|
Z NAIL 10.5X95 LAG SCREW
|
Facility
|
OP
|
$3,121.65
|
|
| Hospital Charge Code |
270663172
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$1,560.83 |
| Rate for Payer: Aetna Commercial |
$936.50
|
| Rate for Payer: Aetna Medicare Advantage |
$936.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$796.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$796.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$624.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$796.02
|
| Rate for Payer: Cigna Commercial |
$1,560.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$755.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.25
|
|
|
Z NAIL 10.5X95 LAG SCREW
|
Facility
|
IP
|
$3,121.65
|
|
| Hospital Charge Code |
270663172
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$755.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$624.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$755.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.25
|
|
|
Z NAIL 5.0X35 CORT SCREW FA
|
Facility
|
OP
|
$1,008.00
|
|
| Hospital Charge Code |
270665474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Aetna Commercial |
$302.40
|
| Rate for Payer: Aetna Medicare Advantage |
$302.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$257.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$257.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$257.04
|
| Rate for Payer: Cigna Commercial |
$504.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$243.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
|
|
Z NAIL 5.0X35 CORT SCREW FA
|
Facility
|
IP
|
$1,008.00
|
|
| Hospital Charge Code |
270665474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$243.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$201.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$243.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
|
|
Z NAIL CPM 10MM X 21.5CM 13
|
Facility
|
OP
|
$7,740.00
|
|
| Hospital Charge Code |
270661017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,161.00 |
| Max. Negotiated Rate |
$3,870.00 |
| Rate for Payer: Aetna Commercial |
$2,322.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,322.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,973.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,973.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,548.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,973.70
|
| Rate for Payer: Cigna Commercial |
$3,870.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,873.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,161.00
|
|
|
Z NAIL CPM 10MM X 21.5CM 13
|
Facility
|
IP
|
$7,740.00
|
|
| Hospital Charge Code |
270661017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,161.00 |
| Max. Negotiated Rate |
$1,873.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,548.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,873.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,161.00
|
|
|
Z NAIL PF 14MM X 38CM
|
Facility
|
OP
|
$9,905.00
|
|
| Hospital Charge Code |
270658856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,485.75 |
| Max. Negotiated Rate |
$4,952.50 |
| Rate for Payer: Aetna Commercial |
$2,971.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,971.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,525.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,525.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,981.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,525.78
|
| Rate for Payer: Cigna Commercial |
$4,952.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,397.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,485.75
|
|
|
Z NAIL PF 14MM X 38CM
|
Facility
|
IP
|
$9,905.00
|
|
| Hospital Charge Code |
270658856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,485.75 |
| Max. Negotiated Rate |
$2,397.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,981.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,397.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,485.75
|
|
|
Z NAIL PF 14MM X 42CM
|
Facility
|
OP
|
$9,905.00
|
|
| Hospital Charge Code |
270658855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,485.75 |
| Max. Negotiated Rate |
$4,952.50 |
| Rate for Payer: Aetna Commercial |
$2,971.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,971.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,525.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,525.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,981.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,525.78
|
| Rate for Payer: Cigna Commercial |
$4,952.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,397.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,485.75
|
|
|
Z NAIL PF 14MM X 42CM
|
Facility
|
IP
|
$9,905.00
|
|
| Hospital Charge Code |
270658855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,485.75 |
| Max. Negotiated Rate |
$2,397.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,981.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,397.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,485.75
|
|
|
Z NAIL TIBIA 9.3MMX34CM UNIV
|
Facility
|
OP
|
$8,460.00
|
|
| Hospital Charge Code |
270665475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.00 |
| Max. Negotiated Rate |
$4,230.00 |
| Rate for Payer: Aetna Commercial |
$2,538.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,538.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,157.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,157.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,692.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,157.30
|
| Rate for Payer: Cigna Commercial |
$4,230.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,047.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,269.00
|
|
|
Z NAIL TIBIA 9.3MMX34CM UNIV
|
Facility
|
IP
|
$8,460.00
|
|
| Hospital Charge Code |
270665475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.00 |
| Max. Negotiated Rate |
$2,047.32 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,692.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,047.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,269.00
|
|
|
Z NAIL TIBIAL NAIL CAP 10MM
|
Facility
|
IP
|
$1,196.40
|
|
| Hospital Charge Code |
270663147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.46 |
| Max. Negotiated Rate |
$289.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$239.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$289.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$179.46
|
|
|
Z NAIL TIBIAL NAIL CAP 10MM
|
Facility
|
OP
|
$1,196.40
|
|
| Hospital Charge Code |
270663147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.46 |
| Max. Negotiated Rate |
$598.20 |
| Rate for Payer: Aetna Commercial |
$358.92
|
| Rate for Payer: Aetna Medicare Advantage |
$358.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$305.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$305.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$239.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$305.08
|
| Rate for Payer: Cigna Commercial |
$598.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$289.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$179.46
|
|
|
ZN T8 ANTIBODY
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86341
|
| Hospital Charge Code |
401186341Z
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ZN T8 ANTIBODY
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86341
|
| Hospital Charge Code |
401186341Z
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$76.37
|
| Rate for Payer: Aetna Medicare Advantage |
$23.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$23.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.36
|
| Rate for Payer: Cigna Commercial |
$23.57
|
| Rate for Payer: Cigna Medicare Advantage |
$11.79
|
| Rate for Payer: Clover Medicare Advantage |
$22.39
|
| Rate for Payer: EmblemHealth Commercial |
$70.71
|
| Rate for Payer: Humana Medicare Advantage |
$24.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$23.57
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$24.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$23.57
|
|
|
ZOCOR 10MG U/D
|
Facility
|
OP
|
$5.00
|
|
| Hospital Charge Code |
60635884
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare Advantage |
$1.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.27
|
| Rate for Payer: Cigna Commercial |
$2.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.65
|
| Rate for Payer: Oxford Commercial |
$2.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.50
|
|
|
ZOCOR 10MG U/D
|
Facility
|
IP
|
$5.00
|
|
| Hospital Charge Code |
60635884
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.75
|
|
|
ZOCOR 20MG
|
Facility
|
OP
|
$15.00
|
|
| Hospital Charge Code |
60635091
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$4.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.83
|
| Rate for Payer: Cigna Commercial |
$7.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.95
|
| Rate for Payer: Oxford Commercial |
$7.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.50
|
|
|
ZOCOR 20MG
|
Facility
|
IP
|
$15.00
|
|
| Hospital Charge Code |
60635091
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.25
|
|
|
ZOCOR 40MG
|
Facility
|
OP
|
$21.00
|
|
| Hospital Charge Code |
60635093
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$6.30
|
| Rate for Payer: Aetna Medicare Advantage |
$6.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.36
|
| Rate for Payer: Cigna Commercial |
$10.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.73
|
| Rate for Payer: Oxford Commercial |
$10.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.50
|
|
|
ZOCOR 40MG
|
Facility
|
IP
|
$21.00
|
|
| Hospital Charge Code |
60635093
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$3.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
|
|
ZOCOR 5MG
|
Facility
|
OP
|
$7.00
|
|
| Hospital Charge Code |
60635092
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.78
|
| Rate for Payer: Cigna Commercial |
$3.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.91
|
| Rate for Payer: Oxford Commercial |
$3.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.50
|
|
|
ZOCOR 5MG
|
Facility
|
IP
|
$7.00
|
|
| Hospital Charge Code |
60635092
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|
|
ZOFRAN 32MG/50ML
|
Facility
|
IP
|
$1,139.00
|
|
| Hospital Charge Code |
60635033
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$170.85 |
| Max. Negotiated Rate |
$170.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.85
|
|