|
3.5MM COMPRESSION PLATE, 2-8 HOLES
|
Facility
|
OP
|
$494.40
|
|
| Hospital Charge Code |
4472223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.16 |
| Max. Negotiated Rate |
$395.52 |
| Rate for Payer: Aetna of NY Commercial |
$346.08
|
| Rate for Payer: Aetna of NY Medicare |
$227.42
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$197.76
|
| Rate for Payer: Cash Price |
$370.80
|
| Rate for Payer: CDPHP Medicare |
$182.93
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$247.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$395.52
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$395.52
|
| Rate for Payer: EmblemHealth Medicaid |
$395.52
|
| Rate for Payer: EmblemHealth Medicare |
$168.10
|
| Rate for Payer: EmblemHealth Select Care |
$247.20
|
| Rate for Payer: Fidelis Medicare |
$197.76
|
| Rate for Payer: Galaxy Health Commercial |
$321.36
|
| Rate for Payer: Hamaspik Choice Medicare |
$197.76
|
| Rate for Payer: Humana Medicare |
$197.76
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$346.08
|
| Rate for Payer: Local 1199SEIU Medicare |
$227.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$321.36
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$321.36
|
| Rate for Payer: MVP Health Care of NY Medicare |
$207.65
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$74.16
|
| Rate for Payer: United Healthcare Medicare |
$197.76
|
| Rate for Payer: WellCare Medicare |
$271.92
|
|
|
3.5MM COMPRESSION PLATE, 9-12 HOLES
|
Facility
|
OP
|
$563.41
|
|
| Hospital Charge Code |
4472224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.51 |
| Max. Negotiated Rate |
$450.73 |
| Rate for Payer: Aetna of NY Commercial |
$394.39
|
| Rate for Payer: Aetna of NY Medicare |
$259.17
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$225.36
|
| Rate for Payer: Cash Price |
$422.56
|
| Rate for Payer: CDPHP Medicare |
$208.46
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$281.70
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$450.73
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$450.73
|
| Rate for Payer: EmblemHealth Medicaid |
$450.73
|
| Rate for Payer: EmblemHealth Medicare |
$191.56
|
| Rate for Payer: EmblemHealth Select Care |
$281.70
|
| Rate for Payer: Fidelis Medicare |
$225.36
|
| Rate for Payer: Galaxy Health Commercial |
$366.22
|
| Rate for Payer: Hamaspik Choice Medicare |
$225.36
|
| Rate for Payer: Humana Medicare |
$225.36
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$394.39
|
| Rate for Payer: Local 1199SEIU Medicare |
$259.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$366.22
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$366.22
|
| Rate for Payer: MVP Health Care of NY Medicare |
$236.63
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$84.51
|
| Rate for Payer: United Healthcare Medicare |
$225.36
|
| Rate for Payer: WellCare Medicare |
$309.88
|
|
|
3.5MM COMPRESSION PLATE, 9-12 HOLES
|
Facility
|
IP
|
$563.41
|
|
| Hospital Charge Code |
4472224
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$253.53 |
| Max. Negotiated Rate |
$394.39 |
| Rate for Payer: Aetna of NY Commercial |
$394.39
|
| Rate for Payer: Cash Price |
$422.56
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$281.70
|
| Rate for Payer: EmblemHealth Select Care |
$281.70
|
| Rate for Payer: Galaxy Health Commercial |
$366.22
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$394.39
|
| Rate for Payer: Multiplan Commercial |
$253.53
|
| Rate for Payer: MVP Health Care of NY Commercial |
$366.22
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$366.22
|
| Rate for Payer: WellCare Medicare |
$309.88
|
|
|
3.5MM CORTICAL SCREW,SF-TAP SMALL HEX RE
|
Facility
|
OP
|
$100.94
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4472220
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.14 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Aetna of NY Commercial |
$70.66
|
| Rate for Payer: Aetna of NY Medicare |
$46.43
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$40.38
|
| Rate for Payer: Cash Price |
$75.70
|
| Rate for Payer: CDPHP Medicare |
$37.35
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$50.47
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$80.75
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$80.75
|
| Rate for Payer: EmblemHealth Medicaid |
$80.75
|
| Rate for Payer: EmblemHealth Medicare |
$34.32
|
| Rate for Payer: EmblemHealth Select Care |
$50.47
|
| Rate for Payer: Fidelis Medicare |
$40.38
|
| Rate for Payer: Galaxy Health Commercial |
$65.61
|
| Rate for Payer: Hamaspik Choice Medicare |
$40.38
|
| Rate for Payer: Humana Medicare |
$40.38
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$70.66
|
| Rate for Payer: Local 1199SEIU Medicare |
$46.43
|
| Rate for Payer: MVP Health Care of NY Commercial |
$65.61
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$65.61
|
| Rate for Payer: MVP Health Care of NY Medicare |
$42.39
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$15.14
|
| Rate for Payer: United Healthcare Medicare |
$40.38
|
| Rate for Payer: WellCare Medicare |
$55.52
|
|
|
3.5MM CORTICAL SCREW,SF-TAP SMALL HEX RE
|
Facility
|
IP
|
$100.94
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4472220
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.42 |
| Max. Negotiated Rate |
$70.66 |
| Rate for Payer: Aetna of NY Commercial |
$70.66
|
| Rate for Payer: Cash Price |
$75.70
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$50.47
|
| Rate for Payer: EmblemHealth Select Care |
$50.47
|
| Rate for Payer: Galaxy Health Commercial |
$65.61
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$70.66
|
| Rate for Payer: Multiplan Commercial |
$45.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$65.61
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$65.61
|
| Rate for Payer: WellCare Medicare |
$55.52
|
|
|
3.5MM CORTICAL SCREW, SLF TAPPING SM HEX
|
Facility
|
IP
|
$108.15
|
|
| Hospital Charge Code |
4479264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.30 |
| Max. Negotiated Rate |
$70.30 |
| Rate for Payer: Cash Price |
$81.11
|
| Rate for Payer: Galaxy Health Commercial |
$70.30
|
|
|
3.5MM CORTICAL SCREW, SLF TAPPING SM HEX
|
Facility
|
OP
|
$108.15
|
|
| Hospital Charge Code |
4479264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.22 |
| Max. Negotiated Rate |
$86.52 |
| Rate for Payer: Aetna of NY Commercial |
$75.70
|
| Rate for Payer: Aetna of NY Medicare |
$49.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$43.26
|
| Rate for Payer: Cash Price |
$81.11
|
| Rate for Payer: CDPHP Medicare |
$40.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$86.52
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$86.52
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$86.52
|
| Rate for Payer: EmblemHealth Medicaid |
$86.52
|
| Rate for Payer: EmblemHealth Medicare |
$36.77
|
| Rate for Payer: EmblemHealth Select Care |
$77.87
|
| Rate for Payer: Fidelis Medicare |
$43.26
|
| Rate for Payer: Galaxy Health Commercial |
$70.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$43.26
|
| Rate for Payer: Humana Medicare |
$43.26
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$75.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$49.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$81.11
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$60.89
|
| Rate for Payer: MVP Health Care of NY Medicare |
$45.42
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$16.22
|
| Rate for Payer: United Healthcare Medicare |
$43.26
|
| Rate for Payer: WellCare Medicare |
$59.48
|
|
|
3.5MM CORTICAL SHAFT SCREW, NON SF-TAP
|
Facility
|
OP
|
$88.58
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4472221
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$70.86 |
| Rate for Payer: Aetna of NY Commercial |
$62.01
|
| Rate for Payer: Aetna of NY Medicare |
$40.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$35.43
|
| Rate for Payer: Cash Price |
$66.44
|
| Rate for Payer: CDPHP Medicare |
$32.77
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$44.29
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$70.86
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$70.86
|
| Rate for Payer: EmblemHealth Medicaid |
$70.86
|
| Rate for Payer: EmblemHealth Medicare |
$30.12
|
| Rate for Payer: EmblemHealth Select Care |
$44.29
|
| Rate for Payer: Fidelis Medicare |
$35.43
|
| Rate for Payer: Galaxy Health Commercial |
$57.58
|
| Rate for Payer: Hamaspik Choice Medicare |
$35.43
|
| Rate for Payer: Humana Medicare |
$35.43
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$62.01
|
| Rate for Payer: Local 1199SEIU Medicare |
$40.75
|
| Rate for Payer: MVP Health Care of NY Commercial |
$57.58
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$57.58
|
| Rate for Payer: MVP Health Care of NY Medicare |
$37.20
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$13.29
|
| Rate for Payer: United Healthcare Medicare |
$35.43
|
| Rate for Payer: WellCare Medicare |
$48.72
|
|
|
3.5MM CORTICAL SHAFT SCREW, NON SF-TAP
|
Facility
|
IP
|
$88.58
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
4472221
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.86 |
| Max. Negotiated Rate |
$62.01 |
| Rate for Payer: Aetna of NY Commercial |
$62.01
|
| Rate for Payer: Cash Price |
$66.44
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$44.29
|
| Rate for Payer: EmblemHealth Select Care |
$44.29
|
| Rate for Payer: Galaxy Health Commercial |
$57.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$62.01
|
| Rate for Payer: Multiplan Commercial |
$39.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$57.58
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$57.58
|
| Rate for Payer: WellCare Medicare |
$48.72
|
|
|
3.5MM RECON PLATE, STRAIGHT, 3-7 HOLES
|
Facility
|
IP
|
$1,114.46
|
|
| Hospital Charge Code |
4472233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$501.51 |
| Max. Negotiated Rate |
$780.12 |
| Rate for Payer: Aetna of NY Commercial |
$780.12
|
| Rate for Payer: Cash Price |
$835.84
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$557.23
|
| Rate for Payer: EmblemHealth Select Care |
$557.23
|
| Rate for Payer: Galaxy Health Commercial |
$724.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$780.12
|
| Rate for Payer: Multiplan Commercial |
$501.51
|
| Rate for Payer: MVP Health Care of NY Commercial |
$724.40
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$724.40
|
| Rate for Payer: WellCare Medicare |
$612.95
|
|
|
3.5MM RECON PLATE, STRAIGHT, 3-7 HOLES
|
Facility
|
OP
|
$1,114.46
|
|
| Hospital Charge Code |
4472233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.17 |
| Max. Negotiated Rate |
$891.57 |
| Rate for Payer: Aetna of NY Commercial |
$780.12
|
| Rate for Payer: Aetna of NY Medicare |
$512.65
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$445.78
|
| Rate for Payer: Cash Price |
$835.84
|
| Rate for Payer: CDPHP Medicare |
$412.35
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$557.23
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$891.57
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$891.57
|
| Rate for Payer: EmblemHealth Medicaid |
$891.57
|
| Rate for Payer: EmblemHealth Medicare |
$378.92
|
| Rate for Payer: EmblemHealth Select Care |
$557.23
|
| Rate for Payer: Fidelis Medicare |
$445.78
|
| Rate for Payer: Galaxy Health Commercial |
$724.40
|
| Rate for Payer: Hamaspik Choice Medicare |
$445.78
|
| Rate for Payer: Humana Medicare |
$445.78
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$780.12
|
| Rate for Payer: Local 1199SEIU Medicare |
$512.65
|
| Rate for Payer: MVP Health Care of NY Commercial |
$724.40
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$724.40
|
| Rate for Payer: MVP Health Care of NY Medicare |
$468.07
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$167.17
|
| Rate for Payer: United Healthcare Medicare |
$445.78
|
| Rate for Payer: WellCare Medicare |
$612.95
|
|
|
3.5MM RECON PLATE, STRAIGHT 7> HOLES
|
Facility
|
OP
|
$1,447.15
|
|
| Hospital Charge Code |
4472234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$217.07 |
| Max. Negotiated Rate |
$1,157.72 |
| Rate for Payer: Aetna of NY Commercial |
$1,013.00
|
| Rate for Payer: Aetna of NY Medicare |
$665.69
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$578.86
|
| Rate for Payer: Cash Price |
$1,085.36
|
| Rate for Payer: CDPHP Medicare |
$535.45
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$723.58
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,157.72
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,157.72
|
| Rate for Payer: EmblemHealth Medicaid |
$1,157.72
|
| Rate for Payer: EmblemHealth Medicare |
$492.03
|
| Rate for Payer: EmblemHealth Select Care |
$723.58
|
| Rate for Payer: Fidelis Medicare |
$578.86
|
| Rate for Payer: Galaxy Health Commercial |
$940.65
|
| Rate for Payer: Hamaspik Choice Medicare |
$578.86
|
| Rate for Payer: Humana Medicare |
$578.86
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,013.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$665.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$940.65
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$940.65
|
| Rate for Payer: MVP Health Care of NY Medicare |
$607.80
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$217.07
|
| Rate for Payer: United Healthcare Medicare |
$578.86
|
| Rate for Payer: WellCare Medicare |
$795.93
|
|
|
3.5MM RECON PLATE, STRAIGHT 7> HOLES
|
Facility
|
IP
|
$1,447.15
|
|
| Hospital Charge Code |
4472234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$651.22 |
| Max. Negotiated Rate |
$1,013.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,013.00
|
| Rate for Payer: Cash Price |
$1,085.36
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$723.58
|
| Rate for Payer: EmblemHealth Select Care |
$723.58
|
| Rate for Payer: Galaxy Health Commercial |
$940.65
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,013.00
|
| Rate for Payer: Multiplan Commercial |
$651.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$940.65
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$940.65
|
| Rate for Payer: WellCare Medicare |
$795.93
|
|
|
3.5MM SURFAS SUCT#1246
|
Facility
|
IP
|
$175.10
|
|
| Hospital Charge Code |
4479280
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$113.81 |
| Max. Negotiated Rate |
$113.81 |
| Rate for Payer: Cash Price |
$131.32
|
| Rate for Payer: Galaxy Health Commercial |
$113.81
|
|
|
3.5MM SURFAS SUCT#1246
|
Facility
|
OP
|
$175.10
|
|
| Hospital Charge Code |
4479280
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.27 |
| Max. Negotiated Rate |
$140.08 |
| Rate for Payer: Aetna of NY Commercial |
$122.57
|
| Rate for Payer: Aetna of NY Medicare |
$80.55
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$70.04
|
| Rate for Payer: Cash Price |
$131.32
|
| Rate for Payer: CDPHP Medicare |
$64.79
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$140.08
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$140.08
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$140.08
|
| Rate for Payer: EmblemHealth Medicaid |
$140.08
|
| Rate for Payer: EmblemHealth Medicare |
$59.53
|
| Rate for Payer: EmblemHealth Select Care |
$126.07
|
| Rate for Payer: Fidelis Medicare |
$70.04
|
| Rate for Payer: Galaxy Health Commercial |
$113.81
|
| Rate for Payer: Hamaspik Choice Medicare |
$70.04
|
| Rate for Payer: Humana Medicare |
$70.04
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$122.57
|
| Rate for Payer: Local 1199SEIU Medicare |
$80.55
|
| Rate for Payer: MVP Health Care of NY Commercial |
$131.32
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$98.58
|
| Rate for Payer: MVP Health Care of NY Medicare |
$73.54
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$26.27
|
| Rate for Payer: United Healthcare Medicare |
$70.04
|
| Rate for Payer: WellCare Medicare |
$96.31
|
|
|
3.5MM T-PLATE, 3-5 HOLE SHAFT
|
Facility
|
IP
|
$481.01
|
|
| Hospital Charge Code |
4472227
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$336.71 |
| Rate for Payer: Aetna of NY Commercial |
$336.71
|
| Rate for Payer: Cash Price |
$360.76
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$240.50
|
| Rate for Payer: EmblemHealth Select Care |
$240.50
|
| Rate for Payer: Galaxy Health Commercial |
$312.66
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$336.71
|
| Rate for Payer: Multiplan Commercial |
$216.45
|
| Rate for Payer: MVP Health Care of NY Commercial |
$312.66
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$312.66
|
| Rate for Payer: WellCare Medicare |
$264.56
|
|
|
3.5MM T-PLATE, 3-5 HOLE SHAFT
|
Facility
|
OP
|
$481.01
|
|
| Hospital Charge Code |
4472227
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.15 |
| Max. Negotiated Rate |
$384.81 |
| Rate for Payer: Aetna of NY Commercial |
$336.71
|
| Rate for Payer: Aetna of NY Medicare |
$221.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$192.40
|
| Rate for Payer: Cash Price |
$360.76
|
| Rate for Payer: CDPHP Medicare |
$177.97
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$240.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$384.81
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$384.81
|
| Rate for Payer: EmblemHealth Medicaid |
$384.81
|
| Rate for Payer: EmblemHealth Medicare |
$163.54
|
| Rate for Payer: EmblemHealth Select Care |
$240.50
|
| Rate for Payer: Fidelis Medicare |
$192.40
|
| Rate for Payer: Galaxy Health Commercial |
$312.66
|
| Rate for Payer: Hamaspik Choice Medicare |
$192.40
|
| Rate for Payer: Humana Medicare |
$192.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$336.71
|
| Rate for Payer: Local 1199SEIU Medicare |
$221.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$312.66
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$312.66
|
| Rate for Payer: MVP Health Care of NY Medicare |
$202.02
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$72.15
|
| Rate for Payer: United Healthcare Medicare |
$192.40
|
| Rate for Payer: WellCare Medicare |
$264.56
|
|
|
3.5MM T-PLATE, 5> HOLE SHAFT
|
Facility
|
OP
|
$681.86
|
|
| Hospital Charge Code |
4472228
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$102.28 |
| Max. Negotiated Rate |
$545.49 |
| Rate for Payer: Aetna of NY Commercial |
$477.30
|
| Rate for Payer: Aetna of NY Medicare |
$313.66
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$272.74
|
| Rate for Payer: Cash Price |
$511.40
|
| Rate for Payer: CDPHP Medicare |
$252.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$340.93
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$545.49
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$545.49
|
| Rate for Payer: EmblemHealth Medicaid |
$545.49
|
| Rate for Payer: EmblemHealth Medicare |
$231.83
|
| Rate for Payer: EmblemHealth Select Care |
$340.93
|
| Rate for Payer: Fidelis Medicare |
$272.74
|
| Rate for Payer: Galaxy Health Commercial |
$443.21
|
| Rate for Payer: Hamaspik Choice Medicare |
$272.74
|
| Rate for Payer: Humana Medicare |
$272.74
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$477.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$313.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$443.21
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$443.21
|
| Rate for Payer: MVP Health Care of NY Medicare |
$286.38
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$102.28
|
| Rate for Payer: United Healthcare Medicare |
$272.74
|
| Rate for Payer: WellCare Medicare |
$375.02
|
|
|
3.5MM T-PLATE, 5> HOLE SHAFT
|
Facility
|
IP
|
$681.86
|
|
| Hospital Charge Code |
4472228
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$306.84 |
| Max. Negotiated Rate |
$477.30 |
| Rate for Payer: Aetna of NY Commercial |
$477.30
|
| Rate for Payer: Cash Price |
$511.40
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$340.93
|
| Rate for Payer: EmblemHealth Select Care |
$340.93
|
| Rate for Payer: Galaxy Health Commercial |
$443.21
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$477.30
|
| Rate for Payer: Multiplan Commercial |
$306.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$443.21
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$443.21
|
| Rate for Payer: WellCare Medicare |
$375.02
|
|
|
3.5MM T-PLATE OBLIQUE
|
Facility
|
OP
|
$715.85
|
|
| Hospital Charge Code |
4472229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.38 |
| Max. Negotiated Rate |
$572.68 |
| Rate for Payer: Aetna of NY Commercial |
$501.10
|
| Rate for Payer: Aetna of NY Medicare |
$329.29
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$286.34
|
| Rate for Payer: Cash Price |
$536.89
|
| Rate for Payer: CDPHP Medicare |
$264.86
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$357.93
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$572.68
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$572.68
|
| Rate for Payer: EmblemHealth Medicaid |
$572.68
|
| Rate for Payer: EmblemHealth Medicare |
$243.39
|
| Rate for Payer: EmblemHealth Select Care |
$357.93
|
| Rate for Payer: Fidelis Medicare |
$286.34
|
| Rate for Payer: Galaxy Health Commercial |
$465.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$286.34
|
| Rate for Payer: Humana Medicare |
$286.34
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$501.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$329.29
|
| Rate for Payer: MVP Health Care of NY Commercial |
$465.30
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$465.30
|
| Rate for Payer: MVP Health Care of NY Medicare |
$300.66
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$107.38
|
| Rate for Payer: United Healthcare Medicare |
$286.34
|
| Rate for Payer: WellCare Medicare |
$393.72
|
|
|
3.5MM T-PLATE OBLIQUE
|
Facility
|
IP
|
$715.85
|
|
| Hospital Charge Code |
4472229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$322.13 |
| Max. Negotiated Rate |
$501.10 |
| Rate for Payer: Aetna of NY Commercial |
$501.10
|
| Rate for Payer: Cash Price |
$536.89
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$357.93
|
| Rate for Payer: EmblemHealth Select Care |
$357.93
|
| Rate for Payer: Galaxy Health Commercial |
$465.30
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$501.10
|
| Rate for Payer: Multiplan Commercial |
$322.13
|
| Rate for Payer: MVP Health Care of NY Commercial |
$465.30
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$465.30
|
| Rate for Payer: WellCare Medicare |
$393.72
|
|
|
3.5" X 22" CERVICAL COLLAR
|
Facility
|
OP
|
$10.30
|
|
| Hospital Charge Code |
4471184
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$8.24 |
| Rate for Payer: Aetna of NY Commercial |
$7.21
|
| Rate for Payer: Aetna of NY Medicare |
$4.74
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.12
|
| Rate for Payer: Cash Price |
$7.72
|
| Rate for Payer: CDPHP Medicare |
$3.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.24
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.24
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$8.24
|
| Rate for Payer: EmblemHealth Medicaid |
$8.24
|
| Rate for Payer: EmblemHealth Medicare |
$3.50
|
| Rate for Payer: EmblemHealth Select Care |
$7.42
|
| Rate for Payer: Fidelis Medicare |
$4.12
|
| Rate for Payer: Galaxy Health Commercial |
$6.70
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.12
|
| Rate for Payer: Humana Medicare |
$4.12
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.21
|
| Rate for Payer: Local 1199SEIU Medicare |
$4.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7.72
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$4.33
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.54
|
| Rate for Payer: United Healthcare Medicare |
$4.12
|
| Rate for Payer: WellCare Medicare |
$5.67
|
|
|
3.5" X 22" CERVICAL COLLAR
|
Facility
|
IP
|
$10.30
|
|
| Hospital Charge Code |
4471184
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Cash Price |
$7.72
|
| Rate for Payer: Galaxy Health Commercial |
$6.70
|
|
|
3" CAST PADDING
|
Facility
|
IP
|
$24.72
|
|
| Hospital Charge Code |
4471956
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$16.07 |
| Rate for Payer: Cash Price |
$18.54
|
| Rate for Payer: Galaxy Health Commercial |
$16.07
|
|
|
3" CAST PADDING
|
Facility
|
OP
|
$24.72
|
|
| Hospital Charge Code |
4471956
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$19.78 |
| Rate for Payer: Aetna of NY Commercial |
$17.30
|
| Rate for Payer: Aetna of NY Medicare |
$11.37
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$9.89
|
| Rate for Payer: Cash Price |
$18.54
|
| Rate for Payer: CDPHP Medicare |
$9.15
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$19.78
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$19.78
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$19.78
|
| Rate for Payer: EmblemHealth Medicaid |
$19.78
|
| Rate for Payer: EmblemHealth Medicare |
$8.40
|
| Rate for Payer: EmblemHealth Select Care |
$17.80
|
| Rate for Payer: Fidelis Medicare |
$9.89
|
| Rate for Payer: Galaxy Health Commercial |
$16.07
|
| Rate for Payer: Hamaspik Choice Medicare |
$9.89
|
| Rate for Payer: Humana Medicare |
$9.89
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$17.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$11.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$18.54
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$13.92
|
| Rate for Payer: MVP Health Care of NY Medicare |
$10.38
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3.71
|
| Rate for Payer: United Healthcare Medicare |
$9.89
|
| Rate for Payer: WellCare Medicare |
$13.60
|
|
