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ANSAN 21 CENTURY HOSPITAL

비급여항목

분류	항목		가격정보 (단위:원)
분류	명칭	코드	구분	비용	최저비용	최대비용	치료대포함여부	약제대포함여부	특이사항
	Xgen Graft 3cc -H-one	BC0105ED		1400000	0	0
	플로실	646601401		900000	0	0
	Intraspine-SM	BF0401WQ		3800000	0	0
	전기수술기용 전극KJ400.KJ401.KJ402.KJ403-SM	BF0201OB		1600000	0	0
	Hibarry(하이배리)-유착방지제	BF0101VT		900000	0	0
	환의(상하)	비급여		16500	0	0
	DEMIOS DBM GEL 1cc	BC0101KJ		650000	0	0
	소변기(남성용)	비급여		5000	0	0
	팔걸이(소아)	비급여		3000	0	0
	팔걸이(성인)	VM061		5000	0	0
	팔자 붕대 -보조기	VM062		20000	0	0
	벨포밴드(붕대)	12064		30000	0	0
	Ice Bag -환자 갖고 감	비급여		30000	0	0
	Colar Cast Shoes	VM070		12000	0	0
	wrist brace	BC1215UZ		30000	0	0
	Thumb+ wrist Brace	BC1208RE		50000	0	0
	Thumb Brace	BC1213UZ		40000	0	0
	EZ Rap Brace	BC1215HT		100000	0	0
	knee brace	BC1002UZ		50000	0	0
	knee MCL brace	BC1002SI		200000	0	0
	immobilize knee-splint (무릎 고정)	BC1010PR		100000	0	0
	ankle brace	BC1216UZ		30000	0	0
	등, 허리, 엉치뼈보조기(Iso식 jacket)	보조기		300000	0	0
	philadelpia brace	20244		70000	0	0
	Blue DBM Wedge	BC0104QT		1850000	0	0
	토닉밴드	BC1201JO		40000	0	0
	Rafugen wedge(solid W6)	BC0100BU		1700000	0	0
	알루미늄 목발	20330		20000	0	0
	MegaDerm(1.5*3)	BST01019		800000	0	0
	MyGen 1cc	BM2601MS		500000	0	0
	Pre Band	BK7000PV		20000	0	0
	CARTISTEM	622900010		8000000	0	0
	Scargen	BM5000AE		120000	0	0
	Surgicon(써지콘)	BM5000SQ		100000	0	0
	3M COBAN	BK7101EA		4000	0	0
	Eden Epidural Catheter	BJ4801GV		700000	0	0
	DIAM	BF0402AW		3800000	0	0
	루플라주	053300081		150000	0	0
	Mygen 3cc	BM2601MS		800000	0	0
	silflex 12*15	BM2001CT		30000	0	0
	silflex 5*7.5	BM2001CT		10000	0	0
	silflex 8*10	BM2001CT		20000	0	0
	MOBI-C with Plug & Fit	BF0001KV		5500000	0	0
	RF-CURER(일회용발조절식전기수술기용 전극)	BF0202XP		1600000	0	0
	InterBlock-유착방지제	BF0100VD		900000	0	0
	NOVOSIS 1cc	BC0301QT		2500000	0	0
	BAGUERA C	BF0003GZ		5500000	0	0
자기공명영상진단료	MRI C-SPINE+E/F	HE109		500000	0	0
	ROTAIO	BF0001HB		5500000	0	0
	MST-HDET	BF0201RG		1600000	0	0
	BONGENER 1cc	BC0102QT		650000	0	0
	BONGENER 2.5cc	BC0102QT		1400000	0	0
	OSG DBM 1cc	BC0101UH		650000	0	0
	OSG DBM 3cc	BC0101UH		1400000	0	0
	RAFUGEN DBM GEL PRO 1cc	BC0103BU		650000	0	0
	RAFUGEN DBM GEL PRO 3cc	BC0103BU		1400000	0	0
	NAVIO Disposable Kit	BE3001AD		1600000	0	0
	EPI-GEN CATH	BJ7001RG		700000	0	0
	knee brace (B)	BC1002UZ		50000	0	0
	Silicone tape(E-tube 고정용)	BM2002SZ		10000	0	0
	미디픽스 NB	BM5101EJ		2000	0	0
	Osteosparx C 1cc-GS	BC0103IE		650000	0	0
	Osteosparx C 3cc-GS	BC0103IE		1400000	0	0
	젠타큐 5*5	M3300010		500000	0	0			인정기준 외 비급여
	케어젤(CAREGEL)	M3304002		500000	0	0			인정기준 외 비급여
	소프트칼라(M/L)	BC1201YU		15000	0	0
	쇄골밴드	BC1205YF		20000	0	0
	DYM 1cc	BC0101OT		650000	0	0
	젠타큐 10*10	M3300110		600000	0	0			인정기준외 비급여
	PENOSS, PEDI-STICK PLUS 3.5*20	BC0106ED		1000000	0	0
	DYM 3CC	BC0101OT		1400000	0	0
	M-CLOT 20*10 (지혈용패드)	K9205250		150000	0	0
	M-CLOT 40*10 (지혈용패드)	K9205250		200000	0	0
	DISK SPINE(일회용발조절식전기수술기용 전극)	BF0201LK		1600000	0	0
	JENITH-L(경막외카테터)	BJ4803LK		600000	0	0
	XPLUS bandage(10*3)-자착성(탄력)붕대	BK7103UC		15000	0	0
	XPLUS bandage(15*3)-자착성(탄력)붕대	BK7103UC		17000	0	0
	EX BAND(압박용밴드)	BC1000VO		100000	0	0
	MST압박용밴드(Short-Arm)2*25	BK7000MS		20000	0	0
	MST압박용밴드(Short-Arm)3*35	BK7000MS		22000	0	0
	MST압박용밴드(Short-Arm)4*35	BK7000MS		22000	0	0
	MST압박용밴드(Long-Arm)3*70	BK7000MS		27000	0	0
	MST압박용밴드(Short-Leg)3*50	BK7000MS		22000	0	0
	MST압박용밴드(Short-Leg)4*55	BK7000MS		22000	0	0
	MST압박용밴드(Long-Leg)4*90	BK7000MS		27000	0	0
	ABEL EPIDURAL CATHETER(C-PEN용)	BJ4801GZ		700000	0	0
	EPISOL(L-PEN용)	BJ4803GZ		600000	0	0
	테니스앨보밴드	BC1214UZ		20000	0	0
	ABRO-C HDET	BF0202RA		1600000	0	0
	ABRO-HDET	BF0203RA		1600000	0	0
	EAN CATH(HDET)	BF0200MU		1600000	0	0
	일회용발조절식전기수술기용전극(IDET)	BF0201OB		1600000	0	0
	NOVOSIS 0.5cc	BC0301QT		1500000	0	0
	ACECOL 1cc	BM2600VT		500000	0	0
	ACECOL 3cc	BM2600VT		800000	0	0
	EPISOL H (L-PEN Balloon)catheter	BJ4804GZ		1400000	0	0
	DEMIOS DBM GEL 2.5cc	BC0101KJ		1200000	0	0
	NOVAS Pedicle rod	한시적비급여		150000	0	0
	NOVAS Pedicle screw	한시적비급여		500000	0	0
	COLLASHIELD 1cc	BM2601OP		500000	0	0
	COLLASHIELD 3cc	BM2601OP		800000	0	0
	ADR(CERVICAL)	BF0000GZ		5500000	0	0
	MegaDerm(3*4)	BTS01019		1500000	0	0
	MegaDerm(4*5)	BTS01019		2100000	0	0
	NEO SURGI GEL	BM5013RQ		120000	0	0
	UP LINE EAB BAND(15*3)	BK7100AL		17000	0	0
	UP LINE EAB BAND(10*3)	BK7100AL		15000	0	0
	JM-105 FINGER BRACE	BC1233PV		18000	0	0
	벨포밴드	12064		35000	0	0
	환의 상-환자 갖고감			10000	0	0
	환의 하-환자 갖고감			10000	0	0
	LINE CATHETER(C-PEN용)	BJ4800LK		700000	0	0
	JENITH-L(경막외카테터)(L-PEN용)	BJ4803LK		600000	0	0
	JENITH-BALLOON catheter	BJ4802LK		1400000	0	0
	BONSSO DBM 1cc	BC0100ER		650000	0	0
	BONSSO DBM 2.5cc	BC0100ER		1200000	0	0
	Frog Splint	FROG		10000	0	0
	SPINAUT-V, ENDO V-STIK PLUS(EEN catheter)	BJ4802UN		2800000	0	0			EEN catheter

분류	항목		가격정보 (단위:원)
분류	명칭	코드	구분	비용	최저비용	최대비용	치료대포함여부	약제대포함여부	특이사항
전체검사료	인플루엔자 A.B 바이러스검사(현장검사)--비급여	CZ394	CZ394	30,000	30,000	30,000	30,000	30,000	특이사항

분류	항목		가격정보 (단위:원)
분류	명칭	코드	구분	비용	최저비용	최대비용	치료대포함여부	약제대포함여부	특이사항
전체검사료	인플루엔자 A.B 바이러스검사(현장검사)--비급여	CZ394	CZ394	30,000	30,000	30,000	30,000	30,000	특이사항

분류	항목		가격정보 (단위:원)
분류	명칭	코드	구분	비용	최저비용	최대비용	치료대포함여부	약제대포함여부	특이사항
전체검사료	인플루엔자 A.B 바이러스검사(현장검사)--비급여	CZ394	CZ394	30,000	30,000	30,000	30,000	30,000	특이사항