|
GUIDE PIN 250MM ALTA
|
Facility
|
OP
|
$136.00
|
|
| Hospital Charge Code |
270335181
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Aetna Commercial |
$40.80
|
| Rate for Payer: Aetna Medicare Advantage |
$40.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.68
|
| Rate for Payer: Cigna Commercial |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.68
|
| Rate for Payer: Oxford Commercial |
$68.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$68.00
|
|
|
GUIDE PIN 250MM ALTA
|
Facility
|
IP
|
$136.00
|
|
| Hospital Charge Code |
270335181
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.40
|
|
|
GUIDE PIN 27MM
|
Facility
|
IP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692916
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.25 |
| Max. Negotiated Rate |
$453.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$453.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.25
|
|
|
GUIDE PIN 27MM
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692916
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$281.25 |
| Max. Negotiated Rate |
$937.50 |
| Rate for Payer: Aetna Commercial |
$562.50
|
| Rate for Payer: Aetna Medicare Advantage |
$562.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$478.12
|
| Rate for Payer: Cigna Commercial |
$937.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$453.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.25
|
|
|
GUIDE PIN 2MM
|
Facility
|
OP
|
$375.00
|
|
| Hospital Charge Code |
270687088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: Aetna Medicare Advantage |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.62
|
| Rate for Payer: Cigna Commercial |
$187.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.75
|
| Rate for Payer: Oxford Commercial |
$187.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$187.50
|
|
|
GUIDE PIN 2MM
|
Facility
|
IP
|
$375.00
|
|
| Hospital Charge Code |
270687088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.25 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
|
|
GUIDE PIN 2MM
|
Facility
|
OP
|
$265.00
|
|
| Hospital Charge Code |
270667236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$132.50 |
| Rate for Payer: Aetna Commercial |
$79.50
|
| Rate for Payer: Aetna Medicare Advantage |
$79.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$53.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.58
|
| Rate for Payer: Cigna Commercial |
$132.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
|
|
GUIDE PIN 2MM
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
270667236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$64.13 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$53.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
|
|
GUIDE PIN 2MM/.078 DIA
|
Facility
|
IP
|
$183.75
|
|
| Hospital Charge Code |
270652502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.56 |
| Max. Negotiated Rate |
$27.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.56
|
|
|
GUIDE PIN 2MM/.078 DIA
|
Facility
|
OP
|
$183.75
|
|
| Hospital Charge Code |
270652502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.89 |
| Max. Negotiated Rate |
$91.88 |
| Rate for Payer: Aetna Commercial |
$55.12
|
| Rate for Payer: Aetna Medicare Advantage |
$55.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.86
|
| Rate for Payer: Cigna Commercial |
$91.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.89
|
| Rate for Payer: Oxford Commercial |
$91.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$91.88
|
|
|
GUIDE PIN 2mm NON THREADED
|
Facility
|
OP
|
$69.44
|
|
| Hospital Charge Code |
270679218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$34.72 |
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: Aetna Medicare Advantage |
$20.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.71
|
| Rate for Payer: Cigna Commercial |
$34.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.03
|
| Rate for Payer: Oxford Commercial |
$34.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.72
|
|
|
GUIDE PIN 2mm NON THREADED
|
Facility
|
IP
|
$69.44
|
|
| Hospital Charge Code |
270679218
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$10.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.42
|
|
|
GUIDE PIN 3.2MM
|
Facility
|
OP
|
$265.00
|
|
| Hospital Charge Code |
270692839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.45 |
| Max. Negotiated Rate |
$132.50 |
| Rate for Payer: Aetna Commercial |
$79.50
|
| Rate for Payer: Aetna Medicare Advantage |
$79.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.58
|
| Rate for Payer: Cigna Commercial |
$132.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.45
|
| Rate for Payer: Oxford Commercial |
$132.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$132.50
|
|
|
GUIDE PIN 3.2MM
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
270692839
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.75 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.75
|
|
|
GUIDEPIN 3X75MM
|
Facility
|
IP
|
$1,715.00
|
|
| Hospital Charge Code |
270700536
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$257.25 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$257.25
|
|
|
GUIDEPIN 3X75MM
|
Facility
|
OP
|
$1,715.00
|
|
| Hospital Charge Code |
270700536
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$222.95 |
| Max. Negotiated Rate |
$857.50 |
| Rate for Payer: Aetna Commercial |
$514.50
|
| Rate for Payer: Aetna Medicare Advantage |
$514.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.32
|
| Rate for Payer: Cigna Commercial |
$857.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$222.95
|
| Rate for Payer: Oxford Commercial |
$857.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$257.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$857.50
|
|
|
GUIDE PIN DRL TIP 2.8X300MM ST
|
Facility
|
IP
|
$1,840.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704918
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$445.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$368.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$445.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$276.00
|
|
|
GUIDE PIN DRL TIP 2.8X300MM ST
|
Facility
|
OP
|
$1,840.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704918
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$920.00 |
| Rate for Payer: Aetna Commercial |
$552.00
|
| Rate for Payer: Aetna Medicare Advantage |
$552.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$469.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$469.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$368.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$469.20
|
| Rate for Payer: Cigna Commercial |
$920.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$445.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$276.00
|
|
|
GUIDE PIN FLAREHAWK 7
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna Commercial |
$150.00
|
| Rate for Payer: Aetna Medicare Advantage |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.50
|
| Rate for Payer: Cigna Commercial |
$250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
GUIDE PIN FLAREHAWK 7
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$121.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
GUIDE PIN METATARSAL
|
Facility
|
OP
|
$425.00
|
|
| Hospital Charge Code |
270669664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
GUIDE PIN METATARSAL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
270672050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna Commercial |
$105.00
|
| Rate for Payer: Aetna Medicare Advantage |
$105.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$70.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.25
|
| Rate for Payer: Cigna Commercial |
$175.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
|
|
GUIDE PIN METATARSAL
|
Facility
|
IP
|
$425.00
|
|
| Hospital Charge Code |
270669664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
GUIDE PIN METATARSAL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
270672050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$84.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$70.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
|
|
GUIDE PIN N-FORCE 7.3 3.2MM
|
Facility
|
OP
|
$495.00
|
|
| Hospital Charge Code |
270687089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.35 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$148.50
|
| Rate for Payer: Aetna Medicare Advantage |
$148.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.22
|
| Rate for Payer: Cigna Commercial |
$247.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.35
|
| Rate for Payer: Oxford Commercial |
$247.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$247.50
|
|