|
SCREW SYN CORT 3.5 85MM 204.85
|
Facility
|
OP
|
$100.85
|
|
| Hospital Charge Code |
270604226
|
|
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 85MM 204.85
|
Facility
|
IP
|
$100.85
|
|
| Hospital Charge Code |
270604226
|
|
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 90MM 204.90
|
Facility
|
IP
|
$76.85
|
|
| Hospital Charge Code |
270604227
|
|
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 CORT 3.5 90MM 204.90
|
Facility
|
OP
|
$76.85
|
|
| Hospital Charge Code |
270604227
|
|
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 CORT 3.5 95MM 204.95
|
Facility
|
IP
|
$100.85
|
|
| Hospital Charge Code |
270604228
|
|
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 95MM 204.95
|
Facility
|
OP
|
$100.85
|
|
| Hospital Charge Code |
270604228
|
|
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 4.5 100 214.100
|
Facility
|
OP
|
$111.25
|
|
| Hospital Charge Code |
270603755
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$55.62 |
| Rate for Payer: Aetna Commercial |
$42.27
|
| Rate for Payer: Aetna Medicare Advantage |
$33.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.37
|
| Rate for Payer: Cigna Commercial |
$55.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.92
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$24.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.95
|
|
|
SCREW SYN CORT 4.5 100 214.100
|
Facility
|
IP
|
$111.25
|
|
| Hospital Charge Code |
270603755
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.69 |
| Max. Negotiated Rate |
$26.92 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.92
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$24.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.69
|
|
|
SCREW SYN CORT 4.5 14MM 214.14
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270603628
|
|
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 4.5 14MM 214.14
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270603628
|
|
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 4.5 16MM 214.16
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270603630
|
|
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 4.5 16MM 214.16
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270603630
|
|
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 4.5/18MM 214.18
|
Facility
|
OP
|
$67.25
|
|
| Hospital Charge Code |
270603632
|
|
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 4.5/18MM 214.18
|
Facility
|
IP
|
$67.25
|
|
| Hospital Charge Code |
270603632
|
|
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 4.5/20MM 214.20
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603723
|
|
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 4.5/20MM 214.20
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603723
|
|
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 4.5/22MM 214.22
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603724
|
|
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 4.5/22MM 214.22
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603724
|
|
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 4.5/24MM 214.24
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603725
|
|
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 4.5/24MM 214.24
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603725
|
|
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 4.5/26MM 214.26
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603726
|
|
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 4.5/26MM 214.26
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603726
|
|
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 4.5/28MM 214.28
|
Facility
|
IP
|
$65.65
|
|
| Hospital Charge Code |
270603727
|
|
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 4.5/28MM 214.28
|
Facility
|
OP
|
$65.65
|
|
| Hospital Charge Code |
270603727
|
|
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 4.5/30MM 214.30
|
Facility
|
IP
|
$91.25
|
|
| Hospital Charge Code |
270603608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.08
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$20.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.69
|
|