|
NAIL FEMUR TFNA TI 11X235MM RT
|
Facility
|
OP
|
$20,995.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,149.25 |
| Max. Negotiated Rate |
$10,497.50 |
| Rate for Payer: Aetna Commercial |
$6,298.50
|
| Rate for Payer: Aetna Medicare Advantage |
$6,298.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,353.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,353.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,199.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,353.73
|
| Rate for Payer: Cigna Commercial |
$10,497.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,080.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,149.25
|
|
|
NAIL FEXIBLE 2.0 X 300MM
|
Facility
|
IP
|
$1,900.00
|
|
| Hospital Charge Code |
270667218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$459.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$285.00
|
|
|
NAIL FEXIBLE 2.0 X 300MM
|
Facility
|
OP
|
$1,900.00
|
|
| Hospital Charge Code |
270667218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$950.00 |
| Rate for Payer: Aetna Commercial |
$570.00
|
| Rate for Payer: Aetna Medicare Advantage |
$570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$484.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$484.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$484.50
|
| Rate for Payer: Cigna Commercial |
$950.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$459.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$285.00
|
|
|
NAIL FIB REM LG CANN RT 3.2MM
|
Facility
|
IP
|
$812.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.88 |
| Max. Negotiated Rate |
$196.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.88
|
|
|
NAIL FIB REM LG CANN RT 3.2MM
|
Facility
|
OP
|
$812.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.88 |
| Max. Negotiated Rate |
$406.25 |
| Rate for Payer: Aetna Commercial |
$243.75
|
| Rate for Payer: Aetna Medicare Advantage |
$243.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.19
|
| Rate for Payer: Cigna Commercial |
$406.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.88
|
|
|
NAIL FIBULA 3.0X130MM RT
|
Facility
|
IP
|
$14,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,246.25 |
| Max. Negotiated Rate |
$3,623.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,995.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,623.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,246.25
|
|
|
NAIL FIBULA 3.0X130MM RT
|
Facility
|
OP
|
$14,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,246.25 |
| Max. Negotiated Rate |
$7,487.50 |
| Rate for Payer: Aetna Commercial |
$4,492.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,492.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,818.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,818.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,995.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,818.62
|
| Rate for Payer: Cigna Commercial |
$7,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,623.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,246.25
|
|
|
NAIL FIBULA 3.0X180MM RT
|
Facility
|
IP
|
$16,224.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,433.60 |
| Max. Negotiated Rate |
$3,926.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,244.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,926.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,433.60
|
|
|
NAIL FIBULA 3.0X180MM RT
|
Facility
|
OP
|
$16,224.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,433.60 |
| Max. Negotiated Rate |
$8,112.00 |
| Rate for Payer: Aetna Commercial |
$4,867.20
|
| Rate for Payer: Aetna Medicare Advantage |
$4,867.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,137.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,137.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,244.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,137.12
|
| Rate for Payer: Cigna Commercial |
$8,112.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,926.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,433.60
|
|
|
NAIL FIBULA LEFT 3.0X130MM
|
Facility
|
IP
|
$14,975.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270694818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,246.25 |
| Max. Negotiated Rate |
$3,623.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,995.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,623.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,246.25
|
|
|
NAIL FIBULA LEFT 3.0X130MM
|
Facility
|
OP
|
$14,975.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270694818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,246.25 |
| Max. Negotiated Rate |
$7,487.50 |
| Rate for Payer: Aetna Commercial |
$4,492.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,492.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,818.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,818.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,995.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,818.62
|
| Rate for Payer: Cigna Commercial |
$7,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,623.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,246.25
|
|
|
NAIL FIXAT TRIM SYST 2.4X30MM
|
Facility
|
OP
|
$11,685.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694442
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,752.75 |
| Max. Negotiated Rate |
$5,842.50 |
| Rate for Payer: Aetna Commercial |
$3,505.50
|
| Rate for Payer: Aetna Medicare Advantage |
$3,505.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,979.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,979.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,337.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,979.68
|
| Rate for Payer: Cigna Commercial |
$5,842.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,827.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,752.75
|
|
|
NAIL FIXAT TRIM SYST 2.4X30MM
|
Facility
|
IP
|
$11,685.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694442
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,752.75 |
| Max. Negotiated Rate |
$2,827.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,337.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,827.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,752.75
|
|
|
NAIL FLEX 3.5MM WIN PED 240703
|
Facility
|
OP
|
$900.00
|
|
| Hospital Charge Code |
270640895
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$270.00
|
| Rate for Payer: Aetna Medicare Advantage |
$270.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$229.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$229.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$229.50
|
| Rate for Payer: Cigna Commercial |
$450.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$217.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.00
|
|
|
NAIL FLEX 3.5MM WIN PED 240703
|
Facility
|
IP
|
$900.00
|
|
| Hospital Charge Code |
270640895
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$217.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$217.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.00
|
|
|
NAIL FMRL 9x80 TRCH RT14443238
|
Facility
|
IP
|
$11,955.00
|
|
| Hospital Charge Code |
270647828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,793.25 |
| Max. Negotiated Rate |
$2,893.11 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,391.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,893.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,793.25
|
|
|
NAIL FMRL 9x80 TRCH RT14443238
|
Facility
|
OP
|
$11,955.00
|
|
| Hospital Charge Code |
270647828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,793.25 |
| Max. Negotiated Rate |
$5,977.50 |
| Rate for Payer: Aetna Commercial |
$3,586.50
|
| Rate for Payer: Aetna Medicare Advantage |
$3,586.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,048.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,048.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,391.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,048.53
|
| Rate for Payer: Cigna Commercial |
$5,977.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,893.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,793.25
|
|
|
NAIL FRACTURE HIP 125 DEG 9X18
|
Facility
|
IP
|
$6,750.00
|
|
|
Service Code
|
HCPCS C1716
|
| Hospital Charge Code |
270698453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,012.50 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,633.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.50
|
|
|
NAIL FRACTURE HIP 125 DEG 9X18
|
Facility
|
OP
|
$6,750.00
|
|
|
Service Code
|
HCPCS C1716
|
| Hospital Charge Code |
270698453
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,012.50 |
| Max. Negotiated Rate |
$2,025.00 |
| Rate for Payer: Aetna Commercial |
$2,025.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,025.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,721.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,721.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,721.25
|
| Rate for Payer: Cigna Commercial |
$1,197.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,633.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.50
|
|
|
NAIL GAMMA 11X380MM 125D LT
|
Facility
|
IP
|
$17,730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698912
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,659.50 |
| Max. Negotiated Rate |
$4,290.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,546.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,290.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,659.50
|
|
|
NAIL GAMMA 11X380MM 125D LT
|
Facility
|
OP
|
$17,730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698912
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,659.50 |
| Max. Negotiated Rate |
$8,865.00 |
| Rate for Payer: Aetna Commercial |
$5,319.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,319.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,521.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,521.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,546.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,521.15
|
| Rate for Payer: Cigna Commercial |
$8,865.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,290.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,659.50
|
|
|
NAIL GAMMA LONG LT11X360MM125D
|
Facility
|
OP
|
$17,730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,659.50 |
| Max. Negotiated Rate |
$8,865.00 |
| Rate for Payer: Aetna Commercial |
$5,319.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,319.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,521.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,521.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,546.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,521.15
|
| Rate for Payer: Cigna Commercial |
$8,865.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,290.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,659.50
|
|
|
NAIL GAMMA LONG LT11X360MM125D
|
Facility
|
IP
|
$17,730.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,659.50 |
| Max. Negotiated Rate |
$4,290.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,546.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,290.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,659.50
|
|
|
NAIL HINDFOOT 10X180MM TI RT
|
Facility
|
IP
|
$5,786.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$868.01 |
| Max. Negotiated Rate |
$1,400.39 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,157.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,400.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$868.01
|
|
|
NAIL HINDFOOT 10X180MM TI RT
|
Facility
|
OP
|
$5,786.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$868.01 |
| Max. Negotiated Rate |
$2,893.38 |
| Rate for Payer: Aetna Commercial |
$1,736.03
|
| Rate for Payer: Aetna Medicare Advantage |
$1,736.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,475.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,475.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,157.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,475.62
|
| Rate for Payer: Cigna Commercial |
$2,893.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,400.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$868.01
|
|