|
SCREW CORT NON LOCK 3.5X10MM
|
Facility
|
IP
|
$495.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.25 |
| Max. Negotiated Rate |
$119.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.79
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$108.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
|
|
SCREW CORT NON LOCK 3.5X10MM
|
Facility
|
OP
|
$495.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$188.10
|
| Rate for Payer: Aetna Medicare Advantage |
$148.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.22
|
| Rate for Payer: Cigna Commercial |
$247.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.79
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$108.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.12
|
|
|
SCREW CORT NON LOCK 3.5X26MM
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672238
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$135.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$123.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.00
|
|
|
SCREW CORT NON LOCK 3.5X26MM
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672238
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: Aetna Commercial |
$212.80
|
| Rate for Payer: Aetna Medicare Advantage |
$168.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$142.80
|
| Rate for Payer: Cigna Commercial |
$280.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$123.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.84
|
|
|
SCREW CORT NON LOCK 3.5x28MM
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
SCREW CORT NON LOCK 3.5x28MM
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270665683
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW CORT NON LOCK 3.5x30MM
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
SCREW CORT NON LOCK 3.5x30MM
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW CORT NON LOCK 3.5x32MM
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW CORT NON LOCK 3.5x32MM
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270648915
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
SCREW CORT NON LOCK 3.5x36MM
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673652
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW CORT NON LOCK 3.5x36MM
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673652
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
SCREW CORT NON LOCK 3.5X40MM
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672237
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$135.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$123.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.00
|
|
|
SCREW CORT NON LOCK 3.5X40MM
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672237
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: Aetna Commercial |
$212.80
|
| Rate for Payer: Aetna Medicare Advantage |
$168.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$142.80
|
| Rate for Payer: Cigna Commercial |
$280.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$123.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.84
|
|
|
SCREW CORT NON LOCK 3.5X54MM
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: Aetna Commercial |
$212.80
|
| Rate for Payer: Aetna Medicare Advantage |
$168.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$142.80
|
| Rate for Payer: Cigna Commercial |
$280.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$123.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.84
|
|
|
SCREW CORT NON LOCK 3.5X54MM
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$135.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$135.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$123.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.00
|
|
|
SCREW CORT NON LOCK 3.5x60MM
|
Facility
|
OP
|
$360.00
|
|
| Hospital Charge Code |
270676099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.68 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$136.80
|
| Rate for Payer: Aetna Medicare Advantage |
$108.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.80
|
| Rate for Payer: Cigna Commercial |
$180.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$79.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.54
|
|
|
SCREW CORT NON LOCK 3.5x60MM
|
Facility
|
IP
|
$360.00
|
|
| Hospital Charge Code |
270676099
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$87.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$79.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.00
|
|
|
SCREW CORT NON-LOCKING 4.5x24m
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
270671865
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$66.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$60.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
SCREW CORT NON-LOCKING 4.5x24m
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
270671865
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$137.50 |
| Rate for Payer: Aetna Commercial |
$104.50
|
| Rate for Payer: Aetna Medicare Advantage |
$82.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.12
|
| Rate for Payer: Cigna Commercial |
$137.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$60.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.29
|
|
|
SCREW CORT NON-LOCKING 4.5x26m
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
270671866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$137.50 |
| Rate for Payer: Aetna Commercial |
$104.50
|
| Rate for Payer: Aetna Medicare Advantage |
$82.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.12
|
| Rate for Payer: Cigna Commercial |
$137.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$60.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.29
|
|
|
SCREW CORT NON-LOCKING 4.5x26m
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
270671866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$66.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$60.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
SCREW CORT NON-LOCKING 4.5x30m
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
270671867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$137.50 |
| Rate for Payer: Aetna Commercial |
$104.50
|
| Rate for Payer: Aetna Medicare Advantage |
$82.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.12
|
| Rate for Payer: Cigna Commercial |
$137.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$60.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.29
|
|
|
SCREW CORT NON-LOCKING 4.5x30m
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
270671867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$66.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$60.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
SCREW CORT NON LOCKNG 3.5x12MM
|
Facility
|
OP
|
$442.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270661775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Aetna Commercial |
$167.96
|
| Rate for Payer: Aetna Medicare Advantage |
$132.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$112.71
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.71
|
|