|
SCREW LOCKING 3.5x36MM
|
Facility
|
IP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$271.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
|
|
SCREW LOCKING 3.5x36MM
|
Facility
|
IP
|
$1,120.00
|
|
| Hospital Charge Code |
270667743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$271.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
|
|
SCREW LOCKING 3.5x36MM
|
Facility
|
OP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Medicare Advantage |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.60
|
| Rate for Payer: Cigna Commercial |
$560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.68
|
|
|
SCREW LOCKING 3.5x36MM
|
Facility
|
IP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$271.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
|
|
SCREW LOCKING 3.5x36MM
|
Facility
|
OP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Medicare Advantage |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.60
|
| Rate for Payer: Cigna Commercial |
$560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.68
|
|
|
SCREW LOCKING 3.5x36MM
|
Facility
|
OP
|
$1,120.00
|
|
| Hospital Charge Code |
270667743
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Medicare Advantage |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.60
|
| Rate for Payer: Cigna Commercial |
$560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.68
|
|
|
SCREW LOCKING 3.5 X 38 MM
|
Facility
|
IP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270659786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.30 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
|
|
SCREW LOCKING 3.5 X 38 MM
|
Facility
|
OP
|
$662.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270659786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$331.00 |
| Rate for Payer: Aetna Commercial |
$251.56
|
| Rate for Payer: Aetna Medicare Advantage |
$198.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.81
|
| Rate for Payer: Cigna Commercial |
$331.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$160.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.54
|
|
|
SCREW LOCKING 3.5x38mm
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270670768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Aetna Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.65
|
| Rate for Payer: Cigna Commercial |
$315.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.70
|
|
|
SCREW LOCKING 3.5x38mm
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270670768
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$152.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
|
|
SCREW LOCKING 3.5x38MM
|
Facility
|
IP
|
$1,120.00
|
|
| Hospital Charge Code |
270656789
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$271.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
|
|
SCREW LOCKING 3.5x38MM
|
Facility
|
OP
|
$1,120.00
|
|
| Hospital Charge Code |
270656789
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Medicare Advantage |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.60
|
| Rate for Payer: Cigna Commercial |
$560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.68
|
|
|
SCREW LOCKING 3.5x40mm
|
Facility
|
OP
|
$630.00
|
|
| Hospital Charge Code |
270670769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Aetna Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.65
|
| Rate for Payer: Cigna Commercial |
$315.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.70
|
|
|
SCREW LOCKING 3.5x40mm
|
Facility
|
IP
|
$630.00
|
|
| Hospital Charge Code |
270670769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$152.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
|
|
SCREW LOCKING 3.5x40MM
|
Facility
|
IP
|
$1,120.00
|
|
| Hospital Charge Code |
270667703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$271.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
|
|
SCREW LOCKING 3.5x40MM
|
Facility
|
OP
|
$1,120.00
|
|
| Hospital Charge Code |
270667703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Medicare Advantage |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.60
|
| Rate for Payer: Cigna Commercial |
$560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.68
|
|
|
SCREW LOCKING 3.5x42mm
|
Facility
|
OP
|
$630.00
|
|
| Hospital Charge Code |
270670773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Aetna Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.65
|
| Rate for Payer: Cigna Commercial |
$315.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.70
|
|
|
SCREW LOCKING 3.5x42mm
|
Facility
|
IP
|
$630.00
|
|
| Hospital Charge Code |
270670773
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$152.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
|
|
SCREW LOCKING 3.5x42MM
|
Facility
|
IP
|
$1,120.00
|
|
| Hospital Charge Code |
270667702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$271.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
|
|
SCREW LOCKING 3.5x42MM
|
Facility
|
OP
|
$1,120.00
|
|
| Hospital Charge Code |
270667702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Medicare Advantage |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.60
|
| Rate for Payer: Cigna Commercial |
$560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.68
|
|
|
SCREW LOCKING 3.5x44mm
|
Facility
|
OP
|
$630.00
|
|
| Hospital Charge Code |
270671862
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Commercial |
$239.40
|
| Rate for Payer: Aetna Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.65
|
| Rate for Payer: Cigna Commercial |
$315.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.70
|
|
|
SCREW LOCKING 3.5x44mm
|
Facility
|
IP
|
$630.00
|
|
| Hospital Charge Code |
270671862
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$152.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$126.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$138.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
|
|
SCREW LOCKING 3.5x44MM
|
Facility
|
IP
|
$1,120.00
|
|
| Hospital Charge Code |
270656790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$271.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
|
|
SCREW LOCKING 3.5x44MM
|
Facility
|
OP
|
$1,120.00
|
|
| Hospital Charge Code |
270656790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$425.60
|
| Rate for Payer: Aetna Medicare Advantage |
$336.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$224.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.60
|
| Rate for Payer: Cigna Commercial |
$560.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.04
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$246.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.68
|
|
|
SCREW LOCKING 3.5X4.5X15MM
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270668579
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$114.00
|
| Rate for Payer: Aetna Medicare Advantage |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.50
|
| Rate for Payer: Cigna Commercial |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$66.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.95
|
|