STRYKER CROSSLINK 35-44MM
|
Facility
OP
|
$3,996.58
|
|
Service Code
|
HCPCS C1776
|
Hospital Charge Code |
40205236
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$339.17 |
Max. Negotiated Rate |
$4,196.41 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,198.12
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$339.17
|
Rate for Payer: Aetna Government |
$339.17
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,998.29
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,298.03
|
Rate for Payer: Fidelis Medicare Advantage |
$4,196.41
|
Rate for Payer: Group Health Inc Commercial |
$1,998.29
|
Rate for Payer: Group Health Inc Medicare |
$1,398.80
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,998.29
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,998.29
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,597.78
|
|
STRYKER CROSS LINK 53-73MM
|
Facility
OP
|
$3,267.28
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40205532
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$3,430.64 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,797.00
|
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 |
$1,633.64
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,878.69
|
Rate for Payer: Fidelis Medicare Advantage |
$3,430.64
|
Rate for Payer: Group Health Inc Commercial |
$1,633.64
|
Rate for Payer: Group Health Inc Medicare |
$1,143.55
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,633.64
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,633.64
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,123.73
|
|
STRYKER CROSS LINK 53-73MM
|
Facility
IP
|
$3,267.28
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40205532
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,633.64 |
Max. Negotiated Rate |
$1,633.64 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,633.64
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,633.64
|
|
STRYKER C-TAPER 26MM
|
Facility
IP
|
$2,142.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40206041
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,071.00 |
Max. Negotiated Rate |
$1,071.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,071.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,071.00
|
|
STRYKER C-TAPER 26MM
|
Facility
OP
|
$2,142.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40206041
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$2,249.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,178.10
|
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 |
$1,071.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,231.65
|
Rate for Payer: Fidelis Medicare Advantage |
$2,249.10
|
Rate for Payer: Group Health Inc Commercial |
$1,071.00
|
Rate for Payer: Group Health Inc Medicare |
$749.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,071.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,071.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,392.30
|
|
STRYKER C-TAPER LFIT 28MM
|
Facility
IP
|
$2,228.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40205540
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,114.00 |
Max. Negotiated Rate |
$1,114.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,114.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,114.00
|
|
STRYKER C-TAPER LFIT 28MM
|
Facility
OP
|
$2,228.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40205540
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$2,339.40 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,225.40
|
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 |
$1,114.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,281.10
|
Rate for Payer: Fidelis Medicare Advantage |
$2,339.40
|
Rate for Payer: Group Health Inc Commercial |
$1,114.00
|
Rate for Payer: Group Health Inc Medicare |
$779.80
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,114.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,114.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,448.20
|
|
STRYKER CURVED AWL
|
Facility
OP
|
$893.00
|
|
Hospital Charge Code |
40205371
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$312.55 |
Max. Negotiated Rate |
$714.40 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$491.15
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$446.50
|
Rate for Payer: Aetna Government |
$446.50
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$714.40
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$607.24
|
Rate for Payer: Group Health Inc Commercial |
$446.50
|
Rate for Payer: Group Health Inc Medicare |
$312.55
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$446.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$446.50
|
|
STRYKER CURVED CHISEL
|
Facility
OP
|
$369.00
|
|
Hospital Charge Code |
40205712
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$129.15 |
Max. Negotiated Rate |
$295.20 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$202.95
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$184.50
|
Rate for Payer: Aetna Government |
$184.50
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$295.20
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$250.92
|
Rate for Payer: Group Health Inc Commercial |
$184.50
|
Rate for Payer: Group Health Inc Medicare |
$129.15
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$184.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$184.50
|
|
STRYKER CURVED PLATE 4HOLE
|
Facility
OP
|
$1,750.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40209952
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$1,837.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$962.50
|
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 |
$875.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,006.25
|
Rate for Payer: Fidelis Medicare Advantage |
$1,837.50
|
Rate for Payer: Group Health Inc Commercial |
$875.00
|
Rate for Payer: Group Health Inc Medicare |
$612.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$875.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$875.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,137.50
|
|
STRYKER CURVED PLATE 4HOLE
|
Facility
IP
|
$1,750.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40209952
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$875.00 |
Max. Negotiated Rate |
$875.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$875.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$875.00
|
|
STRYKER CURVED ROD 76326
|
Facility
OP
|
$403.92
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40201458
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$424.12 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$222.16
|
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 |
$201.96
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$232.25
|
Rate for Payer: Fidelis Medicare Advantage |
$424.12
|
Rate for Payer: Group Health Inc Commercial |
$201.96
|
Rate for Payer: Group Health Inc Medicare |
$141.37
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$201.96
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$201.96
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$262.55
|
|
STRYKER CURVED ROD 76326
|
Facility
IP
|
$403.92
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40201458
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$201.96 |
Max. Negotiated Rate |
$201.96 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$201.96
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$201.96
|
|
STRYKER DISP FLUT 3.2X89MM
|
Facility
IP
|
$1,316.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40206090
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$658.00 |
Max. Negotiated Rate |
$658.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$658.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$658.00
|
|
STRYKER DISP FLUT 3.2X89MM
|
Facility
OP
|
$1,316.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40206090
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$134.20 |
Max. Negotiated Rate |
$1,381.80 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$723.80
|
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 |
$658.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$756.70
|
Rate for Payer: Fidelis Medicare Advantage |
$1,381.80
|
Rate for Payer: Group Health Inc Commercial |
$658.00
|
Rate for Payer: Group Health Inc Medicare |
$460.60
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$658.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$658.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$855.40
|
|
STRYKER DRILL 1.9 MM
|
Facility
OP
|
$165.00
|
|
Hospital Charge Code |
40203391
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$57.75 |
Max. Negotiated Rate |
$132.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$90.75
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$82.50
|
Rate for Payer: Aetna Government |
$82.50
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$132.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$112.20
|
Rate for Payer: Group Health Inc Commercial |
$82.50
|
Rate for Payer: Group Health Inc Medicare |
$57.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$82.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$82.50
|
|
STRYKER DRILL 2.1
|
Facility
OP
|
$138.60
|
|
Hospital Charge Code |
40205583
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$48.51 |
Max. Negotiated Rate |
$110.88 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$76.23
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.30
|
Rate for Payer: Aetna Government |
$69.30
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$110.88
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$94.25
|
Rate for Payer: Group Health Inc Commercial |
$69.30
|
Rate for Payer: Group Health Inc Medicare |
$48.51
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$69.30
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$69.30
|
|
STRYKER DRILL 430MM (1806-4260S)
|
Facility
OP
|
$290.00
|
|
Hospital Charge Code |
40029612
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$101.50 |
Max. Negotiated Rate |
$232.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$159.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$145.00
|
Rate for Payer: Aetna Government |
$145.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$232.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$197.20
|
Rate for Payer: Group Health Inc Commercial |
$145.00
|
Rate for Payer: Group Health Inc Medicare |
$101.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$145.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$145.00
|
|
STRYKER DRILL 4.9MM
|
Facility
IP
|
$308.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40201586
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$154.00 |
Max. Negotiated Rate |
$154.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$154.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$154.00
|
|
STRYKER DRILL 4.9MM
|
Facility
OP
|
$308.00
|
|
Service Code
|
HCPCS C1713
|
Hospital Charge Code |
40201586
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$107.80 |
Max. Negotiated Rate |
$323.40 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$169.40
|
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 |
$154.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$177.10
|
Rate for Payer: Fidelis Medicare Advantage |
$323.40
|
Rate for Payer: Group Health Inc Commercial |
$154.00
|
Rate for Payer: Group Health Inc Medicare |
$107.80
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$154.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$154.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$200.20
|
|
STRYKER DRILL, 5X230MM
|
Facility
OP
|
$268.00
|
|
Hospital Charge Code |
40005864
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$93.80 |
Max. Negotiated Rate |
$214.40 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$147.40
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.00
|
Rate for Payer: Aetna Government |
$134.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$214.40
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$182.24
|
Rate for Payer: Group Health Inc Commercial |
$134.00
|
Rate for Payer: Group Health Inc Medicare |
$93.80
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$134.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$134.00
|
|
STRYKER DRILL BIT 1.2
|
Facility
OP
|
$200.10
|
|
Hospital Charge Code |
40005302
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$70.04 |
Max. Negotiated Rate |
$160.08 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$110.06
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$100.05
|
Rate for Payer: Aetna Government |
$100.05
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$160.08
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$136.07
|
Rate for Payer: Group Health Inc Commercial |
$100.05
|
Rate for Payer: Group Health Inc Medicare |
$70.04
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$100.05
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$100.05
|
|
STRYKER DRILL BIT 2.6MM
|
Facility
OP
|
$210.00
|
|
Hospital Charge Code |
40205494
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$73.50 |
Max. Negotiated Rate |
$168.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$115.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$105.00
|
Rate for Payer: Aetna Government |
$105.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$168.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$142.80
|
Rate for Payer: Group Health Inc Commercial |
$105.00
|
Rate for Payer: Group Health Inc Medicare |
$73.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$105.00
|
|
STRYKER DRILL BIT 3.2MM
|
Facility
OP
|
$246.00
|
|
Hospital Charge Code |
40204669
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$86.10 |
Max. Negotiated Rate |
$196.80 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$135.30
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$123.00
|
Rate for Payer: Aetna Government |
$123.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$196.80
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$167.28
|
Rate for Payer: Group Health Inc Commercial |
$123.00
|
Rate for Payer: Group Health Inc Medicare |
$86.10
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$123.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$123.00
|
|
STRYKER DRILL BIT 3.6MM
|
Facility
OP
|
$197.40
|
|
Hospital Charge Code |
40205492
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$69.09 |
Max. Negotiated Rate |
$157.92 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$108.57
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$98.70
|
Rate for Payer: Aetna Government |
$98.70
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$157.92
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$134.23
|
Rate for Payer: Group Health Inc Commercial |
$98.70
|
Rate for Payer: Group Health Inc Medicare |
$69.09
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$98.70
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$98.70
|
|