|
Z NAIL 5.0X27.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006397
|
|
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 5.0X27.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006313
|
|
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 5.0X27.5 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006313
|
|
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 5.0X30 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006399
|
|
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 5.0X30 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006399
|
|
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 5.0X30 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006317
|
|
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 5.0X30 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006317
|
|
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 5.0X32.5 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006402
|
|
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 5.0X32.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006402
|
|
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 5.0X32.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006321
|
|
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 5.0X32.5 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006321
|
|
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 5.0X35 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006404
|
|
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 5.0X35 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006404
|
|
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 5.0 X 35 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006325
|
|
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 5.0 X 35 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006325
|
|
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 5.0X37.5 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006407
|
|
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 5.0X37.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006407
|
|
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 5.0X37.5 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006329
|
|
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 5.0X37.5 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006329
|
|
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 5.0X40 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006409
|
|
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 5.0X40 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006409
|
|
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 5.0 X 40 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006333
|
|
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 5.0 X 40 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006333
|
|
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 5.0X42.5 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006412
|
|
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 5.0X42.5 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006412
|
|
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
|
|
