|
K-WIRE SINGLE RD END 4 .028
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K-WIRE SINGLE RD END 4 .028
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .035
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .035
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K-WIRE SINGLE RD END 4 .045
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .045
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K-WIRE SINGLE RD END 4 .062
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 4 .062
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K-WIRE SINGLE RD END 9 .028
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 9 .028
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K-WIRE SINGLE RD END 9 .035
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K-WIRE SINGLE RD END 9 .035
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 9 .045
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K-WIRE SINGLE RD END 9 .045
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 9 .062
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
270676059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$2.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
|
|
K-WIRE SINGLE RD END 9 .062
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
270676059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.04
|
| Rate for Payer: Cigna Commercial |
$7.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.12
|
| Rate for Payer: Oxford Commercial |
$3.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
K WIRE SMOOTH 1.4MMX100MM
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270664508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$59.29 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
|
|
K WIRE SMOOTH 1.4MMX100MM
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270664508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$122.50 |
| Rate for Payer: Aetna Commercial |
$93.10
|
| Rate for Payer: Aetna Medicare Advantage |
$73.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.48
|
| Rate for Payer: Cigna Commercial |
$122.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.96
|
|
|
K-WIRE SMOOTH 2.0/2.5
|
Facility
|
OP
|
$148.40
|
|
| Hospital Charge Code |
270668723
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$74.20 |
| Rate for Payer: Aetna Commercial |
$56.39
|
| Rate for Payer: Aetna Medicare Advantage |
$44.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.84
|
| Rate for Payer: Cigna Commercial |
$74.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.58
|
| Rate for Payer: Oxford Commercial |
$29.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$29.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.21
|
|
|
K-WIRE SMOOTH 2.0/2.5
|
Facility
|
IP
|
$148.40
|
|
| Hospital Charge Code |
270668723
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.26 |
| Max. Negotiated Rate |
$22.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.26
|
|
|
KWIRE SNGL TROC TIP 2.0X150MM
|
Facility
|
IP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.32
|
|
|
KWIRE SNGL TROC TIP 2.0X150MM
|
Facility
|
OP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Commercial |
$43.89
|
| Rate for Payer: Aetna Medicare Advantage |
$34.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.45
|
| Rate for Payer: Cigna Commercial |
$57.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.32
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.28
|
|
|
KWIRE SPIKE SHIM 1.5X350MM
|
Facility
|
IP
|
$1,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693944
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$262.50 |
| Max. Negotiated Rate |
$423.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$423.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
|
|
KWIRE SPIKE SHIM 1.5X350MM
|
Facility
|
OP
|
$1,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693944
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$665.00
|
| Rate for Payer: Aetna Medicare Advantage |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$446.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$446.25
|
| Rate for Payer: Cigna Commercial |
$875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$423.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$262.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$55.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.70
|
|
|
KWIRE SS 1.25X150MM
|
Facility
|
IP
|
$70.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$17.11 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.61
|
|