|
SCREW CTR-DRV 2.7x8mm
|
Facility
|
IP
|
$151.25
|
|
| Hospital Charge Code |
270610979
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.69 |
| Max. Negotiated Rate |
$36.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.69
|
|
|
SCREW CTR-DRV 2.7x8mm
|
Facility
|
OP
|
$151.25
|
|
| Hospital Charge Code |
270610979
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$75.62 |
| Rate for Payer: Aetna Commercial |
$57.48
|
| Rate for Payer: Aetna Medicare Advantage |
$45.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.57
|
| Rate for Payer: Cigna Commercial |
$75.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$33.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.01
|
|
|
SCREW CTR-DRV 2x11mm 01-9481
|
Facility
|
IP
|
$114.45
|
|
| Hospital Charge Code |
270610964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.17 |
| Max. Negotiated Rate |
$27.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.17
|
|
|
SCREW CTR-DRV 2x11mm 01-9481
|
Facility
|
OP
|
$114.45
|
|
| Hospital Charge Code |
270610964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$57.23 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna Medicare Advantage |
$34.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.18
|
| Rate for Payer: Cigna Commercial |
$57.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.03
|
|
|
SCREW CTR-DRV 2x13mm 01-9483
|
Facility
|
OP
|
$107.25
|
|
| Hospital Charge Code |
270610965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$53.62 |
| Rate for Payer: Aetna Commercial |
$40.76
|
| Rate for Payer: Aetna Medicare Advantage |
$32.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.35
|
| Rate for Payer: Cigna Commercial |
$53.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$23.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.84
|
|
|
SCREW CTR-DRV 2x13mm 01-9483
|
Facility
|
IP
|
$107.25
|
|
| Hospital Charge Code |
270610965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$25.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$23.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.09
|
|
|
SCREW CTR-DRV 2x19mm
|
Facility
|
OP
|
$116.85
|
|
| Hospital Charge Code |
270610969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$58.42 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare Advantage |
$35.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.80
|
| Rate for Payer: Cigna Commercial |
$58.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.10
|
|
|
SCREW CTR-DRV 2x19mm
|
Facility
|
IP
|
$116.85
|
|
| Hospital Charge Code |
270610969
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.53 |
| Max. Negotiated Rate |
$28.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$25.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.53
|
|
|
SCREW CTR-DRV 2x4mm
|
Facility
|
OP
|
$96.85
|
|
| Hospital Charge Code |
270610960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$48.42 |
| Rate for Payer: Aetna Commercial |
$36.80
|
| Rate for Payer: Aetna Medicare Advantage |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.70
|
| Rate for Payer: Cigna Commercial |
$48.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.44
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$21.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.57
|
|
|
SCREW CTR-DRV 2x4mm
|
Facility
|
IP
|
$96.85
|
|
| Hospital Charge Code |
270610960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$23.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.44
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$21.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.53
|
|
|
SCREW CTR-DRV 2x7mm
|
Facility
|
OP
|
$99.25
|
|
| Hospital Charge Code |
270610962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$49.62 |
| Rate for Payer: Aetna Commercial |
$37.72
|
| Rate for Payer: Aetna Medicare Advantage |
$29.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.31
|
| Rate for Payer: Cigna Commercial |
$49.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.02
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$21.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.63
|
|
|
SCREW CTR-DRV 2x7mm
|
Facility
|
IP
|
$99.25
|
|
| Hospital Charge Code |
270610962
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.89 |
| Max. Negotiated Rate |
$24.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.02
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$21.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.89
|
|
|
SCREW CTR-DRV 2x9mm
|
Facility
|
OP
|
$101.65
|
|
| Hospital Charge Code |
270610963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$50.83 |
| Rate for Payer: Aetna Commercial |
$38.63
|
| Rate for Payer: Aetna Medicare Advantage |
$30.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.92
|
| Rate for Payer: Cigna Commercial |
$50.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.69
|
|
|
SCREW CTR-DRV 2x9mm
|
Facility
|
IP
|
$101.65
|
|
| Hospital Charge Code |
270610963
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.25 |
| Max. Negotiated Rate |
$24.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.25
|
|
|
SCREW CTR-DRV EMER 2.3x5mm
|
Facility
|
OP
|
$96.85
|
|
| Hospital Charge Code |
270610970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$48.42 |
| Rate for Payer: Aetna Commercial |
$36.80
|
| Rate for Payer: Aetna Medicare Advantage |
$29.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.70
|
| Rate for Payer: Cigna Commercial |
$48.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.44
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$21.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.57
|
|
|
SCREW CTR-DRV EMER 2.3x5mm
|
Facility
|
IP
|
$96.85
|
|
| Hospital Charge Code |
270610970
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$23.44 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.44
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$21.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.53
|
|
|
SCREW CTR-DRV EMER 2.3x7mm
|
Facility
|
IP
|
$870.00
|
|
| Hospital Charge Code |
270610971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$130.50 |
| Max. Negotiated Rate |
$210.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$174.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$210.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$191.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.50
|
|
|
SCREW CTR-DRV EMER 2.3x7mm
|
Facility
|
OP
|
$870.00
|
|
| Hospital Charge Code |
270610971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.97 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$330.60
|
| Rate for Payer: Aetna Medicare Advantage |
$261.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$221.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$221.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$174.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$221.85
|
| Rate for Payer: Cigna Commercial |
$435.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$210.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$191.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.05
|
|
|
SCREW CTR-DRV EMER 2.3x9mm
|
Facility
|
IP
|
$104.00
|
|
| Hospital Charge Code |
270610972
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$25.17 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.17
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
|
|
SCREW CTR-DRV EMER 2.3x9mm
|
Facility
|
OP
|
$104.00
|
|
| Hospital Charge Code |
270610972
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.51 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$39.52
|
| Rate for Payer: Aetna Medicare Advantage |
$31.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.52
|
| Rate for Payer: Cigna Commercial |
$52.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.17
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.76
|
|
|
SCREW CTR-DRV EMER 3.2x10mm
|
Facility
|
OP
|
$225.65
|
|
| Hospital Charge Code |
270610991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$112.83 |
| Rate for Payer: Aetna Commercial |
$85.75
|
| Rate for Payer: Aetna Medicare Advantage |
$67.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.54
|
| Rate for Payer: Cigna Commercial |
$112.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.61
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.98
|
|
|
SCREW CTR-DRV EMER 3.2x10mm
|
Facility
|
IP
|
$225.65
|
|
| Hospital Charge Code |
270610991
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.85 |
| Max. Negotiated Rate |
$54.61 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.61
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.85
|
|
|
SCREW CTR-DRV EMER 3.2x12mm
|
Facility
|
OP
|
$225.65
|
|
| Hospital Charge Code |
270610992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$112.83 |
| Rate for Payer: Aetna Commercial |
$85.75
|
| Rate for Payer: Aetna Medicare Advantage |
$67.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.54
|
| Rate for Payer: Cigna Commercial |
$112.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.61
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.98
|
|
|
SCREW CTR-DRV EMER 3.2x12mm
|
Facility
|
IP
|
$225.65
|
|
| Hospital Charge Code |
270610992
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.85 |
| Max. Negotiated Rate |
$54.61 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.61
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.85
|
|
|
SCREW CTR-DRV EMER 3.2x20mm
|
Facility
|
IP
|
$240.00
|
|
| Hospital Charge Code |
270610994
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$52.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|