|
NAIL FEMORAL RETRO 9x340MM
|
Facility
|
OP
|
$15,280.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677972
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$433.95 |
| Max. Negotiated Rate |
$7,640.00 |
| Rate for Payer: Aetna Commercial |
$5,806.40
|
| Rate for Payer: Aetna Medicare Advantage |
$4,584.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,896.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,896.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,056.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,896.40
|
| Rate for Payer: Cigna Commercial |
$7,640.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,697.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,292.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$482.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$433.95
|
|
|
NAIL FEMORAL RETRO 9X460MM
|
Facility
|
IP
|
$10,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,638.75 |
| Max. Negotiated Rate |
$2,643.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,185.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,643.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,638.75
|
|
|
NAIL FEMORAL RETRO 9X460MM
|
Facility
|
OP
|
$10,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$310.27 |
| Max. Negotiated Rate |
$5,462.50 |
| Rate for Payer: Aetna Commercial |
$4,151.50
|
| Rate for Payer: Aetna Medicare Advantage |
$3,277.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,785.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,785.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,185.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,785.88
|
| Rate for Payer: Cigna Commercial |
$5,462.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,643.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,638.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$345.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$310.27
|
|
|
NAIL FEM RETRO 10.5X340MM
|
Facility
|
OP
|
$9,710.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.76 |
| Max. Negotiated Rate |
$4,855.00 |
| Rate for Payer: Aetna Commercial |
$3,689.80
|
| Rate for Payer: Aetna Medicare Advantage |
$2,913.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,476.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,476.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,942.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,476.05
|
| Rate for Payer: Cigna Commercial |
$4,855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,349.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,456.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$306.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$275.76
|
|
|
NAIL FEM RETRO 10.5X340MM
|
Facility
|
IP
|
$9,710.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,456.50 |
| Max. Negotiated Rate |
$2,349.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,942.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,349.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,456.50
|
|
|
NAIL FEM RETRO 12x348mm
|
Facility
|
IP
|
$9,710.00
|
|
| Hospital Charge Code |
270675928
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,456.50 |
| Max. Negotiated Rate |
$2,349.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,942.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,349.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,456.50
|
|
|
NAIL FEM RETRO 12x348mm
|
Facility
|
OP
|
$9,710.00
|
|
| Hospital Charge Code |
270675928
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.76 |
| Max. Negotiated Rate |
$4,855.00 |
| Rate for Payer: Aetna Commercial |
$3,689.80
|
| Rate for Payer: Aetna Medicare Advantage |
$2,913.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,476.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,476.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,942.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,476.05
|
| Rate for Payer: Cigna Commercial |
$4,855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,349.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,456.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$306.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$275.76
|
|
|
NAIL FEM TROCH 10.5x360mm RT
|
Facility
|
OP
|
$11,950.00
|
|
| Hospital Charge Code |
270675721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$339.38 |
| Max. Negotiated Rate |
$5,975.00 |
| Rate for Payer: Aetna Commercial |
$4,541.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,585.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,047.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,047.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,390.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,047.25
|
| Rate for Payer: Cigna Commercial |
$5,975.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,891.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$377.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$339.38
|
|
|
NAIL FEM TROCH 10.5x360mm RT
|
Facility
|
IP
|
$11,950.00
|
|
| Hospital Charge Code |
270675721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,792.50 |
| Max. Negotiated Rate |
$2,891.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,390.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,891.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.50
|
|
|
NAIL FEM TROCH RT 10.5x440mm
|
Facility
|
IP
|
$11,950.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673235
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,792.50 |
| Max. Negotiated Rate |
$2,891.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,390.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,891.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.50
|
|
|
NAIL FEM TROCH RT 10.5x440mm
|
Facility
|
OP
|
$11,950.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673235
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$339.38 |
| Max. Negotiated Rate |
$5,975.00 |
| Rate for Payer: Aetna Commercial |
$4,541.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,585.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,047.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,047.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,390.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,047.25
|
| Rate for Payer: Cigna Commercial |
$5,975.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,891.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$377.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$339.38
|
|
|
NAIL FEM TROCH RT 9x440mm
|
Facility
|
IP
|
$11,950.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,792.50 |
| Max. Negotiated Rate |
$2,891.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,390.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,891.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.50
|
|
|
NAIL FEM TROCH RT 9x440mm
|
Facility
|
OP
|
$11,950.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$339.38 |
| Max. Negotiated Rate |
$5,975.00 |
| Rate for Payer: Aetna Commercial |
$4,541.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,585.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,047.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,047.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,390.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,047.25
|
| Rate for Payer: Cigna Commercial |
$5,975.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,891.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$377.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$339.38
|
|
|
NAIL FEMUR 125D 11X420MM
|
Facility
|
OP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$279.03 |
| Max. Negotiated Rate |
$4,912.50 |
| Rate for Payer: Aetna Commercial |
$3,733.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,947.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,505.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,505.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,965.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,505.38
|
| Rate for Payer: Cigna Commercial |
$4,912.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,377.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$310.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$279.03
|
|
|
NAIL FEMUR 125D 11X420MM
|
Facility
|
IP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,473.75 |
| Max. Negotiated Rate |
$2,377.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,965.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,377.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
|
|
NAIL FEMUR TFNA TI 11X235MM RT
|
Facility
|
OP
|
$20,995.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$596.26 |
| Max. Negotiated Rate |
$10,497.50 |
| Rate for Payer: Aetna Commercial |
$7,978.10
|
| Rate for Payer: Aetna Medicare Advantage |
$6,298.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,353.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,353.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,199.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,353.73
|
| Rate for Payer: Cigna Commercial |
$10,497.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,080.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,149.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$663.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$596.26
|
|
|
NAIL FEMUR TFNA TI 11X235MM RT
|
Facility
|
IP
|
$20,995.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,149.25 |
| Max. Negotiated Rate |
$5,080.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,199.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,080.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,149.25
|
|
|
NAIL FEXIBLE 2.0 X 300MM
|
Facility
|
OP
|
$1,900.00
|
|
| Hospital Charge Code |
270667218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.96 |
| Max. Negotiated Rate |
$950.00 |
| Rate for Payer: Aetna Commercial |
$722.00
|
| Rate for Payer: Aetna Medicare Advantage |
$570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$484.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$484.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$484.50
|
| Rate for Payer: Cigna Commercial |
$950.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$459.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$285.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$60.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.96
|
|
|
NAIL FEXIBLE 2.0 X 300MM
|
Facility
|
IP
|
$1,900.00
|
|
| Hospital Charge Code |
270667218
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$459.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$285.00
|
|
|
NAIL FIB REM LG CANN RT 3.2MM
|
Facility
|
IP
|
$812.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$121.88 |
| Max. Negotiated Rate |
$196.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.88
|
|
|
NAIL FIB REM LG CANN RT 3.2MM
|
Facility
|
OP
|
$812.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.07 |
| Max. Negotiated Rate |
$406.25 |
| Rate for Payer: Aetna Commercial |
$308.75
|
| Rate for Payer: Aetna Medicare Advantage |
$243.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$207.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$207.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$162.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$207.19
|
| Rate for Payer: Cigna Commercial |
$406.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$196.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.88
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.07
|
|
|
NAIL FIBULA 3.0X130MM RT
|
Facility
|
OP
|
$14,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$425.29 |
| Max. Negotiated Rate |
$7,487.50 |
| Rate for Payer: Aetna Commercial |
$5,690.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,492.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,818.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,818.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,995.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,818.62
|
| Rate for Payer: Cigna Commercial |
$7,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,623.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,246.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$473.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$425.29
|
|
|
NAIL FIBULA 3.0X130MM RT
|
Facility
|
IP
|
$14,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,246.25 |
| Max. Negotiated Rate |
$3,623.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,995.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,623.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,246.25
|
|
|
NAIL FIBULA 3.0X180MM RT
|
Facility
|
OP
|
$16,224.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.76 |
| Max. Negotiated Rate |
$8,112.00 |
| Rate for Payer: Aetna Commercial |
$6,165.12
|
| Rate for Payer: Aetna Medicare Advantage |
$4,867.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,137.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,137.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,244.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,137.12
|
| Rate for Payer: Cigna Commercial |
$8,112.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,926.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,433.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$512.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$460.76
|
|
|
NAIL FIBULA 3.0X180MM RT
|
Facility
|
IP
|
$16,224.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,433.60 |
| Max. Negotiated Rate |
$3,926.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,244.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,926.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,433.60
|
|