|
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
|
|
|
NAIL HUMERAL 8 24 340624
|
Facility
|
OP
|
$5,360.00
|
|
| Hospital Charge Code |
270612315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$804.00 |
| Max. Negotiated Rate |
$2,680.00 |
| Rate for Payer: Aetna Commercial |
$1,608.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,608.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,366.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,366.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,072.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,366.80
|
| Rate for Payer: Cigna Commercial |
$2,680.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,297.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$804.00
|
|
|
NAIL HUMERAL 8 24 340624
|
Facility
|
IP
|
$5,360.00
|
|
| Hospital Charge Code |
270612315
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$804.00 |
| Max. Negotiated Rate |
$1,297.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,072.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,297.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$804.00
|
|
|
NAIL HUMERAL 8.5 MM LEFT 225 M
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$235.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
NAIL HUMERAL 8.5 MM LEFT 225 M
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
NAIL HUMERAL 8mm X 28cm 340628
|
Facility
|
IP
|
$6,680.00
|
|
| Hospital Charge Code |
270641406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.00 |
| Max. Negotiated Rate |
$1,616.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,336.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,616.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,002.00
|
|
|
NAIL HUMERAL 8mm X 28cm 340628
|
Facility
|
OP
|
$6,680.00
|
|
| Hospital Charge Code |
270641406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.00 |
| Max. Negotiated Rate |
$3,340.00 |
| Rate for Payer: Aetna Commercial |
$2,004.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,004.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,703.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,703.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,703.40
|
| Rate for Payer: Cigna Commercial |
$3,340.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,616.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,002.00
|
|
|
NAIL HUMERAL 9.5MMx160MM RIGHT
|
Facility
|
IP
|
$11,000.00
|
|
| Hospital Charge Code |
270650152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,650.00 |
| Max. Negotiated Rate |
$2,662.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,662.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,650.00
|
|
|
NAIL HUMERAL 9.5MMx160MM RIGHT
|
Facility
|
OP
|
$11,000.00
|
|
| Hospital Charge Code |
270650152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,650.00 |
| Max. Negotiated Rate |
$5,500.00 |
| Rate for Payer: Aetna Commercial |
$3,300.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,805.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,805.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,805.00
|
| Rate for Payer: Cigna Commercial |
$5,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,662.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,650.00
|
|
|
NAIL HUMERAL 9mm X 24cm 340724
|
Facility
|
IP
|
$5,360.00
|
|
| Hospital Charge Code |
270637677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$804.00 |
| Max. Negotiated Rate |
$1,297.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,072.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,297.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$804.00
|
|
|
NAIL HUMERAL 9mm X 24cm 340724
|
Facility
|
OP
|
$5,360.00
|
|
| Hospital Charge Code |
270637677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$804.00 |
| Max. Negotiated Rate |
$2,680.00 |
| Rate for Payer: Aetna Commercial |
$1,608.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,608.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,366.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,366.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,072.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,366.80
|
| Rate for Payer: Cigna Commercial |
$2,680.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,297.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$804.00
|
|
|
NAIL HUMERAL PROX 8 .0
|
Facility
|
IP
|
$8,003.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687425
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,200.46 |
| Max. Negotiated Rate |
$1,936.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,600.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,936.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,200.46
|
|
|
NAIL HUMERAL PROX 8 .0
|
Facility
|
OP
|
$8,003.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687425
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,200.46 |
| Max. Negotiated Rate |
$4,001.55 |
| Rate for Payer: Aetna Commercial |
$2,400.93
|
| Rate for Payer: Aetna Medicare Advantage |
$2,400.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,040.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,040.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,600.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,040.79
|
| Rate for Payer: Cigna Commercial |
$4,001.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,936.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,200.46
|
|
|
NAIL HUMERAL PROX RT 9.5x180MM
|
Facility
|
IP
|
$8,003.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270651079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,200.46 |
| Max. Negotiated Rate |
$1,936.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,600.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,936.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,200.46
|
|
|
NAIL HUMERAL PROX RT 9.5x180MM
|
Facility
|
OP
|
$8,003.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270651079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,200.46 |
| Max. Negotiated Rate |
$4,001.55 |
| Rate for Payer: Aetna Commercial |
$2,400.93
|
| Rate for Payer: Aetna Medicare Advantage |
$2,400.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,040.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,040.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,600.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,040.79
|
| Rate for Payer: Cigna Commercial |
$4,001.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,936.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,200.46
|
|
|
NAIL HUMERAL RIGHT TI 8.5 MM 2
|
Facility
|
OP
|
$9,120.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,368.03 |
| Max. Negotiated Rate |
$4,560.10 |
| Rate for Payer: Aetna Commercial |
$2,736.06
|
| Rate for Payer: Aetna Medicare Advantage |
$2,736.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,325.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,325.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,824.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,325.65
|
| Rate for Payer: Cigna Commercial |
$4,560.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,207.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,368.03
|
|
|
NAIL HUMERAL RIGHT TI 8.5 MM 2
|
Facility
|
IP
|
$9,120.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,368.03 |
| Max. Negotiated Rate |
$2,207.09 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,824.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,207.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,368.03
|
|
|
NAIL HUMERAL TI 7X180MM RT
|
Facility
|
IP
|
$27,020.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700668
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,053.00 |
| Max. Negotiated Rate |
$6,538.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,404.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,538.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,053.00
|
|
|
NAIL HUMERAL TI 7X180MM RT
|
Facility
|
OP
|
$27,020.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700668
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,053.00 |
| Max. Negotiated Rate |
$13,510.00 |
| Rate for Payer: Aetna Commercial |
$8,106.00
|
| Rate for Payer: Aetna Medicare Advantage |
$8,106.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,890.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,890.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,404.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,890.10
|
| Rate for Payer: Cigna Commercial |
$13,510.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,538.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,053.00
|
|
|
NAIL HUMERL I/M 8x24 225424008
|
Facility
|
IP
|
$4,935.15
|
|
| Hospital Charge Code |
270634031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$740.27 |
| Max. Negotiated Rate |
$1,194.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$987.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,194.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$740.27
|
|
|
NAIL HUMERL I/M 8x24 225424008
|
Facility
|
OP
|
$4,935.15
|
|
| Hospital Charge Code |
270634031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$740.27 |
| Max. Negotiated Rate |
$2,467.57 |
| Rate for Payer: Aetna Commercial |
$1,480.55
|
| Rate for Payer: Aetna Medicare Advantage |
$1,480.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,258.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,258.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$987.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,258.46
|
| Rate for Payer: Cigna Commercial |
$2,467.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,194.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$740.27
|
|
|
NAIL HUMERUS UNIVERSAL 9X240MM
|
Facility
|
IP
|
$6,525.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.75 |
| Max. Negotiated Rate |
$1,579.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,305.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,579.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$978.75
|
|
|
NAIL HUMERUS UNIVERSAL 9X240MM
|
Facility
|
OP
|
$6,525.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$978.75 |
| Max. Negotiated Rate |
$3,262.50 |
| Rate for Payer: Aetna Commercial |
$1,957.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1,957.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,663.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,663.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,305.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,663.88
|
| Rate for Payer: Cigna Commercial |
$3,262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,579.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$978.75
|
|
|
NAIL HUM I/M 10mx24c 225424010
|
Facility
|
OP
|
$4,791.45
|
|
| Hospital Charge Code |
270630548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$718.72 |
| Max. Negotiated Rate |
$2,395.72 |
| Rate for Payer: Aetna Commercial |
$1,437.43
|
| Rate for Payer: Aetna Medicare Advantage |
$1,437.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,221.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,221.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$958.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,221.82
|
| Rate for Payer: Cigna Commercial |
$2,395.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,159.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$718.72
|
|
|
NAIL HUM I/M 10mx24c 225424010
|
Facility
|
IP
|
$4,791.45
|
|
| Hospital Charge Code |
270630548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$718.72 |
| Max. Negotiated Rate |
$1,159.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$958.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,159.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$718.72
|
|