|
WIRE K 1.2
|
Facility
|
OP
|
$250.00
|
|
| Hospital Charge Code |
270665993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$50.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
WIRE K 1.6mm X 152mm 186-090
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270610158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$5.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.56
|
|
|
WIRE K 1.6mm X 152mm 186-090
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270610158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$11.85 |
| Rate for Payer: Aetna Commercial |
$7.11
|
| Rate for Payer: Aetna Medicare Advantage |
$7.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.04
|
| Rate for Payer: Cigna Commercial |
$11.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.56
|
|
|
WIRE K 2.0
|
Facility
|
IP
|
$311.60
|
|
| Hospital Charge Code |
270673789
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.74 |
| Max. Negotiated Rate |
$46.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.74
|
|
|
WIRE K 2.0
|
Facility
|
OP
|
$311.60
|
|
| Hospital Charge Code |
270673789
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.51 |
| Max. Negotiated Rate |
$155.80 |
| Rate for Payer: Aetna Commercial |
$93.48
|
| Rate for Payer: Aetna Medicare Advantage |
$93.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.46
|
| Rate for Payer: Cigna Commercial |
$155.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.51
|
| Rate for Payer: Oxford Commercial |
$155.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$155.80
|
|
|
WIRE K 2.0mm
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669277
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$48.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
WIRE K 2.0mm
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669277
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$60.00
|
| Rate for Payer: Aetna Medicare Advantage |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.00
|
| Rate for Payer: Cigna Commercial |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
WIRE K 9mm X 76mm 186-052
|
Facility
|
OP
|
$22.40
|
|
| Hospital Charge Code |
270610155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$11.20 |
| Rate for Payer: Aetna Commercial |
$6.72
|
| Rate for Payer: Aetna Medicare Advantage |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.71
|
| Rate for Payer: Cigna Commercial |
$11.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.36
|
|
|
WIRE K 9mm X 76mm 186-052
|
Facility
|
IP
|
$22.40
|
|
| Hospital Charge Code |
270610155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$5.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.36
|
|
|
WIRE KATZEN 145 X 12 46196
|
Facility
|
IP
|
$967.75
|
|
| Hospital Charge Code |
270628046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.16 |
| Max. Negotiated Rate |
$234.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$234.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.16
|
|
|
WIRE KATZEN 145 X 12 46196
|
Facility
|
OP
|
$967.75
|
|
| Hospital Charge Code |
270628046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$145.16 |
| Max. Negotiated Rate |
$483.88 |
| Rate for Payer: Aetna Commercial |
$290.32
|
| Rate for Payer: Aetna Medicare Advantage |
$290.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$246.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$246.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$246.78
|
| Rate for Payer: Cigna Commercial |
$483.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$234.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.16
|
|
|
WIRE KATZEN INFUSION 12x180CM
|
Facility
|
IP
|
$900.00
|
|
| Hospital Charge Code |
270626087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$217.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$217.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.00
|
|
|
WIRE KATZEN INFUSION 12x180CM
|
Facility
|
OP
|
$900.00
|
|
| Hospital Charge Code |
270626087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$270.00
|
| Rate for Payer: Aetna Medicare Advantage |
$270.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$229.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$229.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$229.50
|
| Rate for Payer: Cigna Commercial |
$450.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$217.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.00
|
|
|
WIRE KIRSCHNER .028
|
Facility
|
IP
|
$25.99
|
|
| Hospital Charge Code |
270638919
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
|
|
WIRE KIRSCHNER .028
|
Facility
|
OP
|
$25.99
|
|
| Hospital Charge Code |
270638919
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare Advantage |
$7.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.63
|
| Rate for Payer: Cigna Commercial |
$12.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.38
|
| Rate for Payer: Oxford Commercial |
$12.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.99
|
|
|
WIRE KIRSCHNER 03 2X450MM
|
Facility
|
OP
|
$865.00
|
|
| Hospital Charge Code |
270656513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.75 |
| Max. Negotiated Rate |
$432.50 |
| Rate for Payer: Aetna Commercial |
$259.50
|
| Rate for Payer: Aetna Medicare Advantage |
$259.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$220.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$220.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$173.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$220.57
|
| Rate for Payer: Cigna Commercial |
$432.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$209.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.75
|
|
|
WIRE KIRSCHNER 03 2X450MM
|
Facility
|
IP
|
$865.00
|
|
| Hospital Charge Code |
270656513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.75 |
| Max. Negotiated Rate |
$209.33 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$173.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$209.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.75
|
|
|
WIRE KIRSCHNER .062
|
Facility
|
OP
|
$357.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270653119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.62 |
| Max. Negotiated Rate |
$178.75 |
| Rate for Payer: Aetna Commercial |
$107.25
|
| Rate for Payer: Aetna Medicare Advantage |
$107.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.16
|
| Rate for Payer: Cigna Commercial |
$178.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
|
|
WIRE KIRSCHNER .062
|
Facility
|
IP
|
$357.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270653119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.62 |
| Max. Negotiated Rate |
$86.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.62
|
|
|
WIRE KIRSCHNER 1.6x150mm
|
Facility
|
IP
|
$183.85
|
|
| Hospital Charge Code |
270645730
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.58 |
| Max. Negotiated Rate |
$27.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.58
|
|
|
WIRE KIRSCHNER 1.6x150mm
|
Facility
|
OP
|
$183.85
|
|
| Hospital Charge Code |
270645730
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.90 |
| Max. Negotiated Rate |
$91.92 |
| Rate for Payer: Aetna Commercial |
$55.16
|
| Rate for Payer: Aetna Medicare Advantage |
$55.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.88
|
| Rate for Payer: Cigna Commercial |
$91.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.90
|
| Rate for Payer: Oxford Commercial |
$91.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$91.92
|
|
|
WIRE KIRSCHNER 1.8x150mm
|
Facility
|
IP
|
$346.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.91 |
| Max. Negotiated Rate |
$83.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$83.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.91
|
|
|
WIRE KIRSCHNER 1.8x150mm
|
Facility
|
OP
|
$346.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.91 |
| Max. Negotiated Rate |
$173.05 |
| Rate for Payer: Aetna Commercial |
$103.83
|
| Rate for Payer: Aetna Medicare Advantage |
$103.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$88.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$88.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$88.26
|
| Rate for Payer: Cigna Commercial |
$173.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$83.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.91
|
|
|
WIRE KIRSCHNER LONG
|
Facility
|
OP
|
$600.00
|
|
| Hospital Charge Code |
270657310
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Medicare Advantage |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$120.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$153.00
|
| Rate for Payer: Cigna Commercial |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$145.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
|
|
WIRE KIRSCHNER LONG
|
Facility
|
IP
|
$600.00
|
|
| Hospital Charge Code |
270657310
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$145.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$145.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
|