|
NAIL HIP AFFIXUS 125 9MM 180MM
|
Facility
|
OP
|
$6,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,038.75 |
| Max. Negotiated Rate |
$3,462.50 |
| Rate for Payer: Aetna Commercial |
$2,077.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,077.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,765.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,765.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,385.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,765.88
|
| Rate for Payer: Cigna Commercial |
$3,462.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,675.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,038.75
|
|
|
NAIL HIP AFFIXUS 125 9MM 180MM
|
Facility
|
IP
|
$6,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,038.75 |
| Max. Negotiated Rate |
$1,675.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,385.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,675.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,038.75
|
|
|
NAIL HIP FRACT 130DEG 11x180mm
|
Facility
|
OP
|
$6,650.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$997.50 |
| Max. Negotiated Rate |
$3,325.00 |
| Rate for Payer: Aetna Commercial |
$1,995.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,995.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,695.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,695.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,330.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,695.75
|
| Rate for Payer: Cigna Commercial |
$3,325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,609.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$997.50
|
|
|
NAIL HIP FRACT 130DEG 11x180mm
|
Facility
|
IP
|
$6,650.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$997.50 |
| Max. Negotiated Rate |
$1,609.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,609.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$997.50
|
|
|
NAIL HIP FRACTURE 130 9X 80MM
|
Facility
|
IP
|
$6,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,038.75 |
| Max. Negotiated Rate |
$1,675.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,385.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,675.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,038.75
|
|
|
NAIL HIP FRACTURE 130 9X 80MM
|
Facility
|
OP
|
$6,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,038.75 |
| Max. Negotiated Rate |
$3,462.50 |
| Rate for Payer: Aetna Commercial |
$2,077.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,077.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,765.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,765.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,385.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,765.88
|
| Rate for Payer: Cigna Commercial |
$3,462.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,675.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,038.75
|
|
|
NAIL HIP FX LEFT 125D11X360MM
|
Facility
|
OP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,473.75 |
| Max. Negotiated Rate |
$4,912.50 |
| Rate for Payer: Aetna Commercial |
$2,947.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,947.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,505.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,505.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,965.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,505.38
|
| Rate for Payer: Cigna Commercial |
$4,912.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,377.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
|
|
NAIL HIP FX LEFT 125D11X360MM
|
Facility
|
IP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,473.75 |
| Max. Negotiated Rate |
$2,377.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,965.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,377.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
|
|
NAIL HMD GAMMA 11 340 33706025
|
Facility
|
OP
|
$4,193.65
|
|
| Hospital Charge Code |
270621775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$2,096.82 |
| Rate for Payer: Aetna Commercial |
$1,258.10
|
| Rate for Payer: Aetna Medicare Advantage |
$1,258.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,069.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,069.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$838.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,069.38
|
| Rate for Payer: Cigna Commercial |
$2,096.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,014.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$629.05
|
|
|
NAIL HMD GAMMA 11 340 33706025
|
Facility
|
IP
|
$4,193.65
|
|
| Hospital Charge Code |
270621775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$1,014.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$838.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,014.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$629.05
|
|
|
NAIL HMD GAMMA 11 360 33706125
|
Facility
|
IP
|
$4,193.65
|
|
| Hospital Charge Code |
270620982
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$1,014.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$838.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,014.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$629.05
|
|
|
NAIL HMD GAMMA 11 360 33706125
|
Facility
|
OP
|
$4,193.65
|
|
| Hospital Charge Code |
270620982
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$2,096.82 |
| Rate for Payer: Aetna Commercial |
$1,258.10
|
| Rate for Payer: Aetna Medicare Advantage |
$1,258.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,069.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,069.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$838.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,069.38
|
| Rate for Payer: Cigna Commercial |
$2,096.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,014.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$629.05
|
|
|
NAIL HMD GAMMA 11/360 33707125
|
Facility
|
OP
|
$3,992.00
|
|
| Hospital Charge Code |
270617157
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$598.80 |
| Max. Negotiated Rate |
$1,996.00 |
| Rate for Payer: Aetna Commercial |
$1,197.60
|
| Rate for Payer: Aetna Medicare Advantage |
$1,197.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,017.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,017.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$798.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,017.96
|
| Rate for Payer: Cigna Commercial |
$1,996.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$966.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$598.80
|
|
|
NAIL HMD GAMMA 11/360 33707125
|
Facility
|
IP
|
$3,992.00
|
|
| Hospital Charge Code |
270617157
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$598.80 |
| Max. Negotiated Rate |
$966.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$798.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$966.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$598.80
|
|
|
NAIL HMD GAMMA 11/380 33706225
|
Facility
|
OP
|
$4,193.65
|
|
| Hospital Charge Code |
270621062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$2,096.82 |
| Rate for Payer: Aetna Commercial |
$1,258.10
|
| Rate for Payer: Aetna Medicare Advantage |
$1,258.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,069.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,069.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$838.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,069.38
|
| Rate for Payer: Cigna Commercial |
$2,096.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,014.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$629.05
|
|
|
NAIL HMD GAMMA 11/380 33706225
|
Facility
|
IP
|
$4,193.65
|
|
| Hospital Charge Code |
270621062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$629.05 |
| Max. Negotiated Rate |
$1,014.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$838.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,014.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$629.05
|
|
|
NAIL HMD GAMMA 11/390 33707225
|
Facility
|
IP
|
$3,802.45
|
|
| Hospital Charge Code |
270613072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$570.37 |
| Max. Negotiated Rate |
$920.19 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$760.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$920.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$570.37
|
|
|
NAIL HMD GAMMA 11/390 33707225
|
Facility
|
OP
|
$3,802.45
|
|
| Hospital Charge Code |
270613072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$570.37 |
| Max. Negotiated Rate |
$1,901.22 |
| Rate for Payer: Aetna Commercial |
$1,140.73
|
| Rate for Payer: Aetna Medicare Advantage |
$1,140.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$969.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$969.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$760.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$969.62
|
| Rate for Payer: Cigna Commercial |
$1,901.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$920.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$570.37
|
|
|
NAIL HUMERAL 7MM X 220 MM
|
Facility
|
OP
|
$7,605.00
|
|
| Hospital Charge Code |
270667567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.75 |
| Max. Negotiated Rate |
$3,802.50 |
| Rate for Payer: Aetna Commercial |
$2,281.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,281.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,939.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,939.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,521.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,939.28
|
| Rate for Payer: Cigna Commercial |
$3,802.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,840.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,140.75
|
|
|
NAIL HUMERAL 7MM X 220 MM
|
Facility
|
IP
|
$7,605.00
|
|
| Hospital Charge Code |
270667567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.75 |
| Max. Negotiated Rate |
$1,840.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,521.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,840.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,140.75
|
|
|
NAIL HUMERAL 7MM X 230 MM
|
Facility
|
OP
|
$7,605.00
|
|
| Hospital Charge Code |
270667566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.75 |
| Max. Negotiated Rate |
$3,802.50 |
| Rate for Payer: Aetna Commercial |
$2,281.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,281.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,939.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,939.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,521.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,939.28
|
| Rate for Payer: Cigna Commercial |
$3,802.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,840.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,140.75
|
|
|
NAIL HUMERAL 7MM X 230 MM
|
Facility
|
IP
|
$7,605.00
|
|
| Hospital Charge Code |
270667566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,140.75 |
| Max. Negotiated Rate |
$1,840.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,521.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,840.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,140.75
|
|
|
NAIL HUMERAL 7TI MULTIOC 240-S
|
Facility
|
IP
|
$11,046.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694990
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,657.01 |
| Max. Negotiated Rate |
$2,673.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,209.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,673.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,657.01
|
|
|
NAIL HUMERAL 7TI MULTIOC 240-S
|
Facility
|
OP
|
$11,046.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694990
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,657.01 |
| Max. Negotiated Rate |
$5,523.38 |
| Rate for Payer: Aetna Commercial |
$3,314.03
|
| Rate for Payer: Aetna Medicare Advantage |
$3,314.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,816.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,816.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,209.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,816.92
|
| Rate for Payer: Cigna Commercial |
$5,523.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,673.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,657.01
|
|
|
NAIL HUMERAL 7 X 270MM
|
Facility
|
IP
|
$9,120.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,368.05 |
| Max. Negotiated Rate |
$2,207.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,824.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,207.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,368.05
|
|