|
ZIPWIRE .035 ANGLED TIP
|
Facility
OP
|
$94.30
|
|
| Hospital Charge Code |
64905400
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$75.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$51.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$47.15
|
| Rate for Payer: Aetna Government |
$47.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$75.44
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$64.12
|
| Rate for Payer: Group Health Inc Commercial |
$47.15
|
| Rate for Payer: Group Health Inc Medicare |
$33.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$47.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$47.15
|
|
|
ZIPWIRE .035 STRAIGHT TIP
|
Facility
OP
|
$100.05
|
|
| Hospital Charge Code |
64905398
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$80.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.03
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$50.02
|
| Rate for Payer: Aetna Government |
$50.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$80.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.03
|
| Rate for Payer: Group Health Inc Commercial |
$50.02
|
| Rate for Payer: Group Health Inc Medicare |
$35.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.02
|
|
|
ZIPWIRE .038 ANGLED TIP
|
Facility
OP
|
$100.05
|
|
| Hospital Charge Code |
64905404
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$80.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.03
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$50.02
|
| Rate for Payer: Aetna Government |
$50.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$80.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.03
|
| Rate for Payer: Group Health Inc Commercial |
$50.02
|
| Rate for Payer: Group Health Inc Medicare |
$35.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.02
|
|
|
ZIPWIRE .038 STRAIGHT TIP
|
Facility
OP
|
$100.05
|
|
| Hospital Charge Code |
64905402
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$80.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.03
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$50.02
|
| Rate for Payer: Aetna Government |
$50.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$80.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.03
|
| Rate for Payer: Group Health Inc Commercial |
$50.02
|
| Rate for Payer: Group Health Inc Medicare |
$35.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.02
|
|
|
ZIPWIRE HYDRO .038 X 150CM
|
Facility
OP
|
$377.18
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64906747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$132.01 |
| Max. Negotiated Rate |
$396.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$207.45
|
| 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 |
$188.59
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$216.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$396.04
|
| Rate for Payer: Group Health Inc Commercial |
$188.59
|
| Rate for Payer: Group Health Inc Medicare |
$132.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$188.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$188.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$245.17
|
|
|
ZIPWIRE HYDRO .038 X 150CM
|
Facility
IP
|
$377.18
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64906747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.59 |
| Max. Negotiated Rate |
$188.59 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$188.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$188.59
|
|
|
ZM KNEE SYS PLY PTLA 3.8X9.5MM TH
|
Facility
IP
|
$2,200.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
40008264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,100.00 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,100.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,100.00
|
|
|
ZM KNEE SYS PLY PTLA 3.8X9.5MM TH
|
Facility
OP
|
$2,200.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
40008264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$339.17 |
| Max. Negotiated Rate |
$2,310.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,210.00
|
| 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 |
$1,100.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,265.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,310.00
|
| Rate for Payer: Group Health Inc Commercial |
$1,100.00
|
| Rate for Payer: Group Health Inc Medicare |
$770.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,100.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,100.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,430.00
|
|
|
Z NAIL 4.0X100 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006452
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X100 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006452
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X100 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X100 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X20 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X20 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X20 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006299
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X20 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006299
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X22.5 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X22.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X22.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X22.5 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X25 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X25 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X25 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006307
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$436.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$228.42
|
| 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 |
$207.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$238.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$436.06
|
| Rate for Payer: Group Health Inc Commercial |
$207.65
|
| Rate for Payer: Group Health Inc Medicare |
$145.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$269.94
|
|
|
Z NAIL 4.0X25 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006307
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
|
Z NAIL 4.0X27.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$207.65 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.65
|
|
