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ANSAN 21 CENTURY HOSPITAL

비급여항목

분류	항목		가격정보 (단위:원)
분류	명칭	코드	구분	비용	최저비용	최대비용	치료대포함여부	약제대포함여부	특이사항
	MYDERM	BST01079		2100000	0	0
	PRODISC-L-SM	BF0005AT		7500000	0	0
	Discocerv-SM(최대2 level 인정)	BF0001DB		5500000	0	0
	Loop Fixing-SM	BF0001IA		1320000	0	0
	PRODISC-C -SM(최대2 level 인정)	BF0004AT		5500000	0	0
	Baguera- C -GS	BF0003GZ		5500000	0	0
	Xgen Graft 1cc-H-one	BC0105ED		650000	0	0
	Xgen Graft 3cc -H-one	BC0105ED		1400000	0	0
	플로실-DS 메드텍	646601401		750000	0	0
	Intraspine-SM	BF0401WQ		3800000	0	0
	BMAC 2-미라	BL6051UM		3000000	0	0
	Hylofast- 미라	BL6052UM		2000000	0	0
	전기수술기용 전극KJ400.KJ401.KJ402.KJ403-SM	BF0201OB		1600000	0	0
	Osteosparx C 3cc (DBM)-태산	BC0103IE		1500000	0	0
	Bio Eden Peek Cage III-한시적	한시적		400000	0	0
	Hibarry-유착방지제	BF0101VT		900000	0	0
	Eden Fuse DBM 3cc-케이텍	BC0107ED		1500000	0	0
	Needleview CH-SM	BJ4803XU		2800000	0	0
창상보합용액상접착제	Dermabond	BB3004EE		120000	0	0
	젠타큐(GENTA Q)	BM5302VT		550000	0	0
	Demios 2.5cc- DBM	BC0101KJ		1500000	0	0
	Pd-An(KJ401)-SM	BF0201OB		1600000	0	0
	Eden Spinal Fixation System II Rod	한시적		150000	0	0
	Bio BMP2 1cc-심플메드	BC0301BU		1600000	0	0
	Osteosparx C 1cc (DBM)-태산	BC0103IE		700000	0	0
	환의(상하)	비급여		16500	0	0
	Diced Mega Fill - ES	BTT01022		200000	0	0
	Demios 1cc- DBM	BC0101KJ		700000	0	0
	Cartifill - 연골조직수복용(이건메디칼)	BM2621RA		2500000	0	0
	INION S-1 Plate(새움메디텍)	BF0701BP		1100000	0	0
	Eden Spinal Fixation System II Screw	한시적		500000	0	0
창상보합용액상접착제	Dermabond PRINEO	BB3006EE		250000	0	0
	INION S-1 Screw(새움메디텍)	BF0801BP		600000	0	0
	Sure Fuse DBM 3cc	BC0103ED		1500000	0	0
	Allocover Had-나노테크	BTS01114		2100000	0	0
	Spinaut-SM	BJ4801UN		600000	0	0
	Navicath Steerable Catheter	BJ4801ZO		700000	0	0
	Fora-B-H-one	BJ4805RA		1400000	0	0
	Cervical-St .Cox -SM	BJ4802RA		600000	0	0
	소변기(남성용)	비급여		5000	0	0
	대변기(PVC)	비급여		5000	0	0
	Zetuvit E (15*20)	BM5003JK		8500	0	0
	Secuex	BM5001GA		1500	0	0
	소프트칼라(Soft Collar)	20242		15000	0	0
	팔걸이(소아)	비급여		3000	0	0
	팔걸이(성인)	VM061		5000	0	0
	팔자 붕대 -보조기	VM062		20000	0	0
	벨포밴드	VM061		35000	0	0
	케어픽스-S	BC1201NR		150000	0	0
	hot pack(대)-환자 갖고 감	비급여		25000	0	0
	Ice Bag -환자 갖고 감	비급여		30000	0	0
	filter syringe -심플메드	BM1304VH		1000	0	0
	LMA Supreme -마취과	BK4201QL		100000	0	0
	CEB ldeal Bandage(10cm*5m)	BK7101IK		50000	0	0
	New Opsite post -op 10*20cm	BM5013CD		7500	0	0
	New Opsite post -op 10*25cm	BM5013CD		7500	0	0
	New Opsite post -op 5*6.5cm	BM5013CD		2500	0	0
	New Opsite post -op 8.5*9.5cm	BM5013CD		4500	0	0
	New Opsite post -op 8.5*15.5cm	BM5013CD		7500	0	0
	SUPERPORE (5*7)	BM5007BL		1000	0	0
	SUPERPORE (6*9)	BM5001BL		3000	0	0
	SUPERPORE (9*12)	BM5003BL		3500	0	0
	SUPERPORE (9*15)	BM5004BL		4000	0	0
	SUPERPORE(9*20)	BM5005BL		5000	0	0
	SUPERPORE(9*25)	BM5006BL		6000	0	0
	SUPERPORE (9*30)	BM5008BL		8000	0	0
	SUPERPORE (9*35)	BM5009BL		9000	0	0
	SUPERPORE (9*9)	BM5002BL		3000	0	0
	체내형범용 프로브	BL9001BY		100000	0	0
	Dressing Kit	BM5101WI		2000	0	0
	NAFIX PLUS IV	BJ1002PL		6000	0	0
	NAFIX Foly Guard(전규격)	BJ1004PL		10000	0	0
	Colar Cast Shoes	VM070		12000	0	0
	Setect Pad (10*10)	BM5026HF		8000	0	0
	Setect Pad (10*20)	BM5026HF		12000	0	0
	Smart H.C band(compression band)	BK7101WS		200000	0	0
	3M SOFT CLOTH TAPE(10*10)	BM5101LX		3000	0	0
	3M SOFT CLOTH TAPE (15*10)	BM5101LX		6000	0	0
	wrist brace	BC1211UZ		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	BC1001UZ		50000	0	0
	knee MCL brace	BC1002SI		200000	0	0
	immobilize knee-splint (무릎 고정)	BC1010PR		200000	0	0
	ankle brace	BC1212UZ		30000	0	0
	등, 허리, 엉치뼈보조기(Iso식 jacket)	보조기		300000	0	0
	philadelpia brace	20244		70000	0	0
	카티젤8.5g (금청)	684900011		10000	0	0
	Steri-Strip(3M)-1장	BM5003EM		3000	0	0
	Top Probe	BL9001WG		100000	0	0
	X-LITE(open finger cast)	BM2001TM		15000	0	0
	Blue DBM Wedge	BC0104QT		1850000	0	0
	FELIX-L PLIF CAGE	felex-l		400000	0	0
	유밴드(전규격)-성우	bc1200it		40000	0	0
	Multi-Fix Easy Band(전규격)	BK7103AS		40000	0	0
	Regenwel 3.5g	BM5305BH		500000	0	0
	Hiper Pore- 5*7.5cm	BM5001SO		2500	0	0
	Hiper Pore- 7.5*10cm	BM5001SO		4500	0	0
	Hiper Pore- 9*15cm	BM5001SO		7500	0	0
	Hiper Pore- 9*20cm	BM5001SO		8500	0	0
	Hiper Pore- 9*25cm	BM5001SO		10000	0	0
	Surgi-Chito20x40	BJ7002XF		60000	0	0
	Surgi-Chito13x38	BJ7002XF		50000	0	0
	토닉밴드	BC1201JO		40000	0	0
	루브에스겔	657401040		2000	0	0
	Rafugen-YG	BC0100BU		1700000	0	0
	알루미늄 목발	20330		20000	0	0
	JPBio Spinal Fixation System II Rod	한시적		150000	0	0
	JPBio Spinal Fixation System II Screw	한시적		500000	0	0
	Bios Spinal Fixation System Rod	한시적		150000	0	0
	Bios Spinal Fixation System Screw	한시적		500000	0	0
	JPBIO PLIF PEEK CAGE II -한시적	한시적		400000	0	0
	RAFUGEN DBM GEL PRO 1cc-HK메디칼	BC0103BU		700000	0	0
	Neo Skin D-태양	BM5006RQ		35000	0	0
	Silicone tape(E-tube 고정용)	BM2000JI		25000	0	0
	Silicone tape roll (1cut)	BM2000JI		5000	0	0
	JPbio PLIF Spinal Peek Cage III -한시적	jpppc3		400000	0	0
	MegaDerm	BST01019		800000	0	0
	MyGen6%-1cc	BM2601MS		500000	0	0
	Endo Lumbar Cage L	edlcl		400000	0	0
	Episol-H	BJ4804GZ		1400000	0	0
	Enfix Screw Set	enfixs		500000	0	0
	Enfix Rod	enfixr		150000	0	0
	Pre Band	BK7000PV		20000	0	0
	CARTISTEM	622900010		8000000	0	0
	BK BAND PIN	BC4101AK		400000	0	0
	DBM PUTTY 2.5cc	BC0101AT		1400000	0	0
	Scargen	BM5000AE		120000	0	0
	Surgicon	BM5000SQ		100000	0	0
	KMEC Cath	BJ4801XF		700000	0	0
	3M COBAN	BK7101EA		4000	0	0
	Eden Epidural Catheter	bj4801gv		700000	0	0
	Spinal Fixation System Rod	spfsr		150000	0	0
	Spinal Fixation System Screw	spfss		500000	0	0
	COLFINE	BM2600NW		350000	0	0
	DIAM	BF0402AW		3800000	0	0
	루플라주	053300080		150000	0	0
	Dual Patty	BJ7005LJ		50000	0	0
	Mygen 3cc	BM2601MS		800000	0	0
	ENFIX-E Rod	enixer		150000	0	0
	ENFIX-E Screw			500000	0	0
	KAGE2 PLIF			400000	0	0
	스토피헤모스태틱			700000	0	0
	silflex 12*15	BM2001CT		30000	0	0
	silflex 5*7.5	BM2001CT		10000	0	0
	silflex 8*10	BM2001CT		20000	0	0
	X2 R Spinal Fixation System Screw	x2rs		500000	0	0
	X2 R Spinal Fixation System Rod	x2rr		150000	0	0
	X2 R Cage	x2rc		400000	0	0
	MOBI-C with Plug & Fit	bf0001kv		5500000	0	0
	RF-CURER(일회용발조절식전기수술기용 전극)	BF0202XP		1600000	0	0
	MegaDBM 1cc	BC0100OT		650000	0	0
	MegaDBM 3cc	BC0100OT		1400000	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
	Mega DBM S 1cc	BC0101OT		650000	0	0
	Mega DBM S 3cc	BC0101OT		1400000	0	0
	Multi-FIx W Cage	multiwc		400000	0	0
	Muiti-Fix W Rod	multiwr		150000	0	0
	Multi-Fix W Screw set	multiws		500000	0	0
	BONGENER 1cc	BC0102QT		650000	0	0
	BONGENER 2.5cc	BC0102QT		1400000	0	0
	ELDORA-P	eldorap		400000	0	0
	LUX Rod	luxr		150000	0	0
	LUX Screw Set	luxs		500000	0	0
	OSG DBM 1cc	BC0101UH		650000	0	0
	OSG DBM 3cc	BC0101UH		1400000	0	0
	X2 W Cage	x2wc		400000	0	0
	X2 W Rod	x2wr		150000	0	0
	X2 W Screw Set	x2ws		500000	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
	Multi-Fix F Cage	multific		400000	0	0
	Juvencoll 1.5mL	BM5300YY		500000	0	0
	EPISOL(L-PEN)	BJ4803GZ		600000	0	0
	Multi-Fix Z Cage	MULZC		400000	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	38780	500000			인정기준 외 비급여
	JUVENCOLL	M3304014		500000	71180	500000			인정기준 외 비급여
	X2 F Rod	X2FR		150000	0	0
	X2 F Screw Set	X2FS		500000	0	0
	LUX2 Rod	LUXR2		150000	0	0
	LUX2 Screw Set	LUXS2		500000	0	0
	ELDORA-PG(cage)	ELDORAPG		400000	0	0
	케어젤(CAREGEL)	M3304002		500000	157990	500000			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
	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
	FIX CAGE PL	FIXC3		400000	0	0
	FIXCARE Rod	FIXC2		150000	0	0
	FIXCARE Screw Set	FIXC		500000	0	0
	EX BAND(압박용밴드)	BC1000VO		100000	0	0
	FIXCAGE-P	FIXC6		400000	0	0
	SPINEFIX ROD	FIXC5		150000	0	0
	SPINEFIX SCREW SET			500000	0	0
	SST PEDICLE ROD	FIXC8		150000	0	0
	SST PEDICLE SCREW SYSTEM	FIXC7		500000	0	0
	FIXCAGE-PG	FIXC11		400000	0	0
	SPINEFIX2 ROD	FIXC10		150000	0	0
	SPINEFIX2 SCREW SET			500000	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)	BJ4803GZ2		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

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