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For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula

This, in turn, can narrow the arteries, leading to reduced blood flow

Necrosis is usually lacking

It might push pigment deeper or cause pigment to move within the skin, creating an undesirable look (which is why it is not recommended)