|
6" 15G PERCUTANEOUS DISCECTOMY
|
Facility
|
OP
|
$6,528.00
|
|
| Hospital Charge Code |
4471348
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,219.52 |
| Max. Negotiated Rate |
$5,255.04 |
| Rate for Payer: Aetna of NY Commercial |
$4,569.60
|
| Rate for Payer: Aetna of NY Medicare |
$3,002.88
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$4,896.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$4,896.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$2,415.36
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$3,264.00
|
| Rate for Payer: Cash Price |
$4,896.00
|
| Rate for Payer: CDPHP Commercial |
$5,255.04
|
| Rate for Payer: CDPHP Medicare |
$2,415.36
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$5,222.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$5,222.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$5,222.40
|
| Rate for Payer: EmblemHealth Medicaid |
$5,222.40
|
| Rate for Payer: EmblemHealth Medicare |
$2,219.52
|
| Rate for Payer: EmblemHealth Select Care |
$4,700.16
|
| Rate for Payer: Fidelis Medicare |
$2,487.82
|
| Rate for Payer: Galaxy Health Commercial |
$4,243.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$2,415.36
|
| Rate for Payer: Humana Medicare |
$2,415.36
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$4,569.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$3,002.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,896.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$3,675.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$2,536.13
|
| Rate for Payer: United Healthcare Medicare |
$2,415.36
|
| Rate for Payer: WellCare Medicare |
$3,590.40
|
|
|
6" 15G PERCUTANEOUS DISCECTOMY
|
Facility
|
IP
|
$6,528.00
|
|
| Hospital Charge Code |
4471348
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,243.20 |
| Max. Negotiated Rate |
$4,243.20 |
| Rate for Payer: Cash Price |
$4,896.00
|
| Rate for Payer: Galaxy Health Commercial |
$4,243.20
|
|
|
6" 17G PERCUTANEOUS DISCECTOMY
|
Facility
|
OP
|
$6,528.00
|
|
| Hospital Charge Code |
4471347
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,219.52 |
| Max. Negotiated Rate |
$5,255.04 |
| Rate for Payer: Aetna of NY Commercial |
$4,569.60
|
| Rate for Payer: Aetna of NY Medicare |
$3,002.88
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$4,896.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$4,896.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$2,415.36
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$3,264.00
|
| Rate for Payer: Cash Price |
$4,896.00
|
| Rate for Payer: CDPHP Commercial |
$5,255.04
|
| Rate for Payer: CDPHP Medicare |
$2,415.36
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$5,222.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$5,222.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$5,222.40
|
| Rate for Payer: EmblemHealth Medicaid |
$5,222.40
|
| Rate for Payer: EmblemHealth Medicare |
$2,219.52
|
| Rate for Payer: EmblemHealth Select Care |
$4,700.16
|
| Rate for Payer: Fidelis Medicare |
$2,487.82
|
| Rate for Payer: Galaxy Health Commercial |
$4,243.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$2,415.36
|
| Rate for Payer: Humana Medicare |
$2,415.36
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$4,569.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$3,002.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,896.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$3,675.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$2,536.13
|
| Rate for Payer: United Healthcare Medicare |
$2,415.36
|
| Rate for Payer: WellCare Medicare |
$3,590.40
|
|
|
6" 17G PERCUTANEOUS DISCECTOMY
|
Facility
|
IP
|
$6,528.00
|
|
| Hospital Charge Code |
4471347
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,243.20 |
| Max. Negotiated Rate |
$4,243.20 |
| Rate for Payer: Cash Price |
$4,896.00
|
| Rate for Payer: Galaxy Health Commercial |
$4,243.20
|
|
|
6.5 ET TUBE CUFFED
|
Facility
|
IP
|
$23.00
|
|
| Hospital Charge Code |
4479148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Cash Price |
$17.25
|
| Rate for Payer: Galaxy Health Commercial |
$14.95
|
|
|
6.5 ET TUBE CUFFED
|
Facility
|
OP
|
$23.00
|
|
| Hospital Charge Code |
4479148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Aetna of NY Commercial |
$16.10
|
| Rate for Payer: Aetna of NY Medicare |
$10.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$17.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$17.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.51
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$11.50
|
| Rate for Payer: Cash Price |
$17.25
|
| Rate for Payer: CDPHP Commercial |
$18.52
|
| Rate for Payer: CDPHP Medicare |
$8.51
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$18.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$18.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$18.40
|
| Rate for Payer: EmblemHealth Medicaid |
$18.40
|
| Rate for Payer: EmblemHealth Medicare |
$7.82
|
| Rate for Payer: EmblemHealth Select Care |
$16.56
|
| Rate for Payer: Fidelis Medicare |
$8.77
|
| Rate for Payer: Galaxy Health Commercial |
$14.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.51
|
| Rate for Payer: Humana Medicare |
$8.51
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$16.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$10.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$17.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$12.95
|
| Rate for Payer: MVP Health Care of NY Medicare |
$8.94
|
| Rate for Payer: United Healthcare Medicare |
$8.51
|
| Rate for Payer: WellCare Medicare |
$12.65
|
|
|
6" ESMARK
|
Facility
|
IP
|
$17.00
|
|
| Hospital Charge Code |
4471829
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.05 |
| Max. Negotiated Rate |
$11.05 |
| Rate for Payer: Cash Price |
$12.75
|
| Rate for Payer: Galaxy Health Commercial |
$11.05
|
|
|
6" ESMARK
|
Facility
|
OP
|
$17.00
|
|
| Hospital Charge Code |
4471829
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$13.68 |
| Rate for Payer: Aetna of NY Commercial |
$11.90
|
| Rate for Payer: Aetna of NY Medicare |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$6.29
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$8.50
|
| Rate for Payer: Cash Price |
$12.75
|
| Rate for Payer: CDPHP Commercial |
$13.68
|
| Rate for Payer: CDPHP Medicare |
$6.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$13.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$13.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$13.60
|
| Rate for Payer: EmblemHealth Medicaid |
$13.60
|
| Rate for Payer: EmblemHealth Medicare |
$5.78
|
| Rate for Payer: EmblemHealth Select Care |
$12.24
|
| Rate for Payer: Fidelis Medicare |
$6.48
|
| Rate for Payer: Galaxy Health Commercial |
$11.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$6.29
|
| Rate for Payer: Humana Medicare |
$6.29
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$11.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$7.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$12.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$9.57
|
| Rate for Payer: MVP Health Care of NY Medicare |
$6.60
|
| Rate for Payer: United Healthcare Medicare |
$6.29
|
| Rate for Payer: WellCare Medicare |
$9.35
|
|
|
6" SMOOTH CAST PADDING
|
Facility
|
OP
|
$13.00
|
|
| Hospital Charge Code |
4471794
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$10.46 |
| Rate for Payer: Aetna of NY Commercial |
$9.10
|
| Rate for Payer: Aetna of NY Medicare |
$5.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$9.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$9.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.81
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$6.50
|
| Rate for Payer: Cash Price |
$9.75
|
| Rate for Payer: CDPHP Commercial |
$10.46
|
| Rate for Payer: CDPHP Medicare |
$4.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$10.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$10.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$10.40
|
| Rate for Payer: EmblemHealth Medicaid |
$10.40
|
| Rate for Payer: EmblemHealth Medicare |
$4.42
|
| Rate for Payer: EmblemHealth Select Care |
$9.36
|
| Rate for Payer: Fidelis Medicare |
$4.95
|
| Rate for Payer: Galaxy Health Commercial |
$8.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.81
|
| Rate for Payer: Humana Medicare |
$4.81
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$9.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$7.32
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.05
|
| Rate for Payer: United Healthcare Medicare |
$4.81
|
| Rate for Payer: WellCare Medicare |
$7.15
|
|
|
6" SMOOTH CAST PADDING
|
Facility
|
IP
|
$13.00
|
|
| Hospital Charge Code |
4471794
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: Cash Price |
$9.75
|
| Rate for Payer: Galaxy Health Commercial |
$8.45
|
|
|
6" STOCKINETTE DBLE PLY STRL
|
Facility
|
IP
|
$14.00
|
|
| Hospital Charge Code |
4471035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Galaxy Health Commercial |
$9.10
|
|
|
6" STOCKINETTE DBLE PLY STRL
|
Facility
|
OP
|
$14.00
|
|
| Hospital Charge Code |
4471035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.76 |
| Max. Negotiated Rate |
$11.27 |
| Rate for Payer: Aetna of NY Commercial |
$9.80
|
| Rate for Payer: Aetna of NY Medicare |
$6.44
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$10.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$10.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$5.18
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$7.00
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: CDPHP Commercial |
$11.27
|
| Rate for Payer: CDPHP Medicare |
$5.18
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$11.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$11.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$11.20
|
| Rate for Payer: EmblemHealth Medicaid |
$11.20
|
| Rate for Payer: EmblemHealth Medicare |
$4.76
|
| Rate for Payer: EmblemHealth Select Care |
$10.08
|
| Rate for Payer: Fidelis Medicare |
$5.34
|
| Rate for Payer: Galaxy Health Commercial |
$9.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$5.18
|
| Rate for Payer: Humana Medicare |
$5.18
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$9.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$6.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$10.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$7.88
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.44
|
| Rate for Payer: United Healthcare Medicare |
$5.18
|
| Rate for Payer: WellCare Medicare |
$7.70
|
|
|
6"X0.045" K-WIRES
|
Facility
|
IP
|
$22.00
|
|
| Hospital Charge Code |
4471408
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$14.30 |
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Galaxy Health Commercial |
$14.30
|
|
|
6"X0.045" K-WIRES
|
Facility
|
OP
|
$22.00
|
|
| Hospital Charge Code |
4471408
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$17.71 |
| Rate for Payer: Aetna of NY Commercial |
$15.40
|
| Rate for Payer: Aetna of NY Medicare |
$10.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$16.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$16.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.14
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$11.00
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: CDPHP Commercial |
$17.71
|
| Rate for Payer: CDPHP Medicare |
$8.14
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$17.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$17.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$17.60
|
| Rate for Payer: EmblemHealth Medicaid |
$17.60
|
| Rate for Payer: EmblemHealth Medicare |
$7.48
|
| Rate for Payer: EmblemHealth Select Care |
$15.84
|
| Rate for Payer: Fidelis Medicare |
$8.38
|
| Rate for Payer: Galaxy Health Commercial |
$14.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.14
|
| Rate for Payer: Humana Medicare |
$8.14
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$15.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$10.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$16.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$12.39
|
| Rate for Payer: MVP Health Care of NY Medicare |
$8.55
|
| Rate for Payer: United Healthcare Medicare |
$8.14
|
| Rate for Payer: WellCare Medicare |
$12.10
|
|
|
6"X.035 TROCAR 1 END K-WIRE
|
Facility
|
IP
|
$31.00
|
|
| Hospital Charge Code |
4479307
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$21.70 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Multiplan Commercial |
$13.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.035 TROCAR 1 END K-WIRE
|
Facility
|
OP
|
$31.00
|
|
| Hospital Charge Code |
4479307
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Aetna of NY Medicare |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$11.47
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$15.50
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: CDPHP Commercial |
$24.96
|
| Rate for Payer: CDPHP Medicare |
$11.47
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$24.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$24.80
|
| Rate for Payer: EmblemHealth Medicaid |
$24.80
|
| Rate for Payer: EmblemHealth Medicare |
$10.54
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Fidelis Medicare |
$11.81
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$11.47
|
| Rate for Payer: Humana Medicare |
$11.47
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$14.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: MVP Health Care of NY Medicare |
$12.04
|
| Rate for Payer: United Healthcare Medicare |
$11.47
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.035 TROCAR 2 END K-WIRE
|
Facility
|
IP
|
$31.00
|
|
| Hospital Charge Code |
4479306
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$21.70 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Multiplan Commercial |
$13.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.035 TROCAR 2 END K-WIRE
|
Facility
|
OP
|
$31.00
|
|
| Hospital Charge Code |
4479306
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Aetna of NY Medicare |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$11.47
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$15.50
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: CDPHP Commercial |
$24.96
|
| Rate for Payer: CDPHP Medicare |
$11.47
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$24.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$24.80
|
| Rate for Payer: EmblemHealth Medicaid |
$24.80
|
| Rate for Payer: EmblemHealth Medicare |
$10.54
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Fidelis Medicare |
$11.81
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$11.47
|
| Rate for Payer: Humana Medicare |
$11.47
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$14.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: MVP Health Care of NY Medicare |
$12.04
|
| Rate for Payer: United Healthcare Medicare |
$11.47
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.045 TROCAR 1 END K-WIRE
|
Facility
|
OP
|
$31.00
|
|
| Hospital Charge Code |
4479309
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Aetna of NY Medicare |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$11.47
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$15.50
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: CDPHP Commercial |
$24.96
|
| Rate for Payer: CDPHP Medicare |
$11.47
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$24.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$24.80
|
| Rate for Payer: EmblemHealth Medicaid |
$24.80
|
| Rate for Payer: EmblemHealth Medicare |
$10.54
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Fidelis Medicare |
$11.81
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$11.47
|
| Rate for Payer: Humana Medicare |
$11.47
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$14.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: MVP Health Care of NY Medicare |
$12.04
|
| Rate for Payer: United Healthcare Medicare |
$11.47
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.045 TROCAR 1 END K-WIRE
|
Facility
|
IP
|
$31.00
|
|
| Hospital Charge Code |
4479309
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$21.70 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Multiplan Commercial |
$13.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.045 TROCAR 2 END K-WIRE
|
Facility
|
IP
|
$31.00
|
|
| Hospital Charge Code |
4479308
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$21.70 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Multiplan Commercial |
$13.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.045 TROCAR 2 END K-WIRE
|
Facility
|
OP
|
$31.00
|
|
| Hospital Charge Code |
4479308
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Aetna of NY Medicare |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$11.47
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$15.50
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: CDPHP Commercial |
$24.96
|
| Rate for Payer: CDPHP Medicare |
$11.47
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$24.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$24.80
|
| Rate for Payer: EmblemHealth Medicaid |
$24.80
|
| Rate for Payer: EmblemHealth Medicare |
$10.54
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Fidelis Medicare |
$11.81
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$11.47
|
| Rate for Payer: Humana Medicare |
$11.47
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$14.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: MVP Health Care of NY Medicare |
$12.04
|
| Rate for Payer: United Healthcare Medicare |
$11.47
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.062 TROCAR 1 END K-WIRE
|
Facility
|
OP
|
$31.00
|
|
| Hospital Charge Code |
4479311
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Aetna of NY Medicare |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$11.47
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$15.50
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: CDPHP Commercial |
$24.96
|
| Rate for Payer: CDPHP Medicare |
$11.47
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$24.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$24.80
|
| Rate for Payer: EmblemHealth Medicaid |
$24.80
|
| Rate for Payer: EmblemHealth Medicare |
$10.54
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Fidelis Medicare |
$11.81
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$11.47
|
| Rate for Payer: Humana Medicare |
$11.47
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$14.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: MVP Health Care of NY Medicare |
$12.04
|
| Rate for Payer: United Healthcare Medicare |
$11.47
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.062 TROCAR 1 END K-WIRE
|
Facility
|
IP
|
$31.00
|
|
| Hospital Charge Code |
4479311
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$21.70 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Multiplan Commercial |
$13.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
|
6"X.062 TROCAR 2 END K-WIRE
|
Facility
|
IP
|
$31.00
|
|
| Hospital Charge Code |
4479310
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$21.70 |
| Rate for Payer: Aetna of NY Commercial |
$21.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$13.95
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$13.95
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$15.50
|
| Rate for Payer: EmblemHealth Select Care |
$15.50
|
| Rate for Payer: Galaxy Health Commercial |
$20.15
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$21.70
|
| Rate for Payer: Multiplan Commercial |
$13.95
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.15
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$20.15
|
| Rate for Payer: WellCare Medicare |
$17.05
|
|
