|
SCREW HEADLESS CANN 2.4x16MM
|
Facility
|
IP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673751
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$447.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
|
|
SCREW HEADLESS CANN 2.4x16MM
|
Facility
|
OP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673751
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.59 |
| Max. Negotiated Rate |
$925.00 |
| Rate for Payer: Aetna Commercial |
$703.00
|
| Rate for Payer: Aetna Medicare Advantage |
$555.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.75
|
| Rate for Payer: Cigna Commercial |
$925.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.02
|
|
|
SCREW HEADLESS CANN 5.5X 52 MM
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690340
|
|
Hospital Revenue Code
|
278
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$0.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
SCREW HEADLESS CANN 5.5X 52 MM
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690340
|
|
Hospital Revenue Code
|
278
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$0.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$0.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
SCREW HEADLESS CANN 6.5X65MM
|
Facility
|
OP
|
$2,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.29 |
| Max. Negotiated Rate |
$1,437.50 |
| Rate for Payer: Aetna Commercial |
$1,092.50
|
| Rate for Payer: Aetna Medicare Advantage |
$862.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$733.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$733.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$575.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$733.12
|
| Rate for Payer: Cigna Commercial |
$1,437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$695.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$632.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$431.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$69.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$76.19
|
|
|
SCREW HEADLESS CANN 6.5X65MM
|
Facility
|
IP
|
$2,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.25 |
| Max. Negotiated Rate |
$695.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$575.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$695.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$632.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$431.25
|
|
|
SCREW HEADLESS COM 6.5 X 110MM
|
Facility
|
IP
|
$2,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686756
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.25 |
| Max. Negotiated Rate |
$695.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$575.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$695.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$632.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$431.25
|
|
|
SCREW HEADLESS COM 6.5 X 110MM
|
Facility
|
OP
|
$2,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686756
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.29 |
| Max. Negotiated Rate |
$1,437.50 |
| Rate for Payer: Aetna Commercial |
$1,092.50
|
| Rate for Payer: Aetna Medicare Advantage |
$862.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$733.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$733.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$575.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$733.12
|
| Rate for Payer: Cigna Commercial |
$1,437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$695.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$632.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$431.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$69.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$76.19
|
|
|
SCREW HEADLESS COMP 4.3 X 24
|
Facility
|
OP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.59 |
| Max. Negotiated Rate |
$925.00 |
| Rate for Payer: Aetna Commercial |
$703.00
|
| Rate for Payer: Aetna Medicare Advantage |
$555.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.75
|
| Rate for Payer: Cigna Commercial |
$925.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.02
|
|
|
SCREW HEADLESS COMP 4.3 X 24
|
Facility
|
IP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$447.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
|
|
SCREW HEADLESS COMP 4.3 X 24
|
Facility
|
OP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.59 |
| Max. Negotiated Rate |
$925.00 |
| Rate for Payer: Aetna Commercial |
$703.00
|
| Rate for Payer: Aetna Medicare Advantage |
$555.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$471.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$471.75
|
| Rate for Payer: Cigna Commercial |
$925.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$49.02
|
|
|
SCREW HEADLESS COMP 4.3 X 24
|
Facility
|
IP
|
$1,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$447.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$277.50
|
|
|
SCREW HEADLESS COMP 4.5/6.5
|
Facility
|
IP
|
$462.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$92.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$111.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$101.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.30
|
|
|
SCREW HEADLESS COMP 4.5/6.5
|
Facility
|
OP
|
$462.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270685925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$175.56
|
| Rate for Payer: Aetna Medicare Advantage |
$138.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$117.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$117.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$92.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$117.81
|
| Rate for Payer: Cigna Commercial |
$231.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$111.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$101.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.24
|
|
|
SCREW HEADLESS COMPRESSION 2.4
|
Facility
|
IP
|
$1,410.00
|
|
| Hospital Charge Code |
270660883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$211.50 |
| Max. Negotiated Rate |
$341.22 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$282.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$341.22
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$310.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$211.50
|
|
|
SCREW HEADLESS COMPRESSION 2.4
|
Facility
|
OP
|
$1,410.00
|
|
| Hospital Charge Code |
270660883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.98 |
| Max. Negotiated Rate |
$705.00 |
| Rate for Payer: Aetna Commercial |
$535.80
|
| Rate for Payer: Aetna Medicare Advantage |
$423.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$359.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$359.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$282.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$359.55
|
| Rate for Payer: Cigna Commercial |
$705.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$341.22
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$310.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$211.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$37.37
|
|
|
SCREW HEADLESSCOMP ST 6.5X40MM
|
Facility
|
IP
|
$2,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.25 |
| Max. Negotiated Rate |
$695.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$575.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$695.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$632.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$431.25
|
|
|
SCREW HEADLESSCOMP ST 6.5X40MM
|
Facility
|
OP
|
$2,875.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270694533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.29 |
| Max. Negotiated Rate |
$1,437.50 |
| Rate for Payer: Aetna Commercial |
$1,092.50
|
| Rate for Payer: Aetna Medicare Advantage |
$862.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$733.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$733.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$575.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$733.12
|
| Rate for Payer: Cigna Commercial |
$1,437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$695.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$632.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$431.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$69.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$76.19
|
|
|
SCREW HEADLESS MNI 4.0 X 40 MM
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690345
|
|
Hospital Revenue Code
|
278
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$0.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$0.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
SCREW HEADLESS MNI 4.0 X 40 MM
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690345
|
|
Hospital Revenue Code
|
278
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$0.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
SCREW HEADLESSS 2.5X14 TI
|
Facility
|
OP
|
$2,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.70 |
| Max. Negotiated Rate |
$1,487.50 |
| Rate for Payer: Aetna Commercial |
$1,130.50
|
| Rate for Payer: Aetna Medicare Advantage |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$758.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$758.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$758.62
|
| Rate for Payer: Cigna Commercial |
$1,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$719.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$654.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$446.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$78.84
|
|
|
SCREW HEADLESSS 2.5X14 TI
|
Facility
|
IP
|
$2,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$446.25 |
| Max. Negotiated Rate |
$719.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$719.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$654.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$446.25
|
|
|
SCREW HEADLESSS 2.5 X 16TI
|
Facility
|
OP
|
$2,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.70 |
| Max. Negotiated Rate |
$1,487.50 |
| Rate for Payer: Aetna Commercial |
$1,130.50
|
| Rate for Payer: Aetna Medicare Advantage |
$892.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$758.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$758.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$595.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$758.62
|
| Rate for Payer: Cigna Commercial |
$1,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$719.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$654.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$446.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$78.84
|
|
|
SCREW HEADLESSS 2.5 X 16TI
|
Facility
|
IP
|
$2,975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$446.25 |
| Max. Negotiated Rate |
$719.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$719.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$654.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$446.25
|
|
|
SCREW HEADLESS SHORT 2.5X20MM
|
Facility
|
OP
|
$1,058.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270706186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$529.12 |
| Rate for Payer: Aetna Commercial |
$402.13
|
| Rate for Payer: Aetna Medicare Advantage |
$317.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$269.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$269.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$211.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$269.85
|
| Rate for Payer: Cigna Commercial |
$529.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$256.10
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$232.81
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.74
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.04
|
|