|
SCREW 14MM ST FIXED CURE
|
Facility
|
IP
|
$1,827.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698843
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.05 |
| Max. Negotiated Rate |
$442.13 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$365.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$442.13
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$401.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$274.05
|
|
|
SCREW 14MM ST FIXED CURE
|
Facility
|
OP
|
$1,827.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698843
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.03 |
| Max. Negotiated Rate |
$913.50 |
| Rate for Payer: Aetna Commercial |
$694.26
|
| Rate for Payer: Aetna Medicare Advantage |
$548.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$465.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$465.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$365.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$465.88
|
| Rate for Payer: Cigna Commercial |
$913.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$442.13
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$401.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$274.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$48.42
|
|
|
SCREW 14MM ST VARIABLE CURE
|
Facility
|
IP
|
$1,827.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.05 |
| Max. Negotiated Rate |
$442.13 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$365.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$442.13
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$401.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$274.05
|
|
|
SCREW 14MM ST VARIABLE CURE
|
Facility
|
OP
|
$1,827.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.03 |
| Max. Negotiated Rate |
$913.50 |
| Rate for Payer: Aetna Commercial |
$694.26
|
| Rate for Payer: Aetna Medicare Advantage |
$548.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$465.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$465.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$365.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$465.88
|
| Rate for Payer: Cigna Commercial |
$913.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$442.13
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$401.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$274.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$48.42
|
|
|
SCREW 14 MM X 4 MM
|
Facility
|
IP
|
$1,895.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.25 |
| Max. Negotiated Rate |
$458.59 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$379.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$458.59
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$416.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.25
|
|
|
SCREW 14 MM X 4 MM
|
Facility
|
OP
|
$1,895.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.67 |
| Max. Negotiated Rate |
$947.50 |
| Rate for Payer: Aetna Commercial |
$720.10
|
| Rate for Payer: Aetna Medicare Advantage |
$568.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$483.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$483.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$379.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$483.23
|
| Rate for Payer: Cigna Commercial |
$947.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$458.59
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$416.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$50.22
|
|
|
SCREW 1.5mm 16MM ST CORTEX
|
Facility
|
IP
|
$152.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680930
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.91 |
| Max. Negotiated Rate |
$36.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.91
|
|
|
SCREW 1.5mm 16MM ST CORTEX
|
Facility
|
OP
|
$152.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680930
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.68 |
| Max. Negotiated Rate |
$76.38 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: Aetna Medicare Advantage |
$45.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.95
|
| Rate for Payer: Cigna Commercial |
$76.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.91
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.05
|
|
|
SCREW 1.5mm CORTICAL 235004015
|
Facility
|
OP
|
$37.75
|
|
| Hospital Charge Code |
270610102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$18.88 |
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna Medicare Advantage |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.63
|
| Rate for Payer: Cigna Commercial |
$18.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$8.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.66
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.00
|
|
|
SCREW 1.5mm CORTICAL 235004015
|
Facility
|
IP
|
$37.75
|
|
| Hospital Charge Code |
270610102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$9.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$8.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.66
|
|
|
SCREW 1.5MM TI CORTEX SELF TAP
|
Facility
|
IP
|
$148.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656852
|
|
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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$32.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.25
|
|
|
SCREW 1.5MM TI CORTEX SELF TAP
|
Facility
|
IP
|
$144.00
|
|
| Hospital Charge Code |
270656857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$34.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
SCREW 1.5MM TI CORTEX SELF TAP
|
Facility
|
OP
|
$144.00
|
|
| Hospital Charge Code |
270656857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$54.72
|
| Rate for Payer: Aetna Medicare Advantage |
$43.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.72
|
| Rate for Payer: Cigna Commercial |
$72.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.85
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.82
|
|
|
SCREW 1.5MM TI CORTEX SELF TAP
|
Facility
|
IP
|
$152.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.91 |
| Max. Negotiated Rate |
$36.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.91
|
|
|
SCREW 1.5MM TI CORTEX SELF TAP
|
Facility
|
OP
|
$148.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656852
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$74.15 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: Aetna Medicare Advantage |
$44.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.82
|
| Rate for Payer: Cigna Commercial |
$74.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$32.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.93
|
|
|
SCREW 1.5MM TI CORTEX SELF TAP
|
Facility
|
OP
|
$152.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.68 |
| Max. Negotiated Rate |
$76.38 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: Aetna Medicare Advantage |
$45.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.95
|
| Rate for Payer: Cigna Commercial |
$76.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.91
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.05
|
|
|
SCREW 1.5 X 4MM
|
Facility
|
OP
|
$490.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.81 |
| Max. Negotiated Rate |
$245.00 |
| Rate for Payer: Aetna Commercial |
$186.20
|
| Rate for Payer: Aetna Medicare Advantage |
$147.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$124.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$124.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$98.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$124.95
|
| Rate for Payer: Cigna Commercial |
$245.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.58
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$107.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$73.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.98
|
|
|
SCREW 1.5 X 4MM
|
Facility
|
IP
|
$490.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270662164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$118.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$98.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.58
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$107.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$73.50
|
|
|
SCREW 1.5 X 5 MM
|
Facility
|
IP
|
$420.00
|
|
| Hospital Charge Code |
270662167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$101.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$84.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$92.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
|
|
SCREW 1.5 X 5 MM
|
Facility
|
OP
|
$420.00
|
|
| Hospital Charge Code |
270662167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$159.60
|
| Rate for Payer: Aetna Medicare Advantage |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$107.10
|
| Rate for Payer: Cigna Commercial |
$210.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$92.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.13
|
|
|
SCREW 1.5x6m HT X-DRIVE 916106
|
Facility
|
IP
|
$280.00
|
|
| Hospital Charge Code |
270642178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$67.76 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$56.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.76
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$61.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
|
|
SCREW 1.5x6m HT X-DRIVE 916106
|
Facility
|
OP
|
$280.00
|
|
| Hospital Charge Code |
270642178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare Advantage |
$84.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$56.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.40
|
| Rate for Payer: Cigna Commercial |
$140.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.76
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$61.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.42
|
|
|
SCREW 1.6MM
|
Facility
|
OP
|
$5,605.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.08 |
| Max. Negotiated Rate |
$2,802.50 |
| Rate for Payer: Aetna Commercial |
$2,129.90
|
| Rate for Payer: Aetna Medicare Advantage |
$1,681.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,429.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,429.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,121.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,429.28
|
| Rate for Payer: Cigna Commercial |
$2,802.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,356.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,233.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$840.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$135.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$148.53
|
|
|
SCREW 1.6MM
|
Facility
|
IP
|
$5,605.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$840.75 |
| Max. Negotiated Rate |
$1,356.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,121.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,356.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,233.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$840.75
|
|
|
SCREW 16 MM 1.5
|
Facility
|
OP
|
$1,980.00
|
|
| Hospital Charge Code |
270702799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.72 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Aetna Commercial |
$752.40
|
| Rate for Payer: Aetna Medicare Advantage |
$594.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$504.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$504.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$396.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$504.90
|
| Rate for Payer: Cigna Commercial |
$990.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$479.16
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$435.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$297.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$52.47
|
|
