|
SCREW NEURO LOW PROFILE 3MM
|
Facility
|
IP
|
$472.00
|
|
| Hospital Charge Code |
270674573
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.80 |
| Max. Negotiated Rate |
$114.22 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.22
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.80
|
|
|
SCREW NEURO LOW PROFILE 3MM
|
Facility
|
OP
|
$472.00
|
|
| Hospital Charge Code |
270674573
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$236.00 |
| Rate for Payer: Aetna Commercial |
$179.36
|
| Rate for Payer: Aetna Medicare Advantage |
$141.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$120.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$120.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$120.36
|
| Rate for Payer: Cigna Commercial |
$236.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.22
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.51
|
|
|
SCREW NEXGEN HEX 3.5X27MM
|
Facility
|
OP
|
$1,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693275
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.92 |
| Max. Negotiated Rate |
$600.00 |
| Rate for Payer: Aetna Commercial |
$456.00
|
| Rate for Payer: Aetna Medicare Advantage |
$360.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$306.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$240.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$306.00
|
| Rate for Payer: Cigna Commercial |
$600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$290.40
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$264.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.80
|
|
|
SCREW NEXGEN HEX 3.5X27MM
|
Facility
|
IP
|
$1,200.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693275
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$290.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$240.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$290.40
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$264.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$180.00
|
|
|
SCREW NEXGEN HEX 3.5X48MM
|
Facility
|
OP
|
$1,900.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$45.79 |
| Max. Negotiated Rate |
$950.00 |
| Rate for Payer: Aetna Commercial |
$722.00
|
| Rate for Payer: Aetna Medicare Advantage |
$570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$484.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$484.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$484.50
|
| Rate for Payer: Cigna Commercial |
$950.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$459.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$418.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$285.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$50.35
|
|
|
SCREW NEXGEN HEX 3.5X48MM
|
Facility
|
IP
|
$1,900.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$459.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$418.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$285.00
|
|
|
SCREW NEXGEN KNEE REPLACEME
|
Facility
|
IP
|
$835.00
|
|
| Hospital Charge Code |
270665754
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$125.25 |
| Max. Negotiated Rate |
$202.07 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$167.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$202.07
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$183.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.25
|
|
|
SCREW NEXGEN KNEE REPLACEME
|
Facility
|
OP
|
$835.00
|
|
| Hospital Charge Code |
270665754
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$417.50 |
| Rate for Payer: Aetna Commercial |
$317.30
|
| Rate for Payer: Aetna Medicare Advantage |
$250.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$212.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$212.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$167.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$212.93
|
| Rate for Payer: Cigna Commercial |
$417.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$202.07
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$183.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.13
|
|
|
SCREW NEXGEN SDV 4.0X18MM
|
Facility
|
IP
|
$2,100.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$315.00 |
| Max. Negotiated Rate |
$508.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$420.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$508.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$462.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$315.00
|
|
|
SCREW NEXGEN SDV 4.0X18MM
|
Facility
|
OP
|
$2,100.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270696974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$50.61 |
| Max. Negotiated Rate |
$1,050.00 |
| Rate for Payer: Aetna Commercial |
$798.00
|
| Rate for Payer: Aetna Medicare Advantage |
$630.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$535.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$535.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$420.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$535.50
|
| Rate for Payer: Cigna Commercial |
$1,050.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$508.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$462.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$315.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$55.65
|
|
|
SCREW NEXXT MIS PED 6.5X45MM
|
Facility
|
IP
|
$7,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693615
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,125.00 |
| Max. Negotiated Rate |
$1,815.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,815.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,650.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,125.00
|
|
|
SCREW NEXXT MIS PED 6.5X45MM
|
Facility
|
OP
|
$7,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693615
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.75 |
| Max. Negotiated Rate |
$3,750.00 |
| Rate for Payer: Aetna Commercial |
$2,850.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,912.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,912.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,912.50
|
| Rate for Payer: Cigna Commercial |
$3,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,815.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,650.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,125.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$180.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$198.75
|
|
|
SCREW NEXXT MIS PED 7.5X40MM
|
Facility
|
IP
|
$7,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693616
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,125.00 |
| Max. Negotiated Rate |
$1,815.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,815.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,650.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,125.00
|
|
|
SCREW NEXXT MIS PED 7.5X40MM
|
Facility
|
OP
|
$7,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270693616
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.75 |
| Max. Negotiated Rate |
$3,750.00 |
| Rate for Payer: Aetna Commercial |
$2,850.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,912.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,912.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,912.50
|
| Rate for Payer: Cigna Commercial |
$3,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,815.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,650.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,125.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$180.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$198.75
|
|
|
SCREW N-FORCE 7.3 X 5.5MM
|
Facility
|
OP
|
$1,842.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$921.25 |
| Rate for Payer: Aetna Commercial |
$700.15
|
| Rate for Payer: Aetna Medicare Advantage |
$552.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$469.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$469.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$368.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$469.84
|
| Rate for Payer: Cigna Commercial |
$921.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$445.88
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$405.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$276.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$48.83
|
|
|
SCREW N-FORCE 7.3 X 5.5MM
|
Facility
|
IP
|
$1,842.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.38 |
| Max. Negotiated Rate |
$445.88 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$368.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$445.88
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$405.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$276.38
|
|
|
SCREW NKNG PIT SCW 3.5 X 34MM
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701641
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$159.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
|
|
SCREW NKNG PIT SCW 3.5 X 34MM
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701641
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$250.80
|
| Rate for Payer: Aetna Medicare Advantage |
$198.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$168.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$168.30
|
| Rate for Payer: Cigna Commercial |
$330.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.72
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$145.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.49
|
|
|
SCREW NL 18MM
|
Facility
|
OP
|
$370.00
|
|
| Hospital Charge Code |
270661803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$185.00 |
| Rate for Payer: Aetna Commercial |
$140.60
|
| Rate for Payer: Aetna Medicare Advantage |
$111.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$94.35
|
| Rate for Payer: Cigna Commercial |
$185.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$81.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.80
|
|
|
SCREW NL 18MM
|
Facility
|
IP
|
$370.00
|
|
| Hospital Charge Code |
270661803
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$89.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$81.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.50
|
|
|
SCREW NL 2.4X24MM
|
Facility
|
IP
|
$370.00
|
|
| Hospital Charge Code |
270703492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$89.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$81.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.50
|
|
|
SCREW NL 2.4X24MM
|
Facility
|
OP
|
$370.00
|
|
| Hospital Charge Code |
270703492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$185.00 |
| Rate for Payer: Aetna Commercial |
$140.60
|
| Rate for Payer: Aetna Medicare Advantage |
$111.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$94.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$94.35
|
| Rate for Payer: Cigna Commercial |
$185.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.54
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$81.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.80
|
|
|
SCREW NL 3.5X10MM
|
Facility
|
OP
|
$468.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$177.84
|
| Rate for Payer: Aetna Medicare Advantage |
$140.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.34
|
| Rate for Payer: Cigna Commercial |
$234.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$102.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.40
|
|
|
SCREW NL 3.5X10MM
|
Facility
|
IP
|
$468.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.20 |
| Max. Negotiated Rate |
$113.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$102.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.20
|
|
|
SCREW NL 3X12MM
|
Facility
|
IP
|
$950.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270669409
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$229.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$190.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$229.90
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$209.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$142.50
|
|