|
NAIL SUPRACONDYLAR 11x300MM
|
Facility
|
OP
|
$15,885.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270671999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,382.75 |
| Max. Negotiated Rate |
$7,942.50 |
| Rate for Payer: Aetna Commercial |
$4,765.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,765.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,050.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,050.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,050.68
|
| Rate for Payer: Cigna Commercial |
$7,942.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,844.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,382.75
|
|
|
NAIL SUPRACONDYLAR 9X360MM
|
Facility
|
IP
|
$15,130.00
|
|
| Hospital Charge Code |
270668729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,269.50 |
| Max. Negotiated Rate |
$3,661.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,026.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,661.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,269.50
|
|
|
NAIL SUPRACONDYLAR 9X360MM
|
Facility
|
OP
|
$15,130.00
|
|
| Hospital Charge Code |
270668729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,269.50 |
| Max. Negotiated Rate |
$7,565.00 |
| Rate for Payer: Aetna Commercial |
$4,539.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,539.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,858.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,858.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,026.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,858.15
|
| Rate for Payer: Cigna Commercial |
$7,565.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,661.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,269.50
|
|
|
NAIL SYN FEM 10 360MM 465.36S
|
Facility
|
OP
|
$3,371.25
|
|
| Hospital Charge Code |
270611965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$505.69 |
| Max. Negotiated Rate |
$1,685.62 |
| Rate for Payer: Aetna Commercial |
$1,011.38
|
| Rate for Payer: Aetna Medicare Advantage |
$1,011.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$859.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$859.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$674.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$859.67
|
| Rate for Payer: Cigna Commercial |
$1,685.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$815.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$505.69
|
|
|
NAIL SYN FEM 10 360MM 465.36S
|
Facility
|
IP
|
$3,371.25
|
|
| Hospital Charge Code |
270611965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$505.69 |
| Max. Negotiated Rate |
$815.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$674.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$815.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$505.69
|
|
|
NAIL SYN FEM 11 200MM 450.802S
|
Facility
|
OP
|
$5,465.65
|
|
| Hospital Charge Code |
270627045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$819.85 |
| Max. Negotiated Rate |
$2,732.82 |
| Rate for Payer: Aetna Commercial |
$1,639.69
|
| Rate for Payer: Aetna Medicare Advantage |
$1,639.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,393.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,393.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,093.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,393.74
|
| Rate for Payer: Cigna Commercial |
$2,732.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,322.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$819.85
|
|
|
NAIL SYN FEM 11 200MM 450.802S
|
Facility
|
IP
|
$5,465.65
|
|
| Hospital Charge Code |
270627045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$819.85 |
| Max. Negotiated Rate |
$1,322.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,093.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,322.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$819.85
|
|
|
NAIL SYN TIB 9 345MM 479.34S
|
Facility
|
IP
|
$4,713.65
|
|
| Hospital Charge Code |
270612757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$707.05 |
| Max. Negotiated Rate |
$1,140.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$942.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,140.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$707.05
|
|
|
NAIL SYN TIB 9 345MM 479.34S
|
Facility
|
OP
|
$4,713.65
|
|
| Hospital Charge Code |
270612757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$707.05 |
| Max. Negotiated Rate |
$2,356.82 |
| Rate for Payer: Aetna Commercial |
$1,414.10
|
| Rate for Payer: Aetna Medicare Advantage |
$1,414.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,201.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,201.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$942.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,201.98
|
| Rate for Payer: Cigna Commercial |
$2,356.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,140.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$707.05
|
|
|
NAIL SYN TT 3 440 475.930S
|
Facility
|
IP
|
$980.00
|
|
| Hospital Charge Code |
270627124
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$237.16 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
NAIL SYN TT 3 440 475.930S
|
Facility
|
OP
|
$980.00
|
|
| Hospital Charge Code |
270627124
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: Aetna Commercial |
$294.00
|
| Rate for Payer: Aetna Medicare Advantage |
$294.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$249.90
|
| Rate for Payer: Cigna Commercial |
$490.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
NAIL T2 ANKLE 10X200MM
|
Facility
|
OP
|
$30,350.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,552.50 |
| Max. Negotiated Rate |
$15,175.00 |
| Rate for Payer: Aetna Commercial |
$9,105.00
|
| Rate for Payer: Aetna Medicare Advantage |
$9,105.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,739.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,739.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,070.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,739.25
|
| Rate for Payer: Cigna Commercial |
$15,175.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,344.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,552.50
|
|
|
NAIL T2 ANKLE 10X200MM
|
Facility
|
IP
|
$30,350.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,552.50 |
| Max. Negotiated Rate |
$7,344.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,070.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,344.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,552.50
|
|
|
NAIL TBIAL
|
Facility
|
OP
|
$6,180.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685518
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$927.00 |
| Max. Negotiated Rate |
$3,090.00 |
| Rate for Payer: Aetna Commercial |
$1,854.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,854.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,575.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,575.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,236.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,575.90
|
| Rate for Payer: Cigna Commercial |
$3,090.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,495.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$927.00
|
|
|
NAIL TBIAL
|
Facility
|
IP
|
$6,180.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685518
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$927.00 |
| Max. Negotiated Rate |
$1,495.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,236.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,495.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$927.00
|
|
|
NAIL TFN 10X360MM 130 DEG
|
Facility
|
IP
|
$7,812.00
|
|
| Hospital Charge Code |
270670732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,171.80 |
| Max. Negotiated Rate |
$1,890.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,562.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,890.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,171.80
|
|
|
NAIL TFN 10X360MM 130 DEG
|
Facility
|
OP
|
$7,812.00
|
|
| Hospital Charge Code |
270670732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,171.80 |
| Max. Negotiated Rate |
$3,906.00 |
| Rate for Payer: Aetna Commercial |
$2,343.60
|
| Rate for Payer: Aetna Medicare Advantage |
$2,343.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,992.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,992.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,562.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,992.06
|
| Rate for Payer: Cigna Commercial |
$3,906.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,890.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,171.80
|
|
|
NAIL TFN 11mmx130DEG TI CANN L
|
Facility
|
IP
|
$7,919.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,187.95 |
| Max. Negotiated Rate |
$1,916.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,583.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,916.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,187.95
|
|
|
NAIL TFN 11mmx130DEG TI CANN L
|
Facility
|
OP
|
$7,919.65
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679814
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,187.95 |
| Max. Negotiated Rate |
$3,959.82 |
| Rate for Payer: Aetna Commercial |
$2,375.89
|
| Rate for Payer: Aetna Medicare Advantage |
$2,375.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,019.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,019.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,583.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,019.51
|
| Rate for Payer: Cigna Commercial |
$3,959.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,916.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,187.95
|
|
|
NAIL TFN 11x340MM RT 130 DEG
|
Facility
|
OP
|
$7,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270633687
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,100.25 |
| Max. Negotiated Rate |
$3,667.50 |
| Rate for Payer: Aetna Commercial |
$2,200.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,200.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,870.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,870.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,467.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,870.42
|
| Rate for Payer: Cigna Commercial |
$3,667.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,775.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,100.25
|
|
|
NAIL TFN 11x340MM RT 130 DEG
|
Facility
|
IP
|
$7,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270633687
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,100.25 |
| Max. Negotiated Rate |
$1,775.07 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,467.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,775.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,100.25
|
|
|
NAIL TFN 11X360
|
Facility
|
IP
|
$7,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,100.25 |
| Max. Negotiated Rate |
$1,775.07 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,467.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,775.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,100.25
|
|
|
NAIL TFN 11X360
|
Facility
|
OP
|
$7,335.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,100.25 |
| Max. Negotiated Rate |
$3,667.50 |
| Rate for Payer: Aetna Commercial |
$2,200.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,200.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,870.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,870.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,467.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,870.42
|
| Rate for Payer: Cigna Commercial |
$3,667.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,775.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,100.25
|
|
|
NAIL TFNA10MM130DTICANN400MMLT
|
Facility
|
OP
|
$28,700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699976
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,305.00 |
| Max. Negotiated Rate |
$14,350.00 |
| Rate for Payer: Aetna Commercial |
$8,610.00
|
| Rate for Payer: Aetna Medicare Advantage |
$8,610.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,318.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,318.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,740.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,318.50
|
| Rate for Payer: Cigna Commercial |
$14,350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,945.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,305.00
|
|
|
NAIL TFNA10MM130DTICANN400MMLT
|
Facility
|
IP
|
$28,700.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699976
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,305.00 |
| Max. Negotiated Rate |
$6,945.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,740.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,945.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,305.00
|
|