|
PIN STEINMAN 4.5X 150MM
|
Facility
|
OP
|
$351.00
|
|
| Hospital Charge Code |
270656309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$133.38
|
| Rate for Payer: Aetna Medicare Advantage |
$105.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.50
|
| Rate for Payer: Cigna Commercial |
$175.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$91.26
|
| Rate for Payer: Oxford Commercial |
$70.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.97
|
|
|
PIN STEINMAN 4.5X 150MM
|
Facility
|
IP
|
$351.00
|
|
| Hospital Charge Code |
270656309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$52.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
|
|
PIN STEINMAN 5.0x150mm
|
Facility
|
OP
|
$351.00
|
|
| Hospital Charge Code |
270668382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$133.38
|
| Rate for Payer: Aetna Medicare Advantage |
$105.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.50
|
| Rate for Payer: Cigna Commercial |
$175.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$91.26
|
| Rate for Payer: Oxford Commercial |
$70.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.97
|
|
|
PIN STEINMAN 5.0x150mm
|
Facility
|
IP
|
$351.00
|
|
| Hospital Charge Code |
270668382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$52.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.65
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
IP
|
$361.55
|
|
| Hospital Charge Code |
270639901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$54.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
IP
|
$361.55
|
|
| Hospital Charge Code |
270639902
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$54.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
OP
|
$361.55
|
|
| Hospital Charge Code |
270639901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$180.78 |
| Rate for Payer: Aetna Commercial |
$137.39
|
| Rate for Payer: Aetna Medicare Advantage |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92.20
|
| Rate for Payer: Cigna Commercial |
$180.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.00
|
| Rate for Payer: Oxford Commercial |
$72.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.27
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
OP
|
$361.55
|
|
| Hospital Charge Code |
270639903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$180.78 |
| Rate for Payer: Aetna Commercial |
$137.39
|
| Rate for Payer: Aetna Medicare Advantage |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92.20
|
| Rate for Payer: Cigna Commercial |
$180.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.00
|
| Rate for Payer: Oxford Commercial |
$72.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.27
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
OP
|
$361.55
|
|
| Hospital Charge Code |
270639902
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$180.78 |
| Rate for Payer: Aetna Commercial |
$137.39
|
| Rate for Payer: Aetna Medicare Advantage |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92.20
|
| Rate for Payer: Cigna Commercial |
$180.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.00
|
| Rate for Payer: Oxford Commercial |
$72.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.27
|
|
|
PIN STEINMAN F/LG EXTERNAL FI-
|
Facility
|
IP
|
$361.55
|
|
| Hospital Charge Code |
270639903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$54.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.23
|
|
|
PIN STEINMANN 2.4MM
|
Facility
|
IP
|
$120.00
|
|
| Hospital Charge Code |
270670890
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
|
|
PIN STEINMANN 2.4MM
|
Facility
|
OP
|
$120.00
|
|
| Hospital Charge Code |
270670890
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$45.60
|
| Rate for Payer: Aetna Medicare Advantage |
$36.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.60
|
| Rate for Payer: Cigna Commercial |
$60.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.20
|
| Rate for Payer: Oxford Commercial |
$24.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.41
|
|
|
PIN STEINMANN 3.2mm 9
|
Facility
|
IP
|
$535.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.25 |
| Max. Negotiated Rate |
$80.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.25
|
|
|
PIN STEINMANN 3.2mm 9
|
Facility
|
OP
|
$535.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.19 |
| Max. Negotiated Rate |
$267.50 |
| Rate for Payer: Aetna Commercial |
$203.30
|
| Rate for Payer: Aetna Medicare Advantage |
$160.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$136.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$136.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$136.43
|
| Rate for Payer: Cigna Commercial |
$267.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.10
|
| Rate for Payer: Oxford Commercial |
$107.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$107.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.19
|
|
|
PIN STEINMANN 3/32 IN
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$159.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
PIN STEINMANN 3/32 IN
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.74 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$250.80
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.74
|
|
|
PIN STEINMANN #5 9 x 7/64
|
Facility
|
OP
|
$85.29
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$42.65 |
| Rate for Payer: Aetna Commercial |
$32.41
|
| Rate for Payer: Aetna Medicare Advantage |
$25.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.75
|
| Rate for Payer: Cigna Commercial |
$42.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
PIN STEINMANN #5 9 x 7/64
|
Facility
|
IP
|
$85.29
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$20.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.79
|
|
|
PIN STEINMANN SMOOTH 2.5X100MM
|
Facility
|
OP
|
$303.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$151.50 |
| Rate for Payer: Aetna Commercial |
$115.14
|
| Rate for Payer: Aetna Medicare Advantage |
$90.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.27
|
| Rate for Payer: Cigna Commercial |
$151.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.61
|
|
|
PIN STEINMANN SMOOTH 2.5X100MM
|
Facility
|
IP
|
$303.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.45 |
| Max. Negotiated Rate |
$73.33 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.45
|
|
|
PIN STEINMANN TROCAR BLNT 12IN
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
PIN STEINMANN TROCAR BLNT 12IN
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
PINS THREADED PACK
|
Facility
|
IP
|
$250.00
|
|
| Hospital Charge Code |
270684548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
PINS THREADED PACK
|
Facility
|
OP
|
$250.00
|
|
| Hospital Charge Code |
270684548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$95.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.00
|
| Rate for Payer: Oxford Commercial |
$50.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.10
|
|
|
PIN STIENMANN #6 DIA
|
Facility
|
IP
|
$148.32
|
|
| Hospital Charge Code |
270678366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.25 |
| Max. Negotiated Rate |
$35.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.25
|
|