-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 1 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
100 DLS-2000-US DELIVERY SYRINGE- STERILE EA $221.00 $207.27
6.21% N100 DLS-7083-01S DELIVERY NEEDLE 8GA X 10CM-STERILE EA
$55.00 $50.78 7.67% N100 DLS-7083-05S DELIVERY NEEDLE 8GA X
10CM-STERILE P5 $275.00 $253.91 7.67% N100 DLS-7103-01S DELIVERY
NEEDLE 10GA X 10CM-STERILE EA $55.00 $50.78 7.67% N100 DLS-7103-05S
DELIVERY NEEDLE 10GA X 10CM-STERILE P5 $275.00 $253.91 7.67% N100
DLS-7121-05S DELIVERY NEEDLE 12GA X 5CM-STERILE P5 $275.00 $253.91
7.67% N100 DLS-7122-01S DELIVERY NEEDLE 12GA X 7.5CM-STERILE EA
$55.00 $50.78 7.67% N100 DLS-7122-05S DELIVERY NEEDLE 12GA X
7.5CM-STERILE P5 $275.00 $253.91 7.67% N100 DLS-7123-01S DELIVERY
NEEDLE 12GA X 10CM-STERILE EA $55.00 $50.78 7.67% N100 DLS-7123-05S
DELIVERY NEEDLE 12GA X 10CM-STERILE P5 $275.00 $253.91 7.67% N100
DLS-7124-05S DELIVERY NEEDLE 12GA X 12.5CM-STERILE P5 $275.00
$253.91 7.67% N100 DLS-7126-01S DELIVERY NEEDLE 12GA X 10CM
CURVED-STERILE EA $55.00 $50.78 7.67% N100 DLS-7126-05S DELIVERY
NEEDLE 12GA X 10CM CURVED-STERILE P5 $275.00 $253.91 7.67% N100
DLS-7141-05S DELIVERY NEEDLE 14GA X 5CM-STERILE P5 $275.00 $253.91
7.67% N100 E5112-1 CYLINDRICAL RASP EA $203.00 $186.94 7.91% N100
E5112-10 RASP SIZE 10 EA $943.00 $868.97 7.85% N100 E5112-12 RASP
SIZE 12 EA $943.00 $868.97 7.85% N100 E5112-14 RASP SIZE 14 EA
$943.00 $868.97 7.85% N100 E5112-6 RASP SIZE 6 EA $943.00 $868.97
7.85% N100 E5112-8 RASP SIZE 8 EA $943.00 $868.97 7.85% N100
E5113-10 TRIAL STEM SIZE 10 EA $293.00 $269.63 7.98% N100 E5113-10L
TRIAL STEM EPOCA SIZE 10/LONG EA $413.00 $380.87 7.78% N100
E5113-10XL TRIAL STEM EPOCA SIZE 10/EXTRA-LONG EA $470.00 $432.96
7.88% N100 E5113-12 TRIAL STEM SIZE 12 EA $293.00 $269.63 7.98%
N100 E5113-12L TRIAL STEM EPOCA SIZE 12/LONG EA $413.00 $380.87
7.78% N100 E5113-12XL TRIAL STEM EPOCA SIZE 12/EXTRA-LONG EA
$470.00 $432.96 7.88% N100 E5113-14 TRIAL STEM SIZE 14 EA $293.00
$269.63 7.98% N100 E5113-14L TRIAL STEM EPOCA SIZE 14/LONG EA
$413.00 $380.87 7.78% N100 E5113-14XL TRIAL STEM EPOCA SIZE
14/EXTRA-LONG EA $470.00 $432.96 7.88% N100 E5113-6 TRIAL STEM SIZE
6 EA $293.00 $269.63 7.98% N100 E5113-6L TRIAL STEM EPOCA SIZE
6/LONG EA $413.00 $380.87 7.78% N100 E5113-6XL TRIAL STEM EPOCA
SIZE 6/EXTRA-LONG EA $470.00 $432.96 7.88% N100 E5113-8 TRIAL STEM
SIZE 8 EA $293.00 $269.63 7.98% N100 E5113-8L TRIAL STEM EPOCA SIZE
8/LONG EA $413.00 $380.87 7.78% N100 E5113-8XL TRIAL STEM EPOCA
SIZE 8/EXTRA-LONG EA $470.00 $432.96 7.88% N100 E5114-1 SET SCREWS
FOR TRIAL HEAD P5 $7.80 $7.14 8.46% N100 E5114-40 TRIAL HEAD SIZE
40 EA $188.00 $173.19 7.88% N100 E5114-42 TRIAL HEAD SIZE 42 EA
$188.00 $173.19 7.88% N100 E5114-44 TRIAL HEAD SIZE 44 EA $188.00
$173.19 7.88% N100 E5114-46 TRIAL HEAD SIZE 46 EA $188.00 $173.19
7.88% N100 E5114-48 TRIAL HEAD SIZE 48 EA $188.00 $173.19 7.88%
N100 E5114-50 TRIAL HEAD SIZE 50 EA $188.00 $173.19 7.88% N100
E5114-52 TRIAL HEAD SIZE 52 EA $188.00 $173.19 7.88% N100 E5114-54
TRIAL HEAD SIZE 54 EA $188.00 $173.19 7.88% N100 E5114-56 TRIAL
HEAD SIZE 56 EA $188.00 $173.19 7.88% N100 E5114-58 TRIAL HEAD SIZE
58 EA $188.00 $173.19 7.88% N100 E5115-1 6.0MM RETROTORSION BAR EA
$102.00 $93.97 7.87% N100 E5115-2 GONIOMETER EA $212.00 $194.81
8.11% N100 E5115-3 INSERTER/EXTRACTOR FOR TRIAL STEM EA $348.00
$320.79 7.82% N100 E5115-4/2 2.0MM HEX SCREWDRIVER FOR TRIAL
IMPLANT EA $168.00 $154.49 8.04% N100 E5115-4/3 2.5MM HEX
SCREWDRIVER FOR TRIAL IMPLANT EA $168.00 $154.49 8.04% N100
E5115-5/1 PRESS EA $2,819.00 $2,600.23 7.76% N100 E5115-5/10 STEM
HOLDER SIZE 10 FOR PRESS EA $348.00 $320.79 7.82% N100 E5115-5/12
STEM HOLDER SIZE 12 FOR PRESS EA $348.00 $320.79 7.82% N100
E5115-5/14 STEM HOLDER SIZE 14 FOR PRESS EA $348.00 $320.79 7.82%
N100 E5115-5/3 ECCENTER IMPACTOR FOR PRESS EA $63.00 $58.03 7.89%
N100 E5115-5/4 TORQUE WRENCH FOR PRESS EA $1,098.00 $1,012.71 7.77%
N100 E5115-5/6 STEM HOLDER SIZE 6 FOR PRESS EA $348.00 $320.79
7.82% N100 E5115-5/8 STEM HOLDER SIZE 8 FOR PRESS EA $348.00
$320.79 7.82% N100 E5115-6 3.0MM RETROTORSION BAR EA $102.00 $93.97
7.87% N100 E5115-7 HEAD IMPACTOR EA $219.00 $201.74 7.88% N100
E5115-7P PLASTIC TIP FOR HEAD IMPACTOR EA $59.00 $54.11 8.29% N100
E5115-8/38 38MM HUMERAL COVER FOR TRIAL STEM EA $190.00 $175.17
7.81% N100 E5115-8/44 44MM HUMERAL COVER FOR TRIAL STEM EA $190.00
$175.17 7.81% N100 E5115-8/48 48MM HUMERAL COVER FOR TRIAL STEM EA
$190.00 $175.17 7.81% N100 E5117-20 TRIAL ECCENTER EA $409.00
$376.91 7.85% N100 E5211-10 GLENOID IMPACTOR EA $326.00 $300.11
7.94% N100 E5211-10P PLASTIC TIP FOR GLENOID IMPACTOR EA $41.00
$37.64 8.20% N100 E5211-2 RIGID GUIDE EXTENSION EA $313.00 $288.34
7.88% N100 E5211-28 28MM REAMER FOR GLENOID EA $313.00 $288.34
7.88% N100 E5211-3 10MM WRENCH EA $90.00 $82.63 8.19% N100 E5211-32
32MM REAMER FOR GLENOID EA $313.00 $288.34 7.88% N100 E5211-4L
DRILL GUIDE LEFT EA $417.00 $383.80 7.96% N100 E5211-4R DRILL GUIDE
RIGHT EA $417.00 $383.80 7.96% N100 E5211-6K 7.4MM DRILL BIT 150MM
EA $187.00 $172.20 7.91% N100 E5211-6L 7.4MM DRILL BIT 200MM EA
$187.00 $172.20 7.91% N100 E5211-8 GLENOID CLAMP EA $330.00 $304.07
7.86% N100 E5211-8E TRIAL GLENOID CLAMP EA $330.00 $304.07 7.86%
N100 E5211-9 THORN FOR REAMER EA $77.00 $70.83 8.01% N100 E5213-42
TRIAL GLENOID SIZE 42 EA $166.00 $152.51 8.13% N100 E5213-46 TRIAL
GLENOID SIZE 46 EA $166.00 $152.51 8.13% N100 E5213-50 TRIAL
GLENOID SIZE 50 EA $166.00 $152.51 8.13% N100 E5213-54 TRIAL
GLENOID SIZE 54 EA $166.00 $152.51 8.13% N100 MXR-US-2000 ROTARY
MIXER EA $1,890.00 $1,776.60 6.00% N100 SRS-003-FSP SRS FAST SET
PUTTY 3CC BONE VOID FILLER-STERILE EA $1,004.00 $943.08 6.07% Y100
SRS-003-RMS NORIAN® SRS® BONE VOID FILLER ROTARY MIX 3CC-STERILE EA
$1,004.00 $943.08 6.07% Y100 SRS-005-FSP SRS FAST SET PUTTY 5CC
BONE VOID FILLER-STERILE EA $1,649.00 $1,549.35 6.04% Y
State of NY Price list as of 01Feb2012
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 2 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 SRS-005-RMS NORIAN® SRS® BONE VOID FILLER ROTARY MIX
5CC-STERILE EA $1,649.00 $1,549.35 6.04% Y100 SRS-010-FSP SRS FAST
SET PUTTY 10CC BONE VOID FILLER-STERILE EA $3,242.00 $3,046.87
6.02% Y100 SRS-010-RMS NORIAN® SRS® BONE VOID FILLER ROTARY MIX
10CC-STERILE EA $3,242.00 $3,046.87 6.02% Y100 SRS-015-FSP SRS FAST
SET PUTTY 15CC BONE VOID FILLER-STERILE EA $4,758.00 $4,471.86
6.01% Y100 U1.530.412 PRESSURE MEASUREMENT EA $230.00 $209.47 8.93%
N100 02.001.300 4.5MM LCP® CURVED CONDYLAR PLATE 10
HOLES/242MM-LEFT EA $1,982.00 $1,829.96 7.67% Y100 02.001.300S
4.5MM LCP® CURVED CONDYLAR PLATE 10H/242MM/LEFT-STERILE EA
$2,037.00 $1,872.69 8.07% Y100 02.001.302 4.5MM LCP® CURVED
CONDYLAR PLATE 12 HOLES/278MM-LEFT EA $2,024.00 $1,868.31 7.69%
Y100 02.001.302S 4.5MM LCP® CURVED CONDYLAR PLATE
12H/278MM/LEFT-STERILE EA $2,079.00 $1,911.03 8.08% Y100 02.001.304
4.5MM LCP® CURVED CONDYLAR PLATE 14 HOLES/314MM-LEFT EA $2,066.00
$1,906.65 7.71% Y100 02.001.304S 4.5MM LCP® CURVED CONDYLAR PLATE
14H/314MM/LEFT-STERILE EA $2,121.00 $1,949.38 8.09% Y100 02.001.306
4.5MM LCP® CURVED CONDYLAR PLATE 16 HOLES/350MM-LEFT EA $2,106.00
$1,944.05 7.69% Y100 02.001.306S 4.5MM LCP® CURVED CONDYLAR PLATE
16H/350MM/LEFT-STERILE EA $2,161.00 $1,986.68 8.07% Y100 02.001.308
4.5MM LCP® CURVED CONDYLAR PLATE 18 HOLES/386MM-LEFT EA $2,150.00
$1,984.38 7.70% Y100 02.001.308S 4.5MM LCP® CURVED CONDYLAR PLATE
18H/386MM/LEFT-STERILE EA $2,205.00 $2,027.10 8.07% Y100
02.001.310S 4.5MM LCP® CURVED CONDYLAR PLATE 20H/422MM/LEFT-STERILE
EA $2,247.00 $2,066.48 8.03% Y100 02.001.312S 4.5MM LCP® CURVED
CONDYLAR PLATE 22H/458MM/LEFT-STERILE EA $2,283.00 $2,106.90 7.71%
Y100 02.001.320 4.5MM LCP® CURVED CONDYLAR PLATE 10
HOLES/242MM-RIGHT EA $1,982.00 $1,829.96 7.67% Y100 02.001.320S
4.5MM LCP® CURVED CONDYLAR PLATE 10H/242MM/RIGHT-STERILE EA
$2,037.00 $1,872.69 8.07% Y100 02.001.322 4.5MM LCP® CURVED
CONDYLAR PLATE 12 HOLES/278MM-RIGHT EA $2,024.00 $1,868.31 7.69%
Y100 02.001.322S 4.5MM LCP® CURVED CONDYLAR PLATE
12H/278MM/RIGHT-STERILE EA $2,079.00 $1,911.03 8.08% Y100
02.001.324 4.5MM LCP® CURVED CONDYLAR PLATE 14 HOLES/314MM-RIGHT EA
$2,066.00 $1,906.65 7.71% Y100 02.001.324S 4.5MM LCP® CURVED
CONDYLAR PLATE 14H/314MM/RIGHT-STERILE EA $2,121.00 $1,949.38 8.09%
Y100 02.001.326 4.5MM LCP® CURVED CONDYLAR PLATE 16
HOLES/350MM-RIGHT EA $2,106.00 $1,944.05 7.69% Y100 02.001.326S
4.5MM LCP® CURVED CONDYLAR PLATE 16H/350MM/RIGHT-STERILE EA
$2,161.00 $1,986.68 8.07% Y100 02.001.328 4.5MM LCP® CURVED
CONDYLAR PLATE 18 HOLES/386MM-RIGHT EA $2,150.00 $1,984.38 7.70%
Y100 02.001.328S 4.5MM LCP® CURVED CONDYLAR PLATE
18H/386MM/RIGHT-STERILE EA $2,205.00 $2,027.10 8.07% Y100
02.001.330S 4.5MM LCP® CURVED CONDYLAR PLATE
20H/422MM/RIGHT-STERILE EA $2,247.00 $2,066.48 8.03% Y100
02.001.332S 4.5MM LCP® CURVED CONDYLAR PLATE
22H/458MM/RIGHT-STERILE EA $2,283.00 $2,106.90 7.71% Y100
02.007.000S OLECRANON OSTEOTOMY NAIL AND END CAP-STERILE EA $753.00
$694.77 7.73% Y100 02.007.001 OLECRANON OSTEOTOMY NAIL EA $435.00
$401.55 7.69% Y100 02.007.002 OLECRANON OSTEOTOMY END CAP EA
$252.00 $232.22 7.85% Y100 02.007.002S OLECRANON OSTEOTOMY END CAP
STERILE EA $307.00 $273.60 10.88% Y100 02.007.012 2.7MM THRDD
STEPPED SCR 12MM F/OLECRANON OSTEOTOMY NAIL EA $117.00 $107.23
8.35% Y100 02.007.012S 2.7MM THRDD STEPPED SCR 12MM F/OLECRANON
OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100 02.007.014 2.7MM
THRDD STEPPED SCR 14MM F/OLECRANON OSTEOTOMY NAIL EA $117.00
$107.23 8.35% Y100 02.007.014S 2.7MM THRDD STEPPED SCR 14MM
F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.016 2.7MM THRDD STEPPED SCR 16MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.016S 2.7MM THRDD STEPPED SCR
16MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.018 2.7MM THRDD STEPPED SCR 18MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.018S 2.7MM THRDD STEPPED SCR
18MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.020 2.7MM THRDD STEPPED SCR 20MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.020S 2.7MM THRDD STEPPED SCR
20MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.022 2.7MM THRDD STEPPED SCR 22MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.022S 2.7MM THRDD STEPPED SCR
22MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.024 2.7MM THRDD STEPPED SCR 24MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.024S 2.7MM THRDD STEPPED SCR
24MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.026 2.7MM THRDD STEPPED SCR 26MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.026S 2.7MM THRDD STEPPED SCR
26MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.028 2.7MM THRDD STEPPED SCR 28MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.028S 2.7MM THRDD STEPPED SCR
28MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.030 2.7MM THRDD STEPPED SCR 30MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.030S 2.7MM THRDD STEPPED SCR
30MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.032 2.7MM THRDD STEPPED SCR 32MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.032S 2.7MM THRDD STEPPED SCR
32MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.034 2.7MM THRDD STEPPED SCR 34MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.034S 2.7MM THRDD STEPPED SCR
34MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.036 2.7MM THRDD STEPPED SCR 36MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.036S 2.7MM THRDD STEPPED SCR
36MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.038 2.7MM THRDD STEPPED SCR 38MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.038S 2.7MM THRDD STEPPED SCR
38MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.040 2.7MM THRDD STEPPED SCR 40MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.040S 2.7MM THRDD STEPPED SCR
40MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.042 2.7MM THRDD STEPPED SCR 42MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.042S 2.7MM THRDD STEPPED SCR
42MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.044 2.7MM THRDD STEPPED SCR 44MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.044S 2.7MM THRDD STEPPED SCR
44MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.046 2.7MM THRDD STEPPED SCR 46MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.046S 2.7MM THRDD STEPPED SCR
46MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.048 2.7MM THRDD STEPPED SCR 48MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.048S 2.7MM THRDD STEPPED SCR
48MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.007.050 2.7MM THRDD STEPPED SCR 50MM F/OLECRANON OSTEOTOMY NAIL
EA $117.00 $107.23 8.35% Y100 02.007.050S 2.7MM THRDD STEPPED SCR
50MM F/OLECRANON OSTEOTOMY NL-STER EA $172.00 $148.20 13.84% Y100
02.100.004 3.5MM PUBIC SYMPHYSIS PLATE 4 HOLES EA $920.00 $849.36
7.68% Y100 02.100.006 3.5MM PUBIC SYMPHYSIS PLATE 6 HOLES EA
$1,008.00 $930.01 7.74% Y100 02.100.014 3.5MM PUBIC SYMPHYSIS PLATE
4 HOLES INCL 2 DCP(TM) HOLES EA $1,010.00 $932.00 7.72% Y100
02.100.016 3.5MM PUBIC SYMPHYSIS PLATE 6 HOLES INCL 2 DCP(TM) HOLES
EA $1,109.00 $1,023.54 7.71% Y100 02.100.020 2.4MM/2.7MM LOCKING
NAVICULAR PLATE EA $911.00 $856.34 6.00% Y100 02.100.020S 2.4/2.7MM
LOCKING NAVICULAR PLATE-STERILE EA $966.00 $908.04 6.00% Y100
02.100.021 2.4MM/2.7MM LOCKING CUBOID PLATE-LEFT EA $887.00 $833.78
6.00% Y100 02.100.021S 2.4/2.7MM LOCKING CUBOID PLATE LEFT-STERILE
EA $942.00 $885.48 6.00% Y100 02.100.022 2.4MM/2.7MM LOCKING CUBOID
PLATE-RIGHT EA $887.00 $833.78 6.00% Y100 02.100.022S 2.4/2.7MM
LOCKING CUBOID PLATE RIGHT-STERILE EA $942.00 $885.48 6.00% Y100
02.100.023 2.4MM/2.7MM LOCKING TALUS PLATE EA $876.00 $823.44 6.00%
Y100 02.100.023S 2.4/2.7MM LOCKING TALUS PLATE STERILE EA $931.00
$875.14 6.00% Y100 02.100.032S LCP ANTERIOR ANKLE ARTHRODESIS PLATE
6 HOLES/100MM-STERILE EA $1,207.00 $1,114.08 7.70% Y100 02.100.033S
LCP ANTERIOR ANKLE ARTHRODESIS PLATE 7 HOLES/116MM-STERILE EA
$1,240.00 $1,144.62 7.69% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 3 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.100.103 3.5MM LOCKING LOW PROFILE RECON PLATE 3 HOLES EA
$612.00 $564.94 7.69% Y100 02.100.104 3.5MM LOCKING LOW PROFILE
RECON PLATE 4 HOLES EA $642.00 $592.45 7.72% Y100 02.100.105 3.5MM
LOCKING LOW PROFILE RECON PLATE 5 HOLES EA $671.00 $619.02 7.75%
Y100 02.100.106 3.5MM LOCKING LOW PROFILE RECON PLATE 6 HOLES EA
$699.00 $644.60 7.78% Y100 02.100.107 3.5MM LOCKING LOW PROFILE
RECON PLATE 7 HOLES EA $726.00 $670.24 7.68% Y100 02.100.108 3.5MM
LOCKING LOW PROFILE RECON PLATE 8 HOLES EA $755.00 $696.81 7.71%
Y100 02.100.109 3.5MM LOCKING LOW PROFILE RECON PLATE 9 HOLES EA
$783.00 $722.39 7.74% Y100 02.100.110 3.5MM LOCKING LOW PROFILE
RECON PLATE 10 HOLES EA $812.00 $748.91 7.77% Y100 02.100.111 3.5MM
LOCKING LOW PROFILE RECON PLATE 11 HOLES EA $840.00 $775.52 7.68%
Y100 02.100.112 3.5MM LOCKING LOW PROFILE RECON PLATE 12 HOLES EA
$867.00 $800.12 7.71% Y100 02.100.113 3.5MM LOCKING LOW PROFILE
RECON PLATE 13 HOLES EA $896.00 $826.70 7.73% Y100 02.100.114 3.5MM
LOCKING LOW PROFILE RECON PLATE 14 HOLES EA $925.00 $853.27 7.75%
Y100 02.100.115 3.5MM LOCKING LOW PROFILE RECON PLATE 15 HOLES EA
$953.00 $879.90 7.67% Y100 02.100.116 3.5MM LOCKING LOW PROFILE
RECON PLATE 16 HOLES EA $981.00 $905.48 7.70% Y100 02.100.118 3.5MM
LOCKING LOW PROFILE RECON PLATE 18 HOLES EA $1,009.00 $931.00 7.73%
Y100 02.100.120 3.5MM LOCKING LOW PROFILE RECON PLATE 20 HOLES EA
$1,039.00 $958.57 7.74% Y100 02.100.203 3.5MM WIDE ANGLE LOW
PROFILE RECON PLATE 3 HOLES EA $377.00 $347.36 7.86% Y100
02.100.204 3.5MM WIDE ANGLE LOW PROFILE RECON PLATE 4 HOLES EA
$395.00 $364.08 7.83% Y100 02.100.205 3.5MM WIDE ANGLE LOW PROFILE
RECON PLATE 5 HOLES EA $412.00 $379.87 7.80% Y100 02.100.206 3.5MM
WIDE ANGLE LOW PROFILE RECON PLATE 6 HOLES EA $430.00 $396.60 7.77%
Y100 02.100.207 3.5MM WIDE ANGLE LOW PROFILE RECON PLATE 7 HOLES EA
$448.00 $413.32 7.74% Y100 02.100.208 3.5MM WIDE ANGLE LOW PROFILE
RECON PLATE 8 HOLES EA $465.00 $429.11 7.72% Y100 02.100.209 3.5MM
WIDE ANGLE LOW PROFILE RECON PLATE 9 HOLES EA $484.00 $446.82 7.68%
Y100 02.100.210 3.5MM WIDE ANGLE LOW PROFILE RECON PLATE 10 HOLES
EA $503.00 $463.50 7.85% Y100 02.100.211 3.5MM WIDE ANGLE LOW
PROFILE RECON PLATE 11 HOLES EA $529.00 $488.14 7.72% Y100
02.100.212 3.5MM WIDE ANGLE LOW PROFILE RECON PLATE 12 HOLES EA
$559.00 $515.71 7.74% Y100 02.100.213 3.5MM WIDE ANGLE LOW PROFILE
RECON PLATE 13 HOLES EA $588.00 $542.28 7.78% Y100 02.100.214 3.5MM
WIDE ANGLE LOW PROFILE RECON PLATE 14 HOLES EA $613.00 $565.93
7.68% Y100 02.100.215 3.5MM WIDE ANGLE LOW PROFILE RECON PLATE 15
HOLES EA $643.00 $593.43 7.71% Y100 02.100.216 3.5MM WIDE ANGLE LOW
PROFILE RECON PLATE 16 HOLES EA $672.00 $620.00 7.74% Y100
02.100.218 3.5MM WIDE ANGLE LOW PROFILE RECON PLATE 18 HOLES EA
$701.00 $646.59 7.76% Y100 02.100.220 3.5MM WIDE ANGLE LOW PROFILE
RECON PLATE 20 HOLES EA $727.00 $671.22 7.67% Y100 02.100.301 3.5MM
SPRING PLATE/1 HOLE EA $264.00 $243.06 7.93% Y100 02.100.301S 3.5MM
SPRING PLATE 1 HOLE-STERILE EA $319.00 $285.00 10.66% Y100
02.100.302 3.5MM SPRING PLATE/2 HOLES EA $286.00 $263.74 7.78% Y100
02.100.302S 3.5MM SPRING PLATE 2 HOLES-STERILE EA $341.00 $305.73
10.34% Y100 02.100.303 3.5MM SPRING PLATE/3 HOLES EA $314.00
$289.33 7.86% Y100 02.100.303S 3.5MM SPRING PLATE 3 HOLES-STERILE
EA $369.00 $331.63 10.13% Y100 02.100.325S 3.5MM QUADRILATERAL
SURFACE PLATE/STANDARD-STERILE EA $458.00 $430.52 6.00% Y100
02.100.326S 3.5MM QUADRILATERAL SURFACE PLATE/LONG-STERILE EA
$504.00 $473.76 6.00% Y100 02.100.327S 3.5MM QUADRILATERAL SURFACE
PLATE/SHORT-STERILE EA $415.00 $390.10 6.00% Y100 02.100.360 3.5MM
LOCKING LOW PROFILE RECON J-PLATE 10 HOLES RIGHT EA $844.00 $778.45
7.77% Y100 02.100.361 3.5MM LOCKING LOW PROFILE RECON J-PLATE 10
HOLES LEFT EA $844.00 $778.45 7.77% Y100 02.100.362 3.5MM LOCKING
LOW PROFILE RECON J-PLATE 12 HOLES RIGHT EA $891.00 $821.75 7.77%
Y100 02.100.363 3.5MM LOCKING LOW PROFILE RECON J-PLATE 12 HOLES
LEFT EA $891.00 $821.75 7.77% Y100 02.100.364 3.5MM LOCKING LOW
PROFILE RECON J-PLATE 14 HOLES RIGHT EA $939.00 $866.04 7.77% Y100
02.100.365 3.5MM LOCKING LOW PROFILE RECON J-PLATE 14 HOLES LEFT EA
$939.00 $866.04 7.77% Y100 02.100.366 3.5MM LOCKING LOW PROFILE
RECON J-PLATE 16 HOLES RIGHT EA $993.00 $916.26 7.73% Y100
02.100.367 3.5MM LOCKING LOW PROFILE RECON J-PLATE 16 HOLES LEFT EA
$993.00 $916.26 7.73% Y100 02.102.001 UNIVERSAL LOCKING TROCHANTER
STABILIZATION PLATE 131MM EA $768.00 $708.56 7.74% Y100 02.104.004
3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 4H/RT 122MM LONG EA
$1,427.00 $1,317.08 7.70% Y100 02.104.004S 3.5MM LCP EXTRA-ARTICLR
DISTAL HUMERUS PL 4H/RT 122MM-STERIL EA $1,482.00 $1,359.87 8.24%
Y100 02.104.006 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 6H/RT
158MM LONG EA $1,632.00 $1,506.07 7.72% Y100 02.104.006S 3.5MM LCP
EXTRA-ARTICLR DISTAL HUMERUS PL 6H/RT 158MM-STERIL EA $1,687.00
$1,548.85 8.19% Y100 02.104.008 3.5MM LCP EXTRA-ARTICLR DISTAL
HUMERUS PL 8H/RT 194MM LONG EA $1,733.00 $1,599.59 7.70% Y100
02.104.008S 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 8H/RT
194MM-STERIL EA $1,788.00 $1,642.38 8.14% Y100 02.104.010 3.5MM LCP
EXTRA-ARTICLR DISTAL HUMERUS PL 10H/RT 230MM LONG EA $1,834.00
$1,693.11 7.68% Y100 02.104.010S 3.5MM LCP EXTRA-ARTICLR DISTAL
HUMERUS PL 10H/RT 230MM-STER EA $1,889.00 $1,735.90 8.10% Y100
02.104.012 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 12H/RT 266MM
LONG EA $2,039.00 $1,882.09 7.70% Y100 02.104.012S 3.5MM LCP
EXTRA-ARTICLR DISTAL HUMERUS PL 12H/RT 266MM-STER EA $2,094.00
$1,924.88 8.08% Y100 02.104.014 3.5MM LCP EXTRA-ARTICLR DISTAL
HUMERUS PL 14H/RT 302MM LONG EA $2,244.00 $2,071.08 7.71% Y100
02.104.014S 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 14H/RT
302MM-STER EA $2,299.00 $2,113.86 8.05% Y100 02.104.024 3.5MM LCP
EXTRA-ARTICLR DISTAL HUMERUS PL 4H/LT 122MM LONG EA $1,427.00
$1,317.08 7.70% Y100 02.104.024S 3.5MM LCP EXTRA-ARTICLR DISTAL
HUMERUS PL 4H/LT 122MM-STERIL EA $1,482.00 $1,359.87 8.24% Y100
02.104.026 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 6H/LT 158MM
LONG EA $1,632.00 $1,506.07 7.72% Y100 02.104.026S 3.5MM LCP
EXTRA-ARTICLR DISTAL HUMERUS PL 6H/LT 158MM-STERIL EA $1,687.00
$1,548.85 8.19% Y100 02.104.028 3.5MM LCP EXTRA-ARTICLR DISTAL
HUMERUS PL 8H/LT 194MM LONG EA $1,733.00 $1,599.59 7.70% Y100
02.104.028S 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 8H/LT
194MM-STERIL EA $1,788.00 $1,642.38 8.14% Y100 02.104.030 3.5MM LCP
EXTRA-ARTICLR DISTAL HUMERUS PL 10H/LT 230MM LONG EA $1,834.00
$1,693.11 7.68% Y100 02.104.030S 3.5MM LCP EXTRA-ARTICLR DISTAL
HUMERUS PL 10H/LT 230MM-STER EA $1,889.00 $1,735.90 8.10% Y100
02.104.032 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 12H/LT 266MM
LONG EA $2,039.00 $1,882.09 7.70% Y100 02.104.032S 3.5MM LCP
EXTRA-ARTICLR DISTAL HUMERUS PL 12H/LT 266MM-STER EA $2,094.00
$1,924.88 8.08% Y100 02.104.034 3.5MM LCP EXTRA-ARTICLR DISTAL
HUMERUS PL 14H/LT 302MM LONG EA $2,244.00 $2,071.08 7.71% Y100
02.104.034S 3.5MM LCP EXTRA-ARTICLR DISTAL HUMERUS PL 14H/LT
302MM-STER EA $2,299.00 $2,113.86 8.05% Y100 02.108.200 3.0MM DRILL
TIP GUIDE WIRE WITH THREADS 230MM TP $224.00 $206.62 7.76% Y100
02.108.310 PEDIATRIC LCP(TM) HIP PLATE 3.5MM 100° EA $625.00
$578.83 7.39% Y100 02.108.310S PEDIATRIC LCP(TM) HIP PLATE 3.5MM
100°-STERILE EA $680.00 $621.59 8.59% Y100 02.108.311 PEDIATRIC
LCP(TM) HIP PLATE 3.5MM 110° EA $625.00 $578.83 7.39% Y100
02.108.311S PEDIATRIC LCP(TM) HIP PLATE 3.5MM 110°-STERILE EA
$680.00 $621.59 8.59% Y100 02.108.313 PEDIATRIC LCP(TM) HIP PLATE
3.5MM 120° EA $625.00 $578.83 7.39% Y100 02.108.313S PEDIATRIC
LCP(TM) HIP PLATE 3.5MM 120°-STERILE EA $680.00 $621.59 8.59% Y100
02.108.315 PEDIATRIC LCP(TM) HIP PLATE 3.5MM 150° EA $625.00
$578.83 7.39% Y100 02.108.315S PEDIATRIC LCP(TM) HIP PLATE 3.5MM
150°-STERILE EA $680.00 $621.59 8.59% Y100 02.108.320 PEDIATRIC
LCP(TM) HIP PLATE 5.0MM 100° EA $650.00 $601.46 7.47% Y100
02.108.320S PEDIATRIC LCP(TM) HIP PLATE 5.0MM 100°-STERILE EA
$705.00 $644.22 8.62% Y100 02.108.321 PEDIATRIC LCP(TM) HIP PLATE
5.0MM 110° EA $650.00 $601.46 7.47% Y100 02.108.321S PEDIATRIC
LCP(TM) HIP PLATE 5.0MM 110°-STERILE EA $705.00 $644.22 8.62% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 4 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.108.323 PEDIATRIC LCP(TM) HIP PLATE 5.0MM 120° EA $650.00
$601.46 7.47% Y100 02.108.323S PEDIATRIC LCP(TM) HIP PLATE 5.0MM
120°-STERILE EA $705.00 $644.22 8.62% Y100 02.108.325 PEDIATRIC
LCP(TM) HIP PLATE 5.0MM 150° EA $650.00 $601.46 7.47% Y100
02.108.325S PEDIATRIC LCP(TM) HIP PLATE 5.0MM 150°-STERILE EA
$705.00 $644.22 8.62% Y100 02.110.005 LCP DIA-META VOLAR DISTAL
RADIUS PL 5H SHAFT/RT EA $1,836.00 $1,701.00 7.35% Y100 02.110.005S
LCP DIA-META VOLAR DISTAL RADIUS PL 5H SHAFT/RT-STERILE EA
$1,891.00 $1,743.77 7.79% Y100 02.110.007 LCP DIA-META VOLAR DISTAL
RADIUS PL 7H SHAFT/RT EA $1,881.00 $1,742.31 7.37% Y100 02.110.007S
LCP DIA-META VOLAR DISTAL RADIUS PL 7H SHAFT/RT-STERILE EA
$1,936.00 $1,785.09 7.79% Y100 02.110.009 LCP DIA-META VOLAR DISTAL
RADIUS PL 9H SHAFT/RT EA $1,925.00 $1,783.67 7.34% Y100 02.110.009S
LCP DIA-META VOLAR DISTAL RADIUS PL 9H SHAFT/RT-STERILE EA
$1,980.00 $1,826.45 7.76% Y100 02.110.011 LCP DIA-META VOLAR DISTAL
RADIUS PL 11H SHAFT/RT EA $1,969.00 $1,823.99 7.36% Y100
02.110.011S LCP DIA-META VOLAR DISTAL RADIUS PL 11H
SHAFT/RT-STERILE EA $2,024.00 $1,866.78 7.77% Y100 02.110.013S LCP
DIA-META VOLAR DISTAL RADIUS PL 13H SHAFT/RT-STERILE EA $2,055.00
$1,903.77 7.36% Y100 02.110.015S LCP DIA-META VOLAR DISTAL RADIUS
PL 15H SHAFT/RT-STERILE EA $2,122.00 $1,955.47 7.85% Y100
02.110.105 LCP DIA-META VOLAR DISTAL RADIUS PL 5H SHAFT/LT EA
$1,836.00 $1,701.00 7.35% Y100 02.110.105S LCP DIA-META VOLAR
DISTAL RADIUS PL 5H SHAFT/LT-STERILE EA $1,891.00 $1,743.77 7.79%
Y100 02.110.107 LCP DIA-META VOLAR DISTAL RADIUS PL 7H SHAFT/LT EA
$1,881.00 $1,742.31 7.37% Y100 02.110.107S LCP DIA-META VOLAR
DISTAL RADIUS PL 7H SHAFT/LT-STERILE EA $1,936.00 $1,785.09 7.79%
Y100 02.110.109 LCP DIA-META VOLAR DISTAL RADIUS PL 9H SHAFT/LT EA
$1,925.00 $1,783.67 7.34% Y100 02.110.109S LCP DIA-META VOLAR
DISTAL RADIUS PL 9H SHAFT/LT-STERILE EA $1,980.00 $1,826.45 7.76%
Y100 02.110.111 LCP DIA-META VOLAR DISTAL RADIUS PL 11H SHAFT/LT EA
$1,969.00 $1,823.99 7.36% Y100 02.110.111S LCP DIA-META VOLAR
DISTAL RADIUS PL 11H SHAFT/LT-STERILE EA $2,024.00 $1,866.78 7.77%
Y100 02.110.113S LCP DIA-META VOLAR DISTAL RADIUS PL 13H
SHAFT/LT-STERILE EA $2,055.00 $1,903.77 7.36% Y100 02.110.115S LCP
DIA-META VOLAR DISTAL RADIUS PL 15H SHAFT/LT-STERILE EA $2,122.00
$1,955.47 7.85% Y100 02.110.150 LCP WRIST FUSION STANDARD BEND
PLATE EA $1,958.00 $1,805.98 7.76% Y100 02.110.150S LCP WRIST
FUSION STANDARD BEND PLATE-STERILE EA $2,013.00 $1,848.74 8.16%
Y100 02.110.151 LCP WRIST FUSION SHORT BEND PLATE EA $1,958.00
$1,805.98 7.76% Y100 02.110.151S LCP WRIST FUSION SHORT BEND
PLATE-STERILE EA $2,013.00 $1,848.74 8.16% Y100 02.110.152 LCP
WRIST FUSION STRAIGHT PLATE EA $1,958.00 $1,805.98 7.76% Y100
02.110.152S LCP WRIST FUSION STRAIGHT PLATE-STERILE EA $2,013.00
$1,848.74 8.16% Y100 02.110.201 VA-LCP VOLAR DISTAL RADIUS PL 5H
HEAD/3H SHAFT/RT EA $1,166.00 $1,079.88 7.39% Y100 02.110.202
VA-LCP VOLAR DISTAL RADIUS PL 5H HEAD/5H SHAFT/RT EA $1,255.00
$1,162.55 7.37% Y100 02.110.203 VA-LCP VOLAR DISTAL RADIUS PL 5H
HEAD/3H SHAFT/LT EA $1,166.00 $1,079.88 7.39% Y100 02.110.204
VA-LCP VOLAR DISTAL RADIUS PL 5H HEAD/5H SHAFT/LT EA $1,255.00
$1,162.55 7.37% Y100 02.110.205 VA-LCP VOLAR DISTAL RADIUS PL 4H
HEAD/3H SHAFT/RT EA $1,166.00 $1,079.88 7.39% Y100 02.110.206
VA-LCP VOLAR DISTAL RADIUS PL 4H HEAD/5H SHAFT/RT EA $1,255.00
$1,162.55 7.37% Y100 02.110.207 VA-LCP VOLAR DISTAL RADIUS PL 4H
HEAD/3H SHAFT/LT EA $1,166.00 $1,079.88 7.39% Y100 02.110.208
VA-LCP VOLAR DISTAL RADIUS PL 4H HEAD/5H SHAFT/LT EA $1,255.00
$1,162.55 7.37% Y100 02.110.300 1.8MM KIRSCHNER WIRE WITH TROCAR
POINT 150MM TP $97.50 $90.05 7.64% Y100 02.110.330 LCP VOLAR COLUMN
DISTAL RADIUS PL 9H HEAD/3H SHAFT/RT EA $1,010.00 $931.17 7.80%
Y100 02.110.331 LCP VOLAR COLUMN DISTAL RADIUS PL 9H HEAD/3H
SHAFT/LT EA $1,010.00 $931.17 7.80% Y100 02.110.340 LCP VOLAR
COLUMN DISTAL RADIUS PL 9H HEAD/4H SHAFT/RT EA $1,042.00 $960.71
7.80% Y100 02.110.341 LCP VOLAR COLUMN DISTAL RADIUS PL 9H HEAD/4H
SHAFT/LT EA $1,042.00 $960.71 7.80% Y100 02.110.350 LCP VOLAR
COLUMN DISTAL RADIUS PL 9H HEAD/5H SHAFT/RT EA $1,072.00 $988.28
7.81% Y100 02.110.351 LCP VOLAR COLUMN DISTAL RADIUS PL 9H HEAD/5H
SHAFT/LT EA $1,072.00 $988.28 7.81% Y100 02.110.430 LCP VOLAR
COLUMN DISTAL RADIUS PL 8H HEAD/3H SHAFT/RT EA $1,010.00 $931.17
7.80% Y100 02.110.431 LCP VOLAR COLUMN DISTAL RADIUS PL 8H HEAD/3H
SHAFT/LT EA $1,010.00 $931.17 7.80% Y100 02.110.440 LCP VOLAR
COLUMN DISTAL RADIUS PL 8H HEAD/4H SHAFT/RT EA $1,042.00 $960.71
7.80% Y100 02.110.441 LCP VOLAR COLUMN DISTAL RADIUS PL 8H HEAD/4H
SHAFT/LT EA $1,042.00 $960.71 7.80% Y100 02.110.450 LCP VOLAR
COLUMN DISTAL RADIUS PL 8H HEAD/5H SHAFT/RT EA $1,072.00 $988.28
7.81% Y100 02.110.451 LCP VOLAR COLUMN DISTAL RADIUS PL 8H HEAD/5H
SHAFT/LT EA $1,072.00 $988.28 7.81% Y100 02.110.730 LCP VOLAR
COLUMN DISTAL RADIUS PL 6H HEAD/3H SHAFT/RT EA $1,010.00 $931.17
7.80% Y100 02.110.730S LCP VOLAR COLUMN DISTAL RADIUS PL 6H HEAD/3H
SHAFT/RT-STERIL EA $1,065.00 $973.94 8.55% Y100 02.110.731 LCP
VOLAR COLUMN DISTAL RADIUS PL 6H HEAD/3H SHAFT/LT EA $1,010.00
$931.17 7.80% Y100 02.110.731S LCP VOLAR COLUMN DISTAL RADIUS PL 6H
HEAD/3H SHAFT/LT-STERIL EA $1,065.00 $973.94 8.55% Y100 02.110.740
LCP VOLAR COLUMN DISTAL RADIUS PL 6H HEAD/4H SHAFT/RT EA $1,042.00
$960.71 7.80% Y100 02.110.740S LCP VOLAR COLUMN DISTAL RADIUS PL 6H
HEAD/4H SHAFT/RT-STERIL EA $1,097.00 $1,003.49 8.52% Y100
02.110.741 LCP VOLAR COLUMN DISTAL RADIUS PL 6H HEAD/4H SHAFT/LT EA
$1,042.00 $960.71 7.80% Y100 02.110.741S LCP VOLAR COLUMN DISTAL
RADIUS PL 6H HEAD/4H SHAFT/LT-STERIL EA $1,097.00 $1,003.49 8.52%
Y100 02.110.750 LCP VOLAR COLUMN DISTAL RADIUS PL 6H HEAD/5H
SHAFT/RT EA $1,072.00 $988.28 7.81% Y100 02.110.750S LCP VOLAR
COLUMN DISTAL RADIUS PL 6H HEAD/5H SHAFT/RT-STERIL EA $1,127.00
$1,031.05 8.51% Y100 02.110.751 LCP VOLAR COLUMN DISTAL RADIUS PL
6H HEAD/5H SHAFT/LT EA $1,072.00 $988.28 7.81% Y100 02.110.751S LCP
VOLAR COLUMN DISTAL RADIUS PL 6H HEAD/5H SHAFT/LT-STERIL EA
$1,127.00 $1,031.05 8.51% Y100 02.110.830 LCP VOLAR COLUMN DISTAL
RADIUS PL 7H HEAD/3H SHAFT/RT EA $1,010.00 $931.17 7.80% Y100
02.110.830S LCP VOLAR COLUMN DISTAL RADIUS PL 7H HEAD/3H
SHAFT/RT-STERIL EA $1,065.00 $973.94 8.55% Y100 02.110.831 LCP
VOLAR COLUMN DISTAL RADIUS PL 7H HEAD/3H SHAFT/LT EA $1,010.00
$931.17 7.80% Y100 02.110.831S LCP VOLAR COLUMN DISTAL RADIUS PL 7H
HEAD/3H SHAFT/LT-STERIL EA $1,065.00 $973.94 8.55% Y100 02.110.840
LCP VOLAR COLUMN DISTAL RADIUS PL 7H HEAD/4H SHAFT/RT EA $1,042.00
$960.71 7.80% Y100 02.110.840S LCP VOLAR COLUMN DISTAL RADIUS PL 7H
HEAD/4H SHAFT/RT-STERIL EA $1,097.00 $1,003.49 8.52% Y100
02.110.841 LCP VOLAR COLUMN DISTAL RADIUS PL 7H HEAD/4H SHAFT/LT EA
$1,042.00 $960.71 7.80% Y100 02.110.841S LCP VOLAR COLUMN DISTAL
RADIUS PL 7H HEAD/4H SHAFT/LT-STERIL EA $1,097.00 $1,003.49 8.52%
Y100 02.110.850 LCP VOLAR COLUMN DISTAL RADIUS PL 7H HEAD/5H
SHAFT/RT EA $1,072.00 $988.28 7.81% Y100 02.110.850S LCP VOLAR
COLUMN DISTAL RADIUS PL 7H HEAD/5H SHAFT/RT-STERIL EA $1,127.00
$1,031.05 8.51% Y100 02.110.851 LCP VOLAR COLUMN DISTAL RADIUS PL
7H HEAD/5H SHAFT/LT EA $1,072.00 $988.28 7.81% Y100 02.110.851S LCP
VOLAR COLUMN DISTAL RADIUS PL 7H HEAD/5H SHAFT/LT-STERIL EA
$1,127.00 $1,031.05 8.51% Y100 02.111.001 TREPHINE GUIDE WIRE WITH
STOP 3.2MM DIAMETER/1.6MM TIP EA $75.00 $70.50 6.00% Y100
02.111.150 6.5MM MIDFOOT FUSION BOLT 50MM EA $629.00 $581.71 7.52%
Y100 02.111.150S 6.5MM MIDFOOT FUSION BOLT 50MM-STERILE EA $684.00
$624.45 8.71% Y100 02.111.155 6.5MM MIDFOOT FUSION BOLT 55MM EA
$629.00 $581.71 7.52% Y100 02.111.155S 6.5MM MIDFOOT FUSION BOLT
55MM-STERILE EA $684.00 $624.45 8.71% Y100 02.111.160 6.5MM MIDFOOT
FUSION BOLT 60MM EA $629.00 $581.71 7.52% Y100 02.111.160S 6.5MM
MIDFOOT FUSION BOLT 60MM-STERILE EA $684.00 $624.45 8.71% Y100
02.111.165 6.5MM MIDFOOT FUSION BOLT 65MM EA $629.00 $581.71 7.52%
Y100 02.111.165S 6.5MM MIDFOOT FUSION BOLT 65MM-STERILE EA $684.00
$624.45 8.71% Y100 02.111.170 6.5MM MIDFOOT FUSION BOLT 70MM EA
$629.00 $581.71 7.52% Y100 02.111.170S 6.5MM MIDFOOT FUSION BOLT
70MM-STERILE EA $684.00 $624.45 8.71% Y100 02.111.175 6.5MM MIDFOOT
FUSION BOLT 75MM EA $629.00 $581.71 7.52% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 5 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.111.175S 6.5MM MIDFOOT FUSION BOLT 75MM-STERILE EA
$684.00 $624.45 8.71% Y100 02.111.180 6.5MM MIDFOOT FUSION BOLT
80MM EA $629.00 $581.71 7.52% Y100 02.111.180S 6.5MM MIDFOOT FUSION
BOLT 80MM-STERILE EA $684.00 $624.45 8.71% Y100 02.111.185 6.5MM
MIDFOOT FUSION BOLT 85MM EA $629.00 $581.71 7.52% Y100 02.111.185S
6.5MM MIDFOOT FUSION BOLT 85MM-STERILE EA $684.00 $624.45 8.71%
Y100 02.111.190 6.5MM MIDFOOT FUSION BOLT 90MM EA $640.00 $591.56
7.57% Y100 02.111.190S 6.5MM MIDFOOT FUSION BOLT 90MM-STERILE EA
$695.00 $634.31 8.73% Y100 02.111.195 6.5MM MIDFOOT FUSION BOLT
95MM EA $640.00 $591.56 7.57% Y100 02.111.195S 6.5MM MIDFOOT FUSION
BOLT 95MM-STERILE EA $695.00 $634.31 8.73% Y100 02.111.200 6.5MM
MIDFOOT FUSION BOLT 100MM EA $640.00 $591.56 7.57% Y100 02.111.200S
6.5MM MIDFOOT FUSION BOLT 100MM-STERILE EA $695.00 $634.31 8.73%
Y100 02.111.205 6.5MM MIDFOOT FUSION BOLT 105MM EA $640.00 $591.56
7.57% Y100 02.111.205S 6.5MM MIDFOOT FUSION BOLT 105MM-STERILE EA
$695.00 $634.31 8.73% Y100 02.111.210 6.5MM MIDFOOT FUSION BOLT
110MM EA $640.00 $591.56 7.57% Y100 02.111.210S 6.5MM MIDFOOT
FUSION BOLT 110MM-STERILE EA $695.00 $634.31 8.73% Y100 02.111.215
6.5MM MIDFOOT FUSION BOLT 115MM EA $640.00 $591.56 7.57% Y100
02.111.215S 6.5MM MIDFOOT FUSION BOLT 115MM-STERILE EA $695.00
$634.31 8.73% Y100 02.111.220 6.5MM MIDFOOT FUSION BOLT 120MM EA
$640.00 $591.56 7.57% Y100 02.111.220S 6.5MM MIDFOOT FUSION BOLT
120MM-STERILE EA $695.00 $634.31 8.73% Y100 02.111.225 6.5MM
MIDFOOT FUSION BOLT 125MM EA $652.00 $602.34 7.62% Y100 02.111.225S
6.5MM MIDFOOT FUSION BOLT 125MM-STERILE EA $707.00 $645.09 8.76%
Y100 02.111.230 6.5MM MIDFOOT FUSION BOLT 130MM EA $652.00 $602.34
7.62% Y100 02.111.230S 6.5MM MIDFOOT FUSION BOLT 130MM-STERILE EA
$707.00 $645.09 8.76% Y100 02.111.235 6.5MM MIDFOOT FUSION BOLT
135MM EA $652.00 $602.34 7.62% Y100 02.111.235S 6.5MM MIDFOOT
FUSION BOLT 135MM-STERILE EA $707.00 $645.09 8.76% Y100 02.111.240
6.5MM MIDFOOT FUSION BOLT 140MM EA $652.00 $602.34 7.62% Y100
02.111.240S 6.5MM MIDFOOT FUSION BOLT 140MM-STERILE EA $707.00
$645.09 8.76% Y100 02.111.245 6.5MM MIDFOOT FUSION BOLT 145MM EA
$652.00 $602.34 7.62% Y100 02.111.245S 6.5MM MIDFOOT FUSION BOLT
145MM-STERILE EA $707.00 $645.09 8.76% Y100 02.111.250 6.5MM
MIDFOOT FUSION BOLT 150MM EA $652.00 $602.34 7.62% Y100 02.111.250S
6.5MM MIDFOOT FUSION BOLT 150MM-STERILE EA $707.00 $645.09 8.76%
Y100 02.111.255 6.5MM MIDFOOT FUSION BOLT 155MM EA $652.00 $602.34
7.62% Y100 02.111.255S 6.5MM MIDFOOT FUSION BOLT 155MM-STERILE EA
$707.00 $645.09 8.76% Y100 02.111.260 6.5MM MIDFOOT FUSION BOLT
160MM EA $652.00 $602.34 7.62% Y100 02.111.260S 6.5MM MIDFOOT
FUSION BOLT 160MM-STERILE EA $707.00 $645.09 8.76% Y100 02.111.300
2.4MM VA-LCP INTERCARPAL FUSION PLATE/6 HOLE/15MM EA $1,119.00
$1,051.86 6.00% Y100 02.111.300S 2.4MM VA-LCP INTERCARPAL FUSION
PLATE/6H/15MM-STER EA $1,174.00 $1,103.56 6.00% Y100 02.111.301
2.4MM VA-LCP INTERCARPAL FUSION PLATE/7 HOLE/17MM EA $1,119.00
$1,051.86 6.00% Y100 02.111.301S 2.4MM VA-LCP INTERCARPAL FUSION
PLATE/7H/17MM-STER EA $1,174.00 $1,103.56 6.00% Y100 02.111.304.01
1.25MM KIRSCHNER WIRE WITH TROCAR TIP/80MM EA $20.00 $18.80 6.00%
Y100 02.111.304.10 1.25MM KIRSCHNER WIRE WITH TROCAR TIP/80MM TP
$101.00 $94.94 6.00% Y100 02.111.500.01S 1.25MM PLATE REDUCTION
WIRE THRDD TIP W/SM STOP/150MM-STER EA $40.00 $37.60 6.00% Y100
02.111.500.10 1.25MM PLATE REDUCTION WIRE THRDD TIP W/SM STOP/150MM
TP $200.00 $188.00 6.00% Y100 02.111.501.01S 1.25MM PL REDUCTION
WIRE/THRDD TIP W/LRG STOP/150MM-STERILE EA $40.00 $37.60 6.00% Y100
02.111.501.10 1.25MM PLATE REDUCTION WIRE THRDD TIP W/LRG
STOP/150MM TP $200.00 $188.00 6.00% Y100 02.111.520 2.4MM VA-LCP
2-COL DSTL RAD PL NRW 6H HD/2H SHAFT/RT EA $1,122.00 $1,039.49
7.35% Y100 02.111.520S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW 6H HD/2H
SHAFT/RT-STER EA $1,177.00 $1,082.25 8.05% Y100 02.111.521 2.4MM
VA-LCP 2-COL DSTL RAD PL NRW 6H HD/2H SHAFT/LT EA $1,122.00
$1,039.49 7.35% Y100 02.111.521S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW
6H HD/2H SHAFT/LT-STER EA $1,177.00 $1,082.25 8.05% Y100 02.111.530
2.4MM VA-LCP 2-COL DSTL RAD PL NRW 6H HD/3H SHAFT/RT EA $1,166.00
$1,079.88 7.39% Y100 02.111.530S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW
6H HD/3H SHAFT/RT-STER EA $1,221.00 $1,122.65 8.05% Y100 02.111.531
2.4MM VA-LCP 2-COL DSTL RAD PL NRW 6H HD/3H SHAFT/LT EA $1,166.00
$1,079.88 7.39% Y100 02.111.531S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW
6H HD/3H SHAFT/LT-STER EA $1,221.00 $1,122.65 8.05% Y100 02.111.540
2.4MM VA-LCP 2-COL DSTL RAD PL NRW 6H HD/4H SHAFT/RT EA $1,210.00
$1,121.24 7.34% Y100 02.111.540S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW
6H HD/4H SHAFT/RT-STER EA $1,265.00 $1,164.01 7.98% Y100 02.111.541
2.4MM VA-LCP 2-COL DSTL RAD PL NRW 6H HD/4H SHAFT/LT EA $1,210.00
$1,121.24 7.34% Y100 02.111.541S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW
6H HD/4H SHAFT/LT-STER EA $1,265.00 $1,164.01 7.98% Y100 02.111.550
2.4MM VA-LCP 2-COL DSTL RAD PL NRW 6H HD/5H SHAFT/RT EA $1,255.00
$1,162.55 7.37% Y100 02.111.550S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW
6H HD/5H SHAFT/RT-STER EA $1,310.00 $1,205.33 7.99% Y100 02.111.551
2.4MM VA-LCP 2-COL DSTL RAD PL NRW 6H HD/5H SHAFT/LT EA $1,255.00
$1,162.55 7.37% Y100 02.111.551S 2.4MM VA-LCP 2-COL DSTL RAD PL NRW
6H HD/5H SHAFT/LT-STER EA $1,310.00 $1,205.33 7.99% Y100 02.111.620
2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS PL 6H HD/2H SHAFT/RIGHT EA
$1,122.00 $1,039.49 7.35% Y100 02.111.620S 2.4MM VA-LCP 2-CLMN VLR
DSTL RAD PL 6H HD/2H SHAFT/RT-STER EA $1,177.00 $1,082.25 8.05%
Y100 02.111.621 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS PL 6H HD/2H
SHAFT/LEFT EA $1,122.00 $1,039.49 7.35% Y100 02.111.621S 2.4MM
VA-LCP 2-CLMN VLR DSTL RAD PL 6H HD/2H SHAFT/LT-STER EA $1,177.00
$1,082.25 8.05% Y100 02.111.630 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS
PL 6H HD/3H SHAFT/RIGHT EA $1,166.00 $1,079.88 7.39% Y100
02.111.630S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD PL 6H HD/3H
SHAFT/RT-STER EA $1,221.00 $1,122.65 8.05% Y100 02.111.631 2.4MM
VA-LCP 2-CLMN VLR DSTL RADIUS PL 6H HD/3H SHAFT/LEFT EA $1,166.00
$1,079.88 7.39% Y100 02.111.631S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD
PL 6H HD/3H SHAFT/LT-STER EA $1,221.00 $1,122.65 8.05% Y100
02.111.640 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS PL 6H HD/4H
SHAFT/RIGHT EA $1,210.00 $1,121.24 7.34% Y100 02.111.640S 2.4MM
VA-LCP 2-CLMN VLR DSTL RAD PL 6H HD/4H SHAFT/RT-STER EA $1,265.00
$1,164.01 7.98% Y100 02.111.641 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS
PL 6H HD/4H SHAFT/LEFT EA $1,210.00 $1,121.24 7.34% Y100
02.111.641S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD PL 6H HD/4H
SHAFT/LT-STER EA $1,265.00 $1,164.01 7.98% Y100 02.111.650 2.4MM
VA-LCP 2-CLMN VLR DSTL RADIUS PL 6H HD/5H SHAFT/RIGHT EA $1,255.00
$1,162.55 7.37% Y100 02.111.650S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD
PL 6H HD/5H SHAFT/RT-STER EA $1,310.00 $1,205.33 7.99% Y100
02.111.651 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS PL 6H HD/5H
SHAFT/LEFT EA $1,255.00 $1,162.55 7.37% Y100 02.111.651S 2.4MM
VA-LCP 2-CLMN VLR DSTL RAD PL 6H HD/5H SHAFT/LT-STER EA $1,310.00
$1,205.33 7.99% Y100 02.111.720 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS
PL 7H HD/2H SHAFT/RIGHT EA $1,122.00 $1,039.49 7.35% Y100
02.111.720S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD PL 7H HD/2H
SHAFT/RT-STER EA $1,177.00 $1,082.25 8.05% Y100 02.111.721 2.4MM
VA-LCP 2-CLMN VLR DSTL RADIUS PL 7H HD/2H SHAFT/LEFT EA $1,122.00
$1,039.49 7.35% Y100 02.111.721S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD
PL 7H HD/2H SHAFT/LT-STER EA $1,177.00 $1,082.25 8.05% Y100
02.111.730 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS PL 7H HD/3H
SHAFT/RIGHT EA $1,166.00 $1,079.88 7.39% Y100 02.111.730S 2.4MM
VA-LCP 2-CLMN VLR DSTL RAD PL 7H HD/3H SHAFT/RT-STER EA $1,221.00
$1,122.65 8.05% Y100 02.111.731 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS
PL 7H HD/3H SHAFT/LEFT EA $1,166.00 $1,079.88 7.39% Y100
02.111.731S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD PL 7H HD/3H
SHAFT/LT-STER EA $1,221.00 $1,122.65 8.05% Y100 02.111.740 2.4MM
VA-LCP 2-CLMN VLR DSTL RADIUS PL 7H HD/4H SHAFT/RIGHT EA $1,210.00
$1,121.24 7.34% Y100 02.111.740S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD
PL 7H HD/4H SHAFT/RT-STER EA $1,265.00 $1,164.01 7.98% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 6 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.111.741 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS PL 7H HD/4H
SHAFT/LEFT EA $1,210.00 $1,121.24 7.34% Y100 02.111.741S 2.4MM
VA-LCP 2-CLMN VLR DSTL RAD PL 7H HD/4H SHAFT/LT-STER EA $1,265.00
$1,164.01 7.98% Y100 02.111.750 2.4MM VA-LCP 2-CLMN VLR DSTL RADIUS
PL 7H HD/5H SHAFT/RIGHT EA $1,255.00 $1,162.55 7.37% Y100
02.111.750S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD PL 7H HD/5H
SHAFT/RT-STER EA $1,310.00 $1,205.33 7.99% Y100 02.111.751 2.4MM
VA-LCP 2-CLMN VLR DSTL RADIUS PL 7H HD/5H SHAFT/LEFT EA $1,255.00
$1,162.55 7.37% Y100 02.111.751S 2.4MM VA-LCP 2-CLMN VLR DSTL RAD
PL 7H HD/5H SHAFT/LT-STER EA $1,310.00 $1,205.33 7.99% Y100
02.112.006 3.5MM LCP SUP ANT CLAVICLE PL W/LAT EXTN 3H/RT/69MM EA
$1,044.00 $960.57 7.99% Y100 02.112.006S 3.5MM LCP SUP ANT CLAVICLE
PL W/LAT EXTN 3H/RT/69MM-STER EA $1,099.00 $1,003.34 8.70% Y100
02.112.007 3.5MM LCP SUP ANT CLAVICLE PL W/LAT EXTN 3H/LT/69MM EA
$1,044.00 $960.57 7.99% Y100 02.112.007S 3.5MM LCP SUP ANT CLAVICLE
PL W/LAT EXTN 3H/LT/69MM-STER EA $1,099.00 $1,003.34 8.70% Y100
02.112.008 3.5MM LCP SUP ANT CLAVICLE PL W/LAT EXTN 6H/RT/108MM EA
$1,091.00 $1,002.91 8.07% Y100 02.112.008S 3.5MM LCP SUP ANT
CLAVICLE PL W/LAT EXTN 6H/RT/108MM-STER EA $1,146.00 $1,045.68
8.75% Y100 02.112.009 3.5MM LCP SUP ANT CLAVICLE PL W/LAT EXTN
6H/LT/108MM EA $1,091.00 $1,002.91 8.07% Y100 02.112.009S 3.5MM LCP
SUP ANT CLAVICLE PL W/LAT EXTN 6H/LT/108MM-STER EA $1,146.00
$1,045.68 8.75% Y100 02.112.010 3.5MM LCP SUP ANT CLAVICLE PL W/LAT
EXTN 4H/RT/81MM EA $1,061.00 $975.34 8.07% Y100 02.112.010S 3.5MM
LCP SUP ANT CLAVICLE PL W/LAT EXTN 4H/RT/81MM-STER EA $1,116.00
$1,018.10 8.77% Y100 02.112.011 3.5MM LCP SUP ANT CLAVICLE PL W/LAT
EXTN 4H/LT/81MM EA $1,061.00 $975.34 8.07% Y100 02.112.011S 3.5MM
LCP SUP ANT CLAVICLE PL W/LAT EXTN 4H/LT/81MM-STER EA $1,116.00
$1,018.10 8.77% Y100 02.112.012 3.5MM LCP SUP ANT CLAVICLE PL W/LAT
EXTN 5H/RT/94MM EA $1,079.00 $992.06 8.06% Y100 02.112.012S 3.5MM
LCP SUP ANT CLAVICLE PL W/LAT EXTN 5H/RT/94MM-STER EA $1,134.00
$1,034.83 8.75% Y100 02.112.013 3.5MM LCP SUP ANT CLAVICLE PL W/LAT
EXTN 5H/LT/94MM EA $1,079.00 $992.06 8.06% Y100 02.112.013S 3.5MM
LCP SUP ANT CLAVICLE PL W/LAT EXTN 5H/LT/94MM-STER EA $1,134.00
$1,034.83 8.75% Y100 02.112.018 3.5MM LCP SUP ANT CLAVICLE PL W/LAT
EXTN 7H/RT/123MM EA $1,120.00 $1,030.44 8.00% Y100 02.112.018S
3.5MM LCP SUP ANT CLAVICLE PL W/LAT EXTN 7H/RT/123MM-STER EA
$1,175.00 $1,073.20 8.66% Y100 02.112.019 3.5MM LCP SUP ANT
CLAVICLE PL W/LAT EXTN 7H/LT/123MM EA $1,120.00 $1,030.44 8.00%
Y100 02.112.019S 3.5MM LCP SUP ANT CLAVICLE PL W/LAT EXTN
7H/LT/123MM-STER EA $1,175.00 $1,073.20 8.66% Y100 02.112.020 3.5MM
LCP SUP ANT CLAVICLE PL W/LAT EXTN 8H/RT/135MM EA $1,149.00
$1,057.02 8.01% Y100 02.112.020S 3.5MM LCP SUP ANT CLAVICLE PL
W/LAT EXTN 8H/RT/135MM-STER EA $1,204.00 $1,099.79 8.66% Y100
02.112.021 3.5MM LCP SUP ANT CLAVICLE PL W/LAT EXTN 8H/LT/135MM EA
$1,149.00 $1,057.02 8.01% Y100 02.112.021S 3.5MM LCP SUP ANT
CLAVICLE PL W/LAT EXTN 8H/LT/135MM-STER EA $1,204.00 $1,099.79
8.66% Y100 02.112.026 3.5MM LCP SUP ANT CLAVICLE PLATE 6H/RT/94MM
EA $1,091.00 $1,002.91 8.07% Y100 02.112.026S 3.5MM LCP SUP ANT
CLAVICLE PLATE 6H/RT/94MM-STERILE EA $1,146.00 $1,045.68 8.75% Y100
02.112.027 3.5MM LCP SUP ANT CLAVICLE PLATE 6H/LT/94MM EA $1,091.00
$1,002.91 8.07% Y100 02.112.027S 3.5MM LCP SUP ANT CLAVICLE PLATE
6H/LT/94MM-STERILE EA $1,146.00 $1,045.68 8.75% Y100 02.112.028
3.5MM LCP SUP ANT CLAVICLE PLATE 7H/RT/110MM EA $1,120.00 $1,030.44
8.00% Y100 02.112.028S 3.5MM LCP SUP ANT CLAVICLE PLATE
7H/RT/110MM-STERILE EA $1,175.00 $1,073.20 8.66% Y100 02.112.029
3.5MM LCP SUP ANT CLAVICLE PLATE 7H/LT/110MM EA $1,120.00 $1,030.44
8.00% Y100 02.112.029S 3.5MM LCP SUP ANT CLAVICLE PLATE
7H/LT/110MM-STERILE EA $1,175.00 $1,073.20 8.66% Y100 02.112.030
3.5MM LCP SUP ANT CLAVICLE PLATE 8H/RT/120MM EA $1,149.00 $1,057.02
8.01% Y100 02.112.030S 3.5MM LCP SUP ANT CLAVICLE PLATE
8H/RT/120MM-STERILE EA $1,204.00 $1,099.79 8.66% Y100 02.112.031
3.5MM LCP SUP ANT CLAVICLE PLATE 8H/LT/120MM EA $1,149.00 $1,057.02
8.01% Y100 02.112.031S 3.5MM LCP SUP ANT CLAVICLE PLATE
8H/LT/120MM-STERILE EA $1,204.00 $1,099.79 8.66% Y100 02.112.040
3.5MM LCP MEDL ANT CLAVICLE PL 6 HOLE/79MM EA $1,149.00 $1,080.06
6.00% Y100 02.112.040S 3.5MM LCP MEDL ANT CLAVICLE PL 6
HOLE/79MM-STERILE EA $1,204.00 $1,131.76 6.00% Y100 02.112.041
3.5MM LCP MEDL ANT CLAVICLE PL 7 HOLE/91MM EA $1,149.00 $1,080.06
6.00% Y100 02.112.041S 3.5MM LCP MEDL ANT CLAVICLE PL 7
HOLE/91MM-STERILE EA $1,204.00 $1,131.76 6.00% Y100 02.112.042
3.5MM LCP MEDL ANT CLAVICLE PL 8 HOLE/102MM EA $1,149.00 $1,080.06
6.00% Y100 02.112.042S 3.5MM LCP MEDL ANT CLAVICLE PL 8
HOLE/102MM-STERILE EA $1,204.00 $1,131.76 6.00% Y100 02.112.045
2.7MM/3.5MM VA-LCP LAT ANT CLAVICLE PLATE/7 HOLE/77MM EA $1,149.00
$1,080.06 6.00% Y100 02.112.045S 2.7MM/3.5MM VA-LCP LAT ANT
CLAVICLE PL/7H/77MM-STER EA $1,204.00 $1,131.76 6.00% Y100
02.112.046 2.7MM/3.5MM VA-LCP LAT ANT CLAVICLE PLATE/9 HOLE/89MM EA
$1,149.00 $1,080.06 6.00% Y100 02.112.046S 2.7MM/3.5MM VA-LCP LAT
ANT CLAVICLE PL/9H/89MM-STER EA $1,204.00 $1,131.76 6.00% Y100
02.112.047 2.7MM/3.5MM VA-LCP LAT ANT CLAVICLE PLATE/10 HOLE/101MM
EA $1,149.00 $1,080.06 6.00% Y100 02.112.047S 2.7MM/3.5MM VA-LCP
LAT ANT CLAVICLE PL/10 H/101MM-STER EA $1,204.00 $1,131.76 6.00%
Y100 02.112.048 2.7MM/3.5MM VA-LCP LAT ANT CLAVICLE PLATE/11H/113MM
EA $1,149.00 $1,080.06 6.00% Y100 02.112.048S 2.7MM/3.5MM VA-LCP
LAT ANT CLAVICLE PL/11H/113MM-STER EA $1,204.00 $1,131.76 6.00%
Y100 02.112.049 2.7MM/3.5MM VA-LCP LAT ANT CLAVICLE PLATE/12H/124MM
EA $1,149.00 $1,080.06 6.00% Y100 02.112.049S 2.7MM/3.5MM VA-LCP
LAT ANT CLAVICLE PL/12H/124MM-STER EA $1,204.00 $1,131.76 6.00%
Y100 02.112.080 3.5MM LCP SUPERIOR CLAVICLE PLATE/6 HOLE/RIGHT/85MM
EA $1,091.00 $1,002.91 8.07% Y100 02.112.080S 3.5MM LCP SUPERIOR
CLAVICLE PLATE/6H/RIGHT/85MM-STERILE EA $1,146.00 $1,045.68 8.75%
Y100 02.112.081 3.5MM LCP SUPERIOR CLAVICLE PLATE/6 HOLE/LEFT/85MM
EA $1,091.00 $1,002.91 8.07% Y100 02.112.081S 3.5MM LCP SUPERIOR
CLAVICLE PLATE/6H/LEFT/85MM-STERILE EA $1,146.00 $1,045.68 8.75%
Y100 02.112.082 3.5MM LCP SUPERIOR CLAVICLE PLATE/7
HOLE/RIGHT/100MM EA $1,120.00 $1,030.44 8.00% Y100 02.112.082S
3.5MM LCP SUPERIOR CLAVICLE PLATE/7H/RIGHT/100MM-STERILE EA
$1,175.00 $1,073.20 8.66% Y100 02.112.083 3.5MM LCP SUPERIOR
CLAVICLE PLATE/7 HOLE/LEFT/100MM EA $1,120.00 $1,030.44 8.00% Y100
02.112.083S 3.5MM LCP SUPERIOR CLAVICLE PLATE/7H/LEFT/100MM-STERILE
EA $1,175.00 $1,073.20 8.66% Y100 02.112.084 3.5MM LCP SUPERIOR
CLAVICLE PLATE/8 HOLE/RIGHT/115MM EA $1,149.00 $1,057.02 8.01% Y100
02.112.084S 3.5MM LCP SUPERIOR CLAVICLE
PLATE/8H/RIGHT/115MM-STERILE EA $1,204.00 $1,099.79 8.66% Y100
02.112.085 3.5MM LCP SUPERIOR CLAVICLE PLATE/8 HOLE/LEFT/115MM EA
$1,149.00 $1,057.02 8.01% Y100 02.112.085S 3.5MM LCP SUPERIOR
CLAVICLE PLATE/8H/LEFT/115MM-STERILE EA $1,204.00 $1,099.79 8.66%
Y100 02.112.090 3.5MM LCP SUPERIOR CLAVICLE PLATE W/LAT
EXTN/6H/RT/105MM EA $1,091.00 $1,002.91 8.07% Y100 02.112.090S
3.5MM LCP SUP CLAVICLE PLATE W/LAT EXTN/6H/RT/105MM-STER EA
$1,146.00 $1,045.68 8.75% Y100 02.112.091 3.5MM LCP SUPERIOR
CLAVICLE PLATE W/LAT EXTN/6H/LT/105MM EA $1,091.00 $1,002.91 8.07%
Y100 02.112.091S 3.5MM LCP SUP CLAVICLE PLATE W/LAT
EXTN/6H/LT/105MM-STER EA $1,146.00 $1,045.68 8.75% Y100 02.112.092
3.5MM LCP SUPERIOR CLAVICLE PLATE W/LAT EXTN/7H/RT/120MM EA
$1,120.00 $1,030.44 8.00% Y100 02.112.092S 3.5MM LCP SUP CLAVICLE
PLATE W/LAT EXTN/7H/RT/120MM-STER EA $1,175.00 $1,073.20 8.66% Y100
02.112.093 3.5MM LCP SUPERIOR CLAVICLE PLATE W/LAT EXTN/7H/LT/120MM
EA $1,120.00 $1,030.44 8.00% Y100 02.112.093S 3.5MM LCP SUP
CLAVICLE PLATE W/LAT EXTN/7H/LT/120MM-STER EA $1,175.00 $1,073.20
8.66% Y100 02.112.094 3.5MM LCP SUPERIOR CLAVICLE PLATE W/LAT
EXTN/8H/RT/130MM EA $1,149.00 $1,057.02 8.01% Y100 02.112.094S
3.5MM LCP SUP CLAVICLE PLATE W/LAT EXTN/8H/RT/130MM-STER EA
$1,204.00 $1,099.79 8.66% Y100 02.112.095 3.5MM LCP SUPERIOR
CLAVICLE PLATE W/LAT EXTN/8H/LT/130MM EA $1,149.00 $1,057.02 8.01%
Y100 02.112.095S 3.5MM LCP SUP CLAVICLE PLATE W/LAT
EXTN/8H/LT/130MM-STER EA $1,204.00 $1,099.79 8.66% Y100 02.112.106
2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE 3H/RIGHT/77MM EA
$738.00 $673.88 8.69% Y100 02.112.106S 2.7MM/3.5MM LCP POSTLAT DSTL
FIBULA PL 3H/RIGHT/77MM-STER EA $793.00 $707.32 10.80% Y100
02.112.107 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE 3H/LEFT/77MM
EA $738.00 $673.88 8.69% Y100 02.112.107S 2.7MM/3.5MM LCP POSTLAT
DSTL FIBULA PL 3H/LEFT/77MM-STER EA $793.00 $707.32 10.80% Y100
02.112.108 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE
4H/RIGHT/90MM EA $750.00 $684.66 8.71% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 7 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.112.108S 2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL
4H/RIGHT/90MM-STER EA $805.00 $718.08 10.80% Y100 02.112.109
2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE 4H/LEFT/90MM EA $750.00
$684.66 8.71% Y100 02.112.109S 2.7MM/3.5MM LCP POSTLAT DSTL FIBULA
PL 4H/LEFT/90MM-STER EA $805.00 $718.08 10.80% Y100 02.112.110
2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE 5H/RIGHT/103MM EA
$760.00 $694.56 8.61% Y100 02.112.110S 2.7MM/3.5MM LCP POSTLAT DSTL
FIBULA PL 5H/RIGHT/103MM-STER EA $815.00 $728.00 10.67% Y100
02.112.111 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE
5H/LEFT/103MM EA $760.00 $694.56 8.61% Y100 02.112.111S 2.7MM/3.5MM
LCP POSTLAT DSTL FIBULA PL 5H/LEFT/103MM-STER EA $815.00 $728.00
10.67% Y100 02.112.112 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE
6H/RIGHT/116MM EA $772.00 $705.34 8.63% Y100 02.112.112S
2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL 6H/RIGHT/116MM-STER EA
$827.00 $738.76 10.67% Y100 02.112.113 2.7MM/3.5MM LCP POSTLAT
DISTAL FIBULA PLATE 6H/LEFT/116MM EA $772.00 $705.34 8.63% Y100
02.112.113S 2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL
6H/LEFT/116MM-STER EA $827.00 $738.76 10.67% Y100 02.112.114
2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE 7H/RIGHT/129MM EA
$783.00 $715.20 8.66% Y100 02.112.114S 2.7MM/3.5MM LCP POSTLAT DSTL
FIBULA PL 7H/RIGHT/129MM-STER EA $838.00 $748.63 10.66% Y100
02.112.115 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE
7H/LEFT/129MM EA $783.00 $715.20 8.66% Y100 02.112.115S 2.7MM/3.5MM
LCP POSTLAT DSTL FIBULA PL 7H/LEFT/129MM-STER EA $838.00 $748.63
10.66% Y100 02.112.118 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE
9H/RIGHT/155MM EA $794.00 $725.06 8.68% Y100 02.112.118S
2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL 9H/RIGHT/155MM-STER EA
$849.00 $758.51 10.66% Y100 02.112.119 2.7MM/3.5MM LCP POSTLAT
DISTAL FIBULA PLATE 9H/LEFT/155MM EA $794.00 $725.06 8.68% Y100
02.112.119S 2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL
9H/LEFT/155MM-STER EA $849.00 $758.51 10.66% Y100 02.112.122
2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE 11H/RIGHT/181MM EA
$806.00 $735.84 8.70% Y100 02.112.122S 2.7MM/3.5MM LCP POSTLAT DSTL
FIBULA PL 11H/RIGHT/181MM-STER EA $861.00 $769.27 10.65% Y100
02.112.123 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE
11H/LEFT/181MM EA $806.00 $735.84 8.70% Y100 02.112.123S
2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL 11H/LEFT/181MM-STER EA
$861.00 $769.27 10.65% Y100 02.112.126 2.7MM/3.5MM LCP POSTLAT
DISTAL FIBULA PLATE 13H/RIGHT/207MM EA $816.00 $745.74 8.61% Y100
02.112.126S 2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL
13H/RIGHT/207MM-STER EA $871.00 $779.18 10.54% Y100 02.112.127
2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE 13H/LEFT/207MM EA
$816.00 $745.74 8.61% Y100 02.112.127S 2.7MM/3.5MM LCP POSTLAT DSTL
FIBULA PL 13H/LEFT/207MM-STER EA $871.00 $779.18 10.54% Y100
02.112.130 2.7MM/3.5MM LCP POSTLAT DISTAL FIBULA PLATE
15H/RIGHT/233MM EA $828.00 $756.51 8.63% Y100 02.112.130S
2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL 15H/RIGHT/233MM-STER EA
$883.00 $789.95 10.54% Y100 02.112.131 2.7MM/3.5MM LCP POSTLAT
DISTAL FIBULA PLATE 15H/LEFT/233MM EA $828.00 $756.51 8.63% Y100
02.112.131S 2.7MM/3.5MM LCP POSTLAT DSTL FIBULA PL
15H/LEFT/233MM-STER EA $883.00 $789.95 10.54% Y100 02.112.136
2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE 3H/RIGHT/73MM EA
$738.00 $673.88 8.69% Y100 02.112.136S 2.7MM/3.5MM LCP LAT DISTAL
FIBULA PL 3H/RT/73MM-STERILE EA $793.00 $716.61 9.63% Y100
02.112.137 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE 3H/LEFT/73MM
EA $738.00 $673.88 8.69% Y100 02.112.137S 2.7MM/3.5MM LCP LAT
DISTAL FIBULA PL 3H/LT/73MM-STERILE EA $793.00 $716.61 9.63% Y100
02.112.138 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE
4H/RIGHT/86MM EA $750.00 $684.66 8.71% Y100 02.112.138S 2.7MM/3.5MM
LCP LAT DISTAL FIBULA PL 4H/RT/86MM-STERILE EA $805.00 $727.38
9.64% Y100 02.112.139 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE
4H/LEFT/86MM EA $750.00 $684.66 8.71% Y100 02.112.139S 2.7MM/3.5MM
LCP LAT DISTAL FIBULA PL 4H/LT/86MM-STERILE EA $805.00 $727.38
9.64% Y100 02.112.140 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE
5H/RIGHT/99MM EA $760.00 $694.56 8.61% Y100 02.112.140S 2.7MM/3.5MM
LCP LAT DISTAL FIBULA PL 5H/RT/99MM-STERILE EA $815.00 $737.29
9.53% Y100 02.112.141 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE
5H/LEFT/99MM EA $760.00 $694.56 8.61% Y100 02.112.141S 2.7MM/3.5MM
LCP LAT DISTAL FIBULA PL 5H/LT/99MM-STERILE EA $815.00 $737.29
9.53% Y100 02.112.142 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE
6H/RIGHT/112MM EA $772.00 $705.34 8.63% Y100 02.112.142S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 6H/RT/112MM-STERILE EA $827.00
$748.06 9.55% Y100 02.112.143 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA
PLATE 6H/LEFT/112MM EA $772.00 $705.34 8.63% Y100 02.112.143S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 6H/LT/112MM-STERILE EA $827.00
$748.06 9.55% Y100 02.112.144 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA
PLATE 7H/RIGHT/125MM EA $783.00 $715.20 8.66% Y100 02.112.144S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 7H/RT/125MM-STERILE EA $838.00
$757.92 9.56% Y100 02.112.145 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA
PLATE 7H/LEFT/125MM EA $783.00 $715.20 8.66% Y100 02.112.145S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 7H/LT/125MM-STERILE EA $838.00
$757.92 9.56% Y100 02.112.148 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA
PLATE 9H/RIGHT/151MM EA $794.00 $725.06 8.68% Y100 02.112.148S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 9H/RT/151MM-STERILE EA $849.00
$767.79 9.57% Y100 02.112.149 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA
PLATE 9H/LEFT/151MM EA $794.00 $725.06 8.68% Y100 02.112.149S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 9H/LT/151MM-STERILE EA $849.00
$767.79 9.57% Y100 02.112.152 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA
PLATE 11H/RIGHT/177MM EA $806.00 $735.84 8.70% Y100 02.112.152S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 11H/RT/177MM-STERILE EA
$861.00 $778.56 9.57% Y100 02.112.153 2.7MM/3.5MM LCP LATERAL
DISTAL FIBULA PLATE 11H/LEFT/177MM EA $806.00 $735.84 8.70% Y100
02.112.153S 2.7MM/3.5MM LCP LAT DISTAL FIBULA PL
11H/LT/177MM-STERILE EA $861.00 $778.56 9.57% Y100 02.112.156
2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE 13H/RIGHT/203MM EA
$816.00 $745.74 8.61% Y100 02.112.156S 2.7MM/3.5MM LCP LAT DISTAL
FIBULA PL 13H/RT/203MM-STERILE EA $871.00 $788.47 9.48% Y100
02.112.157 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE
13H/LEFT/203MM EA $816.00 $745.74 8.61% Y100 02.112.157S
2.7MM/3.5MM LCP LAT DISTAL FIBULA PL 13H/LT/203MM-STERILE EA
$871.00 $788.47 9.48% Y100 02.112.160 2.7MM/3.5MM LCP LATERAL
DISTAL FIBULA PLATE 15H/RIGHT/229MM EA $828.00 $756.51 8.63% Y100
02.112.160S 2.7MM/3.5MM LCP LAT DISTAL FIBULA PL
15H/RT/229MM-STERILE EA $883.00 $799.24 9.49% Y100 02.112.161
2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE 15H/LEFT/229MM EA
$828.00 $756.51 8.63% Y100 02.112.161S 2.7MM/3.5MM LCP LAT DISTAL
FIBULA PL 15H/LT/229MM-STERILE EA $883.00 $799.24 9.49% Y100
02.112.203 3.5MM LCP DISTAL TIBIA T-PLATE 3 HOLE/64MM EA $861.00
$808.66 6.08% Y100 02.112.203S 3.5MM LCP DISTAL TIBIA T-PLATE 3
HOLE/64MM-STERILE EA $916.00 $851.46 7.05% Y100 02.112.205 3.5MM
LCP DISTAL TIBIA T-PLATE 5 HOLES/90MM EA $896.00 $842.15 6.01% Y100
02.112.205S 3.5MM LCP DISTAL TIBIA T-PLATE 5 HOLE/90MM-STERILE EA
$951.00 $884.94 6.95% Y100 02.112.208 3.5MM LCP POSTERIOR DISTAL
TIBIA T-PLATE/8 HOLE/132MM EA $1,492.00 $1,401.60 6.06% Y100
02.112.208S 3.5MM LCP POSTERIOR DISTAL TIBIA
T-PLATE/8H/132MM-STERILE EA $1,547.00 $1,444.41 6.63% Y100
02.112.212 3.5MM LCP POSTERIOR DISTAL TIBIA T-PLATE/12 HOLE/184MM
EA $1,549.00 $1,455.83 6.01% Y100 02.112.212S 3.5MM LCP POSTERIOR
DISTAL TIBIA T-PLATE/12H/184MM-STER EA $1,604.00 $1,498.63 6.57%
Y100 02.112.216 3.5MM LCP POSTERIOR DISTAL TIBIA T-PLATE/16
HOLE/236MM EA $1,606.00 $1,509.01 6.04% Y100 02.112.216S 3.5MM LCP
POSTERIOR DISTAL TIBIA T-PLATE/16H/236MM-STER EA $1,661.00
$1,551.82 6.57% Y100 02.112.510 3.5MM LCP LOW BEND MEDIAL DSTL
TIBIA PLATE/4H/RIGHT/109MM EA $1,672.00 $1,556.81 6.89% Y100
02.112.510S 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/4H/RT/109MM-STER EA $1,727.00 $1,599.63 7.38% Y100 02.112.511
3.5MM LCP LOW BEND MEDIAL DSTL TIBIA PLATE/4H/LEFT/109MM EA
$1,672.00 $1,556.81 6.89% Y100 02.112.511S 3.5MM LCP LOW BEND
MEDIAL DSTL TIBIA PLATE/4H/LT/109MM-STER EA $1,727.00 $1,599.63
7.38% Y100 02.112.514 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/6H/RIGHT/135MM EA $1,690.00 $1,573.60 6.89% Y100 02.112.514S
3.5MM LCP LOW BEND MEDIAL DSTL TIBIA PLATE/6H/RT/135MM-STER EA
$1,745.00 $1,616.40 7.37% Y100 02.112.515 3.5MM LCP LOW BEND MEDIAL
DSTL TIBIA PLATE/6H/LEFT/135MM EA $1,690.00 $1,573.60 6.89% Y100
02.112.515S 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/6H/LT/135MM-STER EA $1,745.00 $1,616.40 7.37% Y100 02.112.518
3.5MM LCP LOW BEND MEDIAL DSTL TIBIA PLATE/8H/RIGHT/161MM EA
$1,707.00 $1,589.33 6.89% Y100 02.112.518S 3.5MM LCP LOW BEND
MEDIAL DSTL TIBIA PLATE/8H/RT/161MM-STER EA $1,762.00 $1,632.14
7.37% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 8 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.112.519 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/8H/LEFT/161MM EA $1,707.00 $1,589.33 6.89% Y100 02.112.519S
3.5MM LCP LOW BEND MEDIAL DSTL TIBIA PLATE/8H/LT/161MM-STER EA
$1,762.00 $1,632.14 7.37% Y100 02.112.522 3.5MM LCP LOW BEND MEDIAL
DSTL TIBIA PLATE/10H/RIGHT/187MM EA $1,725.00 $1,606.05 6.90% Y100
02.112.522S 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/10H/RT/187MM-STER EA $1,780.00 $1,648.86 7.37% Y100
02.112.523 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/10H/LEFT/187MM EA $1,725.00 $1,606.05 6.90% Y100 02.112.523S
3.5MM LCP LOW BEND MEDIAL DSTL TIBIA PLATE/10H/LT/187MM-STER EA
$1,780.00 $1,648.86 7.37% Y100 02.112.526 3.5MM LCP LOW BEND MEDIAL
DSTL TIBIA PLATE/12H/RIGHT/213MM EA $1,744.00 $1,623.76 6.89% Y100
02.112.526S 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/12H/RT/213MM-STER EA $1,799.00 $1,666.57 7.36% Y100
02.112.527 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/12H/LEFT/213MM EA $1,744.00 $1,623.76 6.89% Y100 02.112.527S
3.5MM LCP LOW BEND MEDIAL DSTL TIBIA PLATE/12H/LT/213MM-STER EA
$1,799.00 $1,666.57 7.36% Y100 02.112.530 3.5MM LCP LOW BEND MEDIAL
DSTL TIBIA PLATE/14H/RIGHT/239MM EA $1,766.00 $1,643.47 6.94% Y100
02.112.530S 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/14H/RT/239MM-STER EA $1,821.00 $1,686.28 7.40% Y100
02.112.531 3.5MM LCP LOW BEND MEDIAL DSTL TIBIA
PLATE/14H/LEFT/239MM EA $1,766.00 $1,643.47 6.94% Y100 02.112.531S
3.5MM LCP LOW BEND MEDIAL DSTL TIBIA PLATE/14H/LT/239MM-STER EA
$1,821.00 $1,686.28 7.40% Y100 02.113.001 1.6MM DRILL TIP GUIDE
WIRE 200MM EA $45.00 $42.30 6.00% Y100 02.113.103 3.5MM LCP HOOK
PLATE 3 HOLE EA $634.00 $584.72 7.77% Y100 02.113.103S 3.5MM LCP
HOOK PLATE 3 HOLE STERILE EA $689.00 $627.49 8.93% Y100 02.114.002
1.5MM LCP PLATE/4 HOLE EA $254.00 $234.26 7.77% Y100 02.114.003
1.5MM LCP ADAPTION PLATE 6 HOLE EA $468.00 $431.19 7.87% Y100
02.114.004 1.5MM LCP PLATE/6 HOLE EA $254.00 $234.26 7.77% Y100
02.114.005 1.5MM LCP ADAPTION PLATE 12 HOLE EA $468.00 $431.19
7.87% Y100 02.114.006 1.5MM LCP T-PLATE/3H HEAD 8 HOLE SHAFT EA
$491.00 $452.85 7.77% Y100 02.114.007 1.5MM LCP T-PLATE/4H HEAD 8
HOLE SHAFT EA $491.00 $452.85 7.77% Y100 02.114.009 1.5MM LCP
EXTENDED H-PLATE LEFT EA $473.00 $436.25 7.77% Y100 02.114.010
1.5MM LCP EXTENDED H-PLATE RIGHT EA $473.00 $436.25 7.77% Y100
02.114.013 1.5MM LCP Y-PLATE/3H HEAD 8 HOLE SHAFT EA $473.00
$436.25 7.77% Y100 02.114.014 1.5MM LCP CONDYLAR PLATE 6 HOLE SHAFT
EA $588.00 $541.86 7.85% Y100 02.114.502 1.5MM LCP PLATE/4 HOLE
WITH GUIDES EA $305.00 $284.66 6.67% Y100 02.114.502S 1.5MM LCP
PLATE/4 HOLE WITH GUIDES-STERILE EA $360.00 $327.43 9.05% Y100
02.114.503 1.5MM LCP ADAPTION PLATE 6 HOLE WITH GUIDES EA $520.00
$482.51 7.21% Y100 02.114.503S 1.5MM LCP ADAPTION PLATE 6 HOLE WITH
GUIDES-STERILE EA $575.00 $525.30 8.64% Y100 02.114.504 1.5MM LCP
PLATE/6 HOLE WITH GUIDES EA $305.00 $284.66 6.67% Y100 02.114.504S
1.5MM LCP PLATE/6 HOLE WITH GUIDES-STERILE EA $360.00 $327.43 9.05%
Y100 02.114.505 1.5MM LCP ADAPTION PLATE 12 HOLE WITH GUIDES EA
$520.00 $482.51 7.21% Y100 02.114.505S 1.5MM LCP ADAPTION PLATE 12
HOLE WITH GUIDES-STERILE EA $575.00 $525.30 8.64% Y100 02.114.506
1.5MM LCP T-PLATE/3H HEAD 8 HOLE SHAFT WITH GUIDES EA $550.00
$509.88 7.29% Y100 02.114.506S 1.5MM LCP T-PLATE/3 HOLE HEAD 8 HOLE
SHAFT W/GUIDES-STERILE EA $605.00 $550.31 9.04% Y100 02.114.507
1.5MM LCP T-PLATE/4H HEAD 8 HOLE SHAFT WITH GUIDES EA $550.00
$509.88 7.29% Y100 02.114.507S 1.5MM LCP T-PLATE/4 HOLE HEAD 8 HOLE
SHAFT W/GUIDES-STERILE EA $605.00 $550.31 9.04% Y100 02.114.509
1.5MM LCP EXTENDED H-PLATE LEFT WITH GUIDES EA $526.00 $442.68
15.84% Y100 02.114.509S 1.5MM LCP EXTENDED H-PLATE LEFT WITH
GUIDES-STERILE EA $581.00 $485.65 16.41% Y100 02.114.510 1.5MM LCP
EXTENDED H-PLATE RIGHT WITH GUIDES EA $526.00 $442.68 15.84% Y100
02.114.510S 1.5MM LCP EXTENDED H-PLATE RIGHT WITH GUIDES-STERILE EA
$581.00 $485.65 16.41% Y100 02.114.513 1.5MM LCP Y-PLATE/3H HEAD 8
HOLE SHAFT WITH GUIDES EA $526.00 $407.38 22.55% Y100 02.114.513S
1.5MM LCP Y-PLATE/3 HOLE HEAD 8 HOLE SHAFT W/GUIDES-STERILE EA
$581.00 $449.79 22.58% Y100 02.114.514 1.5MM LCP CONDYLAR PLATE 6
HOLE SHAFT WITH GUIDES EA $641.00 $591.21 7.77% Y100 02.114.514S
1.5MM LCP CONDYLAR PLATE 6 HOLE SHAFT W/GUIDES-STERILE EA $696.00
$640.56 7.97% Y100 02.115.130 2.4MM VA-LCP DORSAL DISTAL RAD
L-PLATE +90°/2H HD/3H SHAFT EA $638.00 $599.72 6.00% Y100
02.115.130S 2.4MM VA-LCP DORSAL DISTAL RAD L-PL +90°/2H HD/3H
SHAFT-STER EA $693.00 $651.42 6.00% Y100 02.115.131 2.4MM VA-LCP
DORSAL DISTAL RAD L-PLATE -90°/2H HD/3H SHAFT EA $638.00 $599.72
6.00% Y100 02.115.131S 2.4MM VA-LCP DORSAL DISTAL RAD L-PL -90°/2H
HD/3H SHAFT-STER EA $693.00 $651.42 6.00% Y100 02.115.150 2.4MM
VA-LCP DORSAL DISTAL RAD L-PLATE +90°/2H HD/5H SHAFT EA $670.00
$629.80 6.00% Y100 02.115.150S 2.4MM VA-LCP DORSAL DISTAL RAD L-PL
+90°/2H HD/5H SHAFT-STER EA $725.00 $681.50 6.00% Y100 02.115.151
2.4MM VA-LCP DORSAL DISTAL RAD L-PLATE -90°/2H HD/5H SHAFT EA
$670.00 $629.80 6.00% Y100 02.115.151S 2.4MM VA-LCP DORSAL DISTAL
RAD L-PL -90°/2H HD/5H SHAFT-STER EA $725.00 $681.50 6.00% Y100
02.115.230 2.4MM VA-LCP DORSAL DISTAL RAD L-PLATE +90°/3H HD/3H
SHAFT EA $638.00 $599.72 6.00% Y100 02.115.230S 2.4MM VA-LCP DORSAL
DISTAL RAD L-PL +90°/3H HD/3H SHAFT-STER EA $693.00 $651.42 6.00%
Y100 02.115.231 2.4MM VA-LCP DORSAL DISTAL RAD L-PLATE -90°/3H
HD/3H SHAFT EA $638.00 $599.72 6.00% Y100 02.115.231S 2.4MM VA-LCP
DORSAL DISTAL RAD L-PL -90°/3H HD/3H SHAFT-STER EA $693.00 $651.42
6.00% Y100 02.115.250 2.4MM VA-LCP DORSAL DISTAL RAD L-PLATE
+90°/3H HD/5H SHAFT EA $670.00 $629.80 6.00% Y100 02.115.250S 2.4MM
VA-LCP DORSAL DISTAL RAD L-PL +90°/3H HD/5H SHAFT-STER EA $725.00
$681.50 6.00% Y100 02.115.251 2.4MM VA-LCP DORSAL DISTAL RAD
L-PLATE -90°/3H HD/5H SHAFT EA $670.00 $629.80 6.00% Y100
02.115.251S 2.4MM VA-LCP DORSAL DISTAL RAD L-PL -90°/3H HD/5H
SHAFT-STER EA $725.00 $681.50 6.00% Y100 02.115.330 2.4MM VA-LCP
DORSAL DISTAL RAD T-PLATE/3H HD/3H SHAFT EA $659.00 $619.46 6.00%
Y100 02.115.330S 2.4MM VA-LCP DORSAL DISTAL RAD T-PL/3H HD/3H
SHAFT-STER EA $714.00 $671.16 6.00% Y100 02.115.350 2.4MM VA-LCP
DORSAL DISTAL RAD T-PLATE/3H HD/5H SHAFT EA $688.00 $646.72 6.00%
Y100 02.115.350S 2.4MM VA-LCP DORSAL DISTAL RAD T-PL/3H HD/5H
SHAFT-STER EA $743.00 $698.42 6.00% Y100 02.115.430 2.4MM VA-LCP
DORSAL DISTAL RAD L-PLATE +20°/3H HD/3H SHAFT EA $638.00 $599.72
6.00% Y100 02.115.430S 2.4MM VA-LCP DORSAL DISTAL RAD L-PL +20°/3H
HD/3H SHAFT-STER EA $693.00 $651.42 6.00% Y100 02.115.431 2.4MM
VA-LCP DORSAL DISTAL RAD L-PLATE -20°/3H HD/3H SHAFT EA $638.00
$599.72 6.00% Y100 02.115.431S 2.4MM VA-LCP DORSAL DISTAL RAD L-PL
-20°/3H HD/3H SHAFT-STER EA $693.00 $651.42 6.00% Y100 02.115.450
2.4MM VA-LCP DORSAL DISTAL RAD L-PLATE +20°/3H HD/5H SHAFT EA
$670.00 $629.80 6.00% Y100 02.115.450S 2.4MM VA-LCP DORSAL DISTAL
RAD L-PL+20°/3H HD/5H SHAFT-STER EA $725.00 $681.50 6.00% Y100
02.115.451 2.4MM VA-LCP DORSAL DISTAL RAD L-PLATE -20°/3H HD/5H
SHAFT EA $670.00 $629.80 6.00% Y100 02.115.451S 2.4MM VA-LCP DORSAL
DISTAL RAD L-PL-20°/3H HD/5H SHAFT-STER EA $725.00 $681.50 6.00%
Y100 02.115.530 2.4MM VA-LCP DORSAL DISTAL RAD PLATE/RADIAL
COLUMN/5H SHAFT EA $626.00 $588.44 6.00% Y100 02.115.530S 2.4MM
VA-LCP DORSAL DISTAL RAD PL/RADIAL COLUMN/5H SHAFT-STE EA $681.00
$640.14 6.00% Y100 02.115.540 2.4MM VA-LCP DORSAL DISTAL RAD
PLATE/RADIAL COLUMN/6H SHAFT EA $659.00 $619.46 6.00% Y100
02.115.540S 2.4MM VA-LCP DORSAL DISTAL RAD PL/RADIAL COLUMN/6H
SHAFT-STE EA $714.00 $671.16 6.00% Y100 02.115.630 2.4MM VA-LCP
DRSL DRP/INTMD CLMN/+90°/2H HD/3H SHAFT EA $688.00 $646.72 6.00%
Y100 02.115.630S 2.4MM VA-LCP DRSL DRP/INTMD CLMN/+90°/2H HD/3H
SHAFT-STER EA $743.00 $698.42 6.00% Y100 02.115.631 2.4MM VA-LCP
DRSL DRP/INTMD CLMN/-90°/2H HD/3H SHAFT EA $688.00 $646.72 6.00%
Y100 02.115.631S 2.4MM VA-LCP DRSL DRP/INTMD CLMN/-90°/2H HD/3H
SHAFT-STER EA $743.00 $698.42 6.00% Y100 02.115.640 2.4MM VA-LCP
DRSL DRP/INTMD CLMN/+90°/2H HD/4H SHAFT EA $713.00 $670.22 6.00%
Y100 02.115.640S 2.4MM VA-LCP DRSL DRP/INTMD CLMN/+90°/2H HD/4H
SHAFT-STER EA $768.00 $721.92 6.00% Y100 02.115.641 2.4MM VA-LCP
DRSL DRP/INTMD CLMN/-90°/2H HD/4H SHAFT EA $713.00 $670.22 6.00%
Y100 02.115.641S 2.4MM VA-LCP DRSL DRP/INTMD CLMN/-90°/2H HD/4H
SHAFT-STER EA $768.00 $721.92 6.00% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 9 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.115.750 2.4MM VA-LCP VOLAR RIM DISTAL RADIUS PLATE/6H
HD/5H SHAFT/RT EA $1,119.00 $1,051.86 6.00% Y100 02.115.750S 2.4MM
VA-LCP VOLAR RIM DISTAL RAD PL/6H HD/5H SHFT/RT-STER EA $1,174.00
$1,103.56 6.00% Y100 02.115.751 2.4MM VA-LCP VOLAR RIM DISTAL
RADIUS PLATE/6H HD/5H SHAFT/LT EA $1,119.00 $1,051.86 6.00% Y100
02.115.751S 2.4MM VA-LCP VOLAR RIM DISTAL RAD PL/6H HD/5H
SHFT/LT-STER EA $1,174.00 $1,103.56 6.00% Y100 02.115.850 2.4MM
VA-LCP VOLAR RIM DISTAL RADIUS PLATE/7H HD/5H SHAFT/RT EA $1,119.00
$1,051.86 6.00% Y100 02.115.850S 2.4MM VA-LCP VOLAR RIM DISTAL RAD
PL/7H HD/5H SHFT/RT-STER EA $1,174.00 $1,103.56 6.00% Y100
02.115.851 2.4MM VA-LCP VOLAR RIM DISTAL RADIUS PLATE/7H HD/5H
SHAFT/LT EA $1,119.00 $1,051.86 6.00% Y100 02.115.851S 2.4MM VA-LCP
VOLAR RIM DISTAL RAD PL/7H HD/5H SHFT/LT-STER EA $1,174.00
$1,103.56 6.00% Y100 02.120.601 3.5MM LOCKING ATTACHMENT PLATE FOR
4.5MM LCP PLATE/4 HOLES EA $585.00 $544.09 6.99% Y100 02.120.601S
3.5MM LOCKING ATTACHMENT PLATE F/4.5MM LCP PLATE/4H-STER EA $640.00
$584.50 8.67% Y100 02.120.602 3.5MM LOCKING ATTACHMENT PLATE FOR
4.5MM LCP PLATE/8 HOLES EA $641.00 $595.91 7.03% Y100 02.120.602S
3.5MM LOCKING ATTACHMENT PLATE F/4.5MM LCP PLATE/8H-STER EA $696.00
$636.32 8.57% Y100 02.120.603 3.5MM LOCKING ATTACHMENT PLATE
F/4.5MM PROX FEMUR PL/4 HOLE EA $585.00 $544.09 6.99% Y100
02.120.603S 3.5MM LOCKING ATTACHMENT PLATE F/4.5MM PROX FEMUR
PL/4H-STER EA $640.00 $584.50 8.67% Y100 02.120.604 3.5MM LOCKING
ATTACHMENT PLATE F/4.5MM PROX FEMUR PL/8 HOLE EA $641.00 $595.91
7.03% Y100 02.120.604S 3.5MM LOCKING ATTACHMENT PLATE F/4.5MM PROX
FEMUR PL/8H-STER EA $696.00 $636.32 8.57% Y100 02.120.606
CONNECTING SCREW F/LOCKING ATTACHMENT PLATE/STARDRIVE EA $188.00
$172.73 8.12% Y100 02.120.606S CONNECTING SCREW F/LCKNG ATTACHMENT
PL/STARDRIVE-STER EA $243.00 $215.66 11.25% Y100 02.120.701 3.5MM
LCP POSTEROMEDIAL PROXIMAL TIBIA PLATE 1H/69MM EA $1,089.00
$1,005.03 7.71% Y100 02.120.701S 3.5MM LCP POSTEROMEDIAL PROX TIBIA
PL 1 H/69MM -STER EA $1,144.00 $1,047.82 8.41% Y100 02.120.702
3.5MM LCP POSTEROMEDIAL PROXIMAL TIBIA PLATE 2H/79MM EA $1,101.00
$1,015.81 7.74% Y100 02.120.702S 3.5MM LCP POSTEROMEDIAL PROX TIBIA
PL 2 H/79 MM -STER EA $1,156.00 $1,058.60 8.43% Y100 02.120.704
3.5MM LCP POSTEROMEDIAL PROXIMAL TIBIA PLATE 4H/105MM EA $1,112.00
$1,026.70 7.67% Y100 02.120.704S 3.5MM LCP POSTEROMEDIAL PROX TIBIA
PL 4 H/105MM -STER EA $1,167.00 $1,069.48 8.36% Y100 02.120.706
3.5MM LCP POSTEROMEDIAL PROXIMAL TIBIA PLATE 6H/131MM EA $1,124.00
$1,037.48 7.70% Y100 02.120.706S 3.5 MM LCP POSTEROMEDIAL PROX
TIBIA PL 6 H/131 MM -STER EA $1,179.00 $1,080.26 8.37% Y100
02.120.708 3.5MM LCP POSTEROMEDIAL PROXIMAL TIBIA PLATE 8H/157MM EA
$1,136.00 $1,048.33 7.72% Y100 02.120.708S 3.5 MM LCP POSTEROMEDIAL
PROX TIBIA PL 8 H/157 MM -STER EA $1,191.00 $1,091.11 8.39% Y100
02.120.710 3.5MM LCP POSTEROMEDIAL PROXIMAL TIBIA PLATE 10H/183MM
EA $1,148.00 $1,059.12 7.74% Y100 02.120.710S 3.5 MM LCP
POSTEROMEDIAL PROX TIBIA PL 10H/183 MM -STER EA $1,203.00 $1,101.89
8.40% Y100 02.123.020 3.5MM LCP PERIARTICULAR PROX HUMERUS PL 2
HOLE/91MM/RT EA $1,839.00 $1,692.65 7.96% Y100 02.123.020S 3.5MM
LCP PERIARTIC PROX HUM PLATE 2H/91MM/RT-STERILE EA $1,894.00
$1,735.41 8.37% Y100 02.123.021 3.5MM LCP PERIARTICULAR PROX
HUMERUS PL 2 HOLE/91MM/LT EA $1,839.00 $1,692.65 7.96% Y100
02.123.021S 3.5MM LCP PERIARTIC PROX HUM PLATE 2H/91MM/LT-STERILE
EA $1,894.00 $1,735.41 8.37% Y100 02.123.022 3.5MM LCP
PERIARTICULAR PROX HUMERUS PL 4 HOLE/127MM/RT EA $1,895.00
$1,743.83 7.98% Y100 02.123.022S 3.5MM LCP PERIARTIC PROX HUM PLATE
4H/127MM/RT-STERILE EA $1,950.00 $1,786.59 8.38% Y100 02.123.023
3.5MM LCP PERIARTICULAR PROX HUMERUS PL 4 HOLE/127MM/LT EA
$1,895.00 $1,743.83 7.98% Y100 02.123.023S 3.5MM LCP PERIARTIC PROX
HUM PLATE 4H/127MM/LT-STERILE EA $1,950.00 $1,786.59 8.38% Y100
02.123.024 3.5MM LCP PERIARTICULAR PROX HUMERUS PL 6 HOLE/163MM/RT
EA $1,996.00 $1,837.34 7.95% Y100 02.123.024S 3.5MM LCP PERIARTIC
PROX HUM PLATE 6H/163MM/RT-STERILE EA $2,051.00 $1,880.11 8.33%
Y100 02.123.025 3.5MM LCP PERIARTICULAR PROX HUMERUS PL 6
HOLE/163MM/LT EA $1,996.00 $1,837.34 7.95% Y100 02.123.025S 3.5MM
LCP PERIARTIC PROX HUM PLATE 6H/163MM/LT-STERILE EA $2,051.00
$1,880.11 8.33% Y100 02.123.026 3.5MM LCP PERIARTICULAR PROX
HUMERUS PL 8 HOLE/199MM/RT EA $2,073.00 $1,908.21 7.95% Y100
02.123.026S 3.5MM LCP PERIARTIC PROX HUM PLATE 8H/199MM RT-STERILE
EA $2,128.00 $1,950.98 8.32% Y100 02.123.027 3.5MM LCP
PERIARTICULAR PROX HUMERUS PL 8 HOLE/199MM/LT EA $2,073.00
$1,908.21 7.95% Y100 02.123.027S 3.5MM LCP PERIARTIC PROX HUM PLATE
8H/199MM/LT-STERILE EA $2,128.00 $1,950.98 8.32% Y100 02.123.028
3.5MM LCP PERIARTICULAR PROX HUMERUS PL 10 HOLE/235MM/RT EA
$2,150.00 $1,979.07 7.95% Y100 02.123.028S 3.5MM LCP PERIARTIC PROX
HUM PLATE 10H/235MM/RT-STERILE EA $2,205.00 $2,021.84 8.31% Y100
02.123.029 3.5MM LCP PERIARTICULAR PROX HUMERUS PL 10 HOLE/235MM/LT
EA $2,150.00 $1,979.07 7.95% Y100 02.123.029S 3.5MM LCP PERIARTIC
PROX HUM PLATE 10H/235MM/LT-STERILE EA $2,205.00 $2,021.84 8.31%
Y100 02.123.030 3.5MM LCP PERIARTICULAR PROX HUMERUS PL 12
HOLE/271MM/RT EA $2,220.00 $2,043.00 7.97% Y100 02.123.030S 3.5MM
LCP PERIARTIC PROX HUM PLATE 12H/271MM/RT-STERILE EA $2,275.00
$2,085.78 8.32% Y100 02.123.031 3.5MM LCP PERIARTICULAR PROX
HUMERUS PL 12 HOLE/271MM/LT EA $2,220.00 $2,043.00 7.97% Y100
02.123.031S 3.5MM LCP PERIARTIC PROX HUM PLATE 12H/271MM/LT-STER EA
$2,275.00 $2,085.78 8.32% Y100 02.123.032S 3.5MM LCP PERIARTIC PROX
HUM PLATE 14 H/307MM/RT-STERILE EA $2,351.00 $2,155.65 8.31% Y100
02.123.033S 3.5MM LCP PERIARTIC PROX HUM PLATE 14
H/307MM/LT-STERILE EA $2,351.00 $2,155.65 8.31% Y100 02.123.040
3.5MM LCP PERIARTICULAR PROX HUMERUS PL 3 HOLE/109MM/RT EA
$1,866.00 $1,717.24 7.97% Y100 02.123.040S 3.5MM LCP PERIARTIC PROX
HUM PLATE 3H/109MM/RT-STERILE EA $1,921.00 $1,760.01 8.38% Y100
02.123.041 3.5MM LCP PERIARTICULAR PROX HUMERUS PL 3 HOLE/109MM/LT
EA $1,866.00 $1,717.24 7.97% Y100 02.123.041S 3.5MM LCP PERIARTIC
PROX HUM PLATE 3H/109MM/LT-STERILE EA $1,921.00 $1,760.01 8.38%
Y100 02.123.042 3.5MM LCP PERIARTICULAR PROX HUMERUS PL 5
HOLE/145MM/RT EA $1,941.00 $1,786.13 7.98% Y100 02.123.042S 3.5MM
LCP PERIARTIC PROX HUM PLATE 5H/145MM/RT-STERILE EA $1,996.00
$1,828.90 8.37% Y100 02.123.043 3.5MM LCP PERIARTICULAR PROX
HUMERUS PL 5 HOLE/145MM/LT EA $1,941.00 $1,786.13 7.98% Y100
02.123.043S 3.5MM LCP PERIARTIC PROX HUM PLATE 5H/145MM/LT-STERILE
EA $1,996.00 $1,828.90 8.37% Y100 02.124.030S LCP DISTAL FEMUR
PLATE 15 HOLE/356MM RIGHT-STERILE EA $2,112.00 $1,985.28 6.00% Y100
02.124.031S LCP DISTAL FEMUR PLATE 15 HOLE/356MM LEFT-STERILE EA
$2,112.00 $1,985.28 6.00% Y100 02.124.034S LCP DISTAL FEMUR PLATE
17 HOLE/396MM RIGHT-STERILE EA $2,150.00 $2,021.00 6.00% Y100
02.124.035S LCP DISTAL FEMUR PLATE 17 HOLE/396MM LEFT-STERILE EA
$2,150.00 $2,021.00 6.00% Y100 02.124.038S LCP DISTAL FEMUR PLATE
19 HOLE/436MM RIGHT-STERILE EA $2,189.00 $2,057.66 6.00% Y100
02.124.039S LCP DISTAL FEMUR PLATE 19 HOLE/436MM LEFT-STERILE EA
$2,189.00 $2,057.66 6.00% Y100 02.124.200 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 4 HOLES/76MM/RIGHT EA $1,714.00 $1,581.61 7.72% Y100
02.124.200S 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND
4H/76MM/RIGHT-STER EA $1,769.00 $1,624.38 8.18% Y100 02.124.201
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 4 HOLES/76MM/LEFT EA
$1,714.00 $1,581.61 7.72% Y100 02.124.201S 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 4H/76MM/LEFT-STER EA $1,769.00 $1,624.38 8.18% Y100
02.124.204 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 6
HOLES/102MM/RIGHT EA $1,735.00 $1,601.30 7.71% Y100 02.124.204S
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 6H/102MM/RIGHT-STER EA
$1,790.00 $1,644.07 8.15% Y100 02.124.205 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 6 HOLES/102MM/LEFT EA $1,735.00 $1,601.30 7.71% Y100
02.124.205S 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND
6H/102MM/LEFT-STER EA $1,790.00 $1,644.07 8.15% Y100 02.124.208
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 8 HOLES/128MM/RIGHT EA
$1,755.00 $1,620.00 7.69% Y100 02.124.208S 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 8H/128MM/RIGHT-STER EA $1,810.00 $1,662.77 8.13%
Y100 02.124.209 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 8
HOLES/128MM/LEFT EA $1,755.00 $1,620.00 7.69% Y100 02.124.209S
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 8H/128MM/LEFT-STER EA
$1,810.00 $1,662.77 8.13% Y100 02.124.212 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 10 HOLES/154MM/RIGHT EA $1,774.00 $1,637.71 7.68%
Y100 02.124.212S 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND
10H/154MM/RIGHT-STER EA $1,829.00 $1,680.48 8.12% Y100 02.124.213
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 10 HOLES/154MM/LEFT EA
$1,774.00 $1,637.71 7.68% Y100 02.124.213S 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 10H/154MM/LEFT-STER EA $1,829.00 $1,680.48 8.12%
Y100 02.124.216 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 12
HOLES/180MM/RIGHT EA $1,797.00 $1,658.35 7.72% Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 10 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.124.216S 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND
12H/180MM/RIGHT-STER EA $1,852.00 $1,701.11 8.15% Y100 02.124.217
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 12 HOLES/180MM/LEFT EA
$1,797.00 $1,658.35 7.72% Y100 02.124.217S 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 12H/180MM/LEFT-STER EA $1,852.00 $1,701.11 8.15%
Y100 02.124.220 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 14
HOLES/206MM/RIGHT EA $1,817.00 $1,677.04 7.70% Y100 02.124.220S
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 14H/206MM/RIGHT-STER EA
$1,872.00 $1,719.82 8.13% Y100 02.124.221 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 14 HOLES/206MM/LEFT EA $1,817.00 $1,677.04 7.70%
Y100 02.124.221S 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND
14H/206MM/LEFT-STER EA $1,872.00 $1,719.82 8.13% Y100 02.124.224
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 16 HOLES/232MM/RIGHT EA
$1,881.00 $1,736.14 7.70% Y100 02.124.224S 3.5MM LCP PROXIMAL TIBIA
PLATE LOW BEND 16H/232MM/RIGHT-STER EA $1,936.00 $1,778.91 8.11%
Y100 02.124.225 3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 16
HOLES/232MM/LEFT EA $1,881.00 $1,736.14 7.70% Y100 02.124.225S
3.5MM LCP PROXIMAL TIBIA PLATE LOW BEND 16H/232MM/LEFT-STER EA
$1,936.00 $1,778.91 8.11% Y100 02.124.406 4.5MM VA-LCP CURVED
CONDYLAR PLATE/6 HOLE/159MM/RIGHT EA $1,949.00 $1,832.06 6.00% Y100
02.124.406S 4.5MM VA-LCP CURVED CONDYLAR PLATE/6HOLE/159MM/RT-STER
EA $2,004.00 $1,883.76 6.00% Y100 02.124.407 4.5MM VA-LCP CURVED
CONDYLAR PLATE/6 HOLE/159MM/LEFT EA $1,949.00 $1,832.06 6.00% Y100
02.124.407S 4.5MM VA-LCP CURVED CONDYLAR PLATE/6HOLE/159MM/LT-STER
EA $2,004.00 $1,883.76 6.00% Y100 02.124.408 4.5MM VA-LCP CURVED
CONDYLAR PLATE/8 HOLE/195MM/RIGHT EA $1,986.00 $1,866.84 6.00% Y100
02.124.408S 4.5MM VA-LCP CURVED CONDYLAR PLATE/8HOLE/195MM/RT-STER
EA $2,041.00 $1,918.54 6.00% Y100 02.124.409 4.5MM VA-LCP CURVED
CONDYLAR PLATE/8 HOLE/195MM/LEFT EA $1,986.00 $1,866.84 6.00% Y100
02.124.409S 4.5MM VA-LCP CURVED CONDYLAR PLATE/8HOLE/195MM/LT-STER
EA $2,041.00 $1,918.54 6.00% Y100 02.124.410 4.5MM VA-LCP CURVED
CONDYLAR PLATE/10 HOLE/230MM/RIGHT EA $2,079.00 $1,954.26 6.00%
Y100 02.124.410S 4.5MM VA-LCP CURVED CONDYLAR
PLATE/10HOLE/230MM/RT-STER EA $2,134.00 $2,005.96 6.00% Y100
02.124.411 4.5MM VA-LCP CURVED CONDYLAR PLATE/10 HOLE/230MM/LEFT EA
$2,079.00 $1,954.26 6.00% Y100 02.124.411S 4.5MM VA-LCP CURVED
CONDYLAR PLATE/10HOLE/230MM/LT-STER EA $2,134.00 $2,005.96 6.00%
Y100 02.124.412 4.5MM VA-LCP CURVED CONDYLAR PLATE/12
HOLE/266MM/RIGHT EA $2,123.00 $1,995.62 6.00% Y100 02.124.412S
4.5MM VA-LCP CURVED CONDYLAR PLATE/12HOLE/266MM/RT-STER EA
$2,178.00 $2,047.32 6.00% Y100 02.124.413 4.5MM VA-LCP CURVED
CONDYLAR PLATE/12 HOLE/266MM/LEFT EA $2,123.00 $1,995.62 6.00% Y100
02.124.413S 4.5MM VA-LCP CURVED CONDYLAR PLATE/12HOLE/266MM/LT-STER
EA $2,178.00 $2,047.32 6.00% Y100 02.124.414 4.5MM VA-LCP CURVED
CONDYLAR PLATE/14 HOLE/301MM/RIGHT EA $2,266.00 $2,130.04 6.00%
Y100 02.124.414S 4.5MM VA-LCP CURVED CONDYLAR
PLATE/14HOLE/301MM/RT-STER EA $2,321.00 $2,181.74 6.00% Y100
02.124.415 4.5MM VA-LCP CURVED CONDYLAR PLATE/14 HOLE/301MM/LEFT EA
$2,266.00 $2,130.04 6.00% Y100 02.124.415S 4.5MM VA-LCP CURVED
CONDYLAR PLATE/14HOLE/301MM/LT-STER EA $2,321.00 $2,181.74 6.00%
Y100 02.124.416 4.5MM VA-LCP CURVED CONDYLAR PLATE/16
HOLE/336MM/RIGHT EA $2,310.00 $2,171.40 6.00% Y100 02.124.416S
4.5MM VA-LCP CURVED CONDYLAR PLATE/16HOLE/336MM/RT-STER EA
$2,365.00 $2,223.10 6.00% Y100 02.124.417 4.5MM VA-LCP CURVED
CONDYLAR PLATE/16 HOLE/336MM/LEFT EA $2,310.00 $2,171.40 6.00% Y100
02.124.417S 4.5MM VA-LCP CURVED CONDYLAR PLATE/16HOLE/336MM/LT-STER
EA $2,365.00 $2,223.10 6.00% Y100 02.124.418 4.5MM VA-LCP CURVED
CONDYLAR PLATE/18 HOLE/370MM/RIGHT EA $2,460.00 $2,312.40 6.00%
Y100 02.124.418S 4.5MM VA-LCP CURVED CONDYLAR
PLATE/18HOLE/370MM/RT-STER EA $2,515.00 $2,364.10 6.00% Y100
02.124.419 4.5MM VA-LCP CURVED CONDYLAR PLATE/18 HOLE/370MM/LEFT EA
$2,460.00 $2,312.40 6.00% Y100 02.124.419S 4.5MM VA-LCP CURVED
CONDYLAR PLATE/18HOLE/370MM/LT-STER EA $2,515.00 $2,364.10 6.00%
Y100 02.124.420S 4.5MM VA-LCP CURVED CONDYLAR
PLATE/20HOLE/405MM/RT-STER EA $2,938.00 $2,761.72 6.00% Y100
02.124.421S 4.5MM VA-LCP CURVED CONDYLAR PLATE/20HOLE/405MM/LT-STER
EA $2,938.00 $2,761.72 6.00% Y100 02.124.422S 4.5MM VA-LCP CURVED
CONDYLAR PLATE/22HOLE/439MM/RT-STER EA $3,153.00 $2,963.82 6.00%
Y100 02.124.423S 4.5MM VA-LCP CURVED CONDYLAR
PLATE/22HOLE/439MM/LT-STER EA $3,153.00 $2,963.82 6.00% Y100
02.161.210 3.5MM CURVED NARROW LCP PLATE/10 HOLES EA $438.00
$411.72 6.00% Y100 02.161.210S 3.5MM CURVED NARROW LCP PLATE/10
HOLES-STERILE EA $493.00 $454.49 7.81% Y100 02.161.212 3.5MM CURVED
NARROW LCP PLATE/12 HOLES EA $667.00 $618.15 7.32% Y100 02.161.212S
3.5MM CURVED NARROW LCP PLATE/12 HOLES-STERILE EA $722.00 $660.90
8.46% Y100 02.161.214 3.5MM CURVED NARROW LCP PLATE/14 HOLES EA
$772.00 $720.78 6.63% Y100 02.161.214S 3.5MM CURVED NARROW LCP
PLATE/14 HOLES-STERILE EA $827.00 $763.55 7.67% Y100 02.161.216
3.5MM CURVED NARROW LCP PLATE/16 HOLES EA $834.00 $771.71 7.47%
Y100 02.161.216S 3.5MM CURVED NARROW LCP PLATE/16 HOLES-STERILE EA
$889.00 $814.47 8.38% Y100 02.161.218 3.5MM CURVED NARROW LCP
PLATE/18 HOLES EA $939.00 $875.30 6.78% Y100 02.161.218S 3.5MM
CURVED NARROW LCP PLATE/18 HOLES-STERILE EA $994.00 $918.08 7.64%
Y100 02.161.220 3.5MM CURVED NARROW LCP PLATE/20 HOLES EA $1,043.00
$977.97 6.23% Y100 02.161.220S 3.5MM CURVED NARROW LCP PLATE/20
HOLES-STERILE EA $1,098.00 $1,020.76 7.03% Y100 02.161.222 3.5MM
CURVED NARROW LCP PLATE/22 HOLES EA $1,043.00 $977.97 6.23% Y100
02.161.222S 3.5MM CURVED NARROW LCP PLATE/22 HOLES-STERILE EA
$1,098.00 $1,020.76 7.03% Y100 02.161.240 4.5MM CURVED NARROW LCP
PLATE 10 HOLES EA $725.00 $669.24 7.69% Y100 02.161.240S 4.5MM
CURVED NARROW LCP PLATE/10 HOLES-STERILE EA $780.00 $711.99 8.72%
Y100 02.161.242 4.5MM CURVED NARROW LCP PLATE 12 HOLES EA $837.00
$772.56 7.70% Y100 02.161.242S 4.5MM CURVED NARROW LCP PLATE/12
HOLES-STERILE EA $892.00 $815.30 8.60% Y100 02.161.244 4.5MM CURVED
NARROW LCP PLATE 14 HOLES EA $893.00 $823.73 7.76% Y100 02.161.244S
4.5MM CURVED NARROW LCP PLATE/14 HOLES-STERILE EA $948.00 $866.48
8.60% Y100 02.161.246 4.5MM CURVED NARROW LCP PLATE 16 HOLES EA
$1,004.00 $926.12 7.76% Y100 02.161.246S 4.5MM CURVED NARROW LCP
PLATE/16 HOLES-STERILE EA $1,059.00 $968.88 8.51% Y100 02.161.248
4.5MM CURVED NARROW LCP PLATE 18 HOLES EA $1,226.00 $1,131.86 7.68%
Y100 02.161.248S 4.5MM CURVED NARROW LCP PLATE/18 HOLES-STERILE EA
$1,281.00 $1,174.62 8.30% Y100 02.161.250 4.5MM CURVED NARROW LCP
PLATE 20 HOLES EA $1,450.00 $1,338.49 7.69% Y100 02.161.250S 4.5MM
CURVED NARROW LCP PLATE/20 HOLES-STERILE EA $1,505.00 $1,381.25
8.22% Y100 02.161.252 4.5MM CURVED NARROW LCP PLATE 22 HOLES EA
$1,617.00 $1,492.05 7.73% Y100 02.161.252S 4.5MM CURVED NARROW LCP
PLATE/22 HOLES-STERILE EA $1,672.00 $1,534.81 8.21% Y100 02.161.270
3.5MM CURVED BROAD LCP PLATE/10 HOLE EA $553.00 $514.92 6.89% Y100
02.161.270S 3.5MM CURVED BROAD LCP PLATE 10 HOLE-STERILE EA $608.00
$557.67 8.28% Y100 02.161.272 3.5MM CURVED BROAD LCP PLATE/12 HOLE
EA $720.00 $669.44 7.02% Y100 02.161.272S 3.5MM CURVED BROAD LCP
PLATE/12 HOLE-STERILE EA $775.00 $712.20 8.10% Y100 02.161.274
3.5MM CURVED BROAD LCP PLATE/14 HOLE EA $772.00 $720.78 6.63% Y100
02.161.274S 3.5MM CURVED BROAD LCP PLATE/14 HOLE-STERILE EA $827.00
$763.55 7.67% Y100 02.161.276 3.5MM CURVED BROAD LCP PLATE/16 HOLE
EA $834.00 $771.71 7.47% Y100 02.161.276S 3.5MM CURVED BROAD LCP
PLATE/16 HOLE-STERILE EA $889.00 $814.47 8.38% Y100 02.161.278
3.5MM CURVED BROAD LCP PLATE/18 HOLE EA $939.00 $875.30 6.78% Y100
02.161.278S 3.5MM CURVED BROAD LCP PLATE/18 HOLE-STERILE EA $994.00
$918.08 7.64% Y100 02.161.280 3.5MM CURVED BROAD LCP PLATE/20 HOLE
EA $1,001.00 $926.24 7.47% Y100 02.161.280S 3.5MM CURVED BROAD LCP
PLATE/20 HOLE-STERILE EA $1,056.00 $969.00 8.24% Y100 02.161.282
3.5MM CURVED BROAD LCP PLATE/22 HOLE EA $1,053.00 $977.57 7.16%
Y100 02.161.282S 3.5MM CURVED BROAD LCP PLATE/22 HOLE-STERILE EA
$1,108.00 $1,020.34 7.91% Y100 02.161.284 3.5MM CURVED BROAD LCP
PLATE/24 HOLE EA $1,053.00 $977.57 7.16% Y100 02.161.284S 3.5MM
CURVED BROAD LCP PLATE/24 HOLE-STERILE EA $1,108.00 $1,020.34 7.91%
Y
-
Group 11903, Award 21091PC63950
Orthopedic EquipmentSynthes USA
Effective Date: Feb.1, 2012
1190321091PL_SynthesUSAPC6395001FEB2012.xlsx 11 of 286
Co ItemNo Item Description Units 2012 List Price State of NY
Discount Price
Discount PatientChargeable
State of NY Price list as of 01Feb2012
100 02.161.286 3.5MM CURVED BROAD LCP PLATE/26 HOLE EA $1,117.00
$1,029.39 7.84% Y100 02.161.286S 3.5MM CURVED BROAD LCP PLATE/26
HOLE-STERILE EA $1,172.00 $1,072.14 8.52% Y100 02.161.288 3.5MM
CURVED BROAD LCP PLATE/28 HOLE EA $1,229.00 $1,132.70 7.84% Y100
02.161.288S 3.5MM CURVED BROAD LCP PLATE/28 HOLE-STERILE EA
$1,284.00 $1,175.46 8.45% Y100 02.161.290 3.5MM CURVED BROAD LCP
PLATE/30 HOLE EA $1,340.00 $1,235.09 7.83% Y100 02.161.290S 3.5MM
CURVED BROAD LCP PLATE/30 HOLE-STERILE EA $1,395.00 $1,277.85 8.40%
Y100 02.200.003 3.5MM THREADED PLUG STARDRIVE EA $131.00 $119.99
8.40% Y100 02.200.010 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
10MM EA $30.25 $27.98 7.50% Y100 02.200.012 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 12MM EA $30.25 $27.98 7.50% Y100 02.200.014
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 14MM EA $30.25 $27.98
7.50% Y100 02.200.016 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
16MM EA $30.25 $27.98 7.50% Y100 02.200.018 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 18MM EA $30.25 $27.98 7.50% Y100 02.200.020
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 20MM EA $30.25 $27.98
7.50% Y100 02.200.022 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
22MM EA $30.25 $27.98 7.50% Y100 02.200.024 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 24MM EA $30.25 $27.98 7.50% Y100 02.200.026
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 26MM EA $30.25 $27.98
7.50% Y100 02.200.028 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
28MM EA $30.25 $27.98 7.50% Y100 02.200.030 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 30MM EA $30.25 $27.98 7.50% Y100 02.200.032
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 32MM EA $30.25 $27.98
7.50% Y100 02.200.034 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
34MM EA $30.25 $27.98 7.50% Y100 02.200.036 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 36MM EA $30.25 $27.98 7.50% Y100 02.200.038
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 38MM EA $30.25 $27.98
7.50% Y100 02.200.040 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
40MM EA $30.25 $27.98 7.50% Y100 02.200.042 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 42MM EA $30.25 $27.98 7.50% Y100 02.200.044
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 44MM EA $30.25 $27.98
7.50% Y100 02.200.045 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
45MM EA $30.25 $27.98 7.50% Y100 02.200.046 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 46MM EA $30.25 $27.98 7.50% Y100 02.200.048
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 48MM EA $30.25 $27.98
7.50% Y100 02.200.050 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
50MM EA $30.25 $27.98 7.50% Y100 02.200.055 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 55MM EA $30.25 $27.98 7.50% Y100 02.200.060
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 60MM EA $30.25 $27.98
7.50% Y100 02.200.065 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
65MM EA $30.25 $27.98 7.50% Y100 02.200.070 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 70MM EA $30.25 $27.98 7.50% Y100 02.200.075
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 75MM EA $30.25 $27.98
7.50% Y100 02.200.080 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
80MM EA $30.25 $27.98 7.50% Y100 02.200.085 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 85MM EA $30.25 $27.98 7.50% Y100 02.200.090
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 90MM EA $30.25 $27.98
7.50% Y100 02.200.095 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
95MM EA $30.25 $27.98 7.50% Y100 02.200.100 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 100MM EA $37.75 $34.93 7.47% Y100 02.200.105
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 105MM EA $37.75 $34.93
7.47% Y100 02.200.110 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
110MM EA $37.75 $34.93 7.47% Y100 02.200.115 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 115MM EA $37.75 $34.93 7.47% Y100 02.200.120
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 120MM EA $37.75 $34.93
7.47% Y100 02.200.125 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
125MM EA $37.75 $34.93 7.47% Y100 02.200.130 3.5MM STARDRIVE CORTEX
SCREW SELF-TAPPING 130MM EA $122.00 $112.96 7.41% Y100 02.200.135
3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 135MM EA $122.00 $112.96
7.41% Y100 02.200.140 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING
140MM EA $122.00 $112.96 7.41% Y100 02.200.145 3.5MM STARDRIVE
CORTEX SCREW SELF-TAPPING 145MM EA $122.00 $112.96 7.41% Y100
02.200.150 3.5MM STARDRIVE CORTEX SCREW SELF-TAPPING 150MM EA
$122.00 $112.96 7.41% Y100 02.204.014 4.0MM LOCKING SCREW SLF-TPNG
WITH T25 STARDRIVE RECESS 14MM EA $173.00 $159.37 7.88% Y100
02.204.016 4.0MM LOCKING SCREW SLF-TPNG WITH T25 STARDRIVE RECESS
16MM EA $173.00 $159.37 7.88% Y100 02.204.018 4.0MM LOCKING SCREW
SLF-TPNG WITH T25 STARDRIVE RECESS 18MM EA $173.00 $159.37 7.88%
Y100 02.204.020 4.0MM LOCKING SCREW SLF-TPNG WITH T25 STARDRIVE
RECESS 20MM EA $173.00 $159.37 7.88% Y100 02.204.022 4.0MM LOCKING
SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 22MM EA $173.00 $159.37
7.88% Y100 02.204.024 4.0MM LOCKING SCREW SLF-TPNG WITH T25
STARDRIVE RECESS 24MM EA $173.00 $159.37 7.88% Y100 02.204.026
4.0MM LOCKING SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 26MM EA
$173.00 $159.37 7.88% Y100 02.204.028 4.0MM LOCKING SCREW SLF-TPNG
WITH T25 STARDRIVE RECESS 28MM EA $173.00 $159.37 7.88% Y100
02.204.030 4.0MM LOCKING SCREW SLF-TPNG WITH T25 STARDRIVE RECESS
30MM EA $173.00 $159.37 7.