|
2.75 CANNULATED DRILL
|
Facility
|
OP
|
$935.00
|
|
| Hospital Charge Code |
270687158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.55 |
| Max. Negotiated Rate |
$467.50 |
| Rate for Payer: Aetna Commercial |
$280.50
|
| Rate for Payer: Aetna Medicare Advantage |
$280.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$238.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$238.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$238.43
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.55
|
| Rate for Payer: Oxford Commercial |
$467.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$467.50
|
|
|
2.75 CANNULATED DRILL
|
Facility
|
IP
|
$935.00
|
|
| Hospital Charge Code |
270687158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.25 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.25
|
|
|
2.7 DISTAL FIB. PLATE 9 HOLE
|
Facility
|
OP
|
$4,533.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$679.96 |
| Max. Negotiated Rate |
$2,266.53 |
| Rate for Payer: Aetna Commercial |
$1,359.91
|
| Rate for Payer: Aetna Medicare Advantage |
$1,359.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,155.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,155.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$906.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,155.93
|
| Rate for Payer: Cigna Commercial |
$2,266.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,097.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$679.96
|
|
|
2.7 DISTAL FIB. PLATE 9 HOLE
|
Facility
|
IP
|
$4,533.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$679.96 |
| Max. Negotiated Rate |
$1,097.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$906.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,097.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$679.96
|
|
|
2.7 DRILL
|
Facility
|
IP
|
$1,463.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270703607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.51 |
| Max. Negotiated Rate |
$354.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$292.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.51
|
|
|
2.7 DRILL
|
Facility
|
OP
|
$1,463.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270703607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.51 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Aetna Commercial |
$439.02
|
| Rate for Payer: Aetna Medicare Advantage |
$439.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$292.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.17
|
| Rate for Payer: Cigna Commercial |
$731.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.51
|
|
|
2.7 DRILL
|
Facility
|
IP
|
$1,463.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.51 |
| Max. Negotiated Rate |
$354.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$292.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.51
|
|
|
2.7 DRILL
|
Facility
|
OP
|
$1,463.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.51 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Aetna Commercial |
$439.02
|
| Rate for Payer: Aetna Medicare Advantage |
$439.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$292.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.17
|
| Rate for Payer: Cigna Commercial |
$731.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.51
|
|
|
2.7 DRILL BIT
|
Facility
|
OP
|
$610.00
|
|
| Hospital Charge Code |
270672025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.30 |
| Max. Negotiated Rate |
$305.00 |
| Rate for Payer: Aetna Commercial |
$183.00
|
| Rate for Payer: Aetna Medicare Advantage |
$183.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$155.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$155.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$155.55
|
| Rate for Payer: Cigna Commercial |
$305.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.30
|
| Rate for Payer: Oxford Commercial |
$305.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$305.00
|
|
|
2.7 DRILL BIT
|
Facility
|
IP
|
$610.00
|
|
| Hospital Charge Code |
270672025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.50 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.50
|
|
|
2.7 DRILL BIT LONG
|
Facility
|
IP
|
$775.15
|
|
| Hospital Charge Code |
270656860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.27 |
| Max. Negotiated Rate |
$116.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.27
|
|
|
2.7 DRILL BIT LONG
|
Facility
|
OP
|
$775.15
|
|
| Hospital Charge Code |
270656860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.77 |
| Max. Negotiated Rate |
$387.57 |
| Rate for Payer: Aetna Commercial |
$232.54
|
| Rate for Payer: Aetna Medicare Advantage |
$232.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$197.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$197.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$197.66
|
| Rate for Payer: Cigna Commercial |
$387.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$100.77
|
| Rate for Payer: Oxford Commercial |
$387.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$387.57
|
|
|
2.7 LCP 8 HOLE PLATE
|
Facility
|
OP
|
$1,758.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.73 |
| Max. Negotiated Rate |
$879.10 |
| Rate for Payer: Aetna Commercial |
$527.46
|
| Rate for Payer: Aetna Medicare Advantage |
$527.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$351.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.34
|
| Rate for Payer: Cigna Commercial |
$879.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$425.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$263.73
|
|
|
2.7 LCP 8 HOLE PLATE
|
Facility
|
IP
|
$1,758.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674355
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$263.73 |
| Max. Negotiated Rate |
$425.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$351.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$425.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$263.73
|
|
|
2.7 LOCKING 10MM
|
Facility
|
OP
|
$518.15
|
|
| Hospital Charge Code |
270656863
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$259.07 |
| Rate for Payer: Aetna Commercial |
$155.44
|
| Rate for Payer: Aetna Medicare Advantage |
$155.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.13
|
| Rate for Payer: Cigna Commercial |
$259.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOCKING 10MM
|
Facility
|
IP
|
$518.15
|
|
| Hospital Charge Code |
270656863
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$125.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOCKING 12MM
|
Facility
|
IP
|
$518.15
|
|
| Hospital Charge Code |
270656865
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$125.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOCKING 12MM
|
Facility
|
OP
|
$518.15
|
|
| Hospital Charge Code |
270656865
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$259.07 |
| Rate for Payer: Aetna Commercial |
$155.44
|
| Rate for Payer: Aetna Medicare Advantage |
$155.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.13
|
| Rate for Payer: Cigna Commercial |
$259.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOCKING 16MM
|
Facility
|
IP
|
$518.15
|
|
| Hospital Charge Code |
270656862
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$125.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOCKING 16MM
|
Facility
|
OP
|
$518.15
|
|
| Hospital Charge Code |
270656862
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$259.07 |
| Rate for Payer: Aetna Commercial |
$155.44
|
| Rate for Payer: Aetna Medicare Advantage |
$155.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.13
|
| Rate for Payer: Cigna Commercial |
$259.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOCKING 24MM
|
Facility
|
IP
|
$1,036.30
|
|
| Hospital Charge Code |
270656867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$155.44 |
| Max. Negotiated Rate |
$250.78 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$207.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$250.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$155.44
|
|
|
2.7 LOCKING 24MM
|
Facility
|
OP
|
$1,036.30
|
|
| Hospital Charge Code |
270656867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$155.44 |
| Max. Negotiated Rate |
$518.15 |
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: Aetna Medicare Advantage |
$310.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$264.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$264.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$207.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$264.26
|
| Rate for Payer: Cigna Commercial |
$518.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$250.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$155.44
|
|
|
2.7 LOCKING 30MM
|
Facility
|
IP
|
$518.15
|
|
| Hospital Charge Code |
270656868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$125.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOCKING 30MM
|
Facility
|
OP
|
$518.15
|
|
| Hospital Charge Code |
270656868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$259.07 |
| Rate for Payer: Aetna Commercial |
$155.44
|
| Rate for Payer: Aetna Medicare Advantage |
$155.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$132.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$132.13
|
| Rate for Payer: Cigna Commercial |
$259.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.72
|
|
|
2.7 LOKCING 22MM
|
Facility
|
IP
|
$518.75
|
|
| Hospital Charge Code |
270656866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.81 |
| Max. Negotiated Rate |
$125.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$103.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.81
|
|