|
SCREW CANN 6.5x125MM
|
Facility
|
IP
|
$1,071.00
|
|
| Hospital Charge Code |
270676293
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.65 |
| Max. Negotiated Rate |
$259.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
|
|
SCREW CANN 6.5x125MM
|
Facility
|
OP
|
$1,071.00
|
|
| Hospital Charge Code |
270676293
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna Commercial |
$406.98
|
| Rate for Payer: Aetna Medicare Advantage |
$321.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$273.11
|
| Rate for Payer: Cigna Commercial |
$535.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.38
|
|
|
SCREW CANN 6.5x125MM 32MM THRD
|
Facility
|
IP
|
$1,103.15
|
|
| Hospital Charge Code |
270678286
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.47 |
| Max. Negotiated Rate |
$266.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.47
|
|
|
SCREW CANN 6.5x125MM 32MM THRD
|
Facility
|
OP
|
$1,103.15
|
|
| Hospital Charge Code |
270678286
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$551.58 |
| Rate for Payer: Aetna Commercial |
$419.20
|
| Rate for Payer: Aetna Medicare Advantage |
$330.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$281.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$281.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$281.30
|
| Rate for Payer: Cigna Commercial |
$551.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.47
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.23
|
|
|
SCREW CANN 6.5 X 12MM
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688694
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$550.00 |
| Rate for Payer: Aetna Commercial |
$418.00
|
| Rate for Payer: Aetna Medicare Advantage |
$330.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$280.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$280.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$280.50
|
| Rate for Payer: Cigna Commercial |
$550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.15
|
|
|
SCREW CANN 6.5 X 12MM
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688694
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$266.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.00
|
|
|
SCREW CANN 6.5x130MM 16MM THRD
|
Facility
|
IP
|
$1,103.15
|
|
| Hospital Charge Code |
270678287
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.47 |
| Max. Negotiated Rate |
$266.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.47
|
|
|
SCREW CANN 6.5x130MM 16MM THRD
|
Facility
|
OP
|
$1,103.15
|
|
| Hospital Charge Code |
270678287
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$551.58 |
| Rate for Payer: Aetna Commercial |
$419.20
|
| Rate for Payer: Aetna Medicare Advantage |
$330.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$281.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$281.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$281.30
|
| Rate for Payer: Cigna Commercial |
$551.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.47
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.23
|
|
|
SCREW CANN 6.5x35MM
|
Facility
|
OP
|
$1,071.00
|
|
| Hospital Charge Code |
270676287
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna Commercial |
$406.98
|
| Rate for Payer: Aetna Medicare Advantage |
$321.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$273.11
|
| Rate for Payer: Cigna Commercial |
$535.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.38
|
|
|
SCREW CANN 6.5x35MM
|
Facility
|
IP
|
$1,071.00
|
|
| Hospital Charge Code |
270676287
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.65 |
| Max. Negotiated Rate |
$259.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
|
|
SCREW CANN 6.5X35MM
|
Facility
|
IP
|
$6,740.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,011.00 |
| Max. Negotiated Rate |
$1,631.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,348.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,631.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,482.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,011.00
|
|
|
SCREW CANN 6.5X35MM
|
Facility
|
OP
|
$6,740.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.43 |
| Max. Negotiated Rate |
$3,370.00 |
| Rate for Payer: Aetna Commercial |
$2,561.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,022.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,718.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,718.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,348.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,718.70
|
| Rate for Payer: Cigna Commercial |
$3,370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,631.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,482.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,011.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$162.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$178.61
|
|
|
SCREW CANN 6.5x50MM
|
Facility
|
OP
|
$1,071.00
|
|
| Hospital Charge Code |
270676289
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna Commercial |
$406.98
|
| Rate for Payer: Aetna Medicare Advantage |
$321.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$273.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$273.11
|
| Rate for Payer: Cigna Commercial |
$535.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.38
|
|
|
SCREW CANN 6.5x50MM
|
Facility
|
IP
|
$1,071.00
|
|
| Hospital Charge Code |
270676289
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.65 |
| Max. Negotiated Rate |
$259.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$214.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$259.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$235.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$160.65
|
|
|
SCREW CANN 6.5X55X16MM THR
|
Facility
|
IP
|
$5,130.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$769.50 |
| Max. Negotiated Rate |
$1,241.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,026.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,241.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,128.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$769.50
|
|
|
SCREW CANN 6.5X55X16MM THR
|
Facility
|
OP
|
$5,130.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$123.63 |
| Max. Negotiated Rate |
$2,565.00 |
| Rate for Payer: Aetna Commercial |
$1,949.40
|
| Rate for Payer: Aetna Medicare Advantage |
$1,539.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,308.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,308.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,026.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,308.15
|
| Rate for Payer: Cigna Commercial |
$2,565.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,241.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,128.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$769.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$123.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.94
|
|
|
SCREW CANN 6.5x60MM 16MM THRD
|
Facility
|
OP
|
$1,103.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678282
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$551.58 |
| Rate for Payer: Aetna Commercial |
$419.20
|
| Rate for Payer: Aetna Medicare Advantage |
$330.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$281.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$281.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$281.30
|
| Rate for Payer: Cigna Commercial |
$551.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.47
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.23
|
|
|
SCREW CANN 6.5x60MM 16MM THRD
|
Facility
|
IP
|
$1,103.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678282
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.47 |
| Max. Negotiated Rate |
$266.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$220.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$266.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$242.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.47
|
|
|
SCREW CANN 6.5x65MM 16MM THRD
|
Facility
|
OP
|
$1,136.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$568.12 |
| Rate for Payer: Aetna Commercial |
$431.77
|
| Rate for Payer: Aetna Medicare Advantage |
$340.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$289.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$289.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$289.74
|
| Rate for Payer: Cigna Commercial |
$568.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$249.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.44
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.11
|
|
|
SCREW CANN 6.5x65MM 16MM THRD
|
Facility
|
IP
|
$1,136.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.44 |
| Max. Negotiated Rate |
$274.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$249.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.44
|
|
|
SCREW CANN 6.5x70MM 16MM THRD
|
Facility
|
IP
|
$1,136.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676291
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.44 |
| Max. Negotiated Rate |
$274.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$249.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.44
|
|
|
SCREW CANN 6.5x70MM 16MM THRD
|
Facility
|
OP
|
$1,136.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676291
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$568.12 |
| Rate for Payer: Aetna Commercial |
$431.77
|
| Rate for Payer: Aetna Medicare Advantage |
$340.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$289.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$289.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$289.74
|
| Rate for Payer: Cigna Commercial |
$568.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$249.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.44
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.11
|
|
|
SCREW CANN 6.5x75MM 16MM THRD
|
Facility
|
OP
|
$1,136.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680580
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$568.12 |
| Rate for Payer: Aetna Commercial |
$431.77
|
| Rate for Payer: Aetna Medicare Advantage |
$340.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$289.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$289.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$289.74
|
| Rate for Payer: Cigna Commercial |
$568.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$249.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.44
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.11
|
|
|
SCREW CANN 6.5x75MM 16MM THRD
|
Facility
|
IP
|
$1,136.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270680580
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.44 |
| Max. Negotiated Rate |
$274.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$227.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$274.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$249.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.44
|
|
|
SCREW CANN 6.5x75mm SHORT THRD
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673681
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.19 |
| Max. Negotiated Rate |
$937.50 |
| Rate for Payer: Aetna Commercial |
$712.50
|
| Rate for Payer: Aetna Medicare Advantage |
$562.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$478.12
|
| Rate for Payer: Cigna Commercial |
$937.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$453.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$412.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.69
|
|