|
SCREW HDLS COMP 3.5X40MM
|
Facility
|
OP
|
$4,550.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699519
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$109.66 |
| Max. Negotiated Rate |
$2,275.00 |
| Rate for Payer: Aetna Commercial |
$1,729.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,365.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,160.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,160.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$910.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,160.25
|
| Rate for Payer: Cigna Commercial |
$2,275.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,101.10
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,001.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$682.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$109.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$120.58
|
|
|
SCREW HDLS COMP 3.5X40MM
|
Facility
|
IP
|
$4,550.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699519
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$682.50 |
| Max. Negotiated Rate |
$1,101.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$910.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,101.10
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,001.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$682.50
|
|
|
SCREW HDLS COMP FT 2.5X22MM
|
Facility
|
OP
|
$1,675.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.37 |
| Max. Negotiated Rate |
$837.50 |
| Rate for Payer: Aetna Commercial |
$636.50
|
| Rate for Payer: Aetna Medicare Advantage |
$502.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$427.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$427.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$335.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$427.12
|
| Rate for Payer: Cigna Commercial |
$837.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$405.35
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$368.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$251.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$40.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$44.39
|
|
|
SCREW HDLS COMP FT 2.5X22MM
|
Facility
|
IP
|
$1,675.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$251.25 |
| Max. Negotiated Rate |
$405.35 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$335.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$405.35
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$368.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$251.25
|
|
|
SCREW HDLS DARTFIRE 3.0X22MM
|
Facility
|
IP
|
$1,360.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$329.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$272.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$329.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$299.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.00
|
|
|
SCREW HDLS DARTFIRE 3.0X22MM
|
Facility
|
OP
|
$1,360.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$680.00 |
| Rate for Payer: Aetna Commercial |
$516.80
|
| Rate for Payer: Aetna Medicare Advantage |
$408.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$346.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$346.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$272.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$346.80
|
| Rate for Payer: Cigna Commercial |
$680.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$329.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$299.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.04
|
|
|
SCREW HDLS SH THR 2.0X14MM
|
Facility
|
OP
|
$1,141.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$570.62 |
| Rate for Payer: Aetna Commercial |
$433.68
|
| Rate for Payer: Aetna Medicare Advantage |
$342.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$291.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$291.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$228.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$291.02
|
| Rate for Payer: Cigna Commercial |
$570.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$276.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$251.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.24
|
|
|
SCREW HDLS SH THR 2.0X14MM
|
Facility
|
IP
|
$1,141.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.19 |
| Max. Negotiated Rate |
$276.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$228.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$276.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$251.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$171.19
|
|
|
SCREW HEADED 2.0x12MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270662463
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$304.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.20
|
|
|
SCREW HEADED 2.0x12MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662463
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x14MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x14MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270662467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$304.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.20
|
|
|
SCREW HEADED 2.0x16MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270662470
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$304.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.20
|
|
|
SCREW HEADED 2.0x16MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662470
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x24MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270667122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 2.0x24MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270667122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$304.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.20
|
|
|
SCREW HEADED 2.4X 10MM
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$235.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$214.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
SCREW HEADED 2.4X 10MM
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$214.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
SCREW HEADED 2.4X 8MM
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679821
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$235.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$214.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
SCREW HEADED 2.4X 8MM
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679821
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$214.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
SCREW HEADED 2.5x16MM
|
Facility
|
OP
|
$800.00
|
|
| Hospital Charge Code |
270662469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: Aetna Commercial |
$304.00
|
| Rate for Payer: Aetna Medicare Advantage |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$204.00
|
| Rate for Payer: Cigna Commercial |
$400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.20
|
|
|
SCREW HEADED 2.5x16MM
|
Facility
|
IP
|
$800.00
|
|
| Hospital Charge Code |
270662469
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$193.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$160.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$176.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.00
|
|
|
SCREW HEADED 3.0x40MM
|
Facility
|
IP
|
$825.00
|
|
| Hospital Charge Code |
270667118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$123.75 |
| Max. Negotiated Rate |
$199.65 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$165.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.65
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.75
|
|
|
SCREW HEADED 3.0x40MM
|
Facility
|
OP
|
$825.00
|
|
| Hospital Charge Code |
270667118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.88 |
| Max. Negotiated Rate |
$412.50 |
| Rate for Payer: Aetna Commercial |
$313.50
|
| Rate for Payer: Aetna Medicare Advantage |
$247.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$210.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$210.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$210.38
|
| Rate for Payer: Cigna Commercial |
$412.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.65
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$123.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.86
|
|
|
SCREW HEADED 3.5MMX38MM
|
Facility
|
OP
|
$1,055.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.43 |
| Max. Negotiated Rate |
$527.50 |
| Rate for Payer: Aetna Commercial |
$400.90
|
| Rate for Payer: Aetna Medicare Advantage |
$316.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$269.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$269.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$211.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$269.02
|
| Rate for Payer: Cigna Commercial |
$527.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$255.31
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$232.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.96
|
|