|
SCREW N-LOCKING CANC LAG 4.x18
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672332
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
SCREW N-LOCKING CANC LAG 4.x18
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672332
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW N-LOCKING CANC LAG 4.x24
|
Facility
|
IP
|
$340.00
|
|
| Hospital Charge Code |
270672333
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW N-LOCKING CANC LAG 4.x24
|
Facility
|
OP
|
$340.00
|
|
| Hospital Charge Code |
270672333
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
SCREW N-LOCKING CANC LAG 4.x26
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672336
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
SCREW N-LOCKING CANC LAG 4.x26
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270672336
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare Advantage |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$68.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.70
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.28
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
SCREW NL PERIPH 4.5X36MM
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.46 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$228.00
|
| Rate for Payer: Aetna Medicare Advantage |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$120.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$153.00
|
| Rate for Payer: Cigna Commercial |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$145.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$132.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.90
|
|
|
SCREW NL PERIPH 4.5X36MM
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$145.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$145.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$132.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
|
|
SCREW NON LCKNG LG HD 2.7x18MM
|
Facility
|
OP
|
$570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$216.60
|
| Rate for Payer: Aetna Medicare Advantage |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$145.35
|
| Rate for Payer: Cigna Commercial |
$285.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$125.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.11
|
|
|
SCREW NON LCKNG LG HD 2.7x18MM
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$137.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$125.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
|
|
SCREW NON LCKNG LG HD 2.7x22MM
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$137.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$125.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
|
|
SCREW NON LCKNG LG HD 2.7x22MM
|
Facility
|
OP
|
$570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$216.60
|
| Rate for Payer: Aetna Medicare Advantage |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$145.35
|
| Rate for Payer: Cigna Commercial |
$285.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$125.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.11
|
|
|
SCREW NONLKG FT ST 3DI 4X40MM
|
Facility
|
IP
|
$1,365.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700518
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$330.33 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$273.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$330.33
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$300.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.75
|
|
|
SCREW NONLKG FT ST 3DI 4X40MM
|
Facility
|
OP
|
$1,365.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700518
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$518.70
|
| Rate for Payer: Aetna Medicare Advantage |
$409.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$348.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$348.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$273.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$348.07
|
| Rate for Payer: Cigna Commercial |
$682.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$330.33
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$300.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.17
|
|
|
SCREW NONLKG LP 3.5X32MM
|
Facility
|
IP
|
$1,365.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$330.33 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$273.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$330.33
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$300.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.75
|
|
|
SCREW NONLKG LP 3.5X32MM
|
Facility
|
OP
|
$1,365.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$518.70
|
| Rate for Payer: Aetna Medicare Advantage |
$409.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$348.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$348.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$273.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$348.07
|
| Rate for Payer: Cigna Commercial |
$682.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$330.33
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$300.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.17
|
|
|
SCREW NON LKG R3CON 3.5X18MM
|
Facility
|
IP
|
$907.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700174
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.12 |
| Max. Negotiated Rate |
$219.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$181.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$219.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$199.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.12
|
|
|
SCREW NON LKG R3CON 3.5X18MM
|
Facility
|
OP
|
$907.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700174
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$453.75 |
| Rate for Payer: Aetna Commercial |
$344.85
|
| Rate for Payer: Aetna Medicare Advantage |
$272.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$231.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$231.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$181.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$231.41
|
| Rate for Payer: Cigna Commercial |
$453.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$219.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$199.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$136.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.05
|
|
|
SCREW NON LOCK 2.7 X 10 MM
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.50 |
| Max. Negotiated Rate |
$65.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.50
|
|
|
SCREW NON LOCK 2.7 X 10 MM
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Medicare Advantage |
$81.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.85
|
| Rate for Payer: Cigna Commercial |
$135.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW NON LOCK 2.7x15MM
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.50 |
| Max. Negotiated Rate |
$65.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.50
|
|
|
SCREW NON LOCK 2.7x15MM
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270663845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$102.60
|
| Rate for Payer: Aetna Medicare Advantage |
$81.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.85
|
| Rate for Payer: Cigna Commercial |
$135.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
SCREW NON LOCK 2.7x16MM
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$217.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$217.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$198.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.00
|
|
|
SCREW NON LOCK 2.7x16MM
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701890
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.69 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$342.00
|
| Rate for Payer: Aetna Medicare Advantage |
$270.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$229.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$229.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$229.50
|
| Rate for Payer: Cigna Commercial |
$450.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$217.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$198.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.85
|
|
|
SCREW NON LOCK 2.7x16MM
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270673692
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.50 |
| Max. Negotiated Rate |
$65.34 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$59.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.50
|
|