|
SCREW LOCKING 4x38MM
|
Facility
|
OP
|
$927.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.35 |
| Max. Negotiated Rate |
$463.60 |
| Rate for Payer: Aetna Commercial |
$352.34
|
| Rate for Payer: Aetna Medicare Advantage |
$278.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$236.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$236.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$236.44
|
| Rate for Payer: Cigna Commercial |
$463.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.38
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$203.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$139.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.57
|
|
|
SCREW LOCKING 4x44MM
|
Facility
|
IP
|
$927.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.08 |
| Max. Negotiated Rate |
$224.38 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.38
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$203.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$139.08
|
|
|
SCREW LOCKING 4x44MM
|
Facility
|
OP
|
$927.20
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.35 |
| Max. Negotiated Rate |
$463.60 |
| Rate for Payer: Aetna Commercial |
$352.34
|
| Rate for Payer: Aetna Medicare Advantage |
$278.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$236.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$236.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$236.44
|
| Rate for Payer: Cigna Commercial |
$463.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.38
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$203.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$139.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.57
|
|
|
SCREW LOCKING 5.0 40MM
|
Facility
|
IP
|
$1,130.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.50 |
| Max. Negotiated Rate |
$273.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$226.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$248.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.50
|
|
|
SCREW LOCKING 5.0 40MM
|
Facility
|
OP
|
$1,130.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.23 |
| Max. Negotiated Rate |
$565.00 |
| Rate for Payer: Aetna Commercial |
$429.40
|
| Rate for Payer: Aetna Medicare Advantage |
$339.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$288.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$288.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$226.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$288.15
|
| Rate for Payer: Cigna Commercial |
$565.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$273.46
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$248.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.95
|
|
|
SCREW LOCKING 50MM
|
Facility
|
OP
|
$888.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692694
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.41 |
| Max. Negotiated Rate |
$444.15 |
| Rate for Payer: Aetna Commercial |
$337.55
|
| Rate for Payer: Aetna Medicare Advantage |
$266.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$226.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$226.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$226.52
|
| Rate for Payer: Cigna Commercial |
$444.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$195.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.54
|
|
|
SCREW LOCKING 50MM
|
Facility
|
IP
|
$888.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692694
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.25 |
| Max. Negotiated Rate |
$214.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$177.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$195.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.25
|
|
|
SCREW LOCKING 5.0MM
|
Facility
|
OP
|
$1,490.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$745.25 |
| Rate for Payer: Aetna Commercial |
$566.39
|
| Rate for Payer: Aetna Medicare Advantage |
$447.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$380.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$380.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$298.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$380.08
|
| Rate for Payer: Cigna Commercial |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$360.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$327.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$223.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.50
|
|
|
SCREW LOCKING 5.0MM
|
Facility
|
IP
|
$1,490.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$223.57 |
| Max. Negotiated Rate |
$360.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$298.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$360.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$327.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$223.57
|
|
|
SCREW LOCKING 50mm 3705-50
|
Facility
|
OP
|
$615.00
|
|
| Hospital Charge Code |
270640115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$233.70
|
| Rate for Payer: Aetna Medicare Advantage |
$184.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$156.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$156.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$156.82
|
| Rate for Payer: Cigna Commercial |
$307.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$148.83
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$135.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.30
|
|
|
SCREW LOCKING 50mm 3705-50
|
Facility
|
IP
|
$615.00
|
|
| Hospital Charge Code |
270640115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$148.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$148.83
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$135.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.25
|
|
|
SCREW LOCKING 5.0MMX110MM
|
Facility
|
OP
|
$860.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689708
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$430.05 |
| Rate for Payer: Aetna Commercial |
$326.84
|
| Rate for Payer: Aetna Medicare Advantage |
$258.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$219.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$219.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$172.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$219.33
|
| Rate for Payer: Cigna Commercial |
$430.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$189.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.01
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.79
|
|
|
SCREW LOCKING 5.0MMX110MM
|
Facility
|
IP
|
$860.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689708
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.01 |
| Max. Negotiated Rate |
$208.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$172.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$189.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.01
|
|
|
SCREW LOCKING 5.0MMX115MM
|
Facility
|
IP
|
$860.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689709
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.01 |
| Max. Negotiated Rate |
$208.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$172.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$189.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.01
|
|
|
SCREW LOCKING 5.0MMX115MM
|
Facility
|
OP
|
$860.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689709
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$430.05 |
| Rate for Payer: Aetna Commercial |
$326.84
|
| Rate for Payer: Aetna Medicare Advantage |
$258.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$219.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$219.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$172.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$219.33
|
| Rate for Payer: Cigna Commercial |
$430.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$189.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.01
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.79
|
|
|
SCREW LOCKING 5.0MMX120MM
|
Facility
|
OP
|
$860.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$430.05 |
| Rate for Payer: Aetna Commercial |
$326.84
|
| Rate for Payer: Aetna Medicare Advantage |
$258.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$219.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$219.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$172.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$219.33
|
| Rate for Payer: Cigna Commercial |
$430.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$189.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.01
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.79
|
|
|
SCREW LOCKING 5.0MMX120MM
|
Facility
|
IP
|
$860.10
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.01 |
| Max. Negotiated Rate |
$208.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$172.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$189.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.01
|
|
|
SCREW LOCKING 5.0MM X 46MM
|
Facility
|
IP
|
$945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270666924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$141.75 |
| Max. Negotiated Rate |
$228.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$189.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$228.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$207.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$141.75
|
|
|
SCREW LOCKING 5.0MM X 46MM
|
Facility
|
OP
|
$945.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270666924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: Aetna Commercial |
$359.10
|
| Rate for Payer: Aetna Medicare Advantage |
$283.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$240.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$240.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$240.97
|
| Rate for Payer: Cigna Commercial |
$472.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$228.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$207.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$141.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.04
|
|
|
SCREW LOCKING 5.0 X 22 MM
|
Facility
|
OP
|
$883.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$441.88 |
| Rate for Payer: Aetna Commercial |
$335.82
|
| Rate for Payer: Aetna Medicare Advantage |
$265.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$225.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$225.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$176.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$225.36
|
| Rate for Payer: Cigna Commercial |
$441.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$213.87
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$194.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.42
|
|
|
SCREW LOCKING 5.0 X 22 MM
|
Facility
|
IP
|
$883.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270690435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$132.56 |
| Max. Negotiated Rate |
$213.87 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$176.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$213.87
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$194.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.56
|
|
|
SCREW LOCKING 5.0x24mm
|
Facility
|
OP
|
$1,220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.40 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Aetna Commercial |
$463.60
|
| Rate for Payer: Aetna Medicare Advantage |
$366.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$311.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$311.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$244.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$311.10
|
| Rate for Payer: Cigna Commercial |
$610.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$295.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$268.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$183.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.33
|
|
|
SCREW LOCKING 5.0x24mm
|
Facility
|
IP
|
$1,220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.00 |
| Max. Negotiated Rate |
$295.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$244.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$295.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$268.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$183.00
|
|
|
SCREW LOCKING 5.0x26mm
|
Facility
|
OP
|
$1,220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663313
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.40 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Aetna Commercial |
$463.60
|
| Rate for Payer: Aetna Medicare Advantage |
$366.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$311.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$311.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$244.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$311.10
|
| Rate for Payer: Cigna Commercial |
$610.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$295.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$268.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$183.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.33
|
|
|
SCREW LOCKING 5.0x26mm
|
Facility
|
IP
|
$1,220.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663313
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$183.00 |
| Max. Negotiated Rate |
$295.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$244.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$295.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$268.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$183.00
|
|