|
K WIRE PANTA2 2.5X150MM
|
Facility
|
OP
|
$920.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.17 |
| Max. Negotiated Rate |
$460.00 |
| Rate for Payer: Aetna Commercial |
$349.60
|
| Rate for Payer: Aetna Medicare Advantage |
$276.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$234.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$234.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$184.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$234.60
|
| Rate for Payer: Cigna Commercial |
$460.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$222.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$202.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.38
|
|
|
K WIRE PANTA2 2.5X150MM
|
Facility
|
IP
|
$920.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.00 |
| Max. Negotiated Rate |
$222.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$184.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$222.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$202.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.00
|
|
|
KWIRE S END TIP THD 2.3X300
|
Facility
|
IP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.32
|
|
|
KWIRE S END TIP THD 2.3X300
|
Facility
|
OP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Commercial |
$43.89
|
| Rate for Payer: Aetna Medicare Advantage |
$34.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.45
|
| Rate for Payer: Cigna Commercial |
$57.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.32
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.06
|
|
|
KWIRE SGL END TRCT TIP 2.3X150
|
Facility
|
IP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.32
|
|
|
KWIRE SGL END TRCT TIP 2.3X150
|
Facility
|
OP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Commercial |
$43.89
|
| Rate for Payer: Aetna Medicare Advantage |
$34.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.45
|
| Rate for Payer: Cigna Commercial |
$57.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.32
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.06
|
|
|
K-WIRE SHARP-ABBOT SPINE
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270339019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$48.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
K-WIRE SHARP-ABBOT SPINE
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270339019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$48.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.83
|
|
|
K-WIRE SHOULDER DISP 2.5
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691625
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$165.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.88
|
|
|
K-WIRE SHOULDER DISP 2.5
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691625
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$165.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
K-WIRE SINGLE RD END 4 .028
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
K-WIRE SINGLE RD END 4 .028
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .035
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .035
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
K-WIRE SINGLE RD END 4 .045
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
K-WIRE SINGLE RD END 4 .045
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .062
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .062
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
K-WIRE SINGLE RD END 9 .028
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 9 .028
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
K-WIRE SINGLE RD END 9 .035
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 9 .035
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
K-WIRE SINGLE RD END 9 .045
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 9 .045
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|
|
K-WIRE SINGLE RD END 9 .062
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.42
|
|