|
SCREW 4.5MM CORTEX SELFTAP20MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP20MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP22MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP22MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP26MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655725
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP26MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655725
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP28MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP28MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP30MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP30MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP32MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP32MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP34MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP34MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP36MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP36MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP38MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP38MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP40MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655736
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP40MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655736
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP42MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP42MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP44MM
|
Facility
|
IP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
|
|
SCREW 4.5MM CORTEX SELFTAP44MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655740
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
SCREW 4.5MM CORTEX SELFTAP46MM
|
Facility
|
OP
|
$91.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$45.58 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare Advantage |
$27.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.24
|
| Rate for Payer: Cigna Commercial |
$45.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.06
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|