|
SCREW PYRENEES SLF TPNG 4X10MM
|
Facility
|
OP
|
$1,465.00
|
|
| Hospital Charge Code |
270670331
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.31 |
| Max. Negotiated Rate |
$732.50 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare Advantage |
$439.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.57
|
| Rate for Payer: Cigna Commercial |
$732.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.82
|
|
|
SCREW PYRENEES SLF TPNG 4X10MM
|
Facility
|
IP
|
$1,465.00
|
|
| Hospital Charge Code |
270670331
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.75 |
| Max. Negotiated Rate |
$354.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
|
|
SCREW PYRENEES SLF TPNG 4X12MM
|
Facility
|
IP
|
$1,465.00
|
|
| Hospital Charge Code |
270670332
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.75 |
| Max. Negotiated Rate |
$354.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
|
|
SCREW PYRENEES SLF TPNG 4X12MM
|
Facility
|
OP
|
$1,465.00
|
|
| Hospital Charge Code |
270670332
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.31 |
| Max. Negotiated Rate |
$732.50 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare Advantage |
$439.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.57
|
| Rate for Payer: Cigna Commercial |
$732.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.82
|
|
|
SCREW PYRENEES SLF TPNG 4X14MM
|
Facility
|
IP
|
$1,465.00
|
|
| Hospital Charge Code |
270670334
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.75 |
| Max. Negotiated Rate |
$354.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
|
|
SCREW PYRENEES SLF TPNG 4X14MM
|
Facility
|
OP
|
$1,465.00
|
|
| Hospital Charge Code |
270670334
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.31 |
| Max. Negotiated Rate |
$732.50 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare Advantage |
$439.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.57
|
| Rate for Payer: Cigna Commercial |
$732.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.82
|
|
|
SCREW PYRENEES SLF TPNG 4X16MM
|
Facility
|
OP
|
$1,465.00
|
|
| Hospital Charge Code |
270670336
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.31 |
| Max. Negotiated Rate |
$732.50 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare Advantage |
$439.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.57
|
| Rate for Payer: Cigna Commercial |
$732.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.82
|
|
|
SCREW PYRENEES SLF TPNG 4X16MM
|
Facility
|
IP
|
$1,465.00
|
|
| Hospital Charge Code |
270670336
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.75 |
| Max. Negotiated Rate |
$354.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
|
|
SCREW PYRENEES SLF TPNG 4X18MM
|
Facility
|
OP
|
$1,465.00
|
|
| Hospital Charge Code |
270670338
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.31 |
| Max. Negotiated Rate |
$732.50 |
| Rate for Payer: Aetna Commercial |
$556.70
|
| Rate for Payer: Aetna Medicare Advantage |
$439.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.57
|
| Rate for Payer: Cigna Commercial |
$732.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.82
|
|
|
SCREW PYRENEES SLF TPNG 4X18MM
|
Facility
|
IP
|
$1,465.00
|
|
| Hospital Charge Code |
270670338
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$219.75 |
| Max. Negotiated Rate |
$354.53 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$293.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$354.53
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$322.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$219.75
|
|
|
SCREW PYREN SLF TPNG 4.35X10MM
|
Facility
|
IP
|
$1,710.00
|
|
| Hospital Charge Code |
270670340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|
|
SCREW PYREN SLF TPNG 4.35X10MM
|
Facility
|
OP
|
$1,710.00
|
|
| Hospital Charge Code |
270670340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare Advantage |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.05
|
| Rate for Payer: Cigna Commercial |
$855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.31
|
|
|
SCREW PYREN SLF TPNG 4.35X12MM
|
Facility
|
IP
|
$1,710.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270670341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|
|
SCREW PYREN SLF TPNG 4.35X12MM
|
Facility
|
OP
|
$1,710.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270670341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare Advantage |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.05
|
| Rate for Payer: Cigna Commercial |
$855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.31
|
|
|
SCREW PYREN SLF TPNG 4.35X14MM
|
Facility
|
OP
|
$1,710.00
|
|
| Hospital Charge Code |
270670342
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare Advantage |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.05
|
| Rate for Payer: Cigna Commercial |
$855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.31
|
|
|
SCREW PYREN SLF TPNG 4.35X14MM
|
Facility
|
IP
|
$1,710.00
|
|
| Hospital Charge Code |
270670342
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|
|
SCREW PYREN SLF TPNG 4.35X16MM
|
Facility
|
OP
|
$1,710.00
|
|
| Hospital Charge Code |
270670343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare Advantage |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.05
|
| Rate for Payer: Cigna Commercial |
$855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.31
|
|
|
SCREW PYREN SLF TPNG 4.35X16MM
|
Facility
|
IP
|
$1,710.00
|
|
| Hospital Charge Code |
270670343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|
|
SCREW PYREN SLF TPNG 4.5X12MM
|
Facility
|
IP
|
$1,710.00
|
|
| Hospital Charge Code |
270670345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|
|
SCREW PYREN SLF TPNG 4.5X12MM
|
Facility
|
OP
|
$1,710.00
|
|
| Hospital Charge Code |
270670345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare Advantage |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.05
|
| Rate for Payer: Cigna Commercial |
$855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.31
|
|
|
SCREW PYREN SLF TPNG 4.5X14MM
|
Facility
|
OP
|
$1,710.00
|
|
| Hospital Charge Code |
270670346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare Advantage |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.05
|
| Rate for Payer: Cigna Commercial |
$855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.31
|
|
|
SCREW PYREN SLF TPNG 4.5X14MM
|
Facility
|
IP
|
$1,710.00
|
|
| Hospital Charge Code |
270670346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|
|
SCREW PYREN SLF TPNG 4.5X16MM
|
Facility
|
OP
|
$1,710.00
|
|
| Hospital Charge Code |
270670347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare Advantage |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$436.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$436.05
|
| Rate for Payer: Cigna Commercial |
$855.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$41.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.31
|
|
|
SCREW PYREN SLF TPNG 4.5X16MM
|
Facility
|
IP
|
$1,710.00
|
|
| Hospital Charge Code |
270670347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|
|
SCREW PYREN SLF TPNG 4.5X18MM
|
Facility
|
IP
|
$1,710.00
|
|
| Hospital Charge Code |
270670348
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$413.82 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$342.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$413.82
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$376.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$256.50
|
|