|
NAIL LOCKING ANKLE
|
Facility
|
IP
|
$14,820.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,223.00 |
| Max. Negotiated Rate |
$3,586.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,964.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,586.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,223.00
|
|
|
NAIL LOCKING TIBIAL 10.5x280mm
|
Facility
|
IP
|
$8,240.00
|
|
| Hospital Charge Code |
270665226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,236.00 |
| Max. Negotiated Rate |
$1,994.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,648.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,994.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,236.00
|
|
|
NAIL LOCKING TIBIAL 10.5x280mm
|
Facility
|
OP
|
$8,240.00
|
|
| Hospital Charge Code |
270665226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,236.00 |
| Max. Negotiated Rate |
$4,120.00 |
| Rate for Payer: Aetna Commercial |
$2,472.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,472.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,648.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,101.20
|
| Rate for Payer: Cigna Commercial |
$4,120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,994.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,236.00
|
|
|
NAIL LOCKING TIBIAL 10.5X300MM
|
Facility
|
IP
|
$8,240.00
|
|
| Hospital Charge Code |
270664093
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,236.00 |
| Max. Negotiated Rate |
$1,236.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,236.00
|
|
|
NAIL LOCKING TIBIAL 10.5X300MM
|
Facility
|
OP
|
$8,240.00
|
|
| Hospital Charge Code |
270664093
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,071.20 |
| Max. Negotiated Rate |
$4,120.00 |
| Rate for Payer: Aetna Commercial |
$2,472.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,472.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,101.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,101.20
|
| Rate for Payer: Cigna Commercial |
$4,120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,071.20
|
| Rate for Payer: Oxford Commercial |
$4,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,236.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,120.00
|
|
|
NAIL LONG
|
Facility
|
IP
|
$16,745.00
|
|
| Hospital Charge Code |
270661840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,511.75 |
| Max. Negotiated Rate |
$4,052.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,349.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,052.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,511.75
|
|
|
NAIL LONG
|
Facility
|
OP
|
$16,745.00
|
|
| Hospital Charge Code |
270661840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,511.75 |
| Max. Negotiated Rate |
$8,372.50 |
| Rate for Payer: Aetna Commercial |
$5,023.50
|
| Rate for Payer: Aetna Medicare Advantage |
$5,023.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,269.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,269.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,349.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,269.98
|
| Rate for Payer: Cigna Commercial |
$8,372.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,052.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,511.75
|
|
|
NAIL LONG KIT 10X360X125 R1.5
|
Facility
|
OP
|
$17,580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664724
|
|
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 LONG KIT 10X360X125 R1.5
|
Facility
|
IP
|
$17,580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664724
|
|
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 LONG LEFT 10 X 340 MM 125
|
Facility
|
OP
|
$17,580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656536
|
|
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 LONG LEFT 10 X 340 MM 125
|
Facility
|
OP
|
$2,370.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$1,185.00 |
| Rate for Payer: Aetna Commercial |
$711.00
|
| Rate for Payer: Aetna Medicare Advantage |
$711.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$604.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$604.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$474.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$604.35
|
| Rate for Payer: Cigna Commercial |
$1,185.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$573.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$355.50
|
|
|
NAIL LONG LEFT 10 X 340 MM 125
|
Facility
|
IP
|
$17,580.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656536
|
|
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 LONG LEFT 10 X 340 MM 125
|
Facility
|
IP
|
$2,370.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$573.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$474.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$573.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$355.50
|
|
|
Nail Long Proxi HumeralLEFT 8v
|
Facility
|
OP
|
$13,990.00
|
|
| Hospital Charge Code |
270665197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,098.50 |
| Max. Negotiated Rate |
$6,995.00 |
| Rate for Payer: Aetna Commercial |
$4,197.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,197.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,567.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,567.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,798.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,567.45
|
| Rate for Payer: Cigna Commercial |
$6,995.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,385.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,098.50
|
|
|
Nail Long Proxi HumeralLEFT 8v
|
Facility
|
IP
|
$13,990.00
|
|
| Hospital Charge Code |
270665197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,098.50 |
| Max. Negotiated Rate |
$3,385.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,798.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,385.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,098.50
|
|
|
NAIL LONG PROXIMAL HUMERAL RT
|
Facility
|
IP
|
$1,340.00
|
|
| Hospital Charge Code |
270661244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$201.00 |
| Max. Negotiated Rate |
$324.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$268.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$324.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$201.00
|
|
|
NAIL LONG PROXIMAL HUMERAL RT
|
Facility
|
OP
|
$1,340.00
|
|
| Hospital Charge Code |
270661244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$201.00 |
| Max. Negotiated Rate |
$670.00 |
| Rate for Payer: Aetna Commercial |
$402.00
|
| Rate for Payer: Aetna Medicare Advantage |
$402.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$341.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$341.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$268.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$341.70
|
| Rate for Payer: Cigna Commercial |
$670.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$324.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$201.00
|
|
|
NAIL LONG R1.5 TI RT 10X420MM
|
Facility
|
IP
|
$17,580.00
|
|
| Hospital Charge Code |
270667983
|
|
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 LONG R1.5 TI RT 10X420MM
|
Facility
|
OP
|
$17,580.00
|
|
| Hospital Charge Code |
270667983
|
|
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 LONG RIGHT 10X400MMX120
|
Facility
|
OP
|
$17,580.00
|
|
| Hospital Charge Code |
270664777
|
|
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 LONG RIGHT 10X400MMX120
|
Facility
|
IP
|
$17,580.00
|
|
| Hospital Charge Code |
270664777
|
|
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 LONG TI LEFT 10x360mm
|
Facility
|
OP
|
$18,460.00
|
|
| Hospital Charge Code |
270671131
|
|
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 LONG TI LEFT 10x360mm
|
Facility
|
IP
|
$18,460.00
|
|
| Hospital Charge Code |
270671131
|
|
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 MDN RF IM 14 X34 22401434
|
Facility
|
OP
|
$5,106.00
|
|
| Hospital Charge Code |
270635172
|
|
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 MDN RF IM 14 X34 22401434
|
Facility
|
IP
|
$5,106.00
|
|
| Hospital Charge Code |
270635172
|
|
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
|
|