|
NAIL ANKLE 11MMDX15CML 34514
|
Facility
|
OP
|
$8,790.00
|
|
| Hospital Charge Code |
270638406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,318.50 |
| Max. Negotiated Rate |
$4,395.00 |
| Rate for Payer: Aetna Commercial |
$2,637.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,637.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,241.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,241.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,758.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,241.45
|
| Rate for Payer: Cigna Commercial |
$4,395.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,127.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,318.50
|
|
|
NAIL ANKLE 11mmDx18cmL 345145
|
Facility
|
IP
|
$8,775.00
|
|
| Hospital Charge Code |
270638405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,316.25 |
| Max. Negotiated Rate |
$2,123.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,755.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,123.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,316.25
|
|
|
NAIL ANKLE 11mmDx18cmL 345145
|
Facility
|
OP
|
$8,775.00
|
|
| Hospital Charge Code |
270638405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,316.25 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Aetna Commercial |
$2,632.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,632.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,237.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,237.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,755.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,237.62
|
| Rate for Payer: Cigna Commercial |
$4,387.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,123.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,316.25
|
|
|
NAIL ANKLE ARTHRO LF 11X150MM
|
Facility
|
OP
|
$17,815.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270670466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,672.25 |
| Max. Negotiated Rate |
$8,907.50 |
| Rate for Payer: Aetna Commercial |
$5,344.50
|
| Rate for Payer: Aetna Medicare Advantage |
$5,344.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,542.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,542.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,563.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,542.82
|
| Rate for Payer: Cigna Commercial |
$8,907.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,311.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,672.25
|
|
|
NAIL ANKLE ARTHRO LF 11X150MM
|
Facility
|
IP
|
$17,815.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270670466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,672.25 |
| Max. Negotiated Rate |
$4,311.23 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,563.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,311.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,672.25
|
|
|
NAIL ANKLE LOCKING 11x180MM
|
Facility
|
OP
|
$13,110.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,966.50 |
| Max. Negotiated Rate |
$6,555.00 |
| Rate for Payer: Aetna Commercial |
$3,933.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,933.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,343.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,343.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,622.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,343.05
|
| Rate for Payer: Cigna Commercial |
$6,555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,172.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,966.50
|
|
|
NAIL ANKLE LOCKING 11x180MM
|
Facility
|
IP
|
$13,110.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,966.50 |
| Max. Negotiated Rate |
$3,172.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,622.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,172.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,966.50
|
|
|
NAIL ARTHRODES PANTA211X180MM
|
Facility
|
OP
|
$39,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699961
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,996.25 |
| Max. Negotiated Rate |
$19,987.50 |
| Rate for Payer: Aetna Commercial |
$11,992.50
|
| Rate for Payer: Aetna Medicare Advantage |
$11,992.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10,193.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10,193.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,995.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10,193.62
|
| Rate for Payer: Cigna Commercial |
$19,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,673.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,996.25
|
|
|
NAIL ARTHRODES PANTA211X180MM
|
Facility
|
IP
|
$39,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699961
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,996.25 |
| Max. Negotiated Rate |
$9,673.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,995.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,673.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,996.25
|
|
|
NAIL BMT ANKLE 10 15 345120
|
Facility
|
IP
|
$6,076.00
|
|
| Hospital Charge Code |
270622769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$911.40 |
| Max. Negotiated Rate |
$1,470.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,215.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,470.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$911.40
|
|
|
NAIL BMT ANKLE 10 15 345120
|
Facility
|
OP
|
$6,076.00
|
|
| Hospital Charge Code |
270622769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$911.40 |
| Max. Negotiated Rate |
$3,038.00 |
| Rate for Payer: Aetna Commercial |
$1,822.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1,822.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,549.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,549.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,215.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,549.38
|
| Rate for Payer: Cigna Commercial |
$3,038.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,470.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$911.40
|
|
|
NAIL BMT FEM 11 24 346024
|
Facility
|
OP
|
$4,797.65
|
|
| Hospital Charge Code |
270627060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$719.65 |
| Max. Negotiated Rate |
$2,398.82 |
| Rate for Payer: Aetna Commercial |
$1,439.30
|
| Rate for Payer: Aetna Medicare Advantage |
$1,439.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,223.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,223.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$959.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,223.40
|
| Rate for Payer: Cigna Commercial |
$2,398.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,161.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$719.65
|
|
|
NAIL BMT FEM 11 24 346024
|
Facility
|
IP
|
$4,797.65
|
|
| Hospital Charge Code |
270627060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$719.65 |
| Max. Negotiated Rate |
$1,161.03 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$959.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,161.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$719.65
|
|
|
NAIL BMT FEM 11 34 343634
|
Facility
|
IP
|
$3,036.85
|
|
| Hospital Charge Code |
270607860
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$455.53 |
| Max. Negotiated Rate |
$734.92 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$607.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$734.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$455.53
|
|
|
NAIL BMT FEM 11 34 343634
|
Facility
|
OP
|
$3,036.85
|
|
| Hospital Charge Code |
270607860
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$455.53 |
| Max. Negotiated Rate |
$1,518.42 |
| Rate for Payer: Aetna Commercial |
$911.05
|
| Rate for Payer: Aetna Medicare Advantage |
$911.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$774.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$774.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$774.40
|
| Rate for Payer: Cigna Commercial |
$1,518.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$734.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$455.53
|
|
|
NAIL BMT FEM 12 32 346632
|
Facility
|
OP
|
$4,797.65
|
|
| Hospital Charge Code |
270627061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$719.65 |
| Max. Negotiated Rate |
$2,398.82 |
| Rate for Payer: Aetna Commercial |
$1,439.30
|
| Rate for Payer: Aetna Medicare Advantage |
$1,439.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,223.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,223.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$959.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,223.40
|
| Rate for Payer: Cigna Commercial |
$2,398.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,161.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$719.65
|
|
|
NAIL BMT FEM 12 32 346632
|
Facility
|
IP
|
$4,797.65
|
|
| Hospital Charge Code |
270627061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$719.65 |
| Max. Negotiated Rate |
$1,161.03 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$959.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,161.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$719.65
|
|
|
NAIL BMT FEM 12 34 342934
|
Facility
|
OP
|
$3,311.25
|
|
| Hospital Charge Code |
270621703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$496.69 |
| Max. Negotiated Rate |
$1,655.62 |
| Rate for Payer: Aetna Commercial |
$993.38
|
| Rate for Payer: Aetna Medicare Advantage |
$993.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$844.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$844.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$662.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$844.37
|
| Rate for Payer: Cigna Commercial |
$1,655.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$801.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$496.69
|
|
|
NAIL BMT FEM 12 34 342934
|
Facility
|
IP
|
$3,311.25
|
|
| Hospital Charge Code |
270621703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$496.69 |
| Max. Negotiated Rate |
$801.32 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$662.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$801.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$496.69
|
|
|
NAIL BMT FEM 12 35 346635
|
Facility
|
OP
|
$5,594.95
|
|
| Hospital Charge Code |
270624246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$839.24 |
| Max. Negotiated Rate |
$2,797.47 |
| Rate for Payer: Aetna Commercial |
$1,678.48
|
| Rate for Payer: Aetna Medicare Advantage |
$1,678.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,426.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,426.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,118.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,426.71
|
| Rate for Payer: Cigna Commercial |
$2,797.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,353.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.24
|
|
|
NAIL BMT FEM 12 35 346635
|
Facility
|
IP
|
$5,594.95
|
|
| Hospital Charge Code |
270624246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$839.24 |
| Max. Negotiated Rate |
$1,353.98 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,118.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,353.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.24
|
|
|
NAIL BMT FEM 12 38 346638
|
Facility
|
OP
|
$4,806.25
|
|
| Hospital Charge Code |
270627431
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$720.94 |
| Max. Negotiated Rate |
$2,403.12 |
| Rate for Payer: Aetna Commercial |
$1,441.88
|
| Rate for Payer: Aetna Medicare Advantage |
$1,441.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,225.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,225.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$961.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,225.59
|
| Rate for Payer: Cigna Commercial |
$2,403.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,163.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$720.94
|
|
|
NAIL BMT FEM 12 38 346638
|
Facility
|
IP
|
$4,806.25
|
|
| Hospital Charge Code |
270627431
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$720.94 |
| Max. Negotiated Rate |
$1,163.11 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$961.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,163.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$720.94
|
|
|
NAIL BMT FEM 12 41 346641
|
Facility
|
IP
|
$5,594.95
|
|
| Hospital Charge Code |
270624838
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$839.24 |
| Max. Negotiated Rate |
$1,353.98 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,118.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,353.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.24
|
|
|
NAIL BMT FEM 12 41 346641
|
Facility
|
OP
|
$5,594.95
|
|
| Hospital Charge Code |
270624838
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$839.24 |
| Max. Negotiated Rate |
$2,797.47 |
| Rate for Payer: Aetna Commercial |
$1,678.48
|
| Rate for Payer: Aetna Medicare Advantage |
$1,678.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,426.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,426.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,118.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,426.71
|
| Rate for Payer: Cigna Commercial |
$2,797.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,353.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.24
|
|