|
NAIL TFNA 10x235MM 130DEG RT/S
|
Facility
|
IP
|
$8,157.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,223.59 |
| Max. Negotiated Rate |
$1,974.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,631.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,974.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,223.59
|
|
|
NAIL TFNA 10x360MM 130DEG RT
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680077
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
NAIL TFNA 10x360MM 130DEG RT
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680077
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
NAIL TFNA 10X 400 mm
|
Facility
|
IP
|
$10,649.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,597.44 |
| Max. Negotiated Rate |
$2,577.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,129.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,577.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,597.44
|
|
|
NAIL TFNA 10X 400 mm
|
Facility
|
OP
|
$10,649.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.45 |
| Max. Negotiated Rate |
$5,324.80 |
| Rate for Payer: Aetna Commercial |
$4,046.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,194.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,715.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,715.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,129.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,715.65
|
| Rate for Payer: Cigna Commercial |
$5,324.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,577.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,597.44
|
| Rate for Payer: UnitedHealthcare Community & State |
$336.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$302.45
|
|
|
NAIL TFNA 11x130MM 130DEG LT
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
NAIL TFNA 11x130MM 130DEG LT
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
NAIL TFNA 11x170MM 130DEG
|
Facility
|
OP
|
$7,094.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$201.48 |
| Max. Negotiated Rate |
$3,547.12 |
| Rate for Payer: Aetna Commercial |
$2,695.82
|
| Rate for Payer: Aetna Medicare Advantage |
$2,128.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,809.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,809.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,418.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,809.03
|
| Rate for Payer: Cigna Commercial |
$3,547.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,716.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,064.14
|
| Rate for Payer: UnitedHealthcare Community & State |
$224.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$201.48
|
|
|
NAIL TFNA 11x170MM 130DEG
|
Facility
|
IP
|
$7,094.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,064.14 |
| Max. Negotiated Rate |
$1,716.81 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,418.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,716.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,064.14
|
|
|
NAIL TFNA 11x320MM 130DEG RT
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
NAIL TFNA 11x320MM 130DEG RT
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
NAIL TFNA 11x340MM 130DEG LT
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
NAIL TFNA 11x340MM 130DEG LT
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
NAIL TFNA 11x380MM 130DEG RT
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676934
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
NAIL TFNA 11x380MM 130DEG RT
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676934
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
NAIL TFNA 11x420MM 130DEG LT
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
NAIL TFNA 11x420MM 130DEG LT
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
NAIL TFNA 11x420MM 130DEG RT
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
NAIL TFNA 11x420MM 130DEG RT
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270677265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
NAIL TFNA TI CAN 10X170MM 125D
|
Facility
|
IP
|
$19,175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,876.25 |
| Max. Negotiated Rate |
$4,640.35 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,835.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,640.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,876.25
|
|
|
NAIL TFNA TI CAN 10X170MM 125D
|
Facility
|
OP
|
$19,175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$544.57 |
| Max. Negotiated Rate |
$9,587.50 |
| Rate for Payer: Aetna Commercial |
$7,286.50
|
| Rate for Payer: Aetna Medicare Advantage |
$5,752.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,889.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,889.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,835.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,889.62
|
| Rate for Payer: Cigna Commercial |
$9,587.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,640.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,876.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$605.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$544.57
|
|
|
NAIL Ti 011x180mmx125Deg TROC
|
Facility
|
OP
|
$10,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$293.66 |
| Max. Negotiated Rate |
$5,170.00 |
| Rate for Payer: Aetna Commercial |
$3,929.20
|
| Rate for Payer: Aetna Medicare Advantage |
$3,102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,636.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,636.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,068.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,636.70
|
| Rate for Payer: Cigna Commercial |
$5,170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,502.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,551.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$326.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$293.66
|
|
|
NAIL Ti 011x180mmx125Deg TROC
|
Facility
|
IP
|
$10,340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,551.00 |
| Max. Negotiated Rate |
$2,502.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,068.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,502.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,551.00
|
|
|
NAIL TIB 9MM TIT CAN EX/330MM
|
Facility
|
OP
|
$6,180.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$175.51 |
| Max. Negotiated Rate |
$3,090.00 |
| Rate for Payer: Aetna Commercial |
$2,348.40
|
| Rate for Payer: Aetna Medicare Advantage |
$1,854.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,575.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,575.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,236.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,575.90
|
| Rate for Payer: Cigna Commercial |
$3,090.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,495.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$927.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$195.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$175.51
|
|
|
NAIL TIB 9MM TIT CAN EX/330MM
|
Facility
|
IP
|
$6,180.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$927.00 |
| Max. Negotiated Rate |
$1,495.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,236.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,495.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$927.00
|
|