|
SCREW SCHANZ 4X120MM
|
Facility
|
OP
|
$357.00
|
|
| Hospital Charge Code |
270669661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Aetna Commercial |
$135.66
|
| Rate for Payer: Aetna Medicare Advantage |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.03
|
| Rate for Payer: Cigna Commercial |
$178.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.39
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$78.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.46
|
|
|
SCREW SCHANZ 4X80MM
|
Facility
|
OP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$108.45 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$1,710.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,147.50
|
| Rate for Payer: Cigna Commercial |
$2,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$990.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$108.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$119.25
|
|
|
SCREW SCHANZ 4X80MM
|
Facility
|
IP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270698619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$1,089.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$990.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
|
|
SCREW SCHANZ 5.0MMx170MM BLU
|
Facility
|
IP
|
$668.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681240
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$100.25 |
| Max. Negotiated Rate |
$161.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.25
|
|
|
SCREW SCHANZ 5.0MMx170MM BLU
|
Facility
|
OP
|
$668.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681240
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.11 |
| Max. Negotiated Rate |
$334.18 |
| Rate for Payer: Aetna Commercial |
$253.97
|
| Rate for Payer: Aetna Medicare Advantage |
$200.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.43
|
| Rate for Payer: Cigna Commercial |
$334.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.71
|
|
|
SCREW SCHANZ 5.0MMx200MM BLU
|
Facility
|
IP
|
$668.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681239
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$100.25 |
| Max. Negotiated Rate |
$161.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.25
|
|
|
SCREW SCHANZ 5.0MMx200MM BLU
|
Facility
|
OP
|
$668.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681239
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.11 |
| Max. Negotiated Rate |
$334.18 |
| Rate for Payer: Aetna Commercial |
$253.97
|
| Rate for Payer: Aetna Medicare Advantage |
$200.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.43
|
| Rate for Payer: Cigna Commercial |
$334.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.71
|
|
|
SCREW SCHANZ 5.0 x 150mm
|
Facility
|
IP
|
$806.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270642897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.97 |
| Max. Negotiated Rate |
$195.17 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$161.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.17
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$177.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.97
|
|
|
SCREW SCHANZ 5.0 x 150mm
|
Facility
|
OP
|
$806.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270642897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.44 |
| Max. Negotiated Rate |
$403.25 |
| Rate for Payer: Aetna Commercial |
$306.47
|
| Rate for Payer: Aetna Medicare Advantage |
$241.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$205.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$205.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$161.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$205.66
|
| Rate for Payer: Cigna Commercial |
$403.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.17
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$177.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.37
|
|
|
SCREW SCHANZ 5.0x150mm BLUNTED
|
Facility
|
OP
|
$404.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270639898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.76 |
| Max. Negotiated Rate |
$202.40 |
| Rate for Payer: Aetna Commercial |
$153.82
|
| Rate for Payer: Aetna Medicare Advantage |
$121.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$103.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$103.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$103.22
|
| Rate for Payer: Cigna Commercial |
$202.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$89.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.73
|
|
|
SCREW SCHANZ 5.0x150mm BLUNTED
|
Facility
|
IP
|
$404.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270639898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.72 |
| Max. Negotiated Rate |
$97.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$89.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.72
|
|
|
SCREW SCHANZ 5.0x175 60MM THRD
|
Facility
|
IP
|
$806.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270638914
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.97 |
| Max. Negotiated Rate |
$195.17 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$161.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.17
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$177.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.97
|
|
|
SCREW SCHANZ 5.0x175 60MM THRD
|
Facility
|
OP
|
$806.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270638914
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$19.44 |
| Max. Negotiated Rate |
$403.25 |
| Rate for Payer: Aetna Commercial |
$306.47
|
| Rate for Payer: Aetna Medicare Advantage |
$241.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$205.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$205.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$161.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$205.66
|
| Rate for Payer: Cigna Commercial |
$403.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.17
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$177.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.37
|
|
|
SCREW SCHANZ 5.0x200mm BLUNTED
|
Facility
|
OP
|
$469.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270639899
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$234.85 |
| Rate for Payer: Aetna Commercial |
$178.49
|
| Rate for Payer: Aetna Medicare Advantage |
$140.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.77
|
| Rate for Payer: Cigna Commercial |
$234.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.45
|
|
|
SCREW SCHANZ 5.0x200mm BLUNTED
|
Facility
|
IP
|
$469.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270639899
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.45 |
| Max. Negotiated Rate |
$113.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.45
|
|
|
SCREW SCHANZ 5.0X250MM BLUNT
|
Facility
|
IP
|
$668.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681241
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$100.25 |
| Max. Negotiated Rate |
$161.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.25
|
|
|
SCREW SCHANZ 5.0X250MM BLUNT
|
Facility
|
OP
|
$668.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681241
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.11 |
| Max. Negotiated Rate |
$334.18 |
| Rate for Payer: Aetna Commercial |
$253.97
|
| Rate for Payer: Aetna Medicare Advantage |
$200.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$133.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.43
|
| Rate for Payer: Cigna Commercial |
$334.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.71
|
|
|
SCREW SCHANZ 5.0x250mm BLUNTED
|
Facility
|
OP
|
$469.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270639900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$234.85 |
| Rate for Payer: Aetna Commercial |
$178.49
|
| Rate for Payer: Aetna Medicare Advantage |
$140.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.77
|
| Rate for Payer: Cigna Commercial |
$234.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.45
|
|
|
SCREW SCHANZ 5.0x250mm BLUNTED
|
Facility
|
IP
|
$469.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270639900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.45 |
| Max. Negotiated Rate |
$113.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$103.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.45
|
|
|
SCREW SCHANZ 5.0x60x150mm
|
Facility
|
IP
|
$891.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.65 |
| Max. Negotiated Rate |
$215.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$178.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$215.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$196.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.65
|
|
|
SCREW SCHANZ 5.0x60x150mm
|
Facility
|
OP
|
$891.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270674201
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21.47 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna Commercial |
$338.58
|
| Rate for Payer: Aetna Medicare Advantage |
$267.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$227.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$227.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$178.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$227.21
|
| Rate for Payer: Cigna Commercial |
$445.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$215.62
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$196.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.61
|
|
|
SCREW SCHANZ 5.0x80MM SLF DRIL
|
Facility
|
IP
|
$830.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270633730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$201.03 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$166.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$201.03
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$182.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$124.61
|
|
|
SCREW SCHANZ 5.0x80MM SLF DRIL
|
Facility
|
OP
|
$830.70
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270633730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$415.35 |
| Rate for Payer: Aetna Commercial |
$315.67
|
| Rate for Payer: Aetna Medicare Advantage |
$249.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$211.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$211.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$166.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$211.83
|
| Rate for Payer: Cigna Commercial |
$415.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$201.03
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$182.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$124.61
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.01
|
|
|
SCREW SCHANZ 6.0/160MM SPADE
|
Facility
|
IP
|
$408.00
|
|
| Hospital Charge Code |
270676407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$98.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$81.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$89.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.20
|
|
|
SCREW SCHANZ 6.0/160MM SPADE
|
Facility
|
OP
|
$408.00
|
|
| Hospital Charge Code |
270676407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.83 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Aetna Commercial |
$155.04
|
| Rate for Payer: Aetna Medicare Advantage |
$122.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$81.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104.04
|
| Rate for Payer: Cigna Commercial |
$204.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$89.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.81
|
|