|
SCREW CANN 7.0x95mm
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604946
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.0x95mm
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604946
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x100MM 16MM THRD
|
Facility
|
IP
|
$1,129.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.48 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.42
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$248.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.48
|
|
|
SCREW CANN 7.3x100MM 16MM THRD
|
Facility
|
OP
|
$1,129.85
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.23 |
| Max. Negotiated Rate |
$564.92 |
| Rate for Payer: Aetna Commercial |
$429.34
|
| Rate for Payer: Aetna Medicare Advantage |
$338.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$288.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$288.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$225.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$288.11
|
| Rate for Payer: Cigna Commercial |
$564.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.42
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$248.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.48
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.94
|
|
|
SCREW CANN 7.3x100mm FULL THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x100mm FULL THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x105mm FULL THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x105mm FULL THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x110MM 16MM THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x110MM 16MM THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x110mm FULL THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x110mm FULL THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x115mm FULL THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x115mm FULL THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x120MM 16MM THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x120MM 16MM THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x120mm FULL THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x120mm FULL THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x125mm
|
Facility
|
IP
|
$139.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656174
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.86 |
| Max. Negotiated Rate |
$33.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.65
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.86
|
|
|
SCREW CANN 7.3x125mm
|
Facility
|
OP
|
$139.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656174
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$69.53 |
| Rate for Payer: Aetna Commercial |
$52.84
|
| Rate for Payer: Aetna Medicare Advantage |
$41.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.46
|
| Rate for Payer: Cigna Commercial |
$69.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.65
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.86
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.68
|
|
|
SCREW CANN 7.3x125MM 16MM THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x125MM 16MM THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x125mm FULL THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|
|
SCREW CANN 7.3x125mm FULL THRD
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.03 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$252.70
|
| Rate for Payer: Aetna Medicare Advantage |
$199.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.57
|
| Rate for Payer: Cigna Commercial |
$332.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.62
|
|
|
SCREW CANN 7.3x130MM 16MM THRD
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270605039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.75 |
| Max. Negotiated Rate |
$160.93 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.93
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$146.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.75
|
|