|
SCREW CORTEX SELFTAP 1.5x6MM
|
Facility
|
OP
|
$138.30
|
|
| Hospital Charge Code |
270656257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.66
|
|
|
SCREW CORTEX SELFTAP 1.5x6MM
|
Facility
|
IP
|
$138.30
|
|
| Hospital Charge Code |
270656257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x7mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.66
|
|
|
SCREW CORTEX SELFTAP 1.5x7mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x7mm
|
Facility
|
OP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270606012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$51.30
|
| Rate for Payer: Aetna Medicare Advantage |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.42
|
| Rate for Payer: Cigna Commercial |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$29.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.58
|
|
|
SCREW CORTEX SELFTAP 1.5x7mm
|
Facility
|
IP
|
$135.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270606012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$32.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$29.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.25
|
|
|
SCREW CORTEX SELFTAP 1.5x8mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.66
|
|
|
SCREW CORTEX SELFTAP 1.5x8mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5X8MM
|
Facility
|
OP
|
$188.90
|
|
| Hospital Charge Code |
C270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$94.45 |
| Rate for Payer: Aetna Commercial |
$71.78
|
| Rate for Payer: Aetna Medicare Advantage |
$56.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.17
|
| Rate for Payer: Cigna Commercial |
$94.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$41.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.34
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.01
|
|
|
SCREW CORTEX SELFTAP 1.5X8MM
|
Facility
|
IP
|
$188.90
|
|
| Hospital Charge Code |
C270656260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.34 |
| Max. Negotiated Rate |
$45.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.71
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$41.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.34
|
|
|
SCREW CORTEX SELFTAP 1.5x9MM
|
Facility
|
IP
|
$138.30
|
|
| Hospital Charge Code |
270656261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 1.5x9MM
|
Facility
|
OP
|
$138.30
|
|
| Hospital Charge Code |
270656261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.66
|
|
|
SCREW CORTEX SELFTAP 2.0x10mm
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$34.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
|
|
SCREW CORTEX SELFTAP 2.0x10mm
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$71.22 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: Aetna Medicare Advantage |
$42.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.32
|
| Rate for Payer: Cigna Commercial |
$71.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.77
|
|
|
SCREW CORTEX SELFTAP 2.0x11mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.66
|
|
|
SCREW CORTEX SELFTAP 2.0x11mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 2.0x12MM
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$71.22 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: Aetna Medicare Advantage |
$42.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.32
|
| Rate for Payer: Cigna Commercial |
$71.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.77
|
|
|
SCREW CORTEX SELFTAP 2.0x12MM
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654770
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$34.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
|
|
SCREW CORTEX SELFTAP 2.0x13mm
|
Facility
|
OP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654772
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$41.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.27
|
| Rate for Payer: Cigna Commercial |
$69.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.66
|
|
|
SCREW CORTEX SELFTAP 2.0x13mm
|
Facility
|
IP
|
$138.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654772
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$33.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$30.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.75
|
|
|
SCREW CORTEX SELFTAP 2.0x14MM
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$71.22 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: Aetna Medicare Advantage |
$42.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.32
|
| Rate for Payer: Cigna Commercial |
$71.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.77
|
|
|
SCREW CORTEX SELFTAP 2.0x14MM
|
Facility
|
IP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$34.47 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
|
|
SCREW CORTEX SELF TAP 2.0X14MM
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$36.78 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.78
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.80
|
|
|
SCREW CORTEX SELF TAP 2.0X14MM
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Aetna Commercial |
$57.76
|
| Rate for Payer: Aetna Medicare Advantage |
$45.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.76
|
| Rate for Payer: Cigna Commercial |
$76.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.78
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.03
|
|
|
SCREW CORTEX SELFTAP 2.0x16MM
|
Facility
|
OP
|
$142.45
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270654776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$71.22 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: Aetna Medicare Advantage |
$42.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.32
|
| Rate for Payer: Cigna Commercial |
$71.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.47
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$31.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.77
|
|