ENDOBRONCH SHILEY RT 41FR TB ET CUFF REINF MURPHY 6.0MM TB ET CUFF REINF MURPHY 6.5MM TB ET CUFF REINF MURPHY 7.5MM TB ET CUFF REINF MURPHY 8.5MM TB ET CUFF REINF MURPHY 9.0MM CATH FOLEY COUDE 2WAY*CIP* CATH FOLETY TEMP SENS EXT*CIP* CATH FOLEY TEMP SENS EXT*CIP* TB ET ORAL SEALGUARD EVAC6.0MM TB ET ORAL SEALGUARD EVAC6.5MM COLAR PHILADEL TRACH HL 2.25 S COLAR PHILADEL TRACH HL 2.25 L KT CATH QUAD LUM CVC 8.5FRX6 KT CATH QUAD LUM CVC 8.5FRX20 BLN IAB 8FR 50CC SHNT CAROTID W T PORT 9FR SHNT CAROTID W T PORT 8FR BIT DRILL TWIST KL*USE 6150687 TB GASTRO MIC BLN 7-10ML 20FR TB GASTRO MIC BLN 7-10ML 24FR SYS ENTERAL DIL PEELAWAY 24FR SYS ENTERAL DIL PEELAWAY 22FR CANN RF CURV MARKER22G 10X100 CANN RF ST 22GX100MM CANN RF CURV MARKER20G10X100MM CANN RF CURV 20G*DISC 6280103* NDLE SPINAL CRAWFORD 20GX3.5 KT PED CAUDAL MINI*DISC* KT GJ MIC ENDO 18FR 22CM KT PROBE SINERGY 17G 150MM KT INTR MIC J 16FR*USE 6268738 CANN RF ST MARKER 22G 4X54MM KT INTR JEJ/GJ MIC 18FR TB GASTRO MIC BLN 3-5ML 16FR Page 415 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $343.00 $402.00 $476.00 $338.00 $488.00 $324.00 $310.00 $349.00 $112.00 $1,555.00 $76.00 $319.00 $107.00 $107.00 $107.00 $107.00 $107.00 $88.00 $95.00 $110.00 $189.00 $189.00 $96.00 $96.00 $415.00 $416.00 $2,390.00 $2,122.00 $2,122.00 $839.00 $174.00 $174.00 $538.00 $538.00 $127.00 $107.00 $127.00 $123.00 $43.00 $190.00 $1,078.00 $2,172.00 $1,083.00 $127.00 $1,083.00 $174.00 2020 pricing Drugs&Supplies PROCEDURE NAME ANCHOR HEALIX TI 5.5MM CATH VISTA NR4 6FR 100CM CATH ADRIOT AR1 SH 6FR 100CM CATH ADRIOT 3DRC 6FR 100CM SPLT NASAL SILASTIC REG ALLO PERICARDIUM BULLET1X2.5CM ALLO PERICARD TUTOPLAST 2X3CM NDLE ULTRSND ECHOSTIM21GX150MM PILLCAM SB CAMERA DISP EYELID IMPLT PLAT 1.2GM EYELID IMPLT GLD 1.2GM STNT MONOKA MINI STNT MONO CRAWFORD 3MM GLOVE RADIATION EPIM PF 8.0 GLOVE RADIATION EPIM PF 7.5 GLOVE RADIATION EPIM PF 9.0 GLOVE RADIATION EPIM PF 6.5 GLOVE RADIATION EPIM PF 7.0 SLV RADIATION REDUCING LG CATH TUN-L-XL 24 KT EKOSONIC INFUS 106CM 40CM KT EKOSONIC INFUS 106CM 50CM HYDRAJAW INPUT 33MM SET SHNT CAROTID W/ T STOPCOCK KT CATH CENTVEN DL 7FR KT CATH CENTVEN DL 8.5FR KT PREP W/ RESTRICTORS PIN LK HNG 2XS KNEE FEM STEM BOW 14.5X150MM CATH DL PALINDROME 19CM CATH DL PALINDROME 23CM CATH DL PALINDROME 28CM CATH MAHURKAR 11.*USE 6274926* GDWIRE RDRN PC ST STIFF0.035 8 AIRW CATH EXCHANGE DL14FR100CM SET ART PRSS PEDS ST 2.5FR 2.5 DEV ADV VEN ACCESS BRA SURG CHMPGN 24 BTL PLEURX DRN 500ML DILATOR ACHALASIA 35MM DILATOR ACHALASIA 30MM GDWIRE JAGWIREHYDRA STIFF260CM BLN CRE 10-12MM 5.5CM CATH CENTVEN GROSHONG DL 9.5FR KT CATH GLIDEPATH 14.5FR 19CM KT CATH GLIDEPATH 14.5FR 23CM Page 416 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,424.00 $208.00 $208.00 $208.00 $84.00 $1,243.00 $1,578.00 $65.00 $1,605.00 $1,472.00 $1,091.00 $331.00 $406.00 $205.00 $186.00 $186.00 $173.00 $173.00 $1,652.00 $389.00 $5,312.00 $5,312.00 $135.00 $264.00 $227.00 $268.00 $992.00 $1,885.00 $12,404.00 $1,394.00 $1,394.00 $1,394.00 $604.00 $211.00 $331.00 $211.00 $674.00 $203.00 $295.00 $1,883.00 $1,883.00 $788.00 $1,029.00 $1,000.00 $377.00 $377.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT CATH GLIDEPATH 14.5FR 27CM KT CATH GLIDEPATH 14.5FR 31CM TRAY CATH TRIALYSIS ST 15CM TRAY CATH TRIALYSIS ST 20CM TRAY CATH TRIALYSIS ST 30CM PORT CHRONOFLEX TI 8FR CATH HEMODIAL HICK 13.5FR 36CM GRAFT ADVANTA PTFE 6MMX80CM SUCT FLOOR FELT PD ARTHROVAC BIT DRILL BIO-SUTURE TAK 2.4MM WASHER ARTX 7MM SCREW LK LOPRO TI 4.5X24MM SCREW LK LOPRO TI 4.5X26MM SCREW LK LOPRO TI 4.5X28MM SCREW LK LOPRO TI 4.5X38MM SCREW LOPRO TI 5.5X40MM PLATE FUSN ANK LAT TT SCREW LK LOPRO TI 4.5X30MM SCREW LK LOPRO TI 4.5X36MM GDWIRE SPRING ST J 0.025 45CM KT CATH PERC ENTRY 8.5 GDWIRE SPRING ST J 0.025 68CM KT CENTVEN JUGULAR PUNC PEDS VEN ACCESS PORT CT MINI 6.6FR KNIFE SLIT SGL BEVEL ANG 2.4MM BLADE AOK ST BEVEL UP 2.3MM PK EYE ADAMS CUST BZ CRYOPROBE RENAL 3.8MM TIP DRILL SPIRAL CANN ACUTRAK DEL SYS 9FR 45/80 NAIL FEM T2 9X280MM NAIL FEM T2GTN STRY RT11X400MM PLATE OLEC ACUM STD LFT 7H SCREW LK LOPRO TI 4.5X40MM SCREW LK LOPRO TI 4.5X45MM SCREW LK LOPRO TI 4.5X50MM SCREW LOPRO TI 5.5X60MM KWIRE FIX T2 WCH CTD 3X285MM NAIL SLV INSRT STER 8-11SPI NAIL TIB T2 STRY STD 10X315MM PLATE SUPERIOR CURV LFT7HL88MM FINGER IMPLT NEUFLEX PIP SZ4 NAIL FLEX T2 CURV 4.0X450MM NAIL TFNA TI 130D 12X170MM NAIL TFNA TI LFT 130D12X340MM HIP LNR ALTRX PE 0D 40X62MM Page 417 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $377.00 $377.00 $1,087.00 $1,087.00 $1,087.00 $1,015.00 $865.00 $3,441.00 $54.00 $438.00 $175.00 $947.00 $947.00 $947.00 $947.00 $392.00 $4,368.00 $947.00 $947.00 $58.00 $539.00 $56.00 $121.00 $1,170.00 $141.00 $102.00 $853.00 $3,786.00 $1,147.00 $1,419.00 $3,183.00 $3,708.00 $2,965.00 $947.00 $947.00 $947.00 $392.00 $338.00 $338.00 $338.00 $2,279.00 $2,475.00 $1,041.00 $3,356.00 $7,907.00 $2,376.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE HUMR POST LAT RT 5HL CBL BUTTON NCB HEX DRIVE 2.5MM PLATE PROX FEM LFT 15HL 324MM SCREW CORT SLFTP NCB 4.0X46MM SCREW CORT SLFTP NCB 5.0X50MM SCREW CORT SLFTP NCB 5.0X42MM NDLE RIGID ENDO 3.8FRX14.5 BIT DRILL CANN 2MM BIT DRILL TWIST 1.6MM PLATE DIST VOLAR 5PEG 5HL SHLDR RETENT REV INSRT 36MM+6B SHLDR REV TRAY +6 3.5MM SHLDR CMNT HUMR 9X180MM 130D SCREW BONE STABILIS 4.5X24MM BONE MID FUSN GRY 3.3X6MM BONE MID FUSN GRY 3.8X6MM DRN T TB SIL SGL 12X1.14MM SPACER CERV CORNERSTN8X16X14MM SPACER CERV CORNERSTN6X16X14MM ALLO CENTERPIECE STRUT 18MM ALLO DBM PUTTY PROGENIX+ 2.5ML ALLO DBM PUTTY PROGENIX+ 10ML ALLO CENTERPIECE STRUT 14MM ELTD CUT LOOP GRN 24FR ELTD CUT LOOP BLU 22FR 0.25MM SYS SHEATH DISP 6X210MM*NLU* MESH MEDPOR TITAN MTM38X50X1.5 SUT SILK 4-0 TF4 18 STAPLE RELOAD GIA 90 PREM ENDOSHEARS LNG 5MM MESH PERMACOL 10X15X1.5 COLAR CERV PHILADELPHIA LRG 5. HARNESS PAVLIK SM ALLO PLEXUR M LG KWIRE DBL TROC OSTE 0.045X4 PLATE HAND FUSN 2.0MM SCREW FUSN 2.4X20MM SCREW NL 2.0X9MM SCREW NL 2.0X12MM SCREW NL 2.0X11MM BIT DRILL OSTE 1.5MM KT ORTHOFIX WRIST ELTD CUT LOOP RT ANG 24FR CAUT ELTD KNIFE 24FR KNIFE BLADE COLD SERR BSKT SUR-CATCH NIT 3.0FR Page 418 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,725.00 $1,029.00 $4,158.00 $761.00 $1,097.00 $1,097.00 $173.00 $749.00 $587.00 $2,548.00 $5,271.00 $3,367.00 $15,303.00 $754.00 $1,031.00 $1,031.00 $122.00 $2,932.00 $2,932.00 $1,973.00 $1,567.00 $3,086.00 $1,973.00 $1,205.00 $1,205.00 $101.00 $2,689.00 $13.00 $506.00 $377.00 $7,080.00 $60.00 $91.00 $5,308.00 $173.00 $2,508.00 $1,472.00 $465.00 $465.00 $465.00 $902.00 $3,440.00 $354.00 $597.00 $789.00 $860.00 2020 pricing Drugs&Supplies PROCEDURE NAME NDLE INJ 27G 105CM STNT URETRL LUBRIFLEX 6FRX20CM KT GENTLETOUCH JACKSON TBL ELTD NDLE EZ CLN 33CM CONN DOMINO 3.2 TO 5.5MM MASK FACE TENET ALLO ANTERIOR TIB TENDON MESH PROCEED OVAL 20X25CM KT BX LIVER PRCD*DISC 6273597* DRN SURETRANS PLATE DIST HUM LAT LF 9HL PLATE OLECRANON SM 10HL 79MM SCREW LOPRO 3.5X18MM SCREW LOPRO 3.5X46MM SCREW SOLID CORT FT 2.7X50MM KT BRACHY TEMPLATE 18G TB BUTTON GASTRO 18FR 2.4CM TB BUTTON GASTRO 18FR 3.4CM CATH SMART PORT CT DETACHED8FR KT PORTACATH INTR 8FR 14CM PIN CASPAR DISTRAC 12MM SCREW LNG TAP TIP 3.5MM SCREW LNG TAP 2.7MM DRAPE PELVIC FLO*DISC NO RPLC* CUFF URINARY AMS 800 5.5CM IZ MASK AF531 EE LEAK 1 ELBOW SM SCREW SET SOLERA PERC 4.75MM SCREW ILSC 3.5X26MM SCREW SURFIX ILSC 3.5X20MM SCREW SURFIX LNG 3.5X12MM SCREW LK SYST 3.5X18MM RAD HD KATALYST 18MM RAD HD KATALYST 21MM RAD HD KATALYST 24MM SET SCREW KATALYST STEM REPL RAD KATALYST STEM SHAFT 6.5 RAD KATALYST STEM SHAFT 7.5 SCREW ILSC 3.5X24MM DRSG MTX BILYR 4X10IN=258SQCM MTX MESH INFORCE 6.5X9CM PLATE COMP UNICP 4 HL 25MM SCREW SURFIX ILSC 3.5X16MM PROTECT NEURAWRAP 7MMX4CM SCREW SURFIX ST 3.5X14MM SCREW BOLD COMP 3.0X28MM BIT DRILL ILSC 2 IN 1 18MM Page 419 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $324.00 $422.00 $170.00 $224.00 $1,865.00 $147.00 $4,843.00 $4,229.00 $112.00 $663.00 $2,982.00 $2,892.00 $376.00 $376.00 $329.00 $75.00 $1,134.00 $1,134.00 $1,170.00 $203.00 $480.00 $582.00 $651.00 $302.00 $10,225.00 $137.00 $408.00 $991.00 $991.00 $991.00 $991.00 $2,636.00 $2,636.00 $4,211.00 $348.00 $3,773.00 $4,211.00 $2,960.00 $8,985.00 $5,589.00 $3,195.00 $1,103.00 $8,985.00 $2,960.00 $2,960.00 $2,960.00 2020 pricing Drugs&Supplies PROCEDURE NAME MTX DURAL DURAGEN PLUS 1X3 PROTECT NEURAWRAP 5MMX4CM GD NERVE NEURAGEN 6MMX3CM (3U) GD NERVE NEURAGEN1.5MMX3CM(3U) GD NERVE NEURAGEN 7MMX2CM (2U) KWIRE ILSC 1.0X100MM CELL SAVER FAST PK HIGH VOL MESH PARIETEX W SUT 25X20CM SMART PIN BIOABSORB1.5X30MM SYS TIB APERFIX II 8X30MM MESH ALLOMAX 6X20CM MESH ALLOMAX 6X12CM KNEE SIG M PKA GDE/MDL MP MD GRAFT BONE SYN GENEX 5ML ALLO DBM PUTTYOSETOSELECT10ML ALLO OSTEOSPNGFILLER4-10 300ML ALLO OSTEOSPNG FILLER SYR 15ML GD PIN TG 2.0MM KNEE PTLA FEM ARTICU 20MM1X3MM KNEE PTLA FEM FIX STUD8.5X17MM KNEE PTLA FEM TROCHLEAR3.5X2MM KNEE PTLA FEM TROCHLEAR 7X5MM KT KNEE GD PIN PFXL ANCHOR SPEEDLOCK PEEK 3.4MM PROBE LASER ILLUM 23G LOOP MEMBRANE FINESSE FIX HANDPC INJ IOL MONARCH III PK CONSTELLATION W VISCOAT 23G SYS ENTRY ENHANCED 23G PROBE VITRECTOMY ULTRAVIT 23G PROBE DIATHERMY DSP 25G PK CONSTELLATION FRAG TIP 20G CANN IRG SOFT SIL FLAT TIP 23G TIP BACKFLUSH SOFT 23G FORCEPS MICRO IOL HOLDING 21G KNEE FEM SPACER RT MD SZ3 4MM KNEE FEM SPACER RT LAT SZ3 4MM NDLE BX BIOPINCE COAX 17GX20CM SHLDR HUMR STEM REV 9X130MM SUT PP ST CIONNI FIX 9-0 SHLDR HUMRSTEM CMPRHNSV FRAC 4 SHLDR HUMR FX SLV ZIMM SZ7 SHLDR HUMR FX SLV ZIMM SZ9 GD PIN 3X75MM SCREW NL 3.5X28MM SCREW LK FIXED ANG 3.5X26MM Page 420 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,646.00 $8,985.00 $3,472.00 $8,985.00 $3,472.00 $2,960.00 $1,028.00 $3,068.00 $733.00 $1,466.00 $6,387.00 $4,050.00 $2,208.00 $2,700.00 $2,603.00 $4,295.00 $2,776.00 $449.00 $1,781.00 $1,688.00 $9,280.00 $9,280.00 $902.00 $1,508.00 $1,210.00 $881.00 $902.00 $1,999.00 $658.00 $1,184.00 $289.00 $293.00 $147.00 $542.00 $2,157.00 $2,828.00 $2,828.00 $83.00 $16,346.00 $203.00 $4,770.00 $844.00 $844.00 $1,201.00 $862.00 $862.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW LK FIXED ANG 3.5X30MM SCREW LK FIXED ANG 3.5X32.5MM PLATE CLX CALC STD LFT BIT DRILL CLX VP 2.4MM KWIRE ORSD 1.6MM SHLDR HUMR STEM LNG 6B 115MM SCREW LOPRO TI 4.5X38MM SCREW LOPRO TI 4.5X50MM SCREW LOPRO TI 5.5X35MM SCREW LOPRO TI 5.5X50MM TB ENDOBRONCH SHILEY LFT 41FR TRAY BX JAMSHIDI MENG16GX100MM SUT VICRYL+ PS-2 5-0 BRC KNEE POST OP 15 BRC KNEE POST OP SHRT BRC KNEE POST OP LNG PK CONSTELLATION VCF CAUT ACCUTEMP *DUP 6207496* SCREW CROSSDRIVE MINI 2.0X5MM CAUT CURV MONOP ROB XI RPSB CAUT FORCEPS BIPOLR MARY ROBXI FORCEPS BIPOLR FEN ROB XI RPSB DRIV NDLE SUTCUT ROB XI MEGA FORCEPS PROGRASP ROB XI RPSB DRIV NDLE ROB XI RPSB LG SEAL UNIV DISP ROB XI 5-8MM SEAL VESS DISP ROB XI STAPLER RELOAD ROB XI GRN 45MM STAPLER RELOAD ROB XI BLU 45MM DRAPE ARM ROB XI BLN INFL DEV SINUS SE STAPLER RELOAD ROB XI WHT 45MM STAPLER SHEATH DISP ROB SI45MM CANN REDUCER DISP ROB XI 8MM ROB XI STAPLER CANN SEAL 12MM STAPLER ROB XI RPSB 45MM HIP SCREW G7 LOPRODOME6.5X50MM TRAY UNIV BLOCK HAHE SCREW CORT LK 3.5X56MM BINDER ABD 9IN MD BINDER ABD 12IN 3XL ENDO TACKER 30 CAPSURE 5MM CATH TRAY CENTVEN STD ST 5FR12 CATH TRAY CENTVEN STD ST4FR5CM ALLO BONE CHIPS 4-10MM 15CC CATH TRAY CENTVEN STD ST4FR8CM Page 421 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $862.00 $862.00 $3,308.00 $786.00 $65.00 $16,346.00 $413.00 $392.00 $392.00 $392.00 $276.00 $155.00 $19.00 $379.00 $389.00 $385.00 $334.00 $65.00 $186.00 $1,193.60 $1,044.90 $1,044.90 $1,190.40 $1,091.20 $1,091.20 $104.40 $1,838.55 $905.40 $905.40 $287.56 $413.00 $905.40 $114.80 $135.52 $114.80 $721.00 $197.75 $105.00 $844.00 $101.00 $71.00 $1,240.00 $490.00 $490.00 $1,308.00 $490.00 2020 pricing Drugs&Supplies PROCEDURE NAME KT DRN PLEURAL ASPIRA STARTER KT CATH PERITON ASPIRA GDWIRE COPE MANDRIL NIT.018X40 GDWIRE HIWIRE STD ST.035 150CM GDWIRE NITREX INTRMD.018 80CM SYS DURASEAL SPINE SEAL 5ML MESH PARIETEX W SUT 30X20CM SYS O'REGAN LIGATOR BIT DRILL CANN PRGN 2.6X130MM SCREW LK GORILLA 3.5X20MM FORCEPS CADIERE ROB XI RPSB SCREW POST BI CORT 4.5X32.5MM KT HIP PORTAL ENTRY DISP SHLDR HUMR STEM APEX 6X60MM SHLDR HUMR STEM APEX 7X60MM SHLDR HUMR HD UNIV II 50X19 KT SYS ACCUMIX ZIMM CAUT HOOK ROB XI RPSB DRSG SPLT DENVER NOSE LG RAPID INFUSOR RSVR 3L RAPID INFUSOR DUAL PT LINE TRAY SPINAL ARROW 24G BZ ENDO GRSPR MINI LAP GRN ALLO FIB STRUT 70MM ALLO DBM PUTTY PROGENIX+ 5ML ALLO DBM PUTTY PROGENIX+ 1ML PIN STEINMAN TROC BLNT 9/64 BZ GLOVE LNR REPEL LITE PF LG N 3332-040 EA1 BZ GLOVE LNR REPEL LITE PF XL DRAPE MICROSCOPE EYES MESH PARIETEX 20X15CM BUR FLUTED ACORN 7.5MM ALLO BONE TISS HUM SHAFT ALLO BONE CORT STRUT 2X20CM ALLO BONE TISS FEM SPLIT ALLO BONE ILIUM TRICORT 58MM SHLDR PIN ECLIPSE UNIV II BIT DRILL PHOE BIT DRILL CANN FLEX LG 16MM BIT DRILL TAPERED 10MM BIT DRILL STD ORSD 2.4MM CLIP STIMULATION/ACTIVATOR PROBE STIMULATION NUVA BLN CATH FORTREX 6FR7X40MM80CM BLN CATH FORTREX6FR8X40MM80CM Page 422 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,801.00 $2,801.00 $399.00 $173.00 $118.00 $2,254.00 $3,656.00 $364.00 $800.00 $1,044.73 $1,041.60 $511.00 $1,259.00 $8,110.00 $8,110.00 $3,583.00 $1,145.00 $992.00 $235.00 $541.00 $58.00 $107.00 $738.00 $2,449.00 $2,645.00 $1,251.00 $65.00 $300.00 $3,426.00 $300.00 $80.00 $2,478.00 $912.00 $2,235.00 $2,092.00 $2,538.00 $3,981.00 $1,034.00 $1,005.00 $2,159.00 $1,563.00 $1,118.00 $1,404.00 $1,446.28 $875.50 $875.20 2020 pricing Drugs&Supplies PROCEDURE NAME ALLO MTX GRAFIXPRIME5X5CM=25SQ SCREW NL HEXALOBE 3X10MM BREAST EXPAND FULL XTR 650CC HOOK LEGACY RAMP WIDE TI MD SCREW CORT LK ARTX 3.5X32MM PAD GEL METATARSAL MD SET FORCEPS BX TRANSLUMIN BILI SCREW LOPRO TI 4.5X32MM SCREW LOPRO TI 4.5X36MM FUNNEL MAM KLMD KT APEX UNIV SUT REPAIR SUBCAP CATH SGL COUDE VISICAL 7FR SCREW CANN LNG THRDARTX 4X48MM BIT DRILL SOLID MEASURE LNG2MM BIT OVERDRILL SCREW 2.7MM SHLDR SIMPLICITI NUCLEUS SZ2 SHLDR SIMPLICITI NUCLEUS SZ3 SHLDR HUMRHD SIMPLICITI41X15 SHLDR HUMRHD SIMPLICITI46X17 SHLDR HUMRHD SIMPLICITI48X18 SHLDR HUMRHD SIMPLICITI50X16 SHLDR HUMRHD SIMPLICITI50X19 SHLDR HUMRHD SIMPLICITI52X19 SHLDR HUMR STB SIMPLICITI44X15 SHLDR HUMR STB SIMPLICITI48X18 SHLDR HUMR STB SIMPLICITI48X21 DEV TISS REMOV MYOSURE LITE SCREW LOPRO TI 4.5X30MM TB SURG HAND SCRUB BLU CANISTER VAC FREEDOM 300ML PSTNR HD SILVERMAN MRI SZ B SCREW HEX HD 3.5X38MM STNT PROS SPANNER 20FR SZ8 STNT PROS SPANNER 20FR SZ9 ALLO MTX GRAFIXPRIME *DISC* ALLO MTX GRAFIXCORE *DISC* CATH DRN MALECOT SIL 20FR 25CM KNEE PSN ASF MC VELFT14MM4-5CD KNEE PSN ASF MC VELFT10MM6-7CN KNEE PSN ASF MC VELFT11MM6-7CN KNEE PSN ASF MC VELFT12MM6-7CN KNEE PSN ASF MC VELFT14MM6-7CN KNEE PSN ASF MC VELFT10MM6-7EF KNEE PSN ASF MC VELFT11MM6-7EF KNEE PSN ASF MC VELFT12MM6-7EF KNEE PSN ASF MC VELFT13MM6-7EF Page 423 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,896.00 $488.00 $3,378.70 $2,028.00 $579.00 $99.00 $2,019.00 $392.00 $413.00 $757.05 $1,344.00 $276.00 $812.00 $782.58 $797.00 $9,222.00 $8,450.00 $5,123.00 $5,379.00 $5,256.00 $4,977.00 $5,123.00 $5,250.00 $5,123.00 $4,977.00 $5,219.00 $2,109.00 $392.00 $561.00 $203.00 $159.00 $203.00 $1,735.00 $1,735.00 $4,632.00 $4,632.00 $189.00 $2,975.00 $2,975.00 $2,819.00 $2,975.00 $2,819.00 $2,819.00 $2,975.00 $2,975.00 $2,975.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE PSN ASFMCVELFT10MM 8-11EF KNEE PSN ASF MCVELFT11MM8-11EF KNEE PSN ASF MCVELFT12MM8-11EF KNEE PSN ASF MCVELFT11MM8-11GH KNEE PSN ASF MCVELFT12MM8-11GH KNEE PSN ASF MC VELFT11MM12 GH KNEE PSN ASF MC VELFT12MM12 GH KNEE PSN ASF MC VELFT14MM12 GH KNEE PSN ASF MC VERT10MM4-5CD KNEE PSN ASF MC VERT11MM4-5CD KNEE PSN ASF MC VERT12MM4-5CD KNEE PSN ASF MC VERT16MM4-5CD KNEE PSN ASF MC VERT10MM6-7 CD KNEE PSN ASF MC VERT11MM6-7 CD KNEE PSN ASF MC VERT12MM6-7 CD KNEE PSN ASF MC VERT13MM6-7 CD KNEE PSN ASF MC VERT12MM6-7 EF KNEE PSN ASF MC VERT10MM8-11 E KNEE PSN ASF MC VERT11MM8-11 E KNEE PSN ASF MC VERT12MM8-11 E KNEE PSN ASF MC VERT10MM8-11 G KNEE PSN ASF MC VERT11MM8-11 G KNEE PSN ASF MC VERT13MM8-11 G KNEE PSN ASF MC VE RT10MM12 GH KNEE PSN ASF MC VE RT14MM12 GH SHLDR BASEPLATE THRD 25X35MM BREAST SMTH RESPONSE FULL560CC SCREW CANN TRMI 3.0X26MM SCREW LK HEXALOBE 3X45MM BREAST SMTH RESPONSEMODER240CC BIT DRILLCANN 3/16SQ 4.6X220 ARTHROWAND TOPAZ EZ SCREW CANN LK PRECICE 5.0X40MM SCREW CANN LK PRECICE 5.0X45MM BIT DRILL 4MMX52MM BIT DRILLT5MMX355MM FACIAL IMPLT SURGIFORM 17X19CM FACIAL IMPLT SURGIFORM 17X19CM BLADE DUAL EDGE CUT 3.5MM ROD CHROME ST 5.5X500MM CATH 3WAY 75MM 22FR BLN ADV LOPRO18 7X80MMX4CM KWIRE DBL DIMND SMTH 0.035X9 KWIRE DBL DIMND SMTH 0.045X9 KWIRE DBL DIMND SMTH 0.062X9 KWIRE DBL DIMND THRD 0.035X9 Page 424 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,975.00 $2,975.00 $2,975.00 $2,975.00 $2,975.00 $2,975.00 $2,960.00 $2,819.00 $2,975.00 $2,819.00 $2,975.00 $2,975.00 $2,975.00 $2,960.00 $2,975.00 $2,975.00 $2,975.00 $2,407.00 $2,975.00 $2,819.00 $2,975.00 $2,975.00 $2,975.00 $2,819.00 $2,819.00 $3,463.33 $2,329.00 $1,252.35 $781.00 $2,222.00 $1,243.00 $1,130.00 $1,019.00 $1,019.00 $1,019.00 $1,019.00 $966.00 $966.00 $453.00 $3,493.00 $153.00 $1,243.00 $106.00 $103.00 $106.00 $394.00 2020 pricing Drugs&Supplies PROCEDURE NAME KWIRE DBL DIMND THRD 0.045X9 KWIRE DBL DIMND THRD 0.062X9 TRAY PRCD MAXIMAL STER BARR CATH PICC TURBOJECT STDSL3FR40 KNIFE CLEARCUT SIDEPORT ANG1.5 KNIFE CLEARCUT DUAL BEVEL 2.75 PHACO TIP LAMINAR FLOW 30D 21G SLV W/TEST CHAMBER LAMINAR 21G HOOK MD TIP HOOK MD WIDE BLADE KNEE TIB CONSTRUCT LFT SZD3 INTR ADELANTE PEELAWAY 7FR45CM CATH URETRL CONE TIP 4.8FR70CM EXTR STONE ATLAS OCCL 2.8FR115 GDWIRE AMPLZUSTIFFFIX0.038 145 KNIFE VITRECTOMY ST 20G SCREW LK FIXED ANG 3.5X16MM SCREW LK FIXED ANG 3.5X14MM SCREW LK FIXED ANG 3.5X18MM CATH SLIP-CATH SIM1 5FR 100CM SUCT TB KAMVAC MINI CURV FLTR VENA CAVA OPTEASE FEM SPACER PERIMETER PEEK8D 24MM PESSARY CUBE W DRN NO 7 SCREW DELTA PEEK 12X35MM PLATE FEM OPEN 12.5MM SCREW NL 3.5X18MM REAMER CONCAVE 18MM PLATE STD RT BIT DRILL PERC FLEX 6-9MM CANN TONNARD HARVESTER LUER CATH CHAIT CECOSTOMY10.2FR20CM KT INTR JEJ/GJ MIC 16FR KT INTR JEJ/GJ MIC 18FR GDWIRE AMPLZ XSTIFF ST.035 300 BUR ACORN*DISC NO REPLACEMENT* DEV BX PREC CORE 18G 15CM DERMIS DECEL 2.0MM 4X7CM=28SQ BLADE OXFORD CMNT KEEL DERMIS DECEL 3.0MM 4X7CM=28SQ SCREW LK GORILLA 3.5X14MM HIP LNR ALTRX PE 0D 40X60MM CATH LAPCHOLE 4.8MM 23CM ARCH BAR ERICH RL SUT BIOSYN 3-0 C-14 UNDY*CIP* PK CATARACT CUST BZ Page 425 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $394.00 $394.00 $230.00 $807.00 $77.00 $101.00 $438.00 $118.00 $3,484.00 $3,098.00 $4,985.00 $152.00 $68.00 $849.00 $159.00 $121.00 $748.00 $748.00 $748.00 $781.00 $272.00 $2,989.00 $5,075.00 $243.00 $1,198.00 $2,327.00 $862.00 $1,172.00 $3,000.00 $1,715.00 $248.00 $1,960.00 $1,082.00 $1,082.00 $153.00 $289.00 $230.00 $7,667.00 $1,047.00 $7,970.00 $1,044.73 $2,373.00 $630.00 $174.00 $51.00 $839.00 2020 pricing Drugs&Supplies PROCEDURE NAME DRAPE OPH BLU NW SOL PROVISC 0.40ML CARTRDG B MONARCH ALCO CAP REFORM T RING 13.0/11MM KNIFE ACCURATE DEPTH 600MCRN KNIFE XSTAR SGL BEVEL45D2.75MM BLADE MICRO SAG COARSE VALV GLAUCOMA AHMED MODEL S2 PUNCH CORNEAL VACUUM 7.00MM PUNCH CORNEAL VACUUM 7.25MM PUNCH CORNEAL VACUUM 7.50MM PUNCH CORNEAL VACUUM 7.75MM PUNCH CORNEAL VACUUM 8.00MM PUNCH CORNEAL VACUUM 8.25MM PUNCH CORNEAL VACUUM 8.50MM PUNCH CORNEAL VACUUM 8.75MM PUNCH CORNEAL VACUUM 9.00MM PUNCH CORNEAL VACUUM 9.25MM PUNCH CORNEAL VACUUM 9.50MM TREPHINE EYE PTADJVACUUM8.25MM TREPHINE EYE PTADJVACUUM9.0MM TREPHINE EYE PTADJVACUUM9.5MM SUT MONOFIL NYLON 10-0 BLK 12 SUT MONOFIL NYLON 10-0 BLK 6 ALLO AMNIOGRAFT 1.5X1.0CM ALLO AMNIOGRAFT 2.0X1.5CM ALLO AMNIOGRAFT 2.5X2.0CM ALLO AMNIOGRAFT 3.5X3.5CM DEV CORNEA BIOLOGIC PROKERA BNDG CORNEASLIMBIOLOGICPROKERA PEG THRD MULTDIRE*USE 6208207* PEG THRD MULTDIRE*USE 6208208* PROBE MEASURE ARTHRO 60D 220MM BREAST SMTH RESPONSEMODER485CC ANCHOR PEEK SUT TAK 3X12.7MM CATH URETRL CONE TIP 7FR 70CM STNT UNIVERSA FIRM 7FR 24CM STNT UNIVERSA FIRM 7FR 26CM STNT UNIVERSA FIRM 7FR 28CM STNT UNIVERSA FIRM 8FR 24CM STNT UNIVERSA FIRM 8FR 26CM SET STNT SOFFLEX BANDER8.2FR75 EXTR STONE ATLAS OCCL 4.5FR65 REAMER SHAFT STRY 8.0X448MM DRN JP RD SIL W TROC 19FR HIP LNR XLPE PE 0D 36X62MM Page 426 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $68.00 $165.00 $59.00 $1,021.00 $111.00 $767.00 $1,282.00 $1,820.00 $658.00 $658.00 $658.00 $658.00 $658.00 $658.00 $658.00 $658.00 $658.00 $658.00 $658.00 $525.00 $561.00 $561.00 $151.00 $147.00 $1,850.00 $2,034.00 $2,230.00 $2,468.00 $2,505.00 $2,505.00 $953.00 $953.00 $972.00 $2,222.00 $1,397.55 $65.00 $287.00 $287.00 $287.00 $287.00 $287.00 $287.00 $287.00 $751.00 $71.00 $1,972.08 2020 pricing Drugs&Supplies PROCEDURE NAME HIP CENTRALIZER DIST INVIS11MM KNEE PSN ASF CPS LFT 16MM6-9GH NDLE SET EZ-IO PD 15GX15MM NDLE SET EZ-IO LD 15GX45MM PORT CLEARVUE SIL SLIM 8FR KNEE INSRT JIIBCSLFTSZ3-4 11MM END CAP TFNA TI STER 0MM BREAST SMTH RESPONSEXFULL700CC DRN JP RD SIL HBLS 30CH 15FR DRN BLAKE FLAT FLUTED 7MM KNEE PSN ASF UC VE RT11MM-12IJ NAIL FLEX 3.5X450MM CAUT E-Z CLN HAND CTRL MEGA ELTD E-Z CLN L WIRE 33CM ELTD E-Z CLN L HOOK REAMER CUP 14MM REAMER CONE 14MM PLATE MINI MAXLOCK MTP RT SCREW FIXED LK 2.7X8MM SCREW FIXED NL 2.7X22MM SCREW FIXED LK 2.4X10MM SCREW FIXED LK 2.4X16MM BIT DRILL ORSD 1.6MM SCREW NEXA SNAPOFF 2.0X12MM TRNQT STERICUFF W SLV 12IN TRNQT STERICUFF W SLV 8IN TRNQT STERICUFF W SLV 34IN TRNQT STERICUFF W SLV 42IN TRNQT STERICUFF W SLV DUAL18IN TRNQT STERICUFF W SLV DUAL24IN FLIPCUTTER II ARTX SHRT 11.0MM FLIPCUTTER II ARTX SHRT 12.0MM FLIPCUTTER II ARTX SHRT 7.0MM FLIPCUTTER II ARTX SHRT 7.5MM FLIPCUTTER II ARTX SHRT 8.0MM FLIPCUTTER II ARTX SHRT 8.5MM FLIPCUTTER II ARTX SHRT 9.0MM FLIPCUTTER II ARTX SHRT 10.0MM FLIPCUTTER II ARTX SHRT 9.5MM PAD FOR HANA POS*USE 6274302* PIK ILLUM W/RFID 23G SHLDR HUMR INSRT REV +6 36MM SHLDR STEM HUMR REV XL 11X210 SHLDR REV INSRT 42MM +9 B SCREW CORT SLFTP TI 1.0X3MM PLATE MESH TI 4.0MM 38X42MM Page 427 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $77.00 $4,652.00 $614.00 $614.00 $1,466.00 $4,317.76 $1,144.00 $2,345.00 $85.00 $87.00 $2,819.00 $1,012.00 $176.00 $221.00 $253.00 $1,502.00 $1,502.00 $4,842.00 $764.00 $764.00 $764.00 $565.00 $1,117.00 $1,205.00 $97.00 $86.00 $142.00 $154.00 $172.00 $187.00 $1,171.00 $1,171.00 $1,242.00 $1,242.00 $1,242.00 $1,242.00 $1,242.00 $1,242.00 $1,242.00 $403.00 $581.00 $2,430.00 $12,876.00 $2,370.00 $587.00 $3,500.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT SLFTP TI 1.3X4MM DRSG NASOPORE FIRM 8CM HIP LNR G7 PE DUAL 50MM SZ H CPLE ROD/ROD DELTA HOFFMAN3 CLAMP EXTLFIX HOFFMAN3 5HL POST EXTLFIX HOFFMAN3 30D 11MM CPLE PIN/ROD HOFFMAN3 SHLDR LAT HUMR INSRT 36X6MM SCREW CORT SLFTP TI 1.3X6MM SCREW CORT SLFTP TI 1.3X8MM PLATE PROX LAT HUM 3HL HIP SHELL OSSEOTI 4HL G 58MM HIP LNR G7 PE DUAL 46MM SZ G SCREW CORT LK ARTX 3.5X34MM SHLDR SCREW CMPRHNSV 6.5X40MM STAPLER ENDO VASC*CIP* SCREW LK LOPRO TI 4.5X42MM REAMER SHAFT STRY 8X510MM NAIL FEM LFT 11X440MM HIP LNR G7 PE DUAL 44MM SZ F KNEE PSN FEM CR STD RT SZ6 KNEE TIB INSRT RT SZ1-2 9MM KNEE FEM SPACER RT LAT SZ2 4MM KNEE FEM NKII NONPOR RT SZ2 KNEE FEM SPACER RT MD SZ2 4MM ALLO BONE CHIPS 4-10MM 15CC ALLO BONE CHIPS 4-10MM 30CC BONE CORNERSTONE LORDOTIC 6MM BONE CORNERSTONE LORDOTIC 7MM BONE CORNERSTONE LORDOTIC 8MM BLADE SAG NO OFF12.5X1.19X81.5 WAND SURFAC HOOK XL SCREW ASNIS III CANN 4.0X44MM SCREW CNCL STRY 4X20MM NAIL TFNA TI RT 130D 10X380MM SCREW MINI HDLSS SHRT 4.0X44MM PLATE TIB PROX LK RT 5HL LG HOOK CAP RIB TI SYNT SM XLNG SCREW TSRH OSTEOGRIP 5.5X55MM SCREW CORT MDSH 5X40MM GDWIRE TROC TIP 3.1X400MM BIT DRILL MDSH 4MM GDWIRE BEAD TIP 3.1X500MM BLADE SYNVASIVE 90X13X0.89MM PLATE FEM OPEN WEDGE 10.0MM PORT CLEARVUE SLIM 8FR Page 428 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $550.00 $1,041.00 $4,221.00 $1,775.00 $1,863.00 $534.00 $1,757.00 $3,315.00 $578.00 $578.00 $2,974.00 $3,492.00 $4,020.00 $599.15 $584.00 $915.00 $952.00 $1,208.00 $3,887.00 $4,221.00 $8,669.00 $5,164.00 $3,162.00 $15,555.00 $3,162.00 $1,316.00 $1,706.00 $2,938.00 $2,938.00 $2,938.00 $227.00 $742.00 $717.00 $132.00 $4,186.03 $1,158.00 $3,672.00 $3,506.00 $1,973.00 $1,700.00 $1,005.00 $1,429.00 $1,005.00 $843.00 $2,328.00 $1,466.00 2020 pricing Drugs&Supplies PROCEDURE NAME BREAST SMTH RESPONSEXFULL750CC BLN CATH SPIN PLUS 5X16 BLN CATH SPIN PLUS 6X16 DRN FLAT HUBLESS TROC 10MM SCREW LK GORILLA TUFF 3.5X30MM HIP STEM POLARSTEM135D STD SZ7 KT CANISTER FLUID CTRL AQUILEX MESH PHASIX ST 20X25CM SUT PROLENE 6-0 BV1 DBL ARM OBTR BLDLES DISP ROBXI STD 8MM OBTR BLDLES DISP ROBXI LNG 8MM BREAST SMTH RESPONSEXFULL580CC REAMER MTP SPINGUARDFEMALE23MM REAMER MTP SPINGUARD MALE 23MM SCREW COMP GORILLA 4.2X28MM PLATE MTP GORILLA MD RT 0D NAIL FEM RT 9X400MM PIN VERSITOMIC STER LOOP ADJ PROCINCH STD TENSION SHLDR HUMR STEM LNG 2B 93MM SCREW LOPRO TI 5.5X45MM BIT DRILL CANN 3.0MM HIP SHELL OSSEOTI 3HL D 50MM HIP SHELL OSSEOTI 4HL F 54MM HIP SHELL OSSEOTI 4HL H 62MM HIP SHELL OSSEOTI MULT F 54MM HIP SHELL OSSEOTI MULT F 56MM HIP SHELL OSSEOTI MULT H 64MM HIP LNR G7 PE DUAL 40MM SZ D TRACKER PT AXIEM NIV HIP STEM POLARSTEM126D LAT SZ3 KNEE LEGION CR INSRTSZ7-8 10MM PIN GENESIS TROCAR 1/8X3 KNEE LEGION CR INSRTSZ5-6 11MM PIN RIM SPEED ST 65MM BREAST SMTH RESPONSEXFULL495CC BREAST SMTH RESPONSEXFULL545CC BREAST SMTH RESPONSEXFULL650CC NAIL FEM LFT 10X360MM SCREW LK AXSOS TI 5X60MM SCREW LK AXSOS TI 5X65MM SCREW LK AXSOS TI 5X70MM BIT DRILL NL SHRT 3.2X216MM BIT DRILL LK SHORT 4.3X216MM SHLDR GLENOIDSPHERE 2MM29X36MM SCREW LEGACY ILIAC 6.5X70MM Page 429 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,329.00 $4,197.00 $4,213.00 $61.00 $1,103.00 $5,326.00 $116.00 $17,030.00 $503.00 $104.40 $104.40 $2,286.50 $1,447.00 $1,447.00 $1,022.00 $5,913.00 $3,702.00 $1,175.00 $1,559.00 $10,136.00 $392.00 $947.00 $6,984.00 $7,113.00 $6,984.00 $8,590.00 $8,434.00 $8,590.00 $4,140.60 $995.94 $5,425.00 $8,341.00 $175.00 $2,886.00 $665.00 $2,345.00 $2,222.00 $2,222.00 $3,702.00 $212.00 $1,081.00 $1,081.00 $1,097.00 $1,097.00 $7,472.00 $2,596.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW TSRH OSTEOGRIP 5.5X60MM PLATE MTP GORILLA 2SHRT LFT 0D PLATE MTP GORILLA 2SHRT RT 0D PLATE MTP GORILLA SHT LFT 0D PLATE MTP GORILLA LNG LFT 0D PLATE MTP GORILLA 2SHRT RT 10D PLATE MTP REV SHRT RT 5D SCREW LK GORILLA 2.7X15MM SCREW MNSTR CANN SHRT 4.5X50MM SCREW MNSTR CANN SHRT 7.0X78MM KWIRE GD 1.4MM KWIRE GD 7.0MM BIT DRILL CANN3/16SQ 2.9X140MM KNEE PSN ASF CPS LFT 12 6-9EF SCREW LK GORILLA 3.5X36MM SCREW NL GORILLA 2.7X14MM SCREW NL GORILLA 2.7X15MM SCREW NL GORILLA 2.7X16MM SCREW NL GORILLA 3.5X12MM SCREW NL GORILLA 3.5X14MM SCREW NL GORILLA 3.5X26MM SCREW NL GORILLA 3.5X38MM NAIL FEM T2 10X420MM HIP NECK KINECTIV ST B SCREW BIOSURE PK 6X20MM ANCHOR HEALI PK ULTTP ULTBR5.5 SYS MULTIFIX S PEEK 5.5MM KNEE LEGION CR INSRTSZ5-6 10MM SCREW NL GORILLA 4.2X14MM SCREW NL GORILLA 4.2X16MM SCREW NL GORILLA 4.2X42MM SCREW COMP GORILLA 4.2X22MM SCREW COMP GORILLA 4.2X24MM SCREW COMP GORILLA 4.2X26MM SCREW COMP GORILLA 4.2X30MM SCREW LK LOPRO TI 4.5X22MM PLATE FEM OPEN WEDGE 11.0MM SHLDR GLENOID EXAT LFT MD HIP LNR R3 XLPE PE 0D 32X50 PLATE FIB ST 4HL PLATE FIB CLUSTER LFT 7HL ENDOL EXCLUDER ILIAC 12MMX10CM ENDOL EXCLUDER ILIAC 14.5MMX10 ENDOL EXCLUDER INTRL ILIAC12X7 ENDOL EXCLUDERINTRLILIAC14.5X7 SYS CONSTELLATION VISION 25G Page 430 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,973.00 $3,268.48 $3,432.00 $3,432.00 $3,467.06 $3,403.95 $3,934.09 $1,055.00 $1,143.00 $1,706.00 $1,182.00 $1,182.00 $962.00 $2,975.00 $1,103.00 $879.00 $879.00 $862.75 $907.00 $911.00 $907.00 $911.00 $3,409.00 $1,973.00 $1,246.00 $2,168.00 $2,766.00 $2,414.00 $954.00 $949.00 $949.00 $996.96 $996.96 $1,017.00 $968.82 $947.00 $2,090.00 $3,659.00 $2,324.00 $3,060.00 $4,830.00 $20,496.00 $20,496.00 $5,702.00 $5,702.00 $614.00 2020 pricing Drugs&Supplies PROCEDURE NAME KWIRE W STOP STRY 2MM PLATE RECON ST 15HL4.5X284MM SCREW 5.5 EXP VERSE 5.0X95MM KNEE TIB INSRT SZ 7-8 9MM KNEE TIB INSRT SZ 1-2 9MM SCREW CANN TRMI 2.3X20MM COUNTERSINK 2.3MM NAIL TFNA TI RT 130D 10X400MM BIT DRILL CINCHLOCK FLEX PIN STEINMAN MDSH 3.1MM BIT DRILL CANN 7MM BIT DRILL CANN 9MM BIT DRILL 5MM SCREW CORT MDSH 5X30MM SCREW HDLSS PA MDSH 5X75MM NAIL FUSN TTC MDSH 12MMX22CM PLUG PERFIX LT LG 4.1X4.8CM6CA SHLDR REV INSRT 42X6X12.5MM KNEE PSN ASF UCVE LFT13 9-12CD STKNT SYN TERRY-NET 2X15YD BIT DRILL SUTTAK ARTX 2.6MM ANCHOR BIO SUT TAK ARTX 3X12.7 WASHER FOR SCREW ARTX 14MM KNEE LEGION CR INSRTSZ3-4 12MM SYR HEALON OVD 0.85ML PLUG PERFIX LT SM 2.5X3.4CM6CA KNEE FEM PSN STD LFT SZ8 NAILEX LAT ENTRY TIRT8.2X300MM NAILEX LAT ENTRYTILFT8.2X280MM PLUG PERFIX LT MD 1.3X1.6 CA6 PLUG PERFIX LT XL 1.5X2 CA6 MESH PHASIX ST 10X15CM PLUG PERFIX LT SM 1X1.4 PLATE PEANUT ARCH 16MM SCREW PEANUT 32MM PLATE DIST FEM LFT 15HL 317MM SCREW CORT SLFTP 5.0X60MM SCREW CORT SLFTP 5.0X70MM KWIRE TROC TIP ZIMM 2X280MM SHLDR CMNT HUMR STEM 6.5X150MM SHLDR HUMR STEM LNG 8B 125MM SUT TAPE 1.3MM TAPER WHT/BLU36 SCREW CANN TRMI 2.3X28MM KNEE FEM JII BCS OXIN RT SZ5 KNEE TIB BASE JOURNEY RT SZ4 KNEE INSRT JII BCSRTSZ3-4 10MM Page 431 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $85.00 $1,953.00 $2,551.62 $2,414.00 $2,414.00 $1,051.00 $641.00 $4,183.03 $885.00 $1,005.00 $1,700.00 $1,700.00 $1,429.00 $1,700.00 $1,897.00 $24,938.00 $860.00 $2,370.00 $2,407.00 $547.05 $547.05 $1,499.00 $510.00 $2,414.00 $336.00 $843.00 $8,669.00 $3,094.00 $3,094.00 $853.00 $995.00 $5,605.00 $860.00 $1,510.00 $784.00 $4,249.00 $1,154.00 $1,154.00 $169.00 $5,775.00 $10,136.00 $202.00 $1,170.00 $4,317.76 $2,957.00 $2,353.75 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR R3 XLPE PE 0D +4 40X58 HIP HD OXIN MTL 40MM KNEE TIB INSRT SZ3-4 11MM PIN CERCLAGE NONTHRD 3.5MM PLATE PROX TIB LK RT 9HL STD SCREW CNCLS LK FT 4.0X36MM CAGE VERTE-STACK 16X14X5MM BONE PLUG ALLEN 28MM/32MM KNEE TIB TRABEC CONELFTMD55X36 KNEE FEM CONE LFT LG 35MM SUT STRFX PDS 0 CT1 45CM EXPAND MAM X-PROJ W TABS 400CC SURGICLIP PREM III S-9.0 SCREW CORT SLFTP 2.4X34MM SCREW CORT SLFTP 2.4X36MM SCREW CROT SLFTP 2.4X38MM SCREW CORT SLFTP 2.4X40MM PLATE MAND LK TI LFT6X21HL2.0M NDLE CYSTO INJWILLIAMS3.7FR23G KNEE FEM PSN STD RT SZ8 KNEE LEGION CR INSRTSZ5-6 12MM KNEE LEGION CR INSRT SZ5-6 9MM SIZER MAM 410FX RPSB 410CC SPACER INTERBODY SM 12D 16MM SCREW LK T8 FULL THRD 2.7X16MM SCREW VARIAX NL T8FULL2.7X14M SCREW VARIAX NL T8FULL2.7X16MM SCREW VARIAX NL T8FULL2.7X18MM SCREW LOPRO TI 5.5X65MM HIP STEM MALRY LAT131.5D13X170 SCREW QK SNAP 2.0X14MM RDCTN TOOL THRD HEX 3.5X78MM PROS PENILE AMS700 CXR MS 16CM BIT DRILL AXSOS 2.3X125MM PLATE SUPERIOR CURV RT 6HL75MM SCREW LK AXSOS 3.0X14MM PLATE ONE THIRD TUBLR 6HL 76MM HIP LNR R3 XLPE 0D +4 36X56MM PIN EXTL APEX SLFTP 4X120MM PIN EXTL APEX TRANSFIX 5X300MM KNEE TIB BASE JOURNEY RT SZ8 BREAST SMTH RESPONSE LOW 125CC NDLE INJ KLEINSASSER LL ST HIP LNR R3 XLPE PE 0D +4 40X64 BIT DRILL RFLCT FLEX 50MM SIZER MAM 410FX RPSB 690CC Page 432 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,986.00 $2,171.00 $2,414.00 $731.00 $3,744.00 $889.00 $2,590.00 $958.00 $10,382.00 $11,828.00 $124.00 $3,461.00 $302.00 $1,166.00 $1,654.00 $1,166.00 $1,654.00 $3,822.00 $142.00 $8,669.00 $2,414.00 $2,414.00 $146.00 $13,942.00 $835.01 $656.62 $656.62 $656.62 $392.00 $4,631.00 $1,492.00 $841.37 $17,986.00 $297.00 $2,281.00 $399.00 $660.00 $2,015.00 $534.00 $616.00 $2,957.00 $2,222.00 $403.00 $2,015.00 $799.00 $146.00 2020 pricing Drugs&Supplies PROCEDURE NAME BTN ABS TIGHTROPE CONCAVE 14MM KNEE FEM JII BCS OXIN RT SZ6 KNEE INSRT JII BCSRTSZ5-6 10MM TOE PROS ANATOEMIC 20MM KWIRE ANATOEMIC 2.8MM BREAST SIL 410 FULL MODER395CC PAD FOR HANA POST BIT DRILL TRMI 1.8MM KNEE TIB BASE JOURNEY LFT SZ8 KNEE FEM JII BCS OXIN LFT SZ5 KNEE TIB BASE JOURNEY LFT SZ5 KNEE INSRT JII BCSLFTSZ5-6 9MM NAIL SLV INSRT STER 8-13SPI SCREW CRANFAC SLFTP 1.5X4MM SCREW CRANFAC SLFTP 1.5X6MM PLATE DIST FEM RT 12HL 278MM SCREW CORT SLFTP 5.0X85MM SCREW CORT SLFTP 5.0X90MM SCREW MINI HDLSS SHRT 3.0X22MM BIT DRILL CANN AO 2X120MM KWIRE SGL TROC SMTHPRGN1.1X150 SCREW QK SNAP 2.7X14MM KT MENISC ROOT REPAIR SIZER MAM SRX RPSB 545CC ALLO OSTEOCEL PRO 1CC KNEE TIB BASE JOURNEY RT SZ6 KNEE FEM JII BCS OXIN RT SZ7 SPINAL CONN LAT VERTEX ANG19MM PLATE TIB STRY LFT 2HL 95MM SCREW LK SLFTP 4.0X65MM SCREW LK SLFTP 4.0X70MM SCREW LK SLFTP 4.0X80MM SCREW LK SLFTP 4.0X85MM PLATE TIB ANT LAT NARW RT 15HL HIP LNR R3 XLPE PE 0D 40X60 HIP SLV TI MODULAR 12/14 -4 HIP LNR XLPE PE 0D 36X52MM KNEE TIB INSRT MRH 24MM SCREW MINI SHRT THRD 4.0X38MM PLATE DIST FEM RT 18HL 355MM SCREW CORT SLFTP NCB 5.0X55MM SCREW UNICORT 5.0 X10MM SCREW CANN STRY 6.5X80MM SCREW CANN STRY 6.5X70MM SCREW LK ILIAC ARM15T DEV TIB WASHERLOC ZIMM 18MM Page 433 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,134.00 $4,402.00 $2,353.75 $2,102.00 $41.00 $2,836.00 $397.00 $641.00 $2,957.00 $4,317.76 $2,957.00 $2,353.75 $352.00 $984.00 $1,046.00 $4,113.00 $1,154.00 $994.00 $1,047.00 $1,145.00 $141.00 $1,250.00 $2,612.00 $146.00 $1,814.00 $2,957.00 $4,317.76 $1,703.00 $3,063.00 $647.00 $647.00 $647.00 $647.00 $4,169.00 $2,015.00 $1,190.00 $2,015.00 $3,078.00 $1,231.32 $4,449.00 $1,154.00 $1,054.00 $1,078.00 $1,078.00 $408.00 $1,415.70 2020 pricing Drugs&Supplies PROCEDURE NAME CANN PASSPORT BUTTON 12MMX3CM CAUT PENCIL W SMOKE EVAC SHEATH DRYSEAL FLEX 16FR 33CM SHEATH DRYSEAL FLEX 18FR 33CM SHEATH DRYSEAL FLEX 12FR 33CM KNEE FEM CR VNGD LFT SPACER ELVTE STD 8X8MM SPACER ELVTE STD 32X8MM SPACER ELVTE STD 23X8MM SPACER ELVTE STD 23X9 MM SPACER ELVTE STD 28X9MM SPACER ELVTE STD 32X9MM SPACER ELVTE STD 23X10MM SPACER ELVTE STD 28X10MM SPACER ELVTE STD 2X10MM SPACER ELVTE STD 23X11MM SPACER ELVTE STD 8X11MM SPACER ELVTE STD 2X11MM SPACER ELVTE X-LOR 23X7MM SPACER ELVTE X-LOR 28X7MM SPACER ELVTE X-LOR 32X7MM SPACER ELVTE X-LOR 23X8MM SPACER ELVTE X-LOR 28X8MM SPACER ELVTE X-LOR 32X8MM SPACER ELVTE X-LOR 23X9MM SPACER ELVTE X-LOR 28X9MM SPACER ELVTE X-LOR 32X9MM SPACER ELVTE X-LOR 23X10MM SPACER ELVTE X-LOR 28X10MM SPACER ELVTE X-LOR 32X10MM SPACER ELVTE X-LOR 23X11MM SPACER ELVTE X-LOR 28X11MM SPACER ELVTE X-LOR 32X11MM HARVESTER CARRAWAY14G2.1X1.7MM RELOAD XTHN GRY 2.0X30MM RELOAD MD TAN 2.0X30MM RELOAD CURV GRY 2.0X30MM RELOAD CURV MD TAN 2.0X30MM STAPLE RELOAD XTHK BLK2.0X45MM RELOAD CURV XTHN GRY 2.0X45MM RELOAD CURV MD TAN 2.0X45MM RELOAD XTHK BLK 2.0X60MM KT VALV SUCT AIR/WATER SCREW VOYAGER EXT TAB 6.5X50MM KT KNEE SCP BONE FILLER SCREW SOLERA MAS 7.5X70MM Page 434 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,120.00 $130.00 $1,347.00 $1,621.00 $1,130.19 $15,116.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $9,222.00 $235.00 $977.00 $774.00 $1,061.00 $915.00 $1,041.00 $991.00 $1,031.00 $1,143.00 $3.00 $2,436.00 $12,984.00 $2,439.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW SOLERA MAS 7.5X80MM SCREW SOLERA MAS 7.5X60MM SCREW SOLERA MAS 8.5X70MM SCREW SOLERA MAS 8.5X80MM SCREW SOLERA MAS 8.5X90MM CONN SPINE 6-6.0 CLSD LAT 20 CONN SPINE 6-6.0 CLSD LAT 35 SCREW CANN 3.75X30MM PLATE LAT HOOK RT 12X68MM 5HL SCREW LK LOPRO TI 4.5X18MM SCREW LK T10 FULL THRD3.5X14MM SCREW BONE T10FULLTHRD3.5X24MM BIT DRILL AO 2.6X135MM BREAST SIL 410 FULL XFULL615CC BREAST SIL 410 FULL XFULL775CC KNEE FEM JII BCS OXIN RT SZ8 KNEE INSRT JIIBCSLFTSZ5-6 12MM KNEE TIB BASE JOURNEY LFT SZ6 HIP SHELL PNCLE DEEPGRIPTN54MM NAIL FEM T2GTN STRY RT12X360MM SYS PROSTRATE UROLIFT SHLDR REV INSRT 42X9X12.5MM ENDOBLADE PLANTER FASCIA REL SCREW GORILLA R3CONLK2.7X15MM SCREW GORILLA R3CONLK2.7X16MM KNEE FEM NKII NONPOR RT SZ4 KNEE TIB NKII ULT RT SZ3 11MM BREAST SIL 410 LOW FULL 390CC SIZER MAM SRL RPSB 380CC TRAY SHLDR REV TH +6 EC O NAIL FEM LFT 9X420MM SCAFFOLD SERI SURG 5X15 ALLO MTXGRAFIXPRIMEDISC16MM2SQ SIZER MAM 410FF RPSB 535CC SIZER MAM SRX RPSB 700CC SIZER MAM 410FX RPSB 615CC CONN CLSD MDTR 5.5X5.5MM SCREW TSRH OSTEOGRIP 8.5X55MM SHLDR COMP SCREW 30MM PLATE CENTERPIECE LAT HL 14MM SPACER PERIMETER 8D 10X26X21MM SPACER PERIMETER 8D 8X26X21MM SCREW CORT SLFTP NCB 5.0X26MM BREAST SMTH RESPONSE LOW 460CC BIT DRILL QK CPLE 2.5MM PLATE DIST FEM LFT 18HL 355MM Page 435 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,439.00 $2,439.00 $2,439.00 $2,439.00 $2,445.00 $2,025.00 $2,025.00 $984.00 $3,389.00 $948.00 $836.00 $462.00 $399.00 $2,974.00 $2,789.00 $4,192.00 $2,353.75 $2,957.00 $7,625.00 $3,702.00 $2,515.50 $2,833.00 $2,407.55 $1,075.08 $474.68 $4,104.00 $5,100.00 $2,993.00 $991.00 $2,260.00 $3,702.00 $0.00 $520.00 $991.00 $991.00 $991.00 $1,878.00 $1,347.00 $321.00 $1,384.00 $5,075.00 $5,075.00 $1,154.00 $2,766.00 $731.00 $4,491.00 2020 pricing Drugs&Supplies PROCEDURE NAME BIT DRILL LABRAL SWIVELOCK 3.5 ANCHOR PEEK PLK SHRT2.9X12.5MM SUT LABRALTAPE WHT/BLK 1.5MM36 SCREW BONE T10FULLTHRD3.5X28MM SCREW LK LOPRO TI 4.5X48MM NAIL TFNA TI RT 130D 10X360MM BIT DRILL MTX J-LATCH 1.4X6MM BIT DRILL MTX J-LATCH 1.4X8MM SCREW TSRH 3DX MPA 6.5X50MM HIP LNR XLPE PE 0D 36X58MM SPACER CERV ANATOMIC 9X14X11MM MANIP UTERINE V-CARE PLUS MD SUT FBRTAK FBRWIRE CL WHT/BLU2 KT FBRTAK SPEAR OBTR CURV1.6 NAIL FEM T2 GTN LFT 10X400MM SIZER MAM 410FX RPSB 450CC SIZER MAM SRX RPSB 525CC CAGE PEEK VBS MDTR 12X30MM SCREW TSRH OSTEOGRIP 4.5X50MM KNEE FEM JII CR OXIN LFT SZ5 KNEE TIB BASE JOURNEY LFT SZ4 KNEE INSRTJII DEEPLFTSZ3-4 9MM BLN TB DIL EUSTACHAIN SYSSZ6MM BLADE SPECTRUM LOPRO DISP #1 BLADE SPECTRUM LOPRO DISP #2 SCREW MINI SHRT THRD 3.0X24MM KNEE LEGION CR INSRTSZ3-4 10MM ALLO FILLER ACCUFILL BSM 3CC CANN SIDE DEL 11GX120MM SCREW GORILLA R3CONLK2.7X14MM SCREW GORILLA R3CONLK2.7X12MM KWIRE DBL TROC 1.1X150MM SCREW VARIAX LK T8 2.4X16MM SCREW VARIAX LK T8 2.4X22MM SCREW VARIAX LK T8 2.4X18MM BIT DRILL AO 2X135MM KNEE INSRT JII BCS RTSZ3-4 9MM SIZER MAM SRLP RPSB 220CC SIZER MAM SRL RPSB 125CC SIZER MAM SRL RPSB 170CC SIZER MAM SRL RPSB 200CC SIZER MAM SRM RPSB 240CC KNEE FEM JII BCS OXIN LFT SZ6 KNEE FEM JII BCS OXIN LFT SZ8 KNEE INSRT JII BCSLFTSZ7-8 9MM KNEE FEM JII BCS OXIN LFT SZ7 Page 436 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $561.00 $1,299.00 $348.00 $453.99 $999.00 $4,181.80 $1,220.00 $1,220.00 $1,737.00 $2,015.00 $2,255.00 $451.09 $1,141.00 $1,005.00 $3,702.00 $991.00 $991.00 $5,482.00 $1,347.00 $4,411.00 $2,973.00 $2,414.00 $3,816.99 $287.56 $287.56 $1,177.00 $2,398.00 $4,211.00 $1,540.00 $474.68 $1,075.08 $133.68 $835.01 $835.01 $835.01 $391.14 $2,353.75 $987.00 $987.00 $987.00 $987.00 $987.00 $4,402.00 $4,317.76 $2,353.75 $4,317.76 2020 pricing Drugs&Supplies PROCEDURE NAME BREAST SMTH RESPONSE LOW+220CC SCREW ANK FIXR UNIL TLR BIT DRILL 3.2X200MM ROD TI ALLOY 5.5X500MM CAGE HYPR LORD 20D 8X34X24MM SCREW COROENT XLR-F 4.5X25MM STNT LACRIMAL MONOKA MD 4MM KNEE PSN FEM CR STD RT SZ12 SCREW CANN FULL ARTX 3.75X40MM SCREW CANN PART ARTX 3.75X72MM SET CATH TSPEC 0-14CMBLADE18FR INJ SPOON TIP 2.11X1.7X15CM COUNTERSINK CANN 3.0MM BIT DRIL TRMI 2.3X120MM MESH GALASHAPE 3D 6.4X18.5CM MANIP UTERINE V-CARE PLUS LG SHLDR HUMR INSRT ECCN36X12X2MM MESH AMNION MTX THIN 4X4CM DEV FUSN COROENTXL+10D10X18X60 DEV FUSN COROENTXL+10D10X18X55 DEV FUSN COROENT XL+10D9X18X55 PLATE BRIGADE 18X38X28MM 12D SCREW CORORENT XLR-F4.5X22.5MM BLADE PRECEPT FASCIAL SPLITTER KWIRE PRECEPT NIT BEVEL TIP KWIRE PRECEPT NIT THRD TIP SCREW PRECEPT SET ROD PRECEPT TI ST 210MM ROD PRECEPT TI ST 200MM SCREW PRECEPT PA 7.5X70MM SCREW PRECEPT PA 7.5X50MM SCREW PRECEPT PA 7.5X45MM SCREW PRECEPT PA 6.5X50MM SCREW PRECEPT PA 6.5X45MM SIZER MAM SRF RPSB 560CC BIT DRIL G FORCE 2.5MM SCREW LK ILSC 3.5X35MM HIP STEM REDAPT STD 240MM SZ16 BREAST SMTH COHESIVE 295ML SHLDR GLENOID UNIV CLEAT MD SIZER MAM SRL RPSB 350CC SIZER MAM SRM RPSB 485CC KWIRE RECON STRY 3.2X400MM NAIL RECON LFT 10X420MM SCREW RECON LAG T2 6.5X100MM SHLDR HUMR HD LOW 39X14MM Page 437 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,140.00 $15,566.00 $978.00 $861.00 $1,023.00 $11,747.00 $173.00 $6,722.00 $1,012.00 $1,012.00 $2,102.00 $208.00 $880.25 $607.20 $2,562.00 $88.00 $2,764.00 $4,532.00 $9,981.00 $9,981.00 $9,981.00 $10,847.00 $1,023.00 $2,562.00 $252.00 $252.00 $413.00 $1,292.00 $1,292.00 $2,436.00 $2,436.00 $2,436.00 $2,436.00 $2,436.00 $146.00 $1,270.00 $1,215.00 $18,206.00 $2,915.50 $3,208.00 $987.00 $987.00 $598.00 $3,383.00 $1,069.00 $4,329.00 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB BASE JOURNEY RT SZ3 KNEE INSRT JII BCSLFTSZ3-4 9MM KWIRE DRILL TIP STRY 2.0X234MM SCREW CORT AXSOS TI 4.5X38MM SCREW CORT AXSOS TI 4.5X50MM SCREW LK AXSOS TI 5.0X50MM ROD DUAL BEND CCM 5.5 350MM ROD DUAL BEND CCM 5.5 400MM ALLO DBM DBF PUTTY GRAFTON 3CC ALLO DBM DBF PUTTY GRAFTON 1CC CERV DISC PRESTIGE LP 6X12MM CERV DISC PRESTIGE LP 6X14MM CERV DISC PRESTIGE LP 6X16MM CERV DISC PRESTIGE LP 6X18MM CERV DISC PRESTIGE LP 7X14MM CERV DISC PRESTIGE LP 7X16MM CERV DISC PRESTIGE LP 7X18MM BIT DRILL 1.5 PRESTIGE ROD PRECEPT TI PREBENT 55MM KNEE LEGION CR INSRTSZ7-8 11MM SCREW CORT SLFTP NCB 4.0X38MM PLATE FEM OPEN WEDGE TI 9.0MM SCREW TSRH MPA SHRT 5.5X45MM ROD TI PT SPECIFIC HIP PIN ACET HIP PIN PELVIS BUR BALL FLUT 6MM BIT DRILL FBRTAK 1.6MM MESH GALAFLEX RECTANGLE 6X8 SIZER MAM 410FM RPSB 395CC SCREW CRANFAC SLFTP 1.5X5MM SCREW LK STRY 4X70MM PLATE LAT TIB 6HL PENCIL SMOKE EVAC NEPTUNE ESEP SCREW LK STRY 4.0X60MM SCREW ASNIS CANN 4.0X48MM COUNTERSINK CANN 4.0MM NAIL RECON LFT 13X400MM SCREW RECON LAG T2 6.5X110MM DEV FUSN COROENTXL+12D10X18X60 SCREW VERTEX MDTR 4.0X22MM SCREW VERTEX MDTR 4.0X24MM SCREW VERTEX MDTR 4.0X30MM GDWIRE MOTION HYBRID ST 0.038 GDWIRE MOTION HYBRID ST 0.035 SCREW VARIAX NL T8FULL2.7X20MM Page 438 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,957.00 $2,353.75 $144.00 $212.00 $212.00 $1,081.00 $3,616.00 $3,616.00 $2,141.00 $1,475.00 $10,295.00 $10,295.00 $10,295.00 $10,295.00 $10,295.00 $10,295.00 $10,295.00 $1,292.00 $1,149.00 $2,398.00 $788.00 $2,562.00 $1,729.00 $3,355.00 $232.00 $232.00 $632.00 $558.00 $3,875.00 $987.00 $978.00 $579.00 $2,438.00 $167.00 $551.00 $680.00 $1,176.00 $3,224.00 $1,018.00 $9,518.00 $2,763.00 $2,763.00 $2,763.00 $275.00 $275.00 $656.62 2020 pricing Drugs&Supplies PROCEDURE NAME ROD PRECEPT TI PREBENT 50MM ALLO DBM PUTTY STIMUBLAST 5CC TOE PROS ANATOEMIC 21.5MM HIP LNR XLPE PE 0D 36X56MM BREAST SMTH MOD COHESIVE 240ML BREAST SMTH MOD COHESIVE 405ML POST ST HOFFMAN 11MM PIN CNCLS APEX 5X6X250X7MM SYS DRSG VAC PREVENA PLUS CUST SCREW CNCLS LK SM 4.0X40MM SCREW CNCLS LK SM 4.0X55MM SCREW CNCLS LK SM 4.0X60MM SHEATH PRLL RAPID REL12FR 35CM SCREW MINI SHRT THRD 3.0X40MM SCREW MINI SHRT THRD 3.0X18MM SHLDR BASEPLATE RSP P2 30MM SHLDR HUMR INSRT STD NEUT 32MM SHLDR STEM REV ALTIVATE6X108MM BIT DRILL CANN PRECICE 8X260MM SCREW LK CANN PRECICE 5.0X50MM NAIL FEM PRECICE 10D12.5X335MM BIT DRILL PRECICE 5.0X152MM HIP LNR XLPE PE 0D 36X60MM KNEE FEM JII CR OXIN LFT SZ4 KNEE INSRT JII CRLFTSZ3-4 10MM KNEE FEM JII CR OXIN LFT SZ8 KNEE PTLA JII RESURF 38MM KNEE INSRT JII CR RT SZ3-4 9MM KNEE FEM JII CR OXIN RT SZ4 HIP LNR TANDEM BIPOLRPE28X46MM SCREW SOLERA MAS 5.0X30MM CONN CLSD END VERTEX 19MM PLATE TIB PROX LK LFT 7HL STD ELTD HOOK BIPOLR 12D/30D SET SCREW BREAK OFF TI ROD SOLERA CURV COCR 5.5X40MM ALLO DBM DBF PUTTY GRAFTON 6CC CAGE HYPR LORD 20D 10X34X24MM ROD PRECEPT TI PREBENT 10MM ROD PRECEPT TI PREBENT 120MM SCREW PRECEPT PA 7.5X40MM SIZER MAM 410FF RPSB 335CC BREAST SIL 410 2FULL 335CC SIZER MAM 410LF RPSB 310CC KNEE INSRT JII CRLFTSZ7-8 11MM HIP STEM ANTHOLOGY HIGH SZ7 Page 439 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,041.00 $2,144.00 $2,000.00 $1,935.00 $2,915.50 $2,915.50 $601.00 $653.00 $1,709.00 $1,113.00 $996.96 $996.96 $658.00 $1,121.00 $1,121.00 $3,394.00 $2,014.00 $13,610.00 $1,677.00 $1,019.00 $36,716.00 $1,019.00 $2,008.00 $4,402.00 $2,398.00 $4,402.00 $1,197.00 $2,398.00 $4,402.00 $1,212.00 $1,899.00 $1,868.00 $4,410.00 $1,146.00 $777.00 $1,159.00 $3,085.00 $11,747.00 $1,094.00 $1,094.00 $2,436.00 $146.00 $2,329.00 $146.00 $2,398.00 $4,161.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP STEM ANTHOLOGY HIGH SZ5 HIP STEM ANTHOLOGY STD SZ7 KNEE INSRT JII CR RTSZ5-6 11MM KNEE PTLA JII RESURF 35MM KNEE FEM JII CR OXIN RT SZ7 HIP STEM ANTHOLOGY HIGH SZ10 DRAPE MICROSCOPE OPMI 58X150CM NAIL GAMMA RT LNG 130D11X460MM SCREW QK SNAP 2.7X18MM PAD PT POSITION DEV PNK XL SIZER MAM SRX RPSB 750CC KNEE INSRTJII DEEPLFTSZ7-8 9MM KNEE TIB BASE JOURNEY LFT SZ7 KNEE INSRTJII DEEPRTSZ5-6 10MM KNEE FEM JII CR OXIN RT SZ6 SCREW VERTEX MDTR 4.0X16MM SIZER MAM 410LL RPSB 300CC HIP LNR R3XLPE 0D +4 36X58MM KNEE TIB BASE JOURNEY RT SZ7 KNEE FEM JII CR OXIN RT SZ8 KNEE INSRT JIIDEEPRTSZ7-8 11MM KNEE INSRT JIIDEEPRTSZ3-4 11MM KNEE FEM JII CR OXIN RT SZ5 HIP STEM ANTHOLOGY STD SZ12 KNEE FEM JII CR OXIN LFT SZ7 KNEE INSRT JII CRLFTSZ5-6 11MM SCREW NL HEXALOBE 2.7X26MM NAIL FEM T2GTN STRY RT10X360MM CPLE ROD/ROD MULT HOFFMANN3 CPLE PIN/ROD MULT HOFFMANN3 HIP STEM ANTHOLOGY HIGH SZ11 HIP LNR R3 XLPEPE 0D+4 32X50MM HIP STEM ANTHOLOGY HIGH SZ8 NAIL TIB T2 STD 8X285MM SCREW LK THRD 4X30MM SCREW LK THRD 4X35MM ROD SOLERA CURV COCR 5.5X35MM COV PROBE GAMMA ST KNEE FEM JII BCS OXIN RT SZ3 ELBOW RAD HD ALIGN 24MM ELBOW RAD STEM ALIGN 10X0MM PLATE PROX LAT TIB LFT 4HL SCREW LK AXSOS TI 4X70MM SCREW LK AXSOS TI 4X75MM SCREW LK AXSOS TI 4X80MM SCREW CORT AXSOS TI 3.5X30MM Page 440 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,161.00 $4,161.00 $2,398.00 $1,197.00 $4,402.00 $4,161.00 $65.00 $3,565.00 $1,243.00 $592.00 $146.00 $2,398.00 $2,957.00 $2,398.00 $4,402.00 $2,254.00 $146.00 $1,978.00 $2,957.00 $4,402.00 $2,398.00 $2,398.00 $4,402.00 $4,161.00 $4,402.00 $2,398.00 $496.00 $3,689.00 $2,081.00 $2,081.00 $4,161.00 $2,008.00 $4,161.00 $3,127.00 $824.00 $824.00 $1,159.00 $23.00 $4,317.76 $4,935.00 $4,830.00 $4,425.00 $1,016.00 $1,016.00 $1,016.00 $184.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW CORT AXSOS TI 3.5X32MM SCREW CORT AXSOS TI 3.5X34MM SCREW CORT AXSOS TI 3.5X36MM SCREW CORT AXSOS TI 3.5X65MM SCREW CORT AXSOS TI 3.5X75MM SCREW CORT AXSOS TI 3.5X80MM BIT DRILL NL SHRT 2.5X216MM BIT DRILL LK SHRT 3.1X216MM KNEE INSRTJIIXLPELFTSZ5-6 12MM KNEE INSRTJIIDEEPLFTSZ3-4 10MM KNEE INSRTJIIDEEPLFTSZ5-6 9MM CONN EXP TI S/S 4.5X4.5MM SCREW DVR LK 2.7X16MM PLATE TIB AXSOS RT 6HL 147MM PLATE TIB DIST MEDL LK LFT15HL ROD SOLERA CURV COCR 5.5X70MM PLATE PYRAMID 4HL 37MM KNEE INSRT JII DEEPRTSZ5-6 9MM HIP STEM ANTHOLOGY STD SZ8 KNEE INSRT JII CR RTSZ3-4 11MM PASR SUT NOVASTITCH PLUS 2-0 SUT NOVASTITCH PLUS CTRX 2-0 HIP LNR APR PE 0D 53X32MM HIP HD VERS BIOLOX CER 32MM 0 KNEE INSRT JII CRLFTSZ3-4 11MM ROD CP4 CURV TI 5.5X55MM HIP STEM REDAPT STD 190MM SZ13 KNEE INSRT JII CR RTSZ5-6 10MM KNEE FEM JII CR OXIN RT SZ9 KNEE INSRT JIIDEEPRTSZ7-8 13MM KNEE PTLA JII RESURF 41MM KNEE INSRT JIIDEEPRTSZ7-8 12MM HIP LNR R3 XLPE PE 0D +4 40X56 HIP SLV TI MODULAR 12/14 +0 NAIL FEM T2 GTN LFT 12X400MM BLADE TOMCAT LNG HIP 4.0MM KT IRIS URETRL ROB CAGE BRIGADE 8D 34X24X12MM SCREW COROENT XLR-F 4.5X20MM SIZER MAM SRLP RPSB 145CC SCREW VARIAX LK T8 2.4X20MM HIP LNR R3 XLPE 0D +4 36X52MM KNEE INSRTJIIDEEPLFTSZ3-4 12MM KNEE INSRTJIIDEEPRTSZ7-8 9MM KNEE FEM JII CR OXIN LFT S9 KNEE INSRT JII CRLFT SZ7-8 9MM Page 441 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $184.00 $184.00 $184.00 $184.00 $184.00 $184.00 $1,318.00 $1,050.00 $2,398.00 $2,398.00 $2,398.00 $3,797.00 $720.00 $2,438.00 $5,145.00 $1,159.00 $5,088.00 $2,398.00 $4,161.00 $2,398.00 $1,772.00 $1,679.00 $2,369.00 $3,671.00 $2,398.00 $1,224.00 $16,584.00 $2,398.00 $4,234.00 $2,398.00 $1,197.00 $2,404.00 $2,008.00 $1,184.00 $3,689.00 $318.36 $5,443.00 $10,847.00 $1,023.00 $146.00 $835.01 $2,008.00 $2,398.00 $2,398.00 $4,402.00 $2,398.00 2020 pricing Drugs&Supplies PROCEDURE NAME BREAST SMTH RESPONSE LOW 230CC SIZER MAM SRL RPSB 230CC ROD CP4 CURV TI 5.5X90MM SIZER MAM 410FF RPSB 475CC SCREW CORT SLFTP NCB 4.0X34MM SCREW CORT SLFTP NCB 4.0X36MM SCREW CORT SLFTP 5.0X75MM SCREW CORT SLFTP NCB 4.0X30MM SCREW MINI SHRT THRD 3.0X26MM SCREW MINI SHRT THRD 3.0X30MM DISC DIMND PEMD BUR TAPERED PEMD NAIL STD SHRT THRD 3.2X197MM ROD EXTL FIX CBN 11X650MM SCREW SOLERA MAS 6.5X55MM SIZER MAM 410FX RPSB 775CC NAIL FEM T2 GTN 12X440MM PLATE FEM DIST LAT RT 6HL SCREW CORT AXSOS TI 4.5X20MM SCREW CORT AXSOS TI 4.5X36MM SCREW CORT AXSOS TI 4.5X44MM BIT DRILL-KWIRE MEASURING GD SCREW LK T10 FULL THRD3.5X16MM SCREW LK T10 FULL THRD3.5X18MM SCREW BONE T10FULLTHRD3.5X14MM SCREW BONE T10FULLTHRD3.5X16MM SCREW BONE T10FULLTHRD3.5X18MM NAIL FEM T2 GTN LFT 12X440MM NAIL TIB T2 STRY STD 10X300MM KNEE INSRT JII DEEPRTSZ3-4 9MM KNEE INSRT JII XLPERTSZ5-6 9MM HIP LNR R3 XLPE 0D +4 36X54MM KNEE INSRTJIIDEEPLFTSZ3-4 13MM KNEE INSRTJIIDEEPLFTSZ5-6 10MM KNEE TIB BASE JOURNEY RT SZ2 KNEE INSRT JIIDEEPRTSZ1-2 10MM HIP LNR TANDEM BIPOLRPE28X47MM HIP CENTRALIZER DIST INVIS15MM HIP STEM ANTHOLOGY STD SZ11 HIP STEM ANTHOLOGY HIGH SZ12 ROD PRECEPT TI PREBENT100MM CAGE HYPR LORD 20D 6X34X24MM DEV FUSN COROENT XL 8X18X55MM SCREW RELINE-O PA 5.5X45MM SCREW RELINE-O PA 7.5X45MM SCREW RELINE-O PA 6.5X45MM Page 442 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,329.00 $146.00 $1,224.00 $146.00 $788.00 $788.00 $954.00 $840.00 $1,177.00 $1,177.00 $761.00 $528.00 $5,198.00 $1,044.00 $1,899.00 $146.00 $3,689.00 $5,244.00 $212.00 $212.00 $212.00 $587.00 $836.00 $836.00 $462.00 $462.00 $462.00 $3,127.00 $3,127.00 $2,398.00 $2,398.00 $2,008.00 $2,398.00 $2,398.00 $2,957.00 $2,398.00 $1,213.00 $77.00 $4,161.00 $4,161.00 $1,402.00 $11,747.00 $7,402.00 $2,436.00 $2,436.00 $2,436.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW RELINE-O PA 6.5X55MM SCREW RELINE-O PA 8.5X40MM SCREW RELINE-O PA 7.5X55MM SCREW PRECEPT PA 8.5X45MM SCREW PRECEPT PA 5.5X50MM ROD PRECEPT TI PREBENT160MM CONN SPINE ASF25T 2HL 5.5H-5.5 PLATE SUPERIOR CURV RT 8HL99MM SCREW BONE T10 FULLTHRD3.5X8MM SCREW LK T10 FULL THRD 3.5X8MM SCREW BONE T10FULLTHRD2.7X22MM SCREW BONE T10FULLTHRD2.7X18MM BIT DRILL AO SCALED 2.0X135MM OVERDRILL AO 2.7X122MM ENDOL EXCLUDER 14.5MMX10CM KNEE INSRT JIIDEEPRTSZ5-6 13MM HIP LNR TANDEM BIPOLRPE28X51MM HIP CENTRALIZER DIST INVIS14MM NAIL RECON RT 11X400MM SCREW CNCLS SYNT 6.5X32X130MM HIP LNR TANDEM BIPOLRPE28X54MM ROD EXTL FIX H3 11X200MM DEV FUSN COROENT LC8D10X9X25MM SCREW RELINE LK OPENTULIP5.5MM KNEE FEM JII CR OXIN LFT SZ6 KNEE INSRTJIIDEEPLFTSZ5-6 12MM HIP LNR R3 XLPE PE 0D 40X58MM CAGE PEEK VBS MDTR 13X30MM KNEE INSRT JII CR LT SZ3-4 9MM SCREW DELTA PEEK 7X28MM ALLO TENDON PSTR TIBIALIS SCREW SOLERA MAS 7.5X55MM ROD SOLERA CURV COCR 5.5X55MM ROD SOLERA CURV COCR 5.5X50MM SCREW LK T10 FULL THRD3.5X12MM SCREW BONE T10FULLTHRD3.5X20MM SCREW BONE T10FULLTHRD3.5X22MM OVERDRILL AO 3.5X122MM KNEE FEM WEDGE LGN SZ5 5MM KNEE INSRT JII CRLFTSZ3-4 12MM SHLDR HUMR HD 3.5X41X15MM SPACER SPINE MDTR 8X16X14MM PROTECT NEURAWRAP 3MMX4CM(4U) SCREW LWEDGE LGN SZ7 5X10MM SCREW LWEDGE LGN SZ7 5X5MM ANCHOR TACIT QK W CRANIO DRILL Page 443 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,436.00 $2,436.00 $2,436.00 $2,436.00 $2,436.00 $1,402.00 $1,949.00 $2,372.00 $462.00 $836.00 $462.00 $462.00 $399.00 $399.00 $8,446.00 $2,398.00 $1,213.00 $77.00 $3,383.00 $231.00 $1,213.00 $1,099.00 $5,449.00 $408.00 $4,402.00 $2,398.00 $2,008.00 $5,449.00 $2,398.00 $987.00 $4,328.00 $1,899.00 $904.00 $904.00 $1,225.00 $440.44 $462.00 $399.00 $3,085.00 $2,398.00 $3,355.00 $2,258.00 $5,703.00 $4,225.00 $4,225.00 $1,475.00 2020 pricing Drugs&Supplies PROCEDURE NAME SLV SUCT NEPTUNE E-SEP 125MM SLV SUCT NEPTUNE E-SEP 165MM SCREW LWEDGE LGN SZ5 5X10MM KNEE INSRTJII DEEPRTSZ5-6 12MM KT KNEE SCP BONE FILLER DEV FUSN COROENTXL+10D10X18X50 ROD PRECEPT TI PREBENT 45MM SPACER CERV ANAT ALLO5X14X11MM SPACER NCB 3MM SHLDR RETENT REV INSRT 36MM+9B IMMOB SHLDR ST S IMMOB SHLDR ST MD IMMOB SHLDR ST LG IMMOB SHLDR ST XL KNEE INSRTJII DEEPRTSZ5-6 11MM SET CORD TB ROTARYPUMP BIPOLAR BIT DRILL SOLID SIDECUT 2.0X40 PEG SMTH LK SKDY 2.0X22MM PEG SMTH LK SKDY 2.0X20MM BIT DRILL SOLID SIDECUT 2.5X40 KNEE INSRT JIIDEEPRTSZ3-4 10MM KNEE INSRTJIIDEEPLFTSZ5-6 11MM HIP STEM ANTHOLOGY HIGH SZ13 STNT URETRL RESONANCE 6FR 22CM KNEE INSRT JIIDEEPLFTSZ3-4 15MM INJ TULI 18GA KNEE INSRT JIIDEEPRTSZ1-2 9MM KNEE FEM JII CR OXIN RT SZ2 SHLDR HUMR HD 3.5X43X16MM SPACER PLATE 12D 37X27X12MM SCREW SOVEREIGN ANG 5.5X25MM SIZER MAM SRF RPSB 485CC KNEE INSRTJIIDEEPLFTSZ3-4 11MM REAMER PILOT HEADED ARTX 6.0MM REAMER PILOT HEADED ARTX 6.5MM CURETTE ADENOID ELECTROCAUTERY TOOL SEE-N-READ 3X5.5 ROD SOLERA CURV COCR 5.5X60MM ALLO BONE ILIUM TRICORT 60MM KNEE INSRT JIIBCSLFTSZ7-8 11MM HIP LNR ARCOMXL PE 0D 28X44MM KNEE FEM JII CR OXIN LFT SZ3 KNEE INSRTJIIDEEPLFTSZ5-6 13MM SCREW PT THRD STER 8X100MM SCREW PT THRD STER 8X105MM SCREW LK TI SLFTP 5X34MM Page 444 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $23.00 $23.00 $4,095.00 $2,398.00 $6,921.00 $9,981.00 $1,094.00 $2,923.00 $714.00 $2,322.00 $57.00 $57.00 $57.00 $57.00 $2,398.00 $200.85 $672.00 $579.00 $501.00 $672.00 $2,398.00 $2,398.00 $4,161.00 $2,368.00 $2,297.00 $1,026.00 $2,398.00 $4,402.00 $4,463.00 $10,729.00 $1,849.00 $146.00 $2,398.00 $1,038.00 $1,038.00 $148.00 $76.00 $1,159.00 $4,655.00 $2,353.75 $2,831.00 $4,402.00 $2,398.00 $1,073.00 $1,073.00 $935.93 2020 pricing Drugs&Supplies PROCEDURE NAME HIP LNR POLARCUP XLPE 28X51 PLATE FIB ST 6HL LASER FIBER FLEXIVA 365 LOOP CUT BIPOLR EXT 24/26FR PIN APEX EXTL FIX 6.0X180MM KNEE INSRT CRHF XLPESZ5-6 15MM HIP LNR R3 XLPE 0D +4 36X60MM KNEE FEM WEDGE LGN 7-8 5MM KNEE INSRT JIIDEEPRTSZ7-8 18MM KNEE INSRTJIIDEEPLFTSZ5-6 15MM BREAST EXPANDFULLXTRNOTAB450CC SHEATH DYNAMIC STIM NVJJB/M5 SCREW PRECEPT PA 6.5X40MM SCREW PRECEPT PA 5.5X40MM ROD CP4 CURV TI 5.5X50MM PLATE WRIST FUSN SHRT BEND BIT DRILL 2.0X95MM SCREW CORT 2.7X18MM SCREW LK CORT TRMI 2.7X18MM SCREW LK CORT TRMI 2.7X20MM BREAST SIL 410MODER XFULL445CC SCREW CORT TRMI 2.7X146MM SYS REPAIR ACU-SINCH CONN DOMINO SIDE CLSD 6.35X5.5 BIT DRILL BIO-COMP CANN 18MM NAIL FLEX TI 1.5X300MM NAIL FLEX TI 1.75X300MM CAUT LIGASURE BLNT 5MM 37CM PLATE DVR DORSAL RT SIZER MAM 410MX RPSB 520CC SCREW GORILLA R3CON NL2.7X16MM TOE IMPLT CARTILAGE SYN 10MM KNEE TIB LGN WEDGE LLRM SZ3-4 KNEE TIB LGN WEDGE LMRL SZ3-4 KNEE FEM WEDGE DIST SZ5 10MM KNEE TIB BASEPLATE RT SZ3 KNEE FEM WEDGE HK SZ5 5MM KNEE FEM ASSY HK LGN RT SZ5 KNEE BOLT SLV HK LGN 11MM KNEE TIB INSRT HK LGN RT SZ2-3 KNEE INSRT JIIDEEPRTSZ7-8 10MM SUT NICELOOP KAC25 GRN SZ5 SCREW CANN PART THRD 8.0X85MM ROD SOLERA CURV COCR 5.5X45MM SHLDR HUMR STEM REV 7X130MM SCREW SOLERA MAS 4.0X35MM Page 445 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,008.00 $3,045.00 $1,425.31 $1,466.00 $537.00 $2,398.00 $2,008.00 $2,923.00 $2,398.00 $2,398.00 $3,154.00 $672.00 $2,436.00 $2,436.00 $1,224.00 $2,436.00 $606.00 $408.00 $485.00 $485.00 $2,915.50 $453.00 $3,072.00 $1,949.00 $735.00 $1,038.00 $1,072.00 $1,516.20 $2,760.80 $146.00 $878.40 $7,600.00 $3,693.00 $3,693.00 $3,378.00 $10,070.00 $3,378.00 $20,145.00 $2,913.00 $5,290.00 $2,398.00 $490.00 $1,073.00 $1,159.00 $11,945.00 $1,899.00 2020 pricing Drugs&Supplies PROCEDURE NAME HIP CENTRALIZER DIST INVIS10MM PLATE INTRMD SHRT LFT 11HL56MM SUT NICELOOP KAC25 WHT SZ5 SUT NICELOOP KAC25 WHT/GRN SZ5 SCREW BONE T10FULLTHRD3.5X14MM SCREW COROENT XLR-F 5.5X25MM SHLDR HUMR STEM LNG 4B 104MM SHLDR HUMR STEM LNG 4B 98MM PIN TENSION BAND 70MM SIZER MAM SRM RPSB 560CC KT SCP FT AND ANK ACCUPORT ELBOW STEM RHEAD PLAS CTD SZ3 ELBOW RAD HD RHEAD STD SZ4 PLATE OLECRANON RT 8HL 137MM SCREW LK T10 FULL THRD3.5X50MM SCREW LK T10 FULLTHRD 2.7X46MM SCREW LK T10 FULLTHRD 3.5X40MM SCREW LK T10 FULLTHRD 2.7X18MM SCREW LK T10 FULLTHRD 2.7X22MM BIT DRILL ICONIX DISP 2.3MM PLATE VOLAR DIST RADNARWLFT3HL PEG LK HIGH COMP TI 2.7X20MM PEG LK HIGH COMP TI 2.7X22MM SCREW CORT NL 3.5X10MM SCREW CORT LK 3.5X12MM SCREW CORT LK 3.5X10MM ELBOW RAD STEM ALIGN 7X0MM ELBOW RAD HEAD ALIGN 22MM KNEE MARKER FLAT NAVIO SIZER MAM SRM RPSB 310CC CLIP IRR EMAX DRILL SHORT-HD KNEE FEM JII CR OXIN RT SZ3 KNEE FEM STRIDE RM/LL SZ4 KNEE TIB BASE STRIDE RM/LL SZ4 KNEE TIB INSRT STRIDE SZB 9MM KNEE FEM STRIDE RM/LL SZ3 KNEE TIB BASE STRIDE RM/LL SZ6 KNEE TIB INSRT STRIDE SZC 9MM PLATE XCORE2 TI LK SCREW ENDCAP XCORE2 TI LK SCREW VERT REPL XCORE2 TI 18X21-27MM ENDCAP XCORE2 TI 0D 18X18X50MM ENDCAP XCORE2 TI 4D 18X18X50MM SCREW RELINE-O PA 5.5X45MM SCREW RELINE-O PA 6.5X50MM SCREW RELINE-O PA 5.5X50MM Page 446 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $77.00 $2,239.64 $490.00 $490.00 $2,238.00 $1,311.00 $10,075.00 $10,075.00 $1,048.00 $143.50 $5,602.00 $8,515.00 $4,668.00 $2,410.00 $1,226.00 $1,190.00 $1,226.00 $856.00 $856.00 $693.00 $2,612.00 $579.00 $579.00 $579.00 $579.00 $579.00 $4,830.00 $4,830.00 $115.00 $130.41 $600.00 $4,402.00 $7,252.00 $3,467.00 $2,244.00 $7,252.00 $3,467.00 $2,244.00 $606.00 $1,364.00 $10,381.00 $3,554.00 $3,554.00 $2,436.00 $2,436.00 $2,436.00 2020 pricing Drugs&Supplies PROCEDURE NAME BURR FLUTED BALL 6MM PAD POS HERMINATOR KNEE DEMAYO ROD CP4 CURV TI 5.5X60MM DEV FUSN COROENT XL+10D8X18X60 ROD PRECEPT TI PREBENT 70MM ROD PRECEPT TI PREBENT 75MM PLATE FEM DIST LAT AXSOS3TI5MM SCREW CORT AXSOS TI 4.5X24MM NAIL GAMMA3 LFT LNG 130D11X380 NAIL GAMMA LNG LFT11X420X130MM NAILEX LAT ENTRY TI LFT8.2X360 NAILEX LAT ENTRY TI LFT8.2X380 NAIL SUPRA COND STER 11X380MM SCREW VERTEX MDTR 4.5X32MM NAIL FEM T2GTN STRY RT12X440MM PIN EXTL FIX THRD 60X5X180MM SIZER MAM SRX RPSB 580CC SCREW CORT PLUSDRIV SLFTP 2X8 SCREW CANN PART THRD 8.0X80MM SCREW CANN PART THRD 8.0X90MM CATH URETRL OPEN END 5FR 70CM ROD CP4 CURV TI 5.5X110MM ROD CP4 CURV TI 5.5X70MM ROD EXTL FIX H3 11X300MM WASHER ARTX TI 6.5MM HIP STEM REDAPT STD 240MM SZ20 HIP STEM REDAPT HI 240MM SZ21 SYS TIB APERFIX CANN 11X30MM SCREW MINI SHRT THRD 4.0X46MM SCREW BONE T10FULLTHRD3.5X26MM SCREW LK T10 FULL THRD3.5X10MM SCREW LK T10 FULL THRD3.5X20MM KNIFE S SLIT SGL BEVEL ANG2.75 PLATE INTERAXIS 2HL 25MM KNEE PTLA JII RESURF STD 29MM ROD PRECEPT TI ST 300MM VERT REPL XCORE2 TI 18X28-41MM BREAST SMTH SFT XFULL 545CC BREAST SMTH SFT XFULL 580CC KWIRE PRECEPT SS THRD TIP ALLO ACHILLES W BONE BLOCK TB IRR POLY SIZER MAM SRF RPSB 520CC SIZER MAM SRM RPSB 195CC SIZER MAM SRX RPSB 615CC SIZER MAM SRLP RPSB 440CC Page 447 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $735.00 $1,026.00 $1,224.00 $7,402.00 $1,094.00 $1,094.00 $5,244.00 $212.00 $3,427.65 $3,427.65 $3,021.05 $3,021.05 $3,127.00 $2,254.00 $3,127.00 $660.00 $146.00 $1,266.00 $1,073.00 $1,073.00 $263.00 $1,224.00 $1,224.00 $1,127.00 $202.00 $18,206.00 $18,206.00 $1,460.00 $1,146.48 $462.00 $1,225.00 $836.00 $313.55 $3,362.29 $1,197.00 $1,292.00 $10,381.00 $3,049.00 $3,049.00 $252.00 $4,534.00 $276.57 $146.00 $1,000.00 $146.00 $146.00 2020 pricing Drugs&Supplies PROCEDURE NAME BREAST SMTH RESPONSE LOW 170CC KNEE TIB INSRT STRIDE SZB 10MM KNEE FEM STRIDE RM/LL SZ2 KNEE INSRTJII DEEPLFT SZ7-8 10 KNEE TIB BASE STRIDE LM/RL SZ3 KNEE FEM STRIDE LM/RL SZ4 KNEE TIB INSRT STRIDE SZB 8MM PLATE PROX LAT TIB RT 2HL 95MM SCREW CORT AXSOS TI 3.5X60MM SCREW CORT AXSOS TI 3.5X50MM BREAST SIL 410 FULL XFULL410CC BIT DRILL WRIT 5MM TRAY CONTINUOUS ONQ TBLOC CAUT LIGASURE MARYLANDOPEN23CM SET INST PERFUSE SM JOINT DISP HIP STEM POLARSTEM126D LAT SZ6 BUR ELITE RD TAPER EXT 1.0MM BUR ELITE RD TAPER EXT 2.0MM BUR RD S2 MINI CARB RED 2.3MM HIP STEM POLARSTEM126D LAT SZ2 KNEE TIB STEM GII 10X100MM SHLDR HUMR HD LOW 54X23MM KNEE INSRT CNSTND RT SZ5-6 10MM KNEE TIB INSRT STRIDE SZA 10MM KNEE TIB BASE STRIDE RM/LL SZ3 KNEE TIB BASE STRIDE LM/RL SZ6 KNEE FEM STRIDE LM/RL SZ5 KNEE TIB INSRT STRIDE SZC 8MM END CAP ANATOM PEEK 14X16X14MM SUT FBRLOOP 2 CURV BLU 20 HIP CENTRALIZER DIST INVIS12MM KT INTGRTD IRG BIPOLR CORD SCREW MTXMID SYNT SLVR 5MM STNT WLLFLX COLON 22X12MM135CM SUT XBRAID TT COBRAID 1.2MM ANCHOR SUT MICRO CRKSCRW 4-0 SCREW MTXMID SYNT SLVR 4MM ADPTR CARTRDG THRD SCREW CORT AXSOS TI 3.5X22MM SCREW CORT AXSOS TI 3.5X38MM SCREW LK AXSOS TI 4X28MM SCREW LK AXSOS TI 4X36MM SCREW LK AXSOS TI 4X40MM SCREW ARCHON SLFTP 4X11MM SCREW ARCHON SLFTP 4X13MM PLATE ARCHON 2LVL 40MM Page 448 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,329.00 $2,244.00 $7,252.00 $2,398.00 $3,467.00 $7,252.00 $2,244.00 $4,425.00 $184.00 $184.00 $2,974.00 $1,361.25 $413.00 $1,667.83 $3,418.20 $4,161.00 $680.00 $680.00 $897.00 $4,161.00 $3,138.00 $4,239.00 $2,398.00 $2,244.00 $3,467.00 $3,467.00 $7,252.00 $2,244.00 $2,258.00 $282.00 $77.00 $152.00 $325.00 $4,197.00 $469.00 $1,125.00 $490.00 $173.00 $180.80 $180.80 $995.96 $992.39 $992.39 $725.00 $725.00 $2,562.00 2020 pricing Drugs&Supplies PROCEDURE NAME DRILL BIT 2.5X10MM TACK TEMP NUVA CNTRLR DOSAGE AEROFORM EXPAND TISS AEROFORM SM ALLO EVANS WEDGE PRGN 10MM HIP STEM POLARSTEM126D LAT SZ4 HANDPC HYDRODEBRIDER STD STNT VALV NASAL 0.05X16X20MM PK TOTAL JOINT PK LAPAROTOMY CLSR DEV FUSN COHERE 7D 12X14X7MM DEV FUSN COHERE 7D 12X14X8MM CLAMP EXTL FIX PIN HOFFMAN10HL CONN ROD LEGACY 5.5X6.35MM HIP CENTRALIZER DIST IMVIS13MM CATH SWAN CURL KT LFT 62.5CM SCREW LK T10 FULL THRD3.5X32MM PLATE ARCHON 1LVL 20MM SCREW ARCHON SLFTP VAR 4X15MM SCREW VERTEX MDTR 4.5X28MM KNEE PTLA JII RESURF STD 26MM KT SIGMOID LIGHTED BIOS DISP KNEE TIB BASE STRIDE RM/LL SZ5 SCREW LWEDGE LGN SZ6 5X5MM KNEE STEM LGN CMNT 14X160MM HIP STEM POLARSTEM126D LAT SZ5 BUR FLUTED DRUM ANSPACH5X8.4MM BUR FLUTED BALL ANSPACH 5MM SIZER MAM 410MX RPSB 550CC SCREW CMAS BALLAST 8.5X80MM SCREW ARCHON SLFTP 4X15MM SCREW ARCHON SLFTP 4X17MM PLATE ARCHON 1LVL 22MM SCREW NL GORILLA 2.0X9MM SCREW NL GORILLA 2.0X10MM SCREW NL GORILLA 2.0X11MM KNEE FEM STRIDE RM/LL SZ5 KNEE TIB BASE STRIDE RM/LL SZ7 KNEE TIB INSRT STRIDE SZ D 8MM KNEE TIB BASE STRIDE RM/LL SZ5 HANDPC HYDRODEBRIDER FRNTL ROD CP4 CURV TI 5.5X35MM KNEE FEM STRIDE RM/LL SZ6 CAGE CLYDESDALE 6D 16X55MM DEV FUSN COHERE 7D 14X16X7MM NAIL GAMMA 3S RT 11X380X130MM Page 449 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $938.00 $938.00 $1,694.00 $6,101.00 $5,500.00 $5,425.00 $1,234.63 $887.00 $1,519.66 $120.00 $2,923.00 $2,923.00 $2,027.17 $1,949.00 $77.00 $981.00 $836.00 $2,363.00 $725.00 $2,254.00 $1,197.00 $437.00 $2,874.00 $4,095.00 $3,316.00 $5,425.00 $877.00 $814.00 $146.00 $5,755.00 $733.00 $733.00 $2,363.00 $879.00 $879.00 $879.00 $7,252.00 $3,467.00 $2,244.00 $3,467.00 $1,234.63 $1,224.00 $7,252.00 $7,402.00 $2,923.00 $3,656.00 2020 pricing Drugs&Supplies PROCEDURE NAME SHLDR STEM REV HUM STD16X108MM GD SHLDR MATCH PNT SYS CUST SUT FBRLOOP FBRTAG SWAGED ST SCREW VERTEX MDTR 4.0X14MM SCREW VERTEX MDTR 4.0X20MM ROD CP4 CURV TI 5.5X120MM ROD CP4 CURV TI 5.5X100MM KNEE TIB BASE STRIDE LM/RL SZ4 KNEE FEM STRIDE LM/RL SZ3 SHLDR HUMR STEM LNG 5B 109MM SYS CMNT SMARTMIX CTS BOWL ALLO FASCIA LATA MD 10CMX60MM SCREW SOLERA MAS 5.5X55MM ROD CP4 CURV TI 5.5X45MM HIP LNR R3 XLPEPE 0D+4 32X48MM KNEE INSRT XLPE CRHFSZ1-2 10MM NAIL FEM T2GTN STRY RT12X420MM KNEE TIB INSRT DUR TS MD 31MM CAGE ANT CERV FLAT LNK 8X12X14 SCREW RDCTN PA SLFTP LNK6.5X55 HIP LNR R3 XLPEPE 0D+4 32X48MM KT BIOCARTILAGE SM JOINT REAMER FLEX W GD PIN 9.5MM SYS SPACER CRST SPINAL 25X9MM SCREW TSRX OSTEOGRIP 6.5X60MM DEV FUSN COROENTXL+10D12X18X55 KNEE INSRT JIIDEEPRTSZ1-2 13MM PLATE OD LAT WIDE MOUTH 12MM ROD PRECEPT TI PREBENT 80MM SCREW PT THRD 8X175MM SCREW PRECEPT PA 4.5X45MM DEV FUSN COROENTXL+10D8X18X45 HIP LNR TANDEM BIPOLRPE28X55MM KNEE INSRTJIIDEEPLFTSZ7-8 12MM KNEE INSRT JIIDEEPRTSZ1-2 9MM SCREW VERTEX MDTR 4.0X18MM DEV FUSN COROENT XL10D16X18X60 DEV FUSN COROENT XL10D14X18X55 DEV FUSN MONOLITH CORE 12X15MM ENDCAP MONOLITH 7D 15X13MM PLATE ARCHON 2LVL 36MM SCREW LK T10 FULLTHRD3.5X24MM TOGA FLYTE SURGICOOL ZIP XL TOGA FLYTE SURGICOOL ZIP 2XL KNEE INSRT JII BCSRTSZ5-6 12MM ROD PRECEPT TI PREBENT 85MM Page 450 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $12,893.00 $2,481.00 $656.00 $2,254.00 $2,254.00 $844.94 $844.94 $3,467.00 $7,252.00 $9,892.00 $279.43 $1,843.00 $1,865.16 $864.86 $1,912.32 $2,283.75 $3,513.29 $8,400.20 $2,320.00 $2,320.00 $820.04 $1,215.20 $1,270.50 $5,189.50 $1,278.07 $9,506.00 $2,283.75 $1,350.26 $1,041.52 $1,021.84 $2,320.29 $7,049.96 $1,154.78 $2,283.75 $2,283.75 $2,145.42 $7,049.96 $7,049.96 $10,361.54 $3,269.67 $2,440.00 $820.25 $440.20 $440.21 $2,353.75 $1,071.99 2020 pricing Drugs&Supplies PROCEDURE NAME NAIL TIB T2 SUPRACOND 10X320MM SCREW BITE SNAPOFFSHRT2.7X12MM ALLO HAMMERGRAFT 2.3X19MM 0D SCREW BITE SNAPOFFSHRT 2X12MM SCREW GORILLA R3CON NL3.5X28MM KWIRE DBL TROC 1.1X30MM PLANER BONE 8MM SHLDR HUMR LAT 42X12MM ROD SOLERA ST COCR+ 6.0X500MM SCREW SOLERA MAS 6.5X25MM SCREW PRECEPT PA 5.5X45MM SCREW LK T10 FULL THRD3.5X44MM MIXER CMNT PRISMII SYS CARTRDG NAIL HUMR PROX T2LNGLFT8X220MM SYS PT POSITION PAD PNK XL CAP NAIL END STD 6MM KT PRP ANGEL SYS ARTX KNEE INSRT JIIDEEPRTSZ1-2 13MM KNEE INSRT JIIDEEPRTSZ1-2 11MM SCREW LK T10 FULL THRD3.5X46MM SCREW LK T10 FULL THRD3.5X38MM BIT DRILL TWIST 3.2MMX5IN NAIL TIB T2 STD 11X405MM KNEE FEM STRIDE RL/LM SZ7 KNEE TIB BASE STRIDE RL/LM SZ7 KNEE TIB INSRT STRIDE SZC 10MM PLATE PROX LAT TIB LFT 2HL SCREW CORT AXSOS TI 3.5X85MM SCREW LK AXSOS TI 4X85MM KNEE INSRTJII DEEPLFT SZ7-8 15MM KNEE INSRTJIIDEEPLFTSZ7-8 13MM NAIL HUMR PROX T2 LFT 8X150MM BREAST SIL 410 FULL XFULL450CC ALLO BONE CUBE CNCLS6-10MM15CC SCREW CMAS BALLAST 7.5X80MM PLATE COMP VARIAX CURV 11HL SCREW LK T10 FULL THRD3.5X22MM SCREW VARIAX NL T8 2.4X14MM PLATE TIB DIST MEDL RT10HL175 SCREW CORT AXSOS TI 3.5X26MM SCREW CORT AXSOS TI 3.5X55MM SCREW LK AXSOS TI 4X22MM SCREW LK AXSOS TI 4X26MM SCREW LK AXSOS TI 4X42MM SCREW LK AXSOS TI 4X44MM SCREW LK AXSOS TI 4X50MM Page 451 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,686.90 $1,278.45 $3,495.24 $1,219.71 $905.40 $180.80 $913.32 $4,653.54 $1,135.84 $1,865.16 $2,391.44 $1,201.56 $1,099.08 $3,409.54 $469.00 $817.45 $2,528.40 $2,353.75 $2,353.75 $1,201.56 $1,201.56 $521.00 $3,070.47 $7,120.00 $3,394.50 $2,199.60 $4,340.83 $180.80 $995.96 $2,353.75 $2,353.75 $3,409.54 $2,286.50 $1,589.28 $4,238.00 $1,784.47 $754.47 $656.62 $4,456.29 $180.80 $180.80 $995.96 $995.96 $995.96 $995.96 $995.96 2020 pricing Drugs&Supplies PROCEDURE NAME ALLO TENDON SEMI T >20 SCREW LK AXSOS TI 4X24MM NDLE SCORPION CAPSULECLOSE SIZER MAM 410FM RPSB 440CC CAGE HYPR LORD 20D 10X38X28MM SCREW NCB CORT 5X90MM PLATE DIST FEM LFT 13HL SCREW MOTIONLOC 5.0X38MM SCREW MOTIONLOC 5.0X46MM SCREW MOTIONLOC 5.0X54MM SCREW RELINE-O PA 8.5X45MM ROD LORD RELINE-O TI 5.5X75MM HIP SLV TI MODULAR 12/14 +4 HIP LNR TANDEM BIPOLRPE28X57MM DEV FUSN COHERE 7D 12X14X6MM KNEE INSRT JII BCSRTSZ5-6 15MM PLATE ARCHON 3LVL 50MM DRILL BIT HELIX TPOWER2.5X13M TENSIONER CUTTER KNOTLESS SUT SEALER LIGASURE NANO BLNT 44CM NAIL RECON LFT 10X400MM SHLDR BASEPLATE THRD TI36X25MM KNEE STEM LGN PRESSFIT12X120MM SCREW LWEDGE LGN SZ6 10X10MM SCREW CMAS BALLAST 7.5X70MM KWIRE TMPR FIX SMTH SGL1X100MM SPACER CRST PEEK 11X36MM SPACER CRST PEEK 12X36MM SIZER MAM SRM RPSB 600CC BREAST SMTH RESPONSE LP+ 145CC NAIL TIB T2 STD 8X315MM FORCEPS GREISHABER DISP 23G GDWIRE ZIPWIRE 0.035 150CM SCREW ARCHON SLFTP 4X13MM SCREW ARCHON SLFTP 4X15MM SCREW CMAS BALLAST 8.5X80MM SCREW CMAS BALLAST 8.5X90MM KT FIX ACL BACKUP SWIVELOCK SPACER CRST PEEK 13X36MM KNEE INSRT JIIDEEPRTSZ3-4 12MM DEV REPAIR MENISC AIR SPACER CRST PEEK 14X36MM BREAST NATRELLE SOFT 560CC SIZER MAM SRF RPSB 295CC PLATE BRIGADE 12D 14X34X24MM SCREW PRECEPT PA 6.5X55MM Page 452 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $4,614.40 $995.96 $1,215.20 $118.50 $11,534.00 $1,031.68 $3,865.52 $990.72 $990.72 $990.72 $2,294.24 $844.94 $1,160.64 $1,189.87 $2,868.00 $2,353.75 $2,695.00 $915.00 $2,353.75 $7,080.00 $3,312.33 $3,528.70 $3,059.20 $4,014.27 $3,029.00 $169.00 $5,350.00 $5,350.00 $130.41 $2,286.50 $3,070.47 $745.03 $329.07 $710.70 $710.70 $5,650.00 $5,650.00 $1,782.00 $5,350.00 $2,353.75 $1,802.49 $5,350.00 $2,915.50 $130.41 $10,650.00 $2,391.41 2020 pricing Drugs&Supplies PROCEDURE NAME ROD PRECEPT TI PREBENT 140MM ROD PRECEPT TI PREBENT 150MM ANCHOR PEEK CRKSCRW 3.9X10.2MM DRILL KNOTLESS CRKSCRW 3.9MM BLADE ENDO PLANTAR FASCIA SCREW CNCLS LK SM 3.5X58MM ROD EXTL FIX CBN CONN 8X250MM ROD EXTL FIX CBN CONN 8X300MM ROD EXTL FIX CBN CONN 8X350MM SCREW MTXMID SYNT BLU 3MM SCREW MTXMID SYNT SLVR 3MM SHLDR REV INSRT 42MM +6 SPACER CRST PEEK 10X36MM NAIL TIB T2 STD 12X330MM AMNIOCARE TISSUE MATRIX CONN SOLERA SIDE 5/6/6.0 TOP70 HIP CENTRALIZER DIST INVIS8MM HIP LNR TANDEM BIPOLRPE28X45MM SPACER SPINE MDTR 14X11X8MM ROD TAPER TI 3.5-5.5X600MM SCREW CNCLS NL 2.7X30MM SCREW CNCLS NL 2.7X34MM SCREW CNCLS NL 2.7X36MM SCREW TSRH OSTEOGRIP 7.5X60MM PLATE Y RAPIDSORB10HL2.0 4X3X3 DEV FUSN COHERE 9D 14X16X9MM TAP CORT SCREW SLFDR 4MM TAP CORT SCREW SLFDR 6MM SEALER LIGASURE NANO BLNT 23CM PLATE PROX LAT TIB RT4HL 121MM SCREW LK AXSOS TI 4X55MM SCREW CORT AXSOS TI 3.5X70MM PLATE ARCHON 4LVL 74MM SCREW ARCHON SLFTP 4.5X15MM DEV FUSN MONOLITH CORE 12X13MM ENDCAP MONOLITH PRLL12 15X13MM ENDCAP MONOLITH 10D 15X13MM SPACER PLATE 12D 37X27X16MM SPACER INTERBODY12D 32X23X12MM SCREW SHRT THRD 4.0X44MM ROD PRECURV VERTEX 3.5X100MM SPACER CRST PEEK 15X36MM SCREW ARCHON SLFTP VAR 4X13MM KNEE TIB INSRT STRIDE SZD 9MM KNEE TIB BASE JOUNREY LFT SZ6 KNEE INSRTJOURNEYII LFT5-6 8MM Page 453 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $1,071.99 $1,071.99 $1,699.50 $763.50 $2,695.00 $869.62 $998.26 $1,028.06 $1,028.06 $318.36 $318.36 $2,759.92 $5,350.00 $3,070.47 $2,115.00 $19,809.46 $75.40 $1,189.87 $2,216.56 $945.64 $350.08 $350.08 $350.08 $1,318.01 $1,001.57 $2,868.00 $1,247.31 $1,247.31 $7,544.80 $4,340.83 $995.96 $180.80 $2,868.00 $710.70 $10,682.00 $3,374.18 $3,374.18 $10,534.00 $10,534.00 $197.75 $945.64 $5,350.00 $710.70 $2,199.60 $3,119.87 $2,353.75 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE INSRTJOURNEYII LFT5-6 9MM KNEE INSRTJOURNEYII LFT5-610MM KNEE ARTICU INSRT S&N 15MM PLATE ARCHON 2LVL 38MM NAIL FEM T2GTN STRY RT11X380MM PLATE ARCHON 1LVL 24MM KNEE TIB BASE JOURNEY LFT SZ1 KNEE INSRT JIIDEEPLTSZ1-2 12MM HIP STEM POLARSTEM126D LAT SZ7 ALPS PROX CURV TIB PLATE RT 5HL KT ALLO ACCUFILL W ACCUMIX 2CC HIP STEM REDAT STD 190MM SZ20 DEV FUSN COROENTXL+8DX18X50 NAIL TIB T2 STD 12X390MM KNEE INSRT JIIDEEPRTSZ3-4 13MM KT PREP CMNT FEM BONE DEV FUSN COHERE 7D 12X14X9MM PLATE ARCHON 2LVL 44MM SCREW ARCHON SLFTP 4.5X17MM SCREW LOPRO CORT 3.5X75MM BIT DRILL CANN ARTX PUR 5.0MM SCREW COMP FT XL ARTX 7.0X45MM SPACER CRST PEEK 9X36MM TRAY HUMR RVRS CUST KNEE INSRT JII BCSLFTSZ5-6 10MM HIP STEM POLARSTEM126D LAT SZ8 KWIRE THRD TROC 15X2.5X200MM EXPAND MAM ALLE W TAB 750CC SCREW PRECEPT PA 7.5X55MM SCREW COMP FT XL ARTX 7.0X50MM GDWIRE TROC TIP 0.092X9.25IN WEDGE ANAT COTTON 16X6.5MM HIP STEM ENDURANCE RTSZ3 300MM KNEE FEM STRIDE LM/RL SZ1 KNEE FEM STRIDE LM/RL SZ2 KNEE FEM STRIDE LM/RL SZ6 KNEE FEM STRIDE LM/RL SZ8 KNEE FEM STRIDE RM/LL SZ1 KNEE FEM STRIDE RM/LL SZ7 KNEE FEM STRIDE RM/LL SZ8 KNEE TIB BASE STRIDE LM/RL SZ1 KNEE TIB BASE STRIDE LM/RL SZ2 KNEE TIB BASE STRIDE LM/RL SZ8 KNEE TIB BASE STRIDE LM/RL SZ9 KNEE TIB BASE STRIDE LM/RLSZ10 KNEE TIB BASE STRIDE RM/LL SZ1 Page 454 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,353.75 $2,353.75 $4,532.00 $2,510.00 $3,616.11 $2,322.00 $2,901.46 $2,353.75 $4,078.63 $4,078.63 $5,940.00 $16,282.50 $9,800.00 $3,070.47 $2,353.75 $793.07 $2,868.00 $2,510.00 $710.70 $428.80 $880.25 $2,064.15 $5,350.00 $10,000.00 $2,353.75 $4,078.63 $682.06 $3,378.70 $2,391.41 $2,064.15 $123.41 $5,700.00 $9,721.80 $7,120.00 $7,120.00 $7,120.00 $7,120.00 $7,120.00 $7,120.00 $7,120.00 $3,394.50 $3,394.50 $4,650.00 $3,394.50 $3,394.50 $3,394.50 2020 pricing Drugs&Supplies PROCEDURE NAME KNEE TIB BASE STRIDE RM/LL SZ2 KNEE TIB BASE STRIDE RM/LL SZ8 KNEE TIB BASE STRIDE RM/LL SZ9 KNEE TIB BASE STRIDE RM/LLSZ10 KNEE TIB INSRT STRIDE SZA 8MM KNEE TIB INSRT STRIDE SZA 9MM KNEE TIB INSRT STRIDE SZA 11MM KNEE TIB INSRT STRIDE SZB 11MM KNEE TIB INSRT STRIDE SZC 11MM KNEE TIB INSRT STRIDE SZD 10 MM KNEE TIB INSRT STRIDE SZD 11MM KNEE TIB INSRT STRIDE SZE 8MM KNEE TIB INSRT STRIDE SZE 9MM KNEE TIB INSRT STRIDE SZE 10MM KNEE TIB INSRT STRIDE SZE 11MM KNEE INSRTXRXLPE LATRTSZ7-8 10 KNEE INSRT XRMEDLXLPERTSZ7-8 8 KNEE INSRT XLPE CRHFSZ3-4 13MM SCREW LK TI SLFTP 5.0X38MM SCREW LK TI SLFTP 5.0X42MM NAIL TIB T2 SUPRACOND 11X420MM PIN EXTL FIX THRD 200X50X5MM PIN EXTL FIX APEX 4X180MM KNEE TIB BASE JII XR RT SZ7 PLATE EXTNDR LFT 9HL 130MM ENDCAP XCORE2 TI 0D 16X40MM ROD LORD RELINE-O TI 5.5X80MM VERT REPL XCORE2 TI 16X30-49MM KNEE INSRT JII BCSRTSZ5-6 13MM PLATE OLEC EXTNDR RT 9HL 130MM HIP STEM POLAR STEM 126DLATSZ9 SCREW LK GORILLA 2.7X11MM WIRE OLIVE THRD PRGN 1.6MM SCREW SLFTP VA ARCHON 4.0X19MM DEV FUSN COHERE 7D 14X16X8MM DEV FUSN SM INTRLK 7D 8X17X14MM SCREW COROENT SI SLFTP 4X15MM PLATE ARCHON 2LVL 46MM SCREW MA VUEPNT II 3.5X14MM SCREW MA VUEPNT II 4.0X34MM SCREW MA VUEPNT II 4.5X32MM SET SCREW TULIP LAMINAR HOOK SCREW FA VUEPNT II 4.0X32MM SCREW FA VUEPNT II 3.5X16MM ROD VUEPNT II 3.5X240MM KNEE INSRT JIIBCSLFTSZ7-8 12MM Page 455 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $3,394.50 $3,394.50 $3,394.50 $3,394.50 $2,730.00 $2,199.60 $2,199.60 $2,730.00 $2,199.60 $2,199.60 $2,199.60 $2,199.60 $2,199.60 $2,199.60 $2,199.60 $2,353.75 $2,353.75 $3,063.00 $325.62 $325.62 $3,686.90 $671.30 $521.52 $2,901.46 $2,899.07 $3,483.61 $844.94 $10,192.00 $2,353.75 $2,899.07 $4,078.63 $1,034.16 $592.63 $710.70 $2,868.00 $5,154.00 $710.70 $2,510.00 $2,286.50 $2,286.50 $2,286.50 $405.75 $2,286.50 $2,286.50 $1,111.04 $2,353.75 2020 pricing Drugs&Supplies PROCEDURE NAME ALLO OSTEOCEL PRO 5CC KNEE INSRTJIIDEEPLFTSZ7-8 11MM SCREW CMAS BALLAST 7.5X90MM PLATE T LOPRO ARTX 9HL 2.4MM PLATE CALC FX PERIMETER MD RT KT PT SAFETY BED SET UP SM PUSHER KNOT STRY AIR DISP 2-0 KNEE INSRT BCSCNSTNDRTSZ5-6 12 KNEE FEM JII CR OXIN LFT SZ10 HIP STEM POLAR STEM 126DLATSZ10 SCREW LK T10 FULL THRD3.5X28MM PLATE 1/3 TUBLR 9HL 107MM SCREW PRECEPT RDCTN 6.5X50MM SCREW PRECEPT RDCTN 7.5X45MM SCREW PRECEPT RDCTN 7.5X50MM SCREW PRECEPT RDCTN 7.5X55MM SCREW LK AXSOS TI 4X30MM COV DISP HUGUVAC SYS PT POSITION PAD PNK REG KNEE INSRT JII BCSRTSZ5-6 11MM SPLT ORTHOGNATHIC PT SPECIFIC HIP STEM POLARSTEM126D LAT SZ1 KNEE INSRT BCSCNSTNDRTSZ3-4 13 TIGHTROPE BTB DBL LOADED PLATE BRIGADE 12D 12X34X24MM SCREW PRECEPT PA 7.5X90MM ELBOW RAD STEM ALIGN 8X2MM PLATE ANT TLIF COROENT8D9X9X30 PLATE SCAPULA ACROMION RT 6HL PK SURG EYE CATARACT SWAN BZ PLATE BRIGADE 18X42X230MM 12D ROD PRECEPT TI PREBENT 60MM PLATE SUPERIOR CURV RT10HL12MM PLATE 1/3 TUBLR 7HL 83MM PIN EXTL FIX APEX THRD 4X20X90 SCREW MTXMID SYNT SLVR 6MM TOWER CARTRDG CMNT SMARTMIX STNT URETRL RESONANCE 6FR 20MM CAGE CLYDESDALE IB 0D 10X45MM KNEE FEM JII BCS OXIN LFT SZ10 HIP STEM REDAPT HI 300MM SZ16 ROD EXTL FIX H3 11X550MM SCREW PRECEPT PA 5.5X50MM SCREW PRECEPT PA 5.5X55MM PLATE BRIGADE 12D 14X38X32MM CAGE BRIGADE 8D 14X38X28MM Page 456 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $5,334.00 $2,353.75 $3,029.00 $2,064.15 $2,748.45 $2,510.00 $856.30 $2,353.75 $4,317.76 $5,799.00 $820.25 $2,061.42 $3,378.70 $3,378.70 $3,378.70 $3,378.70 $1,035.64 $154.52 $1,035.88 $2,353.75 $5,500.00 $4,078.63 $2,353.75 $2,695.00 $10,650.00 $2,394.07 $4,738.00 $5,950.00 $3,372.60 $1,069.00 $10,650.00 $1,071.99 $2,369.73 $2,061.42 $521.52 $1,113.97 $608.16 $2,327.16 $7,268.00 $4,327.76 $18,850.00 $1,218.59 $2,391.41 $2,391.41 $10,650.00 $10,650.00 2020 pricing Drugs&Supplies PROCEDURE NAME PLATE ARCHON 2LVL 42MM ANCHOR ICONIX 2.3 2.0MMXBRAID SCREW PRECEPT PA 6.5X35MM SCREW PERCEPT PA 6.5X30MM ROD PRECEPT TI ST 170MM SCREW PRECEPT PA 8.5X100MM DEV FUSN COROENT XL+10D8X18X40 SPACER PERIMETER 8D 18X26X21MM CIRCUIT PT WO PEEP 15FT CAGE CLYDESDALE 0D 8X45MM PLATE ARCHON 3LVL 56MM KNEE FEM JII CR OXIN RT SZ10 SENS NASAL ALAR SPO2 ADLT/PED PLATE SUPERIOR BRIDGE RT 6HL99 ALLO MTX PROLAYER DERMAL4X8 SCREW RELINE-O PA 5.0X50MM SCREW RELINE-O PA 5.5X50MM SCREW RELINE-O PA 8.5X90MM SCREW RELINE-O PA 8.5X100MM PLATE ANT TLIF COROENT8D8X9X30 PLATE ANTTLIFCOROENT8D12X25X60 ROD EXTL FIX H3 11X650MM SCREW MINI SHRT THRD 3.0X24MM STNT MONOKA MINI SUT VICRYL+ 2-0 SH BLADE MINI BANANA CURV 4MM SIZER MAM MODPRO+ DISP 500CC SUT PDS II 3-0 PS2 18 UNDY BREAST COHESIVEI MODER+275 BREAST COHESIVEI MODER+300 ENDOL ENDUR BIFUR 36X14X103MM SCREW SOLERA FA TI 6.5X30MM SCREW CORT SLFTP 5.0X80MM PLATE CALC MINI LNG SCREW STD ILSC 3.5X28MM SCREW STD ILSC 3.532MM SCREW STD ILSC 3.5X35MM SCREW STD ILSC 3.5X40MM SCREW LK ILSC 3.5X30MM KWIRE ILSC 100X1.1MM SCREW CORT LK 3.5*USE 6253678* SCREW CORT LK 3.5*USE 6253679* SCREW CORT LK 3.5*USE 6253680* PLATE LK NARW RT *USE 6274663* SCREW CORT NL LOP*USE 6245763* SCREW VERTEX MDTR 4.5X30MM Page 457 of 458 Bozeman Health Deaconess Hospital UNIT PRICE $2,510.00 $6,190.40 $2,391.41 $2,391.41 $1,268.20 $2,391.41 $9,800.00 $4,966.66 $122.00 $7,268.00 $2,695.00 $4,317.76 $114.80 $2,534.59 $7,252.00 $2,394.24 $2,394.24 $2,394.24 $2,394.24 $5,950.00 $5,950.00 $1,472.92 $3,099.23 $349.00 $9.00 $63.33 $229.00 $22.00 $2,261.00 $2,261.00 $20,320.00 $2,295.00 $980.00 $4,305.00 $1,203.00 $1,203.00 $1,203.00 $1,203.00 $1,203.00 $410.00 $877.00 $877.00 $877.00 $4,219.00 $408.00 $2,237.00 2020 pricing Drugs&Supplies PROCEDURE NAME SCREW VERTEX MDTR 4.5X26MM SCREW VERTEX MDTR 4.5X28MM SLV SCLERAL BUCKLE 1MM SLV SCLERAL BUCKLE 1MM BLADE CATARACT 25.5X2.2MM BLADE SPECTRUM LOPRO DISP #3 BLADE SPECTRUM LOPRO DISP #4 LASER FBR OPTILITE 600MCRN PROBE URETRON RIGID GRAFT SKIN DISC APLIGRAF44SQCM ALLO MTX GRAFIX PRIME*DISC* ALLO MTXGRAFIXXC7.5X15CM=111SQ ALLO MTX GRAFIX PRIME2X3CM=6SQ ALLO MTX GRAFIX CORE 2X2CM=4SQ ALLO MTX GRAFIXPRIME3X4CM=12SQ ALLO MTX GRAFIX*DISC 6274088* ALLO MTXGRAFIXPRIME1.5X2CM=3SQ ALLO MTXGRAFIXCORE1.5X2CM=3SQ ALLO MTX GRAFIXCORE2X3CM=6SQ ALLO MTX GRAFIXCORE3X4CM=12SQ PF J3420 VITAMIN B12 INJECTIO ALLO ALLOPATCH 4X4CM=16SQ CNTRCPT IUD KYLEENA 19.5MG UNIT PRICE $2,237.00 $2,237.00 $47.00 $47.00 $113.00 $224.00 $224.00 $2,158.00 $2,158.00 $62.00 $196.00 $224.00 $385.00 $196.00 $236.00 $196.00 $308.00 $616.00 $385.00 $131.00 $5.00 $2,419.00 $2,308.90 Page 458 of 458 Bozeman Health Deaconess Hospital 2020 pricingMicrosoft Excel 2016 Microsoft Excel 2016