NCB CORT SCREW 4.0X34MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007129
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X36MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007130
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X36MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007130
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X38MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007131
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X38MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007131
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X40MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007132
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X40MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007132
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X42MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007133
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X42MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007133
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X44MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007134
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X44MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007134
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X46MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007135
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X46MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007135
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X48MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007136
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X48MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007136
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X50MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007137
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X50MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007137
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X55 SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007138
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X55 SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007138
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X60MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007139
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X60MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007139
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X65MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007140
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|
NCB CORT SCREW 4.0X65MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007140
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X70MM SELF-TAP
|
Facility
|
OP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007141
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.87 |
Max. Negotiated Rate |
$233.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.36
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Brighton Health Commercial |
$133.49
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$111.24
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$127.93
|
Rate for Payer: EmblemHealth Commercial |
$111.24
|
Rate for Payer: Fidelis Medicare Advantage |
$233.60
|
Rate for Payer: Group Health Inc Commercial |
$111.24
|
Rate for Payer: Group Health Inc Medicare |
$77.87
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.61
|
|
NCB CORT SCREW 4.0X70MM SELF-TAP
|
Facility
|
IP
|
$222.48
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40007141
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$111.24 |
Max. Negotiated Rate |
$111.24 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.24
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$111.24
|
|