|
SCREW NON-LOCKING 3.5x30mm
|
Facility
|
IP
|
$500.00
|
|
| Hospital Charge Code |
270670777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$121.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$110.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
SCREW NON-LOCKING 3.5x30mm
|
Facility
|
OP
|
$500.00
|
|
| Hospital Charge Code |
270670777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna Commercial |
$190.00
|
| Rate for Payer: Aetna Medicare Advantage |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.50
|
| Rate for Payer: Cigna Commercial |
$250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$110.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.25
|
|
|
SCREW NON LOCKING 3.5X30MM
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.44 |
| Max. Negotiated Rate |
$590.00 |
| Rate for Payer: Aetna Commercial |
$448.40
|
| Rate for Payer: Aetna Medicare Advantage |
$354.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$300.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$300.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$236.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$300.90
|
| Rate for Payer: Cigna Commercial |
$590.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$285.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$259.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$177.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.27
|
|
|
SCREW NON LOCKING 3.5X30MM
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.00 |
| Max. Negotiated Rate |
$285.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$236.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$285.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$259.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$177.00
|
|
|
SCREW NON LOCKING 3.5x32MM
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679451
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.96
|
|
|
SCREW NON LOCKING 3.5x32MM
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270679451
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW NON LOCKING 3.5x34MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x34MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.46
|
|
|
SCREW NON LOCKING 3.5x34MM
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
270672117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.96
|
|
|
SCREW NON LOCKING 3.5x34MM
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270672117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW NON LOCKING 3.5x36MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667745
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.46
|
|
|
SCREW NON LOCKING 3.5x36MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667745
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x38mm
|
Facility
|
OP
|
$340.00
|
|
| Hospital Charge Code |
270673028
|
|
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 NON LOCKING 3.5x38mm
|
Facility
|
IP
|
$340.00
|
|
| Hospital Charge Code |
270673028
|
|
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 NON LOCKING 3.5x38MM
|
Facility
|
IP
|
$225.00
|
|
| Hospital Charge Code |
270672118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
|
|
SCREW NON LOCKING 3.5x38MM
|
Facility
|
OP
|
$225.00
|
|
| Hospital Charge Code |
270672118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: Aetna Medicare Advantage |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.38
|
| Rate for Payer: Cigna Commercial |
$112.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.45
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$49.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.96
|
|
|
SCREW NON LOCKING 3.5x38MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x38MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.46
|
|
|
SCREW NON LOCKING 3.5x40MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
SCREW NON LOCKING 3.5x40MM
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667744
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.46
|
|
|
SCREW NON LOCKING 3.5X 40 MM
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701209
|
|
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 NON LOCKING 3.5X 40 MM
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270701209
|
|
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 NON LOCKING 3.5x44mm
|
Facility
|
OP
|
$340.00
|
|
| Hospital Charge Code |
270673027
|
|
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 NON LOCKING 3.5x44mm
|
Facility
|
IP
|
$340.00
|
|
| Hospital Charge Code |
270673027
|
|
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 NON LOCKING 3.5x44MM
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270667700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$113.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|