NAIL INTR 1.5MM DIA 300MML T
|
Facility
|
IP
|
$524.88
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903823
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$262.44 |
Max. Negotiated Rate |
$262.44 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$262.44
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$262.44
|
|
NAIL INTR 2.5MM DIA 450MML T
|
Facility
|
OP
|
$615.88
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902567
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$646.67 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$338.73
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$369.53
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$307.94
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$354.13
|
Rate for Payer: EmblemHealth Commercial |
$307.94
|
Rate for Payer: Fidelis Medicare Advantage |
$646.67
|
Rate for Payer: Group Health Inc Commercial |
$307.94
|
Rate for Payer: Group Health Inc Medicare |
$215.56
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$307.94
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$307.94
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$400.32
|
|
NAIL INTR 2.5MM DIA 450MML T
|
Facility
|
IP
|
$615.88
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902567
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$307.94 |
Max. Negotiated Rate |
$307.94 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$307.94
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$307.94
|
|
NAIL INTR 2MM DIA 300MML STA
|
Facility
|
IP
|
$560.63
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903902
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$280.32 |
Max. Negotiated Rate |
$280.32 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$280.32
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$280.32
|
|
NAIL INTR 2MM DIA 300MML STA
|
Facility
|
OP
|
$560.63
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903902
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$588.66 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$308.35
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$336.38
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$280.32
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$322.36
|
Rate for Payer: EmblemHealth Commercial |
$280.32
|
Rate for Payer: Fidelis Medicare Advantage |
$588.66
|
Rate for Payer: Group Health Inc Commercial |
$280.32
|
Rate for Payer: Group Health Inc Medicare |
$196.22
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$280.32
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$280.32
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$364.41
|
|
NAIL INTR 2MM DIA 300MML TTN
|
Facility
|
IP
|
$560.63
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903825
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$280.32 |
Max. Negotiated Rate |
$280.32 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$280.32
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$280.32
|
|
NAIL INTR 2MM DIA 300MML TTN
|
Facility
|
OP
|
$560.63
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903825
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$588.66 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$308.35
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$336.38
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$280.32
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$322.36
|
Rate for Payer: EmblemHealth Commercial |
$280.32
|
Rate for Payer: Fidelis Medicare Advantage |
$588.66
|
Rate for Payer: Group Health Inc Commercial |
$280.32
|
Rate for Payer: Group Health Inc Medicare |
$196.22
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$280.32
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$280.32
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$364.41
|
|
NAIL INTR 3MM DIA 450MML TTN
|
Facility
|
OP
|
$633.75
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902569
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$665.44 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$348.56
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$380.25
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$316.88
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$364.41
|
Rate for Payer: EmblemHealth Commercial |
$316.88
|
Rate for Payer: Fidelis Medicare Advantage |
$665.44
|
Rate for Payer: Group Health Inc Commercial |
$316.88
|
Rate for Payer: Group Health Inc Medicare |
$221.81
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$316.88
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$316.88
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$411.94
|
|
NAIL INTR 3MM DIA 450MML TTN
|
Facility
|
IP
|
$633.75
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902569
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$316.88 |
Max. Negotiated Rate |
$316.88 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$316.88
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$316.88
|
|
NAIL INTR 4MM DIA 450MML TTN
|
Facility
|
OP
|
$671.13
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903900
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$704.69 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$369.12
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$402.68
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$335.56
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$385.90
|
Rate for Payer: EmblemHealth Commercial |
$335.56
|
Rate for Payer: Fidelis Medicare Advantage |
$704.69
|
Rate for Payer: Group Health Inc Commercial |
$335.56
|
Rate for Payer: Group Health Inc Medicare |
$234.90
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$335.56
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$335.56
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$436.23
|
|
NAIL INTR 4MM DIA 450MML TTN
|
Facility
|
IP
|
$671.13
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903900
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$335.56 |
Max. Negotiated Rate |
$335.56 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$335.56
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$335.56
|
|
NAIL INTR 8MM DIA LONG 150M
|
Facility
|
OP
|
$8,485.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904943
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$8,909.25 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,666.75
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$5,091.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,242.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,878.88
|
Rate for Payer: EmblemHealth Commercial |
$4,242.50
|
Rate for Payer: Fidelis Medicare Advantage |
$8,909.25
|
Rate for Payer: Group Health Inc Commercial |
$4,242.50
|
Rate for Payer: Group Health Inc Medicare |
$2,969.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,242.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$4,242.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5,515.25
|
|
NAIL INTR 8MM DIA LONG 150M
|
Facility
|
IP
|
$8,485.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904943
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$4,242.50 |
Max. Negotiated Rate |
$4,242.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,242.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$4,242.50
|
|
NAIL INTR 8MM DIA LONG 220M
|
Facility
|
OP
|
$4,249.38
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903064
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$4,461.85 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,337.16
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$2,549.63
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,124.69
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,443.39
|
Rate for Payer: EmblemHealth Commercial |
$2,124.69
|
Rate for Payer: Fidelis Medicare Advantage |
$4,461.85
|
Rate for Payer: Group Health Inc Commercial |
$2,124.69
|
Rate for Payer: Group Health Inc Medicare |
$1,487.28
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,124.69
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,124.69
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,762.10
|
|
NAIL INTR 8MM DIA LONG 220M
|
Facility
|
IP
|
$4,249.38
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903064
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,124.69 |
Max. Negotiated Rate |
$2,124.69 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,124.69
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,124.69
|
|
NAIL INTRA 2.5 X 800 BALL
|
Facility
|
OP
|
$4,249.38
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903899
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$4,461.85 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,337.16
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$2,549.63
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,124.69
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,443.39
|
Rate for Payer: EmblemHealth Commercial |
$2,124.69
|
Rate for Payer: Fidelis Medicare Advantage |
$4,461.85
|
Rate for Payer: Group Health Inc Commercial |
$2,124.69
|
Rate for Payer: Group Health Inc Medicare |
$1,487.28
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,124.69
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,124.69
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,762.10
|
|
NAIL INTRA 2.5 X 800 BALL
|
Facility
|
IP
|
$4,249.38
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903899
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,124.69 |
Max. Negotiated Rate |
$2,124.69 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,124.69
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,124.69
|
|
NAIL INTRA CANN LCKING 9,340
|
Facility
|
OP
|
$4,682.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64905100
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$4,916.62 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,575.38
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$2,809.50
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,341.25
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,692.44
|
Rate for Payer: EmblemHealth Commercial |
$2,341.25
|
Rate for Payer: Fidelis Medicare Advantage |
$4,916.62
|
Rate for Payer: Group Health Inc Commercial |
$2,341.25
|
Rate for Payer: Group Health Inc Medicare |
$1,638.88
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,341.25
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,341.25
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,043.62
|
|
NAIL INTRA CANN LCKING 9,340
|
Facility
|
IP
|
$4,682.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64905100
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,341.25 |
Max. Negotiated Rate |
$2,341.25 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,341.25
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,341.25
|
|
NAIL INTRA LCKING CANNUL 315
|
Facility
|
IP
|
$3,732.75
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902859
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,866.38 |
Max. Negotiated Rate |
$1,866.38 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,866.38
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,866.38
|
|
NAIL INTRA LCKING CANNUL 315
|
Facility
|
OP
|
$3,732.75
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902859
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$3,919.39 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,053.01
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$2,239.65
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,866.38
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,146.33
|
Rate for Payer: EmblemHealth Commercial |
$1,866.38
|
Rate for Payer: Fidelis Medicare Advantage |
$3,919.39
|
Rate for Payer: Group Health Inc Commercial |
$1,866.38
|
Rate for Payer: Group Health Inc Medicare |
$1,306.46
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,866.38
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,866.38
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,426.29
|
|
NAIL INTRA LK 10 X 300
|
Facility
|
OP
|
$5,442.13
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64905257
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$5,714.24 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,993.17
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$3,265.28
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,721.06
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$3,129.22
|
Rate for Payer: EmblemHealth Commercial |
$2,721.06
|
Rate for Payer: Fidelis Medicare Advantage |
$5,714.24
|
Rate for Payer: Group Health Inc Commercial |
$2,721.06
|
Rate for Payer: Group Health Inc Medicare |
$1,904.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,721.06
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,721.06
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,537.38
|
|
NAIL INTRA LK 10 X 300
|
Facility
|
IP
|
$5,442.13
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64905257
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,721.06 |
Max. Negotiated Rate |
$2,721.06 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,721.06
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,721.06
|
|
NAIL INTRA LOCKING 11MM 1.5
|
Facility
|
IP
|
$4,754.75
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64905098
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,377.38 |
Max. Negotiated Rate |
$2,377.38 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,377.38
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,377.38
|
|
NAIL INTRA LOCKING 11MM 1.5
|
Facility
|
OP
|
$4,754.75
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64905098
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$4,992.49 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,615.11
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$2,852.85
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,377.38
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,733.98
|
Rate for Payer: EmblemHealth Commercial |
$2,377.38
|
Rate for Payer: Fidelis Medicare Advantage |
$4,992.49
|
Rate for Payer: Group Health Inc Commercial |
$2,377.38
|
Rate for Payer: Group Health Inc Medicare |
$1,664.16
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,377.38
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$2,377.38
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,090.59
|
|