|
HFN A/R SCREW 85MM
|
Facility
|
IP
|
$1,047.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.05 |
| Max. Negotiated Rate |
$253.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$209.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$253.37
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$230.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$157.05
|
|
|
HFN LAG SCREW 10.5MMX100MM
|
Facility
|
OP
|
$2,517.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.67 |
| Max. Negotiated Rate |
$1,258.80 |
| Rate for Payer: Aetna Commercial |
$956.69
|
| Rate for Payer: Aetna Medicare Advantage |
$755.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$641.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$641.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$503.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$641.99
|
| Rate for Payer: Cigna Commercial |
$1,258.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$609.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$553.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$377.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$60.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$66.72
|
|
|
HFN LAG SCREW 10.5MMX100MM
|
Facility
|
IP
|
$2,517.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$377.64 |
| Max. Negotiated Rate |
$609.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$503.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$609.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$553.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$377.64
|
|
|
HFN LAG SCREW 10.5MMX105MM
|
Facility
|
IP
|
$2,517.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679318
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$377.64 |
| Max. Negotiated Rate |
$609.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$503.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$609.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$553.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$377.64
|
|
|
HFN LAG SCREW 10.5MMX105MM
|
Facility
|
OP
|
$2,517.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679318
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.67 |
| Max. Negotiated Rate |
$1,258.80 |
| Rate for Payer: Aetna Commercial |
$956.69
|
| Rate for Payer: Aetna Medicare Advantage |
$755.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$641.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$641.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$503.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$641.99
|
| Rate for Payer: Cigna Commercial |
$1,258.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$609.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$553.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$377.64
|
| Rate for Payer: UnitedHealthcare Community & State |
$60.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$66.72
|
|
|
HFN LAG SCREW 10.5MM X 120MM
|
Facility
|
OP
|
$2,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$66.28 |
| Max. Negotiated Rate |
$1,375.00 |
| Rate for Payer: Aetna Commercial |
$1,045.00
|
| Rate for Payer: Aetna Medicare Advantage |
$825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$550.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$701.25
|
| Rate for Payer: Cigna Commercial |
$1,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$665.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$605.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$66.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$72.88
|
|
|
HFN LAG SCREW 10.5MM X 120MM
|
Facility
|
IP
|
$2,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$412.50 |
| Max. Negotiated Rate |
$665.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$665.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$605.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
|
|
HFN LAG SCREW 10.5MM X 85MM
|
Facility
|
IP
|
$2,544.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.60 |
| Max. Negotiated Rate |
$615.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$508.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$615.65
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$559.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$381.60
|
|
|
HFN LAG SCREW 10.5MM X 85MM
|
Facility
|
OP
|
$2,544.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$61.31 |
| Max. Negotiated Rate |
$1,272.00 |
| Rate for Payer: Aetna Commercial |
$966.72
|
| Rate for Payer: Aetna Medicare Advantage |
$763.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$648.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$648.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$508.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$648.72
|
| Rate for Payer: Cigna Commercial |
$1,272.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$615.65
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$559.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$381.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$61.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$67.42
|
|
|
HFN LAG SCREW 10.5MM X 90 MM
|
Facility
|
IP
|
$5,110.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681528
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$766.50 |
| Max. Negotiated Rate |
$1,236.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,022.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,236.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,124.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.50
|
|
|
HFN LAG SCREW 10.5MM X 90 MM
|
Facility
|
OP
|
$5,110.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681528
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$123.15 |
| Max. Negotiated Rate |
$2,555.00 |
| Rate for Payer: Aetna Commercial |
$1,941.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1,533.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,303.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,303.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,022.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,303.05
|
| Rate for Payer: Cigna Commercial |
$2,555.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,236.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,124.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$123.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.41
|
|
|
HFN LH 125 DEG 11MM X 340MM
|
Facility
|
IP
|
$12,770.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683436
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,915.50 |
| Max. Negotiated Rate |
$3,090.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,554.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,090.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,809.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,915.50
|
|
|
HFN LH 125 DEG 11MM X 340MM
|
Facility
|
OP
|
$12,770.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683436
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.76 |
| Max. Negotiated Rate |
$6,385.00 |
| Rate for Payer: Aetna Commercial |
$4,852.60
|
| Rate for Payer: Aetna Medicare Advantage |
$3,831.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,256.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,256.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,554.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,256.35
|
| Rate for Payer: Cigna Commercial |
$6,385.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,090.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,809.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,915.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$307.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$338.40
|
|
|
HFN LH 125 DEG 11MM X 40MM
|
Facility
|
OP
|
$9,144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.37 |
| Max. Negotiated Rate |
$4,572.00 |
| Rate for Payer: Aetna Commercial |
$3,474.72
|
| Rate for Payer: Aetna Medicare Advantage |
$2,743.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,331.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,331.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,828.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,331.72
|
| Rate for Payer: Cigna Commercial |
$4,572.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,212.85
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,011.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,371.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$220.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$242.32
|
|
|
HFN LH 125 DEG 11MM X 40MM
|
Facility
|
IP
|
$9,144.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,371.60 |
| Max. Negotiated Rate |
$2,212.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,828.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,212.85
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,011.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,371.60
|
|
|
HFN RH 125 DEG 11MM X 260MM
|
Facility
|
IP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690403
|
|
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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,161.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
|
|
HFN RH 125 DEG 11MM X 260MM
|
Facility
|
OP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.78 |
| 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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,161.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$236.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$260.36
|
|
|
HFN RH 125 DEG 11MM X 420MM
|
Facility
|
IP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684350
|
|
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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,161.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
|
|
HFN RH 125 DEG 11MM X 420MM
|
Facility
|
OP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.78 |
| 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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,161.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$236.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$260.36
|
|
|
HFN RH 125 DEG 11MM X 95MM
|
Facility
|
IP
|
$14,905.00
|
|
| Hospital Charge Code |
270702734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,235.75 |
| Max. Negotiated Rate |
$3,607.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,981.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,279.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,235.75
|
|
|
HFN RH 125 DEG 11MM X 95MM
|
Facility
|
OP
|
$14,905.00
|
|
| Hospital Charge Code |
270702734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$359.21 |
| Max. Negotiated Rate |
$7,452.50 |
| Rate for Payer: Aetna Commercial |
$5,663.90
|
| Rate for Payer: Aetna Medicare Advantage |
$4,471.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,800.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,800.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,981.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,800.78
|
| Rate for Payer: Cigna Commercial |
$7,452.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,279.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,235.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$359.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$394.98
|
|
|
HFN RH 125 DEG 9MM X 260 MM
|
Facility
|
IP
|
$9,432.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,414.80 |
| Max. Negotiated Rate |
$2,282.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,886.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,282.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,075.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,414.80
|
|
|
HFN RH 125 DEG 9MM X 260 MM
|
Facility
|
OP
|
$9,432.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682505
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.31 |
| Max. Negotiated Rate |
$4,716.00 |
| Rate for Payer: Aetna Commercial |
$3,584.16
|
| Rate for Payer: Aetna Medicare Advantage |
$2,829.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,405.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,405.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,886.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,405.16
|
| Rate for Payer: Cigna Commercial |
$4,716.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,282.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,075.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,414.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$227.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$249.95
|
|
|
HFN RH 125 DEG 9MM X 420MM
|
Facility
|
IP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688657
|
|
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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,161.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
|
|
HFN RH 125 DEG 9MM X 420MM
|
Facility
|
OP
|
$9,825.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688657
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.78 |
| 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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,161.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,473.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$236.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$260.36
|
|