|
SCREW SYN CORT 2.7 36MM 202.36
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604199
|
|
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 36MM 202.36
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604199
|
|
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 38MM 202.38
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604200
|
|
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 38MM 202.38
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604200
|
|
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 40MM 202.40
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604201
|
|
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 40MM 202.40
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604201
|
|
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 8MM 202.08
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270604185
|
|
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 8MM 202.08
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270604185
|
|
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 3.5 100 204100
|
Facility
|
IP
|
$100.85
|
|
| Hospital Charge Code |
270604229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$24.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
|
|
SCREW SYN CORT 3.5 100 204100
|
Facility
|
OP
|
$100.85
|
|
| Hospital Charge Code |
270604229
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$50.42 |
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: Aetna Medicare Advantage |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.72
|
| Rate for Payer: Cigna Commercial |
$50.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.67
|
|
|
SCREW SYN CORT 3.5 105M 204105
|
Facility
|
IP
|
$100.85
|
|
| Hospital Charge Code |
270604230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$24.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
|
|
SCREW SYN CORT 3.5 105M 204105
|
Facility
|
OP
|
$100.85
|
|
| Hospital Charge Code |
270604230
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$50.42 |
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: Aetna Medicare Advantage |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.72
|
| Rate for Payer: Cigna Commercial |
$50.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.67
|
|
|
SCREW SYN CORT 3.5 110M 204110
|
Facility
|
OP
|
$100.85
|
|
| Hospital Charge Code |
270604231
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$50.42 |
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: Aetna Medicare Advantage |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.72
|
| Rate for Payer: Cigna Commercial |
$50.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.67
|
|
|
SCREW SYN CORT 3.5 110M 204110
|
Facility
|
IP
|
$100.85
|
|
| Hospital Charge Code |
270604231
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$24.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.41
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$22.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
|
|
SCREW SYN CORT 3.5/18MM***
|
Facility
|
OP
|
$35.60
|
|
| Hospital Charge Code |
270601832
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$17.80 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare Advantage |
$10.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.08
|
| Rate for Payer: Cigna Commercial |
$17.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.68
|
| Rate for Payer: Oxford Commercial |
$7.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.94
|
|
|
SCREW SYN CORT 3.5/18MM***
|
Facility
|
IP
|
$35.60
|
|
| Hospital Charge Code |
270601832
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$5.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.34
|
|
|
SCREW SYN CORT 3.5 22MM 204.22
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270604208
|
|
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 3.5 22MM 204.22
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270604208
|
|
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 3.5 26MM 204.26
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270604210
|
|
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 3.5 26MM 204.26
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270604210
|
|
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 3.5 28MM 204.28
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270604211
|
|
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 3.5 28MM 204.28
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270604211
|
|
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 3.5 30MM 204.30
|
Facility
|
OP
|
$67.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604212
|
|
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 3.5 30MM 204.30
|
Facility
|
IP
|
$67.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270604212
|
|
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 3.5 32MM 204.32
|
Facility
|
IP
|
$71.25
|
|
| Hospital Charge Code |
270604213
|
|
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
|
|