|
K WIRE
|
Facility
|
IP
|
$81.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.29 |
| Max. Negotiated Rate |
$19.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.29
|
|
|
K WIRE
|
Facility
|
OP
|
$1,043.85
|
|
| Hospital Charge Code |
270704847
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$135.70 |
| Max. Negotiated Rate |
$521.92 |
| Rate for Payer: Aetna Commercial |
$313.15
|
| Rate for Payer: Aetna Medicare Advantage |
$313.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$266.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$266.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$266.18
|
| Rate for Payer: Cigna Commercial |
$521.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.70
|
| Rate for Payer: Oxford Commercial |
$521.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$521.92
|
|
|
K WIRE
|
Facility
|
OP
|
$81.95
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.29 |
| Max. Negotiated Rate |
$40.98 |
| Rate for Payer: Aetna Commercial |
$24.59
|
| Rate for Payer: Aetna Medicare Advantage |
$24.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.90
|
| Rate for Payer: Cigna Commercial |
$40.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.29
|
|
|
K-WIRE
|
Facility
|
IP
|
$49.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$11.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.42
|
|
|
K-WIRE
|
Facility
|
IP
|
$75.00
|
|
| Hospital Charge Code |
270683326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$11.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
|
|
K-WIRE
|
Facility
|
IP
|
$154.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$37.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.20
|
|
|
K-WIRE
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$36.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
|
|
K-WIRE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
270668044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Medicare Advantage |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.50
|
| Rate for Payer: Cigna Commercial |
$50.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
K-WIRE
|
Facility
|
OP
|
$75.00
|
|
| Hospital Charge Code |
270683326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: Aetna Medicare Advantage |
$22.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.12
|
| Rate for Payer: Cigna Commercial |
$37.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.75
|
| Rate for Payer: Oxford Commercial |
$37.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.50
|
|
|
K-WIRE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
270668044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$24.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
K-WIRE
|
Facility
|
OP
|
$1,040.00
|
|
| Hospital Charge Code |
270674915
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$135.20 |
| Max. Negotiated Rate |
$520.00 |
| Rate for Payer: Aetna Commercial |
$312.00
|
| Rate for Payer: Aetna Medicare Advantage |
$312.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$265.20
|
| Rate for Payer: Cigna Commercial |
$520.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.20
|
| Rate for Payer: Oxford Commercial |
$520.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$520.00
|
|
|
K-WIRE
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna Medicare Advantage |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.25
|
| Rate for Payer: Cigna Commercial |
$75.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
|
|
K-WIRE
|
Facility
|
OP
|
$154.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$77.35 |
| Rate for Payer: Aetna Commercial |
$46.41
|
| Rate for Payer: Aetna Medicare Advantage |
$46.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.45
|
| Rate for Payer: Cigna Commercial |
$77.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.20
|
|
|
K-WIRE
|
Facility
|
OP
|
$49.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$24.73 |
| Rate for Payer: Aetna Commercial |
$14.84
|
| Rate for Payer: Aetna Medicare Advantage |
$14.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.61
|
| Rate for Payer: Cigna Commercial |
$24.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.42
|
|
|
K-WIRE
|
Facility
|
IP
|
$1,040.00
|
|
| Hospital Charge Code |
270674915
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$156.00
|
|
|
KWIRE 0.014 MM
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$67.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
KWIRE 0.014 MM
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
KWIRE 0.062 MM
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$35.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$21.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.85
|
| Rate for Payer: Cigna Commercial |
$35.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.50
|
|
|
KWIRE 0.062 MM
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$16.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.50
|
|
|
KWIRE .028 X4 INCH
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$5.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
|
|
KWIRE .028 X4 INCH
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$6.30
|
| Rate for Payer: Aetna Medicare Advantage |
$6.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.36
|
| Rate for Payer: Cigna Commercial |
$10.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
|
|
K WIRE .035X4 LONG SINGLE
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$60.00
|
| Rate for Payer: Aetna Medicare Advantage |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.00
|
| Rate for Payer: Cigna Commercial |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
K WIRE .035X4 LONG SINGLE
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662578
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$48.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
K-WIRE .045
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270621018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$69.00
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
K-WIRE .045
|
Facility
|
IP
|
$230.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270621018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|