|
NAIL TROCH LONG 11mm 36mm RT
|
Facility
|
OP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270641254
|
|
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 LONG 11mm 36mm RT
|
Facility
|
IP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270641254
|
|
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 LONG 11mm RT 34c
|
Facility
|
OP
|
$12,012.50
|
|
| Hospital Charge Code |
270637150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,801.88 |
| Max. Negotiated Rate |
$6,006.25 |
| Rate for Payer: Aetna Commercial |
$3,603.75
|
| Rate for Payer: Aetna Medicare Advantage |
$3,603.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,063.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,063.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,402.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,063.19
|
| Rate for Payer: Cigna Commercial |
$6,006.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,907.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,801.88
|
|
|
NAIL TROCH LONG 11mm RT 34c
|
Facility
|
IP
|
$12,012.50
|
|
| Hospital Charge Code |
270637150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,801.88 |
| Max. Negotiated Rate |
$2,907.03 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,402.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,907.03
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,801.88
|
|
|
NAIL TROCH LONG 11mmX38cm28238
|
Facility
|
IP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637246
|
|
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 LONG 11mmX38cm28238
|
Facility
|
OP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637246
|
|
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 LONG 11mX42m 28342
|
Facility
|
OP
|
$9,750.00
|
|
| Hospital Charge Code |
270639603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,462.50 |
| Max. Negotiated Rate |
$4,875.00 |
| Rate for Payer: Aetna Commercial |
$2,925.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,925.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,486.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,486.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,950.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,486.25
|
| Rate for Payer: Cigna Commercial |
$4,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,359.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,462.50
|
|
|
NAIL TROCH LONG 11mX42m 28342
|
Facility
|
IP
|
$9,750.00
|
|
| Hospital Charge Code |
270639603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,462.50 |
| Max. Negotiated Rate |
$2,359.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,950.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,359.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,462.50
|
|
|
NAIL TROCH LONG 11x34mm 28234
|
Facility
|
OP
|
$11,340.00
|
|
| Hospital Charge Code |
270638430
|
|
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 LONG 11x34mm 28234
|
Facility
|
IP
|
$11,340.00
|
|
| Hospital Charge Code |
270638430
|
|
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 LONG 11x36 LT 28236
|
Facility
|
IP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637201
|
|
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 LONG 11x36 LT 28236
|
Facility
|
OP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637201
|
|
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 LONG 38cm 28338
|
Facility
|
OP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637578
|
|
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 LONG 38cm 28338
|
Facility
|
IP
|
$11,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270637578
|
|
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 X-SHORT 11mmDx17cmL
|
Facility
|
IP
|
$6,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643091
|
|
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 X-SHORT 11mmDx17cmL
|
Facility
|
OP
|
$6,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270643091
|
|
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 TROC LONG 11m 42c LT28242
|
Facility
|
OP
|
$9,750.00
|
|
| Hospital Charge Code |
270640082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,462.50 |
| Max. Negotiated Rate |
$4,875.00 |
| Rate for Payer: Aetna Commercial |
$2,925.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,925.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,486.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,486.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,950.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,486.25
|
| Rate for Payer: Cigna Commercial |
$4,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,359.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,462.50
|
|
|
NAIL TROC LONG 11m 42c LT28242
|
Facility
|
IP
|
$9,750.00
|
|
| Hospital Charge Code |
270640082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,462.50 |
| Max. Negotiated Rate |
$2,359.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,950.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,359.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,462.50
|
|
|
NAIL TRO LNG 11m 32cm LT 28232
|
Facility
|
IP
|
$7,800.00
|
|
| Hospital Charge Code |
270640222
|
|
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 TRO LNG 11m 32cm LT 28232
|
Facility
|
OP
|
$7,800.00
|
|
| Hospital Charge Code |
270640222
|
|
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 VAL 3.0 BEADED KWIRE
|
Facility
|
OP
|
$1,117.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$558.77 |
| Rate for Payer: Aetna Commercial |
$335.26
|
| Rate for Payer: Aetna Medicare Advantage |
$335.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$284.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$284.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$223.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$284.98
|
| Rate for Payer: Cigna Commercial |
$558.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$270.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.63
|
|
|
NAIL VAL 3.0 BEADED KWIRE
|
Facility
|
IP
|
$1,117.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$270.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$223.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$270.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.63
|
|
|
NAIL VAL 3.0 KWIRE
|
Facility
|
IP
|
$1,117.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$270.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$223.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$270.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.63
|
|
|
NAIL VAL 3.0 KWIRE
|
Facility
|
OP
|
$1,117.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$558.77 |
| Rate for Payer: Aetna Commercial |
$335.26
|
| Rate for Payer: Aetna Medicare Advantage |
$335.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$284.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$284.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$223.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$284.98
|
| Rate for Payer: Cigna Commercial |
$558.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$270.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.63
|
|
|
NAIL VAL 4.3MM DRILL SHORT
|
Facility
|
IP
|
$1,427.65
|
|
| Hospital Charge Code |
270699021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$214.15 |
| Max. Negotiated Rate |
$214.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$214.15
|
|