|
SCREW SYN CORT 2.0 28MM 201.28
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270604181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 2.0 30MM 201.30
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270604182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 2.0 30MM 201.30
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270604182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.62 |
| Max. Negotiated Rate |
$33.62 |
| Rate for Payer: Aetna Commercial |
$25.55
|
| Rate for Payer: Aetna Medicare Advantage |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$33.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.78
|
|
|
SCREW SYN CORT 2.0 32MM 201.32
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270604183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.62 |
| Max. Negotiated Rate |
$33.62 |
| Rate for Payer: Aetna Commercial |
$25.55
|
| Rate for Payer: Aetna Medicare Advantage |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$33.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.78
|
|
|
SCREW SYN CORT 2.0 32MM 201.32
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270604183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 2.0 6MM 201.06
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270604170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.62 |
| Max. Negotiated Rate |
$33.62 |
| Rate for Payer: Aetna Commercial |
$25.55
|
| Rate for Payer: Aetna Medicare Advantage |
$20.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$33.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.78
|
|
|
SCREW SYN CORT 2.0 6MM 201.06
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270604170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.09
|
|
|
SCREW SYN CORT 2.7 10MM 202.10
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 10MM 202.10
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 16MM 202.16
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 16MM 202.16
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 22MM 202.22
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604191
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 22MM 202.22
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604191
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 24MM 202.24
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 24MM 202.24
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604192
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 26MM 202.26
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604194
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 26MM 202.26
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604194
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 28MM 202.28
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 28MM 202.28
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604195
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 30MM 202.30
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 30MM 202.30
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 32MM 202.32
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 32MM 202.32
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604197
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|
|
SCREW SYN CORT 2.7 34MM 202.34
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604198
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare Advantage |
$19.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.74
|
| Rate for Payer: Cigna Commercial |
$32.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.74
|
|
|
SCREW SYN CORT 2.7 34MM 202.34
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604198
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.89
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.85
|
|