|
SCREW KREULOCK 2.4X14MM
|
Facility
|
OP
|
$1,519.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$759.62 |
| Rate for Payer: Aetna Commercial |
$577.32
|
| Rate for Payer: Aetna Medicare Advantage |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.41
|
| Rate for Payer: Cigna Commercial |
$759.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.26
|
|
|
SCREW KREULOCK 2.4X14MM
|
Facility
|
IP
|
$1,519.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270695524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$367.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
|
|
SCREW KREULOCK 2.7X10MM
|
Facility
|
IP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$393.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$357.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
|
|
SCREW KREULOCK 2.7X10MM
|
Facility
|
OP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705613
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$812.50 |
| Rate for Payer: Aetna Commercial |
$617.50
|
| Rate for Payer: Aetna Medicare Advantage |
$487.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$414.38
|
| Rate for Payer: Cigna Commercial |
$812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$357.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43.06
|
|
|
SCREW KREULOCK 2.7X16MM
|
Facility
|
IP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705616
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$393.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$357.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
|
|
SCREW KREULOCK 2.7X16MM
|
Facility
|
OP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705616
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$812.50 |
| Rate for Payer: Aetna Commercial |
$617.50
|
| Rate for Payer: Aetna Medicare Advantage |
$487.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$414.38
|
| Rate for Payer: Cigna Commercial |
$812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$357.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43.06
|
|
|
SCREW KREULOCK 2.7X22MM
|
Facility
|
IP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705617
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$393.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$357.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
|
|
SCREW KREULOCK 2.7X22MM
|
Facility
|
OP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705617
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$812.50 |
| Rate for Payer: Aetna Commercial |
$617.50
|
| Rate for Payer: Aetna Medicare Advantage |
$487.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$414.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$325.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$414.38
|
| Rate for Payer: Cigna Commercial |
$812.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$393.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$357.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43.06
|
|
|
SCREW KREULOCK COMP SS2.7X12MM
|
Facility
|
OP
|
$1,599.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$799.75 |
| Rate for Payer: Aetna Commercial |
$607.81
|
| Rate for Payer: Aetna Medicare Advantage |
$479.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$407.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$407.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$319.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$407.87
|
| Rate for Payer: Cigna Commercial |
$799.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$387.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$351.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$239.93
|
| Rate for Payer: UnitedHealthcare Community & State |
$38.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.39
|
|
|
SCREW KREULOCK COMP SS2.7X12MM
|
Facility
|
IP
|
$1,599.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699068
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.93 |
| Max. Negotiated Rate |
$387.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$319.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$387.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$351.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$239.93
|
|
|
SCREW KREULOCK COMP SS2.7X16MM
|
Facility
|
IP
|
$1,599.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$239.93 |
| Max. Negotiated Rate |
$387.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$319.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$387.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$351.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$239.93
|
|
|
SCREW KREULOCK COMP SS2.7X16MM
|
Facility
|
OP
|
$1,599.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699069
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$799.75 |
| Rate for Payer: Aetna Commercial |
$607.81
|
| Rate for Payer: Aetna Medicare Advantage |
$479.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$407.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$407.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$319.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$407.87
|
| Rate for Payer: Cigna Commercial |
$799.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$387.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$351.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$239.93
|
| Rate for Payer: UnitedHealthcare Community & State |
$38.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.39
|
|
|
SCREW KREULOCK SCRW TL 3.0X18
|
Facility
|
OP
|
$1,519.00
|
|
| Hospital Charge Code |
270702475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$759.50 |
| Rate for Payer: Aetna Commercial |
$577.22
|
| Rate for Payer: Aetna Medicare Advantage |
$455.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.35
|
| Rate for Payer: Cigna Commercial |
$759.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.25
|
|
|
SCREW KREULOCK SCRW TL 3.0X18
|
Facility
|
IP
|
$1,519.00
|
|
| Hospital Charge Code |
270702475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.85 |
| Max. Negotiated Rate |
$367.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.85
|
|
|
SCREW KREULOCK TI 3.5C16MM
|
Facility
|
OP
|
$1,519.25
|
|
| Hospital Charge Code |
270702110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$759.62 |
| Rate for Payer: Aetna Commercial |
$577.32
|
| Rate for Payer: Aetna Medicare Advantage |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.41
|
| Rate for Payer: Cigna Commercial |
$759.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.26
|
|
|
SCREW KREULOCK TI 3.5C16MM
|
Facility
|
IP
|
$1,519.25
|
|
| Hospital Charge Code |
270702110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$367.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
|
|
SCREW KREULOCK TI 3.5X14MM
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.09
|
|
|
SCREW KREULOCK TI 3.5X14MM
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW KREULOCK TI 3.5X18
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.25 |
| Max. Negotiated Rate |
$356.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
|
|
SCREW KREULOCK TI 3.5X18
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270697418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.09
|
|
|
SCREW KRULOCK 3.5X20MM
|
Facility
|
IP
|
$1,519.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702066
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$367.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
|
|
SCREW KRULOCK 3.5X20MM
|
Facility
|
OP
|
$1,519.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702066
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$759.62 |
| Rate for Payer: Aetna Commercial |
$577.32
|
| Rate for Payer: Aetna Medicare Advantage |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.41
|
| Rate for Payer: Cigna Commercial |
$759.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.26
|
|
|
SCREW KRULOCK 3.5X24MM
|
Facility
|
IP
|
$1,519.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702067
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$367.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
|
|
SCREW KRULOCK 3.5X24MM
|
Facility
|
OP
|
$1,519.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702067
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$759.62 |
| Rate for Payer: Aetna Commercial |
$577.32
|
| Rate for Payer: Aetna Medicare Advantage |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$303.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.41
|
| Rate for Payer: Cigna Commercial |
$759.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$367.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$334.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.26
|
|
|
SCREW KRULOCK TI 3.5X12MM
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$737.50 |
| Rate for Payer: Aetna Commercial |
$560.50
|
| Rate for Payer: Aetna Medicare Advantage |
$442.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$376.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$295.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$376.12
|
| Rate for Payer: Cigna Commercial |
$737.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$356.95
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$324.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$221.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.09
|
|