|
NAIL Ti FEMORAL 12X38 36346238
|
Facility
|
IP
|
$5,505.65
|
|
| Hospital Charge Code |
270633126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$825.85 |
| Max. Negotiated Rate |
$1,332.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,101.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,332.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$825.85
|
|
|
NAIL Ti FEMORAL 12X38 36346238
|
Facility
|
OP
|
$5,505.65
|
|
| Hospital Charge Code |
270633126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$825.85 |
| Max. Negotiated Rate |
$2,752.82 |
| Rate for Payer: Aetna Commercial |
$1,651.69
|
| Rate for Payer: Aetna Medicare Advantage |
$1,651.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,403.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,403.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,101.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,403.94
|
| Rate for Payer: Cigna Commercial |
$2,752.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,332.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$825.85
|
|
|
NAIL Ti FEMORAL 9mmx360mm RT
|
Facility
|
IP
|
$9,150.00
|
|
| Hospital Charge Code |
270645683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,372.50 |
| Max. Negotiated Rate |
$2,214.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,830.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,214.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,372.50
|
|
|
NAIL Ti FEMORAL 9mmx360mm RT
|
Facility
|
OP
|
$9,150.00
|
|
| Hospital Charge Code |
270645683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,372.50 |
| Max. Negotiated Rate |
$4,575.00 |
| Rate for Payer: Aetna Commercial |
$2,745.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,745.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,333.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,333.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,830.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,333.25
|
| Rate for Payer: Cigna Commercial |
$4,575.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,214.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,372.50
|
|
|
NAIL TI FIXA 11.0X130 456416S
|
Facility
|
OP
|
$6,477.85
|
|
| Hospital Charge Code |
270633857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.68 |
| Max. Negotiated Rate |
$3,238.93 |
| Rate for Payer: Aetna Commercial |
$1,943.36
|
| Rate for Payer: Aetna Medicare Advantage |
$1,943.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,651.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,651.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,295.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,651.85
|
| Rate for Payer: Cigna Commercial |
$3,238.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,567.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$971.68
|
|
|
NAIL TI FIXA 11.0X130 456416S
|
Facility
|
IP
|
$6,477.85
|
|
| Hospital Charge Code |
270633857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.68 |
| Max. Negotiated Rate |
$1,567.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,295.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,567.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$971.68
|
|
|
NAIL TORCHFIXATION 420MM 11MM
|
Facility
|
OP
|
$7,335.00
|
|
| Hospital Charge Code |
270666923
|
|
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 TORCHFIXATION 420MM 11MM
|
Facility
|
IP
|
$7,335.00
|
|
| Hospital Charge Code |
270666923
|
|
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 TRCH ANTEG 10x42 71637242
|
Facility
|
IP
|
$8,605.65
|
|
| Hospital Charge Code |
270633371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,290.85 |
| Max. Negotiated Rate |
$2,082.57 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,721.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,082.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,290.85
|
|
|
NAIL TRCH ANTEG 10x42 71637242
|
Facility
|
OP
|
$8,605.65
|
|
| Hospital Charge Code |
270633371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,290.85 |
| Max. Negotiated Rate |
$4,302.82 |
| Rate for Payer: Aetna Commercial |
$2,581.70
|
| Rate for Payer: Aetna Medicare Advantage |
$2,581.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,194.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,194.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,721.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,194.44
|
| Rate for Payer: Cigna Commercial |
$4,302.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,082.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,290.85
|
|
|
NAIL TROCH 11mm32cm RGHT 28332
|
Facility
|
OP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270651536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,701.00 |
| Max. Negotiated Rate |
$5,670.00 |
| Rate for Payer: Aetna Commercial |
$3,402.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,402.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,891.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,891.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,268.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,891.70
|
| Rate for Payer: Cigna Commercial |
$5,670.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,744.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,701.00
|
|
|
NAIL TROCH 11mm32cm RGHT 28332
|
Facility
|
IP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270651536
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,701.00 |
| Max. Negotiated Rate |
$2,744.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,268.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,744.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,701.00
|
|
|
NAIL TROCH 11mm 36mm DC28236
|
Facility
|
OP
|
$7,688.00
|
|
| Hospital Charge Code |
270635556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,153.20 |
| Max. Negotiated Rate |
$3,844.00 |
| Rate for Payer: Aetna Commercial |
$2,306.40
|
| Rate for Payer: Aetna Medicare Advantage |
$2,306.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,960.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,960.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,537.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,960.44
|
| Rate for Payer: Cigna Commercial |
$3,844.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,860.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,153.20
|
|
|
NAIL TROCH 11mm 36mm DC28236
|
Facility
|
IP
|
$7,688.00
|
|
| Hospital Charge Code |
270635556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,153.20 |
| Max. Negotiated Rate |
$1,860.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,537.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,860.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,153.20
|
|
|
NAIL TROCH 11mm x 32cm RIGHT
|
Facility
|
IP
|
$8,270.00
|
|
| Hospital Charge Code |
270642319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,240.50 |
| Max. Negotiated Rate |
$2,001.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,654.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,001.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,240.50
|
|
|
NAIL TROCH 11mm x 32cm RIGHT
|
Facility
|
OP
|
$8,270.00
|
|
| Hospital Charge Code |
270642319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,240.50 |
| Max. Negotiated Rate |
$4,135.00 |
| Rate for Payer: Aetna Commercial |
$2,481.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,481.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,108.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,108.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,654.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,108.85
|
| Rate for Payer: Cigna Commercial |
$4,135.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,001.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,240.50
|
|
|
NAIL TROCH11mx34cmRTLG DC28334
|
Facility
|
OP
|
$8,270.00
|
|
| Hospital Charge Code |
270642095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,240.50 |
| Max. Negotiated Rate |
$4,135.00 |
| Rate for Payer: Aetna Commercial |
$2,481.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,481.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,108.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,108.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,654.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,108.85
|
| Rate for Payer: Cigna Commercial |
$4,135.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,001.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,240.50
|
|
|
NAIL TROCH11mx34cmRTLG DC28334
|
Facility
|
IP
|
$8,270.00
|
|
| Hospital Charge Code |
270642095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,240.50 |
| Max. Negotiated Rate |
$2,001.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,654.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,001.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,240.50
|
|
|
NAIL TROCH 11X170MM
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.50 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Aetna Commercial |
$459.00
|
| Rate for Payer: Aetna Medicare Advantage |
$459.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$390.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$390.15
|
| Rate for Payer: Cigna Commercial |
$765.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$370.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$229.50
|
|
|
NAIL TROCH 11X170MM
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.50 |
| Max. Negotiated Rate |
$370.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$306.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$370.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$229.50
|
|
|
NAIL TROCH 11x22cm
|
Facility
|
IP
|
$6,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270636173
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,023.75 |
| Max. Negotiated Rate |
$1,651.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,365.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,651.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,023.75
|
|
|
NAIL TROCH 11x22cm
|
Facility
|
OP
|
$6,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270636173
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,023.75 |
| Max. Negotiated Rate |
$3,412.50 |
| Rate for Payer: Aetna Commercial |
$2,047.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,047.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,740.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,740.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,365.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,740.38
|
| Rate for Payer: Cigna Commercial |
$3,412.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,651.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,023.75
|
|
|
NAIL TROCH 11X36mm RT DC28336
|
Facility
|
OP
|
$7,800.00
|
|
| Hospital Charge Code |
270639886
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,170.00 |
| Max. Negotiated Rate |
$3,900.00 |
| Rate for Payer: Aetna Commercial |
$2,340.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,340.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,989.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,989.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,560.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,989.00
|
| Rate for Payer: Cigna Commercial |
$3,900.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,887.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,170.00
|
|
|
NAIL TROCH 11X36mm RT DC28336
|
Facility
|
IP
|
$7,800.00
|
|
| Hospital Charge Code |
270639886
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,170.00 |
| Max. Negotiated Rate |
$1,887.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,887.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,170.00
|
|
|
NAIL TROCH 125D 12X170MM
|
Facility
|
OP
|
$13,120.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700452
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,968.00 |
| Max. Negotiated Rate |
$6,560.00 |
| Rate for Payer: Aetna Commercial |
$3,936.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,936.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,345.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,345.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,624.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,345.60
|
| Rate for Payer: Cigna Commercial |
$6,560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,175.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,968.00
|
|