|
K-WIRE 3.0 MM
|
Facility
|
IP
|
$955.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677454
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$143.25 |
| Max. Negotiated Rate |
$231.11 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$191.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$231.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.25
|
|
|
K-WIRE 3.0MM THREAD TIP
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
270656816
|
|
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 3.0MM THREAD TIP
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
270656816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
KWIRE 3.0X285MM
|
Facility
|
IP
|
$948.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.31 |
| Max. Negotiated Rate |
$229.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$189.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$229.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.31
|
|
|
KWIRE 3.0X285MM
|
Facility
|
OP
|
$948.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694560
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.94 |
| Max. Negotiated Rate |
$474.38 |
| Rate for Payer: Aetna Commercial |
$360.52
|
| Rate for Payer: Aetna Medicare Advantage |
$284.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$241.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$241.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$189.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$241.93
|
| Rate for Payer: Cigna Commercial |
$474.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$229.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.94
|
|
|
K-WIRE 3.2X400MM COCR
|
Facility
|
OP
|
$1,190.00
|
|
| Hospital Charge Code |
270670505
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$595.00 |
| Rate for Payer: Aetna Commercial |
$452.20
|
| Rate for Payer: Aetna Medicare Advantage |
$357.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$303.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$303.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$303.45
|
| Rate for Payer: Cigna Commercial |
$595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$309.40
|
| Rate for Payer: Oxford Commercial |
$238.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$238.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.80
|
|
|
K-WIRE 3.2X400MM COCR
|
Facility
|
IP
|
$1,190.00
|
|
| Hospital Charge Code |
270670505
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$178.50 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.50
|
|
|
K-WIRE 3.2x450MM
|
Facility
|
OP
|
$707.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270625252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.10 |
| Max. Negotiated Rate |
$353.88 |
| Rate for Payer: Aetna Commercial |
$268.94
|
| Rate for Payer: Aetna Medicare Advantage |
$212.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$180.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$180.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$141.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$180.48
|
| Rate for Payer: Cigna Commercial |
$353.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$171.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$106.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.10
|
|
|
K-WIRE 3.2x450MM
|
Facility
|
IP
|
$707.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270625252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$106.16 |
| Max. Negotiated Rate |
$171.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$141.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$171.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$106.16
|
|
|
K-WIRE 3.2x600MM
|
Facility
|
OP
|
$442.75
|
|
| Hospital Charge Code |
270666230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$221.38 |
| Rate for Payer: Aetna Commercial |
$168.25
|
| Rate for Payer: Aetna Medicare Advantage |
$132.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$112.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$112.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$112.90
|
| Rate for Payer: Cigna Commercial |
$221.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.11
|
| Rate for Payer: Oxford Commercial |
$88.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$88.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.57
|
|
|
K-WIRE 3.2x600MM
|
Facility
|
IP
|
$442.75
|
|
| Hospital Charge Code |
270666230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.41 |
| Max. Negotiated Rate |
$66.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.41
|
|
|
K-WIRE .45
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$159.60
|
| Rate for Payer: Aetna Medicare Advantage |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$107.10
|
| Rate for Payer: Cigna Commercial |
$210.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.93
|
|
|
K-WIRE .45
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$101.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$84.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
|
|
K- WIRE 6 .035
|
Facility
|
OP
|
$12.10
|
|
| Hospital Charge Code |
270684571
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$6.05 |
| Rate for Payer: Aetna Commercial |
$4.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.09
|
| Rate for Payer: Cigna Commercial |
$6.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.15
|
| Rate for Payer: Oxford Commercial |
$2.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.34
|
|
|
K- WIRE 6 .035
|
Facility
|
IP
|
$12.10
|
|
| Hospital Charge Code |
270684571
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$1.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
|
|
K- WIRE 6 .045
|
Facility
|
OP
|
$12.10
|
|
| Hospital Charge Code |
270684572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$6.05 |
| Rate for Payer: Aetna Commercial |
$4.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.09
|
| Rate for Payer: Cigna Commercial |
$6.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.15
|
| Rate for Payer: Oxford Commercial |
$2.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.34
|
|
|
K- WIRE 6 .045
|
Facility
|
IP
|
$12.10
|
|
| Hospital Charge Code |
270684572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$1.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
|
|
K- WIRE 6 .062
|
Facility
|
OP
|
$12.10
|
|
| Hospital Charge Code |
270684573
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$6.05 |
| Rate for Payer: Aetna Commercial |
$4.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.09
|
| Rate for Payer: Cigna Commercial |
$6.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.15
|
| Rate for Payer: Oxford Commercial |
$2.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.34
|
|
|
K- WIRE 6 .062
|
Facility
|
IP
|
$12.10
|
|
| Hospital Charge Code |
270684573
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$1.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
|
|
K WIRE .86 MM X 120 MM
|
Facility
|
IP
|
$105.00
|
|
| Hospital Charge Code |
270688265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.75
|
|
|
K WIRE .86 MM X 120 MM
|
Facility
|
OP
|
$105.00
|
|
| Hospital Charge Code |
270688265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna Commercial |
$39.90
|
| Rate for Payer: Aetna Medicare Advantage |
$31.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.77
|
| Rate for Payer: Cigna Commercial |
$52.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.30
|
| Rate for Payer: Oxford Commercial |
$21.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.98
|
|
|
K-WIRE .8X100MM TROCAR TIP
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
|
|
K-WIRE .8X100MM TROCAR TIP
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: Aetna Commercial |
$66.50
|
| Rate for Payer: Aetna Medicare Advantage |
$52.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.62
|
| Rate for Payer: Cigna Commercial |
$87.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.50
|
| Rate for Payer: Oxford Commercial |
$35.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$35.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.97
|
|
|
K- WIRE 9 .035
|
Facility
|
IP
|
$12.10
|
|
| Hospital Charge Code |
270684574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$1.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
|
|
K- WIRE 9 .035
|
Facility
|
OP
|
$12.10
|
|
| Hospital Charge Code |
270684574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$6.05 |
| Rate for Payer: Aetna Commercial |
$4.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.09
|
| Rate for Payer: Cigna Commercial |
$6.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.15
|
| Rate for Payer: Oxford Commercial |
$2.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.34
|
|