Widex USA Inc. Amendment 2 Effective 9/1/14 Price Schedule Behind the Ear Type Hearing Aid (Corrected) BEHIND THE EAR TYPES - The total price shall be for a single hearing aid and appropriate case. List model numbers/name and full range of the instrument has a T-coil or T-coil capability. For analog, programmable and digital aids, indicate whether a remote control is required. For conventional aids, indicate whether it is a linear or compression circuit L = Linear, C = Compression. BEHIND THE EAR db RANGE Dream 110 9 BTE with volume control 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB Dream 110 9 BTE without volume control 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB Dream 110 D1-FS receiver in the ear with push button 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB and 66-85 dB 86 dB + Dream 110 m-CB micro ClearBand BTE 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB Dream 110 Fashion BTE with volume control and program button 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB and 66-85 dB Dream 110 9 BTE with volume control & Widex Wireless Cros System 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB Dream 110 9 BTE without volume control & Widex Wireless Cros System 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB Dream 110 D1-FS receiver in the ear with push button & Widex Wireless Cros System26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB and 66-85 dB 86 dB + Dream 110 m-CB micro ClearBand BTE & Widex Wireless Cros System 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB Dream 110 Fashion BTE with volume control and program button & Widex Wireless 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Programs and Zen+ and audibility extender, adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB and 66-85 dB Clear 220 C2-9 std BTE without VC 26-45 dB 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Programs and Audibility extender, T-Coil, DAI, 46-65 dB DESCRIPTION & FEATURES (See below) 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program MODEL NUMBER (19 Characters or less) HCPC CODE(S) PUBLISHED PERCENT (%) LIST DISCOUNT PRICE OFF LIST TOTAL PRICE NON WARRANTY REPAIR PRICE NON-WARRANTY REPAIR PERIOD (MONTHS) D1-9-VC 5261 Binaural 5257 Monaural $1,198.00 $599.00 37.062% 37.062% $754.00 $377.00 $200.00 $100.00 12 12 D1-9 5261 Binaural 5257 Monaural $1,198.00 $599.00 37.062% 37.062% $754.00 $377.00 $200.00 $100.00 12 12 D1-FS 5261 Binaural 5257 Monaural $1,398.00 $699.00 46.066% 46.066% $754.00 $377.00 $200.00 $100.00 12 12 D1-MR CB 5261 Binaural 5257 Monaural $1,198.00 $599.00 37.062% 37.062% $754.00 $377.00 $200.00 $100.00 12 12 D1FA-VC 5261 Binaural 5257 Monaural $1,198.00 $599.00 37.062% 37.062% $754.00 $377.00 $200.00 $100.00 12 12 V5180 Hearing Aid, Cros, BTE $1,348.00 37.062% $848.40 $100.00 12 V5180 Hearing Aid, Cros, BTE $1,348.00 37.062% $848.40 $100.00 12 V5180 Hearing Aid, Cros, BTE $1,448.00 46.066% $780.96 $100.00 12 V5180 Hearing Aid, Cros, BTE $1,348.00 37.062% $848.40 $100.00 12 V5180 Hearing Aid, Cros, BTE $1,348.00 37.062% $848.40 $100.00 12 5261 Binaural 5257 Monaural $1,498.00 $749.00 46.596% 46.596% $800.00 $400.00 $200.00 $100.00 12 12 D1-9-VC D1-9 D1-FS D1-MR CB D1FA-VC C29 Widex USA Inc. Amendment 2 Effective 9/1/14 Price Schedule Behind the Ear Type Hearing Aid (Corrected) BEHIND THE EAR DESCRIPTION & FEATURES (See below) Clear 220 C2-9 std BTE with VC 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Programs Audibility extender, T-Coil, DAI, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Clear 220 C2 MR micro BTE with Clearband without VC 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, DAI, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Clear 220 C2-MR micro BTE without VC 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, DAI, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Clear 220 C2-PA micro receiver in the ear without VC 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, DAI, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Clear 220 C2-FS receiver in the ear with push button 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, DAI, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Super 220 receiver in the ear power BTE, 675 battery, SP Receiver 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Super 220 receiver in the ear power BTE, 675 battery, SP Receiver 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, DAI, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Super 220 receiver in the ear power BTE, 675 battery, P Receiver 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Super 220 receiver in the ear power BTE, 675 battery, P Receiver 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog Audibility extender, T-Coil, DAI, 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen Program Mind 220 m2-9 std power digital without VC 13 band sensogram, 5 channel processing, 5 channel adaptive directionality, noise manager with SIS, Audibility Extender, multidirectional active feedback canceling, DAI, T-Coil, 3 programs Smart Speak, EDRC (Enhanced Dynamic Range Compression), Servicetracker, Sound Diary, Zen program Mind 220 m2-9 std power digital with VC 13 band sensogram, 5 channel processing, 5 channel adaptive directionality, noise manager with SIS, Audibility Extender, multidirectional active feedback canceling, DAI, T-Coil, 3 programs Smart Speak, EDRC (Enhanced Dynamic Range Compression), Servicetracker, Sound Diary, Zen program db RANGE 26-45 dB and 46-65 dB MODEL NUMBER (19 Characters or less) HCPC CODE(S) PUBLISHED PERCENT (%) LIST DISCOUNT PRICE OFF LIST TOTAL PRICE NON WARRANTY REPAIR PRICE NON-WARRANTY REPAIR PERIOD (MONTHS) C29-VC 5261 Binaural 5257 Monaural $1,498.00 $749.00 46.596% 46.596% $800.00 $400.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB C2-MR CB 5261 Binaural 5257 Monaural $1,498.00 $749.00 46.596% 46.596% $800.00 $400.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB C2-MR 5261 Binaural 5257 Monaural $1,498.00 $749.00 46.596% 46.596% $800.00 $400.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB C2-PA 5261 Binaural 5257 Monaural $1,698.00 $849.00 52.886% 52.886% $800.00 $400.00 $200.00 $100.00 12 12 C2-FS 5261 Binaural 5257 Monaural $1,698.00 $849.00 52.886% 52.886% $800.00 $400.00 $200.00 $100.00 12 12 S2-VS-SP 5261 Binaural 5257 Monaural $1,698.00 $849.00 52.886% 52.886% $800.00 $400.00 $200.00 $100.00 12 12 46-65 dB 66-85 dB 86 dB + S2-VSD-SP 5261 Binaural 5257 Monaural $1,698.00 $849.00 52.886% 52.886% $800.00 $400.00 $200.00 $100.00 12 12 46-65 dB 66-85 dB 86 dB + S2-VS-P 5261 Binaural 5257 Monaural $1,698.00 $849.00 52.886% 52.886% $800.00 $400.00 $200.00 $100.00 12 12 46-65 dB 66-85 dB 86 dB + S2-VSD-P 5261 Binaural 5257 Monaural $1,698.00 $849.00 52.886% 52.886% $800.00 $400.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB m2-9 5261 Binaural 5257 Monaural $1,298.00 $649.00 46.071% 46.071% $700.00 $350.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB m2-9VC 5261 Binaural 5257 Monaural $1,298.00 $649.00 46.071% 46.071% $700.00 $350.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB and 66-85 dB 86 dB + 46-65 dB 66-85 dB 86 dB + Widex USA Inc. BEHIND THE EAR DESCRIPTION & FEATURES (See below) Mind 220 m2-19 power digital without VC 13 band sensogram, 5 channel processing, 5 channel adaptive directionality, noise manager with SIS, Audibility Extender, multidirectional active feedback canceling, DAI, T-Coil, 3 programs Smart Speak, EDRC (Enhanced Dynamic Range Compression), Servicetracker, Sound Diary, Zen program Mind 220 m2-19 power digital with VC 13 band sensogram, 5 channel processing, 5 channel adaptive directionality, noise manager with SIS, Audibility Extender, multidirectional active feedback canceling, DAI, T-Coil, 3 programs Smart Speak, EDRC (Enhanced Dynamic Range Compression), Servicetracker, Sound Diary, Zen program Mind 220 m2-m micro with program button 13 band sensogram, 5 channel processing, 5 channel adaptive directionality, noise manager with SIS, Audibility Extender, multidirectional active feedback canceling, std prgram button (up to 3 listening programs), Smart Speak, EDRC (Enhanced Dynamic Range Compression), Servicetracker, Sound Diary, Zen program Menu 3 ME3-m (micro BTE) 14 band sensogram, 3 channel processing, multi-directional active feedback cancellation, noise reduction Menu 3 ME3-9 BTE 14 band sensogram, 3 channel processing, 2 programs, T-Coil, DAI, active feedback cancellation, noise reduction Menu 3 ME3-19 BTE 14 band sensogram, 3 channel processing, 2 programs, T-Coil, DAI, active feedback cancellation, noise reduction WIDEX USA Amendment 2 Effective 9/1/14 Price Schedule Behind the Ear Type Hearing Aid (Corrected) db RANGE MODEL NUMBER (19 Characters or less) HCPC CODE(S) PUBLISHED PERCENT (%) LIST DISCOUNT PRICE OFF LIST TOTAL PRICE NON WARRANTY REPAIR PRICE NON-WARRANTY REPAIR PERIOD (MONTHS) 26-45 dB and 46-65 dB m2-19 5261 Binaural 5257 Monaural $1,298.00 $649.00 46.071% 46.071% $700.00 $350.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB m2-19VC 5261 Binaural 5257 Monaural $1,298.00 $649.00 46.071% 46.071% $700.00 $350.00 $200.00 $100.00 12 12 m2-m 5261 Binaural 5257 Monaural $1,298.00 $649.00 46.071% 46.071% $700.00 $350.00 $200.00 $100.00 12 12 ME3-m 5261 Binaural 5257 Monaural $798.00 $399.00 50.125% 50.125% $398.00 $199.00 $200.00 $100.00 12 12 ME3-9 5261 Binaural 5257 Monaural $798.00 $399.00 50.125% 50.125% $398.00 $199.00 $200.00 $100.00 12 12 ME3-19 5261 Binaural 5257 Monaural $798.00 $399.00 50.125% 50.125% $398.00 $199.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB 26-45 dB and 46-65 dB 26-45 dB and 46-65 dB 46-65 dB and 66-85 dB Widex USA Inc. Amendment 2 Effective 9/1/14 Price Schedule In the Ear (Full Shell) Hearing Aid (Corrected) IN THE EAR TYPES – Prices shall be for a single hearing aid and case. List model number for the full range of instruments. Include all features. Indicate Class D power or Class B power. MODEL FULL CONCHA MODEL IN THE EAR - FULL SHELL DESCRIPTION & FEATURES (See below) NUMBER db RANGE (19 Characters or less) HCPC CODE(S) PUBLISHED PERCENT (%) LIST PRICE DISCOUNT OFF LIST NON - NON-WARRANTY WARRANTY REPAIR TOTAL PRICE REPAIR PRICE PERIOD (MONTHS) Dream 110 In the Ear-Full Shell 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Prog and Ze and adaptive directional, noise manager, Feedback Canceller, Zen program 46-65 dB D1-XPF 5260 Binaural 5256 Monaural $1,198.00 $599.00 37.062% 37.062% $754.00 $377.00 $200.00 $100.00 12 12 Clear 220 In the Ear-Full Shell 26-45 dB 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog and 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen 46-65 dB C2-XF 5260 Binaural 5256 Monaural $1,498.00 $749.00 46.596% 46.596% $800.00 $400.00 $200.00 $100.00 12 12 Mind 220 m2-X In the Ear-Full Shell 14 band sensogram, 5 channel processing, 3 program 5 channel adaptive directionality, noise manager, Zen program m2-XF 5260 Binaural 5256 Monaural $1,298.00 $649.00 46.071% 46.071% $700.00 $350.00 $200.00 $100.00 12 12 ME3-XF 5260 Binaural 5256 Monaural $798.00 $399.00 50.125% 50.125% $398.00 $199.00 $200.00 $100.00 12 12 26-45 dB and 46-65 dB Menu 3 ME3-XF In the Ear-Full Shell 26-45 dB Digital, 5 channel processing, sensogram, multi-directional active feedback and cancellation, multi-channel noise cancellation, occlusion manager 46-65 dB WIDEX USA Widex USA Inc. Amendment 2 Effective 9/1/14 Price Schedule In the Ear (Half Shell) Hearing Aid (Corrected) IN THE EAR TYPES – Prices shall be for a single hearing aid and case. List model number for the full range of instruments. Include all features. Indicate Class D power or Class B power. HALF SHELL CONCHA MODEL DESCRIPTION & FEATURES (See below) MODEL NUMBER db (19 Characters RANGE or less) Dream 110 In the Ear-Half Shell 26-45 dB 14 band sensogram, 3 channel processing, C-ISP, Wireless, 2 Prog and Zen + T-Coil, adaptive directional, noise manager, Feedback Canceller, Zen program and 46-65 dB Clear 220 Digital In the Ear-Half Shell 26-45 dB 14 band sensogram, 5 channel processing, C-ISP, Wireless, 3 Prog, T-Coil 5 channel adaptive directional, noise manager, IE Feedback Canceller, Zen program and 46-65 dB Mind 220 m2-X In the Ear-Half Shell 26-45 dB 14 band sensogram, 5 channel processing, 3 program, T-Coil 5 channel adaptive directionality, noise manager, Zen program and 46-65 dB Menu 3 ME3-XH In the Ear-Half Shell 26-45 dB 3 channel processing, 14 band sensogram, 2 program, T-Coil, active feedback cancellation, noise manager and 46-65 dB WIDEX USA D1-XPH HCPC CODE(S) NON NON-WARRANTY PUBLISHED PERCENT (%) WARRANTY REPAIR LIST DISCOUNT TOTAL REPAIR PERIOD PRICE OFF LIST PRICE* PRICE ** (MONTHS) 5260 Binaural 5256 Monaural $1,198.00 $599.00 37.062% 37.062% $754.00 $377.00 $200.00 $100.00 12 12 C2-XH 5260 Binaural 5256 Monaural $1,498.00 $749.00 46.596% 46.596% $800.00 $400.00 $200.00 $100.00 12 12 m2-XH 5260 Binaural 5256 Monaural $1,298.00 $649.00 46.071% 46.071% $700.00 $350.00 $200.00 $100.00 12 12 ME3-XH 5260 Binaural 5256 Monaural $798.00 $399.00 50.125% 50.125% $398.00 $199.00 $200.00 $100.00 12 12
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