|
SCREW SYN CANC FT 7 80
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 80
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$387.92
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.05
|
|
|
SCREW SYN CANC FT 7 85
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604996
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$387.92
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.05
|
|
|
SCREW SYN CANC FT 7 85
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604996
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 90
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604997
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$387.92
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.05
|
|
|
SCREW SYN CANC FT 7 90
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604997
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 95
|
Facility
|
IP
|
$1,020.85
|
|
| Hospital Charge Code |
270604998
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$247.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
|
|
SCREW SYN CANC FT 7 95
|
Facility
|
OP
|
$1,020.85
|
|
| Hospital Charge Code |
270604998
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$510.43 |
| Rate for Payer: Aetna Commercial |
$387.92
|
| Rate for Payer: Aetna Medicare Advantage |
$306.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$260.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$204.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$260.32
|
| Rate for Payer: Cigna Commercial |
$510.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$247.05
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$224.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$153.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.05
|
|
|
SCREW SYN CANC PT 4.0 95
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604286
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$29.20
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
SCREW SYN CANC PT 4.0 95
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270604286
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC PT THD 4.0/14MM
|
Facility
|
OP
|
$71.25
|
|
| Hospital Charge Code |
270604265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$35.62 |
| Rate for Payer: Aetna Commercial |
$27.07
|
| Rate for Payer: Aetna Medicare Advantage |
$21.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.17
|
| Rate for Payer: Cigna Commercial |
$35.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.89
|
|
|
SCREW SYN CANC PT THD 4.0/14MM
|
Facility
|
IP
|
$71.25
|
|
| Hospital Charge Code |
270604265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$17.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CANC PT THD 4.0/26MM
|
Facility
|
IP
|
$71.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$17.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
|
|
SCREW SYN CANC PT THD 4.0/26MM
|
Facility
|
OP
|
$71.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$35.62 |
| Rate for Payer: Aetna Commercial |
$27.07
|
| Rate for Payer: Aetna Medicare Advantage |
$21.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.17
|
| Rate for Payer: Cigna Commercial |
$35.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.24
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$15.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.89
|
|
|
SCREW SYN CANC PT THD 4.0/65MM
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270604280
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC PT THD 4.0/65MM
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604280
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$29.20
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
SCREW SYN CANC PT THD 4.0/70MM
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604281
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$29.20
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
SCREW SYN CANC PT THD 4.0/70MM
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270604281
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC PT THD 4.0/75MM
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604282
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$29.20
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
SCREW SYN CANC PT THD 4.0/75MM
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270604282
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC PT THD 4.0/80MM
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270604283
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC PT THD 4.0/80MM
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604283
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$29.20
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
SCREW SYN CANC PT THD 4.0/85MM
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604284
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$29.20
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
SCREW SYN CANC PT THD 4.0/85MM
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270604284
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
|
|
SCREW SYN CANC PT THD 4.0/90MM
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.85 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$29.20
|
| Rate for Payer: Aetna Medicare Advantage |
$23.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.60
|
| Rate for Payer: Cigna Commercial |
$38.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$16.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|