SCREW DRILL 3.5 X 12
|
Facility
OP
|
$1,112.50
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904765
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$1,168.12 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$611.88
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$556.25
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$639.69
|
Rate for Payer: Fidelis Medicare Advantage |
$1,168.12
|
Rate for Payer: Group Health Inc Commercial |
$556.25
|
Rate for Payer: Group Health Inc Medicare |
$389.38
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$556.25
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$556.25
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$723.12
|
|
SCREW DRILL-FREE 1.5X4MM CRS
|
Facility
OP
|
$170.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902430
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$59.50 |
Max. Negotiated Rate |
$178.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$93.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$85.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$97.75
|
Rate for Payer: Fidelis Medicare Advantage |
$178.50
|
Rate for Payer: Group Health Inc Commercial |
$85.00
|
Rate for Payer: Group Health Inc Medicare |
$59.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$85.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$85.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$110.50
|
|
SCREW DRILL-FREE 1.5X4MM CRS
|
Facility
IP
|
$170.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902430
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$85.00 |
Max. Negotiated Rate |
$85.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$85.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$85.00
|
|
SCREW DRILL-FREE 1.5X5MM CRS
|
Facility
IP
|
$144.63
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902404
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$72.32 |
Max. Negotiated Rate |
$72.32 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$72.32
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$72.32
|
|
SCREW DRILL-FREE 1.5X5MM CRS
|
Facility
OP
|
$144.63
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902404
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$50.62 |
Max. Negotiated Rate |
$151.86 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$79.55
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$72.32
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$83.16
|
Rate for Payer: Fidelis Medicare Advantage |
$151.86
|
Rate for Payer: Group Health Inc Commercial |
$72.32
|
Rate for Payer: Group Health Inc Medicare |
$50.62
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$72.32
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$72.32
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$94.01
|
|
SCREW DRILL FREE MAXDRV MIN
|
Facility
IP
|
$155.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903073
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.50 |
Max. Negotiated Rate |
$77.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$77.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$77.50
|
|
SCREW DRILL FREE MAXDRV MIN
|
Facility
OP
|
$155.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64903073
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$54.25 |
Max. Negotiated Rate |
$162.75 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$85.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$77.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$89.12
|
Rate for Payer: Fidelis Medicare Advantage |
$162.75
|
Rate for Payer: Group Health Inc Commercial |
$77.50
|
Rate for Payer: Group Health Inc Medicare |
$54.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$77.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$77.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$100.75
|
|
SCREW DRILLING 5.0 X 20
|
Facility
OP
|
$1,305.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904678
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$1,370.25 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$717.75
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$652.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$750.38
|
Rate for Payer: Fidelis Medicare Advantage |
$1,370.25
|
Rate for Payer: Group Health Inc Commercial |
$652.50
|
Rate for Payer: Group Health Inc Medicare |
$456.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$652.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$652.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$848.25
|
|
SCREW DRILLING 5.0 X 20
|
Facility
IP
|
$1,305.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904678
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$652.50 |
Max. Negotiated Rate |
$652.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$652.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$652.50
|
|
SCREW DRIVER BIT
|
Facility
OP
|
$1,395.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904626
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$1,464.75 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$767.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$697.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$802.12
|
Rate for Payer: Fidelis Medicare Advantage |
$1,464.75
|
Rate for Payer: Group Health Inc Commercial |
$697.50
|
Rate for Payer: Group Health Inc Medicare |
$488.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$697.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$697.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$906.75
|
|
SCREW DRIVER BIT
|
Facility
IP
|
$1,395.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904626
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$697.50 |
Max. Negotiated Rate |
$697.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$697.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$697.50
|
|
SCREWDRIVER BLL-TP
|
Facility
OP
|
$575.58
|
|
Hospital Charge Code |
64907358
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$201.45 |
Max. Negotiated Rate |
$460.46 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$316.57
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$287.79
|
Rate for Payer: Aetna Government |
$287.79
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$460.46
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$391.39
|
Rate for Payer: Group Health Inc Commercial |
$287.79
|
Rate for Payer: Group Health Inc Medicare |
$201.45
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$287.79
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$287.79
|
|
SCREWDRIVER CNLTD
|
Facility
OP
|
$1,171.62
|
|
Hospital Charge Code |
64907381
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$410.07 |
Max. Negotiated Rate |
$937.30 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$644.39
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$585.81
|
Rate for Payer: Aetna Government |
$585.81
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$937.30
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$796.70
|
Rate for Payer: Group Health Inc Commercial |
$585.81
|
Rate for Payer: Group Health Inc Medicare |
$410.07
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$585.81
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$585.81
|
|
SCREWDRIVER SURG HEX CNLTD
|
Facility
OP
|
$660.88
|
|
Hospital Charge Code |
64907333
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$231.31 |
Max. Negotiated Rate |
$528.70 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$363.48
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$330.44
|
Rate for Payer: Aetna Government |
$330.44
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$528.70
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$449.40
|
Rate for Payer: Group Health Inc Commercial |
$330.44
|
Rate for Payer: Group Health Inc Medicare |
$231.31
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$330.44
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$330.44
|
|
SCREWDRIVE/TAP HANDLE 1.5/2.0
|
Facility
IP
|
$890.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40201319
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$445.00 |
Max. Negotiated Rate |
$445.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$445.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$445.00
|
|
SCREWDRIVE/TAP HANDLE 1.5/2.0
|
Facility
OP
|
$890.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40201319
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$934.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$489.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$445.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$511.75
|
Rate for Payer: Fidelis Medicare Advantage |
$934.50
|
Rate for Payer: Group Health Inc Commercial |
$445.00
|
Rate for Payer: Group Health Inc Medicare |
$311.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$445.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$445.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$578.50
|
|
SCREW DRL-FRE CRS-DV 2.0X5MM
|
Facility
IP
|
$147.60
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902376
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$73.80 |
Max. Negotiated Rate |
$73.80 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$73.80
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$73.80
|
|
SCREW DRL-FRE CRS-DV 2.0X5MM
|
Facility
OP
|
$147.60
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902376
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.66 |
Max. Negotiated Rate |
$154.98 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$81.18
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$73.80
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$84.87
|
Rate for Payer: Fidelis Medicare Advantage |
$154.98
|
Rate for Payer: Group Health Inc Commercial |
$73.80
|
Rate for Payer: Group Health Inc Medicare |
$51.66
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$73.80
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$73.80
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$95.94
|
|
SCREW DRL-FRE CRS-DV 2.0X7MM
|
Facility
IP
|
$155.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902378
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$77.50 |
Max. Negotiated Rate |
$77.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$77.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$77.50
|
|
SCREW DRL-FRE CRS-DV 2.0X7MM
|
Facility
OP
|
$155.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64902378
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$54.25 |
Max. Negotiated Rate |
$162.75 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$85.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$77.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$89.12
|
Rate for Payer: Fidelis Medicare Advantage |
$162.75
|
Rate for Payer: Group Health Inc Commercial |
$77.50
|
Rate for Payer: Group Health Inc Medicare |
$54.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$77.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$77.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$100.75
|
|
SCREW DS RESORB 1.7 X 4MM
|
Facility
OP
|
$1,812.60
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64906927
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$1,903.23 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$996.93
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$906.30
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,042.24
|
Rate for Payer: Fidelis Medicare Advantage |
$1,903.23
|
Rate for Payer: Group Health Inc Commercial |
$906.30
|
Rate for Payer: Group Health Inc Medicare |
$634.41
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$906.30
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$906.30
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,178.19
|
|
SCREW DS RESORB 1.7 X 4MM
|
Facility
IP
|
$1,812.60
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64906927
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$906.30 |
Max. Negotiated Rate |
$906.30 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$906.30
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$906.30
|
|
SCREW ELBOW NON L 3.5 44
|
Facility
IP
|
$340.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904571
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$170.00 |
Max. Negotiated Rate |
$170.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$170.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$170.00
|
|
SCREW ELBOW NON L 3.5 44
|
Facility
OP
|
$340.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64904571
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$119.00 |
Max. Negotiated Rate |
$357.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$187.00
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
Rate for Payer: Aetna Government |
$134.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$170.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$195.50
|
Rate for Payer: Fidelis Medicare Advantage |
$357.00
|
Rate for Payer: Group Health Inc Commercial |
$170.00
|
Rate for Payer: Group Health Inc Medicare |
$119.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$170.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$170.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$221.00
|
|
SCREW, EMERGENCY 5MM
|
Facility
IP
|
$171.43
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
64905714
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$85.72 |
Max. Negotiated Rate |
$85.72 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$85.72
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$85.72
|
|