|
K-WIRE THRED TIP 1.6x100MM
|
Facility
|
OP
|
$2,011.50
|
|
| Hospital Charge Code |
270681557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.13 |
| Max. Negotiated Rate |
$1,005.75 |
| Rate for Payer: Aetna Commercial |
$764.37
|
| Rate for Payer: Aetna Medicare Advantage |
$603.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$512.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$512.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$512.93
|
| Rate for Payer: Cigna Commercial |
$1,005.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$522.99
|
| Rate for Payer: Oxford Commercial |
$402.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$402.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$63.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.13
|
|
|
K-WIRE THRED TIP 1.6x100MM
|
Facility
|
IP
|
$2,011.50
|
|
| Hospital Charge Code |
270681557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$301.73 |
| Max. Negotiated Rate |
$301.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.73
|
|
|
K-WIRE TRCR TIP SMTH 1.6X230M
|
Facility
|
OP
|
$1,911.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$54.28 |
| Max. Negotiated Rate |
$955.62 |
| Rate for Payer: Aetna Commercial |
$726.27
|
| Rate for Payer: Aetna Medicare Advantage |
$573.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$487.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$487.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$382.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$487.37
|
| Rate for Payer: Cigna Commercial |
$955.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$462.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$286.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$60.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$54.28
|
|
|
K-WIRE TRCR TIP SMTH 1.6X230M
|
Facility
|
IP
|
$1,911.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$286.69 |
| Max. Negotiated Rate |
$462.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$382.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$462.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$286.69
|
|
|
KWIRE TROCAR 0.8 100 MM
|
Facility
|
IP
|
$235.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.27 |
| Max. Negotiated Rate |
$56.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.27
|
|
|
KWIRE TROCAR 0.8 100 MM
|
Facility
|
OP
|
$235.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
698350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.68 |
| Max. Negotiated Rate |
$117.55 |
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: Aetna Medicare Advantage |
$70.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.95
|
| Rate for Payer: Cigna Commercial |
$117.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.68
|
|
|
KWIRE TROCAR 0.8 100 MM
|
Facility
|
IP
|
$235.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
698350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.27 |
| Max. Negotiated Rate |
$56.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.27
|
|
|
KWIRE TROCAR 0.8 100 MM
|
Facility
|
OP
|
$235.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.68 |
| Max. Negotiated Rate |
$117.55 |
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: Aetna Medicare Advantage |
$70.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.95
|
| Rate for Payer: Cigna Commercial |
$117.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.68
|
|
|
K-WIRE TROCAR 1.1x100MM
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
270675275
|
|
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 TROCAR 1.1x100MM
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
270675275
|
|
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 TROCAR DOUBLE 0.035X4
|
Facility
|
OP
|
$175.00
|
|
| Hospital Charge Code |
270674922
|
|
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 TROCAR DOUBLE 0.035X4
|
Facility
|
IP
|
$175.00
|
|
| Hospital Charge Code |
270674922
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
|
|
KWIRE TROCAR TIP 1.4MMX24IN
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695126
|
|
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 TROCAR TIP 1.4MMX24IN
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695126
|
|
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 TROCAR TIP 1.6MM
|
Facility
|
OP
|
$185.00
|
|
| Hospital Charge Code |
270661697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$92.50 |
| Rate for Payer: Aetna Commercial |
$70.30
|
| Rate for Payer: Aetna Medicare Advantage |
$55.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.17
|
| Rate for Payer: Cigna Commercial |
$92.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.10
|
| Rate for Payer: Oxford Commercial |
$37.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.25
|
|
|
K-WIRE TROCAR TIP 1.6MM
|
Facility
|
IP
|
$185.00
|
|
| Hospital Charge Code |
270661697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.75 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.75
|
|
|
KWIRE TROCAR TIP SMT 1.1X100MM
|
Facility
|
IP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700496
|
|
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 TROCAR TIP SMT 1.1X100MM
|
Facility
|
OP
|
$115.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700496
|
|
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 TROC TIP 1.4X23.5
|
Facility
|
IP
|
$1,680.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270703618
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$252.00 |
| Max. Negotiated Rate |
$406.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$336.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$406.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$252.00
|
|
|
KWIRE TROC TIP 1.4X23.5
|
Facility
|
OP
|
$1,680.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270703618
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$840.00 |
| Rate for Payer: Aetna Commercial |
$638.40
|
| Rate for Payer: Aetna Medicare Advantage |
$504.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$428.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$428.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$428.40
|
| Rate for Payer: Cigna Commercial |
$840.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$406.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$252.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$53.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47.71
|
|
|
KWIRE TROC TIP SMTH 1.4X100MM
|
Facility
|
IP
|
$231.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.65
|
|
|
KWIRE TROC TIP SMTH 1.4X100MM
|
Facility
|
OP
|
$231.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$115.50 |
| Rate for Payer: Aetna Commercial |
$87.78
|
| Rate for Payer: Aetna Medicare Advantage |
$69.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.91
|
| Rate for Payer: Cigna Commercial |
$115.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.56
|
|
|
K-WIRE W/OLIVE 1.2MM
|
Facility
|
OP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.83 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: Aetna Commercial |
$372.40
|
| Rate for Payer: Aetna Medicare Advantage |
$294.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$249.90
|
| Rate for Payer: Cigna Commercial |
$490.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.83
|
|
|
K-WIRE W/OLIVE 1.2MM
|
Facility
|
IP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$237.16 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
KWIRE W STOP F/T10 2X150MM
|
Facility
|
IP
|
$1,400.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$338.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$280.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$338.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$210.00
|
|