|
SCREW PLOY MESA 4.5X40MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670241
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 4.5X45MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 4.5X45MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 4.5X50MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 4.5X50MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.0X25MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.0X25MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.0X30MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670245
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.0X30MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670245
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.0X35MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.0X35MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.0X40MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.0X40MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.5X25MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.5X25MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.5X30MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.5X30MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.5X35MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.5X35MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.5X40MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.5X40MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.5X45MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|
|
SCREW PLOY MESA 5.5X45MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.5X50MM
|
Facility
|
OP
|
$6,250.00
|
|
| Hospital Charge Code |
270670253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$3,125.00 |
| Rate for Payer: Aetna Commercial |
$2,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,593.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,593.75
|
| Rate for Payer: Cigna Commercial |
$3,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.62
|
|
|
SCREW PLOY MESA 5.5X50MM
|
Facility
|
IP
|
$6,250.00
|
|
| Hospital Charge Code |
270670253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,512.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,375.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$937.50
|
|