|
SCREW 4.5MM CORTEX SELFTAP72MM
|
Facility
|
OP
|
$88.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$44.25 |
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Medicare Advantage |
$26.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.57
|
| Rate for Payer: Cigna Commercial |
$44.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.42
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$19.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.35
|
|
|
SCREW 4.5MM CORTEX SELFTAP72MM
|
Facility
|
IP
|
$88.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.42
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$19.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
|
|
SCREW 4.5MM CORTEX SELFTAP80MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MM CORTEX SELFTAP80MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$55.20
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.85
|
|
|
SCREW 4.5MM CORTEX SELFTAP85MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655792
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MM CORTEX SELFTAP85MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655792
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$55.20
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.85
|
|
|
SCREW 4.5MM CORTEX SELFTAP90MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655794
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$55.20
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.85
|
|
|
SCREW 4.5MM CORTEX SELFTAP90MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655794
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MM CORTEX SELFTAP95MM
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655798
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MM CORTEX SELFTAP95MM
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655798
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$55.20
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.85
|
|
|
SCREW 4.5MM CORTEX SELFTTAP76M
|
Facility
|
IP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
|
|
SCREW 4.5MM CORTEX SELFTTAP76M
|
Facility
|
OP
|
$145.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270655788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$72.62 |
| Rate for Payer: Aetna Commercial |
$55.20
|
| Rate for Payer: Aetna Medicare Advantage |
$43.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.04
|
| Rate for Payer: Cigna Commercial |
$72.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.79
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.85
|
|
|
SCREW 4.5MM CORTEX TI 26MM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$65.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
|
|
SCREW 4.5MM CORTEX TI 26MM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare Advantage |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.93
|
| Rate for Payer: Cigna Commercial |
$135.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW 4.5MM CORTEX TI 32MM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare Advantage |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.93
|
| Rate for Payer: Cigna Commercial |
$135.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW 4.5MM CORTEX TI 32MM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$65.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
|
|
SCREW 4.5MM CORTEX TI 34MM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare Advantage |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.93
|
| Rate for Payer: Cigna Commercial |
$135.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW 4.5MM CORTEX TI 34MM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$65.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
|
|
SCREW 4.5MM CORTEX TI 38MM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare Advantage |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.93
|
| Rate for Payer: Cigna Commercial |
$135.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW 4.5MM CORTEX TI 38MM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$65.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
|
|
SCREW 4.5MM CORTEX TI 48MM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare Advantage |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.93
|
| Rate for Payer: Cigna Commercial |
$135.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW 4.5MM CORTEX TI 48MM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$65.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
|
|
SCREW 4.5MM CORTEX TI 50MM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$65.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
|
|
SCREW 4.5MM CORTEX TI 50MM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare Advantage |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.93
|
| Rate for Payer: Cigna Commercial |
$135.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW 4.5mm CORTICAL 54 230655
|
Facility
|
IP
|
$36.25
|
|
| Hospital Charge Code |
270610345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$8.77 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.77
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$7.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.44
|
|