|
SCREW BONE CANN F/THD 4x30MM
|
Facility
|
IP
|
$76.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.45 |
| Max. Negotiated Rate |
$18.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.45
|
|
|
SCREW BONE CANN F/THD 4x30MM
|
Facility
|
OP
|
$76.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$38.17 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare Advantage |
$22.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.47
|
| Rate for Payer: Cigna Commercial |
$38.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.02
|
|
|
SCREW BONE CANN F/THD 4x35MM
|
Facility
|
IP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603210
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$17.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
|
|
SCREW BONE CANN F/THD 4x35MM
|
Facility
|
OP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603210
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare Advantage |
$22.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.91
|
| Rate for Payer: Cigna Commercial |
$37.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.96
|
|
|
SCREW BONE CANN F/THD 4x40MM
|
Facility
|
OP
|
$76.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$38.17 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare Advantage |
$22.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.47
|
| Rate for Payer: Cigna Commercial |
$38.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.02
|
|
|
SCREW BONE CANN F/THD 4x40MM
|
Facility
|
IP
|
$76.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.45 |
| Max. Negotiated Rate |
$18.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.45
|
|
|
SCREW BONE CANN F/THD 4x45MM
|
Facility
|
IP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$17.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
|
|
SCREW BONE CANN F/THD 4x45MM
|
Facility
|
OP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare Advantage |
$22.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.91
|
| Rate for Payer: Cigna Commercial |
$37.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.96
|
|
|
SCREW BONE CANN F/THD 4x50MM
|
Facility
|
OP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare Advantage |
$22.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.91
|
| Rate for Payer: Cigna Commercial |
$37.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.96
|
|
|
SCREW BONE CANN F/THD 4x50MM
|
Facility
|
IP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$17.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
|
|
SCREW BONE CANN F/THD 4x55MM
|
Facility
|
IP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$17.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
|
|
SCREW BONE CANN F/THD 4x55MM
|
Facility
|
OP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare Advantage |
$22.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.91
|
| Rate for Payer: Cigna Commercial |
$37.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.96
|
|
|
SCREW BONE CANN F/THD 4x60MM
|
Facility
|
OP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603220
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare Advantage |
$22.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.91
|
| Rate for Payer: Cigna Commercial |
$37.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.96
|
|
|
SCREW BONE CANN F/THD 4x60MM
|
Facility
|
IP
|
$74.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270603220
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$17.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.12
|
|
|
SCREW BONE CANN P/THD 4x10MM
|
Facility
|
IP
|
$70.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$17.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.54
|
|
|
SCREW BONE CANN P/THD 4x10MM
|
Facility
|
OP
|
$70.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$26.71
|
| Rate for Payer: Aetna Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.93
|
| Rate for Payer: Cigna Commercial |
$35.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.86
|
|
|
SCREW BONE CANN P/THD 4x12MM
|
Facility
|
IP
|
$70.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$17.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.54
|
|
|
SCREW BONE CANN P/THD 4x12MM
|
Facility
|
OP
|
$70.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$26.71
|
| Rate for Payer: Aetna Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.93
|
| Rate for Payer: Cigna Commercial |
$35.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.86
|
|
|
SCREW BONE CANN P/THD 4x16MM
|
Facility
|
IP
|
$70.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$17.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.54
|
|
|
SCREW BONE CANN P/THD 4x16MM
|
Facility
|
OP
|
$70.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$26.71
|
| Rate for Payer: Aetna Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.93
|
| Rate for Payer: Cigna Commercial |
$35.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.86
|
|
|
SCREW BONE CANN P/THD 4x18MM
|
Facility
|
OP
|
$76.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$38.17 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare Advantage |
$22.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.47
|
| Rate for Payer: Cigna Commercial |
$38.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.02
|
|
|
SCREW BONE CANN P/THD 4x18MM
|
Facility
|
IP
|
$76.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.45 |
| Max. Negotiated Rate |
$18.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.45
|
|
|
SCREW BONE CANN P/THD 4x20MM
|
Facility
|
OP
|
$72.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$36.20 |
| Rate for Payer: Aetna Commercial |
$27.51
|
| Rate for Payer: Aetna Medicare Advantage |
$21.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.46
|
| Rate for Payer: Cigna Commercial |
$36.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.86
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.92
|
|
|
SCREW BONE CANN P/THD 4x20MM
|
Facility
|
IP
|
$72.40
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$17.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.86
|
|
|
SCREW BONE CANN P/THD 4x22MM
|
Facility
|
OP
|
$70.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$26.71
|
| Rate for Payer: Aetna Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.93
|
| Rate for Payer: Cigna Commercial |
$35.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.01
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.54
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.86
|
|