|
Z NAIL 4.0X42.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006335
|
|
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 4.0X42.5 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006335
|
|
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 4.0X45 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006413
|
|
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 4.0X45 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006413
|
|
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 4.0X 45 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006339
|
|
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 4.0X 45 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006339
|
|
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 4.0X47.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006416
|
|
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 4.0X47.5 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006416
|
|
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 4.0X47.5 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006343
|
|
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 4.0X47.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006343
|
|
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 4.0X50 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006418
|
|
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 4.0X50 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006418
|
|
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 4.0X50 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006345
|
|
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 4.0X50 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006345
|
|
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 4.0X52.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006421
|
|
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 4.0X52.5 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006421
|
|
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 4.0X52.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006348
|
|
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 4.0X52.5 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006348
|
|
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 4.0X55 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006423
|
|
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 4.0X55 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006423
|
|
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 4.0X55 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006350
|
|
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 4.0X55 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006350
|
|
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 4.0X57.5 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006426
|
|
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 4.0X57.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006426
|
|
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 4.0X57.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006353
|
|
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
|
|
