|
NAIL IM 12mmDIx20cm 2240-12-20
|
Facility
|
IP
|
$5,106.00
|
|
| Hospital Charge Code |
270635476
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$765.90 |
| Max. Negotiated Rate |
$1,235.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,021.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,235.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.90
|
|
|
NAIL IM 12mmDIx20cm 2240-12-20
|
Facility
|
OP
|
$5,106.00
|
|
| Hospital Charge Code |
270635476
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$765.90 |
| Max. Negotiated Rate |
$2,553.00 |
| Rate for Payer: Aetna Commercial |
$1,531.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1,531.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,302.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,302.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,021.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,302.03
|
| Rate for Payer: Cigna Commercial |
$2,553.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,235.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.90
|
|
|
NAIL IM 12mmDIx22cm 2240-12-22
|
Facility
|
IP
|
$5,106.00
|
|
| Hospital Charge Code |
270635477
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$765.90 |
| Max. Negotiated Rate |
$1,235.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,021.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,235.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.90
|
|
|
NAIL IM 12mmDIx22cm 2240-12-22
|
Facility
|
OP
|
$5,106.00
|
|
| Hospital Charge Code |
270635477
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$765.90 |
| Max. Negotiated Rate |
$2,553.00 |
| Rate for Payer: Aetna Commercial |
$1,531.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1,531.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,302.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,302.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,021.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,302.03
|
| Rate for Payer: Cigna Commercial |
$2,553.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,235.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.90
|
|
|
NAIL IM HIP RT 11X180MM 125D
|
Facility
|
IP
|
$6,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270650498
|
|
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 IM HIP RT 11X180MM 125D
|
Facility
|
OP
|
$6,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270650498
|
|
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 IM R-F 11mm 2240-11-36
|
Facility
|
IP
|
$5,620.65
|
|
| Hospital Charge Code |
270639156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$843.10 |
| Max. Negotiated Rate |
$1,360.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,124.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,360.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$843.10
|
|
|
NAIL IM R-F 11mm 2240-11-36
|
Facility
|
OP
|
$5,620.65
|
|
| Hospital Charge Code |
270639156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$843.10 |
| Max. Negotiated Rate |
$2,810.32 |
| Rate for Payer: Aetna Commercial |
$1,686.19
|
| Rate for Payer: Aetna Medicare Advantage |
$1,686.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,433.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,433.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,124.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,433.27
|
| Rate for Payer: Cigna Commercial |
$2,810.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,360.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$843.10
|
|
|
NAIL IM R-F M/DN 14dia 20cm
|
Facility
|
IP
|
$5,147.10
|
|
| Hospital Charge Code |
270637423
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$772.07 |
| Max. Negotiated Rate |
$1,245.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,029.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,245.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$772.07
|
|
|
NAIL IM R-F M/DN 14dia 20cm
|
Facility
|
OP
|
$5,147.10
|
|
| Hospital Charge Code |
270637423
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$772.07 |
| Max. Negotiated Rate |
$2,573.55 |
| Rate for Payer: Aetna Commercial |
$1,544.13
|
| Rate for Payer: Aetna Medicare Advantage |
$1,544.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,312.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,312.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,029.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,312.51
|
| Rate for Payer: Cigna Commercial |
$2,573.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,245.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$772.07
|
|
|
NAIL INSERT SLEEVE
|
Facility
|
OP
|
$1,081.30
|
|
| Hospital Charge Code |
270703688
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.57 |
| Max. Negotiated Rate |
$540.65 |
| Rate for Payer: Aetna Commercial |
$324.39
|
| Rate for Payer: Aetna Medicare Advantage |
$324.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$275.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$275.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$275.73
|
| Rate for Payer: Cigna Commercial |
$540.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$140.57
|
| Rate for Payer: Oxford Commercial |
$540.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$540.65
|
|
|
NAIL INSERT SLEEVE
|
Facility
|
IP
|
$1,081.30
|
|
| Hospital Charge Code |
270703688
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.19 |
| Max. Negotiated Rate |
$162.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.19
|
|
|
NAIL KIT LG R1.5 RT 10x360x125
|
Facility
|
OP
|
$13,061.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,959.16 |
| Max. Negotiated Rate |
$6,530.55 |
| Rate for Payer: Aetna Commercial |
$3,918.33
|
| Rate for Payer: Aetna Medicare Advantage |
$3,918.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,330.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,330.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,612.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,330.58
|
| Rate for Payer: Cigna Commercial |
$6,530.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,160.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,959.16
|
|
|
NAIL KIT LG R1.5 RT 10x360x125
|
Facility
|
IP
|
$13,061.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,959.16 |
| Max. Negotiated Rate |
$3,160.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,612.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,160.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,959.16
|
|
|
NAIL KIT LONG R1.5 LF 10x340MM
|
Facility
|
IP
|
$18,460.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,769.00 |
| Max. Negotiated Rate |
$4,467.32 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,692.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,467.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,769.00
|
|
|
NAIL KIT LONG R1.5 LF 10x340MM
|
Facility
|
OP
|
$18,460.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,769.00 |
| Max. Negotiated Rate |
$9,230.00 |
| Rate for Payer: Aetna Commercial |
$5,538.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,538.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,707.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,707.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,692.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,707.30
|
| Rate for Payer: Cigna Commercial |
$9,230.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,467.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,769.00
|
|
|
NAIL KIT R1.5 10X340MMX130
|
Facility
|
OP
|
$18,460.00
|
|
| Hospital Charge Code |
270671000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,769.00 |
| Max. Negotiated Rate |
$9,230.00 |
| Rate for Payer: Aetna Commercial |
$5,538.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,538.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,707.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,707.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,692.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,707.30
|
| Rate for Payer: Cigna Commercial |
$9,230.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,467.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,769.00
|
|
|
NAIL KIT R1.5 10X340MMX130
|
Facility
|
IP
|
$18,460.00
|
|
| Hospital Charge Code |
270671000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,769.00 |
| Max. Negotiated Rate |
$4,467.32 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,692.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,467.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,769.00
|
|
|
NAIL-LCKG. ANKLE 10X180MM
|
Facility
|
OP
|
$3,808.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$571.25 |
| Max. Negotiated Rate |
$1,904.17 |
| Rate for Payer: Aetna Commercial |
$1,142.51
|
| Rate for Payer: Aetna Medicare Advantage |
$1,142.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$971.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$971.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$761.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$971.13
|
| Rate for Payer: Cigna Commercial |
$1,904.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$921.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$571.25
|
|
|
NAIL-LCKG. ANKLE 10X180MM
|
Facility
|
IP
|
$3,808.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$571.25 |
| Max. Negotiated Rate |
$921.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$761.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$921.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$571.25
|
|
|
NAIL LEFT GAMA 3 10X380MM
|
Facility
|
IP
|
$17,580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,637.00 |
| Max. Negotiated Rate |
$4,254.36 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,516.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,254.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,637.00
|
|
|
NAIL LEFT GAMA 3 10X380MM
|
Facility
|
OP
|
$17,580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,637.00 |
| Max. Negotiated Rate |
$8,790.00 |
| Rate for Payer: Aetna Commercial |
$5,274.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,274.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,482.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,482.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,516.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,482.90
|
| Rate for Payer: Cigna Commercial |
$8,790.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,254.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,637.00
|
|
|
NAIL LEFT GAMA 3 10X400MM
|
Facility
|
OP
|
$17,575.00
|
|
| Hospital Charge Code |
270664110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,636.25 |
| Max. Negotiated Rate |
$8,787.50 |
| Rate for Payer: Aetna Commercial |
$5,272.50
|
| Rate for Payer: Aetna Medicare Advantage |
$5,272.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,481.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,481.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,515.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,481.62
|
| Rate for Payer: Cigna Commercial |
$8,787.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,253.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,636.25
|
|
|
NAIL LEFT GAMA 3 10X400MM
|
Facility
|
IP
|
$17,575.00
|
|
| Hospital Charge Code |
270664110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,636.25 |
| Max. Negotiated Rate |
$4,253.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,515.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,253.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,636.25
|
|
|
NAIL LOCKING ANKLE
|
Facility
|
OP
|
$14,820.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,223.00 |
| Max. Negotiated Rate |
$7,410.00 |
| Rate for Payer: Aetna Commercial |
$4,446.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,446.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,779.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,779.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,964.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,779.10
|
| Rate for Payer: Cigna Commercial |
$7,410.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,586.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,223.00
|
|