|
SCREW CORTICAL FIX 5x45MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 5x50MM
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FIX 5x50MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 6x40MM
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665832
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FIX 6x40MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665832
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 6 x50 MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687614
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 6 x50 MM
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687614
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FIX 7x30MM
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675404
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FIX 7x30MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675404
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 7x35MM
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FIX 7x35MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 7x40MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 7x40MM
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FIX 7 X 45
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FIX 7 X 45
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 7x50MM
|
Facility
|
OP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.88 |
| Max. Negotiated Rate |
$4,375.00 |
| Rate for Payer: Aetna Commercial |
$3,325.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,231.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,231.25
|
| Rate for Payer: Cigna Commercial |
$4,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.88
|
|
|
SCREW CORTICAL FIX 7x50MM
|
Facility
|
IP
|
$8,750.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270676960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$2,117.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,117.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,925.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.50
|
|
|
SCREW CORTICAL FULL THD 5x20MM
|
Facility
|
IP
|
$1,485.00
|
|
| Hospital Charge Code |
270666228
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.75 |
| Max. Negotiated Rate |
$359.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$297.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$359.37
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$326.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.75
|
|
|
SCREW CORTICAL FULL THD 5x20MM
|
Facility
|
OP
|
$1,485.00
|
|
| Hospital Charge Code |
270666228
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.79 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna Commercial |
$564.30
|
| Rate for Payer: Aetna Medicare Advantage |
$445.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$297.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$378.68
|
| Rate for Payer: Cigna Commercial |
$742.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$359.37
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$326.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.35
|
|
|
SCREW CORTICAL FULL THD 5x25MM
|
Facility
|
IP
|
$1,485.00
|
|
| Hospital Charge Code |
270666229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.75 |
| Max. Negotiated Rate |
$359.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$297.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$359.37
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$326.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.75
|
|
|
SCREW CORTICAL FULL THD 5x25MM
|
Facility
|
OP
|
$1,485.00
|
|
| Hospital Charge Code |
270666229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.79 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna Commercial |
$564.30
|
| Rate for Payer: Aetna Medicare Advantage |
$445.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$378.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$297.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$378.68
|
| Rate for Payer: Cigna Commercial |
$742.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$359.37
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$326.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.35
|
|
|
SCREW CORTICAL HD7 2.5X12MM
|
Facility
|
IP
|
$650.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699551
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$157.38 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.38
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.55
|
|
|
SCREW CORTICAL HD7 2.5X12MM
|
Facility
|
OP
|
$650.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699551
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.67 |
| Max. Negotiated Rate |
$325.18 |
| Rate for Payer: Aetna Commercial |
$247.13
|
| Rate for Payer: Aetna Medicare Advantage |
$195.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.84
|
| Rate for Payer: Cigna Commercial |
$325.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.38
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.23
|
|
|
SCREW CORTICAL HD7 2.5X16MM
|
Facility
|
OP
|
$650.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699552
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.67 |
| Max. Negotiated Rate |
$325.18 |
| Rate for Payer: Aetna Commercial |
$247.13
|
| Rate for Payer: Aetna Medicare Advantage |
$195.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$165.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$165.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$165.84
|
| Rate for Payer: Cigna Commercial |
$325.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.38
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.23
|
|
|
SCREW CORTICAL HD7 2.5X16MM
|
Facility
|
IP
|
$650.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699552
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$157.38 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$157.38
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$143.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.55
|
|