|
Z NAIL 5.0X90 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006447
|
|
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 5.0X90 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006447
|
|
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 5.0 X 90 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006374
|
|
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 90 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006374
|
|
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 5.0X95 CORT SCREW FA
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006450
|
|
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 5.0X95 CORT SCREW FA
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006450
|
|
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 5.0 X 95 CORT SCREW PT
|
Facility
IP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006377
|
|
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 5.0 X 95 CORT SCREW PT
|
Facility
OP
|
$415.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006377
|
|
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 6.0 X 100 CANC SCREW FA
|
Facility
IP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006454
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.07 |
| Max. Negotiated Rate |
$215.07 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
|
|
Z NAIL 6.0 X 100 CANC SCREW FA
|
Facility
OP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006454
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$451.65 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$236.58
|
| 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 |
$215.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$247.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$451.65
|
| Rate for Payer: Group Health Inc Commercial |
$215.07
|
| Rate for Payer: Group Health Inc Medicare |
$150.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$279.59
|
|
|
Z NAIL 6.0 X 100 CANC SCREW PT
|
Facility
OP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006381
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$482.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$252.89
|
| 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 |
$229.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$264.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$482.79
|
| Rate for Payer: Group Health Inc Commercial |
$229.90
|
| Rate for Payer: Group Health Inc Medicare |
$160.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$298.87
|
|
|
Z NAIL 6.0 X 100 CANC SCREW PT
|
Facility
IP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006381
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$229.90 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
|
|
Z NAIL 6.0 X 105 CANC SCREW FA
|
Facility
OP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$451.65 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$236.58
|
| 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 |
$215.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$247.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$451.65
|
| Rate for Payer: Group Health Inc Commercial |
$215.07
|
| Rate for Payer: Group Health Inc Medicare |
$150.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$279.59
|
|
|
Z NAIL 6.0 X 105 CANC SCREW FA
|
Facility
IP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.07 |
| Max. Negotiated Rate |
$215.07 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
|
|
Z NAIL 6.0 X 105 CANC SCREW PT
|
Facility
OP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$482.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$252.89
|
| 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 |
$229.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$264.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$482.79
|
| Rate for Payer: Group Health Inc Commercial |
$229.90
|
| Rate for Payer: Group Health Inc Medicare |
$160.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$298.87
|
|
|
Z NAIL 6.0 X 105 CANC SCREW PT
|
Facility
IP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$229.90 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
|
|
Z NAIL 6.0 X 110 CANC SCREW FA
|
Facility
OP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$451.65 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$236.58
|
| 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 |
$215.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$247.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$451.65
|
| Rate for Payer: Group Health Inc Commercial |
$215.07
|
| Rate for Payer: Group Health Inc Medicare |
$150.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$279.59
|
|
|
Z NAIL 6.0 X 110 CANC SCREW FA
|
Facility
IP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.07 |
| Max. Negotiated Rate |
$215.07 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
|
|
Z NAIL 6.0 X 110 CANC SCREW PT
|
Facility
OP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$482.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$252.89
|
| 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 |
$229.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$264.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$482.79
|
| Rate for Payer: Group Health Inc Commercial |
$229.90
|
| Rate for Payer: Group Health Inc Medicare |
$160.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$298.87
|
|
|
Z NAIL 6.0 X 110 CANC SCREW PT
|
Facility
IP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$229.90 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
|
|
Z NAIL 6.0 X 115 CANC SCREW FA
|
Facility
OP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006457
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$451.65 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$236.58
|
| 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 |
$215.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$247.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$451.65
|
| Rate for Payer: Group Health Inc Commercial |
$215.07
|
| Rate for Payer: Group Health Inc Medicare |
$150.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$279.59
|
|
|
Z NAIL 6.0 X 115 CANC SCREW FA
|
Facility
IP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006457
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.07 |
| Max. Negotiated Rate |
$215.07 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
|
|
Z NAIL 6.0 X 115 CANC SCREW PT
|
Facility
IP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$229.90 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
|
|
Z NAIL 6.0 X 115 CANC SCREW PT
|
Facility
OP
|
$459.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$482.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$252.89
|
| 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 |
$229.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$264.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$482.79
|
| Rate for Payer: Group Health Inc Commercial |
$229.90
|
| Rate for Payer: Group Health Inc Medicare |
$160.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$298.87
|
|
|
Z NAIL 6.0 X 120 CANC SCREW FA
|
Facility
IP
|
$430.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006458
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$215.07 |
| Max. Negotiated Rate |
$215.07 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$215.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$215.07
|
|
