|
K-WIRE 2.0x150MM
|
Facility
|
OP
|
$196.95
|
|
| Hospital Charge Code |
270640108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$98.47 |
| Rate for Payer: Aetna Commercial |
$59.09
|
| Rate for Payer: Aetna Medicare Advantage |
$59.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50.22
|
| Rate for Payer: Cigna Commercial |
$98.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.60
|
| Rate for Payer: Oxford Commercial |
$98.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$98.47
|
|
|
K-WIRE 2.0x150MM
|
Facility
|
IP
|
$196.95
|
|
| Hospital Charge Code |
270640108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.54 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.54
|
|
|
K-WIRE 2.0X150 TROC 490101615
|
Facility
|
OP
|
$26.91
|
|
| Hospital Charge Code |
270632815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$13.46 |
| Rate for Payer: Aetna Commercial |
$8.07
|
| Rate for Payer: Aetna Medicare Advantage |
$8.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.86
|
| Rate for Payer: Cigna Commercial |
$13.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.50
|
| Rate for Payer: Oxford Commercial |
$13.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.46
|
|
|
K-WIRE 2.0X150 TROC 490101615
|
Facility
|
IP
|
$26.91
|
|
| Hospital Charge Code |
270632815
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$4.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.04
|
|
|
K-WIRE 2.0X150 TR TP 490102015
|
Facility
|
OP
|
$22.00
|
|
| Hospital Charge Code |
270632814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: Aetna Commercial |
$6.60
|
| Rate for Payer: Aetna Medicare Advantage |
$6.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.61
|
| Rate for Payer: Cigna Commercial |
$11.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.86
|
| Rate for Payer: Oxford Commercial |
$11.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.00
|
|
|
K-WIRE 2.0X150 TR TP 490102015
|
Facility
|
IP
|
$22.00
|
|
| Hospital Charge Code |
270632814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$3.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.30
|
|
|
K WIRE 2.0 X 200 MM
|
Facility
|
IP
|
$195.00
|
|
| Hospital Charge Code |
270682954
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.25 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.25
|
|
|
K WIRE 2.0 X 200 MM
|
Facility
|
OP
|
$195.00
|
|
| Hospital Charge Code |
270682954
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare Advantage |
$58.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.73
|
| Rate for Payer: Cigna Commercial |
$97.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.35
|
| Rate for Payer: Oxford Commercial |
$97.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$97.50
|
|
|
KWIRE 2.0X230MM
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare Advantage |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.35
|
| Rate for Payer: Cigna Commercial |
$85.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.50
|
|
|
KWIRE 2.0X230MM
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$41.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.50
|
|
|
K-WIRE 228MM
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$34.50
|
| Rate for Payer: Aetna Medicare Advantage |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.32
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
K-WIRE 228MM
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$27.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
KWIRE 2.3MM
|
Facility
|
OP
|
$115.00
|
|
| Hospital Charge Code |
270656813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$34.50
|
| Rate for Payer: Aetna Medicare Advantage |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.32
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.95
|
| Rate for Payer: Oxford Commercial |
$57.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$57.50
|
|
|
KWIRE 2.3MM
|
Facility
|
IP
|
$115.00
|
|
| Hospital Charge Code |
270656813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
K-WIRE 2.3X 300MM
|
Facility
|
OP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Commercial |
$34.65
|
| 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: Qualcare PPO/HMO/WC |
$17.32
|
|
|
K-WIRE 2.3X 300MM
|
Facility
|
IP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701480
|
|
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: Qualcare PPO/HMO/WC |
$17.32
|
|
|
K WIRE 2.4 MM X 170 MM
|
Facility
|
OP
|
$75.00
|
|
| Hospital Charge Code |
270685919
|
|
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 2.4 MM X 170 MM
|
Facility
|
IP
|
$75.00
|
|
| Hospital Charge Code |
270685919
|
|
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 2.5
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270686219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
K-WIRE 2.5
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
270686219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.25 |
| 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) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.25
|
| Rate for Payer: Oxford Commercial |
$112.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$112.50
|
|
|
K-WIRE 2.5MM THREAD TIP
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
270656778
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.00 |
| 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) PPO |
$25.50
|
| Rate for Payer: Cigna Commercial |
$50.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.00
|
| Rate for Payer: Oxford Commercial |
$50.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.00
|
|
|
K-WIRE 2.5MM THREAD TIP
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
270656778
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
K-WIRE 2.5mm X 200mm
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
270637467
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.75 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: Aetna Commercial |
$52.50
|
| Rate for Payer: Aetna Medicare Advantage |
$52.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.62
|
| Rate for Payer: Cigna Commercial |
$87.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.75
|
| Rate for Payer: Oxford Commercial |
$87.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$87.50
|
|
|
K-WIRE 2.5mm X 200mm
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
270637467
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
|
|
K-WIRE 2.5x150MM
|
Facility
|
OP
|
$115.00
|
|
| Hospital Charge Code |
270674309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$34.50
|
| Rate for Payer: Aetna Medicare Advantage |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.32
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.95
|
| Rate for Payer: Oxford Commercial |
$57.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$57.50
|
|