|
SCREW CORTEX 2.0/16MM SELF TAP
|
Facility
|
OP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270652392
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$73.78 |
| Rate for Payer: Aetna Commercial |
$56.07
|
| Rate for Payer: Aetna Medicare Advantage |
$44.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.63
|
| Rate for Payer: Cigna Commercial |
$73.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$32.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.91
|
|
|
SCREW CORTEX 2.0mm TI SLF TAP
|
Facility
|
OP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$77.58 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare Advantage |
$46.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.56
|
| Rate for Payer: Cigna Commercial |
$77.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$34.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.11
|
|
|
SCREW CORTEX 2.0mm TI SLF TAP
|
Facility
|
IP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682916
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$34.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
|
|
SCREW CORTEX 2.0mm TI SLF TAP
|
Facility
|
OP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682916
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$77.58 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare Advantage |
$46.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.56
|
| Rate for Payer: Cigna Commercial |
$77.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$34.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.11
|
|
|
SCREW CORTEX 2.0mm TI SLF TAP
|
Facility
|
IP
|
$155.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270682915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$34.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.27
|
|
|
SCREW CORTEX 2.0MMX11MM
|
Facility
|
IP
|
$222.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656837
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.84
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$48.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.38
|
|
|
SCREW CORTEX 2.0MMX11MM
|
Facility
|
OP
|
$222.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656837
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$111.25 |
| Rate for Payer: Aetna Commercial |
$84.55
|
| Rate for Payer: Aetna Medicare Advantage |
$66.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.74
|
| Rate for Payer: Cigna Commercial |
$111.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.84
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$48.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.90
|
|
|
SCREW CORTEX 2.0x10MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669984
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x10MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669984
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.23
|
|
|
SCREW CORTEX 2.0x12mm
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604173
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.23
|
|
|
SCREW CORTEX 2.0x12mm
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604173
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x12MM
|
Facility
|
IP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656877
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$35.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$32.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.13
|
|
|
SCREW CORTEX 2.0x12MM
|
Facility
|
OP
|
$147.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656877
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$73.78 |
| Rate for Payer: Aetna Commercial |
$56.07
|
| Rate for Payer: Aetna Medicare Advantage |
$44.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.63
|
| Rate for Payer: Cigna Commercial |
$73.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$32.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.91
|
|
|
SCREW CORTEX 2.0x14MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604174
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x14MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604174
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.23
|
|
|
SCREW CORTEX 2.0x16MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604175
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x16MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604175
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.23
|
|
|
SCREW CORTEX 2.0X16MM
|
Facility
|
IP
|
$124.50
|
|
| Hospital Charge Code |
270668166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$30.13 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.13
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$27.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.68
|
|
|
SCREW CORTEX 2.0X16MM
|
Facility
|
OP
|
$124.50
|
|
| Hospital Charge Code |
270668166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$62.25 |
| Rate for Payer: Aetna Commercial |
$47.31
|
| Rate for Payer: Aetna Medicare Advantage |
$37.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.75
|
| Rate for Payer: Cigna Commercial |
$62.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.13
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$27.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.30
|
|
|
SCREW CORTEX 2.0x18MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604176
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x18MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604176
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.23
|
|
|
SCREW CORTEX 2.0x20MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604177
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.23
|
|
|
SCREW CORTEX 2.0x20MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604177
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x8MM
|
Facility
|
IP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$29.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
|
|
SCREW CORTEX 2.0x8MM
|
Facility
|
OP
|
$122.05
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$61.02 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare Advantage |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.12
|
| Rate for Payer: Cigna Commercial |
$61.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$26.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.23
|
|