|
K WIRE 1.35 MM
|
Facility
|
OP
|
$107.50
|
|
| Hospital Charge Code |
270684026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.05 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna Commercial |
$40.85
|
| Rate for Payer: Aetna Medicare Advantage |
$32.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.41
|
| Rate for Payer: Cigna Commercial |
$53.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: Oxford Commercial |
$21.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.05
|
|
|
K-WIRE 1.35 THREADED
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
270667451
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$38.00
|
| Rate for Payer: Aetna Medicare Advantage |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.50
|
| Rate for Payer: Cigna Commercial |
$50.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.00
|
| Rate for Payer: Oxford Commercial |
$20.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.84
|
|
|
K-WIRE 1.35 THREADED
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
270667451
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
K WIRE 1.4 MM 4.0 N FORCE
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
K WIRE 1.4 MM 4.0 N FORCE
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.25
|
|
|
K-WIRE 1.4MM THREADED 24 INCH
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692590
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| 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
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
K-WIRE 1.4MM THREADED 24 INCH
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692590
|
|
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
|
|
|
K-WIRE 1.4MMX24IN BLUNT TIP
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693040
|
|
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
|
|
|
K-WIRE 1.4MMX24IN BLUNT TIP
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| 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
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
K-WIRE 1.4MMX24IN SS TROC TIP
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693043
|
|
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
|
|
|
K-WIRE 1.4MMX24IN SS TROC TIP
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| 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
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
K WIRE 1.4MMX24MM
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$228.00
|
| 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
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.04
|
|
|
K WIRE 1.4MMX24MM
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695466
|
|
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
|
|
|
K WIRE 1.4 X 150 MM
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690339
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$50.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.50
|
|
|
K WIRE 1.4 X 150 MM
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690339
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna Commercial |
$79.80
|
| Rate for Payer: Aetna Medicare Advantage |
$63.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.55
|
| Rate for Payer: Cigna Commercial |
$105.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.96
|
|
|
K-WIRE 1.4x150MM BLUNT/TROCAR
|
Facility
|
IP
|
$115.00
|
|
| Hospital Charge Code |
270662459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
K-WIRE 1.4x150MM BLUNT/TROCAR
|
Facility
|
OP
|
$115.00
|
|
| Hospital Charge Code |
270662459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$43.70
|
| Rate for Payer: Aetna Medicare Advantage |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.32
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$23.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.27
|
|
|
K-WIRE 1.4x228MM
|
Facility
|
OP
|
$115.00
|
|
| Hospital Charge Code |
270670889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$43.70
|
| Rate for Payer: Aetna Medicare Advantage |
$34.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.32
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$23.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.27
|
|
|
K-WIRE 1.4x228MM
|
Facility
|
IP
|
$115.00
|
|
| Hospital Charge Code |
270670889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
K WIRE 1.5MM
|
Facility
|
OP
|
$593.75
|
|
| Hospital Charge Code |
270701684
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$296.88 |
| Rate for Payer: Aetna Commercial |
$225.62
|
| Rate for Payer: Aetna Medicare Advantage |
$178.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$151.41
|
| Rate for Payer: Cigna Commercial |
$296.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.06
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.86
|
|
|
K WIRE 1.5MM
|
Facility
|
IP
|
$593.75
|
|
| Hospital Charge Code |
270701684
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.06 |
| Max. Negotiated Rate |
$143.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.06
|
|
|
KWIRE 1.5MM SS BEVELED 18INCH
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$228.00
|
| 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
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.04
|
|
|
KWIRE 1.5MM SS BEVELED 18INCH
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695822
|
|
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
|
|
|
K-WIRE 1.6
|
Facility
|
OP
|
$162.35
|
|
| Hospital Charge Code |
270681465
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.61 |
| Max. Negotiated Rate |
$81.17 |
| Rate for Payer: Aetna Commercial |
$61.69
|
| Rate for Payer: Aetna Medicare Advantage |
$48.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.40
|
| Rate for Payer: Cigna Commercial |
$81.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.21
|
| Rate for Payer: Oxford Commercial |
$32.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.47
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.61
|
|
|
K-WIRE 1.6
|
Facility
|
IP
|
$162.35
|
|
| Hospital Charge Code |
270681465
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.35 |
| Max. Negotiated Rate |
$24.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.35
|
|