|
WIRE PLATE REDUCTN 1.25x150MM
|
Facility
|
IP
|
$751.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270645541
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.67 |
| Max. Negotiated Rate |
$181.78 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$150.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.67
|
|
|
WIRE POSER CRONIOTOME
|
Facility
|
OP
|
$600.00
|
|
| Hospital Charge Code |
270664476
|
|
Hospital Revenue Code
|
272
|
| 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) PPO |
$153.00
|
| Rate for Payer: Cigna Commercial |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$156.00
|
| Rate for Payer: Oxford Commercial |
$120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.04
|
|
|
WIRE POSER CRONIOTOME
|
Facility
|
IP
|
$600.00
|
|
| Hospital Charge Code |
270664476
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
|
|
WIRE POST 4 HOLE
|
Facility
|
IP
|
$1,101.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.18 |
| Max. Negotiated Rate |
$266.49 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.24
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.18
|
|
|
WIRE POST 4 HOLE
|
Facility
|
OP
|
$1,101.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.27 |
| Max. Negotiated Rate |
$550.60 |
| Rate for Payer: Aetna Commercial |
$418.46
|
| Rate for Payer: Aetna Medicare Advantage |
$330.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$280.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$280.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$280.81
|
| Rate for Payer: Cigna Commercial |
$550.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.27
|
|
|
WIRE POST TALL
|
Facility
|
OP
|
$991.90
|
|
| Hospital Charge Code |
270678085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.17 |
| Max. Negotiated Rate |
$495.95 |
| Rate for Payer: Aetna Commercial |
$376.92
|
| Rate for Payer: Aetna Medicare Advantage |
$297.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$198.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.93
|
| Rate for Payer: Cigna Commercial |
$495.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$148.78
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.17
|
|
|
WIRE POST TALL
|
Facility
|
IP
|
$991.90
|
|
| Hospital Charge Code |
270678085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.78 |
| Max. Negotiated Rate |
$240.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$198.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$148.78
|
|
|
WIRE PRECUT .05 X 24 G
|
Facility
|
OP
|
$540.00
|
|
| Hospital Charge Code |
270666929
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$205.20
|
| Rate for Payer: Aetna Medicare Advantage |
$162.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$137.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$137.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$137.70
|
| Rate for Payer: Cigna Commercial |
$270.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$140.40
|
| Rate for Payer: Oxford Commercial |
$108.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$108.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.34
|
|
|
WIRE PRECUT .05 X 24 G
|
Facility
|
IP
|
$540.00
|
|
| Hospital Charge Code |
270666929
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.00
|
|
|
WIRE PROSTR INF 12x145 4127401
|
Facility
|
IP
|
$1,029.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270637236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$154.35 |
| Max. Negotiated Rate |
$249.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$205.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$249.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$154.35
|
|
|
WIRE PROSTR INF 12x145 4127401
|
Facility
|
OP
|
$1,029.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270637236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.22 |
| Max. Negotiated Rate |
$514.50 |
| Rate for Payer: Aetna Commercial |
$391.02
|
| Rate for Payer: Aetna Medicare Advantage |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$262.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$262.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$205.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$262.39
|
| Rate for Payer: Cigna Commercial |
$514.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$249.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$154.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.22
|
|
|
WIRE REDUCTION 1.8MM
|
Facility
|
IP
|
$1,094.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691907
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.11 |
| Max. Negotiated Rate |
$264.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$218.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$264.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.11
|
|
|
WIRE REDUCTION 1.8MM
|
Facility
|
OP
|
$1,094.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691907
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.07 |
| Max. Negotiated Rate |
$547.02 |
| Rate for Payer: Aetna Commercial |
$415.74
|
| Rate for Payer: Aetna Medicare Advantage |
$328.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$278.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$278.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$218.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$278.98
|
| Rate for Payer: Cigna Commercial |
$547.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$264.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
WIRE REDUCTION 1.8MM D 400mm L
|
Facility
|
IP
|
$1,091.65
|
|
| Hospital Charge Code |
270681238
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$163.75 |
| Max. Negotiated Rate |
$163.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.75
|
|
|
WIRE REDUCTION 1.8MM D 400mm L
|
Facility
|
OP
|
$1,091.65
|
|
| Hospital Charge Code |
270681238
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$545.83 |
| Rate for Payer: Aetna Commercial |
$414.83
|
| Rate for Payer: Aetna Medicare Advantage |
$327.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$278.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$278.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$278.37
|
| Rate for Payer: Cigna Commercial |
$545.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$283.83
|
| Rate for Payer: Oxford Commercial |
$218.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$218.33
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.00
|
|
|
WIRE RUNTHROUGH NS 3CM/22CM/18
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642945N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare Advantage |
$135.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$114.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$114.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$114.75
|
| Rate for Payer: Cigna Commercial |
$225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$108.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.78
|
|
|
WIRE RUNTHROUGH NS 3CM/22CM/18
|
Facility
|
IP
|
$3,100.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642945
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$465.00 |
| Max. Negotiated Rate |
$750.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$620.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$750.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.00
|
|
|
WIRE RUNTHROUGH NS 3CM/22CM/18
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642945N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$108.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
|
|
WIRE RUNTHROUGH NS 3CM/22CM/18
|
Facility
|
OP
|
$530.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642945S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$265.00 |
| Rate for Payer: Aetna Commercial |
$201.40
|
| Rate for Payer: Aetna Medicare Advantage |
$159.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$106.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$135.15
|
| Rate for Payer: Cigna Commercial |
$265.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$128.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.05
|
|
|
WIRE RUNTHROUGH NS 3CM/22CM/18
|
Facility
|
IP
|
$530.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642945S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$128.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$106.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$128.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
|
|
WIRE RUNTHROUGH NS 3CM/22CM/18
|
Facility
|
OP
|
$3,100.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270642945
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.04 |
| Max. Negotiated Rate |
$1,550.00 |
| Rate for Payer: Aetna Commercial |
$1,178.00
|
| Rate for Payer: Aetna Medicare Advantage |
$930.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$790.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$790.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$620.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$790.50
|
| Rate for Payer: Cigna Commercial |
$1,550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$750.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$88.04
|
|
|
WIRE SMOOTH 2 MM
|
Facility
|
IP
|
$660.00
|
|
| Hospital Charge Code |
270684458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
WIRE SMOOTH 2 MM
|
Facility
|
OP
|
$660.00
|
|
| Hospital Charge Code |
270684458
|
|
Hospital Revenue Code
|
272
|
| 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) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$171.60
|
| Rate for Payer: Oxford Commercial |
$132.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$132.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.74
|
|
|
WIRE SPADE-POINT 2.0x400MM
|
Facility
|
OP
|
$1,059.85
|
|
| Hospital Charge Code |
270638915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$529.92 |
| Rate for Payer: Aetna Commercial |
$402.74
|
| Rate for Payer: Aetna Medicare Advantage |
$317.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$270.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$270.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$211.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$270.26
|
| Rate for Payer: Cigna Commercial |
$529.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$256.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.98
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.10
|
|
|
WIRE SPADE-POINT 2.0x400MM
|
Facility
|
IP
|
$1,059.85
|
|
| Hospital Charge Code |
270638915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.98 |
| Max. Negotiated Rate |
$256.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$211.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$256.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.98
|
|
