|
SCREW ACR 7.0 35MM 2223-3235
|
Facility
|
OP
|
$2,483.25
|
|
| Hospital Charge Code |
270608049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$1,241.62 |
| Rate for Payer: Aetna Commercial |
$943.63
|
| Rate for Payer: Aetna Medicare Advantage |
$744.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$633.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$633.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$496.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$633.23
|
| Rate for Payer: Cigna Commercial |
$1,241.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$600.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$546.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$372.49
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$65.81
|
|
|
SCREW ACR 7.0 35MM 2223-3235
|
Facility
|
IP
|
$2,483.25
|
|
| Hospital Charge Code |
270608049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$372.49 |
| Max. Negotiated Rate |
$600.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$496.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$600.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$546.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$372.49
|
|
|
SCREW ACUTRAK 2 MICRO 18.0MM
|
Facility
|
OP
|
$2,695.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682452
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$64.95 |
| Max. Negotiated Rate |
$1,347.50 |
| Rate for Payer: Aetna Commercial |
$1,024.10
|
| Rate for Payer: Aetna Medicare Advantage |
$808.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$687.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$687.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$539.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$687.23
|
| Rate for Payer: Cigna Commercial |
$1,347.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$652.19
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$592.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$404.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$64.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$71.42
|
|
|
SCREW ACUTRAK 2 MICRO 18.0MM
|
Facility
|
IP
|
$2,695.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682452
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$404.25 |
| Max. Negotiated Rate |
$652.19 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$539.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$652.19
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$592.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$404.25
|
|
|
SCREW AFFIXUS CORT 5.0X30MM
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$304.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.20
|
|
|
SCREW AFFIXUS CORT 5.0X30MM
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW AFFIXUS CORT 5.0X46MM
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW AFFIXUS CORT 5.0X46MM
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$304.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.20
|
|
|
SCREW ANCHORAGE 3X24MM
|
Facility
|
IP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669551
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$237.16 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$215.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
SCREW ANCHORAGE 3X24MM
|
Facility
|
OP
|
$980.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669551
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.62 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: Aetna Commercial |
$372.40
|
| Rate for Payer: Aetna Medicare Advantage |
$294.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$249.90
|
| Rate for Payer: Cigna Commercial |
$490.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$215.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.97
|
|
|
SCREW ANCHORAGE 3X28MM
|
Facility
|
IP
|
$980.00
|
|
| Hospital Charge Code |
270669552
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$237.16 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$215.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
|
|
SCREW ANCHORAGE 3X28MM
|
Facility
|
OP
|
$980.00
|
|
| Hospital Charge Code |
270669552
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.62 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: Aetna Commercial |
$372.40
|
| Rate for Payer: Aetna Medicare Advantage |
$294.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$249.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$196.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$249.90
|
| Rate for Payer: Cigna Commercial |
$490.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.16
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$215.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.97
|
|
|
SCREW ANGLE SLF TPNG 3.5x10MM
|
Facility
|
OP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$331.00 |
| Rate for Payer: Aetna Commercial |
$251.56
|
| Rate for Payer: Aetna Medicare Advantage |
$198.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.81
|
| Rate for Payer: Cigna Commercial |
$331.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.54
|
|
|
SCREW ANGLE SLF TPNG 3.5x10MM
|
Facility
|
IP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.30 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
|
|
SCREW ANGLE SLF TPNG 3.5x12MM
|
Facility
|
IP
|
$624.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$151.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$124.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$151.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$137.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.60
|
|
|
SCREW ANGLE SLF TPNG 3.5x12MM
|
Facility
|
OP
|
$624.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.04 |
| Max. Negotiated Rate |
$312.00 |
| Rate for Payer: Aetna Commercial |
$237.12
|
| Rate for Payer: Aetna Medicare Advantage |
$187.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$159.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$159.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$124.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$159.12
|
| Rate for Payer: Cigna Commercial |
$312.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$151.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$137.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.54
|
|
|
SCREW ANGLE SLF TPNG 3.5x14MM
|
Facility
|
IP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270659116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.30 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
|
|
SCREW ANGLE SLF TPNG 3.5x14MM
|
Facility
|
OP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270659116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$331.00 |
| Rate for Payer: Aetna Commercial |
$251.56
|
| Rate for Payer: Aetna Medicare Advantage |
$198.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.81
|
| Rate for Payer: Cigna Commercial |
$331.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.54
|
|
|
SCREW ANG LOCKING STR 3.5x30MM
|
Facility
|
IP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.30 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
|
|
SCREW ANG LOCKING STR 3.5x30MM
|
Facility
|
OP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674859
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$331.00 |
| Rate for Payer: Aetna Commercial |
$251.56
|
| Rate for Payer: Aetna Medicare Advantage |
$198.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.81
|
| Rate for Payer: Cigna Commercial |
$331.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.54
|
|
|
SCREW ANODYNE CER SDV 4.0X12MM
|
Facility
|
OP
|
$2,320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55.91 |
| Max. Negotiated Rate |
$1,160.00 |
| Rate for Payer: Aetna Commercial |
$881.60
|
| Rate for Payer: Aetna Medicare Advantage |
$696.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$591.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$591.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$464.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$591.60
|
| Rate for Payer: Cigna Commercial |
$1,160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$561.44
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$510.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$348.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$55.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$61.48
|
|
|
SCREW ANODYNE CER SDV 4.0X12MM
|
Facility
|
IP
|
$2,320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$561.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$464.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$561.44
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$510.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$348.00
|
|
|
SCREW ANTI -ROT 86MM
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.75 |
| Max. Negotiated Rate |
$272.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$272.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$247.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.75
|
|
|
SCREW ANTI -ROT 86MM
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692055
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.11 |
| Max. Negotiated Rate |
$562.50 |
| Rate for Payer: Aetna Commercial |
$427.50
|
| Rate for Payer: Aetna Medicare Advantage |
$337.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$286.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$286.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$286.88
|
| Rate for Payer: Cigna Commercial |
$562.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$272.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$247.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.81
|
|
|
SCREW ANTIROTAT 80MM
|
Facility
|
OP
|
$1,298.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696899
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$649.15 |
| Rate for Payer: Aetna Commercial |
$493.35
|
| Rate for Payer: Aetna Medicare Advantage |
$389.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$331.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$331.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$259.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$331.07
|
| Rate for Payer: Cigna Commercial |
$649.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$314.19
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$285.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.40
|
|