|
PIN STEINMAN 4.5X 150MM
|
Facility
|
IP
|
$351.00
|
|
| Hospital Charge Code |
270656309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$52.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
|
|
PIN STEINMAN 4.5X 150MM
|
Facility
|
OP
|
$351.00
|
|
| Hospital Charge Code |
270656309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.63 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$105.30
|
| Rate for Payer: Aetna Medicare Advantage |
$105.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.50
|
| Rate for Payer: Cigna Commercial |
$175.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.63
|
| Rate for Payer: Oxford Commercial |
$175.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.50
|
|
|
PIN STEINMAN 5.0x150mm
|
Facility
|
OP
|
$351.00
|
|
| Hospital Charge Code |
270668382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.63 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$105.30
|
| Rate for Payer: Aetna Medicare Advantage |
$105.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.50
|
| Rate for Payer: Cigna Commercial |
$175.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.63
|
| Rate for Payer: Oxford Commercial |
$175.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.50
|
|
|
PIN STEINMAN 5.0x150mm
|
Facility
|
IP
|
$351.00
|
|
| Hospital Charge Code |
270668382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$52.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
IP
|
$361.55
|
|
| Hospital Charge Code |
270639903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$54.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
OP
|
$361.55
|
|
| Hospital Charge Code |
270639903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$180.78 |
| Rate for Payer: Aetna Commercial |
$108.47
|
| Rate for Payer: Aetna Medicare Advantage |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92.20
|
| Rate for Payer: Cigna Commercial |
$180.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$47.00
|
| Rate for Payer: Oxford Commercial |
$180.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$180.78
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
OP
|
$361.55
|
|
| Hospital Charge Code |
270639902
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$180.78 |
| Rate for Payer: Aetna Commercial |
$108.47
|
| Rate for Payer: Aetna Medicare Advantage |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92.20
|
| Rate for Payer: Cigna Commercial |
$180.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$47.00
|
| Rate for Payer: Oxford Commercial |
$180.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$180.78
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
IP
|
$361.55
|
|
| Hospital Charge Code |
270639902
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$54.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
IP
|
$361.55
|
|
| Hospital Charge Code |
270639901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$54.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
OP
|
$361.55
|
|
| Hospital Charge Code |
270639901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$180.78 |
| Rate for Payer: Aetna Commercial |
$108.47
|
| Rate for Payer: Aetna Medicare Advantage |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92.20
|
| Rate for Payer: Cigna Commercial |
$180.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$47.00
|
| Rate for Payer: Oxford Commercial |
$180.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$180.78
|
|
|
PIN STEINMANN 2.4MM
|
Facility
|
OP
|
$120.00
|
|
| Hospital Charge Code |
270670890
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: Aetna Medicare Advantage |
$36.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.60
|
| Rate for Payer: Cigna Commercial |
$60.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.60
|
| Rate for Payer: Oxford Commercial |
$60.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$60.00
|
|
|
PIN STEINMANN 2.4MM
|
Facility
|
IP
|
$120.00
|
|
| Hospital Charge Code |
270670890
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
|
|
PIN STEINMANN 3.2mm 9
|
Facility
|
OP
|
$535.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.55 |
| Max. Negotiated Rate |
$267.50 |
| Rate for Payer: Aetna Commercial |
$160.50
|
| Rate for Payer: Aetna Medicare Advantage |
$160.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$136.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$136.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$136.43
|
| Rate for Payer: Cigna Commercial |
$267.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.55
|
| Rate for Payer: Oxford Commercial |
$267.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$267.50
|
|
|
PIN STEINMANN 3.2mm 9
|
Facility
|
IP
|
$535.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.25 |
| Max. Negotiated Rate |
$80.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.25
|
|
|
PIN STEINMANN 3/32 IN
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$159.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
PIN STEINMANN 3/32 IN
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$198.00
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
PIN STEINMANN #5 9 x 7/64
|
Facility
|
OP
|
$85.29
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$42.65 |
| Rate for Payer: Aetna Commercial |
$25.59
|
| Rate for Payer: Aetna Medicare Advantage |
$25.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.75
|
| Rate for Payer: Cigna Commercial |
$42.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.79
|
|
|
PIN STEINMANN #5 9 x 7/64
|
Facility
|
IP
|
$85.29
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$20.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.79
|
|
|
PIN STEINMANN SMOOTH 2.5X100MM
|
Facility
|
OP
|
$303.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.45 |
| Max. Negotiated Rate |
$151.50 |
| Rate for Payer: Aetna Commercial |
$90.90
|
| Rate for Payer: Aetna Medicare Advantage |
$90.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.27
|
| Rate for Payer: Cigna Commercial |
$151.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.45
|
|
|
PIN STEINMANN SMOOTH 2.5X100MM
|
Facility
|
IP
|
$303.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.45 |
| Max. Negotiated Rate |
$73.33 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.45
|
|
|
PIN STEINMANN TROCAR BLNT 12IN
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$225.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
PIN STEINMANN TROCAR BLNT 12IN
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
PIN STEINMAN THRD 3/16 & 5/6**
|
Facility
|
IP
|
$38.00
|
|
| Hospital Charge Code |
1602184
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$9.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.70
|
|
|
PIN STEINMAN THRD 3/16 & 5/6**
|
Facility
|
OP
|
$38.00
|
|
| Hospital Charge Code |
1602184
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$19.00 |
| Rate for Payer: Aetna Commercial |
$11.40
|
| Rate for Payer: Aetna Medicare Advantage |
$11.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.69
|
| Rate for Payer: Cigna Commercial |
$19.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.70
|
|
|
PINS THREADED PACK
|
Facility
|
IP
|
$250.00
|
|
| Hospital Charge Code |
270684548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|